Interview Guest: PLA 307 Hospital, Professor Jiang Zefei
Record interview follows:
incurable disease - breast cancer, but they are still bright radiance, still frequently appears in a variety of important social occasion, women can still be the same as the normal work hard for the family, but behind a huge price to pay, under great pressure. We are concerned about breast cancer prevention at the same time, should be concerned about the treatment of these special women, life and work.
this, Sohu healthy joint between areas with friends to talk about the topic of breast cancer.
Moderator: friends, good afternoon! Welcome to the Sohu health interview room.'s annual March Eighth International Women's Day fast approaching, women's health issues and get everyone's attention Today, we are very honored to go to the PLA 307 Hospital, Professor Jiang Zefei talk about breast cancer prevention and control issues
the same time, there are some here who like the health media, they are the life and Times, Health News, Medical Tribune, China Pharmaceutical News, People of the several reporters.
interviews we started, first a brief introduction Professor Jiang Zefei prevention and treatment of breast cancer in recent years, some progress.
Professor Jiang Zefei
breast cancer Advances in the treatment of these years
Jiang Zefei: Hello, everybody, ladies and good friends, very happy to share with you Sohu health aspects of the latest concepts in breast cancer.
to March 8 every year, there will be a concern when the female breast cancer awareness program, called public attention to .2008 of breast cancer is the Olympic year, the Olympics about technology, about culture, I would like to breast cancer and cancer prevention, we also need to emphasize the concept of science, humanities concept.
academic progress of breast cancer many years, such as classification and treatment are now speaking, with the molecular classification of breast cancer is no longer so after the simple one-like illness, may be three, possibly five, so how to treat breast cancer is no longer that, but that should be how a particular treatment of breast cancer. In addition to the genetics, genomics growing understanding of the future, before the surface looks like the same patient in fact very different. Third, the planning of. There is now national and international norms after treatment guidelines, our clinic more standardized so that each stage of treatment for each patient tends more and more standardized. Fourth, along with government investment and media later, the public health awareness growing stronger and stronger, the various stages of treatment are now into more and have achieved good results.
targeted therapy can not replace the traditional breast cancer treatment
Moderator: You said Breast cancer is the classification and treatment, targeted therapy for breast cancer are now very popular, recently there are some new drugs, these drugs for people what it does?
Jiang Zefei: Targeted therapy of breast cancer is a very big breakthrough, change the mode and mechanism of conventional therapy, so more professional. But we must stress, not a replacement, we do not think people have a genetic drugs, molecular targeted drugs have a future, there will be no use of traditional chemotherapy, and do not need, far from it. the best treatment strategy should be based on the traditional treatment in the standard to play the advantages of new drugs, many drugs are needed in combination with chemotherapy, is through the killing of some tumor cells before chemotherapy, and then targeting Drug inhibition of tumor cells, molecular targeted drugs should now be two points of emphasis, while not a substitute for a breakthrough.
Moderator: That is only part of the molecular targeted therapy.
Jiang Zefei: treatment of breast cancer now found Her-2 target, knew how to inhibit tumor cells, but the Her-2 positive patients is not necessarily targeted therapy is effective, and therefore a new method of treatment is important to find the right people, we would like to stress testing and standards prosecution, and treatment at the right opportunity. For example, some drugs, you put it in the final stages of life for patients, in fact, going to be successful, but if push forward the appropriate stage of treatment that actually benefits won longer. So I think this is also a doctor by profession, the public need to understand a basic principle, choose the best time to use the most appropriate option.
how to classify breast cancer?
Moderator: You mentioned breast cancer now is not a disease, and means that it can be divided into four types to treat, people may now know this idea is not particularly large, and even doctors may not know I think is especially large, how to make Our first time can be used in breast cancer patients the right way to treat? will not write a guide to this year, go inside?
Jiang Zefei: In fact, classification of this year's guide has been referred to the concept of breast cancer patients after surgery may be 5 years Within some relapse, some did not relapse, because where it? situation because everyone is different, the final end is completely different. that slow development, hormone receptor-positive patients with disease progression compared to the relative slow, treatment can ease, it can coexist with the tumor, with survival and longevity.
another patient, Her-2 positive patients with faster progression of the disease, but can be effectively better control after treatment.
