Unemibuzo mayelana nomdlavuza womphimbo? Ake sixoxe!

Kungenzeka ukuthi uke wezwa ngomdlavuza wesisu. Lesi yisimo esibi kakhulu, kodwa kubaluleke kakhulu ukuqaphela . Ngoba ngezinye izikhathi umdlavuza ungase ube usukhulile kakhulu ngesikhathi izimpawu zivela. Kodwa ungakhathazeki, ake sixoxe ngakho konke ngamagama alula.

Uyini umdlavuza womphimbo? Uqala kanjani?

Kalula nje, i-esophagus iyipayipi elide elenziwe ngemisipha ethwala ukudla kusuka emphinjeni kuya esiswini lapho sigwinya. Ngakho-ke, umdlavuza uvela lapho amangqamuzana akule e-esophagus eqala ukuhlukana ngendlela engavamile futhi engalawuleki. Amangqamuzana akha ngale ndlela ahlangana ndawonye futhi akhe isimila.

Umdlavuza wesisu ungoweshumi ovame kakhulu emhlabeni. Ungaba yingozi kakhulu, ngoba njengoba ngishilo ngaphambili, lo mdlavuza ungakhula isikhashana ngaphandle kokubonisa izimpawu . Isizathu salokhu ukuthi isisu sethu singanwebeka kancane, njengalapho sigwinya ukudla okuningi. Ngakho-ke kuze kube yilapho umdlavuza ukhula kancane, singase singazizwa singakhululekile. Kodwa lapho isimila sikhula futhi siqala ukuvimba ukuvulwa komlomo, kuba nzima ukugwinya ukudla, futhi kuba buhlungu lapho sigwinya.

Kunezinhlobo ezimbili eziyinhloko zomdlavuza womphimbo, akunjalo?

Yebo, kunezinhlobo ezimbili ikakhulukazi:

1. I-Adenocarcinoma: Lolu uhlobo oluvame kakhulu, ikakhulukazi emazweni aseNtshonalanga. Lukhula emaseli ezindlala emhubheni akhiqiza ulwelwesi olusiza ekugwinyeni. Lolu hlobo luvame ukukhula engxenyeni engezansi yomhubheni.

2. I-Squamous cell carcinoma: Lolu hlobo luqala kumaseli e-squamous angaphakathi kwe-esophagus. Ngokuvamile luvame ukuvela ezingxenyeni eziphezulu neziphakathi ze-esophagus.

Ingabe lo mdlavuza ungalapheka ngokuphelele?

Lokhu kuncike kakhulu ekutheni umdlavuza usheshe kangakanani utholakale. Uma utholakale kusenesikhathi, okungukuthi, uma umdlavuza umncane, ungasuswa ngokuhlinzwa futhi ngezinye izikhathi welapheke ngokuphelele. Kodwa, ngeshwa, abantu abangu-25% kuphela abanalo mdlavuza batholakala ngaphambi kokuba umdlavuza usakazeke. Yingakho sithi, uma unezimpawu ezincane kakhulu, khathazeka ngazo.

Ubani osengozini enkulu yokuthola lo mdlavuza?

Ngokuvamile, izibalo zibonisa ukuthi lesi sifo sivame kakhulu kwabesilisa abangaphezu kweminyaka engama-60. Futhi, kukhona umehluko phakathi kwezinye izinhlanga. Isibonelo, i-squamous cell carcinoma ivame kakhulu kubantu abamnyama nabase-Asia, kuyilapho i-adenocarcinoma ivame kakhulu kubantu abamhlophe. Kodwa-ke, lokhu kumane kuyizinto ezijwayelekile, futhi noma ubani angahlakulela lesi simo.

Ziyini izimpawu zomdlavuza womphimbo? Ungawubona kanjani?

Uphawu lokuqala abantu abaningi abalubonayo ubunzima bokugwinya (i-dysphagia) . Kungase kuzwakale sengathi kukhona okubambeke emphinjeni. Ngaphezu kwalokho, kungase kube nezimpawu ezifana nalezi:

• Ubuhlungu emphinjeni noma ngemuva kwesifuba, okusho ngemuva kwethambo lesifuba noma phakathi kwamahlombe.
• Ukuhlanza, mhlawumbe ukuhlanza igazi.
• Ukukhwehlela igazi.
• Ukushisa kwenhliziyo okuvamile.
• Izwi elihoshozelayo, noma ukukhwehlela okungapheli.
• Ukwehlisa isisindo ngokungahlosile .

