Ngatidzidzei zvakawanda nezvegomarara remudumbu. Musatya, ngatitaurei!

Wakambonzwa nezvechinhu chinonzi "Vulvar Cancer" here? Ungatya zvishoma paunonzwa zita iri. Asi usazvidya mwoyo. Iri igomarara risingawanzoitiki. Zvisinei, zvakakosha kuziva izvi. Nekuti, kana rikaonekwa nekukurumidza, zviri nyore kurapa. Ngatitaurei nezvazvo zvakadzama uye zviri nyore nhasi.

Chii chinonzi Vulvar Cancer?

Zvichitaurwa zviri nyore, Vulvar Cancer igomarara rinokura munyama dzenhengo yako yepabonde. "Vulva" izita rekuti nhengo dzese dzekunze dzemukadzi dzinoita sei. Unoyeuka here, patakanga tiri vadiki, tainyara kutaura nezvenhengo idzi, asi zvakakosha kuziva nezvenhengo dzese dzemuviri wedu.

Fungidzira, nhengo yako yemurume ine zvikamu zvinotevera:

• Kuvhura nhengo yemukadzi: Chubhu yetsandanyama inoshandiswa pabonde, kubereka, uye kuenda kumwedzi (kuenda kumwedzi).
• Labia Minora: Mapete enyama akakomberedza muromo wemukadzi uye anotambanukira pamusoro peclitoris.
• Marebvu: Nzvimbo ine nyama yakakomberedza miromo yemukati.
• Kiritoris: Bundu diki, rinonyanya kunzwa zvepabonde riri pamusoro peburi remukadzi.
• Mons Pubis: Nzvimbo yakatenderera iri pamberi pemapfupa echiuno inova nemvere panguva yekuyaruka.
• Kuvhurwa kweUrethra: Kuvhurwa kwechubhu inobuda weti mumuviri.
• Perineum: Nzvimbo yeganda iri pakati pemukadzi netsvina.

Rudzi urwu rwegomarara remudumbu rinowanzo tanga zvishoma nezvishoma, kwemakore akawanda. Rinotanga semaronda asati aita kenza. Vanachiremba vanowanzoona kukura uku kusina kujairika muganda rekunze. Maronda aya asati aita kenza anonzi "vulvar intraepithelial neoplasia" (VIN) .

Ndeapi marudzi egomarara remudumbu?

Vanachiremba vanoisa kenza yechikadzi mumapoka zvichienderana nerudzi rwesero rinotangira kenza. Mhando dzakajairika ndeidzi:

• Kansa yeVulvar Squamous Cell: Rudzi urwu rwunokonzera 90% yekenza ye vulvar. Inokura mumasero ari pamusoro peganda.
• Vulvar Melanoma: Rudzi urwu rwe melanoma runoumba 5% yekenza ye vulvar. Inokura nekukurumidza uye ine njodzi huru yekupararira kune dzimwe nhengo dzemuviri.

Mamwe marudzi egomarara remudumbu haawanzoonekwi zvakanyanya. Anosanganisira:

• Kansa yeBasal Cell
• Bartholin Gland Adenocarcinoma
• Chirwere chePaget cheVulva
• Sarcoma
• Kansa yeVerrucous

Kenza yemudumbu yakajairika zvakadii?

Kutaura zvazviri, kenza yemudumbu ikenza isingawanzoitiki. Semuenzaniso, muUnited States, vanhu vashoma pane 6,500 vanobatwa nekenza yemudumbu gore rega rega.

Zvakakosha kuti, 80% yevanhu vanoonekwa vaine chirwere ichi vane makore anopfuura 50. Uyewo, vanhu vanopfuura hafu vanoonekwa vaine chirwere ichi vanoonekwa nevanhu vane makore anopfuura 70. Avhareji yezera rekuonekwa vaine chirwere ichi imakore angangoita 68.

Izvi zvinoreva kuti, zvinoita sekunge njodzi iyi inowedzera nekukura, handiti?

Ndezvipi zviratidzo zvegomarara remudumbu?

Iye zvino ngatitarisei zviratidzo zvechirwere ichi. Zviratidzo zvekutanga zvinowanzoonekwa sekuchinja kweganda paganda rekunze re labia majora kana kuti mukati me labia minora. Zvisinei, kenza inogona kuitika chero kupi zvako mu vulva.

