Navchaa, Doctor of Medicine, and Consulting Doctor of Oncology

Currently, more than 1,600 clients have undergone comprehensive cancer screening at the AI-based NURA Center. We talked to G. Navchaa, Doctor of Medicine and Consulting Doctor of Oncology, about the NURA early detection and comprehensive testing center.

I have seen many statistics that show that Mongolia is leading in the incidences of cancer. What is the main reason behind it? As an Oncologist, could you please provide us information about why the number of cancer incidences is increasing?

Cancer is not only a pressing problem in Mongolia, but it is also a global problem that is the leading cause of illness and death in almost all countries around the world. Countries like Denmark, Ireland, Belgium, and Australia, with more than 300 cases per 100,000 population, exhibit a higher incidence than Mongolia (229 cases per 100,000 population), but they experience a lower mortality rate.It is disheartening to note that our country leads the world in terms of cancer deaths (175.9 per 100,000 population). According to a study by the International Agency for Research on Cancer, cancer incidences worldwide are projected to increase by 20-30 percent by 2030 and by around 55 percent by 2040. Some countries are urging their citizens to “live with cancer”. The idea contained in the appeal, which may sound surprising or objectionable, is to prevent cancer as much as possible by leading a healthy lifestyle, treat and control precancerous diseases without progression, and further, in case of cancer, detect and treat it comprehensively at an early stage, and get back to normal. It means getting back into life and living whilst adapting to it.

In our country, 70-75 percent of cancer cases are diagnosed at later stages, typically the 3rd and 4th stages, leading to significantly reduced chances of complete recovery and a higher death rate. The irresponsibility and indifference of individuals have a significant impact on late diagnosis. People lack understanding about healthy eating, and many mistakenly believe that people who have unhealthy diet, drink alcohol and smoke live normal lives regardless of their habits.Many cases involve individuals neglecting minor illnesses and avoiding hospital visits. When the disease worsens to the point where working and living become too difficult, they finally seek medical attention because they can’t endure the pain, but by then, it’s already too late.Some people think that they should not make their family suffer because of their illness. However, it would be even more unfortunate if their loved ones couldn’t save them, even after giving away all their possessions, selling everything in their house, or, worse still, donating their liver and kidneys.

The topic of early detection has been actively discussed recently. What policies are implemented in foreign countries in this regard? Maybe there is someone who is still putting off their diagnosis. Could you please remind them again of the importance of early detection?

The main goal of NURA early detection and comprehensive testing center is to detect cancer at an early stage when the person has no symptoms. By doing so, the center aims to increase the chances of complete treatment and recovery, elevate the average life expectancy of Mongolians, and enhance overall quality of life.

Many factors affect the development of cancer, such as heredity, genetic factors, unhealthy lifestyle, and toxins etc. However, according to WHO recommendations, research suggests that 60% of cancers can be prevented by adopting a healthy lifestyle.A research article published earlier this year by Irish researchers found that excess body weight is a risk factor for breast, colon, esophageal, kidney, gallbladder, uterine, pancreatic, and liver cancers. For instance, if a woman is overweight, her risk of developing breast cancer increases compared to women of normal weight, and if she does get cancer, the rate of recovery decreases.

As mentioned above, in Mongolia, more than 70% of cancers are diagnosed at a late stage, while in Japan, 70-80% are diagnosed at an early stage. This is why the rate of complete recovery is higher in Japan, and the death rate is lower than in our country. It is not only early detection that reduces morbidity and mortality, but also the fact that Japanese people lead a healthy lifestyle, eat right, exercise regularly, try to work as much as possible despite their old age, and generally have good health education.Another important factor is that primary hospitals and small specialized clinics have a very accessible system for screening and diagnosis, and large hospitals only serve those who need specific treatments. In general, it takes 10-15 years to train a specialized doctor, and the procedures and operations performed by these doctors in a high-level specialist hospital, including the products, drugs, and equipment they use, are expensive.Therefore, for example, the National Cancer Center of Mongolia (NCCM), if a certain number of people with a specific diagnosis of cancer are diagnosed and start further treatment, and if most of the time is devoted to research related to this, while it is effective, a lot of time is spent on to diagnose people who are relatively healthy or do not need the same diagnosis and treatment and overloaded with such cases.Oncologists see dozens of people a day, perform complex treatments such as tumor surgery, chemotherapy, and radiation therapy, whilst also counseling the patient’s family and continuing to monitor the patient’s follow-up. And it is too much of a load to handle.

