Umdlavuza we-Pancreatic awuqhelekanga, kodwa ekubeni uninzi lwama-cancer asemagqabini aphakamileyo ngexesha lokuxilongwa, yinto yesine ebangela ukufa kwe-cancer e-United States. Iimpawu zingabandakanya i-jaundice engenasifo, iintlungu zesisu, ukulahleka kwesisindo, kunye namaxesha athile angalindelekanga ngesifo sikashukela. Iimvavanyo ezifana ne-CT kunye ne-endoscopic ultrasound zisetyenziselwa ukuxilonga imeko.
Izinyango zokwelapha ziquka ukuhlinzwa, i-chemotherapy, iipilisi ezijoliswe kuyo, unyango lwe-radiation, kunye novavanyo lweeklinikhi.
Ukuqonda amaPancreas
I- pancreas iyilungu elincinane ngamasentimitha ama-intshi ubude, amabini ububanzi obubanzi kwaye libunjwa njengepini elincinci kwicala layo. Umphelo obanzi wepakreya ubizwa ngokuba yintloko, ngelixa iqendu eliphakathi libizwa ngokuba ngumzimba, kwaye umgca omncinci umsila. Iintsholongwane ziqhelekileyo entloko.
I-pancreas yenziwe emva kwesisu phambi komgudu. Ayikwazi ukuvalelwa ngexesha lovavanyo lomzimba njengoko lujikelezwe ngamanye amalungu, njengesisu, isibindi, isantya, gallbladder, kunye nentlungu encinci, okwenza ukuba utyilongwe kunye nokuhlinzwa kucelomngeni.
I-pancreas iqulethe iindidi ezimbini zeeseli ezinokunyuka kwiindidi zeekresela. Ininzi kanomdlavuza (adenocarcinomas) iqala kwiiseli eziziwa njengei-cell exocrine ezijongene nokuvelisa i-enzyme ye-pancreatic. Ezi enzyme zifihliwe emathunjini ukunceda ukugawula amaprotheni, i-carbohydrates, kunye namafutha.
Izinto ezincinci kakhulu zikarhulumente (i-neuroendocrine tumors) ezivela kwiiseli ze-endocrine . Ezi iiseli zivelisa amahomoni afana ne-insulin, i-glucagon, kunye ne-somatostatin elawula iinkqubo ezivela kwisetyhu yegazi ukuya kwisixa se-asidi esiswini.
Le ngqungquthela igxile kumdlavuza wepancreatic oyintloko.
Iimpawu
Iimpawu zokuqala zomdlavuza we-pancreatic zingaba ziyingqiqo kwaye zingacacanga, kwaye zinokutshatyalaliswa kalula nje ngenxa yenye, imeko enzima kakhulu.
Ezinye izibonakaliso zengcebiso ziquka:
- Ukuqhwala kwesikhumba kunye nabamhlophe kwamehlo (i- jaundice ) ngenxa yokwakhiwa kwe-bilirubin
- Eyona ndawo, izibonda ezinjengobumba, umchamo omnyama kunye nokubetha, nazo zivela ngenxa yokuqokelela i-bilirubin egazini
- Iintlungu zesisu ezisemgangathweni ezinokudlulela emva
- Ukulahleka kwesisindo esingalindelekanga
- Isihlunu, ukuhlanza, okanye urhudo
- Ukuphelelwa kwesidlo
- Ukuqala okungalindelekanga kwesifo sikashukela kumntu ongenayo ingozi
Izibonakaliso zezicubu ezinqabileyo ze-pancreatic (i-neuroendocrine tumors) zivame ukuhambelana nama-hormone avelisayo kwaye zibandakanya iimpawu ezinjengezo zifumaneka nge-sugar ephantsi okanye ephakamileyo yegazi okanye ishukela ephezulu yegazi.
Zonke ezi zimpawu zivuma ukuba uphononongo olunzulu-kunye nesibini sesibini, ukuba awufumani iimpendulo ezinengqiqo kuwe.
Izizathu kunye neengozi
Nangona abaphandi abaqinisekanga malunga noko kubangelwa yintoni isifo, kukho izicatshulwa ze-isk of cancer ye-pancreatic eziye zachongwa:
- Ubudala: Uninzi lweengcambu ze-pancreatic zenzeka kubantu abangaphezu kweminyaka engama-55 (nangona zinokuthi zenzeke kubantu abatsha ngokunjalo).
- Uhlanga: AbaMnyama banamazinga aphakamileyo emdlavuza we-pancreatic kunezinye iintlanga. Umngcipheko uphakamileyo kubantu baseAshkenazi ilifa lamaYuda, nangona oku kucatshangelwa ukuba kuhambelana nomlinganiselo ophezulu we- BRCA2 .
