http___ljubavnadjelu.hr_stranica.php_str_rak_jetre_jezik_HRV_1.xml
1.1 2.1 3.1 4.1 5.1 6.1 7.1 8.1 9.1 10.1 11.1 12.1 13.1 14.1 15.1 15.2 15.3 15.4 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 17.1 17.2 18.1 18.2 18.3 18.4 19.1 19.2 19.3 20.1 20.2 20.3 20.4 21.1 22.1 23.1 23.2 24.1 24.2 24.3 25.1 25.2 25.3 26.1 27.1 27.2 28.1 28.2 29.1 29.2 30.1 30.2 30.3 31.1 32.1 33.1 33.2 34.1 35.1 36.1 36.2 36.3 36.4 37.1 37.2 37.3 38.1 39.1 40.1 40.2 41.1 41.2 42.1 43.1 44.1 45.1 46.1 47.1 48.1 48.2 49.1 49.2 50.1 51.1 51.2 52.1 52.2 53.1 53.2 54.1 55.1 56.1 56.2 57.1 57.2 58.1 58.2 59.1 60.1 60.2 61.1 62.1 63.1 63.2 64.1 65.1 65.2 65.3 66.1 67.1 68.1 69.1 70.1 71.1 72.1 73.1 74.1
Breast Cancer Stages Key Points - After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body. - There are three ways that cancer spreads in the body. - Cancer may spread from where it began to other parts of the body. - The following stages are used for breast cancer: - Stage 0 (carcinoma in situ) - Stage I - Stage II - Stage IIIA - Stage IIIB - Stage IIIC - Stage IV After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body. The process used to find out whether the cancer has spread within the breast or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process: - Sentinel lymph node biopsy: The removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node to receive lymphatic drainage from a tumor. It is the first lymph node the cancer is likely to spread to from the tumor. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologistviews the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes. - Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. - CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. - Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner. - PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. There are three ways that cancer spreads in the body: Cancer can spread through tissue, the lymph system, and the blood: - Tissue. The cancer spreads from where it began by growing into nearby areas. - Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body. - Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body. Cancer may spread from where it began to other parts of the body. When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood. - Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body. - Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bone, the cancer cells in the bone are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer. Breast Cancer Stages The following stages are used for breast cancer: This section describes the stages of breast cancer. The breast cancer stage is based on the results of testing that is done on the tumor and lymph nodes removed during surgery and other tests. Stage 0 (carcinoma in situ) There are 3 types of breast carcinoma in situ: - Ductal carcinoma in situ (DCIS) is a noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues. At this time, there is no way to know which lesions could become invasive. - Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the lobules of the breast. This condition seldom becomes invasive cancer. However, having LCIS in one breast increases the risk of developing breast cancer in either breast. - Paget disease of the nipple is a condition in which abnormal cells are found in the nipple only. Stage I In stage I, cancer has formed. Stage I is divided into stages IA and IB. - In stage IA, the tumor is 2 centimeters or smaller. Cancer has not spread outside the breast. - In stage IB, small clusters of breast cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes and either: - no tumor is found in the breast; or - the tumor is 2 centimeters or smaller. Stage II Stage II is divided into stages IIA and IIB. - In stage IIA: - no tumor is found in the breast or the tumor is 2 centimeters or smaller. Cancer (larger than 2 millimeters) is found in 1 to 3 axillary lymph nodes or in the lymph nodes near thebreastbone (found during a sentinel lymph node biopsy); or - the tumor is larger than 2 centimeters but not larger than 5 centimeters. Cancer has not spread to the lymph nodes. - In stage IIB, the