{"id":13558,"date":"2022-04-14T11:36:12","date_gmt":"2022-04-14T11:36:12","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=13558"},"modified":"2022-04-14T11:36:12","modified_gmt":"2022-04-14T11:36:12","slug":"preventia-cancerelor-ginecologice","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/preventia-cancerelor-ginecologice\/","title":{"rendered":"Preven\u021bia cancerelor ginecologice"},"content":{"rendered":"

Rom\u00e2nia ocup\u0103 \u00een Uniunea European\u0103 un loc frunta\u0219 \u00een ceea ce prive\u0219te inciden\u021ba cancerului uterin. Se spune c\u0103 preven\u021bia face c\u00e2t o mie de tratamente. Din p\u0103cate, \u00eens\u0103, acest lucru nu este \u00een\u021beles pe deplin, merg\u00e2ndu-se pe principiul c\u0103, dac\u0103 ceva nu doare la un moment dat, probabil c\u0103 nu exist\u0103.<\/strong><\/p>\n

\"\"<\/a>
Dr. Radu Dan Cristian, medic primar Obstetrica-Ginecologie<\/em><\/figcaption><\/figure>\n

Din experien\u021ba dvs. c\u00e2t de mult vin femeile la doctor pentru un control de rutin\u0103?<\/strong><\/p>\n

Depinde \u00a0de mediul de via\u021b\u0103. \u00cen mediile urbane, femeile vin mai des la medic, sunt mai conectate \u00een ceea ce prive\u0219te temele de discu\u021bie din media cu privire la s\u0103n\u0103tate \u0219i atunci au tendin\u021ba s\u0103 vin\u0103 mai frecvent. Dac\u0103 nu anual, m\u0103car o dat\u0103 la doi-trei ani. In mediul rural, mai ales din cauza problemelor de demografie, \u00een sensul \u00een care au r\u0103mas la \u021bar\u0103 mai ales oameni \u00een v\u00e2rst\u0103, femeile au tendin\u021ba s\u0103 nu mai vin\u0103 la medic. S\u0103 zicem, dup\u0103 na\u0219tere mai vin de o dat\u0103, de dou\u0103 ori \u0219i ulterior \u00ee\u0219i \u00eenchipuie c\u0103 nu mai e necesar s\u0103 vin\u0103 la control. Din p\u0103cate, majoritatea afec\u021biunilor pentru care facem screening nu debuteaz\u0103 cu durere \u0219i atunci, dac\u0103 femeile se prezint\u0103 la medic doar \u00een momentul \u00een care au durere sau doar \u00een momentul \u00een care apare un simptom care le \u00eengrijoreaz\u0103, cum ar fi s\u00e2ngerarea, atunci este de foarte multe ori relativ t\u00e2rziu.<\/p>\n

Ce investiga\u021bii pot fi f\u0103cute pentru preven\u021bie?<\/strong><\/p>\n

Preven\u021bia cea mai cunoscut\u0103 \u00een direc\u021bia asta este preven\u021bia cancerului de col uterin. De foarte mult\u0103 vreme avem examenul Babes Papanicolau care, datorit\u0103 faptului c\u0103 se practic\u0103 la scar\u0103 larg\u0103, este foarte accesibil, sunt \u0219i programe na\u021bionale, se deconteaz\u0103 prin Casa de Asigur\u0103ri, deci e u\u0219or de f\u0103cut \u0219i este cel mai cunoscut, cel mai la \u00eendem\u00e2n\u0103 \u0219i cel mai facil mod de a face preven\u021bia cancerului de col uterin. Apoi avem un vaccin pentru HPV. Oamenii \u00eenc\u0103 nu con\u0219tientizeaz\u0103 leg\u0103tura dintre infec\u021bia cu papilomavirusul uman \u0219i cancerul de col uterin. Asadar, avem instrumente de preven\u021bie, dar care nu sunt con\u0219tientizate. Nu e f\u0103cut\u0103 o educa\u021bie sistematic\u0103 astfel \u00eenc\u00e2t beneficiarii s\u0103 \u0219tie c\u0103 au aceast\u0103 posibilitate la \u00eendem\u00e2n\u0103.<\/p>\n

Legat de vaccinul \u00eempotriva HPV-ului de care vorbea\u021bi mai devreme. Exist\u0103 o v\u00e2rst\u0103 maxim\u0103 p\u00e2n\u0103 la care poate fi administrat, are el mai mult efect dac\u0103 este facut p\u00e2n\u0103 la \u00eenceperea vie\u021bii sexuale?<\/strong><\/p>\n

