Ngatidzidzei chaizvo nezvegomarara repancreas. Zvinhu izvi zvakakoshawo kwauri!

Nhasi tichataura nezvechirwere chakakomba zvishoma, asi tese tinofanira kuchiziva. Ikoko ikenza yepancreas, kana kuti `(Pancreatic Cancer)`. Muizvi, masero enhengo inonzi pancreas mumuviri wedu anotanga kuita zvinhu zvisina kujairika. Sezvo ichi chiri chirwere chinonyengera, chinhu chakakosha ndechekuzviziva nenguva.

Chii chinonzi pancreatic cancer?

Zvichitaurwa zviri nyore, kenza yepancreas inguva apo masero ari mupancreas yako anopatsanuka nekukurumidza oita bundu, kana kuti bundu. Iye zvino ungangove uchishamisika kuti pancreas chii uye kuti iri kupi, handiti? Igland riri mudumbu medu, riri pakati pemusana nedumbu. Rinogadzira mahormone anodzora huwandu hweshuga muropa redu, uye ma enzymes anotibatsira kugaya chikafu.

Ruzhinji rwezvirwere zvegomarara repancreas zvinotangira mumigero yepancreas. Mugero mukuru wepancreas unobatanidza pancreas neduct yedu ye bile.

Zvinosuwisa kuti kenza iyi haionekwi nyore nyore nekuongororwa kwemifananidzo iri muchikamu chayo chekutanga. Saka panguva iyo vanhu vazhinji vanozoona kuti vanayo, kenza yacho inenge yatopararira, kana kuti yapararira. Chimwe chikonzero ndechekuti kenza iyi haidi mishonga yakawanda yekurwisa kenza. Saka zvakaoma kurapa.

Tsvagiridzo ichiri kuitwa panyaya iyi, kunyanya kuburikidza nekuongororwa kwemajini uye nzira itsva dzekufungidzira, asi tichine zvakawanda zvekudzidza.

Ndeapi marudzi ekenza yepancreatic?

Kune mhando mbiri huru dzekenza yepancreatic :

• Matumbu emudumbu: Anopfuura 90% ekenza yepancreas ndeyerudzi urwu. Rudzi rwakajairika runonzi adenocarcinoma. Rudzi urwu runotangira mumasero ari mukati menhengo dzedu.
• Matumbu eNeuroendocrine (NETs): Rudzi urwu rwebundu runoumba isingasviki 10% yematumbu ese. Runonziwo islet cell carcinoma.

Gomarara iri rakajairika zvakadii?

Munyika yakaita seAmerica, mhando nhatu pa100 dzegomarara dzinonzi kenza yepancreas. Ndiyo gomarara rechigumi rinonyanya kuwanikwa pakati pevarume uye gomarara rechisere rinonyanya kuwanikwa pakati pevakadzi. Zvinosuwisa kuti huwandu hwevanhu vanobatwa negomarara iri huri kuwedzera zuva nezuva. Sekureva kwemimwe mishumo, inogona kunge iri yechipiri inotungamira mukufa kwegomarara muAmerica panosvika gore ra2030. Ino inguva yekufunganya nezveizvi muSri Lanka zvakare.

Ndezvipi zviratidzo zvegomarara repancreas?

Zvinosuwisa kuti zviratidzo zvegomarara iri hazvionekwe pachena. Zviratidzo zvinongotanga kuonekwa kana gomarara racho rakura zvishoma uye rotanga kukanganisa dzimwe nhengo dzemuviri dziri mudumbu redu.

Zviratidzo zvegomarara repancreatic zvinogona kusanganisira:

• Jaundice (kutsvuka kweganda): Uku kutsvuka kweganda kuchena kwemaziso neganda. Vamwe vanhu vanoidaidzawo kuti 'yellow fever'.
• Weti ine ruvara rwakasviba: Weti inoshanduka kuita yero yakasviba, dzimwe nguva ruvara rwakaita semvura yetii.
• Zvituru zvine ruvara rwakajeka: Unogona kuona kuti zvituru zvako zvine ruvara rwevhu kana kuti grey.
• Kurwadziwa kwemudumbu: Unganzwa kurwadziwa mudumbu repamusoro, kunyanya pamusoro peguvhu.
• Kurwadziwa kwepakati pemusana: Izvi ndizvo zvinotaurwawo nevanhu vazhinji. Pamwe chete nekurwadziwa kwemudumbu, kune kurwadziwa pakati pemusana.
• Kuneta: Kwete kuneta chete, asi kunzwa kuneta zvisinei nekuti unorara zvakadii.
• Ganda rinokwenya: Izvi zvinogona kuitika kunyanya kana paine jaundice.
• Kusvotwa nekurutsa: Kusvotwa nekurutsa pamwe chete nekushaiwa chishuwo chekudya.
• Kuzvimba kana kuzvimba: Kunzwa kuguta kunyangwe mushure mekudya chikafu chidiki, kunzwa kuguta mudumbu.
• Kushaya chido chekudya: Kurasikirwa nechido chekudya.
• Kugwamba kweropa: Dzimwe nguva ropa rinogona kuumbwa mumakumbo.
• Kuderedza huremu: Unodzikisa huremu pasina chikonzero, usingadzore kudya kwako.
• Chirwere cheshuga chitsva: Ichi chinogonawo kuva chiratidzo chechirwere cheshuga chinoitika kamwe kamwe mumunhu asina kumbobvira arwara nechirwere cheshuga.

Kana uchangobva kuonekwa uine chirwere cheshuga, kana kuti uine chirwere chakadai sepancreatitis (kuzvimba kunorwadza kwepancreas), chiremba wako angafungidzira kuti une kenza yepancreas.

Zvisinei, zviratidzo zvegomarara repancreatic neuroendocrine zvinogona kusiyana zvishoma. Semuenzaniso, pachinzvimbo chejaundice nekudzikira kwehuremu, zviratidzo zvakaita semanyoka uye anemia zvinogona kuitika.

Zvinotora nguva yakareba sei kuti uzive kana une kenza yepancreatic?

Sezvambotaurwa, hapana zviratidzo zvekutanga zviri pachena. Kune vamwe vanhu, zviratidzo zvinogona kutanga kuoneka zvishoma nezvishoma, uye zvinogona kutora kusvika gore kuti chirwere chacho chiongororwe.

Vanhu vazhinji vanoti vakatanga kurwadziwa nemusana kana mudumbu. Marwadzo aya anogona kutanga apera, asi anogona kuwedzera mushure mekudya kana kurara pasi.

Chii chinokonzera kenza yepancreatic?

Hapana mhinduro yakajeka yeizvi parizvino. Hatizivi kuti chii chinokonzera izvi. Zvisinei, nyanzvi dzakaona zvinhu zvakawanda zvinogona kukonzera njodzi iyi.

Zvinhu Zvinokonzera Njodzi dzeCancer yePancreatic

Chinhu chinowedzera mukana wekuwana chirwere. Zvinhu zvinowanzokonzera kenza yepancreatic zvinosanganisira:

• Kusvuta: Njodzi huru ndeyekushandisa fodya, fodya, nedzimwe mhando dzefodya.
• Kufuta: Vanhu vane mafuta akawandisa, kunyanya pedyo nedumbu, vari panjodzi huru.
• Chirwere cheshuga: Kunyanya kune avo vane chirwere cheshuga cherudzi rwechipiri, zvinonzi chirwere cheshuga chinongoerekana chatanga chinogonawo kuva chiratidzo chekenza yepancreas.
• Kusangana nemamwe makemikari: Zvinhu zvakaita semishonga yekuuraya zvipembenene nemakemikari epetrochemicals.
• Chirwere chepancreatitis chisingaperi: Kuzvimba kwenguva refu kwepancreas.
• Chirwere chepancreatitis chinogara nhaka: Chirwere chinopfuudzwa kubva kuvabereki kuenda kuvana nekuda kwekuchinja kwemajini.
• Zvimwe zvirwere zvenhaka: Zvinokonzerwa nekuchinja kwemajini akadai seBRCA1 kana BRCA2. Izvi zvinogonawo kupfuudzwa kubva kuvabereki kuenda kuvana.

Ndezvipi zvinetso zvinokonzerwa nekenza yepancreatic?

Kenza yepancreatic inowanzopararira kumidziyo yeropa iri pedyo uye kuma lymph nodes. Inogona kupararira kusvika kuchiropa, mukati medumbu (peritoneum), uye mumapapu.

Zvakakosha: Kazhinji, panguva iyo kenza yepancreas inoonekwa, inenge yatopararira kunze kwepancreas. Ndosaka iine njodzi huru.

