Elevated dog after removal of prostate cancer

PSA after removal of prostate cancer and radiation therapy: norms and causes of deviations

PSA is an abbreviation for prostate-specific antigen. This is a protein that the prostate produces. The content of the antigen in the blood of perfectly healthy men is minimal, but depends on age.

An increase in PSA compared to the norm may indicate a pathology associated with the prostate gland, including a malignant neoplasm.

In the article, we will consider the question: what are the standard PSA values after Prostate cancer surgery, how to obtain objective analysis data.

Why take a prostate specific antigen test after surgery?

Determining the level of antigen in the blood is performed for the following purposes:

• diagnosis at an early stage of diseases of the genitourinary system that occur without symptoms or with not very pronounced signs. It can be both neoplasms and infectious diseases;
• determining the degree of effectiveness of prescribed therapeutic measures. If the level of antigens decreases significantly, this indicates a positive trend in the course of the disease;
• timely detection of oncology recurrence after treatment;
• Cancer prevention. An increase in PSA levels throughout the year indicates the risk of the disease.

Preparation and features of the test

In order for the results of the study to be as informative as possible, it is important to follow the following recommendations before taking the analysis:

• two days before taking a blood test, you should follow a diet: refrain from fried, salty, spicy, fatty foods, meat and alcoholic beverages. Steamed vegetable dishes, cereals, and soups with water or vegetable broth are recommended;
• stress conditions and physical exertion should not be allowed;
• should refrain from intimacy and masturbation;
• You should not eat for 12 hours before blood sampling. You can drink some non-carbonated water;
• Do not smoke 2 hours before the diagnostic manipulation.

Other procedures also affect the accuracy of PSA data.

The minimum time for procedures before analysis is:

• Ultrasound, x-ray diagnostics - 7 days;
• prostate massage - 3 days;
• prostate biopsy - 1.5 to 2 months;
• medication (Methotrexate, Proscar, Cyclophosphamide) - from 10 to 14 days;
• cycling - 1 day;
• masturbation, sexual intercourse, accompanied by ejaculation - 1 day.

PSA after removal of prostate cancer

The most common ways to treat oncology are radical removal of the gland and radiation therapy. The normative values of the tumor marker after these types of therapy are different.

PSA level after radical surgery

In a prostatectomy, the affected prostate gland is removed along with the surrounding tissues. In this case, it is recommended to take a PSA test 1-1.5 months after the operation. Immediate analysis does not make sense, since a high level of antigen persists for some time.

The frequency of blood donation for analysis is:

• with normal PSA (less than 0.2 ng / ml), the level of antigen is determined during the first year 1 time in 3 months. At the end of the first year, testing is carried out once every 6 months;
• If the PSA value is at or above 0.2 ng/ml, then a monthly analysis is performed. This allows you to identify a relapse at an early stage, prescribe adequate therapy with a 100% guarantee of a cure.

In order to exclude false positive results, the patient is prescribed a second test.

An increase in PSA in the blood after a radical operation to remove the gland can be triggered by the following reasons:

• inflammation of the genitourinary system;
• complications after intervention, drug allergy;
• Removal of the tumor is not complete. The remaining cells contribute to an increase in PSA;
• the spread of metastases to tissues and organs located near the gland;
• genital injuries.

The probability of prostate cancer returning in the first 10 years after surgery, even with adequate therapy, is about 37%. That's a pretty big risk. The choice of treatment for a high PSA depends on the type of relapse (systemic or local).

Relapse is determined by monitoring the antigen index over time:

• Local recurrence means localization of a neoplasm within a previously operated area. Exceeding the PSA norm occurs 2-4 years after the intervention;
• If there are distant metastases, they say that a systemic relapse has occurred.An abnormal increase in PSA levels in this type of recurrence occurs less than a year after surgery.

If the patient was given radiation therapy, the PSA reduction is 0.5 ng/mL.

This is due to the fact that irradiation only partially destroys foreign cells. Part of the "surviving" tumor contributes to the growth of tumor markers. With successful radiation therapy, there is a gradual decrease in PSA levels (over about 2 years).

A stable increase indicates that the tumor is "alive", and additional treatment measures are required. Conducting contact radiation (brachytherapy) leads to a sharp jump in PSA immediately after the procedure. You should not be afraid of this: it should be so.

