Izimpawu, Izimbangela, Ukuxilongwa, Nokunakekelwa
Umdlavuza we-Ovarian usungulwe "umbulali ongenamuntu" ngenxa yokuntuleka kwazo izimpawu eziphawulekayo kuze kube yilapho isimo sithuthukile kahle uma singabangela ubulili obubuhlungu, inzuzo yesisindo engaqondakali, nokuningi. Isilinganiso esiphezulu sokuphila komdlavuza singamaphesenti angu-1.6 nje kuphela, kodwa njengoba lesi sifo sivame ukungaqondakali kuze kube yilapho sifinyelela izigaba ezithuthukile, kuyisizathu sesihlanu esivame kakhulu sokufa komdlavuza ephathelene nabesifazane.
Ukwelashwa okunjengokuhlinzwa kanye ne-chemotherapy kungase kusetshenziswe, nakuba impumelelo yabo iyancipha ukuthi lesi sifo siba ngcono kakhulu.
Izinhlobo
Uhlelo lwesibalo sokuzala lubandakanya ubulili, isisu sombeletho (ingxenye engezansi yesibeletho), isibeletho, amashubhu amabili amabili, nama- ovaries amabili. Ama-ovarie angama-almond amancane futhi anesibopho sokuthuthukiswa nokukhululwa kweqanda nomjikelezo ngamunye wokuya esikhathini. Futhi banomthwalo wokukhiqizwa kwamahomoni e-estrogen ne- progesterone .
Umdlavuza we-Ovarian uvame ukuqala engxenyeni ye-tube fallopian esiseduze ne-ovary bese usakazeka kulowo ovary. Lesi sifo singase futhi siqale nge-peritoneum, izimbungulu zizungeze okuqukethwe kwesisu, bese zisakazeka kwi-ovary. Ngenxa yalesi sizathu, umdlavuza we-ovarian, umdlavuza we-tublopian tubes, kanye nomdlavuza we-peritoneal oyinhloko uvame ukuqoqwa ndawonye lapho bexoxa ngalezi zomshukela.
Kunezigaba ezintathu ezisemqoka zomdlavuza we-ovari (nakuba kunezinhlamvu ezingaphezu kuka-30). Lezi zinhlobo ezahlukene zingase ziphathwe ngezindlela ezehlukene, zithole ukuhlonza okuhlukile, futhi zenzeke kwabesifazane abaneminyaka ehlukene ngokujwayelekile.
- Izicubu ze-ovarian epithelial zivela ohlangothini lwamangqamuzana (ungqimba lwama-epithelial) obandakanya ama-ovari nama-tublopian tubes futhi i-akhawunti yamaphesenti angama-90 kuya kwamaphesenti angu-95 ama-ovarian cancers. Ingozi yalezi zomshukela ikhula ngokweminyaka, futhi abantu abaningi bangama-postmenopausal uma betholakala. I-subtypes ejwayelekile kakhulu ihlanganisa ukuphela kwe-endometrioid, i-mucinous, ne-serous, kanti iningi liyingozi kakhulu. Izicubu ezinomsoco nezingapheliyo zivame kakhulu kubantu besifazane abangaphansi kweminyaka engu-40.
- Izicubu ezinamahlumela zingaba zinhle noma zibi futhi ziqale ku-stroma, izicubu ezizungeze iqanda futhi ziphethe ama-ovarie ndawonye. Lezi ziphukile zibe yizinhlayiyana eziningana, kufaka phakathi i-granulosa cell tumors-ezihlukumezayo kwifomu labafana, ezitholakala phakathi kokuzalwa kanye neminyaka engama-20, kodwa ngokuvamile ezingenabuthi ezinhlotsheni zabantu abadala kanye nama-tumor cell tumors.
- Ama-tumor ye-germ cell angase abe amahle noma awonakele futhi yiyona ndlela ejwayelekile kunazo zonke zomdlavuza we-ovarie kulabo abangaphansi kweminyaka engama-30. Iningi lalabo abathola ukuthi liphakathi kweminyaka eyi-10 no-30. Lezi zicubu ziqala emangqamuzaneni okuzala (iqanda) kanye ne-akhawunti ye-3% we-ovarian kansa. Ama-tumor ye-germ cell ajwayele ukutholakala ukuthi asezingeni lokuqala kodwa athambekele ekukhuleni ngokushesha. Eminye yalezi zinhlayiyana zihlanganisa i-dysgerminomas, izidumbu zesifo se-endodermal nesitatomas ezingapheli .
- I-cell carcinoma encane ye-ovary ayinjwayelo, okwenza amaphesenti angu-0.1 kuphela e-cancer angama-ovarian.
