Radiology and Cancer Detection in Kosova: Insights from Local Experts

Written by Rea Gojani and Rubin Jetishi

This Q&A delves into the pressing topic of cancer in Kosova, focusing on detection methods, particularly in the field of radiology. The questions are posed by a student body of two and a field specialist.

1. What are some characteristics or methods that serve as precursors to metastatic cancer detection?

In the local hospital “Isa Grezda,” we currently work with [1] conventional X-rays and [2] computerized tomography (CT). Patients suffering from malignant diseases are required to provide detailed medical history documents, CBC (Complete Blood Count), and biochemical tests, which should include tumor markers (examples: CEA, CA-125, PSA, etc.). If they are not prepared with these biochemical tests, they are asked to undergo testing.

[1] X-rays are used to create contrast between different tissues based on their density.
[2] A CT scan also uses X-rays but combines them with computer processing to take multiple cross-sectional images, producing a detailed 3D image of internal structures.

2. How often should medical examinations be done to prevent cancer occurrence or detect it in the early stages?

There are many factors that can influence how often one should undergo medical examinations, including age, genetics, and other risk factors. People at a higher risk of cancer should have regular examinations to help detect cancer in its early stages. The points mentioned above—age, genetics, and more—are great indicators for determining whether someone should monitor their health more closely. We actively promote the need for medical examinations even for individuals who are not currently affected by cancer or other diseases.

3. Our regional and global communities are facing an ever-growing number of cancer diagnoses. Do you agree with this statement?

Yes, over the past few years, we have seen a noticeable increase in the number of patients diagnosed with various types of cancer. A significant percentage of patients in our hospital suffer from this condition. On a broader scale, the director of Kosovo’s main oncology clinic in Pristina, Dr. Ilir Kurtishi, reported in June 2023 that 890 new cancer cases had already been detected that year, which some local media described as "alarming."

4. What treatments in addition to radiology are commonly used for cancer?

External Beam Radiation Therapy (EBRT) is a common method in radiology where high-energy beams are directed at the cancerous area from outside the body. To maximize patient outcomes, different therapies are often combined or used in a specific order:

• Preoperative Radiation Therapy: Used before surgery to shrink the tumor, making it easier to remove, especially in cancers like rectal or esophageal cancer.

• Postoperative Radiation Therapy: Used after surgery to kill any remaining cancer cells in the tumor area or nearby lymph nodes, reducing the risk of recurrence. This is common in breast, colorectal, and prostate cancers.

• Concurrent Chemoradiation: Chemotherapy is sometimes administered alongside radiation therapy, as it sensitizes cancer cells, making them more vulnerable to radiation. This approach is often used for cancers like head and neck, cervical, lung, and esophageal cancers.

• Radiation as an Immunomodulator: Low doses of radiation can be used to influence the tumor microenvironment, enhancing the effectiveness of certain immunotherapies when combined with radiation.

5. How accurate are radiography results, and are there instances where it may not show the exact health condition?

Radiography is conducted using cutting-edge machinery and the latest technology, ensuring highly accurate examinations in most cases. However, in rare instances, radiography may not provide all necessary information, or it may miss certain details. In such situations, additional tests are required to complement the examination. These additional tests may include:

• PET Scan (Positron Emission Tomography): An imaging test using a radioactive substance that can help detect cancer.

• Ultrasound: An imaging test that uses high-frequency sound waves to examine internal organs.

• MRI (Magnetic Resonance Imaging): An imaging test that provides precise images of internal organs using a magnetic field and radio waves.

Each type of examination varies based on the stage of cancer development.

6. Cancer and malignant diseases can drastically impact a person’s health. What advice would you give to patients to maintain stable mental and physical health?

In addition to regular medical examinations, it is crucial to prioritize mental well-being throughout this process. Each patient’s experience is unique, and mental health can significantly impact the healing and recovery journey. Here are some tips I would recommend:

• Focus on a balanced diet: Ensure your diet is rich in naturally sourced proteins.

• Avoid processed foods as much as possible.

• Stop smoking and eliminate alcohol consumption if diagnosed with cancer.

• Manage stress and negative emotions in a healthy way. Emotional support from psychologists, family, and friends can make this journey easier and improve the chances of remission.