Ake sifunde ngomdlavuza we-oropharyngeal. Kubalulekile ukuthi uzazi lezi zinto!

Ungase futhi ube nomphimbo obuhlungu, ushintsho ezwini lakho, noma ubunzima bokugwinya, akunjalo? Sivame ukunganaki lezi zimpawu ezincane. Sicabanga ukuthi umkhuhlane noma umphimbo obuhlungu nje. Kodwa-ke, ngezinye izikhathi lezi zimpawu ezibonakala zivamile zingabangelwa yinto engathi sína kakhulu. Namuhla sizokhuluma ngesihloko esidinga ukucatshangelwa okwengeziwe. Leso " umdlavuza we-Oropharynegal," umdlavuza owenzeka phakathi komphimbo, ngemuva komlomo wethu, lapho umphimbo uqala khona. Ungesabi, into ebaluleke kakhulu ukuqaphela lokhu.

Uyini lo mdlavuza ophakathi nomphimbo (Umdlavuza We-Oropharyngeal)?

Kalula nje, 'Umdlavuza We-Oropharyngeal' umdlavuza oqala lapho amangqamuzana aphakathi komphimbo wakho, abizwa ngokuthi 'i-Oropharynx' , ekhula ngendlela engajwayelekile futhi abe umdlavuza. 'I-Oropharynx' ihlanganisa ingemuva lomlomo wakho, isisekelo solimi lwakho, amathonsi, kanye nolwanga oluthambile phezulu komphimbo wakho. Le ndawo ikhiqiza amathe, igcina umlomo wakho nomphimbo wakho umanzi, futhi ikusiza ukuthi ugaye ukudla okudlayo. Odokotela banezindlela ezahlukene zokwelapha lo mdlavuza. Kodwa-ke, ngezinye izikhathi ungaphinde 'ubuye' ngemva kokwelashwa. Nakuba lo mdlavuza ungenakuvinjelwa ngokuphelele, unganciphisa ingozi yakho yokuba nawo ngokunakekela ezinye izinto. Isibonelo, kubaluleke kakhulu ukuzivikela egciwaneni le -'Human Papillomavirus (HPV)' , ungabhemi, futhi ulawule ukusetshenziswa kotshwala.

Sivame kangakanani lesi simo?

Eqinisweni, 'umdlavuza we-Oropharyngeal ' uhlobo lomdlavuza olungavamile kakhulu. Isibonelo, ngokusho kwe-American Cancer Society, cishe abantu abangu-53,000 e-United States batholakala benalo mdlavuza minyaka yonke. Kodwa-ke, uma sithatha umdlavuza webele, uthinta abantu abangaphezu kuka-290,000 minyaka yonke. Ngakho-ke, uma kuqhathaniswa nalokho, lokhu kuphansi kancane. Lesi simo sitholakala naseSri Lanka, kodwa asivamile kangako uma siqhathaniswa nezinye izinhlobo zomdlavuza.

Ingabe kunezinhlobo ezahlukene `zomdlavuza we-oropharyngeal`?

Yebo, kunezinhlobo eziningana zalokhu.

• Umdlavuza wamathoni uhlobo oluvame kakhulu lomdlavuza.
• Ngaphezu kwalokho, lo mdlavuza ungavela nasezinsinini, phansi komlomo, nakwezinye izingxenye ze-oropharynx.

Ziyini izimpawu 'zomdlavuza we-ophoryngeal'?

Lokhu kubaluleke kakhulu, ngoba izimpawu zalo mdlavuza ngezinye izikhathi zingafana nezimpawu zezinye izimo ezincane. Ngakho-ke, kubaluleke kakhulu ukuqaphela lokhu.

• Umphimbo obuhlungu ongapheli (` Pharyngitis` ) : Umphimbo obuhlungu ongapholi.
• Ubunzima noma ubuhlungu ekugwinyeni (`I-Dysphagia : Umuzwa wokungakwazi ukugwinya ukudla.
• Ubunzima bokuvula umlomo ngokuphelele (`Trismus`) noma ubunzima bokuhambisa ulimi.
• Ukwehlisa isisindo okungachazeki : Uma wehlisa isisindo ngaphandle kokuzama.
• Ukushintsha kwezwi : Ukushoshozela noma ushintsho ezwini olungathuthuki.
• Ubuhlungu bendlebe : Ubuhlungu bendlebe obungapheli (ikakhulukazi ohlangothini olulodwa).
• Iqhubu ngemuva komphimbo noma emlonyeni : Iqhubu ongalizwa noma ulibone.
• Iqhubu entanyeni : Ukuvuvukala noma iqhubu entanyeni.
• Ukukhwehlela igazi .
• Ibala elimhlophe olimini noma ngaphakathi emlonyeni : Uma ibala lingasuki ngemva kwesikhathi esithile.

