Une kenza munduru yako here? Ngatidzidzei nezvekenza yemunduru.

Wakambofunga here kuti kunyange nhengo diki mumuviri wedu, iyo dzimwe nguva tisinganyatsoiteerera, inogona kukura nechirwere chakakomba? Ndizvo zvazviri negallbladder. Chirwere ichi chinonzi gallbladder cancer chinogona kukura. Kunyangwe izvi zvisingawanzoitiki, zvakakosha kuti uzvizive. Saka, nhasi tichataura nezvegomarara regallbladder zviri nyore, nenzira yaunogona kunzwisisa.

Chii chinonzi Kenza yeGallbladder?

Zvichitaurwa zviri nyore, kenza yemudumbu inguva apo masero ari mudumbu rako anotanga kukura zvisina kujairika uye nekukurumidza, asingachadzoreki. Mamasero aya ndiwo atinodaidza kuti masero anouraya.

Zvino une mubvunzo, chii chinonzi nduru iyi uye chii chinoita? Ganda iri inhengo diki iri kurudyi rwedumbu redu, pasi pechiropa, uye yakaumbwa sepeya diki. Basa rayo guru nderekuunganidza nekuchengetedza nduru, mvura inogadzirwa nechiropa, uye kutibatsira kugaya chikafu chine mafuta chatinodya. Zvakafanana netangi remvura.

Gomarara iri rinowanzo tanga muchikamu chakatetepa chiri mukati menduru. Vanachiremba vanoti ichi `chikamu chemucosal` . Nekufamba kwenguva, masero aya egomarara anogona kupararira nemadziro enduru obuda.

Chinosuwisa ndechekuti, kenza iyi haiwanzo ratidza zviratidzo pakutanga kwayo. Saka, dzimwe nguva inowanikwa netsaona mushure mekuvhiyiwa kuti ibvise gallbladder nekuda kwechimwe chikonzero.

Zvisinei, kana ikaonekwa nekukurumidza uye ikabviswa zvachose nekuvhiyiwa, kenza iyi ine mukana wakakura wekurapwa. Zvisinei, panguva iyo vanhu vazhinji vanoonekwa, kenza yacho inenge yatopararira kupfuura nduru. Panguva iyoyo, kurapwa kunova kwakaoma zvishoma.

Gomarara iri rakajairika zvakadii?

Zvichienzaniswa nenyika dzakadai seUnited States, zvakaoma kuwana nhamba dzakarurama nezvegomarara iri muSri Lanka. Zvisinei, mune dzimwe nyika dzepasi rose, semuenzaniso, munyika dzakadai seIndia, Japan, neKorea, zvinoonekwa zvakanyanya. Izvi zvinogona kunge zvichikonzerwa nekuti kuumbwa kwematombo emunduru nezvimwe zvirwere zvinowedzera njodzi yegomarara iri kwakajairika munyika idzodzo.

Zviratidzo zvacho ndezvipi? Zvakaoma here kuona pachine nguva?

Sezvatakambotaura, kenza yemudumbu haiwanzooneki zviratidzo pakutanga kwayo. Kunyangwe zviratidzo zvikaonekwa, zvinowanzofanana nezvinokonzerwa nematombo emudumbu kana kuvharika kwenzira yemudumbu, saka zvinogona kuvhiringidzika zviri nyore.

Zviratidzo zvikuru zvinogona kuonekwa ndezvi:

• Kurwadziwa kwakanyanya mudumbu rekumusoro kurudyi .
• Kutsvuka kweganda uye kuchena kwemaziso. Izvi zvinonzi jaundice .
• Kunzwa sekuti pane bundu mudumbu.
• Kuderedza uremu pasina chikonzero.
• Kusvotwa nekurutsa.
• Kunzwa sekuti dumbu rako razara (kuzvimba).
• Kugara uchidziya muviri.

Kana uine chimwe chezviratidzo izvi kana kupfuura, hazvirevi kuti une kenza nguva dzose. Zvisinei, kana zviratidzo izvi zvikaramba zviripo, zvakanaka kuti uone chiremba kuti akupe mazano.

