Iningi labantu abahlakulela umdlavuza we-laryngeal yilabo ababhemayo isikhathi eside.
Ngaphambi kokwethulwa kwezigwayi ezikhiqizwa ngobuningi ekhulwini lama-20, umdlavuza we-larynx, noma umdlavuza we-laryngeal, wawungavamile kakhulu. Nokho, abaseYurophu babebhema ugwayi ngasekuqaleni kwekhulu leshumi nesithupha, kusukela ekuqaleni lapho kuqaliswa eYurophu ngabahloli ababuya eNew World.
Ngakho-ke, kungakhathaliseki ukuthi kukhona ugwayi owenza umdlavuza we-laryngeal wanda kakhulu ngemva kuka-1900, noma abantu abaningi bebhema ugwayi ngemuva kokukhiqiza ugwayi.
(Ukukhiqizwa kweMisa kwenza izinto zishibhile futhi zingabizi kakhulu kuwo wonke umuntu.) Kungenzeka ukuthi inhlanganisela ethile yalezi zici ezimbili iye yandisa imvamisa yomdlavuza we-laryngeal phakathi neminyaka eyikhulu edlule.
Iyini i-Laryngeal Cancer?
Umdlavuza we-Laryngeal umdlavuza ochaphazela izintambo zomculo weqiniso (izintambo zamagama). Izwi leqiniso ligoqa lidlidliza ukuze lenze umsindo futhi lisenze sikhulume. Ngokuphambene nalokho, iminyango yamazwi angamanga ingaphezu kwamapulangwe ezwi futhi ayikhiqizi umsindo omkhulu ngaphandle kwe-guttaral (cabanga ngomculo we-throat). Esikhundleni salokho, amafolda amanga angamazwi angamahlombe we- vestibular avikela amathrekhi wezwi langempela.
Umdlavuza we-Laryngeal ungakhula ngokuqondile emaceleni ezwi lamagama (glottic), noma ngaphezulu kwawo (supraglottic) noma ngaphansi kwawo (esifundeni esincane).
Iningi lamakhemikhali angama-laryngeal yi-squamous cancer cancer.
Yiziphi Izingozi Ze-Laryngeal Cancer?
Ukubhema kuyisici esibaluleke kunazo zonke ezihlobene nomdlavuza we-laryngeal.
Ngamanye amazwi, iningi labantu abahlakulela umdlavuza we-laryngeal kukhona ababhemayo besikhathi eside.
Ezinye izici ezingozini zokudlavuza umdlavuza zihlanganisa lokhu okulandelayo:
- ukusetshenziswa kotshwala
- Ukutheleleka kwe-HPV (nge-subtypes 16 no-18 eyingozi kunazo zonke)
- ukungena kwe-asbestos enobuthi
- inhalation of gas of mustard
- i-neck neck irradiation yangaphambili
- ukuntuleka kokudla okunomsoco
Ukubhema nokuphuza ngokweqile ukusetshenziswa kwe-synergize ukwakha ingozi enkulu kakhulu. Ngakho-ke, abantu abaphuza futhi baphuze kakhulu banamathuba amaningi okuthuthukisa umdlavuza we-laryngeal.
Nakuba ochwepheshe bacabanga ukuthi isifo se-reflux se-gastroesophageal (GERD) singase sibe yinto engozini yomdlavuza we-laryngeal, akukho ukutholwa okuqondile okusesho okwamanje okusekela lokhu kuxhumano. Kodwa-ke, abantu abaye baphathwa kakade ngenxa yomdlavuza we-laryngeal futhi bathatha imithi yokwelapha i-GERD, i-Iike PPIs, bancane amathuba okuthola umdlavuza we-laryngeal futhi (isipiliyoni sokuphindaphindiwe).
Ngokusho kwe-American Cancer Society, ngo-2016, kuzoba nezigameko ezintsha ezingu-13,543 zomdlavuza we-laryngeal (amadoda ayi-10,550 nabesifazane abangu-2880).
Izimpawu zeCarry Laryngeal
Umdlavuza we-Laryngeal ovame ukuveza kuqala njengokwesaba. Ngisho noshintsho oluncane kunazo zonke ezindongeni zamagama zingathinta izwi. Amanothi, ama-cancer angaphezu kwamagciwane kanye nalawo angaphansi kwegazi, noma ngokukodwa, ngaphansi kwe-vocal folds, ngokulandelana-njengethuba lokuphuza isikhathi ngoba kuthatha isikhathi sokuba lezi zicubu zikhule zikhulu ngokwanele ukuvimbela ukuhamba kwemimoya ngokusebenzisa iminyango yamazwi eqiniso. Ngakho-ke, abantu abanomdlavuza we-laryngeal and subglottic bavame ukuletha udokotela onesifo esiphezulu.
