Umdlavuza weColon
Uyini umdlavuza kapopopo?
Umdlavuza we-colon waziwa nangokuthi umdlavuza we-colorectal. Umdlavuza we-Colorectal umdlavuza oqala ku-rectum noma ikholoni. Zombili lezi zitho ziyingxenye engezansi yesimiso sakho sokugaya ukudla. Ikholoni yaziwa nangokuthi ithumbu elikhulu. I-rectum isekupheleni kwekholoni.
Kubalulekile ukwazi izinga lomdlavuza wekoloni ukuze kuhlelwe ukwelashwa okufanele. Umdlavuza wekoloni uhlukaniswe izigaba ezi-4. Isigaba 1 yisigaba sangaphambili.
Izigaba zomdlavuza wamathumbu
- Isigaba 1. Umdlavuza usungenile olwelweni, noma kulwelwesi, lwekholoni noma lwe-rectum kodwa awukasabaleli ezindongeni zesitho.
- Isigaba 2. Umdlavuza ususabalele ezindongeni zekholoni noma i-rectum kodwa awukawathinti ama-lymph nodes noma izicubu eziseduze okwamanje.
- Isigaba 3. Umdlavuza usuthuthele kuma-lymph nodes kodwa hhayi kwezinye izingxenye zomzimba okwamanje. Ngokuvamile, ama-lymph nodes eyodwa kuya kwamathathu ahilelekile kulesi sigaba.
- Isigaba 4. Umdlavuza ususabalele kwezinye izitho ezikude, njengesibindi noma amaphaphu.
Izinhlobo zomdlavuza wekoloni
Ngenkathi umdlavuza colorectal kuzwakala kucace, empeleni kunezinhlobo zomdlavuza ezingaphezu koyedwa. Umehluko onjalo uhlobene nezinhlobo zamangqamuzana aphenduka abe umdlavuza kanye nokuthi akheka kuphi.
Uhlobo oluvame kakhulu lomdlavuza wekoloni luyaqala kusuka ku-adenocarcinoma. Ngokusho kwe-American Cancer Society, i-adenocarcinoma yenza amaphesenti angu-96 azo zonke izifo zomdlavuza wekoloni. Ngaphandle uma udokotela wakho esho okuhlukile, umdlavuza wakho wekholoni cishe ulolu hlobo. I-Adenocarcinomas yakha ngaphakathi kwamaseli e-mucus kukholoni noma ku-rectum.
Ngokuvamile, umdlavuza we-colorectal ubangelwa ezinye izinhlobo zezimila, njenge:
- i-lymphomas, engakheka kuma-lymph nodes noma kukholoni kuqala
- ama-carcinoids, aqala kumaseli enza amahomoni ngaphakathi kwamathumbu akho
- ama-sarcomas, akha ezicutshini ezithambile ezifana nemisipha kukholoni
- izimila stromal emathunjini, okungase kuqale njengokugula bese kuba nomdlavuza (Lokhu kuvame ukuvela emgudwini wokugaya ukudla, kodwa kuyaqabukela kuthunjana.)
Izimbangela zomdlavuza wekoloni
Odokotela abaqiniseki ukuthi yini ebangela umdlavuza wamakholoni amaningi.
Ngokuvamile, umdlavuza wekoloni uqala lapho amangqamuzana anempilo ekholoni enza izinguquko (ukuguqulwa) ku-DNA yawo. I-DNA yengqamuzana iqukethe iziqondiso ezitshela ingqamuzana lokho okumelwe lenze.
Amaseli anempilo akhula futhi ahlukane ngendlela ehlelekile ukuze ugcine umzimba wakho usebenza ngendlela evamile. Kodwa lapho i-DNA yeseli ilimele futhi iba nomdlavuza, amaseli ayaqhubeka nokuhlukana - ngisho nalapho amaseli amasha engadingeki. Njengoba amangqamuzana enqwabelana, akha a isisu.
