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Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. No posts published in this language yet Once posts are published, you’ll see them here.

МЕНЮ СТРАНИЦЫ: 1. Преимущества лечения в Турции 2. Рак горла: какие есть методы диагностики? 3. Рак горла: методы лечения 4. Передовые методы лечения рака гортани 5. Жизнь после рака гортани 6. Вопросы пациентов 7. Организация лечения в Турции СТОИМОСТЬ ЛЕЧЕНИЯ РАКА ГОРТАНИ В ТУРЦИИ LARYNX CANCER TREATMENT IN TURKEY MENU PAGES: 1. Benefits of treatment abroad 2. Throat cancer: what are the diagnostic methods? 3. Throat cancer: treatments 4. Advanced treatments for laryngeal cancer 5. Life after laryngeal cancer 6. Patient questions 7. Organization of treatment abroad COST OF TREATMENT FOR LARYNX CANCER IN TURKEY 1. Преимущества лечения за рубежом 1. Benefits of treatment abroad The main procedure in CIS clinics is partial or complete removal of the larynx with vocal cords. Therefore, in Russia, Ukraine and Belarus, only 4 out of 10 patients retain their voice. For the treatment of throat cancer in Turkey, doctors perform low-traumatic laser surgeries that do not affect the quality of the voice. To avoid surgery for large tumors, interventions for large tumors, foreign doctors resort to chemistry, targeted therapy and radiation. If the operation is required, doctors remove the organ, followed by its reconstruction. Therefore, 7 out of 10 patients retain their voice abroad. 2. Throat cancer: what are the diagnostic methods? Throat cancer diagnostics can include the following procedures: Laryngoscopy Visual examination of the larynx. Doctors perform the procedure using a flexible tube with a flashlight or a special mirror. Biopsy Collection of tumor tissue for laboratory research. Histology and immunohistochemistry of the neoplasm Tumor tissue analyzes. Its malignancy is determined, genetic mutations are detected and the effectiveness of drug treatment is predicted. CT scan Helps to determine the localization, size of the neoplasm and its growth into adjacent tissues. MRI Reveals the spread of the tumor to the organs of the neck. Chest x-ray Determines the presence of metastases in the lungs. Positron Emission Computed Tomography (PET-CT) Identifies distant metastases throughout the body. 3. Throat cancer: treatments 1. Surgery Laser microsurgery This is the removal of the tumor through the mouth using a laser. Doctors prescribe this intervention early. Advantages: the procedure preserves the voice and leaves no visible traces of interference. Disadvantages: Large tumors cannot be removed with laser microsurgery. Laryngectomy This is the excision of part of the larynx or the entire organ with the vocal cords. The amount of intervention depends on the size of the neoplasm. Benefits: During surgery, doctors remove large tumors. Disadvantages: After laryngectomy, the patient partially or completely loses his voice. 2. Radiation therapy Types of radiation therapy for laryngeal cancer: therapeutic - destroys small neoplasms without surgery; adjuvant - destroys cancer cells that remain after surgery, and prevents relapse; palliative - reduces symptoms in the last stages. 3. Chemotherapy Types of chemistry for throat cancer: neoadjuvant - reduces the tumor before surgery and radiation; adjuvant - destroys pathological cells that remain after surgery; palliative - improves the quality of life in the later stages. 4. Advanced treatments for laryngeal cancer If the previous treatment is ineffective or relapses, doctors prescribe targeted drugs. They purposefully act on pathological cells, stop their growth and division. Targeted therapy is indicated for patients with a genetic mutation of the neoplasm. Doctors identify it with a laboratory study of the tumor. 5. Life after laryngeal cancer Voice recovery With partial dysfunction of the vocal cords, speech therapists work with patients. After a complete loss of voice, doctors perform a tracheoesophageal puncture. They create openings in the trachea and esophagus, connect them with a valve. After that, air can flow from the lungs into the mouth, making sounds. In case of contraindications to tracheoesophageal puncture, patients use devices that form a voice. They read the movements of the lips and translate them into sounds. Swallowing recovery To restore the swallowing function after surgery and therapy, patients attend consultations with a nutritionist and a rehabilitation therapist. The dietitian adjusts the diet, and the rehabilitation therapist conducts workouts that develop the desired group of neck muscles. Smell recovery Experts restore the sense of smell with the help of breathing exercises. 6. Patient questions Is it possible to keep the voice after treatment for cancer of the vocal cords and larynx? It depends on the size and location of the tumor. If they allow not to remove the organ, the voice will be preserved in whole or in part. If the patient is shown a complete removal of the throat and ligaments, specialists restore the voice with the help of special training, surgery and devices that generate sounds. How to cure stage 4 laryngeal cancer? At stage 4, doctors use surgery, chemistry, radiation and targeted drugs. They select the most effective method of treatment based on the results of a comprehensive diagnosis of laryngeal cancer. 7. Organization of treatment abroad To organize throat cancer treatment abroad, leave a request on the Medikal & Estetik Group website. You will be contacted by a specialized doctor-coordinator who will help you choose the best medical center. Send him your medical records, he will redirect them to the hospital of your choice and request a treatment program. We will help you organize your trip and stay in touch with you throughout your treatment - from the moment you contact us and even after you return home. Medikal & Estetik Group is an independent medical service that does not represent the interests of any of the clinics. Patients do not pay for our services - medical centers do it. Doctors-coordinators will advise you and help you with the choice. Medikal & Estetik Group services are free of charge for you and do not affect your clinic bill. 2. Рак горла: какие есть методы диагностики? 3. Рак горла: методы лечения 4. Передовые методы лечения рака гортани 5. Жизнь после рака гортани 6. Вопросы пациентов 7. Организация лечения за границей СТОИМОСТЬ ЛЕЧЕНИЯ РАКА ГОРТАНИ В ТУРЦИИ COST OF TREATMENT FOR LARYNX CANCER IN TURKEY Biopsy for laryngeal cancer from $ 450 CT (computed tomography) for laryngeal cancer from $ 50 PET / CT for laryngeal cancer from $ 500 Chemotherapy for laryngeal cancer on request Laser surgery for laryngeal cancer on request Radiation therapy for laryngeal cancer on request Laryngeal cancer surgery from $ 10240 Oncologist's second opinion Before traveling, you can get a Turkish doctor's opinion on your diagnosis and treatment prescribed. For the patient, this is an opportunity to receive advice from the world's best specialists. To learn more, click here

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. All answers to questions about our services What does Medikal & Estetik Group do? Medikal & Estetik Group is your access in Turkey to international highly qualified medical services, world-renowned specialists in the field of medicine, and the best world-class clinics. We provide an opportunity for everyone to quickly contact the desired clinic, as well as get a preliminary estimate for medical services, compare prices and treatment methods in different clinics in Turkey, choose the best specialist and get an appointment with even the longest waiting list as soon as possible. Our medical coordinators assist in the planning and implementation of medical tourism. Why is it worth going for treatment in Turkey? Often, in the CIS countries, patients cannot receive proper medical care in their homeland due to the limited range of possibilities of local medicine, the lack of necessary modern diagnostics, outdated standards of therapy, and huge waiting lists. In the meantime, there is no need to worry about it. ” Treatment in Turkey provides a number of benefits: modern diagnostic equipment; current global treatment standards; highly qualified and experienced specialists with practice in the USA and the EU; the ability of clinics to urgently provide emergency care to a patient; the ability to compare the cost; effective treatment at an affordable price without compromising the quality of medical services. How much do our services cost? Patients pay at the clinics' cash desks only for the provision of medical services without any extra charges and hidden commissions on the part of Medikal & Estetik Group. On the contrary, we are ready to offer you additional and advantageous offers and bonuses from clinics, which are known only to the coordinators. The marketing of clinics includes the costs of collaborating with medical coordinators. How to get to the clinic without knowing the Turkish language and country? For each patient, we organize a meeting at the airport with a transfer to the clinic. We provide language support at all stages of stay in a medical institution. These services are provided free of charge. How will Medikal & estetik Group choose a clinic for me? All clinics presented on our website have international accreditation and safety certificates for the provision of medical services. The selection of a clinic and a specialist is carried out individually, based on the medical aspects of each specific case, the patient's personal criteria and his budget. Do you need a visa to Turkey? Is visa support available if needed? The need to open a visa depends on the country of which you are a citizen. If you need a visa to Turkey, the clinic can provide a written invitation for treatment or diagnosis. The invitation is provided to the patient after paying the deposit to the clinic's bank account according to the invoice provided in advance. Upon receipt of a refusal at the embassy to open a visa, the amount of the deposit is returned to the patient. Also, if you need a long stay in Turkey for continuous treatment, you need a special medical visa, in obtaining which we are ready to provide visa support. How is postoperative treatment organized? After discharge from the clinic, recommendations are provided in your native language on the subsequent regimen, nutrition, the timing of preventive examinations, as well as the schedule for taking prescription drugs if you need to take long-term medication.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. DIAGNOSTICS AND TREATMENT OF LIVER CANCER IN TURKEY MENU PAGES: 1. General information about primary liver cancer in adults 2. Types of primary liver cancer in adults. 3. Risk factors for liver cancer 4. Signs and symptoms of primary liver cancer in adults 5. Tests for the diagnosis of primary liver cancer in adults. 6. Several factors affect prognosis (chance of recovery) and treatment options. 7. Stages of primary liver cancer in adults 8. Ways of spreading liver cancer body by three 9. Treatment options for primary liver cancer in adults 10. Treatment of recurrent primary liver cancer in adults 11. COST OF TREATMENT AND DIAGNOSIS OF LIVER CANCER IN TURKEY 1. General information about primary liver cancer in adults KEY POINTS Primary liver cancer in adults is a disease in which malignant (cancerous) cells form in the tissues of the liver. There are two types of primary liver cancer in adults. Having hepatitis or cirrhosis can affect the risk of primary liver cancer in adults. Signs and symptoms of primary liver cancer in adults include swelling or pain on the right side. Tests that examine the liver and blood are used to detect (detect) and diagnose primary liver cancer in adults. Several factors affect prognosis (chance of recovery) and treatment options. Primary liver cancer in adults is a disease in which malignant (cancerous) cells form in the tissues of the liver. Liver is one of the largest organs in the body. It has two share and fills in the top right side belly inside the chest. Three of the many important functions of the liver: For filtering harmful substances from blood, so that they can be excreted from the body with feces and urine ... To do bile, To help digest fat from food. To store glycogen (sugar), which the body uses for energy. 1. Общая информация о первичном раке печени у взрослых This is the text. Drag it anywhere on the page and double-click to write something interesting. Anatomy of the liver. The liver is located in the upper abdomen, next to the stomach, intestines, gallbladder, and pancreas. The liver has a right lobe and a left lobe. Each lobe is divided into two parts (not shown). 2. Типы первичного рака печени у взрослых. 3. Факторы риска рака печени 4. Признаки и симптомы первичного рака печени у взрослых Тесты для диагностики первичного рака печени у взрослых. 6. Некоторые факторы влияют на прогноз (шанс выздоровления) и варианты лечения. 7. Стадии первичного рака печени у взрослых 8. Способы распространения рака пчечени по организму тремя 2. Types of primary liver cancer in adults. Two types of primary liver cancer in adults are: Hepatocellular carcinoma ... Cholangiocarcinoma (bile duct cancer). (To receive additional information see Summary PDQ on treating bile duct cancer (cholangiocarcinoma) ... The most common type of primary liver cancer in adults is hepatocellular carcinoma. This type of liver cancer is the third leading cause of cancer death worldwide. This is a summary of the treatment primary liver cancer ( cancer, which starts in the liver). This summary does not cover the treatment of cancer that starts elsewhere in the body and spreads to the liver. Primary liver cancer can occur in both adults and children. However, treatment for children is different from that for adults. (For more information, see the PDQ summary on treatment of liver cancer in children). 3. Risk factors for liver cancer Having hepatitis or cirrhosis can affect the risk of primary liver cancer in adults. Anything that increases the likelihood of a disease is called risk factor ... Having a risk factor does not mean you will get sick cancer ; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk liver cancer ... Liver cancer risk factors include the following: Having hepatitis B or hepatitis C infections ... Having both hepatitis B and hepatitis C further increases the risk. Having cirrhosis ... Drinking strong alcohol ... Alcohol abuse and hepatitis B infection further increase the risk. Eating foods containing aflatoxin (I fungus, which can grow on foods such as grains and nuts that have not been stored properly). Non-alcoholic steatohepatitis (NASH) condition, in which fat accumulates in liver and can progress to inflammation liver and damage cells liver. Use tobacco e.g. smoking cigarettes ... The presence of certain hereditary or rare diseases that damage the liver, including the following: Glycogen storage disease , a hereditary disorder in which problems arise with how the form glucose (sugar) called glycogen is stored and used in the body. Late cutaneous porphyria is a rare condition that affects the skin and causes painful blisters on parts of the body exposed to the sun, such as hands, arms and face. Liver problems can also occur. Wilson's disease - a rare hereditary disease in which the body accumulates more copper than it needs. Additional copper is stored in the liver, brain , eyes and others bodies ... Alpha-1 antitrypsin deficiency - hereditary disease that can cause liver disease and lungs ... Hereditary hemochromatosis - hereditary disease in which the body accumulates more gland, than he needs. The extra iron is mainly stored in the liver, heart, pancreas , skin and joints ... Old age is a major risk factor for most cancers. The likelihood of developing cancer increases with age. 4. Signs and symptoms of primary liver cancer in adults Signs and symptoms of primary liver cancer in adults include swelling or pain on the right side. These and others signs and symptoms can be caused by primary liver cancer in adults or other conditions. Check with your doctor if you have any of the following: A hard lump on the right side just below the ribcage. Discomfort in the upper abdomen on the right side. Bloating. Pain near the right shoulder blades or in the back. Jaundice (yellowing of the skin and whites of the eyes). Easy bruising or bleeding. Unusual tiredness or weakness. Nausea and vomit ... Loss appetite or feeling full after eating a small meal. Losing weight for an unknown reason. Pale, chalky chair and dark urine. Fever ... 5. Tests for the diagnosis of primary liver cancer in adults. Tests that examine the liver and blood are used to detect and diagnose primary liver cancer in adults. The following tests and procedures can be used: Medical checkup and anamnesis : A body exam to check for general signs of health, including checking for signs of illness such as lumps or anything else that seems unusual. There will also be a history of the patient's health habits, as well as past illnesses and treatments. Serum tumor markers test : a procedure in which a blood sample is examined to measure the amount of certain substances that enter the bloodstream of the organs, fabrics or tumor cells in the body. Certain substances are associated with certain types of cancer when they are found in high amounts in the blood. These are the so -called tumor markers ... Elevated level alpha-fetoprotein (AFP) in the blood may be a sign of liver cancer. Other cancers and some benign diseases, including cirrhosis and hepatitis, can also increase AFP levels. Sometimes AFP levels remain normal even in liver cancer. Liver function tests : A procedure in which a blood sample is tested to measure the amount of certain substances that enter the bloodstream by the liver. A higher than usual amount of the substance may be a sign of liver cancer. CT scan (computed tomography): A procedure in which a series of detailed pictures of areas inside the body, such as the abdomen, are taken from different angles. Pictures were taken by a computer connected to x-ray apparatus. Dye may be introduced in vein or swallow so that organs and tissues are seen more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. Images can be taken up to three times after dye is injected to get the best possible image of abnormal areas in the liver. This is called a three-phase CT. Spiral or spiral CT scanning takes a series of highly detailed images of areas inside the body using an X-ray machine that scans the body in a spiral. MRI (magnetic resonance imaging): a procedure that uses a magnet, radio waves and a computer to create a series of detailed images of areas inside the body, such as the liver. This procedure is also called nuclear magnetic resonance imaging (MRI). To create detailed images blood vessels in the liver and next to it, a dye is injected into a vein. This procedure is called MRA (magnetic resonance imaging angiography ). After dye injection, images can be taken at three different time periods to obtain the best possible image of abnormal liver areas. This is called a three-phase MRI. Ultrasonic research: a procedure in which high energy sound waves (ultrasound) are reflected from internal tissues or organs and create an echo. The echo forms a pattern of body tissue called sonogram ... The picture can be printed to view later. Biopsy : removal of cells or tissues to pathologist could see them under microscope to check for signs of cancer. The procedures used to collect a sample of cells or tissues include the following: Fine needle aspiration biopsy : removal of cells, tissue or liquids using a fine needle. Core needle biopsy : Removal of cells or tissue with a slightly wider needle. Laparoscopy : surgical a procedure to examine the internal organs of the abdominal cavity for signs of illness. The lining of the abdominal cavity is made small incisions (cuts), and one of the cuts is inserted laparoscope (thin tube with illumination). Another instrument is inserted through the same or a different incision to remove tissue samples. A biopsy is not always necessary for diagnostics primary liver cancer in adults. 6. Several factors affect prognosis (chance of recovery) and treatment options. Forecast (chance convalescence ) and treatment options depend on the following conditions: The stage of the cancer (the size of the tumor, whether it affects part or all of the liver, or has spread to other places in the body). How well the liver works. The patient's general health, including the presence of cirrhosis of the liver. 7. Stages of primary liver cancer in adults KEY POINTS After adults are diagnosed with primary liver cancer, tests are done to see if the cancer cells have spread to the liver or to other parts of the body. Cancer spreads through the body in three ways. Cancer can spread from where it originated to other parts of the body. The Barcelona Clinic Liver Cancer Staging System can be used to stage primary liver cancer in adults. The following groups are used for treatment planning. BCLC stages 0, A and B BCLC stages C and D After adults are diagnosed with primary liver cancer, tests are done to see if the cancer cells have spread to the liver or to other parts of the body. The process used to determine if it has spread crayfish in liver or to other parts of the body is called staging ... Information Collected in the Identification Process stages, defines stage diseases. It is important to know the stage in order to plan treatment. During the preparation process, the following tests and procedures can be used: CT scan (computed tomography): a procedure in which a series of detailed pictures of areas inside the body, such as the chest, are taken, stomach and pelvis shot from different angles. Pictures were taken by a computer connected to x-ray apparatus. Dye may be introduced in vein or swallowed to help organs or fabrics show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (magnetic resonance imaging): a procedure that uses a magnet, radio waves and a computer to create a series of detailed images of areas within the body. This procedure is also called nuclear magnetic resonance imaging (MRI). PET scan (positron emission tomography): search procedure malignant tumor cells in the body. A small amount is injected into the vein radioactive glucose (Sahara). Scanner The PET spins around the body and takes a snapshot of where glucose is being used in the body. Malignant tumor cells appear brighter in the image because they are more active and consume more glucose than normal cells. 8. Ways of spreading liver cancer body by three Cancer can spread through fabrics , lymphatic system and blood : Textile. Cancer spreads from where it originated to surrounding areas. The lymphatic system. Cancer spreads from where it originated to the lymphatic system. Cancer is spreading through lymphatic vessels to other parts of the body. Blood. Cancer spreads from where it originated into the bloodstream. Cancer is spreading through blood vessels to other parts of the body. Cancer can spread from where it originated to other parts of the body. When cancer spreads to another part of the body, it is called metastasis ... Cancer cells break away from the place where they arose ( primary tumor ), and move through the lymphatic system or blood. The lymphatic system. Cancer enters the lymphatic system, travels through the lymphatic vessels and forms tumor ( metastatic swelling) in another part of the body. Blood. Cancer enters the bloodstream, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. A metastatic tumor is the same type of cancer as the primary tumor. For example, if the primary liver cancer spreads on lungs , the cancer cells in the lungs are actually liver cancer cells. The disease is metastatic liver cancer, not lung cancer. 9. Treatment options for primary liver cancer in adults Stage 0, A, and B primary liver cancer in adults Treatment primary liver cancer in adults stages 0, A, and B may include the following: Observation per defeats less than 1 centimeters ... Partial hepatectomy ... Total hepatectomy and transplantation liver ... Ablation from tumors using one of the following methods: Radiofrequency ablation ... Microwave therapy ... Percutaneous ethanol injection ... Cryoablation ... Clinical research on electroporation therapy ... Stages C and D Primary liver cancer in adults Treatment primary liver cancer in adults stages C and D may include the following: Embolizing therapy by one of the following methods: Transarterial embolization (TAE). Transarterial chemoembolization (TACHE). Targeted therapy with tyrosine kinase inhibitor ... Immunotherapy ... Radiation therapy ... Clinical research on targeted therapy after chemoembolization or in combination with chemotherapy ... Clinical trials of new drugs targeted therapy. Clinical trials of immunotherapy. Clinical trials of immunotherapy in combination with targeted therapy. Clinical trials stereotactic body radiation therapy or radiation therapy protons ... 10. Treatment of recurrent primary liver cancer in adults Treatment options recurrent primary liver cancer in adults may include the following: Total hepatectomy and transplantation liver ... Partial hepatectomy ... Ablation Transarterial chemoembolization and targeted therapy with sorafenib , in palliative care for relax symptoms and improvements quality of life ... Clinical research a new method of treatment. 10. Лечение рецидивирующего первичного рака печени у взрослых 9. Варианты лечения первичного рака печени у взрослых COST OF LIVER CANCER DIAGNOSTICS AND TREATMENT IN TURKEY Diagnosis of liver cancer + surgery from $ 22710 Liver cancer from $ 31,575 Liver cancer biopsy from $ 450 PET-CT for liver cancer from $ 500 Chemoembolization of the liver for liver cancer from $ 5000 Chemotherapy for liver cancer from $ 800 Cyber Knife for Liver Cancer from $ 4400 Nano Knife for Liver Cancer from $ 12000 Radiofrequency ablation of the liver (RFA of the liver) for liver cancer on request СТОИМОСТЬ

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. The main thing about dentistry in Turkey No posts published in this language yet Once posts are published, you’ll see them here. Video Channel Name All Categories Play Video Play Video 00:23 Video Title This is a great space to update your audience with a description of your video. Include information like what the video is about, who produced it, where it was filmed, and why it’s a must-see for viewers. Remember this is a showcase for your professional work, so be sure to use intriguing language that engages viewers and invites them to sit back and enjoy. Play Video Play Video 00:32 Video Title This is a great space to update your audience with a description of your video. Include information like what the video is about, who produced it, where it was filmed, and why it’s a must-see for viewers. Remember this is a showcase for your professional work, so be sure to use intriguing language that engages viewers and invites them to sit back and enjoy. Play Video Play Video 00:29 Video Title This is a great space to update your audience with a description of your video. Include information like what the video is about, who produced it, where it was filmed, and why it’s a must-see for viewers. Remember this is a showcase for your professional work, so be sure to use intriguing language that engages viewers and invites them to sit back and enjoy. Play Video Play Video 00:31 Video Title This is a great space to update your audience with a description of your video. Include information like what the video is about, who produced it, where it was filmed, and why it’s a must-see for viewers. Remember this is a showcase for your professional work, so be sure to use intriguing language that engages viewers and invites them to sit back and enjoy. Play Video Play Video 00:23 Video Title This is a great space to update your audience with a description of your video. Include information like what the video is about, who produced it, where it was filmed, and why it’s a must-see for viewers. Remember this is a showcase for your professional work, so be sure to use intriguing language that engages viewers and invites them to sit back and enjoy. Play Video Play Video 00:32 Video Title This is a great space to update your audience with a description of your video. Include information like what the video is about, who produced it, where it was filmed, and why it’s a must-see for viewers. Remember this is a showcase for your professional work, so be sure to use intriguing language that engages viewers and invites them to sit back and enjoy. Play Video Play Video 00:29 Video Title This is a great space to update your audience with a description of your video. Include information like what the video is about, who produced it, where it was filmed, and why it’s a must-see for viewers. Remember this is a showcase for your professional work, so be sure to use intriguing language that engages viewers and invites them to sit back and enjoy. Play Video Play Video 00:31 Video Title This is a great space to update your audience with a description of your video. Include information like what the video is about, who produced it, where it was filmed, and why it’s a must-see for viewers. Remember this is a showcase for your professional work, so be sure to use intriguing language that engages viewers and invites them to sit back and enjoy. Play Video Play Video 00:23 Video Title This is a great space to update your audience with a description of your video. Include information like what the video is about, who produced it, where it was filmed, and why it’s a must-see for viewers. Remember this is a showcase for your professional work, so be sure to use intriguing language that engages viewers and invites them to sit back and enjoy.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. TREATMENT OF OVAL CANCER IN TURKEY MENU PAGES: 1. Risk factors for testicular cancer 2. What is testicular cancer? 3. Signs and symptoms of testicular cancer include swelling or discomfort in the scrotum. 4. Tests for the detection (search) and diagnosis of testicular cancer. 5. Several factors affect prognosis (chance of recovery) and treatment options. 6. Methods of treatment of patients with testicular cancer. 7. Treatment options for testicular cancer by stage 8. Cost of treatment and diagnosis of testicular cancer in Turkey Testicular cancer most often begins in the germ cells (cells that produce sperm). It is rare and most commonly diagnosed in men between the ages of 20 and 34. Most types of testicular cancer can be cured even if diagnosed at an advanced stage. Explore the links on this page to learn more about screening, treatment, statistics, and clinical trials for testicular cancer. 1. Risk factors for testicular cancer A condition called cryptorchidism (undescended testis) is a risk factor for testicular cancer. Anything that increases the likelihood of getting sick is called a risk factor. ... Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk. Factors Known to Increase Cancer Risk Smoking cigarettes and using tobacco Infections Radiation Immunosuppressants after organ transplant Factors That May Affect Cancer Risk Diet Alcohol Physical activity Obesity Diabetes Environmental risk factors Scientists study risk factors and protective factors, to find ways to prevent new types of cancer ... Anything that increases the likelihood of developing cancer is called a cancer risk factor; anything that makes you less likely to develop cancer is called a cancer defense factor. Some risk factors for cancer can be avoided, but many cannot. For example, smoking and inheriting certain genes are risk factors for some cancers, but only smoking can be avoided. The risk factors that a person can control are called modifiable risk factors. Many other factors in our environment, diet and lifestyle can cause or prevent cancer. This summary only discusses the major cancer risk factors and protective factors that can be controlled or modified to reduce the risk of cancer. Risk factors that are not covered in the summary include certain sexual behaviors, estrogen use, and exposure to certain substances at work or certain chemicals. 2. What is testicular cancer? Testicular cancer is a disease in which malignant (cancerous) cells form in the tissues of one or both testicles. Testicular cancer is the most common cancer in men between the ages of 15 and 34. White men are four times more likely to develop testicular cancer than black men. Testicular cancer is usually treatable. Although the number of new cases of testicular cancer has doubled in the past 40 years, the number of deaths caused by testicular cancer has dropped significantly due to more effective treatments. Testicular cancer usually succumbs treatment even on later stages diseases. In the testis there are 2 ovoid glands within the scrotum (a sac of loose skin that lies immediately below the penis). The testicles are held by the spermatic cord in the scrotum. The spermatic cord also contains the vas deferens, vessels and nerves of the testicles. The testicles are the male sex glands that produce testosterone and sperm. The germ cells in the testes produce immature sperm. These sperm travel through a network of tubules (tiny tubes) and larger tubes into the epididymis (a long, coiled tube next to the testicles). This is where the sperm mature and are stored. Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumors are seminomas and non-seminomas. 1 2 Anatomy of the male reproductive and urinary systems, including the testes, prostate, bladder and other organs. 4 5 3. Signs and symptoms of testicular cancer include swelling or discomfort in the scrotum. These and other signs and symptoms can be caused by testicular cancer or other conditions. Check with your doctor if you have any of the following: A painless lump or swelling in any testicle. Change in testicular sensation. Dull pain in the lower abdomen or groin. Sudden accumulation of fluid in the scrotum. Pain or discomfort in the testicle or scrotum. 4. Tests for the detection (search) and diagnosis of testicular cancer. The following tests and procedures can be used: Physical examination and medical history: Examining the body to check for general signs of health, including checking for signs of illness such as lumps or anything else that seems unusual. The testicles will be checked for bumps, swelling, or pain. A history of the patient's health habits, as well as past illnesses and treatments will also be recorded. Testicular ultrasound: A procedure in which high energy sound waves (ultrasound) are reflected off internal tissues or organs and create an echo. The echo forms a picture of body tissue called a sonogram. Serum tumor marker test: a procedure in which a blood sample is examined to measure the amount of certain substances that enter the bloodstream of organs, tissues or tumor cells in the body. Certain substances are associated with certain types of cancer when found in high concentrations in the blood. These are the so-called tumor markers. The following tumor markers are used to detect testicular cancer: Alpha-fetoprotein (AFP). Human beta-chorionic gonadotropin (β-hCG). Tumor marker levels are measured before inguinal orchiectomy and biopsy to help diagnose testicular cancer. Inguinal orchiectomy: A procedure to completely remove the testicle through an incision in the groin. The testicular tissue sample is then viewed under a microscope to check for cancer cells. (The surgeon does not cut the scrotum in the testicle to take a tissue sample for biopsy, because if cancer is present, this procedure can cause it to spread to the scrotum and lymph nodes. It is important to select a surgeon who is experienced in this type of surgery.) When cancer is found, the type is determined. cells (seminoma or non-seminoma) to help plan treatment. 5. Several factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following conditions: The stage of the cancer (whether it is in or near the testicle, or has spread to other parts of the body, and blood levels of AFP, β-hCG, and LDH). The type of cancer. The size of the tumor. Quantity and size retroperitoneal lymph nodes. 6. Methods of treatment of patients with testicular cancer. Various treatments are available for testicular cancer patients. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. Testicular tumors are divided into 3 groups depending on how well the tumors respond to treatment: 1. Good forecast For a non-seminoma, all of the following conditions must be met: The tumor is found only in the testicle or in the retroperitoneal space (the area outside or behind the abdominal wall); The tumor has not spread to organs other than the lungs; The levels of all tumor markers are slightly higher than normal. For a seminoma, all of the following conditions must be met: The tumor has not spread to organs other than the lungs; and Level alpha-fetoprotein (AFP) is normal. Human beta-chorionic gonadotropin (β-hCG) and lactate dehydrogenase (LDH) can be at any level. 2. Interim forecast For a non-seminoma, all of the following conditions must be met: The tumor is found only in one testicle or in the retroperitoneal space (the area outside or behind the abdominal wall); The tumor has not spread to organs other than the lungs; The level of any of the tumor markers is more than slightly higher than normal. For a seminoma, all of the following conditions must be met: The tumor has spread to organs other than the lungs; AFP level is normal. β-hCG and LDH can be at any level. 3. Poor prognosis For a non-seminoma, at least one of the following must be true: The tumor is located in the center of the chest between the lungs; or The tumor has spread to organs other than the lungs; or The level of any of the tumor markers is high. There is no poor prognosis group for testicular seminoma! Five types of standard treatments are used: 1. Operation Surgical removal of the testicle (inguinal orchiectomy) and some of the lymph nodes may be done at diagnosis and staging. Tumors that have spread to other parts of the body can be partially or completely removed with surgery. After a doctor removes any tumors that can be seen during surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer recurrence is called adjuvant therapy. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. There are two types of radiation therapy: External beam radiation therapy uses a device outside the body to direct radiation to cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are inserted directly into or near the tumor. How radiation therapy is given depends on the type and stage of cancer treatment. External beam radiation therapy is used to treat testicular cancer. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is injected directly into the cerebrospinal fluid, organ or body cavity, such like the abdomen, drugs mainly target cancer cells in these areas (regional chemotherapy). How chemotherapy is given depends on the type and stage of cancer treatment. 4. Observation Surveillance closely monitors the patient's condition, giving no treatment if there is no change in test results. It is used to detect early signs of cancer recurrence. Patients are regularly monitored for certain examinations and tests. 5. High-dose chemotherapy with stem cell transplantation High doses of chemotherapy are prescribed to kill cancer cells. Healthy cells, including hematopoietic cells, are also destroyed in cancer treatments. Stem cell transplantation is a treatment to replace hematopoietic cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of a patient or donor, frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and returned to the patient as an infusion. These re-injected stem cells germinate (and regenerate) the body's blood cells. Stem cell transplant: Step 1. Blood is drawn from a vein in the donor's arm. The donor can be a patient or other person. The blood goes through a machine that removes stem cells. The blood is then returned to the donor through a vein in the other arm. Step 2. The patient receives chemotherapy to destroy the hematopoietic cells. The patient may receive radiation therapy (not shown). Step 3. The patient receives stem cells through a catheter placed in a blood vessel in the chest. 7. Treatment options for testicular cancer by stage Testicular cancer can usually be cured in patients receiving adjuvant chemotherapy or radiation therapy after initial treatment. Stage 0 (Testicular intraepithelial neoplasia) Stage 0 treatment may include the following: Radiation therapy . Observation. Surgery to remove the testicle. Stage I testicular cancer Treatment for seminoma may include the following: Operation to remove testicles with subsequent observation ... For patients requiring proactive treatment rather than monitoring, treatment may include: Surgery to remove the testicle followed by chemotherapy. Treatment for nonseminoma may include the following: Surgery to remove a testicle with long-term follow-up. Surgery to remove the testicle and lymph nodes in the abdominal cavity with long-term follow-up. Surgery followed by chemotherapy for patients at high risk of recurrence with long-term follow-up. Stage II testicular cancer Treatment for seminoma may include the following: When tumor 5 centimeters or less: Surgery to remove the testicle, followed by radiation therapy to the lymph nodes in the abdomen and pelvis. Combined chemotherapy. Surgery to remove the testicle and lymph nodes in the abdominal cavity. When the tumor is larger than 5 centimeters: Surgery to remove the testicle, followed by combination chemotherapy or radiation therapy for the lymph nodes in the abdomen and pelvis with long-term follow-up. Treatment for nonseminoma may include the following: Surgery to remove the testicle and lymph nodes with long-term follow-up. Surgery to remove the testicle and lymph nodes, followed by combined chemotherapy and long-term follow-up. Surgery to remove the testicle, followed by combined chemotherapy and reoperation if cancer remains, with long-term follow-up. Combination chemotherapy before testicular removal surgery to treat cancer that has spread and is considered life-threatening. Stage III testicular cancer Treatment for seminoma may include the following: Surgery to remove the testicle followed by combined chemotherapy. If tumors remain after chemotherapy, treatment can be one of the following: Follow-up without treatment if the tumor does not grow. Observation of tumors less than 3 centimeters in size and surgery to remove tumors larger than 3 centimeters. PET scans two months after chemotherapy and tumor removal surgeries that appear with cancer on scans. Clinical study of chemotherapy. Treatment for nonseminoma may include the following: Surgery to remove the testicle followed by combined chemotherapy. Combined chemotherapy followed by surgery to remove the testicle and any remaining tumors. Additional chemotherapy may be given if the removed tumor tissue contains growing cancer cells or if subsequent tests indicate that the cancer is progressing. Combination chemotherapy before testicular removal surgery to treat cancer that has spread and is considered life-threatening. Clinical trial of chemotherapy. Treatment for recurrent testicular cancer may include the following: Combined chemotherapy ... High-dose chemotherapy and stem cell transplantation. Surgery to remove cancer that has: return more than 2 years after complete remission; or returns in only one place and does not respond to chemotherapy. Clinical trials of new therapy. Testicular cancer treatments can cause infertility. Certain testicular cancer treatments can cause infertility, which can be permanent. Patients who wish to have children should consider a sperm bank before starting treatment. A sperm bank is the process of freezing semen and storing it for later use. Need help? To organize treatment for testicular cancer in Turkey, leave a request on the Medikal & Estetik Group website. You will be contacted by a specialized doctor-coordinator who will help you choose the best medical center. Send him your medical records, he will redirect them to the hospital of your choice and request a treatment program. We will help you organize your trip and stay in touch with you throughout your treatment - from the moment you contact us and even after you return home. Medikal & Estetik Group is an independent medical service that does not represent the interests of any of the clinics. Patients do not pay for our services - medical centers do it. Doctors-coordinators will advise you and help you with the choice. Medikal & Estetik Group services are free of charge for you and do not affect the clinic bill. 3 6 7 COST OF TREATMENT AND DIAGNOSIS OF OVAL CANCER IN TURKEY Testicular cancer biopsy from $ 450 CT (computed tomography) for testicular cancer from $ 50 PET-CT for testicular cancer from $ 500 Chemotherapy for breast cancer from $ 1200 Radiation therapy for rectal cancer on request 8

1. Основные причины, по которым женщины выбирают лечение РМЖ в Турции 2. Какие прогнозы при опухолях молочной железы? 3. Где лечить РМЖ: популярные страны 5. От чего зависит цена? 4. Как выбрать клинику для лечения онкологии груди? 6. Как проходит диагностика рака груди в Турции? 7. Какие есть инновационные методы диагностики? 8. Как лечить рак груди? 9. Какие есть инновационные методы лечения? 10. Как проходит восстановление груди после лечения? СТОИМОСТЬ ЛЕЧЕНИЯ И ДИАГНОСТИКИ РМЖ В ТУРЦИИ BREAST CANCER TREATMENT IN TURKEY MENU PAGES: 1. The main reasons why women choose breast cancer (BC) treatment in Turkey 2. What are the prognosis for breast tumors? 3. Where to treat breast cancer: popular countries 5. What does the price depend on? 4. How to choose a clinic for the treatment of breast cancer? 4. How to choose a clinic for the treatment of breast cancer? 6. How is breast cancer diagnosed abroad? 7. What are the innovative diagnostic methods? 8. How is breast cancer treated? 9. What innovative methods of treatment are there? 10. How is breast reconstruction going after treatment? 11. How to organize the treatment? 12. COST OF TREATMENT AND DIAGNOSIS OF BREAST CANCER IN TURKEY 1. The main reasons why women choose breast cancer (BC) treatment in Turkey Technologies that maximize breast preservation. During the operation, foreign doctors use special devices that examine the excised tissue. If cancer cells are found at the edges, they increase the volume of the intervention. Surgeons dissect the tissue until the edges are clean. Thanks to the technology, foreign doctors do not need to remove all the gland for reinsurance, as is done in the CIS countries. High precision radiation therapy with minimal risk of side effects . For radiotherapy in hospitals abroad, the latest generation devices have been installed (2013-2019). Such installations are equipped with a system that allows you to adjust the radiation beam to the shape and size of the tumor with an accuracy of 0.5 mm. This minimizes the impact on the surrounding healthy tissue. For comparison, in the CIS countries they use installations from 2003-2008, the accuracy of which is several cm. At the same time, radiation therapy with the help of a new device in a foreign clinic can cost you the same price as with the help of an old one in a domestic hospital. Effective chemotherapy with hair preservation. Abroad, doctors select the chemotherapy drug and its dose individually for each woman based on the results of a tumor study. She is also prescribed effective supportive therapy to relieve her symptoms. In the CIS countries, oncologists use standard chemistry protocols. In some foreign hospitals, special caps are available that cool the scalp during therapy. Due to this, the blood flow in the area of hair growth slows down, the preparations in a smaller amount reach the follicles and they do not fall out. Innovative treatment methods. Targeted and immunotherapy are indicated for malignant breast tumors with a genetic mutation. Doctors abroad have extensive experience in the successful application of these techniques, and more of these drugs are available abroad than in the CIS. For comparison, in world practice, about 70 immunopreparations are used, in Russia - 18, in Ukraine - 12. 2. What are the prognosis for breast tumors? Breast cancer responds well to treatment - this is the first thing to know for women with this diagnosis. According to the American Society of Clinical Oncology, the milestone of 5 years is going through: 99% of patients in whom the disease has not gone beyond the gland (stage 0-1); 85% of women with secondary tumors (metastases) in the lymph nodes (stages 2-3); 27% of patients with metastases in distant organs (stage 4). If we talk about the average 5-year survival rate for all stages, then it is 90%. It is important to understand that statistics are averaged data, and the effectiveness of treatment is individual in each case. In addition to the stage, it is influenced by the type of tumor, the woman's age, general health, properly selected and performed treatment. 3. Where to treat breast cancer: popular countries Germany. In German clinics, the strictest control over the quality of medicine and the level of qualifications of doctors. German hospital departments that specialize in the treatment of breast cancer are equipped with the latest equipment, and their doctors apply effective techniques. This is evidenced by accreditation from the German Cancer Society. Israel. In Israeli hospitals, women with breast cancer receive doctors who are trained and trained in Europe and the United States. The organization of treatment here is faster than in Germany. The difference is due to the fact that the system of work of the international department of Israeli clinics allows you to quickly get a doctor's opinion on medical statements. Turkey. The country's hospitals offer the best value for money. They work according to American and international protocols, some of them are included in the TOP of the most high-tech hospitals in the world from the Top Master's in Healthcare Administration. At the same time, the cost of treatment in Turkey is lower than in Israel and Germany. 4. How to choose a clinic for the treatment of breast cancer? When choosing a clinic for the treatment of breast cancer, it is necessary to consider the following factors: Techniques available at the medical center. It is important to undergo treatment that is most effective in a particular case, and not the only one possible within a particular hospital. Therefore, pay attention that the clinic uses surgery, radiation, chemotherapy, hormonal, targeted and immunotherapy. Equipment level. In order for the treatment to proceed with the minimum risk of side effects, the clinic must have the latest medical equipment. For example, radiation therapy machines (linear accelerators) must be no older than 2013. 5. What does the price depend on? The price of breast cancer treatment depends on the following factors: Treatment program. It can include one technique or a complex of several procedures that doctors select depending on the stage of the disease and the type of tumor. Therefore, the cost of breast cancer treatment is individual in each case. Selected country and clinic. Prices for breast cancer treatment in different countries can differ several times. This is due to the level of economic development of states. For example, the cost of surgery for breast cancer in India is from $ 2 850, in Israel - from $ 9 500. The cost of procedures within one country may differ depending on the type of medical center (private / public) and class. 6. How is breast cancer diagnosed abroad? Diagnosis of breast cancer in Turkey includes: Doctor's consultation and manual examination. A detailed blood test - determines deviations from the norm in its composition, which may indicate violations in the work of any organ. Tumor marker test - with its help, doctors identify proteins in the blood that are characteristic of breast cancer. A mammogram is an X-ray of the breast that can detect a tumor before it can be felt by palpating the breast. Ultrasound - helps to detect neoplasms in tissues and lymph nodes. With the help of an ultrasound examination, doctors can understand what the formation is filled with and distinguish a tumor from a cyst. Breast MRI - a technique used to establish the size of the tumor, its spread to adjacent tissues. A biopsy is a procedure for taking tissue from a tumor for laboratory examination. Histology and immunohistochemistry of the neoplasm - analysis of material obtained using a biopsy. With their help, doctors determine the presence of cancer cells, the type of tumor, the receptor status of the neoplasm (the presence of a genetic mutation in it, in which targeted and immunotherapy is indicated), the stage of the disease and select treatment tactics. CT scan of the chest and abdomen - allows doctors to determine if the tumor has metastases to organs located in these areas. Scintigraphy - performed if bone metastases are suspected. Positron emission computed tomography (PET-CT) is a full-body scan that helps detect even the smallest metastases - up to 3 mm. 7. What are the innovative diagnostic methods? In some Turkish hospitals, the latest breast cancer diagnostics methods are available: Tomosynthesis is a three-dimensional mammography that does not require breast compression. Molecular tomography - allows you to detect a tumor in patients with a dense mammary gland. Positron emission mammography (TEM) is a type of positron emission tomography that can detect even 1.6 mm neoplasms in the breast. Electrical impedance tomography (EIT) - allows you to distinguish a benign tumor from a malignant one without biopsy using a current. Oncotype DX is a genetic tumor test that determines the risk of breast cancer recurrence in patients who are treated early in the disease. Mammaprint test - predicts the likelihood of recurrence and metastases within 10 years after removal of the primary tumor, and doctors use it to determine the need for postoperative chemotherapy. BluePrint test - with its help doctors determine the subtype of breast cancer, predict the effectiveness and need for preoperative therapy. 8. How is breast cancer treated? Breast cancer treatment abroad is carried out using the following methods: 1. Surgery The amount of intervention depends on the size of the tumor. There are the following types of operations for breast cancer: Organ-preserving ones - are indicated in the initial stages of the disease. Subspecies of the procedure: Sectoral resection (tumorectomy, lumpectomy) - is indicated for tumors less than 2 cm.During the operation, surgeons excise the tumor and about 1 cm of the surrounding healthy tissue to prevent relapse - the return of the disease. Quadrantectomy - like a lumpectomy, it saves the breast. During the intervention, surgeons remove the tumor and about 2 cm of nearby tissues. A total mastectomy is the complete removal of the breast. If there is a risk of spreading the disease to a healthy gland, doctors cut it out as well. If there is a risk of metastasis, in addition to the main operation, surgeons can perform lymphadenectomy - removal of lymph nodes. To determine its feasibility, doctors excise 1 lymph node and analyze it. This is called a sentinel biopsy (sentinel lymph node biopsy). 2. Radiotherapy (radiation therapy) This is a course of procedures during which the tumor is irradiated and gradually destroyed. Doctors perform radiation therapy in the following cases: before surgery (neoadjuvant radiotherapy) - to reduce the growth and preserve breast tissue as much as possible; after surgery (adjuvant radiation therapy) - to destroy the remaining cancer cells and prevent the disease from returning; instead of surgery, in the later stages to slow tumor growth and reduce symptoms. 3. Radiosurgery This is the simultaneous destruction of a tumor with high doses of radiation. Such treatment is carried out at the initial stages of the disease, if the patient has contraindications for surgical intervention. 4. Chemotherapy for breast cancer This is the reception of special anticancer drugs, which are carried through the body with the blood flow and destroy cancer cells. Types of chemotherapy: Neoadjuvant (preoperative) - allows you to shrink the tumor so that doctors can preserve the gland tissue as much as possible during surgery. Adjuvant (postoperative) - destroys metastases throughout the body. Palliative - improves the quality of life in the later stages of the disease. 5. Hormone therapy Treatment with hormonal drugs is prescribed to patients with hormone-dependent tumors in such situations: after surgery to prevent the return of the disease; if the disease has metastasized; with relapse. 9. What innovative methods of treatment are there? Such innovative methods of breast cancer treatment are available abroad: 1. Cryotherapy (cryosurgery / cryoablation) This is the freezing of the tumor with an injection of liquid nitrogen. Due to the effect of low temperatures, cancer cells stop multiplying and the neoplasm dies. The technique is indicated for stages 0-1 breast cancer. 2. Intraoperative radiation therapy The purpose of the procedure is to destroy all cancer cells that may have remained in the area of the removed tumor. The procedure takes place once with a high dose of radiation. Thanks to it, the patient does not need to undergo a course of postoperative radiation therapy to prevent relapse. 3. Immunotherapy Immune drugs activate the patient's immunity, so that the body begins to recognize cancer cells and destroy them on its own. 4. Targeted therapy Targeted drugs target cancer cells and do not harm healthy tissues. This treatment has fewer side effects than chemotherapy. 10. How is breast reconstruction going after treatment? For patients who have partially or completely removed their breasts, plastic reconstructive surgeons carry out the restoration of the gland. To do this, they use implants or the woman's own tissue, which is obtained from the lower abdomen. If the nipple was removed during the operation, surgeons create a special elevation on which you can later make a tattoo, giving it the desired color. 11. How to organize the treatment? To organize breast cancer treatment abroad, leave a request on the site. At a convenient time for you, the Bookimed medical coordinator will contact you, who will advise you on all issues of interest. He will tell you about leading doctors, medical centers and help you choose the best clinic for the treatment of breast cancer, focusing on your wishes in terms of price and quality. The coordinating doctor will explain what documents are required for the trip for treatment and will write you to the hospital of your choice. Medikal & Estetik Group will stay in touch from the moment you contact us and even after returning home. Basic diagnostics and tumor removal from $ 5370 Basic diagnostics + Lumpectomy from $ 7116 Mastectomy with check of lymph node involvement in breast cancer from $ 8500 Breast cancer diagnostics from $ 1989 Help is needed? Doctors-coordinators will advise you and help you with the choice. Medikal & Estetik Group services are free of charge for you and do not affect your clinic bill. Medikal & Estetik Group coordinator will help find the best solution for breast cancer treatment CHOOSE CLINIC 1. Основные причины, по которым женщины выбирают лечение рака груди (РМЖ) в Турции 2. Какие прогнозы при опухолях молочной железы? 3. Где лечить рак груди: популярные страны 4. Как выбрать клинику для лечения онкологии груди? 5. Где я могу прочесть отзывы? 6. Как проходит диагностика рака груди за границей? 7. Какие есть инновационные методы диагностики? 8. Как лечить рак груди? 9. Какие есть инновационные методы лечения? 10. Как проходит восстановление груди после лечения? 11. Как организовать лечение? COST OF TREATMENT AND DIAGNOSIS OF BREAST CANCER IN TURKEY Basic diagnostics and tumor removal from $ 5370 Basic diagnostics + Lumpectomy from $ 7116 Breast cancer diagnostics from $ 1989 Biopsy for breast cancer from $ 450 CT (computed tomography) for breast cancer from $ 50 Mastectomy with check of lymph node involvement in breast cancer from $ 8500 PET-CT for breast cancer from $ 500 PET-CT for breast cancer from $ 500 Immunotherapy with Keytruda (Pembrolizumab) for breast cancer from $ 3300 Breast cancer surgery from $ 2500 Surgical breast reconstruction for breast cancer from $ 2500 Chemotherapy for breast cancer from $ 1200 Cyber knife for breast cancer from $ 4400 Gamma Knife for Breast Cancer from $ 6000 Breast cancer hormone therapy for breast cancer on request Immunotherapy for breast cancer on request Breast cancer lumpectomy from $ 5411 Mastectomy for breast cancer from $ 2000 СТОИМОСТЬ ЛЕЧЕНИЯ И ДИАГНОСТИКИ РАКА ГРУДИ В ТУРЦИИ Need help? Doctors-coordinators will advise you and help you with the choice. Services Medikal & Estetik Group are free for you and do not affect the clinic bill. Find a solution Coordinator Medikal & Estetik Group help you find the best solution for cancer treatment CHOOSE CLINIC O Medikal & Estetik Group Second opinion Before traveling, you can get a Turkish doctor's opinion on your diagnosis and treatment prescribed. For the patient, this is an opportunity to receive advice from the world's best specialists.

Мedikal & Estetik Group - международная платформа по бесплатному подбору и организации медицинских решений в Турции. Вы нам НИЧЕГО не платите! DETAILS ABOUT THE ORGANIZATION "MEDIKAL & ESTETIK GROUP" Medikal & Estetik Group understands that the strength of our organization lies not in words, but in the implementation of our mission to help you find the best medical solutions for you. Since 2018, we have been of the opinion that much more can be achieved through the joint efforts of a caring team. This is how the organization "Medikal & Estetik Group" appeared. Contact MEET MEDIKAL & ESTETIK GROUP Free international platform for the selection of a medical solution. You don't pay us anything Medikal & Estetik Group is a Russian-Turkish international platform for free selection of medical solutions in Turkey. We know everything and even more about this country, the nuances of Turkish medicine, its laws, insurance systems, its culture and language, because we live directly in this country! Even knowing English, there is often a distortion in the perception of information in the process of dialogue between two non-native speakers of this language. Medikal & Estetik Group consists of Turkish and Russian coordinator-translators with medical education, which guarantees the provision of 100% correct information about treatment, accommodation and tourism in Turkey. Contact HOW WE HELP As your coordinators among the huge information flow about clinics and doctors in Turkey, our task is to help you make the best medical decision. For this we are ready to provide: selection of a clinic according to your budget; making an appointment with specialists without queuing and intermediaries; getting much quicker feedback than self-referral; obtaining a medical visa if you need to stay in Turkey for a long time; free translation of medical documents; organization of transfer and language support at all stages; representing your side and defending your interests; selection of the most comfortable and favorable conditions and opportunities for you, about which many are silent or do not know; guarantee that you will not face any hidden commissions, volunteer fees or "thanks" to doctors. Everything is as transparent as possible. All payments are made at the clinic's cash desks; payment is made at the clinic's cash desks; organization of a consultation with a doctor you need; feedback with us 24/7. QUESTION-ANSWER ABOUT TREATMENT IN TURKEY Step by step BEST CLINICS IN TURKEY Commitment to principles THE MAIN ABOUT TREATMENT AND DIAGNOSTICS IN TURKEY Helping the community "Every person is guilty of everything good that he has not done in his life." Voltaire MEDIKAL & ESTETIK GROUP: CONTACT medikal.estetik.group@gmail.com +905054791917 Name Email post office Telephone Address Subject Message Send message Submitted. Thank you! Все видео Play Video Search video... All Categories All Categories Cuidar de você encabeça a sua lista de prioridades ⠀Caso não, deveria. ⠀Aproveite toda a energia de renovação que circula nesse período para colocar em prática a retomada da sua autoestima! ⠀E começar pelo Play Video A_responsabilidade_é_enorme_Atingir_e_superar_as_expectativas_do Play Video ✔Possibilidades são o que as lentes de contato dental podem te dar em um curto espaço de tempo, mudando cor e forma de maneira definitivas! Quer ter aquele sorriso dos sonhos.⠀.⠀⠀.⠀Agende sua avaliação-. (31) Play Video Бесплатная организация лечения в Турции Play Video Play Video 07:49 Grup Florence Nightingale Türkçe Florence Nichtingale стали первыми в области молекулярно-генетической диагностики. Подобные обследования уникальны, они предоставляют возможность подобрать оптимальную программу лечения различных болезней в каждом конкретном случае. Диагностики проводятся в специализированных лабораториях сети, оснащенных инновационным оборудованием. Поддерживает связи и партнерские отношения с некоторыми из самых престижных медицинских учреждений в США и других странах. Play Video Play Video 01:38 Kolan International Hospital Tanıtım Filmi Уникальные услуги: 1. лечение ретинопатии недоношенных детей — с помощью наиболее безопасной экстренной лазерной терапии или методом замораживания части сетчатки; 2. увеличение груди без операции — с помощью специально подготовленной гиалуроновой кислоты. Процедура проводится под местной анестезией, поэтому пациент находится в полном сознании и может определятся с желаемым размером прямо во время процедуры. 3. лечение гинекомастии (патологического увеличения молочных желез у мужчин) Проводиться безопасное хирургическое устранение патологии с пожизненным эффектом. Play Video Play Video 06:29 Koç Üniversitesi Hastanesi Качество предоставляемых услуг соответствует мировым стандартам ISO 9001 Quality Management System. Клиника Коч имеет сертификат аккредитационной комиссии JCI, что подтверждает высокое качество предоставляемых услуг и безопасность для пациента. В госпитале Коч работают над проблемами и усовершенствованием лечения онкологических, гематологических, сердечно-сосудистых заболеваний, эндокринологии и метаболизма, ожирения, сахарного диабета, адреналовой дисфункции. Play Video Play Video 02:08 Özel Sağlık Hastanesi Yüksek Sağlık Teknolojileri ve Tecrübeli Hekimleriyle Alsancak'ta Hizmetinizde Один из современных многопрофильных центров Турции с международным уровнем находится в Измире. Özel Sağlık Hastanesi оборудован инновационным технологиями, которые применяются в урологическом отделении (оно является лучшим в Турции) : роботизированной хирургии Da Vinci, аппарату HIFU, диагностике Uronav Prostate Fusion Biopsy, системе HoLEP и процедуре REZUM

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. ABOUT US The free platform for the selection of medical and aesthetic solutions "Medikal & Estetik Group" uses all the knowledge and resources to achieve its goals. We help patients make the right decisions for them, offering a choice of up to 5 options on average from proven specialists with an international reputation in medicine and the best clinics not only in Turkey, but also in the world. We cooperate with more than 40 medical centers in Turkey, therefore our recommendations are absolutely impartial and objective. Our success is measured not by money, but by how efficiently we work and how we are changing the world for the better. Our mission is to help those in need of our help quickly, honestly, professionally, individually, based on your needs and financial capabilities. How it works? All answers to questions about our services Clinic selection criteria History of Lymphoma Treatment in Turkey Health has no geographic boundaries. A few clicks separate you from quality medical services.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. The main thing about 3D computed tomography No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. The main thing about Check-up diagnostics No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. The main thing about cardiology in Turkey No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. The main thing about organ transplantation in Turkey No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. 3 min read 6 most frequently asked questions about anesthesia There are no baseless fears. Someone has had an unpleasant experience of anesthesia in a clinical hospital, and that was... Post not marked as liked 4 min read HOW TO CHOOSE A BREAST IMPLANT BY SHAPE AND VOLUME The eternal topic of breast prosthetics is the choice of a breast implant. At first glance, it may seem that how many people, so many... 1 like. Post not marked as liked 1 2 min read ПОДТЯЖКА БРОВЕЙ ИЛИ ПОДТЯЖКА ЛБА Меню страницы: 1. ЧТО ТАКОЕ ПОДТЯЖКА БРОВЕЙ? 2. КТО ОБРАЩАЕТСЯ ЗА ПОДТЯЖКОЙ? 3. КАКАЯ АНЕСТЕЗИЯ ИСПОЛЬЗУЕТСЯ? 4. ОБЩИЕ СВЕДЕНИЯ Брови... Post not marked as liked 2 min read Главное об офтальмологии в Турции Меню страницы: ДИАГНОСТИКА МЕТОДЫ ЛЕЧЕНИЯ ВОССТАНОВЛЕНИЕ ЗРЕНИЯ СТОИМОСТЬ 80% случаев нарушения зрения могут быть обратимыми. В турецких... Post not marked as liked 4 min read Ринопластика в Турции Меню страницы: ЧТО ТАКОЕ РИНОПЛАСТИКА? ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К РИНОПЛАСТИКЕ ДИАГНОСТИКА И КОНСУЛЬТАЦИЯ ПЕРЕД РИНОПЛАСТИКОЙ МЕТОДЫ... Post not marked as liked 5 min read Главное о лечении рака в Турции Меню страницы: МЕТОДЫ ДИАГНОСТИКИ ДИАГНОСТИКА ОНКОЛОГИИ В ТУРЦИИ ЛЕЧЕНИЕ РАКА В ТУРЦИИ ИННОВАЦИОННАЯ МЕТОДИКА ЛЕЧЕНИЯ РАБОТА С БОЛЬНЫМИ... Post not marked as liked

Что такое второе мнение? Для чего оно нужно? Как организовать? Что спросить? Как подготовиться? сколько стоит? Лучшие онкологи Турции Log In SECOND OPINION Online consultation top oncologists in Turkey ○ Savings on flights and accommodation ○ Only reputable doctors from leading clinics in Turkey ○ Free translation of your medical records ○ Official conclusion Якорь 2 Online consultation an oncologist is the best choice if: You need an urgent consultation, but you are not able to travel abroad. You are afraid of coronavirus infection and are in quarantine. You are thinking about medical treatment abroad and want to understand if there is a difference and how much it will cost. Your doctor cannot make a diagnosis. The prescribed treatment does not help, the disease progresses. You are scheduled for surgery and want to know about other treatment options. What are you getting: Answers A doctor with many years of experience studies your medical history and forms a diagnostic and treatment program according to international protocols. Security You are protected from any infections associated with travel abroad and contact with many people. Saving You do not need to apply for a visa, buy tickets and book accommodation - you only need access to the Internet. Confidence Online consultation reduces the likelihood of medical error and the wrong approach to treatment in the community. How is the online consultation going? : 2 easy steps to your peace of mind PREPARE DOCUMENTS Doctor's conclusion; Survey results; Discs CT, MRI, PET-CT; The prescribed treatment program (if any). 2. LEAVE A CALL WITH US ON THE SITE The medical coordinator of Medikal & Estetik Group will promptly contact you, who will agree on the terms and organize a remote consultation. To get a consultation 2.Collecting extracts You collect medical records, test results and send them to the medical coordinator of Medikal & Estetik Group 3.Free translation Medikal & Estetik Group organizes free translation of your documents into the language of the clinic and forwards them to the selected doctor. 1.Calling on the site You leave a request, and the medical coordinator of Medikal & Estetik Group will contact you to agree on the organizational details. 6. Conclusion and treatment plan After the consultation, you will receive detailed recommendations and an action plan for international protocols. 5.Online consultation with a doctor The doctor will answer your questions and discuss the treatment program with you. The consultation lasts 30-60 minutes, with an interpreter present. 4. Investigating Your Case The doctor preliminarily reviews your discharge, determines treatment tactics and appoints a consultation time. Why do patients trust us? We work directly with the best clinics in Turkey We organize online consultations in 1-3 days from the moment of contact Our services are free for patients Preparation for an online consultation: What documents are needed for an online consultation with an oncologist? To conduct a remote consultation with an oncologist, you need: CT, MRI or PET-CT disks, transcripts; biopsy data (if you had it); the conclusion of the attending physician; history of treatment (if you have had it), a list of medications you are taking. Leave a request on the website and the coordinating doctor will contact you. He will tell you what medical records are needed in your case so that you get the most useful answer, and will agree on all the organizational details. What questions must be asked during an online consultation with an oncologist? It is important to prepare in advance for an online oncology consultation. To do this, write down questions about the diagnosis, test results, treatment and well-being that interest you, for example: Do you agree with the diagnosis I received at home? What do the survey results say? Do I need to undergo additional examinations? What and what will they show? What is my estimated forecast? What techniques will be effective in my case? What is the effectiveness of each method? What to do at this stage? What drugs do you use for chemotherapy in your country? Do I need further treatment after surgery, or is the removal of the tumor sufficient? What method of surgery do you recommend? What do you recommend to improve your well-being? How is an online consultation with a doctor going? You send your medical records to the coordinating doctor in advance. We organize their translation into the language of the clinic and send them to the doctor of your choice. He carefully examines the documents and develops diagnostic and treatment tactics for you according to the latest international protocols. At the agreed time, the doctor will call you by video link, clarify the details with you (if necessary) and answer your questions. You communicate with the doctor through an interpreter who is directly next to the doctor or connects to a video call. After an online consultation, you receive a formal opinion with a treatment plan, often within 1-7 days after the call. What is the difference between an online doctor's consultation and a regular face-to-face consultation? An online consultation with a doctor abroad is similar to a standard full-time appointment at a clinic: the doctor examines the results of tests and examinations, asks clarifying questions, explains the diagnosis and treatment principles, and gives his recommendations. Advantages of remote consultation with a doctor: Effective treatment tactics. You receive advice, a second opinion and a treatment program from reputable world-class specialists who work according to the latest international protocols. Saving time. An online consultation with a foreign doctor can be organized in just 1-5 days, while waiting for an appointment at the place of residence can take weeks. Cost savings. You save on flights and living in another country. Convenience. All you need for a remote consultation with a doctor is the Internet and an application for video communication (Skype, etc.). Cons of consulting a doctor online: During an online consultation, the doctor cannot conduct a physical examination, medical procedures. Therefore, the doctor can only rely on the results of the examinations and your answers. In some cases, you need to wait for a remote consultation, for example, due to the high workload of a particular doctor. During a remote consultation, it is impossible to conduct an inspection, while its cost is often the same as in-person. Online consultation cost The cost of a consultation depends on its format (video or written), a specific clinic and a specialist. Remote video consultation Written consultation (Conclusion without video call) Find out the cost WHAT IS INCLUDED IN THE COST ONLINE CONSULTATION? Examining your medical records. An experienced doctor examines the results of examinations and tests provided by you, medical history and treatment. Formation of an individual treatment program. The doctor determines which treatment tactics are most suitable for you based on the latest international protocols. Answers to your questions about the diagnosis and treatment tactics. The doctor answers all your questions, if necessary, he clarifies the details with you. Official conclusion from the clinic. Within 1-7 days after the online consultation, you will receive a written opinion on the official letterhead of the clinic to your email address. Translation services. If necessary, a qualified translator is connected to the online consultation. In some clinics, his services are paid additionally. TO GET A CONSULTATION Which oncologists advise online Online consultation $ 125 Prof. Duygu Derin Oncologist 10 years of experience Esophageal carcinoma Breast cancer Lungs' cancer Ovarian cancer Liver cancer Stomach cancer Sarcoma Uterine cancer Adenocarcinoma Sigmoid colon cancer Lung cancer stage 4 Specialist in the diagnosis and treatment of cancer. She is the author of scientific publications in 27 international and 8 national publications. In 2010, Duigu Derin received the title of Associate Professor. Membership in associations Society of Medical Oncology; Turkish Oncology Association; European Association of Oncologists. Sign up Online consultation $ 125 Online consultation $ 125 Doc. Meltem Topalgoktseli Oncologist 12 years of experience Ovarian cancer Stomach cancer Adenocarcinoma Small intestine cancer Stomach cancer stage 2 Collaborates with American clinics, in particular, Johns Hopkins Hospital. He consults over 2,000 patients annually. Membership in organizations Turkish Medical Oncology Association; Istanbul Medical Association; Breast Cancer Research Group in Istanbul; Turkish Lung Cancer Association; Uskudar American Academy Alumni Association. Sign up Prof. Muammer Kendirchi Oncologist, Surgeon-urologist, Oncosurgeon 26 years of experience BPH Testicular cancer Azoospermia Endourology General urology Female urology Urinary incontinence Kidney stones, ureters Professor Kendirchi spoke as a speaker at 120 specialized events and received many awards, among them: International North American Society of Sexology Award for Contribution to Stem Cell Research, 2001; American Andrology Association Award for Contribution to the Study of Erectile Dysfunction, 2005; First place at the National Congress of Urology for an experimental study, 2012. Sign up Prof. Orkhan Tanriverdi Oncologist, Surgeon-urologist, Oncosurgeon 28 years of experience Prostate cancer Bladder cancer Kidney cancer Testicular cancer Laparoscopic urology Percutaneous kidney surgery Endourology Urogynecology Robotic urosurgery He combines medical practice with teaching and scientific work. Education Samsat Medical Center (Turkey); Etphal Clinic (Turkey); Wayne University (USA); Avrasia Hospital (Azerbaijan); Hospital OLV (Belgium). Istanbul University (Turkey); Gulhane Military Medical Academy (Turkey); Ankara University (Turkey). Sign up Membership in organizations Turkish Association of Urology; Endourological Society; Society of Andrology of Turkey; European Association of Urology; American Urological Association; Scientific editorial board of the endourological bulletin. Prof. Ertugrul Gazioglu Oncosurgeon 36 years of experience Breast cancer Professional biography Currently - Liv Hospital; 2008 - Acibadem Maslak and Fula hospitals; 2006 - European Institute of Oncology in Milan, Italy; 1991 - University of Paris, Kremlin-Bicetre Hospital, France; 1987-2017 - Istanbul University Faculty of Medicine (General Surgery); 1986 - Bayburt Kopuz Health Center; 1979-1985 - Istanbul University Faculty of Medicine. Membership in associations Turkish Surgical Association; Association of Breast Diseases of Turkey; International Society of Surgery; American Breast Disease Society; Balkan Medical Association. Sign up Online consultation $ 160 Prof. Yeshim Yildirim Oncologist 17 years of experience Esophageal carcinoma Breast cancer Lungs' cancer Ovarian cancer Pancreas cancer Lymphoma Cervical cancer Melanoma Sarcoma Hodgkin's disease Myeloma Adenocarcinoma Neuroblastoma Retinoblastoma Follicular lymphoma Leiomyosarcoma Small intestine cancer Nephroblastoma Leukemia (blood cancer) Rhabdomyosarcoma Chondrosarcoma Acute lymphoblastic leukemia Colon cancer Non-Hodgkin's lymphoma Burkitt's lymphoma Lung cancer stage 4 The main specialization of the doctor is the diagnosis and treatment of breast cancer, sarcoma, lung cancer and gastrointestinal tract cancer. Education Hacettepe University English School of Medicine; Gazi University School of Medicine - Internship; Bashkent University - postgraduate studies; Acibadem University - obtaining the certificate of the European Society of Medical Oncologists; Rambam Medical Center (Israel) - advanced training in the field of oncology. Dr. Yeshim Yıldırım received a fellowship from the European Community of Oncologists in 2005 for an advanced training course “Immunology for Oncologists”. In the same year, she won a grant to attend the Colorectal Cancer Conference. Membership in organizations European Society for Medical Oncology (ESMO) European School of Oncology (ESO) Member of the Board of the Turkish Medical Cancer Foundation founded and heads the Society of Oncology of the Gastrointestinal Tract Sign up Online consultation $ 160 Prof., Master of Science, MD Metin Chakmakchi Oncosurgeon, Specialist in General Surgery, Surgeon-mammologist 35 years of experience Esophageal carcinoma Breast cancer Pancreas cancer Stomach cancer Thyroid cancer Adenocarcinoma Rectal cancer Colon cancer He is the head of the department of general surgery. Specialized directions - oncological surgery, in particular, operations for breast, stomach and intestinal cancers. He specializes in minimally invasive techniques: laparoscopic and robotic surgical interventions. Sign up Prof., MD Zafer Gulbash Hematologist 44 years of experience Lymphoma Hodgkin's disease Myeloma Thrombocytopenia Aplastic anemia Leukemia (blood cancer) Ewing's sarcoma Acute lymphoblastic leukemia Non-Hodgkin's lymphoma Follicular lymphoma Burkitt's lymphoma Professor of Hematology at Eskisehir University He actively uses flow cytometry - a blood test, which helps to identify many diseases and objectively assess the state of the patient's immune system. Professional development in: Center for Pulmonology and Thoracic Surgery. Ataturk (Turkey); Clinic "Hadassah" (Israel); Oncology center them. Hutchinson (USA); Oncology center them. Anderson (USA); University Clinic. Princess Margarita (Canada). Membership in organizations Turkish Association of Hematologists; European Association of Hematology; American Association of Hematology; International Cell Therapy Group. Sign up Online consultation $ 160 Prof. Serdar Turhal Oncologist 22 years of experience Breast cancer Liver cancer Prostate cancer Bladder cancer Kidney cancer Small intestine cancer Colon cancer Liver cancer stage 2 Liver cancer stage 3 Liver cancer stage 4 Liver metastases Add. education: General Surgery at Birmingham Medical Center (USA) Diseases of internal organs at the Griffin clinic at Yale University (USA) BMT at Mount Sinai Medical Complex in New York (USA) Sign up Online consultation $ 160 Doc. Meltem Topalgoktseli Radiology oncologist 22 years of experience Breast cancer Lungs' cancer Cervical cancer Prostate cancer Bone cancer Uterine cancer Osteosarcoma Ewing's sarcoma Chondrosarcoma In 1998, Khale Bashak Chalar graduated from the Faculty of Medicine of Gazi University in Ankara, in 2003 from the University of Marmara. She then worked in the Department of Radiation Oncology at Hacettepe University (Ankara). In 2006-2007. Khale Bashak Chalar worked at Harvard University. In 2015 she received the title of professor at Istanbul Medipol University. Doctor's procedures PET-CT Brachytherapy Cyber Knife Gamma knife Radiation therapy Radiation therapy for rectal cancer Radiation therapy for brain tumors Radiation therapy for laryngeal cancer Radiation therapy for prostate cancer Radiation therapy for lung cancer Radiation therapy for breast cancer Radiation therapy for uterine cancer Radiation therapy for cervical cancer Cyber knife for prostate cancer Cyber knife for lung cancer Membership in organizations ASTRO - American Society of Radiation Oncology; ESTRO - European Society for Therapeutic Radiation Oncology; EORTC - European Organization for Research and Treatment of Cancer; Society of Radiosurgery; Turkish Society of Lung Cancer; Turkish Society of Oncology; Turkish Medical Association; Turkish Cancer Society. Sign up Prof. Khalyuk Duman Oncologist, Plastic Surgeon, Hand Surgery Specialist, Oral and Maxillofacial Surgeon 39 years of experience Melanoma Basalioma Specializes in the treatment of malignant skin neoplasms, recovery from burns. Dr. Duman also performs reconstructive surgeries after cancer. Doctor's procedures MRI of one area Mammography CT (computed tomography) Mastectomy Breast lift Otoplasty (ear plastic) Surgical Breast Reconstruction Lumpectomy Sign up Prof. Orkhan Tanriverdi Oncologist, Surgeon-urologist, Oncosurgeon 28 years of experience Prostate cancer Bladder cancer Kidney cancer Testicular cancer Laparoscopic urology Percutaneous kidney surgery Endourology Urogynecology Robotic urosurgery He combines medical practice with teaching and scientific work. Education Samsat Medical Center (Turkey); Etphal Clinic (Turkey); Wayne University (USA); Avrasia Hospital (Azerbaijan); Hospital OLV (Belgium). Istanbul University (Turkey); Gulhane Military Medical Academy (Turkey); Ankara University (Turkey). Membership in organizations Turkish Association of Urology; Endourological Society; Society of Andrology of Turkey; European Association of Urology; American Urological Association; Scientific editorial board of the endourological bulletin. Sign up Membership in organizations American Urological Association (AUA); European Association of Urology (EAU); International Society for Sexual Medicine (ISSM); Sexual Medicine Society of North America (SMSNA); European Society for Sexual Medicine (ESSM); American Society of Andrology (ASA); Turkish Society of Andrology (TAD); Turkish Urological Association (TUA); Turkish Society of Endourology; Turkish Society of Geriatrics; Istanbul Chamber of Physicians; International Society for Sexual Medicine (ISSM). Membership in organizations American College of Surgeons American College of Physicians National Journal of Surgery; Emergency Medicine Journal; Intensive Care Journal; National Society of Surgery; Society for Endoscopic and Laparoscopic Surgery; Clinic for Enteral and Parenteral Nutrition (KEPAN) Society; Society for Surgical Infection of Europe (President-elect); American Society for Parenteral and Enteral Nutrition; European Society for Parenteral and Enteral Nutrition; Kocaeli Medical Chamber; Hacettepe School of Medicine Alumni Society. Membership in associations American Association of Clinical Oncology (ASCO); European Society for Medical Oncology (ESMO); European Organization for Research and Treatment of Cancer (EORTC), member of the GI and Colorectal Cancer Working Group; Balkan Union of Oncology (BUON); Turkish Society of Oncology (TOD). Якорь 1

