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