Ukusetshenziswa kabi kwegama elithi "umdlavuza" kunezimo ezimbi. Amanqamu angempela adinga isinyathelo, ukungenelela kwezokwelapha okunamandla ngenhloso yokulondoloza impilo. Kodwa cabanga ngenhlekelele engase ibe khona eyenziwe ngokutshela umuntu onomdlavuza uma kuyiqiniso. Le nhlekelele emangalisa eyenzeka ngamadoda ayizinkulungwane eziyi-100 njalo ngonyaka e-United States emadodeni anesifo sezinyosi futhi ayaziswa ukuthi unomdlavuza wesifo sofuba nesigaba seGleason 6.
Kodwa cabanga lokho okushiwo: Kuthiwani uma umdlavuza we- Gleason 6 awuyona umdlavuza ngempela?
I-Gleason 6 ne-Cancer?
Isinqumo sokuhlukanisa uGleason 6 njengomdlavuza wenziwa emuva ngawo-1960; odokotela ngaleso sikhathi babecabanga ukuthi amangqamuzana abheka umdlavuza ngaphansi kwe-microscope. Manje ukuqala kokuqala ukuthi iBanga 6 aliwona umdlavuza ngempela. Kodwa-ke, ukushintsha ingqondo mayelana nento ethiwa ngumdlavuza kusukela ngawo-1960 kuye kwaba nzima. Odokotela abaningi emkhakheni we-prostate bayaqhubeka nokuncoma ukwelashwa okukhulu kweGleason 6.
Ibanga lesi-7 nangaphezulu kune-Cancers Yangempela
Ingxenye yokudideka ihlobene nenye iqiniso lokuthi ezinye izigaba zomdlavuza we-prostate ( Gleason 7 nangaphezulu ) zikhona futhi zivame ukubulala. Imvelo engcolile kaGleason 6 ihlala ididekile namagciwane ephezulu, okuholela ekufeni kwabantu abangaba ngu-30 000 ngonyaka.
Inkinga yaba ukungabi nokuhlolwa okucwaninga kwesayensi oklanyelwe ukuxhuma ngokuqondile isiqalo sokuqala seGleason, esinqunywe ngesikhathi sokuxilongwa, ekufeni kokubulawa komdlavuza okuvame ukwenzeka ngaphezu kweminyaka eyishumi kamuva.
Ngenxa yokungabi nokuqwashisa ukuthi inkinga ikhona ngisho, kuye kwaba nokulibala isikhathi eside ekuqhubeni izifundo ezidingekayo.
Lokhu kubambezeleka kuyingxenye ngenxa yemvelo ekhula kancane kancane yomdlavuza wesi-prostate. Ngisho neqembu elincane labesilisa abafa ngesifo somdlavuza we-prostate ngokuvamile bahlala nayo iminyaka eyishumi kuya kwamashumi amabili ngaphambi kokuba bahlukane.
Njengoba kunesikhathi eside eside phakathi kokuxilongwa nokufa, abacwaningi abazange babheke isifo somdlavuza wesifo sofuba esingabangela ukufa. Ngakho-ke, imiphumela yezifundo ezinjalo manje seyatholakala.
Liyini Izwi "Igciwane" Ngempela?
Njengoba sizama ukwenza umehluko ocacile phakathi kweGleason 6 kanye nezinhlobo eziphakeme zomdlavuza wesifo sofuba sichaza ukuthi igama elithi "umdlavuza" lisho ukuthini ngempela: Amangqamuzana omuntu anamandla okwenza i-metastases anomdlavuza. Amangqamuzana omdlavuza onamandla okusabalalisa ngaphandle kwe-prostate angena kwesinye isitho se- metastatic . Uma nje amangqamuzana e-metastatic efika kwesinye isitho, aqala ukwandisa futhi akhulise izicubu. Uma lezi zicubu zifinyelela usayizi othile, ziqala ukubangela ukungasebenzi komzimba. Uma ukusebenza komzimba kungasebenzi, inqubo iba yingozi.
Ukufaniswa kwamaKhansela ahlukene
I-Cancers ihlukaniswa isayithi labo elivela kumvelaphi, ukuthi i-tumor ikhulile kangakanani, futhi ibanga layo. Isibonelo, amaphaphu, ubuchopho, kanye ne-prostate khansa zonke ziziphatha ngendlela ehluke kakhulu ngoba zivela ezithombeni ezihlukene. Kungakhathaliseki ukuthi yisiphi isici esikhuluma ngaso, i-tumor enkulu, eyingozi kakhulu kungenzeka ukuthi iziphatha.
Izicubu ezinkulu ziyingozi kakhulu ngoba zinamathuba amaningi okubamba izinto eziphezulu zebanga.
Izicubu ezinomzimba zinemikhakha ehlukene engahle ibonakale ehlukaniswe namaseli e-tumor aphansi. Le nkonzo yenziwa udokotela oqeqeshiwe obizwa ngokuthi i-pathologist.
"Ibanga" lihlolisisa ubuchwepheshe bokubukeka kwamangqamuzana omdlavuza ngaphansi kwe-microscope. Ukubamba kungasetshenziselwa ukubikezela amathuba okuba nemasastases ezayo. Lezi zinsuku, ukunemba kokuzimisela ebangeni kuthuthukiswa nakakhulu ngokusetshenziswa kwezivivinyo zofuzo ukuthi isikrini sezinhlobo ezithile zezakhi zofuzo eziyaziwayo ezihlotshaniswa nokuziphatha okunonya.
Ukuziphendukela Kwamanje Ukucabanga Ngomdlavuza We-Prostate
Ngaphambi kokuhlolwa kwe-PSA kanye ne-needle biopsy yanda kakhulu ekuqaleni kwawo-1990, umdlavuza wesifo sofuba wawuvame ukutholakala ngemva kokuba usuhlelwe kabusha.
Umdlavuza we-metastatic prostate awuyingozi futhi uyingozi. Eminyakeni eminingi yokunakekela amadoda ane-metastatic prostate umdlavuza, odokotela bahlakulela ingqondo yokuzivikela: ukukhathazeka okuvamile, konke okubandakanyeka ngokubhekisisa komdlavuza wesifo sofuba. Ngokwemvelo, lesi simo sengqondo sokukhathazeka sagxila kakhulu esimweni sabo sengqondo mayelana nomdlavuza wesandulela ngculaza lapho usuqala ukujwayela ngenxa yokusetshenziswa okuqhubekayo kokuhlolwa kwe-PSA kanye ne-biopsies yenaliti. Ngakho-ke, iminyaka eminingi, odokotela baye bacabanga ngokungaqondile ukuthi zonke izifo zomdlavuza we-prostate zakuqala zizoba yimetastatic uma zingelashwa.
Singazi kanjani ukuthi i-Gleason 6 Subtype ye-Cancer Prostate Ngeke Isakazeke?
Ucwaningo lokuhlola umphumela wesikhathi eside wabantu abaneGleason 6 ehlanzekile ekugcineni sekuphelile. Lezi zifundo kwakudingeka zenziwe ezigulini zokuhlinzeka ngoba ukususwa kokuhlinzwa kwe-prostate kwenza ukuhlolwa okuncane kakhulu kwe-gland yonke. Ukwelashwa yindlela kuphela yokuqinisekisa ukuthi i-needle yokuqala ye-needle ebonisa iBanga 6 yayinembile nokuthi indawo yesifo esiphakeme kakhulu ayiphuthelwa.
Ukususa lonke i-prostate ukuze ihlolwe ngokuphelele yi-pathologist yindlela eyodwa kuphela yokuqiniseka ukuthi amaphesenti angu-100 omdlavuza wesibeletho yiBanga lesi-6 ngempela. Manje, izifundo eziningana zokuhlinzwa eziphindaphindiwe ezihlanganisa izinkulungwane zamadoda zibuke ngaphezu kuka-10 iminyaka yokuthunyelwe, sekuphelile. Ukuthola okuqhubekayo ukuthi iBanga 6 alihambisani nemiphumela.
