Ngaba ungafumana umhlaza onje ngaphakathi esiswini sakho? Masithethe ngomhlaza oyintloko wesisu

Ngaba wakha weva ngeli gama elithi 'umhlaza oyintloko we-peritoneal cancer'? Mhlawumbi akunjalo. Kuba luhlobo lomhlaza olungaqhelekanga. Kodwa kubaluleke kakhulu ukwazi ngalo, ingakumbi kubafazi. Namhlanje, siza kuthetha ngalo ngokulula, ngendlela onokuyiqonda.

Yintoni umhlaza oyintloko we-peritoneal?

Ngamafutshane, umhlaza oyintloko we-peritoneal ngumhlaza oqala kulwelo lwesisu sakho, ilwelo elincinci elingaphakathi kwesisu sakho. Olu lwelo lubizwa ngokuba yi-peritoneum . Cinga ngalo njengolwelo lwebhaluni.

Le peritoneum ikwagubungela amalungu abalulekileyo angaphakathi kwesisu sakho. Umzekelo:

• Isinyi
• Amathumbu
• Ingxolo
• Isibeleko (ibhinqa)

Ubusazi na ukuba le peritoneum yenziwe ngohlobo oluthile lweseli olubizwa ngokuba zii-epithelial cells . Ezi seli zikhusela iindawo ezahlukeneyo zomzimba wethu. Kwakhona, le peritoneum ikhupha ulwelo olukhethekileyo. Olu lwelo luvumela amalungu angaphakathi esiswini ukuba ahambe ngokukhululekileyo ngaphandle kokungqubana.

Ngoko ke, umhlaza oyintloko we-peritoneal ukhula xa iiseli kwi-peritoneum ziqala ukukhula ngendlela engaqhelekanga nangokungalawulekiyo.

Ngoku makhe sijonge iintlobo zomhlaza wesisu. Oogqirha bayahlulahlula zibe ziintlobo ezimbini, kuxhomekeke ekubeni umhlaza uqala phi:

1. Umhlaza oyintloko we-peritoneal: Kolu hlobo lomhlaza, umhlaza uqala kwiiseli ezenza i-peritoneum. Sithetha kakhulu ngolu hlobo namhlanje.

2. Umhlaza wesibini we-peritoneal: Oku kulapho umhlaza uqala kwenye indawo emzimbeni (umzekelo, ama-ovari, isisu, amathumbu) uze usasazeke uye kwi-peritoneum. Oku kuthetha ukuba awuzange uqale kwi-peritoneum.

Ixhaphake kangakanani le ntsholongwane yokuqala ye-peritoneal?

Enyanisweni, umhlaza oyintloko we-peritoneal luhlobo lomhlaza olungaqhelekanga kakhulu . Cinga ngako, esi sifo sifunyanwa kubantu abangaphantsi kwe-7 kwisigidi ngonyaka. Nangona kunjalo, ezi zibalo azichazi yonke into. Ngokutsho kwabanye abaphandi, malunga ne-15% yabasetyhini abafunyaniswe benomhlaza we-ovarian oqhubele phambili banokuba nomhlaza we-peritoneal. Kuba iimpawu zala mabini ziyafana kakhulu.

Ngubani osengozini enkulu yokuphuhlisa oku?

Abafazi banamathuba amaninzi okufumana umhlaza wesisu kunamadoda. Izinto ezibangela oku zifana kakhulu nezo zomhlaza wesibeleko. Makhe sijonge ukuba ziyintoni na:

• Ubudala: Esi sifo sidla ngokufunyaniswa kubantu abaneminyaka engama-60 nangaphezulu.
• I-Endometriosis:Ukuba une-endometriosis (imeko apho iiseli ezifana nezo zifumaneka kulwelo lwesibeleko zikhula ngaphandle kwesibeleko), umngcipheko wakho unokwanda.
• Iimpembelelo zemfuza (imfuza): Ukuba ilungu losapho elisondeleyo (umama, udade, intombi) liye laba nomhlaza wesisu, umhlaza wetyhubhu ye-fallopian, okanye umhlaza wesibeleko, nawe usemngciphekweni omkhulu. Abafazi abane -BRCA1 okanye i-BRCA2 gene mutations nabo basemngciphekweni omkhulu. Abantu abane-genes ye- Lynch syndrome (imeko yemfuza eyonyusa umngcipheko weentlobo ezahlukeneyo zomhlaza) nabo basemngciphekweni omkhulu.
• Ubude: Abantu abade kunomndilili babonakala benomngcipheko ophezulu kancinci wokufumana lo mhlaza.
• Unyango lokutshintshwa kweehomoni: Abafazi abasebenzisa unyango lweehomoni emva kokuya exesheni banokuba semngciphekweni omkhulu.
• Ukutyeba kakhulu: Abantu abanamafutha amaninzi emzimbeni nabo basengozini enkulu.
• Imbali yokuzala: Le ngozi inokwanda kancinci kwabo bebenengxaki yokuba nabantwana (abangenabantwana) kunye/okanye abangazange babe nabantwana.

Yintoni umahluko phakathi komhlaza wesisu kunye nomhlaza wesibeleko?

Kulapho abantu abaninzi badideka khona. Umhlaza we-peritoneal uqala kwindawo eyahlukileyo kunomhlaza we-ovarian. Umhlaza we-ovarian uhlala uqala kwii-ovaries, okanye kwiiseli ezisekupheleni kweetyhubhu ze-fallopian. Nangona kunjalo, umhlaza we-peritoneal, njengoko benditshilo ngaphambili, uqala kwiiseli ze-peritoneum, i-membrane ejikeleze ngaphakathi kwesisu kwaye igqume amalungu esiswini.

Ezi cancer zimbini zinokubhidaniseka ngokulula. Oku kungenxa yokuba i-peritoneum kunye nolwelo lwama-ovari zombini zenziwe ngohlobo olufanayo lweeseli (iiseli ze-epithelial). Kwakhona, ngenxa yokuba zombini iicancer zisasazeka kulwelo lwesisu, ngamanye amaxesha kunzima ukukhomba ngqo apho umhlaza waqala khona.

Ngokwesiqhelo, abantu abafunyaniswe benomhlaza we-peritoneal badala kunabo bafunyaniswe benomhlaza we-ovarian. Kuthiwa kwakhona ukuba uqikelelo lomhlaza we-peritoneal lunokuba lubi kancinci kunomhlaza we-ovarian.

Kutheni le nto lo mhlaza wokuqala we-peritoneal uphuhliswa?

Enyanisweni, abaphandi abakayazi kakuhle ukuba kutheni abanye abantu beba nomhlaza wesisu. Nangona kunjalo, njengoko bekutshiwo ngaphambili, kufunyenwe ukuba abantu abazalwa benotshintsho oluthile lwezakhi zofuzo basengozini enkulu yokuhlaselwa sesi sifo.

Zithini iimpawu zoku?

Njengomhlaza wesibeleko, esi sifo asibonakalisi zimpawu kwasekuqaleni . Nokuba kukho iimpawu, zihlala zingacacanga kwaye zinokufana nezezinye izifo eziqhelekileyo. Uninzi lwabantu lufumana iimpawu kuphela xa umhlaza sele uqhubele phambili, oko kuthetha ukuba usasazekile.

Nangona kunjalo, ukuba umntu ubonakalisa iimpawu ekuqaleni, ezi mpawu zinokuba zezi zilandelayo:

• Intlungu esiswini nasezantsi kwesisu.
• Ukopha okanye ukuphuma kwegazi okungaqhelekanga kwilungu lobufazi.
• Ukuziva uzele, ukuziva unzima esiswini okanye ezantsi kwesisu.
• Utshintsho lwamathumbu (ukuqhinwa kunye/okanye ukwanda kwe-flatulence) okanye ukopha emqolo.
• Ukufuna ukuchama rhoqo.
• Iingxaki zokugaya ukutya, ukuphelelwa ngumdla wokutya, okanye ukuziva uzele emva kokutya ukutya okuncinci kuphela.
• Ukunyuka okanye ukwehla kobunzima obungacwangciswanga ngabom.

