Umdlavuza wesibindi kuvamile e-United States kodwa kuvamile emhlabeni jikelele ngenxa yezici ezinobungozi ezifana nesifo esiwumshayabhuqe esingapheli nesifo sofuba nesifo se-hepatitis C kanye nesifo se-aflatoxin. Izimpawu zingabandakanya i-jaundice (i-yellowing yesikhumba), ubuhlungu esifubeni esingaphezulu, ubuhlungu be-shoulder shoulder, kanye nokulahlekelwa kwesisindo. Odokotela baxilonga lesi simo besebenzisa inhlanganisela yokuhlolwa kwe-imaging nokuhlolwa kwegazi.
Kuye ngobukhulu besisu, ukhetho lwezokwelapha lungase luhlanganise nokususwa kwe-tumor, ukufakelwa kwesibindi, ukwelashwa okuhlosiwe, i-chemotherapy, kanye nokwelapha ngezinye izikhathi.
Umdlavuza wesibindi uvela esibindi, isitho esitholakala ngaphansi kwezimbambo zakho ezingezansi ngakwesokudla kwesisu sakho. Kubalulekile ukuhlukanisa umdlavuza wesibeletho esiyinhloko (i-hepatocellular carcinoma) nomdlavuza we-bile duct (cholangiocarcinoma) kusuka emathunjini aqala kwezinye izindawo zomzimba futhi asakaze esibindi (izibalo zesibindi). Amaphilisi e-foam isifo esivamile kakhulu kunezikhwama zesibindi esiyinhloko futhi aphathwa ngendlela umdlavuza oyinhloko (njengomdlavuza wamaphaphu noma umdlavuza webele), kunendlela indlela umdlavuza oyinhloko wesibindi uphathwa ngayo.
Imisebenzi yesibindi ibalulekile ukwazi ukuthi ubheka kanjani izimpawu zesifo. Isibindi sidlala indima ekuthungeni izinto, ukuvimba ubhiya ukuze kusize ekugayeni nokwenza ama-hormone abalulekile ekukhiqizeni amaseli abomvu egazi.
Ngaphezu kwamanqamu okukhulunywe ngaye ngenhla, kunezinhlobo ezingavamile zesifo somdlavuza wesibindi. Eminye yalezi zihlanganisa i-hepatoblastoma, uhlobo oluyinqaba lomdlavuza wezingane, kanye ne-angiosarcoma yesibindi. Lokhu kubuyekezwa kuzogxila kakhulu kumdlavuza wesibindi oyinhloko nomdlavuza we-bile wokuhamba.
Izimpawu
Izimpawu zomdlavuza we-fover zingavamile ezinyathelweni zokuqala zesifo ngaphandle kokuba isisu sisondele eduze kweminye yamadayidi ebhodlela futhi kubangela ukuvimbela (ngezimpawu ezifana nokuhlasela kwe-gallbladder).
Izimpawu zingafaka:
- Ubuhlungu kwesisu esisenhla kwesokudla
- Isisindo esiswini sangakwesokudla (ngaphansi kwezimbambo zakho noma okungase kube phansi)
- Ubuhlungu be-shoulder shoulder blade
- I-jaundice , ukuchithwa okuphuzi kwesikhumba kanye nabamhlophe bamehlo
- Isigxobo se-Pale noma esimhlophe
- Umchamo omnyama
- Ukuzonda okukhulu
- Ama-Ascite , i-build-up fluid esiswini
- I-fever (ama-101 degrees noma ngaphezulu ahlala izinsuku ezimbalwa ngaphandle kwempawu ebonakalayo yokutheleleka)
- Ukulahleka kwesisindo okungenalutho ngaphandle kokushintsha okukhulu ekudleni noma ekuzivocavoca
- Izimpawu ezingenasisekelo ezifana nokulahlekelwa yidla, ukukhathala, nomqondo ojwayelekile wokungahlali kahle
Izimbangela Nezici Zengozi
Asinaso isiqiniseko sokuthi kungani imbangela yalesi sifo, nakuba siyazi ngezinkinga ezimbalwa ezibangelwa isifo somdlavuza wesibindi . Iningi lalezi zingozi ezibangelwa ukonakala (isibindi) sesibindi, nakuba umdlavuza wesibindi ungase uthuthuke ngaphandle kwe-cirrhosis.
