Umdlavuza we-anal

Uyini umdlavuza wendunu?

Umdlavuza wendunu yisifo lapho izicubu ze-anus ziba namaseli ayingozi (umdlavuza). Indunu isiphetho samathumbu amakhulu, ngaphansi kwe-rectum, lapho umzimba ushiya indle (imfucuza eqinile). Indunu yakheka ingxenye kusuka ezingxenyeni ezingaphandle zesikhumba futhi ingxenye isuka emathunjini. Imisipha emibili efana nendandatho ivula futhi ivale imbobo yendunu, ebizwa ngokuthi imisipha ye-sphincter, futhi idedele indle iphume emzimbeni. Cishe amayintshi angu-1-11⁄2 ubude umsele wendunu, ingxenye yendunu phakathi kwe-rectum kanye nokuvuleka kwendunu.

Isikhumba sibizwa ngokuthi indawo ye-perianal ezungeze ingaphandle lendunu. Izicubu zesikhumba sePerianal ezingathinti i-anal sphincter zivame ukuphathwa ngendlela efanayo nomdlavuza we-anal, yize abanye bengathola ukwelashwa kwasendaweni (ukwelashwa okuqondiswe endaweni encane yesikhumba).

Iningi lomdlavuza wendunu lihlobene nokutheleleka nge-human papillomavirus (HPV).

Izici zobungozi zomdlavuza wendunu

Izici zobungozi zomdlavuza wendunu zifaka okulandelayo:

• Ukutheleleka nge-human papillomavirus (HPV).
• Ukuba nesimo noma isifo esidala amasosha omzimba abuthakathaka, njenge-human immunodeficiency virus (HIV) noma ukufakelwa isitho somzimba.
• Ukuba nomlando womuntu siqu womdlavuza we-vulvar, sowesifazane sangasese, noma wesibeletho.
• Ukuba nabalingani abaningi ocansini.
• Ukuba nezocansi ezamukelekayo (ucansi lwendunu).
• Ukubhema osikilidi.

Izimpawu zomdlavuza wesitho sangasese zifaka ukopha okuvela endunu noma engxenyeni engaphezulu noma kwesigaxa esiseduze nendunu.

Umdlavuza we-Anal noma ezinye izinkinga zingabhekana nalezi nezinye izimpawu nezimpawu. Uma unezinye zalezi zinto ezilandelayo, thintana nodokotela wakho:

• Ukopha kusuka endunu noma engxenyeni.
• Isigaxa esiseduze nendunu.
• Ubuhlungu noma ingcindezi endaweni ezungeze indunu.
• Ukulunywa noma ukukhishwa endunu.
• Ukushintsha kwemikhuba yamathumbu.

Izivivinyo ezihlola i-rectum ne-anus zisetshenziselwa ukuxilonga umdlavuza wendunu.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukubheka izimpawu zezempilo ezijwayelekile, kufaka phakathi ukubheka izimpawu zokugula, njengezigaxa noma enye into ebonakala ingajwayelekile. Kuzobuye kube nesifinyeto samaphethini wesiguli uqobo nezimo zangaphambilini nokwelashwa.
• Ukuhlolwa kwamakhompiyutha edijithali (DRE): Ukuhlaziywa kwe-rectum ne-anus. Umunwe othanjisiwe, ofakwe igilavu ​​ufakwa engxenyeni engezansi ye-rectum ngudokotela noma umhlengikazi ukuzwa izigaxa noma enye into ebonakala ingajwayelekile.