Okubalulekile: Uma unesinye noma ngaphezulu kwalezi zimpawu, ungakhathazeki, ngokuqinisekile umdlavuza. Kodwa-ke, uma lezi zimpawu ziqhubeka isikhathi esingaphezu kwamasonto amabili, kufanele nakanjani ubone udokotela ukuze akunike iseluleko.

Yiziphi izimbangela 'zomdlavuza we-Ophoryngeal'?

Kunezizathu eziningana eziyinhloko zokukhula kwalo mdlavuza.

• Ukutheleleka kwe -Human Papillomavirus ( HPV ) : Lesi yimbangela eyinhloko esitholakele. Igciwane le-HPV lithinta izakhi zofuzo ezilawula ukukhula kwamaseli emlonyeni nasemphinjeni wethu. Lokhu kungabangela ukuba amaseli akhule ngokushesha futhi abe umdlavuza, noma amathumba.
• Ukusetshenziswa kukagwayi : Ukubhema ugwayi, ugwayi, kanye nogwayi ohlafunwayo kungalimaza amangqamuzana asemphinjeni wakho. Lo monakalo ubangela ukuthi amangqamuzana ahlukane ngaphezu kokuvamile. Lokhu kwandisa amathuba okuba namaphutha e-DNA, okungaholela ekukhuleni kwamangqamuzana omdlavuza.
• Utshwala : Ukuphuza utshwala kungalimaza amangqamuzana emphinjeni wakho futhi kuthinte ikhono lakho lokulungisa i-DNA. Ukuphuza utshwala ngenkathi ubhema kwandisa ingozi nakakhulu.

Yiziphi izici eziyingozi zokuthola 'umdlavuza we-oropharyngeal'?

Kunezici eziningana ezandisa ingozi yokuthola lo mdlavuza:

• Ukutheleleka kwe-HPV , ikakhulukazi uhlobo lwe-HPV 16.
• Ukuba nomlando wokusebenzisa ugwayi neminye imikhiqizo kagwayi.
• Ukuphuza utshwala ngokweqile.
• Uma uke waba nomdlavuza wekhanda noma wentamo ngaphambilini.
• Uma uke welashwa ngemisebe endaweni yekhanda noma entanyeni.

Odokotela bayixilonga kanjani i-Oropharyngeal Cancer?

Uma uya kudokotela, uzoqala ngokukubuza ngezimpawu zakho, umlando wakho wezokwelapha (njengokuthi wake waba nomdlavuza yini esikhathini esidlule, ukuthi wake welashwa ngemisebe), kanye nendlela yakho yokuphila (njengokuthi uyabhema noma uyaphuza utshwala). Ngemuva kwalokho, bazohlola ngokucophelela umlomo wakho, umphimbo, kanye nentamo. Bazozwa nanoma yiziphi izigaxa entanyeni yakho. Ngezinye izikhathi, bangasebenzisa isibuko, isibani, noma ipayipi elincane elinekhamera (i-'fiberoptic scope') ukuhlola ingaphakathi lomlomo wakho kanye nomphimbo.

Hlobo luni lokuhlolwa okwenziwayo ngalokhu?

Odokotela bangenza izivivinyo eziningana ukuqinisekisa lesi sifo:

• I-Endoscopic Biopsy : Lokhu kuhilela ukufaka ithubhu elincane neliguquguqukayo (i-endoscope) ngomlomo, kusetshenziswa ikhamera encane ekugcineni ukuze kuthathwe ingxenye encane yezicubu endaweni esolisayo. Izicubu zibe sezihlolwa ngaphansi kwe-microscope elabhorethri ukuze kubonakale ukuthi kukhona yini amangqamuzana omdlavuza noma ukutheleleka kwe-HPV.
• `I-Computed Tomography (CT) Scan` : Lokhu `CT` scan kungalinganisa ubukhulu bomdlavuza futhi kubone ukuthi ususakazekele kwezinye izindawo. Ngezinye izikhathi lokhu kungenziwa kanye ne-`Positron Emission Tomography (PET) Scan`.
• Iskeni se-Magnetic Resonance Imaging (MRI) : Lesi skeni se-MRI singakhiqiza izithombe ezinemininingwane zezicubu ezithambile zomzimba, ikakhulukazi amathonsi kanye nesisekelo solimi. Lokhu kungasiza futhi ekunqumeni usayizi wesimila.

Ingabe zikhona izigaba `zomdlavuza we-oropharyngeal`?

