Kuvamile ukuzizwa wesaba futhi ushaqekile uma uthola ukuthi unomdlavuza we-colonectal. Kodwa kubalulekile ukwaziswa ngezikhathi ezinjengalezi. Ukuqonda ukuthi yiziphi izindlela zokwelapha ozozithola nokuthi yini ongayilindela kungaba usizo olukhulu. Ukwelashwa komdlavuza we-colonectal kuncike kakhulu "esigabeni" sawo. Kalula nje, uhlelo lokwelashwa lunqunywa ukuthi umdlavuza ususakazeke kangakanani.
Isigaba 0: Ukuqala komdlavuza
Lokhu kusho ukuthi umdlavuza usesigabeni sawo sokuqala. Lokhu kusho ukuthi amangqamuzana omdlavuza asezansi kuphela kwekholoni noma i-rectum yakho. Ngakho-ke lesi sigaba sivame ukuphulukiswa ngokuphelele ngokuhlinzwa.
Uhlobo lokuhlinzwa ozoluthola luzoncika ngobukhulu besimila.
- Kumathumba amancane: Udokotela angasusa kuphela isimila esinomdlavuza kanye nengxenye encane kakhulu yezicubu ezisizungezile. Lokhu kubizwa nangokuthi "i-Polypectomy." Lokhu kuvame ukwenziwa ngesikhathi se-colonoscopy, inqubo esebenzisa ikhamera ukubheka i-colon.
- Uma kunezimila ezinkulu: Uma isimila sikhulu impela, udokotela kungase kudingeke asike ingxenye yomdlavuza yekholoni bese exhumanisa izingxenye ezimbili eziphilile. Lokhu kubizwa ngokuthi i-anastomosis. Ngemva kwalokhu, amathumbu akho azophinde asebenze ngendlela evamile.
Ngezinye izikhathi udokotela angase acabangele nokwelashwa ngemisebe.
Isigaba I: Izinga elilawulekayo
Kuleli qophelo, umdlavuza ususakazeke ngale kolwelwesi lwekholoni, wangena ezingqimbeni zesibili nezesithathu. Kodwa okubaluleke kakhulu, umdlavuza awukasakazeki ngale kodonga lwemisipha yekholoni, noma ngaphandle kwekholoni.
Kuleli qophelo, ukwelashwa okuyinhloko kusewukuhlinzwa ukuze kususwe umdlavuza kanye nenani elincane lezicubu ezizungezile. Ezimweni eziningi, ukwelashwa okwengeziwe (njengokwelashwa ngamakhemikhali) akudingeki.
Kodwa-ke, uma isiguli sesikhulile kakhulu, noma sinezinye izifo ezinkulu, udokotela angase anqume ukunikeza ukwelashwa ngemisebe kuphela esikhundleni sokuhlinzwa.
Isigaba II: Sisakazeka odongeni lwamathumbu
Esigabeni sesibili, amangqamuzana omdlavuza makhulu futhi akhule odongeni lwemisipha yekholoni. Kungenzeka ukuthi asakazekele ezithweni eziseduze njengesinye, isibeletho (kwabesifazane), noma indlala ye-prostate (kwabesilisa).
Kodwa izindaba ezinhle lapha futhi ukuthi umdlavuza awukasabalali uye kuma-lymph node noma ezithweni ezikude emzimbeni.
Ngalesi sikhathi, ukwelashwa kungokulandelayo:
- Umdlavuza kanye nezicubu ezizungezile osusakazekele kuzo kuyasuswa ngokuhlinzwa.
- Ukwelashwa ngemisebe kanye ne-chemotherapy kunganikezwa ngaphambi noma ngemva kokuhlinzwa. Lokhu kwelashwa kunikezwa ngaphambi kokuhlinzwa ukuze kwenziwe isimila sibe sincane futhi kube lula ukusisusa. Kunikezwa ngemva kokuhlinzwa ukuze kubhujiswe noma yimaphi amangqamuzana omdlavuza asele futhi kuvinjelwe lesi sifo ukuthi singabuyi.
Isigaba III: Sisakazekela ezindlala ze-sebaceous
Isigaba sesi-3 yilapho umdlavuza ususakazekele kwenye noma ngaphezulu i-lymph node. Ama-lymph node ayizakhiwo ezincane ezenza amaseli alwa nokutheleleka emzimbeni wethu futhi asebenze njengezihlungi.
Lesi sigaba sihlukaniswe izingxenye ezintathu: u-A, u-B, no-C. Kalula nje:
- Isigaba IIIA: Umdlavuza ungaphakathi kodonga lwamathumbu amakhulu futhi ususakazekele kuma-lymph node.
- Isigaba IIIB: Umdlavuza ukhule wadlula odongeni lwekholoni futhi ususakazekele kuma-lymph node angu-1-4.
- Isigaba IIIC: Umdlavuza ususakazeke kuma-lymph node angaphezu kwamane futhi kungenzeka ukuthi ususakazeke nasezithweni eziseduze.
Uhlelo lokwelashwa kuleli qophelo luvame ukubukeka kanje:
- Ukuhlinzwa: Uma kungenzeka, isimila somdlavuza kanye nawo wonke ama-lymph node ahlobene naso kuyasuswa.
- Ukwelashwa ngamakhemikhali: Ukwelashwa ngamakhemikhali kuvame ukunikezwa ngemva kokuhlinzwa.
