Iyini i-Urothelial Carcinoma? Ake sixoxe ngayo ngokuningiliziwe!

Wake waphawula igazi emchameni wakho? Noma ingabe unezinhlungu emhlane noma ukukhathala okuqhubekayo? Nakuba lokhu kungase kungabonakali njengento enkulu okufanele uyikhathazeke, ngezinye izikhathi kungaba izimpawu zomdlavuza oqala emgudwini womchamo. Olunye uhlobo lomdlavuza yi -Urothelial Carcinoma , ngezinye izikhathi olubizwa ngokuthi i-Transitional Carcinoma . Namuhla, sizoxoxa ngalokhu ngemininingwane ethe xaxa , njengokungathi sikhuluma nomngane.

Kuyini i-Urothelial Carcinoma? Kalula nje...

Kalula nje, i-Urothelial Carcinoma ingumdlavuza oqala ezicutshini ezibizwa ngokuthi i-urothelium, ehlanganisa izingxenye ezithile zesistimu yakho yomchamo. Cabanga ngayo njengolwelwesi lwangaphakathi lwezinye izitho emizimbeni yethu. I-urothelium ingenye yezicutshi ezinjalo. Itholakala kakhulu esinyeni, ezinso (ikakhulukazi i-renal pelvis), kanye nasezindlini zomchamo. Ubuwazi ukuthi ama -90% omdlavuza wesinyi kanye nama-7% omdlavuza wezinso umdlavuza we-urothelial? Izimpawu zazo zombili zifana kakhulu. Into engcono kakhulu ukuthi lezi zinhlansi kulula ukuzelapha nokuzelapha uma zitholakala kusenesikhathi . Kodwa-ke, ngezinye izikhathi zingaphinde zibuye. Yingakho kubalulekile ukuqaphela lokhu.

Lo mdlavuza uthinta kanjani imizimba yethu?

Indlela umdlavuza we-urothelial othinta ngayo esinyeni sakho kanye nezinso ingahluka kancane.

Umdlavuza we-Urothelial wesinye

Isinye sakho siyisitho esincane esifana nesikhwama. Sitholakala phakathi kwamathambo akho enqulwini, ngaphezu kwe-urethra yakho, nangaphansi kwezinso zakho. Umchamo ovela ezinso zakho uqoqana kulesi sinye. Ingaphakathi lesinye ligcwele izicubu esikhulume ngazo ekuqaleni ezibizwa ngokuthi i-urothelium . Amaseli akulesi sikhumba anganwebeka lapho isinye sakho sigcwala umchamo futhi sinciphe lapho siphuma. (Isinye sakho ngokuvamile singabamba cishe izinkomishi ezimbili zomchamo.) Uma uba nomdlavuza wesinye, amaseli akulesi sinye ahlukana ngendlela engavamile futhi asakazeke kusukela ongqimbeni olungaphakathi lwesinye sakho kuya kwezinye izendlalelo. Ngezinye izikhathi, la maseli angajwayelekile angadabula izindonga zesinye sakho aye ezicutshini ezinamafutha ezizungezile. Uma ungelashwa, lo mdlavuza ungasakazeka odongeni lwesinye uye kuma-lymph node aseduze futhi ukusuka lapho uye kwezinye izindawo njengamathambo, amaphaphu, nesibindi. Kunezinhlobo ezimbili eziyinhloko zomdlavuza wesinye:

• Umdlavuza we-urothelial wezinga eliphezulu: Lokhu kuyingozi kakhulu. Kungenzeka ukuthi ubuye ngisho noma sekwelashwe. Ungasakazekela emisipheni yesinye, kwezinye izingxenye zomzimba, kanyeKungasakazekela kuma- lymph node .
• Umdlavuza we-urothelial osezingeni eliphansi: Lokhu kungabuya futhi, kodwa akunakwenzeka ukuthi kusakazekele emisipheni yesinye noma kwezinye izingxenye zomzimba.

