Umdla wesibindi awuqhelekanga eUnited States kodwa ixhaphake emhlabeni jikelele ngenxa yezinto ezinobungozi ezifana nesifo esingapheliyo sesifo se-hepatitis B kunye nokusuleleka kwe-hepatitis C kunye ne-aflatoxin. Iimpawu zingabandakanya i-jaundice (i-yellowing yesikhumba), intlungu kwisisu esasentla, intlungu yesigxala sehlombe, kunye nokulahleka kwesisindo. Oogqirha baxilonga le mqathango basebenzisa ukudibanisa iimvavanyo kunye nokuhlolwa kwegazi.
Ngokuxhomekeka kubukhulu be-tumor, ukhetho lwezokwelapha lungabandakanya ukususwa kwe-tumor, ukufakelwa kwesibindi, unyango oluthile, i-chemotherapy, kunye namaxesha athile unyango lwe-radiation.
Umdlavuza wesibindi uvela esibindi, iqumrhu elingaphantsi kweembambo zakho ezingezantsi ngakwesokudla kwesisu sakho. Kubalulekile ukuhlukanisa umdlavuza wesibindi (i-hepatocellular carcinoma) kunye nomdlavuza we-bile duct (cholangiocarcinoma) ukusuka kwiimvumba eziqala kwezinye iindawo zomzimba kwaye zisasaza esibindi (isistimases sesibindi). Ubungqingili bezilwanyana zixhaphake kakhulu kunezonyana zomhlaza zesibindi kwaye ziphathwa ngendlela yokuba umdlavuza oyintloko (njengomdlavuza wamaphaphu okanye umdlavuza wamabele) uphathwa ngayo, endaweni yendlela umdlavuza wesibindi oyintloko ophathwa ngayo.
Imisebenzi yesibindi ibalulekile ukwazi ukuba ubheka njani iimpawu zesifo eso. Isibindi sidlala indima ekukhunjuleni izinto, ukufihla ibhiya ukuze kuncedwe ekutyeni kunye nokwenza i-hormone ebalulekileyo ekuvelweni kweeseli ezibomvu zegazi.
Ukongeza kwii-cancers ezikhankanywe ngasentla, zikhona iintlobo eziqhelekileyo zesifo somhlaza wesibindi. Ezinye ezimbalwa zezi ziquka i-hepatoblastoma, uhlobo olunqabileyo lomhlaza wengane, kunye ne-angiosarcoma yesibindi. Olu hlaziyo luya kugxila kumdlavuza wesibindi sokuqala kunye nomhlaza we-bile.
Iimpawu
Izimpawu zomhlaza wesibindi aziqhelekanga kwizigaba zokuqala zesi sifo ngaphandle kokuba i-tumor ihlala kufuphi nenye yee-ducts kwaye ibangela ukuphazamiseka (kunye neempawu ezifana ne-gallbladder attack).
Iimpawu zingabandakanya:
- Ubunzima kwisisu esisentla
- Ubunzima kwisisu esiselunxwemeni (phantsi kwembambo zakho okanye ezinokuba ziphantsi)
- Intlungu yentlungu
- I-jaundice , i-yellow-discoloration yesikhumba kunye nabamhlophe bamaso
- Isikhundla esisezantsi okanye esimhlophe
- Umchamo omnyama
- Ukutsalisa okukhulu
- Ama-Ascites , i-build-up fluid esiswini
- Umkhuhlane (ama-101 degrees okanye ngaphezulu ahlala iintsuku eziliqela ngaphandle kwempawu ebonakalayo yesifo)
- Ukulahlekelwa kwesisindo esingenakuzenzela ngaphandle kokutshintsha okukhulu ekudleni okanye ngokuzilolonga
- Izimpawu ezingabonakaliyo ezifana nokulahleka kwesidlo, ukukhathala, kunye nesimo esiqhelekileyo sokungahlali
Izizathu kunye neengozi
Asiqinisekanga ukuba yintoni ebangela ukuba eso sifo, nangona siyazi ngemingcipheko emininzi yomhlaza wesibindi . Uninzi lwaloo mngcipheko lubangela ukusila (isifo se-cirrhosis) yesibindi, nangona umdlavuza wesibindi ungakhula ngaphandle kwe-cirrhosis.
