Umdlavuza we-Pancreatic

Uyini umdlavuza we-pancreatic?

Umdlavuza we-pancreatic uqala lapho amangqamuzana angavamile ku-pancreas ekhula futhi ehlukana ngaphandle kokulawuleka futhi akhe isimila. I kwamanyikwe iyindlala etholakala ekujuleni kwesisu, phakathi kwesisu nomgogodla. Yenza ama-enzyme asiza ukugaya namahomoni alawula amazinga kashukela egazini. Izitho, njengamanyikwe, zakhiwe ngamaseli. Ngokuvamile, amangqamuzana ayahlukana akhe amangqamuzana amasha njengoba umzimba uwadinga. Lapho amangqamuzana eguga, ayafa, futhi amangqamuzana amasha athatha indawo yawo. Kwesinye isikhathi le nqubo iyaphuka. Amaseli amasha akha lapho umzimba ungawadingi, noma amangqamuzana amadala angafi. Amaseli engeziwe angase akhe inqwaba yezicubu ezibizwa ngokuthi a isisu. Ezinye izimila zikhona benign. Lokhu kusho ukuthi azijwayelekile kodwa azikwazi ukuhlasela ezinye izingxenye zomzimba. A okubi isimila sibizwa ngokuthi umdlavuza. Amaseli akhula ngendlela engalawuleki futhi angasakazekela kwezinye izicubu nezitho zomzimba. Ngisho noma umdlavuza ususabalele kwezinye izingxenye zomzimba, usabizwa ngokuthi umdlavuza we-pancreatic uma kulapho waqala khona. Umdlavuza we-pancreatic uvame ukusabalala uye esibindini, odongeni lwesisu, emaphashini, emathanjeni kanye/noma noma kuma-lymph nodes.

Izinhlobo zomdlavuza we-pancreatic

Umdlavuza we-Exocrine uwuhlobo oluvame kakhulu lomdlavuza wamanyikwe. Uma utshelwa ukuthi unomdlavuza we-pancreatic, cishe umdlavuza we-exocrine pancreatic. I-adenocarcinoma ye-pancreatic: Cishe ama-95% omdlavuza we-exocrine pancreas yi-adenocarcinomas. Le midlavuza ivamise ukuqala emiseleni yamanyikwe. Kancane kancane, zikhula zisuka kumaseli enza ama-enzyme e-pancreatic, lapho abizwa khona i-acinar cell carcinomas. Izinhlobo ezingavamile zomdlavuza we-exocrine: Okunye, umdlavuza we-exocrine ongavamile uhlanganisa i-adenosquamous carcinomas, i-squamous cell carcinomas, i-signet ring cell carcinomas, i-carcinomas engahlukanisi, kanye ne-carcinomas engahlukanisi namaseli amakhulu. Umdlavuza we-Ampullary (i-carcinoma ye-ampulla ye-Vater): Lo mdlavuza uqala ku-ampulla ye-Vater, okuyindawo lapho ithunjana le-bile kanye ne-pancreatic duct lihlangana khona bese lithululela emathunjini amancane. Umdlavuza we-Ampullary awuwona umdlavuza we-pancreatic, kodwa ufakiwe lapha ngoba uphathwa ngendlela efanayo. Umdlavuza we-ampullary uvame ukuvimba i-bile duct ngenkathi isencane futhi ingasakazeki kude. Lokhu kuvimbeka kudala ibile emzimbeni, okuholela ekutheni isikhumba namehlo sibe phuzi (ijaundice). Ngenxa yalokhu, lezi zomdlavuza zivame ukutholakala ngaphambi komdlavuza we-pancreatic, futhi ngokuvamile zine-prognosis engcono (umbono).

