Umdlavuza wesifuba ukwesaba ngokwaneleyo ngaphandle kokwesaba ukuba unokuya kwezinye iindawo zomzimba. I-Metastasis yithuba lokusasazeka komhlaza. Abafazi abangaba ngu-250,000 bafumaneka ukuba banomdlavuza wesibeleko kunye nama-40,000 aya kufa ngenxa yesifo ngamnye unyaka. Xa umhlaza wesifuba ufumaneka kwiinqanaba zokuqala, amaninzi amabhinqa aya kuphila ubomi obungenasifo somhlaza.
Sekunjalo kwabanye, lesi sifo sisetekisi ngexesha lokuxilongwa okanye kamva kwakhona. Kucingelwa ukuba izifo ze-metastatic zijongene neepesenti ezingama-90 zokufa ezihlobene nomhlaza wesibele. Umhlaza wesibeleko usasazeka njani okanye ubuyele kwakhona?
Ukuxilongwa kwangaphambili
Umngcipheko wokuthi umdlavuza webele uya kubuya okanye usasaze uhambelana nobukhulu be-tumor kunye nobukhulu basasazeka ngexesha lokuxilongwa.
Kuba malunga nama-20 ekhulwini kwabasetyhini, umhlaza wesifuba ufumaneka kwisigaba sokuqala. Isigaba 0 Umhlaza wesifuba okanye i-carcinoma in situ ithathwa njengesifo somhlaza wesifuba sangaphambili. Ekubeni la mayeza okuqala angasasazeka ngaphaya kwezinto ezibizwa ngokuba ngumgca wendawo engaphantsi (abazange bahambele ngaphaya kweengcambu zebele), ukuhlinzwa kufuneka kuthintele le ngqungquthela.
Eminye i-70 ekhulwini yabantu bayifumene nomhlaza wesifuba ongenawo umonakalo (usasazeka kwizitho ezikude). Ezi khansa zamabele, ezithathwa njengegciwane lesigaba 1 ukuya ku-3, ziyakwazi ukusasazeka kwii-lymph nodes kodwa zingekho kwezinye izitho.
Ngonyango ezifana nophando , i- chemotherapy , unyango lwe-radiation, unyango lwe- hormonal , kunye / okanye iipilisi ezijoliswe kuyo, ezininzi zala mathambo ziya kuhlala zihlala. Umngcipheko, nangona kunjalo, ziya kuvela kwakhona (kwakhona) ngaphezulu kunye nezigaba eziphezulu kwaye ukuba i-lymph nodes zibandakanyeka.
Amaphesenti angaphantsi kwe-10 amabhinqa ayafunyanwa xa umhlaza sele usasazeke kwiindawo ezikude zomzimba.
Umdlavuza wesifuba usenokusasazeka emathanjeni, isibindi , imiphunga kunye nengqondo.
Ukuphindaphinda
Uninzi lweengcingo zesifuba ezingummastasti ziqala ukuxilongwa njengengqungquthela yeengcambu zesifuba ezisekudala. Iirejista zingaba:
- Ummandla: Kwibele
- Ummandla: Kwii-lymph nodes okanye kwindonga yesifuba
- Ekude: Izitho ezikude
Xa umhlaza wesifuba uphindela kwindawo ekukude awusayi kuphulukiswa kodwa usaphila, kwaye unyango luyakwazi ukuphucula iimpawu kunye nokwandisa ubomi.
Ukoyika nokuqonda
Abantu abaninzi bayaboyika ukuphindaphinda komdlavuza webele, kodwa abaninzi banako ukufumana ukulinganisela phakathi kokuqaphela nokukhubazeka. Kuqhelekile kwaye kuqhelekile ukuba ube nolwazi oluphakamileyo xa uhlakulela iimpawu zokusasazeka emva kokuba nomhlaza wesibeleko. Intloko inokuba yinto eqhelekileyo yintloko, kodwa ingcamango yengqondo ye-metastases ingafika engqondweni. Ngokufanayo, ukuguqulwa kumqolo wakho kunokukwenza ukhathazeke ngamathambo e-boneastases ngelixa kunokwenzeka ukuba ulala ngephutha.