• I-Anoscopy: Ukuhlolwa kwendunu kanye nengxenyeni engezansi kusetshenziswa i-anoscope ebizwa ngethambo elincane elikhanyayo.
• Proctoscopy: Ukuhlolwa nge-proctoscope ukubuka i-rectum ne-anus ukucinga izindawo ezisolisayo. Ukubuka ingaphakathi le-rectum ne-anus, i-proctoscope iyithuluzi elincane, elifana nethubhu elinokukhanya nelensi. Kungafaka futhi ithuluzi lokususwa kwamasampula wezicubu ahlolelwa izimpawu zomdlavuza ngaphansi kwesibonakhulu.
• I-Endo-anal noma i-endorectal ultrasound: Inqubo lapho kufakwa khona i-ultrasound transducer (isampula) kwi-anus noma i-rectum futhi isetshenziselwe ukubhampa nokwenza ama-echoes amaza omsindo aphezulu (i-ultrasound) asuse izicubu noma izitho zangaphakathi. Ama-echoes akha isithombe esibizwa nge-sonogram yezicubu zomzimba.
• Biopsy: Ukususwa kwamaseli noma izicubu ukuze udokotela wezifo azihlole ngaphansi kwesibonakhulu ukuze afune izimpawu zomdlavuza. I-biopsy ingenziwa ngaleso sikhathi uma indawo esolisayo ibonakala ngesikhathi se-anoscopy.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Isibikezelo sincike kulokhu okulandelayo:

• Usayizi wesimila.
• Ukuthi umdlavuza ususabalele kuma-lymph node.

Izinketho zokwelashwa zincike kokulandelayo:

• Isigaba somdlavuza.
• Lapho okukhona isimila endunu.
• Ukuthi isiguli sine-human immunodeficiency virus (HIV).
• Ukuthi umdlavuza uhlala ngemuva kokwelashwa kokuqala noma ubuyile.

Izigaba Zomdlavuza Wamasende

AMAPHUZU OMSEBENZI

• Ngemuva kokutholakala komdlavuza wendunu, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asabalele ngaphakathi kwendunu noma kwezinye izingxenye zomzimba.
• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.
• Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza wendunu:
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• Umdlavuza wesitho sangasese ungaphinde ubuye (ubuye) ngemuva kokuba welashwe.

Inqubo esetshenziswayo ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwendunu noma kwezinye izitho zomzimba ibizwa ngokuthi yi-staging. Isigaba sokugula sinqunywa ngemininingwane etholwe kule nqubo yesiteji. Ukuze uhlele ukwelashwa, kubalulekile ukwazi iphuzu. Enqubeni yesiteji, izivivinyo ezilandelayo zingasetshenziswa:

• Ukuskena kwe-CT (ukuskena kwe-CAT)Inqubo ethatha uchungechunge lwezithombe ezinemininingwane, ezithathwe ezinhlangothini ezahlukahlukene, zezindawo ezisemzimbeni, njengesisu, ukhalo, noma isifuba. Ikhompyutha exhunywe kumshini we-x-ray yenza izithombe. Ukwenza izitho noma izicubu zivele ngokucacile, idayi ingafakwa emthanjeni noma igwinywe. I-computed tomography, i-computer ene-computer, noma i-computer axial tomography nayo ibizwa ngale ndlela.
• I-X-ray yesifuba: I-x-ray yamathambo nezitho ngaphakathi kwesifuba. I-x-ray uhlobo lwesigongolo samandla esingangena sidlulele kwifilimu ngomzimba, sakhe isithombe sezindawo ezingaphakathi komzimba.
• I-MRI (imaging resonance imaging)Inqubo yokwenza uchungechunge lwezithombe ezifundisayo zezindawo ezingaphakathi komzimba kusetshenziswa uzibuthe, amagagasi omsakazo kanye nesiqaphi. Imvamisa eyaziwa ngokuthi i-nuclear magnetic resonance imaging, le ndlela yi- (NMRI).
• Ukuskena kwe-PET (scan positron emission tomography): Inqubo yokuhlonza amangqamuzana omzimba abulalayo omzimba. Inani elincane lifakwa emthanjeni one-glucose enemisebe (ushukela). Iskena se-PET sijikeleza umzimba wonke futhi sakha isithombe lapho umzimba usebenzisa khona i-glucose. Esithombeni, amangqamuzana amabi esigaxa abonakala ekhanya njengoba esebenza kakhulu futhi ethatha i-glucose eningi kunamaseli avamile.
• Ukuhlolwa kwepelvic: Isitho sangasese sowesifazane, umlomo wesibeletho, isibeletho, amashubhu e-fallopian, ama-ovari kanye nokuhlolwa kwe-rectum. Kufakwa i-speculum esithweni sangasese bese kuthi isitho sangasese sowesifazane nomlomo wesibeletho kuhlolwe udokotela noma umhlengikazi izimpawu zokugula. Ukuhlolwa kwephepha lomlomo wesibeletho kuvame ukwenziwa. Ukuze uzwe ukukala, ukuma, nendawo yesibeletho namaqanda, udokotela noma umhlengikazi uvame ukufaka umunwe owodwa noma emibili ethanjisiwe, efakwe igilavu ​​yesandla esisodwa esithweni sangasese bese ubeka esinye isandla phezu kwesisu esingezansi. Umunwe othanjisiwe, ovalwe uvamise ukufakwa engxenyeni ngudokotela noma umhlengikazi ukuzwela izigaxa noma izifunda ezingajwayelekile.

