Colorectal cancer

Chii chinonzi kenza yakajeka?

Rectum necolon zvinogadzira ura hombe, kana ura hombe. Rectum ndiyo inches yekupedzisira yedumbu guru uye inobatanidza colon kune anus. Kenza yerectum uye/kana colon inonzi colorectal cancer uye ndiyo kenza yechina inonyanya kuwanikwa muUnited States. Magomarara maviri aya akaiswa pamwechete nekuti anogovana maitiro mazhinji uye anorapwa zvakafanana. Chinenge chikamu chimwe muzvitatu chezviitiko 145,000 zvegomarara remukati rinoonekwa gore rega rega rinowanikwa murectum.

Rectal cancer inoitika kana masero ari mu rectum mutate uye achikura kunze kwekudzora. Chirwere ichi chinogona zvakare kukura kana kukura, kunodaidzwa kunzi polyps, kumadziro emukati erectum kukura uye kuita cancer.

Ngozi yekenza rectal inowedzera nezera. Avhareji zera remunhu anoonekwa aine kenza yemavara ane makore makumi masere nemasere. Varume vane njodzi yakakura kupfuura vakadzi. Ngozi yekenza yemukono inogona kudzikiswa, uye chirwere ichi chinogona kudzivirirwa kana kubatwa nekukasira, nekuongororwa nguva dzose uye shanduko yemararamiro, se:

Kuratidza
Kudya zvishoma zvakatsvuka uye zvakagadziriswa nyama uye yakawanda fiber uye miriwo
Kurega kuputa
Kuderedza kunwa doro

Pasi rese, gomarara rakasarudzika kenza yechipiri inowanzoitika kumadzimai uye chechitatu kenza yakajairika muvanhurume.

Ndezvipi zvikonzero zvekenza yakajeka?

Rectal cancer inoitika kana masero ane hutano murecuru achikura zvikanganiso muDNA yavo. Muzviitiko zvakawanda, chikonzero chemakanganiso aya hachizivikanwe.

Masero ane hutano anokura uye anopatsanurwa nenzira yakarongeka kuitira kuti muviri wako ushande zvakanaka. Asi kana DNA yesero ikakuvara ikava kenza, masero anoramba achipatsanuka kunyangwe masero matsva asingadiwe. Sezvo masero anoungana, anogadzira bundu.

Nekufamba kwenguva, maseru egomarara anogona kukura achipinda nekuparadza zvakajairika nyama pedyo. Uye maseru ane gomarara anogona kuenda kune dzimwe nhengo dzemuviri.

Nhaka yekuchinja kwemagene inowedzera njodzi yekenza uye rectal cancer

Mune dzimwe mhuri, shanduko dzemadzitateguru dzakapfuudzwa kubva kuvabereki kuenda kuvana dzinowedzera njodzi yekenza yakajeka. Izvi zvinoshanduka zvinongori chikamu chidiki muzana checancer yekenza. Mamwe majini akabatanidzwa nekenza yemakoko inowedzera njodzi yemunhu yekuvandudza chirwere ichi, asi hazviite kuti chidzivirirwe.

Maviri akanyatsotsanangurwa magene colorectal cancer syndromes ndeaya:

Hereditary nonpolyposis kenza yakajeka kenza (HNPCC). HNPCC, inonziwo Lynch syndrome, inowedzera njodzi yekenza yekoloni uye imwe kanzira. Vanhu vane HNPCC vanowanzo kuve nekenza yekoloni vasati vava nemakore makumi mashanu.
Inowanzozivikanwa adenomatous polyposis (FAP). FAP chirwere chisingawanzoite chinokonzeresa kuti iwe uwedzere zviuru zve polyp mumucheka wekoloni yako uye rectum. Vanhu vane FAP isina kurapwa vane njodzi yakanyanya kukura yekuva nekenza kana rectal cancer vasati vava nemakore makumi mana.

FAP, HNPCC uye nezvimwe, zvakajairika zvakagara nhaka colorectal cancer syndromes inogona kuwanikwa kuburikidza nemajini ekuyedza. Kana iwe uine hanya nezvenhoroondo yemhuri yako yekenza yekoloni, taura nachiremba wako nezvekuti nhoroondo yemhuri yako inoratidza kuti une njodzi yemamiriro aya.

Ndezvipi zvinhu zvinokonzeresa zvecancer?

