Kodi tiyenera kuda nkhawa ndi khansa ya m'mimba ya epithelial?

Kodi mudamvapo za khansa ya m'chiberekero ya Epithelial? Dzinali lingamveke ngati lovuta pang'ono, koma ndi mtundu wa khansa ya m'chiberekero yomwe ndi yofala pakati pa akazi. Tiyeni tikambirane mwachidule, m'njira yomwe mungamvetse. Chifukwa ndikofunikira kwambiri kudziwa zinthu ngati izi.

Kodi Khansa ya Epithelial Ovarian ndi Chiyani?

Mwachidule, khansa ya m'chiberekero cha epithelial ndiyo mtundu wofala kwambiri wa khansa ya m'chiberekero. Khansa iyi imayamba m'chivundikiro chakunja cha chiberekero, chotchedwa minofu ya epithelial. Taganizirani ngati nembanemba yopyapyala yomwe imazungulira chiberekero.

Si zokhazo, koma nthawi zina khansa iyi imathanso kufalikira m'kati mwa machubu a fallopian kapena ngakhale mu peritoneum, minofu yomwe imaphimba ziwalo m'mimba. Madokotala amaphatikizanso khansa ya fallopian tube ndi khansa yoyamba ya peritoneal m'gulu lomwelo ndi khansa ya epithelial ovarian chifukwa zizindikiro ndi mankhwala a matendawa ndi ofanana kwambiri.

Kodi khansa imeneyi ndi yofala bwanji?

Khansa ya m'chiberekero ndi khansa yachiwiri yofala kwambiri ya amayi, pambuyo pa khansa ya m'chiberekero/endometrial. Mkazi wamba ali ndi mwayi umodzi mwa 78 wokhala ndi khansa ya m'chiberekero m'moyo wake wonse.

Mu 2021 yokha, anthu opitilira 21,400 adapezeka ndi khansa ya m'chiberekero. Anthu asanu ndi anayi mwa khumi mwa awa adanenedwa kuti ndi khansa ya m'chiberekero ya epithelial. Khansa iyi ndi yofala kwambiri pakati pa akazi azaka zopitilira 65.

Kodi mitundu ya khansa ya m'mimba ya epithelial ndi iti?

Pafupifupi magawo atatu mwa anayi a khansa ya m'mimba ya epithelial ndi khansa ya m'mimba ya serous (HGSOC). "High-grade" imatanthauza kuti maselo a khansawa amakula ndikufalikira mofulumira kuposa khansa "yotsika".

Akatswiri azachipatala amakhulupirira kuti mtundu uwu wa HGSOC umakula pang'onopang'ono poyamba, koma zingatenge zaka zisanu ndi chimodzi ndi theka kuti ufalikire kuchokera m'machubu a fallopian kupita ku mazira. Koma ukafika m'mazira, umafalikira mofulumira kwambiri. Nthawi zambiri umakhudza chigawo cha m'mimba (peritoneum) ndi ziwalo zina za thupi. Pafupifupi 70% ya odwala a HGSOC amapezeka ndi matendawa pa siteji yachitatu kapena yachinayi. Izi zikutanthauza kuti khansa yafalikira kupitirira chotupa choyambirira ndipo tsopano ndi khansa yofalikira.

Palinso mitundu ina yosadziwika bwino ya khansa ya m'mimba ya epithelial:

• Khansa ya endometrioid:Mtundu uwu umapezeka kwambiri mwa anthu omwe ali ndi endometriosis, yomwe imakhudza mkati mwa chiberekero (endometrium). Umayankha bwino mankhwala a chemotherapy kuposa mitundu ina.
• Khansa ya m'chiberekero ya serous yotsika kwambiri (LGSOC): Iyi ndi khansa yomwe ikukula pang'onopang'ono. Imapezeka mwa akazi achichepere (azaka zapakati pa 45 ndi 57). Imakhala pafupifupi 10% ya khansa ya m'chiberekero ya epithelial. Matendawa nthawi zambiri amakula akapezeka, ndipo sayankha bwino mankhwala a chemotherapy. Ngakhale kuti khansa ya m'chiberekero yotsika imakula pang'onopang'ono, sizingakhale khansa yapamwamba kwambiri.
• Khansa ya mucinous: Zotupa izi ndi zosiyana ndi mitundu ina ndipo zimayankha bwino chithandizo. Nthawi zambiri zimakhala zazikulu (pafupifupi mainchesi 8 kapena masentimita 20). Nthawi zambiri zimakhudza mazira okha.
• Khansa ya m'chiberekero (OCCC): Azimayi aku Asia ndi omwe ali ndi endometriosis ali pachiwopsezo chachikulu chotenga khansa iyi. Matendawa nthawi zambiri amakula akapezeka. Sagwira bwino ntchito ya chemotherapy.
• Kansa ya squamous cell carcinoma (SCC) ya ovary: Mtundu uwu wa SCC nthawi zambiri umayamba chifukwa cha matenda osaopsa/osakhala khansa. Mwachitsanzo, ukhoza kuyamba chifukwa cha ma cysts a ovary, endometriosis, kapena zotupa za Brenner (zotupa zolimba, zosazolowereka m'ma ovary). Ngati zapezeka msanga, zimayankha bwino chithandizo.

Kodi n’chiyani chimayambitsa khansa ya m’chiberekero cha epithelial?

Ndipotu, chomwe chimayambitsa khansa zambiri, kuphatikizapo khansa ya m'chiberekero cha epithelial, sichikudziwikabe. Komabe, kafukufuku watsopano akusonyeza kuti khansa zambiri za m'chiberekero zimayambira m'maselo kumapeto kwa machubu a fallopian. Kenako zimafalikira ku mazira.

Kodi ndi zinthu ziti zomwe zingachititse kuti munthu adwale khansa imeneyi?

Anthu opitilira theka la omwe adapezeka ndi khansa ya m'chiberekero ali ndi zaka zoposa 65 ndipo adapita kusamba, zomwe zikutanthauza kuti nthawi yawo ya kusamba yatha.

Zinthu zina zingawonjezere chiopsezo chotenga khansa ya m'chiberekero.

• Ngati wina m'banja mwanu wakhala ndi khansa ya m'chiberekero, khansa ya m'mawere, kapena khansa ya m'matumbo/m'matumbo.
• Ngati mwalandira kusintha (kusintha) mu jini ya BRCA.
• Ngati mwalandira jini yolumikizidwa ndi matenda a khansa ya m'banja, monga Lynch syndrome.
• Ngati mukumwa mankhwala a mahomoni kuti muchepetse zizindikiro za kusamba.
• Kukhala ndi mwana atakwanitsa zaka 35 kapena kukhala asanaberekepo mpaka nthawi yonse yobereka.
• Kunenepa kwambiri .

Kodi zizindikiro za khansa ya m'mimba ya epithelial ndi ziti?

Vutoli ndi la anthu ambiri. Khansa ya m'chiberekero nthawi zambiri imakhala ndi zizindikiro zochepa kwambiri kumayambiriro. Zizindikiro zimaonekera pokhapokha matendawa atafalikira pang'ono. Akafalikira ku nembanemba yomwe imaphimba ziwalo zam'mimba (peritoneum), madzi amatha kusonkhana m'mimba. Izi zimatchedwa ascites.

Kuphatikiza apo, zizindikiro zotsatirazi zitha kuchitika:

• Kupweteka m'mimba.
• Kuvutika kudya kapena kumva kukhuta mutadya pang'ono.
• Kusanza ndi kusanza.
• Kutupa.
• Kupweteka m'chiuno.

Palinso zizindikiro zomwe sizimaonekera kawirikawiri:

• Kulimbikitsa kusadziletsa kapena kukodza pafupipafupi (chikhodzodzo chogwira ntchito mopitirira muyeso).
• Kutuluka magazi m'mimba molakwika.

Chofunika: Kukhala ndi zizindikiro izi sikutanthauza kuti muli ndi khansa. Komabe, ngati zikupitirira, ndi bwino kupita kwa dokotala kuti akakupatseni upangiri.

Kodi khansa ya m'mimba ya epithelial imapezeka bwanji?

Mwatsoka, palibe mayeso enieni oyezera khansa ya m'chiberekero ikayamba. Kuyezetsa kumachitika pokhapokha ngati muli ndi zizindikiro kapena muli pachiwopsezo chachikulu. Dokotala wanu angachite kaye mayeso a m'chiuno kuti aone ngati pali zotupa kapena kutupa kwina kulikonse.

Kenako, mutha kuyezetsa magazi kuti muwone kuchuluka kwa puloteni yotchedwa `CA-125`. `CA-125` iyi ikuyimira antigen ya khansa 125. Ngati kuchuluka kwake kuli kwakukulu, muyenera kuchita mayeso ambiri.

Mayeso ojambulira zithunzi ngati awa angathandize kuzindikira khansa ya ovarian:

• Kuyesa kwa ultrasound kwa transvaginal.
• Kuyesa kwa CT scan.
• Kuyesa kwa MRI (MRI).
• Kujambula kwa positron emission tomography (PET).
• X-ray pachifuwa (kuti aone ngati khansa yafalikira mpaka m'mapapo).

Nthawi zina njira yotchedwa laparoscopy ingachitike. Izi zili ngati opaleshoni, koma zimachitika popanda kudula kwambiri. Izi zimathandiza dokotala kuyang'ana ziwalo zanu zoberekera. Angatengenso chitsanzo cha minofu (biopsy) kuchokera pa chotupa kuti awone ngati pali maselo a khansa pamenepo. Kuchotsa khansa iyi ndiyo njira yokhayo yodziwira ngati muli ndi khansa ya m'chiberekero.

Kodi magawo a khansa ya m'mimba ya epithelial ndi ati?

Kudziwa siteji ya khansa kumathandiza madokotala kumvetsetsa momwe khansa ikuyendera. Ndikofunikanso kudziwa ngati khansa yafalikira komanso kupanga zisankho za chithandizo. Gawo la khansa limatsimikiziridwa ndi mayeso omwewo omwe amagwiritsidwa ntchito pozindikira khansa.

Pali magawo anayi akuluakulu a khansa ya m'chiberekero. Magawo ena amakhala ndi magawo ang'onoang'ono. Chiwerengero cha magawo chikakhala chachikulu, khansa imakula kwambiri.

• Gawo 1: Khansa ili mu dzira limodzi lokha kapena mu chubu chimodzi cha fallopian.
• Gawo lachiwiri: Khansa yafalikira mpaka ku chiberekero kapena mkati mwa m'mimba (m'mimba).
• Gawo 3: Khansa yafalikira ku ziwalo zina kunja kwa chiuno, mpaka ku ma lymph nodes, kapena zonse ziwiri.
• Gawo 4: Maselo a khansa ali m'madzi ozungulira mapapo, ma lymph nodes m'malo olumikizirana mafupa, ziwalo zina, kapena ziwalo zina za thupi.

Kodi khansa ya m'mimba ya epithelial ingachiritsidwe?

Madokotala amachita opaleshoni yochotsa khansa yambiri momwe angathere. Izi zimatsatiridwa ndi mankhwala a chemotherapy. Ngakhale kuti anthu ambiri amachira poyamba, matendawa amatha kubwereranso mwa anthu ambiri pambuyo pake.

Odwala oyambilira angasankhe kuchotsa mazira ndi thireyi ya fallopian yokha.