Sigur, modific\u0103rile care au loc la nivelul colului determinate hormonal sunt de amploare mai mare \u00een prima parte a vie\u021bii, ulterior regenerarea celular\u0103 fiind mai sc\u0103zut\u0103, deci \u0219i replicarea viral\u0103 mai sc\u0103zut\u0103 \u0219i atunci evident c\u0103 vaccinarea are un impact mai mic. Dar v\u00e2rsta nu e limitant\u0103 \u0219i, din contr\u0103, poate avea un efect pozitiv \u00een cazul \u00een care persoana care se vaccineaz\u0103 are o via\u021b\u0103 sexual\u0103 activ\u0103, poten\u021bial cu mai mul\u021bi parteneri.<\/p>\n

Dac\u0103 s-a f\u0103cut vaccinul anti-HPV mai exist\u0103 riscul de cancer uterin sau este eliminat complet?<\/strong><\/p>\n

Riscul este mult diminuat pentru c\u0103, de exemplu, vaccinul care se face acum, nonavalent, acoper\u0103 \u0219apte tulpini cu risc crescut \u0219i dou\u0103 cu risc sc\u0103zut. Evident tulpinile cele mai frecvente care dau cel mai frecvent cancer de col uterin deci mai r\u0103m\u00e2ne o por\u021biune \u00eengust\u0103 de tulpini care ar putea s\u0103 fac\u0103, s\u0103 dea leziuni care \u00een timp s\u0103 ajung\u0103 la cancer de col uterin, dar evident c\u0103 porti\u021ba s\u0103 zicem este mult \u00eengustat\u0103. \u00cen mod real, teoretic putem s\u0103 spunem c\u0103 vaccinarea ar putea s\u0103 scoat\u0103 cancerul de col uterin din zona de interes.<\/p>\n

Care sunt factorii care, dincolo de HPV, ar putea influen\u021ba apari\u021bia unui cancer uterin?<\/strong><\/p>\n

Mai exist\u0103 \u0219i cancerul de endometru care apare predominant la v\u00e2rste mai \u00eenaintate, dup\u0103 menopauz\u0103 \u0219i unde, s\u0103 zicem, greutatea excesiv\u0103, deci pacientele supraponderale au un risc mai mare. \u0218i aici avem alte mecanisme, aici ecografia ar avea un rol \u00een screening si un regim de via\u021b\u0103 care s\u0103 implice un aport caloric adaptat necesarului zilnic. Pentru c\u0103 \u0219i aici este o problem\u0103: majoritatea femeilor dup\u0103 menopauz\u0103 sunt supraponderale \u0219i atunci pot sa apara mai multe tipuri de afectiuni, nu numai ginecologice.<\/p>\n

Exista investiga\u021bii \u00eemp\u0103r\u021bite pe grupe de v\u00e2rst\u0103? Care este v\u00e2rsta minima pentru testul Babes Papanicolau?<\/strong><\/p>\n

Testul Babes Papanicolau nu se recomand\u0103 la v\u00e2rste extrem de mici. Sunt asocia\u021bii profesionale \u00een alte \u021b\u0103ri care nu recomand\u0103. Ar putea s\u0103 fie 21 de ani, poate \u00een alte \u021b\u0103ri e mai mare varsta pentru c\u0103 \u00een momentul \u00een care avem un screeningnvrem s\u0103 depist\u0103m cele mai multe cazuri dintr-un num\u0103r de teste pe care le efectu\u0103m, ori dac\u0103 cobor\u00e2m v\u00e2rsta foarte-foarte jos nu mai este relevant esantionul.<\/p>\n

Care este simptomatologia, care sunt principalele simptome pentru care femeile vin la dvs. \u0219i care duc la astfel de diagnostic?<\/strong><\/p>\n

Cel mai frecvent semn care le determin\u0103 pe femei s\u0103 vin\u0103, tardiv, \u0219i s\u0103 li se pun\u0103 diagnosticul de cancer de col uterin este o s\u00e2ngerare vaginal\u0103. La o femeie \u00een menopauz\u0103, deci care \u00een mod normal n-ar trebui s\u0103 mai s\u00e2ngereze, este un semnal de alarm\u0103 \u00a0care trebuie s\u0103 o trimit\u0103 \u00a0de \u00eendat\u0103 la medic. In cazul femeilor tinere sunt s\u00e2nger\u0103ri la contactul sexual, s\u00e2nger\u0103ri f\u0103r\u0103 leg\u0103tura cu menstrua\u021bia.<\/p>\n

Care este circuitul pacientei \u00een momentul \u00een care pune\u021bi diagnosticul clar de cancer. Ce urmeaz\u0103 apoi? <\/strong><\/p>\n