Uma unesinye noma ngaphezulu salezi zimpawu, akusho ukuthi unomdlavuza womphimbo. Kodwa-ke, uma lezi zimpawu ziqhubeka, kungcono ukubona udokotela ukuze akuhlole.

Lo mdlavuza usakazeka ngokushesha kangakanani?

Umdlavuza we-esophageal uvame ukuba uhlobo lomdlavuza olungakhula ngokushesha okukhulu . Njengoba ngishilo ngaphambili, ngenxa yokuthi umphimbo wethu uyaguquguquka, njengoba umdlavuza ukhula, uvame ukuwuzungeza. Yingakho izimpawu zivame ukuvela ngemva kokuba umdlavuza ususakazeke kancane.

Yiziphi izimbangela eziyinhloko zalo mdlavuza? Yiziphi izici eziyingozi?

Kunzima ukusho ngokuqinisekile ukuthi iyini imbangela yangempela. Kodwa-ke, odokotela bathole izici eziningana ezandisa ingozi yokuthola lo mdlavuza. Ake sibheke ukuthi ziyini:

• Ukusetshenziswa kukagwayi: Lokhu kuhlanganisa kokubili ukubhema nogwayi ongenantuthu (isib. ukuhlafuna ugwayi one-chewing gum, i-chewing gum ene-chewing gum). Lokhu kungalimaza amangqamuzana omphimbo futhi kwandise kakhulu ingozi yomdlavuza.
• Ukusetshenziswa kotshwala: Ukuphuza utshwala isikhathi eside noma ngokweqile nakho kuyisici esiyingozi esikhulu.
• Ukukhuluphala ngokweqile: Ukukhuluphala ngokweqile noma ukukhuluphala ngokweqile kungabangela ukuvuvukala emphinjeni. Lokhu kuvuvukala kungagcina kuholele kumdlavuza.
• I-Barrett's esophagus kanye ne-chronic acid reflux: I-long term acid reflux, okuyi-backflow ye-asidi yesisu iye e-esophagus, ingabangela izinguquko emaseli engxenyeni engezansi ye-esophagus uma ingelashwa kahle. Lesi simo sibizwa ngokuthi i-Barrett's esophagus. Akuyona umdlavuza, kodwa yisimo esinengozi enkulu yokuba nomdlavuza. Abantu abangenayo i-Barrett's esophagus kodwa abanesifo sokushiswa yinhliziyo isikhathi eside nabo basengozini enkulu yokuba nomdlavuza we-esophagus.
• I-Human Papillomavirus (HPV): I-HPV iyigciwane elivame kakhulu. Ingabangela ushintsho ezicutshini zezwi, umlomo, izandla, izinyawo kanye nezitho zangasese. Ezinye izinhlobo ze-HPV zandisa ingozi yomdlavuza womphimbo.
• Uma uke waba nomdlavuza ngaphambili: Abantu abake baba nomdlavuza wekhanda noma wentamo basengozini enkulu yokuba nomdlavuza womphimbo.
• Ezinye izimo zezokwelapha:Lo mdlavuza uhlotshaniswa nezinye izimo ezingavamile nezizuzwa njengefa. Isibonelo, i-achalasia , isimo esingavamile esenza kube nzima ukugwinya , kanye ne-tylosis , isimo esingavamile, esizuzwa njengefa esibangela ukuqina kwesikhumba ezintendeni nasematheni ezinyawo.
• Ukuchayeka kumakhemikhali athile: Abantu abachayeka kumakhemikhali afana nezithambisi zokuhlanza ezomile isikhathi eside nabo basengozini enkulu yalo mdlavuza.

Odokotela bawuthola kanjani lo mdlavuza? (Ukuxilongwa)

Uma unezimpawu ezishiwo ngenhla, udokotela wakho uzoqala ngokukubuza ngezimpawu zakho kanye nomlando wakho wezokwelapha. Ngemuva kwalokho, bangenza izivivinyo ezithile, ezifana nalezi:

• Ukuhlolwa kokugwinya kwe-Barium: Lokhu kuhilela ukukuphuza uketshezi oluqukethe into ebizwa ngokuthi i-barium bese uthatha uchungechunge lwe-X-ray. I-barium yenza i-esophagus ibonakale ngokucacile ezithombeni ze-X-ray. Lokhu kungasetshenziswa ukubona ukuthi kukhona yini ukuphazamiseka ku-esophagus.
• I-CT scan (i-Computed Tomography scan): Lokhu kuhlolwa kuvumela odokotela ukuthi babone ukuthi umdlavuza ususakazekele kwezinye izingxenye zesifuba nesisu (isisu).
• I-Esophagogastroduodenoscopy (EGD): Kulokhu, kufakwa ithubhu elincane neliguquguqukayo elibizwa ngokuthi i-endoscope (elifakwe ikhamera) ngomlomo bese libhekwa ngqo emhubheni. Lokhu kungabona ngokucacile noma yiziphi izinguquko noma izimila odongeni lomhubhe.
• I-ultrasound ye-endoscopic esophageal: Lokhu kungenziwa ngesikhathi esifanayo ne-EGD. Kusebenzisa amaza omsindo ukuthatha izithombe zangaphakathi komphimbo. Lokhu kungasiza ekunqumeni ukuthi umdlavuza usukhule kangakanani wangena odongeni lomphimbo nokuthi ngabe ususakazekele yini kuma-lymph node aseduze.
• I-Biopsy: Uma udokotela ebona indawo esolisayo ngesikhathi se-EGD, uzothatha ingxenye encane yezicubu ayihlole ngaphansi kwe-microscope. Lena yindlela abangaqinisekisa ngayo ukuthi akhona yini amangqamuzana omdlavuza noma cha.

Odokotela basebenzisa ulwazi oluvela kulezi zivivinyo ukuze bathole isigaba kanye nezinga lomdlavuza. Isigaba somdlavuza siwukuthi umdlavuza ususakazeke kangakanani (isib., ubukhulu besimila, ukuthi sisakazeke yini kuma-lymph node, noma ezithweni ezikude). Ibanga lesimila liwukuthi amangqamuzana omdlavuza afana kangakanani namaseli anempilo nokuthi ahlukana ngokushesha kangakanani. Ukwelashwa kuhlelwa ngokusekelwe kulesi sigaba kanye nezinga.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa komdlavuza womphimbo kuncike esigabeni kanye nezinga lomdlavuza, njengoba kushiwo ngenhla, kanye nempilo yesiguli iyonke. Kunezindlela eziningana zokwelapha eziyinhloko:

• Ukuhlinzwa: Ukwelashwa okuvame kakhulu komdlavuza womphimbo osesigabeni sokuqala yilokhuUkuhlinzwa okubizwa ngokuthi i-esophagectomy. Lokhu kuhilela ukususa ingxenye noma yonke i-esophagus, kanye nezicubu ezizungezile. Bese kuthi ingxenye yesisu idonswe phezulu bese ixhunyaniswa nesifuba nentamo, kudale i-esophagus entsha.
• Ukwelashwa ngemisebe: Lokhu kuhilela ukuqondisa imisebe enamandla aphezulu (imisebe yemisebe) esimila ukuze kubulawe amangqamuzana omdlavuza. Iphinde isetshenziswe njengokwelashwa okusizayo ngaphambi noma ngemva kokuhlinzwa.
• Ukwelashwa ngamakhemikhali: Lokhu kuhilela ukunikeza imithi ebulala amangqamuzana omdlavuza noma ewavimba ukuba akhule. Lokhu kunganikezwa ngaphambi, ngemva kokuhlinzwa, noma kuhlanganiswe nokwelashwa ngemisebe.
• Ukususwa Kwe-Submucosal Endoscopic (ESD): Le nqubo isetshenziselwa ukususa umdlavuza osesigabeni sokuqala ovalwe ezingqimbeni ezingaphezulu zodonga lomphimbo.
• Ukususwa Kwama-Mucosal Endoscopic (EMR): Lena inqubo efana ne-ESD, esetshenziselwa ukususa izimila ezinomdlavuza olwelwesini lwama-mucous lwe-esophagus.
• Ukwelashwa nge-laser nge-endoscopic: Uma isimila esinomdlavuza sivimba umphimbo futhi senza kube nzima ukugwinya, kusetshenziswa i-laser beam ukususa ingxenye yesimila ukuze kuncishiswe ukungakhululeki.
• Ukwelashwa nge-Photodynamic (PDT): Kulokhu, kunikezwa imithi ekhethekile ebizwa ngokuthi ama-photosensitizers emzimbeni, bese kukhanya okukhethekile kuqondiswa endaweni yomdlavuza. Uma lokhu kukhanya kushaya, umuthi uyavuselelwa futhi ubangele ukusabela kwamakhemikhali okubhubhisa amangqamuzana omdlavuza.
• Ukwelashwa okuqondiwe: Amanye amangqamuzana omdlavuza womphimbo anenani elingavamile leprotheyini ebizwa ngokuthi i-HER2 protein . Le phrotheyini isiza amangqamuzana omdlavuza ukuba akhule. Ukwelashwa okuqondiwe kuhilela ukunikeza imithi eqondisa le phrotheyini ye-HER2.
• Ukwelashwa nge-immunotherapy: Lokhu kuhilela ukuvuselela amasosha omzimba wethu ukuze alwe namaseli omdlavuza. Imithi ebizwa ngokuthi i-immune checkpoint inhibitors isetshenziselwa le njongo.

