{"id":43716,"date":"2023-11-16T08:56:43","date_gmt":"2023-11-16T07:56:43","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=43716"},"modified":"2023-11-16T08:56:43","modified_gmt":"2023-11-16T07:56:43","slug":"hrozi-ji-rakovina-po-porodu-ji-proto-ceka-operace","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=43716","title":{"rendered":"Hroz\u00ed j\u00ed rakovina, po porodu ji proto \u010dek\u00e1 operace"},"content":{"rendered":"\n<p><strong>Poprv\u00e9 vy\u0161la Tereze (24) z Prahy hor\u0161\u00ed cytologie p\u0159ibli\u017en\u011b p\u0159ed p\u011bti lety. Kv\u016fli mo\u017en\u00e9mu rozvoji rakoviny d\u011blo\u017en\u00edho hrdla je proto pod pe\u010dliv\u00fdm dohledem l\u00e9ka\u0159\u016f. Mezit\u00edm zvl\u00e1dla Tereza i p\u0159es komplikace v&nbsp;podob\u011b preeklampsie porodit zdrav\u00e9ho chlapce a znovu ot\u011bhotn\u011bt. V sou\u010dasn\u00e9 dob\u011b \u010dek\u00e1 druh\u00e9 d\u00edt\u011b a v\u00fdsledky posledn\u00ed cytologie nazna\u010duj\u00ed, \u017ee riziko rozvoje rakoviny bohu\u017eel st\u00e1le trv\u00e1. Po porodu ji proto velmi pravd\u011bpodobn\u011b \u010dek\u00e1 operace. N\u00e1dorov\u00e9mu onemocn\u011bn\u00ed p\u0159itom \u0161lo p\u0159edej\u00edt.<\/strong><\/p>\n\n\n\n<p>\u201e<em>Kdy\u017e m\u011b m\u00e1 l\u00e9ka\u0159ka poprv\u00e9 poslala na podrobn\u00e9 vy\u0161et\u0159en\u00ed do nemocnice, vlastn\u011b m\u011b to nijak zvl\u00e1\u0161\u0165 neznepokojilo. M\u011bla jsem v&nbsp;t\u00e9 dob\u011b zkou\u0161kov\u00e9 a spolu s n\u00edm plnou hlavu u\u010den\u00ed. V\u016fbec jsem netu\u0161ila, co mi hroz\u00ed,\u201c<\/em> vzpom\u00edn\u00e1 Tereza. L\u00e9ka\u0159 j\u00ed tehdy sd\u011blil, \u017ee zm\u011bny na d\u011blo\u017en\u00edm \u010d\u00edpku nazna\u010duj\u00ed, \u017ee by se u n\u00ed pozd\u011bji mohla objevit rakovina d\u011blo\u017en\u00edho hrdla. N\u00e1lez v\u0161ak nebyl natolik v\u00e1\u017en\u00fd, aby bylo nutn\u00e9 ihned zah\u00e1jit l\u00e9\u010dbu. Tereza proto doch\u00e1zela ka\u017ed\u00e9ho p\u016fl roku na vy\u0161et\u0159en\u00ed do nemocnice, a kdy\u017e se jej\u00ed stav nem\u011bnil, vr\u00e1tila se do p\u00e9\u010de ambulantn\u00edho gynekologa. Z\u00e1va\u017en\u00e9 zm\u011bny na d\u011blo\u017en\u00edm \u010d\u00edpku jsou v&nbsp;takto mlad\u00e9m v\u011bku velmi vz\u00e1cn\u00e9. Mnohem \u010dast\u011bji se t\u00fdkaj\u00ed \u017een po t\u0159ic\u00e1t\u00e9m roce \u017eivota. V&nbsp;ka\u017ed\u00e9m p\u0159\u00edpad\u011b je z\u00e1sadn\u00ed zachytit tyto zm\u011bny v\u010das, a proto je sou\u010d\u00e1st\u00ed pravideln\u00fdch gynekologick\u00fdch prohl\u00eddek st\u011br bun\u011bk z&nbsp;d\u011blo\u017en\u00edho \u010d\u00edpku ur\u010den\u00fdch k&nbsp;cytologick\u00e9mu rozboru. Ka\u017ed\u00e1 \u017eena by je m\u011bla v&nbsp;r\u00e1mci hrazen\u00e9 prevence absolvovat jednou ro\u010dn\u011b.