Ingabe unezinkinga ngezinso zakho? Ake sifunde nge-Renal Cell Carcinoma (RCC)!

Wake wacabanga ngokujulile ngezinso zakho? Izinso ziyizitho ezimbili ezincane kodwa ezibaluleke kakhulu emzimbeni wethu. Zifana nezihlungi emzimbeni wethu. Kodwa-ke, ngezinye izikhathi lezi zinso zingaba nezinkinga. Namuhla sizokhuluma ngolunye lwezinhlobo ezivame kakhulu zomdlavuza ongenzeka ezinso, i-"Renal Cell Carcinoma" noma i-RCC . Ungakhathazeki, sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.

Iyini i-renal cell carcinoma (RCC)?

Kalula nje, i-renal cell carcinoma (RCC) uhlobo oluvame kakhulu lomdlavuza wezinso. Izinso zethu zinenethiwekhi encane kakhulu yamapayipi abizwa ngokuthi ama-tubules . Lawa mapayipi yiwo athutha amanzi kanye nezakhamzimba zomzimba aye egazini futhi asuse imfucuza emchameni. Kungaphakathi kwala ma-tubules lapho i-RCC iqala ukwakheka khona. Cishe ama-85% omdlavuza wezinso angalolu hlobo.

Ngokuvamile, i-RCC iqala njengeqhubu elincane lamaseli omdlavuza enso eyodwa. Lokhu kubizwa nangokuthi isimila . Kodwa-ke, ngezinye izikhathi amaqhubu amaningi angakheka enso eyodwa, noma kuzo zombili izinso.

Yiziphi izinhlobo eziyinhloko ze-RCC?

Kunezinhlobo ezahlukene ze-RCC. Cabanga ngakho njengokuba nabantu abahlukene emndenini ofanayo. Lokhu kuhlukaniswa kusekelwe endleleni amangqamuzana omdlavuza abukeka ngayo ngaphansi kwe-microscope, i-DNA yawo, noma izinto zofuzo. Kunezinhlobo ezimbalwa eziyinhloko:

• I-Clear cell renal cell carcinoma (ccRCC): Lolu hlobo luhlanganisa cishe ama-85% e-RCC. Lubizwa ngokuthi ngoba amangqamuzana omdlavuza abonakala ecacile ngaphansi kwe-microscope.
• I-papillary renal cell carcinoma: Lolu hlobo luhlanganisa phakathi kuka-10% no-15% wazo zonke izinhlobo ze-renal cell carcinoma. Iqanjwe ngama-protrusions afana neminwe ( ama-papillae ) atholakala kulezi zimila.
• I-Chromophobe renal cell carcinoma: Lolu hlobo lubalelwa phakathi kuka-5% no-10%. Lawa maseli avame ukuba nombala okhanyayo, afana namaseli acacile, kodwa makhulu kancane.
• I-RCC Engahlelwanga: Cishe u-6% we-RCC awukwazi ukuhlukaniswa nganoma yiluphi uhlobo olukhulu. Kodwa-ke, ososayensi bazama njalo ukuhlukanisa leli qembu elingahlelwanga ngezindlela ezintsha, ngokusekelwe ezintweni ezifana nezici ezincane kakhulu zamaseli kanye ne-DNA yawo.

Kungenzeka ukuthi uke wezwa odokotela besebenzisa amagama athi “localized” noma “advanced” noma “metastatic” lapho bekhuluma nge-RCC. I- Localized RCC isho ukuthi umdlavuza usezinso kuphela, futhi kungenzeka ukuthi usakazekele ezicutshini eziseduze.Lokhu kusho ukuthi umdlavuza ususakazekele kwezinye izingxenye zomzimba. Uhlobo onalo lunquma izinketho zakho zokwelapha kanye namathuba okululama.

Ivame kangakanani i-RCC?

Emhlabeni wonke, kubikwa amacala amasha angaba ngu-400,000 e-RCC minyaka yonke. E-United States, inani lingaba ngu-80,000. Nakuba noma ubani angaba ne-RCC, ivame kakhulu kwabesilisa abaneminyaka ephakathi kuka-60 no-80 .

Ziyini izimpawu ze-renal cell carcinoma?

Abantu abaningi ababi nazo izimpawu ezigabeni zokuqala. Izimpawu ziqala ukuvela lapho umdlavuza ukhula futhi uqala ukuthinta izicubu noma izitho ezizungezile.

