Uyazazi yini ngomdlavuza wezinso? Ake sixoxe ngakho!

Wake waphawula ubuhlungu obuqhubekayo ohlangothini olulodwa lomzimba wakho, ikakhulukazi endaweni yesisu, noma igazi emchameni wakho? Ngezinye izikhathi asizinaki kakhulu lezi zinto, kodwa zingaba uphawu lwenkinga yezinso. Namuhla sizokhuluma ngesimo esingaba sibi kakhulu, okungukuthi umdlavuza wezinso. Ungesabi, into ebaluleke kakhulu ukuqaphela lokhu.

Uyini Umdlavuza Wezinso?

Kalula nje, umdlavuza wezinso ulapho amangqamuzana ezinso zakho eqala ukukhula ngendlela engavamile futhi engalawuleki. Ngokuhamba kwesikhathi, lawa maseli ahlukana ngendlela engavamile ahlangana ndawonye ukuze akhe isimila. Umdlavuza uqala lapho lawa maseli eshintsha ngesizathu esithile futhi eqala ukuhlukana ngendlela engalawuleki.

Isimila esibi njengalesi singaba yingozi ngoba singasakazeka ngale kwezinso siye ezicutshini eziseduze nakwezinye izitho ezibalulekile. Lokhu kusakazeka komdlavuza kwezinye izingxenye zomzimba kubizwa ngokuthi i-metastasis.

Ubani onamathuba amaningi okuthola umdlavuza wezinso?

Uma kukhulunywa ngomdlavuza wezinso, uvame kakhulu kubantu abaneminyaka ephakathi kuka-65 no-74. Kutholakale nokuthi amadoda anamathuba aphindwe kabili okuthola lesi sifo kunabesifazane. Kubikwa nokuthi sivame kakhulu phakathi kwamaqembu athile ezinhlanga.

Kodwa-ke, umdlavuza wezinso awuvamile ezinganeni ezincane. Kodwa-ke, kukhona uhlobo lomdlavuza wezinso olubizwa ngokuthi `(i-Wilms tumor)` oluvela ezinganeni. Isibonelo, e-United States kuphela, izingane ezingaba ngu-500-600 zihlushwa yilesi `(i-Wilms tumor)` minyaka yonke.

Yiziphi izinhlobo eziyinhloko zomdlavuza wezinso?

Kunezinhlobo ezahlukene zomdlavuza wezinso. Ake sibheke eziyinhloko:

• I-Renal cell carcinoma (RCC): Lolu uhlobo oluvame kakhulu lomdlavuza wezinso kubantu abadala. Lubangela cishe u-85% wazo zonke izinhlobo zomdlavuza wezinso. I-RCC ivame ukukhula njengesimila esisodwa enso eyodwa, kodwa ngezinye izikhathi ingathinta zombili izinso. Lo mdlavuza uqala emaseli ahambisana namapayipi amancane (ama-tubules) ezinso abuyisela izakhamzimba kanye noketshezi egazini. Uhlobo oluvame kakhulu lwe-RCC yi-clear cell renal cell carcinoma (ccRCC).

• Umdlavuza weseli oguqukayo: Lolu hlobo lomdlavuza lubangela u-6% kuya ku-7% wazo zonke izinhlobo zomdlavuza wezinso. Lo mdlavuza uvame ukuqala lapho i-ureter yakho ixhumana khona nengxenye eyinhloko yezinso zakho. Le ndawo ibizwa ngokuthi i-renal pelvis. I-Transitional cell carcinoma ingakhula futhi kuma-ureter akho noma esinyeni.

• I-Sarcoma yezinso:Lolu uhlobo lomdlavuza wezinso olungavamile kakhulu. Lubangela u-1% kuphela womdlavuza wezinso. Luqala ezicutshini zezinso. Uma lungelashwa kahle, lungasakazekela ezithweni nasemathanjeni aseduze.

• Isimila sikaWilms: Lolu uhlobo lomdlavuza wezinso oluvame kakhulu ezinganeni ezincane, olubangela cishe u-5% womdlavuza wezinso.

Uvame kangakanani umdlavuza wezinso?

Kwamanye amazwe emhlabeni jikelele, njenge-United States, umdlavuza wezinso ubanga cishe u-3.7% wazo zonke izinhlobo zomdlavuza. Lokhu kusho ukuthi izinkulungwane zabantu zitholakala zinesifo minyaka yonke. Ingozi yokuba nomdlavuza wezinso iyanda njengoba iminyaka ikhula.

Ziyini izimpawu zomdlavuza wezinso?

