Ake sifunde kabanzi ngomdlavuza we-vulvar. Ungesabi, ake sixoxe!

Wake wezwa ngento ebizwa ngokuthi "i-Vulvar Cancer"? Ungase wesabe kancane uma uzwa leli gama. Kodwa ungakhathazeki. Lolu uhlobo lomdlavuza olungavamile kakhulu. Kodwa-ke, kubaluleke kakhulu ukuqaphela lokhu. Ngoba, uma lutholakala kusenesikhathi, kulula futhi ukuluphatha. Ake sixoxe ngalokhu ngokuningiliziwe nangokulula kakhulu namuhla.

Uyini umdlavuza we-Vulvar?

Kalula nje, i-Vulvar Cancer ingumdlavuza okhula ezicutshini ze-vulva yakho. Igama elithi "Vulva" yigama elijwayelekile lazo zonke izitho zangasese zangaphandle zowesifazane. Uyakhumbula, ngesikhathi sisebancane, sasinamahloni kancane ukukhuluma ngalezi zitho, kodwa kubaluleke kakhulu ukwazi ngazo zonke izingxenye zomzimba wethu.

Cabanga nje, i-vulva yakho inalezi zingxenye:

• Ukuvulwa kwesitho sangasese sowesifazane: Ipayipi lemisipha elisetshenziselwa ucansi, ukubeletha, kanye nokuya esikhathini (ukuya esikhathini).
• I-Labia Minora: Ukugoqana kwezicubu ezizungeze ukuvulwa kwesitho sangasese sowesifazane futhi kudlule phezu kwe-clitoris.
• I-Labia Majora: Indawo enenyama ezungeze izindebe zangaphakathi.
• I-Clitoris: Iqhubu elincane, elizwela ucansi ngaphezu komgodi wesitho sangasese sowesifazane.
• I-Mons Pubis: Indawo eyindilinga phambi kwamathambo e-pelvic eba noboya ngesikhathi sokuthomba.
• Ukuvulwa kwe-Urethra: Ukuvulwa kwepayipi lapho umchamo uphuma khona emzimbeni.
• I-Perineum: Indawo yesikhumba phakathi kwesitho sangasese sowesifazane kanye ne-anus.

Lolu hlobo lomdlavuza we-vulvar luvame ukukhula kancane, eminyakeni eminingi. Luqala njengezicubu ezingaphambi komdlavuza (izilonda). Odokotela bavame ukubona lokhu kukhula okungavamile engxenyeni engaphandle yesikhumba. Lezi zilonda ezingaphambi komdlavuza zibizwa ngokuthi "i-vulvar intraepithelial neoplasia" (VIN) .

Yiziphi izinhlobo zomdlavuza we-vulvar?

Odokotela bahlukanisa umdlavuza wesitho sangasese sowesifazane ngokusekelwe ohlotsheni lweseli lapho umdlavuza uqala khona. Izinhlobo ezivame kakhulu yilezi:

• I-Vulvar Squamous Cell Carcinoma: Lolu hlobo lubangela cishe u-90% womdlavuza we-vulvar. Lukhula emaseli ebusweni besikhumba.
• I-Vulvar Melanoma: Lolu hlobo lwe-melanoma lubangela cishe u-5% womdlavuza we-vulvar. Lukhula ngokushesha futhi lunengozi enkulu yokusabalala kwezinye izingxenye zomzimba.

Ezinye izinhlobo zomdlavuza we-vulvar azivamile kakhulu. Zihlanganisa:

• I-Basal Cell Carcinoma
• I-Bartholin Gland Adenocarcinoma
• Isifo se-Paget se-Vulva
• I-Sarcoma
• I-Verrucous Carcinoma

Uvame kangakanani umdlavuza we-vulvar?

Eqinisweni, umdlavuza we-vulvar umdlavuza ongavamile kakhulu. Isibonelo, e-United States, kutholakala amacala amasha angaphansi kuka-6,500 omdlavuza we-vulvar minyaka yonke.