Frequency of testing after radiotherapy:

• when the antigen concentration drops to 0.5 ng/ml and below - once every 6 months;
• when the PSA indicator is slowly lowering or its value remains unchanged - at least 1 time in 3 months.

Additional diagnostic methods for suspected relapse

An increase in the antigen score after an intervention to remove a tumor does not always indicate a return of the cancer. For an accurate diagnosis, it is necessary to perform the analysis several times. Helps to confirm or exclude relapse additional diagnostics.

If the PSA level is elevated after surgery, then a relapse is suspected. In this case, patients are prescribed the following diagnostic procedures:

• MRI of the pelvis;
• prostate biopsy;
• PES. This is an innovative technique, which is widely used in the West, allows you to detect metastases in the lymph nodes even before they increase;
• CT of the abdomen;
• Bone scintigraphy.

The last two procedures at an early stage are practically uninformative.

Only with an increase in the level of antigen to 40 ng / ml is there a chance of detecting a relapse.

Related video

Urologist about the informativeness of the test for prostate specific antigen (PSA, PSA) in the diagnosis of prostate cancer:

Cancer is an insidious disease that sometimes shows unpredictable "bends" of the course. Therefore, it is important to monitor the indicator of the tumor marker in order to take timely measures. Using the test results, the specialist adjusts the treatment.

The norm of the dog after removal of prostate cancer

PSA level after prostate tumor surgery

The normal PSA after removal of prostate cancer depends on the age of the patient, as well as on the type of surgery he underwent. Prostate-specific antigen or PSA (PSA) is the main indicator by which the doctor monitors the condition of a man after surgery. This antigen is contained in the prostate secretion. It acts on sperm after ejaculation, diluting it.

Abnormal PSA can lead to cancer recurrence. The indicator of the prostate-specific antigen directly indicates whether the patient's health will be restored after the removal of the malignant neoplasm. The PSA level is especially important to monitor if the patient's soft tissues, nerves and lymph nodes were removed during surgery.

How PSA values are interpreted in cancer and other diseases

In urological practice, there are clear concepts about the optimal PSA. They change as a man grows up: in people of retirement age, the PSA rate is 2 times higher than in young boys. In prostate cancer, a significant increase in the antigen in the blood and semen is observed. This is directly related to the development of a tumor and a change in the secretion of the prostate. Deviations from the established norm may indicate completely different diseases of the prostate. A change in the level of PSA is diagnosed with prostatitis, adenoma and other pathological processes.

Patients are required to undergo a PSA test in the following cases:

• if the man's age is over 40;
• after removal of a malignant tumor;
• to monitor the effectiveness of therapeutic intervention in various diseases of the prostate.

After surgery to remove the cancer, the PSA value most often returns to normal, and patients begin to recover. With a normal level of this antigen, the man again becomes capable of fertilization. In case of any deviations, a recurrence of prostate cancer is suspected.

How to get tested

Blood after the operation will have to be taken regularly. This is necessary so that the doctor can monitor the patient's condition. You need to prepare for the delivery of an analysis to identify the level of PSA. Some factors can affect the indicator, causing it to become inaccurate.Preparation consists of the following steps:

Abstinence from sexual intercourse and masturbation 5 days before the day of the test; refusal of TUR and transurethral ultrasound 7 days before blood donation; refusal of manual therapy of the prostate 3 days before the examination; 8 hours before donating blood, you need to refrain from eating and drinking. Properly observed preparation helps to obtain the most accurate test results. You can donate blood for testing at any time of the day. Experts recommend checking at least once a year. People who have undergone surgery need to be tested a little more often (2-3 times a year). Timely examination will help to recognize the recurrence of prostate cancer or other diseases of this organ.

The main sign of relapse is a stable increase in the level of antigen in the blood. In such a situation, the patient is prescribed a course of radiation therapy and hormones are prescribed. In advanced cases, a second operation is performed, during which the prostate is completely removed. After such a surgical intervention, the health of a man is not fully restored.

So, the following indicators are considered normal for different age categories:

Men under 50 years old - 2.5 ng per ml; patients under 60 years old - 3.5 ng per ml; men under 70 - 4.5 ng per ml; over 70 years old - up to 6.5 ng per ml. Prostate cancer is rarely diagnosed in men under 45 years of age. With age, the risks increase several times, as the prostate itself begins to deform. By the age of 60-70, a man automatically falls into the risk zone, regardless of the field of activity and lifestyle.

