Yini Oyenzayo Uma It Spreads?
Njengoba ubuchwepheshe buqhubekela phambili, ukujula kwethu kokuqonda kuthuthukisa. Esikhathini esidlule, ukusho ukuthi "umdlavuza" bekuyosho konke. Kwakusho ukuthi othile ufa. Ngokujabulisayo, lokhu kuyashintsha futhi sichaza ukubikezelwa komuntu othile ngokusekelwe lapho awela khona ngaphakathi kwendawo enkulu. Izici eziningi zichaza ukuhlaziya okubandakanya ubukhulu, indawo, kanye nebanga le-tumor. Nazi ezinye izici eziyisisekelo mayelana nendawo yomdlavuza nokuthi ihlobene kanjani nokubikezela nokukhethwa kokwelapha.
Ukuthola umdlavuza we-prostate
Ngaphambi kokuthuthukiswa kwe-MRI ye-3-Tesla eminingi, i-extra-capsular umdlavuza wesi-prostate itholakale kuphela lapho udokotela ezwa ukungajwayelekile ngaphandle kwegciwane ngokuhlolwa kwe- digital rectal . Manje, i-imaging yesimanje ne-biopsy ithola ukuthi sithole amancane amancane omdlavuza asakazwa nge-capsule. I-Cancer isakazeka nje ngaphandle kwe-capsule ye-gland noma i-vesicles ye-seminal, lapho i-CT ne-scan scan ikhanya ngokucacile, kuthiwa "iqhubekile endaweni yangakini." Naphezu kokuba nomdlavuza usakaze ukudlula i-capsule ye-gland, imisebe yamuva ne-IMRT, ngokuvamile ukugqugquzelwa kwe-brachytherapy, kungaba ngempumelelo kakhulu ekulawuleni isisu esikhulu.
I-Cancer isaphulukiswa uma iqhutshwa endaweni yakithi uma nje lesi sifo sihlala sivalelwe esifundeni esivele sisungeze i-prostate. Okuhlangenwe nakho kubonisa ukuthi umdlavuza we-prostate osendaweni yakithi uzovame ukuhlotshaniswa ne-metastases ezincane ezinqenqemeni ze-pelvic.
Imisebe ye-prophylactic ye-pelvic kanye ne-testosterone inactivation pharmaceuticals (TIP) kufanele ibhekwe ngokuqinile njengesilinganiso sokuvimbela.
Ngemuva kwesiteji sokuqala nge-CT noma i-scan scan, ngezinye izikhathi i-metastases eyodwa noma amabili iyatholakala. Isimo se-metastatic esinama-metastases ama-5 noma ambalwa abizwa ngokuthi "i-oligometastase" (i-oligo ngesiGreki isho ukuthi "bambalwa").
I-oncology lore lore isho ukuthi noma yikuphi ukutholakala kwe-metastases okuwukuthi "yi-tip of the iceberg," ukuthi ngisho imetastasis eyodwa ibonisa ukuthi izidakamizwa ezengeziwe ezincane zikhona kwezinye izindawo zomzimba. Le nkolelo yavela esikhathini esedlule lapho izilinganiso zingenangqondo futhi kuphela imetastasis enkulu kuphela engayithola.
Izinketho zokwelapha
Manje, kungenzeka ukuphulukisa amadoda ane-oligometastases ngemisebe ehlosiwe akufanele kunganakwa. Ukuphulukisa ukwelashwa okungenzeka ukwelapha cishe kuholela ekuqhubeleni phambili kwemithi ngaphansi komugqa. Kuyadabukisa lapho ukwelashwa okuqondile njengokungathi imisebe ibe lymph node yangasese noma i-metastasis yamathambo igcinwa nje ngenxa yokwesaba okungenangqondo ukuthi "ngeke isebenze." Uma i-oligometastases iphathwa nge-radiation, ukwelashwa okuqhubekayo nge-TIP, futhi mhlawumbe ne-Taxotere kufanele kucatshangwe ngokujulile.
Uma i-bone ihlola noma i-CT izikrini zibonisa inombolo enkulu kakhulu ye-metastases, imisebe ejwayelekile ayisakwazi ukufezeka ngoba imisebe eya ezindaweni eziningi zethambo izolimaza umongo wesithambo. I-TIP yindlela yokwelashwa yokuqala ejwayelekile yamadoda ane-metastases amaningi we-bone. Kukhona nobufakazi obuqinile bokuthi ukwengeza i-Taxotere chemotherapy ku-TIP kukhulisa kakhulu ukusinda nokuthuthukisa izinga lokulawula umdlavuza.
Ngaphezu kwalokho, i-agent exhasayo njenge-Xgeva noma i-Zometa kufanele iphindwe futhi. Ifomu elivunyelwe i-FDA ye-radiation engenayo ebizwa nge-Xofigo nayo iboniswe ukuthi ihlala isikhathi eside futhi ilawula kahle ubuhlungu be-bone.
Ngokuvamile, ngokuvamile isigaba somdlavuza wesi-prostate singasakazeka emaphashini noma esibindi. Amadoda aneziphazamiso zamaphaphu avame ukuphendula kahle ezinhlobonhlobo zokwelapha. Izidakamizwa zesibindi ziyingozi kakhulu futhi zingenasiphelo sokuphendula ukwelashwa kwama-hormone. Lapho i-metastases yesibindi ikhona, i-chemotherapy ngokushesha ikhonjisiwe. Ngiye ngabona ukukhishwa okunomthelela ekubanjeni kwesibindi semastast nge ukwelashwa okungukuthi i-FDA-evunyelwe umdlavuza wekoloni obizwa ngokuthi " SIR-Spheres ," uhlobo lwe-radiation therapy olwenziwe egazini elinesibindi.
Umdlavuza we-prostate uveza ngezindlela ezihlukahlukene. Ukuphathwa okuphelele kudinga ukulinganisa okunembile kanye nohlelo oluhlelwe ukwelashwa. Ukuze uthole imiphumela engcono kakhulu, iziguli kufanele zithole ukwelashwa kwe-multimodality ezinonya noma nini lapho ukuhlolwa kwesiteji kubonisa umdlavuza usakazeka ngaphandle kwe-prostate.