Umdlavuza wezinso uhlanganisa izifo ezimbalwa ezihlukene, nakuba i-renal cell carcinoma iwuhlobo oluvame kakhulu. Ngokomlando, izimpawu zobuhlungu be-flank (ubuhlungu ohlangothini oluphansi nangemuva), isisindo somzimba, kanye negazi emcimbini kwakuyizibonakaliso ezivame kakhulu zokuveza, kodwa namuhla zivame ukusola lapho umuntu edala i-anemia (isibalo esincane segazi elibomvu) , noma "njengengozi" uma ucabanga ukuthi izivivinyo zenzelwe esinye isimo.
Ukuhlolwa kwe-CT kuyisimo esivamile kakhulu sokuhlola, nakuba ezinye izifundo ze-imaging zingenziwa futhi. Umdlavuza wezinso usuke uhlukile kulowo msebenzi wokuhlinzwa kungenziwa ngisho nezicubu eziphambili. Zombili ezihloselwe izindlela zokwelapha nezidakamizwa zingasetshenziswa, nge-chemotherapy kanye nokwelashwa kwemisebe edlala indima encane kunezinye ezinye zegciwane.
Kunezinhlobo eziningana zomdlavuza wezinso kubandakanya:
- I-Renal cell carcinoma: I-Renal cell carcinomas yiyona ndlela ejwayelekile kunazo zonke zomdlavuza wezinso kanye ne-akhawunti yama-9 kwezingu-10 zomdlavuza wezinso.
- I-transitional cell carcinoma: i-Transitional cell cell carcinomas akhawunti engama-7 amaphesenti e-cancer. Zivela ohlobo olufanayo lwamangqamuzana abathintekayo emdlavuza wesibeletho, futhi i-transitional cell carcinoma iphathwa kangcono njengomdlavuza wesisu kunomsoco we-cell carcinoma.
- Isifo sikaWilm: isisu sikaWilm ngumdlavuza ovame ukukhula ngesikhathi seyingane, futhi phakathi kokudla komdlavuza, kujwayelekile.
- I-sarcoma yama-renal: I-Sarcoma yezinso yisifo esiyinqaba esingajwayelekile esiqala emathanjeni axhunyiwe wezinso.
Le ngxoxo izogxila ngokuyinhloko kwi-renal cell carcinoma.
I-Anatomy neSebenzi
Ukwazi kancane mayelana nesimo somzimba kanye nokusebenza kwezinso kungakusiza ukuba uqonde kangcono izimpawu zakho, futhi uqonde ukuthi umdlavuza kule ndawo ungathinta kanjani umzimba wakho.
Izinso zakhiwa izitho ezimbili ezinobhontshisi, ngobukhulu besibhamu esincane. Izinso ngayinye zitholakala ngemuva kwezitho zomzimba zesisu, ngakwesokunene somgogodla, ngokulandelana. Abanye abantu banezinso ezilodwa kuphela, ngenxa yecala lokuzalwa noma ukugula. Bangaphila kahle ngezinso ezilodwa kuphela, uma nje lezinso zisebenza.
Imisebenzi eyinhloko yezinso ukuhlunga ukungcola, ukususa amaminerali amaningi kanye nosawoti, futhi ususe amanzi angaphezu kwegazi; okuyizinto zonke ezikhishwe emcinini. Amakhilomitha angaba ngu-180 (ama-altare angama-45) wegazi ahlungwa ngezinso zethu nsuku zonke, ukukhiqiza cishe 1 kuya ku-2 amakhilomitha omchamo. Umchamo bese uhamba ngezansi nezilimo eziyizigaxa, ezibizwa ngokuthi ama-ureters, futhi zigcinwe esilinganisweni kuze kube yilapho ukuphuma (ukuvuthwa).
Ngaphakathi kwezinso kukhona ezingaphezu kwezigidi zephrononi, i-unit function of the izinso. I-nephron ngayinye ikhiwa i-glomerulus ne-tubule. Umdlavuza wezinso (i-renal cell carcinoma) kucatshangwa ukuthi ivela emathinini we-nephron.
Izimpawu
Ngeshwa, izimpawu zomdlavuza wezinso azivame ukubonakala kuze kube yilapho lesi sifo siphumelele. Eqinisweni, isibonakaliso esivela kunazo zonke sokuveza umdlavuza wezinso yi-red red count count ( anemia ). Uma izimpawu zenzeka, ezinye zazo zingabandakanya:
- Igazi emcimbini , kubonakala ngemuva kokugcoba noma okuncane kakhulu.
- Isisindo eceleni kwesisu (umcibisholo).
- Ubuhlungu ohlangothini noma ophansi emuva (esifundeni se-flank).
- Umkhuhlane.
- Umfutho wegazi ophezulu.
- Ukulahlekelwa kwesisindo okungenalutho .
