Children's oncologist Olga Zheludkova: Remember! All brain tumors are treated. What does a pediatric oncologist treat?

One of the most qualified specialists Moscow doctors who work in private clinics for a certain price are considered. In state oncology dispensaries in small regions, as a rule, there are no enough professional doctors due to lack of qualifications.

A pediatric oncologist is a specialist who treats benign and malignant formations. His only difference from the usual doctor of this profile is the age of the patients. Some specificity is observed in approaches to the treatment of patients. Besides, in pediatric oncology, a completely different distribution of diseases by prevalence.

When should you contact a pediatric oncologist?

An appointment with a pediatric oncologist most often occurs after visiting a general practitioner. Parents should be extremely attentive to their child, since ignoring the signs of the tumor process significantly reduces the patient's survival.

If the child has the following symptoms, then pediatric oncologists are engaged in their thorough diagnosis:

• causeless subfebrile temperature of a permanent or periodic nature;
• night sweats, decreased skin turgor;
• unmotivated weight loss;
• persistent headaches that are not stopped by pills;
• frequent colds, which are long and difficult to treat;
• an increase in several groups of lymph nodes for a long time;
• loss of consciousness and (or) convulsive seizures;
• pain syndromes different localization that progress over time.

Features of working with children

Unlike an adult pediatrician treats diseases skin, blood and lymph nodes several times more often. The basis of his work is hematology - the science of circulatory system person. It is leukemias that are most often encountered in the practice of a pediatric oncologist..

In the treatment of patients, the same methods are used as in adults, but the dosages differ significantly. Despite the heaviness oncological process or the age of the child, in this category of patients the survival rate is quite high.

Unfavorable indicators are typical for brain tumors due to their inoperable location.

How is the appointment with the doctor?

Many parents are afraid to take their child to an oncologist because they have no idea how it goes. At a consultation with a pediatric oncologist, complaints are collected from the words of the parents or they are told by the patient himself (depending on age). Then the details of the course of the disease and the life lived in general are specified. During the initial examination, be sure to palpate The lymph nodes, but most often the tumor does not give external specific manifestations.

Additional studies that the oncologist uses are as follows:

• laboratory indicators (sometimes even specific tumor markers);
• computed tomography or magnetic nuclear resonance (the most informative visual examination methods);
• histological examination of the material taken (is the only way to confirm or exclude the diagnosis of cancer).

The diagnosis of an oncological nature is made according to the generally accepted classification, which indicates the size of the formation, damage to the lymph nodes and metastases. In addition, the oncologist writes in the diagnosis the localization of the tumor and its morphological form.

Olga G. Zheludkova– pediatric oncologist with 30 years of experience, one of the most respected specialists in brain tumors in Russia, chief scientific specialist Russian Scientific Center for Roentgen Radiology. She takes on the most difficult patients, which all doctors have refused, experiments with new drugs that are not yet used in Russia. And heals! On the wall in her office is a huge stand with photographs of recovered children. And every year there are more of them.

Remember: today all brain tumors are treated!

– Olga Grigorievna, today it is more often said that children have a brain tumor – have they really started to get sick more often?

- The incidence does not change - all the years it remains the same. It's just that we began to make correct diagnoses, and patients - to receive adequate treatment.
Until the 1990s, they were not treated at all. Now 90% or even 95% get medical care with timely diagnosis.

- According to statistics, 50% of the sick people die only because of an incorrect diagnosis. This is true?

– Yes, this disease goes under the mask various diseases- ARI, influenza, intestinal infection. The main symptom is vomiting and headache that appears in the morning. And these symptoms slowly, over a long period of time, increase in dynamics.

Vomiting brings relief, the child feels adequate, walks in Kindergarten, goes to school. There was a headache, they drank a pill, and everything went away, a month later the pain again and again a pill. And so it can continue until vomiting and headaches become daily.

And only when the symptoms are clearly evident, they begin to sound the alarm, consult a doctor, undergo an examination and put correct diagnosis. For example, a child has impaired vision or gait, or he stops walking altogether. Symptoms of a brain tumor depend on the location.