Izimila ze-Benign pancreatic

Ezinye izimila ku-pancreas zimane zilungile (hhayi umdlavuza), kanti ezinye zingase zibe umdlavuza ngokuhamba kwesikhathi uma ziyekwa zingelashwa (okwaziwa ngokuthi omdlavuza). Ngenxa yokuthi abantu bathola ukuhlolwa kwe-imaging okufana ne-CT scan kaningi kunangaphambili (ngenxa yezizathu ezimbalwa), lezi zinhlobo zokukhula kwe-pancreatic manje sezitholakala kaningi. Ama-serous cystic neoplasms (SCNs) (obeye aziwe njengo i-cystadenoma ye-serous) yizimila ezinamasaka (cysts) agcwele uketshezi. Ama-SCN cishe ahlala enempilo, futhi amaningi awadingi ukwelashwa ngaphandle uma ekhula noma edala izimpawu. Ama-mucinous cystic neoplasms (MCNs) (obeye aziwe njengo i-cystadenoma ye-mucinous) amathumba akhula kancane anamaqhubu agcwele into efana nejeli ebizwa ngokuthi mucin. Lezi zimila cishe zenzeka njalo kwabesifazane. Yize bengewona umdlavuza, abanye babo bangathuthukela kumdlavuza ngokuhamba kwesikhathi uma bengelashwa, ngakho lezi zimila zivame ukususwa ngokuhlinzwa. I-Intraductal papillary mucinous neoplasms (IPMNs) yizimila eziyingozi ezikhula kuma-pancreas. Njengama-MCN, lezi zimila zenza i-mucin, futhi ngokuhamba kwesikhathi ziba umdlavuza uma zingelashwa. Amanye ama-IPMN angavele alandelwe eduze ngokuhamba kwesikhathi, kodwa amanye angase adinge ukususwa ngokuhlinzwa uma enezici ezithile, njengokuthi asemgudwini omkhulu we-pancreatic. I-Solid pseudopapillary neoplasms (SPNs) ayivelakancane, izimila ezikhula kancane ezihlala zivela kwabesifazane abasebasha. Nakuba lezi zimila zivame ukukhula kancane, ngezinye izikhathi zingasakazeka kwezinye izingxenye zomzimba, ngakho zelashwa kangcono ngokuhlinzwa. Umbono wabantu abanalezi zimila ngokuvamile muhle kakhulu.

Izimbangela zomdlavuza wepancreatic

Akukacaci ukuthi yini ebangela umdlavuza we-pancreatic. Odokotela baye bahlonza izici ezithile ezingase zandise amathuba okuba nalo lolu hlobo lomdlavuza, okuhlanganisa ukubhema nokuba nofuzo oluthile.

Ukuqonda ama-pancreas akho

Amanyikwe wakho angaba amayintshi angu-6 (amasentimitha angu-15) ubude futhi abukeka njengepheya elilele ngohlangothi. Ikhipha (imfihlo) amahomoni, okuhlanganisa ne-insulin, ukusiza umzimba wakho ukucubungula ushukela ekudleni okudlayo. Futhi ikhiqiza amajusi okugaya ukuze isize umzimba wakho ugaye ukudla futhi umunce imisoco.

Ukwakheka komdlavuza we-pancreatic?

Umdlavuza we-pancreatic kwenzeka lapho amaseli ku-pancreas akho enza izinguquko (ukuguqulwa) ku-DNA yawo. I-DNA yengqamuzana ineziqondiso ezitshela ingqamuzana lokho okumelwe lenze. Lezi zinguquko zitshela amaseli ukuthi akhule ngokungalawuleki futhi aqhubeke ephila ngemva kokufa kwamangqamuzana avamile. Lawa maseli anqwabelanayo angakha isimila. Uma ingelashwa, i-pancreatic amangqamuzana omdlavuza angasakazekela ezithweni eziseduze nasegazini ezitsheni nasezithweni ezikude zomzimba. Iningi lomdlavuza we-pancreatic liqala emangqamuzaneni agudle imigudu yamanyikwe. Lolu hlobo lomdlavuza lubizwa nge-pancreatic i-adenocarcinoma noma umdlavuza we-pancreatic exocrine. Kancane kancane, umdlavuza ungakha kumaseli akhiqiza amahomoni noma kumaseli e-neuroendocrine we-pancreas. Lezi zinhlobo zomdlavuza zibizwa nge-pancreatic neuroendocrine tumors, islet cell tumors noma umdlavuza we-pancreatic endocrine. Izinguquko ku-DNA yakho zibanga umdlavuza. Lezi zingatholwa kubazali bakho noma zingavela ngokuhamba kwesikhathi. Ushintsho oluvela ngokuhamba kwesikhathi lungenzeka ngenxa yokuthi uke wabhekana nento eyingozi. Zingenzeka futhi ngokungahleliwe. Izimbangela eziqondile zomdlavuza we-pancreatic aziqondi kahle. Cishe u-5% kuya ku-10% womdlavuza we-pancreatic uthathwa njengowomndeni noma ufuzo. Iningi lomdlavuza we-pancreatic kwenzeka ngokungahleliwe noma ubangelwa izinto ezinjengokubhema, ukukhuluphala kanye neminyaka. Ungaba nengozi eyengeziwe yokuba nomdlavuza we-pancreatic uma une:

• Izihlobo ezimbili noma ngaphezulu ze-degree yokuqala ezike zaba nomdlavuza we-pancreatic
• Isihlobo sokuqala esakhula umdlavuza we-pancreatic ngaphambi kweminyaka engama-50
• I-genetic syndrome ezuzwe njengefa ehambisana nomdlavuza we-pancreatic

Uma unokunye kwalokhu, i-Pancreatic Cancer Action Network incoma ngokuqinile ukuthi uthintane nomeluleki wezofuzo ukuze unqume ubungozi bakho nokufaneleka kwakho ohlelweni lokuhlola. Umuntu angase futhi abe namathuba amaningi okuthola umdlavuza we-pancreatic ngenxa yalokhu:

• Isifo sikashukela esinesikhathi eside
• I-pancreatitis engapheli kanye ne-hereditary
• Ukubhema
• Uhlanga (uhlanga): UmJuda wase-Afrika-waseMelika noma umJuda wase-Ashkenazi
• Ubudala: ngaphezu kweminyaka engama-60
• Ubulili: abesilisa kungenzeka kancane
• Ukudla okuphezulu kwenyama ebomvu negayiwe
• Ukukhuluphala

Lokhu kuyakwenza hhayi kusho ukuthi wonke umuntu onalezi zici eziyingozi uzothola umdlavuza we-pancreatic noma ukuthi wonke umuntu othola umdlavuza we-pancreatic unoyedwa noma ngaphezulu kwalokhu.

Izici eziyingozi zomdlavuza we-pancreatic

Izinto ezingase zandise ingozi yakho yomdlavuza we-pancreatic zihlanganisa:

• Ukubhema
• Diabetes
• Ukuvuvukala okungapheli kwama-pancreas (pancreatitis)
• Umlando womndeni wama-syndromes ofuzo angandisa ingozi yomdlavuza, okuhlanganisa ukuguqulwa kofuzo lwe-BRCA2, i-Lynch syndrome kanye ne-atypical mole-malignant yomndeni. melanoma (FAMMM) syndrome
• Umlando womndeni womdlavuza we-pancreatic
• Ukukhuluphala
• Iminyaka yobudala, njengoba iningi labantu litholwa ngemuva kweminyaka engama-65

Ucwaningo olukhulu lwabonisa ukuthi inhlanganisela yokubhema, isifo sikashukela esinesikhathi eside kanye nokudla okungenamsoco kwandisa ingozi yomdlavuza we-pancreatic ngaphezu kwengozi yanoma iyiphi yalezi zici zodwa.

Izimpawu zomdlavuza wepancreatic

Izimpawu nezimpawu zomdlavuza we-pancreatic ngokuvamile aziveli kuze kube yilapho isifo sesithuthukile. Angase ahlanganise:

• Ubuhlungu besisu obuphumela emhlane wakho
• Ukulahlekelwa ukudla noma ukuncipha kwesisindo okungahlosiwe
• Ukuphuzi kwesikhumba sakho nokumhlophe kwamehlo akho (i-jaundice)
• Izihlalo ezinombala okhanyayo
• Umchamo onombala omnyama
• Isikhumba esinamahloni
• Ukuxilongwa okusha kwesifo sikashukela noma isifo sikashukela esikhona okunzima ukusilawula
• Ama-clots egazi
• Ukukhathala

Izinkinga zomdlavuza we-pancreatic

Njengoba umdlavuza we-pancreatic uqhubeka, ungabangela izinkinga ezifana nalezi:

• Ukwehla kwesisindo. Ziningi izici ezingabangela ukuncipha kwesisindo kubantu abanomdlavuza we-pancreatic. Ukuncipha kwesisindo kungenzeka njengoba umdlavuza udla amandla omzimba. Isicanucanu nokuhlanza okubangelwa ukwelashwa komdlavuza noma isimila esicindezela esiswini sakho kungase kwenze kube nzima ukudla. Noma umzimba wakho ungase ube nobunzima bokucubungula imisoco ekudleni ngenxa yokuthi amanyikwe wakho awenzi amajusi okugaya anele.
• Jaundice. Umdlavuza we-pancreas ovimbela i-bile duct yesibindi ungabangela i-jaundice. Izimpawu zihlanganisa isikhumba namehlo aphuzi, umchamo onombala omnyama, kanye nendle enombala ophaphathekile. Ijaundice ivamise ukuvela ngaphandle kobuhlungu besisu.Udokotela wakho angase atuse ukuthi ishubhu lepulasitiki noma lensimbi (i-stent) lifakwe ngaphakathi komgudu wenyongo ukuze ulivule. Lokhu kwenziwa ngosizo lwenqubo ebizwa ngokuthi i-endoscopic retrograde cholangiopancreatography (ERCP). Phakathi I-ERCP i-endoscope idluliselwa emphinjeni wakho, ngesisu sakho nasengxenyeni engenhla yamathumbu akho amancane. Udayi ube usujovwa ku-pancreatic kanye ne-bile ducts ngeshubhu elincane elingenalutho (catheter) elidlula ku-endoscope. Ekugcineni, kuthathwa izithombe zamapayipi.
• Pain. Isimila esikhulayo singacindezela izinzwa esiswini sakho, okubangela ubuhlungu obungase bube nzima. Imithi yezinhlungu ingakusiza uzizwe ukhululekile. Ukwelashwa, okufana nemisebe kanye nokwelashwa ngamakhemikhali, kungasiza ekubambeni ukukhula kwesimila futhi kunikeze ukukhululeka kobuhlungu. Ezimeni ezimbi kakhulu, udokotela wakho angase ancome inqubo yokujova utshwala ezinzwa ezilawula ubuhlungu esiswini sakho (i-celiac plexus block). Le nqubo ivimba imizwa ekuthumeleni izimpawu zobuhlungu ebuchosheni bakho.
• Ukuvinjwa kwamathumbu. Umdlavuza we-pancreatic okhula ungene noma ucindezela engxenyeni yokuqala yamathumbu amancane (i-duodenum) ungavimbela ukugeleza kokudla okugayiwe kusuka esiswini kuya emathunjini akho. Udokotela wakho angase atuse ukuba kufakwe ishubhu (stent) emathunjini akho amancane ukuze ubambe. ivuliwe. Kwezinye izimo, kungase kusize ukuhlinzwa ukuze ubeke ishubhu yokudla yesikhashana noma unamathisele isisu sakho endaweni ephansi emathunjini akho engavinjwanga umdlavuza.

Ukuxilongwa komdlavuza we-pancreatic

Ngemva kokuthatha phansi umlando wakho wezempilo kanye nokuhlola ngokomzimba, udokotela angase acele ukuhlolwa okuningana ukuze athole imbangela yenkinga yakho noma izinga lesimo, okuhlanganisa:

• I-CT scan (i-computed tomography)
• I-MRI (imaging resonance magnetic)
• I-endoscopic ultrasound (EUS)
• I-Laparoscopy (inqubo yokuhlinzwa yokubheka izitho)
• I-endoscopic retrograde ye-cholangiopancreatographyography (ERCP)
• I-Percutaneous transhepatic cholangiography (PTC; inqubo esetshenziselwa i-X-ray yesibindi nemigudu yenyongo)
• I-Biopsy (ukususwa kwezicubu ukuze uyibuke ngesibonakhulu).

Izigaba zomdlavuza we-pancreatic

Lapho umdlavuza we-pancreatic utholwa, odokotela cishe bazokwenza izivivinyo ezengeziwe ukuze baqonde ukuthi umdlavuza usabalele kuphi noma kuphi. Ukuhlolwa kwezithombe, njenge-PET scan, kusiza odokotela babone ukuthi kukhona yini umdlavuza. Ukuhlolwa kwegazi kungase kusetshenziswe. Ngalezi zivivinyo, odokotela bazama ukuthola isigaba somdlavuza. Isiteji sisiza ukuchaza ukuthi umdlavuza usuthuthuke kangakanani. Kuphinde kusize odokotela banqume izindlela zokwelapha. Uma ukuxilongwa sekwenziwe, udokotela wakho uzokwabela isiteji ngokusekelwe emiphumeleni yokuhlolwa:

• isigaba 1: izimila zikhona kumanyikwe kuphela
• isigaba sesi-2: amathumba asesabalele ezicutshini zesisu eziseduze noma ama-lymph nodes
• isigaba sesi-3: umdlavuza ususabalele emithanjeni yegazi emikhulu nama-lymph nodes
• isigaba 4: amathumba asesabalele kwezinye izitho, njengesibindi

Isigaba 4 somdlavuza we-pancreatic

Isiteji sesi-4 somdlavuza we-pancreatic ususabalele ngale kwesiza sokuqala waya ezindaweni ezikude, njengezinye izitho, ubuchopho, noma amathambo. Umdlavuza we-pancreatic uvame ukutholakala kulesi sikhathi ngoba awuvamile ukubangela izimpawu uze udlulele kwezinye izingosi. Izimpawu ongase ube nazo kulesi sigaba esithuthukile zihlanganisa:

• ubuhlungu esiswini esingenhla
• ubuhlungu emhlane
• ukukhathala
• i-jaundice (isikhumba esiphuzi)
• ukulahlekelwa ukudla
• kwesisindo
• ukucindezeleka

Isigaba sesi-4 somdlavuza wama-pancreas asikwazi ukwelapheka, kodwa ukwelashwa kungadambisa izimpawu futhi kuvimbele izinkinga ezivela kumdlavuza. Lezi zindlela zokwelapha zingabandakanya:

• imiphumela emibi yokwelashwa ngamakhemikhali
• ukwelashwa kwezinhlungu ze-palliative
• ukuhlinzwa kwe-bile duct bypass
• i-bile duct stent
• ukuhlinzeka ngesisu socansi

Isilinganiso seminyaka emihlanu sokusinda somdlavuza we-pancreatic 4 singamaphesenti ama-3.

Isigaba 3 somdlavuza we-pancreatic

Isiteji sesi-3 somdlavuza we-pancreatic yisimila ku-pancreas futhi mhlawumbe nezindawo eziseduze, njengama-lymph nodes noma imithambo yegazi. Umdlavuza we-pancreatic kulesi sigaba awukasabalali ezindaweni ezikude. Umdlavuza we-pancreatic ubizwa ngokuthi umdlavuza othule ngoba ngokuvamile awutholakali uze ufinyelele esigabeni esiphezulu. Uma unezimpawu zesigaba sesi-3 somdlavuza we-pancreatic, ungathola:

• ubuhlungu emhlane
• ubuhlungu noma ububele endaweni engaphezulu yesisu
• ukulahlekelwa ukudla
• kwesisindo
• ukukhathala
• ukucindezeleka

Isigaba sesi-3 somdlavuza we-pancreatic kunzima ukwelapha, kodwa ukwelashwa kungasiza ekuvimbeleni ukusabalala komdlavuza futhi kudambise izimpawu ezibangelwa isimila. Lezi zindlela zokwelapha zingafaka:

• ukuhlinzwa ukususa ingxenye yamanyikwe (inqubo ye-Whipple)
• izidakamizwa zokulwa nomdlavuza
• ukwelashwa kwemisebe

Izinga leminyaka emihlanu lokusinda kwesigaba sesi-3 somdlavuza we-pancreatic singamaphesenti ama-3 kuya kwayi-12. Iningi labantu abanalesi sigaba somdlavuza lizophinde livele. Lokho kungenzeka ukuthi kungenxa yokuthi ama-micrometastase, noma izindawo ezincane zokukhula komdlavuza ongabonakali, zisakazeke ngale kwamanyikwe njengesikhathi sokutholwa.

Isigaba 2 somdlavuza we-pancreatic

Isigaba sesi-2 somdlavuza we-pancreatic umdlavuza ohlala ku-pancreas futhi kungenzeka ukuthi ususakazekele kuma-lymph nodes ambalwa aseduze. Ayikasakazeki ezicutshini eziseduze noma emithanjeni yegazi, futhi ayizange isabalale ezindaweni kwenye indawo emzimbeni. Umdlavuza wamanyikwe kunzima ukuwubona ezigabeni zokuqala, okuhlanganisa nesigaba 2. Lokho kungenxa yokuthi mancane amathuba okuba ubangele izimpawu ezibonakalayo. Uma unezimpawu kulesi sigaba sokuqala, ungase ube:

• jaundice
• izinguquko kumbala womchamo
• ubuhlungu noma ububele endaweni engaphezulu yesisu
• kwesisindo
• ukulahlekelwa ukudla
• ukukhathala

Ukwelashwa kungafaka:

• ukuhlinzwa
• imisebe
• imiphumela emibi yokwelashwa ngamakhemikhali
• imithi yokwelapha ehlosiwe

Udokotela wakho angase asebenzise inhlanganisela yalezi zindlela ukusiza ukunciphisa isimila futhi avimbele ama-metastases angenzeka. Izinga lokusinda leminyaka emihlanu labantu abanomdlavuza we-pancreatic 2 cishe lingamaphesenti angama-30.