Izimbangela Nezicabangela Ze-Cancer Cancer
Nakuba singaqiniseki ngezimbangela eziqondile, abacwaningi baye baveza izinkinga eziningana zempilo yomdlavuza wezinso . Ezinye zazo zihlanganisa:
- Ubudala: Ingozi yomdlavuza wezinso iyakhula uma ineminyaka yobudala, kanti iningi le-cell rencin cell carcinomas livela ngaphezu kweminyaka engama-40. (Ngokuphambene, isikhumba sikaWilm sivame kakhulu ezinganeni.)
- Ubulili: Umdlavuza wezinso uvame kakhulu emadodeni kunabesifazane.
- Umjaho: Umdlavuza wezinso uvame kakhulu kubantu abamnyama namaNdiya aseMelika.
- Ukubhema: Abantu ababhemayo banengozi enkulu yomdlavuza wezinso.
- Ukusebenza: Ukuchayeka emsebenzini ezindaweni zamakhemikhali nezinto ezifana ne-asbestos, benzene, nokuningi.
- Ukukhuluphala .
- Umlando womndeni wesifo somdlavuza wezinso noma izifo ezithile ze-genetic syndromes.
- Ezinye imithi.
Ukuqaphela I-Cancer Cancer
Ukuxilongwa komdlavuza wezinso kungasolwa ngokususelwa ku-anemia, igazi emcimbini, izimpawu zomzimba, nokunye okungajwayelekile kokuhlolwa, futhi kuvame ukuhlanganiswa nokuhlanganiswa kokuhlolwa kwe-imaging. Ngokuphindaphindiwe, ukutholakala kobuningi ekutadisheni kwe-radiographic, njenge-X-ray, CT scan noma i-MRI, ngesikhathi uphenyo ngesinye isimo kungaholela udokotela ukusola umdlavuza wezinso.
Isivivinyo sokuqala uma umdlavuza wezinso usolwa ngokujwayelekile i-ultrasound. I-ultrasound isebenzisa amagagasi omsindo ukudala isithombe, futhi ingahlukanisa izicubu eziqinile ezivela kuma-cysts. I-CT (i-computerized tomography) mhlawumbe iyisivivinyo esiwusizo kakhulu futhi ingasetshenziselwa kokubili ukutholakala kanye nesiteleka somdlavuza wezinso. I-CT isebenzisa uchungechunge lwe-x-ray ukudala isithombe sesithathu esingaphakathi komzimba. I-MRI (imaging magnontic resonance) ingenziwa kubantu abangakwazi ukuthola i-CT (ngenxa ye-allergies kuya kwezinto ezihlukile ze-CT noma umsebenzi omncane wezinso). I-MRI isebenzisa ukucabanga kwamagnetic esikhundleni se-x-ray. I-MRI iyasiza futhi uma kucatshangwa ukuthi i-tumor isakaze emithanjeni eduze nezinso. Ngezinye izikhathi ukuhlolwa kwe-PET noma ukuskena kwethambo kwenziwa ukuze kusize ngokugxilisa isisu sezinso.
Ngokungafani nama-tumor amaningi, i-biopsy ngokuvamile ayidingi ukuhlolisisa umdlavuza wezinso. I-biopsy, uma kudingeka, ingenziwa ngezindlela ezimbalwa ezihlukene, futhi ivumela i-pathologists ukuba ibuke khona ukuba khona kwamangqamuzana omdlavuza ngaphansi kwe-microscope. Amasampula omdlavuza wezinso ayasiza kakhulu ekuqondiseni ukwelashwa ngezinqubo ezithintekayo, kodwa ngokuvamile atholakala ngenkathi ehlinzwa ukuze aphathe umdlavuza, kunokuba ngesikhathi senqubo yokuxilonga.
Isiteji
Uma umdlavuza utholakala, ukuhlolwa okungaphezulu kungadingeka kwenziwe ukuthi kunqume ukuthi umdlavuza wezinso usakaze kumathisini aseduze noma kwezinye izitho. Lokhu kubizwa ngokuthi isiteji. Umdlavuza wezinso ugxiliwe ngokulinganisa ubukhulu be-tumor, kanye nanoma yibuphi ubufakazi bokusabalalisa ezakhiweni eziseduze, noma ezindaweni ezikude zomzimba.
Ukwelapha I-Cancer Cancer
Ukwelashwa komdlavuza wezinso kuxhomeke esiteji sesifo, kanye nezinye izici eziningi, ezifana nempilo yakho jikelele, indawo yomdlavuza ezinso, nokuningi.
Abantu abaningi abanomdlavuza wezinso bazoba nohlobo oluthile lokuhlinzwa. Labo abanomdlavuza wezinso zakuqala bangcono kakhulu ukuhlinzwa, kodwa umdlavuza wezinso ungomunye wamathumba ambalwa okuqinile lapho ukuhlinzeka kungasiza ngisho nezifo eziphezulu eziphezulu (isigaba 4). Ngenkathi ukuhlinzwa kungukuthi ukwelashwa kwezinhlobo eziningi zezinso zezinso, lokhu kungaba nzima kubantu asebekhulile kakhulu noma labo abanezimo eziningi zezokwelapha eziningi. Kulabo abangenakubekezelela ukuhlinzeka, ukwelashwa okufana ne-cryosurgery (ukuphefumula i-tumor), noma ukukhishwa kwe-radiofrequency (ukuvutha isisu), kungaba okukhethwa kukho.
Imithi eminingi yokwelashwa ehlosiwe ivunyelwe ukusetshenziswa kwabanye abantu abanomdlavuza wezinso ophakeme. Lezi zidakamizwa zivimbela futhi zivimbele ukukhula nokusabalalisa kwamaseli amabi. Benza lokhu ngokuphazamisa ngqo indlela ehilelekile ekukhuleni komdlavuza, noma ngokuvimbela ukukhula kwemithambo yegazi okudingekayo ukuhlinzeka lesi sifo ngezakhi (zivimbela i- angiogenesis ). Imithelela emibi yalezi zidakamizwa ihluke kunezokwelapha zamakhemikhali, futhi kuvame ukubekezelela kangcono.
I-Immunotherapy , eyaziwa ngokuthi yi-biologic therapy, iyindlela entsha yokwelashwa yomdlavuza, esebenza ngokulula ngokuvuselela umzimba wesiguli somzimba ukuze ilwa namaseli omdlavuza. Kunezigaba ezimbalwa ezihlukene zalezi zidakamizwa ezitholakale ziphumelela kumdlavuza wezinso.
Ngaphandle kwezinketho zokwelashwa ezivunyiwe ezitholakalayo, okwamanje kuningi ukuhlolwa kweminye imithi eqhubekayo, ukufuna izindlela ezintsha zokwelapha ukuphatha umdlavuza wezinso. Ngokungafani nezinkolelo zemilingo yokuhlolwa kwemithi abaningi baye bazwa, ezinye zalezi zivivinyo manje zinikeza abantu ithuba lokusebenzisa imithi engase ikwazi ukuthuthukisa imiphumela yabo. Kungasiza ukukhumbula ukuthi yonke imithi okwamanje esinomdlavuza yake yafundwa esilingo somtholampilo, futhi ngesikhathi samanje, kokubili ukwelashwa, kanye namanani okusinda kusuka, umdlavuza wezinso uyathuthuka.
Imishanguzo ayivame ukusetshenziswa njengendlela yokwelapha umdlavuza wezinso, kepha ingasetshenziswa "nge-palliatively," ukuze kukhululwe ukungahambi kahle okubangelwa imiphumela yomdlavuza osabalalisa. I-Chemotherapy inegalelo elilinganiselwe ngokumelene ne-renal cell carcinoma.
Ukunakekelwa kwe-palliative, ukunakekelwa okugxila ekwelapheni izimpawu zomdlavuza nokuthuthukisa ikhwalithi yokuphila, kubaluleke kakhulu, ngisho nakubantu abanamasondo okuqala okuqala ukwelashwa.
Izwi elivela
Ukuze uthole umdlavuza wezinso ezindaweni zokuqala, kungenzeka kubalulekile ukuthi abantu baqaphele izimpawu zesifo, kanye nezinkinga zabo. Uma kutholakala, kunamathuba amaningi okwelashwa manje.
Lokho kusho ukuthi i-ounce yokuvimbela ibhilidi isilonda semithi, futhi kukhona izinto eziningi ezilula abantu abangayenza ukuze banciphise amathuba abo. Yeka ukubhema noma ungaqali, ngoba lokhu kuyingozi kakhulu. Ingozi iyancipha uma uyeka, ngakho-ke akukaze kube sekwephuzile kakhulu, futhi kunezizathu eziningi zokuyeka ukubhema ngemuva kokuxilongwa komdlavuza ngisho noma uthola ukuthi unesifo. Thatha isikhathi sokufunda mayelana nanoma yimaphi amakhemikhali noma ezinye izinto ozitholayo emsebenzini, futhi ulandele izinyathelo zokunconywa ezinconywayo. Okokugcina, ukudla ukudla okunempilo ukugcina isisindo esinempilo kubalulekile, njengoba ukukhuluphala kuyinkinga engozini yamanccer amaningi, hhayi nje umdlavuza wezinso.
> Imithombo:
> Society of American of Clinical Oncology. I-Cancer.Net. I-Cancer Cancer.
> Bast, R., Croce, C., Hait, W. et al. Holland-Frei Cancer Medicine. UWiley Blackwell, ngo-2017.
> National Cancer Institute. Ukwelashwa Kwemithi Ye-Canal Renal (PDQ) -Health Professional Version. Kubuyekezwe 04/05/18.