Kodi muli ndi khansa mu ndulu yanu? Tiyeni tiphunzire za khansa ya ndulu.

Kodi munayamba mwaganizapo kuti ngakhale chiwalo chaching'ono kwambiri m'thupi lathu, chomwe nthawi zina sitimachisamala kwambiri, chingayambitse matenda aakulu kwambiri? Umu ndi momwe zimakhalira ndi ndulu. Matendawa otchedwa khansa ya ndulu amatha kuyamba. Ngakhale kuti izi sizichitika kawirikawiri, ndikofunikira kwambiri kudziwa. Chifukwa chake, lero tikambirana za khansa ya ndulu mosavuta, m'njira yomwe mungamvetse.

Kodi Khansa ya Gallbladder ndi chiyani?

Mwachidule, khansa ya ndulu ndi pamene maselo omwe ali mu ndulu yanu amayamba kukula modabwitsa komanso mwachangu, osalamulirika. Maselo amenewa ndi omwe timawatcha maselo oopsa.

Tsopano muli ndi funso, kodi ndulu iyi ndi chiyani ndipo imagwira ntchito chiyani? Ndulu ndi chiwalo chaching'ono chomwe chili kumanja kwa mimba yathu, pansi pa chiwindi, ndipo chimaoneka ngati peyala yaying'ono. Ntchito yake yayikulu ndikusonkhanitsa ndikusunga ndulu, madzi opangidwa ndi chiwindi, ndikutithandiza kugaya zakudya zamafuta zomwe timadya. Zili ngati thanki yamadzi.

Khansa iyi nthawi zambiri imayamba mu gawo lopyapyala mkati mwa ndulu. Madokotala amatcha izi kuti 'gawo la mucosal' . Pakapita nthawi, maselo a khansa awa amatha kufalikira kudzera m'makoma a ndulu ndi kutuluka.

Chomvetsa chisoni n'chakuti, khansa iyi nthawi zambiri siionetsa zizindikiro zilizonse kumayambiriro kwake. Chifukwa chake, nthawi zina imapezeka mwangozi pambuyo pa opaleshoni kuti ichotse ndulu pazifukwa zina.

Komabe, ngati yapezeka msanga ndikuchotsedwa kwathunthu ndi opaleshoni, khansa iyi imakhala ndi mwayi waukulu wochira. Komabe, anthu ambiri akamaipeza, khansayo imakhala itafalikira kale kupitirira ndulu. Pamenepo, chithandizo chimakhala chovuta pang'ono.

Kodi khansa imeneyi ndi yofala bwanji?

Poyerekeza ndi mayiko monga United States, n'kovuta pang'ono kupeza ziwerengero zolondola zokhudza khansa iyi ku Sri Lanka. Komabe, m'maiko ena padziko lapansi, mwachitsanzo, m'maiko monga India, Japan, ndi Korea, zimaoneka zambiri. Izi zitha kukhala chifukwa chakuti kupangika kwa miyala ya ndulu ndi matenda ena omwe amawonjezera chiopsezo cha khansa iyi ndizofala kwambiri m'maiko amenewo.

Kodi zizindikiro zake ndi ziti? Kodi n'zovuta kuzizindikira pasadakhale?

Monga tanenera kale, khansa ya ndulu siimasonyeza zizindikiro nthawi zambiri kumayambiriro kwake. Ngakhale zizindikiro zikaonekera, nthawi zambiri zimakhala zofanana ndi zomwe zimachitika chifukwa cha miyala ya ndulu kapena kutsekeka kwa ndulu, kotero zimatha kusokonezeka mosavuta.

Zizindikiro zazikulu zomwe zingawonekere ndi izi:

• Kupweteka kwambiri m'mimba pamwamba pa kumanja .
• Khungu ndi maso oyera zimaoneka zachikasu. Izi zimatchedwa jaundice .
• Kumva ngati chotupa m'mimba.
• Kuchepetsa thupi popanda chifukwa.
• Kusanza ndi kusanza.
• Kumva ngati mimba yanu yadzaza (kutupa).
• Malungo obwerezabwereza.

Ngati muli ndi chimodzi mwa zizindikiro izi, sizitanthauza kuti nthawi zonse muli ndi khansa. Komabe, ngati zizindikirozi zikupitirira, ndi bwino kupita kwa dokotala kuti akakupatseni upangiri.

