Uyini umdlavuza we-esophageal?

Umphimbo uyishubhu elingenalutho, elinemisipha elixhuma umphimbo nesisu futhi lingamasentimitha angu-10 ubude. Kuyingxenye yesimiso somuntu sokugaya ukudla, okuvame ukwaziwa ngokuthi umgudu wamathumbu. Izindonga zomphimbo ziyahlangana lapho umuntu egwinya, ephushela ukudla esiswini.

Umdlavuza ubangelwa amangqamuzana anempilo aguqukayo futhi andise ngendlela engalawuleki, okuholela ekubeni kube nesimila. Amathumba angaba yingozi noma angabi nomdlavuza. Isimila esiyingozi yileso esinamandla okukhula futhi sisakazekele kwezinye izifunda zomzimba. Igama elithi “benign tumor” libhekisela esimila esingakhula kodwa singasakazeki. Umdlavuza womminzo, owaziwa kakhulu ngokuthi umdlavuza womminzo, uwuhlobo lomdlavuza oluqala emangqamuzaneni agudle umminzo.

Esophageal cancer, in particular, starts in the inner layer of the esophageal wall and spreads outward. It can spread through the esophageal wall to lymph nodes, which are small bean-shaped organs that help fight infection, as well as blood arteries in the chest and other surrounding organs, if it goes through the esophageal wall. Esophageal cancer has the potential to spread to the lungs, liver, stomach, and other organs.

Umdlavuza womminzo wuhlobo lomdlavuza oqala emthonjeni, okuyishubhu elide elingenalutho elixhuma umphimbo nesisu. I-esophagus yakho iyishubhu exhuma ngemuva komphimbo wakho nesisu sakho, lapho icutshungulwa khona.

Umdlavuza womminzo ngokuvamile uqala emangqamuzaneni azungeze ingaphakathi lomminzo. Umdlavuza womminzo ungakhula nganoma yisiphi isikhathi ku-esophagus. Umdlavuza womminzo uhlasela amadoda amaningi kunabesifazane.

I-Esophageal carcinoma iyimbangela yesithupha yokufa kwabantu ngenxa yomdlavuza emhlabeni jikelele. Amazinga okutheleleka ayashintsha kuye ngokuthi uhlala kuphi. Ukusetshenziswa kogwayi notshwala, kanye nemikhuba ethile yokudla nokukhuluphala, kungase kuxhunywe ezingozini ezinkulu zomdlavuza womminzo ezindaweni ezithile.

Yini ebangela umdlavuza womminzo?

Izinto ezingandisa ingozi yomdlavuza we-esophageal zihlanganisa:

• Ukubhema
• Ukuphuza kakhulu utshwala
• Ukuvutha kwenhliziyo okungapheli noma i-acid reflux
• Isifo se-reflux ye-gastroesophageal (GERD)
• I-Barrett's esophagus, isimo esivame ukuvela kubantu abane-GERD
• I-Achalasia, ukuphazamiseka okungavamile kwemisipha ku-esophagus engezansi

Izimpawu zomdlavuza wokuqopha

Izimpawu nezimpawu zomdlavuza we-esophageal zihlanganisa:

• Ubunzima bokugwinya (dysphagia)
• Ukuncipha kwesisindo ngaphandle kokuzama
• Ubuhlungu besifuba, ingcindezi noma ukushisa
• Ukungagayeki kahle kokudla noma isilungulela
• Ukukhwehlela noma ukuhayiza

Umdlavuza we-Early esophageal ngokuvamile awubangeli zimpawu noma izimpawu.

Sicela ukhulume nomhlinzeki wakho wokunakekelwa kwezempilo uma ukhathazekile nganoma yiziphi izinguquko ohlangabezana nazo. Ngokungeziwe kweminye imibuzo, udokotela wakho uzobuza mayelana nokuthi ubune(izimpawu) isikhathi esingakanani nokuthi kaningi kangakanani unalezi zimpawu. Lokhu kwenzelwa ukusiza ekutholeni imbangela yalesi simo, okubizwa ngokuthi ukuxilongwa.

