He aha te Urothelial Carcinoma? Me kōrero taipitopito tātou mōna!

Kua kite koe i te toto i roto i tō mimi? He mamae tuara rānei tōu, he ngenge tonu rānei? Ahakoa te āhua nei kāore ēnei e nui hei āwangawanga, he tohu pea ēnei mō te mate pukupuku e puta ana i roto i te ara mimi. Ko tētahi momo mate pukupuku ko te Urothelial Carcinoma , e kiia ana i ētahi wā ko te Transitional Carcinoma . I tēnei rā, ka kōrerohia tēnei mea me te taipitopito ake , me te mea kei te kōrero tātou ki tētahi hoa.

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 kiko e kiia nei ko te urothelium, e whakakī ana i ētahi wāhanga o tō pūnaha mimi. Whakaarohia he rite ki te arai o roto o ētahi okana o roto i ō tātou tinana. Ko te urothelium tētahi o aua kiko. Ko te nuinga o te wā ka kitea i roto i te pūkahukahu, ngā whatukuhu (ina koa ko te pelvis whatukuhu), me ngā ureter. I mōhio koe ko te 90% o ngā mate pukupuku pūkahukahu me te 7% o ngā mate pukupuku whatukuhu he mate pukupuku urothelial? He tino ōrite ngā tohu o ngā mea e rua. Ko te mea pai ko te ngāwari ake o te rongoā me te whakaora i ēnei mate pukupuku mēnā ka kitea wawe . Heoi, ka taea e rātou te hoki mai anō i ētahi wā. Koia te mea nui kia mōhio koe ki tēnei.

He aha te pānga o tēnei mate pukupuku ki ō tātou tinana?

Ka rerekē pea te pānga o te mate pukupuku urothelial ki tō pūkahukahu me ō whatukuhu.

Te mate pukupuku urothelial o te pūkahukahu

He okana iti rite ki te pēke tō pūkahukahu. Kei waenganui i ngā wheua hope, kei runga ake i tō urethra, ā, kei raro iho i ō whatukuhu. Ka kohia te mimi mai i ō whatukuhu ki roto i tēnei pūkahukahu. Kei roto i te pūkahukahu te kiko i kōrerotia i mua ake nei, ko te urothelium . Ka taea e ngā pūtau o tēnei kiko te totoro ina kī tō pūkahukahu i te mimi, ā, ka whakawhāiti ina mimiti. (Ka taea e tō pūkahukahu te pupuri i te rua kapu mimi.) Ina pāngia koe e te matepukupuku pūkahukahu, ka wehea ngā pūtau o tēnei urothelium i runga i te āhua rerekē, ka horapa mai i te paparanga o roto o tō pūkahukahu ki ētahi atu paparanga. I ētahi wā, ka taea e ēnei pūtau rerekē te pakaru i roto i ngā pakitara o tō pūkahukahu, ka uru ki roto i te kiko ngako e karapoti ana. Ki te kore e rongoatia, ka horapa tēnei matepukupuku mā roto i te pakitara pūkahukahu ki ngā kōpū lymph tata, ā, mai i reira ki ētahi atu wāhi pērā i ngā wheua, ngā pukahukahu, me te ate. E rua ngā momo matua o te matepukupuku pūkahukahu:

• Matepukupuku urothelial taumata teitei: He ahua morearea ake tēnei. He nui ake te tūponotanga ka hoki mai ahakoa kua rongoatia. Ka horapa pea ki te paparanga uaua o te pūkahukahu, ki ētahi atu wāhanga o te tinana, meKa taea te horapa ki ngā kōpū lymph .
• Matepukupuku urothelial iti te taumata: Ka taea hoki tēnei te hoki mai, engari he iti rawa te tūponotanga ka horapa ki te paparanga uaua o te pūkahukahu, ki ētahi atu wāhanga rānei o te tinana.

Te mate pukupuku urothelial o ngā whatukuhu

E rua ā tātou whatukuhu. He rite ki ngā okana e rua he āhua pīni, kei raro noa iho i te rara, kei muri hoki i te puku. Ka tātarihia e ngā whatukuhu ngā para me ngā paitini mai i te toto, ā, ka hanga mimi. Ka kohia tēnei mimi ki waenganui o te whatukuhu e kiia nei ko te pelvis whatukuhu . Mai i reira, ka haere te mimi ki raro i tētahi ngongo roa e hono ana i te whatukuhu ki te pūkahukahu. E kiia ana tēnei ngongo ko te ureter . Pērā i ngā whatukuhu, kua whakakikoruatia hoki te pelvis whatukuhu me te ureter ki te kiko urothelial. Ka puta te mate pukupuku whatukuhu ina tupu ngā pūtau urothelial rerekē, ā, ka hanga he pukupuku i roto i ngā whatukuhu, te pelvis whatukuhu, te ureter rānei. Ka taea hoki e te mate pukupuku whatukuhu te horapa ki ētahi atu okana, ki ngā kiko rānei.

Ko wai te mea tino tūpono ka pāngia e tēnei mate pukupuku?

Ko te mate pukupuku tōngāmimi te tuaono o ngā mate pukupuku tino kitea i te Hononga o Amerika. Ā, 90% o ngā mate pukupuku tōngāmimi he mate pukupuku urothelial. E whā ngā wā ka nui ake te tūponotanga o ngā tāne ki te pāngia e te mate pukupuku tōngāmimi i ngā wāhine . Ko te mate pukupuku tākihi te tuawaru o ngā mate pukupuku tino kitea. Tata ki te 7% o ngā mate pukupuku tākihi he mate pukupuku urothelial. Ko te nuinga o te wā ka pāngia te hunga i waenga i te 65 me te 74 tau te pakeke. E rua ngā wā ka nui ake te tūponotanga o ngā tāne ki te pāngia e te mate.

He aha te tohu matua o te mate pukupuku urothelial?

Kāore pea he tohu o te mate pukupuku urothelial i ōna wāhanga tōmua. Heoi, ko te toto i roto i te mimi (hematuria) te tohu tuatahi. Mena ka kite koe i te toto i roto i te mimi, ka pāngia rānei koe e tētahi o ēnei tohu, me toro atu koe ki te tākuta :

• Te mamae tuara e mau tonu ana.
• Ngenge, ngenge .
• Te hiroki noa iho , kāore he take.
• Te mamae i te wā e mimi ana ( dysuria ).
• He rite ki te pukupuku kei te wāhi kei reira ngā whatukuhu .
• He paku kirika tōku.

He aha te take o tēnei mate pukupuku?

Kāore anō kia tino mōhiotia e ngā kairangahau hauora te pūtake o te mate pukupuku urothelial o te pūkahukahu me ngā whatukuhu. Heoi, kua tautuhia e rātou ētahi āhuatanga mōrearea noa:

• Te momi hikareti : He nui ake te tūponotanga o te hunga momi hikareti ki te whakawhanake i te mate pukupuku urothelial i roto i te pūnaha mimi.He tino teitei te mōrearea o te mate pukupuku . Koinei te tino take mōrearea.
• Te pānga ki ētahi matū: Kua whakaatuhia e ngā rangahau he nui ake te mōrearea o te hunga e mahi ana i ngā wāhi e hanga ana i ētahi tae, rapa, taonga hiako, peita, ētahi papanga, me ngā hua hanga makawe ki te pāngia e tēnei mate pukupuku.

Me pēhea te tautuhi a ngā tākuta i tēnei mate pukupuku?

Ka whakamahia e ngā tākuta ēnei whakamātautau hei tātaritanga i ngā mate pukupuku o te pūkahukahu me te whatukuhu, tae atu ki te mate pukupuku urothelial:

• Te tātari mimi: He whakamātautau e tirotiro ana i tō mimi mō te tae, te huka, te pūmua, te toto, me ngā huakita.
• Te tirotiro ira o tō mimi: Ka tangohia he tauira o tō mimi, ā, ka tirohia i raro i te karuārai hei tirotiro mō ngā pūtau rerekē. Mena he mate pukupuku tōu i roto i ngā whatukuhu, i te pūhā, i te urethra rānei, tera pea ka kitea ngā pūtau mate pukupuku i roto i tō mimi.
• Pyelogram intravenous (IVP): He raupapa whakamātautau hihi-X tēnei. Ka mahia hei tirotiro mō te mate pukupuku i roto i ngā whatukuhu, ngā ureter, me te pūhā. Ka werohia e ngā tākuta he wai motuhake (tae rerekē) ki roto i tō uaua. Kātahi ka tangohia ngā hihi-X i te mea ka haere te wai mā roto i ō whatukuhu, ngā ureter, me te pūhā hei tirotiro mēnā he aukati.
• Ureteroscopy: Ka tukuna he taputapu angiangi rite ki te ngongo (me te kāmera me te mārama) mā roto i te urethra hei tirotiro i roto i te ureter me te pelvis whatukuhu. Ka whakamahia hoki hei tango tauira kiko.
• Matawai CT (Tomography rorohiko - Matawai CT): Ka tango pikitia taipitopito o ngā wāhanga rerekē o te tinana mā te rorohiko e hono ana ki tētahi mīhini hihi-X.
• Ultrasound: Ka tukuna ngā ngaru oro kaha-teitei (ultrasound) ki roto i ngā kiko o roto i te tinana, ā, ka whakamahia ngā oro e hoki mai ana hei hanga pikitia (sonogram). Tērā pea ka mahia he ultrasound puku hei kite i ngā mate pukupuku o te pelvis whatukuhu me te ureter.
• MRI (Whakaahua aukume - MRI): Ka whakamahia he aukume, he ngaru reo irirangi, me te rorohiko hei tango pikitia taipitopito o ngā wāhi o roto i te tinana, pērā i te kōhao hope.

He aha te whakatau i te taumata o te mate pukupuku?

Ka whakamahia e ngā tākuta he pūnaha whakatau i te mate pukupuku hei whakamahere i te maimoatanga me te whakatau i te putanga. E whakaahua ana tēnei i te tipu me te horapa o te mate pukupuku.

He mahi uaua te whakatau i te mate pukupuku. Mēnā kei te ahua kei te whakauruhia tō mate ki roto i tētahi tauira me ētahi reta me ētahi tau, ka mataku, ka pōhēhē hoki. He mea mārama tēnā. Mēnā kāore koe i te tino mōhio ki tēnei, kei te mataku rānei koe, pātai atu ki tō tākuta kia whakamārama mai me pēhea te whakamahi o tēnei pūnaha ki tō mate.

Ngā wāhanga o te mate pukupuku pūkahukahu

Ka taea e te mate pukupuku tōngāmimi te tīmatanga (kei te arai anake o te tōngāmimi) te whanaketanga rānei (kua uru ki roto i te pakitara tōngāmimi, ā, kua horapa ki ngā whekau tata, ki ngā kōpuku lymph rānei). Ko ngā wāhanga o te mate pukupuku tōngāmimi e whai ake nei:

• Wāhanga I: Ka herea te mate pukupuku ki te arai o te pūkahukahu, ki te kiko honohono rānei i raro iho. Kāore anō kia horapa ki te pakitara uaua matua o te pūkahukahu.
• Wāhanga II: Kua horapa te mate pukupuku ki te pakitara uaua o te pūkahukahu.
• Wāhanga III: Kua horapa te mate pukupuku mai i te uaua o te pūkahukahu ki te kiko ngako i waho.
• Wāhanga IV: Kua horapa te mate pukupuku mai i te pūkahukahu ki ngā kōpū lymph, ki ētahi atu whekau, ki ngā wheua rānei.

Ka whakarōpūhia hoki e ngā tākuta te mate pukupuku pūkahukahu hei kore-whakaeke , kore-whakaeke-uaua , kore -whakaeke-uaua rānei.

• Kore-whakaekenga: I tēnei wā, tera pea ka kitea te mate pukupuku i tētahi wāhi iti noa iho o te kiko, ka herea rānei ki te mata o te pūkahukahu.
• Kāore e uru ki te uaua: I tēnei āhuatanga, kua uru hohonu te mate pukupuku ki roto i te pūkahukahu, engari kāore anō kia horapa ki ngā uaua.
• Te urutomo i te uaua: I tēnei wā, kua horapa te mate pukupuku ki ngā uaua o te pakitara o te pūhā, ā, kua horapa pea ki ngā paparanga ngako i waho o te pūhā, ki ngā kiko rānei o ngā whekau.

Ngā wāhanga o te mate pukupuku whatukuhu

Kāore te mate pukupuku whatukuhu e whakarōpūtia i runga i te momo pūtau mate pukupuku. Tata ki te 7% o ngā mate pukupuku whatukuhu e pā ana ki te mate pukupuku urothelial. He rerekē te whakarōpūtanga o te mate pukupuku whatukuhu me te mate pukupuku pelvis/ureter whatukuhu.

• Wāhanga I: Kāore anō te mate pukupuku kia horapa ki tua atu i te whatukuhu.
• Wāhanga II: Kua tupu te mate pukupuku, engari kāore anō kia horapa ki tua atu i te whatukuhu.
• Wāhanga III: Kua horapa te mate pukupuku mai i te whatukuhu ki ngā uaua toto matua - te uaua whatukuhu me te vena cava o raro - ki ngā kiko e karapoti ana i te whatukuhu, ki ngā kōpū lymph tata rānei.
• Wāhanga IV: Kua horapa te mate pukupuku mai i te repe adrenal (he repe iti kei runga ake i te whatukuhu), ki ngā kōpū lymph tawhiti, ki ētahi atu whekau rānei.

Ngā wāhanga o te mate pukupuku o te pelvis whatukuhu me te ureter

• Wāhanga 0: He pūtau rerekē kei roto i te arai o te pelvis whatukuhu, o te ureter rānei. Ka kiia hoki tēnei ko te papillary carcinoma , ko te carcinoma in situ rānei.
• Wāhanga I (Wāhanga 1): Kua horapa te mate pukupuku mā roto i te paparanga o roto o te pelvis whatukuhu me/ranei te ureter, ā, ki roto i te paparanga kiko honohono.
• Wāhanga II:Kua horapa te mate pukupuku mā roto i te kiko honohono ki te paparanga uaua o te pelvis whatukuhu me/te ureter rānei.
• Wāhanga IV: (Kāore te Wāhanga III i te whakahuatia i konei, engari kei waenganui i te II me te IV te nuinga o te wā, e tohu ana i te horapa ki ngā hanganga tata) Kua horapa te mate pukupuku ki ngā whekau tata, ki tētahi, ki ētahi atu rānei o ngā kōpū lymph, ki te paparanga 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 a ngā tākuta i te mate pukupuku urothelial?

He rerekē ngā tikanga maimoatanga i runga i te wāhi kei reira te mate pukupuku urothelial i roto i te pūkahukahu, ngā whatukuhu, te pelvis whatukuhu, me te ureter.

Te maimoatanga mate pukupuku pūkahukahu

Ko ngā kōwhiringa maimoatanga pea ko:

• Pokanga: Ka tangohia e ngā taote te puku matepukupuku, ka tahuna rānei mā te whakamahi i te hiko kaha-nui. Ka kiia tēnei ko te electrocautery (fulguration) .
• Te rongoā matū: Ka hoatu he rongoā hei whakangaro i ngā pūtau matepukupuku.
• Ārai Mate: Ka whakaoho i te pūnaha ārai mate o tō tinana kia whawhai ki te mate pukupuku.
• Te rongoā irahiko: Ka whakamahia ngā hihi kaha-nui hei whakangaro i ngā pūtau matepukupuku.
• Te rongoā arotahi: Ngā rongoā e arotahi ana ki ngā ngota motuhake e āwhina ana i te tipu o ngā pūtau matepukupuku.

Te rongoā mate pukupuku whatukuhu

Ka whakamahia ētahi o ngā maimoatanga ōrite mō te mate pukupuku whatukuhu me te mate pukupuku tōngāmimi. Hei tāpiritanga, ka taea te whakamahi i ēnei maimoatanga:

• Pokanga: Ko te wāhanga anake o te whatukuhu me te matepukupuku ka taea te tango, ko te whatukuhu katoa rānei ka taea te tango.
• Cryoablation: Ka whakamahia te makariri nui hei whakangaro i ngā pūtau matepukupuku.
• Te tango i ngā pūtau matepukupuku mā te whakamahi i ngā ngaru reo irirangi: Ka whakamahia ngā ngaru reo irirangi hei whakamahana me te whakangaro i ngā pūtau matepukupuku.

Te rongoā i te mate pukupuku o te pelvis whatukuhu me/ranei te ureter

• Pokanga: Ka tangohia te wāhanga o te pelvis whatukuhu, te ureter rānei kei reira te matepukupuku.

He aha te ōrau oranga mēnā ka pāngia koe e te mate pukupuku urothelial?

