Uyazi nge-peritoneal carcinomatosis? Ake sixoxe ngayo!

Ingabe ngezinye izikhathi uzizwa ungakhululekile esiswini, ukuvuvukala, noma ubuhlungu besisu? Lezi zimpawu empeleni zivame kakhulu, futhi ngezinye izikhathi zingabangelwa okuthile esikudlayo noma esikuphuzayo, noma ngisho nokutheleleka okuncane. Kodwa-ke, ngezinye izikhathi kungase kube nokuthile okubi kakhulu ngemuva kwazo okudinga ukunakwa. Yilokho okushiwo yi -peritoneal carcinomatosis . Igama lingase lizwakale liyinkimbinkimbi kancane, kodwa ake sixoxe ngakho kalula futhi sikuqonde.

Kuyini i-Peritoneal Carcinomatosis?

Kalula nje, lokhu kusho ukuthi umdlavuza oqale kwenye indawo emzimbeni wethu ususakazekele olwelwesini olubizwa ngokuthi i-peritoneum . Manje ungase uzibuze ukuthi iyini le peritoneum. Iyi-membrane encane emboze ingaphakathi lesisu sethu, okungukuthi, ulwelwesi lwesisu kanye nolwelwesi lwe-pelvic. Izitho eziningana zangaphakathi, njengamathumbu ethu, isibindi, kanye nesisu, zimbozwe yilolu lwelwesi.

Ngakho-ke, uma umdlavuza ukhula kwesinye isitho, isibonelo, i-ovary noma i-colon, futhi lawo maseli omdlavuza eza e-peritoneum futhi akhe amathumba amasha lapho, siwubiza ngokuthi i-peritoneal carcinomatosis . Lokhu kuhlukile kumdlavuza we-peritoneal oyinhloko, oqala e-peritoneum uqobo, ngoba kulokhu umdlavuza uqala kwenye indawo.

Lezi zinhlobo zomdlavuza zibizwa nangokuthi umdlavuza wesigaba sokugcina noma umdlavuza osakazeka kalula . Yiqiniso, lezi zimbi kakhulu kunomdlavuza wesigaba sokuqala. Kodwa ungakhathazeki. Njengoba kunezindlela ezintsha zokwelapha ezitholakalayo, kungenzeka ukulawula ukusabalala kwalesi sifo nokusiza isiguli siphile isikhathi eside.

Yiziphi izinhlobo zomdlavuza ezivame ukubangela lesi simo?

Cishe noma yimuphi umdlavuza ungasakazekela e-peritoneum, kodwa izinhlobo ezilandelayo zomdlavuza cishe zibangela lesi simo:

• Umdlavuza wesibeletho (lona uvame kakhulu)
• Umdlavuza wamathumbu amakhulu
• Umdlavuza wesisu
• Umdlavuza we-pancreatic
• Umdlavuza wesithasiselo
• Umdlavuza we-rectal

Ziyini izimpawu ze-Peritoneal Carcinomatosis?

Esikhathini esiningi, lesi simo asibangeli zimpawu kuze kube yilapho sithinta indawo enkulu ye-peritoneum. Okusho ukuthi, izimpawu ziqala ukuvela kuphela ngemva kokuba isifo sesisakazeke kancane. Uma lokhu kwenzeka, uphawu oluvame kakhulu ukunqwabelana koketshezi esiswini (ascites) . Yilapho isisu siqala ukuvuvukala ngendlela engavamile.

Kungase kube nezinye izimpawu eziningana ezihlobene nalokhu:

• Ukukhathala okuvamile
• Isisu esivuvukile ( ngenxa yokugcina uketshezi)
• Ubuhlungu besisu
• Isisindo sesisu
• Ubuhlungu obuphansi emhlane
• Isicanucanu nokuhlanza
• Ukuqunjelwa
• Ukwehla kwesisindo okungachazeki noma ukukhuluphala

Manje, bheka, iningi lalezi zimpawu livame nakwezinye izifo ezivamile. Isibonelo, ubuhlungu besisu bungaba khona naku-gastritis. Ngakho-ke, ngoba nje unalezi zimpawu, ungesabi ucabange ukuthi unalesi simo esibi. Kodwa-ke, uma uqhubeka nokuba nalezi zimpawu, kuwukuhlakanipha ukubona udokotela futhi uhlolwe. Ngoba udokotela kuphela ongasho ngokuqinisekile ukuthi lokhu kungumdlavuza noma cha.

