Kodi muli ndi khansa ya mkamwa mwanu yofewa? (Khansa Yofewa ya Mkamwa) Tiyeni tidziwe izi!

Kodi mudayamba mwadzifunsapo za gawo lofewa komanso lokhala ndi mnofu wa pakamwa panu, lomwe lili kumbuyo kwa pakamwa panu? Ndicho chimene timachitcha 'pakamwa lofewa'. Nthawi zina, monga kwina kulikonse m'thupi lathu, maselo a khansa amatha kupangika m'pakamwa lofewa ili. Lero tikambirana za 'Khansa Yofewa ya Pakamwa'. Ngakhale zingamveke zoopsa pang'ono mukamva izi, ngati mukudziwa, mutha kuzindikira zizindikiro msanga ndikupeza chithandizo.

Kodi Khansa Yofewa ya Mkamwa ndi Chiyani?

Mwachidule, pakamwa pofewa ndi gawo lofewa kumbuyo kwa denga la pakamwa panu. Kunena zoona, ndi gawo lofewa, losunthika komwe gawo lolimba la denga la pakamwa panu limathera ndikutsikira kukhosi. Khansa ikayamba m'derali, imatchedwa khansa ya pakamwa pofewa.

Uwu kwenikweni ndi mtundu wa khansa womwe umapezeka pakhosi. Madokotala amauika m'gulu la `(Oropharynegal Cancer)`. Nthawi zambiri, khansa iyi imachokera ku mtundu wa selo wotchedwa `(Squamous Cell Carcinoma - SCC)`. Maselo awa `(Squamous)` ndi mtundu wa maselo athyathyathya omwe amaphimba mkati mwa pakamwa ndi pakhosi pathu. Pazifukwa zina, maselowa amagawikana modabwitsa, mosalamulirika, ndipo amachulukana mofulumira, ndikupanga zotupa za khansa.

Kodi iyi ndi khansa yofala?

Tsopano mwina mukudabwa kuti izi ndi zofala bwanji. Ndipotu, si khansa yofala kwambiri . Mwachitsanzo, m'dziko ngati United States, muli milandu pafupifupi 53,000 ya khansa ya m'kamwa yomwe imanenedwa chaka chilichonse, ndipo pakati pa 5% ndi 12% ya khansayi ndi yofewa pakamwa. Izi zikutanthauza kuti pafupifupi anthu 2,000 ndi 6,000 amadwala matendawa chaka chilichonse. Iyi ndi milandu yochepa poyerekeza ndi khansa ya m'mapapo.

Komabe, ngakhale kuti si zachilendo, si bwino kunyalanyaza izi. Chifukwa ngati wina akupeza, ikhoza kukhala vuto lalikulu. Mwamwayi, khansa iyi nthawi zambiri imapezeka isanafalikire ku ziwalo zina za thupi. Kenako zimakhala zosavuta kuchiza pochotsa chotupacho mwa opaleshoni.

Kodi zizindikiro za khansa ya mkamwa yofewa ndi ziti?

Ndiye, kodi tingazindikire bwanji zizindikiro za khansa ya minofu yofewa? Samalani ngati muli ndi chilichonse mwa izi:

• Chilonda chakumbuyo kwa pakamwa, chotchedwa soft palate. Chilondachi chingakhale chopweteka, chingatulutse magazi, ndipo sichingachiritse kwa kanthawi.
• Zili ngati banga loyera mkamwa, lomwe silitha pakapita nthawi. Nthawi zina izi zimatha kufiira.
• Mpweya woipa (Halitosis) ndi vuto lomwe limachitika mukatsuka mano anu ndi kutsuka pakamwa panu. Ngati fungo ili silikutha, muyenera kuda nkhawa.
• Kuvuta kumeza (Dysphagia). Zingamveke ngati chakudya kapena chakumwa chatsekeredwa pakhosi, kapena mungamve kupweteka mukamameza.
• Chotupa pakhosi. Mungamve ngati chotupa chaching'ono pakhosi panu. Izi zitha kukhala kutupa kwa ma lymph nodes.
• Kuvuta kutsegula pakamwa (Trismus).Mungamve kupsinjika m'dera la nsagwada, ngati kuti simungathe kutsegula pakamwa panu mokwanira.
• Kupweteka kosalekeza pakhosi (Pharyngitis). Mosiyana ndi chimfine wamba, kupweteka kwa pakhosi kumeneku sikuyenera kunyalanyazidwa ngati kumatenga milungu ingapo.
• Kupweteka kwa khutu. Nthawi zina mungamve kupweteka kwa khutu, makamaka mbali imodzi yokha.

