{"id":2758,"date":"2024-05-04T20:24:28","date_gmt":"2024-05-04T17:24:28","guid":{"rendered":"https:\/\/odyova.com\/haberler\/?p=2758"},"modified":"2024-05-04T20:24:28","modified_gmt":"2024-05-04T17:24:28","slug":"larenks-kanseri-girtlak-kanseri","status":"publish","type":"post","link":"https:\/\/odyova.com\/haberler\/larenks-kanseri-girtlak-kanseri\/","title":{"rendered":"Larenks kanseri \u2013 g\u0131rtlak kanseri"},"content":{"rendered":"<p><b><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-01.jpg\"\/><\/b><\/p>\n<p><strong>G\u0131rtlak nedir?<\/strong><\/p>\n<p>T\u0131bbi ad\u0131 T\u00fcrk\u00e7e\u2019ye bazen larenks, bazen larinks olarak ge\u00e7en g\u0131rtlak, \u0130ngilizce\u2019de larynx veya voicebox (ses kutusu) diye adland\u0131r\u0131l\u0131r. Boynun \u00f6n k\u0131sm\u0131nda, \u00e7enenin 3-4 cm alt\u0131ndan ba\u015flayan g\u0131rtlak, a\u015fa\u011f\u0131da iman tahtas\u0131 olarak da bilinen sternum kemi\u011finin \u00fcst \u00e7\u0131k\u0131nt\u0131s\u0131n\u0131n 2-4 cm yukar\u0131s\u0131na kadar uzan\u0131r.<\/p>\n<p>Sert ve yumu\u015fak k\u0131k\u0131rdaklar taraf\u0131ndan iskeleti olu\u015fturulan g\u0131rtlak, \u00e7ok hassas bir \u015fekilde idare edilen pek \u00e7ok k\u00fc\u00e7\u00fck kas sayesinde hayati fonksiyonlar\u0131n\u0131 s\u00fcrd\u00fcr\u00fcr. Bu organ soluk borusunun (trakea) ba\u015flang\u0131c\u0131na yerle\u015fmi\u015f olup soluk borusu ve yemek borusunu (\u00f6sefagus) birbirinden ay\u0131r\u0131r.<\/p>\n<p>Erkeklerde boyunda adem elmas\u0131 olarak bilinen belirginlik, g\u0131rtla\u011f\u0131n en b\u00fcy\u00fck k\u0131k\u0131rda\u011f\u0131 olan tiroid \/ tiroit k\u0131k\u0131rda\u011f\u0131n \u00fcst \u00e7\u0131k\u0131nt\u0131s\u0131 taraf\u0131ndan olu\u015fturulur. Bayanlarda bu k\u0131k\u0131rdak anatomik yap\u0131s\u0131 gere\u011fi erkekteki kadar belirgin bir \u00e7\u0131k\u0131nt\u0131 olu\u015fturmaz. Tiroid k\u0131k\u0131rdak ses tellerini \u00f6nde ve yanlarda \u00e7evreler ve onlar i\u00e7in iyi bir koruma olu\u015fturur.<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-03.jpg\"\/><\/p>\n<p>B\u00fct\u00fcn memeli hayvanlarda bulunan bu organ\u0131n en \u00f6nemli g\u00f6revi, ileti\u015fimin esas unsuru olan sesi \u00fcretmektir. \u0130nsanda bu organ\u0131n \u00fcretti\u011fi ham ses dil, damak, di\u015fler ve dudaklar sayesinde harflere, hecelere, kelimelere ve sonu\u00e7ta temel ileti\u015fim arac\u0131m\u0131z olan konu\u015fmaya d\u00f6n\u00fc\u015f\u00fcr.<\/p>\n<p>G\u0131rtla\u011f\u0131n ikinci \u00f6nemli fonksiyonu, soluk borusuna yedi\u011fimiz ve i\u00e7ti\u011fimiz g\u0131dalar\u0131n ka\u00e7mas\u0131n\u0131 \u00f6nlemektir. G\u0131rtlak bu koruyucu fonksiyonu, nefes al\u0131p verirken birbirinden uzakla\u015fm\u0131\u015f olan ses tellerinin (vocal cord, vokal kord) ve hemen yukar\u0131s\u0131nda bulunan yalanc\u0131 ses tellerinin (false cord, ventrik\u00fcler bant) s\u0131k\u0131ca kapanmas\u0131 sayesinde ger\u00e7ekle\u015ftirir. Bu durumda yutma i\u015flemi s\u0131ras\u0131nda dil ve dil k\u00f6k\u00fc taraf\u0131ndan a\u015fa\u011f\u0131ya itilen g\u0131dalar, g\u0131rtla\u011f\u0131n iki yan\u0131ndaki bo\u015fluklardan (piriform sinusler) soluk borusunun arkas\u0131nda bulundan yemek borusuna y\u00f6nlendirilir.<\/p>\n<p>Nefes al\u0131p verirken birbirinden uzak olan ses telleri, konu\u015fma ve ses \u00e7\u0131kartma s\u0131ras\u0131nda birbirine biti\u015fir. Ses tellerinin aras\u0131ndan ge\u00e7en hava, ses tellerinin \u00fczerini kaplayan \u00f6rt\u00fcc\u00fc tabakay\u0131 (mukoza) titre\u015ftirir ve sonu\u00e7ta ortaya ham ses \u00e7\u0131kar. G\u0131rtlak kaslar\u0131 taraf\u0131ndan belirlenen ses tellerinin gerginli\u011fi ve uzunlu\u011fu, \u00e7\u0131kan sesin tonunu (frekans\u0131n\u0131, kal\u0131nl\u0131\u011f\u0131n\u0131 ve inceli\u011fini) belirler. Ses sanat\u00e7\u0131lar\u0131nda bu \u00f6zellikler \u00f6n plana \u00e7\u0131kar.<\/p>\n<p>Ayr\u0131ca \u00f6ks\u00fcr\u00fck de, g\u0131rtla\u011f\u0131n kapanmas\u0131, solunum kaslar\u0131n\u0131n kas\u0131larak g\u00f6\u011f\u00fcs i\u00e7i bas\u0131nc\u0131n\u0131 artt\u0131rmas\u0131, ard\u0131ndan ses tellerinin birden a\u00e7\u0131larak bas\u0131n\u00e7l\u0131 havan\u0131n a\u011f\u0131zdan d\u0131\u015far\u0131 \u00e7\u0131kmas\u0131yla olu\u015fan akci\u011fer soluk borusu sisteminin temizli\u011fini sa\u011flayan bir reflekstir ve g\u0131rtla\u011f\u0131n fonksiyonlar\u0131ndan biri say\u0131l\u0131r.