Uthola ukuthi unesifo somdlavuza we-prostate , wenzani manje? Wonke umuntu uhlukile futhi ukhetho lwezokwelapha luxhomeke ezintweni eziningi. Ukuze kukusize unqume endleleni yokwelashwa, odokotela abaningi bazobukela ubudala bakho, impilo ejwayelekile, i- Prostate Specific Antigen (PSA) , i- Gleason Grade , i- Cancer Stage (kuhlanganise nanoma yiziphi izifundo ze-radiographic okungenzeka zenziwe), i-Cancer Volume (ingakanani umdlavuza i-prostate yakho) nomlando wakho wezokwelapha odlule (yiziphi izinhlinzeko nezinkinga zezokwelapha ozitholile esikhathini esidlule).
Iziguli eziningi zifuna impendulo "efanele". Bazizwa uma babheka kanzima futhi bafunde ngokwanele bayothola impendulo. Lokho esikutholayo kunemibono eminingi ehlangene namaqiniso nemiphumela yokufunda. Ngeluleka iziguli zami ukuba zithole impendulo "ekulungele" kubo. Ukwelashwa komuntu oneminyaka engu-50 ubudala nomdlavuza we-Gleason 8 kufanele kube okuhlukile kunomuntu oneminyaka engu-78 ubudala onomthamo omncane, umdlavuza we-Gleason 6. Zonke izikwelapha zifanelekile kwezinye iziguli kodwa hhayi zonke iziguli. Izinzuzo kanye nokuqeda ukwelashwa ngalunye kufanele kulinganiswe ngokucophelela ngaphambi kokuqala ukhetho lwezokwelapha.
Enye yezinqumo zokuqala okumele ukwenze kungukuthi umdlavuza wakho udinga ukuphathwa noma uma ungabhekwa ngokuphepha.
Ukulinda okuqaphile
Kwezinye iziguli, inkambo yokubamba noma yikuphi ukwelapha okusebenzayo nokulandela i-PSA kuyindlela engcono kakhulu. Sibiza ngokuthi ukulinda okulindile noma ukuhlola okusebenzayo. Lokhu kuvame ukwenziwa ngegciwane lesandulela ngculaza eliphansi futhi eliphansi.
Futhi kuyindlela enhle kumuntu omncane onempilo noma omdala. Ukuqapha okusebenzayo kusho ukuhlolwa kwe-PSA njalo futhi kufaka phakathi i-biopsy yesibili (Izincomo ezivela ezinyangeni ezingu-3 kuya ku-1 ngonyaka ngemva kokuxilongwa). Uma kunoma yisiphi isikhathi umdlavuza uqala ukuqhubeka ukwelashwa okusebenzayo kungenziwa ukusebenza. Kulinganiselwa ukuthi cishe ama-25% weziguli ezifanele ababhalisile kwizivumelwano zokulinda ezilindile zizodinga ukwelashwa okuqondile esikhathini esizayo.
Ukwelashwa Okusebenzayo
Ukwelapha okusebenzayo kuyindlela yokwelapha ngenhloso yokwelapha, ukususa noma ukubulala wonke amangqamuzana omdlavuza. Kukhona izinketho ezintathu zokwelashwa ezisebenzayo ezijwayelekile.
Ukuhlinzwa
Ukuhlinzwa komdlavuza we-prostate kususa lonke i-prostate gland kanye nezicubu ezizungezile. Lokhu kungabandakanya ama-vesicles esondlo kanye nama-lymph nodes. Ukuhlinzwa kuthiwa yi-Radical Prostatectomy futhi kungenziwa ngezindlela ezahlukene.
I-Robot-Assisted Radical Prostatectomy
Ngalolu hlobo lokuhlinzeka, udokotela wakho ohlinzayo ngokuvamile uyokwenza izibalo ezincane eziyisithupha kwisisu sakho esingaphansi. Ngalokhu kuhloswe, izinsimbi zibekiwe ezilawulwa udokotela ohlinzayo nge-robot. I-brand ejwayelekile kakhulu yebhobhothi iyisistimu Yokuhlinza i-da Vinci. Izinzuzo ze-prostatectomy ye-robotic yilapho ngokuvamile kuvame ukulahleka kwegazi, ukubonakala okungcono kanye nesikhathi esifushane sokubekwa kwe-catheter. Ukuphazamiseka ukuthi ayikho impendulo ephathekayo kumhlinzeki ohlinzayo (udokotela ohlinzayo akakwazi ukuzwa izicubu zakho) futhi kunendlela ephakeme yokufunda kule nqubo. Abaningi be-urologists abasha baqeqeshwa ukwenza i-prostatectomy enamandla ngale ndlela.
I-prostatectomy e-Retropubic enamandla kakhulu
I-incision yenziwe kusukela ngaphansi kwe-umbilicus kuya phezulu kwethambo le-pubic.
Izinzuzo zihlanganisa ukuhlinzwa okufutshane futhi ngakho-ke i-anesthesia encane nokuzwa okugcwele okuthinta ngudokotela ohlinzayo. Ukuhlehla kwegazi ngokuvamile kuvame ukulahleka kwegazi kanye nobude be-catheter.
