According to the legislative framework, all patients with suspected neoplasms should be required to register and register. Using dispensary observation, it is possible to detect pathology in a timely manner and prescribe the correct treatment, prevent the presence of complications, relapses and the spread of metastases. For the convenience of the clinical examination, 4 clinical groups of cancer patients were developed, thanks to which the correct management of patients can be distributed.
What is a tumor?
Everyone knows that the human body consists of cells that perform different functions. However, under the influence of certain factors, they can stop functioning correctly and begin to divide endlessly, thereby forming tumors. Moreover, such formations consume hidden and basic reserves of the body and release toxic metabolic products. As they grow, cells can “detach” and, together with the movement of blood or lymph, be redirected to the nearest organs or lymph nodes. Thus, the tumor "metastasizes".
The concept of clinical groups of cancer patients
There are specially designed 4 groups for accounting, as well as tracking the timing and rules of medical examination of patients. They are created for careful control over the conduct of therapeutic measures and their effectiveness. And also, such a record helps to conduct a timely examination of patients, detect the presence of metastases and relapses, and control the first sick, cured and dead patients.
Clinical groups of cancer patients help to organize lists for an adequate assessment of the situation for each individually selected patient. Thanks to this division, the oncological territorial departments monitor and timely notify the patient about the need for a second examination or additional measures. A similar distribution is required in oncology to obtain information about each patient and his condition. Thanks to this classification, it is possible to compile truthful statistical information that helps to determine the overall picture and take measures for prevention.
It should be noted that the rules of dispensary observation are slightly different. There are such forms of pathology that require lifelong recording, in other cases, such observation lasts 5 years after complete cure and lack of metastases, and then the data is transferred to the archive.
Patient monitoring is carried out according to the following scheme:
- during the year after therapy - 1 time in several months;
- in the second year - once every six months;
- for the third and more - once a year.
Below is a description of the clinical groups of cancer patients. This technique was created to facilitate the registration of patients. The patient belongs to different groups on the basis of the results of treatment or examination. Depending on the dynamics and therapy, the patient can be redirected from one group to another.
Description and features of the first group
The first clinical group of cancer patients includes patients with suspected presence of precancerous diseases or tumors.
Group a - it includes patients with an unspecified diagnosis and unclear signs of the disease. There are pre-established periods for monitoring such patients, which are 10 days. After this period, doctors are required to make an accurate diagnosis. Further, the patient is either deregistered or transferred to another clinical group of oncology.
Group b - there are patients with precancerous diseases in it:
- An optional precancer is a pathology that develops into cancer, but the likelihood of this is very small. Patients of this type are registered with different specialists.
- Obligate precancer is an ailment that is very likely to develop into a malignant neoplasm. Patients of this type are required to be registered with an oncologist.
People in the first clinical group of cancer patients are actively monitored for 2 years after treatment. Then they are removed from the register, and if complications are observed, then they are transferred to other groups.
For such patients, the usual dispensary card 030-6 / u is started. All patient records that have been deregistered are stored until the beginning of the reporting period, and then sent to computer processing and to the archive. If you want to re-enter the patient in this group, a new card is made on the patient.
Description and features of the second group
The division of cancer patients into clinical groups is very important. For example, the second group includes patients who have confirmed a malignant neoplasm and who need special therapy to achieve a stable remission or complete recovery.
In this group are all patients who have the opportunity to perform therapy to eliminate the focus of inflammation and fully restore the lost functions to improve the quality of life.
And also experts distinguish a separate group of cancer - 2a. In this clinical group of cancer patients are all patients requiring radical therapy. Often patients consist in 2a at stages 1-2 of the tumor process, in which there is the possibility of full recovery. There are patients with a strictly localized or limited state. After dispensary observation, such patients can be redirected to group 3 or 4.
For the 2nd clinical group of cancer patients, certain registration documents are drawn up. After the diagnosis is established for each patient, form 090 / y is formed, which indicates that the patient went for the first time. It is compiled for everyone who seeks medical help on their own or the problem was identified at the examination. Further, for 3 days, the document is transferred to the oncological institution and stored for at least 3 years.
After the end of therapy, form 027-1 / y is filled. It is written out on the day of inpatient discharge, and then transferred to the territorial oncological institution located at the place of residence. And also the form 030-6 / y is drawn up, which contains all the information about the course of the patient’s illness. It is filled in for the generation and registration of statistics.
