{"id":46973,"date":"2024-03-12T16:50:12","date_gmt":"2024-03-12T15:50:12","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=46973"},"modified":"2024-03-12T16:50:14","modified_gmt":"2024-03-12T15:50:14","slug":"kazdy-desaty-ma-vysoke-riziko-rakoviny-slinivky-brisni-pomuze-cilene-vyhledavani","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=46973","title":{"rendered":"Ka\u017ed\u00fd des\u00e1t\u00fd m\u00e1 vysok\u00e9 riziko rakoviny slinivky b\u0159i\u0161n\u00ed, pom\u016f\u017ee c\u00edlen\u00e9 vyhled\u00e1v\u00e1n\u00ed"},"content":{"rendered":"\n

V\u010dasn\u00e9 odhalen\u00ed zv\u00fd\u0161\u00ed \u0161anci na del\u0161\u00ed \u017eivot<\/em><\/p>\n\n\n\n

Kdy\u017e za\u010dne \u201ezlobit\u201c, u\u017e b\u00fdv\u00e1 pozd\u011b. \u0158e\u010d je o rakovin\u011b slinivky b\u0159i\u0161n\u00ed. Jde o jeden z\u00a0nejz\u00e1ke\u0159n\u011bj\u0161\u00edch n\u00e1dor\u016f v\u016fbec, a proto se jej l\u00e9ka\u0159i sna\u017e\u00ed zachytit v\u00a0co nejran\u011bj\u0161\u00edm stadiu. Ji\u017e loni v\u00a0\u010cR odstartoval program v\u010dasn\u00e9ho vyhled\u00e1v\u00e1n\u00ed t\u00e9to nemoci, zalo\u017een\u00fd na vy\u0161et\u0159ov\u00e1n\u00ed osob s vysok\u00fdm rizikem vzniku rakoviny. V budoucnu by se do projektu mohlo za\u0159adit a\u017e 30 specializovan\u00fdch center po cel\u00e9 zemi a l\u00e9ka\u0159i doufaj\u00ed, \u017ee v\u00fdhledov\u011b zkontroluj\u00ed i\u00a0n\u011bkolik stovek pacient\u016f ro\u010dn\u011b.<\/strong><\/p>\n\n\n\n

Boj proti rakovin\u011b slinivky b\u0159i\u0161n\u00ed byl tak\u00e9 jedn\u00edm z\u00a0hlavn\u00edch t\u00e9mat 26. ro\u010dn\u00edku Hradeck\u00fdch gastroenterologick\u00fdch dn\u00ed, na kter\u00e9 se minul\u00fd t\u00fdden do Fakultn\u00ed nemocnice Hradec Kr\u00e1lov\u00e9 sjely stovky expert\u016f na onemocn\u011bn\u00ed tr\u00e1vic\u00edho traktu z\u00a0cel\u00e9ho \u010ceska i zahrani\u010d\u00ed.<\/strong><\/p>\n\n\n\n

Rakovina slinivky b\u0159i\u0161n\u00ed je mezi n\u00e1dorov\u00fdmi onemocn\u011bn\u00edmi t\u0159et\u00ed nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou \u00famrt\u00ed, ro\u010dn\u011b ji v\u00a0\u010cR l\u00e9ka\u0159i diagnostikuj\u00ed 2 400 osob\u00e1m a t\u00e9m\u011b\u0159 2 200 pacient\u016f na ni um\u00edr\u00e1. Po\u010det p\u0159\u00edpad\u016f nav\u00edc podle expert\u016f setrvale roste a do roku 2050 p\u0159edpokl\u00e1daj\u00ed jejich zdvojn\u00e1soben\u00ed. <\/p>\n\n\n\n

Rakovina slinivky b\u0159i\u0161n\u00ed zpo\u010d\u00e1tku nep\u016fsob\u00ed \u017e\u00e1dn\u00e9 pot\u00ed\u017ee, a l\u00e9ka\u0159i ji tak v\u00a0naprost\u00e9 v\u011bt\u0161in\u011b odhal\u00ed a\u017e v\u00a0pokro\u010dil\u00e9m stadiu. To se ji\u017e projevuje hubnut\u00edm, nechutenstv\u00edm, bolestmi b\u0159icha a zad nebo \u017eloutnut\u00edm k\u016f\u017ee.<\/p>\n\n\n\n