Yiziphi izinketho zokwelashwa kumdlavuza wendunu?

Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa komdlavuza we-Anal

• Ukuthengiswa kabusha kwasendaweni: Inqubo yokuhlinza lapho, kanye nezinye izicubu ezinempilo ezizungezile isimila sinqunywa endunu. Uma umdlavuza umncane futhi ungakaze usakazeke, ukusetshenziselwa kabusha kwendawo kungasetshenziswa. Le nqubo ingagcina imisipha ye-sphincter ukuze ukunyakaza kwamathumbu kusengalawulwa yisiguli. Ngokuvuselelwa kwendawo, izicubu ezikhula engxenyeni engezansi ye-anus nazo zingasuswa.
• Ukuthengiswa kabusha kwesisu: Inqubo yokuhlinzwa esusa ididi, irectum, kanye nengxenye yekholoni ye-sigmoid ngokusika okudalwe esiswini. Ukuze aqoqe udoti womzimba esikhwameni esilahlwayo ngaphandle komzimba, udokotela uthunga ukuphela kwamathumbu endaweni ebizwa ngokuthi i-stoma eyenziwe ebusweni besisu. I-colostomy ibizwa ngokuthi lokhu. Phakathi nale nqubo, ama-lymph nodes aqukethe umdlavuza nawo angasuswa. Le nqubo isetshenziselwa kuphela umdlavuza ophikelelayo noma obuyayo ngemva kokwelashwa ngemisebe kanye nokwelashwa ngamakhemikhali.

Ukuhlinzwa Komdlavuza Wamasende

Ukuhlinzwa akuyona inqubo yokuqala esetshenziselwa umdlavuza we-anal ezimweni eziningi. Indlela yenqubo incike ohlotsheni nasendaweni yesimila seziguli ezidinga ukuhlinzwa.

Ukuthengiswa kabusha kwasendaweni

Ukuthengiswa kwasendaweni kuyinqubo lapho kususwa khona isimila kuphela, kanye nomugqa omncane (onqenqemeni) wezicubu ezijwayelekile ezungeze isimila. Uma isimila sincane futhi singakasakazeki ezicutshini ezizungezile noma ama-lymph node, sisetshenziswa kakhulu ekwelapheni umdlavuza wekhasi lendunu.

Ukuthengiswa kwendawo kaningi kusindisa imisipha ye-sphincter evimbela isitokisi ukuthi singawi ngaphandle kuze kuphumule ngemuva kokuhamba kwamathumbu. Lokhu kusiza umuntu ngemuva kokuhlinzwa ukuthi ahambise amathumbu akhe ngokwemvelo.

Ukuthengiswa kabusha kwesisu

Inqubo enkulu ukubuyiswa kwesisu (noma i-APR). Esiswini (esiswini), udokotela ohlinzayo wenza ukusikeka okukodwa (ukusika) nomunye azungeze indunu ukukhipha ingquza kanye nengxenyeni. Noma yimaphi ama-lymph node azungezile nawo angasikwa ngudokotela ohlinzayo, kepha lokhu (okubizwa ngokuthi yi-dissection ye-lymph node) nakho kungenziwa ngokuhamba kwesikhathi.