Yini ebangela lokhu?

I-Peritoneal carcinomatosis iyenzeka, njengoba kushiwo ngaphambili, lapho umdlavuza ovela engxenyeni ethile yomzimba usakazekela ku-peritoneum. Ngokuvamile, lo mdlavuza uqala ngaphakathi esiswini, esithweni esiseduze ne-peritoneum. Isibonelo, ama-ovari noma ikholoni.

Kodwa-ke, cishe kumaphesenti ayishumi (10%) ezimo, lo mdlavuza uqala esithweni esingaphandle komgodi wesisu. Uma kunjalo, amangqamuzana omdlavuza ahamba ngegazi noma ohlelweni lwe-lymphatic ukuze afinyelele ku-peritoneum. Cabanga ngakho njengezingcezu ezincane zothuli ezihamba emgudwini wamanzi, lawa maseli ahamba nangoketshezi lomzimba.

Lesi sifo sitholakala kanjani? (Ukuxilongwa)

Odokotela basebenzisa izivivinyo eziningana ukuze bathole lesi simo. Ezinye zazo yilezi:

• Ukuhlolwa kwezithombe: Lokhu kufaka phakathi ama-CT scan , ama-MRI scan , kanye nama-PET scan . Lezi zinhlobo zama-scan zinganikeza isithombe esicacile sokuthi umdlavuza ususakazeke kangakanani waya e-peritoneum nokuthi ukuphi.
• Ukuhlolwa kwegazi: Igazi lakho lihlolwa amaprotheni akhethekile abizwa ngokuthi ama-tumor markers . Amanye amangqamuzana omdlavuza ayawakhipha egazini. Amazinga aphezulu alawa angaba uphawu lwesifo.
• I-Paracentesis: Uma unoketshezi esiswini sakho (i-ascites), udokotela wakho angase athathe isampula encane yoketshezi bese eluhlola elebhu. Lokhu kungasiza ekunqumeni ukuthi hlobo luni lomdlavuza olusakazeke, noma ukuthi uyini umdlavuza oyinhloko.
• I-Biopsy: Lokhu kuhilela ukuthatha ingxenye encane kakhulu yesimila bese uyihlola ngaphansi kwesibonakhulu ukuze ubone ukuthi kukhona yini amangqamuzana omdlavuza. Lokhu kuwukuphela kokuhlolwa okungabona ngokuqinisekile ukuthi umdlavuza noma cha.

Iyini i-Peritoneal Carcinomatosis Index (PCI)?

Le PCI iyithuluzi elibalulekile enkambisweni yokuxilonga esiza odokotela ukuhlela ukwelashwa. Besebenzisa lolu hlu, odokotela bakunikeza amaphuzu asekelwe ekutheni amangqamuzana omdlavuza akuphi futhi makhulu kangakanani esiswini sakho nasemathunjini amancane.

Lolu lwazi lungasiza udokotela ukuthi aqonde futhi athole umbono wokuthi ukuhlinzwa kungawasusa ngokuphelele yini la mathumba noma cha.

Yiziphi izindlela zokwelapha lokhu? (Ukwelashwa)

Ukwelashwa okuyinhloko nokwejwayelekile kwamanje kwe-peritoneal carcinomatosis ukwelashwa okubizwa ngokuthi i-Hyperthermic Intraperitoneal Chemotherapy (HIPEC) kuhlanganiswe nokuhlinzwa kwe-cytoreductive (CRS) .

Nakuba lokhu kungase kubonakale sengathi kuyinkulumo enamagama amabili eyinkimbinkimbi, kumane nje kufana nalokhu:

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* I-CRS (Ukuhlinzwa Kwe-Cytoreductive): Umgomo walokhu kuhlinzwa ukususa zonke izimila zomdlavuza ezibonakalayo olwelwesini lwe-peritoneal.

* I-HIPEC (Hyperthermic Intraperitoneal Chemotherapy): Le ndlela isetshenziselwa ukubhubhisa noma yimaphi amangqamuzana omdlavuza asele amancane kakhulu ukuba angabonwa ngamehlo enyama ngemva kokuhlinzwa kwe-CRS. Kulokhu, imithi ye-chemotherapy efudumele ifakwa ngqo esiswini, ishiywe endaweni yayo isikhashana, bese isuswa. Ngenxa yokuthi imithi iyashiswa futhi ihanjiswe ngqo kumdlavuza, isebenza kangcono kune-chemotherapy yendabuko.

Lokhu kwelashwa kwe-CRS kanye ne-HIPEC kunikezwa ngaphezu kokwelashwa okunikezwa isitho lapho umdlavuza waqala khona.

Ngezinye izikhathi, akuwona wonke umuntu ongenza ukuhlinzwa kwe-CRS. Okusho ukuthi, isimo sesiguli singase singafaneleki ukuhlinzwa. Ngisho nakubantu abanjalo, ukunakekelwa kobuhlungu kungasiza ekulawuleni izimpawu nokunciphisa ubuhlungu. Ukunakekelwa kobuhlungu kuyindlela yokwelapha esiza isiguli ukuba sikhululeke ngangokunokwenzeka, kungakhathaliseki ukuthi umdlavuza ukusiphi isigaba.

Ingabe zikhona izinkinga zokwelashwa?

Ucwaningo lwakamuva lubonisa ukuthi kokubili i-CRS kanye ne-HIPEC kuyindlela yokwelapha ephephile nephumelelayo uma iziguli zihlolwa ngokucophelela futhi zikhethwa ngendlela efanele. Imiphumela iba mihle kakhulu uma ukuhlinzwa kwenziwa esikhungweni esinolwazi esenza lokhu kwelashwa njalo.

Kodwa-ke, njenganoma yikuphi ukuhlinzwa okukhulu, kunezinkinga ezithile ezingase zenzeke. Nakuba zingavamile kakhulu, lezi zingaba yingozi empilweni uma zingelashwa ngokushesha. Lezi zinkinga zifaka:

• Ukopha okukhulu
• Ukubhoboka kwesitho
• Ukuvuza kwe-anastomotic ngemuva kokuhlinzwa
• Ukutheleleka
• Ithumba
• I-Sepsis ( isifo esibi esibangelwa amagciwane angena egazini)

Udokotela wakho uzokuchazela konke lokhu kusenesikhathi. Into ebalulekile ukuthi uqonde ukuthi izinzuzo zokwelashwa zidlula kanjani izingozi.

Iyini i-prognosis ye-peritoneal carcinomatosis?

Isibikezelo esibi esihambisana ne-peritoneal carcinomatosis manje sesithuthuke kakhulu ngokufika kwezokwelapha ze-CRS kanye ne-HIPEC. Nakuba kungekho ikhambi lalesi simo, lezi zindlela zokwelapha zisiza iziguli ukuba ziphile isikhathi eside .

Kulabo abaye bahlinzwa ukuze kususwe yonke iminonjana yomdlavuza (CRS), abangu-45% bayaphila ngemva kweminyaka emihlanu. Okusho ukuthi, amaphesenti angamashumi amane nanhlanu alabo abaye baba ne-CRS ephumelelayo bayaphila iminyaka emihlanu. Kodwa-ke, uma ukuhlinzwa kungenakuwususa ngokuphelele umdlavuza, izinga lokusinda leminyaka emihlanu lingaphansi kuka-10%.

