Ngaba unemibuzo malunga nomhlaza womqala? Masithethe!

Usenokuba ukhe weva nge-Esophageal Cancer. Le yimeko enzima kakhulu, kodwa kubaluleke kakhulu ukuba uyiqaphele . Kuba ngamanye amaxesha umhlaza usenokuba sele uqhubele phambili ngexesha iimpawu zibonakala. Kodwa ungakhathazeki, masithethe ngayo yonke into ngokulula.

Yintoni umhlaza womqala? Uvela njani?

Ngamafutshane, i-esophagus yityhubhu ende eyenziwe ngemisipha ethwala ukutya ukusuka emqaleni ukuya esiswini xa siginya. Ngoko ke, umhlaza uvela xa iiseli ezikule esophagus ziqala ukwahlukana ngendlela engaqhelekanga nangokungalawulekiyo. Iiseli ezibunjwa ngale ndlela ziyahlangana kwaye zenze ithumba.

Umhlaza wesisu ngumhlaza weshumi oxhaphakileyo emhlabeni. Unokuba yingozi kancinci, kuba njengoko benditshilo ngaphambili, lo mhlaza unokukhula okwethutyana ngaphandle kokubonisa zimpawu . Isizathu soku kukuba isisu sethu sinokolula kancinci, njengaxa siginya ukutya okuninzi. Ngoko ke ude umhlaza ube mkhulu kancinci, sisenokungaziva singonwabanga. Kodwa xa isisu sikhula size siqale ukuvala ukuvulwa kwesisu, kuba nzima ukuginya ukutya, kwaye kuba buhlungu xa siginya.

Kukho iintlobo ezimbini eziphambili zomhlaza womqala, akunjalo?

Ewe, kukho iintlobo ezimbini eziphambili:

1. I-Adenocarcinoma: Olu lolona hlobo luxhaphakileyo, ingakumbi kumazwe aseNtshona. Lukhula kwiiseli zamadlala kwi-esophagus ezivelisa i-mucus enceda ekuginyeni. Olu hlobo ludla ngokukhula kwinxalenye esezantsi ye-esophagus.

2. I-Squamous cell carcinoma: Olu hlobo luqala kwiiseli ze-squamous ezingaphakathi kwe-esophagus. Ihlala ikhula kwiindawo eziphezulu neziphakathi ze-esophagus.

Ngaba lo mhlaza unganyangeka ngokupheleleyo?

Oku kuxhomekeke ekubeni umhlaza ufunyanwa kwangethuba kangakanani. Ukuba ufunyenwe kwangethuba, oko kukuthi, xa umhlaza umncinci, unokususwa ngotyando kwaye ngamanye amaxesha unyangeke ngokupheleleyo. Kodwa, ngelishwa, yi-25% kuphela yabantu abanalo mhlaza abafunyaniswa ngaphambi kokuba umhlaza usasazeke. Yiyo loo nto sithi, ukuba uneempawu ezincinci, xhalaba ngazo.

Ngubani osengozini enkulu yokufumana lo mhlaza?

Ngokubanzi, izibalo zibonisa ukuba esi sifo sixhaphake kakhulu kumadoda angaphezulu kweminyaka engama-60 ubudala. Kwakhona, kukho umahluko phakathi kwezinye iintlanga. Umzekelo, i-squamous cell carcinoma ixhaphake kakhulu kubantu abamnyama nabaseAsia, ngelixa i-adenocarcinoma ixhaphake kakhulu kubantu abamhlophe. Nangona kunjalo, ezi zizinto nje ezibonwayo ngokubanzi, kwaye nabani na unokuba nale meko.

Zithini iimpawu zomhlaza womqala? Ungawubona njani?

Uphawu lokuqala abantu abaninzi abalubonayo kubunzima bokuginya (dysphagia) . Kungavakala ngathi kukho into ebambeke emqaleni. Ukongeza, kunokubakho iimpawu ezifana nezi:

• Intlungu emqaleni okanye ngasemva kwesifuba, oko kuthetha ukuba ngasemva kwesifuba okanye phakathi kweebhleyidi zamagxa.
• Ukuhlanza, mhlawumbi ukuhlanza igazi.
• Ukukhohlela igazi.
• Isitshiso sentliziyo esihlala sihleli.
• Ilizwi elitshothozayo, okanye ukukhohlela okungapheliyo.
• Ukunciphisa umzimba ngengozi .

Ukuba unenye okanye ngaphezulu kwezi mpawu, akuthethi ukuba unomhlaza womqala. Nangona kunjalo, ukuba ezi mpawu ziyaqhubeka, kungcono ukubona ugqirha ukuze akuhlole.

Lo mhlaza usasazeka ngokukhawuleza kangakanani?

Umhlaza womqala uhlala uluhlobo lomhlaza olunokukhula ngokukhawuleza . Njengoko benditshilo ngaphambili, kuba umqala wethu uguquguqukayo, njengoko umhlaza ukhula, udla ngokuwujikeleza. Yiyo loo nto iimpawu zihlala zibonakala emva kokuba umhlaza usasazeke kancinci.

Zithini izizathu eziphambili zomhlaza? Zithini izinto ezibangela umngcipheko?

Kunzima ukutsho ngokuqinisekileyo ukuba yintoni kanye kanye imbangela. Nangona kunjalo, oogqirha bachonge izinto ezininzi ezibangela umngcipheko wokuba nalo mhlaza. Makhe sijonge ukuba zeziphi:

• Ukusetyenziswa kwecuba: Oku kuquka ukutshaya icuba elingenamsi (umz. ukuhlafuna icuba eline-chewing gum, i-chewing gum ene-chewing gum). Ezi zingonakalisa iiseli zomqala kwaye zonyuse kakhulu umngcipheko womhlaza.
• Ukusetyenziswa kotywala: Ukusela utywala ixesha elide okanye ngokugqithisileyo nako kukwangumngcipheko omkhulu.
• Ukutyeba kakhulu: Ukutyeba kakhulu okanye ukutyeba kakhulu kunokubangela ukudumba emqaleni. Oku kutyeba ekugqibeleni kunokukhokelela kumhlaza.
• I-Barrett's esophagus kunye ne-chronic acid reflux: I-acid reflux yexesha elide, eyindlela yokubuyela kwe-asidi yesisu kwi-esophagus, inokubangela utshintsho kwiiseli ezikwinxalenye esezantsi ye-esophagus ukuba ayinyangwa ngokufanelekileyo. Le meko ibizwa ngokuba yi-Barrett's esophagus. Ayingomhlaza, kodwa yimeko enomngcipheko omkhulu wokuba ngumhlaza. Abantu abangenayo i-Barrett's esophagus kodwa abanesitshiso sentliziyo ixesha elide nabo basengozini enkulu yokuba nomhlaza we-esophagus.
• I-Human Papillomavirus (HPV): I-HPV yintsholongwane eqhelekileyo kakhulu. Inokubangela utshintsho kwizicubu zemisonto yelizwi, umlomo, izandla, iinyawo kunye namalungu esini. Ezinye iintlobo ze-HPV zandisa umngcipheko womhlaza womqala.
• Ukuba ukhe waba nomhlaza ngaphambili: Abantu abakhe baba nomhlaza wentloko okanye wentamo basengozini enkulu yokuba nomhlaza womqala.
• Ezinye iimeko zonyango:Lo mhlaza ukwanxulunyaniswa nezinye izifo ezingaqhelekanga nezizuzwa njengelifa. Umzekelo, i-achalasia , imeko engaqhelekanga eyenza kube nzima ukuyiginya , kunye ne-tylosis , imeko engaqhelekanga, ezuzwa njengelifa ebangela ukuqina kolusu ezintendeni nasezinyaweni zeenyawo.
• Ukuvezwa kwiikhemikhali ezithile: Abantu abachaphazeleka ziikhemikhali ezifana nezinyibilikisi zokucoca umzimba ixesha elide nabo basengozini enkulu yokuba nomhlaza.

Oogqirha bayixilonga njani le mhlaza? (Ukuxilongwa)

Ukuba uneempawu ezikhankanyiweyo apha ngasentla, ugqirha wakho uza kuqala akubuze ngeempawu zakho kunye nembali yakho yezonyango. Emva koko, banokwenza uvavanyo oluthile, olufana nolu:

• Uvavanyo lokugwinya iBarium: Oku kuquka ukukusela ulwelo olunento ebizwa ngokuba yiBarium kunye nokuthatha uthotho lweeX-ray. I-barium yenza i-esophagus ibonakale ngokucacileyo kwimifanekiso ye-X-ray. Oku kungasetyenziselwa ukubona ukuba kukho naziphi na iingxaki kwi-esophagus.
• I-CT scan (i-Computed Tomography scan): Olu vavanyo luvumela oogqirha ukuba babone ukuba umhlaza usasazeke na kwezinye iindawo zesifuba nesisu (isisu).
• I-Esophagogastroduodenoscopy (EGD): Kule nto, kufakwa ityhubhu encinci, eguquguqukayo ebizwa ngokuba yi-endoscope (exhotyiswe ngekhamera) ngomlomo ize ijongwe ngqo kwi-esophagus. Oku kunokubona ngokucacileyo naluphi na utshintsho okanye iithumba eludongeni lwe-esophagus.
• I-ultrasound ye-Esophageal endoscopic: Oku kungenziwa ngaxeshanye ne-EGD. Isebenzisa amaza esandi ukuthatha imifanekiso yangaphakathi kwe-esophagus. Oku kunokunceda ekuqinisekiseni ukuba umhlaza ukhule kangakanani waya eludongeni lwe-esophagus kwaye nokuba usasazeke na kwii-lymph nodes ezikufutshane.
• I-Biopsy: Ukuba ugqirha ubona indawo ekrokrisayo ngexesha le-EGD, uza kuthatha iqhekeza elincinci lesicwili aze alihlole phantsi kwemakroskopu. Le yindlela abanokuqinisekisa ngayo ukuba kukho iiseli zomhlaza okanye azikho.

Oogqirha basebenzisa ulwazi oluvela kwezi mvavanyo ukuze bafumanise inqanaba kunye nenqanaba lomhlaza. Inqanaba lomhlaza kukuba umhlaza usasazeke kangakanani (umz., ubungakanani bethumba, nokuba lisasazeke kwi-lymph nodes, okanye kwizitho ezikude). Inqanaba lethumba yindlela iiseli zomhlaza ezifana ngayo neeseli eziphilileyo kunye nendlela ezikhawuleza ngayo ukwahlukana. Unyango lucwangcisiwe ngokusekelwe kweli nqanaba kunye nenqanaba.

Zithini iindlela zonyango zoku?

Unyango lomhlaza womqala luxhomekeke kwinqanaba kunye nomgangatho womhlaza, njengoko kukhankanyiwe ngasentla, kunye nempilo iyonke yesigulana. Kukho iindlela ezininzi zonyango eziphambili:

• Utyando: Olona nyango luqhelekileyo lomhlaza womqala okwinqanaba lokuqala lomhlazaUtyando olubizwa ngokuba yi-esophagectomy. Oku kuquka ukususa inxalenye okanye yonke i-esophagus, kunye nezicwili ezijikelezileyo. Emva koko, inxalenye yesisu iyatsalwa ize idityaniswe nesifuba nentamo, nto leyo eyenza i-esophagus entsha.
• Unyango ngemitha: Oku kubandakanya ukujolisa kwimitha enamandla aphezulu (imitha yemitha) kwithumba ukuze kubulawe iiseli zomhlaza. Ikwasetyenziswa njengonyango oluncedisayo ngaphambi okanye emva kotyando.
• Unyango lweKhemotherapy: Oku kuquka ukunika amayeza abulala iiseli zomhlaza okanye athintele ukukhula kwazo. Oku kunokunikwa ngaphambi, emva kotyando, okanye kudityaniswe nonyango lwemitha.
• Ukuqhaqha i-Endoscopic Submucosal Dissection (ESD): Le nkqubo isetyenziselwa ukususa umhlaza okwinqanaba lokuqala kakhulu ohlala uphezulu eludongeni lomqala.
• Ukususwa kwe-Endoscopic Mucosal (EMR): Le yinkqubo efana ne-ESD, esetyenziselwa ukususa iithumba ezinomhlaza kulwelo lwe-mucous lwe-esophagus.
• Unyango lwe-laser lwe-Endoscopic: Xa ithumba elinomhlaza livala umphimbo kwaye lenze kube nzima ukuliginya, kusetyenziswa i-laser beam ukususa inxalenye yethumba ukunciphisa ukungonwabi.
• Unyango lwe-Photodynamic (PDT): Kule meko, amayeza akhethekileyo abizwa ngokuba zii-photosensitizers anikwa umzimba, aze emva koko kuqondiswe ukukhanya okukhethekileyo kwindawo yomhlaza. Xa oku kukhanya kubetha, iyeza liyasebenza kwaye libangele ukusabela kweekhemikhali okutshabalalisa iiseli zomhlaza.
• Unyango olujoliswe kuko: Ezinye iiseli zomhlaza womqala zineproteni engaqhelekanga ebizwa ngokuba yiproteni ye-HER2 . Le proteni inceda iiseli zomhlaza zikhule. Unyango olujoliswe kuko lubandakanya ukunika amayeza ajoliswe kolu hlobo lweproteni ye-HER2.
• Unyango lwe-immunotherapy: Oku kuquka ukuvuselela amajoni omzimba wethu ukuze alwe neeseli zomhlaza. Amayeza abizwa ngokuba zi-immune checkpoint inhibitors asetyenziselwa le njongo.

Khumbula, ayizizo zonke ezi ndlela zonyango ezifanelekileyo kubo bonke abaguli. Iqela lakho lezonyango liza kugqiba ukuba loluphi unyango olufanele imeko yakho.

Yintoni enokulindelwa ngumntu onomhlaza womqala?

Oku kuxhomekeke kakhulu kwizinto ezininzi, njengempilo yakho iyonke kunye nokuba umhlaza usasazeke kangakanani xa ufunyaniswa. Ukuba ufunyenwe kwangethuba, oogqirha badla ngokuwunyanga ngempumelelo. Malunga nama-46% abantu abanyangwa kwangethuba basaphila emva kweminyaka emihlanu emva kokuba ufunyaniswe.

Nangona kunjalo, ukuba umhlaza sele usasazekile, kusenokungabi lula ukuwutshabalalisa ngokupheleleyo. Kwiimeko ezinjalo, oogqirha bagxila ekuboneleleni ngonyango olunceda isigulana siphile ixesha elide kangangoko kunokwenzeka, sigcine umgangatho wobomi, kwaye sinciphise iimpawu. Oku kukwabizwa ngokuba lunyango lokudambisa iintlungu . Kunceda isigulana siphile kamnandi kwaye singabi nantlungu.

Ndingawunciphisa njani umngcipheko wokuba nomhlaza?

Nangona ingenakuthintelwa ngokupheleleyo, kukho izinto ezininzi esinokuzenza ukunciphisa umngcipheko:

• Landela ukutya okunempilo: Yitya ukutya okunesondlo, yitya iziqhamo nemifuno emininzi, kwaye ugcine ubunzima obusempilweni obukufaneleyo.
• Ukuzikhwebula kwicuba notywala: Ezi zimbini zezona zinto ziphambili ezibangela umngcipheko.
• Kuphephe ukudibana neekhemikhali ezithile (kuxhomekeke kumsebenzi).
• Usulelo lwe-HPV luyinto ebangela umhlaza womqala. Buza ugqirha wakho malunga nogonyo lwe-HPV.
• Ukuba unesifo esifana nesophagus sikaBarrett , ugqirha wakho uya kukucebisa ukuba uhlolwe rhoqo. Landela loo miyalelo.

Okwangoku akukho vavanyo lokuhlola umhlaza womqala olucetyiswayo kuluntu ngokubanzi, kodwa oogqirha banokucebisa uvavanyo olufana ne-EGD kubantu abaneengxaki ezinkulu zomhlaza.

Ndingazinyamekela njani emva konyango?

Ezinye iziphumo ebezingalindelekanga zinokwenzeka emva kotyando lomhlaza womqala. Umzekelo, isicaphucaphu, ukuhlanza, kunye nesitshiso sentliziyo. Ungadinga uncedo lokulawula ezi zinto. Abantu abaninzi banokuhlangabezana neengxaki ezifana nezi:

• Ubunzima bokutya: Umhlaza kunye nonyango lwawo lunokwenza kube nzima kwaye kube buhlungu ukuginya ukutya. Oku kunokubangela nokwehla kobunzima bomzimba. Ukuba kunjalo, cela ingcebiso kugqirha wakho. Banokucebisa izinto ezifana nokutya ukutya okuncinci rhoqo kunye nokuthatha izongezo zesondlo.
• I-Dumping syndrome: Oku kwenzeka xa isisu sithatha indawo yomqala emva kotyando. Isisu asikwazi ukubamba nokugaya ukutya, kwaye ukutya kungena ngokukhawuleza emathunjini amancinci. Oku kunokubangela iimpawu ezifana nokucaphuka, ukuhlanza, iintlungu zesisu, ukubila, kunye nokuhlambuluka.