Ingabe Odokotela Benza I-Big Mistake?
Umdlavuza we-prostate utholakala ngendlela engavamile neyingqayizivele. Izidakamizwa eziyizinkulungwane eziyishumi nambili eziqondiswa ngenaliti zigwazwa ngodonga lwama-rectal zibe yi-prostate ngaphandle kokuzama ukukhomba okungavamile. Le nqubo engavamile isebenze kahle ngoba i-prostate iyinkinga encane, ngobukhulu be-walnut. Ukuphazamiseka yilokho ngoba ukugwaza kungenangqondo, bangaphuthelwa umdlavuza we-prostate ophezulu (uGleason 7 noma ngenhla).
Umdlavuza we-prostate uvame ukuphindaphindiwe; lokhu kusho ukuthi izicubu zingatholakala engxenyeni engaphezu kweyodwa ye-prostate gland. Lezi zicubu ezihlukene zingaba ngamamaki ahlukene. Ingxenye eyodwa ingaba yiGleason 6 kanti enye indawo ingabonisa uGleason 8. Ngakho-ke, uma izinaliti zihlaselwa ngogesi, kungenzeka ukuthi i-biopsy ithole i-Gleason 6 kuphela lapho ngempela uGleason 8 ekhona. Izifundo ezenziwe kuze kube yimanje zibonisa ukuthi cishe owesilisa oyedwa kwabayisine abahamba kahle nge-12-core random nucleal biopsy ebonisa iGleason 6 empeleni ayitholanga izifo eziphakeme eziphezulu kwesinye indawo ku-prostate.
Ukuthembela kuphela kule nqubo ye-biopsy engahleliwe, odokotela bangakhohliswa ekukholweni ukuthi isiguli sineGleason 6 kuphela uma kwezinye izimo ibanga liphakeme ngempela. Lona ngumthombo wangempela wenkolelo yamanga ukuthi iGleason 6 ingakwazi ukumisa. Amadoda athola ukuthi une-"Gleason 6," oye waphathwa ukwelashwa, futhi kamuva wagula umdlavuza, wahola odokotela ukuba bakholelwe ukuthi amangqamuzana omdlavuza we-Gleason 6 ayesebenzile. Manje siyazi ukuthi ukuphindaphinda, okucatshangwa ukuthi kuvela ku-Gleason 6, empeleni kwakwenzeka kuphela kumadoda ayenomdlavuza we-Gleason 7 noma ophakeme wesicathulo owawufihlekile kwenye indawo ye-prostate futhi engatholakali yi-prostate biopsy yangempela .
Izindlela Zendabuko Zokuqedela Ukungaqondile Kwe-Biopsy
Ukuqinisekisa ukuthi ukufa komdlavuza we-prostate kuncishisiwe, indlela ejwayelekile yokukhuthaza ukuhlinzeka okukhulu noma imisebe kuwo wonke umuntu, "ukuze uphephe." Ukwelapha wonke umuntu kuhlanganisa ngokuphelele ukuthi kungenzeka ukuthi isifo esiphezulu sezinga elingenakubalwa futhi siphumelele icala lomdokotela ongenakuthola uma Ukuphindaphinda kwenzeka esikhathini esizayo. Ngeshwa, eminyakeni engaba ngu-20 edlule, le nqubomgomo enobudlova ibangele ukwelashwa okungadingekile emadodeni angaphezu kwezigidi ezimbili kanti ukwelashwa kungabangela ukungabi namandla nokungaziphathi kahle.
