{"id":50988,"date":"2024-07-31T06:03:53","date_gmt":"2024-07-31T04:03:53","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=50988"},"modified":"2024-07-31T06:03:54","modified_gmt":"2024-07-31T04:03:54","slug":"rakovina-plic-buji-rychle-pocita-se-kazdy-tyden","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=50988","title":{"rendered":"Rakovina plic buj\u00ed rychle \u2013 po\u010d\u00edt\u00e1 se ka\u017ed\u00fd t\u00fdden"},"content":{"rendered":"\n

Plicn\u00ed l\u00e9ka\u0159i se sna\u017e\u00ed zkr\u00e1tit cestu pacienta od diagn\u00f3zy k l\u00e9\u010db\u011b<\/em><\/p>\n\n\n\n

Praha, 30. 7. 2024 \u2013 Pokud se v plic\u00edch rozbuj\u00ed n\u00e1dor, je t\u0159eba zah\u00e1jit l\u00e9\u010dbu v co nejkrat\u0161\u00edm \u010dase. Plicn\u00ed n\u00e1dory toti\u017e rychle rostou a metastazuj\u00ed. V tom, zda se pacient uzdrav\u00ed, hraje roli ka\u017ed\u00fd t\u00fdden. \u010c\u00e1st lid\u00ed v\u0161ak na diagn\u00f3zu a l\u00e9\u010dbu \u010dek\u00e1 m\u011bs\u00edce. To se sna\u017e\u00ed zm\u011bnit pneumologov\u00e9, kte\u0159\u00ed iniciovali program \u010dasn\u00e9ho z\u00e1chytu plicn\u00edho karcinomu, jen\u017e um\u00ed odhalit tumory v\u010das. Usiluj\u00ed tak\u00e9 o zkr\u00e1cen\u00ed cesty pacienta od vy\u0161et\u0159en\u00ed k \u201ena m\u00edru \u0161it\u00e9\u201c l\u00e9\u010db\u011b. Mluv\u00ed o tom <\/strong>v r\u00e1mci Sv\u011btov\u00e9ho dne rakoviny plic, kter\u00fd p\u0159ipad\u00e1 na 1. srpna.<\/strong><\/p>\n\n\n\n

\u201eA\u010dkoliv m\u00e1me v komplexn\u00edch onkologick\u00fdch centrech \u0159adu nov\u00fdch l\u00e9k\u016f, kter\u00e9 v\u00fdznamn\u011b napom\u00e1haj\u00ed v terapii pacient\u016f s plicn\u00edmi karcinomy, je po\u0159\u00e1d kl\u00ed\u010dov\u00e9, aby se lid\u00e9 dostali ke spr\u00e1vn\u00e9 l\u00e9\u010db\u011b v\u010das. Zbyte\u010dn\u00e1 prodleva m\u016f\u017ee pro nemocn\u00e9ho znamenat, \u017ee se z vyl\u00e9\u010diteln\u00e9ho \u2013 \u010dasn\u00e9ho stadia \u2013 dostane do stavu, kdy u\u017e operace nen\u00ed mo\u017en\u00e1. Tito pacienti pak maj\u00ed v\u00fdznamn\u011b ni\u017e\u0161\u00ed \u0161anci na dlouhodob\u00e9 p\u0159e\u017eit\u00ed,\u201c<\/em> \u0159\u00edk\u00e1 doc. MUDr. Martin Svato\u0148, Ph.D., p\u0159ednosta Kliniky pneumologie a ftizeologie FN Plze\u0148. Dod\u00e1v\u00e1, \u017ee pacient\u016fm, kter\u00e9 \u010dek\u00e1 operace, l\u00e9ka\u0159i nov\u011b nab\u00edz\u00ed krom\u011b chemoterapie tzv. imunoterapii. V\u00fdrazn\u011b tak zv\u00fd\u0161\u00ed pravd\u011bpodobnost, \u017ee se tumor znovu neobjev\u00ed. \u201eTato l\u00e9\u010dba vede dokonce k tomu, \u017ee se p\u0159ibli\u017en\u011b u 30 % nemocn\u00fdch najde p\u0159i operaci m\u00edsto n\u00e1doru u\u017e jen vazivov\u00e1 tk\u00e1\u0148,\u201c<\/em> dopl\u0148uje doc. Svato\u0148.<\/p>\n\n\n\n

K\u00a0tomu, aby se pacient rychle dostal k\u00a0pro n\u011bj ide\u00e1ln\u00ed l\u00e9\u010db\u011b, je t\u0159eba dob\u0159e proveden\u00e1 diagnostick\u00e1 bronchoskopie (vy\u0161et\u0159en\u00ed plic zevnit\u0159 pomoc\u00ed bronchoskopu a odebr\u00e1n\u00ed vzorku tk\u00e1n\u011b pro p\u0159esn\u00e9 ur\u010den\u00ed typu n\u00e1doru). Pr\u00e1v\u011b na tu se cht\u011bj\u00ed plicn\u00ed l\u00e9ka\u0159i soust\u0159edit. \u201eProbl\u00e9mem jsou lo\u017eiska ulo\u017een\u00e1 hloub\u011bji v\u00a0plic\u00edch, kter\u00e1 nejsou p\u0159\u00edmo dostupn\u00e1 p\u0159i bronchoskopick\u00e9m vy\u0161et\u0159en\u00ed. Jestli\u017ee se v\u00a0t\u011bchto p\u0159\u00edpadech ud\u011bl\u00e1 bronchoskopie a odb\u011br \u201anaslepo\u2018, pak \u0161ance, \u017ee vzorek bude dostate\u010dn\u011b kvalitn\u00ed, nen\u00ed vysok\u00e1. P\u0159i pou\u017eit\u00ed modern\u00edch metod \u00fasp\u011b\u0161nost diagn\u00f3zy \u0161patn\u011b dostupn\u00fdch plicn\u00edch lo\u017eisek v\u00fdrazn\u011b nar\u016fst\u00e1,\u201c<\/em>\u00a0\u0159\u00edk\u00e1 MUDr. Petr\u00a0Jakubec Ph.D.,\u00a0p\u0159ednosta\u00a0Kliniky plicn\u00edch nemoc\u00ed a tuberkul\u00f3zy FN Olomouc.<\/p>\n\n\n\n

<\/em>Modern\u00ed p\u0159\u00edstroje, jako je nap\u0159\u00edklad virtu\u00e1ln\u011b nebo elektromagneticky navigovan\u00e1 bronchoskopie\u00a0\u010di radi\u00e1ln\u00ed\u00a0endobronchi\u00e1ln\u00ed\u00a0ultrazvuk m\u00e1 pouze mal\u00e1 \u010d\u00e1st plicn\u00edch pracovi\u0161\u0165 \u2013 technika je drah\u00e1 a stoj\u00ed \u0159\u00e1dov\u011b miliony korun.\u00a0\u201eNa\u0161e odborn\u00e1 spole\u010dnost usiluje o to, aby se bronchoskopick\u00e1 vy\u0161et\u0159en\u00ed n\u00e1doru, kter\u00fd je usazen v\u00a0t\u011b\u017eko dostupn\u00fdch m\u00edstech plic, prov\u00e1d\u011bla pouze na pracovi\u0161t\u00edch, je\u017e maj\u00ed adekv\u00e1tn\u00ed p\u0159\u00edstrojov\u00e9 a person\u00e1ln\u00ed vybaven\u00ed,\u201c <\/em>pokra\u010duje <\/em>MUDr. Jakubec, v\u011bdeck\u00fd sekret\u00e1\u0159 \u010cesk\u00e9 pneumologick\u00e9 a ftizeologick\u00e9 spole\u010dnosti (\u010cPFS). Po bronchoskopii vzorek putuje do laborato\u0159e na histologii, co\u017e v\u010detn\u011b dal\u0161\u00edch molekul\u00e1rn\u00edch vy\u0161et\u0159en\u00ed zabere v\u00a0pr\u016fm\u011bru 2\u2013<\/em>3 t\u00fddny. \u201eKdy\u017e je vzorek mal\u00fd nebo nen\u00ed dob\u0159e odebran\u00fd, mus\u00ed pacient na bronchoskopii znovu a proces se op\u011bt natahuje,\u201c <\/em>vysv\u011btluje doc. Svato\u0148. Plicn\u00ed l\u00e9ka\u0159i usiluj\u00ed o zrychlen\u00ed cesty \u010dlov\u011bka s\u00a0n\u00e1dorem od chv\u00edle, kdy nav\u0161t\u00edv\u00ed praktick\u00e9ho l\u00e9ka\u0159e, a\u017e po l\u00e9\u010dbu ve specializovan\u00e9m centru.<\/p>\n\n\n\n

\u201eAnonymizovan\u00e1 data, kter\u00e1 nemocnice vykazuj\u00ed zdravotn\u00edm poji\u0161\u0165ovn\u00e1m ukazuj\u00ed, \u017ee 58 % pacient\u016f s karcinomem plic \u010dek\u00e1 na operaci p\u0159es 6 t\u00fddn\u016f (m\u011b\u0159eno od prvn\u00ed bronchoskopie), na radioterapii si 64 % lid\u00ed po\u010dk\u00e1 tak\u00e9 p\u0159es 6 t\u00fddn\u016f a stejn\u011b tak dlouho trv\u00e1 i zah\u00e1jen\u00ed farmakoterapie u 47 % pacient\u016f,\u201c<\/em> dopl\u0148uje doc. Dr. Rer. Nat. Ale\u0161 Tichop\u00e1d, Ph.D., z Fakulty biomedic\u00ednsk\u00e9ho in\u017een\u00fdrstv\u00ed \u010cesk\u00e9ho vysok\u00e9ho u\u010den\u00ed technick\u00e9ho v Praze.<\/p>\n\n\n\n

Zpo\u017ed\u011bn\u00ed v\u0161ak nast\u00e1v\u00e1 i z\u00a0jin\u00fdch p\u0159\u00ed\u010din \u2013 rakovina plic toti\u017e zpo\u010d\u00e1tku nijak nebol\u00ed \u2013 ti\u0161e postupuje, a kdy\u017e pacient zjist\u00ed, \u017ee se v\u00a0jeho t\u011ble d\u011bje n\u011bco nekal\u00e9ho, b\u00fdv\u00e1 u\u017e obvykle \u201epozd\u011b\u201c. K\u00a0\u010dasn\u00e9mu odhalen\u00ed n\u00e1doru pom\u00e1h\u00e1 u\u017e p\u0159es rok program \u010dasn\u00e9ho z\u00e1chytu rakoviny plic. Ten je ur\u010den lidem mezi 55. a 74. rokem, kte\u0159\u00ed maj\u00ed \u201en\u00e1lo\u017e\u201c alespo\u0148 200 000 cigaret \u010dili kou\u0159ili nebo kou\u0159\u00ed bu\u010f po dobu 20 let asi 20 cigaret denn\u011b, nebo 10 let p\u0159ibli\u017en\u011b 40 cigaret za den. Praktick\u00fd l\u00e9ka\u0159 tyto rizikov\u00e9 jedince pos\u00edl\u00e1 k\u00a0plicn\u00edmu specialistovi, a ten je po prohl\u00eddce odes\u00edl\u00e1 na akreditovan\u00e1 radiologick\u00e1 pracovi\u0161t\u011b k vy\u0161et\u0159en\u00ed n\u00edzkod\u00e1vkov\u00fdm CT.<\/p>\n\n\n\n