Zviratidzo zvegomarara remudumbu zvinogona kusanganisira:

• Kuchinja kweruvara rweganda: Dzimwe nzvimbo dzinogona kusviba kana kupenya kupfuura zvakajairika, kana kuti mavanga machena anogona kuoneka.
• Kukora kana kuti kuomarara kweganda: Dzimwe nzvimbo dzinogona kunzwa dzakakora uye dzakaomarara kana dzikabatwa.
• Mapundu kana mapundu: Unogona kuva nemapundu, mapundu, maronda asingapore, kana ma cysts.
• Kukwenya kana kupisa: Unganzwa kuvaviwa kana kupisa kunoramba kuripo, kusingaderedzi.
• Kubuda ropa kusiri kwekuenda kumwedzi: Kana uine kubuda ropa kusiri kwekuenda kumwedzi, izvozvo zvinofanirawo kufungwa nezvazvo.
• Kurwadziwa uye kurwadziwa kana ukagunzwa: Unogona kunzwa kurwadziwa panguva yebonde kana weti.

Kana uine chimwe chezviratidzo izvi kana kupfuura, iva nechokwadi chekuona chiremba. Zviratidzo zvegomarara remudumbu zvingasaonekwa pakutanga. Saka, zvakanaka kuti uongororwe nekukurumidza.

Zvisinei, zviratidzo izvi zvinowanzoonekwa mune zvimwe zvirwere zvisiri zvegomarara. Saka, zvakakosha kuti usatye, asi kuti uone chiremba kuti uone kana shanduko idzi dziri zviratidzo zvegomarara kana chimwe chinhu.

Ndezvipi zvinokonzera kenza yemudumbu?

Mukenza yechikadzi, masero anotanga kuwanda zvisingadzoreki. Kana akasarapwa, masero aya ekenza anogona kupararira kune dzimwe nhengo dzemuviri.

Vulvar Squamous Cell Carcinoma, inova ndiyo mhando inonyanya kuwanikwa, inokonzerwa nezvirwere zviviri zvikuru:

• Hutachiona hweHuman Papillomavirus (HPV): Uhu utachiona hunowanzo pararira pabonde (STI) hunopararira kuburikidza nekubatana kweganda neganda. Mamwe marudzi eHPV anowedzera njodzi yemhando dzakasiyana dzekenza, kusanganisira kenza yemuromo wechibereko, kenza yemusana, uye kenza yemudumbu.
• Lichen Sclerosus: Ichi chirwere cheganda chisingaperi (kwehupenyu hwese). Lichen Sclerosus inogona kukonzera zviratidzo zvakaita sekuzvimba kweganda, kuchinja kweganda, uye kuvaviwa.

Ndezvipi zvinhu zvinokonzera njodzi?

Kune zvinhu zvakawanda zvinowedzera njodzi yekubatwa nekenza yemudumbu:

• Zera: Njodzi yekubatwa nekenza yemudumbu inowedzera nekukura.
• Kusangana neHPV: Haasi marudzi ese eHPV anokonzera kenza, asi mamwe marudzi anogona kukonzera shanduko dzemasero izvo zvinogona kupedzisira zvaita kuti pave nekenza ye vulvar.
• Zvirwere zveganda zveVulvar: Kukura kunokonzerwa nezvirwere zvakaita se'Lichen Sclerosus' kunogona kufambira mberi kuita kenza yevulvar.
• Vulvar intraepithelial neoplasia (VIN): VIN chirwere chisati chatanga kenza, icho, kana chikasarapwa, chinogona kukura kuita kenza ye vulvar.
• Utachiona hweHIV (Human Immunodeficiency Virus): Kana masoja emuviri akadzikira simba nekuda kwechirwere chakadai seHIV, zvinova zvakaoma kuti muviri urwise gomarara.
• Kusvuta: Kusvuta kunowedzera njodzi yekubatwa nekenza yemhando dzakasiyana-siyana, kusanganisira kenza yemudumbu.

Kenza yeVulvar Inoonekwa Sei?

Kana ukaona chiremba, anokubvunza nezvenhoroondo yako yezveutano, zvinhu zvinokukonzera njodzi, uye zviratidzo. Miedzo yakati wandei inowanzoitwa kuti uone kana chirwere chacho chiripo.