Ngokuhamba kwesikhathi, amangqamuzana omdlavuza angakhula ahlasele futhi abhubhise izicubu ezivamile eduze. Futhi amangqamuzana anomdlavuza angahamba aye kwezinye izingxenye zomzimba ukuze akhe amadiphozithi lapho (metastasis).
Abacwaningi basacwaninga ngezimbangela zomdlavuza wesikhumba. Nakuba kunohlu olukhulayo lwezici eziyingozi, zisebenza zodwa noma zihlangene ukuze zandise ubungozi bokuthola umdlavuza we-colorectal.
Ukukhula okuyingozi
Amangqamuzana angavamile anqwabelana olwelweni lwekholoni, akhe ama-polyps. Lezi yizitshalo ezincane, ezinobuhle. Ukususa lezi zimila ngokuhlinzwa kuyindlela evamile yokuvimbela. Ama-polyps angalashwa angaba umdlavuza.
Ukuguqulwa kofuzo
Kwesinye isikhathi umdlavuza we-colorectal uvela kumalungu omndeni. Lokhu kungenxa yoguquko lofuzo olusuka kumzali luye enganeni. Lezi zinguquko aziqinisekisi ukuthi uzoba nomdlavuza we-colorectal, kodwa zandisa amathuba akho.
Izici eziyingozi zomdlavuza wekoloni
Imbangela eqondile yomdlavuza wekoloni ayaziwa. Odokotela ngokuvamile abakwazi ukuchaza ukuthi kungani umuntu eba nalesi sifo kanti omunye angakutholi. Nokho, ukuqonda kwezimbangela ezithile zofuzo kuyaqhubeka kwanda. Lezi zici ezilandelayo zingandisa ingozi yomuntu yokuba nomdlavuza wekoloni.
- Ubudala: Bangaphezu kuka-90% abantu abatholakala benomdlavuza we-colorectal ngemuva kweminyaka engama-50.
- Umlando womndeni womdlavuza we-colorectal (ikakhulukazi abazali noma izingane zakini).
- Umlando womuntu siqu we-Crohn's disease noma i-ulcerative colitis iminyaka eyisishiyagalombili noma ngaphezulu.
- Ama-polyps we-Colorectal.
- Umlando womuntu webele, umdlavuza wesibeletho noma wesibeletho.
Ezinye izici eziyingozi ezingagwemeki yilezi:
- umlando wangaphambili we-colon polyp
- umlando wangaphambili wezifo zamathumbu
- umlando womndeni womdlavuza we-colorectal
- Ukuba nesifo sofuzo, njenge-familia adenomatous polyposis (FAP)
- ungowozalo lwamaJuda aseMpumalanga Yurophu noma lwase-Afrika
Izici ezigwemekayo
Ezinye izici eziyingozi ziyagwemeka. Lokhu kusho ukuthi ungazishintsha ukuze unciphise amathuba okuba nomdlavuza we-colorectal. Izinto eziyingozi ezingagwemeka zihlanganisa:
- ukukhuluphala ngokweqile noma ukukhuluphala
- ukubhema
- ukuphuza kakhulu utshwala
- unesifo sikashukela sohlobo 2
- ukuba nempilo yokunganyakazi
- ukudla ukudla okuphezulu ekudleni okugayiwe noma inyama ebomvu
Izinto ezingase zandise ingozi yakho yomdlavuza wekoloni zihlanganisa:
- Ukuguga. Umdlavuza wamathumbu ungatholakala kunoma ibuphi ubudala, kodwa iningi labantu abanomdlavuza kapopopo lingaphezu kweminyaka engama-50. Amazinga omdlavuza kapopopo kubantu abangaphansi kweminyaka engama-50 aye anda, kodwa odokotela abanasiqiniseko sokuthi kungani.
- Umjaho wase-Afrika-waseMelika. Abantu base-Afrika-baseMelika basengozini enkulu yomdlavuza wekoloni kunabantu bezinye izinhlanga.
- Umlando womuntu siqu womdlavuza obala ngokusobala noma ama-polyps. Uma usuvele unomdlavuza we-colon noma ama-polyps angenayo umdlavuza, unengozi enkulu yomdlavuza wekoloni esikhathini esizayo.
- Izimo ezivuthayo zamathumbu. Izifo ezingapheli zokuvuvukala kwekholoni, njenge-ulcerative colitis nesifo sika-Crohn, zingandisa ingozi yomdlavuza wekoloni.
- Ama-syndromes azuzwe njengefa akhulisa ingozi yomdlavuza wekoloni. Okunye ukuguqulwa kofuzo okudlule ezizukulwaneni zomndeni wakho kungakhuphula kakhulu ingozi yomdlavuza wamakholoni. Iphesenti elincane kuphela lomdlavuza wamakholoni axhumene nezakhi zofuzo. Ama-syndromes atholakala ngofuzo avame kakhulu andisa ubungozi bomdlavuza wamakholoni yi-familia adenomatous polyposis (FAP) kanye ne-Lynch syndrome, eyaziwa nangokuthi i-hereditary nonpolyposis colorectal cancer (HNPCC).
- Umlando womndeni womdlavuza wekoloni. Kungenzeka kakhulu ukuthi uthuthukise ikholoni umdlavuza uma unegazi isihlobo esike saba nesifo. Uma amalungu omndeni angaphezu kwelilodwa anomdlavuza wekoloni noma umdlavuza wamabele, ingozi yakho inkulu nakakhulu.
- I-low-fiber, ukudla okunamafutha amaningi. Umdlavuza wekoloni nomdlavuza wamabele kungase kuhlotshaniswe nokudla okuvamile kwaseNtshonalanga, okune-fibre ephansi namafutha amaningi nama-calories. Ucwaningo kule ndawo lube nemiphumela exubile. Ezinye izifundo zithole ingozi eyengeziwe yomdlavuza wekoloni kubantu abadla ukudla okunenyama ebomvu nenyama egayiwe.
- Indlela yokuphila yokuhlala phansi. Abantu abangasebenzi banamathuba amaningi okuba nomdlavuza wamathumbu. Ukuvivinya umzimba njalo kunganciphisa ingozi yomdlavuza wekoloni.
- Isifo sikashukela. Abantu abanesifo sikashukela noma ukumelana ne-insulin banengozi eyengeziwe yomdlavuza wekoloni.
- Ukukhuluphala. Abantu abakhuluphele basengozini enkulu yokuba nomdlavuza wekoloni kanye nengozi eyengeziwe yokufa ngenxa yomdlavuza wekoloni uma beqhathaniswa nabantu ababhekwa njengesisindo esivamile.
- Ukubhema. Abantu ababhemayo bangaba nengozi eyengeziwe yomdlavuza wamathumbu.
- Utshwala. Ukusebenzisa kakhulu utshwala kwandisa amathuba okuba nomdlavuza wamathumbu.
- Ukwelashwa ngemisebe yomdlavuza. Ukwelashwa ngemisebe okuqondiswe esiswini ukuze kwelashwe umdlavuza wangaphambili kwandisa ingozi yomdlavuza wamathumbu.
Ukuxilongwa komdlavuza wekoloni
Ukuxilongwa kusenesikhathi komdlavuza we-colorectal kukunikeza ithuba elingcono kakhulu lokuwelapha.
Udokotela wakho uzoqala ngokuthola ulwazi mayelana nomlando wakho wezempilo kanye nomndeni. Bazokwenza nokuhlolwa komzimba. Bangase bacindezele isisu sakho noma benze ukuhlolwa kwe-rectal ukuze banqume ukuba khona kwezigaxa noma ama-polyps.
Ukuhlolwa kwegazi
Udokotela wakho angase ahlole igazi ukuze athole umbono ongcono wokuthi yini ebangela izimpawu zakho. Nakuba kungekho ukuhlolwa kwegazi okuhlola ngokuqondile umdlavuza we-colorectal, ukuhlolwa kokusebenza kwesibindi nokuhlolwa okuphelele kwenani legazi kungakhipha ezinye izifo nokuphazamiseka.
I-Colonoscopy
I-colonoscopy ihilela ukusetshenziswa kweshubhu elide elinekhamera encane, enamathiselwe. Le nqubo ivumela udokotela wakho ukuthi abone ngaphakathi kwekholoni yakho kanye ne-rectum ukuze ahlole noma yini engavamile.
Ngesikhathi se-colonoscopy, udokotela wakho angaphinde akhiphe izicubu ezindaweni ezingajwayelekile. Lawa masampula ezicubu angathunyelwa elabhorethri ukuze ahlaziywe.
X-ray
Udokotela wakho angase a-ode i-X-ray esebenzisa isixazululo sokungafani somsakazo esiqukethe i-metallic element barium. Udokotela wakho uzofaka lolu ketshezi emathunjini akho ngokusebenzisa i-enema. Uma ususendaweni, isixazululo se-barium simboza ulwelwesi lwekholoni. Lokhu kusiza ukuthuthukisa ikhwalithi yezithombe ze-X-ray.
CT scan
Ama-CT scan anikeza udokotela wakho isithombe esinemininingwane yekholoni yakho. Uma isetshenziselwa ukuxilonga umdlavuza we-colorectal, elinye igama le-CT scan yi-colonoscopy ebonakalayo.
Yiziphi izindlela zokwelapha umdlavuza we-colorectal?
Ukwelashwa komdlavuza we-colorectal kuncike ezintweni ezihlukahlukene. Isimo sempilo yakho iyonke kanye nesigaba somdlavuza wakho we-colorectal kuzosiza udokotela wakho ukuthi enze uhlelo lokwelapha.
Ukuhlinzwa
Ezigabeni zokuqala zomdlavuza we-colorectal, kungenzeka ukuthi udokotela wakho ohlinzayo asuse ama-polyp anomdlavuza ngokuhlinzwa. Uma i-polyp ingazange inamathele odongeni lwamathumbu, cishe uzoba nombono omuhle kakhulu.
Uma umdlavuza wakho ususabalele ezindongeni zamathumbu akho, udokotela wakho ohlinzayo angase adinge ukususa ingxenye yekholoni noma i-rectum, kanye nanoma imaphi ama-lymph nodes angomakhelwane. Uma kungenzeka, udokotela wakho ohlinzayo uzophinde anamathisele ingxenye esele enempilo yekholoni ku-rectum.
Uma lokhu kungenzeki, bangase benze i-colostomy. Lokhu kuhilela ukudala ukuvuleka odongeni lwesisu ukuze kukhishwe imfucuza. I-colostomy ingaba yesikhashana noma ibe unomphela.
Ukwelashwa ngamakhemikhali
I-Chemotherapy ihlanganisa ukusetshenziswa kwezidakamizwa ukubulala amangqamuzana omdlavuza. Endabeni yomdlavuza we-colorectal, i-chemotherapy iyindlela yokwelapha evamile ngemva kokuhlinzwa ukuze kucekelwe noma yimaphi amangqamuzana omdlavuza asele. I-Chemotherapy iphinde ilawule ukukhula kwezimila.
Nakuba i-chemotherapy inikeza ukukhululeka kwezimpawu ezithile kumdlavuza wesigaba sekwephuzile, imvamisa iza nemiphumela engemihle edinga ukulawulwa ngemithi eyengeziwe.