In fact, the PSA antigen itself is a protein that is constantly produced in the prostate. In medicine, this indicator is called a "tumor marker". For analysis, blood is taken directly from a vein. Most often, the total antigen level is studied, but in some cases it may be necessary to determine the free PSA.

What indicators are considered normal after surgery? There is a general norm for all ages, which is 4-4.5 ng per ml. This indicator can be observed in both 40-year-old and 70-year-old men. A PSA level of 6.5 ng per ml is acceptable for people of retirement age.

After removal of the prostate, the amount of antigen is significantly reduced. Recurrent prostate cancer can be diagnosed with 80% accuracy using MRI. When a tumor develops and grows, the PSA level can become extremely elevated: from 10 to 50 ng per ml. An indicator of 100 ng per ml indicates deep metastases. All values up to 10 ng per ml are the so-called "gray zone".

Slight deviations from the norm may indicate the development of prostatitis or prostate adenoma. An indicator above 10 ng per ml is already oncogenic.

Facts to know about PSA

Before taking tests for the level of PSA in the blood, you need to familiarize yourself with the following facts:

Cancer cells produce large amounts of alpha-1 antichymotrypsin. Therefore, with the development of a tumor, the level of free PSA increases several times. A lowered rate, in turn, may indicate chronic prostatitis. In a healthy male body, the ratio of free and total antigen is no more than 10-15%. A false positive result is a phenomenon experienced by many doctors and patients. The level of PSA in the male body lowers manual therapy and ejaculation. Suspicions of recurrence of prostate cancer after radical prostatectomy appear in the case of an increase in the amount of antigen in the blood. A constant value of more than 0.3 ng per ml is considered abnormal. Optimal PSA level after radical prostatectomy: 0.2 ng per ml. Relapse after radiotherapy can be said after three increases in the level of PSA. Normal rate: from 0.2 ng per ml to 0.3 ng per ml. Strong and consistent deviations from the norm indicate the resumption of the disease in 70% of cases. Recurrent prostate cancer is common among older men. That is why many doctors prescribe additional treatment after surgery. The increase in antigen levels can be stopped by various therapeutic methods. After radiation therapy, the PSA level decreases by 1 ng / ml, and after radical prostatectomy by 0.2-0.3 ng / ml. Additional treatment is mandatory for suspected recurrence of prostate cancer.

How to check PSA levels after prostate cancer surgery

PSA is the main indicator of health in a man who underwent surgery to remove a cancer in the prostate area. This is an essential element that the cells of this gland produce. It belongs to the indispensable components of prostate juice. Such an antigen is necessary for participation in the process of fertilization. He carries out the liquefaction of the sperm after the eruption of the seed.

Why are deviations in PSA indicators dangerous?

PSA norm is a medical term for the necessary standards for a healthy male body. This indicator is quite unstable and directly depends on the age factor. The older the man, the higher the allowable rate.

For example, standard Rh factor, at age:

• up to 50 years is 2.5 ng/ml;
• from 50 to 60 years should be 3.5 ng/ml;
• from 60 to 70 must equal 4.5 ng/ml;
• over 70 years is 6.5 ngml.

Why is a PSA test done? It must be done:

• to test the effectiveness of the treatment process for diseases associated with the prostate;
• men over the age of 40;
• after surgery to remove prostate cancer.

At the same time, men under the age of 40 usually do not need such a study. The likelihood of malignant pathologies in them is minimal. Therefore, the norm in these cases is the absolute absence of the previously mentioned standards.

If after the analysis a slight excess of the standard is recorded, then several additional studies should be carried out to confirm or, conversely, refute the diagnosis of cancer in this zone. If the level is much higher, then this indicates the development of a newly formed tumor. A very large excess of the amount of antigen indicates the occurrence of metastases. In this case, it is necessary to perform a surgical operation to get rid of prostate cancer. If it is carried out successfully, the PSA level comes to the required standard.

Peculiarities of passing the analysis

To know the correct result, you must follow the recommendations of medical specialists. First of all, it concerns the observance of certain recommendations related to the conditions that must be followed before the blood donation procedure to check the PSA level. There are many nuances that can lead to a temporary decrease, or, conversely, an increase in such indicators.

