A strong prayer to Luka Crimean before a complex operation. Saint Luke of Crimea: prayer, what helps, miracles, relics Prayer of Saint Luke of Crimea, what helps

The history of Russia is rich in righteous people; they appeared even during times of persecution of the Church of Christ. The example of Saint Luke of Crimea is unique, whose prayers and medical art saved hundreds of people. There was a lot in his destiny - a happy childhood, marriage, exile, service to God and people. Already in the 20th century. was recognized as a saint of the Russian Orthodox Church. In this article we will consider a prayer to Luke of Crimea for healing.

The choice of life path of Luka Krymsky

Valentin (the worldly name of the future monk) came from an ancient Belarusian family, his father was a Catholic, his mother was Orthodox. Both were very pious, kind people; mutual understanding and respect reigned in the family. Carefully preparing his servant, the Lord gave him enough good memories worthy of parents so that the future shepherd could withstand the trials of adult life.

Prayer for the future Saint Luke of Crimea has become a common activity since childhood. Therefore, when the time came to get acquainted with the text of the New Testament, the words of the Lord fell on prepared soil, which yielded abundant fruit. At first, the young man wanted to be an artist, but he considered it unworthy to develop his high feelings when so many people were suffering around him. His youth occurred at the end of the 19th century, when the ideas of Count Tolstoy were popular. True, Valentin himself soon saw their inconsistency.

• After graduating from Kiev University, the talented young man declared his desire to treat ordinary men, which greatly surprised those around him, since he had a talent for science. Soon he married a nurse he knew, who became his faithful assistant. Not yet thinking about the priesthood, Saint Luke of Crimea began to save people. Forgetting about rest, he fought epidemics of typhus and smallpox; peasants even from neighboring counties came to him for advice.

In the year the revolution began, he took a post in Tashkent, trying to save his wife from the onset of tuberculosis by changing the climate. 2 years later she died, leaving her husband with 4 children in his arms. From this period, the doctor began to turn to prayer more and more often, which became noticeable to everyone around him. A couple of years after the death of his wife, he accepted holy orders at the suggestion of the local bishop.

What to do if illness strikes

Everything in this life is in the hand of God. When He sends an illness, we must accept it calmly and patiently, but this does not mean that we cannot pray for healing. St. Luke of Crimea was a doctor of medicine, but during operations he came in vestments, with a cross on his chest. Icons hung in the room. Relying on his knowledge and experience, he still recognized the primacy of God.

In what cases do they turn to Saint Luke of Crimea?

• Before the operation, so that it is successful.
• They pray for the child's healing.
• About a quick recovery after surgery.

Saint Luke of Crimea combined the ministry of a clergyman and the profession of a surgeon almost all his life. He was not just an ordinary doctor, he wrote scientific papers and moved medicine forward. The human soul also requires an experienced mentor. This is how Saint Luke of Crimea can be for you. He never looked at titles, was not afraid of anyone, boldly professed his faith, and did everything for the good of his charges.

You can read a prayer for healing yourself, but it is better to ask relatives and friends about it. If the illness is serious, and there is no strength to get out of bed, you can turn to the saints even in this situation. When the condition improves, you will be able to sit down or stand up as much as your strength allows.

Let the relatives go to church and order a church commemoration during the Liturgy. And at home you can turn to Saint Luke of Crimea in the morning and before bed. There is no need to change the text of the Orthodox prayer; you need to add your own words after the reading is finished. If there are a lot of people around, you can read “to yourself,” but for spiritually fragile people, experienced people recommend saying the holy words out loud. Quietly so that you can hear it yourself. They have a beneficial effect on the body and soul.

Saint Luke of Crimea became the founder of Christian anthropology. Already during his lifetime, the common people respected the saint so much that one day there was a riot when the conditions of his exile were tightened. After the death of the righteous man, people who prayed at his grave began to receive healings. In 1996, incorruptible relics were discovered, which are now located in Simferopol. In 2000 he was canonized as a new martyr.
May Saint Luke help you!

Text of the prayer to Saint Luke of Crimea for recovery

O all-blessed confessor, holy saint, our Father Luke, great servant of Christ. With tenderness we bow the knee of our hearts, and falling before the race of your honest and multi-healing relics, like the children of our father, we pray to you with all diligence: hear us sinners and bring our prayer to the Merciful and Humane-loving God. To whom you stand now in the joy of the saints and with the faces of an angel. We believe that you love us with the same love with which you loved all your neighbors while you were on earth.

Ask Christ our God, may He strengthen His children in the spirit of right faith and piety: may He give holy zeal and care for the salvation of the people entrusted to them to the shepherds: to observe the right of believers, to strengthen the weak and infirm in the faith, to instruct the ignorant, and to reprove those who oppose. Give us all a gift that is useful to everyone, and everything that is useful for temporary life and eternal salvation.

Strengthening our cities, fruitful lands, deliverance from famine and destruction. Comfort for the grieving, healing for the ailing, return to the path of truth for those who have lost their way, blessing for the parents, education and teaching for the children in the fear of the Lord, help and intercession for the orphaned and needy.

Grant us all your archpastoral blessing, so that if we have such prayerful intercession, we will get rid of the wiles of the evil one and avoid all enmity and disorder, heresies and schisms.

Guide us on the path that leads to the villages of the righteous, and pray to the omnipotent God for us, so that in eternal life we ​​will be worthy with you to constantly glorify the Consubstantial and Indivisible Trinity, the Father and the Son and the Holy Spirit. Amen.

Listen to prayer for healing

Prayer to Saint Luke of Crimea for healing and recovery was last modified: July 8th, 2017 by Bogolub

A person has to live with many diseases. And from whom should we ask for help, if not from Our Lord Jesus Christ, His Most Holy Mother, the Virgin Mary, and His saints? During his earthly life he helped people a lot in their illnesses, and the saint still helps those who pray to him and ask for help.

Prayer to Luke of Crimea for healing

O all-blessed confessor, holy saint, our Father Luke, great servant of Christ. With tenderness we bow the knee of our hearts, and falling before the race of your honest and multi-healing relics, like the children of our father, we pray to you with all earnestness: hear us, sinners, and bring our prayer to the merciful and man-loving God, to whom you now stand in the joy of the saints and from the face of an angel . We believe that you love us with the same love that you loved all your neighbors while you were on earth.
Ask Christ our God to confirm His children in the spirit of right faith and piety: to the shepherds to give holy zeal and care for the salvation of the people entrusted to them: to observe the right of believers, to strengthen the weak and infirm in the faith, to instruct the ignorant, to reprove the contrary. Give us all a gift that is useful to everyone, and everything that is useful for temporary life and eternal salvation: the establishment of our cities, the fruitfulness of the land, deliverance from famine and destruction, consolation for the afflicted, healing for the sick, return to the path of truth for those who have gone astray, blessing for the parent, blessing for the child in distress. The Lord's upbringing and teaching, help and intercession for the orphaned and needy. Grant us all your Archpastoral blessing, so that if we have such prayerful intercession, we will get rid of the wiles of the evil one and avoid all enmity and disorder, heresies and schisms. Guide us on the path that leads to the villages of the righteous, and pray for us to the omnipotent God, in eternal life we ​​will be worthy with you to constantly glorify the Consubstantial and Indivisible Trinity, the Father and the Son and the Holy Spirit. Amen.

Brothers and sisters! We are pleased to inform you that now, if you do not have the opportunity to visit the temple and order any request in the temple - forty morning for health, for example - you can order prayer for you through the form on our website! The priesthood of our church in honor of St. Luke will pray for you or your loved ones. >>.

Below is a video and a prayer to St. Luke performed orally (you can just listen to the prayer and repeat it to yourself).

Also see: a short prayer of a sick person to the Lord, text in Russian.

The meaning of cancer from a doctor's point of view

Oncology is a special field of medicine, where both the high professional training of the doctor and his ability to communicate with a sick person are equally important. Violation of this unity can have a very sad effect on the fate of the patient.

Various types of errors and omissions in oncology usually do not appear immediately, as, for example, in acute surgical or therapeutic diseases, but only after some time, sometimes long, when eliminating them can be very difficult, and sometimes impossible. At the same time, the biological property of tumors to progress and people’s disbelief in a permanent cure for cancer to some extent mask a medical error, and sometimes, roughly speaking, they “write off” it.

Every disease has its own meaning. The Lord sends the disease, or rather, allows it, in the place, organ or system where the passion that affects the human soul is most manifested. Illness is then a medicine that prevents the further development of passion.