- Ukwabelana ngesondo: Amanqanaba kunye nokufa kwabantu aphezulu kunamadoda kunabasetyhini.
- Ukubhema i-cigarette: Oku kuyingozi enkulu ( ukutshaya kwandisa umngcipheko wamaninzi emdlavuza ) kwaye kucatshangwa ukuba uxanduva lokufikelela kwisithathu kwisifo somdlavuza we-pancreatic.
- Isifo se-gum esiphezulu ( periodontitis ) kunye nokulahleka kwezinyo zonke (ukuguquka)
- Imbali yentsapho yomdlavuza we-pancreatic okanye i-syndromes ethile yemfuza: Ezi zicatshangelwa ukuba yimbangela ye-5 ekhulwini ukuya kuma-10 ekhulwini lala makhansela.
- Imbali yomntu wesifo sikashukela
- Ukuvutha okungapheliyo kwepascreas ( pancreatitis )
- Kwixesha elide, ukusetyenziswa kotywala okunzima, ngakumbi xa kudibene nokutshaya
- Ukunyaniseka: Ukugqithisa okanye ukugqithisa kucingelwa ukuba kuxanduva malunga neyesibhozo zale khansela.
Ukuxilongwa
Ukuxilongwa kokuxilongwa komdlavuza we-pancreatic kuqala ngembali echanekileyo ekukhangela iziganeko zobungozi, kunye nokuhlolwa ngokomzimba kubheka nawuphi na ubungqina bendoda yegazi, ubuninzi besisu, okanye ukulahleka kwesisindo.
Ucwaningo lokucinga luyintloko ye-diagnostic, ngokukodwa i-CT i-scans eyenzelwe ukukhangela umdlavuza we-pancreatic (i-pancreatic protocol CT). I-ultrasound yamathumbu rhoqo isenokunceda ukulawula ezinye iingxaki zesisu kodwa kuncinci ekufumaneni umhlaza wengqondo ngenxa yegesi emathunjini.
Kunoko, i-endoscopic ultrasound-apho ityhubhu ene-ultrasound tip isethwe emlonyeni kwaye ifakwe phantsi kwisahlulo esezantsi kwesisu okanye inxalenye ephezulu yamathumbu amancinci-ingaba luncedo. Ezinye iimvavanyo zokucinga ezidla ngezinye iindawo ziquka i-ERCP (i-endoscopic retrograde i-cholangiopancreatographyography) kunye neMRI.
I-biopsy ayisoloko ifunekayo ukwenzela ukuba ukuxilongwa, kodwa xa kunjalo (njengokungathi ukuhlinzwa kuqwalaselwa) kukho ezimbini iindlela eziphambili: i-good aspiration aspiration kunye ne-laparoscopic biopsy.
Iimvavanyo zegazi azihambelani nomdlavuza we-pancreatic kodwa zinokuba luncedo xa zidibene nezinye iziphumo. Ukuba i-jaundice ikhona, ukuvavanya ukujonga iintlobo ezahlukeneyo ze-bilirubin kunceda.
Ngokusekelwe kwiziphumo zovavanyo lweemifanekiso kunye nezinye iziphumo, ezi khansa zinikwe isigaba phakathi kwe-0 (precancerous) kunye nesigaba se-4 okanye zihlelwe njengomhlaza wesifo semitha.
Unyango
Izinyango zokwelapha umhlaza wengqumbo zixhomekeke kwisigaba sesi sifo kunye nendawo yomhlaza kwi-pancreas.
Kwiintsuku zamanomhlaza, ikakhulukazi ezo zintloko zepascreas, utyando linika ithuba lokunyanga lesi sifo. Ngelishwa, kuphela i-15 ukuya kwi-20 ekhulwini labantu abaviwa ngabagqatswa (ukuba kusele, umhlaza usasazeke kakhulu ukuhlinzwa ukuze uphucule ukusinda).
Inkqubo eqhelekileyo eyenziwa yayaziwa njengenkqubo ye-Whipple kwaye ibandakanya ukususa intloko yepakreta, i-buct ye-bison ephakathi, inxalenye yesisu, inxalenye yesisu esincinci, i-pleen kunye ne-lymph node eseduze. Kukho ukutshintshwa kwenkqubo, kubandakanywa uphando olususa zonke iipencre, kodwa oku kuqhutywa rhoqo. Ezi zinzulu kakhulu uphando, kwaye uqinisekisa ukuba uphando luyenzeka (njenge-biopsy laparoscopic kunye nezinye iimvavanyo) kuyimfuneko.
I-Chemotherapy esebenzisa ukudibanisa iziyobisi inikeza ukuphucula okuthobekileyo kwixesha elifutshane lokuphila kodwa lingaba luncedo xa lidibaniswa nezokwelapha ezifana neligulo elijoliswe kuyo kunye / okanye unyango lwe-radiation.
