Ngaba kufuneka sikhathazeke nge-Epithelial Ovarian Cancer?

Ngaba wakha weva nge-Epithelial Ovarian Cancer? Eli gama lisenokuvakala liyinkimbinkimbi, kodwa luhlobo lomhlaza we-ovarian oluqhelekileyo phakathi kwabasetyhini. Masithethe ngalo ngokulula, ngendlela onokuyiqonda. Kuba kubaluleke kakhulu ukuqaphela izinto ezinje.

Yintoni i-Epithelial Ovarian Cancer?

Ngamafutshane, umhlaza we-epithelial ovarian lolona hlobo luqhelekileyo lomhlaza we-ovarian. Lo mhlaza ukhula kwisigqubuthelo esincinci sangaphandle se-ovary, esibizwa ngokuba yi-epithelial tissue. Cinga ngawo njenge-membrane encinci ejikeleze i-ovary.

Akunjalo nje kuphela, kodwa ngamanye amaxesha lo mhlaza ungakhula nakwimibhobho ye-fallopian okanye nakwi-peritoneum, izicubu ezigubungela amalungu esiswini. Oogqirha bakwabandakanya umhlaza we-fallopian tube kunye nomhlaza we-primary peritoneal kudidi olufanayo nomhlaza we-epithelial ovarian kuba iimpawu kunye nonyango lwezi meko ziyafana kakhulu.

Ixhaphake kangakanani le mhlaza?

Umhlaza wesibeleko sesibini ngumhlaza wesibini oxhaphakileyo wabasetyhini, emva komhlaza wesibeleko/we-endometrial. Umfazi oqhelekileyo unethuba eli-1 kwi-78 lokufumana umhlaza wesibeleko ebomini bakhe.

Ngowama-2021 kuphela, abantu abangaphezu kwama-21,400 bafunyaniswa benomhlaza wesibeleko. Abantu abalithoba kwabalishumi baxelwa ukuba banomhlaza wesibeleko se-epithelial. Lo mhlaza uxhaphake kakhulu kubasetyhini abangaphezu kweminyaka engama-65 ubudala.

Ziziphi iintlobo zomhlaza we-ovarian we-epithelial?

Malunga nesithathu kwisine somhlaza we-epithelial ovarian yi-serous ovarian carcinomas yezinga eliphezulu (i-HGSOC). "Izinga eliphezulu" lithetha ukuba ezi seli zomhlaza zikhula kwaye zisasazeka ngokukhawuleza kunezo "zingasezantsi".

Iingcali zonyango zikholelwa ukuba olu hlobo lwe-HGSOC lukhula kancinci ekuqaleni, kodwa lungathatha ukuya kuthi ga kwiminyaka emithandathu enesiqingatha ukuba lusasazeke ukusuka kwimibhobho ye-fallopian ukuya kwi-ovari. Kodwa xa lufika kwi-ovari, lusasazeka ngokukhawuleza. Ludla ngokuchaphazela ulwelo lwesisu (peritoneum) kunye nezinye iindawo zomzimba. Malunga nama-70% ezigulana ze-HGSOC zifunyaniswa zinesifo kwinqanaba lesi-3 okanye lesi-4. Oku kuthetha ukuba umhlaza usasazeke ngaphaya kwethumba lokuqala kwaye ngoku ngumhlaza osasazekayo.

Kukho ezinye iintlobo ezingaqhelekanga zomhlaza we-ovarian we-epithelial:

• Umhlaza we-endometrioid:Olu hlobo luxhaphake kakhulu kubantu abane-endometriosis, echaphazela ulwelo lwesibeleko (i-endometrium). Lusabela ngcono kwi-chemotherapy kunezinye iintlobo.
• I-Low-grade serous ovarian carcinoma (LGSOC): Le yi-cancer ekhula kancinci. Iyenzeka kubasetyhini abancinci (abaphakathi kweminyaka engama-45 ukuya kwengama-57 ubudala). Imalunga ne-10% yomhlaza we-epithelial ovarian. Esi sifo sidla ngokuba sibi kakhulu xa sixilongwa, kwaye asisabeli kakuhle kwi-chemotherapy. Nangona umhlaza we-low-grade ukhula kancinci, awunakwenzeka ukuba ube ngumhlaza we-high-grade.
• I-Mucinous carcinoma: Ezi thumba zahlukile kwezinye iintlobo kwaye zisabela kakuhle kunyango. Zihlala zinkulu (malunga nee-intshi ezi-8 okanye iisentimitha ezingama-20). Zidla ngokuchaphazela kuphela ii-ovari.
• I-Ovarian clear cell carcinoma (OCCC): Abafazi baseAsia kunye nabo bane-endometriosis basengozini enkulu yokufumana lo mhlaza. Esi sifo sidla ngokuba sibi kakhulu xa sifunyenwe. Asisabeli kakuhle kwi-chemotherapy.
• I-Primary squamous cell carcinoma (SCC) ye-ovary: Olu hlobo lwe-SCC ludla ngokuvela kwiimeko ezingezizo zomhlaza/ezingenazo umhlaza. Umzekelo, lunokuvela kwi-ovarian cysts, i-endometriosis, okanye ii-Brenner tumors (ukukhula okuqinileyo, okungaqhelekanga kwi-ovari). Ukuba ifunyenwe kwangethuba, isabela kakuhle kunyango.

Yintoni ebangela umhlaza we-ovarian epithelial?

Enyanisweni, imbangela echanekileyo yomhlaza, kuquka nomhlaza wesibeleko se-epithelial, ayikaziwa. Nangona kunjalo, uphando olutsha lubonisa ukuba uninzi lomhlaza wesibeleko luqala kwiiseli ezisekupheleni kweetyhubhu ze-fallopian. Emva koko lusasazeka luye kwii-ovari.

Ziziphi izinto ezibangela umhlaza?

Ngaphezulu kwesiqingatha sabo bafunyaniswe benomhlaza wesibeleko baneminyaka engaphezu kwama-65 ubudala kwaye sele bedlule kwixesha lokuya exesheni, nto leyo ethetha ukuba umjikelo wabo wokuya exesheni uyekile.

Ezinye izinto ezinokunyusa umngcipheko wokuba nomhlaza wesibeleko. Nazi:

• Ukuba kukho umntu kusapho lwakho okhe waba nomhlaza wesibeleko, umhlaza webele, okanye umhlaza we-colorectal/colon.
• Ukuba uzuze utshintsho (uguquko) kwi-gene ye-BRCA.
• Ukuba uzuze ilifa le-gene enxulumene ne-familial cancer syndromes, njenge-Lynch syndrome.
• Ukuba usebenzisa unyango lwehomoni ukulawula iimpawu zokuya exesheni.
• Ukuba nomntwana emva kweminyaka engama-35 okanye ukungamzali umntwana ixesha elipheleleyo.
• Ukutyeba kakhulu .

Ziziphi iimpawu zomhlaza we-ovarian we-epithelial?

Le yingxaki kubantu abaninzi. Umhlaza wesibeleko se-epithelial udla ngokuba neempawu ezimbalwa kakhulu kwizigaba zokuqala. Iimpawu zibonakala kuphela emva kokuba isifo sisasazeke kancinci. Xa sisasazeka kwi-membrane egubungela amalungu esisu (i-peritoneum), ulwelo olunamanzi lunokuqokelelana esiswini. Oku kubizwa ngokuba yi-ascites.

Ukongeza, ezi mpawu zilandelayo zinokwenzeka:

• Intlungu zesisu.
• Ubunzima bokutya okanye ukuziva uzele emva kokutya kancinci.
• Isicaphucaphu nokuhlanza.
• Ukudumba.
• Intlungu yesinqe.

Kukwakho neempawu ezingabonakaliyo rhoqo:

• Ukunyanzelisa ukuba umntu angachami okanye achame rhoqo (isinyi esisebenza kakhulu).
• Ukopha okungaqhelekanga kwilungu lobufazi.

Kubalulekile: Ukuba nezi mpawu akuthethi ukuba unomhlaza. Nangona kunjalo, ukuba ziyaqhubeka, kungcono ukubona ugqirha ukuze akunike ingcebiso.