Kuongororwa kwekuona kenza yechikadzi

Miedzo iyi inogona kusanganisira:

• Kuongororwa kwePelvic: Chiremba achaongorora nhengo yako yemukadzi nemaziso uye achaona kana paine shanduko dzisina kujairika paganda. Vachaisa chigunwe chimwe kana zviviri zvakaputirwa magirovhosi munhengo yako yemukadzi uye vachazviongorora nemaoko kuti vaone mapundu kana zvimwe zviratidzo zvegomarara. Nzvimbo yekubvisa tsvina inogonawo kuongororwa nenzira imwecheteyo. Vanogonawo kushandisa mudziyo unonzi speculum kuwedzera nhengo yemukadzi uye kutsvaga zvisina kunaka.
• Pap Smear: Panguva yekuongororwa muchiuno, chiremba wako anogona kutora sampuli yemasero otarisa shanduko dzegomarara. Muenzaniso wacho unogona zvakare kuongororwa HPV kuti uone kana une hutachiona hweHPV.
• Colposcopy: Chiremba anogona kushandisa mudziyo une chiedza, unoratidza kukura unonzi "colposcope" kuti aone vhudzi rako, vhudzi rako, nemuromo wechibereko (nhengo iri pakati pevhudzi rako nechibereko) zvakadzama. Anogonawo kushandisa mushonga wakakosha unogona kuratidza masero asina kujairika uye kuita kuti zvive nyore kuona.
• Kuongororwa kwemuviri: Chiremba anogona kutora sampuli yenyama isina kujairika oiedza kuona masero ekenza. Kuongororwa kwemuviri ndiyo chete nzira yekuziva kana uine kenza yekubereka.

Kuongororwa kuti uone kana kenza yapararira

Kana uine kenza, chiremba wako achaita bvunzo dzakawanda kuti aone kana yapararira kupfuura vulva. Kana ikasarapwa, kenza yevulvar inogona kupararira ichienda kunhengo yechikadzi kana kune dzimwe nhengo dziri pedyo, kuenda kuma lymph nodes ari muchiuno, uye pakupedzisira kuenda kuropa. Kenza yakapararira mumuviri yakaoma kurapa.

Miedzo iyi inosanganisira:

• Kuongororwa kweScope: Ungangoitwa cystoscopy kuti uone kana kenza yapararira kusvika muurethra kana dundira. Proctoscopy inotsvaga masero ekenza ari mu rectum kana mu anus.
• Kuongororwa kwemifananidzo: X-rays, CT scans, MRIs, uye PET scans zvinogona kuratidza kana kenza yapararira kubva mudumbu kuenda kune dzimwe nhengo dzemuviri.
• Kuongororwa kweBonde reSentinel: Chiremba wako anogona kubvisa lymph node (sentinel node) iri pedyo nebundu rako rekenza kuti aongorore masero ekenza. Mukenza yevulvar, kenza inowanzopararira kusvika kumalymph node esentinel ari munzvimbo yehudyu.

Matanho ekenza yemudumbu (vulvar cancer) ndeapi?

Kuongororwa kwechirwere chegomarara remudumbu kunobatsira vanachiremba kuona kana gomarara rako rapararira kupfuura dumbu. Ruzivo urwu runobatsira kutungamira sarudzo dzekurapa. Pane matanho mana makuru:

• Danho rekutanga: Kenza yegomarara regomarara iri pakutanga inongowanikwa mugomarara kana muperineum (nzvimbo iri pakati peanus nemukadzi). Yakakamurwa kuita IA kana IB, zvichienderana nehukuru hwegomarara uye kuti rakapararira kusvika papi kumatishu ari pedyo.
• Danho rechipiri: Bundu (remhando ipi zvayo) rapararira kusvika pasi peurethra, pasi pechikadzi, kana kuburitswa kwetsvina.
• Danho rechitatu: Gomarara rapararira kune rimwe kana kupfuura ma lymph nodes ari pedyo. Izvi zvakakamurwa kuita IIIA, IIIB, uye IIIC, zvichienderana nehuwandu nehukuru hwema lymph nodes aripo.
• Danho rechina: Gomarara rapararira kusvika kumusoro kweurethra, chibereko, kana zvimwe zvikamu zvemuviri. Izvi zvakakamurwa kuita IVA neIVB, zvichienderana nekuti kupararira kwacho kuri pedyo here kana kuti kure nechibereko.

Zvakakosha kubvunza chiremba wako kuti danho regomarara rako richakanganisa sei kurapwa kwako.

Ko chirwere cheVulvar Cancer chinorapwa sei?

