Chest bone cancer. Why are boundaries and coordinates of a land plot needed and what does the mark “without boundary coordinates” mean?

SOCIAL PSYCHOLOGY

approaches to defining intimacy in foreign psychology

Goreltseva V.V.

The scientific definition of the phenomenon of intimacy allows us to penetrate deeper into the mechanisms and processes of communication and interpersonal relationships. Today, intimacy as a term does not have clear substantive boundaries and is often confused with other concepts that describe interpersonal interaction. The article provides an overview of foreign concepts of intimacy. The levels, key components and temporal aspects of the phenomenon are highlighted.

Keywords: intimacy, closeness.

The concept of intimacy includes sexual and personal relationships characterized by closeness and openness. The Latin root intimus means "innermost." Consequently, intimacy concerns the innermost qualities of a person. Intimacy is associated with one person’s understanding of the deep internal qualities of the Other. This understanding is confidential and usually kept from the public. That's why scientific definition the phenomenon of intimacy allows us to penetrate deeper into the mechanisms and processes of communication and interpersonal relationships. However, how to give a strict scientific definition of what characterizes deeply internal processes interpersonal relationships? K. Prager draws attention to the fact that in attempts to define intimacy, the problem is attributing this phenomenon either to the individual quality of a person or to the quality of his system of relationships. Intimacy is often confused with concepts of love, closeness, self-disclosure, support, connection, attachment and sexuality.

K. Prager identifies four functions that a scientific definition of intimacy should perform: 1) integration of different perspectives in understanding what intimacy is; 2) determining the relationship between the various components of proximity; 3) distinguishing intimacy itself from related concepts; 4) recognition of the unattainability of an absolute definition of the phenomenon of intimacy.

Intimacy is typically characterized by a wide range of emotions, including kindness, tenderness, sexual attraction, pleasure in satisfying the wants and needs of Another, and joy in sharing meaningful moments, activities, and projects. According to E. Giddens, intimacy, first of all, presupposes emotional connection with myself

and others in the context of equality, with trust to be won and actively maintained. E. Berne believes intimacy as a special - sincere - relationship between partners in the “Child” ego state, which is characterized by an emphasis on sensuality. E. Eron and his colleagues consider intimacy as an emotional experience of psychological closeness, coupled with the involvement of resources (material goods, knowledge (conceptual, informational, procedural), objects of the social sphere), perspective and identity of the Other in the personality of partners.

R. Bergner and E. Bridges identify the following features characteristic of intimacy, understood as emotional closeness: 1) investment in the well-being of a loved one, 2) connections, 3) admiration, 4) sexual desire, 5) intimacy, 6) commitment, 7) exclusivity, 8) understanding.

As a result of a phenomenological study of intimacy, L. Register and T. Henley identified seven components that make up central structure intimacy: 1) non-verbal communication; 2) existence; 3) time; 4) borders (blurring of boundaries between people); 5) body (increasing the importance of the body and bodily touch); 6) fate and surprise (describing the experience as unusual and very natural; destiny); 7) transformation, transformation (something new through movement or fusion).

The experience of subjects ranking categories describing intimacy relationships, identified in the process of a similar study, showed that self-disclosure is defined as the main aspect of intimacy in interpersonal relationships. Expressions of love, compatibility, cohesion, identity, and conflict resolution skills were

also highlighted as important aspects intimacy. Sexual satisfaction is considered less important than the previous components of intimacy.

K. Praeger and L. Roberts propose to separate interactional intimacy/ intimate interactions and intimate relationships. Interactional intimacy is associated with self-disclosure behavior, positive involvement with the Other, and shared agreements. Whereas intimate relationships are characterized by the degree and quality of intimacy. Self-disclosure behavior consists of showing personal, private aspects of personality to Another or inviting the Other into a zone of privacy, which can be represented through verbal and nonverbal behavior. Positive involvement in an interaction is visible through verbal and nonverbal behavior that shows positive immediacy of testimony. In intimate interaction, both partners experience a sense of knowledge or understanding of some aspect of the Other's internal experience, private thoughts, feelings, or beliefs, characteristic rhythms, habits, or established practices, private sexual fantasies and preferences. Intimate relationships, according to K. Prager and L. Roberts, develop on the basis of long-term interactional intimacy. They are characterized by mutual, accumulated, shared personal knowledge. The criterion for defining a relationship as intimate is the continuum of relative closeness, its degree and quality. Intimate relationships develop under the influence of two factors: the completeness and accuracy of personal information received about each other by closely interacting partners.

For development intimate relationships It is necessary for couples to use coordinated strategies to move along the continuum of intimate interactions (from personal closeness to personal distance). The authors cited identify three main types of intimacy regulation sequences that determine the frequency and content of intimate interactions and link predictable consequences to appropriate behavior.

The first type determines the sequence of mutual exchange of personal information, the sequence of rapprochement and distance in the dynamics of the development of intimate relationships. The second type determines the sequence of actions to terminate intimate relationships, their curtailment through consent to distance or resistance to it. The third type defines steps to reduce intimacy. Dynamics in the functioning of intimate relationships are inevitable because the need for intimacy

with the Other is in “dialectical tension” with other needs (for example, autonomy).

E. Kouneski and D. Olson argue that intimacy is associated with patterns of flexibility and psychological closeness in relationships. Intimacy in a couple means being emotionally connected, being able to rely on each other, being supportive, enjoying the relationship, and accepting each other. To assess couple intimacy, these researchers identified the following categories: communication, conflict resolution, family and friends, leisure, sexual relationships, spirituality and faith, children and parenting, financial management, identity issues, and egalitarian roles. In this case, intimacy is measured as the degree of positive perception of the relationship.

