Izigulane zomhlaza wesifo seprotate, isicwangciso socwangciso esona sigxina esibaluleke kakhulu sokuphila kwangexesha elide, kwaye ukufumanisa ukuba unyango olufanelekileyo luqala ngokuchanekileyo. I-Prostate Cancer Research Institute (i-PCRI) inika izixhobo ezininzi zokunceda izigulane zibone kwaye ziqonde isigaba sabo. Bahlula izigulane zibe zigaba ezintlanu, banikezela ngamnye umthunzi ohlukileyo weBlue- Sky, Teal, Azure, Indigo okanye iRoyal.
Isigaba sichazwa ngokuphendula imibuzo yeembuzo ezisibhozo ehambelana nemibandela eyahlukeneyo-i- PSA , i-biopsy, i-scans, kunye novavanyo lwe-digital rectal-olufumaneka kwideshi yonyango. Ikhonkco lemibuzo ye-PCRI kwikhasi lasekhaya le-PCRI kwi-pcri.org.
Isatifiketi sezonyango
Akukho sidingo sokuba isigulane sitshitshise ngokucela udokotela wakhe ikopi yetshathi yonyango. Izigulane zinelungelo lokufumana iirekhodi zabo, kwaye ukuba nolwazi ngalo-isandla lunokubasiza ukuba baqonde kangcono umdlavuza wabo, baqaphele isigaba sabo, kwaye bakhethe icebo elifanelekileyo lokunyango. Ezinye iofisi zinokuhlawulisa umrhumo wokumisela, kwaye kunokufuneka ukuba ucele ulwazi kwii-ofisi ezingaphezu kweyodwa ukuba uqokelele zonke iinkcukacha eziyimfuneko. Xa isiguli sinekhophi yetshathi yakhe yonyango, uya kubona ukuba ihlulwe ibe ngamacandelo esibhalwe ngebhubhoratri, kwi-pathology, kwinqanaba leenkqubela phambili nakwi-radiology. Kulezi ziqendu izigulane ziya kufumana ulwazi oluthile olufunekayo ukucacisa isigaba sabo:
ILebhu
Emva kokuba isigulane sifumana ishati, kufuneka senze imbali yokulandelwa kwazo zonke ii-PSA. Imibuzo, i-PSA ephezulu ifakiwe. Ukwahlukana kuphela kuya kuba yi-PSA ephakamileyo ngokungabonakali ngenxa yeengcambu zeengcambu. Ngokomzekelo, amanqanaba e-PSA aya kuhlala ephakanyisiwe kwiinyanga ezimbini emva kwe-aphiop biopsy.
I-PSA inokuphinda iphakanyiswe ngokukhawuleza malunga neeyure ezingama-24 okanye njalo emva kokuhlolwa kwesigxina se-digital okanye emva kwemisebenzi yesondo. Enye into yinkalo ye testosterone egazini. Ngamanye amaxesha amadoda asebekhulile anamaqondo aphantsi e-testosterone, athi ngaphantsi kwe-100, aya kuba ne-PSA echithwe ngokutsha. Ukuba uvavanyo lwe testosterone alukwenziwanga, izigulane mazixelele oogqirha babo ngexesha lovavanyo oluzayo lwegazi. Ekugqibeleni, ukuba akukho namacandatshana angentla asebenzayo, umntu kufuneka asebenzise iPSA ephezulu xa ebala isigaba somhlaza.