Pokud objev\u00ed podez\u0159el\u00fd n\u00e1lez, n\u00e1sleduj\u00ed dal\u0161\u00ed vy\u0161et\u0159en\u00ed a ide\u00e1ln\u011b porada tzv. multidisciplin\u00e1rn\u00edho t\u00fdmu, jak\u00fd postup l\u00e9\u010dby nejl\u00e9pe zvolit. \u201eSpole\u010dn\u011b s\u00a0praktiky jsme v\u00a0r\u00e1mci screeningu oslovili 21 028 rizikov\u00fdch osob, k\u00a0pneumologovi p\u0159i\u0161lo 9 832 lid\u00ed, z\u00a0toho 6\u00a0532 absolvovalo vy\u0161et\u0159en\u00ed n\u00edzkod\u00e1vkov\u00fdm CT. To zachytilo 211 rizikov\u00fdch n\u00e1lez\u016f. U 42 % se diagn\u00f3za karcinomu plic u\u017e potvrdila, u poloviny z\u00a0nich byl n\u00e1lez v\u00a0\u010dasn\u00e9m, operabiln\u00edm stadiu,\u201c <\/em>\u0159\u00edk\u00e1 prim. MUDr. Ivana \u010ciern\u00e1 Peterov\u00e1, p\u0159edsedkyn\u011b Sekce ambulantn\u00edch pneumolog\u016f \u010cPFS.<\/p>\n\n\n\n

Plicn\u00ed l\u00e9ka\u0159i zd\u016fraz\u0148uj\u00ed, \u017ee by se p\u00e9\u010de o pacienty s rakovinou plic m\u011bla soust\u0159edit do m\u00edst, kde funguj\u00ed tzv. multidisciplin\u00e1rn\u00ed t\u00fdmy (MDT), slo\u017een\u00e9 z plicn\u00edho l\u00e9ka\u0159e, hrudn\u00edho chirurga, radiodiagnostika, onkologa a radia\u010dn\u00edho onkologa. MDT toti\u017e zaji\u0161\u0165uj\u00ed kvalitn\u00ed a komplexn\u00ed p\u00e9\u010di a souvis\u00ed s lep\u0161\u00edm p\u0159e\u017eit\u00edm pacienta. \u201eK MDT se v\u0161ak bohu\u017eel nedostanou v\u0161ichni pacienti, a to se sna\u017e\u00edme, ve spolupr\u00e1ci s region\u00e1ln\u00edmi centry, zm\u011bnit,\u201c <\/em>dod\u00e1v\u00e1 doc. Svato\u0148.<\/p>\n\n\n\n

V \u010cesk\u00e9 republice ka\u017ed\u00fd rok onemocn\u00ed rakovinou plic p\u0159ibli\u017en\u011b 6 600 lid\u00ed a t\u00e9m\u011b\u0159 5 400 na ni zem\u0159e.<\/p>\n\n\n\n

\u010cesk\u00e1 pneumologick\u00e1 a ftizeologick\u00e1 spole\u010dnost \u010cLS JEP (\u010cPFS)<\/strong><\/p>\n\n\n\n

Odborn\u00e1 l\u00e9ka\u0159sk\u00e1 spole\u010dnost, kter\u00e1 \u0159e\u0161\u00ed problematiku v\u0161ech respira\u010dn\u00edch nemoc\u00ed v\u010detn\u011b tuberkul\u00f3zy po str\u00e1nce prevence, vyhled\u00e1v\u00e1n\u00ed, diagnostiky i terapie. \u010cPFS vytv\u00e1\u0159\u00ed doporu\u010den\u00e9 klinick\u00e9 postupy, vypracov\u00e1v\u00e1 odborn\u00e1 stanoviska k r\u016fzn\u00fdm probl\u00e9m\u016fm z vlastn\u00ed iniciativy nebo na \u017e\u00e1dost org\u00e1n\u016f st\u00e1tn\u00ed spr\u00e1vy. Odborn\u00e9 sekce \u010cPFS prohlubuj\u00ed a roz\u0161i\u0159uj\u00ed informace v jednotliv\u00fdch funk\u010dn\u00edch specializac\u00edch obor\u016f pneumologie a ftizeologie. Hlavn\u00edmi sm\u011bry odborn\u00e9ho zam\u011b\u0159en\u00ed t\u011bchto obor\u016f jsou nemoci spojen\u00e9 s bronchi\u00e1ln\u00ed obstrukc\u00ed, n\u00e1dory d\u00fdchac\u00edho \u00fastroj\u00ed, infek\u010dn\u00ed z\u00e1n\u011bty v\u010detn\u011b tuberkul\u00f3zy, interstici\u00e1ln\u00ed a granulomat\u00f3zn\u00ed plicn\u00ed procesy, poruchy d\u00fdch\u00e1n\u00ed ve sp\u00e1nku, l\u00e9\u010dba cystick\u00e9 fibr\u00f3zy dosp\u011bl\u00fdch a dal\u0161\u00ed plicn\u00ed nemoci. Informace o spole\u010dnosti lze nal\u00e9zt na www.plicnilekarstvi.cz<\/a>.<\/p>\n\n\n\n

Garantem programu \u010dasn\u00e9ho z\u00e1chytu karcinomu plic je Ministerstvo zdravotnictv\u00ed a na proveden\u00ed se pod\u00edl\u00ed N\u00e1rodn\u00ed screeningov\u00e9 centrum \u00dastavu zdravotnick\u00fdch informac\u00ed a statistiky \u010cR s odborn\u00fdmi spole\u010dnostmi a dal\u0161\u00edmi institucemi. Informace o programu \u010dasn\u00e9ho z\u00e1chytu karcinomu plic lze nal\u00e9zt na https:\/\/prevenceproplice.cz<\/a>.<\/p>\n\n\n\n

\u010cesk\u00e1 aliance proti chronick\u00fdm respira\u010dn\u00edm onemocn\u011bn\u00edm<\/strong> (\u010cARO)<\/strong><\/p>\n\n\n\n

Instituce, kter\u00e1 napom\u00e1h\u00e1 zmen\u0161ovat z\u00e1t\u011b\u017e chronick\u00fdmi respira\u010dn\u00edmi nemocemi v populaci \u010cesk\u00e9 republiky. \u010cARO se hl\u00e1s\u00ed ke sv\u011btov\u00e9 organizaci GARD (Global Alliance against Chronic Respiratory Diseases) a jej\u00ed \u010dinnost prob\u00edh\u00e1 pod patronac\u00ed Sv\u011btov\u00e9 zdravotnick\u00e9 organizace (WHO). C\u00edlem je v\u00fdrazn\u011b zv\u00fd\u0161it spole\u010densk\u00e9 pov\u011bdom\u00ed o chronick\u00fdch chorob\u00e1ch d\u00fdchac\u00edho syst\u00e9mu na v\u0161ech \u00farovn\u00edch zdravotn\u00ed p\u00e9\u010de. \u010cARO sdru\u017euje p\u0159es 20 odborn\u00fdch i laick\u00fdch organizac\u00ed, kter\u00e9 se zab\u00fdvaj\u00ed diagnostikou, l\u00e9\u010dbou a popularizac\u00ed nejz\u00e1va\u017en\u011bj\u0161\u00edch respira\u010dn\u00edch onemocn\u011bn\u00ed, kam pat\u0159\u00ed chronick\u00e1 obstruk\u010dn\u00ed plicn\u00ed nemoc (CHOPN), bronchi\u00e1ln\u00ed astma, rakovina plic, TBC a \u0159ada dal\u0161\u00edch z\u00e1va\u017en\u00fdch nemoc\u00ed. \u010cARO apeluje na zlep\u0161en\u00ed prevence a v\u010dasn\u00e9 diagnostiky u rizikov\u00e9 \u010d\u00e1sti populace s c\u00edlem zv\u00fd\u0161it \u00fa\u010dinnost racion\u00e1ln\u00ed l\u00e9\u010dby. V\u00edce informac\u00ed na www.caro-gard.cz<\/a><\/p>\n\n\n\n

\u010cesk\u00fd ob\u010dansk\u00fd spolek proti plicn\u00edm nemocem (\u010cOPN)<\/strong><\/p>\n\n\n\n

Od roku 2019 se v\u011bnuje i pacient\u016fm s\u00a0rakovinou plic. \u010cinnost \u010cOPN garantuje odborn\u00e1 spole\u010dnost (\u010cPFS). Informace o \u010cOPN lze nal\u00e9zt na port\u00e1le www.copn.cz<\/u><\/a>.<\/p>\n\n\n\n

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Seznam center vysoce specializovan\u00e9 pneumoonkochirurgick\u00e9 p\u00e9\u010de:<\/p>\n\n\n\n