{"id":26975,"date":"2017-01-14T19:06:46","date_gmt":"2017-01-14T18:06:46","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=26975"},"modified":"2017-01-14T19:06:46","modified_gmt":"2017-01-14T18:06:46","slug":"cernobila-volba","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=26975","title":{"rendered":"\u010cernob\u00edl\u00e1 volba"},"content":{"rendered":"<p>N\u00e1dor je slovo, kter\u00e9 vzbuzuje strach a beznad\u011bj. Roste jako patologick\u00fd \u00fatvar a vymyk\u00e1 se kontrole organismu. Vzbuzuje v n\u00e1s paniku, a proto je d\u016fle\u017eit\u00e9 v\u011bd\u011bt o n\u00e1dorech v\u00edc.<!--more--><\/p>\n<p>N\u00e1dory se obecn\u011b d\u011bl\u00ed na zhoubn\u00e9, tedy takov\u00e9, kter\u00e9 jsou agresivn\u00ed a destruuj\u00ed okoln\u00ed tk\u00e1n\u011b, zakl\u00e1daj\u00ed nov\u00e1 lo\u017eiska, rozp\u00ednaj\u00ed se do okol\u00ed a pacienta p\u0159\u00edmo ohro\u017euj\u00ed na \u017eivot\u011b, a na n\u00e1dory benign\u00ed, kter\u00e9 b\u00fdvaj\u00ed ost\u0159e ohrani\u010den\u00e9, nezakl\u00e1daj\u00ed metast\u00e1zy, a pokud nejsou na m\u00edst\u011b, kde by utla\u010dovaly \u017eivotn\u011b d\u016fle\u017eit\u00fd org\u00e1n, tak nejsou \u017eivot ohro\u017euj\u00edc\u00ed.<br \/>\nHranice mezi t\u011bmito definicemi je ale mnohem ten\u010d\u00ed, ne\u017e si uv\u011bdomujeme. &#8222;Nap\u0159\u00edklad u n\u00e1dor\u016f semimalign\u00edch je velmi t\u011b\u017ek\u00e9 ur\u010dit, jak se n\u00e1dor v budoucnosti bude chovat. Jsou to n\u00e1dory s nejist\u00fdm biologick\u00fdm chov\u00e1n\u00edm. Pak existuj\u00ed i zm\u011bny, kter\u00e9 naz\u00fdv\u00e1me prekancer\u00f3zy, tedy stavy, kter\u00e9 jsou z pohledu rozvoje malign\u00edho n\u00e1doru rizikov\u00e9. Zv\u00fd\u0161en\u00e9 sledov\u00e1n\u00ed v\u0161ak vy\u017eaduj\u00ed nap\u0159\u00edklad i dlouho se hoj\u00edc\u00ed r\u00e1ny \u010di vlekl\u00e9 z\u00e1n\u011btliv\u00e9 procesy v t\u011ble,&#8220; shrnuje \u00favodem prof. MUDr. Lubo\u0161 Petru\u017eelka, CSc., p\u0159ednosta Onkologick\u00e9 kliniky 1. LF UK, VFN a \u00daVN v Praze.<\/p>\n<p>Prekancer\u00f3zy znamenaj\u00ed riziko<\/p>\n<p>T\u011blesn\u00e9 zm\u011bny nebo onemocn\u011bn\u00ed, z nich\u017e se m\u016f\u017ee vyvinout rakovina, se naz\u00fdvaj\u00ed prekancer\u00f3zy. Tento pojem nej\u010dast\u011bji znaj\u00ed \u017eeny v souvislosti s prekancer\u00f3zou d\u011blo\u017en\u00edho \u010d\u00edpku.<br \/>\n&#8222;Odhalen\u00ed tohoto stavu je c\u00edlem cytologick\u00fdch vy\u0161et\u0159en\u00ed, kter\u00e1 se u \u017een prov\u00e1d\u011bj\u00ed v r\u00e1mci preventivn\u00edch gynekologick\u00fdch prohl\u00eddek. D\u00edky st\u011bru bun\u011bk z povrhu d\u011blo\u017en\u00edho \u010d\u00edpku je mo\u017en\u00e9 zjistit, zda v bu\u0148k\u00e1ch doch\u00e1z\u00ed \u010di nedoch\u00e1z\u00ed ke zm\u011bn\u00e1m vedouc\u00edm k rozvoji n\u00e1doru,&#8220; popisuje l\u00e9ka\u0159.<br \/>\n&#8222;Kdy\u017e dojde k podez\u0159en\u00ed, \u017ee jde o prekancer\u00f3zu, je t\u0159eba odebrat bu\u0148ky z dan\u00e9ho m\u00edsta a ty odeslat na histologick\u00e9 vy\u0161et\u0159en\u00ed do laborato\u0159e. Kdy\u017e se podez\u0159en\u00ed potvrd\u00ed, je t\u0159eba nastavit dal\u0161\u00ed postup. Jde-li o m\u00edsto, kde je mo\u017en\u00e9 lo\u017eiska chirurgicky odstranit, dojde k jejich odstran\u011bn\u00ed. V p\u0159\u00edpad\u011b, \u017ee toto mo\u017en\u00e9 nen\u00ed, je t\u0159eba m\u00edsto sledovat a v p\u0159\u00edpad\u011b dal\u0161\u00ed zm\u011bny zah\u00e1jit l\u00e9\u010dbu,&#8220; dod\u00e1v\u00e1 l\u00e9ka\u0159.<\/p>\n<p>Nebezpe\u010d\u00ed \u010d\u00edhaj\u00edc\u00ed v z\u00e1n\u011btech<\/p>\n<p>Probl\u00e9m m\u016f\u017ee vzniknout i u mnoh\u00fdch &#8222;ban\u00e1ln\u011bj\u0161\u00edch&#8220; z\u00e1le\u017eitost\u00ed. Rizikov\u00e9 jsou t\u0159eba dlouho se nehoj\u00edc\u00ed r\u00e1ny a v\u0159edy \u010di m\u00edsta s dlouhodob\u00fdm chronick\u00fdm z\u00e1n\u011btem, kde m\u016f\u017ee doj\u00edt k rozvoji malign\u00edho n\u00e1doru.<br \/>\n&#8222;U z\u00e1n\u011btu nelze jednozna\u010dn\u011b \u0159\u00edct, \u017ee jde o p\u0159edrakovinov\u00fd stav.<br \/>\nAle je t\u0159eba tato m\u00edsta sledovat.<br \/>\nDlouhodob\u011b prob\u00edhaj\u00edc\u00ed z\u00e1n\u011bty jsou spojeny se zv\u00fd\u0161en\u00fdm rizikem rozvoje onkologick\u00e9ho onemocn\u011bn\u00ed. Nap\u0159\u00edklad chronick\u00fd z\u00e1n\u011bt slinivky b\u0159i\u0161n\u00ed, Crohnova choroba, ulcer\u00f3zn\u00ed kolitida \u010di dlouhotrvaj\u00edc\u00ed, nehoj\u00edc\u00ed se v\u0159edy na k\u016f\u017ei \u010di sliznic\u00edch jsou stavy, u kter\u00fdch se doporu\u010duje nepodcenit zv\u00fd\u0161en\u00e9 riziko rozvoje onkologick\u00e9ho onemocn\u011bn\u00ed.<br \/>\nV p\u0159\u00edpad\u011b podez\u0159en\u00ed, \u017ee doch\u00e1z\u00ed ke zm\u011bn\u00e1m, kter\u00e9 by mohly souviset s rozvojem n\u00e1dorov\u00e9ho onemocn\u011bn\u00ed, se doporu\u010duje odebr\u00e1n\u00ed vzorku tk\u00e1n\u011b, tzv. biopsie, a n\u00e1sledn\u00e9 histologick\u00e9 vy\u0161et\u0159en\u00ed,&#8220; popisuje profesor Petru\u017eelka. Smyslem vy\u0161et\u0159en\u00ed je op\u011bt z\u00edskat informace o tom, co se v posti\u017een\u00fdch tk\u00e1n\u00edch d\u011bje.<\/p>\n<p>Nebezpe\u010dn\u011b bezpe\u010dn\u00e9<\/p>\n<p>Rizika jsou ale i u n\u011bkter\u00fdch n\u00e1dor\u016f, kter\u00e9 jsou v dob\u011b po\u010d\u00e1te\u010dn\u00ed diagnostiky benign\u00ed. &#8222;U n\u011bkter\u00fdch n\u00e1dor\u016f skute\u010dn\u011b hroz\u00ed, \u017ee z f\u00e1ze benign\u00ed p\u0159ejdou do f\u00e1ze malign\u00ed.<br \/>\nTak je tomu nap\u0159\u00edklad u gli\u00e1ln\u00edch n\u00e1dor\u016f. To jsou n\u00e1dory, kter\u00e9 vznikaj\u00ed v mozkov\u00fdch tk\u00e1n\u00edch a m\u016f\u017ee u nich doj\u00edt k jejich zm\u011bn\u011b,&#8220; \u0159\u00edk\u00e1 l\u00e9ka\u0159. Pokud by do\u0161lo ke zm\u011bn\u011b v charakteristice n\u00e1doru, je t\u0159eba zm\u011bnit p\u0159\u00edstup k l\u00e9\u010db\u011b pacienta.<\/p>\n<p>Nenechat bez dohledu<\/p>\n<p>Prekancer\u00f3zy a dal\u0161\u00ed rizikov\u00e9 stavy je t\u0159eba sledovat. Pokud to jejich lokalita umo\u017en\u00ed, je vhodn\u00e9 odebrat vzorek tk\u00e1n\u011b a nechat ho vy\u0161et\u0159it, p\u0159\u00edpadn\u011b rizikovou tk\u00e1\u0148 odstranit v cel\u00e9m jej\u00edm rozsahu. &#8222;Dob\u0159e p\u0159\u00edstupn\u00fd je z tohoto pohledu pr\u00e1v\u011b ji\u017e zm\u00edn\u011bn\u00fd d\u011blo\u017en\u00ed \u010d\u00edpek, kde je mo\u017en\u00e9 v p\u0159\u00edpad\u011b potvrzen\u00ed zm\u011bny na bu\u0148k\u00e1ch prov\u00e9st konizaci. P\u0159i n\u00ed je problematick\u00e1 tk\u00e1\u0148 odejmuta a \u017eena je t\u00edm vyl\u00e9\u010dena,&#8220; dopl\u0148uje l\u00e9ka\u0159. Kde to lokalita neumo\u017e\u0148uje, doporu\u010duje