Ngati muli ndi chimodzi mwa zizindikiro izi kapena zingapo, ndi bwino kupita kwa dokotala nthawi yomweyo ndikupita kuchipatala.

Kodi khansa ya m'kamwa yofewa imawoneka bwanji?

Kodi khansa iyi imawoneka bwanji? Ingawoneke ngati chilonda choyera , chilonda chofiira , kapena chotupa chaching'ono pakamwa panu pofewa. Mkamwa wofewa ndi gawo lofewa, la mnofu wa pakhosi panu lomwe limathera pa gawo lolimba la pakamwa panu. Ndi gawo lomwe lili patsogolo pa uvula, lomwe lili ngati lilime laling'ono lomwe likugwera pakhosi panu.

N’chifukwa chiyani khansa ya m’kamwa yofewa imayamba?

Nthawi zambiri, khansa ya m'kamwa yofewa iyi imayamba chifukwa cha mtundu wa selo lomwe latchulidwa kale lotchedwa `(Squamous Cell Carcinoma - SCC)`. Maselo amenewa amapezeka mkamwa mwathu komanso mkati mwa pakhosi pathu ngati chiwalo. Pazifukwa zina, majini a maselo athanzi awa amasintha (kusintha), amakhala maselo a khansa, amagawikana mwachangu ndikukula popanda kulamulira, ndikupanga zotupa.

Madokotala apeza kuti pali zinthu zina zomwe zimawonjezera mwayi wopeza khansa iyi.

• Kugwiritsa ntchito fodya mopitirira muyeso, makamaka ndudu. Anthu ambiri m'dziko lathu ali ndi chizolowezi chogwiritsa ntchito fodya mopitirira muyeso. Ndi koopsa kwambiri. Mankhwala omwe ali mu fodya amawononga maselo a mkamwa ndi pakhosi, zomwe zimawonjezera chiopsezo cha khansa.
• Kumwa mowa pafupipafupi komanso mopitirira muyeso. Kumwa pang'ono pa maphwando ndi zikondwerero ndi nkhani yosiyana, koma kumwa mowa nthawi zonse komanso mopitirira muyeso si chinthu chabwino. Chiwopsezo chimakhala chachikulu kwambiri ngati mumamwa mowa mukusuta.

Kodi kachilombo ka papillomavirus ka munthu (HPV) kamayambitsa matendawa?

Inde, zimenezo zingakhalenso chifukwa chake. Mwina munamvapo za kachilombo kotchedwa `(Human Papillomavirus - HPV)`. Kafukufuku wazachipatala wapeza kuti matenda a HPV amawonjezeranso chiopsezo chotenga khansa ya pakhosi, kutanthauza khansa ya pakamwa pofewa. Makamaka, HPV type 16 ndiyo yomwe imagwirizana kwambiri ndi izi. Chifukwa chake ndikofunikira kudziwa izi.

Kodi mavuto a khansa ya mkamwa yofewa ndi otani?

Kodi chimachitika ndi chiyani ngati khansa iyi sichiritsidwa? Choopsa kwambiri ndichakuti khansa iyi imatha kufalikira (kufalikira) ku ziwalo zina za thupi. Mwachitsanzo, imatha kufalikira ku ma lymph nodes m'khosi, m'mapapo, ndi m'chiwindi. Ikafalikira, imakhala yovuta kwambiri kuchiza ndipo ikhoza kukhala pachiwopsezo cha moyo.

Kodi khansa iyi imapezeka bwanji? (Kuzindikira)

Chabwino, ngati muli ndi zizindikiro ngati izi, kodi dokotala amazindikira bwanji izi?

Choyamba, dokotala adzakufunsani za zizindikiro zanu. Mwachitsanzo:

• Kuyambira liti pamene munaona kuvulala kapena kusintha kumeneku pakhungu lanu?
• Kodi bala likukulirakulira? Kodi likutuluka magazi? Kodi likupweteka?
• Kodi n'kovuta kumeza? Kodi chakudya chikukakamira?
• Kodi mumakumana ndi zinthu monga khosi lotupa kapena chotupa m'dzanja lanu?
• Kodi muli ndi ululu m'khutu? (Ichi ndi chizindikiro chofala cha khansa ya pakhosi).

Kenako adzakufunsani za zizolowezi zanu. Kodi mumagwiritsa ntchito fodya (ndudu, beedis, ndudu, fodya wopanda utsi), kodi mumamwa mowa, ndi zina zotero. Adzagwiritsanso ntchito galasi laling'ono kapena nyali kuti awone mkamwa mwanu wofewa komanso mkati mwa pakamwa panu. Adzakhudzanso khosi lanu ngati pali kutupa kulikonse.