Description and features of the third group
This category consists of patients who are practically healthy and simply consisting under supervision after the therapy. The 3rd clinical group is distinguished by the fact that in case of relapse, patients are transferred to the 2nd or 4th group. There are certain periods of the dispensary, and they depend on the form of cancer. Certain patients are forced to be observed by an oncologist for life, while others are only 5 years old. If there are no relapses, they are completely deregistered. Special documentation is also maintained for this group, and after deregistration it is stored for 3 years and redirected to the archive.
Description and features of the fourth group
In this category are patients with common forms of the disease or in advanced stages, in which there is no way to perform radical therapy, as in other clinical groups of oncological diseases. In 4 categories are people who have been diagnosed with relapse that is not subject to therapy. Still here patients of 2 groups who refused treatment, or when treatment is ineffective, are brought here. All such people are observed by a specialist in the community.
It is possible that patients can be brought here even after the initial examination, this is often the case in case of late seeking help. Many doctors refuse medical care to patients of this category, but it is strictly forbidden to do this, since they need help to normalize the quality of life to a more comfortable level.
In addition to all of the above documents, a protocol 027-2 / y is drawn up for this group, when a malignant tumor is detected for the first time at the final stages. And also a similar document is drawn up posthumously if the disease is fatal.
The first actions of the doctor
After the malignant tumor is established, the doctor sends the patient to the oncological institution, since there, according to the classification of oncological diseases by clinical groups, the specialists will refer the patient to the necessary group. All the required documents are also prepared, after which the person is redirected to the oncology room or clinic. The patient is required to have an extract from the medical record with him. If the tumor was detected at an advanced stage, then, in addition to all the papers, a protocol is sent to the dispensary to detect cancer neglect.
Diagnostics
Everyone knows that with the early recognition of any disease, there is a much greater chance for successful therapy, especially oncology. All doctors know that a feature of any malignant neoplasm is the presence of local symptoms associated with the location of the tumor, as well as general signs, regardless of the affected organ.
Despite modern technologies, for oncological practice it is important to interview a patient and a description of his complaints, according to which specialists establish a diagnosis.
Medical history and complaints
The main reason that patients seek medical help late is that the tumor process does not manifest itself in the initial stages. Further, such general symptoms are formed that A. I. Savitsky called "the syndrome of small symptoms." Patients most often have increased fatigue and decreased performance. Constant drowsiness appears, and interest in what is happening decreases. Then the appetite goes away, often enough to meat dishes, and the satisfaction of food disappears. Unusual and new sensations are formed. A feeling of heaviness and tightness may occur.
Quite often, the first sign is a simple feeling of discomfort, which the patient tries to explain with anything, but not with a disease.
The presence of vomiting and nausea without visible symptoms, bloating, difficulty swallowing, the presence of blood in the urine and feces, or blood discharge from the vagina are often a sign of oncology.
Treatment methods
Knowing the clinical groups of cancer patients and their characteristics, doctors use different methods of therapy for each patient:
- 1a group. At the first suspicion of a disease, the doctor is obliged to perform a patient examination in the shortest possible time, up to 10 days. If there are no conditions for examination, then for making a diagnosis it is necessary to redirect the patient to the dispensary or to the oncology room, providing him with an extract with the results of the studies. After 5-7 days, the doctor must check whether he got to the consultation. With this group, hospitalization is justified only if a special examination is required.
- 1st group. Patients who have facultative or obligate precancers are required special treatment (radiation, surgical), so such people are referred to an oncologist. In case of facultative precancer, patients require special treatment, and they should be under dispensary supervision in the general treatment network. There they take conservative therapy and undergo all examinations within the time frame established for such a disease.
- 2 and 2a groups. If a patient is diagnosed with a malignant neoplasm, the doctor sends the patient with a similar discharge to the oncology room of a district or city clinic. It is also possible to redirect the patients of the general network immediately to the oncology clinic or to another special institution where special treatment will be presented. After 7-10 days, the local therapist must determine whether the patient went for therapy. Immediately, the doctor fills out and redirects the notification to the oncological office, while indicating which center the patient was redirected to.
- 3 group. As prescribed by the doctor, the local therapist provides the patient with a follow-up examination in the oncology room. If there is no oncologist, then the doctor will independently examine and examine the patient and decide on the absence of metastases and relapse. Next, the identified information is transmitted to the oncological institution.
- 4 group. When a satisfactory condition is present, the doctor redirects the patient to an oncologist to develop a symptomatic treatment regimen. If the disease is serious, all consultations and procedures are performed at home under the guidance of an oncologist. For patients whose pathology was detected for the first time at an advanced stage, a special protocol is filled out, redirected to the oncology room.
All clinical groups of cancer patients are created to facilitate monitoring of patients and their condition.