Doctorafanasev.pdt

Doctorafanasev.pdt Oncogynecologist Afanasyev M.S. Professor of Moscow State Medical University I.M Sechenova
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ENDOMETRIOID OVARIAN CYST.A frequent reason for contacting me for organ-preserving treatment is endometrioid ovarian cys...
22/02/2025

ENDOMETRIOID OVARIAN CYST.

A frequent reason for contacting me for organ-preserving treatment is endometrioid ovarian cysts, also called chocolate cysts due to their color.

This diagnosis is a manifestation of the external form of endometriosis.

Considering the ability of endometriosis to spread beyond the ge****ls, the so-called extra-organ spread, I conduct a thorough examination of the patient to exclude endometrioid infiltrates (formations) in the cellular spaces of the pelvis or lesions of the large and small intestine.

Such studies include MRI of the pelvis, gastro and colonoscopy

I perform the operation using laparoscopic access on the 10-13th day of the menstrual cycle. The possibility of preserving the o***y is finally determined interoperatively.

In most cases, it can be preserved with minimal resection or without it.

The use of modern video-endoscopic technologies allows us to successfully cope with such ovarian neoplasms as endometrioid cysts while maintaining reproductive function

I can help you in my competence👌

Your doctor Afanasyev

Treatment of cervical dysplasia, endometrial hyperplasia and basalioma

CONTACTS⬇️
► Send tests and studies to email: doctor@drafanasev.com
► Viber/WhatsApp +7 987 980-25-34
► Make an appointment 8-800-555-77-26

TREATMENT OF OVARIAN CYST AND CYSTOMAIn my practice as a gynecological oncologist, I often encounter women with neoplasm...
21/02/2025

TREATMENT OF OVARIAN CYST AND CYSTOMA

In my practice as a gynecological oncologist, I often encounter women with neoplasms in the appendages.

It is no coincidence that, according to the clinical classification, any ovarian formations are tumor-like.
This rightly emphasizes the oncological alertness when choosing treatment tactics for such patients.

✔️Ultrasound and MRI of the pelvis in most cases help to determine the nature of neoplasms in the appendages.

At the same time, the detection of partitions and chambers, as well as parietal formations inside the «cyst», classify this formation as a cystoma - an ovarian tumor.

If such a diagnosis is confirmed, the patient is always warned that during the operation a decision will be made to remove the o***y.
If a malignant nature of the formation is suspected, a biopsy of the second o***y and resection of the greater omentum are performed.

❗️In any case, the main goal is to preserve the ovarian reserve of both ovaries.
Therefore, most often it is possible to limit the scope of the operation to cisectectomy (cyst enucleation) and resection of the affected o***y.

To get an expert opinion, you just need to send the results of the examinations that are available today📩.

Your doctor Afanasyev

Treatment of cervical dysplasia, endometrial hyperplasia and basalioma

CONTACTS⬇️
► Send tests and studies to the mail: doctor@drafanasev.com
► Viber/WhatsApp +7 987 980-25-34
► Make an appointment 8-800-555-77-26

ENDOMETRIOTIC OVARIAN CYSTSA common reason patients consult me for organ-preserving treatment is endometriotic ovarian c...
10/01/2025

ENDOMETRIOTIC OVARIAN CYSTS
A common reason patients consult me for organ-preserving treatment is endometriotic ovarian cysts, often referred to as «chocolate cysts» due to their characteristic appearance. This condition is a manifestation of external endometriosis.

Given the ability of endometriosis to spread beyond the ge***al organs, referred to as extrage***al dissemination, I conduct a thorough examination to rule out endometriotic infiltrates (lesions) in the pelvic connective tissue spaces or involvement of the colon and small intestine. Diagnostic tools include pelvic MRI, gastroscopy, and colonoscopy.

I perform surgery using a laparoscopic approach, typically scheduled between the 10th and 13th day of the menstrual cycle. The possibility of preserving the o***y is ultimately determined intraoperatively. In most cases, it is possible to preserve the o***y with minimal or no resection.

The use of modern video-endoscopic technologies enables the effective treatment of ovarian lesions, such as endometriotic cysts, while preserving reproductive function.

