Ingabe unomdlavuza enyongweni yakho? Ake sifunde ngomdlavuza wenyongo.

Wake wacabanga ukuthi ngisho nesitho esincane kakhulu emzimbeni wethu, esingasinaki kakhulu ngezinye izikhathi, singaba nesifo esibi kakhulu? Yilokho okwenzekayo nge-gallbladder. Lesi simo esibizwa ngokuthi umdlavuza we-gallbladder singakhula. Nakuba lokhu kungavamile, kubaluleke kakhulu ukukuqaphela. Ngakho-ke, namuhla sizokhuluma ngomdlavuza we-gallbladder kalula, ngendlela ongayiqonda.

Uyini Umdlavuza Wesinqe?

Kalula nje, umdlavuza wenyongo yilapho amangqamuzana enyongo yakho eqala ukukhula ngendlela engavamile futhi ngokushesha, engalawuleki. Lawa maseli yilokho esikubiza ngokuthi amangqamuzana anonya.

Manje unombuzo, iyini le gallbladder futhi yenzani? Igallbladder iyisitho esincane esitholakala ngakwesokudla kwesisu sethu, ngaphansi kwesibindi, futhi sime njengepheya elincane. Umsebenzi waso oyinhloko ukuqoqa nokugcina inyongo, uketshezi olukhiqizwa yisibindi, nokusisiza ukugaya ukudla okunamafutha esikudlayo. Kufana nethangi lamanzi.

Lo mdlavuza uvame ukuqala ongqimbeni oluncane ngaphakathi kwenyongo. Odokotela bakubiza ngokuthi 'ungqimba lwama-mucosal '. Ngokuhamba kwesikhathi, la maseli omdlavuza angasakazeka odongeni lwenyongo aze aphume.

Okudabukisayo ukuthi lo mdlavuza awuvamile ukubonisa zimpawu ezigabeni zawo zokuqala. Ngakho-ke, ngezinye izikhathi utholakala ngengozi ngemva kokuhlinzwa ukuze kususwe inyongo ngesinye isizathu.

Kodwa-ke, uma utholakala kusenesikhathi futhi ususwe ngokuphelele ngokuhlinzwa, lo mdlavuza unethuba elikhulu kakhulu lokwelashwa. Kodwa-ke, ngesikhathi abantu abaningi betholakala ukuthi unesifo, umdlavuza usuvele usakazekele ngale kwenyongo. Ngaleso sikhathi, ukwelashwa kuba nzima kakhulu.

Uvame kangakanani lo mdlavuza?

Uma kuqhathaniswa namazwe afana ne-United States, kunzima kancane ukuthola izibalo ezinembile ngalo mdlavuza eSri Lanka. Kodwa-ke, kwamanye amazwe omhlaba, isibonelo, emazweni afana ne-India, i-Japan, ne-Korea, kubonakala kakhulu. Lokhu kungenzeka ngoba ukwakheka kwamatshe enyongo nezinye izimo ezandisa ingozi yalo mdlavuza kuvame kakhulu kulawo mazwe.

Ziyini izimpawu? Ingabe kunzima ukubona kusenesikhathi?

Njengoba sishilo ngaphambili, umdlavuza wenyongo awubonakalisi izimpawu ezigabeni zawo zokuqala. Ngisho noma izimpawu zivela, zivame ukufana nalezo ezibangelwa amatshe enyongo noma ukuvaleka kwe-bile duct, ngakho-ke zingadideka kalula.

Izimpawu eziyinhloko ezingabonakala yilezi:

• Ubuhlungu obukhulu engxenyeni ephezulu kwesokudla yesisu .
• Ukuphuzi kwesikhumba kanye nokumhlophe kwamehlo. Lokhu kubizwa ngokuthi i-jaundice .
• Ukuzizwa sengathi kuneqhubu esiswini.
• Ukwehlisa isisindo ngaphandle kwesizathu.
• Isicanucanu nokuhlanza.
• Ukuzizwa sengathi isisu sakho sigcwele (ukuqunjelwa).
• Umkhuhlane ovamile.

Uma unesinye noma ngaphezulu salezi zimpawu, akusho ukuthi unomdlavuza ngaso sonke isikhathi. Kodwa-ke, uma lezi zimpawu ziqhubeka, kungcono ukubona udokotela ukuze akunike iseluleko.

Kungani lolu hlobo lomdlavuza lukhula?

Umdlavuza wenyongo uqala lapho amangqamuzana aphilile eba amangqamuzana omdlavuza futhi eqala ukukhula ngaphandle kokulawulwa. Lokhu kwenzeka lapho izinguquko, ezibizwa ngokuthi 'izinguquko' , zenzeka ezintweni zofuzo ezisemaselini ethu. Lokhu kuguquka kwezakhi zofuzo kukhula ngokuhamba kwesikhathi, hhayi kubazali bethu.

Ososayensi abakakazi kahle ukuthi kungani amangqamuzana aphilile ephenduka ngokuzumayo abe amangqamuzana omdlavuza. Kodwa-ke, bathole ezinye izinto eziyingozi ezandisa ingozi yokuthola lo mdlavuza.

Yiziphi izinto ezibangela ingozi?

Kunezinhlobo eziningana zezimo ezikubeka engcupheni enkulu yokuthola lo mdlavuza:

• Abesifazane basengozini enkulu kunabesilisa.
• Abantu abangaphezu kweminyaka engama-65 basengozini enkulu. (Isilinganiso seminyaka yokuxilongwa sicishe sibe ngu-72.)
• E-United States, kutholakale ukuthi kwenzeka kaningi kubantu baseNdiya baseMelika, aboMdabu base-Alaska, kanye nabantu baseMexico-America.

Ezinye izinto eziyingozi:

• Ukuba khona noma umlando wangaphambilini wamatshe enyongo .
• Ukuba nama -polyp enyongo ( izimila ezincane ezifana nesimila).
• Ukuvuvukala okungapheli kwenyongo (i-cholecystitis) .
• Ukutheleleka isikhathi eside ngebhaktheriya i-Salmonella typhi, okubangela umkhuhlane we-typhoid.
• Ukuqongelela kwe-calcium ezindongeni zenyongo (lokhu kubizwa ngokuthi 'inyongo ye-porcelain ').
• Ukuvuvukala kwemisele ye-bile isikhathi eside ( i-primary sclerosing cholangitis ).
• Ukwakheka kwama-cysts emgudwini oyinhloko we-bile ( ama-cysts e-choledochal ).
• Ukukhuluphala ngokweqile .

Ngaphezu kwalokho, ukubhema kanye nokuchayeka kumakhemikhali athile asetshenziswa ekukhiqizeni izindwangu nerabha nakho kucatshangwa ukuthi kwandisa ingozi.

Ukubona kanjani lokhu?

Njengoba sixoxile ngaphambili, umdlavuza wenyongo uvame ukutholakala sekwephuzile ngoba izimpawu zawo zokuqala zincane futhi izimpawu zawo zifana nezinye izifo. Ngezinye izikhathi utholakala ngengozi, kungaba ngenxa yamatshe enyongo noma ngesikhathi sokuhlinzwa ukuze kususwe inyongo.

Uma udokotela wakho esola ukuthi unomdlavuza wenyongo, uzokuhlola, akubuze ngomlando wakho wezokwelapha, bese e-oda ukuhlolwa okuthile.

Yiziphi izivivinyo ezenziwayo?

Lokhu kuhlolwa kungafaka ukuhlolwa kwegazi, ukuskena okuhlukahlukene, ngisho nokuhlinzwa okuncane.

• Ukuhlolwa kwegazi (Ukuhlolwa kwelebhu):
• Ukuhlolwa kokusebenza kwesibindi: Lokhu kulinganisa amazinga ezinto ezithile ezikhishwa yisibindi. Lokhu kunganikeza umbono wokuthi umdlavuza we-gallbladder uthinte isibindi yini.
• Ukuhlolwa kwe-CEA (i-carcinoembryonic antigen): I-CEA iwuphawu lwesimila olukhishwa amaseli aphilile kanye nomdlavuza. Amazinga aphezulu alokhu angaba uphawu lomdlavuza wenyongo.
• Ukuhlolwa kwe-CA 19-9: Lokhu futhi kuyisibonakaliso sesimila. Amazinga aphezulu alokhu angaba uphawu lomdlavuza we-gallbladder noma we-pancreatic.

• Ukuhlolwa kwezithombe: Lokhu kungasiza odokotela ukuthi babone ukuthi umdlavuza ukhona yini nokuthi ususakazekile yini.
• I-ultrasound yesisu: Lokhu kusebenzisa amaza omsindo ukuthatha izithombe zezitho zesisu. Uma lokhu kubonisa okuthile okufana nesimila senyongo, ungase ucelwe ukuba wenze i-CT scan noma i-MRI scan.
• I-CT scan (i-computed tomography scan): Uhlobo lwe-X-ray lusetshenziselwa ukuthatha izithombe ezinemininingwane yezitho zangaphakathi.
• I-MRI scan (i-magnetic resonance imaging): Isebenzisa i-magnet, amaza omsakazo, kanye nekhompyutha ukuthatha izithombe zengaphakathi lomzimba.
• I-ultrasound ye-Endoscopic: Izithombe zomgudu wokugaya ukudla zithathwa kusetshenziswa ithuluzi elifana nethubhu elibizwa ngokuthi i-endoscope.
• I-ERCP (i-Endoscopic retrograde cholangiopancreatography): Inqubo ethatha izithombe ze-X-ray zemibhobho yenyongo. Umdlavuza wenyongo ungabangela ukuthi le mibhobho ibe mincane.

• Ukuhlinzwa okuncane:
• I-Biopsy: Lokhu kuhilela ukuthatha isampula encane yezicubu ezisolisayo bese uzihlola ngaphansi kwe-microscope ukuze ubone ukuthi kukhona yini amangqamuzana omdlavuza. I-biopsy iyindlela kuphela yokuqinisekisa umdlavuza we-gallbladder.
• I-Laparoscopy: Kule nqubo, kufakwa ipayipi elincane elinekhamera (elibizwa ngokuthi i-laparoscope) esiswini ngomsikelo omncane ukuhlola i-gallbladder nezicubu ezizungezile. Lokhu kusiza ekunqumeni ukuthi umdlavuza ususakazeke kangakanani.

Ziyini izigaba zomdlavuza?

Ukuhlolwa komdlavuza kuyindlela udokotela wakho anquma ngayo ukuthi umdlavuza ususakazeke (ususakazeke kakhulu) ngaphezu kwalokho owaqala kukho. Kuye ngokuthi umdlavuza ususakazeke kangakanani, udokotela wakho uzonikeza umdlavuza wakho inombolo (kusukela ku-zero kuya ku-4). Izinombolo eziphakeme zisho ukuthi umdlavuza ususakazeke ezindaweni eziningi zomzimba wakho.

Nazi izigaba zomdlavuza we-gallbladder:

• Isigaba 0 (Isigaba 0 - `i-carcinoma in situ`): Amaseli angajwayelekile, angaba nomdlavuza atholakala engxenyeni engaphakathi (i-mucosa) yenyongo.
• Isigaba 1: Amaseli omdlavuza asezansi kwenyongo futhi kungenzeka ukuthi asakazekele emisipheni yenyongo.
• Isigaba 2:Umdlavuza ususakazeke ngale kwengqimba yemisipha waze wafika ezingqimbeni zezicubu ezixhumeneyo zenyongo.
• Isigaba 3: Umdlavuza ususakazekele esibindini noma kwezinye izitho eziseduze, noma ongqimbeni olungaphandle (ungqimba lwe-serosal) lwenyongo. Kungenzeka ukuthi ususakazekele nasezinhlayiyeni ze-lymph.
• Isigaba sesi-4: Umdlavuza ususakazekele kuma-lymph node angaphezu kwamathathu aseduze, imithambo yegazi, kanye/noma izitho ezikude nenyongo.

Odokotela babiza umdlavuza wenyongo wesigaba sokuqala ngokuthi "wendawo." Lokhu kusho ukuthi umdlavuza awusakazekanga ngaphandle kwenyongo. Umdlavuza wesigaba sokuqala unamathuba amaningi okwelashwa. Izigaba 2, 3, kanye ne-4 zinzima kakhulu ukwelapha.

Lo mdlavuza usakazeka kanjani?

Umdlavuza wenyongo uqala engxenyeni engaphakathi yenyongo bese usakazekela engxenyeni engaphandle. Ngokuhamba kwesikhathi, ungasakazekela kuma-lymph node aseduze, esibindini, nakwezinye izitho zomzimba, njengemibhobho yenyongo. Umdlavuza wenyongo osakazekayo ungasakazeka ohlelweni lwe-lymphatic, egazini, noma ezithweni ezikude emzimbeni.

Yiziphi izindlela zokwelapha?

Isigaba somdlavuza sinquma izindlela zokwelapha kanye nemigomo yokwelapha. Esigabeni sokuqala somdlavuza, umgomo oyinhloko ukususa umdlavuza ngokuphelele nokuwuvimba ukuthi ungabuyi. Uma umdlavuza ususakazeke, umgomo wokwelashwa ukwandisa impilo nokulawula izimpawu.