Ndi mayeso amtundu wanji omwe amachitidwa?

Kuti mutsimikizire, mutha kuchita mayeso otsatirawa:

• Kufufuza za khansa: Ichi ndi gawo lofunika kwambiri. Izi zikutanthauza kuti chidutswa chaching'ono cha minofu chimatengedwa kuchokera ku chotupa kapena chotupacho pansi pa mankhwala oletsa ululu ndikuwunikidwa pogwiritsa ntchito maikulosikopu kuti awone ngati pali maselo a khansa. Izi zimachitika ndi akatswiri a labotale yachipatala.
• Kujambula kwa CT: Izi zingathandize kudziwa kukula kwa khansa, momwe yafalikira ku minofu yozungulira, komanso ngati yafalikira ku ma lymph nodes m'khosi.
• Kujambula kwa MRI: Nthawi zina kujambulidwa kwa MRI kungachitike kuwonjezera pa kapena m'malo mwa CT scan. Izi zingapangitsenso kuti pakhale zithunzi zatsatanetsatane za chotupa ndi minofu yozungulira.
• Kujambula kwa PET: Kuyeza kumeneku kungagwiritsidwe ntchito kuona ngati khansa yafalikira mbali zakutali za thupi.

Magawo a Khansa

Akatsimikizira kuti khansa yayamba, madokotala amazindikira 'gawo' lake. Umu ndi momwe khansa yafalikira komanso kuopsa kwake. Izi zimatsimikizira mtundu wa chithandizo chomwe muyenera kulandira.

Khansa ya pakamwa yofewa ndi mtundu wa khansa ya pakhosi. Imayamba kuyambira siteji yoyamba (yomwe ingakhale yabwino kwambiri, chotupa chaching'ono, chomwe sichinafalikire) mpaka siteji yachinayi (yomwe ingakhale yoipa kwambiri, chotupa chachikulu, chomwe chafalikira kwambiri). Gawoli limatsimikiziridwa ndi kukula kwa chotupa (T), ngati chafalikira ku ma lymph nodes apafupi (Lymph Nodes) (N), ngati chafalikira kumadera akutali (Metastasis) (M), komanso ngati HPV yakhudzidwa. Izi zimatchedwanso TNM Staging System.

Mukamva za gawo la khansa yanu, mungamve mantha, nkhawa, kapena kutopa. Zingamveke ngati matenda anu akufotokozedwa m'malembo ndi manambala ochepa. Zimenezo ndi zachilendo. Madokotala amamvetsanso zimenezo. Ngati pali chinachake chomwe simukumvetsa kapena chomwe mukuda nkhawa nacho, onetsetsani kuti mwafunsa dokotala wanu kuti akufotokozereni.

Kodi khansa ya mkamwa yofewa imachiritsidwa bwanji?

Kodi chimachiritsidwa bwanji? Madokotala adzasankha chithandizo chabwino kwambiri kutengera zinthu zambiri, kuphatikizapo gawo la khansa komanso thanzi lanu lonse. Pali njira zingapo zazikulu zochizira:

• Opaleshoni:Nthawi zambiri, makamaka pa khansa yoyambirira, chotupacho chimachotsedwa kwathunthu mwa opaleshoni. Nthawi zina, njira yochepetsera kufalikira kwa khansa yotchedwa Transoral Robotic Surgery (TORS) imagwiritsidwa ntchito, yomwe imachitika kudzera pakamwa. Izi zimathandiza kuti munthu achire mwachangu popanda kudula ziwalo zakunja. Ngati khansayo yafalikira ku ma lymph nodes m'khosi, ingafunikenso kuchotsedwa mwa opaleshoni (yotchedwa Neck Dissection).
• Chithandizo cha Radiation: Izi zimagwiritsa ntchito kuwala kwamphamvu kwambiri kuti ziwononge maselo a khansa. Zingaperekedwe ngati chithandizo choyamba cha zotupa zazikulu kapena zikafalikira ku minofu yapafupi kapena ma lymph nodes. Zingaperekedwenso kuti ziphe maselo aliwonse a khansa omwe angakhalepo pambuyo pa opaleshoni.
• Chemotherapy: Izi zimaphatikizapo kupatsa thupi mankhwala opha maselo a khansa. Mankhwalawa amayenda m'thupi lonse, kotero ndi ofunikira kwambiri ngati khansa yafalikira ku ziwalo zina za thupi. Nthawi zina, amaperekedwa pamodzi ndi chithandizo cha radiation (chemoradiation), chomwe chingathandize kuti zotsatira za chithandizocho ziwonjezeke.
• Chemoradiation: Monga momwe dzinalo likusonyezera, iyi ndi njira yophatikiza chemotherapy ndi radiation therapy. Imagwiritsidwa ntchito khansa ikafalikira ku ma lymph nodes koma osati ku ziwalo zina za thupi. Izi zimapangitsa kuti chithandizocho chigwire bwino ntchito.
• Opaleshoni Yokonzanso: Chotupa chikachotsedwa, mungafunike opaleshoni yowonjezera kuti malowo abwezeretsedwe momwe analili poyamba. Ngati gawo lalikulu la pakamwa panu lofewa lachotsedwa, mungafunike kuyika chipangizo chopangira. Ichi chimatchedwa Soft Palate Obturator. Ichi chikufanana ndi chosungira chomwe mumavala mukakhala ndi zomangira. Izi zimapangitsa kuti zikhale zosavuta kumeza ndi kulankhula.
• Chithandizo cha Maganizo: Kukhala ndi khansa ndi kulandira chithandizo kungakhale kovuta kwambiri m'maganizo. Anthu ena amavutika kuzolowera kusintha kwa matupi awo pambuyo pa chithandizochi. Ngati muyenera kukhala ndi chipangizo chopangira opaleshoni, mungamachite manyazi komanso kuda nkhawa. Mungamve chisoni ndi vuto lanu. Ngati zili choncho kwa inu, chithandizo chamaganizo chingakhale chothandiza kwambiri. Chidzakupatsani mphamvu zothanirana ndi vutoli.

Kodi ndi mavuto otani omwe angabwere chifukwa cha chithandizo?

Mkamwa mwanu wofewa umakuthandizani kumeza ndi kulankhula. Choncho opaleshoni ndi chithandizo cha khansa ya radiation zingakupangitseni kukhala kovuta kumeza ndi kulankhula monga kale. Muthanso kumva pakamwa pouma, kusintha kwa kukoma, komanso kuvutika kutsegula pakamwa panu. Komabe, palinso njira zothetsera vutoli. Kugwira ntchito ndi katswiri wolankhula komanso katswiri wa zakudya kungakuthandizeni kuthana ndi mavuto ambiriwa.

Kodi khansa iyi ingapewedwe?

Mwina sizingatheke kupewa matendawa kotheratu, koma mutha kuchepetsa chiopsezo chanu popewa zina mwa zinthu zomwe zimawonjezera chiopsezo chanu.

• Ngati mukusuta fodya kapena mumagwiritsa ntchito mitundu ina ya fodya (beedis, ndudu, kutafuna fodya), yesani kusiya lero. Sizophweka, koma ndi ndalama zazikulu zomwe mungayike m'moyo wanu. Lankhulani ndi dokotala ndipo mudziwe za mapulogalamu omwe angakuthandizeni.
• Ngati mumamwa mowa nthawi zonse, chepetsani kuchuluka kwa mowa womwe mumamwa komanso kuchuluka kwa mowa womwe mumamwa. Ngati mukuganiza kuti muli ndi vuto ndi mowa, zomwe zikutanthauza kuti mukuvutika kuuletsa, funsani thandizo kwa dokotala.
• Idyani zakudya zabwino zomwe zimaphatikizapo zipatso ndi ndiwo zamasamba. Izi zingathandizenso kuti chitetezo cha mthupi lanu chikhale bwino.
• Dzitetezeni ku HPV. Matenda a HPV amawonjezera chiopsezo chanu. Mutha kuchepetsa chiopsezo chanu chotenga kachilombo ka HPV mwa kulandira katemera wa HPV (makamaka kwa achinyamata) ndikupewa machitidwe ogonana omwe ali pachiwopsezo chachikulu, monga kugonana mkamwa mosadziteteza komanso kugonana mosadziteteza.
• Pitani kwa dokotala wa mano nthawi zonse kuti muzindikire kusintha kulikonse kwachilendo mkamwa mwanu msanga.

Kodi khansa iyi ingachiritsidwe?

Zimadalira momwe mulili. Poyamba, chotupa chikakhala chaching'ono ndipo sichinafalikire, madokotala nthawi zambiri amatha kuchichiritsa kwathunthu ndi opaleshoni kapena chithandizo cha radiation. Nthawi zina, khansa zomwe zimapezeka mochedwa ndipo zafalikira pang'ono zimatha kuchiritsidwa ndi kuphatikiza kwa mankhwala (monga opaleshoni, radiation, ndi chemotherapy). Chifukwa chake, ngati muli ndi zizindikiro, musachite mantha ndikupita kwa dokotala nthawi yomweyo.