I am here to help you within the scope of my expertise. 👌

Yours sincerely,
Dr. Afanasyev

Treatment of cervical dysplasia, endometrial hyperplasia, and basal cell carcinoma

CONTACTS ⬇️
📧 Email for test results and diagnostic reports: doctor@drafanasev.com
📱 Viber/WhatsApp: +7 987 980-25-34
📞 Appointments: 8-800-555-77-26

A "CLEAN" CYTOLOGY MEANS NOTHING.The cytology smear is a mandatory test in the examination of the cervix, however, it ha...
12/09/2022

A "CLEAN" CYTOLOGY MEANS NOTHING.
The cytology smear is a mandatory test in the examination of the cervix, however, it has many false-negative results (when the smear does not show dysplasia, but it is there) due to the lack of standardization of the material collection☝️.
Nobody canceled the human factor at the stage of interpretation of the smear by the cytologist.
It happens this way: during colposcopy, obvious signs of dysplasia are detected on the cervix, but the results of cytological examination show that everything is "normal", without atypia.
I biopsy the suspicious area, send it for histology and get HSIL and even cancer in situ 😐.
The problem of such false-negative cytological findings is especially acute with glandular epithelial cells. Sometimes even an experienced cytologist can mistake glandular epithelial cell changes for endometriosis or reactive changes.

The situation with "clean" cytology is quite dangerous because it creates a false sense that there is nothing wrong with the cervix.
No one likes to be sick, and it's more pleasant to think of yourself as healthy.
Especially when the patient has no complaints, nothing bothers her, and she visits the gynecologist regularly.

Therefore, we must remember that for objective investigation of cervical pathology, the results of the cytological examination should always be compared with the colposcopic picture, as well as the results of the viral load of HPV👆.

There is also the opposite problem - "false positive" results. But we'll talk about that another time...

Be vigilant, don't skip your annual check-up with your gynecologist, and take care of yourself!

Your doctor Afanasyev
🚑Treatment of cervical dysplasia, endometrial hyperplasia and basal cell carcinoma🔬

CONTACTS
► Send your analysis and research to doctor@drafanasev.com
► Viber / WhatsApp +7 987 980-25-34
► Making an appointment 8-800-555-77-26
doctorafanasev

One of the illustrative and instructive women's stories, which I have collected quite a lot in my practice.Behind each o...
07/09/2022

One of the illustrative and instructive women's stories, which I have collected quite a lot in my practice.
Behind each of them is the most important thing - the health, and sometimes the life of someone's daughter, wife, mother...

Dusty allowed me to share her story, and I encourage you to be vigilant when discovering the enemy of cervical dysplasia👆.
Because in her case, in February, she was sent for observation with dysplasia grade 1, and in April, she already has grade 3 and, as usual, was offered conization.
But it didn't help - there was a relapse🤷‍♂️.
The good thing was that Dusty did not let it go but had regular check-ups and came to me for treatment on time. It is now over a year since the PDT, and she is fine!
So if you have any questions, ask Dusti 👌
She's already put a lot of people on the right path😉
Thank you so much for that!🙌


Your doctor Afanasyev
🚑Treatment of cervical dysplasia, endometrial hyperplasia and basal cell carcinoma🔬

CONTACTS
► Send your analysis and research to doctor@drafanasev.com
► Viber / WhatsApp +7 987 980-25-34
► Making an appointment 8-800-555-77-26
doctorafanasev

LOW EFFECTIVENESS OF THE SCREENING SYSTEM.It is no coincidence that I used the word "system" in the title because cervic...
29/08/2022

LOW EFFECTIVENESS OF THE SCREENING SYSTEM.
It is no coincidence that I used the word "system" in the title because cervical cancer screening as such may and should be improved by adding three tests:
🔹PAP test,
🔹 HPV test (with viral load detection),
🔹Extended colposcopy.

I will explain why I think it is necessary today👆.
According to the International Federation of Obstetricians and Gynecologists (FIGO), screening "cytology + HPV testing" is recommended from the age of 25 with a frequency of 5 years.

The World Health Organization (WHO) recommends HPV testing, cytology, and imaging with acetic acid as a screening test for every woman in the target age group: 30-49 years old.

In Russia, gynecologists are guided by Clinical Guidelines for the prevention of cervical cancer, which specify the start of screening at age 21, and it's only about the PAP test, which is supposed to be taken once every 3 years if you are 21 to 29 years old.
And from the age of 30, it is recommended to have it once every 5 years.
The HPV test is regulated only from the age of 30.
And the indication for colposcopic examination is only abnormal results of the cytological examination.

This is the reason why there are so many young patients with severe cervical dysplasia.
Because even if a girl starts sexual activity at the age of 18 (average age), by the time of the first screening, she may have already developed an extreme grade of precancer.