Yebo, impela. Odokotela bahlela ukwelashwa futhi banikeza umbono wesimo esibikezelwayo ngokusekelwe esigabeni somdlavuza (Cancer Staging). Kunezigaba ezine eziyinhloko zomdlavuza we-Oropharyngeal (Isigaba I kuya ku-IV). Lezi zigaba zingahluka kancane kuye ngokuthi unegciwane le-HPV noma cha. Ngaphezu kwalokho, ubukhulu besimila, noma ngabe sisakazekele kuma-lymph node aseduze, noma ezingxenyeni ezikude zomzimba, nakho kudlala indima ekunqumeni isigaba.

Iphathwa kanjani i-'Oropharyngeal Cancer'?

Odokotela basebenzisa kakhulu izindlela ezifana nokuhlinzwa, ukwelashwa ngemisebe, i-chemotherapy, ukwelashwa ngemithi okuqondiwe, noma i-immunotherapy ukwelapha lo mdlavuza. Umgomo wabo oyinhloko ukususa amangqamuzana omdlavuza ngendlela ethinta ikhono lakho lokukhuluma nokugwinya kancane ngangokunokwenzeka.

Ukuhlinzwa

Uma umdlavuza umncane futhi ungakasabalali kwezinye izindawo, ungasuswa ngokuhlinzwa.

• `Ukuhlinzwa Kwerobhothi Okuguquguqukayo (TORS)`: Lena inqubo entsha yokuhlinzwa engangenisi kakhulu eyenziwa ngomlomo. Ingasusa umdlavuza ekujuleni komphimbo, ezindaweni okunzima ukuzifinyelela. Ngenxa yokuthi isebenzisa ubuchwepheshe berobhothi, asikho isidingo sokwenza i-incision enkulu entanyeni noma ukususa i-uvula. Ngokuvamile futhi ayidingi i-'tracheostomy' (ukufakwa kwepayipi lokuphefumula).
• Izinzuzo ze-`TORS`:
• Isikhathi sokuhlala esibhedlela ngemva kokuhlinzwa sifushane.
• Ungalulama ngokushesha.
• Kunomonakalo omncane ezicutshini nasemisipheni ezungezile okusiza ekugwinyeni.
• Zimbalwa izinkinga zesikhathi eside zokukhuluma nokugwinya.
• Imiphumela emibi/izinkinga ze-`TORS`:
• Ukopha okungavamile (`Ukopha`).
• Ukudla noma uketshezi olungena emaphashini (`Ukuphefumula`).
• Ukungakwazi ukuthola umoya-mpilo owanele emaphashini (Respiratory Compromise).
• Ubunzima bokugwinya (i-Dysphagia).
• Ubunzima bokuhlafuna ukudla.
• Ukulahlekelwa yizwi unomphela noma ubunzima bokukhuluma.
• Kudingeka ukuhlinzwa kwe-tracheostomy ngenxa yobunzima bokuphefumula.
• Izinguquko ekubukekeni kobuso.

Abanye abantu bangadinga ukwelashwa okwengeziwe ngemva kokuhlinzwa kwe-TORS, njengokuhlinzwa okwakha kabusha, ukwelashwa kokukhuluma, noma ukwelashwa kokudla okunempilo, ukuze kulawulwe imiphumela emibi.

Ukwelashwa ngamakhemikhali

Udokotela wakho angakunikeza i-chemotherapy eyedwa noma ngokwelashwa ngemisebe. Ezimweni lapho ukuhlinzwa kungenzeki, isibonelo uma umdlavuza mkhulu kakhulu ukuba ungasuswa ngokuhlinzwa, lezi zindlela zokwelapha ezimbili zinganikezwa ndawonye. Futhi:

• Uma umdlavuza ususakazeke usuka e-oropharynx uye kwezinye izingxenye zomzimba.
• Cwilisa isimila ngaphambi kokuhlinzwa.
• Lokhu kwelashwa kusetshenziselwa nokubhubhisa noma yimaphi amangqamuzana omdlavuza angase asale ngemva kokuhlinzwa.
• Imiphumela emibi ye-chemotherapy kanye ne-radiation therapy: Uma lezi zindlela zokwelapha ezimbili zinikezwa ndawonye, ​​​​ikhono lakho lokukhuluma lingathinteka. Lokhu kungenxa yokuthi ukwelashwa nge-radiation emphinjeni kungalimaza izicubu ezinempilo, kwenze kube nzima ukukhuluma nokugwinya. Lokhu kungadinga ukwelashwa okukhethekile.