se pravideln\u00e9 sledov\u00e1n\u00ed pacienta. Barbora Neubergerov\u00e1 odborn\u00e1 spolupr\u00e1ce: prof. MUDr. Lubo\u0161 Petru\u017eelka, CSC., Onkologick\u00e1 klinika 1. LF UK, VFN a \u00daVN v Praze<\/p>\n<p>Co byste m\u011bli v\u011bd\u011bt Diagnostika malign\u00edho n\u00e1doru v\u017edy pacienta a jeho nejbli\u017e\u0161\u00ed okol\u00ed zasko\u010d\u00ed. Ne v\u017edy tato diagn\u00f3za mus\u00ed souviset s n\u00e1slednou onkologickou l\u00e9\u010dbou. &#8222;N\u011bkter\u00e9 typy malign\u00edch n\u00e1dor\u016f je mo\u017en\u00e9 odstranit chirurgicky, bez nutnosti dal\u0161\u00ed l\u00e9\u010dby. Tak je tomu nap\u0159\u00edklad u n\u00e1dor\u016f in situ, v polypech sliznice tlust\u00e9ho st\u0159eva,&#8220; popisuje profesor MUDr. Lubo\u0161 Petru\u017eelka, CSc. Podobn\u011b je to i s bazaliomem. Tento ko\u017en\u00ed n\u00e1dor se \u0159ad\u00ed mezi n\u00e1dory malign\u00ed i p\u0159esto, \u017ee metast\u00e1zy zakl\u00e1d\u00e1 jen z\u0159\u00eddkakdy. &#8222;Bazaliom destruuje okoln\u00ed tk\u00e1n\u011b.<\/p>\n<p>Pokud se v\u0161ak diagnostikuje v\u010das, je mo\u017en\u00e9 jej odstranit chirurgicky \u010di pomoc\u00ed sv\u011btla a dal\u0161\u00ed l\u00e9\u010dba pak nen\u00ed nutn\u00e1,&#8220; dod\u00e1v\u00e1 l\u00e9ka\u0159.<br \/>\nPokud by biopsie prok\u00e1zala histologick\u00e9 zm\u011bny, p\u0159i\u0161la by na \u0159adu chirurgick\u00e1 \u010di onkologick\u00e1 l\u00e9\u010dba.<\/p>\n<p>D\u011blo\u017en\u00ed \u010d\u00edpek v\u0161ak zdaleka nen\u00ed jedin\u00fdm m\u00edstem, kde se prekancer\u00f3zy m\u016f\u017eou vyskytnout. Tyto zm\u011bny se mohou rozvinout na k\u016f\u017ei \u010di sliznici cel\u00e9ho t\u011bla. &#8222;Mezi prekancer\u00f3zy pat\u0159\u00ed nap\u0159\u00edklad i leukoplakie, tedy b\u00edl\u00e9 skvrny vznikaj\u00edc\u00ed na m\u011bkk\u00fdch sliznic\u00edch dutiny \u00fastn\u00ed. Tato lo\u017eiska nejdou nijak set\u0159\u00edt \u010di se\u0161kr\u00e1bat. Jde o zm\u011bnu barvy sliznice souvisej\u00edc\u00ed se zm\u011bnou bun\u011bk. Odhalen\u00ed t\u011bchto stav\u016f by m\u011blo b\u00fdt sou\u010d\u00e1st\u00ed preventivn\u00edch stomatologick\u00fdch prohl\u00eddek,&#8220; dod\u00e1v\u00e1 l\u00e9ka\u0159.<\/p>\n<p>Prekancer\u00f3zy se mohou vyskytovat i na sliznic\u00edch vnit\u0159n\u00edch org\u00e1n\u016f, na j\u00edcnu, na sliznici \u017ealudku a podobn\u011b.<\/p>\n<p>Moje zdrav\u00ed<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>N\u00e1dor je slovo, kter\u00e9 vzbuzuje strach a beznad\u011bj. Roste jako patologick\u00fd \u00fatvar a vymyk\u00e1 se kontrole organismu. Vzbuzuje v n\u00e1s paniku, a proto je d\u016fle\u017eit\u00e9 <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=26975\" title=\"\u010cernob\u00edl\u00e1 volba\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":21147,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,9],"tags":[],"class_list":["post-26975","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/26975","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=26975"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/26975\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/21147"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26975"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26975"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26975"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}