Ingabe kufanele sikhathazeke ngomdlavuza we-Epithelial Ovarian?

Wake wezwa nge-Epithelial Ovarian Cancer? Leli gama lingase lizwakale liyinkimbinkimbi kancane, kodwa uhlobo lomdlavuza wesibeletho oluvame kakhulu kwabesifazane. Ake sixoxe ngalo kalula, ngendlela ongayiqonda. Ngoba kubaluleke kakhulu ukuqaphela izinto ezinjengalezi.

Iyini i-Epithelial Ovarian Cancer?

Kalula nje, umdlavuza wesibeletho se-epithelial uhlobo oluvame kakhulu lomdlavuza wesibeletho. Lo mdlavuza ukhula embozweni ongaphandle omncane wesibeletho, obizwa ngokuthi izicubu ze-epithelial. Cabanga ngawo njengolwelwesi oluncane oluzungeze isibeletho.

Akukhona lokho kuphela, kodwa ngezinye izikhathi lo mdlavuza ungakhula nasolwelweni lwamapayipi e-fallopian noma ngisho nase-peritoneum, izicubu ezimboza izitho esiswini. Odokotela bafaka nomdlavuza we-fallopian tube kanye nomdlavuza we-primary peritoneal esigabeni esifanayo nomdlavuza we-epithelial ovarian ngoba izimpawu kanye nokwelashwa kwalezi zimo kufana kakhulu.

Uvame kangakanani lo mdlavuza?

Umdlavuza wesibeletho ungowesibili ovame kakhulu kumdlavuza wabesifazane, ngemuva komdlavuza wesibeletho/we-endometrial. Owesifazane ojwayelekile unethuba elilodwa kwangu-78 lokuthola umdlavuza wesibeletho empilweni yakhe.

Ngo-2021 kuphela, abantu abangaphezu kuka-21,400 batholakala benomdlavuza wesibeletho. Abayisishiyagalolunye kwabayishumi babikwa njengomdlavuza wesibeletho se-epithelial. Lo mdlavuza uvame kakhulu kwabesifazane abangaphezu kweminyaka engu-65.

Yiziphi izinhlobo zomdlavuza we-epithelial ovarian?

Cishe izingxenye ezintathu kwezine zomdlavuza wesibeletho se-epithelial ziyi-serous ovarian carcinomas yezinga eliphezulu (i-HGSOC). "Izinga eliphezulu" lisho ukuthi la maseli omdlavuza akhula futhi asakazeke ngokushesha kunomdlavuza "wezinga eliphansi".

Ochwepheshe bezokwelapha bakholelwa ukuthi lolu hlobo lwe-HGSOC lukhula kancane ekuqaleni, kodwa kungathatha iminyaka eyisithupha nengxenye ukuthi lusabalale lusuka emapayipini e-fallopian luye emaqanda. Kodwa uma selufikile emaqanda, lusabalala ngokushesha okukhulu. Luvame ukuthinta ulwelwesi lwesisu (i-peritoneum) nezinye izingxenye zomzimba. Cishe ama-70% eziguli ze-HGSOC atholakala enalesi sifo esigabeni sesi-3 noma sesi-4. Lokhu kusho ukuthi umdlavuza ususabalale ngale kwesimila sokuqala futhi manje usuwumdlavuza osakazekile.

Kunezinye izinhlobo ezingavamile kakhulu zomdlavuza we-ovarian we-epithelial:

• I-carcinoma ye-endometrioid:Lolu hlobo luvame kakhulu kubantu abane-endometriosis, ethinta ulwelwesi lwesibeletho (i-endometrium). Lusabela kangcono ku-chemotherapy kunezinye izinhlobo.
• I-Low-grade serous ovarian carcinoma (LGSOC): Lona umdlavuza okhula kancane. Wenzeka kwabesifazane abasebasha (abaphakathi kweminyaka engu-45 no-57). Ubangela cishe u-10% womdlavuza wesibeletho se-epithelial. Lesi sifo sivame ukuthuthuka uma sitholakala, futhi asisabeli kahle ku-chemotherapy. Nakuba umdlavuza wesibeletho ukhula kancane, mancane amathuba okuba umdlavuza wesibeletho.
• I-Mucinous carcinoma: Lezi zimila zihlukile kwezinye izinhlobo futhi zisabela kahle ekwelashweni. Ngokuvamile zinkulu (cishe amasentimitha angu-8 noma amasentimitha angu-20). Zivame ukuthinta ama-ovari kuphela.
• I-Ovarian clear cell carcinoma (OCCC): Abesifazane base-Asia kanye nalabo abane-endometriosis basengozini enkulu yokuthola lo mdlavuza. Lesi sifo sivame ukuba sibi kakhulu uma sitholakala. Asisabeli kahle ku-chemotherapy.
• I-Primary squamous cell carcinoma (SCC) ye-ovary: Lolu hlobo lwe-SCC luvame ukuvela ezimweni ezingengozi/ezingenawo umdlavuza. Isibonelo, lungavela kuma-cyst e-ovarian, i-endometriosis, noma ama-tumor e-Brenner (ukukhula okuqinile, okungajwayelekile kuma-ovari). Uma lutholakala kusenesikhathi, lusabela kahle ekwelashweni.

Yini ebangela umdlavuza we-epithelial ovarian?

Eqinisweni, imbangela eqondile yomdlavuza omningi, okuhlanganisa nomdlavuza wesibeletho se-epithelial, ayikaziwa. Kodwa-ke, ucwaningo olusha lusikisela ukuthi umdlavuza wesibeletho omningi uqala emangqamuzaneni asekugcineni kwamapayipi esibeletho. Bese usakazekela emaqandeni.

Yiziphi izinto ezingabangela umdlavuza?

Abantu abangaphezu kwengxenye abatholakale benomdlavuza wesibeletho baneminyaka engaphezu kwengu-65 ubudala futhi sebedlule esikhathini sokuya esikhathini, okusho ukuthi umjikelezo wabo wokuya esikhathini umile.

Ezinye izinto zingase zandise ingozi yokuba nomdlavuza wesibeletho. Lezi yizi:

• Uma othile emndenini wakho eke waba nomdlavuza wesibeletho, umdlavuza webele, noma umdlavuza we-colorectal/colon.
• Uma uzuze ushintsho (ukuguqulwa) ku-BRCA gene.
• Uma uzuze ifa lofuzo elihlobene nezifo zomdlavuza womndeni, njenge-Lynch syndrome.
• Uma uthatha ukwelashwa ngama-hormone ukulawula izimpawu zokunqamuka kokuya esikhathini.
• Ukuba nomntwana ngemva kweminyaka engu-35 noma ukungakaze abelethe ingane kuze kube yilapho isigwebo sakhe siphelele.
• Ukukhuluphala ngokweqile .

Ziyini izimpawu zomdlavuza we-epithelial ovarian?

Lokhu kuyinkinga kubantu abaningi. Umdlavuza wesibeletho se-epithelial uvame ukuba nezimpawu ezimbalwa kakhulu ezigabeni zokuqala. Izimpawu zibonakala kuphela ngemva kokuba lesi sifo sesisakazeke kancane. Uma sisakazekela olwelwesini olumboza izitho zesisu (i-peritoneum), uketshezi olunamanzi lunganqwabelana esiswini. Lokhu kubizwa ngokuthi ama-ascites.

Ngaphezu kwalokho, izimpawu ezilandelayo zingase zivele:

• Ubuhlungu besisu.
• Ubunzima bokudla noma ukuzizwa usuthi ngemva kokudla okuncane.
• Isicanucanu nokuhlanza.
• Ukuqunjelwa.
• Ubuhlungu be-pelvic.

Kukhona nezimpawu ezingavamile ukubonakala:

• Khuthaza ukungakwazi ukuzibamba noma ukuchama njalo (isinyi esisebenza ngokweqile).
• Ukopha okungajwayelekile kwesitho sangasese sowesifazane.

Okubalulekile: Ukuba nalezi zimpawu akusho ukuthi unomdlavuza. Kodwa-ke, uma ziqhubeka, kungcono ukubona udokotela ukuze akunike iseluleko.