Every gynecologist has a history of a patient whose PAP test is normal and whose colposcopy shows obvious signs of problems with the epithelium of the cervix, which is a reason for biopsy, and histological examination, in such cases, often reveals dysplasia.
But based on the Clinical Guidelines, colposcopy is not indicated for this patient🤷‍♂️.
This is how cancer is missed.

The reason for the low efficiency of the screening system is the insufficient number of obligatory tests from the beginning of a sexual activity.
Thus, diagnostics should consist of three tests: "oncocytology + HPV testing + colposcopy" and should be performed from the moment of sexual debut.
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📍WHY CAN A PAP TEST GIVE A FALSE NEGATIVE RESULT?Patients often come to me with the same question: "I had regular examin...
18/08/2022

📍WHY CAN A PAP TEST GIVE A FALSE NEGATIVE RESULT?
Patients often come to me with the same question: "I had regular examinations at the gynecologist and took a Pap test. But when the gynecologist insisted on a biopsy, it showed moderate dysplasia".

For me, the situation here is quite clear, so I'll try to explain it understandably 👌.

Every diagnostic method has its limitations, and cytology involves the examination of epithelial cell scrapings taken from the surface of the cervix.
Your doctor may treat mild or initial dysplastic changes in the epithelium as an acute viral process.
However, he does not diagnose you with dysplasia because of the test result📃.

Often doctors prescribe antiviral medications, and at this point, with this doctor's conclusion based on the PAP test, you are still conditionally healthy.

Time passes, and for obvious reasons, the doctor usually sees no positive dynamics and decides to perform a biopsy.

I think this is the right and necessary decision when a physician has received a negative PAP test or acute viral-like cell changes and has noted abnormal colposcopic patterns☝️.
This is a direct indication for cervical biopsy before prescription of antiviral medications, which often results in wasted time and worsening of the situation.

Your doctor Afanasyev
🚑Treatment of cervical dysplasia, endometrial hyperplasia and basal cell carcinoma🔬

CONTACTS
► Send your analysis and research to doctor@drafanasev.com
► Viber / WhatsApp +7 987 980-25-34
► Making an appointment 8-800-555-77-26
doctorafanasev

Reposted from .naganovaI rarely write about personal things here, it's not my thing. But this may help someone, as simil...
16/08/2022

Reposted from .naganova
I rarely write about personal things here, it's not my thing. But this may help someone, as similar reviews once helped me a lot. And I promised myself to share my experience if it turns out to be successful.

Several years ago, at a routine checkup at a gynecologist in St. Petersburg, I was diagnosed with HPV (human papillomavirus) of high risk. I should say right away that my visits to the gynecologist were always as regular as to the dentist (I'm afraid to imagine how it would be otherwise). My doctor assured me then that it was nothing to worry about, and even if the virus starts to cause cell changes, it is a very long process, it takes decades, not one year, to reach the cancer stage (as it turned out later when I started actively studying this topic, this information is outdated and from initial stage of dysplasia CIN1 to cancer can take only a year. Unfortunately, a huge percentage of gynecologists don't know this, just like they don't know much else either... Once again, I was convinced that you have to look through a lot of information when it comes to health problems to be somehow sure that you are moving in the right direction...)

In October 2019, after another visit to my doctor in the USA, I received the results: Pap test - Abnormal. The biopsy showed mild dysplasia - CIN 1, HPV had not gone anywhere. My immune system could not fight it.
At this stage, no treatment is presumed as there is a chance that the body will get rid of the virus and it will not progress further. I had to go for another visit in a year.

Then I started actively looking for information about the treatment of high dysplasia so that I would know where to go if the situation got worse.

I searched through a lot of information: from forums (absolutely disappointing stories) to scientific articles and protocols followed by American and Russian doctors. It didn't bring any relief because the main method of treatment both here and there was conization, which, firstly, does not eliminate the virus and, secondly, in a great number of cases, relapse occurs after this procedure.

I was desperate, to say the least. Fortunately, I decided to search on Instagram and came across a post of Maxim Stanislavovich Afanasiev, oncogynecologist , where he was telling me about the method of photodynamic therapy to get rid of atypical cells, as well as HPV. It was a breath of air at the time, a hope that there was a way out after all.

