Izimpawu zomdlavuza we-pancreatic zingabandakanya i-jaundice, ubuhlungu esiswini esiphezulu esiya emhlane, ukuqala okungaqondakali kwesifo sikashukela, isisindo esinzima esibelethweni esingaphezulu, kanye nezimpawu ezingezona ezithile ezifana nesicashu, ukulahlekelwa isisindo, ukulahleka yokudla, futhi ngezinye izikhathi ukucindezeleka. Ngeshwa, izimpawu zokuqala zivame ukungaqondakali futhi zingabonakali kahle, nezimpawu ezibonakalayo-okungenzeka kube lula ukuba umuntu afune ukuhlolwa kochwepheshe-ngokuvamile ehluleka kuze kube yilapho lesi sifo sisezigaba eziphambili.
Izimpawu Ezivamile
Kunezinhlobo zampawu ezihambisana nomdlavuza we-pancreatic, nakuba eziningi zazo zivame ukubangelwa izimo ezingathí sina. Lezi zimpawu eziyisixwayiso zingashintsha kuye ngokuthi umdlavuza usekhanda lama-pancre noma umzimba womsila nomsila.
I-Jaundice Engenalutho (I-Urine Plus ne-Stool Changes and Itching)
I-jaundice , i-yellowing discoloration yesikhumba kanye nabamhlophe bamehlo, yisimo esibangelwa ukwakheka kwe-bilirubin esikhumbeni futhi sikhona cishe amaphesenti angu-30 abantu ngesikhathi sokuxilongwa. I-Bilirubin ingaqongelela uma isifo se-pancreatic sinciphisa noma sivimbela ngokuphelele i-buct buct evamile (i-duct ephethe i-bile esesibindi kuya emathunjini amancane) futhi ijwayele kakhulu kancelisi ekhanda lama-pancreas. Ngomdlavuza we-pancreatic, i-jaundice ngokuvamile ayibuhlungu, ngokungafani nezinye izimbangela eziningi ze-jaundice (njenge- hepatitis noma i- gallstones ) evame ukuhambisana nobuhlungu.
Ukwakhiwa kwe-bilirubin kungabangela nokuba izithamela zibe ziphaphathekile kanye nobumba-njengawo, kanye nokukhanya komchamo (i-cola color). Izitshalo zingase zibe nephunga eliqinile, elingavamile.
Ngokuvamile ukuphutha ngesimo sesikhumba, isikhumba esibi (ngokuvamile esibi kakhulu) sibangelwa futhi ukwakheka kwe-bile usawoti esikhumbeni.
I-jaundice ingaba uphawu lokuqala lwe-cancer e-pancreatic ekhanda lama-pancreas ngenxa yokuvinjelwa kwe-bile duct, kodwa futhi kungenzeka nge-kansa emikhulu emsila noma emzimbeni we-pancreas, noma uma la kansela isakaza esibindi (metastases yesibindi ).
Ubuhlungu besisu nesisu
Ubuhlungu phakathi, isisu esisemuva esiya ngemuva kuyisifo esivamile somdlavuza we-pancreatic, sikhona cishe amaphesenti angu-70 abantu ngesikhathi sokuxilongwa. Kuvame kakhulu nezicubu emsila we-pancreas. Lobu buhlungu buvame ukwedlula amahora amathathu kuya kwezine ngemva kokudla noma uma ulele phansi. Ngokuphambene nalokho, ubuhlungu buvame ukunciphisa uma umuntu ehlala futhi ehamba phambili.
Uhudo
I-diarrhea ingase ivele ngenxa yokungenwa okuncane emathunjini ehlobene nokungabi nalutho kwamakhemikhali e-pancreatic okusiza ukugaya ukudla. I-diarrhea ngezinye izikhathi isifo sokuqala somdlavuza we-pancreatic. Izitshalo zingase zibe nephunga elimnandi, zivele zifakwe noma zifakwe, zifake, zivame ukwenza kube nzima ukuzitshela.
I-Nausea ne-Vomiting
I-nausea nokuhlanza akuvamile kubantu abanomdlavuza we-pancreatic, nakuba bevame ukungaziwa kahle ngezigaba zakudala zesifo. Ukuhlanza okunzima kungase kube uphawu lokuvimbela engxenyeni engezansi yesisu (isisu sangasese) noma ingxenye engaphezulu yamathumbu amancane (duodenum) abangelwa ukucindezelwa kwesisu.
Ukulahlekelwa kwesisindo okungenasisekelo
Ukulahleka kwesisindo okungazelelwe nokungaqondakali ngokuvamile kubonisa ukuthi kukhona okungalungile ngokwemithi. Ukulahleka kwesisindo okungenalutho , kanye nokunciphisa ukudla, kungaba esinye sezibonakaliso zokuqala zomdlavuza we-pancreatic.
Abanye abantu bangase babone ukuthi bazizwa bezwa masinyane, ngisho nalapho bedla ukudla okuncane.
Ukuxilongwa Okungalindelekile Kwesifo Sikashukela
Ukuqala okungalindelekile kohlobo lwe-2 lwesifo sikashukela (njengokuthi ukuxilongwa komuntu ongenayo ingozi , njengokungaphezu komzimba ngokweqile) kumuntu oneminyaka engaphezu kwengu-45 kungaba uphawu lomdlavuza we-pancreatic. Kwenzeka lapho ama-pancre akakwazi ukukhiqiza i-insulin eyanele ngenxa yokutholakala kwesisu.
Izindwangu zegazi
Ama-blood clots nomdlavuza kungangena ngesandla, futhi ngezinye izikhathi i-clot yegazi iyisignali yokuqala yesifo. Ngomdlavuza we-pancreatic, i-clots yegazi ingenzeka eziningana zezindawo emzimbeni ngokuhamba kwesikhathi (thrombophlebitis efudukayo).
Ama-clots avamile egazi ngaphandle kwesizathu esizwakalayo afanele ukuhlolwa.
Mass Mass
Abanye abantu bangase babone isisindo esinzima esiswini sangasese-empeleni yi-gallbladder. Inhlanganisela ye-gallbladder engase izwe futhi i-jaundice (uma ama-gallstones noma ukutheleleka kwe-gallbladder engekho) uyaziwa njengesignali se-Courvoisier. Lesi isibonakaliso esinamandla kakhulu ukuthi umdlavuza we-pancreatic ungaba khona.
Ukucindezeleka
Ngokuqinisekile ngeke kusimangaze ukucindezeleka ngemva kokufunda unomdlavuza we-pancreatic, kodwa sifunda ukuthi ukucindezeleka ngezinye izikhathi kuyisibonakaliso sokuqala somdlavuza. Njengoba ukucindezeleka kuvame ukuqala ngaphambi kokuba kutholakale ukuxilongwa, kucatshangwa ukuthi izinguquko zezinto eziphilayo ezihambisana nomdlavuza yimbangela eyinhloko, kunokuba isabele ekufundeni ngesifo. Ngokwe-2017 ukubuyekezwa kwezifundo, ukuqala kokucindezeleka ngaphambi kokuxilongwa komdlavuza we-pancreatic kuvame kakhulu kunezinye ezinye umdlavuza.
Izimpawu ezingavamile
Izimpawu ezingavamile, kodwa ngezinye izikhathi eziyingqayizivele zomdlavuza we-pancreatic, zivame ukutholakala lapho umdlavuza uphuthukile. Lokhu kungafaka:
I-Lymph Node ekhulisiwe ngaphezu kwe-collarbone
I-lymph node ekhudlwana (evuvukile) engase ibonakale nje ngaphezu kwe-collarbone ngakwesokunxele (i-node supraclavicular) ingenzeka. Lokhu kubhekiselwa emzimbeni njenge-node kaVerchow.
Imisa ebhokisini le-Belly
Isibungu noma inqwaba esivela inkinobho yesisu (umbilicus) akuvamile futhi ibizwa ngokuthi udadewabo uMary Mary Joseph.
Ama-Syndromes eParanoplastic
I-paraneoplastic syndromes yizinhlobonhlobo zezimpawu ezihlobene nama-hormone noma ezinye izinto ezifihliwe ngamangqamuzana omdlavuza. Omunye walawa ma-syndromes angabonwa ngomdlavuza we-pancreatic uhlanganisa inhlanganisela yezinwele zomzimba zesikhumba (ngenxa yokuvuvukala kwezicubu ezinamahloni ngaphansi kwesikhumba), amalunga abilayo (i-arthritis), kanye nenani elikhudlwana lohlobo lwamaseli egazi amhlophe aziwa ngokuthi i-eosinophils .
Ama-Tumor Pancreatic ajwayelekile
Amansela amaningi e-pancreatic ayenzeka amangqamuzana e-exocrine, enza ama-enzyme e-pancreatic asiza ekugayeni. Lokho okwenzeka kuma-endocrine amangqamuzana (amangqamuzana enza ama-hormone) kaningi, kodwa hhayi ngaso sonke isikhathi, amemezela ama-hormone abangela izimpawu. Iningi lalezi zinambuzane "ze-neuroendocrine" zingaholela ekulahlekeni kwesisindo. Ezinye zazo zingabandakanya:
Insulinomas
I-insulinomas ivikela i- insulini eholela ekushukela kwegazi elincane ( hypoglycemia ). Izimpawu zilawo ushukela ophansi wegazi, njengokungathi ukukhanya, ukujuluka, ukukhathazeka, nokushaya kwenhliziyo okusheshayo.
