Iimpawu, Izizathu, Ukuxilongwa, kunye noTyango
Umhlaza we-Ovarian uye waqulunqa "umbulali ongenangqondo" ngenxa yokungabi naso kwempawu eziphawulekayo kude kube yimeko eqhubekileyo xa ingenza ubundlobongela obubuhlungu, ukufumana ubunzima obungachazi kakuhle, kunye nokunye. Umngcipheko wokuphila komngcipheko wokuba nomhlaza ungama-1.6% kuphela, kodwa ekubeni eso sifo sisoloko singagcinwa size sifinyelele kwizigaba eziphambili, yinto yesihlanu esona sizathu esiqhelekileyo sokufa kwabantu abachaphazeleka ngumhlaza kubasetyhini.
Unyango olunjengokuhlinzwa kunye ne-chemotherapy lungasetyenziselwa, nangona impumelelo yabo iyancipha ekugqibeleni isifo sifana.
Iintlobo
Inkqubo yokuzala isetyhini iqulethwe ngumfazi, umlomo wesibeleko (inxalenye engaphantsi kwesibeletho), isisu, amabhubhu amabini, kunye nama-ovari . Ama-ovari anokulingana nobukhulu be-almondi kwaye banoxanduva lokuphuhliswa nokukhutshwa kweqanda ngexesha lomjikelezo wesini. Banoxanduva lokuvelisa i-hormones isrogen kunye neprogesterone .
Umdlavuza we-ovariya uqala ngokuyinxalenye yesikhuni sokutshatyalaza esiseduze ne-ovary uze usasaze kwi-ovary. Esi sifo maxa wambi siqala kwi-peritoneum, iimbumba zijikeleza iziqulatho zesisu, kwaye zisasazeka kwi-ovary. Ngenxa yeso sizathu, umdlavuza we-ovari, umhlaza wesifo se-fallopian, kunye nomhlaza wokuqala we-peritoneal bahlala behlanganisene xa bexoxa ngala ma-cancer.
Kukho iindidi ezintathu ezisisiseko somhlaza we-ovari (nangona kunama-subtypes angaphezulu kwama-30). Ezi ntlobo ezahlukeneyo zingaphathwa ngeendlela ezahlukeneyo, zineendlela ezahlukileyo zokuhlaziya, kwaye zenzeke kwabasetyhini beeminyaka ezahlukeneyo ngokubanzi.
- Iimvumi ze-ovarian epithelial zivela kwinqanaba leeseli (i-ecithelial layer) efaka ii-ovaries kunye nezigubhu ze-fallopian kunye ne-90% ukuya kuma-95 ekhulwini lamanomdla e-ovari. Umngcipheko wale kansini ukwandiswa ngobudala, kwaye abaninzi abantu bangama-postmenopausal xa befunyanwe. Iintlobo eziqhelekileyo ziquka i-endometrioid, i-mucinous, ne-serous tumors, eninzi ininzi. Iimvumi ezincinci kunye ne-endometrioid ziqhelekileyo kubasetyhini abangaphantsi kweminyaka engama-40.
- Iimathumbu zesisu ezinokuthi zingabonakali okanye zibi kwaye ziqale kwi-stroma, izicubu ezijikeleza iqanda kwaye zigcina ii-ovari kunye. Ezi zincinci zibe ziincinci ezincinci, kubandakanywa i-granulosa cell tumors-ezinobundlobongela kwifom yesantya, ezifumaneka phakathi kokuzalwa kunye neminyaka engama-20 ubudala, kodwa ngokuqhelekileyo zingenabundlobongela kumntu omdala-kunye ne-Sertoli cell tumors.
- Iimvumba zesiginja zentsholongwane zinokuthi zibe zizifo ezinobungozi okanye zibi kwaye ziyimpawu eziqhelekileyo zesifo somhlaza we-ovariya kulabo abangaphantsi kwe-30. Uninzi lufunyaniswa phakathi kweminyaka eyi-10 ukuya kwe-30. Ezi zicubu ziqala kwiiseli zokuzala (iqanda) kunye neakhawunti malunga neepesenti ezingama-3 i-ovarian cancers. Izilonda zejeremani zivame ukuxilongwa kwizigaba zokuqala kodwa zivame ukukhula ngokukhawuleza. Ambalwa amancinci aquka i-dysgerminomas, i-endodermal sinus tumors, kunye neetatatas ezingapheliyo .
- Incinci ye-cell carcinoma ye-ovary ayiqhelekanga, eyenza kuphela i-0.1 ekhulwini yamanomdla omhlaza we-ovari.