I-anus (ne-anal sphincter) sezihambile, ngakho-ke kubalulekile ukwenza ukuvulwa okusha kwesitulo ukuphuma emzimbeni. Ukuphela kwekholoni kuxhunywe emgodini omncane (obizwa nge-stoma) owenziwe esiswini ukwenza lokhu. Ngokuvulwa, isikhwama sokuqoqa indle sinamathela emzimbeni. I-colostomy ibizwa ngale ndlela.

I-APR ibiyindlela yokwelapha ejwayelekile yomdlavuza wesitho sangasese esidlule, kepha odokotela bathole ukuthi ngokusebenzisa i-radiation therapy kanye ne-chemotherapy manje kungavikelwa njalo. I-APR isetshenziswa namuhla kuphela uma ezinye izindlela zokwelapha zingasebenzi noma uma umdlavuza ubuya ngemuva kokwelashwa.

Izingozi ezingaba khona nemiphumela engemihle yokuhlinzwa

Imiphumela emibi yokuhlinzwa, kufaka phakathi uhlobo lokuhlinzwa kanye nempilo yomuntu ngaphambi kokuhlinzwa, incike ezintweni eziningi. Ngemuva kwenqubo, abantu abaningi bangazizwa okungenani bengakhululekile, kepha ngokujwayelekile kungalawulwa ngemithi. Ezinye izingqinamba zingabandakanya ukusabela kwe-anesthesia, ukulimala kwezitho eziseduze, ukuvuvukala, amahlule egazi lomlenze, kanye nokutheleleka.

I-APR ibonakala inemiphumela engemihle eminingi, eminingi yayo okungukuthuthuka okuhlala isikhathi eside. Ungakhula izicubu ezibomvu (ezibizwa ngokuthi ukunamathela) esiswini sakho ngemuva kwe-APR, ngokwesibonelo, okungadala ukuthi izitho noma izicubu zihlangane. Lokhu kungadala ukuthi ukudla okudlula emathunjini kube nokungaphatheki kahle noma izinkinga, okungaholela ezinkingeni zokugaya ukudla.

Ngemuva kwe-APR, abantu basadinga i-colostomy yaphakade. Lokhu kuzothatha isikhashana ukujwayela izinguquko ezithile zendlela yokuphila futhi kungazisho.

I-APR ingadala izinkinga zokwakhiwa kwabesilisa, inkathazo yokuthola i-orgasm, noma ukwaneliseka kwe-orgasm kungancipha kakhulu. I-APR nayo ingalimaza izinzwa ezilawula ukuphuma kwe-ejaculation, okuholela kuma-orgasms "omile" (ama-orgasms ngaphandle kwesidoda).

Imvamisa, i-APR ayibangeli ukuthi abesifazane balahlekelwe ngumsebenzi wobulili, kepha ukunamathela esiswini (isikhumba esibomvu) kungadala ubuhlungu ngesikhathi sokuya ocansini.

Ukwelashwa kwemisebe yomdlavuza

Ukwelashwa ngemisebe ukwelashwa komdlavuza okuqeda amangqamuzana omdlavuza noma okuwavimbela ekukhuleni ngokusebenzisa i-x-ray enamandla amakhulu noma ezinye izinhlobo zemisebe. Izinhlobo ezimbili zokwelashwa ngemisebe ziyatholakala:

• Ukuletha imisebe esifundeni somzimba esinomdlavuza, ukwelashwa kwemisebe yangaphandle isebenzisa umshini ongaphandle komzimba.
• Into enemisebe eboshwe ngezinaliti, imbewu, amakhebuli, noma ama-catheters afakwa ngqo noma eduze komdlavuza isetshenziswa ekwelashweni kwemisebe yangaphakathi.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuya ngohlobo nesigaba somdlavuza owelashwa. Ukwelashwa kwemisebe yangaphandle neyangaphakathi kusetshenziselwa ukwelapha umdlavuza wendunu.

Indlela ejwayelekile kakhulu yomdlavuza wesitho sangasese yokwelashwa ngemisebe ukusebenzisa ugongolo olugxile lwemisebe evela emshinini ongaphandle komzimba. Lokhu kwaziwa njenge ukwelashwa kwemisebe yangaphandle.