<\/p>\n<p><strong>G\u0131rtla\u011f\u0131n b\u00f6l\u00fcmleri nelerdir?<\/strong><\/p>\n<p><strong>Supraglottik B\u00f6lge:<\/strong> Ses tellerinin bulundu\u011fu b\u00f6lgenin \u00fcst\u00fcnde kalan ve \u00fcst g\u0131rtlak olarak adland\u0131rabilece\u011fimiz k\u0131sm\u0131d\u0131r.<\/p>\n<p><strong>Glottik B\u00f6lge:<\/strong> Ses tellerinin bulundu\u011fu k\u0131s\u0131md\u0131r. Ses bu b\u00f6lgede olu\u015fur.<\/p>\n<p><strong>Subglottik B\u00f6lge:<\/strong> Ses tellerinin bulundu\u011fu b\u00f6lgenin alt\u0131nda kalan ve alt g\u0131rtlak olarak adland\u0131rabilece\u011fimiz k\u0131sm\u0131d\u0131r.<\/p>\n<p><strong>G\u0131rtlak kanseri nedir?<\/strong><\/p>\n<p>G\u0131rtlak kanseri, temel olarak g\u0131rtlak yap\u0131lar\u0131n\u0131n \u00fczerini \u00f6rten epitel h\u00fccrelerinin kontrols\u00fcz b\u00fcy\u00fcmesi, \u00e7evre yap\u0131lar\u0131 harap etmesi ile seyreden bir hastal\u0131kt\u0131r. G\u0131rtlak kanserlerinin \u00f6rt\u00fcc\u00fc tabakadan kaynaklanan bu t\u00fcr\u00fcne <strong>Skuamoz H\u00fccreli Kanser<\/strong> ad\u0131 verilir ve bu organda ortaya \u00e7\u0131kan k\u00f6t\u00fc huylu t\u00fcm\u00f6rlerin \u00e7ok b\u00fcy\u00fck bir k\u0131sm\u0131n\u0131 olu\u015fturur.<\/p>\n<p>G\u0131rtlak kanserleri, di\u011fer k\u00f6t\u00fc huylu t\u00fcm\u00f6rler gibi tedavisiz kal\u0131p ilerlemesi durumunda boyundaki lenf bezeleri ve v\u00fccudun di\u011fer organlar\u0131na s\u0131\u00e7rayarak (metastaz) hayat\u0131 tehdit eder hale gelir.<\/p>\n<p><strong>G\u0131rtlak t\u00fcm\u00f6r\u00fc nedir?<\/strong><\/p>\n<p>T\u0131bbi anlamda t\u00fcm\u00f6r, kanseri de i\u00e7erecek \u015fekilde kontrols\u00fcz h\u00fccre b\u00fcy\u00fcmelerinin t\u00fcm\u00fcn\u00fc ifade eder. Bu b\u00fcy\u00fcme k\u00f6t\u00fc huylu (habis, malign) olabilece\u011fi gibi iyi huylu (selim, benign) da olabilir.<\/p>\n<p>Genel olarak k\u00f6t\u00fc huylu t\u00fcm\u00f6rler, etraf dokular\u0131 i\u015fgal edip zarar vererek b\u00fcy\u00fcmesinin yan\u0131 s\u0131ra \u00e7evredeki lenf bezelerine ve v\u00fccudun di\u011fer organlar\u0131na s\u0131\u00e7rama yap\u0131p (metastaz) o b\u00f6lgelerde de kontrols\u00fcz b\u00fcy\u00fcmeye devam eder. Sonu\u00e7ta bu s\u00fcre\u00e7, hayat\u0131 tehdit eder hale gelecektir.<\/p>\n<p>\u0130yi huylu t\u00fcm\u00f6rler, \u00e7evre dokular\u0131 i\u015fgal etmeden ve genel olarak hasar vermeden \u2018iterek\u2019 b\u00fcy\u00fcrler. Lenf bezelerine ve v\u00fccudun di\u011fer organlar\u0131na s\u0131\u00e7ray\u0131p (metastaz) hayati bir tehdit olu\u015fturmazlar.<\/p>\n<p>G\u0131rtla\u011f\u0131n kanserleri, k\u00f6t\u00fc huylu t\u00fcm\u00f6rleri d\u0131\u015f\u0131nda daha nadir g\u00f6r\u00fclse de kimi iyi huylu t\u00fcm\u00f6rleri de mevcuttur. \u00d6rne\u011fin, papillom, t\u00fck\u00fcr\u00fck bezlerinden kaynaklanan pleomorfik adenom, yumu\u015fak dokulardan kaynaklanan lipom ve fibrom, damarlardan kaynaklanan hemanjiyom, k\u0131krdaktan kaynaklanan kondrom g\u0131rtlakta rastlanabilecek iyi huylu t\u00fcm\u00f6r tipleridir.<\/p>\n<p><strong>G\u0131rtlak kanseri, g\u0131rtla\u011f\u0131n hangi b\u00f6l\u00fcmlerinde g\u00f6r\u00fcl\u00fcr?<\/strong><\/p>\n<p>G\u0131rtlak kanseri en s\u0131k ses tellerini i\u00e7eren glottik b\u00f6lge ve onun \u00fczerinde kalan supraglottik b\u00f6lgeden kaynaklan\u0131r. Ses tellerinin alt\u0131nda bulunan subglottik b\u00f6lge kaynakl\u0131 kanserler olduk\u00e7a nadirdir.<\/p>\n<p><strong>G\u0131rtlak kanserinin t\u00fcrleri nelerdir?<\/strong><\/p>\n<p>G\u0131rtlak kanserlerinin %90 kadar\u0131, g\u0131rtla\u011f\u0131n i\u00e7ini d\u00f6\u015feyen ve epitel ad\u0131n\u0131 alan \u00f6rt\u00fcc\u00fc tabakadan kaynaklanan skuamoz h\u00fccreli kanser (epidermoid kanser) t\u00fcr\u00fcndedir. Bu kanser t\u00fcr\u00fc a\u011f\u0131z, bo\u011faz ve yutak b\u00f6lgelerinin de en s\u0131k g\u00f6r\u00fclen kanseridir. Skuamoz h\u00fccreli kanserin verr\u00fck\u00f6z (nas\u0131r\u0131ms\u0131) kanser, i\u011fisi h\u00fccreli kanser, bazaloid skuamoz h\u00fccreli kanser ve berrak h\u00fccreli kanser (clear cell carcinoma) gibi alt t\u00fcrleri de bulunmaktad\u0131r.