Kodi muli ndi vuto ndi impso zanu? Tiyeni tiphunzire za Renal Cell Carcinoma (RCC)!

Kodi munayamba mwaganizirapo mozama za impso zanu? Impso ndi ziwalo ziwiri zazing'ono koma zofunika kwambiri m'thupi lathu. Zili ngati zosefera m'thupi lathu. Komabe, nthawi zina impso izi zimathanso kukhala ndi mavuto. Lero tikambirana za mtundu umodzi wofala kwambiri wa khansa womwe ungachitike m'impso, "Renal Cell Carcinoma" kapena RCC . Musadandaule, tikambirana izi mosavuta, m'njira yomwe mungamvetse.

Kodi khansa ya maselo a impso (RCC) ndi chiyani?

Mwachidule, khansa ya impso (RCC) ndiyo khansa yofala kwambiri ya impso. Impso zathu zili ndi machubu opangidwa bwino otchedwa ma tubules . Machubu amenewa ndi omwe amanyamula madzi ndi michere ya thupi kupita m'magazi ndikuchotsa zinyalala mu mkodzo. M'machubu amenewa ndi momwe RCC imayambira kupangika. Pafupifupi 85% ya khansa ya impso ndi yamtunduwu.

Kawirikawiri, RCC imayamba ngati chotupa chaching'ono cha maselo a khansa mu impso imodzi. Izi zimatchedwanso chotupa . Komabe, nthawi zina ziphuphu zingapo zimatha kupangika mu impso imodzi, kapena mu impso zonse ziwiri.

Kodi mitundu ikuluikulu ya RCC ndi iti?

Pali mitundu yosiyanasiyana ya RCC. Taganizirani ngati kukhala ndi anthu osiyanasiyana m'banja limodzi. Kugawika kumeneku kumadalira momwe maselo a khansa amaonekera pogwiritsa ntchito maikulosikopu, DNA yawo, kapena zinthu za majini. Pali mitundu ikuluikulu ingapo:

• Khansa ya maselo a impso yoyera bwino (ccRCC): Mtundu uwu umakhala pafupifupi 85% ya RCC. Dzina lake limatchedwa chifukwa maselo a khansa amaoneka oyera pogwiritsa ntchito maikulosikopu.
• Khansa ya impso ya papillary: Mtundu uwu umakhala pakati pa 10% ndi 15% ya khansa yonse ya impso. Dzina lake limatchedwa chifukwa cha zotupa zonga zala ( papillae ) zomwe zimapezeka pa zotupa izi.
• Khansa ya maselo a impso ya Chromophobe: Mtundu uwu umakhala pakati pa 5% ndi 10%. Maselo amenewa nthawi zambiri amakhala ndi mtundu wopepuka, wofanana ndi maselo omveka bwino, koma ndi akuluakulu pang'ono.
• RCC Yosasankhidwa: Pafupifupi 6% ya RCC singathe kugawidwa m'magulu akuluakulu. Komabe, asayansi akupitilizabe kuyesa kugawa gulu losasankhidwali m'magulu m'njira zatsopano, kutengera zinthu monga mawonekedwe a maselo ndi DNA yawo.

Mwina munamvapo madokotala akugwiritsa ntchito mawu akuti "localized" kapena "advanced" kapena "metastatic" akamanena za RCC. Localized RCC imatanthauza kuti khansa ili mu impso zokha, ndipo mwina yafalikira ku minofu yapafupi.Izi zikutanthauza kuti khansa yafalikira ku ziwalo zina za thupi. Mtundu wa khansa yomwe muli nayo ndi umene umasankha njira zochiritsira komanso mwayi wochira.

Kodi RCC ndi yofala bwanji?

Padziko lonse lapansi, milandu yatsopano pafupifupi 400,000 ya RCC imanenedwa chaka chilichonse. Ku United States, chiwerengerochi ndi pafupifupi 80,000. Ngakhale kuti aliyense akhoza kukhala ndi RCC, imapezeka kwambiri mwa amuna azaka zapakati pa 60 ndi 80 .

Kodi zizindikiro za khansa ya impso ndi ziti?

Anthu ambiri saona zizindikiro zilizonse kumayambiriro. Zizindikiro zimayamba kuonekera khansa ikakula ndipo imayamba kukhudza minofu kapena ziwalo zozungulira.