Diagnosticul clar sau de certitudine \u00eel avem la biopsie. Deci se face o biopsie, avem un rezultat dup\u0103 care se fac investiga\u021bii imagistice, \u00eencerc\u0103m s\u0103 afl\u0103m extinderea afec\u021biunii, s\u0103 stadializ\u0103m boala din preoperator, se face pe urm\u0103 un consult oncologic, eventual radioterapie \u0219i \u00een ultim\u0103 instan\u021b\u0103, dac\u0103 mai este cazul, se face \u0219i interven\u021bia chirurgical\u0103. Deci, cumva, interven\u021bia chirurgical\u0103 nu-\u0219i mai are rolul central pe care \u00eel avea acum c\u00e2teva zeci de ani, ci este parte component\u0103 a unui ansamblu mai complex care se articuleaz\u0103 \u00een vederea ob\u021binerii s\u0103n\u0103t\u0103\u021bii pacientei.<\/p>\n

Exist\u0103 vreun procent din cazurile de cancer de col uterin care este determinat genetic \u0219i nu de HPV?<\/strong><\/p>\n

Implicare genetic\u0103 exist\u0103 \u00een toate, dar nu e implicarea genetic\u0103 pe care s-o determin\u0103m ca fiind o gen\u0103, s\u0103 ar\u0103t\u0103m cu degetul precum la cancerul mamar, de exemplu, c\u00e2nd avem genele BRCA sau la cancerul ovarian c\u00e2nd, la fel, BRCA 1 \u0219i BRCA 2 sunt specifice sau pot indica c\u0103 au un risc crescut. In ceea ce prive\u0219te cancerul de col uterin sunt, s\u0103 zicem, implica\u021bii colaterale. Poate o imunitate de o asemenea natur\u0103 care nu reac\u021bioneaz\u0103 cum trebuie fa\u021b\u0103 de o infec\u021bie viral\u0103, a\u0219a \u00eenc\u00e2t virusul HPV s\u0103 r\u0103m\u00e2n\u0103, s\u0103 dea infec\u021bie cronic\u0103. Deci asta ar putea s\u0103 fie componenta ereditar\u0103 sau componenta genetic\u0103. E doar ceva care suspect\u0103m c\u0103 ar putea s\u0103 fie. Deci un sistem imun care s\u0103 nu reu\u0219easc\u0103 s\u0103 fac\u0103 fa\u021b\u0103 \u00een mod optim infec\u021biei cu HPV.<\/p>\n

Ce le transmite\u021bi femeilor legat de preven\u021bie?<\/strong><\/p>\n

Cumva, e un subiect delicat. \u00cen ceea ce prive\u0219te preven\u021bia ar trebui s\u0103 ne adres\u0103m, mai ales femeilor tinere, tinerelor care-\u0219i \u00eencep via\u021ba sexual\u0103. Cea mai eficient\u0103 preven\u021bie este folosirea prezervativului. Deci asta este de departe cel mai eficient mod de a face preven\u021bie. Ulterior, iar\u0103\u0219i, tot \u00een partea de preven\u021bie, avem vaccinarea. Aceasta ofer\u0103 siguran\u021b\u0103 \u0219i o lini\u0219te subtantiala \u00een ceea ce prive\u0219te viitorul. De asemenea controalele de rutin\u0103 sunt extrem de importante. C\u0103ut\u0103m, nu neap\u0103rat s\u0103 depist\u0103m cancerul \u00een stadii incipiente ci s\u0103 \u00a0depist\u0103m leziunile pre-canceroase. Leziuni care ar putea eventual, \u00een pu\u021bine cazuri, sa conduca la cancerul de col uterin.<\/p>\n","protected":false},"excerpt":{"rendered":"

Rom\u00e2nia ocup\u0103 \u00een Uniunea European\u0103 un loc frunta\u0219 \u00een ceea ce prive\u0219te inciden\u021ba cancerului uterin. Se spune c\u0103 preven\u021bia face c\u00e2t o mie de tratamente. Din p\u0103cate, \u00eens\u0103, acest lucru […]<\/p>\n","protected":false},"author":4,"featured_media":13560,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[168],"tags":[],"class_list":["post-13558","post","type-post","status-publish","format-standard","has-post-thumbnail","category-oncologie"],"yoast_head":"\nPreven\u021bia cancerelor ginecologice - Jurmed - Medici<\/title>\n<meta name=\"description\" content=\"cancerelor ginecologice pot fi diagnosticate ca urmare a sangerarii. virusul HPV poate s\u0103 r\u0103m\u00e2n\u0103, s\u0103 dea infec\u021bie cronic\u0103\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/preventia-cancerelor-ginecologice\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Preven\u021bia cancerelor ginecologice - 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