An oncological disease, especially a malignant one, from a religious point of view, has as its purpose “notifying” a person that he has a path to the Kingdom of Heaven, his life time has been calculated, measured, and the Lord has decided to recall the soul of this person to Himself in Eternity. It does not matter how much time passes from the moment of histological examination confirming the cancerous nature of the tumor until death: a month or fifteen years (against the background of surgery, radiation treatment and chemotherapy). It is important that a bell sounded from above, calling for repentance for the entire life lived. Why do we have the right to consider this a “notice”? Because there are many diseases that result in sudden death, when, due to exhaustion from the disease and its characteristics, a person is no longer able to resort to the Church Sacraments, and cannot meaningfully speak, see, hear, or analyze. Any Church Sacrament is based on the fact that a person who wants to begin it must be in a state of clear consciousness or slight deafening of consciousness, but self-analysis of the person must necessarily take place, otherwise it will be impossible to either express one’s thoughts or express everything that is the subject repentance.

Of course, modern surgery allows one to achieve good results: the survival rate of patients with malignant neoplasms with radical removal of tumors reaches 15 and 20 years. However, the age from the starting point to Eternity is no longer important; the very fact of “warning” is important. “Notification” does not imply slow dying from the disease sent; it is possible that a cure will occur (both religious and non-religious in nature).

Patient I., with stage III stomach cancer (T3 N0 M0) was warned about the need for surgical treatment. She rethought her life and made a vow to God that if she remained alive, she would devote the remaining time of her life to the Church. Soon, during a preoperative examination, doctors were surprised to discover the disappearance of the tumor. The patient subsequently took part in the restoration of sixteen Orthodox churches.

In the 80s of the 10th century, newspapers on the island of Cyprus circulated sensational news about the cure of stage IV cancer of an elderly man who prayed for the healing of St. Archangel Raphael. The healing took place within one night (story from a local resident of the island of Cyprus).

And here is one of the most striking examples of “notification” with a delay.

Patient M., the former head sister of one of the departments of TsMSCH-122, was bedridden for the second year due to destruction of the vertebrae due to metastases of a malignant neoplasm. Despite conversations with priests and constant communication with sisters of mercy, the patient was not predisposed to repentance, confession and communion. She began to express doubts about the existence of God and stated that she would not believe it until she personally verified the reality of the afterlife and communicated with the dead. Seeing such insolence towards God and the failure to achieve at least some understanding, the spiritual care of the patient was stopped.

About a month passed and the priest was urgently called by the patient herself. When he entered the room, he saw the face of a completely different person: the petrified insensibility and folds of pride, arrogance and disdain disappeared. The patient greedily absorbed every word spoken by the priest. When he tried to find out what happened, it turned out that on the night before the feast of the Entry of the Most Holy Theotokos into the Temple, the Lord took the sick soul to the afterlife and then returned it back. In the “other world” she communicated with relatives, some secrets were revealed to her regarding the future deaths of her loved ones and hospital staff (which was later justified). She was shown the importance of remembering the dead both through prayer and by offering food on the eve. She saw the doors of heaven and hell, the gatekeepers. But she was not even allowed close to the gates of heaven, since she did not know a single prayer. She was given a short prayer rule, which she had to do until death. After this, some of her requests were fulfilled, and she again ended up in the hospital.

In the morning, the department was alarmed by the patient’s cry: “Believe, people! God exists!". The alarmed medical staff tried to calm her down, but she constantly repeated this phrase and asked to write down the words of the prayers said to her by the gatekeepers of heaven. The patient tried to explain something, but those around her thought that it was either an overdose of medications or a reactive state against the background of a long-term oncological disease. Seeing that no one took her request seriously, she asked to call a clergyman. During a calm conversation with him, she told him what she saw and what she learned.

For some time after this event, the patient felt well and did not need the daily medications and painkillers she had previously taken. Four months later, in April 1996, she died as a deeply religious person who had repented of her sins, although not very church-going, but still in some way a church-going person. Before her death, she quite consciously took unction and received communion.

Psychology of a cancer patient. Religious and psychological aspects

Let's consider the psychology of cancer patients.

Recently, psychological problems in oncology have acquired new features due to advances in diagnosis and treatment. The emerging conditions for identifying diseases in the preclinical period and the possibility of a complete cure put on the agenda the need for a broad discussion of the problem of the psychology of a person who does not feel sick, but is forced to undergo treatment that involves a risk to life.

In the early stages, patients with clinical manifestations of cancer try to explain their feelings by random causes. They expect the pain to go away and try to treat it with home remedies. Patients either reject thoughts that arise about the possibility of cancer as unacceptable, or, accepting them, withdraw into themselves, anxiously awaiting further developments of events. This period of the disease is characterized by a tendency of patients to introspection and secrecy. A minority of patients quickly fall into a panic state and immediately consult a doctor. Most usually wait several months until new symptoms of the disease appear, which force them to see a doctor. Patients who are inattentive to themselves or, conversely, are afraid of a possible “terrible” diagnosis and avoid visiting a doctor, seek medical help under the influence of others.

After the first visit to the doctor, the psychological situation changes. The patient’s mood from this period largely depends on the impression the doctor made on him.

During this period, one can expect mainly two types of reactions to unfolding events. Some patients are prone to fright, panic and, when asked to be hospitalized, fall into a state of depression. Other patients who do not show outward signs of anxiety also need attention. Under the mask of external calm, people who are closed by nature may hide a severe mental reaction to the environment.

For non-believers, a diagnosis of cancer sounds like a bolt from the blue and, as a rule, becomes a real tragedy in life. Believers react differently, depending on how churched, strengthened, and prepared they are to enter the Kingdom of Heaven. A Christian, even from the cradle, strives to gain the Kingdom of Heaven through observance of God’s commandments.

A person who has developed cancer can take one of three paths:

1. riotous: take everything possible from the remaining time in life. As a rule, non-believers follow this path, because they believe that beyond the threshold of this life there is nothing, only non-existence.
2. rational: the patient comes to the doctor, attempts a cure, believes the doctor, believes in his hands, professionalism, i.e., strives to help his body.
3. spiritual: the patient perceives his illness precisely as a notice of the time of preparation for eternity, not as punishment, but as God’s mercy, as God’s warning about the coming eternity.

Spiritual, moral and deontological tasks of an oncologist in relation to patients

An oncologist has the following tasks in relation to patients:

1. Extend the patient’s active life time.

The doctor may ask the question: “What should I do if a person goes into all serious troubles, goes into chaos?” In response, the doctor can remember that he has been given blessed functions, and by prolonging the life of the patient, he gives him the opportunity to gain additional reserve of time for repentance and solving his life problems.

2. The second task of the oncologist is to bring healing to the patient, without forcing him to believe, but also without allowing the patient to go into superstition, mysticism, and not go down the path of rampant self-immolation.

The uncertainty of the etiology of malignant neoplasms gives rise to doubts among the population about the capabilities of medicine. Doctors cannot yet give a clear, unambiguous answer to the question asked by patients and their relatives about the origin of cancer and do not always have the opportunity in a conversation with them to illuminate the rather complex modern ideas about the etiology and pathogenesis of the disease. This situation gives rise to various guesses among the population and creates the basis for trust in the unscientific judgments of non-specialists and healers.

The creation of an atmosphere of mistrust is promoted, to a certain extent, by the publication in the scientific and general press of superficial judgments about the origin of tumors, and these judgments give many people unrealistic hopes of eliminating the disease in one “simple” way. At the same time, the “simplicity” of the theory gives rise to its understandability, and understandability for an unprepared person contributes to the emergence of conviction in its correctness.

The influence of this kind of publications, not to mention fictions that are completely far from science, is explained by a number of psychological characteristics of people. S. Camp, a prominent American psychologist, wrote: “...Science becomes more complex, specialized, and more difficult to understand for a non-specialist every day: As a result, it is difficult for an ordinary person to keep up with scientific discoveries. On the other hand, pseudoscientific myths allow the average person who believes in them to feel like they are in the midst of the modern flow, or to believe that they know something hidden from others, without forcing themselves to make special efforts to do so.”

That is why the first deontological task of oncologists, in relation not to an individual patient, but to society, is to refute emerging myths and legends. The most common idea is that there are “folk”, “foreign” and all other life-saving remedies for cancer. It should be noted that turning to healers is by no means the lot of poorly educated people. On the contrary, oddly enough, well-educated people who read a lot of diverse literature, where careless, incompetent publications about “new methods” of treating cancer appear from time to time, are especially persistent and persistent in their search for supposedly unknown original medical methods for treating this serious disease. Usually this is done not by the patients themselves, but by their relatives and friends. Not a day goes by without a writer, a journalist, a non-medical researcher, and sometimes even a doctor far removed from the problems of oncology coming to the doctor for advice about a patient who is not subject to special treatment methods. In this case, rumors are cited as arguments about one or two cases of healing of patients known to them, or about publication in the general press.

Talking on this topic and not having the means to treat a patient in an advanced stage of cancer and the opportunity to at least somewhat reassure his friends and relatives, doctors do not immediately and categorically reject the possibility of turning to so-called folk remedies or simply healers. Statements such as “there is nothing to do, why not try?”, “the patient is absolutely hopeless, what if a new treatment method will help him?”, only indicate the professional helplessness of the doctor and his lack of spirituality.