Neuro-oncologists should inform doctors, especially pediatricians, neurologists and ophthalmologists, who need not treat vision, but immediately send the child for further examination.

One day, a mother-doctor noticed a strabismus in her child, which was periodic. So she immediately took the child for an MRI - this was the first case when a brain stem tumor was diagnosed in the size of one centimeter! But this rare case, usually parents do not notice this.

Recently, my mother visited me, a couple of months ago she came to a neurologist in her city, said that the child had a gait disorder and periodically had a headache. The neurologist looked and said - this is vegetovascular dystonia. And the family calmly went to rest in Anapa. And the symptoms began to increase. There, my mother again turned to a neurologist, and only then she was told: “My God, you have all the symptoms of a tumor!”. And they immediately came here.

- And the momentcould be missed due to misdiagnosis?

– We are faced with such a situation, because due to a long wait, the tumor turns from small to large, metastasizes, and then we are talking about treatment with less effectiveness. For example, stage M0 with medulloblastoma, that is, in the absence of metastases, has a survival rate of 80%, and M2 - M3 (in the presence of metastases in the head and / or spinal cord) is already 70%.

– What diagnostic methods are available today?

Now there are methods that allow you to make an accurate diagnosis. Everyone knows about magnetic resonance imaging (MRI). By the way, doctors themselves are often afraid to prescribe this method, although it is absolutely safe. Only sometimes for small child anesthesia may be required.

Now molecular diagnostics stepped forward. There are not so many molecular laboratories in our country yet, and sometimes we turn to foreign clinics to make a diagnosis, because the diagnosis determines everything - prognosis, treatment tactics, results.

The main thing is that the doctor should be alert: he should immediately think that headache and vomiting are not a disease gastrointestinal tract and not an infection. Seizures, even single, not repeated epileptic seizures, should also be a reason for examination.

The pediatrician is the very first link where the patient turns. And he, like no one else, should know about the signs of a tumor and that it is treated. After all, before everyone thought that they would die anyway, why bother at all. Now we say that the majority recover and cancer is not a death sentence.

What treatments are considered breakthrough?

I can say that today neurosurgery has made such a step forward that if twenty years ago no treatment was offered to a person with a relapse, today there is every chance to cure him. Today we ask neurosurgeons: “How many times can a patient with a relapse be operated on?” - "As long as it is operable, you can!" And it can be an unlimited number of times!

So far, there is only one group of patients for whom there is no effective method treatment is an inoperable diffuse tumor of the brainstem. After 6-13 months after irradiation, symptoms of the disease reappear and tumor growth is observed. These are the same 15% among all the patients we are talking about - yes, it is difficult to cure. Everything else is being treated.

What about radiation therapy?

She's getting better too! 20 years ago, when we treated patients with medulloblastoma, our main desire was to cure them. Now our goal is not only to cure these children, but also to make sure that their quality of life is good, that they are full-fledged citizens of the country, have the opportunity to give birth to children, and receive a full-fledged education.

Today, devices allow point methods radiation therapy, in which healthy tissue is not irradiated.

Remember: all brain tumors are treated! This is our most important achievement in the last twenty years. True, recovery does not occur for everyone.

- What conditions of recovery depend on the person?

It's still the task of doctors, of course. Adequate treatment provides best result. The patient must have an accurate histological diagnosis and proper examination to ensure adequate and effective treatment.

It is necessary to be regularly examined - clinical examination includes an examination by a neurologist and an ophthalmologist. And these doctors, first of all, should be wary of looking for symptoms of a brain tumor. And you don't have to be afraid.

Performing miracles is the doctor's job

– Have you experienced healing miracles in your practice?

- One charming girl from Cheboksary had a small tumor, neurological symptoms were not expressed. And my mother and I agreed to do an MRI in a month to see the dynamics. The tumor did not grow, although, in theory, it should have grown. We have postponed treatment. And then they found that the tumor had shrunk! And now this girl is alive and well, the tumor has almost disappeared. Maybe it was not a tumor, although it was determined by all examinations. There are non-standard cases, and they should alert the doctor, make him observe.