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. TREATMENT OF STOMACH CANCER IN TURKEY MENU PAGES: 1. What is worth knowing about gastric cancer treatment? 2. What is the advantage of treating stomach cancer in Turkey? 3. How to choose a clinic for the treatment of stomach cancer and make an appointment? 4. What are the methods for diagnosing stomach cancer? 5. What methods are used by doctors to treat stomach cancer abroad? 6. COST OF TREATMENT AND DIAGNOSTICS OF STOMACH CANCER IN TURKEY 1. What is worth knowing about gastric cancer treatment? The main method of treating the disease at stages 1-3 in the absence of metastases is surgery. In clinics of international level, doctors perform interventions with low-traumatic methods - using a laparoscope or a Da Vinci robot through small incisions up to 2 cm and a traditional open one through an incision up to 15 cm. The choice of technique depends on the size of the neoplasm. International clinics accept patients even with stage 4 stomach cancer. They are prescribed chemotherapy, immunotherapy and radiation therapy. For multiple abdominal metastases (peritoneal carcinomatosis), doctors give HIPEC hot chemotherapy, which improves 5-year survival, according to the Cancer Network. After surgery without intraperitoneal chemotherapy, 6 out of 100 people survive the turn of 5 years, 3. For comparison, after tumor removal and HIPEC, 20 out of 100 patients survive the turn of 5 years, and 15 recover. Where is stomach cancer treated? ➨ Medikal & Estetik Group has gathered clinics throughout Turkey that specialize in the treatment of stomach cancer. The rating is formed based on the choice of our patients. Leave a request on the site to receive detailed advice on the issues of interest to you and the cost of procedures. Our medical coordinator will help you choose the best option for your case and will organize your trip as soon as possible. You do not pay for Medikal & Estetik Group services. 2. What is the advantage of treating stomach cancer in Turkey? Doctors of leading foreign hospitals use all the methods that are included in the international protocol for the treatment of stomach cancer: surgery, immuno-, chemo-, radiation and targeted therapy. Therefore, patients receive the treatment that is most effective in their case, and not the only one possible. 3. How to choose a clinic for the treatment of stomach cancer and make an appointment? Leave a request on our website, and the coordinating doctor of Medikal & Estetik Group will contact you, who will help you choose the best clinic in your case. He will send your documents to the hospital, receive a treatment program and arrange a consultation. From the moment of your request and throughout the entire treatment, we will coordinate you. If necessary, our care department helps patients with the selection of the best-priced tickets and convenient accommodation. Learn more about this from the medical coordinator of Medikal & Estetik Group. Medikal & Estetik Group is an independent medical service that does not represent the interests of specific clinics. Patients do not pay for our services. Hospitals provide their patients with transfer and translation services. Whether your chosen medical center charges an additional fee, check with the coordinating physician of Medikal & Estetik Group. The accompanying person will live in the same room with the patient or in a hotel located next to the medical center. It depends on the clinic. 1. Что стоит знать о лечении рака желудка? 2. В чем преимущество лечения рака желудка за границей? 3. Как выбрать клинику для лечения рака желудка и записаться на консультацию? 4. Какие существуют методы диагностики рака желудка? 4. What are the methods for diagnosing stomach cancer? Methods for diagnosing stomach cancer: A blood test with a test for tumor markers. Shows deviations from the norm in its composition and substances characteristic of stomach cancer. Gastroscopy with biopsy - visual diagnosis of the stomach and collection of affected tissues for analysis. CT. Helps to establish the size, localization of the neoplasm. Tumor histology and immunohistochemistry. Allow 5. Какие методы применяют врачи для лечения рака желудка за рубежом? determine the malignancy of the neoplasm and choose a medicine for therapy. Magnetic resonance imaging (MRI). With its help, doctors determine the prevalence of the pathological process in the abdominal cavity. Positron emission computed tomography (PET-CT). Shows the presence of secondary neoplasms throughout the body. 5. What methods are used by doctors to treat stomach cancer abroad? 1. Surgery for stomach cancer Specialists carry out surgical treatment of stomach cancer for people with stages 1-3 of the pathology. Types of interventions: endoscopic submucosal dissection - removal of a tumor that is located in the mucous membrane. Doctors perform the procedure with an endoscope without any incisions on the body; resection - excision of a part of the stomach. Surgeons perform a resection if the tumor is in the lower part of the organ; gastrectomy - removal of the entire stomach. Intervention is indicated if the neoplasm is localized in the upper part of the stomach or has spread throughout the organ. 2. Radiation therapy (radiotherapy) To reduce the amount of intervention, doctors perform preoperative radiation. Postoperative radiotherapy destroys the remaining abnormal cells. In stage 4 of the disease, therapy relieves symptoms. 3. Chemotherapy to treat stomach cancer To shrink the tumor, oncologists prescribe preoperative chemotherapy. Medical treatment for stomach cancer after surgery destroys the remaining abnormal cells and prevents relapse. In advanced stages of stomach cancer, taking chemotherapy drugs improves the quality of life. 4. Intraperitoneal hot chemotherapy HIPEC Hot chemistry is indicated for patients with an inoperable tumor that has spread to the abdominal organs. During HIPEC, doctors use a heated concentrated preparation. Due to the high temperature, it penetrates deeper into organ tissues and destroys more malignant cells than traditional chemistry. 5. Targeted therapy Targeted drugs block the growth and division of abnormal cells. Such treatment is indicated if the analysis showed a genetic mutation in the tumor. 6. Immunotherapy If the treatment does not work, oncologists prescribe drug immunotherapy Keytruda . It helps the body distinguish malignant cells from healthy ones and destroy them on its own. COST OF TREATMENT AND DIAGNOSIS OF STOMACH CANCER IN TURKEY Comprehensive diagnostics for stomach cancer from $ 2499 Biopsy for stomach cancer from $ 450 CT (computed tomography) for stomach cancer from $ 50 PET-CT for stomach cancer from $ 500 Immunotherapy with Keytruda (Pembrolizumab) for stomach cancer from $ 3300 Da Vinci robotic system for stomach cancer from $ 16,000 Gamma Knife for stomach cancer from $ 6000 Intraperitoneal chemotherapy HIPEC for stomach cancer from $ 20,000 Nano Knife for Stomach Cancer from $ 12000 Radiation therapy for stomach cancer from $ 8500 Stomach cancer surgery from $ 5000 Stomach resection for gastric cancer from $ 5000 СТОИМОСТЬ ЛЕЧЕНИЯ И ДИАГНОСТИКА РАКА ЖЕЛУДКА В ТУРЦИИ

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. TREATMENT OF KIDNEY CANCER IN TURKEY MENU PAGES: 1. Risk factors for kidney cancer 2. Renal cell carcinoma: 2.1. Signs of renal cell carcinoma 2.2. Diagnosis of renal cell carcinoma 2.3. How does cancer spread in renal cell carcinoma patients? 2.4. Treatments for patients with renal cell carcinoma 3. Transitional cell carcinoma of the renal pelvis and ureter 3.1. Signs and symptoms of transitional cell carcinoma of the renal pelvis and ureter 3.2. Factors influence prognosis (chance of recovery) and treatment options. 3.3. Tests for detecting metastases 3.4. How cancer spreads throughout the body 3.5. Types of transitional cell carcinoma of the renal pelvis and ureter 3.6. Treatment methods for patients with transitional cell carcinoma of the renal pelvis and ureter. 4. Wilms' tumors and other kidney tumors in children 4.1. Types of Wilms tumor in children 4.2. Wilms tumor risk factors 4.3. Williams Tumor Screening Tests 4.4. Signs of Williams' tumor 4.5. Tests for the diagnosis of Wilms tumor and other kidney tumors in children 4.6. Factors affecting the prognosis of recovery and treatment options 4.7. How cancer spreads throughout the body 4.8. Treatments for Williams' tumor in children 4.9. Side Effects of Treating Williams' Kidney Tumor in Children COST OF TREATMENT AND DIAGNOSIS OF KIDNEY CANCER IN TURKEY 1. Risk factors for kidney cancer Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk. Risk factors for renal cell carcinoma include the following: Smoking. Abusing certain pain medications, including over-the-counter pain relievers, for a long time. Excess weight . High blood pressure. Has a family history of renal cell carcinoma. The presence of certain genetic diseases, such as von Hippel-Lindau disease or hereditary papillary renal cell carcinoma 2. Renal cell carcinoma Kidney cancer can develop in adults and children. The main types of kidney cancer are renal cell carcinoma, transitional cell carcinoma, and Wilms' tumor. Certain inherited conditions increase the risk of kidney cancer. Explore the links on this page to learn more about kidney cancer treatments, statistics, research, and clinical trials. Renal cell carcinoma is a disease in which malignant (cancerous) cells form in the tubules of the kidneys. Renal cell carcinoma (also called kidney cancer or renal cell adenocarcinoma) is a disease in which malignant (cancerous) cells are found in the lining of the tubules (very small tubes) in the kidneys. Above the waist are 2 kidneys, one on each side of the spine. Tiny tubules in the kidneys filter and purify the blood. They excrete waste products and produce urine. Urine travels from each kidney through a long tube called the ureter into the bladder. The bladder retains urine until it passes through the urethra and leaves the body. Cancer that begins in the ureters or the renal pelvis (the part of the kidney that collects urine and diverts it to the ureters) is different from renal cell carcinoma. 2.1. Signs of renal cell carcinoma These and others signs and symptoms can be caused by renal cell carcinoma or other conditions. Early stages there may be no signs or symptoms. Signs and symptoms may appear as you grow tumors ... Check with your doctor if you have any of the following: Blood in the urine. Bump in belly ... Side pain persists. A loss appetite ... Losing weight for an unknown reason. Anemia ... 2.2. Diagnosis of renal cell carcinoma Tests that examine the abdomen and kidneys are used to diagnose renal cell carcinoma. The following tests and procedures can be used: Physical examination and health history A body exam to check for general signs of health, including checking for signs of illness such as bumps or anything else that seems unusual. There will also be a history of the patient's health habits, as well as past illnesses and treatments. Ultrasound examination : A procedure in which high energy sound waves (ultrasound) are reflected off internal tissues or organs and create an echo. The echo forms a picture of body tissue called a sonogram. Studies of the chemical composition of blood : A procedure in which a blood sample is tested to measure the amount of certain substances that enter the bloodstream by organs and tissues of the body. An unusual (more or less than usual) amount of a substance may be a sign of illness. General urine analysis : a test to check the color of urine and its contents such as sugar, protein, red blood cells and white blood cells. CT (computed tomography) : A procedure in which a series of detailed pictures of areas inside the body, such as the abdomen and pelvis, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed so that organs or tissues can be seen more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (Magnetic Resonance Imaging) : A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI). Biopsy : Removing cells or tissues so that a pathologist can examine them under a microscope to check for signs of cancer. To get a biopsy for renal cell carcinoma, a thin needle is inserted into the tumor and a tissue sample is taken. After renal cell cancer is diagnosed, tests are done to find out if the cancer cells have spread to the kidneys or other parts of the body. The process used to determine if cancer has spread to the kidneys or to other parts of the body is called staging. The information gathered during the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. During the preparation process, the following tests and procedures can be used: CT (computed tomography) : A procedure in which a series of detailed pictures of areas inside the body, such as the chest or brain, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to help organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (magnetic resonance imaging) : A procedure that uses a magnet, radio waves and a computer to create a series of detailed pictures of areas inside the body, such as the brain. This procedure is also called nuclear magnetic resonance imaging (MRI). Chest x-ray : X-ray of internal organs and bones of the chest. An X-ray is a type of energy beam that can pass through a body onto a film, creating an image of areas within the body. Bone scan: a procedure to check for rapidly dividing cells such as cancer cells in the bone. A very small amount of radioactive material is injected into a vein and passed through the bloodstream. The radioactive material builds up in the bones in cancer and is detected by a scanner. 2.3. How does cancer spread in renal cell carcinoma patients? Cancer spreads through the body in three ways. Cancer can spread through tissues, the lymphatic system, and the blood: Textile. Cancer spreads from where it originated to surrounding areas. The lymphatic system. Cancer spreads from where it originated to the lymphatic system. Cancer spreads through the lymphatic vessels to other parts of the body. Blood. Cancer spreads from where it originated into the bloodstream. Cancer spreads through the blood vessels to other parts of the body. Cancer can spread from where it originated to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they originated (primary tumor) and travel through the lymphatic system or blood. The lymphatic system. Cancer enters the lymphatic system, travels through the lymphatic vessels and forms tumor ( metastatic swelling) in another part of the body. Blood. Cancer enters the bloodstream, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. A metastatic tumor is the same type of cancer as the primary tumor. For example, if renal cell carcinoma spreads to the bone, the cancer cells in the bone are actually cancerous kidney cells. The disease is metastatic renal cell carcinoma, not bone cancer. 2.4. Treatments for patients with renal cell carcinoma There are various treatments for renal cell carcinoma patients. Various treatments are available for renal cell carcinoma patients. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. Five types of standard treatments are used: 1.Operation Surgery to remove part or all of the kidney is often used to treat renal cell carcinoma. The following types of surgical procedures can be used: Partial nephrectomy : A surgical procedure to remove a tumor of the kidney and some tissue around it. Partial nephrectomy can be performed to prevent loss of kidney function when the other kidney is damaged or has already been removed. Simple nephrectomy : a surgical procedure to remove only the kidney. Radical nephrectomy : A surgical procedure to remove the kidney, adrenal gland, surrounding tissue and usually nearby lymph nodes. A person can live with part 1 of a working kidney, but if both kidneys are removed or not working, they will need dialysis (a procedure to purify blood with an apparatus outside the body) or a kidney transplant (replacement of a healthy kidney). donor kidney). A kidney transplant can be done if only the kidney is affected and a donor kidney can be found. If the patient needs to wait for a kidney donation, another treatment is prescribed if necessary. When surgery to remove the cancer is not possible, a treatment called arterial embolization can be used to shrink the tumor. A small incision is made and a catheter (thin tube) is inserted into the main blood vessel that flows to the kidney. Small pieces of a special gelatinous sponge are inserted through a catheter into a blood vessel. The sponges block blood flow to the kidneys and prevent cancer cells from receiving oxygen and other substances necessary for growth. After a doctor removes any tumors that can be seen during surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer recurrence is called adjuvant therapy. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. External beam radiation therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. External beam radiation therapy is used to treat renal cell carcinoma and can also be used as palliative therapy to relieve symptoms and improve quality of life. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). 4. Immunotherapy Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances produced by the body or in the laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or biological therapy. The following types of immunotherapy are used in the treatment of renal cell carcinoma: Immune checkpoint inhibitor therapy: Certain types of immune cells, such as T cells and some cancer cells, have certain proteins on their surface called checkpoint proteins that control immune responses. When cancer cells contain large amounts of these proteins, they will not be attacked and killed by T cells. Inhibitors of immune checkpoints block these proteins and the ability of T cells to kill cancer cells is increased. They are used to treat some patients with advanced renal cell carcinoma that cannot be surgically removed. There are two types of immune checkpoint inhibitor therapy: CTLA-4 Inhibitor: CTLA-4 is a protein on the surface of T cells that helps control the body's immune responses. When CTLA-4 attaches to another protein, called B7, on a cancer cell, it stops the T cell from killing the cancer cell. CTLA-4 inhibitors attach to CTLA-4 and allow T cells to kill cancer cells. Ipilimumab is one of the CTLA-4 inhibitors. Inhibitor PD-1 : PD-1 is a protein on the surface of T cells that helps control the body's immune responses. When PD-1 attaches to another protein, called PDL-1, on a cancer cell, it stops the T cell from killing it. PD-1 inhibitors attach to PDL-1 and allow T cells to kill cancer cells. Nivolumab , pembrolizumab and avelumab are types of PD-1 inhibitors. Interferon: Interferon affects cancer cell division and may slow tumor growth. Interleukin-2 (IL-2): IL-2 enhances the growth and activity of many immune cells, especially lymphocytes (a type of white blood cell). Lymphocytes can attack and kill cancer cells. 5. Targeted therapy Targeted therapy uses drugs or other substances to identify and attack certain cancer cells without harming normal cells. Targeted anti-angiogenic therapy is used to treat advanced renal cell carcinoma. Anti-angiogenic agents interfere with the formation of blood vessels in the tumor, causing the tumor to starve and stop growing or shrinking. Monoclonal antibodies and kinase inhibitors are two types of anti-angiogenic agents used to treat renal cell carcinoma. Monoclonal antibody therapy uses antibodies obtained in the laboratory from a single cell type of the immune system. These antibodies can identify substances on cancer cells or normal substances that can promote the growth of cancer cells. Antibodies attach to substances and kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or to carry drugs, toxins, or radioactive materials directly to cancer cells. Monoclonal antibodies, used to treat renal cell carcinoma, attach to and block substances that cause new blood vessels to form in tumors. Bevacizumab is a monoclonal antibody. Kinase inhibitors stop cell division and can prevent the growth of new blood vessels necessary for tumor growth . Vascular endothelial growth factor (VEGF) inhibitors and mTOR inhibitors are kinase inhibitors used in the treatment of renal cell carcinoma. VEGF inhibitors: Cancer cells produce a substance called VEGF, which causes new blood vessels to form (angiogenesis) and helps the cancer grow. VEGF inhibitors block VEGF and prevent new blood vessel formation. This can kill cancer cells because they need new blood vessels to grow. Sunitinib, Pazopanib, cabozantinib, axitinib, sorafenib, and lenvatinib are VEGF inhibitors. MTOR inhibitors: mTOR is a protein that helps cells divide and survive. MTOR inhibitors block mTOR and can inhibit the growth of cancer cells and prevent the growth of new blood vessels necessary for tumor growth. Everolimus and temsirolimus are mTOR inhibitors. 1) 2 1 2) 3) 4) 3. Transitional cell carcinoma of the renal pelvis and ureter Transitional cell carcinoma of the renal pelvis and ureter is a disease in which malignant (cancerous) cells form in the renal pelvis and ureter. The renal pelvis is the upper part of the ureter. The ureter is a long tube that connects the kidney to the bladder. Above the waist are two kidneys, one on each side of the spine. The kidneys of an adult are about 5 inches long and 3 inches wide and are shaped like a bean. Tiny tubules in the kidneys filter and purify the blood. They excrete waste products and produce urine. Urine collects in the middle of each kidney in the renal pelvis. Urine passes from the renal pelvis through the ureter into the bladder. The bladder retains urine until it passes through the urethra and leaves the body. 3 Anatomy of the male urinary system (left panel) and the female urinary system (right panel), showing the kidneys, ureters, bladder and urethra. Urine is produced in the renal tubules and collected in the renal pelvis of each kidney. Urine flows from the kidneys through the ureters into the bladder. Urine is stored in the bladder until it leaves the body through the urethra. The renal pelvis and ureters are lined with transitional cells. These cells can change shape and stretch without collapsing. Transitional cell carcinoma begins in these cells. Transitional cell carcinoma can form in the renal pelvis, ureter, or both. Renal cell carcinoma is the more common type of kidney cancer. 3.1. Signs and symptoms of transitional cell carcinoma of the renal pelvis and ureter These and other signs and symptoms can be caused by transitional cell carcinoma of the renal pelvis and ureter or other conditions. In the early stages, there may be no signs or symptoms. Signs and symptoms may appear as the tumor grows. Check with your doctor if you have any of the following: Blood in the urine. Back pain that does not go away. Great fatigue. Weight loss for no known reason. Painful or frequent urination. 3.1. Ureteroscopy. A ureteroscope (a thin, tube-like instrument with a light and viewing lens) is inserted through the urethra into the ureter. The doctor looks at an image of the inside of the ureter on a computer monitor. Urine cytology : A laboratory test in which a urine sample is checked under a microscope for abnormal cells. Cancer of the kidney, bladder, or ureter can shed cancer cells into the urine. CT (computed tomography) : A procedure in which a series of detailed pictures of areas inside the body are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to help organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. Ultrasound : A procedure in which high energy sound waves (ultrasound) are reflected from internal tissues or organs and create an echo. The echo forms a picture of body tissue called a sonogram. An abdominal ultrasound can help diagnose cancers of the renal pelvis and ureter. MRI (magnetic resonance imaging) : A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body, such as the pelvis. This procedure is also called nuclear magnetic resonance imaging (MRI). Biopsy : Removing cells or tissues so that a pathologist can examine them under a microscope to check for signs of cancer. This can be done during ureteroscopy or surgery. 3.2. Factors influence prognosis (chance of recovery) and treatment options. Forecast depends on the stage and degree tumors. Treatment options depend on the following: Stage and grade of the tumor. Where is the tumor. Whether the patient's other kidney is healthy. Does the cancer have a relapse. Most transitional cell cancers of the renal pelvis and ureter can be cured if detected early. 3.3. Tests for detecting metastases The process used to determine if cancer has spread to the renal pelvis and ureter or to other parts of the body is called staging. The information gathered during the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The doctor, based on the results of diagnostic tests, will help determine the stage of the disease. The following tests and procedures can also be used in the preparation process: Chest x-ray : X-ray of organs and bones inside the chest. An X-ray is a type of energy beam that can pass through a body onto a film, creating an image of areas within the body. PET scan (positron emission tomography) : a procedure to search for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Malignant tumor cells appear brighter in the image because they are more active and consume more glucose than normal cells. Bone scan : A procedure to check for rapidly dividing cells such as cancer cells in the bone. A very small amount of radioactive material is injected into a vein and passed through the bloodstream. The radioactive material builds up in the bones in cancer and is detected by a scanner. 3.4. How cancer spreads throughout the body Cancer can spread through tissues, the lymphatic system, and the blood: Textile. Cancer spreads from where it originated to surrounding areas. The lymphatic system . Cancer spreads from where it originated to the lymphatic system. Cancer spreads through the lymphatic vessels to other parts of the body. Blood. Cancer spreads from where it originated into the bloodstream. Cancer spreads through the blood vessels to other parts of the body. Cancer can spread from where it originated to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they originated (primary tumor) and travel through the lymphatic system or blood. The lymphatic system. Cancer enters the lymphatic system, travels through the lymphatic vessels, and forms a tumor (metastatic tumor) in another part of the body. Blood. Cancer enters the bloodstream, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. A metastatic tumor is the same type of cancer as the primary tumor. For example, if transitional cell carcinoma of the ureter has spread to the lungs, the lung cancer cells are actually ureteral cancer cells. The disease is metastatic cancer of the ureter, not lung cancer. 3.5. Types of transitional cell carcinoma of the renal pelvis and ureter Transitional cell carcinoma of the renal pelvis and ureter is also described as localized, regional, metastatic, or recurrent: 1. Localized Cancer is found only in the kidneys. 2. Regional The cancer has spread to tissues around the kidney and nearby lymph nodes and blood vessels in the pelvic region. 3. Metastatic The cancer has spread to other parts of the body. 4. Recurrent The cancer was recurred (come back) after it was treated. Cancer can return to the renal pelvis, ureter, or other parts of the body such as the lungs, liver, or bone. 3.6. Treatment methods for patients with transitional cell carcinoma of the renal pelvis and ureter. Various treatments are available for patients with transitional cell carcinoma of the renal pelvis and ureter. Some treatments are standard (currently used) and some are in clinical trials. A clinical trial of treatment is a scientific study designed to help improve current treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than standard treatment, the new treatment may become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. One type of standard treatment is used: 1. Operation One of the following surgical procedures can be used to treat transitional cell carcinoma of the renal pelvis and ureter: Nephroureterectomy : Surgery to remove the entire kidney, ureter, and bladder cuff (the tissue that connects the ureter to the bladder). Segmental ureteral resection: A surgical procedure to remove a portion of the ureter with cancer and a portion of the healthy tissue around it. Then the ends of the ureter are reattached. This procedure is used when the cancer is superficial and only near the bladder in the lower third of the ureter. 2. Fulguration is a surgical procedure in which tissue is destroyed by an electric current. An instrument with a small wire loop at the end is used to remove a tumor or to burn off a tumor with electricity. 3. Segmental resection of the renal pelvis It is a surgical procedure to remove localized cancer from the renal pelvis without removing the entire kidney. Segmental resection can be done to preserve renal function when the other kidney is damaged or has already been removed. 4. Laser surgery A laser beam (a narrow beam of intense light) is used like a knife to remove cancer. The laser beam can also be used to kill cancer cells. This procedure can also be called laser fulguration. 5. Regional chemotherapy and regional biological therapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. Biological therapy is a treatment that uses the patient's immune system to fight cancer; substances produced by the body or made in a laboratory are used to enhance, direct or restore the body's natural defenses against cancer. Local treatment means that anticancer drugs or biological agents are injected directly into an organ or body cavity, such as the abdominal cavity, so the drugs will affect cancer cells in that area. Clinical trials are looking at chemotherapy or biologic therapy using drugs that are injected directly into the renal pelvis or ureter. 4. Wilms' tumors and other kidney tumors in children Kidney tumors in children are diseases in which malignant (cancerous) cells form in the tissues of the kidneys. Above the waist are two kidneys, one on each side of the spine. Tiny tubules in the kidneys filter and purify the blood. They excrete waste products and produce urine. Urine travels from each kidney through a long tube called the ureter into the bladder. The bladder retains urine until it passes through the urethra and leaves the body. 3.2. 3.3. 3.4. 3.5. 3.6. 4 Anatomy of the female urinary system: kidneys, adrenal glands, ureters, bladder and urethra. Urine is produced in the renal tubules and collected in the renal pelvis of each kidney. Urine flows from the kidneys through the ureters into the bladder. Urine is stored in the bladder until it leaves the body through the urethra. 4.1. Types of Wilms tumor in children There are many types of kidney tumors in children. 1. Wilms' tumor With Wilms' tumor, one or more tumors may be found in one or both kidneys. Wilms' tumor can spread to the lungs, liver, bones, brain, or nearby lymph nodes. In children and adolescents under the age of 15, the majority of kidney cancers are Wilms' tumors. 2. Renal cell carcinoma (RCC) Renal cell carcinoma is rare in children and adolescents under 15 years of age. It is much more common in adolescents from 15 to 19 years old. Children and adolescents are more likely to be diagnosed with a large renal cell tumor or cancer that has spread. Renal cell carcinoma can spread to the lungs, liver, bones, or lymph nodes. Renal cell carcinoma can also be called renal cell carcinoma. 3. Rhabdoid tumor of the kidney Rhabdoid kidney tumor is a type of kidney cancer that is more common in infants and young children. At the time of diagnosis, the disease is often progressing. A renal rhabdoid tumor grows rapidly and spreads, often to the lungs or brain. Children with a specific SMARCB1 gene change can also grow tumors in the kidney, brain, or soft tissue. These children are regularly checked for a rhabdoid tumor in the kidney or brain: Children from birth or diagnosis under 5 years old MRI head and dorsal brain and Abdominal ultrasound every 3 months. 4. Clear cell sarcoma of the kidney Clear cell renal sarcoma is an uncommon kidney cancer that can spread to the bones, lungs, brain, liver, or soft tissue. Most often occurs before the age of 3 years. It can recur (come back) up to 14 years after treatment, often in the brain or lungs. 5. Congenital mesoblastic nephroma Congenital mesoblastic nephroma is a tumor of the kidney that is often diagnosed during the first year of life or before birth. It is the most common kidney tumor found in children under 6 months of age and is more common in men than women. It can usually be cured. 6. Ewing's sarcoma of the kidneys Ewing's sarcoma (formerly called neuroepithelial tumor) of the kidney is rare and usually occurs in young adults. This cancer grows rapidly and spreads to other parts of the body. 7. Primary myoepithelial carcinoma of the kidney Primary myoepithelial carcinoma of the kidney is a rare type of cancer that usually affects soft tissue but sometimes forms in internal organs (such as the kidneys). This cancer grows and spreads rapidly. 8. Cystic partially differentiated nephroblastoma Cystic partially differentiated nephroblastoma is a very rare type of Wilms tumor, consisting of cysts. 9. Multilocular cystic nephroma Multilocular cystic nephroma is a benign tumor of cysts that is most common in infants, young children, and adult women. These tumors can occur in one or both kidneys. Children with this type of tumor may also have pleuropulmonary blastoma, so imaging tests are done to check the lungs for cysts or solid tumors. Since multilocular cystic nephroma can be hereditary, genetic counseling and genetic testing may be considered. For more information, see the PDQ Summary of Pediatric Pleuropulmonary Blastoma Management. 10. Primary renal synovial sarcoma Primary synovial renal sarcoma is a cystic tumor of the kidney that is most common in young adults. These tumors grow and spread rapidly. 11. Anaplastic renal sarcoma Anaplastic renal sarcoma is a rare tumor that most often occurs in children or adolescents under 15 years of age. Anaplastic renal sarcoma often spreads to the lungs, liver, or bones. Imaging tests may be performed that check the lungs for cysts or solid tumors. Since anaplastic sarcoma can be hereditary, genetic counseling and genetic testing may be considered. Nephroblastomatosis is not cancer, but it can develop into Wilms tumor. Sometimes, after the kidneys form in the fetus, abnormal groups of kidney cells remain in one or both of the kidneys. In nephroblastomatosis (diffuse hyperplastic perilobar nephroblastomatosis), these abnormal groups of cells can grow in many places within the kidney or form a thick layer around the kidney. When these groups of abnormal cells are found in a kidney after removal for a Wilms tumor, the child is at increased risk of a Wilms tumor in the other kidney. Regular follow-up is important at least every 3 months for at least 7 years after the child is diagnosed or treated. 4.2. Wilms tumor risk factors Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your child's doctor if you think your child may be at risk. Wilms' tumor may be part of a genetic syndrome that affects growth or development. A genetic syndrome is a collection of signs and symptoms or conditions that occur together and are caused by certain changes in genes. Certain conditions or environmental influences can also increase a child's risk of developing Wilms tumor. The following has been associated with Wilms' tumor: WAGR syndrome (Wilms tumor, aniridia, anomaly of the genitourinary system and mental retardation). Denis-Drash syndrome (anomaly of the genitourinary system). Fraser's syndrome (an anomaly of the genitourinary system). Beckwith-Wiedemann syndrome (abnormally large growth of one or more body parts, large tongue, umbilical hernia at birth and abnormalities of the genitourinary system). Family history of Wilms tumor. Aniridia (part or all of the iris, the colored part of the eye is missing). Isolated hemihyperplasia (abnormally large growth of one or more parts of the body). Urinary tract problems such as cryptorchidism or hypospadias. The baby's mother was exposed to pesticides during pregnancy. Having certain conditions can increase your risk of renal cell cancer. Renal cell carcinoma can be associated with the following conditions: Von Hippel-Lindau disease (an inherited disorder that causes abnormal growth of blood vessels). Children with von Hippel-Lindau disease should be screened annually for kidney cancer by abdominal ultrasound or MRI (magnetic resonance imaging), starting at 8-11 years of age. Tuberous sclerosis (an inherited disorder characterized by benign fatty cysts in the kidneys). Familial renal cell carcinoma (an inherited disorder that occurs when certain changes in the genes that cause kidney cancer are passed from parent to child). Medullary kidney cancer (rare kidney cancer that grows and spreads rapidly). Hereditary leiomyomatosis (an inherited disorder that increases the risk of cancers of the kidney, skin, and uterus). Chemotherapy or radiation therapy for childhood cancers such as neuroblastoma, soft tissue sarcomas, leukemia, or Wilms' tumor may also increase the risk of kidney cancer. 4.3. Williams Tumor Screening Tests Screening tests are performed on children at increased risk of Wilms' tumor. These tests can help detect cancer early and reduce the chances of dying from cancer. In general, children with an increased risk of Wilms tumor should be screened for Wilms tumor every 3 months until they are 8 years old. Abdominal ultrasound is usually used for screening. Small Wilms tumors can be detected and removed before symptoms appear. Children with Beckwith-Wiedemann syndrome or hemihyperplasia are also screened for liver and adrenal tumors that are associated with these genetic syndromes. A test to check the level of alpha-fetoprotein (AFP) in the blood and an ultrasound of the abdominal cavity are performed up to 4 years of age. An ultrasound of the kidneys is done at the age of 4 to 7 years. A medical examination by a specialist (geneticist or pediatric oncologist) is done twice a year. In children with certain gene changes, a different abdominal ultrasound schedule may be used. Children with aniridia and a certain gene change are tested for Wilms tumor every 3 months until they are 8 years old. An abdominal ultrasound is used for screening. Some children develop Wilms' tumor in both kidneys. They often appear when a Wilms tumor is first diagnosed, but a Wilms tumor can also occur in a second kidney after successfully treating a child for a Wilms tumor in one kidney. Children with an increased risk of a second Wilms tumor in another kidney should be screened for Wilms tumor every 3 months for up to 8 years. Abdominal ultrasound can be used for screening. 4.4. Signs of Williams' tumor Sometimes childhood kidney tumors do not cause signs and symptoms, and the parent finds the mass in the abdomen by accident or the mass is in the process of a good child health check. These and other signs and symptoms can be caused by kidney tumors or other conditions. Check with your child's doctor if your child has any of the following: A lump, swelling, or pain in the abdomen. Blood in the urine. High blood pressure (headache, feeling very tired, chest pain, or problems with vision or breathing). Hypercalcemia (loss of appetite, nausea and vomiting, weakness or feeling very tired). Fever for no known reason. Loss of appetite. Losing weight for an unknown reason. A Wilms tumor that has spread to the lungs or liver can cause the following signs and symptoms: Cough. Blood in sputum. Labored breathing. Abdominal pain. 4.5. Tests for the diagnosis of Wilms tumor and other kidney tumors in children The following tests and procedures can be used: Physical examination and health history A body exam to check for general signs of health, including checking for signs of illness such as bumps or anything else that seems unusual. There will also be a history of the patient's health habits, as well as past illnesses and treatments. Complete blood count (CBC) : a procedure in which a blood sample is taken and checked for the following: The number of erythrocytes, leukocytes and platelets. The amount of hemoglobin (oxygen-carrying protein) in red blood cells. The portion of a blood sample made up of red blood cells. Studies of the chemical composition of blood : A procedure in which a blood sample is tested to measure the amount of certain substances that enter the bloodstream by organs and tissues of the body. An unusual (more or less than usual) amount of a substance may be a sign of illness. This test is done to check how well the liver and kidneys are working. Kidney function test: A procedure in which blood or urine samples are analyzed to measure the amount of certain substances excreted by the kidneys into the blood or urine. An increased or less than normal amount of a substance may be a sign that the kidneys are not working properly. Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, blood, and bacteria. Ultrasound procedure : A procedure in which high energy sound waves (ultrasound) are reflected from internal tissues or organs and create an echo. The echo forms a picture of body tissue called a sonogram. To diagnose a kidney tumor, an ultrasound of the abdominal cavity is done. 4.1. 4.2. 4.3. 4.4 4.5. Abdominal ultrasound. An ultrasound probe connected to the computer is pressed against the abdominal skin. The transducer reflects sound waves from internal organs and tissues, creating an echo that forms a sonogram (computer image). CT (computed tomography) : A procedure in which a series of detailed images of areas inside the body, such as the chest, abdomen and pelvis, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye will be injected into a vein or swallowed to make organs and tissues more visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (magnetic resonance imaging) with gadolinium : A procedure that uses a magnet, radio waves, and a computer to create a series of detailed images of areas inside the body, such as the abdomen. A substance called gadolinium is injected into a vein. Gadolinium gathers around cancer cells, so they appear brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (MRI). X-ray : An X-ray is a type of energy beam that can pass through the body onto a film, creating an image of areas inside the body, such as the chest and abdomen. PET-CT : A procedure that combines positron emission tomography (PET) and computed tomography (CT) images. PET and CT scans are performed simultaneously on the same machine. Images from both scans are combined to create a more detailed picture than any test could do on its own. A PET scan is a procedure to look for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Cancer cells appear brighter because they are more active and consume more glucose than normal cells. Biopsy : Removing cells or tissues so that a pathologist can examine them under a microscope to check for signs of cancer. The decision to have a biopsy is based on the following: The size of the tumor. Stage of cancer. If the tumor appears to be resectable or Wilms' tumor is stage I or II, biopsy is not performed to avoid proliferation of tumor cells during the procedure. Whether there is cancer in one or both kidneys. Whether cancer is clearly shown on imaging. Whether the patient is in a clinical trial. A biopsy can be done before starting treatment, after chemotherapy to shrink a tumor, or after surgery to remove a tumor. 4.6. Factors influencing the forecast convalescence and treatment options The prognosis and treatment options for Wilms' tumor depend on the following conditions: How tumor cells differ from normal kidney cells under a microscope. Stage of cancer. The type of tumor. Child's age. Is it possible to completely remove the tumor with surgery? Are there any changes in chromosomes or genes. Whether the cancer has just been diagnosed or has recurred (returned). The prognosis for renal cell carcinoma depends on the following: Stage of cancer. Whether the cancer has spread to the lymph nodes. The prognosis for rhabdoid kidney tumors depends on the following: The age of the child at the time of diagnosis. Stage of cancer. Whether the cancer has spread to the head or spinal cord ... The prognosis for clear cell sarcoma of the kidney depends on the following: The age of the child at the time of diagnosis. Stage of cancer. 4.7. How cancer spreads throughout the body Cancer spreads through the body in three ways. Cancer can spread through tissues, the lymphatic system, and the blood: Textile. Cancer spreads from where it originated to surrounding areas. The lymphatic system. Cancer spreads from where it originated to the lymphatic system. Cancer spreads through the lymphatic vessels to other parts of the body. Blood. Cancer spreads from where it originated into the bloodstream. Cancer spreads through the blood vessels to other parts of the body. Cancer can spread from where it originated to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they originated (primary tumor) and travel through the lymphatic system or blood. The lymphatic system. Cancer enters the lymphatic system, travels through the lymphatic vessels, and forms a tumor (metastatic tumor) in another part of the body. Blood. Cancer enters the bloodstream, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. A metastatic tumor is the same type of cancer as the primary tumor. For example, if a Wilms tumor spreads to the lungs, the cancer cells in the lungs are actually Wilms tumor cells. The disease is Wilms' metastatic tumor, not lung cancer. 4.8. Treatments for Williams' tumor in children There are various treatments for patients with Wilms' tumor and other kidney tumors in children. Various treatments are available for children with Wilms kidney tumors and other childhood kidney tumors. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Because cancer is rare in children, clinical trials should be considered. Some clinical trials are only open to patients who have not yet started treatment. Children with Wilms' tumor or other kidney tumors in children should plan for treatment with a team of healthcare professionals who are experts in treating childhood cancer. Your child's treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric providers who are experts in treating children with Wilms' tumor or other kidney tumors in children and who specialize in specific areas of medicine. This may include the following specialists: Pediatrician. Pediatric surgeon or urologist. Radiologist oncologist. Rehabilitation specialist. Specialist Pediatric Nurse. Social worker . Six types of treatments are used: 1. Operation Two types of surgeries are used to treat kidney tumors: Nephrectomy : Wilms tumor and other kidney tumors in children are usually treated with nephrectomy (surgery to remove the entire kidney). You can also remove nearby lymph nodes and check them for signs of cancer. Sometimes a kidney transplant (surgery to remove a kidney and replace it with a kidney from a donor) is done when the cancer affects both kidneys and the kidneys are not working properly. Partial nephrectomy : If cancer is found in both kidneys or may have spread to both kidneys, surgery may include partial nephrectomy (removal of a tumor in the kidney and a small amount of normal tissue around it). A partial nephrectomy is done to keep the kidneys working. Partial nephrectomy is also called renal sparing surgery. After a doctor removes any tumors that can be seen during surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer recurrence is called adjuvant therapy. Sometimes surgery is done again to see if the cancer remains after chemotherapy or radiation therapy. Sometimes the tumor cannot be removed with surgery for one of the following reasons: The tumor is too close to important organs or blood vessels. The tumor is too large to be removed. Cancer affects both kidneys if the tumors are not very small. There is a blood clot in the vessels near the liver. The patient has trouble breathing because the cancer has spread to the lungs. In this case, a biopsy is done first. Chemotherapy is then given to reduce the size of the tumor before surgery, to preserve as much healthy tissue as possible and reduce problems after surgery. This is called neoadjuvant chemotherapy. Radiation therapy is given after surgery. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. External beam radiation therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. External beam radiation therapy is used to treat Wilms' tumor and other kidney tumors in children. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Combination chemotherapy is treatment with two or more anticancer drugs. Systemic chemotherapy is used to treat Wilms' tumor and other kidney tumors in children. Chemotherapy is sometimes given before surgery to reduce the size of the tumor, to preserve as much healthy tissue as possible and to reduce problems after surgery. This is called neoadjuvant chemotherapy. 4. Immunotherapy Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances produced by the body or in the laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biological therapy. Interferon and interleukin-2 (IL-2) are types of immunotherapy used to treat renal cell carcinoma in children. Interferon can slow tumor growth and help kill cancer cells. IL-2 enhances the growth and activity of many immune cells, especially lymphocytes (a type of white blood cell). Lymphocytes can attack and kill cancer cells. 5. High-dose stem cell rescue chemotherapy High doses of chemotherapy are prescribed to kill cancer cells. Healthy cells, including hematopoietic cells, are also destroyed in cancer treatments. Stem cell rescue is a treatment to replace hematopoietic cells. Stem cells (immature blood cells) are removed from the patient's blood or bone marrow, frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and returned to the patient as an infusion. These stem cells turn into (and repair) blood cells. High-dose stem cell rescue chemotherapy can be used to treat rhabdoid kidney tumor or recurrent Wilms tumor. 6. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and destroy certain cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. Targeted therapies used to treat kidney tumors in children may include the following: Tyrosine kinase inhibitors: This targeted therapy blocks the signals that cancer cells need to grow and divide. Larotrectinib and entrectinib can be used to treat congenital mesoblastic nephroma with a specific gene change that cannot be removed with surgery, has spread to other parts of the body, or has continued to grow during treatment. This combination is also being studied for the treatment of congenital mesoblastic nephroma that has returned after treatment. Sunitinib or cabozantinib can be used to treat renal cell carcinoma. Axitinib is being studied in combination with a monoclonal antibody (nivolumab) to treat renal cell carcinoma that cannot be surgically removed or has spread to other parts of the body. Histone methyltransferase inhibitors: This targeted therapy can inhibit the growth and division of cancer cells. Tasemetostat is being studied for the treatment of a rhabdoid kidney tumor that does not respond or has returned after treatment. Monoclonal Antibody Therapy: Monoclonal antibodies of the immune system are proteins made in the laboratory for the treatment of many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that can promote cancer cell growth. The antibodies are then able to kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or to carry drugs, toxins, or radioactive materials directly to cancer cells. Nivolumab, or a combination of nivolumab and a tyrosine kinase inhibitor (axitinib), is being studied for renal cell carcinoma that cannot be removed with surgery or has spread to other parts of the body. 4.9. Side Effects of Treating Williams' Kidney Tumor in Children Treating Wilms' tumor and other kidney tumors in children can cause side effects. Side effects from cancer treatments that start after treatment and last for months or years are called late effects. Late effects of cancer treatments may include the following: Physical problems such as heart, kidney, or pregnancy problems. Infertility. Changes in mood, feelings, thinking, learning, or memory. A second cancer (newer cancers), such as leukemia, gastrointestinal cancer, or breast cancer. Some late effects can be treated or controlled. It is important to talk with your child's healthcare providers about the impact cancer treatment can have on your child. Clinical trials are being done to find out if lower doses from chemotherapy and radiation can be used to reduce the late effects of treatment without changing how well the treatment works. Monitoring for late kidney-related effects in patients with Wilms tumor and related conditions includes the following: Children with WAGR syndrome are monitored throughout their lives as they are at increased risk of developing hypertension and kidney disease. Children with Wilms' tumor and genitourinary abnormalities are monitored because they are at increased risk of late renal failure. Patients with Wilms tumor and aniridia without genitourinary pathology are at lower risk but are monitored for kidney disease or renal failure. 4.6. 4.7. 4.8. 4.9. COST OF TREATMENT AND DIAGNOSIS OF KIDNEY CANCER IN TURKEY Kidney cancer biopsy from $ 450 CT (computed tomography) for kidney cancer from $ 50 PET-CT for kidney cancer from $ 500 Chemotherapy for breast cancer from $ 1200 Cyberknife for kidney cancer from $ 4400 Da Vinci robotic system for kidney cancer from $ 16,000 Gamma Knife for Kidney Cancer from $ 6000 Nano Knife for Kidney Cancer from $ 12,000 Removal of the kidney for kidney cancer from $ 10,000 Radiation therapy for rectal cancer on request сттт Need help? Doctors-coordinators will advise you and help you with the choice. Medikal & Estetik Group services are free of charge for you and do not affect the clinic bill. Find a solution Medikal & Estetik Group coordinator will help you find the best solution for cancer treatment CHOOSE CLINIC About Medikal & Estetik Group Second opinion Before traveling, you can get an opinion from a Turkish doctor on your diagnosis and prescribed treatment. 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Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. All about plastic surgery in Turkey No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. DIAGNOSTIC PROCEDURES Contrast-enhanced CT in Turkey Oncological screening in Turkey PET / CT in Turkey 3D Computed Tomography in Turkey Check-UP diagnostics in Turkey BRAF genetic mutation in Turkey Fusion biopsy in Turkey Endoscopic ultrasound biopsy in Turkey Genetic analysis in Turkey Endoscopy in Turkey Ultrasound-guided transrectal biopsy in Turkey AREAS OF SPECIALIZATION. DIAGNOSES Cancer treatment in Turkey Neurosurgery in Turkey Neurology in Turkey Cardiac surgery in Turkey Dentistry in Turkey Plastic surgery in Turkey Ophthalmology in Turkey Transplantology in Turkey Orthopedics and Traumatology in Turkey

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. Key points about ultrasound-guided endoscopic biopsy In the meantime, there is no need to worry about it. ” No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. 3 min read 6 most frequently asked questions about anesthesia There are no baseless fears. Someone has had an unpleasant experience of anesthesia in a clinical hospital, and that was... Post not marked as liked 4 min read HOW TO CHOOSE A BREAST IMPLANT BY SHAPE AND VOLUME The eternal topic of breast prosthetics is the choice of a breast implant. At first glance, it may seem that how many people, so many... 1 like. Post not marked as liked 1 2 min read ПОДТЯЖКА БРОВЕЙ ИЛИ ПОДТЯЖКА ЛБА Меню страницы: 1. ЧТО ТАКОЕ ПОДТЯЖКА БРОВЕЙ? 2. КТО ОБРАЩАЕТСЯ ЗА ПОДТЯЖКОЙ? 3. КАКАЯ АНЕСТЕЗИЯ ИСПОЛЬЗУЕТСЯ? 4. ОБЩИЕ СВЕДЕНИЯ Брови... Post not marked as liked 2 min read Главное об офтальмологии в Турции Меню страницы: ДИАГНОСТИКА МЕТОДЫ ЛЕЧЕНИЯ ВОССТАНОВЛЕНИЕ ЗРЕНИЯ СТОИМОСТЬ 80% случаев нарушения зрения могут быть обратимыми. В турецких... Post not marked as liked 4 min read Ринопластика в Турции Меню страницы: ЧТО ТАКОЕ РИНОПЛАСТИКА? ПОКАЗАНИЯ И ПРОТИВОПОКАЗАНИЯ К РИНОПЛАСТИКЕ ДИАГНОСТИКА И КОНСУЛЬТАЦИЯ ПЕРЕД РИНОПЛАСТИКОЙ МЕТОДЫ... Post not marked as liked 5 min read Главное о лечении рака в Турции Меню страницы: МЕТОДЫ ДИАГНОСТИКИ ДИАГНОСТИКА ОНКОЛОГИИ В ТУРЦИИ ЛЕЧЕНИЕ РАКА В ТУРЦИИ ИННОВАЦИОННАЯ МЕТОДИКА ЛЕЧЕНИЯ РАБОТА С БОЛЬНЫМИ... Post not marked as liked

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. MEDIKAL & ESTETIK GROUP medikal.estetik.group@gmail.com +90 505 479 19 17 Name Email post office Telephone Address Subject Message Send message Submitted. Thank you!

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. To test this feature, visit your live site. All Posts My Posts Форум Добро пожаловать! Осмотритесь вокруг и присоединяйтесь к обсуждениям. Already Have an Account? Log in to access the forum. Log In Sign Up Today Join the forum to check out the posts and add your voice. Get Started Forum - Frameless

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. The main thing about neurosurgery in Turkey No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. Fusion Biopsy Essentials No posts published in this language yet Once posts are published, you’ll see them here.