Hunhu uye mararamiro ehupenyu anowedzera njodzi yako yekenza rectal akafanana neaya anowedzera njodzi yako yekenza yemukenza. Zvinosanganisira:

Kukwegura. Ruzhinji rwevanhu vanoonekwa kuti vane cancer uye rectal cancer vane makore anopfuura makumi mashanu. Colorectal cancer inogona kuitika kune vechidiki vanhu, asi inoitika zvakanyanya kushomeka.
African-American dzinza. Vanhu vemadzitateguru eAfrica vakaberekerwa muUnited States vane njodzi huru yekenza yakajeka kupfuura zvinoita vanhu vekuEurope.
Nhoroondo yega yekenza yakajeka kana polyps. Kana iwe uchinge watove nekenza rectal, kenza yekoloni kana adenomatous polyps, iwe une njodzi huru yekenza yakajeka mune ramangwana.
Chirwere chekuputira ura. Zvirwere zvisingaperi zvekuzvimba zvekoloni uye rectum, senge ulcerative colitis uye chirwere cheCrohn, zvinowedzera mukana wako wekenza yakajeka.
Nhaka syndromes iyo inowedzera colorectal kenza njodzi. Mageneti syndromes akapfuura kuburikidza nezvizvarwa zvemhuri yako anogona kuwedzera njodzi yako yekenza yakajeka. Aya syndromes anosanganisira FAP uye HNPCC.
Nhoroondo yemhuri yekenza yakajeka. Iwe unowanzo kuve nekenza yakajeka kenza kana iwe uine mubereki, mukoma kana mwana ane chirwere. Kana inopfuura imwe nhengo yemhuri ine kenza yekoloni kana kenza rectal, njodzi yako yakatonyanya kukura.
Kudya. Colorectal cancer inogona kusanganisirwa nechikafu chakaderera mumiriwo uye chakakwirira munyama tsvuku, kunyanya kana nyama ichinge yatsva kana yagadzirwa zvakanaka.
Hupenyu hwekugara. Kana iwe usinga shande, iwe unowanzo kuve nekenza yakajeka kenza. Kuwana chiitiko chemuviri chenguva dzose kunogona kudzikisa njodzi yako yekenza yemukenza.
Chirwere cheshuga. Vanhu vane hutachiona husina kunyatso chengetedzwa 2 chirwere cheshuga uye insulin kudzvinyirira vanogona kuva nenjodzi yakawedzera yekenza yakajeka.
Kuwedzera muviri. Vanhu vakafutisa vane njodzi yakawedzera yekenza yakajeka uye nenjodzi yakawedzera yekufa nekenza yekoloni kana rectal kana ichienzaniswa nevanhu vanoonekwa sehuremu hwakajairika.
Kusvuta. Vanhu vanosvuta vanogona kuva nenjodzi yakawedzera yekenza yemukondoni.
Doro. Kugara uchinwa zvinopfuura zvitatu zvinwiwa zvinwiwa pavhiki zvinogona kuwedzera njodzi yako yekenza yakajeka.
Radiation kurapwa kwegomarara rekare. Radiation kurapwa yakanangiswa padumbu kurapa kenza yapfuura inogona kuwedzera njodzi yekenza yakajeka.

Nzira yekuongorora sei kenza yakajeka?

Miedzo inoshandiswa kuongorora chirwere chekenza inosanganisira zvinotevera:

Kuongorora kwepanyama uye nhoroondo: Kuongororwa kwemuviri kutarisa zviratidzo zvehutano, kusanganisira kuongorora zviratidzo zvehosha, senge mapundu kana chero chinhu chinoratidzika sechisina kujairika. Nhoroondo yemaitiro ehutano hwemurwere uye kurwara kwakapfuura uye kurapwa kuchatorwawo.
Dhijitari rectal bvunzo (DRE): Kuongorora kwe rectum. Chiremba kana mukoti vanoisa chigunwe chakazorwa mafuta, chakapfekerwa mukati mechikamu chepasi kuti unzwe mapundu kana chero chinhu chinoratidzika sechisina kujairika. Mune vakadzi, nyinyo inogona kuongororwa.
Colonoscopy: Maitiro ekutarisa mukati mehuturu nekoloni yemapolyps (zvidimbu zvidiki zvebundu), nzvimbo dzisina kujairika, kana gomarara. Colonoscope chishoma, mutopu-senge chiridzwa chine mwenje nelenzi yekutarisa. Inogona zvakare kuve nechishandiso chekubvisa polyps kana matissue sampuli, ayo anoongororwa pasi pe microscope yezviratidzo zvegomarara.
- Biopsy: Kubviswa kwemasero kana zvinyama kuitira kuti zvionekwe pasi pe microscope kutarisa zviratidzo zvegomarara. Tumor tishu inobviswa panguva yeiyo biopsy inogona kuongororwa kuti ione kana murwere angangoita geni mutation inokonzeresa HNPCC. Izvi zvinogona kubatsira kuronga kurapwa. Iyi bvunzo inotevera inogona kushandiswa:
  Reverse transcript- polymerase chain reaction (RT – PCR) bvunzo: Kuedzwa kwerabhoritari umo huwandu hwechinhu chinonzi genetic mRNA chakagadzirwa neimwe geni chinoyerwa. Enzyme inonzi reverse transcriptase inoshandiswa kushandura chidimbu cheRNA kuita chidimbu cheDNA, icho chinogona kukwidziridzwa (chakaitwa muzvizhinji) neimwe enzyme inonzi DNA polymerase. Akawedzeredzwa maDNA makopi anobatsira kutaurira kana chaiyo mRNA iri kugadzirwa negene. RT-PCR inogona kushandiswa kuongorora kumisikidza kwemamwe majeni anogona kuratidza kuvepo kwemasero ekenza. Iyi bvunzo inogona kushandiswa kutsvaga kumwe kuchinjika mugene kana chromosome, iyo inogona kubatsira kuongorora kenza.
  Immunohistochemistry: Kuedzwa kwerabhoritari kunoshandisa masoja ekudzivirira kuti aone mamwe maantigen (mamaki) mune imwe sampuro yetishu yemurwere. Masoja ekudzivirira chirwere anowanzo sunganidzwa ne enzyme kana dhayi ye fluorescent. Mushure mekunge maantibodies akasunga kune yakasarudzika antigen mune yeiyo sampuli, iyo enzyme kana dhayi inoitwa, uye iyo antigen inogona kuzoonekwa pasi pe microscope. Rudzi urwu rweyedzo runoshandiswa kubatsira kuongorora gomarara uye kubatsira kutaurira imwe mhando yekenza kubva kune imwe mhando yegomarara.
- Carcinoembryonic antigen (CEA) kuyedza: Muedzo unoyera chiyero cheECA muropa. CEA inosunungurwa ichipinda muropa kubva kune ese maseru ekenza uye akajairwa maseru. Kana ikawanikwa mune yakakwira kupfuura zvakajairwa zviyero, inogona kuve chiratidzo chekenza rectal kana mamwe mamiriro.
  Kufungidzira (mukana wekupora) uye sarudzo dzekurapa dzinoenderana nezvinotevera:
  Chikamu checancer (chingave chinokonzeresa mukati memukati mechirikadzi chete, chinosanganisira rese rese, kana rakapararira kune lymph node, nhengo dziri pedyo, kana dzimwe nzvimbo mumuviri).
  Kunyangwe bundu rakapararira mukati kana kuburikidza nemadziro emukati.
  Ikoko gomarara rinowanikwa mune rectum.
  Kunyangwe ura hwakavharika kana hune buri mukati.
  Kunyangwe bundu rose rinogona kubviswa nekuvhiyiwa.
  Hutano hwese hwemurwere.
  Kunyangwe kenza ichangobva kuongororwa kana kuti yadzokazve (dzoka).

Ndeapi matanho ekenza yakajeka?

Mushure mokunge gomarara redziviriro raonekwa, kuongororwa kunoitwa kuti uone kana gomarara maseru rapararira mukati mechuru kana kune zvimwe zvikamu zvemuviri.
Pane nzira nhatu dzinopararira negomarara mumuviri.
Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.
Aya matanho anotevera anoshandiswa nekenza rectal:
- Chikamu 0 (Carcinoma muSitu)
- Stage I
- Stage II
- Stage III
- Stage IV

Mushure mokunge gomarara redziviriro raonekwa, kuongororwa kunoitwa kuti uone kana gomarara maseru rapararira mukati mechuru kana kune zvimwe zvikamu zvemuviri.

Maitiro anoshandiswa kutsvaga kana gomarara rapararira mukati mechikamu kana kune dzimwe nhengo dzemuviri inonzi staging. Ruzivo rwakaunganidzwa kubva munzira yekugadzwa rinotara danho rechirwere. Izvo zvakakosha kuti uzive nhanho kuitira kuronga kurapwa.