Zizindikiro za RCC zingakhale monga:

• Magazi mu mkodzo (hematuria). Ichi ndiye chizindikiro chofala kwambiri.
• Kupweteka kwa m'mbali mwa chiuno: Izi zikutanthauza ululu womwe umachitika mbali zonse ziwiri za thupi, pamwamba pa chiuno ndi pansi pa nthiti.
• Kumva ngati pali chotupa m'mimba, pansi pa msana, kapena m'chifuwa.
• Malungo omwe amabwera popanda chifukwa.
• Thukuta la usiku.
• Kuchepetsa thupi kosamveka bwino.

Kuphatikiza apo, zizindikiro za kuchepa kwa magazi m'thupi , monga kupuma movutikira komanso kutopa, zingaonekenso. Kapena zizindikiro za matenda otchedwa paraneoplastic syndromes zingaonekenso. Pankhaniyi, zinthu monga mahomoni zimatulutsidwa kuchokera ku zotupa za khansa, zomwe zimayambitsa kusintha kosiyanasiyana m'thupi.

Kodi zifukwa za RCC ndi ziti?

RCC imachitika pamene maselo osazolowereka m'machubu a impso ayamba kukula mosalamulirika. Chifukwa chenicheni sichinadziwikebe. Komabe, asayansi apeza zinthu zina zomwe zimawonjezera chiopsezo cha RCC.

Kodi zinthu zoopsa ndi ziti?

Chiwopsezo cha matenda a RCC chimakhala chachikulu ngati muli ndi zinthu izi:

• Kusuta: Mukamasuta kwambiri, chiopsezo chimakhala chachikulu.
• Kunenepa Kwambiri: Ngati muli ndi BMI yambiri, chiopsezo chanu chimakhala chachikulu.
• Kuthamanga kwa magazi (BP).
• Matenda a impso osatha: Izi zikuphatikizapo omwe amalandira chithandizo cha dialysis cha nthawi yayitali.
• Matenda a Hepatitis C osatha.
• Kugwiritsa ntchito mankhwala ena ochepetsa ululu kwa nthawi yayitali (monga NSAIDs, acetaminophen).
• Popeza adalandira kale chithandizo cha radiation m'mimba.
• Kukhudzidwa ndi zinthu zomwe zimayambitsa khansa, monga cadmium ndi asbestos .
• Matenda a sickle cell: Izi zimagwirizana ndi mtundu wosowa wa RCC.
• Mbiri ya banja la khansa ya impso.
• Kusintha kwa majini: Izi ndi kusintha kwa DNA ya maselo.
• Matenda a chifuwa chachikulu (tuberous sclerosis complex).
• Matenda a Von Hippel-Lindau (VHL).

Ngati muli ndi chimodzi mwa zinthuzi zoopsa, dokotala wanu angakulangizeni kuti muyezedwe impso nthawi zonse, zomwe zingakuthandizeni kuzindikira khansa pachiyambi.

Kodi mungazindikire bwanji RCC?

Pafupifupi 25% ya anthu omwe ali ndi RCC amapezeka ndi matendawa khansa ikafalikira pang'ono, kutanthauza kuti zizindikiro zimayamba kuwonekera.

Komabe, nkhani yabwino ndi yakuti mayeso ojambulidwa ndi zithunzi omwe amachitika pazifukwa zina tsopano akupeza zotupa za RCC mwangozi, zizindikiro zisanayambe kuonekera. Chifukwa cha zimenezi, anthu ambiri akulandira chithandizo cha khansa pamlingo woyenera kuchiritsidwa.

Mayeso ozindikiritsa RCC

Madokotala amagwiritsa ntchito mayeso ojambulira zithunzi kuti adziwe khansa ndikukonzekera chithandizo. Mayeso odziwika kwambiri ndi awa:

• Kujambula kwa Ultrasound: Izi zimaphatikizapo kutumiza mafunde amphamvu kwambiri kudzera m'thupi ndikupanga zithunzi zomwe zingawonekere pa chowunikira. Kujambula kwa Ultrasound kungathandize kudziwa ngati chotupacho chadzaza ndi madzi (omwe nthawi zambiri amakhala cyst ) kapena cholimba (chomwe chimapezeka kwambiri m'mabowo a khansa).
• Kujambula kwa CT (computed tomography): Izi zimapanga zithunzi zingapo zomwe zimapereka chithunzi chatsatanetsatane cha mkati mwa thupi. Mwina mudzafunika kubaya utoto wotchedwa contrast mumtsempha ndikuwujambula musanayambe komanso mutamaliza. Utoto uwu umapita ku khansa ndipo umawonetsa bwino.
• Kujambula zithunzi za maginito (MRI): Izi zimagwiritsa ntchito maginito akuluakulu, mafunde a wailesi, ndi kompyuta kuti apange zithunzi zamkati mwa thupi. Dokotala wanu angakulangizeni kuti mujambula zithunzi za MRI ngati simungathe kujambulidwa ndi CT scan (mwachitsanzo, ngati muli ndi vuto la khungu chifukwa cha utoto womwe watchulidwa kale), kapena ngati zotsatira za ultrasound ndi CT scan sizikudziwika bwino.

Ngakhale kuti nthawi zambiri amachitidwa biopsy kuti adziwe khansa, izi sizimachitika kawirikawiri mu RCC. Biopsy imaphatikizapo kutenga tinthu tating'onoting'ono ta chotupacho ndikuchiyang'ana pansi pa maikulosikopu kuti muwone ngati pali maselo a khansa.

Koma kuchita biopsy RCC nthawi zambiri kumakhala koopsa chifukwa kungawononge impso. Chifukwa chake, madokotala nthawi zambiri amayesa maselo a khansa akachotsa chotupa chonsecho ngati chithandizo. Ngati chithunzi chikuwonetsa kuti khansa yafalikira, amatha kutenga maselo a khansa kuchokera kwina osati impso ndikuyesa.

Kuyesa maselo awa ndiyo njira yokhayo yodziwira mtundu wa RCC womwe muli nawo (ngati sizikumveka bwino kuchokera ku zithunzi). Zimathandizanso kuzindikira mankhwala omwe amagwira ntchito bwino pa mtundu wa khansa.

Kuchuluka kwa khansa ya impso

Kudziwa gawo la khansa yanu kumathandiza dokotala wanu kumvetsetsa momwe khansa yanu yafalikira. Zimakuuzaninso ngati khansayo ili m'dera linalake kapena yofalikira . Izi zingakuthandizeni kukonzekera chithandizo chanu ndikukupatsani lingaliro la zomwe zidzachitike.

Madokotala amagwiritsa ntchito njira yotchedwa TNM (chotupa, lymph node, metastasis) kuti adziwe siteji ya RCC. Amagawa khansa m'magawo I mpaka IV. Magawo I, II, ndi III a khansa amagawidwa m'magulu a malo, pomwe gawo IV ndi metastatic RCC.

• Gawo Loyamba la RCC: Khansa ndi yaying'ono kuposa masentimita 7 ndipo sinafalikire kunja kwa impso.
• Gawo Lachiwiri la RCC: Khansa ndi yayikulu kuposa masentimita 7, koma sinafalikire kunja kwa impso.
• Gawo Lachitatu la RCC: Chotupacho chikhoza kukhala cha kukula kulikonse ndipo chafalikira ku minofu yapafupi yozungulira impso.
• Gawo Lachinayi la RCC: Khansa yafalikira kupitirira impso kupita ku ma lymph nodes ndi ziwalo zina.

Chofunika: Kudziwa siteji ya khansa ndikofunikira kwambiri podziwa chithandizo, choncho kambiranani izi mosamala ndi dokotala wanu.

Kodi RCC imafalikira kuti poyamba?

Matenda a Metastatic RCC nthawi zambiri amafalikira ku ma lymph nodes, mapapo, mafupa, chiwindi, ndi ubongo. Nthawi zina amatha kufalikira ku mazira kapena ma testicles anu.

Kodi mankhwala a khansa ya impso ndi otani?

Chithandizo chimadalira zinthu zambiri, kuphatikizapo gawo la khansa ndi thanzi lanu lonse. Chithandizo cha RCC yodziwika bwino ndi chosiyana ndi chithandizo cha RCC yofalikira .

Chithandizo cha khansa ya impso m'derali

Chithandizo cha izi ndi kuchotsa khansa, kapena kuwononga khansa pogwiritsa ntchito njira zochotsera maselo (kupha maselo ndi kutentha kwambiri kapena kuzizira).

