Uyazazi yini ngomdlavuza wendunu? Ake sixoxe ngakho!

Ingabe ngezinye izikhathi uzwa ukulunywa njalo eduze kwendunu, noma igazi elincane uma ukhipha indle? Kuyadumaza ngempela ukukhuluma ngalezi zinto nanoma ubani, akunjalo? Kodwa lezi zingase zingabi izinto ezilula njalo. Namuhla, ake sixoxe ngesifo esibizwa ngokuthi umdlavuza wendunu. Lokhu kuyinto sonke okudingeka siyiqaphele.

Uyini umdlavuza wendunu?

Kalula nje, umdlavuza wendunu umdlavuza okhula ezicutshini zendunu yakho, noma ulwelwesi lomsele wakho wendunu. Uyazi, umsele wendunu yipayipi elixhumanisa indunu yakho (indawo lapho kuphuma khona ukungcola) ne-rectum yakho (ingxenye ephansi kakhulu yesistimu yakho yokugaya ukudla). Ukuze kube sobala, indle yakho iphuma emzimbeni wakho ngaleli payipi. Ingxenye engcono kakhulu ukuthi uma lo mdlavuza utholakala futhi welashwa kusenesikhathi, ungelapheka ngokuphelele.

Ingabe zikhona izinhlobo zomdlavuza we-rectal?

Yebo, kunezinhlobo ezimbili eziyinhloko zomdlavuza we-rectal.

• I-Squamous Cell Carcinoma: Lolu uhlobo oluvame kakhulu lomdlavuza we-rectal. Kodwa-ke, luhlukile kumdlavuza wesikhumba, okhula engxenyeni ephezulu yesikhumba.
• I-Adenocarcinoma: Lolu futhi uhlobo oluhlukile.

Ingabe lesi yisifo esivamile?

Cha, umdlavuza we-rectal empeleni awuvamile kangako. Cabanga ngalokhu: Ngokusho kwe-American Cancer Society, abantu ababalelwa ku-9,000 kuphela e-United States abazotholakala benalesi sifo ngo-2023. (Lokhu kufaka phakathi umdlavuza we-rectal, umdlavuza we-anorectal, kanye nomdlavuza we-anal.) Kodwa-ke, balinganisela ukuthi kuzoba nabantu ababalelwa ku-153,000 abatholakale benomdlavuza we-colon. Ngakho-ke ungabona ukuthi lokhu kuphansi kakhulu.

Ziyini izimpawu zalokhu?

Izimpawu zomdlavuza we-rectal ngezinye izikhathi zingase zizwakale njengezimo ezijwayelekile. Isibonelo, ukulunywa okuqhubekayo endunu. Ezinye izimpawu zingafaka:

• Ukopha okuvela e-rectum , ikakhulukazi ngesikhathi sokuhamba kwamathumbu.
• Ukuzwa okuthile okufana neqhubu noma iqhubu lenyama. (Lolu hlobo lweqhubu lungabonakala futhi eduze komgodi wendunu.)
• Ubuhlungu.
• Izinguquko emikhubeni yokuthulula isisu. Okusho ukuthi, izinguquko ezikhathini zokunyakaza kwamathumbu, noma ukuqina kwendle.
• Ukunyakaza kwamathumbu okungalawuleki.
• Umuzwa oqhubekayo wokudinga ukuzikhulula (lokhu kubizwa ngokuthi "iTenesmus" ngokwezokwelapha).

Into ebalulekile ukuthi ukuthi nje unesinye noma ngaphezulu kwalezi zimpawu akusho ukuthi unomdlavuza wamathumbu. Kungaba nezinye izimbangela eziningi zalezi zimpawu. Kodwa-ke, uma lezi zimpawu zingapheli ezinsukwini ezimbalwa noma ziba zimbi kakhulu, kubalulekile ukubona udokotela ukuze uthole iseluleko.

Kujwayelekile ukuzizwa unamahloni noma unamahloni ukukhuluma nodokotela wakho ngezimpawu ezithile, njengokulunywa yindunu. Kodwa khumbula, kunezimbangela eziningi ezahlukene zomdlavuza wendunu. Ngakho-ke asikho isizathu sokuba namahloni ngokuba nalezi zimpawu. Odokotela bakho balapha ukuzokusiza ngazo zonke izinkinga zakho zempilo, okuhlanganisa nalezi zimpawu zomdlavuza wendunu.