N’chifukwa chiyani khansa yamtunduwu imayamba?

Khansa ya ndulu imayamba pamene maselo athanzi amakhala maselo a khansa ndipo amayamba kukula mosalamulirika. Izi zimachitika pamene kusintha, kotchedwa 'mutations' , kumachitika m'zinthu za majini m'maselo athu. Kusintha kwa majini kumeneku kumachitika pakapita nthawi, osati kuchokera kwa makolo athu.

Asayansi sakudziwabe chifukwa chake maselo abwino amasanduka maselo a khansa mwadzidzidzi. Komabe, apeza zinthu zina zomwe zimawonjezera chiopsezo chotenga khansa iyi.

Kodi zinthu zoopsa ndi ziti?

Pali magulu ndi matenda angapo omwe amakuika pachiwopsezo chachikulu chotenga khansa iyi:

• Azimayi ali pachiwopsezo chachikulu kuposa amuna.
• Anthu azaka zopitilira 65 ali pachiwopsezo chachikulu. (Zaka zapakati zomwe munthu amazindikira matendawa ndi pafupifupi zaka 72.)
• Ku United States, zapezeka kuti zimapezeka kawirikawiri mwa anthu amitundu ya Amwenye aku America, Amwenye aku Alaska, ndi amitundu ya Mexico.

Zina mwa zinthu zoopsa:

• Kupezeka kapena mbiri yakale ya miyala ya ndulu .
• Kukhala ndi ma polyps a ndulu ( zomera zazing'ono zofanana ndi chotupa).
• Kutupa kosatha kwa ndulu (cholecystitis) .
• Matenda a nthawi yayitali a bakiteriya wotchedwa Salmonella typhi, omwe amayambitsa malungo a typhoid.
• Kuchuluka kwa calcium m'makoma a ndulu (izi zimatchedwa `porcelain gallbladder` ).
• Kutupa kwa nthawi yayitali kwa ndulu ( primary sclerosing cholangitis ).
• Kupangidwa kwa ma cysts mu duct yayikulu ya bile ( choledochal cysts ).
• Kunenepa kwambiri .

Kuphatikiza apo, kusuta fodya ndi kukhudzana ndi mankhwala ena omwe amagwiritsidwa ntchito popanga nsalu ndi rabara kumaganiziridwanso kuti kumawonjezera chiopsezo.

Kodi mumazindikira bwanji izi?

Monga tafotokozera kale, khansa ya ndulu nthawi zambiri imapezeka mochedwa chifukwa zizindikiro zake zoyambirira zimakhala zochepa ndipo zizindikiro zake zimafanana ndi matenda ena. Nthawi zina imapezeka mwangozi, kaya chifukwa cha miyala ya ndulu kapena panthawi ya opaleshoni yochotsa ndulu.

Ngati dokotala wanu akukayikira kuti muli ndi khansa ya ndulu, adzakuyesani, adzakufunsani za mbiri yanu yachipatala, kenako adzakulamulani kuti muyesedwe.

Ndi mayeso ati omwe amachitidwa?

Mayeso amenewa angaphatikizepo kuyezetsa magazi, ma scan osiyanasiyana, komanso opaleshoni zazing'ono.

• Mayeso a magazi (Mayeso a labu):
• Kuyesa kwa ntchito ya chiwindi: Izi zimayesa kuchuluka kwa zinthu zina zomwe chiwindi chimatulutsa. Izi zingapereke lingaliro la ngati khansa ya ndulu yakhudza chiwindi.
• Mayeso a CEA (Carcinoembryonic antigen): CEA ndi chizindikiro cha chotupa chomwe chimachokera ku maselo athanzi komanso a khansa. Kuchuluka kwa izi kungakhale chizindikiro cha khansa ya ndulu.
• Kuyezetsa kwa CA 19-9: Ichi ndi chizindikiro cha chotupa. Kuchuluka kwa izi kungakhale chizindikiro cha khansa ya ndulu kapena kapamba.