Sei rudzi urwu rwekenza ruchikura?

Kenza yemudumbu inotanga kana masero ane hutano ashanduka kuita masero ekenza otanga kukura asingachadzoreki. Izvi zvinoitika kana shanduko, dzinonzi 'mutations' , dzikaitika mumajini ari mumasero edu. Kuchinja kwemajini uku kunoitika nekufamba kwenguva, kwete kubva kuvabereki vedu.

Masayendisiti haasati aziva kuti sei masero ane hutano achingoerekana achinja kuita masero ekenza. Zvisinei, vakaona zvimwe zvinhu zvinokonzera njodzi zvinowedzera njodzi yekubatwa nekenza iyi.

Ndezvipi zvinhu zvinokonzera njodzi?

Kune mapoka akawanda nemamiriro ezvinhu anokuisa panjodzi huru yekubatwa negomarara iri:

• Vakadzi vari panjodzi huru kupfuura varume.
• Vanhu vane makore anopfuura 65 ndivo vari panjodzi huru. (Avhareji yezera rekuonekwa kuti vane chirwere ichi imakore angangoita 72.)
• MuUnited States, zvakaonekwa kuti zvinoitika kakawanda muvanhu vemadzinza eAmerican Indian, Alaskan Native, uye Mexico-America.

Zvimwe zvinhu zvinokonzera njodzi:

• Kuvapo kana nhoroondo yekare yematombo emunduru .
• Kuva nemapolyps emudumbu ( zvikurumbira zvidiki zvakaita sebundu).
• Kuzvimba kwenguva refu kwenyongo (cholecystitis) .
• Kutapukirwa kwenguva refu nebhakitiriya rinonzi Salmonella typhi, iro rinokonzera fivha yetyphoid.
• Calcium inowanikwa mumadziro enyongo (izvi zvinonzi `porcelain gallbladder` ).
• Kuzvimba kwenguva refu kwemukoto we bile ( primary sclerosing cholangitis ).
• Kuumbwa kwema cysts mu main bile duct ( choledochal cysts ).
• Kufuta zvakanyanya .

Pamusoro pezvo, kusvuta uye kusangana nemamwe makemikari anoshandiswa mukugadzira machira nerabha zvinofungidzirwawo kuti zvinowedzera njodzi.

Unozviziva sei izvi?

Sezvatakambotaura, kenza yemudumbu inowanzoonekwa pave paya nekuti zviratidzo zvayo zvekutanga hazvina kunyanya kuipa uye zviratidzo zvayo zvakafanana nezvimwe zvirwere. Dzimwe nguva inowanikwa netsaona, kungave nekuda kwematombo emudumbu kana panguva yekuvhiyiwa kubvisa dumbu.

Kana chiremba wako achifungidzira kuti une kenza yemudumbu, achakuongorora, obvunza nezvenhoroondo yako yehutano, uye obva araira kuti uongororwe zvimwe zvirwere.

Miedzo ipi inoitiswa?

Miedzo iyi inogona kusanganisira kuongororwa kweropa, kuskena kwakasiyana-siyana, uye kunyange kuvhiyiwa kudiki.

• Kuongororwa kweropa (Kuongororwa kweLabhoritari):
• Kuongororwa kwebasa rechiropa: Izvi zvinoyera huwandu hwezvimwe zvinhu zvinoburitswa nechiropa. Izvi zvinogona kupa pfungwa yekuti kenza yenduru yakakanganisa chiropa here.
• Kuongororwa kweCEA (Carcinoembryonic antigen): CEA chiratidzo chebundu rinoburitswa nemasero ekenza ane hutano uye ekenza. Kuwedzera kwehuwandu hweizvi kunogona kuva chiratidzo chegomarara remudumbu.
• Kuongororwa kweCA 19-9: Ichi chiratidzo chebundu. Kuwedzera kwehuwandu hweizvi kunogona kuva chiratidzo chegomarara remudumbu kana dumbu.

• Kuongororwa kwemifananidzo: Izvi zvinogona kubatsira vanachiremba kuona kana kenza iripo uye kana yapararira.
• Ultrasound yemudumbu: Izvi zvinoshandisa mafungu eruzha kutora mifananidzo yenhengo dzemudumbu. Kana izvi zvikaratidza chimwe chinhu chakaita sebundu remunduru, unogona kukumbirwa kuti uitwe CT scan kana MRI scan.
• CT scan (computer tomography scan): Rudzi rweX-ray runoshandiswa kutora mifananidzo yakadzama yenhengo dzemukati.
• MRI scan (magnetic resonance imaging): Inoshandisa magineti, mafungu eredhiyo, uye komputa kutora mifananidzo yemukati memuviri.
• Endoscopic ultrasound: Mifananidzo yenzira yekugaya inotorwa uchishandisa chinhu chakaita sechubhu chinonzi endoscope.
• ERCP (Endoscopic retrograde cholangiopancreatography): Nzira yekutora mifananidzo yeX-ray yemutsinga dzenyongo. Gomarara renyongo rinogona kukonzera kuti mitsinga idzi dzitete.

• Kuvhiyiwa kudiki:
• Kuongororwa kwemuviri: Izvi zvinosanganisira kutora sampuli diki yenyama inofungirwa woiongorora pasi pemaikorosikopu kuti uone kana paine masero ekenza. Kuongororwa kwemuviri ndiyo chete nzira yekusimbisa kenza yemudumbu.
• Laparoscopy: Mukuita uku, chubhu diki ine kamera (inonzi laparoscope) inopinzwa mudumbu kuburikidza nekucheka kudiki kuti iongorore gallbladder nenyama dzakapoteredza. Izvi zvinobatsira kuona kuti kenza yapararira kusvika papi.

Matanho egomarara ndeapi?

Kuyera kenza inzira yekuti chiremba wako aone kana kenza yapararira (yakapararira) kupfuura payakatanga. Zvichienderana nekuti kenza yapararira kusvika papi, chiremba wako achapa kenza yako nhamba (kubva pazero kusvika pachina). Nhamba dzakakwira dzinoreva kuti kenza yapararira kunzvimbo dzakawanda dzemuviri wako.

Heano matanho ekenza yemudumbu:

• Danho 0 (Danho 0 - `carcinoma in situ`): Masero asina kujairika, anogona kunge aine kenza anowanikwa mukati-kati memucosa (mucosa) yenyongo.
• Danho rekutanga: Masero egomarara ari mudumbu renyongo uye anogona kunge apararira kusvika kune tsandanyama dzenyongo.
• Danho rechipiri:Kenza yapararira kupfuura tsandanyama uye yapinda muzvikamu zvenyama zvinobatana zvegallbladder.
• Danho rechitatu: Gomarara rapararira kusvika kuchiropa kana kune dzimwe nhengo dziri pedyo, kana kusvika kune chikamu chekunze (serosal layer) chegallbladder. Rinogonawo kunge rapararira kusvika kuma lymph nodes.
• Danho rechina: Kenza yapararira kune anopfuura matatu ma lymph nodes ari pedyo, mitsipa yeropa, uye/kana nhengo dziri kure nedundira.

Vanachiremba vanodana kenza yemudumbu rechikamu chekutanga kuti "yemunharaunda." Izvi zvinoreva kuti kenza haina kupararira kunze kwedumbu redumbu. Kenza yemuchikamu chekutanga ine mukana wekurapwa. Kenza yechipiri, yechitatu, neyechina dzakaoma kurapa.

Gomarara iri rinopararira sei?

Kenza yenyongo inotangira mukati menyongo yopararira kusvika kunze. Nekufamba kwenguva, inogona kupararira kusvika kuma lymph nodes ari pedyo, chiropa, nedzimwe nhengo dzemuviri, dzakadai sema ducts enyongo. Kenza yenyongo inogona kupararira kuburikidza ne lymphatic system, ropa, kana nhengo dziri kure mumuviri.

Ndezvipi zviri kurapwa?