I started searching about this method and found several articles by American and German authors. Their and M.S. 's statistics were the same, incredibly encouraging!
In the U.S. it turned out that this method is not used to treat CIN, and not all doctors are aware of its existence. I even found a clinic that uses PDT, but only at the cancer stage.
Of course, I had my doubts, was it really going to work? Was this doctor as good as he seemed? Live broadcasts where the professor gives a very detailed, professional coverage of the topic and answers the questions helped a lot + communication with the patients of Maxim Stanislavovich who went through PDT several years ago and were healthy and many got pregnant quickly and without problems after treatment (unlike conization, which negatively affects this process) was incredibly important and inspiring great faith.
In 20, the COVID epic began. Our trip to Russia in June was canceled (as well as the appointment). Without waiting a year since the last examination, I went to the gynecologist again at the beginning of August 2020. The result was high degree dysplasia (CIN 2-3). I went from mild to advanced stage in 10 months. I could not wait any longer (it turns out that in Russia some doctors at this stage try to treat women with some medications and lose time this way. Or worse, they allow women to get pregnant with this diagnosis).
Thank God I managed to fly away, thanks to Turkish Airlines. And thank God I had my green card, which allowed me to go back to the U.S. with no worries...
M.S. usually operates in Moscow. I was very lucky because when I had my PDT appointment, he was in St. Petersburg.
I arrived in Russia on August 23 (it took a lot of nerves because I was not used to flying in the present conditions and with such a purpose, to say the least...). I was examined three days before my PDT and all the necessary tests were taken (Oh, thank you very much, Olga, the wonderful administrator, for your organization, responsiveness, and kindness!) Then we had PDT on 29.08. It took me a week to recover. The temperature rose on the second day, the maximum was 38.5, and for 5 days I was in bed with a fever, drank a lot, and ate almost nothing. Sometimes my stomach felt heavy, but it was quite bearable.
It was good that by the day of departure, both my temperature and my well-being more or less normalized.

I will not write about the procedure, there are a lot of articles and information in the account of Dr. Afanasyev.
The professor operated on me with his colleague, wonderful Tatyana Georgievna Grishacheva (Tatyana, thank you!!! For your answers, for your experiences, for your hard work! Appreciate it a lot!)

Two months after PDT, I was examined again in the U.S., and there were no abnormal cells or HPV. It is such a relief, such a joy to see good results, to know that I continue to live, live without this headache, live with my family, with my adored children, and my energy, my strength is not spent in large quantities on the disease.

Maxim Stanislavovich, thank you! A huge thank you from me and my family for my health!

Girls who are reading this post. Make sure you visit your gynecologist at least once a year.
If you have HPV or dysplasia, there is a way out. Don't do conization. Try PDT, but don't go to just anyone for the procedure. It's very, VERY important to know and know how to do PDT. Some doctors cripple women without understanding how it works and what to do about it. Take care of yourself!

Maxim Stanislavovich answers all questions in great detail, I wish there were more doctors like him.

Take care of your health! This is the most important thing we have :)

If you have any questions, write to me. Be sure I will answer!

POSTMENOPAUSAL CERVICAL DYSPLASIA.The risk of cervical cancer in postmenopause remains, even if you are no longer sexual...
13/08/2022

POSTMENOPAUSAL CERVICAL DYSPLASIA.
The risk of cervical cancer in postmenopause remains, even if you are no longer sexually active for several years👆.
Screening for cervical cancer (cytological examination once in 3 years) in Russia in women is completed at 69 years.
But among my patients, there are women aged 70-80 years🤷‍♂️.

As a result of estrogen deficiency, the multilayered squamous epithelium becomes thin, making it more sensitive to even minor trauma.

The vinegar test may not give a reliable colposcopic picture. The area of transformation is usually already hidden from view during colposcopy, as it goes entirely into the cervical canal.
The atrophic epithelium loses glycogen, so there may be areas not stained with iodine when testing with Lugol.

These age-related changes make diagnosis a little more difficult, but it is much more difficult to explain to the patient the need for preventive check-ups regardless of the age👵.

If cervical dysplasia is detected in the postmenopausal period, surgery would seem to be the easiest solution.
And the doctor will easily justify it by saying that since the reproductive function is no longer possible, it is better to remove the organ🔪.

But I will never tire of repeating that no one has extra organs, and if there is a possibility of organ-preserving treatment, it should be used🙌.

I will not hide that due to insufficient vascularization, PDT treatment in postmenopausal patients is more complicated.
And repeated PDT is often performed in such patients.

