{"id":25478,"date":"2016-05-08T09:41:13","date_gmt":"2016-05-08T07:41:13","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=25478"},"modified":"2016-05-08T09:41:13","modified_gmt":"2016-05-08T07:41:13","slug":"rakovina-prsu-ohrozuje-i-mladsi-zeny","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=25478","title":{"rendered":"Rakovina prsu ohro\u017euje i mlad\u0161\u00ed \u017eeny"},"content":{"rendered":"

I kdy\u017e je tato z\u00e1ke\u0159n\u00e1 nemoc nej\u010dast\u011bji spojov\u00e1na s \u017eenami ve v\u011bku nad 45 let, zapom\u00ednat by na ni nem\u011bly ani mlad\u0161\u00ed ro\u010dn\u00edky. St\u00e1le \u010dast\u011bji se toti\u017e objevuje i u t\u0159ic\u00e1tnic, a to dokonce v agresivn\u011bj\u0161\u00ed podob\u011b.<\/strong><\/p>\n

Pravd\u011bpodobnost, \u017ee rakovinou prsu onemocn\u011bla \u010di onemocn\u00ed n\u011bkter\u00e1 z va\u0161ich zn\u00e1m\u00fdch, je obrovsk\u00e1. Ro\u010dn\u011b se toti\u017e v \u010cesk\u00e9 republice objev\u00ed pr\u016fm\u011brn\u011b \u0161est tis\u00edc nov\u00fdch p\u0159\u00edpad\u016f, p\u0159es 1 700 \u017een pak sv\u016fj boj s t\u00edmto agresivn\u00edm onemocn\u011bn\u00edm prohraje.<\/p>\n

D\u011bsiv\u00e1 \u010d\u00edsla v\u0161ak maj\u00ed i sv\u00e9 sv\u011btl\u00e9 prot\u011bj\u0161ky. Rychleji ne\u017e samotn\u00fd v\u00fdskyt rakoviny roste i po\u010det \u017een, kter\u00e9 dok\u00e1\u017eou nad nemoc\u00ed zv\u00edt\u011bzit. A to p\u0159edev\u0161\u00edm proto, \u017ee se poda\u0159\u00ed n\u00e1dor odhalit v\u010das. V ran\u00e9m stadiu ji l\u00e9ka\u0159i diagnostikuj\u00ed zhruba u 40 procent pacientek. To je sice dosud rekordn\u00ed mno\u017estv\u00ed, ide\u00e1ln\u00ed v\u0161ak st\u00e1le nen\u00ed. Prostor pro zlep\u0161en\u00ed je zna\u010dn\u00fd. V prvn\u00ed f\u00e1zi by sta\u010dilo, kdyby v\u0161echny mlad\u00e9 \u017eeny pravideln\u011b chodily ke sv\u00e9mu l\u00e9ka\u0159i na kontroly a prov\u00e1d\u011bly samovy\u0161et\u0159en\u00ed prsu.<\/p>\n

\u017den\u00e1m ve v\u011bku nad 45 let ka\u017ed\u00e9 dva roky hrad\u00ed mamograf zdravotn\u00ed poji\u0161\u0165ovna. Probl\u00e9mem je \u010dasn\u00e1 diagn\u00f3za u \u017een kolem t\u0159ic\u00edtky, u kter\u00fdch se rakovina prsu vyskytuje tak\u00e9 st\u00e1le \u010dast\u011bji a p\u0159itom \u017e\u00e1dn\u00fdm plo\u0161n\u00fdm screeningem neproch\u00e1zej\u00ed. „Problematikou onemocn\u011bn\u00ed mlad\u00fdch \u017een se zab\u00fdv\u00e1 n\u00e1\u0161 celorepublikov\u00fd Projekt 35. Tato v\u011bkov\u00e1 kategorie vy\u017eaduje d\u00edky agresivit\u011b nemoci speci\u00e1ln\u00ed pozornost,“ \u0159\u00edk\u00e1 Petra Tesa\u0159ov\u00e1 z Onkologick\u00e9 kliniky V\u0161eobecn\u00e9 fakultn\u00ed nemocnice, kter\u00e1 pat\u0159\u00ed mezi p\u0159edn\u00ed specialistky na problet\u0159eba matiku karcinomu prsu. „Pokud m\u00e1 mlad\u00e1 \u017eena v rodin\u011b p\u0159\u00edbuzn\u00e9 s karcinomem prsu, je rozumn\u00e9 podstoupit ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed pro zji\u0161t\u011bn\u00ed rizikovosti jej\u00ed ml\u00e9\u010dn\u00e9 \u017el\u00e1zy. Pro mlad\u00e9 \u017eeny bez rizika posta\u010duje samovy\u0161et\u0159en\u00ed. Nau\u010dit je to m\u016f\u017ee nap\u0159\u00edklad Dr. House v na\u0161em edukativn\u00edm klipu na www.rucenaprsa.cz,“ pokra\u010duje l\u00e9ka\u0159ka.<\/p>\n

SAMOVY\u0160ET\u0158EN\u00cd JE Z\u00c1KLAD<\/p>\n

Pr\u00e1v\u011b proto, \u017ee \u017een\u00e1m nad 45 let hrad\u00ed poji\u0161\u0165ovna screening ka\u017ed\u00e9 dva roky, ty mlad\u0161\u00ed maj\u00ed pocit, \u017ee se jich nemoc net\u00fdk\u00e1. Jen\u017ee opak je pravdou. V\u00fdskyt karcinomu prsu u t\u0159ic\u00e1tnic je st\u00e1le vy\u0161\u0161\u00ed. A nemoc agresivn\u011bj\u0161\u00ed. „Aby zhoubn\u00e9 onemocn\u011bn\u00ed propuklo, mus\u00ed p\u0159ekonat obranyschopnost organismu, kter\u00e1 je u mlad\u00fdch osob samoz\u0159ejm\u011b lep\u0161\u00ed. Proto\u017ee se u mlad\u0161\u00edch pacientek na rakovinu nemysl\u00ed, zjist\u00edme n\u00e1dor \u010dasto pozd\u011bji, v pokro\u010dilej\u0161\u00ed f\u00e1zi,“ dod\u00e1v\u00e1 Tesa\u0159ov\u00e1.
\nPr\u00e1v\u011b proto vznikl ji\u017e zm\u00edn\u011bn\u00fd Projekt 35, kter\u00fd p\u0159ipravila skupina odborn\u00edk\u016f. Sna\u017e\u00ed se nejen zv\u00fd\u0161it informovanost o nemoci, ale tak\u00e9 zlep\u0161it diagnostiku u mlad\u0161\u00edch pacientek. Ta m\u00e1 toti\u017e dosud sv\u00e9 mezery. Pokud si \u017eena sama objev\u00ed zm\u011bnu v prsu a zajde za sv\u00fdm l\u00e9ka\u0159em, neznamen\u00e1 to, \u017ee m\u00e1 vyhr\u00e1no. Z\u00e1le\u017e\u00ed toti\u017e i na jeho erudici, zku\u0161enostech a schopnostech. Zhoubn\u00e9 n\u00e1dory se v prsou mlad\u00fdch \u017een projevuj\u00ed mnohdy netypicky, vy\u0161et\u0159en\u00ed by tedy ide\u00e1ln\u011b m\u011bl prov\u00e1d\u011bt skute\u010dn\u00fd odborn\u00edk, kter\u00fd m\u00e1 ve sv\u00e9 praxi p\u0159\u00edle\u017eitost vid\u011bt r\u016fzn\u00e9 n\u00e1lezy. Jen\u017ee to se mnohdy nestane a m\u016f\u017ee chv\u00edli trvat, ne\u017e se \u017een\u011b dostane kvalitn\u00ed pomoci. Pokud m\u00e1te podez\u0159en\u00ed, obra\u0165te se proto rad\u011bji rovnou na specializovan\u00e9 pracovi\u0161t\u011b.<\/p>\n

