Kua kite koe i te toto i roto i tō mimi, i te mamae tuara tonu rānei, me te ngenge kāore e taea te whakamārama? Ahakoa te āhua iti noa iho o ēnei tohu, he tohu pea ēnei mō te mate pukupuku e pā ana ki te pūnaha mimi. Ko tētahi momo ko te Urothelial Carcinoma , e kiia ana i ētahi wā ko te Transitional Cell Carcinoma . I Nirogi Lanka, e hiahia ana mātou ki te kōrero taipitopito i tēnei ki a koe, pērā i te mahi a tētahi hoa pono.
He aha te Urothelial Carcinoma? He māmā noa iho…
He whakarāpopototanga noa iho, ko te Urothelial Carcinoma he mate pukupuku e tīmata ana i roto i te urothelium — te kiko motuhake e whakarārangi ana i ngā wāhanga o tō pūnaha mimi. Whakaarohia he paparanga angiangi, he paparanga tiaki e kapi ana i ngā mata o roto o ētahi okana. Ko te nuinga o tēnei kiko kei roto i te pūkahukahu, i ngā whatukuhu (ina koa ko te pelvis whatukuhu), me ngā ngongo e kawe ana i te mimi (ngā ureters).
I mōhio koe e 90% o ngā mate pukupuku tōngāmimi , me te 7% pea o ngā mate pukupuku tākihi, he Urothelial Carcinomas? He rite tonu ngā tohu mō ngā mea e rua. Ko te mea pai, ki te kitea wawe ēnei mate pukupuku, he maha ngā wā ka taea te rongoā. Heoi anō, he nui te tūponotanga ka hoki anō mai, koia te mea nui kia mōhio tonu koe mō tō haerenga hauora.
He aha te pānga o tēnei mate pukupuku ki tō tinana?
He rerekē pea te pānga o te Urothelial Carcinoma ki tō mimi me ō whatukuhu.
Matepukupuku Urothelial o te Pūngāwerewere
He okana rite ki te putea tō pūkahukahu kei waenganui i ō wheua hope, kei runga ake i te urethra me raro iho i ngā whatukuhu. Ka kohia e ia te mimi i hangaia e ngā whatukuhu. Ko te arai o roto o te pūkahukahu he mea hanga mai i taua kiko urothelium i kōrerotia i mua ake nei. He ahurei ēnei pūtau nā te mea ka taea e rātou te totoro i te mea ka whakakiia tō pūkahukahu, ka whakaiti i a koe e whakawātea ana (ko te tikanga ka taea e te pūkahukahu te pupuri i te rua kapu mimi).
Ina puta te mate pukupuku i konei, ka tīmata te wehewehe rerekē o ngā pūtau i roto i te urothelium, ka horapa mai i te paparanga o roto ki ngā kiko e karapoti ana. I ētahi wā, ka neke ēnei pūtau rerekē mā roto i te pakitara o te pūkahukahu ki roto i ngā kiko ngako e karapoti ana. Ki te kore e rongoatia, ka horapa pea tēnei mate pukupuku mā roto i ngā pakitara o te pūkahukahu ki ngā kōpū lymph tata, ā, ka mutu, ka horapa ki ngā whekau tawhiti pērā i ngā wheua, ngā pukahukahu, te ate rānei.
E rua ngā momo matua o te mate pukupuku pūkahukahu:
- Te Matepukupuku Urothelial Tino Kaha: He kaha ake tēnei. Ahakoa i muri i te maimoatanga, he nui ake te tūponotanga o te hokinga mai. He nui ake te tūponotanga ka uru ki te paparanga uaua o te pūkahukahu, ki ngā kōpū lymph tata, ki ētahi atu wāhanga rānei o te tinana.
- Te Matepukupuku Urothelial iti: Ahakoa ka taea te hoki mai anō, he iti ake te tūponotanga ka uru ki te uaua tōngāmimi, ka horapa rānei ki ētahi atu whekau.