A doctor talking with the patient’s loved ones and relatives, and sometimes with the patient himself, is obliged to take a strong and irreconcilable position in relation to such “innovations.” Naturally, in order for the position to be strong and irreconcilable, it is necessary to know the degree of confirmation of the diagnosis in all its details and clearly understand the possibilities and ways of palliative and symptomatic treatment of cancer patients of clinical group IV. We must remember that in almost every cancer patient with an advanced form of the tumor, through palliative and symptomatic measures, it is possible to achieve remission, sometimes quite long, and, most importantly, alleviate his suffering. Moreover, in a number of cancer localizations, remissions often occur spontaneously, which can stimulate the success of completely nonspecific and even completely ineffective drugs and influences, which is also widely used by charlatans. Every oncologist can give examples of subjective and objective improvement in general condition and even the return of patients to work as a result of the use of palliative treatment methods.

The above considerations and facts leave no room for the doctor’s consent to transfer the patient into the hands of incompetent people, especially into the hands of charlatans, allegedly because he, the doctor, does not have the means to fulfill his medical duty. It is necessary to warn against these mistakes in every possible way also because such a recommendation, while harming the patient, also harms medicine, undermining its authority. Its consequence can be, and probably often happens, a completely curable patient with a malignant neoplasm who has learned about a case of an imaginary cure, which was in fact a normal remission, unrelated to the method used, refuses treatment and goes to the “doctors.”

S. Laborde in the book “Cancer” (1979) writes that a cancer patient who turns to a healer for help is a lost patient, since he misses precious time when he can still be cured. The author emphasizes how difficult it is to convince people that there are no secret cures and goes on to write: “Whether they like it or not, driven by an unconscious need to believe, they find themselves in a dilemma, the conclusion from which is inevitable:

• or there is a real discovery that will be able to cure a huge number of cancer patients, and those who keep it secret are committing a crime against humanity;
• or we are dealing with an impostor who criminally abuses people's trust. This is even more so without any justification, since we are talking about patients, who are especially easy to deceive and at whose expense it is unacceptable to profit.”

Thus, we repeat, the position of the oncologist in relation to unprofessional methods of influencing cancer patients should be firm and unshakable.

However, there are still cases when hype arises around various dubious proposals and the authors of these, so to speak, treatment methods, sometimes supported by the press, try to circumvent the laws. There is nothing more dangerous for others than active ignorance!

It is worth recalling the materials from the testing of the “methods” of cancer treatment according to Guman, Prodan, Kachugin, which caused a lot of noise 20 years ago, which few people remember today. These people claimed to have found radical ways to treat malignant tumors. Official control of their “methods” in a clinical setting in compliance with strict rules for clarifying the diagnosis and monitoring the effectiveness of the drugs showed that this time the discovery did not occur. However, the authors of the “new methods” did not give up immediately. They tried to explain the failure by the fact that during the test they were allowed to treat patients only with an advanced stage of the cancer process. However, they previously claimed that they were saving people almost on the verge of death. Naturally, if such an amazing effect is advertised, testing should be done by treating the same category of patients. In addition, for less common stages of cancer, modern oncology has reliable and effective means.

Self-proclaimed healers are trying to challenge the conclusions of qualified commissions with pseudoscientific statistical calculations, while a serious analysis shows that in a significant number of their “patients” the diagnosis was not confirmed by the morphological method - the only reliable evidence of cancer.

3. The doctor must be patient with the ignorance that patients and their relatives may show regarding the radicality and breadth of surgical intervention and the need for treatment.

In our time, no disease causes such horror and despair in people as cancer. Oncologists often observe severe emotional reactions to the disease with malignant neoplasms, psychologically associated with ideas about the incurability of these diseases.

There are patients who reluctantly and irregularly visit the clinic and avoid examination due to minor manifestations of the disease. They see no reason to be alarmed, and therefore do not follow the doctor’s orders. With such patients it is necessary to carry out persistent work, proving the validity of the examination and the inevitability of treatment, and sometimes disclose the seriousness of their situation, despite the absence of visible severe signs of illness.

The first contact with a doctor for patients has a strong emotional overtones. Patients harbor hope that their fears are in vain, and the disease can be cured with conventional medications. During an outpatient examination, the doctor tries to help the patient overcome emotional experiences.

The period of hospital stay of patients is usually associated with mental depression. Patients are worried that they are in an oncological institution and react sharply to the condition and fate of their neighbors in the ward. Personal contact between the doctor and the patient and the help of the priest are the key to a successful background for treatment. A favorable environment in the hospital is created by a well-coordinated, well-functioning team of doctors, nurses and nurses, and the presence of nurses. Even the smallest defects in the work of medical personnel are not hidden from the attention of patients - wary, acutely perceiving everything around them.

Poor information from patients about the nature of the disease is one of the serious reasons for their refusal of treatment. N. N. Blokhin (1977) wrote that a patient’s refusal to undergo an operation based on misinformation made for false deontological reasons negates the deontological principles that place the interests of the patient above all else.

B. M. Shubin and co-authors (1980) studied the most common reasons for refusal of operations in cancer patients. Thus, 39 patients had fear of the operation, 25 had fear of the consequences of the operation, 25 had no complaints and felt well, 26 had decided to try medicinal treatments, 14 had distrust of the doctors of the hospital, 14 had disbelief in the possibility of a cure. 5 patients.

Instructive details of the circumstances that caused patients to refuse or delay treatment were revealed. Among them: a too hasty and one-time offer of an operation by a doctor who is not sufficiently authoritative, in their opinion, disputes in the presence of the patient about the advisability of surgical treatment, the choice of a method without sufficient, from the patient’s point of view, examination, pressure from relatives, etc. Reasons for refusals described above, are of particular importance for small tumors that do not give any noticeable clinical manifestations. In these cases, as a rule, active surgical treatment is necessary, although patients consider themselves practically healthy. Following the proposal of a treatment plan, the patient usually asks for time to think and consult with loved ones. Some patients, after the first conversation with a doctor, disappear from his field of vision and appear after some, often long, time with symptoms of an advanced disease. The doctor needs to be persistent, even to the point of actively visiting or calling the patient for a second conversation. The examination in the clinic should be as short as possible, not only due to the need to start treatment faster, but also from a purely psychological point of view. We must always remember that the doctor is dealing with a patient who has no symptoms of the disease and doubts the necessity of treatment. Without giving time for doubt, you need to place the patient in a hospital as quickly as possible. Is it permissible to disclose the diagnosis if there is persistent disagreement with the proposed examination and treatment? In such cases, it is customary to inform the patient that there is a suspicion of cancer and that a detailed examination is required. After hospitalization, a patient with an asymptomatic disease encounters a seriously ill patient, with complications from operations and radiation therapy, the effects of which are often unfavorable. Therefore, the attending physician must explain that the department treats not only patients with malignant tumors, for whom treatment is complex and dangerous, but also those with benign, precancerous diseases. The patient should be helped to understand that the later treatment is started, the more difficult it is for the patient, and that it is better to start treatment before the oncological disease develops.

The patient should be told that in the initial stages, cancer can be asymptomatic, almost no different from the course of precancerous disease.

The first rule is to begin implementing the treatment plan as quickly as possible.. It is advisable to operate such patients as soon as possible after hospitalization. Patients should be advised not to discuss the details of the course of the disease, its treatment and outcomes with other patients, and not to touch upon medical topics in their conversations.

Hospitalization in an oncological institution puts the patient on guard, but nevertheless, it is usually possible to convince him that he has a curable disease. This is the psychology of the patient - to believe in a successful outcome of the disease. The tendency of modern medicine to hospitalize patients in a specialized medical institution is developing and strengthening. Psychological losses are covered by maximum opportunities to receive the most qualified treatment.

Some patients feel worse after treatment than before treatment. They are haunted by the thought that they agreed to treatment in vain. After all, they did not consider themselves sick before treatment.

The doctor must keep this possibility in mind and provide for it.

So, the belief that cancer is incurable is the main source of fear, followed by other severe psychological changes.

S. B. Korzh described the following tragic incident.

A 35-year-old woman, after a gynecological examination, was sent for further examination to the oncology clinic. She believed that only cancer patients were sent to this facility, and so she told her friends that if the diagnosis was confirmed, she would commit suicide. At the dispensary, after an outpatient examination, the patient was offered hospitalization for treatment. They did not study the psychological state of this woman; they did not talk to her. She went home for 1-2 days to “settle the children” and disappeared. Only a month later her body was discovered in the river.

The medical task, as mentioned above, is to use every opportunity to shake this opinion. There are many ways to solve this problem, the most important of which is an individual conversation between the doctor and each cancer patient and his relatives.

The oncologist's responsibility for the patient's life

Often a priest is invited to a sick person too late. A patient, especially a non-believer, can react to the “tragic” news of his diagnosis in two ways: prepare for further adaptation to life after surgery (or without surgery), or commit suicide by ending his life on his own. Is an oncologist responsible for the fact that his patient committed suicide? Indirectly - yes. Why? Because the task of any doctor is to treat not only the body, but also to take care of the patient’s soul. The attending physician always has the opportunity, if he cannot cope with psychosocial disorders in his patient, to call a psychiatrist, a psychologist, at the same time he can call a priest who will help the patient to understand his illness in a slightly different way, to feel what the dying person has to do with Eternity Human.