Iyi inotevera bvunzo uye maitiro anogona kushandiswa mune yekuratidzira maitiro:

Chest x-ray: X-ray yenhengo nemapfupa mukati mechipfuva. X-ray imhando yesimba remagetsi rinogona kupfuura nemuviri uye kupinda mufirimu, richiita mufananidzo wenzvimbo dziri mukati memuviri.
Colonoscopy: Maitiro ekutarisa mukati merevhuru nekoloni yemapolyps (zvidimbu zvidiki zvemabhuru). nzvimbo dzisina kujairika, kana kenza. Colonoscope chishoma, mutopu-senge chiridzwa chine mwenje nelenzi yekutarisa. Inogona zvakare kuve nechishandiso chekubvisa polyps kana matissue sampuli, ayo anoongororwa pasi pe microscope yezviratidzo zvegomarara.

CT scan (CAT scan): Maitiro anoita akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri, senge dumbu, chiuno, kana chipfuva, zvakatorwa kubva kumakona akasiyana. Mifananidzo yacho inogadzirwa nekombuta yakabatana neiyo x-ray muchina. Dhayi inogona kuiswa jekiseni kana kumedzwa kubatsira nhengo kana zvinyama kuratidza zvakajeka. Iyi nzira inonziwo computed tomography, computerized tomography, kana komputa axial tomography.
MRI (yemagineti resonance imaging): Maitiro anoshandisa magineti, masaisai eredhiyo, uye komputa kugadzira akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri. Iyi nzira inonziwo nyukireya magnetic resonance imaging (NMRI).
PET scan (positron emission tomography scan): Iyo nzira yekuwana yakaipa malone maseru mumuviri. Chishoma che radioactive glucose (shuga) inoiswa mutsinga. Iyo PET scanner inotenderera yakatenderedza muviri uye inogadzira mufananidzo wepo glucose iri kushandiswa mumuviri. Malignant tumarara maseru anoratidza kupenya mumufananidzo nekuti anoshanda uye anotora glucose yakawanda kupfuura zvinoita maseru akajairwa.
Endorectal Ultrasound: Maitiro anoshandiswa kuongorora rectum uye nhengo dziri pedyo. An ultrasound transducer (probe) inoiswa mukati meye rectum uye inoshandiswa kudzora mafungu ane simba-ruzha (ultrasound) kubva munyama dzemukati kana mitezo uye kuita maungira. Maungira anoumba mufananidzo wemuviri munyama unonzi sonogram. Chiremba anogona kuona mamota nekutarisa sonogram. Iyi nzira inonziwo transrectal ultrasound.

Pane nzira nhatu dzinopararira negomarara mumuviri.

Kenza inogona kupararira kuburikidza nematinji, iyo lymph system, uye neropa:

Tishu. Kenza inopararira kubva kwayakatanga nekukura ichipinda munzvimbo dziri pedyo.
Lymph maitiro. Kenza inopararira kubva kwayakatanga nekupinda muiyo lymph system. Kenza inofamba nemumidziyo yema lymph ichienda kune dzimwe nhengo dzemuviri.
Ropa. Gomarara rinopararira kubva kwarakatanga nekupinda muropa. Kenza inofamba nemidzi yeropa ichienda kune dzimwe nhengo dzemuviri.

Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.

Kana kenza ikapararira kune chimwe chikamu chemuviri, inonzi metastasis. Cancer maseru anotsemuka kubva kwaakatanga (iro bundu rekutanga) uye achifamba kuburikidza neiyo lymph system kana ropa.

Lymph maitiro. Gomarara rinopinda mu "lymph system", rinofamba nemumidziyo ye "lymph", uye rinogadzira bundu (metastatic tumor) mune chimwe chikamu chemuviri.
Ropa. Kenza inopinda muropa, inofamba nemutsinga dzeropa, uye inogadzira bundu (metastatic tumor) mune chimwe chikamu chemuviri.

Iyo metastatic bundu imhando imwechete yegomarara seyokutanga bundu. Semuenzaniso, kana kenza yerectal ikapararira kumapapu, masero egomarara mumapapu ndiwo chaiwo maseru ekenza. Chirwere ichi chinonzi metastatic rectal cancer, kwete kenza yemapapu.

Aya matanho anotevera anoshandiswa nekenza rectal:

Chikamu 0 (Carcinoma muSitu)

Muchikamu chegomarara 0 rectal, masero asina kujairika anowanikwa mu mucosa (mukati-kati mehwindo) yemadziro erectum. Aya maseru asina kujairika anogona kuva cancer uye achipararira mune zvinyama zviri pedyo. Chikamu 0 chinonziwo carcinoma in situ.

Chikamu I kenza yakajeka

Muchikamu chekenza ini rectal, gomarara rakaumbwa mukati memukati (mukatikati medenga) remadziro erectum uye rapararira kune submucosa (rukoko rwechitunha padhuze nemucosa) kana kune mhasuru yakatenderera yeiyo rectum madziro.

