{"id":2847,"date":"2020-03-12T09:02:32","date_gmt":"2020-03-12T09:02:32","guid":{"rendered":"http:\/\/uraloguzloc.com\/?page_id=2847"},"modified":"2020-12-11T10:48:38","modified_gmt":"2020-12-11T10:48:38","slug":"prostate-cancer","status":"publish","type":"page","link":"https:\/\/uraloguz.com\/tr_TR\/prostate-cancer\/","title":{"rendered":"Prostat Kanseri"},"content":{"rendered":"<p>[vc_row][vc_column][vc_column_text]<strong>Kanser nedir? nas\u0131l olu\u015fur?<\/strong><\/p>\n<p>Kanser bir organ veya dokuyu olu\u015fturan h\u00fccrelerin yap\u0131s\u0131n\u0131n bozularak kontrols\u00fcz \u00e7o\u011falmas\u0131d\u0131r. Bu kontrols\u00fcz \u00e7o\u011falma organ\u0131n \u015feklini bozarak zamanla b\u00fcy\u00fcmeye ba\u015flar. \u00a0B\u00fcy\u00fcmenin h\u0131z\u0131 ise organ ya da dokunun yap\u0131s\u0131na ve kanser h\u00fccrelerinin cinsine g\u00f6re farkl\u0131l\u0131k g\u00f6sterir. Zamanla \u00e7evre dokulara da yay\u0131l\u0131rlar. Kan ve lenf damarlar\u0131na girmeleri halinde \u00a0v\u00fccudun di\u011fer organlar\u0131na da yerle\u015fir ki buna metastaz ad\u0131 verilir.<\/p>\n<p>Prostat kanseri erkeklerde en s\u0131k g\u00f6r\u00fclen 2. kanser olup t\u00fcm d\u00fcnyada\u00a0\u00a0 her y\u0131l yakla\u015f\u0131k tan\u0131 alan hasta say\u0131s\u0131 1 milyon civar\u0131ndad\u0131r. B\u00fct\u00fcn prostat kanserlerinin %15\u2019i ailesel, kal\u0131tsald\u0131r. Bu hastalarda kanser genellikle erken ya\u015flarda (&lt;55 ya\u015f) saptan\u0131r. Baz\u0131 kromozomlarda (s\u0131kl\u0131kla 1. kromozom \u00fczerinde durulmaktad\u0131r) prostat kanseri yatk\u0131nl\u0131k b\u00f6lgeleri \u00f6nerilmi\u015f olmakla birlikte kesin bir gen lokalizasyonu g\u00f6sterilememi\u015ftir.[\/vc_column_text][\/vc_column][\/vc_row][vc_row gradient_colors=&#8221;%5B%7B%7D%5D&#8221; css=&#8221;.vc_custom_1584012268710{margin-top: -120px !important;margin-bottom: -120px !important;}&#8221;][vc_column width=&#8221;1\/3&#8243; gradient_colors=&#8221;%5B%7B%7D%5D&#8221;][vc_single_image image=&#8221;2852&#8243; img_size=&#8221;full&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;2854&#8243; img_size=&#8221;375&#215;200&#8243;][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;2855&#8243; img_size=&#8221;375&#215;200&#8243;][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]<strong>Prostata kanseri i\u00e7in risk fakt\u00f6rleri nelerdir?<\/strong><\/p>\n<p>Prostat kanseri i\u00e7in en \u00f6nemli risk fakt\u00f6rleri: Ya\u015f, aile \u00f6yk\u00fcs\u00fc ve \u0131rk t\u0131r.<\/p>\n<p>Prostat kanseri ileri ya\u015f kanseri olup ya\u015f ilerledik\u00e7e risk artar.<\/p>\n<p>Ailede prostat kanseri tan\u0131l\u0131 akrabalar\u0131n olmas\u0131 yine riski artt\u0131rmaktad\u0131r. Babada prostat kanseri varl\u0131\u011f\u0131nda risk 2 kat, karde\u015fte olmas\u0131 durumunda 3 kat artar. \u0130kiden fazla birinci derece akrabalarda olmas\u0131 halinde ise risk 5 kat artar.