Izimpawu ze-RCC zingafaka:

• Igazi emchameni (i-hematuria). Lolu uphawu oluvame kakhulu.
• Ubuhlungu besifuba: Lokhu kubhekisela ebuhlungwini obenzeka kuzo zombili izinhlangothi zomzimba, ngaphezu kwesinqe nangaphansi kwezimbambo.
• Umuzwa weqhubu esiswini, emhlane ongezansi, noma endukwini.
• Umkhuhlane oza ngaphandle kwesizathu.
• Ukujuluka ebusuku.
• Ukwehlisa isisindo okungachazeki.

Ngaphezu kwalokho, kungase kube nezimpawu ze- anemia , njengokuphelelwa umoya nokukhathala. Noma kungase kuvele izimpawu zesimo esibizwa ngokuthi ama-paraneoplastic syndromes . Kulokhu, izinto ezifana nama-hormone zikhishwa ezimilanjeni zomdlavuza, ezibangela izinguquko ezahlukahlukene emzimbeni.

Yiziphi izimbangela ze-RCC?

I-RCC yenzeka lapho amangqamuzana angajwayelekile kuma-reso tubules eqala ukukhula ngokungalawuleki. Imbangela eqondile ayaziwa okwamanje. Kodwa-ke, ososayensi bathole izici ezithile eziyingozi ezandisa ingozi yokuthola i-RCC.

Yiziphi izinto ezibangela ingozi?

Ingozi yokuthola i-RCC iphakeme uma unalezi zinto:

• Ukubhema: Uma ubhema kakhulu, kulapho ingozi iba nkulu khona.
• Ukukhuluphala ngokweqile: Uma inkomba yakho yesisindo somzimba (i-BMI) iphakeme, kulapho ingozi yakho iba nkulu khona.
• Umfutho wegazi ophezulu (i-Hypertension).
• Isifo sezinso esingamahlalakhona: Lokhu kufaka phakathi labo abathola ukwelashwa kwe-dialysis yesikhathi eside.
• Ukutheleleka kwe-Hepatitis C okungapheli.
• Ukusetshenziswa kwesikhathi eside kwemithi ethile yokudambisa izinhlungu (isib. ama-NSAID, i-acetaminophen).
• Njengoba ngike ngathola ukwelashwa ngemisebe endaweni yesisu.
• Ukuchayeka ezintweni ezibangela umdlavuza, njenge -cadmium kanye ne-asbestos .
• Isifo se-sickle cell: Lokhu kuhlotshaniswa nohlobo olungavamile lwe-RCC.
• Umlando womndeni womdlavuza wezinso.
• Ukuguquka kwezakhi zofuzo: Lezi izinguquko ku -DNA yamaseli.
• I-Tuberous sclerosis complex.
• Isifo sikaVon Hippel-Lindau (VHL).

Uma unesinye salezi zici eziyingozi, udokotela wakho angase akuncome ukuthi uhlolwe njalo ngezinso, okungasiza ekutholeni umdlavuza kusenesikhathi.

Ungayibona kanjani i-RCC?

Cishe abantu abangu-25% abane-RCC batholakala benalesi sifo ngemva kokuba umdlavuza ususakazeke kancane, okusho ukuthi izimpawu ziqala nini ukubonakala.

Kodwa-ke, izindaba ezinhle ukuthi ukuhlolwa kwezithombe okwenziwe ngezinye izizathu manje sekuthola kakhulu izimila ze-RCC ngengozi, ngaphambi kokuba kuvele izimpawu. Ngenxa yalokho, abantu abaningi bathola ukwelashwa komdlavuza esigabeni sawo esingelapheka kakhulu.

Ukuhlolwa kokuxilonga i-RCC

Odokotela basebenzisa izivivinyo zezithombe ukuze bathole umdlavuza futhi bahlele ukwelashwa. Izivivinyo ezivame kakhulu yilezi:

• Ukuskena nge-ultrasound: Lokhu kuhilela ukuthumela amaza omsindo avame kakhulu ezicutshini zomzimba nokudala izithombe ezingabukwa kusikrini. I-ultrasound ingasiza ekunqumeni ukuthi iqhubu ligcwele uketshezi (okuvame ukuba yi-cyst ) noma okuqinile (okuvame kakhulu eziqhumeni ezinomdlavuza).
• I-computed tomography (CT) scan: Lokhu kudala uchungechunge lwezithombe ezinikeza isithombe esiningiliziwe sangaphakathi lomzimba. Cishe kuzodingeka ufake idayi ebizwa ngokuthi i-contrast emthanjeni bese uskena ngaphambi nangemva kwalokho. Le dayi iya kumdlavuza futhi iwubonise ngokucacile.
• Ukuskena kwe-magnetic resonance imaging (MRI): Lokhu kusebenzisa i-magnet enkulu, amaza omsakazo, kanye nekhompyutha ukudala izithombe ezinemininingwane zangaphakathi lomzimba. Udokotela wakho angase akuncomele i-MRI uma ungakwazi ukwenza i-CT scan (isibonelo, uma une-allergy kudayi okukhulunywe ngawo ekuqaleni), noma uma imiphumela ye-ultrasound kanye ne-CT scan ingacaci.

