Izimpawu, Izimbangela, Ukuxilongwa, Nezokwelapha
Umdlavuza we-Endometrial ngumdlavuza ochaphazela uketshezi kwesibeletho futhi uvame kakhulu kwabesifazane emva kokumisa esikhathini. Ukukhathazeka ukuthi lolu hlobo lomdlavuza luye landa eNyakatho Melika naseYurophu. Yini okufanele ukwazi ngezimpawu, ukuxilongwa, kanye nokwelapha kulo mdlavuza?
I-Endometrial Cancer-Definition
Umdlavuza we-Endometrial, owaziwa nangokuthi umdlavuza wesibeletho, umdlavuza ovela emangqamuzaneni ahlanganisa isisu (i- endometrium ) futhi uhlobo oluvame kakhulu lomdlavuza oluthinta umzimba wesibeletho.
I-endometrium iyasebenza kakhulu kumjikelezo wesifazane wesimeni nokukhulelwa. Phakathi nesigamu sokuqala somjikelezo wokuya esikhathini, i-estrogen ibangela i-endometrium ukwakha ekulungiseleleni ukufakwa kokukhulelwa. Uma ukukhulelwa kungenzeki, i-progesterone iholela ekuqhekekeni kwalesi sicubu, esilahlelwa ngesikhathi senyanga yowesifazane.
Enye umdlavuza wesibeletho esingajwayelekile kakhulu, i-uterine sarcoma, iqala emgqeni wesisindo ngaphansi kwe-endometrium ebizwa ngokuthi i-myometrium (isisu sombeletho).
Kunezinhlobo eziningana ze-subtypes yomdlavuza we-endometrial, njenge-adenocarcinoma, i-adenosquamous, i-carcinoma, i-cell cell ecacile, nabanye. Iningi lala makhankaso liyatholakala ngaphambi kwesikhathi, esiteji lapho ukuhlinzwa kunika ithuba elihle lokuthola ukwelashwa. Lokho kusho ukuthi izinto ezibeka engozini eziphakamisa ingozi yokuthuthukisa lezi zomshukela ziye zanda njengoba zinombono wokuxilongwa ngonyaka ngonyaka emazweni athuthukile.
I-Endometrial ngokumelene neCervical Cancer
Umehluko phakathi komdlavuza we-endometrial nomdlavuza womlomo wesibeletho ungadideka kusukela umlomo wesibeletho empeleni ingxenyeni engezansi yesibeletho. Ngenkathi isitho esifanayo sithinteka, kunezinhlobo eziningi ezibalulekile ezivela ekuhloleni izimbangela ezibaluleke kakhulu zalezi zomshukela.
Ingxenyeni engenhla yesibeletho ihlanganisa umzimba noma i-fundus, kanti umlomo wesibeletho yingxenye engezansi yesibeletho, esithinta ubulili.
Isifo se-Cancer Endometrial
Umdlavuza we-Endometrial kuye kwaba nethonya labesifazane abangu-61,380 ngo-2017, okwaholela ekufeni kwabangu-10 920 kulaba besifazane. Kutholakale ukuthi umdlavuza we-endometrial wanda eminyakeni yamuva, ikakhulukazi eNyakatho Melika naseYurophu. Kucatshangwa ukuthi lokhu kungenzeka kuhlobene nokwanda kwezimo ezingozini eminyakeni yamuva, njengokukhuluphala, abesifazane abanabantwana abambalwa, nokubeletha ukubambezeleka kokubeletha. Nakuba umdlavuza we-endometrial wawungavamile kakhulu kubantu base-Afrika baseMelika kunabamhlophe e-United States, lesi sifo manje sesifana.