Okubalulekile ukuthi abantu abangu-80% abatholakale benalesi sifo baneminyaka engaphezu kwengu-50 ubudala. Futhi, ngaphezu kwengxenye yokuxilongwa kwenzeka kubantu abaneminyaka engaphezu kwengu-70 ubudala. Isilinganiso seminyaka yokuxilongwa sicishe sibe yiminyaka engu-68 ubudala.

Lokho kusho ukuthi, kubonakala sengathi le ngozi iyanda njengoba iminyaka ikhula, akunjalo?

Ziyini izimpawu zomdlavuza we-vulvar?

Manje ake sibheke izimpawu zalesi sifo. Izimpawu zokuqala zivame ukubonakala njengokushintsha kwesikhumba ku-labia majora yakho yangaphandle noma ku-inner labia minora. Kodwa-ke, umdlavuza ungavela noma kuphi ku-vulva.

Izimpawu zomdlavuza wesitho sangasese sowesifazane zingafaka:

• Ukushintsha kombala wesikhumba: Ezinye izindawo zingase zibe mnyama noma zikhanye kunokujwayelekile, noma kuvele amabala amhlophe.
• Ukujiya noma ukugoba kwesikhumba: Ezinye izindawo zingase zizwakale zijiyile futhi ziqinile uma zithintwa.
• Amaqhubu noma ukukhula: Ungase ube namaqhubu, amaqhubu, noma izilonda ezingapholi.
• Ukuluma noma ukusha: Ungase uzizwe ukuluma noma ukusha okuqhubekayo, okunganciphisi.
• Ukopha okungahlobene nokuya esikhathini: Uma ukopha kwesitho sangasese sowesifazane okungahlobene nokuya esikhathini, lokho kufanele kucatshangelwe.
• Ubuhlungu nobuhlungu lapho uthintwa: Ungase uzwe ubuhlungu ngesikhathi socansi noma ngesikhathi sokuchama.

Uma unesinye noma ngaphezulu salezi zimpawu, qiniseka ukuthi ubona udokotela. Izimpawu zomdlavuza wesitho sangasese sowesifazane zingase zingabonakali ezigabeni zokuqala. Ngakho-ke, kungcono ukuhlolwa ngokushesha okukhulu.

Kodwa-ke, lezi zimpawu zivame ukubonakala kwezinye izimo ezingezona ezomdlavuza. Ngakho-ke, kubalulekile ukungesabi, kodwa ukubona udokotela ukuze uthole ukuthi lezi zinguquko ziyizimpawu zomdlavuza noma okunye.

Yiziphi izimbangela zomdlavuza we-vulvar?

Kumdlavuza wesitho sangasese sowesifazane, amangqamuzana aqala ukwanda ngokungalawuleki. Uma engelashwa, lawa maseli omdlavuza angasakazekela kwezinye izingxenye zomzimba.

I-Vulvar Squamous Cell Carcinoma, uhlobo oluvame kakhulu, ibangelwa yizimo ezimbili eziyinhloko:

• Ukutheleleka kwe-Human Papillomavirus (HPV): Lokhu kuyisifo esithathelwana ngocansi esivame ukusabalala ngokuthintana kwesikhumba nesikhumba. Ezinye izinhlobo ze-HPV zandisa ingozi yezinhlobo eziningana zomdlavuza, okuhlanganisa umdlavuza wesibeletho, umdlavuza wendunu, kanye nomdlavuza we-vulvar.
• I-Lichen Sclerosus: Lesi yisifo sesikhumba esingapheli (ukuphila konke). I-Lichen Sclerosus ingabangela izimpawu ezifana nokuvuvukala kwe-vulva, izinguquko zesikhumba, kanye nokulunywa.

Yiziphi izinto ezibangela ingozi?