tumor is: - larger than 2 centimeters but not larger than 5 centimeters. Small clusters of breast cancercells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or - larger than 2 centimeters but not larger than 5 centimeters. Cancer has spread to 1 to 3axillary lymph nodes or to the lymph nodes near the breastbone (found during a sentinel lymph node biopsy); or - larger than 5 centimeters. Cancer has not spread to the lymph nodes. Stage IIIA - In stage IIIA: - no tumor is found in the breast or the tumor may be any size. Cancer is found in 4 to 9 axillary lymph nodes or in the lymph nodes near the breastbone (found during imaging tests or a physical exam); or - the tumor is larger than 5 centimeters. Small clusters of breast cancer cells (larger than 0.2millimeter but not larger than 2 millimeters) are found in the lymph nodes; or - the tumor is larger than 5 centimeters. Cancer has spread to 1 to 3 axillary lymph nodes or to the lymph nodes near the breastbone (found during a sentinel lymph node biopsy). Stage IIIB In stage IIIB, the tumor may be any size and cancer has spread to the chest wall and/or to the skin of the breast and caused swelling or an ulcer. Also, cancer may have spread to: - up to 9 axillary lymph nodes; or - the lymph nodes near the breastbone. Cancer that has spread to the skin of the breast may also be inflammatory breast cancer. See the section on Inflammatory Breast Cancer for more information. Stage IIIC In stage IIIC, no tumor is found in the breast or the tumor may be any size. Cancer may have spread to the skin of the breast and caused swelling or an ulcer and/or has spread to the chest wall. Also, cancer has spread to: - 10 or more axillary lymph nodes; or - lymph nodes above or below the collarbone; or - axillary lymph nodes and lymph nodes near the breastbone. Cancer that has spread to the skin of the breast may also be inflammatory breast cancer. For treatment, stage IIIC breast cancer is divided into operable and inoperable stage IIIC. Stage IV In stage IV, cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain. Reference: National Cancer Institute Last updated: February 9, 2018
1.1 1.2 1.3 2.1 2.2 2.3 2.4 2.5 3.1 3.2 3.3 3.4 4.1 6.1 6.2 7.1 8.1 9.1 10.1 11.1 12.1 13.1 14.1 15.1 15.2 15.3 15.4 16.1 18.1 19.1 20.1 20.2 21.1 21.2 22.1 23.1 24.1 25.1 26.1 27.1 28.1 29.1 30.1 30.2 31.1 32.1 32.2 32.3 32.4 32.5 33.1 33.2 34.1 35.1 36.1 36.2 36.3 37.1 38.1 38.2 38.3 39.1 40.1 40.2 41.1 42.1 43.1 43.2 43.3 44.1 45.1 45.2 46.1 46.2 47.1 48.1 48.2 49.1
Primarni rak jetre započinje u hepatocitima (stanicama jetre). Ovaj tip raka naziva se hepatocelularnim karcinomom ili malignim hepatomom. Djeca mogu razviti hepatocelularni karcinom ili hepatoblastom. Kada se rak jetre širi (metastazira) izvan jetre, stanice raka imaju tendenciju širenja u obližnje limfne čvorove, kosti i pluća. Kada se to dogodi, novi tumor ima istu vrstu abnormalnih stanica kao i primarni tumor u jetri. Primjerice, ako se rak jetre raširi u kosti, stanice raka u kostima zapravo su stanice raka jetre. Bolest je metastatički rak jetre, ne rak kosti. Tretira se kao rak jetre, a ne kao rak kosti. Slično, rak koji se iz drugih organa proširi na jetru različit je od primarnog raka jetre. Stanice raka u jetri, u tom slučaju, su kao stanice u originalnom tumoru. Kada se stanice raka rašire s drugog organa (debelo crijevo, pluća ili dojku) na jetru, liječnici mogu tumor u jetri nazvati sekundarnim tumorom. U SAD-u su sekundarni tumori jetre češći nego primarni tumori. Rak jetre ponekada se naziva tihom bolešću zbog toga što u ranim fazama često nema simptoma, ali kako rak napreduje mogu se pojaviti sljedeći simptomi: Bol u gornjem dijelu abdomena na desnoj strani. Bol se može širiti u leđa i ramena. · Otečeni abdomen (nadutost) · Gubitak na težini · Gubitak apetita i osjećaji sitosti · Oslabljenost ili osjećaj umora · Vrtoglavica i povraćanje · Žuta koža i oči i tamni urin od žutice · Povišena tjelesna temperatura Navedeni simptomi nisu siguran znak raka jetre. Druge bolesti jetre i drugi zdravstveni problemi također mogu uzrokovati simptome. Osoba s navedenim simptomima trebala