Masifunde ngakumbi ngomhlaza we-vulvar. Musa ukoyika, masithethe!

Ngaba wakha weva ngento ebizwa ngokuba yi "Vulvar Cancer"? Usenokuba noloyiko kancinci xa usiva eli gama. Kodwa ungakhathazeki. Olu luhlobo lomhlaza olungaqhelekanga. Nangona kunjalo, kubaluleke kakhulu ukuqaphela oku. Kuba, ukuba lufunyenwe kwangethuba, kulula nokulunyanga. Makhe sithethe ngale nto ngokweenkcukacha nangokulula namhlanje.

Yintoni iVulvar Cancer?

Ngamafutshane, iVulvar Cancer ngumhlaza okhula kwizicubu ze-vulva yakho. Igama elithi "Vulva" ligama eliqhelekileyo lazo zonke izitho zangasese zangaphandle zomfazi. Uyakhumbula, xa sasisebancinci, sasineentloni ukuthetha ngezi zitho, kodwa kubaluleke kakhulu ukwazi malunga nenxalenye nganye yomzimba wethu.

Khawucinge nje, i-vulva yakho inala macandelo:

• Ukuvulwa kwesisu: Umbhobho wemisipha osetyenziselwa ukulala ngesondo, ukuzala, kunye nokuya exesheni (ukuya exesheni).
• ILabia Minora: Imiphetho yezicubu ezijikeleze ukuvulwa kwelungu lobufazi kwaye idlulele phezu kwe-clitoris.
• ILabia Majora: Indawo enenyama ejikeleze imilebe yangaphakathi.
• I-Clitoris: Iqhubu elincinci, elinovakalelo lwezesondo elingaphezulu komnyango welungu lobufazi.
• IMons Pubis: Indawo engqukuva phambi kwamathambo esinqe eba noboya ngexesha lokufikisa.
• Ukuvulwa kwe-Urethra: Ukuvulwa kombhobho apho umchamo uphuma khona emzimbeni.
• I-Perineum: Indawo yesikhumba phakathi kwelungu lobufazi kunye ne-anus.

Olu hlobo lomhlaza we-vulvar ludla ngokukhula kancinci, kangangeminyaka emininzi. Luqala njengezicubu ezingaphambi komhlaza (izilonda). Oogqirha badla ngokubona oku kukhula kungaqhelekanga kumaleko wangaphandle wolusu. Ezi zilonda ezingaphambi komhlaza zibizwa ngokuba yi- "vulvar intraepithelial neoplasia" (VIN) .

Ziziphi iintlobo zomhlaza we-vulvar?

Oogqirha bahlula umhlaza wesibeleko ngokwesihlunu somhlaza ngokusekelwe kuhlobo lweseli oqala kuyo umhlaza. Ezona ntlobo zixhaphakileyo zezi:

• I-Vulvar Squamous Cell Carcinoma: Olu hlobo lubangela malunga ne-90% yomhlaza we-vulvar. Lukhula kwiiseli ezikumphezulu wesikhumba.
• I-Vulvar Melanoma: Olu hlobo lwe-melanoma lubangela malunga ne-5% yomhlaza we-vulvar. Lukhula ngokukhawuleza kwaye lunomngcipheko omkhulu wokusasazeka kwezinye iindawo zomzimba.

Ezinye iintlobo zomhlaza we-vulvar azixhaphakanga kakhulu. Ziquka:

• I-Basal Cell Carcinoma
• I-Bartholin Gland Adenocarcinoma
• Isifo sePaget seVulva
• I-Sarcoma
• I-Verrucous Carcinoma

Uxhaphake kangakanani umhlaza we-vulvar?

Enyanisweni, umhlaza we-vulvar ngumhlaza ongaqhelekanga. Umzekelo, eMelika, amatyala amatsha angaphantsi kwama-6,500 omhlaza we-vulvar afunyanwa minyaka le.