In general, probably, there are not so many miracles in oncology to somehow rely on them. In fact, this is rare. Performing miracles is a medical job.

I am always asked how it is possible to work in oncology, because it is already so difficult, and even more so children get sick. And the children are the most grateful! And they get better, you know! Children with a brain tumor in most cases are cured, unlike adults.

Each cured patient is an impulse to work and create further. Why do I have this board with pictures of recovered patients hanging on my wall? Every morning I go into the office and look - they are recovered!

Every child is a destiny. They grow up, start families, but still call me. Once my ex-patient became pregnant and came to the gynecologist, and she said that the pregnancy would lead to a relapse, and sent her for an abortion. Yes, this can not be! I called this gynecologist and said: “Definitely she can give birth! She is healthy! The main thing is that you help her carry this pregnancy and deliver it.”

Until some point, we ourselves did not assume that these children could become pregnant after radiation therapy. And you have no idea what heaven I was in with happiness when I later saw that girl with a child!

Another girl with medulloblastoma has already given birth to her second baby! They put me in everything! And for us, this is also happiness - we are proud that we cured these guys and saved them a full life!

I would very much like these mothers to appear on television and tell the whole country about it. But they are afraid, because they and many relatives do not know that they had such a disease in childhood, and if they find out, they will think that a person is still sick and a brain tumor can be transmitted.

Call: Yes, Elena Vasilievna. Look, you need to urgently refer to bypass surgery! Is the child on the device or not? Ahh, conscious, that's good. Then let me call the Roshal center now and arrange a transfer.

Two patients worsened yesterday. One of them developed hydrocephalus during treatment, that is, dropsy of the brain. The other one had a tumor growth, convulsions developed, and now he is in intensive care. I need a shunt urgently. We send to the center of Roshal.

- Zhanna Borisovna, good afternoon! We urgently need your help. In our child with a trunk tumor, hydrocephalus has developed on the background of radiation therapy, which requires shunting. Can we transport to you?
- You can, of course. Why not?
– What do we need to do for this?
- Today is Thursday. Let's go Monday.
- Oh, we need today.
“Then bring an ambulance, write a request to the neurosurgeon on duty for emergency indications. Do you know the phone? I'll warn you, okay?
- Thanks a lot!

Everything, now we will translate, right this minute.

Call: Elena Vasilyevna is transporting the child, but please call this number first, make a request and say that you are at the emergency hospitalization post.
Thank you, Olga Grigorievna!

Well, everything was decided, now it will be translated. In fact, when we treat, everyone is very in contact. If they call me from another hospital, then I will not refuse help either.

Once a patient with astrocytoma came to me. He was operated on at the Institute of Neurosurgery. Burdenko, and there was a question about radiation therapy. We did an MRI and there was a suspicion of a residual tumor. And it needs to be removed!

Neurosurgeons resisted for a long time, reoperation it's still an operation. Especially in the brain. It can lead to some neurological deficits. But still agreed and, fortunately, there was scar tissue. He did get the treatment though. radiation therapy and is now a grown man and doing well. I am happy that neurosurgeons are on the same team with us and together we can discuss our patients. Sometimes I can sit up and forget about the time, write to the neurosurgeon at two in the morning, and he will answer!

From the regions they send me tomograms of primary patients, and I can consult patients with neurosurgeons from the Burdenko Institute. I remember how in the Central clinical hospital during a meeting with neurosurgeons, they sent me a tomogram of the boy by mail, and five minutes later, a call from his dad: “Olga Grigoryevna, the tumor was recognized as inoperable, we don’t know what to do, we are offered radiation therapy.”

And sitting next to me was neurosurgeon Yuri Vladimirovich Kushel. I show him the tomograms: “Yuri Vladimirovich, what do you say?”. – “Operable!”. And we immediately discussed this child with him, he agreed to the operation, set a date. Dad and son came to the Burdenko Institute, the boy was operated on and it turned out that he had benign tumor, which did not require either radiation or chemotherapy! Fiction! The patient was saved from radiation therapy!

How lucky he is! But not everyone can get into the federal center ...