Kurapwa kwauchaitwa kunoenderana nezvinhu zvakaita sehutano hwako, danho regomarara, uye kana gomarara racho rakawanikwa richangobva kuongororwa kana kuti radzoka. Chiremba wako achakutsanangurira nzira yakanakisisa yekurapa chirwere chako.

Kuvhiya

Kurapa gomarara remuchibereko kunonyanya kushandiswa pakuvhiyiwa.Chinangwa ndechekubvisa kenza zvachose uku uchichengetedza kushanda kwepabonde. Kune mhando dzakasiyana dzekuvhiyiwa:

• Kuvhiyiwa neLaser: Izvi zvinosanganisira kushandisa laser beam kuita kucheka kwenyama pasina ropa kana kubvisa maronda ekenza ari pamusoro.
• Kubviswa kwemasero emudumbu: Kuvhiyiwa uku kunobvisa kenza pamwe chete nenyama diki kana kuti yakawanda yakaipoteredza. Dzimwe nguva, ma lymph nodes ari pedyo anobviswa kuti vaongorore masero ekenza, kana kuti kana paine humbowo hwekenza, ma lymph nodes iwayo anobviswa.
• Kubviswa kweganda: Kuvhiyiwa uku kunobvisa chikamu cheganda rako kana kuti dumbu rako rese, pamwe pamwe chete nema lymph nodes ari pedyo. Kuiswa kweganda kunogona kushandiswawo kutsiva ganda rakabviswa.
• Kubuda kwePelvic Exenteration: Kuvhiyiwa uku kunobvisa ura hwezasi, rectum, dundira, cervix, vagina, ovaries, uye lymph nodes dziri pedyo. Chiremba anoita mavanga kuti weti netsvina zvibude mubhegi rinozvitora kubva mumuviri wako.

Kurapa Nemwaranzi

Kurapa nemwaranzi kunoshandisa maX-ray kana mamwe marara ane simba guru kuparadza masero ekenza. Kurapa kwakajairika kwekenza yechikadzi ndeye external beam radiation therapy (EBRT). EBRT inoshandisa muchina kutungamira mwaranzi kuburikidza neganda rako kuenda kunzvimbo yekenza yakanangwa.

Kazhinji, varwere vanopihwa kurapwa nemwaranzi pamwe chete nechemotherapy (izvi zvinonzi chemoradiation). Unogona kupihwa kurapwa nemwaranzi usati wavhiyiwa kuti uderedze bundu, kana mushure mekuvhiyiwa kuti uuraye chero masero ekenza asara.

Kurapwa nemakemikari

Chemotherapy inoshandisa mishonga kurwisa masero egomarara mumuviri wese. Chiremba wako anogona kukupa mushonga uyu sejekiseni mutsinga kana tsandanyama, kana kuti ungapihwa piritsi rekutora. Unogonawo kupihwa kirimu yaunogona kuzora zvakananga kunhengo yako yesikarudzi. Rudzi urwu rwekemotherapy runorwisa kenza munzvimbo yako chete - zvichireva kuti munzvimbo yacho chete.

Cisplatin (Cisplatin - Platinol®, Platinol-AQ®) uye fluorouracil (Fluorouracil - Carac®) ndiyo mishonga inonyanya kunyorerwa yekurapa kenza yemudumbu.

Kurapa nekudzivirira muviri

Kurapa nekudzivirira muviri kunoshanda nekubatsira masoja emuviri wako kuziva masero egomarara uye kurwisa masero aya zvinobudirira. Imiquimod Cream (Aldara®, Zyclara®) mushonga unoshandiswa kurapa kenza yeganda.

Ndinofanira kutarisira rudzii rwekutevera mushure mekurapwa kwegomarara remudumbu?

Mushure mekurapwa, chiremba wako anogona kuita bvunzo panguva dzakasiyana-siyana kuti aongorore mamiriro ako uye ave nechokwadi chekuti kenza haina kudzoka.

Miedzo iyi inowanzo sanganisira bvunzo dzakafanana dzinoshandiswa kuongorora kenza yechikadzi uye kuyera kenza yechikadzi.

Kenza yechikadzi yakakomba here?

Ehe, zvinogona. Kenza yemudumbu isina kurapwa inoisa upenyu panjodzi. Kurapa kenza yakapararira kuma lymph nodes kana kune dzimwe nhengo dzemuviri kwakaoma kupfuura kurapa kenza inoonekwa nekukurumidza.