Ingozi ejwayelekile kunazo zonke zesifo somdlavuza wesibindi ingenye yezinhlobo ze-hepatitis. Ngokubambisana, isifo sobhejane B nesifo se-hepatitis C kucatshangwa ukuthi imbangela yamaphesenti angama-85 wegciwane lesibindi emhlabeni wonke. Ezinye zezici eziyingozi zihlanganisa:
- Ukusetshenziswa kotshwala nokubhema: Ukusetshenziswa kotshwala okwedlule isikhathi eside (iziphuzo ezingaphezu kwezingu-3 ngosuku) ngokucacile kuhlotshaniswa nokuthuthukiswa kwe-cirrhosis, futhi kungabangela ingozi yomdlavuza wesibindi. Ukubhema kubonakala kuphakamisa ingozi, ikakhulukazi uma kuhlangene nezinye izinto eziyingozi, njenge-hepatitis B.
- Umlando womndeni kanye nezifo zofuzo: Uma unelungu lomndeni onesifo somdlavuza wesibindi, ingozi yakho iphakeme kunezilinganiso. Ingozi nayo yanda kulabo abanezifo zofuzo ezifana ne- hemochromatosis nesifo sikaWilson.
- Izimo zezokwelapha: Izimo zezokwelapha ezandisa ingozi yomdlavuza wesibindi zibandakanya i-sclerosing cholangitis eyinhloko, i-cirrhosis eyinhloko ye-biliary, isifo sesibindi esingenalo utshwala , nesifo sikashukela.
- I-Aflatoxin ukuchayeka: Okuvamile eNetherlands, kodwa emhlabeni jikelele, ukuvezwa kwama-aflatoxin-amakhemikhali akhishwe yi-fungi ekhula ngamagilebhisi namagxolo angalungile-iyimbangela enkulu yesifo somdlavuza wesibindi.
Ukuxilongwa
Labo abanezimpawu zesifo somdlavuza wesibindi noma izingozi zokuthuthukisa lesi sifo kumele babone udokotela wabo. Udokotela angathatha umlando oqaphele futhi enze ukuhlolwa ngokomzimba. Kwabanye, ukuhlolwa kokuhlola kungacatshangwa. Kuye ngokuhlola, inhlanganisela yokuhlolwa kwegazi nokucwaninga nge-imaging nayo ingenziwa.
- Ama-Labs nezivivinyo: Umsebenzi wegazi (njengokuhlolwa kwesibindi ), iphaneli ye-hepatitis, kanye nabamaki be-tumor ngokuvamile yizinyathelo zokuqala zokuthola umdlavuza wesibindi. Isivivinyo esithile esithile, ukuhlolwa kwe-alpha-fetoprotein tumor marker marker (AFP), kungalawulwa ukuthi kuhlolwe izifo zesibindi.
- Ukucabanga: Ukuhlolwa kokuqala kwe-imaging okuvame kwenziwa kwenziwa i-ultrasound. Ezinye izivivinyo ezingase ziwusizo ekuxilongweni zihlanganisa i-MRI ne-CT. I-angiogram yesibindi ingabuye iphakanyiswe.
- I-Biopsy: Ngokungefani ne- kansa eminingi, ukuxilongwa kwesifo somdlavuza wesibindi kuvame ukususelwa ekucatshangweni okufingqiwe kunokuba kube yi-biopsy. I-biopsy ingase ingadingeki ngaphandle kokuthi kubalulekile ukuqonda izici zamangqamuzana zesisu, njengesivivinyo somtholampilo.
Ukwelapha
Izinketho zokwelapha ezitholakala kumdlavuza wesibindi zixhomeke esigabeni sesifo, impilo yakho jikelele, nokunye okuningi. Izinketho zokwelashwa ziwela emakamu amabili:
I-Treatment System
Lezi zilapha amangqamuzana omdlavuza kunoma yikuphi lapho zikhona khona futhi iyindlela enkulu yokudla kancelisi yesibindi esiphezulu.
Izinketho zihlanganisa:
- I-Chemotherapy: Kukhona inhlanganisela ehlukene yemithi ye- chemotherapy enganikezwa isifo somdlavuza wesibindi. I-Chemotherapy isebenza ngokuhlasela amaseli ahlukanisa ngokushesha emzimbeni. Ngeshwa, kukhona amangqamuzana avamile emzimbeni ohlukanisa ngokushesha, okwenza kube nemiphumela emibi kakhulu yamakhemikhali, njengokulahlekelwa kwezinwele kanye nokwanda okukhulu kokutheleleka. I-Chemoembolization yinkqubo lapho i-chemotherapy ihlinzekwa khona ngqo emthini omkhulu (ongama-transarterial) ongena esibindi. I-Chemoembolization ingasetshenziselwa ukwelashwa okuyinhloko, kepha isetshenziselwa ukunciphisa ukukhula kwesisu ngenkathi umuntu elindele ukufakelwa kwesibindi.