Yini ebangela lokhu? Yiziphi izinto ezibangela ingozi?

Imbangela eqondile yomdlavuza wendunu ayaziwa okwamanje. Kodwa-ke, kuye kwatholakala ezinye izinto eziyingozi ezihambisana nalesi sifo. Isibonelo, iningi lomdlavuza wendunu lihlotshaniswa nokutheleleka ngezinhlobo ezithile ze -human papillomavirus (HPV) . Kodwa-ke, into ebalulekile ukuthi akuwona wonke umuntu one-HPV ozohlakulela umdlavuza wendunu.

Ngaphezu kwe-HPV, kunezinye izici eziningana ezingandisa ingozi yakho yokuthola umdlavuza we-anal:

• Ukusetshenziswa kwemithi yokucindezela amasosha omzimba. Lena imithi evimba amasosha omzimba wakho ekulimazeni amangqamuzana anempilo.
• Ukuba negciwane le-HIV (i-Human Immunodeficiency Virus). Ngenxa yokuthi i-HIV ithinta amasosha omzimba wakho futhi ucansi olungavikelekile lwendunu lungadlulisela i-HIV, ingozi yomdlavuza wendunu iyanda.
• Ukuba ngumlingani otholayo ngesikhathi socansi lwendunu. Lokhu kuvamile kuwo wonke umuntu, kungakhathaliseki ubulili. Ukuba nabalingani abaningi kunoma yiluphi uhlobo lobuhlobo bocansi kwandisa ingozi ye-HPV, ngakho-ke kwandisa ingozi yomdlavuza wendunu.
• Ukungagonyelwa i-HPV. Ezinye izinhlobo ze-HPV ziyimbangela enkulu yomdlavuza wendunu.
• Uneminyaka engu-55 noma ngaphezulu. Odokotela bavame ukuxilonga umdlavuza we-rectal kaningi kubantu abakuleli qembu leminyaka.
• Ukubhema. Abantu ababhemayo banamathuba amaningi okuthola zonke izinhlobo zomdlavuza.
• Ukuba nesifo noma ukuthatha imithi ebuthakathaka amasosha omzimba. Isibonelo, abantu abake bafakelwa isitho kungadingeka bathathe imithi yokuvimbela ukwenqatshwa kwesitho esifakelwe.
• Ukuba nomgodi ongavamile (`i-Anal Fistula`) osuka e-rectum uye esikhumbeni esizungeze i-anus.
• Ukuba neminye imidlavuza. Isibonelo, umdlavuza we-vulvar, umdlavuza wesitho sangasese sowesifazane, noma umdlavuza wesibeletho.

Kwenzekani uma ukwelashwa kunganikezwa? (Izinkinga)

Uma ingelashwa kahle, umdlavuza we-rectal ungasakazeka ezicutshini eziseduze (lokhu kubizwa ngokuthi "i-metastasize"). Akuvamile ukuthi usakazeke emaphashini noma esibindini sakho.

Ukuthola kanjani lokhu?

Udokotela uzokubuza ngezimpawu zakho, ukuthi sezinesikhathi esingakanani zikhona, umlando wakho wezokwelapha, okuhlanganisa nezimo ezithinta amasosha omzimba wakho, futhi angase akubuze nangomsebenzi wakho wocansi.

Yiziphi izivivinyo ezenziwayo ukuze kutholakale lesi simo?

Udokotela wakho uzokwenza ukuhlolwa kwe-rectal yedijithali . Ngemuva kwalokho, uzothatha amaseli awathumele kudokotela wezifo ukuze awabheke ngaphansi kwe-microscope. Uzokwenza ukuhlolwa kwe-Pap endunu noma i- biopsy . (Kwabesifazane, bangenza nokuhlolwa kwe-pelvic.) Ngaphezu kwalokho, udokotela wakho uzokwenza ukuhlolwa kwe-endoscopic kanye nokuhlolwa kwezithombe .

Ukuhlolwa kwe-Endoscopic

Odokotela basebenzisa i-endoscopy ukubheka ngaphakathi kwe-rectum yakho kanye ne-anus. Lokhu kuhlolwa kwenziwa kusetshenziswa amathuluzi akhethekile. Lawa ngamapayipi amancane, aguquguqukayo anekhamera yokukhanya, ilensi, kanye nevidiyo. Phakathi nalesi sikhathi, amasampula ezicubu (abizwa ngokuthi 'ama-biopsies') angathathwa futhi ahlolwe ngudokotela wezifo. Ukuhlolwa kwe-Endoscopy kufaka phakathi:

• I-Anoscopy: Odokotela basebenzisa ithubhu elifushane, elikhanyayo elibizwa ngokuthi i-anoscope ukuze babheke i-anus yakho kanye ne-rectum engezansi.
• I-Flexible Sigmoidoscopy: Ihlola i-rectum yakho kanye ne-anus ukuze ihlole ukuthi ayinazo yini izimila ezinomdlavuza kanye nama-polyps.
• I-Colonoscopy: Ikholoni lakho lonke lihlolwa ukuthi alinazo yini izimila ezinomdlavuza kanye nama-polyps.

Ukuhlolwa Kwezithombe

Ukuhlolwa kwezithombe kungasiza odokotela ukuthi bafunde kabanzi ngezimila ezinomdlavuza, njengosayizi wazo nendawo ezikuyo ngqo. Lokhu kuhlolwa kungafaka:

• Ukuskena kwe-Magnetic Resonance Imaging (MRI).
• I-Ultrasound Eqondile.
• I-Computed Tomography (CT) scan.
• Ukuskena kwe-Positron Emission Tomography (PET).

Ukuhlolwa Komdlavuza Wendunu

Odokotela basebenzisa izinhlelo zokulinganisa umdlavuza ukuhlela ukwelashwa nokunikeza isibikezelo, okungukuthi, lokho ongakulindela ngemva kokwelashwa. Bacabangela izici ezifana nobukhulu besimila, ukuthi umdlavuza usezinhlayiyeni ze-lymph, nokuthi isimila sisakazeke yini (sisakazeke kakhulu). Kunezigaba ezinhlanu zomdlavuza we-rectal:

• Isigaba 0:

Kukhona amangqamuzana angajwayelekile kulwelwesi lwama-mucous (`Mucosa`), ulwelwesi lwangaphakathi lwe-rectum yakho. Lawa maseli angajwayelekile awawona umdlavuza, kodwa angaba umdlavuza. Umdlavuza we-rectal wesigaba 0 ubizwa nangokuthi ``High-Grade Squamous Intraepithelial Lesion`` (``HSIL``) .

• Isigaba I:

Amaseli omdlavuza aqoqene ndawonye ukuze akhe iqhubu elingamasentimitha amabili noma ngaphansi, elingangosayizi we-peanut.

• Isigaba II:

Umdlavuza we-rectal wesigaba sesi-2 uhlukaniswe izingxenye ezimbili:

• Isigaba IIA sisho ukuthi kukhona iqhubu elikhulu kunamasentimitha amabili kodwa elincane kunamasentimitha amahlanu.
• Isigaba se-IIB sisho ukuthi isimila singamasentimitha angu-5 – lokho kufana nosayizi kalamula – kodwa asikasabalali ngale kwendunu yakho.

• Isigaba III:

Isigaba III sihlukaniswe izingxenye ezintathu:

• Isigaba IIIA: Isimila singamasentimitha angu-5 noma ngaphansi, futhi sesisakazekele kuma-lymph node endunu noma embotsheni yakho.
• Isigaba IIIB: Umdlavuza we-rectal ususakazekele ezithweni eziseduze, njengesitho sakho sangasese sowesifazane, i-urethra, noma esinyeni.
• Isigaba IIIC: Umdlavuza usezithweni zomzimba eziseduze, futhi ususakazekele kuma-lymph node eduze kwe-anus noma i-groin yakho.

• Isigaba IV:

Umdlavuza ukhona kuma-lymph node akude ne-anus yakho nasezithweni ezikude, njengamaphaphu akho noma isibindi.

Umdlavuza we-rectal welashwa kanjani?

