{"id":5774,"date":"2016-06-07T13:21:37","date_gmt":"2016-06-07T13:21:37","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=5774"},"modified":"2016-06-07T13:21:37","modified_gmt":"2016-06-07T13:21:37","slug":"obezitatea-si-cancerul","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/obezitatea-si-cancerul\/","title":{"rendered":"Obezitatea \u0219i cancerul"},"content":{"rendered":"

\"Dr-Radu-Ion-Berceanu-oncolog\"Dr. Berceanu-Ion Radu-Emanuel<\/strong><\/p>\n

Medic specialist oncologie medical\u0103<\/p>\n

Clinica Amethyst<\/strong><\/p>\n

Otopeni, Drumul Od\u0103i 42, Ilfov<\/p>\n

 <\/p>\n

 <\/p>\n

Cadru general <\/strong><\/p>\n

Epoca actual\u0103 se caracterizeaz\u0103 printr-un nivel economic relativ ridicat, care a crescut \u00een mod constant \u00een ultimele decenii \u0219i care probabil va continua \u00een aceea\u0219i direc\u021bie. Acest aspect, combinat cu reducerea mortalit\u0103\u021bii prin alte cauze care \u00een trecut cauzau cele mai multe decese (cum ar fi conflictele militare \u0219i epidemiile majore), a f\u0103cut ca \u00een ziua de azi principalele cauze de mortalitate s\u0103 fie bolile cardiovasculare<\/u> \u0219i cancerul<\/u>. Obezitatea este un factor de risc major pentru am\u00e2ndou\u0103<\/em>.<\/p>\n

Defini\u021bii <\/strong><\/p>\n

Parametrul de baz\u0103 care se folose\u0219te pentru a defini obezitatea este indicele de mas\u0103 corporal\u0103<\/strong> (IMC<\/strong>; en. BMI = body mass index);acesta se calculeaz\u0103 \u00een func\u021bie de greutatea corpului \u0219i de \u00een\u0103l\u021bime, fiind exprimat \u00een kilograme pe metru p\u0103trat suprafa\u021b\u0103 corporal\u0103 (kg\/mp). Conform defini\u021biilor Organiza\u021biei Mondiale a S\u0103n\u0103t\u0103\u021bii (OMS), un individ este supraponderal<\/strong> dac\u0103 IMC= 25,0 \u2013 29,9 kg\/mp<\/u> \u0219i are obezitate<\/strong> dac\u0103 IMC \u2265 30 kg\/mp<\/u>.<\/p>\n

Obezitatea \u2013 epidemiologie <\/strong><\/p>\n

Datorit\u0103 abunden\u021bei alimentare \u0219i stilului de via\u021b\u0103 sedentar, prevalen\u021ba obezit\u0103\u021bii este \u00een continu\u0103 cre\u0219tere<\/em> pe plan mondial, mai ales \u00een \u021b\u0103rile dezvoltate \u0219i \u00een curs de dezvoltare. Mai mult, obezitatea afecteaz\u0103 \u00eentr-o propor\u021bie tot mai mare persoanele tinere<\/em>, fapt care cre\u0219te riscul apari\u021biei problemelor de s\u0103n\u0103tate la v\u00e2rste tot mai timpurii.<\/p>\n

\u00cen plus, exist\u0103 un fenomen numit tranzi\u021bie perceptual\u0103<\/strong>, caracterizat prin faptul c\u0103 indivizi care \u00een trecut erau considera\u021bi gra\u0219i sunt acum considera\u021bi (\u00een mod subiectiv) ca av\u00e2nd greutate normal\u0103; acest aspect nu face dec\u00e2t s\u0103 agraveze situa\u021bia, deoarece persoanele afectate nu con\u0219tientizeaz\u0103 faptul c\u0103 au o problem\u0103. Trebuie \u00een\u021beles c\u0103 statutul de persoan\u0103 supraponderal\u0103 sau cu obezitate nu reprezint\u0103 un stigmat \u0219i nici o norm\u0103 social\u0103, ci un factor de risc major (fundamentat \u0219tiin\u021bific) pentru numeroase probleme de s\u0103n\u0103tate. Amploarea problemei nu trebuie neglijat\u0103 de indivizi, de medici sau de societate, deoarece obezitatea progreseaz\u0103 repede c\u0103tre pozi\u021bia \u00eent\u00e2i \u00eentre cauzele prevenibile<\/u> ale cancerului \u0219i bolilor cardiovasculare (urm\u00e2nd ca \u00een anii urm\u0103tori s\u0103 dep\u0103\u0219easc\u0103 fumatul<\/em>).<\/p>\n