Izimpawu Nezibonakaliso
Ekuqaleni, owesifazane angeke abe nezimpawu nge-cancer ye-endometrial. Uma izimpawu zikhula, okuvame kakhulu ukuguqula ukuphuma kwegazi. Lokhu kungase kuphuluke ngemuva kokuba owesifazane esedlule esikhathini sokusuka esikhathini futhi akasenayo izikhathi. Kuphuma kwe-premenopausal, umdlavuza we-endometrial ungabangela ukuphuma kwamagciwane okungavamile , njengokuphuma kwegazi nokwehlukanisa phakathi kwezinkathi. Abanye besifazane abanalo ukuphuma okwehlukile kodwa kunalokho babone umsele ocacile noma ogazini owenziwe ngegazi. Abanye besifazane bangase bahlakulele i- anemia (isibalo esiphansi se-cell cell) ngenxa yokuphuma kwegazi.
Ezinye izimpawu ezingenzeka kungenzeka zihlanganisa ubuhlungu be-pelvic noma ubukhulu be-pelvic. Uma umdlavuza uphuthukisiwe, izimpawu ezifana nokulahlekelwa isisindo esingenhloso , ukukhathala, noma isilonda kanye nezinguquko zesibindi kungase kuphawulwe.
Izimbangela Nezici Zengozi
Nakuba singaqiniseki ngezimbangela eziqondile zomdlavuza we-endometrial, kunezici eziningana zobungozi eziye zabonakala. Izinto ezaziwayo nezingozi ezingase zibandakanye zihlanganisa:
- Ubudala: Umdlavuza we-Endometrial uvame kakhulu kwabesifazane abangaphezu kweminyaka yobudala bokuya esikhathini.
- Amazinga e-estrogen aphakeme (ngaphandle kokuphakama okuhambisana neprogesterone): Noma yisiphi isimo esandisa amazinga e- estrogen ngaphandle kokwanda okufanayo ku- progesterone kungandisa ingozi.
- Ukusetshenziswa komlomo ngokwemlomo: Ukusetshenziswa kwezibeletha zomlomo okungenani unyaka owodwa kunciphisa ingozi. Ukunciphisa ingozi kubaluleke kakhulu kwabesifazane abasebenzisa amaphilisi okulawula ukubeletha isikhathi eside futhi baqhubeka nokunciphisa ingozi iminyaka eminingana emva kokuthi amaphilisi aqedwe.
- I-hormone-substitution therapy (HRT): i-HRT ene-estrogen kodwa ngaphandle kwe-progesterone (ukwelapha isrogen engavunyelwe) yandisa ingozi yomdlavuza we-endometrial.
- Izici zokuzala: Abesifazane abaneminyaka eminingi yokubeletha, njengalabo abaqala ukuhamba esikhathini esisheshayo noma labo abadlulela esikhathini sokuphumula baye engozini enkulu. Abesifazane abangenazo izingane basengozini enkulu kunelabo abanezingane.
- Umlando wokungasebenzi
- Umlando we- endometrial hyperplasia
- Ukukhuluphala ngokweqile: Ukuba ukhuluphele kunama-triples engozini yokuthuthukisa lesi sifo.
- I-Polycystic ovarian syndrome (i-PCOS): I-PCOS yandisa ingozi yokuthuthukisa umdlavuza we-endometrial nakuba ezinye zezokwelapha ze-PCOS, njenge-metformin, zinganciphisa ingozi.
- Isifo sikashukela: Ingozi yomdlavuza we-Endometrial iphindwe kasikhombisa kwabesifazane abanesifo sikashukela.
- Ukusetshenziswa kwe-IUD: Ukusebenzisa i- IUD kunciphisa ingozi yowesifazane wesifo somdlavuza we-endometrium.
- I-Tamoxifen: Ukusetshenziswa kwe- tamoxifen ukunciphisa ingozi yokuphindaphinda noma ukunciphisa ingozi yokuthuthukisa umdlavuza webele kunokwandisa ingozi yokuthuthukisa umdlavuza we-endometrial.
- Ezinye izicubu ze-ovarian ezifana ne-granulosa cell tumor secrete estrogen futhi zingabangela ingozi yomdlavuza we-endometrial.
- Umlando wokuba nosomdlavuza njengengculaza yesifuba noma umdlavuza we-ovarian
- Ukuba nomlando womndeni we-cancer ye-endometrial noma umdlavuza we-colon
- Abantu abanomdlavuza wesibeletho ofana neLynch syndrome (umdlavuza we-nonpolyposis we-hereditary noma i-HNPCC)
- Umlando wemisebe kuze kufike emagqumeni njengengxenye yokwelashwa komdlavuza
- Ukuba nempilo yokuphila
- Ukudla ukudla okunamafutha aphezulu
Ukuhlola / Ukutholwa Kokuqala
Ngokungafani nomdlavuza womlomo wesibeletho, akukhona ukuhlolwa kwesimiso sokuhlola umdlavuza we-endometrial. Abesifazane abasengozini enkulu yokuthuthukisa lesi sifo, njengalabo abanomlando womndeni, isifo somdlavuza ozalwa njengeLynch syndrome, noma abaye basebenzisa tamoxifen ukuphatha noma ukunciphisa ingozi yomdlavuza webele kufanele bakhulume nodokotela wabo mayelana nokuhlola. Kwabesifazane abathile, izivivinyo ezifana ne-endometrial biopsy kanye / noma i-ultrasound ye-uterine zingase zithathwe njengokukhulisa amathuba okuthola lesi sifo ngokushesha ngangokunokwenzeka.
Ukuxilongwa kwe-Cancer Endometrial
Ukuxilongwa kungase kutholakale ukuthi kuP Pap smear, kodwa ama-Pap smears awayilona ithuluzi lokuhlola eliphumelelayo lesi sifo. Ukuthola izifo ngokuvamile kuqala ngokuhlolwa kwe-pelvic, nakuba i-cancer yokuqala ingajwayelekile.
Uma uye waba nokuphuma kwegazi okungavamile kunezivivinyo eziningana okungahlolwa ngudokotela wakho. I-ultrasound yangaphandle (i-ultrasound eyenziwa ngokufakela iphenyo ye-ultrasound ngaphakathi kwesiswini sakho) ingenziwa ukuze ubuke ubukhulu be-endometrium yakho. Isixazululo saline singase singene ngaphakathi kwesibeletho sakho (sonohysterogram) ngaphambi kwenqubo yokuthuthukisa ukuboniswa kwanoma yikuphi okungajwayelekile.
I-hysteroscopy yinkqubo lapho "i-telescope" ifakwa emlonyeni wesibeletho sakho esibelethweni sakho ukuze ucabange ngeso lengqondo uhlaka lwe-uterine.
Ucwaningo oluvamile yi-biopsy ye-endometrial. Kule nqubo yehhovisi, ithuluzi lifakwe ngaphakathi kwesiswini sakho ukuze uthole ukukhipha ngaphakathi kwesibeletho sakho ukuhlola ebhodini. Udokotela wakho angase futhi ancoma ukuhlenga nokukhishwa (D no C) okuvame ukuqhutshwa ekamelweni lokusebenza ngaphansi kwe-anesthetic jikelele. Nge-anesthesia nokuxilonga kwesibeletho sakho, isampula engcono yesinkwa sakho se-uterine ingatholakala.
Uma kucatshangwa ukuthi umdlavuza we-endometrial, i-biopsy iyadingeka ukuze kuqinisekiswe ukuthi ukuxilongwa nokuthi kuqhubeka kanjani ukuchaza izici zesisu.
Isiteji
Ukunquma ukhetho olungcono kakhulu lwezokwelapha, isiteji esinembile siyisinyathelo esibalulekile ngemuva kokuxilongwa kwakho. Ukugxilwa kwenziwa ngokubheka ubukhulu besisu, ukuhlukunyezwa okusekelwe ekubukeni kwayo ngaphansi kwe-microscope (amamaki amathumba kusuka ku-1 kuya ku-3), nokuhlola ukubona ukuthi umdlavuza uye wahlasela noma usakazeka kunoma yiziphi izicubu ezingaphandle kwesibeletho.
