Fenzitate or Phenazepam?

Phenazepam is a tranquilizing drug with a sedative and hypnotic effect, which is prescribed for psychoneurological pathologies with fear and anxiety syndrome. A pharmacological drug often causes unpleasant consequences in the form of addiction and adverse reactions, so safer and no less effective analogues are selected instead.

Who is this article for?

These and other questions are answered by the surgeon of the International Clinic Medica24 Allahverdyan Alexander Sergeevich

Our expert in this field:

Allahverdyan Alexander Sergeevich

Surgeon-oncologist, professor, MD. Head of the ROH expert group. International expert

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In this article we will speak in simple, understandable, and at the same time scientific language about a very serious problem - the general misconception about the impossibility of further treating cancer if even one metastatic lesion is detected in the liver. This actually criminal delusion has ruined more than one human life.

Therefore, the text below is written specifically for “advanced” patients and their relatives who do not want to sit back and wait for only morphine to help, who want to save the lives of themselves or their loved ones as much as possible.

We hope that this text will be useful to allied doctors - first of all, non-operating oncologists (from among former therapists who have undergone retraining in oncology), chemotherapists in clinics and day hospitals, gastroenterologists, ultrasound diagnostic doctors, computed tomography and magnetic resonance imaging doctors , namely, those who diagnosed “cancer metastases to the liver” and actually put an end to the patient.

If you are a patient, or you are a medical specialist, send us the results of examinations, an oncologist’s report, and a link to an ultrasound scan, video archive of MRI or CT, and we will be happy to advise you. Within 1 day, you will receive a conclusion about the prospects of organ-saving surgery on the liver, or the possibility of performing chemoembolization of cancer foci in the liver. In some cases, we completely remove the diagnosis of “cancer metastasis to the liver,” which turns out to be a liver cyst, a parasitic liver lesion, a consequence of toxic liver damage, and even a benign tumor.

If we give consent to a certain type of intervention - radiofrequency ablation, liver resection, including atypical, chemoembolization, intra-arterial chemotherapy, combined intervention, then we guarantee the result in the form of the patient returning to active work.

When sending your questions, know that I, Konstantin Yuryevich Ryabov, will personally answer them.

What are cancer metastases to the liver?

Cancer metastases to the liver are secondary foci that develop from screenings of tumor cells of the main, “maternal” tumor, which entered through the blood or lymph and multiplied to the minimum size that can be diagnosed by non-invasive methods - 0.5 mm.

The issue of micrometastases of cancer to the liver is practically not understood in the scientific literature. The liver is affected by metastases with almost the same frequency as the lymph nodes. In almost every third patient with cancer, regardless of the location of the primary tumor, in-depth diagnostics reveal metastatic liver lesions.

The primary sites for cancer metastases to the liver are the following cancers in descending order:

• cancer of the rectum, sigmoid and colon (colorectal cancer), which metastasizes depending on the histological type in 15 to 35% of cases;
• stomach cancer, which metastasizes with a frequency of 17% to 85%;
• pancreatic cancer - an average of 40%; lung cancer - 15–75%;
• breast cancer - 20–65%.

Much less often, metastases of ovarian cancer, cervical cancer, kidney cancer, melanoma and others are found in the liver.

Phenazepam: pharmacological features

Phenazepam is a potent tranquilizer based on the active substance bromodihydrochlorophenylbenzodiazepine. Phenazepam tablets are used in the treatment of various neuropsychiatric disorders accompanied by anxiety or fear syndrome.

Main indications for the use of a tranquilizer:

• alcohol withdrawal;
• alcohol, drug or drug intoxication of the body;
• neurosis;
• psychosis;
• phobias;
• epilepsy;
• hypochondriacal syndrome.

Phenazepam acts directly on the central nervous system, due to which it is widely used in neurosis-like, neurotic, psychopathic and psychopath-like conditions. Most often, such pathologies are accompanied by a feeling of panic, anxiety, increased irritability and emotional instability.

It is recommended to drink the pharmacological drug in a minimum dosage - no more than 0.25-0.5 tablets.

Phenazepam is sold in pharmacies only with a doctor's prescription. According to the law, this tranquilizer is included in the Register of Substances Subject to Special State Control. This resolution is enshrined in the Single Convention on Narcotic Drugs at the proposal of the UN.

