Uyazazi yini ngomdlavuza wamathumbu amancane? Ake sixoxe ngokuningiliziwe!

Namuhla sizokhuluma ngesifo ongasizwa kangako ngaso, kodwa esingaba sibaluleke kakhulu. Leso umdlavuza wamathumbu amancane. Ungase ungabi nalwazi oluningi ngalokhu. Kodwa kulungile, ake sixoxe ngaso kalula, ngendlela ongayiqonda.

Uyini Umdlavuza Wamathumbu Amancane?

Kalula nje, umdlavuza wamathumbu amancane ukukhula kwamangqamuzana omdlavuza emathunjini akho amancane, noma lokho esikubiza ngokuthi " amathumbu amancane ". Ubuwazi ukuthi amathumbu amancane ayingxenye ebaluleke kakhulu ohlelweni lwethu lokugaya ukudla ? Lolu hlelo luhlanganisa nezinye izitho eziningi, njengesibindi kanye ne-pancreas . Amathumbu amancane atholakala endleleni yethu yokugaya ukudla (GI) . Okusho ukuthi, atholakala endleleni esuka emlonyeni, nge-esophagus, aye esiswini, bese eya emathunjini amancane, bese esuka lapho eya emathunjini amakhulu (colon). Ukuze kube sobala, isisu kanye namathumbu amakhulu kuxhunywe yileli thumbu elincane. Kunezingxenye ezintathu eziyinhloko zamathumbu amancane:

• I-Duodenum : Lena yingxenye yokuqala eseduze nesisu.
• I-Jejunum: Lena yingxenye ephakathi yamathumbu amancane.
• Ileum: Lena yingxenye yokugcina nende kakhulu yamathumbu amancane.

Iningi lomdlavuza wamathumbu amancane luvela ku-colon noma ku-ileum.

Uvame kangakanani lo mdlavuza?

Eqinisweni, umdlavuza wamathumbu amancane uyisimo esingavamile kakhulu . Ngokusho kwedatha yaseMelika, lolu hlobo lomdlavuza lubangela cishe u-3% wazo zonke izinhlobo zomdlavuza emgudwini wokugaya ukudla. Umdlavuza wamathumbu amakhulu , umdlavuza wamathumbu amancane, umdlavuza womphimbo, kanye nomdlavuza wesisu kuvame kakhulu. Ngakho-ke, ungacabanga ukuthi lokhu kuphansi kancane.

Yiziphi izinhlobo zomdlavuza wamathumbu amancane ?

Kunezinhlobo eziningana zomdlavuza ezenzeka emathunjini amancane. Lezi zihlukaniswa ngokusekelwe ohlotsheni lweseli lapho umdlavuza uqala khona.

• Izimila ze-carcinoid: Lezi ziqala kumaseli akho e-neuroendocrine . Lawa maseli asiza umzimba wakho ukukhiqiza ama-hormone futhi alawule ukukhiqizwa kwamajusi okugaya ukudla emathunjini amancane. Izimila ze-carcinoid ziyingxenye cishe yazo zonke izinhlobo zomdlavuza wamathumbu amancane.
• Ama-Adenocarcinoma: Lawa aqala kumaseli ezindlala azungeze ulwelwesi lwamathumbu amancane. Angaba yingxenye yesithathu yazo zonke izinhlobo zomdlavuza wamathumbu amancane.
• Ama-Sarcomas: Lawa aqala ku-cartilage.noma izicubu ezixhumeneyo njengemisipha. Uhlobo oluvame kakhulu lwe-sarcoma oluthinta amathumbu amancane yi -gastrointestinal stromal tumor (GIST) . Ngaphambilini yayibizwa ngokuthi i-leiomyosarcoma.
• I-Lymphoma: Lawa aqala kumaseli abizwa ngokuthi ama-lymphocyte . Ama-lymphocyte awuhlobo lwamaseli amhlophe egazi atholakala ohlelweni lwakho lwe-lymphatic . Uhlelo lwe-lymphatic luyingxenye ebaluleke kakhulu yesistimu yethu yokuzivikela. Lusiza umzimba ukulwa namaseli ayingozi namagciwane abangela izifo.

