To treat or wait?

[Albina]

Hello!



At mum (54) on -thow biopsy it is diagnosed *quot; a carcinoma in situ, preinvazivnyj a cancer urinary O?UOn*quot;. To me as daughters, have shown an extract. Doctors do not speak mum about the diagnosis, treatment not naznachajut-only to come in half a year. Whether it is correct?

[MT]

Continuation of a question: from a dispensary have sent the invitation to come to be checked up. But the attending physician (zav.otdeleniem) by phone skazal-to not pay attention of urology of the same dispensary. To come it is not necessary. To seem in 2-3 months. Mum in panike-but in fact he sends it or her and there is no place to go more. Where to address? Telephone conversation to business you will not sew.

[belowmind]

Continuation of a question: from a dispensary have sent the invitation to come to be checked up. But the attending physician (zav.otdeleniem) by phone skazal-to not pay attention of urology of the same dispensary. To come it is not necessary. To seem in 2-3 months. Mum in panike-but in fact he sends it or her and there is no place to go more. Where to address? Telephone conversation to business you will not sew.



Ndaaas! That I to you shall tell or say. It is necessary to change these or it doktoril for competent doctors. The matter is that carcinoma in situ it potentially rather dangerous invasive or aggressive disease. So under the order.



How the biopsy urinary muzyrja was carried out? If it was the transurethral resection of a wall of a bladder - it's OK. Then it is necessary to know depth of a lesion of a vesical wall (within the limits of mucous or is deeper). If the biopsy undertook only a method otshchipa tissues is a disturbance of standards of diagnostics of a cancer of a bladder existing today and nothing gives.



Today in the world carcinoma in situ it is considered potentially rather aggressive and often a recurring tumour of a bladder. She rezetsiruetsja by means of transurethral resections (ROUND) within the limits of visually healthy tissues. Then depth of a lesion of a wall of a bladder is defined or determined. If the tumour has got more deeply mucous - it is necessary to delete all bladder (a radical cystectomy). If a tumour within the limits of mucous, right after resections in a bladder enter mitomitsin TS (Mitomycin C) and then local treatment by vaccine BTSZH in a combination with intronom And or without it or him (6 weekly instilljatsy) is necessary. Then dynamic observation - cystoscopy each 3 months. And if after treatment there will be a relapse, most likely it is necessary to delete all bladder. In any case to wait it is impossible, it be simple can fatal expectation!!!



Where do you live?

[lews]

Thanks for the detailed answer!

We live in a Vitebsk, Belarus.

As to me objasnili-in urinary there was a polyp. It or him have removed (like pravilno-with *quot; ??*quot;). On itself on -thow biopsy cancer cells are found out. As I have understood, assay mucous and tissues did not take (I can not approve or confirm). But the doctor approves or confirms, that time a polyp udalen-to worry there is nothing. I doubt, that cells could be deployed only on a polyp.

[Natalika]

Thanks for the detailed answer!

We live in a Vitebsk, Belarus.

As to me objasnili-in urinary there was a polyp. It or him have removed (like pravilno-with *quot; ??*quot;). On itself on -thow biopsy cancer cells are found out. As I have understood, assay mucous and tissues did not take (I can not approve or confirm). But the doctor approves or confirms, that time a polyp udalen-to worry there is nothing. I doubt, that cells could be deployed only on a polyp.



Such medical concept or the term as *quot; a polyp urinary O?UOn*quot; is not present in the nature. That to you have told or said (and that have similar made) looks or appears as full bosh from the point of view of the standards of treatment of a cancer of a bladder standard in the world. All anything, but the price of medical illiteracy is at times too high.



In Minsk (on mine in goronkodispansere) rather competent oncourologist by name Alexander (or Alexey) Rolevich works. If you want goods to the mum - urgently find this doctor and address to it or him;them for the help.



To in total you of the kindest!

[84]

Dr. Zhivov! You studied or investigated a deontology? Opinion on colleagues leave at itself! On a question answer without comments. This or thus superfluous. And doctors explain to people so, that people has understood, in their tongue. If will speak on terms will be worse.