Okubalulekileyo kukuba, ama-80% abantu abafunyaniswe benale ngxaki baneminyaka engaphezu kwama-50 ubudala. Kwakhona, ngaphezulu kwesiqingatha sabantu abafunyaniswe benale ngxaki baneminyaka engaphezu kwama-70 ubudala. Ubudala obuqhelekileyo bokufunyaniswa benale ngxaki bumalunga nama-68 eminyaka ubudala.

Oko kuthetha ukuba, kubonakala ngathi le ngozi iyanda ngokuhamba kweminyaka, akunjalo?

Zithini iimpawu zomhlaza we-vulvar?

Ngoku makhe sijonge iimpawu zesi sifo. Iimpawu zokuqala zihlala zibonakala njengotshintsho lolusu kwi-labia majora yakho yangaphandle okanye kwi-inner labia minora. Nangona kunjalo, umhlaza unokubakho naphi na kwi-vulva.

Iimpawu zomhlaza wesibeleko zingabandakanya:

• Ukutshintsha kombala wolusu: Ezinye iindawo zinokuba mnyama okanye zikhanye kunesiqhelo, okanye kuvele amabala amhlophe.
• Ukujiya okanye ukurhawuzelela kwesikhumba: Ezinye iindawo zinokuvakala ziqinile kwaye zirhabaxa xa zichukunyiswa.
• Amaqhuma okanye ukukhula: Usenokuba namaqhuma, iintsumpa, izilonda ezingapholiyo, okanye amaqhuma.
• Ukurhawuzelela okanye ukutsha: Usenokuziva urhawuzelela okanye uvutha rhoqo, kodwa unganciphisi.
• Ukopha igazi okungahambelani nokuya kwakho exesheni: Ukuba ukopha igazi kwilungu lobufazi lakho okungahambelani nokuya kwakho exesheni, oko kufanele kuthathelwe ingqalelo.
• Intlungu kunye nobuhlungu xa uchukumisa: Usenokuziva iintlungu ngexesha lokwabelana ngesondo okanye xa uchama.

Ukuba unenye okanye ngaphezulu kwezi mpawu, qiniseka ukuba ubona ugqirha. Iimpawu zomhlaza wangasese zisenokungabonakali kwasekuqaleni. Ke ngoko, kungcono ukuvavanywa ngokukhawuleza.

Nangona kunjalo, ezi mpawu zinokubonakala nakwezinye iimeko ezingezizo ezomhlaza. Ngoko ke, kubalulekile ukuba ungoyiki, kodwa ubone ugqirha ukuze uqiniseke ukuba olu tshintsho luyimpawu zomhlaza okanye enye into.

Zithini izizathu zomhlaza we-vulvar?

Kwi-vaginal cancer, iiseli ziqala ukwanda ngokungalawulekiyo. Ukuba azinyangwa, ezi seli zomhlaza zinokusasazeka ziye kwezinye iindawo zomzimba.

I-Vulvar Squamous Cell Carcinoma, uhlobo oluqhelekileyo, ibangelwa ziimeko ezimbini eziphambili:

• Usulelo lweHuman Papillomavirus (HPV): Olu lusulelo oluqhelekileyo oludluliselwa ngesondo (STI) olusasazeka ngokunxibelelana ngolusu nolusu. Ezinye iintlobo zeHPV zonyusa umngcipheko weentlobo ezahlukeneyo zomhlaza, kubandakanya umhlaza womlomo wesibeleko, umhlaza wempundu, kunye nomhlaza we-vulvar.
• I-Lichen Sclerosus: Le yimeko yolusu engapheliyo (ubomi bonke). I-Lichen Sclerosus inokubangela iimpawu ezifana nokudumba kwe-vulva, utshintsho lolusu, kunye nokurhawuzelelwa.

Zithini izinto ezibangela umngcipheko?