Jamison identified six key characteristics of intimacy: 1) similar associations; 2) general knowledge; 3) knowledge about the secret, intimate sides of each other’s personality; 4) knowledge and understanding of love and trust; 5) care; 6) participation in each other's lives.

Close relationships can be successfully understood through the analysis of interdependence theory. K. Rusbult, together with her colleagues, proposed a matrix representation of the situational structure of intimacy relationships (based on the developments of Thibault and Kelly). Interdependence theory presents a logical analysis of the structure of interpersonal situations and proposes conceptual framework to analyze situations of interdependence, in terms of the above properties. The authors suggested that intimacy exists if at least one of the partners is addicted. The combination of dependence and other structural properties determines the nature of close interdependence, presenting partners with a certain kind of problems and opportunities, allowing one to logically assess the likelihood of certain motives and find acceptable ways of expressing them. The level of dependence describes the degree to which an individual "relies" on an interaction partner, in that his or her outcomes are influenced by the partner's actions. The structures of interdependence are determined by the following components: 1) control of the subject - the influence of each subject on their own actions; 2) partner management - the impact of each subject on the partner’s results; 3) joint management - the influence of joint actions of the subject and the partner on the results of the partner; 4) covariation of interests - a measure in which the results of the subject and the partner correlate positively (coordinated interests) or negatively (conflict of interests).

The above components define four structural properties intimacy: level of dependence, reciprocity of dependence, basis for

SOCIAL PSYCHOLOGY

dependencies and covariance of interests. The level of dependence determines the extent to which the subject's outcomes depend on the actions of the partner. Reciprocity of dependence determines the degree of equivalence of the dependence of the partners. A dependency basis describes the way partners influence each other's outcomes using either partner control or joint control. Covariance of interests describes the extent to which partners' results correspond to each other.

D. Bennett emphasizes the temporal and dynamic components of an intimate connection and identifies four forms of the “intimacy-time” equation. The first, defined by the author as the most popular, shows that real intimacy requires time: for true intimacy, two people must be willing to give or spend time with each other with a friend. The first form suggests that intimacy is equated with mutual exchanges of self-disclosure, vulnerability, or sexuality. Second form: a deeper experience of intimacy entails an experience of some transcendence of the temporary world. The third form consists of sensitivity to natural temporal qualities, such as cycles, rhythms, periods of approach and distance - determines the ability to be intimate. It is in the language of sensuality and sexual dialogue that this equation can be seen most often. The fourth form is that the experience of time in all its personal aspects and even in terms of mortality depends on the priorities of intimacy and spending time with other people. That is, our social relations, especially those we consider the most intimate, define time in the most existential and personal manner. The author also believes that time passes faster in pleasant or intimate contact. The experience of the fourth equation is most acute when we wait, or have waited, for intimacy with the Other, or when we redeem the past through forgiveness. Close relationships often force one to develop the virtues of sobriety, patience, humility and calm; atti-tudes that require a deeper relationship to time.

The experience of intimacy can shape relationships and differentiate them from other relationships. On the other side, various shapes relationships can stimulate and shape intimate experiences. D. Bennett also argues that it is the experience of intimacy that catalyzes the transformation of relationships, through a change in their character, into friendly, exclusive, partner, family or sexually committed.

G. Reis and P. Shever define intimacy as an interpersonal process that includes

communicating personal feelings and information to another person who responds warmly and sympathetically. Such a process is also a sequential unfolding of corresponding thoughts, feelings and behavior, each of which depends on antecedent conditions and expected consequences. The authors identify two fundamental components of intimacy: self-disclosure and a lively response from the partner. Self-disclosure is categorized as belonging to one of the types: a) factual or descriptive (communication of personal facts, information) and b) emotional or evaluative (connection of personal feelings and opinions). The authors also describe intimacy as a type of closeness, emphasizing the need for validation and caring. Other types of intimacy involve more behavioral forms of interdependence, in which partners influence each other's behavior. Feelings of intimacy and behavior of intimacy are independent forms of intimacy.

W. Ikes, together with his colleagues, in the context of the model of G. Reis and P. Shever, expanded the definition of intimacy to include empathic accuracy - the ability to accurately deduce a certain content of the thoughts and feelings of an interaction partner. Empathic capacity, or accuracy, may influence the degree to which one faithfully interprets another's self-disclosure and, in turn, follows a path that demonstrates faithfulness to the partner's understanding, caring, and acceptance. Too much high level empathic precision can produce negative effect in the form of increased conflict in relationships in cases where (a) emotional and cognitive abilities partners involve contradictory differences that must remain unresolved; (b) their empathic accuracy modifies or even destroys the illusions that helped maintain the relationship; and (c) one partner's empathic accuracy is interpreted by the other as intrusive and direct.

The process of perceiving a partner during interactions can influence the interpretation of disclosed personal information. G. Reis and colleagues conceptualize the role of social perception in intimacy as the interpretive filters that individuals use to record and interpret a partner's behavior in an interaction, including motives and goals that affect the kinds of interpretations and evaluations that have already been made.

The central characteristic of intimacy is interaction. Intimacy is conceptualized as a dynamic process that unfolds over time. Researchers acknowledge that although stable characteristics may make a relationship close, the degree of closeness can vary significantly.

The described model provides a theoretical mechanism reflecting the mediation and regulation of the process of intimacy through which it develops while being influenced by individual factors differences. This model confirms that close relationships consist of repeated close interactions over time that contribute to more global assessments of relationship quality. The methodological significance of the considered model lies in the possibility of studying the process of intimacy through assessing the self-disclosure and lively response of the partner repeatedly, at certain intervals within the relationship.