bi posjetiti liječnika. Samo liječnik može postaviti dijagnozu i liječiti bolest. Ukoliko pacijent pokazuje navedene simptome raka jetre liječnik može provesti jednu ili više pretraga: Tjelesni pregled – liječnik opipava abdomen kako bi provjerio, odnosno, utvrdio kvržice ili promjene u veličini na jetri, slezeni i drugim organima. Liječnik također provjerava prisustvo ascitesa (abnormalne nakupine tekućine u abdomenu). Liječnik može pregledati kožu i oči u potrazi za znakovima žutice. · Krvne pretrage · CT · Ultrazvuk · MRI · Angiogram · Biopsija Stadij raka jetre Ukoliko se dijagnosticira rak jetre, liječnik treba znati stadij ili razmjer bolesti kako bi isplanirao najbolji tretman za pacijenta. Utvrđivanje stadija bolesti zapravo je pokušaj određivanja veličine tumora, da li se bolest proširila i ukoliko je – na koje dijelove tijela, da li se tumor može odstraniti operacijom. Tretman Mnogi pacijenti s rakom jetre žele imati aktivnu ulogu pri odlučivanju o tretmanu. Žele naučiti sve što mogu o svojoj bolesti i odabiru tretmana. Međutim, šok i stres koji pacijenti dožive kada čuju dijagnozu otežava im razmišljanje o svemu što bi željeli pitati liječnika. Često pomaže sastaviti listu pitanja prije susreta s liječnikom. Kako bi zapamtili sve što liječnik kaže, pacijenti mogu uzimati zabilješke ili povesti člana obitelji. U današnje vrijeme se rak jetre može izliječiti samo ukoliko se otkrije u ranoj fazi (prije nego što se proširi) i samo ako je pacijentovo opće zdravstveno stanje dovoljno dobro da podnese operaciju. Međutim, osim operacije postoje i drugi tretmani koji mogu pomoći u kontroli bolesti, pomoći da se pacijenti bolje osjećaju i produžiti im život. Lokalizirani operabilni rak Lokalizirani operabilni rak jetre je rak koji se može odstraniti tijekom operacije te nema dokaza da se rak proširio na obližnje limfne čvorove ili druge dijelove tijela, a laboratorijski testovi ukazuju na dobru funkciju jetre. Operacija kojom se odstranjuje dio jetre naziva se hepatektomija. Opseg operacije ovisi o veličini, broju i lokaciji tumora i o tome koliko jetra dobro radi. Liječnik može odstraniti dio tkiva koje sadrži tumor, cijeli režanj ili veći dio jetre. Kod djelomične hepatektomije kirurg odstranjuje tumor do granice normalnog tkiva koje preuzima funkciju jetre. Kod nekih pacijenata opcija može biti transplantacija jetre. Kod ove procedure kirurg odstranjuje cijelu jetru i zamjenjuje je zdravim organom od donora. Transplantacija jetre je opcija samo ako se bolest nije proširila izvan jetre i samo ako se može pronaći odgovarajući donor. Lokalizirani neoperabilni rak Lokalizirani neoperabilni rak ne može se odstraniti operacijom iako se nije proširio na obližnje limfne čvorove ili druge dijelove tijela. Operacija nije moguća zbog ciroze (ili drugih stanja koja dovode do oslabljene funkcije jetre), lokalizacije tumora unutar jetre ili drugih zdravstvenih problema. Pacijenti s lokaliziranim neoperabilnim tumorom mogu biti pogodni za druge oblike tretmana kojima se nastoji kontrolirati bolest i produžiti život. Uznapredovali rak Uznapredovali rak je rak koji se nalazi u oba jetrena režnja ili koji se proširio na druge dijelove tijela. Iako se uznapredovali rak ne može izliječiti neki pacijenti primaju terapiju kojom se nastoji usporiti progresija bolesti. Drugi pacijenti, nakon razmatranja dobrobiti i štete od terapije odlučuju kako ne žele terapiju. Tretman uznapredovalog raka uključuje kemoterapiju i/ili radioterapiju. · Kemoterapija – predstavlja upotrebu lijekova koji ubijaju stanice raka. Pacijent može primiti jedan lijek ili kombinaciju lijekova. · Radioterapija – koriste se visoko-energetske zrake kako bi se ubile stanice raka. Radioterapija je lokalna terapija, odnosno, djeluje na stanice raka koje se nalaze u tretiranom području. Recidivirajući rak Recidivirajući rak predstavlja bolest koja se vraća nakon inicijalnog tretmana. Čak i kada se čini da je rak u jetri u potpunosti odstranjen ili uništen bolest se ponekad vraća zbog neopaženih stanica raka koje su ostale negdje u tijelu nakon tretmana. Rak se najčešće ponovno pojavljuje u periodu od dvije godine od tretmana