Njengamanye amakhemikhali, lezi zicubu zivame ukunikezwa ngezinga elithi "TNM" lapho iT limelela khona ubukhulu be-tumor (futhi ngezinye izikhathi ezinye izici), N imele ukubandakanyeka kwamakhemikhali eseduze noma okude, kanti M imelela imithwalo yokudla, noma isakazeka ezithombeni ezikude.
Uma kunethuba lokuthi umdlavuza uye wahlasela noma wasakaza kwezinye izitho, ezinye izivivinyo zingase zihlanganise i-cystoscopy kanye / noma i-proctoscopy ukubuka noma yibuphi ubufakazi obusakaze kulesi isisindo noma i-rectum, kanye ne-CT, MRI, kanye / noma i-PET scan ukubheka ukusabalala okude kwe-tumor.
Njengamanye ama-tumor amaningi aqinile, umdlavuza we-endometrial uhlehliselwe ngezigaba ezine (kusukela ngoJanuwari 2018 akusekho isigaba 0). Lokhu kufaka:
- Isigaba 1: Umdlavuza ulinganiselwe esibelethweni, futhi awusakazeki esibelethweni, kwezinye izindawo zesikhumba, noma izitho ezikude.
- Isigaba sesi-2: Isidumbu sisakaze esibelethweni, kepha hhayi kwezinye izingxenye zomzimba.
- Isigaba sesi-3: I-tumor isakaze ngaphesheya kwesibeletho, kodwa zonke izindawo zokusabalalisa zisasendaweni yesigcawu.
- Isigaba sesi-4: Umdlavuza usakaze endaweni yesibindi, i-rectum, noma ezindaweni ezikude zomzimba.
Lezi zigaba zingaphinde zaphulwa zibe yizingxenye (njengesigaba 2A no 2B) kuye ngokuthi ezinye izici zesisu.
Izinketho zokwelapha ze-Endometrial Cancer
Izinketho ezinhle zokwelashwa zomdlavuza we-endometriya zixhomeke esigabeni sesifo, izimpawu, kanye nezinye izinto ezifana nempilo ejwayelekile. Izinketho zihlanganisa:
Ukuhlinzwa: Ukwelashwa yindlela ejwayelekile kakhulu yokwelapha umdlavuza we-endometrial. Kulokhu kuhlinzwa isisu sisusiwe ( hysterectomy ), kaningi kanye nama-tubes nama-ovari (salpingo-ophorectomy). Kulabo besifazane abaqedile ukubeletha, lokhu akuvame ukuletha inkinga enkulu ngaphandle kweengozi yokuhlinzwa. Kulabo abasebancane futhi befisa ukuba nengane noma izingane eziningi, noma kunjalo, lokhu kungaba ukukhathazeka kwenhliziyo.
Ukwelashwa kwezidakamizwa: Ukwelashwa kwe- radiation yindlela yokwelapha yendawo engasetshenziswa uma kukhona kungenzeka ukuthi amanye amangqamuzana omdlavuza asakaze ngaphesheya kwesifunda asuswe ngokuhlinzwa.
Ukwelashwa kwamahomoni: Ukwelashwa kwamahomoni kungasetshenziswa ukunciphisa inani le-estrogen noma ukwandise inani le-progesterone emzimbeni. Imithi ejwayelekile kakhulu ihlanganisa enye yezinhlobo ze-progesterone. Ngama-tumors asezingeni eliphakeme noma ephindaphindiwe, ezinye izindlela zokwelapha zihlanganisa tamoxifen, ukuqondisa ukukhipha ama-hormonone agonists, ne-aromatase inhibitors.
I-Chemotherapy: I- Chemotherapy ayidingi isidingo samagciwane e-endometrial asencane. Ngama-cancers asakazekile noma aphindaphindiwe, noma kunjalo, i-chemotherapy ivame ukusetshenziswa.
Ukuhlolwa kwemitholampilo: Zonke izindlela zokwelapha umdlavuza we-endometrial ezitholakala manje ziye zafundwa ezinkulweni zomtholampilo. Kukhona izivivinyo zokwelashwa eziqhubekayo zomdlavuza we-endometrili zifuna izindlela zombili kokuthuthukisa ukusinda nokunciphisa imiphumela emibi kanye nokungahambi kahle kwezokwelapha.
Ukubhekana
Ukuthola ukuxilongwa komdlavuza kungakhathaliseki ukuthi uhlobo noma isiteji esabeka yini. Imfundo inika amandla, futhi ukufunda ngomdlavuza wakho kungakusiza ube ngummeli wakho ekunakekeleni kwakho. Thatha isikhashana ukuthi ufunde ukuthi ungathola kanjani ulwazi lomdlavuza omuhle ku-intanethi . Ukusekela kubalulekile. Ukuxilongwa komdlavuza yisikhathi esihle sokuqoqa uhlelo lwakho lokusekela okuzungezile. Abantu abaningi bakuthola kuwusizo ukujoyina iqembu lokusekela emphakathini wabo noma bahlanganyele kwelinye lamaqembu asekela inthanethi noma imiphakathi yokusekela umdlavuza we-endometrial.
Isibikezelo
Isibikezelo jikelele somdlavuza we-endometrial e-United States sinhle, njengoba eziningi zalezi zomshukela zitholakele ekuqaleni. Ezinye izinhlobo ezingavamile zomdlavuza we-endometriya njenge-clear cell carcinoma zihlukumezekile futhi zihlushwa ukuhlaselwa okuncane.
Izindleko zokusinda ezineminyaka emihlanu manje zingama-75-88 ngamaphesenti esizigaba, amaphesenti angu-69 eSigaba sesibili, amaphesenti angu-47-58 esigabeni sesi-III, namaphesenti angu-15-17 esigabeni IV. Kubalulekile ukuqaphela ukuthi izibalo zivame ukuba neminyaka eminingana ubudala futhi azibonakalisi ukwelapha okusha nokuphumelelayo okuye kwavunyelwa kusukela ngaleso sikhathi.
Izwi elivela
Umdlavuza we-Endometrial ngumdlavuza wesibeletho okwenzeka ngeshwa e-United States naseYurophu. Uphawu oluvame kakhulu (ngamaphesenti angaba ngu-90 wabesifazane) lungelapheki igazi elingavamile. Ngenhlanhla abesifazane abaningi bafuna ukwelashwa uma banezikhathi ezingavamile noma begazi emva kokuya esikhathini sokuya esikhathini, futhi eziningi zalezi zicubu zitholakala ezinyathelweni zangaphambili. Ukwelashwa okungcono kuncike esigabeni sokuxilongwa.
Uma uthola ukuthi unomdlavuza we-endometrial into ebaluleke kakhulu ongayenza uba ummeli wakho ekunakekeleni kwakho. Buza imibuzo eminingi. Cabanga ukuthola umbono wesibili. Futhi funda ngesifo sakho.
> Imithombo:
> Lortet-Tiuelent, J., Ferlay, J., Bray, F. et al. Amathrendi Namathrendi Emhlabeni Wonke Endlebeni Yomdlavuza We-Endometrial, 1978-2013. Journal of the National Cancer Institute . 16 Okthoba 2017.
> National Cancer Institute. I-Endometrial Cancer Treatment (PDQ) -Health Professional Version. Kubuyekezwe 08/18/17. https://www.cancer.gov/types/uterine/hp/endometrial-treatment-pdq
> Tang, Y., Zhu, L., Li, Y. et al. Ukusetshenziswa kwe-Metformin kuhlotshaniswa nokukhubazeka okunciphise nokuphunyuka okuthuthukisiwe kwe-Cancer Endometrial: A Meta-Analysis. I-BioMed Research International . 2017. 2017: 5905384.