<\/p>\n<p>Irk, bir di\u011fer \u00f6nemli risk fakt\u00f6r\u00fcd\u00fcr. \u00d6zellikle siyah \u0131rkta prostat kanser g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 artm\u0131\u015ft\u0131r. Siyah \u0131rktaki kanserler ayr\u0131ca daha agresif seyirli olmaktad\u0131r.<\/p>\n<p>Son ara\u015ft\u0131rmalarda \u201chipertansiyon\u201d hastal\u0131\u011f\u0131n\u0131n prostat kanser riskini %15; \u201cabdominal obezite\u201dnin (bel \u00e7evresinin >102 cm olmas\u0131) ise \u00a0%56 artt\u0131rd\u0131\u011f\u0131 g\u00f6sterilmi\u015ftir.[\/vc_column_text][\/vc_column][\/vc_row][vc_row gradient_colors=&#8221;%5B%7B%7D%5D&#8221; css=&#8221;.vc_custom_1584012290774{margin-top: -140px !important;}&#8221;][vc_column][vc_column_text]<strong>Prostat kanserinde tarama nas\u0131l ve kime yap\u0131lmal\u0131?<\/strong><\/p>\n<p>50 ya\u015f \u00fczeri erkeklerde, aile \u00f6yk\u00fcs\u00fc olan 45 ya\u015f \u00fczeri erkeklerde, 40\u2019l\u0131 ya\u015flarda >1 ng\/mL PSA \u00f6l\u00e7\u00fcm\u00fc olan hastalarda ve 60\u2019l\u0131 ya\u015flarda >2 ng\/mL PSA \u00f6l\u00e7\u00fcm\u00fc olan hastalarda PSA taramas\u0131 \u00f6nerilmektedir.<\/p>\n<p><strong>PSA nedir? Ne i\u015fe yarar?<\/strong><\/p>\n<p>\u201cProstat Spesifik Antijen\u201d\u00a0 k\u0131saca \u201cPSA\u201d olarak isimlendirilir. \u0130sminden de anla\u015f\u0131laca\u011f\u0131 \u00fczere prostattan sentezlenen bu hormon bir serin proteaz proteinidir ve meninin koag\u00fclasyonunu \u00f6nler. PSA kansere \u00f6zg\u00fc de\u011fil organa (prostat) \u00f6zg\u00fc bir hormondur. Dolay\u0131s\u0131yla PSA y\u00fcksekli\u011fi her zaman kanser d\u00fc\u015f\u00fcnd\u00fcrmez. Prostat\u0131n enfeksiyonlar\u0131, sonda tak\u0131lmas\u0131 ya da trans\u00fcretral yap\u0131lan her t\u00fcrl\u00fc endoskopik[\/vc_column_text][\/vc_column][\/vc_row][vc_row gradient_colors=&#8221;%5B%7B%7D%5D&#8221; css=&#8221;.vc_custom_1584012315864{margin-top: -100px !important;}&#8221;][vc_column][vc_column_text css=&#8221;.vc_custom_1584012062416{margin-top: -80px !important;}&#8221;]<strong>Prostat kanserinde belirtiler nelerdir?<\/strong><\/p>\n<p>Kanser s\u0131kl\u0131kla prostat\u0131n idrar kanal\u0131ndan uzak olan ve rektum (barsak) ile kom\u015fu olan arka b\u00f6lgesinden (periferik zon) geli\u015fti\u011fi i\u00e7in erken d\u00f6nemde klinik semptomu yoktur. Ancak kanser \u00e7ok b\u00fcy\u00fcmesi halinde ileri evreye geldi\u011finde idrar kanal\u0131na bas\u0131 yaparak i\u015femede g\u00fc\u00e7l\u00fc\u011fe neden olabilir.\u00a0 Yine ileri evrelerde idrar ve meniden kan gelmesine neden olabilir. Kemiklere s\u0131\u00e7rad\u0131\u011f\u0131 durumlarda (metastaz) b\u00f6lgesel a\u011fr\u0131lara neden olabilir.<\/p>\n<p><strong>Prostat kanser tan\u0131s\u0131 nas\u0131l konulur?<\/strong><\/p>\n<p>Prostat kanserinin kesin tan\u0131s\u0131 biyopsi ile al\u0131nan prostat dokular\u0131nda t\u00fcm\u00f6r h\u00fccrelerinin g\u00f6sterilmesi ile konulur.<\/p>\n<p><strong>Parmakla rektal prostat muayenesinin \u00f6nemi nedir?<\/strong><\/p>\n<p>Prostat kanseri s\u0131kl\u0131kla prostat\u0131n rektum (barsak) ile kom\u015fu olan arka b\u00f6lgesinden (periferik zon) geli\u015fir. Prostat\u0131n bu b\u00f6l\u00fcm\u00fc, ayn\u0131 zamanda kom\u015fulu\u011fu nedeniyle rektal muayenede prostat\u0131n parmakla hissedilen k\u0131sm\u0131d\u0131r. Bu b\u00f6lgede ele gelen nod\u00fcller olas\u0131 kanser i\u00e7in risk olu\u015fturmaktad\u0131r. PSA\u2019s\u0131 normalken \u00a0muayenede \u015f\u00fcpheli nod\u00fcl olan hastalar\u0131n yakla\u015f\u0131k %15 inde kanser saptan\u0131yor olmas\u0131 prostat muayenesinin \u00f6nemini ortaya koymaktad\u0131r.<\/p>\n<p><strong>Kime prostat biyopsi yap\u0131lmal\u0131d\u0131r?<\/strong><\/p>\n<p>PSA de\u011feri riskli seviyede olan hastalar ve PSA de\u011feri normal olsa dahi parmakla rektal muayenede ele gelen nod\u00fcllerin olmas\u0131 durumunda prostat biyopsisi yap\u0131lmal\u0131d\u0131r.<\/p>\n<p><strong>Tekrar biyopsi kime yap\u0131lmal\u0131d\u0131r?<\/strong><\/p>\n<p>Y\u00fckselmeye devam eden PSA \u00f6l\u00e7\u00fcmleri varsa,<\/p>\n<p>Muayenede \u015f\u00fcpheli lezyon varsa,<\/p>\n<p>\u0130lk biyopside ASAP (atypical small acinar proliferation) olarak adland\u0131r\u0131lan patolojik tan\u0131 varsa,<\/p>\n<p>\u0130lk biyopside en az 3 odakta HPIN (high-grade prostatic intraepithelial neoplasia) olarak adland\u0131r\u0131lan patolojik tan\u0131 varsa,<\/p>\n<p>\u0130lk biyopside intraductal carcinoma olarak adland\u0131r\u0131lan patolojik tan\u0131 varsa,<\/p>\n<p>MRI (multiparametric magnetic resonance imaging) g\u00f6r\u00fcnt\u00fcmelerde \u015f\u00fcpheli alan varsa<\/p>\n<p>Tekrar biyopsi yap\u0131lmal\u0131d\u0131r.[\/vc_column_text][\/vc_column][\/vc_row][vc_row gradient_colors=&#8221;%5B%7B%7D%5D&#8221; css=&#8221;.vc_custom_1584012079960{margin-top: -100px !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]<strong>Prostat biyopsi nedir, nas\u0131l yap\u0131l\u0131r?<\/strong><\/p>\n<p>Rektumdan yerle\u015ftirilen prob yard\u0131m\u0131yla prostat\u0131n ultrasonografik g\u00f6r\u00fcnt\u00fcs\u00fc elde edilir. Bu g\u00f6r\u00fcnt\u00fc klavuzlu\u011funda lokal anestezi alt\u0131nda i\u011fne yard\u0131m\u0131yla prostattan 10-12 kadran doku \u00f6rne\u011fi al\u0131n\u0131r. (Resim 1) Bu doku \u00f6rnekleri inceleme i\u00e7in patoloji laboratuvar\u0131na g\u00f6nderilir. Bu i\u015flem s\u0131ras\u0131nda her bir par\u00e7an\u0131n prostat\u0131n neresinden al\u0131nd\u0131\u011f\u0131n\u0131n bilinmesi \u00e7ok \u00f6nemlidir. Zira t\u00fcm\u00f6r\u00fcn lokalizasyonu\u00a0 ameliyat s\u0131ras\u0131nda cerrah\u0131n yakla\u015f\u0131m\u0131n\u0131 etkileyebilmektedir.