Rahim kanserinin \u00e7e\u015fitleri \u00e7oktur. Endometrium kanseri kad\u0131nlarda meme, kolorektal ve akci\u011fer kanserinden sonra en s\u0131k g\u00f6r\u00fclen jinekolojik kanserdir. \u00d6zellikle ya\u015fl\u0131 ve postmenopozal kad\u0131nlar\u0131n hastal\u0131\u011f\u0131d\u0131r. Vakalar\u0131n %70’i 45-74 ya\u015f aras\u0131ndad\u0131r. Hastal\u0131\u011f\u0131 saptamada etkin bir tarama testi olmamas\u0131na ra\u011fmen erken belirti vermesi nedeniyle %75’i ba\u015flang\u0131\u00e7 evrelerinde yakalan\u0131r. Menopozdan sonra olu\u015fan bir vajinal kanama ya da lekelenme nedeniyle doktora ba\u015fvurmak kanserin hen\u00fcz erken evredeyken saptanmas\u0131n\u0131 sa\u011flayabilir. 5 y\u0131ll\u0131k ya\u015fam \u015fans\u0131 t\u00fcm evreler i\u00e7in ortalama %84 civar\u0131ndad\u0131r, hastal\u0131k erken yakaland\u0131\u011f\u0131nda bu oran daha da y\u00fckselir.<\/p>\n

Rahim kanseri (endometrium kanseri) denildi\u011finde rahim i\u00e7 tabakas\u0131n\u0131 olu\u015fturan endometriumdan kaynaklanan kanserler anla\u015f\u0131l\u0131r.<\/p>\n

Risk Fakt\u00f6rleri:
\n60 ya\u015f \u00fcst\u00fcnde olmak,
\n\u015ei\u015fmanl\u0131k (obesite)
\nProgesteron i\u00e7ermeyen, sadece estrogenleri i\u00e7eren hormon ila\u00e7lar\u0131n\u0131n uzun s\u00fcre kullan\u0131m\u0131,
\nAdet kanamalar\u0131n\u0131n k\u00fc\u00e7\u00fck ya\u015flarda ba\u015flay\u0131p ileri ya\u015flarda menopoza girilmesi,
\nHi\u00e7 do\u011fum yapmamak ya da k\u0131s\u0131rl\u0131k \u00f6yk\u00fcs\u00fc,
\nKendisinde veya ailesinde kal\u0131n barsak kanseri veya endometrium kanseri \u00f6yk\u00fcs\u00fcn\u00fcn varl\u0131\u011f\u0131
\nMeme yada over kanseri \u00f6yk\u00fcs\u00fc
\nOver hastal\u0131klar\u0131
\nTamoksifen (meme kanseri tedavisinde kullan\u0131lan bir hormon ilac\u0131) kullan\u0131m\u0131,
\nDiyabet (\u015feker hastal\u0131\u011f\u0131),
\nHayvansal ya\u011fdan zengin beslenme,
\nHipertansiyon (tansiyon y\u00fcksekli\u011fi),
\nAdet d\u00fczensizlikleridir.
\n\u00d6strojen replasman tedavisi<\/p>\n

Endometrial kanser riskini azaltan fakt\u00f6rler:<\/p>\n

Uzun s\u00fcre do\u011fum kontrol hap\u0131 kullan\u0131lmas\u0131 riski azalt\u0131r, bu koruma ilac\u0131n b\u0131rak\u0131lmas\u0131ndan sonra da 10 y\u0131l devam eder.
\nAdet g\u00f6rmekte olan han\u0131mlarda yo\u011fun, fazla ya da d\u00fczensiz kanama geli\u015fti\u011finde doktor kontrolu yap\u0131lmas\u0131
\nMenopoz sonras\u0131 vajinal kanama endometrium kanserinin en erken bulgusudur, vakit kaybetmeden kontrol edilmeli
\nEndometrial hiperplazi olgular\u0131n\u0131n baz\u0131 tipleri (Atipili Kompleks Hiperplazi) tedavi edilmedi\u011fi taktirde kansere d\u00f6n\u00fc\u015fme e\u011filimindendir. Bu durumda rahimin cerrahi olarak \u00e7\u0131kar\u0131lmas\u0131 bunu \u00f6nleyebilir.
\nHerediter Nonpolipozis Kolon Kanser’li yada bu y\u00f6nden artm\u0131\u015f risk varsa 35 ya\u015f\u0131ndan itibaren her y\u0131l endometrial biopsi ya da \u00e7ocuk istemini tamamlam\u0131\u015fsa rahmin al\u0131nmas\u0131 \u00f6nerilebilir
\nMeme kanseri tedavisinde kullan\u0131lan Tamoksifen endometrium kanseri riskini artt\u0131rd\u0131\u011f\u0131ndan hastalar\u0131n bu konuda bilin\u00e7lendirilmeleri ve rutin jinekolojik muayenelerini aksatmamalar\u0131,
\nSa\u011fl\u0131kl\u0131 kiloda olmak, dengeli beslenme, var olan diabet ve y\u00fcksek tansiyonun kontrol alt\u0131na al\u0131nmas\u0131<\/p>\n