Kukho izinto ezininzi ezibangela umngcipheko wokufumana umhlaza we-vulvar:

• Ubudala: Umngcipheko wokuba nomhlaza we-vulvar uyanda njengoko iminyaka ikhula.
• Ukuvezwa kwi-HPV: Ayizizo zonke iintlobo ze-HPV ezibangela umhlaza, kodwa ezinye iintlobo zinokubangela utshintsho kwiiseli olunokukhokelela kumhlaza we-vulvar ekugqibeleni.
• Izifo zesikhumba se-Vulvar: Uphuhliso oluhambelana neemeko ezifana ne-'Lichen Sclerosus' lunokuqhubela phambili lube ngumhlaza we-vulvar.
• I-Vulvar intraepithelial neoplasia (VIN): I-VIN yimeko engaphambi komhlaza, ukuba ayinyangwa, inokukhula ibe ngumhlaza we-vulvar.
• Ukosuleleka yiNtsholongwane kaGawulayo (HIV): Xa inkqubo yomzimba yokuzikhusela ibuthathaka ngenxa yesifo esifana neHIV, kuba nzima ukuba umzimba ukwazi ukulwa nomhlaza.
• Ukutshaya: Ukutshaya kwandisa umngcipheko weentlobo ezininzi zomhlaza, kuquka nomhlaza we-vulvar.

Ufunyaniswa Njani Umhlaza WeVulvar?

Xa ubona ugqirha, uza kukubuza ngembali yakho yezonyango, izinto ezinobungozi kunye neempawu. Kudla ngokwenziwa uvavanyo oluninzi ukuze kufunyanwe isifo.

Uvavanyo lokufumanisa umhlaza wangasese

Olu vavanyo lungabandakanya:

• Uvavanyo lwePelvic: Ugqirha uza kuhlola i-vagina yakho ngamehlo aze ajonge naluphi na utshintsho olungaqhelekanga lolusu. Baza kufaka iminwe emibini egqunywe iiglavu, ethanjiswe ngethambiso kwi-vagina yakho baze bayihlole ngesandla ukuze babone amaqhuma okanye ezinye iimpawu zomhlaza. I-anus nayo ingahlolwa ngendlela efanayo. Basenokusebenzisa isixhobo esibizwa ngokuba yi-speculum ukwandisa i-vagina baze bajonge izinto ezingaqhelekanga.
• I-Pap Smear: Ngexesha lovavanyo lwe-pelvic, ugqirha wakho unokuthatha isampuli yeeseli aze azijonge ukuba azinazo na iinguqu zomhlaza. Isampuli ingavavanywa ne-HPV ukuze kubonwe ukuba unayo na i-HPV.
• I-Colposcopy: Ugqirha angasebenzisa isixhobo esikhanyiswe kakuhle nesikhulisayo esibizwa ngokuba yi-"colposcope" ukujonga i-vulva yakho, i-vagina, kunye ne-cervix (ilungu eliphakathi kwe-vagina kunye ne-uterus) ngokweenkcukacha. Angasebenzisa nesisombululo esikhethekileyo esinokubonisa iiseli ezingaqhelekanga kwaye zenze kube lula ukuzibona.
• I-Biopsy: Ugqirha usenokuthatha isampuli yezicubu ezingaqhelekanga aze ayivavanye ukuze abone ukuba kukho iiseli zomhlaza. I-biopsy yeyona ndlela yokwazi ngokuqinisekileyo ukuba unomhlaza wangasese.

Uvavanyo lokujonga ukuba umhlaza usasazekile na

Ukuba unomhlaza, ugqirha wakho uza kwenza uvavanyo olongezelelekileyo ukuze abone ukuba usasazeke ngaphaya kwe-vulva. Ukuba awunyangwanga, umhlaza we-vulvar ungasasazeka uye kwi-vagina okanye kwezinye izitho ezikufutshane, uye kwi-lymph nodes kwi-pelvis, kwaye ekugqibeleni uye egazini. Umhlaza we-metastatic kunzima kakhulu ukuwunyanga.

Ezi mvavanyo ziquka:

• Uvavanyo lweScope: Usenokwenza i-cystoscopy ukuze ubone ukuba umhlaza usasazeke kwi-urethra okanye kwisinyi. I-proctoscopy ijonga iiseli zomhlaza kwi-rectum okanye kwi-anus.
• Uvavanyo lwemifanekiso: Ii-X-ray, ii-CT scans, ii-MRIs, kunye nee-PET scans zinokubonisa ukuba umhlaza usasazeke ukusuka kwi-vulva ukuya kwezinye izicwili.
• I-Sentinel Node Biopsy: Ugqirha wakho unokususa i-lymph node (i-sentinel node) ekufutshane neqhuma lakho elinomhlaza ukuze ajonge iiseli zomhlaza. Kumhlaza we-vulvar, umhlaza udla ngokusasazeka uye kwi-sentinel lymph nodes kwindawo ye-groin.

Zithini izigaba zomhlaza we-vulvar?

Ukubeka inqanaba lomhlaza wangasese kunceda oogqirha baqonde ukuba umhlaza wakho usasazeke ngaphaya kwelungu lobufazi. Olu lwazi lunceda ekukhokeleni izigqibo zonyango. Kukho amanqanaba amane aphambili:

• Inqanaba lokuQala: Umhlaza we-vulvar wenqanaba lokuqala uphelela kwi-vulva okanye kwi-perineum (indawo ephakathi kwe-anus kunye ne-vagina). Wahlulwe waba yi-IA okanye i-IB, kuxhomekeke kubukhulu be-tumor kunye nokuba isasazeke kangakanani kwizicubu ezikufutshane.
• Inqanaba lesiBini: Ithumba (lalo naluphi na ubungakanani) lisasazeke liye kwi-urethra esezantsi, kwi-vagina esezantsi, okanye kwi-anus.
• Inqanaba lesi-3: Umhlaza usasazeke kwenye okanye ngaphezulu kwe-lymph nodes ezikufutshane. Oku kwahlulwe phakathi kwe-IIIA, IIIB, kunye ne-IIIC, kuxhomekeke kwinani kunye nobukhulu bee-lymph nodes ezibandakanyekayo.
• Inqanaba lesi-4: Umhlaza usasazeke kwinxalenye ephezulu ye-urethra, kwilungu lobufazi, okanye kwezinye iindawo zomzimba. Oku kwahlulwe nge-IVA kunye ne-IVB, kuxhomekeke ekubeni ukusasazeka kukufutshane okanye kude nelungu lobufazi.

Kubaluleke kakhulu ukubuza ugqirha wakho malunga nendlela inqanaba lomhlaza wakho eliza kuyichaphazela ngayo unyango lwakho.

Inyangwa njani iVulvar Cancer?

Unyango olufumanayo luya kuxhomekeka kwizinto ezifana nempilo yakho ngokubanzi, inqanaba lomhlaza, kunye nokuba umhlaza usandul' ukufunyaniswa okanye ubuyile. Ugqirha wakho uza kukuchazela isicwangciso sonyango esifanelekileyo sokuxilongwa kwakho.

Utyando

Unyango oluqhelekileyo lomhlaza wesibeleko lutyando.Injongo kukususa umhlaza ngokupheleleyo ngelixa ugcina ukusebenza kwakho ngokwesondo. Kukho iintlobo ezahlukeneyo zotyando:

• Utyando lweLaser: Oku kuquka ukusebenzisa umqadi welaser ukwenza amanxeba angenagazi kwizicubu okanye ukususa izilonda zomhlaza ezingacacanga.
• Ukususwa Kwendawo: Olu tyando lususa umhlaza kunye nenani elincinci okanye elikhulu lezicubu eziqhelekileyo ezijikeleze wona. Ngamanye amaxesha, ii-lymph nodes ezikufutshane ziyasuswa ukuze kuhlolwe iiseli zomhlaza, okanye ukuba kukho ubungqina bomhlaza, ezo lymph nodes ziyasuswa.
• Ukususwa kwe-Vulvectomy: Le nkqubo isusa inxalenye okanye yonke i-vulva yakho, mhlawumbi kunye nee-lymph nodes ezikufutshane. Ii-grafts zesikhumba zingasetyenziselwa ukubuyisela ulusu olususiweyo.
• Ukukhupha iPelvic Exenteration: Olu tyando lususa ikholoni yakho esezantsi, i-rectum, i-bladder, i-cervix, i-vagina, ama-ovari, kunye nama-lymph nodes akufutshane. Ugqirha wenza imingxunya ukuze umchamo kunye nendle ziphume zingene kwingxowa eziqokelela emzimbeni wakho.

