Oncologist Dr. Vladimir Vukov answers your questions • Atlas hospital

Oncologist Dr. Vladimir Vukov answers your questions

21-02-2020

Dr. Vladimir Vukov – oncologist in Atlas General Hospital, answered the questions asked by the visitors of the „Stetoskop“ webite.

Can chemotherapy, immunological and biological therapy, be performed at the same time for liver and lung metastases?

Dr Vladimir Vukov – oncologist  “Certainly it is possible to perform a combination therapy. It is most accurate if certain biomarkers show useful this kind of therapy, whether it is biological or chemotherapy. If biomarkers prove to be accurate and appropriate for the type of tumor, it is definitely recommended to do a combination”.

Dr Vladimir Vukov oncologist - Atlas

I was told I had breast cysts and that it was harmless. What do the terms “highly hypoechoic change” and “dilated ductus” mean?

Dr Vladimir Vukov – oncologist  ” There is, certainly, a discrepancy about what was said and what is written in that finding. I would take such a finding with a reservation if it were benign. I would still do additional diagnostic methods to see what these changes are. The patient does not need to know this terminology, she really needs to go to a specialist in order to be further checked in the most modern way possible, especially those high hypogenic changes that can be misleading.

There are some more diagnostics to be done. For example, I would do a breast magnetic resonance (MRI) here, to see what kind of change it is and whether that type of change requires a biopsy, and to see what it is about. I assume that the patient went on her own on the ultrasound of the breast, but that she was not given adequate advice on what to do next. So an isolated ultrasound examination of the breast may not be enough on its own. However, the diagnosis of the breast requires a clinical examination, a well-taken anamnesis with certain diagnostic tests and, to begin with, an ultrasound of the breast. So I absolutely advise patients to contact a medical oncologist and preferably an oncology surgeon”.

Two and a half years ago, I had surgery of a malignant breast tumor. Having two lumps, the complete breast and surrounding lymph nodes were removed. After the operation, I finished all the therapies prescribed by the treatment protocol (chemotherapy and radiation), and now I am taking hormonal therapy. Breast reconstruction surgery is planned. I wonder if therapy should be stopped before surgery.

Should hormone therapy be stopped before breast reconstruction surgery?

Dr Vladimir Vukov – oncologist  “Before starting surgical treatment, you should stop taking certain medications, including anti hormone therapy. How many days earlier? This will be determined in conversation with the anesthesiologist, as the anesthesiologist will determine the type of anesthesia under which the therapy will be discontinued.”

I am in the eighth month of pregnancy, and a few days ago I felt a pea-sized ball or something bigger. The change is in the left breast, more precisely at the nipple, on the upper side. It’s hard and I can’t catch it with two fingers. It is not movable. There are no other changes and it doesn’t hurt me. Is there reason to worry?

A pea-sized ball in the breast that doesn’t hurt, is there reason to worry?

breast selfcheck

Dr Vladimir Vukov – oncologist  “I absolutely advise pregnant women to contact their gynecologist. The gynecologist is the one who monitors the health condition of the pregnant woman, and the first thing that should be done is an ultrasound examination. Further diagnostic methods should be performed according to the findings of the ultrasound examination and the clinical findings. In any case, the gynecologist is the first instance which the patient should contact.”

Can I do yoga exercises since I had surgery two years ago? I had cervical cancer. After the operation, I had radiation and chemotherapy. To what extent can I do sports?

When to start sport activities after cervical cancer surgery?

Dr Vladimir Vukov – oncologist “The absolute recommendation is that oncology patients, whether they have completed treatment or are in the middle of the therapy, should engage in certain physical exercises and activities. What the precise level of physical activity will be, it all depends on the patient’s condition, the type of operation, the type of therapy and everything else. My recommendation is for the patient to afford a personal trainer, who will still dose the level of physical activity.

As for yoga, it belongs to the domain of these mild exercises, so it is an absolute recommendation for yoga. As for physical activity, they can be common. Walking is an extremely good physical activity, where the whole organism is activated. My big recommendation is a walk through the woods or in areas where there are a lot of trees. Phytoncides from the forest release substances that positively affect our immune system. A study was done in Japan where it was proven that patients who walked through the forest every day had better success in therapy and better survival.”

 

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