KDY\u017d JE TO DOBROVOLN\u00c9, NEJDU<\/p>\n

U star\u0161\u00edch \u017een, jim\u017e poji\u0161\u0165ovna screening hrad\u00ed, pot\u00ed\u017ee s diagnostikou nejsou. Ml\u00e9\u010dn\u00e1 \u017el\u00e1za v tomto v\u011bku u\u017e nen\u00ed tak hutn\u00e1 a rentgenov\u00e9 paprsky tak dok\u00e1\u017eou zobrazit p\u0159\u00edpadn\u00e9 zm\u011bny s velmi malou radia\u010dn\u00ed z\u00e1t\u011b\u017e\u00ed \u017el\u00e1zy. Objevu j\u00ed se ale jin\u00e9 probl\u00e9my \u2013 program je toti\u017e zcela dobrovoln\u00fd a mnoho \u017een se jej ne\u00fa\u010dastn\u00ed. „A tak zat\u00edmco se v\u00fdznamn\u011b zv\u00fd\u0161il z\u00e1chyt \u010dasn\u00fdch, tedy l\u00e9pe l\u00e9\u010diteln\u00fdch stadi\u00ed karcinomu prsu, po\u010det nemocn\u00fdch, kter\u00e9 p\u0159ich\u00e1zej\u00ed zcela pozd\u011b, tedy ve f\u00e1zi metast\u00e1z zhoubn\u00e9ho n\u00e1doru, se nijak nezm\u011bnil. Tyto nemocn\u00e9 screening ignoruj\u00ed, a ten jim tedy nem\u016f\u017ee nijak pomoci,“ popisuje pot\u00ed\u017ee Tesa\u0159ov\u00e1. Douf\u00e1, \u017ee zapojen\u00ed \u017een do screeningu by mohlo vylep\u0161it jejich adresn\u00e9 zvan\u00ed, ke kter\u00e9mu poji\u0161\u0165ovny p\u0159istoupily v lednu 2014.
\nOnemocn\u011bt ale mohou i \u017eeny, kter\u00e9 prevenci nepodce\u0148uj\u00ed, existuj\u00ed toti\u017e i takzvan\u00e9 intervalov\u00e9 karcinomy. „Ty se objev\u00ed mezi mamografiemi navzdory tomu, \u017ee na screening nemocn\u00e1 vzorn\u011b doch\u00e1z\u00ed. Na\u0161t\u011bst\u00ed jsou v\u0161ak tyto p\u0159\u00edpady vz\u00e1cn\u00e9,“ dod\u00e1v\u00e1 Tesa\u0159ov\u00e1.<\/p>\n

