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Oncology
Stomach cancer
Stomach cancer is one of the major common types of cancer. According to statistics, in 2020, stomach cancer ranked first in terms of incidence among other cancers in Korea.
Diagnostics
EFGDS (gastroscopy) is the most accurate method for diagnosing stomach cancer, during which the inner surface of the gastric mucosa is examined and biopsy material is taken. Diagnosis of stomach cancer is possible only through a histological examination of the material obtained.
X-ray of the upper gastrointestinal tract is a screening method for diagnosing stomach cancer, does not cause much discomfort. However, during this examination, it is impossible to take a biopsy material.
Endoscopic ultrasound of the stomach, CT of the abdominal organs, ultrasound of the abdominal organs are performed to determine the stage of the disease and the presence of metastases. In some cases, PET-CT or MRI is also performed .
Treatment
Surgical treatment is the treatment of choice whenever possible .
During resection of the stomach, the localization and size of the tumor, the degree of prevalence of the process and the patient's condition are taken into account, regional lymph nodes are removed, which may have metastases.
If the tumor is in the lower part of the stomach, then a partial resection is performed (2/3 of the stomach is removed),
if in the upper part - then total.
At the initial stage, when the tumor grows into the mucosal and submucosal layer by no more than 2 cm, endoscopic dissection of the submucosal layer can be performed .
In addition, operations such as gastric resection with preservation of the pyloric sphincter, gastric resection with preservation of the vagus nerve, proximal resection of the stomach, etc. are performed at the initial stages.
In stages 2 and 3, radical surgery is performed followed by chemotherapy to reduce the likelihood of recurrence and increase survival. With advanced cancer with metastases to nearby and distant organs, palliative chemotherapy is performed .
Cost of diagnosis and treatment: 25,000,000 - 30,000,000 won (abdominal surgery)
11,000,000 - 13,000,000 won (endoscopic surgery)
Esophageal carcinoma
Esophageal cancer most often occurs in 50-60 year old patients. The incidence among men is 10 times higher than
than among women. Esophageal cancer is diagnosed during EFGDS (usually in the initial stages)
or when symptoms associated with difficulty swallowing appear (usually in the later stages).
Diagnostics
Endoscopy of the esophagus is a mandatory diagnostic study for suspected esophageal cancer, during which a biopsy is performed. If there is a strong narrowing of the lumen of the esophagus and it is impossible to carry out an endoscopic examination with the sampling of biopsy material, then with the help of a special brush a scraping is made from the esophageal mucosa for cytological examination.
Computed tomography is an examination with which you can determine the stage, assess the extent of the process (invasion of nearby organs, lungs, liver, lymph nodes, etc.), as well as the possibility of surgical treatment.
Endoscopic ultrasound is used to determine the degree of germination of the tumor in depth.
This is an auxiliary type of examination that can help in choosing a method of treatment.
PET-CT is an important diagnostic study that allows you to detect the presence of metastases in nearby lymph nodes and in distant organs.
Treatment
Surgical treatment (in the absence of distant metastases), radiotherapy, chemotherapy.
Cost of diagnosis and treatment: 40,000,000 - 45,000,000 won (surgery)
colon cancer
Colon cancer is a malignant tumor of the lining of the colon and rectum. Types of colorectal cancer: adenocarcinoma (the most common type), lymphomas, sarcomas, squamous cell carcinoma, metastatic cancer.
Diagnostics
A digital rectal examination (DRE) is done to look for tumors in the rectum. Through this method, rectal cancer is diagnosed in 75%. After age 40, experts recommend having a DRE every year.
Irrigoscopy with double contrast is an x-ray examination in which a contrast agent (barium) and air are injected through the anus to detect pathologies of the colon mucosa.
Colonoscopy is the most reliable test for diagnosing diseases of the colon, which allows you to accurately detect cancer, perform biopsies and remove polyps.
When confirming the diagnosis of colon cancer, the following additional studies are carried out: a blood test for the oncomarker CEA, CT and MRI of the abdominal organs, ultrasound, PET-CT.
Endoscopic ultrasound is used to determine the degree of germination of the tumor in depth.
This is an auxiliary type of examination that can help in choosing a method of treatment.
Abdominal CT scan is performed to detect metastases in nearby organs, liver, lymph nodes and is one of the widely used diagnostic methods.
Abdominal MRI is performed if liver metastases cannot be clearly seen on CT scan results. In cases of rectal cancer, this examination helps to determine the degree of involvement in the process of organs adjacent to the rectum, as well as to determine the tactics of treatment.
