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Ukrainian cancer patients.Cancer does not go away during the war, but much of the resources needed to treat cancer go away.

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A 9-year-old patient and his mother at the Unicorn Clinic in Poland. March 31, 2022

Hundreds of thousands of Ukrainians every year Diagnosed In the case of cancer — and for many years the Ukrainian health system has been quite successful in treating them. However, since the beginning of the war, Ukrainian medical centers have been overwhelmed by those injured in the war and have little capacity to accommodate cancer patients. While international organizations are mobilizing young cancer patients to evacuate quickly and efficiently, adults with this disease often have to protect themselves. Neighboring countries, meanwhile, are concerned that their health systems are overwhelmed by Ukrainian patients.

Sudden burden on the system

As of February 24, hundreds of thousands of Ukrainians were being treated for cancer. Determining the exact number is difficult, but it’s definitely huge.163,000 Ukrainians Diagnosed I will get sick only in 2020. All of them need treatment.

Like all of Ukraine, medical care has changed dramatically in the last two months.Cancer treatment has increased It is insufficient — And where it’s available, it’s often incomplete.Complete, according to some estimates number 3 Many cancer treatment centers are currently unable to provide care. According to a representative of the Ukrainian Ministry of Health who spoke at the WHO meeting on April 26 WHO representative, Cancer treatment is not just one of the national priorities. Medical resources are, first and foremost, directed at people with war-related wounds and infectious diseases.Some humanitarian organizations report It has the same priority hierarchy. On the other hand, even in areas under attack by Russian troops, some cancer treatments are still being treated. Many oncologists and other professionals are lagging behind to help cancer patients.

According to Ukrainian doctors, the drug situation isn’t really that bad. Many hospitals still have most of the medicines they need.It’s thanks to the support from Charity, Pharmaceutical companyAnd the fact that medical institutions have begun share record.Patient Maximum risk Those who were taking clinical trials taking drugs that weren’t on the market yet, but pharmaceutical companies are working with many of them. continue process.

Still, the situation is far from perfect. Due to myriad difficulties, doctors are choosing chemotherapeutic regimens that make it easier (even remotely) to monitor adverse reactions, even in areas where patients can get help. Until recently, the National Cancer Center did not offer radiation therapy due to a power outage. Physicians have also reduced the number of surgeries that require long-term hospitalization and intensive care.In fact, in general, the number of cancer-related surgeries is Decrease ――To some extent because There is an urgent need for surgical intervention among the killed in action.Also, now Impossible Perform a bone marrow transplant in Ukraine from an unrelated living donor as donors (often coming from abroad) cannot enter the country.

Even in peacetime, cancer treatment may need to be interrupted — for example, If the patient’s condition worsens during the course of chemotherapy. The general consensus among physicians is that these pauses do not significantly affect treatment outcomes. Nevertheless, patients in these situations require special care and treatment to reduce the risk of infection and help their body cope with adverse reactions.

Even radiation therapy must be interrupted from time to time, and no one knows exactly how the interruption affects the effectiveness of the treatment. for example, the study A two-week break has been shown to have a significant (and negative) impact on the outcome of treatment.Surgery may be postponed Impossible No additional risk.

The most effective treatments for cancer usually consisted of high-quality drugs, well-designed treatment plans, state-of-the-art diagnostic equipment, and care by competent medical professionals. The risks are clear. The risk of evacuating patients from Ukrainian hospitals is also clear. according to For Mykolaiv hematologists, they include “interruption of treatment, separation from family, disruption of diagnostic continuity, and bombardment of convoys.”

Since the beginning of the war, Ukrainian oncologists have been contact Ask oncology scientists from other countries to help transport the patient abroad. According to many doctors, this required a great deal of time and energy.

Unicorn Clinic

After the war began, children with cancer Evacuated With Kyiv Other cities Quite early to western Ukraine and abroad. One of the challenges faced by the organizers was shipping The proportion of children who have recently had a bone marrow transplant is a relatively dangerous operation. To help send children to clinics in Europe and North America, the SAFER Ukraine Project has set up a center called the Unicorn Clinic. according to Anna Sonkina-Dorman, a pediatrician working in SAFER Ukraine, has more than 1,000 patients enrolled in the project and more than 600 have already been evacuated from Ukraine.

At the Unicorn Clinic, the kids Assigned To Volunteer doctor From different countries (they currently have especially A child oncologist needs to come to Poland for a two-week shift).

Western doctors examining patients from Ukraine It pointed out Even in the best scenario, the patient arrival In their document in Ukrainian. Sometimes they arrive without any paperwork, and the patient’s parents do not know what medications were previously used to treat the child and what their radiation treatment regimen looked like. .. Generally, there are no CAT scan results or tissue samples for study. In addition, the treatment received by the child in Ukraine may not be used at all in the new country. Studies and tests conducted by doctors in Ukraine do not always stimulate self-confidence.Sometimes they have to Redo, Leads to changes in diagnosis and treatment.Ukraine has some Highest childhood cancer mortality rate in Europe..

“The other problem we faced was more about culture than medicine.” I have written A group of Italian doctors who have accepted Ukrainian patients since the beginning of the war. “For example, our patients had unexpected difficulties in adapting to Italian food, especially the food served in the hospital (some patients developed gastrointestinal problems).” They others. I am also facing logistic problems. For example, hospitals were unable to discharge some patients because they had nowhere to go.

In addition to all these problems, the Russian invasion Created A more common problem for Ukrainian cancer patients: It is difficult for health systems in different countries to cope with the sudden influx of new patients.

Less options for adults

The Unicorn Clinic has created an effective route for children to resume treatment immediately, none Similar to an adult. The majority of Ukrainian adult cancer patients remain in Ukraine, unfathomable Burden the clinics in the western part of the country. many Of the adults going abroad, women with breast cancer and older men with prostate cancer (two fairly widespread diagnoses).Young men prohibited Leave the country at all.

Cancer treatment facilities in neighboring countries are often not ready to accept Ukrainian patients. In late March, Richard Sullivan, a member of the WHO Emergency Committee It pointed out Even 100 new patients put a heavy burden on Moldova’s healthcare system. Ukrainian patients are currently waiting alongside Moldovan citizens, according to Ruslan Baltaga, director of the Institute of Oncology in Chişinău, who spoke at the WHO conference on April 26. ..In Poland, the number of cancer patients Be expected Increase by 10% — Difficult adjustments even in the health system of a relatively rich country.

On the other hand, the situation in some countries is much better.Main problem In those countries, patients are unaware that there are resources available.Information on the best countries for Ukrainian cancer patients can be found by phone Special hotline Or by phone Dedicated organization..

Future issues

Today, the evacuation, treatment, and even living expenses of patients are often covered by charities and different countries. government..this is clearHowever, this does not last long, so what happens next to Ukrainian cancer patients being treated abroad is an urgent issue. This is one of the reasons why Ukrainian doctors keep patients out of the country unless absolutely necessary. Sooner or later all these patients will be forced to return to Ukraine. difficult To finish the treatment they started abroad (for example, if the medicines they took abroad are not available in Ukraine).

Before the war, about 13,000 Ukrainians Diagnosed Many Ukrainian refugees are diagnosed with cancer abroad because they have cancer every month, but it is not surprising that they will be treated later in their home countries.Statistically, cancer among immigrants is diagnosed with More advanced stage Than if they stayed in their home country.

story To Dariya Sarkian

Translated by Sam Breeze Ale

https://meduza.io/en/feature/2022/04/29/ukraine-s-cancer-patients Ukrainian cancer patients.Cancer does not go away during the war, but much of the resources needed to treat cancer go away.

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