A late appeal to a clergyman for help is fraught with deprivation of a person’s dying instructions and confession, which aggravates his fate in the other world. The doctor should remember that if the priest managed to forgive some of the sins of his patient, he will no longer be responsible for them after death, but if he does not have time, then the sins will remain with the soul, and in that world there is no longer repentance, and even if If the soul of the deceased really wanted to be freed from at least one sin - this is no longer possible.

Thus, the role of the doctor and sisters is to try to call the priest in time, when the patient’s consciousness is still clear, there is no cancer cachexia, so that the patient can confess and receive communion. Therefore, regardless of the desire of the doctor, the fate of the person’s soul, entrusted to him by God, also depends on him, whether it will end up in hell or heaven. The repentance of a person’s soul is hidden from our eyes; it is a great mystery. But at the moment of repentance to the priest or at the moment of preparation for the sacrament, enormous changes occur in the soul of a person. The Lord who knows the heart sees these changes in a person and can change his fate in eternity.

Of course, not only the doctor, but also the patient himself is responsible for where the patient’s soul ends up after death. If the doctor offered the patient the help of a priest, told him about life in the afterlife, then everything depends on the good will of the patient himself.

In our time, when atheistic prejudices have not been eliminated among the Russian population, such conversations with a patient may be unsafe for a doctor’s career. Therefore, it is better if a priest or sister of mercy who is outside the department’s staff speaks with the patient. However, the doctor's personality greatly influences the patient.

The mother of one of the parishioners of parish N. survived the blockade, had pronounced changes in the spine, the size of her pelvis did not allow her to give birth to a normal child, there was poor Rh compatibility with the fetus (Rhesus conflict), etc. She was told: “You will give birth, but nothing will happen.” no good will come of this.” But she answered decisively: “I will give birth.” Later, Professor S, quite well-known in the field of medicine, came to her room. He came up, sat on the bed, stroked her stomach and asked: “Are you reading Theotokos?” She looked at him, not expecting (these were years of persecution of the Church) to hear such a question from the professor’s lips, and did not answer anything. The professor continued as if nothing had happened: “If you read, everything will be fine, you and I will give birth, don’t worry, don’t listen to them,” he nodded his head towards the door, “they don’t understand anything.” To the surprise of everyone, she gave birth to a healthy son, without any physical or mental defects. The son grew up, received a higher education, and at the moment is the mother’s only support in her life and illnesses.

Here is an example when just a few words of prayerful strengthening from the lips of a doctor can give strength to the patient’s soul. And although he can now freely call a priest to himself, the first person he meets in the hospital is the sister and the doctor.

Cancer detection. How to deal with this and act correctly

One of the most difficult questions of a moral, deontological and bioethical nature in the work of an oncologist is when and how to inform the patient and his relatives about the incurability of the detected disease or its malignant nature, since everyone clearly understands that first there must be a radical operation, then a long treatment, and, in some cases, not recovery, but death.

On the one hand, the medical one, the doctor, sparing the patient’s psyche, tries not to voice an exact diagnosis, gradually preparing the patient for an adequate perception of the tragic message. On the other hand, the religious one, delay leads to the loss of time, which the patient could use to prepare for eternity, and this time is irretrievably lost.

The next feature of oncology that seriously affects the proper behavior of a doctor is the crippling nature of many types of treatment, which threatens each patient individually. This circumstance is aggravated by the fact that with proper preventive examinations and early detection of cancer, the disease can be detected in people of working age who consider themselves healthy.

Mutilation surgery (lobectomy, pneumonectomy) is proposed. The surprise of offering a major and undoubtedly dangerous operation to a person who considers himself healthy requires thorough and convincing argumentation to obtain his consent. We are faced with a sudden disruption of all the plans, affairs, aspirations, and interests of an actively living person. He is completely unprepared for a drastic change in his lifestyle.

It’s a different matter when the disease itself changed the conditions of existence. Prolonged temperature reaction, cough, poor sleep - all this develops gradually and the patient himself comes to the conclusion about the need for treatment, up to major surgery. But if there is no feeling of illness, people, experiencing fear of illness and serious surgery, tend to psychologically “disengage” themselves from misfortune. The doctor does not know how to convince, the patient refuses treatment or postpones it. As a result, valuable time is wasted.

In January 1975, patient F., 58 years old, felt the first, still small, signs of dysphagia. He hid this from his wife, doctor and daughter, but turned to a radiologist he knew. An X-ray examination suggested cancer of the cardia of the stomach and esophagus. There was a recommendation to go to hospital for examination and treatment. As often happens, the symptoms of dysphagia passed, and the patient, comparing his feelings and the not very persistent medical recommendation, decided to postpone further examination. At this time, the wife was preparing to defend her doctoral dissertation, and the daughter was finishing school. He was waiting for the completion of these important family events. The patient appeared in the clinic only in August, i.e., after 8 months. after the appearance of the first clinical signs of the disease. X-ray and endoscopically the diagnosis was confirmed, but thoracolaparotomy revealed tumor growth into the pancreas and metastases into the hilum of the spleen. A combined gastrectomy with resection of the pancreas and removal of the spleen was required. The loss of time led to further spread of the process and a poor prognosis.

There are no ready-made recipes for how to do this. Everything will depend on experience, intuition, strict adherence to the principles of deontology and the doctor’s churchliness, and on this - the fate of each of his patients.

So, the uncertainty of the etiology of oncological diseases, doubts of patients about the possibility of curability of cancer, the crippling nature of many types of treatment, threatening disability, and finally, true tragedies experienced by patients and people close to them - all this creates in any oncological institution, at every outpatient appointment with an oncologist a very special psychological atmosphere that places its own exceptional demands on the art of communication with the patient. This situation is aggravated by the fact that changes in the mental state of patients, reactions of fear, anger, etc. are manifestations of the disease itself, which the doctor must understand and try to relieve by all available means. The emergence of a conflict between cancer patients and a doctor is always evidence of doctors’ non-compliance with the requirements of deontology.

Conducting a conversation with cancer patients requires following certain rules. First of all, until the diagnosis is confirmed morphologically, there should be no statements about the essence of the disease either to relatives, or, especially, to the patient himself. Among patients referred for consultation to oncological institutions, the diagnosis of cancer is confirmed in no more than one in three.

It should be remembered that even if cancer is identified positively, this must be taken carefully.

Patient K. was diagnosed with cancer of the stomach and esophagus, undetermined form, in 1984. The doctor has made a prognosis of possible life for only 4-5 weeks. The patient did not receive any treatment, since death was expected in the near future.

1.5 months after staying in the hospital, an unexpected improvement began. The doctors again regarded this as a temporary phenomenon, but the sick daughter, seeing that her mother was stronger, took her home. After this, the patient lived for five and a half years in satisfactory condition until 1989. During this time, she managed to normalize relations with all her closest relatives, reconcile “with her neighbors and join the full life of a pensioner and grandmother.”

Another case. Patient N. was diagnosed with breast cancer. She was not operated on due to multiple tumor metastases. After the anointing of St. With oil in the church, the growth of the tumor stopped, the pain disappeared, the patient lived a full life for another 6 years and died of bronchial asthma.

The diagnosis of cancer, especially of visceral localizations, is difficult and almost always requires the use of special reliable research methods, and therefore every patient suspected of having a malignant tumor should be consulted by an oncologist and undergo a special additional examination. There should be no medical frivolity here, which could cost the patient his life.

At the same time, referral for further examination to an oncologist or to an oncological institution very often frightens patients and even gives rise to cancerophobia. Therefore, it is necessary not only to write out a referral, but also to explain to the patient that he is being sent to a highly qualified institution, where all the conditions have been created for a more accurate diagnosis, where not only cancer patients go. That, finally, there is a large group of precancerous diseases, which are also dealt with by oncologists, and without the advice of a specialist, this doctor cannot properly organize and treat the patient.

The oncologist is not the “first contact” doctor with the patient. It is extremely rare for a patient with a malignant tumor to immediately come to him. Usually he makes a long journey to the oncologist, having visited the head of the department, the surgeon of the clinic, etc. If the first conversation is incorrectly structured, when the doctor, suspecting the patient has cancer, refers him to the oncologist and, moreover, allows himself to speak out definitely, without having A proven diagnosis, but only a suspicion, results in a reaction in the form of fear. The undesirable consequences are twofold. Some patients, afraid of getting a more precise diagnosis, do not go to the oncologist for months, delaying the treatment of their illness.

