Okudingeka ukwazi ngomdlavuza we-Ampullary

Uke waphawula muva nje ukuthi amehlo akho nesikhumba sakho kuyashintsha kancane kube phuzi? Noma, ingabe uke wehla isisindo ngokuzumayo ngaphandle kwesizathu esicacile? Nakuba lezi yizinto ezivamile esizicabanga ngezinye izikhathi njengokunganaki kakhulu, lezi kungaba izimpawu zokuqala zesifo esingavamile kodwa esibi esibizwa ngokuthi i-Ampullary Cancer. Ungesabi uma uzwa leli gama. Into ebaluleke kakhulu ukuba nolwazi oluphelele nganoma yisiphi isifo. Ngakho-ke, namuhla sizokhuluma ngokuthi iyini i-Ampullary Cancer, ukuthi ikhula kanjani, yiziphi izimpawu, kanye nezindlela zokwelapha ngendlela elula ongayiqonda.

Uyini umdlavuza we-Ampullary?

Ukuze siqonde lokhu, sidinga kuqala ukwazi ngendawo encane yomzimba wethu. Sinezitho ezimbili emzimbeni wethu ezibizwa ngokuthi i-pancreas nesibindi. Zombili lezi zikhipha ujusi okhethekile osisiza ekugayeni ukudla kwethu. Cabanga ukuthi lawa majusi amabili ayahlangana futhi afike endaweni eyodwa, njengendawo lapho kuhlangana khona imigwaqo emibili. Bese kuthi kusukela lapho, wonke lawa majusi ahlangane futhi angene emathunjini ethu amancane (i-duodenum).

Kwezokwelapha, sibiza umgodi omncane lapho lowo mphunga uqoqa khona i-ampulla ye-Vater .

Ngakho-ke, lapho amangqamuzana omdlavuza eqala ukukhula kule ndawo ebizwa ngokuthi i-ampulla ye-Vater , siyibiza ngokuthi i-ampullary carcinoma . Lolu uhlobo lomdlavuza olunamandla kakhulu. Futhi, ngoba indawo lapho lukhula khona iseduze kakhulu nezitho ezibalulekile njengesibindi kanye ne-pancreas, umdlavuza unethuba elikhulu lokusabalala kulezo zitho. Ngakho-ke, indlela engcono kakhulu yokuthola imiphumela emihle ukususa lo mdlavuza ngokuhlinzwa ngaphambi kokuba usabalale.

Sivame kangakanani lesi sifo?

Empeleni lokhu kungumdlavuza ongavamile kakhulu. Ngaphansi kwe-1% yazo zonke izinhlobo zomdlavuza ohlelweni lwethu lokugaya ukudla (indlela yokugaya ukudla) kubikwa ukuthi ziwumdlavuza we-ampullary. Ngakho-ke, lesi akusona isifo esithinta wonke umuntu.

Ziyini izimpawu? Sikubona kanjani lokhu?

Into eyingqayizivele kakhulu ngalo mdlavuza ukuthi ubonisa izimpawu ezigabeni zokuqala. Phakathi kwazo, uphawu oluyinhloko noluvame kakhulu yi -jaundice . Lokhu kusho ukuthi amhlophe emehlweni nasesikhumbeni aphenduka aphuzi.

Ngaphezu kwalesi sibonakaliso esiyinhloko, kunezinye izimpawu eziningana ezingabonakala. Ake sizibheke ngendlela elula ukuyiqonda.

Kungani lolu hlobo lomdlavuza lukhula?

Eqinisweni, ochwepheshe abakakwazi ukusho ngqo ukuthi kungani lo mdlavuza we-ampullary ukhula. Kodwa siyazi ukuthi wonke umdlavuza ukhula uma kukhona ushintsho (ukuguqulwa) ku-DNA olulawula ulwazi lwezakhi zofuzo emaseli omzimba wethu. Ngale ndlela, amangqamuzana angajwayelekile anezinguquko ze-DNA aqala ukuhlukana ngokushesha nangokungalawuleki. Isimila somdlavuza sakhiwa lapho amangqamuzana amaningi ekhula ndawonye ngaphandle kokulawulwa.

Ochwepheshe basacwaninga ngezinguquko ze-DNA ezihlobene nalo mdlavuza. Ngokusekelwe kulolo lwazi, ukwelashwa okuphumelelayo kakhulu kungatholakala esikhathini esizayo.

Izinto Eziyingozi

Kunezici eziningana ezandisa ingozi yokuthola lo mdlavuza:

• Abantu abangaphezu kweminyaka engama-70 ubudala: Ingozi iyanda njengoba iminyaka ikhula.
• Ukuba yindoda: Lo mdlavuza uvame kakhulu kwabesilisa kunabesifazane.
• Ezinye izimo zofuzo: Ezinye izimo zofuzo zingandisa ingozi yomdlavuza. Isibonelo, izimo ezifana ne-Familial Adenomatous Polyposis (FAP) kanye ne-Lynch syndrome.

Udokotela usithola kanjani lesi sifo ngokunembile? (Ukuxilongwa)

Ngokuvamile, uma umuntu eya kudokotela onamehlo aphuzi nesikhumba (i-jaundice), kuvela izinsolo bese kuqala ukuhlolwa. Kwenziwa izivivinyo eziningana ukuqinisekisa lesi sifo.