Ezimweni eziningi, umdlavuza wezinso awubonisi zimpawu ezisobala ezigabeni zokuqala. Kodwa-ke, njengoba isimila sikhula, izimpawu ziqala ukuvela. Yingakho umdlavuza wezinso uvame ukutholakala ngemva kokuba ususakazeke kancane.

Izimpawu zomdlavuza wezinso zingafaka:

• Igazi elisemchameni (i-hematuria): Igazi lingase libonakale emehlweni, noma kungaba yiconsi elincane legazi elitholakala ngesikhathi sokuhlolwa komchamo.
• Ukuzwa iqhubu noma ukuvuvukala endaweni yezinso (ezinhlangothini zombili zesinqe).
• Ubuhlungu besifuba: Lokhu kungaba ubuhlungu obuhlala njalo.
• Ukuzizwa ukhathele kakhulu njalo .
• Ukuzizwa ungaphilile kahle ngokuvamile.
• Ukulahlekelwa yisifiso sokudla .
• Ukwehlisa isisindo ngaphandle kwesizathu .
• Umkhuhlane ongapheli oqhubekayo.
• Ubuhlungu bamathambo ( uma umdlavuza usakazeka).
• Umfutho wegazi ophakeme .
• I-anemia (ukuntuleka kwegazi).
• Amazinga aphezulu e-calcium egazini .

Cabanga nje, uma usunesinye salezi zimpawu isikhathi eside, kubaluleke kangakanani ukubona udokotela ngaphandle kokuzishaya indiva.

Yiziphi izimbangela eziyinhloko zomdlavuza wezinso?

Imbangela eqondile yomdlavuza wezinso ayaziwa okwamanje. Kodwa-ke, kuye kwatholakala ezinye izinto eziyingozi ezandisa ingozi yokuthola lesi sifo. Lezi yizi:

• Ukubhema: Abantu ababhemayo basengozini enkulu yokuba nomdlavuza wezinso. Futhi, uma umuntu ebhema isikhathi eside, ingozi iba nkulu.
• Ukukhuluphala ngokweqile: Uma unamafutha amaningi emzimbeni, kulapho ingozi yakho yokuba nomdlavuza wezinso ikhula khona.
• Umfutho wegazi ophezulu (umfutho wegazi ophezulu): Kutholakale ukuthi abantu abanomfutho wegazi ophezulu nabo basengozini enkulu yomdlavuza wezinso.
• Umlando womndeni: Uma othile emndenini wakho eke waba nomdlavuza wezinso, abanye bangase babe sengozini yokuba nawo.
• Ukwelashwa ngemisebe: Uma abesifazane beke baphathwa ngemisebe yokwelapha umdlavuza wesimiso sokuzala, kungase kube nengozi encane yokuba nomdlavuza wezinso.
• Izinguquko zezakhi zofuzo/ukuguquka kwezakhi zofuzo: Izakhi zofuzo zitshela amangqamuzana ethu ukuthi asebenze kanjani. Izinguquko kwezinye izakhi zofuzo zingandisa ingozi yokuba nomdlavuza wezinso.
• Ukwelashwa nge-dialysis yesikhathi eside: I-Dialysis iyindlela yokuhlanza igazi ngomshini okhethekile lapho izinso zingasasebenzi kahle. Kukhona nezingozi kulabo abathola lokhu kwelashwa isikhathi eside.
• I-Tuberous sclerosis complex: Lesi yisimo esibangela ukuquleka, ukukhubazeka kwengqondo, kanye nezimila ezithweni ezahlukene zomzimba. Laba bantu basengozini enkulu yokuba nomdlavuza wezinso.
• Isifo sikaVon Hippel-Lindau (VHL): Lesi yisifo esizuzwe njengefa. Abantu abanalesi sifo banengozi enkulu yokuba nomdlavuza wezinso. Lesi sifo sibangela ukwakheka kwezimila ezingezona umdlavuza emithanjeni yegazi yezindawo ezifana namehlo nobuchopho.

Ingakanani ingozi yomdlavuza wezinso?

Kuyahlukahluka kuye ngohlobo lwesimila. Amanye amathumba ezinso awawona umdlavuza (angabi yingozi / awawona umdlavuza). Lawa ngokuvamile mancane kunezimila ezinomdlavuza futhi awasabalali kwezinye izingxenye zomzimba. Ukwelashwa okuvame kakhulu kwala mathumba angenawo umdlavuza ukususwa ngokuhlinzwa.

Kodwa-ke, kungakhathaliseki ukuthi isimila sakho sezinso sinomdlavuza noma cha, kungcono ukuqala ukwelashwa ngokushesha ngangokunokwenzeka ukuze uvimbele izinkinga.

