Ngaba kutshanje uqaphele ukuba amehlo akho nolusu lwakho lujika lube tyheli kancinci? Okanye, ngaba ngequbuliso ulahlekelwe bubunzima ngaphandle kwesizathu esicacileyo? Nangona ezi zizinto eziqhelekileyo ngamanye amaxesha esicinga ukuba azinaki kakhulu, ezi zinokuba ziimpawu zokuqala zesifo esingaqhelekanga kodwa esibi esibizwa ngokuba yi-Ampullary Cancer. Musa ukoyika xa usiva eli gama. Eyona nto ibalulekileyo kukwazi ngokupheleleyo malunga naso nasiphi na isifo. Ngoko ke, namhlanje siza kuthetha ngokuba yintoni i-Ampullary Cancer, indlela ekhula ngayo, zithini iimpawu, kunye neendlela zonyango ngendlela elula onokuyiqonda.
Yintoni umhlaza we-Ampullary?
Ukuze sikuqonde oku, kufuneka siqale sazi ngenxalenye encinci yomzimba wethu. Sinezitho ezimbini emzimbeni wethu ezibizwa ngokuba yipancreas kunye nesibindi. Zombini ezi zikhupha iijusi ezikhethekileyo ezisinceda ekugayeni ukutya kwethu. Khawuthelekelele ezi jusi zimbini zidibana zize zifike kwindawo enye, njengendawo apho iindlela ezimbini zidibana khona. Emva koko, zonke ezi jusi ziyadibana zize zingene emathunjini ethu amancinci (duodenum).
Kwizonyango, sibiza umngxuma omncinci apho loo jusi iqokelela khona i-ampulla yeVater .
Ngoko ke, xa iiseli zomhlaza ziqala ukukhula kule ndawo ibizwa ngokuba yi-ampulla yeVater , siyibiza ngokuba yi-ampullary carcinoma . Olu luhlobo lomhlaza olunobundlongondlongo kakhulu. Kwakhona, kuba indawo apho lukhula khona ikufutshane kakhulu nezitho ezibalulekileyo ezifana nesibindi kunye nepancreas, umhlaza unethuba elikhulu lokusasazeka nakwezo zitho. Ke ngoko, eyona ndlela ilungileyo yokufumana iziphumo ezilungileyo kukususa lo mhlaza ngotyando ngaphambi kokuba usasazeke.
Ixhaphake kangakanani le sifo?
Lo ngumhlaza ongaqhelekanga kakhulu. Ngaphantsi kwe-1% yazo zonke iintlobo zomhlaza kwinkqubo yethu yokugaya ukutya (indlela yokugaya ukutya) zixelwa njengomhlaza we-ampullary. Ke ngoko, esi ayisosifo sichaphazela wonke umntu.
Zithini iimpawu? Siyibona njani le nto?
Eyona nto ingaqhelekanga ngalo mhlaza kukuba ubonisa iimpawu kwizigaba zokuqala. Phakathi kwazo, uphawu oluphambili noluqhelekileyo yi -jaundice . Oku kuthetha ukuba amhlophe emehlweni naselusu ajika abe tyheli.
Kutheni oku kusenzeka? Umhlaza uvala umbhobho wenyongo, othwala inyongo esuka esibindini. Oku kubangela ukuba inyongo emthubi ekufanele ukuba iye emathunjini amancinci ibuyele egazini lethu. Yiyo loo nto amehlo nolusu lwethu luba tyheli.
Ukongeza kolu phawu luphambili, kukho nezinye iimpawu ezininzi ezinokubonwa. Masizijonge ngendlela elula ukuyiqonda.
| Uphawu | Ingcaciso elula |
|---|---|
| I-Jaundice | Ukutyheli kwamehlo nolusu. Olu lolona phawu lokuqala luqhelekileyo. |
| Ukunciphisa umzimba ngaphandle kwesizathu | Ukuba ngequbuliso wehla ubunzima ngaphandle kokutshintsha indlela otya ngayo. |
| Umnqweno wokutya | Ukulahlekelwa yintliziyo. |
| Isicaphucaphu nokuhlanza | Ukucaphuka nokuhlanza okungapheliyo. |
| Intlungu yesisu nomqolo | Intlungu esiswini esingaphezulu okanye emqolo. |
| Ulusu olurhawuzelelayo | Ukurhawuzelela umzimba wonke ngenxa yenyongo eqokelelana egazini. |
| Ifiva | Ukunyuka kobushushu bomzimba ngaphandle kwesizathu esicacileyo. |
| Urhudo | Ukuqunjelwa. |
| Izihlalo ezinamafutha | Indle enamafutha, enamafutha, nenombala ofana nodongwe. |
| I-anemia | Uburhabaxa kunye nokudinwa kakhulu okubangelwa kukuncipha komthamo wegazi emzimbeni. |
Kutheni olu hlobo lomhlaza luvela?
