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Poznaj swój nowotwór

Poznaj swój nowotwór
Rak piersi HER2–dodatni jest jednym z bardzo agresywnych typów nowotworów piersi. Co gorsze, dotyka on aż 20–30% pacjentek. Dawniej chore, które cierpiały na tego typu nowotwór, mimo że ich rokowania były dobre, i tak umierały, a lekarze nie wiedzieli dlaczego. Dziś na szczęście, mają szansę na wyleczenie.
Rak piersi jest najczęściej występującym nowotworem złośliwym u kobiet. W Polsce co roku wykrywany jest u ponad 14000 kobiet. Niestety ponad 5000 pań umiera. W samym Województwie Małopolskim w roku 2008 zachorowało ponad 1200 kobiet. W tym samym roku zmarło ponad 400 pacjentek. Coraz częściej chorują również młode kobiety (w wieku 35–39 lat), u których przebieg tej choroby jest bardzo agresywny. Statystyki są przerażające.

Główne czynniki ryzyka w przypadku raka piersi to: starszy wiek (chorują głównie kobiety po 50. roku życia, ale oczywiście nie tylko!), pojawienie się pierwszej miesiączki we wczesnym wieku, menopauza w późnym wieku, późny wiek pierwszego porodu, długotrwała terapia hormonalna, predyspozycje genetyczne, a także siedzący tryb życia, nadwaga i zła dieta.

Rak piersi HER2-dodatni

Rak piersi niestety nie jest nowotworem jednolitym. Istnieje bowiem wiele typów raka piersi, a najważniejsze z nich to: rak hormonozależny, rak hormononiezależny, rak HER2–dodatni, rak HER2–ujemny, rak potrójnie ujemny, rak genetycznie uwarunkowany.

Na szczególną uwagę zasługuje rak HER2–dodatni, który cechuje się agresywnym przebiegiem, u chorej stosunkowo szybko pojawiają się przerzuty odległe, a rokowania nie są najlepsze. Sytuacja ta dotyczy około 20-30% chorych. Naukowcy odkryli, że jest to związane z występowaniem u tej grupy pacjentek defektu genetycznego w postaci zwiększonej liczby genu HER2. Na szczęście wraz z rozwojem medycyny pojawiła się nowa opcja terapeutyczna w leczeniu chorych na ten rodzaj raka piersi i onkolodzy mogą leczyć pacjentki coraz nowocześniejszymi metodami.

- Przez wiele lat mieliśmy grupę pacjentek, które chorowały na raka piersi, miały bardzo dobre czynniki rokownicze, ale mimo to umierały – mówił podczas konferencji zatytułowanej „Rak piersi w pigułce” doc. Krzysztof Krzemieniecki ze Szpitala Uniwersyteckiego w Krakowie, Konsultant Wojewódzki w dziedzinie Onkologii Klinicznej. - Sytuacja musiała dopiero trafić na kolegów z Rotterdamu, którzy zbadali to środowisko i odkryli, że wszystkie te kobiety, które dobrze rokowały, a zmarły miały pewien defekt genetyczny, polegający na nadekspresji, czyli zwiększonej liczbie genu HER2. To był ten moment, gdy los wielu kobiet chorych na raka piersi, się zmienił. Dawniej pacjentki z tym genem umierały, dziś można je leczyć – dodał doc. Krzysztof Krzemieniecki.



Najpierw trastuzumab, potem lapatynib

W przypadku chorych na rozsianego raka piersi HER2–dodatniego obecnie w pierwszej kolejności stosuje się lek trastuzumab. Posiada on zdolność przyłączania się do receptora i hamowania jego działania, powodując tym samym zmniejszenie wielkości guza. Niestety u około 50% chorych w czasie roku trwania leczenia lekiem trastuzumab dochodzi do progresji choroby. Wtedy, gdy trastuzumab okazuje się nieskuteczny w leczeniu raka piersi HER2–dodatniego lub doszło do nawrotu choroby, zalecany jest lapatynib. Mowa tu o pierwszej doustnej terapii celowanej – z zastosowaniem leku lapatynib, pozwalającej na coraz skuteczniejszą walkę z nowotworem i wydłużenie przeżycia bez progresji choroby. - Stosujemy w niej leki ukierunkowane molekularnie, co oznacza, że terapia ta nie oddziałuje na cały organizm, tylko atakuje wyłącznie komórki nowotworowe, oszczędzając jednocześnie zdrowe komórki organizmu – powiedział doc. Krzysztof Krzemieniecki podczas konferencji „Rak piersi w pigułce”. Dodatkowo terapia ta pozwala chorej na zachowanie jak najwyższego komfortu życia. Lek dostępny jest bowiem w formie tabletek, które przyjmuje się raz dziennie, bez konieczności stałej hospitalizacji i wlewów dożylnych. Pacjentka w czasie trwania terapii może zatem pracować zawodowo.

