Umuntu akakwazi ukukhuluma ngokuhlakanipha ngomdlavuza wesi-prostate ngaphandle kolwazi olusebenzayo lokuhlolwa kwegazi le- PSA . Iningi labantu lijwayele ukusebenzisa i-PSA ukuxilonga umdlavuza wesi-prostate ekuqaleni. Kodwa-ke, kukhona nezinye izinto ezibalulekile ezisetshenziswayo ze-PSA.
Izindima ezihlukahlukene ze-PSA
I-PSA idlala indima ehlukahlukene. Okujwayele kakhulu ukuhlolwa komdlavuza. Ibuye isetshenziselwe ukulinganisa amadoda asanda kutholakala.
Isibonelo, amadoda ase- Low-Risk abe ne-PSA engaphansi kwe-10. Amadoda angama -Risk aphakathi aphakathi kwe- 10 kuya ku-20. Amadoda aphakeme kakhulu abengozi be-PSA anamazinga e-PSA angaphezulu kwe-20. I-PSA ingasetshenziselwa ukuthola umdlavuza emuva kokuhlinzwa noma imisebe. Isifo esivamile singakwazi ukuziphatha ngendlela engavamile noma singakhula ngokushesha. Okuthakazelisayo ukuthi izinga lokuphakama kwe-PSA, isikhathi esithathayo ukuba liphindwe kabili, linikeza ukuqonda okujulile ukuthi umdlavuza uzoziphatha kanjani ngokuzayo esikhathini esizayo. Ngakho-ke, ukwelashwa kungabuka ekuqaphelisweni kuya emisebeni yesikhumba noma i-cryotherapy ku-thropyone yokunakekelwa kwemithi ye-testosterone ne-Lupron ngisho nakumakhemikhali.
Ukuqapha i-PSA Ngemuva kokuhlinzwa noma ukukhwabanisa
I-PSA ibalulekile ekutholeni ukubuyiselwa komdlavuza ngemuva kokuhlinzwa noma ukushiswa kwemisebe. Ngokuvamile, ngemuva kokuhlinzwa i-PSA kufanele ihlehlele ezingeni elingabonakali. Ngisho nokukhuphuka okuncane kwe-PSA kuyinkomba yokuthi kungenzeka ukuthi umdlavuza uphinde uphinde uphinde uphumelele. Emva kwemisebe , ukucabanga ukuthi lesi sifo siphululiwe, i-PSA ngokuvamile ihlala ngaphansi kwe-1.0 kuze kube phakade.
Noma kunjalo, nge-radiation kukhona okungafani. Okokuqala, amazinga e-PSA avame ukwehla kancane ngemva kwemisebe, ngezinye izikhathi athatha iminyaka eminingana ukuze afinyelele iphuzu lawo eliphansi kakhulu. Okwesibili, ukuphakama kwesikhashana ku-PSA kungenzeka, ikakhulukazi emva kohlobo lokufakelwa kwezimbewu. Ukunyuka kwe-PSA okungavunyelwe, okubizwa ngokuthi "i-PSA Bumps" kungathuthuka ngemva kweminyaka engu-1 ukuya kwengu-4, kudala ukuphazamiseka mayelana nokwenzeka komdlavuza.
I-PSA Bump kucatshangwa ukuthi ibangelwa ukusabela kwe-immune okubambezelekile ku-prostate. Izindaba ezinhle ukuthi i-PSA Bump ingase ihlotshaniswe namazinga aphezulu okuphulukisa. Izindaba ezimbi ukuthi ukungahambisani kahle ne-bump njengokuphindaphinda kungabesabisa amadoda (nodokotela bawo) ekuqaliseni ukwelashwa kwe-hormone okungadingekile.