• Mayeso ojambulira: Izi zingathandize madokotala kuona ngati khansa ilipo komanso ngati yafalikira.
• Ultrasound ya m'mimba: Izi zimagwiritsa ntchito mafunde a phokoso kujambula zithunzi za ziwalo za m'mimba. Ngati izi zikuwonetsa chinthu chonga chotupa cha ndulu, mungapemphedwe kuti muyesedwe ndi CT scan kapena MRI scan.
• Kujambula kwa CT (computed tomography scan): Mtundu wa X-ray umagwiritsidwa ntchito kujambula zithunzi za ziwalo zamkati mwatsatanetsatane.
• Kujambula zithunzi za MRI (magnetic resonance imaging): Kumagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kujambula zithunzi za mkati mwa thupi.
• Endoscopic ultrasound: Zithunzi za njira yogayira chakudya zimatengedwa pogwiritsa ntchito chida chonga chubu chotchedwa endoscope.
• ERCP (Endoscopic retrograde cholangiopancreatography): Njira yojambulira zithunzi za X-ray za ducts za ndulu. Khansa ya ndulu ingayambitse ducts izi kukhala zochepa.

• Maopaleshoni ang'onoang'ono:
• Kufufuza za khansa: Izi zimaphatikizapo kutenga chitsanzo cha minofu yokayikitsa ndikuiyang'ana pansi pa maikulosikopu kuti muwone ngati pali maselo a khansa. Kufufuza za khansa ndiyo njira yokhayo yotsimikizira khansa ya ndulu.
• Laparoscopy: Mu njira imeneyi, chubu chopyapyala chokhala ndi kamera (yotchedwa laparoscope) chimayikidwa m'mimba kudzera mu kabowo kakang'ono kuti chione ndulu ndi minofu yozungulira. Izi zimathandiza kudziwa momwe khansa yafalikira.

Kodi magawo a khansa ndi ati?

Kuyeza kuchuluka kwa khansa ndi njira yodziwira ngati khansa yafalikira (yomwe yafalikira) kupitirira komwe idayambira. Kutengera ndi momwe khansa yafalikira, dokotala wanu adzakupatsani nambala ya khansa yanu (kuyambira pa zero mpaka anayi). Manambala okwera amatanthauza kuti khansa yafalikira m'malo ambiri a thupi lanu.

Nazi magawo a khansa ya ndulu:

• Gawo 0 (Gawo 0 - `carcinoma in situ`): Maselo osazolowereka, omwe angakhale ndi khansa amapezeka mkati mwa ndulu (mucosa).
• Gawo 1: Maselo a khansa ali mkati mwa ndulu ndipo mwina afalikira mpaka ku minofu ya ndulu.
• Gawo 2:Khansa yafalikira kupitirira minofu mpaka kufika pa minofu yolumikizana ya ndulu.
• Gawo lachitatu: Khansa yafalikira ku chiwindi kapena ziwalo zina zapafupi, kapena ku gawo lakunja (serosal layer) la ndulu. Ikhozanso kufalikira ku ma lymph nodes.
• Gawo 4: Khansa yafalikira ku ma lymph nodes opitilira atatu apafupi, mitsempha yamagazi, ndi/kapena ziwalo zomwe zili kutali ndi ndulu.

Madokotala amatcha khansa ya ndulu ya gawo loyamba kuti "yapafupi." Izi zikutanthauza kuti khansayo sinafalikire kunja kwa ndulu. Khansa ya Gawo loyamba ndi yotheka kuchiritsidwa. Gawo lachiwiri, lachitatu, ndi lachinayi ndi lovuta kwambiri kuchiza.

Kodi khansa iyi imafalikira bwanji?

Khansa ya ndulu imayamba mkati mwa ndulu ndikufalikira mpaka kunja. Pakapita nthawi, imatha kufalikira ku ma lymph nodes apafupi, chiwindi, ndi ziwalo zina, monga ndulu. Khansa ya ndulu yomwe imafalikira imatha kufalikira kudzera mu dongosolo la lymphatic, m'magazi, kapena ku ziwalo zakutali m'thupi.

Kodi mankhwala ake ndi otani?

Gawo la khansa limatsimikizira njira zochiritsira komanso zolinga za chithandizo. Pa khansa yoyambirira, cholinga chachikulu ndikuchotsa khansa yonse ndikuiletsa kuti isabwererenso. Ngati khansa yafalikira, cholinga cha chithandizo ndi kutalikitsa moyo ndikuchepetsa zizindikiro.

