{"id":126,"date":"2024-10-23T06:48:51","date_gmt":"2024-10-23T06:48:51","guid":{"rendered":"https:\/\/umuterenerdogdu.com\/?p=126"},"modified":"2024-10-23T06:48:51","modified_gmt":"2024-10-23T06:48:51","slug":"pankreas-kanseri","status":"publish","type":"post","link":"https:\/\/umuterenerdogdu.com\/?p=126","title":{"rendered":"Pankreas Kanseri"},"content":{"rendered":"<p>Pankreas, kar\u0131n en arka b\u00f6l\u00fcm\u00fcnde yerle\u015fmi\u015f, yakla\u015f\u0131k 15 cm uzunlu\u011funda, mide, onikiparmak ba\u011f\u0131rsa\u011f\u0131 (duodenum) ve kal\u0131n ba\u011f\u0131rsakla (kolon) \u00f6n y\u00fcz\u00fc t\u00fcm\u00fcyle kapat\u0131lm\u0131\u015f bir organd\u0131r. Bir\u00e7ok \u00f6nemli g\u00f6revi olmakla birlikte, al\u0131nan g\u0131dalar\u0131n sindiriminde ve kan \u015fekerinin dengede tutulmas\u0131nda \u00f6nemli rol oynamaktad\u0131r. Pankreas kanserleri organ\u0131n her b\u00f6lgesinden geli\u015fmekle birlikte en s\u0131k ba\u015f b\u00f6lgesinden geli\u015fmektedir. Yine en s\u0131k salg\u0131 yapan h\u00fccrelerden k\u00f6ken al\u0131rlar ve adenokanser olarak adland\u0131r\u0131l\u0131rlar.<\/p>\n<p>&nbsp;<\/p>\n<h4>Pankreas Kanserleri Risk Fakt\u00f6rleri<\/h4>\n<p>Hastal\u0131\u011f\u0131n sebebi bilinmemekle birlikte sigara i\u00e7enlerde ve \u015fi\u015fman bireylerde daha s\u0131k g\u00f6r\u00fcl\u00fcr. Hastalar\u0131n hemen hemen %30\u2019unda pankreas kanserinin nedeni sigara kullan\u0131m\u0131d\u0131r. Eri\u015fkin tip \u015feker hastal\u0131\u011f\u0131na ba\u011fl\u0131 pankreas kanseri tart\u0131\u015fmal\u0131d\u0131r. \u00c7ok az say\u0131da hastada soya \u00e7ekim ile pankreas kanseri geli\u015febilir. Pankreas kanseri erkeklerde kad\u0131nlardan daha s\u0131k g\u00f6r\u00fclmekte olup risk ya\u015fla birlikte artar. Ortalama ya\u015f erkeklerde 63, kad\u0131nlarda ise 67\u2019dir.<\/p>\n<p>&nbsp;<\/p>\n<h4>Pankreas Kanserleri Belirtileri<\/h4>\n<p>Kilo kayb\u0131, kar\u0131n a\u011fr\u0131s\u0131, sar\u0131l\u0131k, i\u015ftah kayb\u0131, bulant\u0131-kusma, halsizlik, yorgunluk, ishal, sindirim zorlu\u011fu, s\u0131rt a\u011fr\u0131s\u0131, camc\u0131 macunu renginde d\u0131\u015fk\u0131lama, solgunluk, aniden ortaya \u00e7\u0131kan ve aile \u00f6yk\u00fcs\u00fc bulunmayan \u015feker hastal\u0131\u011f\u0131, depresyon gibi psikolojik bozukluklarla ortaya \u00e7\u0131kabilir. \u015ei\u015fkinlik, haz\u0131ms\u0131zl\u0131k ve i\u015ftah kayb\u0131 ile birlikte yetersiz g\u0131da al\u0131m\u0131 sonucunda hasta kilo verir. Sar\u0131l\u0131k en s\u0131k ve en erken ortaya \u00e7\u0131kan belirtidir. Ba\u015flang\u0131\u00e7ta g\u00f6zlerde ortaya \u00e7\u0131kar, daha sonra deride sararma olur, bunu idrar renginin koyula\u015farak \u2018\u00e7ay renkli idrar\u2019 yapmaya d\u00f6n\u00fc\u015fmesi takip eder ve nihayet \u2018camc\u0131 macunu\u2019 olarak tan\u0131mlan d\u0131\u015fk\u0131n\u0131n a\u00e7\u0131k renk almas\u0131 ile sonu\u00e7lan\u0131r. Sar\u0131l\u0131\u011f\u0131n nedeni, karaci\u011ferde yap\u0131lan bilirubin maddesinin pankreas kanseri taraf\u0131ndan safra yolunun t\u0131kanmas\u0131 sonucunda at\u0131l\u0131m\u0131n\u0131n engellenmesidir.