<\/p>\n<p>Skuamoz h\u00fccreli kanser d\u0131\u015f\u0131nda epitel tabakas\u0131 i\u00e7indeki mikroskobik t\u00fck\u00fcr\u00fck bezlerinden kaynaklanan adenokanser, adenoid kistik kanser, mukoepidermoid kanser, asinik h\u00fccreli kanser ya da g\u0131rtla\u011f\u0131n\u0131 iskeletini olu\u015fturan k\u0131k\u0131rdaktan kaynaklanan kondrosarkom, osteosarkom, damarlardan kaynaklanan anjiyosarkom, yumu\u015fak dokular ve g\u0131rtlakta bulunabilen ba\u015fka dokulardan k\u00f6ken alan n\u00f6roendokrin kanser, k\u00fc\u00e7\u00fck h\u00fccreli kanser, fibrosarkom, liposarkom, leiyomiyosarkom ve rabdomiyosarkom gibi kanserler olabilir.<\/p>\n<p><strong>G\u0131rtlak kanserinin sebepleri nelerdir?<\/strong><\/p>\n<p>G\u0131rtlak kanseri olu\u015fumu a\u00e7\u0131s\u0131ndan en b\u00fcy\u00fck riski t\u00fct\u00fcn ve alkol t\u00fcketimi olu\u015fturmaktad\u0131r. \u00d6zellikle bu iki al\u0131\u015fkanl\u0131k birlikte bulundu\u011funda kanser riski kat be kat artmaktad\u0131r.<\/p>\n<p>A\u015fa\u011f\u0131da g\u0131rtlak kanseri olu\u015fumundaki temel risk fakt\u00f6rleri liselenmi\u015ftir:<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-06.jpg\"\/><\/p>\n<p><strong>Sigara ve di\u011fer t\u00fct\u00fcn \u00fcr\u00fcnleri,<\/strong> g\u0131rtlak kanserlerinin olu\u015fumunda \u015f\u00fcpheye yer b\u0131rakmayacak \u015fekilde en \u00f6nde gelen fakt\u00f6rd\u00fcr. G\u00fcnde t\u00fcketilen sigara miktar\u0131 ile sigara al\u0131\u015fkanl\u0131\u011f\u0131n\u0131n s\u00fcresi, kanserin olu\u015fma riskini do\u011frudan etkiler. A\u011f\u0131z tiryakili\u011fi ya da sigara duman\u0131n\u0131 i\u00e7e \u00e7ekmemek, kanser riskini san\u0131ld\u0131\u011f\u0131 gibi \u00e7ok azaltmaz. G\u00fcnde 3 adet sigaran\u0131n \u00fczerinde t\u00fcketimin a\u011f\u0131z, bo\u011faz, yutak ve g\u0131rtlak b\u00f6lgelerinde kanser riskini ciddi artt\u0131rd\u0131\u011f\u0131 kabul edilmektedir.<\/p>\n<p>Sigara ayr\u0131ca dudaktan akci\u011fere kadar t\u00fcm solunum yollar\u0131, yemek borusu hatta mesane kanserlerinin olu\u015fumunda da temel risk fakt\u00f6r\u00fcd\u00fcr.<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-07.jpg\"\/><\/p>\n<p><strong>Alkol,<\/strong> \u00f6zellikle supraglottik b\u00f6lge (g\u0131rtla\u011f\u0131n \u00fcst b\u00f6lgesi) kanserlerinin olu\u015fumunda etkin olan ikinci fakt\u00f6rd\u00fcr.Burada da etki g\u00fcnde t\u00fcketilen miktar ve al\u0131\u015fkanl\u0131\u011f\u0131n s\u00fcresi ile do\u011fru orant\u0131l\u0131d\u0131r. Sigara al\u0131\u015fkanl\u0131\u011f\u0131 ile birlikte alkol al\u0131\u015fkanl\u0131\u011f\u0131n\u0131n varl\u0131\u011f\u0131 kanser riskini \u00e7ok daha fazla artt\u0131r\u0131r.<\/p>\n<p>Alkol\u00fcn daha \u00e7ok ses telinin \u00fczerinde kalan supraglottik b\u00f6lge kanserlerine, sigaran\u0131n ise ses tellerinin bulundu\u011fu glottik b\u00f6lge kanserlerine yol a\u00e7t\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmektedir.<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-08.jpg\"\/><\/p>\n<p><strong>Mesleki maruziyet<\/strong>, a\u011fa\u00e7, mobilya, tekstil, metal, petrol, kimya sanayii kollar\u0131nda \u00e7al\u0131\u015fan ve baz\u0131 kimyasallara maruz kalm\u0131\u015f ki\u015filerde g\u0131rtlak kanseri riski artmaktad\u0131r.<\/p>\n<p><strong>Gastro-\u00f6zafageal ve laringo-faringeal refl\u00fcn\u00fcn,<\/strong> yani mide asitli \u00f6zsuyunun gev\u015fek olan mide \u00fcst kapak\u00e7\u0131\u011f\u0131ndan s\u0131zarak yemek borusundan (\u00f6sefagus) yukar\u0131lara g\u0131rtlak, yutak b\u00f6lgelerine ula\u015fmas\u0131 ve orada olu\u015fturdu\u011fu kronik (s\u00fcregen) tahri\u015finin kanser olu\u015fumuna yol a\u00e7abilece\u011fi d\u00fc\u015f\u00fcn\u00fclmektedir. Sigara ve alkol al\u0131\u015fkanl\u0131\u011f\u0131 olmayan, mesleki maruziyetin s\u00f6z konusu olmad\u0131\u011f\u0131 kimi bireylerde g\u0131rtlak kanserinin geli\u015fmesi refl\u00fc ile bu hastal\u0131k aras\u0131nda bir ili\u015fki olabilece\u011fini d\u00fc\u015f\u00fcnd\u00fcrmektedir.<\/p>\n<p><strong>HPV (Human Papilloma Vir\u00fcs \u2013 \u0130nsan Si\u011fil Vir\u00fcs\u00fc)<\/strong> Tip 16 \u2013 18, bademcik ve dil k\u00f6k\u00fc kanserlerine yol a\u00e7t\u0131\u011f\u0131 iyi bilinen bir vir\u00fcst\u00fcr. Bu vir\u00fcs\u00fcn hipofarenks (alt yutak) ve larenks (g\u0131rtlak) kanserlerinin olu\u015fumunda etkili olabilece\u011fine dair \u015f\u00fcpheler mevcuttur.