Hi\u00e7bir \u015fikayeti olmayan ya da kanser i\u00e7in ailesel risk ta\u015f\u0131mayan kad\u0131nlara rahim kanserini saptamak i\u00e7in \u00f6nerilecek bir tarama testi yoktur. Fakat endometrium kanseri olan \u00e7o\u011fu kad\u0131nda erken belirtiler vard\u0131r. Bu belirtiler:
\nAnormal vajinal kanama, lekelenme veya ak\u0131nt\u0131: Menopozdaki kad\u0131nlarda \u00f6zellikle \u00f6nem ta\u015f\u0131r. Hala adet g\u00f6rmekte olan kad\u0131nlarda ise d\u00fczensiz adet kanamalar\u0131 \u015feklindedir. Menopoz sonras\u0131 kanamas\u0131 olan veya 40 ya\u015f sonras\u0131 artm\u0131\u015f vajinal kanama \u015fikayeti olan t\u00fcm kad\u0131nlar\u0131n rahim kanseri olma olas\u0131l\u0131\u011f\u0131na kar\u015f\u0131 doktora ba\u015fvurmas\u0131 gerekmektedir. Ayr\u0131ca periyodik jinekolojik muayeneler s\u0131ras\u0131nda transvaginal ultrason ile rahim i\u00e7 zar\u0131 (endometrium) kal\u0131nl\u0131\u011f\u0131 \u00f6l\u00e7\u00fcm\u00fc de rahim kanseri hakk\u0131nda fikir verebilmektedir. Menopoz sonras\u0131 y\u0131llarda kal\u0131nla\u015fm\u0131\u015f bir endometrium saptan\u0131rsa kanser a\u00e7\u0131s\u0131ndan de\u011ferlendirilmelidir. Kanl\u0131 olmayan vajinal ak\u0131nt\u0131 da bir bulgu olabilir, endometrium kanserine ba\u011fl\u0131 ak\u0131nt\u0131lar\u0131 %10’u kanl\u0131 de\u011fildir.
\n\u0130drar yaparken yanma, cinsel ili\u015fki s\u0131ras\u0131nda a\u011fr\u0131,
\nPelvik b\u00f6lgede a\u011fr\u0131 veya kitle<\/p>\n

Yukar\u0131daki belirtilerin herhangi birinin varl\u0131\u011f\u0131nda jinekologa ba\u015fvurulmal\u0131d\u0131r. Jinekolog endometrium kanseri \u015f\u00fcphesi duydu\u011funda endometrial biopsi ya da k\u00fcretaj yoluyla rahim i\u00e7inden bir miktar doku al\u0131p patolojiye g\u00f6nderir. Al\u0131nan par\u00e7a patolog taraf\u0131ndan de\u011ferlendirildi\u011finde kanser varsa tipi ve derecesi raporda bildirilir. Kanserin derecesi artt\u0131k\u00e7a hastal\u0131\u011f\u0131n yay\u0131lma ve tekrarlama olas\u0131l\u0131\u011f\u0131 artar.<\/p>\n

Endometrial kanser tan\u0131s\u0131nda transvajinal ultrason, bilgisayarl\u0131 tomografi (BT), magnetik rezonans g\u00f6r\u00fcnt\u00fcleme (MRG) ve gibi g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemleri de gerekti\u011finde uygulanabilir.<\/p>\n

Endometrial kanseri yay\u0131l\u0131rken ilk olarak t\u00fcpler, yumurtal\u0131klar ve lenf nodlar\u0131na ilerler. Serviks, vajina ve akci\u011ferlere de yay\u0131labilir. \u0130lerlemi\u015f kanser mesane ve kal\u0131n ba\u011f\u0131rsa\u011f\u0131 tutabilir.<\/p>\n