Elokom is a hormonal ointment and cream for external use with a pronounced anti-inflammatory, regenerating and anti-allergenic effect. The drug is widely used in the field of dermatology and cosmetology for the treatment of allergic rashes and skin diseases. Read more in the article: “What is Elokom cream used for?”

Prediction of survival with cancer metastases to the liver

Life expectancy differs with the initial detection of cancer metastases in the liver in the absence of a diagnosis of cancer and with metastases against the background of treatment for already identified cancer.

It is generally accepted, without taking into account the results of histological and immunohistochemical studies of the results of a biopsy of cancer metastasis to the liver, that the life expectancy of a patient with such a diagnosis without treatment ranges from 4-8 to 12 months maximum from the moment of detection of the first metastasis.

With various treatment options for both cancer metastases to the liver and the primary focus of the malignant tumor, life expectancy can be increased to 3.5 - 5 years.

If we take statistics, then life expectancy is absolutely influenced by the source of metastases and, in fact, the course of the main tumor process - in the intestines, pancreas, etc., as well as the gender and age of the patient and the presence of concomitant diseases. According to domestic data, the survival rate of women is higher than that of men.

Only 10-15% of men and 15-19% of women survive to 1 year after diagnosis. Up to 3 years - respectively, 7-10% of men and 10-15% of women. The threshold of 5 years after cancer diagnosis is reached by only 3-6% of men and 9-12% of women. The survival rate of patients with cancer metastases does not depend so much on age. The annual survival rate for people under 50 years of age is 20-25%, for people from 50 to 70 years old it is 10-15%, and for people over 70 years old it is 12-13%.

Survival prognosis

How long people live with cancer metastases to the liver is determined by a complex of factors. Maximum life expectancy in patients with single (solitary) nodes, up to 3 cm in diameter, located in the right lobe of the liver. The minimum duration is in patients with bilobar liver disease, that is, in the right and left lobes, with multiple heterogeneous nodes.

Chemotherapy itself is practically not used to treat metastatic liver cancer. Chemotherapy can increase the life expectancy of patients with cancer metastases to the liver to 1.5-2 years. Moreover, polychemotherapy (PCT) for the primary cancer site and anti-relapse PCT are of particular value.

The main treatment method that ensures long-term survival of patients with cancer metastases to the liver is radical - surgery, chemoembolization, radiofrequency ablation of lesions and other less common methods.

Actually, surgical resection of the liver can be performed due to a combination of factors only in 5-20% of patients with various tumors with metastases to the liver. Chemoembolization and radiofrequency ablation can increase this proportion to approximately 50% of all patients with cancer metastases to the liver. Unfortunately, up to 50% of all patients are forced to settle for palliative or symptomatic treatment.

We actively recommend that in the initial diagnosis of colorectal cancer and single liver metastases, active surgical treatment with simultaneous removal of the primary lesion and metastases. This makes it possible to increase the five-year survival rate to 30-40% of all initially operated patients.

In general, cancer metastases in the liver reduce life expectancy, although they are not a death sentence. We believe that it makes sense to fight with all possible modern methods of treatment. If you don’t give up and do everything possible, then you have a chance to live for many more years!

Causes of liver metastases

The liver is one of the most abundantly supplied organs. Up to 30-40% of the body’s total blood passes through it every minute, on average about 1.5 liters per minute. In this case, approximately 30–35% of the blood enters through the hepatic arteries, and the remaining 70–75% through the portal vein from the intestine. Then both of these flows, mixed, return to the heart through the inferior vena cava.

The liver, due to the specificity of its blood supply, is a place of “retention” of tumor cells, which leads to the most frequent localization of hematogenous tumor metastases in it, regardless of whether the primary tumor is drained by the portal vein system or other veins of the systemic circulation.

In this case, half of the metastases come from primary tumors localized in the abdominal cavity and pelvis, and draining into the portal vein system. Thus, in colorectal cancer, after radical resection of the affected part of the intestine, and subsequently having no relapses in the area of ​​the primary operation, PET-CT reveals single liver metastases in approximately 50% of cases.

In the absence of radical treatment, the average life expectancy of such patients is less than 2 years.

With other gastrointestinal tumors, including cancer of the stomach, esophagus, and pancreas, metastases are detected in approximately 40-50% of patients. In lung cancer, breast cancer, and melanoma, metastases are detected in approximately 30% of patients. Metastases to the liver occur very rarely in cancer of the oral cavity, pharynx, prostate gland, and bladder. Quite rarely, cancer of the uterus and cancer of the ovaries, pharynx, oral cavity, bladder, and kidneys metastasize to the liver.

