Chii chinonzi Urothelial Carcinoma? Ngatikurukurei zvakadzama nezvazvo!

Wakamboona ropa muweti yako here? Kana kuti une kurwadziwa nemusana kana kuneta nguva dzose? Kunyange zvazvo izvi zvingasaita sekunge zvakanyanya kunetsa nezvazvo, dzimwe nguva zvinogona kuva zviratidzo zvegomarara rinokura muweti. Rumwe rudzi rwegomarara rwakadaro iUrothelial Carcinoma , dzimwe nguva inonzi Transitional Carcinoma . Nhasi, tichataura nezvazvo zvakadzama , sekunge tiri kutaura neshamwari.

Chii chinonzi Urothelial Carcinoma? Zvichitaurwa zviri nyore...

Zvichitaurwa zviri nyore, Urothelial Carcinoma igomarara rinotanga munyama inonzi urothelium, iyo iri muzvikamu zveweti yako. Funga nezvayo semukati menhengo dzemuviri wedu. Urothelium ndeimwe yenyama dzakadaro. Inonyanya kuwanikwa mudundira, itsvo (kunyanya pelvis yeitsvo), uye ureters. Waizviziva here kuti 90% yegomarara redundira uye 7% yegomarara reitsvo igomarara redundira? Zviratidzo zvezvose zvakafanana. Chinhu chakanakisa ndechekuti gomarara iri riri nyore kurapa uye kurapa kana rikaonekwa nekukurumidza . Zvisinei, dzimwe nguva rinogona kudzoka. Ndosaka zvichikosha kuziva izvi.

Gomarara iri rinokanganisa sei miviri yedu?

Mabatirwo anoita kenza yemudumbu neitsvo zvinogona kusiyana zvishoma.

Kenza yemudumbu

Dundira rako inhengo diki yakaita sebhegi. Iri pakati pemapfupa ehudyu yako, pamusoro peurethra yako, uye pasi peitsvo dzako. Weti inobva muitsvo dzako inoungana mudundira iri. Mukati medundira mune tishu yatakambotaura inonzi urothelium . Masero ari mudundira iri anogona kutambanuka kana dundira rako razara neweti uye richigumburwa parinobuda. (Dundira rako rinowanzo takura makapu maviri eweti.) Paunova nekenza yedundira, masero ari mudundira iri anopatsanuka zvisina kujairika uye anopararira kubva mukati medundira rako kuenda kune mamwe maturikirwo. Dzimwe nguva, masero aya asina kujairika anogona kupwanya nemadziro edundira rako uye kupinda mumafuta akaripoteredza. Kana rikasarapwa, kenza iyi inogona kupararira nemadziro edundira kuenda kuma lymph nodes ari pedyo uye kubva ipapo kuenda kune dzimwe nzvimbo dzakadai semapfupa, mapapu, nechiropa. Kune mhando mbiri huru dzekenza yedundira:

• Kenza yemudumbu ine urothelial yepamusoro: Iyi ine njodzi zvishoma. Inogona kudzoka kunyangwe kana yarapwa. Inogona kupararira kusvika mutsandanyama dzemudumbu, dzimwe nhengo dzemuviri, uyeInogona kupararira kusvika kuma lymph nodes .
• Kenza yemudumbu ine mazinga akaderera: Izvi zvinogona kudzoka zvakare, asi hazviwanzoitika kuti zvipararire mutsandanyama dzemudumbu kana kune dzimwe nhengo dzemuviri.

Kenza yeitsvo yemudumbu

Tinowanzova neitsvo mbiri. Dzakaita senhengo mbiri dzakaita sebhinzi, dziri pasi pembabvu uye kumashure kwedumbu. Itsvo dzinosefa tsvina nehupfu hunobva muropa dzogadzira weti. Weti iyi inoungana pakati peitsvo inonzi renal pelvis . Kubva ipapo, weti inofamba ichidzika nechubhu refu inobatanidza itsvo nedundira. Chubhu iyi inonzi ureter . Kufanana neitsvo, chiuno neureter zveitsvo zvakazarawo ne urothelial tissue. Kenza yeitsvo inoitika kana masero eurothelial asina kujairika achikura uye achigadzira bundu muitsvo, chiuno neitsvo, kana ureter. Kenza yeitsvo inogonawo kupararira kune dzimwe nhengo kana matishu.

Ndiani ane mukana mukuru wekuwana gomarara iri?

Kenza yedundira ndiyo kenza yechitanhatu inonyanya kuwanikwa muUnited States. Uye 90% yekenza yedundira ikenza yemudumbu. Varume vane mukana wekuwana kenza yedundira wakapetwa kana kupfuura vakadzi . Kenza yeitsvo ndiyo kenza yechisere inonyanya kuwanikwa. Inenge 7% yekenza yeitsvo ikenza yemudumbu. Inowanzoonekwa muvanhu vari pakati pemakore 65 ne74. Varume vane mukana wakapetwa kaviri wekuwana chirwere ichi.

