Ukubhema noNxila ngokukodwa Ukwandisa ingozi yeCarcer Oral
Sibanzi
EUnited States nakwihlabathi lonke, ubude bomdlavuza womlomo, okanye umdlavuza ochaphazela umlomo, umlomo womlomo, nomqala, uphakamileyo kakhulu ngenxa yokuba abantu abaninzi baphuza baze bashiye. Le ngxaki yomngcipheko, ukusela nokutshaya, inokunyusa ukwanda komngcipheko womlomo ngomdlavuza womlomo-nangona kunjalo kunomngcipheko womntu ngamnye.
Indlela ecacileyo kakhulu yokuthintela umdlavuza womlomo kukugwema ukusela nokutshaya; Nangona kunjalo, sonke siyazi ukuba ukuphelelwa ngumsebenzi kunzima kubantu abaninzi abaxhomekeke kwiziyobisi kunye notywala okanye ukusetyenziswa kakubi kweziyobisi kunye notywala.
Izibalo
Phantse ama-85 ekhulwini kwentloko kunye neentamo ze-khancer are oral cancer. (Intloko kunye nentamo yeengcingo zihluke kwii-cancer cancer.) Ngaphezu koko eUnited States, iipesenti ezi-3 zazo zonke iidlingozi ezinobungozi kumadoda kunye neepesenti ezi-2 zazo zonke iindawo ezinobungozi ezingabandlululo kumabhinqa zi-cancer.
Umdlavuza womlomo uchaphazela amadoda amaninzi kunabesifazana, kwaye amadoda ase-Afrika-Amerika angaphezu kwamadoda amhlophe ukuphucula umdlavuza ngomlomo. Ekugqibeleni, umdlavuza womlomo uqheleke kakhulu kubantu abaneminyaka engama-40 nangaphezulu.
Kwi-mpuma ye-Asia, i-40 percent ye-cancer nganye yomlomo isifo somhlaza. Kwiintlanga eziphuhlisiwe, ipesenteji zee-cancer zomsana zomlomo zihamba malunga neepesenti ezingama-4.
Ithuba lokuba nayiphi na umntu ngamnye uya kuvelisa umdlavuza ngomlomo ngexesha lokuphila kwakhe malunga neepesenti eziyi-1.1.
Unyaka ngamnye, umhlaza womlomo ubulala abantu abayi-8000 eMelika. Ngaphezu koko, malunga nabantu abangama-42 000 eUnited States bafumanisa ukuba banolu hlobo lomhlaza minyaka yonke.
Ngo-2012, phantse abantu abangama-300 000 kuwo wonke ama-United States babe nomhlaza womlomo. Ukubeka eli nani inombolo, abantu baseCincinnati bangabantu abangama-300,000.
Nangona uphumelele ekusebenziseni ubuchule bokuxilonga nokugqithisa, inani labantu abaphila iminyaka emi-5 emva kokuxilongwa komhlaza womlomo, okanye umlinganiselo weminyaka emihlanu yokusinda, kuye kwafana kunye nama-4 eminyaka: phakathi kwama-50 no-55 ekhulwini.
Ngamanye amazwi, malunga nesiqingatha sabantu abaxilongwa namhlanje ngomhlaza womlomo baya kufa eminyakeni emi-5 ezayo. Lo mgangatho wokusinda kwenzeka ngokuba nangona singakwazi ukufumana umdlavuza ngomlomo kwangaphambili, abantu abanesi sifo bavame ukuza kunyango emva koko, banezifo eziphambili kunye nezigulane.
Inatomy of Canal Oral
Uninzi lwee-cancer zomlomo luchaphazela iibini zokuqala zelwimi. Ngokukodwa, ezi ngqanda zikhula ukusuka kumgangatho ophantsi (dorsal) kunye (kunye nolwasemva) kolwimi. Inxalenye ephezulu (yehla) yelwimi lwakho inzima kunye neengcamango zengcamango. Inxalenye engaphantsi kolwimi lwakho ilula.
Inqabile kakhulu, umdlavuza womlomo unokuchaphazela okanye umlomo okanye iinxalenye zomlomo womlomo kuquka oku kulandelayo:
- ngaphakathi kwezihlathi (buccal mucosa)
- uphahla lomlomo (i-palate enzima)
- indawo encinci ekhoyo emva kwamazinyo okuhlakanipha (i-retromolar trigone)
- iigums (gingiva)
Amanqamzana omlomo ngamanye amaxesha angakhula ukusuka emva emqaleni okanye emagqabini . Ngokukodwa, ii-cancer ziyakhula ukusuka kwi- oropharynx kunye ne- hypopharynx .
