Issue №5-93, 2019

Rehabilitation of oncogynecological patients: current problems and possible solutions

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1 Solopova A.G., 1 Vlasina A.Y., 1 Idrisova L.E., 1 Moskvichyova V.S., 1 Bazhanov S.A.

1 I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia


ABSTRACT

In recent decades the increase in life expectancy of Russian women in combination with the increase in the incidenceof reproductive organ tumors has required the development of new approaches to the management of oncogynecologicalpatients. The widespread introduction of screening programs, improvement of methods of diagnosis and treatment,increased public awareness of the need for timely access to a doctor, have significantly improved the detection of gynecologicalcancer in the early stages. Today, the medical community and patients who have received special antitumor therapyare interested not only in survival statistics, but in the quality of future life after the treatment too. There is an urgent needfor medical rehabilitation specialists, searching for clinically, socially and economically effective forms of rehabilitation assistance,developing national guidelines and practical recommendations.Unfortunately, there is no system for the rehabilitation of oncogynecological patients in Russia nowadays. Also, there areno medical organizations specializing in this issue. It should be noted the lack of knowledge of the rehabilitation methodsand the limitations of their use due to the small conduct of randomized controlled studies in our country.The lack of pre-rehabilitation and delayed rehabilitation activities are still staying a huge problem. Often, the anatomicaland physiological changes and the psychoemotional background of women after the treatment of gynecological malignanciesare not taken into account. However, the lack or insuffi cient amount of psychological and psychotherapeutic assistanceleads to the disadaptation of patients, distress, a sharp decline in the quality of life.The main goal of rehabilitation should be lifelong observation of oncogynecological patients, constant alertness regardingthe recurrence of the malignant process and the search for preclinical forms of relapse. Such an approach will increasenot only the effectiveness of the rehabilitation measures, but will allow women to live with the highest quality of life.In this publication, the authors tried not only to formulate the main problems in the rehabilitation of gynecological patients,but also to propose possible solutions.


KEYWORDS: health strategy, oncology, gynecology, quality of life, rehabilitation, interdisciplinary medical rehabilitation, reproductive system, pre-rehabilitation, psychotherapy, relapse.



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