Chii chiratidzo chikuru chegomarara remudumbu?

Kenza yemudumbu inogona kunge isina zviratidzo pakutanga kwayo. Zvisinei, ropa muweti (hematuria) rinowanzova chiratidzo chekutanga. Kana ukaona ropa muweti kana uine chimwe chezviratidzo izvi, unofanira kuona chiremba :

• Kurwadziwa kwemusana kunoramba kuripo.
• Kuneta, kuneta .
• Kuonda pasina chikonzero.
• Kurwadziwa pakuita weti ( dysuria ).
• Zvinoita sebundu riri paitsvo .
• Ndine fivha diki.

Chii chinokonzera gomarara iri?

Vaongorori vezvekurapa havasati vaziva kuti chii chinokonzera kenza yemudumbu neitsvo. Zvisinei, vakaona zvinhu zvinoverengeka zvinowanzokonzera njodzi:

• Kusvuta fodya : Vanosvuta fodya vane njodzi yakakura yekubatwa nekenza yemudumbu mudumbu.Njodzi yekubatwa negomarara yakakura kwazvo. Ichi ndicho chinhu chikuru chinokonzera njodzi.
• Kusangana nemamwe makemikari: Ongororo dzakaratidza kuti vanhu vanoshanda munzvimbo dzinogadzira madhayi, rabha, zvinhu zvedehwe, pendi, mamwe machira, uye zvigadzirwa zvekugadzira bvudzi vari panjodzi yakakura yekubatwa negomarara iri.

Vanachiremba vanoongorora sei gomarara iri?

Vanachiremba vanoshandisa bvunzo idzi kuongorora kenza yedundira neitsvo, kusanganisira kenza yemudumbu:

• Kuongororwa kweweti: Kuongororwa kweweti yako kunoongorora ruvara, shuga, mapuroteni, ropa, uye mabhakitiriya.
• Kuongororwa kweweti: Muenzaniso weweti yako unotorwa woongororwa uchishandisa maikorosikopu kuti uone kana masero asina kujairika. Kana uine kenza muitsvo, dundira, kana urethra, masero ekenza anogona kuwanikwa muweti yako.
• Intravenous pyelogram (IVP): Iyi iongororo yeX-ray. Inoitwa kuti ionekwe kana paine kenza muitsvo, ureter, uye dundira. Vanachiremba vanobaya mvura yakakosha (contrast dye) mutsinga yako. Zvadaro, maX-ray anotorwa mvura yacho ichipinda nemuitsvo dzako, ureter, uye dundira kuti vaone kana paine chakavharika.
• Ureteroscopy: Chishandiso chitete chakaita sechubhu (chine kamera nechiedza) chinopfuudzwa nemuurethra kuti chitarise mukati meureter nechiuno cheitsvo. Chinoshandiswawo kutora sampuli dzenyama.
• Kuongororwa kweCT (Computed tomography - CT scan): Kombiyuta yakabatana nemuchina weX-ray inotora mifananidzo yakadzama yezvikamu zvakasiyana-siyana zvemuviri.
• Ultrasound: Mafungu eruzha ane simba guru (ultrasound) anotumirwa munyama dziri mukati memuviri uye manzwi anodzoka anoshandiswa kugadzira mufananidzo (sonogram). Ultrasound yemudumbu inogona kuitwa kuti ione kenza yemuchiuno neureter.
• MRI (Magnetic resonance imaging - MRI): Inoshandisa magineti, mafungu eredhiyo, uye komputa kutora mifananidzo yakadzama yenzvimbo dziri mukati memuviri, dzakadai sepadumbu.

Chii chinonzi kenza staging?

Vanachiremba vanoshandisa nzira yekuongorora kenza kuti varonge kurapwa kwayo uye kuona kuti kenza yacho ichakura sei. Izvi zvinotsanangura kuti kenza inogona kukura sei uye kupararira sei.

Kugadzirisa kenza inzira yakaoma. Kana uchinzwa sekunge chirwere chako chiri kuiswa mufomula ine mavara nenhamba shoma, zvinogona kutyisa uye kuvhiringa. Zvinonzwisisika kuti ndizvo zvazviri. Kana usina chokwadi nezveizvi kana kuti uri kunzwa kutya, bvunza chiremba wako kuti akutsanangurire kuti nzira iyi inoshanda sei pachirwere chako.

Matanho ekenza yedundira

Kenza yedundira inogona kuva padanho rekutanga (rinongogumira pamucheto wedundira) kana kuti rakatokura (rapinda mumadziro edundira ndokupararira kune nhengo dziri pedyo kana ma lymph nodes). Matanho ekenza yedundira ndeaya anotevera:

• Danho rekutanga: Gomarara iri rinongogumira padundira kana panhengo dziri pasi paro. Harina kupararira kusvika kumadziro makuru emhasuru yedundira.
• Danho rechipiri: Kenza yapararira kusvika pamadziro emhasuru edundira.
• Danho rechitatu: Kenza yapararira kubva mutsandanyama yedundira ichienda kumafuta ari kunze.
• Danho rechina: Kenza yapararira kubva padundira kuenda kuma lymph nodes, dzimwe nhengo dzemuviri, kana mapfupa.

Vanachiremba vanoisawo kenza yedundira muzvikamu seisina kukuvadza , isingakuvadzi tsandanyama , kana kuti inokuvadza tsandanyama .

• Hazvipindi: Muchiitiko ichi, kenza inogona kunge iri munzvimbo diki chete yenyama, kana kuti inogona kunge yakaganhurirwa pamusoro pedundira.
• Hazvipindi tsandanyama: Panyaya iyi, kenza yapinda zvakanyanya mudundira, asi haina kupararira mutsandanyama.
• Kupinda tsandanyama: Muchiitiko ichi, kenza yapararira kusvika kutsandanyama dziri pamadziro edundira uye inogona kunge yapararira kusvika kune mafuta ari kunze kwedundira kana kumatishu enhengo dzemuviri.

Matanho ekenza yeitsvo

Kenza yeitsvo hairatidzwi zvichienderana nerudzi rwekenza. Kenza yemudumbu inokonzeresa kenza yeitsvo inosvika 7%. Kenza yeitsvo nekenza yeitsvo/ureter inokonzereswa zvakasiyana.

• Danho rekutanga: Kenza haina kupararira kunze kweitsvo.
• Danho rechipiri: Kenza yakura, asi haina kupararira kupfuura itsvo.
• Danho rechitatu: Gomarara rapararira kubva muitsvo kuenda kutsinga huru dzeropa - mutsinga yeitsvo nevena cava iri pasi - kana kumatishu akakomberedza itsvo, kana kuma lymph nodes ari pedyo.
• Danho rechina: Kenza yapararira kubva pagland readrenal (gland diki riri pamusoro peitsvo), kuenda kuma lymph nodes ari kure, kana kune dzimwe nhengo dzemuviri.

Matanho ekenza ye pelvis yetsvo neureter

• Danho 0: Kune masero asina kujairika muchikamu chechiuno cheitsvo kana ureter. Izvi zvinonziwo papillary carcinoma kana carcinoma in situ .
• Danho rekutanga (Danho rekutanga): Gomarara rapararira nepakati pechiuno cheitsvo uye/kana ureter uye richipinda muchikamu chetishu chinobatana.
• Danho rechipiri:Kenza iyi yakapararira kuburikidza nenyama inopinda mutsandanyama dzechiuno cheitsvo uye/kana ureter.
• Danho rechitatu: (Danho rechitatu harina kutaurwa pano, asi rinowanzova pakati pechipiri nechina, zvichiratidza kupararira kune nhengo dziri pedyo) Kenza yapararira kune nhengo dziri pedyo, rimwe kana kupfuura lymph nodes, mafuta akakomberedza itsvo, kana nhengo dziri kure dzakadai semapapu, chiropa, kana mapfupa.

Vanachiremba vanorapa sei gomarara remudumbu?

Nzira dzekurapa dzinosiyana zvichienderana nekuti kenza yemudumbu iri iri kupi mudundira, itsvo, chiuno cheitsvo, uye muureter.

Kurapa kenza yedundira

Sarudzo dzekurapa dzingasanganisira:

• Kuvhiyiwa: Vanachiremba vanobvisa bundu rekenza kana kuripisa vachishandisa magetsi ane simba guru. Izvi zvinonzi electrocautery (fulguration) .
• Kurapa nemakemikari: Mishonga inopihwa kuparadza masero ekenza.
• Kurapa nekudzivirira muviri: Kunokurudzira masoja emuviri wako kurwisa kenza.
• Kurapa nemwaranzi: Kunoshandisa mwaranzi ine simba guru kuparadza masero ekenza.
• Kurapa kwakanangana: Mishonga inonanga mamorekuru chaiwo anobatsira masero ekenza kukura.