Chithandizo cha khansa yoyambirira

Khansa ya ndulu yomwe imayamba msanga, yomwe ingachotsedwe ndi opaleshoni, ili ndi zotsatira zabwino kwambiri pa chithandizo.

• Opaleshoni: Dokotala wochita opaleshoni (dokotala wa khansa) adzachotsa ndulu yanu ndi minofu yomwe yakhudzidwa mozungulira. Izi zimatchedwa cholecystectomy . Nthawi zina ndulu yokha ndi yomwe imachotsedwa (cholecystectomy yosavuta), koma nthawi zina ma lymph nodes omwe ali ndi maselo a khansa kapena gawo la chiwindi, monga ndulu, amathanso kuchotsedwa (cholecystectomy yowonjezereka).
• Chithandizo cha radiation: Mu izi, makina omwe ali kunja kwa thupi (EBRT - external beam radiation therapy) amatsogolera kuwala kwa radiation kumalo omwe khansa yafalikira. Radiation iyi imapha maselo a khansa kapena kuchepetsa kukula kwa chotupacho. Izi zimachitika m'njira yochepetsera kuwonongeka kwa maselo athanzi. Chithandizochi chingaperekedwe kuti chiphe maselo aliwonse a khansa omwe angatsale pambuyo pa opaleshoni. Chithandizo cha radiation chingathandizenso kuchepetsa zizindikiro.
• Chemotherapy: Izi zimagwiritsa ntchito mankhwala ophera maselo a khansa kapena kuwaletsa kuti asachuluke. Monga chithandizo cha radiation, chemotherapy imathandiza kupha maselo ena onse a khansa mutachita opaleshoni. Nthawi zina, dokotala wanu angakulangizeni chemotherapy pamodzi ndi chithandizo cha radiation.

Chithandizo cha khansa yosachiritsika, yobwerezabwereza, kapena yofalikira

Khansa zomwe sizingachotsedwe ndi opaleshoni (`zosachotsedwa`), zomwe zabweranso pambuyo pa chithandizo (`zobwerezabwereza`), kapena zomwe zafalikira ku ziwalo zina za thupi (`zosasinthika`) zimakhala zovuta kuzichiritsa kwathunthu. Ngakhale kuti mankhwala monga radiation therapy ndi `chemotherapy` sizingathetseretu khansa, zingathandize kuchepetsa zizindikiro zanu ndikutalikitsa moyo wanu. Komanso, ngati khansa ikutseka njira yanu yopezera chakudya, opaleshoni ikhoza kuchitidwa kuti ithetse zizindikirozo.

Muzochitika izi, mungakhalenso ndi mwayi wochita nawo mayeso azachipatala . Mayeso azachipatala ndi maphunziro omwe amayesa mankhwala atsopano ndi njira zatsopano zochiritsira zomwe zilipo. Zina mwa mankhwala omwe akuyesedwa pakadali pano m'mayesero azachipatala a khansa ya ndulu ndi awa:

• Chithandizo cholunjika: Chithandizo chomwe chimayang'ana maselo a khansa okha omwe ali ndi kusintha kwa majini.
• Chithandizo cha Immunotherapy: Mankhwala omwe amalimbitsa chitetezo cha mthupi lanu kuti chithandizire kuzindikira ndikuwononga maselo a khansa.
• Mankhwala ochepetsa ululu: Mankhwala omwe amapangitsa maselo a khansa kukhala omasuka ku chithandizo cha radiation.

Funsani dokotala wanu ngati mukuyenerera kuyesedwa kuchipatala.

Kodi pali zotsatirapo zilizonse za mankhwalawa?

Monga momwe zimakhalira ndi opaleshoni iliyonse, pali zoopsa za matenda, mavuto omwe amabwera chifukwa cha mankhwala oletsa ululu, komanso magazi kuundana. Muyenera kukambirana zonsezi ndi dokotala wanu musanayambe kulandira chithandizo.