Uma umdlavuza utholakala, ukukhululeka kwezimpawu kuyisici esibalulekile ekunakekelweni nasekulashweni komdlavuza. Lokhu kwaziwa ngokuthi ukunakekela okusizayo noma okusekelayo. Ivame ukuqaliswa ngokushesha ngemva kokuxilongwa futhi iqhubeke phakathi nesikhathi sokwelashwa. Yenza isikhathi sokubonana nomhlinzeki wakho wezempilo ukuze nixoxe ngezimpawu zakho, okuhlanganisa noma yiziphi izimpawu ezintsha noma ezishintshayo.

Izinhlobo zomdlavuza womminzo

Kunezinhlobo ezi-2 eziyinhloko zomdlavuza womphimbo:

I-squamous cell carcinoma: Lolu hlobo lomdlavuza womminzo luqala kuma-squamous cells ahambisana nomminzo. Ivamise ukukhula engxenyeni engenhla nemaphakathi yomminzo.

I-Adenocarcinoma: Lolu hlobo luqala esithweni sezindlala engxenyeni engezansi yomgudu lapho kuhlangana khona umphimbo nesisu.

Treatment is similar for both of these types of esophageal cancer. There are other types of very rare tumors of the esophagus. These include small cell neuroendocrine cancers, lymphomas, and i-sarcoma and make up less than 1% of esophageal cancers.

Ukuxilongwa komdlavuza we-esophageal

Ukuhlolwa nezinqubo ezisetshenziselwa ukuxilonga umdlavuza wommizo zihlanganisa:

• Isifundo sokugwinya kwe-barium. Phakathi nalolu cwaningo, ugwinya uketshezi oluhlanganisa i-barium bese wenza ama-X-ray. I-barium imboza ingaphakathi lomminzo wakho, elibe selibonisa noma yiziphi izinguquko esicukwini se-X-ray.
• Ukusebenzisa i-scope ukuhlola i-esophagus yakho (i-endoscopy). Ngesikhathi se-endoscopy, udokotela wakho udlulisa ishubhu eguquguqukayo efakwe ilensi yevidiyo (i-videoendoscope) yehle emphinjeni wakho iye emphinjeni wakho. Usebenzisa i-endoscope, udokotela wakho uhlola umminzo wakho, efuna umdlavuza noma izindawo zokucasuka.
• Ukuqoqa isampula yethishu ukuze ihlolwe (i-biopsy). Udokotela wakho angase asebenzise indawo ekhethekile eyedlule emphinjeni wakho ingene emphinjeni wakho (i-endoscope) ukuze aqoqe isampula yezicubu ezisolisayo (i-biopsy). Isampula lethishu lithunyelwa elabhorethri ukuyobheka amaseli omdlavuza.

Ukunquma izinga lomdlavuza

Uma ukuxilongwa komdlavuza we-esophageal sekuqinisekisiwe, udokotela wakho angase atuse ukuhlolwa okwengeziwe ukuze anqume ukuthi umdlavuza wakho ususabalele yini kuma-lymph nodes noma kwezinye izindawo zomzimba wakho.

Ukuhlola kungase kuhlanganise:

• I-bronchoscopy
• I-endoscopic ultrasound (EUS)
• I-Computerized tomography (CT)
• I-Positron emission tomography (PET)

Udokotela wakho uzokwabela isigaba somdlavuza wakho ngokusekelwe emiphumeleni yalezi zinqubo. Izigaba zomdlavuza womminzo zichazwa ngezinombolo zamaRoma ezisukela ku-0 kuye ku-IV, nezigaba eziphansi kakhulu ezibonisa ukuthi umdlavuza mncane futhi uthinta kuphela izingqimba zomminzo. Ngesigaba IV, umdlavuza ususabalele kwezinye izingxenye zomzimba futhi ubizwa ngokuthi ukuqhubeka.

Njengoba odokotela bethuthukisa ukutholwa nokwelashwa komdlavuza, uhlelo lokumisa umdlavuza luyaqhubeka nokuvela futhi luba nzima nakakhulu. Udokotela wakho uzokhetha izindlela zokwelapha ezilungele wena ngokusekelwe esigabeni sakho somdlavuza.

Ukwelashwa komdlavuza wommizo

Izinhlobo ezehlukene zochwepheshe zivame ukuhlanganyela ekunakekelweni komdlavuza ukuze kwakhiwe uhlelo lokwelapha lwesiguli lulonke, olungase luhlanganise izinhlobo ezihlukahlukene zokwelapha. Ithimba lezinhlaka eziningi yilokhu okubizwa ngakho. Abasizi bodokotela, abahlengikazi, abahlengikazi be-oncology, osonhlalakahle, osokhemisi, abeluleki, izazi zokudla okunomsoco, kanye nabanye ochwepheshe bezempilo bonke bayingxenye yamaqembu okwelapha umdlavuza.

Izinhlobo ezivame kakhulu zokwelapha umdlavuza womphimbo zibalwe ngezansi. Ukwelashwa kwezimpawu nemiphumela engemihle, okuyingxenye ebalulekile yokwelashwa komdlavuza, kungase kufakwe ohlelweni lwakho lokwelapha.

Uhlobo nesigaba somdlavuza, imiphumela engemihle engaba khona, kanye nezinto ezithandwa isiguli kanye nempilo iyonke, konke kuthonya izindlela zokwelapha nezincomo. Zinike isikhathi sokufunda ngazo zonke izindlela zokwelapha ongakhetha kuzo, futhi ungesabi ukubuza imibuzo uma unokuthile okukukhathazayo. Xoxa ngezinhloso zokwelashwa ngakunye nodokotela wakho, kanye nokuthi yini ongayilindela ngesikhathi sokwelashwa. “Ukwenza izinqumo okwabiwe” yitemu lalezi zinhlobo zezingxoxo. Uma wena nodokotela bakho nisebenza ndawonye ukuze nihlonze ukwelashwa okufana nezinhloso zakho zokunakekela, lokhu kwaziwa njengokuthatha izinqumo okwabiwe. Ngenxa yokuthi kunezinketho zokwelashwa eziningana zomdlavuza womphimbo, ukwenza izinqumo okwabelwana ngazo kubaluleke kakhulu. Thola kabanzi mayelana nokukhetha ukukhetha kokwelashwa.

Odokotela bavame ukuphakamisa ukuthi kuhlanganiswe izinhlobo eziningi zokwelapha isimila esingakadluli kummizo nama-lymph nodes, njengokwelashwa ngemisebe, ukwelashwa ngamakhemikhali, nokuhlinzwa. I-Chemotherapy kanye nokwelashwa ngemisebe ngezinye izikhathi kuhlanganiswe enkambweni eyaziwa ngokuthi "i-chemoradiotherapy." Indlela yokwelapha enikezwa ngayo iyahlukahluka kuye ngezimo eziningi, okuhlanganisa nohlobo lomdlavuza womminzo.

I-ASCO incoma indlela yokwelapha ehlanganisa izinhlobo eziningi zokwelapha umdlavuza wendawo wommizo othuthuke kakhulu.

