Umdlavuza wesifuba ukwesaba okwanele ngaphandle kokwesaba ukuthi ungahamba kwezinye izingxenye zomzimba. I-Metastasis yigama lokusakaza komdlavuza. Abesifazane abangaba ngu-250 000 batholakala benomdlavuza wesifuba cishe abangaba ngu-40 000 bazofa ngesifo minyaka yonke. Uma umdlavuza webele usitholakele ezinyathelweni zokuqala, abesifazane abaningi bayaqhubeka nokuphila impilo engenawo umdlavuza.
Kodwa kwabanye, lesi sifo singumetastatic ngesikhathi sokuxilongwa noma emuva kwesikhathi. Kucatshangwa ukuthi izifo ze-metastatic zibangela amaphesenti angama-90 okufa okuhlobene nomdlavuza webele. Umdlavuza wesifuba usakazeka kanjani noma ubuyela kanjani?
Ukutholwa Kokuqala
Ingozi yokuthi umdlavuza webele uzobuya noma usakaze uhlotshaniswa nobukhulu besisu kanye nesilinganiso sokusakaza ngesikhathi sokuxilongwa.
Ngamaphesenti angama-20 abesifazane, umdlavuza webele utholakala esiteji sokuqala. Umdlavuza webele we-Stage 0 noma i-carcinoma in situ kubhekwa njengomdlavuza webele we-pre-invasive. Njengoba lezi zingqimba zokuqala zomshukela azizange zisakaze ngaphezu kwezinto ezibizwa ngokuthi i-membrane yengaphansi (azizange zithuthele ngaphesheya kwezingcingo zesifuba), ukuhlinzekwa kumele kuphethwe ngokuqondile ngalezi zomshukela.
Eminye amaphesenti angu-70 abantu abhekwa ukuthi banesifo somdlavuza webele wesibindi esingakaze senziwe (sisakaze ezithombeni ezikude). Lezi zomshukela zebele, ezibhekwa njengegciwane lesigaba 1 kuya ku-3, kungenzeka zisakaze kuma-lymph nodes kodwa azikho kwezinye izitho.
Ngezokwelapha ezifana nokuhlinza , ukwelashwa kwamakhemikhali , ukwelashwa kwama- radiation , ukwelashwa kwe-hormonal , kanye / noma izindlela zokwelashwa ezihlosiwe, eziningi zalezi zicubu zizohlala zikhona. Nokho, ingozi yokuthi izovela futhi (i-recur) inkulu kakhulu ngezigaba eziphakeme futhi uma i-lymph nodes ihilelekile.
Amaphesenti angaphansi kwezingu-10 kwabesifazane atholakala lapho umdlavuza usuvele usakaze ezindaweni ezikude zomzimba.
Umdlavuza wesifuba cishe usakazeka emathanjeni, isibindi , amaphaphu, nobuchopho.
Ukuphindaphindiwe
Amanqamu amaningi amabele aseMetastatic aqala ukuxilongwa njengama-cancer angamaqanda asheshe abuyele emuva. Ukuphindaphinda kungase kube:
- Indawo: Esibelethweni
- Esifundazweni: Emagqumeni lymph or wall wall
- Okude: Ezithombeni ezikude
Uma umdlavuza webele usuka endaweni ekude awusaphuluki kodwa usazophulukiswa, futhi ukwelashwa kungakuthuthukisa izimpawu futhi kwandise impilo.
Ukwesaba nokuqonda
Abantu abaningi besaba ukuphindaphindiwe komdlavuza wesifuba, kodwa abaningi bayakwazi ukuthola ukulinganisela phakathi kokuqaphela nokukhubazeka ngokwesaba. Kuyinto evamile futhi evamile ukuba nokuqwashisa okukhulu uma uthuthukisa izimpawu zokusabalala ngemuva kokuba nomdlavuza webele wesifuba. Kungenzeka ukuba ikhanda libe ikhanda elivamile, kodwa umqondo we-metastases yobuchopho ungase ufike engqondweni. Ngokufanayo, i-ache emhlane wakho ingakwenza ukhathazeke ngamathambo ayisifo ngesikhathi sithembeke kakhulu ukuthi ulale ngephutha.