Umdlavuza wezinso utholakala kanjani?

Uma unezimpawu zomdlavuza wezinso, udokotela wakho uzoqala ngokuthatha umlando ophelele wezokwelapha bese enza ukuhlolwa ngokomzimba. Ngemuva kwalokho, bazo-oda ezinye izivivinyo ukuthola ukuthi unomdlavuza yini, futhi uma kunjalo, ukuthi ukusiphi isigaba. Lezi zivivinyo zifaka:

• Ukuhlolwa Komchamo: Kuthathwa isampula yomchamo wakho bese kuhlolwa igazi. Lokhu kuhlolwa kungathola ngisho nenani elincane legazi elincane kakhulu ukuba lingabonwa ngamehlo enyama.
• Ukuhlolwa kwegazi: Lokhu kubala izinhlobo ezahlukene zamaseli egazini, kanye nama-electrolyte ahlukene emzimbeni. Lokhu kuhlolwa kwegazi kungabona futhi ukubalwa kwamaseli abomvu egazi aphansi (i-anemia) noma izinkinga zokusebenza kwezinso ngokulinganisa amazinga e-creatinine.
• I-CT scan: Lokhu ukuhlolwa kwe-X-ray okukhethekile. Ikhompyutha isetshenziselwa ukuthatha izithombe eziningi ezihlukanisayo (izingcezu) zangaphakathi lomzimba. Ngokuvamile, uketshezi olukhethekile (umehluko we-intravenous / idayi) lufakwa emthanjeni phakathi nalolu vivinyo. Kodwa-ke, lolu dayi kungenzeka lunganikezwa abantu abangasebenzi kahle kwezinso.
• Ukuskena kwe-MRI (i-Magnetic resonance imaging - i-MRI): Lokhu kusebenzisa i-magnet enkulu, amaza omsakazo, kanye nekhompyutha ukuthatha izithombe zengaphakathi lomzimba.
• Ukuskena kwe-Ultrasound: Lokhu kuhlola kusebenzisa amaza omsindo avame kakhulu ukudala izithombe ezingabukwa kusikrini. Lokhu kuyasiza ekutholeni izimila ezihlukile ngobukhulu kunezicubu ezinempilo.
• I-biopsy ye-Renal mass: Kule nqubo, kufakwa inaliti encane esikhumbeni iye endaweni yesimila bese kuthathwa isampula encane yezicubu (i-'biopsy'). Udokotela wezifo ubheka izicubu ngaphansi kwesibonakhulu ukuze abone ukuthi kukhona yini amangqamuzana omdlavuza. Kodwa-ke, lezi zivivinyo ze-'biopsy' zomdlavuza wezinso azinembile ngaso sonke isikhathi ngo-100%, ngakho udokotela wakho angase noma angancomi lokhu kuhlolwa.

Yiziphi izigaba zomdlavuza wezinso?

Iningi lomdlavuza lihlukaniswa ngezigaba. Lokhu kunikeza incazelo yomdlavuza, okwenza kube lula ukuhlela ukwelashwa. Isigaba somdlavuza sinqunywa yilokhu:

• Indawo lapho kukhona khona isimila kanye nobukhulu baso.
• Izinga ama-lymph node athinteke ngalo. (Ama-lymph node afana "nezihlungi" ezincane ezibamba amagciwane, amangqamuzana omdlavuza, kanye namangqamuzana agcina alwa nokutheleleka.)
• Ukuthi umdlavuza ususakazeke kangakanani kwezinye izicubu nezitho zomzimba.

Udokotela wakho usebenzisa ulwazi oluvela ezivivinyweni ezifana ne-CT, i-MRI, kanye ne-biopsy ukuze anqume isigaba somdlavuza.

• Isigaba I: Isimila singamasentimitha angu-7 (cm) noma ngaphansi. Sisezinso kuphela. Asikasabalali kuma-lymph node noma kwezinye izicubu.
• Isigaba II: Isimila sikhulu ngaphezu kwamasentimitha angu-7, kodwa sisalokhu sisezinso. Asikasabalali siye kuma-lymph node noma kwezinye izicubu.
• Isigaba sesiThathu: Isimila sesisabalale emithanjeni yegazi emikhulu - umthambo wezinso kanye ne-inferior vena cava - noma ezicutshini ezizungeze izinso noma ama-lymph node aseduze.
• Isigaba IV: Isimila sesisabalale ngale kwezinso, saya endlaleni yakho ye-adrenal (indlala encane phezu kwezinso), noma kuma-lymph node akude noma kwezinye izitho zomzimba.