1. САРКОМА МЯГКИХ ТКАНЕЙ У ВЗЛОСЛОГО 2. ЛЕЧЕНИЕ СТРОМАЛЬНЫХ ОПУХОЛЕЙ ЖЕЛУДОЧНО-КИШЕЧНОГО ТРАКТА (взрослые) 3. ЛЕЧЕНИЕ СТРОМАЛЬНЫХ ОПУХОЛЕЙ ЖЕЛУДОЧНО-КИШЕЧНОГО ТРАКТА У ДЕТЕЙ  4. ЛЕЧЕНИЕ САРКОМЫ КАПОШИ 5. ЛЕЧЕНИЕ РАБДОМОИСАРКОМ В ДЕТСТВЕ  6. ЛЕЧЕНИЕ САРКОМЫ МЯГКИХ ТКАНЕЙ У ДЕТЕЙ  7. ЛЕЧЕНИЕ СОСУДИСТЫХ ОПУХОЛЕЙ У ДЕТЕЙ  Стоимость лечения и диагностики в Турции TREATMENT OF SOFT TISSUE SARCOMA IN TURKEY MENU PAGES 1. SOFT TISSUE SARCOMA IN AN ADULT 1.1. General information about soft tissue sarcoma 1.2. Risks of developing sarcoma in adults 1.3. Sarcoma Symptoms 1.4. Diagnosis of Sarcoma 1.5. Factors affecting the chance of recovery 1.6. Stages of soft tissue sarcoma in adults 1.7. Overview of treatment options 2. TREATMENT OF STROMAL TUMORS OF THE GASTROINTESTINAL TRACT (adults) 2.1. Risks of developing a stromal tumor of the gastrointestinal tract 2.2. Symptoms of the development of a stromal tumor of the gastrointestinal tract 2.3. Diagnostics of the stromal tumor of the gastrointestinal tract 2.4. Recovery prognosis 2.5. Overview of treatment options 3. TREATMENT OF STROMAL TUMORS OF THE GASTROINTESTINAL TRACT IN CHILDREN 3.1. Symptoms 3.2 Diagnostics 3.3. Overview of treatment options 4. TREATMENT OF KAPOSHA'S SARCOMA 4.1. Diagnostics 4.2. Factors affecting the prognosis of recovery 4.3. Classic Kaposi's sarcoma 4.4. Epidemic Kaposi's sarcoma (HIV-associated Kaposi's sarcoma) 4.5. Overview of treatment options 5. TREATMENT WITH RABDOMOISARCOM IN CHILDHOOD 5.1. Risks of developing rhabdomyosarcoma in children 5.2. Symptoms 5.3. Diagnostics 5.4. Factors influencing the forecast 5.5. Stages of childhood rhabdomyosarcoma 5.6. Overview of treatment options 5.7. Side Effects of Treatment 5.8. Treatment of childhood rhabdomyosarcoma 5.9. Treatment of progressive or recurrent childhood rhabdomyosarcoma 6. TREATMENT OF SOFT TISSUE SARCOMA CHILDREN 6.1. Risks of developing sarcoma of myanic tissues in children 6.2. Symptoms 6.3. Diagnostics 6.4. Types of soft tissue sarcoma tumors in children 6.5. Factors affecting the prognosis of recovery 6.6. Overview of treatment options infantile soft tissue sarcoma 6.7. Treatment for soft tissue sarcoma in children can cause side effects. 6.8. Treatment options for soft tissue sarcoma in children 7. TREATMENT OF VASCULAR TUMORS IN CHILDREN 7.1. Tests are used to detect (search) and diagnose vascular tumors in children. 7.2. Groups of vascular tumors in children 7.3. Overview of treatment options 7.4. Benign tumors 7.5. Intermediate tumors that spread locally 7.6. Intermediate tumors that rarely spread 7.7. Malignant tumors 1. SOFT TISSUE SARCOMA IN AN ADULT Soft tissue sarcoma is a broad term for cancers that begin in soft tissues (muscles, tendons, fat, lymphatic and blood vessels, and nerves). These cancers can develop anywhere in the body, but are more common in the arms, legs, chest, and abdomen. Explore the links on this page to learn more about the different types of soft tissue sarcomas and how to treat them. We also have information on research and clinical trials. 1.1. General information about soft tissue sarcoma Adult soft tissue sarcoma is a disease in which malignant (cancerous) cells form in the soft tissues of the body. The soft tissues of the body include muscles, tendons (bands of fibers that connect muscles to bones), fat, blood vessels, lymphatic vessels, nerves, and tissues around joints. Soft tissue sarcomas in adults can form almost anywhere in the body, but are most common in the head, neck, arms, legs, trunk, abdomen, and retroperitoneal space. 1.1. Якорь 1 Soft tissue sarcoma forms in the soft tissues of the body, including muscles, tendons, fat, blood vessels, lymph vessels, nerves, and tissues around joints. There are many types of soft tissue sarcomas. In each type of cell, sarcomas look different under a microscope, based on the type of soft tissue in which the cancer started. 1.2. Risks of developing sarcoma in adults Having certain inherited conditions can increase the risk of soft tissue sarcoma in adults. Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk. Risk factors for soft tissue sarcoma include the following inherited conditions: Retinoblastoma. Neurofibromatosis type 1 (NF1; von Recklinghausen's disease). Tuberous sclerosis (Bourneville disease). Familial adenomatous polyposis (FAP; Gardner's syndrome). Li-Fraumeni syndrome. Werner's syndrome (progeria in adults). Nevoid basal cell carcinoma syndrome (Gorlin's syndrome). Other risk factors for soft tissue sarcoma include the following: Past radiation therapy for certain cancers. Exposure to certain chemicals such as thorotrast (thorium dioxide), vinyl chloride, or arsenic. Swelling (lymphedema) of the hands or feet for a long time. 1.3. Sarcoma Symptoms A sign of adult soft tissue sarcoma is a lump or swelling in the soft tissues of the body. A sarcoma can present as a painless mass under the skin, often on an arm or leg. Sarcomas that start in the abdomen may not cause signs or symptoms until very large. As the sarcoma grows larger and puts pressure on nearby organs, nerves, muscles, or blood vessels, signs and symptoms may include: Pain. Labored breathing. Other conditions can cause the same signs and symptoms. Check with your doctor if you have any of these problems. 1.4. Diagnosis of Sarcoma Adult soft tissue sarcoma is diagnosed by biopsy. If your doctor thinks you may have soft tissue sarcoma, a biopsy will be done. The type of biopsy depends on the size of the tumor and its location in the body. Three types of biopsies can be used: Postoperative biopsy: Removal of part of a tumor or tissue sample. Primary biopsy: Removal of tissue with a wide needle. Excisional biopsy: Removal of an entire tumor or area of tissue that does not appear normal. Samples will be taken from the primary tumor, lymph nodes, and other suspicious areas. The pathologist examines the tissue under a microscope for the presence of cancer cells and finds out the grade of the tumor. The extent of the tumor depends on how abnormal the cancer cells look under the microscope and how quickly the cells divide. High-grade tumors usually grow and spread faster than low-grade tumors. Because soft tissue sarcoma is difficult to diagnose, patients should ask that tissue samples be screened by a pathologist experienced in diagnosing soft tissue sarcoma. The following tests can be performed on the removed tissue: Immunohistochemistry: a laboratory test that uses antibodies to check for specific antigens (markers) in a tissue sample from a patient. Antibodies are usually associated with an enzyme or fluorescent dye. After antibodies bind to a specific antigen in a tissue sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test is used to help diagnose cancer and to help distinguish one type of cancer from another. Light and electron microscopy: A laboratory test in which cells in a tissue sample are viewed under a conventional and high-power microscope to detect specific changes in the cells. Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a tissue sample are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in some chromosomes can be a sign of cancer. Cytogenetic analysis is used to diagnose cancer, plan treatment, or determine the effectiveness of a treatment. FISH (Fluorescence In Situ Hybridization): A laboratory test used to study and count genes or chromosomes in cells and tissues. Pieces of DNA containing fluorescent dyes are made in the laboratory and added to a sample of the patient's cells or tissues. When these stained DNA fragments attach to specific genes or regions of chromosomes in a sample, they light up when viewed under a fluorescent microscope. The FISH test is used to diagnose cancer and plan treatment. Flow cytometry: A laboratory test that measures the number of cells in a sample, the percentage of living cells in the sample, and certain characteristics of cells such as size, shape, and the presence of tumor (or other) markers on the cell surface. Cells from a sample of blood, bone marrow, or other tissue from a patient are stained with a fluorescent dye, placed in a liquid, and then passed one at a time through a beam of light. The test results are based on how cells stained with a fluorescent dye respond to a beam of light. After a soft tissue sarcoma in an adult is diagnosed, tests are done to find out if the cancer cells have spread to the soft tissue or to other parts of the body. The process used to determine if cancer has spread to soft tissue or to other parts of the body is called staging. The stage of soft tissue sarcoma also depends on the extent and size of the tumor and whether it has spread to the lymph nodes or other parts of the body. The information gathered during the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. During the preparation process, the following tests and procedures can be used: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness, such as tumors or anything else that seems unusual. A history of the patient's health-related habits as well as past illnesses and treatments will also be recorded. Chest X-ray: An X-ray of organs and bones inside the chest. X-rays are a type of energy beam that can pass through the body onto film, creating an image of areas within the body. Blood chemistry tests: A procedure in which a blood sample is tested to measure the amount of certain substances that enter the bloodstream by organs and tissues of the body. An unusual (more or less than usual) amount of a substance may be a sign of illness. Complete blood count (CBC): A procedure in which a blood sample is taken and checked for the following: The number of erythrocytes, leukocytes and platelets. The amount of hemoglobin (oxygen-carrying protein) in red blood cells. The portion of a blood sample made up of red blood cells. CT (computed tomography): A procedure in which a series of detailed pictures of the internal parts of the body, such as the lungs and the abdomen, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to help organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI). PET scan (positron emission tomography): a procedure to look for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Malignant tumor cells appear brighter in the image because they are more active and consume more glucose than normal cells. The results of these tests are reviewed along with the results of the tumor biopsy to determine the stage of the soft tissue sarcoma prior to treatment. Sometimes chemotherapy or radiation therapy is prescribed as the initial treatment, and then the soft tissue sarcoma is re-inserted. 1.5. Factors affecting the chance of recovery Several factors influence treatment options and prognosis (chance of recovery). Treatment options and prognosis depend on the following: A type of soft tissue sarcoma. The size, grade and stage of the tumor. How quickly cancer cells grow and divide. Where is the tumor in the body. Has the entire tumor been removed? surgical by. Patient's age and general health. If the cancer has recurred (come back). 1.6. Stages of soft tissue sarcoma in adults The grade of the tumor is also used to describe the cancer and the treatment plan. The grade of the tumor describes how abnormal the cancer cells look under the microscope and how quickly the tumor can grow and spread. Low, medium and high grade are used to describe soft tissue sarcoma: Low grade: In low grade soft tissue sarcoma, cancer cells look more like normal cells under a microscope and grow and spread more slowly than in moderate to high grade soft tissue sarcoma. Moderate: In moderate soft tissue sarcoma, the malignant cells appear more abnormal under the microscope and grow and spread faster than in low-grade soft tissue sarcoma. High Grade: In high-grade soft tissue sarcoma, cancer cells appear more abnormal under the microscope and grow and spread faster than in low to moderate soft tissue sarcoma. For sarcoma of soft tissues of the trunk, arms and legs in adults, the following stages are used: Stage I Stage I of adult soft tissue sarcoma of the trunk, arms and legs is divided into stages IA and IB: 1.2. 1.3. 1.4. 1.5. 1.6 Tumor sizes are often measured in centimeters (cm) or inches. Common foods that can be used to display tumor size in cm include: pea (1 cm), peanuts (2 cm), grapes (3 cm), walnut (4 cm), lime (5 cm or 2 cm). inches), egg (6 cm), peach (7 cm) and grapefruit (10 cm or 4 inches). In stage IA, the tumor is 5 centimeters or less and is of low grade or unknown grade. In stage IB, a tumor larger than 5 centimeters is of low grade or unknown grade. Stage II In stage II adult soft tissue sarcomas of the trunk, arms and legs, the swelling is 5 centimeters or less and middle-class or high-class. Stage III Sarcoma of soft tissues of the trunk, arms and legs in stage III adults is divided into stages IIIA and IIIB: In stage IIIA, the tumor is larger than 5 centimeters, but not more than 10 centimeters, and has a moderate to high grade. In stage IIIB, the tumor is larger than 10 centimeters and has a moderate to high grade. Stage IV With sarcoma of the soft tissues of the trunk, arms and legs in a stage IV adult, one of the following is found: the tumor is of any size, any grade, and has spread to nearby lymph nodes; or a tumor of any size, of any degree, and could have spread to nearby lymph nodes. The cancer has spread to other parts of the body, such as the lungs. For sarcoma of the soft tissues of the retroperitoneal space in adults, the following stages are used: Stage I Stage I of adult retroperitoneal soft tissue sarcoma is divided into stages IA and IB: Tumor sizes are often measured in centimeters (cm) or inches. Common foods that can be used to display tumor size in cm include: pea (1 cm), peanuts (2 cm), grapes (3 cm), walnut (4 cm), lime (5 cm or 2 cm). inches), egg (6 cm), peach (7 cm) and grapefruit (10 cm or 4 inches). In stage IA, the tumor is 5 centimeters or less and is of low grade or unknown grade. In stage IB, a tumor larger than 5 centimeters is of low grade or unknown grade. Stage II In stage II adult retroperitoneal soft tissue sarcoma, the tumor is 5 centimeters or less and middle class or high class. Stage III Stage III retroperitoneal soft tissue sarcoma in adults is divided into stages IIIA and IIIB: In stage IIIA, the tumor is larger than 5 centimeters, but not more than 10 centimeters, and has a moderate to high grade. Stage IIIB shows one of the following: tumors larger than 10 centimeters and middle grade or high grade; or a tumor of any size, of any degree, and has spread to nearby lymph nodes. Stage IV In stage IV adult retroperitoneal soft tissue sarcomas, the tumor is of any size, any grade, and can spread to nearby lymph nodes. The cancer has spread to other parts of the body, such as the lungs. There is no standardized staging system for soft tissue sarcomas in the head, neck, chest, or abdomen. Soft tissue sarcoma may recur (come back) after treatment. Cancer can return to the same soft tissue or to other parts of the body. 1.7. Overview of treatment options 1.7. Mohs Surgery. A surgical procedure to remove a visible lesion on the skin in several stages. First, a thin layer of cancerous tissue is removed. Then a second thin layer of tissue is removed and viewed under a microscope to check for cancer cells. Several layers are removed one at a time until the remaining cancer is found on the tissue viewed under a microscope. This type of surgery is used to remove as little healthy tissue as possible. 1. Wide local excision: removal of the tumor along with the normal tissue around it. For tumors of the head, neck, abdomen and trunk, as little normal tissue as possible is removed. Limb-sparing surgery: Removal of a tumor on an arm or leg without amputation, while maintaining the use and appearance of the limb. Radiation therapy or chemotherapy may be given first to shrink the tumor. Then the tumor is removed by wide local excision. The removed tissue and bone can be replaced with a graft using tissue and bone taken from another part of the patient's body, or with an implant such as artificial bone. Amputation: Surgery to remove part or all of a limb or appendage, such as an arm or leg. Amputation is rarely used to treat soft tissue sarcoma of the arm or leg. Lymphadenectomy: A surgical procedure in which lymph nodes are removed and a sample of tissue is checked under a microscope for signs of cancer. This procedure is also called lymphadenectomy. Radiation therapy or chemotherapy may be given before or after surgery to remove the tumor. If given before surgery, radiation therapy or chemotherapy will shrink the tumor and reduce the amount of tissue that needs to be removed during surgery. Treatment before surgery is called neoadjuvant therapy. When given after surgery to remove all visible tumor, radiation therapy or chemotherapy kills any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer recurrence is called adjuvant therapy. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. There are two types of radiation therapy: External beam therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Internal beam therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are inserted directly into or near the tumor. Intensity modulated radiation therapy (IMRT) is a type of three-dimensional (3-D) radiation therapy that uses a computer to produce images of the size and shape of a tumor. Thin beams of radiation of different intensity (strength) are directed at the tumor at different angles. This type of external radiation therapy causes less damage to nearby healthy tissue and is less likely to cause dry mouth, trouble swallowing, and skin damage. How radiation therapy is given depends on the type and stage of cancer treatment. External radiation therapy and internal radiation therapy can be used to treat soft tissue sarcoma in adults. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). 4. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and target certain cancer cells. Targeted therapy can do less harm to normal cells than chemotherapy or radiation therapy. Tyrosine kinase inhibitor therapy: Tyrosine kinase inhibitors are small molecule drugs that travel across the cell membrane and work inside cancer cells, blocking the signals that cancer cells need to grow and divide. Some tyrosine kinase inhibitors also have angiogenesis inhibitory effects. Pazopanib is used to treat advanced soft tissue sarcoma. 2. TREATMENT OF STROMAL TUMORS OF THE GASTROINTESTINAL TRACT (adults) A stromal tumor of the gastrointestinal tract is a disease in which abnormal cells form in the tissues of the gastrointestinal tract. The gastrointestinal (GI) tract is part of the body's digestive system. It helps digest food and removes nutrients from food ( vitamins, minerals, carbohydrates, fats, proteins and water) so that they can be used by the body. The gastrointestinal tract consists of the following organs: Stomach . Small intestine . Colon ( colon ). Some gastrointestinal stromal tumors (GIST) grow slowly over time and may never cause problems for the patient, while others can grow and spread very quickly. They are most commonly found in the stomach and small intestine, but can be found anywhere in or near the gastrointestinal tract. Some scientists believe that GIST begins in cells called interstitial Cajal cells (ICCs) in the wall of the gastrointestinal tract. Якорь 2 Gastrointestinal stromal tumors (GIST) can be found anywhere or near the gastrointestinal tract. 2.1. Development risks stromal tumor of the gastrointestinal tract Genetic factors can increase the risk of developing gastrointestinal stromal tumors. Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk. These genes in cells carry hereditary information received from a person's parents. The risk of GIST is increased in people who are inherited with a mutation (change) in a particular gene. In rare cases, GIST can be found in several members of the same family. GIST can be part of a genetic syndrome, but this is rare. A genetic syndrome is a collection of symptoms or conditions that occur together and are usually caused by abnormal genes. The following genetic syndromes are associated with GIST: Neurofibromatosis type 1 (NF1) A rare genetic disorder that causes brown spots and tumors on the skin, freckles on areas of the skin not exposed to the sun, nerve tumors, and changes in the development of the nervous system, muscles, bones, and skin. Also called NF1. Carney's triad. A very rare disease characterized by tumors of the gastrointestinal tract (usually the stomach), tumors that form in the nervous tissue of the embryo in the head, neck and trunk, and tumors that form in the cartilage of the lungs. Sometimes tumors also form in the adrenal glands and esophagus. The Carney triad is most common in young women. 2.2. Symptoms of the development of a stromal tumor of the gastrointestinal tract Signs of gastrointestinal stromal tumors include blood in the stool or vomiting. These and other signs and symptoms can be caused by GIST or other causes. Check with your doctor if you have any of the following: Blood (bright red or very dark) in stool or vomit. Abdominal pain, which can be very severe. Feeling very tired. Problems or pain when swallowing. Feeling full after eating very little food. 2.3. Diagnostics stromal tumor of the gastrointestinal tract Tests that examine the gastrointestinal tract are used to diagnose tumors of the gastrointestinal stroma. The following tests and procedures can be used: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness such as bumps or anything else that seems out of the ordinary. There will also be a history of the patient's health habits, as well as past illnesses and treatments. CT (computed tomography): a procedure in which a series of detailed pictures of areas inside the body are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI). Endoscopic ultrasound and biopsy: Endoscopy and ultrasound are used to take an image of the upper gastrointestinal tract and a biopsy is performed. An endoscope (a thin, tubular instrument with light and viewing lenses) is inserted through the mouth and into the esophagus, stomach, and first part of the small intestine. A probe at the end of an endoscope is used to reflect high-energy sound waves (ultrasound) from internal tissues or organs and create an echo. The echo forms a picture of body tissue called a sonogram. This procedure is also called endosonography. Based on the sonogram, the doctor removes the tissue with a thin hollow needle. A pathologist examines the tissue under a microscope for cancer cells. When cancer is found, the following tests can be performed to look at cancer cells: Immunohistochemistry: a laboratory test that uses antibodies to check for specific antigens (markers) in a tissue sample from a patient. Antibodies are usually associated with an enzyme or fluorescent dye. After antibodies bind to a specific antigen in a tissue sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test is used to diagnose cancer and help distinguish one type of cancer from another. Mitosis rate: A measure of how quickly cancer cells divide and grow. The rate of mitosis is determined by counting the number of cells dividing in a given amount of cancer tissue. Very small GISTs are common. Sometimes GIST is less than a pencil eraser. Tumors can be found during a procedure that is done for another reason, such as an X-ray or surgery. Some of these small tumors will not grow and cause signs or symptoms or spread to the abdomen or other parts of the body. Doctors disagree on whether these small tumors should be removed or monitored to see if they begin to grow. After a gastrointestinal stromal tumor has been diagnosed, tests are done to find out if cancer cells have spread through the gastrointestinal tract or other parts of the body. The process used to determine if a cancer has spread in the gastrointestinal (GI) tract or to other parts of the body is called staging. The information gathered during the staging process determines the stage of the disease. During the preparation process, the following tests and procedures can be used: PET scan (positron emission tomography): a procedure to look for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Malignant tumor cells appear brighter in the image because they are more active and consume more glucose than normal cells. CT (computed tomography): a procedure in which a series of detailed pictures of areas inside the body are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed so that organs or tissues can be seen more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI). Chest X-ray: An X-ray of the internal organs and bones of the chest. An X-ray is a type of energy beam that can pass through a body onto a film, creating an image of areas within the body. Bone scan: A procedure to check for rapidly dividing cells such as cancer cells in the bone. A very small amount of radioactive material is injected into a vein and passed through the bloodstream. The radioactive material builds up in the bones in cancer and is detected by a scanner. Additional tests may be required. Some tests that have been done to diagnose cancer or to determine the stage of cancer may be repeated. Some tests will be repeated to see how effective the treatment is. Decisions to continue, change, or stop treatment may be based on the results of these tests. Some tests will continue from time to time after treatment ends. The results of these tests can show if your condition has changed or if the cancer has recurred (returned). These tests are sometimes called follow-up or follow-up examinations. Follow-up for GST that have been surgically removed may include CT of the liver and pelvis or wait-and-see. For GISTs that are treated with tyrosine kinase inhibitors, follow-up tests such as CT, MRI, or PET scans may be done to check how well targeted therapy is working. 2.4. Recovery prognosis Several factors affect prognosis (chance of recovery) and treatment options. The prognosis and treatment option depends on the following conditions: How quickly cancer cells grow and divide. The size of the tumor. Where is the tumor in the body. Is it possible to completely remove the tumor with surgery? Whether the tumor has spread to other parts of the body. 2.5. Overview of treatment options The results of diagnostic and staging tests are used to plan treatment. For many cancers, it is important to know the stage of the cancer in order to plan treatment. However, GIST treatment is independent of the stage of the cancer. Treatment is based on whether the tumor can be surgically removed and whether the tumor has spread to other parts of the abdomen or distant parts of the body. Treatment is based on whether the tumor is: Resectable: These tumors can be removed with surgery. Inoperable: These tumors cannot be completely removed with surgery. Metastatic and recurrent: Metastatic tumors have spread to other parts of the body. Recurrent tumors recurred (returned) after treatment. Recurrent GISTs may return to the gastrointestinal tract or to other parts of the body. They are usually found in the abdomen, peritoneum, and / or liver. Refractory: These tumors did not improve after treatment. There are various treatments for patients with gastrointestinal stromal tumors. Various treatments are available for patients with gastrointestinal stromal tumors (GIST). Some treatments are standard (currently used) and some are in clinical trials. A clinical trial of treatment is a scientific study designed to help improve current treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than standard treatment, the new treatment may become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. Four types of standard treatments are used: 1. Operation If the GIST has not spread and is in a safe place for surgery, the tumor and some tissue around it may be removed. Sometimes surgery is done using a laparoscope (a thin, illuminated tube) to look inside the body. Small incisions (incisions) are made in the abdominal wall, into one of which a laparoscope is inserted. Instruments can be inserted through the same incision or through other incisions to remove organs or tissues. 2. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and target certain cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. Tyrosine kinase inhibitors (TKIs) are targeted therapies that block signals required for tumor growth. TKIs can be used to treat GISTs that cannot be surgically removed, or to shrink the GISTs so that they are small enough to be surgically removed. Imatinib mesylate and sunitinib are two BCIs used to treat GIST. TKI is sometimes prescribed until the tumor grows and serious side effects occur. 3. Watchful waiting Expectant closely monitor the patient's condition without giving any treatment until signs or symptoms appear or change. 4. Supportive therapy If GIST worsens during treatment or side effects occur, supportive care is usually given. The goal of supportive care is to prevent or treat the symptoms of the disease, the side effects caused by the treatment, and the psychological, social and spiritual problems associated with the disease or its treatment. Supportive care helps improve the quality of life for patients with serious or life-threatening medical conditions. Radiation therapy is sometimes prescribed as supportive therapy to relieve pain in patients with large, spreading tumors. Treatment of resectable stromal tumors of the gastrointestinal tract Resectable gastrointestinal stromal tumors (GIST) can be completely or almost completely removed by surgery. Treatment may include the following: Surgery to remove tumors measuring 2 centimeters or more. Laparoscopic surgery can be done if the tumor is 5 cm or less. If there are cancer cells remaining at the edges of the area where the tumor was removed, careful waiting or targeted therapy with imatinib mesylate may follow. Clinical study on targeted therapy with imatinib mesylate after surgery to reduce the chance of tumor recurrence (return). Treatment of inoperable stromal tumors of the gastrointestinal tract Inoperable FSW cannot be completely removed by surgery because they are too large, or in a location where there would not be too much damage to nearby organs if the tumor is removed. Treatment is usually a clinical study of targeted therapy with imatinib mesylate to shrink the tumor, followed by surgery to remove as much of the tumor as possible. Treatment of metastatic and recurrent stromal tumors of the gastrointestinal tract Treatments for GISTs that are metastatic (spread to other parts of the body) or recur (come back after treatment) may include the following: Targeted therapy with imatinib mesylate. Targeted sunitinib therapy if tumor begins to grow during imatinib mesylate therapy or if side effects are too severe. Surgery to remove tumors that have been treated with targeted therapy and that are shrinking, stable (not changing), or slightly increased in size. Targeted therapy can be continued after surgery. Surgery to remove tumors for serious complications such as bleeding, a hole in the gastrointestinal tract, a blockage in the gastrointestinal tract, or an infection. Clinical study of a new treatment method. Treatment of refractory stromal tumors of the gastrointestinal tract Many GISTs treated with a tyrosine kinase inhibitor (TKI) become unresponsive (stop responding) to the drug over time. Treatment is usually a clinical trial with a different TKI or a clinical trial of a new drug. 2.1. 2.2 2.3. 2.4 2.5. 3. TREATMENT OF STOMAL TUMORS OF THE GASTROINTESTINAL TRACT IN CHILDREN Stromal tumors of the gastrointestinal tract are diseases in which malignant (cancerous) cells form in the tissues of the wall of the stomach or intestines. Gastrointestinal stromal tumors (GIST) usually begin in cells in tissues in the wall of the stomach or intestines. These cells, called Cajal interstitial cells, help food move through the digestive tract. During childhood, GIST usually occurs in the stomach. It is more common in girls and usually appears during adolescence. GIST in children is different from GIST in adults. Patients should be visited at centers that specialize in GIST treatment. Якорь 3 Gastrointestinal stromal tumors (GIST) are most common in the stomach and small intestine, but can be found anywhere in or near the gastrointestinal tract. GIST can develop as part of the syndrome. GIST can occur as part of the following syndromes: Carney triad (GIST, lung chondroma and paraganglioma). A very rare disease characterized by tumors of the gastrointestinal tract (usually the stomach), tumors that form in the nervous tissue of the embryo in the head, neck and trunk, and tumors that form in the cartilage of the lungs. Sometimes tumors also form in the adrenal glands and esophagus. The Carney triad is most common in young women. Carney-Stratakis syndrome (GIST and paraganglioma). A rare hereditary disease characterized by tumors of the gastrointestinal tract and tumors that form in the nervous tissue of the embryo in the head, neck and trunk. Also called the Karni dyad and the Karni-Stratakis dyad. 3.1. Symptoms Signs and symptoms of GIST include anemia and abdominal induration. These and other signs and symptoms can be caused by GIST or other conditions. Check with your child's doctor if your child has any of the following: Anemia (tiredness, dizziness, fast or irregular heartbeat, shortness of breath, or pale skin). Lump in the abdomen. Intestinal blockage (cramping abdominal pain, nausea, vomiting, diarrhea, constipation, and bloating). 3.2 Diagnostics Tests that examine the digestive tract are used to diagnose GIST. The following tests and procedures can be used: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness such as bumps or anything else that seems out of the ordinary. There will also be a history of the patient's health habits, as well as past illnesses and treatments. Gene testing: A laboratory test in which cells or tissues are analyzed to look for changes in the KIT, PDGFA, and SDH genes. It is important to know if there are changes in these genes in order to diagnose GIST and plan treatment. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI). CT (computed tomography): A procedure in which a series of detailed images of areas inside the body are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to help organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. PET scan (positron emission tomography): a procedure to look for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Malignant tumor cells appear brighter in the image because they are more active and consume more glucose than normal cells. 3.1. 3.2. Positron Emission Tomography (PET). The baby lies on a table that goes through a PET scanner. The headrest and white strap help the baby to lie quietly. A small amount of radioactive glucose (sugar) is injected into the baby's vein and the scanner takes a picture of where the glucose is being used in the body. Cancer cells appear brighter in the image because they consume more glucose than normal cells. X-ray: An X-ray is a type of energy beam that can pass through the body and onto the film, creating an image of areas inside the body, such as the abdomen or the area where a tumor has formed. Biopsy: Removal of cells or tissues so that a pathologist can examine them under a microscope to check for signs of cancer. Fine needle aspiration: Removal of tissue with a fine needle. Endoscopy: A procedure to examine organs and tissues inside the body for abnormal areas. The endoscope is inserted through an incision (incision) in the skin or holes in the body, such as the mouth or anus. An endoscope is a thin tubular instrument with a light and a viewing lens. He may also have an instrument to remove tissue samples or lymph nodes that are checked under a microscope for signs of disease. The following laboratory test can be done to examine tissue samples: Immunohistochemistry: A laboratory test that uses antibodies to check for specific antigens (markers) in a tissue sample from a patient. Antibodies are usually associated with an enzyme or fluorescent dye. After antibodies bind to a specific antigen in a tissue sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test looks for the SDH enzyme in a tissue sample from a patient. When SDH is missing, it is called SDH deficient GIST. To plan treatment, it is important to know if the cancer is insufficient for SDH. After GIST has been diagnosed, tests are done to find out if cancer cells have spread to nearby areas or to other parts of the body. The process used to determine if GIST has spread to nearby areas or other parts of the body is called staging. GIST can spread to the lymph nodes, liver, and peritoneum. There is no standard GIST staging system in children. The results of tests and procedures performed to diagnose GIST are used to make treatment decisions. Sometimes GIST in childhood relapses (comes back) after treatment. 3.3. Overview of treatment options There are various types of treatment for children with GIST. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Because cancer is rare in children, clinical trials should be considered. Some clinical trials are only open to patients who have not yet started treatment. Treatment for children with GIST should be planned by a team of doctors who are experts in the treatment of childhood cancers. The treatment will be supervised by a pediatric oncologist, a doctor specializing in the treatment of oncological children. The pediatric oncologist works with other pediatric health professionals who are experts in treating children with cancer and specialize in specific areas of medicine. This may include the following professionals and others: Pediatrician. Children's surgeon. Pathologist. Specialist Pediatric Nurse. Social worker . Rehabilitation specialist. Psychologist . Child life specialist. The following types of standard treatments are used: 1. Operation Cancer removal surgery is an SDH deficient GIST treatment. 2. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to target cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. Tyrosine kinase inhibitor therapy: These drugs block signals required for tumor growth. Imatinib and sunitinib are used to treat GIST and GIST with SDH deficiency with KIT or PDGFR gene changes. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). GIST treatment in children can cause side effects. Side effects from cancer treatments that start after treatment and last for months or years are called late effects. Late effects of cancer treatments may include: Physical problems. Changes in mood, feelings, thinking, learning, or memory. Second cancer (new cancers) or other conditions. Some late effects can be treated or controlled. It is important to talk to your child's doctors about the possible late effects of some treatments. GIST treatment Treatment for children newly diagnosed with tumors with changes in the KIT or PDGFR gene include the following: Targeted therapy with a tyrosine kinase inhibitor (imatinib or sunitinib). Treatment for children newly diagnosed with an SDH-deficient tumor may include the following: Surgery to remove the tumor. If intestinal obstruction or bleeding occurs, additional surgery may be required. Targeted therapy with a tyrosine kinase inhibitor (sunitinib). Treatment of recurrent GIST Treatment for recurrent GIST in children may include the following: A clinical trial that tests a patient's sample of a tumor for some gene changes. The type of targeted therapy that will be given to a patient depends on the type of gene change. Clinical trials of a new chemotherapy drug. 3.3. 4. TREATMENT OF KAPOSHA'S SARCOMA Якорь 4 Kaposi's sarcoma is a disease in which malignant neoplasms (cancer) can form on the skin, mucous membranes, lymph nodes, and other organs. Kaposi's sarcoma is cancer that causes lesions (abnormal tissue) to grow on the skin; on the mucous membranes lining the mouth, nose and throat; The lymph nodes ; or other bodies. The lesions are usually purple in color and consist of cancer cells, new blood vessels, red blood cells, and white blood cells. Kaposi's sarcoma differs from other cancers in that lesions can start in more than one place in the body at the same time. Human herpes virus-8 (HHV-8) is found in lesions in all patients with Kaposi's sarcoma. This virus is also called Kaposi's sarcoma herpes simplex virus (KSHV). Most people with HHV-8 do not develop Kaposi's sarcoma. People with HHV-8 are more likely to develop Kaposi's sarcoma if their immune systems are weakened by a disease such as human immunodeficiency virus (HIV) or medications taken after organ transplants. There are several types of Kaposi's sarcoma. This summary discusses two types: Classic Kaposi's sarcoma. Epidemic Kaposi's sarcoma (HIV-associated Kaposi's sarcoma). 4.1. Diagnostics Tests that examine the skin, lungs, and gastrointestinal tract are used to diagnose Kaposi's sarcoma. The following tests and procedures can be used: Physical examination and health history: A body exam to check for general signs of health, including checking the skin and lymph nodes for signs of disease, such as lumps or anything else that seems unusual. There will also be a history of the patient's health habits, as well as past illnesses and treatments. Chest X-ray: X-ray of internal organs and bones of the chest. An X-ray is a type of energy beam that can pass through a body onto a film, creating an image of areas within the body. It is used to detect Kaposi's sarcoma in the lungs. Biopsy: Removal of cells or tissues so that a pathologist can examine them under a microscope to check for signs of cancer. One of the following types of biopsies can be done to check for Kaposi's sarcoma on the skin: Endoscopy or bronchoscopy can be done to check for Kaposi's sarcoma lesions in the gastrointestinal tract or lungs. Excisional biopsy: A scalpel is used to remove all skin growth. Postoperative biopsy: A scalpel is used to remove part of the skin growth. Primary biopsy: A wide needle is used to remove part of the skin lesion. Fine needle aspiration (FNA) biopsy: A fine needle is used to remove part of the skin growth. Endoscopy for biopsy: A procedure to examine organs and tissues inside the body for abnormal areas. The endoscope is inserted through an incision (incision) in the skin or holes in the body, such as the mouth. An endoscope is a thin tubular instrument with a light and a viewing lens. He may also have an instrument to remove tissue samples or lymph nodes that are checked under a microscope for signs of disease. It is used to detect lesions of Kaposi's sarcoma in the gastrointestinal tract. Bronchoscopy for biopsy: A procedure to examine the trachea and large airways in the lungs for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tubular instrument with a light and a viewing lens. He may also have an instrument for taking tissue samples, which are checked under a microscope for signs of disease. It is used to detect lesions of Kaposi's sarcoma in the lungs. After Kaposi's sarcoma has been diagnosed, tests are done to find out if the cancer cells have spread to other parts of the body. The following tests and procedures can be used to find out if cancer has spread to other parts of the body: Blood chemistry tests: A procedure in which a blood sample is tested to measure the amount of certain substances that enter the bloodstream by organs and tissues of the body. An unusual (more or less than usual) amount of a substance may be a sign of illness. CT (computed tomography): A procedure in which a series of detailed pictures of areas inside the body, such as the lungs, liver, and spleen, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs and tissues more visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography. PET scan (positron emission tomography): a procedure to detect malignant growths in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Malignant growths appear brighter in the image because they are more active and consume more glucose than normal cells. This imaging test checks for signs of lung, liver, and spleen cancer. CD34 lymphocyte count: A procedure in which a blood sample is tested to measure the number of CD34 cells (a type of white blood cell). A lower than normal CD34 cell count may be a sign that the immune system is not working properly. 4.2. Factors affecting the prognosis of recovery The prognosis and treatment option depends on the following conditions: Type of Kaposi's sarcoma. The patient's general health, especially his immune system. Whether the cancer has just been diagnosed or has recurred (returned). 4.3. Classic Kaposi's sarcoma Classic Kaposi's sarcoma is most common in older men of Italian or Eastern European Jewish descent. Classic Kaposi's sarcoma is a rare disease that progresses slowly over many years. Signs of classic Kaposi's sarcoma may include slow-growing lesions on the legs and feet. Patients may have one or more red, purple, or brown skin lesions on the legs and feet, most often on the ankles or soles of the feet. Over time, lesions can form in other parts of the body, such as the stomach, intestines, or lymph nodes. The lesions usually do not cause any symptoms, but may increase in size and number over a period of 10 years or more. The pressure from the lesions can block the flow of lymph and blood in the legs and cause painful swelling. Digestive tract lesions can cause gastrointestinal bleeding. Another cancer may develop. Some patients with classic Kaposi's sarcoma may develop a different type of cancer before the appearance of foci of Kaposi's sarcoma or at a later age. Most often, this second cancer is non-Hodgkin's lymphoma. Frequent follow-up is necessary to keep track of these second forms of cancer. 4.4. Epidemic Kaposi's sarcoma (HIV-associated Kaposi's sarcoma) Patients with human immunodeficiency virus (HIV) are at risk of developing epidemic Kaposi's sarcoma (HIV-associated Kaposi's sarcoma). Acquired Immunodeficiency Syndrome (AIDS) is caused by HIV, which attacks and weakens the body's immune system. A weakened immune system is unable to fight off infections and diseases. People with HIV have an increased risk of infection and cancer. A person with HIV and certain types of infection or cancer, such as Kaposi's sarcoma, is diagnosed with AIDS. Sometimes a person is diagnosed with AIDS and Kaposi's sarcoma at the same time. The use of a drug therapy called highly active antiretroviral therapy (HAART) reduces the risk of epidemic Kaposi's sarcoma in people with HIV. HAART is a combination of several drugs used to reduce the damage to the immune system caused by HIV infection. Treatment with HAART reduces the risk of epidemic Kaposi's sarcoma, although a person can develop epidemic Kaposi's sarcoma while on HAART. For information on AIDS and its treatment, visit the AIDSinfo website. Signs of epidemic Kaposi's sarcoma can include lesions that form in many parts of the body. The signs of epidemic Kaposi's sarcoma can include lesions in various parts of the body, including one of the following: Leather. Mouth lining. The lymph nodes . Stomach and intestines. Lightweight and chest lining. Liver . Spleen. Kaposi's sarcoma is sometimes found on the lining of the mouth during a regular dental check-up. In most patients with epidemic Kaposi's sarcoma, the disease spreads over time to other parts of the body. 4.5. Overview of treatment options There are different treatments for patients with Kaposi's sarcoma. Various treatments are available for Kaposi's sarcoma patients. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. Six standard treatments are used to treat Kaposi's sarcoma: Treatment for Epidemic Kaposi's sarcoma combines treatment for Kaposi's sarcoma with treatment for acquired immunodeficiency syndrome (AIDS). The six types of standard treatments used to treat Kaposi's sarcoma include: 1. HAART Highly active antiretroviral therapy (HAART) is a combination of several drugs used to reduce damage to the immune system caused by human immunodeficiency virus (HIV) infection. For many patients, HAART alone may be sufficient to treat epidemic Kaposi's sarcoma. For other patients, HAART may be combined with other standard treatments for epidemic Kaposi's sarcoma. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. There are two types of radiation therapy: External beam therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Internal beam therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are inserted directly into or near the tumor. How radiation therapy is given depends on the type of cancer being treated. Several types of external beam radiation therapy are used to treat lesions of Kaposi's sarcoma. Photon radiation therapy treats injuries with high energy light. Electron beam therapy uses tiny, negatively charged particles called electrons. 3. Operation The following surgical procedures can be used for Kaposi's sarcoma to treat small, superficial lesions: Local excision: The tumor is excised from the skin along with some normal tissue around it. Electrodesification and scraping: the tumor is excised from the skin with a curette (a sharp, spoon-shaped instrument). A needle electrode is then used to shock the area with an electric current, which stops the bleeding and destroys the cancer cells remaining at the edge of the wound. This process can be repeated one to three times during surgery to remove the entire tumor. 4. Cryosurgery Cryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy. 5. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body ( systemic chemotherapy ). When chemotherapy is injected directly into the cerebrospinal fluid, organ, tissue, or body cavity, such like the abdomen, drugs mainly target cancer cells in these areas (regional chemotherapy). With electrochemotherapy , intravenous chemotherapy is given and a probe is used to send electrical impulses to the tumor. The pulses make a hole in the membrane around the tumor cell and allow the chemotherapist to enter. How chemotherapy is administered depends on where the foci of Kaposi's sarcoma occur in the body. For Kaposi's sarcoma, chemotherapy can be performed in the following ways: For local lesions of Kaposi's sarcoma, such as in the mouth, anticancer drugs can be injected directly into the lesion (intralesional chemotherapy). For localized skin lesions, a topical gel can be applied to the skin. Electrochemotherapy can also be used. For extensive skin lesions, intravenous chemotherapy may be prescribed. Liposomal chemotherapy uses liposomes (very tiny particles of fat) to carry anticancer drugs. Liposomal doxorubicin is used to treat Kaposi's sarcoma. Liposomes accumulate in the tissue of Kaposi's sarcoma more than in healthy tissue, and doxorubicin is released slowly. This enhances the action of doxorubicin and causes less damage to healthy tissue. 5. Immunotherapy Immunotherapy is a treatment that uses a patient's immune system to fight cancer. Substances produced by the body or in the laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biological therapy. Interferon alpha and interleukin-12 are biological agents used to treat Kaposi's sarcoma. 6. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and target certain cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. Monoclonal antibody therapy and tyrosine kinase inhibitors (TKIs) are types of targeted therapies that are being studied in the treatment of Kaposi's sarcoma. Monoclonal antibodies are proteins of the immune system created in the laboratory for the treatment of many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that can promote cancer cell growth. The antibodies are then able to kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or to carry drugs, toxins, or radioactive materials directly to cancer cells. Bevacizumab is a monoclonal antibody that can be used to treat Kaposi's sarcoma. TKIs block signals required for tumor growth. Imatinib mesylate is a TKI that can be used to treat Kaposi's sarcoma. Treatment of classic Kaposi's sarcoma Treatment for isolated skin lesions may include the following: Radiation therapy . Surgery. Treatments for skin lesions throughout the body may include the following: Radiation therapy. Chemotherapy. Electrochemotherapy. Treatment for Kaposi's sarcoma, which affects the lymph nodes or the gastrointestinal tract, usually includes chemotherapy with or without radiation therapy. Treatment of epidemic Kaposi's sarcoma Treatment for epidemic Kaposi's sarcoma may include the following: Surgery, including local excision or electrodesiccation and curettage. Cryosurgery. Radiation therapy . Chemotherapy using one or more anticancer drugs. Biological therapy using interferon alpha or interleukin-12. Targeted therapy using imatinib or bevacizumab. 4.1. 4.2. 4.3. 4.4. 4.5. 5. TREATMENT WITH RABDOMOISARCOM IN CHILDHOOD Якорь 5 Infantile rhabdomyosarcoma is a condition in which malignant (cancerous) cells form in muscle tissue. Rhabdomyosarcoma is a type of sarcoma. Sarcoma is cancer of soft tissue (such as muscle), connective tissue (such as tendons or cartilage), or bone. Rhabdomyosarcoma usually starts in the muscles that are attached to the bones and help the body move, but it can start in many parts of the body. Rhabdomyosarcoma is the most common type of soft tissue sarcoma in children. There are four main types of rhabdomyosarcoma: Fetal: This type is most commonly found in the head and neck area, as well as in the genitals or urinary tract, but can occur anywhere on the body. This is the most common type of rhabdomyosarcoma. Alveolar: This type is most commonly found in the arms or legs, chest, abdomen, genitals, or anal area. Spindle cell / sclerosis: The spindle cell type is most commonly found in the paratesticular region (testis or spermatic cord). There are two other subtypes of spindle / sclerosis cells. One is more common in babies and is found in the trunk region. The other can affect children, adolescents, and adults. It is often found in the head and neck area and is more aggressive. Pleomorphic: This is the least common type of rhabdomyosarcoma in children. 5.1. Development risks rhabdomyosarcoma in children Certain genetic conditions increase the risk of developing rhabdomyosarcoma in children. Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your child's doctor if you think your child may be at risk. Risk factors for rhabdomyosarcoma include the following inherited conditions: Li-Fraumeni syndrome. Dicer syndrome 1. Neurofibromatosis type 1 (NF1). Costello's Syndrome. Beckwith-Wiedemann syndrome. Noonan's syndrome. Babies who were high birth weight or were larger than expected at birth may have an increased risk of fetal rhabdomyosarcoma. In most cases, the cause of rhabdomyosarcoma is unknown. 5.2. Symptoms The hallmark of rhabdomyosarcoma in childhood is a swelling or lump that continues to grow. Signs and symptoms can be caused by rhabdomyosarcoma in children or other medical conditions. The signs and symptoms that occur depend on where the cancer starts. Check with your child's doctor if your child has any of the following: A lump or lump that keeps getting bigger or doesn't go away. It can be painful. Crossed eyes or bulging eye. Headache. Problems with urination or bowel movements. Blood in the urine. Bleeding from the nose, throat, vagina, or rectum. 5.3. Diagnostics Diagnostic tests and biopsies are used to diagnose rhabdomyosarcoma in children. The diagnostic tests that are done depends in part on where the cancer is. The following tests and procedures can be used: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness such as bumps or anything else that seems out of the ordinary. There will also be a history of the patient's health habits, as well as past illnesses and treatments. X-rays: X-rays of organs and bones inside the body, such as the chest. An X-ray is a type of energy beam that can pass through a body onto a film, creating an image of areas within the body. CT (computed tomography): A procedure in which a series of detailed pictures of areas inside the body, such as the chest, abdomen, pelvis, or lymph nodes, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas of the body, such as the skull, brain, and lymph nodes. This procedure is also called nuclear magnetic resonance imaging (MRI). PET scan (positron emission tomography): a procedure to look for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Malignant tumor cells appear brighter in the image because they are more active and consume more glucose than normal cells. Bone scan: A procedure to check for rapidly dividing cells such as cancer cells in the bone. A very small amount of radioactive material is injected into a vein and passed through the bloodstream. The radioactive material builds up in the bones in cancer and is detected by a scanner. Bone marrow aspiration and biopsy: Removal of bone marrow, blood, and a small piece of bone by inserting a cannula into the hip bone. Samples are removed from both hip bones. A pathologist examines the bone marrow, blood, and bones under a microscope to look for signs of cancer. Lumbar puncture: A procedure used to collect cerebrospinal fluid (CSF) from the spine. This is done by inserting a needle between two bones in the spine and into the cerebrospinal fluid and taking a sample of the fluid. A sample of cerebrospinal fluid is checked under a microscope for signs of cancer cells. This procedure is also called LP or lumbar puncture. If these tests show that there may be rhabdomyosarcoma, a biopsy is done. A biopsy is the removal of cells or tissues so that a pathologist can examine them under a microscope to check for signs of cancer. Because treatment depends on the type of rhabdomyosarcoma, biopsy specimens should be screened by a pathologist experienced in diagnosing rhabdomyosarcoma. It may use one of the following types of biopsies: Fine needle aspiration (FNA) biopsy: Removal of tissue or fluid with a fine needle. Shaft biopsy: Removal of tissue with a wide needle. This procedure can be guided by ultrasound, computed tomography, or MRI. Open biopsy: Removal of tissue through an incision (incision) in the skin. Sentinel lymph node biopsy: Removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node in a group of lymph nodes to receive lymphatic drainage from the primary tumor. This is the first lymph node to which cancer can spread from the primary tumor. A radioactive substance and / or blue dye is injected near the tumor. The substance or dye flows through the lymphatic tract. To the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist examines tissue under a microscope for cancer cells. If no cancer cells are found, it may not be necessary to remove additional lymph nodes. Sometimes a sentinel lymph node is found in more than one group of nodes. Sentinel lymph node biopsy may be used in patients with rhabdomyosarcoma of the extremities or trunk when enlarged lymph nodes are not found on imaging or physical examination. The following tests can be performed on a sample of tissue removed: Light microscopy: a laboratory test in which cells in a tissue sample are viewed under a normal, high-power microscope to detect certain changes in the cells. Immunohistochemistry: A laboratory test that uses antibodies to check for specific antigens (markers) in a tissue sample from a patient. Antibodies are usually associated with an enzyme or fluorescent dye. After antibodies bind to a specific antigen in a tissue sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test is used to diagnose cancer and help distinguish one type of cancer from another. FISH (Fluorescence In Situ Hybridization): A laboratory test used to study and count genes or chromosomes in cells and tissues. Pieces of DNA containing fluorescent dyes are made in the laboratory and added to a sample of the patient's cells or tissues. When these stained DNA fragments attach to specific genes or regions of chromosomes in a sample, they light up when viewed under a fluorescent microscope. The FISH test is used to diagnose cancer and plan treatment. Reverse transcription polymerase chain reaction (RT-PCR) test: A laboratory test that measures the amount of a genetic substance called mRNA created by a particular gene. An enzyme called reverse transcriptase is used to convert a specific piece of RNA into a corresponding piece of DNA that can be amplified (produced in large quantities) by another enzyme called DNA polymerase. Amplified copies of DNA help determine if a particular mRNA is being made by the genome. RT-PCR can be used to check for the activation of certain genes that may indicate the presence of cancer cells. This test can be used to look for specific changes in a gene or chromosome that can help diagnose cancer. Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a tissue sample are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in some chromosomes can be a sign of cancer. Cytogenetic analysis is used to diagnose cancer, plan treatment, or determine the effectiveness of a treatment. Once children are diagnosed with rhabdomyosarcoma, treatment depends in part on the stage of the cancer and sometimes on whether the cancer has been completely removed by surgery. The process used to determine if cancer has spread to tissue or to other parts of the body is called staging. It is important to know the stage in order to plan treatment. The doctor, based on the results of diagnostic tests, will help determine the stage of the disease. Treatment for rhabdomyosarcoma in children is based in part on the stage and sometimes on the size of the cancer that remains after surgery to remove the tumor. The pathologist will use a microscope to check tissue removed during surgery, including tissue samples from the edges of areas where cancer was removed and lymph nodes. This is done to see if all of the cancer cells have been removed during surgery. 5.4. Factors influencing the forecast Several factors affect prognosis (chance of recovery) and treatment options. The prognosis and treatment option depends on the following conditions: The age of the patient. Where the tumor started in the body. The size of the tumor at the time of diagnosis. Whether the tumor has been completely removed by surgery. Type of rhabdomyosarcoma (embryonic, alveolar, spindle cell / sclerosing, or pleomorphic). Are there any changes in the genes. Whether the tumor has spread to other parts of the body at the time of diagnosis. Whether there was a tumor in the lymph nodes at the time of diagnosis. Whether the tumor is responding to chemotherapy and / or radiation therapy. For patients with recurrent cancer, prognosis and treatment also depend on the following: Where in the body the tumor has recurred (returned). How much time elapsed between the end of cancer treatment and its relapse. Has the cancer been previously treated with radiation therapy? Additional tests may be required. Some tests that have been done to diagnose cancer or to determine the stage of cancer may be repeated. Some tests will be repeated to see how effective the treatment is. Decisions to continue, change, or stop treatment may be based on the results of these tests. Some tests will continue from time to time after treatment ends. The results of these tests can show if your child's condition has changed or if the cancer has recurred (returned). These tests are sometimes called control or control tests. 5.5. Stages of childhood rhabdomyosarcoma The stage of rhabdomyosarcoma in children has three parts. Childhood rhabdomyosarcoma is assessed using three different ways to describe cancer: System setting. Grouping system. Risk group. The staging system is based on the size of the tumor, its location in the body, and its spread to other parts of the body: Stage 1 In stage 1, a tumor of any size may have spread to the lymph nodes and is found only in one of the following “favorable” sites: The eye or the area around the eye. Head and neck (but not in tissues around the ear, nose, sinuses, base of the skull, brain, or spinal cord). Gallbladder and bile ducts. Ureters or urethra. Testes, ovary, vagina, or uterus. Rhabdomyosarcoma, which develops in a “favorable” location, has a better prognosis. If the site where the cancer occurs is not among the favorable sites listed above, it is considered an “unfavorable” site. 5.1. 5.2. 5.3. 5.4. 5.5. Tumor sizes are often measured in centimeters (cm) or inches. Common foods that can be used to display tumor size in cm include: pea (1 cm), peanuts (2 cm), grapes (3 cm), walnut (4 cm), lime (5 cm or 2 cm). inches), egg (6 cm), peach (7 cm) and grapefruit (10 cm or 4 inches). Stage 2 In stage 2, cancer is found in an “unfavorable” location (in any area not described as “favorable” in stage 1). The tumor is no more than 5 centimeters long and has not spread to the lymph nodes. Stage 3 In stage 3, cancer is found in an “unfavorable” location (in any area not described as “favorable” in stage 1) and one of the following conditions is met: The tumor is no more than 5 centimeters long and the cancer has spread to nearby lymph nodes. The tumor is larger than 5 centimeters, and the cancer could have spread to nearby lymph nodes. Stage 4 In stage 4, the tumor can be of any size and the cancer can spread to nearby lymph nodes. The cancer has spread to distant parts of the body, such as the lungs, bone marrow, or bones. The grouping system is based on whether the cancer has spread and whether all of the cancer has been surgically removed: Group I The cancer was only found where it started and was completely removed by surgery. The tissue was taken from the edges where the tumor was removed. This tissue was examined under a microscope by a pathologist and no cancer cells were found. II group Group II is divided into groups IIA, IIB and IIC. IIA: Cancer is removed by surgery, but cancer cells were seen when tissue taken from the edges where the tumor was removed was examined under a microscope by a pathologist. IIB: The cancer has spread to nearby lymph nodes, and the cancer and lymph nodes have been surgically removed. IIC: Cancer has spread to nearby lymph nodes, cancer and lymph nodes have been surgically removed, and at least one of the following is true: Tissue taken from the edges of where the tumor was removed was examined under a microscope by a pathologist and cancer cells were found. The lymph node farthest from the removed tumor was examined under a microscope by a pathologist and cancer cells were found. III group The cancer was partially removed by biopsy or surgery, but a tumor remains that can be seen with the naked eye. IV group When the diagnosis was made, the cancer had spread to distant parts of the body. Cancer cells are detected by imaging; or Cancer cells are found in fluid around the brain, spinal cord, or lungs, or in abdominal fluid; or tumors are found in these areas. The risk group is built on the basis of a stepwise systems and systems of grouping. The risk group describes the likelihood that rhabdomyosarcoma will recur (come back). Every child treated for rhabdomyosarcoma should receive chemotherapy to reduce the likelihood of cancer recurrence. The type of cancer drug, dose, and number of treatments prescribed will depend on whether the child has low, medium, or high risk rhabdomyosarcoma. The following risk groups are used: 1. Low-risk childhood rhabdomyosarcoma Low-risk childhood rhabdomyosarcoma is one of the following: An embryonic tumor of any size, which is located in a “favorable” place. After the operation, a tumor may remain, which can be seen with or without a microscope. Cancer can spread to nearby lymph nodes. The following areas are "favorable" sites: The eye or the area around the eye. Head or neck (but not in tissue around the ear, nose, sinuses, base of the skull, brain, or spinal cord). Gallbladder and bile ducts. Ureter or urethra. Testes, ovary, vagina, or uterus. An embryonic tumor of any size that is not in a “favorable” location. After the operation, a tumor may remain that can only be seen under a microscope. The cancer could have spread to nearby lymph nodes. 2. Pediatric rhabdomyosarcoma of medium risk Mid-risk childhood rhabdomyosarcoma is one of the following: An embryonic tumor of any size that does not occur at one of the “favorable” sites listed above. After the operation, a tumor remains that can be seen with or without a microscope. Cancer can spread to nearby lymph nodes. An alveolar tumor of any size at a “favorable” or “unfavorable” site. After the operation, a tumor may remain, which can be seen with or without a microscope. The cancer could have spread to nearby lymph nodes. 3. High-risk childhood rhabdomyosarcoma A high risk of childhood rhabdomyosarcoma can be of the embryonic type or the alveolar type. It may have spread to nearby lymph nodes and has spread to one or more of the following: Other parts of the body not located near the site where the tumor first formed. Fluid around the brain or spinal cord. Fluid in the lungs or abdomen. Sometimes rhabdomyosarcoma in children continues to grow or returns after treatment. Progressive rhabdomyosarcoma is cancer that keeps growing, spreading, or getting worse. Progressive illness may be a sign that the cancer has become refractory to treatment. Recurrent rhabdomyosarcoma in children is cancer that has recurred (returned) after treatment. Cancer may reappear in the same place or in other parts of the body, such as the lungs, bone, or bone marrow. Less commonly, rhabdomyosarcoma can recur in the breasts of adolescent girls or in the liver. 5.6. Overview of treatment options There are various treatments for rhabdomyosarcoma patients in children. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Because cancer is rare in children, clinical trials should be considered. Some clinical trials are only open to patients who have not yet started treatment. Children with rhabdomyosarcoma should plan for treatment by a team of healthcare professionals who are experts in treating childhood cancer. Because rhabdomyosarcoma can form in many different parts of the body, many different treatments are used. The treatment will be supervised by a pediatric oncologist, a doctor specializing in the treatment of oncological children. The pediatric oncologist works with other health care providers who are experts in treating children with rhabdomyosarcoma and specialize in specific areas of medicine. This may include the following specialists: Pediatrician. Children's surgeon. Radiologist oncologist. Children's hematologist. Children's radiologist. Specialist Pediatric Nurse. Geneticist or cancer genetics consultant. Social worker . Rehabilitation specialist. Three types of standard treatments are used: 1. Operation Surgery (removal of cancer during surgery) is used to treat rhabdomyosarcoma in children. An operation called a wide local excision is often performed. A wide local excision is the removal of the tumor and part of the tissue around it, including the lymph nodes. A second surgery may be required to remove all of the cancer. Whether the operation will be performed and its type depends on the following: Where the tumor started in the body. Influence of the operation on the appearance of the child. Influence of the operation on important functions of the child's body. How did the tumor respond to chemotherapy or radiation therapy, which may have been prescribed in the first place. In most children with rhabdomyosarcoma, it is not possible to remove the entire tumor with surgery. Rhabdomyosarcoma can form in different parts of the body, and the operation will be different for each one. Surgery to treat rhabdomyosarcoma of the eye or genital area is usually a biopsy. Chemotherapy, and sometimes radiation therapy, may be given before surgery to shrink large tumors. After the doctor removes any tumors that can be seen during surgery, patients will be given chemotherapy after surgery to kill any remaining cancer cells. Radiation therapy may also be prescribed. Treatment given after surgery to reduce the risk of cancer recurrence is called adjuvant therapy. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill or stop cancer cells from growing. There are two types of radiation therapy: External beam therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Certain treatments for radiation therapy can help prevent radiation from damaging nearby healthy tissue. These types of external radiation therapy include: Conformal radiation therapy: Conformal radiation therapy is a type of external radiation therapy in which a computer creates a three-dimensional (3-D) image of the tumor and generates beams of radiation that match the tumor. This allows a high dose of radiation to reach the tumor and cause less damage to nearby healthy tissue. Intensity Modulated Radiation Therapy (IMRT): I MRT is a type of three-dimensional (3-D) radiation therapy that uses a computer to produce images of the size and shape of a tumor. Thin beams of radiation of different intensity (strength) are directed at the tumor at different angles. Volumetric Modulated Arc Therapy (VMAT): VMAT is a type of three-dimensional radiation therapy in which a computer takes pictures of the size and shape of the tumor. During treatment, the radiation machine goes around the patient once in a circle and directs thin beams of radiation of different intensities to the tumor. Treatment with VMAT is faster than treatment with IMRT. Stereotactic body radiation therapy: Stereotactic body radiation therapy is a type of external radiation therapy. Special equipment is used to position the patient in the same position for every radiation therapy session. Once a day for several days, a radiation unit directs a higher than usual dose of radiation directly to the tumor. If the patient is in the same position during each treatment session, there is less damage to nearby healthy tissue. This procedure is also called stereotaxic external beam radiation therapy and stereotaxic radiation therapy. Proton beam therapy: Proton beam therapy is a type of high-energy external beam therapy. A radiation therapy machine directs beams of protons (tiny, invisible, positively charged particles) to cancer cells to kill them. This type of treatment can cause less damage to nearby healthy tissue. Internal beam therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are inserted directly into or near the tumor. It is used to treat cancer in areas such as the vagina, vulva, uterus, bladder, prostate, head, or neck. Internal radiation therapy is also called brachytherapy, internal radiation, implant radiation, or interstitial radiation therapy. This approach requires specialized technical skills and is offered in only a few health centers. The type and amount of radiation therapy, as well as when it is given, depends on the child's age, the type of rhabdomyosarcoma, the site of the tumor, the amount of tumor left after surgery, and the presence of a tumor in nearby lymph nodes. ... External radiation therapy is commonly used to treat rhabdomyosarcoma in children, but internal radiation therapy is sometimes used. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Chemotherapy may also be prescribed to shrink the tumor before surgery to preserve as much healthy tissue as possible. This is called neoadjuvant chemotherapy. Every child receiving treatment for rhabdomyosarcoma should receive systemic chemotherapy to reduce the likelihood of cancer recurrence. The type of anticancer drug, dose and number of treatments prescribed will depend on the child's age and whether the child has low, medium, or high risk rhabdomyosarcoma. In addition to the standard treatment, the following treatments are used: 1. Immunotherapy Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances produced by the body or in the laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biological therapy. There are different types of immunotherapy: Vaccine therapy is a cancer treatment that uses a substance or group of substances to stimulate the immune system to find a tumor and kill it. Vaccine therapy is being studied for the treatment of metastatic rhabdomyosarcoma. Immune Checkpoint Inhibitor Therapy uses the body's immune system to destroy cancer cells. Two types of immune checkpoint inhibitors are being studied in the treatment of childhood rhabdomyosarcoma that has returned from treatment: CTLA-4 is a protein on the surface of T cells that helps control the body's immune responses. When CTLA-4 attaches to another protein, called B7, on a cancer cell, it stops the T cell from killing the cancer cell. CTLA-4 inhibitors attach to CTLA-4 and allow T cells to kill cancer cells. Ipilimumab is being studied for the treatment of childhood rhabdomyosarcoma that has returned or progressed during treatment. Therapy with PD-1 and PD-L1 inhibitors: PD-1 is a protein on the surface of T cells that helps control the body's immune responses. PD-L1 is a protein found on some types of cancer cells. When PD-1 binds to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors prevent the PD-1 and PD-L1 proteins from attaching to each other. This allows T cells to kill cancer cells. Nivolumab and pembrolizumab are types of PD-1 inhibitors that are being studied in the treatment of rhabdomyosarcoma in children that recurs or progresses during treatment. 2. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and destroy certain cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. There are different types of targeted therapy: MTOR inhibitors stop a protein that helps cells divide and survive. Sirolimus is a type of mTOR inhibitor therapy being studied in the treatment of recurrent rhabdomyosarcoma. Tyrosine kinase inhibitors block signals that cancer cells should grow and divide. MK-1775, cabozantinib-s-malate, and palbociclib are tyrosine kinase inhibitors that are being studied in the treatment of newly diagnosed or recurrent rhabdomyosarcoma. 5.7. Side Effects of Treatment Treatment for rhabdomyosarcoma in children can cause side effects. Side effects from cancer treatments that start after treatment and last for months or years are called late effects. Late effects of rhabdomyosarcoma cancer treatments may include: Physical issues affecting the following: Teeth, eyes, or gastrointestinal tract. Fertility (the ability to have children). Changes in mood, feelings, thinking, learning, or memory. Second cancer (newer cancers). Some late effects can be treated or controlled. It is important to talk with your child's doctors about the impact cancer treatment can have on your child and the types of symptoms to expect after completing cancer treatment. 5.8. Treatment of childhood rhabdomyosarcoma Treatment for newly diagnosed rhabdomyosarcoma in children often includes surgery, radiation therapy, and chemotherapy. The order in which these procedures are performed depends on where the tumor started in the body, the size of the tumor, the type of tumor, and whether the tumor has spread to lymph nodes or other parts of the body. See the Treatment Options Overview section of this summary for more information on surgery, radiation therapy, and chemotherapy used to treat children with rhabdomyosarcoma. Rhabdomyosarcoma of the brain, head and neck For tumors in the brain: Treatment may include surgery to remove the tumor, radiation therapy, and chemotherapy. For head and neck tumors in or near the eye: Treatment may include chemotherapy and radiation therapy. If the tumor remains or returns after chemotherapy and radiation therapy, surgery may be required to remove the eye and some tissue around the eye. For head and neck tumors that are near the ear, nose, sinuses, or base of the skull, but not in or near the eye: Treatment may include radiation therapy and chemotherapy. For head and neck tumors that are not in or near the eye, or near the ear, nose, sinuses, or base of the skull: Treatment may include chemotherapy, radiation therapy, and surgery to remove the tumor. For head and neck tumors that cannot be removed with surgery: Treatment may include chemotherapy and radiation therapy, including stereotactic radiation therapy. For tumors of the larynx (voice box): Treatment may include chemotherapy and radiation therapy. Surgery to remove the larynx is usually not done to avoid damaging the voice. Rhabdomyosarcoma of the arms or legs Chemotherapy followed by surgery to remove the tumor. If the tumor has not been removed completely, a second surgery may be performed to remove the tumor. Radiation therapy may also be prescribed. For tumors of the hand or foot, radiation therapy and chemotherapy may be prescribed. The tumor cannot be removed because it will affect the function of the hand or foot. Dissection of the lymph nodes (one or more lymph nodes are removed and a tissue sample is checked under a microscope for signs of cancer). For arm tumors, the lymph nodes near the tumor and in the armpits are removed. For leg tumors, lymph nodes near the tumor and in the groin area are removed. Rhabdomyosarcoma of the chest, abdomen, or pelvis For tumors of the chest or abdomen (including the chest wall or abdominal wall): Surgery (wide local excision) may be performed. If the tumor is large, chemotherapy and radiation therapy are given before surgery to shrink the tumor. For pelvic tumors: surgical intervention is possible (wide local excision). If the tumor is large, chemotherapy is given before surgery to shrink the tumor. Radiation therapy may be prescribed after surgery. For tumors of the diaphragm: Tumor biopsy is followed by chemotherapy and radiation therapy to shrink the tumor. Later, surgery may be done to remove the remaining cancer cells. For tumors of the gallbladder or bile ducts: Tumor biopsy is followed by chemotherapy and radiation therapy. Later, surgery may be done to remove the remaining cancer cells. For muscle or tissue tumors around the anus, between the vulva and the anus, or between the scrotum and anus: surgery may be performed to remove as much of the tumor and some nearby lymph nodes as possible, followed by chemotherapy and radiation therapy. Rhabdomyosarcoma of the kidney For kidney tumors: surgery to remove as much of the tumor as possible. Chemotherapy and radiation therapy may also be prescribed. Rhabdomyosarcoma of the bladder or prostate For tumors that are only in the upper part of the bladder: Surgery (wide local excision) is performed. For tumors of the prostate or bladder (other than the upper part of the bladder): Chemotherapy and radiation therapy are given first to shrink the swelling. If cancer cells remain after chemotherapy and radiation therapy, the tumor is surgically removed. Surgery may involve removal of the prostate, part of the bladder, or pelvic exenteration without removing the rectum. (This may include removing the lower colon and bladder. In girls, the cervix, vagina, ovaries, and nearby lymph nodes may be removed.) Chemotherapy is given first to shrink the tumor. Surgery is performed to remove the tumor, but not the bladder or prostate. After surgery, internal or external radiation therapy may be prescribed. Surgery to remove the tumor, but not the bladder or prostate. After the operation, internal radiation therapy is prescribed. Rhabdomyosarcoma of the testicular area Surgery to remove the testicle and spermatic cord. The lymph nodes in the back of the abdomen can be checked for cancer, especially if the lymph nodes are large. Nerve-sparing retroperitoneal lymph node dissection should be performed in patients over 10 years of age without evidence of lymph node enlargement in the posterior abdomen. Radiation therapy may be prescribed if the tumor cannot be completely removed with surgery. Rhabdomyosarcoma of the vulva, vagina, uterus, or ovary For tumors in the vulva and vagina: Treatment may include chemotherapy followed by surgery to remove the tumor. After surgery, internal or external radiation therapy may be prescribed. For tumors of the uterus: Treatment may include chemotherapy with or without radiation therapy. Surgery may sometimes be required to remove any remaining cancer cells. For ovarian tumors: Treatment may include chemotherapy followed by surgery to remove the remaining tumor. Metastatic rhabdomyosarcoma Treatment, such as chemotherapy followed by radiation therapy or surgery to remove the tumor, is done at the site where the tumor first formed. If the cancer has spread to the brain, spinal cord, or lungs, radiation therapy may also be given where the cancer has spread. The following treatments are being investigated for metastatic rhabdomyosarcoma: Clinical study on immunotherapy (vaccine therapy). 5.9. Treatment of progressive or recurrent childhood rhabdomyosarcoma Treatment options for progressive or recurrent rhabdomyosarcoma in children are based on many factors, including where the cancer has returned in the body, what type of treatment the child has received before, and the child's needs. Treatment for progressive or recurrent rhabdomyosarcoma may include one or more of the following: Surgery. Radiation therapy . Chemotherapy. Clinical trial in combination chemotherapy with or without Temsirolimus. Clinical study for targeted therapy or immunotherapy (sirolimus, Ipilimumab, nivolumab, or pembrolizumab). Clinical trial of targeted therapy with a tyrosine kinase inhibitor (MK-1775, cabozantinib-s-malate or palbociclib) and chemotherapy. A clinical trial that tests a sample of a patient's tumor for certain gene changes. The type of targeted therapy that will be given to a patient depends on the type of gene change. New therapies being investigated in the early stages of clinical trials should be considered for patients with recurrent rhabdomyosarcoma. 5.6. 5.7. 5.8. 5.9. 6. TREATMENT OF SOFT TISSUE SARCOMA CHILDREN Якорь 6 Soft tissue sarcoma in childhood is a disease in which malignant (cancer) cells form in the soft tissues of the body. General information about soft tissue sarcoma (clickhere ) 6.1. Risks of developing soft tissue sarcoma in children The presence of certain diseases and hereditary disorders can increase the risk of developing soft tissue sarcoma in children. Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your child's doctor if you think your child may be at risk. Risk factors for soft tissue sarcoma in children include the presence of the following inherited conditions: Li-Fraumeni syndrome. Familial adenomatous polyposis (FAP). Changes in the RB1 gene. Changes in the SMARCB1 (INI1) gene. Neurofibromatosis type 1 (NF1). Werner syndrome. Tuberous sclerosis. Severe combined immunodeficiency with adenosine deaminase deficiency. Other risk factors include the following: Past treatment with radiation therapy. Sick of AIDS (acquired immunodeficiency syndrome) and Epstein-Barr virus infection at the same time. 6.2. Symptoms The most common symptom of childhood soft tissue sarcoma is a painless swelling or swelling in the soft tissues of the body. Sarcomas may appear as a painless lump under the skin, often on the arm, leg, chest, or abdomen. At first, there may be no other signs or symptoms. As the sarcoma gets larger and presses on nearby organs, nerves, muscles, or blood vessels, it may cause signs or symptoms, such as pain or weakness. Other conditions may cause the same signs and symptoms. Check with your child's doctor if your child has any of these concerns. 6.3. Diagnosis The following tests and procedures may be used: Medical examination and health history: examining the body to check for general signs of health, including checking for signs of disease such as tumors or anything else that seems unusual. An anamnesis of the patient's health habits as well as past illnesses and treatments will also be taken. X-rays : X-rays are a type of energy beam that can pass through the body onto film, taking pictures of areas inside the body. MRI (magnetic resonance imaging) : a procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas of the body, such as the chest, abdomen, arms, or legs. This procedure is also called nuclear magnetic resonance imaging (NMRI). CT (computed tomography) : a procedure in which a series of detailed pictures of areas inside the body, such as the chest or abdomen, are taken from different angles. The pictures were taken by a computer connected to an x-ray machine. The dye may be injected into a vein or swallowed to make organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. Ultrasound procedure : a procedure in which high-energy sound waves (ultrasound) bounce off internal tissues or organs and create an echo. The echo forms a picture of body tissues called a sonogram. The picture can be printed to view later. If tests show that there may be a soft tissue sarcoma, a biopsy is performed. The type of biopsy depends in part on the size of the growth and whether it is close to the surface of the skin or deeper in the tissue. One of the following types of biopsy is usually used: Core needle biopsy: removal of tissue with a wide needle. Several tissue samples are taken. This procedure can be guided by ultrasound, computed tomography, or MRI. Postoperative biopsy: removal of part of the tumor or tissue sample. Excision biopsy : removal of the entire tumor or an area of tissue that does not look normal. A pathologist examines tissue under a microscope for the presence of cancer cells. An excisional biopsy can be used to completely remove smaller tumors near the surface of the skin. This type of biopsy is rarely used because cancer cells may remain after the biopsy. If cancer cells remain, the cancer may return or spread to other parts of the body. An MRI of the tumor is performed before the excisional biopsy. This is done to show where the original tumor formed and can be used to guide future surgery or radiation therapy. Whenever possible, the surgeon who removes any tumor found should be involved in planning the biopsy. The placement of biopsy needles or incisions may affect the ability to remove the entire tumor during later surgery. To plan the best treatment, the tissue sample taken during the biopsy must be large enough to determine the type of soft tissue sarcoma and perform other laboratory tests. Tissue samples will be taken from the primary tumor, lymph nodes, and other areas that may have cancer cells. The pathologist examines the tissue under a microscope to look for cancer cells and determine the type and grade of the tumor. The extent of the tumor depends on how abnormal the cancer cells look under the microscope and how quickly the cells divide. High- and intermediate-grade tumors usually grow and spread faster than low-grade tumors. Because soft tissue sarcoma is difficult to diagnose, the tissue sample should be reviewed by a pathologist experienced in diagnosing soft tissue sarcoma. One or more of the following laboratory tests may be performed to study tissue samples: Molecular test : a laboratory test to check for certain genes, proteins, or other molecules in a sample of tissue, blood, or other body fluid. A molecular test may be done with other procedures, such as a biopsy, to help diagnose some types of cancer. Molecular tests check for certain gene or chromosomal changes that occur in some soft tissue sarcomas. Reverse transcription polymerase chain reaction (RT-PCR) test : a laboratory test that measures the amount of a genetic substance called mRNA made by a particular gene. An enzyme called reverse transcriptase is used to convert a specific piece of RNA into a matching piece of DNA that can be amplified (done in large quantities) by another enzyme called DNA polymerase. Amplified DNA copies help determine if a particular mRNA is being created by a genome. RT-PCR can be used to check for the activation of certain genes that may indicate the presence of cancer cells. This test can be used to look for specific changes in a gene or chromosome that can help diagnose cancer. Cytogenetic analysis: a laboratory test in which the chromosomes of cells in a sample of tumor tissue are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in some chromosomes can be a sign of cancer. Cytogenetic analysis is used to diagnose cancer, plan treatment, or determine the effectiveness of a treatment. Fluorescence in situ hybridization (FISH) is a type of cytogenetic analysis. Immunocytochemistry: a laboratory test that uses antibodies to test for specific antigens (markers) in a sample of a patient's cells. The antibodies are usually associated with an enzyme or fluorescent dye. After the antibodies bind to the antigen in the patient's cell sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test can be used to tell the difference between different types of soft tissue sarcoma. Light and electron microscopy: a laboratory test in which the cells in a tissue sample are looked at under a conventional and powerful microscope to look for specific changes in the cells. After being diagnosed with soft tissue sarcoma in childhood, tests are done to see if the cancer cells have spread to other parts of the body. The process used to determine if cancer has spread to soft tissues or to other parts of the body is called staging. There is no standard staging system for soft tissue sarcoma in children. To plan treatment, it is important to know the type of soft tissue sarcoma, whether the tumor can be surgically removed, and whether the cancer has spread to other parts of the body. To find out if the cancer has spread, the following procedures can be used: Sentinel lymph node biopsy: removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node in the lymph node group to receive lymphatic drainage from the primary tumor. This is the first lymph node to which cancer can spread from the primary tumor. A radioactive substance and/or a blue dye is injected near the tumor. The substance or dye flows through the lymphatic pathways to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist examines tissue under a microscope to look for cancer cells. If no cancer cells are found, it may not be necessary to remove additional lymph nodes. Sometimes a sentinel lymph node is found in more than one group of nodes. This procedure is used for epithelioid and clear cell sarcomas. CT (computed tomography) : a procedure that takes a series of detailed pictures of areas inside the body, such as the chest, taken from different angles. The pictures were taken by a computer connected to an x-ray machine. The dye can be injected into a vein or swallowed to make organs or tissues more clearly visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography. PET scan : A PET scan is a procedure to detect malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. The cells of malignant tumors appear brighter in the picture because they are more active and consume more glucose than normal cells. This procedure is also called a positron emission tomography (PET) scan. PET-CT scan : a procedure that combines PET scan and computed tomography (CT) images. PET and CT scans are performed simultaneously on the same machine. The images from both scans are combined to give a more detailed picture than either test could do on its own. 6.4. Types of soft tissue sarcoma tumors in children There are many different types of soft tissue sarcomas. Cells of each type of sarcoma look different under a microscope. Soft tissue tumors are grouped according to the type of soft tissue cells in which they first formed. This summary is about the following types of soft tissue sarcomas: Tumors of adipose tissue Liposarcoma. This is a cancer of the fat cells. Liposarcoma usually forms in the fatty layer just under the skin. In children and adolescents, liposarcoma is often of low severity (it is likely to grow and spread slowly). There are several different types of liposarcomas, including: Myxoid liposarcoma . It is usually a low-grade cancer that responds well to treatment. Pleomorphic liposarcoma . It is usually a high-grade cancer that is less likely to be cured. Tumors of bones and cartilage Bone and cartilage tumors are a mixture of bone and cartilage cells. Tumors of bones and cartilage are of the following types: Extraskeletal mesenchymal chondrosarcoma. This type of bone and cartilage tumor often affects young people and occurs in the head and neck. It is usually highly malignant (can grow rapidly) and can spread to other parts of the body. It may also return many years after treatment. Extraskeletal osteosarcoma . This type of bone and cartilage tumor is very rare in children and adolescents. It will likely return after treatment and may spread to the lungs. Tumors of fibrous (connective) tissue Fibrous (connective tissue) tumors include the following types: Desmoid fibromatosis (also called desmoid tumor or aggressive fibromatosis). This is a low grade fibrous tissue tumor (likely to grow slowly). It may return to nearby tissues but does not usually spread to distant parts of the body. Sometimes fibromatosis of the desmoid type can stop growing for a long time. In rare cases, the tumor may disappear without treatment. Children sometimes develop desmoid tumors with a change in the APC gene. Changes in this gene can also cause familial adenomatous polyposis (FAP). FAP is a hereditary disease (passed from parents to offspring) in which many polyps (growths on mucous membranes) form on the inner walls of the colon and rectum. Genetic counseling may be required (discussing hereditary diseases and genetic testing options with a trained specialist). Protuberan dermatofibrosarcoma . This is a tumor of the deep layers of the skin, which most often forms in the trunk, arms or legs. The cells of this tumor have a specific genetic change called a translocation (part of the COL1A1 gene switches places with part of the PDGFRB gene). To diagnose protuberans dermatofibrosarcoma, tumor cells are tested for this genetic change. Dermatofibrosarcoma protuberance usually does not spread to the lymph nodes or other parts of the body. Inflammatory myofibroblastic tumor . This cancer is made up of muscle cells, connective tissue cells, and certain immune cells. It occurs in children and adolescents. It forms most commonly in the soft tissues, lungs, spleen, and breasts. It often returns after treatment but rarely spreads to distant parts of the body. Some genetic variation has been found in about half of these tumors. Fibrosarcoma. Pediatric fibrosarcoma (also called congenital fibrosarcoma). This type of fibrosarcoma usually occurs in children 1 year of age and younger and can be detected on prenatal ultrasound. This tumor grows rapidly and is often large at diagnosis. It rarely spreads to distant parts of the body. The cells of this tumor usually have some kind of genetic change called a translocation (part of one chromosome switches places with part of another chromosome). To diagnose childhood fibrosarcoma, tumor cells are tested for this genetic change. A similar tumor has been observed in older children, but it does not have the translocation that is often seen in younger children. Fibrosarcoma in adults. This is the same type of fibrosarcoma that occurs in adults. The cells of this tumor do not have genetic changes characteristic of childhood fibrosarcoma. There are two types of fibrosarcoma in children and adolescents: Myxofibrosarcoma . It is a rare fibrous tissue tumor that is less common in children than in adults. Low grade fibromyxoid sarcoma . It is a slow-growing tumor that forms deep in the arms or legs and mostly affects young and middle-aged people. The tumor may return many years after treatment and spread to the lungs and chest lining. Lifelong monitoring is required. Sclerosing epithelioid fibrosarcoma. This is a rare tumor of fibrous tissue that grows rapidly. It may return and spread to other parts of the body years after treatment. Long-term follow-up is required. Skeletal muscle tumors Skeletal muscles attach to bones and help the body move. Rhabdomyosarcoma . Rhabdomyosarcoma is the most common soft tissue sarcoma in children 14 years of age and younger. (For more information, see PDQ summary for treatment of pediatric rhabdomyosarcoma.) Smooth muscle tumors Smooth muscles line the interior of blood vessels and hollow internal organs such as the stomach, intestines, bladder, and uterus. Leiomyosarcoma . This smooth muscle tumor has been linked to the Epstein-Barr virus in children who also have HIV or AIDS. Leiomyosarcoma may also form as a second cancer in survivors of hereditary retinoblastoma, sometimes many years after initial treatment for retinoblastoma. So-called fibrohistiocytic tumors Plexiform fibrohistiocytic tumor . It is a rare tumor that usually affects children and young adults. The tumor usually starts as a painless growth on or just below the skin of the arm, hand, or wrist. Rarely, it can spread to nearby lymph nodes or the lungs. Tumors of the nerve sheaths The nerve sheath consists of protective layers of myelin that cover nerve cells that are not part of the brain or spinal cord. Nerve sheath tumors are of the following types: Malignant tumor of the peripheral nerve sheath. Some children with peripheral nerve sheath cancer have a rare genetic disorder called neurofibromatosis type 1 (NF1). This tumor can be low grade or high grade. Malignant newt tumor. These are very fast growing tumors that most often occur in children with NF1. Ectomesenchymoma . It is a fast growing tumor that occurs mainly in children. Ectomesenchymomas can form in the eye socket, abdomen, arms, or legs. Pericytic (perivascular) tumors Pericytic tumors form in cells that surround blood vessels. Pericytic tumors are of the following types: Myopericytoma . Pediatric hemangiopericytoma is a type of myopericytoma. Children younger than 1 year of age at diagnosis may have a better prognosis. In patients older than 1 year, infantile hemangiopericytoma is more likely to spread to other parts of the body, including the lymph nodes and lungs. Childhood myofibromatosis. Children's myofibromatosis is another type of myopericytoma. This is a fibrous tumor that often forms in the first 2 years of life. There may be a single nodule under the skin, usually in the head and neck (myofibroma), or multiple nodules in the skin, muscles, or bones (myofibromatosis). In patients with infantile myofibromatosis, the cancer can also spread to organs. These tumors may disappear without treatment. Tumors of unknown cellular origin Tumors of unknown cellular origin (the type of cell in which the tumor first formed is unknown) include the following types: Synovial sarcoma . Synovial sarcoma is a common type of soft tissue sarcoma in children and adolescents. It usually forms in the tissues around the joints of the arms or legs, but it can also form in the trunk, head, or neck. The cells of this tumor usually have some kind of genetic change called a translocation (part of one chromosome switches places with part of another chromosome). Larger tumors have a greater risk of spreading to other parts of the body, including the lungs. Children younger than 10 years of age who have a tumor that is 5 centimeters or smaller in the arms or legs have a better prognosis. Epithelioid sarcoma . This is a rare sarcoma that usually starts deep in the soft tissues as a slowly growing hard lump and may spread to the lymph nodes. If cancer has formed in the arms, legs, or buttocks, a sentinel lymph node biopsy may be done to check for cancer in the lymph nodes. Soft alveolar sarcoma parts . This is a rare tumor of soft, supportive tissue that connects and surrounds organs and other tissues. It most commonly occurs in the arms and legs, but can occur in the tissues of the mouth, jaws, and face. It can grow slowly and often spreads to other parts of the body. Soft alveolar sarcoma may have a better prognosis when the tumor is 5 centimeters or smaller, or when the tumor is completely removed by surgery. The cells of this tumor usually have a certain genetic change called a translocation (part of the ASSPL gene switches places with part of the TFE3 gene). To diagnose soft alveolar sarcoma, tumor cells are tested for this genetic change. Soft tissue clear cell sarcoma . It is a slow-growing soft tissue tumor that starts in a tendon (tough, fibrous, umbilical cord tissue that connects a muscle to a bone or to another part of the body). Clear cell sarcoma most commonly occurs in the deep tissues of the foot, heel, and ankle. It can spread to nearby lymph nodes. The cells of this tumor usually have some kind of genetic change called a translocation (part of the EWSR1 gene switches places with part of the ATF1 or CREB1 gene). To diagnose clear cell soft tissue sarcoma, tumor cells are tested for this genetic change. Extraskeletal myxoid chondrosarcoma. This type of soft tissue sarcoma can occur in children and adolescents. Over time, it tends to spread to other parts of the body, including the lymph nodes and lungs. The tumor may return many years after treatment. Extraskeletal Ewing's sarcoma Desmoplastic small cell tumor . This tumor most commonly forms in the peritoneum of the abdomen, pelvis, and/or peritoneum in the scrotum, but may form in the kidneys or other solid organs. Dozens of small tumors can form in the peritoneum. Desmoplastic small cell tumor can also spread to the lungs and other parts of the body. The cells of this tumor usually have some kind of genetic change called a translocation (part of one chromosome switches places with part of another chromosome). To diagnose a desmoplastic small cell tumor, tumor cells are tested for this genetic change. Extrarenal (extracranial) rhabdoid tumor . This rapidly growing tumor forms in soft tissues such as the liver and bladder. It usually occurs in young children, including newborns, but may occur in older children and adults. Rhabdoid tumors may be associated with a change in a tumor suppressor gene called SMARCB1. This type of gene makes a protein that helps control cell growth. Changes in the SMARCB1 gene can be inherited. Genetic counseling may be required (discussion with a qualified specialist of hereditary diseases and the possible need for genetic testing). Perivascular epithelioid cell tumors (PEComas). Benign PEComas can occur in children with an inherited condition called tuberous sclerosis. They occur in the stomach, intestines, lungs and urinary organs. PEComas grow slowly and most of them are unlikely. Undifferentiated/unclassified sarcoma. These tumors usually occur in the bones or muscles that are attached to the bones and help the body move. Undifferentiated pleomorphic sarcoma/malignant fibrous histiocytoma (high grade). This type of soft tissue tumor can form in parts of the body where patients have previously received radiation therapy, or as a second cancer in children with retinoblastoma. The tumor usually forms in the arms or legs and may spread to other parts of the body. Tumors of blood vessels Blood vessel tumors include the following types: Epithelioid hemangioendothelioma . Epithelioid hemangioendotheliomas can occur in children but are most common in adults between the ages of 30 and 50. They usually originate in the liver, lungs, or bones. They can be either fast growing or slow growing. In about a third of cases, the tumor spreads very quickly to other parts of the body. Angiosarcoma of soft tissues. Soft tissue angiosarcoma is a rapidly growing tumor that forms in the blood or lymph vessels anywhere in the body. Most angiosarcomas are in or under the skin. Those found in deeper soft tissues may form in the liver, spleen, or lungs. They are very rare in children, who sometimes have more than one tumor in the skin or liver. In rare cases, childhood hemangioma can become soft tissue angiosarcoma. Sometimes soft tissue sarcoma in children continues to grow or comes back after treatment. Progressive soft tissue sarcoma in children is a cancer that continues to grow, spread, or get worse. Progressive disease may be a sign that the cancer has become refractory to treatment. Recurrent soft tissue sarcoma in children is cancer that has recurred (come back) after treatment. The cancer could reappear in the same place or in other parts of the body. 6.5. Factors affecting the prognosis of recovery Prognosis and treatment options depend on the following: The part of the body where the tumor first formed. Size and grade of the tumor. type of soft tissue sarcoma. How deep is the tumor under the skin. Whether the tumor has spread to other parts of the body and where it has spread. The amount of tumor left after surgery to remove it. Whether radiation therapy was used to treat the tumor. Whether the cancer was just diagnosed or recurred (came back). 6.6. Overview of treatment options for children's soft tissue sarcoma There are various methods of treatment for patients with soft tissue sarcoma in childhood. A variety of treatments are available to patients with childhood soft tissue sarcoma. Some treatments are standard (currently used) and some are in clinical trials. A clinical trial of a treatment is a scientific study designed to help improve existing treatments or provide information about new treatments for cancer patients. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Since childhood cancer is rare, participation in clinical trials should be considered. Some clinical trials are only open to patients who have not yet started treatment. Children with soft tissue sarcoma in childhood should be planned for treatment by a team of healthcare professionals who are experts in treating childhood cancer. Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. A pediatric oncologist works with other health care providers who are experts in treating children with soft tissue sarcoma and specialize in specific areas of medicine. This may be a pediatric surgeon who has special training in the removal of soft tissue sarcomas. The following specialists may also be included: Pediatrician. Radiation Oncologist. Pediatric hematologist. Pediatric Nurse Specialist. Rehabilitation Specialist. Psychologist . Social worker . Children's Life Specialist. Seven types of standard treatment are used: 1. Operation If possible, an operation is performed to completely remove the soft tissue sarcoma. If the tumor is very large, radiation therapy or chemotherapy may be given first in order to shrink the tumor and reduce the amount of tissue that needs to be removed during surgery. This is called neoadjuvant (preoperative) therapy. The following types of surgical interventions can be used: Wide local excision : removal of the tumor along with the normal tissue around it. Amputation : surgery to remove all or part of an arm or leg with cancer. Lymphadenectomy : removal of lymph nodes for cancer. Mohs surgery: a surgical procedure used to treat skin cancer. Individual layers of cancerous tissue are removed and examined under a microscope one at a time until all of the cancerous tissue has been removed. This type of surgery is used to treat protuberance dermatofibrosarcoma. It is also called Mohs micrographic surgery. Hepatectomy : surgery to remove all or part of the liver. A second operation may be required for: Removal of all remaining cancer cells. Check the area around where the tumor was removed for cancer cells and then remove more tissue if necessary. If the cancer is in the liver, a hepatectomy and liver transplant (the liver is removed and replaced with a healthy one from a donor) may be done. After the doctor removes any tumors that can be seen during surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer coming back is called adjuvant therapy. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or prevent them from growing. There are two types of radiation therapy: External Beam Therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Certain ways of delivering radiation therapy can help prevent radiation damage to nearby healthy tissue. This type of radiation therapy may include the following: Stereotactic Body Radiation Therapy : Stereotactic Body Radiation Therapy is a type of external beam radiation therapy. Special equipment is used to position the patient in the same position for each radiation therapy session. Once a day for several days, the radiation machine delivers a larger than usual dose of radiation directly to the tumor. If the patient is in the same position for each treatment session, there is less damage to nearby healthy tissue. This procedure is also called stereotactic external beam radiation therapy and stereotactic radiation therapy. Conformal radiotherapy: conformal radiation therapy is a type of external beam radiation therapy in which a computer creates a three-dimensional (3-D) image of the tumor and generates radiation beams that match the tumor. This allows a high dose of radiation to reach the tumor and cause less damage to nearby healthy tissue. Intensity Modulated Radiation Therapy (IMRT): IMRT is a type of three-dimensional (3-D) radiation therapy that uses a computer to produce images of the size and shape of a tumor. Thin beams of radiation of different intensity (strength) are directed to the tumor at different angles. This type of external beam radiation therapy does less damage to nearby healthy tissue. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are injected directly into or near the tumor. Whether radiation therapy is given before or after cancer surgery depends on the type and stage of cancer being treated, the presence of any cancer cells after surgery, and the expected side effects of the treatment. External and internal radiation therapy is used to treat soft tissue sarcoma in children. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is injected directly into the cerebrospinal fluid, organ, or body cavity, such as the abdominal cavity, the drugs mainly target cancer cells in those areas (regional chemotherapy). Combination chemotherapy is the use of more than one anticancer drug. Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a type of treatment used during surgery that is being studied for desmoplastic small cell tumor. After the surgeon has removed as much of the tumor tissue as possible, warm chemotherapy is directed directly into the abdomen. Method of conducting chemotherapy depends on the type of soft tissue sarcoma being treated. Most types of soft tissue sarcomas do not respond to chemotherapy. 4. Surveillance Observation is closely monitoring the patient's condition without giving any treatment until signs or symptoms appear or change. Observation may be carried out when: Complete removal of the tumor is not possible. There are no other treatments available. The tumor is unlikely to damage any vital organs. Observation may be used to treat desmoid-type fibromatosis, childhood fibrosarcoma, PEComa, or epithelioid hemangioendothelioma. 5. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to target and target specific cancer cells. Targeted therapy usually causes less damage to normal cells than chemotherapy or radiation therapy. Kinase inhibitors block an enzyme called a kinase (a type of protein). There are different types of kinases in the body that have different actions. ALK inhibitors can stop the growth and spread of cancer. Crizotinib may be used to treat inflammatory myofibroblastic tumor, childhood fibrosarcoma, and soft tissue clear cell sarcoma. Tyrosine kinase inhibitors (TKIs) block the signals necessary for tumor growth. Imatinib is used to treat protuberance dermatofibrosarcoma. Pazopanib may be used to treat desmoid-type fibromatosis, epithelioid hemangioendothelioma, and some types of recurrent and progressive soft tissue sarcoma. Sorafenib can be used to treat desmoid-type fibromatosis and epithelioid hemangioendothelioma. Sunitinib can be used to treat soft alveolar sarcoma. Larotrectinib is used to treat childhood fibrosarcoma. Ceritinib is used to treat inflammatory myofibroblastic tumor. Axitinib may be used to treat some types of advanced soft tissue sarcoma, including alveolar soft tissue sarcoma. mTOR inhibitors are a type of targeted therapy that stops a protein that helps cells divide and survive. mTOR inhibitors are used to treat recurrent desmoplastic small cell tumors, PEComas, and epithelioid hemangioendothelioma and are also being studied to treat malignant peripheral nerve sheath tumors. Sirolimus and temsirolimus are mTOR inhibitor therapies New types of tyrosine kinase inhibitors are being studied, such as: Entrectinib and selitrectinib in childhood fibrosarcoma. Trametinib for epithelioid hemangioendothelioma. 6. Immunotherapy Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances produced by the body or produced in a laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biological therapy. Interferon and immune checkpoint inhibitor therapy are types of immunotherapy. Interferon prevents tumor cells from dividing and can slow tumor growth. It is used to treat epithelioid hemangioendothelioma. Immune checkpoint inhibitor therapy: Some types of immune cells, such as T cells and some cancer cells, have certain proteins on their surface, called checkpoint proteins, that control immune responses. When cancer cells contain large amounts of these proteins, they will not be attacked and killed by T cells. Immune checkpoint inhibitors block these proteins, and the ability of T cells to kill cancer cells is increased. There are two types of immune checkpoint inhibitor therapy: CTLA-4 inhibitor therapy: CTLA-4 is a protein on the surface of T cells that helps control the body's immune responses. When CTLA-4 attaches to another protein called B7 on a cancer cell, it stops the T cell from killing the cancer cell. CTLA-4 inhibitors attach to CTLA-4 and allow T cells to kill cancer cells. Ipilimumab is a type of CTLA-4 inhibitor that is being studied for the treatment of angiosarcoma. PD-1 and PD-L1 inhibitor therapy: PD-1 is a protein on the surface of T cells that helps control the body's immune responses. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors prevent the PD-1 and PD-L1 proteins from attaching to each other. This allows T cells to kill cancer cells. Pembrolizumab is a type of PD-1 inhibitor that is used to treat progressive and recurrent soft tissue sarcoma. Nivolumab is a type of PD-1 inhibitor that is being studied for the treatment of angiosarcoma. Atezolizumab is a type of PD-L1 inhibitor that is being studied for the treatment of soft alveolar sarcoma. 7. Other drug therapy Steroid therapy has an antitumor effect in inflammatory myofibroblastic tumors. hormone therapy is a cancer treatment that removes or blocks hormones and stops the growth of cancer cells. Hormones are substances produced by glands in the body and circulate in the bloodstream. Certain hormones can cause certain types of cancer to grow. If tests show that cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working. Antiestrogens (drugs that block estrogen), such as tamoxifen, may be used to treat desmoid-type fibromatosis. Prasterone is being studied for the treatment of synovial sarcoma. Non-steroidal anti-inflammatory drugs (NSAIDs) are drugs (such as aspirin, ibuprofen, and naproxen) commonly used to reduce fever, swelling, pain, and redness. When treating desmoid-type fibromatosis, an NSAID called sulindac can be used to help block the growth of cancer cells. 6.7. Treatment for soft tissue sarcoma in children can cause side effects. Side effects from cancer treatment that begin after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include: physical problems. Changes in mood, feelings, thinking, learning, or memory. Second cancer (new types of cancer). 6.8. Treatment options soft tissue sarcomas in children Tumors of adipose tissue Liposarcoma Treatment for newly diagnosed liposarcoma may include the following: Surgery to completely remove the tumor. If the cancer is not completely removed, a second operation may be done. Chemotherapy to shrink the tumor followed by surgery. Radiation therapy before or after surgery. Tumors of bones and cartilage Extraskeletal mesenchymal chondrosarcoma Treatment for newly diagnosed extraskeletal mesenchymal chondrosarcoma may include the following: Surgery to completely remove the tumor. Radiation therapy may be given before and/or after surgery. Chemotherapy followed by surgery. After surgery, chemotherapy is prescribed with or without radiation therapy. Extraskeletal osteosarcoma Treatment for newly diagnosed extraskeletal osteosarcoma may include the following: Surgery to completely remove the tumor followed by chemotherapy. Fibrous (connective) tissue tumors Fibromatosis desmoid type Treatment for newly diagnosed desmoid-type fibromatosis may include the following: Surveillance for asymptomatic tumors, tumors that cannot damage any vital organs, and tumors that cannot be completely removed by surgery. Chemotherapy for tumors that have not been completely removed by surgery or that have recurred. Targeted therapy (sorafenib or pazopanib). Non-steroidal anti-inflammatory drugs (NSAIDs) therapy. Antiestrogenic drug therapy. Surgery to completely remove the tumor. Radiation therapy . Clinical study on targeted therapy with an inhibitor of the NOTCH pathway. Protuberan dermatofibrosarcoma Treatment for newly diagnosed protuberance dermatofibrosarcoma may include the following: Surgery to completely remove the tumor, if possible. This may include the Mohs operation. Radiation therapy before or after surgery. Radiation therapy and targeted therapy (imatinib) if the tumor cannot be removed or has returned. Inflammatory myofibroblastic tumor Treatment for a newly diagnosed inflammatory myofibroblastic tumor may include the following: Surgery to completely remove the tumor, if possible. Chemotherapy. Steroid therapy. Non-steroidal anti-inflammatory drugs (NSAIDs) therapy. Targeted therapy (crizotinib and ceritinib). fibrosarcoma Pediatric fibrosarcoma Treatment for newly diagnosed childhood fibrosarcoma may include the following: Surgery to remove the tumor, if possible, followed by follow-up. Surgery followed by chemotherapy. Chemotherapy to shrink the tumor followed by surgery. Targeted therapy (crizotinib and larotrectinib). A clinical trial that tests a sample of a patient's tumor for certain gene changes. The type of targeted therapy that will be administered to a patient depends on the type of gene change. Clinical trials of targeted therapies (larotrectinib, entrectinib, or selitrectinib). Fibrosarcoma in adults Treatment for newly diagnosed fibrosarcoma in adults may include the following: Surgery to completely remove the tumor, if possible. Myxofibrosarcoma Treatment for newly diagnosed myxofibrosarcoma may include the following: Surgery to completely remove the tumor. Fibromyxoid sarcoma, low grade Treatment for newly diagnosed low-grade fibromyxoid sarcoma may include the following: Surgery to completely remove the tumor. Sclerosing epithelioid fibrosarcoma Treatment for newly diagnosed sclerosing epithelioid fibrosarcoma may include the following: Surgery to completely remove the tumor. Skeletal muscle tumors Rhabdomyosarcoma Smooth muscle tumors Leiomyosarcoma Treatment for newly diagnosed leiomyosarcoma may include the following: Chemotherapy. So-called fibrohistiocytic tumors Plexiform fibrohistiocytic tumor Treatment for a newly diagnosed plexiform fibrohistiocytic tumor may include the following: Surgery to completely remove the tumor. Tumors of the nerve sheath Malignant tumor of the peripheral nerve sheath Treatment for a newly diagnosed malignant peripheral nerve sheath tumor may include the following: Surgery to completely remove the tumor, if possible. Radiation therapy before or after surgery. Chemotherapy for tumors that cannot be removed surgically. A clinical trial that tests a sample of a patient's tumor for certain gene changes. The type of targeted therapy that will be administered to a patient depends on the type of gene change. Clinical trials of targeted therapy (ganetespib or sirolimus) for tumors that cannot be surgically removed. Clinical trials of targeted therapy (tazemetostat). It is unclear whether radiation therapy or chemotherapy after surgery improves tumor response to treatment. Malignant triton tumor Newly diagnosed malignant newt tumors can be treated in the same way as rhabdomyosarcomas and include surgery, chemotherapy, or radiation therapy. It is unclear whether radiation therapy or chemotherapy improves tumor response to treatment. Ectomesenchymoma Treatment for a newly diagnosed ectomesenchymoma may include the following: Surgery. Chemotherapy. Radiation therapy . Pericytic (perivascular) tumors Pediatric hemangiopericytoma Treatment for newly diagnosed childhood hemangiopericytoma may include the following: Chemotherapy. Childhood myofibromatosis Treatment for newly diagnosed infantile myofibromatosis may include the following: Combined chemotherapy. Tumors of unknown cell origin (the place where the tumor first formed is unknown) synovial sarcoma Treatment for newly diagnosed synovial sarcoma may include the following: Surgery. Radiation therapy and/or chemotherapy may be given before or after surgery. Chemotherapy. Stereotactic radiotherapy for tumors that have spread to the lungs. Clinical Research on Gene Therapy. Clinical Trials of Hormone Therapy. Epithelioid sarcoma Treatment for newly diagnosed epithelioid sarcoma may include the following: If possible, surgery to remove the tumor. Chemotherapy. Radiation therapy before or after surgery. Clinical study on targeted therapy (tazemetostat). Sarcoma of the alveolar soft part Treatment for newly diagnosed soft alveolar sarcoma may include the following: Surgery to completely remove the tumor, if possible. Radiation therapy before or after surgery if the tumor cannot be completely removed by surgery. Targeted therapy (sunitinib). Clinical study on targeted therapy (cediranib or sunitinib). Clinical trials of immunotherapy (atezolizumab). Clear cell soft tissue sarcoma Treatment for newly diagnosed clear cell soft tissue sarcoma may include the following: If possible, surgery to remove the tumor. Radiation therapy before or after surgery. Targeted therapy (crizotinib). Extraskeletal myxoid chondrosarcoma Treatment for newly diagnosed extraskeletal myxoid chondrosarcoma may include the following: If possible, surgery to remove the tumor. Radiation therapy . Clinical study on targeted therapy (tazemetostat). Extraskeletal Ewing's sarcoma Four types of standard treatment are used: Chemotherapy Radiation therapy Operation High-dose chemotherapy with stem cell rescue New treatments are undergoing clinical trials. Targeted Therapy Immunotherapy Desmoplastic small cell tumor There is no standard treatment for a newly diagnosed desmoplastic small round cell tumor. Treatment may include the following: Surgery to completely remove the tumor, if possible. Surgery and Hyperthermic Intraperitoneal Chemotherapy. Chemotherapy followed by surgery. Radiation therapy . Chemotherapy and targeted therapy (temsirolimus) for recurrent tumors. Extrarenal (extracranial) rhabdoid tumor Treatment for a newly diagnosed extrarenal (extracranial) rhabdoid tumor may include the following: If possible, surgery to remove the tumor. Chemotherapy. Radiation therapy . A clinical trial that tests a sample of a patient's tumor for certain gene changes. The type of targeted therapy that will be administered to a patient depends on the type of gene change. Clinical trials of targeted therapy (tazemetostat). Perivascular epithelioid cell tumors (PEComas) Treatment for newly diagnosed perivascular epithelioid cell tumors may include the following: Surgery to remove the tumor. Observation followed by surgery. Targeted therapy (sirolimus) for tumors that have certain genetic changes and cannot be removed by surgery. Undifferentiated / unclassified sarcoma Undifferentiated pleomorphic sarcoma/malignant fibrous histiocytoma (high grade) There is no standard treatment for these tumors. Tumors of blood vessels Epithelioid hemangioendothelioma Treatment for newly diagnosed epithelioid hemangioendothelioma may include the following: Observation. If possible, surgery to remove the tumor. Immunotherapy (interferon) and targeted therapy (thalidomide, sorafenib, pazopanib, sirolimus) for tumors that can spread. Chemotherapy. Total hepatectomy and liver transplantation for liver tumors. Clinical study on targeted therapy ( trametinib ). Soft tissue angiosarcoma Treatment for newly diagnosed angiosarcoma may include the following: Surgery to completely remove the tumor. Combination of surgery, chemotherapy and radiotherapy for advanced angiosarcoma. Targeted therapy (bevacizumab) and chemotherapy for angiosarcomas that started as infantile hemangiomas. Clinical trial of chemotherapy with or without targeted therapy (Pazopanib). Clinical trials for immunotherapy (nivolumab and ipilimumab). Metastatic soft tissue sarcoma in children Treatment for childhood soft tissue sarcoma that has spread to other parts of the body at diagnosis may include the following: Chemotherapy and Radiation Therapy. Surgery may be done to remove tumors that have spread to the lung. Stereotactic radiotherapy for tumors that have spread to the lungs. Treatment of progressive or recurrent soft tissue sarcoma in children Treatment for advanced or recurrent soft tissue sarcoma in children may include the following: Surgery to remove cancer that has returned to where it first formed or has spread to the lungs. Surgery followed by external or internal radiation therapy, if radiation therapy has not yet been performed. Surgery to remove the cancerous arm or leg if radiation therapy has already been given. Surgical treatment of recurrent synovial sarcoma with or without chemotherapy. Chemotherapy. Targeted therapy (Pazopanib or axitinib). Immunotherapy (pembrolizumab). Stereotactic radiation therapy to treat cancer that has spread to other parts of the body, especially the lungs. Clinical trial of a new chemotherapy regimen with or without targeted therapy (Pazopanib). A clinical trial that tests a sample of a patient's tumor for certain gene changes. The type of targeted therapy that will be administered to a patient depends on the type of gene change. 6.1. 6.2. 6.3 6.4. 6.5. 6.6 6.7. 6.8. Vascular tumors in children are formed from cells that form blood or lymphatic vessels. Vascular tumors can form from abnormal cells in the blood or lymph vessels anywhere in the body. They can be benign (not cancer) or malignant (cancer). There are many types of vascular tumors. The most common type of vascular tumor in children is childhood hemangioma, a benign tumor that usually resolves on its own. Since malignant vascular tumors are rare in children, there is not much information about what is the best treatment. 7.1. The tests are used to detect (search for) and diagnose vascular tumors in children. The following tests and procedures may be used: Medical examination and history: examining the body to check for general signs of health, including checking for signs of disease such as lumps, lesions, or anything else that seems unusual. The patient's history, health habits, past illnesses, and treatments will also be recorded. Ultrasound procedure : a procedure in which high-energy sound waves (ultrasound) bounce off internal tissues or organs and create an echo. The echo forms a picture of body tissues called a sonogram. The picture can be printed to view later. CT (computed tomography) : a procedure in which a series of detailed photographs of areas within the body taken from different angles are taken. The pictures were taken by a computer connected to an x-ray machine. The dye may be injected into a vein or swallowed to make organs and tissues more visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (magnetic resonance imaging) : a procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI) 7.2. Groups of vascular tumors in children Vascular tumors in children can be divided into four groups. 1. Benign tumors Benign tumors are not cancer. This summary contains information about the following benign vascular tumors : Children's hemangioma. congenital hemangioma. Benign vascular tumors of the liver. Hemangioma spindle cell. Epithelioid hemangioma. Pyogenic granuloma (lobular capillary hemangioma). Angiofibroma. Juvenile angiofibroma of the nasopharynx. 2. Intermediate (locally aggressive) tumors Interstitial tumors that are locally aggressive often spread to the area around the tumor. This review provides information on the following locally aggressive vascular tumors: Kaposiform hemangioendothelioma and bundle angioma. 3. Intermediate (rarely metastasizing) tumors Intermediate (rarely metastatic) tumors sometimes spread to other parts of the body. This summary provides information on the following vascular tumors that rarely metastasize: Pseudomyogenic hemangioendothelioma. Retiform hemangioendothelioma. Papillary intralymphatic angioendothelioma. Composite hemangioendothelioma. Kaposi's sarcoma. 4. Malignant tumors Malignant tumors are cancer. This summary provides information on the following vascular malignancies: Epithelioid hemangioendothelioma. Soft tissue angiosarcoma. 7.3. Overview of treatment options There are various treatments for vascular tumors in children. A variety of treatments are available for children with vascular tumors. Some treatments are standard (currently used) and some are in clinical trials. A clinical trial of a treatment is a scientific study designed to help improve existing treatments or provide information about new treatments. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Since vascular tumors are rare in children, participation in clinical trials should be considered. Some clinical trials are only open to patients who have not yet started treatment. Treatment of children with childhood vascular tumors should be planned by a team of healthcare professionals who are experts in the treatment of childhood cancer. Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. A pediatric oncologist works with other pediatric providers who are experts in treating children with cancer and specialize in specific areas of medicine. This may include the following professionals: Pediatric specialist in vascular anomalies (specialist in the treatment of vascular tumors in children). Pediatric surgeon. Orthopedic surgeon. Radiation Oncologist. Pediatric Nurse Specialist. Rehabilitation Specialist. Psychologist . Social worker . Treatment of vascular tumors in children may cause side effects. Some treatments, such as chemotherapy and radiation therapy, cause side effects that continue or appear months or years after treatment ends. These are the so-called late effects. Late effects of treatment may include the following: physical problems. Changes in mood, feelings, thinking, learning, or memory. Second cancer (new types of cancer). Some late effects can be treated or controlled. It is important to talk to your child's doctors about possible late effects of certain treatments. Eleven types of standard treatment are used: 1. Beta-blocker therapy Beta blockers are drugs that lower blood pressure and heart rate. When used in patients with vascular tumors, beta-blockers may help shrink the tumor. Beta-blocker therapy may be given by vein (IV), by mouth, or placed on the skin (topical). The method of application of beta-blockers depends on the type of vascular tumors and where the tumor first formed. The beta-blocker propranolol is usually the first drug to treat hemangiomas. Infants receiving intravenous propranolol may need to start treatment in the hospital. Propranolol is also used to treat benign vascular tumors in the liver and kaposiform hemangioendothelioma. Other beta-blockers used to treat vascular tumors include atenolol, nadolol, and timolol. Pediatric hemangioma can also be treated with propranolol and steroid therapy, or propranolol and topical beta-blocker therapy. 2. Operation The following types of surgery can be used to remove many types of vascular tumors: Excision : an operation to remove the entire tumor and part of the healthy tissue around it. Laser surgery : a surgical procedure in which a laser beam (a narrow beam of intense light) is used as a knife to make bloodless cuts in tissue or remove skin lesions such as a tumor. For some hemangiomas, a pulsed dye laser can be used. This type of laser uses a beam of light that affects the blood vessels in the skin. The light is converted to heat and the blood vessels are destroyed without damaging the adjacent skin. Curettage : a procedure in which abnormal tissue is removed using a small, spoon-shaped instrument called a curette. Total hepatectomy and liver transplant: a surgical procedure to remove the entire liver, followed by transplantation of a healthy liver from a donor. The type of surgery used depends on the type of vascular tumor and its location in the body. For malignant tumors, after the doctor has removed all tumors that can be seen during surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer coming back is called adjuvant therapy. 3. Photocoagulation Photocoagulation is the use of an intense beam of light, such as a laser, to close blood vessels or destroy tissue. Used to treat pyogenic granuloma. 4. Embolization Embolization is a procedure in which particles, such as tiny gelatin sponges or beads, block blood vessels in the liver. It can be used to treat certain benign vascular tumors of the liver and kaposiform hemangioendothelioma. 5. Chemotherapy Chemotherapy is a treatment that uses drugs to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. There are different ways of giving chemotherapy: Systemic chemotherapy: when chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach tumor cells throughout the body. Sometimes more than one anticancer drug is prescribed. This is called combination chemotherapy. Local chemotherapy: when chemotherapy is applied to the skin in the form of a cream or lotion, the drugs primarily target the tumor cells in the treated area. Regional chemotherapy: when chemotherapy is injected directly into the cerebrospinal fluid, organ, or body cavity, such as the abdominal cavity, the drugs mainly target tumor cells in those areas. How chemotherapy is given depends on the type of vascular tumor being treated. Systemic and local chemotherapy are used to treat some vascular tumors. 6. Sclerotherapy Sclerotherapy is a treatment used to destroy a blood vessel leading to swelling and swelling. Fluid is injected into the blood vessel, causing it to become scarred and destroyed. Over time, the destroyed blood vessel is absorbed into normal tissues. Instead, blood flows through nearby healthy veins. Sclerotherapy is used in the treatment of epithelioid hemangioma. 7. Radiation therapy Radiation therapy is a treatment that uses high-energy x-rays or other types of radiation to kill tumor cells or prevent their growth. There are two types of radiation therapy: External Beam Therapy uses a device located outside the body to direct radiation at a tumor. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are injected directly into or near the tumor. The way radiation therapy is given depends on the type of vascular tumor being treated. External radiation is used to treat some vascular tumors. 8. Targeted therapy Targeted Therapy is a type of treatment that uses drugs or other substances to attack specific tumor cells. Targeted therapy usually causes less damage to normal cells than chemotherapy or radiation therapy. Various types of targeted therapies are being used or are being studied to treat vascular tumors in children: Angiogenesis inhibitors : angiogenesis inhibitors are drugs that stop cell division and prevent the growth of new blood vessels needed for tumor growth. The targeted therapy drugs thalidomide, sorafenib, pazopanib, and sirolimus are angiogenesis inhibitors used to treat vascular tumors in children. Mammalian target for rapamycin (mTOR) inhibitors: mTOR inhibitors block a protein called mTOR, which can inhibit the growth of cancer cells and prevent the growth of new blood vessels needed for tumor growth. Kinase inhibitors: kinase inhibitors block the signals necessary for tumor growth. Trametinib is being studied for the treatment of epithelioid hemangioendothelioma. 9. Immunotherapy Immunotherapy is a treatment that uses the patient's immune system to fight disease. Substances produced by the body or produced in a laboratory are used to enhance, direct, or restore the body's natural defenses against disease. In the treatment of vascular tumors in children, the following types of immunotherapy are used: Interferon is a type of immunotherapy used to treat vascular tumors in children. It prevents tumor cells from dividing and can slow tumor growth. It is used in the treatment of juvenile angiofibroma of the nasopharynx, kaposiform hemangioendothelioma, and epithelioid hemangioendothelioma. Therapy with immune checkpoint inhibitors: some types of immune cells, such as T cells and some cancer cells, have certain proteins on their surface called checkpoint proteins that control immune responses. When cancer cells contain large amounts of these proteins, they will not be attacked and killed by T cells. Immune checkpoint inhibitors block these proteins, and the ability of T cells to kill cancer cells is increased. There are two types of immune checkpoint inhibitor therapy: CTLA-4 inhibitor: CTLA-4 is a protein on the surface of T cells that helps control the body's immune responses. When CTLA-4 attaches to another protein called B7 on a cancer cell, it stops the T cell from killing the cancer cell. CTLA-4 inhibitors attach to CTLA-4 and allow T cells to kill cancer cells. Ipilimumab is a type of CTLA-4 inhibitor being studied in the treatment angiosarcomas of soft tissue . 10. Other drug therapy Other medicines used to treat or reverse the effects of vascular tumors in children include the following: Steroid Therapy: Steroids are hormones produced naturally by the body. They can also be made in a laboratory and used as medicines. Steroid drugs help reduce vascular tumors. Corticosteroids such as prednisone and methylprednisolone are used to treat childhood hemangioma. Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs are commonly used to reduce fever, swelling, pain, and redness. Examples of NSAIDs are aspirin, ibuprofen and naproxen. In the treatment of vascular tumors, NSAIDs can increase blood flow through tumors and reduce the chance of unwanted thrombus formation. Antifibrinolytic therapy: these drugs aid blood clotting in patients with Kasabach-Merritt syndrome. Fibrin is the main protein in a blood clot that helps stop bleeding and heal wounds. Some vascular tumors cause fibrin to break down and the patient's blood does not clot normally, causing uncontrolled bleeding. Antifibrinolytics help prevent the breakdown of fibrin. 11. Surveillance Observation is closely monitoring the patient's condition without giving any treatment until signs or symptoms appear or change. 7.4. benign tumors In this section Pediatric hemangioma congenital hemangioma Benign vascular tumors of the liver Hemangioma spindle cell Epithelioid hemangioma Pyogenic granuloma Angiofibroma Juvenile angiofibroma of the nasopharynx 1. Pediatric hemangioma Infantile hemangiomas - the most common type of benign vascular tumor in children. Baby hemangiomas form when immature cells that should form blood vessels form a tumor instead. An infantile hemangioma can also be called a "strawberry mark". These tumors do not usually appear at birth, but appear between 3 and 6 weeks of age. Most hemangiomas enlarge for about 5 months and then stop growing. Hemangiomas gradually disappear over the next few years, but a red mark or loose or wrinkled skin may remain. Infantile hemangioma rarely comes back. Childhood hemangiomas can be on the skin, in tissues under the skin, and/or in an organ. They are usually found on the head and neck, but can be anywhere on the body or anywhere. Hemangiomas may present as a single lesion, one or more lesions spreading over a large area of the body, or multiple lesions in more than one part of the body. Lesions that spread over a large area of the body or multiple lesions are more likely to cause problems. Infantile hemangioma with minimal or delayed growth (IH-MAG) is a specific type of infantile hemangioma that occurs at birth and does not tend to increase. The lesion appears as light and dark patches of redness on the skin. The lesions are usually found on the lower body, but may be on the head and neck. This type of hemangiomas resolves over time without treatment. Risk factors Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean you will get sick; the absence of risk factors does not mean that you will not get sick. Talk to your child's doctor if you think your child may be at risk. Infantile hemangiomas are more common in the following cases: Girls. White. Premature babies. Twins, triplets or other multiple births. Babies from mothers who are older at the time of pregnancy or who have problems with the placenta during pregnancy. Other risk factors for infantile hemangiomas include the following: A family history of childhood hemangioma, usually in the mother, father, sister, or brother. Presence of certain syndromes: PHACE Syndrome: a syndrome in which the hemangioma spreads to most of the body (usually the head or face). Other health problems may also occur that affect large blood vessels, the heart, eyes, and/or brain. LUMBAR/Pelvic/CUT Syndrome : a syndrome in which the hemangioma extends over much of the lower back. Other health problems may also occur that affect the urinary system, reproductive organs, rectum, anus, brain and spinal cord, and nerve function. Having more than one hemangioma, respiratory hemangioma, or ophthalmic hemangioma increases the risk of other health problems. Multiple hemangiomas: the presence of more than five hemangiomas on the skin is a sign that there may be hemangiomas in the organ. Liver dependent most often. Heart, muscle, and thyroid problems may also occur. Airway hemangiomas: airway hemangiomas usually occur along with a large beard-shaped hemangioma on the face (from the ears, around the mouth, lower chin, and front of the neck). It is important to treat airway hemangiomas before the child has breathing problems. Ophthalmic hemangiomas: hemangiomas that affect the eye can cause vision problems or blindness. Infantile hemangiomas can occur in the conjunctiva (the membrane that lines the inside of the eyelid and covers the front of the eye). These hemangiomas may be associated with other abnormal eye conditions. It is important that children with ophthalmic hemangioma be evaluated by an ophthalmologist. Signs and symptoms Childhood hemangiomas can cause any of the following signs and symptoms. Check with your child's doctor if your child has any of the following: Skin lesions: an area of spider veins, as well as clarified or discolored skin, may appear earlier than a hemangioma. Hemangiomas are hard, warm, bright red or crimson skin lesions or may look like a bruise. Lesions that form ulcers are also painful. Later, as the hemangiomas pass, they begin to pale in the center, then become flatter and lose color. Skin lesions: lesions that grow under the skin in fatty tissue may appear blue or purple. If the lesions are deep enough under the surface of the skin, they may not be noticed. Lesions in the body: signs of hemangioma formation in the organ may be absent. While most childhood hemangiomas are nothing to worry about, if your child develops bumps or red or blue spots on their skin, check with your child's doctor. If necessary, he can refer the child to a specialist. Diagnostic tests Medical examination and history is usually all that is needed to diagnose infantile hemangiomas. If there is anything unusual in the tumor, a biopsy may be done. If the hemangioma is deeper inside the body with no skin changes, or the lesions spread over a large area of the body, an ultrasound may be performed. If hemangiomas are part of the syndrome, additional tests may be performed such as an echocardiogram, MRI, magnetic resonance angiogram, and an eye exam. Treatment Most hemangiomas disappear and shrink without treatment. If the hemangioma is large or causing other health problems, treatment may include the following: Propranolol or other beta-blocker therapy. Steroid therapy before starting beta-blocker therapy or when beta-blockers cannot be used. Pulsed dye laser surgery for hemangiomas that have ulcers or have not completely disappeared. Surgical intervention (excision) of hemangiomas that have ulcers, have vision problems, or have not completely disappeared. Surgery may also be used for facial lesions that do not respond to other treatments. Local therapy with beta-blockers for hemangiomas in one area of the skin. Combination therapy such as propranolol and steroid therapy or propranolol and topical beta-blocker therapy. Clinical trial with beta-blockers (Nadolol and propranolol). Clinical trials of local therapy with beta-blockers (timolol). 2. Congenital hemangioma congenital hemangioma is a benign vascular tumor that begins to form even before birth and is fully formed at the birth of a child. They are usually found on the skin, but may be elsewhere. Congenital hemangioma may appear as a rash of purple patches, with the skin around the patch may be lighter in color. There are three types of congenital hemangiomas: Rapidly invasive congenital hemangioma: these tumors go away on their own 12 to 15 months after birth. They can ulcerate, bleed, and cause temporary problems with blood and heart clotting. The skin may look slightly different even after the hemangiomas are gone. Partial involutional congenital hemangioma: these tumors do not disappear completely. Non-involutional congenital hemangioma: these tumors never go away on their own. Treatment Treatment for rapidly involuting congenital hemangioma and partial involutive congenital hemangioma may include the following: Only observation. Treatment for non-involutional congenital hemangioma may include the following: Surgery to remove the tumor, depending on where it is located and whether it is causing symptoms. 3. Benign vascular tumors of the liver Benign vascular tumors of the liver can be focal vascular lesions (single lesion in one area of the liver), multiple hepatic lesions (multiple lesions in one area of the liver), or diffuse hepatic lesions (multiple lesions in more than one area of the liver). The liver performs many functions, including filtering the blood and making proteins needed for blood clotting. Sometimes the blood that normally flows through the liver is blocked or slowed down by the tumor. This directs blood directly to the heart without passing through the liver and is called a hepatic shunt. This can cause heart failure and blood clotting problems. Focal vascular lesions Focal vascular lesions are usually rapidly involutional congenital hemangiomas or non-involutional congenital hemangiomas. Treatment Treatment of focal vascular lesions of the liver depends on the presence of symptoms and may include the following: Observation. Medicines to treat symptoms including heart failure and bleeding problems. Embolization of the liver to treat symptoms. Surgery for lesions not amenable to other treatment. Multiple and diffuse liver lesions Multifocal and diffuse liver lesions are usually infantile hemangiomas. Diffuse liver damage can cause serious consequences, including thyroid and heart problems. The liver may enlarge, press on other organs, and cause more symptoms. Treatment Treatment for multifocal liver lesions may include the following: Monitor for lesions that do not cause symptoms. Therapy with beta-blockers (propranolol) for lesions that are starting to grow. Treatment for diffuse liver disease may include the following: Beta-blocker therapy (propranolol). Chemotherapy. Steroid therapy. Total hepatectomy and liver transplantation when lesions are not amenable to drug therapy. This is done only when the lesions have spread widely in the liver and more than one organ has failed. If a vascular lesion in the liver does not respond to standard treatment, a biopsy may be done to see if the tumor has become malignant. 4. Hemangioma spindle cell Spindle cell hemangiomas contain cells called spindle cells. Under a microscope, spindle cells look long and thin. Risk factors Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean you will get sick; the absence of risk factors does not mean that you will not get sick. Talk to your child's doctor if you think your child may be at risk. Spindle cell hemangiomas are more common in children with the following syndromes: Maffucci syndrome, which affects cartilage and skin. Klippel-Trenaune syndrome, which affects blood vessels, soft tissues, and bones. Signs Spindle cell hemangiomas appear on or under the skin. These are painful red-brown or bluish growths that usually appear on the arms or legs. They can start as one defeat and develop into new ones over time. Treatment There is no standard treatment for spindle cell hemangiomas. Treatment may include the following: Surgery to remove the tumor. Spindle cell hemangiomas may return after surgery. 5. Epithelioid hemangioma Epithelioid hemangiomas usually form on or in the skin, especially on the head, but can also occur in other areas, such as bones. Signs and symptoms Epithelioid hemangiomas sometimes result from trauma. On the skin, they may look like hard pink or red bumps and may be itchy. An epithelioid hemangioma of bone can cause swelling, pain, and weakening of the bone in the affected area. Treatment There is no standard treatment for epithelioid hemangiomas. Treatment may include the following: Operation (curettage or resection). Sclerotherapy. Radiation therapy in rare cases. Epithelioid hemangiomas often return after treatment. 6. Pyogenic granuloma Pyogenic granuloma is also called lobular capillary hemangioma. It is most common in older children and young adults, but can occur at any age. These lesions sometimes result from injury or from the use of certain medications, including birth control pills and retinoids. They can also form, for no known reason, inside capillaries (tiny blood vessels), arteries, veins, or other places on the body. Usually there is only one lesion, but sometimes multiple lesions occur in the same area or lesions may spread to other areas of the body. Symptoms Pyogenic granulomas are raised, bright red masses that can be small or large, smooth or bumpy. They grow rapidly over weeks or months and may bleed heavily. These lesions are usually found on the surface of the skin, but may form in the tissues under the skin and look like other vascular lesions. Treatment Some pyogenic granulomas go away without treatment. Other pyogenic granulomas require treatment, which may include the following: Operation (excision or curettage) to remove the lesion. Photocoagulation. Local therapy with beta-blockers. Pyogenic granulomas often return after treatment. 7. Angiofibroma Angiofibromas are rare. These are benign skin lesions that usually occur in a condition called tuberous sclerosis (an inherited disorder that causes skin lesions, seizures, and mental disorders). Symptoms Angiofibromas look like red bumps on the face. Treatment Treatment for angiofibroma may include the following: Operation (excision) to remove the tumor. laser therapy. Targeted therapy (sirolimus). 8. Juvenile angiofibroma of the nasopharynx Juvenile angiofibromas of the nasopharynx are benign tumors, but they can grow into nearby tissues. They begin in the nasal cavity and may spread to the nasopharynx, paranasal sinuses, bones around the eyes, and sometimes to the brain. Treatment Treatment for juvenile nasopharyngeal angiofibromas may include the following: Surgery (excision) to remove the tumor. Radiation therapy . Chemotherapy. Immunotherapy (interferon). Targeted therapy (sirolimus). 7.5. Intermediate tumors spreading locally Kaposiform hemangioendothelioma and crested angioma Kaposiform hemangioendotheliomas and tufted angiomas are blood vessel tumors that occur in infants or young children. These tumors can cause the Kasabagh-Merritt phenomenon, a condition in which blood cannot clot and severe bleeding can occur. In the Kasabah-Merritt phenomenon, the tumor traps and destroys platelets (blood clotting cells). Then there are not enough platelets in the blood to stop the bleeding. This type of vascular tumor is unrelated to Kaposi's sarcoma. Signs and symptoms Kaposiform hemangioendotheliomas and fascicular angiomas usually occur on the skin of the arms and legs, but can also form in deeper tissues such as muscle or bone, or in the chest or abdomen. Signs and symptoms may include the following: Dense painful areas of skin with bruises. Purple or brownish-red patches of skin. Light bruising. More severe than normal bleeding from mucous membranes, wounds, and other tissues. Patients with kaposiform hemangioendothelioma and tuft angioma may have anemia (weakness, feeling tired, or pale). If the physical examination and MRI clearly show that the tumor is a kaposiform hemangioendothelioma or tufted angioma, a biopsy may not be required. A biopsy is not always done because serious bleeding can occur. Treatment Treatment of kaposiform hemangioendotheliomas and tufted angiomas depends on the child's symptoms. Infection, delay in treatment, and surgery can cause life-threatening bleeding. Kaposiform hemangioendotheliomas and tufted angiomas are best treated by a specialist in vascular anomalies. Treatment and supportive care to stop bleeding may include the following: Steroid therapy, which may be followed by chemotherapy. Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin. Immunotherapy (interferon). Antifibrinolytic therapy to improve blood clotting. Chemotherapy with one or more anticancer drugs. Beta-blocker therapy (propranolol). Surgery ( excision ) to remove the tumor with or without embolization . Targeted therapy (sirolimus) with or without steroid therapy. Clinical trial of chemotherapy or targeted therapy (sirolimus). Even after treatment, these tumors do not completely go away and may return. Pain and inflammation may increase with age, often around puberty. Long-term effects include chronic pain, heart failure, bone problems, and lymphedema (accumulation of lymph fluid in tissues). 7.6. Interstitial tumors that rarely spread In this section 1) Pseudomyogenic hemangioendothelioma 2) Retiform hemangioendothelioma 3) Papillary intralymphatic angioendothelioma 4) Composite hemangioendothelioma 5) Kaposi's sarcoma 1) Pseudomyogenic hemangioendothelioma Pseudomyogenic hemangioendothelioma can occur in children but is most common in men between the ages of 20 and 50. These tumors are rare and usually occur on or under the skin or in the bone. They may spread to nearby tissues but do not usually spread to other parts of the body. In most cases, multiple tumors occur. Signs and symptoms Pseudomyogenic hemangioendotheliomas may present as a soft tissue lump or cause pain in the affected area. Treatment Treatment for pseudomyogenic hemangioendotheliomas may include the following: If possible, surgery to remove the tumor. If there are multiple tumors in the bone, amputation may be required. Chemotherapy. Targeted therapy (mTOR inhibitors). Because pseudomyogenic hemangioendothelioma is very rare in children, treatment options are based on clinical trials in adults. 2) Retiform hemangioendothelioma Reform hemangioendotheliomas are slow-growing, flat tumors that occur in young people and sometimes in children. These tumors usually occur on or under the skin of the arms, legs, and torso. These tumors usually do not spread to other parts of the body. Treatment Treatment for retiform hemangioendotheliomas may include the following: Operation (excision) to remove the tumor. Follow-up will include monitoring to see if the tumor comes back. Radiation therapy and chemotherapy when surgery cannot be performed or when the tumor has returned. Retiform hemangioendothelioma may return after treatment. 3) Papillary intralymphatic angioendothelioma Papillary intralymphatic angioendotheliomas are also called Dubsky tumors. These tumors form in or under the skin anywhere on the body. Sometimes the lymph nodes are affected. Symptoms Papillary intralymphatic angioendotheliomas may appear as firm, raised purplish bumps that may be small or large. Treatment Treatment for papillary intralymphatic angioendotheliomas may include the following: Operation (excision) to remove the tumor. 4) Composite hemangioendothelioma Compound hemangioendotheliomas have features of both benign and malignant vascular tumors. These tumors usually occur on or under the skin of the hands or feet. They can also occur on the head, neck, or chest. Composite hemangioendotheliomas are unlikely to metastasize (spread), but they may reappear in the same location. When a tumor metastasizes, it usually spreads to nearby lymph nodes. Treatment Treatment for composite hemangioendotheliomas may include the following: Surgery to remove the tumor. Radiation therapy and chemotherapy for advanced tumors. 5) Kaposi's sarcoma Kaposi's sarcoma is a cancer that causes lesions to grow on the skin; on the mucous membranes that line the mouth, nose and throat; The lymph nodes ; or other bodies. It is caused by the Kaposi's sarcoma herpes virus (KSHV). In the United States, it occurs most often in children who have a weak immune system caused by rare immune system diseases, HIV infection, or drugs used in organ transplants. Symptoms Signs in children may include the following: Lesions of the skin, mouth or throat. Skin lesions are red, purple, or brown in color and vary from flat to raised, scaly areas called plaques, and nodules. Enlarged lymph nodes. Treatment Treatment for Kaposi's sarcoma may include the following: Chemotherapy. Immunotherapy (interferon). Radiation therapy . Because Kaposi's sarcoma is very rare in children, some treatment options are based on clinical trials in adults. 7.7. Malignant tumors In this section 1) Epithelioid hemangioendothelioma 2) Angiosarcoma of soft tissues 1) Epithelioid hemangioendothelioma Epithelioid hemangioendotheliomas can occur in children but are most common in adults between the ages of 30 and 50. They usually originate in the liver, lungs, or bones. They may grow quickly or slowly. In about a third of cases, the tumor spreads very quickly to other parts of the body. Signs and symptoms Signs and symptoms depend on where the tumor is located: On the skin, the tumors may be raised, round, or flat, reddish-brown patches that feel warm. In the lungs, there may be no early symptoms. Signs and symptoms that may occur include: Chest pain. Spitting up blood. Anemia (weakness, feeling tired or pale). Breathing problems (due to scarring of the lung tissue). In bones, tumors can cause fractures. Tumors that originate in the liver or soft tissues can also cause signs and symptoms. Diagnostic tests Epithelioid hemangioendotheliomas in the liver are detected using computed tomography and magnetic resonance imaging. You can also do x-rays. Treatment Treatment for slow-growing epithelioid hemangioendotheliomas includes the following: Observation. Treatment for rapidly growing epithelioid hemangioendotheliomas may include the following: If possible, surgery to remove the tumor. Immunotherapy (interferon) and targeted therapy (thalidomide, sorafenib, pazopanib, sirolimus) for tumors that can spread. Chemotherapy. Total hepatectomy and liver transplantation for liver tumors. Clinical study on targeted therapy ( trametinib ). Clinical trials of chemotherapy and targeted therapy (pazopanib). 2) Angiosarcoma of soft tissues Angiosarcomas are fast-growing tumors that form in the blood or lymph vessels anywhere in the body, usually the soft tissues. Most angiosarcomas are on or near the skin. Those found in deeper soft tissues can form in the liver, spleen, and lungs. These tumors are very rare in children. Children sometimes have more than one tumor in the skin and/or liver. Risk factors Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean you will get sick; the absence of risk factors does not mean that you will not get sick. Talk to your child's doctor if you think your child may be at risk. Risk factors for angiosarcoma include the following: Exposure to radiation. Chronic (long-term) lymphedema is a condition in which excess lymphatic fluid accumulates in the tissues, causing swelling. Having a benign vascular tumor. A benign tumor such as a hemangioma can become an angiosarcoma, but this is rare. Symptoms Signs of angiosarcoma depend on where the tumor is located and may include the following: Red spots on the skin that bleed easily. Purple Tumors. Treatment Treatment for angiosarcoma may include the following: Surgery to completely remove the tumor. Combination of surgery, chemotherapy and radiotherapy for advanced angiosarcoma. Targeted therapy (bevacizumab) and chemotherapy for angiosarcomas that started as infantile hemangiomas. Clinical trial of chemotherapy with or without targeted therapy (Pazopanib). Clinical trials for immunotherapy (nivolumab and ipilimumab). 7. TREATMENT OF VASCULAR TUMORS IN CHILDREN Якорь 7 7.1 7.2 7.3. 7.4. 1) 2) 3) 4) 5) 6) 7) 8) 7.5. 7.6. 76.1 76.2 76.3 76.4 76.5 7.7. 77.1 77.2 8. TREATMENT OF EUING'S SARCOMA Якорь 8 Ewing's sarcoma is a type of tumor that forms in bone or soft tissue. Ewing's sarcoma is a type of tumor that forms from a specific type of cells in bone or soft tissue. Ewing's sarcoma can be found in the bones of the legs, arms, feet, hands, chest, pelvis, spine, or skull. Ewing's sarcoma can also be found in the soft tissues of the trunk, arms, legs, head, neck, and retroperitoneal space (the area in the back of the abdomen behind the tissue that lines the abdominal wall and covers most of the abdominal organs). or in other areas. Ewing's sarcoma is most common in adolescents and young adults (from adolescence to 25 years). Ewing's sarcoma has also been called peripheral primitive neuroectodermal tumor, Askin's tumor (Ewing's sarcoma of the chest wall), extraosseous Ewing's sarcoma (Ewing's sarcoma in tissues other than bone), and the Ewing's sarcoma family of tumors. Undifferentiated round cell sarcoma can also occur in bones or soft tissues. Undifferentiated round cell sarcoma usually occurs in the bones or muscles that attach to the bones and help the body move. There are three types of undifferentiated round cell sarcoma that are treated as Ewing's sarcoma: Undifferentiated round cell sarcoma with rearrangements BCOR-CCNB3. This type of bone tumor usually forms in the pelvis, arms, or legs. It can spread to other parts of the body. In this type of round cell sarcoma, the BCOR gene is linked to the CCNB3 gene. To diagnose round cell sarcoma, tumor cells are tested for this gene change. Undifferentiated round cell sarcoma with rearrangements CIC-DUX4. This type of soft tissue tumor usually forms in the trunk, arms, or legs. It is most common in men and young adults between the ages of 21 and 40. In this type of round cell sarcoma, the CIC gene is linked to the DUX4 gene. To diagnose round cell sarcoma, tumor cells are tested for this gene change. Undifferentiated round cell sarcoma with CIC-NUTM1 rearrangements. This type of soft tissue tumor usually forms in the central nervous system, but can also form in the trunk. Most often seen in young patients. 8.1. Symptoms Ewing's sarcoma signs and symptoms include swelling and pain near the tumor. These and other signs and symptoms can be caused by Ewing's sarcoma or other conditions. Check with your child's doctor if your child has any of the following: Pain and / or swelling, usually in the arms, legs, chest, back, or pelvis. A lump (which may feel soft and warm) in the arms, legs, chest, or pelvis. Fever for no known reason. A bone that breaks for no known reason. 8.2. Diagnostics Tests that examine bones and soft tissue are used to diagnose and stage Ewing's sarcoma. Procedures that take pictures of bones, soft tissue, and surrounding areas help diagnose Ewing's sarcoma and show how far the cancer has spread. The process used to determine if cancer cells have spread in and around bones and soft tissues or to other parts of the body is called staging. To plan treatment, it is important to know if the cancer has spread to other parts of the body. Tests and procedures to detect, diagnose, and stage Ewing's sarcoma are usually done at the same time. The following tests and procedures can be used to diagnose or stage Ewing's sarcoma: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness, such as tumors or anything else that seems unusual. There will also be a history of the patient's health habits, as well as past illnesses and treatments. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body, such as an area where a tumor has formed. This procedure is also called nuclear magnetic resonance imaging (MRI). CT (computed tomography): A procedure in which a series of detailed pictures of areas inside the body, such as the area of a tumor or the chest, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs and tissues more visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography. PET scan (positron emission tomography): a procedure to look for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Cancer cells appear brighter because they are more active and consume more glucose than normal cells. PET and computed tomography are often done at the same time. If there is any cancer, it increases the chance of finding it. Bone scan: A procedure to check for rapidly dividing cells such as cancer cells in the bone. A very small amount of radioactive material is injected into a vein and passed through the bloodstream. The radioactive material builds up in the bones in cancer and is detected by a scanner. Bone marrow aspiration and biopsy: Removal of bone marrow and a small piece of bone by inserting a cannula into the hip bone. Samples are removed from both pelvic bones. A pathologist examines the bone marrow and bones under a microscope to see if the cancer has spread. X-ray: An X-ray is a type of energy beam that can pass through the body onto a film, creating an image of areas inside the body, such as the chest or the area where a tumor has formed. Complete blood count (CBC): A procedure in which a blood sample is taken and checked for the following: The number of erythrocytes, leukocytes and platelets. The amount of hemoglobin (oxygen-carrying protein) in red blood cells. The portion of a blood sample made up of red blood cells. Blood chemistry tests: A procedure in which a blood sample is tested to measure the amount of certain substances, such as lactate dehydrogenase (LDH), released into the blood by the body's organs and tissues. An unusual (more or less than usual) amount of a substance may be a sign of illness. A biopsy is done to diagnose Ewing's sarcoma. Tissue samples are taken during a biopsy so that a pathologist can examine them under a microscope to check for signs of cancer. It is helpful if the biopsy is done at the same center where the treatment will be given. Needle biopsy: For a needle biopsy, tissue is removed with a needle. This type of biopsy can be done if it is possible to take tissue samples large enough to be used for testing. Postoperative biopsy: For a postoperative biopsy, a tissue sample is removed through an incision in the skin. Excisional biopsy: Removal of an entire tumor or area of tissue that does not appear normal. The specialists (pathologist, oncologist and surgeon) who will treat the patient will usually work together to select the best site to place the needle or biopsy incision. The choice of the biopsy site is very important. An incorrectly selected biopsy site can lead to more extensive surgery to remove the tumor or a larger area that is being treated with radiation therapy. If there is a chance that the cancer has spread to nearby lymph nodes, one or more of the lymph nodes may be removed and checked for signs of cancer. The following tests can be performed on the removed tissue: Cytogenetic analysis: a laboratory test in which the chromosomes of cells in a tissue sample are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in some chromosomes can be a sign of cancer. Cytogenetic analysis is used to diagnose cancer, plan treatment, or determine the effectiveness of a treatment. Immunohistochemistry: A laboratory test that uses antibodies to check for specific antigens (markers) in a tissue sample from a patient. Antibodies are usually associated with an enzyme or fluorescent dye. After antibodies bind to a specific antigen in a tissue sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test is used to diagnose cancer and help distinguish one type of cancer from another. Flow cytometry: A laboratory test that measures the number of cells in a sample, the percentage of living cells in the sample, and certain characteristics of cells such as size, shape, and the presence of tumor (or other) markers on the cell surface. Cells from a sample of blood, bone marrow, or other tissue from a patient are stained with a fluorescent dye, placed in a liquid, and then passed one at a time through a beam of light. The test results are based on how cells stained with a fluorescent dye respond to a beam of light. Additional tests may be required. Some of the tests that have been done to diagnose cancer or to determine the stage of cancer may be repeated. Some tests will be repeated to see how effective the treatment is. Decisions to continue, change, or stop treatment may be based on the results of these tests. Some tests will continue from time to time after treatment ends. The results of these tests can show if your child's condition has changed or if the cancer has recurred (returned). These tests are sometimes called follow-up or follow-up examinations. 8.3. Factors affecting the prognosis of recovery Factors affecting prognosis are different before and after treatment. Before any treatment is prescribed, the prognosis depends on: Whether the tumor has spread to lymph nodes or distant parts of the body. Where the tumor started in the body. Whether the tumor has formed in the bone or soft tissue. How large is the tumor when a tumor is diagnosed. Whether the tumor is caused by bone fractures. The LDH level in the blood is higher than normal. Whether there are specific gene changes in the tumor. Has the tumor DNA been found in the blood. Whether the patient is younger than 15 years old. Patient gender. Whether the patient was being treated for another cancer. Whether the tumor has just been diagnosed or whether it has relapsed (come back). After treatment, the prognosis is influenced by: Whether the tumor has been completely removed by surgery. If the tumor has responded to chemotherapy or radiation therapy. If cancer recurs after initial treatment, the prognosis depends on: Whether cancer has returned more than two years after initial treatment. Whether the cancer originated in the place where it first formed or in other parts of the body. 8.4. Stages of Ewing's sarcoma The results of diagnostic and staging tests are used to find out if cancer cells have spread. The process used to determine if cancer has spread to other parts of the body is called staging. There is no standard staging system for Ewing's sarcoma. The results of tests and procedures performed to diagnose and stage Ewing's sarcoma are used to describe tumors as localized or metastatic. Ewing's sarcoma is described as localized, metastatic, or recurrent ... Localized Ewing's sarcoma Cancer is found in the bones or soft tissues where it started and can spread to nearby tissues, including nearby lymph nodes. Ewing's metastatic sarcoma The cancer has spread from bone or soft tissue, where it started to other parts of the body. With Ewing's bone tumor, cancer most often spreads to the lung, other bones, and bone marrow. Recurrent Ewing's sarcoma The cancer has recurred (returned) after treatment. Cancer can return to the bones or soft tissue where it originated or to another part of the body. 8.5. Overview of treatment options There are various treatments for children with Ewing's sarcoma. Various treatments are available for children with Ewing's sarcoma. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Since cancer is rare in children and adolescents, clinical trials should be considered. Some clinical trials are only open to patients who have not yet started treatment. Four types of standard treatments are used: 1. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Combination chemotherapy is treatment that uses more than one anticancer drug. Systemic combination chemotherapy is part of the treatment for all patients with Ewing's tumors. This is often the first treatment that lasts 6 to 12 months. Chemotherapy is often used to shrink the tumor before surgery or radiation therapy and to kill any tumor cells that may have spread to other parts of the body. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. External beam radiation therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Radiation therapy is used when the tumor cannot be removed with surgery, or when surgery to remove the tumor affects important body functions or how the baby will look. It can be used to shrink the tumor and reduce the amount of tissue that needs to be removed during surgery. It can also be used to treat any tumors left over from surgery and tumors that have spread to other parts of the body. 3. Operation Surgery is usually done to remove cancer left over from chemotherapy or radiation therapy. If possible, the entire tumor is surgically removed. The removed tissue and bone can be replaced with a graft that uses tissue and bone taken from another part of the patient's or donor's body. Sometimes an implant is used, such as an artificial bone. After a doctor has removed any tumors that can be seen during surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer recurrence is called adjuvant therapy. 4. High-dose stem cell rescue chemotherapy High doses of chemotherapy are prescribed to kill cancer cells. Healthy cells, including hematopoietic cells, are also destroyed in cancer treatments. Stem cell transplantation is a treatment to replace hematopoietic cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of a patient or donor, frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and returned to the patient as an infusion. These re-injected stem cells germinate (and regenerate) the body's blood cells. Stem cell rescue chemotherapy is used to treat localized and recurrent diseases. Ewing's sarcoma. Also used to treat Ewing's sarcoma: 1. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and target certain cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. The types of targeted therapies used to treat Ewing's sarcoma include the following: Monoclonal Antibody Therapy: Monoclonal antibodies of the immune system are proteins made in the laboratory for the treatment of many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that can promote cancer cell growth. The antibodies are then able to kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or to carry drugs, toxins, or radioactive materials directly to cancer cells. Ganitumab is a monoclonal antibody that is being studied for the treatment of metastatic Ewing's sarcoma. Kinase inhibitor therapy: This treatment blocks a protein that is required for cancer cells to divide. Cabosantinib is a kinase inhibitor being studied for the treatment of recurrent Ewing's sarcoma. NEDD8 Activating Enzyme Inhibitor (NAE) Therapy: NAE inhibitors are drugs that attach to the NAE and stop cancer cells from dividing. Pevonedistat is an NAE inhibitor being studied for the treatment of recurrent Ewing's sarcoma. 2. Immunotherapy Immunotherapy is a treatment that uses a patient's immune system to fight cancer. Substances produced by the body or in the laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biological therapy. Immune Checkpoint Inhibitor Therapy: This treatment blocks certain proteins produced by certain cells of the immune system, such as T cells and some cancer cells. These proteins help control immune responses and prevent T cells from killing cancer cells. When these proteins are blocked, the “brakes” of the immune system are released and T cells are better able to kill cancer cells. Nivolumab and ipilimumab are types of immune checkpoint inhibitors that are being studied for the treatment of recurrent Ewing's sarcoma. CAR T Cell Therapy: This treatment alters the patient's T cells (a type of cells in the immune system) so they will attack certain proteins on the surface of the cancer cells. T cells are taken from the patient, and special receptors are added to their surface in the laboratory. The altered cells are called chimeric antigen receptor (CAR) T cells. CAR T cells are grown in the laboratory and infused into the patient. CAR T cells multiply in the patient's blood and attack cancer cells. CAR T-cell therapy is being investigated for the treatment of recurrent Ewing's sarcoma. 8.6. Treatment for Ewing's sarcoma can cause side effects. Side effects from cancer treatments that start after treatment and last for months or years are called late effects. Late effects of cancer treatments may include the following: Physical problems. Changes in mood, feelings, thinking, learning, or memory. Second cancer (newer cancers). Patients treated for Ewing's sarcoma are at increased risk of acute myeloid leukemia and myelodysplastic syndrome. There is also an increased risk of sarcoma in the area that has undergone radiation therapy. Some late effects can be treated or controlled. It is important to talk with your child's healthcare providers about the impact cancer treatment can have on your child. 8.7. Treatment options Treatment of localized Ewing's sarcoma Standard treatments first identified localized Ewing's sarcomas include: Chemotherapy. Surgery and / or radiation therapy. High-dose stem cell rescue chemotherapy. Treatment of metastatic Ewing's sarcoma Standard treatments for newly diagnosed metastatic Ewing's sarcoma include: Chemotherapy. Surgery. Radiation therapy . Treatment of recurrent Ewing's sarcoma There is no standard treatment for recurrent Ewing's sarcoma, but treatment options may include the following: Combined chemotherapy. Radiation therapy for bone tumors as palliative care to relieve symptoms and improve quality of life. Radiation therapy, which may be followed by surgery to remove tumors that have spread to the lungs. High-dose chemotherapy with stem cell rescue ... Treatment options for recurrent Ewing's sarcoma that are being explored include the following: Checking a sample of a patient's tumor for certain gene changes. The type of targeted therapy that will be given to a patient depends on the type of gene change. Targeted therapy with a tyrosine kinase inhibitor (cabozantinib). Immunotherapy with an immune checkpoint inhibitor (nivolumab or Ipilimumab). CAR T-cell therapy. Targeted therapy with a NEDD8-activating enzyme inhibitor (pevoneedistat) and chemotherapy. Clinical study of a new type of targeted therapy. 8.1. 8.2. 8.3. 8.4. 8.5 8.6. 8.7. 9. TREATMENT OF OSTEOSARCOMA Якорь 9 Osteosarcoma and undifferentiated pleomorphic sarcoma (UPS) of bone are diseases in which malignant (cancer) cells form in the bone. Osteosarcoma usually starts with osteoblasts, which are a type of bone cell that becomes new bone. Osteosarcoma is most common in adolescents. It usually forms at the ends of the long bones of the body, including the bones of the arms and legs. In children and adolescents, it often forms in the long bones near the knee. In rare cases, osteosarcoma can be found in the soft tissues or organs of the chest or abdomen. Osteosarcoma is the most common type of bone cancer. UPS (formerly called malignant fibrous histiocytoma [MFH]) is a rare type of bone cancer that usually begins in soft tissue but can form in bone. In bone, UPS cells look like osteosarcoma under the microscope. UPS is treated like osteosarcoma. 9.1. Development risks Undergoing treatment with chemotherapy or radiation therapy may increase the risk of osteosarcoma. Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your child's doctor if you think your child may be at risk. Risk factors for osteosarcoma include the following: Received chemotherapy or radiation therapy. Having a certain change in the RB1 gene. Having certain conditions, for example the following: Bloom's syndrome. Diamond-Blackfan anemia. Li-Fraumeni syndrome. Paget's disease. Hereditary retinoblastoma. Rothmund-Thomson syndrome. Werner's syndrome. 9.2. Symptoms Signs and symptoms of osteosarcoma and UPS include swelling of the bone or bone of the body and joint pain. These and other signs and symptoms can be caused by osteosarcoma, UPS, or other conditions. Check with your doctor if your child has any of the following: Swelling over a bone or bony part of the body. Bone or joint pain. A bone that breaks for no known reason. 9.3. Diagnostics Imaging tests are used to detect (detect) osteosarcoma and UPS. Imaging tests are done before the biopsy. The following tests and procedures can be used: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness, such as tumors or anything else that seems unusual. There will also be a history of the patient's health habits, as well as past illnesses and treatments. X-rays: X-rays of organs and bones inside the body. X-rays are a type of energy beam that can pass through the body onto film, creating an image of areas within the body. CT (computed tomography): a procedure in which a series of detailed pictures of areas inside the body are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs and tissues more visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI). A biopsy is done to diagnose osteosarcoma. Cells and tissues are removed during a biopsy so that a pathologist can examine them under a microscope to check for signs of cancer. It is important that the biopsy is done by a surgeon who is an expert in the treatment of bone cancer. It is best if this surgeon removes the tumor. The biopsy and surgery to remove the tumor are planned together. The way the biopsy is taken will affect which surgery can be done later. The type of biopsy depends on the size of the tumor and its location in the body. Two types of biopsies can be used: Primary biopsy: Removal of tissue with a wide needle. Postoperative biopsy: Removal of a portion of a tumor or tissue sample that does not appear normal. The following test can be performed on the removed tissue: Electron microscopy: a laboratory test in which cells in a tissue sample are viewed under a regular and powerful microscope to detect specific changes in the cells. 9.4. Factors affecting the prognosis of recovery Several factors can affect prognosis (chance of recovery) and treatment options. On forecast certain factors before and after treatment may be affected. The prognosis of untreated osteosarcoma and IBD may depend on the following: Where is the tumor in the body and whether tumors have formed in more than one bone. The patient has two or more tumors in the same bone. The size of the tumor. Whether the cancer has spread to other parts of the body and where it has spread. The type of tumor (based on how cancer cells look under a microscope). Gender, age and weight of the patient at the time of diagnosis. Whether the patient was being treated for another cancer. Whether the patient has certain genetic diseases. After treatment for osteosarcoma or IBD, the prognosis also depends on the following: How much of the cancer has been killed by chemotherapy. Whether the tumor has been completely removed by surgery. If the cancer has recurred (come back) within 2 years after diagnosis. Treatment options for osteosarcoma and IBD depend on the following: Where is the tumor in the body and whether it has spread. The size of the tumor. Cancer assessment. Are the bones still growing? Patient's age and general health. The desire of the patient and his family for the patient to be able to participate in sports activities or to look a certain way. Whether the cancer was diagnosed for the first time or whether there was a relapse after treatment. 9.5. Stages of osteosarcoma and undifferentiated pleomorphic sarcoma (UPS) After osteosarcoma or undifferentiated pleomorphic sarcoma (UPS) is diagnosed, tests are done to find out if cancer cells have spread to other parts of the body. The process used to determine if cancer has spread to other parts of the body is called staging. Most patients with osteosarcoma and IBD are grouped according to whether the cancer is localized or metastatic. Localized osteosarcoma, or UPS, has not spread from the bone where the cancer started. There may be one or more areas of cancer in the bone that can be removed during operations ... Metastatic osteosarcoma, or IBD, has spread from the bone in which the cancer started to other parts of the body. Cancer most often spreads to lungs ... It can also spread to other bones. The following tests and procedures can be used to find out if the cancer has spread: X-rays: X-rays of organs such as the chest and bones inside the body. X-rays are a type of energy beam that can pass through the body onto film, creating an image of areas within the body. An x-ray of the chest and area of the tumor will be taken. CT (computed tomography): A procedure in which a series of detailed pictures of areas inside the body, such as the chest, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. X-rays of the chest and the area where the tumor is forming will be taken. PET-CT scan: A procedure that combines positron emission tomography (PET) and computed tomography (CT) images. PET and CT scans are performed simultaneously on the same machine. Images from both scans are combined to create a more detailed picture than either test could do on its own. PET is a procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and shows where glucose is being used in the body. Cancer cells appear brighter because they are more active and consume more glucose than normal cells. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI). Bone scan: A procedure to check for rapidly dividing cells such as cancer cells in the bone. A very small amount of radioactive material is injected into a vein and passed through the bloodstream. The radioactive material builds up in the bones in cancer and is detected by a scanner. Occasionally, osteosarcoma and bone oocytes come back after treatment. Cancer can recur (return) to bones or other parts of the body. Osteosarcoma and IBD most often recur in the lung, bone, or both. When osteosarcoma recurs, it usually occurs within 18 months after treatment ends. 9.6. Overview of treatment options There are various treatments for patients with osteosarcoma or undifferentiated pleomorphic sarcoma (UPS). Various treatments are available for children with osteosarcoma or bone disease. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Because cancer is rare in children, clinical trials should be considered. Some clinical trials are only open to patients who have not yet started treatment. Five types of standard treatments are used: 1. Operation If possible, an operation will be performed to remove the entire tumor. Chemotherapy may be given before surgery to shrink the swelling. This is called neoadjuvant chemotherapy. Chemotherapy is given, so less bone needs to be removed and fewer problems after surgery. The following types of surgical procedures can be performed: Wide local excision: Surgery to remove the tumor and some healthy tissue around it. Limb-sparing surgery: Removal of a tumor of a limb (arm or leg) without amputation, which allows you to preserve the appearance of the limb. Most patients with limb osteosarcoma can be treated with sparing surgery. The tumor is removed by wide local excision. The removed tissue and bone can be replaced with a graft using tissue and bone taken from another part of the patient's body, or with an implant such as artificial bone. If a fracture is found at the time of diagnosis or during preoperative chemotherapy, limb-sparing surgery may still be possible in some cases. If the surgeon cannot remove the entire tumor and enough healthy tissue around it, amputation may be done. Amputation: Surgery to remove part or all of an arm or leg. This can be done when it is not possible to remove the entire tumor with limb-sparing surgery. A prosthesis (prosthesis) may be placed on the patient after amputation. Rotational plasty: surgery to remove the tumor and the knee joint. The part of the leg that remains below the knee is then attached to the part of the leg that remains above the knee, with the foot facing back and the ankle acting as the knee. The prosthesis can then be attached to the foot. Studies have shown that survival is the same regardless of whether the first limb-sparing surgery or amputation was performed. After the doctor removes any cancer that can be seen during surgery, patients are given chemotherapy to kill any cancer cells that remain in the area where the tumor was removed or that have spread to other parts of the body. Treatment given after surgery to reduce the risk of cancer recurrence is called adjuvant therapy. 2. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Combined chemotherapy is the use of more than one anticancer drug. Chemotherapy is usually done before and after surgery to remove primary tumor ... 3. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. There are two types of radiation therapy: External beam therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Internal beam therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are inserted directly into or near the tumor. Osteosarcoma and UPS cells are not easy to kill with external radiation therapy. It can be used when there is little cancer left after surgery, or it can be used in conjunction with other treatments. 4. Samaria Samarium is a radioactive drug that targets areas where bone cells grow, such as tumor cells in bone. It helps relieve pain caused by bone cancer and also kills blood cells in the bone marrow. It is used to treat osteosarcoma that has returned after treatment in another bone. Samarium treatment may be accompanied by stem cell transplantation. Before samarium treatment, stem cells (immature blood cells) are removed from the patient's blood or bone marrow, frozen and stored. After completing the samarium treatment, the preserved stem cells are thawed and returned to the patient by infusion. These re-injected stem cells germinate (and regenerate) the body's blood cells. 5. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and target certain cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. There are different types of targeted therapy: Kinase inhibitor therapy blocks a protein required for cancer cell division. Sorafenib is a type of kinase inhibitor therapy used to treat recurrent osteosarcoma. Regorafenib is a type of kinase inhibitor that is being studied in adults for the treatment of recurrent metastatic osteosarcoma. Lenvatinib is a type of kinase inhibitor that is being studied in combination with ifosfamide and etoposide for recurrent and refractory osteosarcoma. Mammals targeting rapamycin inhibitors (mTORs) block a protein called mTOR, which can inhibit the growth of cancer cells and prevent the growth of new blood vessels necessary for tumor growth. Everolimus is an mTOR inhibitor used to treat recurrent osteosarcoma. Treatment for osteosarcoma or UPS can cause side effects. Side effects from cancer treatments that start after treatment and last for months or years are called late effects. Late effects of cancer treatments may include the following: Physical problems such as infertility. Changes in mood, feelings, thinking, learning, or memory. A second cancer (newer cancers), such as breast cancer or acute myeloid leukemia. Additional tests may be required. Some of the tests that have been done to diagnose cancer or to determine the stage of cancer may be repeated. Some tests will be repeated to see how effective the treatment is. Decisions to continue, change, or stop treatment may be based on the results of these tests. Some tests will continue from time to time after treatment ends. The results of these tests can show if your child's condition has changed or if the cancer has recurred (returned). These tests are sometimes called follow-up or follow-up examinations. 9.7. Treatment options Treatment of localized osteosarcoma and undifferentiated pleomorphic sarcoma (UPS) of bone Treatment for newly diagnosed localized osteosarcoma and bone disease may include the following: Surgery to remove the primary tumor. Chemotherapy may be given before or after surgery to remove the primary tumor. Radiation therapy if surgery cannot be performed or the tumor has not been completely removed with surgery. Treatment of metastatic osteosarcoma and undifferentiated pleomorphic sarcoma (UPS) of bone Lung metastases When osteosarcoma or UPS spreads, it usually spreads to the lungs. Treatment for newly diagnosed osteosarcoma and IBD with lung metastases may include the following: Chemotherapy followed by surgery to remove the primary cancer. This is followed by postoperative combination chemotherapy, followed by surgery to remove lung cancer, and another postoperative chemotherapy. Bone metastasis or bone with lung metastasis Newly diagnosed osteosarcoma and IBD can spread to distant bones and / or lungs. Treatment may include the following: Chemotherapy followed by surgery to remove the primary tumor and cancer that has spread to other parts of the body. After surgery, additional chemotherapy is prescribed. Surgery to remove the primary tumor followed by chemotherapy and surgery to remove cancer that has spread to other parts of the body, followed by combination chemotherapy. Radiation therapy of the extremities. Treatment of recurrent osteosarcoma and undifferentiated pleomorphic sarcoma (UPS) of bone Treatment for recurrent osteosarcoma and bone disease may include the following: Surgery to remove cancer in all areas where it has spread. Chemotherapy and targeted therapy (sorafenib or everolimus). Samarium and radiation therapy. Treatment depends on the area and type of relapse, for example: For tumors that have recurred in the same bone where the cancer started: Operation. For tumors that have recurred in the lungs only: Operation. Chemotherapy. Targeted therapy. For tumors that have recurred in bones other than where the cancer started: Operation. Samarium with or without stem cells as a palliative treatment to relieve pain and improve quality of life. For tumors that have recurred twice: Surgery to remove cancer and / or chemotherapy. Clinical trials for the treatment of recurrent osteosarcoma and bone disease may include the following: A clinical trial that tests a sample of a patient's tumor for certain gene changes. The type of targeted therapy that will be given to a patient depends on the type of gene change. Clinical trials of targeted therapy (lenvatinib) in combination with chemotherapy. 9.1 9.2. 9.3. 9.4. 9.5 9.6. 9.7. COST OF TREATMENT AND DIAGNOSIS OF SARCOMA IN TURKEY Biopsy for sarcoma from $ 450 PET-CT for sarcoma from $ 500 Focused ultrasound ablation (HIFU) for sarcoma from $ 11,000 Radiation therapy for sarcoma from $ 6500 Biopsy for Ewing's sarcoma from $ 450 PET-CT for Ewing's sarcoma from $ 500 Chemotherapy for breast cancer from $ 1200 Radiation therapy for sarcoma from $ 6500 Oncology diagnostics (click here) Oncology treatment (click here) ст Need help? Doctors-coordinators will advise you and help you with the choice. Services Medikal & Estetik Group are free for you and do not affect the clinic bill. Find a solution Coordinator Medikal & Estetik Group help you find the best solution for cancer treatment CHOOSE CLINIC O Medikal & Estetik Group Second opinion Before traveling, you can get a Turkish doctor's opinion on your diagnosis and treatment prescribed. For the patient, this is an opportunity to receive advice from the world's best specialists.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. OVARIAN CANCER TREATMENT IN TURKEY MENU PAGES: 1. What is ovarian cancer? 2. Risk factors for ovarian cancer 3. Types of ovarian malignant tumors. 4. Risk factors for ovarian cancer 5. Signs and symptoms of ovarian cancer 7. Stages of ovarian cancer in childhood 8. Review of treatment options. Types of treatment 9. Methods of treatment for ovarian cancer. 10. Side effects of treatment in children 11. COST OF TREATMENT AND DIAGNOSIS OF OVARIAN CANCER IN TURKEY 1. What is ovarian cancer? Ovarian cancer is a disease in which malignant (cancerous) cells form in the tissues of the ovary. The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ in which the fetus grows). Each ovary resembles an adult woman's almond in size and shape. The ovaries produce eggs and female hormones (chemicals that control the function of certain cells or organs). 2. Risk factors for ovarian cancer Family history of ovarian cancer in a first-degree relative (mother, daughter, or sister). Inherited changes in the BRCA1 or BRCA2 genes. Other inherited conditions, such as hereditary non-polyposis colorectal cancer (HNPCC; also called Lynch syndrome). Endometriosis Postmenopausal hormone therapy. Obesity. High height. Old age is a major risk factor for most cancers. The likelihood of developing cancer increases with age. 3. Types of ovarian malignant tumors. To types malignant ovarian tumors include the following: Germ cell tumors: tumors that develop in the eggs of women. These are the most common ovarian tumors in girls. Epithelial tumors: tumors that develop in the tissue that covers the ovary. It is the second most common ovarian tumor in girls. Epithelial ovarian cancer in children is usually found early and is easier to treat than in adult patients. Stromal tumors: Tumors that start in the stromal cells that make up the tissues that surround and support the ovaries. Minor cell granulosa tumors and Sertoli-Leydig tumor are two types of stromal tumors. Small cell ovarian carcinoma: Cancer that begins in the ovary and can spread to the abdomen, pelvis, or other parts of the body. This type of ovarian cancer is growing rapidly and has a poor prognosis. This summary focuses on non-germinal ovarian tumors (epithelial tumors, stromal tumors, and small cell ovarian carcinoma). 4. Risk factors for ovarian cancer Anything that increases the likelihood of getting sick is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. The risk of ovarian cancer is increased if you have one of the following conditions: Ollie's disease (a disease that causes abnormal growth of cartilage at the end of long bones). Maffucci syndrome (a condition that causes abnormal growth of cartilage at the ends of the long bones and blood vessels of the skin). Peitz-Jeghers Syndrome (a condition that causes polyps in the intestines and dark spots on the lips and fingers). Familial pleuropulmonary blastoma syndrome (a disorder that can cause cystic nephroma, lung cysts, thyroid problems, and cancers of the lungs, kidneys, ovaries, and soft tissue). DICER1 syndrome (a disease that can cause goiter, polyps in the colon, and tumors of the ovaries, cervix, testis, kidneys, brain, eyes, and lung lining). 5. Signs and symptoms of ovarian cancer Abdominal pain, swelling, or lump, and other signs and symptoms can be caused by ovarian cancer or other medical conditions. Check with your child's doctor if your child has any of the following: Pain or bloating. Lump in the abdomen. Constipation Painful or missed periods. Unusual vaginal bleeding. Male sex characteristics such as body hair or a deep voice. Early signs of puberty. 6. Tests for the diagnosis of ovarian cancer. The following tests and procedures can be used: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness, such as bumps or anything else that seems out of the ordinary. A history of the patient's health habits, as well as past illnesses and treatments will also be recorded. Computed tomography (computed tomography) : A procedure in which a series of detailed pictures of areas inside the body, such as the pelvis or abdomen, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (Magnetic Resonance Imaging) : A procedure that uses a magnet and radio waves to take a series of detailed pictures of areas inside the body, such as the pelvis or abdomen. The pictures were taken by a computer. This procedure is also called nuclear magnetic resonance imaging (MRI). Ultrasound examination : A procedure in which high-energy sound waves (ultrasound) are reflected from internal tissues or organs in the abdomen or pelvis and create an echo. The echo forms a picture of body tissue called a sonogram. The picture can be printed to view later. Biopsy : Tissue removed during surgery is examined under a microscope by a pathologist to check for signs of cancer. Serum tumor marker test : A procedure in which a blood sample is examined to measure the amount of certain substances that enter the bloodstream of organs, tissues, or tumor cells in the body. Certain substances are associated with certain types of cancer when found in high concentrations in the blood. These are the so-called tumor markers. Tumor markers alpha-fetoprotein, beta-human chorionic gonadotropin (β-hCG), CEA, CA-125 and others are used to diagnose ovarian cancer. During surgery to remove the tumor, the fluid in the abdomen is checked for signs of cancer. 1 2 3 4 5 6 7. Stages of ovarian cancer in childhood Most ovarian tumors in children are benign (not cancer). They most often occur in women between the ages of 15 and 19. The process used to determine if cancer has spread from the ovary to nearby sites or to other parts of the body is called staging. There is no standardized system for diagnosing ovarian cancer in children. The results of tests and procedures performed to diagnose ovarian cancer are used to make treatment decisions. Sometimes ovarian cancer in children recurs (comes back) after treatment. 8. Review of treatment options for children and adolescents. Types of treatment There are different treatments for ovarian cancer in children and adolescents. Children and adolescents with ovarian cancer should plan for treatment with a team of doctors who are experts in treating childhood cancer. There are five standard treatments for ovarian cancer. Operation Radiation therapy Chemotherapy High-dose chemotherapy with autologous stem cell rescue Targeted therapy Treatment for ovarian cancer in children can cause side effects. Patients may want to take part in a clinical trial. Patients can participate in clinical trials before, during, or after starting cancer treatment. Additional tests may be required. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Because cancer is rare in children, clinical trials should be considered. Some clinical trials are only open to patients who have not yet started treatment. Children and adolescents with ovarian cancer should plan for treatment with a team of doctors who are experts in treating childhood cancer. The treatment will be supervised by a pediatric oncologist, a doctor specializing in the treatment of oncological children. The pediatric oncologist works with other pediatricians who are experts in treating children with cancer and specialize in specific areas of medicine. This may include the following professionals and others: Pediatrician. Children's surgeon. Gynecologist. Specialist Pediatric Nurse. Rehabilitation specialist. Social worker . Psychologist . 9. Methods of treatment for ovarian cancer. 1. Operation The surgery is used to remove ovarian cancer. Surgery can also be used to remove ovarian and ovarian cancers or ovarian and fallopian tube cancers. Different types of surgery can include: Hysterectomy: Surgery to remove the uterus and sometimes the cervix. When only the uterus is removed, it is called a partial hysterectomy. When both the uterus and cervix are removed, it is called a total hysterectomy. If the uterus and cervix are passed out through the vagina, the operation is called vaginal hysterectomy. If the uterus and cervix are removed through a large incision (incision) in the abdomen, the operation is called total abdominal hysterectomy. If the uterus and cervix are removed through a small incision (incision) in the abdomen using a laparoscope, the operation is called total laparoscopic hysterectomy. Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube. Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes. Omentectomy: A surgical procedure to remove an omentum (tissue in the peritoneum that contains blood vessels, nerves, lymphatic vessels, and lymph nodes). Lymph node biopsy: Removal of all or part of a lymph node. A pathologist examines lymph node tissue under a microscope to check for cancer cells 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. External beam radiation therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can infect cancer cells throughout the body (systemic chemotherapy). When chemotherapy is injected directly into the cerebrospinal fluid, organ or body cavity, such like the abdomen, drugs mainly target cancer cells in these areas (regional chemotherapy). The type of regional chemotherapy used to treat ovarian cancer is intraperitoneal (IP) chemotherapy. In IP chemotherapy, cancer drugs are transferred directly into the abdomen (the space that contains the abdominal organs) through a thin tube. Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment used during surgery and is being studied for ovarian cancer. After the surgeon has removed as much of the tumor tissue as possible, warm chemotherapy is directed directly into the abdominal cavity. Treatment with more than one anticancer drug is called combination chemotherapy. How chemotherapy is given depends on the type and stage of cancer treatment. 4. High-dose chemotherapy with salvage of autologous stem cells High doses of chemotherapy are prescribed to kill cancer cells. Healthy cells, including hematopoietic cells, are also destroyed in cancer treatments. Stem cell rescue is a treatment to replace hematopoietic cells. Stem cells (immature blood cells) are removed from the patient's blood or bone marrow, frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and returned to the patient as an infusion. These re-injected stem cells germinate (and regenerate) the body's blood cells. 5. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and destroy cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy and radiation therapy. Histone methyltransferase inhibitors: This type of targeted therapy slows the ability of cancer cells to grow and divide. Tasemetostat is used to treat ovarian cancer. Monoclonal antibodies are proteins of the immune system created in the laboratory for the treatment of many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that can promote cancer cell growth. The antibodies are then able to kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or for carrying drugs, toxins or radioactive materials directly to cancer cells. Monoclonal antibodies can be used in combination with chemotherapy as adjuvant therapy. Bevacizumab is a monoclonal antibody and angiogenesis inhibitor that can be used with chemotherapy to treat ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer that has recurred (come back). It binds to a protein called vascular endothelial growth factor (VEGF) and can prevent the growth of new blood vessels required for tumor growth. Other inhibitors of angiogenesis are being studied in the treatment of advanced or recurrent ovarian cancer. 6. Immunotherapy Immunotherapy is the treatment that uses immune system patient to fight cancer. Substances produced by the body or produced in the laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This cancer treatment is a variety biological therapy ... Vaccine therapy is a cancer treatment that uses a substance or group of substances to stimulate the immune system to find a tumor and kill it. Vaccine therapy is being studied for the treatment of advanced ovarian cancer. 10. Side effects of treatment in children. For information on side effects that occur during cancer treatment. Side effects from cancer treatments that start after treatment and last for months or years are called late effects. Physical problems such as fertility problems are a late effect of treatment. Some late effects can be treated or controlled. It is important to talk with your child's doctors about the possible late effects of some treatments. Need help? To organize treatment for ovarian cancer in Turkey, leave a request on the Medikal & Estetik Group website. You will be contacted by a specialized doctor-coordinator who will help you choose the best medical center. Send him your medical records, he will redirect them to the hospital of your choice and request a treatment program. We will help you organize your trip and stay in touch with you throughout your treatment - from the moment you contact us and even after you return home. Medikal & Estetik Group is an independent medical service that does not represent the interests of any of the clinics. Patients do not pay for our services - medical centers do it. Doctors-coordinators will advise you and help you with the choice. Medikal & Estetik Group services are free of charge for you and do not affect the clinic bill. 7 8 9 10 COST OF TREATMENT AND DIAGNOSIS OF OVARIAN CANCER IN TURKEY Biopsy for Ovarian Cancer from $ 450 CT (computed tomography) for ovarian cancer from $ 50 PET-CT for Ovarian cancer from $ 500 Hysterectomy with Da Vinci Robot for Ovarian Cancer from $ 21,700 Chemotherapy for breast cancer from $ 1200 Cyber Knife for Ovarian Cancer from $ 4400 Gamma Knife for Ovarian Cancer from $ 6000 Hormone therapy for ovarian cancer on request Intraperitoneal chemotherapy HIPEC for ovarian cancer from $ 20,000 Radiation therapy for rectal cancer on request ст