Kunezici eziningana ezandisa ingozi yokuthola umdlavuza we-vulvar:

• Ubudala: Ingozi yokuba nomdlavuza we-vulvar iyanda njengoba iminyaka ikhula.
• Ukuchayeka ku-HPV: Akuzona zonke izinhlobo ze-HPV ezibangela umdlavuza, kodwa ezinye izinhlobo zingabangela izinguquko zamaseli ezingagcina ziholele kumdlavuza we-vulvar.
• Izifo zesikhumba ze-vulvar: Ukukhula okuhlobene nezimo ezifana ne-'Lichen Sclerosus' kungaqhubekela phambili ekubeni umdlavuza we-vulvar.
• I-Vulvar intraepithelial neoplasia (VIN): I-VIN yisimo esingaphambi komdlavuza, uma singelashwa, singaba umdlavuza we-vulvar.
• Ukutheleleka kwe-Human Immunodeficiency Virus (HIV): Uma amasosha omzimba ebuthakathaka ngenxa yesimo esifana ne-HIV, kuba nzima ngomzimba ukulwa nomdlavuza.
• Ukubhema: Ukubhema kwandisa ingozi yezinhlobo eziningi zomdlavuza, okuhlanganisa nomdlavuza we-vulvar.

Umdlavuza weVulvar Uhlolwa Kanjani?

Uma ubona udokotela, uzobuza ngomlando wakho wezokwelapha, izici eziyingozi, kanye nezimpawu. Ngokuvamile kwenziwa izivivinyo eziningana ukuze kutholakale ukuthi unesifo yini.

Ukuhlolwa kokuthola umdlavuza wesitho sangasese sowesifazane

Lezi zivivinyo zingafaka:

• Ukuhlolwa Kwesitho Sangasese Sowesifazane: Udokotela uzohlola isitho sakho sangasese sowesifazane ngamehlo futhi abheke noma yiziphi izinguquko zesikhumba ezingavamile. Bazofaka iminwe eyodwa noma emibili egcotshwe amagilavu ​​​​esitho sakho sangasese sowesifazane bese behlola isitho sakho sangasese sowesifazane ngesandla ukuze babone amaqhubu noma ezinye izimpawu zomdlavuza. Indunu nayo ingahlolwa ngendlela efanayo. Bangasebenzisa nedivayisi ebizwa ngokuthi i-speculum ukuze bandise isitho sangasese sowesifazane futhi babheke ukukhubazeka.
• I-Pap Smear: Ngesikhathi sokuhlolwa kwe-pelvic, udokotela wakho angase athathe isampula yamaseli awahlole ukuthi awanazo yini izinguquko zomdlavuza. Isampula ingabuye ihlolwe i-HPV ukuze kubonakale ukuthi unesifo se-HPV.
• I-Colposcopy: Udokotela usebenzisa ithuluzi elikhanyayo nelikhulisayo elibizwa ngokuthi "i-colposcope" ukuze abheke i-vulva yakho, isitho sangasese sowesifazane, kanye nomlomo wesibeletho (isitho esiphakathi kwesitho sangasese sowesifazane kanye nesibeletho) ngokuningiliziwe. Angase futhi asebenzise ikhambi elikhethekile elingagqamisa amangqamuzana angajwayelekile futhi lenze kube lula ukuwabona.
• I-Biopsy: Udokotela angase athathe isampula yezicubu ezingavamile azihlolele amangqamuzana omdlavuza. I-biopsy iyindlela kuphela yokwazi ngokuqinisekile ukuthi unomdlavuza wesitho sangasese sowesifazane.

Ukuhlolwa ukuze kubonakale ukuthi umdlavuza ususabalele yini

Uma unomdlavuza, udokotela wakho uzokwenza izivivinyo ezengeziwe ukuze abone ukuthi ususakazeke ngale kwe-vulva. Uma ungelashwa, umdlavuza we-vulvar ungasakazeka uye esithweni sangasese sowesifazane noma kwezinye izitho eziseduze, uye kuma-lymph node e-pelvis, futhi ekugcineni uye egazini. Umdlavuza we-metastatic kunzima kakhulu ukuwuphatha.

Lezi zivivinyo zifaka:

• Ukuhlolwa Kobubanzi: Ungase wenze i-cystoscopy ukuze ubone ukuthi umdlavuza ususakazekele yini e-urethra noma esinyeni. I-proctoscopy ibheka amangqamuzana omdlavuza e-rectum noma e-anus.
• Ukuhlolwa kwezithombe: Ama-X-ray, ama-CT scan, ama-MRI, kanye nama-PET scan kungabonisa ukuthi umdlavuza ususakazeke kusukela esikhumbeni uye kwezinye izicubu.
• I-Biopsy ye-Sentinel Node: Udokotela wakho angasusa i-lymph node (i-sentinel node) eseduze neqhubu lakho elinomdlavuza ukuze ahlole amangqamuzana omdlavuza. Kumdlavuza we-vulvar, umdlavuza uvame ukusabalala uye kuma-lymph node e-sentinel endaweni ye-groin.