<\/p>\n<p>&nbsp;<\/p>\n<h4>Pankreas Kanserlerinde Tan\u0131<\/h4>\n<p>Hastal\u0131k sinsi belirtilerle ortaya \u00e7\u0131kt\u0131\u011f\u0131 i\u00e7in tan\u0131 zor olabilir. Serum bilirubinleri, alkalen fosfataz, karaci\u011fer transaminazlar\u0131 ile CEA, CA 19-9 ve CA 125 gibi t\u00fcm\u00f6r belirte\u00e7leri y\u00fckselmi\u015ftir. \u0130drarda bilirubin pozitifli\u011fi mevcuttur.<\/p>\n<p>Ultrasonografi Hemen daima ilk ba\u015fvurulacak inceleme y\u00f6ntemidir. Pankreasta sert ya da kistik kitle varl\u0131\u011f\u0131, kitlenin boyutu, kitlenin di\u011fer \u00e7evre yap\u0131larla olan ili\u015fkisi ve damarsal yap\u0131lara olan yak\u0131nl\u0131\u011f\u0131 hakk\u0131nda bilgi verir.<\/p>\n<p>Bilgisayarl\u0131 tomografi (BT) ve manyetik rezonans g\u00f6r\u00fcnt\u00fcleme (MR): Yakla\u015f\u0131k %95 ve \u00fczerinde tan\u0131 koydurucu \u00f6zelli\u011fi vard\u0131r. MR g\u00f6r\u00fcnt\u00fcleme ayn\u0131 \u015fekilde t\u00fcm\u00f6r\u00fcn ay\u0131r\u0131c\u0131 tan\u0131s\u0131nda \u00f6nemlidir. Bu iki inceleme gerekti\u011finde birlikte kullan\u0131larak hastaya verilecek ameliyat karar\u0131 i\u00e7in do\u011fru sonu\u00e7lara ula\u015f\u0131lmas\u0131n\u0131 ve t\u00fcm\u00f6r\u00fcn evrelemesinin do\u011fru yap\u0131lmas\u0131n\u0131 sa\u011flarlar.<\/p>\n<p>Endoskopik retrograd kolangiopankreatikografi (ERCP): Safra kanallar\u0131 ve pankreastaki sorunlar\u0131 te\u015fhis ve tedavi etmek i\u00e7in uygulanan ileri bir endoskopik tan\u0131 ve tedavi y\u00f6ntemidir.<\/p>\n<p>Endoskopik ultrason (EUS): Pankreas kanserleri ve pankreastaki solid, kistik nod\u00fcllerin g\u00f6r\u00fcnt\u00fclenmesi ve bunlardan biyopsi al\u0131nmas\u0131na izin veren g\u00fcncel bir tekniktir.<\/p>\n<p>&nbsp;<\/p>\n<p><strong> \u00a0Pankreas Kanserlerinde Tedavi <\/strong><\/p>\n<p>Pankreas t\u00fcm\u00f6r\u00fcn\u00fcn hangi evrede oldu\u011fu, kom\u015fu organlarla ili\u015fkisinin ne durumda oldu\u011fu, \u00f6zellikle kom\u015fu damarlara ve\/veya uzak organlara yay\u0131l\u0131m\u0131n\u0131n olup olmad\u0131\u011f\u0131 ortaya konulup ameliyatla \u00e7\u0131kar\u0131lma \u015fans\u0131 de\u011ferlendirilir. \u0130leri evredeki t\u00fcm\u00f6rlerde cerrahi uygulanamaz. Bu hastalara uygulanacak kemoterapi ile birlikte, mevcut sar\u0131l\u0131\u011f\u0131n\u0131n d\u00fczeltilmesi, beslenme deste\u011finin sa\u011flanmas\u0131, a\u011fr\u0131n\u0131n azalt\u0131lmas\u0131 yoluyla ya\u015fam konforunu d\u00fczeltmek amac\u0131yla baz\u0131 giri\u015fimler uygulanabilir. Bu ama\u00e7la a\u011f\u0131zdan mide yoluyla yap\u0131lan endoskopi ile safra yoluna ge\u00e7i\u015fi sa\u011flayan bir boru (stent) konulmas\u0131, kar\u0131n cildinden karaci\u011fer i\u00e7i safra yollar\u0131na bir i\u011fne yard\u0131m\u0131yla konulan kateter ile safran\u0131n d\u0131\u015far\u0131 ak\u0131t\u0131lmas\u0131 (PTK), a\u011fr\u0131 ile ileri m\u00fccadele teknikleri, onikiparmak ba\u011f\u0131rsa\u011f\u0131nda t\u0131kan\u0131kl\u0131\u011fa yol a\u00e7an t\u00fcm\u00f6rlerde bu k\u0131sma a\u011f\u0131zdan endoskopik y\u00f6ntemle girilerek stent tak\u0131lmas\u0131 gibi y\u00f6ntemler kullan\u0131lmaktad\u0131r.