Ziyini izimpawu zalo mdlavuza?

Izimpawu zomdlavuza wamathumbu amancane zingahluka. Ziya ngohlobo lwesimila nendawo esikuyo. Ngezinye izikhathi, izimila zingaba khona kodwa zingabangeli zimpawu (ezingenazimpawu) . Isibonelo, izimila ze-carcinoid zivame ukungabi nazimpawu. Ngezinye izikhathi zitholakala ngengozi ngesikhathi sokuhlolwa kwesithombe sesinye isimo. Izimpawu ezivamile zifaka:

• Ubuhlungu besisu noma ukuqaqamba kwesisu.
• Isigaxa esiswini esizwakala sengathi sibanjwe esandleni.
• Isicanucanu, ukuhlanza, kanye nohudo.
• Ukwehlisa isisindo ngaphandle kwesizathu.
• I-anemia ( ukuntuleka kwegazi).
• I-jaundice ( ukuphuzi kwamehlo noma isikhumba).
• Indle enegazi (ingase ibonakale ibomvu noma imnyama endlini yangasese).
• Ukubomvu kwesikhumba, ikakhulukazi izandla nomzimba ongaphezulu, kuba nsomi.

Yiziphi izimbangela zomdlavuza wamathumbu amancane?

Izimila eziyingozi zamathumbu amancane ziyakhula lapho amangqamuzana omdlavuza ehlukana ngokushesha futhi ekhula ndawonye abe yinqwaba. Ngokuhamba kwesikhathi, lawa maseli omdlavuza angahlukana nesimila sokuqala futhi ahambe ngama-lymph node noma igazi aye kwezinye izingxenye zomzimba, lapho angakha khona isimila esisha (isimila sesibili). Le nqubo ibizwa ngokuthi i-metastasis . Amangqamuzana omdlavuza akhula ngenxa yokuguquka kwezakhi zofuzo . Lokhu kusho ukuthi izinguquko zenzeka ku-DNA yeseli, okubangela ukuba iseli lihlukane ngokungalawuleki. Abacwaningi abasazi kahle ukuthi yini ebangela lezi zinguquko.

Yiziphi izinto ezibangela umdlavuza?

Isici esiyingozi yinoma yini ekhulisa amathuba okuthola isifo. Kodwa-ke, ukuba nesifo esiyingozi akusho ukuthi uzoba nomdlavuza. Ngokufanayo, ukungabi nezici eziyingozi akusho ukuthi ngeke ube nomdlavuza. Kunezici eziningana eziyingozi ezingathinta umdlavuza wamathumbu amancane:

• Ubudala: Ingozi yezinhlobo eziningi zomdlavuza wamathumbu amancane iyanda njengoba iminyaka ikhula. Isilinganiso seminyaka yokuxilongwa sicishe sibe yiminyaka engama-65.
• Ubulili: Amadoda anamathuba amancane okuthola lo mdlavuza.
• Uhlanga: Ngokusho kwedatha evela e-United States, lesi sifo sivame kakhulu kubantu abamnyama, kuyilapho i-lymphoma ivame kakhulu kubantu abamhlophe.
• Izimo zofuzo: Uma abazali bakho, izingane zakini, noma izingane zakho zinezimo ezithile, ungase ube sengozini enkulu. Izibonelo zifaka phakathi (i-Familial Adenomatous Polyposis - FAP) , (i-Peutz-Jeghers syndrome) , (i-Hereditary Nonpolyposis Colorectal Cancer - HNPCC) , kanye (i-Lynch syndrome) .
• Izimo zokuvuvukala: Izifo ezibangela ukuvuvukala kwamathumbu isikhathi eside, njengesifo sikaCrohn nesifo seCeliac , zingandisa ingozi.
• Izifo ezithinta amasosha omzimba ngokuzenzakalelayo noma isimiso somzimba sokuzivikela esibuthakathaka: Izifo ezenza amasosha omzimba abe buthaka, njenge -HIV/AIDS , isifo sikaCrohn , kanye nesifo se-Celiac, zingandisa ingozi yakho. Futhi, ukwelashwa okufana nokwelashwa ngemisebe kungenza amasosha omzimba abe buthaka, kwandise ingozi yakho yokuba nomdlavuza wamathumbu amancane. Imithi ecindezela isimiso somzimba sokuzivikela ngemva kokufakelwa isitho ingandisa ingozi yakho.