Ukwelashwa Okuqondiwe

Lawa ngamaprotheni akhethekile enziwa elebhu (ama-antibody e-monoclonal). Lokhu kwelashwa kusebenza ngokuvimbela iphrotheni esiza amangqamuzana omdlavuza ukuthi ahlukane, akhule futhi asakazeke.

• Imiphumela emibi: Lokhu kuyahlukahluka kuye ngohlobo lomuthi. Isibonelo, imiphumela emibi evamile yomuthi i-`Cetuximab` ingafaka:
• Izimpawu zokutheleleka njengomkhuhlane kanye nokubanda.
• Ukucasuka kwesikhumba, ukulunywa.
• Isiyezi.
• Umlomo owomile.
• Ukungagayeki kahle kokudla.
• Izinguquko zesikhumba nezinzipho.

Ukwelashwa nge-immunotherapy

Lokhu ukwelashwa kokuqala uma umdlavuza ubuya noma ususakazekile. I-immunotherapy isebenza ngokusiza amasosha omzimba wakho ukuthi athole futhi abhubhise amangqamuzana omdlavuza. I-Pembrolizumab (Keytruda®) kanye ne-Nivolumab (Opdivo®) yimithi emibili enjalo.

• Okuqhamuka uma udla imishanguzo:Esikhathini esiningi, imiphumela emibi incane kakhulu.
• Ukukhathala.
• Ukuqhuma okubuhlungu.
• Uhudo.
• Isicanucanu nokuhlanza.

Ingabe umdlavuza we-Oropharyngeal ungavinjelwa?

Nakuba kungenakuvinjelwa ngokuphelele, kunezinto ongazenza ukuze unciphise ingozi yakho:

• Gwema ukutheleleka nge-Human Papillomavirus (HPV). Ukuba nabalingani abaningi bocansi kanye/noma ukuzibandakanya ocansini lomlomo kwandisa ingozi yakho yokuthola i-HPV. Buza udokotela wakho ngomuthi wokugomela i-HPV.
• Ungaqali ukubhema. Uma ubhema, yeka. Ukuqhubeka nokubhema kwandisa kakhulu ingozi yakho yokuthola umdlavuza wesibili womlomo, umphimbo, i-larynx, noma amaphaphu. Cela usizo kudokotela wakho ukuyeka.
• Ungaphuzi utshwala njalo noma ngobuningi. Utshwala buyandisa imiphumela kagwayi ebangela umdlavuza. Ngakho-ke, kubaluleke kakhulu ukugwema ukusebenzisa kokubili ndawonye.
• Yidla ukudla okunempilo nokulinganiselayo. Vivinya umzimba njalo.
• Bona udokotela wakho nodokotela wamazinyo ngesikhathi esijwayelekile. Bangahlola umlomo wakho nomphimbo wakho futhi bathole noma yiziphi izinguquko kusenesikhathi.

Kwenzekani uma nginalesi simo?

Uma unomdlavuza we-oropharyngeal, kuzodingeka ukuthi uhlolwe njalo ukuze kuhlolwe ukuthi awuphinde ubuye yini noma umdlavuza omusha. Uma uphuza utshwala noma ubhema, khuluma nodokotela wakho mayelana nokuyeka. Ukubhema nokusebenzisa utshwala kwandisa ingozi yokubuya komdlavuza noma umdlavuza omusha.

Ingabe 'umdlavuza we-oropharyngeal' ungelapheka?

Odokotela bangayilapha le cancer. Kodwa-ke, ingabuya ngisho nangemva kokwelashwa okuphumelelayo. Ngokusho kwe-American Cancer Society, cishe abantu abangu-70% abanomdlavuza we-oropharyngeal basaphila eminyakeni emihlanu ngemva kokuxilongwa. Odokotela bathole izici eziningana ezithinta indlela lesi sifo esiqhubeka ngayo:

• Njengezinhlobo eziningi zomdlavuza, imiphumela iba ngcono uma umdlavuza utholakala futhi welashwa ngaphambi kokuba usabalale.
• Abantu abathola umdlavuza ngenxa yokutheleleka yi-HPV banemiphumela engcono kunalabo abangenalo igciwane.
• Abantu abangasebenzisi ugwayi bathola imiphumela engcono kunalabo abayisebenzisayo.

Ngizinakekela kanjani?

Indlela engcono kakhulu ongazinakekela ngayo yile:

• Gwema ugwayi. Uma ubhema, zama ukuyeka.
• Gwema utshwala.
• Uma une-HPV, khuluma nodokotela wakho mayelana nokuthola umuthi wokugomela ukuze uvikeleke ezifweni ezintsha.
• Cela usizo. Ukwelashwa kwakho kungenza kube nzima ukukhuluma noma ukudla. Kodwa-ke, kunezindlela zokwelapha ezikhethekile nezinhlelo zokusiza ukulawula le miphumela emibi.
• Bona udokotela njalo.Qaphela impilo yakho iyonke nokuthi umdlavuza uphinde wavela yini.