In this respect, our NURA Center was established. At NURA Center, we conduct a general screening and early detection for people who wish to go to a specialized center for the diagnosis of the above tumor or are relatively healthy, and from there, we send those who are required to take a detailed tissue test or are in need to go to a hospital for a high-level diagnosis.For example, by conducting early detection for 100 people who would have otherwise sought diagnosis at the NCCM, we can identify 5 individuals with suspicions. It then will be more possible for the specialists of the NCCM to devote their valuable time to the patients who are in need and to the exact treatment that is needed for them. In this way, we believe that it will be possible to put the health system of our country on the right track, and NURA Mongolia, an early detection center is working to contribute to this.

For years, a culture of treating minor pain with pain relievers has been deeply rooted in our country. On top of that, almost everyone is tested for Helicobacter pylori, but the infection often goes untreated. Is it right to forego treatment?

There are several factors in this matter. Firstly, it depends on the individual. Some people adopt the wrong attitude of hiding illnesses due to a lack of attention or the belief that it will cause trouble for their family. Due to the lack of treatment at an early stage, it becomes even more difficult for the family when it finally gets worse.The situation worsens both emotionally and financially. Therefore, we aim to dispel this misconception and foster a culture where individuals take responsibility for themselves, their families, and loved ones, seeking early detection, treatment, and recovery”. Simply put, if you hide or ignore a disease that could have been treated with 100,000 MNT in the past, there is a risk that it might become untreatable even with 100 million MNT.

Mongolia ranks second in the world in the number of stomach cancer cases per 100,000 people. A major influence is the high rate of Helicobacter pylori infection, which causes gastric ulcer and is the main risk factor for stomach cancer in most of the healthy population.Currently, more than 1,600 people have undergone early detection package tests at the NURA Mongolia Center. Helicobacter pylori is found in more than 70% of those tested. This high percentage is indeed a matter of concern.It is regrettable that people who are unaware of their Helicobacter pylori infection, or choose to ignore, hide, or delay treatment, may opt to endure gastric ulcer and stomach cancer. Instead, they could take a combination of drugs, determined by scientific findings, for 10-14 days under the supervision of a specialist doctor, offering a 90-100% chance of recovery.

Many people feel frightened to undergo a gastroscopy to detect Helicobacter pylori which is a difficult procedure for them.

Helicobacter pylori can be detected in three ways. Methods include detecting antibodies in human feces, with a breath test, and as you just asked, by obtaining tissue samples from gastric mucosa during gastric endoscopy. If the person has been treated several times and there is no result, it may be necessary to undergo an endoscopy to determine if there is resistance to the antibiotics.If you want to determine whether you have an infection, we recommend the latest highly effective breath test method, which is painless and provides 99 percent accurate results. NURA Mongolia Center is employing this method, in which the client puts the disposable kit in his/her mouth and blows it. The most important thing is that it meets all the hygiene requirements, plus it is safe and painless. It has the advantage of showing the result on the spot.I would also like to emphasize a factor concerning why Helicobacter pylori, the cause of stomach cancer, is detected in almost everybody.

The parents, especially grandmothers, give food to small children from their mouths, blow on hot food to cool it down. Even if it is not immediately visible, the saliva is splashing there. Even worse, they give chewed food to their children, and do not use separate spoons and chopsticks when eating in the family. These seemingly simple habits, such as taking your own food from public dishes, contribute to Helicobacter pylori becoming a family disease.If only one person in the family is infected with Helicobacter pylori, it means they can infect others in the family. However, they may not realize that they are spreading the infection to their family. If you are unsure whether you have Helicobacter pylori, you should get tested. If diagnosed, you should seek treatment. This will give you a great chance to prevent stomach cancer. Overall, citizens should focus on improving their health education.Additionally, public catering establishments and restaurants should wash their reusable items, such as cups, plates, and spoons, with special hot water in a dishwasher. This will have a positive effect on reducing the spread of this bacteria.

Artificial intelligence is a widely discussed topic. What innovation is this bringing to the field of medicine? Could you please explain how it is used for diagnosis in the simplest way?

 AI, or artificial intelligence, has been in use in the field of medicine worldwide for some time now. In the future, it will definitely be used more widely. It is extensively used in the manufacturing of medical equipment, analyzing large volumes of quantitative data in health research and disease, as well as in robotic or remote surgery, and further in diagnosis.”In keeping with global trends, our NURA early detection center stands as a prime example of modern advanced technology using artificial intelligence in analysis and diagnosis. NURA Center’s computed tomography, breast X-ray machine, and DEXA devices for diagnosing osteoporosis of the whole body are based on AI or artificial intelligence.The ReiLI artificial intelligence-based computed tomography machine by Japan’s Fujifilm Corporation has been continuously upgraded since 2018 and analyzes basic data based on millions of diagnostic images. A doctor looks at dozens of images processed by a simple CT scan to detect changes, and human error is not uncommon.Then, based on its continuously growing and developing database, artificial intelligence processes dozens of images in a very short time, compares them with normal images, and provides the doctor with the changes that are likely to be abnormal. It makes the doctor’s work easier, allowing them to focus on more detailed information and spend time on analysis. These are the advantages of our center, offering the combination of ‘AI + Doctor’ for a double check-up and diagnosis.

There is a saying that “Health is everything”. There are many things to worry about, such as work, life, money, and finances, so there are probably many people who put themselves aside. Please provide us with basic advice on how to take care of our health.

First of all, I would like to make a point. Early detection is not a one-time examination. The person who received the cancer diagnosis said, ‘I was undergoing tests. Why did this happen to me?’ When the doctor asked, ‘Well, when did you have the test?’, the patient responded, ‘I had a full-body test four years ago, and I was told I was fine except for a little redness. So, I was taking medicine to treat it.’

In other words, the person knew there was a risk, received treatment, but did not have it checked again, did not even know whether the treatment was effective, and trusted their health to the medicine taken at that time. Therefore, it is recommended to undergo regular early detection once a year to have a clear and stable review of your health, changes, diseases, and treatment results. Cancer is not a disease that suddenly occurs in the human body. For instance, some studies show that stomach cancer can remain silent for several years before symptoms are detected. It takes 100-300 days for the tumor to double in size, and in some cases, it takes 1.6-9.5 years for the tumor to develop since it first appeared.In other words, a stomach ulcer or a precursor disease occurs, and then the cells go under changes and become malignant cells, which takes some time. Therefore, by regularly participating in early detection tests for a certain period of time, it is possible to diagnose the tumor in its early stages, before it turns into cancer, when it is just forming inside the cells. The probability of complete recovery can be increased to 100%.

Please tell us about the advantages of your NURA center. Maybe many people are interested in it.

The NURA Center’s computed tomography machine has the advantage of using 50 times less radiation dose, equivalent to a 97% reduction compared to other machines.

As a doctor, it pains me to see people overusing CT scans with a high X-ray dose without a doctor’s prescription, even for issues that can be clarified with other less harmful tests, such as an echocardiogram. There are even people who have it done to their young children.

There is a recommended dose for the average amount of radiation and X-rays that a person should receive in a year. When having a computer scan for the brain, the person receives a dose of 8 months of normal natural dose. For a chest, a 2-year dose of normal natural dose is received, and so on. Of course, it is a different matter to do the necessary diagnosis and to monitor the results of the treatment under the doctor’s prescription as it is used because the results of such treatment is better than the disease.It is not necessary to undergo a CT scan if you have a headache. We should pay attention to the fact that X-rays themselves are carcinogenic. For this reason, the advantage of our center is that a relatively healthy person can undergo a full-body screening with a significantly reduced X-ray dose when there are no medical prescription.Based on AI technology, it reduces the risk of human-related errors, diagnoses are made by comparing the data of “a large database with hundreds and millions of images processed by artificial intelligence”, and this conclusion is double-checked and verified by a specialist doctor.Clearly, having the 32 types of indicators explained by a qualified doctor and receiving the test results in both paper and digital formats is a time-saving advantage in today’s hectic society. It is very vital to know whether further detailed examination is really necessary in this short period of time.Since we started operating, we have detected several undiagnosed tumors and referred them to the next-level hospital for accurate diagnosis and examination at the right time. This is our contribution to the health of the population of Mongolia. Many people were diagnosed as healthy. Many people have been diagnosed as healthy. I am happy to see everyone who receives such a diagnosis.

For more information about the NURA Center, please visit our website HERE.

Contact number: 7588-7588

E-mail: Info@nura.mn

Website: www.nura.mn

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