Zithini ezi thumba zenzeka emzimbeni wakho, kwimibhobho yakho yenyongo? Masithethe ngeeKlatskin Tumors!

Ngaba wakha waziva ngathi amehlo akho ajika abe tyheli ngenxa yesisu esibuhlungu? Okanye mhlawumbi uziva ngathi ulahlekelwa bubunzima? Ezi zizinto ngamanye amaxesha esingazinaki kangako, kodwa zinokuba ziimpawu zezifo ezingaqhelekanga. Namhlanje siza kuthetha ngesifo esibi kancinci, kodwa kubaluleke kakhulu ukuba siqaphele. Leyo yimeko ebizwa ngokuba yiKlatskin Tumor .

Yintoni iKlatskin Tumor?

Ngamafutshane, ezi thumba zeKlatskin luhlobo lwethumba elinomhlaza elikhula kwimibhobho yenyongo engaphandle kwesibindi sethu. Cinga ngako, isibindi sethu sivelisa ulwelo olubizwa ngokuba yinyongo, olunceda ekugayweni kokutya. Le nyongo ihamba ngemijelo emincinci kwaye idibana ukuze yenze umjelo oyintloko wenyongo. Ngokukodwa, ezi thumba zihlala zenzeka kwindawo ebizwa ngokuba yi-'hilum', apho imibhobho yenyongo yasekunene neyasekhohlo evela esibindini idibana khona ukuze yenze umjelo oyintloko wenyongo. Oogqirha bakwabiza oku ngokuba yi -'Hilar Cholangiocarcinoma' . Ukuba ezi thumba zichongiwe kwaye zinyangwa kwangethuba, kukho amathuba okuba zinokunyangeka. Izinto ezifana notyando kunye nokufakelwa kwesibindi zezona ndlela ziphambili zonyango. Kukwakho nonyango lokunciphisa iimpawu. Uphando luyenziwa kunyango olutsha.

Kunqabile kangakanani oku?

Esi sisifo esingaqhelekanga kakhulu . Kuqikelelwa ukuba malunga nomntu omnye kwikhulu lamawaka unesifo. Oko kuthetha ukuba asisosifo esichaphazela abantu abaninzi.

Zithini iimpawu zeKlatskin Tumor?

Ngoko ke, xa ezi thumba ze-bile duct zenzeka, zithintela ukuhamba kwe-bile kwi-gallbladder. Kulapho kuvela khona iimpawu ezahlukeneyo. Ezi zibonakala kancinci kancinci, ngoko ngamanye amaxesha sisenokungaziboni.

• Intlungu yesisu: Intlungu yesisu engapheliyo, ngamanye amaxesha eba mandundu, ingakumbi kwicala eliphezulu lasekunene lesisu.
• Ukudinwa: Ukuziva udiniwe kakhulu okungapheli nokuba ulele kamnandi ebusuku.
• Isicaphucaphu: Ukuziva ugula, mhlawumbi nokuhlanza.
• Ukunciphisa umzimba: Ukunciphisa umzimba ngaphandle kwesizathu esicacileyo nangaphandle kokunciphisa umzimba.
• I-Jaundice: Ukutyhelika kwamhlophe emehlweni naselusu. Oku kwenzeka xa inyongo ingaphumi kakuhle, nto leyo ebangela ukuba into etyheli ebizwa ngokuba yi-bilirubin iqokelele egazini. Umchamo unokuba tyheli mnyama kwaye indle inokuba mhlophe okhanyayo.
• Ulusu olurhawuzelelayo: Abanye abantu banokuba nokurhawuzelela kuwo wonke umzimba wabo, nto leyo ekwayingxaki enxulumene nenyongo.

Ezi mpawu zinokuba nzima ukuzinyamezela, ngoko ke ungathandabuzi ukufuna ingcebiso kagqirha. Eyona nto ibalulekileyo kukufumana unobangela ngokukhawuleza.

Zithini izizathu zeKlatskin Tumor?