<\/p>\n<p>\u0130\u015flem s\u0131kl\u0131kla lokal anestezi ile yap\u0131ld\u0131\u011f\u0131 i\u00e7in hastan\u0131n a\u00e7 kalmas\u0131 gerekmez. Her ne kadar 100 mg aspirin kullan\u0131m\u0131n\u0131n prostat biyopsi sonras\u0131 kanama riskini artt\u0131rmad\u0131\u011f\u0131na dair \u00e7al\u0131\u015fmalar bildirilmi\u015f olsa da, hastalar\u0131n i\u015flemden en az 1 hafta \u00f6nce kan suland\u0131r\u0131c\u0131 ila\u00e7lar\u0131n\u0131n kesilmesi istenir.<\/p>\n<p>\u0130\u015flem, rektumdan (barsak) yap\u0131lmas\u0131 ve bu b\u00f6lgenin bakteri bar\u0131nd\u0131rmas\u0131 nedeniyle enfeksiyon riski bar\u0131nd\u0131r\u0131r. \u0130\u015flem sonras\u0131 <%1 hastada ate\u015f y\u00fcksekli\u011fi g\u00f6r\u00fclebilmektedir. Bu riski azaltmak i\u00e7in i\u015flemden 1 g\u00fcn \u00f6nce antibiyotik ba\u015flan\u0131r ve i\u015flem sonras\u0131 da en az 3 g\u00fcn daha kullan\u0131l\u0131r.\n\n[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\"][vc_single_image image=\"2857\" img_size=\"full\"][\/vc_column][\/vc_row][vc_row gradient_colors=\"%5B%7B%7D%5D\" css=\".vc_custom_1584012362695{margin-top: -150px !important;}\"][vc_column][vc_column_text]<strong>Gleason skoru ve \u00f6nemi nedir?<\/strong><\/p>\n<p>Kanser, organ ya da dokudaki h\u00fccrelerin farkl\u0131la\u015farak kontrols\u00fcz \u00e7o\u011falmas\u0131 olarak tan\u0131mlan\u0131r. Prostat kanserinde bu farkl\u0131la\u015fman\u0131n derecesine g\u00f6re her bir hastada gleson paterni hesaplan\u0131r. Bu patern 1 den 5\u2019e kadard\u0131r. (Resim 2) En y\u00fcksek g\u00f6r\u00fclen 2 patern yan yana yaz\u0131l\u0131p toplanarak gleason skoru hesaplan\u0131r (\u00d6rn: Gl (3+4)7 gibi).Tek patern var ise bu patern 2 kez yaz\u0131larak toplan\u0131r (\u00d6rn: Gl(4+4)8). Prostat biyopsi materyalleri incelenirken 3\u2019den daha d\u00fc\u015f\u00fck paternler raporlanmad\u0131\u011f\u0131 i\u00e7in en k\u00fc\u00e7\u00fck gleason skoru 6 iken en b\u00fcy\u00fck gleason skoru 10 dur. Gleason skoru artt\u0131k\u00e7a kanserin agresifli\u011fi de artar ve metastaz yapma olas\u0131l\u0131\u011f\u0131 y\u00fckselir.