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4>Pankreas Kanserlerinde Cerrahi Tedavi<\/h4>\n<p>T\u00fcm\u00f6r\u00fcn cerrahi olarak \u00e7\u0131kart\u0131lmas\u0131 bu hastalar i\u00e7in tek k\u00fcr \u015fans\u0131n\u0131 olu\u015fturmaktad\u0131r. Pankreas ba\u015f\u0131 t\u00fcm\u00f6rlerinde, cerrahi olarak yaln\u0131zca pankreas\u0131n ba\u015f k\u0131sm\u0131n\u0131 \u00e7\u0131kartabilmek m\u00fcmk\u00fcn olamad\u0131\u011f\u0131 i\u00e7in ameliyat daha karma\u015f\u0131k olmaktad\u0131r. Uygulanan Whipple ameliyat\u0131nda; pankreas\u0131n ba\u015f\u0131 ile birlikte, safra kesesi, ana safra kanal\u0131n\u0131n bir k\u0131sm\u0131, oniki parmak ba\u011f\u0131rsa\u011f\u0131, midenin bir k\u0131sm\u0131 ve etraf lenf bezleri blok halinde \u00e7\u0131kar\u0131lmaktad\u0131r.<\/p>\n<p>Pankreas kanseri operasyonunda (whipple ameliyat\u0131) olduk\u00e7a uzun s\u00fcreli, \u00e7ok \u00e7e\u015fitli organlar\u0131n \u00e7\u0131kart\u0131ld\u0131\u011f\u0131 ve yeniden devaml\u0131l\u0131\u011f\u0131n sa\u011fland\u0131\u011f\u0131 bu ameliyat s\u0131ras\u0131nda veya k\u0131sa s\u00fcre sonras\u0131nda hastan\u0131n \u00f6l\u00fcm (mortalite) veya kanama olmas\u0131, sindirim sisteminin devaml\u0131l\u0131\u011f\u0131n\u0131 sa\u011flamak i\u00e7in yap\u0131lan diki\u015flerden ka\u00e7ak olmas\u0131 (fist\u00fcl) gibi k\u00f6t\u00fc durumlarla (morbidite) kar\u015f\u0131la\u015f\u0131labilmektedir. D\u00fcnyada kabul edilen \u00f6l\u00fcm oran\u0131 %5 ve alt\u0131ndaki orand\u0131r. Yine ameliyat sonras\u0131nda ortaya \u00e7\u0131kan komplikasyonlar i\u00e7in d\u00fcnyada kabul edilen oran %15-20\u2019dir. \u00dclkemiz \u015fartlar\u0131nda bu oranlar %5-10 mortalite ve %20-25 morbidite oranlar\u0131d\u0131r.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4>Pankreas Kanserlerinde Di\u011fer Tedavi<\/h4>\n<p>Radyasyon Tedavisi: Kanser h\u00fccrelerini \u00f6ld\u00fcrmek i\u00e7in y\u00fcksek enerjili \u0131\u015f\u0131nlar\u0131n kullan\u0131lmas\u0131n\u0131 i\u00e7ermektedir. Radyasyon tedavisi, yan\u0131zca tedavi edilen alandaki h\u00fccreleri etkiler. Radyasyon bir makine arac\u0131l\u0131\u011f\u0131 ile d\u0131\u015far\u0131dan \u0131\u015f\u0131n verilmesi \u015feklindedir. Radyoterapi, \u00f6zellikle t\u00fcm\u00f6r\u00fcn yerle\u015fimi ve b\u00fcy\u00fckl\u00fc\u011f\u00fc cerrahiyi zorla\u015ft\u0131r\u0131yor ise veya cerrahi uygulanamayan durumlarda cerrahinin yerine tek ba\u015f\u0131na veya kemoterapi ile kombine kullan\u0131lmaktad\u0131r. Cerrahi \u00f6ncesinde t\u00fcm\u00f6r\u00fc k\u00fc\u00e7\u00fcltmek i\u00e7in kemoterapi ile birlikte radyoterapi kombine kullan\u0131labilir. Baz\u0131 durumlarda ameliyat sonras\u0131 n\u00fcksleri engellemek amac\u0131 ile radyoterapi verilebilir.