Several years ago, while on a business trip to another city, one of the oncologists lived in a hotel. The administrator, having learned from the regular registration card about the guest’s profession, asked to talk with one of the employees. This relatively young woman is 8 months old. Before his arrival, she underwent the usual medical examination for people of her profession, and the doctor discovered diffuse mastopathy in her, gave a referral for further examination to an oncologist, but the extremely frightened woman did not go anywhere, fearing, as she said, a clarification of the diagnosis and surgery. None of the medical staff spoke to her or explained the success of treating the disease at this stage. Moreover, at that time, judging by the note in the referral, the doctor generally thought about the presence of a mixed form of mastopathy, and not about breast cancer.

When examining the patient after 8 months. After a preventive examination, the diagnosis of breast cancer was no longer in doubt, since there were skin symptoms. Taking into account the psychological alertness of the patient, as well as the fact that her fear is aimed at the fear of diagnosis and all her doubts must be immediately dispelled, and also bearing in mind that the regional lymphatic system, apparently, is not affected, she was directly told about the presence of a curable forms of breast cancer. I also had to explain the possible consequences of continuing to do nothing. She was reassured that the treatment consisted only of breast removal without radiation therapy and ovary removal, which was her greatest fear. Since the patient was convinced of the need for immediate treatment, she was hospitalized the next day and operated on 2 days later. For several years now, this woman has been living and working, forgetting all her previous fears.

The second form of undesirable reaction is the appearance of cancerophobia. Many patients think that if they were sent for consultation to an oncological institution, then they have cancer, but they are denied antitumor treatment due to the incurability of the disease.

N.A. Kraevsky described the tragic ending of the life of one such patient.

She was sent for examination to an oncological institution with suspected malignant neoplasm. The suspicion turned out to be unfounded, and the absence of cancer was proven by modern and completely reliable research methods. Not believing in the truth of the successful diagnosis, the patient began to seek consultation from different specialists, but everywhere she received the same, absolutely correct answer. The clinic, which at that time was headed by N.A. Kraevsky, in her mind was the last diagnostic authority, and, having received the same answer here, the woman, not believing it, jumped out of the window and died. An autopsy revealed no signs of cancer.

Before morphological confirmation of the diagnosis, as already noted, in no case can one speak with certainty about the diagnosis, because diagnostic errors occur quite often.

The mother of one of the largest surgeons in Moscow lived in Gorky. She fell ill and was diagnosed with stomach cancer by X-ray. The operation was performed by an experienced professor in the presence of the patient’s son and two other professors – friends of the son. During laparotomy, tumor lesions of the entire stomach, enlarged and dense lymph nodes in all areas of metastasis, and contamination of the peritoneum were discovered. To everyone present at the operation, the diagnosis seemed so clear and reliable that a biopsy was not taken. The patient lived for more than ten years and died from another cause. An autopsy revealed almost complete regression of the process, and histological examination revealed tuberculosis of the stomach and peritoneum.

Here it is appropriate to draw attention to the fact that this kind of observation is widely used for selfish purposes by charlatans and “healers.” Each of them knows how to talk about cases of miraculous cures and show such cured people. Rumors about them spread quickly and widely among the population.

Doctors, when medically examining cancer patients and talking with them and their relatives, depending on their characterological characteristics, often fall into two extremes. This refers to unjustified optimism and intimidation, a sharply pessimistic attitude of the doctor towards the possible outcome of the disease. Neither one nor the other should take place, especially when talking to patients. If a doctor suspects a malignant tumor in a patient, then both the patient and his relatives should be immediately informed in a non-intimidating manner about the seriousness of the situation and the need for further examination. Focusing on the seriousness of the disease should not in itself cause a natural reaction of fear for a cancer patient. Unfortunately, this happens quite often.

Woman, 43 years old, professor of mathematics. A few months ago she began to experience slight pain in both mammary glands; they seemed to become denser to the touch. Bypassing the usual stages of examination, she immediately went to a well-known surgeon who does not professionally deal with breast diseases. After a three-minute examination, the professor recommended surgery for the woman because he suspected bilateral breast cancer. This suspicion was expressed to the patient and her husband in a fairly transparent manner and a treatment plan was immediately outlined: bilateral mastectomy, oophorectomy with possible subsequent chemotherapy.

It is easy to imagine the degree of fright of this actively living and working woman. She came to another institution for advice in a state of extreme depression - she gave the impression of being sentenced to death. During a detailed clinical examination, which included, in addition to a detailed examination, x-ray and cytological examination, bilateral diffuse mastopathy was diagnosed, which required only long-term drug therapy and regular follow-up examinations.

7 years have passed. The woman is healthy and works successfully. This highly cultured and educated person spoke about difficult experiences during the period when she was intimidated, and said that she did not agree to the operation and began to look for another doctor precisely because of the fleeting examination and the frightening conclusions of the professor.

Even if the diagnosis of cancer seems undoubted, it is more correct to direct the patient to serious further examination and treatment. This should result from a careful, leisurely examination and examination and an equally serious conversation. A hasty conclusion by a doctor gives rise to either distrust of his opinion or a judgment about the complete evidence of an advanced tumor process.

Typically, a diagnosis of cancer is not the final stage of the examination. Only after cancer is detected do we have to find out important details that determine the possibility of using special treatment. Therefore, already at the outpatient stage, a plan for in-hospital examination should be drawn up, which should be explained to the patient, explain why all this is necessary, and strictly implement it within the scheduled time frame.

For example, in case of cervical cancer, if combined radiation therapy is planned, a urological examination is necessary. Such patients often complain that they are not hospitalized for treatment, but are “chased” to doctors for no apparent reason. The basis of each such complaint is the lack of proper contact between the doctor preparing the patient for treatment and his patient.

Many outpatient oncologists, having made a tentative diagnosis of a malignant neoplasm, without deontological training, inform the patient that he needs urgent hospitalization and surgery. Indeed, cancer patients should not wait more than 10 days to start treatment, counting from the moment of diagnosis. But 10 days is not emergency hospitalization. It is much better for the patient to schedule a full examination on an outpatient basis and hospitalize him in a specialized institution, where he will be provided with adequate medical care.

Being focused on the need for emergency hospitalization, the patient begins to get nervous, accuse doctors of being slow, or strive to get into any medical institution just to shorten the time before treatment begins. As a result, complaints arise or the patient ends up in a non-core institution, from which he is transferred to oncologists with a significant loss of time. All these facts, unfortunately, are not uncommon and give rise to a requirement to familiarize the patient with the plan of his examination and the duration of his hospitalization. Then he will calmly undergo the examination and wait for exactly the place in the hospital that he needs and is intended for. This behavior of the doctor is correct and deontologically justified.

Very often, an oncologist at a clinic allows himself to single-handedly draw up a treatment plan and announce it to the patient. In particular, this applies to the proposal of surgery when the examination has not yet been completed. Later, after the examination is completed, especially in the hospital, additional circumstances may be revealed that exclude the possibility of surgery.

In this case, an unusually complex deontological situation arises. The patient has already experienced and overcome the fear of surgery; he believes that only after it can recovery occur (many patients think that only the surgical method is effective for all forms of tumors). And suddenly he is denied surgery. Now thoughts of incurability appear and despair sets in. It is precisely on the basis of these deontological considerations that only the doctor who takes personal responsibility for the upcoming treatment has the right to propose an operation and discuss with the patient and his relatives the possible outcomes and consequences of the operation. Only him and no one else.

In all doubtful cases, when different methods of treatment can be chosen or combined methods proposed, a consultation is absolutely necessary. It is absolutely unacceptable in our case for the opinion of a doctor of any qualification that he can equally well know all the treatment methods used in oncology: surgery, radiation therapy, chemotherapy, immunotherapy, etc. If the patient is facing a very large and objectively dangerous operation, and There are other methods of treatment, perhaps less radical, but giving hope for recovery or a fairly long-term remission, then the doctor is obliged to tell the patient and his relatives in detail about all possible treatment options.

In oncology, there are many variants of the disease with malignant neoplasms, when the alternative is clear and undeniable: radical treatment or death. This is the case, for example, with operable stomach cancer. However, in such cases, the decision on the use of a relatively life-threatening treatment method looks different than in general, especially emergency, surgery. Postoperative mortality during major operations on the lungs, rectum, stomach, esophagus, and kidney, despite all our efforts, continues to remain quite high.

In addition, even if the operation is performed most carefully in compliance with all the principles of oncological surgery and complex treatment, there is no guarantee against the appearance of metastases in the coming months. For stage III gastric cancer, only 30–35% of those operated on live more than 5 years. If the number of deaths in these periods is taken to be 100%, then almost 50% of them die within the first two years, with the bulk in the first year. Thus, for some of the apparently successfully operated patients, the average lifespan is almost no longer than the average lifespan of unoperated patients with stomach cancer. It follows from this that deciding on surgery for stomach cancer is not at all easy and requires taking into account all the life circumstances of a given person and discussing these circumstances with his relatives and friends.