I-oropharynx inezinto ezilandelayo:
- isalathisi
- iindonga zangasemva nangemuva yomqala
- buyela kwisithathu kwiselwimi
- toni
I-hypopharynx yindawo engezantsi yomqala. I-pharynx iyi-tube enama-5 intshi ende edibanisa i-real estate phakathi kwempumlo kunye nokungena kwe-esophagus kunye ne-larynx (i-windpipe). Ukutya nomoya kudlula kwi-hypopharynx endleleni yabo ukuya kwisisu nangemiphunga, ngokulandelanayo.
Indawo yokuhlambalaza (umhlaza) emlonyeni womlomo okanye i-pharynx ibalulekile kuba indawo inokuchaphazela ukuziphatha kwezifo (ukugula) kunye nokonyango.
Ekugqibeleni, umdlavuza womlomo ungathintela nayiphi na inxalenye yomlomo, umlomo womlomo kunye ne-pharynx.
Ziziphi iiKhansela zomlomo ezenziwe
Uninzi lwee-cancer zomlomo zingumdlavuza weeselm . Iiseli ze-Squamous zincinci, ezicwangcisiweyo zeseli ezidibanisa umlomo womlomo kunye ne-pharynx.
Izikhwama zeescamous zeeselingi ziqala ukwenza emva kokuba utshintsho luphelelwa kwiqondo lee molecular. Emva kokuba iiseli ezinqambileyo zidibanise kwiqondo le-molecular, ukubonakala kwala maseli kuyashintsha. Njengoko ezinye iiseli zitshintsha ngokubonakala, umdlavuza womlomo uyabonakala, okanye kubonakala kliniki kwaye iimpawu ziqala ukubonakalisa.
Iingqomzana zomlomo ezingenasidlangalaleni zingabonakali kwaye zingabandakanya i-tumors, i-sarcomas kunye ne-melanoma.
Izinto zobungozi
Imiba yengozi ichazwa njengalowo nawuphi na uphawu okanye ukuvezwa okwandisa ubunzima (ingozi) yokuphuhlisa izifo.
Nazi ezinye iingozi zomdlavuza zomlomo:
- utywala
- icuba
- I-HPV16 (uhlobo lwegciwane le-papilloma yabantu 16 oludibaniswa nokunyuka kwamaxesha emitha ye-tonsillar cancer)
- ukutya okunqongophele kwiziqhamo nemifuno
- ukugqithisa kwelanga (kwandisa ingozi yomdlavuza womlomo)
- ukuxilongwa kwe-immunosuppression (inamandla omzimba omzimba)
- i-betel quid chewing (isilwanyana esikhuselekileyo esitholakala kwi-subcontinent yaseNdiya eguzwa njengokwenza itekisi kwaye ihlala ixutywe necuba)
- umlingane wokusela (intlawu yendabuko yaseMzantsi Melika ecebile kwi-caffeine kwaye yenziwa yerba mate)
Iimpawu
Nazi ezinye iimpawu kunye neempawu zomhlaza womlomo. (I-FYI: Umqondiso nayiphi na isiphumo esibonakalayo sesifo; kanti, impawu yinto isigulane esikhalayo ngayo kwaye ngoko ke ingumntu ophantsi.)
- amathanga amhlophe ngaphakathi emlonyeni (leukoplakia)
- umqala omzimba ongahambiyo
- i-scab (emlonyeni) okanye isilonda esingahambi
- ukubola ngaphakathi ngaphakathi emlonyeni
- intlungu ekuhlafuneni
- intlungu ngokugwinya
- izigulane ezivuvuzayo (i-lymph nodes)
- intlungu
- intlungu
- amazinyo avulekileyo
- a mazinyo omzimba
Izimpawu eziphambili kakhulu zomhlaza womlomo ziquka ezi zilandelayo:
- ukuhla ukusinda
- ukukhwehlela igazi
- ingxaki yokutya (dysphagia)
- ukuthobeka
- ukuphefumula ukuphefumula
Ngokuqhelekileyo, abantu abaneengqungquthela zomlomo babonisa iimpawu zokuqala zesifo kunye nezinye izizathu. Ngenxa yoko, aba bantu banomdlavuza emva kwexesha lokugula xa ugula lunzima kakhulu. Ukongezelela, oogqirha bokunakekelwa ngokusisiseko (oogqirha bamayeza oluntu okanye abaqeqeshiweyo) ngamanye amaxesha banokungaqwalasela ukubaluleka kweempawu zesifo somhlaza ngomlomo.