<\/p>\n<p>[\/vc_column_text][vc_row_inner gradient_colors=&#8221;%5B%7B%7D%5D&#8221; css=&#8221;.vc_custom_1584012122516{margin-top: -70px !important;}&#8221;][vc_column_inner width=&#8221;2\/3&#8243;][vc_column_text]Gleason skoru:6\u00a0 iyi diferansiye kanser (iyi nitelikte farkl\u0131\u015fama g\u00f6steren)<\/p>\n<p>Gleason skoru:7 orta diferansiye kanser (orta nitelikte farkl\u0131\u015fama g\u00f6steren)<\/p>\n<p>Gleason skoru:8-10\u00a0 k\u00f6t\u00fc diferansiye kanser (k\u00f6t\u00fc nitelikte farkl\u0131\u015fama g\u00f6steren)[\/vc_column_text][\/vc_column_inner][vc_column_inner width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;2859&#8243; img_size=&#8221;full&#8221; alignment=&#8221;right&#8221;][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row gradient_colors=&#8221;%5B%7B%7D%5D&#8221; css=&#8221;.vc_custom_1584012144575{margin-top: -120px !important;}&#8221;][vc_column width=&#8221;2\/3&#8243; gradient_colors=&#8221;%5B%7B%7D%5D&#8221; css=&#8221;.vc_custom_1584012378853{margin-top: -80px !important;}&#8221;][vc_column_text]<strong>Prostat kanseri nas\u0131l evrelenir?<\/strong><\/p>\n<p>Evrelemede TNM s\u0131n\u0131flama sistemi kullan\u0131lmaktad\u0131r. Burada T: t\u00fcm\u00f6r\u00fc; N: lenf nodlar\u0131n\u0131; M: uzak metastaz\u0131 temsil eder.<\/p>\n<p>Tx: T\u00fcm\u00f6r varl\u0131\u011f\u0131 de\u011ferlendirilmemi\u015f<\/p>\n<p>T<sub>0<\/sub>: T\u00fcm\u00f6r yok<\/p>\n<p>T<sub>1 <\/sub>: Klinik olarak (parmakla ya da g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemleriyle) tespit edilemeyen<\/p>\n<ul>\n<li>T<sub>1a <\/sub>:Ba\u015fka nedenle yap\u0131lan ameliyat (TUR-P) materyalinde t\u00fcm\u00f6r dokular\u0131n <%5 de saptan\u0131r<\/li>\n<li>T<sub>1b <\/sub>:Ba\u015fka nedenle yap\u0131lan ameliyat (TUR-P) materyalinde t\u00fcm\u00f6r dokular\u0131n >%5 de saptan\u0131r<\/li>\n<li>T<sub>1c <\/sub>:PSA y\u00fcksekli\u011fi nedeniyle yap\u0131lan biyopside t\u00fcm\u00f6r\u00fcn yakalanmas\u0131<\/li>\n<\/ul>\n<p>T<sub>2<\/sub>: T\u00fcm\u00f6r prostat i\u00e7inde s\u0131n\u0131rl\u0131 ve muayenede hissedilebilir<\/p>\n<ul>\n<li>T<sub>2a<\/sub>: T\u00fcm\u00f6r prostat\u0131n bir taraf\u0131n\u0131n (sa\u011f ya da sol), yar\u0131s\u0131ndan az\u0131nda vard\u0131r<\/li>\n<li>T<sub>2b<\/sub>: T\u00fcm\u00f6r prostat\u0131n bir taraf\u0131n\u0131n (sa\u011f ya da sol), yar\u0131s\u0131ndan \u00e7o\u011funda vard\u0131r<\/li>\n<li>T<sub>2c<\/sub>: T\u00fcm\u00f6r prostat\u0131n her iki taraf\u0131n\u0131nda (sa\u011f ve sol) vard\u0131r<\/li>\n<\/ul>\n<p>T3: T\u00fcm\u00f6r prostat kaps\u00fcl\u00fcn\u00fc a\u015fm\u0131\u015ft\u0131r<\/p>\n<ul>\n<li>T<sub>3a<\/sub>: T\u00fcm\u00f6r prostat kaps\u00fcl\u00fcn\u00fc a\u015fm\u0131\u015ft\u0131r ya da mesane boynuna ilerlemi\u015ftir<\/li>\n<li>T<sub>3b<\/sub>: T\u00fcm\u00f6r seminal vezik\u00fcllere (meni bezleri) s\u0131\u00e7ram\u0131\u015ft\u0131r<\/li>\n<\/ul>\n<p>T4: T\u00fcm\u00f6r seminal vezik\u00fcl d\u0131\u015f\u0131ndaki kom\u015fu organlara yay\u0131lm\u0131\u015ft\u0131r<br \/>\nNx: b\u00f6lgesel lenf bezlerinden \u00f6rnekleme yap\u0131lmam\u0131\u015f<br \/>\nN0: B\u00f6lgesel lenf bezlerinde t\u00fcm\u00f6r yok<br \/>\nN1: B\u00f6lgesel lenf bezlerinde t\u00fcm\u00f6r var<\/p>\n<p>M0: Metastaz yok<br \/>\nM1: Metastaz var<\/p>\n<ul>\n<li>M1a: B\u00f6lgesel olmayan lenf nodu metastaz\u0131<\/li>\n<li>M1b: Kemik metastaz\u0131<\/li>\n<li>M1c: Di\u011fer uzak metastaz<\/li>\n<\/ul>\n<p>Prostat kanserini lokalize, lokal ileri ve metastatik olarak s\u0131n\u0131fland\u0131rabiliriz.