Iziguli zomdlavuza we-prostate, uhlelo oluhle kakhulu lwezokwelapha luyisici esibaluleke kakhulu sokusinda isikhathi eside, futhi ukuthola ukuthi ukwelashwa okuhle kuqala ngesiteji esinembile. I-Prostate Cancer Research Institute (PCRI) inikeza izinsiza eziningi zokusiza iziguli zithole futhi ziqonde isigaba sabo. Bahlukanisa iziguli zibe yizigaba ezinhlanu, banikela omunye emthunzini ohlukile weBlue- Sky, Teal, Azure, Indigo noma iRoyal.
Isigaba sitholwa ngokuphendula imibuzo emibuzo eyisishiyagalombili ehlobene nezici ezihlukahlukene-i- PSA , i-biopsy, izilinganiso, nokuhlolwa kwe-digital rectal-ezitholakala eshadini lezokwelapha. Isixhumanisi semibuzo ye-PCRI sisekhasini lasekhaya le-PCRI ku-pcri.org.
I-Chart Medical
Asikho isidingo sokuba isiguli sihlasele ngokucela udokotela wakhe ikhophi yeshadi lezokwelapha. Iziguli zinezizathu ezifanele kumarekhodi abo, futhi ukuba nolwazi olukhona ngezandla lungabasiza ukuba baqonde kangcono umdlavuza wabo, banqume isigaba sabo, futhi bakhethe uhlelo olufanele lwezokwelapha. Amanye amahhovisi angase akhokhe imali ekhokhwayo, futhi kungadingeka ukuthi ucele ulwazi kusuka emahhovisi angaphezu kwelilodwa ukuhlanganisa yonke imininingwane edingekayo. Uma isiguli sinekhophi yeshadi lakhe lezokwelapha, uzobona ukuthi lihlukaniswe laba yizigaba ezibhalwe ngebhola labatholampilo, izifo, amaphuzu okuqhubekayo kanye ne-radiology. Kulezi zigaba iziguli zizothola ulwazi oluthile oludingekayo ukucacisa isigaba sabo:
I-Laboratory
Ngemuva kokuba isiguli sithola ishadi, kufanele senze umlando wokulandelana kwazo zonke amazinga we-PSA. Ngemibuzo, i-PSA ephezulu ingenisiwe. Ukuphela kokuphela kungaba iPSA engavamile ngenxa ye-traumatic trauma. Isibonelo, amazinga we-PSA azohlala ephakanyisiwe izinyanga ezimbili ngemuva kwe-needle biopsy.
I-PSA ingahle iphakanyiswe kahle ngamahora angu-24 noma ngemuva kokuhlolwa kwe-digital rectal noma ngemuva kokusebenza ngokocansi. Esinye isici izinga le-testosterone egazini. Ngezinye izikhathi amadoda asebekhulile anamazinga aphansi e-testosterone, athi angaphansi kuka-100, azoba ne-PSA ekhishwe ngokugcwele. Uma ukuhlolwa kwe-testosterone kungakenziwa, iziguli kufanele zikhulume odokotela bazo ngesikhathi sokuhlolwa kwegazi okulandelayo. Ekugcineni, uma kungekho okunye okushiwo ngenhla, omunye kufanele asebenzise i-PSA ephakeme uma ebala isiteleka somdlavuza.
I-pathology
Umbiko we-biopsy ugcinwa esigabeni sokukhubazeka kweshadi. I-prostate biopsy engahleliwe ingabandakanya noma yikuphi okuvela ku-6 kuya kwezingu-20 noma ngaphezulu kwama-biopsy cores. Ulwazi oluvela kwi-biopsy luhlukaniswe ngezigaba ezintathu ezizimele. Isigaba esisodwa sihlobene nebanga lomdlavuza, okuthiwa yiGleason score . Ezinye ezimbili zihlobene nomdlavuza otholiwe. Ake sihlanganise inani lemali kuqala:
- Inani lezinhlamvu eziqukethe umdlavuza linikeza umqondo wesayizi we-tumor. Isibonelo, ukuba nengqikithi yezinhlamvu ezine zomdlavuza eziphuma kumakhiwane ayisithupha kusikisela ukuthi isisu esinesisindo esihle sisekhona, ngoba ingxenye engaphezu kwesigamu sezinhlamvu ziqukethe umdlavuza. Ngakolunye uhlangothi, esinye isibonelo singabe sinezinhlamvu ezimbili zomdlavuza eziphuma kuma-cores angu-20, okungafakazela ukuthi lesi sifo sincane kakhulu.
- Kubuye kubalulekile ukucabangela ukuthi ingakanani umdlavuza okhona ngaphakathi kwendawo ngayinye ye-biopsy. Ukwazi iphesenti yamathisayo omdlavuza engundoqo kusiza ukucacisa ubukhulu besisu (okusho ukuthi umdlavuza ukhula kanjani futhi usakazeke). I-pathologist obuka ingqikithi nge-microscope angakwazi ukwahlulela ukuthi ingakanani yomgogodla ishintshwe umdlavuza nokuthi ubuningi bomgogodla buqukethe izicubu ezivamile zesisu. Lolu lwazi lungabikwa ngezindlela ezimbili: Okokuqala, lungaboniswa njengenani eliphelele lamamitha omdlavuza (1 kuya ku-18, ne-18 emele ubude bomhlaba wonke). Ngaphandle kwalokho, inani lomdlavuza engqenjini lingabikwa njengephesenti yenani eliphelele. Ngokujwayelekile, umbiko wezokugula uveza lolu lwazi njengamaphesenti kanye nenani lamamitha. Ngakho izinga lomdlavuza lingaqondwa kokubili ngenani lezinhlamvu eziqukethe umdlavuza nokuthi umdlavuza ngamunye umgogodla uqukethe, njengoba kuboniswe ngamaphesenti noma njengephesenti.
- Lapho abantu becabanga nge-prostate biopsy, isiqephu seGleason, esibonisa ibanga lomdlavuza, ngokuvamile yiyona nto yokuqala efika engqondweni, futhi yilokho okucabangayo. Ibanga libonisa indlela engavamile ngayo amangqamuzana omdlavuza, futhi kubaluleke kakhulu kunesayizi se-tumor. Isibonelo, kungcono kakhulu ukuba ne-tumor enkulu kakhulu yebanga lesi-6 kunesikhumba esincane kakhulu sebanga le-10.
Uhlelo lwe-Gleason lokubamba luhlelwe eminyakeni eminingi edlule, futhi, ngenxa yalokho, luneziqu zalo. Isibonelo, amaphuzu aphansi kunawo wonke angama-6 futhi aphezulu kakhulu. Isilinganiso se-Gleason esibikwa njenge-6 sizobhalwa njengo-3 + 3 = 6. I-Gleason ayisishiyagalolunye izobhalwa njengo-4 + 5 = 9 noma njengo-5 + 4 = 9. Uma i-biopsy iqukethe izikolo eziningana ezihlukene, amaphuzu aphezulu kusuka kulo mbiko yilowo okufanele afakwe emibuthanweni.
Isiteji | Incazelo |
I-T1 noma i- "A" | I-T1c: I- Tumor ayikwazi ukuzwa ngokuhlolwa kwe-digital rectal |
I-T2 noma i- "B" | I-tumor ivalwe ngaphakathi kwe-prostate I-T2a : I-Tumor izwa yi-DRE kodwa ingaphansi kwesigamu se-lobe eyodwa I-T2b : I-tumor yangasese evezwe yi-DRE equkethe ingxenye engaphezu kwesigamu se-lobe eyodwa I-T2c : I-tumor ye-Bilateral izwa kuzo zombili lobes |
T3 noma "C" | I-tumor izwa yi-DRE ehamba nge-capate capsule I- T3a: isandiso se-Extracapsular I-T3b : I-Tumor izwa yi-DRE ehlasela ama-vesicle (s) |
T4 | I-tumor izwa yi-DRE ehlasela i-rectum noma isinye |
Amanothi okuthuthuka
Imiphumela evela ekuhloleni komunwe we-prostate, okuthiwa i-digital rectal examination, noma i- " DRE ", ibizwa ngokuthi isigaba sezempilo noma isigaba se - T . Endaweni ethile kumanothi okuqhubekayo, ngokuvamile endaweni ekhonjiwe ngokuthi "Ukuhlola Ngokwemvelo," udokotela uzorekhoda ukuthi ngabe uzizwa yini noma yikuphi ukulinganisa, futhi uma kunjalo, ubukhulu bomzimba obunjalo. Uhlelo lokukwaziswa odokotela abasebenzisa ukurekhoda okutholakele eshadini lunikezwa etafuleni elingezansi. Ukuze uphendule imibuzo uzodinga ukwazi isigaba sakho se-T.
Imibiko ye-Radiology (Imaging Studies)
Ukuchazwa kwanoma yikuphi ukucabanga kwesiguli esivele kunakho kuyotholakala esigabeni sama Radiology eshadini. Le mibiko ibhaliwe yi-radiologist, onguchwepheshe ozinikele ekufuneni ama-scans. Ulwazi olubaluleke kunazo zonke oluqukethwe umbiko we-radiology lufingqiwe esigabeni esithi "Ukushicilelwa." Ngenhloso yemibuto, amaqiniso abaluleke kakhulu okumele atholakale embikweni we-prostate MRI yilokho okukhona noma okunye okulandelayo: extracapsular isandiso, ukuhlasela kwe-vesicle, noma ukusabalalisa kwe-lymph node.
Ezinye izicathulo, ngokuvamile ukukhipha amathambo noma ukuhlolwa kwe-CT kwesisu nesifuba (ukufuna izitho zamakhansela ezikhulisiwe), kungenziwa, ikakhulukazi emadodeni ama- PSA amazinga angaphezulu kuka-10 noma i-Gleason yayo ingaphezulu kuka-6. Uma i-CT noma i- I-bone scan ibonisa umdlavuza we-metastatic , kubalulekile ukuqaphela indawo ye-metastases nokuthi, noma ngabe i-metastase iphela emigqumeni ye-lymph ye-pelvic noma kwenye indawo yomzimba. Iskena esisha okuthiwa i- Axumin isebenzisa i-positron emission tomography (i-PET) futhi inembile kakhulu kune-CT scan. Njengoba izinto zimi njengamanje, i-Axumin ivunyiwe kuphela yi-FDA ekuhloleni kwamadoda abuyele emuva kwesifo (i-PSA ekhulayo) ngemuva kokuhlinzwa noma ukushiswa kwemisebe.
Noma yimuphi ukwelashwa kwangaphambili kwe-Cancer Prostate?
Isici sokugcina okufanele sicatshangelwe uma uthatha imibuzo ye-PCRI's staging isifo sokuthi kukhona yini ukwelashwa kwangaphambili komdlavuza wesifo sofuba. Amadoda athola ukwelashwa kwangaphambilini ngokuhlinzwa, imishanguzo, i-cryotherapy, noma i-hormone blockade manje esebenzelana ne-PSA ekhulayo ngokuvamile inomdlavuza owedlulele wesifo sofuba futhi ngaleyo ndlela ibelwe esigabeni esithile. Kodwa-ke, akusiyo njalo i-crystal ecacile ukuthi yini eyenza umdlavuza ubuyeke. I-PSA ekhulayo ngokuvamile ibonakaliso enembile, kodwa iziguli kudingeka zijwayelane nokunye okubukeka komdlavuza we-relapsing.
I-PSA ivuka emva kokuhlinzwa
Ukuqapha i-PSA ngemuva kokuhlinzwa kunembile. I-PSA, emva kwakho konke, kulindeleke ukuba ibe yero uma i-prostate gland isuswe ngokuphelele. Kodwa-ke, ukukhishwa okuphelele kokugcoba akulula futhi inani elincane le-prostate lingashiywa ngemuva. Uma lokho kwenzeka, i-PSA ingase ihambe ngokungapheli emkhakheni we-0.1 kuya ku-0.3, ngisho noma kungekho mdlavuza. Amadoda anamazinga aphansi kakhulu e-PSA ngemuva kokuhlinzwa angacabangela ukwelashwa okusheshayo okusheshayo nokuqapha i-PSA yabo eduze ukuze abone ukuthi kukhona ukunyuka okuphezulu. Ukwelashwa kungavinjelwa uma i-PSA ihlala igxile. Uma isikhathi eside i-PSA ihlala isigxilile, cishe i-PSA ingenxa yokuhlala i-prostate gland tishu kunomdlavuza.
I-PSA iphakama ngemva kokusakazwa kwemisebe
Ukuqapha i-PSA ngemuva kwemisebe kungaba yinselele. Njengengqalasizinda embi, cabanga ukuphakama kwe-PSA ngaphezu kwe-1.0 ukuba "okungavamile." Kodwa kukhona okuhlukile. Kungenzeka ukuba ube ne-PSA engaphezulu kwe-1.0 futhi ungenaso umdlavuza. Ukuphakama kwe- PSA okungenangqikithi kwenzeka ngempela kunomumo ngemva kokushisa imisebe, ikakhulukazi ngemva kwemifucumfucu yembewu. Lezi ziphakamiso zibizwa ngokuthi "i-PSA bounce." Ukunciphisa kuthathwa ukuthi kubangelwa ukuvuvukala kwe-prostate-infusion, okungukuthi, i- prostatitis . Ngenhlawulo, okubaluleke kakhulu ukuyihlukanisa nomdlavuza. Indlela enokwethenjelwa kakhulu yokwenza lokhu ukuhlola igrafu eqhubekayo yamazinga amaningi e-PSA ahloliwe isikhathi esiningi. I-PSA kusuka kumdlavuza ophindaphindiwe ijwayele ukubonakalisa njengenqubekela phambili ebushelelezi, engavamile, ephakeme. Njengoba ukuqhuma kubangelwa ukuvuvukala, la mazinga e-PSA athambekele ekuguleni futhi agxilile, aqhube phezulu futhi ahlele egrafu ephatheni le-zig-zag, iphethini yokupaka.
Ukuqapha Ukwelashwa Kwama-Hormonal
Ukumelana namahomoni kuchazwa ngokuthi i-PSA ekhulayo naphezu kwamazinga aphansi e-testosterone egazini. Amazinga e-PSA kufanele abuyekezwe ekuqalisweni kwe-hormone therapy futhi ngokuqhubekayo. Ukuthola ukumelana nokuvimbela i-hormone kulula kakhulu ngoba i-PSA kufanele ihlale ingaphansi kwe-0.1 ezinyangeni ezingu-6 kuya kwezi-8 zokuqala ukuvimbela i-hormone. Uma lokhu kuhluleka, ngokuvamile kusho ukuthi i-PSA izoqala ukukhula esikhathini esizayo esiseduze.
Isiphetho
Njengoba uhlola izinketho zakho zokwelashwa ezihlukahlukene, kufanele ubuyekeze ishadi lakho lezokwelapha uphinde ugcwalise imibuzo ye-PCRI ukuze ubone isiteleka sakho somdlavuza. Ukuqonda ukuthi ukuhlinzeka isiteleka kumdlavuza wakho kuzokubopha kanjani ukuqonda okudingekayo ukuze ukhethe uhlelo oluhle lokuphulukisa futhi uthuthukise izinkinga zakho zezinga eliphezulu lokuphila nokuphila okukhulu.