All news 04.02.2019



5-year survival rate of cancer patients was 50% in 1990 while in 2015 it has gone up to 78% according to World Health Organization data

At a meeting on the occasion of the World Cancer Day, national consultants, specialists and representatives of patient organizations presented updated data and information about cancer incidence rate in Bulgaria. The discussion under the title “The Role of Multidisciplinary Approach and Teamwork in Complex Cancer Treatment“ was held at ACC –Oncology Centre on 1 February.

 “Cancer has undergone serious changes in its treatment that can be measured with the statistical indicator of 5-year survival rate. In 1900 the survival rate of cancer patients was 5% while in 1990s it was 10 times more or 50%. Exactly this indicator helps us to figure out how successful we have been. The last data of the World Health Organization shows that in 2015 this percentage went up to 78- 80%.“, said Prof. Dudov, the President of the Bulgarian Cancer Scientific Society and Medical Director at Acibadem City Clinic Oncology Center.

The professor said that sadly the national data for cancer patients in Bulgaria ‘has frozen” and it did not give adequate measurement of the most common localizations of cancer, frequency of incidence and morbidity; in many cases the physicians need to count on reliabe data from European and American sources.

According to Prof. Dudov the fast adaptation and implementation of new technologies and treatment methods results in the increase of survival rate in cancer diseases in Bulgaria, too.  From this point of view the biggest progress in medicine has been experienced at the first step of detecting and diagnosing cancer diseases, namely in the area of imaging and nuclear medicine.

The newest diagnostic methods of breast cancer comprises 3D mammography, contrast-enhanced mammography and breast IMR, which gives the opportunity to early detection of cancer in young women with higher density of breast grandular tissues.

Every 6th woman in cancer cases is aged 40-49. Today, the new technologies and examinations of breast cancer with tomosynthesis make it possible for us figuratively speaking to “cut” the image of the mammary gland and help us to discover tumor cell nuclei at an earlier stage. Therefore we advise patients in their 40s and older ones to perform a mammography examination once a year“, explained  Assoc. Prof. Veselka Stoynova, Head of Imaging Department at Acibadem City Clinic Oncology Center.

Virtual Colonoscopy /VCS/, which makes it possible to detect colon cancer as well as pre-cancerous formations (colon polyps); it is a comparatively new examination in fight against cancer. The research shows that the application of VCS reduces by 60-70% the risk of death from colon cancer.

The fight against lung cancer, which is the second most common cancer for men and women and the leading cause of death, is backed up by a new type of examination called low-dose computer tomography of lungs. It gives the opportunity to discover diseases at an earlier stage when the treatment chances are much better.

Recently after the implementation of specific radiopharmaceutical 68Ga-PSMA in the sphere of nuclear medicine it has become possible to get information earlier about the development of prostate cancer and detection of relapses. Something that was not possible a year ago“, emphasized  Prof. Irena Kostadinova, the head of Nuclear Medicine Department.

The development of clinical pathology and genetics is also playing a key role more and more in defining a patient‘s treatment. The innovative histopathological and immunohistochemical tests show whether it is possible to include the patient into an immunooncology treatment or into a target treatment. In the last 10 years liquid biopsies have been getting a bigger part in genetic examinations, in addition to classical samples – tissue materials. They make it possible to examine tumour markers in venous blood, give information about the progress of the disease and would help to apply a more precise treatment. An innovation in clinical practice is the new generation sequencing. This method examines multigene panels that provide more information about the primary disease and hence more alternatives for personalized treatment.

Nowadays, with the advance of new avant-garde  examination and treatment methods, it is impossible for one physician to know everything, therefore, only the team work helps to work out the right treatment strategy for each individual patient“, said Assoc. Prof. Handzhiev. He highlighted the importance of general practitioners in the so called screening programmes and early diagnosis. In bigger  part of oncogastroenterology diseases patients have gone through a benign disease, which often paves the way for a malignant disease. A general practitioner should foresee exactly that.

The novelties in the treatment of oncological diseases are not fewer that the novelties in diagnostic methods. Before the appearance of brain metastasis was considered as an event that stopped the further treatment of many patients with cancer diseases, now stereotactical radio-surgery makes it possible to attack such brain metastases. High doses of radiotherapy is used, which destroys the metastasis without affecting the surrounding brain.

It is great that in clinics such as ours the treatment of cervical cancer has been actively implemented through brachytherapy. Although it was available in Bulgaria, it was episodically used in addition to radiotherapy in cases of cervical cancer and a huge number of women underwent this radical operation after percutaneous radiotherapy“, said Dr. Nedev, Head of Radiotherapy and Radiosurgery Department.

He explained that this type of operation after radiotherapy is not a standard treatment anywhere in the world. Brachytherapy consists of a couple of radiotherapy sessions where the radiotherapy source is placed in special applicators into the uterine cavity and vagina; in this way  a high dosage of radiation is applied directly onto the tumour. This type of brachytherapy, in combination with modern technology radiotherapy and with the modulation of the dosage and chemotherapy, makes it possible to treat even locally advanced cases of cervical cancer, which were considered as hopeless in the past.

Assoc. Prof. Arcadi Ivanov, who closed the meeting on the occasion of World Cancer Day, said that the development of chemo- and radiotherapy has consistently changed the work of a surgeon, too, as all that gives the opportunity to take away a smaller and smaller part of the affected organ and it can be achieved through invasive and laparoscopic intervention.