Umdlavuza we-ovarian we-epithelial utholakala kanjani?

Ngeshwa, azikho izivivinyo ezithile zokuhlola ezingabona umdlavuza wesibeletho ezigabeni zokuqala. Ukuhlolwa kuvame ukwenziwa kuphela uma unezimpawu noma usengozini enkulu. Udokotela wakho angase aqale enze ukuhlolwa kwe-pelvic ukuze ahlole noma yiziphi izigaxa noma ukuvuvukala okungajwayelekile.

Ngemuva kwalokho, ungenza ukuhlolwa kwegazi ukuhlola izinga leprotheni ebizwa ngokuthi `CA-125`. Le `CA-125` imele i-cancer antigen 125. Uma izinga liphezulu, kuzodingeka wenze ukuhlolwa okwengeziwe.

Ukuhlolwa kwezithombe ezinjengalezi kungasiza ekuxilongeni umdlavuza wesibeletho:

• Ukuhlolwa kwe-ultrasound kwe-transvaginal.
• Ukuhlolwa kwe-CT scan.
• Ukuhlolwa kwe-MRI (MRI).
• Iskeni se-positron emission tomography (PET).
• Ama-X-ray esifubeni (ukubona ukuthi umdlavuza ususakazekele emaphashini).

Ngezinye izikhathi inqubo ebizwa ngokuthi i-laparoscopy ingenziwa. Lokhu kufana nokuhlinzwa, kodwa kwenziwa ngaphandle kokwenza i-incision enkulu. Lokhu kuvumela udokotela ukuthi abheke izitho zakho zokuzala. Bangase futhi bathathe isampula yezicubu (i-biopsy) eqhubu ukuze babone ukuthi kukhona yini amangqamuzana omdlavuza lapho. Le biopsy iyindlela kuphela yokwazi ngokuqinisekile ukuthi unomdlavuza wesibeletho.

Yiziphi izigaba zomdlavuza we-ovarian we-epithelial?

Ukwazi isigaba somdlavuza kusiza odokotela baqonde inqubekela phambili yomdlavuza. Kubalulekile futhi ekunqumeni ukuthi umdlavuza ususakazeke yini kanye nokwenza izinqumo zokwelashwa. Isigaba somdlavuza sinqunywa ngokuhlolwa okufanayo okusetshenziselwa ukuxilonga umdlavuza.

Kunezigaba ezine eziyinhloko zomdlavuza wesibeletho. Ezinye izigaba zinezigaba ezincane. Uma inani lesigaba liphezulu, umdlavuza uba ngcono kakhulu.

• Isigaba 1: Umdlavuza usesibelethweni esisodwa noma epayipini elilodwa le-fallopian.
• Isigaba sesi-2: Umdlavuza ususakazekele esibelethweni noma olwelwesini lwesisu (umgodi we-peritoneal).
• Isigaba sesi-3: Umdlavuza ususakazekele kwezinye izitho ezingaphandle kwe-pelvis, kuma-lymph node, noma kokubili.
• Isigaba 4: Amaseli omdlavuza asemanzini azungeze amaphaphu, ama-lymph node endaweni ye-groin, ezinye izitho zomzimba, noma ezinye izingxenye zomzimba.

Ingabe umdlavuza wesibeletho se-epithelial ungalapheka?

Odokotela abahlinzayo benza ukuhlinzwa kokususa ama-bulking ukuze basuse umdlavuza omningi ngangokunokwenzeka. Lokhu kulandelwa yi-chemotherapy. Nakuba abantu abaningi belulama ekuqaleni, lesi sifo singabuya kubantu abaningi kamuva.

Iziguli ezisesigabeni sokuqala zingase zinqume ukususa kuphela i-ovary kanye ne-fallopian tube enesifo.

Kubantu abanomdlavuza osezingeni eliphezulu, ukuhlinzwa kokususa ama-bulking kuvame ukwenziwa ukuze kususwe izitho ezilandelayo:

• Ukususwa kwamapayipi e-fallopian kanye nama-ovari womabili (i-bilateral salpingo-oophorectomy).
• Ukususwa kwesibeletho (i-hysterectomy).
• Ukususwa kwezicubu ezinamafutha (i-omentum) ezimboza isisu (i-omentectomy).
• Ukususwa kwama-lymph node azungezile.
• Ukususwa kwezinye izingxenye ezigulayo (njengethumbu elincane, ithumbu elikhulu, noma ubende).

