Umdlavuza we-Pancreatic awuvamile, kodwa njengoba iningi lala makhambi asemasimweni ethuthukile ngesikhathi sokuxilongwa, yisisusa sesine esiholela ekufeni okuhlobene nomdlavuza e-United States. Izimpawu zingabandakanya i-jaundice engenangqondo, ubuhlungu besisu, ukulahlekelwa isisindo, futhi ngezinye izikhathi ukuqala okungaqondakali kwesifo sikashukela. Izivivinyo ezifana ne-CT ne-endoscopic ultrasound zisetshenziselwa ukuxilonga lesi simo.
Izinketho zokwelashwa zibandakanya ukuhlinzeka, ukwelashwa ngamakhemikhali, imithi yokwelapha, ukuphathwa kweminye imithi, nokuhlolwa kwezidakamizwa.
Ukuqonda ama-Pancreas
I- pancreas iyisitho esingaba ngamasentimitha ayisithupha ubude obude, amasentimitha ama-ububanzi ububanzi futhi senziwe njengepare elimhlophe eceleni kwalo. Umkhawulo obanzi we-pancreas ubizwa ngokuthi ikhanda, kanti isigaba esiphakathi sabizwa ngokuthi umzimba, futhi umkhawulo omncane umsila. I-Cancer ivame kakhulu ekhanda.
I-pancreas ikhiphe ngemuva kwesisu phambi komgogodla. Awukwazi ukuzwa ngesikhathi sokuhlolwa komzimba njengoba kuhlotshwe ezinye izitho, ezifana nesisu, isibindi, i-spleen, gallbladder, nesisu somzimba omncane, okwenza ukuxilongwa nokuhlinzwa kube inselele.
I-pancreas iqukethe izinhlobo ezimbili zamaseli ezingabangela izinhlobo zamanqamu. Iningi lamdlavuza (adenocarcinomas) aqala emaseli aziwa ngokuthi amangqamuzana e-exocrine anesibopho sokukhiqiza ama-enzyme e-pancreatic. La ma-enzyme ayangena emathunjini ukusiza ukugaya amaprotheni, ama-carbohydrate namafutha.
Okungavamile kakhulu yi-cancer (i-neuroendocrine tumors) evela kuma- endocrine amangqamuzana . Lawa maseli akhiqiza ama-hormone afana ne-insulini, i-glucagon, kanye ne-somatostatin elawula izinqubo ezivela ushukela wegazi kuze kube ne-asidi esiswini.
Lokhu kubuka kabanzi kugxile kumdlavuza omkhulu we-pancreatic.
Izimpawu
Izimpawu zokuqala zomdlavuza we-pancreatic zingase zibe ezicashile futhi zingacacile, futhi zingasuswa kalula njengezinye ngenxa yesimo esithile esibi kakhulu.
Ezinye izibonakaliso ezingase zixwayise zihlanganisa:
- I-yellowing yesikhumba namhlophe ebusweni (i- jaundice ) ngenxa yokwakhiwa kwe-bilirubin
- Pale, izitshalo ezifana nobumba, umcibisholo omnyama, nokuvuthwa, nakho kwenzeka ngenxa yokuqoqwa kwe-bilirubin egazini
- Ubuhlungu obukhulu besisu obungase bufinyelele emuva
- Ukulahleka kwesisindo esingalindelekile
- Ukudabuka, ukuhlanza, noma isifo sohudo
- Ukulahlekelwa kwesifiso
- Ukuqala okungalindelekile kwesifo sikashukela kumuntu ongenayo ingozi
Izimpawu zamathumba we-pancreatic ezingavamile (izicubu ze-neuroendocrine) zivame ukuhlobene nama-hormone awakhiqizayo futhi zingafaka izimpawu ezinjengezo ezithola ushukela wegazi ophansi noma ophakeme noma ushukela wegazi ophakeme.
Zonke lezi zimpawu zidinga ukuhlolwa okuphelele kwezokwelapha-nombono wesibili, uma ungatholi izimpendulo ezizwakalayo kuwe.
Izimbangela Nezici Zengozi
Nakuba abacwaningi bengenaso isiqiniseko sokuthi yini eyenza ngempela lesi sifo, kunezici ezi- r isk zomdlavuza we-pancreatic eziye zabonwa:
- Ubudala: Iningi lama-cancers we-pancreatic lwenzeka kubantu abangaphezu kweminyaka engu-55 (nakuba kungenzeka futhi kubantu abasha).
- Umjaho: Abomnyama banezibalo eziphakeme zomdlavuza we-pancreatic kunezinye izinhlanga. Ingozi nayo iphakeme kubantu befa le-Ashkenazi lamaJuda, nakuba lokhu kucatshangwa ukuthi kuhlotshaniswa nesilinganiso esiphakeme se- BRCA2 yezinguquko zezakhi zofuzo .
- Ubulili: Amanani okukhubazeka nokufa aphezulu kunamadoda kunabesifazane.