Glucagonomas
I-glucagonomas ihlanganisa i-glucagon, i-hormone eyandisa ushukela wegazi. Lokhu ngezinye izikhathi kungabangela isifo sikashukela, ngezimpawu zokweba ukwanda, ukuvuthwa njalo, nokulahleka kwesisindo kuvamile. Kungase kubangele isifo sohudo kanye nokuntuleka kokudla okunomsoco okuholela ebuhlungu emlonyeni naselulwimi.
I-Gastrinomas
I-Gastrinomas ikhiphe i-gastrin, i-hormone engabangela izilonda zesisu eziphuma egazini ( isifo se-ulcer peptic ), i-reflux ye-asidi, nobuhlungu besisu.
I-Somatostatinomas
I-Somatostatinomas yizicubu ezifihla i-somatostatin, i-hormone ebuye ivuselele ukukhululwa kwamanye ama-hormone. Izimpawu zingafaka phakathi isifo sohudo, ubuhlungu besisu, izisindo ezinomsoco, izimpawu zesifo sikashukela, ne-jaundice.
I-VIPomas
I-VIPomas ivame ukumisa i-peptide ye-vasoactive emathunjini (VIP), okuholela ekuhuleni (okuvame kakhulu amanzi futhi okumangalisayo), ukuhlanza, ukuhlanza, ubuhlungu besisu nokuqhaqhazela, nokuqhuma ubuso nosizi.
Izinkinga
Umdlavuza we-Pancreatic ungaholela ezinkingeni ngezizathu eziningana, kuhlanganise nokucindezela ezakhiweni eziseduze, ukungabi khona kwezinto ezikhiqizwa amangqamuzana avamile we-pancreatic, ukuqubuzana komdlavuza ngokwawo, noma ukusakazeka (imetastases) kusuka emzimbeni.
Izinkinga ezingase zibandakanye:
Ukuntuleka kwePancretic
Amagciwane e-Pancreatic ngokuvamile avela emaseli (amangqamuzana e-exocrine) enza ama-enzyme e-pancreatic. Ama-pancreas akhiqiza izitshalo eziyisishiyagalombili ezithinta lezi zinkimbinkimbi nsuku zonke, ezivimbela i-asidi yesisu futhi zisize ekuqhekekeni kwamafutha, amaprotheni, nama-carbohydrate. Lapho isikhumba sithatha phezu kwala maseli, ukungabi namabhomu e-enzyme kungabangela ukushaywa kwe-malabsorption, ukukhulelwa kwesisu, nokungondleki, ngisho nokudla okuvamile. Ukuntuleka kwe-pancreatic kwenzeka kuma-80% kuya kubantu abangamaphesenti angu-90 abanomdlavuza we-pancreatic futhi uphathwa ngokushintshwa kwe-encreatic pancreatic .
Ukwakhiwa Kwezingcingo Ezimbi
Ukwakhiwa kwe-biling bude evamile kuyinkimbinkimbi ejwayelekile kakhulu yomdlavuza we-pancreatic futhi kungenzeka ube khona ngesikhathi sokuxilongwa. Ngisho nalapho ukuhlinzeka kungenakwenzeka, i-stent ingafakwa nge- endoscopy , inqubo efaka ukufaka ithubhu emlonyeni nokuyibeka phansi futhi ibe yindlela ejwayelekile ye-buct.
Ukuvimbela isisu noma isitholampilo esincane
Ukuvimbela (okubangelwa yi-tumor ekhulayo kungase kwenzeke endaweni lapho okuqukethwe kwesisu kungena emathunjini amancane (i-gastric outlet) noma engxenyeni yokuqala yamathumbu amancane (i-duodenum). Uma lokhu kwenzeka, i-stent ingabekwa ukugcina lezi zindawo zivulekile, noma kunalokho, ukuhlinzwa kungenziwa ukunqanda ukuvinjelwa.
Isifo sikashukela
Njengoba kuphawuliwe ngenhla, ukuqala okungazelelwe nokungalindelekile kwesifo sikashukela kungamemezela ukuba khona komdlavuza we-pancreatic. Ngisho noma ingekho ngesikhathi sokuxilongwa, cishe abantu abangamaphesenti angama-85 abantu abanesifo bazoba nesifo se- insulin noma isifo sikashukela ngesikhathi esithile.
I-Cachexia
I-cachexia ye-Cancer , eyaziwa nangokuthi i-anorexia-cachexia syndrome (i-CACS) ehlobene nomdlavuza, i-syndrome ehilela ukulahlekelwa kwesisindo, ukulahleka kwemisipha nokulahlekelwa ukudla, nakuba kungenzeka ukuthi iqala ngisho nangaphambi kokulahleka kwesisindo. Kucatshangwa ukuba khona kwamaphesenti angama-80 abantu abanomdlavuza we-pancreatic ngesikhathi sokuxilongwa.
I-cachexia ingase ibe imbangela eqondile yokufa emaphesenti angu-20 abantu abanomdlavuza. Ngaphandle kwe-cachexia "evamile", noma kunjalo, ukuntuleka kwe-enzyme ye-pancreatic kungabangela ukungondleki nokulahleka kwesisindo, okwenza lokhu kube yinkinga ebalulekile yokubhekana nanoma ubani otholwe nomdlavuza we-pancreatic.
Izindwangu zegazi
Njengoba kuphawuliwe, ama-clots egazi (i- vein thrombosis ) ejulile ephumula futhi ehamba emapapheni ( amapulmonary emboli ) akuyona nje inkinga yomdlavuza we-pancreatic-ingaba uphawu lokuqala lwayo. Zibuye zijwayele kakhulu kunoma yikuphi isifo. Abantu abanomdlavuza we-pancreatic nabo banamathuba amaningi okuthuthukisa ukuphuma kwegazi phezu kwegazi elincane kunabantu abanezinye izinhlobo zomdlavuza, ngakho-ke ukwelashwa kudinga ukuhlolwa ngokucophelela.
Ubuhlungu
Ubuhlungu obuhlobene nomdlavuza we-pancreatic bungaba nzima kakhulu, kodwa kunezinhlobo ezahlukene zezindlela zokulawula ubuhlungu bomdlavuza . Ngokuvamile, kunezimiso eziningi ezihlukene ezihlanganisiwe, njengezidakamizwa zobuhlungu, ukwelapha imishanguzo esiswini, kanye ne "block block", inqubo evimbela isisindo esiswini esithumela izimpawu zobuhlungu ebuchosheni. Ngenkinga ye-opioid yamanje, kunconywa ukuthi abantu abanomdlavuza we-pancreatic bacabange ukubonisana nochwepheshe noma ubuchwepheshe bokunakekelwa kwezinhlungu ukuze baqinisekise ukuthi bathola imithi ephuzile, ephephile, futhi ngesikhathi esifanele lapho kudingeka.
Nini Ukubona Udokotela
Uma ubona noma yiziphi izimpawu ezingenhla, bheka udokotela wakho ngokushesha. Izimpawu eziningi zomdlavuza we-pancreatic zakuqala kunezinye izimbangela, kepha eziningana zazo zibaluleke kakhulu ukuxilonga. Izimpawu zindlela yethu yomzimba yokutshela ukuthi into ayilungile. Kubalulekile ukuba ube nencazelo, futhi uma ungafuni, cela futhi. Uma ungatholi izimpendulo, cabanga ukuthola imibono yesibili.
Abanye abantu baye banqikaza ukubona udokotela ngezimpawu zomdlavuza we-pancreatic ngenxa yedumela lesi sifo. Kuyiqiniso ukuthi, lapho itholakala, eziningi zalezi khansela zithuthukile kakhulu ukuze zisuswe ngokuhlinzwa, kodwa kusekhona izinketho zokwelashwa ezitholakalayo. Ngaphezu kwalokho, ukuxilongwa ukuthi lezi zomshukela zivumela abantu nodokotela bazo ukuba bavimbele ezinye zezinkinga zesifo, futhi ngokwenza kanjalo, ngcono izinga lokuphila ngisho nangabe umdlavuza ukhona.
> Imithombo:
> Ukwelashwa Kwamanje Nekukhulayo Emdlalweni We-Pancreatic Cancer , Springer Verlag, 2017.
> Khadka, R., Tian, W., Xin, H., no R. Koirala. Isici Sengozi, Ukutholakala Kokuqala Nokusinda Okuphelele Emiphumeleni Yenhlangano Phakathi KweCancreatic Cancer neSifo Sikashukela Mellitus: Izinguquko Nokuthuthuka, Ukubuyekeza. I-International Journal of Surgery . 2018 Mashi 10. (Epub ngaphambi kokuphrinta).
> Laquente, B., Calsina-Berna, A., Caromona-Bayonas, A. et al. Ukunakekelwa Okusekela Pancreatic Ductal Adenocarcinoma. I-Oncology yezokwelapha kanye nokuhumusha . 2017. 19 (11): 1293-1302.
> Sebti, J., Desseigne, F., noP. Saltel. Ukucindezeleka Kwe-Prodromal ku-Cancer Pancreatic: Ukuhlola Okubukekayo Kuziguli Eziyishumi. Ukunakekelwa kwe-Palliative nokusekela . 2015. 13 (3): 801-7.