Unyango lweMisebe

Unyango lwemitha lusebenzisa ii-X-reyi okanye ezinye iimitha ezinamandla aphezulu ukutshabalalisa iiseli zomhlaza. Unyango oluqhelekileyo lomhlaza wesibeleko yi-external beam radiation therapy (EBRT). I-EBRT isebenzisa umatshini ukuhambisa imitha eluswini lwakho ukuya kwindawo yomhlaza ekujoliswe kuyo.

Amaxesha amaninzi, izigulana zinikwa unyango lwemitha kunye ne-chemotherapy kunye (oku kubizwa ngokuba yi-chemoradiation). Usenokufumana unyango lwemitha ngaphambi kotyando lokunciphisa ithumba, okanye emva kotyando lokubulala naziphi na iiseli zomhlaza eziseleyo.

Unyango ngamakhemikhali

I-Chemotherapy isebenzisa amayeza ukuhlasela iiseli zomhlaza emzimbeni wonke. Ugqirha wakho angakunika iyeza njengenaliti emthanjeni okanye kwisihlunu, okanye unganikwa ipilisi ukuba uyithathe. Unganikwa nekhrimu onokuyithambisa ngqo kwisini sakho. Olu hlobo lwe-chemotherapy luhlasela umhlaza ngakumbi kwindawo ethile - oko kuthetha ukuba kuphela kwindawo ekuthethwa ngayo.

I-Cisplatin (i-Cisplatin - i-Platinol®, i-Platinol-AQ®) kunye ne-fluorouracil (i-Fluorouracil - i-Carac®) zezona ziyobisi ze-chemotherapy ezisetyenziswa kakhulu kumhlaza we-vulvar.

Unyango lwe-immunotherapy

I-Immunotherapy isebenza ngokunceda amajoni omzimba wakho ukuba aqaphele iiseli zomhlaza aze azilwe ngempumelelo. I-Imiquimod Cream (Aldara®, Zyclara®) liyeza eliqhelekileyo le-immunotherapy elisetyenziselwa ukunyanga umhlaza we-vulvar.

Luhlobo luni lolandelelwano endimele ndilulindele emva konyango lomhlaza we-vulvar?

Emva konyango, ugqirha wakho unokwenza uvavanyo ngamaxesha ahlukeneyo ukujonga imeko yakho nokuqinisekisa ukuba umhlaza awukabuyi.

Olu vavanyo ludla ngokuquka uvavanyo olufanayo olusetyenziswa ekuxilongeni nasekubekeni kwinqanaba lomhlaza wangasese.

Ingaba umhlaza wangasese uyingozi?

Ewe, inokwenzeka. Umhlaza we-vulvar onganyangwanga ubeka ubomi esichengeni. Ukunyanga umhlaza osasazeke kwiindawo ze-lymph okanye kwezinye iindawo zomzimba kunzima kakhulu kunokunyanga umhlaza ofunyenwe kwangethuba.

Nangona kusoloko kukho umngcipheko wokuba umhlaza ubuye emva konyango, abantu abaninzi abafumana unyango kwisigaba sokuqala sesi sifo baphila bengenawo umhlaza.

Lingakanani izinga lokusinda komhlaza wangasese?

Izinga lokusinda kweminyaka emihlanu kubantu abanomhlaza wangasese limalunga nama-70%. Nangona kunjalo, amazinga okusinda aphezulu ngakumbi xa isifo sifunyenwe kwaye sinyangwa kumanqanaba okuqala. Umzekelo, izinga lokusinda kweminyaka emihlanu kumhlaza wasekhaya (kwisitho sangasese) limalunga nama-86%. Xa umhlaza usasazekile, eli zinga lehla liye kuma-30%.