Ukwelashwa komdlavuza wesigaba sokuqala

Umdlavuza wenyongo osesigabeni sokuqala, ongasuswa ngokuhlinzwa, unemiphumela emihle kakhulu yokwelashwa.

• Ukuhlinzwa: Udokotela ohlinzayo (udokotela ohlinzayo womdlavuza) uzosusa inyongo yakho kanye nezicubu ezithintekile ezizungezile. Lokhu kubizwa ngokuthi i-cholecystectomy . Ngezinye izikhathi kususwa inyongo kuphela (i-cholecystectomy elula), kodwa ngezinye izikhathi ama-lymph node aqukethe amangqamuzana omdlavuza noma ingxenye yesibindi, njengenyongo, nawo angasuswa (i-cholecystectomy enwetshiwe).
• Ukwelashwa ngemisebe: Kulokhu, umshini ongaphandle komzimba (i-EBRT - ukwelashwa ngemisebe yangaphandle) uqondisa imisebe yemisebe endaweni yomdlavuza. Lo msebe ubulala amangqamuzana omdlavuza noma unciphise ukukhula kwesimila. Lokhu kwenziwa ngendlela enciphisa umonakalo kumaseli aphilile. Lo kwelashwa kunganikezwa ukubulala noma yimaphi amangqamuzana omdlavuza angase ashiywe ngemva kokuhlinzwa. Ukwelashwa ngemisebe kungasiza futhi ekunciphiseni izimpawu.
• Ukwelashwa ngamakhemikhali: Lokhu kusebenzisa imithi ukubulala amangqamuzana omdlavuza noma ukuwavimba ukuthi angaphindaphindeki. Njengokwelashwa ngemisebe, ukwelashwa ngamakhemikhali kusiza ukubulala noma yimaphi amangqamuzana omdlavuza asele ngemva kokuhlinzwa. Ngezinye izikhathi, udokotela wakho angase akuncome ukwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe.

Ukwelashwa komdlavuza ongasebenzi, ophindaphindayo, noma osakazeka kalula

Umdlavuza ongeke ususwe ngokuhlinzwa (`ongasuswa`), obuyile ngemva kokwelashwa (`ophindaphindayo`), noma osakazekele kwezinye izingxenye zomzimba (`osakazeka kalula`) kunzima ukuwuqeda ngokuphelele. Nakuba ukwelashwa okufana nokwelashwa ngemisebe kanye ne-`chemotherapy` kungenakuwuqeda ngokuphelele umdlavuza, kungasiza ekunciphiseni izimpawu zakho futhi kwandise impilo yakho. Futhi, uma umdlavuza uvimba ipayipi lakho lokudla, ukuhlinzwa kungenziwa ukuze kuqedwe lezo zimpawu.

Kulezi zimo, ungase ube nethuba lokubamba iqhaza esivivinyweni somtholampilo . Izivivinyo zemitholampilo ziyizifundo ezihlola ukwelashwa okusha kanye nezindlela ezintsha zokwelapha ezikhona. Ezinye zezindlela zokwelapha ezivivinywayo njengamanje ezivivinyweni zemitholampilo zomdlavuza wenyongo zifaka:

• Ukwelashwa okuqondiwe: Ukwelashwa okuqondiswe kuphela kumaseli omdlavuza anezinguquko ezithile zofuzo.
• Ukwelashwa Ngezifo Ezingalawuleki: Ukwelashwa okuqinisa amasosha omzimba wakho ukuze kusize ekuqapheleni nasekubhubhiseni amangqamuzana omdlavuza.
• Ama-Radiosensitizer: Ukwelashwa okwenza amangqamuzana omdlavuza azwele kakhulu ekwelashweni ngemisebe.

Buza udokotela wakho ukuthi uyakufanelekela yini ukuhlolwa kwezokwelapha.

Ingabe ikhona imiphumela emibi yokwelashwa?

Njenganoma yikuphi ukuhlinzwa, kunezingozi zokutheleleka, izinkinga ezivela ekubulaweni yizinzwa, kanye nokuqhekeka kwegazi. Kufanele uxoxe ngakho konke lokhu nodokotela wakho ngaphambi kokuqala ukwelashwa.