Ufunyaniswa njani umhlaza we-ovarian we-epithelial?

Ngelishwa, akukho vavanyo luthile lokuhlola olunokufumanisa umhlaza wesibeleko kwisigaba sawo sokuqala. Uvavanyo ludla ngokwenziwa kuphela xa uneempawu okanye usemngciphekweni omkhulu. Ugqirha wakho angaqala ngokukwenza uvavanyo lwe-pelvic ukujonga naziphi na iziqwenga okanye ukudumba okungaqhelekanga.

Emva koko, ungenza uvavanyo lwegazi ukujonga inqanaba leproteni ebizwa ngokuba yi-'CA-125'. Le 'CA-125' imele i-antigen yomhlaza 125. Ukuba inqanaba liphezulu, kuya kufuneka wenze uvavanyo olongezelelekileyo.

Uvavanyo lwemifanekiso olufana nolu lunokunceda ekuxilongeni umhlaza wesibeleko:

• Uvavanyo lwe-ultrasound oluvela kwisini.
• Uvavanyo lwe-CT scan.
• Uvavanyo lwe-MRI (MRI).
• Iskeni se-Positron emission tomography (PET).
• Ii-X-reyi zesifuba (ukubona ukuba umhlaza usasazeke na emiphungeni).

Ngamanye amaxesha inkqubo ebizwa ngokuba yi-laparoscopy inokwenziwa. Oku kufana notyando, kodwa kwenziwa ngaphandle kokwenza umsikelo omkhulu. Oku kuvumela ugqirha ukuba ajonge amalungu akho okuzala. Basenokuthatha isampuli yezicubu (i-biopsy) kwiqhuma ukuze babone ukuba kukho iiseli zomhlaza apho. Le biopsy yeyona ndlela yokwazi ngokuqinisekileyo ukuba unomhlaza wesibeleko.

Zithini izigaba zomhlaza we-ovarian we-epithelial?

Ukwazi inqanaba lomhlaza kunceda oogqirha baqonde inkqubela phambili yomhlaza. Kubalulekile nasekuqinisekiseni ukuba umhlaza usasazekile na nasekuthatheni izigqibo zonyango. Inqanaba lomhlaza limiselwa ngovavanyo olufanayo olusetyenziswa ukufumanisa umhlaza.

Kukho izigaba ezine eziphambili zomhlaza wesibeleko. Amanye amanqanaba anezigaba ezincinci. Okukhona inani lesigaba liphezulu, kokukhona umhlaza uqhubeka phambili.

• Inqanaba loku-1: Umhlaza ukwisibeleko esinye okanye umbhobho omnye we-fallopian.
• Inqanaba lesi-2: Umhlaza usasazeke uye kwisibeleko okanye kulwelo lwesisu (i-peritoneal cavity).
• Inqanaba lesi-3: Umhlaza usasazeke nakwamanye amalungu angaphandle kwe-pelvis, ukuya kwi-lymph nodes, okanye zombini.
• Inqanaba lesi-4: Iiseli zomhlaza zikhona kulwelo olujikeleze imiphunga, ii-lymph nodes kwindawo ye-groin, kwezinye izitho zomzimba, okanye kwezinye iindawo zomzimba.

Ngaba umhlaza we-epithelial ovarian unganyangeka?

Oogqirha benza utyando lokususa umhlaza omninzi kangangoko kunokwenzeka. Oku kulandelwa yi-chemotherapy. Nangona uninzi lwabantu luyaphola ekuqaleni, esi sifo sinokubuya kubantu abaninzi kamva.

Izigulana ezikwinqanaba lokuqala zinokugqiba ekubeni zisuse kuphela i-ovary kunye ne-fallopian tube enesifo.

Kubantu abanomhlaza osele uphucukile, utyando lokususa i-bulking ludla ngokwenziwa ukuze kususwe amalungu omzimba anje:

• Ukususwa kweetyhubhu ze-fallopian kunye nama-ovari omabini (i-bilateral salpingo-oophorectomy).
• Ukususwa kwesibeleko (i-hysterectomy).
• Ukususwa kwezicubu ezinamafutha (i-omentum) ezigubungela isisu (i-omentectomy).
• Ukususwa kwee-lymph nodes ezikufutshane.
• Ukususwa kwezinye iindawo ezinezifo (ezifana namathumbu amancinci, amathumbu amakhulu, okanye ipleen).

Ziziphi ezinye iindlela zonyango?

Ngokuxhomekeke kuhlobo lomhlaza, unganikwa olunye okanye ngaphezulu kwezi ndlela zonyango emva kotyando:

• Unyango lweKhemotheraphi: Ukubulala iiseli zomhlaza. Oku kusebenzisa amayeza anjengeekhompawundi zeplatinum (carboplatin) kunye nepaclitaxel (Taxol®) okanye idocetaxel (Taxotere®).
• I-intraperitoneal chemotherapy: Ukunyanga umhlaza wesibeleko wesigaba sesi-3, amayeza e-cisplatin kunye ne-paclitaxel afakwa ngqo kwisisu nge-catheter efakwe ngotyando (ityhubhu encinci, engenanto).
• Unyango olujoliswe kulo: Amayeza afana neBevacizumab (Avastin®) ayathintela ukukhula nokwanda kweeseli zomhlaza.
• Unyango lwemitha: Isebenzisa imisebe ye-X-ray enamandla aphezulu ukutshabalalisa iiseli zomhlaza.

Ngaba umhlaza we-epithelial ovarian ungathintelwa?

Uphando lubonisa ukuba abafazi abathatha iipilisi zokulawula ukuzalwa ngeehomoni iminyaka emihlanu nangaphezulu banokunciphisa umngcipheko wabo wokuba nomhlaza wesibeleko ngesiqingatha.

Ezinye iindlela zotyando zinokunciphisa umngcipheko womhlaza. Utyando lokuthintela umhlaza lubizwa ngokuba lutyando lokuthintela. Oku kubandakanya ukususwa kweetyhubhu ze-fallopian kunye nama-ovari, nokuba une-uterus okanye awunayo. Oku kudla ngokuqwalaselwa kubafazi abasengozini enkulu ngenxa yembali yosapho (njengabo bane-BRCA mutation okanye i-Lynch syndrome). Nangona kunjalo, oogqirha bacebisa ukuba ezi nkqubo zenziwe kuphela ukuba kuyimfuneko kwezonyango. Oku kungenxa yokuba ukususwa kwee-ovari kunokubangela ukuyeka ukuya exesheni kwangethuba, okunokuba nefuthe elibi emzimbeni.

Olu tyando aluyisusi ngokupheleleyo ingozi yomhlaza. Abanye abantu banokuba nomhlaza ongafumanekiyo ngexesha lotyando. Abantu abane-BRCA gene mutations basenokufumana umhlaza we-peritoneal nokuba iityhubhu zabo ze-fallopian kunye nama-ovari zisusiwe. Buza ugqirha wakho malunga novavanyo lwe-BRCA ukuze ufumane ukuba unayo na i-BRCA gene.

Iyintoni imbono yabantu abanomhlaza we-ovarian we-epithelial?

Abantu abangaphezu kwe-13,000 bayafa ngenxa yomhlaza wesibeleko minyaka le. Lo ngunobangela wesihlanu ophambili wokufa komhlaza phakathi kwabasetyhini. Nangona kunjalo, kukho ithemba lonyango olutsha olukwizilingo zeklinikhi okwangoku. Abaphandi bakwasebenza ukufumanisa esi sifo kwasekuqaleni.

Ukuba umhlaza wesibeleko se-epithelial ufunyenwe ngaphambi kokuba usasazeke, izinga lokusinda leminyaka emihlanu lingaphezulu kwama-90%. Nangona kunjalo, xa umhlaza usasazeke (usususwe ngokupheleleyo), eli zinga liyehla liye kuma-30%.

Zininzi izinto ezichaphazela ukubikezela komhlaza:

• Ubungakanani bokusasazeka komhlaza.
• Impumelelo yonyango.
• Indawo, ubungakanani, kunye nenani leethumba ezinomhlaza (inqanaba lomhlaza).

Ufanele uye nini kugqirha?

Ukuba unayo nayiphi na kwezi mpawu, bona ugqirha ngokukhawuleza:

• Utshintsho kwinani okanye ukungxamiseka kokuchama.
• Ukuphelelwa ngumdla wokutya okanye ukuziva ugcwele emva kokutya kancinci.
• Intlungu engapheliyo esiswini okanye kwindawo ye-pelvic ngaphandle kwesizathu.

Yeyiphi imibuzo omele uyibuze ugqirha wakho?

Ungabuza ugqirha imibuzo efana nale:

• Ngaba kufuneka ndifumane uvavanyo lwe-BRCA?
• Luhlobo luni lomhlaza we-ovarian epithelial endinalo?
• Yeyiphi indlela engcono yonyango kum?
• Zithini iziphumo ebezingalindelekanga zonyango?
• Ngaba ndisengozini yokuba nomhlaza osasazekayo? Ndingayinciphisa njani loo ngozi?
• Ngaba kufuneka ndixhalabele iingxaki?

Yeyiphi indlela eyingozi kakhulu yomhlaza wesibeleko?

Umhlaza we-ovarian osezingeni eliphezulu (i-HGSOC) luhlobo lomhlaza we-ovarian oluhlasela kakhulu. Nangona lo mhlaza uqala ukukhula kancinci kwi-fallopian tubes, usasazeka ngokukhawuleza xa ufika kwi-ovaries. Ngelishwa, abantu abaninzi abane-HGSOC banomhlaza we-ovarian oqhubele phambili/okhula ngokukhawuleza xa befunyaniswa ukuba banawo.

Ngaba kunokwenzeka ukuba ube nee-cysts ze-ovarian ezingezizo zomhlaza (ezingenabungozi) ze-epithelial ovarian?

Ewe. Enyanisweni, uninzi lwee-ovarian tumors ze-epithelial azingomhlaza. Ezinye ii-tumors zibizwa ngokuba zii-borderline tumors okanye ii-atypical proliferating tumors. Ezi ngaphambili zazibizwa ngokuba zii-low malignant potential tumors.

Kwizimila ezinqamlezileyo, iiseli ezingaqhelekanga zikhula zibe yizicubu ze-epithelial kodwa azingeni kwizicubu ezixhasayo ze-ovary (stroma). Ezi seli zihlala zifumaneka kwi-ovary ngokwayo kwaye azifane zibe ngumhlaza. Ukuba umhlaza uyavela, ezintathu kwezine zikwinqanaba loku-1 (zivaleleke kwi-ovary kwaye kulula ukuzinyanga). Ezi zimila zihlala zichaphazela abantu abancinci.

Umyalezo Wokuya Ekhaya

Umhlaza we-ovarian we-epithelial lolona hlobo luqhelekileyo lomhlaza we-ovarian. Ukwaquka umhlaza we-fallopian tube kunye nomhlaza we-primary peritoneal. Umhlaza we-ovarian uhlala uneempawu ezimbalwa kakhulu kwizigaba zawo zokuqala. Esi sifo sidla ngokuba siphambili kakhulu ukuba singabonwa ngexesha esifunyaniswa ngalo. Oku kuyinyani ngakumbi kuhlobo oluqhelekileyo lomhlaza we-epithelial, olubizwa ngokuba yi-'HGSOC'.

Ukuba usemngciphekweni omkhulu wokuba nomhlaza wesibeleko (njengembali yosapho), kubalulekile ukubuza ugqirha wakho malunga nokuba amanyathelo okuthintela afanelekile na kuwe. Soloko unyamekela umzimba wakho. Musa ukungazinaki naziphi na iimpawu ezingaqhelekanga. Funa ingcebiso kagqirha.

Umhlaza wesibeleko, umhlaza we-epithelial, impilo yabasetyhini, iimpawu zomhlaza, unyango lomhlaza, i-BRCA gene, i-gynecology