Imisebe ingalimaza izicubu ezinempilo eziseduze namaseli womdlavuza. Lokhu kubangela imiphumela emibi. Ukunciphisa ubungozi bemiphumela emibi, odokotela bathola ngokucophelela umthamo oqondile owudingayo bese behlose imishayo ngokunembile ngangokunokwenzeka. Ngaphambi kokuqala ukwelashwa, iqembu lemisebe lizothola PET / CT noma i-MRI scan yendawo ezokwelashwa ukusiza ukuthola lokhu. Ukwelashwa ngemisebe kufana nokuthola i-x-ray, kepha imisebe inamandla kakhulu. Inqubo uqobo ayilimazi. Ukwelashwa ngakunye kuthatha imizuzu embalwa kuphela, kepha isikhathi sokusetha - ukukubeka endaweni yokwelashwa - imvamisa kuthatha isikhathi eside. Isikhathi esingamasonto ama-5 noma ngaphezulu, izindlela zokwelashwa zivamise ukunikezwa izinsuku ezinhlanu ngesonto.

Amasu amasha avumela odokotela ukuthi banikeze umdlavuza ngemithamo ephakeme yemisebe ngenkathi benciphisa imisebe ezicubwini ezinempilo eziseduze:

I-3D-CRT (ukwelashwa kwemisebe ehambisanayo oku-ntathu) isebenzisa amakhompyutha akhethekile ukudweba ngokuthembekile indawo yomdlavuza. Imishayo yemisebe yabe isakhiwa ivela ezinhlangothini eziningi bese iqondiswa isimila. Lokhu kubenza babe mancane amathuba okuthi izicubu ezijwayelekile zithinteke. Ukuze sikubambe endaweni efanayo isikhathi ngasinye, cishe uzofakwa isikhunta sepulasitiki njengomzimba womzimba ukuze imisebe iqondiswe ngokunembile.

Ifomu eliphambili lokwelashwa kwe-3-D kanye nendlela enconyiwe ye-EBRT yomdlavuza wesitho sangasese Ukwelashwa kwamandla emisebe (i-IMRT). Isebenzisa uhlelo oluqhutshwa yikhompyutha okuthi njengoba liletha imisebe, luhambe eduze kwakho. Ukuqina (amandla) kwemishayo kungashintshwa kanye nokwakha imishayo nokuyikhomba ezinhlangothini eziningi. Kuyasiza ukunciphisa umthamo ongena ezicutshini ezijwayelekile. I-IMRT isiza odokotela ukuphatha umthamo womdlavuza ophakeme kakhulu.

Imiphumela emibi yokwelashwa kwemisebe yangaphandle

Imiphumela engemihle iyahluka ngokuya ngengxenye yomzimba ephethwe kanye nomthamo wemisebe onikeziwe. Eminye imiphumela emibi ejwayelekile yokusetshenziswa kwesikhashana ifaka:

• Uhudo
• Izinguquko zesikhumba (njengokushiswa yilanga) ezindaweni ezilashwa
• Ukucasuka kwe-anal yesikhashana kanye nobuhlungu (obizwa nge-radiation proctitis)
• Ukungakhululeki ngesikhathi sokuhamba kwamathumbu
• Ukukhathala
• I-nausea
• Ukubalwa kwamaseli egazi aphansi

Imisebe ingacasula isitho sowesifazane sangasese kubantu besifazane. Lokhu kungaletha ukungakhululeki nokukhululwa.

Ngemuva kokuphela kwemisebe, iningi lale miphumela emibi iyaqina ngokuhamba kwesikhathi.

Futhi, imiphumela emibi yesikhathi eside ingenzeka:

• Ukulimala ngemisebe kwezicubu zangemuva kungadala izicubu ezibomvu. Lokhu kungavimbela futhi imisipha ye-anal sphincter ekusebenzeni njengoba kufanele, okungaba nomthelela ezindabeni zokuhamba kwamathumbu.
• Imisebe ye-pelvic ingalimaza amathambo, ikhuphule ubungozi bokuqhekeka kwamathambo noma okhalweni.
• Imisebe ingalimaza imithambo yegazi eyondla ulwelwesi lwe-rectum futhi ibangele i-radiation proctitis engapheli (ukuvuvukala kolwelwesi lwe-rectum). Ukuphuma kwegazi nokungajabuli kungabangelwa yilokhu.
• Imisebe ingathinta ukuzala (amandla okuba nezingane) kwabesifazane nabesilisa. (Ukuthola okuningi ngalokhu, bheka Ukuzala kanye naMadoda Anomdlavuza kanye Ukuzala kanye nabesifazane abanomdlavuza.)
• Imisebe ingaholela ekomeni kwesitho sangasese sowesifazane ngisho nokuncipha kwesitho sangasese sowesifazane (okubizwa nge-vaginal stenosis), okungenza ucansi lube buhlungu. Ngokwelula izindonga zesitho sakhe sangasese kaningi ngesonto owesifazane angasiza ukugwema le nkinga. Kungenzeka ukwenza lokhu usebenzisa i-dilator yesitho sangasese sowesifazane (ipulasitiki noma ithubhu yerabha esetshenziselwa ukwelula isitho sangasese sowesifazane).
• Kungaholela ezinkingeni zokuvuvukala ezithweni zangasese nasemilenzeni, ebizwa i-lymphedema, uma imisebe inikezwa ama-lymph node ku-groin.

Imisebe yangaphakathi (brachytherapy)

Ukuze welaphe umdlavuza wendunu, imisebe yangaphakathi ayisetshenziswa kabanzi. Lapho sisetshenziswa, lapho isimila singaphenduli ku-chemoradiation ejwayelekile, kuvame ukuhlinzekwa njengokwenyusa imisebe kanye nemisebe yangaphandle (i-chemo kanye nemisebe yangaphandle).

Imisebe yangaphakathi idinga ukufakwa noma eduze kwesimila semithombo emincane yezinto ezinemisebe ye-radioactive. Kungabizwa nangokuthi imisebe ye-intracavitary, i-radiation yangaphakathi, noma i-brachytherapy. Isetshenziselwa ukugxila emisebeni esifundeni somdlavuza.

Imiphumela emibi engaba khona ifana kakhulu naleyo ebonwa ngemisebe yangaphandle.

Ukwelashwa Kwemisebe Yomdlavuza We-Anal Cancer

Uhlobo oluvame kakhulu lwemisebe yomdlavuza wesinqe ukwelashwa ngemisebe okunamandla (IMRT). Kuyindlela yemisebe evela ngaphandle-ngogongolo. I-IMRT isebenzisa isoftware yekhompiyutha eyinkimbinkimbi kwezobuchwepheshe njengokuthi imishayo yemisebe ingabunjwa ngokufanele ngobukhulu besifunda sokwelashwa yithimba lakho lokunakekela.

Ongoti be-radiation oncologists kanye ne-physicists yezokwelapha bazoqoqa imininingwane enembile mayelana nendawo yokwelashwa ngaphambi kokuqala ukwelashwa. Uzoba:

• ukuskena kwe-CT ukudweba isimila ku-3-D
• I-PET, CT, neMRI iskena ukukhomba uhlaka lwesimila

Lolu lwazi lusetshenziswa yithimba lakho lokunakekela kanye namathuluzi wokuhlela ukwelashwa athuthukile. Singalinganisa inani elifanele lemishayo yemisebe kanye ne-engeli ngqo yaleyo migongolo ngalolu hlelo lokusebenza. Ngaphambi kokwelashwa ngemisebe, futhi ungathola ukwelashwa ngamakhemikhali ukuze unciphise amangqamuzana omdlavuza. Lokhu kubangela ukuthi imisebe iphumelele ngokwengeziwe.

Le ndlela isisiza ukuthi sinikeze isimila ngemithamo ethile yemisebe ngenkathi kugcinwa izicubu ezinempilo endaweni eseduze.