Opaleshoni ndiyo njira yodziwika kwambiri yothandizira RCC yapafupi.

• Kuchotsa impso ndi khansa ya m'magazi: Izi zimaphatikizapo kuchotsa impso ndi khansa ndi minofu ina yozungulira (monga ma lymph nodes ndi adrenal glands, komwe maselo a khansa angakhale). Kwa anthu ambiri, impso imodzi yathanzi ndi yokwanira.
• Kuchotsa minyewa ya m'mitsempha pang'ono:Izi zikuphatikizapo kuchotsa gawo la impso lomwe lili ndi khansa. Opaleshoni iyi ikhoza kuchitika ngati khansa yanu ndi yaying'ono. Izi zitha kupulumutsa ntchito ya impso zanu. Izi ndizofunikira kwambiri ngati mulibe impso ziwiri zathanzi.

Ngati simuli woyenera kuchitidwa opaleshoni, dokotala wanu angakulangizeni njira zochotsera ululu m'thupi . Izi zikuphatikizapo:

• Cryotherapy: Maselo a khansa amafa chifukwa cha kuzizira.
• Kuchotsa ma radiofrequency: Maselo a khansa amatenthedwa ndi kutentha kwambiri.

Chithandizo cha khansa ya impso yofalikira m'maselo a impso

Chithandizo cha khansa ya RCC yomwe yafalikira m'thupi lonse chimaphatikizapo kulimbana ndi maselo a khansa m'thupi lonse. Opaleshoni ikhoza kuchitika kuti achotse chotupacho, koma sikokwanira kuthetseratu khansa yafalikira m'thupi lonse. Komabe, kuchotsa chotupacho kungathandize kuchepetsa zizindikiro ndikuchedwetsa kuyamba kwa mankhwala ena.

Mankhwala odziwika kwambiri ndi immunotherapy ndi therapy yolunjika . Kutengera ndi zinthu zosiyanasiyana, mankhwalawa amaperekedwa okha kapena kuphatikiza.

Mankhwala a Immunotherapy

Chithandizo cha matenda a immunotherapy chimagwira ntchito polimbitsa chitetezo cha mthupi lanu, kuchithandiza kupeza ndikulimbana ndi maselo a khansa. Ena mwa mankhwala awa ndi awa:

• Avelumab (Avelumab - Bavencio®)
• Ipilimumab (Ipilimumab - Yervoy®)
• Nivolumab (Nivolumab - Opdivo®)
• Pembrolizumab (Pembrolizumab - Keytruda®)

Mankhwala ochiritsira omwe akuyembekezeredwa

Mankhwala ochiritsira omwe cholinga chake ndi kuchiza matenda amagwira ntchito posokoneza kuchulukana kwa maselo a khansa. Mankhwalawa amachepetsa magazi omwe amalowa m'maselo a khansa, zomwe zimapangitsa kuti asamakule msanga. Ena mwa mankhwala amenewa ndi awa:

• Axitinib (Axitinib - Inlyta®)
• Bevacizumab (Bevacizumab - Avastin®)
• Cabozantinib (Cabozantinib - Cabometyx®)
• Everolimus (Everolimus - Afinitor®)
• Lenvatinib (Lenvatinib - Lenvima®)
• Pazopanib (Pazopanib - Votrient®)
• Sorafenib (Sorafenib-Nexavar®)
• Sunitinib (Sunitinib - Sutent®)
• Temsirolimus (Temsirolimus-Torisel®)
• Tivozanib (Tivozanib - Fotivda®)

Kutengera ndi gawo la khansa, komwe yafalikira, kuopsa kwake, komanso momwe mwayankhira ku mankhwala ena, dokotala wanu angakulangizeni njira zina zochizira khansa, monga chithandizo cha radiation .

Kodi RCC ingachiritsidwe kwathunthu?

Zimatengera matenda anu enieni .Anthu omwe ali ndi RCC yodziwika bwino yomwe ili pachiwopsezo chachikulu omwe achotsedwa opaleshoni ya khansa nthawi zambiri amakhala ndi zotsatira zabwino kwa nthawi yayitali. Anthu omwe ali ndi RCC yodziwika bwino amathanso kupatsidwa chithandizo cha chitetezo chamthupi khansa ikachotsedwa kuti zinthu ziyende bwino kwa nthawi yayitali.