Nazi ezinye izimpawu zomdlavuza we- laryngeal:
- i-dysphagia (inkathazo yokudla)
- ubuhlungu bomphimbo
- ubuhlungu bezindlebe
- isifiso
- ukuvinjelwa kwezindiza nokunciphisa
- ubulili besilisa (cishe amadoda angamahlanu anesifo somdlavuza we-laryngeal)
- ubudala (abantu abaneminyaka engama-60 no-70)
Ukuxilongwa kweCarry Laryngeal
Uma udokotela esho umdlavuza womjovo, uzokwenza ikhanda eliphelele nekhanda ukuhlola ngokomzimba. Umdlavuza we-Laryngeal ungabonwa ngesikhala sehhovisi usebenzisa i-laryngoscopy (cabanga ngesilazi noma i-endoscope). Ukucubungula izifundo ezifana ne-CT ne-x-rays kuyasiza uma kutholakala ukusabalala komdlavuza emakristini namaphaphu noma uma ufuna umthombo we-metastases.
Ukwelashwa Nokuguqulwa Kwegciwane Laryngeal
Lapho ukwelapha umdlavuza we-laryngeal, ochwepheshe benza konke okusemandleni abo ukuze balondoloze ama-larynx amaningi kanye namafolumu omlomo ngangokunokwenzeka, ukuze balondoloze izwi futhi banciphise ukukhubazeka. Umdlavuza weLaryngeal uphathwa ngokuhlinzwa kanye nemisebe. Ucwaningo oluvela kuDuke University lisikisela ukuthi i-chemotherapy iwusizo lapho ukwelapha umdlavuza ophezulu we-laryngeal.
Umdlavuza we-Laryngeal uyaphiliswa-ikakhulukazi uma utholakala kusenesikhathi-futhi amazinga okusinda eminyaka emihlanu alungile. Esikhathini sokuqala (isiteji I) umdlavuza we-laryngeal, amaphesenti angaphezu kuka-95 abantu asephila eminyakeni emihlanu emva kokuxilongwa. Ngemuva komdlavuza we-laryngeal, abantu abangama-50 kuya kwangu-60 abantu baphila iminyaka emihlanu emva komdlavuza.
Ngeshwa, naphezu kokuthuthukiswa kwezinqubo zokuhlinza nokwandisa ukhetho lwezokwelapha phakathi neminyaka engu-30 eyedlule, amazinga okusinda komdlavuza we-laryngeal awazange athuthuke. Kodwa-ke, ukuhlukunyezwa kuye kwaphuthuka, nabantu abathola ukwelashwa komdlavuza we-laryngeal aba nezimpawu ezincane kanye nokugula okuhambisanayo.
Isihluthulelo sokwelashwa okuphumelelayo ngomdlavuza we-laryngeal ukutholakala kokuqala kanye nokwelapha. Uma uhlangabezana nanoma yiziphi izimpawu ezibonisa ukuthi umdlavuza we-laryngeal-ikakhulukazi ukuzwakalisa noma ukushintsha kwezwi-sicela wenze i-aphoyintimenti ukuze ubone udokotela wakho. Kufanele usolise ngokukhethekile uma udela isikhathi eside (futhi uphinde usebenzise kabi utshwala). Nakuba ithuba lokuthi noma yimuphi umuntu onikeziwe unomdlavuza wezinyosi futhi uzodinga ukuqhubeka nokusebenza kanye nokwelashwa ngumchwepheshe (njengokwenziwa ngogqirha we-ENT noma i- oncologist ) iphansi, kungcono ukuphutha eceleni kokuqapha.
Imithombo ekhethiwe
I-Concus AP, i-Tran TN, i- Sanfilippo NJ, i- DeLacure MD. Isahluko 31. Izilonda ezinamaLaryngeal Malignant. Ku: Lalwani AK. ama-eds. Ukuqaphela Kokuqala Nokuphathwa Kwe-Otolaryngology-Inhloko Nokukhishwa Kwezinyosi, 3e . ENew York, NY: McGraw-Hill; 2012. Kufinyelelwe ngoFebhuwari 28, 2016.
I-Weinberger PM, iTerris DJ. I-Otolaryngology: Inhloko Nokuhlinzwa Kwezinyosi. Ku: Doherty GM. ama-eds. Ukuqaphela Kokuqala Nokuphathwa: Ukuhlinzwa, 14e . ENew York, NY: McGraw-Hill; 2015. Kufinyelelwe ngoFebhuwari 28, 2016.
Isihloko esithi "I-induction chemotherapy ne-radiation uma kuqhathaniswa nokuhlinzwa kanye nemisebe yezigulane ezinomdlavuza we-laryngeal advanced" yi-GT Wolf kanye nabalobi ababambisene nabo abashicilelwe ku-NEJM ngo-1991.