Kunezinye izici eziningana ezithinta indlela obheka ngayo izinto:

• Uhlobo lomdlavuza oyinhloko
• Indlela amangqamuzana omdlavuza abukeka ngayo engajwayelekile
• Izimpawu zakho zimbi kangakanani
• Isikolo sakho se-PCI

Udokotela wakho angachaza kabanzi ngalezi zici ezithinta isimo sakho.

Ngizinakekela kanjani? (Ukuzinakekela)

Ukuphila nomdlavuza osakazeke kakhulu, isimo esifana ne-peritoneal carcinomatosis, kungaba nzima. Izimpawu zomzimba zingenza kube nzima ukudlula usuku. Futhi ukungaqiniseki ngokuthi umzimba wakho uzosabela kanjani ekwelashweni kungaba nzima ngokomzwelo.

Yingakho kubalulekile ukuthola lonke ukwesekwa ongakuthola.

Lokhu kungafaka phakathi ukuthola ukunakekelwa kokunciphisa ubuhlungu ukuze kusize ekuphatheni izimpawu. Kungumqondo omuhle futhi ukufuna ukwelulekwa ukuze kukusize ubhekane nemizwa eyinkimbinkimbi ehambisana nokuxilongwa. Kuwusizo kakhulu ukujoyina iqembu lokusekela lapho ungaxhumana khona nabanye abaphila nezimo zomdlavuza ezithuthukile njengawe. Lokhu kungakusiza uzizwe ungedwa futhi ungafunda kokuhlangenwe nakho kwabanye.

Buza udokotela wakho ngezinsiza ezingenza ukuphila ne-peritoneal carcinoma kube lula kancane.

Kufanele ngimbone nini udokotela?

Kuzodingeka ubone udokotela wakho njalo ukuze ubone ukuthi ukwelashwa kwakho kusebenza kahle kangakanani. Okwamanje, uma uba nezimpawu ezintsha noma uma izimpawu zakho ziba zimbi kakhulu, tshela udokotela wakho ngokushesha.Angabe esencoma ukwelashwa okwengeziwe noma izinguquko ohlelweni lwakho lokwelashwa ezingakusiza.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma uhlangana nodokotela wakho, kuwumqondo omuhle ukubuza imibuzo efana nale:

• Yiziphi izivivinyo okudingeka ngizenze?
• Hlobo luni lokwelashwa olungincomayo?
• Yimiphi imiphumela emibi engingayilindela ekwelashweni?
• Yimiphi imiphumela engingayilindela ngemva kokwelashwa?
• Yiziphi izinsiza ezitholakalayo zokungisiza ngibhekane nezimpawu nemiphumela emibi?

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Esikhathini esidlule, lapho umuntu etholakala ene-Peritoneal Carcinomatosis, kwakucatshangwa ukuthi unesikhathi sokuphila esifushane kakhulu. Kodwa-ke, isimo sihlukile manje. Ngenxa yokwelashwa okuthuthukile okutholakalayo namuhla, isikhathi sokusinda kwabantu abanalesi simo sandisiwe kakhulu.

Kodwa-ke, ulwazi lwakho luzoncika ekuxilongweni kwakho okuthile. Udokotela wakho angakuchazela ukuthi ungumuntu ofanele yini ukwelashwa okufana ne-CRS ne-HIPEC. Angakuxhumanisa nezinsiza ukuqinisekisa ukuthi uthola ukwesekwa okudingayo ukuze ubhekane nalesi simo.

Ungalokothi ulahle ithemba. Ukuthola ulwazi olufanele, ukuthola ukwelashwa ngesikhathi, nokuthola ukwesekwa kwengqondo nokwenyama okudingayo kubaluleke kakhulu kule mpi.

I- Peritoneal Carcinomatosis, I-Peritoneal Carcinomatosis, Umdlavuza, I-Peritoneum, Ama-Ascites, i-CRS, i-HIPEC, Izimpawu Zomdlavuza, Ukwelashwa Komdlavuza