Stage II kenza yakajeka

Chikamu chechipiri chekenza rectal yakakamurwa muzvikamu IIA, IIB, uye IIC.

Chikamu chechipiri IIA: Kenza yakapararira kuburikidza nemhasuru yakatetepa yeiyo rectum madziro kune iyo serosa (yekunze yakatetepa) yeiyo rectum madziro.
Chikamu chechipiri IIB: Kenza yakapararira kuburikidza neserosa (yekunze kwekunze) yeiyo rectum madziro kune iyo turu iyo inoisa nhengo mudumbu (visceral peritoneum).
Nhanho IIC: Kenza yakapararira kuburikidza neserosa (yekunze kwekunze) yeiyo rectum rusvingo kune nhengo dziri pedyo.

Stage III kenza yakajeka

Chikamu chechitatu chekenza rectal yakakamurwa muzvikamu IIIA, IIIB, uye IIIC.

Muchikamu IIIA, kenza yapararira:

kuburikidza neiyo mucosa (yemukati-pasi) yeiyo rectum madziro kune iyo submucosa (rukoko rwechitunha padhuze nemucosa) kana kune mhasuru yakatetepa yerectum wall. Gomarara rakapararira kune rimwe kusvika kumatatu ma "lymph node" kana maseru emukenza akaumbwa munyama padhuze ne "lymph node"; kana
kuburikidza neiyo mucosa (yemukati-pasi) yeiyo rectum madziro kune iyo submucosa (rukoko rwechitunha padhuze nemucosa). Kenza yakapararira kusvika kumana kusvika matanhatu matanhatu ema lymph node.

Muchikamu IIIB, kenza yakapararira:

kuburikidza nehutete hwemhasuru yeruzhowa kumadziro kune serosa (yekumusoro kwekunze) yeiyo rectum madziro kana yakapararira kuburikidza neserosa kusvika munyama inoisa nhengo mudumbu (visceral peritoneum). Gomarara rakapararira kune rimwe kusvika kumatatu ma "lymph node" kana maseru emukenza akaumbwa munyama padhuze ne "lymph node"; kana
kune iyo mhasuru yakatetepa kana kune iyo serosa (yekunze yakatetepa) yeiyo rectum madziro. Gomarara rakapararira kusvika kumana kusvika matanhatu matanhatu ema lymph node; kana
kuburikidza neiyo mucosa (yemukati-pasi) yeiyo rectum madziro kune iyo submucosa (rukoko rwechitunha padhuze nemucosa) kana kune mhasuru yakatetepa yerectum wall. Kenza yakapararira kusvika kumanomwe kana kupfuura ma lymph node.

Muchikamu IIIC, kenza yapararira:

kuburikidza neserosa (yekumusoro kwekunze) yeiyo rectum madziro kune iyo turu iyo inoisa mitezo mudumbu (visceral peritoneum). Gomarara rakapararira kusvika kumana kusvika matanhatu matanhatu ema lymph node; kana
kuburikidza nehutete hwemhasuru yeruzhowa kumadziro kune serosa (yekumusoro kwekunze) yeiyo rectum madziro kana yakapararira kuburikidza neserosa kusvika munyama inoisa nhengo mudumbu (visceral peritoneum). Kenza yakapararira kusvika kumanomwe kana kupfuura ma lymph node; kana
kuburikidza neserosa (yekumusoro yakaturikidzana) yeiyo rectum madziro kunhengo dziri pedyo. Gomarara rakapararira kune rimwe kana mamwe ari pedyo ma lymph node kana maseru emukenza akaumbwa munyama padhuze nema lymph node.

Stage IV kenza yakajeka

Stage IV rectal kenza yakakamurwa muzvikamu IVA, IVB, uye IVC.

Nhanho IVA: Kenza yakapararira kune imwe nzvimbo kana nhengo isiri padhuze nerectum, senge chiropa, mapapu, ovary, kana lymph node iri kure.
Chikamu IVB: Kenza yakapararira kune inopfuura imwe nzvimbo kana nhengo isiri padhuze nerectum, senge chiropa, mapapu, ovary, kana lymph node iri kure.
Stage IVC: Kenza yakapararira kumatishu ayo anotara madziro edumbu uye anogona kunge akapararira kune dzimwe nzvimbo kana nhengo.

Kakawanda Rectal Cancer

Chirwere chenguva dzose gomarara igomarara rakadzokazve (radzoka) mushure mekurapwa. Gomarara rinogona kudzoka muchikamu kana mune zvimwe zvikamu zvemuviri, senge colon, chiuno, chiropa, kana mapapu.