Ulwaphulo olulindelekileyo lonyango olutsha "olujolise" kwizinto ezingaqhelekanga ekukhuleni kweekomhlaza. Elinye unyango, iTarceva (erlotinib), luncedo kwabanye abantu, baninzi badibanisa ne-chemotherapy.
Izilingo zonyango zijonge ukuhlanganiswa kwezi zonyango ezingentla kunye neendlela ezintsha, ezifana ne-immunotherapy.
Ukujamelana
Ukuba wena okanye othandekayo wakho ufumanisa ukuba unomdlavuza we-pancreatic, thatha ixesha lokufunda ngesifo sakho kwaye uthathe inxaxheba ebalulekileyo ekukhathaleleni kwakho njengommeli wakho . Ukwenza oko akuncedisi kuphela ukunciphisa uxhalabe kodwa kungenza umehluko kwiziphumo zabanye abantu ngokunjalo.
Ezinye iziphakamiso ezinokukunceda:
- Thatha isikhashana ufunde malunga nendlela yokuphanda umdlavuza wakho kwi-intanethi .
- Cinga ukufumana uluvo lwesibini, mhlawumbi kwelinye leNational Cancer Institute-centers of cancer.
- Xoxa kwi-oncologist yakho malunga naziphi na izilingo zonyango ezinokuthi zilungele wena, okanye ujonge ukukhangela enye yeenkonzo zokulinganisa iikliniki ezikhululekile ezinika abahamba ngeemoto abanokungqinelana neemeko ezithile kwiimeko zonyango ezenzeka naphi na emhlabeni.
Abanye abantu bafumana kukunceda ukuba bahlanganyele kwiqela leenkxaso. Ukuba iqela elinjalo alitholakali kwingingqi yakho, enoba yintoni imeko yokuba umdlavuza we-pancreatic awuqhelekanga, uluntu lwenkxaso yoluntu lunokuba yindlela efanelekileyo yokufumana abanye abajongene nemingeni efanayo.
Fumana kwiintsapho kunye nabahlobo uze ubavumele ukuba bancede. Intsholongwane ithatha idolophana. Amanqanaba omhlaza amaninzi anika neenketho zenkxaso yemoya, ukusuka kumcebisi weengcebiso kumagqabantshintshi okunyamekela abantu abajongana nomntu wonke, umzimba, ingqondo kunye nomphefumlo. Zisebenzise naluphi na olu lukhetho olukholelwayo oluya kunceda. Ngamanye amaxesha into ebalulekileyo abantu abangayenzayo bayavuma ukuba bafuna uncedo olungakumbi kunye nenkxaso.
ILizwi
Ukuba wena okanye othandekayo uye wafumanisa ukuba unomdlavuza we-pancreatic, okanye ucinga ukuba unayo impawu, akukho nto unokuqiniseka ukuba unokukhathazeka kakhulu. Umdlavuza wePancreatic unomdla owaziyo abaninzi. Nangona kunjalo njengoko unyango luphucula ezinye i-cancer, kukho inkqubela phambili kwesi sifo. Amanye amaziko amakhulu enyango aqhuba ngokuhlinzwa ngenxa yeengqungquthela ezazingenakucingwa. Kwaye kunye nezifo eziphambili, unyango olutsha njengoluphiko olujoliswe kuko kunye nolwazi lwe-immunotherapy lunokutshintsha ubuso bomdlavuza we-pancreatic, njengoko unayo nezinye i-cancer.
Nangona unyango alukho into esiyifisa ukuba ibe namhlanje, i-oncology ifike ixesha elide kakhulu ekulawuleni iimpawu kunye nokuxhalabisa okunxulumene nomhlaza ukwenzela ukuba abantu banako ukufumana uninzi lwabo kwixesha labo kunye nosapho kunye nabahlobo kungakhathaliseki ixesha elingakanani seleyo.
> Imithombo:
> IiNtsholongwane ezikhoyo kunye neZiphuthumayo kwiCancreatic Cancer, i-Springer Verlag, ngo-2017.
> De la Cruz, M., Young, A., noMnu Ruffin. Ukuxilongwa noLawulo lweCancretic Cancer. WaseMerika ugqirha . 2014. 89 (8): 626-632.
> INational Cancer Institute. Ukwelashwa kweCancreatic Cancer (PDQ) -I-Professional Professional Version. Ukuhlaziywa 01/26/18. https://www.cancer.gov/types/pancreatic/hp/pancreatic-treatment-pdq
> Rosenberg, A., noD. Mahalingam. I-Immunotherapy kwi-Pancreatic Adenocarcinoma-Ukuyithintela imiqobo yokuphendula. Umbhalo we-Oncology . 2018. 9 (1): 143-159.