\u201eV\u00a0t\u00e9to f\u00e1zi ji\u017e progn\u00f3za l\u00e9\u010dby pacienta nen\u00ed p\u0159\u00edzniv\u00e1, pr\u016fm\u011brn\u00e9 p\u0159e\u017eit\u00ed se pohybuje kolem 8 m\u011bs\u00edc\u016f. Proto je naprosto kl\u00ed\u010dov\u00e9 n\u00e1dory pankreatu odhalit v\u00a0ran\u00e9 f\u00e1zi, kdy je je\u0161t\u011b mo\u017en\u00e9 jejich chirurgick\u00e9 odstran\u011bn\u00ed a dal\u0161\u00ed onkologick\u00e1 l\u00e9\u010dba, \u010d\u00edm\u017e se \u0161ance na p\u011btilet\u00e9 p\u0159e\u017eit\u00ed zved\u00e1 na 12 %,\u201c<\/em> \u0159\u00edk\u00e1 prof.\u00a0MUDr.\u00a0Ond\u0159ej Urban, p\u0159ednosta II. intern\u00ed kliniky \u2013 gastroenterologick\u00e9 a geriatrick\u00e9 Fakultn\u00ed nemocnice Olomouc. I proto se s kolegy v\u00a0minul\u00fdch letech zasazoval o spu\u0161t\u011bn\u00ed programu vyhled\u00e1v\u00e1n\u00ed \u010dasn\u00fdch forem rakoviny slinivky b\u0159i\u0161n\u00ed, kter\u00fd na konci lo\u0148sk\u00e9ho roku skute\u010dn\u011b odstartoval. <\/p>\n\n\n\n

\u201eZam\u011b\u0159ujeme se na pacienty, u kter\u00fdch lze nemoc p\u0159edv\u00eddat a riziko v\u00fdskytu je u nich vysok\u00e9. T\u011bch je asi 10 % a jsou to p\u0159edev\u0161\u00edm lid\u00e9, u nich\u017e se rakovina vyskytuje v\u00a0rodin\u011b nebo jsou nositeli rizikov\u00e9 genetick\u00e9 mutace. V\u00a0tuto chv\u00edli ji\u017e m\u00e1me do programu vybran\u00fdch v\u00edce ne\u017e 100\u00a0pacient\u016f. Douf\u00e1me, \u017ee vy\u0161et\u0159\u00edme \u0159\u00e1dov\u011b stovky pacient\u016f ro\u010dn\u011b,\u201c <\/em>vysv\u011btluje prof. Urban. <\/p>\n\n\n\n

Na ja\u0159e se podle n\u011bj pl\u00e1nuje tak\u00e9 spu\u0161t\u011bn\u00ed registru t\u011bchto pacient\u016f, d\u00edky n\u011bmu\u017e bude mo\u017en\u00e9 l\u00e9pe vyhodnocovat data a sledovat \u00fasp\u011b\u0161nost programu. U v\u00fdb\u011bru rizikov\u00fdch p\u0159\u00edpad\u016f pak spol\u00e9haj\u00ed na \u00fazkou spolupr\u00e1ci s\u00a0onkology, genetiky a chirurgy, ale tak\u00e9 s praktick\u00fdmi l\u00e9ka\u0159i, kte\u0159\u00ed pacienty odes\u00edlaj\u00ed na vy\u0161et\u0159en\u00ed do tzv. center vysoce specializovan\u00e9 p\u00e9\u010de pro digestivn\u00ed endoskopii. T\u011bch je nyn\u00ed v\u00a0\u010cesku ji\u017e devaten\u00e1ct, do budoucna by se v\u0161ak m\u011bl jejich po\u010det zv\u00fd\u0161it nad t\u0159icet. <\/p>\n\n\n\n

\u201eCentra jsou um\u00edst\u011bna v\u00a0p\u0159edn\u00edch \u010desk\u00fdch gastroenterologick\u00fdch pracovi\u0161t\u00edch, kter\u00e1 jsou schopna zajistit komplexn\u00ed p\u00e9\u010di o\u00a0nemocn\u00e9ho s\u00a0t\u00edmto z\u00e1va\u017en\u00fdm onemocn\u011bn\u00edm bez zbyte\u010dn\u00fdch \u010dasov\u00fdch ztr\u00e1t,\u201c <\/em>\u0159\u00edk\u00e1 doc. MUDr. Ilja Tachec\u00ed, p\u0159ednosta II. intern\u00ed gastroenterologick\u00e9 kliniky LF UK a FN Hradec Kr\u00e1lov\u00e9. <\/p>\n\n\n\n

\u201ePo za\u0159azen\u00ed do programu proch\u00e1zej\u00ed rizikov\u00e9 osoby krom\u011b krevn\u00edch test\u016f tak\u00e9 vy\u0161et\u0159en\u00edm magnetickou rezonanc\u00ed a speci\u00e1ln\u00edm ultrazvukov\u00fdm vy\u0161et\u0159en\u00edm pomoc\u00ed endoskopu. Krit\u00e9ria v\u00fdb\u011bru pacient\u016f, konkr\u00e9tn\u00ed vy\u0161et\u0159en\u00ed a jejich na\u010dasov\u00e1n\u00ed p\u0159esn\u011b specifikuje nov\u00fd doporu\u010den\u00fd postup \u010cesk\u00e9 gastroenterologick\u00e9 spole\u010dnosti, vypracovan\u00fd ve spolupr\u00e1ci s\u00a0onkology a chirurgy. Skon\u010dila doba pasivn\u00edho p\u0159ihl\u00ed\u017een\u00ed, probl\u00e9m je pot\u0159eba intenzivn\u011b \u0159e\u0161it, i kdy\u017e si v\u0161ichni uv\u011bdomujeme, jak to je obt\u00ed\u017en\u00e9,\u201c<\/em> dod\u00e1v\u00e1 doc. Tachec\u00ed. To podle n\u011bj podtrhuje i\u00a0mno\u017estv\u00ed kongres\u016f, kter\u00e9 se t\u00e9matu v\u011bnuj\u00ed, a intenzivn\u00ed spolupr\u00e1ce odborn\u00edk\u016f zm\u00edn\u011bn\u00fdch obor\u016f. Cel\u00fd program v\u010dasn\u00e9ho vyhled\u00e1v\u00e1n\u00ed pak prob\u00edh\u00e1 v\u00a0r\u00e1mci v\u011bdeck\u00e9 studie, kter\u00e1 by m\u011bla ov\u011b\u0159it, zda se t\u00edmto zp\u016fsobem v\u00fdznamn\u011b zv\u00fd\u0161\u00ed po\u010det l\u00e9\u010diteln\u00fdch n\u00e1dor\u016f v\u00a0ran\u00e9m stadiu.<\/p>\n\n\n\n