Be healthy and take care of yourself at any age☘️

Your doctor Afanasyev
🚑Treatment of cervical dysplasia, endometrial hyperplasia and basal cell carcinoma🔬

CONTACTS
► Send your analysis and research to doctor@drafanasev.com
► Viber / WhatsApp +7 987 980-25-34
► Making an appointment 8-800-555-77-26
doctorafanasev

08/08/2022

WHY SHOULD YOU TREAT DYSPLASIA PDT
Medicine has established that HPV can lead to cervical cancer, however, reassures that only 1% of women having HPV of high oncogenic risk end up with cervical cancer.
And no one yet knows what is the "trigger" that lowers the body's defenses🤷‍♂️.

Suggestions include stress, smoking, sexual promiscuity, and early onset of sexual activity...

But I like the "viral load" version better.
After all, there are more than 200 papillomaviruses. The more we contact other people, the bigger the "zoo" begins to live inside us😐.

One day, not so great, the general activity of viruses blows a hole in the immune system (the fortress is taken by storm).
And even if the other viruses do no harm, their oncogenic types manage to start their destructive work.

PDT is the method that destroys the human papillomavirus in the cervical epithelium and almost nullifies the viral load.
Therefore, a woman is protected from the risk of cervical cancer👌

Your doctor Afanasyev
🚑Treatment of cervical dysplasia, endometrial hyperplasia and basal cell carcinoma🔬

CONTACTS
► Send your analysis and research to doctor@drafanasev.com
► Viber / WhatsApp +7 987 980-25-34
► Making an appointment 8-800-555-77-26
doctorafanasev

Sometimes the way to recovery can be quite challenging for patients with dysplasia.If you are still in doubt about wheth...
25/07/2022

Sometimes the way to recovery can be quite challenging for patients with dysplasia.
If you are still in doubt about whether to have PDT under anesthesia or not, read this feedback!

When Natalya was diagnosed with cervical dysplasia (CIN3) and HPV, she did not agree to an operation to remove her female organs right away, and decided to research the problem and get doctors' opinions.
And I am glad that my posts and numerous patient feedback played an important role in this🙌.

Natalia went to another specialist for PDT.
PDT was performed without anesthesia in the cervix and v***a. Perhaps this was a reason for the ineffectiveness of the procedure.
I have previously written posts on this.
The procedure was painful, and it was probably not possible to get the necessary dose of light.

And it's a good thing that the failed PDT didn't lead to disappointment in the method itself because after the treatment the tests showed that HPV and CIN3 didn't disappear😐.

Natalia decided to try again and asked me for help.
I treated her with photodynamic therapy, and today Natalia is healthy!

Natalia, thank you for your courage and for sharing your experience! Stay healthy! ☘️
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Your doctor Afanasyev
🚑Treatment of cervical dysplasia, endometrial hyperplasia and basal cell carcinoma🔬
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
CONTACTS
► Send your analysis and research to doctor@drafanasev.com
► Viber / WhatsApp +7 987 980-25-34
► Making an appointment 8-800-555-77-26
doctorafanasev

07/07/2022

HOW NOT TO MISS SKIN CANCER.
📌 The most common cancers directly related to environmental exposure, particularly sun exposure, are basal cell cancer, squamous cell skin cancer, and melanoma.

Predisposing skin type is the first thing to consider👆.
This applies to people with fair skin, especially freckles, with increased sensitivity to the sun, prone to the formation of pigment spots and nevi.

Typical locations for skin cancer are exposed areas of the body with skin appendages: the head, neck, upper and lower extremities, i.e. those areas that are uncovered on a sunny day.
I recommend checking your skin periodically and asking family members to inspect your back and other hard-to-reach places, paying attention not only to changes in existing " birthmarks", but also to the appearance of new ones, and any long-lasting formations on the surface of the skin👆.
If you find any, see a dermatologist or oncologist.

Basalioma and squamous cell skin cancer are well-treated, and the prognosis for recovery is usually good. The same cannot be said for melanoma, which develops rapidly and metastasizes quickly.😐
Melanoma is likely to relapse - re-growth of the tumor after several years, even with timely treatment.
Seeing your doctor regularly will help you avoid this👌.
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Your doctor Afanasyev
🚑Treatment of cervical dysplasia, endometrial hyperplasia and basal cell carcinoma🔬
〰〰〰〰〰〰〰〰〰〰〰〰〰〰
CONTACTS
► Send your analysis and research to doctor@drafanasev.com
► Viber / WhatsApp +7 987 980-25-34
► Making an appointment 8-800-555-77-26
doctorafanasev

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