Decoding the diagnosis according to ICD 10. Oncological diagnosis and treatment of cancer

. Worry about the uncontrollable side effects(such as constipation, nausea or confusion. Concern about addiction to pain medications. Non-adherence to prescribed pain medication regimen. Financial barriers. Health system issues: Low priority for cancer pain management. Most suitable treatment may be too expensive for patients and their families. Tight regulation of controlled substances. Problems with access to or availability of treatment. Opiates not available over the counter to patients. Unavailable medications. Flexibility is key to managing cancer pain. Since patients differ in diagnosis, stage of disease, response to pain and personal preferences, it is necessary to be guided by these characteristics. Read more in the following articles: ">Cancer pain 6

to cure or at least stabilize the development of cancer. Like other therapies, choice in use radiation therapy treatment for a specific cancer depends on a number of factors. These include, but are not limited to, the type of cancer, the patient's physical condition, the stage of the cancer, and the location of the tumor. Radiation therapy (or radiotherapy is an important technology for shrinking tumors. High energy waves are directed at cancerous tumor. The waves cause damage to cells, disrupting cellular processes, preventing cell division, and ultimately leading to the death of malignant cells. The death of even part of the malignant cells leads to a reduction in the tumor. One significant disadvantage of radiation therapy is that the radiation is not specific (that is, it is not aimed exclusively at cancer cells for cancer cells and can also harm healthy cells. Response of Normal and Cancer Tissue to Therapy The response of tumor and normal tissue to radiation depends on their growth pattern before and during treatment. Radiation kills cells through interaction with DNA and other target molecules. Death does not occur instantly, but occurs when cells try to divide, but as a result of exposure to radiation, a failure occurs in the division process, which is called abortive mitosis. For this reason, radiation damage occurs more quickly in tissues containing cells that divide quickly, and cancer cells are the ones that divide quickly. Normal tissues compensate for the cells lost during radiation therapy by speeding up the division of remaining cells. In contrast, tumor cells begin to divide more slowly after radiation therapy, and the tumor may shrink in size. The extent of tumor shrinkage depends on the balance between cell production and cell death. Carcinoma is an example of a type of cancer that often has a high rate of division. These types of cancer tend to respond well to radiation therapy. Depending on the dose of radiation used and the individual tumor, the tumor may begin to grow again after stopping therapy, but often more slowly than before. To prevent the tumor from growing back, radiation is often given in combination with surgery and/or chemotherapy. Goals of Radiation Therapy Curative: For curative purposes, radiation exposure is usually increased. Reaction to radiation ranges from mild to severe. Symptom relief: This procedure aims to relieve cancer symptoms and prolong survival, creating more comfortable conditions life. This type of treatment is not necessarily performed with the intention of curing the patient. Often this type of treatment is prescribed to prevent or relieve pain caused by cancer that has metastasized to the bones. Radiation instead of surgery: Radiation instead of surgery is an effective tool against a limited number of cancers. Treatment is most effective if the cancer is found early, while it is still small and non-metastatic. Radiation therapy may be used instead of surgery if the location of the cancer makes surgery difficult or impossible to perform without serious risk to the patient. Surgery is the preferred treatment for lesions that are located in an area where radiation therapy may be more harmful than surgery. The time required for the two procedures is also very different. Surgery can be performed quickly after diagnosis; Radiation therapy may take weeks to be fully effective. There are pros and cons to both procedures. Radiation therapy may be used to save organs and/or avoid surgery and its risks. Radiation destroys rapidly dividing cells in the tumor, while surgical procedures may miss some of the cancerous cells. However, large tumor masses often contain oxygen-poor cells in the center that do not divide as quickly as cells near the surface of the tumor. Because these cells do not divide rapidly, they are not as sensitive to radiation therapy. For this reason, large tumors cannot be destroyed using radiation alone. Radiation and surgery are often combined during treatment. Useful articles for a better understanding of radiation therapy: ">Radiation Therapy 5

Skin reactions at targeted therapy Skin problems Shortness of breath Neutropenia Disorders nervous system Nausea and vomiting Mucositis Menopause symptoms Infections Hypercalcemia Male sex hormone Headaches Hand-foot syndrome Hair loss (alopecia Lymphedema Ascites Pleurisy Edema Depression Cognitive problems Bleeding Loss of appetite Restlessness and anxiety Anemia Confusion. Delirium Difficulty swallowing. Dysphagia Dry mouth. Xerostomia Not uropathy O For specific side effects, read the following articles: "> Side effects36

cause cell death in various directions. Some of the drugs are natural compounds that have been identified in various plants, while others chemicals are created in laboratory conditions. Some various types chemotherapy drugs are briefly described below. Antimetabolites: Drugs that can affect the formation of key biomolecules inside the cell, including nucleotides, the building blocks of DNA. These chemotherapeutic agents ultimately interfere with the process of replication (the production of daughter DNA molecules and hence cell division. An example of antimetabolites is the following drugs: Fludarabine, 5-Fluorouracil, 6-Thioguanine, Ftorafur, Cytarabine. Genotoxic drugs: Drugs that can damage DNA. By causing this damage, these agents interfere with DNA replication and cell division. As an example of drugs: Busulfan, Carmustine, Epirubicin, Idarubicin. Spindle inhibitors (or mitosis inhibitors): These chemotherapy agents aim to prevent proper cell division by interacting with cytoskeletal components that allow one cell to divide into two parts. An example is the drug paclitaxel, which is obtained from the bark of the Pacific Yew and semi-synthetically from the English Yew ( Yew berry, Taxus baccata. Both drugs are prescribed in a series. intravenous injections. Other chemotherapeutic agents: These agents inhibit cell division through mechanisms not covered in the three categories above. Normal cells are more resistant to drugs because they often stop dividing under conditions that are not favorable. However, not all normal dividing cells avoid the effects of chemotherapy drugs, which is evidence of the toxicity of these drugs Cell types that tend to divide rapidly, e.g. bone marrow and the lining of the intestines tends to be most affected. Death of normal cells is one of the common side effects of chemotherapy. More details about the nuances of chemotherapy in the following articles: ">Chemotherapy 6

and not small cell carcinoma lung These types are diagnosed based on how the cells look under a microscope. Based on established type, treatment options are selected. To understand the prognosis of the disease and survival rate, I present statistics from open US sources for 2014 on both types of lung cancer together: New cases of the disease (prognosis: 224210 Number of projected deaths: 159260 Let us consider in detail both types, specifics and treatment options.">Lung cancer 4
in the United States in 2014: New cases: 232,670 Deaths: 40,000 Breast cancer is the most common non-cutaneous cancer among women in the United States (public sources, an estimated 62,570 cases of preinvasive disease (in situ, 232,670 new cases of invasive disease, and 40,000 deaths Thus, less than one in six women diagnosed with breast cancer will die from the disease. By comparison, an estimated 72,330 American women will die from lung cancer in 2014. glands in men (yes, yes, there is such a thing, it accounts for 1% of all cases of breast cancer and mortality from this disease. Widespread screening has increased the incidence of breast cancer and changed the characteristics of detected cancer. Why has it increased? Yes, because the use of modern methods has made it possible to detect incidence of low-risk cancer, precancerous lesions and ductal carcinoma in situ (DCIS. Population-based studies in the US and UK show an increase in DCIS and incidence invasive cancer breast since 1970, this is due to the widespread hormone therapy in postmenopause and mammography. In the last decade, postmenopausal women have refrained from using hormones and the incidence of breast cancer has decreased, but not to the level that can be achieved with the widespread use of mammography. Risk and protective factors Increasing age is the most important factor risk for breast cancer. Other risk factors for breast cancer include the following: Family history diseases o Underlying hereditary susceptibility Sex mutations in the BRCA1 and BRCA2 genes, and other breast cancer susceptibility genes Alcohol consumption Breast tissue density (mammographic) Estrogen (endogenous: o Menstrual history (onset of menstruation/late menopause o No history of childbirth o Old age at the birth of the first child History of hormone therapy: o Estrogen and progestin combination (HRT Oral contraception Obesity Absence physical exercise Personal history of breast cancer Personal history of proliferative forms benign diseases breast Radiation exposure to the breast Of all women with breast cancer, 5% to 10% may have germline mutations in the BRCA1 and BRCA2 genes. Research has found that specific BRCA1 and BRCA2 mutations are more common among women Jewish origin. Men who carry the BRCA2 mutation also have increased risk development of breast cancer. Mutations in both the BRCA1 and BRCA2 genes also create an increased risk of developing ovarian cancer or other primary cancers. Once BRCA1 or BRCA2 mutations have been identified, it is advisable for other family members to undergo genetic counseling and testing. Protective factors and measures to reduce the risk of developing breast cancer include the following: Using estrogen (especially after a hysterectomy Creating an exercise habit Early pregnancy Breast-feeding Selective estrogen receptor modulators (SERMs) Aromatase inhibitors or inactivators Reducing the risks of mastectomy Reducing the risk of oophorectomy or oophorectomy Screening Clinical trials have established that screening asymptomatic women with mammography, with or without clinical examination breast, reduces mortality from breast cancer. Diagnosis If breast cancer is suspected, the patient usually must go through the following steps: Confirmation of the diagnosis. Assessment of the stage of the disease. Choice of therapy. The following tests and procedures are used to diagnose breast cancer: Mammography. Ultrasound. Breast magnetic resonance imaging (MRI, if clinically indicated. Biopsy. Contralateral breast cancer Pathologically, breast cancer can be multicentric and bilateral. Bilateral disease is slightly more common in patients with invading focal carcinoma. Within 10 years of diagnosis, The risk of primary breast cancer in the contralateral breast ranges from 3% to 10%, although endocrine therapy may reduce this risk. Development of second breast cancer is associated with an increased risk of distant recurrence in cases where a BRCA1/BRCA2 gene mutation has been diagnosed. Before the age of 40 years, the risk of second breast cancer in the next 25 years is almost 50%. Patients diagnosed with breast cancer should undergo bilateral mammography at the time of diagnosis to exclude synchronous disease. The role of MRI in screening for contralateral breast cancer and monitoring. of women treated with breast conservation therapy continues to develop. Because mammography's increased detection rate of possible disease has been demonstrated, selective use of MRI for adjunctive screening is occurring more frequently, despite the lack of randomized controlled data. Because only 25% of MRI-positive findings represent malignancy, pathological confirmation before treatment is recommended. Whether this increased rate of disease detection will lead to improved treatment outcomes is unknown. Prognostic Factors Breast cancer is usually treated with various combinations of surgery, radiation therapy, chemotherapy and hormonal therapy. Conclusions and selection of therapy may be influenced by the following clinical and pathological features (based on conventional histology and immunohistochemistry: Menopausal status of the patient. Stage of disease. Grade of primary tumor. Tumor status depending on the status of estrogen receptors (ER and progesterone receptors (PR). Histological types Breast cancer is classified into different histological types, some of which have prognostic significance. For example, favorable histologic types include colloid, medullary, and tubular carcinomas. Uses of molecular profiling in breast cancer include the following: ER and PR status testing. HER2/Neu receptor status testing. Based on these results, breast cancer is classified as: Hormone receptor positive. HER2 positive. Triple negative (ER, PR, and HER2/Neu negative. Although some rare inherited mutations, such as BRCA1 and BRCA2, predispose carriers to breast cancer, prognostic data for BRCA1/BRCA2 mutation carriers is inconsistent; these women are simply more susceptible risk of developing second breast cancer. But it is not certain that this will occur. Hormone replacement therapy After careful consideration, patients with severe symptoms may be treated with hormone replacement therapy. Follow-up frequency and appropriateness of screening after completion. primary treatment Stage I, stage II, or stage III breast cancer remains controversial. Data from randomized trials suggest that periodic follow-up with bone scans, liver ultrasound, radiography chest and blood tests for liver function do not improve survival or quality of life at all compared with routine medical examinations. Even when these tests allow early detection relapse of the disease, this does not affect the survival of patients. Based on these data, limited screening and annual mammography may be an acceptable continuation for asymptomatic patients who have been treated for stage I to III breast cancer. More detailed information in articles: "> Breast cancer5
The ureters, ureters, and proximal urethra are lined with a specialized mucosa called transitional epithelium (also called urothelium. Most cancers that form in the bladder, renal pelvis, ureters, and proximal urethra are transitional cell carcinomas (also called urothelial carcinomas, derived from transitional epithelium Transitional cell carcinoma bladder may be low-grade or full-grade: Low-grade bladder cancer often recurs in the bladder after treatment, but rarely invades the muscle walls of the bladder or spreads to other parts of the body. Patients rarely die from low-grade bladder cancer. Full-blown bladder cancer usually recurs in the bladder and also has a strong tendency to invade the muscular walls of the bladder and spread to other parts of the body. High-grade bladder cancer is considered more aggressive than low-grade bladder cancer and is much more likely to cause death. Almost all deaths from bladder cancer are due to high-grade cancer. Bladder cancer is also divided into muscle-invasive and non-muscle-invasive disease, based on invasion of the muscle lining (also referred to as the detrusor muscle, which is located deep in the muscle wall of the bladder. Muscle-invasive disease is much more likely to spread to other parts of the body and is usually treated by either removing the bladder or treating the bladder with radiation and chemotherapy. As noted above, high-grade cancers are much more likely to be muscle-invasive cancers than low-grade cancers. Muscle-invasive cancer is generally considered to be more aggressive than non-muscle-invasive cancer. Non-muscle-invasive disease can often be treated by removing the tumor using a transurethral approach and sometimes chemotherapy or other procedures in which a drug is injected into the urinary cavity. bladder with a catheter to help fight cancer. Cancer can arise in the bladder in the setting of chronic inflammation, such as a bladder infection caused by the parasite haematobium Schistosoma, or as a result of squamous metaplasia; The incidence of squamous cell carcinoma of the bladder is higher in the setting of chronic inflammation than otherwise. In addition to transitional carcinoma and squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and sarcoma can form in the bladder. In the United States, transitional cell carcinomas make up the vast majority (more than 90% of bladder cancers. However, a significant number of transitional cell carcinomas have areas of squamous or other differentiation. Carcinogenesis and risk factors There is convincing evidence of the impact of carcinogens on the occurrence and development of bladder cancer. The most common risk factor for developing bladder cancer is cigarette smoking. It is estimated that up to half of all bladder cancer cases are caused by smoking and that smoking increases the risk of developing bladder cancer at two to four times the baseline risk. Smokers with a less functional N-acetyltransferase-2 polymorphism (known as a slow acetylator) have a higher risk of developing bladder cancer compared with other smokers, presumably due to a decreased ability to detoxify carcinogens. Some occupational hazards have also been associated with bladder cancer, and higher rates of bladder cancer have been reported due to textile dyes and rubber in the tire industry; among shoemakers and aluminum, iron, and steel workers; Bladder carcinogens include beta-naphthylamine, 4-aminobiphenyl, and benzidine. Although these chemicals are now generally banned in Western countries, many other chemicals that are still used are also suspected of causing bladder cancer. Exposure to the chemotherapy agent cyclophosphamide. also found to be associated with an increased risk of bladder cancer. Chronic infections urinary tract infections and infections caused by the parasite S. haematobium are also associated with an increased risk of developing bladder cancer, and often squamous cell carcinoma. Chronic inflammation, is believed to play a key role in the process of carcinogenesis in these conditions. Clinical signs Bladder cancer usually presents with simple or microscopic hematuria. Less commonly, patients may complain of frequent urination, nocturia, and dysuria, symptoms that are more common in patients with carcinoma. Patients with urothelial cancer of the upper urinary tract may experience pain due to obstruction by the tumor. It is important to note that urothelial carcinoma is often multifocal, necessitating examination of the entire urothelium if a tumor is detected. In patients with bladder cancer, imaging of the upper urinary tract is important for diagnosis and monitoring. This can be achieved using urethroscopy, retrograde pyelogram in cystoscopy, intravenous pyelogram, or computed tomography (CT urogram). In addition, patients with transitional cell carcinoma of the upper urinary tract have a high risk of developing bladder cancer; these patients require periodic cystoscopy and monitoring the opposite upper urinary tract. Diagnosis When bladder cancer is suspected, the most useful diagnostic test is a radiological test such as a radiological test. computed tomography or Ultrasounds are not sensitive enough to be useful for detecting bladder cancer. Cystoscopy can be performed in a urology clinic. If cancer is detected during cystoscopy, the patient is typically scheduled for a bimanual examination under anesthesia and a repeat cystoscopy in the operating room so that transurethral tumor resection and/or biopsy can be performed. Survival Patients who die from bladder cancer almost always have metastases from the bladder to other organs. Low-grade bladder cancer rarely grows into the muscle wall of the bladder and rarely metastasizes, so low-grade (stage I) bladder cancer patients very rarely die from the cancer. However, they may experience multiple recurrences that should be treated Resections Almost all deaths from bladder cancer occur in patients with high-grade disease, which has a much greater potential to invade deep into the muscular walls of the bladder and spread to other organs in approximately 70% to 80% of patients with newly diagnosed bladder cancer. bladder have superficial bladder tumors (i.e., stage Ta, TIS, or T1. The prognosis of these patients depends largely on the grade of the tumor. Patients with high-grade tumors have a significant risk of dying from the cancer, even if it is not muscle-invasive cancer Those patients with high-grade tumors who are diagnosed with superficial, non-muscle-invasive bladder cancer in most cases have a high chance of cure, and even in the presence of muscle-invasive disease, sometimes the patient can be cured. Studies have shown that in some patients with distant metastases, oncologists achieved long-term complete responses after treatment with a combination chemotherapy regimen, although most of these patients have metastases limited to their lymph nodes. Secondary Bladder Cancer Bladder cancer tends to recur, even if it is non-invasive at the time of diagnosis. Therefore, standard practice is to monitor urinary tract after a diagnosis of bladder cancer. However, no studies have yet been conducted to evaluate whether surveillance affects progression rates, survival, or quality of life; although there is clinical trials to determine the optimal observation schedule. Urothelial carcinoma is believed to reflect a so-called field defect in which the cancer arises due to genetic mutations, which are widely present in the patient's bladder or throughout the urothelium. Thus, people who have had a resected bladder tumor often subsequently have ongoing tumors in the bladder, often in other locations than the primary tumor. Similarly, but less frequently, they may develop tumors in the upper urinary tract(i.e., in renal pelvis or ureters. An alternative explanation for these patterns of recurrence is that cancer cells that are destroyed during tumor excision may reimplant elsewhere in the urothelium. Support for this second theory is that tumors are more likely to recur lower than in the opposite direction from primary cancer. Upper tract cancer is more likely to recur in the bladder than bladder cancer to recur in the upper tract. The rest is in the following articles: "> Bladder cancer4
, as well as an increased risk of metastatic disease. The degree of differentiation (determining the stage of tumor development has important influence on the natural history of this disease and on the choice of treatment. An increase in the incidence of endometrial cancer has been found to be associated with long-term, unopposed estrogen exposure (increased levels). In contrast, combination therapy (estrogen + progesterone) prevents the increased risk of endometrial cancer associated with unopposed estrogen exposure specifically. Receiving a diagnosis is not the most good moment. However, you should know - endometrial cancer is a treatable disease. Follow the symptoms and everything will be fine! In some patients, a previous history of complex hyperplasia with atypia may also play an “activator” role. An increase in the incidence of endometrial cancer has also been found. in connection with the treatment of breast cancer with tamoxifen. According to researchers, this is due to the estrogenic effect of tamoxifen on the endometrium. Because of this increase, patients who are prescribed therapy with tamoxifen should undergo regular examinations of the pelvic area and should be careful about any. pathological uterine bleeding. Histopathology The distribution pattern of malignant endometrial cancer cells depends in part on the degree of cellular differentiation. Well differentiated tumors, as a rule, limit their spread to the surface of the uterine mucosa; Myometrial expansion occurs less frequently. In patients with poorly differentiated tumors, invasion of the myometrium is much more common. Invasion of the myometrium is often a precursor to lesions lymph nodes and distant metastases, and often depends on the degree of differentiation. Metastasis occurs in the usual way. Spread to the pelvic and para-aortic nodes is common. When distant metastases occur, it most often occurs in: Lungs. Inguinal and supraclavicular nodes. Liver. Bones. Brain. Vagina. Prognostic factors Another factor that is associated with ectopic and nodal spread of the tumor is the participation of the capillary-lymphatic space in histological examination. Three prognostic groups clinical stage I became possible thanks to careful operational planning. Patients with stage 1 tumors involving only the endometrium and no evidence of intraperitoneal disease (i.e., adnexal extension) are at low risk (">Endometrial Cancer 4

One of the most ominous diagnoses of our time - malignant formations. On early stage Oncology diseases are treated quite successfully. The cure rate is almost one hundred percent. But the most difficult thing is to detect a tumor on time: often they find out about it too late. That's why doctors advise you to undergo annual examinations.

A large amount of information about malignant tumors is available to everyone. Have you ever wondered why cancer was called cancer? These questions come to mind almost out of nowhere: why was the ladybug called that, why is the dragonfly called that, where did the names plantain come from, the Paralympic Games and much more.

History of the name of the disease

The name is so established and familiar that we don’t even ask questions about its origin. The ancient Greek name for this disease is carcinoma, meaning a malignant tumor with perifocal inflammation. Hippocrates gave this name to the disease because of the similarity of the tumor to this type of arthropod. It clings to healthy tissues of the body like claws. Processes developing tumor diverge from her to different organs, spreading the disease.

This name is still attached to oncological diseases. By the way, oncology oncos (Greek) is also the name given by Hippocrates.

This disease has been known since 1600 BC. At that time the disease was considered incurable. In the first century BC. We were just beginning to fight cancer at an early stage. This proposal was made by a doctor from Rome, Aulus Cornelius Celsus. But even then the treatment consisted only of surgical removal of the tumor. Late stages were not treated at all.

What you need to know about oncology

What do we not know about this terrible diagnosis? Here are some interesting facts that will help you get to know the “enemy in person” better.

About the number of patients:

for last ten There has been a twenty percent increase in diagnosed cancer patients over the years;
Every year, about 12 million new cancer patients are diagnosed worldwide;
almost three million cases of the disease - due to poor nutrition and virtually complete absence physical activity;
today cancer has become one of the most common causes of death in Russia;
Every day about 20 thousand people on the planet die from this disease;
The majority of cancer patients (about 70 percent) are from countries where the standard of living is low.

Most common reasons that cause cancer:

Poor nutrition;
High body mass index;
Insufficient physical activity;
Smoking;
Alcohol;
Hereditary predisposition;
Chemical carcinogens;
Increased hormone levels;
Presence of precancerous diseases.

Conditions for cancer:

1. It is impossible to catch cancer from someone. For the development of cancer, a change in human DNA is necessary, leading to the “immortality” of the cell due to uncontrolled reproduction. Another condition for the development of oncology is a violation of the immune system, that is, that part of it that directs the body to fight cancer cells.

2. Cancer is not inherited, although heredity plays a large role in predisposition to cancer pathologies.

What determines the possibility of a complete cure:

Depending on the type of tumor;
From the stage of development of the disease when the diagnosis was made;
From accurate diagnosis;
From correctly prescribed treatment;
From availability in hospital necessary equipment and qualified medical personnel.

Most cancer patients are elderly. With age, the likelihood of the disease increases. But the worst thing is when children suffer from cancer. Stay healthy.

Where does the fight against cancer begin? Of course, from making a diagnosis and determining the stage of development of the disease. The further course of the disease and the effectiveness of the prescribed treatment depend on this stage.

In medicine there are generally accepted international standards definition of stages oncological diseases, which are characterized by specific signs and differ in both symptoms and clinical picture. Each type of malignant neoplasm also has its own distinctive features.

How to decipher an oncological diagnosis

According to the requirements of the unified international system classification of oncological diseases (TNM classification), the characteristics of malignant neoplasms are designated by certain in Latin letters: T (Tumor), N (Nodulis) and M (Metastases). Together they show the degree of danger and stage of development of cancer. What do these letters mean?

The symbol T describes the characteristics and location of the tumor, its size and extent of spread. N characterizes the condition of the lymph nodes. For example, how close is malignancy, what is the degree of their damage, etc. The presence or absence of metastases is indicated by the letter M.

As a rule, numbers are added to these components, by which the degree of development of the process can be determined. For T these are parameters from 0 to 4, for N - from 0 to 3, for M - 0 or 1.

Thus, the following notations exist:

Tx - it is not possible to assess the size and spread of the primary tumor;
T0 - the primary tumor is not determined;
Tis - preinvasive carcinoma (carcinoma in situ);
T1 - malignant neoplasm spreads throughout the affected organ over a short distance;
T2 - the tumor develops on the affected organ, but does not grow deeper;
TZ - a malignant neoplasm grows into an organ;
T4 - tumor spreads to adjacent structures;
Nx - there is not enough data to assess the condition of the lymph nodes;
N0 - lymph nodes are not affected;
N1 - one regional node is affected;
N2 - several regional lymph nodes are affected;
N3 - distant lymph nodes are affected;
Mx - there is not enough information to determine distant metastases;
M0 - no signs of distant metastases were detected;
M1 - there are distant metastases.

There are two additional criteria, which are usually denoted by the letters G (gradus) and R (resection). These elements make it possible to assess the degree of malignancy of the tumor after surgical intervention. But the main indicators are still the letters T, N, M.

Stages of cancer development

The stage of cancer development is determined by the presence of certain characteristics:

Stage I- DNA damage has been detected, which provokes uncontrolled breakdown and mutation of cells. This damage can occur from exposure to ultraviolet light, radioactive elements, or certain chemicals. If you contact an oncologist in a timely manner, treatment of a malignant tumor at the first stage is highly effective. According to statistics, the process of cured patients is 95-100%.