Umdlavuza we-Urothelial wezinso

Ngokuvamile sinezinso ezimbili. Zifana nezitho ezimbili ezimise okwebhontshisi, ezitholakala ngaphansi nje kwesikhala sezimbambo nangemuva kwesisu. Izinso zihlunga ukungcola kanye nobuthi obuvela egazini bese zenza umchamo. Lo mchamo uqoqana phakathi kwezinso okuthiwa i-renal pelvis . Ukusuka lapho, umchamo uhamba ngepayipi elide elixhumanisa izinso nesinye. Leli payipi libizwa ngokuthi i-ureter . Njengezinso, i-renal pelvis kanye ne-ureter nazo zigcwele izicubu ze-urothelial. Umdlavuza wezinso uvela lapho amangqamuzana e-urothelial angajwayelekile ekhula futhi akha izimila ezinso, i-renal pelvis, noma i-ureter. Umdlavuza wezinso ungasakazeka nakwezinye izitho noma izicubu.

Ubani okungenzeka kakhulu ukuthi athole lo mdlavuza?

Umdlavuza wesinye ungowesithupha ovame kakhulu e-United States. Futhi ama-90% omdlavuza wesinye umdlavuza we-urothelial. Amadoda anamathuba aphindwe kane okuthola umdlavuza wesinye kunabesifazane . Umdlavuza wezinso ungowesishiyagalombili ovame kakhulu. Cishe ama-7% omdlavuza wezinso umdlavuza we-urothelial. Uvame kakhulu ukwenzeka kubantu abaneminyaka ephakathi kuka-65 no-74. Amadoda anamathuba aphindwe kabili okuthola lesi sifo.

Yiluphi uphawu oluyinhloko lomdlavuza we-urothelial?

Umdlavuza we-Urothelial ungase ungabi nazimpawu ezigabeni zawo zokuqala. Kodwa-ke, igazi emchameni (i-hematuria) livame ukuba uphawu lokuqala. Uma ubona igazi emchameni noma unezinye zalezi zimpawu, kufanele nakanjani ubone udokotela :

• Ubuhlungu obungapheli emhlane .
• Ukukhathala, ukukhathala .
• Ukuba mncane ngaphandle kwesizathu.
• Ubuhlungu lapho uchama ( i-dysuria ).
• Kuzwakala sengathi kuyisimila lapho kukhona khona izinso .
• Nginomkhuhlane omncane.

Yini ebangela lo mdlavuza?

Abacwaningi bezokwelapha abakakazi kahle ukuthi yini ebangela umdlavuza wesinye kanye nezinso. Kodwa-ke, bathole izici eziningana ezivamile zengozi:

• Ukubhema ugwayi : Ababhema ugwayi basengozini enkulu yokuthola umdlavuza we-urothelial ohlelweni lomchamo.Ingozi yokuba nomdlavuza iphezulu kakhulu. Lesi yisona sici esiyinhloko esiyingozi.
• Ukuchayeka kumakhemikhali athile: Ucwaningo luye lwabonisa ukuthi abantu abasebenza ezindaweni ezikhiqiza amadayi athile, irabha, izimpahla zesikhumba, upende, ezinye izindwangu, kanye nemikhiqizo yokulungisa izinwele basengozini enkulu yokuthola lo mdlavuza.

Odokotela bawuthola kanjani lo mdlavuza?

Odokotela basebenzisa lezi zivivinyo ukuxilonga umdlavuza wesinyi kanye nezinso, okuhlanganisa nomdlavuza we-urothelial:

• Ukuhlolwa komchamo: Ukuhlolwa komchamo wakho okuhlola umbala, ushukela, amaprotheni, igazi kanye namagciwane.
• I-cytology yomchamo: Kuthathwa isampula yomchamo wakho bese ihlolwa ngaphansi kwe-microscope ukuze kuhlolwe amangqamuzana angajwayelekile. Uma unomdlavuza ezinso, esinyeni, noma e-urethra, amangqamuzana omdlavuza angatholakala emchameni wakho.
• I-Intravenous pyelogram (IVP): Lolu uchungechunge lwezivivinyo ze-X-ray. Kwenziwa ukuhlola umdlavuza ezinso, kuma-ureter, kanye nasesinyeni. Odokotela bafaka uketshezi olukhethekile (idayi yokungafani) emthanjeni wakho. Ngemuva kwalokho, kuthathwa ama-X-ray njengoba uketshezi ludlula ezinso zakho, kuma-ureter, kanye nasesinyeni ukuze kubonakale ukuthi kukhona yini ukuvaleka.
• I-Ureteroscopy: Ithuluzi elincane elifana nethubhu (elinekhamera nokukhanya) lidluliselwa e-urethra ukuze libheke ngaphakathi kwe-ureter kanye ne-renal pelvis. Liphinde lisetshenziswe ukuthatha amasampula ezicubu.
• I-CT scan (i-computed tomography - i-CT scan): Ikhompyutha exhunywe emshinini we-X-ray ithatha izithombe ezinemininingwane yezingxenye ezahlukene zomzimba.
• I-Ultrasound: Amaza omsindo anamandla aphezulu (i-ultrasound) athunyelwa ezicutshini ezingaphakathi komzimba futhi ama-echo abuyayo asetshenziselwa ukudala isithombe (i-sonogram). I-ultrasound yesisu ingenziwa ukuthola umdlavuza we-renal pelvis kanye ne-ureter.
• I-MRI (i-Magnetic resonance imaging - i-MRI): Isebenzisa i-magnet, amaza omsakazo, kanye nekhompyutha ukuthatha izithombe ezinemininingwane zezindawo ezingaphakathi komzimba, njenge-pelvic cavity.

Kuyini ukulinganisa umdlavuza?

Odokotela basebenzisa uhlelo lokuhlola umdlavuza ukuhlela ukwelashwa nokunquma ukuthi kuzokwenzekani. Lokhu kuchaza ukuthi umdlavuza ungase ukhule futhi usabalale kanjani.

Ukuhlukanisa umdlavuza kuyinqubo eyinkimbinkimbi. Uma kuzwakala sengathi isimo sakho sifakwa efomini enezinhlamvu nezinombolo ezimbalwa, kungaba yinto eyesabekayo nedidayo. Kuyaqondakala ukuthi kunjalo. Uma ungaqiniseki ngalokhu noma uzizwa wesaba, cela udokotela wakho ukuthi akuchazele ukuthi lolu hlelo lusebenza kanjani esimweni sakho.

Izigaba zomdlavuza wesinye

Umdlavuza wesinye ungaba yisigaba sokuqala (kukhawulelwe ongqimbeni lwesinye) noma ube sezingeni eliphezulu (ungene odongeni lwesinye futhi wasakazekela ezithweni eziseduze noma kuma-lymph node). Izigaba zomdlavuza wesinye zimi kanje:

• Isigaba I: Umdlavuza ukhawulelwe olwelwesini lwesinyi noma ezicutshini ezixhumene ngaphansi kwawo. Awukasabalali odongeni oluyinhloko lwemisipha yesinyi.
• Isigaba II: Umdlavuza ususakazekele odongeni lwemisipha yesinye.
• Isigaba III: Umdlavuza ususakazeke kusukela emsipheni wesinye kuya ezicutshini ezinamafutha ngaphandle.
• Isigaba IV: Umdlavuza ususakazeke kusukela kwesinye kuya kuma-lymph node, kwezinye izitho zomzimba, noma emathanjeni.

Odokotela baphinde bahlukanise umdlavuza wesinyi njengongahlaseli , ongahlaseli imisipha , noma ohlasela imisipha .

• Ayihlaseli: Kulesi simo, umdlavuza ungase ube khona endaweni encane yezicubu, noma ungase ukhawulelwe ebusweni besinye.
• Akuhlaseli imisipha: Kulesi simo, umdlavuza usungene wajula esinyeni, kodwa awusakazekelanga emisipheni.
• Imisipha ehlaselayo: Kulesi simo, umdlavuza ususakazekele emisipheni yodonga lwesinye futhi kungenzeka ukuthi ususakazekele ezingqimbeni ezinamafutha ezingaphandle kwesinye noma ezicutshini zezitho zomzimba.

Izigaba zomdlavuza wezinso

Umdlavuza wezinso awuhlelwa ngezigaba ngokusekelwe ohlotsheni lweseli lomdlavuza. Umdlavuza we-Urothelial ubanga cishe u-7% womdlavuza wezinso. Umdlavuza wezinso kanye nomdlavuza we-renal pelvis/ureter unezigaba ezahlukene.