Unjustified optimism leads to the fact that after 1-2 years, a doctor who promised a complete recovery sometimes remains face to face with the patient’s bereaved family and must answer to them - primarily because people believe that their relative did not die due to neglect illness, but due to the lack of skill of the doctor.

It is difficult to solve this deontological problem: on the one hand, the doctor’s confidence in the complete futility of the future life of a cancer patient (if he has not undergone special treatment) comes into conflict, and on the other hand, there is a still insignificant number of successful outcomes of such treatment.

This does not mean that patients with stage III tumors should be denied surgery. Vast experience in oncological surgery shows that even with severe forms of gastric cancer with metastases to neighboring organs and regional lymph nodes, it is possible in some cases to achieve a complete cure. The contradictory position of the oncologist and the surgeon, discussing questions about the appointment of an operation for each patient, gives rise to significant deontological difficulties. In fact, the patient’s refusal to undergo surgery should quite reasonably be considered a consequence of a deontological error. At the same time, complaints from relatives about a doctor whose patient died immediately or very shortly after a major operation are also a consequence of a deontological error. There is only one way out of this situation. When the examination of the patient is completed and his fate is fully discussed at the council, two conversations should take place: one with the patient, the second - always in the absence of the patient - with people close to him.

It is better to first talk with relatives and then with the patient, because most people want to discuss this issue with their loved ones as soon as possible after the proposal to undergo surgery, and they should be prepared for this conversation. The patient is informed that after a comprehensive discussion by experienced doctors of his disease and state of health, taking into account literally all the circumstances, there is no other option but surgery. It must be said that he certainly has a curable form of the disease, without naming the disease itself.

Oddly enough, most patients do not ask for a diagnosis. If they ask, they should say that they have a borderline form of the disease, which may later turn into cancer if the diseased organ is not removed in a timely manner. Only if the patient refuses or hesitates, and the form of the disease really gives reasonable hope for recovery, there is nothing left to do but tell the patient that he has a curable form of cancer.

When talking with relatives, the tone should be different. If the decision to undergo an operation is made unconditionally at a medical consultation, the patient’s relatives must be told about this, but the possible complications and, albeit small, possible possibility of an unfavorable outcome should be pointed out. If surgery is truly necessary, the recommendation should be categorical and categorical. If doctors have doubts, it is absolutely necessary to inform relatives of the matter in order to avoid further misunderstandings.

At the same time, it is far from indifferent who conducts the conversations. You cannot entrust the most important conversation with a patient and his relatives to a young doctor, even a qualified and conscientious one, but due to his age and official position, he does not yet inspire much confidence in patients. The interview should be carried out by the most authoritative doctor in the department, well prepared not only by medical experience, but also by life experience to solve complex deontological problems. The presence of the attending physician during the conversation is also mandatory.

It is necessary to emphasize once again that the issue of surgery or another method of treatment that is dangerous for a cancer patient should be decided collectively, and the conversation with the patient and his relatives on this topic must be conducted by the most authoritative doctor of the given team. This should become the norm of behavior for people working in the oncology department, and should not cause any internal disagreements or mutual mistrust.

The same should be said about choosing a surgeon. Resolving this issue requires great tact from the head of the department. This question is not worth raising at all. Both parties imply that the patient trusts the entire team of the department, and the head of the department guarantees that the operation is performed at the required operational and technical level.

If the patient and his relatives request that the operation be performed by a certain doctor and the operation can actually be performed by this doctor, then there is no reason to refuse the patient, even if this doctor does not directly treat this patient. Another decision may lead to the patient’s refusal to undergo surgery and the loss of time, so precious to the patient himself, on persuasion and explanations.

Only when a doctor who has earned the trust of his patient is not ready to perform an operation of the required volume and complexity, the head of the department, in a conversation with the patient and his relatives, should, emphasizing respect for the doctor they have chosen, say that the department has some specialization of doctors . The profile of the chosen doctor is somewhat different. He, the manager, will personally ensure the quality of the operation.

There is also the opposite situation, when the most experienced head of the department, due to his age or state of health, cannot perform this operation, but the patient trusts him, having learned from other patients, and sometimes from the press, about his skill and good outcomes of operations performed in past years.

Every experienced surgeon, especially an oncologist who performs complex, multi-hour volumetric operations, has to eventually move away directly from work at the operating table and limit his surgical activities. One or more students are ahead of their boss in a purely technical sense, but have not yet had time to gain his experience and wisdom, which comes with age.

The wisdom of a teacher should be manifested not only in diagnosis and choice of treatment tactics, but also in the ability to maintain a healthy team, not create competition with students, and at every stage of a doctor’s entire life, take the right place in the team he leads. In this case, the leading oncologist surgeon explains to the patient who has approached him with a request to personally operate that he will definitely take part in the operation.

The balance of power at the operating table, especially now when most operations are performed under anesthesia, ultimately remains unknown to the patient. He must have complete confidence that the operation is being carried out by the “first team” of operators, and in no case should there be deception. Nihilism in these cases is not acceptable. Failure to comply with the “ritual” becomes known to other patients and can be a reason for refusing operations. In cases where these simple deontological rules are not followed, a conflict situation inevitably arises.

Nursing staff both in the clinic and in the hospital play an important role in creating a sincere atmosphere. Many nurses perfectly understand their place in the oncology service system and correctly assess the mental state of patients. Still, the work of a nurse in an oncology department is very difficult, and not everyone is capable of working in the complex atmosphere of an oncology institution. S. B. Korzh gives the following striking example:

Nurse X. performed her professional duties well and accurately. She has never been subject to administrative penalties. But here are the facts indicating that her choice of profession turned out to be wrong; her sister works without a soul.

The patient asked her sister for headache powder. An hour passed, maybe more, but the sister still didn’t give me the powder. When the patient again asked to give her the powder, the sister got angry and said: “Wait, you won’t die from a headache, but you will die from the disease with which you came here.” This was said in the ward in the presence of several other patients with cervical cancer.

After such a frank statement from the nurse, the patients were extremely upset, cried and lost their peace of mind for a long time. A month later, this nurse in another ward, when asked by a patient what illness she had, answered: “If I tell you what you have, the doctor will cut out my tongue.” This was said to the patient, who an hour before had been in a deep faint... Such obvious cruelty forced the head of the department to invite the sister to his office for an explanation. She expressed her attitude towards the sick and towards her profession in one phrase: “I will not be their sun.”

Many complaints arise due to incomplete information that patients and their relatives receive from paramedics, nurses and roommates. The reason for this is primarily due to the insufficient deontological qualifications of some doctors who do not find the time or desire to have exhaustive conversations with interested parties. The lack of information, when it is absolutely necessary, in patients with malignant neoplasms, experiencing the fear that is natural for this category of patients, forces them to look for new sources of information, often completely incompetent, from which patients receive perverted descriptions of the doctors treating them, fantastic information about supposedly unusually effective drugs, who begin to urgently “get”, etc. The search for additional consultants and other methods of treatment begins. As a result, an extremely nervous environment is created around the patient, interfering with planned and carefully thought-out examination and treatment.

It is common for cancer patients to attempt to consult with many doctors at different institutions. At the same time, they are driven by a natural and understandable desire to overcome fear, perhaps to discover an error in the diagnosis and hear the offer of a less stressful, more gentle treatment. At the same time, many patients carefully hide from both the consultant and their attending physician the facts of visiting another doctor, based on the following considerations. Firstly, they do not want to offend their doctor or spoil their relationship with him by the appearance of mistrust. Secondly, patients want to hear from the consultant his own opinion, not related to the previous diagnosis.

In such cases, it is not at all difficult to guess what is happening. The attending physician commits a deontological error if he at least makes it clear to the patient about his offense at the lack of trust, even if there is one. In reality, the doctor can only be offended by himself, because the patient’s appeal to another doctor for advice indicates that he, the doctor, is not authoritative enough for his patient. This means that he did not do everything convincingly, he himself did not understand this in a timely manner and did not organize such a consultation.

The normal situation from a deontological point of view should be the participation of the attending physician in all consultations and consultations concerning his patient. He must himself determine who and when to show the patient to and promptly inform him of his plans, and take care of his spiritual care from the Church. Then there will be no search for experienced doctors on the side, consultations on the sly, conflicting judgments that create confusion and uncertainty in the patient and lead to loss of time and delay in starting treatment.

The behavior and deontological training of the doctor consulted, who usually has extensive experience and extensive scientific titles, play a very important role in the fate of the patient. Often the consultant finds himself in a difficult position, not having received at the time of the examination a set of objective data that had already been collected by that time by the attending physician.

Considering the difficulty of making a detailed and substantiated oncological diagnosis and developing the correct modern tactical decision, a consultant, agreeing to examine a patient being examined in another institution, as a rule, must set the condition that the patient be introduced by the attending physician, having all the examination data in hand. Then the consultation immediately takes on the correct character and can allow a truly very experienced doctor to give useful advice on clarifying the diagnosis and choosing an adequate treatment method. If the participation of the attending physician in the consultation is impossible, but he knows about it, then before examining the patient, the consultant must obtain the necessary information from the attending physician by telephone or other means, and the outcome of his conversation with the patient must be reported to him before the patient comes back for an appointment. . Only such behavior is deontologically sound and justified.