Umlinganiselo wokusinda ophakathi komdlavuza ophezulu we-ovarian (zonke izigaba ezidibeneyo) yiminyaka emihlanu, kodwa malunga nama-15 ekhulwini abantu abaxilongwa ukuba baphila emva kweminyaka eyi-10. Abaphandi ngoku bafundela "abaphumayo" benethemba lokuba bafumane iindlela ezingcono zokunyanga esi sifo. Ukuxela abantu ngabanye kuxhomekeke kwiimeko ezininzi, ezifana nobudala, isigaba kunye nomdlavuza womhlaza, impendulo kwonyango, nangaphezulu.
Iimpawu
Iimpawu zesifo somhlaza we-ovari zivame ukungaqondakali kwaye zingacacanga kwiimpawu zokuqala zesifo kwaye zidla ngokubhekiselele kwezinye izimo ezingathí sina. Nangona phantse iipesenti ezingama-80 zala makhansela sele sele esecaleni eliphambili xa kufunyaniswa, uphando lwangoku lufumene iimpawu ezine eziqhelekileyo kwizigaba zangaphambili. Ezi ziquka:
- Utshintsho kwimigca yesisu, njengokuqhawulwa okanye urhudo
- Ubuhlungu bepelvic okanye uxinzelelo
- Iimfuneko eziqhelekileyo zokuvuthwa okanye ukunyanzeliswa komchamo
- Ukukhupha okanye ukuvuvuka kwesisu
Ezinye iimpawu zesifo somhlaza we-ovari kaninzi asibonakali kwaze kwaba yilapho isifo siphumelele. Ezi zinokuquka intlungu ngexesha lokwabelana ngesondo, ukukhathala okuqhubekayo, ukufumana isisindo somzimba okanye ukwakheka kwamanzi (ascites), phakathi kwabanye.
Ezinye iimpawu zibangelwa ngokuthe ngqo kuma-hormone eziveliswa yi-tumor, kuquka ukujuliswa kwezwi, ukukhula kweenwele zesisu, kunye nokuphuma kwamanzi okungaqhelekanga.
Izizathu kunye neengozi
Ngelishwa, asinakukwazi ukuba yintoni eyenza umdlavuza we-ovarian, kodwa abaphandi baye bafumanisa izinto ezinobungozi ezaziwayo ekuphuhlisweni kwayo. Nangona iimeko zobungozi zibalulekile, kubalulekile ukukhumbula ingqalelo ukuba ii-ovarian cancers zingenzeka kubantu abangenayo ingozi okanye imbali yentsapho yesi sifo.
Izinto ezinobungozi zibandakanya, kodwa azikhawulelwanga, ubudala; Uhlanga lwaseCaucasia; Imbali yentsapho ye-ovarian, isifuba okanye umhlaza wekolon; ukunyanya ; kwaye unyango olusandul 'u-estrogen olusandulwanga.
Izinto ezinxulumene nomngcipheko omncinci womhlaza wesi-ovari zibandakanya, kodwa azikhawulelwanga ukuba nomntwana ngaphambi kweminyaka engama-26, ukuncelisa, ukusetyenziswa komlomo ngomlomo, utyando lwe-tubal ligation kunye ne-hysterectomy.
Umhlaza we-Ovarian awuqhelekanga kubasetyhini abaselula. Xa kwenzeka, kukho imbali yentsapho kwaye kunokwenzeka ukuba inxulumene nezinto ezifana ne-BRCA1 okanye i-BRCA2. Umhlaza we-Ovarian ngowesihlanu oqhelekileyo ngumhlaza ofunyanwe ngethuba lokukhulelwa kwaye kwenzeka kwi-1 kwi-18,000 yokukhulelwa.
Ukuxilongwa
Umhlaza we-Ovarian awuhloliswanga rhoqo. Ukufumanisa umdlavuza we-ovariy ifuna i-index ephakamileyo yokusola kwinxalenye yodokotela ukuze kuqhutywe ukulungiswa kwemifanekiso kunye neemvavanyo zebhabhi ezingabonisa eso sifo.
Oogqirha basoloko bahlela i-ultrasound yangaphandle kunye ne-CA-125 yokuhlola kwegazi kuqala, nangona okokugqibela kunokuqhelekileyo kwabanye abantu abanomdlavuza wokuqala we-ovari kunye kwaye banokuphakanyiswa kwezinye iimeko zonyango. Ugqirha unokuqalisa le mvavanyo emva kokuhlola uvavanyo lweplavic, okanye umntu angabonisa ngeempawu ze-metastase (ukusasazeka) kwi-tumor eyenza la ma nyathelo alandelayo.