Ultrasound of the abdominal organs is used to differentiate metastases and benign lesions in the liver and is of a complementary auxiliary nature. However, rectal ultrasound in rectal cancer plays a very important role, because. allows you to assess the degree of invasion, detect enlarged lymph nodes, set the stage and determine the tactics of treatment.
PET-CT is usually done before surgery if CT scans suggest metastases to the liver or other organs. After surgical treatment, it is used for dynamic monitoring and in case of suspected recurrence or metastases.
Treatment
Surgery is the main treatment for colon cancer. The volume of the operation depends on the localization of the tumor, however, in any operation, a wide excision of the tumor, lymph node dissection and ligation of the vessels to prevent metastasis are necessarily performed. For advanced cancer, adjuvant chemotherapy is given after surgery , for colon cancer, chemotherapy is given before or after surgery, which reduces the chance of recurrence and increases survival.
Cost of diagnosis and treatment: 25,000,000 - 30,000,000 won
Lung cancer
According to statistics, in 2020, lung cancer ranked second in terms of incidence among other cancers in Korea.
Lung cancer is divided into primary and metastatic. Based on the type of tumor cells, primary cancer is classified into non-small cell and small cell cancer. If non-small cell cancer (squamous cell carcinoma, adenocarcinoma, large cell carcinoma) is detected in the early stages, in most cases, recovery can be achieved through surgical treatment.
Small cell occurs among patients with a long history of smoking and accounts for 13% of the total number of all types of cancer. It is considered aggressive and tends to metastasize early to the lymph nodes, brain, liver, bones, adrenal glands, kidneys, and other organs.
Diagnostics
If lung cancer is suspected, tests such as chest x-rays,
CT scan of the chest, PET-CT. To determine the nature of the formation in the lung (malignant or benign), the most reliable way is a biopsy.
There are the following methods of biopsy: bronchoscopy, fine needle aspiration puncture biopsy, examination of pleural effusion, thoracoscopic lung biopsy, endobronchial ultrasound.
Determining the stage of the disease
Staging in non-small cell cancer
The first and second stages of the disease are a condition in which the tumor has not spread to nearby organs and it can be removed surgically. The third stage is a condition in which there are metastases in the lymph nodes of the mediastinum. The third stage requires surgery, chemotherapy and radiotherapy. At stage 4, when there are distant metastases or a malignant pleural effusion is detected, chemotherapy is performed.
Staging in small cell cancer
In small cell lung cancer, only two stages are distinguished: organic (the tumor is localized in only one lung) and extensive (metastasizing to another lung or distant organs). Usually complex chemo and radiotherapy treatment is prescribed.
Treatment
Methods for the treatment of lung cancer: surgical treatment, radiotherapy, chemotherapy, targeted therapy, anticancer immunotherapy, special endoscopic methods of treatment at the initial or late stages (photodynamic therapy, laser therapy, cryotherapy, electrosurgery, balloon dilatation, bronchial stenting, etc.)
The choice of treatment tactics depends on the stage of the disease, the type of cancer, the age of the patient, his state of health, medical history, the presence of cardiac, respiratory and other diseases.
Cost of diagnosis and treatment: 24,000,000 - 30,000,000 won (surgery)
Mammary cancer
Breast cancer is a malignant tumor that occurs in the epithelium of the milk ducts or lobules of the glandular tissue of the mammary glands.
Diagnostics
Methods of visual diagnosis of breast cancer: mammography, ultrasound of the mammary glands,
MRI of the mammary glands.
Types of breast biopsy: fine-needle aspiration biopsy followed by cytological examination, core-needle biopsy, Mammotome stereotactic breast biopsy,
incisional biopsy.
Treatment
Surgery is the main effective treatment for breast cancer.
Types of surgical treatment: total mastectomy, organ-preserving surgery (with a small tumor size), biopsy of the sentinel lymph node.
Chemotherapy is an auxiliary method in the case of surgery and reduces the likelihood of postoperative relapses and mortality. The use of chemotherapy, including two to three drugs, is considered quite effective. For advanced, metastatic, or recurrent breast cancer, chemotherapy is the first choice.
Radiotherapy is a local method of treatment, which is used in organ-preserving operations to prevent local relapses, as well as in total mastectomy in case of multiple metastases in the lymph nodes. Can be used as a palliative treatment for metastases to bones or other organs.
In hormone-dependent forms of breast cancer, hormone therapy is effective .
Cost of diagnosis and treatment: 13,000,000 - 17,000,000 won
prostate cancer
Prostate cancer is a malignant tumor that develops from the cells of the glandular epithelium of the prostate. Risk factors include advanced age (morbidity increases sharply among patients over 50 years of age), race (high incidence among Caucasians), genetic factor, and family history.