Isilinganiso sokusinda esiphakathi komdlavuza we-high-grade epithelial ovarian (zonke izigaba ezihlanganisiwe) yiminyaka emihlanu, kodwa cishe amaphesenti angu-15 abantu abatholwe bephila ngemva kweminyaka eyishumi. Abacwaningi manje bafunda lezi "ngaphandle" ngethemba lokuthola izindlela ezingcono zokuphatha lesi sifo. Ukubikezela abantu ngabanye kuncike ezintweni eziningi, ezifana nobudala, isigaba kanye nesibalo somdlavuza, impendulo yokwelashwa, nokunye okuningi.
Izimpawu
Izimpawu zomdlavuza we-ovari zivame ukucabangela futhi zingaqondakali ezinkathini zokuqala zesifo futhi ngokuvamile zibhekiswe kwezinye izimo ezingathí sina. Nakuba amaphesenti angama-80 alawo mdlavuza asevele esesiteji esithuthukisiwe uma kutholakala ukuthi, ucwaningo lwamuva luye lwathola izimpawu ezine ezivamile ezinyathelweni zangaphambili. Lokhu kufaka:
- Izinguquko emikhondweni yemilenze, njengokuqunjelwa noma isifo sohudo
- Ubuhlungu be-pelvic noma ukucindezelwa
- Isidingo esiningi sokuvuthwa noma ukuphuthuma komchamo
- Ukuvuvukala noma ukuvuvukala kwesisu
Ezinye izimpawu zomdlavuza we-ovarie ngokuvamile azibonakali kuze kube yilapho lesi sifo siphumelele. Lezi zingabandakanya ubuhlungu ngesikhathi sokulala ngokocansi, ukukhathala okuqhubekayo, isisindo somzimba esiswini noma ukwakhiwa kwamanzi (ascites), phakathi kwabanye.
Ezinye izimpawu zifanele ngokuqondile kuma-hormone akhiqizwa yi-tumor, kuhlanganise nokujula kwezwi, ukukhula kwezinwele ebusweni, nokuphuma kwegazi okungavamile.
Izimbangela Nezici Zengozi
Ngeshwa, asikwazi ukubona ukuthi yini ebangela umdlavuza we-ovarian, kodwa abacwaningi baye baveza izinto eziningana ezaziwayo ezingozini zokuthuthukiswa kwayo. Ngenkathi izici zobungozi zibalulekile, kubalulekile ukukhumbula ukuthi i-ovarian cancers ingenzeka kubantu abangenayo ingozi noma umlando womndeni wesifo.
Izici zengozi zihlanganisa, kodwa azikhawulelwanga, ubudala; Ubuzwe beCaucasia; umlando womndeni we-ovarian, isifuba noma umdlavuza wekoloni; ukukhuluphala ; futhi ukwelapha isrogen okungenakuphikiswa.
Izinto ezihlobene nengozi ephansi yomdlavuza we-ovarian zihlanganisa, kodwa azikhawulelwanga ukuba nengane ngaphambi kweminyaka engama-26, ukuncelisa, ukusebenzisa izakhi zomlomo, ukuhlinzwa kwe-tubal ligation, kanye ne-hysterectomy.
Umdlavuza we-ovariya awuvamile kubantu besifazane abasha. Uma kwenzeka, kunomlando womndeni kaningi futhi kungenzeka ukuthi uhlobene nezici zokuzalwa ezifana ne-BRCA1 noma i-BRCA2 ishintsho. Umdlavuza we-Ovarian ungumdlavuza wesihlanu ovame ukutholakala ngesikhathi ukhulelwe futhi kwenzeka ku-1 ku-18,000 ukukhulelwa.
Ukuxilongwa
Umdlavuza we-Ovarian awuhlolwe njalo. Ukuqaphela umdlavuza we-ovarian ngokuvamile kudinga ukuba ukhokhelwe phezulu udokotela ukuze enze ukuhlelwa kwezinto zokuhlola izithombe kanye nokuhlolwa kwelebhu okungabonisa lesi sifo.
Odokotela ngokuvamile bahlela i-ultrasound yangaphandle kanye nokuhlolwa kwegazi kwe-CA-125 kuqala, nakuba lesi sigaba singase sijwayelekile kwabanye abantu abanomdlavuza wokuqala we-ovari futhi kungase kuphakanyiswe ezinye izimo eziningi zezokwelapha. Udokotela angase aqalise lezi zivivinyo ngemuva kokuhlola ukuhlolwa kwe-pelvic, noma umuntu angabonisa ngezimpawu zamathambo (ukusakazwa) esitokisini esenza lezi zinyathelo ezilandelayo.