- I- thérapie ehlosiwe: Imithi yokwelashwa ehlosiwe ihluke kusuka kumakhemikhali ngoba "ihlose" indlela ethile ekukhuleni kwesifo somdlavuza. I-Nexavar (sorafenib), uLenvima (lenvatinib), ne-Sivorga (regorafenib) konke kuthuthukisa ukusinda futhi okwamanje kunezokwelapha ezijwayelekile kubantu abane-cancer ephakeme yesibindi.
Izindlela zokwelashwa zendawo
Lawa aphathe umdlavuza lapho uvela khona. Izinketho ezingacatshangelwa zihlanganisa:
- I-hepatectomy ehlukile: Lokhu kukhishwa kokukhishwa komdlavuza nezinye izicubu ezijwayelekile. Lokhu kungaba okukhethwa kukho kwezicubu ezincane zesibindi (ngaphansi kuka-5 cm ububanzi), kuye ngokuthi indawo yazo.
- Ukufakelwa kwesibindi: Isibindi sesifo sisusiwe futhi sithathwe indawo ethile noma isibindi sonke esinempilo. Lokhu kungaba yindlela enhle kulabo abanesifo esiningi noma abaye bahlukumeza ukwehluleka kwesibindi kodwa ngenye indlela empilweni enengqondo.
- Ukwelashwa kwezidakamizwa: Lokhu kungabandakanya ukwelashwa kwemisebe yangaphandle ye-radium (ukwelapha indawo enkulu ye-tumor, ngokuvamile ukunciphisa izimpawu noma ukwandisa impilo, hhayi ukuphilisa isisu); i-radiotherapy yomzimba, noma i- SBRT (esebenzisa umthamo omkhulu wemisebe yendawo encane yezicubu ukuqeda isisu); noma i-brachytherapy (ukubeka ubuhlalu obusakazayo esibindi).
- I-Radiofrequency ablation (RFA): Lokhu kuyisisetshenziswa esine-electrode encane ebhubhisa amangqamuzana omdlavuza.
- I-Cryotherapy: Lokhu kuhilela ukuqeda izicubu zomdlavuza.
- Umjovo we-ethanol we-Percutaneous: Lokhu kuhilela umjovo wesiphuzo esibusweni futhi inqubo ephephile kakhulu yezicubu ezincane, kodwa ikakhulukazi ithathelwe indawo yokukhishwa kwe-radiofrequency eminyakeni embalwa yamuva.
Kungakhathaliseki ukuthi uluphi uhlobo lwezokwelapha ozokhetha wena nodokotela wakho, kufanele wazi zonke izinketho ezitholakalayo. I-National Cancer Institute iphinde ikhuthaze ukucubungula ukhetho lwezilingo zomtholampilo . Abaningi bayaqhubeka futhi babheka izinhlanganisela zezikhungo ezingenhla, kanye nezinqubo ezintsha ezifana ne- angiogenesis inhibitors , izindlela zokuzivikela nge-immunotherapy , nokuningi.
Ukunakekelwa kwe-Palliative
Ukunakekelwa kwe-palliative kuhilela ukuphatha izimpawu zesifo somdlavuza nomdlavuza, kunomdlavuza ngokwawo. Ngokungafani nokunakekelwa kwe-hospice, ukunakekelwa kwe-palliative kungase kusetshenziswe ngisho nabantu abane-kansa ephilile kakhulu. Ngaphezu kokuthuthukisa ikhwalithi yokuphila, isifundo se-2018 sikhombisa ukuthi lolu hlobo lokunakekela lungathuthukisa imiphumela yabantu abanomdlavuza wesibindi kanye.
Ukuvimbela
Uma kuziwa ekuvimbeleni umdlavuza wesibindi , i-ounce yokuvimbela ifaneleka isisindo somuthi-futhi ukuvimbela ukushisa kwesifo sofuba B no-C kubaluleke kakhulu. Uma ungakwazi ukugwema ukuthuthukisa lezi zifo, noma ukuthola ukwelashwa uma unayo, ungase unciphise ingozi yomdlavuza wesibindi ngamaphesenti angaba ngu-90. Ngisho nalabo abathwala lezi zifo, kunezindlela zokwelapha ezinganciphisa ingozi yokukhula kwe-cirrhosis, futhi mhlawumbe umdlavuza wesibindi.
Nciphisa ukusetshenziswa kwakho kotshwala, futhi uma ubhema, shiya. Thatha isikhathi sokufunda ngomlando wakho womndeni kunoma yiziphi izimo zezokwelapha, ikakhulukazi lezo eziholela ezinkingeni zesibindi. Futhi uqaphele nganoma yimaphi amakhemikhali owakuthola emsebenzini, njengoba amanye alawa ayaziwa ngenxa yesifo somdlavuza wesibindi.