- Ukubhema ugwayi: Lokhu kuyingozi enkulu ebalulekile ( ukubhema kwandisa ingozi kaningi yamangqamuzana ) futhi kucatshangwa ukuthi kubhekene nengxenye yesithathu yamagciwane e-pancreatic.
- Isifo se-gum esithuthukisiwe ( periodontitis ) nokulahlekelwa kwamazinyo okuphelele (ukuguquka)
- Umlando womndeni wesifo somdlavuza we-pancreatic noma ezinye izifo zengqondo zofuzo: Lokhu kucatshangwa ukuthi imbangela yamaphesenti angu-5 kuya ku-10 amaphesenti alawa kansa.
- Umlando womuntu wesifo sikashukela
- Ukuvuvukala okungapheli kwama-pancreas ( pancreatitis )
- Isikhathi eside, ukusetshenziswa kotshwala obunzima, ikakhulu uma kuhlangene nokubhema
- Ukukhuluphala ngokweqile: Ukucatshangelwa ngokweqile noma okugqithisayo kubhekwa ukuthi kunesibophezelo sezungeze eyodwa kwayisishiyagalombili yalezi zomshukela.
Ukuxilongwa
Ukuxilongwa kokuxilongwa komdlavuza we-pancreatic kuqala ngomlando oqaphelayo obheka izinto eziyingozi, futhi ukuhlola ngokomzimba kubheka noma yibuphi ubufakazi be-jaundice, isisindo somzimba noma isisindo.
Ukucwaninga ukucwaninga yiyona ndlela yokutholwa, ikakhulukazi ukuhlolwa kwe-CT oklanyelwe ukuhlola umdlavuza we-pancreatic (i-pancreatic protocol CT). Ama-ultrasound avame ukuhlala esiswini angasiza ekulawuleni ezinye izinkinga zesisu kodwa anqunyelwe ekutholeni umdlavuza we-pancreatic ngenxa yegesi emathunjini.
Esikhundleni salokho, i-endoscopic ultrasound-lapho i-tube ene-ultrasound tip efaka emlonyeni futhi ifakwe phansi engxenyeni engezansi yesisu noma engxenyeni engenhla yamathumbu amancane-ingaba ithuluzi eliwusizo. Okunye ukuhlolwa kwama-imaging okusetshenziswa ngezinye izikhathi kuhlanganisa i-ERCP (endoscopic retrograde cholangiopancreatography) ne-MRI.
I-biopsy ayidingi ngaso sonke isikhathi ukuze ihlolwe, kodwa uma (njengokungathi ukuhlinzekwa kucatshangelwa) kunezinketho ezimbili eziyinhloko: isifiso esihle senaliti kanye ne-laoposcopic biopsy.
Ukuhlolwa kwegazi akunandaba neze nomdlavuza we-pancreatic kodwa kungasiza uma uhlangene nezinye iziphumo. Uma i-jaundice ikhona, ukuhlolwa ukucacisa izinhlobo ezahlukene ze-bilirubin kuyasiza.
Ngokusekelwe emiphumeleni yokuhlolwa kwe-imaging nezinye iziphumo, lezi zomshukela zinikwe isiteji phakathi kwe-0 (precancerous) nesigaba 4 noma zihlukaniswa njengomdlavuza we-metastatic.
Ukwelapha
Izinketho zokwelashwa zomdlavuza we-pancreatic zixhomeke esiteji sesifo kanye nendawo yomdlavuza ku-pancreas.
Amagciwane e-early-stage, ikakhulukazi lawo asekhanda lama-pancreas, ukuhlinzwa kunika ithuba lokuphulukisa lesi sifo. Ngeshwa, abantu abangamaphesenti angama-15 ukuya kwangu-20 kuphela abavunyelwe ukuhlinzeka (okusalayo, umdlavuza usakaze kakhulu ukuhlinzekwa ukuthuthukisa ukusinda).
Inqubo evamile kakhulu eyenziwa yayaziwa ngokuthi yinqubo ye-Whipple futhi ihilela ukukhipha ikhanda lama-pancreas, i-biling buct evamile, ingxenye yesisu, ingxenye yamathumbu amancane, i-spleen, kanye namagqabhezana aseduze. Kukhona ukuhlukahluka kwenkambiso, kufaka phakathi ukuhlinzwa okususa wonke ama-pancreas, kodwa lokhu kwenziwa kancane kancane. Lezi zindlela ezinkulu zokuhlinza, nokuqinisekisa ukuthi ukuhlinzwa kungenzeka (njenge-laparoscopic biopsy nezinye izivivinyo) kubalulekile.
I-Chemotherapy esebenzisa inhlanganisela yezidakamizwa inikeza ukuthuthuka okuncane kakhulu kokuphila kwesikhashana kodwa kungase kusebenze ngokuphumelelayo uma kuhlanganiswa nemithi yokwelashwa njengokwelapha okuhlosiwe kanye / noma ukwelashwa kwemisebe.