Ukwelashwa komdlavuza we-pancreatic

Ukwelashwa komdlavuza we-pancreatic kuncike esigabeni somdlavuza. Inemigomo emibili: ukubulala amangqamuzana anomdlavuza nokuvimbela ukusakazeka kwalesi sifo.

Ukuncipha kwesisindo, ukuvaleka kwamathumbu, ubuhlungu besisu, nokwehluleka kwesibindi kuphakathi kwezinkinga ezivame kakhulu ngesikhathi umdlavuza wepancreatic ukwelashwa.

Ukuhlinzwa

Isinqumo sokusebenzisa ukuhlinzwa ukwelapha umdlavuza we-pancreatic sifika ezintweni ezimbili: indawo yomdlavuza kanye nesigaba somdlavuza. Ukuhlinzwa kungasusa zonke noma izingxenye ezithile zamanyikwe. Lokhu kungaqeda isimila sokuqala, kodwa ngeke kususe umdlavuza osusakazekele kwezinye izingxenye zomzimba. Ukuhlinzwa kungase kungafaneleki kubantu abanomdlavuza we-pancreatic osezingeni eliphezulu ngenxa yaleso sizathu.

Ukwelashwa kwamafutha

Ezinye izindlela zokwelapha kufanele zihlolwe uma umdlavuza ususabalala ngaphandle kwamanyikwe. Ukwelapha ngemisebe kusebenzisa ama-X-ray neminye imishayo enamandla amakhulu ukubulala amangqamuzana omdlavuza.

Ukwelashwa ngamakhemikhali

Kwezinye izimo, udokotela wakho angase ahlanganise ezinye izindlela zokwelapha nge-chemotherapy, esebenzisa izidakamizwa ezibulala umdlavuza ukusiza ukuvimbela ukukhula kwamangqamuzana omdlavuza esikhathini esizayo.

Ukwelapha okuhlosiwe

Lolu hlobo lokwelapha umdlavuza lusebenzisa izidakamizwa noma ezinye izindlela ukuze luqondise amangqamuzana omdlavuza futhi lusebenze ukuwabhubhisa. Le mithi yakhelwe ukuthi ingalimazi amaseli anempilo noma avamile.

Ukuvimbela umdlavuza we-pancreatic

Unganciphisa ingozi yomdlavuza we-pancreatic uma:

• Yeka ukubhema. Uma ubhema, zama ukuyeka. Khuluma nodokotela wakho mayelana namasu angakusiza ukuthi uyeke, okuhlanganisa namaqembu okusekela, imithi kanye nokwelapha esikhundleni se-nicotine. Uma ungabhemi, ungaqali.
• Gcina isisindo esinempilo. Uma unesisindo esinempilo, sebenzela ukusigcina. Uma udinga ukwehlisa isisindo, hlose ukunciphisa umzimba kancane, kancane kancane - amakhilogremu angu-1 kuya kwangu-2 (0.5 kuya ku-1 kilogram) ngesonto. Hlanganisa ukuvivinya umzimba kwansuku zonke nokudla okunothe ngemifino, izithelo nezinhlamvu ezigcwele nezingxenye ezincane ukukusiza wehlise isisindo.
• Khetha ukudla okunempilo. Ukudla okugcwele izithelo nemifino emibalabala kanye nezinhlamvu kungase kusize ukunciphisa ingozi yomdlavuza.

Cabangela ukuhlangana nomeluleki wezofuzo uma unomlando womndeni onomdlavuza we-pancreatic. Angabuyekeza umlando wezempilo yomndeni wakho kanye nawe futhi anqume ukuthi ungase uzuze yini ekuhlolweni kofuzo ukuze uqonde ubungozi bakho bomdlavuza we-pancreatic noma eminye imidlavuza.

Ngemininingwane yokwelashwa komdlavuza wepancreatic nombono wesibili, sishayele ku- + 91 96 1588 1588 noma ubhalele ku-cancerfax@gmail.com.