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Основные виды опухоли ЦНС у взрослых и экологические факторы: cовременные данные

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Большое спасибо за крайне интересный материал. И все-таки, как Вам представляется: на какие факторы следует обратить первоочередное внимание: химические, неионизирующее излучение, ионизирующее излучение при медицинских процедурах. И еще одно - общераспространенное старение общества- как этот фактор сказывается на распространенность онкологических заболеваний центральной нервной системы?

Thank you very much for the interesting material. And yet, as you see it, what factors should be given priority attention: chemical, non-ionizing radiation or ionizing radiation during medical procedures... And one more thing - the widespread aging of society - how does this factor affect the prevalence of oncological diseases of the central nervous system?

Dear May Irina,
I think ionizing radiation during medical procedures and chemical should be given high priority when designing studies and of course in a prospective manner. Recall bias is a real problem when evaluating the results. All kinds of medical procedures are normally documented, so it gives more reliable data than picking up a random sample and investigate. We must start somewhere and of course have a control group.
As for aging, the prevalence of brain tumor has not changed with regard to age groups, it seems to be constant in both groups of gliomas. What we see with aging people is more of degenerative brain diseases than oncological ones. Brain tumors are very rare even in a normal population.

Уважаемая проф. Бернтссон! Спасибо за конкретный и скорый ответ. Есть данные, что до 70% радиационного облучения обычные люди получает во время медицинских диагностических процедур. При этом в последнее время широко обсуждается проблема избыточности диагностических назначений. Поднимается и обсуждается ли такая проблема в Швеции?
Dear prof. Berntsson! Thanks for the specific and speedy response. There is evidence that up to 70% of radiation exposure is received by ordinary people during medical diagnostic procedures. Moreover, the problem of redundancy of diagnostic prescriptions has recently been widely discussed. Is such a problem being raised and discussed in Sweden (icluding from the standpoint of reducing the cancer risks)?

Уважаемая профессор Бернтссон, Ваше сообщение содержит очень интересный аналитический материал,представляющий особую значимость в связи с сохраняющимися угрозами здоровью человека. Это особенно важно в отношении отдаленных последствий экспозиции различных факторов, определяющих развитию онкологических,в том числе злокачественных новообразований центральной нервной системы. По Вашему мнению , является ли бенз(а) пирен соединением, тропным к органам и тканям центральной нервной системы и участвует ли он в формировании опухолевого процесса именно в этой системе?.

Dear Prof. May,
Regarding radiation exposure during medical diagnostic procedures, the answer is yes, the question has been discussed throughly and there are guidelines and tables showing how do different procedures affect different organs, and the doses are discussed. We know from the Japanese atomic bomb survivors that doses above 100mS induce cancer, but this is not the case for the medical procedures, where doses between 10-100 mS are most common. Unfortunately, there are people undergoing multiple CT studies in a short time. Nowadays, it is almost a rule to refer to a CT scan when patients come to the emergency department, in most cases in the absence of a room in the ward (Cost/expense thinking). I am afraid that our young physicians are not really aware of the increased risk of cancer when they refer patients to multiple and sometimes quite unnecessary procedures of different reasons, most often because of the shortage of time/ being efficient. In spite of the available information I sometimes find patients with 5-10 CT scans of brain in a period of 1-2 year without any specific pathology. We need to raise the question and inform our young students and colleagues to think one extra time of radiation risk. Long-term thinking and being aware of side-effects of what we daily expose our patients to, is not a modern type of thinking, but very important.
Best regards,

Shala Ghaderi Berntsson
MD, PhD, Associate Professor

Dear Prof.Shala Berntsson! I completely share your point of view and respect your active position on this issue.
Prof. May Irina

Dear Prof. Zaitseva,
The answer to this question is that we don´t really know. Benso (a) pyrene exposure is linked with the incidence of breast cancer and it may promote inflammatory microenvironment of importance for metastatic progression of breast cancer. Moreover, there are a few animal models/studies where we see an indirect role in neuronal death by activating the immune cells of CNS. I am not aware of studies in human glioma cell lines or epidemiological studies with focus on the role of Benso (a) pyrene as a potential carcinogen or being tropic to the CNS compounds.
Best regards,

Shala Ghaderi Berntsson
MD, PhD, Associate Professor

Professor Berntsson, many thanks for the very interesting and very relevant report!
The issue is more related to CNS tumors than to environment. But does the hormonal background influence on the tumor CNS formation in adults?