Timely verified: is it possible to detect cancer and diabetes at an early stage
Oncological, cardiovascular diseases, type 2 diabetes, and neurodegenerative pathologies are four groups of chronic non—communicable diseases that most often cause disability or premature death. Almost 37% of the adult population of Russia are affected by these ailments. They are called "horseman diseases" - the term originated by analogy with the biblical horsemen of the Apocalypse, symbolizing disasters such as plague, war, famine and death. How to recognize illnesses at an early stage and prevent their development is in the "Izvestia" material.
Genetics versus Horsemen
Any medical professional is confronted with diseases of the cardiovascular system, diabetes, oncology, and Alzheimer's and Parkinson's diseases, says Denis Prokofiev, a general practitioner with the status of "Moscow Doctor" and cardiologist.
— And if all the specialists working at outpatient appointments applied modern diagnostic strategies and gave correct clinical recommendations for the treatment of these diseases, then there would be fewer problems. But since there are certain nuances in this sense, such diseases are often detected at late stages, and patients do not receive adequate treatment," he points out.
As a result, the consequences are formed in the form of heart attacks, strokes, diabetic coma, panic attacks and other disorders.
At the same time, there are not so many aspects of the occurrence of "horseman diseases". First of all, according to the expert, a genetic predisposition plays a role. Therefore, doctors primarily pay attention to the burdened heredity of the first link, that is, they ask about health problems on the mother's and father's side.
Modern genetic tests allow us to assess a person's innate predisposition to various diseases and help us understand which risks require special attention, says Alexander Rakitko, Director of Science at the Genotek Scientific and Genetic Laboratory, Candidate of Physico-mathematical Sciences.
— The genetic contribution to the development of these diseases is really significant. According to research, the heritability of type 2 diabetes is estimated at 25-72%, coronary heart disease — at 40-60%, and Alzheimer's disease — at 60-80%. At the same time, a genetic predisposition does not mean that the disease will necessarily develop: the individual risk is also influenced by age, lifestyle and environmental factors, the expert draws attention to.
In addition, genetic analysis does not cancel the standard medical examination, but only helps to make prevention more targeted, he emphasizes.
— To continue the metaphor of the four horsemen, a DNA test is not a crystal ball or a silver bullet capable of defeating all diseases at once. Rather, it is a map that shows which of the "horsemen" may pose the greatest threat and where it is worthwhile to strengthen protection in advance. In many ways, the key to health and longevity really lies inside our cells: by decoding our genome, we gain the opportunity to better understand our risks and manage them more consciously," Rakitko is convinced.
Diabetes mellitus and hypertension
Doctors believe that unhealthy lifestyle, such as physical inactivity, smoking, and alcohol abuse, also play a role in the formation of diseases.
— But you need to understand that hypertension, oncology, diabetes and other stress-related problems always have triggers. And the problem is that there are more and more of these mechanisms. We are increasingly talking about various bacterial and viral infections," says Denis Prokofiev.
The source of "Izvestia" recalls that due to the coronavirus pandemic, the level of development of diabetes, hypertension and oncology has sharply increased. The trigger for this was a viral-bacterial infection of a new formation.
— The stress factor also spurs the development of diseases. Now it is primarily related to the current political and economic situation, domestic difficulties and other problems. The stress factor can trigger both hypertension and cancer, not to mention a mental disorder," the cardiologist complains.
It is very important, according to him, to undergo scheduled medical examinations or individual checks every year. First of all, general blood and urine tests, cardiographic studies, and biochemistry are necessary. And further examination depends on an individual approach.
— All modern medicine is based on starting antihypertensive therapy, hypoglycemic therapy, as well as drugs that suppress the stress factor as early as possible. It is also important to start cancer treatment at the earliest stage," the general practitioner continues.
Thus, the trend based on the passive surveillance strategy has already receded into the background. Doctors do not wait until hypertension becomes critical, sugar levels reach critical levels, and oncology passes into the fourth degree.
— We pay attention to those early stages of diseases that signal that it is time to start treatment. These are prediabetes, hyperglycemia, and high blood pressure. In short, conditions where it is already necessary to identify possible risks and select therapy," the expert explains.
But even if patients have sought help in the late stages of hypertension or diabetes, time is still not lost, says Dr. Prokofiev. And here the task of doctors is to convince the patient of the need for daily drug therapy to compensate for the condition, so as not to get severe complications in the form of stroke, heart attack, diabetic foot or damage to target organs, the expert says.
— Reducing body mass index, regular physical activity, quitting smoking, alcohol, excess salt and sugar, minimizing stress factors are important, but few people manage to fully adhere to ideal recommendations. Therefore, the "easiest" way is often left for people — medical correction," he adds.
Even if you do only this, without avoiding medical care, the risks are still reduced, the editorial interlocutor emphasizes, separately emphasizing the need for self-control. At home, according to the cardiologist, it is necessary to have a blood pressure monitor, glucose meter, pulse oximeter and thermometer in order to carry out self-diagnosis. For example, if a person regularly measures blood pressure, at least twice a week, and sugar levels twice a month, they will not miss a steady increase in these indicators.
The first signs of cancer
Alexander Mikhailov, head of the surgical department of the "Be Healthy" clinic on Sretenka, oncologist and surgeon, calls fear and denial the main enemies of timely examination and treatment.