Yiziphi izigaba zomdlavuza we-vulvar?

Ukuhlolwa kwesigaba somdlavuza wesitho sangasese sowesifazane kusiza odokotela ukuthi banqume ukuthi umdlavuza wakho ususakazeke ngale kwesitho sangasese sowesifazane. Lolu lwazi lusiza ekuqondiseni izinqumo zokwelashwa. Kunezigaba ezine eziyinhloko:

• Isigaba I: Umdlavuza we-vulvar wesigaba sokuqala utholakala kuphela e-vulva noma e-perineum (indawo ephakathi kwe-anus nesitho sangasese sowesifazane). Uhlukaniswe nge-IA noma i-IB, kuye ngobukhulu besimila nokuthi sisakazeke kangakanani ezicutshini eziseduze.
• Isigaba II: Isimila (sanoma yisiphi isayizi) sesisabalale saya e-urethra engezansi, esithweni sangasese sowesifazane esingezansi, noma endunu.
• Isigaba III: Umdlavuza ususakazekele kwenye noma ngaphezulu kwama-lymph node aseduze. Lokhu kuhlukaniswe ngama-IIIA, IIIB, kanye nama-IIIC, kuye ngenani nosayizi wama-lymph node ahilelekile.
• Isigaba IV: Umdlavuza ususakazekele engxenyeni engenhla ye-urethra, esithweni sangasese sowesifazane, noma kwezinye izingxenye zomzimba. Lokhu kuhlukaniswe nge-IVA kanye ne-IVB, kuye ngokuthi ukusabalala kuseduze noma kude nesitho sangasese sowesifazane.

Kubaluleke kakhulu ukubuza udokotela wakho ukuthi isigaba somdlavuza wakho sizothinta kanjani ukwelashwa kwakho.

Umdlavuza weVulvar welashwa kanjani ?

Ukwelashwa okutholayo kuzoncika ezicini ezifana nempilo yakho iyonke, isigaba somdlavuza, nokuthi umdlavuza usanda kutholakala yini noma usuphinde wavela. Udokotela wakho uzokuchazela uhlelo lokwelashwa olungcono kakhulu lokuxilongwa kwakho.

Ukuhlinzwa

Ukwelashwa okuvamile kakhulu komdlavuza wesitho sangasese sowesifazane ukuhlinzwa.Umgomo uwukususa ngokuphelele umdlavuza ngenkathi ulondoloza ukusebenza kwakho kocansi. Kunezinhlobo eziningana zokuhlinzwa:

• Ukuhlinzwa Nge-Laser: Lokhu kuhilela ukusebenzisa umsebe we-laser ukwenza ukusikeka kwezicubu ngaphandle kwegazi noma ukususa izilonda zomdlavuza ezingatheni.
• Ukususwa Kwendawo: Lokhu kuhlinzwa kususa umdlavuza kanye nenani elincane noma elikhulu lezicubu ezivamile ezizungezile. Ngezinye izikhathi, ama-lymph node aseduze ayasuswa ukuze kuhlolwe amangqamuzana omdlavuza, noma uma kukhona ubufakazi bomdlavuza, lawo ma-lymph node ayasuswa.
• Ukususwa kwe-Vulvectomy: Le nqubo isusa ingxenye noma yonke i-vulva yakho, mhlawumbe kanye nama-lymph node aseduze. Ukufakelwa kwesikhumba kungasetshenziswa futhi ukufaka esikhundleni sesikhumba esisusiwe.
• Ukukhishwa Kwesitho Sangasese Sowesifazane: Lokhu kuhlinzwa kususa ikholoni yakho engezansi, i-rectum, isinye, umlomo wesibeletho, isitho sangasese sowesifazane, ama-ovari, kanye nama-lymph node aseduze. Udokotela wenza izimbobo ukuze avumele umchamo nendle kuphume esikhwameni esikuqoqa emzimbeni wakho.