Ngokomlando i-prostate yasuswa nge-incine perineal (phakathi kwe-anus ne-scrotum) kodwa lokhu akuvumeli ukufinyelela kuma-lymph nodes futhi akuvamile ukwenza. Indlela ehlanzekile ye-laparoscopic (ngaphandle kokusebenzisa i-robot) isetshenziswa abahlinzayo abambalwa.
Izingozi zazo zonke ukuhlinzwa zihlanganisa ukulahleka kwegazi, ukungaziphathi kahle, ukungasebenzi kahle kwe-erectile nokulimala ezakhiweni ezungezile. Kunobufakazi obuncane obungasikisela ukuthi noma yiyiphi inqubo eyodwa iyanciphisa kakhulu ingozi yokungahlambuluki noma ukungasebenzi kahle kwe-erectile.
Kungakhathaliseki indlela oyisebenzisayo ofuna ukuqiniseka ukuthi udokotela wakho ohlinzayo uyakwazi futhi ukhululekile kumasu akhethiwe.
I-radiation isebenzisa i-high-energy x-ray ukubulala amangqamuzana omdlavuza. Kunezinhlobo eziningana zokwelashwa kwama-radiation kanti amafomu amasha asebenzisa amamaki afakwe ku-prostate gland ngakho-ke kunesidingo sokuhlose amandla. Izinhlobo ezintsha zemilayezo efana neProton Beam Therapy ayingakaze iboniswe kangcono noma ephephile kunamanje.
I-radiation inikezwa ngezindlela ezimbili ezahlukene. Iforamu yangaphandle inomthombo wangaphandle ohlose imisebe ye-prostate. I-Brachytherapy iyindlela lapho imbewu enomswakama ifakwa khona ku-prostate. Ukuphumelela kuncike ekunembile kokuletha imisebe kanye nokutholakala kwamangqamuzana omdlavuza. Imishanguzo izovame ukuhlanganiswa nama-hormone kumagciwane amaningi anonya.
Cryotherapy
I-Cryotherapy ye-prostate yinkqubo lapho amangqamuzana e-prostate aqhwaqwe khona futhi abulawe ukubulala amangqamuzana. Izindlela zanamuhla zisebenzisa i-argon ne-helium ukuze kufinyelele lokhu futhi inqubo yefriji / thaw iphindwe kabili. Inqubo yenziwa ekamelweni lokusebenza ngaphansi kwe-anesthesia. I-Cryotherapy isebenza kuphela uma umdlavuza uqukethe ngaphakathi kwe-prostate. Kuyindlela evame ukusetshenziswa uma umdlavuza usendaweni eyodwa kuphela noma ngemuva kokwelashwa kwama-radiation ahlulekile. Izinzuzo zihlanganisa ukuhlala esifushane esibhedlela nokubuyela okusheshayo emisebenzini uma kuqhathaniswa nokuhlinzwa. Ukwehla kwezinga kuhlanganisa amazinga aphezulu e-Erectile Dysfunction kunemisebe uma yonke ingqungquthela iqhwa.
Ukwelapha Okungahambi
Umdlavuza we-prostate ukhula ekuphenduleni u-testosterone, i-hormone yesilisa yesilisa. Ukuvimbela noma ukususa i-testosterone kuzokwenza ukuthi amangqamuzana amaningi avuselele noma afe. Kwaphela iminyaka eminingi lokhu kwakuwukuphela kokwelashwa kwezifo zamathambo. Esikhathini esedlule, amathemikhali kwakudingeka asuswe (orchiectomy) kodwa manje imishanguzo yesikhashana ingahle ijojowe ukuze ifinyelele umgomo ofanayo. Ukwelashwa kwama-hormones ngokuvamile kuvame ukusetshenziswa ngokuhambisana nokwelashwa kwemisebe.
Amasu amabili asemqoka asetshenziselwa ukuvimbela i-testosterone: ukuyeka ukukhiqiza nokuvimbela i-receptor. Lezi zitholakala ngezindlela eziningi ezibandakanya amaphilisi, izimila nezijova. Imithi emisha eminingi yomdlavuza wesi-prostate isebenzisa izindlela ezingcono zokuvimba ukukhiqizwa kwe-testosterone noma ukuvimbela i-receptor.
I-Chemotherapy
I-Chemotherapy yomdlavuza wesi-prostate ngokuvamile isetshenziswa lapho ama-hormone ehlulekile. Ukuthuthukiswa okuningi kuye kwenziwa eminyakeni eyishumi edlule.
I-HIFU
I-Ultrasound Focused Focs Ultrasound ubuchwepheshe obusebenzisa amagagasi e-ultrasound agxile endaweni encane. Lokhu kudala ukushisa okukhulu futhi kubulala amaseli. Ngenxa yokusebenza okuncane kokuqala, le nqubo itholakale kuphela ngaphansi kocwaningo lwama-protocol e-US.
I-Sipuleucel-T (Nikeza) I-Sipuleucel-T ngumuthi wokugoma umdlavuza we-prostate umdlavuza. Lenzelwe iziguli ezingabonakali noma ezincane ezibonisa ukuthi unesifo somdlavuza wesifo se-prostate esingenamandla.