You know, we try very hard. The Konstantin Khabensky Foundation has now organized a training program with field trips to the regions. Usually only one doctor can go to advanced training courses, and when we ourselves go to the place, almost all doctors gather there and are informed about all modern methods diagnosis and treatment of brain tumors. For example, we recently went to Belgorod, held a seminar for oncologists, and we were invited to give a lecture to pediatricians. I felt how they listened with interest, perhaps they came across such patients.

In addition, our center has become an institution for approbation of the register of all oncological diseases in children. A database has been created, and we need to see how accessible it is. A brain tumor is complex in that the disease is treated in different institutions and patient routing can be difficult.

The operation is carried out in one, radiation therapy in the other, and they go home for chemotherapy. BUT diagnostic examinations may be carried out in other institutions. And it is important that everyone knows about the planned treatment, the examination algorithm. This will allow for unified standard protocols treatments that ensure the adequacy of treatment.

For example, if a person is being treated in Krasnodar, I will go to this database, see what he needs and conduct an online consultation. And another doctor in Krasnodar will open the program and understand what to do next.

– Do you have to constantly study?

– A brain tumor is a very complex area, large group neoplasms with different histological diagnoses, more than 120 histological variants in new classification that require different treatment. Therefore, of course, we need to constantly learn, we try to attend conferences, travel to foreign congresses in order to be informed.

And it is also very important for me to participate in international trials using new drugs. They are also often referred to as trials. A new drug always entails something interesting, something unknown, maybe even a breakthrough - no one knows. And participation in these studies allows us to learn a lot in this area.

For example, a new drug is currently being planned for relapsed patients, as they have fewer treatment options after standard therapy. New drugs are not chemotherapy, but already immune therapy. They have already been studied in adults, and now the children's contingent is next in line.

- Is that why you are called “a doctor from Moscow who gives miracle medicines”?

– Oh, is it true? (smiles) A miracle is not a miracle, but of course, the more drugs in the arsenal, the better, because you always know how to treat the patient, and you are not afraid of any relapse. There are no barriers to continuing treatment.

- Are you afraid to prescribe such drugs?

- No, on the contrary, this is some kind of prospect for a cure. you apply new drug and possibly be successful. I am the type of person who is always ready to use something new. There are no barriers for me. Some say that there are no drugs in our country, they are not approved.

But if I have confidence, I use all drugs, even if they are not registered with us. If possible, we try everything. These are very expensive drugs, and thank God, charitable foundations help.

If there is no effect, then we can immediately prescribe another drug, because chemotherapy is excreted from the body, and does not remain for life, like radiation.

There were cases when parents, without our knowledge, used unconventional methods treatment. Here I am categorically against it! If new drugs have been formally studied and shown to work in adults, then there is great hope that children will have an even greater effect.

Do you always give hope to people?

Always, absolutely always! Often there are completely unpredictable situations. Therefore, I say: "Let's be treated, and then we'll see!"

My husband's dissertation supervisor once began heavy bleeding. She was hospitalized in the ENT department and called her husband: "Maria Ivanovna has cancer of the nasopharynx." Then she was already 72 years old, and I just worked in the cancer center.

Marya Ivanovna came to me, I met her, and here we go, and she asks me: “Olechka, what do I have?”. It would seem understandable, since we are in the oncology center. I say: "Mar-Ivanna, you have a benign tumor." She ended up getting radiation therapy but never found out she had cancer. After that, she lived another 15 years and did not die of cancer.

Another colleague of her husband turned to me - they found breast cancer. And all the week before the operation, she called me every hour: “Olga Grigorievna, I will probably die, I will not live to see the operation. Cancer is eating me!” And I told her: “Yes, you wait!”. She lived another 20 years and died of a stroke.

And ten years ago, our relative was also diagnosed with a tumor. And the oncologist told her: “Well, you are 78 years old! Stretch three years, and you will be 80 years old. Are you not enough?” And this is what the oncologist says! Of course, it is necessary to treat! The tumor was removed and irradiated. Now she is 88 years old, plows in the garden and feels good. It's curable, you know! Doctors sometimes misinform the patient themselves.

Let her become an oncologist!

– And after all, children come to you who were abandoned by doctors ...