Obezitatea \u0219i cancerul <\/strong><\/p>\n

Rela\u021bia \u00eentre obezitatea \u0219i cancer este complex\u0103 \u0219i se desf\u0103\u0219oar\u0103 la mai multe niveluri. \u00cen primul r\u00e2nd obezitatea este un factor de risc<\/strong> pentru cancer, ceea ce \u00eenseamn\u0103 c\u0103 persoanele cu obezitate au \u0219anse mai mari s\u0103 devin\u0103 pacien\u021bi oncologici \u00een compara\u021bie cu persoanele care au greutate corporal\u0103 normal\u0103; cele mai multe date \u00een acest sens exist\u0103 pentru cancerul de prostat\u0103 (mai ales formele agresive) \u0219i cancerul de colon.<\/p>\n

Totodat\u0103, obezitatea este un factor de prognostic negativ<\/strong> la pacien\u021bii cu cancer, ceea ce \u00eenseamn\u0103 c\u0103 pacien\u021bii oncologici cu obezitate au risc mai mare de a muri din cauza cancerului<\/em> \u00een compara\u021bie cu persoanele normoponderale. Exist\u0103 o serie de efecte indirecte considerate surogate pentru prognostic negativ: rat\u0103 de r\u0103spuns<\/u> mai mic\u0103 la tratamentele oncologice, durat\u0103 a r\u0103spunsurilor<\/u> la tratament mai scurt\u0103 \u0219i risc de recidiv\u0103<\/u> tumoral\u0103mai mare. \u00cen plus, deoarece obezitatea este un factor de risc pentru boli cardiovasculare \u0219i diabet, pacien\u021bii cu obezitate care supravie\u021buiesc timp \u00eendelungat dup\u0103 diagnosticul de cancer au risc relativ ridicat de a muri din cauza bolilor cardiovasculare<\/em>, fapt care se poate traduce \u00eentr-o supravie\u021buire general\u0103 mai mic\u0103 pe termen lung a popula\u021biei de pacien\u021bi oncologici cu obezitate.<\/p>\n

Mai mult, obezitatea este un factor predictiv negativ<\/strong> pentru eficacitatea<\/u> terapiilor oncologice (ceea ce \u00eenseamn\u0103 c\u0103 la persoanele cu obezitate exist\u0103 \u0219anse mai mari ca aceste tratamente \u2013 chirurgie, radioterapie, chimioterapie, hormonoterapie \u2013 s\u0103 nu aib\u0103 efectele scontate) \u0219i un factor predictiv pozitiv pentru efectele secundare<\/u> ale tratamentelor oncologice (adic\u0103 persoanele cu obezitate au risc mai mare de a avea reac\u021bii adverse severe \u00een urma tratamentului \u2013 ex. vindecare \u00eent\u00e2rziat\u0103 a pl\u0103gilor dup\u0103 opera\u021bie, infec\u021bii postoperatorii, edem limfatic etc.). \u00cen plus, deoarece pacien\u021bii oncologici cu obezitate au de obicei \u0219i alte boli \u00een afar\u0103 de cancer (ex. boli cardiovasculare, diabet, boal\u0103 arterial\u0103 periferic\u0103 etc.), exist\u0103 risc mai mare ca aplicarea optim\u0103<\/u> a tratamentelor oncologice s\u0103 aib\u0103 de suferit.<\/p>\n

Rolul medicului oncolog <\/strong><\/p>\n

Este important ca medicul oncolog s\u0103 se obi\u0219nuiasc\u0103 s\u0103 discute cu pacien\u021bii despre greutatea corporal\u0103. \u00cen mod ideal indicele de mas\u0103 corporal\u0103 ar trebui calculat de fiecare dat\u0103 c\u00e2nd dac\u0103 greutatea pare a fi peste limita considerat\u0103 normal\u0103, iar la pacien\u021bii cu obezitate aspectul greut\u0103\u021bii corporale ar trebui abordat \u00een mod specific.<\/p>\n

\u00cen primul r\u00e2nd este important ca medicul s\u0103 \u00een\u021beleag\u0103<\/em> efectele negative ale obezit\u0103\u021bii pentru pacientul pe care \u00eel trateaz\u0103; \u00een acest scop vor fi trecute \u00een vedere toate aspectele de mai sus (rolul prognostic \u0219i predictiv al obezit\u0103\u021bii). Urmeaz\u0103 informarea \u0219i educarea pacientului<\/em> \u00een leg\u0103tur\u0103 cu aceste aspecte, scopul fiind ca acesta din urm\u0103 s\u0103 \u00een\u021beleag\u0103 necesitatea<\/u> implic\u0103rii personale active \u0219i consecvente \u00een combaterea obezit\u0103\u021bii \u0219i importan\u021ba<\/u> m\u0103surilor care trebuie implementate \u00een acest sens.<\/p>\n