Enyanisweni, iingcali azikakwazi ukusho ngqo ukuba kutheni le mhlaza we-ampullary ukhula. Kodwa siyazi ukuba zonke ii-cancer zikhula xa kukho utshintsho (utshintsho) kwi-DNA olulawula ulwazi lwezakhi zofuzo kwiiseli zomzimba wethu. Ngale ndlela, iiseli ezingaqhelekanga ezinotshintsho lwe-DNA ziqala ukwahlukana ngokukhawuleza nangokungalawulekiyo. Ithumba lomhlaza lenziwa xa iiseli ezininzi zikhula kunye ngaphandle kolawulo.
Iingcali zisaphanda ngotshintsho lwe-DNA olunxulumene nalo mhlaza. Ngokusekelwe kolo lwazi, unyango olusebenzayo ngakumbi lunokufumaneka kwixesha elizayo.
Izinto Ezinobungozi
Kukho izinto ezininzi ezibangela umngcipheko wokufumana lo mhlaza:
- Ngaphezulu kweminyaka engama-70 ubudala: Umngcipheko uyanda xa ukhula.
- Ukuba yindoda: Lo mhlaza uxhaphake kakhulu kumadoda kunabafazi.
- Ezinye iimeko zemfuza: Ezinye iimeko zemfuza zinokunyusa umngcipheko womhlaza. Umzekelo, iimeko ezifana neFamilial Adenomatous Polyposis (FAP) kunye neLynch syndrome.
Ugqirha uluchonga njani ngokuchanekileyo olu sifo? (Ukuxilongwa)
Ngokwesiqhelo, xa umntu eya kugqirha onamehlo atyheli kunye nolusu (i-jaundice), kuvela amathandabuzo kwaye kuqala uvavanyo. Kwenziwa uvavanyo oluninzi ukuqinisekisa isifo.
- Uvavanyo lwegazi nomchamo: Olu vavanyo lujonga amanqanaba eekhemikhali emzimbeni ezinxulumene neeseli zomhlaza, ezibizwa ngokuba zii-tumor markers.
- Uvavanyo Lomfanekiso: Olu vavanyo lusetyenziselwa ukuthatha imifanekiso yamalungu angaphakathi emzimbeni ukujonga umhlaza. Uvavanyo olufana ne-'CT scan', 'Ultrasound scan' kunye ne-'MRCP' lusetyenziselwa oku.
- Uvavanyo lwe-Endoscopic: Oku kuquka ukufaka ityhubhu ende, ebhityileyo (i-endoscope) enekhamera enamathele emlonyeni wakho ukuze ujonge umhlaza. I-Upper endoscopy kunye ne-ERCP (Endoscopic Retrograde Cholangiopancreatography) zezinye zezo vavanyo. Uza kunikwa i-anesthesia ngexesha lovavanyo, ngoko awuyi kuva ntlungu.
- Uvavanyo lwebhayoloji:Olu lolona vavanyo lunokuqinisekisa ngokupheleleyo ukuba ngumhlaza. Ngexesha le-endoscopy, kuthathwa iqhekeza elincinci kakhulu lesicwili kwindawo ekrokrisayo lize livavanywe kwilebhu ukuqinisekisa ukuba kukho iiseli zomhlaza.
Ithini inqanaba lomhlaza?
Xa isifo sifunyenwe, ugqirha uya kufumanisa ukuba umhlaza usasazeke kangakanani. Oku kubizwa ngokuba yi-staging. Unyango lumiselwa ngokweli nqanaba. Umhlaza ofunyenwe usekwinqanaba lokuqala unokuba luncedo ngakumbi ekunyangweni.
| Iqonga | Intsingiselo |
|---|---|
| Ityala 1 (1) | Umhlaza uphelela kwi-ampulla yeVater kunye nemisipha ejikelezileyo. |
| Ityala lesiBini (2) | Umhlaza usasazeke kwi-pancreas okanye kumaleko angaphandle kwamathumbu amancinci. |
| Ityala lesi-3 (3) | Umhlaza usasazeke kwiindawo ze-lymph ezikufutshane. |
| Ityala IV (4) | Umhlaza usasazeke kwiindawo ezikude emzimbeni (ezifana nesibindi, imiphunga). (i-metastasis) |
Kubaluleke kakhulu ukuqonda ngokucacileyo inqanaba lomhlaza wakho kunye nendlela eliya kuyichaphazela ngayo unyango lwakho ngokubuza ugqirha wakho.
Zithini iindlela zonyango?
Kukho iindlela ezahlukeneyo zonyango lomhlaza we-ampullary.
- Inkqubo yeWhipple:Olu lolona tyando luqhelekileyo noluqhelekileyo kolu hlobo lomhlaza. Lutyando olunzima nolunzima. Kulo, akususulwa umhlaza ngokwawo kuphela, kodwa nakwiindawo ezingqongileyo apho iiseli zomhlaza zisenokuba zisasazeke khona (i-gallbladder, inxalenye ye-bile duct, inxalenye yamathumbu amancinci, kunye nentloko yepancreas).
- Utyando lwe-Endoscopic: Ukuba umhlaza usekwinqanaba lokuqala, ngamanye amaxesha kunokwenzeka ukususa umhlaza usebenzisa i-endoscope.
- Unyango lweKhemotherapy: Oku kuquka ukunika umzimba amayeza anamandla abulala iiseli zomhlaza. Olu nyango lunikezelwa ukubulala naziphi na iiseli zomhlaza eziseleyo emva kotyando okanye ukulawula ukukhula komhlaza xa utyando lungenakwenzeka.
- Unyango lweMisebe: Kulapho kusetyenziswa khona imisebe yamandla enamandla ukutshabalalisa iiseli zomhlaza. Ngamanye amaxesha olu nyango lunikwa kunye ne-chemotherapy ukunciphisa ithumba ngaphambi kotyando okanye ukutshabalalisa naziphi na iiseli eziseleyo emva kotyando.
- Unyango lokudambisa iintlungu: Olu lunyango olugxile ekunciphiseni iimpawu endaweni yokunyanga isifo. Umzekelo, i-stent ingafakwa kumbhobho wenyongo ovalekileyo ukuze ivuleke. Oku kunokunceda ukunciphisa iimpawu ezifana ne-jaundice kunye nokurhawuzelelwa, okunokubonelela ngoncedo olukhulu.
Ngaba lo mhlaza unganyangeka ngokupheleleyo?
Eyona ndlela yokunyanga ngokupheleleyo lo mhlaza kukususa ngokupheleleyo umhlaza ngotyando. Oku kunokwenzeka ukuba kuphumelele xa umhlaza ufunyenwe usekwinqanaba lokuqala.
Ngamanye amaxesha umhlaza uyanyamalala ngokupheleleyo emva kotyando. Nangona kunjalo, unokuphinda ubuye emva kwexesha elithile (umhlaza ophinda ubuye). Ke ngoko, nokuba emva kotyando, kubaluleke kakhulu ukuqhubeka nokuya kugqirha ukuze kwenziwe uvavanyo kunye neekliniki njengoko kucetyiswa. Umngcipheko wokuphinda ubuye umhlaza uphezulu kakhulu kwiminyaka emihlanu yokuqala.
Musa ukoyika ngala manani. La ngamanani nje. Isigulana ngasinye sahlukile. Izinto ezininzi, kuquka imeko yakho yempilo kunye nendlela osabela ngayo kunyango, ziyayichaphazela le nto. Umntu ofanelekileyo ukwazi kakuhle imeko yakho ngugqirha wakho. Thetha naye ngale nto ngokukhululekileyo uze umbuze.
Ngaba ikho indlela yokuthintela oku?
Ngelishwa, izinto ezibangela umhlaza (ubudala, i-genetics) azikho izinto esinokuzilawula. Ngoko ke, akukho ndlela ithile yokuwuthintela. Nangona kunjalo, ukuba unesifo se-genetic esifana ne-FAP okanye i-Lynch syndrome, ugqirha wakho unokucebisa ukuba uhlolwe rhoqo. Oku kunokunceda ekufumaneni umhlaza kwasekuqaleni.
Kuqhelekile ukuziva uxinezelekile kwaye wothukile xa ufunda ngomhlaza. Thetha ngokukhululekileyo nogqirha wakho kunye nosapho malunga nemibuzo yakho, uloyiko, kunye namathandabuzo. Ukufumana ulwazi olufanelekileyo, unyango olufanelekileyo, kunye nenkxaso yeemvakalelo kuya kuba namandla amakhulu kolu hambo.
Umyalezo Wokuya Ekhaya
- I-Ampullary carcinoma luhlobo lomhlaza olungaqhelekanga kodwa olukhula ngokukhawuleza oluvela kwinkqubo yokugaya ukutya.
- Uphawu oluqhelekileyo lokuqala yi-jaundice (ukutyheli kwamehlo nolusu). Ezinye iimpawu ziquka ukwehla kobunzima ngendlela engachazekiyo kunye nokuphelelwa ngumdla wokutya.
- Eyona ndlela ilungileyo yokunyanga esi sifo ngokupheleleyo kukususa umhlaza ngotyando kwangethuba. Olona tyando luqhelekileyo yinkqubo yeWhipple.
- Ukuba unazo ezi mpawu okanye unamathandabuzo ngesi sifo, qhagamshelana nogqirha wakho ngokukhawuleza ukuze akunike icebiso.
- Musa ukoyika izibalo, thetha ngokukhululekileyo nogqirha wakho malunga nemeko yakho yempilo kunye neendlela zonyango.
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