Kenza yakajeka inorapwa sei?

Kune akasiyana marudzi ekurapa kwevarwere vane rectal cancer.
Mhando nhanhatu dzekurapwa kwakajairika dzinoshandiswa:
- Surgery
- Radiation therapy
- Kurapwa
- Kuongorora kuri kuita
- Targeted therapy
- immunotherapy
Dzimwe mhando dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.
Kurapa kwekenza rectal kunogona kukonzera mhedzisiro.
Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki.
Varwere vanogona kupinda mumakiriniki miedzo vasati, panguva, kana mushure mekutanga kwavo kenza kurapwa.
Yekutevera-bvunzo inogona kudikanwa.

Kune akasiyana marudzi ekurapa kwevarwere vane colorectal cancer.

Mhando dzakasiyana dzekurapa dzinowanikwa kuvarwere vane gomarara reredza. Kumwe kurapwa kwakajairwa (iko iko iko kurapa kuri kushandiswa), uye kumwe kuri kuyedzwa mumakiriniki ekuedzwa. A kurapwa kiriniki kuyedzwa chidzidzo chekutsvaga chakaitirwa kubatsira kuvandudza marapirwo azvino kana kuwana ruzivo marapirwo matsva evarwere vane gomarara. Kana kiriniki miedzo ikaratidza kuti kurapwa kutsva kuri nani pane kwese kurapwa, kurapwa kutsva kunogona kuve kwakajairwa kurapwa. Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki. Mimwe miedzo yekiriniki yakavhurwa chete kune varwere vasina kutanga kurapwa.

Mhando nhanhatu dzekurapwa kwakajairika dzinoshandiswa:

Kuvhiya mukenza yakajeka

Kuvhiya ndiko kurapwa kwakanyanya pamatanho ese ekenza rectal. Kenza inobviswa uchishandisa imwe yeanotevera marudzi ekuvhiya:

Polypectomy: Kana gomarara richiwanikwa mune polyp (chidimbu chidiki chechipundu), iyo polyp inowanzo bviswa panguva yekolonoscopy.
Kununurwa kwenzvimbo: Kana gomarara rikawanikwa mukati memukati mechikamu uye risina kupararira mumadziro ereceum, gomarara uye hushoma hwehutachiona hwakakomberedza hunobviswa.
Kubvongodza: Kana gomarara rapararira kumadziro ereceum, chikamu chekenza nekenza uye zvinyama zvine hutano zviri pedyo zvinobviswa. Dzimwe nguva turu iri pakati perevhuru uye nemadziro emudumbu inobviswawo. Iwo ma "lymph node" ari padyo nereceum anobviswa otariswa pasi pe microscope kuti aone zviratidzo zvegomarara.
Radiofrequency ablation: Iko kushandiswa kweiyo yakakosha probe ine tudiki ma electrode anouraya cancer maseru. Dzimwe nguva probe inoiswa yakananga kuburikidza neganda uye inesthesia yemuno chete inodiwa. Mune zvimwe zviitiko, iyo probe inoiswa kuburikidza nekacheka mudumbu. Izvi zvinoitwa muchipatara neanesthesia yakajairika.
Cryosurgery: Mushonga unoshandisa chishandiso kupisa uye kuparadza zvisizvo zvisina kujairika. Mhando iyi yekurapa inonziwo cryotherapy.
Pelvic exenteration: Kana kenza yapararira kune dzimwe nhengo padhuze nereceum, iyo yezasi colon, rectum, uye bladder zvinobviswa. Mumadzimai, muromo wechibereko, mukadzi, mazai, uye node dzepedyo dzinogona kubviswa. Mune varume, prostate inogona kubviswa. Chakavanzika kuvhura (stoma) chinoitirwa weti uye chigaro kuyerera kubva mumuviri kuenda kuunganidzwa bhegi.

Mushure mekunge kenza yabviswa, chiremba anovhiya angave:

ita anastomosis (sona zvikamu zvine hutano zverende pamwe chete, sona iyo yakasara rectum kukoni, kana kusona colon kune anus);

or
gadzira stoma (kuvhura) kubva puruze kusvika kunze kwemuviri kuti tsvina ipfuure. Maitiro aya anoitwa kana gomarara riri padhuze nepaburi uye richinzi colostomy. Bhegi rakaiswa rakatenderedza stoma kutora marara. Dzimwe nguva iyo colostomy inongodiwa chete kusvikira rectum yapora, uyezve inogona kudzoserwa. Kana iyo rese rectum yabviswa, zvakadaro, iyo colostomy inogona kunge isingaperi.