<\/p>\n<p>Bu vir\u00fcs\u00fcn kansere yol a\u00e7mayan di\u011fer tiplerinin \u00e7ocuklarda ve eri\u015fkinlerde g\u0131rtlak ve ses telinde papillom ad\u0131n\u0131 alan si\u011filimsi iyi huylu t\u00fcm\u00f6rlere yol a\u00e7t\u0131\u011f\u0131 iyi bilinmektedir. Her ne kadar papillomlar\u0131n kansere d\u00f6n\u00fc\u015ft\u00fc\u011f\u00fc kan\u0131tlanmam\u0131\u015fsa da bu durum vir\u00fcs \u00fczerindeki \u015f\u00fcpheleri artt\u0131rmaktad\u0131r.<\/p>\n<p>Ba\u015f boyun b\u00f6lgesi kanserleri ile u\u011fra\u015fan bir uzman olarak fark etmekteyim ki; sigara i\u00e7en \u00e7o\u011fu insan kendilerine bir zarar gelmeyece\u011fini d\u00fc\u015f\u00fcnmekte. Bu insanlar kimi zaman yo\u011fun sigara t\u00fcketip uzun y\u0131llar ya\u015fayan tan\u0131d\u0131klar\u0131n\u0131 \u00f6rnek al\u0131p kendilerini teselli ederler.<\/p>\n<p>Kanser, kansere yol a\u00e7an etkenler ile ona kar\u015f\u0131 direnen v\u00fccudun ba\u011f\u0131\u015f\u0131kl\u0131k sistemi ve hasar d\u00fczeltici mekanizmalar aras\u0131ndaki sava\u015f\u0131n kaybedilmesiyle ortaya \u00e7\u0131kar. Ba\u011f\u0131\u015f\u0131kl\u0131k sistemi ve kanser h\u00fccrelerinin olu\u015fmas\u0131n\u0131 engelleyici mekanizmalar, her bireyde ayn\u0131 \u015fekilde \u00e7al\u0131\u015fmaz. Ba\u011f\u0131\u015f\u0131kl\u0131k sistemi ve bu mekanizmalarda bir zaafiyet varsa, kanser h\u00fccreleri b\u00fcy\u00fcme ve \u00e7o\u011falma \u015fans\u0131 bulabilir ve hastal\u0131k ortaya \u00e7\u0131kabilir.<\/p>\n<p>Ba\u011f\u0131\u015f\u0131kl\u0131k sistemi ve kanser h\u00fccrelerinin olu\u015fmas\u0131n\u0131 engelleyici mekanizmalar\u0131n \u00e7al\u0131\u015fmas\u0131 ki\u015fiden ki\u015fiye de\u011fi\u015fiklik g\u00f6sterece\u011finden, ba\u015fkalar\u0131n\u0131n ya\u015fam s\u00fcrelerini \u00f6rnek alarak bu zararl\u0131 al\u0131\u015fkanl\u0131\u011fa devam etmek hata olacakt\u0131r. Kimi bireyler k\u00f6t\u00fc al\u0131\u015fkanl\u0131klar\u0131na ra\u011fmen 90\u2019l\u0131 ya\u015flara kadar nispeten sa\u011fl\u0131kla gelebilirken kimileri 30\u2019lu ya\u015flarda sigara ve alkole ba\u011fl\u0131 kanserlere yakalanabilmektedir. \u00d6zetle bu al\u0131\u015fkanl\u0131klardan uzak durmak pek \u00e7ok k\u00f6t\u00fc hastal\u0131\u011fa kar\u015f\u0131 en etkili \u00f6nlem olacakt\u0131r.<\/p>\n<p><strong>G\u0131rtlak kanseri kimlerde daha s\u0131k g\u00f6r\u00fcl\u00fcr?<\/strong><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-09.jpg\"\/><\/p>\n<p>G\u0131rtlak kanseri (larenks kanseri) tipik olarak 40 ya\u015f\u0131ndan b\u00fcy\u00fck erkeklerin hastal\u0131\u011f\u0131d\u0131r. Ancak 30\u2019lu ya\u015flarda da ortaya \u00e7\u0131kabilmektedir. Sigara ve alkole maruz kal\u0131nan s\u00fcre uzad\u0131k\u00e7a g\u0131rtlak kanseri riski de artmaktad\u0131r. Bu hastal\u0131k kad\u0131nlarda daha nadir g\u00f6r\u00fcl\u00fcr. Yakla\u015f\u0131k 4 erke\u011fe 1 kad\u0131n hasta oran\u0131 s\u00f6z konusudur. Artan sigara al\u0131\u015fkanl\u0131\u011f\u0131, kad\u0131nlarda da bu hastal\u0131\u011f\u0131n g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131n\u0131 artt\u0131rmaktad\u0131r.<\/p>\n<p><strong>G\u0131rtlak kanserlerinin olu\u015fumundan ka\u00e7\u0131nmak m\u00fcmk\u00fcn m\u00fc?<\/strong><\/p>\n<p>G\u0131rtlak kanserlerinin olu\u015fum riskini azaltaca\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclen \u00f6nlemler;<\/p>\n<p>T\u00fct\u00fcn \u00fcr\u00fcnlerinin t\u00fcketimini sonland\u0131rmak,<\/p>\n<p>Sigara duman\u0131ndan uzak durmak,<\/p>\n<p>Alkol t\u00fcketimini s\u0131n\u0131rland\u0131rmak,<\/p>\n<p>\u00c7al\u0131\u015f\u0131lan i\u015fte kimyasallara maruziyeti azaltan \u00f6nlenmler almak,<\/p>\n<p>Refl\u00fc var ise tedavisi yoluna gitmek,<\/p>\n<p>Genel olarak sa\u011fl\u0131kl\u0131 beslenmek ve fiziksel aktivitelerde bulunmak<br \/>  olarak s\u0131ralanabilir.<\/p>\n<p><strong>G\u0131rtlak kanserinin belirtileri nelerdir?<\/strong><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-02.jpg\"\/><\/p>\n<p>Temel olarak g\u0131rtlak kanserinin en s\u0131k g\u00f6r\u00fclen belirtisi, uzun s\u00fcreli ses de\u011fi\u015fikli\u011fi veya ses k\u0131s\u0131kl\u0131\u011f\u0131d\u0131r. Bunun yan\u0131 s\u0131ra boyunda \u015fi\u015flik, yutma g\u00fc\u00e7l\u00fc\u011f\u00fc, uzun s\u00fcreli bo\u011faz a\u011fr\u0131s\u0131 da s\u0131k g\u00f6r\u00fclen belirtiler aras\u0131ndad\u0131r.