<\/p>\n<p>Lokalize prostat kanseri prostatta s\u0131n\u0131rl\u0131 (T<sub>1-2<\/sub>, N<sub>0<\/sub>, M<sub>0<\/sub>) kanseri tan\u0131mlar. \u00a0D\u2019Amico s\u0131n\u0131flamas\u0131na g\u00f6re kendi i\u00e7inde d\u00fc\u015f\u00fck, orta ve y\u00fcksek risk gruplar\u0131na ayr\u0131l\u0131r. (Tablo 1)<\/p>\n<p>Tablo1: Lokalize prostat kanserinde D\u2019Amico risk s\u0131n\u0131flamas\u0131<\/p>\n<p>Lokal ileri prostat kanserinde ise t\u00fcm\u00f6r prostat\u0131 a\u015fm\u0131\u015ft\u0131r, b\u00f6lgesel lenf nodlar\u0131n\u0131 tutmu\u015f olabilir yada olmayabilir (T<sub>3-4<\/sub>, N\u00b1, M<sub>0<\/sub>).<\/p>\n<p>Metastatik hastal\u0131kta ise kanser ba\u015fka organ ya da dokulara yay\u0131lm\u0131\u015ft\u0131r.[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;2862&#8243; img_size=&#8221;full&#8221;][vc_single_image image=&#8221;2862&#8243; img_size=&#8221;full&#8221;][vc_single_image image=&#8221;2863&#8243; img_size=&#8221;full&#8221;][vc_single_image image=&#8221;2866&#8243; img_size=&#8221;full&#8221;][vc_single_image image=&#8221;2865&#8243; img_size=&#8221;full&#8221;][vc_column_text css=&#8221;.vc_custom_1584011851305{padding-right: 0px !important;}&#8221;]<\/p>\n<p style=\"text-align: center; margin-top: -40px;\">Tablo 1<\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row gradient_colors=&#8221;%5B%7B%7D%5D&#8221; css=&#8221;.vc_custom_1584012169066{margin-top: -100px !important;}&#8221;][vc_column gradient_colors=&#8221;%5B%7B%7D%5D&#8221; css=&#8221;.vc_custom_1584012407030{margin-top: -60px !important;}&#8221;][vc_column_text]<strong>Prostat kanserinde tedavi se\u00e7enekleri nelerdir?<\/strong><\/p>\n<p>Prostat kanserinde tedavi hastal\u0131\u011f\u0131n evresine g\u00f6re farkl\u0131l\u0131k g\u00f6sterir.<\/p>\n<p>Lokalize (prostatta s\u0131n\u0131rl\u0131) prostat kanserinde risk gruplar\u0131na g\u00f6re radikal prostatektomi ameliyat\u0131, radyoterapi ya da radyoterapi + s\u0131n\u0131rl\u0131 bir s\u00fcre LHRH tedavilerinden biri, hasta ile konu\u015fularak karar verilir. Kanserin genel olarak yava\u015f seyirli olmas\u0131 nedeniyle \u201caktif izlem\u201d denilen \u201ctedaviyi erteleme\u201d bir ba\u015fka alternatiftir. Bunun i\u00e7in hasta se\u00e7imi ve hastan\u0131n takibe uyumu son derece \u00f6nemlidir. Lokalize kanserde fokal tedaviler de \u00f6neri d\u00fczeyi d\u00fc\u015f\u00fck olmakla birlikte uygulanabilmektedirler.