Nakuba i-biopsy ivame ukwenziwa ukuze kutholakale umdlavuza, lokhu akuvamile ukwenziwa ku-RCC. I-biopsy ihilela ukuthatha isampula encane yezicubu ezivela esigaxeni bese uyihlola ngaphansi kwe-microscope ukuze kubonakale ukuthi akhona yini amangqamuzana omdlavuza.

Kodwa ukwenza i-biopsy ye-RCC kuvame ukuba yingozi ngoba kungalimaza izinso. Ngakho-ke, odokotela bavame ukuhlola amangqamuzana omdlavuza ngemva kokususa lonke isimila njengokwelashwa. Uma izithombe zibonisa ukuthi umdlavuza ususakazeke, bangathatha amangqamuzana omdlavuza kwenye indawo ngaphandle kwezinso bawahlole.

Ukuhlola la maseli kuyindlela kuphela yokwazi ngokuqinisekile ukuthi hlobo luni lwe-RCC onalo (uma kungacaci ngezithombe). Kuphinde kusize ekuboneni ukuthi yiziphi izindlela zokwelapha ezisebenza kahle kakhulu kulolo hlobo lomdlavuza.

Ukuhlolwa kwesigaba se-renal cell carcinoma

Ukwazi isigaba somdlavuza wakho kusiza udokotela wakho aqonde ukuthi umdlavuza wakho ususakazeke kangakanani. Kuphinde kukutshele ukuthi umdlavuza usendaweni noma usakazeke kangakanani . Lolu lwazi lungakusiza ukuhlela ukwelashwa kwakho futhi lukunike umbono wesimo esibikezelwayo.

Odokotela basebenzisa uhlelo olubizwa nge -TNM (isimila, i-lymph node, i-metastasis) ukuthola isigaba se-RCC. Bahlukanisa umdlavuza ngezigaba I kuya ku-IV. Izigaba I, II, kanye nomdlavuza we-III zihlukaniswa njengezindawo, kanti isigaba IV siyi-metastatic RCC.

• Isigaba I RCC: Umdlavuza mncane kune-7 centimeters futhi awusakazekanga ngaphandle kwezinso.
• Isigaba II RCC: Umdlavuza mkhulu ngaphezu kwamasentimitha angu-7, kodwa awukasabalali ngaphandle kwezinso.
• Isigaba sesi-3 se-RCC: Isimila singaba yinoma yisiphi isayizi futhi sisakazekele ezicutshini eziseduze ezizungeze izinso.
• Isigaba IV RCC: Umdlavuza ususakazekele ngale kwezinso waya kuma-lymph node nakwezinye izitho zomzimba.

Okubalulekile: Ukwazi isigaba somdlavuza kubalulekile ekunqumeni ukwelashwa, ngakho xoxa ngalokhu ngokucophelela nodokotela wakho.

I-RCC isakazeka kuphi kuqala?

I-Metastatic RCC ivame ukusabalala iye kuma-lymph node akho, emaphashini, emathanjeni, esibindini nasebuchosheni. Ngezinye izikhathi ingasabalala iye kuma-ovari noma emasendeni akho.

Yiziphi izindlela zokwelapha i-renal cell carcinoma?

Ukwelashwa kuncike ezintweni eziningi, okuhlanganisa isigaba somdlavuza kanye nempilo yakho iyonke. Ukwelashwa kwe -RCC yendawo kuhlukile ekwelashweni kwe -RCC esakazeke kakhulu .

Ukwelashwa kwe-renal cell carcinoma yendawo

Ukwelashwa kwalokhu ukususa umdlavuza, noma ukubhubhisa umdlavuza kusetshenziswa amasu okususa umdlavuza (ukubulala amangqamuzana ngokushisa okukhulu noma ukubanda).

Ukuhlinzwa kuyindlela yokwelapha evame kakhulu ye-RCC yendawo.

• Ukususwa kwe-radical nephrectomy: Lokhu kuhilela ukususa izinso ezinomdlavuza kanye nezinye izicubu ezizungezile (njenge-lymph nodes kanye nezindlala ze-adrenal, lapho kungase kube khona amangqamuzana omdlavuza). Kubantu abaningi, inso eyodwa enempilo yanele.
• Ukususwa kwe-nephrectomy okuyingxenye:Lokhu kuhilela ukususa ingxenye yezinso enomdlavuza kuphela. Lokhu kuhlinzwa kungenziwa uma umdlavuza wakho umncane. Lokhu kungasindisa umsebenzi wezinso zakho. Lokhu kubaluleke kakhulu uma ungenazo izinso ezimbili eziphilile.

Uma ungeyena umuntu ofanele ukuhlinzwa, udokotela wakho angase akuncomele izinqubo zokuhlanza . Lokhu kufaka phakathi:

• Ukwelashwa nge-Cryotherapy: Amaseli omdlavuza ayabulawa ngokuwaqandisa.
• Ukususwa kwama-radiofrequency: Amaseli omdlavuza ayashiswa ngokuwabeka ekushiseni okuphezulu.

Ukwelashwa kwe-metastatic renal cell carcinoma

Ukwelashwa kwe -metastatic RCC kuhilela ukulwa namaseli omdlavuza kuwo wonke umzimba. Ukuhlinzwa kungenziwa ukuze kususwe isimila, kodwa akwanele ukuqeda ngokuphelele umdlavuza we-metastatic. Kodwa-ke, ukususa isimila kungasiza ekunciphiseni izimpawu futhi kubambezele ukuqala kwezinye izindlela zokwelapha.

Izindlela zokwelapha ezivame kakhulu ukwelashwa nge-immunotherapy kanye nokwelashwa okuqondisiwe . Kuye ngezici ezahlukahlukene, le mithi inikezwa yodwa noma ihlanganiswe.

Ukwelashwa nge-immunotherapy

I-immunotherapy isebenza ngokuqinisa amasosha omzimba wakho, iwusize ekutholeni nasekulweni namaseli omdlavuza. Eminye yale mithi ihlanganisa:

• I-Avelumab (i-Avelumab - i-Bavencio®)
• I-Ipilimumab (Ipilimumab - Yervoy®)
• I-Nivolumab (Nivolumab - Opdivo®)
• I-Pembrolizumab (i-Pembrolizumab - i-Keytruda®)

Ukwelashwa okuqondiwe

Izindlela zokwelapha eziqondiwe zisebenza ngokuphazamisa inqubo yokwanda kwamangqamuzana omdlavuza. Lokhu kwelashwa kunciphisa ukuphakelwa kwegazi kumaseli omdlavuza, kunciphisa ukukhula kwawo. Eminye yale mithi ihlanganisa:

• I-Axitinib (Axitinib - Inlyta®)
• I-Bevacizumab (Bevacizumab - Avastin®)
• I-Cabozantinib (i-Cabozantinib - i-Cabometyx®)
• I-Everolimus (Everolimus - Afinitor®)
• I-Lenvatinib (Lenvatinib - Lenvima®)
• I-Pazopanib (Pazopanib - Votrient®)
• I-Sorafenib (Sorafenib - Nexavar®)
• I-Sunitinib (i-Sunitinib - i-Sutent®)
• I-Temsirolimus (Temsirolimus - Torisel®)
• I-Tivozanib (Tivozanib - Fotivda®)

Kuye ngesigaba somdlavuza, ukuthi usakazeke kuphi, ubukhulu bawo, kanye nempendulo yakho kwezinye izindlela zokwelapha, udokotela wakho angase ancome ezinye izindlela zokwelapha umdlavuza, njengokwelashwa ngemisebe .

Ingabe i-RCC ingalapheka ngokuphelele?

Kuya ngokuthi unesifo esingakanani. I-RCC yendawoAbantu abane-RCC esendaweni enobungozi obukhulu abasuswa umdlavuza wabo ngokuhlinzwa bavame ukuba nomphumela omuhle wesikhathi eside. Abantu abane-RCC esendaweni enobungozi obukhulu banganikezwa nokwelashwa nge-immunotherapy ngemva kokususwa komdlavuza ukuze kuthuthukiswe imiphumela yesikhathi eside.