Kenza yepancreatic inoonekwa sei?

Gomarara repancreatitis rakaoma kuona pakutanga nekuti vanachiremba havagone kunzwa pancreas panguva yekuongororwa nguva dzose. Uye mabundu aya haagone kuonekwa pakuongorora kwakajairika.

Kana chiremba achifungidzira kuti ane kenza yepancreas, vanoraira bvunzo dzakawanda kuti vaone mashandiro epancreas. Izvi zvinogona kusanganisira:

Miedzo yemifananidzo

Chiremba wako anogona kukuudza kuti uite chimwe kana kupfuura chezvinotevera:

• CT scan (CT - computed tomography scans)
• Kuongororwa kweMRI (MRI - magnetic resonance imaging)
• Kuongororwa kwePET `(PET - positron emission tomography)`
• Endoscopic ultrasound (EUS): Izvi zvinosanganisira kuisa kamera diki nemuromo kuti unyatsoona pancreas.

Kuongororwa kweropa

Kuongororwa kweropa repancreas kunogona kuona zviratidzo zvegomarara. Chiratidzo chegomarara chinhu chinoratidza kuvapo kwegomarara.

Kune kenza yepancreas, bundu rinogona kufungidzirwa kana puroteni inonzi ``Carbohydrate antigen (CA) 19-9'' (ichi chinhu chinoburitswa nemasero ekenza yepancreas) iri muropa rakawanda.

Kuongororwa kwe laparoscopy

Dzimwe nguva, vanachiremba vanoshandisa nzira inonzi laparoscopy kuti vaone kuti kenza yepancreas yapararira kusvika papi uye kana ichigona kubviswa.

Mukuita uku, chiremba anochera dumbu zvishoma nezvishoma uye anoisa chubhu refu ine kamera yakabatana. Izvi zvinoita kuti chiremba akwanise kutarisa mukati medumbu kuti aone kana paine zvisina kunaka. Kazhinji, sampuli diki inotorwa panguva iyi kuti iongororwe (biopsy).

Kuongororwa kwemajini

Kana ukaonekwa uine kenza yepancreatic, ungangoda kufunga nezvekuongororwa kwemajini. Izvi zvinodaro nekuti unogona kunge wakatogara nhaka yekenza. Izvi zvichabatsirawo chiremba wako kusarudza kuti ndeipi mishonga yakakunakira.

Vamwe vanhu vane kenza yepancreatic vane shanduko mumajini anonzi BRCA1 neBRCA2. Ungave wakambonzwa nezvemajini aya se "majini ekenza yemazamu." Asi shanduko mumajini eBRCA1 neBRCA2 dzinogona kukonzera kwete kenza yemazamu chete, asiwo kenza yeprostate, kenza ye ovarian, uye kenza yepancreatic.

Kana mumwe munhu mumhuri yako (mubereki, mwana, munin'ina kana hanzvadzi) akamborwara nekenza yepancreas, funga nezvekuongororwa kwemajini. Izvi zvinogona kukuudza kana uine gene mutation ye 'BRCA1` kana 'BRCA2`. Asi yeuka, kuva negene mutation hazvirevi kuti uchava nekenza. Asi zvakakosha kuziva njodzi yako.

Ndeupi musiyano uripo pakati pekenza yepancreatic inobviswa nekubviswa?

Vanachiremba vanopatsanura kenza yepancreatic muzvikamu zvikuru zvina:

• Inobviswa: Bundu iri riri mupancreas chete. Harina kupararira kutsinga dzeropa dziri pedyo kana dzimwe nhengo dzemuviri. Rinogona kubviswa zvachose nekuvhiyiwa.
• Inogona kubviswa pamucheto: Bundu iri riri mupancreas uye rine zvimwe zvinokanganisa tsinga dzeropa dziri pedyo, asi chiremba wezvekuvhiya achiri kugona kuribvisa.
• Yafambira mberi munharaunda: Bundu iri riri mupancreas uye rapararira zvakanyanya kutsinga dzeropa dziri pedyo. Muzviitiko izvi, kubviswa kwepamuviri kunogona kuoma kana kutova nengozi.
• Kupararira kweropa:Kenza iyi yapararira kusvika kunzvimbo dziri kure dzemuviri, dzakadai sechiropa, mapapu, kana mudumbu. Inogonawo kunge yapararira kune nhengo dzemuviri, nyama, kana lymph nodes dziri pedyo nepancreas.