Ezinye iimvavanyo zokucinga, ezifana ne-CT, i-MRI, kunye ne-PET, kunye nezinye iimvavanyo zegazi zinokuyalelwa (ikakhulukazi ukubona ukuba umhlaza, ukuba ukhona, usasazeka). I-biopsy iyadingeka kokubili ukuqinisekisa ukuxilongwa kunye nokuchonga uhlobo lomhlaza we-ovari.
Emva kokuxilongwa, ukuxhaswa kwe-tumor kubaluleke kakhulu ukwenzela ukuba kuchongwe iindlela ezifanelekileyo zokunyango. Oku kunokwenziwa ngokudibanisa kweziphumo zesifo se-tumor kwiisampuli ze-biopsy kunye nokufunda i-imaging, kodwa kudla ngokufuna ukuhlinzwa.
Unyango
Izinyango zokwelapha umdlavuza we-ovari zixhomekeke kuhlobo, isigaba, kunye nesigaba somhlaza we-ovari, kunye nezinye izinto ezifana nobudala kunye nempilo jikelele.
Kukho iindlela ezintathu zonyango zokuqala zonyango lomhlaza. Ugqirha kunye ne-chemotherapy yindlela eqhelekileyo yokonyango bonke kodwa izigaba zokuqala zesifo. Ulwaphulo lwe-radiation aluqhelekanga kodwa luyacetyiswa kubafazi abathile abaneemitha ezithintekayo kwiisisu zabo.
- Ugqirha: Ukususwa kwe-ovary ne-fallopian tube kwicala elinye kunokucatshangelwa ngalabo banethemba lokulondoloza ukuzala kwabo . Utyando lwe-Debulking okanye i-cytoreduction ingacingwa ukuba isuse ubuninzi be-tumor (kunye ne-metastase) ngokunokwenzeka ukwenzela ukwandisa ukusebenza kwe-chemotherapy.
- I-Chemotherapy: I-Chemotherapy isetyenziselwa ukuqeda iiseli zomhlaza eziseleyo emva kokuhlinzwa, okanye ukunciphisa umngcipheko wokuphindaphinda xa kungekho namaseli omhlaza. Inokunikezelwa yedwa nje ngekhemotherapy ephuculwayo yokunciphisa iimpawu.
- Ulwaphulo olujoliswe kulo: Oku kubandakanya unyango kunye neziyobisi ezijolise kumzila othile ekukhuleni kwamaseli omhlaza. Ngenxa yokugxila kwabo, bahlala rhoqo, kodwa kungekho njalo, banemiphumo embalwa yecala kunezilwanyana zamachiza eziqhelekileyo. Kukho iintlobo ezimbini zeengcaphephe ezijoliswe kuyo: ezo zijolise ekuvimbeleni ukuveliswa kwemithambo yegazi ngamathambo, kunye nalabo abajolise kwindlela ekukhuleni kweeseli zomhlaza.
Iimvavanyo zonyango ziyaqhubeka nokufunda ukudibanisa kwezi zonyango ezilapha ngasentla, kunye nezonyango ezintsha, ezifana nezidakamizwa ze-immunotherapy . Ngokutsho kweNational Cancer Institute, abantu abafumene unomdlavuza we-ovari kufuneka baqwalasele ukuthatha inxaxheba kwilingo lonyango.
ILizwi
Ngexesha langoku, amaninzi e-epithelial ovarian cancers afunyanwe kwiindlela ezilandelayo zesifo. Ekubeni singenayo i-testing testing test, kubalulekile ukuba uqaphele iimpawu kwaye ufune unyango xa ufumana nanoma ubani-nokuba ucinga ukuba mhlawumbi akukho nto.
Ukuba wena okanye othandekayo usandululwazi ukuba unomdlavuza we-ovari, unokuvakala ukothuka njengoko ubheka izibalo ezijikeleze eso sifo. Naphezu kwezi manani ezikhathazayo, unyango lwezifo luya kuphucula njengoko zikhoyo, kwaye ezininzi izilingo zonyango namhlanje zifuna iindlela ezitsha kunye neendlela zokuphatha izigulane.
> Imithombo:
> Hoppenot, C., Eckert, M., Tienda, S., no-E. Lengyel. Ngoobani abaPhezulu bexesha elide beCarous-Serous Ovarian Cancer? . Gynecologic Oncology . 2018. 148 (1): 204-212.
> INational Cancer Institute. I-Ovarian Epithelial, iTallopian Tube, kunye ne-Primary Peritoneal Cancer Treatment (PDQ). Ukuhlaziywa 01/19/18. https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq