Kodi mukudziwa za Cholangiocarcinoma? Tiyeni tikambirane mwachidule.

Kodi munayamba mwamvapo kupweteka kwachilendo m'mimba mwanu, pansi pa nthiti zanu, khungu lanu ndi maso anu kukhala achikasu (monga jaundice), kapena kungomva kufooka? Ngakhale izi zingawoneke ngati zinthu wamba, nthawi zina pangakhale chifukwa chachikulu chomwe chimayambitsa izi. Lero tikambirana za mtundu wa khansa wosowa koma womwe ungakhale woopsa kwambiri. Umenewo ndi khansa ya bile duct, yomwe imadziwika kuti Cholangiocarcinoma .

Mwachidule, kodi cholangiocarcinoma ndi chiyani?

Chabwino, tiyeni choyamba tiwone zomwe ma duct a ndulu awa ali. Tangoganizirani, chiwindi chathu chimapanga madzi otchedwa "bile". Izi zimathandiza kwambiri kugaya zakudya zamafuta. Chifukwa chake, dongosolo la machubu ang'onoang'ono omwe amanyamula ndulu iyi kuchokera ku chiwindi kupita kumatumbo athu ang'onoang'ono amatchedwa ma duct a ndulu .

Cholangiocarcinoma ndi khansa yomwe imayamba m'maselo a bile duct system.

Uwu ndi mtundu wa khansa woopsa kwambiri. Chomvetsa chisoni n'chakuti nthawi zambiri, khansa ikapezeka, imakhala itafalikira kale kupitirira ndulu. Zikatero, chithandizo chimakhala chovuta kwambiri, ndipo chiyembekezo cha matendawa chimakhala choipa. Koma musadandaule, madokotala ndi asayansi nthawi zonse amapeza njira zatsopano zothandizira khansa imeneyi ndikupatsa odwala moyo wabwino.

Kodi mitundu ikuluikulu ya khansa iyi ndi iti?

Khansa ya m'mapapo imagawidwa m'magulu atatu akuluakulu kutengera komwe ili:

1. Intrahepatic cholangiocarcinoma: Izi zimapangidwa m'mitsempha yaying'ono ya ndulu mkati mwa chiwindi .

2. Perihilar/hilar cholangiocarcinoma: Iyi ndi mtundu wofala kwambiri. Umakula pafupi ndi hilum, komwe ndulu imatuluka m'chiwindi. Umatchedwanso Klatskin tumor .

3. Distal cholangiocarcinoma: Mtundu uwu umapezeka m'mitsempha ya ndulu yomwe ili kunja kwa chiwindi, pafupi ndi matumbo ang'onoang'ono.

Mitundu yonse iwiri ya 2 ndi 3 imatchedwa khansa ya extrahepatic bile duct . Izi zikutanthauza kuti, khansa yomwe imayamba "kunja kwa chiwindi."

Kodi zizindikiro za matendawa zingakhale zotani?

Nthawi zambiri, palibe zizindikiro mpaka khansa itakhala yayikulu kwambiri ndipo imatseka njira ya ndulu. Zizindikiro zikayamba kuonekera, mungazindikire zinthu ngati izi.

Poyamba, khansa iyi siimayambitsa ululu. Komabe, pamene chotupacho chikukulirakulira, ululu ukhoza kuchitika mbali yakumanja ya mimba. Kwa anthu ena, ululuwu ukhoza kufalikira kumadera ena a mimba kapena ngakhale kumbuyo.

Kodi ndi zinthu ziti zomwe zimayambitsa khansa iyi komanso zomwe zimayambitsa matendawa?

Choyambitsa chenicheni cha khansayi sichinapezekebe. Komabe, akukhulupirira kuti kutupa kosatha , kapena matenda otupa, m'mitsempha ya ndulu, kungakhale chifukwa chachikulu.

Mwachidule, kuwonongeka kosalekeza kungawononge DNA ya maselo a bile duct. DNA ili ngati "dongosolo lalikulu" lomwe limauza maselo athu momwe angagwirire ntchito. DNA iyi ikawonongeka, maselo amatha kuyamba kugawikana mosalamulirika, zomwe zimapangitsa kuti pakhale zotupa za khansa.

Pali zinthu zingapo zomwe zimawonjezera chiopsezo cha izi:

• Matenda okhudzana ndi njira zotulutsira ndulu: Matenda monga miyala ya ndulu, miyala ya njira zotulutsira ndulu, ndi `Primary sclerosing cholangitis` (matenda omwe njira zotulutsira ndulu zimakhala zopapatiza komanso zotsekeka).
• Matenda a chiwindi: Cirrhosis (mabala a chiwindi), matenda a chiwindi a Hepatitis B kapena Hepatitis C.
• Matenda ena: Matenda a zilonda zam'mimba osatha, matenda otupa m'matumbo (IBD), matenda a shuga.
• Zinthu zokhudzana ndi moyo: kumwa mowa mopitirira muyeso, kunenepa kwambiri, kusuta fodya.
• Matenda a parasitic: Matenda a parasitic otchedwa `Clonorchiasis` amapezeka kwambiri m'maiko akumwera chakum'mawa kwa Asia.
• Kukhudzidwa ndi mankhwala oopsa: Mankhwala ena, makamaka omwe amagwiritsidwa ntchito m'mafakitale a rabara kapena magalimoto.