Njengoko umhlaza wesisu uqhubeka, ezinye iimpawu zinokuvela. Ezi ziquka:

• Ukudinwa.
• Ukwanda kolwelo esiswini (oku kubizwa ngokuba yi-'ascites' ).
• Isicaphucaphu okanye ukuhlanza.
• Ubunzima bokuphefumla (ukuphelelwa ngamandla).
• Ukudumba kwemilenze.

Zithini iziphumo ebezingalindelekanga (iingxaki) ezinokubakho ngenxa yoku?

Abantu abanomhlaza we-peritoneal ophucukileyo banokufumana iingxaki ezifana nezi:

• Intlungu ebuhlungu esiswini.
• Ukungakwazi ukutya okanye ukusela.
• Ukucaphuka okanye ukuhlanza okukhulu.
• Ukuvaleka kwamathumbu amancinci, ukuvaleka kwamathumbu amakhulu, okanye ukuvaleka komchamo.

Ungayixilonga njani ngokuchanekileyo le sifo?

Xa ubona ugqirha, baza kuqala bakubuze ngeempawu zakho baze benze uvavanyo lomzimba. Ukuba iimpawu zakho zibonisa umhlaza wesisu, banokuyalela iimvavanyo ezifana nezi:

• Uvavanyo lwegazi: Olu vavanyo lwegazi lukhangela ikhemikhali ebizwa ngokuba yi-CA-125, eveliswa ziiseli ezithile zomhlaza. Abantu abanomhlaza we-peritoneal banokuba namanqanaba aphezulu ale nto. Basenokukhangela nokwanda kweproteni ebizwa ngokuba yi -HE4 (enokuthi iveliswe ziiseli zomhlaza we-peritoneal).
• Uvavanyo lokufota: Uvavanyo olufana ne -ultrasound, i-MRI, okanye i-CT scan lunokukhangela ukukhula komhlaza. Nangona kunjalo, olu vavanyo ngamanye amaxesha lunokuba nzima ukulubona kwiimeko zomhlaza we-peritoneal.
• I-Laparoscopy: Ukuqinisekisa ukuxilongwa, ugqirha angenza i-laparoscopy. Oku kuquka ukwenza imingxunya emininzi emincinci esiswini nokufaka isixhobo esifakwe ikhamera. Ngexesha lale nkqubo, kuthathwa isampuli encinci yezicubu ezingaqhelekanga (ebizwa ngokuba yi-biopsy) , emva koko ihlolwe phantsi kwe-microscope yingcali yezifo (ugqirha ochwephesha ekuhloleni izicubu) ukuze abone ukuba umhlaza ukhona na.
• I-Paracentesis: Ukuba isisu sakho sigcwele ulwelo (olubizwa ngokuba yi-ascites), ugqirha wakho unokuthatha isampuli yolwelo aze aluvavanye. Oku kudla ngokwenziwa ngexesha le-laparoscopy.
• Uvavanyo lwe-pelvic:Ilungu lakho lobufazi, umlomo wesibeleko, isibeleko, iityhubhu ze-fallopian, ama-ovari, kunye ne-rectum ziya kuhlolwa ukuba azikho na iziqwenga okanye iindawo ezingaqhelekanga.

Masifunde nangeemvavanyo ezikhethekileyo

Ukuba unayo nayiphi na kwezi meko, ugqirha wakho unokukuthumela kumcebisi wezemfuza ukuze athethe ngezinye zeemeko zemfuza ezinxulumene nomngcipheko ophezulu wokuba nomhlaza wesisu:

• Ukuba ilungu losapho elisondeleyo (umama, udade, intombi) liye laba nomhlaza wesisu, umhlaza wetyhubhu ye-fallopian, okanye umhlaza wesibeleko.
• Ukuba kukho umntu kusapho one-'BRCA1` okanye 'BRCA2` yenguqu yejini.
• Ukuba kukho umntu kusapho oneLynch Syndrome.

Ithini inqanaba lalo mhlaza?

Ngenxa yokuba iimpawu azisoloko zibonakala kwizigaba zokuqala zomhlaza wesisu, umhlaza uhlala ukwinqanaba lesi-3 okanye lesi-4 xa ufunyaniswa.

• Inqanaba lesi-3: Umhlaza usasazeke ngaphandle komngxuma we-pelvic okanye ukuya kwi-lymph nodes ngasemva kwesisu.
• Inqanaba lesi-4: Umhlaza usasazeke kwizitho ezingaphandle kwesisu (umz., imiphunga, isibindi, ipleyini) okanye kwi-membrane egubungela imiphunga nesifuba.

Iphathwa kwaye ilawulwa njani le nto?

Unyango lomhlaza oyintloko we-peritoneal luxhomekeke kwizinto ezininzi:

• Ubungakanani kunye nendawo yethumba lomhlaza.
• Inqanaba lomhlaza.
• Ubudala bakho kunye nempilo yakho iyonke.

Amaxesha amaninzi, oogqirha baya kwenza utyando njengonyango lokuqala. Usenokuba nenkqubo ebizwa ngokuba yi -cytoreductive surgery . Injongo yoku kukususa iiseli zomhlaza ezininzi kangangoko kunokwenzeka. Uphando lubonise ukuba iziphumo ziba ngcono xa olu tyando lwenziwa yi-gynecologic oncologist (ugqirha ochwephesha ekunyangeni izifo kunye nomhlaza wenkqubo yokuzala yabasetyhini).

Ugqirha angasusa:

• Iityhubhu zeFallopian kunye nama-ovari (oku kubizwa ngokuba yi-'oophorectomy' ).
• Isibeleko (oku kubizwa ngokuba yi-'hysterectomy ').
• Izicubu ezinamafutha ezijikeleze amathumbu akho, ezibizwa ngokuba yi-omentum (oku kubizwa ngokuba yi-'omentectomy' ).
• Ezinye izicwili ezingaqhelekanga.

Ukuze uthintele ukusasazeka kweeseli zomhlaza kwezinye iindawo zomzimba, isicwangciso sakho sonyango singabandakanya oku kulandelayo:

• Unyango lweKhemotherapy: Ikhemotherapy yendabuko yomhlaza wesisu inikwa ngemithambo okanye ngqo kwisisu (intraperitoneal). Kwezinye iimeko, oogqirha basebenzisa amayeza ekhemotherapy ashushu (oku kubizwa ngokuba yi -hyperthermic intraperitoneal chemotherapy (HIPEC)).) isetyenziswa. Olu nyango lwe-'HIPEC' lunikwa kwangoko emva kotyando lwe-cytoreductive, ngelixa usephantsi kwe-anesthesia kwigumbi lotyando, kwaye lufakwa kwisisu. Le ndlela ye-'HIPEC' inokuba luncedo ngakumbi ekunikezeni i-chemotherapy kwezinye ii-cancer.
• Unyango olujoliswe kulo: Ugqirha angasebenzisa amayeza athile ajoliswe kwiiseli zomhlaza kuphela, ngaphandle kokulimaza iiseli eziqhelekileyo.
• Unyango lweeHormonal: Kwiimeko eziphucukileyo, oogqirha ngamanye amaxesha badibanisa unyango lweeHormonal kunye neChemotherapy. Olu nyango lusebenza ngokuthintela iiHormonal zendalo zomzimba wakho ukuba zingafikeleli kwiiseli zomhlaza, zithintele ukukhula kwazo.
• Unyango ngemitha: Unyango ngemitha alusetyenziswa rhoqo njengonyango lokuqala lomhlaza wesisu. Ukuba umhlaza ubuyile emva konyango lokuqala kwaye ugcinwe kwindawo encinci, unyango ngemitha lunokunikwa.

Ndingawunciphisa njani umngcipheko wokuba ndibe nale meko?

Ukuba uzenzile ezi zinto, umngcipheko wakho wokuba nomhlaza wesisu ungancitshiswa kancinci:

• Ukuba abantwana bancancisiwe.
• Ukuba uzele abantwana.
• Ukuba ukhe wathatha iipilisi zokulawula ukukhulelwa.
• Ukuba ukhe wasuswa iityhubhu zakho ze-fallopian kunye/okanye ama-ovari ngotyando.
• Ukuba imibhobho ye-fallopian ibotshelelwe (i-tubal ligation).