<\/p>\n\n\n\n<p>\u201e<em>P\u0159ed dv\u011bma lety jsem poprv\u00e9 ot\u011bhotn\u011bla. Dokon\u010dovala jsem v&nbsp;t\u00e9 dob\u011b je\u0161t\u011b vysokou \u0161kolu, tak\u017ee to bylo pom\u011brn\u011b stresov\u00e9 obdob\u00ed. Kdy\u017e jsem pak v&nbsp;38. t\u00fddnu p\u0159i\u0161la na ambulanci s&nbsp;tlakem 170 na 110, nechali si m\u011b tam. Druh\u00fd den se potvrdilo, \u017ee m\u00e1m preeklampsii, a museli mi porod vyvolat,\u201c <\/em>popisuje Tereza dramatick\u00e9 chv\u00edle sv\u00e9ho t\u011bhotenstv\u00ed. Ani po t\u0159ech dnech kontrakc\u00ed se jej\u00edmu prvorozen\u00e9mu necht\u011blo na sv\u011bt. Nakonec se l\u00e9ka\u0159i rozhodli pro c\u00edsa\u0159sk\u00fd \u0159ez. <em>\u201eNa gynekologick\u00e9 kontrole dva m\u011bs\u00edce po prvn\u00edm porodu jsem m\u011bla znovu n\u00e1lez na d\u011blo\u017en\u00edm \u010d\u00edpku,\u201c <\/em>vysv\u011btluje Tereza<em>. <\/em>Nyn\u00ed je Tereza znovu t\u011bhotn\u00e1 a tak\u00e9 te\u010f j\u00ed hroz\u00ed preeklampsie.Sna\u017e\u00ed se j\u00ed proto p\u0159edch\u00e1zet u\u017e\u00edv\u00e1n\u00edm kyseliny acetylsalicylov\u00e9. Z\u00e1rove\u0148 si hl\u00edd\u00e1 hodnoty tlaku a b\u00edlkoviny v&nbsp;mo\u010di. Ka\u017ed\u00fd den tak\u00e9 sportuje a c\u00edt\u00ed se l\u00e9pe ne\u017e p\u0159i prvn\u00edm t\u011bhotenstv\u00ed. Po porodu, kter\u00fd vych\u00e1z\u00ed na konec prosince, ji ale velmi pravd\u011bpodobn\u011b \u010dek\u00e1 z\u00e1krok na d\u011blo\u017en\u00edm \u010d\u00edpku, kter\u00fd by m\u011bl zabr\u00e1nit budouc\u00edmu rozvoji n\u00e1dorov\u00e9ho onemocn\u011bn\u00ed. Tomu lze p\u0159edej\u00edt tak\u00e9 o\u010dkov\u00e1n\u00edm proti HPV (lidsk\u00fd papilomavirus), kter\u00e9 d\u00edvk\u00e1m i chlapc\u016fm ve v\u011bku t\u0159in\u00e1cti let hrad\u00ed zdravotn\u00ed poji\u0161\u0165ovny. Od p\u0159\u00ed\u0161t\u00edho roku se v\u011bkov\u00e1 kategorie s plnou \u00fahradou roz\u0161i\u0159uje na obdob\u00ed mezi jeden\u00e1cti a \u010dtrn\u00e1cti lety. Star\u0161\u00ed d\u011bti a dosp\u011bl\u00ed mohou k&nbsp;\u00fahrad\u011b o\u010dkov\u00e1n\u00ed vyu\u017e\u00edt p\u0159\u00edsp\u011bvky sv\u00e9 zdravotn\u00ed poji\u0161\u0165ovny. <em>\u201eProti HPV o\u010dkovan\u00e1 nejsem, i kdy\u017e v\u00edm, \u017ee ta mo\u017enost tu pro m\u011b byla. V\u0161em d\u00edvk\u00e1m bych ur\u010dit\u011b doporu\u010dila chodit na pravideln\u00e9 prohl\u00eddky,\u201c <\/em>uzav\u00edr\u00e1 Tereza. \u017den\u00e1m, kter\u00e9 onemocn\u00ed rakovinou d\u011blo\u017en\u00edho hrdla, vaje\u010dn\u00edk\u016f, vulvy nebo endometria, se dlouhodob\u011b v\u011bnuje pacientsk\u00e1 organizace Veronica. Pom\u00e1h\u00e1 tak\u00e9 pacientk\u00e1m, kter\u00e9 jsou nositelkami gen\u016f <em>BRCA1<\/em> a <em>BRCA2<\/em>, u nich\u017e je velk\u00e1 pravd\u011bpodobnost, \u017ee onemocn\u00ed rakovinou prsu nebo vaje\u010dn\u00edku.