Ukubhema nokuphuza ngokuyinhloko kwandisa ingozi ye-Canal Oral
Sibutsetelo
E-United States nasemhlabeni wonke, ukuvama komdlavuza womlomo, noma umdlavuza ochaphazela izindebe, umlomo womlomo, nomphimbo, kuphakeme kakhulu ngoba abantu abaningi baphuza futhi baphuze. Lokhu kubandakanya ingozi, ukuphuza nokubhema, kukhulisa kakhulu ingozi yomuntu wokuthuthukisa umdlavuza womlomo-kodwa ngakho kunokuba ingozi ingabe iyodwa.
Indlela evelele kakhulu yokuvimbela umdlavuza womlomo ukugwema ukuphuza nokubhema; Kodwa-ke, sonke siyazi ukuthi ukuqeda kuyinselele kubantu abaningi abaxhomeke kwizidakamizwa nokuphuza utshwala noma izidakamizwa nokuphuza utshwala.
Izibalo
Cishe ngamaphesenti angama-85 ekhanda nekhanda ukwelapha isifo somdlavuza. (Ikhanda nekhanda lomdlavuza lihlukile emdlalweni wegciwane lobuchopho.) Ngaphezu kwalokho e-United States, amaphesenti angu-3 azo zonke izinhlobo zomdlavuza ezibulalayo emadodeni namaphesenti angu-2 kuwo wonke ama-canal angamantombazane angama-cancers omlomo.
Umdlavuza womlomo uthinta amadoda amaningi kunabesifazane, futhi amadoda ase-Afrika namaMelika angaphezu kwamadoda amhlophe ukuthuthukisa umdlavuza womlomo. Ekugcineni, umdlavuza womlomo uvame kakhulu kubantu abaneminyaka engama-40 nangaphezulu.
ENingizimu-mpumalanga ye-Asia, amaphesenti angama-40 azo zonke izinhlobo zomdlavuza angomdlavuza womlomo. Ezizweni ezithuthukile, iphesenti yamagciwane e-khancer yomlomo ehamba ngamaphesenti angama-4.
Ithuba lokuthi noma yimuphi umuntu ozoba nomdlavuza womlomo ngenkathi ephila ngayo cishe amaphesenti angu-1.1.
Unyaka ngamunye, umdlavuza womlomo ubulala abantu abangaba ngu-8000 e-United States. Ngaphezu kwalokho, abantu abangaba ngu-42 000 e-United States batholakala ukuthi banalo hlobo lomdlavuza unyaka ngamunye.
Ngo-2012, abantu abangaba ngu-300 000 kulo lonke elase-United States babe nomdlavuza womlomo. Ukuze ubeke le namba ngendlela enombono, inani labantu baseCincinnati lingabantu abangaba ngu-300,000.
Naphezu kwentuthuko emasu okuxilonga nokuhlinzeka, inani labantu abaphila iminyaka emihlanu emva kokuxilongwa komdlavuza womlomo, noma isilinganiso seminyaka emihlanu yokusinda, kuye kwaba okufanayo cishe emashumini amane eminyaka: phakathi kwamaphesenti angu-50 no-55.
Ngamanye amazwi, cishe isigamu sabantu abatholakala ukuthi banomdlavuza ngomlomo bazofa eminyakeni emihlanu ezayo. Lokhu kusinda okulindile kwenzeka ngenxa yokuthi nakuba singakwazi ukuthola umdlavuza womlomo ekuqaleni, abantu abanesifo ngokuvamile bavele bezokwelashwa kamuva, abanezifo eziphambili nakakhulu.
I-Anatomy ye-Canal Oral
Iningi lomdlavuza womlomo lithinta izingxenye ezimbili zokuqala zolimi. Ngokuqondile, lawa makhrikhi akhula ukusuka ezinhlangothini ezingezansi (dorsal) kanye (lateral) zolimi. Ingxenye ephezulu (dorsal) yelulwimi lwakho inzima ngamafihledi. Ingxenye engezansi yolimi lwakho iyabushelela.
Ngokuvamile, umdlavuza womlomo ungathinta noma izindebe noma izingxenye zomlomo womlomo kufaka phakathi okulandelayo:
- ngaphakathi kwezihlathi (buccal mucosa)
- uphahla lomlomo (i-palate enzima)
- indawo encane etholakala ngemuva kwamazinyo okuhlakanipha (i-retromolar trigone)
- izinsini (gingiva)
Amagciwane omlomo ngezikhathi ezithile angakhula emhlane we-throat noma pharynx . Ngokuqondile, amagciwane angakhula kusuka oropharynx ne- hypopharynx .