Umswakama
Ukukhishwa kwemisebe kusebenzisa umsebe wamandla onamandla, ofana nalowo osetshenziswa kuma-X ray, ukuze uqondise futhi ubhubhise amangqamuzana anomdlavuza ngaphambi nangemuva kokuhlinzwa. Ukwelashwa ngemisebe ngokuvamile kwenzeka kanye ne-chemotherapy.
Imithi
NgoSepthemba 2012, i-US Food and Drug Administration Umthombo Othembekile igunyaze isidakamizwa i-regorafenib (i-Stivarga) ukwelapha i-metastatic, noma isigaba sakamuva, umdlavuza wamathumbu ongaphenduli kwezinye izinhlobo zokwelashwa futhi osusakazekele kwezinye izingxenye zomzimba. Lesi sidakamizwa sisebenza ngokuvimbela ama-enzyme akhuthaza ukukhula kwamangqamuzana omdlavuza.
AMAPHUZU OMSEBENZI
- Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza kapopopo.
- Izinhlobo eziyisikhombisa zokwelashwa okujwayelekile zisetshenziswa:
- Ukuhlinzwa
- Ukuqothulwa kwemisebe ye-Radiofrequency
- Cryosurgery
- Ukwelashwa ngamakhemikhali
- Ukwelashwa kwamafutha
- Ukwelapha okuhlosiwe
- immunotherapy
- Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
- Ukwelashwa komdlavuza wamathumbu kungase kubangele imiphumela engemihle.
- Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.
- Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.
- Ukuhlolwa kokulandelela kungadingeka.
Ukuhlinzwa komdlavuza wamakoloni
Ukuhlinzwa (ukususa umdlavuza lapho uhlinzwa) kuwukwelashwa okuvame kakhulu kuzo zonke izigaba zomdlavuza wekoloni. Udokotela angase asuse umdlavuza esebenzisa olunye lwalezi zinhlobo ezilandelayo zokuhlinzwa:
- Ukukhishwa kwendawo: Uma umdlavuza utholakala kusenesikhathi, udokotela angase awususe ngaphandle kokusika udonga lwesisu. Esikhundleni salokho, udokotela angase afake ishubhu elinethuluzi lokusika embotsheni ye-rectum futhi akhiphe umdlavuza. Lokhu kubizwa ngokuthi ukukhishwa kwendawo. Uma umdlavuza utholakala ku-polyp (indawo encane eqhumayo yezicubu), ukuhlinzwa kubizwa nge-polypectomy.
- Ukukhishwa kabusha kwekholoni nge-anastomosis: Uma umdlavuza umkhulu, udokotela uzokwenza i-colectomy eyingxenye (esusa umdlavuza kanye nenani elincane lezicubu ezinempilo ezizungezile). Udokotela angase enze i-anastomosis (ukuthunga izingxenye ezinempilo zekholoni ndawonye). Udokotela uzophinde akhiphe ama-lymph nodes eduze kwekholoni futhi awahlole ngaphansi kwesibonakhulu ukuze abone ukuthi anomdlavuza yini.
Ukukhishwa kabusha kwekholoni nge-colostomy: Uma udokotela engakwazi ukuhlanganisa iziphetho ezi-2 zekholoni, i-stoma (imbobo) yenziwa ngaphandle komzimba ukuze kudlule imfucuza. Le nqubo ibizwa ngokuthi i-colostomy. Isikhwama sibekwe eduze kwe-stoma ukuze kuqoqwe udoti. Ngezinye izikhathi i-colostomy idingeka kuphela kuze kube yilapho ikholoni engezansi ipholile, bese ingabuyiselwa emuva. Uma udokotela edinga ukususa yonke ikholoni engezansi, noma kunjalo, i-colostomy ingase ibe unomphela.
Ngemva kokuba udokotela esuse wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, ezinye iziguli zingase zinikezwe i-chemotherapy noma i-radiation therapy ngemva kokuhlinzwa ukuze zibulale noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwa ngemva kokuhlinzwa, ukuze kwehliswe ingozi yokuthi umdlavuza uzobuya, kubizwa ngokuthi i-adjuvant therapy.