Danho regomarara ndiro rinosarudza nzira dzekurapa nezvinangwa zvekurapa. Pagomarara rekutanga, chinangwa chikuru ndechekubvisa gomarara zvachose uye kurimisa kuti risadzoke. Kana gomarara rapararira, chinangwa chekurapa ndechekurebesa hupenyu uye kudzora zviratidzo.

Kurapa kwekenza yepakutanga

Kenza yemudumbu inotanga kukura, iyo inogona kubviswa nekuvhiyiwa, ine mhedzisiro yakanaka kwazvo yekurapa.

• Kuvhiyiwa: Chiremba wezvirwere zvegomarara (surgical oncologist) achabvisa gallbladder yako nenyama yakakanganiswa yakaipoteredza. Izvi zvinonzi cholecystectomy . Dzimwe nguva gallbladder ndiyo inobviswa chete (simple cholecystectomy), asi dzimwe nguva lymph nodes dzine masero egomarara kana chikamu chechiropa, senge gallbladder, dzinogonawo kubviswa (extended cholecystectomy).
• Kurapa nemwaranzi: Muchiitiko ichi, muchina uri kunze kwemuviri (EBRT - external beam radiation therapy) unotungamira mwaranzi kunzvimbo ine kenza. Mwaranzi iyi inouraya masero ekenza kana kunonotsa kukura kwebundu. Izvi zvinoitwa nenzira inoderedza kukuvara kwemasero ane hutano. Kurapa uku kunogona kupiwa kuuraya chero masero ekenza angasara mushure mekuvhiyiwa. Kurapa nemwaranzi kunogonawo kubatsira kuderedza zviratidzo.
• Kurapa nemakemikari: Izvi zvinoshandisa mishonga kuuraya masero ekenza kana kuamisa kuwanda. Kufanana nekurapa nemwaranzi, chemotherapy inobatsira kuuraya chero masero ekenza asara mushure mekuvhiyiwa. Dzimwe nguva, chiremba wako anogona kukurudzira chemotherapy pamwe chete nemwaranzi.

Kurapa kenza isingarapike, inodzokororwa, kana kuti inopararira mumuviri

Magomarara asingabviswe nekuvhiyiwa (`unresectable`), ayo akadzoka mushure mekurapwa (`recurrent`), kana kuti akapararira kune dzimwe nhengo dzemuviri (`metastatic`) akaoma kurapa zvachose. Kunyange hazvo kurapwa kwakadai seradiation therapy ne`chemotherapy` kusingakwanise kubvisa kenza zvachose, kunogona kubatsira kuderedza zviratidzo zvako uye kuwedzera hupenyu hwako. Zvakare, kana kenza iri kuvhara pombi yako yechikafu, kuvhiyiwa kunogona kuitwa kuderedza zviratidzo izvozvo.

Muzviitiko izvi, unogona zvakare kuwana mukana wekutora chikamu mukuyedzwa kwekiriniki . Miedzo yekiriniki izvidzidzo zvinoyedza mishonga mitsva uye nzira itsva dzekurapa dziripo. Mamwe emishonga ari kuyedzwa pari zvino mukuyedzwa kwekiriniki kwegomarara remunduru anosanganisira:

• Kurapa kwakanangana: Kurapa kunongonangana nemasero ekenza ane mamwe majini akachinja.
• Kurapa nekudzivirira chirwere chegomarara: Kurapa kunosimbisa masoja emuviri wako kuti aone uye aparadze masero egomarara.
• Maradiosensitizers: Kurapa kunoita kuti masero egomarara anzwe nyore nyore kurapwa nemwaranzi.

Bvunza chiremba wako kana uchikodzera kuongororwa kwekiriniki.

Pane migumisiro yakaipa here yekurapwa kwacho?

Sekunge kune chero kuvhiyiwa kupi zvako, kune njodzi dzehutachiona, matambudziko anokonzerwa nekushandisa mushonga weanesthesia, uye kuvhara ropa. Unofanira kukurukura zvese izvi nachiremba wako usati watanga kurapwa.