Kubalulekile ukuthi wonke owesifazane (nomuntu) onomdlavuza webele abe nolwazi mayelana nokulindela kwabo. I-oncologist yakho ingakusiza ukuthi uyiqonde lokhu okusekelwe kumdlavuza wakho othize, isiteji sayo, nezinye izici.
Ukuba nokuqwashisa okukhulu kungaqinisekisa ukuthi ulandela ukuhambela okufanele futhi wazi ukuthi uzobiza nini. Uma ukwesaba kuba ukukhubazeka ngokomzwelo, noma kunjalo, umelavuza womdlavuza angabalulekile ekusizeni ukuthi ugcine ibhalansi phakathi kokuziqhenya nokwesaba.
Indlela I-Cancer Isakazeka Ngayo
Umdlavuza wesibeletho ungasakazeka kwezinye izifunda zomzimba ngezindlela ezintathu eziyinhloko:
- Ngesimiso se-lymph: Amangqamuzana omzimba we-Breast angase avele esithombeni esiswini bese efaka izitsha ezincane ze-lymphatic ezikhona kuwo wonke amabele. Ukusuka lapho bangathathwa ngamashaneli lymphatic kuze kube lymph nodes nangaphezulu. Kuyinto isakazeka lymphatic okuyingxenye ebalulekile yokuxilongwa kanye nesiteleka somdlavuza webele. Uma i-tumor isakaze kusukela esifubeni kuya ku-lymph node ye-sentinel (uma umdlavuza i- lymph node positive ) uye "ngokumemezela" ukuthi inhloso yayo yokusakazeka ngaphezu kwebele. Abantu bangadideka kakhulu uma befunda imibiko yabo yokugula . Uma umdlavuza usakaze ema-lymph node eseduzane, umbiko ungase ubike "imetraphicatic to lymph nodes." Lokhu akusho ukuthi unomdlavuza wesifuba we-metastatic, kanti ngisho nesigaba sokuqala se-1B kancelisi yesifuba sebele singase sibe nokubandakanyeka kwe-lymph node.
- Ngegazi legazi: Njengoba nje kunezitsha ezincane ze-lymph kulo lonke isifuba kunezitsha eziningi zegazi ezincane. Amaseli e-Cancer angangena emifuleni encane yegazi futhi athwale egazini ezindaweni ezikude, ikakhulukazi izindawo ezifana namaphaphu nesibindi esinegazi elikhulu.
- Ukuhlasela kwendawo: Umdlavuza wesifuba ungase usakaze nasezicubu eziseduze ezifana nodonga lwesifuba noma izimbambo ngokuhlasela. Amaseli omdlavuza ahlukile kunezingqamuzana ezivamile ngale ndlela. Izicubu ze-Benign zingakhula futhi zifake izicubu eziseduze, ngezinye izikhathi zidale umonakalo. Kodwa izicubu zomdlavuza zihlasela lezi zicubu. Eqinisweni, igama elithi "umdlavuza" lisuselwa egameni lesiGreki elisho ukuthi "crab" ukuchaza ukwandiswa kwe-crab-kufana ne-khansa ezitokisini eziseduze.
Uma umdlavuza webele usakazeka kwesinye isitho kusengumdlavuza webele. Isibonelo, uma umdlavuza webele usakazeka emaphashini ngeke ubizwa ngokuthi umdlavuza wamaphaphu. Esikhundleni salokho, singabhekisela kuyo njengengculaza yesifuba isakazeka emaphashini noma kumdlavuza webele wezimpawu zamaphaphu. Ukube ubuzobuka amangqamuzana omdlavuza emaphashini ngaphansi kwe-microscope babeyoba amangqamuzana ebelebulavuza, hhayi amangqamuzana e-lung cancer.
Amanqamu asakazeke kwezinye izicubu angase ahluke kune-tumor yokuqala, futhi lokhu kungenye indawo yokudideka. Amanqamu akuyona nje isimiso samangqamuzana angavamile asakaza ngokungenangqondo. Kunalokho, zilokhu zishintsha njalo futhi zithuthuka izinguquko ezintsha. Ngenxa yalesi sizathu, i-tumor eyayiyitholile i-estrogen receptor emihle uma itholakala esifubeni ingaba isamukeli se-estrogen manje. Isimo sakhe esingu-2 singashintsha futhi. Lokhu kuchaza nokuthi kungani izicubu ze-metastatic ngezinye izikhathi zihlukumeze kakhulu kune-tumor yangempela.