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КАК ДИАГНОСТИРУЕТСЯ РАК? Лабораторные тесты Визуальные тесты Биопсия После диагностики рака СТОИМОСТЬ ДИАГНОСТИКИ РАКА В ТУРЦИИ 2. ПОСТАНОВКА ДИАГНОЗА Стадия рака Как определяется этап Системы, описывающие стадию 3. ПОНИМАНИЕ ПРОГНОЗА Многие факторы могут повлиять на ваш прогноз Поиск информации о вашем прогнозе - личное решение Понимание статистики выживания Понимание разницы между лечением и ремиссией 4. ВИДЫ ЛЕЧЕНИЯ  СТОИМОСТЬ ЛЕЧЕНИЯ РАКА В ТУРЦИИ DIAGNOSTICS, INSTALLATION, TYPES OF TREATMENT MENU PAGES: 1. HOW IS CANCER DIAGNOSED? 1.1. Laboratory tests 1.2. Visual tests 1.3. Biopsy 1.4. After cancer diagnosis 1.5. COST OF CANCER DIAGNOSIS IN TURKEY 2. STATEMENT OF DIAGNOSIS 2.1. STAGE OF CANCER 2.2. How the stage is determined 2.3. Systems describing the stage 3. UNDERSTANDING THE FORECAST 3.1. Many factors can affect your prognosis 3.2. Finding information about your forecast is a personal decision 3.3. Understanding survival statistics 3.4. If you decide not to be treated 3.5. Understanding the difference between treatment and remission 4. TYPES OF TREATMENT 1. HOW IS CANCER DIAGNOSED? If you have a symptom or screening test result that suggests cancer, your doctor should find out if it is caused by cancer or some other cause. The doctor may start by asking about your personal and family medical history and conduct a physical examination. The doctor may also order lab tests, imaging (scans), or other tests or procedures. You may also need a biopsy, which is often the only way to accurately determine if you have cancer. This page describes tests that are often used to diagnose cancer. Other tests may be ordered depending on your symptoms. 1.1. Laboratory tests High or low levels of certain substances in the body can be a sign of cancer. Thus, laboratory tests of your blood, urine, or other body fluids that detect these substances can help doctors make a diagnosis. However, abnormal laboratory results are not a sure sign of cancer. Learn more about laboratory tests and how they are used to diagnose cancer. Some laboratory tests involve testing blood or tissue samples for tumor markers. Tumor markers are substances that are produced by cancer cells or other cells in the body in response to cancer. Most tumor markers are produced by normal cells and cancer cells, but at a much higher level they are produced by cancer cells. Learn more about tumor markers and how they are used to diagnose cancer. 1.2. Visual tests Imaging tests create images of areas inside your body that help the doctor determine if a tumor is present. These pictures can be done in several ways: 1. Computed tomography Computed tomography uses an x-ray machine connected to a computer to take a series of pictures of your organs from different angles. These images are used to create detailed 3D images of the inside of your body. Sometimes, you may receive dye or other contrast material before scanning. You can swallow the dye or inject it into a vein with a needle. The contrast material helps make images easier to read by highlighting specific areas on the body. During a CT scan, you will lie motionless on a table that is inserted into a donut-shaped scanner. The CT machine moves around you to take pictures. Learn more about CT scans and how they are used to diagnose cancer. 2. MRI An MRI uses powerful magnetic and radio waves to photograph your body in slices. These slices are used to create detailed images of the inside of your body, which can show the difference between healthy and unhealthy tissue. When you have an MRI, you lie motionless on a table that is placed in a long, circular chamber. The MRI machine makes loud pounding sounds and rhythmic beats. Sometimes you may be injected with a special dye into a vein before or during an MRI. This dye, called a contrast agent, can brighten tumors in images. 3. Nuclear scanning A nuclear scan uses RadioActive material to shoot inside the body. This type of scan can also be called radionuclide scan. Before this scan, you receive an injection of a small amount of radioactive material, sometimes called an indicator. It travels through your bloodstream and builds up in certain bones or organs. During a scan, you lie motionless on a table while a machine called a scanner detects and measures the radioactivity in your body, creating images of bones or organs on a computer screen or film. After scanning, the radioactive material in your body will lose its radioactivity over time. It can also leave your body in urine or stool. 4. X-ray A bone scan is a type of nuclear scan that checks for abnormal areas or damage in bones. They can be used to diagnose bone cancer or cancer that has spread to the bone (also called metastatic bone tumors). Before this test, a very small amount of radioactive material is injected into your vein. Passing through the blood, the material accumulates in abnormal areas of the bone. Places of accumulation of material are displayed on images taken with a special scanner. These areas are called hotspots. 5. PET scan PET is a type of nuclear scan that marks detailed 3-D images of the areas inside the body where glucose is absorbed. Since cancer cells often consume more glucose than healthy cells, images can be used to detect cancer in the body. Before the scan, you receive an injection of an indicator called radioactive glucose. During scanning, you will lie on a table that moves back and forth through the scanner. 6. ultrasound Ultrasound examinations use high energy sound waves that people cannot hear. Sound waves bounce off the tissues inside your body. The computer uses these echoes to create images of areas inside your body. This picture is called a sonogram. During the ultrasound exam, you will lie on a table while the technician slowly moves a device, called a transducer, on the skin over the area of the body being examined. The sensor is coated with a warm gel that makes it easier to glide over the skin. 6. X-rays X-rays use low doses of radiation to create images inside your body. The x-ray machine will position you and direct the x-ray beam to the desired part of your body. While the photo is being taken, you will need to remain still and may need to hold your breath for a second or two. 1.3. Biopsy In most cases, doctors need to do a biopsy to diagnose cancer. A biopsy is a procedure in which a doctor takes a sample of tissue. The pathologist looks at the tissue under a microscope and runs other tests to see if the tissue is cancer. The pathologist describes the results in a pathology report, which provides details of your diagnosis. Pathology reports play an important role in the diagnosis of cancer and help guide treatment options. Learn more about pathology reports and the type of information they contain. A biopsy sample can be obtained in several ways : 1. With a needle: The doctor uses a needle to extract tissue or fluid. This method is used for bone marrow aspiration, lumbar puncture, and some biopsies of the breast, prostate, and liver. 2. With endoscopy : The doctor uses a thin, illuminated tube called an endoscope to examine areas inside the body. Endoscopes go into natural openings in the body, such as the mouth or anus. If the doctor sees abnormal tissue during the examination, he or she will remove the abnormal tissue along with some of the surrounding normal tissue through an endoscope. Examples of endoscopic examinations: Colonoscopy - examination of the colon and rectum. In this type of examination, an endoscope is passed through the anus, allowing the doctor to examine the rectum and colon. If the doctor finds polyps, he will remove them and send them to the laboratory for analysis. Bronchoscopy - examination of the trachea, bronchi and lungs. In this type of examination, the endoscope is passed through the mouth or nose and into the throat. 3. During the operation: the surgeon removes the area of abnormal cells during surgery. The operation can be excisional or postoperative. 4. With excisional biopsy the surgeon removes the entire area of abnormal cells. Often, some of the normal tissue around these cells is also removed. 5. For postoperative biopsy the surgeon removes only part of the abnormal area. Some biopsies may require sedation or anesthesia. Sedatives are medicines that help you relax and stay still or sleep during the biopsy. Anesthesia relieves pain. This refers to drugs or other substances that make you feel or faint. There are three types of anesthesia: Local anesthesia causing loss of sensation in one small area of the body. Regional anesthesia causing numbness in a part of the body, such as an arm or leg. General anesthesia causing loss of sensation and complete loss of consciousness, which seems to be a very deep sleep. 1.4. After cancer diagnosis If the biopsy and other tests show you have cancer, you may need to have several more tests to help your doctor plan treatment. For example, your doctor will need to figure out the stage of your cancer. For some cancers, knowing the extent of the tumor or the risk group you are at is important in deciding the best treatment. Your tumor may also be further tested for other tumor or genetic markers. 1.5. COST OF CANCER DIAGNOSIS IN TURKEY F Focus Onco test $ 6932 - $ 6932 А Blood test for tumor markers $ 150 - $ 500 Thyroid hormone test (including T3, T4, TSH) $ 150 - $ 200 Blood tests for lymphoma $ 800 - $ 1100 Angiography $ 700 - $ 1500 B Biopsy $ 450 - $ 4853 Lung biopsy $ 1500 - $ 3000 Breast biopsy $ 1000 - $ 1500 Breast biopsy $ 1000 - $ 1500 Liver biopsy $ 1500 - $ 1750 Pancreas biopsy $ 1500 - $ 1500 Kidney biopsy $ 1500 - $ 1500 Fusion Prostate Biopsy $ 2200 - $ 2680 TRUS guided prostate biopsy $ 700 - $ 900 Thyroid biopsy $ 1200 - $ 1500 Bronchoscopy with biopsy $ 1796 - $ 5000 D Genetic examination $ 200 - $ 900 D Dermatoscopy $ 100 - $ 150 And Immunohistochemistry $ 600 - $ 1000 By CT (computed tomography) $ 50 - $ 400 Abdominal CT scan $ 300 - $ 950 Chest CT scan $ 100 - $ 350 CT scan of the paranasal sinuses $ 128 - $ 300 Capsule endoscopy $ 4000 - $ 4000 Colonoscopy $ 200 - $ 1500 Colonoscopy with biopsy $ 250 - $ 350 Comprehensive diagnostics of oncology Find out the price Comprehensive diagnostics for stomach cancer $ 3000 - $ 5600 Comprehensive diagnostics for esophageal cancer $ 2000 - $ 4500 Comprehensive diagnostics for cervical cancer $ 2000 - $ 5000 Comprehensive diagnostics of breast cancer $ 1500 - $ 5000 Comprehensive diagnostics of lung cancer $ 1500 - $ 5800 Comprehensive diagnostics of prostate cancer $ 2200 - $ 7300 Comprehensive diagnosis of thyroid cancer $ 2300 - $ 3200 Comprehensive diagnosis of sarcoma $ 2600 - $ 4000 Consultation with an interventional radiologist $ 110 - $ 125 Consultation with a mammologist $ 80 - $ 160 Consultation with a neurosurgeon $ 50 - $ 140 Consultation with an oncologist $ 80 - $ 200 Radiologist's consultation $ 80 - $ 160 Thoracic surgeon consultation $ 80 - $ 120 M abdominal MRI $ 150 - $ 650 MRI of the abdominal cavity with contrast $ 550 - $ 550 MRI of the brain with contrast $ 320 - $ 550 MRI of one area $ 50 - $ 1200 Mammography $ 50 - $ 250 About Cancer Check-up $ 700 - $ 1220 Cancer Check-up for Women $ 676 - $ 1250 Cancer Check-up for men $ 1000 - $ 1250 Online consultation with a hematologist $ 140 - $ 140 P PET of the brain with FDG $ 1000 - $ 1000 PET / CT $ 500 - $ 1100 PET-CT for lymphoma $ 600 - $ 1100 PET-CT for breast cancer $ 600 - $ 800 PET-CT for lung cancer $ 600 - $ 1100 PET / CT with Gallium 68 (DOTA) $ 800 - $ 2000 PET / CT with Gallium 68 (DOTATATE) $ 950 - $ 2000 PET-CT with Gallium 68 (PSMA) $ 800 - $ 3000 Revision of MRI results $ 80 - $ 200 P Revision of histological material $ 350 - $ 2100 C Scintigraphy $ 75 - $ 2000 Scintigraphy $ 75 - $ 105 T KRAS, NRAS, BRAF gene mutation test $ 2200 - $ 2200 Fine needle aspiration biopsy $ 550 - $ 2400 Trepan biopsy $ 1000 - $ 2250 In breast ultrasound $ 150 - $ 200 F Fiber Scan $ 450 - $ 450 Якорь 1 1.1 1.2. 1.3. 1.4. 1.5. 2. STATEMENT OF DIAGNOSIS 2.1. Stage of cancer Stage refers to the degree of your cancer, such as how large the tumor is and whether it has spread. Cancer stage information will help your doctor: Understand how serious your cancer is and your chances of survival Plan the best treatment for you Identify clinical trials that may be treatment options for you Cancer is always referred to as the stage at which it was diagnosed, even if it is getting worse or spreading. New information about how the cancer has changed over time is added to the baseline stage. So the stage doesn't change, even if the cancer can. 2.2. How the stage is determined To find out the stage of your illness, your doctor may order x-rays, lab tests, and other tests or procedures. 2.3. Systems describing the stage There are many staging systems. Some, such as the TNM staging system, are used for many types of cancer. Others are specific to a certain type of cancer. Most intermediate systems include information about: Where is the tumor in the body Cell type (eg, adenocarcinoma or squamous cell carcinoma) Tumor size Whether the cancer has spread to nearby lymph nodes Whether the cancer has spread to another part of the body The grade of the tumor, which indicates how abnormal the cancer cells look and how likely the tumor is to grow and spread. Intermediate system TNM The TNM system is the most widely used cancer staging system. Most hospitals and health centers use TNM as their primary cancer reporting method. You are likely to see your cancer with this staging system in your pathology report, unless you have cancer that uses a different staging system. Examples of cancers with different staging systems include brain and spinal cord tumors and blood cancers. In TNM system: T indicates the size and grade of the underlying tumor. The primary tumor is commonly referred to as the primary tumor. The letter N indicates the number of nearby lymph nodes that have cancer. The letter M indicates the presence of cancer metastases. This means that the cancer has spread from the primary tumor to other parts of the body. When your cancer is described by the TNM system, there will be numbers after each letter that give more information about the cancer, such as T1N0MX or T3N1M0. The following explains what the letters and numbers mean: Primary tumor (T) TH: It is impossible to measure the underlying tumor. T0: No underlying tumor found. T1, T2, T3, T4: Refers to the size and / or size of the underlying tumor. The higher the number after the letter T, the larger the tumor or the more it grows into nearby tissues. T can be further split to provide more detailed information, eg T3a and T3b. Regional lymph nodes (N) NX: Cancer in nearby lymph nodes cannot be measured. N0: There is no cancer in the neighboring lymph nodes. N1, N2, N3: Refers to the number and location of lymph nodes containing cancer. The higher the number after N, the more lymph nodes are affected by cancer. Distant metastases (M) MX: Metastases impossible to measure. M0: Cancer has not spread to other parts of the body. M1: Cancer has spread to other parts of the body. Other ways to describe a stage The TNM system helps to describe cancer in detail. But for many cancers, TNM combinations are grouped into five less detailed stages. When talking about your cancer, your doctor or nurse may describe it as one of the following stages: Stage 0: Abnormal cells are present, but have not spread to nearby tissues. Also called carcinoma in situ or CIS. CIS is not cancer, but it can become cancer. Stage I, Stage II and Stage III: Cancer is present. The higher the number, the larger the cancer and the more it has spread to nearby tissues. Stage IV: Cancer has spread to distant parts of the body. Another staging system that is used for all types of cancer divides cancer into one of five main categories. This staging system is used more often by cancer registries than by doctors. But you can still hear your doctor or nurse describe your cancer in one of the following ways: In situ - Abnormal cells are present but have not spread to nearby tissues. Localized - The cancer is confined to the site where it started, with no signs of spreading. Regional - The cancer has spread to nearby lymph nodes, tissues, or organs. Distant - The cancer has spread to distant parts of the body. Unknown - Insufficient information is available to determine the stage. 2.2 Якорь 2 2.3 2.1. 3. UNDERSTANDING THE FORECAST If you have cancer, you may have questions about how serious your cancer is and what your chances of survival are. Assessing how your illness will go is called prognosis. It can be difficult to understand what the prognosis means, and it can also be difficult to talk about it even to doctors. 3.1. Many factors can affect your prognosis Some of the factors that affect the prognosis include: The type of cancer and its location in your body The stage of the cancer, which refers to the size of the cancer and if it has spread to other parts of your body Cancer in a class that talks about how abnormal cancer cells look under a microscope. The score gives an idea of how quickly the cancer can grow and spread. Some features of cancer cells Your age and how healthy you were before cancer How do you respond to treatment 3.2. Finding information about your forecast is a personal decision When you have cancer, you and your loved ones are confronted with many unknowns. Understanding your cancer and knowing what to expect can help you and your loved ones make decisions. Here are some of the solutions you may come across: Which treatment is best for you If you want treatment How to best take care of yourself and deal with treatment side effects How to deal with financial and legal issues Many people want to know their prognosis. It is easier for them to cope when they know more about their cancer. You can ask your doctor about survival statistics or find this information yourself. Or, you may find the statistics confusing and intimidating and think they are too impersonal to be of value to you. It's up to you how much information you need. If you do decide you want to know more, the doctor who knows the most about your situation can discuss your prognosis and explain what the statistics might mean. 3.3. Understanding survival statistics Doctors estimate the prognosis using statistics that researchers have collected over the years about people with the same type of cancer. Several types of statistics can be used to evaluate a forecast. The most commonly used statistics include: Cancer-related survival. This is the percentage of patients with a particular type and stage of cancer who did not die of cancer within a specified period of time after diagnosis ... The time period can be 1 year, 2 years, 5 years, etc., with 5 years being the most commonly used time period. Cancer-related survival is also called disease-specific survival. In most cases, cancer-related survival is based on the causes of death listed on medical records. Relative survival. This statistic is another method used to estimate cancer survival that does not use information about the cause of death. This is the percentage of cancer patients who survived for a period of time after diagnosis, compared to people without cancer. Overall survival This is the percentage of people with a particular type and stage of cancer who did not die for any reason within a specified period of time after diagnosis. Disease Free Survival This statistic represents the percentage of patients who show no signs of cancer within a specified period of time after treatment. Other names for this statistic are - survival without relapses or progression ... Since statistics are based on large groups of people, they cannot be used to accurately predict what will happen to you. All different. Treatment options and how people respond to treatment can vary greatly. It also takes years to see the benefits of new treatments and cancer searches. Thus, the statistics your doctor uses to predict may not be based on the treatments that are in use today. However, your doctor can tell you that you have a good prognosis if statistics show that your cancer is likely to respond well to treatment. Or he may tell you that you have a poor prognosis if the cancer is harder to control. Whatever your doctor tells you, remember that the prognosis is an educated guess. Your doctor cannot say for sure how this will go for you. 3.4. If you decide not to be treated If you choose not to get treatment, the doctor who knows your situation best will be able to discuss your prognosis. Survival statistics are most often taken from studies that compare treatments with each other, rather than treatment without treatment. Therefore, it can be difficult for your doctor to give you an accurate prognosis. 3.5. Understanding the difference between treatment and remission To be cured means that after treatment there will be no trace of cancer and the cancer will never come back. Remission means a decrease in the signs and symptoms of cancer. Remission can be partial or complete. In complete remission, all signs and symptoms of cancer disappeared. If you remain in complete remission for 5 years or more, some doctors may say that you are cured. However, some cancer cells can remain in your body for years after treatment. These cells could one day cause cancer to recur. In most cases, cancers return within the first 5 years after treatment. But there is a chance the cancer will come back later. For this reason, doctors cannot say for sure that you are cured. The best they can say is that there are currently no signs of cancer. Because cancer may return, your doctor will monitor you for years and run tests to look for signs of cancer returning. They will also look for signs of late side effects from the cancer treatment you received. 3.1. Якорь 3 3.2. 3.3. 3.4. 3.5. TYPES OF TREATMENT FOR CANCER There are many types of cancer treatments. The types of treatment you receive will depend on the type of cancer and its prevalence. Some cancer patients will be given only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and / or radiation therapy. When you need cancer treatment, there is a lot to learn and think about. It's okay to feel overwhelmed and confused. But by talking to your doctor and learning about the types of treatment you can get, you can better control the situation. Якорь 4 Testing biomarkers for cancer treatment Biomarker testing is a way of looking for genes, proteins, and other substances (called biomarkers or tumor markers) that can provide information about cancer. Biomarker testing can help you and your doctor choose your cancer treatment. Chemotherapy Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells. Find out how chemotherapy works against cancer, why it causes side effects and how it is used with other cancer treatments. Hormone therapy Hormone therapy is a treatment that slows or stops the growth of breast cancer and prostate, which uses hormones for growth. Learn about the types of hormone therapy and possible side effects. Immunotherapy for cancer treatment Immunotherapy is a type of cancer treatment that helps your immune system fight off cancer. This page explains the types of immunotherapy and how it is used. against cancer and what to expect during treatment. Radiation therapy Radiation therapy is a type of cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. Learn about the types of radiation, why side effects occur, which ones may occur and much more. Stem cell transplant Stem cell transplantation is a procedure that restores hematopoietic stem cells in cancer patients in whom very high doses have been destroyed chemotherapy or radiation therapy. Learn about the types of grafts, side effects, that may occur and how stem cell transplants are used in cancer treatment. Surgery In cancer treatment, surgery is a procedure by which a surgeon removes cancer from your body. Learn about the different types of cancer surgery and what to expect before, during, and after surgery. \ Targeted therapy Targeted therapy is a type of cancer treatment that targets changes in cancer cells, that help them grow, share and spread. Find out how targeted therapy works against cancer, and common side effects that may occur. The doctor selects the most effective techniques based on the results of a comprehensive examination. The treatment plan depends on factors: location of the tumor; the size of the neoplasm; the presence of secondary foci (metastases); age and general condition of the patient. 4.1. Rehabilitation after cancer treatment For physical and psychological recovery after treatment, doctors may prescribe: classes with a psychologist; special training to improve the functioning of the organ on which the doctors performed the operation; diet. The patient's recovery takes place in a clinic, a specialized rehabilitation center or at the place of residence. The duration of rehabilitation is from several weeks to six months. 4.2. Benefits of cancer treatment in clinics in Turkey Cancer treatment in Turkey is: Operations with the preservation of limbs and organs. High level of technical equipment in clinics. Equipment in foreign medical centers is renewed every 1-3 years. An effective drug treatment that oncologists select after the genetic diagnosis of a tumor. Access to the latest therapy and surgery techniques. The best clinics in Turkey (click here ) 4.3. Which doctors treat cancer? The following specialists are involved in the treatment of cancer: Oncosurgeon - performs operations to remove tumors. Medical oncologist - specializes in cancer drug treatment (chemotherapy, immunotherapy, targeted therapy). Radiation Oncologist - Performs radiation therapy. The best specialists in Turkey (click here) 4.4. Examples of the cost of treatment in Turkey BREAST CANCER TREATMENT : Basic diagnostics and tumor removal from $ 5370 Basic diagnostics + Lumpectomy from $ 7116 Mastectomy with check of lymph node involvement in breast cancer from $ 8500 Breast cancer diagnostics from $ 1989 LUNG CANCER TREATMENT: Diagnostics + 1st line of drug therapy from $ 7420 Diagnostics and treatment of lung cancer in the oncological center from $ 18113 Extended diagnostics for lung cancer from $ 2849 Extended diagnostics for suspected lung cancer from $ 3502 TREATMENT OF PROSTATE CANCER: Prostatectomy with Da Vinci robot from $ 14920 Special diagnostic program for prostate cancer from $ 3901 Prostate cancer from $ 6560 Prostate cancer from $ 4610 TREATMENT OF SARCOMA: Diagnostics and treatment of sarcoma from $ 23682 LIVER CANCER TREATMENT: Diagnosis of liver cancer + surgery from $ 22710 Liver cancer from $ 31,575 TREATMENT OF STOMACH CANCER: Surgery for stomach cancer on request Diagnosis + Surgery + Chemotherapy on request Comprehensive diagnostics for stomach cancer from $ 2499 BRAIN CANCER TREATMENT: Diagnostics and treatment of brain cancer from $ 24460 Basic diagnostics for brain cancer from $ 1028 TREATMENT OF MELANOMA: Extended diagnostics + removal of education from $ 11232 TREATMENT OF ADENOCARCINOMA: Diagnostics + Removal of adenocarcinoma of the lungs from $ 17260 Treatment for adenocarcinoma of the head of the pancreas from $ 28510 Diagnostics and treatment of gastric adenocarcinoma from $ 18230 Removal of adenocarcinoma of the prostate using the Da Vinci robot from $ 22,180 PANCREAS CANCER TREATMENT: Diagnostics + Operation + Chemotherapy from $ 30560 Pancreatic cancer from $ 5020 THYROID CANCER TREATMENT: Diagnostics + Radioiodine therapy from $ 3720 Thyroid cancer from $ 7080 OVARIAN CANCER TREATMENT: on request TREATMENT OF CERVICAL CANCER: Basic diagnostics for cervical cancer from $ 943 4.1. 4.2. 4.3. 4.4. 4.5. COST OF CANCER TREATMENT IN TURKEY S Liver SIRT $ 30,000 - $ 45,000 A Autologous bone marrow transplant $ 37000 - $ 55000 B Brachytherapy for prostate cancer $ 2500 - $ 5500 V Intraperitoneal chemotherapy HIPEC $ 20,000 - $ 46,000 G Gamma Knife for Brain Tumor $ 5000 - $ 12000 Gastrectomy $ 5000 - $ 9000 Gastrectomy with Da Vinci robot $ 21500 - $ 21500 Hysterectomy (removal of the uterus) $ 2000 - $ 84000 Hysterectomy with Da Vinci robot $ 21700 - $ 21700 AND Immunotherapy $ 2000 - $ 6000 Immunotherapy with Keytruda (Pembrolizumab) Find out the price Immunotherapy for sarcoma $ 3600 - $ 4200 TO Cyber Knife $ 4400 - $ 12000 Cyberknife for brain tumors $ 4400 - $ 12000 Cyber knife for lung cancer Find out the price Cyber Knife for Prostate Cancer $ 6000 - $ 8000 Colectomy (colon resection) $ 8650 - $ 18000 Craniotomy $ 13300 - $ 27000 Xofigo Radium-223 Find out the price L Lumpectomy $ 5426 - $ 8000 Laryngectomy $ 4000 - $ 7000 Treatment with Lutetium-177 $ 11000 - $ 13000 Lobectomy (removal of a lobe of the lung) $ 7000 - $ 29489 Radiation therapy $ 3500 - $ 11000 Radiation therapy for brain tumor $ 8000 - $ 15000 Radiation therapy for stomach cancer $ 8500 - $ 15000 Radiation therapy for lung cancer $ 8000 - $ 18000 Radiation therapy for uterine cancer $ 8000 - $ 14000 Radiation therapy for breast cancer $ 8000 - $ 16000 Radiation therapy for esophageal cancer $ 7000 - $ 12000 Radiation therapy for prostate cancer Find out the price Radiation therapy for cervical cancer $ 3000 - $ 15000 Radiation therapy for ovarian cancer $ 8000 - $ 12000 Radiation therapy for sarcoma $ 6500 - $ 11000 M Mastectomy $ 2000 - $ 7700 H Nano Knife $ 12000 - $ 18000 O Omentectomy $ 6400 - $ 6400 Oophorectomy $ 2500 - $ 3000 Wertheim's operation $ 24000 - $ 24000 Whipple operation $ 14500 - $ 28000 Laryngeal cancer surgery $ 10240 - $ 10240 Stomach cancer surgery $ 5000 - $ 21000 Lung cancer surgery $ 10300 - $ 27000 Breast cancer surgery $ 2500 - $ 15000 Pancreatic cancer surgery $ 8500 - $ 14000 Tongue cancer surgery $ 20,000 - $ 20,000 Ovarian cancer surgery $ 6500 - $ 28000 NS Bone marrow transplant $ 19,900 - $ 130,000 Pneumonectomy (pulmonectomy) $ 11200 - $ 11200 Prostatectomy $ 7300 - $ 23000 Prostatectomy with Da Vinci robot $ 12000 - $ 23000 R Radioiodine therapy $ 3000 - $ 6000 Radioembolization of the liver Find out the price Bone resection with implant replacement Find out the price Laryngeal tumor resection $ 4000 - $ 7000 Liver resection Find out the price Esophageal resection Find out the price Resection for liver cancer $ 20,000 - $ 25,000 Rectum resection $ 8000 - $ 30,000 Thyroid resection $ 4000 - $ 7700 Da Vinci robotic system $ 16000 - $ 22000 WITH Segmental lung resection $ 11300 - $ 25000 Stereotactic radiosurgery Find out the price Subtotal thyroidectomy $ 6000 - $ 6000 T TUR (transurethral resection) of the prostate $ 2000 - $ 7500 Targeted therapy $ 3000 - $ 5000 Targeted therapy for lung cancer $ 2500 - $ 11700 Thyroidectomy $ 6000 - $ 11000 Allogeneic bone marrow transplant from an unrelated donor $ 75000 - $ 125000 Allogeneic bone marrow transplant from a related donor $ 60,000 - $ 75,000 Have Glioma removal $ 12600 - $ 21600 Removal of melanoma $ 7000 - $ 15000 Removal of meningioma Find out the price Removal of the bladder with reconstruction $ 23000 - $ 26000 Brain tumor removal $ 4200 - $ 30,000 Pancreatic tumor removal Get the price Spinal cord tumor removal $ 4200 - $ 4500 Testicular tumor removal $ 5000 - $ 8000 Kidney removal $ 10000 - $ 10000 Kidney removal laparoscopic $ 13000 - $ 16000 F Focused ultrasound ablation (HIFU) Find out the price NS Chemotherapy $ 600 - $ 9000 Chemotherapy for a brain tumor $ 1000 - $ 3000 Chemotherapy for stomach cancer $ 1700 - $ 5000 Chemotherapy for lung cancer $ 1200 - $ 9000 Chemotherapy for uterine cancer $ 2000 - $ 8000 Chemotherapy for uterine cancer $ 1500 - $ 5000 Chemotherapy for breast cancer Find out the price Chemotherapy for liver cancer $ 800 - $ 4170 Chemotherapy for pancreatic cancer $ 1500 - $ 3500 Chemotherapy for prostate cancer $ 1000 - $ 5000 Chemotherapy for sarcoma $ 800 - $ 5444 Chemoembolization of the liver $ 5000 - $ 6000 NS Esophagectomy $ 8000 - $ 10000 4.5. Need help? Doctors-coordinators will advise you and help you with the choice. Services Medikal & Estetik Group are free for you and do not affect the clinic bill. Find a solution Coordinator Medikal & Estetik Group help you find the best solution for cancer treatment CHOOSE CLINIC O Medikal & Estetik Group Second opinion Before traveling, you can get a Turkish doctor's opinion on your diagnosis and treatment prescribed. For the patient, this is an opportunity to receive advice from the world's best specialists.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. Endoscopy Essentials No posts published in this language yet Once posts are published, you’ll see them here.