[ndrey K]

Dr. Zhivov! You studied or investigated a deontology? Opinion on colleagues leave at itself! On a question answer without comments. This or thus superfluous. And doctors explain to people so, that people has understood, in their tongue. If will speak on terms will be worse.



Dear skorpio!

First about a deontology and medical ethics. In the ethical code of the American Urological Association which member I am to be spoken, that each doctor should state an appropriate estimation to nonprofessionalism of the colleagues and to protect a society from medical illiteracy which at times costs or stands to patients of a life. That have told or said to the patient not is at all *quot; explain so, that people ?n?*quot;. This simply full misunderstanding of a subject and absolutely incorrect approach to treatment carcinoma in situ a bladder. And what for us it is more important? The Life of people or corporate pseudo-ethics? And then I words have not told or said on not clear terms (if they and were, I have explained them), I have simply stated that approach which today professes all formed medical world. To in total you kind also I advise in the future better to understand that actually occurs or happens.

[Taisja]

Dear Doctor Zhivov!

It is disappointed by that that you obviously PROFESSIONAL by your reports have considered necessary to respond n??nOa?OO/on an extreme measure in present or true probleme/

N???*quot; a polyp on ??N*quot;-, it only words explaining to family about the form of display of process named a-cancer/try to describe to the patient or its or his family as that looks or appears that udalili/not hiding a short of an event and naturally forecast provided that under indications in sootstvetstvii with received at cystoscopy rezultatami/operation TUR is executed and that the MAIN THING-PROCESS of observation corresponds or meets to the standard that basically it's OK

Yours faithfully

doctor Polonsky

israel

[Tiff]

[QUOTE] Dear skorpio!

And what for us it is more important? The Life of people or corporate pseudo-ethics?



And nevertheless corporate solidarity should be! It is impossible for the patient to speak in eyes, that it or he was treated by the bad doctor and not so. It is possible to direct with words: *quot; there there are more than opportunities, there it is better than a condition, the equipment, etc. and quot there is better; And among themselves, at clinical analyses and conferences to place all points above And. In this case the life lbdej will be saved also and the face of the doctor (we do not know what expert he actually and than it has been caused or called the given statement) is saved, he can the perfect doctor who has rescueed or saved hundreds lives, and you the words have spoiled its or his reputation?

I try to discuss never at patients other doctors and methods of their treatment (while in Russia there will be no standards, any method has the right to exist).

And where it is possible to read through the ethical code of the American urological Association?

[a999@meta.ua]

While in Russia there will be no standards, any method has the right to exist).



I with it or this do not agree categorically!!! While in Russia there are no Standards, any doctor (if he in general understands, THAN he zanimatesja) should follow standards of diagnostics and the treatment, accepted in the civilized world. For these standards quite D-O-S-T-U-P-N-Y (People AUUUU!!!!) and thanks God in Russia the Internet is not forbidden yet and public libraries are not closed. In opposite sluche *quot; nOO*quot;, for which *quot; any method has the right ?OUN?OooaOy*quot; it becomes simple at least the legalized gangster duplicating stresses or any sort physical injuries and as a maximum by the serial murderer. Examples around of myself I see much.



Clinical analysis? Misters if carcinoma in situ a bladder the patient is removed also is sent TO WALK SIMPLY SOME MONTHS are a simple illiteracy and a duty or debt of each fair doctor to fence the patient from not qualified actions of the doctor which can kill simply it or him (is the answer and to you doctor101). Simple universal ethics also consist In it or this, which immeasurably above any corporate interests and the same corporate ethics.



In general than more people will know, that in a situation when in our unfortunate country DOCTORS think, that *quot; any method has the right ?OUN?OooaOy*quot;, they addressing to these doctors seriously risk the LIFE, the our population will be better for understanding, that instead of MEDICINE in Russia prevails full bespredel, the, probably, we from this de... MA we shall more quickly come up. For now we shall be afraid to speak the truth aloud, we and will sit in this most evil-smelling substance and to serve pugalom for other world. Reflect, colleagues!



Here you will find the Ethical Code American Urological Asotsiatsii (http: // www.ama-assn.org/ama/pub/article/7665-4731.html)

[Paul]

Many thanks for the link! And why www.andros.ru the second day does not work?