There is also a patient, hormone receptor and Her-2 were negative, there is no target, but it is such a class of diseases that we still have drugs, such as bevacizumab, for some patients to obtain the same effect, I would like to at least divided into three categories.
the concept of how to tell the people to do this? such as lung cancer now we know, is divided into non-small cell lung cancer and small cell lung cancer, breast cancer is such a concept I am afraid, there are always some people sensitive to certain drugs is continuous, and some people are not sensitive, such as doctors we now have a suggestion for those drugs continuously sensitive man, seize the opportunity to go step by step, do not frequently change the drugs because drugs do not change some benefit, at least be able to control the tumor and prolong survival. For people not sensitive to these drugs may be surgery, chemotherapy will be effective. The doctor does not need to try a lot of drugs in patients with no effect of time, and then consider whether or not chemotherapy, should be by the experience for him to choose the best treatment, I think this is the basic classification and treatment.
present, to some extent, we may not cure the disease, but we may control the disease, cure cancer is our ideal , in fact, high blood pressure, diabetes, we have no cure, but we can control, harm reduction, the patient can be a very good life.
breast cancer patients can have a baby do?
Moderator: Her-2 positive breast cancer Will a genetic situation? breast patients can have children?
Jiang Zefei: the problem of genetics, in fact, everyone has a lot of genes, and only when the gene mutation or gene expression changes when it is the behavior of disease So what not to say there have disease genes.
The problem of children, sure there are many young women face this problem, my point is, can students, early, curable after completion of treatment should be reproductive rights, while giving due consideration to her treatment of the health effects have completely eliminated, otherwise the child's health is also affected.
What is a receptor?
Moderator: Professor Jiang spoke about some of Her -2 receptor-positive, and the concepts that users are able to do a brief introduction?
Jiang Zefei: receptors inside the human tissue is estrogen receptor, its role is to accept the body of estrogen, can influence the occurrence of tumor cells, differentiation and development. If by some means to control hormones and drugs, or competitive inhibition of the formation of hormones and receptor binding, then, is to play a role in controlling tumor development, which is endocrine therapy. < br> H2 receptor is actually a gene receptor, if the overexpression of this receptor is not good then.
monitoring of breast cancer to a specialist hospital
best Moderator: just talking about a few receptor for the receptor is not very standardized testing is common, what kind of hospital can guarantee that the test results do?
Jiang Zefei: Speaking of targeted therapy, and if even this target is crooked, then the targeted therapy certainly problem, just ask if targeted therapy is male, female, smoking does not smoke, I do not think this targeted therapy, targeted therapy should be to find the exact target.
so testing is important, should take the This appeal, first, the standard test, the second a close look. because some people are negative measured five years ago, and now recurred, but also do not think the same, then another test may be positive, and the third, the city, various hospitals doctors to cooperate with each other, when a patient to another when a hospital, the hospital may be required to provide him with five or ten years ago to retain the specimens, it was not a suspect, but rather to find more opportunities. We also encountered such a case, that is negative, the results of a test is positive to see that the former is positive, the technical standards should not accurate targeting will also be lost, this would delay the proper treatment of patients. If you test positive for negative, it will allow patients to freely do these medications.
I think college may be more important, the hospital size may not be the main key is to test the basic conditions for workers is not standard, and The inspection items to do much more, because it's more a chance to correct.
Moderator: patients should choose a number of specialties, where a relatively high number of hospital cases.
Jiang Zefei: U.S. did such a study, the same breast cancer patients, on the one year less than one hundred cases of hospital treatment, and treatment of over one thousand cases a year in the hospital, concluded that the therapeutic effect of the latter would be better.
how women of different age groups of breast cancer screening
Moderator: Here we look at users concerned about breast cancer early detection of breast cancer issues, before we enter the topic of Professor Jiang first of a brief screening method of the mammary gland of different ages What's the difference.
Jiang Zefei: In fact, as professional associations and professional doctors, are in the recommended screening and screening professional, we introduce the treatment in progress at the same time also called for the timely inspection.
last year, our hospital has also been invited reporters and editors of different media personnel listen to a health talk, do a physical examination, physical examination results according to our proposal to do B-who, who do mammography. This is the good way, let everyone get professional care, Also, let everyone get a professional inspection. Some young women do not need B ultrasound, mammography does not need to do, because she was completely normal.
age to 40-year-old women, we would suggest that she take pictures mammography film, because film mammography is the standard for her inspection means, and young girls is not suitable for mammography film, the first partial young, so young we do not want her to take X ray damage. it is proposed that the young Women do B-, B-if the individual who is suspected nodules suggested that she followed up when you can do MRI or even biopsy.
that there add that the 2007 U.S. Oncology, which has a press, the United States approved MRI for screening. The first scientifically proven useful, as it low radiation, so damage is low. Second, high accuracy, especially in relatively deep. it is more deep mammography film may not be seen, B-also not see clearly, I think such measures, especially for young women in China, I think it is more useful. premise that China's current health care conditions, if for all to enjoy, 500 million women can do the screening, I believed to be impossible, so we want to emphasize the different means of different groups of people better.
Moderator: Just now you mentioned that more than 40 years old wooden target, do a two-or three years to do a little better, more secure?
Jiang Zefei: I am 40 years old the first time emphasized to encourage women in the age of 40 took the first film, the first time after finishing with a family history, combined with previous history of breast and the performance of the X ray, look at each film is not, or take two years or three years of filming, we first ensure that women over the age of 40 have the first film, and then discuss specific next time when the film should also no requirement must take one year, there is no need. Still others may be next month or next month and then, you need to do B-or other test, because some are skeptical. and some all normal, I think She does not need to shoot every year, so I think to emphasize, at least for the first time is the case, then depending on the circumstances behind the decision by a doctor the frequency of follow-up.
Moderator: So about 20 years old who want to do search? what check it ?
Jiang Zefei: 20 years old I think it may be more concerned about normal development, as well as future breastfeeding, childbirth preparation stage, I feel that for this population of women is concerned, may be more to know that the health health knowledge, and this healthy reserves, is now on, I think this is the most important, at least put the risk of breast cancer, although some said that younger, but in fact to some extent a common disease of breast cancer, It's just that some rural women, the elderly do not enjoy the city's health insurance, so I do not see. In recent years, often say that the trend of breast cancer at a younger age, I think getting younger and younger reasonable, but can not overlook the fact that our health insurance does not include all rural women and older women, said the hospital would appear to see the doctor inside the young patients.
Moderator: the significance of palpation for breast cancer found that, because until there is, some experts say palpation did not make any sense, but some people still think it is a regular means.
Jiang Zefei: My view is that palpation absolute sense, in spite of studies have shown that physical examination does not reduce mortality or self-examination can not, do not forget conditions, it is the city in the conditions, developed in the health insurance and have a family doctor in North America to the conclusion.
often, we see some build-up to 15 cm long, 18 cm, and even some long build-up than girls head is also great to come for medical treatment, and that palpation have meaning? is because she did not palpate the tumor becomes unresectable.
speaking young again, if you do not go to palpation, until the eye can see that there are opportunities to do breast conservation, the valuable opportunity lost. So I think we read the article to see a time when the data, do not forget the background, normal family if every year a medical examination, then the may not be important, because palpation is not necessarily so accurate. But in China at this stage is concerned, I highly recommend self-examination and medical examination.
Moderator: Breast self-examination how much that means it?
Jiang Zefei: Do not be too dependent on self-examination, because you own professional knowledge and professional habits are not the same, relying on self-examination and re-light if you decide when medical treatment is risky, first, over-easy, you touch everything that there is a problem will be very tense, while the real problem may be omissions away. My point is about self-examination should be under the guidance of a doctor, the doctor told you that you do not have problems, you can each month self-examination. means that doctors advise you on how to complete self-examination after the test, this is to go through under the guidance of a professional, I would hope that after the popularity of community health, our community health survey of disease in terms of health professional education and to do some health education, of course, a number of specialist doctors, from time to time go on to do some promotion and guidance, I think this is better effective.
Moderator: Do you think the true concept of breast cancer screening should be like? because a lot a lot of meaning in society, but there are some economic benefits to some extent the color of the inside.
Jiang Zefei: my ideal height of the census should be a women's self-examination every month, then every six months to one year the hands of a specialist investigation, according to the results of hand check to see if she made B-or mammography, or magnetic resonance imaging, and then based on these results followed up to see what people need to do, for those who require biopsy.
Moderator: That needs breast specialist, right?
Jiang Zefei: should say need, but specialists alone is not enough, because much of our examination of the survey and not in the hands of a specialist investigation. medical examination if a person checked the morning of 200 healthy women, breast , I think he will be sensitive to the problem is.
milk through the breast cancer screening does not make sense!
Moderator: milk some units have also done through the year, there is no meaning?
Jiang Zefei: milk Infrared inspection is through the United States is not approved, I think it is meaningless, because on the sensitivity and specificity is that it is not too good, so is now internationally recognized advocate the use of standard film mammography, or B-, Indeed, through the milk is not accurate, so the U.S. has not ratified.
Moderator: Screening should not have a hierarchical concept in which, because according to each person's genetic, its not the same, may need to check project is not the same, do you have any suggestions?
Jiang Zefei: breast health so important for every woman, and we often say that this is the world's most expensive ; built a file is necessary, at a certain time we build a file, B-What is the result of what the results of mammography, and then let the doctor give you a suggestion when to do a check. I suggest that the examination unit, more to pay attention to more common diseases, such as electrocardiogram, blood pressure, blood lipids such. and some specialist areas, such as the uterus, gynecological examination, as do specialist, breast, too. In the United States have a family doctor, then there is an eye a doctor, one dentist and so on. just like reading the same, you have a portfolio, different results will be inside, reading the results when the portfolio is very concerned about, but we people from birth to so many years now health records, may be only a few people from birth to my health condition now is how, so I suggest that after the personnel files and health records to go with.
elderly people how to regulate the treatment of breast cancer?
Moderator: just that treatment of the problem, more and more breast cancer patients, there may be some people did not know had breast cancer, in particular, should be how to regulate the treatment of some elderly people.
Jiang Zefei: First, the elderly get sick I am sorry that the second, older children spend more fear of disease, fear of Fat. So here say, an aging population more and more, give our professional doctors to ask more questions, the elderly, treatment issues. the prognosis for these people and survival, if not treated carefully, it is highly likely to die of complications. Also, all the new clinical study, when age limits are 18 to 70 years old, if extended to 75 years, 80 years old, certainly not the same.
many older people slow development of breast cancer, more likely to rely on endocrine therapy, targeted therapy, mild chemical drugs, oral drugs, can be combined together. So I think it comes in March 8 Care for women at the same time, you can also add a love older women, and her health, her sociological characteristics, features of her disease, I believe that her treatment with the basic principles we have adopted should be similar, but specific to the patient Be careful when some of our patients may also want to do chemotherapy, but a bad heart, or would like to surgery, but there is danger, so that control of complications and treatment of cancer patients as important, or even shelve the treatment, first to cure heart disease, if the blind start of treatment may lead to complications, resulting in serious consequences.
but one thing is to remind the public, they should not be treated like this so terrible, the elderly have the disease, doctors who have experience They will go to categories, not to mention the fear of the doctor. Now there are many elderly patients, 70, 80, and I also saw a more than 90, the treatment very well, particularly happy day, because they live in the ward to see so many patients, there Instead, she accompanied a lot of people very happy, usually living at home, the children busy,.
Moderator: This elderly cancer patients, many general practitioners will not be consultation with the pattern?
Jiang Zefei: I feel is necessary, also need to do such a thing, when deciding cancer treatment, from the tumor may be very simple to see medical specialists, along with diabetes, cardiovascular disease may be more serious, so we will together with other specialists, Considering the treatment, the effect will be even better.
patients in the treatment of the misunderstanding?
Moderator: You encountered in clinical patients with the most misunderstanding what?