KuPathology
Ingxelo ye-biopsy igcinwe kwicandelo lokukhubazeka kwetshathi. I-biopsy engaqhelekanga inokubandakanya naphi na kwi-six-20 okanye ngaphezulu kwe-coop cores. Ulwazi oluvela kwi-biopsy lukwahlula kwiindidi ezintathu ezizimeleyo. Olunye uhlobo luhlobene nebakala lomdlavuza, elibizwa ngokuba ngumlinganiselo weGleason . Eminye emibini inxulumene nemali yomhlaza efunyenweyo. Masibalekele umba wokuqala:
- Inani elipheleleyo leebhola ezinomdlavuza linikeza ubungqina besayizi somzimba. Ngokomzekelo, ukuba neengqekembe ezine zomdlavuza eziphuma kwiibhola ezithandathu zibonisa ukuba i-tumor ehle kakhulu, kuba i- half half of the cores iqukethe umdlavuza. Ngakolunye uhlangothi, omnye umzekelo uza kuba neengqungquthela zombini zomdlavuza eziphuma kuma-cores angama-20, nto leyo ibonisa ukuba i-tumor ayincinci.
- Kwakhona kubalulekile ukuqwalasela ukuba umhlaza unjani ngaphakathi kwinqanaba le-biopsy nganye. Ukwazi ipesenti yomzimba wesifo somhlaza kunceda ukuqonda ubungakanani besisu (esichazela ukuba umhlaza usanda kwaye usasazeka). I-pathologist ejongene nengundoqo kunye ne-microscope inokugweba ukuba ingaba yintoni enye yengundoqo ethathelwa ngumhlaza kwaye ubuninzi bentloko iqulethe i-prostate gland tissue. Le ngcaciso ingaxelwa ngeendlela ezimbini: Okokuqala, inokuboniswa njengenani elipheleleyo leemitha zomhlaza (1 ukuya kwe-18, kunye ne-18 emele ubude bomhlaba wonke). Ngaphandle koko, umlinganiselo womhlaza ongundoqo ungabikwa njengepesenti yenqaku elipheleleyo. Ngokuqhelekileyo, ingxelo ye-pathology ichaza le ngcaciso njengesixa sepesenti kunye nenani leemitha. Ngoko umlinganiselo womhlaza unokuqondwa kabini ngenani leenqwelomoya ezinomdlavuza kunye nokuba umdla ngamnye umxholo uqulethe kangakanani, njengoko kuboniswe kwiimithamitha okanye njengepesenti.
- Xa abantu bacinga nge-prostate biopsy, umlinganiselo weGleason, obonisa ibakala lomdlavuza, ngokuqhelekileyo yinto yokuqala efika engqondweni, kwaye yile ingqondo echanekileyo. Ibanga libonisa indlela engavumelekanga ngayo iiseli zomhlaza, kwaye ibaluleke ngakumbi kunokuba ubukhulu be-tumor. Umzekelo, kungcono ukuba ne-tumor enkulu kakhulu ebangeni lesi-6 kune-tumor ye-grade 10.
Inkqubo yokubamba i-Gleason yenzelwe iminyaka emininzi edlulileyo, kwaye, ngenxa yoko, ine-quirks yayo. Ngokomzekelo, amanqaku aphantsi kakhulu angama-6 kwaye iphezulu ngowama-10. Isiphumo se-Gleason esichazwa ngo-6 siya kubhalwa ngo-3 + 3 = 6. I-Gleason yesithoba iya kubhalwa ngo-4 + 5 = 9 okanye ngo-5 + 4 = 9. Ukuba i-biopsy iqulethe amanqaku amaninzi ahlukeneyo, amanqaku aphezulu ukusuka kwingxelo yiyo leyo kufuneka ifakwe kwi-quiz.
