Prim\u00e1\u0159 Richard Pabi\u0161ta uji\u0161\u0165uje, \u017ee onkologi\u010dt\u00ed pacienti maj\u00ed na urologick\u00e9m odd\u011blen\u00ed v Klaudi\u00e1nov\u011b nemocnici p\u0159ednost.<\/p>\n
Rozhovor<\/p>\n
Skute\u010dn\u011b je rakoviny prostaty \u010d\u00edm d\u00e1l v\u00edc, nebo se o tom jen v\u00edc mluv\u00ed?<\/p>\n
V absolutn\u00edch \u010d\u00edslech skute\u010dn\u011b n\u00e1dor\u016f prostaty p\u0159ib\u00fdv\u00e1. Nikdo p\u0159esn\u011b nev\u00ed pro\u010d, faktor\u016f je ve h\u0159e cel\u00e1 \u0159ada, a\u0165 u\u017e jde o stres, \u017eivotn\u00ed styl, genetick\u00e9 faktory\u2026 D\u016fle\u017eit\u00e9 je s t\u00edm n\u011bco d\u011blat. U n\u00e1s na Boleslavsku existuje u\u017e od roku 2002 preventivn\u00ed program Zdravotn\u00ed poji\u0161\u0165ovny \u0160koda, ur\u010den\u00fd k vyhled\u00e1v\u00e1n\u00ed ran\u00fdch st\u00e1di\u00ed karcinomu prostaty. To je vynikaj\u00edc\u00ed v\u011bc, kter\u00e1 m\u016f\u017ee opravdu zachra\u0148ovat \u017eivoty.<\/p>\n
– V \u010dem ta prevence spo\u010d\u00edv\u00e1?<\/p>\n
V urologii existuje jeden velk\u00fd pomocn\u00edk. Je to krevn\u00ed marker (ukazatel) PSA (Prostatick\u00fd specifick\u00fd antigen, pozn. red), jeho\u017e zv\u00fd\u0161en\u00e1 hodnota v krvi m\u016f\u017ee signalizovat vznik a v\u00fdvoj zhoubn\u00fdch zm\u011bn v prostat\u011b. \u00dakolem praktick\u00fdch l\u00e9ka\u0159\u016f tedy je u v\u0161ech mu\u017e\u016f nad pades\u00e1t let odebrat jednou za rok krev a nechat ji otestovat pr\u00e1v\u011b na onen zm\u00edn\u011bn\u00fd PSA. Pokud se uk\u00e1\u017ee jeho zv\u00fd\u0161en\u00e1 hodnota, ode\u0161le pacienta k n\u00e1m na urologii a my si pacienta do vy\u0161et\u0159\u00edme. Zv\u00fd\u0161en\u00e1 hodnota ov\u0161em nutn\u011b nemus\u00ed znamenat, \u017ee jde o n\u00e1dor, jen n\u00e1m ukazuje, \u017ee se v prostat\u011b n\u011bco d\u011bje \u2013 m\u016f\u017ee j\u00edt nap\u0159\u00edklad i o z\u00e1n\u011bt, p\u0159\u00ed\u010din je v\u00edc, ale je nutn\u00e9 v\u0161echno prov\u011b\u0159it. V p\u0159\u00edpad\u011b nutnosti m\u016f\u017ee n\u00e1sledovat biopsie prostaty, tedy odebr\u00e1n\u00ed vzork\u016f tk\u00e1n\u011b, kter\u00e1 n\u00e1m po histologick\u00e9m rozboru \u0159ekne v\u00edc.<\/p>\n
– Testy se d\u011blaj\u00ed tedy a\u017e po pades\u00e1tce, d\u0159\u00edve to nem\u00e1 smysl?<\/p>\n
Smysl to ur\u010dit\u011b m\u00e1 tehdy, m\u00e1\u00ad li mu\u017e v p\u0159\u00edm\u00e9m pokrevn\u00edm p\u0159\u00edbuzenstvu\u00ad tedy otce a bratra se zhoubn\u00fdm n\u00e1dorem prostaty. V takov\u00e9m p\u0159\u00edpad\u011b by se hladina PSA m\u011bla monitorovat ji\u017e po 40.roce v\u011bku pacienta. Genetick\u00e1 dispozice toti\u017e m\u016f\u017ee hr\u00e1t ur\u010ditou roli.<\/p>\n
– M\u016f\u017ee \u010dlov\u011bk s\u00e1m na sob\u011b n\u011bjak pozorovat p\u0159\u00edznaky rakoviny prostaty?<\/p>\n
To je docela slo\u017eit\u00e1 ot\u00e1zka. Obvykle toti\u017e p\u0159\u00edznaky nast\u00e1vaj\u00ed a\u017e ve f\u00e1zi, kdy n\u00e1dor metast\u00e1zuje, a v tomto p\u0159\u00edpad\u011b hlavn\u011b do kost\u00ed \u2013 tedy jsou to bolesti v k\u0159\u00ed\u017ei, p\u00e1nvi, bolesti ky\u010dl\u00ed… Ov\u0161em i p\u0159\u00edznaky „prostaty u star\u0161\u00edch p\u00e1n\u016f“, jak se \u0159\u00edk\u00e1, to znamen\u00e1 \u010dast\u00e9 mo\u010den\u00ed, nemo\u017enost se vymo\u010dit, \u010dast\u00e9 no\u010dn\u00ed mo\u010den\u00ed a tak d\u00e1le mohou b\u00fdt p\u0159\u00edznakem jak nezhoubn\u011b zv\u011bt\u0161en\u00e9 prostaty, tak i zhoubn\u00e9ho n\u00e1doru. Tady je nezbytn\u011b nutn\u00e9, aby takov\u00fd mu\u017e vyhledal l\u00e9ka\u0159e. A pokud nav\u0161t\u011bvuje praktick\u00e9ho l\u00e9ka\u0159e pravideln\u011b jednou za rok, tak je sledov\u00e1n a v\u0161echno by m\u011blo b\u00fdt v\u010das odhaleno.<\/p>\n
– Jak\u00fd je dal\u0161\u00ed postup v p\u0159\u00edpad\u011b, \u017ee se n\u00e1dor prostaty v ran\u00e9m st\u00e1diu potvrd\u00ed?<\/p>\n
V takov\u00e9m p\u0159\u00edpad\u011b indikujeme pacienta k radik\u00e1ln\u00ed operaci prostaty. To je operace, kter\u00e1 se je\u0161t\u011b p\u0159ed t\u0159iceti lety d\u011blala jen na vybran\u00fdch klinik\u00e1ch.<\/p>\n
– Dnes se prostata operuje i za pomoci robot\u016f, je n\u011bjak\u00fd rozd\u00edl mezi ob\u011bma zp\u016fsoby operace?<\/p>\n
Samoz\u0159ejm\u011b je to modern\u00ed metoda, kterou prov\u00e1d\u011bj\u00ed specializovan\u00e1 pracovi\u0161t\u011b, nap\u0159\u00edklad v Praze na Homolce. I my na\u0161im pacient\u016fm tuhle mo\u017enost v\u017edy p\u0159edstav\u00edme, a d\u00e1me jim na v\u00fdb\u011br. Co se t\u00fdk\u00e1 v\u00fdhod robotick\u00e9 operace, je tam rychlej\u0161\u00ed poopera\u010dn\u00ed f\u00e1ze. Pacienti nepot\u0159ebuj\u00ed tak dlouhou rekonvalescenci jako p\u0159i klasick\u00e9 otev\u0159en\u00e9 operaci, vracej\u00ed se d\u0159\u00edv do pr\u00e1ce\u2026 Z dlouhodob\u00e9ho hlediska jsou ale v\u00fdsledky obou zp\u016fsob\u016f odstran\u011bn\u00ed prostaty podobn\u00e9, ur\u010dit\u011b to nen\u00ed tak, \u017ee by robotick\u00e1 prostatektomie tu klasickou vyt\u011bsnila.<\/p>\n
– Jak dlouho se u v\u00e1s na operaci \u010dek\u00e1?<\/p>\n
Pokud mysl\u00edte operace pro zhoubn\u00fd n\u00e1dor a ostatn\u00ed \u00ad tedy nezhoubn\u00e9 \u2013 z\u00e1le\u017eitosti, je to jednozna\u010dn\u00e9. Onkologicky nemocn\u00fd pacient m\u00e1 u n\u00e1s v\u017edy s term\u00ednem operace p\u0159ednost. Sna\u017e\u00edme se o co nejkrat\u0161\u00ed dobu do z\u00e1kroku, proto\u017ee v\u00edme, \u017ee v\u010dasnost z\u00e1kroku m\u016f\u017ee ovlivnit progn\u00f3zu nemoci. Ur\u010dit\u011b u n\u00e1s neexistuj\u00ed \u017e\u00e1dn\u00e9 po\u0159adn\u00edky podle zn\u00e1most\u00ed, v tomhle nezn\u00e1m bratra, a pokud jde o zhoubn\u00fd n\u00e1dor, m\u011bl by m\u00edt v\u017edy p\u0159ednost p\u0159ed odlo\u017eiteln\u00fdmi z\u00e1kroky.<\/p>\n
– Jak\u00e1 omezen\u00ed z odstran\u011bn\u00ed prostaty vypl\u00fdvaj\u00ed?<\/p>\n
Nebudeme si nic nalh\u00e1vat, je to velk\u00fd z\u00e1krok a je to velk\u00fd z\u00e1sah i do psychiky pacienta. Mysl\u00edm t\u00edm ztr\u00e1tu ejakulace, v n\u011bkter\u00fdch p\u0159\u00edpadech jsou to i n\u00e1sledn\u00e9 probl\u00e9my s erekc\u00ed. Ta se ale d\u00e1 navodit l\u00e9ky \u010di injekcemi. Nejsou to samoz\u0159ejm\u011b p\u0159\u00edjemn\u00e9 v\u011bci, ale na druhou stranu, ti lid\u00e9 \u017eij\u00ed, dostali \u0161anci. Na to by pacient i jeho rodina nikdy nem\u011bli zapom\u00ednat, v\u017edy je k nutno k t\u011bmto citliv\u00fdm z\u00e1le\u017eitostem p\u0159istupovat s pokorou.<\/p>\n","protected":false},"excerpt":{"rendered":"
Prim\u00e1\u0159 Richard Pabi\u0161ta uji\u0161\u0165uje, \u017ee onkologi\u010dt\u00ed pacienti maj\u00ed na urologick\u00e9m odd\u011blen\u00ed v Klaudi\u00e1nov\u011b nemocnici p\u0159ednost. Rozhovor Skute\u010dn\u011b je rakoviny prostaty \u010d\u00edm d\u00e1l v\u00edc, nebo se […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":39424,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,11],"tags":[],"class_list":["post-14931","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-rozhovory","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14931","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14931"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14931\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/39424"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14931"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14931"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14931"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}