<\/p>\n<p>Lokal ileri (prostattan ta\u015fm\u0131\u015f ama ba\u015fka organlara yay\u0131lmam\u0131\u015f) prostat kanserinde radikal prostatektomi ameliyat\u0131 ya da radyoterapi +2-3 y\u0131l LHRH analo\u011fu tedavisi tercih edilir.<\/p>\n<p>Metastatik (ba\u015fka organ-dokulara yay\u0131lm\u0131\u015f) hastal\u0131kta ise or\u015fiektomi (her iki testisin al\u0131nmas\u0131) ya da LHRH anolo\u011fu kombinasyonlar\u0131 uygulanmaktad\u0131r.<\/p>\n<p>\u00c7oklu metastazlar\u0131 olan hastalarda ise or\u015fiektomi ya da LHRH anologlar\u0131 ile birlikte kemoterapi uygulanmas\u0131n\u0131n ya\u015fam s\u00fcresini ortalama 13 ay uzatt\u0131\u011f\u0131 g\u00f6sterilmi\u015ftir.<\/p>\n<p><strong>Metastatik kanserde hastan\u0131n testisleri ni\u00e7in al\u0131n\u0131r?<\/strong><\/p>\n<p>Prostat kanseri bir erkeklik hormonu olan \u201ctestosteron\u201d ba\u011f\u0131ml\u0131 bir kanserdir. Kanseri yava\u015flatabilmek i\u00e7in v\u00fccuttaki testosteronun ana kayna\u011f\u0131 olan testisler al\u0131n\u0131r. Bu tedavi ile kanser yakla\u015f\u0131k 24-36 ay s\u00fcreyle sessizle\u015fir. Ancak kanser h\u00fccreleri bu s\u00fcrenin sonunda \u00e7o\u011falabilmek i\u00e7in testosteron d\u0131\u015f\u0131nda ba\u015fka molek\u00fcller bulur ve hastal\u0131k bu a\u015famadan sonra\u00a0 \u201ckastrasyon diren\u00e7li\u201d olarak tan\u0131mlan\u0131r.<\/p>\n<p>Testisleri almadan LHRH anolu\u011fu \/ antagonisti ila\u00e7lar ile de or\u015fiektomideki gibi \u00e7ok d\u00fc\u015f\u00fck testosteron seviyeleri sa\u011flanabilir. Bu ila\u00e7lar testis dokusundan testosteron \u00fcretilmesine mani olur.<\/p>\n<p><strong>Prostat kanserinin tedavisinde kemoterapinin yeri var m\u0131d\u0131r?<\/strong><\/p>\n<p>Prostat kanserinde kemoterapi kastrastyon diren\u00e7li metastatik hastal\u0131kta ilk tercihtir.<\/p>\n<p>Ayr\u0131ca kastrasyon diren\u00e7li hale gelmemi\u015f, yeni tan\u0131 alm\u0131\u015f hormon-duyarl\u0131 ama y\u00fcksek hacimli (visseral organ matastaz\u0131, \u22654 kemik metastaz\u0131 ya da omurga d\u0131\u015f\u0131 kemik metastaz\u0131) matastatik hastal\u0131k varl\u0131\u011f\u0131nda da kemoterapi ile ya\u015fam s\u00fcresinde yakla\u015f\u0131k 13 ayl\u0131k bir uzama oldu\u011fu g\u00f6sterilmi\u015ftir.<\/p>\n<p><strong>Tedavilerle ilgili hastalar\u0131n \u00e7ekinceleri<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u0130drar ka\u00e7\u0131rma<\/strong><\/p>\n<p>Radikal prostatektomi ameliyat\u0131 sonras\u0131nda idrar ka\u00e7\u0131rma ihtimali hastalar\u0131 en \u00e7ok kayg\u0131land\u0131ran hususlardan biridir. Prostat\u0131n tamamen al\u0131nmas\u0131n\u0131 takiben erken d\u00f6nemdeki idrar ka\u00e7\u0131rma, yard\u0131mc\u0131 kaslar\u0131n g\u00fc\u00e7lenmesi ile