Ngaphezu kwalezi zigaba, izimila nazo ziyahlolwa . Lokhu kuyisilinganiso sokuthi amaseli esimila awajwayelekile kangakanani. Lokhu kuhlolwa kutshela nodokotela wakho ukuthi isimila singakhula ngokushesha kangakanani. Izimila ezingabonakali njengamaseli ajwayelekile futhi ezinamaseli ahlukana ngokushesha zibizwa ngokuthi izimila zezinga eliphezulu . Lezi zimila zikhula futhi zisabalale kakhulu kunezimila zezinga eliphansi.

Umdlavuza wezinso welashwa kanjani?

Ukwelashwa komdlavuza wezinso kuyahlukahluka kuye ngesigaba kanye nezinga lesimila, kanye nobudala bakho kanye nempilo yakho iyonke. Izinketho zokwelapha zifaka phakathi ukuhlinzwa, ukususwa kwezicubu, ukwelashwa ngemisebe, ukwelashwa ngemithi eqondiwe, ukwelashwa nge-immunotherapy, kanye ne-chemotherapy ngezinye izikhathi.

Ukuhlinzwa

Ukuhlinzwa kuyindlela eyinhloko yokwelapha izigaba eziningi zomdlavuza wezinso. Kunezinketho eziningana zokuhlinzwa:

• Ukususwa kwe-nephrectomy okuyingxenye: Udokotela ohlinzayo ususa kuphela ingxenye yezinso zakho equkethe isimila.
• Ukususwa kwe-radical nephrectomy: Udokotela ohlinzayo ususa yonke inso yakho kanye nezicubu ezizungezile. Amanye ama-lymph node endaweni nawo angasuswa.

Uma kususwa inso eyodwa, inso esele ivame ukukwazi ukwenza umsebenzi wezinso zombili. Akumangalisi lokho?

Ukuqothula: Ukubhubhisa amangqamuzana omdlavuza ngokushisa noma ukubanda

Ngezinye izikhathi, ukushisa nokubanda kungasetshenziswa ukubhubhisa amangqamuzana omdlavuza. Ukususwa kwe-cryoablation noma i-radiofrequency kungaba usizo kubantu abangafaneleki ukuhlinzwa.

• Ukwelashwa kwe-Cryoablation: Kulokhu kwelashwa, udokotela wakho ufaka inaliti esikhumbeni sakho iye esimila sezinso. Bese kusetshenziswa umoya obandayo kakhulu ukuze kuqandiswe amangqamuzana omdlavuza.
• Ukususwa kwama-radiofrequency: Kule nqubo, udokotela ufaka inaliti esikhumbeni iye esimila sezinso. Bese kuthi ugesi uthunyelwe ngamaseli omdlavuza ukuze uwabhubhise.

Ukwelashwa Ngemisebe

Uma unenso eyodwa kuphela, noma uma ungesiye umuntu ofanele ukuhlinzwa, udokotela wakho angase akuncome ukwelashwa ngemisebe. Ukwelashwa ngemisebe kuvame ukusetshenziselwa ukunciphisa izimpawu zomdlavuza wezinso, njengobuhlungu.

Ukwelashwa Kwemithi Okuqondiwe

Ukwelashwa ngemithi okuqondiwe kusebenza ngokuvimbela izici ezithile ezisiza amangqamuzana omdlavuza ukuba akhule. Isibonelo, le mithi ingavimba ukwakheka kwemithambo yegazi emisha noma amaprotheni ondla umdlavuza.

Ukwelashwa ngemithi okuqondiwe kuvame ukusetshenziswa lapho ukuhlinzwa kungenzeki. Kwezinye izimo, le mithi inikezwa nangemva kokuhlinzwa ukuze kuncishiswe ingozi yokuthi umdlavuza uphinde ubuye.

Ukwelashwa nge-immunotherapy

I-immunotherapy iwukwelashwa okusebenzisa imithi ethile ukuvuselela amasosha omzimba wakho. Lokhu kuvumela umzimba wakho ukuthi uqaphele futhi ubhubhise amangqamuzana omdlavuza ngempumelelo enkulu. I-immunotherapy inganikezwa njengokwelashwa okukodwa noma kuhlanganiswe nokuhlinzwa.

Ukwelashwa ngamakhemikhali

Ukwelashwa ngamakhemikhali akuyona indlela ejwayelekile yokwelapha umdlavuza wezinso. Kodwa-ke, kwezinye izimo - ngokuvamile ngemva kokuba ukwelashwa ngamakhemikhali kanye nokwelashwa ngemithi okuqondisiwe sekuzanyiwe - kungaba usizo. Imithi yokwelapha ngamakhemikhali inikezwa njengamaphilisi athathwa ngomlomo noma ngemithambo yegazi. Lawa avame ukubekezelelwa kahle ngaphandle kwemiphumela emibi emikhulu.