What conditions must be met before checking:

• prostate massage should not be done before this study;
• ultrasound (transrectal) should be discontinued for seven days before the procedure;
• sexual intercourse or masturbation is prohibited two days before blood sampling;
• transrectal resection before the procedure is also impossible;
• You can donate blood at any time, since the amount of protein does not depend on the time of day.

According to the recommendations of experts, such an analysis should be done annually. This will make it possible to monitor the health of the prostate and respond in a timely manner to emerging problems, including the possibility of cancer.

What else needs to be considered?

Positive false result. The level of prostate antigen can be increased not only with the existing malignant new formation, but also for other reasons. If the above conditions for preparing for the test are not met, then the result will be incorrect. It can be caused by the eruption of the seed before analysis or examination with a finger. In addition, after receiving the test results, it must be taken into account that a high percentage of PSA can be observed not only due to cancer in the prostate region, but with other inflammatory processes.

Currently, experts are trying to improve the analysis mechanism. Positive results have already been achieved. A variant of blood donation for the PSA coefficient was thought out and created. Unlike the test for the level of content, it makes it possible to determine a positive result or a false positive much more accurately.

For example, if such a study found an increase in the number of free antigens, this is a sign of adenoma. In the case of an increase in "associated" - such a result directly indicates the presence of prostate cancer.

An advanced pathology. If the negative processes of cancer have been going on for a long time, then the solution to the problem is surgical intervention. But in some cases it can also be ineffective. Therefore, constant monitoring of PSA is an opportunity for timely detection of pathology. It will allow you to prevent the negative processes that have begun in the male body, to "see" the resulting pathology in a timely manner and to carry out competent treatment. When cancer is detected, there is no time to waste. The more he is diagnosed, the higher the chances of a full recovery.

The period after surgery. The surgical method of treatment consists in the process of removing the prostate. After surgery, PSA should be at a level of 0.2 ng / ml to 0.4. It can be up to 0.7 ng / ml. The minimum antigen in the blood cells is due to the fact that not only the prostate is removed, but also the channels that are involved in protein production.

In small quantities, prostate-specific antigen is produced by the perianal and periurethral glands. If after the operation there is a constant increase in PSA, then this is a symptom of the continuation of the development of cancer.Then radiation is prescribed, and in some cases hormone therapy may be used.

It should be taken into account that the test should be carried out within a few weeks after the operation, since an elevated PSA may remain in the blood for some time. As already mentioned, this procedure will allow you to control a possible recurrence of the disease.

Radical prostatectomy (features, nuances and postoperative period)

This procedure is a radical treatment. It is most often used in the early stages of prostate cancer. The main condition for such treatment is that the age of a man should not exceed 70 years. It is most often used in the early stages of prostate cancer. The main condition for its implementation is the age of less than 70 years. Prostatectomy involves not only the removal of the gland, but also the lymph nodes, as well as tissues located nearby. After that, the patient does not have the opportunity to recover.

But you should know that according to statistics, from 25 to 50 percent of patients, after undergoing surgery, again get a relapse of the disease. Previously, the possible recurrence of problems was determined by the detection of a new formation by palpation.

Today, relapse, as already mentioned, is determined by an increase in PSA, in particular, a doubling of the prostatic antigen index. The above is the rate that is acceptable after the implementation of this operation. But at the same time, it should be remembered that analyzes must be carried out regularly within a year after the operation.

In any case, it should be understood that in order to prevent negative processes fraught with the appearance of cancer in the prostate area, it is necessary to regularly check with specialists and immediately begin treatment if problems are detected.

PSA for prostate cancer: definition and purpose of the test

Normally, in a healthy man, prostate cells secrete a special enzyme - a serine protease fraction. In the blood, it exists in two versions - free and bound.

PSA can be used not only as a tumor marker, but also as a marker of inflammation or mechanical damage to the prostate gland. Normally, in healthy men, it is kept at a low level and a significant increase in its concentration indicates a pathology of the prostate gland.

Both in oncology and in benign prostatic hyperplasia and prostatitis, the main symptom is difficulty urinating due to a mechanical obstruction. The detection of a large PSA value in the blood helps to diagnose the presence of a malignant disease at an early stage.

The test for determining the level of free PSA is carried out by the NHA method - indirect hemagglutination.