Ukwelashwa Ngemisebe

Ukwelashwa ngemisebe kusebenzisa imisebe ye-X noma eminye imisebe enamandla amakhulu ukubhubhisa amangqamuzana omdlavuza. Ukwelashwa okuvamile kakhulu komdlavuza wesitho sangasese sowesifazane ukwelashwa ngemisebe yangaphandle (i-EBRT). I-EBRT isebenzisa umshini ukuqondisa imisebe esikhumbeni sakho iye endaweni yomdlavuza oqondiwe.

Ngokuvamile, iziguli zinikezwa ukwelashwa ngemisebe kanye ne-chemotherapy ndawonye (lokhu kubizwa ngokuthi i-chemoradiation). Ungase uthole ukwelashwa ngemisebe ngaphambi kokuhlinzwa ukuze unciphise isimila, noma ngemva kokuhlinzwa ukuze ubulale noma yimaphi amangqamuzana omdlavuza asele.

Ukwelashwa ngamakhemikhali

Ukwelashwa ngamakhemikhali kusebenzisa imithi ukuhlasela amangqamuzana omdlavuza emzimbeni wonke. Udokotela wakho angakunika umuthi njengomjovo emthanjeni noma emisipheni, noma unganikwa iphilisi okufanele ulithathe. Unganikwa futhi ukhilimu ongawusebenzisa ngqo esithweni sakho sangasese sowesifazane. Lolu hlobo lwe-chemotherapy luhlasela umdlavuza endaweni ethile - okusho ukuthi kuphela endaweni okukhulunywa ngayo.

I-Cisplatin (Cisplatin - Platinol®, Platinol-AQ®) kanye ne-fluorouracil (Fluorouracil - Carac®) yimithi evame kakhulu yokwelashwa ngamakhemikhali yomdlavuza we-vulvar.

Ukwelashwa nge-immunotherapy

I-Immunotherapy isebenza ngokusiza amasosha omzimba wakho ukuthi aqaphele amangqamuzana omdlavuza futhi alwe nawo ngempumelelo. I-Imiquimod Cream (Aldara®, Zyclara®) umuthi ovamile we-immunotherapy osetshenziselwa ukwelapha umdlavuza we-vulvar.

Uhlobo luni lokulandelela okufanele ngilulindele ngemva kokwelashwa komdlavuza we-vulvar?

Ngemva kokwelashwa, udokotela wakho angenza izivivinyo ngezikhathi ezahlukene ukuze aqaphe isimo sakho futhi aqinisekise ukuthi umdlavuza awukabuyi.

Lezi zivivinyo zivame ukufaka izivivinyo ezifanayo ezisetshenziselwa ukuxilonga nokuhlukanisa umdlavuza wesitho sangasese sowesifazane.

Ingabe umdlavuza wesitho sangasese sowesifazane uyingozi?

Yebo, kungenza. Umdlavuza we-vulvar ongelashwanga usongela impilo. Ukwelapha umdlavuza osakazekele kuma-lymph node noma kwezinye izingxenye zomzimba kunzima kakhulu kunokwelapha umdlavuza otholakala kusenesikhathi.

Nakuba kuhlale kunengozi yokuthi umdlavuza uzobuya ngemva kokwelashwa, abantu abaningi abathola ukwelashwa ezigabeni zokuqala zalesi sifo baphila bengenawo umdlavuza.

Lingakanani izinga lokusinda komdlavuza wesitho sangasese sowesifazane?

Izinga lokusinda kweminyaka emihlanu kubantu abanomdlavuza wesitho sangasese sowesifazane cishe lingama-70%. Kodwa-ke, amazinga okusinda aphezulu nakakhulu uma lesi sifo sitholakala futhi selashwa ezigabeni zokuqala. Isibonelo, izinga lokusinda kweminyaka emihlanu lomdlavuza wendawo (esitho sangasese sowesifazane uqobo) cishe lingama-86%. Uma umdlavuza ususakazeke, leli zinga lehla laya cishe kuma-30%.

Kodwa-ke, ukubikezela kwakho kuncike ezintweni ezihlukile ekuxilongweni kwakho, njengesimo sakho sempilo kanye nempendulo yakho ekwelashweni. Buza udokotela wakho ngemiphumela engaba khona ngokusekelwe ekuxilongweni kwakho.