Kubalulekile ukuba wonke umfazi (kunye nomntu) onomdlavuza webele uyazi malunga nokulindela kwabo. I-oncologist yakho inokukunceda uqonde oku kusekelwe kumhlaza wakho, isigaba sayo kunye nezinye iimpawu.
Ukuba nolwazi oluphakamileyo lunokuqinisekisa ukuba ulandelelwano olufanelekileyo kunye nokungazi ixesha lokubiza. Ukuba uloyiko luba lukhuni ngokwemvakalelo, kunjalo, unomdlavuza womhlaza unokungabalulekanga ekuncedeni ukugcina umlinganiselo phakathi kokunyaniseka kunye nokwesaba.
Indlela umdlavuza webele usasazeka ngayo
Umhlaza wesifuba ungasasazeka kwezinye iindawo zomzimba ngezindlela ezintathu eziphambili:
- Ngokusebenzisa i-lymph system: Iiseli zesisu zesisu ziyakunqumla kwi-tumor ebeleni kwaye ufake iinqanawa ezincinci ze-lymphatic ezikhoyo kuwo onke amabele. Ukususela apho banokuqhutyelwa ngeendlela zelymphatic ukuya kuma-lymph nodes nangaphezulu. Yandwendwela i-lymphatic ebaluleke kakhulu ekuxilongweni nasekuxhasweni komhlaza wesifuba. Ukuba i-tumor isasazeke kwibele iya kwi-lymph node ye-sentinel (ukuba umhlaza ngumlenze we-lymph node positive ) "uye wachaza" injongo yokusabalalisa ngaphaya kwebele. Abantu banokudideka kakhulu xa befunda iingxelo zabo zokugula . Ukuba umhlaza usasazeke kwii-lymph node eziseduze, ingxelo ingathi "i-metastatic to lymph nodes." Oku akuthethi ukuba unomdlavuza webele we-metastatic, kwaye nakwiminyaka yokuqala ye-1B isifo somdlavuza sinokubandakanyeka kwe-lymph node.
- Ngegazi legazi: Kanye njengoko kukho iinqwelo ezincinci zelinfo kwibele, zininzi iimithambo ezincinci zegazi. Iiseli ze-Cancer zingangena kwiimitha ezincinci zegazi kwaye ziqhutywe ngegazi kwiindawo ezikude, ngokukodwa iinkalo ezinjengemiphunga kunye nesibindi esinegazi elikhulu.
- Ukuhlasela kwendawo: Umhlaza wesisu unokusasazeka kwiimveliso ezikufutshane ezifana nodonga lwesifuba okanye iimbambo ngokuhlasela. Iiseli zomhlaza zihlukile kuneeseli eziqhelekileyo ngale ndlela. Izibilini ze-Benign zingakhula kwaye zifake iifomthi eziseduze, ngezinye izihlandlo zidale umonakalo. Kodwa izicubu zomhlaza zihlasela ezi zicuksi. Enyanisweni, igama elithi "umhlaza" livela kwigama lesiGrike elisho "isikratshi" ukuchaza ukwanda kwe-crab-like cancer kumathiskhi asondeleyo.
Xa umdlavuza webele usasazeka kwelinye iqumrhu kusekhona umdlavuza webele. Ngokomzekelo, ukuba umhlaza wesibeleko wawusasazeka kwimipopeni awungayi kuthiwa ngumhlaza wamaphaphu. Esikhundleni salo, siza kubhekisela kuyo njengengqambela yesifo somhlaza emathunjini okanye umdlavuza webele kunye neemiphunga zamaphaphu. Ukuba ukhangele iiseli zomhlaza emiphakeni phantsi kwe-microscope babeza kuba ngamaseli esifo somhlaza, kungekhona amangqamuzana emiphunga yomhlaza.
Iintsholongwane eziye zasasazeka kwezinye izicubu zinokuthi zihluke kune-tumor yokuqala, kwaye le yinye indawo yokudideka. Amanqwelana awayena nje iqoqo leeseli ezingavumelekanga ezonakalisa ingqondo. Kunoko, zihlala ziguqula kwaye ziphucula utshintsho olutsha. Ngenxa yesi sizathu, i-tumor eyayisisiphumo se- estrogen esilungileyo xa ifunyenwe kwisifuba sinokungenayo i-estrogen receptor. ISI-2 sayo sinokutshintsha kwakhona. Oku kwacaca ukuba kutheni ama-tumortic metrium ngezinye izidlova kunesifo sokuqala.