Список лучших клиник в Турции междунаровного уровня с наличием самого престижного в мировой медицине сертификатом JCI MAIN SPECIALIZATIONS OF TURKISH MEDICINE Over 1000 clinics in Turkey accept foreign patients. Most of these clinics have confirmed their highest level, having passed accreditation according to international standards, and 49 clinics received the prestigious international JCI certificate (clinics are evaluated according to 1300 parameters and certification if they meet at least 1100 key criteria). The number of JCI-level clinics is several times higher than Germany (5 clinics) and Israel (3 clinics in total). In the meantime, there is no need to worry about it. ” Especially it is necessary to highlight the 4th in terms of technological equipment in the world Anadolu Cancer Center and rich experience of specialists in several areas, as well as Liv Hospital, which is the first and only institution outside the United States that has certificates for Robotic Surgery, Robotic Abdominal Surgery ". After training in the United States, Germany or France, local doctors perform thousands of kidney, liver, bone marrow, corneal and hair transplants - industries unmatched by Turkey. In addition, to help patients in the most difficult cases, the best clinics in Turkey work with leading hospitals and Institutes in the United States. The best JCI level clinics in Turkey KENT HASTANESI IZMIR, TURKEY Services: DIAGNOSTICS ONCOLOGY NEUROSURGERY ORTHOPEDICS AND TRAUMATOLOGY CARDIOLOGY AND CARDIAC SURGERY GYNECOLOGY TRANSPLANTOLOGY RADIOLOGY (RADIATION ONCOLOGY) PREGNANCY AND CHILDBIRTH GENERAL SURGERY More details ESTETIK INTERNATIONAL, ISTANBUL / BURSA, TURKEY Services: ORGANIC HAIR TRANSPLANT SPIDER WEB REJUVENATION METHOD SAFE RHINOPLASTY SAFE OTOPLASTY FAT TRANSFER WITH THE CIHANTIMUR METHOD More details LIV HOSPITAL, ISTANBUL, TURKEY More details Services: CARDIAC SURGERY ONCOLOGY ABDOMINAL SURGERY BARIATRICS NEUROSURGERY STOMATOLOGY MEMORIAL, ISTANBUL, ANTALYA, TURKEY Services: Cardiology TRANSPLANTOLOGY NEUROSURGERY ONCOLOGY ORTHOPEDICS AND TRAUMOTOLOGY SURGERY More details MEDIKAL PARK, IZMIR, ISTANBUL, BURSA, ANTALYA ..., TURKEY Services: NEUROSURGERY ONCOLOGY OPHTHALMOLOGY ORTHOPEDICS AND TRAUMOTOLOGY CARDIAC SURGERY OBSTETRICS AND GYNECOLOGY More details AMERIKAN HASTANESI, ISTANBUL, TURKEY Services: ONCOLOGY TRANSPLANTOLOGY CARDIAC SURGERY NEUROSURGERY ORTHOPEDICS AND TRAUMOTOLOGY More details KOÇ UNIVERSITY HOSPITAL, ISTANBUL, TURKEY Services: OBSTETRICS AND GYNECOLOGY ONCOHEMOTOLOGY NEUROSURGERY TRANSPLANTOLOGY CARDIAC SURGERY ONCOLOGY More details HISAR INTERCONTINENTAL HOSPITAL, ISTANBUL, TURKEY Services: NEUROSURGERY PLASTIC SURGERY REPRODUCTIVE MEDICINE SPINAL SURGERY More details BATI GÖZ, IZMIR, TURKEY More details Services: EYE ultrasound OPHTHALMOSCOPY BIOMICROSCOPY KERATOMETRY CORNEAL TRANSPLANTATION TREATMENT OF SQUANE LASER LASIK CORRECTION TREATMENT OF MYOPIA TREATMENT OF CATARACT TREATMENT OF ASTIGMATISM MEDIKANA, ISTANBUL, ANKARA, TURKEY More details Services: NEUROSURGERY TRANSPLANTOLOGY ONCOLOGY CARDIOLOGY CARDIAC SURGERY GYNECOLOGY OBSTETRICS MEDISTATE, ISTANBUL, TURKEY More details Services: In the meantime, there is no need to worry about it. ” NEUROSURGERY CARDIAC SURGERY BANDAGE OF THE STOMACH SPINE TUMOR RESECTION REPLACING THE HIP JOINT ONCOHEMATOLOGY ORTHOPEDICS LUNG CANCER TREATMENT LYMPHOMA TREATMENT TREATMENT OF ALZHEIMER ÖZEL SAĞLIK HASTANESI, IZMIR, TURKEY More details Services: TREATMENT OF ONCOLOGY UROLOGY PLASTIC AND RECONSTRUCTION SURGERY SURGERY NEUROLOGY AND NEUROSURGERY CARDIOVASCULAR SURGERY CHECK-UP MEDIPOL HOSPITAL ISTANBUL, TURKEY More details Services: NEUROSURGERY AND NEUROLOGY BONE MARROW, KIDNEY AND LIVER TRANSPLANTATION TREATMENT OF ONCOLOGY CARDIOVASCULAR SURGERY ECO STOMATOLOGY ORTHOPEDICS ACIBADEM, ISTANBUL, TURKEY More details Services: CARDIOLOGY OPHTHALMOLOGY ONCOLOGY DIAGNOSTICS ORTHOPEDICS TURKEY HAIR AKADEMY, ISTANBUL, TURKEY More details Services: HAIR / EYEBROW / BEARD TRANSPLANTATION WITH FUE, DHI, FUT METHODS PLASTIC SURGERY STOMATOLOGY YEDITEPE, ISTANBUL, TURKEY More details Services: ORGAN AND BIOLOGICAL TISSUE TRANSPLANTATION CARDIOVASCULAR SURGERY NEUROSURGERY BARIATRIC SURGERY GENETIC DIAGNOSTICS ANADOLU, GEBZE, ISTANBUL, TURKEY More details Services: BONE MARROW TRANSPLANTATION CENTER TREATMENT OF ONCOLOGISTS EARLY DIAGNOSTICS OF ONCOLOGY REPRODUCTIVE MEDICINE DÜNYA GÖZ OPHTHALMIC CLINIC CHAIN, ISTANBUL, TURKEY More details Services: LABORARY ANALYSIS LASER VISION CORRECTION PHACOEMULSIFICATION TREATMENT OF SQUANE VITREKTOMIA PHYSIOTHERAPY AND REHABILITATION CENTER ROMATEM, ISTANBUL, TURKEY More details Services: NEUROLOGICAL REHABILITATION ORTHOPEDIC REHABILITATION MANUAL THERAPY PHYSIOTHERAPY CARDIOLOGICAL REHABILITATION ESTETHICA AESTHETIC MEDICINE CENTERS, ISTANBUL, TURKEY More details Services: PLASTIC SURGERY STOMATOLOGY HAIR TRANSPLANTATION DERMATOLOGY REHABILITATION KOLAN HOSPITAL GROUP CLINIC CHAIN More details Services: TRANSPLANTOLOGY PLASTIC SURGERY DERMATOLOGY ONCOHEMATOLOGY SURGERY FLORENCE NICHTINGALE, ISTANBUL, TURKEY More details Services: TRANSPLANTOLOGY ONCOLOGY PEDIATRICS OPHTHALMOLOGY SURGERY NP BRAIN HOSPITAL CLINIC, ISTANBUL, TURKEY More details Services: PSYCHOLOGY AND PSYCHIATRY PSYCHOSOMATICS NEUROSURGERY BARIATRIC SURGERY

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. Cancer recurrence. METASTATIC CANCER, MENU PAGES: 1. RELEASE OF CANCER 1.1. Why does cancer return? 1.2. Recurrent cancer types 1.3. Cancer recurrence stage 1.4. Recurrent cancer treatment 2. METASTATIC CANCER 2.1. How cancer spreads 2.2. Where does cancer spread 2.3. Symptoms of metastatic cancer 2.4. Metastatic cancer treatment 2.5. When metastatic cancer can no longer be controlled. Palliative care 2.6. Hospice care for cancer patients 2.7. Questions about advanced cancer to ask your doctor When cancer comes back after treatment, doctors call it a relapse or recurrent cancer. Finding a cancer recurrence can cause feelings of shock, anger, sadness, and fear. But now you have something that was not there before - experience. You are already a cancer survivor and you know what to expect. Also remember that treatment may have improved since you were first diagnosed. New medications or methods can help you heal or treat side effects. In some cases, improved treatments have helped turn cancer into a chronic disease that people can cope with and live with for years. 1. RELEASE OF CANCER Якорь 1 1.1. Why does cancer return? Cancer recurrence begins with cancer cells that were not completely removed or destroyed in the first treatment. This does not mean that you received the wrong treatment. It simply means that a small number of cancer cells survived the treatment and were too small to be detected in subsequent tests. Over time, these cells have developed into tumors or cancers that your doctor can now detect. Sometimes a new type of cancer occurs in people who have had cancer. When this happens, the new cancer is called the second primary cancer. The second primary cancer is different from recurrent cancer. 1.2. Recurrent cancer types Doctors describe cancer recurrence by where it develops and how far it has spread. Different types of relapses: Local recurrence means that the cancer is in the same place as or very close to the original cancer. Regional recurrence means that the tumor has grown into lymph nodes or tissues near the original cancer. Distant relapse means that the cancer has spread to organs or tissues that are far from the original cancer. When cancer spreads to distant parts of the body, it is called metastasis. or metastatic cancer . When cancer spreads, it is still the same type of cancer. For example, if you have had colon cancer, it may return to your liver. But cancer is still called colon cancer. 1.3. Cancer recurrence stage To find out what kind of relapse you have, you will need to go through many of the same tests you did when you first diagnosed your cancer, such as laboratory tests and imaging procedures. These tests help determine where the cancer has returned to your body, whether it has spread, and how far. Your doctor may refer to this new assessment of your cancer as "restyling." After these tests, the doctor may prescribe a new stage for the cancer. The letter "r" will be added to the beginning of a new stage to reflect the re-staging. The initial stage in the diagnosis does not change. Check out our diagnostic information. to learn more about tests that can be used to assess recurrent cancer. 1.4. Recurrent cancer treatment The type of treatment for recurrent cancer will depend on your type of cancer and how far it has spread. To find out about the methods of treatment that can be used to treat your recurrent cancer, you can order a consultation / second opinion from the best international oncologists in Turkey on our website. 1.1. 1.2. 1.3. 1.4 SECOND OPINION Cancer that spreads from where it originated to a distant part of the body is called metastatic cancer. Many cancers are also called stage IV cancers (4). The process by which cancer cells spread to other parts of the body is called metastasis. When observed under microscope and other studies, metastatic cancer cells have features similar to those of the primary cancer and are not similar to the cells where metastatic cancer is found. This way, doctors can determine that it is cancer that has spread from another part of the body. Metastatic cancer has the same name as primary cancer. For example, breast cancer that spreads to the lungs is called metastatic breast cancer, not lung cancer. It is treated as stage IV breast cancer, not lung cancer. Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started. This type of cancer is called cancer of unknown primary origin or CUP. 2. METASTATIC CANCER Якорь 2 During metastasis, cancer cells break away from where they first formed (primary cancer), travel through the circulatory or lymphatic system, and form new tumors (metastatic tumors) elsewhere in the body. A metastatic tumor is the same type of cancer as the primary tumor. 2.1. How cancer spreads Cancer cells spread throughout the body in several stages. These steps include: grows into or invades adjacent normal tissue movement through the walls of nearby lymph nodes or blood vessels travel through the lymphatic system and bloodstream to other parts of the body stopping in small blood vessels at a distant location, invading blood vessel walls and moving into surrounding tissues grows in this tissue until a tiny tumor forms causes the growth of new blood vessels, which creates a blood supply that allows the metastatic tumor to continue to grow In most cases, cancer cells die at some point. But as long as conditions are favorable for cancer cells at each stage, some of them can form new tumors in other parts of the body. Metastatic cancer cells can also remain inactive in a distant location for years before they start growing again, if ever. 2.2. Where does cancer spread? Cancer can spread to almost any part of the body, although different types of cancer are more likely to spread to certain areas than others. The most common sites for cancer to spread are bones, liver and lungs. The following list shows the most common metastatic sites, excluding lymph nodes, for some common cancers: Bladder: Bone, liver, lung Chest: Bone, brain, liver, lung Large intestine: Liver, lung, peritoneum Kidney: Adrenal gland, bone, brain, liver, lung Lung: Adrenal gland, bone, brain, liver, other lung Melanoma: Bone, brain, liver, lungs, skin, muscles Ovary: Liver, lung, peritoneum Pancreas: Liver, lung, peritoneum Prostate: Adrenal gland, bone, liver, lung Rectal: Liver, lung, peritoneum Stomach: Liver, lung, peritoneum Thyroid: Bone, liver, lung Uterus: Bone, liver, lung, peritoneum, vagina 2.3. Symptoms of metastatic cancer Metastatic cancer does not always cause symptoms. When symptoms do occur, what they are and how often they occur will depend on the size and location of the metastatic tumors. Some common signs of metastatic cancer include: pain and fractures when the cancer has spread to the bones headache, cramps, or dizziness when cancer has spread to the brain shortness of breath when the cancer has spread to the lungs jaundice or swelling in the abdomen when cancer has spread to the liver 2.4. Metastatic cancer treatment There are treatments for most types of metastatic cancer. Often, the goal of treatment for metastatic cancer is to control it by stopping or slowing its growth. Some people can live for years with metastatic cancer that is well controlled. Other treatments can improve quality of life by relieving symptoms. This type of care is called palliative care. It can be administered at any stage of cancer treatment. The treatment you can get depends on your type of primary cancer, where it has spread, treatment you have received in the past, and your overall health. 2.5. When metastatic cancer can no longer be controlled. Palliative care If you've been told that your cancer is no longer controllable, you and your loved ones may want to discuss end-of-life patient care. Regardless of whether you decide to continue treatment to reduce cancer or control its growth, you can always get palliative care to control cancer symptoms and side effects treatment. Palliative care is care that helps patients feel better, but does not cure the disease itself. Palliative care should be started when cancer is diagnosed. This continues during and after treatment. Research shows that palliative care improves the quality of life for patients and their families. All patients are entitled to comfort and quality of life throughout the entire treatment period. Palliative care is especially important if you decide to stop cancer treatment. It includes: treating or preventing symptoms and side effects caused by cancer treatments receiving emotional and spiritual support solving practical problems of patients and their families Palliative care: many of the same methods that are used to treat cancer, such as medications and certain therapies, can also be used to reduce pain or other symptoms and help the patient feel more comfortable. For advanced cancer, palliative treatment may be prescribed to help the person feel better, even if it is not intended to treat cancer. For example, doctors may prescribe chemotherapy or radiation therapy to slow the growth of a tumor that is causing pain. Or, surgery may be done to remove a mass that is pressing on certain nerves and causing pain. Your healthcare team can help you to get palliative care. However, sometimes a palliative care professional may be the best person to treat the problem. Ask your doctor or nurse if you have access to a specialist. 2.6. Hospice care for cancer patients Hospice is a special type of care that provides medical, psychological and spiritual support to cancer patients and their loved ones when treatment no longer helps control the disease. At the hospice, a team of healthcare professionals works with patients and their families to provide the comfort and care they need towards the end of their lives. Hospice care is not the same as palliative care. Although both hospice and palliative care provide patients with comfort and support, palliative care is available throughout the patient's experience with cancer. Cancer treatment continues while the person is receiving palliative care, but hospice care shifts the focus to symptom relief and end-of-life support. Hospice care is care, not treatment. The goal of hospice is to help you live every day to the fullest by controlling pain and other symptoms and making you as comfortable as possible. It is neither designed to hasten nor to delay death. Choosing a hospice does not mean that you have given up hope. Instead, hospice care means changing what you hope for. It can be the hope for a good quality of the rest of your life, including more time with family and friends. Hospice care is available in various locations. Hospice care is most often provided at home, but it can also be provided in specialized inpatient facilities, hospitals and nursing homes. It can also be done in conjunction with professional home care if needed. Hospice services will differ depending on where you live and the hospice's philosophy, but will generally include: medical and nursing services medical supplies and equipment medicines to treat cancer-related symptoms and pain short term inpatient treatment volunteers to give caregivers a break counseling and spiritual assistance social work services prompt consultation and support Hospice specialists and volunteers undergo special training. They are committed to supporting the emotional needs of both patients and their families and are trained to cope with medical symptoms. A hospice team typically includes doctors, nurses, home care aides, social workers, clergy or other counselors, and trained volunteers. The team may also include speech therapists, physical therapists and therapists, if needed. The hospice team will focus on your end-of-life care goals, creating a treatment plan tailored to your needs and desires. Hospice can provide support for several months. Although many people unfortunately believe that hospice is only available in the last days or weeks of life, it can provide support for several months. Many people said they would like hospice care to start earlier. They were surprised by the attentiveness and understanding of the hospice specialists. Your doctor must confirm that you are eligible for hospice care. Most insurance plans cover hospice care after receiving a statement from your PCP and hospice medical director that your life expectancy is 6 months or less. You must also sign a statement that you are choosing a hospice. Hospice care can be continued if you live longer than 6 months if the hospice doctor re-confirms your condition. You always have the option to discontinue hospice treatment if you want. Sometimes patients change their minds, decide to switch to another hospice provider, or their situation changes in some way. Less often, but not uncommon, patients may be discharged from hospice if their condition improves or if they resume cancer treatment. Although hospice care focuses on end-of-life care, it can be difficult to predict with certainty what will happen to a person, and sometimes unforeseen circumstances occur or the person's situation improves. For information on the types of costs covered by private health policies, contact your hospital office, your hospice social worker, or your insurance company. Local community, charitable or faith-based organizations can also help patients and their families with hospice costs. Choosing a hospice. If you decide to use hospice services, talk to the organizations as soon as possible. The choice of hospice will depend on what services are available in your area. Not all hospices provide the same services. It will also depend on which one you like. Talk to family and friends who have used hospice services. Ask your healthcare team for advice. 2.7. Questions about advanced cancer to ask your doctor Communication is important when providing cancer care. If you find out that you have advanced cancer, you will have a choice of treatment and steps to take. Many people find it difficult to ask questions about what these steps should be. Some people with advanced cancer benefit from new treatments, while others do not. Whether you've just been diagnosed or the standard treatment isn't working, it's important to ask your healthcare team what to expect in the future. Research shows that patients who discuss these issues with their doctor have a better quality of life than those who do not. You can hope for the best while still being informed of your choice. The more information you have, the better decisions you and your loved ones can make about how you want to move forward with your concern. When you meet with your doctor, consider asking some of the following questions: Questions about your cancer: What does advanced cancer mean to me? How Long Can I Live With Advanced Cancer? Are there any tests I need to take now to better understand the extent of my cancer? Questions about treatment options: What can we hope for by trying another treatment? What is the purpose? What are my treatment options? What do you recommend me and why? Is this treatment plan for treating side effects, slowing cancer growth, or both? Is there a chance that a new treatment will be found while we try the old one? Is a clinical trial right for me? What help will I get to feel comfortable if I choose not to actively get treatment for my cancer? Questions about symptoms and side effects: What are the possible side effects and other disadvantages of this treatment? How likely are they? How can I manage the symptoms of advanced cancer or the side effects of cancer treatment? Can you refer me to a palliative care specialist to help me manage my side effects? Questions about moving from cancer treatment to hospice: How do I decide whether to continue or stop my cancer treatment? When should I consider hospice treatment? How can I be sure that I have the best quality of life - that I am comfortable and that I am not in pain? Can I get help with hospice at home or do I have to go to a special institution? How can I get help with financial and legal issues (such as paying for hospice care or preparing a will or advance directive)? How can I get help for my spiritual needs? Discussing these issues can help you decide whether to continue or begin active treatment. Tell your healthcare team exactly what you want to know and how much you can take. If possible, it is best to involve your loved ones in this process. This will help you understand your needs and the needs of those close to you. 2.1. 2.2. 2.3. 2.4. 2.5. 2.6. 2.7. Need help? Doctors-coordinators will advise you and help you with the choice. Services Medikal & Estetik Group are free for you and do not affect the clinic bill. Find a solution Coordinator Medikal & Estetik Group help you find the best solution for cancer treatment CHOOSE CLINIC O Medikal & Estetik Group Second opinion Before traveling, you can get an opinion from a Turkish doctor on your diagnosis and prescribed treatment. For the patient, this is an opportunity to receive advice from the world's best specialists.

