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umdlavuza Colorectal

Uyini umdlavuza obala ibala?

I-rectum nekholoni kwakha amathumbu amakhulu, noma amathumbu amakhulu. I-rectum ingamasentimitha ayisithupha wokugcina wamathumbu amakhulu futhi ixhumanisa ikholoni nendunu. I-Cancer ye-rectum kanye / noma i-colon ibizwa ngokuthi umdlavuza we-colorectal futhi ingumdlavuza wesine ovame kakhulu e-United States. Imidlavuza emibili iqoqelwe ndawonye ngoba inezici eziningi futhi iphathwa ngokufanayo. Cishe ingxenye eyodwa kwezintathu yezigameko ezingama-145,000 zomdlavuza obala unyaka nonyaka ezitholakala ku-rectum.

Umdlavuza we-Rectal wenzeka lapho amaseli ku-rectum eguquka futhi ekhula ngaphandle kokulawulwa. Lesi sifo singakhula futhi lapho ukukhula, okubizwa ngokuthi ama-polyps, odongeni lwangaphakathi lwe-rectum kukhula futhi kube nomdlavuza.

Ingozi yomdlavuza we-rectal ikhula ngokukhula. Isilinganiso seminyaka yomuntu otholakale enomdlavuza onemibala engu-68. Abesilisa basengozini enkulu kunabesifazane. Ingcuphe yomdlavuza wesikhumba ingancishiswa, futhi lesi sifo singavinjelwa noma sibanjwe kusenesikhathi, ngokuhlolwa okuvamile nokushintshwa kwendlela yokuphila, njenge:

  • Ukusebenzisa
  • Ukudla inyama ebomvu engacutshungulwa kakhulu nefayibha nemifino eyengeziwe
  • Ukuyeka ukubhema
  • Ukunciphisa ukusetshenziswa kotshwala

Emhlabeni wonke, umdlavuza obala umbala wesibili ngumdlavuza wesibili ovame kakhulu kwabesifazane futhi ungowesithathu umdlavuza ovame kakhulu kwabesilisa.

Ziyini izimbangela zomdlavuza obala ngokobulili?

Umdlavuza we-Rectal wenzeka lapho amaseli anempilo ku-rectum eba namaphutha ku-DNA yawo. Ezimweni eziningi, imbangela yala maphutha ayaziwa.

Amaseli aphilile akhula futhi ahlukane ngendlela ehlelekile ukugcina umzimba wakho usebenza ngokujwayelekile. Kepha uma i-DNA yeseli yonakele futhi iba nomdlavuza, amangqamuzana ayaqhubeka ahlukane noma kungadingeki amaseli amasha. Njengoba amangqamuzana enqwabelana, akha isimila.

Ngokuhamba kwesikhathi, amangqamuzana omdlavuza angakhula ahlasele futhi abhubhise izicubu ezijwayelekile eziseduze. Futhi amaseli anomdlavuza angahambela ezinye izingxenye zomzimba.

Ukuguqulwa kwezakhi zofuzo okwandisa ubungozi bomdlavuza wekoloni nowesikhumba

Kweminye imindeni, ukuguqulwa kwezakhi zofuzo okudluliselwe kusuka kubazali kuya ezinganeni kwandisa amathuba okuba nomdlavuza obala. Lezi zinguquko zibandakanyeka kuphela kumaphesenti amancane omdlavuza wama-rectal. Ezinye izakhi zofuzo ezixhunyaniswe nomdlavuza we-rectal zandisa ingozi yomuntu yokuthuthukisa lesi sifo, kepha azenzi ukuthi kungenakugwemeka.

Ama-syndromes womdlavuza acaciswe kahle angaba:

  • Umdlavuza we-nonpolyposis colorectal cancer (HNPCC). I-HNPCC, ebizwa nangokuthi i-Lynch syndrome, yandisa ingozi yomdlavuza wekoloni namanye amagciwane. Abantu abane-HNPCC bavame ukuthuthukisa umdlavuza wekoloni ngaphambi kweminyaka engama-50.
  • I-adenomatous polyposis (FAP) ejwayelekile. I-FAP yisifo esingajwayelekile esidala ukuthi uhlakulele izinkulungwane zama-polyp emgqeni wekholoni ne-rectum yakho. Abantu abane-FAP abangalashwa banengozi enkulu kakhulu yokuthola umdlavuza wekoloni noma we-rectal ngaphambi kweminyaka engama-40.

I-FAP, i-HNPCC kanye namanye, ama-syndromes womdlavuza we-colorectal cancer angatholakala ngokuhlolwa kofuzo. Uma ukhathazekile ngomlando womndeni wakho womdlavuza wekoloni, khuluma nodokotela wakho mayelana nokuthi umlando wakho womndeni uphakamisa ukuthi unengozi yalezi zimo.

