| Abstract | Zloćudne (maligne) novotvorine (rak) skupina je bolesti koje uzrokuju znakove ili simptome koji ovise o tome gdje se rak nalazi, koja je veličina raka i koliko utječe na tkiva ili organe. Oko 25% svih zloćudnih bolesti obuhvaćaju tumori probavnog sustava. Infekcija Helicobacter pylori povećava rizik distalnog [1], difuznog i intestinalnog tipa te je odgovorna za oko 60 – 80 % karcinoma tih tipova. U ranoj fazi bolesti dijagnozu je teško postaviti, simptomi su netipični, fizikalni nalaz je uredan. Potrebno je obraditi sve osobe starije od 40 godina sa nerazjašnjenim tegobama u gornjem dijelu abdomena koji traju dulje od 20 dana te ih je potrebno uputiti na gastroskopiju. Operiranih bolesnika preživljavanje nakon 5 godina iznosi oko 15 – 20%. Liječiti se može resekcijom, kemoterapijom, radioterapijom ili kombinacijom navedenoga što ovisi o stanju bolesnika i stadiju bolesti. Kod svih radikalnih operacija potrebna je kemo - radioterapija kod II stadija te kod bolesnika sa pozitivnim resekcijskom rubovima. Prognoza bolesti je loša jer samo 15-25% bolesnika preživi 5 godina, te je u trenutku postavljanja dijagnoze (dg) bolest je inoperabilna. Oboljele osobe život se mijenja tako zahtijevajući brojne prilagodbe od same spoznaje da boluje od maligne bolesti, potrebi liječenja i postupke vezane za samo liječenje te oporavak što rezultira nevjerica, šok, strah od moguće boli, patnji pa i smrti. Uloga medicinske sestre je veoma važna i velika u zaštiti i ranom otkrivanju malignih oboljenja. Potrebno je preko raznih savjetodavnih i edukativnih aktivnosti podići razinu volje, zdravstvene svijesti i znanje o čimbenicima rizika nastanka malignih oboljenja, usvajanje zdravih stilova života, redovita samokontrola zdravlja [2]. |
| Abstract (english) | Malignant neoplasms are a group of diseases that cause signs and symptomps depending on location, size of the cancer and how it affects the tissues and organs. About 25% of all malignant diseases are tumors oft he digestive system. Helicobacter pylori infection increases the risk of distal, diffuse and intestinal type of malignancy and is responsible for 60 – 80 % of all cases. In early phase, diagnosis is difficult to make, symptoms are nonspecific and physical status is normal. It is necessary to examine all the patients older than 40 years with unexplained symptoms in the upper abdomen lasting longer than 20 days, and they should be directed to gastroscopy. 5 year surviving percentage for patients who undervent surgical procedure is 15 – 20%. Treatment is possible with surgical resection, chemotherapy, radiotherapy or a combination, depending on the condition of the patient and stage of the disease. After every radical surgery, in second stage of the disease and in patients with positive resection margins, chemo – radiotherapy is required. Prognosis is poor because only 15 – 25% of patients survive 5 years and at the time of diagnosis, disease is inoperable. At the time of diagnosis, person's life is changing and requires a number of adjustments. The fact that patient is suffering from malignant diseases, need for medical treatment, procedures related to the treatment and recovery result with disbelief, shock, fear of possible pain and even death. Roll oft he medical nurse is very important in prevention and early diagnosis of malignant neoplasms. It is necessary to raise the level of motivation, health awareness and knowledge about the risk factors through different educational and advisory activities, stimulation of adopting healthy lifestyle and regular medical selfcontrol.
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