ICarcinoma yamabanga aphansi angaziwa (CUP)

ICarcinoma yamabanga aphansi angaziwa (CUP)

I-Carcinoma ye-primary engaziwa (CUP) ivela lapho umdlavuza amaseli athuthele kuwo wonke umzimba futhi asungula izimila ze-metastatic, kodwa indawo yomdlavuza owumthombo ayaziwa. Yaziwa nangokuthi isimila esiyinhloko semilingo.

Indlela evame kakhulu odokotela yokuthola umdlavuza yilapho bethola indawo lapho kwaqala khona (isimila esiyinhloko). Lezo zindawo zingase zibonwe futhi uma umdlavuza isabalale (i-metastasized).

Odokotela bangakwazi ukubona amangqamuzana omdlavuza asakazeke kuwo wonke umzimba ku-carcinoma ye-primary engaziwa, eyaziwa nangokuthi i-occult primary umdlavuza, kodwa abakwazi ukuthola isimila esingaphansi.

Lapho benquma ngokwelashwa okungcono kakhulu, odokotela bahlola indawo yesimila esiyinhloko. Lapho kutholakala i-carcinoma enomthombo ongaziwa, odokotela balwela ukuthola indawo yokuqala yesimila. Uma uzama ukuthola ukuthi umdlavuza wakho waqala kuphi, udokotela wakho angase abheke izici zakho zobungozi, izimpawu, nokuhlolwa, ukuthwebula izithombe, kanye nemiphumela yokuhlolwa kwe-pathology.

Kungani umdlavuza oyinhloko ungatholakali?

Umdlavuza oyinhloko (umdlavuza owaqala ukuvela) ungase ungatholakali ngoba:

• Belilincane kakhulu ukuthi lingatholwa ngokuhlolwa kwezithombe.
• Amasosha omzimba wakho awubhubhisile.
• Yakhishwa ngesikhathi sokuhlinzwa ngenxa yesinye isizathu (ngingazi ukuthi ukhona umdlavuza owawukhona).

Izinhlobo ze-carcinoma ye-primary engaziwa (CUP)

I-Adenocarcinoma:  I-Adenocarcinoma ilandisa ngaphezu kuka-60% wezimila ezihlukaniswa njengomdlavuza womsuka ongaqinisekile. Lezi zimila zenziwe ngamangqamuzana e-epithelial akha indlala. Ngenxa yokuthi izindlala zihilelekile ekukhipheni noma ekuthutheni amakhemikhali, i-adenocarcinoma ingakheka cishe kunoma yisiphi isitho somzimba.

Ulwelwesi lwezitho zangaphakathi eziningi lwakhiwe amangqamuzana e-epithelial endlala. Lokhu kungenza kube nzima ukuthola indawo yokuqala yesimila. Amaphaphu, amanyikwe, amabele, i-prostate, isisu, isibindi, kanye nekholoni yizo zonke iziza ezijwayelekile ezisetshenziswayo. i-adenocarcinoma.

I-carcinoma ehlukaniswe kahle:

Amangqamuzana omdlavuza ahluke kabi atholakala kumaphesenti angu-20 kuya kwangu-30 azo zonke izifo ezimbi zemvelaphi engaqinisekiswanga. Lezi zifo ezimbi azibonakali njengamaseli avamile futhi zivame ukuba nolaka kunezinye izinhlobo zomdlavuza.

Lezi zomdlavuza kungenzeka ukuthi ziqale kuma-lymphocyte, amangqamuzana esikhumba, amangqamuzana e-neuroendocrine (akhiqiza amahomoni egazini), noma amanye amangqamuzana akhethekile, ngokusho kokuhlolwa okukhethekile. Ngakolunye uhlangothi, amangqamuzana omdlavuza amaningi ahlukaniswe kancane abonakala engafani namaseli avamile kangangokuthi odokotela abakwazi ukusungula uhlobo lwamangqamuzana abo okuqala.

I-squamous cell carcinoma: I-squamous cell carcinoma yenza ngaphansi kuka-10% wezifo ezimbi ngaphandle kwesizathu esaziwayo. Yakhiwe ngamangqamuzana e-epithelial ayisicaba angatholakala ebusweni besikhumba noma olwelweni lwezitho ezithile ezihlanganisa umlomo ne-esophagus. I-squamous cell carcinoma iwuhlobo lwe umdlavuza wamaphaphu.

I-Neuroendocrine carcinoma: Amaseli e-Neuroendocrine atholakala kwezinye izifo ezimbi zemvelaphi engacacile. Amaseli aqukethe ama-hormone noma akhiqiza ama-hormone awuhlu olubanzi lwezinhlobo zamaseli. Ngoba i-neuroendocrine carcinoma ingaqala noma kuphi emzimbeni, ukuthola indawo eyinhloko kungaba nzima.

Izimpawu ze-carcinoma ye-primary engaziwa (CUP)

Izimpawu nezimpawu ze-carcinoma ye-primary engaziwa zincike ekutheni iyiphi ingxenye yomzimba ehilelekile. Ngokuvamile, zingafaka:

• Isigaxa esingazwakala ngesikhumba
• Ubuhlungu
• Izinguquko emikhubeni yamathumbu, njengokuqunjelwa okusha nokuqhubekayo noma isifo sohudo
• Ukuvuthwa njalo
• Isikhukhula
• Fever
• Izithukuthuku ebusuku
• Ukwehlisa isisindo ngaphandle kokuzama

Izimbangela ze-carcinoma ye-primary engaziwa

Ngokuvamile, umdlavuza ukhula lapho i-DNA yamaseli iba noshintsho (ukuguqulwa kwezakhi zofuzo). Ikhodi ye-DNA iqukethe imiyalelo yamaseli okufanele ayilandele. Ukuguquka kwezakhi zofuzo ezithile kungavumela ingqamuzana ukuba lande ngokungalawuleki futhi liphile ngisho nalapho ngokuvamile belizobhubha. Ama-aberrant cells ahlangana ndawonye bese enza isimila ngenxa yalokho. I-Tumor amaseli angagqashuka futhi asakazekele kwezinye izindawo zomzimba (metastasize).