<\/p>\n<p>Kemoterapi: Kanser h\u00fccrelerini \u00f6ld\u00fcrmek i\u00e7in antikanser ila\u00e7lar\u0131n kullan\u0131lmas\u0131d\u0131r. Pankreas kanserlerinde ameliyat \u00f6ncesi veya sonras\u0131 hastalar\u0131n genel durumlar\u0131 dikkate al\u0131narak kemoterapi denilen ila\u00e7 tedavisi uygulanabilir. Kemoterapi cerrahi \u00f6ncesinde t\u00fcm\u00f6r\u00fc k\u00fc\u00e7\u00fcltmek i\u00e7in veya cerrahinin yerine primer tedavi olarak radyoterapi ile birlikte kullan\u0131labilir. Yayg\u0131n ileri evre hastal\u0131kta cerrahi ve radyoterapinin yeri yoktur. Bu grup hastalara kemoterapi uygulanmas\u0131 ile hastalar\u0131n hayat kalitelerinin belirgin iyile\u015ftirilebildi\u011fi ve sa\u011fkal\u0131mlar\u0131nda uzama olabilece\u011fi bildirilmi\u015ftir.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4>Tedaviden Sonra Sa\u011fkal\u0131m<\/h4>\n<p>Erken tan\u0131 ile ameliyat edilip tam iyile\u015fme \u015fans\u0131 %50\u2019nin alt\u0131ndad\u0131r. Antikanser ila\u00e7lar ve \u0131\u015f\u0131n tedavisi iyile\u015fme oran\u0131n\u0131 art\u0131r\u0131r. Ancak geride kanser h\u00fccresi b\u0131rak\u0131lan ameliyatlardan sonra veya kom\u015fu organlara yay\u0131l\u0131m olan durumlarda sa\u011fkal\u0131m oranlar\u0131 iyi de\u011fildir.<\/p>\n<p>&nbsp;<\/p>\n<h4>Korunma<\/h4>\n<p>Korunma i\u00e7in t\u00fct\u00fcnden uzak durmal\u0131, dengeli beslenme ve d\u00fczenli egzersiz yapmal\u0131 ve fazla kilolardan kurtulmal\u0131d\u0131r.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Pankreas, kar\u0131n en arka b\u00f6l\u00fcm\u00fcnde yerle\u015fmi\u015f, yakla\u015f\u0131k 15 cm uzunlu\u011funda, mide, onikiparmak ba\u011f\u0131rsa\u011f\u0131 (duodenum) ve kal\u0131n ba\u011f\u0131rsakla (kolon) \u00f6n y\u00fcz\u00fc t\u00fcm\u00fcyle kapat\u0131lm\u0131\u015f bir organd\u0131r. Bir\u00e7ok \u00f6nemli g\u00f6revi olmakla birlikte, al\u0131nan g\u0131dalar\u0131n sindiriminde ve kan \u015fekerinin dengede tutulmas\u0131nda \u00f6nemli rol oynamaktad\u0131r. Pankreas kanserleri organ\u0131n her b\u00f6lgesinden geli\u015fmekle birlikte en s\u0131k ba\u015f b\u00f6lgesinden geli\u015fmektedir. Yine en s\u0131k &hellip;<\/p>\n","protected":false},"author":1,"featured_media":127,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,18],"tags":[21],"class_list":["post-126","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-cerrahi","category-kanser-cerrahisi","tag-pankreas-kanseri"],"_links":{"self":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts\/126","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=126"}],"version-history":[{"count":1,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts\/126\/revisions"}],"predecessor-version":[{"id":128,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/posts\/126\/revisions\/128"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=\/wp\/v2\/media\/127"}],"wp:attachment":[{"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=126"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=126"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/umuterenerdogdu.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=126"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}