Iqembu elincane leziguli alisoze lazi lapho umdlavuza wayo uqale khona
Umdlavuza wesibeletho. Umdlavuza we-prostate. Umdlavuza weColon. Iziguli ezinomdlavuza zibhalwe ngokusekelwe emvelweni wezinhlupho zabo. Lezi zigaba zinikeza inhloso yangempela: enye yezinto ezibaluleke kakhulu ekunqumeni izinketho zokwelapha kanye nokubikezelwa ngumsuka womdlavuza, isayithi elithi "primary tumor".
Kodwa cishe iziguli ezingamatshumi amathathu kuzo zonke izifo zomdlavuza, indawo yokuqala yomdlavuza ayitholakali.
Okokuthi, isiguli sinikeza izimpawu ezintsha (ezifana nobuhlungu noma ukuphuma kwegazi noma ihlombe) noma i-asymptomatic (ayinayo izimpawu) kodwa itholakala ekuhloleni ngokomzimba, i-X-ray evamile, noma olunye ucwaningo lokuba nomdlavuza. Yini ngempela ehlolwe ukuthi iyinhlangano yesifo somdlavuza - isisu (noma izicubu) ezikhulile kusuka kumaseli ahamba kusukela kumdlavuza oyinhloko manje ongenaziwa futhi ahlasela esinye isayithi (noma amasayithi) emzimbeni. I-metastasis iphikisiwe, isifo somdlavuza siyatholakala, futhi ukucwaninga kubangela isisu esiyisisekelo, ukuhlolwa okunzulu ngokuvamile kuxhomeke kakhulu kwizifundo ze-imaging radiological ezifana ne-CT scans. Kodwa isifo sofuba esiyinhloko sangempela asitholakali. Futhi sinikezwe ukuthi sibhala wonke iziguli zomdlavuza, leli qembu eliyingqayizivele kuthiwa lihlushwa "umdlavuza wemvelaphi engaziwa (CUP)."
Ngakho-ke, kunokwenzeka kanjani ukuthi ungatholi isisu sokuqala somdlavuza? Phela, ngisho nasezigulini umdlavuza usuvele uziqhathanise nezinye izingosi (njengobindi, amaphaphu, amathambo, kanye / noma ubuchopho), umsuka we-metastase, isisu esikhulu, ngokuvamile uvame futhi uhlale ehlonishwa njengesixuku ku-mammogram, i-nodule ekuhlolweni kwe-prostate, ukukhula okutholakala ngesikhathi se-colonoscopy.
Ngakho-ke i-tumor enkulu ingabeka kanjani? Kunezincazelo eziningi ezingenzeka. Ezinye izicubu eziyinhloko zingase zifake igazi labo futhi zife noma zinciphise usayizi ongatholakali, zinyamalale ngenkathi i-metastase yomdlavuza odelayo iqhubeka ikhula. Kwezinye iziguli, i-tumor yokuqala engalindelekile ingasuswa ngokuhlinzwa phakathi nenqubo yokwelapha isimo esibucayi.
Isibonelo, i-Food & Drug Administration ingakabhubhisa ukusetshenziswa kokusetshenziswa kwe-laparoscopic (i-laparoscopic) okusetshenziselwa ukwenza umsebenzi we-hysterectomy (ukususwa kwesibeletho) ngezicubu ezinobuthi ezibizwa nge-fibroids. Kubonakala ukuthi, engaziwa ngaleso sikhathi, owesifazane oyedwa kwabangu-350 abhekana ne-hysterectomy ngenxa yalesi simo esingenayo umdlavuza ubamba umdlavuza we-uterine obizwa ngokuthi i-sarcoma, futhi ukusetshenziswa kwalesi sixhobo sokuhlinza (umfelandazi) kungasakaza amasosha omdlavuza ongabonwayo , ukulimaza isiguli.
