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Abstract
CONSCIENCE-BASED MEDICINE: NEW APPROACHES TO THE MANAGEMENT OF PROSTATE CANCER PATIENTS
Lisovy V.N.1, Pilipenko I.N.2, Pilipenko N.I.1
1Kharkiv National Medical University, 2Grigoriev Institute for Medical Radiology of NAMSU, Ukraine
Abstract. Almost half of prostate men cancer, the disease is benign and not life threatening. However, some patients with aggressive tumors have manifestations that can lead to death if not treated. Now the problem concerns to predict the nature of its course. This will prevent useless severe treatment when most patients the tumor can be controlled minimal therapeutic intervention or even just to keep the patient under regular diagnostic control. At present there are real possibilities to confidently enough differentiate the cases where a radical medical aid to the patient is needed and where either only minimal therapeutic support or even just regular periodic examinations and consultations would suffice. What is respectfully acknowledged at major meetings and in editorials is not being applied to patients. The explanations are complex and rooted in a conflict between knowledge and belief with disturbing undertones of economic self-interest. It is time to practice conscience-based medicine.
Keywords: prostate cancer, management of patients, conscience-based medicine.
МЕДИЦИНА ЗАСНОВАНА НА СОВІСТІ: НОВІ ПІДХОДИ ДО ВЕДЕННЯ ХВОРИХ НА РАК ПРОСТАТИ
Лісовой В.М.1, Пилипенко М.І.2, Пилипенко І.М.1
1Харківський національний медичний університет, 2Інститут медичної радіології ім. С.П.Григор'єва, Україна
Реферат. Майже у половини хворих на рак простати, хвороба протікає доброякісно і не загрожує життю. Але у деяких пацієнтів пухлини бувають з агресивними проявами і можуть призвести до смерті,якщо не лікуються. Таким чином, наразі ставиться проблема прогнозувати характер її перебігу. Це дасть можливість запобігти марного тяжкого лікування у випадках, коли у більшості хворих пухлину можна контролювати мінімальним терапевтичним втручанням або навіть вести хворого лише під регулярним діагностичним контролем. Наразі існують реальні можливості достатньо впевнено диференціювати випадки захворювання, коли не обхідна радикальна лікувальна допомога хворому від тих, що потребують або мінімальну терапевтичну підтримку, або ж лише регулярний періодичний огляд і консультацію. Але те, що з повагою визнано на великих нарадах та в редакційних статтях, не стало повсякденною клінічною реальністю. Поясненняє складним і йде корінням у конфлікт між знанням і вірою з тривожним відтінком економічних інтересів. Настав час медицини, заснованої на сумлінні.
Ключові слова: рак простати, ведення хворого, сумлінна медицина
МЕДИЦИНА ОСНОВАННАЯ НА СОВЕСТИ: НОВЫЕ ПОДХОДЫ К ВЕДЕНИЮ БОЛЬНЫХ РАКОМ ПРОСТАТЫ
Лесовой В.Н.1, Пилипенко Н.И.2, Пилипенко И.Н.1
1Харьковский национальный медицинский университет, 2Институт медицинской радиологии им. С.П.Григорьева, Украина
Реферат. Примерно у половины заболевших раком простаты болезнь протекает доброкачественно и не угрожает жизни. Но у некоторых пациентов опухоль имеет агрессивное течение и может привести к смерти, если не лечить. Следовательно, ныне проблема состоит в прогнозировании характера заболевания. Это дает возможность избежать для большинства больных тяжкого лечения, контролируя опухоль только минимальными средствами, или даже ведя больного лишь под регулярным активным наблюдением. Ныне существуют возможности достаточно уверенно дифференцировать случаи заболевания, когда действительно не обходима радикальная лечебная помощь больному, от тех, когда нужна минимальная терапевтическая поддержка или даже всего лишь регулярное периодическое обследование и консультации. Тем не менее, то, что признано на широких совещаниях специалистов и в редакционных статьях, не стало широкой клинической реальностью. Найти объяснение этому явлению сложно, и уходит оно корнями, вероятно, в конфликт между знанием и верой с тревожным оттенком экономических интересов. Пришло время медицины совести.
Ключевые слова: рак простаты, ведение больного, основанная на совести медицина.
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14. Co-authors have the right to control their personal non-property rights by familiarizing themselves with the text (content) and form of the Work before its publication on the University's website, when transferring it to a printing company for reproduction or when using the Work in other ways.
15. The Co-authors, in addition to the property rights not transferred under this Agreement and taking into account the non-exclusive nature of the rights transferred under this Agreement, retain the property rights to finalize the Work and to use certain parts of the Work in other works created by the Co-authors.
16. The Co-authors are obliged to notify the Editorial Board of all errors in the Work, discovered by them independently after the publication of the Work, and to take all measures to eliminate such errors as soon as possible.
17. The University undertakes to indicate the names of the Co-authors on all copies of the Work during any public use of the Work. The list of Co-authors may be shortened according to the rules for the formation of bibliographic descriptions determined by the University or third parties.
18. The University undertakes not to violate the integrity of the Work, to agree with the Corresponding Author on all changes made to the Work during processing and editing.
19. In case of violation of their obligations under this Agreement, its parties bear the responsibility defined by this Agreement and the current legislation of Ukraine. All disputes under the Agreement are resolved through negotiations, and if the negotiations do not resolve the dispute – in the courts of the city of Kharkiv.
20. The parties are not responsible for the violation of their obligations under this Agreement, if it occurred through no fault of theirs. The party is considered innocent if it proves that it has taken all measures dependent on it for the proper fulfillment of the obligation.
21. The Co-authors are responsible for the truthfulness of the facts, quotes, references to legislative and regulatory acts, other official documentation, the scientific validity of the Work, all types of responsibility to third parties who have claimed their rights to the Work. The co-authors reimburse the University for all costs caused by claims of third parties for infringement of copyright and other rights to the Work, as well as additional material costs related to the elimination of identified defects.