Ingaba unengxaki ngezintso zakho? Masifunde ngeRenal Cell Carcinoma (RCC)!

Ngaba wakha wacinga nzulu ngezintso zakho? Izintso zizitho ezimbini ezincinci kodwa ezibaluleke kakhulu emzimbeni wethu. Zifana nezihluzo emzimbeni wethu. Nangona kunjalo, ngamanye amaxesha ezi zintso zinokuba neengxaki. Namhlanje siza kuthetha ngenye yezona ntlobo zixhaphakileyo zomhlaza ezinokwenzeka kwizintso, "iRenal Cell Carcinoma" okanye iRCC . Ungakhathazeki, siza kuthetha ngale nto ngokulula, ngendlela onokuyiqonda.

Yintoni i-renal cell carcinoma (RCC)?

Ngamafutshane, i-renal cell carcinoma (RCC) lolona hlobo luqhelekileyo lomhlaza wezintso. Izintso zethu zinothungelwano oluhle kakhulu lweetyhubhu ezibizwa ngokuba zii-tubules . Ezi tyhubhu zezona zithutha amanzi omzimba kunye nezondlo ziye egazini kwaye zikhuphe inkunkuma kumchamo. Kungaphakathi kwezi tyhubhu apho i-RCC iqala ukwakheka khona. Malunga nama-85% omhlaza wezintso ulolu hlobo.

Amaxesha amaninzi, i-RCC iqala njengeqhuma elincinci leeseli zomhlaza kwintso enye. Oku kukwabizwa ngokuba yi-tumor . Nangona kunjalo, ngamanye amaxesha amaqhuma amaninzi anokubakho kwintso enye, okanye kuzo zombini izintso.

Ziziphi iintlobo eziphambili ze-RCC?

Kukho iintlobo ezahlukeneyo ze-RCC. Cinga ngayo njengokuba nabantu abahlukeneyo kusapho olunye. Olu hlu lusekelwe kwindlela ezibonakala ngayo iiseli zomhlaza phantsi kwe-microscope, i-DNA yazo, okanye izinto zemfuza. Kukho iintlobo ezimbalwa eziphambili:

• I-Clear cell renal cell carcinoma (ccRCC): Olu hlobo lumalunga ne-85% ye-RCC. Igama layo livela kuba iiseli zomhlaza zibonakala zicacile phantsi kwe-microscope.
• I-papillary renal cell carcinoma: Olu hlobo lubandakanya phakathi kwe-10% kunye ne-15% yazo zonke ii-renal cell carcinomas. Ibizwa ngokuba zii-protrusions ezifana neminwe ( ii-papillae ) ezifumaneka kwezi thumba.
• I-Chromophobe renal cell carcinoma: Olu hlobo luphakathi kwe-5% ne-10%. Ezi seli zihlala zinombala okhanyayo, zifana neeseli ezicacileyo, kodwa zinkulu kancinci.
• I-RCC engahlelwanga: Malunga ne-6% ye-RCC ayinakuhlelwa ngokwahlukileyo kwiintlobo eziphambili. Nangona kunjalo, izazinzulu zizama rhoqo ukwahlula eli qela lingahlelwanga ngeendlela ezintsha, ngokusekelwe kwizinto ezifana neempawu ezincinci zeeseli kunye ne-DNA yazo.

Usenokuba ukhe weva oogqirha besebenzisa amagama athi "localized" okanye "advanced" okanye "metastatic" xa bethetha nge-RCC. I- Localized RCC ithetha ukuba umhlaza ukwizintso kuphela, kwaye usenokuba usasazeke kwizicubu ezikufutshane.Kuthetha ukuba umhlaza usasazeke nakwamanye amalungu omzimba. Uhlobo onalo luchaza iindlela zonyango lwakho kunye namathuba okuphila.

Ixhaphake kangakanani i-RCC?

Ehlabathini lonke, malunga nama-400,000 amatyala amatsha e-RCC axelwa minyaka le. E-United States, eli nani limalunga nama-80,000. Nangona nabani na enokuba ne-RCC, ixhaphake kakhulu kumadoda aphakathi kweminyaka engama-60 ukuya kwengama-80 .

Zithini iimpawu ze-renal cell carcinoma?

Abantu abaninzi abanazo iimpawu ekuqaleni. Iimpawu ziqala ukubonakala xa umhlaza ukhula kwaye uqala ukuchaphazela izicubu okanye amalungu omzimba angqongileyo.

Iimpawu ze-RCC zingabandakanya:

• Igazi kumchamo (hematuria). Olu lolona phawu luqhelekileyo.
• Intlungu yesifuba: Oku kubhekisa kwintlungu eyenzeka kumacala omabini omzimba, ngaphezulu kwesinqe nangaphantsi kweembambo.
• Ukuziva ngathi kukho iqhubu esiswini, emqolo ongezantsi, okanye emqolo.
• Umkhuhlane oza ngaphandle kwesizathu.
• Ukubila ebusuku.
• Ukunciphisa umzimba ngendlela engachazekiyo.

Ukongeza, iimpawu ze- anemia , ezinje ngokuphefumla kancinci kunye nokudinwa, nazo zinokuvela. Okanye iimpawu zesifo esibizwa ngokuba yi-paraneoplastic syndromes nazo zinokuvela. Kwimeko enjalo, izinto ezifana neehomoni zikhutshwa kwi-tumor yomhlaza, ezibangela utshintsho olwahlukeneyo emzimbeni.

Zithini izizathu ze-RCC?

I-RCC yenzeka xa iiseli ezingaqhelekanga kwi-kidney tubules ziqala ukukhula ngokungalawulekiyo. Isizathu esichanekileyo asikaziwa okwangoku. Nangona kunjalo, izazinzulu zichonge izinto ezithile ezinobungozi ezonyusa umngcipheko wokufumana i-RCC.

Zithini izinto ezibangela umngcipheko?

Umngcipheko wokuba ne-RCC uphezulu ukuba unale nto ilandelayo:

• Ukutshaya: Okukhona utshaya kakhulu, kokukhona umngcipheko uphezulu.
• Ukutyeba kakhulu: Okukhona i-body mass index yakho (BMI) iphezulu, kokukhona umngcipheko wakho uphezulu.
• Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu).
• Isifo sezintso esingapheliyo: Oku kuquka abo bafumana unyango lwe-dialysis lwexesha elide.
• Usulelo lweHepatitis C olungapheliyo.
• Ukusetyenziswa ixesha elide kwee-painkillers ezithile (umz. ii-NSAIDs, i-acetaminophen).
• Ekubeni sele ndifumene unyango lwe-radiation kwindawo yesisu ngaphambili.
• Ukuchatshazelwa zizinto ezibangela umhlaza, ezifana ne -cadmium kunye ne-asbestos .
• Isifo seSickle cell: Oku kunxulunyaniswa nohlobo olungaqhelekanga lwe-RCC.
• Imbali yosapho yomhlaza wezintso.
• Utshintsho kwi-genetic: Olu lutshintsho kwi -DNA yeeseli.
• I-Tuberous sclerosis complex.
• Isifo sikaVon Hippel-Lindau (VHL).

Ukuba unenye yezi zinto zinobungozi, ugqirha wakho unokucebisa ukuba uhlolwe izintso rhoqo, nto leyo enokukunceda ufumane umhlaza kwasekuqaleni.

Ungayichonga njani i-RCC?

Malunga nama-25% abantu abane-RCC bafunyanwa benale ntsholongwane emva kokuba umhlaza usasazeke kancinci, oko kuthetha ukuba xa iimpawu ziqala ukubonakala.

Nangona kunjalo, iindaba ezimnandi zezokuba uvavanyo lwemifanekiso olwenziwe ngezinye izizathu ngoku lufumanisa ngakumbi iithumba ze-RCC ngengozi, ngaphambi kokuba kuvele iimpawu. Ngenxa yoko, abantu abaninzi bafumana unyango lomhlaza kwinqanaba lawo elinokunyangeka.

Uvavanyo lokuchonga i-RCC

Oogqirha basebenzisa uvavanyo lwemifanekiso ukuxilonga umhlaza kunye nokucwangcisa unyango. Uvavanyo oluqhelekileyo zezi:

• I-ultrasound scan: Oku kuquka ukuthumela amaza esandi avakala kakhulu kwizicwili zomzimba kunye nokudala imifanekiso enokubukwa kwisikrini. I-ultrasound inokunceda ekuqinisekiseni ukuba iqhuma lizaliswe lulwelo (oludla ngokuba yi-cyst ) okanye liqinile (elixhaphake kakhulu kumaqhuma anomhlaza).
• I-computed tomography (CT) scan: Oku kudala uthotho lwemifanekiso enika umfanekiso ocacileyo wangaphakathi lomzimba. Kuya kufuneka ufake idayi ebizwa ngokuba yi-contrast emthanjeni uze uyiskene ngaphambi nasemva koko. Le dayi iya kumhlaza kwaye iyibonise ngokucacileyo.
• Iskeni ye-magnetic resonance imaging (MRI): Oku kusebenzisa imagnethi enkulu, amaza erediyo, kunye nekhompyutha ukwenza imifanekiso eneenkcukacha zangaphakathi lomzimba. Ugqirha wakho unokucebisa ukuba wenze i-MRI ukuba awukwazi ukwenza i-CT scan (umzekelo, ukuba une-allergy kwidayi ekhankanyiweyo ngaphambili), okanye ukuba iziphumo ze-ultrasound kunye ne-CT scan aziqinisekanga.

Nangona i-biopsy idla ngokwenziwa ukuze kufunyanwe umhlaza, oku akwenzeki rhoqo kwi-RCC. I-biopsy ibandakanya ukuthatha isampuli encinci yezicubu ezivela kwithumba kwaye uyihlolisise phantsi kwe-microscope ukuze kubonwe ukuba kukho iiseli zomhlaza na.

Kodwa ukwenza i-biopsy kwi-RCC kudla ngokuba yingozi kuba kunokonakalisa izintso. Ngoko ke, oogqirha badla ngokuvavanya iiseli zomhlaza emva kokususa lonke ithumba njengonyango. Ukuba imifanekiso ibonisa ukuba umhlaza usasazekile, banokuthatha iiseli zomhlaza kwenye indawo ngaphandle kwezintso baze bazivavanye.

Ukuvavanya ezi seli yindlela ekuphela kwayo yokwazi ngokuqinisekileyo ukuba loluphi uhlobo lwe-RCC onalo (ukuba alucaci kwimifanekiso). Kukwanceda ekuchongeni ukuba loluphi unyango olusebenza kakuhle kolo hlobo lomhlaza.

Ukuxilongwa kwe-renal cell carcinoma

Ukwazi inqanaba lomhlaza wakho kunceda ugqirha wakho aqonde ukuba umhlaza wakho usasazeke kangakanani na. Kukwakuxelela nokuba umhlaza usendaweni ethile okanye usasazeka . Olu lwazi lunokukunceda ucwangcise unyango lwakho kwaye lukunike umbono wesifo esiza kwenzeka.

Oogqirha basebenzisa inkqubo ebizwa ngokuba yi -TNM (i-tumor, i-lymph node, i-metastasis) ukuze bafumanise inqanaba le-RCC. Bahlula umhlaza ngokwamanqanaba oku-1 ukuya kwele-IV. Amanqanaba omhlaza oku-1, okwesibini, kunye nowesithathu ahlulwe ngokweendawo ezithile, ngelixa inqanaba lesi-IV liyi-metastatic RCC.

• Inqanaba lokuQala le-RCC: Umhlaza ungaphantsi kweesentimitha ezi-7 kwaye awukasasazeki ngaphandle kwezintso.
• Inqanaba lesiBini le-RCC: Umhlaza mkhulu ngaphezu kweesentimitha ezi-7, kodwa awukasasazeki ngaphandle kwezintso.
• Isigaba sesiThathu se-RCC: Ithumba lingaba loluphi na ubungakanani kwaye lisasazeke kwizicubu ezikufutshane ezijikeleze izintso.
• Isigaba sesi-IV se-RCC: Umhlaza usasazeke ngaphaya kwezintso ukuya kwi-lymph nodes nakwezinye izitho zomzimba.

Kubalulekile: Ukwazi inqanaba lomhlaza kubalulekile ekumiseleni unyango, ngoko ke xoxa ngononophelo nogqirha wakho ngale nto.

I-RCC isasazeka phi kuqala?

I-Metastatic RCC idla ngokusasazeka kwii-lymph nodes zakho, imiphunga, amathambo, isibindi, kunye nengqondo. Ngamanye amaxesha inokusasazeka kwii-ovari okanye kumasende akho.

Ziziphi iindlela zonyango lwe-renal cell carcinoma?

Unyango luxhomekeke kwizinto ezininzi, kuquka inqanaba lomhlaza kunye nempilo yakho iyonke. Unyango lwe -RCC ekwindawo ethile lwahlukile kunyango lwe -RCC esasazekayo .

Unyango lwe-renal cell carcinoma olukwindawo ethile

Unyango loku kukususa umhlaza, okanye ukutshabalalisa umhlaza kusetyenziswa iindlela zokukhupha iiseli (ukubulala iiseli ngobushushu obugqithisileyo okanye ngokubanda kakhulu).

Utyando lolona nyango luqhelekileyo kwi-RCC yendawo.

• Ukususwa kwe-radical nephrectomy: Oku kuquka ukususwa kwezintso ezinomhlaza kunye nezinye izicwili ezijikelezileyo (ezifana nee-lymph nodes kunye nee-adrenal glands, apho iiseli zomhlaza zinokubakho khona). Kubantu abaninzi, izintso enye esempilweni yanele.
• Ukususwa kwe-nephrectomy okuyingxenye:Oku kuquka ukususa kuphela inxalenye yezintso enomhlaza. Olu tyando lungenziwa ukuba umhlaza wakho mncinane. Oku kunokusindisa umsebenzi wezintso zakho. Oku kubaluleke kakhulu ukuba awunazo izintso ezimbini eziphilileyo.

Ukuba awungomntu ufanelekileyo wotyando, ugqirha wakho unokucebisa ukuba usebenzise iindlela zokukhupha isisu . Ezi ziquka:

• Unyango lweCryotherapy: Iiseli zomhlaza ziyabulawa ngokuziqandisa.
• Ukususwa kwee-radiofrequency: Iiseli zomhlaza ziyatsha ngokuzibeka kwindawo eshushu kakhulu.

Unyango lwe-metastatic renal cell carcinoma

Unyango lwe -metastatic RCC lubandakanya ukulwa neeseli zomhlaza emzimbeni wonke. Utyando lunokwenziwa ukuze kususwe ithumba, kodwa akwanelanga ukuphelisa ngokupheleleyo umhlaza we-metastatic. Nangona kunjalo, ukususa ithumba kunokunceda ukunciphisa iimpawu kunye nokulibazisa ukuqala kolunye unyango.

Ezona ndlela zonyango zixhaphakileyo yi -immunotherapy kunye nonyango olujoliswe kulo . Ngokuxhomekeke kwiimeko ezahlukeneyo, la mayeza anikwa ewodwa okanye edibene.

Unyango lwe-immunotherapy

I-immunotherapy isebenza ngokuqinisa inkqubo yakho yomzimba yokuzikhusela, iyincede ekufumaneni nasekulweni neeseli zomhlaza. Amanye ala mayeza aquka:

• I-Avelumab (Avelumab - Bavencio®)
• I-Ipilimumab (Ipilimumab - Yervoy®)
• Nivolumab (Nivolumab - Opdivo®)
• I-Pembrolizumab (Pembrolizumab - Keytruda®)

Unyango olujoliswe kulo

Unyango olujoliswe kulo lusebenza ngokuphazamisa inkqubo yokwanda kweeseli zomhlaza. Olu nyango luthintela ukunikezelwa kwegazi kwiiseli zomhlaza, lucothisa ukukhula kwazo. Amanye ala mayeza aquka:

• I-Axitinib (Axitinib - Inlyta®)
• I-Bevacizumab (Bevacizumab-Avastin®)
• I-Cabozantinib (i-Cabozantinib - i-Cabometyx®)
• I-Everolimus (Everolimus-Afinitor®)
• ILenvatinib (Lenvatinib - Lenvima®)
• I-Pazopanib (Pazopanib - Votrient®)
• I-Sorafenib (Sorafenib-Nexavar®)
• I-Sunitinib (i-Sunitinib - i-Sutent®)
• I-Temsirolimus (Temsirolimus-Torisel®)
• Tivozanib (Tivozanib - Fotivda®)

Ngokuxhomekeke kwinqanaba lomhlaza, apho usasazeke khona, ubukhali bawo, kunye nendlela osabela ngayo kwezinye iindlela zonyango, ugqirha wakho unokucebisa ezinye iindlela zonyango lomhlaza, ezifana nonyango lwemitha .

Ngaba i-RCC inganyangeka ngokupheleleyo?

Kuxhomekeke kwisifo sakho esithile. I-RCC ekufutshaneAbantu abane-RCC ekwindawo enobungozi kakhulu abasuswe umhlaza ngotyando badla ngokuba neziphumo ezilungileyo zexesha elide. Abantu abane-RCC ekwindawo enobungozi kakhulu banokunikwa unyango lwe-immunotherapy emva kokuba umhlaza ususiwe ukuphucula iziphumo zexesha elide.