Khumbula, akuzona zonke lezi zindlela zokwelapha ezifanele wonke umuntu ogulayo. Ithimba lakho lezokwelapha lizonquma ukuthi yiziphi izindlela zokwelapha ezifanele isimo sakho.

Yini umuntu onomdlavuza womphimbo angayilindela?

Lokhu kuncike kakhulu ezicini eziningi, njengempilo yakho iyonke nokuthi umdlavuza ususakazeke kangakanani uma utholakala. Uma utholakale kusenesikhathi, odokotela bavame ukuwulapha ngempumelelo. Cishe abantu abangu-46% abathola ukwelashwa kusenesikhathi basaphila eminyakeni emihlanu ngemva kokuxilongwa.

Kodwa-ke, uma umdlavuza usuvele usakazeke, kungase kungenzeki ukuwubhubhisa ngokuphelele. Ezimweni ezinjalo, odokotela bagxila ekuhlinzekeni ngemithi yokwelapha esiza isiguli ukuba siphile isikhathi eside ngangokunokwenzeka, silondoloze izinga lempilo, futhi sinciphise izimpawu. Lokhu kubizwa nangokuthi ukunakekelwa kwe-palliative . Kusiza isiguli ukuba siphile ngokunethezeka futhi singabi nobuhlungu.

Ngingayinciphisa kanjani ingozi yami yokuthola lo mdlavuza?

Nakuba kungenakuvinjelwa ngokuphelele, kunezinto eziningana esingazenza ukuze sinciphise ingozi:

• Landela ukudla okuhle: Yidla ukudla okunempilo, yidla izithelo nemifino eminingi, futhi ugcine isisindo esinempilo esikufanele.
• Ukugwema ugwayi notshwala: Lezi yizici ezimbili eziyinhloko ezibangela ingozi.
• Gwema ukuchayeka kumakhemikhali athile (kuye ngokuthi umsebenzi unjani).
• Ukutheleleka nge-HPV kuyisici esiyingozi somdlavuza womphimbo. Buza udokotela wakho ngomuthi wokugomela i-HPV.
• Uma unesifo esifana ne- Barrett's esophagus , udokotela wakho uzoncoma ukuhlolwa okuvamile. Landela leyo miyalelo.

Okwamanje akukho ukuhlolwa kokuhlolwa komdlavuza womphimbo okunconywayo kubantu bonke, kodwa odokotela bangase batuse ukuhlolwa okufana ne-EGD kubantu abanezici eziyingozi kakhulu.

Ngizinakekela kanjani ngemva kokwelashwa?

Eminye imiphumela emibi ingase ivele ngemva kokuhlinzwa komdlavuza womphimbo. Isibonelo, isicanucanu, ukuhlanza, kanye nesilungulela. Ungadinga usizo lokulawula lokhu. Abantu abaningi bangase babe nezinkinga ezifana nalezi:

• Ubunzima bokudla: Umdlavuza kanye nokwelashwa kwawo kungenza kube nzima futhi kube buhlungu ukugwinya ukudla. Lokhu kungabangela nokwehla kwesisindo. Uma kunjalo, funa iseluleko kudokotela wakho. Bangase batuse izinto ezifana nokudla ukudla okuncane, okuvamile kanye nokuphuza izithasiselo zokudla okunempilo.
• I-Dumping syndrome: Lokhu kwenzeka lapho isisu sithatha indawo yomhubhe ngemva kokuhlinzwa. Isisu asikwazi ukubamba nokugaya ukudla, futhi ukudla kudlula ngokushesha emathunjini amancane. Lokhu kungabangela izimpawu ezifana nokucanuzela kwenhliziyo, ukuhlanza, ubuhlungu besisu, ukujuluka, kanye nokushawa.