Ukwelashwa kwe-Proton yomdlavuza wendunu

Uhlobo lwemisebe olusebenzisa izinhlayiya ezishajiwe ezibizwa ngokuthi ama-proton ukwelashwa kwe-proton. Ama-X-ray asetshenziswa ngemisebe evamile. Ingozi yokulimala kwezicubu ezinempilo ingancishiswa ngokwelashwa kwe-proton ngoba imishayo ye-proton ayifinyeleli ngaphambili kwesimila. Kusisiza futhi ukuthi sinikeze imithamo ephezulu yemisebe, okwandisa ingozi yokubhujiswa kwesimila.

Indlela esanda kuqhamuka ukusebenzisa i-proton therapy ukwelapha umdlavuza wendunu. Izinzuzo zayo zisaphenywa ngodokotela. Ekwelapheni umdlavuza wekhanda nentamo nomdlavuza wobuntwana, i-proton therapy isetshenziswa kakhulu.

I-anal cancer chemotherapy

I-Chemotherapy luhlobo lokwelashwa komdlavuza olusebenzisa imishanguzo ukunqanda ukukhula kwamangqamuzana omdlavuza, kungaba ngokucekela phansi amaseli noma ngokuvimbela amaseli ukuthi angahlukani. Imithi ingena egazini uma i-chemotherapy ithathwa ngomlomo noma ifakwe emthanjeni noma emisipheni futhi ingafinyelela kumaseli omdlavuza emzimbeni (systemic chemotherapy).

Imithi emibili noma ngaphezulu isetshenziswa ngasikhathi sinye ezimweni eziningi, ngoba umuthi owodwa ungakhulisa ithonya lomunye.

I-5-fluorouracil (5-FU) ne-mitomycin iyinhlanganisela evelele yezidakamizwa ezisetshenziselwa ukwelapha umdlavuza wendunu.
Inhlanganisela ye-5-FU ne-cisplatin nayo iyasetshenziswa, ikakhulukazi kubantu abangakwazi ukuthola i-mitomycin noma abanomdlavuza osezingeni eliphezulu.

Kulezi zindlela zokwelapha, i-5-FU yinto esetshenziswa amahora angama-24 ngosuku emthanjeni izinsuku ezine noma ezinhlanu. Ifakwa empompini omncane ongahamba nawo ubuyele ekhaya. Kwezinye izinsuku ezithile esikhathini sokwelashwa, eminye imithi inikezwa ngokushesha okukhulu. Futhi okungenani amasonto ama-4, imisebe ihanjiswa izinsuku ezi-5 ngesonto.

Imiphumela emibi ye-chemo

Izidakamizwa ze-Chemo zihlasela amaseli ahlukanisa ngokushesha, yingakho enza ngokumelene namaseli omdlavuza. Kodwa amanye amaseli emzimbeni nawo ahlukana ngokushesha, njengalawo asemnkantsheni wethambo (lapho kukhiqizwa khona amangqamuzana egazi amasha), ulwelwesi lomlomo namathumbu, kanye nezicubu zezinwele. IChemo, nayo, kungenzeka ukuthi iwathinte la maseli, angaholela emiphumeleni emibi. Imiphumela emibi incike enanini lemithi esetshenzisiwe inani elithathiwe nesikhathi sokwelashwa. Imiphumela emibi yesikhathi esifushane ejwayelekile ingafaka:

• I-nausea nokuhlanza
• Ukulahlekelwa kwesifiso
• Ukulahlekelwa izinwele
• Uhudo
• Izilonda zomlomo

Iziguli zingaba nokubalwa kwamaseli egazi aphansi ngoba i-chemo ingabhubhisa amaseli akhiqiza igazi womnkantsha. Lokhu kuzoholela ku:

• Ithuba elandayo lokutheleleka (ngenxa yokushoda kwamaseli amhlophe egazi)
• Ukopha noma ukulimaza ngemuva kokusikeka okuncane noma ukulimala (ngenxa yokushoda kwamaplatelets egazi)
• Ukukhathala noma ukuphefumula okuncane (ngenxa yokubalwa kwamaseli abomvu abomvu).

• Amazwana Avaliwe
• Septhemba 2nd, 2020