I-oropharynx iqukethe okulandelayo:
- i-soft palate
- izindonga ezingemuva nangemuva emphinjeni
- ubuyele emuva kwengxenye eyodwa kwezintathu zolimi
- amathani
I-hypopharynx ingxenyeni engaphansi komphimbo. I-pharynx iyishubhu elide elingama-intshi elingu-intshi elihlanganisa i-real estate emkhatsini wekhala kanye nokungena kwe-esophagus ne-larynx (i-windpipe). Ukudla nomoya kudlula i-hypopharynx endleleni eya esiswini nasemaphaphu, ngokulandelana.
Indawo yesikhumba esibi (umdlavuza) emlonyeni womlomo noma i-pharynx kubalulekile ngoba indawo ingathinta ukuziphatha kwezifo (ukukhubazeka) nokwelapha.
Ekugcineni, umdlavuza womlomo ungathinta noma iyiphi ingxenye yomlomo, umlomo womlomo kanye ne-pharynx.
Yiziphi Izifo Zomdlavuza Zomlomo Zenziwe Ngayo
Iningi lamangqamuzana omlomo asemangqamuzaneni amancane . Amangqamuzana angama-squamous amaseli amancane, amancane ahlanganisa umlomo womlomo kanye ne-pharynx.
Amagciwane e-squamous amangqamuzana aqala ukwakha emva kokuguqulwa okuphelelwa yisikhathi ezingeni lemangqamuzana. Uma nje amangqamuzana ahlambalaza ehlaselwa kwizinga lesimangqamuzana, ukubukeka kwala maseli kuyashintsha. Njengoba amangqamuzana amaningi ashintsha ekubukeni, umdlavuza womlomo uyabonakala, noma ubonakale emitholampilo, futhi izimpawu ziqala ukubonakalisa.
Amagciwane omlomo angenasidingo futhi angakwazi ukufaka izicubu ze-salivary gland, ama-sarcomas, ne-melanoma.
Izingozi Zezingozi
Izici zengozi zichazwa ngokuthi yiziphi izici noma ukuvezwa okwandisa amathuba (engozini) yokuthuthukisa izifo.
Nazi ezinye zezinto ezibangelwa umdlavuza ngomlomo:
- utshwala
- ugwayi
- I-HPV16 (uhlobo lwegciwane lomuntu we-papilloma 16 oluxhunywe nemvamisa ekhulayo yamathambo e-tonsillar)
- Ukudla okungafanele izithelo nemifino
- ukushisa kwelanga ngokweqile (kwandisa ingozi yomdlavuza womlomo)
- ukuzivikela komzimba (ukukhubazeka kwesimiso somzimba)
- i-betel quid chewing (i-drug stimulant etholakala emazweni angaphandle aseNdiya okuthiwa ugwayi udoti futhi ngokuvamile exubene nogwayi)
- ukuphuza umlingani (isiphuzo sendabuko saseNingizimu Melika esine-caffeine futhi esenziwe nge-yerba mate)
Izimpawu
Nazi ezinye izimpawu nempawu zomdlavuza womlomo. (I-FYI: Isibonakaliso yisiphi isici esibonakalayo sesifo; kanti, isibonakaliso isifo isiguli esikhala ngakho ngakho-ke sizithoba.)
- ama-white patches ngaphakathi emlonyeni (leukoplakia)
- umkhuhlane ongeke uhambe
- isikhumba (emlonyeni) noma isilonda esingahambi
- Phuma ngaphakathi emlonyeni
- ubuhlungu ekufuneni
- ubuhlungu ngokugwinya
- izigulane ezivuvukala (izilonda zesikhumba)
- ubuhlungu bomhlathi
- ulimi lobuhlungu
- amazinyo okuxekethile
- amazinyo okuxekethile
Izimpawu eziphambili kakhulu zomdlavuza womlomo zihlanganisa okulandelayo:
- ukulahlekelwa isisindo
- ukukhwehlela kwegazi
- inkathazo yokudla (dysphagia)
- ukukhathazeka
- ukukhathazeka ukuphefumula
Ngokuvamile, abantu abanomdlavuza womlomo babonisa izimpawu zokuqala zesifo nesinye sezimbangela. Ngenxa yalokho, laba bantu bakhona ngaleli gciwane lapho begula lapho sekugula kakhulu. Ukwengeza, odokotela bokunakekelwa okuyinhloko (odokotela bemithi yomndeni noma abaqeqeshi be-internists) ngezinye izikhathi bangabheka ukubaluleka kokubonakaliswa kwempawu zomdlavuza zomlomo.