Zvakakoshawo kuziva nezvemigumisiro inogona kuitika kana munhu atora mishonga yechemotherapy uye radiation. Haasi munhu wese anowana migumisiro yakafanana. Zvisinei, chiremba wako anogona kukutsanangurira kuti ndeapi migumisiro inogona kuitika zvichienderana nehurongwa hwako hwekurapa.

Pane nzira yekudzivirira izvi here?

Hapana nzira yekudzivirira zvachose kenza yemudumbu. Zvisinei, unogona kuedza kuderedza zvinhu zvine njodzi zvatakakurukura kare zvakanyanya sezvinobvira. Semuenzaniso, unogona kutaura nachiremba wako woramba uine huremu hwakanaka hunokunakira. Zvisinei, kunyangwe ukadaro hazvigone kuvimbisa 100% kuti hauzove nekenza.

Mikana yekupora iri sei?

Kenza yemudumbu inowanzoonekwa mushure mekunge chirwere chapararira, saka fungidziro yacho haina kunaka. Inenge 20% yekenza yemudumbu ndiyo inoonekwa pakutanga. Huwandu hwevanhu vane kenza yakapararira kune dzimwe nhengo dzemuviri (yakapararira) hunosvika 2%. Zvisinei, kana kenza yacho yapararira mudumbu, ndiko kuti, pakutanga, huwandu hwevanhu vanorarama hunowedzera kusvika 66%.

Izvi zvinoreva kuti, kana zvikaonekwa nekukurumidza, pane tariro huru yekupora!

Chii chaungaita kana uchirarama negomarara?

Kuziva kuti une kenza yemudumbu kunogona kuoma. Asi zvakakosha kunzwisisa chirwere chako, zvakanakira nezvakaipira zvesarudzo dzako dzekurapa, uye hurongwa hwako hwekupora. Chikwata chako chekuchengetedza kenza ndicho nzvimbo yakanakisisa yekukutsanangurira zvese izvi.

Kubatana nenyanzvi dzinopa rubatsiro rwekuderedza kushushikana kunogonawo kukubatsira kudzora zviratidzo zvako. Rubatsiro rwekuderedza kushushikana ibasa rinotarisa pakunyaradzwa kwako uye zvaunoda, zvisinei nemamiriro ako ezvinhu. Bvunza chiremba wako kana uchida rubatsiro rwekuderedza kushushikana.

Chii chaunofanira kubvunza chiremba?

Paunoenda kunoona chiremba wako, nyora runyorwa rwemibvunzo yauinayo nezvegomarara remudumbu. Semuenzaniso, ungabvunza mibvunzo yakaita seiyi:

• Ndedzipi bvunzo dzandinofanira kuita kuti ndizive danho chairo rekenza yangu?
• Kenza yangu yemudumbu inenge iri padanho ripi?
• Ndeipi nzira yekurapa yakanakira ini?
• Ndezvipi zvakanakira uye njodzi dzinogona kuvapo kubva mukurapa uku?
• Ndezvipi zvinhu zviripo zvinondibatsira panguva ino?

Mharidzo Yekuenda Nayo Kumba

Gomarara remudumbu chirwere chisingawanzoitiki asi chakakomba zvikuru. Kana uchifunga kuti ungave uine zviratidzo zvegomarara remudumbu, enda kuna chiremba nekukurumidza. Rangarira kuti kunyange zvazvo mamwe marudzi egomarara angaratidza zviratidzo pakutanga, gomarara remudumbu rinogona kusaratidza zviratidzo zviri pachena kusvika chirwere chapera. Saka, zvakakosha kutsvaga kurapwa nekukurumidza.

Kana chirwere ichi chikaonekwa nekukasika, chinorapika zvikuru. Saka, usaregeredza zviratidzo. Chengetedza muviri wako uye tsvaga mazano echiremba kana zvichidikanwa.

` Kenza yemudumbu, kenza yemudumbu, zviratidzo zvekenza, nduru, nyongo, nhanho dzekenza, kurapwa kwekenza, CEA, CA 19-9