Jiang Zefei: one for the experts expectations. so-called experts Ye Hao, Ye Hao specialist, experts must be very proficient in one area, but there is one area do not speak, that is, experts, or to miscellaneous home. Many people do not know, where the expert professionals , it is too much trouble, the experts may be exclusively in the high blood pressure, you find him cancer in trouble. For example, I also know that the comparison of breast cancer more, but you have to diagnose high blood pressure, then I would say I'm sorry, you find next door to a specialist. the doctors themselves have to understand what you are most expertise, you have to dare to say no. you recommend this to a patient in the industry's most experienced doctors, this is your thing the best thing to do .
as the patient's family and society at large, but also really need the points classification, if the doctors see 100 patients a year, of which 50 disease, the average year to see a disease that only two cases, and a doctors see 100 patients a year, but only one disease, I think that the experts behind the front is eclectic. This is a common misunderstanding exists that doctors tried to solve all the problems of patients, and our patients and parents who I want the doctor to help solve all problems.
second myth, stage errors. When the time is better governance, how to treat all good anyway, so I casually go to a doctor first to see, or I nearby, and or I know him, I will go first to him. wait until a problem, and relapse, and die, said no I'm going to large hospitals, I'm going to the top three hospitals, I think this is the stage errors, always hard, very painful time to find a higher level of demand. Here I appeal, in fact, the higher you come the greater the benefits obtained, because these experts will give you good advice, you do not have a lot of extra money, this time get a better return.
Moderator: whether checking or treatment, they should go to regular hospitals, I would think that when breast cancer diagnosis would be better sense to find experts, this can clearly understand what their specific disease , at what stage.
Jiang Zefei: So I propose to establish a good model, should be the focus of professional consulting as a comparison, and our expert patient should gradually become a professional guide, professional advice and professional counseling-based, the treatment reserved for different hospitals and medical centers, I think this would be better, that is standardized, normalized for each patient and each hospital clinics.
Moderator: Why is not he the first professional There go the doctor because she does not think that is a matter of, first, not many specialized hospitals, and many patients, not easy to find specialized doctor, this is an objective reality. Second, he knew not.
Jiang Zefei: people believe that medical professionals do, open each of several knives, is also quite good, the problem is bad here in his surgery patients do not have to go to other hospitals.
here I was asked to say a few professional media , now doing professional media guide every year to promote the progress of the introduction, the network of expert interviews, in fact, the message is that we have this: a reasonable treatment and reasonable treatment. some of our patients and relatives who, if from users have to search about, as we have to buy a house, car, doing research, purchase, buying a car should study the budget, cost-effective hh When a person has cancer, had mastectomy for breast cancer, we have research. cut or not cut, large cut, or small cut, or recycling, after the system works. These clinics have rules for each disease, and our friends who were not afraid of hard work, even in very simple browser on the network look, you will find in these treatments which had so many rules, so much the norm, I would like to avoid many problems.
people how to treat breakthrough?
Moderator: Sometimes a media log information, there is a way possible in animals or cell level there is hope, but not to the person's level, people look at this situation how do?
Jiang Zefei: Because people always want to suddenly come to a breakthrough, anything to completely overcome, I think these people overcome cancer is life-long ideal, but that in itself is a misleading number of diseases are now being overcome, we can say there is little disease is now being overcome, otherwise people will be able to live a few hundred years, the thousand years old, it should be said that we go to conquer, to control us.
example just mentioned, the United States for certain what the scientist or scientists found that cancer two months is unrealistic, he saw at the most in animals with these things to make cells die, so that cells die too many things, and threw a handful of salt down cells live, the problem is from animal experiments to human trials, into drugs, require a long process . ten thousand active ingredient, a hundred on the clinical, and ultimately can be used for treatment may be only a few, the high rate of screening and phase-out is too high, so when they heard this news, I hope that we have a information, medical experts and scientists in the effort. Second, this is a bit like the moon, we know that the moon is no road, but we have to go above, so have the standard treatment based on the present, then the basis for better treatment, so science is important to treat this information.
Moderator: Another question is, just you say the capture of an ideal, but all patients want to hear the word, if you say which parts of the therapy with this more positive words, the kind of article, that the speed of information dissemination, communication range, with a less than positive words, precise language, a number of things may be more easily transmitted.
Jiang Zefei: for example, now says overcome high blood pressure, overcome diabetes, if less, we do not believe it, because we all know that this disease is difficult to overcome, even without capture, control on it. cancer treatment is a certain degree of difficulty, after all, there are some patients can be cured. I have just referred to the specialist requirements, we do not expect a drug can cure all disease, that's hard to come by a medicine is unlikely to cure all disease.
