Attention, Chernobyl! Fighting the effects of the accident

Interview with the head of the Center for the treatment of diseases of the thyroid gland, Professor Igor BRANOVAN.

The medical columnist of our newspaper, Doctor of Medical Sciences Leonid Lozinsky, met with the head of a specialized Center created to increase the effectiveness of the fight against the consequences of the Chernobyl accident. Here is what Professor Igor Branovan tells.

Igor BRANOVAN:

I would like to inform numerous people from Belarus and Ukraine, as well as from the western regions of Russia, that a new medical Center for the diagnosis and treatment of various thyroid diseases associated with the consequences of the Chernobyl disaster continues to operate in New York. The center is open in Manhattan at The New York Eye and Ear Infirmary, where I conduct medical, scientific and teaching work. I am the head of this Center. To make an appointment with the doctors at our center, you need to call (212) 979 - 4646. Information about the work of the center can also be obtained from my office by calling (718) 616 - 1000. We accept all those who were exposed to radiation during Chernobyl accident, regardless of the type of insurance.

— Who do you recommend to contact you? Should this be done for those who feel practically healthy?

— In order to more accurately answer this question, I would like to first remind you of what happened more than 17 years ago in Chernobyl. At the end of April 1986, an accident occurred at one of the power units of the Chernobyl nuclear power plant, located in the north-west of Ukraine, which was at that time a republic of the USSR. Chernobyl is located close to the borders of Belarus and the western regions of the Russian Federation. During this disaster, a huge number of people in Belarus, Ukraine and partly in Russia were dangerously exposed to significant doses of radiation. Around 1 / 4, parts of the territory of Belarus and Ukraine were covered with a radioactive cloud and the 1 / 5 part of the population of these republics was exposed to high doses of radioactive substances.

Among other consequences, the accident led to the exposure of a large number of people to isotopes of radioactive iodine, which has a negative effect primarily on the human thyroid gland. This effect is due to the fact that iodine is used in the body for the synthesis of thyroid hormones. Therefore, radioactive iodine accumulates mainly in it. Even before the Chernobyl disaster, scientists had established the harmful effects of radiation on the thyroid gland and other human organs. This became known after the atomic bombings of Hiroshima and Nagasaki, as well as after a number of accidents at nuclear power plants and various military facilities using atomic energy. Scientists' observations have established a certain sequence of effects of radiation on the thyroid gland. According to previous observations, damage to the thyroid gland usually occurs only 10 to 20 years after irradiation. It is during this period of time that the number of patients with malignant diseases increases significantly.

However, the scale of the Chernobyl accident changed the usual countdown of time and the tragic consequences of a huge radioactive release began to affect public health much faster than before. In this case, children and adolescents were especially affected, in whom the accumulation of radioactive iodine occurred much faster and led to the development of lesions of the thyroid gland within the first 2–3 years. For example, in Gomel (Belarus), the number of malignant tumors among children and adolescents has increased by 50 - 60 times compared to the period before the Chernobyl accident (100 cases per 1 million people compared to 1 - 3 cases per the same population before 1986 .!). As for adults, since 1986 the number of benign tumors discovered, as well as cases of autoimmune thyroid diseases, has tripled, and the number of patients with malignant thyroid tumors has increased by 40%.

Unfortunately, due to the significant deterioration in the economy of the former Soviet Union in recent years, the number and level of scientific research has sharply decreased. All this made it difficult to develop effective measures to combat the consequences of the Chernobyl disaster. In addition, hundreds of thousands of people who were in irradiated areas at that time left their homes and found themselves in other countries, most of them in the United States, especially in New York.

This was one of the main reasons for organizing a special program to combat the consequences of the Chernobyl disaster. As part of this program, we will try to examine all those who have been exposed to radiation. This should help identify the maximum number of people affected by the effects of radiation and, accordingly, carry out their full treatment.

In this work, we use modern diagnostic methods that are used in the United States, in particular, ultrasound and biopsy using a thin needle, as well as some other methods. In addition, we plan to use an early and accurate diagnosis of thyroid cancer using the latest technology. This technology is completely safe for humans. It is based on the theory that each molecule in a living organism, when rays are directed at it in the ultraviolet range, phosphorizes in a special way, which allows its changes to be detected early. In the most recent years, our institute participated in the creation and testing of such equipment. With its help, we are able to carry out an early diagnosis of the tumor when a biopsy is taken with a thin needle.

At the same time, the technique of surgical intervention is being improved when a tumor of the thyroid gland is removed. For many years, such operations were performed under general anesthesia (anesthesia) in order to have sufficient access to the thyroid gland. New diagnostic approaches allow us to perform such operations under local anesthesia, not by the usual traditional incision in the neck, but with the help of special ultrasound equipment and laser technology. This greatly facilitates the operation, increases its safety, significantly reduces its risk to the patient.

Now I want to go back directly to the answer to your question about who should now first contact us for an examination. Scientific studies conducted earlier by scientists in Russia have shown that those who were children or adolescents during the Chernobyl accident were at particular risk.

This must be taken into account by the people applying to us. In addition, we recommend that all former residents of these areas (countries) who have goiter, toxic goiter, Graves disease, as well as other thyroid lesions, should be examined, with both increasing and decreasing its function.

It should be borne in mind that we often detect thyroid tumors in people who do not present any complaints about their health. Therefore, all people exposed to radiation are recommended to undergo an examination.

— If the effects of Chernobyl radiation occurred more than 13-15 years ago and it caused obvious damage to the thyroid gland in most cases already in the first few years, then what diagnostic findings can you identify now?

The data obtained in Belarus and Ukraine show that the number of new cases of thyroid tumors among those exposed to radiation continues to grow from year to year.

— And they are connected specifically with the exposure of 1986?

-Yes. But, fortunately, malignant tumors of the thyroid gland are different from most other malignant tumors in that they grow extremely slowly and give metastasis late. This allows for more successful surgical treatment (removal of the tumor).

Therefore, patients even with huge thyroid tumors and metastases have a chance of successful survival after surgery in 90 - 95% of cases, which sharply distinguishes them from other types of cancer, in which survival in the presence of metastases gives a much bleaker prognosis. Along with the removal of the thyroid tumor, additional treatment with iodide drugs is carried out.

— Tell us, at least briefly, about the main symptoms that occur in patients with lesions of the thyroid gland.

- Most patients with thyroid lesions experience two types of disorders - increased or decreased thyroid function. With an increase in function, increased nervous excitability is observed, body temperature rises, sleep is disturbed, body weight decreases, and other symptoms associated with an increase in metabolic processes in the patient’s body are noted. A decrease in thyroid function is characterized by reverse processes - increased body weight, drowsiness, chilliness, etc. In connection with the Chernobyl accident, the number of people suffering from autoimmune diseases of the thyroid gland has increased. As for thyroid tumors (both benign and malignant), in most cases (80%) they do not affect the functions of the thyroid gland. Therefore, in diagnosing a tumor, identifying an enlargement of the gland or part of it is important. The patient himself may feel an unpleasant feeling of compression of the trachea, impaired swallowing (due to compression of the esophagus), and sometimes voice disturbances (due to compression of the recurrent nerve innervating the vocal cords).

Differences between benign and malignant tumors of the thyroid gland are often insignificant. Basically, the pressure on the surrounding organs and the one and the other tumor. However, a malignant tumor can grow into the surrounding organs and tissues, which is dangerous. Unfortunately, both types of tumors for a long time are hardly distinguishable. Therefore, we need a serious examination, which we offer. It provides an opportunity to conduct an early accurate diagnosis of any disease of the thyroid gland, allows us to prescribe timely treatment.