Pakadali pano palibe mankhwala a RCC yapamwamba omwe afalikira kupitirira impso. Komabe, pamene asayansi akupeza njira zabwino zochizira khansa, anthu omwe ali ndi RCC yofalikira tsopano akukhala ndi moyo wautali.

Kodi chiyembekezo cha ma RCC ndi chotani?

Madokotala tsopano atha kuzindikira RCC kumayambiriro kwake, pomwe khansa imatha kuchiritsidwa bwino. Kuzindikira msanga ndi chithandizo chabwino kwathandiza kuti anthu apulumuke. 90% ya anthu omwe ali ndi gawo I RCC amakhala ndi moyo kwa zaka zisanu. Mofananamo, ngakhale kuti nthawi ya moyo wa anthu omwe ali ndi gawo IV RCC inali yochepa kwa miyezi, ambiri tsopano amakhala ndi moyo kwa zaka zingapo.

Kodi RCC ingapewedwe?

RCC sichitha kupewedwa nthawi zonse. Koma mutha kuchepetsa chiopsezo chanu. Mwachitsanzo, kusasuta fodya (kapena kusiya ngati mutasiya) ndi chimodzi mwa zinthu zabwino kwambiri zomwe mungachite kuti muchepetse chiopsezo chanu cha khansa. Ndikofunikiranso kukhala ndi kulemera koyenera, kudya zakudya zopatsa thanzi, komanso kuwongolera kuthamanga kwa magazi.

Kodi ndingadzisamalire bwanji?

Lankhulani ndi dokotala wanu za dongosolo losamalira odwala lomwe lingakuthandizeni kuthana ndi zizindikiro za khansa yanu komanso zotsatirapo zake. Mwachitsanzo, anthu ena angafunike kuyamba dialysis mutachita opaleshoni ngati impso imodzi kapena zonse ziwiri sizikugwira ntchito bwino. Ndikofunikira kudziwa momwe mankhwalawa angakukhudzireni.

Mungafunike thandizo pothana ndi mavuto omwe amabwera chifukwa cha chithandizo chamankhwala kapena chithandizo cha immunotherapy . Funsani dokotala zomwe mungayembekezere musanayambe kulandira chithandizo.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

• Kodi ndili ndi mtundu wanji wa RCC?
• Kodi khansa yanga yafalikira mpaka pati (kodi yafika pati)?
• Kodi ubwino ndi kuipa kwa mankhwala omwe alipo ndi chiyani?
• Kodi ndi zotsatirapo kapena mavuto ati omwe ndiyenera kudziwa ndisanalandire chithandizo?
• Kodi ndiyenera kupita kangati kukayezetsa ndikalandira chithandizo?
• Ndi kusintha kotani komwe ndiyenera kuyembekezera pa moyo wanga panthawi ya chithandizo?
• Kodi vuto langa lidzakhala lotani?

Chithandizo cha khansa ya impso yanu (RCC) chidzadalira zinthu zambiri, kuphatikizapo thanzi lanu lonse, mtundu ndi gawo la RCC, komanso momwe mumayankhira chithandizocho. Koma aliyense amene wapezeka ndi khansa ya impso adzapindula pomanga ubale wapamtima ndi gulu lawo lachipatala. Musazengereze kufunsa mafunso okhudza matenda anu, zabwino ndi zoyipa za njira zochiritsira, komanso zotsatira zomwe mukuyembekezera. Dokotala wanu ndiye munthu wabwino kwambiri woti akufotokozereni tanthauzo la kukhala ndi RCC.

Pomaliza, zinthu zoti muzikumbukira

Ngakhale kuti khansa ya impso (RCC) ndi matenda oopsa, kuchuluka kwa mankhwala ake kwakula kwambiri chifukwa cha kupezeka msanga ndi chithandizo choyenera. Ngati muli ndi zizindikiro zilizonse, makamaka magazi mu mkodzo wanu, kupweteka m'mimba mwanu, chotupa m'manja mwanu, kapena mbiri ya banja lanu ya khansa ya impso, funsani upangiri wa dokotala nthawi yomweyo. Mutha kuchepetsa chiopsezo chanu chotenga matendawa popewa kusuta fodya ndikukhala ndi moyo wathanzi. Musaope kulankhula ndi dokotala wanu ngati muli ndi nkhawa. Simuli nokha.

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