Umdlavuza wesifo

Uyini umdlavuza womphimbo?

Umdlavuza womphimbo usho izimila ezinomdlavuza ezikhula emphinjeni wakho (pharynx), ibhokisi lezwi (umphimbo) noma amathoni.

Umphimbo wakho uyishubhu elinemisipha eliqala ngemva kwekhala lakho liphele entanyeni yakho. Umdlavuza womphimbo uvame ukuqala kumaseli ayisicaba aphakathi komphimbo wakho.

Ibhokisi lakho lezwi lihlala ngaphansi nje komphimbo wakho futhi lingangenwa umdlavuza womphimbo. Ibhokisi lezwi lenziwe ngoqwanga futhi liqukethe izintambo zezwi ezidlikizayo ukuze zenze umsindo lapho ukhuluma.

Umdlavuza womphimbo ungase uthinte ingxenye yoqwanga (epiglottis) esebenza njengesivalo soqhoqhoqho. Umdlavuza wamathoni, olunye uhlobo lomdlavuza womphimbo, uthinta amathoni, atholakala ngemuva komphimbo.

Ziyini izimpawu zomdlavuza womphimbo?

Izimpawu nezimpawu zomdlavuza womphimbo zingabandakanya:

• Ukukhwehlela
• Izinguquko ezwini lakho, njengokuhhahhaza noma ukungakhulumi kahle
• Kunzima ukugwinya
• Ubuhlungu bendlebe
• Isigaxa noma isilonda esingapholi
• Umphimbo obuhlungu
• Ukwehla kwesisindo

Ziyini izimbangela zomdlavuza womphimbo?

Umdlavuza womlomo kwenzeka lapho amaseli emphinjeni wakho eba nezinguquko zofuzo. Lokhu kuguquka kubangela ukuthi amaseli akhule ngokungalawuleki futhi aqhubeke nokuphila ngemuva kokuthi amaseli aphilile angafa ngokujwayelekile. Amaseli aqongelelayo angakha isimila emphinjeni wakho.

Yiziphi izinhlobo zomdlavuza womphimbo?

Umdlavuza womphimbo yigama elivamile elisebenza kumdlavuza oqala emphinjeni (umdlavuza wepharyngeal) noma ebhokisini lezwi (umdlavuza welaryngeal). Umphimbo nebhokisi lezwi kuxhumene eduze, nebhokisi lezwi elingaphansi kancane komphimbo.

Nakuba iningi lomdlavuza womphimbo lihlanganisa izinhlobo ezifanayo zamangqamuzana, amagama athile asetshenziselwa ukuhlukanisa ingxenye yomphimbo lapho umdlavuza waqala khona.

• Umdlavuza weNasopharyngeal iqala ku-nasopharynx - ingxenye yomphimbo wakho engemuva kwekhala lakho.
• Umdlavuza we-Oropharyngeal iqala ku-oropharynx - ingxenye yomphimbo wakho ngemuva komlomo wakho efaka amalaka akho.
• Umdlavuza we-Hypopharyngeal (umdlavuza we-laryngopharyngeal) iqala ku-hypopharynx (i-laryngopharynx) - ingxenye engezansi yomphimbo wakho, ngenhla nje komphimbo wakho nophiko lomoya.
• Umdlavuza we-Glottic kuqala ezintanjeni zezwi.
• Umdlavuza we-Supraglottic iqala engxenyeni engenhla yomphimbo futhi ifaka nomdlavuza othinta i-epiglottis, okulucezu lwenqwaba oluvimba ukudla kungangeni ku-windpipe yakho.
• Umdlavuza we-Subglottic iqala engxenyeni engezansi yebhokisi lakho lezwi, ngaphansi kwezintambo zakho zezwi.

Ziyini izici eziyingozi zomdlavuza womphimbo?

Izici ezingakhuphula ubungozi bomdlavuza womphimbo zifaka:

• Ukusetshenziswa kukagwayi, kufaka phakathi ukubhema nokuhlafuna ugwayi
• Ukuphuza ngokweqile
• Igciwane elidluliselwa ngocansi elibizwa nge-human papillomavirus (HPV)
• Ukudla kushoda ngezithelo nemifino
• Isifo se-reflux ye-gastroesophageal (GERD)

Utholakala kanjani umdlavuza womphimbo?

Okulandelayo izindlela zokuthola umdlavuza womphimbo:

• Usebenzisa ububanzi ukuze ubhekisise umphimbo wakho. Udokotela wakho angasebenzisa indawo ekhethekile ekhanyisiwe (i-endoscope) ukuze ubhekisise umphimbo wakho ngesikhathi senqubo ebizwa nge-endoscopy. Ikhamera encanyana ekugcineni kwe-endoscope idlulisela izithombe kusikrini sevidiyo udokotela wakho asibhekile ukuthola izimpawu zokungahambi kahle emphinjeni wakho. Olunye uhlobo lomthamo (i-laryngoscope) lungafakwa ebhokisini lakho lezwi. Isebenzisa ilensi yokukhulisa ukusiza udokotela wakho ahlole izintambo zakho zezwi. Le nqubo ibizwa ngokuthi i-laryngoscopy.
• Ukususa isampula lesicubu sokuhlolwa. Uma kutholakala ukungajwayelekile ngesikhathi se-endoscopy noma i-laryngoscopy, udokotela wakho angadlulisa izinsimbi zokuhlinza ebangeni lokuqoqa isampula lesicubu (i-biopsy). Isampuli ithunyelwa elabhorethri ukuze ihlolwe. Udokotela wakho futhi anga-oda isampula le-lymph node evuvukile esebenzisa inqubo ebizwa nge-fine-needle aspiration.
• Ukuhlola ukuhlolwa. Ukufanekisa izivivinyo, kufaka phakathi i-X-ray, i-computerised tomography (CT), i-magnetic resonance imaging (MRI) ne-positron emission tomography (PET), kungasiza udokotela wakho ukuthi anqume ukuthi umdlavuza wakho ungakanani ngaphezu komphimbo wakho noma ibhokisi lezwi.

Uphathwa kanjani umdlavuza womphimbo?

Izinketho zakho zokwelashwa zisuselwa ezicini eziningi, ezifana nendawo nomdlavuza womphimbo wakho, uhlobo lwamaseli abandakanyekile, impilo yakho yonke, nezinto ozithandayo. Xoxa ngezinzuzo nezingozi zokhetho ngalunye lwakho nodokotela wakho. Ngokubambisana unganquma ukuthi iziphi izindlela zokwelashwa ezizokufanelekela kakhulu.

Ukwelashwa kwamafutha

Ukwelashwa ngemisebe kusebenzisa imishayo enamandla amakhulu evela emithonjeni enjengama-X-ray nama-proton ukuletha imisebe kumangqamuzana omdlavuza, okubangela ukuba afe.

Ukwelashwa ngemisebe kungavela emshinini omkhulu ongaphandle komzimba wakho (imisebe ye-beam yangaphandle), noma ukwelapha ngemisebe kungavela ezinhlamvini ezincane ezinemisebe nezintambo ezingafakwa ngaphakathi emzimbeni wakho, eduze nomdlavuza wakho (i-brachytherapy).

Ngomdlavuza womphimbo wesigaba sokuqala, ukwelashwa ngemisebe kungase kube ukuphela kokwelashwa okudingekayo. Ngomdlavuza womphimbo osethuthuke kakhulu, ukwelapha ngemisebe kungase kuhlanganiswe nokwelashwa ngamakhemikhali noma ukuhlinzwa. Emidlavuza yomphimbo ethuthuke kakhulu, ukwelapha ngemisebe kungase kusetshenziswe ukunciphisa izimpawu nezimpawu futhi kukwenze ukhululeke kakhudlwana.

Ukuhlinzwa

Izinhlobo zezinqubo zokuhlinza ongazicabangela ukwelapha umdlavuza wakho womphimbo zixhomeke endaweni nesigaba somdlavuza wakho. Izinketho zingafaka:

• Ukuhlinzwa komdlavuza womphimbo wokuqala. Umdlavuza womphimbo ovalelwe ebusweni bomphimbo noma ezintanjeni zezwi ungaphathwa ngokuhlinzwa usebenzisa i-endoscopy. Udokotela wakho angafaka i-endoscope engenalutho emphinjeni noma ebhokisini lezwi bese edlulisa amathuluzi wokuhlinza akhethekile noma i-laser esikalini. Usebenzisa la mathuluzi, udokotela wakho angazisusa, asike noma, esimweni se-laser, avuselele umdlavuza ongenasisekelo.
• Ukuhlinzwa ukususa konke noma ingxenye yebhokisi lezwi (i-laryngectomy). Ngezicubu ezincane, udokotela wakho angasusa ingxenye yebhokisi lakho lezwi elithintwa ngumdlavuza, ashiye ibhokisi lezwi eliningi ngangokunokwenzeka. Udokotela wakho angakwazi ukugcina amandla akho okukhuluma nokuphefumula ngokujwayelekile, ukuze kube nezicubu ezinkudlwana, ezinwe kakhulu, kungadingeka ukuthi ususe lonke ibhokisi lakho lezwi. I-windpipe yakho ibese ifakwa emgodini (stoma) emphinjeni wakho ukuze ukwazi ukuphefumula (tracheotomy). Uma umphimbo wakho wonke ususiwe, unezinketho eziningana zokubuyisa inkulumo yakho. Ungasebenza nodokotela wezifo zokukhuluma ukuze ufunde ukukhuluma ngaphandle kwebhokisi lakho lezwi.
• Ukuhlinzwa ukususa ingxenye yomphimbo (pharyngectomy). Umdlavuza omncane womphimbo ungadinga ukukhipha izingxenye ezincane kuphela zomphimbo wakho ngesikhathi sokuhlinzwa. Izingxenye ezisusiwe zingakhiwa kabusha ukuze zikuvumele ukugwinya ukudla ngokujwayelekile.Ukuhlinzwa ukuze ususe umphimbo wakho ngokuvamile kubandakanya nokususwa kwebhokisi lakho lezwi. Udokotela wakho angakwazi ukwakha umphimbo wakho kabusha ukuze akuvumele ukugwinya ukudla.
• Ukuhlinzwa ukususa ama-lymph node anomdlavuza (ukuhlukaniswa kwentamo). Uma umdlavuza womphimbo usakazeke ngaphakathi entanyeni yakho, udokotela wakho angancoma ukuhlinzwa ukuze kususwe amanye noma wonke ama-lymph node ukubona ukuthi aqukethe amangqamuzana omdlavuza.

Ukuhlinzwa kubeka engcupheni yokopha nokutheleleka. Ezinye izinkinga ezikhona, njengobunzima bokukhuluma noma ukugwinya, kuzoya ngenqubo ethile oyenzayo.

Ukwelashwa ngamakhemikhali

I-Chemotherapy isebenzisa izidakamizwa ukubulala amangqamuzana omdlavuza.

I-Chemotherapy ivame ukusetshenziswa kanye nokwelashwa ngemisebe ekwelapheni umdlavuza womphimbo. Imithi ethile ye-chemotherapy yenza amangqamuzana omdlavuza azwele kakhulu ekwelapheni ngemisebe. Kodwa ukuhlanganisa i-chemotherapy kanye nokwelashwa ngemisebe kwandisa imiphumela emibi yakho kokubili ukwelashwa.

Xoxa nodokotela wakho ngemiphumela engemihle ongase ube nayo nokuthi ingabe ukwelashwa okuhlanganisiwe kuzokunikeza yini izinzuzo ezingaphezu kwaleyo miphumela.

Imithi yokwelashwa ehlosiwe

Izidakamizwa ezihlosiwe zelapha umdlavuza womphimbo ngokusebenzisa ukukhubazeka okuthile kumaseli omdlavuza abhebhezela ukukhula kwamaseli.

Njengesibonelo, umuthi i-Cetuximab (Erbitux) uyindlela eyodwa yokwelapha eqondiwe egunyazwe ukwelapha umdlavuza womphimbo ezimeni ezithile. I-Cetuximab imisa ukusebenza kwephrotheni etholakala ezinhlotsheni eziningi zamaseli anempilo, kodwa ivame kakhulu ezinhlotsheni ezithile zamaseli omdlavuza womphimbo.

Eminye imithi ehlosiwe iyatholakala futhi eminye iyacwaningwa ezivivinyweni zomtholampilo. Izidakamizwa ezihlosiwe zingasetshenziswa zodwa noma zihlanganiswe nokwelashwa ngamakhemikhali noma ukwelapha ngemisebe.

Ukuvuselelwa ngemuva kokwelashwa

Ukwelashwa komdlavuza womphimbo kuvame ukudala izinkinga ezingadinga ukusebenza nochwepheshe ukuze baphinde bakwazi ukugwinya, badle ukudla okuqinile nokukhuluma. Ngesikhathi nangemva kokwelashwa komdlavuza womphimbo, udokotela wakho kungenzeka ukuthi ufune usizo lwe:

• Ukunakekelwa kokuvulwa kokuhlinzwa emqaleni wakho (stoma) uma ngabe une-tracheotomy
• Ubunzima bokudla
• Ukwehlisa ubunzima
• Ukuqina nobuhlungu entanyeni yakho
• Izinkinga zokukhuluma