- Many clinics, even federal ones, treat only primary patients and refuse patients with relapse. Therefore, such patients in case of relapse or with diffuse tumor trunk, that is, a deliberately incurable situation, come to us.

Although in all reference books and clinical guidelines it is written that such patients need to be treated, many refuse their hospitalization: “Go home and count how many days you have lived.” Therefore, when they come to us, the main questions for us are to prolong their lives as much as possible, and to make sure that this life is of high quality.

I do not refuse... This is my credo - to treat the patient to the last breath.

Especially if it is a patient with a promising tumor. Sometimes he is severe on his own, after the operation he is in a coma, he does not speak, he breathes through a tube and feeds with a tube, and naturally, everyone refuses him. Who needs a patient so seriously ill to deal with? Yes, and our radiologists sometimes say: “Oh, he is so heavy.” But their disease is being treated, they are promising!

Therefore, our department takes all seriously ill patients - we know that everything is being treated. Meningitis or infection is certainly not a hindrance to treatment.
We now have a patient with a tracheostomy. Everyone said he was hopeless. But, fortunately, the tumor was completely removed from him, and the prognosis is favorable. I'm sure he should be fine!

– But after all, all these happy stories are still our time. You said that twenty years ago such patients could not be cured...

“It was actually very difficult. Neurosurgeons did not attract oncologists, only then did publications appear that tumors could be treated, and we began to work together. My boss Arkady Efremovich Bukhny, who now lives in America, was the first oncologist who started chemotherapy for brain tumors in our country. Alexander Grigorievich Rumyantsev ( CEO Center for Pediatric Oncology, Hematology and Immunology. Dmitry Rogachev - ed.) was the initiator of this idea.

As a result, a group was created at the Institute of Pediatric Hematology, which began to treat brain tumors on the basis of the RCCH. I then worked in the oncology center, and did not intend to deal with brain tumors, and Arkady Efremovich invited me.

I came for the first time to a neurosurgical meeting, where they discussed patients with a brain tumor, and I was overwhelmed by a feeling of fear that these patients have a diverse clinic, and there is no treatment - how are we going to treat them?!

It seemed to me that we would never achieve anything in our lives. Fifteen years have passed. New treatment protocols have appeared, a lot of research is being done, and now we know that this disease is 100% curable! We have become more aware of brain tumors. Happiness just overwhelms!

- But when fear seized you, did you think to turn back before it was too late?

– Nooo... I was puzzled: now the tumor was removed, but what to do next, how to treat? Something must determine the future of the patient, which will help to understand this tumor. And the morphologist helped me.

- How?

– I started studying neurooncology after a meeting with a morphologist: I came to the Institute of Neurosurgery to see pathomorphologist Professor Andrey Gennadievich Korshunov, and he said to me: “Do you want to look through a microscope?” - "Want!". And Andrei Gennadievich showed me various brain tumors. He is now working in Germany, we have many common projects.

And Andrey Gennadyevich just opened my eyes to the fact that histologically, brain tumors are different.

I always tormented him, demanded clarity: is this tumor malignant or benign? Because malignant requires the use of all methods of treatment, and benign - only surgery. To which Andrey Gennadievich said to me: “Am I going to count the cells?” And in the end, he counted the cells! If in immature teratoma malignant cells less than 20%, then low degree malignancy, and we will not do radiation therapy.
Our best friends are neurosurgeons and morphologists. You can discuss difficult cases with them. I am ready not to be separated from Andrey Gennadievich!

– But you worked as a pediatrician for 15 years! How did you end up in oncology?

- You know, my husband and I have such a fate ... overwhelmed. He wanted to become an oncologist. After graduating from the institute, together with his friend Grisha, he was sent to the oncology department. science Center. Grisha immediately went and filled out the documents for applying for a job, and my husband went to rest. And when I returned, this place was already taken.

As a result, my husband went to redistribution and became an infectious disease specialist, Grisha an oncologist, and I a pediatrician. And having met one day, my husband and Grisha decided my fate. Grisha said: “Listen, why does your Olga work as a pediatrician? Let her become an oncologist! She will be able to do science and defend her dissertation.” And in 1989 I came to pediatric oncology, and five years later - to neuro-oncology.