Kodwa kunendaba yini ukuthi umdlavuza oyinhloko awutholakali? Ngeshwa kubaguli be-CUP, kubalulekile kakhulu. Futhi, umsuka wangempela womdlavuza womuntu ubaluleke kakhulu ngokwezinketho zokwelashwa nokubikezela (kufaka phakathi ukusinda). Ngakho-ke, ngenkathi eziningi zegciwane zivela ezinhlobonhlobo zezicubu (isibonelo, isifuba, i-thyroid, i-prostate, kanye nezinye izifo zomdlavuza zonke zivela ezinhlotsheni ezibandayo), kunemifuziselo emangqamuzana ephawulekayo nangokomtholampilo phakathi kwezinhlobo zezicubu ezinamahlombe (isifuba se-thyroid, isibonelo).
Emakhakheni we-CUP, siqala ngokubeka amakhemikhali omdlavuza abe yiqembu elilodwa lamaqembu ahlobene nokubukeka kwawo nezinye izici zamaselula: I-Adenocarcinoma (amathishu angama-glandular; amacala angama-60% we-CUP); I-Carcinoma ehlukumezekile kabi (amangqamuzana omdlavuza olakalayo ongafani nhlobo nanoma yiluhlobo luni lwesisindo; cishe ama-20% kuya ku-30% amacala we-CUP); I-Squamous Carcinoma (ebalwa ngamacala angaphansi kuka-10% we-CUP amacala; afana nesikhumba namaseli ahlanganisa izitho ezithile); ne-Neuroendocrine Carcinoma (engavamile; amaseli afana nalawo ahlakazekile kuwo wonke umzimba okhiqiza ama-hormone).
Futhi namhlanje, singakwazi futhi ukubeka amangqamuzana omdlavuza ngokusebenzisa izivivinyo eziningi zamangqamuzana, ukucwaninga nge-DNA yabo yezigxivizo zeminwe eziveza ngokucacile ukuthi zivelaphi izicubu zangempela.
Ngolwazi oluthe xaxa mayelana nohlobo lweseli ngangokunokwenzeka, odokotela besifo somdlavuza benza ukuqagela okufundisiwe mayelana nomuthi wokwelapha okungenzeka ukuthi uthinte umdlavuza futhi uzuze isiguli se-CUP. Ngeshwa, njengoba i-CUP ngencazelo ibe nesifo se-metastatic (spreads), futhi sinikezwa ukuthi asazi ngokuqinisekile umsuka wangempela we-CUST patient's illignancy, ukubikezela okujwayelekile kubumpofu kakhulu. Ukusinda kweMedian (isigamu sisinde isikhathi esifushane nesigamu) kubaguli be-CUP kungaphansi kwezinyanga ezine; ngonyaka owodwa emva kokuxilongwa, iziguli ezingaphansi kuka-25% ze-CUP ziphila, futhi eminyakeni emihlanu, ngaphansi kuka-10%.
Ngakho-ke kufanele wenzeni uma wena noma othandekayo kuthiwa unomdlavuza, kodwa ukulimala okuyinhloko akukwazi ukukhonjwa? Ngokushesha yenza ukunakekelwa kwakho esikhungweni esikhulu somdlavuza (isikhungo somdlavuza esaziwayo ezweni noma isikhungo esikhulu semfundo) .CUP yisimo esingavamile esiyingozi esidinga ulwazi, ubuchwepheshe, nobuchwepheshe ukuhlola nokuphatha, futhi izikhungo zomdlavuza zigcwele ulwazi, ubuchwepheshe, futhi ubuchwepheshe. Isikhungo esinjalo sizokwenza izifundo eziphambili ze-imaging radiologic kanye nokuhlolwa kwamangqamuzana emzamweni wokuthola isisu esiyisisekelo nokuphatha ukwelashwa okuhlosiwe. Futhi uma ukuxilongwa kwe-CUP kungashintshi, izikhungo zomdlavuza zinikeza ithuba elikhulu kakhulu lokwelapha okunomthelela nokukhethekile, ukunakekelwa ngomusa ngesiguli se-CUP kanye nabathandekayo babo.