• Ukuhlolwa kwegazi nomchamo: Lokhu kuhlola amazinga amakhemikhali emzimbeni ahlotshaniswa namaseli omdlavuza, abizwa ngokuthi ama-tumor markers.
• Ukuhlolwa Kwezithombe: Lokhu kusetshenziselwa ukuthatha izithombe zezitho zomzimba ngaphakathi komzimba ukuhlola umdlavuza. Ukuhlolwa okufana ne-'CT scan', 'i-Ultrasound scan' kanye ne-'MRCP' kuyasetshenziswa kulokhu.
• Ukuhlolwa Kwe-Endoscopic: Lokhu kuhilela ukufaka ithubhu elide, elincane (i-endoscope) elinekhamera exhunywe ngomlomo wakho ukuze ubheke umdlavuza. I-endoscopy ephezulu kanye ne-ERCP (Endoscopic Retrograde Cholangiopancreatography) yizivivinyo ezimbili ezinjalo. Uzonikezwa i-anesthesia phakathi nalezi zivivinyo, ngakho ngeke uzwe ubuhlungu.
• Ukuhlolwa kwebhayoloji:Lokhu kuwukuphela kokuhlolwa okungaqinisekisa ngokuphelele ukuthi umdlavuza ungowomdlavuza. Ngesikhathi se-endoscopy, kuthathwa ingxenye encane kakhulu yezicubu endaweni esolisayo bese ihlolwa elabhorethri ukuqinisekisa ukuthi akhona yini amangqamuzana omdlavuza.

Iyini i-stage yomdlavuza?

Uma lesi sifo sesitholakele, udokotela uzonquma ukuthi umdlavuza ususakazeke kangakanani. Lokhu kubizwa ngokuthi ukwakheka kwesigaba. Ukwelashwa kunqunywa ngokusekelwe kulesi sigaba. Umdlavuza otholakale ezigabeni zokuqala cishe uzophulukiswa.

Kubaluleke kakhulu ukuqonda kahle isigaba somdlavuza wakho nokuthi sizothinta kanjani ukwelashwa kwakho ngokubuza udokotela wakho.

Yiziphi izindlela zokwelapha?

Kunezindlela eziningana zokwelapha umdlavuza we-ampullary.

• Inqubo ye-Whipple:Lokhu kuyindlela yokuhlinzwa evame kakhulu futhi evame kakhulu yalolu hlobo lomdlavuza. Kungumsebenzi oyinkimbinkimbi kakhulu futhi omkhulu. Kulokhu, akususi umdlavuza ngokwawo kuphela, kodwa futhi nezindawo ezizungezile lapho amangqamuzana omdlavuza kungenzeka ukuthi asakazeke khona (i-gallbladder, ingxenye ye-bile duct, ingxenye yamathumbu amancane, kanye nekhanda le-pancreas).
• Ukuhlinzwa Kwe-Endoscopic: Uma umdlavuza usesigabeni sokuqala, ngezinye izikhathi kungenzeka ukususa umdlavuza usebenzisa i-endoscope.
• Ukwelashwa ngamakhemikhali: Lokhu kuhilela ukunikeza umzimba imithi enamandla ebulala amangqamuzana omdlavuza. Lokhu kwelashwa kunikezwa ukubulala noma yimaphi amangqamuzana omdlavuza asele ngemva kokuhlinzwa noma ukulawula ukukhula komdlavuza lapho ukuhlinzwa kungenzeki.
• Ukwelashwa Ngemisebe: Yilapho kusetshenziswa khona imisebe yamandla enamandla ukubhubhisa amangqamuzana omdlavuza. Ngezinye izikhathi lokhu kwelashwa kunikezwa kanye ne-chemotherapy ukuze kuncishiswe isimila ngaphambi kokuhlinzwa noma kubhujiswe noma yimaphi amangqamuzana asele ngemva kokuhlinzwa.
• Ukunakekelwa Kokuphulukisa: Lokhu kuyindlela yokwelapha egxile ekunciphiseni izimpawu kunokwelapha lesi sifo. Isibonelo, i-stent ingafakwa emgudwini we-bile ovalekile ukuze ivuleke. Lokhu kungasiza ekunciphiseni izimpawu ezifana ne-jaundice kanye nokulunywa, okunganikeza impumuzo ebalulekile.

Ingabe lo mdlavuza ungalapheka ngokuphelele?

Ukuphela kwendlela yokwelapha lo mdlavuza ngokuphelele ukuwususa ngokuphelele ngokuhlinzwa. Lokhu cishe kuzophumelela uma umdlavuza utholakala usesesigabeni sawo sokuqala.

Ngezinye izikhathi umdlavuza uyanyamalala ngokuphelele ngemva kokuhlinzwa. Kodwa-ke, ungaphinde ubuye ngemva kwesikhathi esithile (umdlavuza ophindaphindayo). Ngakho-ke, ngisho nangemva kokuhlinzwa, kubaluleke kakhulu ukuqhubeka nokuya kudokotela ukuze uyohlolwa kanye nemitholampilo njengoba kunconywa. Ingozi yokuphindaphinda komdlavuza iphakeme kakhulu phakathi neminyaka emihlanu yokuqala.

Ingabe ikhona indlela yokuvimbela lokhu?

Ngeshwa, izici eziyingozi (ubudala, izakhi zofuzo) ezibangela lo mdlavuza akuyona into esingayilawula. Ngakho-ke, ayikho indlela ethile yokuwuvimbela. Kodwa-ke, uma unesifo sofuzo njenge-FAP noma i-Lynch syndrome, udokotela wakho angancoma ukuthi uhlolwe njalo. Lokhu kungasiza ekutholeni umdlavuza kusenesikhathi.

Kuvamile ukuzizwa ukhungathekile futhi ushaqekile uma ufunda ngomdlavuza. Khuluma ngokukhululekile nodokotela wakho nomndeni wakho ngemibuzo yakho, ukwesaba, kanye nokungabaza. Ukuthola ulwazi olufanele, ukwelashwa okufanele, kanye nokusekelwa ngokomzwelo kuzoba amandla amakhulu kulolu hambo.