Ngeshwa, ukutholakala kokutholakala kokuqala yisisusa esikhulu umdlavuza womlomo ubulala cishe isigamu sabantu abawunzima. Izifo ezitholwe kusheshe zilapha kakhulu.
Ukuxilongwa
Uma udokotela noma udokotela wamazinyo ebona isilonda esolisayo, noma okungavamile, emlonyeni wakho noma emphinjeni ngemva kokwenza ukuhlolwa ngokomzimba, i-biopsy yenzeka ukuze uthole ukuthi lesi silonda siyini. Nge-biopsy, isampula encane yesisindo sinqunywa kusuka emthonjeni futhi sihlaziywe usebenzisa i-microscope ebhodini.
Ngaphezu kwe-biopsy, ezinye izindlela zokuxilonga zingasetshenziswa ukusiza ukuxilonga umdlavuza womlomo noma ukuthola ukuthi usakaze yini (okusetshenzisiwe). Lezi zivivinyo zifaka okulandelayo:
- I-MRI
- CT scan
- Ukuskena kwe-PET (okuhle ekutholeni amametasethi noma ekusakazeni)
- isifuba sama-x-ray
- i-endoscopy (i-tube eguquguqukayo enekhamera nokukhanya ekupheleni esetshenziselwa ukubona ngeso lengqondo ngaphakathi komzimba wakho)
- i-barium yokugwinya (uchungechunge lwesisu somzimba wama-x-ray we-esophagus nesisu)
Isiteji
Isiteji , noma ukuqina, komdlavuza womlomo kusekelwe ekutheni i-TNM isetshenziswe kanjani.
I-T e-TNM ibhekisela ekutheni i-anatomic izinga le-tumor enkulu. Ngamanye amazwi, i-T ibhekisela ekutheni umthamo womdlavuza womlomo oyinhloko ukhula ube yizakhi ezungezile.
Khona-ke i-TNM imelela ukusabalala kwe-lymph node noma izinga lomdlavuza womlomo lihlasela kangakanani izilonda zendawo zesifunda. (I-lymph nodes ingasakaza isisu kulo lonke umzimba ngokusebenzisa uhlelo lymph.)
Okokugcina, i-M ku-TNM imelela ukuguqulwa kwamathambo noma ukukhula okuyisimanga esibi emasimini ahamba phambili avela endaweni yangasese yokuqala.
Kunezigaba ezinhlanu eziyinhloko zomdlavuza womlomo: Isigaba 0, I, II, III no-IV. Inothi, isigaba IV sihlukaniswe ngokuphindaphindiwe sibe yizigaba ezintathu-IVA, IVB kanye ne-IVC-esizoxoxa ngakho ngokukhethekile ukugcina izinto zibe lula kakhulu.
Ukuthungatha kungenza kube nzima. Noma kunjalo nayizincazelo ezimfushane ze-khansa yomlomo ezongena kuzo zonke izigaba ezinhlanu eziyinhloko.
- Isigaba somdlavuza we-0 ngomlomo sibhekisela ku- carcinoma in situ , noma umdlavuza ongazange usakaze futhi uhlale lapho uqala khona. Amagciwane e-Stage 0 aphethwe kakhulu.
- Isigaba I Umdlavuza womlomo ubhekisela ku-tumor engakaze isakaze kuma-lymph nodes noma ezindaweni ezikude ezibonakalayo futhi zilinganiselwa ku-2 cm noma ngaphansi ngapha nangapha.
- Isigaba II somdlavuza womlomo sikhuluma ngesifo esingazange sisakaze futhi sisayizi phakathi kuka-2 no-4 cm nendawo enkulu kakhulu.
- Umdlavuza we-Stage III ngomlomo ungabhekisela kunoma yisiphi isisu esiyisisekelo esiyinhloko esingasakazeka noma esingasakazeki kuma-lymph nodes.
- Ngokuya ngesiteji esincane, amagciwane e-Stage IV angabhekisela kunoma yisiphi isisu esinesisindo esinomdlavuza we-lymph node kanye namasastases okude.