Kodi dokotala amazindikira bwanji matendawa?

Mukapita kwa dokotala, choyamba adzamvetsera mosamala zizindikiro zanu, kutenga mbiri yanu yachipatala, ndikukuyesani thupi. Kenako, ngati mukukayikira kuti muli ndi khansa, angakulangizeni mayeso angapo, monga:

Mayeso a Magazi

• Mayeso a ntchito ya chiwindi: Izi zingapereke lingaliro la momwe chiwindi chikugwira ntchito bwino. Ngati njira zotulutsira ndulu zatsekedwa, kuchuluka kwa ma enzyme ena (`ma enzyme a chiwindi`) m'magazi kudzawonjezeka.
• Mayeso a zizindikiro za chotupa: Mayeso omwe amayesa zinthu zina (zizindikiro za chotupa) zomwe zimawonjezeka m'magazi khansa ikakhalapo. `CA 19-9` ndi `CEA` ndi zizindikiro ziwiri zomwe zingawonjezere mtundu uwu wa khansa.

Mayeso Ojambula

• Kujambula kwa ultrasound m'mimba nthawi zambiri kumachitika kaye.
• Kuphatikiza apo, CT scan kapena MRI scan ingachitike. Magnetic resonance cholangiopancreatography (MRCP) ndi mtundu wapadera wa MRI womwe umatha kuona bwino njira ya ndulu.

Mayeso a Endoscopic

Izi zimaphatikizapo kuyika chubu chopyapyala komanso chosinthasintha (endoscope) chokhala ndi kamera yolumikizidwa kudzera pakamwa panu, kuidutsa m'mimba mwanu ndi m'matumbo anu ang'onoang'ono, komwe ndulu imatseguka, ndikuyang'ana malowo mosamala. Mudzapatsidwa mankhwala oletsa ululu panthawiyi, kotero simudzamva kupweteka kulikonse. Endoscopic retrograde cholangiopancreatography (ERCP) ndi mayeso ofala.

Kufufuza za thupi

Apa, chidutswa chaching'ono kwambiri cha minofu chimatengedwa kuchokera pamalo okayikitsa ndikuyang'aniridwa pogwiritsa ntchito maikulosikopu. Chidutswachi cha minofu chingapezeke panthawi ya ERCP. Chitsanzo cha minofuchi chingayesedwenso kusintha kwa majini (biomarkers) m'maselo a khansa. Izi zingathandizenso kudziwa ngati anthu ena angapatsidwe "chithandizo cholunjika" chenicheni.

Kodi magawo ndi machiritso a khansa ndi ati?

Matendawa akapezeka, timadziwa siteji ya khansa kuti tidziwe momwe yafalikira m'thupi. Izi ndizofunikira kwambiri pokonzekera chithandizo. Nthawi zambiri imagawidwa m'magawo 0 mpaka 4. Gawo 4 limatanthauza kuti khansa yafalikira kupitirira ndulu kupita kumadera akutali a thupi (metastatic).

Njira yochiritsira imatsimikiziridwa ndi komwe khansa ili, gawo lake, komanso thanzi la wodwalayo.

• Opaleshoni: Ngati khansayo sinafalikire, opaleshoni ndiyo njira yabwino kwambiri yochotseratu khansayo ndi minofu yozungulira. Nthawi zina opaleshoni imagwiritsidwanso ntchito kuyika stent kuti ndulu yotsekeka isatseguke.
• Kuika chiwindi: Kuika chiwindi ndi mwayi wabwino wochira khansa zina za m'mimba zomwe zimafalikira msanga.
• Chithandizo cha radiation: Chimagwiritsa ntchito mphamvu zambiri kuwononga maselo a khansa kapena kuchepetsa zotupa.
• Chemotherapy: Kupatsa thupi mankhwala opha maselo a khansa.
• Chithandizo cholunjika: Izi zimaphatikizapo kupereka mankhwala omwe amakhudza mapuloteni enaake omwe amathandiza maselo a khansa kukula ndikuyimitsa ntchito yawo.
• Chithandizo cha Immunotherapy: Kupereka mankhwala omwe amalimbikitsa chitetezo cha mthupi lathu ndikuthandiza kulimbana ndi maselo a khansa.

Kodi pali njira zodzitetezera ku matendawa?

Palibe njira yodzitetezera 100% ku khansa iyi. Komabe, tingachepetse chiopsezochi mwa kusunga chiwindi ndi ndulu zathu zili bwino.

• Dzitetezeni ku mavairasi monga Hepatitis B, Hepatitis C, ndi HIV (monga kulandira katemera wa Hepatitis B, kutsatira njira zodzitetezera)
• Pewani kumwa mowa mopitirira muyeso.
• Khalani ndi thupi labwino.
• Pewani kusuta fodya kotheratu.

N’zoona kuti cholangiocarcinoma ndi matenda oopsa kwambiri. Komabe, kudziwa zimenezi, kudziwa zinthu zoopsa ngati zilipo, komanso kuonana ndi dokotala zizindikiro zachilendo zikangoyamba kuwoneka, kumatithandiza kukhala ndi mphamvu zothana ndi matendawa. Dokotala wanu ndiye munthu amene angakupatseni upangiri wabwino kwambiri komanso chithandizo.