Sledenje bolnikov z rakom Follow- up of cancer patients

Abstract

Rak postaja najpogostejša bolezen in tudi najpogostejši vzrok smrti sodobnega človeka. Breme te bolezni se iz leta v leto povečuje. Na račun zgodnjega odkrivanja in učinkovitejšega ter varnejšega zdravljenja pa se izboljšuje tudi preživetje bolnikov z rakom. To povzroča strmo naraščanje števila preživelih od raka, tako da v razvitem svetu predstavljajo okrog 3 % celotne populacije. Preživeli od raka potrebujejo skrbno spremljanje zdravstvenega stanja tudi po končanem onkološkem zdravljenju. Ne sledimo jih le zaradi nevarnosti ponovitve bolezni (lokoregionalne ali oddaljene), temveč tudi zaradi poznih posledic in neželenih učinkov zdravljenja (fizičnih, psihičnih, socialnih) ter povečanega tveganja zbolevanja za drugimi (sekundarnimi) raki. Ozavestiti jih je treba o zdravem načina življenja in zgodnjem odkrivanju sekundarnih rakov ter tudi o poznih posledicah zdravljenja. Za nekatere vrste raka, ki so dedno pogojene, so na voljo metode genetskega testiranja, predvsem pa je bolnike in svojce treba poučiti o presejalnih metodah (npr. mamografija, kolonoskopija). Preživeli od raka tudi pogosteje od ostale populacije zbolevajo za drugimi, nemalignimi obolenji. Ob vse večjem številu preživelih od raka in v času, ko rak postaja kronična bolezen, je nujno, da se v celostno oskrbo poleg onkologa in družinskega zdravnika vključijo tudi strokovnjaki drugih specialnosti, npr. visoko izobražene medicinske sestre, usmerjene v onkologijo, in psihologi.

Abstract (Eng)

Cancer is a disease with nearly the highest incidence and also the most frequent cause of death in humans today. Cancer burden is getting higher every year. However, due to early detection of cancer, more efficient and less harmful treatment, the survival of cancer patients is improving. Consequently, also the percentage of cancer survivors is significantly on the rise and, in the developed world, this percentage amounts to 3% of total population there. Cancer survivors require careful follow-up also after completed cancer treatment. These patients are not followed up only because of recurrence risk (locoregional or distant recurrence) but also because of late sequelae and undesired effect of treatment (physical, psychological and social) as well as of increased risk for developing secondary cancers. There is an urgent need to make people aware of the importance of healthy lifestyle and of early detection of secondary malignancies as well as of late sequelae of cancer treatment. The patients and their relatives should be informed that, for hereditary cancers, genetic testing is available, while for the detection of other cancers, screening methods (mammography, coloscopy) are used. Cancer survivors more frequently develop other non-malignant diseases. With the increasing number of cancer survivors and considering that cancer is becoming a chronic disease, it is indispensable that the team who is in charge of comprehensive care of cancer survivors includes, in addition to an oncologist and family doctor, also experts of other disciplines, such as nurses specialized in oncology nursing and psychologists.