Ezinye izivivinyo ze-imaging, ezifana ne-CT, MRI, ne-PET, kanye nezinye izivivinyo zegazi zingase ziyalwe (ngokuyinhloko ukubona ukuthi umdlavuza, uma ukhona, usakazeke). I-biopsy iyadingeka kokubili ukuqinisekisa ukuxilongwa nokubona uhlobo lomdlavuza we-ovariya olutholakalayo.
Ngemuva kokuxilongwa, ukufakwa kwesisu kubaluleke kakhulu ukuze kunqume izinketho zokwelashwa ezifanele kakhulu. Lokhu kungenziwa ngenhlanganisela yokuthola izifo zesampula ze-biopsy nokuhlola izithombe, kepha ngokuvamile kudinga ukuhlinzwa.
Ukwelapha
Izinketho zokwelashwa zomdlavuza we-ovari zixhomeke kuhlobo, isigaba, nesigaba somdlavuza we-ovarian, kanye nezinye izinto ezifana nobudala kanye nempilo ejwayelekile.
Kunezindlela ezintathu zokwelashwa eziyinhloko zomdlavuza we-ovarian. Ukuhlinzwa okuhlangene ne-chemotherapy kuyindlela ejwayelekile kunazo zonke yokwelashwa kwabo bonke kodwa izigaba zokuqala zesifo. Ukwelashwa kwezidakamizwa akuvame ukusetshenziswa kodwa kunganconywa abanye besifazane abanezidakamizwa ezinzulu esiswini.
- Ukuhlinzwa: Ukususwa kwe-ovary ne-fallopian tube ngakolunye uhlangothi kungacatshangelwa kulabo abanethemba lokulondoloza ukuzala kwabo . Ukuhlinzekwa nge-Debulking noma i-cytoreduction kungacatshangwa ukuthi kususwe ubuningi be-tumor (kanye nama-metastase) ngangokunokwenzeka ukuze kwandiswe ukusebenza kwe-chemotherapy.
- I-Chemotherapy: I- Chemotherapy isetshenziselwa ukuqeda umdlavuza wamangqamuzana asele ngemva kokuhlinzwa, noma ukunciphisa ingozi yokuphindaphinda lapho kungekho mdlavuza ocacile ohlala khona. Kungabuye inikezwe yedwa njenge- chemotherapy ene-palliative ukunciphisa izimpawu.
- Ukwelashwa okuhloswe: Lokhu kuhilela ukwelashwa nezidakamizwa ezikhomba izindlela ezithile ekukhuleni kwamangqamuzana omdlavuza. Ngenxa yokugxila kwabo, kaningi, kodwa hhayi njalo, banemiphumela emibi kakhulu kunezidakamizwa ezivamile zamakhemikhali. Kunezinhlobo ezimbili zezindlela zokwelashwa ezihlosiwe: lezo ezihloswe ukuvimbela ukwakheka kwemithambo yegazi emisha ngamathumba, nalabo abhekisela endleleni emdlalweni wesifo somdlavuza.
Izivivinyo zemitholampilo ziyaqhubeka nokufunda ukuhlanganiswa kwezilapha ezingenhla, kanye nemithi emisha, njengezidakamizwa ze- immunotherapy . Ngokusho kweNational Cancer Institute, abantu abatholakala benomdlavuza we-ovarian kufanele bacabange ukuthi bahlanganyele ekuvivinyweni komtholampilo.
Izwi elivela
Ngesikhathi samanje, eziningi ze-epithelial ovarian cancer zitholakala ngezigaba kamuva zesifo. Njengoba singenayo ukuhlolwa kokuhlolwa okunconywayo, kubalulekile ukuqaphela izimpawu futhi ufune ukunakekelwa kwezokwelapha uma uhlangabezana nanoma iyiphi yazo-ngisho noma ucabanga ukuthi ayilutho.
Uma wena noma othandekayo usanda kuthiwa unomdlavuza we-ovarian, ungase ukhathazeke kakhulu njengoba ubheka izibalo ezungeze lesi sifo. Naphezu kwalezi zinamba ezikhathazayo, ukwelashwa kwalesi sifo kuthuthuka njengoba kungamazinga okusinda, futhi eziningi zezilingo zomtholampilo zanamuhla zifuna izindlela ezintsha nezindlela zokuphatha iziguli.
> Imithombo:
> Hoppenot, C., Eckert, M., Tienda, S., no-E. Lengyel. Ubani Abaqaphi Besikhathi Eside Sengculazi Ephezulu? I-Serous Ovarian Cancer? . I-Gynecologic Oncology . 2018. 148 (1): 204-212.
> National Cancer Institute. I-Ovarian Epithelial, I-Tube yama-Fallopian, ne-Primary Peritoneal Cancer Treatment (PDQ) -Health Professional Version. Kubuyekezwe 01/19/18. https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq