Valeria Nazarenko
Oct 6, 2025
Good afternoon, Natalya Yurievna,
and everyone who was involved in our experience of interacting with the Spizhenko clinic.
I did not dare to write this letter for a long time.
Several years have passed, but I still have the feeling that my husband could have lived at least longer if someone had looked at the facts more carefully.
A little context.
My husband was given an extremely rare diagnosis - adenoid cystic carcinoma stage IV, a locally advanced form. He underwent proton irradiation. A few months later, bone metastases appeared.
Since this was atypical for ACC, a biopsy of the metastasis was performed, the results of which led to a suspicion of Ewing's sarcoma. It was impossible to wait for treatment - he received two courses of "sarcoma" chemotherapy.
And it was then that positive dynamics were pronounced.
The tumor decreased, the pain disappeared, and the blood parameters improved.
And then came a second result from another laboratory, which confirmed ACC after all.
And the treatment was immediately changed - to the standard protocol for head and neck tumors.
I understand that formally it looked logical.
But this is precisely the tragedy: where clinical intuition and a desire to understand were needed, automatism worked.
After all, ACC is considered a chemoresistant disease, and here a case of reaction to the sarcoma regimen was recorded. And at least it was necessary to consider the possibility of continuing it - it was a chance.
Later, we independently initiated tumor sequencing and discovered the NOTCH1 mutation, a potential therapeutic target.
We found publications, clinical trials, examples of the use of bortezomib for similar mutations.
He tried to discuss this with you, but, unfortunately, he did not receive any support or interest.
After Covid, his condition deteriorated sharply, new metastases appeared in the liver.
And then we finally understood that in the eyes of the clinic he was already “written off”.
I don’t want to go into the details of how we had to seek at least minimal help when he was already lying there fighting for every breath.
I don’t blame you for his death.
But I must say: medical indifference can kill just as much as the disease itself.
You know perfectly well that the same tumor in two people is not the same disease.
Every mutation, every response to therapy can be the key to life.
And if there is even a minimal chance, the doctor should try to understand why it worked, and not dismiss it.
I am writing this not out of malice or resentment.
I am writing to remind you - about conscience, about attentiveness, about the meaning of the profession,
which is not about being right, but about saving.
Sometimes a person's life depends not on the drug, but on the doctor who found the time to read another scientific article,
to think outside the box, take a step outside the protocol - and save him.
My husband died.
But I want his story to remind you: behind every analysis, behind every case, there is a person.
And sometimes all he needs is for you not to lower your eyes.
Sincerely,
Valeria Nazarenko