Thus, intimacy can be conceptualized in a variety of ways, based on different dimensions related to intimacy, and includes levels of analysis (e.g., individual or interactional level), central component (e.g., disclosure and partner responsiveness), and temporal dimensions (static vs. processual). ).

LITERATURE

1. Bern E. Sex in human love / trans. from English M.P. Daddy. - M.: Publishing house EKSMO-Press, 2001.

2. Giddens E. Transformation of intimacy. Sexuality, love and eroticism in modern societies / trans. from English V. Anurin. - St. Petersburg: Peter, 2004.

3. Aron A.P., Mashek D.J., Aron E.N. Closeness as Including Other in the Self // Handbook of Closeness and Intimacy. - Mahwah, New Jersey, London: Lawrence Erlbaum Associates, 2004. - P. 27-42.

4. Bennett Joel B. Time and Intimacy: A New Science of Personal Relationships. - Mahwah, NJ/London: Lawrence Erlbaum Associates, 2000. - P. 349.

5. Bergner R., Bridges A. The significance of heavy pornography involvement for romantic partners: Research and clinical implications // Journal of Sex and Marital Therapy. - 2002. - No. 28. - R. 198-206.

6. Ickes W., Hutchison J., Mashek D. Closeness as Intersubjectivity: Social Absorption and Social

Individuation. Handbook of Closeness and Intimacy. -Mahwah, New Jersey, London: Lawrence Erlbaum Associates, 2004. - P. 357-174.

7. Jamieson L. Intimacy: Personal relationships in modern societies. - Cambridge, MA: Polity Press, 1999.

8. Kouneski E.F., Olson D.H. A Practical Look at Intimacy: ENRICH Couple Typology. Handbook of Closeness and Intimacy. - Mahwah, New Jersey, London: Lawrence Erlbaum Associates, 2004. - P. 117-136.

9. Prager K.J., Roberts L.J. Deep Intimate Connection: Self and Intimacy in Couple Relationships Handbook of Intimacy and Intimacy. - Mahwah, New Jersey, London: Lawrence Erlbaum Associates, 2004.

10. Prager K.J. The psychology of intimacy. - New York: The Guilford Press, A Division of Guilford publications, 1995.

11. Reis H.T., & Shaver P.T. Intimacy as interpersonal process. In S. Duck (Ed.), Handbook of personal relationships: Theory, relationships, and interventions. - Chichester, England: Wiley, 1988. -P. 367-389.

12. Reis H.T., Clark M.S., Holmes J.G. Perceived Partner Responsiveness as an Organizing Construct in the Study of Intimacy and Intimacy Handbook of Intimacy and Intimacy. - Mahwah, New Jersey, London: Lawrence Erlbaum Associates, 2004. -P. 201-228.

13. Register L.M., Henley T.B. The Phenomenology of Intimacy // Journal of Social and Personal Relationships. - 1992. - Volume 9. - Issue 4. -P. 124-151.

14. Rusbult C.E., Kumashiro M., Coolsen M.K., Kirchner J.L. An Attachment Theory Perspective on Closeness and Intimacy Handbook of Closeness and Intimacy. -Mahwah, New Jersey, London: Lawrence Erlbaum Associates, 2004. - P. 137-163.

15. Sexton R., Sexton B. Intimacy: A historical perspective // Fisher M., & Stricker, G. (Eds.). I'm intimacy. -New York: Plenum Press, 1982. - P. 1-20.

16. Waring E.M., Tillman M.P., Frelick L., Russell L., Weisz G. Concepts of intimacy in the general population // Published as a separate and in The Journal of Psychology. - 1980. - No. 104. - P. 221-231.

... has the worst prognosis of all primary CNS tumors. It grows rapidly, grows into brain tissue, and has no clear boundaries.

Glioblastoma(GB) is the most malignant of all glial tumors. It is the most common primary tumor of the central nervous system (about 10-20% of all intracranial tumors). Approximately half of all gliomas are GB. HD is the most common supratentorial tumor in adults, usually occurring in patients over 50 years of age and rarely before 30 years of age. There is a slight predominance of occurrence in the male population. According to A.I. Romodanova, these tumors account for up to 5% of the total number of brain tumors in children.

Macroscopically GB are usually formations that have a heterogeneous structure with central necrosis and a richly vascularized stroma. Intratumoral hemorrhages are often observed. At histological examination GB are tumors with pronounced cell atypia and high mitotic activity. Characteristic feature GB are multiple foci of necrosis with the presence of so-called pseudo-palisade structures, which are represented by a multinucleated palisade of elongated hyperchromic nuclei and pronounced proliferation of vascular endothelial cells. Like other infiltrating gliomas, GB does not have a clear boundary between tumor, edema, and normal medulla.

In patients with this malignant tumor, there is a rapid increase in clinical symptoms, a sudden deterioration in condition due to increased intracranial pressure and the appearance of symptoms of brain herniation. Often less than one month passes from the appearance of the first signs of the disease to the patient’s almost complete disability. In most cases, headache affects the cerebral hemispheres and is more often localized in the deep white matter of the temporal, frontal and parietal lobe brain, in the corpus callosum with distribution to one or both hemispheres in the shape of a “butterfly”. Less commonly, headache occurs in the cortical regions and posterior cranial fossa, as well as in basal ganglia. Metastasis to the central nervous system may occur. HD has the worst prognosis of all primary CNS tumors. Average duration life is 8 months, 5-year survival without relapse is equal to zero.

On a computed tomography(CT) tumor density is quite heterogeneous. A central zone of low density represents necrosis and is observed in 95% of cases. Petrifications are rare in GB. Often defined of various ages hemorrhages. Typically surrounding the tumor is perifocal edema extending into the white matter of the brain. Increased after administration contrast agent(KB) is pronounced, but very heterogeneous - the contrast appears in the form of a ring with a heterogeneous internal contour. Sometimes headache does not have a separate node, but infiltratively widely affects the hemisphere and has minimal radiologically visible signs of damage to the blood-brain barrier (BBB). Contrast enhancement in these cases is weak or completely absent.

Magnetic resonance(MR) manifestations of HD generally reflect pathological changes, demonstrating significant tumor heterogeneity. T1-weighted CT scans reveal poorly demarcated extensive education with a mixed (iso- and hypointense) signal, central necrosis, which usually has a reduced signal in relation to the tumor mass. Tumor manifestations on T2-weighted MRI are also varied, with areas of hypo-, iso-, and hyperintense signal from the GB stroma, necrosis, cysts, and hemorrhages. Extensive mass effect and swelling of the white matter often accompanies small tumors. The boundaries of the tumor are indistinguishable from perifocal edema, so the peripheral zone of headache is often called “tumor + edema.”

In GB tumor cells may be present outside the area of signal enhancement and perifocal edema seen on MRI. HDs spread widely and rapidly along white matter tracts. Spread to the other hemisphere through the corpus callosum, anterior and posterior commissures is also typical, but spread along the internal and external capsule can also occur. With hemispheric headaches, sometimes the spread downward, into the cerebral peduncles and into the back cranial fossa. In most patients with hypertension, separate nodes gradually form, which are externally distant from the primary tumor, but are microscopically connected to it. In the final stage, tumor spread through the ependyma and subarachnoid spaces of the brain and spinal cord. Most GBs are significantly but heterogeneously contrasted by KB administration. Since these tumors are often highly vascularized, on MRI, especially in T2 mode, tumor vessels can be observed in the form of tortuous elongated areas with the phenomenon of loss of signal from moving blood. In 5% of cases, multiple headaches occur - on MRI they are practically indistinguishable from metastases. Treatment of glioblastoma consists of three successive stages: 1 - neurosurgery: complete surgical removal tumors; 2 - combined treatment: radiation therapy + Temodal (temozolomide); 3 - maintenance chemotherapy: Temodal.

Drawing a continental border is very difficult. Between Asia and Europe it constantly changed its shape. This happened due to the gradual development of the mountains and lands of Siberia.

The official division of one continent into two (in the North-South direction) was carried out in 1964. At the 20th Congress of the International Geographical Union, scientists drew a clear boundary line between Asia and Europe. Based on these data, the following situation was recorded.

The border begins in the Kara Sea, in Baydaratskaya Bay. Further the dividing line runs along the eastern part Ural mountains and follows down east Perm region. Thus, both Chelyabinsk and Yekaterinburg turn out to be located in Asia.

Further, the border goes along the Ural River, passes into the Orenburg region and descends to the northern part of Kazakhstan. There it is “picked up” by the Emba River and descends straight into the Caspian Sea. Leaving the northern coast of the Caspian Sea in Europe, the border reaches the Kuma River and, along with it, crosses the northern part of the Caucasus Mountains. Further, the path passes along the Don to the Sea of Azov, and then to the Black Sea. From the latter, the border between Asia and Europe “flows” into the Bosphorus Strait, where it ends.

Ending at the Bosphorus Strait, the border divided Istanbul into two continents. As a result, there are two parts to it: European and Asian (Eastern).

Along the path of the border there are several states, which it happily “divides” into two continents. This applies to Russia, Ukraine, Kazakhstan, Turkey. It should be noted that the latter “got it” the most: the border divided its capital into two parts.

However, after the official border was drawn, disputes and discussions did not subside. Scientists assure that it is impossible to clearly draw a line based on any external/internal parameters. For example, by vegetation, climate or soils. The only real measure is the geological history of the area. Therefore, the Urals and the Caucasus turned out to be the main border landmarks.

Today the Caucasus and the Urals are not divided into parts by a border. It passes only along their bases, leaving the mountains untouched. This approach greatly simplified the work of geologists.

But this situation caused difficulties in the work of cartographers. In reproducing one, scientists had to divide mountain ranges into unequal parts. It is almost impossible to carry out such a procedure accurately. This situation had a negative impact on the work of geologists who often use maps: parts of the mountains were “scattered”, although historically they were single massifs.

To the group malignant neoplasms human body includes cancer of the chest bones. There are primary and secondary oncology. Primary disease occurs when a cancer process develops directly in the area of the ribs and sternum. Secondary cancer is the result of metastasis of malignant tumors from other organs. Quite often this pathology affects young people.

The human chest consists of 12 pairs of ribs, which are connected in front by the sternum, and in the back - adjacent to the thoracic vertebra. Together they form a framework for the lungs and heart, and thanks to the surrounding muscle layer, they can move and participate in breathing.

Primary tumors can develop in:

cartilaginous part of the ribs;
bone part;
red bone marrow of the sternum.

Metastatic lesions of the chest are also common. In this case, the primary tumor may be located in neighboring or distant organs and tissues. Metastases enter the bones through the bloodstream or directly when the tumor grows soft fabrics.

Chest bone cancer: treatment and prognosis

Breast cancer grows quite quickly and unnoticed. As the tumor grows, which, for example, has developed in one rib, spreads to other ribs or the sternum. The spine may also be involved in the process, which is accompanied by additional complications. The most dangerous are metastases to the lymph nodes and mediastinal tissue.

In addition, bone cancer in the chest can affect the nerves and blood vessels that are located in the large quantities in the grooves of the ribs. When metastasis occurs, the lungs are the first to be affected.

Causes of chest bone cancer

The causes of this disease cannot be determined with certainty. But scientists have proven that:

a patient's history of trauma may be a precursor to the onset of the formation of a tumor process;
heredity is a predisposing factor in the development of this disease;
DNA mutations under the influence of exposure to radioactive radiation and carcinogens can cause cancer;
disturbances during the embryonic development of the sternum affect the formation of tumors in this place in adulthood;
There are non-malignant diseases that can cause cancer. These include Paget's disease, eosinophilic granuloma, fibrous dysplasia.

Types of neoplasms

Several types of tumors can appear in the bones of the chest:

– develops directly in bone cells. This is an aggressive type of cancer that can metastasize to other organs (lungs, etc.). This disease is slightly more common in men;
– affects cartilage cells. Men get sick more often. The disease can metastasize to internal organs (lymph nodes, lungs, etc.). Among malignant neoplasms of the sternum, chondrosarcoma ranks first and occupies 85%.

Rarely found:

reticulosarcoma.

In addition to sarcomas, in the bone marrow of the sternum, in particular, can occur.

Symptoms of chest bone cancer (clinic)

At first, clinical symptoms may be mild. The main symptom of the disease is pain, which often radiates to the intercostal space. It can be of different intensity. At the initial pain syndrome poorly expressed, comparable to a bruise. It is observed mainly at night or after heavy exertion. In later stages, the pain intensifies and becomes constant.

The time to first see a doctor depends on the severity of the symptoms of the disease and can vary from a couple of weeks to many years. The development of the tumor leads to weakening of the bones. The area of the body in the area where the tumor develops may become deformed over time. The soft tissue around it swells and changes color, and the blood vessels protrude. Although, if the tumor grows from the periphery inward, there may be no visible manifestations.

The neoplasm can be identified by palpation. The tumor is painful formation fused to adjacent tissues. About availability inflammatory process indicates hot skin over the sore area.

On early stages Some tumors grow very rapidly, but subsequently the growth of the cancer may slow down or stop.

Symptoms such as fever, chills, weakness, and night sweats may develop after the disease has metastasized to other organs and tissues.

Diagnosis of chest bone cancer

Due to the fact that sometimes the only symptom of chest damage is pain, it is difficult for doctors to diagnose oncology. This symptom is characteristic of many other ailments. For these reasons correct diagnosis It is often placed late, when the process is so advanced that complications arise.

Patients who are suspected of developing a cancer process must be fully examined. First of all, appoint x-ray examination. Often it helps, but sometimes more is needed precise methods to detect a tumor. These include computed tomography and skeletal scintigraphy.

After they are completed, the doctor will have all the necessary information about the tumor: its size, location, degree of spread. The condition of the bone will also be visible: there may be areas of destruction, ossification, and thinning. In some cases, it is possible to determine the type of formation. Malignant tumor, as a rule, does not have clear boundaries and penetrates into adjacent soft tissues, and sometimes into organs. Benign has clearly defined boundaries.

Additionally, a person needs to undergo blood and urine tests to determine the presence of tumor markers, if any, and also check the composition of the blood. Abnormalities in urine analysis may indicate kidney problems. A blood test can detect lymphoma.

If metastases are suspected, apply ultrasonography organs of the mediastinum and abdominal cavity, MRI or PET may be prescribed.

A mandatory step in diagnosing cancer is a biopsy (taking tumor material for microscopic examination). It is carried out using a puncture needle, which is inserted into the patient under the skin, or during open surgery. A biopsy makes it possible to diagnose accurate diagnosis, indicating the histological type of tumor, and also outline a treatment plan.

Treatment of chest bone cancer

Surgical intervention is the main method. This method removes the area of bone affected by cancer or the entire bone. Then implants, which can be artificial or natural, are inserted into the place of the removed gap.

Surgeons are faced with the difficult task of restoring the chest frame so that it can perform its previous functions. This is even more difficult if several ribs or the entire sternum have been removed. Tumors that have spread greatly are not operated on at all due to the great difficulties in reconstructing the chest and the danger of pulmonary and cardiac complications.

If the tumor has given single metastases to the internal organs, they are also subjected to surgical removal. If the operation was performed on initial stages development of the disease, the prognosis is quite favorable.

Radiation therapy has also been used successfully to treat bone cancer in the chest. Sometimes this method is the main one. It can be used before or after surgery. The basis of this method is irradiation, as a result of which cancer cells are destroyed.

Chemotherapy is also used to treat this serious illness. The patient is given chemotherapy drugs intravenously or orally that help slow the growth of cancer cells and destroy them. Chemotherapy is often given after surgery to remove any remaining metastases. Currently, doctors also use chemotherapy in the preoperative period to help shrink the tumor.

Chemotherapy and radiation can be used for palliative purposes in inoperable patients.

Informative video:

When doctor Jerry Nielsen (47 years old), after divorcing her husband, was recruited to the American research station at the South Pole, she could not know that the words of her father, spoken at parting: “What if you get cancer?” would turn out to be prophetic and soon the whole country will watch the drama in the ice with bated breath.

The Hercules transport plane landed Jerry on an ice plateau 2880 meters high on November 21, 1998. It was summer at the South Pole, the thermometer showed minus 37 degrees Celsius. The only doctor at the station of 41 people, Jerry Nielsen, had enough to do: accidents, frostbite, plus cleaning the first aid station - it was all on her. Communication with the mainland was carried out mainly by e-mail, completely dependent on the position of the satellite.

Jerry discovered the nodule in her chest by accident and at first did not attach much importance to it. Six months ago she underwent a special medical examination, and the result was negative. A month later, a lump appeared around the nodule, but the doctor was in no hurry to sound the alarm. I didn’t want to think about terrible things, and besides, Jerry understood that her evacuation from the pole was impossible. The polar winter has arrived with frosts below minus seventy. In such cold weather, the kerosene used to fuel airplanes almost instantly turns to jelly.

From time immemorial female breast considered a symbol of motherhood, femininity and sexuality. Magazines for men are full of photographs of naked beauties with magnificent busts - a miracle of plastic surgery. The bigger, the better. But a woman’s breasts are not only an obligatory component of the 90–60–90 parameters and an object of male desire, they can become a time bomb.

Oncology statistics are as merciless as the disease itself. Within five years, 40 percent of women treated in cancer facilities die. The annual mortality rate in Moscow is 23–25 percent. That is, out of a hundred newly diagnosed patients, every fourth dies within a year.

A friend reassured me: it’s okay, the tumor is apparently benign. And Jerry herself tried to forget about the unpleasant discovery. In her letters to her parents there is not a word about this; the lines are permeated with a feeling of happiness and human brotherhood, which Jerry suddenly discovered at the end of the world. But she had no right to pretend that nothing was happening. If she cannot work, the polar explorers will be left without medical care.

The station manager notified central control in Denver. The doctor supervising the polar explorers advised taking a puncture from the nodule: if the liquid is clear, then the neoplasm is most likely not malignant. But the attempt turned out to be torture. Four times the station employee, a brilliant rock and roll dancer, but, as it turned out, a zero assistant, tried unsuccessfully to insert a thin long needle. Each time the instrument rested on hard cartilage.

At this time, Jerry's friend contacted Indianapolis oncologist Katie Miller. She reacted instantly. From that moment began one of the most dramatic correspondences ever conducted by email. “I’m not thrilled with your idea of removing the seal,” warned Katie Miller. – There is danger postoperative complications... You are describing a highly aggressive tumor that we would not immediately remove if you were a patient at my clinic. If the biopsy confirms the diagnosis, a course of chemotherapy will have to be administered, which should shrink the tumor.”

The vast majority of women (83–84 percent) discover their tumor themselves. In every fourth case, this is the last stage of the disease, a death sentence. A terrible discovery is usually made in the shower or in bed, when the hand suddenly gropes for a knot. Alas, the most sensitive fingers can feel a lump in the mammary gland of more than one or two centimeters.

Meanwhile, a mammographic examination can detect a tumor as small as half a centimeter. But not every Russian woman dangerous age regularly visits a specialist. And preventive examinations have not been carried out for a long time. IN Soviet times When general medical examination was as obligatory as winter or summer, advanced tumors were less common than today.

In countries where mammography screening is well established, about 70 percent of cancers are detected promptly, within initial stages illness when the chances of success are high enough. In the UK, Denmark and Sweden, doctors detect nodules in seven out of ten women at a stage when the lump is not yet palpable. Experienced radiologists detect tumors with a diameter of only three millimeters. Accordingly, these countries have managed to significantly reduce cancer mortality mammary gland. Early diagnosis – best medicine. Only when the cancer cells separate and form new foci in the bones, lungs, liver, brain, there is little hope left.

The biopsy was scheduled for June 22. He was assisted by a station employee who had served in the army as an orderly twelve years earlier and had at least some skills. Two days before the manipulation, he and Jerry trained on apples and potatoes.

“Our doctor is an amazing woman,” Jerry’s polar friend reported to her parents, “you would have thought that we were preparing to operate sled dog. No one would have thought that the doctor was going to perform an operation on himself. She performed the first biopsies herself. During the break, I applied ice to my chest and drank mineral water.”

At this time, the United States began preparing an aircraft to drop medical equipment and drugs at the South Pole. The enterprise was extremely dangerous due to the low air temperature. In another message addressed to Katie Miller, Jerry asked if she had a chance, otherwise the crew should not risk their lives. “There are chances, I don’t prescribe chemotherapy to women who have less than three months left,” answered Katie.

The thermometer froze at minus 68.9 when the huge plane reached the station and seemed to hover at a height of two hundred meters. The polar explorers waiting on the runway breathed a sigh of relief, because deep down they did not believe that the rescue operation of Jerry Nielsen would be successful: never before had pilots dared to fly in such severe frost. Bags of invaluable cargo flew onto the ice: microscopes, medicines, X-ray films, vegetables, fruits and even a huge bouquet of flowers for Dr. Nielsen. Only the device for ultrasound diagnostics did not survive the hard landing and crashed.

And time passed. It wasn't until July 22 that Jerry received word from the National Cancer Institute in Washington. This was the final diagnosis: breast cancer. Katie Miller was in a hurry: to start chemotherapy sessions immediately. The tumor has grown to a size chicken egg. Jerry's chances were dwindling every day.

“Dear Katie, I must admit that I have lost all hope,” she wrote. – Treatment seems to me an unnecessary and stupid activity in last days life. For me, cancer is metastases in the bones and brain, pneumosclerosis provoked by radiation, physical deformity, loss of sexuality... Is this really what my future looks like?”

“These types of tumors are incredibly aggressive,” Miller explained to her in her usual honest manner. – In about half of women they metastasize, which leads to death. But in any case, ten percent is not zero, and ninety is not a hundred.”

“Dear Katie, I’m one of those people who should know the truth,” Jerry answered. “After learning the statistics, I decided that I wanted to live...”

In the West, it is customary to tell the patient the truth, no matter how terrible it may be. A person has the right to know his diagnosis in order to regulate property issues and change his life, in the end. Until recently, only close relatives were informed, and they, hiding their eyes, told the unfortunate women: “It’s okay. This is a benign formation, but it is better to remove it.” Today, many Russian oncologists tell their patients in plain text: “Unfortunately, you have been diagnosed with a malignant tumor.”