It is important to note that approximately 2/3 of metastases histologically and immunohistochemically repeat the “maternal” tumor, and a third morphologically differ from primary tumors in the degree of differentiation of tumor cells, which makes it difficult to determine the organ affiliation of the primary tumor.

Treatment of cancer metastases in the liver

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Cons of Phenazepam

Phenazepam is a powerful tranquilizer that causes various side effects. The most common ones include:

• attacks of nausea;
• vomit;
• Strong headache;
• painful abdominal cramps;
• bronchospasm;
• allergic skin rashes;
• apathy, drowsiness;
• destruction of the kidneys and liver;

• decreased blood pressure;
• deterioration of memory and brain activity.

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When taking the tranquilizing drug Phenazepam, side effects in older people appear much more often and more intensely. That is why the drug is prohibited for use in old age.

In elderly patients, the tranquilizer causes serious impairment of motor coordination, which often causes dangerous injuries.

In some cases, instead of the expected sedative effect, Phenazepam has a stimulating effect on the nervous system, causing attacks of uncontrolled aggression and sudden mood swings.

In addition, with long-term use, Phenazepam inhibits the functioning of the cardiovascular system and disrupts full-fledged brain activity. For elderly patients, taking a tranquilizer can result in a stroke or myocardial infarction.

Symptoms of cancer metastases to the liver

If a patient has single cancer metastases to the liver, then in most cases, until they reach a diameter of 5-7 cm or begin to compress the biliary tract, then due to the high regenerative ability of the liver, metastases do not manifest themselves for a long time. In the presence of a primary tumor focus (before radical or cytoreductive surgery), the clinical symptoms of metastases are summarized with the symptoms of the primary tumor.

If we talk about metastases in the liver, the disease can manifest itself with the following symptoms. First of all, this is astheno-vegetative syndrome. The patient loses significant weight while maintaining his diet and appetite; he complains of constant fatigue and a feeling of weakness at any time of the day. Performance gradually decreases.

I begin to worry about constant acute paroxysmal or minor pain in the right side, sometimes accompanied by an unpleasant sensation of friction in the right hypochondrium. The patient complains of uncontrollable nausea and vomiting, bitter belching, diarrhea or constipation. The skin takes on an earthy tint. All manifestations of this syndrome are caused by functional impairment of the biliary and detoxifying functions of the liver, and, in principle, are reversible, provided that the primary factor—cancer metastasis to the liver—is eliminated.

The syndrome of obstruction of the biliary tract develops due to compression of large bile ducts by the tumor mass, primarily the common bile duct and lobar intrahepatic ducts. The patient constantly complains of bursting pain in the right hypochondrium. He begins to be bothered by itchy skin, and the skin acquires a yellowish tint along with the sclera. Spontaneous attacks of fever are observed. Urine takes on a dark (beer) color.

Compression syndrome of the inferior vena cava is accompanied by persistent edema of the lower extremities that does not change during the day, which is accompanied by the accumulation of fluid in the abdominal cavity. The pain becomes diffused throughout the abdomen.

Gradually, the severity of both astheno-vegetative syndrome, biliary tract compression syndrome, and inferior vena cava compression syndrome begin to increase. Decompensation of liver function leads to weight loss up to an extreme degree of exhaustion - cachexia, while there is a deterioration in appetite up to complete refusal of food.

Compression of the biliary tract, and as a result, the development of obstructive jaundice, is accompanied by portal hypertension syndrome with compression of the portal vein. As a result, according to the law of communicating vessels, dilation of the veins of the esophagus, rectum, and anterior abdominal wall (“head of the jellyfish”) occurs, which leads to episodic bleeding from the dilated veins. Small ascites increases in size and can reach a maximum of 20-25 liters, according to our clinical data.

The most dangerous conditions become closer to the end of the disease - persistent vomiting lasting up to a day, especially with scarlet blood, black stools, severe abdominal enlargement, as a rule, indicate gastric or intestinal bleeding that requires emergency surgical care.

To avoid the development of the above-mentioned complications, we recommend regular, at least once a month, control examinations - ultrasound of the liver, and at least once every 3 months, MRI of the abdominal organs with intravenous contrast. This is the only way to achieve prolongation of life with satisfactory health. Late detection ends in the death of the patient.

Analogues of funds

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Among the analogues of Phenzitate and Phenazepam there are drugs with the same active substance and other drugs from the group of anxiolytics:

The drugs should not be taken together with other drugs with the same effect. If possible, benzodiazepines should be replaced with more modern anxiolytics due to their dangers and side effects.

Diagnosis of cancer metastases to the liver

In most cases, cancer metastases to the liver are diagnosed during a random examination (for example, during a planned cholecystectomy), less often during an examination to clarify the nature of the lesion in primary cancer of another location.

Typically, studies include non-invasive and invasive examination methods. Among the non-invasive ones, the simplest and most accessible is liver ultrasound, which mainly performs a screening function. However, its resolution does not make it possible to see metastases less than 0.4-0.5 cm in diameter.

Imaging methods such as PET-CT, CT or MRI scans allow you to evaluate their size, quantity, location, growth pattern, detect suppuration and decay, and involvement of neighboring tissues and organs in the tumor process.

However, the diagnosis of micrometastases in the liver area is based on contrast portography, which allows a detailed study of the state of blood flow in the portal vessels. Micrometastases themselves are detected on portograms based on the depletion of the vascular pattern in the area of ​​metastatic formations. With their help, you can notice damage to the vascular bed; the procedure is monitored on a CT monitor.

Invasive diagnosis of cancer metastases to the liver includes performing a liver biopsy, including using a needle (fine-needle aspiration biopsy) or a special instrument - a trephine (core biopsy, trephine biopsy).

It is necessary to dispel the myth that liver biopsy leads to tumor growth or the appearance of peripheral metastases. No results - liver biopsy does not increase the risk of metastasis.

The biomaterial is sent to a specialized laboratory for histological and immunohistochemical examination. On the one hand, 2/3 of the metastases coincide in their histological portrait with the maternal tumor, but 1/3 do not coincide.

All of the above diagnostic methods are available to patients of the International Clinic Medica24.

Compatibility of Phenazepam with alcohol

Many patients are interested in whether it is possible to take Phenazepam and alcohol at the same time - the consequences of such a combination can be life-threatening. The compatibility of a tranquilizer with alcohol is unacceptable, since ethyl alcohol significantly enhances the effect of the drug. This leads to severe intoxication of the body.

The action of the pharmacological agent is aimed at suppressing the increased excitability of the central nervous system, while at the same time alcohol has an stimulating effect. Taking a tranquilizing drug after drinking alcohol causes the so-called phenazepamine sleep - a dangerous condition in which the functioning of almost all internal organs and systems is inhibited.

In medical practice, there are cases where phenazepam sleep ended in cardiac arrest.

The simultaneous use of Phenazepam with alcoholic beverages increases the side effects of the pharmaceutical drug.

This combination causes severe vomiting mixed with blood, alcohol-induced confusion, attacks of uncontrollable aggression, disorientation in space, deterioration of thinking and the appearance of suicidal tendencies.

How are cancer metastases in the liver treated?

The treatment tactics for cancer metastases to the liver are determined by the number of metastases - single or multiple, their localization in the region of the edge of the liver or the porta hepatis, and the histological type of cancer.

In principle, all major treatments for liver cancer metastases include surgery, chemotherapy, radiation, and chemoembolization. The International Clinic Medica24 performs all main types of liver operations - lobar, segmental and atypical resections.

In addition to exclusive liver surgeries, our specialists routinely perform modern minimally invasive liver interventions, including percutaneous transhepatic radiofrequency ablation (RFA), as well as RFA of the liver during laparoscopic and open laparotomy operations.

Treatment of cancer metastases to the liver has certain difficulties. Thus, about 1/3 of all liver metastases are not sensitive to those chemotherapy drugs that are used to eliminate the primary tumor. Therefore, for effective chemotherapy of metastatic liver cancer in most patients, it is necessary to combine chemotherapy and targeted drugs.

Moreover, in many cases of metastatic liver cancer, systemic chemotherapy is ineffective, and intra-arterial chemotherapy must be administered into the hepatic artery. In our clinic, for the purposes of regional chemotherapy for cancer metastases to the liver, implantable venous and arterial port systems are used, followed by regional infusion of chemotherapy drugs. Drugs with proven effectiveness have been registered in Russia for targeted therapy of cancer metastases to the liver.

Chemoembolization of liver cancer metastases is used to treat single and large metastases located near large neurovascular bundles when surgical resection is difficult or impossible. Chemoembolization is carried out using microspheres filled with chemotherapy. Microspheres restrict blood flow in the metastatic node, and the chemotherapy itself, released over a long period of time, leads to necrosis of the tumor tissue.

