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VERIFIED CONTENTConsultation: dr Tadeusz Oleszczuk, gynecologist-obstetrician

What was once the cause of death can be effectively treated today. Medicine has undergone enormous changes and we, as its beneficiaries, are living longer and increasing our quality of life. We talked with an expert, Dr. Tadeusz Oleszczuk, about, among other things, what has already changed in gynecology, as well as what the diagnostics and treatment of ailments of the female reproductive system will look like in the future.

Patrycja Pupiec: Since you started your practice, gynecology has undergone a positive metamorphosis. What do you think was an important part of these changes?

Tadeusz Oleszczuk:The elimination of diseases that caused death shows the power of medical development. Progress in diagnostics, gene therapies, and immuno-oncology are examples of solutions that will prevent some cancers from appearing in the future, and some of them will become a chronic disease, such as diabetes. I had the opportunity to witness this progress.

For example, in oncology, a serious disease called a molar, which develops during pregnancy and can progress to cancer. It used to be very disturbing and too late to recognize it, which led to death. Now, thanks to the progress of medicine, there are effective drugs that save the patient's life - she can have children and live peacefully.

When I started my practice, I remember that in each province there was one hospital with an ultrasound machine. Then there were others, and today virtually every specialist has an ultrasound examination at his place. This is a very important study that contributed a lot to diagnostics. Similarly to computed tomography or magnetic resonance imaging.

I was definitely waiting for a portable KTG device. Current IT techniques made it possible to create such a tool. Today, a pregnant woman can do an examination at home, the equipment sends information to specialists via an application, and they remotely analyze the results and supervise the situation. They can even call an ambulance if disturbing fetal heart rate records suddenly appear.

There is also a special camera controlled by the application,which helps women struggling with urinary incontinence exercise. The application controls the apparatus that is located in the woman's vagina, and the exercises are based on the appropriate tightening of the pelvic muscles. The result of such exercises is sent to a physiotherapist who evaluates the results and orders further exercises. The effect is that we do not have to go to a rehabilitation specialist physically, only women exercise remotely themselves and see positive effects increasing the automatism of urine maintenance by improving the function of the pelvic floor muscles, the so-called Kegel muscles.

On the other hand, the fact that there have been changes does not mean that it is good, because we are still departing from the west. What changes does the current he alth care system require in terms of gynecology and obstetrics?

The changes are visible and they are certainly positive, but when comparing the Polish reality with the Western reality, one can see huge differences. First of all, adequate education at school is needed. The he alth care system itself requires many modifications in terms of gynecology and obstetrics. Today, a woman with cancer has to take care of all the certificates and referrals - she cannot just go to a specialist, get the results, she just has to go from one doctor to a referral, to do another examination and so on, because there are administrative procedures.

Contraception requires a prescription, each test requires a referral. When I have an appointment, I have to complete the documents in the paper version for some time. Although he enters the data into the system anyway, paper documentation is kept separately, for example by writing down the data for the cytology.

A woman could go straight to the radiologist for a breast examination, but she can't because she has to be referred first. The education system also requires changes. Young girls entering adulthood do not take reliable data from school, and searching for them on the Internet is often unreliable.

It is very sad when I see a young woman in the office who says that she had intercourse yesterday and would like to know if she is pregnant and to know the sex of the child. I am asking where she thinks conception is taking place and she doesn't know. However, it is not her fault, but the fault of the lack of education.

These needs in the quality of education also affect women's he alth. An example is cervical cancer, which does not exist in statistics in the west thanks to vaccination. And in Poland? It ranks sixth in terms of morbidity and seventh in mortality. It is a real disaster of lack of awareness.

In which direction do you think gynecology will develop?

I think there will be more and moretechniques that will facilitate the work of doctors. It is artificial intelligence that will carry out the diagnosis and we will not run away from it. Automation, digital techniques, genetic treatment is a great future that is already happening.

I think that someday the basic tests will no longer be performed by a doctor, and a robot, not a human, will be standing behind the operating table. The doctor will only supervise. Currently, operations with the use of robots are carried out.

There are already studies of artificial intelligence that can better than humans determine whether a given radiological result is disturbing or not. The result of one such analysis confirmed that the machine was able to analyze the results more efficiently and, above all, faster, having data from several hundred thousand tests. The use of technology developed for the production of vaccines will probably also be used in the future.

There has yet to be a case where a vaccinated woman developed cervical cancer. Maybe there will be vaccines for other he alth problems as well. Genetic technologies are already being researched and used in the production of drugs.

Should new specializations emerge? We've talked about a mammologist or a doctor dedicated to men before.