Radiation therapy uye / kana chemotherapy inogona kupihwa usati wavhiyiwa kudzikisa bundu, kuita kuti zvive nyore kubvisa gomarara, uye kubatsira nekubata ura mushure mekuvhiyiwa. Mushonga unopihwa usati wavhiyiwa unonzi neoadjuvant therapy. Mushure mekunge kenza yese inogona kuonekwa panguva yekuvhiyiwa yabviswa, vamwe varwere vanogona kupihwa radiation radiation uye / kana chemotherapy mushure mekuvhiyiwa kuuraya chero gomarara maseru akasara. Mushonga wakapihwa mushure mekuvhiyiwa, kudzikisa njodzi yekuti gomarara richadzoka, inonzi adjuvant therapy.

Radiation kurapwa mukenza yakajeka

Radiation kurapa kurapwa kenza iyo inoshandisa yakakwira-simba x-ray kana mamwe marudzi emwaranzi kuuraya cancer maseru kana kuachengetedza kuti asakura. Kune mhando mbiri dzeradiotherapy kurapwa:

External radiation therapy inoshandisa muchina uri kunze kwemuviri kutumira radiation kune kenza.
Yemukati radiation kurapa inoshandisa radioactive chinhu chakanamwa mune tsono, mhodzi, waya, kana makateti anoiswa akananga mukati kana padyo nekenza.

Maitiro ekurapwa nemwaranzi anoenderana nerudzi uye nhanho yekenza iri kurapwa. External radiation therapy inoshandiswa kurapa chirwere chekenza.

Ipfupi-kosi preoperative radiation kurapwa kunoshandiswa mune mamwe marudzi ekenza rectal. Mushonga uyu unoshandisa mashoma uye akaderera madosi emwaranzi kupfuura kurapwa kwakajairwa, kuchiteverwa nekuvhiyiwa mazuva mazhinji mushure mekupedzisira muyero.

Chemotherapy mukenza yakajeka

Chemotherapy mushonga wekenza unoshandisa mishonga kumisa kukura kwemasero ekenza, kungave nekuuraya maseru kana nekumisa maseru kubva pakupatsanuka. Kana chemotherapy ikatorwa nemuromo kana kujowa mutsinga kana mhasuru, mishonga inopinda muropa uye inogona kusvika masero emukenza mumuviri wese (systemic chemotherapy). Kana chemotherapy ikaiswa yakanangana mucerebrospinal fluid, nhengo, kana dumbu remuviri senge dumbu, mishonga inokanganisa maseru egomarara munzvimbo idzodzo (chemotherapy yedunhu).

Chemoembolization yeiyo hepatic arteri rudzi rweyedunhu chemotherapy inogona kushandiswa kurapa kenza yakapararira kuchiropa. Izvi zvinoitwa nekudzivirira iyo hepatic artery (iyo huru arteri inopa ropa kuchiropa) uye jekiseni anticancer mishonga pakati pekuvhara uye chiropa. Tsinga dzechiropa dzinobva dzaendesa mishonga yacho muchiropa. Chishoma chete chemushonga chinosvika kune dzimwe nhengo dzemuviri. Kuvharika kwacho kungave kwechinguva kana kwechigarire, zvinoenderana nezvinoshandiswa kuvhara tsinga Chiropa chinoramba chichigamuchira rimwe ropa kubva kune iyo hepatic portal vein, iyo inotakura ropa kubva mudumbu uye ura.

Nzira iyo chemotherapy inopihwa inoenderana nerudzi uye nhanho yekenza iri kurapwa.

Ona Zvinodhaka Zvinotenderwa kuCoron uye Rectal Kenza kuti uwane rumwe ruzivo.

Kuongorora kuri kuita

Kushanda kwekutarisa kuri padhuze kutevera mamiriro emurwere pasina kupa chero kurapwa kunze kwekunge paine shanduko mune bvunzo mhedzisiro. Iyo inoshandiswa kuwana zviratidzo zvekutanga zvekuti mamiriro ari kuramba achiwedzera. Mukushingairira kwekutarisa, varwere vanopihwa mimwe bvunzo uye bvunzo kuti vaone kana gomarara riri kukura. Kana gomarara rikatanga kukura, kurapwa kunopihwa kurapa gomarara. Miedzo inosanganisira zvinotevera:

Dhijitari rectal bvunzo.
MRI.
Endoscopy.
Sigmoidoscopy.
CT scan.
Carcinoembryonic antigen (CEA) kuyedza.