Endometrium kanserinin tedavisine karar verirken kanserin tipi, derecesi, evresi, hastan\u0131n genel sa\u011fl\u0131k durumu ve ki\u015fisel tercihleri g\u00f6z \u00f6n\u00fcne al\u0131n\u0131r. Endometrium kanserinde cerrahinin amac\u0131 kanserli dokuyu v\u00fccuttan m\u00fcmk\u00fcn oldu\u011funca \u00e7\u0131kartmakt\u0131r. Bu nedenle rahimin total \u00e7\u0131kar\u0131lmas\u0131 (histerektomi) temel prensiptir. T\u00fcpler ve yumurtal\u0131klar \u00e7\u0131kart\u0131l\u0131r. \u00c7ok erken evre olgularda (t\u00fcmor uterusta s\u0131n\u0131rl\u0131 ve derin myometrial invazyon yok) yaln\u0131zca rahmin ve yumurtal\u0131klar\u0131n al\u0131nmas\u0131 (TAH+BSO) ve periton y\u0131kama s\u0131v\u0131s\u0131n\u0131n sitolojik incelemesi yeterli olur. Geri kalan di\u011fer evrelerde , pelvik ve paraaortik lenf bezlerinden biopsi yap\u0131l\u0131r ve patolojik de\u011ferlendirmeye al\u0131narak hastal\u0131\u011f\u0131n yayg\u0131nl\u0131\u011f\u0131 saptan\u0131r. Bulgulara g\u00f6re postoperatif d\u00f6nemde tedaviye radyoterapi ve\/veya kemoterapi eklenmesi planlan\u0131r.<\/p>\n

Endometriyum Kanserinde Evreleme (FIGO 2009 evrelemesi):<\/p>\n

Evre I T\u00fcmor uterus s\u0131n\u0131rl\u0131d\u0131r
\nIA: T\u00fcm\u00f6r derinli\u011fi myometriyumun yar\u0131s\u0131n\u0131 ge\u00e7mez.
\nIB: Myometriyumun yar\u0131s\u0131na kadar veya yar\u0131s\u0131n\u0131 ge\u00e7en t\u00fcm\u00f6r derinli\u011fi vard\u0131r.<\/p>\n

Evre II: T\u00fcm\u00f6r rahim a\u011fz\u0131 stromas\u0131na yay\u0131lm\u0131\u015ft\u0131r ancak uterus d\u0131\u015f\u0131na \u00e7\u0131kmam\u0131\u015ft\u0131r.<\/p>\n

Evre III T\u00fcm\u00f6r\u00fcn lokal veya b\u00f6lgesel yay\u0131l\u0131m\u0131 vard\u0131r
\nIIIA: T\u00fcm\u00f6r rahimin seroza tabakas\u0131na ve\/veya adnekslere yay\u0131lm\u0131\u015ft\u0131r.
\nIIIB: Vajinal ve\/veya parametriyal yay\u0131l\u0131m vard\u0131r.
\nIIIC: Pelvik ve \/veya paraaortik lenf noduna metastas vard\u0131r
\nIIIC1: Pelvik lenf nodu yay\u0131l\u0131m\u0131
\nIIIC2: Paraaortik lenf nodu yay\u0131l\u0131m\u0131 ve\/veya pelvik lenf nodu tutulumu<\/p>\n

Evre IV: Mesane ve\/veya rektum mukozas\u0131 tutulumu, ve\/veya uzak organ yay\u0131l\u0131m\u0131
\nIVA: Mesane ve\/veya rektum mukozas\u0131 yay\u0131l\u0131m\u0131
\nIVB: Uzak metastaz kar\u0131n i\u00e7i yay\u0131l\u0131m\u0131 ve\/veya inguinal lenf nodu tutulumunu i\u00e7erir.<\/p>\n

Hen\u00fcz kanser uterus d\u0131\u015f\u0131na yay\u0131lmad\u0131ysa cerrahi tedavi tam bir iyile\u015fme sa\u011flamaktad\u0131r.
\nAncak ba\u015fka organlara veya lenf dokular\u0131na da yay\u0131lm\u0131\u015fsa ek bir tedavi gerekecektir. \u0130lerlemi\u015f rahim kanserlerinde cerrahiden sonra radyasyon (\u0131\u015f\u0131n) tedavisi uygulanmaktad\u0131r.<\/p>\n

Kemoterapi kanser h\u00fccrelerini \u00f6ld\u00fcrmek i\u00e7in kullan\u0131lan ila\u00e7lard\u0131r. Endometriyum kanserinde kemoterapinin yeri s\u0131n\u0131rl\u0131d\u0131r, genellikle bu ila\u00e7lar kombinasyonlar halinde kullan\u0131l\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":"

Rahim…<\/p>\n","protected":false},"author":1,"featured_media":8072,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1576],"tags":[310,5186,3973,5229,153],"_links":{"self":[{"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/posts\/8069"}],"collection":[{"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/comments?post=8069"}],"version-history":[{"count":0,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/posts\/8069\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/media\/8072"}],"wp:attachment":[{"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/media?parent=8069"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/categories?post=8069"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.coolkadin.com\/wp-json\/wp\/v2\/tags?post=8069"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}