<\/p>\n\n\n\n<p><strong>Koment\u00e1\u0159 l\u00e9ka\u0159e:<\/strong><\/p>\n\n\n\n<p>\u201e<em>Sledov\u00e1n\u00ed bun\u011b\u010dn\u00fdch nebo tk\u00e1\u0148ov\u00fdch zm\u011bn na d\u011blo\u017en\u00edm \u010d\u00edpku, kter\u00e9 by \u010dasem mohly v\u00e9st k&nbsp;rozvoji rakoviny d\u011blo\u017en\u00edho hrdla, jsou hlavn\u00edm d\u016fvodem, pro\u010d by \u017eeny m\u011bly pravideln\u011b doch\u00e1zet na gynekologick\u00e1 preventivn\u00ed vy\u0161et\u0159en\u00ed. Prekancer\u00f3zy \u2013 tedy p\u0159edn\u00e1dorov\u00e9 stavy \u2013 nebol\u00ed a neprozrazuj\u00ed je ani \u017e\u00e1dn\u00e9 p\u0159\u00edznaky. Spole\u010dn\u011b s&nbsp;vakcinac\u00ed jsou proto gynekologick\u00e9 prohl\u00eddky d\u016fle\u017eitou sou\u010d\u00e1st\u00ed prevence rakoviny d\u011blo\u017en\u00edho hrdla. Chirurgick\u00e9 o\u0161et\u0159en\u00ed \u010d\u00edpku, kter\u00e9 zabra\u0148uje vzniku onemocn\u011bn\u00ed, pak prov\u00e1d\u00edme pouze v&nbsp;p\u0159\u00edpad\u011b, \u017ee jde o skute\u010dn\u011b z\u00e1va\u017enou prekancer\u00f3zu. Chirurgick\u00fd z\u00e1krok na d\u011blo\u017en\u00edm \u010d\u00edpku toti\u017e m\u016f\u017ee m\u00edt vliv na pr\u016fb\u011bh budouc\u00edho t\u011bhotenstv\u00ed. P\u0159i m\u00edrn\u00fdch p\u0159edn\u00e1dorov\u00fdch zm\u011bn\u00e1ch proto pacientky sledujeme na pravideln\u00fdch kontrol\u00e1ch. Pokud objev\u00edme prekancer\u00f3zu v&nbsp;dob\u011b t\u011bhotenstv\u00ed pacientky, je dokonce velk\u00e1 pravd\u011bpodobnost, \u017ee d\u00edky aktivaci imunitn\u00edho syst\u00e9mu zejm\u00e9na v&nbsp;z\u00e1v\u011bru t\u011bhotenstv\u00ed a po porodu dojde k&nbsp;jej\u00edmu samovyl\u00e9\u010den\u00ed. Infekce, kter\u00e1 zp\u016fsobila p\u0159edn\u00e1dorov\u00fd stav, nem\u016f\u017ee o\u010dek\u00e1van\u00e9 miminko nijak ohrozit nebo dokonce nakazit. Rakovina d\u011blo\u017en\u00edho hrdla, kterou zp\u016fsobuj\u00ed lidsk\u00e9 papilomaviry (HPV), m\u016f\u017ee vypuknout deset a \u010dasto i v\u00edce let po p\u0159enosu. V&nbsp;sou\u010dasnosti jde o jednu z&nbsp;nejb\u011b\u017en\u011bj\u0161\u00edch pohlavn\u011b p\u0159en\u00e1\u0161en\u00fdch infekc\u00ed. Jakmile se v\u0161ak objev\u00ed z\u00e1va\u017en\u00e9 p\u0159edn\u00e1dorov\u00e9 zm\u011bny na d\u011blo\u017en\u00edmu \u010d\u00edpku, hroz\u00ed, \u017ee se rakovina rozvine u\u017e za n\u011bkolik m\u011bs\u00edc\u016f nebo jednotky let,\u201c<\/em> vysv\u011btluje prof. MUDr. Ji\u0159\u00ed Sl\u00e1ma, Ph.D., z&nbsp;Kliniky gynekologie, porodnictv\u00ed a neonatologie 1. l\u00e9ka\u0159sk\u00e9 fakulty Univerzity Karlovy a V\u0161eobecn\u00e9 fakultn\u00ed nemocnice.