One step ahead: how Moscow doctors are buying time in the fight against cancer

Over the past six years, the capital's healthcare has managed to significantly improve the effectiveness of cancer detection and treatment. The most important result is a steady increase in early diagnosis. According to Deputy Mayor Anastasia Rakova, in 2019, malignant tumors were detected at an early stage in 62% of cases, and by 2025 this figure had reached almost 68%. Read more about how the capital's doctors managed to build a system of oncological care aimed at achieving the best results in the Izvestia publication.

Working ahead of schedule

— Early diagnosis of a tumor is one of the main factors for successful treatment. Because it significantly expands the possibilities of both local treatment and faster rehabilitation, using various minimally invasive endoscopic treatment methods," explains Dmitry Yerygin, MD, Deputy Chief Physician of the S.S. Yudin State Clinical Hospital for Oncology.

According to the oncologist, small tumors often do not make themselves felt, and the symptoms are easily confused with other, less dangerous diseases. That is why it is so important for each of us to regularly and systematically monitor our health. In Moscow, this work is being carried out systematically, and every year more and more cases of cancer are detected at the very initial, zero or first stage, when the chances of a full recovery are as high as possible. For example, head and neck cancer is now detected at an early stage by 14.3% more often, thyroid gland — by 12.9%, stomach — by 7.4%.

A separate reason for optimism is the increase in the detection of so—called cancer in situ (in situ). This is the earliest stage, when the tumor has not yet grown deep into the tissues. The progress in the diagnosis of breast and cervical cancer at this stage is particularly noticeable: here, compared with 2019, the figures increased three and six times, respectively. These changes became possible after a new standard of oncological care was adopted, which prioritized not the process, but the result of treatment.

Fast and accurate

Tumors of the digestive system are one of the most common types of cancer. To detect it earlier, a network of five endoscopic centers based on large hospitals was created in Moscow. These are not just classrooms, but entire departments with modern equipment and teams of experienced specialists.

Their job is to make gastro and colonoscopy accessible, fast and comfortable for the patient. As Irina Korzheva, head of the Endoscopic Service at the Botkin Moscow National Cancer Center, explains, this allows "to suspect, identify, and in some cases immediately remove small tumors during the examination."

After receiving the referral, the patient signs up for the procedure, prepares for it and comes to the center. The whole process from arrival to receiving the report takes about two hours. A huge plus for the patient is the opportunity to undergo a study under sedation, in a state of drug—induced sleep.

— We can say that in the endoscopic center of the Moscow State Medical Center named after S.P. Botkin, the vast majority of studies are performed under anesthesia — it is painless, convenient and comfortable for both the patient and the endoscopist. The center works seven days a week from morning until late at night, about 200 studies are performed per day," adds Korzheva.

During the activity of the centers, more than 10,000 cases of cancer have been detected, and 60% of them are in the early stages. More than 60,000 patients were diagnosed with precancerous conditions, and 100,000 had polyps removed, thereby preventing the disease from developing. The detection of colon cancer at the very initial stage has increased more than fivefold. This is the case when infrastructure development directly affects people's health and lives.

Specialized assistance

For the prevention of female oncological diseases in Moscow, a complex of examinations is available in the capital's Women's Health Centers. Here you can have a mammogram in one visit, be examined by a gynecologist and take the necessary tests.

— All the necessary examinations can be completed in one place — you do not need to travel to different institutions, waste time on the road and adapt to new conditions, — says Arina Tovmasyan, head of the Center at GCB No. 31. — Favorable conditions have been created for spending time during breaks between appointments — this reduces stress levels and makes the visit less exhausting.

The convenience and calm atmosphere help women to undergo these examinations regularly, which directly affects the early detection of breast and cervical cancer.

Another important area is the program for the early detection of skin cancer, which has been operating for several years on the basis of the Moscow Scientific and Practical Center for Dermatovenerology and Cosmetology.

— Melanoma is one of the most aggressive tumors: it quickly metastasizes, and in the later stages treatment is much more difficult. That is why it is so important not to miss the moment. Early diagnosis in the first or second stages dramatically changes the prognosis and gives a chance to maintain a high quality of life," explains Nikolai Potekaev, MD, Chief dermatovenerologist and cosmetologist in Moscow and Russia, Director of the Center for Dermatovenerology and Cosmetology at the Moscow Department of Health.

The program works in stages: from the initial examination and photofixation of moles in the prevention rooms to in-depth diagnostics using special equipment. If serious suspicions arise, the patient is referred to an oncologist as soon as possible.

A single mechanism

The results that Moscow has managed to achieve in oncology are largely related not only to the introduction of modern diagnostic and treatment methods, but also to the way the medical care system itself is built. It depends on the organization of the processes how quickly the patient goes from the first suspicion to the start of therapy, how well the various links work and whether doctors have the opportunity to apply new approaches without wasting time.

In recent years, a unified model of cancer care has been formed in the capital, in which diagnosis, treatment and follow-up are combined into one continuous route. This approach minimizes delays between the stages and eliminates situations where the patient is forced to independently seek the necessary medical services in different institutions.

The key stage of these changes was the introduction of a new standard of oncological care at the end of 2019. He set uniform operating rules for the entire system and shifted the focus from formal indicators to real clinical results — the length and quality of life of patients. All the main stages of treatment are concentrated in large multidisciplinary centers equipped with modern equipment and operating according to common protocols.

Digital infrastructure plays an additional role: all medical information is stored in a single electronic system, which ensures continuity of treatment and allows doctors to make decisions quickly. The development of remote forms of interaction has also expanded access to consultations and patient support without the need for frequent face-to-face visits.

One of Moscow's most significant achievements is the one—year mortality rate, which has decreased by 33% in recent years. This clearly reflects systemic changes, thanks to which more and more patients receive treatment on time and with a prognosis for a full life.