I-Chemoradiotherapy ivame ukuphakanyiswa njengokwelashwa kokuqala kwe-squamous cell carcinoma. Kuye ngokuthi i-chemoradiotherapy isebenze kahle kangakanani, ukuhlinzwa kungasetshenziswa. Ngokocwaningo lwakamuva, i-chemoradiotherapy ngaphambi kokuhlinzwa ingcono kunokuhlinzwa kuphela. Bonke abantu abanomdlavuza we-esophageal squamous cell othuthukile kufanele bathole i-chemoradiotherapy ngaphambi kokuhlinzwa, ngokusho kwe-American Society of Clinical Oncology (ASCO). Lokhu kwelashwa kungase kubangele ukuthi umdlavuza udlulele ekuxolelweni kwabanye abantu, futhi kungase kungadingeki ukuhlinzwa ngokushesha. Uma amaseli e-tumor esabonakala esicutshini esikhishwe ngesikhathi sokuhlinzwa ngemva kwe-chemoradiotherapy nokuhlinzwa, i-immunotherapy (bheka ngezansi) ingase yelulekwe. Ukwelashwa ngemisebe kungase kungabi inketho kwabanye abantu. Ngaphambi kokuhlinzwa, abanye abantu bangathola i-chemotherapy bodwa.

Chemoradiotherapy is the most prevalent treatment for i-adenocarcinoma in the United States, followed by surgery. Unless there are conditions that increase the risks of surgery, such as a patient’s overall health, surgery is almost always indicated after chemoradiotherapy. ASCO advises chemoradiotherapy before surgery or chemotherapy before and after surgery for locally advanced esophageal cancer. If tumour cells are discovered in the tissue removed during surgery after chemoradiotherapy and surgery, immunotherapy (see below) may be advised. Surgery is not an option for some people. In that circumstance, chemoradiotherapy is the only treatment option. When chemotherapy and radiation therapy are used together, the adverse effects can be more severe. However, in other cases, this treatment combination may be more successful. It’s critical to discuss which treatment options are best for you with your doctor.

Ukuhlinza ukususa umdlavuza kungasetshenziswa uwedwa noma kuhlanganiswe nezinye izindlela zokwelapha.

Imisebenzi esetshenziselwa ukwelapha umdlavuza we-esophageal ihlanganisa:

• Ukuhlinzwa ukususa izimila ezincane kakhulu. Uma umdlavuza wakho umncane kakhulu, uvaleleke ezingxenyeni ezingaphezulu ze-esophagus yakho futhi ungazange usabalale, udokotela wakho ohlinzayo angase atuse ukususa umdlavuza kanye nomkhawulo wezicubu ezinempilo eziwuzungezile. Ukuhlinzwa kungenziwa kusetshenziswa i-endoscope eyedlule emphinjeni wakho futhi ingene emthonjeni wakho.
• Ukuhlinzwa ukuze kukhishwe ingxenye yomminzo (esophagectomy). Phakathi ne-esophagectomy, udokotela ohlinzayo ususa ingxenye ye-esophagus yakho equkethe umdlavuza, kanye nengxenye yengxenye engenhla yesisu sakho, nama-lymph nodes aseduze. Umminzo osele uxhunywa kabusha esiswini sakho. Ngokuvamile lokhu kwenziwa ngokudonsa isisu phezulu ukuze kuhlangatshezwane nomminzo osele.
• Ukuhlinzwa ukususa ingxenye yomminzo wakho kanye nengxenye engenhla yesisu sakho (i-esophagogastrectomy). Phakathi ne-esophagogastrectomy, udokotela ohlinzayo ususa ingxenye yomminzo wakho, ama-lymph nodes aseduze kanye nengxenye enkulu yesisu sakho. Isisu sakho esisele sibe sesidonswa futhi sixhunywe kumphimbo wakho. Uma kunesidingo, ingxenye yekholoni yakho isetshenziselwa ukusiza ukuhlanganisa kokubili.

Infection, haemorrhage, and leakage from the place where the surviving oesophagus is reattached to the stomach are all risks associated with esophageal cancer ukuhlinzwa.

Ukukhishwa kommizo wakho kungenziwa njengenqubo evulekile enezimbobo ezinkulu noma ngochungechunge lwamanxeba amancane esikhumbeni sakho ngemishini ethile yokuhlinza (i-laparoscopically). Indlela okwenziwa ngayo ukuhlinzwa kwakho inqunywa isimo sakho esiyingqayizivele kanye nendlela ethathwe udokotela wakho ohlinzayo ekubhekaneni naso.