Nukae nye Urothelial Carcinoma? Mina míaƒo nu tso eŋu tsitotsito!

Ède dzesi ʋu le wò aɖuɖɔ me kpɔa? Alo ɖe akɔta le veve sem na wò alo ɖeɖi tea ŋuwò ɣesiaɣia? Togbɔ be adze abe nusiawo manye nusi ŋu woatsi dzi ɖo boo o hã la, woate ŋu anye kansa si dona le aɖuɖɔtoe me ƒe dzesiwo ɣeaɖewoɣi. Kansa ƒomevi mawo dometɔ ɖekae nye Urothelial Carcinoma , si woyɔna ɣeaɖewoɣi be Transitional Carcinoma . Egbea, míele nu ƒom tso esia ŋu tsitotsito vie , abe ɖe míele nu ƒom na mía xɔlɔ̃ aɖe ene.

Nukae nye Urothelial Carcinoma? Kpuie ko la,...

Kpuie ko la, Urothelial Carcinoma nye kansa si dzea egɔme tso lãkusi si woyɔna be urothelium, si le wò aɖuɖɔtoe ƒe akpa aɖewo me. Bu eŋu abe míaƒe ŋutilã ƒe ŋutinu aɖewo ƒe akpa ememetɔ ene. Urothelium nye lãmenugbagbevi mawo dometɔ ɖeka. Tsinyegoe, ayiku (vevietɔ ayiku ƒe akɔta), kple tsinyegoe me koŋue wònɔna. Ènya be tsinyegoe me kansa 90% kple ayiku me kansa 7% nye tsinyegoe me kansa? Wo ame evea siaa ƒe dzesiwo ɖi wo nɔewo ŋutɔ. Nu nyuitɔ kekeakee nye be kansa siawo dada kple wo dada le bɔbɔe ne wokpɔ wo kaba . Ke hã, woate ŋu agbugbɔ ɣeaɖewoɣi. Esia tae wòle vevie be nànya esia ɖo.

Aleke kansa sia gblẽa nu le míaƒe ŋutilã ŋui?

Alesi tsinyegoe me kansa kpɔa ŋusẽ ɖe wò tsinyegoe kple ayiku dzi ate ŋu ato vovo vie.

Tsinyegoe me kansa si tso tsinyegoe me

Wò tsinyegoe nye ŋutinu sue aɖe si le abe kotoku ene. Enɔa wò akɔtaƒuwo dome, wò tsinyegoea tame, kple wò ayikuwo te. Aɖuɖɔ si tso wò ayiku me ƒoa ƒu ɖe tsinyegoe sia me. Tsinyegoea ƒe eme kple lãkusi si míeyɔ va yi si woyɔna be urothelium . Lãmenugbagbevi siwo le lãkusi sia me ate ŋu akeke ne aɖuɖɔ yɔ wò tsinyegoe me eye woatsi ne ekɔ. (Zi geɖe la, wò tsinyegoe ate ŋu alé aɖuɖɔ si ade kplu eve.) Ne tsinyegoe me kansa dze dziwò la, lãmenugbagbevi siwo le tsinyegoe sia me ma le mɔ si mesɔ o nu eye wokaka tso wò tsinyegoe ƒe akpa si le eme la me yia ƒuƒoƒo bubuwo me. Ɣeaɖewoɣi la, lãmenugbagbevi siawo siwo mesɔ o ate ŋu ato wò tsinyegoe ƒe gliwo me age ɖe ami siwo ƒo xlãe me. Ne womewɔ atike na kansa sia o la, ate ŋu ato tsinyegoe ƒe gli me ayi ʋuka siwo te ɖe wo ŋu me eye tso afima ayi teƒe bubuwo abe ƒuwo, lãkusiwo, kple aklã ene. Tsinyegoe me kansa ƒomevi vevi eve li:

• High-grade urothelial cancer : Esia nye afɔku vie wu. Anɔ eme be wòagatrɔ ava ne wowɔ atike nɛ gɔ̃ hã. Ate ŋu akaka ɖe tsinyegoe ƒe lãmekawo, ŋutilã ƒe akpa bubuwo, kple...Ate ŋu akaka ɖe ʋuka siwo me ʋu sina tona me .
• Aɖuɖɔtoe me dɔdzẽ si ƒe dzeside mede o: Esia hã ate ŋu atrɔ ava, gake anɔ eme kura be makaka ɖe tsinyegoe ƒe lãmekawo me alo ayi ŋutilã ƒe akpa bubuwo o.

Ayikuwo ƒe dɔdzẽ si tsoa tsinyegoe me

Zi geɖe la, ayiku eve nɔa mía si. Wole abe ŋutinu eve siwo le abe gbe ene, siwo le akɔta te tututu kple ƒodo megbe. Ayikuawo ɖea gbeɖuɖɔ kple aɖi siwo le ʋua me ɖa eye wowɔa aɖuɖɔ. Aɖuɖɔ sia ƒoa ƒu ɖe ayiku titina si woyɔna be ayiku ƒe akɔta . Tso afima la, aɖuɖɔa toa mɔ̃ didi aɖe si doa ka kple ayiku kple tsinyegoe la me. Woyɔa mɔ̃ sia be tsinyegoe . Abe ayiku ene la, ayiku ƒe akɔta kple tsinyegoe hã le tsinyegoe me lãkusiwo me. Ayiku me kansa dzɔna ne tsinyegoe me lãmenugbagbevi siwo mesɔ o tsi eye wowɔ dɔdzẽ le ayiku, ayiku ƒe akɔta, alo tsinyegoe me. Ayiku me dɔdzẽ ate ŋu akaka ɖe ŋutinu alo lãkusi bubuwo hã me.

Amekae ate ŋu axɔ kansa sia wu?

Tsinyegoe me kansae nye kansa adelia si bɔ wu le United States. Eye tsinyegoe me kansa ƒe 90% nye tsinyegoe me kansa. Ŋutsuwo ate ŋu axɔ tsinyegoe me kansa wu nyɔnuwo abe zi gbɔ zi ene ene . Ayiku me dɔdzẽe nye kansa enyilia si bɔ wu. Ayiku me kansa siwo ade 7% nye urothelial cancers. Edzɔna zi geɖe le amesiwo xɔ tso ƒe 65 va ɖo ƒe 74. Ŋutsuwo ate ŋu axɔ dɔlélea zi gbɔ zi eve.

Nukae nye tsinyegoe me dɔdzẽ ƒe dzesi vevitɔ?

Ðewohĩ dzesi aɖeke manɔ tsinyegoe me dɔdzẽ ŋu le eƒe gɔmedzedze o. Gake zi geɖe la, ʋu si le aɖuɖɔ me (hematuria) ye nyea dzesi gbãtɔ. Ne ède dzesi ʋu le aɖuɖɔ me alo dzesi bubu siawo dometɔ aɖe le ŋuwò la, ele be nàkpɔ ɖɔkta godoo :

• Akɔtave si nɔa anyi ɖaa .
• Ðeɖiteameŋu, ɖeɖiteameŋu .
• Be woanye ame tsɛ le susu aɖeke manɔmee.
• Vevesese ne wole aɖuɖɔ tom ( dysuria ).
• Ewɔna nam abe dɔdzẽ ene le afisi ayikuawo le.
• Asrã vi aɖe le ŋunye.

Nukae hea kansa sia vɛ?

Atikewɔlawo menya nusi tututu hea tsinyegoe kple ayiku ƒe tsinyegoe me kansa vɛ haɖe o. Gake wode dzesi afɔku geɖe siwo bɔ:

• Sigaretnono : Afɔku le sigaretnolawo ŋu be woaxɔ aɖuɖɔtoe me kansa le aɖuɖɔtoe me.Afɔku si le kansa xɔxɔ me lolo ŋutɔ. Esiae nye afɔku vevitɔ.
• Atike aɖewo zazã: Numekukuwo ɖee fia be amesiwo wɔa dɔ le teƒe siwo wowɔa amadede aɖewo, rababa, lãgbalẽnuwo, amadedewo, avɔ aɖewo, kple ɖawɔnuwo le la ate ŋu axɔ kansa sia.

Aleke ɖɔktawo wɔa dea dzesi kansa siae?

Ðɔktawo zãa dodokpɔ siawo tsɔ dea dzesi tsinyegoe kple ayiku me kansa, siwo dometɔ aɖewoe nye tsinyegoe me kansa:

• Aɖuɖɔtoe me dzodzro: Dodokpɔ si me woléa ŋku ɖe wò aɖuɖɔ me amadede, sukli, protein, ʋu, kple dɔlékuiwo ŋu.
• Aɖuɖɔtoe me lãmenugbagbeviwo: Woɖea wò aɖuɖɔ ƒe kpɔɖeŋu aɖe hedoa wo kpɔ le nusuekpɔmɔ̃ me be woakpɔe ɖa be lãmenugbagbevi siwo mesɔ o hã le eme hã. Ne kansa le ŋuwò le ayiku, tsinyegoe, alo tsinyegoe me la, kansa lãmenugbagbeviwo ate ŋu anɔ wò aɖuɖɔ me.
• Intravenous pyelogram (IVP): Esia nye X-ray dodokpɔ siwo kplɔ wo nɔewo ɖo. Wowɔa esia tsɔ léa ŋku ɖe kansa ŋu le ayiku, tsinyegoe, kple tsinyegoe me. Ðɔktawo doa tsi tɔxɛ aɖe (contrast dye) wò ʋuka me. Emegbe, woɖea X-ray ne tsia to wò ayiku, tsinyegoe, kple tsinyegoe me be woakpɔe ɖa be xe mɔ aɖe hã.
• Ureteroscopy: Wotsɔa dɔwɔnu tsɛ aɖe si le abe mɔ̃ ene (si me fotoɖemɔ̃ kple akaɖi le) toa tsinyegoea me be woakpɔ tsinyegoea kple ayiku ƒe akɔta. Wozãnɛ hã tsɔ ɖea lãmenugbagbeviwo ƒe kpɔɖeŋuwo.
• CT scan (Computed tomography - CT scan): Kɔmpiuta si wotsɔ do ka kple X-ray mɔ̃ aɖe ɖea ŋutilã ƒe akpa vovovowo ƒe foto tsitotsito.
• Ultrasound: Woɖoa gbeɖiɖi ƒe ƒutsotsoe siwo ŋu ŋusẽ geɖe le (ultrasound) ɖe lãkusi siwo le ŋutilãa me eye wozãa gbeɖiɖi siwo trɔna la tsɔ wɔa nɔnɔmetata (sonogram). Woate ŋu awɔ ƒodo me ultrasound atsɔ ade dzesi kansa siwo le ayiku ƒe akɔta kple tsinyegoe me.
• MRI (Magnetic resonance imaging - MRI): Ezãa magnet, radio ƒutsotsoewo, kple kɔmpiuta tsɔ ɖea teƒe siwo le ŋutilãa me, abe akɔta ƒe do ene, ƒe foto tsitotsito.

Nukae nye kansa ƒe afɔɖeɖe?

Ðɔktawo zãa kansa ƒe ɖoɖowɔwɔ ƒe ɖoɖo aɖe tsɔ wɔa ɖoɖo ɖe atikewɔwɔ ŋu henyaa nusi ava dzɔ ɖi. Esia ɖɔ alesi wòanya wɔ be kansa la natsi ahakakae.

Kansa ƒe ɖoɖowɔwɔ ɖe ɖoɖo nu nye nuwɔna sesẽ aɖe. Ne ewɔ na wò abe ɖe wotsɔ wò nɔnɔmea de mɔli si me ŋɔŋlɔdzesi kple xexlẽdzesi ʋɛ aɖewo le me ene la, ate ŋu ado vɔvɔ̃ na ame eye wòatɔtɔ. Gɔmesese le eŋu be nenemae. Ne mèka ɖe esia dzi o alo nèle vɔvɔ̃m na wò la, bia wò ɖɔkta be wòaɖe alesi ɖoɖo sia ku ɖe wò nɔnɔmea ŋui me na wò.

Tsinyegoe me dɔdzẽ ƒe afɔɖeɖewo

Tsinyegoe me kansa ate ŋu anye eƒe gɔmedzedze (tsinyegoe ƒe akpa si le tsinyegoea me ko) alo esi de ŋgɔ (ege ɖe tsinyegoe ƒe gli me eye wòkaka ɖe ŋutinu alo ʋuka siwo te ɖe eŋu me). Tsinyegoe me dɔdzẽ ƒe afɔɖeɖewoe nye esiawo:

• Afɔɖeɖe I: Tsinyegoe ƒe akpa si le tsinyegoea me alo kadodoŋusẽ si le ete la koe kansa la le. Mekaka ɖe tsinyegoea ƒe lãmeka ƒe gli vevitɔ gbɔ o.
• Afɔɖeɖe II: Kansa la kaka ɖe tsinyegoea ƒe lãmekawo ƒe gli ŋu.
• Afɔɖeɖe III: Kansa la kaka tso tsinyegoe ƒe lãmeka me yi ami si le egodo me.
• Akpa IV: Kansa la kaka tso tsinyegoe me yi ʋukawo, ŋutinu bubuwo, alo ƒuwo me.

Ðɔktawo hã bua tsinyegoe me dɔdzẽ ɖe hatsotso siwo me megena ɖe lãmekawo me o , esiwo mexɔa lãmekawo o , alo esiwo xɔa lãmekawo me .

• Noninvasive: Le go sia me la, kansa ate ŋu anɔ lãmeka sue aɖe ko me, alo ate ŋu anɔ tsinyegoea ƒe gowo dzi ko.
• Non-muscle-invasive: Le go sia me la, kansa la ge ɖe tsinyegoea me goglo, gake mekaka ɖe lãmekawo me o.
• Lãmetsiwo: Le go sia me la, kansa la kaka ɖe tsinyegoe ƒe gli ƒe lãmekawo me eye ate ŋu akaka ɖe ami siwo le tsinyegoea godo alo ŋutinuwo ƒe lãkusiwo me.

Ayiku me dɔdzẽ ƒe afɔɖeɖewo

Womenɔa te ɖe kansa ƒe lãmenugbagbevi ƒomevi dzi ɖoa ayiku me dɔdzẽ ɖe ɖoɖo nu o. Aɖuɖɔtoe me kansa nye ayiku me kansa ƒe 7% lɔƒo. Woɖoa ayiku me dɔdzẽ kple ayiku ƒe akɔta/aɖuɖɔtoe me dɔdzẽ ɖe ɖoɖo vovovowo nu.

• Afɔɖeɖe I: Kansa la mekaka yi ŋgɔ wu ayiku o.
• Afɔɖeɖe II: Kansa la tsi, gake mekaka yi ŋgɔ wu ayiku o.
• Afɔɖeɖe III: Kansa la kaka tso ayiku me yi ʋuka veviwo me - ayiku ƒe ʋuka kple ʋuka si le ete - alo yi lãkusi siwo ƒo xlã ayiku la me, alo yi ʋuka siwo te ɖe eŋu me.
• Afɔɖeɖe IV: Kansa la kaka tso adrenal gland (si nye lãkusi sue aɖe si le ayiku tame), yi ʋuka siwo le didiƒe, alo yi ŋutinu bubuwo me.

Afɔɖeɖe siwo me kansa le ayiku ƒe akɔta kple tsinyegoe me

• Afɔɖeɖe 0: Lãmenugbagbevi siwo mesɔ o le ayiku ƒe akɔta alo tsinyegoe ƒe lãkusi me. Wogayɔa esia be papillary carcinoma alo carcinoma in situ .
• Afɔɖeɖe I (Afɔɖeɖe 1): Kansa la kaka to ayiku ƒe akɔta kple/alo tsinyegoe ƒe akpa si le eme me eye wòge ɖe kadodoŋusẽ ƒe ƒuƒoƒoa me.
• Afɔɖeɖe II:Kansa la kaka to kadodoŋusẽa me yi ayiku ƒe akɔta kple/alo tsinyegoe ƒe lãmekawo me.
• Afɔɖeɖe IV: (Womeyɔ Akpa III le afisia o, gake zi geɖe la, enɔa II kple IV dome, si fia be ekaka ɖe xɔtunu siwo te ɖe eŋu me) Kansa la kaka ɖe ŋutinu siwo te ɖe eŋu, ʋuka ɖeka alo esi wu nenema, ami si ƒo xlã ayiku, alo ŋutinu siwo le didiƒe abe lãkusi, aklã, alo ƒuwo ene me.

Aleke ɖɔktawo daa aɖuɖɔtoe me kansae?

Atikewɔwɔmɔnuawo toa vovo le afisi tsinyegoe me kansa le le tsinyegoe, ayiku, ayiku ƒe akɔta, kple tsinyegoe me nu.

Tsinyegoe me kansa dada

Atikewɔwɔ ƒe tiatia ate ŋu anye:

• Amekoko: Amekolawo ɖea kansa ƒe dɔdzẽa ɖa alo zãa elektrikŋusẽ si me ŋusẽ geɖe le tsɔ fiãnɛ. Woyɔa esia be elektrikŋusẽ (fulguration) .
• Atikewo zazã: Wona atikewo be woatsɔ atsrɔ̃ kansa lãmenugbagbeviwo.
• Dɔlélenutsiŋutete ƒe atikewɔwɔ: Eʋãa wò ŋutilã ŋutɔ ƒe dɔlélenutsiŋutete be wòawɔ avu kple kansa.
• Kekeli ƒe atikewɔwɔ: Ezãa keklẽŋusẽ si me ŋusẽ geɖe le tsɔ tsrɔ̃a kansa lãmenugbagbeviwo.
• Atikewɔwɔ si woɖo taɖodzinu na: Atike siwo tɔa ŋku molecule aɖewo koŋ siwo kpena ɖe kansa lãmenugbagbeviwo ŋu be woatsi.

Ayiku me kansa dada

Wozãa atike siwo wozãna na ayiku me dɔdzẽ abe alesi wozãa tsinyegoe me dɔdzẽ ene la dometɔ aɖewo. Tsɔ kpe ɖe eŋu la, woate ŋu azã atikewɔmɔnu siawo:

• Amekoko: Ayiku ƒe akpa si ŋu kansa le koe woate ŋu aɖe, alo ayiku bliboa ɖeɖe.
• Cryoablation: Ezãa vuvɔ si nu sẽ tsɔ tsrɔ̃a kansa lãmenugbagbeviwo.
• Radiofrequency ablation: Wozãa radio ƒe ƒutsotsoewo tsɔ doa dzo na kansa lãmenugbagbeviwo hetsrɔ̃a wo.

Ayiku ƒe akɔta kple/alo tsinyegoe me kansa dada

• Amekoko: Woɖea ayiku ƒe akɔta alo tsinyegoe ƒe akpa si kansa la le la ɖa.

Nukae nye agbetsitsi ƒe agbɔsɔsɔme ne èxɔ aɖuɖɔtoe me kansa?

Togbɔ be tsinyegoe me kansa nye kansa si dzea egɔme tso lãmenugbagbevi ƒomevi ɖeka me hã la, dɔlélea ƒe zɔzɔ ate ŋu ato vovo le afisi wòdze le nu (tsinyegoe, ayiku, ayiku ƒe akɔta, tsinyegoe).

Mɔkpɔkpɔ le tsinyegoe me dɔdzẽ ŋu

Abe kansa akpa gãtɔ ene la, tsinyegoe me dɔdzẽ ate ŋu anɔ agbe ne wokpɔe dze sii hedae kaba. Le ƒe 2018 ƒe nyatakaka siwo tso Dukɔa ƒe Kansa Dɔwɔƒe (NCI) gbɔ nu la, amesiwo woda dɔ na le kansa ƒe gɔmedzedze ƒe 96% gakpɔtɔ nɔ agbe ƒe atɔ̃ le esi wokpɔ dɔlélea le wo ŋu vɔ megbe. Le nusianu me la, amesiwo ŋu tsinyegoe me kansa le ƒe 77% gakpɔtɔ nɔ agbe ƒe atɔ̃ le esi wokpɔ dɔlélea le wo ŋu vɔ megbe.

Mɔkpɔkpɔ le ayiku me dɔdzẽ ŋu

Abe kansa akpa gãtɔ ene la, ayiku me dɔdzẽ (si me ayiku me dɔdzẽ hã le) dada le bɔbɔe ne wokpɔe kaba.Le NCI ƒe nyatakakawo (2018) nu la, ame siwo woda ayiku me dɔdzẽ ƒe gɔmedzedze la dometɔ 93% gakpɔtɔ le agbe ƒe atɔ̃ le dɔlélea kpɔkpɔ vɔ megbe. Ƒe atɔ̃ ƒe agbetsitsi ƒe agbɔsɔsɔme katã nye 76.5%.

Aleke mawɔ aɖe afɔku si le nye aɖuɖɔtoe me dɔdzẽ xɔxɔ le nye aɖuɖɔtoe me dzi akpɔtɔ?

Nu vevi eve li nàte ŋu awɔ atsɔ aɖe kansa sia xɔxɔ ƒe afɔkua dzi akpɔtɔ:

• Menye sigaret nono o.
• Ƒo asa na atike siwo gblẽa nu le ame ŋu aɖewo zazã.

Aleke mawɔ alé be na ɖokuinye?

Ne woxɔ kansa kaba la, zi geɖe la, ɖɔktawo ate ŋu ada aɖuɖɔtoe me kansa, si dona le aɖuɖɔtoe me. Gake nublanuitɔe la, anɔ eme ŋutɔ be kansa ƒomevi siawo agatrɔ ava. Ne woda dɔ na wò le kansa sia ƒomevi ta la, ele vevie be nàyi edzi anɔ beléle si akplɔ wò ɖo abe alesi wò ɖɔkta gblɔe ene. Esia le vevie ŋutɔ.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne ède dzesi tɔtrɔ aɖewo le wò ŋutilã me, vevietɔ dzesi siwo fia be tsinyegoe me kansa gadze aɖuɖɔtoe me la, yi ɖɔkta gbɔ enumake. Esia fia be ne èkpɔ dzesi yeye aɖewo, abe ʋu le wò aɖuɖɔ me, akɔtave, alo ɖeɖiteameŋu yeye ene la, ele be nàkpɔ ɖɔkta godoo.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Enyo, eyata, esiawoe nye nu vevitɔ kekeake siwo dzi wòle be nàɖo ŋkui tso nusiwo ŋu míeƒo nu tsoe egbea me:

• Urothelial carcinoma nye kansa si dona le wò aɖuɖɔtoe ƒe akpa si le eme (tsinyegoe, ayiku, kple tsinyegoe me).
• Dzesi vevitɔe nye ʋu si le aɖuɖɔ me . Dzesi bubuwoe nye akɔtave, ɖeɖiteameŋu, kple lolo dzi ɖeɖe kpɔtɔ.
• Sigaretnono kple atike aɖewo zazã nye nusiwo koŋ gbɔ wòtsona be afɔkua le eme.
• Ne wokpɔe kaba la, anɔ eme be woadae ahadae.
• Esi wònye be kansa sia ate ŋu agadzɔ ake ta la, ele vevie be woayi atikewɔlawo ƒe dodokpɔwo dzi le atikewɔwɔ vɔ megbe.
• Ne ɖikeke alo dzesi aɖe le ŋuwò la, mègavɔ̃ be yeaƒo nu kple ɖɔkta o. Woakpe ɖe ŋuwò.

Mele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me! Aɖuɖɔtoe me kansa, Aɖuɖɔtoe me dɔdzẽ, Aɖuɖɔtoe me kansa, Tsinyegoe me kansa, Ayiku me kansa, Ʋu le aɖuɖɔ me, Kansa ƒe dzesiwo