RFA of cancer metastases to the liver can be used repeatedly for recurrent cancer. Most often it is included in complex treatment.

Radiation therapy for cancer metastases to the liver is practically ineffective, since it does not affect the survival of patients and their life expectancy. It only allows in some cases to reduce the intensity of the pain syndrome.

The main thing that our patients need to know is the ability to achieve a positive treatment result for any type of cancer metastasis to the liver.

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Prognosis for cancer metastases to the liver?

The most common question that we are asked by relatives of patients admitted to the Medica24 International Clinic with cancer metastases to the liver is “does it make sense to treat metastases in the fourth stage of cancer”, “is it necessary to operate on the patient”, “what is the prognosis of life and the outcome of treatment”? The outcome of treatment is determined by the genetic profile of the tumor, the degree of tumor differentiation, and the location of the primary tumor.

In general, it is important to know that after the initial detection of liver metastases, patients live on average for 6-18 months. Life expectancy is slightly higher in patients with primary colon cancer with liver metastases. With comprehensive patient management, with radical or cytoreductive interventions, the life expectancy of patients can be up to 2.5 years. If during a PET-CT or CT scan of the body cancer metastases are detected in the bones or brain, the prognosis sharply worsens.

Our oncologists and surgeons at the Medica24 International Clinic have significant experience in the complex treatment of cancer metastases to the liver and primary tumors. Therefore, in many cases we can guarantee a significant improvement in the quality of life, and in some cases, a significant prolongation of life. The greatest effect is achieved with highly differentiated metastases of well-differentiated adenocarcinoma of colon cancer. In the case of such patients, the life extension as a result of treatment is about 3-5 years. It is important to combine this intervention with cytoreductive surgery to remove the primary tumor site.

If liver metastases are caused by primary cancer of the lung, pancreas, stomach and other organs, then resection of liver metastases is not so critical for determining the prognosis of patient survival. However, economical resection, RFA of single nodes, and chemoembolization can reduce the toxic load on the liver and make it possible to carry out chemotherapy for the primary cancer.

If the patient’s follow-up examination reveals multiple foci in the liver and lymph nodes, the prognosis is significantly worse, it is generally negative. In most of these cases, it is impossible to radically help, but it is possible to preserve the quality of life of patients through complex blood purification procedures (plasmapheresis and hemosorption).

IMPORTANT: statistics show that if by the end of the first year after the first cancer metastases are detected in the liver, the patient still has the strength to continue the fight, then the likelihood of living another 2-5 years increases significantly.

Complications during combined treatment of cancer metastases to the liver?

Against the background of repeated metastasis of the lesion or recurrence of the primary cancer in the liver, the growing tumor tissue compresses the intrahepatic bile ducts, portal vein, and inferior vena cava. As a result, the existing signs of hepatic jaundice are complemented by obstructive jaundice, which leads to brain damage. A negative aspect of the development of obstructive jaundice is the inability to continue treatment - chemotherapy and surgery.

In this case, surgical restoration of the patency of the bile duct is performed using a temporary scheme - using percutaneous transhepatic stenting, or a permanent scheme - using retrograde stenting of the common bile duct under endoscopic control. In the first case, the bile flows out into the bile receptacle. In the second case, bile enters the intestinal lumen.

Percutaneous transhepatic stenting is performed in the X-ray operating room, under X-ray control of the C-arm. The interventions themselves are performed by x-ray endovascular surgeons with extensive experience in Russian state x-ray surgery centers.

Retrograde endoscopic stenting is also performed in the X-ray operating room with simultaneous X-ray (C-arm) and endoscopic control. The interventions themselves are performed by endoscopists who have surgical skills and have been trained in various techniques for stenting the biliary tract.

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What happens to the liver after removal of metastases?

When cancer metastases in the liver are removed non-invasively - using chemoembolization, radiofrequency ablation or radioembolization - a zone of necrosis is formed and then replaced by a scar. This process usually takes from 2 to 6 months. The scar is sometimes significant and forms a dense cord or knot up to 2-4 cm in diameter. It can compress the internal bile ducts.

When removing cancer metastases to the liver non-invasively - using the surgical method, the scar is usually thread-like. Complete restoration of the size and structure of the liver after major resections is observed after 3-6 months. In a healthy person, the liver can restore its full volume from the remainder after surgery in the amount of 20% of the original.