Isigaba | Inkcazo |
T1 okanye "A" | I-T1c: I- tumor ayikwazi ukuvalelwa yi-digital rectal examination |
T2 okanye "B" | Ukuxhaphaza kuvaliwe ngaphakathi kweprotate I-T2a : I-tumor evezwe yi-DRE kodwa ngaphantsi kwengxenye yesibini I-T2b : I- tumilor e- Unilateral evezwe yi-DRE ebandakanya ngaphezu kwehafu yesi-lobe I-T2c : I- tumoralal tumor yavakalelwa kuzo zombini i-lobes |
T3 okanye "C" | I-Tumor ivakalelwa yi-DRE eyenza i-prostate capsule I-T3a : Ukongezwa kwangaphandle I-T3b : I-tumor evezwe yi-DRE ehlasela i-vesicle (s) |
T4 | Ukuxhamla kuvezwa yi-DRE ehlasela i-rectum okanye ibladder |
Amanqaku okuqhubela phambili
Iziphumo ezivela kumnwe wokuhlolwa kweprotrate, ebizwa ngokuba yi-digital rectal examination, okanye " DRE ", kuthiwa isigaba seklinikhi okanye isigaba se- T . Endaweni ethile kwiinkcazo zenkqubela phambili, ngokuqhelekileyo kwindawo ephawulwe "Ukuhlolwa kweMpilo," ugqirha uya kubhala ukuba uvakalelwa nayiphi na i-nodule kwaye, ukuba kunjalo, ubukhulu bomlinganiselo we-nodule. Inkqubo yokwaziswa oogqirha abayisebenzisa ukurekhoda iziphumo zabo kwitshati iboniswe kwitheyibhile elingezantsi. Ukuphendula umbuzo oya kuwufuna ukwazi isigaba sakho.
Iingxelo zeRadioology (IiNgxelo zoTyikityo)
Ingcaciso yalo naluphi na ukucamngca kwesigulane esifumaneke iya kufumaneka kwicandelo le- Radiology yetshathi. Ezi ngxelo zibhalwa ngu-radiologist, onguchwepheshe onikezelwe ukufundwa. Ingcaciso ebaluleke kakhulu equkethwe kwingxelo ye-radiology isishwankathelwe kwicandelo elinesihloko esithi "Impendulo." Ngenjongo yemibuzo, ezibalulekileyo iinkcukacha ezimele ziqokelelwe kwingxelo ye-prostate ye-MRI ibakho bodwa okanye ngaphezulu koku: i-extracapsular ukwandiswa, ukuhlaselwa kwe-vesicle invicle, okanye i-lymph node.
Ezinye izikrini, ngokuqhelekileyo ukutshekisha amathambo okanye i-CT scan yesisu kunye neengxowa (ukukhangela i-lymph nodes ekhulisiwe), inokuthi yenziwe, ngakumbi kumadoda anamazinga e- PSA angaphezulu kwe-10 okanye i-Gleason yayo ingaphezulu kwe-6. Ukukhangela amathambo kubonisa umdlavuza we-metastatic , kubalulekile ukuba uqaphele indawo ye-metastases kwaye, ingaba i-metastase iphela kwii-lymph nodes okanye kwezinye iindawo zomzimba. I-scan entsha ebizwa ngokuthi i- Axumin isebenzisa i-positron ukukhishwa kwe-tomography (PET) kwaye ichaneke ngakumbi kune-CT scan. Njengoko izinto zimi njengamanje, i-Axumin ivunyiwe kuphela yi-FDA ekuphononongweni kwamadoda aphinde ahlaziya isifo (i-PSA ekhulayo) emva kokuhlinzwa okanye i-radiation.
Nawuphi na unyango lweCataltic Cancer?
Inqaku lokugqibela eliza kuqwalaselwa xa kuthatha imibuzo ye-PCRI yesiteji kukuba ngaba kukho nawuphi na unyango lwe-prostate yomhlaza. Amadoda aphethwe unyango odlulileyo kunye nokuhlinzwa, i-radiation, cryotherapy, okanye i-hormone blockade ngoku ejongene nokunyuka kwe-PSA ngokuqhelekileyo unomdlavuza ogqithisileyo kwaye unikwe isigaba esahlukileyo. Nangona kunjalo, akusoloko i-crystal icacisa ukuba yintoni impela isifo somhlaza. I-PSA ekhulayo ngokuqhelekileyo isalathisi esilungileyo, kodwa izigulane kufuneka ziqhelane nezinye zezinto zokuqhawula umdlavuza.