Ziyini izinto eziyingozi zomdlavuza obala ngokobulili?

Izici nezici zokuphila ezandisa ingozi yomdlavuza we-rectal zifana nalezo ezandisa ingozi yomdlavuza wekoloni. Kubandakanya:

  • Ukuguga. Iningi labantu abatholwa benomdlavuza wekoloni nowesitho sangaphezulu selineminyaka engaphezu kwengama-50. Umdlavuza ogqamile ungenzeka kubantu abasha, kodwa uvela kancane kakhulu.
  • Umdabu wase-Afrika-waseMelika. Abantu bozalo lwase-Afrika abazalelwe e-United States basengozini enkulu yokuba nomdlavuza obala kakhulu kunabantu bozalo lwaseYurophu.
  • Umlando womuntu siqu womdlavuza obala ngokusobala noma ama-polyps. Uma usuvele unomdlavuza we-rectal, umdlavuza we-colon noma ama-polyp adenomatous, unengozi enkulu yomdlavuza obala ngokuzayo.
  • Isifo samathumbu esivuthayo. Izifo ezingapheli zokuvuvukala kwekholoni ne-rectum, njenge-ulcerative colitis nesifo sikaCrohn, zandisa ingozi yokuba nomdlavuza obala kakhulu.
  • Ama-syndromes azuzwe njengefa akhulisa ubungozi bomdlavuza obucayi. Ama-syndromes ezakhi zofuzo adluliswa ezizukulwaneni zomndeni wakho angakhuphula ubungozi bakho bomdlavuza obucayi. Lawa ma-syndromes afaka i-FAP ne-HNPCC.
  • Umlando womndeni womdlavuza obomvu. Kungenzeka ukuthi ube nomdlavuza obomvu uma unomzali, ingane yakini noma ingane enalesi sifo. Uma ilungu lomndeni elingaphezu kwelilodwa linomdlavuza wekoloni noma umdlavuza we-rectal, ingozi yakho inkulu kakhulu.
  • Izici zokudla. Umdlavuza we-Colorectal ungahlotshaniswa nokudla okuphansi kwemifino kanye nenyama ebomvu ephezulu, ikakhulukazi lapho inyama ishiswa noma yenziwe kahle.
  • Indlela yokuphila yokuhlala phansi. Uma ungasebenzi, unamathuba amaningi okuba nomdlavuza obomvu. Ukuthola ukuvivinya umzimba njalo kunganciphisa ingozi yokuba nomdlavuza wamathumbu.
  • Isifo sikashukela. Abantu abanesifo sikashukela sohlobo lwe-2 esilawulwa kabi kanye nokumelana ne-insulin bangaba nengozi eyengeziwe yomdlavuza obala.
  • Ukukhuluphala. Abantu abakhuluphele banobungozi obandayo bomdlavuza obubomvu kanye nengozi eyengeziwe yokufa komdlavuza wekoloni noma we-rectal uma kuqhathaniswa nabantu ababhekwa njengesisindo esivamile.
  • Ukubhema. Abantu ababhemayo bangaba nengozi eyengeziwe yomdlavuza wamathumbu.
  • Utshwala. Ukuphuza njalo iziphuzo ezidakayo ezingaphezu kwezintathu ngesonto kungakhuphula amathuba okuba nomdlavuza wobala.
  • Ukwelashwa ngemisebe yomdlavuza odlule. Ukwelashwa ngemisebe okuqondiswe esiswini ukwelapha umdlavuza wangaphambilini kungakhuphula ingozi yomdlavuza wobala.

Ungawuthola kanjani umdlavuza onamabala amabi?

Ukuhlolwa okusetshenziselwa ukuthola umdlavuza we-rectal kufaka okulandelayo:

  • Ukuhlolwa ngokomzimba nomlando: Ukuhlolwa komzimba ukubheka izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.
  • Ukuhlolwa kwe-digital rectal (DRE): Ukuhlolwa kwe-rectum. Udokotela noma umhlengikazi ufaka umunwe othanjisiwe, ofakwe igilavu ​​engxenyeni engezansi ye-rectum ukuzwa izigaxa noma yini enye ebonakala ingajwayelekile. Kwabesifazane, isitho sangasese sowesifazane singabuye sihlolwe.
  • I-Colonoscopy: Inqubo yokubheka ngaphakathi kwe-rectum kanye ne-colon yama-polyps (izingcezu ezincane zezicubu ezibandayo), izindawo ezingajwayelekile, noma umdlavuza. I-colonoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa ama-polyps noma amasampuli wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
    • Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubukwe ngaphansi kwesibonakhulu ukuhlola izimpawu zomdlavuza. Izicubu zesimila ezisuswa ngesikhathi sokuhlolwa komzimba zingase zihlolwe ukuze kubonwe ukuthi isiguli kungenzeka yini sinezinguquko zofuzo ezibangela i-HNPCC. Lokhu kungasiza ukuhlela ukwelashwa. Lezi zivivinyo ezilandelayo zingasetshenziswa:
      • Ukubuyisela emuva ukuhlolwa kwe-transcription – polymerase chain reaction (RT – PCR)Ukuhlolwa kwelabhorethri lapho kulinganiswa inani lezinto zofuzo ezibizwa nge-mRNA ezenziwe ngofuzo oluthile. Kusetshenziswa i-enzyme ebizwa nge-reverse transcriptase ukuguqula ucezu oluthile lwe-RNA lube ucezu olufanayo lwe-DNA, olungakhuliswa (lwenziwe ngamanani amakhulu) ngenye i-enzyme ebizwa nge-DNA polymerase. Amakhophi we-DNA akhulisiwe asiza ukusho ukuthi ngabe i-mRNA ethile yenziwa ngofuzo. I-RT – PCR ingasetshenziselwa ukuhlola ukwenziwa kwezakhi zofuzo ezithile ezingakhombisa ukuba khona kwamangqamuzana omdlavuza. Lokhu kuhlolwa kungasetshenziselwa ukubheka ushintsho oluthile ku-gene noma i-chromosome, engasiza ukuthola umdlavuza.
      • Immunohistochemistry: Ukuhlolwa kwelabhorethri esebenzisa amasosha omzimba ukubheka ama-antigen (omaka) athile kusampula yezicubu zesiguli. Amasosha omzimba avamise ukuhlanganiswa ne-enzyme noma udayi we-fluorescent. Ngemuva kokuthi ama-antibody abophele kwi-antigen ethile kusampula yezicubu, i-enzyme noma idayi iyasebenza, bese kuthi i-antigen ibonakale ngaphansi kwesibonakhulu. Lolu hlobo lokuhlola lusetshenziselwa ukuxilonga umdlavuza nokusiza ukutshela uhlobo oluthile lomdlavuza kolunye uhlobo lomdlavuza.
    • Isilingo seCarcinoembryonic antigen (CEA): Isivivinyo esikala izinga le-CEA egazini. I-CEA ikhishwa ingene egazini kusuka kumaseli womdlavuza namaseli ajwayelekile. Lapho kutholakala ngamanani aphakeme kunejwayelekile, kungaba uphawu lomdlavuza we-rectal noma ezinye izimo.
      Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:
      • Isigaba somdlavuza (noma ngabe sithinta ulwelwesi lwangaphakathi lwe-rectum kuphela, sibandakanya lonke i-rectum, noma selusabalalele kuma-lymph node, ezithweni eziseduze, noma kwezinye izindawo emzimbeni).
      • Ukuthi isimila sesisakazele ngaphakathi noma odongeni lwamathumbu.
      • Lapho umdlavuza utholakala khona kunxande.
      • Noma ngabe ithumbu livinjiwe noma linembobo.
      • Ukuthi sonke isimila singasuswa ngokuhlinzwa.
      • Impilo ejwayelekile yesiguli.
      • Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Ziyini izigaba zomdlavuza obala ngokobulili?

  • Ngemuva kokutholakala komdlavuza wesibeletho, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kwe-rectum noma kwezinye izingxenye zomzimba.
  • Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
  • Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.
  • Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-rectal:
    • Isigaba 0 (I-Carcinoma eSitu)
    • Isigaba I
    • Isigaba II
    • Isigaba III
    • Isigaba IV

Ngemuva kokutholakala komdlavuza wesibeletho, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kwe-rectum noma kwezinye izingxenye zomzimba.

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza usabalale ngaphakathi kukalayini noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

  • I-X-ray yesifuba: I-x-ray yezitho namathambo ngaphakathi kwesifuba. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.
  • I-Colonoscopy: Inqubo yokubheka ngaphakathi kwe-rectum nekholoni yama-polyps (izingcezu ezincane zezicubu ezibandayo). izindawo ezingajwayelekile, noma umdlavuza. I-colonoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa ama-polyps noma amasampuli wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • Ukuskena kwe-CT (ukuskena kwe-CAT)Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, njengesisu, ukhalo, noma isifuba, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.
  • I-MRI (imaging resonance imaging)Inqubo esebenzisa uzibuthe, amagagasi omsakazo nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).
  • Ukuskena kwe-PET (scan positron emission tomography): Inqubo yokuthola amangqamuzana amabi esigaxa emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.
  • I-endorectal ultrasoundInqubo esetshenziselwa ukuhlola i-rectum nezitho eziseduze. I-ultrasound transducer (iphenyo) ifakwa kunxande futhi isetshenziselwe ukubhebhethekisa amaza omsindo aphezulu (i-ultrasound) ezicutshini zangaphakathi noma ezithweni bese yenza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Udokotela angabona izimila ngokubheka i-sonogram. Le nqubo ibizwa nangokuthi i-transrectal ultrasound.

Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

Umdlavuza ungasakazeka ngezicubu, uhlelo lwe-lymph, kanye negazi:

  • Izicubu. Umdlavuza usakazeka lapho uqale khona ngokukhulela ezindaweni eziseduze.
  • Uhlelo lweLymph. Umdlavuza usakazeka lapho uqale khona ngokungena ohlelweni lwe-lymph. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.
  • Igazi. Umdlavuza usakazeka lapho uqale khona ngokungena egazini. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.

Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Lapho umdlavuza usakazekela kolunye uhlangothi lomzimba, ubizwa ngokuthi yi-metastasis. Amaseli womdlavuza aqhamuka lapho aqale khona (isimila sokuqala) futhi ahamba ngohlelo lwe-lymph noma igazi.

  • Uhlelo lweLymph. Umdlavuza ungena ohlelweni lwe-lymph, udabule emithanjeni ye-lymph, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.
  • Igazi. Umdlavuza ungena egazini, udabule emithanjeni yegazi, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

Isigaxa se-metastatic luhlobo olufanayo lomdlavuza njengesimila sokuqala. Isibonelo, uma umdlavuza we-rectal usakazeka emaphashini, amangqamuzana omdlavuza amaphaphu empeleni amangqamuzana omdlavuza we-rectal. Lesi sifo umdlavuza we-rectal metastatic, hhayi umdlavuza wamaphaphu.

 

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-rectal:

Isigaba 0 (I-Carcinoma eSitu)

Esigabeni 0 somdlavuza we-rectal, amaseli angajwayelekile atholakala ku-mucosa (ungqimba lwangaphakathi) lodonga lwe-rectum. Lawa maseli angajwayelekile angaba ngumdlavuza futhi asabalale abe izicubu ezijwayelekile eziseduze. Isigaba 0 sibizwa nangokuthi i-carcinoma in situ.

Isigaba I umdlavuza ocacile

Esigabeni I umdlavuza we-rectal, umdlavuza wakhekile ku-mucosa (ungqimba lwangaphakathi) odongeni lwe-rectum futhi usakazekele ku-submucosa (ungqimba lwezicubu eduze kwe-mucosa) noma kusendlalelo semisipha sodonga lwe-rectum.

Isifo somdlavuza wesigaba II

Umdlavuza wesigaba sesibili II uhlukaniswe ngezigaba IIA, IIB, kanye ne-IIC.

  • Isigaba IIA: Umdlavuza usabalele ungqimba lwezicubu zodonga lwe-rectum kuya ku-serosa (ungqimba olungaphandle kakhulu) lwodonga lwe-rectum.
  • Isigaba IIB: Umdlavuza usabalale nge-serosa (ungqimba olungaphandle kakhulu) lwodonga lwe-rectum kuya ezicutshini ezibeka izitho esiswini (i-visceral peritoneum).
  • Isigaba IIC: Umdlavuza usabalale nge-serosa (ungqimba olungaphandle kakhulu) lodonga lwe-rectum kuya ezithweni eziseduze.

Isifo somdlavuza wesigaba III

Umdlavuza wesigaba sesithathu III uhlukaniswe ngezigaba IIIA, IIIB, kanye ne-IIIC.

Esigabeni IIIA, umdlavuza usakazekile:

  • ngokusebenzisa i-mucosa (ungqimba lwangaphakathi) lodonga lwe-rectum kuya ku-submucosa (ungqimba lwezicubu eduze kwe-mucosa) noma kusendlalelo semisipha sodonga lwe-rectum. Umdlavuza usabalalele kwesinye kuya kwamathathu ama-lymph node noma amangqamuzana omdlavuza abunjwe ezicutshini eziseduze kwama-lymph node; noma
  • ngokusebenzisa i-mucosa (ungqimba lwangaphakathi) lodonga lwe-rectum kuya ku-submucosa (ungqimba lwezicubu eduze kwe-mucosa). Umdlavuza usabalalele ezindaweni ezine kuya kweziyisithupha eziseduze.

Esigabeni IIIB, umdlavuza usakazekile:

  • ngokusebenzisa ungqimba lomsipha wodonga lwe-rectum kuya ku-serosa (ungqimba olungaphandle kakhulu) lwodonga lwe-rectum noma lusabalale nge-serosa kuya ezicutshini ezibeka izitho esiswini (i-visceral peritoneum). Umdlavuza usabalale waya kolunye kuya kwamathathu ama-lymph node noma amangqamuzana omdlavuza akhiwe ezicutshini eziseduze kwama-lymph node; noma
  • kusendlalelo semisipha noma ku-serosa (ungqimba olungaphandle kakhulu) lwodonga lwe-rectum. Umdlavuza usabalalele ezindaweni ezine kuya kweziyisithupha zama-lymph node; noma
  • ngokusebenzisa i-mucosa (ungqimba lwangaphakathi) lodonga lwe-rectum kuya ku-submucosa (ungqimba lwezicubu eduze kwe-mucosa) noma kusendlalelo semisipha sodonga lwe-rectum. Umdlavuza usabalalele kuma-lymph node aseduze ayisikhombisa noma ngaphezulu.

Esigabeni IIIC, umdlavuza usakazekile:

  • ngokusebenzisa i-serosa (ungqimba olungaphandle kakhulu) lwodonga olungunxande kuya ezicutshini ezibeka izitho esiswini (i-visceral peritoneum). Umdlavuza usabalalele ezindaweni ezine kuya kweziyisithupha zama-lymph node; noma
  • ngokusebenzisa ungqimba lomsipha wodonga lwe-rectum kuya ku-serosa (ungqimba olungaphandle kakhulu) lwodonga lwe-rectum noma lusabalale nge-serosa kuya ezicutshini ezibeka izitho esiswini (i-visceral peritoneum). Umdlavuza ususabalale waba ezindaweni ezingama-lymph eziyisikhombisa noma ngaphezulu eziseduze; noma
  • ngokusebenzisa i-serosa (ungqimba olungaphandle kakhulu) lwodonga lwe-rectum kuya ezithweni eziseduze. Umdlavuza usabalalele kwelinye noma ngaphezulu ama-lymph node noma amangqamuzana omdlavuza akha izicubu eduze kwama-lymph node.

Umdlavuza wesigaba IV ovuthayo

Umdlavuza wesigaba se-IV uhlukaniswe ngezigaba ze-IVA, IVB, ne-IVC.

  • Isigaba IVA: Umdlavuza usabalalele endaweni eyodwa noma isitho esiseduze ne-rectum, njengesibindi, amaphaphu, i-ovary, noma i-lymph node ekude.
  • Isigaba IVB: Umdlavuza usabalalele endaweni engaphezu kweyodwa noma isitho esiseduze ne-rectum, njengesibindi, amaphaphu, i-ovary, noma i-lymph node ekude.
  • Isigaba IVC: Umdlavuza usabalalele ezicutshini ezigoqa udonga lwesisu futhi kungenzeka ukuthi zisabalalele nakwezinye izindawo noma ezithweni.

Umdlavuza Wokubuyisa Ophindayo

Umdlavuza ophindaphindiwe womdlavuza wesifo somdlavuza obuye wabuya (ubuye) ngemuva kokuba welashwe. Umdlavuza ungabuya ku-rectum noma kwezinye izingxenye zomzimba, njengekholoni, ukhalo, isibindi noma amaphaphu.

Uphathwa kanjani umdlavuza obomvu?

  • Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza we-rectal.
  • Izinhlobo eziyisithupha zokwelashwa okujwayelekile zisetshenzisiwe:
    • Ukuhlinzwa
    • Ukwelashwa kwamafutha
    • Ukwelashwa ngamakhemikhali
    • Ukuqapha okusebenzayo
    • Ukwelapha okuhlosiwe
    • immunotherapy
  • Ezinye izinhlobo zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
  • Ukwelashwa komdlavuza we-rectal kungadala imiphumela emibi.
  • Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.
  • Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.
  • Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza obala ngokwebala.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza we-rectal. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zomtholampilo zikhombisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izinhlobo eziyisithupha zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa ngomdlavuza obala ngokwezibalo

Ukuhlinzwa ukwelashwa okuvame kakhulu kuzo zonke izigaba zomdlavuza we-rectal. Umdlavuza ususwa kusetshenziswa enye yezinhlobo zokuhlinzwa ezilandelayo:

  • I-Polypectomy: Uma umdlavuza utholakala ku-polyp (ucezu oluncane lwezicubu ezibandayo), i-polyp ivame ukususwa ngesikhathi se-colonoscopy.
  • Ukudonswa kwendawo: Uma umdlavuza utholakala engxenyeni engaphakathi le-rectum futhi awusakazekanga odongeni lwe-rectum, umdlavuza nenani elincane lezicubu ezinempilo ezizungezile liyasuswa.
  • Ukutholakala kabusha: Uma umdlavuza usakaze odongeni lwe-rectum, isigaba se-rectum esinomdlavuza kanye nezicubu ezinempilo eziseduze ziyasuswa. Kwesinye isikhathi izicubu eziphakathi kwengxenyeni nodonga lwesisu nazo ziyasuswa. Ama-lymph node aseduze ne-rectum ayasuswa futhi ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • I-Radiofrequency ablation: Ukusetshenziswa kwephenyo ekhethekile enama-electrode amancane abulala amangqamuzana omdlavuza. Kwesinye isikhathi iphenyo lifakwa ngqo ngesikhumba futhi kudingeka kuphela i-anesthesia yendawo. Kwezinye izimo, iphenyo lifakwa ngokusikeka esiswini. Lokhu kwenziwa esibhedlela nge-anesthesia ejwayelekile.
  • I-Cryosurgery: Ukwelashwa okusebenzisa ithuluzi lokuqandisa nokubhubhisa izicubu ezingavamile. Lolu hlobo lwezokwelapha lubizwa nangokuthi i-cryotherapy.
  • Ukuqina kwepelvic: Uma umdlavuza usakaze kwezinye izitho eziseduze ne-rectum, ikholoni engezansi, i-rectum, nesinye kuyasuswa. Kwabesifazane, umlomo wesibeletho, isitho sangasese sowesifazane, ama-ovari, nama-lymph node aseduze kungasuswa. Emadodeni, i-prostate ingasuswa. Ukuvulwa kokufakelwa (stoma) kwenzelwa umchamo nesitulo ukugeleza kusuka emzimbeni kuya esikhwameni sokuqoqa.

Ngemuva kokuthi umdlavuza ususwe, udokotela ohlinzayo uzoba:

  • yenza i-anastomosis (thunga izingxenye ezinempilo ze-rectum ndawonye, ​​thunga i-rectum esele kukholoni, noma uthunge ikholoni endunu);
  • or
  • yenza i-stoma (imbobo) kusuka engxenyeni iye engaphandle komzimba ukuze kudlule imfucuza. Le nqubo yenziwa uma umdlavuza usondele kakhulu endunu futhi ubizwa ngokuthi yi-colostomy. Kubekwa isikhwama esizungeze i-stoma ukuqoqa imfucuza. Kwesinye isikhathi i-colostomy idingeka kuphela kuze kuphole i-rectum, bese ingaguqulwa. Uma yonke i-rectum isusiwe, noma kunjalo, i-colostomy ingahlala unomphela.

Ukwelashwa ngemisebe kanye / noma ukwelashwa ngamakhemikhali kunganikezwa ngaphambi kokuhlinzwa ukuze kuncishiswe isimila, kwenze kube lula ukukhipha umdlavuza, nokusiza ekulawuleni amathumbu ngemuva kokuhlinzwa. Ukwelashwa okunikezwa ngaphambi kokuhlinzwa kubizwa ngokuthi ukwelashwa kwe-neoadjuvant. Ngemuva kokuthi wonke umdlavuza obonakala ngesikhathi sokuhlinzwa ususiwe, ezinye iziguli zinganikezwa i-radiation therapy kanye / noma i-chemotherapy ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwe ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

Ukwelashwa ngemisebe emdlavuzeni obomvu

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Kunezinhlobo ezimbili zokwelashwa ngemisebe:

  • Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni.
  • Ukwelashwa kwemisebe yangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuya ngohlobo nesigaba somdlavuza owelashwa. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha umdlavuza we-rectal.

Ukwelashwa kwemisebe emincane yangaphambi kokuhlinzwa kusetshenziswa kwezinye izinhlobo zomdlavuza wesikhumba. Le ndlela yokwelashwa isebenzisa imithamo emincane nephansi yemisebe kunokwelashwa okujwayelekile, kulandelwe ukuhlinzwa ezinsukwini ezimbalwa ngemuva komthamo wokugcina.

Ukwelashwa ngamakhemikhali emdlavuzeni obala

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuvimba amaseli ukuthi angahlukani. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda).

I-Chemoembolization ye-artery hepatic uhlobo lwe-chemotherapy yesifunda engasetshenziselwa ukwelapha umdlavuza osakaze esibindini. Lokhu kwenziwa ngokuvimba umthambo we-hepatic (umthambo omkhulu onikeza igazi esibindini) nokujova imishanguzo yokulwa nomdlavuza phakathi kokuvaleka nesibindi. Imithambo yesibindi bese ihambisa izidakamizwa esibindini. Inani elincane kuphela lomuthi elifinyelela kwezinye izingxenye zomzimba. Ukuvinjelwa kungaba okwesikhashana noma unomphela, kuya ngokuthi yini esetshenziselwa ukuvimba umthambo. Isibindi siyaqhubeka nokuthola igazi elivela emthanjeni we-portatic hepatic, ophethe igazi esiswini nasemathunjini.

Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Bheka Izidakamizwa ezivunyelwe i-Colon ne-Rectal Cancer ukuthola eminye imininingwane.

Ukuqapha okusebenzayo

Ukuqapha okusebenzayo kulandela eduze isimo sesiguli ngaphandle kokunikeza noma yiluphi ukwelashwa ngaphandle kokuthi kube nezinguquko emiphumeleni yokuhlolwa. Isetshenziselwa ukuthola izimpawu zakuqala zokuthi isimo siya ngokuba sibi kakhulu. Ekuqapheni okusebenzayo, iziguli zinikezwa izivivinyo ezithile nokuhlolwa ukubheka ukuthi umdlavuza uyakhula yini. Lapho umdlavuza uqala ukukhula, kunikezwa imishanguzo yokwelapha umdlavuza. Ukuhlolwa kufaka okulandelayo:

  • Ukuhlolwa kwe-rectal digital.
  • I-MRI.
  • I-Endoscopy.
  • I-Sigmoidoscopy.
  • CT scan.
  • Isilingo seCarcinoembryonic antigen (CEA).

Ukwelashwa okubhekiswe kumdlavuza we-colorectal

Ukwelashwa okuhlosiwe uhlobo lwezokwelapha olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile.

Izinhlobo zezindlela zokwelashwa ezihlosiwe ezisetshenziselwa ukwelashwa komdlavuza we-rectal zifaka okulandelayo:

  • Ama-antibody e-monoclonal: Ukwelashwa kwe-monoclonal antibody uhlobo lwezokwelapha ezihlosiwe ezisetshenziselwa ukwelapha umdlavuza we-rectal. I-monoclonal antibody therapy isebenzisa amasosha omzimba enziwe elebhu evela ohlotsheni olulodwa lwamaseli omzimba. La ma-antibody angakhomba izinto kumaseli womdlavuza noma ezintweni ezijwayelekile ezingasiza amangqamuzana omdlavuza ukuthi akhule. Amasosha omzimba anamathela ezintweni futhi abulale amangqamuzana omdlavuza, avimbe ukukhula kwawo, noma awagcine ekusakazekeni. Ama-antibody e-monoclonal anikezwa ngokumnika. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi, noma okokukhipha imisebe ngqo emangqamuzaneni omdlavuza.

    Kunezinhlobo ezahlukahlukene zokwelashwa kwe-antioclonal antibody:

    • Ukwelashwa kwe-inhibitor endothelial factor factor (VEGF) inhibitor therapy: Amaseli womdlavuza enza into ebizwa nge-VEGF, edala ukuthi kwakheke imithambo yegazi emisha (angiogenesis) futhi isize umdlavuza ukuba ukhule. Ama-VEGF inhibitors avimba i-VEGF futhi amise imithambo yegazi emisha ukuba yakheke. Lokhu kungabulala amangqamuzana omdlavuza ngoba adinga imithambo emisha yegazi ukuze ikhule. I-Bevacizumab ne-ramucirumab yi-VEGF inhibitors kanye ne-angiogenesis inhibitors.
    • Ukwelashwa kwe-inhibitor ye-Epidermal factor factor (EGFR): Ama-EGFRs amaprotheni atholakala ebusweni bamaseli athile, kufaka phakathi amangqamuzana omdlavuza. Isici sokukhula se-Epidermal sinamathela ku-EGFR ebusweni beseli futhi sidale ukuthi amangqamuzana akhule futhi ahlukane. Ama-inhibitors e-EGFR avimba i-receptor futhi amise isici sokukhula se-epidermal ekuhlanganiseni neseli lomdlavuza. Lokhu kumisa iseli lomdlavuza ukuthi lingakhuli lihlukane. I-Cetuximab ne-panitumumab yi-EGFR inhibitors.
  • Ama-angiogenesis inhibitors: Ama-angiogenesis inhibitors amisa ukukhula kwemithambo yegazi emisha okudingeka ukuthi izimila zikhule.
    • I-Ziv-aflibercept isicupho se-vasot endothelial growth factor esivimba i-enzyme edingekayo ekukhuleni kwemithambo yegazi emisha kwizicubu.
    • I-Regorafenib isetshenziselwa ukwelapha umdlavuza obala ngokwebala osabalalele kwezinye izitho zomzimba futhi awuzange ube ngcono nolunye ukwelashwa. Ivimbela ukwenziwa kwamaprotheni athile, kufaka phakathi isici se-vasot endothelial grow factor. Lokhu kungasiza ukugcina amangqamuzana omdlavuza angakhuli futhi angawabulala. Kungavimbela nokukhula kwemithambo yegazi emisha okudingeka ukuthi izimila zikhule.

I-Immunotherapy kumdlavuza obomvu

I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Izinto ezenziwe ngumzimba noma ezenziwe elabhoratri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba kumdlavuza. Lolu hlobo lokwelashwa komdlavuza lubizwa nangokuthi i-biotherapy noma i-biologic therapy.

Ukwelashwa kwe-immune checkpoint inhibitor therapy uhlobo lwe-immunotherapy:

  • Ukwelashwa kwe-inhibitor yokuhlola amasosha omzimba: I-PD-1 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba womzimba zibhekiwe. Lapho i-PD-1 inamathela kwenye iprotheni ebizwa nge-PDL-1 kuseli lomdlavuza, iyeka i-T cell ekubulaleni iseli lomdlavuza. Ama-PD-1 inhibitors anamathisela ku-PDL-1 futhi avumela amaseli we-T ukuthi abulale amangqamuzana omdlavuza. I-Pembrolizumab uhlobo lwe-immune checkpoint inhibitor.
 

Ukwelashwa komdlavuza we-Colorectal yi-Stage

Isigaba 0 (I-Carcinoma eSitu)

Ukwelashwa kwesigaba 0 kungafaka okulandelayo:

  • I-polypectomy elula.
  • Ukuqothulwa kwendawo.
  • Ukuphinda uthole (lapho isimila sikhulu kakhulu ukuthi singasuswa ngokuqunywa kwasendaweni).

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo.

Isigaba I Umdlavuza Wengxenye

Ukwelashwa komdlavuza we-rectal wesigaba I kungafaka okulandelayo:

  • Ukuqothulwa kwendawo.
  • Ukuthola kabusha.
  • Ukuphinda uthole ukwelashwa ngemisebe nokwelashwa ngamakhemikhali ngemuva kokuhlinzwa.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo.

Ukwelashwa komdlavuza wesigaba II no-III

Ukwelashwa kwesigaba II somdlavuza we-rectal wesigaba III kungafaka okulandelayo:

  • Ukuhlinzwa.
  • I-Chemotherapy ihlangene nokwelashwa ngemisebe, kulandele ukuhlinzwa.
  • Ukwelashwa kwemisebe emifushane okulandelwa ukuhlinzwa nokwelashwa ngamakhemikhali.
  • Ukuphinda kulandelwe kulandelwe ukwelashwa ngamakhemikhali kuhlangene nokwelashwa ngemisebe.
  • I-Chemotherapy ihlangene nokwelashwa ngemisebe, kulandelwa ukubhekwa okusebenzayo. Ukuhlinzwa kungenziwa uma umdlavuza ubuyela emuva (ubuya emuva).
  • Isivivinyo somtholampilo sokwelapha okusha.

Isigaba IV kanye nokwelashwa komdlavuza ophindaphindiwe

Ukwelashwa kwesigaba IV kanye nomdlavuza ophindaphindiwe wesikhumba kungafaka okulandelayo:

  • Ukuhlinzwa nge-chemotherapy noma nge-radiation therapy noma ngaphandle kwayo.
  • Ukwelashwa ngamakhemikhali okuhleliwe noma ukwelashwa okuhlosiwe noma okungenakho (i-angiogenesis inhibitor).
  • I-chemotherapy ehlelekile ene-immunotherapy noma engenayo (i-immune checkpoint inhibitor therapy).
  • I-Chemotherapy yokulawula ukukhula kwesimila.
  • Ukwelashwa ngemisebe, i-chemotherapy, noma inhlanganisela yakho kokubili, njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.
  • Ukubekwa kwe-stent ukusiza ukugcina i-rectum ivulekile uma ivinjelwe ingxenye yesifo, njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.
  • I-Immunotherapy.
  • Ukuhlolwa kwemitholampilo kwe-chemotherapy kanye / noma ukwelashwa okuhlosiwe.

Ukwelashwa komdlavuza wesikhumba osakaze kwezinye izitho kuncike lapho umdlavuza usakaze khona.

  • Ukwelashwa kwezindawo zomdlavuza osekusabalale kwesibindi kufaka lokhu okulandelayo:
    • Ukuhlinzwa ukukhipha isimila. I-Chemotherapy inganikezwa ngaphambi kokuhlinzwa, ukunciphisa isimila.
    • I-Cryosurgery noma i-radiofrequency ablation.
    • I-Chemoembolization kanye / noma i-chemotherapy yesistimu.
    • Isivivinyo somtholampilo se-chemoembolization esihlanganiswe nokwelashwa ngemisebe kuya kwizicubu zesibindi.
    Ngemininingwane yokwelashwa komdlavuza wesikhumba kanye nombono wesibili, sishayele ku- + 91 96 1588 1588 noma ubhalele ku-cancerfax@gmail.com.
  • Amazwana Avaliwe
  • Julayi 28th, i-2020

Umdlavuza we-Pancreatic

Okuthunyelwe Okwedlule:
okuthunyelwe

Sarcoma

Okuthunyelwe Okulandelayo:

Qala ingxoxo
Siku-inthanethi! Xoxa Nathi!
Skena ikhodi
Sawubona,

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Sazise ukuthi yini esingakwenzela yona.

1) Ukwelashwa komdlavuza phesheya?
2) Ukwelashwa kwe-CAR T-Cell
3) Umuthi wokugomela umdlavuza
4) Ukubonisana ngevidiyo eku-inthanethi
5) Ukwelashwa kweProton