Ukwelashwa komdlavuza we-rectal kuncike ohlotsheni kanye nesigaba somdlavuza, kodwa kungafaka:

Ukwelashwa Ngemisebe

Odokotela belapha umdlavuza we-rectal nge-external beam radiation therapy (EBRT). Kunezinhlobo eziningana ze-EBRT:

• Ukwelashwa Ngemisebe Okuguquliwe Kakhulu (IMRT): Lokhu kusebenzisa imisebe eminingi yemisebe yamandla ahlukene ukuhlasela isimila.
• Ukwelashwa Ngemisebe Yomzimba Oku-Stereotactic (SBRT): Lokhu kuhlasela izimila ezincane ngaphandle kokulimaza izicubu ezinempilo eziseduze.
• Ukwelashwa Ngemisebe Enezinhlangothi Ezintathu (3D-CRT): Lokhu kudala isithombe sesisu esinobukhulu obuthathu.
• Ukwelashwa nge-Brachy: Lokhu ukwelashwa ngemisebe yangaphakathi.

Ukwelashwa ngamakhemikhali

Odokotela bavame ukusebenzisa i-chemotherapy kanye nokwelashwa ngemisebe ndawonye njengokwelashwa okuyinhloko komdlavuza we-rectal. Lokhu kwelashwa okuhlangene ngokuvamile kungaqeda umdlavuza we-rectal, ngakho awudingi ukuhlinzwa.

Kodwa-ke, uma udinga ukuhlinzwa, unganikezwa i-chemotherapy ngaphambi kokuhlinzwa ukuze kuncishiswe isimila (`Neoadjuvant Chemotherapy`), noma ngemva kokuhlinzwa ukuze kubhujiswe noma yimaphi amangqamuzana omdlavuza asele (`Adjuvant Chemotherapy`).

Ukuhlinzwa

Yelapha umdlavuza wamathumbu obuye wavela noma ongasabelanga ekwelashweni ngemisebe kanye/noma nge-chemotherapy.Kusetshenziswa ukuhlinzwa okuncane okubizwa ngokuthi i-laparoscopic abdominoperineal resection. Lokhu kuhilela ukususa indunu yakho, i-rectum, kanye nengxenye yekholoni lakho.

Uma wenza lokhu kuhlinzwa, udokotela wakho ohlinzayo uzophinde akwenzele i -colostomy ehlala njalo. Lokhu kusho ukuthi indle yakho izodlula esikhwameni noma esikhwameni esinamathiselwe emzimbeni wakho. Nakuba lokhu kungase kubonakale kuyinselele kancane, awuwedwa. Ithimba lakho lezokwelapha lizokusiza ukuthi ujwayele.

Ukwelashwa nge-immunotherapy

Uma unomdlavuza we-rectal osezingeni eliphezulu, udokotela wakho angase akuncomele ukwelashwa nge-immunotherapy ukuze akusize ulawule izimpawu zakho. Lokhu kwelashwa kusiza umzimba wakho ukulwa nomdlavuza.

Iyini imiphumela emibi yokwelashwa?

Izindlela eziningi zokwelapha umdlavuza zingadala imiphumela emibi. Isibonelo, imiphumela emibi yokwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe ingafaka ukuqubuka kwesikhumba, ubuhlungu endaweni yendunu, ukukhathala, inkungu yobuchopho ebangelwa yi-chemotherapy, isicanucanu, nokuhlanza.

Yiziphi izinkinga zokwelashwa?

Odokotela bangelapha umdlavuza we-rectal ngokuhlinzwa. Izinkinga zokuhlinzwa zingafaka:

• Ukusabela kokubulala izinzwa.
• Ukopha ngokweqile.
• Ukutheleleka.

Zingakanani amazinga okusinda komdlavuza we-rectal?

Izinga lokusinda komdlavuza we-rectal liyisilinganiso sephesenti labantu abaphila eminyakeni emihlanu ngemva kokutholakala ukuthi banawo. Leli zinga liyahlukahluka kuye ngokuthi lesi sifo sitholakale futhi selashwe yini ngaphambi kokuba sisabalale. Sekukonke, ngokusho kweNational Cancer Institute, abantu abangu-70% abanomdlavuza we-rectal baphila eminyakeni emihlanu ngemva kokutholakala benewo.

Kodwa-ke, kubalulekile ukukhumbula ukuthi lezi zindlela zokululama zisekelwe kokuhlangenwe nakho kweqembu elikhulu labantu abanezinkinga ezahlukene zempilo. Okuyiqiniso kubo kungase kungabi yiqiniso kuwe. Uma unemibuzo, cela udokotela wakho akuchazele ukuthi yini ongayilindela.