Kana muine mibvunzo chaiyo nezvekukura kwegomarara repancreas, taurai nachiremba wenyu. Kunzwisisa chirwere chegomarara iri kuchakubatsirai kuita sarudzo dzakakodzera nezvekurapa.

Ko gomarara repancreas rinogona kurapwa here?

Kunyangwe huwandu hwevanhu vanorarama nekenza yepancreas huri pasi, kuregererwa zvachose kunogoneka kana zvikaonekwa uye zvikarapwa nekukurumidza. Nzira chaiyo chete yekurapa kenza yepancreas ndeyekubvisa kenza zvachose kuburikidza nekuvhiyiwa.

Ko chirwere chegomarara repancreas chinorapwa sei?

Kurapwa chaiko kunoenderana nezvinhu zvakati wandei, zvinosanganisira:

• Nzvimbo chaiyo yebundu.
• Danho regomarara.
• Hutano hwako hwese .
• Kana kenza yakapararira kunze kwepancreas.

Kurapa kwekenza yepancreatic kunosanganisira:

Kuvhiya

Kuvhiyiwa ndiyo nzira chete chaiyo yekurapa kenza yepancreas. Asi vanachiremba vanokurumbidza chete kana vachifunga kuti vanogona kubvisa kenza zvachose. Zvikasadaro, hazvizobatsiri zvakanyanya.

Kuti kuvhiyiwa kubudirire, kenza inofanira kunge iri mudumbu chete. Kunyangwe zvakadaro, zvingasakwanisika kubvisa kenza zvachose.

Kune nzira dzakasiyana dzekuvhiya zvichienderana nenzvimbo uye saizi yebundu:

• Maitiro eWhipple `(Maitiro eWhipple - pancreaticoduodenectomy)`:

Kana bundu riri mumusoro wepancreas (chikamu chakakura kwazvo chepancreas, pedyo neura hudiki), chiremba wako anogona kukurudzira kuti uitwe oparesheni yeWhipple. Izvi zvinosanganisira kubvisa musoro wepancreas, duodenum yako (chikamu chekutanga cheura hudiki), gallbladder yako, chikamu chemugero we bile, uye lymph nodes dziri pedyo. Chiremba anozobatanidza mugero we bile wasara nepancreas kuura hudiki hwako. Izvi zvinogadzirisazve gadziriro yako yekugaya.

• Kubviswa kwepancreat yedivi:

Kana bundu riri mumuswe wepancreas, chiremba anogona kuita oparesheni iyi. Izvi zvinosanganisira kubvisa muswe wepancreas nechikamu chemuviri wepancreas. Kazhinji, dumbu rinobviswawo. Nekuti dumbu rinotibatsira kurwisa zvirwere, chiremba wako anogona kukukurudzira kuti uwane majekiseni usati wavhiyiwa.

• Kubviswa kwepancreat zvachose:

Kana kenza yapararira kupancreat yese asi ichiri kukwanisa kubviswa (kubviswa), chiremba wako anogona kufunga nezvekuvhiyiwa kwepancreat yese. Kuvhiyiwa uku kunobvisa pancreat yako yese, gallbladder, spleen, uye chikamu chedumbu rako neura diki.

Zvinokwanisika kurarama usina pancreas. Asi zvinogona kuva nemigumisiro yakaipa. Pancreas yako inogadzira mahormone akaita se insulin anobatsira kuchengetedza huwandu hweshuga muropa rako. Paunorasikirwa nepancreas yako, unotanga chirwere cheshuga uye unofanirwa kubayiwa majekiseni e insulin kuti urarame. Unofanirawo kutora mapiritsi e enzymes e pancreas kuti akubatsire kugaya chikafu.

Kurapwa nemakemikari

Kurapa nemakemikari (chemotherapy) kushandiswa kwemishonga kuuraya masero egomarara. Mishonga iyi inopihwa semapiritsi kana jekiseni remutsinga (intravenous) mutsinga iri muruoko rwako.

Vanachiremba vanopawo chemotherapy semushonga mumwe chete - kunyanya kune vanhu vane kenza yakapararira. Vanogonawo kukurudzira chemotherapy vasati vavhiyiwa kuti vaderedze bundu kana kuuraya chero masero ekenza asara mushure mekuvhiyiwa.