<\/p>\n<p>G\u0131rtlak kanserinin belirtileri hastal\u0131\u011f\u0131n g\u0131rtlakta bulundu\u011fu b\u00f6lgeye g\u00f6re de\u011fi\u015fiklik g\u00f6sterebilmektedir. A\u015fa\u011f\u0131da b\u00f6lgelere g\u00f6re g\u0131rtlak t\u00fcm\u00f6r\u00fc belirtileri a\u00e7\u0131klanm\u0131\u015ft\u0131r:<\/p>\n<p><strong>Ses teli \u00fczerinde olu\u015fan t\u00fcm\u00f6r,<\/strong> erken d\u00f6nemlerde sesin tonunda de\u011fi\u015fiklik ve ses k\u0131s\u0131kl\u0131\u011f\u0131 belirtisine yol a\u00e7acakt\u0131r. Bu hastalar ara ara hafifleme ve artma g\u00f6sterse de 2-3 haftadan uzun s\u00fcre bulunan ses k\u0131s\u0131kl\u0131\u011f\u0131ndan ya da ses de\u011fi\u015fkli\u011finden yak\u0131nmaktad\u0131r. Zaman i\u00e7erisinde ses k\u0131s\u0131kl\u0131\u011f\u0131 artar ve devaml\u0131 hale gelir. Ses teli b\u00f6lgesindeki t\u00fcm\u00f6r b\u00fcy\u00fcd\u00fck\u00e7e ses k\u0131s\u0131kl\u0131\u011f\u0131 d\u0131\u015f\u0131nda nefes darl\u0131\u011f\u0131, yutarken olu\u015fan a\u011fr\u0131 ve a\u011f\u0131zdan kan gelmesi gibi ba\u015fka belirtiler de ortaya \u00e7\u0131kmaya ba\u015flar.<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-10.jpg\"\/><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-11.jpg\"\/><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-12.jpg\"\/><\/p>\n<p>Ses telinin yukar\u0131s\u0131nda bulunan supraglottik b\u00f6lge kanserleri genellikle daha ge\u00e7 d\u00f6nemlerde ses k\u0131s\u0131kl\u0131\u011f\u0131na yol a\u00e7ar. Bu t\u00fcm\u00f6rlerde \u00f6ne \u00e7\u0131kan belirtiler; yutma g\u00fc\u00e7l\u00fc\u011f\u00fc, yutarken olu\u015fan ve bo\u011fazda ve kulakta hissedilen a\u011fr\u0131, nefes darl\u0131\u011f\u0131, a\u011f\u0131zdan kan gelmesidir.<\/p>\n<p>T\u00fcm\u00f6r\u00fcn kendisi veya kom\u015fu dokularda olu\u015fturdu\u011fu de\u011fi\u015fiklikler, ses teli b\u00f6lgesine ula\u015ft\u0131\u011f\u0131nda sesin tonunda de\u011fi\u015fklik, ses k\u0131s\u0131kl\u0131\u011f\u0131 gibi belirtiler de ortaya \u00e7\u0131kacakt\u0131r. Ayr\u0131ca bu b\u00f6lge t\u00fcm\u00f6rleri, ses teli t\u00fcm\u00f6rlerinden farkl\u0131 olarak boyun lenf bezelerine daha s\u0131k s\u0131\u00e7rama (metastaz) yapar ve boyun \u015fi\u015fli\u011fi \u015feklinde belirti verebilir.<\/p>\n<p><strong>Ses tellerinin a\u015fa\u011f\u0131s\u0131nda yer alan subglottik b\u00f6lge t\u00fcm\u00f6rleri<\/strong> daha ge\u00e7 belirti verirler. \u00d6ne \u00e7\u0131kan belirtiler ses de\u011fi\u015fikli\u011fi ve k\u0131s\u0131kl\u0131\u011f\u0131, nefes darl\u0131\u011f\u0131, a\u011f\u0131zdan kan gelmesi ve boyun lenf bezelerinde \u015fi\u015fmedir. Bu t\u00fcm\u00f6rler, t\u00fcm g\u0131rtlak kanserlerinin %1\u2019inden az\u0131n\u0131 kapsamaktad\u0131r.<\/p>\n<p>G\u0131rtlak t\u00fcm\u00f6rleri daha ileri evrelerde i\u015ftahs\u0131zl\u0131k, bitkinlik, kilo kayb\u0131 gibi belirtilere de sebep olabilmektedir.<\/p>\n<p><strong>\u00d6zet olarak;<\/strong> sigara ve alkol t\u00fcketen birey, birka\u00e7 haftay\u0131 ge\u00e7en ses k\u0131s\u0131kl\u0131\u011f\u0131, yutma g\u00fc\u00e7l\u00fc\u011f\u00fc, a\u011fr\u0131l\u0131 yutma, yutarken kula\u011fa vuran a\u011fr\u0131, boyunda \u015fi\u015flik olu\u015fmas\u0131 gibi belirtiler ortaya \u00e7\u0131kt\u0131\u011f\u0131nda vakit kaybetmeden bir kulak burun bo\u011faz doktoruna ba\u015fvurmal\u0131d\u0131r.<\/p>\n<p><strong>Doktor muayenesi ne zaman gereklidir?<\/strong><\/p>\n<p>Uzun s\u00fcreli ses de\u011fi\u015fikli\u011fi, ses k\u0131s\u0131kl\u0131\u011f\u0131, yutma g\u00fc\u00e7l\u00fc\u011f\u00fc, a\u011fr\u0131l\u0131 yutma, kula\u011fa vuran a\u011fr\u0131, a\u011f\u0131zdan kan gelmesi, boyunda \u015fi\u015flik gibi belirtiler varl\u0131\u011f\u0131nda ge\u00e7 kalmadan bir kulak burun bo\u011faz hekimine ba\u015fvurmakta yarar vard\u0131r.<\/p>\n<p>\u00d6zellikle sigara ve alkol al\u0131\u015fkanl\u0131\u011f\u0131 olan bireylerde bu belirtiler, ciddi bir rahats\u0131zl\u0131\u011f\u0131n habercisi olabilir. \u00d6rne\u011fin sigara i\u00e7en biri iki haftay\u0131 ge\u00e7en ses k\u0131s\u0131kl\u0131\u011f\u0131 varl\u0131\u011f\u0131nda mutlaka bir KBB hekimine g\u00f6r\u00fcnmeli, onun tetkikler ve tedavi konusundaki \u00f6nerilerini dikkate almal\u0131d\u0131r.<\/p>\n<p>Ba\u015fvurulacak bir kulak burun bo\u011faz uzman\u0131 e\u011fer g\u00f6r\u00fcnt\u00fcy\u00fc \u015f\u00fcpheli buluyorsa biyopsi ad\u0131 verilen doku \u00f6rne\u011fi alma i\u015flemini \u00f6nerebilir.<\/p>\n<p><strong>G\u0131rtlak muayenesi nas\u0131l yap\u0131l\u0131r?<\/strong><\/p>\n<p>Kulak burun bo\u011faz hekimleri kendilerine ba\u015fvuran hastalarda genellikle tam bir kulak \u2013 burun \u2013 bo\u011faz muayenesi yaparlar. \u00d6zel olarak g\u0131rtla\u011f\u0131n muayenesi ge\u00e7mi\u015fte daha \u00e7ok larenks aynas\u0131 verilen ve di\u015f hekimlerinin kulland\u0131\u011f\u0131 aynalara benzeyen ufak metal sapl\u0131 larenks aynalar\u0131 ile yap\u0131l\u0131rken g\u00fcn\u00fcm\u00fczde endoskop ad\u0131 verilen sert veya b\u00fck\u00fclebilen optik cihazlar ve kamera, ekran i\u00e7eren sistemler kullan\u0131larak yap\u0131lmaktad\u0131r.<\/p>\n<p>\u00c7o\u011fu kulak burun bo\u011faz doktorunun muayenehanesinde bulunan bu optik aletler, a\u011f\u0131z yoluyla bo\u011faza ilerletebilece\u011fi gibi \u00f6zellikle b\u00fck\u00fclebilenleri burun ve geniz yoluyla g\u0131rtla\u011fa uzat\u0131labilmektedir. Bu i\u015fleme endoskopik larenks muayenesi veya larenks endoskopisi ad\u0131 verilir.<\/p>\n<p>Ayr\u0131ca stroboskop ad\u0131 verilen bir t\u0131bbi cihaz saniyede y\u00fczlerce kere kesikli \u0131\u015f\u0131k vererek ses tellerinin hareketini daha ayr\u0131nt\u0131l\u0131 g\u00f6stermekte ve ses teli lezyonlar\u0131 hakk\u0131nda fazla bilgi sahibi olunmas\u0131n\u0131 sa\u011flamaktad\u0131r.<\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-13.jpg\"\/><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-14.jpg\"\/><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-15.jpg\"\/><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-16.jpg\"\/><\/p>\n<p>Tarihten g\u00fcn\u00fcm\u00fcze g\u0131rtlak muayenesi.<\/p>\n<p><b><strong>G\u0131rtlak hastal\u0131klar\u0131nda hangi tetkikler uygulan\u0131r?<\/strong><\/b><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-17.jpg\"\/><\/p>\n<p>Hekim, hastan\u0131n yak\u0131nmalar\u0131n\u0131, hikayesini, \u00f6zge\u00e7mi\u015findeki \u00f6zellikleri, muayene bulgular\u0131n\u0131, kendi deneyiminin s\u00fczgecinden ge\u00e7irdikten sonra kimi zaman \u00f6ncelikle bir s\u00fcreli\u011fine belirtilere y\u00f6nelik basit bir tedaviyi ye\u011fler.<\/p>\n<p>Bu s\u00fcre\u00e7te hekim kimi zaman, baz\u0131 tetkikler de isteyebilir. \u00d6rne\u011fin; enfeksiyonun sebep oldu\u011fu bir sorun d\u00fc\u015f\u00fcn\u00fcyorsa ona y\u00f6nelik kan tahlilleri, enfeksiyon oda\u011f\u0131 ara\u015ft\u0131rmak a\u00e7\u0131s\u0131ndan akci\u011fer filmi ya da tomografisi gibi\u2026<\/p>\n<p>Kimi zaman da hekim, tedaviyle vakit ge\u00e7irmeyip do\u011frudan biyopsi almay\u0131 \u00f6nerir. Biyopsi sonucu kanser \u015f\u00fcphesini destekler ise tedavi plan\u0131n\u0131 en sa\u011fl\u0131kl\u0131 \u015fekilde yapabilmek, kanserin boyun b\u00f6lgesi ve v\u00fccutta yay\u0131l\u0131m\u0131n\u0131 ara\u015ft\u0131rabilmek i\u00e7in;<\/p>\n<p>Boyun ultrason,<\/p>\n<p>Boyun ve g\u00f6\u011f\u00fcs bo\u015flu\u011funun bilgisayarl\u0131 tomografi (BT \/ CT) incelemesi,<\/p>\n<p>Boynun MR (manyetik rezonans g\u00f6r\u00fcnt\u00fcleme) incelemesi,<\/p>\n<p>T\u00fcm v\u00fccudun pozitron emisyon tomografisi (PET CT)<\/p>\n<p>gibi i\u015flemlerden bir veya birden fazlas\u0131n\u0131 yapt\u0131rmak isteyebilir.<\/p>\n<p><strong>G\u0131rtlak lezyonu ne demektir?<\/strong><\/p>\n<p>G\u0131rtlak ad\u0131 verilen organ\u0131n i\u00e7 y\u00fczeyini d\u00f6\u015feyen tabakalardaki kabar\u0131kl\u0131k, \u00e7\u00f6kme, renk de\u011fi\u015fikli\u011fi gibi geli\u015fmeler g\u0131rtlak lezyonu olarak adland\u0131r\u0131labilir. Bu terim, t\u00fcm\u00f6r d\u0131\u015f\u0131 olu\u015fumlar\u0131 i\u015faret edebilece\u011fi gibi erken veya ge\u00e7 g\u0131rtlak t\u00fcm\u00f6r\u00fc i\u00e7in de kullan\u0131labilir. Lezyonun niteli\u011fi, biyopsi i\u015flemi sonras\u0131 a\u00e7\u0131kl\u0131\u011fa kavu\u015fur.<\/p>\n<p><strong>G\u0131rtlak (Larenks) Biyopsisi nedir ve nas\u0131l yap\u0131l\u0131r?<\/strong><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-18.jpg\"\/><\/p>\n<p>Biyopsi t\u0131pta, \u015f\u00fcpheli bir lezyondan doku \u00f6rne\u011fi alma i\u015flemi i\u00e7in kullan\u0131lan bir terimdir. Larenks biyopsisi genellikle direkt laringoskopi, mikro laringoskopi, suspansiyon laringoskopi, mikro laringeal cerrahi gibi adlarla an\u0131lan bir cerrahi i\u015flem ile uygulan\u0131r. Bu i\u015flem hemen her zaman ameliyathane \u015fartlar\u0131nda, hasta anestezi alt\u0131ndayken yap\u0131l\u0131r. Laringoskop ad\u0131 verilen ve boru benzeri metalik bir gere\u00e7 hastan\u0131n a\u011fz\u0131ndan g\u0131rtla\u011fa do\u011fru uzat\u0131l\u0131r ve ameliyat mikroskobu ad\u0131 verilen geli\u015fmi\u015f cihazlarla g\u0131rtla\u011f\u0131n ses teli ve di\u011fer b\u00f6lgelerinin yan\u0131 s\u0131ra dil k\u00f6k\u00fc, hipofarenks (alt yutak) gibi kom\u015fu b\u00f6lgeler hasta uyuyorken incelenir. \u015e\u00fcpheli g\u00f6r\u00fclen alanlardan doku \u00f6rnekleri al\u0131narak biyopsi i\u015flemi tamamlan\u0131r. Bu i\u015flem i\u00e7in boyun cildinde bir kesiye ihtiya\u00e7 yoktur.<\/p>\n<p><strong>G\u0131rtlak kanseri te\u015fhisi i\u00e7in biyopsi \u015fart m\u0131 ve biyopsi almak t\u00fcm\u00f6r\u00fcn yay\u0131l\u0131m\u0131n\u0131 artt\u0131r\u0131r m\u0131?<\/strong><\/p>\n<p>Evet, biyopsi \u015fartt\u0131r. Biyopsi \u00f6ncesinde sadece kanser \u015f\u00fcphesinden s\u00f6z edebiliriz. Tan\u0131y\u0131 kesinle\u015ftirecek olan ve sonraki tedavileri olanakl\u0131 k\u0131lacak olan sadece biyopsidir. G\u0131rtlaktan biyopsi alma i\u015flemi de t\u00fcm\u00f6r h\u00fccrelerinin yay\u0131l\u0131m\u0131na kesinlikle yol a\u00e7maz.<\/p>\n<p><b>Displazi ne demektir?<\/b><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-19.jpg\"\/><\/p>\n<p>Displazi, g\u0131rtlak lezyonundan al\u0131nan biyopsinin, patoloji uzman\u0131 hekimler taraf\u0131ndan incelenmesi sonucu konulan bir te\u015fhistir. H\u00fccrelerin kansere giden de\u011fi\u015fikli\u011fi yolundaki ilk basamak olarak kabul edilir. Mukoza ad\u0131 verilen \u00f6rt\u00fcc\u00fc tabakan\u0131n h\u00fccrelerinin de\u011fi\u015fikli\u011fini tan\u0131mlamaktad\u0131r. H\u00fccrelerin normalden sapma derecesine g\u00f6re displazi de derecelendirilmektedir.<\/p>\n<p>Displazi te\u015fhisi konulan hastada kesin olarak g\u0131rtlak kanseri geli\u015fecek diye bir kaide yoktur. Ancak bir kez displazi tan\u0131s\u0131n\u0131 alan lezyon, dikkatli takip edilmeli ve gerekirse mikrolarengeal cerrahi ad\u0131 verilen i\u015flemle o alan tamamen \u00e7\u0131kart\u0131lmal\u0131d\u0131r. Hastan\u0131n sigara ve alkol al\u0131\u015fkanl\u0131\u011f\u0131 varsa bu al\u0131\u015fkanl\u0131klar\u0131n\u0131 mutlaka terk etmelidir.<\/p>\n<p><strong>Biyopsi sonucunda yer alan in situ kanser ya da in situ karsinom ne anlama gelmektedir?<\/strong><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-20.jpg\"\/><\/p>\n<p>\u0130n situ kanser \/ in situ karsinom, patolog hekimlerin kulland\u0131\u011f\u0131 bir terimdir ve h\u00fccrelerin kanser h\u00fccresine d\u00f6n\u00fc\u015ft\u00fc\u011f\u00fc ancak mukoza tabakas\u0131n\u0131n i\u00e7inde s\u0131n\u0131rl\u0131 kald\u0131\u011f\u0131, hen\u00fcz hi\u00e7bir yere yay\u0131lmad\u0131\u011f\u0131 durumu tan\u0131mlamaktad\u0131r. Kanser, mukoza tabakas\u0131nda \u00e7ok y\u00fczeydedir, lenf (ak kan) ve kan damarlar\u0131na ula\u015fmam\u0131\u015ft\u0131r. Bu nedenle uzak b\u00f6lgelere yay\u0131lma imkan\u0131na sahip de\u011fildir.<\/p>\n<p>Muayenede bu safhadaki lezyon ses teli veya g\u0131rtla\u011f\u0131n di\u011fer b\u00f6lgelerinde mukozan\u0131n di\u011fer k\u0131s\u0131mlar\u0131ndan farkl\u0131 renkte, bazen k\u0131rm\u0131z\u0131, hafif\u00e7e kabar\u0131k olarak g\u00f6r\u00fcl\u00fcr. Ancak, g\u0131rtlakta bariz kanser b\u00f6lgelerine kom\u015fu alanda, sa\u011flkl\u0131 mukoza ile ge\u00e7i\u015f b\u00f6lgesinde de karsinoma in situ g\u00f6r\u00fclebilmektedir.<\/p>\n<p><strong>Mikro invaziv kanser ne anlama gelmektedir?<\/strong><\/p>\n<p>Mikro invaziv kanser de, patolog hekimler taraf\u0131ndan kullan\u0131lan bir terimdir ve kanserin erken evrelerinden birini tan\u0131mlar. Burada kanser h\u00fccreleri in situ kanserden farkl\u0131 olarak \u00e7ok s\u0131n\u0131rl\u0131 bir alanda derin dokulara ula\u015fm\u0131\u015ft\u0131r. Burada bahsi ge\u00e7en mesafe, milimetreden bile k\u00fc\u00e7\u00fckt\u00fcr.<\/p>\n<p><strong>\u0130nvaziv kanser ne demektir?<\/strong><\/p>\n<p>\u0130nvaziv kanser, mukoza ad\u0131 verilen \u00f6rt\u00fcc\u00fc tabakan\u0131n s\u0131n\u0131rlar\u0131 a\u015f\u0131lm\u0131\u015f, lenfa ve damarlara ula\u015fma, lenf bezeleri ve uzak organlara s\u0131\u00e7rama (metastaz) olas\u0131l\u0131\u011f\u0131 olan kanserdir.<\/p>\n<p>\u0130nvaziv kanserde t\u00fcm\u00f6r\u00fcn boyutuna, b\u00f6lgesel yap\u0131lara ve uzak organlara yay\u0131l\u0131m\u0131na g\u00f6re d\u00f6rt a\u015fama (evre) vard\u0131r. Tedavi plan\u0131n\u0131 yaparken en \u00f6nemli kriter t\u00fcm\u00f6r\u00fcn evresidir.<\/p>\n<p><strong>G\u0131rtlak kanserinde evreleme nas\u0131l yap\u0131l\u0131r?<\/strong><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-21.jpg\"\/><\/p>\n<p>T\u0131pta TNM s\u0131n\u0131flamas\u0131 olarak bilinen bu sistemi klinisyenler, hastal\u0131\u011f\u0131n evresini belirtmek ve prognozu (hastal\u0131\u011f\u0131n seyri, gidi\u015fat\u0131 hakk\u0131ndaki \u00f6ng\u00f6r\u00fc) tahmin etmek ve sonu\u00e7ta hasta i\u00e7in en uygun tedaviyi planlamak amac\u0131yla kullan\u0131lmaktad\u0131rlar.<\/p>\n<p><strong>T<\/strong>; t\u00fcm\u00f6r\u00fcn kaynakland\u0131\u011f\u0131 yerdeki boyutu ve uzan\u0131m\u0131,<\/p>\n<p><strong>N<\/strong>; ba\u015f boyun b\u00f6lgesindeki t\u00fcm\u00f6rler i\u00e7in boyun lenf bezelerine metastaz yapm\u0131\u015f (s\u0131\u00e7ram\u0131\u015f) olan t\u00fcm\u00f6r\u00fcn boyutu, metastazl\u0131 lenf nodu say\u0131s\u0131 ve durumu,<\/p>\n<p><strong>M<\/strong>; boynun \u00f6tesinde, uzak organlarda \u00e7o\u011fu kez kan yoluyla metastaz varl\u0131\u011f\u0131n\u0131 g\u00f6steririr.<\/p>\n<p>Bu s\u0131n\u0131flamada;<\/p>\n<p>T: 1\u2019den 4\u2019e<br \/>  N: 0\u2019dan 3\u2019e<br \/>  M: 0 veya 1 \u015feklinde ifade edilmektedir.<\/p>\n<p>Bu \u00fc\u00e7 harften hastal\u0131\u011f\u0131n seyrine ili\u015fkin en belirleyicisi M (kan yoluyla veya uzak b\u00f6lgelere hastal\u0131\u011f\u0131n yay\u0131l\u0131m\u0131) olmaktad\u0131r. Uzak organlara metastaz varl\u0131\u011f\u0131nda M1 olmakta, bu da, di\u011fer s\u0131n\u0131flama olan \u2019stage\u2019 (evre) 4C, yani en son evre hastal\u0131k anlam\u0131na gelmektedir.<\/p>\n<p><strong>** \u00d6nemli Not: Bu karma\u015f\u0131k s\u0131n\u0131flama hastalar i\u00e7in kafa kar\u0131\u015ft\u0131r\u0131c\u0131 olabilir. Kafan\u0131zda olu\u015fabilecek sorular\u0131 hekiminize dan\u0131\u015f\u0131n\u0131z.<\/strong><\/p>\n<p><img decoding=\"async\" src=\"http:\/\/www.cetinvural.com\/wp-content\/uploads\/2013\/03\/girtlak-kanseri-22.jpg\"\/><\/p>\n<p>Hastal\u0131\u011f\u0131n ilk \u00e7\u0131kt\u0131\u011f\u0131 yerdeki boyutu ve uzan\u0131m\u0131, boyundaki lenf bezleri i\u00e7erisindeki varl\u0131\u011f\u0131, uzak organlarda metastaz \u015feklinde var olup olmad\u0131\u011f\u0131 hastal\u0131\u011f\u0131n seyrini kestirebilmek ve hasta i\u00e7in en uygun tedaviyi se\u00e7ebilmek a\u00e7\u0131s\u0131ndan \u00e7ok \u00f6nemlidir. \u00d6rne\u011fin \u00e7ok erken evre ses teli t\u00fcm\u00f6r\u00fc (T1a N0 M0 glottik t\u00fcm\u00f6r) hastas\u0131, tek ba\u015f\u0131na \u00e7ok s\u0131n\u0131rl\u0131 bir ameliyat veya radyoterapi ile tedavi olabilecek iken, daha ileri (\u00f6rne\u011fin T4a N1 M0 glottik t\u00fcm\u00f6r) b\u00fcy\u00fck ve ciddi g\u0131rtlak ameliyatlar\u0131 ve sonras\u0131nda da radyoterapi, hatta kemoterapi ile ya da \u2018organ koruma protokol\u00fc\u2019 ad\u0131n\u0131 alan kemoterapi ve radyoterapinin birlikte kullan\u0131ld\u0131\u011f\u0131 a\u011f\u0131r tedavi y\u00f6ntemleri ile tedavi edilmektedir.<\/p>\n<p>G\u0131rtlak kanserinde evreleme, tedavi se\u00e7iminde en \u00f6nemli fakt\u00f6r olsa da tabi ki hastan\u0131n genel t\u0131bbi durumu, hastan\u0131n \u00f6ncelikleri, hekimin deneyimleri de g\u00f6z \u00f6n\u00fcnde bulundurulmal\u0131d\u0131r.<\/p>\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Larenks kanseri \u2013 g\u0131rtlak kanseri Konu hakk\u0131nda detayl\u0131 ve g\u00fcncel bilgiler i\u00e7in bu makaleyi okuyun<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[110,134,136,25,135],"class_list":["post-2758","post","type-post","status-publish","format-standard","hentry","category-kulak-burun-bogaz","tag-bolge","tag-girtlak","tag-girtlak-kanseri","tag-hasta","tag-kanser"],"_links":{"self":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/2758","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/comments?post=2758"}],"version-history":[{"count":1,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/2758\/revisions"}],"predecessor-version":[{"id":2759,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/2758\/revisions\/2759"}],"wp:attachment":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media?parent=2758"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/categories?post=2758"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/tags?post=2758"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}