Ezinye izifundo zisikisela ukuthi ukudla (ukudla okunosawoti omningi noma okubhemayo kanye nenyama ebomvu), ukusetshenziswa kukagwayi, kanye nokuphuza utshwala nakho kungathinta ingozi yomdlavuza wamathumbu amancane.

Uma ucabanga ukuthi unezinye zalezi zinto eziyingozi, kungcono ukukhuluma nodokotela .

Umdlavuza wamathumbu amancane utholakala kanjani?

Umdlavuza wamathumbu amancane kungaba nzima ukuwuthola ngoba awuvamile. Futhi, izimpawu ziyahlukahluka kuye ngohlobo lwesimila. Kungase kudingeke ukuthi uhlolwe kabanzi futhi uhlolwe ngaphambi kokuba uthole ukuxilongwa.

Ukuhlolwa ngokomzimba kanye nomlando wezokwelapha

Udokotela uzokuxilonga, ahlole impilo yakho iyonke, ahlole izimpawu zokugula, futhi akubuze ngezifo zakho zangaphambilini, ukwelashwa, kanye nemikhuba yakho yezempilo.

Ukuhlolwa kwegazi

• Izifundo ze-blood chemistry: Lezi zilinganisa inani lezinto ezithile ezikhishwa egazini ezivela ezithweni nasezicutshini. Uma kukhona inani elingavamile (eliphezulu noma eliphansi) lento ethile, kungase kubonise isifo esithweni noma ezicutshini ezikhiqiza leyo nto. Isibonelo, ukuhlolwa kokusebenza kwesibindi kungenziwa ukuze kubonwe ukuthi umdlavuza ususakazekele esibindini.
• Ukubalwa kwegazi okuphelele (i-CBC): Lokhu kuhlolwa kunikeza udokotela wakho ulwazi mayelana namaseli egazini lakho. Amathumba amancane amathumbu angabangela ukopha, okungabangela ukwehla kwenani lamaseli abomvu egazi, okubangela i-anemia.

Ukuthwebula izithombe

• I-Endoscopy: Lokhu kuhilela ukubuka ngaphakathi kwendlela yokugaya ukudla (GI) usebenzisa ithuluzi elincane, elifana nethubhu (i-endoscope). Leli thubhu linokukhanya kanye nekhamera kulo.Ngesikhathi sokuhlolwa kwe-endoscopy ephezulu, udokotela ufaka i-endoscope ngomlomo bese ehlola umphimbo, isisu, kanye nengxenye yokuqala yamathumbu amancane (i-duodenum). I-endoscope ekhethekile ebizwa ngokuthi i-double-balloon enteroscopy ingabheka ngokujulile emathunjini amancane. Ngesikhathi sokuhlolwa kwe-endoscopy, udokotela angathatha amasampula ezicubu ( ama-biopsies ) awathumele ukuze ayohlolwa. Bese ehlolwa ngaphansi kwe-microscope ukuze abone ukuthi kukhona yini izimpawu zesifo.
• I-Capsule endoscopy (ikhamera yamaphilisi): Lokhu kuhilela ukugwinya i-capsule equkethe ikhamera encane. Njengoba i-capsule idlula emzimbeni, ithatha izithombe ze-GI tract. Lezi zithombe zingalandwa kwikhompyutha futhi zibukwe udokotela. Nakuba igama lingase lidideke kancane, le nqubo ayisebenzisi i-endoscope.
• I-CT scan (i-CT scan - i-CAT scan): Lena inqubo ethatha uchungechunge lwezithombe ezinemininingwane zangaphakathi lomzimba ngezindlela ezahlukene. Lezi zithombe ziboniswa kukhompyutha exhunywe kumshini we-X-ray. Ngezinye izikhathi idayi ingafakwa emthanjeni noma inikwe isiphuzo. Lokhu kuvumela izitho noma izicubu ukuba zibonakale kahle.
• I-MRI (magnetic resonance imaging): Lokhu kusebenzisa i-magnet, amaza omsakazo, kanye nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yengaphakathi lomzimba. Nakuba kokubili i-MRI kanye ne-CT scan zinikeza ulwazi olufanayo mayelana nendlela isimila esithinta ngayo izicubu ezithambile, i-CT scan ivame ukusetshenziswa ukuthola umdlavuza wamathumbu amancane.
• I-X-ray yesisu: I-X-ray yezitho ezisesiswini. I-X-ray iwumsebe wamandla odlula emzimbeni bese ubonakala efilimini, udale isithombe sengaphakathi lomzimba.
• I-X-ray ye-Barium: Lokhu kuhilela ukumboza umgudu wakho we-GI ngento efana ne-chalk ebizwa ngokuthi i-barium. I-barium yenza umgudu we-GI ubonakale ku-X-ray. Ochungechungeni lwe-GI oluphezulu , uchungechunge lwezithombe ze-X-ray luthathwa njengoba i-barium idlula kumgudu we-GI (umphimbo, isisu, amathumbu amancane). Ochungechungeni lwe-GI oluphansi (i-barium enema) , kufakwa i-barium ewuketshezi ku-rectum. Izithombe ze-X-ray zithathwa njengoba i-barium imboza umgudu we-GI ongezansi.