Uma kunqunywa ukwelashwa okufanele, ukubeka isisu ngenqubo yokuhlola kuyisihluthulelo. Ukufakwa kwesiteleka kungasetshenziselwa ukubikezela ukubikezela, noma umbono, kulabo abanomdlavuza.
Ukwelapha
Ngokuya ngobukhulu, isiteji nendawo, umdlavuza womlomo ungaphathwa ngokusebenzisa ukuhlinzwa, i-radiotherapy kanye ne-chemotherapy.
Amaqembu e-oncology abhekene nokwelapha iziguli ngomdlavuza womlomo ahlanganisa ochwepheshe bezempilo abahlinzeka ngezinsizakalo ezengeziwe ezifana nokunakekelwa kwamazinyo, ukwelulekwa kwengqondo, ukwesekwa kwezenhlalakahle nokwelulekwa kokudla.
Uma isifo somdlavuza somlomo womlomo oyinhloko siqondile kahle, noma sichazwe kahle, futhi sifinyeleleka, i-ENT (indlebe, umphuzi wephunga kanye nomphimbo noma i-otolaryngologist) izoyiphatha ngokuyisusa.
Ngesinye isikhathi, kungaba nzima ukuthola isidumbu noma isisu sesisakazeke, noma senziwe ngokuyisisindo, kuma-lymph nodes nangaphezulu. Kulezi zimo, i-chemotherapy ne-radiotherapy ingasetshenziswa. Ngaphezu kwalokho, i-chemotherapy kanye ne-radiotherapy ingasetshenziswa njengezokwelapha, noma ezengeziwe, zokwelapha ezihambisana nokuhlinzwa futhi zinciphise ukusakazeka komdlavuza.
Abantu abathola ukwelashwa ngomdlavuza womlomo kufanele balandele ngokucophelela ukuhlolwa okuphelele njalo ezinyangeni ezingu-6. Ithuba lokuthi umdlavuza ngomlomo uzobuya phakathi kwama-3 amaphesenti namaphesenti angu-7 ngonyaka.
Isibikezelo
I-Stage I ne-Stage II yomshuwalense ngomlomo iyaphathwa kakhulu ngemali emihlanu yokusinda engaphezu kwamaphesenti angu-90. Ngamanye amazwi, inani labantu abaphila iminyaka emihlanu emva kokuxilongwa nge-Stage I ne-Stage II yomdlavuza ngomlomo kunamaphesenti angu-90.
I-Stage III kanye ne-Stage IV kanomdlavuza banamaphesenti amahlanu aphansi okusinda: phakathi kwamaphesenti angu-23 no-58.
Ekuphetheni, uma wena noma othandekayo usola umdlavuza womlomo nganoma yisiphi isizathu, kubalulekile ukuba wenze i-aphoyintimenti nodokotela wakho ngokushesha. Ngenxa yokuthi izimpawu zokuqala zomdlavuza womlomo akuyona into ebalulekile, kufanele wabelane ngokukhathazeka okuqondene nomdlavuza womlomo nodokotela wakho. Ungaphinde ucele ukuthi udluliselwe kuchwepheshe, noma i-ENT, ukuze uhlolwe ngokuqhubekayo. Umdlavuza womlomo yisifo esibi kakhulu okufanele siphathwe kusenesikhathi ukuze siqinisekise ukuthi sisinda.
Imithombo
Kim ES, Gunn G, William W, Jr., Kies MS. Isahluko 16. Inhloko nomdlavuza wegazi. Ku: HM Kantarjian, Wolff RA, Koller CA. ama-eds. I-MD Anderson Manual ye-Medical Oncology, 2e . ENew York, NY: McGraw-Hill; 2011. Kufinyelelwe kuMashi 17, 2016.
Isihloko esithi "I-TNM Ukunyatheliswa Kwemikhaza Yekhanda Nekhanda: Ukuzama Ukungafani Phakathi Kokuhlukahluka" nguSG Patel noJP Shah abashicilelwe ku-CA: I-Cancer Journal for Clinicians ngo-2005
Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. Isahluko 43. I-Oropharyngeal Cancer. Ku: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. eds. Umbala we-Atlas of Family Medicine, u-2e . ENew York, NY: McGraw-Hill; 2013. Kufinyelelwe ngo-Mashi 16, 2016.