WHEN THE PRIMARY TUMOUR IS UNDETECTED BUT METASTASES ARE PRESENT: THE NATIONAL MEDICAL RESEARCH CENTER OF RADIOLOGY PROVIDES TREATMENT FOR COMPLEX CASES

The Department of Drug Therapy for Tumors at the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology is a relatively new unit — it is only five years old — but it is rightfully considered unique. It treats highly complex patients who require an individualized treatment regimen and especially careful monitoring of their condition.

“A key component of the department’s structure and work is the Centre for Personalized Oncology and Supportive Therapy, where diagnostic and treatment strategies are developed for patients with the most complex clinical situations — those that require individualized, multidisciplinary, and sometimes non‑standard solutions”, – says Inessa Kononenko, MD, Head of the Department. “This situation arises in patients with metastases but no identified primary tumor. Such patients are relatively few, but each case demands a thorough diagnostic and clinical investigation. A team of specialists is involved in this process: radiologists, pathomorphologists, molecular geneticists, and colleagues from other clinical disciplines.”

It is this multidisciplinary collaboration that enables the selection of the most evidence‑based treatment approach in such complex clinical scenarios — whether in cases of renal failure, the need for programmed hemodialysis, the ineffectiveness of prior standard treatment lines, or situations where there seems to be no remaining hope for treatment.

Here is just one such story. “In March of this year, I started experiencing back pain, and after an examination, I was diagnosed with stage 4 stomach cancer with multiple bone metastases,” says a young mother of four children. “The disease progressed rapidly: within three months, I could no longer walk; a metastasis had fractured one of my vertebrae, the pain was excruciating, and I also developed gastrointestinal bleeding. My husband contacted the Research Institute of Urology, the drug therapy department; then my doctors held a teleconsultation with the specialists, and here I am”, the patient smiles, though just a short while ago she could move only in a wheelchair. “They devised an individualized treatment plan for me, and it produced a very good result. I feel like I’ve been given a second life”.

One of the most important principles of the department’s work is the prevention of complications and the management of adverse effects, which helps preserve the patient’s quality of life during treatment. “We are constantly exploring new ways to support our patients”, – emphasizes Inessa Borisovna. “For example, we use a device for respiratory adaptation training with alternating phases of hypoxia and hyperoxia. This is an additional component of supportive therapy aimed at preventing toxicity, improving tolerance to anticancer treatment, and enabling faster recovery during therapy”.