Kodi kuchuluka kwa kupulumuka ndi kotani?

Izi ndi ziwerengero zoyerekeza kutengera zomwe zinachitikira ena omwe adakumana ndi matenda ofanana. Chiwerengero cha anthu omwe apulumuka khansa ya minofu yofewa chimasiyana malinga ndi zinthu monga gawo la khansa, momwe HPV ilili, komanso thanzi la wodwalayo.

Ponseponse, kafukufuku wasonyeza kuti pakati pa 75% ndi 100% ya anthu omwe ali ndi khansa yoyambirira (Gawo Loyamba kapena Lachiwiri) amakhala ndi moyo zaka zisanu atapezeka ndi matendawa. Zimenezo ndi zotsatira zabwino kwambiri. Mwa iwo omwe ali ndi zotupa zazikulu, zofala (Gawo Lachitatu kapena Lachinayi), pakati pa 33% ndi 47% amakhala ndi moyo zaka zisanu pambuyo pake. Khansa zokhudzana ndi HPV zapezekanso kuti zitha kuchiritsidwa bwino kuposa khansa zomwe sizikhudzana ndi HPV.

Mukamaganizira za kuchuluka kwa anthu omwe akupulumuka, ndikofunikira kukumbukira kuti izi ndi zomwe zinachitikira anthu ena . Izi ndi ziwerengero chabe. Matenda anu, momwe mumayankhira chithandizo, komanso mphamvu za thupi lanu zonse zimakhudza kuchira kwanu. Dokotala wanu ndiye munthu wabwino kwambiri woti akupatseni chidziwitso chokhudza izi.

Kodi ndimadzisamalira bwanji nditalandira chithandizo?

Anthu omwe ali ndi khansa ya m'kamwa yofewa amafunika thandizo pakudya ndi kulankhula mutatha opaleshoni ndi mankhwala ena. Dokotala wanu, katswiri wolankhula, komanso katswiri wa zakudya angakuthandizeni kuthana ndi mavutowa, kukonza kalankhulidwe kanu, komanso kusintha kadyedwe kanu.

• Anthu ena amapitirizabe kusuta ngakhale kuti akuchitidwa opaleshoni ndi chithandizo china. Ngati zili choncho, muyenera kupempha thandizo kwa dokotala kuti asiye kusuta. Kusuta fodya, ngakhale mutagonjetsa khansa, kungapangitse kuti khansayo ibwererenso.
• Pitani kuzipatala zotsatila monga momwe mwakonzera. Kayezetseni monga momwe madokotala alangizira.
• Khalani olimba m'maganizo. Lankhulani ndi achibale ndi abwenzi. Funsani uphungu ngati pakufunika kutero.

Ndi mafunso ati omwe muyenera kufunsa dokotala wanu?

Mukapita kwa dokotala, funsani mafunso anu onse. Musachite mantha.

• Kodi khansa iyi ili pamlingo wotani?
• Kodi mumalimbikitsa chithandizo chanji? Chifukwa chiyani?
• Kodi chithandizo chimenecho chinayenda bwino bwanji?
• Kodi zotsatirapo zake ndi ziti? Zimatenga nthawi yayitali bwanji?
• Kodi kulankhula ndi kumeza kwanga kudzakhudzidwa nditalandira chithandizo? Kodi ndingachite chiyani pankhaniyi?
• Kodi khansa ingabwererenso? Ndiyenera kuchita chiyani kuti ndipewe?
• Kodi ndiyenera kupita kwa katswiri wa za kulankhula kapena katswiri wa zakudya kuti andithandize?

Pomaliza, uthenga wopita nawo kunyumba

Khansa ya m'kamwa yofewa ndi yoopsa, koma ndi matenda ochiritsika ngati muzindikira zizindikiro msanga ndikupeza upangiri woyenera wachipatala ndi chithandizo. Kumbukirani, kusuta fodya ndi kumwa mowa mopitirira muyeso ndi zinthu zazikulu zomwe zimayambitsa izi. Kuzipewa kudzakuthandizani kwambiri kuti mudziteteze ku khansa yamtunduwu.

Chithandizo chingakhudze luso lanu lolankhula ndi kumeza. Koma palinso njira zothetsera mavuto ndi njira zochiritsira matenda m'mankhwala amakono. Chofunika kwambiri ndikulankhula momasuka ndi dokotala wanu za chilichonse, ndikukumana ndi chithandizo ndi malingaliro abwino. Simuli nokha, pali madokotala, anamwino, akatswiri azachipatala ndi okondedwa anu kuti akuthandizeni.

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