Matepukupuku Urothelial o te Tākihi
E rua ā tātou whatukuhu, he rite ki te pīni te āhua, kei raro i te rara o te puku. Ko tā rātou mahi he tātari i ngā paitini me ngā para mai i te toto hei whakaputa mimi. Ka kohia tēnei mimi ki waenganui o te whatukuhu, he wāhi e kiia nei ko te pelvis whatukuhu . Mai i reira, ka rere ki raro i tētahi ngongo e hono ana i te whatukuhu ki te pūhā, e kiia nei ko te ureter . Pērā i te pūhā, kua whakakikoruatia te pelvis whatukuhu me ngā ureter ki te kiko urothelial.
I roto i te mate pukupuku urothelial e pā ana ki te whatukuhu, ka huihui ngā pūtau rerekē hei hanga pukupuku i roto i te pelvis whatukuhu, i te ureter rānei. Ka horapa atu hoki ēnei ki ētahi atu kiko, ki ētahi atu okana rānei mēnā kāore e whakatikahia.
Ko wai te mea tino mōrearea?
Ko te mate pukupuku tōngāmimi te tuaono o ngā mate pukupuku tino kitea i te Hononga o Amerika, ā, 90% o aua mate he Urothelial Carcinomas. E whā ngā wā ka nui ake te tūponotanga o te mate pukupuku tōngāmimi ki ngā tāne i ngā wāhine.
Ko te mate pukupuku whatukuhu te tuawaru o ngā mate pukupuku e tino kitea ana, ā, e 7% o ēnei mate ko ngā Urothelial Carcinomas. Ko te nuinga o te wā ka kitea tēnei mate i roto i ngā tāngata i waenga i te 65 ki te 74 tau te pakeke , ā, e rua te nui ake o te tūponotanga o ngā tāne ki te pāngia e tēnei mate i ngā wāhine.
He aha te tohu matua o te Urothelial Cancer?
I ngā wāhanga tōmua, kāore pea he tohu o te Urothelial Carcinoma. Heoi, ko te toto i roto i te mimi (hematuria) te tohu tuatahi e kitea ana. Ki te kite koe i te toto i roto i tō mimi, ki te pāngia rānei koe e tētahi o ngā tohu i raro nei, me toro atu koe ki te tākuta tonu :
- Te mamae tuara e mau tonu ana.
- Te ngenge tonu, te ngoikore rānei.
- Te whakahekenga taumaha kāore i te whakamāramatia.
- Te mimi mamae ( dysuria ).
- Te rongo i tētahi puranga, i tētahi puku rānei i te rohe o te whatukuhu .
- He kirika iti.
He aha te take o tēnei mate pukupuku?
Kāore anō kia kitea e ngā kairangahau hauora tētahi tino take mō te mate pukupuku Urothelial o te pūkahukahu me ngā whatukuhu. Heoi anō, he maha ngā āhuatanga mōrearea noa kua kitea:
- Te momi hikareti : Koinei te tino take mōrearea. He nui ake te mōrearea o te hunga momi hikareti ki te pāngia e te mate pukupuku o te pūnaha mimi.
- Te pānga ki ētahi matū: Kua whakaatuhia e ngā rangahau ko te hunga e mahi ana i ngā ahumahi e whakamahi ana i ngā tae, te rapa, te hiako, te kakahu, te peita, ētahi hua makawe rānei, ka nui ake te tūponotanga ki te whakawhanake i ēnei mate pukupuku.
Me pēhea te tautuhi a ngā tākuta i tēnei mate pukupuku?
He maha ngā whakamātautau tātaritanga e whakamahia ana e ngā tākuta hei tautuhi i ngā mate pukupuku o te pūkahukahu me te whatukuhu, tae atu ki te Urothelial Carcinoma:
- Te tātari mimi: He whakamātautau e tirotiro ana i tō mimi mō ngā tohu rerekē, pērā i te panoni o te tae, te aroaro rānei o te huka, te pūmua, te toto, te huakita rānei.
- Te Hitori Mimi: Ka tirohia tō tauira mimi i raro i te karuārai hei rapu i ngā pūtau rerekē. Mena he mate pukupuku kei roto i ō whatukuhu, tō puku, ō ureter rānei, tera pea kei roto i tō mimi aua pūtau mate pukupuku.
- Pyelogram Ā-roto (IVP): He raupapa whakamātautau hihi-X tēnei e whakamahia ana hei kite i te mate pukupuku pea i roto i ngā whatukuhu, i ngā ureter, i te pūkahukahu rānei. Ka werohia e ngā tākuta he tae rerekē motuhake ki roto i tō uaua. I a te tae e haere ana i roto i tō ara mimi, ka tangohia ngā hihi-X hei tautuhi i ngā aukati, i ngā āhuatanga rerekē rānei.
- Ureteroscopy: Ka tukuna he taputapu angiangi, rite ki te ngongo, he kāmera me te mārama kei roto i tō urethra kia taea ai e tō tākuta te tirotiro i te roto o ō urethra me te pelvis whatukuhu. Ka taea hoki te whakamahi i tēnei tikanga hei kohi tauira kiko (biopsies).
- Matawai CT: He matawai e whakamahi ana i tētahi mīhini hihi-X e hono ana ki tētahi rorohiko hei hanga i ngā whakaahua taipitopito, whakawhiti-wāhanga o roto o tō tinana.
- Ultrasound: Ka tukuna ngā ngaru oro kaha-nui ki roto i ō kiko, ā, ka hangaia he sonogram (pikitia) e ngā haruru e hoki mai ana. Ka taea e te ultrasound o te puku te āwhina ki te kimi i ngā pukupuku i roto i te pelvis whatukuhu me ngā ureter.
- MRI: Ka whakamahia ngā aukume, ngā ngaru reo irirangi, me te rorohiko hei whakaputa whakaahua tino taipitopito o ngā wāhi motuhake i roto i tō tinana, pērā i te kōhao hope.
He aha te Whakatakotoranga Mate Pukupuku?
Ka whakamahia e ngā tākuta he pūnaha whakatau i te mate pukupuku hei whakamahere i tō maimoatanga me te whakatau i tō matapae - te āhua pea o tō mate. E whakaahua ana i te nui o te tipu, te horapa rānei o te mate pukupuku puta noa i tō tinana.
He mahi uaua te whakatau i te āhua o tō mate. Mēnā kei te whakaahuahia tō mate mā te huinga o ngā reta me ngā tau, he mea maori te manukanuka, te taumaha rānei. He mea tino mārama te pēnei o te whakaaro. Mēnā he mea kāore i te mārama, he mea rānei e whakararuraru ana i a koe, tena koa pātai atu ki tō tākuta kia whakamārama mai me pēhea te whai pānga o tēnei pūnaha ki tō āhuatanga.
Ngā Wāhanga o te Matepukupuku Pūngāwerewere
Ka taea e te mate pukupuku tōngāmimi te tīmata (kua noho ki te arai o roto) te whanake rānei (kua uru ki te pakitara tōngāmimi, kua horapa rānei ki ngā whekau tata, ki ngā kōpuku lymph rānei). Ko ngā wāhanga o te mate pukupuku tōngāmimi ko:
- Wāhanga I: Kei roto noa i te arai o roto o te pūhā te matepukupuku, i te kiko honohono rānei i raro iho. Kāore anō kia tae ki te pakitara uaua matua o te pūhā.
- Wāhanga II: Kua horapa te mate pukupuku ki roto i te pakitara uaua o te pūhā.
- Wāhanga III: Kua horapa te mate pukupuku ki te kiko ngako i waho o te uaua tōngāmimi.
- Wāhanga IV: Kua horapa te mate pukupuku ki ngā kōpū lymph, ki ētahi atu whekau, ki ngā wheua rānei.
Ka whakarōpūhia hoki e ngā tākuta te mate pukupuku pūkahukahu hei Kore-whakaekenga , Kore-whakaekenga-uaua , Kore-whakaekenga-uaua rānei:
- Kore-whakaekenga: Tērā pea ka piri te mate pukupuku ki tētahi wāhi kiko iti, ki te mata anake rānei o te pūkahukahu.
- Kāore e uru ki te uaua: Kua hohonu ake te tipu o te mate pukupuku ki roto i te pūkahukahu engari kāore anō kia tae ki ngā paparanga uaua.
- Te urutomo ki te uaua: Kua tae te mate pukupuku ki te uaua o te pakitara o te pūhā, ā, kua horapa pea ki ngā paparanga ngako, ki ngā kiko okana tata rānei i waho o te pūhā.
Ngā Wāhanga o te Matepukupuku Tākihi
Mō te mate pukupuku whatukuhu, kāore te momo pūtau mate pukupuku e whakatau i te taumata o te mate. Tata ki te 7% noa iho o ngā mate pukupuku whatukuhu e pā ana ki te mate pukupuku urothelial. Kia mahara he rerekē te taumata o te mate pukupuku whatukuhu i te taumata o te pelvis whatukuhu, te ureter rānei.
- Wāhanga I: Kei roto i te whatukuhu te mate pukupuku.
- Wāhanga II: Kua nui haere te mate pukupuku engari kei roto tonu i te whatukuhu.
- Wāhanga III: Kua horapa te mate pukupuku ki ngā uaua toto nui (pērā i te uaua whatukuhu, te vena cava o raro rānei), ngā kiko e karapoti ana, ngā kōpū lymph tata rānei.
- Wāhanga IV: Kua horapa te mate pukupuku ki te repe adrenal, ki ngā kōpū lymph tawhiti, ki ētahi atu whekau rānei.
Ngā Wāhanga o te Matepukupuku Pelvis me te Ureter o te Tākihi
- Wāhanga 0: Ka kitea ngā pūtau rerekē i roto i te arai o te pelvis whatukuhu, te ureter rānei. Ka kiia hoki tēnei ko te papillary carcinoma , ko te carcinoma in situ rānei.
- Wāhanga I: Kua horapa te mate pukupuku mā roto i te arai o roto o te pelvis whatukuhu, o te ureter rānei, ki roto i te paparanga kiko honohono.
- Wāhanga II: Kua neke te matepukupuku mā roto i te kiko honohono ki roto i te paparanga uaua o te pelvis whatukuhu, o te ureter rānei.
- Wāhanga IV: Kua horapa te mate pukupuku ki ngā whekau tata, ki tētahi, ki ētahi atu rānei o ngā kōpū waikura, ki te ngako e karapoti ana i te whatukuhu, ki ngā whekau tawhiti rānei pērā i ngā pukahukahu, te ate, ngā wheua rānei.
Me pēhea te rongoā i te mate pukupuku Urothelial i Nirogi Lanka?
Ko ngā huarahi maimoatanga e whakawhirinaki ana ki te wāhi motuhake o te mate pukupuku urothelial—ahakoa i roto i te pūkahukahu, i ngā whatukuhu, i te pelvis whatukuhu, i te ureter rānei.
Te Maimoatanga Matepukupuku Pūngāwerewere
Ko ngā kōwhiringa maimoatanga pea ko:
- Pokanga: Ka tangohia e ngā taote pokanga te puku, ka whakamahia rānei te hiko kaha-nui hei tahu atu, he tukanga e mōhiotia ana ko te fulguration .
- Te rongoā matū: Ka whakamahia ngā rongoā hei whakangaro i ngā pūtau matepukupuku.
- Ārai Mate: Ka whakaoho i tō ake pūnaha ārai mate kia whawhai ki te mate pukupuku.
- Whakaora Irahiko: Ka whakamahi i ngā hihi pūngao nui hei whakangaro i ngā pūtau matepukupuku.
- Whakaora Whaiaro: Ngā rongoā e aro motuhake ana ki ngā ngota e āwhina ana i te tipu o ngā pūtau matepukupuku.
Te Maimoatanga Matepukupuku Tākihi
He rite ētahi maimoatanga mō te mate pukupuku whatukuhu ki te mate pukupuku tōngāmimi, me ētahi atu kōwhiringa tae atu ki:
- Pokanga: I runga i te āhua o te mate, ka tangohia pea tetahi wāhanga o te whatukuhu, te whatukuhu katoa rānei.
- Cryoablation: Ka whakamahia te makariri nui hei whakangaro i ngā pūtau matepukupuku.
- Te Whakakorenga Auautanga Reo Irirangi: Ka whakamahi i ngā ngaru reo irirangi hei whakamahana me te whakangaro i ngā pūtau matepukupuku.
Te Maimoatanga o te Mate Pukupuku o te Pelvis me/ranei te Ureter
- Pokanga: Ka tangohia te wāhanga o te pelvis whatukuhu, te ureter rānei, kei roto nei te mate pukupuku.
He aha te matapae mō te matepukupuku urothelial?