Nangona kunjalo, ukubikezela kwakho isifo kuxhomekeke kwizinto ezikhethekileyo ekuxilongweni kwakho, ezifana nemeko yakho yempilo kunye nendlela osabela ngayo kunyango. Buza ugqirha wakho ngeziphumo ezinokubakho ngokusekelwe kuxilongo lwakho.

Usasazeka ngokukhawuleza kangakanani umhlaza wangasese?

Uninzi lweentlobo zomhlaza we-vulvar zikhula kancinci, kwiminyaka emininzi. Iintlobo ezingaqhelekanga, ezifana ne-melanoma, zivame ukukhula kwaye zisasazeke ngokukhawuleza.

Ngaba umhlaza we-vulvar ungathintelwa?

Eyona ndlela ilungileyo yokunciphisa umngcipheko wakho kukufumana isitofu se-HPV ukuthintela usulelo lwe-HPV. E-United States, abantu abadala abaneminyaka engama-45 ubudala banokufumana isitofu se-Gardasil 9®, kuxhomekeke kumngcipheko wabo wokuvezwa yi-HPV. I-Cervarix® kunye ne-Gardasil® zii-HPV vaccines ezifumaneka kwamanye amazwe.

Ukuba uneempawu zomhlaza wangasese, bonana nogqirha ngokukhawuleza. Cwangcisa uhlolo rhoqo, kuquka novavanyo lomzimba ubuncinane kanye ngonyaka, ukuze kujongwe impilo yakho yabasetyhini.

Ndingazinyamekela njani?

Abantu abaninzi banokuziva beneentloni okanye beneentloni malunga notshintsho olukwilungu labo lobufazi. Kodwa ukuba nomhlaza wesibeleko akuthethi ukuba kufuneka uyeke ukusondelelana ngokomzimba. Musa ukuba neentloni ngokubuza ugqirha wakho ukuba ukuxilongwa kwakho kunokuchaphazela njani ubomi bakho bokwabelana ngesondo. Angakudibanisa nezixhobo ezinokuxhasa iimfuno zakho zomzimba nezeemvakalelo njengoko ujongana nolu nyango.

Umhlaza wesibeleko uqala phi?

Umhlaza wesini udla ngokuqala phezu kolusu olujikeleze isini sakho, nokuba yi-outer labia majora okanye inner labia minora. Akuqhelekanga ukuba ukhule nakwezinye iindawo zesini, njenge-Bartholin's gland kunye ne-clitoris.

Yintoni inqanaba lokuqala lomhlaza wesibeleko?

Isigaba I sisigaba sokuqala somhlaza we-vulvar. Kweli nqanaba, umhlaza awukasasazeki ngaphaya kwe-vulva okanye i-perineum. Isigaba IA Umhlaza we-vulvar uneesentimitha ezimbini (ubukhulu be-peanut) okanye mncinci. Awukasasazeki kwizicubu ezikufutshane ngaphezu kwe-millimeter enye (ubukhulu bencam yepensile). Isigaba IB Umhlaza mkhulu kwaye usenokuba usasazeke nzulu kwizicubu ezikufutshane.

Okokugqibela, eyona nto ibalulekileyo endinokuyithetha kuwe! (Umyalezo Wokuya Ekhaya)

Udlala indima enkulu kwimpilo yakho. Lumka kuwo onke amalungu omzimba wakho, kuquka nelungu lakho lobufazi. Ukwazi indlela ojongeka ngayo ngoku kuya kukunceda ubone utshintsho kamva. Ukuba ubona naluphi na utshintsho, yenza idinga lokubona ugqirha ngoko nangoko. Okwangoku, ungaze ulibale ukutyelela ugqirha wakho wezifo zabesifazane. Banokubona utshintsho olungaphambi komhlaza ngaphambi kokuba lube yingozi.

Khumbula, ungoyiki. Ukuqonda yeyona nto inamandla amakhulu. Awuwedwa.

I- Vaginitis, umhlaza wabasetyhini, i-HPV, iimpawu ze-vulvar, unyango lomhlaza, impilo yesini, ukuthintela umhlaza