Manje njengoba odokotela beqaphela ukushiyeka kokuncoma ukwelashwa kuwo wonke umuntu, enye inkambo ebizwa ngokuthi ukubhekwa okusebenzayo iye yathola ukwamukelwa. Phakathi neminyaka eyishumi edlule, ukubhekwa okusebenzayo sekuye kwamukelwa ngokwengeziwe njengendlela ekwazi ukuphatha amadoda akhethiwe ngomdlavuza we-Gleason 6 wesibeletho. Ukubhekwa ngokucophelela kuyamukelwa yiNational Care Comprehensive Network Network (NCCN), i-American Society of Clinical Oncology (ASCO) kanye ne-American Urological Association (AUA) njengendlela ejwayelekile yokwelapha i-Gleason 6.
Amadoda athole ukuhlolwa kwebanga leBanga lesi-6 ahlolwe ngokucophelela ngokuhlolwa njalo kwe-PSA yabo. Babuye babe nezikhathi eziyi-12 eziyisisekelo zezinyosi ze-needle njalo eminyakeni embalwa emzamweni wokuthola noma yisiphi isifo esiphakeme esingase siphuthelwe ekuqaleni kwe-biopsy. Inqubomgomo yokuhlolwa kwe-PSA kanye ne-biopsies ngezikhathi ezithile ayithandeki, kepha ukwelashwa okukhulu ngokuhlinzwa noma imisebe kunemiphumela emibi nakakhulu. Noma kunjalo, maduzane nje, amasu amasha wokuskena ayatholakala ukuthi anikeze okunye okunye okushiwo yi-biopsy engahleliwe.
Ukufanekisa kwe-MRI ne-Biopsy
I-Biopsies ayijabuli futhi ngezinye izikhathi ibangela izifo ezisongela ukuphila noma ukuphuma kwegazi. Nakuba i-biopsy engahleliwe iye yacatshangelwa ukuthi izinga legolide lokuxilongwa komdlavuza wesifo sofuba, liqhathaniswa kanjani ne-imaging yesimanje nge-MRI multi-parametric?
Lo mbuzo uvivinywe kahle ekutadisheni okukhulu okubandakanya amadoda angama-600 anamazinga aphezulu e-PSA azinikele ekutheni abe nemisaka eminingi ye-parameter, i-biopsy engahleliwe kanye ne- saturation biopsy ukuhlola ukuthi yiyiphi indlela enembile kakhulu (i-saturation biopsy ihilela izinaliti ezingu-30 + i-prostate ngaphansi kwe-anesthesia futhi iyindlela enembile kunazo zonke yokuthola umdlavuza we-prostate). Uma kuqhathaniswa ne-biopsy ye-saturation, i-biopsy engahleliwe ithola amaphesenti angama-75 amadoda ayenesifo esiphezulu. I-MRI eyimingcele eminingi ihlonze amaphesenti angama-90 ala madoda ayenomdlavuza ophawulekayo emtholampilo.
Lolu cwaningo lwafakazela ngokucacile ukuthi i-MRI enhle eyenziwa kahle, i-multi-parametric inembile kakhulu kune- biopsy engahleliwe . Ngeshwa, iningi labakwa-urologists , uhlobo lodokotela abathweswe umthwalo wemfanelo yokuphatha abalingani bokuhlola abasebenzayo, namanje baqeqeshiwe indlela yokungahleliwe ye-biopsy yokumisa nokuqapha umdlavuza wesi-prostate.
Isiphetho
Amadoda aneGleason 6 abanalo umdlavuza ngomqondo weqiniso wezwi. Ayikho ingozi yokuthola imithi . Kuze kube maduzane, ukuhlukumeza okukhulu kokuqapha okusebenzayo kuye kwaba isidingo sokuphinda i-biopsy engahleliwe ngezikhathi ezithile. Ukufika kwe-MRI ehlukene-parametric kubonakala sengathi kuyindlela ephakeme kakhulu. Lezi zinsuku, indoda etholakale ene-Gleason 6 inezinketho zokuqalisa uhlelo lokuqapha ngaphandle kwesidingo se-biopsies ye-needle ngezikhathi ezingu-12.