• Isigaba I: Umdlavuza awukasabalali ngale kwezinso.
• Isigaba II: Umdlavuza usukhulile, kodwa awusakazekelanga ngale kwezinso.
• Isigaba III: Umdlavuza ususakazeke kusukela ezinso kuya emithanjeni yegazi eyinhloko - umthambo wezinso kanye ne-vena cava engaphansi - noma ezicutshini ezizungeze izinso, noma kuma-lymph node aseduze.
• Isigaba IV: Umdlavuza ususakazeke kusukela endlaleni i-adrenal (indlala encane etholakala ngaphezu kwezinso), uye kuma-lymph node akude, noma kwezinye izitho zomzimba.

Izigaba zomdlavuza we-renal pelvis kanye ne-ureter

• Isigaba 0: Kunamaseli angajwayelekile olwelwesini lwe-renal pelvis noma i-ureter. Lokhu kubizwa nangokuthi i-papillary carcinoma noma i-carcinoma in situ .
• Isigaba I (Isigaba 1): Umdlavuza ususakazeke ngengqimba yangaphakathi ye-renal pelvis kanye/noma i-ureter futhi uye engxenyeni yezicubu ezixhumeneyo.
• Isigaba II:Umdlavuza ususakazeke ngezicubu ezixhumene nawo uye engxenyeni yemisipha ye-renal pelvis kanye/noma i-ureter.
• Isigaba IV: (Isigaba III asikhulunywa ngaso lapha, kodwa ngokuvamile siphakathi kwesigaba II nese-IV, okubonisa ukusabalala kwezakhi eziseduze) Umdlavuza ususabalale ezithweni eziseduze, i-lymph node eyodwa noma ngaphezulu, ungqimba olunamafutha oluzungeze izinso, noma izitho ezikude njengamaphaphu, isibindi, noma amathambo.

Odokotela bamelapha kanjani umdlavuza we-urothelial?

Izindlela zokwelapha ziyahlukahluka kuye ngokuthi umdlavuza we-urothelial ukuphi esinyeni, ezinso, e-renal pelvis, kanye nase-ureter.

Ukwelashwa komdlavuza wesinye

Izinketho zokwelapha zingafaka:

• Ukuhlinzwa: Odokotela abahlinzayo basusa isimila esinomdlavuza noma basishise besebenzisa ugesi onamandla aphezulu. Lokhu kubizwa ngokuthi i-electrocautery (i-fulguration) .
• Ukwelashwa ngamakhemikhali: Kunikezwa imithi yokubhubhisa amangqamuzana omdlavuza.
• Ukwelashwa Ngezifo Ezithathelwana Ngomzimba: Kuvuselela amasosha omzimba wakho ukuze alwe nomdlavuza.
• Ukwelashwa ngemisebe: Kusebenzisa imisebe enamandla amakhulu ukubhubhisa amangqamuzana omdlavuza.
• Ukwelashwa okuqondiwe: Imithi eqondisa ama-molecule athile asiza amangqamuzana omdlavuza ukuba akhule.

Ukwelashwa komdlavuza wezinso

Ezinye zezindlela zokwelapha ezifanayo zisetshenziselwa umdlavuza wezinso njengomdlavuza wesinye. Ngaphezu kwalokho, lezi zindlela zokwelapha zingasetshenziswa:

• Ukuhlinzwa: Ingxenye yezinso enomdlavuza kuphela engasuswa, noma yonke inso ingasuswa.
• I-Cryoablation: Isebenzisa umkhuhlane omkhulu ukubhubhisa amangqamuzana omdlavuza.
• Ukususwa kwamaza omsakazo: Amaza omsakazo asetshenziselwa ukushisa nokubhubhisa amangqamuzana omdlavuza.

Ukwelashwa komdlavuza we-renal pelvis kanye/noma i-ureter

• Ukuhlinzwa: Ingxenye ye-kidney pelvis noma i-ureter lapho umdlavuza ukhona khona iyasuswa.