Okwamanje akukho ukwelashwa kwe -RCC ethuthukisiwe esesakazekele ngale kwezinso. Kodwa-ke, njengoba ososayensi bethola izindlela zokwelapha ezingcono eziqondisa amangqamuzana athile omdlavuza, abantu abane-RCC esakazekile manje sebephila isikhathi eside.

Iyini inhloso yama-RCC?

Odokotela manje sebekwazi kangcono ukubona i-RCC ezigabeni zayo zokuqala, lapho umdlavuza ungelapheka kakhulu. Ukutholwa kusenesikhathi kanye nokwelashwa okuthuthukisiwe kuye kwathuthukisa amazinga okusinda. Abantu abangu-90% abane -RCC yesigaba I baphila iminyaka emihlanu. Ngokufanayo, nakuba isikhathi sokuphila sabantu abane -RCC yesigaba IV sasinqunyelwe ezinyangeni, abaningi manje baphila iminyaka eminingana.

Ingabe i-RCC ingavinjelwa?

I-RCC ayikwazi ukuvinjelwa ngaso sonke isikhathi. Kodwa ungayinciphisa ingozi yakho. Isibonelo, ukungabhemi (noma ukuyeka uma ukwenza) kungenye yezinto ezinhle kakhulu ongazenza ukunciphisa ingozi yakho yomdlavuza. Kubalulekile futhi ukugcina isisindo esinempilo, ukudla ukudla okunempilo, nokulawula umfutho wegazi ophakeme.

Ngingazinakekela kanjani?

Khuluma nodokotela wakho ngohlelo lokunakekelwa oluzokusiza ukuphatha izimpawu zomdlavuza wakho kanye nemiphumela emibi yokwelashwa kwakho. Isibonelo, abanye abantu kungadingeka baqale i-dialysis ngemuva kokuhlinzwa uma enye noma zombili izinso zingasebenzi kahle. Kubalulekile ukwazi ukuthi lokhu kwelashwa kuzokuthinta kanjani.

Ungadinga usizo lokulawula imiphumela emibi yokwelashwa okuqondiwe noma i-immunotherapy . Buza udokotela wakho ukuthi yini ongayilindela ngaphambi kokuqala ukwelashwa.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

• Nginaluphi uhlobo lwe-RCC?
• Umdlavuza wami ususabalele kangakanani (isigaba sini)?
• Yiziphi izinzuzo kanye nokungalungi kokwelashwa okutholakalayo?
• Yimiphi imiphumela emibi noma izinkinga okufanele ngizazi ngaphambi kokuthola ukwelashwa?
• Kufanele ngize kangaki ukuzohlolwa ngemva kokwelashwa?
• Yiziphi izinguquko okufanele ngizilindele endleleni yami yokuphila ngesikhathi sokwelashwa?
• Iyini inkomba yesimo sami?

Okuhlangenwe nakho kwakho kokwelashwa komdlavuza we-renal cell carcinoma (RCC) kuzoncika ezintweni eziningi, okuhlanganisa impilo yakho iyonke, uhlobo kanye nesigaba se-RCC, kanye nempendulo yakho ekwelashweni. Kodwa noma ubani otholakale enomdlavuza wezinso uzozuza ngokwakha ubuhlobo obuseduze nethimba lakhe lezokwelapha. Unganqikazi ukubuza imibuzo mayelana nokuxilongwa kwakho, izinzuzo kanye nokubi kwezinketho zokwelashwa, kanye nemiphumela elindelekile. Udokotela wakho ungumuntu ongcono kakhulu ukuchaza ukuthi kusho ukuthini kuwe ukuba ne-RCC.

Okokugcina, izinto okufanele uzikhumbule

Nakuba i-renal cell carcinoma (RCC) iyisimo esibucayi, izinga lokuphulukiswa kwayo lithuthuke kakhulu ngokutholwa kusenesikhathi kanye nokwelashwa okufanele. Uma unezimpawu, ikakhulukazi igazi emchameni wakho, ubuhlungu embotsheni yakho, iqhubu engalweni yakho, noma umlando womndeni womdlavuza wezinso, funa iseluleko sezokwelapha ngokushesha. Unganciphisa ingozi yakho yokuthola lesi sifo ngokugwema ukubhema nokulandela indlela yokuphila enempilo. Ungesabi ukukhuluma nodokotela wakho uma unezinkinga. Awuwedwa.

Umdlavuza wezinso , i-renal cell carcinoma, i-RCC, izimila zezinso, izimpawu zomdlavuza, ukwelashwa komdlavuza, impilo yezinso