Umdlavuza wesitho sangasese sowesifazane usakazeka ngokushesha kangakanani?

Izinhlobo eziningi zomdlavuza we-vulvar zikhula kancane, eminyakeni eminingi. Izinhlobo ezingavamile, njenge-melanoma, zivame ukukhula futhi zisakazeke ngokushesha.

Ingabe umdlavuza we-vulvar ungavinjelwa?

Indlela engcono kakhulu yokunciphisa ingozi yakho ukuthola umuthi wokugomela i-HPV ukuze uvimbele ukutheleleka kwe-HPV. E-United States, abantu abadala abaneminyaka engu-45 bangathola umuthi wokugomela i-Gardasil 9®, kuye ngokuthi basengozini yokuchayeka ku-HPV. I-Cervarix® kanye ne-Gardasil® yimithi yokugomela i-HPV etholakala kwamanye amazwe.

Uma unezimpawu zomdlavuza wesitho sangasese sowesifazane, bona udokotela ngokushesha. Hlela ukuhlolwa njalo, okuhlanganisa nokuhlolwa ngokomzimba okungenani kanye ngonyaka, ukuze kutholakale ukuthi unesifo sabesifazane.

Ngizinakekela kanjani?

Abantu abaningi bangase bazizwe benamahloni noma benamahloni ngezinguquko esithweni sabo sangasese sowesifazane. Kodwa ukuba nomdlavuza wesitho sangasese sowesifazane akusho ukuthi kufanele uyeke ukusondelana ngokomzimba. Ungabi namahloni ngokubuza udokotela wakho ukuthi ukuxilongwa kwakho kungathinta kanjani impilo yakho yocansi. Angakuxhumanisa nezinsiza ezingasekela izidingo zakho zomzimba nezingokomzwelo njengoba ubhekana nalokhu kuxilongwa nokwelashwa.

Umdlavuza wesitho sangasese sowesifazane uqala kuphi?

Umdlavuza wesitho sangasese sowesifazane uvame ukuqala ebusweni besikhumba esizungeze isitho sakho sangasese sowesifazane, kungaba yi-labia majora yangaphandle noma i-inner labia minora. Akuvamile ukuthi ukhule nakwezinye izingxenye zesitho sangasese sowesifazane, njenge-Bartholin's gland kanye ne-clitoris.

Iyini isigaba sokuqala somdlavuza wesitho sangasese sowesifazane?

Isigaba I yisigaba sokuqala somdlavuza we-vulvar. Kulesi sigaba, umdlavuza awukasabalali ngale kwe-vulva noma i-perineum. Isigaba IA Umdlavuza we-vulvar ungamasentimitha amabili (usayizi we-peanut) noma mncane. Awukasabalali ezicutshini eziseduze ngamamilimitha angaphezu kweyodwa (usayizi wesihloko sepensela). Isigaba I Umdlavuza we-IB mkhulu futhi kungenzeka ukuthi usabalale wajula ezicutshini eziseduze.

Okokugcina, into ebaluleke kakhulu engingayisho kuwe! (Umyalezo Wokuya Ekhaya)

Udlala indima enkulu empilweni yakho. Qaphela zonke izingxenye zomzimba wakho, okuhlanganisa nesitho sakho sangasese sowesifazane. Ukwazi ukuthi ubukeka kanjani manje kuzokusiza ukuthi ubone izinguquko kamuva. Uma ubona noma yiziphi izinguquko, hlela i-aphoyintimenti yokubonana nodokotela ngokushesha. Okwamanje, ungalokothi weqe ukuvakashela udokotela wakho wezifo zabesifazane. Bangakwazi ukubona izinguquko zangaphambi komdlavuza ngaphambi kokuba zibe zimbi kakhulu.

Khumbula, ungesabi. Ukuqwashisa kungamandla amakhulu. Awuwedwa.

I- Vaginitis, umdlavuza wabesifazane, i-HPV, izimpawu ze-vulvar, ukwelashwa komdlavuza, impilo yesitho sangasese sowesifazane, ukuvimbela umdlavuza