Kubalulekile futhi ukuqaphela imiphumela emibi engaba khona ye-chemotherapy kanye ne-radiation therapy. Akuwona wonke umuntu obhekana nemiphumela emibi ngendlela efanayo. Kodwa-ke, udokotela wakho angakuchazela ukuthi yimiphi imiphumela emibi engase yenzeke kuye ngohlelo lwakho lokwelashwa.

Ingabe ikhona indlela yokuvimbela lokhu?

Ayikho indlela eqinisekile yokuvimbela ngokuphelele umdlavuza we-gallbladder. Kodwa-ke, ungazama ukunciphisa izici eziyingozi esixoxe ngazo ekuqaleni ngangokunokwenzeka. Isibonelo, ungakhuluma nodokotela wakho futhi ugcine isisindo esinempilo esikufanele. Kodwa-ke, ngisho nokwenza kanjalo akuqinisekisi ukuthi ngeke ube nomdlavuza ngokuphelele.

Ingakanani amathuba okululama?

Umdlavuza we-gallbladder uvame ukutholakala ngemva kokuba lesi sifo sesisabalele, ngakho-ke ukubikezela akukuhle. Cishe ama-20% kuphela omdlavuza we-gallbladder atholakala esiteji sokuqala. Izinga lokusinda kweminyaka emihlanu kubantu abanomdlavuza osakazekele kwezinye izingxenye zomzimba (owakhiwe ngama-metastasized) liphansi njengo-2%. Kodwa-ke, uma umdlavuza utholakala e-gallbladder, okungukuthi, esigabeni sokuqala, izinga lokusinda kweminyaka emihlanu likhuphuka lifike kuma-66%.

Lokho kusho ukuthi, uma kutholakala kusenesikhathi, kunethemba elikhulu lokululama!

Yini ongayenza uma uphila nomdlavuza?

Ukuthola ukuthi unomdlavuza wenyongo kungaba nzima ukubhekana nawo. Kodwa kubalulekile ukuqonda ukuxilongwa kwakho, izinzuzo nezinkinga zezinketho zakho zokwelashwa, kanye nohlelo lwakho lokululama. Ithimba lakho lokunakekelwa komdlavuza liyindawo engcono kakhulu yokukuchazela konke lokhu.

Ukuxhumana nochwepheshe abanikeza ukunakekelwa kokunciphisa ubuhlungu nakho kungakusiza ukuphatha izimpawu zakho. Ukunakekelwa kokunciphisa ubuhlungu kuyisevisi egxile ekududuzeni nasezidingweni zakho, kungakhathaliseki ukuthi isimo sakho sinjani. Buza udokotela wakho uma udinga ukunakekelwa kokunciphisa ubuhlungu.

Yini okufanele uyibuze udokotela?

Uma uya kudokotela wakho, bhala uhlu lwemibuzo onayo mayelana nomdlavuza wenyongo. Isibonelo, ungase ubuze imibuzo efana nale:

• Yiziphi izivivinyo okufanele ngizenze ukuze ngazi isigaba esiqondile somdlavuza wami?
• Umdlavuza wami wenyongo usezingeni elingakanani?
• Iyiphi indlela yokwelapha engcono kakhulu kimi?
• Yiziphi izinzuzo kanye nezingozi ezingaba khona zalokhu kwelashwa?
• Yiziphi izinsiza ezitholakalayo zokungisekela phakathi nalesi sikhathi?

Umlayezo Wokuya Nawe Ekhaya

Umdlavuza we-gallbladder uyisimo esingavamile kodwa esibi kakhulu. Uma ucabanga ukuthi ungase ube nezimpawu zomdlavuza we-gallbladder, bona udokotela ngokushesha okukhulu. Khumbula ukuthi nakuba ezinye izinhlobo zomdlavuza zingase zibonise izimpawu kusenesikhathi, umdlavuza we-gallbladder ungase ungabonakali izimpawu ezisobala kuze kube yilapho sekwephuzile kulesi sifo. Ngakho-ke, kubaluleke kakhulu ukufuna ukwelashwa kusenesikhathi.

Uma sitholakale kusenesikhathi, lesi sifo selapheka kakhulu. Ngakho-ke, ungazinaki izimpawu. Nakekela umzimba wakho futhi ufune iseluleko sezokwelapha uma kudingeka.

Umdlavuza wenyongo, umdlavuza wenyongo, izimpawu zomdlavuza, inyongo, izigaba zomdlavuza, ukwelashwa komdlavuza, i-CEA, CA 19-9