For a person who only yesterday considered himself healthy, this is a severe shock. After removal of the mammary gland, up to 90 percent of women fall into a depressive state, from which many cannot escape for years, sometimes for the rest of their lives. They withdraw into themselves and lead a secluded life. Fates are crumbling. Some people cannot get used to artificial prostheses, they are afraid to appear on the beach, they never take off their bra, even at night.

“I was terribly afraid of the operation,” says Svetlana N. “They assured me that I wouldn’t feel pain, that everything would be fine, but I was still shaking like a leaf. And I can say that the worst thing is not the scalpel and not the anesthesia, not the bandages and not the most difficult treatment afterwards. The worst thing is the first look in the mirror after surgery. I don’t know how people feel who have had an arm or leg amputated, but when I saw stitches where my left breast should have been, I almost lost consciousness. Then my husband said that I looked like an Amazon.

Three quarters of patients are over fifty years of age. But breast cancer is getting younger. Even twenty-year-old girls fall under the surgeon’s scalpel. Why? Nobody knows. Patients in cancer hospitals usually have one thing in common – a diagnosis. Between five and eight percent of affected women have a hereditary predisposition.

Some scientists believe that one of the reasons for the rejuvenation of breast cancer may be early puberty And late onset menopause. Thus, the period of production of the hormone estrogen is extended, which, according to experts, plays a role not only in the growth, but also in the occurrence of cancer cells. Frequent abortions and frequent abortions may also increase the risk of cancer. overweight, and lack of vitamins, and poor nutrition, and smoking, and alcohol, and radiation. Often the trigger is severe stress.

“People began to violate the laws of nature,” says Dingir Dmitrievich Pak, head of the department of general oncology, Moscow Research Oncology Institute (MNIOI) named after P.A. Herzen, Doctor of Medical Sciences. – Previously women gave birth to at least six children and very rarely developed breast cancer. Nature arranged it this way female body what he should, starting with of a certain age, become pregnant, bear, give birth and breastfeed. Moreover, this factor works after the fourth birth. When the cycle is disrupted, unspent hormones from the egg enter the bloodstream and indirectly affect the pituitary gland and breast tissue.

Jerry makes a decision: fight at all costs. She still wants to see the world, to do trip around the world. But chemotherapy takes all my strength. Jerry suffers from terrible weakness and pain, she gets hot and cold. The day comes when chemistry consumes the beautiful blonde hair: They have to be shaved bald.

But the tumor finally gives in. It is decreasing. Jerry feels the constant support of friends and family. “You look stunning with this haircut!” - her brother writes to her. The whole country is worried about the “doctor in the ice.” Only Jerry's children, who remained with their father after the divorce, do not write a single line to their mother.

Slowly life is returning to normal. The first aid station is open to receive patients. Polar explorers again turn to Dr. Nielsen with their problems.

But the end of September brought another deterioration. The tumor grew like a monster. Chemotherapy takes away the last of my strength. Jerry can no longer get out of bed. She is shaking, ice cold and exhausted. The polar explorers fear for her life.

Now the fight for life is counting down to days. Finally, on October 6, a cargo plane takes off from New York, but due to a snowstorm, it gets stuck in New Zealand for almost two weeks. The station already knows that due to the danger of icing, the plane will land for exactly three minutes in order to bring the terminally ill Jerry on board.

Despite hurricane wind with a force of 20 knots and terrible visibility, the plane landed. Jerry struggles up the steps of the gangway and drops to his knees. Her strength is leaving her...

Malignant breast tumors do not grow instantly; usually the development period lasts from three to fourteen years. The exception is sarcoma, which can reach the size of a soccer ball in a few months. But this is still a rare case.

The smaller the tumor, the better the prospects. But the insidiousness of cancer is that the disease has no warning signs. She hits like a tornado. And yet, most women are in no hurry to see a doctor, postponing the visit. Up to 80 percent of patients in oncology hospitals, before getting to specialists, managed to receive treatment outside: from psychics, herbalists, and sorcerers. The gates and doors of specialized clinics are plastered with advertisements: “miraculous cure for cancer”, “100% victory over cancer”, “conspiracy against cancer”. Unlike oncologists, who never give such guarantees, but simply promise to help, would-be doctors promise miracles. But no lotions, rubbing or passes can affect a cancerous tumor. And precious time is running out. The clock is ticking and nothing can stop it.

Irina K., who was diagnosed with breast cancer a year ago, was promised by a certain magician to open her “third eye” and persuaded... to get pregnant. Thank God, the young woman was smart enough to first consult an oncologist, who explained to the victim of magic that pregnancy and cancer are incompatible things. During this period, the tumor develops at a very rapid pace. Before starting cancer treatment, doctors advise terminating the pregnancy, if timing allows.

Galina O. was treated by a herbalist for two years, scrupulously fulfilling all the appointments, sparing neither time nor money. The tumor that grew during this time shocked even the doctors at the oncology clinic.

Until the eighties of the last century, surgery was the main method of treating breast cancer abroad and especially in our country. It was believed that cancer could only be cured with a scalpel. In a country where “there is no sex,” the beauty of the breasts was the least thought about. The operations were carried out on a large scale and were mutilating. Not only the mammary gland was removed, but also pectoral muscles, The lymph nodes a number of zones. Surgeons tried to keep the patients alive. But 40 percent of women became severely disabled.