In the case of massive resections in cancer patients with reduced regenerative capacity, recovery occurs within 6-8 months. and, in the limit, from a stump measuring 30% of the original size of the liver.

Where to treat cancer metastases to the liver: abroad or in Russia?

“The diagnosis of stage 4 cancer” is made already in the presence of a single cancer metastasis to the liver. For almost every patient, such a diagnosis—“cancer with metastases to the liver”—sounds like a death sentence. Having received it, many Russian patients refuse any treatment and stop fighting. Very few choose the path of struggle and go abroad.

In fact, in Russia, in Moscow, specifically, at the Medicine 24/ clinic, all modern technologies and drugs for the treatment of cancer metastases of any origin are available. We believe that a patient can always be helped, even if he cannot be cured radically. That is why we undertake the treatment of patients with cancer at any stage. Our specialists have accumulated many years of experience in managing palliative patients with various stages of cancer in almost any location, including those previously treated abroad, in Germany, Israel, Switzerland and the USA.

Withdrawal syndrome after Phenazepam

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Very often there is a need to select safer and no less effective substitutes for Phenazepam. This is due to the huge number of side effects that the tranquilizing drug causes.

One of the main disadvantages of the pharmacological drug is the dependence and persistent addiction that it causes with long-term use. It is extremely difficult to give up the medication, as withdrawal syndrome develops.

After taking Phenazepam, many patients experience prolonged depression, anxiety, increased anxiety and irritability, sensitivity to sound, light and tactile touch, convulsions of the upper and lower extremities. That is why, when taking a tranquilizer, you need to know how much Phenazepam you can drink so as not to get used to it.

The increased concentration of the active substance in the blood lasts up to 20-60 hours, after which Finazepam is excreted from the body in the urine.

When taking the drug Phenazepam, the dosage in tablets is 0.25-5 mg, which are divided into 2-3 doses. The exact dose of the tranquilizer is selected by the doctor individually, but it should not exceed 10 mg of Phenazepam per day. The maximum permissible duration of treatment is 8 weeks.

Coronavirus is a viral infection that infects humans through the mucous membranes of the nasopharynx and eyes. The microorganism spreads through the blood, binding to a certain type of protein, which causes damage to the respiratory tract and gastrointestinal tract, so it is important to quickly select drugs for treatment. Read more in the article: “what antibiotics are prescribed for coronavirus.”

The most frequently asked questions by patients with cancer metastases to the liver

Is treatment indicated in my particular case?

Just send me, Konstantin Yuryevich Ryabov, the results of your latest PET-CT, MRI, CT scan as a link to a cloud archive - to Google - or a Yandex disk. In your cover letter, tell us about all your problems.

How will the consultation with an oncologist-surgeon go?

IMPORTANT: We ask our patients not to become doctors, not to try to create and implement an examination program on their own: we do not use the results of radiography, liver ultrasound, or plain radiography. Your individual program of examination and preparation for surgery will be developed by our oncologist-surgeon personally or as part of a consultation.

Fundamentally, during a preliminary consultation, the presence of a primary lesion or its recurrence, the relative location of metastases, and the prospects for conservative and surgical treatment are determined.

One of our know-how in determining the feasibility and possibility of achieving results after surgery in patients with cancer metastases in the liver is the combined performance of high-resolution CT and MRI on the same day. The combined implementation of both studies gives the oncologist-surgeon a complete picture of pathological changes in the liver, and makes an informed choice in the treatment regimen.

Feedback on the treatment of stage IV ovarian cancer 08/19/2020

The patient was admitted in serious condition. She couldn't walk. Diagnosis: stage IV ovarian cancer with metastases, ascites. Other medical institutions refused treatment. The patient underwent laparocentesis. Ascitic fluid is removed through a small puncture in the abdominal wall. A course of chemotherapy was carried out. The patient's condition is stabilized. Thanks to the assistance provided, the patient leaves the international clinic Medica24 feeling well on her feet. “I’m leaving on my own two feet…. Read full review

Stage 4 kidney cancer: Review of treatment

The patient is 61 years old. Was examined and treated at the hospital named after. S. P. Botkina. There were difficulties in making a diagnosis. After the outbreak of the COVID-19 epidemic, hospitalization there became impossible. The patient contacted the international clinic Medica24. Here he was examined. An accurate diagnosis was made - stage 4 kidney cancer with metastatic damage to the bones, lungs and brain. Full treatment has begun. At the time of admission to the region... Read full review