<\/p>\n\n\n\n<p><strong>Rakovina d\u011blo\u017en\u00edho \u010d\u00edpku a o\u010dkov\u00e1n\u00ed proti HPV:<\/strong><\/p>\n\n\n\n<p><a><\/a> Ro\u010dn\u011b v&nbsp;\u010cR onemocn\u00ed rakovinou d\u011blo\u017en\u00edho hrdla p\u0159ibli\u017en\u011b 750 \u017een a asi 300 z&nbsp;nich na toto onemocn\u011bn\u00ed zem\u0159e. Jedn\u00e1 se o t\u0159et\u00ed nej\u010dast\u011bj\u0161\u00ed n\u00e1dorov\u00e9 onemocn\u011bn\u00ed u \u017een v&nbsp;produktivn\u00edm v\u011bku (15\u201344 let) v&nbsp;\u010cR, p\u0159i\u010dem\u017e incidence i \u00famrtnost na&nbsp;karcinom d\u011blo\u017en\u00edho hrdla jsou v \u010cR hor\u0161\u00ed, ne\u017e je pr\u016fm\u011br EU. Rozvoji nejen tohoto n\u00e1dorov\u00e9ho onemocn\u011bn\u00ed, kter\u00e9 zp\u016fsobuje HPV (lidsk\u00fd papilomavirus), lze p\u0159edej\u00edt o\u010dkov\u00e1n\u00edm a doch\u00e1zen\u00edm na pravideln\u00e9 gynekologick\u00e9 prohl\u00eddky. HPV m\u00e1 na sv\u011bdom\u00ed nejen 98 % p\u0159\u00edpad\u016f rakoviny d\u011blo\u017en\u00edho hrdla, ale z&nbsp;90 % je p\u0159\u00ed\u010dinou nap\u0159\u00edklad i velmi nep\u0159\u00edjemn\u00fdch genit\u00e1ln\u00edch bradavic. O\u010dkov\u00e1n\u00ed je nej\u00fa\u010dinn\u011bj\u0161\u00ed v&nbsp;dob\u011b p\u0159ed zah\u00e1jen\u00edm sexu\u00e1ln\u00edho \u017eivota (tj. u HPV naivn\u00edch jedinc\u016f), ale i pot\u00e9 m\u00e1 smysl, neo\u010dkovan\u00ed z\u016fst\u00e1vaj\u00ed v&nbsp;riziku rozvoje HPV asociovan\u00fdch onemocn\u011bn\u00ed.<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Poprv\u00e9 vy\u0161la Tereze (24) z Prahy hor\u0161\u00ed cytologie p\u0159ibli\u017en\u011b p\u0159ed p\u011bti lety. Kv\u016fli mo\u017en\u00e9mu rozvoji rakoviny d\u011blo\u017en\u00edho hrdla je proto pod pe\u010dliv\u00fdm dohledem l\u00e9ka\u0159\u016f. Mezit\u00edm <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=43716\" title=\"Hroz\u00ed j\u00ed rakovina, po porodu ji proto \u010dek\u00e1 operace\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":13998,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-43716","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-spolecnost"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/43716","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=43716"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/43716\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/13998"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=43716"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=43716"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=43716"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}