Ukuchaza Izinhlobo Ezihlukene Zokubuyiselwa
Lapho ukuvuselelwa komdlavuza kuqinisekiswa, izinga le-PSA kabili libonisa ukuhlukumezeka kwesisu. Isibonelo, i-PSA edinga izinyanga ezingaphezu kwezingu-12 ukuba iphindwe kabili, imelela ukuphindaphinda kwezinga eliphansi kakhulu - elilodwa elingase lingadingi ukwelashwa. Ngakolunye uhlangothi, umdlavuza odinga izinyanga ezingaphansi kwezintathu ukuphindaphinda kabili ukuziphatha kabi. Ekugcineni, ukwelashwa kwezifo ezibuyiselwayo kuqondiswa izinto ezintathu: isigaba sokuqala sengozi ngaphambi kokuhlinzwa noma ukushiswa kwemisebe ( ephansi kuya ephakathi nendawo ephezulu ), isikhathi se-PSA sokuphindaphinda kanye nendawo yomdlavuza wokubuyiselwa esinqunywe ngendlela engcono kakhulu ngokuskena , noma yiziphi izidakamizwa zesifo somdlavuza we-prostate.
I-PSA Time Doubling
Ukukhetha ukwelashwa kuthinteka kakhulu izinga lokuphakama kwe-PSA. Isibonelo, uma i-PSA kabili ezinyangeni ezingaphansi kwezinyanga ezintathu (noma ngisho nezinyanga ezingaphansi kwezinyanga eziyisithupha), ukwelashwa okuhlangene okuhlangene ne-Lupron plus radiation (noma i-cryosurgery emadodeni ayenakekelwa ngaphambili ngemisebe) cishe kuyadingeka.
Uma izinga le-PSA lokuphindaphindiwe liphakathi kwezinyanga eziyisithupha nesishiyagalolunye, indlela yokwelapha encane kakhulu nge-radiation yodwa, i-cryosurgery yedwa noma i-Lupron ephakathi kuyoba nengqondo. Amanye amadoda anesifo se-PSA-abuyele esimweni esikhula kancane kancane futhi akukho ukwelashwa okudingekayo. Lokhu kunjalo uma kuthatha okungaphezu konyaka ukuba i-PSA iphindwe kabili.
I-PSA Izikhathi Zokungabaza Phakathi kwezinyanga eziyisithupha kuya kwezingu-12
Kuthiwani ngokuthi "phakathi" kwezimo lapho izifo ezivame ukubonakala sengathi zitholakala ku-prostate noma i-prostate fossa, ama-node acacile, isigaba sokuqala sengozi sasiyi- Intermediate-Risk kanti isikhathi se-PSA sokuphindaphindiwe sisezinyangeni eziyisithupha kuya kwezingu-12?
Ingabe umuntu onomdlavuza we-prostate kufanele abe nokwelapha wendawo kuphela nge-radiation noma cryotherapy? Kuthiwani nge-Lupron ephakathi? Ingabe kufanele senze imisebe yesikhashana ngesifundo esifushane saseLupron? Impendulo engcono kakhulu ukuthi asiyazi ngempela. Esimweni esinjengalezi, iziguli kufanele zizijwayeze zonke izimo ezimbi ezingase zivele kuzo zonke lezi zifundo zesenzo. Okuncamelayo komuntu kuyindlela ekhethiwe yokukhetha.
I-Fast Fast PSA Times Yokubamba
Isikhathi esiphuthumayo se-PSA sokuphindaphinda, sithi izinyanga ezintathu noma ngaphansi, kuyisibonakaliso esinamandla sengozi engase isongele ukuphila. Ngisho noma izikrini zingase zicacile, ukwelashwa kufanele kube nobudlova. Ngisho nokusebenzisa ukwelashwa okungaphelele kungavunyelwa. Amalungu amasha afana ne-Zytiga noma i-Xtandi angase acatshangelwe. Ucwaningo lwamuva lubonisa nokuthi amadoda angasinda kangcono uma ethatha imijikelezo eyisithupha ye-Taxotere kanye no-Lupron.
Isigaba Sokuqala Sengozi
Ngokuvamile, ukwelashwa kufanele kube nobudlova (okuhlanganisa inhlanganisela ye-Lupron ne-pelvic i-lymph node imisebe) uma isigaba sokuqala sengozi sasiphezulu. Ukwelashwa kufanele kuxhomeke ekutheni inqubo-cryotherapy yodwa engacindezeli, imisebe yedwa noma i-Lupron yodwa-uma isigaba sangempela sengozi sasiyi- Low-Risk .
