Rakovina štítnej žľazy

10.7.2012 , Jakub Šulta

rakovina-stitne-zlazy.jpg - kopie
rakovina-stitne-zlazy.jpg - kopie
Rakovina je podľa niektorých pomerne častá, podľa iných naopak vzácna. Pravdou však zostáva, že zhubný nádor štítnej žľazy postihuje jedného na desať tisíc obyvateľov. Dnes patrí medzi dobre liečiteľné choroby, ktoré majú veľmi dobrú prognózu. Predovšetkým preto, že najčastejšou formou je nezhubný nádor zvaný adenóm. Zhubná forma rakoviny štítnej žľazy zvyčajne nemá žiadne prejavy a jej hlavnou nevýhodou sú metastázy.

Rakovina štítnej žľazy

Rakovina štítnej žľazy je laické označenie pre nádor štítnej žľazy. Správne by sme však mali termín rakovina vyhradiť iba pre karcinóm štítnej žľazy, čo je zhubný nádor. Medzi hlavné rizikové faktory patrí ionizujúce žiarenie, ktoré je nebezpečné predovšetkým v mladšom veku. Ďalej genetické dispozície, autoimunitné zápaly či nedostatok jódu alebo porucha tvorby hormónov štítnej žľazy.

Štítna žľaza

Štítna žľaza je orgán nachádzajúci sa na prednej strane krku. Je uložená pred priedušnicou a pod štítnou chrupavkou. Hlavnou úlohou štítnej žľazy je tvorba hormónov trijódtyronin (T3) a tyroxínu (T4), ktoré sa uplatňujú v mnohých procesoch nášho organizmu a kalcitonínu ktorý znižuje hladinu vápnika v krvi. Zjednodušene povedané, štítna žľaza hovorí iným orgánom čo majú robiť.

Čo je rakovina?

Rakovina, presnejšie povedané nádor je porucha buniek, ktoré sa v dôsledku svojho poškodenia začnú nekontrolovateľne deliť a rásť. Nádory delíme na zhubné (malígne) a nezhubné (benígne). Nezhubné nádory väčšinou rastú pomaly, nepoškodzujú okolité tkanivá a nezakladajú metastázy čiže druhotné nádorové ložiská. Naopak zhubné nádory rastú agresívne, prerastajú do okolitých tkanív a zakladajú metastázy, ktoré sú najčastejšou príčinou úmrtia.

Nezhubná rakovina štítnej žľazy

Nezhubné nádory štítnej žľazy sú oveľa častejšie, ako zhubné nádory, ktoré tvoria približne 1% zo všetkých malígnych nádorov. Samotná hranica medzi benígnymi a malígnymi nádormi však nie je úplne jasná. Najčastejším nezhubným nádorom je adenóm.

Adenóm

Adenóm štítnej žľazy je nezhubný nádor, ktorý sa môže vyskytovať samostatne alebo vo väčšom množstve, čo označujeme ako nodózna struma. Niekedy sa stretávame s termínom uzol, ktorý je súhrnným označením všetkých nádorových i nenádorových útvarov štítnej žľazy. Adenóm štítnej žľazy postihuje predovšetkým ženy, najčastejšie vo veku nad 40 rokov. Všeobecne rozdeľujeme uzly na tzv. studené a horúce. Studené uzly nevykazujú jódový metabolizmus a nemajú endokrinologické prejavy. Veľmi často bývajú zhubného charakteru, napr. karcinóm. Horúce uzly naopak vykazujú zvýšený metabolizmus jódu. Veľmi často u nich dochádza k zvýšenej produkcii hormónov (hypertyreóze) a následným zmenám v krvnom obraze. Predstaviteľom horúceho uzla je tiež adenóm. V niektorých prípadoch hrozí aj jeho zvrat v malígnu formu.

Zhubná rakovina štítnej žľazy

Zhubné nádory štítnej žľazy sa vyskytujú skôr zriedkavo, v SR je ročne zachytených asi 800 prípadov. Bohužiaľ v posledných rokoch má toto číslo tendenciu mierne narastať. Nezanedbateľný vplyv na vznik tohto ochorenia má ožiarenie krku či radiácia vo vzduchu (napr. po výbuchu atómovej bomby).

Karcinóm štítnej žľazy

Rakovina čiže karcinóm štítnej žľazy postihne približne 1 z 10 000 obyvateľov. Väčšina karcinómov štítnej žľazy nemá žiadne výrazné prejavy. Často je možné nahmatať tuhý útvar v prednej časti krku tzv. uzol štítnej žľazy, väčšinou však nebolestivý bez preukázania vplyvu na organizmus. Výhodou karcinómu štítnej žľazy je skutočnosť, že metastázuje iba v 3%, čo nám dáva veľmi dobrú šancu na vyliečenie. Cieľové orgány pre vznik týchto druhotných nádorových ložísk sú väčšinou krčné uzliny, pľúca a kosti.

Diagnostika rakoviny štítnej žľazy

Pri diagnostike rakoviny štítnej žľazy musíme najprv vyšetriť funkciu štítnej žľazy pomocou biochémie. Biochemické vyšetrenie najčastejšie vykonávame odberom krvi, ktorá nám poskytuje dôležité informácie o stave organizmu a jeho orgánov. Sonografické vyšetrené spresní veľkosť uzla prípadne štítnej žľazy a dovolí nám skontrolovať okolie. V prípade nálezu uzla vykonáme odber tkaniva tenkou ihlou tzv. biopsiu, ktorá objasní či sa jedná o nádorový či nenádorový útvar a odhalí jeho biologickú aktivitu, či je zhubný alebo nezhubný. Spresnenie konkrétneho nádoru nám určuje liečbu i prognózu ochorenia.

Liečba rakoviny štítnej žľazy

Liečba rakoviny štítnej žľazy sa odvíja od charakteru ochorenia, ktorý určuje postup aj prognózu.

Adenóm

Pokiaľ sa jedná o adenóm sú základným medikamentom v terapii tyreostatiká čiže lieky tlmiace aktivitu štítnej žľazy. Cieľom je normalizovať funkciu žľazy a potom zvoliť liečbu definitívnu. Tyreostatiká môžu mať rad nežiaducich účinkov ako začervenanie tváre, svrbenie kože alebo zvýšenú teplotu. Chirurgická liečba (tyreoidektómia) je najčastejším definitívnym riešením adenómu. U pacientov sa neodstraňuje väčšinou celá žľaza, ale iba postihnutý lalok. Nevýhodou chirurgického zákroku je riziko poranenia vratného nervu (nervus laryngeus recurrens), čo vedie k čiastočnej alebo úplnej strate hlasu či dýchacím ťažkostiam. Na skúsených pracoviskách je však riziko týchto komplikácií iba okolo 1% výkonov. Liečba rádioaktívnym jódom je podávaná dospelým pacientom u ktorých je vysoké riziko chirurgického výkonu. K optimalizácii funkcie dochádza najčastejšie za 2-6 mesiacov po aplikácii. Prognóza adenómov je veľmi dobrá, ale je potrebné ich dôkladne liečiť. Neliečený adenóm je život ohrozujúcim ochorením.

Karcinóm

Základom v liečbe karcinómu štítnej žľazy je úplné odstránenie žľazy tzv. totálna tyreoidektómia (TTE). Ďalší postup v liečbe závisí predovšetkým od druhu karcinómu. Najčastejší papilárny karcinóm (80%) dobre akumuluje jód, preto používame približne 6 až 8 týždňov po odstránení žľazy rádiojód, ktorý preukáže prípadné vzdialené metastázy. Liečba rádiojódom spočíva v naviazaní rádioaktívneho jódu na bunky štítnej žľazy, ktoré jód z krvi vychytávajú a ich následnom usmrtení. Používame ho predovšetkým na odstránenie zvyškov žľazy po TTE, kedy u približne 95% pacientov sú zvyšky preukázané. U iných nádorov, ktoré napríklad nekumulujú jód používame rádioterapiu čiže vonkajšie ožiarenie. Problematika liečby karcinómov štítnej žľazy je veľmi obsiahla a vždy záleží od mnohých faktorov, ktoré rozhodnú o postupe v liečbe.