Target yakatarwa kurapwa mukenza yakajeka

Targeted therapy mhando yekurapa inoshandisa zvinodhaka kana zvimwe zvinhu kuti zvione uye kurwisa chaiwo maseru ekenza pasina kukuvadza zvakajairika maseru.

Mhando dzeanotarisirwa marapirwo anoshandiswa pakurapa gomarara rekenza anosanganisira anotevera:

Monoclonal antibodies: Monoclonal antibody therapy imhando yekurapa kwakanangwa kuchishandiswa kurapa gomarara rekwere. Monoclonal antibody therapy inoshandisa masoja akagadzirwa murabhoritari kubva kune imwechete mhando yemasoja emuviri masero. Aya ma antibodies anokwanisa kuona zvinhu pane cancer cancer kana zvakajairika zvinhu zvinogona kubatsira gomarara maseru kukura. Masoja ekudzivirira chirwere anonamira pazvinhu uye anouraya maseru egomarara, anovharira kukura kwawo, kana kuti aachengetedze kubva pakupararira. Monoclonal antibodies inopihwa nekumisirwa. Inogona kushandiswa yoga kana kutakura zvinodhaka, chepfu, kana zvinhu zvine radioactive zvakanangana nemasero ekenza.
Kune mhando dzakasiyana dze monoclonal antibody therapy:
- Vascular endothelial growth factor (VEGF) inhibitor therapy: Masero eCancer anoita chinhu chinonzi VEGF, icho chinokonzera mitsipa yeropa mitsva kuumba (angiogenesis) uye inobatsira gomarara kukura. VEGF inhibitors inovhara VEGF uye inomisa mitsipa yeropa kubva pakuumba. Izvi zvinogona kuuraya cancer maseru nekuti anoda matsva eropa tsinga kuti akure. Bevacizumab uye ramucirumab ndivo VEGF inhibitors uye angiogenesis inhibitors.
- Epidermal growth factor receptor (EGFR) inhibitor therapy: EGFRs mapuroteni anowanikwa pamusoro pemamwe maseru, anosanganisira cancer maseru. Epidermal kukura chinhu chinonamira kune EGFR pamusoro pechiso uye chinokonzeresa kuti masero akure uye apatsanurane. EGFR inhibitors inodzivirira iyo inogamuchira uye inomisa iyo epidermal yekukura chinhu kubva pakubatanidza kune kenza kenza. Izvi zvinomisa kenza yesero kubva mukukura nekukamurwa. Cetuximab uye panitumumab ndivo EGFR inhibitors.
Angiogenesis inhibitors: Angiogenesis inhibitors inomisa kukura kwemidziyo yeropa mitsva iyo mamota anoda kukura.
- Ziv-aflibercept ndeyevascular endothelial kukura chinhu musungo unovhara enzyme inodiwa pakukura kwemidzi mitsva yeropa mumamota.
- Regorafenib inoshandiswa kurapa kenza yakajeka iyo yakapararira kune dzimwe nhengo dzomuviri uye isina kuwana zvirinani nekumwe kurapwa. Iyo inovhara chiito chemamwe mapuroteni, kusanganisira vascular endothelial kukura chinhu. Izvi zvinogona kubatsira kuchengetedza maseru ekenza kubva mukukura uye anogona kuvauraya. Izvo zvinogona zvakare kudzivirira kukura kwemidzi mitsva yeropa iyo mamota anoda kukura.

Immunotherapy mukenza yakajeka

Immunotherapy kurapwa kunoshandisa immune system yemurwere kurwisa gomarara. Zvinhu zvinogadzirwa nemuviri kana kugadzirwa murabhoritari zvinoshandiswa kusimudzira, kunongedza, kana kudzorera kudzivirira kwemuviri kurwisa kenza. Rudzi rwekurapa kenza urwu rwunonziwo biotherapy kana biologic therapy.

Immune checkpoint inhibitor therapy rudzi rwe immunotherapy:

Immune checkpoint inhibitor therapy: PD-1 ipuroteni iri pamusoro peT-maseru ayo anobatsira kuchengetedza mhinduro dzemumuviri. Kana PD-1 yakanamatira kune imwe protein inonzi PDL-1 pane kenza kenza, inomisa iyo T cell kuuraya kenza kenza. PD-1 inhibitors inonamira kuPDL-1 uye inobvumira iwo maseru eT kuuraya maseru ekenza. Pembrolizumab rudzi rwe immune checkpoint inhibitor.