Yini ongayilindela uma unomdlavuza wezinso?

Ukubikezela kwakho umdlavuza wezinso kuncike ohlotsheni kanye nesigaba sawo (okungukuthi, ukuthi uphelele ezinso noma usakazekele kwezinye izingxenye zomzimba). Amathuba akho okululama nawo ancike empilweni yakho iyonke.

Ingabe umdlavuza wezinso ungelapheka?

Njengezinhlobo eziningi zomdlavuza, umdlavuza wezinso welapheka kakhulu uma utholakala kusenesikhathi. Umdlavuza wezinso uvame ukwelapheka uma utholakala kusenesikhathi, ngaphambi kokuba umdlavuza usabalale ngale kwengxenye engaphandle yezinso.

Ingabe umdlavuza wezinso ungavinjelwa?

Ngenxa yokuthi imbangela eqondile yomdlavuza wezinso ayaziwa, ayikho indlela yokuyivimbela ngokuphelele. Kodwa-ke, unganciphisa ingozi yakho ngokungabhemi nokulawula izimo ezifana nomfutho wegazi ophakeme, isifo sikashukela kanye nokukhuluphala ngokweqile.

Kufanele ubonane nini nodokotela?

Uma unezimpawu zomdlavuza wezinso, njengobuhlungu ohlangothini olulodwa lomzimba wakho, iqhubu elizwakala njengeqhubu ezinso zakho, noma igazi emchameni wakho, bona udokotela ngokushesha. Udokotela wakho angenza izivivinyo ukuthola imbangela yezimpawu zakho futhi athuthukise uhlelo lokwelashwa olufanele wena.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ukufunda okuningi ngangokunokwenzeka mayelana nokuxilongwa komdlavuza wezinso kuzokunika amandla futhi kukusize wenze izinqumo ezinolwazi mayelana nokwelashwa kwakho. Nansi eminye imibuzo okufanele uyibuze udokotela wakho:

• Uhlobo luni lomdlavuza wezinso enginalo?
• Ikuphi ithumba?
• Ingabe umdlavuza usezinso kuphela, noma ingabe ususakazekile?
• Nginasiphi isigaba somdlavuza wezinso?
• Yiziphi izindlela zokwelapha enginazo?
• Iyini inkomba yesifo sami?

Kuvamile ukuzizwa wesaba, udabukile, futhi ukhungathekile uma utholakala unomdlavuza wezinso. Njengezinhlobo eziningi zomdlavuza, umdlavuza wezinso usebenza kahle kakhulu uma utholakala kusenesikhathi. Udokotela wakho angakhuluma nawe ngokwelashwa kwakho futhi akunikeze izinsiza ezengeziwe zokukusiza uqonde izinketho zakho. Uma ungakwazi, joyina iqembu lokusekela lendawo noma ucele usizo kumeluleki noma isisebenzi sezenhlalakahle. Lezi zinto zingakusiza uhlale uphilile engqondweni phakathi nalesi sikhathi esinzima.

Izinto ezibaluleke kakhulu okudingeka sizikhumbule (Umyalezo Wokuya Ekhaya)

Ngakho-ke, sikhulume kakhulu ngomdlavuza wezinso namuhla, akunjalo? Ungesabi, ukuqwashisa kungamandla amakhulu.

• Okokuqala, naka izimpawu. Uma unezimpawu eziqhubekayo njengegazi emchameni wakho, ubuhlungu beqolo, ukuphelelwa yisifiso sokudla, noma ukwehla kwesisindo, qiniseka ukuthi ubona udokotela.
• Umdlavuza wezinso welapheka kalula uma utholakala kusenesikhathi. Ngakho-ke ungesabi ukuhlolwa.
• Ukugwema ukubhema, ukugcina isisindo esinempilo, nokulawula izifo ezifana nomfutho wegazi nesifo sikashukela kungasiza ekunciphiseni ingozi yomdlavuza wezinso.
• Uma utholakale unalesi sifo, into engcono kakhulu ongayenza ukukhuluma ngokukhululekile nodokotela wakho bese ukhetha indlela yokwelapha ekufanelekela kangcono.

Khumbula, awuwedwa. Ngolwazi olufanele kanye nokusekelwa, ungabhekana nalesi simo.

umdlavuza wezinso , umdlavuza wezinso, izimpawu zomdlavuza, isifo sezinso, i-RCC, isimila saseWilms, ukwelashwa komdlavuza