V sou\u010dasn\u00e9 dob\u011b jedin\u00e1 skute\u010dn\u011b efektivn\u00ed l\u00e9\u010dba rakoviny slinivky b\u0159i\u0161n\u00ed spo\u010d\u00edv\u00e1 v chirurgick\u00e9m odstran\u011bn\u00ed n\u00e1doru. \u201eOdstraniteln\u00e9 n\u00e1dory se v\u0161ak diagnostikuj\u00ed pouze v 10\u201315 % p\u0159\u00edpad\u016f. Prim\u00e1rn\u011b tyto pacienty operujeme, pouze pokud jsou v celkov\u011b dobr\u00e9m stavu, tedy bez v\u00fdrazn\u00e9ho \u00fabytku na v\u00e1ze, a pokud se hladina n\u00e1dorov\u00fdch marker\u016f nepohybuje ve vysok\u00fdch hodnot\u00e1ch, co\u017e varuje p\u0159ed mo\u017en\u00fdmi mikrometast\u00e1zami, kter\u00e9 nelze odhalit na zobrazovac\u00edch metod\u00e1ch. N\u00e1dory slinivky s metast\u00e1zami jsou l\u00e9\u010deny syst\u00e9movou chemoterapi\u00ed. Bohu\u017eel takov\u00fdch pacient\u016f je velk\u00e1 v\u011bt\u0161ina, okolo 50\u201360 %. U zb\u00fdvaj\u00edc\u00edch zhruba 25 % p\u0159\u00edpad\u016f jsou n\u00e1dory lok\u00e1ln\u011b pokro\u010dil\u00e9, ale bez metast\u00e1z. \u010casto jsou ve v\u00fdznamn\u00e9m kontaktu s okoln\u00edmi d\u016fle\u017eit\u00fdmi c\u00e9vn\u00edmi strukturami nebo do nich pror\u016fstaj\u00ed. \u010c\u00e1st pacient\u016f m\u016f\u017ee podstoupit resekci slinivky jen za cenu n\u00e1hrady c\u00e9v nebo a\u017e po eventu\u00e1ln\u00edm zmen\u0161en\u00ed lok\u00e1ln\u011b pokro\u010dil\u00fdch n\u00e1dor\u016f onkologickou syst\u00e9movou l\u00e9\u010dbou,\u201c <\/em>\u0159\u00edk\u00e1 prof. MUDr. Zden\u011bk Kala, CSc., p\u0159edseda \u010cesk\u00e9 chirurgick\u00e9 spole\u010dnosti \u010cLS JEP. Zbyl\u00fdch p\u0159ibli\u017en\u011b 60 % n\u00e1dor\u016f slinivky je podle n\u011bj v dob\u011b diagn\u00f3zy ji\u017e natolik pokro\u010dil\u00fdch, \u017ee nen\u00ed mo\u017en\u00e9 je operovat a l\u00e9ka\u0159i nasazuj\u00ed chemoterapii. Operace se podle prof. Kaly tak\u00e9 st\u00e1le \u010dast\u011bji prov\u00e1d\u00ed tzv. miniinvazivn\u00edmi technikami a za pomoci chirurgick\u00e9ho robota. To umo\u017e\u0148uje prov\u00e9st co nejmen\u0161\u00ed z\u00e1sah a usnad\u0148uje rekonvalescenci pacienta.<\/p>\n","protected":false},"excerpt":{"rendered":"

V\u010dasn\u00e9 odhalen\u00ed zv\u00fd\u0161\u00ed \u0161anci na del\u0161\u00ed \u017eivot Kdy\u017e za\u010dne \u201ezlobit\u201c, u\u017e b\u00fdv\u00e1 pozd\u011b. \u0158e\u010d je o rakovin\u011b slinivky b\u0159i\u0161n\u00ed. Jde o jeden z\u00a0nejz\u00e1ke\u0159n\u011bj\u0161\u00edch n\u00e1dor\u016f v\u016fbec, […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":46976,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-46973","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\/46973","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=46973"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/46973\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/46976"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=46973"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=46973"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=46973"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}