Ukuhlinzwa

Uma ezinye izivivinyo zinganikezi ulwazi olwanele ukuze kutholakale isifo, udokotela wakho angase anqume ukwenza ukuhlinzwa. Lezi zinqubo zivumela udokotela wakho ukuthi ahlole izitho zakho ngqo. Uma kukhona izicubu ezisolisayo, kuthathwa i -biopsy ukuze kuhlolwe izimpawu zomdlavuza. Ukuhlinzwa kungenziwa ukuze:

• I-Laparoscopy: Kule nqubo, kufakwa ishubhu elincane, elifana ne-telescope (i-laparoscope) ngokusikwa okukodwa noma ngaphezulu okuncane esiswini. I-laparoscope ivumela udokotela ukuthi abone izitho zesisu ukuze abone izimpawu zomdlavuza.
• Ukuhlinzwa kweLaparotomy:Kulokhu, udokotela wenza i-incision odongeni lwesisu futhi ahlole izitho zesisu ukuze abone izimpawu zomdlavuza.

Yiziphi izigaba zomdlavuza wamathumbu amancane?

Isigaba somdlavuza sikutshela ukuthi isimila sikhulu kangakanani, ukuthi sikuphi, nokuthi sisakazeke yini (sisakazeke kakhulu). Ukuhlolwa nezinqubo ezinquma isigaba somdlavuza wamathumbu amancane kuvame ukwenziwa ngesikhathi sokuxilongwa. Uhlobo lomdlavuza wamathumbu amancane onawo (isimila se-carcinoid, i-adenocarcinoma, i-sarcoma, noma i-lymphoma) lunquma uhlelo lokulinganisa olusetshenziswa udokotela wakho.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa okutholayo kuncike ohlotsheni lomdlavuza onawo, isigaba sawo, indawo yesimila, kanye nezici zamaseli angaphakathi kwesimila. Izintandokazi zakho nazo zithonya izinqumo zokwelashwa.

Ukuhlinzwa

Ukuhlinzwa kuyindlela yokwelapha evame kakhulu yomdlavuza wamathumbu amancane. Ukuhlinzwa kungafaka:

• Ukususwa: Ukuhlinzwa kokususa sonke noma ingxenye yesitho lapho umdlavuza ukhona khona. Uma umdlavuza ususakazeke, udokotela angasusa izingxenye zamathumbu amancane nezitho eziseduze. Ngemuva kwalokho, kungenziwa i-anastomosis (ukuxhuma kabusha iziphetho zamathumbu ezisikiwe). Ama-lymph node aseduze kwamathumbu amancane nawo angasuswa futhi ahlolwe ukuze kubonakale ukuthi umdlavuza ususakazeke yini.
• Ukudlula: Uma kukhona isimila esivimba amathumbu kodwa singenakususwa, ukuhlinzwa ukuze kuvunyelwe ukudla emathunjini amancane ukuthi kudlule isimila.