Okwenza Sisakaze Futhi Sibuye
Ungase uzibuze ukuthi kungani amangqamuzana omdlavuza wesifu ehamba nhlobo. Noma, kungani amangqamuzana avamile engasabalali emzimbeni wethu. Amaseli e-Cancer ahluke kumaseli avamile ngezindlela eziningi. Elinye lalawo ma-cell ajwayelekile awaziwa ngokuthi "ama-molecule wokunamathela." Lezi zinqamuzana ezinamathela zifana ne-glue futhi zigcina amangqamuzana lapho zingabanye ingxenye ethile yomzimba.
Amaseli avamile abuye abe "nemingcele" noma izindlela amaseli axhumana ngayo. Lokhu kufana nezwe elilodwa lisho komunye "awunabo lapha." Amaseli e-Cancer, ngokuphambene, awahloniphi lokhu kuxhumana kwamaselula, ngokuyinhloko ukungazinaki "izici" eziphakathi kwezicubu ezahlukene.
Okunye okunye okudidekayo lapho ukhuluma ngesifo somdlavuza wesifuba kungani kungenzeka iminyaka noma ngisho emashumini eminyaka kamuva. Siyazi ukuthi, ikakhulukazi nge-cancer e-receptor-positive yamabele, isifo somdlavuza singabonakala sinyamalale kuphela ukuze siphinde senze iminyaka eminingi emva kwesisu. Akekho owazi kahle ukuthi lokhu kwenzeka kanjani, kodwa kunezinkolelo eziphathelene nokuphindaphinda okubonisa ukuthi amanye amangqamuzana omdlavuza webele anesibindi kunabanye nokuthi le "methini" yesifo somdlavuza iyakwazi ukulala phansi ngisho nangokwelashwa.
Izingozi Zezingozi
Asazi ukuthi iziphi ukwelashwa zesisu ezizobuyela emuva futhi ezingeke zenzeke, kodwa kunezici ezithile ezandisa ingozi. Lokhu kufaka:
- Amakhansela asemagcekeni aphakeme (isibonelo, isigaba 3 vs isigaba 1)
- Amanqamu adluliselwe kuma-lymph nodes
- Amanqamu angaphezu kobudlova (abe nebanga eliphakeme le- tumor )
- I-Cancer eyenzeka kwabesifazane abasebasha
Izimpawu
Uma une-metastases ungase ube noma ungenayo izimpawu. Amanye ama-metastases atholakale ekuhlolweni kokuhlola, njengokuskena kwethambo noma ukuskena kwe-PET. Njengoba lezi zivivinyo zingase zibone izidakamizwa, abesifazane abanomdlavuza wesifuba osencane bangase bazibuze ukuthi kungani ukuhlola okujwayelekile okulandelwayo kungenziwa. Isizathu siwukuthi nakuba i-metastases ingahle ibonakale ngokushesha ngokuhlolwa, ukuthola lezi zindawo zokusabalala ngaphambi kokuthi ube nezimpawu akuphuculisi ukusinda.
Izimpawu ezivamile zomdlavuza webele we-metastatic zingase zihlanganise nomuzwa wokungahlali kahle, ukulahlekelwa isisindo ngokungenasisekelo , noma ukuncipha kwesifiso.
Lapho umdlavuza webele usakazeka emaphashini angabangela ukuphefumula nokukhwehlela. Izidumbu ze-liver ngenxa yomdlavuza webele zingabangela ukuhlukunyezwa kwesisu nesifo se-jaundice, ukukhishwa kwesikhumba okuphuzi.
Isayithi elijwayelekile kakhulu le-metastases yebele isamathambo, futhi izimpawu ngokuvamile zihlanganisa ubuhlungu. Ngezinye izikhathi isibonakaliso sokuqala siwukuhlukunyezwa kwe- pathologic , ukuphuka okwenzeka endaweni yethambo elibuthakathaka yi-tumor futhi ngokuvamile kubangelwa ukuhlukunyezwa okuncane. Ama-metastase we-Brain angabangela izimpawu ezifana nesifo sekhanda, umbono obonakalayo, ubuthakathaka, nobunzima, noma ukugubha.