Stage II characterized by the germination and uncontrolled increase of damaged cells, resulting in the active development of a tumor. The situation is quite dangerous, but still a forecast successful treatment at this stage it is close to 75%.

Stage III determined by the presence of metastasis. Atypical cells begin to quickly divide and move throughout the patient’s body with the flow of lymph or blood. This is the penultimate one, quite dangerous stage, and the favorable forecast for the development of the situation is only 30%.

IV stage- recurrence. It is characterized by the active uncontrolled emergence of new tumors localized in various organs person. At this stage there is no longer any hope for full recovery, and treatment is aimed at pain relief, maximum prolongation and improvement of the patient’s quality of life.

There is a myth that the patient dies quickly last stage cancer. Fortunately, this is not entirely true. Professional medical care And modern methods Treatments can not only prolong the patient’s life, but also significantly improve its quality. But, of course, much depends on the type of tumor and the extent of damage to vital organs. The patient’s attitude and the support of loved ones have a great influence on the development of the disease. Often work with patients suffering from cancer professional psychologists and psychotherapists.

How is a cancer diagnosis made?

Cancer - enough serious illness, which annually claims thousands of lives from different countries. However, thanks to progress modern medicine Today such a diagnosis is not always a death sentence. With timely access to qualified specialists, when the disease has not yet reached its peak, a favorable outcome is possible.

In addition, it must be remembered that the final diagnosis in oncology is made only after a biopsy. This procedure involves histological examination tissue from the tumor. A biopsy can determine whether the growth is truly cancerous.

For example, benign tumors have their own focus and grow slowly within its boundaries, without forming metastases. Histologically, they differ slightly from normal tissue. Removal benign neoplasm with the membrane in almost all cases leads to a complete cure of the patient.

In malignant tumors, on the contrary, the capsule is almost always absent. Therefore, they are characterized by rapid, infiltrating growth. Another sign of malignant tumor tissue is anaplasia - a return to more simple view buildings. In this case, differentiation is lost and specific function is lost. Histologically, undifferentiated, anaplastic structures and large number mitoses. In addition, many types of malignant tumors metastasize aggressively.

An oncological diagnosis leaves very little time to choose a good clinic and attending physician. Every minute counts. Great value has early diagnosis and timely medical care. The effectiveness and cost of treatment directly depend on the stage at which the fight against the disease begins.

That is why, if you detect various seals, you must immediately consult a doctor. In addition, it is extremely important to regularly undergo examination of the body for the presence of any diseases, because prevention is always better than cure.

The International Classification of Diseases is a generally accepted coding system for medical diagnoses developed by WHO. The classification includes 21 sections, each of which contains disease codes and. Currently, the ICD 10 system is used in the healthcare system and serves as a regulatory document.

Groups of diseases according to ICD 10

The largest part of the document is devoted to describing the diagnoses of diseases. Due to the use general classification In the medical field of different countries, general statistical calculations are carried out, the degree of mortality and the incidence rate of individual diseases are noted.

Diseases according to ICD 10:

Thus, diagnosis codes according to ICD 10 are an element of the general classification used in the medical field.

Other diseases in the ICD

The international classification describes a number of diseases associated with disorders of the excretory system, lesions of the skin, bone and muscle tissue. The presented groups of pathologies have their own coding in the ICD.

Pathologies of pregnancy and childbirth in the ICD

In the ICD 10 classification, in addition to diseases separate groups organs and systems, include conditions associated with pregnancy and childbirth. Pathological or not pathological process during the period of bearing a child - a medical diagnosis, which is noted accordingly in the classification.

The classification of oncological diseases helps the doctor describe the stage of cancer (the extent of the tumor process, the severity of the disease), as well as assess the risks for the patient and prescribe adequate treatment.

There are several principles for assessing malignant neoplasms.

Classification of cancer by stages

The classification was adopted in 1956 and is still used to quickly characterize a patient's condition. Indicates simultaneously the size, prevalence and presence of metastases:

Stage 1 – limited tumor(up to 2 cm). For some tissues, the dimensions at the first stage can be up to 5 cm;
Stage 2 – the tumor has same sizes, but there is one metastasisto the regional lymph node;
Stage 3 – the tumor is increasing up to 5 or more cm, thickens, loses mobility, and grows into surrounding tissues. Eatmultiple metastasesto regional lymph nodes;
Stage 4 – tumor any size with at least one metastasis to a distant organ, or tumor body invasionto neighboring organs.

Some types of tumors are larger than 5 cm, but can be effectively cured. At the same time, small malignant formations (up to 1 cm) can quickly spread throughout the body (for example,). Early diagnosis plays a key role in such cases.

Get advice on diagnosis

International classification TNM

A convenient classification for oncologists that allows accurately describe the prevalence of the process. Used to determine the type and extent of surgery, chemotherapy methods, and radiation exposure.

T– indicates size of the primary tumor(from Latin Tumor, “compaction”);
N– lymph node damage(from Latin Nodus, "knot");
M– metastasesto distant organs and/or tissue (from Latin Metastasis, “metastases”).

The letters are supplemented by numbers indicating the size of the tumor (for T), the number of affected lymph nodes (for N) and the presence of secondary lesions (for M).

Examples of deciphering oncological diagnoses

Т1N0M0 corresponds to stage 1 cancer, where the primary tumor is up to 2 cm, the lymph nodes are not affected and there are no metastases;
Т1N1M0– stage 2, there is one provoked (affected) lymph node;
Т0N3M1– Stage 4. In this example of diagnosis, the primary tumor was not found, which happens with rapidly metastasizing cancer. A relatively small colony of cells immediately metastasized to the lymph nodes and a distant organ (usually the lungs or liver), which were discovered by the doctor.

Metastases are designated by the numbers 0 or 1. It is not customary to indicate the number of distant metastases: they are either present (which corresponds to stage 4 cancer) or not.

Get help deciphering the diagnosis

Clarifying symbols in the classification of tumors TN.M.

TX– there is a primary tumor, but for technical reasons it cannot be assessed;
Tis(short for in situ) – malignant cells are detected, but they have not grown into the deeper layers (the most favorable prognosis for the patient);
NX– there is no way to assess the damage to the lymph nodes.

To detail the stage, subcategories of the form can be usedN2a or T1b:

add. T– multiple tumors in a specific part of the body;
U– indicates that the stage was determined immediately after intensive chemotherapy or surgery;
V– recurrent process or venous invasion, i.e. tumor damage to large veins;
L– damage to the lymphatic tract (X – suspected, 0 – absent);
Рn– the presence of perineural invasion (the tumor has penetrated the nerve, which is typical for cancer of the head, neck, as well as prostate and intestine).

Criterion describing tumor invasion (for hollow organs)

P1 – formation within the mucosa;
P2 – the tumor extends into the submucosal layer;
P3 – cancer penetrates the muscle layer;
P4 – the process has gone beyond the boundaries of the hollow organ.

Classification for sentinel lymph nodes

"Watchmen" called the first lymph nodes on the path of lymph outflow from the tumor-affected area. In other words, doctors know the typical ways cancer spreads, so they evaluate the condition of certain lymph nodes.

Notations used:

pN 1(sn) – lymph node affected by cancer;
pNO(sn) – no changes were detected in the lymph node;
pNX(sn) – the node cannot be evaluated (for technical reasons).

Classification of tumors by histological structure

The more primitive and smaller the cells, the more dangerous the tumor: a low-grade tumor spreads quickly and forms multiple metastases.

This is measured in levels of differentiation or degree of malignancy (English Grade, “degree”) and is denoted by the letter G:

G1– highly differentiated tumor; rarely metastasizes, which improves the prognosis of treatment;
G2– moderately differentiated process;
G3-4 – poorly differentiated and undifferentiated tumors, respectively – high level malignancy;
GX– it is impossible to determine the degree (degree) of malignancy.

C-factor, or classification of tumors by reliability

Considering the quantity controversial situations, oncologists agreed to difficult cases indicate the expected accuracy of the diagnosis, or C-factor:

C1 – indicates a malignant process external signs And standard studies: examination, survey, radiography, endoscopy. The doctor takes into account characteristic complaints and symptoms (bleeding, weight loss, etc.);
C2 – data C1 is confirmed special diagnostics :, angiography, targeted ultrasound, scintigraphy;
C3 – the above is supplemented with cytology;
C4 – biopsy was obtained during surgical intervention, a cytological examination was performed;
C5 – data obtained as a result of autopsy (autopsy).

Classification of postoperative tumors–category R

Treatment effectiveness criterion, which describes the tumor after therapy:

R0 – no tumor;
R1 – microscopy revealed residual tumor;
R2 – neoplasm is detected without microscopy;
RX – it is impossible to assess the presence or absence of a tumor.

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