Being a representative and sometimes the leader of a certain direction in oncology, affirming and promoting his existing system of views, the consultant should not, has no right to forget that his point of view may not be the only correct one, and most importantly, that the patient does not care about scientific disagreements. An example is the controversy surrounding the treatment of breast cancer.

For many years, the Leningrad School of Oncologists regularly promoted and practiced the use of postoperative chemotherapy for relatively early forms of cancer of this localization. At the same time, at the Moscow Scientific Research Institute named after. P. A. Herzen, for these same forms, only surgical treatment was used. When analyzing long-term results, almost identical data were obtained. Consequently, until the large randomized trials currently underway in many countries are completed, which will make it possible to objectively establish truly optimal treatment methods for each stage and form of the disease, no doctor has the right to speak negatively about the methods in a conversation with patients. used in other institutions, giving rise to doubts among patients about the correctness of the recommended or performed treatment.

Here's another example. In a number of scientific studies carried out on large, but retrospective material, it was proven that in case of melanoma of the skin it is necessary to perform prophylactic lymphadenectomy. This seemed obvious primarily because when examining lymph nodes removed for prophylactic purposes, melanoma metastases were found in almost 1/4 of the cases. An international randomized study conducted with the participation of Russian scientists, using a very large number of carefully controlled observations, found that prophylactic lymphadenectomy for skin melanoma does not improve treatment results, while therapeutic lymphadenectomy for palpable nodes is undoubtedly useful. What basis did doctors have for telling patients who had been treated for the primary lesion without prophylactic lymphadenectomy that the doctor who treated them was using the wrong, erroneous tactics?

When assessing the prescribed or performed treatment, the consultant only then has the right, in a cautious manner, and even then not to the patient, but to the attending physician, to advise a change in tactics or additional treatment if he is sure of the insufficiency or inadequacy of the treatment, and not only from his personal point of view, but also based on the main, fundamentally important prognosis factors.

For example, in oncology, regardless of the general settings of a particular clinic, it seems necessary to carry out complex or combination therapy for breast cancer in the presence of regional, especially multiple metastases. This point of view at this stage of development of oncology is generally accepted, and disagreements concern only the choice of methods of additional exposure (radiation therapy, chemotherapy, etc.), as well as the sequence of their use. Therefore, for example, if during a consultation with a patient with breast cancer stage T2-N2-MO the attending physician decided to limit himself to surgical treatment only, then the consultant must make adjustments to the treatment plan, but do this carefully, without instilling in the patient the idea that the measures being taken are incorrect.

If the patient is prescribed chemotherapy, and the consultant prefers a combination of radiation and hormonal therapy, he has no moral right to change the prescription. It is only possible in contact with the attending physician, and not at all with the patient, to try to justify the recommended amendments to the treatment plan. Any other behavior of the consultant from a deontological point of view is incorrect, because it worsens the patient’s mental state and gives rise to doubts about the correctness of the treatment with all the ensuing consequences.

The greatest deontological difficulties are encountered when providing medical care to cancer patients of clinical group IV. As is known, responsibility for these patients lies with local therapists with consultation and assistance from district oncologists. However, it is local therapists who are least prepared in matters of deontology in relation to cancer patients. Most often, the incorrect behavior of doctors lies in the fact that, when faced with significant psychological difficulties at the bedside of a seriously ill patient at home without the prospect of a full recovery, they voluntarily or involuntarily strive to limit communication with this person, rarely visit him, and do not know how to create an environment of struggle for his health and life. The patient develops, in addition to fear for his fate, a feeling of abandonment, uselessness, and detachment.

At the same time, the doctor, using basic psychotherapy techniques, regulating the patient’s nutrition and physiological functions, promptly bandaging him or emptying the body cavities of fluids (evacuation of ascitic or pleural fluid, etc.), can significantly improve the patient’s general condition. Even the most seriously ill patient, with the skillful behavior of the doctor and relatives, is able to believe in the success of treatment.

An example of this is the medical history of N. I. Pirogov. In 1881, the medical community solemnly celebrated the half-century anniversary of the medical and scientific activities of the outstanding surgeon. In the small Ukrainian village of Vishnya, where the “old doctor” lived (as N.I. Pirogov called himself in the “Diary” he was working on in those days), messages of greetings arrived from all over Russia. Various medical societies and institutes elected N. I. Pirogov as an honorary member; Memorial chambers were opened in his honor, and personalized scholarships were established.

Nikolai Ivanovich had not experienced such spiritual uplift for a long time. And if it weren’t for the ulcer in the mouth, which sometimes stung and made itself felt, everything would have been great. “Isn’t this a cancerous thing?” - Pirogov sometimes asked his wife and immediately drove away this terrible thought.

May 21 was approaching - the “round” date and the climax of the celebration. Nikolai Ivanovich arrived in Moscow, where he became an honorary citizen these days. He was honored at the university. The artist I. E. Repin expressed a desire to paint a portrait of the surgeon, and Pirogov posed for him several times.

Busy with the anniversary celebrations, he completely forgot about the wound in his mouth and only a few days after his arrival in Moscow showed it to Professor N.V. Sklifosovsky. Meanwhile, the ulcer managed to increase. The diagnosis was beyond doubt: cancer of the upper jaw. The very next day, an authoritative medical council met and decided to operate on the famous surgeon.

This news seriously traumatized Pirogov. Having hardly sat through the grand banquet at the Assembly of Nobility, which was held in his honor, he, at the insistence of his wife and relatives, went to Vienna to the famous European surgeon Theodor Billroth. After examining the patient, Billroth categorically rejected the previous diagnosis and reassured his brilliant patient. According to the testimony of Doctor S.S. Shklyarevsky, who accompanied N.I. Pirogov on this trip, “N.I. Pirogov’s disposition of spirit in Vienna changed sharply and quickly: from the murdered and decrepit old man he was during the road from Moscow to Vienna, he again became cheerful and fresh... N.I. and those accompanying him were full of happiness.”

Billroth gave Pirogov his photograph as a souvenir with the following inscription on the back: “Dear teacher Nikolai Pirogov. – Truthfulness and clarity of thoughts and feelings, both in words and in deeds, are the steps of the ladder that brings a person closer to the gods. To you, who must follow this not always safe path as a reliable leader, is always my zealous desire.

Your sincere admirer and friend is Billroth.”

Upon returning home, Nikolai Ivanovich sent him his portrait. Pirogov’s cheerful and good mood, caused by Billroth’s categorical conclusion about the benign nature of the ulcer, lasted almost until his death.

Was Billroth wrong in his diagnosis? From published epistolary materials it is known that he knew about the true nature of the disease. However, the patient’s advanced age and the neglect of the process did not allow him to offer surgery. “It’s unlikely he would have undergone surgery; but even with a favorable outcome, one would have to fear a very quick relapse,” he wrote to Doctor Vyvodtsev in Russia. Billroth used his unquestioned authority to instill in Pirogov hopes for a favorable outcome of the disease and thereby provided him with peace of mind. “...I wanted to divert the patient’s attention from the nature of his illness, to maintain fortitude and patience in him... I acted as my duty and many years of experience prescribed me...”, he explained his behavior to the same addressee.

The core of medicine is mercy, and if it is impossible to radically help the patient, then we must strive with all our might to alleviate his suffering.

Most complaints arise when hospitalization is denied to patients of clinical group IV. It is not uncommon for heads of health authorities and institutions to make no difference in the concepts of hospitalization “for care”.

First concept- purely medical, and for palliative therapy patients must be hospitalized without fail. This refers to hospitalization for the imposition of an unnatural anus, elimination of airway stenosis and other important non-radical operations and manipulations.

It is deontologically correct to determine the indications for palliative treatment when it is not caused by emergency indications, talk with the patient and his relatives about the actual period of the patient’s placement in the hospital and explain why this is being done. Palliative therapy almost always brings relief to patients, and they willingly return home, especially if they are in good contact with the local doctor and local oncologist and are confident that at home they will be surrounded by attention and receive all the necessary medical care. If the doctor behaves incorrectly and does not understand the tasks of deontology, then misunderstandings arise and then complaints are inevitable.

Second concept– hospitalization “for care” is social and means the hospitalization of those patients who do not have relatives or their living conditions do not allow them to sufficiently organize medical care at home. Experience shows that if such patients are denied hospitalization and they begin to contact higher authorities, then sooner or later they will still be hospitalized, even if the head of the health care institution seems to have insufficient social validity of the demands of the patient and his relatives. Therefore, one should not insist on refusal and give advice to the patient’s relatives about reorganizing their life and work to serve a seriously ill patient at home.