Okwangoku akukho nyango lwe -RCC ephucukileyo esasazeke ngaphaya kwezintso. Nangona kunjalo, njengoko izazinzulu zifumana unyango olungcono olujolise kwiiseli ezithile zomhlaza, abantu abane-RCC esasazekileyo ngoku baphila ixesha elide.

Iyintoni imbono yee-RCCs?

Oogqirha ngoku bayakwazi ukubona i-RCC kwisigaba sayo sokuqala, xa umhlaza unganyangeka kakhulu. Ukufunyanwa kwangoko kunye nonyango oluphuculweyo kuye kwaphucula amazinga okusinda. Ama-90% abantu abanesigaba soku-I RCC baphila iminyaka emihlanu. Ngokufanayo, nangona ixesha lokuphila kwabantu abanesigaba soku-IV RCC lalihlala lilinganiselwe kwiinyanga, uninzi ngoku luphila iminyaka eliqela.

Ngaba i-RCC ingathintelwa?

I-RCC ayinakuthintelwa rhoqo. Kodwa ungayinciphisa ingozi yakho. Umzekelo, ukungatshayi (okanye ukuyeka ukuba uyayeka) yenye yezona zinto zibalaseleyo onokuzenza ukunciphisa umngcipheko wakho womhlaza. Kubalulekile nokuba nobunzima obusempilweni, ukutya ukutya okunesondlo, kunye nokulawula uxinzelelo lwegazi oluphezulu.

Ndingazinyamekela njani?

Thetha nogqirha wakho malunga nesicwangciso sokhathalelo esiza kukunceda ulawule iimpawu zakho zomhlaza kunye nemiphumo emibi yonyango lwakho. Umzekelo, abanye abantu banokufuna ukuqala i-dialysis emva kotyando ukuba enye okanye zombini izintso azisebenzi kakuhle. Kubalulekile ukwazi ukuba olu nyango luza kukuchaphazela njani.

Ungadinga uncedo lokulawula iziphumo ebezingalindelekanga zonyango olujoliswe kulo okanye unyango lwe-immunotherapy . Buza ugqirha wakho ukuba ulindele ntoni ngaphambi kokuba uqale unyango.

Ndingayibuza yiphi imibuzo ugqirha wam?

• Luhlobo luni lwe-RCC endinalo?
• Umhlaza wam usasazeke kangakanani (lithini inqanaba)?
• Ziziphi iingenelo kunye neengxaki zonyango olufumanekayo?
• Zithini iziphumo okanye iingxaki endifanele ndizazi ngaphambi kokuba ndifumane unyango?
• Ndifanele ndiye kangaphi ukuza kuhlolwa emva konyango?
• Zeziphi iinguqu endimele ndizilindele kwindlela endiphila ngayo ngexesha lonyango?
• Ithini ingxelo yemeko yam?

Amava akho okunyanga umhlaza we-renal cell carcinoma (RCC) aza kuxhomekeka kwizinto ezininzi, kuquka impilo yakho iyonke, uhlobo kunye nenqanaba le-RCC, kunye nempendulo yakho kunyango. Kodwa nabani na ofunyaniswe enomhlaza wezintso uya kuzuza ngokwakha ubudlelwane obusondeleyo neqela lakhe lezonyango. Musa ukuthandabuza ukubuza imibuzo malunga nokuxilongwa kwakho, iingenelo kunye neengxaki zeendlela zonyango, kunye neziphumo ezilindelekileyo. Ugqirha wakho ngumntu ongcono ukucacisa ukuba kuthetha ukuthini kuwe ukuba ne-RCC.

Okokugqibela, izinto ekufuneka uzikhumbule

Nangona i-renal cell carcinoma (RCC) yimeko enzima, izinga lokuphiliswa kwayo liphucuke kakhulu xa ifunyenwe kwangethuba kwaye inyangwa ngokufanelekileyo. Ukuba uneempawu, ingakumbi igazi kumchamo wakho, iintlungu emqolo wakho, iqhuma engalweni yakho, okanye imbali yosapho lwakho yomhlaza wezintso, funa ingcebiso kagqirha ngoko nangoko. Ungawunciphisa umngcipheko wakho wokufumana esi sifo ngokuphepha ukutshaya kunye nendlela yokuphila enempilo. Musa ukoyika ukuthetha nogqirha wakho ukuba uneengxaki. Awuwedwa.

Umhlaza wezintso , umhlaza weeseli zezintso, i-RCC, iithumba zezintso, iimpawu zomhlaza, unyango lomhlaza, impilo yezintso