Thetha neqela lakho lezonyango ngezi zinto uze ufumane ingcebiso malunga nendlela yokujongana nazo.

Ingaba lo mhlaza ungabuya?

Ewe, ngamanye amaxesha umhlaza ungabuya (ukuphinda ubuye). Ungenza ezi zinto ukunciphisa loo mngcipheko:

• Nciphisa utywala: Ukusela utywala kakhulu kwandisa umngcipheko wokubuya komhlaza.
• Kuphephe ukusebenzisa icuba: Ukuba uyatshaya, zama ukuyeka. Funa ingcebiso kagqirha ukuba kuyimfuneko.

Ndifanele ndimbone nini ugqirha?

Oku kuya kwahluka ngokuxhomekeke kwimeko yakho. Ishedyuli yokulandelela yomntu osuswe umhlaza kwangethuba yahlukile kwishedyuli yomntu onomhlaza osasazekileyo.

Ukuba unyango lwakho luphumelele, ugqirha wakho uya kukucela ukuba uze kuhlolwa rhoqo emva kweenyanga ezintathu ukuya kwezintandathu kwiminyaka emibini yokuqala, kwaye rhoqo emva kweenyanga ezintandathu ukuya kwezilishumi elinesibini kwiminyaka emithathu ezayo. Olu vavanyo lungabandakanya uvavanyo lomzimba, uvavanyo lwegazi, uvavanyo lwemifanekiso, kunye ne-endoscopy.

Ndingayibuza yiphi imibuzo ugqirha wam?

Umhlaza womqala sisifo esisongela ubomi. Ukuba unale meko, ungabuza ugqirha wakho imibuzo efana nale:

• Luhlobo luni lomhlaza womqala endinawo?
• Umhlaza wam ukuliphi inqanaba?
• Loluphi unyango olucebisayo?
• Ngaba oku kunganyangwa ngokupheleleyo?
• Ukuba andinakuphiliswa ngokupheleleyo, ungenza ntoni ukuze undincede?
• Ndingaphila ixesha elingakanani nalo mhlaza?
• Ngaba kufuneka ndenze uvavanyo lwemfuza okanye uvavanyo lwe-biomarker?

Musa ukoyika ukubuza le mibuzo. Kubaluleke kakhulu ukuba uyiqonde kakuhle imeko yakho.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Umhlaza wesisu ngumhlaza weshumi oxhaphakileyo ehlabathini, kwaye ungowona mhlaza unzima ukuwunyanga. Oku kungenxa yokuba iimpawu zihlala zivela emva kokuba umhlaza usasazekile. Kunokuba nzima ukufumana unyango olupheleleyo. Kwiimeko ezinjalo, oogqirha bagxila ekuboneleleni izigulane ngonyango oluzinceda ziphile ixesha elide kangangoko kwaye ziphile ubomi obusemgangathweni.

Mhlawumbi akukho nto inzima ebomini njengokuxelelwa ukuba, "Unesifo esinganyangekiyo." Ngexesha elinjalo, unokufuna ixesha noncedo lokujongana nale meko. Oogqirha bayakuqonda oku kwaye baya kwenza konke okusemandleni abo ukukunceda. Ukuba kuyimfuneko, baya kukuthumela kwingcali yezempilo yengqondo.

Eyona nto ibalulekileyo kukwazi utshintsho emzimbeni wakho kwaye ufune iingcebiso zonyango ngokukhawuleza ukuba uneengxaki. Okukhona ufumanisa kwangoko, kokukhona unyango luya kuphumelela.

Umhlaza wesisu , umhlaza wesisu, iimpawu zomhlaza, umqala, ubunzima bokuginya, unyango lomhlaza, unyango lwekhemotherapy