Ukuqothulwa kwemisebe ye-Radiofrequency
I-Radiofrequency ablation ukusetshenziswa kwe-probe ekhethekile enama-electrode amancane abulala amangqamuzana omdlavuza. Ngezinye izikhathi i-probe ifakwa ngqo esikhumbeni futhi i-anesthesia yendawo kuphela iyadingeka. Kwezinye izimo, i-probe ifakwa ngokusikwa esiswini. Lokhu kwenziwa esibhedlela nge-anesthesia jikelele.
Cryosurgery
I-Cryosurgery iwukwelashwa okusebenzisa ithuluzi ukumisa nokucekela phansi izicubu ezingavamile. Lolu hlobo lokwelashwa lubizwa nangokuthi i-cryotherapy.
Ukubikezelwa komdlavuza wekoloni
Ukuxilongwa komdlavuza we-colorectal kungathusa, kodwa iqiniso liwukuthi lolu hlobo lomdlavuza luyelapheka kakhulu, ikakhulukazi uma lubanjwe kusenesikhathi.
Izinyathelo zokwelapha sezihambe indlela ende ezimweni ezithuthuke kakhulu zomdlavuza wamathumbu. Ngokusho kweNyuvesi yaseTexas Southwestern Medical Center, isilinganiso sokusinda komdlavuza wekoloni wesigaba 4 cishe izinyanga ezingama-30. Lokhu kukhuphuka kusukela ezinyangeni eziyisi-6 kuye kweziyisi-8 okwakuyisilinganiso phakathi nawo-1990.
Ngesikhathi esifanayo, odokotela manje sebebona umdlavuza wekoloni ezigulini ezincane. Lokhu kungenzeka kungenxa yezinketho ezingezinhle zokuphila ezivame kakhulu kunamashumi eminyaka ngaphambili. I-American Cancer Society ithi, nakuba ukufa komdlavuza we-colon kuye kwehla jikelele, ukufa okuhlobene ezigulini ezingaphansi kweminyaka engama-55 kukhuphuke ngephesenti elilodwa ngonyaka phakathi kuka-1 no-2007.
Ukuvimbela umdlavuza wamathumbu
Ezinye izici eziyingozi zomdlavuza wekoloni, njengomlando womndeni neminyaka yobudala, azigwemeki. Nokho, izici zokuphila ezingase zibe nomthelela womdlavuza we-colorectal kukhona kungagwemeka, futhi kungasiza ukunciphisa ingozi yakho yonke yokuba nalesi sifo.
Ungathatha izinyathelo manje ukuze wehlise ubungozi bakho ngoku:
- ukunciphisa inani lenyama ebomvu oyidlayo
- ukugwema ukudla okugayiwe, njengezinja ezishisayo kanye nenyama yokupheka
- ukudla ukudla okunezitshalo eziningi
- ukunciphisa amafutha okudla ekudleni kwakho
- ukuzivocavoca nsuku zonke
- ukulahlekelwa isisindo, uma udokotela wakho ekuncoma
- ukuyeka ukubhema
- ukunciphisa ukusetshenziswa kotshwala
- ukuncipha kwengcindezi
- ukulawula isifo sikashukela esivele sikhona
Esinye isinyathelo sokuvimbela siwukuqinisekisa ukuthi uthola i-colonoscopy ngemva kweminyaka yobudala engama-50 - ngisho noma ungenazo izici eziyingozi zomdlavuza wekoloni. Uma umdlavuza usheshe utholakale, umphumela uba ngcono.
Ngemininingwane yokwelashwa komdlavuza wamaphaphu kanye nombono wesibili, sishayele ku- +91 96 1588 1588 noma ubhalele ku-cancerfax@gmail.com.
- Amazwana Avaliwe
- Julayi 28th, i-2020
