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The National Oncological Center of Georgia reports
that 7,000 new cancer cases were diagnosed over the last year.
It's an unusually high number in a country of about four million people.
It appears that many of these cancer patients are younger than in the past:
between 55 and 60 years old. And many of them are women.
But the high cancer rate is nothing new. Cancer in Georgia surged in 1986,
after the Chernobyl nuclear power plant disaster more than
1,500 km away in present-day Ukraine. During the week that followed,
the amount of ionizing radiation in Georgia's environment
reached 15,000 times the normal level.
The Chernobyl disaster had serious consequences for Georgia.
It resulted in a fast growth of leukemia and leucosis cases.
And it happened within just 10-15 years of the Chernobyl tragedy.
New ecological problems have appeared in Georgia
since last year's war in South Ossetia.
The conflict led to widespread fires. A lot of carcinogenic substances
were thrown into the atmosphere. On the whole,
the ecosystem of the country was badly damaged.
According to the calculations of our scientists and specialists,
the damage reached a billion Lari (U.S.$600 million).
And it is not only about the burnt wood.
The fire was followed by changes in the whole ecosystem
and the disruption of the balance.
About a thousand hectares of forest has been burnt.
The restoration of the Georgian ecosystem will take many years.
But, as in the case of Chernobyl, the measure of the health consequences
of this war isn't immediately apparent.
The effect of carcinogenic substances is very long lasting.
It means that their after-effects do not occur in 1-2 years.
We expect that in approximately 10 years, the number
of malignant tumors will greatly increase.
This is confirmed by statistics.
Doctors here operate on more than 4,000 cancer patients a year.
Foreign experts think it's a high rate for Georgia.
Dr. Aillen Flavio, of Ireland, has been working with
Georgian oncologists for several months.
What is very obvious here is that we get cancer at a more advanced stage.
So I feel that is probably related to less screening, less early detection
of cancer, maybe less opportunity in the past for treatment.
I suppose that's the thing that strikes me is that we are seeing
some tumors at a later stage than we would normally expect to see.
Doctors are particularly worried about women.
Free breast cancer screening is carried out only in Tbilisi,
but not in the rest of the country,
and only among women who are at least 40 years old.
But studies show the death-rate from breast cancer among women
who get screened is 30-50% lower than among those who
have not been screened.
Unfortunately, there are too many cases where the treatment
comes very late. Often patients are coming to our center
when they already have metastasis and recurrence.
Their treatment from a medical point of view is less effective and,
at the same time, too expensive.
In recent years, the number of women with lung cancer has also increased
as more women have started smoking.
More than a third of Georgian women smoke now,
compared with 4% just two decades ago.
Dr. Maka Maglakelidze's office is full of files of lung cancer patients.
She says tobacco smoke isn't only the most important carcinogenic factor
in Georgia, but it's the one that's easiest to control.
A great number of people smoke in Georgia.
If in the past the ratio of cases
of lung cancer for women and men was 1 to 10,
now, maybe it's because of increase of female-smokers,
indicators of lung cancer among women have increased.
Now the ratio is 1 to 6.
When cancer is in the early stages, doctors usually can guarantee remission.
But when the disease is more advanced, all they can do is try to extend a patient's life.
New methods of diagnosis and treatment are making that easier, however.
Other European countries have been using these linear accelerators
for a few years, but Georgia is just now catching up.
Radiation oncology irradiates cancer cells by radiation of high energy,
which has the possibility of decomposing cancer tissue.
Thanks to the latest linear accelerator, "Varian,"
and with the use of 3D planning "Eclipse,"
we can irradiate tumor formation with a maximum dose.
And thanks to MLC system, we cover critical organs.
This is special equipment which consists of 120 tungsten discs,
and covers all critical organs. As a result, a tumor cell changes
its shape and size, and in some cases dies.
Linear accelerators are very high- energy X-ray machines capable
of treating very deep tumors, and here in this department we have a CT scanner
that is used to delineate the tumor, which we want to treat to high dose.
But it also shows the normal tissues, which we want to avoid.
So we can do conformal high-dose radio therapy so you have the advantage
of being able to increase the dose to the tumor while at the same time
reducing the dose to the normal tissues.
And that's very important because what we want is patients to survive
after cancer treatment and not to have any side effects.
Ideally, this method could be used on about 70% of cancer patients.
But it will not solve the underlying cause of Georgia's rising cancer rate.
Georgia spends about 4 million Lari (U.S$2.4 million) on combating cancer,
but that is not enough to make cancer screening more widely available,
and improve the environment by detecting and neutralizing
carcinogens in the soil and water.
Within the next few years, doctors expect cancer to overcome
heart disease as the most widespread disease in the nation.