Yintoni i-Urothelial Carcinoma? Makhe sithethe ngayo ngokweenkcukacha!

Ngaba wakha waphawula igazi kumchamo wakho? Okanye ngaba uneentlungu zomqolo okanye ukudinwa okungapheliyo? Nangona ezi zinto zisenokungabonakali ngathi zixhalabisa kakhulu, ngamanye amaxesha zinokuba ziimpawu zomhlaza okhula kwindlela yomchamo. Olunye uhlobo lomhlaza yi- Urothelial Carcinoma , ngamanye amaxesha ebizwa ngokuba yiTransitional Carcinoma . Namhlanje, siza kuthetha ngale nto ngokweenkcukacha ezithe vetshe , ngokungathi sithetha nomhlobo.

Yintoni i-Urothelial Carcinoma? Ngamafutshane...

Ngamafutshane, i-Urothelial Carcinoma ngumhlaza oqala kwizicubu ezibizwa ngokuba yi-urothelium, ezikwiindawo ezithile zenkqubo yakho yomchamo. Cinga ngayo njengolwelo lwangaphakathi lwamalungu athile emizimbeni yethu. I-urothelium yenye yezi zicubu. Ifumaneka kakhulu kwisinyi, kwizintso (ingakumbi kwi-renal pelvis), nakwii-ureters. Ubusazi na ukuba i-90% yomhlaza wesinyi kunye ne -7% yomhlaza wezintso yimimhlaza ye-urothelial? Iimpawu zazo zombini ziyafana kakhulu. Eyona nto ilungileyo kukuba le mihlaza kulula ukuyinyanga nokuyinyanga ukuba ifunyenwe kwangethuba . Nangona kunjalo, ngamanye amaxesha inokuphinda ivele. Yiyo loo nto kubalulekile ukuqaphela oku.

Lo mhlaza uyichaphazela njani imizimba yethu?

Indlela umhlaza we-urothelial ochaphazela ngayo isinyi sakho kunye nezintso ingahluka kancinci.

Umhlaza we-Urothelial wesinyi

Isinyi sakho sisitho esincinci esifana nengxowa. Sifumaneka phakathi kwamathambo akho esinqeni, ngaphezulu kwe-urethra yakho, nangaphantsi kwezintso zakho. Umchamo ovela kwizintso zakho uqokelelana kwesinyi. Ingaphakathi lesinyi ligcwele izicubu esizikhankanyileyo ngaphambili ezibizwa ngokuba yi-urothelium . Iiseli ezikule thishu zinokunwebeka xa isinyi sakho sizele ngumchamo kwaye zinciphe xa siphuma. (Isinyi sakho sinokubamba malunga neekomityi ezimbini zomchamo.) Xa unesifo somhlaza wesinyi, iiseli ezikule urothelium zahlukana ngokungaqhelekanga kwaye zisasazeke ukusuka kumaleko angaphakathi esinyini sakho ukuya kwezinye iileya. Ngamanye amaxesha, ezi seli ezingaqhelekanga zinokugqobhoza kwiindonga zesinyi sakho ziye kwizicubu ezinamafutha ezisijikelezileyo. Ukuba asinyangwa, esi sinyi sinokusasazeka ngodonga lwesinyi ukuya kwi-lymph nodes ezikufutshane kwaye ukusuka apho siye kwezinye iindawo ezifana namathambo, imiphunga, nesibindi. Kukho iintlobo ezimbini eziphambili zomhlaza wesinyi:

• Umhlaza we-urothelial osezingeni eliphezulu: Oku kuyingozi ngakumbi. Kunokwenzeka ukuba ubuye nokuba sele unyangiwe. Ungasasazeka uye kumaleko wemisipha yesinyi, kwezinye iindawo zomzimba, kwayeIngasasazeka iye kwiindawo ze-lymph nodes .
• Umhlaza we-urothelial okumgangatho ophantsi: Oku kungabuya kwakhona, kodwa akunakwenzeka ukuba kusasazeka kwimisipha yesinyi okanye kwezinye iindawo zomzimba.

Umhlaza we-Urothelial wezintso

Ngokwesiqhelo sinezintso ezimbini. Zifana nezitho ezimbini ezimile okwembotyi, ezifumaneka ngaphantsi kwembambo nangasemva kwesisu. Izintso zihluza inkunkuma kunye neetyhefu ezivela egazini kwaye zenze umchamo. Lo mchamo uqokelelana embindini wezintso obizwa ngokuba yi-renal pelvis . Ukusuka apho, umchamo uhamba ngetyhubhu ende edibanisa izintso kunye nesinyi. Lo mchamo ubizwa ngokuba yi-ureter . Njengezintso, i-renal pelvis kunye ne-ureter nazo zigcwele izicubu ze-urothelial. Umhlaza wezintso uvela xa iiseli ze-urothelial ezingaqhelekanga zikhula kwaye zenze ii-tumor kwizintso, kwi-renal pelvis, okanye kwi-ureter. Umhlaza wezintso unokusasazeka nakwezinye izitho okanye kwizicubu.

Ngubani onokuthi abe nalo mhlaza?

Umhlaza wesinyi ngumhlaza wesithandathu oxhaphakileyo eMelika. Kwaye ama-90% omhlaza wesinyi ngumhlaza we-urothelial. Amadoda anamathuba aphindwe kane okuba nomhlaza wesinyi kunabasetyhini . Umhlaza wezintso ngumhlaza wesibhozo oxhaphakileyo. Malunga ne -7% yomhlaza wezintso ngumhlaza we-urothelial. Uxhaphake kakhulu kubantu abaphakathi kweminyaka engama-65 nama-74. Amadoda anamathuba aphindwe kabini okufumana esi sifo.

Yintoni uphawu oluphambili lomhlaza we-urothelial?

Umhlaza we-Urothelial usenokungabi nazimpawu kwasekuqaleni. Nangona kunjalo, igazi kumchamo (i-hematuria) lidla ngokuba luphawu lokuqala. Ukuba ubona igazi kumchamo okanye unezinye zezi mpawu, ngokuqinisekileyo kuya kufuneka ubone ugqirha :

• Intlungu yomqolo engapheliyo.
• Ukudinwa, ukudinwa .
• Ukuba mncane ngaphandle kwesizathu.
• Intlungu xa uchama ( i-dysuria ).
• Kuvakala ngathi sisimila apho kukho izintso .
• Ndinomkhuhlane omncinci.

Yintoni ebangela lo mhlaza?

Abaphandi bezonyango abakayazi kakuhle into ebangela umhlaza we-urothelial wesinyi kunye nezintso. Nangona kunjalo, bafumanise izinto ezininzi ezinobungozi eziqhelekileyo:

• Ukutshaya icuba : Abantu abatshaya icuba basengozini enkulu yokuba nomhlaza we-urothelial kwinkqubo yomchamo.Umngcipheko wokuba nomhlaza uphezulu kakhulu. Le yeyona nto iphambili ebangela umngcipheko.
• Ukuchanabeka kwiikhemikhali ezithile: Izifundo zibonise ukuba abantu abasebenza kwiindawo ezenza iidayi ezithile, irabha, izinto zesikhumba, iipeyinti, amanye amalaphu, kunye neemveliso zokuhombisa iinwele basengozini enkulu yokuba nalo mhlaza.

Oogqirha bayixilonga njani le mhlaza?

Oogqirha basebenzisa olu vavanyo ukuxilonga umhlaza wesinyi kunye nezintso, kuquka umhlaza we-urothelial:

• Uvavanyo lomchamo: Luvavanyo olujonga umbala womchamo wakho, iswekile, iiproteni, igazi kunye neebhaktheriya.
• I-cytology yomchamo: Isampulu yomchamo wakho iyathathwa ize ihlolwe phantsi kwe-microscope ukujonga iiseli ezingaqhelekanga. Ukuba unomhlaza kwizintso, kwisinyi, okanye kwi-urethra, iiseli zomhlaza zinokufunyanwa kumchamo wakho.
• Intravenous pyelogram (IVP): Olu luluhlu lweemvavanyo ze-X-ray. Lwenziwa ukujonga umhlaza kwizintso, kwii-ureters, nakwi-bladder. Oogqirha bafaka ulwelo olukhethekileyo (idayi yokungafani) emthanjeni wakho. Emva koko, ii-X-ray zithathwa njengoko ulwelo ludlula kwizintso zakho, kwii-ureters, nakwi-bladder ukuze kubonwe ukuba akukho nto ivalelekileyo na.
• I-Ureteroscopy: Isixhobo esincinci esifana netyhubhu (esinekhamera kunye nokukhanya) sidluliselwa kwi-urethra ukuze sijonge ngaphakathi kwi-ureter kunye ne-renal pelvis. Sikwasetyenziswa ukuthatha iisampuli zezicubu.
• I-CT scan (i-computed tomography - i-CT scan): Ikhompyutha eqhagamshelwe kumatshini we-X-ray ithatha imifanekiso eneenkcukacha zamalungu ahlukeneyo omzimba.
• I-Ultrasound: Amaza esandi anamandla aphezulu (i-ultrasound) athunyelwa kwizicwili ezingaphakathi emzimbeni kwaye imisindo ebuyayo isetyenziselwa ukwenza umfanekiso (sonogram). I-ultrasound yesisu inokwenziwa ukuze kufunyanwe umhlaza we-renal pelvis kunye ne-ureter.
• I-MRI (Magnetic resonance imaging - MRI): Isebenzisa imagnethi, amaza erediyo, kunye nekhompyutha ukuthatha imifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezifana nomngxuma we-pelvic.

Yintoni inqanaba lomhlaza?

Oogqirha basebenzisa inkqubo yokulinganisa umhlaza ukucwangcisa unyango kunye nokufumanisa ukuba umhlaza uza kuqhubeka njani. Oku kuchaza indlela umhlaza onokukhula ngayo kwaye usasazeke ngayo.

Ukumisela umhlaza ngokwezigaba yinkqubo enzima. Ukuba uvakalelwa kukuba imeko yakho ifakwa kwifomyula enoonobumba namanani ambalwa, kunokuba yinto eyoyikisayo nedidayo. Kuyaqondakala ukuba kunjalo. Ukuba awuqinisekanga ngale nto okanye uziva usoyika, cela ugqirha wakho ukuba akuchazele indlela esebenza ngayo le nkqubo kwimeko yakho.

Amanqanaba omhlaza wesinyi

Umhlaza wesinyi unokuba kwinqanaba lokuqala (ukuphela kolwelo lwesinyi) okanye ube phambili (ungene eludongeni lwesinyi waza wasasazeka kwizitho ezikufutshane okanye kwii-lymph nodes). Amanqanaba omhlaza wesinyi ngala alandelayo:

• Inqanaba lokuQala: Umhlaza ukhawulelwe kulwelo lwesinyi okanye kwizicubu ezidityanisiweyo ezingaphantsi kwaso. Awukasasazeki eludongeni oluphambili lwemisipha yesinyi.
• Inqanaba lesiBini: Umhlaza usasazeke waya kudonga lwemisipha yesinyi.
• Inqanaba lesi-3: Umhlaza usasazeke ukusuka kwimisipha yesinyi ukuya kwizicubu ezinamafutha ngaphandle.
• Inqanaba lesi-4: Umhlaza usasazeke ukusuka kwisinyi ukuya kwi-lymph nodes, kwezinye izitho zomzimba, okanye emathanjeni.

Oogqirha bakwabeka umhlaza wesinyi njengongenasihlaseli , ongangenisi izihlunu , okanye ongenisi izihlunu .

• Ayihlaseli: Kule meko, umhlaza unokuba kwindawo encinci yezicubu, okanye unokuthi uthintelwe kumphezulu wesinyi.
• Ayingenisi izihlunu: Kule meko, umhlaza ungene nzulu kwisinyi, kodwa awuzange usasazeke kwimisipha.
• Ihlasela izihlunu: Kule meko, umhlaza usasazeke kwimisipha yodonga lwesinyi kwaye usenokuba usasazeke kwiinqatha ezingaphandle kwesinyi okanye kwizicubu zamalungu omzimba.

Amanqanaba omhlaza wezintso

Umhlaza wezintso awuhlelwa ngokweenqanaba ngokusekelwe kuhlobo lweseli yomhlaza. Umhlaza we-Urothelial ubangela malunga ne-7% yomhlaza wezintso. Umhlaza wezintso kunye nomhlaza we-renal pelvis/ureter zihlelwa ngokwahlukileyo.

• Inqanaba lokuQala: Umhlaza awukasasazeki ngaphaya kwezintso.
• Inqanaba lesiBini: Umhlaza ukhulile, kodwa awukasasazeki ngaphaya kwezintso.
• Inqanaba lesiThathu: Umhlaza usasazeke ukusuka kwizintso ukuya kwimithambo yegazi ephambili - umthambo wezintso kunye ne-vena cava engaphantsi - okanye ukuya kwizicubu ezijikeleze izintso, okanye ukuya kwii-lymph nodes ezikufutshane.
• Inqanaba lesi-4: Umhlaza usasazeke ukusuka kwi-adrenal gland (idlala elincinci elingaphezulu kwezintso), ukuya kwii-lymph nodes ezikude, okanye kwamanye amalungu omzimba.

Amanqanaba omhlaza we-renal pelvis kunye ne-ureter

• Inqanaba 0: Kukho iiseli ezingaqhelekanga kumphezulu we-renal pelvis okanye i-ureter. Oku kukwabizwa ngokuba yi-papillary carcinoma okanye i-carcinoma in situ .
• Inqanaba loku-1 (Inqanaba loku-1): Umhlaza usasazeke kumaleko angaphakathi e-renal pelvis kunye/okanye kwi-ureter ukuya kumaleko wezicubu ezidityanisiweyo.
• Inqanaba lesiBini:Umhlaza usasazeke kwizicubu ezidityanisiweyo ukuya kumaleko wemisipha ye-renal pelvis kunye/okanye i-ureter.
• Inqanaba lesi-4: (Inqanaba lesi-3 alikhankanywanga apha, kodwa lidla ngokuba phakathi kwe-II kunye ne-IV, nto leyo ebonisa ukusasazeka kwezicubu ezikufutshane) Umhlaza usasazeke kwizitho ezikufutshane, i-lymph nodes enye okanye ezingaphezulu, umaleko wamafutha ojikeleze izintso, okanye izitho ezikude ezifana nemiphunga, isibindi, okanye amathambo.

Oogqirha banyanga njani umhlaza we-urothelial?

Iindlela zonyango ziyahluka ngokuxhomekeke ekubeni umhlaza we-urothelial ukuphi kwisinyi, kwizintso, kwi-renal pelvis, nakwi-ureter.

Unyango lomhlaza wesinyi

Iindlela zonyango zingabandakanya:

• Utyando: Oogqirha bayayisusa ithumba elinomhlaza okanye balitshise besebenzisa umbane onamandla aphezulu. Oku kubizwa ngokuba yi -electrocautery (fulguration) .
• Unyango lweKhemotherapy: Kunikwa amayeza okutshabalalisa iiseli zomhlaza.
• Unyango lwe-Immunotherapy: Luvuselela amasosha omzimba wakho ukuze alwe nomhlaza.
• Unyango ngemitha: Isebenzisa imitha enamandla aphezulu ukutshabalalisa iiseli zomhlaza.
• Unyango olujoliswe kulo: Amayeza ajolise kwiimolekyuli ezithile ezinceda iiseli zomhlaza zikhule.

Unyango lomhlaza wezintso

Ezinye zeendlela zonyango ezifanayo zisetyenziswa kumhlaza wezintso njengomhlaza wesinyi. Ukongeza, ezi ndlela zonyango zingasetyenziswa:

• Utyando: Yinxalenye yezintso enomhlaza kuphela enokususwa, okanye yonke intso inokususwa.
• I-Cryoablation: Isebenzisa umkhuhlane omkhulu ukutshabalalisa iiseli zomhlaza.
• Ukususwa kwee-radiofrequency: Amaza erediyo asetyenziselwa ukufudumeza nokutshabalalisa iiseli zomhlaza.

Unyango lomhlaza we-renal pelvis kunye/okanye i-ureter

• Utyando: Inxalenye ye-kidney pelvis okanye i-ureter apho umhlaza ukhoyo iyasuswa.

Lingakanani izinga lokusinda ukuba unesifo somhlaza we-urothelial?

Nangona umhlaza we-urothelial ngumhlaza oqala kuhlobo olufanayo lweeseli, indlela esihamba ngayo esi sifo inokwahluka ngokuxhomekeke kwindawo esikhula kuyo (isinyi, izintso, i-renal pelvis, i-ureter).

Ingcinga yomhlaza wesinyi

Njengemininzi yemihlaza, umhlaza wesinyi unokuba sengozini yokusinda ukuba ufunyenwe kwaye unyangwa kwangethuba. Ngokwedatha ka-2018 evela kwiNational Cancer Institute (NCI), ama-96% abantu abanyangelwa umhlaza wesigaba sokuqala basaphila emva kweminyaka emihlanu bexilongiwe. Lilonke, ama-77% abantu abanomhlaza wesinyi basaphila emva kweminyaka emihlanu bexilongiwe.

Ingqikelelo yomhlaza wezintso

Njengeminye imihlaza, umhlaza wezintso (kuquka nomhlaza we-renal pelvis) kulula ukuwunyanga ukuba ufunyenwe kwangethuba.Ngokwedatha ye-NCI (2018), ama-93% abantu abanyangelwa umhlaza wezintso okwinqanaba lokuqala basaphila emva kweminyaka emihlanu bexilongiwe. Izinga lokusinda leminyaka emihlanu lilonke liyi-76.5%.

Ndingawunciphisa njani umngcipheko wokuba nomhlaza we-urothelial kwinkqubo yam yomchamo?

Zimbini izinto eziphambili onokuzenza ukunciphisa umngcipheko wakho wokuba nalo mhlaza:

• Ukungatshayi icuba.
• Ukuphepha ukuvezwa kwiikhemikhali ezithile eziyingozi.

Ndingazinyamekela njani?

Ukuba umhlaza ufunyenwe kwangethuba, oogqirha banokunyanga umhlaza we-urothelial, okhula kwindlela yomchamo. Kodwa ngelishwa, olu hlobo lomhlaza lunokubuya kwakhona. Ukuba ukhe wanyangwa olu hlobo lomhlaza, kubalulekile ukuqhubeka nonyango olulandelayo njengoko ugqirha wakho eyalele. Oku kubaluleke kakhulu.

Ndifanele ndimbone nini ugqirha?

Ukuba ubona naluphi na utshintsho emzimbeni wakho, ingakumbi iimpawu ezibonisa ukuphinda komhlaza we-urothelial kwinkqubo yomchamo, bona ugqirha ngoko nangoko. Oku kuthetha ukuba ukuba ufumana naziphi na iimpawu ezintsha, ezifana negazi kumchamo wakho, iintlungu zomqolo, okanye ukudinwa okutsha, ngokuqinisekileyo kufuneka ubonane nogqirha.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ke, ezi zezona zinto zibalulekileyo ekufuneka uzikhumbule kwizinto esithethe ngazo namhlanje:

• I-Urothelial carcinoma ngumhlaza okhula kumaleko angaphakathi kwenkqubo yakho yomchamo (isinyi, izintso, kunye nee-ureters).
• Uphawu oluphambili ligazi kumchamo . Ezinye iimpawu ziquka iintlungu zomqolo, ukudinwa, kunye nokwehla kobunzima.
• Ukutshaya kunye nokuchanabeka kwiikhemikhali ezithile zezona zinto ziphambili ezibangela umngcipheko.
• Ukuba ifunyenwe kwangethuba, inokuba lula ukunyangwa nokunyangwa.
• Ngenxa yokuba lo mhlaza ungaphinda ubuye, kubalulekile ukuqhubeka nokuhlolwa ngugqirha emva konyango.
• Ukuba unamathandabuzo okanye iimpawu, ungoyiki ukuthetha nogqirha. Baza kukunceda.

Ndiyathemba ukuba olu lwazi luluncedo kuwe. Hlala usempilweni! Umhlaza we-Urothelial, i-Urothelial Carcinoma, umhlaza womchamo, umhlaza wesinyi, umhlaza wezintso, igazi kumchamo, iimpawu zomhlaza