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МЕНЮ СТРАНИЦЫ ​ 1. Лечение лимфомы Ходжкина у взрослых 1.1. Риски развития лимфомы 1.2. Симптомы лимфомы Ходжкина 1.3. Диагностика и определение стадии лимфомы Ходжкина 1.4. Факторы, влияющие на прогноз и варианта лечения лимфомы Ходжкина 1.5. Стадии лимфомы Ходжкина у взрослых 1.6. Обзор вариантов лечения 2. Лечение неходжкинской лимфомы у взрослых СТОИМОСТЬ ЛЕЧЕНИЯ ЛИМФОМЫ НЕХОДЖКИНА В ТУРЦИИ 3. ЛЕЧЕНИЕ ЛИМФОМЫ, СВЯЗАННОЙ СО  СПИДом 4. ЛЕЧЕНИЕ ГРИБКОВОГО МИКОЗА (включая синдром Сезари) COST OF TREATMENT AND DIAGNOSTICS OF CANCER IN TURKEY MENU PAGES 1. Treatment of Hodgkin's lymphoma in adults 1.1. Risks of developing lymphoma 1.2. Symptoms of Hodgkin's lymphoma 1.3. Diagnosis and staging of Hodgkin's lymphoma 1.4. Factors affecting prognosis and treatment options for Hodgkin's lymphoma 1.5. Stages of Hodgkin's lymphoma in adults 1.6. Overview of treatment options 1.7. Side effects after treatment COST OF TREATMENT FOR HODGKIN'S LYMPHOMA IN TURKEY 2. Treatment of non-Hodgkin's lymphoma in adults 2.1. NHL types 2.2. NHL Symptoms 2.3. Tests to diagnose and stage non-Hodgkin's lymphoma in adults 2.4. Factors affecting prognosis (chance of recovery) and treatment options 2.5. NHL stages in adults 2.6. Overview of NHL Treatment Options 2.7. Treatments for patients with non-Hodgkin's lymphoma 2.8. Side effects of NHL treatment 2.9. Standard treatments COST OF TREATMENT FOR NEHOJKIN'S LYMPHOMA IN TURKEY Lymphoma is a broad term for cancer that begins in the cells of the lymphatic system. The two main types are Hodgkin's lymphoma and non-Hodgkin's lymphoma (NHL). Hodgkin's lymphoma can often be cured. The NHL prognosis depends on the specific type. Explore the links on this page to learn more about lymphoma treatments, research, and clinical trials. Hodgkin's lymphoma in adults is a disease in which malignant (cancerous) cells form in the lymphatic system. Hodgkin's lymphoma in adults is a type of cancer that develops in the lymphatic system. The lymphatic system is part of the immune system. This helps protect the body from infections and disease. The lymphatic system consists of the following: Lymph : a colorless watery liquid that moves through the lymphatic vessels and carries T- and B-lymphocytes. Lymphocytes are white blood cells. Lymphatic Vessels: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream. Lymph Nodes: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infections and disease. Lymph nodes are located along a network of lymphatic vessels throughout the body. Groups of lymph nodes are found in the mediastinum (the area between the lungs), neck, armpits, abdomen, pelvis and groin. Hodgkin's lymphoma most often forms in the lymph nodes above the diaphragm and often in the lymph nodes of the mediastinum. Spleen : an organ that produces lymphocytes, stores red blood cells and lymphocytes, filters blood and destroys old blood cells. The spleen is located on the left side of the abdomen next to the belly. Thymus : the organ in which T-lymphocytes mature and multiply. The thymus is located in the chest behind the sternum. Bone marrow : soft, spongy tissue in the center of certain bones, such as the femur and sternum. Leukocytes, red blood cells, and platelets are produced in the bone marrow. Tonsils: Two small formations of lymphatic tissue at the back of the pharynx. The tonsils are located on each side of the throat. Hodgkin's lymphoma in adults rarely forms in the tonsils. 1. TREATMENT OF LYMPHOMA IN ADULTS Якорь 1 Anatomy of the lymphatic system showing lymphatic vessels and lymphatic organs including lymph nodes, tonsils, thymus, spleen, and bone marrow. Lymph (clear fluid) and lymphocytes travel through the lymphatic vessels to the lymph nodes, where the lymphocytes destroy harmful substances. Lymph enters the bloodstream through a large vein near the heart. Lymphatic tissue is also found in other parts of the body, such as the lining of the digestive tract, bronchi, and skin. There are two main types of lymphoma: Hodgkin's lymphoma and non-Hodgkin's lymphoma. This is a summary of the treatment of Hodgkin's lymphoma in adults, including during pregnancy. The two main types of Hodgkin's lymphoma are classic lymphoma with a predominance of nodular lymphocytes. Most Hodgkin's lymphomas are of the classic type. When a sample of lymph node tissue is viewed under a microscope, cancer cells in Hodgkin's lymphoma, called Reed-Sternberg cells, can be seen. The classic type is classified into the following four subtypes: Nodal sclerosing Hodgkin's lymphoma. Mixed cellularity of Hodgkin's lymphoma. Hodgkin's lymphocytic lymphoma. Classic Hodgkin's lymphoma with a high lymphocyte count. Lymphocyte-dominated Hodgkin's lymphoma is rare and tends to grow more slowly than classic Hodgkin's lymphoma. Lymphocyte-dominated Hodgkin's lymphoma often presents with swollen lymph nodes in the neck, chest, armpit, or groin. Most people do not have any other signs or symptoms of cancer at the time of diagnosis. Treatment often differs from classic Hodgkin's lymphoma. 1.1. Risks of developing lymphoma Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk. Risk factors for developing Hodgkin's lymphoma in adults include the following: Age . Hodgkin's lymphoma is most common in early adulthood (ages 20–39) and late adulthood (ages 65 and older). Be a man . The risk of adult Hodgkin's lymphoma in men is slightly higher than in women. Past Epstein-Barr virus infection. Infection with the Epstein-Barr virus during adolescence or early childhood increases the risk of Hodgkin's lymphoma. A family history of Hodgkin's lymphoma. Having a parent, sibling, or sister with Hodgkin's lymphoma increases your risk of developing Hodgkin's lymphoma. 1.2. Symptoms of Hodgkin's lymphoma These and other signs and symptoms can be caused by Hodgkin's lymphoma in adults or other conditions. Talk to your doctor if you have any of the following symptoms that persist: Painless swollen lymph nodes in the neck, armpits, or groin. Fever for no known reason. Wet night sweats. Weight loss for no known reason in the last 6 months. Itching, especially after bathing or drinking alcohol. Feeling very tired. Unknown cause fever, unknown cause weight loss and severe night sweats are called B symptoms. B symptoms are an important part of staging Hodgkin's lymphoma and understanding the patient's chance of recovery. 1.3. Diagnosis and staging of Hodgkin's lymphoma The results of the tests and procedures below will also help you decide on treatment. These tests may include: 1. Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness such as tumors or anything else that seems unusual. The patient's health history will also be recorded, including fever, profuse night sweats and weight loss, illness and treatment. 2. Complete blood count (CBC): A procedure in which a blood sample is taken and checked for the following: The number of erythrocytes, leukocytes and platelets. The amount of hemoglobin (oxygen-carrying protein) in red blood cells. The portion of the sample composed of red blood cells. 1.1 1.2. 1.3. типы лимфом Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing blood to flow into the tube. A blood sample is sent to a laboratory to count red blood cells, white blood cells, and platelets. A complete blood count is used to test, diagnose, and monitor many different conditions. 3. Studies of the chemical composition of blood : A procedure in which a blood sample is tested to measure the amount of certain substances that enter the bloodstream by organs and tissues of the body. An unusual (more or less than usual) amount of a substance may be a sign of illness. 4. LDH test: A procedure in which a blood sample is tested to measure the amount of lactate dehydrogenase (LDH). An increased amount of LDH in the blood may be a sign of tissue damage, lymphoma, or other medical conditions. 5. Hepatitis B and Hepatitis C Test: A procedure in which a blood sample is tested to measure the amount of antigens and / or antibodies specific to the hepatitis B virus and the amount of antibodies specific to the hepatitis C virus. These antigens or antibodies are called markers. Various markers or combinations of markers are used to determine if a patient has a hepatitis B or C infection, has had a prior infection or vaccination, or is susceptible to infection. Knowing whether a patient has hepatitis B or C can help plan treatment. 6. HIV test: a test to measure the level of antibodies to the human immunodeficiency virus (HIV) in a blood sample. Antibodies are produced by the body when a foreign substance invades it. A high level of antibodies to HIV can mean that the body is infected with HIV. Knowing if a patient has HIV can help plan treatment. 7. Sedimentation rate: a procedure in which a blood sample is taken and the rate at which red blood cells settle to the bottom of the tube is checked. The settling rate is a measure of how much inflammation is in the body. An excess settling rate may be a sign of lymphoma or other medical conditions. Also called erythrocyte sedimentation rate, sedimentation rate, or ESR. 8. PET / CT scan: A procedure that combines positron emission tomography (PET) and computed tomography (CT) images. PET and CT scans are performed simultaneously on the same machine. Images from both scans are combined to create a more detailed picture than either test could do on its own. PET-CT scans can be used to diagnose a disease such as cancer, determine the stage, plan treatment, or find out if a treatment is effective. Computed tomography (computed tomography): A procedure in which a series of detailed pictures of areas inside the body, such as the neck, chest, abdomen, pelvis, and lymph nodes, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed so that organs and tissues can be seen more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. If a PET-CT scan is not available, only computed tomography can be done. PET scan (Positron Emission Tomography): A PET scan is a procedure to detect malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Cancer cells appear brighter because they are more active and consume more glucose than normal cells. 9. Lymph node biopsy: removal of all or part of the lymph node. A pathologist examines tissue under a microscope for the presence of cancer cells called Reed-Sternberg cells. Reed-Sternberg cells are common in classic Hodgkin's lymphoma. Reed-Sternberg cell. Reed-Sternberg cells are large, abnormal lymphocytes that can contain more than one nucleus. These cells are found in Hodgkin's lymphoma. One of the following biopsies can be done: Excisional biopsy: Removal of the entire lymph node. Postoperative biopsy: removal of part of the lymph node. Primary biopsy: Removal of tissue from a lymph node using a wide needle. Other areas of the body, such as the liver, lungs, bones, bone marrow, and marrow, may also have a tissue sample taken and checked by a pathologist for signs of cancer. The following test can be performed on the removed tissue: Excisional biopsy: Removal of the entire lymph node. Postoperative biopsy: removal of part of the lymph node. Primary biopsy: Removal of tissue from a lymph node using a wide needle. 10. Immunophenotyping: a laboratory test that uses antibodies to identify cancer cells based on the types of antigens or markers on the cell surface. This test is used to diagnose certain types of lymphoma. This test can be performed on the removed tissue. 11. For pregnant women with Hodgkin's lymphoma, imaging techniques are used to protect the unborn baby from the harmful effects of radiation. This includes: MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI). In pregnant women, no contrast dye is used during the procedure. Ultrasound examination: A procedure in which high energy sound waves (ultrasound) are reflected off internal tissues or organs and create an echo. The echo forms a picture of body tissue called a sonogram. After Hodgkin's lymphoma is diagnosed in adults, tests are done to find out if cancer cells have spread in the lymphatic system or to other parts of the body. The process used to determine if cancer has spread in the lymphatic system or to other parts of the body is called staging. The information gathered during the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of tests and procedures performed to diagnose and stage Hodgkin's lymphoma are used to make treatment decisions. Cancer spreads through the body in three ways. Cancer can spread through tissues, the lymphatic system, and the blood: Textile. Cancer spreads from where it originated to surrounding areas. The lymphatic system. Cancer spreads from where it originated to the lymphatic system. Cancer spreads through the lymphatic vessels to other parts of the body. Blood. Cancer spreads from where it originated into the bloodstream. Cancer spreads through the blood vessels to other parts of the body. 1.4. Factors affecting prognosis and treatment options for Hodgkin's lymphoma The prognosis and treatment option depends on the following conditions: The patient's signs and symptoms, including B-symptoms (fever for no known cause, weight loss for no known cause, or severe night sweats). The stage of the cancer (the size of the cancerous tumors and the spread of the cancer to the abdomen or more than one group of lymph nodes). A type of Hodgkin's lymphoma. Blood test results. Age, gender and general condition of the patient. Whether the cancer was first diagnosed, continues to grow during treatment, or has returned after treatment. Treatment options for Hodgkin's lymphoma during pregnancy also depend on: Patient wishes. Age of the unborn child. Adult Hodgkin's lymphoma can usually be cured if detected and treated early. Hodgkin's lymphoma in adults can be grouped for treatment as follows: 1. Early favorable Early favorable Hodgkin's lymphoma in adults is stage I or stage II, with no risk factors that increase the likelihood that the cancer will return after treatment. 2. Early adverse Early adverse Hodgkin's lymphoma in adults is stage I or stage II with one or more of the following risk factors that increase the likelihood that cancer will return after treatment: The presence of a tumor in the breast that is more than 1/3 of the width of the breast or at least 10 centimeters. Cancer of an organ other than the lymph nodes. Having a high sedimentation rate (in the blood sample, the red blood cells settle to the bottom of the tube faster than usual). Having three or more lymph nodes with cancer. Group B symptoms (fever for unknown cause, weight loss for unknown cause, or severe night sweats). 3. Advanced Advanced Hodgkin's lymphoma is stage III or IV. Advanced favorable Hodgkin's lymphoma means that the patient has 0–3 of the following risk factors. Progressive Adverse Hodgkin's Lymphoma means that the patient has 4 or more of the risk factors listed below. The more risk factors a patient has, the more likely the cancer will return after treatment: Low level of albumin (protein) in the blood (below 4). Low hemoglobin levels (below 10.5). Be a man. Age 45 and older. Stage IV disease. Having a high white blood cell count (15,000 or higher). Low lymphocyte count (less than 600 or less than 8% of the white blood cell count). 1.5. Stages of Hodgkin's lymphoma in adults Stage I 1.4. 1.5. Adult stage I lymphomas. Cancer is found in one or more lymph nodes in a group of lymph nodes or, in rare cases, cancer is found in Waldeyer's ring, thymus, or spleen. In stage IE (not shown), the cancer has spread to one area outside the lymphatic system. Stage I adult Hodgkin's lymphoma is divided into stages I and IE. In stage I, cancer is found in one of the following areas of the lymphatic system: One or more lymph nodes in a group of lymph nodes. Waldeyer's ring. Thymus. Spleen. In stage IE, cancer is found in one area outside the lymphatic system. Stage II Stage II adult Hodgkin's lymphoma is subdivided into stage II and IIE. In stage II, cancer is found in two or more groups of lymph nodes located either above the diaphragm or below the diaphragm. Stage II adult lymphomas. Cancer is found in two or more groups of lymph nodes located either above the diaphragm or below the diaphragm. In stage IIE, the cancer has spread from a group of lymph nodes to a nearby area that is outside the lymphatic system. The cancer may have spread to other groups of lymph nodes on the same side of the diaphragm. Adult stage IIE lymphomas. The cancer has spread from a group of lymph nodes to a nearby area that is outside the lymphatic system. The cancer may have spread to other groups of lymph nodes on the same side of the diaphragm. In stage II, the term "bulky disease" refers to a larger tumor. The size of the tumor mass, called bulk disease, depends on the type of lymphoma. Stage III Stage III adult lymphomas. Cancer is found in groups of lymph nodes both above and below the diaphragm; or in a group of lymph nodes above the diaphragm and in the spleen. Stage III adult Hodgkin's lymphoma, cancer occurs: in groups of lymph nodes both above and below the diaphragm; or in the lymph nodes above the diaphragm and in the spleen. Stage IV Stage IV adult lymphomas. Cancer (a) has spread to one or more organs outside the lymphatic system; or (b) is found in two or more groups of lymph nodes that are either above the diaphragm or below the diaphragm, and in one organ that is outside the lymphatic system and not near the affected lymph nodes; or (c) is found in groups of lymph nodes above the diaphragm and below the diaphragm and in any organ outside the lymphatic system; or (d) is found in the liver, bone marrow, more than one location in the lungs, or cerebrospinal fluid (CSF). The cancer has not spread directly to the liver, bone marrow, lungs, or cerebrospinal fluid from nearby lymph nodes. Stage IV adult Hodgkin's lymphoma, cancer: Has spread to one or more organs outside the lymphatic system or is found in two or more groups of lymph nodes that are either above the diaphragm or below the diaphragm, and in one organ that is outside the lymphatic system, and not next to the affected lymph nodes; or found in groups of lymph nodes both above and below the diaphragm, as well as in any organ outside the lymphatic system; or is found in the liver, bone marrow, more than one place in the lungs, or cerebrospinal fluid (CSF). The cancer has not spread directly to the liver, bone marrow, lungs, or cerebrospinal fluid from nearby lymph nodes. 1.6. Overview of treatment options KEY POINTS There are various treatments for patients with Hodgkin's lymphoma in adults. For patients with Hodgkin's lymphoma, treatment should be planned by a team of healthcare professionals experienced in treating lymphomas. Treatment for Hodgkin's lymphoma in adults can cause side effects. Four types of standard treatments are used: Chemotherapy Radiation therapy Targeted therapy Immunotherapy For pregnant women with Hodgkin's lymphoma, treatment options also include: Watchful waiting Steroid therapy New treatments are undergoing clinical trials. Stem Cell Transplant Chemotherapy Patients may want to take part in a clinical trial. Patients can participate in clinical trials before, during, or after starting cancer treatment. Additional tests may be required. There are various treatments for patients with Hodgkin's lymphoma in adults. Various treatments are available for patients with adult Hodgkin's lymphoma. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for cancer patients. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. For pregnant women with Hodgkin's lymphoma, treatment is carefully tailored to protect the unborn baby. Treatment decisions depend on the mother's wishes, the stage of Hodgkin's lymphoma, and the age of the unborn child. Your treatment plan may change as the signs and symptoms of cancer and pregnancy change. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family and healthcare staff. For patients with Hodgkin's lymphoma, treatment should be planned by a team of healthcare professionals experienced in treating lymphomas. Treatment will be overseen by an oncologist, a doctor who specializes in cancer treatment. Your medical oncologist may refer you to other health care providers who have experience and expertise in treating Hodgkin's lymphoma in adults and specialize in specific areas of medicine. This may include the following specialists: Radiologist oncologist. Rehabilitation specialist. Hematologist. Other specialists are oncologists. 1.7. Side effects after treatment Treatment for Hodgkin's lymphoma in adults can cause side effects. Side effects from cancer treatments that start after treatment and last for months or years are called late effects. Treating Hodgkin's lymphoma with chemotherapy and / or radiation therapy may increase the risk of recurring cancer and other health problems for many months or years after treatment. These late effects depend on the type of treatment and the age of the patient at the time of treatment and may include the following: Second cancer. Acute myeloid leukemia and non-Hodgkin's lymphoma. Solid tumors such as mesothelioma and cancer of the lungs, breast, thyroid, bones, soft tissues, stomach, esophagus, colon, rectum, cervix, and head and neck. Infertility. Hypothyroidism (too little thyroid hormone in the blood). Heart disease, such as a heart attack. Lung problems such as shortness of breath. Avascular bone necrosis (death of bone cells due to lack of blood flow). Severe infection. Chronic fatigue . Regular follow-up by physicians who are experts in detecting and treating late effects is important for the long-term health of patients being treated for Hodgkin's lymphoma. 1.6. 1.7. 2. TREATMENT OF NONHODGKIN'S LYMPHOMA IN ADULTS Якорь 2 Non-Hodgkin's lymphoma is a type of cancer that forms in the lymphatic system. The lymphatic system is part of the immune system. This helps protect the body from infections and disease. The lymphatic system consists of the following: Lymph: A colorless, watery fluid that travels through the lymphatic vessels and carries lymphocytes (white blood cells). There are three types of lymphocytes: B lymphocytes, which produce antibodies that help fight infection. Also called B cells. Most types of non-Hodgkin's lymphoma begin with B cells. T lymphocytes, which help B lymphocytes make antibodies that help fight infection. Also called T-lymphocytes. Natural killer cells attacking cancer cells and viruses. Also called NK cells. Lymphatic Vessels: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream. Lymph Nodes: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infections and disease. Lymph nodes are located along a network of lymphatic vessels throughout the body. Lymph node groups are found in the neck, armpits, mediastinum, abdomen, pelvis, and groin. Spleen: an organ that produces lymphocytes, stores red blood cells and lymphocytes, filters blood and destroys old blood cells. The spleen is located on the left side of the abdomen next to the belly. Thymus: The organ in which T-lymphocytes mature and multiply. The thymus is located in the chest behind the sternum. Tonsils: Two small formations of lymphatic tissue at the back of the pharynx. The tonsils are located on each side of the throat. Bone marrow: The soft, spongy tissue in the center of certain bones, such as the femur and sternum. Leukocytes, red blood cells, and platelets are produced in the bone marrow. лимфатическая ситстема из Anatomy of the lymphatic system showing lymphatic vessels and lymphatic organs including lymph nodes, tonsils, thymus, spleen, and bone marrow. Lymph (clear fluid) and lymphocytes travel through the lymphatic vessels to the lymph nodes, where the lymphocytes destroy harmful substances. Lymph enters the bloodstream through a large vein near the heart. Lymphatic tissue is also found in other parts of the body, such as the lining of the digestive tract, bronchi, and skin. Cancer can spread to the liver and lungs. There are two main types of lymphomas: Hodgkin's lymphoma and non-Hodgkin's lymphoma. This is a summary of the treatment for non-Hodgkin's lymphoma in adults, including during pregnancy. 2.1. NHL types Non-Hodgkin's lymphoma grows and spreads at different rates and can be sluggish or aggressive. Painless lymphoma tends to grow and spread slowly and has few signs and symptoms. Aggressive lymphoma grows and spreads rapidly, and its signs and symptoms can be very serious. Treatments for indolent and aggressive lymphoma are different. This is a brief description of the following types of non-Hodgkin's lymphoma: Indolent non-Hodgkin lymphomas Follicular lymphoma. Follicular lymphoma is the most common type of indolent non-Hodgkin's lymphoma. It is a very slowly growing type of non-Hodgkin's lymphoma that begins with B cells. It affects the lymph nodes and can spread to the bone marrow or spleen. Most patients with follicular lymphoma are 50 years of age or older at the time of diagnosis. Follicular lymphoma can go away without treatment. The patient is closely monitored for signs or symptoms of disease recurrence. Treatment is necessary if signs or symptoms appear after the cancer has gone away or after initial cancer treatment. Sometimes follicular lymphoma can become a more aggressive type of lymphoma, such as diffuse large B-cell lymphoma. Lymphoplasmacytic lymphoma. In most cases of lymphoplasmacytic lymphoma, B lymphocytes, which convert to plasma cells, produce large amounts of a protein called monoclonal immunoglobulin M (IgM) antibody. A high level of IgM antibodies in the blood leads to a thickening of the blood plasma. It can cause signs or symptoms such as vision or hearing problems, heart problems, shortness of breath, headache, dizziness, and numbness or tingling in the hands and feet. Sometimes there are no signs or symptoms of lymphoplasmacytic lymphoma. This can be found in the blood test for another reason. Lymphoplasmacytic lymphoma often spreads to the bone marrow, lymph nodes, and spleen. Patients with lymphoplasmacytic lymphoma should be tested for hepatitis C virus infection. This is also called Waldenstrom's macroglobulinemia. Lymphoma of the marginal zone. This type of non-Hodgkin's lymphoma begins with B cells in a part of the lymphatic tissue called the marginal zone. The prognosis may be worse for patients age 70 or older, stage III or stage IV disease, and high lactate dehydrogenase (LDH) levels. There are five different types of marginal zone lymphoma. They are grouped by the type of tissue in which the lymphoma has formed: Marginal zone nodular lymphoma. In the lymph nodes, nodular lymphoma of the marginal zone is formed. This type of non-Hodgkin's lymphoma is rare. It is also called monocytoid B-cell lymphoma. Lymphoma associated with the gastric mucosa, lymphoid tissue (MALT). MALT gastric lymphoma usually begins in the stomach. This type of marginal lymphoma forms in the cells of the mucous membrane that help make antibodies. Patients with gastric MALT lymphoma may also have Helicobacter gastritis or an autoimmune disease such as Hashimoto's thyroiditis or Sjogren's syndrome. Extra-gastric lymphoma MALT. Extra-gastric MALT lymphoma begins outside the stomach in almost all parts of the body, including other parts of the gastrointestinal tract, salivary glands, thyroid gland, lungs, skin, and around the eyes. This type of marginal lymphoma forms in the cells of the mucous membrane that help make antibodies. Extra-gastric MALT lymphoma may return many years after treatment. Mediterranean lymphoma of the abdominal cavity. It is a type of MALT lymphoma that occurs in young people in the Eastern Mediterranean countries. It often forms in the abdominal area and patients can also become infected with a bacteria called Campylobacter jejuni. This type of lymphoma is also called immunoproliferative disease of the small intestine. Lymphoma of the marginal zone of the spleen. This type of marginal lymphoma begins in the spleen and can spread to peripheral blood and bone marrow. The most common sign of this type of marginal splenic lymphoma is the spleen, which is larger than usual. Primary cutaneous anaplastic large cell lymphoma. This type of non-Hodgkin's lymphoma affects only the skin. It may be a benign (non-cancer) nodule that may go away on its own, or it may have spread to many areas of the skin and require treatment. Aggressive non-Hodgkin lymphomas Large diffuse B-cell lymphoma. Diffuse large B cell lymphoma is the most common type of non-Hodgkin's lymphoma. It grows rapidly in the lymph nodes, and often the spleen, liver, bone marrow, or other organs are also affected. Signs and symptoms of diffuse large B cell lymphoma can include fever, severe night sweats, and weight loss. They are also called B symptoms. Primary large B-cell lymphoma of the mediastinum. This type of non-Hodgkin's lymphoma is a type of diffuse large B-cell lymphoma. The proliferation of fibrous (cicatricial) lymphatic tissue is noted. Tumors most often form behind the sternum. It can press on the airways and cause coughing and shortness of breath. Most patients with primary large B-cell lymphoma of the mediastinum are women between the ages of 30 and 40. Follicular large cell lymphoma stage III. Stage III follicular large cell lymphoma is a very rare type of non-Hodgkin's lymphoma. Treatment for this type of follicular lymphoma is more like treating aggressive NHL than indolent NHL. Anaplastic large cell lymphoma. Anaplastic large cell lymphoma is a type of non-Hodgkin's lymphoma that usually begins in T lymphocytes. Cancer cells also have the CD30 marker on the cell surface. There are two types of anaplastic large cell lymphoma: 1 . Cutaneous anaplastic large cell lymphoma. This type of anaplastic large cell lymphoma primarily affects the skin, but other parts of the body can also be affected. Signs of cutaneous anaplastic large cell lymphoma include one or more bumps or sores on the skin. This type of lymphoma is rare and sluggish. 2. Systemic anaplastic large cell lymphoma. This type of anaplastic large cell lymphoma begins in the lymph nodes and can affect other parts of the body. This type of lymphoma is more aggressive. Patients may have a lot of anaplastic lymphoma kinase (ALK) protein inside lymphoma cells. These patients have a better prognosis than those who do not have the supplemental ALK protein. Systemic anaplastic large cell lymphoma is more common in children than in adults. (For more information, see the PDQ Treatment Summary for Pediatric Non-Hodgkin's Lymphoma.) Extranodal NK- / T-cell lymphoma. Extranodal NK / T cell lymphoma usually begins in the area around the nose. It can also affect the paranasal sinuses (cavities in the bones around the nose), palate, trachea, skin, stomach, and intestines. In most cases of extranodal NK- / T-cell lymphoma, the Epstein-Barr virus is present in the tumor cells. Sometimes hemophagocytic syndrome (a serious condition in which there are too many active histiocytes and T cells causing severe inflammation in the body) occurs. Treatment is needed to suppress the immune system. This type of non-Hodgkin's lymphoma is not common in the United States. Lymphatic granulomatosis. Lymphomatoid granulomatosis most commonly affects the lungs. It can also affect the sinuses (cavities in the bones around the nose), skin, kidneys, and the central nervous system. In lymphomatoid granulomatosis, cancer attacks the blood vessels and kills tissue. Because cancer can spread to the brain, intrathecal chemotherapy or radiation therapy to the brain is given. Angioimmunoblastic T-cell lymphoma. This type of non-Hodgkin's lymphoma starts with T cells. Swollen lymph nodes are a common symptom. Other signs may include a skin rash, fever, weight loss, or severe night sweats. There may also be high levels of gamma globulin (antibodies) in the blood. Patients can also have opportunistic infections because their immune systems are weakened. Peripheral T-cell lymphoma. Peripheral T-cell lymphoma begins with mature T-lymphocytes. This type of T lymphocyte matures in the thymus gland and travels to other lymphatic regions of the body, such as the lymph nodes, bone marrow, and spleen. There are three subtypes of peripheral T-cell lymphoma: Hepatosplenic T-cell lymphoma. This is an uncommon type of peripheral T-cell lymphoma that occurs mainly in young men. It starts in the liver and spleen, and cancer cells also have a T cell receptor called gamma / delta on the cell's surface. Subcutaneous panniculitis-like T-cell lymphoma. Subcutaneous panniculitis-like T-cell lymphoma begins on the skin or mucous membrane. This can happen with hemophagocytic syndrome (a serious condition in which there are too many active histiocytes and T cells that cause severe inflammation in the body). Treatment is needed to suppress the immune system. Intestinal T-cell lymphoma of the enteropathic type. This type of peripheral T-cell lymphoma occurs in the small intestine of patients with untreated celiac disease (an immune response to gluten that causes malnutrition). Patients diagnosed with celiac disease in childhood and who follow a gluten-free diet rarely develop enteropathic-type intestinal T-cell lymphoma. Intravascular large B-cell lymphoma. This type of non-Hodgkin's lymphoma affects the blood vessels, especially the small blood vessels in the brain, kidneys, lungs, and skin. The signs and symptoms of intravascular large B-cell lymphoma are caused by blockage of blood vessels. It is also called intravascular lymphomatosis. Burkitt's lymphoma ... Burkitt's lymphoma is a type of B-cell non-Hodgkin's lymphoma that grows and spreads very quickly. It can affect the jaw, facial bones, intestines, kidneys, ovaries, or other organs. There are three main types of Burkitt's lymphoma (endemic, sporadic, and immunodeficient). Endemic Burkitt's lymphoma is commonly found in Africa and is associated with the Epstein-Barr virus, while sporadic Burkitt's lymphoma occurs throughout the world. Burkitt's lymphoma, associated with immunodeficiency, is most common in people with AIDS. Burkitt's lymphoma can spread to the brain and spinal cord and requires treatment to prevent it from spreading. Burkitt's lymphoma is most common in children and young adults. Burkitt's lymphoma is also called diffuse small cell lymphoma. Lymphoblastic lymphoma. Lymphoblastic lymphoma can start in T cells or B cells, but it usually starts in T cells. In this type of non-Hodgkin's lymphoma, there are too many lymphoblasts (immature white blood cells) in the lymph nodes and thymus gland. These lymphoblasts can spread to other parts of the body, such as the bone marrow, brain, and spinal cord. Lymphoblastic lymphoma is most common in adolescents and young adults. This is very similar to acute lymphoblastic leukemia (lymphoblasts are mainly found in the bone marrow and blood). (For more information, see the PDQ Treatment Summary for Acute Lymphoblastic Leukemia in Adults.) Adult T cell leukemia / lymphoma. Adult T cell leukemia / lymphoma is caused by human T cell leukemia virus type 1 (HTLV-1). Signs include bone and skin lesions, high blood calcium levels, and larger than normal lymph nodes, spleen, and liver. Mantle cell lymphoma. Mantle cell lymphoma is a type of B-cell non-Hodgkin's lymphoma that commonly occurs in middle-aged and older people. It begins in the lymph nodes and spreads to the spleen, bone marrow, blood, and sometimes to the esophagus, stomach, and intestines. Patients with mantle cell lymphoma have too much of a protein called cyclin-D1, or certain gene changes in lymphoma cells. In some patients who do not have signs or symptoms of lymphoma, delaying treatment initiation does not affect prognosis. Post-transplant lymphoproliferative disease. This disease occurs in patients who have undergone heart, lung, liver, kidney, or pancreas transplants and require lifelong immunosuppressive therapy. Most post-transplant lymphoproliferative diseases involve B cells and contain the Epstein-Barr virus in the cells. Lymphoproliferative disorders are often treated like cancer. True histiocytic lymphoma. This is a rare, very aggressive type of lymphoma. It is not known whether it starts in B cells or T cells. He is difficult to treat with standard chemotherapy. Primary effusion lymphoma. Primary effusion lymphoma begins with B cells, which are found in areas of large accumulation of fluid, such as the areas between the lining of the lung and the chest wall (pleural effusion), the sac around the heart, and the heart. (pericardial effusion) or abdominal cavity. Usually, the tumor is not visible. This type of lymphoma is common in HIV-infected patients. Plasmablastic lymphoma ... Plasmablastic lymphoma is a very aggressive type of large cell non-Hodgkin's lymphoma. Most often seen in patients with HIV infection. 2.2. NHL Symptoms Signs and symptoms of non-Hodgkin's lymphoma in adults include swollen lymph nodes, fever, profuse night sweats, weight loss, and fatigue. These signs and symptoms can be caused by adult non-Hodgkin's lymphoma or other medical conditions. Check with your doctor if you have any of the following: Swelling of the lymph nodes in the neck, armpits, groin, or abdomen. Fever for no known reason. Wet night sweats. Feeling very tired. Losing weight for an unknown reason. Skin rash or itching. Pain in the chest, abdomen, or bones for no known cause. When fever, wet night sweats, and weight loss occur together, this group of symptoms is called symptom B. Other signs and symptoms of non-Hodgkin's lymphoma in adults may occur, depending on the following: Where cancer forms in the body. The size of the tumor. How quickly the tumor grows. 2.3. Tests for diagnosis and staging of non-Hodgkin's lymphoma in adults The following tests and procedures can be used: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness such as bumps or anything else that seems out of the ordinary. The patient's health history will also be recorded, including fever, profuse night sweats and weight loss, his health habits, and any illnesses and treatments he has suffered. Complete blood count (CBC): A procedure in which a blood sample is taken and checked for the following: The number of erythrocytes, leukocytes and platelets. The amount of hemoglobin (oxygen-carrying protein) in red blood cells. The portion of the sample composed of red blood cells. Blood chemistry tests: A procedure in which a blood sample is tested to measure the amount of certain substances that enter the bloodstream by organs and tissues of the body. An unusual (more or less than usual) amount of a substance may be a sign of illness. LDH test: A procedure in which a blood sample is tested to measure the amount of lactodehydrogenase. An increased amount of LDH in the blood may be a sign of tissue damage, lymphoma, or other medical conditions. Hepatitis B and Hepatitis C Test: A procedure in which a blood sample is tested to measure the amount of antigens and / or antibodies specific to the hepatitis B virus and the amount of antibodies specific to the hepatitis C virus. These antigens or antibodies are called markers. Various markers or combinations of markers are used to determine if a patient has a hepatitis B or C infection, has had a prior infection or vaccination, or is susceptible to infection. Patients who have been treated for the hepatitis B virus in the past need constant monitoring to see if it has reactivated. Knowing whether a person has hepatitis B or C can help plan treatment. HIV test: A test to measure the level of HIV antibodies in a blood sample. Antibodies are produced by the body when a foreign substance invades it. A high level of antibodies to HIV can mean that the body is infected with HIV. CT (Computed Tomography): A procedure in which a series of detailed pictures of areas inside the body, such as the neck, chest, abdomen, pelvis, and lymph nodes, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs and tissues more visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography. PET scan (positron emission tomography) : a procedure to search for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Cancer cells appear brighter because they are more active and consume more glucose than normal cells. Bone marrow aspiration and biopsy: Removal of bone marrow and a small piece of bone by inserting a needle into the hip or sternum. A pathologist examines the bone marrow and bones under a microscope to look for signs of cancer. 2.1 2.3. 2.2. Bone marrow aspiration and biopsy. After a small area of skin is numb, a bone marrow needle is inserted into the patient's hip bone. Samples of blood, bone, and bone marrow are taken for examination under a microscope. Lymph node biopsy: Removal of all or part of a lymph node. A pathologist examines the tissue under a microscope to check for cancer cells. One of the following biopsies can be done: Excisional biopsy: Removal of the entire lymph node. Postoperative biopsy: removal of part of the lymph node. Primary biopsy: Removal of part of the lymph node with a wide needle. When cancer is found, the following tests can be performed to look at cancer cells : Immunohistochemistry: a laboratory test that uses antibodies to check for specific antigens (markers) in a tissue sample from a patient. Antibodies are usually associated with an enzyme or fluorescent dye. After antibodies bind to a specific antigen in a tissue sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test is used to diagnose cancer and help distinguish one type of cancer from another. Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a blood or bone marrow sample are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in some chromosomes can be a sign of cancer. Cytogenetic analysis is used to diagnose cancer, plan treatment, or determine the effectiveness of a treatment. Immunophenotyping: A laboratory test that uses antibodies to identify cancer cells based on the types of antigens or markers on the cell surface. This test is used to diagnose certain types of lymphoma. FISH (Fluorescence In Situ Hybridization): A laboratory test used to study and count genes or chromosomes in cells and tissues. DNA fragments containing fluorescent dyes are made in the laboratory and added to a sample of the patient's cells or tissues. When these stained DNA fragments attach to specific genes or regions of chromosomes in a sample, they light up when viewed under a fluorescent microscope. The FISH test is used to diagnose cancer and plan treatment. Other tests and procedures may be performed depending on the signs and symptoms observed and where the cancer is forming in the body. 2.4. Factors affecting prognosis (chance of recovery) and treatment options Prognosis and treatment options depend on the following: The patient's signs and symptoms, including B-symptoms (fever for no known cause, weight loss for no known cause, or severe night sweats). The stage of the cancer (the size of the cancerous tumors and whether the cancer has spread to other parts of the body or lymph nodes). A type of non-Hodgkin's lymphoma. The amount of lactate dehydrogenase (LDH) in the blood. Are there any changes in the genes. Age, gender and general condition of the patient. Whether lymphoma is a new diagnosis, continues to grow during treatment, or recurs (comes back). Treatment options for non-Hodgkin's lymphoma during pregnancy also depend on: Patient wishes. What trimester of pregnancy is the patient in? Is it possible to give birth to a child ahead of time. Some types of non-Hodgkin's lymphoma spread faster than others. Most non-Hodgkin lymphomas that occur during pregnancy are aggressive. Delaying treatment for aggressive lymphoma until the baby is born can lower the mother's chances of survival. Immediate treatment is often recommended, even during pregnancy. 2.5. NHL stages in adults KEY POINTS After adults are diagnosed with non-Hodgkin's lymphoma, tests are done to see if cancer cells have spread in the lymphatic system or to other parts of the body. Cancer spreads through the body in three ways. For adult non-Hodgkin lymphoma, the following stages are used: Stage I Stage II Stage III Stage IV Adult non-Hodgkin's lymphomas can be grouped for treatment depending on whether the cancer is indolent or aggressive, whether the affected lymph nodes are close to each other in the body, and whether the cancer is newly diagnosed or recurrent. After adults are diagnosed with non-Hodgkin's lymphoma, tests are done to see if cancer cells have spread in the lymphatic system or to other parts of the body. The process used to identify the type of cancer and the spread of cancer cells in the lymphatic system or to other parts of the body is called staging. The information gathered during the staging process determines the stage of the disease. It is important to know the stage of the disease in order to plan treatment. The results of tests and procedures performed to diagnose non-Hodgkin's lymphoma are used to make treatment decisions. The following tests and procedures can also be used in the preparation process: Gadolinium MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body, such as the brain and spinal cord. A substance called gadolinium is given to the patient through a vein. Gadolinium gathers around cancer cells, so they appear brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (MRI). Lumbar puncture: A procedure used to collect cerebrospinal fluid (CSF) from the spine. This is done by inserting a needle between two bones in the spine and into the cerebrospinal fluid and taking a sample of the fluid. A sample of spinal fluid is checked under a microscope for signs that cancer has spread to the brain and spinal cord. This procedure is also called LP or lumbar puncture. 2.4. 2.5 Lumbar puncture. The patient lies on the table, curled up in a ball. After a small area in the lower back is numb, a spinal needle (long, thin needle) is inserted into the lower spinal column to remove cerebrospinal fluid (cerebrospinal fluid, shown in blue). Liquid can be sent to the laboratory for testing. For pregnant women with non-Hodgkin's lymphoma, interim tests and procedures are used to protect the unborn baby from the harmful effects of radiation. These tests and procedures include MRI (no contrast), lumbar puncture, and ultrasound. Cancer spreads through the body in three ways. Cancer can spread through tissues, the lymphatic system, and the blood: Textile. Cancer spreads from where it originated to surrounding areas. The lymphatic system. Cancer spreads from where it originated to the lymphatic system. Cancer spreads through the lymphatic vessels to other parts of the body. Blood. Cancer spreads from where it originated into the bloodstream. Cancer spreads through the blood vessels to other parts of the body. For adult non-Hodgkin lymphoma, the following stages are used: Stage I Adult stage I lymphomas. Cancer is found in one or more lymph nodes in a group of lymph nodes or, in rare cases, cancer is found in Waldeyer's ring, thymus, or spleen. In stage IE (not shown), the cancer has spread to one area outside the lymphatic system. Stage I adult non-Hodgkin's lymphoma is divided into stage I and IE. In stage I, cancer is found in one of the following areas of the lymphatic system: One or more lymph nodes in a group of lymph nodes. Waldeyer's ring. Thymus. Spleen. In stage IE, cancer is found in one area outside the lymphatic system. Stage II Stage II adult non-Hodgkin's lymphoma is divided into stage II and IIE. In stage II, cancer is found in two or more groups of lymph nodes located either above the diaphragm or below the diaphragm. In stage IIE, the cancer has spread from a group of lymph nodes to a nearby area that is outside the lymphatic system. The cancer may have spread to other groups of lymph nodes on the same side of the diaphragm. In stage II, the term "volumetric disease" refers to a greater tumors ... The size of the tumor mass, called volumetric disease, depends on the type lymphomas ... Stage III Stage III adult lymphomas. Cancer is found in groups of lymph nodes both above and below the diaphragm; or in a group of lymph nodes above the diaphragm and in the spleen. Stage III adult non-Hodgkin lymphoma, cancer occurs: in groups of lymph nodes both above and below the diaphragm; or in the lymph nodes above the diaphragm and in the spleen. Stage IV Stage IV adult lymphomas. Cancer (a) has spread to one or more organs outside the lymphatic system; or (b) is found in two or more groups of lymph nodes that are either above the diaphragm or below the diaphragm, and in one organ that is outside the lymphatic system and not near the affected lymph nodes; or (c) is found in groups of lymph nodes above the diaphragm and below the diaphragm and in any organ outside the lymphatic system; or (d) is found in the liver, bone marrow, more than one location in the lungs, or cerebrospinal fluid (CSF). The cancer has not spread directly to the liver, bone marrow, lungs, or cerebrospinal fluid from nearby lymph nodes. Stage IV adult non-Hodgkin lymphoma, cancer: Has spread to one or more organs outside the lymphatic system or is found in two or more groups of lymph nodes that are either above the diaphragm or below the diaphragm, and in one organ that is outside the lymphatic system, and not next to the affected lymph nodes; or found in groups of lymph nodes both above and below the diaphragm, as well as in any organ outside the lymphatic system; or is found in the liver, bone marrow, more than one place in the lungs, or cerebrospinal fluid (CSF). The cancer has not spread directly to the liver, bone marrow, lungs, or cerebrospinal fluid from nearby lymph nodes. Adult non-Hodgkin's lymphomas can be grouped for treatment depending on whether the cancer is indolent or aggressive, whether the affected lymph nodes are close to each other in the body, and whether the cancer is newly diagnosed or recurrent. Non-Hodgkin's lymphoma can also be described as contiguous or non-contiguous: Adjacent lymphomas: Lymphomas in which lymph nodes with cancer are located next to each other. Non-contiguous lymphomas: Lymphomas in which lymph nodes with cancer are not located next to each other, but on one side of the diaphragm. Recurrent non-Hodgkin's lymphoma in adults is cancer that has recurred (returned) after treatment. Lymphoma can return to the lymphatic system or to other parts of the body. Painless lymphoma can return to aggressive lymphoma. Aggressive lymphoma can return to lazy lymphoma. 2.6. Overview of NHL Treatment Options KEY POINTS There are various treatments for patients with non-Hodgkin's lymphoma. For patients with non-Hodgkin's lymphoma, treatment should be planned by a team of healthcare professionals who are experts in the treatment of lymphomas. Treatment for non-Hodgkin's lymphoma in adults can cause side effects. Nine types of standard treatments are used: Radiation therapy Chemotherapy Immunotherapy Targeted therapy Plasmapheresis Watchful waiting Antibacterial therapy Operation Stem cell transplant New treatments are undergoing clinical trials. Vaccine therapy Patients may want to take part in a clinical trial. Patients can participate in clinical trials before, during, or after starting cancer treatment. Additional tests may be required. 2.7. Treatments for patients with non-Hodgkin's lymphoma Various treatments are available for patients with non-Hodgkin lymphoma. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. For pregnant women with non-Hodgkin's lymphoma, treatment is carefully chosen to protect the unborn baby. Treatment decisions depend on the mother's wishes, the stage of non-Hodgkin's lymphoma, and the age of the unborn child. Your treatment plan may change as the signs and symptoms of cancer and pregnancy change. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family and healthcare staff. For patients with non-Hodgkin's lymphoma, treatment should be planned by a team of healthcare professionals who are experts in the treatment of lymphomas. Your treatment will be overseen by an oncologist, a doctor who specializes in cancer treatment, or a hematologist, a doctor who specializes in treating blood cancer. Your medical oncologist may refer you to other health care providers who are experienced and expert in treating non-Hodgkin's lymphoma in adults and specialize in specific areas of medicine. This may include the following specialists: Neurosurgeon. Neurologist. Radiologist oncologist. Endocrinologist. Rehabilitation specialist. Other specialists are oncologists. 2.8. Side effects of NHL treatment Treatment for non-Hodgkin's lymphoma in adults can cause side effects. Side effects from cancer treatments that start after treatment and last for months or years are called late effects. Treating non-Hodgkin's lymphoma with chemotherapy, radiation therapy, or stem cell transplantation may increase the risk of late effects. Late effects of cancer treatments may include the following: Heart problems. Infertility (inability to have children). Loss of bone density. Neuropathy (damage to nerves that causes numbness or difficulty walking). Second cancer, such as: Lungs' cancer . Brain cancer. Kidney cancer. Bladder cancer. Melanoma. Hodgkin's lymphoma. Myelodysplastic syndrome. Acute myeloid leukemia. Some late effects can be treated or controlled. It is important to talk to your doctor about the effects of cancer treatments on you. Regular follow-up is important to detect late effects. 2.9. Standard treatments Nine types of standard treatments are used: 1. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. External beam radiation therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Sometimes the whole body is irradiated before stem cell transplantation. Proton beam radiation therapy is a type of high-energy external beam therapy that uses beams of protons (tiny particles with a positive charge) to destroy tumor cells. This type of treatment can reduce the level of radiation damage to healthy tissues near the tumor, such as the heart or chest. External beam radiation therapy is used to treat non-Hodgkin's lymphoma in adults and can also be used as palliative therapy to relieve symptoms and improve quality of life. Pregnant women with non-Hodgkin's lymphoma should receive radiation therapy after delivery, if possible, to avoid risk to the unborn baby. If treatment is needed immediately, the woman may decide to continue the pregnancy and receive radiation therapy. A lead shield is used to cover a pregnant woman's belly to help protect the unborn baby from radiation as much as possible. 2. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is injected directly into the cerebrospinal fluid (intrathecal chemotherapy), an organ or body cavity such as the abdomen, the drugs mainly target cancer cells in those areas (regional chemotherapy). Combined chemotherapy treatment using two or more anticancer drugs. Steroid medications may be added to reduce inflammation and lower the body's immune response. Systemic combination chemotherapy is used to treat non-Hodgkin's lymphoma in adults. Intrathecal chemotherapy can also be used to treat lymphoma that first forms in the testes or sinuses (cavities) around the nose, diffuse large B-cell lymphoma, Burkitt's lymphoma, lymphoblastic lymphoma, and some aggressive T-cell lymphomas. It is prescribed to reduce the likelihood of lymphoma cells spreading to the brain and spinal cord. This is called CNS prophylaxis. 2.6 2.7 2.8 2.9 Intrathecal chemotherapy. Anti-cancer drugs are injected into the intrathecal space, which is the space that contains the cerebrospinal fluid (cerebrospinal fluid, shown in blue). This can be done in two different ways. One way, shown at the top of the picture, is to inject drugs into the Ommaya reservoir (a domed container that is placed under the scalp during surgery; it holds the drugs as they pass through a small tube to the brain.). Another method, shown at the bottom of the figure, is to inject the drugs directly into the cerebrospinal fluid in the lower spine after a small area in the lower back is numb. When a pregnant woman is undergoing chemotherapy for non-Hodgkin's lymphoma, the unborn baby cannot be protected from the effects of the chemotherapy. Some chemotherapy regimens can cause birth defects if given in the first trimester. 3. Immunotherapy Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances produced by the body or produced in the laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biological therapy. Immunomodulators: lenalidomide is an immunomodulator used to treat non-Hodgkin's lymphoma in adults. CAR T Cell Therapy: The patient's T cells (a type of cells in the immune system) change so they attack certain proteins on the surface of the cancer cells. T cells are taken from the patient, and special receptors are added to their surface in the laboratory. The altered cells are called chimeric antigen receptor (CAR) T cells. CAR T cells are grown in the laboratory and infused into the patient. CAR T cells multiply in the patient's blood and attack cancer cells. CAR T cell therapy (eg axicabtagen ciloleucel or tisagenlekleucel) is used to treat large B cell lymphomas that do not respond to treatment. CAR T-cell therapy is being studied to treat mantle cell lymphoma that has recurred or has not responded to treatment. 4. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and target certain cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. Monoclonal antibody therapy, proteasome inhibitor therapy, and kinase inhibitor therapy are the types of targeted therapies used to treat adult non-Hodgkin's lymphoma. Monoclonal antibody therapy: Monoclonal antibodies are immune system proteins created in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that can promote cancer cell growth. The antibodies are then able to kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or to carry drugs, toxins, or radioactive materials directly to cancer cells. Types of monoclonal antibodies include: Obinutuzumab, used to treat follicular lymphoma. Mogamulizumab, used to treat certain types of recurrent or refractory T-cell lymphoma. Tafasitamab in combination with lenalidomide for the treatment of recurrent or refractory diffuse large B-cell lymphoma. Pembrolizumab for the treatment of primary large B-cell lymphoma of the mediastinum. Polatuzumab vedotin in combination with bendamustine and rituximab for the treatment of recurrent or refractory diffuse large B-cell lymphoma. Brentuximab vedotin, a monoclonal antibody that binds to the CD30 protein found on some lymphoma cells. It also contains an anticancer drug that can help kill cancer cells. Yttrium Y 90-ibritumomab tuxetan, an example of a radiolabeled monoclonal antibody. Rituximab used to treat many types of non-Hodgkin's lymphoma. Proteasome inhibitor therapy: This treatment blocks the action of proteasomes in cancer cells. Proteasomes remove proteins that the cell no longer needs. When proteasomes are blocked, proteins build up in the cell and can cause cancer cell death. Bortezomib is used to reduce the amount of immunoglobulin M in the blood after treatment for cancer of lymphoplasmacytic lymphoma (Waldenstrom's macroglobulinemia). It is also being studied for the treatment of recurrent mantle cell lymphoma. Kinase inhibitor therapy: This treatment blocks certain proteins that can help prevent the growth of lymphoma cells and kill them. Kinase inhibitor therapy includes: Copanlisib, idealisib, dubelisib, and umbralisib, which block P13K proteins and may help prevent lymphoma cell growth. They are used to treat follicular non-Hodgkin's lymphomas that have recurred (returned) or have not improved after treatment with at least two other treatments. Umbralisib is also used to treat marginal zone lymphoma that has recurred or has not improved after treatment. Ibrutinib, acalabrutinib, and zanubrutinib, which are types of Bruton tyrosine kinase inhibitor therapy. They are used to treat mantle cell lymphoma. Ibrutinib and acalabrutinib are also used to treat lymphoplasmacytic lymphoma, and zanubrutinib is being studied for its treatment. Histone methyltransferase inhibitor therapy: Tasemetostat is used to treat follicular lymphoma that has returned or has not improved with other treatments. It is used in adults in whom cancer has a specific mutation (change) in the EZH2 gene that has already been treated with at least two other anticancer drugs. B cell lymphoma-2 (BCL-2) inhibitor therapy: Venetoclax can be used to treat mantle cell lymphoma. It blocks the action of the BCL-2 protein and may help kill cancer cells. 5. Plasmapheresis If the blood becomes thick due to additional antibody proteins and affects circulation, plasmapheresis is done to remove excess plasma and antibody proteins from the blood. In this procedure, blood is drawn from a patient and passed through a machine that separates the plasma (the liquid portion of the blood) from the blood cells. The patient's plasma contains unnecessary antibodies and is not returned to the patient. Normal blood cells are returned to the bloodstream along with donated plasma or plasma substitutes. Plasmapheresis does not prevent the formation of new antibodies. 6. Watchful waiting Expectant close monitoring of the patient's condition without giving any treatment until signs or symptoms or changes appear. 7. Antibiotic therapy Antibiotic therapy is a treatment that uses medications to treat infections and cancers caused by bacteria and other microorganisms. 8. Operation Surgery may be used to remove lymphoma in some patients with indolent or aggressive non-Hodgkin's lymphoma. The type of surgery used depends on where the lymphoma originated in the body: Local excision in some patients with mucosal lymphoma, lymphoid (MALT) lymphoma, PTLD, and small bowel T-cell lymphoma. Splenectomy for patients with marginal zone lymphoma from the spleen. Patients who have had heart, lung, liver, kidney, or pancreas transplants usually need to take medications that suppress their immune system for the rest of their lives. Long-term immunosuppression after organ transplantation can cause a specific type of non-Hodgkin's lymphoma called post-transplant lymphoproliferative disorder (PLTD). Small bowel surgery is often needed to diagnose celiac disease in adults who develop a type of T-cell lymphoma. 9. Stem cell transplant Stem cell transplantation is a method of administering high doses of chemotherapy and / or whole-body radiation, followed by replacement of hematopoietic cells destroyed by cancer treatment. Stem cells (immature blood cells) are removed from the patient's blood or bone marrow (autologous transplant) or donor (allogeneic transplant), frozen and stored. After completing chemotherapy and / or radiation therapy, retained stem cells defrost and return to the patient as an infusion. These re-injected stem cells germinate (and regenerate) the body's blood cells. Stem cell transplant. (Step 1): Blood is drawn from a vein in the donor's arm. The donor can be a patient or other person. The blood goes through a machine that removes stem cells. The blood is then returned to the donor through a vein in the other arm. (Step 2): The patient receives chemotherapy to destroy the blood-forming cells. The patient may receive radiation therapy (not shown). (Step 3): The patient receives stem cells through a catheter placed in a blood vessel in the chest. New treatments are undergoing clinical trials. Vaccine therapy is a cancer treatment that uses a substance or group of substances to stimulate the immune system to find a tumor and kill it. COST OF TREATMENT AND DIAGNOSTICS OF LYMPHOMA IN TURKEY Immunotherapy with Keytruda (Pembrolizumab) $ 3300 - $ 4700 Ultrasound $ 100 - $ 300 Blood test for tumor markers $ 150 - $ 500 Biopsy $ 1000 - $ 4900 MRI of one area $ 100 - $ 1000 Immunohistochemistry $ 600 - $ 1000 Diagnostics + Chemotherapy from $ 2800 Diagnosis for lymphomas + BMT from $ 40,050 Comprehensive diagnostics for suspected lymphoma from $ 3800 Allogeneic bone marrow transplant from a related donor for lymphoma from $ 60,000 Allogeneic bone marrow transplant from an unrelated donor for lymphoma from $ 75,000 Autologous bone marrow transplant for lymphoma from $ 37,000 Bone marrow transplant for lymphoma from $ 19,900 CAR T-cell therapy for lymphoma on request with HODGKIN'S lymphoma: Immunotherapy with Keytruda (Pembrolizumab) for Hodgkin's disease from $ 3300 Chemotherapy for breast cancer from $ 1200 Radiation therapy for rectal cancer on request with FOCULAR lymphoma: Complex diagnostics of lymphomas in follicular lymphoma on request Allogeneic bone marrow transplant from a related donor for follicular lymphoma from $ 60,000 Allogeneic bone marrow transplant from an unrelated donor for follicular lymphoma from $ 75,000 Autologous bone marrow transplant for follicular lymphoma from $ 37,000from Bone Marrow Transplant for Follicular Lymphoma from $ 19,900 Chemotherapy for breast cancer from $ 1200 Radiation therapy for rectal cancer on request with NECHODGKIN'S lymphoma: Comprehensive diagnosis of lymphomas in non-Hodgkin's lymphoma on request Allogeneic bone marrow transplant from a related donor for non-Hodgkin's lymphoma from $ 60,000 Allogeneic bone marrow transplant from an unrelated donor for non-Hodgkin's lymphoma from $ 75,000 Autologous bone marrow transplant for non-Hodgkin's lymphoma from $ 37,000 Bone Marrow Transplant for Non-Hodgkin's Lymphoma from $ 19,900 Chemotherapy for breast cancer from $ 1200 Radiation therapy for rectal cancer on request with BERKITT's lymphoma: Comprehensive diagnosis of lymphomas in Burkitt's lymphoma on request Allogeneic bone marrow transplant from a related donor for Burkitt's lymphoma from $ 60,000 Allogeneic bone marrow transplant from an unrelated donor for Burkitt's lymphoma from $ 75,000 Autologous Bone Marrow Transplant for Burkitt's Lymphoma from $ 37,000 Bone marrow transplant for Burkitt's lymphoma from $ 19900 Chemotherapy for breast cancer from $ 1200 Radiation therapy for rectal cancer on request с Need help? Doctors-coordinators will advise you and help you with the choice. Services Medikal & Estetik Group are free for you and do not affect the clinic bill. Find a solution Coordinator Medikal & Estetik Group help you find the best solution for cancer treatment CHOOSE CLINIC O Medikal & Estetik Group Second opinion Before traveling, you can get a Turkish doctor's opinion on your diagnosis and treatment prescribed. For the patient, this is an opportunity to receive advice from the world's best specialists. 3. TREATMENT OF LYMPHOMA ASSOCIATED WITH AIDS Якорь 3 3.1. General information about AIDS-related lymphoma AIDS-related lymphoma is a disease in which malignant (cancerous) cells form in the lymphatic system of patients with acquired immunodeficiency syndrome (AIDS). AIDS is caused by the Human Immunodeficiency Virus (HIV), which attacks and weakens the body's immune system. A weakened immune system is unable to fight off infections and diseases. People with HIV infection have an increased risk of infection and lymphoma or other types of cancer. A person with HIV and certain types of infection or cancer, such as lymphoma, is diagnosed with AIDS. Sometimes people are diagnosed with AIDS and AIDS-related lymphoma at the same time. The lymphatic system consists of the following: (click here ) Lymphomas are divided into two main types : (click here ) 3.2. Signs of AIDS-related lymphoma These and other signs and symptoms can be caused by AIDS-related lymphoma or other conditions. Check with your doctor if you have any of the following: Weight loss or increased body temperature for an unknown reason. Wet night sweats. Painless swollen lymph nodes in the neck, chest, armpits, or groin. Feeling of fullness under the ribs. 3.3. Tests for the diagnosis of AIDS-related lymphoma. Tests that examine the lymphatic system and other parts of the body are used to diagnose AIDS-related lymphoma. The following tests and procedures can be used: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness such as bumps or anything else that seems out of the ordinary. The patient's health history will also be recorded, including fever, profuse night sweats and weight loss, health habits, and medical and medical history. Complete blood count (CBC): A procedure in which a blood sample is taken and checked for the following: The number of erythrocytes, leukocytes and platelets. The amount of hemoglobin (oxygen-carrying protein) in red blood cells. The portion of the sample composed of red blood cells. Blood chemistry tests: A procedure in which a blood sample is tested to measure the amount of certain substances that enter the bloodstream by organs and tissues of the body. An unusual (more or less than usual) amount of a substance may be a sign of illness. LDH test: A procedure in which a blood sample is tested to measure the amount of lactodehydrogenase. An increased amount of LDH in the blood may be a sign of tissue damage, lymphoma, or other medical conditions. Hepatitis B and Hepatitis C Test: A procedure in which a blood sample is tested to measure the amount of antigens and / or antibodies specific to the hepatitis B virus and the amount of antibodies specific to the hepatitis C virus. These antigens or antibodies are called markers. Various markers or combinations of markers are used to determine if a patient has a hepatitis B or C infection, has had a prior infection or vaccination, or is susceptible to infection. HIV test: A test to measure the level of HIV antibodies in a blood sample. Antibodies are produced by the body when a foreign substance invades it. A high level of antibodies to HIV can mean that the body is infected with HIV. CT (Computed Tomography): A procedure in which a series of detailed pictures of areas inside the body, such as the neck, chest, abdomen, pelvis, and lymph nodes, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs and tissues more visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography. PET scan (positron emission tomography): a procedure to look for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Cancer cells appear brighter because they are more active and consume more glucose than normal cells. Bone marrow aspiration and biopsy: Removal of bone marrow and a small piece of bone by inserting a cannula into the hip or sternum. A pathologist examines the bone marrow and bones under a microscope to look for signs of cancer. Lymph node biopsy: Removal of all or part of a lymph node. A pathologist examines tissue under a microscope for cancer cells. One of the following biopsies can be done: Excisional biopsy: Removal of the entire lymph node. Postoperative biopsy: removal of part of the lymph node. Primary biopsy: Removal of tissue from a lymph node using a wide needle. Other areas of the body, such as the liver, lungs, bones, bone marrow, and marrow, may also have a tissue sample taken and checked by a pathologist for signs of cancer. When cancer is found, the following tests can be performed to look at cancer cells: Immunohistochemistry: a laboratory test that uses antibodies to check for specific antigens (markers) in a tissue sample from a patient. Antibodies are usually associated with an enzyme or fluorescent dye. After antibodies bind to a specific antigen in a tissue sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test is used to help diagnose cancer and to help distinguish one type of cancer from another. Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a blood or bone marrow sample are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in some chromosomes can be a sign of cancer. Cytogenetic analysis is used to diagnose cancer, plan treatment, or determine the effectiveness of a treatment. FISH (Fluorescence In Situ Hybridization): A laboratory test used to study and count genes or chromosomes in cells and tissues. Pieces of DNA containing fluorescent dyes are made in the laboratory and added to a sample of the patient's cells or tissues. When these stained DNA fragments attach to specific genes or regions of chromosomes in a sample, they light up when viewed under a fluorescent microscope. The FISH test is used to diagnose cancer and plan treatment. Immunophenotyping: A laboratory test that uses antibodies to identify cancer cells based on the types of antigens or markers on the cell surface. This test is used to diagnose certain types of lymphoma. After AIDS-related lymphoma is diagnosed, tests are done to see if cancer cells have spread in the lymphatic system or to other parts of the body. The process used to determine if cancer cells have spread in the lymphatic system or to other parts of the body is called staging. The information gathered during the staging process determines the stage of the disease. It is important to know the stage to plan treatment, but AIDS-related lymphoma is usually in an advanced stage when diagnosed. The following tests and procedures can be used to find out if the cancer has spread: Gadolinium MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of the interior of the body, such as the brain and spinal cord. A substance called gadolinium is given to the patient through a vein. Gadolinium gathers around cancer cells, so they appear brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (MRI). Lumbar puncture: A procedure used to collect cerebrospinal fluid (CSF) from the spine. This is done by placing a needle between two bones in the spine and into the cerebrospinal fluid and taking a sample of the fluid. A sample of spinal fluid is checked under a microscope for signs that cancer has spread to the brain and spinal cord. The sample can also be tested for the Epstein-Barr virus. This procedure is also called LP or lumbar puncture. 3.4. Factors affecting prognosis (chance of recovery) and treatment options The prognosis and treatment option depends on the following conditions: Stage of cancer. The age of the patient. The number of CD4 lymphocytes (a type of white blood cell) in the blood. A number of places in the body of lymphoma are outside the lymphatic system. Whether the patient has a history of intravenous (IV) drug use. The patient's ability to carry out normal daily activities. 3.5. Overview of treatment options KEY POINTS There are various treatments for patients with AIDS-related lymphoma. Treatment for AIDS-related lymphoma combines treatment for lymphoma with treatment for AIDS. Four types of standard treatments are used: Chemotherapy Radiation therapy High-dose chemotherapy with stem cell transplant Targeted therapy New treatments are undergoing clinical trials. Treatment for AIDS-related lymphoma can cause side effects. Patients may want to take part in a clinical trial. Patients can participate in clinical trials before, during, or after starting cancer treatment. Additional tests may be required. For treatment, AIDS-related lymphomas are grouped according to where they originated in the body, as follows: Peripheral / systemic lymphoma Lymphoma that begins in the lymphatic system or elsewhere in the body besides the brain is called peripheral / systemic lymphoma. It can spread throughout the body, including the brain or bone marrow. It is often diagnosed at an advanced stage. Treatment for AIDS-related peripheral / systemic lymphoma may include the following: Combined chemotherapy with or without targeted therapy. High-dose chemotherapy and stem cell transplant for lymphoma that has not responded to treatment or has returned. Intrathecal chemotherapy for lymphoma, which can spread to the central nervous system (CNS). Primary CNS lymphoma Primary CNS lymphoma begins in the central nervous system (brain and spinal cord). It is associated with the Epstein-Barr virus. Lymphoma that starts elsewhere in the body and spreads to the central nervous system is not primary CNS lymphoma. Treatment for AIDS-related primary central nervous system lymphoma may include the following: External beam therapy. Treatment for AIDS-related lymphoma combines treatment for lymphoma with treatment for AIDS. AIDS patients have a weakened immune system, and treatment may cause the immune system to become weaker. For this reason, treatment of patients who have AIDS-related lymphoma is difficult and some patients may be treated with lower doses of medication than patients with lymphomas who do not have AIDS. Highly active antiretroviral therapy (HAART) is used to reduce the damage to the immune system caused by HIV. HAART treatment may allow some patients with AIDS-related lymphoma to safely receive anti-cancer drugs at standard or higher doses. In these patients, treatment may work just as well as in patients with lymphoma who do not have AIDS. Medicines are also used to prevent and treat infections that can be serious. Four types of standard treatments are used: 1. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is injected directly into the cerebrospinal fluid (intrathecal chemotherapy), an organ or body cavity such as the abdomen, the drugs mainly target cancer cells in those areas (regional chemotherapy). Combination chemotherapy is treatment that uses more than one anticancer drug. Intrathecal chemotherapy can be used in patients who are more likely to have central nervous system (CNS) lymphoma. Chemotherapy is used in the treatment of AIDS-related peripheral / systemic lymphoma. It is not yet known whether it is better to administer HAART at the same time as chemotherapy or after chemotherapy ends. Colony-stimulating factors are sometimes given in conjunction with chemotherapy. This helps reduce the side effects that chemotherapy can have on the bone marrow. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. External beam radiation therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. 3. High-dose chemotherapy with stem cell transplantation High doses of chemotherapy are prescribed to kill cancer cells. Healthy cells, including hematopoietic cells, are also destroyed in cancer treatments. Stem cell transplantation is a treatment to replace hematopoietic cells. Stem cells (immature blood cells) are removed from the patient's blood or bone marrow, frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and returned to the patient as an infusion. These re-injected stem cells germinate (and regenerate) the body's blood cells. 4. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to target and attack certain cancer cells without harming normal cells. Monoclonal antibody therapy: This treatment uses antibodies obtained in the laboratory from one type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that can promote the growth of cancer cells. Antibodies attach to substances and kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Rituximab is used to treat AIDS-related peripheral / systemic lymphoma. 3.1. 3.2. 3.3. 3.4. 3.5. якорь 4 4. TREATMENT OF FUNGAL MYCOSIS (including Sesari's syndrome) Fungal mycosis and Sesary's syndrome are diseases in which lymphocytes (a type of white blood cell) become malignant (cancerous) and affect the skin. Usually, the bone marrow produces blood stem cells (immature cells), which over time become mature blood stem cells. A blood stem cell can become a myeloid stem cell or a lymphoid stem cell. The myeloid stem cell becomes an erythrocyte, leukocyte or platelet. The lymphoid stem cell becomes a lymphoblast and then one of three types of lymphocytes (leukocytes): B-cell lymphocytes, which make antibodies to help fight infection. T lymphocytes, which help B lymphocytes produce antibodies that help fight infection. Natural killer cells that attack cancer cells and viruses. Development of blood cells. A blood stem cell goes through several stages to become an erythrocyte, platelet, or white blood cell. Fungal mycosis and Sesary's syndrome are types of cutaneous T-cell lymphoma. Fungal mycosis and Sesary's syndrome are the two most common types of cutaneous T-cell lymphoma (a type of non-Hodgkin's lymphoma). see NHL treatment (click here ) 4.1. Symptoms 1. A sign of fungal mycosis is a red rash on the skin. Fungal mycosis can go through the following phases: Premycotic phase: a scaly red rash on areas of the body that are not normally exposed to the sun. This rash does not cause symptoms and can last for months or years. At this stage, it is difficult to diagnose the rash as fungal mycosis. Patch phase: Thin, flushed, eczema-like rash. Plaque phase: Small bumps (papules) or hard rashes on the skin that may turn red. Tumor phase: Tumors form on the skin. Ulcers can form in these tumors and the skin can become infected. Check with your doctor if you have any of these signs. 2. With Sesari's syndrome, cancer T cells are found in the blood. In addition, the skin all over the body was red, itchy, flaky, and painful. There may also be spots, plaques, or swellings on the skin. It is not known whether Sesari's syndrome is an advanced form of fungal mycosis or a separate disease. 4.2. Diagnostics fungal mycosis and Cesari's syndrome To diagnose fungal mycosis and Cesari's syndrome, tests are used that examine the skin and blood. The following tests and procedures can be used: Physical examination and health history: A body exam to check for general signs of health, including checking for signs of illness such as bumps, the number and type of skin lesions, or anything else that seems unusual. Skin scans and a history of the patient's habits as well as past illnesses and treatments will also be taken. Complete blood count with differential: A procedure in which a blood sample is taken and tested for the following: The number of red blood cells and platelets. The number and type of leukocytes. The amount of hemoglobin (oxygen-carrying protein) in red blood cells. The portion of a blood sample made up of red blood cells. Cesari Blood Cell Counting: A procedure in which a blood sample is viewed under a microscope to count the number of Cesari cells. HIV test: A test to measure the level of HIV antibodies in a blood sample. Antibodies are produced by the body when a foreign substance invades it. A high level of antibodies to HIV can mean that the body is infected with HIV. Skin biopsy: Removing cells or tissues so they can be viewed under a microscope for signs of cancer. The doctor may remove the growth from the skin, which will be examined by a pathologist. More than one skin biopsy may be required to diagnose fungal mycosis. Other tests that can be performed on cells or a tissue sample include the following: Immunophenotyping: a laboratory test that uses antibodies to identify cancer cells based on the types of antigens or markers on the cell surface. This test is used to diagnose certain types of lymphoma. Flow cytometry: A laboratory test that measures the number of cells in a sample, the percentage of living cells in the sample, and certain characteristics of cells such as size, shape, and the presence of tumor (or other) markers on the cell surface. Cells from a sample of blood, bone marrow, or other tissue from a patient are stained with a fluorescent dye, placed in a liquid, and then passed one at a time through a beam of light. The test results are based on how cells stained with a fluorescent dye respond to a beam of light. This test is used to diagnose and treat certain types of cancer, such as leukemia and lymphoma. T cell receptor gene rearrangement (TCR) test: A laboratory test that tests cells in a sample of blood or bone marrow to see if there are certain changes in genes that create receptors on T cells (white blood cells). Testing for these gene changes can determine if a large number of T cells are being produced with a specific T cell receptor. After fungal mycosis and Sesari's syndrome are diagnosed, tests are done to find out if the cancer cells have spread from the skin to other parts of the body. The process used to determine if cancer has spread from the skin to other parts of the body is called staging. The information gathered during the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. During the preparation process, the following procedures can be used: Chest X-ray: X-ray of organs and bones inside the chest. X-rays are a type of energy beam that can pass through the body onto film, creating an image of areas within the body. CT (computed tomography): A procedure in which a series of detailed pictures of areas inside the body, such as the lymph nodes, chest, abdomen, and pelvis, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. PET scan (positron emission tomography): a procedure to look for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Cancer cells appear brighter because they are more active and consume more glucose than normal cells. Lymph node biopsy: Removal of all or part of a lymph node. A pathologist examines the lymph node tissue under a microscope to check for cancerous cells. Bone marrow aspiration and biopsy: Removal of bone marrow and a small piece of bone by inserting a cannula into the hip or sternum. A pathologist examines the bone marrow and bone under a microscope to look for signs of cancer. 4.3 Factors influencing on prognosis (chance of recovery) and treatment options. The prognosis and treatment option depends on the following conditions: Stage of cancer. The type of lesion (spots, plaques, or tumors). Age and gender of the patient. Fungal mycosis and Sesari's syndrome are difficult to cure. Treatment is usually palliative to relieve symptoms and improve quality of life. Patients with an early stage of the disease can live for many years. 4.4. Stages at fungal mycosis and Sesari's syndrome With fungal mycosis and Sesari's syndrome, the following stages are used: Fungal mycosis stage I Stage I is divided into stages IA and IB as follows: Stage IA: spots, papules and / or plaques cover less than 10% of the skin surface. Stage IB: spots, papules and / or plaques cover 10% or more of the skin surface. There may be a small number of Cesars cells v blood ... Fungoid mycosis stage II Phase II is divided into Phases IIA and IIB as follows: Stage IIA: spots, papules and / or plaques cover any surface of the skin. Lymph nodes are abnormal, but they are not cancerous. Stage IIB: One or more tumors of 1 cm or more are found on the skin. Lymph nodes may be abnormal, but they are not cancerous. There may be a small number of Cesari cells in the blood. Fungoid mycosis stage III In stage III, 80% or more of the skin's surface turns red and may have spots, papules, plaques, or tumors. Lymph nodes may be abnormal, but they are not cancerous. There may be a small number of Cesari cells in the blood. Fungal mycosis stage IV / Sesari's syndrome When a large number of Sesari cells are present in the blood, the disease is called Sesari's syndrome. Stage IV is divided into stages IVA1, IVA2 and IVB as follows: Stage IVA1: spots, papules, plaques, or tumors may cover any part of the skin surface, and 80% or more of the skin surface may be reddened. The lymph nodes may be abnormal, but they are not cancerous. There are a large number of Cesars of cells in the blood. Stage IVA2: spots, papules, plaques, or tumors may cover any part of the skin surface, and 80% or more of the skin surface may be reddened. The lymph nodes are very abnormal, or cancer has formed in the lymph nodes. There may be a large number of Sesari cells in the blood. Stage IVB: Cancer has spread to other organs in the body, such as the spleen or liver. Spots, papules, plaques, or tumors can cover any part of the skin's surface, and 80% or more of the skin's surface may be reddened. Lymph nodes can be abnormal or cancerous. There may be a large number of Sesari cells in the blood. Fungal mycosis and Sesari's syndrome may recur (come back) after treatment. Fungal mycosis and Sesari's syndrome can recur on the skin or in other parts of the body, such as the spleen or liver. 4.5. Overview of treatment options There are various treatments for patients with fungal mycosis and cancer with Sesari's syndrome. Various treatments are available for patients with fungal mycosis and Sesari's syndrome. Some treatments are standard (currently used) and some are in clinical trials. A clinical trial of treatment is a scientific study designed to help improve current treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than standard treatment, the new treatment may become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. Seven types of standard treatments are used: 1. Photodynamic therapy Photodynamic therapy is a cancer treatment that uses drugs and a certain type of laser beam to kill cancer cells. A drug that is inactive before exposure to light is injected into a vein. The drug accumulates in cancer cells more than in normal cells. In skin cancer, a laser beam hits the skin and the drug becomes active and kills the cancer cells. Photodynamic therapy practically does not damage healthy tissues. Patients undergoing photodynamic therapy should limit their exposure to the sun. There are different types of photodynamic therapy: With psoralen and ultraviolet A (PUVA) therapy, the patient is given a drug called psoralen and then the ultraviolet A light is directed to the skin. In extracorporeal photochemotherapy, drugs are administered to the patient, then some blood cells are taken from the body, placed in a special ultraviolet light A and returned back to the body. Extracorporeal photochemotherapy can be used alone or in combination with total skin electron beam (TSEB) radiation therapy. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. External beam radiation therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Sometimes, total skin electron beam (TSEB) radiation therapy is used to treat fungal mycosis and Sesari's syndrome. This is a type of external beam treatment in which a radiation therapy machine directs electrons (tiny invisible particles) to the skin that covers the entire body. External beam radiation therapy can also be used as palliative therapy to relieve symptoms and improve quality of life. Ultraviolet A (UVA) radiation therapy or ultraviolet B (UVB) radiation therapy can be performed using a special lamp or laser that directs radiation to the skin. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Sometimes chemotherapy is topical (applied to the skin with a cream, lotion, or ointment). 4. Other drug therapy Topical corticosteroids are used to reduce redness, swelling, and inflammation of the skin. This is a type of steroid. Topical corticosteroids can be in the form of a cream, lotion, or ointment. Retinoids such as bexarotene are vitamin A-related drugs that can slow the growth of certain types of cancer cells. Retinoids can be taken orally or applied to the skin. Lenalidomide is a medicine that helps the immune system kill abnormal blood cells or cancer cells and can prevent the growth of new blood vessels needed for tumors to grow. Vorinostat and romidepsin are two histone deacetylase (HDAC) inhibitors used to treat fungal mycosis and Sesari's syndrome. HDAC inhibitors cause a chemical change that stops tumor cells from dividing. 5. Immunotherapy Immunotherapy is a treatment that uses a patient's immune system to fight cancer. Substances produced by the body or produced in the laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or biological therapy. Interferon: This treatment prevents fungal mycosis and Sesari cells from dividing and may slow tumor growth. 6. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to target cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. Monoclonal antibody therapy: This treatment uses antibodies obtained in the laboratory from one type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that can promote the growth of cancer cells. Antibodies attach to substances and kill cancer cells, block their growth, or prevent them from spreading. They can be used alone or to carry drugs, toxins, or radioactive materials directly to cancer cells. Monoclonal antibodies are given by infusion. Types of monoclonal antibodies include: Brentuximab vedotin, which contains monoclonal antibodies that bind to the CD30 protein found on some types of lymphoma cells. It also contains an anti-cancer drug that can help kill cancer cells. Mogamulizumab, which contains monoclonal antibodies that bind to the CCR4 protein found on certain types of lymphoma cells. It can block this protein and help the immune system kill cancer cells. It is used to treat fungal mycosis and Sesari's syndrome that have returned or failed to improve after treatment with at least one systemic therapy. 7. High-dose chemotherapy and radiation therapy with stem cell transplantation High doses of chemotherapy and sometimes radiation therapy are given to kill cancer cells. Healthy cells, including hematopoietic cells, are also destroyed in cancer treatments. Stem cell transplantation is a treatment to replace hematopoietic cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of a patient or donor, frozen and stored. After the patient completes chemotherapy and radiation therapy, the stored stem cells are thawed and returned to the patient as an infusion. These re-injected stem cells germinate (and regenerate) the body's blood cells. 4.6. Treatment options by stage Treatment of fungal mycosis stage I and II Treatment for newly diagnosed stage I and II fungal mycoses may include the following: Psoralen and ultraviolet A radiation therapy (PUVA). Ultraviolet radiation In therapy. Radiation therapy with total electron beam therapy of the skin. In some cases, radiation therapy is applied to skin lesions as palliative therapy to reduce tumor size, relieve symptoms, and improve quality of life. Immunotherapy given alone or in combination with skin-targeted therapy. Local chemotherapy. Systemic chemotherapy with one or more drugs that can be combined with skin-directed therapy. Other drug therapy (topical corticosteroids, retinoid therapy, lenalidomide, histone deacetylase inhibitors). Targeted therapy (brentuximab vedotin). Treatment of fungal mycosis stage III and stage IV (including Sesari syndrome) Treatment for newly diagnosed stage III and IV mycoses, including Sesari syndrome, is palliative (to relieve symptoms and improve quality of life) and may include the following: Psoralen and ultraviolet A radiation therapy (PUVA). Ultraviolet radiation In therapy. Extracorporeal photochemotherapy, administered alone or in combination with total skin electron beam radiation therapy. Radiation therapy with total electron beam therapy of the skin. In some cases, radiation therapy is applied to skin lesions as palliative therapy to reduce tumor size, relieve symptoms, and improve quality of life. Immunotherapy given alone or in combination with skin-targeted therapy. Systemic chemotherapy with one or more drugs that can be combined with skin-directed therapy. Local chemotherapy. Other drug therapy (topical corticosteroids, lenalidomide, bexarotene, histone deacetylase inhibitors). Targeted therapy with brentuximab vedotin. Treatment of recurrent fungal mycosis (including Sesari's syndrome) Treatment for recurrent fungal mycosis, including Sesari's syndrome, can be done in clinical trials and may include the following: Radiation therapy with total electron beam therapy of the skin. In some cases, radiation therapy is applied to skin lesions as palliative therapy to reduce tumor size, relieve symptoms, and improve quality of life. Psoralen and ultraviolet A radiation therapy (PUVA), which can be given in conjunction with immunotherapy. Ultraviolet B radiation. Extracorporeal photochemotherapy. Systemic chemotherapy with one or more drugs. Other drug therapy (topical corticosteroids, retinoid therapy, lenalidomide, histone deacetylase inhibitors). Immunotherapy given alone or in combination with skin-targeted therapy. High-dose chemotherapy and sometimes radiation therapy with stem cell transplantation. Targeted therapy. 4.1. 4.2. 4.3. 4.4 4.5. 4.6. 5. TREATMENT OF PRIMARY CNS LYMPHOMA Primary central nervous system (CNS) lymphoma is a disorder in which malignant (cancerous) cells form in the lymphatic tissue of the brain and / or spinal cord. Lymphoma is a disease in which malignant ( cancerous) cells are formed in the lymphatic system. The lymphatic system is part of the immune system and consists of lymph, lymphatic vessels, lymph nodes spleen, thymus, tonsils and bone marrow. Lymphocytes (carried by lymph) travel to and from the central nervous system (CNS). It is believed that some of these lymphocytes become cancerous and cause lymphoma in the central nervous system. Primary CNS lymphoma may begin in the head, the spinal cord or meninges (the layers that form the outer lining of the brain). Because the eye is so close to the brain, primary CNS lymphoma can also start in the eye (called ocular lymphoma). Якорь 5 Anatomy of the lymphatic system showing lymphatic vessels and lymphatic organs including lymph nodes, tonsils, thymus, spleen, and bone marrow. Lymph (clear fluid) and lymphocytes travel through the lymphatic vessels to the lymph nodes, where the lymphocytes destroy harmful substances. Lymph enters the bloodstream through a large vein near the heart. 5.1. Risks of developing CNS lymphoma A weakened immune system can increase the risk of developing primary CNS lymphoma. Anything that increases the likelihood of getting sick is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk. Primary CNS lymphoma can occur in patients who have acquired immunodeficiency syndrome (AIDS) or other immune system disorders or who have had an organ transplant. For more information on lymphoma in AIDS patients click here 5.2. Symptoms of Primary CNS Lymphoma Signs and symptoms of primary CNS lymphoma may include nausea, vomiting, or seizures. These and other signs and symptoms can be caused by primary CNS lymphoma or other conditions. Check with your doctor if you have any of the following: Nausea and vomit ... Convulsions ... Headache. Weakness in an arm or leg. Confusion ... Double vision. Loss of hearing. 5.3. Tests for the diagnosis of primary CNS lymphoma Tests that examine the eyes, brain, and spinal cord are used to diagnose primary CNS lymphoma. The following tests and procedures can be used: Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness such as bumps or anything else that seems out of the ordinary. A history of the patient's health-related habits as well as past illnesses and treatments will also be recorded. Neurological examination: A series of questions and tests to check the function of the brain, spinal cord and nerves. The exam tests the person's mental state, coordination, ability to walk normally and how well muscles, feelings and reflexes work. It can also be called a neurological or neurological examination. Dilated eye exam: An eye exam in which the pupil is dilated (enlarged) with medicated eye drops so that the doctor can look through the lens and pupil at the retina. The inside of the eye is checked, including the retina and optic nerve. Images can be taken over time to track changes in tumor size. There are several types of eye examinations: Ophthalmoscopy: Examining the inside of the back of the eye to check the retina and optic nerve with a small magnifying lens and light. Slit lamp biomicroscopy: Examining the inside of the eye to check the retina, optic nerve and other parts of the eye using a strong beam of light and a microscope. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the brain and spinal cord. A substance called gadolinium is injected into the patient's body through a vein. Gadolinium gathers around cancer cells, so they appear brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (MRI). Lumbar puncture: A procedure used to collect cerebrospinal fluid (CSF) from the spine. This is done by inserting a needle between two bones in the spine and into the cerebrospinal fluid and taking a sample of the fluid. A sample of cerebrospinal fluid is checked under a microscope for signs of tumor cells. You can also check the amount of protein and glucose in the sample. Protein levels above normal or below normal glucose may be a sign of a tumor. This procedure is also called LP or lumbar puncture. Stereotactic biopsy: A biopsy procedure that uses a computer and a three-dimensional (3-D) scanning device to locate the tumor and guide tissue removal so that it can be viewed under a microscope to check for signs of cancer. The following tests can be performed on removed tissue samples: Flow cytometry: a laboratory test that measures the number of cells in a sample, the percentage of living cells in the sample, and certain characteristics of cells such as size, shape, and the presence of tumor (or other) markers on the cell surface. Cells from a sample of blood, bone marrow, or other tissue from a patient are stained with a fluorescent dye, placed in a liquid, and then passed one at a time through a beam of light. The test results are based on how cells stained with a fluorescent dye respond to a beam of light. This test is used to diagnose and treat certain types of cancer, such as leukemia and lymphoma. Immunohistochemistry: A laboratory test that uses antibodies to check for specific antigens (markers) in a tissue sample from a patient. Antibodies are usually associated with an enzyme or fluorescent dye. After antibodies bind to a specific antigen in a tissue sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test is used to diagnose cancer and help distinguish one type of cancer from another. Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a blood or bone marrow sample are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in some chromosomes can be a sign of cancer. Cytogenetic analysis is used to diagnose cancer, plan treatment, or determine the effectiveness of a treatment. FISH (Fluorescence In Situ Hybridization): A laboratory test used to study and count genes or chromosomes in cells and tissues. Pieces of DNA containing fluorescent dyes are made in the laboratory and added to a sample of the patient's cells or tissues. When these stained DNA fragments attach to specific genes or regions of chromosomes in a sample, they light up when viewed under a fluorescent microscope. The FISH test is used to diagnose cancer and plan treatment. Complete blood count (CBC) with differential: A procedure in which a blood sample is taken and checked for the following: The number of red blood cells and platelets. The number and type of leukocytes. The amount of hemoglobin (oxygen-carrying protein) in red blood cells. The portion of a blood sample made up of red blood cells. After primary central nervous system (CNS) lymphoma is diagnosed, tests are done to find out if cancer cells have spread in the brain and spinal cord or into the eyes. Primary CNS lymphoma usually does not extend beyond the central nervous system or the eye. The process used to determine the spread of cancer is called staging. There is no standardized system for staging primary CNS lymphoma. The following tests and procedures can be used to plan treatment: CT (computed tomography): a procedure in which a series of detailed pictures of areas inside the body are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to help organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. PET scan (positron emission tomography): a procedure to look for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Malignant tumor cells appear brighter in the image because they are more active and consume more glucose than normal cells. PET scans and CT scans can be performed at the same time. This is called a PET-CT scan. MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI). Bone marrow aspiration and biopsy: Removal of bone marrow, blood, and a small piece of bone by inserting a cannula into the hip or sternum. A pathologist examines the bone marrow, blood, and bones under a microscope to look for signs of cancer. Primary CNS lymphoma often recurs (comes back) after treatment. Primary CNS lymphoma often recurs in the brain, spinal cord, or eyes. 5.4. Overview of treatment options There are various treatments for patients with primary central nervous system (CNS) lymphoma. Various treatments are available for patients with primary CNS lymphoma. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. Surgery is not used to treat primary CNS lymphoma. Four standard treatments are used: 1. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. External beam radiation therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Because primary CNS lymphoma spreads throughout the brain, external radiation therapy is applied to the entire brain. This is called whole-brain radiation therapy. High-dose radiation therapy to the brain can damage healthy tissue and cause disturbances that can affect thinking, learning, problem solving, reading, writing, speaking, and memory. Clinical trials have tested the use of chemotherapy alone or before radiation therapy to reduce the damage to healthy brain tissue that occurs with radiation therapy. 2. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is injected directly into the cerebrospinal fluid (intrathecal chemotherapy), an organ or body cavity such as the abdomen, the drugs mainly target cancer cells in those areas (regional chemotherapy). How chemotherapy is given depends on where the tumor is in the central nervous system or in the eye. Primary CNS lymphoma can be treated with systemic chemotherapy, intrathecal chemotherapy, and / or intraventricular chemotherapy, in which anticancer drugs are injected into the ventricles (fluid-filled cavities) of the brain. If primary CNS lymphoma is found in the eye, anticancer drugs are given directly. 3. Steroid therapy Steroids are hormones produced naturally by the body. They can also be made in the laboratory and used as medicines. Glucocorticoids are steroid drugs that have anticancer effects for lymphomas. 4. Targeted therapy Targeted therapy is a type of treatment that uses drugs or other substances to identify and target certain cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy or radiation therapy. Monoclonal antibodies: Monoclonal antibodies are immune system proteins created in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that can promote cancer cell growth. The antibodies are then able to kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or to carry drugs, toxins, or radioactive materials directly to cancer cells. Rituximab and nivolumab are types of monoclonal antibodies used to treat newly diagnosed or recurrent primary CNS lymphomas. Tyrosine kinase inhibitors: These small molecule drugs travel across the cell membrane and work inside cancer cells to block signals that cancer cells need to grow and divide. Ibrutinib is a type of tyrosine kinase inhibitor used to treat newly diagnosed or recurrent primary CNS lymphoma. High-dose chemotherapy with stem cell transplant High doses of chemotherapy are prescribed to kill cancer cells. Healthy cells, including hematopoietic cells, are also destroyed in cancer treatments. Stem cell transplantation is a treatment to replace hematopoietic cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of a patient or donor, frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and returned to the patient as an infusion. These re-injected stem cells germinate (and regenerate) the body's blood cells. 5.5. Treatment options for primary CNS lymphoma Treatment of primary CNS lymphoma Treatment for newly diagnosed primary central nervous system (CNS) lymphoma may include the following: Whole Brain Radiation Therapy. Chemotherapy with or without radiation therapy. Targeted therapy alone (rituximab, nivolumab, or ibrutinib). Targeted therapy (rituximab) and chemotherapy. Clinical study on high-dose chemotherapy and stem cell transplantation. A clinical trial of high-dose chemotherapy with or without targeted therapy (rituximab), stem cell transplantation, or whole-brain radiation therapy. Clinical trial of chemotherapy followed by whole-brain radiation therapy or chemotherapy followed by high-dose chemotherapy and stem cell transplantation. Clinical trial of chemotherapy with or without stem cell transplantation. Treatment of primary intraocular lymphoma Treatment for newly diagnosed primary intraocular lymphoma may include the following: Chemotherapy (intraocular or systemic) with or without whole-brain radiation therapy. Whole Brain Radiation Therapy. Treatment of recurrent primary CNS lymphoma Treatment for recurrent primary central nervous system (CNS) lymphoma may include the following: Chemotherapy. Targeted therapy (rituximab, nivolumab, or ibrutinib). Radiation therapy (if not previously treated). Clinical investigation of a new drug or treatment regimen. 5.1. 5.2. 5.3. 5.4. 5.5.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. Key points about contrast-enhanced CT No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. My History of Lymphoma Treatment in Turkey Hello! My name is Olga, I am one of the Russian-speaking coordinators of the international platform Medikal & Estetik Group. For the second year I have been in remission of Non-Hodgkin's lymphoma and for the third year I have been living in the most modern city of Turkey in Izmir. LUCK literally helped me to find and cure, so I feel obliged to my chance to be cured in order to help those in need, and sometimes have lost hope, in finding "their" specialist ... I want to tell my story of the fight against cancer, suddenly it will be useful to someone. Page menu: TREATING ONCOLOGY IN THE CIS IS VERY SCARY !!! AS CANCER WAS NOT FOUND IN MOSCOW HOW CANCER DETECTED BIOPSY MY TREATMENT A LITTLE ABOUT THE CLINIC CONCLUSION 3 1. TO TREAT ONCOLOGY IN THE CIS IS VERY SCARY !!! Unfortunately, in the CIS, most doctors are still guided by carbon copy treatment protocols. There is no individual approach, the methods are outdated for a long time. Reading stories about treatment protocols for the same disease as mine, I was horrified !!! A multi-week course of ONE chemotherapy is strong, friends! Any organism after such "treatment" will be exhausted and there will be no energy left for subsequent courses, which often happens !!! The attitude of the medical staff must be "earned" with gifts, gifts, tributes, I don’t know what else to call it, because otherwise the health gods simply will not honor you! Medicines. This is a separate topic, since they are either not available, or are very expensive, or are subject to sanctions, and it is forbidden to order from abroad ... It is depressing that the new generation drugs have not yet received accreditation from the Ministry of Health. Everything is clear about equipping diagnostic centers and hospitals. Queues. Waiting queues for admission, bed-places, for a biopsy, waiting for the results of this biopsy ... It is not worth reminding that cancer develops rapidly, and the main factor in the success of treatment in oncology is its timely detection ... So ... 2. AS CANCER WAS NOT FOUND IN MOSCOW In 2017. at the next scheduled ultrasound examination, enlarged lymph nodes were found, which my doctor advised to check with her professor of the Department of Ultrasound Diagnostics with almost 40 years of experience from the Russian Medical Academy. Madame worked in a specialized center for vascular diagnostics at Patriarch's Ponds, because there, in addition, the most powerful and modern equipment! Well, that's what they say. After conducting the examination, the "professor" dismissively told me that I am an alarmist and all enlarged processes of the lymph nodes are the result of playing sports. How did I "remember" her when I was informed in 2019 that my lymphoma was developing for the fourth or fifth year !!! By the way, I wrote to this clinic, also on the forums of this clinic (my reviews were deleted), attached the conclusion of the "professor" and the results of the course of the disease - SILENCE. About six months later, for the first time in my life, I began to swell terribly, my legs became one and a half sizes larger, my stomach increased, starting from the ribs, without a hint of fat, the cycle was lost. Naturally, I decided to turn to another eminent professor of endocrinologist-gynecologist. No hormone failure was found, and the answer to the weight gain was: "You are over 30, weight gain is the norm!" Having resigned myself to "age and the inevitable" I already lived in the gym, exhausted on the treadmill and in the gym. At the beginning of 2018, I still gained weight due to constant swelling, but a new problem was added - food allergy to all dairy products, to all meat, fried ... at the 9th month ... Pancreatitis and allergies were not confirmed at the next examinations. By August 2018, varicose veins appeared (after all, after swelling that did not subside), and again there were many examinations and treatment. The reason for the persistent migraines that tormented me for a couple of years was also not found in the institutes of the capital, and on MRI they generally wondered why I was sent for examinations ... 3. HOW CANCER DETECTED With a planned ultrasound scan with another eminent doctor in Turkey for an appointment of 800 LIR / 8000 rubles. (for Turkey it is extraordinarily expensive) nothing was found either, but there was no shortage of courtesies. In the meantime, the symptoms progressed, I did not give up sports, but it was getting worse for me - I could sleep half-sitting, otherwise I just choked in my sleep. I decided to go to see an ordinary doctor without any regalia in one of the local network of clinics. While doing an ultrasound, the doctor saw a strange seal between the organs, on the same day she sent me to a specialized center for ultrasound with contrast. The results literally knocked the soil out from under my feet ... Behind the spleen, a "bag" of 2-3 cm was found. The preliminary diagnosis is stage 2 non-Hodgkin's lymphoma, which has been developing for the fourth or fifth year. I was in SHOCK !!! How could the doctors in Russia fail to see this ?? Having spent so much time and money was very disappointing for myself. But the next stage of the examination was a biopsy, in order to understand the nature of the "find". It is extremely difficult to find a specialist in your city, let alone another country with a foreign language. From the beginning I wanted to return to Moscow, but, having contacted cancer centers in my homeland and hearing about the queues and the need to re-undergo examinations, this thought disappeared instantly))) After examining dozens of sites and forums about doctors and clinics. Having settled on the best of the best according to the Internet, I went to the receptions, there was no need to wait for them. Everyone was ready to take a biopsy "tomorrow", but the problem was this: by that time my abdomen had begun to increase in size very quickly, which made it difficult to take the material for analysis, that is, the history could not do with a puncture, it was necessary to do a strip operation because for the accumulation of fluid in the abdominal cavity. By the way, I slept only sitting in tandem with a terrible shortness of breath. By a lucky coincidence, through literally a sixth friend who turned out to be a local football star, they find the best specialist for me not only in Turkey, but also abroad. By the way, he turned out to be the rector of a prestigious university)). It is extremely difficult to get an appointment with him, but on the recommendation of a friend of my acquaintances, I find myself at his appointment. And again everything is solved very quickly. The doctor decides to take a different unusual path. 4. BIOPSY He will personally take a biopsy from the lymph nodes, since even with Non-Hodgins' lymphoma, traces of cancer may also be in the lymph nodes. But there is, of course, no guarantee that his idea will succeed. After going through a few more necessary examinations, I was ready for the procedure. The doctor recommended a JCI level clinic (international accreditation standard) in Izmir. His status in the medical world opens many doors, so he is given the exclusive right to conduct a biopsy on his own with his assistants. Since it was not clear whether it would be possible to take the material for analysis from the very first lymph node, the anesthesia was divided into two parts for two possible areas of collection. That is, to say that I felt pain is to say nothing, but this action turned out to be justified, since only the second lymph node was successful for collection. 5. MY TREATMENT After 4 days, the diagnosis was confirmed, and a week later, a port was installed for me to administer the medicine. On the day of the port installation, treatment of 8 courses of red chemotherapy, immunotherapy and "smart" medicine, which hit exclusively the affected area, began immediately. Each of my three weeks looked like this: 5-7 days in the clinic (depending on blood results and general well-being), 2 weeks of medication at home. Of course, my path is not over yet, as little time has passed, and health issues in the form of disturbed hormonal levels and vision problems remain open. The body is still in the process of recovery, and this is normal. 6. A LITTLE ABOUT THE CLINIC It is worth noting that I was amazed at the luxurious conditions in the wards with the space provided for one relative and the attitude of the staff, from nurses to professors! Any request was fulfilled with lightning speed, any complaint 24/7 was reported to the attending physician, and a decision was immediately made, answers to any questions were not long in coming. My attending doctor worked absolutely seven days a week, it was amazing! The atmosphere and interior of the clinic is more like a hotel. On the ground floor there is a chic grand piano, on which masterpieces of world classics are performed every day. There is an excellent restaurant with European cuisine, but there was no need for it, since the food was full and very varied. The only thing I regretted was that before the course of chemotherapy, in a panic, I did not pay attention to the technology for preserving hair during chemotherapy, because after the first one I decided to leave my hair ... All doctors undergo training in the United States, speak excellent English. There are a huge number of English and Europeans among foreign patients, you rarely meet Russian-speaking patients, this is not Istanbul and Antalya. Izmir is, in principle, the most Europeanized city in Turkey, therefore, foreigners are most comfortable here, in places it looks like Cannes, in places like Italy, in places like Greece. The Turks themselves say that Izmir is not Turkey, and Turkey is not Izmir. And if all of Turkey dreams of moving to live in Istanbul, then Istanbul moves to Izmir. By the way, the most expensive and luxurious resorts of the country are in the Izmir region, so to speak, where world and local stars rest here. There are simply no All Inclusive hotels. 7. CONCLUSION In conclusion, I would like to say that you should not be afraid to trust specialists in organizing your treatment in another country, especially if this specialist himself has gone all this way. It's great that there are so many unique clinics, outstanding doctors .. But HOW to find a truly specialist in this diversity yourself? Should you try your luck and trust solely to forums or soulless representatives of medical tourism? As it turned out, a luxurious clinic is not professionalism yet. The success of treatment abroad consists of two components, namely, the capabilities and level of the chosen clinic and the level of professionalism and experience of the staff. All health and good luck, friends! Здравствуйте! Меня зовут Ольга, я являюсь одним из русскоязычных координаторов международной платформы Medikal & Estetik Group. Уже второй год нахожусь в ремиссии Неходжкинской лимфомы и третий год живу в самом современном городе Турции в Измире. Обнаружить и вылечить мне помогла буквально УДАЧА, поэтому чувствую себя обязанной своему шансу вылечиться, чтобы помогать в поиске «своего» специалиста нуждающимся, а порой и потерявшим надежду… Я хочу рассказать свою историю борьбы с раком, вдруг кому-то это будет полезным. 2 4 5 6 7