Kufanele ngimbone nini udokotela? Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Kubaluleke kakhulu ukubona udokotela wakho njalo ngemva kokwelashwa. Kungase kudingeke ukuthi uhlolwe njalo impilo yakho yonke. Ngokuvamile, uzocelwa ukuthi uhlolwe njalo emavikini angu-6-12 ngonyaka wokuqala ngemva kokwelashwa, njalo ezinyangeni ezi-3 ngonyaka wesibili, njalo ezinyangeni ezi-3-4 ngonyaka wesithathu, bese kuba njalo ezinyangeni ezi-6 ngemva kwalokho. Uma uke wahlinzwa ukuze kususwe izimila ezinomdlavuza, kufanele uye ekamelweni lezimo eziphuthumayo ngokushesha uma unezimpawu zokutheleleka . Lezi zimpawu zifaka:

• Imfiva.
• Uma indawo yokuhlinzwa ibomvu futhi ibuhlungu.
• Uma kukhona uketshezi olufana nobovu oluvela endaweni yokuhlinzwa.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ungabuza le mibuzo uma uvakashela udokotela:

• Uphi ngempela umdlavuza wami?
• Ingabe umdlavuza wami usakazeke? Ukusiphi isigaba? Kusho ukuthini lokho?
• Yiziphi ezinye izivivinyo okudingeka ngizenze?
• Obani odokotela eqenjini lami lokwelapha?
• Ingabe umdlavuza wami uhlobene ne-Human Papillomavirus (HPV)?
• Yiziphi izinguquko okudingeka ngizenze endleleni yami yokuphila?
• Luyini uhlelo lwami lokwelashwa? Yiziphi zonke izinketho zami?
• Angakanani amathuba okuba isifo sami selapheke?
• Iyini imiphumela emibi yokwelashwa?
• Kwenzekani uma umdlavuza ubuya? Yiziphi izinketho zami?

Ingabe "umdlavuza we-oropharyngeal" ufana "nomdlavuza womlomo"?

Cha. Nakuba zombili ziyizinhlobo zomdlavuza wekhanda nowentamo, zihlukile.

• Umdlavuza womlomo umdlavuza okhula emlonyeni wakho noma emlonyeni wakho. Ungavela ngaphambili kolimi lwakho, ngaphakathi kwezihlathi zakho, ngaphambili kophahla lomlomo wakho, naphansi komlomo wakho.
• Umdlavuza we-Oropharyngeal umdlavuza okhula e-oropharynx yakho, ohlanganisa amathonsi, umhlane wolimi, ulwanga oluthambile, izinhlangothi kanye nomhlane womphimbo. Lokhu kwakheka ngamaseli aqinile azungeze umlomo nomphimbo.

Umdlavuza we-Oropharyngeal uhlobo olungavamile lomdlavuza wekhanda nentamo. Nakuba odokotela bengawelapha, ungabuya ngemva kokwelashwa. Ngokuvamile, lo mdlavuza ubangelwa ukuchayeka ku-Human Papillomavirus (HPV). Abantu abasebenzisa ugwayi futhi baphuza utshwala nabo basengozini enkulu yokuthola lo mdlavuza.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ngakho ake sikukhumbuze amaphuzu abalulekile kulokho esikhulume ngakho.

• Umdlavuza we-Oropharyngeal umdlavuza owenzeka engxenyeni ephakathi yomphimbo. Ukutheleleka nge-HPV, ukubhema, kanye nokusetshenziswa kotshwala yizona zinto eziyinhloko ezibangela ingozi.
• Umphimbo obuhlungu oqhubekayo, ubunzima bokugwinya, izinguquko zezwi, amaqhubu entanyeniQaphela izimpawu ezinjengokuthi: Uma lezi ziqhubeka isikhathi esingaphezu kwamasonto amabili, funa iseluleko sezokwelapha.
• Kunezindlela eziningana zokwelapha. Ukutholwa kusenesikhathi kubaluleke kakhulu.
• Ingozi ingancishiswa ngezinto ezifana nomjovo we-HPV, ukugwema ukubhema, kanye nokuphuza utshwala ngokweqile.
• Uma unesifo esifana nalesi noma unemibuzo, ungesabi ukubona udokotela bese ukhuluma naye. Bazokusiza.

Khumbula, ukuqaphela kuyindlela engcono kakhulu yokuzivikela. Kufanelekile ukunakekela impilo yakho.