– Olga Grigoryevna, why did you choose medicine in general?

“When I was in school, my father was mistakenly diagnosed with cancer. Probably, the feeling of fear so fettered, there was such a shock, but then, when it turned out that this was not at all oncology, but a banal situation, some incredible relief came.

And now I understand parents when they are told that their children have a brain tumor. With a breath they ask: “Is this cancer?”

Therefore, at the age of 16, my twin sister Natasha and I decided that we potentially had a medical essence and we could become doctors. And so each other stimulated.

We studied at an ordinary rural school near Feodosia. And this desire to become doctors brought us to Moscow, although there was a medical school in the Crimea. In the family, no one had anything to do with medicine: dad is a party worker, mom is a teacher at school. But our parents supported us! Moreover, they understood that with ordinary school knowledge in a Moscow university - and we wanted to go to the Second Medical School (RNIMU named after Pirogov - ed.) - don't do it.

But apparently, my sister and I were so purposeful, at the age of 16 we wanted to study so much that we arrived in Moscow a month before the entrance exams: our parents found tutors for us in biology, physics and chemistry.

We studied every day from morning to night - biology, physics, chemistry. Mom even turned off the light in the room so that we could go to bed. This is probably why I have a reflex - I can work at night. Then I told my daughter Masha that we need to work all day. My sister Natalia still works as a pediatrician.
It is difficult to choose from the whole variety of professions who you want to be ... But then our parents supported our desire. And this played a role.

- You also said that since childhood you wanted to change the situation in hospitals ...

- Yeees! (laughs) It was horror! I was locked up in the infectious box with pneumonia. Imagine! And this is ordinary banal pneumonia, not even oncology. But everyone was lying without parents, the patient was completely closed from the outside world, everyone only hurt you. And naturally the question arose: what kind of horror is this medicine? A similar situation was with dentists. We had dental treatment without anesthesia. How could it exist? Today, of course, things are different.

I always cry with the parents of a dead child

– Do you remember the first patient with a brain tumor who was not saved?

- Of course I remember. It was a 12-year-old boy with a recurrence of medulloblastoma. When we started working on brain tumors, we mainly treated patients with relapses. He came to us with metastases, and the first chemotherapy was very successful. Metastases almost completely disappeared.

Six months later, he again had a recurrence of the tumor. Then we began to introduce him a new drug, which was tested abroad. It was purchased for us by the Gift of Life Foundation. But unfortunately, the tumor of this child was resistant even to new methods of treatment… It’s a pity…

“And this death did not frighten you?”

- No, no way. Vice versa! After all, there were already patients who were recovering! And that allowed me to move on.

They must have been crying...

- Together with my mother. I always cry with my parents, even now. We just can't resist. After all, this is a child who has become close to you, who has gone through that difficult path with you. And of course, when he dies, you naturally cry with your parents.

- Do you have enough tears for so many guys?

– Nuuu… Thank God, now they rarely die. But when we know that the treatment does not help, we send them home. Another option is to go to a hospice, but usually everyone wants to be at home. And then the parents call or write that the child has died ...

How do you support them?

“I apologize for not being cured.

- How do you calm yourself down?

- I say that we will come up with something, there is already a study and soon this drug will appear with us, and we can help!

- Olga Grigoryevna, have you ever had such a question: why do children get sick?

- Sometimes you wonder why this happens, because everything was fine with the child, but I can’t find the answer to this question. This is a completely unpredictable disease. We do not yet know what leads to the development of brain tumors in children. Recently, a boy was born in Orel with congenital tumor. It's unexplainable. It can occur even in completely healthy child who never got sick.

How did you come to terms with death?

“It's impossible, you see. When I first came to oncology, a very competent nurse, Galya, worked with me. Our patients are constantly undergoing intravenous manipulations, and she easily got into any vein. But from the leukemia department, she moved to a day hospital.

I said: “Galya, how is it? You are needed here!”. And Galya answered: “Olga Grigorievna, I cannot look at death.” By that time, she had already been working for 20 years.