Absolutely such specializations should arise. Men are left to themselves at all, and yet everyone should be treated with an individual approach. We have doctors dedicated to kidneys, arterial hypertension, and we don't have a breast specialist …

Many women suffer from various types of breast disorders as well as hormonal and metabolic disorders at the same time. There is no doctor who could solve them, because everything goes to a gynecologist, who in theory should deal with the female reproductive system, and in fact often deals with all women's he alth problems. There is also no holistic assessment of he alth, and it is known that diabetes or glucose tolerance disorders affect fertility and the course of pregnancy.

Gentlemen may also have various he alth problems, especially after the age of 40. For example, they lose testosterone with age, and this is somewhat similar to the female menopause. But how can a man know what will happen to him when his hormone levels fall.

It often happens that when I cure a woman of an ailment, she can ask or bring her partner who is struggling with another problem. This should not be the case, because a man must also have his own doctor who is dedicated only to his he alth. Prevention is also very importantmen. Blood tests, genetic tests or ultrasound.

The approach of some doctors, that is, "this type is like that", "such a beauty" should also change, right?

I hate this approach. It is better for such a doctor to say nothing or to refer you to another specialist. When he says "such a beauty", a woman may feel that her ailments are being underestimated. She stops inquiring because she heard it from a doctor. However, you should always look for the reason.

Only this will ensure effective treatment and get rid of the problem. Often the causes lie in diet, environmental conditions or stress. It is worth taking a look at it and trying to change something. However, you need to know how and what.

Are you waiting for vaccinations, e.g. against HPV, to gain popularity?

Education would be the best - women would have known the risks of HPV from an early age and would have had regular and confident vaccinations. Other countries, as I have already mentioned, got rid of this cancer thanks to vaccinations. Even in a pandemic, you can see how big the problem is the lack of adequate education.

What can patients do to facilitate effective treatment for you? All you need to do is eat well and get tested so you don't come with a cancer that is so advanced that the chances of it being helped are slim?

Yes of course. Prevention is the key. Regular testing is very important, as is our lifestyle, which includes diet, the right amount of physical activity, sleep, knowing what is harmful to us, i.e. recognizing food intolerances. Checking vitamin and micronutrient deficiencies.

These are very important issues that will allow you to not only live he althy, but also feel better and find out where you are at all. You can assess the level of micronutrients in the blood serum and perform genetic tests.

I often meet patients in the office who take vitamins and supplements without first checking whether their body is actually deficient. It's dangerous.

They ingest vitamin C, D, zinc, selenium, and do not even check whether they should actually do it, and it can harm them, because excess amounts also cause he alth problems. Without proper research, we shouldn't take anything.

As never before, thanks to modern machines, chemistry, molecular tests and experiments, scientists are looking for new diagnostic and treatment pathways. Is there any equipment or research that scientists are working on that you are especially waiting for?

I personally wait forchanging the approach to education. This is a huge problem, a huge gap that causes many women to die every day. Whole families get sick, and people don't think about getting themselves tested because they didn't learn this basic knowledge from school.

They are even afraid to name the basic elements of the reproductive system, let alone know what the physiology of the cycle looks like. This ignorance generates stress and problems, because not only is the quality of life worse, but these people sometimes get chronically ill. Through ignorance, inept changes in the education system, and the complicated he althcare system itself.

In Poland, a person suffering from cancer has a problem with the quick diagnosis and treatment that is offered in other European countries.

gynecologist-obstetrician Tadeusz OleszczukGynecologist-obstetrician with over 30 years of experience. Author of the books "What the gynecologist will not tell you" and "Calm your hormones". / drtadeusz

Read other articles from the StrefaKobiety series:

  • First visit to the gynecologist: what can you expect?
  • Ignorance or maybe ignorance? Why do women die of cancer?
  • 20 percent couples deal with infertility. Mostly not the fault of the woman
  • Last menstruation and menopause. How to prepare for it?
  • A woman must be he althy before starting contraception
  • How to take care of intimate hygiene to avoid infections?
  • Allergies - where do they come from? Allergy to semen and condoms
  • Gynecologist banning abortion: Let's not condemn women to suffering at risk of losing he alth and life
  • Pain in the intimate areas. Is it normal to feel pain?
  • Sexually transmitted diseases. How to take care of your safety?
  • Polycystic Ovary Syndrome (PCOS), or when the body and mind suffer
  • Gynecological visit during a pandemic. What has changed?
  • Breasts. What about their appearance should worry us?
  • Are you pregnant and afraid to vaccinate against COVID-19? Expert explains why it is worth doing this
  • Why is it so long to be diagnosed with endometriosis?
  • Endometrial cancer, i.e. a cancer in which lifestyle is important
  • Why are uterine fibroids mostly only monitored?

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