Umdla wecala lomdlavuza wesibindi ungenye yeentlobo ze-hepatitis. Ngokubambisana, i- hepatitis B kunye ne-hepatitis C bacingelwa ukuba yimbangela ye-85 ekhulwini yeentsholongwane zeesibindi emhlabeni jikelele. Ezinye zezinto ezinobungozi zibandakanya:
- Ukusetyenziswa kotywala nokubhema: Ukusetyenziswa kotywala obude ixesha elide (ngaphezulu kwezi-3 iziphuzo ngosuku) kuboniswa ngokucacileyo nophuhliso lwe-cirrhosis, kwaye lunokuphakamisa umngcipheko wesifo somhlaza. Ukutshaya kubonakala kuphakamisa umngcipheko, ngakumbi xa kuhlanganiswe nezinye izinto ezinobungozi, njenge-hepatitis B.
- Imbali yentsapho kunye nezifo zofuzo: Ukuba unelungu losapho olunomdlavuza wesibindi, umngcipheko wakho uphakeme ngaphezu kohlobo. Umngcipheko ukwandisiwe nakwabo abanezifo ze-genetic ezifana ne- hemochromatosis kunye nesifo sikaWilson.
- Izimo zonyango: Izimo zonyango ezandisa ingozi yomhlaza wesibindi ziquka i-sclerosing cholangitis eyintloko, isifo se-cirrhosis esiyintloko, isifo esingasinxilisayo sesifo sesibindi , nesifo sikashukela.
- I-Aflatoxin: Ukungaqhelekanga e-United States, kodwa ngokuqhelekileyo kwihlabathi jikelele, ukuxhamla kwi-aflatoxins-i-toxins ekhutshwe yi-fungi ekhula kwimbewu engafanelekanga egciniweyo kunye neentonga-ibangelwa ngumdlavuza wesibindi.
Ukuxilongwa
Abo baneempawu zesifo somhlaza okanye isifo sengozi yokuphuhlisa eso sifo kufuneka babone ugqirha wabo. Udokotela angathatha umlando oqinileyo kwaye enze uvavanyo lomzimba. Kweminye, ukuhlolwa kweemvavanyo kunokuqwalaselwa. Ngokuxhomekeke kuvavanyo, ukuhlanganiswa kweemvavanyo zegazi kunye nokuphonononga iifoto kungenziwa.
- IiLabs kunye neemvavanyo: Umsebenzi wegazi (njenge- test function function ), iphaneli ye-hepatitis, kunye ne-marker tumors zidla ngokuba ngamanyathelo okuqala ekufumaneni umdlavuza wesibindi. Olunye uvavanyo oluthile, uvavanyo lwe-alpha-fetoprotein tumor marker (AFP), lunokuthi luyalelwe ukuba lukhusele izifo zesibindi.
- Ukufanekisa: Uvavanyo lokuqala lokuqala lokufakela i-imaging test. Ezinye iimvavanyo ezinokuba luncedo ekuhloliseni ziquka iMRI kunye ne-CT. I-angiogram yesibindi isenokucetyiswa kwakhona.
- I-Biopsy: Ngokungafani namaninzi emdlavuza, ukuxilongwa komdlavuza wesibindi kudlalwa ngokusekelwe ekufunyanweni kweengcamango kunokuba i-biopsy. I-biopsy ayinakufuneka ngaphandle kokuba kubalulekile ukuqonda iimpawu ze-molecule zesisu, njengesilingo seklinikhi.
Unyango
Izinyango zokwelapha ezifumaneka kumhlaza wesibindi zixhomekeke kwisigaba sesi sifo, impilo yakho jikelele kunye nokunye okuninzi. Izinyango zokwelapha ziwela kwiinkampu ezimbini:
Unyango lweZonyango
Ezi ziphethe iiseli zomhlaza apho zikhona khona kwaye ziyiyona ndlela ekhethekileyo yokukhangela umdlavuza wesibindi.
Khetha ziquka:
- I-Chemotherapy: Kukho ukudibanisa okungafaniyo kwezidakamizwa ze- chemotherapy ezinokunikezelwa ngumhlaza wesibindi. I-Chemotherapy isebenza ngokuhlasela iiseli ngokukhawuleza emzimbeni. Ngelishwa, kukho iiseli eziqhelekileyo emzimbeni okwahlula ngokukhawuleza, okubangela ukuba kube nemiphumo emibi eyaziwayo ye-chemotherapy, ezifana nokulahlekelwa yintlungu kunye nobungozi obuninzi bentsholongwane. I-Chemoembolization yinkqubo apho i-chemotherapy inikwe ngqo kwi-artery enkulu (i-transarterial) engena esibindi. I-Chemoembolization ingasetyenziselwa nje ngonyango oluphambili, kodwa isetyenziswe ukuzama ukunciphisa ukukhula kwe-tumor ngelixa umntu elindele ukufakelwa kwesibindi.
- I- thérapi ejoliswe kuyo: Iyeza zonyango ezijoliswe kuzo zihluke kwi-chemotherapy ngokuthi "zijolise" kwindlela ethile ekukhuleni kweseli somhlaza. I-Nexavar (sorafenib), uLenvima (lenvatinib), kunye ne-Sivorga (regorafenib) konke kuphucula uphulo kwaye njengamanje unyango oluqhelekileyo kubantu abanomdla wesibindi.
Zengingqi zonyango
Ezi ziphethe umdlavuza apho zivela khona. Izinketho ezinokuqwalaselwa ziquka:
- I-hepatectomy ekhethekileyo: Oku kususwa komhlaza kunye nezinye izicubu eziqhelekileyo. Le nto inokukhethwa kwintsholongwane encinci yesibindi (ngaphantsi kwe-5 cm ububanzi), kuxhomekeke kwindawo yabo.
- Ukufakelwa kwesibindi: Isibindi sokugula sisuswe kwaye satshintshwa inxalenye okanye isibindi esipheleleyo sempilo. Le nto inokuba yinto enhle kulabo abanesifo esiphezulu okanye abaye bachitha ukuhluleka kwesibindi kodwa nangenye indlela kwimpilo efanelekileyo.
- Uphulo lwe-radiation: Oku kungabandakanya ukwelashwa kwemitha yangaphandle ye-radium (ukuphatha indawo enkulu ye-tumor, ngokuqhelekileyo ukunciphisa iimpawu okanye ukwandisa ubomi, ukuba ungaphilisi isisu); umzimba we-stereotactic radiotherapy, okanye i- SBRT (usebenzisa umthamo ophezulu wemisebe yendawo encinci yeesisisu ukuphelisa isisu); okanye i-brachytherapy (ukubeka ubuhlalu be-radioactive kwisibindi).
- I-Radiofrequency ablation (RFA): Oku kukusetyenziswa kweprobethi enee-electrode ezincinci ezibhubhisa iiseli zomhlaza.
- I-Cryotherapy: Oku kubandakanya ukuqhwala izicubu zomhlaza.
- Injoyi ye-ethanol emfutshane: Oku kubandakanya ukujova kotywala kwisibindi kwaye yinkqubo ekhuselekileyo yamathumba amancinci, kodwa sele ithathelwe ingqalelo ngokutshatyalaliswa kwee-radiofrequency kwiminyaka yamuva.
Kungakhathaliseki ukuba uluphi uhlobo lwesicwangciso sonyango wena kunye nogqirha wakho ukhetha, kufuneka wazi zonke iinketho ezikhoyo. I-National Cancer Institute ikwacebisa nokuqwalasela ukhetho lwezilingo zeklinikhi . Abaninzi bayaqhubeka kwaye bajonge ukudibanisa kwezi zonyango ezilapha ngasentla, kunye neendlela ezintsha zonyango ezifana ne- angiogenesis inhibitors , iindlela ze- immunotherapy , kunye nokunye.
Unonophelo loLuntu
Ukunyamekela okubandakanyekayo kubandakanya ukuphatha iimpawu zomhlaza kunye nomhlaza wonyango, kunokuba umhlaza ngokwawo. Ngokungafani nokunyamekelwa kwabantwana base-hospice, ukunakekelwa ngokunyamekela kungasetyenziselwa abantu abaneentsholongwane eziphilisa kakhulu. Ukongezelela ekuphuculeni umgangatho wobomi, uvavanyo lwe-2018 lubonisa ukuba olu hlobo lononophelo lunokuphucula iziphumo kubantu abanomdla wesibindi.
Thintelo
Xa kufikelele ekukhuseleni umdlavuza wesibindi , i-ounce yokuthintela ifanele i-pounds yokunyanga-kwaye ukukhusela i-hepatitis B ne-C kubaluleke kakhulu. Ukuba unako ukuphepha ukuhlakulela ezi zifo, okanye ukufumana unyango ukuba unabo, unokunciphisa ingozi yomdlavuza wesibindi ngamaphesenti angama-90. Kwabo baphethe ezi zifo, kukho unyango olunokunciphisa umngcipheko wokuphuhlisa i-cirrhosis, kunye nomdlavuza wesibindi.
Ukunciphisa utywala, kwaye ukuba ubhema, shiya. Thatha ixesha lokufunda ngembali yentsapho yakho nayiphi na imeko yonyango, ingakumbi ezo zibangelwa iingxaki zesibindi. Yaye uqaphele nangayiphi na imichiza oye wavelelwa kuyo emsebenzini, njengoko ezinye zaziwa ngokubangela umdlavuza wesibindi.