Abanye abantu abanembali yosapho yomhlaza wesibeleko okanye abo bane-BRCA gene change abasengozini enkulu yokuba nomhlaza wesibeleko bakhetha ukususwa kwamaqanda abo kunye neetyhubhu ze-fallopian. Kubalulekile ukukhumbula ukuba nangona olu tyando lunciphisa umngcipheko wokuba nomhlaza wesibeleko, aluwususi ngokupheleleyo .

Liyintoni ikamva lomntu onesi sifo? (Ingqikelelo)

Ngenxa yokuba umhlaza we-peritoneal udla ngokufunyaniswa kwinqanaba elilandelayo lesi sifo, i-prognosis ayilungile. Umhlaza ungaphinda ubuye emva konyango. Nangona kunjalo, ukufunyaniswa kwangoko kunokunceda ukuphucula iziphumo.

Malunga nesiqingatha sabantu abanomhlaza we-peritoneal, fallopian tube, okanye ovarian baphila iminyaka emihlanu okanye ngaphezulu emva kokuba bexilongiwe. Nangona abantu abancinci benokuphila ixesha elide, i-prognosis kubantu abadala inokuba mbi kancinci.

Amazinga okusinda anokunyuka kwiimeko ezifana nezi:

• Ukuba umhlaza awukasasazekanga kwi-lymph nodes zakho.
• Ukuba ufumene unyango lwe-'HIPEC'.
• Ukuba ugqirha otyandayo ukhuphe umhlaza omninzi kangangoko kunokwenzeka.

Sele kuqhutywa uvavanyo oluninzi lwezonyango ukuze kufunyanwe iindlela ezintsha zokunyanga umhlaza wesisu. Olu nyango lutsha luquka unyango olujoliswe kulo kunye nonyango lwe-immunotherapy.Unyango lwe-immunotherapy lubandakanya ukuvuselela inkqubo yakho yomzimba yokuzikhusela ukuze ibone kwaye ihlasele iiseli zomhlaza emzimbeni wakho.

Ndingazinyamekela njani?

Ukuze uncede ukulawula iimpawu zomhlaza wesisu oqhubele phambili, ugqirha wakho unokucebisa ukuba ubone umboneleli wamayeza okuthomalalisa (icandelo lezonyango eligxile ekunciphiseni nasekulungiseni iimpawu zesifo esinzulu). Unyango lwakho lungabandakanya:

• Ukunciphisa isicaphucaphu nokuhlanza.
• Ingcebiso ngesondlo ukuze ufumane iingcebiso malunga nomdla wokutya kunye nokutya.
• Ulawulo lweentlungu.
• I-Paracentesis yokususa ulwelo esiswini sakho (i-ascites).

Ndingamelana njani kakuhle nemeko efana nale?

Ukujoyina iqela lenkxaso kunye nabanye abafumana unyango olufanayo nolwakho kunokukunceda uzive ungodwa. Amaqela enkxaso anokunceda nosapho lwakho ukuba luqonde oko ukutyhubelayo.

Umyalezo obalulekileyo onokuwuthatha ekhaya

Umhlaza wesisu oyintloko luhlobo olungaqhelekanga lomhlaza oluvela kulwelo lwesisu. Iimpawu zihlala zibonakala emva kokuba umhlaza ukhulile, ngoko ke udla ngokufunyaniswa kamva. Nangona kunjalo, unyango oluphambili olufana ne-HIPEC, unyango olujoliswe kulo, kunye notyando lunokuphucula iziphumo. Uvavanyo lweklinikhi luyaqhubeka ukufumana ezinye iindlela zonyango ezinokunyusa amazinga okusinda.

Eyona nto ibalulekileyo kukuba ukuba uqhubeka uneempawu ezikhankanyiweyo apha ngasentla (ingakumbi utshintsho olungaqhelekanga esiswini, iintlungu, ubunzima), ngokuqinisekileyo kufuneka ufune ingcebiso kagqirha. Okukhona ibonwa kwangoko, kokukhona kunokwenzeka ukuba unyango luphumelele.

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