Üreter Kanseri ve Hemşirelik Bakımı
Özet
Üreter, primer kanser lezyonundan bağımsız olarak nadiren kanser metastazının olduğu bir organdır. Üreter kanseri ürotelyal kanserlerin yalnızca %1-3’ünü oluşturur. Üreter kanserinin gelişiminde bir takım çevresel faktörler rol oynamaktadır. Üreter kanseri gelişimindeki en önemli risk faktörü sigara dumanına maruz kalmaktır. En sık görülen semptom makroskopik veya mikroskopik hematüridir. Bilgisayarlı tomografi ürografisi (BTU) standart görüntüleme yöntemidir. Hasta ve tümörle ilişkili birçok prognostik faktör, en uygun lokal tedaviye (radikal ve konservatif) karar vermede ve perioperatif sistemik tedaviyi tartışmada hastaları sınıflandırmak için kullanılabilir. Hemşireler hastaları ameliyat öncesi riskler açısından iyi değerlendirmeli ve bu risklere bağlı komplikasyonların gelişmemesi için önlem almalıdırlar. Hemşirelik bakımı, tanı öncesi testlerle başlar ve metastatik hastalık tedavisi boyunca devam eder. Hemşireler, hastaları desteklemek ve yönlendirmek için tanı testleri, tedavi seçenekleri ve cerrahi girişimlerin ve/veya tedavilerin yaşam kalitesi etkileri hakkında bilgi sahibi olmalıdır. Eğitim kapsamlı olmalı, yalnızca tedavinin yan etkilerini değil aynı zamanda hastaların yaşamları ve yaşam tarzları üzerindeki uzun vadeli etkileri de ele almalıdır. Üreter kanseri tedavisinden sonra yapılan izlemin amacı, hastanın rehabilitasyon gereksinimlerine uyum, ürotelyumdaki mevcut veya yeni primer tümörleri tespit etmek ve bölgesel ve uzak metastazları tespit etmektir. Hasta, tümör ve tedavi özellikleri, bireysel bir hastanın takip süresinin planlanmasında etkilidir.
The ureter is an organ where cancer metastases rarely occur, regardless of the primary cancer lesion. Ureteral cancer accounts for only 1–3% of urothelial cancers. A number of environmental factors play a role in the development of ureteral cancer. The most important risk factor for the development of ureteral cancer is exposure to cigarette smoke. The most common symptom is macroscopic or microscopic hematuria. Computed tomography urography (CTU) is the standard imaging method. Many prognostic factors related to the patient and tumor can be used to stratify patients in deciding on the most appropriate local treatment (radical and conservative) and in discussing perioperative systemic treatment. Nurses should evaluate patients carefully in terms of preoperative risks and take precautions to prevent complications related to these risks. Nursing care begins with prediagnostic testing and continues throughout treatment for metastatic disease. Nurses must be knowledgeable about diagnostic testing, treatment options, and the quality of life impacts of surgical interventions and/or treatments to support and guide patients. Education should be comprehensive, addressing not only the side effects of treatment but also the long-term effects on patients’ lives and lifestyles. The goal of follow-up after ureteral cancer treatment is to ensure compliance with the patient's rehabilitation needs, to detect existing or new primary tumors in the urothelium, and to detect regional and distant metastases. Patient, tumor, and treatment characteristics are influential in planning the follow-up period of an individual patient.
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