Ukuvimbela kanjani lokhu? (Ukuvimbela)

Ayikho indlela eqinisekisiwe yokuvimbela umdlavuza we-rectal. Kodwa-ke, unganciphisa ingozi yakho yokuba nawo ngokulandela lezi zinyathelo:

• Ungabhemi. Uma ubhema, thola izindlela zokukusiza ukuthi uyeke. Udokotela wakho angakusiza futhi.
• Yenza ucansi oluphephile. Uma wenza ucansi lwendunu, qiniseka ukuthi usebenzisa ikhondomu.
• Uma ufanelekile, thola umuthi wokugomela i-Human Papillomavirus (HPV). Lo muthi wokugomela awuvimbeli nje kuphela umdlavuza wendunu, kodwa futhi nomdlavuza womlomo nomphimbo, umdlavuza wesibeletho, kanye nomdlavuza wepenis.

Kufanele ubonane nini nodokotela?

Uma welashwa umdlavuza we-rectal, kufanele uye kudokotela wakho ngezinsuku ezihleliwe bese uxhumana naye njengoba kuyalelwe. Isibonelo, udokotela wakho angakutshela ukuthi ushayele ucingo uma unesifo noma umkhuhlane.

Ngezinye izikhathi, ukwelashwa komdlavuza we-rectal kuhilela ukususa izingxenye zesimiso sakho sokugaya ukudla nokudala i-colostomy ehlala njalo (uhlobo lokuhlinzwa) ukuze kuvunyelwe indle ukuthi idlule. Ukuphila ne-colostomy ehlala njalo kungaba yinselele. Kodwa awuwedwa. Ithimba lakho lezokwelapha lingakusiza ukuphatha ukuhamba kwakho kwamathumbu futhi ujwayele ukuphila impilo ephelele, evamile ngemva kokuhlinzwa komdlavuza we-rectal.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma unomdlavuza we-rectal, ungase ufune ukubuza udokotela wakho le mibuzo:

• Uhlobo luni lomdlavuza we-rectal enginalo?
• Iyini isigaba somdlavuza wami?
• Yiziphi izindlela zokwelapha enginazo?
• Uma ngidinga ukuhlinzwa, ungangincoma luphi uhlobo lokuhlinzwa?

Uyini umehluko phakathi komdlavuza we-anal kanye ne-anal dysplasia?

Umehluko uwukuthi, i-anal dysplasia ayiyona umdlavuza, kodwa ingaholela kumdlavuza we-anal. Ku-anal dysplasia, amangqamuzana ase-anus yakho aba angajwayelekile. Ngokuhamba kwesikhathi, lawa maseli angajwayelekile angaqala ukwanda futhi akhe amaqhubu anomdlavuza.

Umdlavuza we-rectal uhluke kanjani kumdlavuza we-rectal kanye nomdlavuza wamathumbu amakhulu?

Indunu yakho, i-rectum, kanye ne-colon konke kuyizingxenye zesimiso sakho sokugaya ukudla. Kodwa amangqamuzana akha izicubu engxenyeni ngayinye ahlukile kakhulu. Lokho kusho ukuthi odokotela belapha lezi zinhlayiya ngezindlela ezahlukene.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Umdlavuza wendunu umdlavuza okhula endunu yakho - ingxenye yomzimba wakho osula ngayo ngemva kokuphuma kwamathumbu. Izimpawu ezivame kakhulu ukuphuma kwegazi endunu noma ukulunywa. Lokhu kungakwenza ungabaze ukukhuluma nodokotela wakho ngalezi zinto. Kodwa-ke, umdlavuza wendunu welapheka kangcono uma utholakala futhi welashwa kusenesikhathi, ngaphambi kokuba usakazeke. Uma unezimpawu ezifana nokulunywa kwendunu okuqhubekayo futhi okungapheli, qiniseka ukuthi ukhuluma nodokotela wakho. Balapha ukuzokusiza. Asikho isidingo sokwesaba noma sokuba namahloni. Impilo yakho iyona nto ebaluleke kakhulu.

Umdlavuza Wezitho Zobulili, Umdlavuza Wezitho Zobulili, Izimpawu Zomdlavuza, I-HPV, Impilo Yezitho Zobulili, Ukwelashwa Komdlavuza, Ukuvimbela Umdlavuza