— Many people have a "it won't affect me" mechanism. The thought of possible cancer is so frightening that it's easier to push it out than to face it face-to-face. The slogan "don't look, you'll find it" is still very tenacious, he explains.
According to the expert, low medical literacy also plays a negative role. Many young people do not know the key symptoms of the disease, confuse cancer alertness with hypochondria, and do not understand at what age and what screenings they need to undergo.
— People are also in no hurry to seek advice because of their distrust of the healthcare system. They are afraid to face rudeness and incompetence, expect indifference, queues and bureaucracy. It seems to them that it's easier to do nothing than waste time getting a simple consultation," the doctor adds.
"""" It is also widely believed that in the clinic "they will not find anything anyway," or, conversely, "they will find something that is not there," continues the interlocutor of Izvestia. And some are held back by cultural stereotypes, because "don't go to the doctors without a good reason" is still strong in our mentality. Preventive visits are sometimes perceived as something superfluous, typical for "overindulged" or suspicious people.
Mikhailov compares the cancer awareness of people aged 25-45 years to a patchwork quilt. A progressive, mostly urban, part of the youth leads a healthy lifestyle, looks after themselves, reads the necessary information, listens to doctors and undergoes regular examinations. But for other people, the topic of oncology remains distant and frightening.
— In order for cancer awareness to become a mass norm, it is necessary to simplify access to high-quality and fast diagnostics, increase the communication culture of medical staff, and large-scale educational campaigns. It is necessary to inform the population about the importance of cancer diagnosis, its regularity and accessibility, to popularize the real stories of survivors, to provide accessible information about the symptoms, the doctor is convinced.
The main tools for early detection of cancer, according to the oncologist, are divided into two main types: screening (for healthy people without symptoms) and diagnosis (if suspicious signs appear). If a person has alarming symptoms (unexplained weight loss, prolonged cough, lump in the chest, blood in the stool, etc.) or screening has revealed abnormalities, then more accurate methods are used: ultrasound, CT, MRI, PET-CT, gastroscopy, colonoscopy, bronchoscopy, biopsy with histological examination.
"One person may need enhanced cancer screening, another may need early and especially careful monitoring of cholesterol, blood pressure and vascular health, and a third may need closer monitoring of body weight, glucose levels and other metabolic parameters," Alexander Rakitko continues the topic.
The value of this approach, including conducting a genetic test, is clearly evident in the diagnosis of oncology. For example, when breast cancer is detected at a localized stage, the five-year relative survival rate reaches about 99%, the geneticist adds. However, it is advisable to interpret the results of a genetic test together with a doctor, he warns.
Cancer treatment in the 21st century has experienced a real revolution and has shifted from total destruction of the tumor at any cost to an accurate, personalized and comprehensive approach, Alexander Mikhailov draws attention. For example, in targeted therapy, drugs do not "hit" all rapidly dividing cells, but specific target molecules that are found only in cancer cells and are necessary for their growth and survival.
— And the most breakthrough field, awarded the Nobel Prize in 2018, is immunotherapy. Its essence is that drugs "remove the brakes" from the patient's own immune system, allowing it to recognize and destroy cancer cells, the oncologist continues.
Traditional radiation therapy has also become much safer and more effective — the maximum radiation to the tumor is carried out with minimal impact on healthy tissues.
— Oncologists are also armed with minimally invasive and robotic surgery. Surgery remains the main method for localized tumors, but it has become gentle — tumors are removed through minimal incisions. Laparoscopy and robot-assisted systems (Da Vinci) provide high-definition 3D images and incredible precision of the surgeon's movements," says the specialist.
Many cancers can be completely cured today, especially if they are diagnosed at an early stage, he emphasizes. However, in oncology, another term is often used — "persistent remission" — a condition in which all signs and symptoms of cancer disappear and do not return for many years.
How not to miss Alzheimer's disease
Another "horseman" — neurodegenerative diseases — has a complex, multifactorial nature, the editors at Dr. Isaev's psychiatric clinic explain. The development of such diseases is influenced by age and genetic predisposition, vascular and metabolic disorders, traumatic brain injuries, lifestyle features and some environmental factors. Modern medicine does not yet allow us to talk about one reason, eliminating which could be guaranteed to prevent the disease, says Ruslan Isaev, head of the clinic, psychiatrist, president of the Independent Narcological Guild.
But some of the risk factors, in his opinion, can really be changed. He agrees with Denis Prokofiev on this — it is necessary to control blood pressure, sugar and cholesterol levels, get rid of bad habits, be physically active, and eat right.
— The quality of sleep, timely correction of hearing and visual impairments, prevention of traumatic brain injuries and even reduction of exposure to air pollution are important. It is the combination of several such measures that is considered today as the most reasonable strategy for reducing the risk of cognitive decline and dementia," the doctor emphasizes.
The new WHO recommendations, published in July 2026, explicitly include these areas in preventive measures, the source adds. Separately, the psychiatrist identifies intellectual activity. It is important for the brain to continue working with tasks that require effort, learning, and adaptation. It is necessary to learn new skills, to read, to study, and also to maintain professional and social activity.
Scientists associate education, intellectually challenging work, and mental stress throughout life with a higher cognitive reserve, Isaev notes. This way, the brain functions normally for longer, despite age-related or pathological changes.
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