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. DIAGNOSTIC SERVICES IN TURKEY MENU PAGES: Diagnostic services Ultrasound Computed tomography (CT) PET-CT Angiography Duplex scanning (DS) Medical genetics Microbiology Clinical laboratory Pathology Analysis for tumor markers Biopsy Liquid biopsy Magnetic resonance imaging (MRI) Scintigraphy Histopathological studies Radiology Nuclear medicine Diagnosis of diseases is the use of various methods and techniques of medicine to study the state of human health, existing deviations from the norm and make an accurate diagnosis. In order to establish exactly what kind of disorder is present in the body's work, a systematic study of the history, patient complaints and data from various studies is required: endoscopy, radiography, laboratory blood tests and other samples, biopsy, ultrasound diagnostics, etc. Modern methods of diagnosing diseases often involve a comprehensive study. It is understood as a set of diagnostic techniques that help to establish not only the type of disease, the stage of its development and the degree of spread, but also the exact cause of the appearance (etiology). It is especially important to carry out such a check in the presence of a serious illness that threatens a person's life, accompanied by functional disorders of various internal systems, a malfunction in metabolism. In this case, not only the degree of violations in the pathological zone will be determined, but also the state of organs and systems associated with it anatomically or physiologically. This approach allows doctors to prescribe effective treatment. Early diagnosis of diseases is of great importance for their quick and effective treatment. Due to the fact that in recent years medicine has advanced significantly in the quality of research, it has become possible to detect abnormalities at the cellular level. The latest generation equipment has high accuracy in determining the diagnosis. The Anadolu Medical Center uses modern diagnostic methods such as radiology, medical genetics, radiography, microbiology, interventional radiology, clinical laboratory research and other areas. Methods for diagnosing diseases Modern medical diagnostics does not yet have such a unique technique that would allow to qualitatively determine the state of all internal systems of the body. Therefore, comprehensive measures are needed to determine the existing diseases using both simple checks and specific tests. Almost always, a laboratory study of the quantitative and qualitative composition of blood and other physiological body fluids is required. Instrumental examination methods are very popular, including ultrasound diagnostics, electrocardiogram, fibroscopy, electroencephalogram, etc. Medical examination abroad involves the use of high-tech computer developments. Among them, the most in demand are magnetic-nuclear resonance, computed tomography, thermography, radioisotope scanning. The popularity of these methods is due to the high accuracy and information content of the data obtained with their help. They are indicative for many disorders: the formation of tumors, organic lesions of internal organs, developmental defects, congenital anomalies, etc. Diagnostic services are prescribed by the attending physician depending on the specific clinical case, taking into account the general condition of the patient and contraindications to the use of a particular method. Find out the price Select your countryAzerbaijanArmeniaBelarusKazakhstanKyrgyzstanMoldaviaRussiaTajikistanUzbekistanTurkmeniaGeorgiaUkraineOther countries In foreign clinics, diagnostic services include: duplex ultrasound scanning of veins and arteries located on the legs and arms; echocardiography (3D and transesophageal method); ultrasound elastography; positron emission tomography (PET) - helps in the diagnosis of epilepsy, stroke, chorea, cancer metastases; magnetic resonance imaging (MRI) - obtaining three-dimensional and layer-by-layer images of internal tissues, using the effect of nuclear resonance (detects pathologies at the cellular level); simple and extended colposcopy; colpomicroscopy; simple radiography and technique with intravenous administration of a contrast agent; computed tomography (CT) - layer-by-layer visualization of organs of a complex structure to identify problem areas; interventional techniques for the diagnosis of defects in the vascular system; hysteroscopy - examination of the female reproductive system to detect hyperplasia, tumors, fibroids, cysts; biopsy - used for many diseases and involves taking a sample of abnormal tissue for subsequent analysis in the laboratory. Modern diagnostics Medicine is developing, and more modern diagnostic methods appear every year. They are distinguished by fewer contraindications, minimal or complete absence of side effects. Currently, diagnostics abroad uses the following techniques: Flash CT - instant computed tomography with a minimum dose of radiation. The tomograph provides images of almost any part of the body. It is especially easy to use. Most often it is used to examine the work of cardiac and pulmonary activity. PET CT is a combination of computed tomography and positron emission tomography. The most effective technology for imaging malignant neoplasms in the early stages, the prevalence of metastases. It is also used for planning radiotherapy and analyzing therapeutic responses. Digital mammography with tomosynthesis - obtaining high quality 2D and 3D images. Allows to carry out high-precision operations on the mammary glands. Cancer is diagnosed early to maximize the effectiveness of treatment and the chances of a full recovery. Intraoperative MRI 3 Tesla is an innovative imaging device used to detect abnormalities throughout the body. It can be used even during the operation. The high speed is very helpful for doctors in brain surgery. Allows you to accurately determine the size and location of abnormal formations in hard-to-reach places. Ultrasound Ultrasound diagnostics is a very accurate and indicative method of examining internal organs and systems by fixing reflected ultrasonic waves. One of the main advantages of ultrasound examination abroad is considered to be the speed of execution, absolute painlessness and non-invasiveness, as well as affordable cost. The data is recorded by a special sensor that captures ultrasonic waves reflected by the tissues, and the computer processes them and displays the image on the screen. A specialist can analyze the state of internal organs, their structure, functional features, and also detect pathological processes even at an early stage of their development. An ultrasound scan is performed in Turkey for many patients to diagnose various diseases. For this, new generation devices are used, which have high accuracy and ease of use. General information about ultrasound Due to its availability in all medical institutions, ultrasound diagnostics makes it possible to quickly examine a wide range of diseases. Among them are chronic diffuse changes in internal organs, the formation of malignant and benign tumors, the presence of congenital malformations, stones in the gallbladder, abnormalities in the work of the heart, disorders of the genitourinary and digestive systems, etc. Penetrating through tissues of different densities, ultrasound is reflected in different ways from them, due to which the visible boundaries of organs and pathological formations. The operation of an ultrasound device depends on the length of the wave radiation: the shorter it is, the more clearly the internal tissues are visible. Ultrasound has no contraindications and can be performed as many times as necessary to accurately record internal changes and control treatment. There is absolutely no harm to the patient's health. Ultrasound diagnostics is used in various fields of medicine: cardiology, pediatrics, gynecology and obstetrics , urology and etc. Depending on which area will be examined, it depends on how much it costs to do an ultrasound. Indications for ultrasound diagnostics and its main advantages Most often, ultrasound is performed to detect diseases: liver (fatty liver, jaundice, ascites, hepatitis, cholangitis, cirrhosis); female genital organs (cyst, fibroids, polycystic); the prostate gland; urinary tract and kidney (cystitis, pyelonephritis, congenital developmental deformities, glomerulonephritis, renal hypertension, stone formation); abdominal cavity (cholelithiasis, dyspepsia, cholecystitis, gastritis, pancreatitis); thyroid gland (goiter, pathological change in size); hearts (congenital and acquired defects, open oval window, control of blood supply). Ultrasound is used to detect early pregnancy, monitor child development, identify breast pathologies, perform preventive examinations and determine the patient's health before hospitalization. Ultrasound is indicative in the diagnosis of almost all body systems and diseases. Exceptions are some pathologies of the brain, lungs, skeletal system and gastrointestinal tract. However, the uniqueness of the technique lies in the fact that it is possible to examine many areas of the body without harm to health. The need for examination is usually determined by the attending physician, he also determines the appropriate time for the examination and possible preparation measures. Ultrasound process To improve the conduction, a special guide gel is applied to the skin. Then the diagnostician takes an ultrasonic sensor over the area under investigation and records the results on a computer. Sometimes a breath holding is required for the accuracy of the study. In general, the duration of the diagnosis takes 10-20 minutes. For some types of ultrasound diagnostics, special training is required, the doctor warns about it in advance: thyroid gland - there should be no accessories on the neck, a roller is placed under the head; abdominal cavity - you should stop drinking fluids and food 6-8 hours before the start of the examination; pelvic organs - to check the bladder, you must first drink 1 liter of water, do this one hour before the procedure. Diagnostic cost Many patients are worried about how much it costs to have an ultrasound scan. This type of diagnostics is one of the most accessible. The price depends on the status of the medical institution. In Turkey, the medical center "Anadolu" provides patients with the most democratic pricing policy, on average, the cost of one examination is 20-30% lower than in Europe or America. You can clarify the cost immediately before the appointment by phone or through the feedback form on this page of the site. COST of ultrasound Ultrasound $ 50 - $ 300 Eye ultrasound $ 380 - $ 380 Breast ultrasound $ 150 - $ 200 Ultrasound of the heart $ 100 - $ 150 Ultrasound of the carotid arteries $ 150 - $ 200 Ultrasound of the thyroid gland $ 100 - $ 150 Computed tomography (CT) In modern medical institutions, computed tomography is often used to diagnose vascular pathologies, benign and malignant tumors, tissue damage after trauma, and inflammatory processes. The best computed tomography is carried out, of course, in foreign clinics - there the equipment is always of the latest generation, and the doctors are more experienced in the treatment and examination of complex cases. The technique is based on the use of X-rays to study the state and structure of internal organs and systems. CT allows you to get a high-quality image of high resolution in the cross-section of the investigated area. Computer diagnostics are especially in demand when detecting pathologies of the respiratory and musculoskeletal systems, paranasal sinuses and inner ear. The cost of computed tomography is determined by the status of the selected medical institution, the vastness of the study area and the need for contrast for better visualization. How is computed tomography done? During the examination, X-rays pass through the patient's body at different angles. The computer registers the tissue density through which ionizing radiation is passed, and then displays images of sections of internal structures on the monitor. CT is not as harmful as X-rays due to the reduced exposure to radiation. In this case, you can get not only two-dimensional, but also three-dimensional images. This allows you to more accurately investigate the disease and prescribe effective treatment. The examination does not take much time and is completely painless. The data is processed quickly and accurately. Another advantage is the cost of computed tomography, which is usually much lower than for magnetic resonance imaging. Contrast is applied to improve visualization. For this, a contrast agent is injected intravenously, mainly containing iodine in its composition. It gradually spreads through the bloodstream and accumulates in tissues with intensive blood supply, the patient can feel warmth. The use of contrast allows you to identify places with an inflammatory process, neoplasms and bleeding. After the examination, the substance is quickly excreted by the kidneys. Diagnostics is carried out using a special device - a tomograph. This is a ring-shaped piece of equipment with a couch that slides into the Gantry ring and starts to rotate when launched. The data from the machine is transferred to the computer, which displays the received images. The best computed tomography in modern medicine is not hazardous to health due to the reduced dose of radiation exposure. However, it should not be carried out by young children and pregnant women. Also, it is not worth checking often without a doctor's prescription. The disadvantages of this diagnostic method include: the examination is performed only for limited areas of the body; it is not recommended to carry out often; negative effects of ionizing radiation on the body; you can not examine children, pregnant and breastfeeding women; the check shows the anatomical structure of internal organs and systems, their condition, but does not give an idea of the functions they perform. Computed tomography abroad: indications The technique is used for visualization: bone structures after fractures, in places of degenerative disorders, the formation of malignant tumors and their metastases, bone thickness in osteoporosis, herniated intervertebral discs; heart conditions, congenital and acquired defects; · Large intestine without endoscopic intervention; bleeding, cerebral infarction, pathological neoplasms; the walls of the coronary arteries, the state of the vessels, their blockages, narrowing, the presence of aneurysms; inflammatory process in the lungs, embolism; disorders of the gastrointestinal tract, genitourinary system, kidneys, etc. CT is also done to monitor the effectiveness of treatment and to identify complications after surgery. Contraindications to CT Consider a list of absolute and relative contraindications to the survey: an allergic reaction to a contrast agent; renal failure; severe thyroid disease; pregnancy; body weight over 130 kg; the presence of foreign bodies in the surveyed area; the last stage of diabetes mellitus; general serious state of health of the patient; multiple myeloma. The decision on the possibility of diagnostics is made by the doctor. Computed tomography in Turkey The best computed tomography is performed in foreign medical centers. There, patients are provided with the proper level of service, attention and modern diagnostic capabilities. Diagnostics abroad is a comprehensive examination of the patient's health, clarification of all aspects of the disease, the reasons for its occurrence and the methods of the most effective treatment. It can be aimed at identifying the correct medical tactics, clarifying the diagnosis, and also be carried out as a preventive measure for the early detection of the prerequisites for the disease. Computed tomography is available in any clinic, since it has become widespread in modern diagnostics, the price of which is affordable for all patients. In Turkey, CT is used to identify many diseases. The examination is performed by doctors of the highest category with extensive medical experience. They use advanced multi-detector spirals that provide more 2D images in a shorter period of time. Accurate and high-quality diagnostics takes just a few minutes. The cost of computed tomography primarily depends on the country in which the examination is carried out. The status of the medical institution and the qualifications of working doctors also affect. Computed tomography is performed for individual organs, internal systems or areas of the body, so the price is determined by the vastness of the area under study. Computed tomography in Turkey is performed at an affordable price, which is an order of magnitude lower than in America, Europe or Israel. COST OF CT CT (computed tomography) $ 50 - $ 400 Abdominal CT scan $ 300 - $ 950 Chest CT scan $ 100 - $ 350 CT scan of the chest, abdomen and pelvic organs Find out the price CT scan of one anatomical area $ 127 - $ 600 CT scan of one jaw (upper / lower) $ 76 - $ 550 Spine CT $ 130 - $ 130 CT scan of the paranasal sinuses $ 127 - $ 300 PET-CT PET-CT (Positron Emission and Computed Tomography) is a modern diagnostic method using radiopharmaceutical drugs and special equipment, which allows you to build a three-dimensional model of functional processes and the state of internal organs in the human body. The main advantage of PET-CT, which justifies its expensive cost, is the ability to detect a pathological process at an early stage of development, as well as to conduct a comprehensive check of the whole organism at a time. Such informational content allows doctors to quickly and accurately diagnose, prescribe effective treatment in Turkey. How is PET-CT performed? Positron emission computed tomography is performed after intravenous administration of a radioactive tracer passing through the bloodstream to the area under study. The greatest accumulation of contrast agent occurs in places of increased metabolism and intense blood supply. Therefore, such a diagnosis is very indicative in the detection of cancer cells. Verification begins with low doses of radiation during computed tomography , followed by a more detailed examination using positron emission tomography. After the end of the diagnostics, the computer processes the information and combines the images obtained from the two research methods. Sometimes, for a clearer picture of internal changes, the patient may be asked to hold his breath. The total scan duration is 2-3 hours, depending on the type of examination and the extent of the area. Due to the non-invasiveness and accuracy of PET-CT information about diseases in the early stages of development, the cost of the service is absolutely justified. Doing a PET-CT scan if you suspect cancer is necessary in order to: accurately determine whether the tumor belongs to a benign or malignant type; diagnose the stage of cancer or advanced metastases; determine the boundaries of the neoplasm, its spread to other tissues; timely identify a relapse of the disease during follow-up; evaluate the effectiveness of the treatment; make a prognosis for the recovery or development of a tumor. This diagnostic technique is indicative not only for the detection of cancerous pathologies. Examination of patients is performed with lesions of the central nervous system, memory impairment, the need to detect foci of epilepsy. It also helps in the early stages to identify Alzheimer's, Huntington's or Parkinson's diseases. In cardiology, the study allows you to visualize the complications of a heart attack, as well as to identify areas requiring reconstruction of damaged vessels or coronary bypass grafting, which appear during ischemia. The main advantages of PET-CT: Non-invasive and painless examination. Despite the fact that the duration of the procedure is long, the subject does not experience discomfort. The equipment is kept in a specially prepared room without strangers. Security. The dose of the injected radiopharmaceutical is calculated exactly in accordance with the patient's weight, individual characteristics of his health. After diagnosis, the decay of the contrast agent occurs quickly enough (about an hour), and complete elimination from the body takes several days. The doctor checks in advance if there is an allergy to the drug in order to prevent the occurrence of undesirable consequences. The ability to examine the entire body in one go. Identification of pathologies in the early stages, which significantly increases the chances of a quick and complete recovery. Where is the best place to do PET-CT Medical facilities where you can do PET-CT are ubiquitous. However, a better survey is carried out, of course, abroad. The clinics there are equipped with more modern equipment, and the doctors undergo international practice in the best centers and have experience in the accurate formulation of even complex diagnoses. Before choosing a medical center for diagnostics, you should ask how often the quality control of equipment is carried out, what experience and qualifications the doctor has. The main factors affecting the quality of diagnosis: conditions of the event; the quality of the positron emission computed tomography scanner (standard parameters of the operating system); the experience of the doctors giving the opinion; following the list of instructions. Doctors do not recommend multiple examinations of PET-CT, therefore it is better to immediately do PET-CT with high quality. Then you do not have to repeat the introduction of the isotope (creates a load on the excretory system) and expose the body to radiation. PET / CT in Turkey Among all foreign medical institutions, special attention should be paid to Turkish clinics. PET-CT in Turkey has a number of advantages: diagnostics is carried out very quickly, long preliminary preparation is not required; high scanning accuracy thanks to the use of powerful new generation machines and proper maintenance; affordable pricing policy for all types of surveys, fixed prices; absence of errors in the diagnosis; a wide range of clinics where you can do PET-CT; high safety with reduced radiation load on the body; speed of scanning (from 15 minutes); affordable cost of the flight; no need for a visa. In foreign clinics, the cost of PET-CT is an order of magnitude higher than in domestic ones. However, the price is fully justified by the greater accuracy and quality of service. In Turkey, the cost of a diagnostic procedure is 20-30% lower than in America, Europe and Israel, while the quality of medical care does not suffer at all. You can sign up for a PET-CT scan at Anadolu Medical Center by sending a request form through our website. PRICE PET PET of the brain with FDG $ 1000 - $ 1000 PET-CT $ 500 - $ 1100 PET / CT for lymphoma $ 600 - $ 1100 PET-CT for breast cancer $ 600 - $ 800 PET-CT for lung cancer $ 600 - $ 1100 PET / CT with Gallium 68 (DOTA) $ 800 - $ 2000 PET / CT with Gallium 68 (DOTATATE) $ 950 - $ 2000 PET-CT with Gallium 68 (PSMA) $ 800 - $ 3000 PET-MRI $ 500 - $ 1200 Angiography of cerebral vessels Angiography is a vascular imaging technique that uses X-rays. With the help of this examination, it is possible to assess the state of the blood supply in a particular organ and the functional activity of the vessels, as well as to identify various disorders in the structure and operation of the circulatory network. Angiography: general information The main advantage is that this examination method makes it possible to diagnose pathologies of the vascular bed at the initial stages of occurrence. That is, at the moment when the chances of getting rid of them without a trace are maximum. With the help of angiography, diseases such as: atherosclerosis of the vessels, which is manifested by deposits (the appearance of plaques) on the walls; vascular thrombosis - both in the brain and in other organs; arteriovenous shunts - areas of the pathological junction of veins and arteries, where poor and oxygen-rich blood mixes; abnormal vasodilatation - protrusion of their walls with the formation of aneurysms; various diseases of the heart cavities, for example, neoplasms or cysts formed in this area; kidney pathologies associated with impaired functional activity; various disorders in the lymphatic system; diseases of the retina of the eyes, etc. Intraoperative angiographic studies, which are carried out directly during surgical interventions on the brain or on the heart muscle, are also extremely useful. With the help of such examinations, surgeons control all their actions and monitor the patient's condition. Where is the best place to do an angiography of the arteries of the brain? Such an examination is carried out mainly by large clinical and diagnostic centers that have the appropriate equipment, in particular: installation for fluorography, operating at high speed; angiograph - a specialized system for X-ray studies of the vascular bed; camera for X-ray photo and video recording of the results. The most modern approach in this area is CT angiography. Devices for its implementation provide higher quality and detail of the image, and hence more reliable results. How is brain angiography performed? This examination is associated with the intravascular injection of an X-ray contrast agent, and therefore must be carried out under sterile conditions. The specialist chooses the injection site depending on which organ needs to be examined. But in most cases, the contrast is injected through the femoral artery, since this vessel has a large diameter and at the same time is located close to the surface of the skin. Therefore, in the morning before the examination, the patient needs to hygiene the groin area and remove the hair in this area. In addition, you should refuse to eat 6 hours before the procedure. For cerebral angiography, a catheter is usually inserted into the right femoral artery. Occasionally, the ulnar, brachial, carotid, or subclavian arteries can also be used. Before the puncture, the injection site is anesthetized with local anesthesia and disinfected with an antiseptic. Often, the patient is also given a sedative and an antihistamine to reduce the risk and severity of potential side effects. This is necessary because the intake of contrast medium sometimes causes symptoms such as: dizziness and headache; redness of the skin; acceleration of the heart rate; sensation of heat on the skin; chest discomfort; the appearance of a metallic taste on the tongue; nausea. In the overwhelming majority of cases, these side effects disappear very quickly and do not affect the patient's health in the future. The artery is accessed through a small surgical incision. Through it, a short hollow tube is inserted into the vessel, which will serve as a guide for the catheter. The catheter itself has a diameter of 1–2 mm, and the doctor slowly moves it along the vascular bed to the area that needs to be visualized. All this time, the progress of the catheter is monitored on the monitor of the X-ray unit. After reaching the desired vessel, a contrast agent is injected into it and observing how it spreads along the surrounding vasculature, then several X-rays are taken. After that, the catheter is carefully removed, and the damaged vessel through which the access was made is closed with a pressure bandage. This bandage will need to be worn for at least a day, and the patient is recommended to spend the next 6-10 hours in bed - this will reduce the risk of blood clot formation. Despite the fact that angiography of the cerebral vessels is completely painless and does not damage the vascular walls, it is usually prescribed only if serious disorders are suspected. These are pathologies such as: narrowing of the vascular bed; blood clots; other circulatory disorders; aneurysms; extensive hematomas; neoplasms. Cerebral angiography is today considered the gold standard in the diagnosis of cerebrovascular accidents. This study has a high accuracy of the results, on the basis of which the need for surgical intervention is assessed. Angiography in Turkey The Turkish medical center "Anadolu" has all the modern equipment necessary for this study. Our specialists are highly qualified doctors, each of whom has extensive experience in successfully performing angiography of the brain and other organs. Therefore, the examination in our clinic will be completely safe, fast and as accurate as possible. And besides, the cost of angiography in "Anadolu" is noticeably lower than in diagnostic centers in other countries. COST OF ANGIOGRAPHY Angiography $ 700 - $ 1500 Duplex scanning (DS) Duplex scanning (DS) COST OF DS Angiography $ 700 - $ 1500

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. COLOR / RECTAL CANCER TREATMENT IN TURKEY MENU PAGES: 1. What is colon cancer? 1.1. Colon cancer risk factors 1.2. Colon cancer signs 1.3. Colon Cancer Diagnostic Tests 1.4. Diagnosis of metastases 1.5. Treatments for Colon Cancer Patients 1.6. Treatment options by stage 2. What is rectal cancer? 2.1. Rectal cancer risk factors 2.2. Rectal cancer signs 2.3. Tests for the diagnosis of rectal cancer 2.4. Treatments for rectal cancer patients 3. Factors affecting prognosis (chance of recovery) and treatment options COST OF TREATMENT AND DIAGNOSIS OF RECTAL CANCER IN TURKEY COST OF TREATMENT AND DIAGNOSIS OF COLOR CANCER IN TURKEY Colorectal cancer is a disease in which malignant (cancerous) cells form in the tissues of the colon or rectum. The large intestine is part of the body's digestive system. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps eliminate waste from the body. The digestive system consists of the mouth, throat, esophagus, stomach, and the small and large intestines. The colon (large intestine) is the main part of the large intestine and in an adult is about 5 feet long. Together, the rectum and anal canal makes up the last part of the large intestine and is 6 to 8 inches long. The anal canal ends at the anus (the exit of the large intestine to the outside). The prognosis for recovery depends on the following: Whether the tumor has been completely removed by surgery. Whether the cancer has spread to other parts of the body, such as the lymph nodes, lungs, liver, pelvis, ovaries, or bones. Whether the cancer has just been diagnosed or has recurred (returned). 1. What is colon cancer? Colon cancer is a disease in which malignant (cancerous) cells form in the tissues of the colon. The large intestine is part of the body's digestive system. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps eliminate waste from the body. The digestive system consists of the esophagus, stomach, small and large intestines. The colon (large intestine) is the main part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine and are about 6 to 8 inches long. The anal canal ends at the anus (exit colon outward). Stromal tumors of the gastrointestinal tract can occur in the colon. 1 1.1. Colon cancer risk factors Anything that increases the likelihood of getting sick is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk of developing colorectal cancer. Risk factors for colorectal cancer include the following: Having a family history of colon or rectal cancer in the first degree of relationship (parent, sibling, or child). Personal history of colon, rectal, or ovarian cancer. Personal history of high-risk adenomas (colorectal polyps 1 centimeter or larger, or cells that look abnormal under a microscope). Having inherited changes in certain genes that increase the risk of familial adenomatous polyposis (FAP) or Lynch's syndrome (hereditary non-polyposis colorectal cancer). A history of chronic ulcerative colitis or Crohn's disease for 8 years or more. Drinking three or more alcoholic beverages a day. Smoking cigarettes. Be African American. Be obese. Old age is a major risk factor for most cancers. The likelihood of developing cancer increases with age. 1.1. Colon polyps. Some polyps have a pedicle, while others do not. The inset shows a photo of a polyp with a stem. 1.2. Colon cancer signs Signs of colon cancer include blood in your stools or changes in bowel habits. These and other signs and symptoms can be caused by colon cancer or other conditions. Check with your doctor if you have any of the following: Change in bowel habits. Blood (bright red or very dark) in the stool. Diarrhea, constipation, or a feeling that the bowels are not emptying completely. The stool is narrower than usual. Frequent gas pains, bloating, fullness, or cramps. Losing weight for an unknown reason. Feeling very tired. Vomit . 1.2. 1.3. Colon Cancer Diagnostic Tests The following tests and procedures can be used: Physical examination and health history A body exam to check for general signs of health, including checking for signs of illness such as bumps or anything else that seems unusual. There will also be a history of the patient's health habits, as well as past illnesses and treatments. Digital rectal examination : examination of the rectum. A doctor or nurse inserts an oiled gloved finger into the rectum to feel for lumps or anything else that seems unusual. Fecal occult blood test (FOBT): A test to check stool (solid waste) for the presence of blood that can only be seen under a microscope. A small stool sample is placed on a special card or container and returned to the doctor or laboratory for analysis. Blood in your stools can be a sign of polyps, cancer, or other medical conditions. There are two types of FOBT: 1. Guaiac FOBT: The stool sample shown on the special card is tested with a chemical. If there is blood in the stool, the special card changes color. 2. Immunochemical FOBT: Liquid is added to the stool sample. This mixture is injected into a machine that contains antibodies that can detect blood in the stool. If there is blood in the stool, a line will appear in the car window. This test is also called the stool immunochemical test or FIT. Barium enema : a series of X-rays of the lower gastrointestinal tract. A liquid containing barium (a silvery-white metallic compound) is injected directly into the intestine. Barium covers the lower part of the gastrointestinal tract, x-rays are taken. This procedure is also called the lower GI series. 1.3. Barium enema procedure. The patient lies on the X-ray table. Liquid barium is injected into the rectum and passed through the colon. X-rays are used to find abnormal areas. Rigmoidoscopy : A procedure to look at your rectum and sigmoid (lower) colon for polyps (small areas of bulging tissue), other abnormal areas, or cancer. A sigmoidoscope is inserted through the rectum into the sigmoid colon. A sigmoidoscope is a thin tubular instrument with a light and a viewing lens. He may also have an instrument to remove polyps or tissue samples that are checked under a microscope for signs of cancer. Sigmoidoscopy. A thin, illuminated tube is inserted through the anus and rectum into the lower colon to look for abnormal areas. Colonoscopy: A procedure to look at the rectum and colon for polyps, abnormal areas, or cancer. The colonoscope is inserted through the rectum into the large intestine. A colonoscope is a thin tubular instrument with a light and a viewing lens. He may also have an instrument to remove polyps or tissue samples that are checked under a microscope for signs of cancer. Colonoscopy. A thin, illuminated tube is inserted through the anus and rectum into the colon to look for abnormal areas. Virtual colonoscopy : A procedure that uses a series of X-rays, called a computed tomography, to create a series of pictures of the colon. The computer combines the images to create detailed images that can show polyps and anything else that seems unusual on the inside of the colon. This test is also called colonography or CT colonography. Biopsy : Removing cells or tissues so that a pathologist can examine them under a microscope to check for signs of cancer. 1.4. Diagnosis of metastases The process used to determine if cancer has spread in the colon or to other parts of the body is called staging. The information gathered during the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. During the preparation process, the following tests and procedures can be used: CT (computed tomography) : A procedure in which a series of detailed pictures of areas inside the body, such as the abdomen, pelvis or chest, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to help organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (magnetic resonance imaging) : A procedure that uses a magnet, radio waves, and a computer to create a series of detailed images of areas inside the colon. A substance called gadolinium is given to the patient through a vein. Gadolinium gathers around cancer cells, so they appear brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (MRI). PET scan (positron emission tomography) : a procedure for finding malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into the vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. Cancer cells appear brighter because they are more active and consume more glucose than normal cells. Chest X-ray: An X-ray of the internal organs and bones of the chest. X-rays are a type of energy beam that can pass through the body onto film, creating an image of areas within the body. Surgery : A procedure to remove a tumor and find out how far it has spread in the colon. Lymph node biopsy : Removal of all or part of the lymph node. A pathologist examines the lymph node tissue under a microscope to check for cancerous cells. This can be done during surgery or with a fine-needle aspiration biopsy under endoscopic ultrasound guidance. Complete blood count (CBC) : a procedure in which a blood sample is taken and tested for the following: The number of erythrocytes, leukocytes and platelets. The amount of hemoglobin (oxygen-carrying protein) in red blood cells. The portion of a blood sample made up of red blood cells. Carcinoembryonic Antigen Assay (CEA) : a test that measures the level of CEA in the blood. CEA enters the bloodstream from both cancerous and normal cells. When found in higher than normal amounts, it could be a sign of colon cancer or other conditions. 1.5. The Ides of treatment of patients with colon cancer Various treatments are available for patients with colon cancer. Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment. Patients may want to take part in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. Seven types of standard treatments are used: 1. Operation Surgery (removal of cancer through surgery) is the most common treatment for all stages of colon cancer. A doctor can remove cancer using one of the following types of surgery: Local excision : If cancer is found at a very early stage, the doctor can remove it without cutting the abdominal wall. Instead, the doctor may insert a tube with a cutting instrument through the rectum into the colon and cut out the cancer. This is called a local excision. If cancer is found in a polyp (a small bulging area of tissue), the surgery is called polypectomy. Colon resection with anastomosis : If the tumor is larger, the doctor will perform a partial colectomy (removal of the tumor and a small amount of healthy tissue around it). The doctor may then perform an anastomosis (stitching the healthy portions of the colon together). The doctor will also usually remove the lymph nodes near the colon and examine them under a microscope to determine if they contain cancer. 1.4. 1.5. Colon resection with anastomosis. The portion of the colon containing the cancer and nearby healthy tissue is removed, and then the severed ends of the colon are reattached. Colon resection with colostomy: If the doctor is unable to stitch the two ends of the colon together, a stoma (hole) is made on the outside of the body to allow the waste to pass. This procedure is called a colostomy. A waste collection bag is placed around the stoma. Sometimes a colostomy is only needed until the lower part of the colon heals, and then it can be canceled. However, if the doctor needs to remove the entire lower part of the colon, the colostomy may be permanent. Colon cancer surgery with colostomy. The portion of the colon containing the cancer and nearby healthy tissue is removed, a stoma is created, and a colostomy bag is attached to the stoma. Colon resection with colostomy : If the doctor cannot sew the two ends of the colon together, a stoma (hole) is made on the outside of the body to allow waste to pass through. This procedure is called a colostomy. A waste collection bag is placed around the stoma. Sometimes a colostomy is needed only until the lower part of the colon has healed, and then it can be cancelled. However, if the doctor needs to remove the entire lower colon, the colostomy may be permanent. After the doctor removes any tumors that can be seen during surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer coming back is called adjuvant therapy. 2. Radiofrequency ablation RF ablation is the use of a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in a hospital under general anesthesia. 3. Cryosurgery Cryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy. 4. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is injected directly into the cerebrospinal fluid, organ, or body cavity, such as the abdominal cavity, the drugs primarily target cancer cells in those areas (regional chemotherapy). Chemoembolization from the hepatic artery can be used to treat cancer that has spread to the liver. This includes blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver arteries then deliver the drugs to the liver. Only a small amount of the drug reaches other parts of the body. The blockage can be temporary or permanent, depending on what is being used to block the artery. The liver continues to receive blood from the hepatic portal vein, which carries blood from the stomach and intestines. How chemotherapy is given depends on the type and stage of cancer treatment. 5. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or prevent them from growing. There are two types of radiation therapy: External Beam Therapy uses a device outside the body to direct radiation to an area of the body affected by cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are injected directly into or near the tumor. How radiation therapy is given depends on the type and stage of cancer treatment. External beam radiation therapy is used as a palliative therapy to relieve symptoms and improve quality of life. 6. Targeted therapy Targeted Therapy is a type of treatment that uses drugs or other substances to target and target specific cancer cells. Targeted therapy usually causes less damage to normal cells than chemotherapy or radiation therapy. Types of targeted therapies used in the treatment of colon cancer include the following: Monoclonal antibodies : Monoclonal antibodies are immune system proteins created in a laboratory to treat many diseases, including cancer. As a treatment for cancer, these antibodies can attach to a specific target on cancer cells or other cells that can promote cancer cell growth. The antibodies are then able to kill the cancer cells, block their growth, or stop them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or to carry drugs, toxins, or radioactive materials directly to cancer cells. Species: There are different types of monoclonal antibody therapy: Vascular endothelial growth factor (VEGF) inhibitor therapy: Cancer cells produce a substance called VEGF, which causes new blood vessels to form (angiogenesis) and promotes cancer growth. VEGF inhibitors block VEGF and prevent the formation of new blood vessels. This can kill cancer cells because they need new blood vessels to grow. Bevacizumab and ramucirumab are VEGF inhibitors and angiogenesis inhibitors. Epidermal growth factor receptor (EGFR) inhibitor therapy: EGFRs are proteins found on the surface of certain cells, including cancer cells. Epidermal growth factor attaches to EGFR on the cell surface and causes cells to grow and divide. EGFR inhibitors block the receptor and prevent epidermal growth factor from attaching to the cancer cell. This stops the growth and division of the cancer cell. Cetuximab and panitumumab are EGFR inhibitors. Angiogenesis Inhibitors: Angiogenesis inhibitors stop the growth of new blood vessels needed for tumor growth. Ziv-aflibercept is a vascular endothelial growth factor decoy that blocks an enzyme needed for the growth of new blood vessels in tumors. Regorafenib is used to treat colorectal cancer that has spread to other parts of the body and has not improved with other treatments. It blocks the action of certain proteins, including vascular endothelial growth factor. This can help prevent cancer cells from growing and killing them. It can also prevent the growth of new blood vessels needed for tumor growth. 7. Immunotherapy Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances produced by the body or produced in a laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biological therapy. Immune checkpoint inhibitor therapy is a type of immunotherapy: PD-1 and PD-L1 inhibitor therapy: PD-1 is a protein on the surface of T cells that helps control the body's immune responses. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors prevent the PD-1 and PD-L1 proteins from attaching to each other. This allows T cells to kill cancer cells. Pembrolizumab is one of the PD-1 inhibitors. 1.6. Treatment options by stage Stage 0 treatment (carcinoma in situ) Treatment for stage 0 (carcinoma in situ) may include the following types of surgery: Local excision or simple polypectomy. Resection and anastomosis. This is done when the tumor is too large to be removed by local excision. Treatment of colon cancer stage I Treatment for stage I colon cancer usually includes the following: Resection and anastomosis . Treatment of colon cancer stage II Treatment for stage II colon cancer may include the following: Resection and anastomosis. Treatment for stage III colon cancer Treatment for stage III colon cancer may include the following: Resection and anastomosis followed by chemotherapy. Clinical trials of new chemotherapy regimens after surgery. Treatment of stage IV and recurrent colon cancer Treatment for stage IV and recurrent colon cancer may include the following: Local excision for tumors that recur. Resection with or without anastomosis. Surgery to remove parts of other organs such as the liver, lungs, and ovaries where the cancer may have recurred or spread. Treatment for cancer that has spread to the liver may also include the following: Chemotherapy is given before surgery to shrink the tumor, after surgery, or both before and after. Radiofrequency ablation or cryosurgery for patients who cannot be operated on. Chemoembolization from the hepatic artery. For some patients, radiation therapy or chemotherapy may be offered as palliative therapy to relieve symptoms and improve quality of life. Chemotherapy and/or targeted therapy with monoclonal antibodies or an angiogenesis inhibitor. Immunotherapy. Clinical trials of chemotherapy and/or targeted therapy. 2. What is rectal cancer? Rectal cancer is a disease in which malignant (cancer) cells form in the tissues of the rectum. The rectum is part of the body's digestive system. The digestive system obtains nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps eliminate waste from the body. The digestive system consists of the esophagus, stomach, small intestine, and large intestine. The large intestines (large intestine) are the first part of the large intestine and are about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine and are 6 to 8 inches long. The anal canal ends at the anus (the exit of the large intestine to the outside). 2.1. Factors risk of colorectal cancer Anything that increases the likelihood of a disease is called a risk factor. Having a risk factor does not mean you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk of developing colorectal cancer. Risk factors for colorectal cancer include the following: Having a family history of colon or rectal cancer in the first degree of relationship (parents, sibling, or child). Having a personal history of colon, rectal, or ovarian cancer. Having a personal history of high-risk adenomas (colorectal polyps 1 centimeter or larger, or cells that look abnormal under a microscope). Having inherited changes in certain genes that increase the risk of familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colorectal cancer). A history of chronic ulcerative colitis or Crohn's disease for 8 years or more. Drinking three or more alcoholic drinks per day. Smoking cigarettes. Be African American. Be obese. Old age is a major risk factor for most types of cancer. The chance of getting cancer increases with age. 2.2. Signs of colorectal cancer Signs of rectal cancer include changes in the bowel or blood in the stool. These and other signs and symptoms may be caused by colon cancer or other conditions. Check with your doctor if you have any of the following: Blood (bright red or very dark) in stool. Change in bowel habits. Diarrhea. Constipation. Sensation that the bowels are not emptying completely. The stool is narrower or of a different shape than usual. General abdominal discomfort (frequent gas pains, bloating, feeling of fullness or cramps). Change in appetite. Weight loss for unknown reason. Feeling very tired. 2.3. Tests for diagnostics rectal cancer Tests used to diagnose rectal cancer include the following: Medical examination and medical history : examining the body to check for general signs of health, including checking for signs of disease such as lumps or anything else that seems unusual. An anamnesis of the patient's health habits as well as past illnesses and treatments will also be taken. Digital Rectal Examination (DRE) : examination of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower rectum to feel for lumps or anything else that seems unusual. In women, the vagina can also be examined. Colonoscopy : a procedure for examining the rectum and colon for polyps (small pieces of raised tissue), abnormal areas, or cancer. The colonoscope is a thin, tube-like instrument with light and viewing lenses. It may also have a tool to remove polyps or tissue samples that are checked under a microscope for signs of cancer. Biopsy : removal of cells or tissue so that they can be viewed under a microscope for signs of cancer. Tumor tissue that is removed during a biopsy can be tested to see if the patient has a gene mutation that causes HNPCC. This can help plan treatment. The following tests may be used: Reverse transcription polymerase chain reaction (RT-PCR) test : A laboratory test that measures the amount of a genetic substance called mRNA made by a particular gene. An enzyme called reverse transcriptase is used to convert a specific piece of RNA into a matching piece of DNA that can be amplified (done in large quantities) by another enzyme called DNA polymerase. Amplified DNA copies help determine if a particular mRNA is being created by a genome. RT-PCR can be used to check for the activation of certain genes that may indicate the presence of cancer cells. This test can be used to look for specific changes in a gene or chromosome that can help diagnose cancer. Immunohistochemistry: a laboratory test that uses antibodies to test for specific antigens (markers) in a patient's tissue sample. The antibodies are usually associated with an enzyme or fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated and the antigen can be seen under a microscope. This type of test is used to diagnose cancer and helps distinguish one type of cancer from another. Carcinoembryonic antigen (CEA) analysis: a test that measures the level of CEA in the blood. CEA enters the bloodstream from both cancerous and normal cells. If its amount exceeds normal, it may be a sign of rectal cancer or other diseases. After rectal cancer has been diagnosed, tests are done to find out if the cancer cells have spread in the rectum or to other parts of the body. The process used to determine if cancer has spread to the rectum or to other parts of the body is called staging. The information gathered during the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the preparation process: Chest x-ray : X-ray of the organs and bones inside the chest. An X-ray is a type of energy beam that can pass through the body onto film, creating an image of areas within the body. Colonoscopy : a procedure for examining the rectum and colon for polyps (small pieces of raised tissue). abnormal areas or cancer. The colonoscope is a thin, tube-like instrument with light and viewing lenses. It may also have a tool to remove polyps or tissue samples that are checked under a microscope for signs of cancer. CT (computed tomography) : A procedure that takes a series of detailed pictures of areas inside the body, such as the abdomen, pelvis, or chest, taken from different angles. The pictures were taken by a computer connected to an x-ray machine. The dye may be injected into a vein or swallowed to make organs and tissues more visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography. MRI (magnetic resonance imaging) : A procedure that uses a magnet, radio waves and a computer to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). PET scan (positron emission tomography) : procedure for searching for malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and takes a picture of where glucose is being used in the body. The cells of malignant tumors appear brighter because they are more active and consume more glucose than normal cells. Endorectal Ultrasound : A procedure used to examine the rectum and nearby organs. An ultrasound transducer (transducer) is inserted into the rectum and is used to bounce high energy sound waves (ultrasound) from internal tissues or organs and make echoes. The echo forms a picture of body tissues called a sonogram. A doctor can identify a tumor by looking at a sonogram. This procedure is also called transrectal ultrasound. 2.4. Types of treatment for patients with rectal cancer A variety of treatments are available for patients with rectal cancer. Some treatments are standard (currently used) and some are in clinical trials. A clinical trial of a treatment is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may wish to participate in a clinical trial. Some clinical trials are only open to patients who have not yet started treatment. Six types of standard treatment are used: 1. Operation Surgery - the most common treatment for rectal cancer at all stages. The cancer is removed with one of the following types of surgery: Polypectomy : If cancer is found in a polyp (a small piece of swollen tissue), the polyp is often removed during a colonoscopy. Local excision : If the cancer is found on the inside of the rectum and has not spread to the rectal wall, the cancer and a small amount of surrounding healthy tissue are removed. Resection : if the cancer has spread to the rectal wall, the area of the rectum with cancer and nearby healthy tissue is removed. Sometimes the tissue between the rectum and the abdominal wall is also removed. The lymph nodes near the rectum are removed and checked under a microscope for signs of cancer. Radiofrequency ablation: using a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in a hospital under general anesthesia. Cryosurgery : a treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy. Pelvic exenteration : If the cancer has spread to other organs near the rectum, the lower colon, rectum, and bladder are removed. In women, the cervix, vagina, ovaries, and nearby lymph nodes may be removed. In men, the prostate may be removed. Artificial openings (stoma) are designed to drain urine and stool from the body into a collection bag. After cancer removal surgeon : make an anastomosis (sew healthy parts of the rectum, sew up the rest or make a stoma (hole) from the rectum to the outside of the body to allow waste to pass through. This procedure is done if the cancer is too close to the anus and is called a colostomy. A waste collection bag is placed around the stoma. Sometimes a colostomy is needed only until the rectum has healed, and then it can be cancelled. However, if the entire rectum is removed, the colostomy may be permanent. Radiation therapy and/or chemotherapy may be given before surgery to shrink the tumor, make it easier to remove the cancer, and help with bowel control after surgery. Treatment before surgery is called neoadjuvant therapy. After all cancer that can be seen during surgery is removed, some patients may be given radiation therapy and/or chemotherapy after surgery to kill any remaining cancer cells. Treatment given after surgery to reduce the risk of cancer coming back is called adjuvant therapy. 2. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or prevent them from growing. There are two types of radiation therapy: External Beam Therapy uses a device located outside the body to target cancer with radiation. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are inserted directly into or near the tumor. How radiation therapy is given depends on the type and stage of cancer treatment. External beam radiation therapy is used to treat rectal cancer. Short-term preoperative radiation therapy is used for some types of rectal cancer. This treatment uses smaller and lower doses of radiation than standard treatment, followed by surgery a few days after the last dose. 3. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is given directly to the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs primarily target cancer cells in those areas (regional chemotherapy). Chemoembolization of the hepatic artery is a type of regional chemotherapy that can be used to treat cancer that has spread to the liver. This is done by blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver arteries then carry the drugs to the liver. Only a small amount of the drug reaches other parts of the body. The blockage can be temporary or permanent, depending on what is being used to block the artery. The liver continues to receive blood from the hepatic portal vein, which carries blood from the stomach and intestines. How chemotherapy is given depends on the type and stage of cancer treatment. 4. Active Surveillance Active surveillance closely monitors the patient's condition without giving any treatment unless there is a change in test results. It is used to detect early signs of deterioration. In active surveillance, patients undergo certain examinations and tests to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Tests include the following: Digital rectal examination. MRI. Endoscopy. Sigmoidoscopy. CT scan . Carcinoembryonic antigen (CEA) analysis 5. Targeted Therapy Targeted Therapy is a type of treatment that uses drugs or other substances to target and attack specific cancer cells without harming normal cells. Types of targeted therapies used in the treatment of rectal cancer include the following: Monoclonal antibodies: Monoclonal antibody therapy is a type of targeted therapy that is used to treat rectal cancer. Monoclonal antibody therapy uses antibodies made in a laboratory from a single cell type of the immune system. These antibodies can identify substances on cancer cells or normal substances that can promote cancer cell growth. Antibodies attach to substances and kill cancer cells, block their growth or stop them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or to carry drugs, toxins, or radioactive materials directly to cancer cells. There are different types of monoclonal antibody therapy: Vascular endothelial growth factor (VEGF) inhibitor therapy: Cancer cells produce a substance called VEGF, which causes new blood vessels to form (angiogenesis) and promotes cancer growth. VEGF inhibitors block VEGF and prevent the formation of new blood vessels. This can kill cancer cells because they need new blood vessels to grow. Bevacizumab and ramucirumab are VEGF inhibitors and angiogenesis inhibitors. Epidermal growth factor receptor (EGFR) inhibitor therapy: EGFRs are proteins found on the surface of certain cells, including cancer cells. Epidermal growth factor attaches to EGFR on the cell surface and causes cells to grow and divide. EGFR inhibitors block the receptor and prevent epidermal growth factor from attaching to the cancer cell. This stops the growth and division of the cancer cell. Cetuximab and panitumumab are EGFR inhibitors. Angiogenesis Inhibitors: Angiogenesis inhibitors stop the growth of new blood vessels needed for tumor growth. Ziv-aflibercept is a vascular endothelial growth factor decoy that blocks an enzyme needed for the growth of new blood vessels in tumors. Regorafenib is used to treat colorectal cancer that has spread to other parts of the body and has not improved with other treatments. It blocks the action of certain proteins, including vascular endothelial growth factor. This can help prevent cancer cells from growing and killing them. It can also prevent the growth of new blood vessels needed for tumor growth. 6. Immunotherapy Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances produced by the body or produced in a laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or biological therapy. Immune checkpoint inhibitor therapy is a type of immunotherapy: Immune checkpoint inhibitor therapy: PD-1 is a protein on the surface of T cells that helps control the body's immune responses. When PD-1 attaches to another protein called PDL-1 on a cancer cell, it stops the T cell from killing it. PD-1 inhibitors attach to PDL-1 and allow T cells to kill cancer cells. Pembrolizumab is one of the immune checkpoint inhibitors. 3. Factors affecting prognosis (chance of recovery) and treatment options The prognosis (chance of recovery) and treatment options depend on the following conditions: The stage of the cancer (whether it affects the internal lining of the rectum only, involves the entire rectum, or has spread to lymph nodes, nearby organs, or to other locations in the body). Whether the tumor has spread to or through the intestinal wall. Where cancer is found in the rectum. Whether the intestines are clogged or there is a hole in it. Is it possible to remove the entire tumor surgically. The general health of the patient. Whether the cancer was just diagnosed or recurred (came back). 1.6. 2 2.1. 2.2. 2.3. 2.4. 3 COST OF TREATMENT AND DIAGNOSIS OF RECTAL CANCER IN TURKEY Biopsy for rectal cancer from $ 450 CT (computed tomography) for rectal cancer from $ 50 Immunotherapy with Keytruda (Pembrolizumab) for rectal cancer from $ 3300 Chemotherapy for breast cancer from $ 1200 Cyberknife for rectal cancer from $ 4400 Da Vinci robotic system for rectal cancer from $ 16,000 Removal of polyps of the gastrointestinal tract for rectal cancer on request Intraperitoneal chemotherapy HIPEC for rectal cancer from $ 20,000 Nano Knife for Rectal Cancer from $ 12,000 Rectum resection for rectal cancer from $ 8000 COST OF TREATMENT AND DIAGNOSIS OF COLOR CANCER IN TURKEY Colon cancer biopsy from $ 450 CT (computed tomography) for colon cancer from $ 50 PET-CT for colon cancer from $ 500 Immunotherapy with Keytruda (Pembrolizumab) for colon cancer from $ 3300 Colectomy (colon resection) for colon cancer from $ 8650 Cyber Knife for Colon Cancer from $ 4400 Da Vinci robotic system for colon cancer from $ 16,000 Removal of polyps of the gastrointestinal tract for colon cancer on request Intraperitoneal chemotherapy HIPEC for colon cancer from $ 20,000 Nano Knife for Colon Cancer from $ 12,000 прямой толстой Need help? Doctors-coordinators will advise you and help you with the choice. Services Medikal & Estetik Group are free for you and do not affect the clinic bill. Find a solution Coordinator Medikal & Estetik Group help you find the best solution for cancer treatment CHOOSE CLINIC O Medikal & Estetik Group Second opinion Before traveling, you can get an opinion from a Turkish doctor on your diagnosis and prescribed treatment. For the patient, this is an opportunity to receive advice from the world's best specialists.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. LUNG CANCER TREATMENT IN TURKEY MENU PAGES: 1. What are the benefits of lung cancer treatment in Turkey? 2. How to choose a clinic for the treatment of lung cancer? 3. How to get to a foreign clinic for lung cancer treatment? 4. Which countries are chosen for the treatment of lung cancer? 5. What methods of lung cancer diagnostics are available abroad? 6. How is lung cancer treated in Turkey? 7. What new techniques are used in the world? 8. How is the treatment stage by stage? 9. What influences the prognosis in lung cancer? 10. What affects the cost of treatment? 11. COST OF TREATMENT AND DIAGNOSTICS OF LUNG CANCER IN TURKEY 1. What are the benefits of lung cancer treatment in Turkey? Low-traumatic operations. In leading clinics abroad, surgeons in most cases prefer low-traumatic VATS (video-assisted thoracoscopic surgery) interventions. Unlike the traditional open surgery, which is used in the CIS, VPATS allows you to keep the ribs intact and speed up recovery by 2 times. This is possible due to the low-traumatic access - the doctor performs all actions through 3 punctures up to 1 cm in the intercostal space. New installations for effective and safe radiation therapy. The leading foreign hospitals use the latest generation devices (2013-2018). They are equipped with a 3D imaging system that provides irradiation with an accuracy of 0.5 mm. As a result, the impact on healthy tissue is minimal. For comparison, in the clinics of the CIS, linear accelerators were installed in 2003-2008. The irradiation accuracy with such installations is a few cm. Large selection of drugs for drug therapy. More anticancer drugs are available abroad than in the CIS. For example, if we talk about immunologic drugs, in the world oncological practice more than 70 of them are used, in Ukraine - 12, in Russia - 18. The same situation is with chemotherapy drugs. For example, in Israel there are about 200 registered, in Ukraine and Russia - about 40. This is one of the reasons why the effectiveness of treatment abroad is higher. Here, patients undergo the therapy that is most effective in their case. The catalog contains the best clinics for the treatment of lung cancer abroad. The rating is based on the selection of our patients. Leave a request on the website so that the coordinating doctor of Medikal & Estetik Group will contact you at a convenient time for you. He will answer your questions, tell you about the leading oncologists, and guide you on the cost of the procedures. The coordinating doctor will help with the selection of the best medical center for your case and the organization of treatment. You do not pay for Medikal & Estetik Group services. 2. How to choose a clinic for the treatment of lung cancer? When choosing a clinic for the treatment of lung cancer, you must focus on: The level of qualifications of doctors. Check out their resume. Leading foreign specialists who carry out therapy and surgery of lung tumors have more than 15 years of practical experience. They are trained and trained in top medical institutions in Europe and the United States. Thanks to this, doctors exchange experience with foreign colleagues and improve their skills in treatment. Available techniques. It is important that the doctors of the clinic use not only the traditional treatment of lung cancer (surgery, chemotherapy and radiation therapy), but also the latest techniques that have proven their effectiveness (targeted and immunotherapy). In this case, the patient will undergo the most effective treatment in his case, and not the only one possible within the framework of a particular medical center. The level of technical equipment. For effective and safe treatment of lung cancer, the clinic must have the latest medical equipment. For example, for radiotherapy, it is important to use the 2013-2018 installations. release. They irradiate tumors with an accuracy of 0.5 mm, which minimizes the risk of exposure to surrounding healthy tissue. For comparison, the accuracy of older linear accelerators is a few cm. 3. How to get to a foreign clinic for lung cancer treatment? To undergo lung cancer treatment abroad, leave a request on the Medikal & Estetik Group website. Our specialized coordinator doctor will contact you. He will tell you about the leading clinics, oncologists, and guide you on the cost of the procedures. Together with the coordinating doctor, you will choose the best medical center for your case. He will explain what documents are needed to register at the clinic and ask you for an individual diagnostic and treatment program. If you are satisfied with the program and cost, the coordinating doctor will book a date for you to arrive at the medical center. If necessary, the care department of Medikal & Estetik Group will help with booking tickets and accommodation. Patients do not pay for our services. 4. Which countries are chosen for the treatment of lung cancer? When choosing where to treat lung cancer, patients of Medikal & Estetik Group in most cases prefer the following countries: Germany. In German clinics, the strictest control over the quality of medicine and the level of qualifications of doctors. The departments of clinics that specialize in the treatment of lung tumors are equipped with the latest equipment, and their doctors apply effective methods. This is evidenced by accreditation from the German Cancer Society. Israel. In Israeli clinics, patients are accepted by world-renowned oncologists who are trained and trained in Europe and the United States. The organization of treatment here is faster than in Germany. The difference is due to the fact that the system of work of the international department of Israeli clinics allows you to quickly get a doctor's opinion on medical statements. Turkey. Turkish clinics offer the best value for money. They work according to American and international protocols. Leading clinics are included in the TOP of the most high-tech hospitals in the world from the Top Master's in Healthcare Administration. At the same time, the cost of lung cancer treatment in Turkey is lower than in other countries from this list. 5. What methods of lung cancer diagnostics are available abroad? In more than 50% of cases, a tumor in the lungs is not primary, but secondary (metastasis, which is caused by cancer of another organ, such as the stomach). Therefore, it is necessary to undergo a thorough examination not only of the lungs, but of the whole organism, on the basis of which doctors will make an accurate diagnosis and select the most effective methods of therapy and surgery. Interesting to know: In some foreign clinics, it is possible to choose a treatment using artificial intelligence - IBM Watson. The system, with an accuracy of 96%, determines the effective methods for a specific patient with lung cancer, according to the developer's data. To make decisions, IBM Watson processes 25,000 patient records, 15 million scientific studies, 300 medical journals, 200 textbooks in a few minutes. No oncologist is capable of this. The main methods for diagnosing lung cancer abroad include: Laboratory tests - general and biochemical blood tests, urinalysis. A test for tumor markers - allows you to detect substances in the blood that are characteristic of lung cancer. Sputum cytology to detect cancer cells. Chest X-ray - with its help doctors determine if there is a neoplasm in the lungs. CT of the chest - allows you to establish the size, location of the tumor and its extent to the surrounding tissue. Pleurocentesis (puncture of the pleural cavity) is the collection of fluid from the pleura for analysis, which determines the presence of cancer cells. The procedure takes place through a puncture in the chest wall. Mediastinoscopy is an examination of the tissues of the mediastinum (the area between the two lungs) using an endoscope. Bronchoscopy - allows doctors to visually examine the trachea, bronchi and take a fragment of the tumor for analysis. The procedure is carried out using a special tube with a camera, which doctors insert into the patient through the nose or mouth. Endobronchial ultrasound EBUS is a modern method of bronchoscopy. It additionally allows you to take the tissue of the lymph nodes for analysis. Electromagnetic Navigation Bronchoscop with the SuperDimension Bronchus System is a technique that helps explore even the most difficult-to-reach organ tissues. It is carried out using a special probe. Percutaneous puncture biopsy (transthoracic aspiration biopsy) - sampling of neoplasm tissue for analysis. Doctors resort to the procedure if they have not received material during bronchoscopy / EBUS. In some clinics in Turkey, an innovative biopsy for the diagnosis of lung cancer, which was developed by German scientists, is available - the NEOliquid liquid biopsy (NEOliquid). It passes with the help of a blood test, without puncture of the sternum. The technique allows you to track the reaction of the tumor to different methods of treatment and select the most effective of them. Tumor analyzes (histology, immunohistochemistry, genetic test) - with their help, doctors: distinguish a benign tumor from a malignant one; determine the rate of its growth, the type of lung cancer; select the most effective chemotherapy; identify genetic mutations for which immuno- and targeted therapy is indicated. In some clinics (for example, Souraski and Assuta in Israel, Anadolu in Turkey), a tumor test is available to select the most effective drug for immuno- and targeted therapy - FoundationOne CDx. Scintigraphy (osteoscanning) - allows you to identify metastases (secondary tumors) in the bones. MRI or CT of the head - Magnetic resonance imaging and computed tomography can help detect brain metastases. Positron emission computed tomography (PET-CT) is a full-body scan that doctors use to determine the presence of even the smallest secondary neoplasms - 2-3 mm. 1. Какие преимущества лечения рака легких в Турции? 2. Как выбрать клинику по лечению рака легких? 3. Как попасть в зарубежную клинику на лечение рака легких? 4. Какие страны выбирают для лечения онкологии легких? 5. Какие методы диагностики рака легких доступны за границей? 6. Как лечат рак легких в Турции? 6. How is lung cancer treated in Turkey? To help patients with lung cancer, doctors use the following techniques: 1. Surgical treatment Surgery is the main treatment for lung cancer. Depending on the size, location of the tumor and 10. Что влияет на стоимость лечения? stage of the disease, surgeons carry out the following types of procedures: wedge resection - removal of the neoplasm and a small amount of surrounding healthy tissue; segmentectomy - removal of an organ segment; lobectomy - removal of a lobe of the lung; pneumonectomy - complete removal of an organ. In leading foreign clinics, lung cancer operations are performed using the low-traumatic method VATS (Video-Assisted Thoracoscopic Surgery) - VATS (video-assisted thoracoscopic surgery). It allows you to keep the ribs intact, in contrast to the traditional open intervention, and to speed up the recovery by 2 times. This is possible due to the fact that the surgeon performs all actions through 3 punctures up to 1 cm in the intercostal space. The visibility of the operated area is provided by a special camera. If it is impossible to conduct a minimally invasive operation, the surgeon removes the tumor using the traditional open method through 1 incision in the chest area. 2. Chemotherapy Chemotherapy stops the growth and division of cancer cells with anticancer drugs, which the patient takes with droppers or in pill form. Chemotherapy is given to: reduce the neoplasm before removing it; prevent relapse (return of the disease) by destroying cancer cells that remain after the operation; destroy an inoperable tumor; slow down the progression of the disease and reduce symptoms in the later stages. 3. Radiation therapy (radiotherapy) During radiation therapy, cancer cells are destroyed by exposure to ionizing radiation. For malignant lung tumors, doctors may prescribe radiation therapy: as the main treatment if there are contraindications to surgery or the tumor is not resectable; after surgery to kill cancer cells that have not been removed; to destroy metastases; to reduce symptoms and improve quality of life in the later stages of the disease. For lung oncology, doctors perform radiation therapy with a remote or contact method. Remote irradiation is carried out using a linear accelerator - a special installation that is located at a distance from the patient. Most of the TOP clinics abroad use the TrueBeam STx device for this. According to the manufacturer ( Varian Medical System ), the device irradiates the neoplasm with an accuracy of 1 millimeter, which minimizes the risk of exposure to healthy tissues and ensures high safety of the procedure. Contact radiation therapy is called brachytherapy . Doctors place special radioactive grains (which are 2.5 times smaller than a grain of rice) or needles into the tumor. They irradiate the tumor pointwise without affecting the surrounding healthy tissue. 4. Radiosurgery Radiosurgery is a one-time irradiation of a tumor with a high dose of radiation. To do this, leading clinics abroad use the CyberKnife apparatus, which adapts to the patient's breathing, so the procedure is accurate and safe. 7. What new techniques are used in the world? Innovative treatments for lung cancer include photodynamic therapy, cryosurgery, targeted therapy and immunotherapy. The approach to cancer treatment with immune and targeted drugs is not new, but large research centers are constantly developing and researching drugs, making them more effective and safer. 1. Photodynamic therapy Doctors inject the patient with a photosensitive anticancer drug and activate it with a laser in the area of the tumor. The medicine destroys the vessels that feed the neoplasm, and it dies. The procedure is resorted to only at the initial 0 stage of the disease. 2. Cryosurgery Cryotherapy is the freezing of a tumor with liquid nitrogen. As a result, malignant cells stop multiplying and the neoplasm dies. The technique is shown at stage 0 of the disease. 3. Targeted (targeted) therapy Targeted therapy, unlike chemistry, does not harm healthy tissues, but its use is possible only for tumors with a genetic mutation (EML4-ALK, EGFR, ROS-1, PG-L1). 4. Immunotherapy (biological therapy) If chemotherapy is ineffective, patients with advanced non-small cell lung cancer are prescribed Keytruda's medication by oncologists. It is an immunotherapy drug that helps the body identify cancer cells and destroy them on its own. Other medicines that patients may be prescribed are Nivolumab and Ipilimumab. Scientists are actively exploring vaccines against cancer, monoclonal antibodies and signal transduction inhibitors - promising drugs for small and non-small cell tumors. It's important to know! Today in the world there are more than 7,000 clinical trials for the treatment of lung cancer, including stage 4. They give a chance of recovery to people who are not helped by standard protocol treatment. 8. How is the treatment stage by stage? The treatment program for lung cancer is individual in each case. It depends on the stage of the disease, the location and type of neoplasm, the presence and localization of metastases, the general state of human health. 0 stage Non-small cell lung cancer: Photodynamic therapy, segmentectomy or wedge resection. For hard-to-reach tumors - lobectomy or pneumonectomy. Brachytherapy (sometimes at risk of recurrence) Carcinoid lung cancer: Photodynamic therapy or surgical removal of the tumor. Stage 1 Non-small cell lung cancer: segmentectomy or lobectomy; postoperative radiation, chemotherapy, or targeted therapy to reduce the risk of the disease returning. Small cell lung cancer: surgery to remove the neoplasm and, if necessary, regional lymph nodes chemotherapy and radiation therapy. Carcinoid lung cancer: surgery to remove the tumor. Stage 2 Non-small cell lung cancer: lobectomy or pneumonectomy and removal of lymph nodes; preoperative or postoperative chemotherapy and radiotherapy. Small cell lung cancer: operation; chemotherapy, radiation therapy and, in the presence of mutations, targeted or immunotherapy. Carcinoid lung cancer: surgical intervention. Stage 3 Non-small cell lung cancer: preoperative chemotherapy and radiation therapy; operation; in the presence of genetic mutations - immuno or targeted therapy. Small cell lung cancer: chemo, radiation, immuno and targeted therapy; surgery (if the patient's condition and the size of the tumor allow). Carcinoid lung cancer: chemotherapy, radiation, immuno, targeted therapy; operation. Stage 4 For any type of tumor, palliative therapy is indicated to reduce symptoms. 9. What influences the prognosis in lung cancer? The prognosis for lung cancer is individual in each case. It depends on such factors: size, location and type of tumor; the presence of genetic mutations in the neoplasm; the presence and location of secondary tumors (metastases); age, general condition of the patient and the presence of concomitant diseases. Lung carcinoma develops quickly, so when a tumor is detected, it is important to start treatment as soon as possible so that the prognosis is better. 10. What affects the cost of treatment? The price for lung cancer treatment depends on the following factors: The scope of diagnostics. The more procedures include diagnostics, the higher the final check. Therefore, patients who have already undergone some kind of examination at the place of residence (biopsy, MRI, CT, PET-CT) should take their results with them to the clinic. If they are informative, the doctor will review them and the procedure will not have to be repeated. The more techniques are used by specialists to help a patient, the higher the final cost of treatment. Also, the price depends on the volume of surgery and the number of courses of therapy. Selected country and clinic. The cost of lung cancer treatment in different countries depends on the general price level for medical services. The price of therapy and surgery in different medical centers of the same state differs depending on the type of institution (private / public), the level of service and the class of the ward for hospitalization. Help is needed? Doctors-coordinators will advise you and help you with the choice. Medikal & Estetik Group services are free of charge for you and do not affect your clinic bill. Medikal & Estetik Group coordinator will help find the best solution for lung cancer treatment 7. Какие новые методики применяют в мире? 8. Как проходит лечение по стадиям? Якорь 1 COST OF TREATMENT AND DIAGNOSTICS OF LUNG CANCER IN TURKEY Diagnostics + 1st line of drug therapy from $ 7420 Diagnostics and treatment of lung cancer at the Nordwest Cancer Center from $ 18,113 Extended diagnostics for lung cancer from $ 2849 Extended diagnostics for suspected lung cancer from $ 3502 Lung cancer biopsy from $ 450 CT (computed tomography) for lung cancer from $ 50 PET-CT for lung cancer from $ 500 Brachytherapy for lung cancer on request Immunotherapy with Keytruda (Pembrolizumab) for lung cancer from $ 3300 Chemotherapy for lung cancer from $ 1200 Cyber knife for lung cancer from $ 4400 Cyber knife for lung cancer from $ 6000 Da Vinci robotic system for lung cancer from $ 16,000 Lung cancer immunotherapy on request Lobectomy (removal of a lobe of the lung) for lung cancer from $ 7000 Lung cancer surgery from $ 10,300 Segmental lung resection for lung cancer from $ 11300 СТОИМОСТЬ ЛЕЧЕНИЯ И ДИАГНОСТИКИ РАКА ЛЕГКИХ В ТУРЦИИ

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. No posts published in this language yet Once posts are published, you’ll see them here.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. No posts published in this language yet Once posts are published, you’ll see them here.

Симптомы последней стадии рака Причины появления Лечение рака на последней стадии Помощь пациентам в турецких центрах Турции LATEST STAGE OF CANCER MENU PAGES: 1. Symptoms of the last stage of cancer 2. Reasons for the appearance 3. Treatment of cancer at the last stage 4. Helping patients in Turkish centers in Turkey Oncological diseases are included in the list of the most serious violations of the work and health of the human body. If cancer is detected early, it can be successfully treated. But the later it is possible to diagnose it, the less chances for a full recovery. Unfortunately, the initial stages of the development of the disease are asymptomatic, and when the first signs appear, the patient does not attach particular importance to them due to the non-specificity of the manifestations. In order to detect the problem in a timely manner, you should regularly undergo a comprehensive examination. The fourth stage of cancer is the uncontrolled spread of atypical malignant cells throughout the body that cannot be reversed. The disease is no longer localized in one specific organ, the tumor grows into neighboring tissues, affects the circulatory and lymphatic systems and with their help spreads to distant parts of the body (metastases). In this case, the primary oncological focus can have dimensions within 1 cm or reach large diameters (up to 30 cm). 1. Symptoms of the last stage of cancer The World Cancer Organization has defined the criteria according to which a diagnosis is made. These include: any type of bone cancer; the presence of a malignant tumor of a progressive nature with spread to several organs (pancreas, bone tissue, brain, liver, lungs); aggressive forms of oncology development (multiple myeloma, melanoma, pancreatic cancer, lung damage, etc.); fast-growing neoplasms. The fourth stage has pronounced symptoms. First of all, it is strong pain in the area affected by cancer. Other symptoms depend on the location of the primary focus. With the spread of malignant cells in the intestine, there is a violation of the stool, lungs - shortness of breath, cough, sputum with blood, stomach - indigestion, nausea, vomiting, etc. Also, there are signs of the last stage of cancer, characteristic of all forms of oncology: a sharp loss of body weight; loss of appetite; subfebrile temperature; headache; excessive fatigue and drowsiness; general weakening of the body and immunity; poor exercise tolerance. The life expectancy of a person in the last stage of cancer varies significantly. This is due to the aggressiveness of various types of oncology and the speed of spread. If the lung structures are damaged for more than 5 years, 10% live, the stomach - 15-20%, the pancreas and liver - 5%, this is the worst indicator. It is impossible to completely cure the disease at this stage, but thanks to palliative treatment, you can significantly prolong life and improve well-being. Symptoms depend on the location and rate of penetration into other areas of the body of metastases. When the neoplasm grows into the mediastinum and lymph nodes, problems with swallowing and pronunciation of words are observed, and superior vena cava syndrome appears. The pressure of the tumor on the chest organs has a very negative effect on the general condition of the patient. The symptoms may seem unrelated to the disease. Examples include jaundice, pain in the abdomen, back, frequent fractures, etc. 2. Reasons for the appearance Recently, there has been a steady tendency for patients to seek medical help late in the fight against oncology. Insufficiently strict control of regular examinations and patients' own inattention to their health lead to frequent cases of diagnosing the last stage of cancer. A number of factors can lead to the appearance of cancer. The main ones are: unfavorable ecology; alcohol and smoking abuse; diseases with a violation of the structure of cells; exposure to radiation or ultraviolet rays; the action of carcinogens; hereditary predisposition; old age (the development of cancer in people over 45 occurs most often). 1 2 3. Treatment of cancer at the last stage Even the use of modern medical methods to treat cancer , unfortunately, will not achieve radical results. But it is also wrong to believe that stage four cancer quickly kills a person. Reasonably chosen treatment tactics allow not only to significantly improve living conditions, but also to increase its duration to 5 years or more. First of all, various techniques are used to maintain the vital functions of the body. To do this, use: transfusion of blood and its individual components; intensified treatment through intravenous administration of substances; hemosorption; plasmapheresis. To relieve symptoms, treatment may include assistive surgery, including: drainage and stenting of bile canals; installation of arterial and venous stents for chemotherapy ; for the prevention of thromboembolism, special filtering devices are installed in the inferior vena cava; nephrostatic overlays with kidney damage; venous stenting in the presence of obstruction. Additional palliative care methods: analgesic therapy; individual vaccines against neoplasms; radiofrequency ablation (local effect on the tumor with radio waves); chemo- and radio-embolization; thoracocentesis to reduce the amount of fluid in the lungs; the use of monoclonal antibodies. 4. Helping patients in Turkish centers in Turkey In Turkey, special attention is paid to cancer patients. Comfortable wards, attentive and experienced staff, modern diagnostic methods - all this will help to make your well-being as easy as possible and improve your life. The non-commercial status of some medical centers in Turkey allows keeping prices for the most modern therapy and examination 20-30% lower than in Israel, the USA and European countries. In accordance with individual indications, patients undergo palliative operations, which significantly reduce pain and relieve stress on vital organs. Specially designed cancer vaccines and the targeted use of chemotherapy and radiation therapy are considered effective. In Turkish medical centers, cancer patients are helped to cope with the problem of the last stage of cancer, both in medical and moral aspects. The cost and prognosis of cancer treatment at the last stage are individual in each case: send us an application for calculation through the feedback form. 4 3 Recurrence and metastatic cancer Need help? Doctors-coordinators will advise you and help you with the choice. Services Medikal & Estetik Group are free for you and do not affect the clinic bill. Find a solution Coordinator Medikal & Estetik Group help you find the best solution for cancer treatment CHOOSE CLINIC O Medikal & Estetik Group Second opinion Before traveling, you can get a Turkish doctor's opinion on your diagnosis and treatment prescribed. For the patient, this is an opportunity to receive advice from the world's best specialists.

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. The main thing about genetic tests No posts published in this language yet Once posts are published, you’ll see them here.

Как происходит организация лечения в Турции медицинскими координаторами? В чем заключается их помощь? How it works? Medikal & Estetik Group will organize for you a trip to Turkey for diagnosis, treatment or plastic procedure. You will receive quality medical services, comfort and safety. We accompany our patients from the application on the website until they return home at the end of the treatment. All our services are free. Our services What does it mean to organize a medical trip to Turkey? Получение быстрого ответа из клиник Сравнение предложений разных клиник Бронирование визита к опытному специалисту Защита Ваших интересов Бесплатная поддержка на всех этапах Предоставление актуальной стоимости How do we organize it? ECONOMICAL FLIGHT Our coordinator assists in finding and booking the best air ticket to Turkey. If necessary, we will organize an air evacuation for patients in serious condition. HOTEL RESERVATION We select a hotel or apartment within walking distance from the clinic of interest at the best prices. We help to book a room for you and your companions. TRANSFER TO CLINIC We will arrange a meeting at the airport, as well as a transfer to the clinic immediately after arrival at the airport. Also, a transfer is possible during the period of treatment "clinic-hotel", "hotel-clinic". TRANSLATION OF DOCUMENTS We will translate your medical documents into Turkish. Perhaps before personal and online consultations. LANGUAGE SUPPORT At the clinic, you will be provided with language support to understand doctors and staff during consultations, examinations and treatment. The translator has medical training. VISA SUPPORT If you need long-term treatment, we provide assistance in obtaining a medical visa, advise on the preparation of medical documents as soon as possible. Как мы её организуем? Sign me up! PREPARE FOR YOUR TRAVEL IN ADVANCE In the meantime, there is no need to worry about it. ” Plan your visit to the clinic before you arrive, get an estimate for treatment or an independent second medical opinion completely free of charge. To provide you with up-to-date and detailed information about treatment options, as well as to make a request to the clinic, we need your documentation (medical reports, extracts and epicrisis, test results, MRI, CT, PET CT, passport). In the meantime, there is no need to worry about it. ” Your personal coordinator will provide you with all the comprehensive information from the clinic for treatment to come to Turkey. Name Surname Email Your comments Send message Your message has been sent!