Isizathu Sokuba Sisasaze kwaye sibuye
Unokuzibuza ukuba kutheni iiseli zomhlaza zesifuba zihamba nonke. Okanye, kutheni amangqamuzana aqhelekileyo engasabalalisi emzimbeni wethu. Iiseli zomhlaza ziyahluka kwiiseli eziqhelekileyo ngeendlela ezininzi. Enye yezo iiseli eziqhelekileyo ziyaziwa ngokuba yi "molecules". Ezi iamolekyu zokunamathela zenza njengeglue kwaye zigcina iiseli apho ziyingxenye ethile yomzimba.
Iiseli eziqhelekileyo zinayo "imida" okanye iindlela apho iiseli zixhulumana. Oku kufana nelizwe elinye lisithi kwenye "awunabo apha." Iiseli zeCans, ngokuchaseneyo, azihloneli ezo nxibelelwano zamaseli, ngokungaqhelekanga ukungazihoxisi "iingcingo" phakathi kwamathambo ahlukeneyo.
Enye into edidekayo xa uthetha ngomhlaza wesibeleko sebele ngenxa yoko kwenzeka ntoni kwiminyaka okanye kwamashumi eminyaka kamva. Siyazi ukuba, ngokukodwa ngeengcingo zesisu ze-estrogen-receptor-positive, umdlavuza unokubonakala unqabile kuphela ukubuyela emva kweminyaka emininzi emva kwesisu sokuqala. Akukho mntu ngokuqinisekileyo ukuba oko kwenzeka njani, kodwa kukho iingcamango malunga nokuphindaphinda okubonisa ukuba ezinye iiseli zomhlaza zesifuba zinzima kunabanye kwaye ukuba le mhlaza "i-cell stem" iyakwazi ukulala kakhulu nangona unyango.
Izinto zobungozi
Asiyazi ukuba yeyiphi i-cancer yebele iya kuphinda ibe yinto engayiyo, kodwa kukho ezinye izinto ezandisa ingozi. Ezi ziquka:
- Amanqanaba angamazinga aphakamileyo (umzekelo, isigaba 3 vs isigaba 1)
- Iintsholongwane eziye zasasazeka kwii-lymph nodes
- Iintsholongwane ezinobundlobongela ( zinebanga eliphezulu le- tumor )
- Iintsholongwane ezenzeka kubasetyhini abaselula
Iimpawu
Ukuba unemastastases unakho okanye ungenayo nayiphi na impawu. Ezinye izidumbu zitholakala kwiimvavanyo zokuhlola, ezifana ne-scan scan okanye iPET scan. Ekubeni le mvavanyo iyakwazi ukubona i-metastase, abafazi abanomhlaza wesibeleko basesekuqaleni bangase bazibuze ukuba kutheni i-scans follow-up scans ingenziwanga. Isizathu kukuba nakuba i-metastases ingafunyanwa ngokukhawuleza ngokujonga, ukufumana le mimandla yokusasazwa phambi kokuba unayo impawu ayiphuculanga ukusinda.
Iimpawu eziqhelekileyo zomhlaza wesibeletho se-metastatic zingabandakanya ukuvakalelwa, ukulahlekelwa ngumzimba okanye ukunciphisa ukutya.
Xa umhlaza wesifuba usasazeka kwimiphunga ingabangela ukuphefumula nokuphefumula. Ubunzima besifo ngenxa yesifo somhlaza wesisu kunokubangela ukukhathazeka kwesisu kunye ne-jaundice, ukukhwabanisa okwesibhakabhaka kwesikhumba.
Indawo eqhelekileyo ye-breastastas isifo samathambo, kwaye iimpawu zihlala ziquka intlungu. Maxa wambi isibonakaliso sokuqala sisifo se- pathologic , i-break break that occurs through the bone of the bone and is often caused by a traumatic trauma. I-Brain metastases ingabangela iimpawu ezinjengentloko, umbono otyhafayo, ubuthathaka, kunye noxinzelelo.
