- What is the current state of public health and why are oncological diseases becoming a more noticeable problem?
- In recent years, we have observed a significant shift in the structure of causes of mortality: despite progress in the treatment of cardiovascular diseases, the share of deaths from malignant neoplasms is increasing. This phenomenon is a consequence of demographic changes and improvements in medical care: people are living longer, and oncology is becoming an important part of the healthcare system. It is essential for the oncological service to develop as a unified technological system, rather than as a collection of separate institutions, ensuring accessibility and high-quality services for all citizens.
Statistical data in Russia highlight the scale of the problem: the number of newly diagnosed cases is increasing, the structure of tumors is changing, and some types of diseases are becoming more common among young people, including colorectal cancer, breast cancer, and prostate cancer. Although in some cases there is a decrease in mortality, indicating that more patients are living with diagnoses and requiring monitoring, rehabilitation, and support throughout their illness. Oncological care is transforming from a simple course of chemotherapy into long-term patient support.
- What modern approaches to oncological care exist in Russia and abroad?
- Modern oncology is based on three key aspects:
- individual characteristics of the patient,
- prevalence of the disease,
- biological properties of the tumor.
These aspects shape the treatment tactics, and there are many combinations of them. Therefore, the system must provide doctors with quick access to diagnostics and all possible methods of antitumor treatment, while ensuring patients have a convenient route without delays.
The first aspect is the patient. Age, comorbidities, previous therapies, and social factors play an important role in the choice of therapy, its intensity, and goals. The increasing share of primary multiple tumors requires the system to maintain constant interdisciplinary interaction and readiness for non-standard situations.
The second aspect concerns the prevalence of the tumor process. The quality of staging and dynamic assessment of the patient's condition is critically important: it is necessary to clearly understand what exactly is being treated (primary disease, recurrence, progression, etc.) and how accurate the examination results are. Ideally, the clinician should have access to an electronic database of images for analysis and comparison of studies over time. This is the foundation for ensuring safety and quality.
The third point is the biology of the tumor. The heterogeneity of tumors and the need for precise morphological and molecular-genetic studies necessitate a strong oncopathological service and modern laboratory infrastructure to select optimal therapy and rational resource expenditure. It is also important to emphasize the role of digital pathology and the participation of oncopathologists in consultations, which contributes to improving the accuracy of diagnoses and clinical outcomes.
- How can oncological services be optimally organized to enhance accessibility?
- I believe that the foundation of the system should be large oncological centers that combine outpatient and inpatient care and serve a sufficiently large population. This will allow for the accumulation of experience in complex and rare cases, avoiding the transformation of the center into an "unmanageable mega-complex." The optimal scale is a center focused on several million people.
At the same time, the emphasis should be on outpatient care, while the inpatient facility should be designated for surgical interventions and complex drug therapy. This approach reduces the burden on beds and speeds up access to care.
- What components are necessary for a high-tech oncological center?
- Within the center, there should be a structured system divided by specialties (head and neck, thoracic oncology, etc.), as well as specialized councils. Outpatient and inpatient doctors should work as a single team, jointly making decisions and accompanying the patient throughout the treatment. The system should focus on results rather than the volume of services, encouraging consultations between different departments.
- What additional measures can improve the functionality of the oncological center?
- The implementation of global trends may include the following components:
Creating a unified digital contour: registries, routing, access to images and molecular data. This will help reduce variability, time losses, and the risk of errors.
Navigation for patients: oncological care should be organized so that patients do not have to seek consultations and examinations on their own. A coordination service can significantly enhance efficiency.
Quality as a managed variable: measurable indicators should be established, and analyses conducted to continuously improve processes.
Development of palliative care and symptom control from an early stage: this improves the quality of life for patients and promotes more rational use of resources.
Prevention and early detection of diseases should be part of a unified system: screening, vaccination, and addressing risk factors. Without this, the treatment aspect will always be "catching up" with the incidence.
- What questions are most important when creating an oncological service?
- No structure will be effective without qualified personnel and funding. It is necessary to train doctors of all specialties, provide systematic postgraduate education, and support young specialists. It is important to ensure funding for both training and internships; otherwise, the system will not be able to retain staff. Moreover, oncological care must be accessible to all citizens: if treatment is not available, the purpose of creating an oncological center is lost.
My conclusion is as follows: modern oncological care should be integrated, specialized, and patient-oriented, where decisions are made based on the stage and biology of the tumor, as well as the individual characteristics of patients. Access to diagnostics and treatment should be quick, and quality should be a constant focus for improvement. Education of personnel and accessibility of care must be real, not just declarations. Only such a model will help contain the growth of incidence, reduce mortality, and ensure a decent life for people who live long with a diagnosis.
- What are your impressions after your visit to Manas and the problems in the region?
- In November 2025, I visited Manas at the invitation of Jalal-Abad State University. NOPK ZHAGU, together with the Regional Clinical Hospital, organized an oncology conference where I gave a lecture. I also participated in a meeting of the regional administration dedicated to oncological care.
I am pleased that local authorities recognize the problems of oncology among the population. This is an important step, as effectively addressing medical issues can significantly improve the social situation in the region by providing people with timely assistance for the most common diseases.
However, at present, Manas and the Jalal-Abad region do not have a full-fledged oncological service. Residents are forced to seek medical help in Osh or Bishkek, which complicates the process of diagnosis and specialized oncological assistance.
Manas is in urgent need of a modern oncological center that could serve as a practical assistance institution and a scientific-educational center for training new specialists and conducting modern research in oncology. Proper planning of such a center will help harmoniously develop oncological care and education in the country.
I am confident that a university clinic built as a center of competence in oncology will be able to provide the local population, doctors, and students with quality assistance and education in the field of oncology.