Poznaj swój nowotwór

Każda pacjentka, u której rozpoznany został rak piersi, powinna mieć oznaczony status receptora HER2. Jeśli tego wyniku nie otrzymała na karcie badań, powinna się tego domagać. Chorzy z HER2 muszą bowiem obligatoryjnie otrzymać leczenie najpierw lekiem trastuzumab, a ci, dla których jest on nieskuteczny – terapię z zastosowaniem lapatynibu. Stąd też oznaczenie receptora HER2 jest tak istotne. Wyniki badań muszą być kompletne.
Najskuteczniejsze jest leczenie świadomych pacjentów, którzy wiedzą co im dolega i jakie badania powinni mieć wykonane. Kobiety, u których wykryto raka piersi, powinny zatem pamiętać, że jednym z typów raka jest rak HER2-dodatni i w celu podjęcia skutecznej terapii, konieczne jest oznaczenie receptora HER2. Pacjentka powinna otrzymać rzetelny wynik tego badania i z nim udać się do onkologa, który rozpocznie właściwe leczenie.


Anna Piątkowska-Borek


***
Receptor HER2

Receptor HER2 występuje w komórkach ludzkich i jest zaangażowany w przewodzenie sygnałów, mających indukować wzrost i różnicowanie komórki. W komórkach nowotworowych może dojść do zwiększenia liczby kopii genu kodującego receptor. Uważa się, że około 20–30% z rozpoznanych raków piersi ma zbyt wiele kopii tego genu, co powoduje nadmierną ekspresję receptora HER2. Wtedy mamy do czynienia z tzw. nadekspresją HER2. To z kolei może doprowadzić do tego, że nastąpi znacznie szybszy wzrost raka i przebieg choroby będzie miał bardziej agresywny charakter. Wówczas komórki rakowe mogą odrywać się od pierwotnego ogniska nowotworowego w piersi i rozprzestrzeniać się do innych części ciała poprzez krwioobieg lub układ chłonny. Mówimy wtedy o przerzutowym raku piersi.


***
Federacja Stowarzyszeń „Amazonki”

Federacja Stowarzyszeń „Amazonki” jest związkiem samodzielnych, niezależnych, samofinansujących się stowarzyszeń i klubów, działających na rzecz osób dotkniętych rakiem piersi. Celem Federacji jest wszechstronne działanie na rzecz chorych na ten nowotwór. Federacja tworzy warunki sprzyjające wzajemnemu wsparciu, reprezentuje interesy kobiet dotkniętych rakiem piersi. Zaznajamia społeczeństwo i organy władzy z problematyką kobiet po leczeniu raka piersi. „Amazonki” pomagają również osobom dotkniętym tym nowotworem w powrocie do normalnego życie. Organizują szkolenia profesjonalistów (rehabilitantów, psychologów), liderek i ochotniczek. Działają na rzecz wczesnego wykrywania, leczenia oraz rehabilitacji kobiet po mastektomii. Wydają również materiały edukacyjne, broszury, poradniki, plakaty, ulotki. Członkinie Federacji uczestniczą w konferencjach krajowych i zagranicznych, reprezentują kobiety po leczeniu raka piersi. Federacja podejmuje również działania zmierzające do współdziałania z władzami, innymi stowarzyszeniami, organizacjami naukowymi, społecznymi, zawodowymi i fundacjami na rzecz chorych i niepełnosprawnych.

Więcej informacji na stronie internetowej: www.amazonkifederacja.pl


Siedziba Krakowskiego Stowarzyszenia „Amazonek”

Kraków, ul. Garncarska 11

Tel.: (0-12) 422 99 00 wew. 235






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