Ukwazi oku, abafazi abanomdlavuza wesibeleko besifuba bangase babe nexhala xa behlakulela nayiphi na le mpawu. Kubalulekile ukuba ukhumbule ukuba abafazi abangenayo umdlavuza webele bafumana intloko. Kodwa ube nomnene nawe. Abo bangenayo umdlavuza wamabele bangakuncengcazela malunga neenkxalabo ezinxulumene neentlungu kunye neentlungu ezintsha, kodwa abo banomdlavuza webele baya kufumana. Ukuba kuthatha ukufumana uphawu oluhlolisweyo ukuze ukhululeke, qiniseka ukwenza njalo.
Ukuxilongwa
Oogqirha baneendlela eziliqela zokumisela ukuba umhlaza usasazeke okanye awuyi. Oku kuquka ukucinga ngomzimba usebenzisa i-x-ray, i-bone scans, i-MRIs, i-CT, okanye i-PET. Iimvavanyo zegazi zihlola ubungakanani beekhemikhali ezithile kwigazi, kubandakanywa amanqaku amathinteli anxulumene ne-metastasis.
Kananjalo, oogqirha bahlala bexhomekeka kwii- biopsies , eziziisampuli zamathambo ezihlanganiselwe ukususwa okanye ukuchithwa kwenaliti. Ezi sampulu zihlolwe phantsi kwe-microscope yezinto ezingaqhelekanga zamaselula ezibonisa ukuba kukho ukunyuka komhlaza.
Unyango kunye ne-Outlook
Xa umdlavuza webele usuka kwisigaba se-4 (i-metastatic) akusayi kuphulukiswa kodwa isaphathwa kakhulu. Izinyango zokwelapha umhlaza wesibeletho se-metastatic ziquka i-chemotherapy, unyango olujoliswe kuyo, unyango lwe-osteoporosis, unyango lwe-hormonal, kunye neyeza zonyango ezifana ne-immunotherapy izilingo kwizilingo zonyango. Iimitha zesithintelo eziqhelekileyo, ezinjengezo zengqondo, ngamanye amaxesha ziphathwa ngokuhlinzwa okanye unyango lwe-radiation.
Ngokuqhelekileyo, injongo yonyango ihluke kakhulu nomhlaza wesifo se-metastatic xa kuthelekiswa nezigaba zangaphambili zesifo. Ngezifo ezisekuqaleni, unyango luvame ukunyusa ngenjongo yokuphilisa umdlavuza. Nangona isigaba 4, nangona kunjalo, umlinganiselo omncinci wonyango wokulawula isifo ngokuqhelekileyo usukelo. Ukuphatha ngokugqithisileyo eli nqanaba akuphuculisi iziphumo kodwa kwandisa ingozi kwimiphumo emibi kunye nomgangatho obuthathaka obomi.
ILizwi
Ipesenti encinci yabasetyhini banomdlavuza wesibeleko ngexesha le-diagnostic, kodwa ngokuphindaphindiweyo i-metastases iphindaphindwa ngokukhawuleza kwesifo somhlaza wesifuba sangaphambili. Ithuba lokuba umhlaza uza kuphinda uxhomekeke kwiimeko ezininzi. Ukwesaba ukuphindaphinda kunokushiya abanye abantu bazive bexhalabile, nangona ixesha elininzi abantu banako ukufumana ukulinganisela. Olunye uhlobo lokuxhalabisa lubalulekile ekuncedeni abasetyhini (kunye namadoda) ukuba alandele kunye nokunyangwa okucetywayo kunye nokulandelelana.
I-Cancer ingasasaza kwiindawo ezikufutshane okanye ngeethambo kunye negazi. Ekubeni ukusasazeka komhlaza wesifuba obangela uxanduva lwabantu abaninzi abaswele kwisifo, abaphandi abaninzi bajonga ngezizathu zokuba iiseli zomhlaza zisasazeka kwaye ziphi na izinto ezinokubathintela ukuba benze njalo.
> Imithombo
> I-American Cancer Society. I-Cancer yeBester Facts and Figures 2017-2018 .
> Ama-Muzes, G., kunye noF. Sipos. I-Metastatic Cell Dormancy kunye noKuvuselela kwakhona: Ingqwalasela kwiiNqaku zeeMilecular Events ezibalulekileyo kwiCarcer. Agent Agent in Medicine Chemistry . 2017. 17 (4): 472-482.
> INational Cancer Institute. Canast Metastatic.