Doctors are obliged to take care not only of saving a person’s life, but also of creating an encouraging moral atmosphere around the patient. If a conflict situation arises around a patient with a malignant tumor belonging to clinical group IV, the doctor’s duty is to find an opportunity to at least temporarily change this situation. Hospitalization in such cases immediately changes everything dramatically and eliminates the conflict.

Is cancer cured by performing the Church Sacraments?

Is it possible to cure cancer by performing church sacraments? It's possible, although it doesn't happen often. Usually, healing is associated with internal changes in a person that occur in the Sacrament of Repentance. Cleansing the soul leads to healing the body. As a result of unction (the Sacrament of Anointing), the Lord forgives a person for sins that he committed out of ignorance or that he forgot during the course of his life over a long period of time. Unction is a sacrament, during or after which the patient’s mental strength is strengthened and his physical condition is improved until the tumor self-destructs.

Cases of God's help in the form of healings are possible after prayers before the icons of the Mother of God, the relics of the holy saints of God (see appendices) and other shrines. Sometimes it happens that after prayers a person is not healed of a tumor, but it seems to “freeze”, “freeze” at the stage at which the person came with a request to God. There is a group of patients who have passed all the deadlines for which both metastasis and transition to another stage should have occurred, but everything “stopped.” This is a manifestation of the action of God’s grace, strengthening the mental and physical makeup of a person, according to the strength of his faith and trust in the Creator.

Often, a patient can receive a significant improvement in his condition and even possibly recover from immersion in the waters of the Holy Springs. To this day, near ancient Russian monasteries there are springs that, in addition to their beneficial powers, have natural healing properties due to the unique chemical composition of the water they contain. Every diocese, every Russian province has its own local shrines, which you can learn about and to which you can and should resort.

However, the oncologist and cancer patient should know that another process is also possible - rapid malignancy (“malignization”) of tumors. The reason for this is the influence of a psychic, sorcerer, bioenergetics, etc. while contacting him. The action of another force manifests itself - satanic, contrary in nature to the action of the grace of God. The price to pay for this is malignancy.

Saint Luke of Crimea is one of the righteous people who are most often turned to for help in illnesses. Along with Saint Panteleimon, he is the quickest helper and intercessor before God for all those who are sick. On the path to recovery, it is important not to forget in whose hands our lives and all good are in. The saint prays to the Almighty for all the sick and those who are already on the road to recovery.

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For the miracles of healing, the saint received recognition during his lifetime - Professor Voino-Yasenetsky headed the department of operative surgery and there were legends about his talents. Saint Luke combined medical work with his priestly vocation, healing ailments not only of the body, but also of the soul. And just as the saint helped the sick during his lifetime, he helps now.

About Saint Luke

A prayer to Luka Krymsky for healing will help the patient even in very difficult cases, when it seems that there is no hope. Even during his lifetime, the saint had a reputation as a famous scientist, a talented surgeon, a specialist who wrote works on purulent surgery, which are still used today. There were legends about the saint's high medical skill - if he was given a book and told to cut through a certain number of pages with a scalpel, the saint was never mistaken. The saint endured many trials during his life: due to persecution of the church, he was exiled three times, did not agree to an offer to head the department in exchange for refusing priestly service, and at the end of his life, after suffering from an illness, he became blind in one eye.

People turned to the saint in prayer at his grave long before his canonization. Orthodox Christians felt that the archbishop was helping them from heaven. The church added the healer to the list of saints in 1995, and his relics are in the Simferopol Cathedral.



About healing

An Orthodox person endures illness courageously, as a remedy for the atonement of sins, but it is not considered shameful to ask the Lord for recovery. Whether God will send healing or not is unknown for sure, but a person, asking for help from the saints, can trust in His holy mercy. There is the will of God for everything, which both gives health and can deprive it.

When praying to the Lord for a sick person, you should ask Saint Luke for healing, since he is known as the patron saint of all those who suffer and the deliverer from illnesses. When visiting church, you should order notes about the sick, place candles in front of the icon of St. Luke and pray for the need. In the temple you can order prayers for health to a specific saint, which are read by the priest. After reading a prayer service mentioning the names of the sick, everyone is sprinkled with holy water.

At home, prayers should be read daily, adding requests to the saint to the morning and evening prayers. The number of readings is not so important, although repeating the prayer up to 40 times can achieve greater results. It is better to read the texts of prayers for recovery in front of the saint icon; you can light a church candle. Sincerity and perseverance in turning to the Lord will be rewarded to the one who prays a hundredfold. Before praying for healing, it is necessary to ask for forgiveness of the sins of the sick person. In order for a saint to intercede for the sick, one must get rid of bad habits, foul language, and avoid theft and deception. Often illness is sent as a punishment, or to protect a person from falling into more serious sins.

The shortest but most powerful prayer to the saint is the appeal: “St. Father Luke, pray to God for us”

Text of prayer for all diseases:






Before and after surgery

Those who are about to undergo surgery must prepare themselves not only morally, but also spiritually. If your health condition allows you to visit the temple, it is worth taking advantage of it, because the church offers many means for saving the soul and well-being.

Before going to the hospital, a Christian confesses, takes communion, and asks his confessor for a blessing for the operation. If possible, you should order a special request - a “sorokoust” for health, which is served for forty days with the mention of the name at the Liturgy. Another requirement for the occasion is a prayer service before surgery. All those submitting notes need to know that church prayer is valid only when it is accompanied by the request of those who ordered it.

If the sick person has Orthodox relatives or friends, they are usually asked to pray together. Such general prayer for a specific need is called a petition by agreement and has very effective power.

When going to a medical institution, it is important not to forget to take a prayer book, an icon of Christ, your heavenly patron and St. Luke. The presence of icons nearby will help create a prayerful mood and give the patient confidence in heavenly support. In small containers you can take blessed oil and holy water. There should be a pectoral cross on the body, as a personal shrine that protects and protects from diseases and troubles.

On the day of the operation, handing yourself over to the hands of the doctors, you should read the “Our Father” prayers, the prayer to St. Luke and St. Panteleimon, and internally surrender yourself into the hands of God. The Lord does not require from the sick person those daily appeals that are written in prayer books for the healthy, so you can turn to God in your own words or with short prayers.

Prayer before surgery:




If the patient is formally baptized, but in practice does not even know the basic prayers, you should try to convince him to pray as best he can, the main thing is ardent faith that his request will be heard and hope for a successful outcome.

Upon completion, you need to thank God for the successful operation, and St. Luke for the heavenly help provided. It is customary to read special prayers of thanks.

Text of the prayer:

If you suddenly fall ill and cannot cope with a serious illness, be sure to read the prayer to Saint Luke for healing and health.
It is to this apostle that Orthodox Christians turn when they want to be healed of their illness.
Saint Luke also helps to get rid of the witchcraft interference of an evil person.
Saint Luke of Crimea helps those in need even after his death.
If you do not have his Orthodox icon, be sure to purchase one from the Temple.
Light 12 church candles. Place the icon of Luke and a glass of holy water nearby.
With faith in your soul, imagine your own health and peace of mind.
Having crossed yourself, begin reading the prayer lines.

Saint Luke, healer and magician. Heal me from illness and disease, save me from mental pain. Cleanse me from sinful scourge, from carnal and tempting sweetness. Reject the villains and sorcerers and heal our souls forever and ever. Thy will be done. Amen.
Sip holy water.
Cross yourself heartily.
If the disease is advanced, pray for health until complete recovery.
And Luke will certainly hear you.
Be healthy!

PRAYER TO LUKA OF CRIMEAN FOR HEALING

O all-blessed confessor, holy saint, our Father Luke, great servant of Christ. With tenderness we bow the knee of our hearts, and falling before the race of your honest and multi-healing relics, like the children of our father, we pray to you with all earnestness: hear us, sinners, and bring our prayer to the merciful and man-loving God, to whom you now stand in the joy of the saints and from the face of an angel . We believe that you love us with the same love that you loved all your neighbors while you were on earth.
Ask Christ our God to confirm His children in the spirit of right faith and piety: to the shepherds to give holy zeal and care for the salvation of the people entrusted to them: to observe the right of believers, to strengthen the weak and infirm in the faith, to instruct the ignorant, to reprove the contrary. Give us all a gift that is useful to everyone, and everything that is useful for temporary life and eternal salvation: the establishment of our cities, the fruitfulness of the land, deliverance from famine and destruction, consolation for the afflicted, healing for the sick, return to the path of truth for those who have gone astray, blessing for the parent, blessing for the child in distress. The Lord's upbringing and teaching, help and intercession for the orphaned and needy. Grant us all your Archpastoral blessing, so that if we have such prayerful intercession, we will get rid of the wiles of the evil one and avoid all enmity and disorder, heresies and schisms. Guide us on the path that leads to the villages of the righteous, and pray for us to the omnipotent God, in eternal life we ​​will be worthy with you to constantly glorify the Consubstantial and Indivisible Trinity, the Father and the Son and the Holy Spirit. Amen.

Video and prayer to St. Luke performed orally (you can just listen to the prayer and repeat it to yourself).