Feedback on oncological hip replacement surgery

Yuri Alekseevich was admitted to the clinic with a fracture of the femur due to metastatic lesions. Due to the severity of the patient’s condition, he was denied surgical treatment in clinics in Germany and Israel. The head of the oncology department of the international clinic Medica24, surgeon, oncologist Petr Sergeevich Sergeev, candidate of medical sciences, took on segmental resection of the femur with oncological prosthetics of the hip joint. The operation, which lasted more than three hours, was successful... Read full review

“Here I realized there is hope...”

In February 2021, I was given a terrible diagnosis: ovarian cancer, liver metastasis. Chemotherapy and symptomatic treatment were urgently required. Faced with this disaster, I saw how many people there are with cancer and how many of them are denied treatment and prolongation of life, being sent home to die. I was among them. I was rejected by five hospitals. Already desperate, we saw an advertisement... Read full review

Feedback on the treatment of metastatic lesions of the skull bones

Vladimir Aleksandrovich ended up in the international clinic Medica24 after repeated refusals in clinics in Nizhny Novgorod and Novosibirsk. The tumor, which is a metastasis of kidney cancer, affected the bones of the skull in the parietal region, and the soft tissues of the head were operated on by neurosurgeon Igor Yuryevich Malakhov. The patient feels well, the prognosis for life is favorable. Read full review

Feedback on the treatment of metastatic lesions of the spine

Irina Iosifovna was admitted to the clinic with a compression fracture of the spine due to metastatic lesions of the spine. Due to the complexity of the fracture with loss of mobility and sensitivity, due to oncology, she was not admitted to several clinics, so she was forced to come to the international clinic Medica24 from Kaliningrad. Neurosurgeon Igor Yurievich Malakhov performed an operation to remove... Read full review

Feedback on radiofrequency ablation of bone metastases

Iraida Alekseevna was admitted to the Medica24 international clinic with severe pain and difficulty moving due to metastases in the pelvic bones due to stage 4 breast cancer. The main metastasis of breast cancer compressed large nerve trunks in the spine, causing pain that was intractable with conservative treatment, and also led to dysfunction of the corresponding nerves. The operation lasted 40 minutes, was performed under local anesthesia, under… Read full review

The material was prepared by oncologist, surgeon at the International Clinic Medica24, Konstantin Yurievich Ryabov.

Sources:

1. Plechev V.V., Mufazalov F.F., Shestakov A.I., Ishmetov V.Sh., Loginov M.O., Utenskaya I.D. Efficiency of treatment of hepatocellular cancer and cancer metastases of other localizations in the liver using chemoembolization // Medical Bulletin of Bashkortostan. 2012. No. 1.
2. Zakharchenko Alexander Alexandrovich, Kochetova Lyudmila Viktorovna Options for combined treatment of patients with colorectal cancer metastases to the liver // Kazan Medical Journal.. 2009. No. 2.
3. Aksel E.M., Davydov M.I., Ushakova T.I. Malignant neoplasms of the gastrointestinal tract: main statistical indicators and trends // Sovrem. oncol. - 2001. - T.3, No. 4. - P.141-145.
4. Patyutko Yu.I., Sagaidak I.V., Pylev A.L. Surgical and combined treatment for multiple and bilobar metastatic liver disease // Surgery. - 2005. - No. 6. - P.15-19.

Compatibility of Phenazepam with other drugs

Phenazepam is one of the most potent tranquilizers that cannot be combined not only with alcoholic beverages, but also with many other medications. These include:

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• sleeping pills;
• anticonvulsants;
• sedatives;
• tranquilizing.

Phenazepam and Corvalol, the compatibility of which is considered unacceptable, are strictly prohibited from being taken together. Corvalol contains ethyl alcohol and the tranquilising substance phenobarbital - which is why simultaneous use with Phenazepam causes an overdose of tranquilizers with the most severe consequences.

The drug should not be taken together with antiparkinsonian drugs, since Phenazepam significantly reduces their effectiveness.

When treating arterial hypertension, it must be taken into account that the tranquilizer increases the effect of antihypertensive medications. In such cases, it is necessary to reduce their dosage.

Also, Phenazepam tablets should not be combined with Clozapine and other antipsychotics. This drug combination often causes depression of breathing and the respiratory center.