Ngelishwa, ukungabikho kokufunyanwa kwangaphambili kuyisona sizathu esibangela ukuba umdlavuza womlomo ubulale phantse isiqingatha sabantu abawunzima. Izifo ezibanjwe kusenokwenzeka kakhulu zonyango.
Ukuxilongwa
Ukuba ugqirha okanye ugqirha wamazinyo ubona i-lesion esolisayo, okanye into engaqhelekanga, emlonyeni wakho okanye emqaleni emva kokuqhuba uvavanyo lomzimba, i-biopsy yenziwe ukufumanisa ukuba yintoni lesi sifo. Nge-biopsy, isampuli esincinci isinqunywe ukusuka kumthombo kwaye ihlaziywa isebenzisa i-microscope kwibra.
Ukongeza kwi-biopsy, ezinye iindlela zokuxilonga zingasetyenziselwa ukuncedisa umhlaza womlomo okanye ufumane ukuba ingaba isasazeka (i-metastasized). Ezi zivavanyo ziquka oku kulandelayo:
- MRI
- CT scan
- Ukuphenya kwe-PET (kakuhle ekufumaneni i-metastases okanye isasazeka)
- isifuba kunye namazinyo x-ray
- i-endoscopy (ityhubhu eguquguqukayo enekhamera kunye nokukhanya ekugqibeleni isetyenziswe ukujonga ngaphakathi ngaphakathi emzimbeni wakho)
- i-barium ingumlambo (uchungechunge lwesisu esiswini se-x-ray esophagus nesisu)
Ukucwangcisa
Isigaba , okanye ubunzima, somhlaza wesibeleko kusekelwe kwiimpawu ze-TNM.
I-T kwi-TNM ibhekisela kumlinganiselo we-anatomiki we-tumor yokuqala. Ngamanye amagama, T ibhekisela kumlinganiselo apho isifo somdlavuza somlomo esisisiseko sakhula kwizakhiwo ezungeleleyo.
Emva koko i-TNM imele i-lymph node yasasazeka okanye umlinganiselo umhlaza womlomo ungena ngayo i-lymph node zesithili. (I-lymph nodes ingasasaza i-tumor kuwo wonke umzimba ngokusebenzisa inkqubo ye-lymph.)
Ekugqibeleni, i-M kwi-TNM imele i-metastases okanye ubukho bokukhula okwesibini kwimihlaba ye-anatomical esivela kwindawo yangasese.
Kukho izigaba ezi-5 zomdlavuza womlomo: Isigaba 0, I, II, III ne-IV. Ingqalelo, iSigaba IV sisahlukana ngokwengeziwe kwiinqanaba ezi-3-IVA, IVB kunye ne-IVC-esingazixubusha ngokuqondile ukugcina izinto zilula ngakumbi.
Isitetimenti sinokuqhatha. Nangona kunjalo apha iincwadana ezimfutshane zomhlaza wezomlomo eziwela nganye kwii-5 eziphambili.
- Isigaba 0 Umhlaza womlomo uthetha kwi- carcinoma in situ , okanye umdlavuza ongazange usasaze kwaye uye wahlala ngqo apho yaqala khona. Isigaba se-0 seentsholongwane zinyango kakhulu.
- Isigaba Umhlaza wesibeleko ubhekisela kwisifo esingazange sisasaze kwii-lymph nodes okanye kwiindawo ezikude ezisemgangathweni kwaye zikhulu kwi-2 cm okanye ngaphantsi kweyona nto inkulu.
- Isigaba sesi-2 somhlaza ngomlomo sibhekisela kwisifo esingazange sisasaze kwaye sisilinganise phakathi kwe-2 no-4 cm kunye nomlinganiselo omkhulu.
- Umdlavuza womlomo wesigaba se-III ungabhekisela kuyo nayiphi na isayizi somswakama oyintloko onokuthi okanye ungasasazeka kwii-lymph nodes.