Kunyangwe paine njodzi yekuti kenza ichadzoka mushure mekurapwa, vanhu vazhinji vanorapwa pakutanga kwechirwere vanorarama vasina kenza.

Ko kenza yechikadzi inorarama sei?

Huwandu hwevanhu vane kenza yechikadzi hunosvika 70%. Zvisinei, huwandu hwevanhu vanorarama hunowedzera kana chirwere ichi chikaonekwa uye chikarapwa pakutanga. Semuenzaniso, huwandu hwevanhu vanorarama kenza yechikadzi hunosvika 86%. Kana kenza yapararira, huwandu uhwu hunoderera kusvika pa30%.

Zvisinei, fungidziro yako yechirwere inoenderana nezvinhu zvakasiyana-siyana zvine chekuita nekuongororwa kwako, zvakaita sehutano hwako uye maitiro ako ekurapwa. Bvunza chiremba wako nezvemhedzisiro inogona kuitika zvichienderana nekuongororwa kwako.

Kenza yemudumbu inopararira nekukurumidza sei?

Mhando zhinji dzegomarara remudumbu dzinokura zvishoma nezvishoma, kwemakore mazhinji. Mhando dzisinganyanyi kuwanikwa, dzakadai se melanoma, dzinowanzokura nekupararira nekukurumidza.

Ko gomarara remudumbu rinogona kudzivirirwa here?

Nzira yakanakisisa yekuderedza njodzi yako ndeyekuwana mushonga weHPV kudzivirira hutachiona hweHPV. MuUnited States, vanhu vakuru vane makore ari pasi pe45 vanogona kuwana mushonga weGardasil 9®, zvichienderana nenjodzi yavo yekubatwa neHPV. Cervarix® neGardasil® imishonga yeHPV inowanikwa mune dzimwe nyika.

Kana uine zviratidzo zvegomarara remudumbu, enda kuna chiremba nekukasika. Ronga kuongororwa nguva nenguva, kusanganisira kuongororwa muviri kamwe chete pagore, kuti uone hutano hwako hwegomarara.

Ndinozvitarisira sei?

Vanhu vazhinji vanogona kunyara kana kunyara nezvekuchinja kuri kuitika munhengo dzavo dzepabonde. Asi kuva nekenza yemunhengo dzepabonde hazvirevi kuti unofanira kurega kushamwaridzana nevanhu. Usanyara kubvunza chiremba wako kuti kuongororwa kwako kungakanganisa sei hupenyu hwako hwepabonde. Iye anogona kukubatanidza nezvinhu zvinogona kutsigira zvaunoda mumuviri nemupfungwa paunenge uchibata nekuongorora uku nekurapwa.

Kenza yemudumbu inowanzo tangira papi?

Kenza yekubereka inowanzo tanga pamusoro peganda rakatenderedza nhengo yako yemukadzi, kungave kunze kwenhengo yemukadzi kana mukati menhengo yemukadzi. Kashoma, inogonawo kuitika mune dzimwe nzvimbo dzenhengo yemukadzi, dzakadai seBartholin's gland neclitoris.

Danho rekutanga regomarara remudumbu nderei?

Danho rekutanga rekenza yemudumbu. Panguva ino, kenza haina kupararira kupfuura vulva kana perineum. Danho IA Kenza yemudumbu ine masendimita maviri (saizi yenzungu) kana kuti diki. Haina kupararira kune nyama dziri pedyo neanopfuura mirimita imwe (saizi yepenzura). Danho IB Kenza dzakakura uye dzinogona kunge dzakapararira zvakadzika munyama dziri pedyo.

Chekupedzisira, chinhu chakakosha kukuudza! (Meseji yekuenda nayo kumba)

Une basa guru muhutano hwako. Ziva nhengo dzese dzemuviri wako, kusanganisira nhengo yako yemukadzi. Kuziva kuti uri kutaridzika sei pari zvino kuchakubatsira kuona shanduko gare gare. Kana ukaona shanduko, ronga nguva yekuona chiremba nekukasika. Panguva ino, usamborega kuenda kuna chiremba wevakadzi. Vanogona kuona shanduko dzisati dzaitika kenza dzisati dzanyanya kuipa.

Yeuka, usatya. Kuziva ndicho chinhu chikuru. Hausi wega.

` Vaginitis, kenza yevakadzi, HPV, zviratidzo zve vulvar, kurapwa kwekenza, hutano hwechikadzi, kudzivirira kenza