The norm for PSA levels depends on age. The level of concentration of prostate-specific antigen in the blood of a man under the age of 70 should be no more than 4.5 ng / ml, up to 60 years no more than 3.5 ng / ml, and under 50 years old should not exceed 2.5 ng / ml .

PSA diagnostics is used as a screening for preventive examinations after 40 years to identify the risk of cancer. If an elevated PSA value is detected and a tumor disease is suspected, a rectal examination is performed and additional examination methods are prescribed, such as ultrasound, needle biopsy.

The doctor measures PSA in prostate cancer in order to monitor the effectiveness of tumor treatment after surgery, after chemotherapy or radiation therapy, as well as to assess the effectiveness of hormone therapy, for the timely detection of metastases and relapse.

After radical prostatectomy, the level of prostate-specific antigen, as a rule, is extremely low and should not increase more than 0.2 ng / ml.

Prostate massage may affect blood levels of total PSA. ejaculation, biopsy, rectal examination of the prostate gland, as well as ultrasound examination.

It also increases with inflammation of the patient's prostate, due to trauma, ischemia, and with age.

In oncology and relapse, the increase in the amount of PSA occurs steadily and gradually, over several months to a year, while after mechanical effects on the prostate gland, for example, after brachytherapy, its amount increases sharply and for a short time.

After the surgical treatment, it is recommended to determine PSA not immediately after prostate cancer surgery. and after a month or more. Also, the analysis is done no earlier than 7-10 days after mechanical effects or inflammation of the prostate.

Also, before the study, you should not smoke for 30 minutes, avoid nervous and physical stress, and do not eat fatty foods for 24 hours.

PSA values for prostate cancer: what "normal" looks like

Normal PSA values in a healthy person range from 0 to 4.5 ng/ml.

PSA levels in early-stage prostate cancer may be low, up to 10 ng/ml.

At a later stage, PSA values in prostate cancer can increase significantly, and mainly due to free PSA.

An increase in the amount of PSA after surgical treatment of more than 0.2 ng / ml indicates the development of metastases or recurrence of the tumor process.

Prostate-specific protein should be measured a few weeks after surgery. A small level of PSA in prostate cancer remains in the blood after partial resection of the prostate.

Carrying out medicinal and radiation exposures does not completely remove prostate tissue from the body, as it destroys tumor cells. This can lower PSA levels, but they decrease slowly over a year or more.

Determination of free PSA in prostate cancer makes it possible to differentiate the symptoms of postoperative inflammation from the symptoms of a recurrence of the tumor process.

The indication of PSA in prostate cancer can be determined not only in absolute, but also in relative terms, that is, in the form of the ratio of free PSA to the total as a percentage. The level of free PSA12-100% indicates the presence of a tumor process or its recurrence.

How to lower PSA in prostate cancer?

The level of PSA is a diagnostic marker of the success of the treatment of prostate cancer and decreases after therapeutic measures - surgery for prostate cancer. chemotherapy, radiation and radiation exposure.

What is the PSA for prostate cancer?

The amount of free PSA in prostate cancer can significantly exceed the standard value. The detection of a PSA level at screening of more than 10 ng / ml indicates a probability of a tumor process of more than 50%.

Determining the PSA norm after removal of prostate cancer

The normal PSA after removal of prostate cancer is 0.2 ng / ml. This is due to the fact that, apart from the removed cells of the prostate gland, no other organ produces the serine protease fraction. The amount of free PSA after prostate cancer surgery for the greatest reliability should be measured after a month.

In the early postoperative period, a significant increase in PSA levels is possible, up to 40 ng / ml or more. After chemotherapy, radiation therapy, there is usually a gradual decrease in the level of PSA in the blood, so the PSA test after prostate cancer treatment is done for the first time in a month, and then repeatedly, in order to control.

The result of PSA after removal of prostate cancer must be monitored for a long time in order to timely relapse. A high PSA level, which rises sharply and for a short time, is caused by a mechanical effect on the male prostate gland.

• How does PSA change with recurrent prostate cancer? When prostate cancer recurs, it is possible to observe a long-term, significant and persistent increase in free PSA levels.
• What is the normal PSA level after prostate cancer surgery? After radical prostatectomy, a minimum PSA level should be observed in the blood after a month.

What PSA result is considered normal after removal of prostate cancer

PSA - prostate specific antigen, organ-specific marker of prostate diseases. Determining its amount in blood serum is a way of early diagnosis of prostate diseases and control of their treatment. All men who have undergone removal of an adenoma or prostatectomy for cancer should regularly donate blood to measure PSA. Thanks to this, it is possible to control the effectiveness of radical treatment and timely notice the recurrence of oncopathology.

Why take a PSA test

In prostate cancer, the PSA level rises significantly, indicating the destruction of the organ. After the full removal of the gland, it should decrease sharply (since the source of the antigen was eliminated during the operation). After surgical treatment of prostate cancer, PSA should return to normal after 4-6 weeks (after radiation therapy it decreases gradually).

The first analysis is of primary importance. If the result is normal, laboratory control is prescribed every 3 months throughout the year. The stability of the indicator allows you to control PSA even less often - once every 6 months.

If the amount of antigen exceeds the norm, doctors are alert. They prescribe PSA tests every month and monitor the dynamics of its changes. Growth is observed when:

• incomplete removal of the cancer focus;
• the appearance of metastases;
• drug allergies;
• postoperative complications.

The result of each PSA test after surgery is important for the doctor. According to the dynamics of values, it is possible to diagnose a relapse and suspect its type (systemic or local).

Preparing for analysis

At least 2 days should be prepared for PSA measurement. This depends on the accuracy of the information received. Doctors recommend giving 7 days to the preparation.Features of the preparatory period:

• 4-6 weeks after a prostatectomy;
• 2-4 days before blood donation, a man is shown a diet (a menu of soups, cereals, vegetables);
• coffee and alcohol should be excluded from the diet;
• stress and hard work should be minimized;
• avoid sexual intercourse and masturbation.

Biomaterial sampling is carried out on an empty stomach (the last meal should take place no later than 12 hours before the visit to the laboratory). Smokers should give up cigarettes 2 hours before the manipulation.

Lack of preparation is fraught with a change in the level of the tumor marker - its unreasonable increase. The amount of the marker in the blood may increase after:

• abuse of fatty and protein foods;
• psycho-emotional overstrain;
• ejaculation;
• physical activity.

Another antigen growth factor is medical manipulations and invasive procedures. Between the analysis and biopsy of the prostate, an interval of at least 8 weeks is required, treatment with cytostatics and hormones - at least 2 weeks, endorectal ultrasound - a week, Prostate massage - 3 days.

Indicators after surgery

The normal PSA value in men does not have a single value. It increases with age:

• up to 50 years - 2.5 ng/ml;
• up to 60 years - 3.4 ng/ml;
• up to 70 years - 4.3 ng/ml;
• after 70 - 6.5 ng/ml

The norm for a remote prostate is significantly lower - 0.2 ng / ml. Permissible values - 0.4-0.6 ng / ml. The reason for this is the absence of specific tissues in the body. The antigen continues to be produced by the paraprostatic glands (if they were saved), but the amount of protein equal to the age norm will never be reached.

If the PSA titer is above normal, radiation is prescribed. After it, monthly monitoring of the dynamics of the antigen is carried out. Conclusions are made on the basis of the obtained values and the rate of their growth. A doubling period of 3-4 months indicates a systemic recurrence of the disease or incomplete removal of the tumor. If PSA doubles in 7-11 months, a local recurrence is suspected - a malignant process in tissues adjacent to the prostate.

A false positive result is said to be when the results of the first or subsequent tests are unreasonably high. More often this happens if a man neglects preparation. A mistake is fraught with consequences - the patient may unnecessarily prescribe radiation or chemotherapy, repeat the biopsy, and even recommend surgery. To prevent unnecessary interventions, when the analysis values are rejected, doctors always prescribe a second study after some time with the condition of proper preparation.

Recurrence Elimination

After removal of prostate cancer, recurrence occurs in 25-50% of cases. The systemic form usually manifests itself after a year, the local form can occur after 2-9 years or more. PSA rises even if metastases cannot yet be seen visually. The main way to control the disease is regular protein testing in combination with MRI of the pelvic organs. Other diagnostic methods (ultrasound, scintigraphy) do not allow to detect small foci of oncology.

Irradiation is prescribed immediately after surgery if a high PSA is detected in the first and control tests. Late relapses are treated with antiandrogenic drugs, radio and radiation therapy. Treatment is carried out in a hospital or on an outpatient basis - it depends on the patient's condition and the degree of danger of oncopathology for his life.