Kwa anthu omwe ali ndi khansa yapamwamba, opaleshoni yochotsa ziwalo zotsatirazi nthawi zambiri imachitika:

• Kuchotsa machubu onse a fallopian ndi mazira onse awiri (bilateral salpingo-oophorectomy).
• Kuchotsa chiberekero (hysterectomy).
• Kuchotsa minofu yamafuta (omentum) yomwe imaphimba mimba (omentectomy).
• Kuchotsa ma lymph nodes ozungulira.
• Kuchotsa ziwalo zina zodwala (monga matumbo ang'onoang'ono, matumbo akulu, kapena ndulu).

Kodi mankhwala ena ndi ati?

Kutengera mtundu wa khansa, mutha kupatsidwa chithandizo chimodzi kapena zingapo mwa izi mutachita opaleshoni:

• Chemotherapy: Kupha maselo a khansa. Izi zimagwiritsa ntchito mankhwala monga platinum compounds (carboplatin) ndi paclitaxel (Taxol®) kapena docetaxel (Taxotere®).
• Mankhwala a chemotherapy a m'mimba: Pochiza khansa ya m'chiberekero ya gawo lachitatu, mankhwala a cisplatin ndi paclitaxel amalowetsedwa mwachindunji m'mimba kudzera mu catheter yoyikidwa opaleshoni (chubu chopyapyala, chopanda kanthu).
• Mankhwala ochiritsira: Mankhwala monga Bevacizumab (Avastin®) amaletsa maselo a khansa kukula ndi kuchulukana.
• Chithandizo cha radiation: Chimagwiritsa ntchito kuwala kwa X-ray kwamphamvu kwambiri kuti chiwononge maselo a khansa.

Kodi khansa ya m'mimba ya epithelial ingapewedwe?

Kafukufuku akusonyeza kuti akazi omwe amamwa mapiritsi oletsa kubereka a mahomoni kwa zaka zisanu kapena kuposerapo amatha kuchepetsa chiopsezo chawo chokhala ndi khansa ya m'chiberekero ndi theka.

Maopaleshoni ena angachepetsenso chiopsezo cha khansa. Opaleshoni yopewera khansa imatchedwa opaleshoni yoteteza. Izi zimaphatikizapo kuchotsa machubu a fallopian ndi mazira, okhala ndi chiberekero kapena opanda. Izi nthawi zambiri zimaganiziridwa kwa akazi omwe ali pachiwopsezo chachikulu chifukwa cha mbiri ya banja (monga omwe ali ndi BRCA mutation kapena Lynch syndrome). Komabe, madokotala amalangiza kuti njirazi zichitike pokhapokha ngati pakufunika thandizo lachipatala. Izi zili choncho chifukwa kuchotsa mazira kungayambitse kusamba msanga, komwe kungayambitse vuto lalikulu pa thupi.

Maopaleshoni amenewa sachotsa kotheratu chiopsezo cha khansa. Anthu ena akhoza kukhala ndi khansa yomwe siipezeka panthawi ya opaleshoni. Anthu omwe ali ndi kusintha kwa majini a BRCA amatha kukhala ndi khansa yoyamba ya m'mimba ngakhale machubu awo a fallopian ndi mazira atachotsedwa. Funsani dokotala wanu za kuyezetsa BRCA kuti mudziwe ngati muli ndi jini ya BRCA.

Kodi chiyembekezo cha anthu omwe ali ndi khansa ya m'mimba mwa epithelial ndi chotani?

Anthu opitilira 13,000 amafa ndi khansa ya m'chiberekero chaka chilichonse. Ndi chifukwa chachisanu chomwe chimayambitsa imfa pakati pa akazi ndi khansa. Komabe, pali chiyembekezo cha mankhwala atsopano omwe akuyesedwa kuchipatala pakadali pano. Ofufuza akugwiranso ntchito kuti azindikire matendawa pachiyambi.

Ngati khansa ya m'mimba ya epithelial yapezeka isanafalikire, kuchuluka kwa moyo wa zaka zisanu kumakhala kopitilira 90%. Komabe, khansa ikafalikira (yomwe yafalikira), kuchuluka kumeneku kumatsika kufika pafupifupi 30%.

Zinthu zambiri zimakhudza kukula kwa khansa:

• Kufalikira kwa khansa.
• Kupambana kwa chithandizo.
• Malo, kukula, ndi chiwerengero cha zotupa za khansa (gawo la khansa).

Kodi muyenera kupita kwa dokotala liti?

Ngati muli ndi zizindikiro izi, pitani kwa dokotala nthawi yomweyo:

• Kusintha kwa kuchuluka kapena kufulumira kwa kukodza.
• Kusowa chilakolako kapena kumva kukhuta mutadya pang'ono.
• Kupweteka kosalekeza m'mimba kapena m'chiuno popanda chifukwa.

Ndi mafunso ati omwe muyenera kufunsa dokotala wanu?

Mungathe kufunsa dokotala mafunso monga awa:

• Kodi ndiyenera kupita ku mayeso a BRCA?
• Ndi mtundu wanji wa khansa ya m'mimba ya epithelial yomwe ndili nayo?
• Kodi chithandizo chabwino kwambiri kwa ine ndi chiti?
• Kodi zotsatirapo zake ndi ziti?
• Kodi ndili pachiopsezo chotenga khansa yofalikira m'thupi? Kodi ndingachepetse bwanji chiopsezo chimenecho?
• Kodi ndiyenera kuda nkhawa ndi zovuta?

Kodi khansa ya m'chiberekero ndi yoopsa kwambiri iti?

Khansa ya m'chiberekero ya serous yapamwamba kwambiri (HGSOC) ndi mtundu woopsa kwambiri wa khansa ya m'chiberekero. Ngakhale kuti khansa iyi imakula pang'onopang'ono m'machubu a fallopian, imafalikira mofulumira kwambiri ikafika m'machubu a mazira. Mwatsoka, anthu ambiri omwe ali ndi HGSOC amakhala ndi khansa ya m'chiberekero yopitirira/yofalikira akapezeka ndi matendawa.

Kodi n'zotheka kukhala ndi ma cysts a epithelial ovarian omwe si a khansa (osavulaza)?

Inde. Ndipotu, zotupa zambiri za m'chiberekero cha epithelial si khansa. Zotupa zina zimatchedwa borderline tumors kapena atypical proliferating tumors. Izi kale zinkatchedwa low malignant potential tumors.

Mu zotupa za m'malire, maselo osazolowereka amakula kukhala minofu ya epithelial koma salowa mu minofu yothandizira ya ovary (stroma). Maselo amenewa nthawi zambiri amapezeka mu ovary yokha ndipo nthawi zambiri samakhala khansa. Ngati khansa iyamba, atatu mwa anayi ndi gawo loyamba (lomwe limakhala mu ovary ndipo ndi losavuta kuchiza). Zotupa zimenezi nthawi zambiri zimakhudza achinyamata.

Uthenga Wopita Nawo Kunyumba

Khansa ya m'chiberekero cha epithelial ndi mtundu wofala kwambiri wa khansa ya m'chiberekero. Ikuphatikizaponso khansa ya m'chubu cha fallopian ndi khansa yoyamba ya m'chiberekero. Khansa ya m'chiberekero nthawi zambiri imakhala ndi zizindikiro zochepa kwambiri kumayambiriro kwake. Matendawa nthawi zambiri amakhala atakula kwambiri kuti asadziwike akapezeka. Izi ndi zoona makamaka pa mtundu wofala kwambiri wa khansa ya m'chiberekero, wotchedwa `HGSOC`.

Ngati muli ndi chiopsezo chachikulu chotenga khansa ya m'chiberekero (monga mbiri ya banja), ndikofunikira kufunsa dokotala wanu ngati njira zodzitetezera zili zoyenera kwa inu. Nthawi zonse samalirani thupi lanu. Musanyalanyaze zizindikiro zilizonse zachilendo. Funsani upangiri kwa dokotala.

Khansa ya m'chiberekero , khansa ya epithelial, thanzi la akazi, zizindikiro za khansa, chithandizo cha khansa, jini la BRCA, matenda a akazi