Khuluma nethimba lakho lezokwelapha ngalezi zinto bese uthola iseluleko sendlela yokubhekana nazo.

Ingabe lo mdlavuza ungabuya?

Yebo, ngezinye izikhathi umdlavuza ungabuya (ukuphinda ubuye). Ungenza lezi zinto ukunciphisa leyo ngozi:

• Nciphisa utshwala: Ukuphuza utshwala ngokweqile kwandisa ingozi yomdlavuza wokubuya.
• Gwema ukusebenzisa ugwayi: Uma ubhema, zama ukuyeka. Funa iseluleko sezokwelapha uma kudingeka.

Kufanele ngimbone nini udokotela?

Lokhu kuzohluka kuye ngesimo sakho. Uhlelo lokulandelela lomuntu osuswe umdlavuza esigabeni sokuqala luhlukile kolulomuntu onesifo somdlavuza esisakazekile.

Uma ukwelashwa kwakho kuphumelele, udokotela wakho uvame ukukucela ukuthi uze uzohlolwa njalo ezinyangeni ezintathu kuya kweziyisithupha eminyakeni emibili yokuqala, kanye njalo ezinyangeni eziyisithupha kuya kweziyishumi nambili eminyakeni emithathu ezayo. Lokhu kuhlolwa kungafaka ukuhlolwa ngokomzimba, ukuhlolwa kwegazi, ukuhlolwa kwezithombe, kanye ne-endoscopy.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Umdlavuza we-esophageal uyisifo esingasongela impilo. Uma unalesi simo, ungase ufune ukubuza udokotela wakho imibuzo efana nale:

• Uhlobo luni lomdlavuza womphimbo enginawo?
• Umdlavuza wami ukusiphi isigaba?
• Yikuphi ukwelashwa okuncomayo?
• Ingabe lokhu kungelapheka ngokuphelele?
• Uma ngingelapheki ngokuphelele, yini ongayenza ukuze ungisize?
• Ngingaphila isikhathi esingakanani nalo mdlavuza?
• Ingabe ngidinga ukwenza ukuhlolwa kofuzo noma ukuhlolwa kwe-biomarker?

Ungesabi ukubuza le mibuzo. Kubaluleke kakhulu ukuthi uqonde kahle isimo sakho.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Umdlavuza we-esophageal ungoweshumi kumdlavuza ovame kakhulu emhlabeni, futhi ubuye ube umdlavuza onzima ukuwulapha. Lokhu kungenxa yokuthi izimpawu zivame ukuvela ngemva kokuba umdlavuza ususakazeke. Ngokuvamile kungaba nzima ukuthola ikhambi eliphelele. Ezimweni ezinjalo, odokotela bagxila ekuhlinzekeni iziguli ngokwelashwa okuzisiza ukuba ziphile isikhathi eside ngangokunokwenzeka futhi zibe nekhwalithi engcono kakhulu yokuphila.

Cishe akukho okunzima empilweni njengokutshelwa ukuthi, "Unesifo esingelapheki." Ngesikhathi esinjengaleso, ungase udinge isikhathi nosizo ukuze ubhekane nesimo. Odokotela bayakuqonda lokhu futhi bazokwenza konke okusemandleni abo ukukusiza. Uma kudingeka, bazokudlulisela nakuchwepheshe wezempilo yengqondo.

Into ebaluleke kakhulu ukuqaphela izinguquko emzimbeni wakho futhi ufune iseluleko sezokwelapha ngokushesha okukhulu uma unenkinga. Uma usheshe ukuyibona, kulapho kungenzeka khona ukuthi ukwelashwa kuphumelele.

Umdlavuza Wesisu , Umdlavuza Wesisu, Izimpawu Zomdlavuza, Umphimbo, Ubunzima Bokugwinya, Ukwelashwa Komdlavuza, Ukwelashwa Nge-Chemotherapy