I-PSA iphakama emva kokuPiliswa
Ukubeka iliso kwi-PSA emva kokuhlinzwa ngokuthe ngqo. I-PSA, emva kwayo yonke, ilindeleke ukuba ibe yinto xa iprotrate gland isuswe ngokupheleleyo. Nangona kunjalo, ukukhutshwa okupheleleyo kwenkunkuma kungelula kwaye ixabiso elincinane leprotate lingashiywa ngasemva. Xa oko kwenzeka, i-PSA inokuthi ihambe ngexesha elingenammiselo kwi-0.1 kuya kwi-0.3 uluhlu, nangona kungekho mhlaza. Amadoda ngala manqanaba aphantsi kakhulu e-PSA emva kokuhlinzwa angakwazi ukuqwalasela ngokukhawuleza unyango kunye nokubeka iliso kwi-PSA yabo ngokukhawuleza ukubona ukuba kukho umgangatho ophezulu. Unyango luyakunqandwa ukuba iPSA ihlale isigxina. Ngokude i-PSA ihlala isisigxina, i-PSA ingakumbi ngenxa yeprostate ye-prostate gland tissue kunomdlavuza.
I-PSA iphakama emva kweMida
Ukubeka iliso kwi-PSA emva kokuba i-radiation ingaba ngumngeni. Njengengqungquthela yokuqala, qwalasela ukuphakama kwe-PSA ngaphezu kwe-1.0 ukuba "kungavamile." Kodwa kukho ukungafani. Kunokwenzeka ukuba ube ne-PSA engaphezulu kwe-1.0 kwaye usengenayo umdlavuza. Ukuphakama kwe-PSA okungenakuncinci kwenzeka ngokwenene emva kweemitha, ngokukodwa emva kwemitha yomsindo. Ezi ziphakamileyo zibizwa ngokuba yi-"PSA bounce." Kukholelwa ukuba ukuxhamla kubangelwa ukuvuvukala kweprotate eyenziwa nge-radiation, oko kukuthi, i- prostatitis . Ngomngcipheko, into ephambili kukuba ukwahlule kumdlavuza kwakhona. Indlela ethembekileyo yokwenza oku kukuhlola igrafu eqhubekayo yamanqanaba e-PSA amaninzi ahlolwe ixesha elide. I-PSA kumdlavuza ophindaphindiweyo iqala ukubonakalisa njengentlupheko engabonakaliyo, engapheliyo, ephakamileyo. Ekubeni i-bounce ibangelwa ukuvuvukala, la manqanaba e-PSA athambekele ekukhenkeleni aze aphephe, aqhube phezulu aze ahla egrafu kwi-zig-zag, iphethini ye-spiking.
Ukujongana noLwaphulo lweHormonal
Ukuxhatshazwa kweHormone kuchazwa njengePSA ephakamileyo naphezu kwamazinga aphantsi e-testosterone egazini. Amanqanaba e-PSA kufuneka ahlaziywe ekuqaleni kokunyanga kwama-hormone kwaye ngokuqhubekayo. Ukubona ukuchasana ne-hormone blockade kulula ukuba i-PSA kufuneka ihlale iyancipha ukuya ngaphantsi kwe-0.1 kwisithuba seenyanga ezi-6 ukuya kwezi-8 zokuqala i-hormone blockade. Ukuba oku kungaphumeleli, ngokuqhelekileyo kuthetha ukuba i-PSA iya kuqala ukuphakama kwixesha elizayo.
Isiphelo
Njengoko ucinga ngeendlela ezahlukeneyo zonyango, kufuneka uhlaziye ishadi lakho lonyango kwaye uzalise imibuzo yePCRI ukuze uqonde isigaba sakho somhlaza. Ukuqonda indlela ukunikezela ngayo isigaba kumdlavuza wakho kuya kubhinqa ngoluvo olufunekayo lokukhetha isicwangciso sonyango olufanelekileyo kunye nokuphucula umgangatho wakho wobomi kunye nobomi obukhulu.