Urmeaz\u0103 stabilirea obiectivelor<\/em>pentru greutatea corporal\u0103 (este bine ca acestea s\u0103 fie realizabile f\u0103r\u0103 un efort excesiv, ex. sc\u0103dere \u00een greutate cu 1-2 kg\/lun\u0103 pentru urm\u0103toarele 6-12 luni) \u0219i precizarea m\u0103surilor specifice<\/em> (diet\u0103, sport, medicamente, opera\u021bii) care s\u0103 conduc\u0103 la atingerea acestor obiective. \u00cen mod ideal acest proces se realizeaz\u0103 \u00een str\u00e2ns\u0103 colaborare cu un medic nutri\u021bionist<\/strong>; ace\u0219ti speciali\u0219ti posed\u0103 cuno\u0219tin\u021bele specifice (care de cele mai multe ori dep\u0103\u0219esc expertiza medicului oncolog), r\u0103bdarea \u0219i instrumentele necesare pentru a-i informa pe pacien\u021bi cu privire la ceea ce ar trebui s\u0103 fac\u0103, reprezent\u00e2nd alia\u021bi valoro\u0219i \u00een lupta pacien\u021bilor pentru o via\u021b\u0103 mai lung\u0103 \u0219i mai s\u0103n\u0103toas\u0103.<\/p>\n

\u00cen mod ideal, tratamentul obezit\u0103\u021bii este ini\u021biat \u00een paralel cu tratamentul oncologic. Caracterul repetitiv al terapiilor oncologice reprezint\u0103 un avantaj fundamental pentru monitorizarea progreselor<\/em> efectuate \u00een direc\u021bia combaterii obezit\u0103\u021bii; \u00eent\u00e2lnirile medic-pacient sunt momente prielnice pentru educarea continu\u0103 a pacien\u021bilor, verificarea progreselor efectuate \u0219i \u00eencurajarea de a continua \u00een direc\u021bia potrivit\u0103.<\/p>\n

Cei care citi\u021bi acest articol, indiferent de statutul dumneavoastr\u0103 (pacien\u021bi oncologici, rude ale unor pacien\u021bi etc.), trebuie s\u0103 \u00een\u021belege\u021bi c\u0103 e\u0219ecurile de respectare a indica\u021biilor medicale (mai ales c\u00e2nd vine vorba de comportamente \u0219i stil de via\u021b\u0103) sunt perfect normale \u0219i apar aproape f\u0103r\u0103 excep\u021bie \u00eentr-un fel sau altul, uneori chiar foarte frecvent; toate aceste e\u0219ecuri sunt \u00eenso\u021bite de sentimente de descurajare \u0219i de reducerea puternic\u0103 a dorin\u021bei de a continua \u00een direc\u021bia potrivit\u0103 (regim alimentar s\u0103n\u0103tos, activitate fizic\u0103 regulat\u0103, medicamente etc.). \u00cen\u021belege\u021bi toate aceste tr\u0103iri negative \u0219i pur \u0219i simplu ignora\u021bi-le, f\u0103r\u0103 a le permite s\u0103 v\u0103 perturbe drumul corect pe care l-a\u021bi ales pentru a deveni mai s\u0103n\u0103to\u0219i \u0219i pentru a avea o via\u021b\u0103 mai bun\u0103. E\u0219ecurile sunt o parte a procesului \u0219i nimic mai mult; pur \u0219i simplu replia\u021bi-v\u0103 \u0219i re\u00eencepe\u021bi s\u0103 avansa\u021bi pe calea care \u0219ti\u021bi c\u0103 este cea bun\u0103. Comportamentele corecte pe care le implementa\u021bi vor deveni o parte integrant\u0103 a noului stil de via\u021b\u0103, iar rezultatele pozitive pe care le ve\u021bi ob\u021bine vor deveni astfel durabile \u0219i v\u0103 vor transforma \u00eentr-un exemplu de reu\u0219it\u0103 pentru familie, prieteni \u0219i al\u021bi pacien\u021bi ca dumneavoastr\u0103.<\/p>\n","protected":false},"excerpt":{"rendered":"

Dr. Berceanu-Ion Radu-Emanuel Medic specialist oncologie medical\u0103 Clinica Amethyst Otopeni, Drumul Od\u0103i 42, Ilfov     Cadru general Epoca actual\u0103 se caracterizeaz\u0103 printr-un nivel economic relativ ridicat, care a crescut […]<\/p>\n","protected":false},"author":5,"featured_media":5777,"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":[33,282],"tags":[],"class_list":["post-5774","post","type-post","status-publish","format-standard","has-post-thumbnail","category-articole","category-diabet"],"yoast_head":"\nObezitatea \u0219i cancerul - Jurmed - Medici<\/title>\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\/obezitatea-si-cancerul\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Obezitatea \u0219i cancerul - 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