zamanla azal\u0131r. Ameliyattan sonraki 1. y\u0131lda hastalar\u0131n tam kuruluk oranlar\u0131 farkl\u0131 kliniklerde %80 ile %97 aral\u0131\u011f\u0131nda bildirilir. Burada hastan\u0131n ya\u015f\u0131, ameliyat \u00f6ncesi idrar tutma sorunu varl\u0131\u011f\u0131, i\u015flem s\u0131ras\u0131nda mesane boynunun korunmas\u0131 ve cerrahi tecrube ameliyat sonras\u0131 idrar ka\u00e7\u0131rmay\u0131 etkilen \u00f6nemli fakt\u00f6rlerdir.<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Erektil disfonksiyon (sertle\u015fme sorunu)<\/strong><\/p>\n<p>Radikal prostatektomi ameliyat\u0131 sonras\u0131nda g\u00f6r\u00fclebilen ve hastalarda kayg\u0131 uyand\u0131ran bir di\u011fer durum ise ereksiyon (sertle\u015fme) sorunudur. Ameliyat sonras\u0131 hastalar\u0131n %70-75 inde farkl\u0131 d\u00fczeylerde ereksiyon\u00a0 sorunlar\u0131 g\u00f6r\u00fclebilmektedir. Tabi burada cerrahi teknik (sinir koruyucu yakla\u015f\u0131m) ameliyat sonras\u0131 erektil disfonksiyon oran\u0131n\u0131 \u00f6nemli \u00f6l\u00e7\u00fcde etkilemektedir.<\/p>\n<p>Radyoterapi sonras\u0131nda da hastalar\u0131n yar\u0131s\u0131na yak\u0131n\u0131nda ereksiyon sorunlar\u0131 g\u00f6r\u00fclebilmektedir.<\/p>\n<p>LHRH agonistleri ya da or\u015fiektomi ameliyatlar\u0131 sonras\u0131nda testosteron d\u00fczeyi \u00e7ok azaltt\u0131\u011f\u0131 i\u00e7in ereksiyon sorunu ya\u015fanmakta ve libido \u00a0azaltmaktad\u0131r.[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text]<strong>Kanser nedir? nas\u0131l olu\u015fur?<\/strong><\/p>\n<p>Kanser bir organ veya dokuyu olu\u015fturan h\u00fccrelerin yap\u0131s\u0131n\u0131n bozularak kontrols\u00fcz \u00e7o\u011falmas\u0131d\u0131r. Bu kontrols\u00fcz \u00e7o\u011falma organ\u0131n \u015feklini bozarak zamanla b\u00fcy\u00fcmeye ba\u015flar. \u00a0&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"page-full-width.php","meta":{"inline_featured_image":false,"footnotes":""},"class_list":["post-2847","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/uraloguz.com\/tr_TR\/wp-json\/wp\/v2\/pages\/2847","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/uraloguz.com\/tr_TR\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/uraloguz.com\/tr_TR\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/uraloguz.com\/tr_TR\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/uraloguz.com\/tr_TR\/wp-json\/wp\/v2\/comments?post=2847"}],"version-history":[{"count":21,"href":"https:\/\/uraloguz.com\/tr_TR\/wp-json\/wp\/v2\/pages\/2847\/revisions"}],"predecessor-version":[{"id":3281,"href":"https:\/\/uraloguz.com\/tr_TR\/wp-json\/wp\/v2\/pages\/2847\/revisions\/3281"}],"wp:attachment":[{"href":"https:\/\/uraloguz.com\/tr_TR\/wp-json\/wp\/v2\/media?parent=2847"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}