There are moments in life that change people and their lives forever. This happened in the fate of the participant of the project "I will live!" Ruslana Shuk. A bright red dress, model appearance and a confident gaze. Looking at Ruslana's portrait, it's really hard to imagine that a few years ago she had to literally fight for her own life and the life of an unborn child.
It all started in 2018 during pregnancy. Doctors attributed constant weakness and excruciating nausea to toxicosis. In the third month, the gynecologist sent Ruslana for an endoscopic examination of the stomach. The examination showed the presence of a tumor. Ruslana was in Odessa at the time.
The pregnant woman was sent to Kiev. There, she first learned about lymphoma. This is where doctors announced a verdict: termination of pregnancy and chemotherapy.
“They made it clear to me that there is practically no chance that I will survive, let alone a child. But it was on the day when the diagnosis was announced that the baby began to move. I made a clear decision: I would keep the baby at any cost. My mom was told: "You will lose both of them," Ruslana recalls. “Of course, there were doubts. But I am a religious person, and I did not understand how I could have an abortion and then ask God for my own salvation. With this thought in mind, I went to the church, where I was told: Everything will be fine with you and your child. With these words in mind, I went through my whole journey.”
The warning of Kiev doctors did not stop Ruslana. Medical documents with the request: "Treatment of primary mediastinal large B-cell lymphoma at 4 months of pregnancy" were sent to medical tourism companies in all countries of the world. The answer, like a carbon copy, came from Germany, Austria, America, Israel: "There are no standard treatment protocols. It is not possible to preserve the fetus at such a time."
At that moment Ruslana thought about Russia. She turned to friends in Moscow who helped her find a treatment center.
“When I left, the Kiev doctors sent me with these words: "You will not find a cure, everyone is treated with the same protocols. And there are simply no such protocols where treatment can begin at the 16th week of pregnancy, while preserving both the mother and the child.” But I clearly understood that if I did not save the child, I would not save myself. Either I keep the baby, or we both die.”
Ruslana flew to Moscow with her mother. Upon arrival, she was admitted to the National Medical Research Center of Surgery named after A.V.Vishnevsky. Based on the revision of the paraffin blocks, she was accurately diagnosed with primary mediastinal lymphoma involving the anterior mediastinum of the left lung with a secondary stage 4 gastric lesion. She was recommended to contact the NMRC for Hematology, where patients are treated not only with standard protocols.
As a result, Ruslana got an appointment with Valeriy Grigoryevich Savchenko. At that time, he was the director of the NMRC for Hematology of the Ministry of Health of Russia.
“He told me that I was not the first pregnant woman with such a diagnosis, and that they were ready to start my treatment. After that, the choice was obvious. I have never heard of such opportunities anywhere in the world. Medical tourism companies sent requests to all countries of the world, but no one wanted to help me. Yes, Valery Grigorievich also said that the deadline is short, but he did not refuse treatment!”
Then the treatment began. Ruslana spent 10 days in intensive care. In 4 months, she underwent five courses of chemotherapy in the Department of Intensive High-dose Lymphoma Chemotherapy under the guidance of Dr. Evgeny E. Zvonkov.
“I set myself the goal of having a healthy baby. I wasn't afraid for my life. I simply told myself that I was just in the hospital for the protection of my baby.”
On 27 June 2018 a planned operative delivery was performed at the Family Planning Center. A healthy boy was born. As Ruslana admits, it was the greatest joy in her life.
However, the happiness did not last long. Another PET CT scan showed the progression of the disease with damage to the central nervous system. The question arose: "what do we do?" The patient was just out of surgery. There was no guarantee that high-dose chemotherapy would help.
“That's when we found out that the so-called CAR-T therapy. This is cell therapy, when cells are taken from a patient, genetically modified and injected back into the body. Cells can penetrate the blood-brain barrier, eliminate the tumor even in the central nervous system, which practically no chemotherapy can do.”
In 2018, CAR-T therapy was performed in America, Israel and China. The US clinic charged 1.5 million dollars. Israel - 200 thousand dollars. China – 40 thousand dollars.
“Initially, I did not even consider treatment in China, because the concept of "Chinese counterfeit" had taken root. As a result, thanks to the help of family and friends, I flew to Israel. However, they told me that without a second line of chemotherapy and bone marrow transplantation, CAR-T therapy would not be done. I was outraged. Transplantation and chemotherapy could have been done perfectly well in Moscow. I returned to Russia.”
Only China remained. In China, the treatment is conducted by Professor of the University of Florida and the initiator of CAR–T therapy, Professor Lung-Ji Chang.
“I began to feel better immediately after the first injection of cells. However, due to low blood counts, I did not dare to return home immediately.”
During the three months that Ruslana lived in the hospital, the professor suggested that she be injected with a second and third dose of cells. At the professor's request, she communicated with Russian patients. Upon returning to Moscow, Ruslana first and foremost came to the NMRC for Hematology and visited the head of the department, Doctor of Medical Sciences, Evgeny E. Zvonkov.
“He was very happy for me. CAR-T therapy had just started to gain momentum in Russia, and the first patients were children. The experience of treating an adult patient with cell therapy had aroused interest. I continued to be observed at the NMRC for Hematology. After a while, Professor Long-Ji Chang invited me and Evgeny E. Zvonkov to take part in an international conference.”
At the conference, a doctor from Russia presented to the scientific community the experience of treating a patient with lymphoma during pregnancy. And a professor from China spoke about the use of cell therapy. After this conference, international cooperation began. Russian patients were sent to China for CAR-T therapy. Excellent knowledge of the English language and sociability did not go unnoticed. Six months after the therapy, Professor Ling-Ji Chang offered Ruslana a job as a coordinator for working with patients from Russia and the former CIS countries.
“He decided that he needed a Russian-speaking employee who had undergone CAR-T therapy and was showing positive results. I received special training for two months. Organizationally, I help patients interact with the clinic and receive cell therapy. I work as Director of Marketing and Organizational Affairs for Professor Ling-Ji Chang and GIMI in Russia and CIS countries.”
The illness and the birth of the baby taught Ruslana to treat life differently and to appreciate those around her.
“I want to give a huge thank you to Evgeny Evgenievich Zvonkov. He is a wonderful person and a specialist with a capital letter. To Nellie Georgievna Gabeeva- this is a person who lives by her work. She is always in touch and ready to help at any time of the day or night. She can give great comfort, and when necessary, then “give a good talking to.” For me, she is more than a doctor. I would also like to thank Svetlana Andreevna Tatarnikova. When I was pregnant, she, while still a resident, practically lived in my ward. She is a wonderful doctor and a great person.”
Having walked her path, Ruslana wishes patients dedication, strength, patience and faith. And the most important thing is not to give up and move towards recovery with purpose.