“Then there was a revision of the concept of breast cancer development,” saysDingir Dmitrievich Pak.– Our institute has developed organ-preserving, functionally sparing and reconstructive plastic surgeries. In 70 percent of cases, the breast can be saved. If the tumor is more than three centimeters, part of the gland must be removed, but at the same time reconstructive plastic surgery is performed with the movement of the patient’s own tissues. Of course, this is the best option, but if the disease has entered the third stage, restorative plastic surgery is recommended after a year or two, when there is confidence that there are no distant metastases. The operation is complex, requiring jewelry craftsmanship, and lasts from five to six hours.

The new breast looks no worse than the old one, and sometimes even better. It happens that patients ask surgeons to lift a healthy breast. Plastic surgery is not performed free of charge, although the price of reconstruction cannot be compared with the cost of similar services in beauty clinics. The money paid by patients of the Herzen Moscow Oncology Research Institute is mainly used to purchase absorbable threads and special medications.

Lyudmila N. never thought that she might get breast cancer, although the danger hung over her like a sword of Damocles. Her mother and mother's sisters died from this disease. “This won’t happen to me,” Lyudmila told herself.

One day, together with some employees of her company, she went to the Oncology Center on Kashirskoe Highway to undergo an ultrasound examination. “You have a lump in your right breast, get checked just in case,” they told her and sent her for a mammogram examination. The result was negative: there was nothing dangerous. After some time, Lyudmila came to the doctor again: look again. But what if? Nothing again. But she still signed up for a consultation with a famous professor. “Forget it,” he said confidently, “you don’t need to do anything. Apart from mastopathy, you have nothing. I don’t see any tumor.”

A family friend, who had his ulcer treated by a psychic woman, persuaded Lyudmila to go see a “clairvoyant.” “There’s nothing wrong,” she said. - I would feel it. When there is swelling, I immediately want to wash my hands.”

“After these words I flew,” says Lyudmila. – At each reception, the psychic waved her arms and made some passes. The nodule did not resolve. It turned into a lump the size of an egg. But I believed the psychic and was in no hurry to turn to oncologists. Then my husband could not stand it and brought me to the Herzen Moscow Scientific Research Institute. There they did all the tests and took a puncture. The doctor sighed: “Oh my God! Looks like the swelling is bad. We need surgery." I went outside, tears blurred my eyes, people were happy about spring, and I felt that I had nothing to do with it. It was as if a blank wall had grown between me and the world.

The operation lasted more than five hours. Amputation and plastic surgery at the same time. The chest was formed from the back muscle. Then a course of chemotherapy. Long recovery. And a feeling of happiness: everything is behind.

Five and a half years have passed. Approaching New Year. Lyudmila and her husband were going to Canada for Christmas. Tickets have already been purchased and visas have been received. And on December 19, while washing in the shower, Lyudmila felt a lump on her other breast.

- It was terrible. I thought that I had recovered. And if for the first time I was sure that my healthy body will withstand everything, now I doubted it. Chemotherapy sapped my strength. But the next morning I was already standing in front of the surgeon. “We need to have surgery,” he said. "When?" – I asked. “Now,” was the answer. We didn't go to Canada.

The new operation is resection of the left mammary gland with its simultaneous reconstruction. The golden hands of a doctor. Beautiful, firm breasts. And again chemotherapy, after which the hair came out in armfuls. They stayed on the pillow and scattered on the floor. Lyudmila was terribly worried about this, it seemed to her that she had lost her femininity, and the doctor laughed: “Everyone wants to live, but you’re crying over your hair. They will grow up."

If she had felt even one glance from her husband, she would have died on the spot. And he kissed her bald head and said: “Now I have you, Aelita.”

The disease has not returned. Lyudmila lives a full life. She's still beautiful. And on the beach the men look after her. Only at night she dreams of the hospital. We have no control over our dreams. There are things that cannot be forgotten. But when she wakes up, she feels the happiest in the world. Every new day is like a holiday, where there are no reproaches, no insults, no envy. Without the support of her husband, she probably would not have survived.

What to hide, there are individuals of the stronger sex who rush to the recovery room to their wife with the news of an impending divorce: they say, I’m sorry, dear, but I don’t need you like that, I can’t love a woman with a defect.

Of course, such extreme situations occur quite rarely. The love boat gradually breaks down due to illness. This doesn't make it any easier. When spouses are relatively young, drama plays out too often.

There are men (about 4 percent) who are afraid of contracting cancer. Intellectually, they understand that such a danger does not exist, but they cannot help themselves. They try to minimize close communication with their sick wife and avoid intimacy. An oncologist surgeon I know said that his former patient was forced to file for divorce from her husband after fifteen years family life. Every time after sex, which happened extremely rarely anyway, the husband treated his body with alcohol and thoroughly rinsed his mouth.

If two people are over fifty, divorces due to cancer are not common. Perhaps in families with experience, the problem of sex is not so acute, and other priorities appear in life. It happens that a common misfortune only unites spouses and throws them into each other’s arms again.

At the Indianapolis hospital, Jerry Nielsen was already waiting for her parents and, of course, Dr. Katie Miller. They met like close friends. Examinations showed that, contrary to all forecasts, the tumor did not metastasize. How does the sentenced person feel? death penalty, unexpectedly learning about the pardon?

Jerry underwent a sparing operation and managed to save his breast. Now there was a four-month course of chemotherapy and eight weeks of radiation. She went through that too. Gradually my strength returned. My hair has grown back, as light and beautiful as before.

After recovery, she wrote a book called “I Will Live.” This is gratitude to the people whose support helped Jerry survive at the most difficult moment. And at the same time, hope for millions of women who have been given a terrible diagnosis. Cancer is not a death sentence. He can be defeated. Jerry's greatest wish is to return to the South Pole. But she knows that this is unlikely to be feasible.