Ermakov is calling. They all know my phone.

Call: Hello! Yes, Ermakovs, hello! Come by 11 on Saturday.

There are a lot of patients, I have to appoint a consultation on Saturday. I will have a business trip soon: we are going to Irkutsk, and then to Paris for a meeting on new drugs. And then you need to work and consult patients, so on Saturday.

How many patients do you usually have per day?

- There were two today. Sometimes 22, but on average - 15-17 people. Besides phone calls and online consultations by mail. Once I forgot my phone at home, and I look - 60 missed ones. (laughs)

– And what helps you to endure such a rhythm?

The only thing that heals me is work.

At work, I forget about everything, I see children who have recovered, and they distract me from those difficult adverse situations. But the death of a patient is always a tragedy for us, we remember everyone who has already died.

- You once admitted that you are a believer. Does faith help?

- Probably, we are just looking for some kind of argument that would help us. I am not a very religious person. Sometimes I can say: “God, you must be helping us, and I can withstand all this, I can work and go to work the next day.”

But I don’t go to church, I go there extremely rarely - on Easter or some other big celebration. Most of the time I just don't have time. But I believe in God, it seems to me that this faith somehow supports us. Maybe we have come up with and believe in it, but maybe not.

- And when did you believe?

– When I started working in oncology, I think. When I worked as a pediatrician, everything was simple: I cured pneumonia, cured tonsillitis - no problems. And this is where you face death, you see severe cases, you think about why one patient is doing well, and the other has a relapse, because you treated them the same way!

Of course, we now know a number of factors that can lead to a relapse of the disease. For example, a child with medulloblastoma has an unfavorable molecular group. And immediately there is a feeling of fear, you begin to treat this patient more reverently.

Something must be present in us, we must somehow support ourselves psychologically. On the other hand, we are stimulated by cured patients, a team where you can discuss all issues.

The child is not believed that he had a tumor and was cured

- Do you have enough time for your family?

– Oh, very little, very much. We mostly go for birthdays. It is very interesting for me to communicate with my eldest granddaughter Liza, she is already 14 years old, she is sympathetic to my work. When charitable foundation arranges meetings with cancer patients, my granddaughter always walks, sculpts various crafts with the guys.

I think it's good for her too. Patients can call me at any time, wherever I am, and if earlier Liza was indignant, she said: “Well, wait, grandma, I’m talking to you, and here again some kind of call and again you have to treat someone! ”, now he understands everything.

- And what did you answer her then?

“He is sick, but you are healthy. You can wait, but he can't." She understands that I can sit at night, even on vacation. We are resting in the Baltic, in those places where we used to go with my late husband.

But her mother, my daughter Masha, also works from morning till night. She is an oncohematologist at the Botkin Hospital. And you know, it's easy for me: if our patients have problems in adulthood, I know where to direct them. (smiles).

Does your granddaughter want to be a doctor?

The older one doesn't know yet. But the youngest, who is five years old, is already a potential doctor. Her favorite game is ambulance. She has a dressing gown, a hat, a suitcase, syringes. And daughter Masha was the same: already at the age of two she was treating everyone, including herself, saying: “Grandma, I have an allergy, let’s suprastin as soon as possible!”. Of course she became a doctor.

– Olga Grigorievna, what do you consider the main victory in your life?

- That I became a doctor! It's such a blessing that when you enter an institute and graduate from it, you don't say that you don't want to be that specialist. I was lucky to choose a specialty that I love. And I will be a doctor for the rest of my life.

In your opinion, what is the purpose of man?
- O! This mission is to bring joy to others! Do you rejoice if the person next to you gives you joy? I believe that this is what a person is meant for!

When you say to parents with a sick child: “Healthy! Your child is healthy! We cured him!“, you just don’t know if you have the seventh or some other heaven from happiness inside you! You did, you helped, you cured!

How many of these guys do you already have?

- Oh, a lot. (takes out a photo album and walks over to the wall with patient photos).

