According to the legislation of the Russian Federation, all patients with suspected cancer and with a confirmed diagnosis must be registered without fail and be registered. Dispensary observation of patients helps to find out about the disease in time and take the necessary measures: prescribe treatment, prevent complications and relapses. It is also necessary to maintain statistics of sick people by region and country. For the convenience of keeping records, it was decided to divide cancer patients into four clinical groups, which have their own characteristics in the course and treatment of the disease.
What is cancer
The human body consists of a huge number of cells that perform various functions. Under the influence of certain factors, cells can stop developing properly and start dividing continuously, thus forming tumors. Neoplasms can be benign and malignant. The clinical group is determined after a complete examination of the patient. During the period of illness, the formations consume the reserves of the body, while releasing toxic metabolic products. Gradually, the tumor grows, at a certain moment some cells can "separate" and, together with the blood, spread to the nearest organs. This process is called metastasis.
Dispensary rules
Dispensary registration of cancer patients has its own rules, which are designed to control therapeutic interventions and monitor their effectiveness. It also allows you to conduct examinations in time, determine the development of pathology, know the number of sick, cured and dead.
Four groups are needed to systematize the list of patients in order to adequately consider the situation for each patient. Thanks to them, a clinical oncological dispensary that monitors a person with a pathology can inform him in time about the need for examination and additional treatment. Maintaining such a record allows you to obtain data about each patient and the course of his illness. Statistical data from oncology centers allow us to form an overall picture and take the necessary measures to prevent cancer, as well as adjust the availability of places in a medical institution.
You need to know that the rules for dispensary observation of cancer patients differ depending on the type of tumor. In some forms of cancer, records are kept throughout a person's life, and in other cases, the patientobserve five years after the cure and the data about it go to the archive. As a rule, a patient after therapy is observed during the first year - once every three months, in the second year - once every six months, for three to five years or more - once a year.
Four oncology clinical groups have been created in order to facilitate the registration of patients. Grouping occurs after a full examination or based on the results of therapy. During the course of the disease, a cancer patient can move from one group to another.
First group
This includes patients with suspected tumor and patients with precancerous diseases. In turn, it is divided into two subgroups:
- A - it houses patients with suspected cancer. After the examination and clarification of the diagnosis, the patient is either removed from the register or transferred to another group, ten days are given for this.
- B - it includes patients with precancer, which in turn is facultative and obligate.
Facultative precancerous pathologies are diseases that can develop into a malignant tumor. These include: gastritis, cervical erosion, papillomas and other diseases that rarely develop into cancer.
Obligate precancer is a pathology that often transforms into malignant tumors. These include: colon polyposis, stomach polyps, xeroderma pigmentosa and other diseases.
All patients from the first clinical group in oncology undergo a mandatory examination andget registered. Patients are followed up for two years after therapy. For each person registered in the first group, a control card is created in the form 030-used, which is kept for a certain time, and after being entered into the computer database, sent to the archive. If the patient does not appear within a year, he is removed from the register. If it is necessary to re-enter the patient in the first group, a new dispensary card is drawn up for him.
Second clinical group
This group includes patients with a specified diagnosis who need treatment. This includes all patients who can undergo therapy aimed at eliminating the disease and restoring body functions. This group has one subgroup: 2a. It includes patients who need radical cancer treatment. As a rule, this is the first or second stage of the disease, in which a complete cure is possible.
For patients in this group, certain documents are drawn up:
- For those who are initially ill, they issue a certificate 090 / y. It is filled out for all patients admitted to the second clinical group and kept for three years.
- Before the end of therapy, a certificate is drawn up in the form 027-1 / y. This is a complete extract from the patient's card. This document is transferred to the oncology center at the place of residence.
- Also, a 030-used certificate is filled out for each cancer patient of this group, it contains all the information about the patient's illness.
- Certificate in the form 030-b/gr is required for statistical research.
Patients of the third group
Patients included in this group are at the stage of recovery, they are observed after the therapy. If the disease manifests itself repeatedly, then patients from the third clinical group in oncology are transferred either to the second or to the fourth. Clinical examination of patients takes place at certain times, they are different for each type of cancer. In some cases, patients in this group may be monitored for life. If within five years after treatment there was no relapse, the patient is removed from the register, and his documents go to the archive.
Features of the fourth group
It includes patients with advanced forms of cancer, in which radical treatment does not make sense. Such patients are recommended to be monitored in palliative care centers to improve the quality of life and alleviate the condition.
In addition, this group includes people who have been diagnosed with the disease again and treatment is no longer possible. Also, this may include patients from the second group who refused therapy or it did not bring a significant result. Such cancer patients are observed by medical workers at the place of residence, if necessary, they can be consulted by oncologists.
Sometimes people from the first group are transferred to the fourth group. This happens if a person applied too late and was diagnosed with stage 4 cancer with metastases. All patients in this group require special care and treatment. Observation in the dispensary is carried out forthroughout the life of the patient.
Cancer Diagnosis
In order for the disease to be successfully cured, it is necessary to learn about it as early as possible. To do this, there are diagnostic measures that help to recognize cancer cells in the early stages. But it is impossible to undergo weekly medical examinations, so each person must listen to the signals of the body, which may indicate the presence of some kind of disease. These include:
- fatigue;
- drowsy;
- reduced interest in everything;
- pain in a certain place;
- possible nausea and vomiting.
When contacting a specialist with such signs, an examination of the whole body will be carried out, which will make it possible to identify the disease and begin treatment. As a rule, the following methods are used for diagnosis:
- blood tests;
- biopsy;
- magnetic resonance imaging;
- examinations by highly specialized specialists;
- mammography;
- CT scan.
Treatment
There are a lot of methods of treating oncological diseases. Let's analyze the main ones:
- Surgical method. With the help of this method, neoplasms are treated at the initial stages of the disease. It involves the complete removal of a tissue site with a tumor surgically. When using this method at the first stage of the disease, it is possible to achievecomplete cure.
- Radiation therapy. This method is used both separately and in conjunction with surgery. It involves using X-rays to target cancer cells.
- Chemotherapy. This method is based on the use of drugs in large quantities to destroy tumor cells. Chemicals kill cancer cells and prevent them from dividing.
- Hormonotherapy. With this method, receptors are blocked in cancer cells, in connection with this, they stop growing.
- Specific inhibitors. Drugs in this group act on a protein inside the cancer cell, blocking its growth and division.
- Antibodies. This method is based on the use of antibodies against malignancy. Antibodies are the body's own defensive reaction to everything foreign. Modern science has learned to artificially create antibodies that can fight tumors, they are used in the form of drugs. This method allows you to target cancer without affecting he althy cells.
- Biological response modifiers. With the help of protein and special substances, they stimulate the body's own forces to fight the disease.
- Vaccines. During the use of this method, the human immune system is stimulated with special drugs. As a result, the body begins to fight the neoplasm on its own.
Painkillers for oncology
Drugs used forcancer patients are divided into several groups. At different stages of cancer, different remedies are used depending on the pain experienced. All medicines can be divided into narcotic and non-narcotic drugs. The first group includes opiates, which differ in the degree of effect on the body, the second group includes analgesics, most of which are sold only by prescription.
In order for the therapy to give the desired result, it is necessary to take painkillers for oncology according to certain schemes drawn up by a specialist. For example, analgesics are taken in conjunction with supportive drugs. And strong narcotic drugs are prescribed together with immune drugs and non-narcotic drugs. With the right combination of drugs, a positive effect occurs quickly enough to alleviate the suffering of a sick person.
As a rule, all drugs are administered intramuscularly or intravenously, so the medicine begins to work faster than when taking pills.
Painful sensations in cancer are classified into three types, they can be weak, moderate and strong. Medicines from both groups can be used for any type of pain. Almost all painkillers are prescribed together with immunodrugs, which together give a more effective effect.
Cancer stages and prognosis
Depending on the degree of development of the pathology, oncological diseases are divided into five stages:
- Zero stage. With this form of pathology, cancer cells have not yet gone beyond the boundaries of the epithelial tissue. If on timedetect a neoplasm, there is a high probability of a complete cure.
- The first stage. With this form of the disease, the tumor is already quite large, but the lymph nodes are not affected and there are no metastases. Thanks to modern diagnostics, the number of patients who are diagnosed with cancer at this stage has recently increased. The probability of a complete cure with the first degree is much higher than with subsequent ones.
- Second stage. During this period, cancer begins to show activity. It has already reached a large size and began to grow into the surrounding tissues. During this period, the formation of metastases begins. Unfortunately, it is this stage that is considered the most common in the detection of cancer. The prognosis in treatment depends on many factors: the type of tumor and its features. In general, it can be said that cancer in the second stage is treatable.
- Third stage. At this point, the tumor is actively developing, it is already of considerable size and has grown into the nearest organs, and metastases spread through the lymph nodes. But at the same time, the process of metastasis has not yet passed to other organs, which indicates the possibility of treatment. Recovery depends on the type of tumor and the general condition of the patient. It makes no sense to talk about a complete cure, since at this stage the cancer develops into a chronic disease. But still, with the right therapy, you can prolong the life of the patient.
- Cancer stage 4 with metastases is the most serious and dangerous disease. At this point, the neoplasm has the largestsizes, in comparison with the previous stages, is characterized by metastases to distant organs and tissues. A cure at this stage is no longer possible. With the right treatment, it is possible to bring the disease into remission, thus prolonging the life of the patient. In advanced cases, when the pathology is not treatable, patients with such a diagnosis are recommended to be monitored in palliative care centers.