Лучшие хирурги и специалисты не только Турции, но и мира. Лучшие пакетные предложения. Адвокатская защита в судебных органах Турции пациентов, пострадавших от недобросовестных и непрофессиональных хирургов, врачей, медицинских агенств. HIGHLIGHTS ABOUT LEUKEMIA (BLOOD CANCER) TREATMENT IN TURKEY Page menu: STAGES OF LEUKEMIA TREATMENT DIAGNOSTICS OF LEUKEMIA METHODS FOR TREATMENT OF LEUKEMIA IN TURKEY BONE MARROW TRANSPLANTATION IN TURKEY ONE OF THE BEST CLINICS IN TURKEY COST OF TREATMENT LEUKEMIA IN TURKEY Leukemia, a dangerous disease, is difficult to treat. Comparison of survival statistics after treatment in the CIS countries and Turkey: in the CIS countries with leukemia, the 5-year survival rate is only 40-50%. In Turkey, the chances of salvation are above 70%; in hospitals in the CIS countries, acute lymphoblastic leukemia (more common in children) is treatable only 60% of children. In Turkish clinics, 95% of patients under 20 live for more than 5 years. 1. STAGES OF LEUKEMIA TREATMENT The main goal of therapy is to destroy the maximum number of leukemic cells, as well as to achieve a stable remission in the patient. The success of treatment often depends on age: patients from 1 to 10 years old have the most favorable prognosis. preparatory therapy Therapy of lymphoblastic or myeloid leukemia in Turkish clinics involves several stages, carried out with great care, therefore, first, oncologists carry out preparatory treatment. This is a weekly course of chemotherapy in order to assess the body's response to treatment and to plan the intensity of therapy. induction After preparing a safe therapy protocol, a course of intensive chemotherapy is applied for a duration of 5 to 7 weeks. In the process, they try to bring the patient into remission. consolidation therapy The third stage, in order to prevent neuroleukemia and consolidate the state of remission, is prescribed new drugs for chemotherapy or a course of radiation therapy. re-induction To prevent the return of the disease, a 5-week course of intensive chemotherapy is repeated after a couple of months. The last remaining leukemia cells are destroyed, thus ending the main course of treatment for lymphoblastic or myeloid leukemia. transplantation If the course of high-dose chemotherapy has been able to kill almost all of the leukemia cells, and the patient is in remission, a bone marrow transplant can be performed. In the case of the possibility of drug treatment of acute leukemia, doctors try to choose it. supportive therapy After completing an intensive course of chemotherapy, the patient needs to undergo supportive therapy from weak courses of chemotherapy for another two years. This usually does not interfere with daily activities. If 5 years have passed without relapse since the start of therapy, then the patient is considered healthy. 2. DIAGNOSTICS OF LEUKEMIA Symptoms of leukemia may include: weakness; losing weight; fever; bone pain; causeless hemorrhages4 lymphadenitis; spleno- and hepatomegaly; meningeal symptoms; frequent infections. As part of diagnostic studies for leukemia, a general and biochemical blood test, diagnostic puncture of the bone marrow (sternal) and spinal cord (lumbar), trepanobiopsy and biopsy of lymph nodes, radiography, ultrasound, CT and MRI of vital organs are performed. The key in leukemia is the study of bone marrow biopsies (myelogram) and cerebrospinal fluid, including morphological, cytogenetic, cytochemical and immunological analyzes. This makes it possible to clarify the forms and subtypes of leukemia, which is important for choosing a treatment protocol and predicting the disease. Leukemic infiltration of internal organs is established by ultrasound of the lymph nodes, abdominal cavity and small pelvis, chest x-ray, skull, bones and joints, chest CT, MRI of the brain and spinal cord with contrast, echocardiography. With leukemia, consultation with an otolaryngologist, neurologist, urologist, ophthalmologist is indicated. 1 2 3. METHODS OF TREATMENT OF LEUKEMIA Chemotherapy Radiation therapy Bone marrow transplant Chemotherapy is the main treatment for myeloid and lymphoblastic leukemia. The treatment program consists of several courses of varying intensity in order to slow down the growth of leukemic cells and destroy existing ones. Radiation therapy is needed to prevent neuroleukemia. When cancer blood cells penetrate into the brain or spinal cord by radiation, they are destroyed. Treatment is prescribed according to the protocol. In Turkey, the following protocols are used for the treatment of acute lymphoblastic leukemia in children: AIEOP-BFM ALL 2009, COALL-08-09, INTERFANT-06, SCTped 2012 FORUM, EsPhALL and others. Treatment of leukemia requires long-term continuous polychemotherapy, symptomatic therapy, and, if necessary, bone marrow or stem cell transplantation. 4. BONE MARROW TRANSPLANTATION It is very important to find a "quality" donor, this is possible thanks to access to the International Stem Cell Bank. This allows you to select a donor at a compatibility level of more than 90% in 2-3 months. The cost of a bone marrow transplant is the most affordable to carry out the procedure in Turkish clinics, and it is the easiest to get to, plus an interpreter can be provided. The cost of autologous bone marrow transplant in Turkey is from $ 57,000. 5. ONE OF THE BEST CLINICS IN TURKEY MEMORIAL, ISTANBUL / ANTALYA, TURKEY MEDIPOL HOSPITAL, ISTANBUL, TURKEY (90% of bone marrow transplants are successful); KOÇ UNIVERSITY HOSPITAL, ISTANBUL, TURKEY MEDICANA, ISTANBUL, ANKARA, TURKEY (more than 800 bone marrow transplants have been successfully performed. The pediatric oncohematological department was organized for the comfort of the child, the opportunity to study and socialize). MEDISTATE, ISTANBUL, TURKEY (the best equipment for radiotherapy). KENT HASTANESI, IZMIR, TURKEY. All these clinics have passed JСI accreditation, and also comply with the most stringent international standards for the provision of medical services. 6. COST OF LEUKEMIA TREATMENT IN TURKEY Chemotherapy from $ 1,500 Autologous BMT from $ 45,000 Allogeneic BMT from a relative donor from $ 60,000-80,000 BMT from an unrelated donor from $ 80,000-110,000 To organize blood cancer treatment in Turkey, leave a request on the Medikal & Estetik Group website. You will be contacted by a specialized doctor-coordinator who will help you choose the best medical center. Send him your medical records, he will redirect them to the hospital of your choice and request a treatment program. We will help you organize your trip and stay in touch with you throughout your treatment - from the moment you contact us and even after you return home. Medikal & Estetik Group is an independent medical service that does not represent the interests of any of the clinics. Patients do not pay for our services - medical centers do it. Doctors-coordinators will advise you and help you with the choice. Medikal & Estetik Group services are free of charge for you and do not affect the clinic bill. 3 4 5 6

Пластическая хирургия в Турции. Лучшие хирурги. Особенности процедур. Ответы на самые частые вопросы. Стоимость в 2021 году. Фото и видео работ. PLASTIC SURGERY IN TURKEY Price for plastic procedures breast augmentation Breast reduction Breast lift Gynecomastia BBL (butt lift) Liposuction Liposculpture / Lipomodeling Vaser liposuction J Plasma Rhinoplasty Simple rhinoplasty Arm lift Blepharoplasty Eyebrow lift + forehead Face lift Need help? Doctors-coordinators will advise you and help you with the choice. Services Medikal & Estetik Group are free for you and do not affect the clinic bill. Find a solution Coordinator Medikal & Estetik Group will help find the best solution for cancer treatment FIND A CLINIC O Medikal & Estetik Group RHINOPLASTY 1. How many times do I need to come for an examination before nose aesthetics? Before rhinoplasty, you must undergo at least 2 examinations. The first is called a preliminary interview, it is possible to pass it online, the second or third is a final one, it is carried out in person at an in-person appointment with a doctor. The preliminary interview examines the formal or functional problems of your nose and provides general information about the process of the operation. The last interview takes place about a week before the operation, or for visiting patients, the appointment is carried out one day before the scheduled operation. The final interview examines the design patterns (3D modeling) of your nose, and explains in detail the preparation that must be done before and after the operation. 2. How many hours does the operation take, what technique is used and how is the process in Turkish clinics? Depending on the additional procedures or the condition of the nose, this takes on average 2-3 hours. The choice of technique depends on the structure of your nose and existing problems. After the operation, you need to stay in the hospital for 1 night. 3. Is the postoperative process very painful and in how many days can I return to my daily life? Rhinoplasty is a completely painless process in 99% of patients. It is only on the first night after surgery that some patients develop a headache that can be relieved with pain relievers. The patch and tampon are removed 1 week after the operation, and the nose is sealed with protective tape again. The second bandage is removed after 5 days. Usually, most patients can return to their daily routine a week after surgery. 4. Is there a lot of swelling and bruising after the operation? Are you using a piezo or other system? Although almost everyone has swelling in the first 3 days after surgery, it gradually diminishes after the 3rd day and your face returns to normal in 1 week on average. Although bruising is not common in all patients, your skin structure and skin response to injury are very important for bruising. In the same way, bruises completely disappear within 7-10 days. The surgery uses the Piezzo ultrasound system and the Bienair motor system. Hammer and rasp processes have not been used for more than 5 years. 5. Will I have breathing problems after surgery? Although you may have nasal congestion due to crusts and stitches in your nose for 6 months postoperatively, this situation is not permanent. Your preoperative allergic situation will not go away after this surgery. This surgery is not a solution to the problem of nasal congestion during periods of allergy. 6. I live outside of Turkey, what will my surgery be like? Patients arriving from outside Turkey must stay in Turkey for 7-8 days in the postoperative period. The last preoperative examination of these patients is carried out 1-2 days before the operation. 7. How is our control process going and how many times do we need to come for control? On average, we have 3 controls for each patient. Check 1-3 first. Between 6 months the second control is between 6-9 months, the third control is between 12-15 months. This is done between months. 6-9 patients arrive from outside Turkey. Checks are very important. 8. Will my nose be crooked again and will it sag after surgery? Curvatures of the nose are usually divided into 3 types: curvatures in the cartilage structure, curvatures in the bone structure, and cases where curvatures occur in both structures. It should be noted that in the case of a curvature of the nose in the cartilage structure, these curvatures will not improve by 100%, and a curvature of 10-20% may reappear. In the postoperative period, there is some descent (loss of rotation) of each tip of the nose. Therefore, the tip of the nose on the operating table should be raised 5-6 degrees more than the patient needs. However, in some cases (eg, weak cartilage, very thick skin), the tip of the nose may sink more than intended. Patients who may face such a situation are provided with detailed information before the operation. 9. Can rhinoplasty solve my breathing problems? Before surgery, your breathing problems due to a curved middle cartilage (septum) of the nose or due to curvature of the bones can be corrected at the same time as rhinoplasty. However, this surgery is not a solution to your breathing problems caused by allergic rhinitis or the turbinates (nasal passages) that existed before the surgery. 10. When and how can I schedule an examination or operation? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 You will find rhinoplasty works, as well as the best surgeons on our Instagram: рино грудь BREAST ENLARGEMENT 1. What is the difference between breast augmentation and breast lift aesthetics? How do I know which one I need? Breasts sag over time due to many reasons such as age, breastfeeding, pregnancy and genetic factors. When you come for an examination, many are assessed first. parameters such as distance from nipples to collarbones, breast circumference, shoulder width, height and weight, and it is determined which operation you need. 2. How is the operation going? According to the measurements and drawings made before the operation, the operation is planned in 4 directions: 1.the place of the incision; Deciding where the breast implant will be placed, the implant can be placed with a 1.5 cm incision under the breast, an incision from the nipple or an incision under the armpit. The site of the incision takes into account the patient's age, breastfeeding status, keloid predisposition (bad scar) and social life. 2 .. Plan where the implant will be installed; The implant can be installed in approximately 2 planes: axillary or axillary. The axillary plane is now classified as a 1-2-3 double plane. In cases where the patient's chest thickness is moderate to good, an supramuscular plan may be preferred. However, in cases where there is not enough breast tissue, the axillary (double) plan is preferred. In our daily practice, we generally prefer the axillary (dual) plan because it looks more natural and conceals the implant lines better. 3. The shape of the implant; There are 2 main forms of the implant: anatomical (drop) or round. The patient's breast structure, weight, shoulder width, desired breast shape will help us in choosing an implant. During these elections, the doctor asks his patients the following questions: 1) If you no longer want to use a supported bra and want full breasts even without a bra, choose the round implant. 2) If naturalness is paramount for you, if you dream of a slightly lowered breast shape in the nude, choose a drop implant. 4. The size of the implant; The range of implant sizes can be communicated to the patient by calculating many parameters, including chest measurements, shoulder width, waist width, height-weight on a preoperative drawing. For example, a minimum of 250 and a maximum of 350 cubic implants can be installed. After that, examples of results from patients who have previously undergone surgery are shown, and together the size that is closer to the patient's request is determined. 3. Does it hurt badly after surgery, when is it possible to return to daily life? After the operation, you stay in the hospital for 1 night. At the end of the operation, you will be given a new bra and you should not remove your bra for 1 week. Therefore, you cannot take a shower for 1 week. In some patients, drainage is placed. The drain is removed after 24 hours. In 24 hours after the operation, the pain is almost gone, but a serious rest is required for a week. Because during this week, even during light exercise such as standing up and walking, there may be a feeling of pain and tension in the chest. In surgical procedures where an axillary plan is preferred, this pain may be slightly worse. After a week, you can return to all your daily activities except lifting weights. 4. What can be done to reduce pain after surgery? In some eligible patients, intercostal block can be performed under ultrasound after surgery. Thanks to this block, patients can live this week much more comfortably. If the patient rests for 1 week after the operation, the possibility of feeling pain will be low. 5. Will this surgery prevent me from breastfeeding in the future? Will the nipples be numb? Breast augmentation surgery will not prevent you from breastfeeding, this surgery has nothing to do with milk ducts or glands. If the place where the implant will be placed is chosen as the nipple, you may lose 10-20% of the nipple sensitivity, which is very unlikely. Therefore, in everyday practice, surgeons prefer the incision of the lower breast fold to all patients under the age of 40. 6. When after the operation you can play sports, swim and sunbathe? After the first week after surgery, you can start doing light sports, including walking, yoga, and some Pilates exercises. After the first month, you can practice all kinds of sports, swimming and diving. Again, after 1 week, you can sunbathe in a protective bra. 7. Do I need to replace my breast implant in the future? What is capsule formation? Most new generation implants are durable and may need to be replaced for two reasons: firstly, if you want to enlarge or shrink the implant, and secondly, when a capsule forms around the implant. The formation of a capsule is a shell that surrounds the implant and deforms the shape of the implant, which can occur in 1-2 patients per hundred thousand on average 5-10 years after surgery. Numerous scientific studies of the causes of capsule formation have been carried out, some of which can be attributed to the choice of an implant with a rough surface, accumulation of blood in the postoperative field (hematoma), and infection. In this case, remove the implant, clean the capsule and insert a new implant. Capsule formation is a very rare condition and the probability becomes almost zero if every precaution is taken to prevent capsule formation. 8. Is it true that these implants cause breast cancer? Not true. Although lymphoma was observed around the shell of some implants, it was found to be related to the structure of the implant and these implants were discontinued. 9. What brand of implant is used in Turkey? I currently use Mentor and Motiva implants. After explaining the advantages and disadvantages of both of my patients, we make a joint decision with my patient. Both brands offer a lifetime warranty. 10 When can I make an appointment for an operation and examination in the near future? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Breast augmentation jobs, as well as the best surgeons, you will find on our Instagram: BREAST REDUCTION 1. What is breast reduction? Breast reduction is a surgical procedure aimed at reducing large breasts that pose problems both in terms of health and aesthetics. Disproportionately large and heavy breasts can cause a range of problems, ranging from back pain, poor posture, fatigue, diaper rash under the breast, to skeletal deformities. In addition, large breasts give an unaesthetic appearance, make it difficult to choose clothes and, at the same time, lead to a loss of self-confidence, which forces women to resort to breast reduction operations. Breast reduction surgery can be described as a practice that allows women who complain of large volume to feel comfortable in every sense. 2. What is done during the operation? During breast reduction surgery, excess fat and glandular tissue, excess skin, and, if necessary, the enlarged nipple is reduced over time. 3. Breast lift and reduction In some cases, during preliminary studies of patients in our clinic, the form of the disease has changed, which has been changed. For this reason, it is possible to establish which type of operation will be most suitable for the patient only during the examination. Over-sized breasts lose their resistance to gravity over time. Breast reduction surgery improves the patient's quality of life from discomfort. 4. Who can get breast reduction surgery? • Those with disproportionately large breasts • Those with other large volumes have sagging • Those who cannot pick up clothes due to large breasts • Those who experience diaper rash, back pain and poor posture • Those who have large breasts interferes with physical activity • Those who have creases in the back under the bra due to heavy breasts • Those who experience self-confidence due to an unaesthetic appearance • Those who have orthopedic problems such as hand numbness, loss of sensation, poor posture All these problems to the profile of candidates, suitable for breast reduction surgery. Enlarges the breast for one or more of the above reasons, which successfully and effectively solves not only aesthetic problems, but also health problems. 5. How much can breasts be reduced? Planning of the reduction surgery is performed by the procedure of functional patients, and the amount of tissue to be removed, the last amount must be calculated. 6. How is breast reduction surgery performed? The reduction surgery is performed under general anesthesia. During surgery, excess tissue and excess skin is removed from the breast. At the same time, the areola decreases to the corresponding size, increasing over time. Lift is used to solve the biggest problem of large breasts - sagging and then stitches are applied. During breast reduction surgery, the reduction is performed based on the size of the breast. The shape of the stitches can vary depending on the method used, but inverted T stitches are commonly used, which fade over time and do not affect patients with aesthetic problems. 7. How long does the operation take? The reduction surgery is performed under general anesthesia and takes approximately 1 hour. уменьшение груди 8. How many scars will remain after breast reduction surgery? Increase the size of the image. The incision scar in the form of an inverted T, executed vertically under the nipple and extending longitudinally under the mammary gland, fades over time and becomes almost invisible, since the main part of it is located under the breast. Differences in size. Whichever method is used, the scar-scar theme is the one that deserves the most attention. 9. Prerequisites for performing breast reduction surgery Breast reduction surgery planning as an aesthetic look. Breast reduction should be tailored to the size of the breast, the likelihood of future motherhood and breastfeeding. The operation, which lasts approximately 1 hour, is performed with the smallest incisions, is aimed at achieving the sizes agreed before with the patient and ensuring a comfortable recovery process. A quick recovery and a problem-free postoperative period, among other things, have a positive effect on the patient's psyche. Despite the likelihood of re-growth of breast tissue as a result of weight gain. Moreover, after breast reduction surgery is not an obstacle to breastfeeding. The operation is directed to remove excess fatty tissue, not the mammary glands. During breast reduction surgery. The preservation of the former sensitivity is associated with these diseases removed from this area. Nipple sensitivity is essential for breastfeeding and channel stimulation. In addition, it is imperative to create symmetry between the mammary glands and nipples. moving the nipple to the desired area is performed with the obligatory consideration of sensitivity. 10. After aesthetic breast reduction surgery Temporal sizes, symmetry and degree of sagging breasts in women are different, the methods used will also differ. However, in Turkish clinics, first of all, we provide the most comfortable period due to the minimum number of scars. Individual breast surgery is one of the most successful practices in our partners' clinics. On average, within a few weeks, the scar marks begin to wear off. Immediately after the operation, patients feel relief; reducing the reduction of pain in the lower back and back, and even their complete disappearance, as well as solving other health problems. Patients receive aesthetic, beautifully shaped breasts. 11. Can the breasts grow back? The regrowth of breast tissue can be associated with a set of previous sizes. Women emphasize the fact that after the reduction surgery, they became happier, both in personal and social life. 12. Will I be able to breastfeed after surgery? You will be able to breastfeed after breast reduction surgery, however this is due to the removed mammary glands. If you are planning a pregnancy, please discuss it in advance. 13 . When can I make an appointment for an operation and examination in the near future? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Breast reduction jobs, as well as the best surgeons, can be found on our Instagram: Липоскульптура LIPOSCULTURE Liposculpture, i.e. painless liposuction is an operation to correct the body contour, which is constantly used with the help of liposuction, which technically differs from it in the methods used. Liposculpture, which most people take for a method of losing weight, only provides correction of problem areas. Liposuction means suction of fat, and liposculpture, by its definition, is about correcting the contour of the fatty tissue and creating an aesthetic shape. The first stage of liposculpture is the removal of vacuum in the back, waist, abdomen, on the back of the upper leg, on the thighs, above the knees, under the jaw and in other body parameters, and ends with the correction of the body shape. Liposculpture can be performed during breast augmentation and reduction surgery, tummy tuck or similar plastic surgeries. Liposculpture is not a treatment for obesity. If you want to take advantage of genetic procedures, then you should take advantage of these procedures. 1. Am I suitable for liposculpture? As with all other plastic surgeries, the decision to undergo liposurgery is not made for the satisfaction of others, but for oneself. If you have fat deposits in some of your body's indicators. 2. Prices for liposculpture Liposculpture prices fluctuate a lot. But at the same time, there are more important aspects than the prices for liposculpture, namely the experience of the surgeon and the equipment of the clinic where the operation will be performed. Therefore, when choosing a clinic or a surgeon for liposculpture. 3. How is the examination for liposculpture performed? When contacting the clinics, the doctor first conducts an examination, then the medical photographer takes photographs before the operation. During the examination, you can share your medications, drug allergies and all other information. In the light of the information received, the doctor will make a complete assessment of your operation. After the examination, they share with you full information about what you need to do before the operation. During the first examination, you need to explain your wishes to the doctor in detail. In addition, you would like to share information with your doctor about the ideal weight you would like to achieve and about your plans for the future, for example, the desire to have children. Preoperative conversation with the patient for liposculpture. That is why, in this situation, the exchange of a patient with a doctor is extremely useful. In addition, the doctor will give you answers to your questions regarding liposculpture and the method used. For medical records, your images are taken and the size of the area where the liposculpture will be performed is taken. Check with your doctor about the risks or complications of surgery. 4. How is liposculpture performed? General anesthesia is performed before the operation. At the end of liposculpture, the patient, with the permission of the doctor, can go home and take a bath in a day. Liposculpture used in our clinics is carried out according to a reliable approved medical method that is used in renowned world centers. The benefits of liposculpture eliminate many of the negative side effects. High vibration removes large amounts of fat in one session and minimizes postoperative pain. Liposculpture is a stable deposit using a balloon and a vacuum device and body reshaping. When using the Tumescent method, local anesthesia is applied to the area of fatty deposits on which liposculpture is used, followed by a saline water solution. This method can reduce blue discoloration and swelling after liposculpture. 5. Process after liposculpture Swelling after liposculpture completely disappears in a few weeks. Every day your body harmoniously merges with the new contour and gradually takes shape. Permanent form of life. The most important thing is to exclude weight fluctuations, engage in vigorous exercise and lifestyle. After you are discharged home, we recommend that you leave the hospital after receiving information on the necessary procedures. 6. Return to normal life after liposculpture Liposculpture gave extremely positive reviews. The wound healing time lasts from 5 to 10 days. After 1 week after surgery, the swelling begins to subside. You can return to your normal life by using cosmetics. In addition to this, a healthy lifestyle contributes to the preservation of the results of the procedures. 7. What is the difference between liposculpture and liposuction? Liposculpture is different from the liposuction technique. Liposculpture, i.e. painless liposuction is an operation to correct the body contour, which is constantly used with the help of liposuction, which technically differs from it in the methods used. Liposculpture uses microcannulas. The plastic surgeon first has small centimeter incisions in places near the problem area where liposculpture will be performed, then thin cannulas are inserted into the incisions made. These cannulas are much thinner than the cannulas used in liposuction, and as a result, the surgeon gains more control over the fat cells. In our partner clinics, NIL (Nutritional Infrasound Liposculpture), approved by the Food and Drug Administration (FDA), is performed as an equipment for correcting surgeries and body fat. NIL (Nutational Infrasonic Liposculpture) is known as Tickle Lipo. With this technique, fat is removed simultaneously. As a result of this method, the healing process is formed and is shortened. 8. Why is liposculpture called painless liposuction? When performing all these actions, such disadvantages as damage to blood vessels and nerves or muscle rupture, which is observed with liposuction, are excluded. The high vibration and function ensures optimal shock while keeping the skin smooth and bruising. Thanks to the structure of the cannulas, it is possible to accurately remove adipose tissue from hard-to-reach areas. For this reason, liposculpture is painless. 9. Advantages of liposculpture: • Active safety system that instantly stops the process in the absence of • adipose tissue in the treated area • Less traumatic bruising and swelling • Excellent response and smooth skin • A more gentle system for the patient and less tiring for the surgeon • Short duration of the procedure • Even less pain • Faster recovery 10. When can I make an appointment for an operation and examination in the near future? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 You will find liposculpture works and the best surgeons on our Instagram подтяжка груди Breast lift Breast lift surgery (mastopexy) is a plastic surgery that aims to restore the correct proportions and shape of the breasts. Partial pull from the chest. In addition, sagging breasts can be delayed at a young age. Sagging breasts make it impossible to wear the desired outfits and in most cases leads to a loss of self-confidence in women. Violation of the shape of the breast, which is an integral aesthetic decollete, manifests itself not only in sagging breasts, but also in the expansion of the areola, which we call the nipple, under the influence of hormonal decollete. A sagging breast also damages the skin structure under the breast and friction causes skin problems. Breast lift surgeries are generally recommended after the end of the breast period in order to avoid re-breaking the shape of the breast. In addition, in most cases, a breast lift is performed using a breast kit. In fact, it has shrunk in size, and the skin covering it has not been able to adapt to the change in size. With the help of a breast lift operation, the excess skin thus formed can be removed. Breast lift alone will not add volume to the breast. Those. In such a situation, the operation is insufficient; another plastic operation is used to improve the appearance. To increase the size, use lipofilling or silicone implant, i.e. breast augmentation surgery. 1. Who can undergo a breast lift? • Suffering breast problems after lactation • Those suffering from delayed breast development • Suffering from sagging breasts due to frequent weight and weight loss • Sagging breasts under this set of age and gravity • Suffering from a widening of the halo, i.e. breast nipple • Lost self-confidence due to sagging breasts • Desired outfits that have lost the ability due to sagging breasts Diagonal disease is reported. Modern and innovative methods used in clinics in Turkey provide candidates for breast lift surgery with a comfortable healing process and the acquisition of the desired breast shape. 2. Why are there problems with the nipple? Can you correct it? Loss of breast shape is not only a cause of sagging. At the end of this process, many women experience an enlargement of the area around the nipple of the breast, i.e. in a halo. Lift surgery corrects the shape of the breast and reduces the halo. 3. Will my breasts shrink after the operation? A breast lift does not change the size of the breast, it corrects the shape, eliminates sagging and tightens the breast. 4. Is it possible to use implants within one operation? Yes. If you want to increase the size of the operation, the enlargement operation is performed. 5. Is it possible to reduce the breast during the operation? Yes. If you want to reduce your breast size, breast reduction surgery is performed. 6. How is breast lift surgery performed? Breast lift surgery is in most cases synchronous with breast augmentation or reduction operations. During the preliminary examination, the issue of inserting the implant, the introduction of fat, i.e. lipofilling or simply performing a breast lift surgery depending on what the patient expects from the surgery. The condition of the breast tissue and excess skin is analyzed and an operation plan is drawn up. Breast lift surgery performed under general anesthesia begins with a reduction in the halo, if present. During the operation, an incision is made according to the method of a vertical central incision without a scar. The leather and the underlying tissue are then processed separately. Considering the future potential of breastfeeding, the breast tissue is leveled, tightened and the breast shaped. In this case, you should pay attention to the fact that there are no changes in the size of the breast during the breast lift operation. The operation only allows the breast to return to its shape and tighten it, the breast is lifted and the operation is completed. Lift surgery involves resizing surgery. For this purpose, the breast is enlarged with breast or lipofilling. 7. How long does the operation take? After the lifting operation, which lasts on average about 1-3 hours, the patient is not hospitalized, but if necessary, he can be left in the hospital for one night. 8. How many marks are left during the lifting operation? In the structure of Turkish clinics, methods are preferred that ensure the formation of the most natural and minimal scar in our patients during breast lift operations. As mentioned earlier, a vertical, scarless central incision is used in Turkey. This technique is innovative, which ensures that the surgery is completed with the most optimal postoperative trace. Thanks to this technique, tissue and skin are treated and treated separately and without potential stress on the skin. Thanks to this method, in which, in addition to the aesthetic appearance, attention is paid to the elements of health during the breast lift, it also provides such advantages as nourishing the entire structure through blood circulation, eliminating problems with the sensitivity of the nipple of the breast. In addition, the vertical central central patient method is able to return home. Integral elements of a breast lift operation During a breast lift operation, the degree of sagging of the breast, its plan, skin elasticity, its quality and existing excess skin are analyzed without fail, on the basis of which the operation is compiled. The incision on the chest is modeled in accordance with the analysis of the indicated indicators, the shape of the tissue is corrected and the chest is tightened. Excess skin is removed and sutures are applied. Sutures are applied according to the newly created shape. All incisions are closed with minimal suture or dermatological glue. Process after breast lift surgery Used innovative technique used in breast lift surgery. As a rule, our patients, who went home on the same day, underwent surgery, without hospitalization, for no more than 1 week. 9. When can I make an appointment for an operation and examination in the near future? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Breast lift jobs as well as top surgeons you will find on our Instagram: VASER LIPOSUCTION 1. What is liposuction? Liposuction is the process of removing subcutaneous fat from the abdomen, thighs, jaw, back, waist, inner legs, and back using a variety of devices. 2.How many kilograms of fat can be removed at one time? With liposuction, it is safe to take a maximum of 8000 cc at a time. See fat. If this number is exceeded, life-threatening complications can occur. It should be emphasized that liposuction is not a weight loss surgery, but a body shaping surgery. Therefore, it is not suitable for every patient. 3. What kind of patient is liposuction suitable for? Liposuction is ideal for patients who are not overweight or obese, have excess fat in certain areas (such as the waist circumference) and do not have excess and loose skin. With the help of liposuction, they try to bring the body into a certain shape; this method is not used for weight loss. 4. Will there be loose skin in the areas of fat removal after liposuction? This is a very important and frequently asked question. Therefore, patient selection is very important. If this method is applied to overweight and obese patients, of course, sagging skin will occur. The second important point is that some devices are used in surgery to prevent sagging that can occur on the skin. Vaser and J-Plasma are the two devices we most often use to prevent sagging skin. 5. What exactly do Vaser and J-Plasma do? This is how we explain it to our patients. When you wear an XL dress, imagine that you have lost a lot of weight and have dropped to size S, and visualize how the dress will look on you when you try to wear the same dress again. The dress will seem too loose and even wrinkled to you. This is exactly what happens with liposuction: the fat is drained, but your skin is the same width. Now take this XL dress and wash it in very hot water, you will see the dress shrink. Here is a vaser and plasma; By interacting with the layers of collagen and dermis in the skin, they cause the skin to shrink and tighten. Unfortunately, liposuction surgery in which at least one of these two devices is no longer used can be frustrating. 6. Is it possible to stretch the abdominal muscles (six / four) with liposuction? Yes, we can paint the abdomen of suitable patients in the style we want, we can make some of the muscle structures more prominent. 7. What should I pay attention to after the operation and in how many days will I be able to return to my daily life? The operation must be performed under general anesthesia and in a full-fledged hospital; after the operation, you usually need to stay in the hospital for 1 night. Drainages in patients who have drainage are removed within 2-3 days. At the end of the operation, a corset is made to the patient. And we recommend using this corset for 1.5 months. After 5 days, you can take a shower. Starting from 5 days, our nutritionist prepares a special dietary recipe for them. We recommend rest for the first 5-7 days. After a week, you can start light exercises. After 2-3 weeks, you can do all kinds of sports. 8. How soon can I make an appointment? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Works on Vaser liposuction, as well as the best surgeons, you will find on our Instagram vaser Gynecomastia Gynecomastia is an uncontrolled increase in breast tissue in men, and surgery to eliminate it is called gynecomastic surgery. This type of adipose tissue deposition, inherent in women and unusual for the anatomy of men, leads to problems in intimate relationships and a loss of self-confidence in the social environment. As a result of this problem, which occurs in both overweight and thin men, patients who come to our clinic complain that they cannot swim in the sea, are embarrassed to undress and cannot even dress as they would like. Enlarged breasts in a man can put him in an extremely stressful and humiliating position. The number of males who avoid intimate relationships in order to hide the problem of gynecomastia, and become the subject of ridicule during adolescence, as a result of which they receive psychological trauma, is enormous. Nowadays, it is possible to solve the problem of gynecomastia in every fifth man with the help of a simple procedure. At the same time, if you think about the fact that your age and hormones "change" you, then you should not be upset. If you think you are upset and depressed due to gynecomastia, in addition to the gynecomastia surgery, we strongly recommend that you do not delay with the treatment plan. 1. What is the reason for the enlargement of the mammary gland in men? The problem of gynecomastia ranks among the aesthetic problems of our time. Most of this growth in breast tissue is rooted in unhealthy diets, uncontrolled use of supplements in the food industry, and associated hormonal changes. In addition to this, in addition to this immobile lifestyle, the growth of the mammary gland is also promoted. The second factor that causes the growth of the mammary gland in men is drugs that the patient is forced to take due to health problems. Other causes of gynecomastia include alcohol and drug use, hypogonadism, aging, tumors, hyperthyroidism, renal and hepatic failure, malnutrition that disrupts hormonal balance. The risk of gynecomastia is increased, especially in adolescence or over the age of 60, when using dietary supplements to enhance athletic performance that contain steroids or androgens, and in certain chronic conditions. 2. Is it possible to prevent breast enlargement in men? If breast tissue grows, exercise and diet will not be beneficial. The deposition of fat in this area in most cases has the character of a persistent and difficult to remove formation. However, exercise and a healthy diet should be considered to protect against gynecomastia and ensure hormonal balance. To protect against this problem, which has a huge impact on men psychologically and emotionally, you can turn to surgical treatment of gynecomastia. Gynecomastic surgery without incision is an extremely comfortable procedure for enlarged mammary glands. 3. How is gynecomastic surgery performed? Before gynecomastic surgery, the doctor conducts a physical examination, analyzes the current state of the breast tissue. The size of the developed breast tissue and the tissue itself are carefully examined. Check for any nipple discharge or other symptoms. Then the presence of a real problem of gynecomastia and false gynecomastia is revealed, a dividing line is drawn between them. Sometimes tests may be needed to evaluate the tissue. The size and presence or absence of the nodular structure of fatty relations are specified. In addition, the presence of one of the diseases is analyzed: chronic liver disease, thyroid disease, or kidney disease. In the structure of Turkish clinics, operations are performed to treat gynecomastia without an incision, with minimal swelling and blue discoloration. After examining the causes of breast growth, which is done first, other conditions that can cause similar symptoms and genicomastia are considered. For example, some men and boys have masses in the mammary gland that resemble but do not resemble gynecomastia. This growth of the mammary gland, which develops in connection with development in adolescence, stops within 1-3 years. Breast cancer in men is rare, but at the same time, the likelihood of its occurrence exists and it usually appears in one breast. In addition, during the examination, the presence of an infection in the breast tissue, the so-called inflammation of the breast (mastitis), is checked. Patients who do not have these problems are candidates for surgery to treat gynecomastia. If the decision is made to perform an operation to treat gynecomastia without an incision, an extremely practical and comfortable procedure is performed. In parallel with the development of technology, instead of removing adipose tissue in the mammary gland, as was done previously, this procedure is performed in extremely comfortable conditions through micro-holes. Earlier, after the operation, the patient's return to social life took quite a long time, and the formation in the breast tissue caused damage to the vessels and cells. Gynecological surgery without incision is performed under local anesthesia and allows you to extract the adipose tissue through pinholes. The operation is practical and does not violate the internal characteristics and structure of the mammary gland. 4. What is non-incision gynecomastia surgery? This method, which allows you to solve the problem with the fatty tissue in the mammary gland and remove it through the micro-holes, does not affect the nerves and blood vessels. Due to this, complications such as blue discoloration and swelling, which are observed in classical gynecomastic operations, do not occur, and the patient returns to social life. This method, which can significantly shorten the length of the recovery period and make it extremely comfortable, has fallen into preference for many men. Advantages of Gynecomastic Surgery without Incision: • Execution under local or general anesthesia • Short duration of the procedure • Performing the procedure using micro-holes without incision • Instant return to social life after surgery • No damage to nerves and blood vessels • Minimal level of swelling, blue discoloration and pain • Maximum patient comfort Some of our recommendations for protecting against the risk of gynecomastia and reducing the risk of developing it are: • Try to eat a healthy diet • Avoid excessive drinking • Do not use drugs • Use supplements (such as steroids and androgens) used for bodybuilding only under the supervision of a sports nutritionist. Check the drugs you are using. If you are taking a medication that causes gynecomastia, be sure to talk to your doctor about this. 5. Am I eligible for surgery? Before deciding on gynecomastic surgery, you should ask yourself the question: Do the size of breast tissue cause me physical and psychological discomfort? If the answer to this question is yes, you can ask for a solution to the problem. 6. At what age is this operation performed? We generally recommend that you wait until your 18th birthday. Hormonal surges that occur in adolescence, over the course of several years, correct themselves, which actually happens with an increase in the mammary gland. 7. How to choose a doctor? The most important aspect in choosing such a doctor is his experience in performing such an individual procedure. In addition, communication with the office staff and your doctor is essential. Receiving comprehensive and convincing answers to all questions will help you achieve harmony in communication with the surgeon and office staff before the operation and is extremely important for the successful result of such an operation. 8. What results can be expected after the operation? In light of the upcoming results, you should discuss this issue before surgery and set absolutely realistic expectations for yourself. Our experienced surgeons will help you in this matter and inform you about the result of the procedure. 9. When can I return to social life? In our clinics, gynecomastic surgeries are performed without an incision. Therefore, you will be able to return to social life 1 day after surgery. 10. Do any traces remain after the operation? The operation is performed without an incision in the chest area, and the removal of adipose tissue is performed through thin microcannulas, after which pinpoint marks may remain. 11. What type of anesthesia is used during the operation? The decision on the type of anesthesia is made according to the patient's medical condition and tolerance. The operation can be performed under local or general anesthesia. 12. Do I need to prepare before surgery? You will be given detailed instructions before the operation. In addition, you are informed about medications and herbal supplements that should not be consumed. Instead of clothing that is tight or tight in the chest area, it is preferable to wear loose clothing with a front closure with buttons. 13. When can I make an appointment for an operation and examination in the near future? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 You will find works on gynecomastia, as well as the best surgeons on our Instagram Гинекомастия J plasma J PLASMA Renuvion is a non-surgical skin tightening procedure. Also known as J Plasma or J Plasty, this procedure lifts and refreshes loose skin without the need for invasive surgery, prolonged downtime, or large surgical scars. This precise repair is unique because plastic surgeons can apply controlled heat to specific areas to tighten the skin. 1. How is RENUVION going? For the Renuvion procedure, the specialist creates a small entry point by placing the device directly under the skin. Once the device is installed, the technician releases helium gas and radio frequency (RF) to create a precise flow of energy (plasma). This energy generates enough heat to compress the skin, while excess helium gas cools the treated area. This combination of energy compresses the tissues just under the skin, which tightens it. 2. When is RENUVION J-PLASMA used? Renuvion can be used to tighten skin almost anywhere on the body. Common areas include: Arm lift Tightening the skin of the abdomen and sides Breast lift Buttock lift Thigh lift Lift of the lower face and neck Tightening the skin of the legs, especially the area above the knees 3. Who is this procedure suitable for? Renuvion is a treatment option for patients who want skin tightening results but do not want to undergo invasive plastic surgery. No other minimally invasive technology will tighten the skin to the same degree as J-PLASMA, which also has the following advantages: tiny cut, little or no scarring, and minimum recovery time. 4. How soon can I make an appointment? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 You will find works on J-PLASMA, as well as the best surgeons on our Instagram ARM LIFT / BRACHIOPLASTY (ArmLift) Upper arm lift surgery is a plastic surgery performed on the sagging and flabby skin of the upper arm, which occurs in parallel with aging and weight loss. You can strengthen the muscles of the upper arm without surgery, through exercise, but this will not help you regain elasticity and get rid of excess fat and even excess skin. In addition, the upper arm lift, the so-called Arm fit, is known in the medical literature as brachioplasty. To create a more proportional look by reducing body fat during upper arm lift surgery, the shape of the excess skin in the area between the elbow and armpits is corrected. When performing more extensive operations, a longitudinal incision mark remains on the dorsum of the upper arm. Lift surgery rejuvenates the upper arm and looks toned, and the patient's self-confidence is increased, which allows him to freely wear short-sleeved clothing. 1. Am I eligible for an upper arm lift? If you have sagging skin in the upper arm due to a lot of weight loss, if the skin in the upper arm has become loose, if there is more fat in the upper arm than in the lower arm, if the shape of the skin is not restored despite exercise, then you can refer to upper arm lift surgery. 2. How is the upper arm lift performed? Upper arm lift surgery first removes sagging, removes fat, excess skin and subcutaneous tissue in the inner area, and ends with reshaping and giving the upper arm a natural and rejuvenated look. Liposculpture is sometimes used as an adjunct during upper arm lift surgery. Medicines are used to ensure your comfort during the surgical procedure. Having chosen the option that is best for you, the doctor proceeds to the operation after performing general anesthesia or intravenous sedation. The length and shape of the incision in the upper arm depends on the amount of skin to be removed. Incisions are made on the back or back of the upper arm at the discretion of the surgeon and only in the elbow aisles and up to the lower arm. After the incision, liposuction is performed to remove fatty deposits or lipofilling. After adjusting the shape of the muscles in the upper arm and adipose tissue, the surgeon proceeds to close the incision. Upper arm lift incisions are sutured with absorbable or removable suture material. 3. Process after arm lift surgery After the upper arm lift surgery, you will have a fairly comfortable process. Swelling and blue discoloration in the upper arms and a very slight sensation of numbness in this area lasts about 2 weeks. After you are discharged home, we recommend that you leave the hospital after receiving information on the necessary procedures. 4. Return to normal life after upper arm lift surgery Upper arm lift surgeries have received overwhelmingly positive reviews. The healing time of the first wound lasts from 5 to 10 days. 2 weeks after the operation, the swelling disappears and the incision lines begin to become faded. The patient at this time can return to normal life, and within 2 months after the operation, it is necessary to refrain from heavy sports. You can maintain a rejuvenated look throughout your life with exercise and weight control. In addition to this, a healthy lifestyle contributes to the preservation of the results of the procedure. 5. What to choose between liposuction and an arm lift? The decision on the type of operation can be made after examination. In order to perform liposuction alone, you need sufficient skin and tissue in the upper arm. Patients who have lost a lot of weight usually suffer from excess skin, which is more than necessary for the incision when the upper arm is lifted. If you suffer from sagging skin, then liposuction is not for you. 6. The recovery process After surgery, your arm will remain bandaged for several days. Thereafter, tightening clothing should be worn for 2 weeks. This will help tighten the skin around the perimeter. In addition, tightening clothing has a beneficial effect on wounds as they heal. 7. When is it possible to return to exercise? It takes about 1-2 weeks to engage in daily activities, and about 4-6 weeks to continue playing sports. 8. How painful is the procedure? Many patients report good pain tolerance. Most of the patients refer to a reasonably good condition a few days after the operation. 9. What anesthesia is used? The operation is usually performed under general anesthesia in the operating room. In addition, a preparation for local anesthesia is additionally injected into the operated area. 10. Where is the incision made? Location of the incision is determined depending on the amount of tissue removed and the place of its removal, or the back of the upper part or the lower part of the arm. The traditional vertical cut extends from the armpits to the elbow. If the excess tissue is limited to the top of the shoulder, a short crescent-shaped incision can be made in the armpit area. 11. How long does it take for the suture to heal? The healing of the first suture takes about two weeks. The surgeon will then give you various guidelines to help you minimize the visibility of your incision. 12. How long does the operation take? The total duration of the operation is about 2 hours. 13. How soon can I make an appointment? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Hand-LIFTING jobs, as well as the best surgeons, you will find on our Instagram подтяжка рук SIMPLE RHINOPLASTY 1. What is Simple Rhinoplasty? Simple rhinoplasty, also called no-scalpel rhinoplasty, is a surgery performed without a scalpel. Simple rhinoplasty, which allowed us to achieve the most effective results in the framework of non-surgical plastic surgery, gives the nose, located in the central line of the face, a shape that harmoniously fits the overall contour. 2. Why Simple Rhinoplasty? Rhinoplasty occupies the main place among the aesthetic operations that cause fear in most patients and to which they approach with some distrust due to the trauma that occurs in the postoperative process. In addition, among other factors that cause mistrust, it should be noted the length of the recovery process after rhinoplasty, the patient's separation from social life, the use of a tampon and a questionable approach to plaster. Many people with nose problems who, for aesthetic reasons, do not like their nose, postpone rhinoplasty precisely for the reasons we have listed above. That is why a simple rhinoplasty appeared, which, due to its structure, eliminates the possible problems that we listed earlier and gives our patients maximum comfort without using plaster and tampons. 3. Who can perform simple rhinoplasty? The aim of simple rhinoplasty is to lift the tip of the nose, which has dropped with age or which is congenital, in those patients who do not want to radically change the shape of the nose. With simple rhinoplasty, the tip of the nose is lifted without affecting most of the skin and the bridge of the nose, and if necessary, slight filing can be performed. 4. Application of simple rhinoplasty Simple rhinoplasty, which has a number of advantages over classical rhinoplasty, provides the patient with maximum comfort during the recovery process. Simple rhinoplasty does not use a tampon, cast, or bandage. Simple rhinoplasty is performed under local anesthesia and is completed on average within 15-20 minutes. Before performing a simple rhinoplasty, a profile and front view of the patient is taken from the patient. The picture can be taken before contacting our clinic and sent to us via our website in digital form. Our specialist doctors create the required model and develop the latest version of your nose in 3 different alternatives. Simple rhinoplasty, if desired, can be performed under local anesthesia while the patient is awake, or other anesthetic techniques can be used. The problematic tip of the nose rises, and for minor problems with the bridge of the nose, filing is performed. Simple rhinoplasty, if desired, can be performed in combination with different operations, again one of the methods of non-surgical plastic. Since the face is one whole and only a general look at the face will allow you to correct each problem area and achieve the required goal. Within about 15-20 minutes, thanks to a simple procedure, you get the nose that you have dreamed of for years. 5. The period after simple rhinoplasty The patient returns to social life in a fairly short time. With simple rhinoplasty, pain, swelling and blue discoloration are almost invisible or minimal. The benefits of simple rhinoplasty, which provide the patient with a fairly comfortable recovery period, are most evident during this period. 6. Benefits of Simple Rhinoplasty: • Procedure without the use of plaster, swab and scalpel • No incision, micropoint procedure • Application of local anesthesia • Sufficiently short recovery time • Instant return to social life • Simple, risk-free procedure • Alternative surgery for those who are afraid of classical rhinoplasty • Simulation in a digital environment of the patient's view after surgery and demonstration to the patient • Completion of the procedure within 15-20 minutes 7. Is it possible to predict the result? Yes, thanks to digital simulation, we can show the final result after the operation. We show the patient how he will look after the operation, thus avoiding unwanted surprises. 8. Which season of the year is suitable for the operation? Simple rhinoplasty can be performed any season of the year. The absence of an incision does not require protecting the nose from the sun as much as possible, as was the case with classical rhinoplasty, it is enough to protect it from the sun as required. 9. When can you return to social life? Immediately after surgery. Depending on the condition, 1 day of rest after the operation is recommended. 10. When can I make an appointment for an operation and examination in the near future? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 You will find works on simple rhinoplasty, as well as the best surgeons on our Instagram простая рино абдомино ABDOMINOPLASTY (tummy tuck) Tummy tuck surgery (abdominoplasty) is an auxiliary operation that allows you to solve possible aesthetic problems in the abdomen that have arisen after childbirth, with frequent weight loss, weight gain and genetic character. 1. What is an abdominoplasty? Most of the internal organs. Extensive fatty layer in the case does not respond to sports, diet and exercise. In addition, skin problems, called stretch marks on the skin, which are associated with the destruction of collagen, leads to an unaesthetic appearance, again become a problem. Deformation of the abdominal muscles, which manifests itself after the birth of overweight children, leads to the appearance of an "apron" and sagging of the abdominal skin. 2. What does an abdominoplasty cover? The area that is tummy tuck surgery starts from the last rib bone and extends to the pubic eminence (pubic eminence). The pubis (Mons pubis) is a part protruding above the surrounding area, often called the Hillock of Venus. Excessive abdominal obesity is a problem not only for women, it also affects men. The food used in this area is called food. Obesity puts on the agenda for a tummy tuck due to the fact that, despite adhering to a strict diet, complete elimination of violations of the structure of the skin regime, and obesity in this area is not possible. Even in the case of belly slimming, which will achieve successful results. The inability to put on the desired item of clothing and in addition to this limitation in physical mobility, such as bending forward, due to sagging skin, in some cases the emergence of bacteria as a result of sweating causes such people not only psychological problems, but also health problems. 3. Who can have tummy tuck surgery? • Persons with abdominal obesity • Persons with skin deformities and skin cracks in the abdomen • Persons with damaged internal muscles of the abdominal cavity • Persons with sagging skin, apron effect, shape loss • Wanting to get rid of the unaesthetic look. If you have all of the listed problems, then you can be contacted for a tummy tuck operation. 4. How is tummy tuck performed? Tummy tuck surgery is a surgical procedure performed under general anesthesia. The operation begins with an incision just below the caesarean section. Then the abdominal muscles are strengthened and tightened. Then the problematic adipose tissue is removed. If necessary, the pubis and waist are re-formed. If female patients complain of loss of shape in the chest area, then breast augmentation and plastic surgery is included in the tummy tuck operation. This combination surgery, performed at the request of the patient, does not make an incision to insert the silicone implant into the breast. The implant is inserted into the abdominal cavity through a finished incision. Then a new navel is formed in the turned away skin and sutures are applied. 5. Integral factors of abdominoplasty With abdominoplasty, you should pay attention to some aspects. In terms of its structure, a new belly created as a result of a successful tummy tuck operation must meet the following positions: 1) Location of the new navel The location of the newly created navel is the most important aspect of abdominoplasty that is constantly overlooked. The new navel should be formed at the level of the two pelvic bones, taking into account the proportion of the body. If the new navel is not in the desired location, a completely new look appears that does not meet aesthetic requirements. 2) Eminence of the pubis Tummy tuck surgery allows you to achieve an aesthetically pleasing belly, and the tubercle between the clitoris and the caesarean section should support this new model. The problem of obesity in the pubic region, often called the Venus tubercle, can be resolved with similar surgery. Since the problem of obesity in this area in most cases occurs simultaneously with the obesity of the abdominal cavity, therefore, the creation of an aesthetic pubis is an essential condition. 6. Where should the scar be located? The incision mark after the tummy tuck operation, which should be within the bikini line, will create the maximum aesthetic effect for the patient and help mask the seam. The scar is located as low as possible, along the line of the cesarean section. 7. Waist The waist area, which is not in harmony with the new toned belly, needs plastic surgery. Waist obesity can also be eliminated. Benefits of tummy tuck surgery • In our clinics, individual plastic surgery solutions for tummy tuck are created, each surgical operation is performed individually according to the patient. • Rescue from the problem of obesity in the abdomen, not solved by sports and diets • Removal of skin with a damaged structure in the form of stretch marks, the formation of a new skin structure. • Strengthening the tone of the abdomen, eliminating the protrusion of the anterior abdominal wall. • Hiding the scar under the underwear • Formation of a toned and shaped abdomen • Correctly positioned navel and incision mark • Waist in proportion to the new belly • Extremely aesthetic body 8. Process after tummy tuck surgery All of the above problems are solved with tummy tuck surgery. Tummy tuck surgeries, which will allow you to get a toned and smooth abdomen, provide a fairly comfortable recovery process for the patient, thanks to the advantages of modern technology. Within about 1 week, you will be able to return to social life and return to life again with a renewed aesthetic body. 9. Is abdominoplasty performed for men? Tummy tuck surgery, which is most often used by women to resolve deformities after childbirth, can also be performed for men. 10. Who is being carried out? When they are spread apart relative to the middle fascia of the abdomen, problems arise with a strong increase in adipose tissue, weakened muscles and in particular with diastasis, which occur when the rectus abdominis muscles are separated / separated. 11. Why? For various reasons, the skin in the abdomen loses its elasticity and sagging occurs. In addition, the waist lines help to increase the sagging of the skin. Cracks in the skin, causes of signs of phenomena, such as deep, red marks, on the burn. Intensive deposition of adipose tissue on the walls of the abdominal cavity, cracked and weakened tone of the abdominal region as a result of pregnancy, and weakened abdominal muscles were resolved only with the help of abdominoplasty. 12. How? A tummy tuck is performed under general anesthesia and starts with an incision below the caesarean section. Excess sagging and out of shape skin is removed, the tone of the stenocot is restored. 13. Is the result of tummy tuck surgery permanent? Abdominoplasty is the final and most effective treatment for abdominal problems. You will never return to your previous state, but you may return to your previous state due to factors such as weight gain or childbirth. 14. Is tummy tuck painful? A mini tummy tuck is much less painful than a full tummy tuck. There may be some pain after the procedure due to your upright position. This takes a maximum of 1 week. 14 . How soon can I make an appointment? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Works on ABDOMINOPLASTY, as well as the best surgeons, you will find on our Instagram bbl Brazilian Butt Lift (BBL) 1. What is BBL? BBL is a buttock lift and augmentation surgery that allows you to give your buttocks a more youthful, toned, natural look and shape. Patients who are dissatisfied with the shape of their buttocks can do a similar plastic personality regardless of the size, buttocks, or the presence of saggy skin. 2. How is BBL Performed? To give the buttocks an aesthetic shape, the patient's own tissues are used during this operation. It is not possible to use other patient tissues. If there is not enough fat in the patient's body for this operation, then fillers are used. This operation is called the Brazilian Butt Lift, also known as the Brazilian Butt Lift / BBL preferred by those who want a younger, distinct buttocks and a correct body profile. Your own systemic tissue components are used for this procedure. During BBL The fat is produced from the site of the patient's body fat and transported in the purest form and the best combination of fat and stem cells. This ensures the most lasting result. This procedure is called liposuction-assisted fat extraction and involves enriching the fat with stem cells after it has been removed. A centrifuge is used for enrichment with stem cells. In the last step, injections are injected into the buttocks. The procedure is designed to fill the upper quadrants of the buttocks, thus, the buttocks will appear bulging and toned. The effect of this procedure is a more attractive profile of your figure. If you describe in more detail; First, 1 mm punctures are made in the area of the body, using 3 mm cannulas, the fat is pumped out. The small openings of the cannula allow even the smallest particles of fat to be collected. Fats collected after liposuction are centrifuged and enriched with stem cells, the collected fats are processed in this way. Only a certain part of the collected donor fats is suitable for making injections and injecting into the buttock area. Basically, more than 33% of the fat cells are suitable for injection. Due to this, due to transplantation with stem cells, the duration of the effect of this procedure is increased. Only the highest quality donor fat cells are injected into the buttocks. In order to get good and injectable fat, 3. Why should you have a buttock plasty? Anyone who is dissatisfied with the appearance of their buttocks, their firmness and firmness. You don't have to live with buttocks of unwanted size and shape. Don't forget that there is a simple and effective solution to this problem that will give you a natural look! Fat transfer to the buttocks is the most advanced method. This method produces a softer natural look. At the same time, adipose tissue is extracted from the patient's body, so there is no risk of rejection 4. Preparation With buttock augmentation, fat cells are removed from the abdomen (mainly from the abdomen) and transplanted into the buttocks. The operation is performed with a certain type of anesthesia and lasts approximately 1.5-2 hours. You will be informed that you must not eat or drink 6 hours before the operation. Nothing else is required from you! 5. Combination Breast augmentation, breast lift and tummy tuck are surgeries that can be combined with berry plastics to achieve a slimmer and more toned look. Removing the fat from the waist can provide a more curved proportion. If necessary, the operation can be performed in combination with buttock plasty. 6. Recovery and Results The length of time you recover from buttock surgery will depend on your age, health, physical condition, and environmental factors. No stitches are applied during the procedure. The operation is performed through micro punctures. There is no need for bandaging. You can return to social life immediately after the surgery, but you must not lift weights, run or engage in active activities for 1 week after the surgery. The more you rest, the faster you will recover. 7. Benefits • Elastic and natural result • Fresh look and healthy skin • Fast recovery • Getting rid of body fat • Beautiful curves of the waist and hips 8. Factors influencing the result Age Many patients think that it takes a little aging for this procedure. However, it is not. This can be done at any age. Patient Gender Typically, in female patients, the adipose tissue is softer and less fibrous. However, if desired, men can also resort to buttocks plastic surgery. 9. Is this procedure safe? Safe because only the patient's own natural fat is used 10. What is the cost of the operation? The price for each procedure will differ, depending on the size of the body and the area of therapy. To find out the prices for buttock plastic surgery, it would be more correct to contact us and submit a request for a free examination. 11. How is the recovery period going? After a Brazilian butt plasty, the recovery period lasts an average of 1 week. It is very important not to put pressure on the buttocks for three weeks after surgery. We recommend using a special pillow to avoid damaging the fatty tissue. After 48 hours, you will be able to take a shower. Practitioners have no pain You will also be able to exercise again within three weeks. 12. Is the effect permanent? The administration of injections with donor fat-treated stem cell enrichment provides a permanent effect as the stem cells in the transplanted area continue to live and provide vascularization. 13. Will cellulite disappear? Fat injections and the design of the aesthetic appearance of the buttocks of this procedure, which implies the treatment of cellulite. 14. How much fat is required? This can vary from patient to patient. It is related to how bulging the buttocks the patient wants. 15. When can I make an appointment for an operation and examination in the near future? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 You will find BBL works , as well as the best surgeons on our Instagram блефаро BLEPHAROPLASTY 1. What is blepharoplasty? The eyes are one of the most important organs. At the same time, the eyes themselves and the area around the eyes, in their structure, perform a protective function. A joyful state, sadness and even tiny facial movements in our daily life move the area around the eyes millions of times throughout the day, and the eyelids open and close. While this area is dynamic, it also has a very sensitive texture and is most exposed to sunlight. In addition to this, if we add signs associated with aging to all the listed features, then this background causes certain problems in the area around the eyes, on the eyelids, forehead and under the eyes. 2. Why is blepharoplasty needed? In communication, the eyes and the area around the eyes most often attract the attention of the interlocutor. Therefore, in everyday life, looking at ourselves in the mirror, we most of all pay attention to this particular area. We notice signs of aging around our eyes and become frustrated by our tired, tense and sleepy reflection in the mirror. This situation, associated with the loss of the shape of the eyelids, causes changes in appearance, leads to the appearance of a tired and dull facial expression that has lost its aesthetic appearance, which can cause misunderstanding among people around us. Gender, race, and age lead to changes in the anatomy of the eye area. The area around the eyes varies significantly depending on the gender and race of the person. Moreover, the size of the eye area is different for men and women. In women, the eyebrows and eyelids are significantly higher and more arched, but the line of the eyelid fold is less pronounced compared to men. In men, the eyebrows are more pronounced, and the fold line of the eyelids is located much closer to their border. In terms of race, people with Asian and Far Eastern facial types have completely different eyes and eyelids that are expressed in shape. In light of the above, surgery in the eyelid area to shape the eye line and the area around the eyes in accordance with the anatomy should be performed by a specialist surgeon. 3. What does blepharoplasty include? Blepharoplasty is treated as a whole in our clinics. Problems with the eyes and the area around the eyes should not be eliminated in a pinpoint way, but with the solution of all problems and signs of aging. It is with this decision that you will be able to acquire the much desired fresh and lively look. Most often, when blepharoplasty is faced with such problems as drooping eyelids, the appearance of crow's feet, drooping eyebrows, bags under the eyes, hollows between the area under the eyes and cheeks. With blephoplasty, all these problems are solved. All of the listed solutions are provided not only for creating an aesthetic look, but also have health benefits. Sagging or drooping eyelids with bags under the eyes can disrupt the angle of the field of view, which in turn leads to secondary health problems such as headaches. 4. Who can have blepharoplasty? The weakening of the upper and lower eyelids occurs against the background of aging and is caused by the deformation of sagging skin towards fatty deposits. Therefore, due to such problems, performing blepharoplasty, especially as part of facial rejuvenation operations, allows you to eliminate fatigue and get rid of bags under the eyes. Baggy drooping upper eyelids are caused by stretching of the skin of the eyelids. The most common complaints about the lower eyelids are bags under the eyes or swelling. All problems are solved within the framework of eyelid surgery, i.e. blepharoplasty. Anyone who faces the listed problems can undergo blepharoplasty. Some patients, despite the absence of the primary problem, as well as middle and even young age, may have deficiencies over the centuries due to genetic problems. Young patients or middle-aged patients, having undergone blepharoplasty, can acquire a lively and free shape of the area around the eyes. 5. How is the plastic around the eyes performed? In the framework of plastic surgery of the area around the eyes, sagging eyelids that violate the angle of the field of view are corrected using laser technology and the skin that causes vision problems is removed. At the same time, instead of a tired and sluggish facial expression, the patient acquires a youthful and fresh look. Saggy bags under the eyes not only cause vision problems, they give the face a tired look and make a person look older than his age. Eliminating bags under the eyes is one operation that is particularly difficult and requires extreme attention. This area, due to its structure, has extremely sensitive skin, so any incision made will cause a long recovery period and in addition to this leads to redness and blue discoloration. That is why in our clinics microintervention is carried out in the area of the roots of the eyelashes of the lower eyelid and using the existing fat deposits are evaporated using laser technology. Thanks to this, our patients go through a fairly comfortable recovery period without bruising and redness. The second aspect of blepharoplasty is drooping of the eyelids. The drooping of the eyelids occurs due to the effort caused by the sagging of the eyelids and against the background of the loss of the shape of the forehead. As part of the eyebrow lift, a non-surgical method is again used by hanging the eyebrows on a thread, which allows you to eliminate drooping and wrinkles. In addition, depressions that form due to the drooping of the cheeks due to gravity and the separation of the lower eyelid from the cheek are solved with the help of Lipofilling. The period after blepharoplasty Within 3-4 days after the operation, the patient recovers and looks at life with a fresh look and confidence thanks to a rejuvenated look. 6. Features of laser blepharoplasty All tissues around the eyes are structured to give the face a beauty and a youthful appearance. Together with new directions in plastic surgery, innovative solutions are applied in blepharoplasty. Any operation in the area around the eyes and in front of the eyes, especially in our country, causes fear and doubts in people, but thanks to new methods, we present adequate solutions to these problems, and people are starting to treat blepharoplasty more favorably than before. 7. Non-surgical blepharoplasty Non-surgical blepharoplasty is performed in 3 stages using a laser. First, an intervention is performed with microinstruments in the area of \ u200b \ u200bthe hairline from the side of the forehead and the lowered eyebrow is raised up with the help of threads. Thus, the stress on the area around the eyes is eliminated and wrinkles, sagging and drooping of the eyelid are corrected. Non-surgical blepharoplasty, which lasts about 15 minutes and is performed under local anesthesia, due to its peculiarity does not require dressing, and also does not carry possible postoperative risks and complications. Thus, the patient immediately returns to social life. The threads used are a durable medical device, adapted to the tissues, and the patient begins to live with a new look. Reverting to a previous view is extremely difficult. At the second stage, the second extremely important question is posed - the elimination of bags under the eyes. Such an operation, which we can call lower eyelid plastics, is particularly difficult all over the world due to the sensitivity of this area and causes many difficulties during the patient's recovery. Given the presence of lymphatic tissue in this area, which stretches under the eyelashes, in the case of an operation, recovery occurs within a period of 3 weeks to 3 months. In addition, this area belongs to the category where complications arise most of all. Correction of any problem that arises is extremely difficult and includes risks that do not allow you to return to the previous view. That is why, in order to eliminate the previously listed risks and eliminate the occurrence of problems in the patient during operations to eliminate bags under the eyes or blepharoplasty, we carry out a point microintervention of 5 millimeters in size immediately under the eyelashes of the lower eyelid to eliminate fat deposits causing the formation of bags under the eyes. In laser blepharoplasty, we use a laser to remove sagging tissue, starting from the eyelashes of the lower eyelid, and in the case of plastic surgery of the upper eyelid, from the oval line that occurs when the eye is opened. In a sense, we evaporate excess skin. After this operation, which is applied without an incision, the depressions that form due to the drooping of the cheeks due to gravity and cause the lower eyelid to separate from the cheek are resolved with Lipofilling. After solving all these problems, the patient gets better within 3-4 days and begins to look at the world with a young look. 8. Benefits of non-surgical blepharoplasty • No incision • Using laser technology • Correction of the angle of view caused by sagging skin • Correction of the shape of the upper eyelids causing headaches • Create a fresh and rejuvenated look • fast recovery • Minimal risk of complications 9. Benefits of non-surgical eyebrow lift • No incision • Using the technique of hanging on a thread • Minimal risk of complications • Expressive eyes and elimination of the tired look • fast recovery 10. Benefits of non-surgical removal of bags under the eyes • No incision • Evaporation of fatty deposits by microinterventions • Minimal blueing and redness • fast recovery • Young and fresh look 11 . How soon can I make an appointment? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Works on BLEPHAROPLASTY, as well as the best surgeons, you will find on our Instagram липосакция LIPOSUCTION Liposuction ranks among the basic elements for a balanced distribution of fat, proportional contours of the figure and an attractive body. Liposuction allows you to correct body lines and shape. Many people, despite playing sports and dieting, cannot get rid of and solve the problem of local obesity. Liposuction is the most modern method of solving the problem of persistent obesity, adjusting the shape and giving the body an aesthetic appearance. 1. What is liposuction? Liposuction is a surgical procedure used to correct and shape the uneven distribution of fat on the body. As an effective solution to the problem, especially local obesity, liposuction is used as an auxiliary element in many plastic surgeries. For example, when performing gynecomastia, liposuction is used to solve the problem of breast augmentation in men. In an operation to correct the curvature of the legs, fat is taken from the patient and introduced into the problem area to mask the curvature. In short, liposuction is often used to improve and enhance the results of the performed plastic surgery. When using liposuction treatments alone, without using obesity treatment methods, it has not been possible to cope with diet and exercise. The use of liposuction in the area of obesity and sagging to form a natural contour will create a sculptural form. Today in plastic surgery, there are different types of liposuction. The goal of all types of liposuction is to remove fatty deposits. The types of liposuction differ in their effectiveness and benefits. Turmescent liposuction provides an anesthetic solution to the problem area to minimize bleeding and discomfort after liposuction and to increase the volume of this area. Ultrasonic liposuction uses ultrasonic energy to quickly and easily remove some of the fat. Laser liposuction uses laser technologies known by the brand name smartlipo or Slimlipo. In addition, there are liposculpture methods. 2. Areas of application of liposuction The areas of the body in men and women that can be subjected to liposuction to remove fat are different. Upper legs. The most common areas causing liposuction in men, accounting for 15-25% of such patients, are the jaw, neck, abdomen, chest and shoulder blades. 3. How is liposuction performed? When using liposuction alone, without combining with any plastic surgery, it can be performed under local anesthesia. However, it is possible to use general anesthesia. The plastic surgeon decides on the form of anesthesia and marks the areas where the liposuction will be performed with a pencil. One or more small incisions are made near the area. Depending on the technique used, thin cannulas or thinnest balloons are inserted through the incisions made. The surgeon directs the vibration of the device to liquefy the fat layer under the skin and remove it. The duration of the operation depends on the size of the area and the amount of fat removed. 4. Process after liposuction After the surgery, the problems of swelling, blue discoloration or sagging of the skin are reduced to a minimum to the most modern lime technique. Many patients have a few days after liposuction, depending on their daily activities and daily life. Although pain after surgery depends on your threshold, many patients claim that they did not use pain relievers during their recovery. In some cases, after liposuction, your surgeon may recommend that you wear a corset. Wearing a brace is a preventative measure that prevents contractions and swelling. The incisions made will heal in a few weeks and completely disappear within 1 year. 5. Weight gain after liposuction Liposuction almost completely removes fat deposits in case of local obesity. It could be obesity. For this reason, for a new figure, we recommend that you follow a weight maintenance program. When performing the procedure by a qualified surgeon, you can get extremely positive feedback and you have no doubts about the safety of this procedure. Liposuction, which has won preference as an excellent method for correcting body shape and creating an aesthetic figure, should in no way be considered as a method of losing weight. It relieves you of localized deposits. First you need to exercise and go on a diet, and if the results are not successful, you can have liposuction. 6. Results Many patients who come to our clinic for this procedure go away in a few days. As a rule, the surrounding cuts do not notice, they become invisible. Aids, such as wearing a corset after liposuction, will provide optimal results. When preserved after surgery, our patients achieved an aesthetic and effective result. Liposuction is not a weight loss method. It allows you to solve the problem of local obesity, leads to the formation of an unaesthetic appearance and loss of shape. You can turn to liposuction if you have aesthetic doubts about localized obesity despite regular exercise and a healthy and balanced diet. 7. Who can get liposuction? Healthy individuals with realistic expectations for liposuction are good candidates for liposuction to maximize joy in liposuction results. Those who, despite a healthy diet, diet and exercise, have not been able to cope with local obesity, can undergo liposuction. 8. What should be realistic expectations from the operation? After liposuction, the patient acquires a new body or corrected body contours, depending on the place where the liposuction is performed. After liposuction, the regrowth of fat cells in such an area is not observed, but with a strong weight gain, it can change. 9. What are the possible complications and risks after liposuction? The liposuction procedure carries no serious risks and complications. According to the research done to date, the most dangerous thing about liposuction is the very large number of liposuction performed in one day and many unrelated surgeries performed on the same day the liposuction was performed. Although liposuction is extremely reliable, it carries risks such as nerve damage, skin ulcers, bleeding, and rarely infections. 10. How should you choose a surgeon? Among the most frequently asked questions is the price of liposuction. The very low cost of liposuction may indicate an incomplete procedure. For this reason, we recommend that you think not about the price, but your health and ask questions in this direction. Feel free to ask your doctor questions about liposuction. Ask all important and extremely interesting questions and before making a decision, make a choice based on the answers received. 11. What are the important features of reliable liposuction? Liposuction should be performed in a clinical setting in a hospital or operating room. A reliable surgical liposuction unit minimizes the risk of infection during surgery. In addition, such conditions require the maintenance of high cleanliness and maximum patient comfort. 12. Do you experience pain after surgery? After that, minimal pain is possible. They decrease over time. 13. Does liposuction affect the appearance of the skin? The appearance of the skin after liposuction depends on the elasticity of the skin. With good elasticity of the skin after liposuction, a smooth and natural look is created. 14. Are there any visible traces of the operation? Liposuction uses tiny cannulas (microcannulas), so small incisions are made. The incisions heal completely or remain subtle. 15. Does liposuction help weight loss? Liposuction is not a weight loss method. Liposuction can only solve the problem of local obesity, which could not be dealt with with the help of diets and exercise. 16. When can I make an appointment for an operation and examination in the near future? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 You will find liposuction works , as well as the best surgeons on our Instagram Эндо брови 1.эндо лоб 2. Эндотины 3. Подтяжка бровей 4. Специф ENDOSCOPIC EYEBROW LIFT There are several methods that can be used in eyebrow lift surgeries, but the most commonly used and popular application today, the endoscope, is a procedure performed with small, thin cameras without leaving any incision marks. It is an operation that is easy to perform in the operating room under local anesthesia, supported by general or sedative therapy. An endoscopic brow lift can be operated without bleeding or scarring by opening small holes in the lower parts of the scalp from several different parts. In this way, the risk of scarring is avoided, as the older methods provide less swelling, pain and a shorter healing process. If pain does not occur after surgery, a regular pain reliever pill is sufficient. The stitches are removed between 8 and 12 days. Since the scars from the surgery will remain under the scalp, there are no problems with scarring. Compared to the botox process, the shape given to your eyebrows lasts much longer in this position, and this operation does not need to be repeated in certain processes, as is done with a botox brow lift. Endoscopic brow lift can provide long-lasting results compared to non-surgical use. How soon can I make an appointment? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Works on ENDOSCOPIC EYEBROW LIFTING, as well as the best surgeons, you will find on our Instagram подтяжка лиуа Endoscopic Facial Surgery (Midface Lift - Forehead Lift - Eyebrow Lift) An endoscopic facelift is a popular technique because it is a surgical procedure with a very small and hidden incision, which gives very effective results in patients with early signs of aging who do not yet require “complete face rejuvenation”. By itself, this method is a great option for a patient who has less laxity or sagging skin and no problems in the lower face and neck. In an endoscopic facelift, a small number of small, invisible incisions are made in the scalp and in the temples, and sometimes in the mouth. Sagging tissues on the cheeks are lifted with an endoscope (a small camera with a light source) and special instruments. The face is rejuvenated and rejuvenated without leaving visible scars. This method can be used in combination if you have severely saggy skin and excess fat or skin on your neck. Good; The forehead, eyebrows and midface can be adjusted endoscopically, while the neck and chin line can be corrected using traditional facial rejuvenation techniques. 1. Who is an endoscopic facelift suitable for? An endoscopic facelift is especially effective when the following symptoms are present: persons with a sagging area from the lower eyelid to corner of the mouth; persons with a deep crease extending from the nostrils to the corner of the mouth (nasolabial region); faces with a smile. that began to fall. An endoscopic facelift can be thought of as a light touch to reduce gravity. The face, which is pulled down by gravity, rises vertically. This procedure is less invasive than other face lifts, providing a natural, more youthful look without the need for a full facelift. The most important benefit of an endoscopic facelift is that it leaves no scars on the patient or leaves very few scars. 2. What is done during an endoscopic facelift? During an endoscopic facelift, an endoscope (a very small camera) is inserted through one incision and a surgical instrument through another. Dr. Basaran controls the camera and surgical instrument through the image on the TV screen and can modify the subcutaneous tissue. While an endoscopic facelift is not as dynamic as a traditional facelift, it does provide forehead and cheek benefits that are more difficult to achieve with a traditional facelift. However, due to the nature of the procedure, it is impossible to cope with problems of the jaw line and neck. 3. What is an endoscopic mid-face lift? An endoscopic mid-face lift is a surgical procedure applied to the cheekbones, around the mouth, eyelid lines and cheekbones on the 2 middle sides of the face. These areas on your face can cause bad appearance, such as sagging, wrinkling and bagging, which are mainly caused by aging and the effects of gravity. Mid-face lift surgery removes these bad facial images and makes the person who has the surgery look younger and prettier. The endoscopic mid-face lift is a popular surgery performed using an endoscope and is widely known and used among women. In this operation, which is simpler and shorter than conventional facelift surgeries, the healing and recovery process is painless and faster. Endoscopic mid-face lift is not recommended for severe depression and old age. How soon can I make an appointment? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Works on ENDOSCOPIC FACE LIFTING, as well as the best surgeons, you will find on our Instagram ПОДТЯЖКА ЛБА FOREHEAD LIFT During the natural aging process, repetitive movements such as sun exposure, environmental factors, gravity, concentration, and squinting cause wrinkles to appear on the surface of the forehead. Many patients are concerned about the negative impact these lines have on the overall aesthetic appearance and opt for forehead lift surgery to reduce discomfort. Thanks to advances in modern surgery, it is now possible to offer forehead lift options where very small incisions are used and these incisions are not visible at all due to the hairline. Men and women who are looking for solutions to the following problems are good candidates for a forehead lift: deep horizontal wrinkles on forehead an angry or tired look due to sagging eyebrows lines between the eyebrows and at the top of the nose. forehead lift techniques Coronal incision technique: This widely used forehead lift technique often uses an incision covered in hair. The incision begins above the ears and continues across the scalp. In some patients, the incision is made in front of the hairline to avoid elevation of the hairline. Regardless of the location, the incision will be as indistinct as possible after healing. The doctor, with a successful coronal incision, can reconstruct or remove some of the wrinkle-causing muscles by removing excess skin before raising the eyebrows to a more youthful position. Endoscopic forehead lift: This limited incision technique uses an endoscope (a thin tube with a light attached to a video camera) for surgical imaging. This endoscope is inserted through several incisions in the scalp rather than through a long incision, thus minimizing scar tissue and shortening the healing period. Other limited incision methods: some limited incision forehead lift techniques can be performed without the use of an endoscope. Small incisions can be made at the temple area to stretch out drooping brows, and incisions on the upper eyelid may be preferred to correct frown lines. How soon can I make an appointment? our mail: medikal.estetik.group@gmail.com Whats App / Viber: +90 505 479 19 17 Forehead lift jobs, as well as the best surgeons, you can find on our Instagram