Yiziphi ezinye izindlela zokwelapha?

Kuye ngohlobo lomdlavuza, unganikezwa ukwelashwa okukodwa noma ngaphezulu kwalokhu ngemva kokuhlinzwa:

• Ukwelashwa ngamakhemikhali: Ukubulala amangqamuzana omdlavuza. Lokhu kusebenzisa izidakamizwa ezifana namakhemikhali e-platinum (carboplatin) kanye ne-paclitaxel (Taxol®) noma i-docetaxel (Taxotere®).
• I-chemotherapy ye-intraperitoneal: Ukwelapha umdlavuza wesibeletho wesigaba sesi-3, imithi i-cisplatin ne-paclitaxel ifakwa ngqo emgodini wesisu nge-catheter efakwe ngokuhlinzwa (ithubhu elincane, elingenalutho).
• Izindlela zokwelapha eziqondiwe: Imithi efana ne-Bevacizumab (Avastin®) ivimba amangqamuzana omdlavuza ekukhuleni nasekuphindaphindeni.
• Ukwelashwa ngemisebe: Kusebenzisa imisebe ye-X enamandla aphezulu ukubhubhisa amangqamuzana omdlavuza.

Ingabe umdlavuza we-epithelial ovarian ungavinjelwa?

Ucwaningo lubonisa ukuthi abesifazane abaphuza amaphilisi okuvimbela inzalo angama-hormone iminyaka emihlanu noma ngaphezulu banganciphisa ingozi yabo yokuthola umdlavuza wesibeletho cishe ngesigamu.

Okunye ukuhlinzwa kunganciphisa nengozi yomdlavuza. Ukuhlinzwa ukuvimbela umdlavuza kubizwa ngokuthi ukuhlinzwa kokuvimbela. Lokhu kuhilela ukususa amashubhu e-fallopian nama-ovari, ngesibeletho noma ngaphandle kwaso. Lokhu kuvame ukucatshangelwa kwabesifazane abasengozini enkulu ngenxa yomlando womndeni (njengalabo abane-BRCA mutation noma i-Lynch syndrome). Kodwa-ke, odokotela beluleka ukuthi lezi zinqubo zenziwe kuphela uma kudingeka ngokwezokwelapha. Lokhu kungenxa yokuthi ukususa ama-ovari kungabangela ukunqamuka kokuya esikhathini kusenesikhathi, okungaba nomthelela omubi emzimbeni.

Lokhu kuhlinzwa akuqedi ngokuphelele ingozi yomdlavuza. Abanye abantu bangase babe nomdlavuza ongatholakali ngesikhathi sokuhlinzwa. Abantu abanezakhi zofuzo ze-BRCA basengaba nomdlavuza we-peritoneal oyinhloko noma ngabe amashubhu abo e-fallopian nama-ovari asusiwe. Buza udokotela wakho mayelana nokuhlolwa kwe-BRCA ukuze uthole ukuthi unayo yini i-BRCA gene.

Iyini inhloso yabantu abanomdlavuza we-epithelial ovarian?

Abantu abangaphezu kuka-13,000 bafa ngenxa yomdlavuza wesibeletho minyaka yonke. Uyimbangela yesihlanu ehamba phambili yokufa komdlavuza phakathi kwabesifazane. Kodwa-ke, kunethemba lokwelashwa okusha okwamanje ezivivinyweni zemitholampilo. Abacwaningi basebenza futhi ukuthola lesi sifo kusenesikhathi.

Uma umdlavuza wesibeletho se-epithelial utholakala ngaphambi kokuba usakazeke, izinga lokusinda kweminyaka emihlanu lingaphezu kuka-90%. Kodwa-ke, uma umdlavuza ususakazeke (ususakazeke), leli zinga lehla laya cishe ku-30%.