Ndikofunikanso kudziwa zotsatirapo zoyipa zomwe zingachitike chifukwa cha mankhwala a chemotherapy ndi radiation therapy. Si aliyense amene amakumana ndi zotsatirapo zoyipa mwanjira yofanana. Komabe, dokotala wanu angakuuzeni zotsatirapo zoyipa zomwe zingachitike malinga ndi dongosolo lanu la chithandizo.

Kodi pali njira yopewera izi?

Palibe njira yotsimikizika yopewera khansa ya ndulu. Komabe, mutha kuyesa kuchepetsa zoopsa zomwe takambirana kale momwe mungathere. Mwachitsanzo, mutha kulankhula ndi dokotala wanu ndikukhala ndi kulemera koyenera komwe kungakuyenerereni. Komabe, ngakhale mutachita izi sikungatsimikizire 100% kuti simudzadwala khansa.

Kodi mwayi wochira uli bwanji?

Khansa ya ndulu nthawi zambiri imapezeka matendawa atafalikira, kotero kuti matendawa sapezeka bwino. Pafupifupi 20% yokha ya khansa ya ndulu ndi yomwe imapezeka msanga. Chiwerengero cha anthu omwe khansa yawo yafalikira m'thupi lawo (yomwe yafalikira m'thupi lawo) chimakhala chotsika ndi 2%. Komabe, khansayo ikafalikira m'thupi, ndiko kuti, kumayambiriro kwa matendawa, chiwerengero cha anthu omwe apulumuka m'zaka zisanu chimawonjezeka kufika pa 66%.

Izi zikutanthauza kuti, ngati zapezeka msanga, pali chiyembekezo chachikulu choti munthu adzachira!

Kodi mungatani mukakhala ndi khansa?

Kudziwa kuti muli ndi khansa ya ndulu kungakhale kovuta kuthana nayo. Koma ndikofunikira kumvetsetsa matenda anu, ubwino ndi kuipa kwa njira zanu zochiritsira, komanso dongosolo lanu lochira. Gulu lanu losamalira khansa ndilo malo abwino kwambiri okufotokozerani zonsezi.

Kulumikizana ndi akatswiri omwe amapereka chithandizo chamankhwala ochepetsa ululu kungakuthandizeninso kuthana ndi zizindikiro zanu. Chithandizo chamankhwala ochepetsa ululu ndi chithandizo chomwe chimayang'ana kwambiri chitonthozo chanu ndi zosowa zanu, mosasamala kanthu za vuto lanu. Funsani dokotala wanu ngati mukufuna chithandizo chamankhwala ochepetsa ululu.

Kodi muyenera kufunsa dokotala chiyani?

Mukapita kukaonana ndi dokotala wanu, lembani mndandanda wa mafunso omwe muli nawo okhudza khansa ya ndulu. Mwachitsanzo, mungafunse mafunso monga:

• Ndi mayeso ati omwe ndiyenera kuchita kuti ndidziwe gawo lenileni la khansa yanga?
• Kodi khansa yanga ya ndulu ili pamlingo wotani?
• Ndi njira iti yothandizira yomwe ndi yabwino kwa ine?
• Kodi ubwino ndi zoopsa zomwe zingabwere chifukwa cha njira zimenezi ndi ziti?
• Ndi zinthu ziti zomwe zilipo zondithandiza panthawiyi?

Uthenga Wopita Nawo Kunyumba

Khansa ya ndulu ndi matenda osowa koma oopsa kwambiri. Ngati mukuganiza kuti muli ndi zizindikiro za khansa ya ndulu, pitani kwa dokotala mwamsanga. Kumbukirani kuti ngakhale mitundu ina ya khansa ingayambe kusonyeza zizindikiro msanga, khansa ya ndulu singayambe kusonyeza zizindikiro zoonekeratu mpaka matendawa atachedwa. Chifukwa chake, ndikofunikira kwambiri kufunafuna chithandizo msanga.

Ngati matendawa apezeka msanga, amatha kuchiritsidwa mosavuta. Choncho, musanyalanyaze zizindikiro zilizonse. Samalani thupi lanu ndipo funsani upangiri kwa dokotala ngati pakufunika kutero.

Khansa ya ndulu, khansa ya ndulu, zizindikiro za khansa, ndulu, ndulu, magawo a khansa, chithandizo cha khansa, CEA, CA 19-9