Professor Igor Vasilevich Komissarenko
Surgeon, Institute of Endocrinology, Kiev
Great accuracy is needed when operating on the thyroid gland. You must not harm the major nerves in the neck, or the parathyroid gland. We remove the whole thyroid gland, in cases of thyroid cancer.
This is in case the cancer is growing in more than one place, but it also helps us search for metastases [secondary cancerous growths] using radioactive iodine.
There was a sharp jump in cases of thyroid cancer about three-and-a-half or four years after the accident - mostly among children. We used to have a maximum of two or three child thyroid cancer cases per year in this clinic, but in 1989 we had seven and in 1990, 21.
The closer to the source, to the Chernobyl region, the more cases of cancer. The further, the fewer. There was a release of radioactive iodine, and children were affected most because they were growing. They breathed it in, or drank it in milk.
When will it all end? I think when this generation passes away
We immediately understood they were radiation cancers, because of the way they were formed. They were also aggressive, and metastasised quickly, invading surrounding tissue.
The initial cancer might be small, but the metastases were big. In many cases there were already metastases before the illness was discovered. Another tell-tale sign was the presence, often, of multiple sources of cancer in the same gland.
In 1991, 1992 and 1993 we reached a plateau. We had up to 50 cases per year. Then in 2003 the number of cases among children and young people declined. Why? One reason is that children born after Chernobyl were not exposed to radioactive iodine, which quickly decayed. Another is that people who were children at the time of the accident were already adults.
The increase in cases of thyroid cancer among adults began after five years, and increased sharply after 10 years. Now there are lots of cases, and not only among people who were children at the time of the accident. Our diagnostics have improved. It's rare now to find children with a big cancer and lots of metastases, but it still happens with adults.
Today, the number of child patients is one-and-a-half or two times higher than before the accident, but this is due to other sources of pollution. The ecological situation is generally bad. Also, iodine was not the only isotope thrown out by Chernobyl.
When will it all end? I think when this generation passes away.