Ahakoa e puta mai ana ngā mate pukupuku urothelial i te momo pūtau kotahi, ka rerekē pea te tirohanga i runga i te wāhi tuatahi (te pūkahukahu, te whatukuhu, te pelvis whatukuhu, te ureter rānei).
Te Tirohanga mō te Matepukupuku Pūngāwerewere
Pērā i te nuinga o ngā mate pukupuku, mā te kitenga wawe me te maimoatanga wā tika ka nui ake te tūponotanga o te oranga roa me te mate pukupuku tōngāmimi. E ai ki ngā raraunga o te tau 2018 mai i te National Cancer Institute (NCI), 96% o ngā tāngata i kitea he mate pukupuku tōngāmimi i te wā tōmua i ora tonu i muri i ngā tau e rima i muri i tā rātou tautuhi. I te katoa, ko te reiti oranga e rima tau mō te mate pukupuku tōngāmimi he 77%.
Te Tirohanga mō te Matepukupuku Whatukuhu
Pērā i te maha atu o ngā mate pukupuku, he māmā ake te rongoā i te mate pukupuku tākihi (tae atu ki ngā mate pukupuku o te hope tākihi) ina kitea i ngā wāhanga tōmua. E ai ki ngā raraunga a te NCI (2018), 93% o ngā tūroro i rongoatia mō te mate pukupuku tākihi wāhanga tōmua i ora mō te iti rawa e rima tau i muri i te tātaritanga. Ko te ōrau oranga mō ngā tau e rima katoa e 76.5%.
Me pēhea taku whakaiti i te mōrearea o te mate pukupuku urothelial i roto i taku ara mimi?
E rua ngā huarahi matua hei āwhina i a koe ki te whakaiti i tō tupono ki te whakawhanake i ēnei momo mate pukupuku:
- Āta karohia te momi hikareti.
- Whakaitihia tō pānga ki ngā matū kino.
Me pēhea taku tiaki i ahau anō?
Ina kitea wawetia, ka taea e ngā tākuta te rongoā angitu i ngā mate pukupuku urothelial o te ara mimi. Heoi, heoi anō, he nui te tūponotanga ka hoki anō ēnei mate pukupuku. Mena kua rongoatia koe mō tēnei momo mate pukupuku, he mea nui kia piri tonu koe ki te mahere tiaki whai muri i tūtohutia e tō tākuta. He mea nui tēnei mō tō hauora mō te wā roa.
Āhea ahau me toro atu ki te tākuta?
Ki te kite koe i ētahi huringa i roto i tō tinana, i ētahi tohu rānei e tohu ana i te hokinga mai o te mate pukupuku urothelial, me toro atu ki tō tākuta tonu. Kei roto i tēnei ko ngā tohu pēnei i te toto i roto i tō mimi, te mamae tuara tonu, te ngenge rānei kāore i te whakamāramatia. Kaua e mangere ki te rapu awhina hauora mēnā ka hoki mai ēnei tohu.
Karere Tangohia ki te Kāinga
Hei whakarāpopototanga, koinei ngā kōrero tino nui o tā tātou kōrero i te rā nei:
- Ko te mate pukupuku urothelial he mate pukupuku e puta ana i roto i te arai o roto o tō ara mimi (te pūkahukahu, ngā whatukuhu, me ngā ureters).
- Ko te toto i roto i te mimi te tohu whakatūpato matua, ahakoa ka pāngia pea koe e te mamae o te tuara, te ngenge, te ngaronga taumaha rānei kāore i te mārama.
- Ko te momi hikareti me te pānga ki ētahi matū ngā tino take mōrearea.
- Mā te kitenga wawe ka nui ake te angitu o te maimoatanga.
- Nā te mea he nui te tūponotanga ka hoki anō mai ēnei mate pukupuku, he mea nui kia whakaritea he tirotiro tirotiro auau i muri i tō maimoatanga.
- Mena he āwangawanga, he tohu rānei āu, kaua e mangere ki te kōrero ki tō kaiwhakarato hauora. Kei reira rātou hei tautoko i a koe.
Ko te tumanako i whai hua ēnei mōhiohio. Kia ora tonu koe me Nirogi Lanka!
Matepukupuku urothelial, Matepukupuku ara mimi, Matepukupuku tōngāmimi, Matepukupuku whatukuhu, Toto i roto i te mimi, Ngā tohu o te matepukupuku