- Ngokuxhomekeke kwinqanaba elincinane, i-Stage IV kanomdla ingabhekisela kunoma yiyiphi i-tumor yesayizi kunye ne-lymph node kunye ne-metastase ezikude.
Xa kuchongwa unyango olufanelekileyo, ukubeka i-tumor usebenzisa iindlela zokuxilonga kubalulekile. Isitetimenti singasetyenziselwa ukuqikelela ukuxela, okanye umbono, kulabo abanomdlavuza.
Unyango
Ngokuxhomekeke kubukhulu, isigaba kunye nendawo, umdlavuza womlomo unokuphathwa ngokusetyenziswa ngophengululo, i-radiotherapy kunye ne-chemotherapy.
Amaqela e-oncology anembopheleleko yokunyanga izigulane ngomhlaza womlomo zibandakanya ootitshala abahlukahlukeneyo bezempilo ababonelela ngeenkonzo ezongezelelweyo ezifana nokunakekelwa kwamazinyo, ukunikwa kwengqondo, ukuncedwa kwezenhlalakahle kunye nokucebisa ngokutya.
Xa i-tumor yomlomo oyintloko isetyenziswe kakuhle, okanye ichazwe kakuhle, kwaye ifikeleleke, i-ENT (indlebe, impumlo kunye nomphambo wekhosi okanye i-otolaryngologist) iya kugqithisa.
Ngamanye amaxesha, nokuba kunzima ukufumana i-tumor okanye i-tumor isasazekile, okanye i-metastasized, kwi-lymph nodes nangaphezulu. Kule meko, i-chemotherapy kunye ne-radiotherapy ingasetyenziswa. Ukongezelela, i-chemotherapy kunye ne-radiotherapy ingasetyenziswa njengesigqityiweyo, okanye ezongezelelweyo, unyango oluzalisa ukuhlinzwa kwaye lunciphise ukusasazeka komhlaza.
Abantu abafumana unyango lomhlaza womlomo kufuneka balandele ngokunyanisekileyo ukuba bahlolisise iinyanga ezi-6. Ithuba lokuba umhlaza womlomo uza kubuya phakathi kweepesenti ezingama-3 kunye ne-7 ekhulwini ngonyaka.
Prognosis
I-Stage I kunye neCape II ye-cancer yomlomo iyaphathwa kakhulu kunye nama-5 angama-90 ekhulwini. Ngamanye amazwi, inani labantu abaphila iminyaka emi-5 emva kokuxilongwa kokuqala kunye neSigaba I kunye neSigaba II somhlaza womlomo lukhulu kunama-90 ekhulwini.
I-Stage III kunye ne-Stage IV, i-Stage IV, iyancipha amanqanaba eminyaka emihlanu yokuphila: phakathi kwama-23 ne-58 ekhulwini.
Ekugqibeleni, ukuba wena okanye umntu obathandayo uphonsela umdlavuza ngomlomo nayiphi na isizathu, kubalulekile ukuba wenze isiganeko kunye nodokotela wakho ngokukhawuleza. Ngenxa yokuba iimpawu zokuqala zomhlaza wesibeleko zingabalulekanga, kufuneka wabelane ngeengxaki ezithile malunga nomhlaza womlomo kunye nodokotela wakho. Unokucela kwakhona ukuba uthunyelwe kwiingcali, okanye kwi-ENT, ukuze uhlalutye. Umhlaza womlomo sisifo esibalulekileyo esifanele siphathwe kusenokwenzeka ukuze siqinisekise ukuba sisinda.
Imithombo
U-Kim ES, u-Gunn G, uWilliam W, uJr., u-Kies MS. Isahluko 16. Intloko kunye neCeck Cancer. Ku: Hant Kantarjian, Wolff RA, Koller CA. eds. Umqulu we-Anderson we-Oncology Medical, 2e . New York, NY: McGraw-Hill; Ngo-2011. Ukufikelela kuMatshi 17, 2016.
I-athimba ebizwa ngokuthi "iTM Stage of Cancers yeNtloko kunye neNeck: Ukuzama ukulingana phakathi kweentlobo ezahlukeneyo" nguSG Patel noJP Shah opapashwe kwi-CA: I-Cancer Journal ye-Clinic ngo-2005
Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. Isahluko 43. I-Oropharyngeal Cancer. Ku: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. eds. Umbala we-Atlas we-Medicine Family, 2e . New York, NY: McGraw-Hill; Ngo-2013. Ukufikelela kuMatshi 16, 2016.