Ukwelashwa okuhlosiwe yizokwelapha ezintsha ezithi "zihlose" okungavamile ekukhuleni kwamagciwane. Imithi eyodwa, i-Tarceva (erlotinib), iyasiza kubantu abathile, ngokuvamile abahlanganiswa ne-chemotherapy.
Ukuvivinywa kwemitholampilo kubheka izinhlanganisela zokwelashwa okungenhla kanye nezindlela ezintsha, njenge-immunotherapy.
Ukubhekana
Uma wena noma othandekayo wakho uthola ukuthi unomdlavuza we-pancreatic, thatha isikhathi sokufunda ngesifo sakho futhi uthathe ingxenye ekhuthele ekunakekeleni kwakho njengommeli wakho . Ukwenza kanjalo kungasiza ekunciphiseni ukukhathazeka kepha kungenza umehluko emiphumeleni yabanye abantu.
Ezinye iziphakamiso ezingasiza:
- Thatha isikhashana ukuthi ufunde mayelana nokuthi ungacwaninga kanjani umdlavuza wakho ku-intanethi .
- Cabanga ngokuthola umbono wesibili, mhlawumbe kwelinye leNational Cancer Institute-izikhungo zomdlavuza ezikhethiwe.
- Khuluma ne-oncologist yakho nganoma yikuphi ukuhlolwa okusemtholampilo okungase kukufanele, noma ucabange ukuhlola enye yezinsiza zokulingana zamavivinyo zamahhala ezihlinzeka ngezinsiza zabahlengikazi abangakwazi ukufanisa nesimo sakho esithile ekuvivinyweni kokwelashwa okwenzeka noma kuphi emhlabeni.
Abanye abantu futhi bakuthola kuwusizo ukuhileleka eqenjini lokusekela. Uma iqembu elinjalo lingatholakali endaweni yakho, okungenzeka ukuthi umdlavuza we-pancreatic awuvamile, imiphakathi yokusekela inthanethi ingase ibe yindlela enhle yokuthola abanye ababhekene nezinselele ezifanayo.
Finyelela emndenini nabangani futhi uvumele ukuba bakusize. I-Cancer ithatha umuzi ngempela. Izikhungo eziningi zomdlavuza nazo zinikeza izinketho zokwesekwa ngokomzwelo, kusukela ekululekeleni komdlavuza kuya emaqenjini okunakekelwa kwezinkinga ezithintekayo okhuluma nomuntu wonke, umzimba, ingqondo nomphefumulo. Sebenzisa ngokunoma yikuphi kwalokhu okukhethwa kukho okukholelwa ukuthi kuzokusiza. Ngezinye izikhathi izinto ezinesibindi abantu abangayenza zivuma ukuthi zidinga usizo olwengeziwe nokusekelwa.
Izwi elivela
Uma wena noma othandekayo uthola ukuthi unomdlavuza we-pancreatic, noma ucabanga ukuthi ungaba nezimpawu, akungabazeki ukuthi ungakhathazeka kakhulu. Umdlavuza we-Pancreatic unedumela abaningi abakwaziyo. Kodwa njengoba nje ukwelashwa kuthuthukiswa kwamanye amagciwane, kwenziwa inqubekela phambili yalesi sifo. Ezinye izikhungo ezinkulu zezokwelapha manje zenza ukuhlinzeka ngamanqamu ayebhekwa ngaphambilini angasebenzi. Futhi ngisho nezifo eziphambili, ukwelapha okusha okufana nokwelashwa okuhlosiwe kanye nokuzivikela komzimba kungase kushintshe ubuso bomdlavuza we-pancreatic, njengoba unayo nezinye ezinye izinhlobo zomdlavuza.
Ngisho noma imishanguzo ayiyona into esiyifisa ukuba yona namuhla, i-oncology ifike isikhathi eside kakhulu ekulawuleni izimpawu kanye nokukhathazeka okuhlobene nomdlavuza ukuze abantu bakwazi ukuthola okuningi kusukela ngesikhathi sabo nomndeni nabangane kungakhathaliseki isikhathi esingakanani ishiywe.
> Imithombo:
> Ukwelashwa Kwamanje Nekukhulayo Emdlalweni We-Pancreatic Cancer, Springer Verlag, 2017.
> De la Cruz, M., Young, A., noMnu Ruffin. Ukuxilongwa Nokuphathwa Kwe-Cancer Pancreatic. I-American Family Physician . 2014. 89 (8): 626-632.
> National Cancer Institute. Ukwelapha I-Cancer Pancreatic (PDQ) -Health Professional Version. Kubuyekezwe 01/26/18. https://www.cancer.gov/types/pancreatic/hp/pancreatic-treatment-pdq
> Rosenberg, A., no D. Mahalingam. I-Immunotherapy e-Pancreatic Adenocarcinoma-Yokunqoba Izithiyo Zokuphendula. I-Journal ye-Oncology yamathumbu . 2018. 9 (1): 143-159.