Ukufuna indawo yeCanscer
Amadoda anePSA ekhuphuka ngemva kokuhlinzwa noma imisebe kufanele aqale ukuhlola izifundo ezijwayelekile zokuzama ukuthola indawo yomdlavuza. Ngeshwa, i-"standard" ihlola njenge-CT ne-MRI ivame ukuhluleka ukubona umdlavuza ophindaphindiwe, ikakhulukazi uma i-PSA engaphansi kwe-10. Ukuthuthukiswa kwe-PET ku-C11 i-acetate noma i-choline ingayibona indawo yesifo esivamile esinezinga eliphezulu le-PSA. Ngeshwa, lezi zilinganiso ze-PET zintsha kakhulu ukuthi ukutholakala komshuwalense kungatholakali.
Ama-scans "ajwayelekile" avame ukusetshenziswa ase:
- Umbala we-Doppler ultrasound noma i-MRI multi-parametric ingasetshenziselwa ukubuka umdlavuza osuhleliwe ku-fossa yokuhlinzwa emva kokuhlinzwa noma ku-prostate gland kubantu abaphathwa ngaphambili ngemisebe.
- I-MRI yama-pelvic noma i-CT isetshenziselwa ukuhlola ukusabalala kuma-lymph nodes we-pelvic.
- I-Technetium bone scans yindinganiso endala. Kodwa ama-bone scans e-F18 PET, angcono kakhulu ngoba angathola kancane kancane kune-technetium bone scans.
Lapho ama-scans awabonisi ama-metastases ngemuva kokuhlinzwa
Ngokuvamile, amadoda ayenobungozi obuphansi noma obungozi obukhulu ngaphambi kokuhlinza futhi athuthukisa ukunyuka kwe-PSA ngesikhatsi sokuphindaphindiwe phakathi kwezinyanga eziyisithupha kuya kwezingu-12 bazoba namanani amahle okuphulukisa ama-radiation kuya ku-prostate fossa. Ngaphandle kwalokho, amadoda abesabekayo ngemiphumela emibi yomswakama angabheka ukucindezela i-PSA nge-Lupron ephakathi kokuphathwa kwezinyanga eziyisithupha. Amadoda anezikhathi eziphindaphindiwe eziphindaphindiwe, ngaphansi kwezinyanga eziyisithupha, isibonelo, kufanele ukuthi abe nemisebe emidlalweni ye-pelvic ehlanganiswe nobude obude beLupron, kusho izinyanga ezingu-12 kuya kwezingu-18. Amadoda ayesengozini enkulu kufanele nakanjani acabangele imisebe ye-node ezinyangeni ezingu-12 kuya kwezingu-18 zeLupron. Bangase bacabangele ukwengeza amanxusa anamandla anjengeZytiga, Xtandi noma i-Taxotere.
Lapho ama-scans evuliwe ngemuva kwemisindo
Ukuze i-PSA ekhuphuka ngemva kwemisakazo, enye yezindlela ezithandwa kakhulu ziqhwaza umdlavuza we-residual ku-prostate nge-cryosurgery. Le ndlela iye yathandwa nakakhulu ngokufika kwezingcingo ezingcono ezivumela i-cryosurgeon ukuba ikhethe kancane ingxenye yegland futhi ithathe umdlavuza ngokugxila kunokuba uphathe lonke i-prostate. Imiphumela emibi ene-cryotherapy eqondile inkulu kakhulu uma kuqhathaniswa nokuqhwaza lonke igulane futhi ibe yingozi kakhulu kunokuzama ukususa i-prostate ngokuhlinzwa. Ukususwa kokuhlinzwa kwe-prostate ngemuva kwemisebe kufanele kungabikho kucatshangelwe ngenxa yamanani aphezulu kakhulu okungahambisani nokungabi namandla.
Okunye okunye okukhona kule simo ukunikeza uLupron ngezikhathi ezithile. Lokhu kuzokwenqabela ngokuphumelelayo isifo sendawo futhi lokhu kuwukucatshangelwa okunengqondo kumadoda anezikhathi eziphindaphindiwe ezinyangeni eziyisithupha uma isigaba sokuqala sengozi sasingahle sibe yi- Low-Risk noma Isiphephelo Esiphezulu . Amadoda aphinde abuyele endaweni yangakini kodwa abesengozini ephezulu cishe ayesebenza kangcono ngomzamo ohlukumezayo wokuphulukisa lesi sifo nge-cryosurgery noma ukufakelwa kwembewu esikhundleni sokumane ukucindezela lesi sifo ngeLupron ngokwayo.