Ukubhekana
Uma wena noma othandekayo uthola ukuthi unesifo somdlavuza wesibindi, ungase uzizwe sengathi umhlaba wakho uphenduke phansi. Noma kunjalo, kunezinto ongayenza ezingakusiza uzizwe sengathi unamandla okuphefumulela okungenani. Funda okuningi ngangokunokwenzeka mayelana nomdlavuza, kodwa qaphela ukubheka ulwazi olusanda kulwazi olusesikhathini. Ukwelapha nezinga lokusinda ziyathuthuka, futhi ulwazi oluneminyaka embalwa lungase lungabonakali lezo zinguquko. Okufanayo kuya ezibalo zokusinda.
Ukuxhuma nomphakathi wesifo somdlavuza wesibindi kungabasiza kokubili ngokombono wokusekelwa ngokomzwelo futhi njengendlela yokufunda ngocwaningo lwamuva mayelana nomdlavuza wesibindi. Abantu abaphila nalesi sifo bashukunyiswa futhi bavame ukwazi okuningi kunabanye oncologists jikelele mayelana nezindlela zokwelapha zakamuva. Ungabheka iqembu lokusekela emphakathini wakho, noma uthole umphakathi womdlavuza wesibindi ku-intanethi. Ukuze uthole abantu abalungile, zama ukusebenzisa ama-hashtag #livercancer kanye #livertumor.
Finyelela emndenini nabangani futhi wamukele ukusekelwa abanganikeza. Ukubhekana nomdlavuza wesibindi ngempela kuthatha idolobha.
Ukunakekelwa
Bambalwa abantu abazwa umdlavuza ngokweqile, futhi ukubhekana nesifo somdlavuza wesibindi kungaba yinselele kumnakekeli womndeni njengalabo abaphila nalesi sifo. Ingxenye yezinkinga ezinzima kakhulu zokunakekelwa ngumqondo umuzwa wokungabi namandla ongase uzizwe, kodwa kunezindlela ongamsiza ngazo zombili othandekayo wakho futhi ubhekane nalo mzwelo. Ukufunda kabanzi mayelana nomdlavuza wesibindi yindawo enhle ukuqala.
Ukungqubuzana kuvamile lapho abantu abanomdlavuza nabathandekayo babo behluke endleleni abazobhekana ngayo nokwelapha. Nika imicabango yakho, kodwa khumbula ukuthi lolu luhambo lomuntu othandekayo oludinga ukuhamba ngendlela yakhe.
Okokugcina, kubaluleke kakhulu kunanini ngaphambili ukuzinakekela njengomnakekeli kanye. Lokhu kungase kubonakale kungenakwenzeka ngezinye izikhathi, kodwa kuthatha isikhathi ukuqinisekisa ukuthi izidingo zakho siqu zihlangene nakho kuzokusiza ukuba uhlale uphilile ngangokunokwenzeka ngenkathi unakekela othandekayo wakho.
Izwi elivela
Uma ukhathazekile ukuthi unomdlavuza wesibindi, khuluma nodokotela wakho. Ukwelapha kuphumelela kakhulu ezinyathelweni zokuqala zesifo, futhi ukubamba lezi zansana kuqala kunika ithuba lokuthola ukwelashwa.
Kulabo abatholwe benesifo somdlavuza wesibindi, kusekhona ithemba. Ukwelashwa kuyathuthuka, futhi ukwelapha okusha kuyatholakala ekuvivinyweni kwemitholampilo. Qinisekisa ukuba yingxenye esebenzayo yokunakekelwa komdlavuza wakho. Funda ukuthi ungaba kanjani ummeli wakho, noma uthole umngane noma othandekayo ongakuphikisa. Ukuzimela, uma unomdlavuza, akutholakalanga nje ukunciphisa ukukhathazeka kodwa ngezinye izikhathi kungase kuthuthukise imiphumela.
> Imithombo:
> Forner, A., Reig, M., noJ. Bruix. I-Hepatocellular Carcinoma. I-Lancet . 2018 Jan 4. (Epub ngaphambi kokuphrinta).
> National Cancer Institute. I-Primary Liver Cancer Treatment (PDQ) -Health Professional Version. Kubuyekeziwe -2/06/18. https://www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq
> Woodrell, C., Hansen, L., Schiano, T., noN. Goldstein. Ukunakekelwa Kwama-Palliative Kwabantu abane-Hepatocellular Carcinoma, Nezinzuzo Eziqondile Kubantu Abadala. Therapeutics Clinical . 2018 Mashi 20. (Epub ngaphambi kokuphrinta).