Abaphandi abakafumani unobangela ochanekileyo wezi thumba zesikhumba.Kodwa nantsi into eyenzekayo. Ezi thumba zenzeka xa utshintsho lwemfuza (ukuguqulwa) lwenzeka kwiiseli eziqhelekileyo zomzimba wethu, nto leyo ebangela ukuba ezo seli zahlulwe ngendlela engaqhelekanga kwaye zande ngendlela engalawulekiyo.

Nangona kunjalo, kufunyenwe izinto ezithile ezibangela umngcipheko wale meko. Oko kukuthi, izinto ezifana nezifo ezithile kunye notshintsho lwemfuza olwenzeka emva kokuba sizelwe.

Ezinye iimeko ezonyusa le ngozi zezi:

• Ingxaki yokusebenzisa utywala: Wonke umntu uyazi ukuba utywala abulungelanga isibindi. Ukusetyenziswa kotywala obuninzi ixesha elide konakalisa isibindi kwaye kwandisa umngcipheko wolu hlobo lomhlaza.
• Amatye enyongo (iCholdocholithiasis): Amatye avala imibhobho yenyongo anokubangela ukudumba kwexesha elide kunye notshintsho lweeseli.
• I-pancreatitis engapheliyo: Ukudumba kwexesha elide kwe-pancreas.
• I-Clonorchiasis: Olu luhlobo losulelo olubangelwa yintsholongwane yesibindi yaseTshayina. Le ntsholongwane ihlala kwimibhobho yenyongo kwaye ibangela umonakalo ohlala ixesha elide.
• I-Primary sclerosing cholangitis (PSC): Le yimeko apho imibhobho yenyongo ivuvukala, ibe namanxeba, ize inciphe. Le yimeko eyonyusa kakhulu umngcipheko weethumba zeKlatskin.
• Ezinye iintsholongwane: Umonakalo wesibindi obangelwa ziintsholongwane, ingakumbi i-hepatitis B kunye ne-hepatitis C, nawo unokuba negalelo.
• Ubudala: Abantu abangaphezu kweminyaka engama-50 ubudala basengozini enkulu.
• Ukutyeba kakhulu kunye nesifo seswekile kucingelwa ukuba kuyandisa umngcipheko ngandlela ithile.

Zeziphi iingxaki ezinokubangela oku?

Le meko inokubangela iingxaki ezinkulu .

• Amahlwili egazi: Umhlaza unokusasazeka uye kwimithambo yegazi emikhulu uze wenze amahlwili egazi.
• I-cholestasis engaphandle kwesibindi: Oku kwenzeka xa umjelo omkhulu wenyongo ngaphandle kwesibindi uvalwa sisimila. Oku kunokwenza i-jaundice ibe mandundu.
• Umhlaza osasazekayo: Ezi thumba zeKlatskin zinokusasazeka ukusuka kwimibhobho yenyongo engaphandle kwesibindi ziye kwisibindi ngokwaso, emiphungeni, emathanjeni, kwii-lymph nodes, nakwezinye iindawo zesisu.

Ifunyanwa njani iKlatskin Tumor?

Ukuba unale mpawu, into yokuqala ugqirha wakho aza kuyenza kukuxilonga kakuhle. Ingakumbi isisu sakho. Baza kujonga ukuba isisu sakho sidumbile, sinamaqhuma, okanye sibuhlungu xa usichukumisa. Baza kujonga nokuba ulusu namehlo akho atyheli.

Emva koko, benza uvavanyo lwegazi, uvavanyo lwemifanekiso, kunye nezinye izinto ukuze babone ukuba kwenzeka ntoni kanye kanye kwimibhobho yenyongo. Banokwenza novavanyo lwemfuza ukuze bajonge utshintsho lwemfuza.

Uvavanyo lwegazi

• Iimpawu zesifo somhlaza:Ezi zijonga izinto ezithile egazini ezinokuba luphawu lwethumba leKlatskin. Umzekelo, zijonga inqanaba lento ebizwa ngokuba yi-carbohydrate antigen (CA) 19-9 . Ukuba inqanaba loku liphezulu kakhulu, lingaba luphawu lwesi sifo. Nangona kunjalo, ayinguye wonke umntu onalo nqanaba onomhlaza, kwaye linokuba phezulu nangezinye izizathu.
• Uvavanyo lokusebenza kwesibindi: Olu vavanyo luquka uvavanyo lwe-bilirubin kunye novavanyo lokujonga ii-enzymes zesibindi eziphezulu. Ezi zinokunika umbono wokuba isibindi sonakele okanye ukuba ukuhamba kwenyongo kuvaliwe.

Uvavanyo lokufota

Olu vavanyo luthatha imifanekiso yangaphakathi lomzimba. Ezinye iimvavanyo zokuthatha imifanekiso zingathatha isampuli yezicubu (i-biopsy) kwaye zihlolwe yingcali yezonyango. Yiyo le nto eya kugqiba ukuba ingaba ngumhlaza okanye akunjalo.

• Iskeni ye-ultrasound: Olu luvavanyo olulula olwenziwa kuqala.
• I-CT (CT - Computed Tomography) Scan: Oku kungathatha imifanekiso ecacileyo.
• I-MRI (Umfanekiso weMagnetic Resonance): Oku kungathatha imifanekiso ecacileyo neneenkcukacha.
• I-ERCP (i-Endoscopic Retrograde Cholangiopancreatography): Kule nkqubo, i-endoscope (ityhubhu encinci enekhamera) ifakwa ngomlomo, esiswini, nakwimibhobho yenyongo. Iisampulu zingathathwa apho, kwaye i-stent ingafakwa kwindawo evaliweyo ukunceda inyongo ihambe.
• I-MRCP (iMagnetic Resonance Cholangiopancreatography): Oku kufana ne-MRI, kodwa kwenziwa ngokukodwa ukujonga imibhobho yenyongo kunye nemibhobho yepancreatic. Akubandakanyi ukufaka nantoni na emzimbeni.

Amanqanaba omhlaza

Ukuba ufunyaniswe ukuba unesi sifo, ugqirha wakho uya kugqiba inqanaba lomhlaza (ukukhula komhlaza) . Oku kubalulekile ekucwangciseni unyango nasekumiseleni ikamva emva konyango.

Amanqanaba omhlaza ahlulwe ngokusekwe kubukhulu bethumba (T), nokuba umhlaza usasazeke kwi-lymph nodes (N), nokuba usasazeke nakwizitho ezikude (M - metastasized). Ngamanye amaxesha, ukubonakala kweeseli zomhlaza phantsi kwe-microscope (udidi lomhlaza) nako kuyaqwalaselwa.

Amanqanaba eethumba zeKlatskin ngala alandelayo:

• Inqanaba 0: Ithumba likwiingqimba zangaphakathi ze-bile duct kuphela. Alikasasazekanga liye kwiingqimba ezinzulu, ii-lymph nodes, okanye kwezinye iindawo zomzimba.
• Inqanaba lokuQala: Umhlaza ukwidonga lomsele wenyongo, kodwa awukasasazeki ngaphandle komsele wenyongo.
• Inqanaba lesiBini: Ithumba lisasazeke kwizicubu ezinamafutha ezikufutshane okanye kwizicubu zesibindi ezikufutshane.
• Inqanaba lesi-IIIA: Umhlaza usasazeke kumasebe omnye wemithambo yegazi ephambili esibindini (ngasekunene okanye ngasekhohlo).
• Inqanaba lesi-IIIB: Ithumba lisasazeke kumacala omabini emithambo yegazi ephambili esibindini, okanye kwezinye imisele yenyongo kwelinye icala lesibindi nakwimithambo yegazi ephambili kwelinye icala.
• Inqanaba lesi-3C: Umhlaza usasazeke ukuya kwi-lymph nodes enye ukuya kwezintathu ezikufutshane.
• Isigaba se-IVA: Ithumba lisasazeke laya kuma-lymph nodes amane okanye ngaphezulu.
• Inqanaba le-IVB: Umhlaza ngoku usasazeke kwiindawo ezikude zemiphunga, amathambo, okanye isibindi.

Ziziphi iindlela zonyango lweKlatskin Tumor?

Iindlela zonyango zixhomekeke kwizinto ezininzi, kuquka imeko yakho, inqanaba lomhlaza, kunye nempilo yakho iyonke. Nangona kunjalo, utyando ludla ngokuba lolona nyango lokuqala noluqhelekileyo lwesi sifo.

Kukho iintlobo ezahlukeneyo zotyando:

• Ukukhupha inyongo: Oku kwenzelwa ukususa inyongo egqithisileyo eqokelelene esibindini. Oku kunokunciphisa iimpawu ezifana ne-jaundice. Oku kungenziwa nge-ERCP ene-stent okanye ngetyhubhu yangaphandle.
• Utyando lwe-hepatectomy olwandisiweyo: Kubantu abaneethumba ezikwinqanaba lokuqala, i-hepatectomy inokususa inxalenye yesibindi, imibhobho yenyongo, inyongo yenyongo, kunye nee-lymph nodes ezikufutshane.
• Ukufakelwa kwesibindi: Eyona ndlela yokunyanga ngokupheleleyo esi sifo kukususa ithumba (ii-tumor) elinomhlaza. Oku kungafuna ukususa isibindi sonke kunye nokwenza utyando lwesibindi. Oku akunakwenzeka kuwo wonke umntu, kwaye kufuna ukufaneleka.

Kunye notyando, okanye kwiimeko apho utyando lungenakwenzeka, oogqirha basebenzisa unyango olubizwa ngokuba yi-chemoradiation . Olu ludibaniso lwe -chemotherapy kunye nonyango lwe-radiation . Olu nyango lubulala iiseli zomhlaza okanye lulawula ukukhula kwazo.

Ngoku kukho iindlela ezimbini ezintsha zonyango lwe-metastatic squamous cell tumors:

• Unyango lwe-Immunotherapy: Umzekelo, amayeza abizwa ngokuba yi -'immune checkpoint inhibitors' . La mayeza asebenza ngokunceda inkqubo yakho yomzimba yokulwa nomhlaza.
• Unyango olujoliswe kulo: Amayeza afana ne -fibroblast growth factor receptor (FGFR) inhibitors okanye i-IDH inhibitors . Ii-FGFR inhibitors zithintela ukukhula kweeseli zomhlaza kwaye zizibulale. Ii-IDH inhibitors zithintela iproteni engaqhelekanga echaphazela ukukhula kweeseli okuqhelekileyo. Ezi azisebenzi kuye wonke umntu, kwaye zinikwa kuphela abantu abanotshintsho oluthile kwizakhi zofuzo kwiiseli zabo zomhlaza.

Iingxaki kunye nemiphumo emibi yonyango

Utyando lwesibindi kunye nokufakelwa kwesibindi zizinto ezinkulu, kwaye ngenxa yoko, zinokuba neengxaki ezinkulu.

• I-Ascites: Ukuqokelelana kolwelo esiswini.
• Ukuvuza kwenyongo: Ngexesha lotyando lwesibindi, imibhobho yenyongo yesibindi inokonakala, nto leyo ebangela ukuba inyongo egqithisileyo ivuthele esibindini.
• I-Deep vein thrombosis (DVT): Ukwakheka kwe-blood clot kwimithambo enzulu yomzimba emva kotyando.
• Usulelo: Usulelo lunokwenzeka kwindawo yotyando, kwindlela yomchamo, okanye emiphungeni.
• Ukungasebenzi kakuhle kwezintso: Ngamanye amaxesha utyando lwesibindi lunokuchaphazela izintso luze lubangele ukuba ziyeke ukusebenza.
• Ukungasebenzi kakuhle kwesibindi: Oku kunokwenzeka ukuba inxalenye yesibindi isusiwe (i-hepatectomy).
• Ukwaliwa kwamalungu omzimba: Umzimba usenokungakwamkeli isibindi esifakwe kwenye indawo.

Iziphumo ebezingalindelekanga eziqhelekileyo zonyango lwe-radiation kunye ne-chemotherapy zezi:

• Ndidiniwe.
• Ukulahleka kweenwele.
• Isicaphucaphu nokuhlanza.
• Izilonda zomlomo.
• Urhudo.
• I-anemia.

Oogqirha bakwanika iingcebiso kunye namayeza okulawula ezi ziphumo ebezingalindelekanga.

Ingakanani izinga lokusinda kwiKlatskin Tumor?

Xa usiva ngesifo esifana nesi, omnye wemibuzo yokuqala efika engqondweni kukuba 'izinga lokusinda' lithini. Oku kubhekisa kwipesenti yabantu abanohlobo oluthile lomhlaza abasaphila emva kweminyaka emihlanu emva kokuba bexilongiwe.

I-National Cancer Institute (NCI) eMelika iqokelela idatha enjalo. Nangona kungekho datha ithile yeethumba zeKlatskin, kukho idatha yazo zonke iintlobo zomhlaza we-bile duct ezikhula ngaphandle kwesibindi. Ngoko ke, ngokubanzi, i-9% yabantu abanomhlaza we-bile duct ongaphandle kwesibindi bayaphila emva kweminyaka emihlanu emva kokufunyaniswa ukuba banayo.

Kodwa xa ucinga ngezi zibalo, kufuneka kukhunjulwe izinto ezimbini:

• Ezi ziingqikelelo nje: zisekelwe kumava abanye abantu. Imeko yakho inokwahluka kakhulu. Umzekelo, impilo yakho iyonke, ubudala, inqanaba lomhlaza, kunye nendlela osabela ngayo kunyango zinokuchaphazela la mazinga.
• La manani ayimbali: Abonisa ixesha elidlulileyo, hayi elangoku. La manani alinganiswa rhoqo emva kweminyaka emihlanu. Ngoko ke impembelelo yonyango olutsha ayibonakali koku.

Into ebalulekileyo kukuba ezi zibalo azixeli yonke into. Wonke umntu wahlukile, kwaye unyango luyaphucuka ngalo lonke ixesha. Kungumbono olungileyo ukuthetha nogqirha wakho ngale nto uze umbuze ukuba olu lwazi luthetha ukuthini kuwe. Kubalulekile ukuhlala unethemba kwaye unethemba.

Ndingazinyamekela njani?

Ukugcina umgangatho wobomi bakho emva kokuxilongwa, unyango, kunye nokuchacha yeyona nto ilungileyo onokuyenza ngokwakho. Nazi ezinye iingcebiso:

• Yitya kakuhle:Yitya ukutya okunesondlo nokulinganiselayo. Yitya iiproteni ezingenamafutha amaninzi, imifuno, iziqhamo, kunye neenkozo ezipheleleyo. Nxibelelana nogqirha wakho okanye ingcali yesondlo ukuze ufumane ingcebiso.
• Ziphephe ulwazi olungeyonyani: Ekubeni esi sisifo esingaqhelekanga, usenokungazi nto ingako ngaso. Ukukhangela ulwazi kwi-intanethi kunokudida kwaye koyike. Kodwa ulwazi lunamandla . Fumana ulwazi kwimithombo ethembekileyo kuphela. Yenza konke okusemandleni akho ukuphanda iinyani, kwaye ubuze iqela lakho lezonyango nayiphi na imibuzo okanye iinkxalabo onokuba nazo.
• Xhasa impilo yakho yengqondo: Ngomhlaza ongaqhelekanga onje, unokuba yingozi kwimpilo yakho yengqondo, njengoko uhlala ufuna utyando kunye nonyango olude. Kuqhelekile ukuba uzive ulusizi, usoyika, kwaye uxhalabile. Buza iqela lakho lezonyango malunga neenkqubo kunye neengcebiso ezinokukunceda koku. Thetha nosapho kunye nabahlobo.
• Cinga ngeenkqubo zokusinda kumhlaza: Ezi zigxile kwimpilo, impilo-ntle, kunye nomgangatho wobomi ngelixa uphila nomhlaza.
• Buza ngonyango lokudambisa iintlungu: Unyango lokudambisa iintlungu lunyango olungenakunyanga isifo, kodwa lunokunceda ukulawula iimpawu kunye nokuphucula umgangatho wobomi. Unyango lokudambisa iintlungu kumhlaza we-bile duct lunokunceda ngesicaphucaphu, ukunciphisa iintlungu, kunye nokugcina ukuhamba kwe-bile kwiindawo apho ithumba liyivimba khona.

Ndifanele ndimbone nini ugqirha?

Ukuba ufunyenwe une-Klatskin tumor, hlala unxibelelana nogqirha wakho rhoqo.

• Buza ugqirha wakho ukuba loluphi utshintsho (ukwanda kweempawu, iimpawu ezintsha) onokululindela.
• Ukuba iimpawu ezifana nentlungu, isicaphucaphu, kunye nokuhlanza ziyanda, okanye ukuba kuvela iimpawu ezintsha , yazisa ugqirha wakho ngoko nangoko .
• Ukuba iziphumo ebezingalindelekanga zonyango zinzima, baxelele ngazo.
• Ugqirha wakho uneendlela zonyango ezinokunceda ekunciphiseni iimpawu ezichaphazela ubomi bakho bemihla ngemihla kunye nomgangatho wobomi bakho.

Ndingayibuza yiphi imibuzo ugqirha?

Mhlawumbi sele ufunde okuninzi malunga neethumba zeKlatskin kwaye unemibuzo malunga nemeko yakho. Bhala le mibuzo xa usiya kugqirha wakho.

• Wazi njani ukuba ndinolu hlobo lomhlaza?
• Ithini inqanaba lomhlaza? Ithetha ukuthini loo nto?
• Ziziphi iindlela zonyango endinazo? Zithini iingenelo kunye neengxaki zalo naluphi na unyango?
• Ngaba ikho indlela epheleleyo yokunyanga oku?
• Buza kuba njani ubomi bam emva konyango?
• Ngaba kukho naziphi na iimvavanyo zeklinikhi endifanele ndiziqwalasele?
• Ngaba kufuneka nditshintshe indlela enditya ngayo nendlela endiphila ngayo?
• Ndingalufumana phi uncedo mna nosapho lwam ukuze ndikwazi ukumelana nale meko?

Okokugqibela, khumbula...

I-Klatskin tumor (hilar cholangiocarcinoma) sisifo esinzima ngokwenene nesinzima.Akukho mathandabuzo ukuba sisifo. Kuqhelekile ukuba uzive usoyika xa usiva. Nangona kunjalo, idatha efana namazinga okusinda ayixeli lonke ibali lesi sifo. Sisifo esinokunyangwa kakhulu, kwaye abaphandi benza uvavanyo lweklinikhi lonyango olutsha.

Ukuba unale meko, iqela lakho lezonyango linokukunceda ulawule iimpawu zakho kunye nemiphumo emibi yonyango. Baya kukuvuyela nokucebisa uvavanyo lweklinikhi onokuthi ulucinge. Ungaze ulahle ithemba. Eyona nto ibalulekileyo kukwaziswa nokulandela icebiso likagqirha wakho.

Ithumba leKlatskin , iHilar Cholangiocarcinoma, umhlaza we-bile duct, umhlaza wesibindi, umkhuhlane otyheli, i-jaundice, iimpawu zomhlaza, unyango lomhlaza