I-Lupron Yodwa Ngemuva Kokuhlinzwa noma Ukushiswa Kwesikhumba Uma Izikrini Zisulwa
Njengoba kuphakanyisiwe ngenhla, uma izikrini seziqediwe futhi indawo yokubuyiselwa kubonakala sengathi yendawo, amadoda futhi anakho ukukhetha ukwelapha izifo ezibuyiselwe ngeLupron. I-Lupron ngokwayo, noma kunjalo, inezimpikiswano ezihlukahlukene futhi cishe ayisoze iphethwe. Noma kunjalo, ukulawulwa kwezifo okungaphezu kweminyaka eyishumi kuvamile. Ukuze unciphise imiphumela emibi, i-Lupron ingasetshenziswa ngezikhathi ezithile. I-protocol ejwayelekile ejwayelekile iqukethe ukwelashwa okwenziwa izinyanga eziyisithupha kuya kwezingu-12 emva kwalokho i-Lupron imisiwe. Ngokuhamba kwesikhathi, i-testosterone ibuye futhi i-PSA iqala ukuphakama. Umjikelezo wesibili we-Lupron uqaliswa lapho i-PSA ibuyela emuva kwisisekelo sokuqala se-PSA, noma kufike ku-range ezintathu kuya kweyisithupha, noma yikuphi okuphansi. I-Lupron engekho phakathi kwaba yindlela ejwayelekile yokuphatha amadoda anePSA ephindela emuva iminyaka engaphezu kwengu-20. Lupron yedwa indlela enengqondo kakhulu uma umzamo wokuphulukisa ungenakwenzeka ngokusebenzisa imisebe noma i-cryotherapy.
Ukubeka konke ndawonye
Ngakho-ke ukufingqa, ezimweni ezingcono uma izikrini zibonisa ukuthi umdlavuza awusakazeki kumanothi, ukwelashwa nge-cryosurgery yodwa noma imisebe yedwa yinto enengqondo uma nje isigaba sangasese sengozi kanye nesikhathi sokuphinda kabili se-PSA sinomusa. Yiqiniso, ngisho noma izikrini zingabonisi ama-metastases, kungenzeka ukuthi izinto ezincane ezinamakhompiyutha kufanele zicatshangelwe. Izifo ezincane ezincane kakhulu amathuba emadodeni anama-PSA aphindaphindiwe okuphindaphindiwe kabili noma abengoziNgcono ngesikhathi beqala ukutholakala benomdlavuza we-prostate. Kulezi zimo, ukungezwa kwe-prophylactic i-lymph node imisebe ngaphezu kwenkambo ende yeLupron kunconywa.
Inqubo yokukhetha ukwelashwa yamadoda ane- PSA ephindaphinda inzima. Inqubo iqala ngokukwakha iphrofayli yesiguli usebenzisa isigaba sengozi yangempela, isikhathi se- PSA sokuphindaphindiwe, kanye nokuthola okuskena. Ngeshwa, indawo yomdlavuza ophindaphindiwe ingase ihlale ingaqiniseki, ngisho nangemva kokwenza ama-scans amahle kakhulu. Uma kunjalo, izinga lesifo lingadinga uchwepheshe "ukuqagela" ngokusekelwe esikhathini se-PSA sokuphindaphinda kanye nesigaba sokuqala sengozi. Naphezu kwazo zonke lezi zinkinga nokungaqiniseki, izindaba ezinhle ukuthi izinketho eziningi zokwelapha ziyatholakala. Kubantu abaningi, lesi sifo singalawulwa isikhathi eside, futhi ezinye izimo zize zelashwa. Umbono jikelele unethemba. Ngisho nalabo abangelapheki, iningi lizokwazi ukugcina isifo sabo lihlolwe iminyaka uma kungengamashumi eminyaka ekwelapheni.