Serviks Kanseri
Özet
Serviks kanseri kadınlarda görülen en sık dördüncü kanserdir. Diğer jinekolojik kanserlere kıyasla daha genç yaşta tanı alırlar. Bakım koordinasyonunun nasıl yapılacağı standardize edilmemiştir. Tedavi sonrası gözetimin ana amacı nükslerin erken tespit edilerek küratif tedavi şansının korunmasıdır. Yüksek riskli olup onkolojik tedavi alan hastalar ilk iki yıl üç ayda bir, beşinci yıla kadar altı ayda bir ve beşinci yıldan sonra yıllık takipleri planlanmalıdır. Diğer bir grup olan düşük riskli hastalar (onkolojik tedavi almayan) ilk iki yıl altı ayda bir, iki yıldan sonra ise yıllık takip planları yapılmalıdır. Servikal kanser tanılı hastalardan sağ kurtulan kadınlar için multidisipliner yaklaşım çok önemlidir. Detaylı fizik muayene, jinekolojik muayene ve sistem sorgusu değerlendirmenin en önemli bileşenidir. Asemptomatik servikal kanser hastalarında sınırlı yarar tanımlansa da nüks şüphesinde ve metastatik hasta takibinde görüntüleme yöntemlerinin katkısı daha fazladır. Hem lokal hemde uzak nüks riski taşıyan takip hastalarında nüksler en sık ilk iki yılda tespit edilir. Tedavi ilişkili uzun dönem komplikasyonların takibi ve tedavi yönetimi de multidisipliner takibin önemli bir gereksinimidir. Mesane disfonksiyonu, bağırsak disfonksiyonu, cinsel işlev bozukluğu, lenfödem, yorgunluk, psikososyal sorunlar ve seconder malignite görülmesi önemi uzun dönem takiplerde klinisyenlerin multidisipliner bakış açısı ile hastayı yönetmelerinin önemini ortaya koymaktadır. Bu çalışmada serviks kanseri tanısı olan hastaların tanı ve tedavi sürecinde takip algoritmaları değerlendirilecektir.
Cervical cancer is the fourth most common cancer among women and is diagnosed at a younger age than other gynaecological cancers. However, care coordination is not standardised, with the main aim of post-treatment surveillance being to detect recurrences early to preserve the chance of curative treatment.High-risk patients receiving oncological treatment should be followed up every three months for the first two years, every six months until the fifth year and annually after the fifth year. A further group of low-risk patients (not receiving oncological treatment) should be followed up every six months for the first two years and annually after two years.A multidisciplinary approach is very important for women who survive cervical cancer, with a detailed physical examination, gynaecological examination and system questioning being the most important components of the evaluation. Although the benefits of such an approach have been described as limited in asymptomatic cervical cancer patients, imaging modalities have been shown to contribute significantly to the suspicion of recurrence and the monitoring of metastatic patients.In follow-up patients at risk of both local and distant recurrence, recurrences are most commonly detected within the first two years.The management of treatment-related long-term complications is also an important requirement of multidisciplinary follow-up. The significance of bladder dysfunction, bowel dysfunction, sexual dysfunction, lymphedema, fatigue, psychosocial problems and secondary malignancy underscores the necessity for clinicians to adopt a multidisciplinary approach in long-term follow-up management. The present study will evaluate follow-up algorithms in the diagnosis and treatment process of patients diagnosed with cervical cancer.
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https://www.nccn.org/professionals/physician_gls/pdf/cervical.pdf,1.2025
