Erken evre meme kanserli hastaların takibinde ortaya çıkan beden kütle indeksi değişiklikleri ve bu değişikliklerin yol açtığı sağlık problemlerinin tespiti
Body mass index changes emerging in management of early stage breast cancer patients and establishing the consequent healtcare problem
- Tez No: 308253
- Danışmanlar: PROF. HALİL KAVGACI
- Tez Türü: Tıpta Uzmanlık
- Konular: Onkoloji, Oncology
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2011
- Dil: Türkçe
- Üniversite: Karadeniz Teknik Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: İç Hastalıkları Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 61
Özet
Meme kanseri, dünyada kadınlarda en yaygın görülen kanser tipidir. Tedavi modaliteleri ve görüntüleme yöntemlerindeki gelişmeler meme kanseri ile yaşayan hastaların sayısında artışa neden olmuştur. Bu durum sağkalımı ve yaşam kalitesini artıracak değiştirilebilir risk faktörlerinin araştırılmasını gerektirmektedir. Meme kanserli hastalarda yaygın görülen BKİ'deki artışlar, bu hastaların ileriki yaşamlarında obezite ile ilgili sağlık sorunlarını artırmaktadır. Çalışmaya Mart 2010 ile Aralık 2010 tarihleri arasında Karadeniz Teknik Üniversitesi Tıp Fakültesi Medikal Onkoloji Bilim Dalı Polikliniğine başvuran ``Erken evre meme kanseri'' tanısı almış 142 hasta dahil edildi. Takibe gelen hastaların BKİ ölçümleri tanı sırasında ölçülen BKİ ölçümleriyle karşılaştırılarak hastaların BKİ değişiklikleri gözlendi. Hastaların tanıda ve klinik takipleri sırasında gelişen obezite ile ilişkili sağlık sorunları (DM, HT, KAH, OA, Hiperlipidemi) kaydedildi. BKİ' değişiklikleri ile bu hastalıklar arasındaki ilişki istatiksel olarak incelendi. Hastaların ortalama yaşı 52,7 ± 1,1 (en küçüğü 31 yaşında en büyüğü 78 yaşında) olarak tespit edildi. Tanı anında hastaların % 56,3 premenapozal, % 43,7 postmenapozal idi. Hastaların meme kanseri tanısı aldıklarında BKİ ortalaması 27,9 ± 5,3 iken 2. değerlendirmede BKİ ortalaması 30,7 ± 5,7 olarak hesaplandı. Bu artış istatiksel olarak anlamlı bulundu (p
Özet (Çeviri)
Breast cancer is the most common female malignancy in the world. While improved screening, combined with advances in treatment has resulted in a decline in breast cancer mortality, an increasing number of women are living with a diagnosis of breast cancer. This situation underscores a critical need for investigating modifiable risk factors that will have positive impact on overall health, disease remission and long-term survivorship. Increasing of BMI which is common in patients with breast cancer, causes rising of obesity related health problems in future lifetime of patients. 142 patients who applied to KTU Faculty of Medicine Medical Oncology Clinics the dates between March ? December 2010 and diagnosed before at the early stage of breast cancer were included in this study. From the beginning of the diagnose and during the clinical follow up, patients? height and weight measurements were used and BMI alternations were analysed. At the time of diagnose and during the clinical follow up, patients? health problems related to obesity (DM, HT, CVD, Degenarative osteoarthritis, hyperlipidemia) were recorded. Relation between these diseases and alternation of BMI was statistically analysed. Patients? average age was found as 52,7 ± 1,1 (minimum 31 maximum 78 years old). At the time of diagnose, %56,3 of patients were in premenopausal period and %43,7 of them were postmenopausal period. During the second clinical control, patients? mean BMI was measured as 30,7 ± 5,7 while their mean BMI was 27,9 ±5,3 at the time of diagnose. This increase in BMI was found as statistically significant. An increase in BMI was established in %90,8 of patients. While decrease in BMI was established in%8 of patients, there was no difference in %1,2 of patients. Only when patients having an increase in BMI were analysed according to duration of disease, statistically significant difference was found. It was established that this significant difference was caused by patients who were in the first, fifth or over years of that disease. While approximately 3,6 ± 3,2 kg/m2 increase was established with patients in premenopausal period at the time of diagnose, it was realized that there was approximately 1,6 ±2,2 increase in patients who were in postmenopausal period ant that difference was found as statistically significant. When BKI increases were compared with each other according to whether they receive endocrin treatment or not, statistically significant difference was not found. When the patients with increased BMI were analysed; it was established that, in 20 of 120 patients with breast cancer at the time of diagnose, cases of DM; in 31 of 100 non hypertensive patients cases of HT; in 44 0f 121 patients with no hyperlipidemia cases ofhyperlipidemia and in 31 of 108 patients with no OA cases of OA developed during the folow up. One of 127 patients who did not have CVD at the time of diagnose developed CVD and this was not found as statistically significant. When the relation between differantation of BMI and CVD mortality was analysed, it was found that while the rate of relative increase in death risk, developing in accordance with CVD was measured as % 24 in the second year, % 16 in the third year, % 17,3 in the fourth and % 20,8 in the fifth year of this disease.Increasing of BMI that is common in patients with breast cancer causes an increase in obesity relatedchronic diseases. Life span and life quality will be affected positively by maintaining weight gain at the minimum level after diagnose. During the follow up satge of patients with breast cancer, it is of great importance to inform patients in terms of diet and weight gain together with medical treatment.
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