Amaseli omdlavuza asabalele kwezinye izindawo zomzimba abonwa ku-carcinoma engaziwa ukuthi ivelaphi. Nokho, isimila esiyinhloko asikatholakali.

Lokhu kungenzeka uma:

• Umdlavuza wangempela mncane kakhulu ukuthi ungabonwa ngokuhlolwa kwesithombe
• Umdlavuza wokuqala wabulawa amasosha omzimba
• Umdlavuza wangempela wakhishwa lapho kuhlinzwa esinye isimo

Ukuxilongwa kwe-carcinoma ye-primary engaziwa

Ukuhlolwa namasu alandelayo asetshenziselwa ukukhomba i-carcinoma yemvelaphi engaziwa:

Ukuhlolwa komzimba: Ukuze uthole izinkomba mayelana nokuxilongwa kwakho, udokotela wakho angase akubuze ngezimpawu zakho futhi ahlole indawo ekukhathazayo.
Ukuhlola ukuhlolwa ziyenziwa. Ukuhlolwa kwesithombe, okufana ne-X-ray, i-CT scan, noma i-MRI, kungase kusetshenziselwe ukusiza ekuxilongweni kwakho.
Ukuthatha isampula yethishu ukuze ihlolwe: Udokotela wakho angase aphakamise inqubo yokukhipha isampula lamaseli ukuze ahlolwe elebhu ukuze kuqinisekiswe ukuthi izimpawu zakho zidalwa umdlavuza (i-biopsy). Lokhu kungenziwa ngokujova inaliti esikhumbeni sakho, noma kungase kudingeke ukuthi uhlinzwe. Odokotela bazohlola amaseli e-lab ukuze babone ukuthi ayingozi yini nokuthi avelaphi.

Ukwelashwa kwe-carcinoma ye-primary engaziwa

Udokotela wakho uzohlola ukuthi amangqamuzana omdlavuza wakho atholwe kuphi, uhlobo lwamangqamuzana avamile afana kakhulu nawo, kanye nemiphumela yokuhlolwa ngelebhu lapho unquma ukuthi iziphi izindlela zokwelapha ezikulungele wena. Uhlelo lokwelashwa lwenzelwe izidingo zakho ezithile zomtholampilo kanye nezinto ozikhethayo.

Izindlela zokwelapha ezilandelayo zingasetshenziswa:

I-Chemotherapy: Ukwelashwa ngamakhemikhali iwukwelapha okusebenzisa amakhemikhali ukubulala amangqamuzana omdlavuza. Okukodwa noma ngaphezulu imiphumela emibi yokwelashwa ngamakhemikhali Imithi ingase inikezwe ngomthambo (ngokusebenzisa umthambo ongalweni), noma iphuzwe ngomlomo, noma inhlanganisela yakho kokubili. Uma unamaseli omdlavuza ezindaweni ezingaphezu kweyodwa, imiphumela emibi yokwelashwa ngamakhemikhali kungase kuphakanyiswe.

Ukwelashwa ngemisebe: Ukwelashwa kwamafutha wuhlobo lokwelapha olubandakanya ukusetshenziswa kwe-Ukubulala amaseli omdlavuza, ukwelashwa kwemisebe isebenzisa imishayo yamandla enamandla amakhulu evela emithonjeni efana nama-X ray nama-proton. Ulala etafuleni ngesikhathi ukwelashwa kwemisebe njengoba umshini uzungeza ngakuwe, usabalalisa imisebe ezindaweni ezithile emzimbeni wakho. Nge-carcinoma yemvelaphi engaziwa ekhawulelwe engxenyeni eyodwa yomzimba, ukwelashwa kwemisebe ingase iqashwe. Ingase futhi isetshenziselwe ukuphatha izimpawu, njengokungakhululeki okubangelwa isifo esiyingozi esikhulayo.

Ukuhlinzwa: Uma i-carcinoma yomthombo ongaziwa ikhawulelwe endaweni eyodwa, njenge-lymph node noma isibindi, ukuhlinzwa ukuze kukhishwe umdlavuza kungase kwenzeke. Ngemva kokuhlinzwa, udokotela wakho angase atuse ngemisebe ukuze kucekelwe noma yimaphi amangqamuzana omdlavuza asele.

Ukunakekelwa kwePalliative (okusekelayo): Ukunakekelwa kwe-Palliative kuwuhlobo lokwelashwa olugxile ekudambiseni ubuhlungu nezinye izimpawu ezihlobene nesifo esibi. Ochwepheshe bezokunakekelwa kwe-Palliative babambisana nawe, umndeni wakho, nabanye odokotela bakho ukuze bengeze isengezo esengeziwe sokwesekwa ekwelashweni kwakho okuqhubekayo. Ukunakekelwa kwe-Palliative kungasetshenziswa kanye nezinye izindlela zokwelapha ezinolaka ezifana nokuhlinzwa, i-chemotherapy, noma imisebe.