Ukwazi lokhu, abesifazane abaye banomdlavuza webele wesandulela-ngculazi bangase besabe uma behlakulela noma iyiphi yalezi zimpawu. Kubalulekile ukukhumbula ukuthi abesifazane abangenayo umdlavuza webele banamahloni. Kodwa ube mnene nawe. Labo abangakaze banomdlavuza webele bangakudonsa mayelana nokukhathazeka kwakho okuhlobene nezinhlungu nezinhlungu ezintsha, kodwa labo abanomdlavuza webele bayothola. Uma kuthatha ukuthola uphawu ekhishwe ukuze uphumule, qiniseka ukwenza kanjalo.
Ukuxilongwa
Odokotela banezindlela eziningana zokunquma ukuthi umdlavuza usakazeke noma cha. Lokhu kuhilela ukucabanga ngomzimba usebenzisa ama-x-ray, ama-bone scans, ama-MRIs, ama-CT, noma ama-PET. Ukuhlolwa kwegazi kungabheka amazinga amakhemikhali athile egazini, kuhlanganise nabamaki abathintekayo be- tumor abahlobene nemetastasis.
Kanti futhi odokotela bavame ukuthembela kwi- biopsies , okuyizibonelo zesisulu ezihlangene ngokukhishwa okuhlinzekwayo noma ukukhishwa kwesinaliti. Lawa masampuli ahlolwe ngaphansi kwe-microscope yezinto ezingekho emthethweni ezikhombisa ukuthi kukhona yini ukuqhubeka komdlavuza.
Ukwelapha kanye ne-Outlook
Lapho umdlavuza webele uba isigaba 4 (imetastatic) akusekho ukuphulukiswa kodwa isaphathwa kakhulu. Izinketho zokwelashwa zomdlavuza webele we-metastatic zihlanganisa i-chemotherapy, ukwelashwa okuhlosiwe, imithi ye-osteoporosis, ukwelashwa kwe-hormonal, kanye nokwelashwa okusha okufana nemithi yokuzivikela e-immunotherapy. Ama-metastases ase-Isolated, afana nalawo asebenza ebuchosheni, ngezinye izikhathi aphathwa ngokuhlinzwa noma imithi yokwelashwa.
Ngokuvamile, umgomo wokwelapha uhluke kakhulu nomdlavuza webele we-metastatic uma kuqhathaniswa nezigaba zangaphambili zesifo. Njengoba isifo sesisandulela ngculaza, ukwelashwa kuvame ukuhlaselwa ngenhloso yokuphulukisa umdlavuza. Ngesigaba sesi-4, noma kunjalo, ukwelashwa okungenani okuncane ukulawula lesi sifo ngokuvamile umgomo. Ukwelapha ngokweqile lesi sigaba akuphuculisi imiphumela kodwa kwandisa ingozi yemiphumela emibi kanye nemfanelo yokuphila empofu.
Izwi elivela
Amaphesenti amancane abesifazane abe nomdlavuza wesifuba wezinyosi ngesikhathi sokuxilongwa, kodwa kaningi imithi ye-metastases iphindaphindiwe kude nomdlavuza webele wesandulela. Ithuba lokuthi umdlavuza uzobuyela emuva kuncike ezinkathini eziningi. Ukwesaba ukuphindaphinda kungashiya abanye abantu bazizwe bekhathazekile, nakuba iningi lesikhathi abantu bekwazi ukuthola ibhalansi. Okunye ukukhathazeka okubalulekile ekusizeni abesifazane (namadoda) ukuthi balandele ngezokwelapha eziphakanyisiwe kanye nokulandelwa.
I-Cancer ingasakazeka endaweni yangakini kuma-tissue aseduze noma ngokusebenzisa amathisini negazi. Ngenxa yokuthi isifo somdlavuza wesifuba sibhekene nokufa kwabantu abaningi kule sifo, abacwaningi abaningi babheka izizathu zokuthi kungani amangqamuzana omdlavuza angase asakaze nokuthi yini engavimbela ukuba benze kanjalo.
> Imithombo
> I-American Cancer Society. I-Breast Cancer Amanani Nezibalo 2017-2018 .
> Ama-Muzes, G., no-F. Sipos. Cell Metastatic Dormancy nokuvuselela kabusha: Ukubheka ngokuchungechunge lwezinkinga zeMolcular Critical for Cancer. Ama-Anticancer Agents eMitholampilo Yamakhemikhali . 2017. 17 (4): 472-482.
> National Cancer Institute. I-Canast Metastatic.