- Ukwelashwa ngemisebe: Uma umdlavuza umkhulu futhi ususakazekele ezicutshini ezizungezile, ukwelashwa ngemisebe nakho kunganikezwa.
Isigaba IV: Umdlavuza Osakazeka Kakhulu
Isigaba sesi-4 yilapho umdlavuza ususakazekele ezithweni ezikude emzimbeni, ikakhulukazi isibindi noma amaphaphu . Odokotela babiza lesi sigaba ngokuthi umdlavuza "osakazeka kalula". Kulesi sigaba, umgomo oyinhloko wokwelashwa ukulawula lesi sifo, ukunciphisa izimpawu, ukwandisa impilo yesiguli ngangokunokwenzeka, nokugcina impilo isezingeni eliphezulu.
Ake sibheke izindlela zokwelapha eziyinhloko ezisetshenziswa ngalesi sikhathi kuthebula elingezansi.
| Indlela yokwelapha | Incazelo nezibonelo |
|---|---|
| Ukwelashwa ngamakhemikhali | Lokhu ukwelashwa okuyinhloko ngalesi sikhathi. Imithi evame ukusetshenziswa ihlanganisa i-`5-fluorouracil`, i-`Capecitabine (Xeloda)`, i-`Irinotecan (Camptosar)`, i-`Oxaliplatin (Eloxatin)`, kanye ne-`trifluridine kanye ne-tipiracil (Lonsurf)`. Uma umdlavuza ususakazekele esibindini, i-chemotherapy inganikezwa ngqo esibindini. |
| Ukwelashwa Okuqondiwe | Lezi yizidakamizwa eziqondisa ama-molecule athile asiza amangqamuzana omdlavuza ukukhula nokusabalala, kuyilapho zinciphisa umonakalo kumaseli avamile. Lezi zidakamizwa zifaka phakathi izidakamizwa ezifana ne-'Bevacizumab (Avastin), 'Cetuximab (Erbitux),' kanye ne-'Panitumumab (Vectibix).' Lezi zibizwa nangokuthi '(ama-antibodies e-Monoclonal)'. |
| Ukuhlinzwa | Umgomo wokuhlinzwa ukulawula izimpawu. Isibonelo, ukuhlinzwa kwenziwa ukuze kuncishiswe ukuvaleka kwamathumbu noma kumiswe ukopha okungalawuleki. Ngezinye izikhathi, isimila esisodwa noma ezimbili ezinomdlavuza esibindini zingasuswa. Ezinye izindlela zifaka phakathi ukuqandisa izimila (cryosurgery) noma ukusebenzisa ukushisa (radiofrequency ablation). |
| Ukwelashwa ngemisebe | Ukwelashwa ngemisebe kusetshenziselwa ukunciphisa izimpawu ezifana nobuhlungu. |
Kuthiwani uma umdlavuza ubuya? (Umdlavuza Ophindaphindayo)
Ngezinye izikhathi, umdlavuza ungabuya ngemva kokwelashwa. Odokotela babiza lokhu ngokuthi "umdlavuza ophindaphindayo." Lokhu kungaba sendaweni efanayo lapho umdlavuza wawukhona ngaphambili noma kwenye ingxenye yomzimba. Le ngozi iphakeme kancane kubantu ababenomdlavuza esigabeni esithuthukile (isib., Isigaba III).
Ukwelashwa uma umdlavuza uphindela emuva:
- Ukuhlinzwa: Ucwaningo luye lwabonisa ukuthi uma umdlavuza ophinde wabuyela esimweni sawo ungasuswa ngokuphelele ngokuhlinzwa, kungasiza isiguli siphile isikhathi eside.
- Ukwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe: Lokhu kwelashwa kusetshenziswa uma ukuhlinzwa kungakwazi ukususa umdlavuza ngokuphelele. Ngezinye izikhathi lokhu kwelashwa kunganciphisa isimila ukuze sisuswe ngokuhlinzwa kamuva.
- Izivivinyo Zemitholampilo:Lezi izifundo ngemithi noma izindlela zokwelapha ezintsha. Ngezinye izikhathi, lokhu kungakunika ithuba lokuzama ukwelashwa okusha okungasetshenziswa njalo njengamanje. Khuluma nodokotela wakho ngalokhu.
Umlayezo Wokuya Nawe Ekhaya
- Uhlelo lokwelapha umdlavuza wamathumbu luncike cishe ngokuphelele esigabeni sesifo.
- Ezimweni zokuqala (Isigaba 0, I), ukwelashwa okuyinhloko ukuhlinzwa.
- Ezimweni ezithuthukile lapho umdlavuza ususakazeke khona (Isigaba II, III, IV), indlela eyodwa noma ngaphezulu njengokuhlinzwa, ukwelashwa ngamakhemikhali, ukwelashwa ngemisebe, kanye nokwelashwa okuqondiwe kusetshenziswa ndawonye.
- Ithimba lezokwelapha, eliholwa udokotela ohlola isimo sakho, lizonquma uhlelo lokwelashwa olufanele kakhulu kuwe noma kothandekayo wakho.
- Ngakho-ke, vuleka kakhulu futhi uthembeke kubo nganoma yimiphi imibuzo, ukungabaza, noma ukwesaba ongase ube nakho. Ngolwazi olufanele kanye nokwelashwa okufanele, ungalwa ngempumelelo nalesi simo.
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