Kurapa kenza yeitsvo

Mamwe emishonga yakafanana inoshandiswa pakurapa kenza yeitsvo nekenza yedundira. Pamusoro pezvo, mishonga iyi inogona kushandiswa:

• Kuvhiyiwa: Chikamu cheitsvo chine kenza ndicho chete chinogona kubviswa, kana kuti itsvo yese inogona kubviswa.
• Kupisa: Kunoshandisa kutonhora kwakanyanya kuparadza masero ekenza.
• Kubviswa kwemasaisai emagetsi: Mafungu emagetsi emagetsi anoshandiswa kupisa nekuparadza masero ekenza.

Kurapa kenza yemuchiuno cheitsvo uye/kana ureter

• Kuvhiyiwa: Chikamu chechiuno cheitsvo kana ureter chiri panowanikwa kenza chinobviswa.

Mukana wekurarama kana ukabatwa negomarara remudumbu (urotellial cancer) wakaita sei?

Kunyangwe kenza yemudumbu iri kenza inotangira pamhando imwe chete yemasero, nzira yechirwere inogona kusiyana zvichienderana nekuti chinokura kupi (dundira, itsvo, chiuno cheitsvo, ureter).

Mafungiro ekenza yedundira

Kufanana nekenza zhinji, kenza yedundira inogona kuramba iripo kana ikaonekwa uye ikarapwa nekukurumidza. Sekureva kwedata ra2018 kubva kuNational Cancer Institute (NCI), 96% yevanhu vakarapwa kenza yekutanga vachiri vapenyu makore mashanu mushure mekuonekwa kuti vane chirwere ichi. Kazhinji, 77% yevanhu vane kenza yedundira vachiri vapenyu makore mashanu mushure mekuonekwa kuti vane chirwere ichi.

Mafungiro ekenza yeitsvo

Kufanana nekenza zhinji, kenza yeitsvo (kusanganisira kenza yechiuno cheitsvo) iri nyore kurapa kana ikaonekwa nekukurumidza.Zvichienderana nedata reNCI (2018), 93% yevanhu vakarapwa kenza yeitsvo vachiri vapenyu makore mashanu mushure mekuonekwa kuti vane chirwere ichi. Huwandu hwevanhu vanorarama kwemakore mashanu i76.5%.

Ndingaderedza sei njodzi yangu yekubatwa nekenza yemudumbu mumuviri wangu weti?

Pane zvinhu zviviri zvikuru zvaunogona kuita kuti uderedze njodzi yako yekubatwa negomarara iri:

• Kusasvuta fodya.
• Kudzivirira kusangana nemamwe makemikari anokuvadza.

Ndingazvitarisira sei?

Kana kenza ikabatwa nekukurumidza, vanachiremba vanogona kurapa kenza yemudumbu, iyo inokura mudumbu remudumbu. Asi zvinosuwisa kuti mhando dzekenza idzi dzinogona kudzoka. Kana wakamborapwa kenza yerudzi urwu, zvakakosha kuti urambe uchiwana rubatsiro rwekutevera sezvakarairwa nachiremba wako. Izvi zvakakosha zvikuru.

Ndinofanira kuona chiremba rini?

Kana ukaona chero shanduko mumuviri wako, kunyanya zviratidzo zvinoratidza kudzoka kwegomarara remudumbu muchikamu cheweti, enda kuna chiremba nekukasika. Izvi zvinoreva kuti kana ukaona zviratidzo zvitsva, zvakaita seropa muweti yako, kurwadziwa kwemusana, kana kuneta kutsva, unofanira kuona chiremba.

Zvinhu zvakakosha zvekurangarira (Mharidzo Yekuenda Kumba)

Zvakanaka, saka, izvi ndizvo zvinhu zvakakosha zvaunofanira kurangarira kubva pane zvatataura nezvazvo nhasi:

• Kansa yemudumbu (Urothelial carcinoma) igomarara rinokura mukati memuviri weti (dundira, itsvo, uye ureters).
• Chiratidzo chikuru iropa muweti . Zvimwe zviratidzo zvinosanganisira kurwadziwa kwemusana, kuneta, uye kudzikira kwehuremu.
• Kusvuta uye kusangana nemamwe makemikari ndizvo zvinhu zvikuru zvinokonzera njodzi.
• Kana zvikaonekwa nekukurumidza, zvingangoita kuti zvirapwe uye zvirapwe.
• Nekuti gomarara iri rinogona kudzoka, zvakakosha kuti munhu arambe achiongororwa nachiremba mushure mekurapwa.
• Kana uine kusava nechokwadi kana zviratidzo, usatya kutaura nachiremba. Vachakubatsira.

Ndinovimba ruzivo urwu ruchakubatsira. Ramba uine hutano! Kenza yemudumbu, Kansa yemudumbu, Kenza yeweti, Kenza yedundira, Kenza yeitsvo, Ropa muweti, Zviratidzo zveKenza