Moderator: We do regulate the media to do more lower transmission rates, the hospital's more prone to spread misleading effect, because the media wanted to do, the more accurate the better, but the more accurate the more people do not want to see, because he needs to know More information before Nengkanmingbai. Quite simply, if given a very positive response, he remembered on the line, not ready knowledge.
Jiang Zefei: This thing can only say that we continue to work with the scientific stuff to write lively and that is written so that people understand that we have to endure a little bit lonely, because false information is always faster than the real news media, news hit rate higher than the sex scandal, what we have to adhere to adhere to what.
Moderator: Is not the day we should not chase the latest development, the latest trends in particular to the pursuit of these things, may have accumulated a lot of things out little by little, I think it is not to be more concerned about some of the more advanced the concept of human geography read more on ordinary people, they need to accept some ideas, some of it is more important?
Jiang Zefei: Yes, because I think in terms of our medical professionals, we certainly should be in constant specification At the same time to innovate, to create new technologies, new methods, new tools, new drugs, but as a doctor is concerned, we find it difficult to create their own new medicines, new ideas that we can only use this tool good. As the media think is best if you have this, but the media must be sense, the treatment may be classified, not the targeted therapy, this new thing is to encourage us to strive, to struggle, and this new thing, like a few years ago about genes, gene now become a reality. have We have a good harvest.
example, in the treatment guidelines of the update, we are not saying that the so-called updated in 2008 down to 2007, we may retain 85% to 90% of the basic content, and then we divided the year sort out something new, which link has changed, which added a new program areas, which get rid of outdated, so I think the update is not reinvent the wheel, is based on the original to add some new things, remove obsolete . is the need for new news, but the public really need to know the relative maturity also need something to tell you now which is something new.
Professor Jiang Zefei in the eyes of the public health education
Moderator: We are now interviews with health education specialists to do more, and users have to look at how we spread this knowledge? For example, many users will use health information to set himself to find experts to theory, you should think how to solve this phenomenon? < br> Jiang Zefei: I think that health education is very positive, and that is making people inadvertently or intentionally to get useful information, I think this is the meaning of our interview today, I see patients in clinic is limited , but we chat on here a couple of hours, and today he may not see, but maybe for one day he could see, no patient in his house when he could not see, but the day may come back to retrieve a patient.
But I would also like to remind patients not to expect such an interview by, and even the dialogue on the network, your treatment can solve the problem, the reason is simple, with textbooks, but also a teacher, but also a guide with medical books, Otherwise, not on the Tsinghua University, Beijing, buy a few Tsinghua University, Beijing University's book, that does not become a Tsinghua University, Beijing the top students. In addition, we must at the local regular hospital, the doctor will give you good views of the professional advice .
computer, turn on the lights at night are likely to get breast cancer do?
Moderator: We have talked about the increasing incidence of breast cancer, and the general public is more concerned about is that there may be some aspects of their will have to pay attention to breast cancer, so now the media reports, for example, a woman used the computer 43% increase in breast cancer disease, or turn on the lights at night to sleep will increase female breast cancer, which is relatively attractive, how to treatment? Is not it in their daily lives to avoid?
Jiang Zefei: Of course that is the most energy-saving lights to sleep, the most environmentally friendly. for the use of computers increased risk for breast cancer, frankly speaking I have not seen the detailed report, not The results clearly this is not easy to say, or the findings, I believe, will not be so high, if the words are so high we would dare to use computers, not that the computer is becoming a high cancer risk factors. But the long-term use of computer possible cervical spine, the heart is not good, so they encourage kids as far away from the computer. but we have people who work in the computer, you can do less time, which is right. But I believe this is not use, I do not believe he has done rigorous randomized studies, to really study the numbers, track and analyze research must be fixed, I guess to remind you there is no multi-purpose computer is bad, I think this is right, but can not say that because it would not have computers, technology is how to do without computers. Second, the light on and off to bed to sleep problems, turn on the lights were not good enough to sleep on, turn on the lights to sleep or sleep well, this is certainly . As for the light on and off to bed to sleep on the impact of breast cancer, I think not ...
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