Ukwelashwa ngamakhemikhali

Ukwelashwa ngamakhemikhali (chemotherapy) ukusetshenziswa kwemithi ukuvimba ukukhula kwamangqamuzana omdlavuza. Kungabulala amangqamuzana noma kuwavimbele ukuthi ahlukane. Kuye ngokwelashwa ngamakhemikhali, imithi ingahlasela amangqamuzana omdlavuza engxenyeni ethile yomzimba (i-regional chemotherapy) noma ibulale amangqamuzana omdlavuza kuwo wonke umzimba (i-systemic chemotherapy). Udokotela wakho angakunikeza imithi yamakhemikhali ukubulala noma yimaphi amangqamuzana omdlavuza angase asale ngemva kokuhlinzwa (ukwelashwa okusizayo) . Uma umdlavuza wakho ususakazeke (usuhlukaniswe), unganikezwa imithi yamakhemikhali (systemic chemotherapy).

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukusetshenziswa kwe-X-ray enamandla aphezulu noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwavimba ekukhuleni kwawo. Udokotela wakho angase ancome ukwelashwa ngemisebe uma umdlavuza wakho ungenakususwa ngokuhlinzwa. Ukwelashwa ngemisebe nakho kunganikezwa njengengxenye yokunakekelwa kokunciphisa izimpawu. Ngezinye izikhathi, ukwelashwa ngemisebe kunikezwa kanye ne-chemotherapy (i-chemoradiation therapy) ukubulala noma yimaphi amangqamuzana omdlavuza asele ngemva kokuhlinzwa.

Ama-analogue e-Somatostatin

Udokotela welapha izimila ze-carcinoid zamathumbu amancane nge-somatostatin analogues.Le mithi ivimba umzimba wakho ekwenzeni ama-hormone amaningi kakhulu. Lokhu kungasiza ekunciphiseni izimpawu nokulawula lesi sifo. Izibonelo zale mithi zifaka phakathi i-lanreotide ne-octreotide.

Kudingeka ucwaningo olwengeziwe ngezinzuzo zokuhlanganisa ukwelashwa ngemisebe kanye ne-chemotherapy ngemva kokuhlinzwa komdlavuza wamathumbu amancane.

Ukwelashwa okuqondiwe

Izindlela zokwelapha eziqondiwe zisebenza ngokubona ubuthakathaka emangqamuzaneni omdlavuza nokusebenzisa lobo buthakathaka ukuze zibubhubhise. Abacwaningi okwamanje bafunda izindlela zokwelapha eziqondiwe ezingasiza ekwelapheni ama-adenocarcinoma, ama-GIST, kanye nama-lymphoma.

Ukwelashwa nge-immunotherapy

I-immunotherapy isebenza ngokuqinisa amasosha omzimba wakho nokwandisa ikhono lawo lokulwa namaseli omdlavuza. Amasosha omzimba wakho alwa ngokwemvelo namaseli angajwayelekile kanye nabahlaseli abayingozi njengamagciwane. Kodwa-ke, ngezinye izikhathi amaseli omdlavuza angadlula izivikelo zamasosha omzimba. I-immunotherapy yenza kube lula ukuthi amasosha omzimba aqaphele futhi abhubhise amaseli omdlavuza. Kuye ngohlobo lokuguqulwa kwezakhi zofuzo esimila sakho, udokotela wakho angase akuncome i-immunotherapy.