Ziningi izinto ezithonya ukubikezelwa komdlavuza:

• Izinga umdlavuza osakazeke ngalo.
• Impumelelo yokwelashwa.
• Indawo, usayizi, kanye nenani lezimila ezinomdlavuza (isigaba somdlavuza).

Kufanele ubonane nini nodokotela?

Uma unezinye zalezi zimpawu, xhumana nodokotela ngokushesha:

• Izinguquko ekuphindaphindeni noma ekuphuthumeni kokuchama.
• Ukulahlekelwa yisifiso sokudla noma ukuzizwa usuthi ngemva kokudla okuncane.
• Ubuhlungu obungapheli esiswini noma endaweni ye-pelvic ngaphandle kwesizathu.

Yimiphi imibuzo okufanele uyibuze udokotela wakho?

Ungabuza udokotela imibuzo efana nale:

• Ingabe kufanele ngithole ukuhlolwa kwe-BRCA?
• Uhlobo luni lomdlavuza we-epithelial ovarian enginalo?
• Yikuphi ukwelashwa okungcono kakhulu kimi?
• Iyini imiphumela emibi yokwelashwa?
• Ingabe ngisengozini yokuthola umdlavuza osakazeke kakhulu? Ngingayinciphisa kanjani leyo ngozi?
• Ingabe kufanele ngikhathazeke ngezinkinga?

Yiluphi uhlobo lomdlavuza wesibeletho oluyingozi kakhulu?

Umdlavuza we-serous ovarian wezinga eliphezulu (i-HGSOC) uhlobo lomdlavuza we-ovarian olunolaka kakhulu. Nakuba lo mdlavuza uqala ukukhula kancane emapayipini e-fallopian, usakazeka ngokushesha kakhulu uma usufika ema-ovarian. Ngeshwa, abantu abaningi abane-HGSOC banomdlavuza we-ovarian osezingeni eliphezulu/osakazeka kakhulu lapho betholakala.

Kungenzeka yini ukuba nama-cyst e-ovarian angewona umdlavuza (angenawo umdlavuza)?

Yebo. Eqinisweni, izimila eziningi ze-epithelial ovarian aziwona umdlavuza. Ezinye izimila zibizwa ngokuthi izimila eziseduze noma izimila ezikhula ngokushesha. Lezi zazibizwa ngokuthi izimila ezinobungozi obuphansi.

Ezimilanjeni eziseduze, amangqamuzana angajwayelekile akhula abe yizicubu ze-epithelial kodwa awangeni ezicutshini ezisekelayo zesibeletho (stroma). Lawa maseli avame ukutholakala esibelethweni ngokwaso futhi awavamile ukuba nomdlavuza. Uma umdlavuza uvela, amathathu kwamane ayisigaba 1 (avalelwe esibelethweni futhi kulula ukwelapha). Lawa mathumba avame ukuthinta abantu abasebasha.

Umlayezo Wokuya Nawe Ekhaya

Umdlavuza wesibeletho se-Epithelial uhlobo oluvame kakhulu lomdlavuza wesibeletho. Luhlanganisa nomdlavuza we-fallopian tube kanye nomdlavuza we-peritoneal oyinhloko. Umdlavuza wesibeletho uvame ukuba nezimpawu ezimbalwa kakhulu ezigabeni zaso zokuqala. Lesi sifo sivame ukuba sesithuthuke kakhulu ukuba singatholakali ngesikhathi sitholakala. Lokhu kuyiqiniso ikakhulukazi ngohlobo oluvame kakhulu lomdlavuza wesibeletho, olubizwa ngokuthi `HGSOC`.

Uma usengozini enkulu yokuba nomdlavuza wesibeletho (njengomlando womndeni), kubalulekile ukubuza udokotela wakho mayelana nokuthi izinyathelo zokuvimbela zikulungele yini. Njalo nakekela umzimba wakho. Ungazinaki izimpawu ezingavamile. Funa iseluleko sezokwelapha.

Umdlavuza wesibeletho , umdlavuza we-epithelial, impilo yabesifazane, izimpawu zomdlavuza, ukwelashwa komdlavuza, i-BRCA gene, i-gynecology