Diagnostics
The main diagnostic method for prostate cancer is digital rectal examination . A blood test for PSA is also given . PSA values should not exceed 3-4 ng / ml. In case of deviation from the norm , a biopsy is prescribed . MRI.
Treatment
For local prostate cancer without metastases, radical prostatectomy is performed . Recently, robotic surgeries have been increasingly used to reduce the risk of damage to nerves, blood vessels and the occurrence of erectile dysfunction. If surgery is not possible, then the patient is given radiotherapy. With the progression of the disease, hormone therapy may be prescribed.
Cost of diagnosis and treatment: 13.500.000 - 20.000.000 won
Pancreas cancer
Pancreatic cancer is one of the complex types of cancer. There are various types of pancreatic tumors, ranging from ductal adenocarcinoma (poor prognosis) to pancreatic neuroendocrine tumor (comparatively favorable prognosis).
Diagnostics
Diagnostic methods of pancreatic cancer: abdominal ultrasound, abdominal CT, abdominal MRI, endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, PET-CT.
Treatment
At the first and second stages, a radical resection of the pancreas (pancreatoduodenectomy, pancreato-splenectomy) is performed in combination with postoperative radiotherapy and chemotherapy. In the third and fourth stages, surgical treatment is impossible. However, despite the fact that sometimes surgical treatment is performed for stage 3 local cancer, in many cases it is not possible to completely remove cancer cells. To prevent this, radio or chemotherapy is often given before surgery.
Cost of diagnosis and treatment: 20,000,000 - 40,000,000 won
Liver cancer
Liver cancer is a malignant tumor that arises from liver cells. In a broad sense, liver cancer includes both primary (arising from liver cells) and metastatic cancer (metastases in the liver).
Risk factors for liver cancer: chronic hepatitis B, hepatitis C, alcohol abuse.
Diagnostics
Methods for diagnosing liver cancer include ultrasound, CT of the abdominal organs, MRI of the liver, angiography of the hepatic artery, a blood test for the AFP tumor marker, and a biopsy.
Treatment
Surgery is considered the most effective treatment for liver cancer . In cases where surgery is not possible due to reduced liver function or advanced cancer, transarterial chemoembolization, percutaneous ethanol injection, and radiofrequency ablation may be performed.
Cost of diagnosis and treatment: 25.500.000 - 33.500.000 won
thyroid cancer
Thyroid cancer is a malignant tumor that occurs in the cells of the thyroid gland.
Types of thyroid cancer: papillary carcinoma, follicular carcinoma, medullary carcinoma, poorly differentiated thyroid cancer, anaplastic carcinoma, malignant non-epithelial tumors, malignant lymphomas, secondary tumors, and others.
Diagnostics
If a formation is found in the thyroid gland, a study of the function of the gland and ultrasound is performed . Depending on the blood result, a scintigraphy may be ordered for thyroid function . Based on the ultrasound result , a fine- needle aspiration biopsy is prescribed , and then a decision is made on further treatment tactics (surgery, repeated fine-needle aspiration biopsy, etc.). To clarify the diagnosis, a BRAF gene mutation test may be performed. If necessary, CT, PET-CT, bone scintigraphy are performed before and after the operation.
Treatment
Total thyroidectomy is the main treatment for thyroid cancer. Its advantages are increased effectiveness of postoperative radioiodine therapy, increased sensitivity of the study to thyroglobulin, no need for a second operation in case of detection of multiple foci of cancer or metastases in the lymph nodes.
Suppressive hormone therapy after surgical treatment of thyroid cancer is a very important stage of treatment, which allows not only to compensate for the hormone deficiency, but also to reduce the risk of recurrence.
Radioiodine therapy is used to destroy the remaining cancer cells and possible metastases. Depending on the dosage, treatment is carried out both on an outpatient basis (low dose) and inpatient (high dose).
Cost of diagnosis and treatment: 11,000,000 - 17,000,000 won
Skin cancer
Skin cancer is a malignant tumor that arises from skin cells. It is divided into primary and metastatic cancer.
Types of skin cancer: melanoma (acral melanoma, superficially spreading melanoma, malignant lentigo melanoma, nodular melanoma), basalioma, squamous cell skin cancer. Rare types of skin cancer: angiosarcoma, dermatofibrosarcoma bulging, Paget's extramamillary carcinoma and cancer of the skin appendages (hair follicles, sebaceous and sweat glands).
Precancerous conditions include actinic keratosis, Bowen's disease, and arsenic keratosis. These diseases can eventually degenerate into cancer. The probability of degeneration into cancer of actinic keratosis is 8%, Bowen's disease - 3-5%.
Diagnostics
The main method for diagnosing skin cancer is a biopsy . A more in-depth examination is prescribed at a high risk of spreading metastases to distant organs.
Treatment
Methods of treatment: resection of the tumor with reconstructive surgery of the skin with a local flap.
Recently, photodynamic therapy, as well as local immunomodulators (imiquimod), cryotherapy, electrocautery, have been widely used as a method of treating superficial basalioma and precancerous conditions. For aggressive types of cancer, complex treatment is prescribed - surgery followed by chemotherapy, radiotherapy, etc.
Cost of diagnosis and treatment: 9,500,000 - 14,000,000 won (surgery)
kidney cancer
Depending on the location of the tumor, kidney cancer is divided into renal pelvis cancer and renal cell carcinoma, which accounts for 80% of all cases of malignant tumors of the kidney. The remaining cases are mostly benign formations.
Usually kidney cancer is primary.
For a long time, kidney cancer is asymptomatic. Symptoms appear when the tumor reaches a large size and compresses nearby organs. Side pain, hematuria, masses in the side or upper abdomen that can be felt - these are the three main symptoms indicating the progression of the disease and the formation of metastases. However, at the same time, all three symptoms appear only in 10-15% of cases. In advanced stages, weight loss, fatigue, loss of appetite, fever, and lung or brain disease may occur.
Diagnostics
Ultrasound, abdominal CT, MRI, bone scan, PET, biopsy.
Treatment
Cancer treatments depend on the type of cancer and stage. Generally, chemotherapy and radiation therapy are not effective for kidney cancer. The main method of treatment is radical nephrectomy, which includes not only the removal of a malignant tumor, but also adipose tissue, fascia, pelvis and part of the ureter. Recently, a method that allows preserving kidney function - partial nephrectomy (if the tumor is small) is becoming more common. Partial nephrectomy can be performed through open surgery, laparoscopic and robotic. In cases of complex localization and small size of the tumor, as well as if the patient has one kidney or he does not want to undergo surgery, methods such as radiofrequency ablation, cryotherapy can be offered.
Renal artery embolization is recommended in the following cases: the impossibility of performing an operation due to tumor invasion into nearby organs, the patient's advanced age or the presence of concomitant diseases, and also in case the patient himself refuses the operation.
Cost of diagnosis and treatment: 15,000,000 - 17,000,000 won
Lymphomas
Lymphoma is a malignant disease of the lymphatic system. In Korea, nodular T-cell lymphoma, unspecified (63% of all cases of lymphoma), angioimmunoblastic T-cell lymphoma, and anaplastic large cell lymphoma are relatively common.
Diagnostics
Diagnosis of the disease is carried out by resection of the lymph nodes and histological and immunohistochemical studies. Also, through a blood test, an assessment of the function of the liver, kidneys and bone marrow is given. To determine the degree of prevalence of the disease, it is necessary to make a CT scan of the chest and abdominal cavity, as well as to conduct a study of the bone marrow. In addition, PET-CT, examination of cerebrospinal fluid (if metastases to the central nervous system are suspected) can be additionally performed.
Treatment
Surgical treatment, high-dose chemotherapy, bone marrow transplantation are used as treatment .
Cost of diagnosis and treatment: from 50,000,000 won (bone marrow transplant)
Leukemia
Leukemia (leukemia) is the formation of tumor cells in the blood or bone marrow. Leukemias are divided into acute (acute myeloid leukemia, acute lymphoblastic leukemia) and chronic.
Diagnostics
Diagnostic examinations: peripheral blood analysis, peripheral blood smear, bone marrow examination (smear, biopsy), bone marrow immunophenotyping, chromosomal and molecular genetic analysis, cerebrospinal fluid examination.
Treatment
Treatment: chemotherapy (induction therapy, prevention of central nervous system damage, consolidation therapy, maintenance therapy), stem cell transplantation, radiotherapy, targeted therapy.
Cost of diagnosis and treatment: 60,000,000 - 110,000,000 won (stem cell transplant)
Sarcoma
Sarcoma is a group of malignant tumors that develop from connective tissue cells. Sarcoma is divided into malignant tumors of bones and soft tissues: skin, blood vessels, muscles, fat, nerves, etc. Tumors can occur at any age, however, some types of sarcomas occur in certain age groups, for example, Ewing's sarcoma is most often found in 10-20 year olds, and chondrosarcoma - after 30-40 years.
Diagnostics
If a sarcoma is suspected, an X-ray examination, ultrasound, MRI, and biopsy are performed.
Treatment
The choice of treatment method (surgery, chemotherapy, radiotherapy) depends on many factors: the presence or absence of metastases in other organs, the degree of malignancy, localization, age and mental state of the patient.