Ahakoa he mate pukupuku te mate pukupuku urothelial e tīmata ana i te momo pūtau kotahi, ka rerekē pea te ahunga o te mate i runga i te wāhi e whanake ai (pūkahukahu, whatukuhu, pelvis whatukuhu, ureter).

Te tirohanga mō te mate pukupuku pūkahukahu

Pērā i te nuinga o ngā mate pukupuku, he nui ake te tūponotanga ka ora te mate pukupuku tōngāmimi mēnā ka kitea wawetia, ka rongoatia hoki. E ai ki ngā raraunga o te tau 2018 mai i te National Cancer Institute (NCI), 96% o te hunga i rongoatia mō te mate pukupuku wāhanga tōmua i ora tonu i ngā tau e rima i muri i te tātaritanga. I te katoa, 77% o te hunga he mate pukupuku tōngāmimi i ora tonu i ngā tau e rima i muri i te tātaritanga.

Te tirohanga mō te mate pukupuku whatukuhu

Pērā i te nuinga o ngā mate pukupuku, he māmā ake te rongoā i te mate pukupuku tākihi (tae atu ki te mate pukupuku hope whatukuhu) mēnā ka kitea wawetia.E ai ki ngā raraunga a te NCI (2018), e 93% o te hunga i rongoatia mō te mate pukupuku whatukuhu i te wā tōmua e ora tonu ana i ngā tau e rima i muri i te tātaritanga. Ko te ōrau oranga katoa mō ngā tau e rima ko te 76.5%.

Me pēhea taku whakaiti i te mōrearea o te mate pukupuku urothelial i roto i taku pūnaha mimi?

E rua ngā mea matua ka taea e koe te mahi hei whakaiti i tō tupono ki te whakawhanake i tēnei mate pukupuku:

• Kāore e momi hikareti.
• Te karo i te pānga o ētahi matū kino.

Me pēhea taku tiaki i ahau anō?

Ki te kitea wawe te mate pukupuku, ka taea e ngā tākuta te rongoā i te mate pukupuku urothelial, e puta ana i roto i te ara mimi. Engari , heoi anō, he tino tūponotanga ka hoki mai anō ēnei momo mate pukupuku. Ki te mea kua rongoatia koe mō tēnei momo mate pukupuku, he mea nui kia haere tonu te tiaki whai muri i ngā tohutohu a tō tākuta. He mea tino nui tēnei.

Āhea ahau me toro atu ki te tākuta?

Ki te kite koe i ētahi huringa i roto i tō tinana, inā koa ngā tohu e tohu ana i te hokinga mai o te mate pukupuku urothelial i roto i te pūnaha mimi, me toro atu ki te tākuta tonu. Ko te tikanga tēnei, ki te pāngia koe e ētahi tohu hou, pērā i te toto i roto i tō mimi, te mamae o te tuara, te ngenge hou rānei, me toro atu koe ki te tākuta.

Ngā mea tino nui hei maumahara (Karere hei kawe ki te kāinga)

Āe, koinei ngā mea tino nui hei maumahara māu i roto i ngā kōrero kua kōrerohia e tātou i tēnei rā:

• Ko te mate pukupuku urothelial he mate pukupuku e puta ana i te paparanga o roto o tō pūnaha mimi (te pūkahukahu, ngā whatukuhu, me ngā ureters).
• Ko te tohu matua ko te toto i roto i te mimi . Ko ētahi atu tohu ko te mamae o te tuara, te ngenge, me te ngaronga taumaha.
• Ko te momi hikareti me te pānga ki ētahi matū ngā tino take mōrearea.
• Ki te kitea wawetia, he nui ake te tūponotanga ka taea te rongoā me te whakaora.
• Nā te mea ka hoki anō pea tēnei mate pukupuku, he mea nui kia haere tonu ngā tirotiro hauora i muri i te maimoatanga.
• Ki te mea he ruarua, he tohu rānei āu, kaua e wehi ki te kōrero ki te tākuta. Mā rātou koe e āwhina.

Ko tāku tumanako ka whai hua ēnei kōrero ki a koe. Kia ora tonu koe! Matepukupuku Urothelial, Matepukupuku Urothelial, Matepukupuku mimi, Matepukupuku tōngāmimi, Matepukupuku whatukuhu, Toto i roto i te mimi, Ngā tohu o te matepukupuku