Lingakanani izinga lokusinda uma unesifo somdlavuza we-urothelial?

Nakuba umdlavuza we-urothelial umdlavuza oqala ohlotsheni olufanayo lwamaseli, inkambo yalesi sifo ingahluka kuye ngokuthi sikhula kuphi (isinyi, izinso, i-renal pelvis, i-ureter).

Umbono womdlavuza wesinye

Njengezinhlobo eziningi zomdlavuza, umdlavuza wesinye unamathuba amaningi okusinda uma utholakala futhi welashwa kusenesikhathi. Ngokusho kwedatha ka-2018 evela kwi-National Cancer Institute (NCI), abantu abangu-96% abelashelwa umdlavuza wesigaba sokuqala babesaphila eminyakeni emihlanu ngemva kokuxilongwa. Sekukonke, abantu abangu-77% abanomdlavuza wesinye babesaphila eminyakeni emihlanu ngemva kokuxilongwa.

Umbono ngomdlavuza wezinso

Njengezinhlobo eziningi zomdlavuza, umdlavuza wezinso (kufaka phakathi umdlavuza we-renal pelvis) kulula ukuwulapha uma utholakala kusenesikhathi.Ngokusho kwedatha ye-NCI (2018), abantu abangu-93% abelashelwa umdlavuza wezinso osesigabeni sokuqala basaphila eminyakeni emihlanu ngemuva kokutholakala benalesi sifo. Izinga lokusinda leminyaka emihlanu lilonke lingu-76.5%.

Ngingayinciphisa kanjani ingozi yami yokuba nomdlavuza we-urothelial ohlelweni lwami lomchamo?

Kunezinto ezimbili eziyinhloko ongazenza ukuze unciphise ingozi yakho yokuthola lo mdlavuza:

• Ukungabhemi ugwayi.
• Ukugwema ukuchayeka kumakhemikhali athile ayingozi.

Ngingazinakekela kanjani?

Uma umdlavuza utholakala kusenesikhathi, odokotela bavame ukwelapha umdlavuza we-urothelial, okhula emgudwini womchamo. Kodwa ngeshwa, lolu hlobo lomdlavuza lungase lubuye. Uma uke welashwa lolu hlobo lomdlavuza, kubalulekile ukuqhubeka nokunakekelwa okulandelayo njengoba kuqondiswe udokotela wakho. Lokhu kubaluleke kakhulu.

Kufanele ngimbone nini udokotela?

Uma ubona noma yiziphi izinguquko emzimbeni wakho, ikakhulukazi izimpawu ezibonisa ukuphinda komdlavuza we-urothelial ohlelweni lomchamo, bona udokotela ngokushesha. Lokhu kusho ukuthi uma uhlangabezana nanoma yiziphi izimpawu ezintsha, njengegazi emchameni wakho, ubuhlungu bomhlane, noma ukukhathala okusha, kufanele nakanjani ubone udokotela.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngakho-ke, lezi yizinto ezibaluleke kakhulu okudingeka uzikhumbule kulokho esikhulume ngakho namuhla:

• I-Urothelial carcinoma umdlavuza okhula engxenyeni engaphakathi yesistimu yakho yomchamo (isinyi, izinso, kanye nama-ureter).
• Uphawu oluyinhloko igazi emchameni . Ezinye izimpawu zifaka phakathi ubuhlungu emhlane, ukukhathala kanye nokwehla kwesisindo.
• Ukubhema kanye nokuchayeka kumakhemikhali athile yizona zinto eziyinhloko eziyingozi.
• Uma kutholakala kusenesikhathi, kungenzeka kakhulu ukuthi selashwe futhi selapheke.
• Ngenxa yokuthi lo mdlavuza ungaphinde ubuye, kubalulekile ukuqhubeka nokuhlolwa kwezokwelapha ngemva kokwelashwa.
• Uma unokungabaza noma izimpawu, ungesabi ukukhuluma nodokotela. Bazokusiza.

Ngiyethemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile! Umdlavuza we-Urothelial, i-Urothelial Carcinoma, umdlavuza womchamo, umdlavuza wesinye, umdlavuza wezinso, igazi emchameni, izimpawu zomdlavuza