Ukujamelana
Ukuba wena okanye umntu obathandayo ufunyanwe ukuba unomhlaza wesibindi, unokuvakalelwa ngathi ihlabathi lakho liye laphendulwa. Sekunjalo, kukho izinto onokuzenza ezinokukunceda uzive ngathi unako ukuphefumula. Funda ngokubanzi njengoko unako ngomdlavuza, kodwa qaphela ukuba ukhangela ulwazi olusandul 'ukutsha kwangoko. Amanyango kunye namazinga okusinda aya kuphucula, kwaye ulwazi oluneminyaka embalwa ubudala alukwazi ukubonakalisa olo tshintsho. Okufanayo kuya kwiinkcukacha zobomi.
Ukudibanisa nomdla wesifo sesibindi kunokuncedisa kokubili kwimbono yenkxaso yemoya kwaye njengendlela yokufunda malunga nophando olutsha kwimihlaza yesibindi. Abantu abaphila nesi sifo bayakhuthazwa kwaye kaninzi bayazi ngakumbi kunokuba baninzi kwi-oncologists malunga neyeza zonyango. Unokukhangela iqela loxhaso kuluntu lwakho, okanye ufumane umdlavuza wesibindi kwi-intanethi. Ukufumana abantu abalungileyo, zama ukusebenzisa ii-hashtag #livercancer kunye #livertumor.
Fumana kwiintsapho kunye nabahlobo kwaye wamkele inkxaso abanokuyinika. Ukujamelana nomdlavuza wesibindi ngokwenene kuthatha idolophana.
Ukunyamekela
Bambalwa abantu abanomdla wedwa, kwaye ukujamelana nomdlavuza wesibindi kunokuba ngumngeni kubanakekeli bentsapho njengabo bahlala nesifo. Enye yezona nkalo ezinzima kakhulu zokunakekelwa ngumntu ongenakunceda, kodwa kukho iindlela zokuncedisa umhlobo wakho kunye nokujamelana nale ntliziyo. Ukufunda okungaphezulu malunga nomhlaza wesibindi yindawo enkulu yokuqala.
Ingxabano iyaxhaphaka xa abantu abanomdlavuza kunye nabathandekayo babo behluke ngendlela abaya kuyifumana ngayo unyango. Nika iingcamango zakho, kodwa khumbula ukuba lo luhambo lwakho lomthandayo olufunekayo ukuhamba ngendlela yakhe.
Ekugqibeleni, kubaluleke kunanini ngaphambili ukuzinyamekela njengomncedisi. Oku kungabonakala kungenakwenzeka ngamanye amaxesha, kodwa kuthatha ixesha lokuqinisekisa ukuba iimfuno zakho zidibene nazo ziya kukunceda ukuba uhlale uphilile ngokusemandleni akho xa unakekela umthandayo.
ILizwi
Ukuba ukhathazekile ukuba unomdlavuza wesibindi, xela ugqirha wakho. Unyango luyasebenza kakhulu kwiinqanaba zokuqala zesifo, kwaye ukubamba le ngqayi kunika ithuba lokunyanga.
Kwabo bafumene ukuba banomhlaza wesibindi, kusekho ithemba. Unyango luya kuphucula, kwaye unyango olutsha lunokufumaneka kwiimvavanyo zeclini. Qinisekisa ukuba yingxenye esebenzayo yokunyamekela umdlavuza. Funda indlela yokuba ngummeli wakho, okanye ufumane umhlobo okanye othandekayo onokukukhuthaza. Ukuzimela ngokwakho, xa unomdlavuza, awufumananga nje ukunciphisa ukuxhalabisa kodwa ngamanye amaxesha kunokukwazi ukuphucula iziphumo.
> Imithombo:
> Umgqugquzeli, A., Reig, M., noJ. Bruix. I-Hepatocellular Carcinoma. Lancet . 2018 Jan 4. (Epub ngaphambi kokuprinta).
> INational Cancer Institute. Ukwelashwa kweNtsholongwane yeMhlaza yePilisi (PDQ) -I-Professional Professional Version. Ukuhlaziywa -2/06/18. https://www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq
> Woodrell, C., Hansen, L., Schiano, T., noN. Goldstein. Ukunyamekela ngokunyamekela abantu abane-Hepatocellular Carcinoma, kunye neNzuzo ekhethekileyo yabadala abadala. Therapy . 2018 uMatshi wama-20 (uEpub ngaphambi kokuprinta).