POZD\u011aJ\u0160\u00cd POROD ZVY\u0160UJE PRAVD\u011aPODOBNOST<\/p>\n

Dosud nen\u00ed p\u0159esn\u011b jasn\u00e9, co rakovinu prsu zp\u016fsobuje, nicm\u00e9n\u011b rizikov\u00e9 faktory l\u00e9ka\u0159i znaj\u00ed. Vedle obezity a celkov\u011b nezdrav\u00e9ho \u017eivotn\u00edho stylu mezi n\u011b pat\u0159\u00ed nap\u0159\u00edklad i \u010dasn\u00e9 zah\u00e1jen\u00ed (p\u0159ed 12. rokem) a ukon\u010den\u00ed ( po 55. roce) menstruace, alkohol, kou\u0159en\u00ed, prvn\u00ed porod po t\u0159ic\u00edtce, p\u0159\u00edpadn\u011b bezd\u011btnost. N\u011bkter\u00e9 studie naopak poukazu j\u00ed na kladn\u00fd dopad kojen\u00ed.
\nVelk\u00e9 debaty se vedou o roli hormon\u00e1ln\u00ed antikoncepce. Zat\u00edmco podle n\u011bkter\u00fdch l\u00e9ka\u0159\u016f a v\u011bdc\u016f jednozna\u010dn\u011b riziko rakoviny prsu zvy\u0161uje, jin\u00ed jsou v posuzov\u00e1n\u00ed jej\u00edho vlivu obez\u0159etn\u011bj\u0161\u00ed a sp\u00ed\u0161e zd\u016fraz\u0148uj\u00ed jej\u00ed pozitivn\u00ed vliv na rakovinu vaje\u010dn\u00edku. Statistick\u00e1 data toti\u017e poukazuj\u00ed na v\u00fdrazn\u00fd pokles karcinom\u016f tohoto typu a gynekologov\u00e9 \u010d\u00edsla spojuj\u00ed pr\u00e1v\u011b s roz\u0161\u00ed\u0159en\u00edm dostupnosti hormon\u00e1ln\u00ed antikoncepce. Dlouhodob\u00e9 u\u017e\u00edv\u00e1n\u00ed pilulek podle nich sni\u017euje v\u00fdskyt rakoviny vaje\u010dn\u00edku a\u017e o 50 procent.
\n„U\u017e\u00edv\u00e1n\u00ed antikoncepce n\u011bkolik des\u00edtek let nen\u00ed jist\u011b p\u0159irozen\u00e9, nicm\u00e9n\u011b klinick\u00e9 studie u obecn\u00e9 populace \u017een bez rizika karcinomu prsu neprok\u00e1zaly jej\u00ed zv\u00fd\u0161en\u00fd v\u00fdskyt, zvl\u00e1\u0161\u0165 pokud u\u017e\u00edvaly prepar\u00e1ty s n\u00edzkou d\u00e1vkou hormon\u016f. Mysl\u00edm si ale, \u017ee u mlad\u00fdch d\u00edvek s rodinnou z\u00e1t\u011b\u017e\u00ed karcinomem prsu bychom p\u0159i p\u0159edepisov\u00e1n\u00ed antikoncepce m\u011bli b\u00fdt podobn\u011b ostra\u017eit\u00ed jako u \u017een s geneticky podm\u00edn\u011bnou tendenc\u00ed k vzniku tromb\u00f3zy,“ up\u0159es\u0148uje Tesa\u0159ov\u00e1.
\nDo rizikov\u00e9 skupiny spad\u00e1te automaticky, pokud se s rakovinou prsu l\u00e9\u010dil n\u011bkdo z va\u0161\u00ed rodiny. Jestli\u017ee m\u00e1 zhoubn\u00fd n\u00e1dor prsu matka, sestra \u010di dcera, je riziko onemocn\u011bn\u00ed skoro dvojn\u00e1sobn\u00e9 ne\u017e u ostatn\u00ed populace. U rodin s v\u00fdskytem n\u00e1dor\u016f prsu nebo vaje\u010dn\u00edk\u016f u dvou a v\u00edce bl\u00edzk\u00fdch p\u0159\u00edbuzn\u00fdch, kdy alespo\u0148 jedna z \u017een onemocn\u011bla v \u010dasn\u00e9m v\u011bku pod 50 let, je vysok\u00e9 podez\u0159en\u00ed na d\u011bdi\u010dnou poruchu n\u011bkter\u00e9ho genu.<\/p>\n

—<\/p>\n

\u017divot s rakovinou<\/p>\n

B\u00e1ra Rektorov\u00e1 \u0159adu let \u00fasp\u011b\u0161n\u011b podnik\u00e1 se sushi. Loni v listopadu j\u00ed l\u00e9ka\u0159i na\u0161li n\u00e1dor na mozku. Jak j\u00ed to zm\u011bnilo \u017eivot? A jak se v\u016fbec \u017eije s rakovinou? To se do\u010dtete v pond\u011bln\u00edm magaz\u00ednu Ona Dnes.<\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

I kdy\u017e je tato z\u00e1ke\u0159n\u00e1 nemoc nej\u010dast\u011bji spojov\u00e1na s \u017eenami ve v\u011bku nad 45 let, zapom\u00ednat by na ni nem\u011bly ani mlad\u0161\u00ed ro\u010dn\u00edky. St\u00e1le \u010dast\u011bji […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14166,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-25478","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25478","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=25478"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25478\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14166"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25478"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25478"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25478"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}