We treated this boy for medulloblastoma at the age of six, he has been in remission for six years, now he is 12, and he switched from home schooling to regular education. They ask him at school: “Why were you away for so long?” – “And I was being treated, I had a brain tumor!”. So they don't believe him! They say: "Don't lie! Zhanna Friske died, but what, have you been cured?

This girl from Yakutia fell ill at 9 months old, was also cured, and now she works as a nurse! Many want to go to medical school after school! They are generally smart, everyone wants to learn. And they also become much more mature than their peers and much more reasonable, they understand more what it is to live and be alive.

This girl became an endocrinologist and came to us for an internship. And we sent this girl from a remote village to Switzerland for proton irradiation - 10 years ago we did not have such a method. Her parents kept saying that there was no money for the trip, and I stamped my feet and said that they should go only there! And again, the Gift of Life Charitable Foundation helped! Now she is 15 years old, alive and well!

And this our girl with ependymoma asked everyone the question: “Will I have children?” Look what a beauty! And this girl received radiation therapy. This year she received a red diploma! Fiction! But this girl sings and dances in the ensemble. And this boy from Kazakhstan was practically blind - the tumor was localized in the area optic nerve. They were told to do radiation, but these patients are being treated with chemotherapy. He is now sighted! In general, there are a lot of them!

- You once talked about a boy who could not walk and talk, and suddenly he came into your office in flowers.

– Yes, this is a story about Tsolak, I had such a patient, a handsome Armenian boy. He fell ill at the age of 13 and after the operation was in a very serious condition- did not speak, did not swallow. And he endured chemotherapy very hard, he suffered from all the organs of the system, and after the first cycle we realized that if we continue further, he may die from the effects of chemotherapy. And I made a decision - to irradiate. The tumor is gone, everything is fine. But he did not get up and did not speak, and we puzzled over what to do.

They offered them a hospice, because then only there were psychologists, rehabilitation classes. The family was allowed to be together and the Armenians brought all their children. A month later, in November, I came to see, but he only nodded his head, but did not speak.

And then on the phone, my parents told me that everything was stable, they were silent about any improvements. On the eve of March 8, the door of my office opens - Tsolak! FROM yellow tulips! On your own feet! Is this not a miracle? And now he is a footballer, lives in France. Can you imagine it? Groom wow!

What did you feel when he walked in?

It feels like you are in space. This is something incomprehensible. Of course, I will never fly into space, but I had the impression that I was ready to break through the walls! After all, he was told that he would not be able to walk! And here he is standing in front of me with a bouquet of tulips! I say: "I do not believe!" But it was him! Moments like these keep us going.

Call: Hello! Kind! Dr. Khizhnikov, did you arrange the organization correctly? I think it was different before. Well, what are the complaints? I looked at the abstract, everything is fine.

I enjoy working with young doctors. I really want them to know this area and be able to work with the same desire, momentum and potential. I already have 16 students who have defended dissertations: both candidate and doctoral. And I am ready to work with them further. Insanely happy that they are drawn to me, and I am ready to teach them.

But where do you get your energy from?

“My whole life is work. And work is an incentive for everything! Sometimes I scold myself that I can’t go to the theater on weekdays, because I’m at work until the evening. Before, at least my husband pulled it out, but I can’t do it myself ... But I went with my granddaughter a couple of times. I think, okay, I'll go on a business trip, I'll have a rest.

– How would you like to change Russian medicine?

– I believe that there should be less bureaucracy, especially in oncology. This system of registration of quotas is such a bureaucratic system that specifically interferes with the treatment of the patient. If the doctor has prescribed treatment, then the patient should be hospitalized urgently, and not wait for the quota to come.

All medicines must be available to patients. And it often happens that a patient enters a clinic, but there has not yet been a tender and the right medicine did not purchase. All this can be with any other pathology, but not with us. Medicine, and even more so oncology, should be accessible to everyone. You can't wait here.

The neurosurgeon is calling.

Bell: Yes, Andrey Petrovich, hello! So you want to know the date when he will be hospitalized? Today he passes the commission. I think tomorrow or the day after tomorrow. I'll check it out and call you back.

In general, of course, it is possible to work in our area now. And this work brings me pleasure!

Interviewed by Nadezhda Prokhorova