Kurapa nemwaranzi

Kurapa nemwaranzi kunoshandiswa kwemaX-ray ane simba guru kuparadza masero ekenza. Nzira iyi inonyanya kushandiswa pakurapa kenza yepancreas.

Vanachiremba vanowanzo sanganisa kurapwa nemwaranzi nechemotherapy (chemoradiation). Inogona kupiwa vasati vavhiyiwa, mushure mekuvhiyiwa, kana sechikamu chekurapa kenza huru. Kurapa nemwaranzi kunogonawo kubatsira kuderedza zviratidzo zvekenza yepancreas kuvanhu vasingagoni kuvhiyiwa (kana kenza yapararira).

Kurapa kwakanangana

Kurapa uku kunoshandisa mishonga 'inotarisa' mamwe mapuroteni. Mapuroteni aya anodzora kukura nekupararira kwemasero egomarara. Vanachiremba vanogona kusanganisa kurapwa kwakanangana nemamwe marapirwo, akadai sekurapa nemwaranzi.

Mishonga inonyanya kushandiswa pakurapa kenza yepancreatic ndeiyi:

• `Erlotinib`
• `Olaparib`
• `Larotrectinib`
• `Entrectinib`

Kugadzirisa marwadzo

Gomarara repancreas rinogona kurwadza zvikuru nekuti rinogona kukanganisa tsinga dziri pedyo. Chiremba wako anogona kukubatsira kudzora marwadzo ako nemishonga inonwiwa, anesthesia, kana majekiseni esteroid.

Kana uine kenza yepancreas uye ukatanga kurwadziwa zvakanyanya, iva nechokwadi chekuudza chiremba wako. Iye achawana mushonga unoderedza zviratidzo zvako.

Ndinogona here kudzivirira cancer yepancreas?

Kenza yepancreatic haigoni kudzivirirwa zvachose, asi pane zvinhu zvaunogona kuita kuderedza njodzi yako:

• Usasvuta.
• Deredza kunwa doro.
• Idya michero mitsva yakawanda, miriwo, uye zviyo zvakakwana.
• Deredza kudya nyama tsvuku, zvinwiwa zvine shuga, uye zvekudya zvakagadzirwa nesimbi.
• Deredza mikana yekusangana nemakemikari anokuvadza akadai seasbestos, mishonga yezvipembenene, uye petrochemicals.
• Ramba uine huremu hwakanaka kwauri.

Kuongororwa kwegomarara repancreatic

Vanachiremba havawanzoiti bvunzo dzekenza yepancreas nguva dzose. Zvisinei, vanachiremba vanokurudzira kuti vanhu vari panjodzi huru yekubatwa nekenza yepancreas nekuda kwezvikonzero zvemajini vanofanira kuongororwa nguva dzose nemifananidzo uye kuongororwa kwe endoscopic ultrasound.

Kana hama yako yepamusoro mumhuri (vabereki kana vanun'una kana hanzvadzi) yakambova nekenza yepancreas, unofanira kutaura nachiremba nezvenjodzi yako yekubatwa nekenza yepancreas uye nezvekuongororwa kwakakodzera uye kuongororwa kwemajini.

Chii chandingatarisira kana ndine kenza yepancreatic?

Kuziva kuti une kenza yepancreas kunogona kukuomera zvikuru. Munhu wese akasiyana, uye mamiriro emunhu mumwe nemumwe akasiyana. Chiremba wako achaunganidza timu yenyanzvi kuti vasarudze nzira yakanakisisa yekurapa mamiriro ako ezvinhu. Chikwata chako chekurapa chinogona kusanganisira:

• Chiremba wezvematumbu
• Chiremba wezvirwere
• Vanachiremba veOncologists (vezvekurapa, vekuvhiya uye vemwaranzi)
• Mushandi wezvemagariro evanhu

Nguva yekupararira kwegomarara repancreatic

Kazhinji, zvinotora makore gumi kusvika makumi maviri kuti sero rimwe chete rekenza mupancreas yako rikure kuita bundu. Chinangwa chetsvagurudzo iripo ndechekutsvaga nzira yekuona kenza yepancreas pakutanga, panguva iyo inogona kurapwa zvakanyanya.

Mwero wekupona kwekenza yepancreatic

Munyika yakaita seAmerica, huwandu hwevanhu vane kenza yepancreatic vanorarama kwemakore mashanu i11%. Izvi zvinoreva kuti vanhu gumi nemumwe pavanhu zana vanorarama makore mashanu mushure mekuonekwa vaine chirwere ichi.

Mwero wekupona chirwere ichi ingori fungidziro chete. Hazvikuudzi kuti uchararama kwenguva yakareba sei kana kuti uchapindura zvakanaka sei kana ukarapwa. Kana uine mibvunzo chaiyo nezve mwero uyu kana kuti ungakanganisa sei, taura nachiremba wako.

Ndinofanira kuona chiremba rini?

Kenza yepancreatic yekutanga haina zviratidzo zvinoonekwa. Zvisinei, enda kuna chiremba nekukasika kana ukaona chimwe chezvinotevera:

• Jaundice
• Kurwadziwa kwemudumbu kana musana
• Kuderedza uremu pasina chikonzero
• Kutanga kamwe kamwe kwechirwere cheshuga

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

Vaka hukama hwakasununguka uye hwekushandira pamwe nachiremba wako. Kana iwe kana mumwe munhu waunoda akaonekwa kuti ane kenza yepancreatic, munogona kubvunza mibvunzo yakaita seiyi:

• Kenza iri padanho ripi? Zvicharevei kwandiri?
• Ndedzipi nzira dzekurapa dzandinadzo? Chii chamunokurudzira uye nei?
• Ndezvipi zvimwe zvingaitika kubva mukurapwa kwacho?
• Kuongororwa kwemajini kwakakodzera here kwandiri?
• Pane miedzo yekiriniki here?
• Ndichakwanisa here kuramba ndichishanda uye ndichiita mabasa angu ezuva nezuva?
• Mungandiudzewo here kuti ndingawana kupi rubatsiro rwemari?
• Mungandiudzewo nezvenzvimbo dzandingawana zororo repfungwa here?
• Chii chandinofanira kuita kuti ndirambe ndiine hutano hwakanaka sezvinobvira?

Ndezvipi zviratidzo zvekuti kenza yepancreatic yapararira?

Sezvo kenza yepancreas ichifambira mberi, unogona kutanga zviratidzo zvitsva. Zviratidzo zvekenza yepancreas yakakwira zvinogona kusanganisira:

• Kurwadziwa kwemudumbu
• Kuneta kwakanyanya
• Kuderedza uremu pasina chikonzero
• Jaundice
• Kuzvimba kwedumbu (ascites)

Kuziva kuti une kenza yepancreas kunogona kuva chiitiko chinoparadza uye chinoshandura hupenyu. Chiremba wako aripo kuti akubatsire munguva ino yakaoma. Kana uchikwanisa, batana neboka rekutsigira remunharaunda kana online revanhu vane kenza yepancreas. Kupedza nguva nevamwe vari kusangana nedambudziko rimwe chete kunogona kubatsira zvikuru hutano hwepfungwa dzako. Unogona zvakare kutaura nezvemanzwiro ako neanopa mazano, nyanzvi yekurapa, kana mushandi wezvemagariro evanhu. Ruzivo isimba. Kune zvinhu zvakawanda zviripo zvekukubatsira iwe nemhuri yako.

Muchidimbu, zvinhu zvatinofanira kurangarira (Mharidzo Yekuenda Kumba)

Kenza yepancreatic chirwere chakaoma uye chinokuvadza, asi zvakakosha kuti uzive nezvacho. Sezvo zviratidzo zvako zvisipo pakutanga, chinhu chakanakisa chekuita kuziva zvinhu zvinogona kukonzera njodzi uye kuona chiremba nekukurumidza kana ukaona chimwe chinhu chisingawanzoitika. Yeuka, usaregeredza jaundice, kurwadziwa kwemudumbu/musana kunoramba kuripo, kudzikira uremu kamwe kamwe, kana kutanga kwechirwere cheshuga. Kana uine njodzi yemajini, taura nachiremba wako nezvazvo uye uongororwe. Kune marapirwo aripo, uye tsvakiridzo itsva iri kuitwa nguva dzose. Chinhu chakakosha kusatya, kutsvaga mazano echiremba kana uine kusava nechokwadi, uye kuramba uine tariro.

'Kenza yePancreatic, Kenza yePancreatic, Pancreas, Zviratidzo zveKenza, Kurapwa kweKenza, Jaundice, Chirwere cheshuga