Izivivinyo zemitholampilo

Izivivinyo zemitholampilo ziyizifundo zokunquma ukuthi ukwelashwa okusha komdlavuza kuphephile, kuyasebenza, noma kungcono kunokwelashwa okujwayelekile. Njengamanje, i-adjuvant chemotherapy, ukwelashwa okuqondiwe, kanye ne-immunotherapy kuyafundwa ezivivinyweni zemitholampilo. Buza udokotela wakho ukuthi ungumuntu ofanele yini ukuhlolwa kwemitholampilo.

Lingakanani izinga lokwelashwa komdlavuza wamathumbu amancane?

Amazinga okusinda ayahlukahluka kuye ngohlobo lomdlavuza wamathumbu amancane, isigaba sawo, nokuthi umdlavuza waqala kuphi emathunjini amancane. Isibonelo, abantu abangu-65% abatholakale benama-adenocarcinomas asesigabeni sokuqala baphila ngemva kweminyaka emihlanu. Leli zinga liphansi kakhulu, ku-4%, kumdlavuza osesigabeni sokugcina. Izinga lokusinda kweminyaka emihlanu kumdlavuza we-carcinoid osesigabeni sokuqala lingu-95%, kanti kumdlavuza osesigabeni sokugcina lingu-42%.

Buza udokotela wakho ukuthi izimpawu zomdlavuza wakho zithinta kanjani ukubikezela kwakho.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ngesikhathi esinjengalesi, ungase ube nemibuzo eminingi engqondweni yakho. Ungesabi. Khuluma ngokukhululekile nodokotela wakho. Nansi eminye imibuzo ebalulekile ongayibuza:

• Hlobo luni lwesimila enginaso?
• Umdlavuza wami ukusiphi isigaba?
• Yiziphi izinto ezithinta amathuba ami okululama?
• Yikuphi ukwelashwa okuncomayo?
• Yiziphi izingozi nezinzuzo zalezi zindlela zokwelapha?
• Kuzothatha isikhathi esingakanani ukululama ohlelweni lwami lokwelashwa?
• Yimiphi imiphumela okufanele ngiyilindele ngokusekelwe kumdlavuza wami, impilo ejwayelekile, kanye nendlela esabela ngayo ekwelashweni?

Ngenxa yokuthi umdlavuza wamathumbu amancane awuvamile, kungaba nzima ukuqonda imiphumela kanye nezinketho zokwelapha. Ziningi izinto ezithinta uhlelo lwakho lokunakekelwa kanye namathuba okuphumelela kokwelashwa. Lungela ukukhuluma nodokotela wakho ngokuthi uhlobo lwesimila onaso luthinta kanjani izinketho zakho zokwelapha. Kuye ngomdlavuza wakho, udokotela wakho angancoma inhlanganisela yokuhlinzwa kanye ne-chemotherapy ukuze kususwe isimila sakho futhi kuvinjelwe ukuthi singasabalali.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Umdlavuza Wamathumbu Amancane yisimo esingavamile ukuzwakala ngaso, kodwa sifanelwe ukunakwa.

• Lokhu akuvamile kakhulu , kodwa kubalulekile ukufuna iseluleko sezokwelapha ngokushesha uma kuvela izimpawu.
• Qaphela izimpawu ezifana nobuhlungu besisu, ukwehla kwesisindo okungachazeki, kanye nendle enegazi.
• Uma unezinto eziyingozi , khuluma nodokotela bese wenza izivivinyo ezidingekayo.
• Kunezinhlobo ezahlukene zokuhlolwa kokuxilongwa . Ungakhathazeki, odokotela bazokusiza.
• Kunezindlela eziningana zokwelapha , kuye ngesimo sakho.
• Uma kutholakala kusenesikhathi, amathuba okululama aphezulu.

Into ebaluleke kakhulu ukuthi uma unokungabaza noma ukwesaba ngalokhu, ungahlupheki wedwa, kodwa khuluma nodokotela omethembayo . Bazokunikeza isiqondiso nokusekelwa okudingayo. Hlala uphilile!

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Umdlavuza Wamathumbu Amancane, Umdlavuza, Uhlelo Lokugaya Ukudla, Izimpawu, Ukwelashwa Komdlavuza, Amathumbu, Umdlavuza Wamathumbu Amancane