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REMONTvalp: #House property / #Video
<p>#House #property House property Loss from House Property: Income Tax Treatment Select your email service Close Loss from House Property is a fairly popular scenario and commonly arises while filing the Income Tax Return. In this article, we would mainly be focussing on the Reason for Loss from House Property and the Income Tax treatment of the same. The Income/ Loss from House Property is computed in the following manner:- Reason for Loss from House Property There can be 2 reasons for Loss under head House Property:- In case of Self Occupied Property , the Gross Annual Value will be ...</p>
<p>The post <a href="http://remmont.com/house-property-video/">#House property / #Video</a> appeared first on <a href="http://remmont.com">Finance USA</a>.</p>
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<h1>#House #property</h1>
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<img src="https://i1.wp.com/remmont.com/demotivator/3611.jpg?resize=250%2C250" alt="#House property / #Video, REMMONT.COM" height="250" width="250"></div>
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<p><iframe width="640" height="360" src="http://www.youtube.com/embed/?feature=player_detailpage" allowfullscreen=""></iframe></p>
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<h2>House property</h2>
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<h1>Loss from House Property: Income Tax Treatment</h1>
<p>Select your email service Close</p>
<p>Loss from House Property is a fairly popular scenario and commonly arises while filing the Income Tax Return. In this article, we would mainly be focussing on the <em>Reason for Loss from House Property and the Income Tax treatment of the same.</em></p>
<p>The Income/ Loss from House Property is computed in the following manner:-</p>
<h2>Reason for Loss from House Property</h2>
<p>There can be 2 reasons for Loss under head House Property:-</p>
<ol>
<li>In case of Self Occupied Property , the Gross Annual Value will be Nil. From this Gross Annual Value (which is Nil), Municipal taxes and Interest on Loan would be reduced which would ultimately result in a Loss arising under head House Property. (In case of Home Loan for Self Occupied property, the maximum deduction under Section 24 for Interest on Home Loan would be Rs. 2 Lakhs only)</li>
<li>In case of other type of Property , the Gross Annual Value will not be Nil. However, if the Deductions claimed are more than the Gross Annual Value, this would again result a Loss arising under the head House Property.</li>
</ol>
<ul>
<li>Recommended Read: Deductions from House Property allowed under Income Tax Act</li>
</ul>
<h2>Treatment of Loss from House Property for Tax purposes</h2>
<p><b>Set-off of Loss from House Property</b></p>
<p>The Loss from House Property is allowed to be set-off against any other Income arising during the same year. Therefore, if there is a loss under head House Property, and there is Income under any of the other 5 heads of Income i.e. Salary/ House Property/ Business or Profession/ Capital Gains/ Other Sources, this loss from House Property can be adjusted against such income.</p>
<p>The net income so computed after set-off of Loss under head House Property would be taxable as per the Income Tax Slabs</p>
<p><strong>Amendment introduced vide Finance Act 2017:</strong> The Loss under head House Property which is allowed to be set-off against Income from Other Sources is restricted to Rs. 2 Lakhs for each assessment year. The balance unabsorbed loss would be allowed to be carried forward to the next assessment year and set-off accordingly. This amendment is applicable from Assessment Year 2018-19 onwards.</p>
<h3>Carry-forward of Loss from House Property</h3>
<p>In case the Loss from House Property has not been adjusted in the same year, such loss will be carried forward to the next year and allowed to be set off with income arising other the same head i.e. House Property.</p>
<p>It should be noted while setting off the Loss under head House Property in the same year, it can be set-off with any other head of income but in case the loss is being carried forward to the next assessment year, it can only be set-off against incomes arising under the same head i.e. Income from House Property only.</p>
<p>Such Loss from House Property is <b>allowed to be carried forward for a maximum of 8 assessment years</b>. Such carry forward of Loss would be required to be shown in the Income Tax Return.</p>
<h3>Relevant Point regarding Loss from House Property</h3>
<p>Although the Loss from House Property is allowed to be carried forward for 8 assessment years, such loss should be set off in the subsequent assessment year if there is income under head House Property. The balance which has not been set-off shall be carried forward to the next assessment year.</p>
<p>In other words, the taxpayer cannot keep carrying forward the loss from House Property for 8 assessment years as per his own wish and he would be required to adjust the loss in that year itself in which there is income under head house property.</p>
<p>If the taxpayer does not set-off the loss against the income, such losses will not be allowed to be set-off at a future date. <Tyrosoles>(India) v CIT (1963)49ITR 515 (Mad)]</p>
<p>Karan is CA by Qualification with the rare distinction of being awarded All India Rank 22. He is also the founder of this website and is an expert in helping people save Taxes legally. He can be reached by booking an appointment for Tax Advisory Service.</p>
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SOURCE: <a href="http://nef2.com">NEF2.COM</a> </p>
<blockquote><p><a href="https://www.charteredclub.com/loss-from-house-property/">Loss from House Property: Income Tax Treatment</a></p></blockquote>
<p><iframe title="“Loss from House Property: Income Tax Treatment” — Chartered Club" src="https://www.charteredclub.com/loss-from-house-property/embed/#?secret=YGoEj3rsZv" width="600" height="338"></iframe></p>
<p>The post <a href="http://remmont.com/house-property-video/">#House property / #Video</a> appeared first on <a href="http://remmont.com">Finance USA</a>.</p>
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