Xa uvavanyo lwegazi lwe- prostate-specific antigen (PSA) lwavunywa ngo-1994 njengesixhobo sokuhlola ukuqala komhlaza wesifo somhlaza, sasidunyiswa njengesiphumo sonyango esiza kusindisa ubomi obungenakubalwa.
Ngaphambi koko, ukungabikho kwindlela yokujonga inkqubo efanelekileyo kwathetha ukuba umdlavuza wesifo seprotate kaninzi wawungafumanekiyo kwaze kwasasazeka kwezinye iindawo zomzimba, ukwandisa kakhulu amathuba okuba abulawe.
Kunyaka ngamnye ukususela kwisingeniso sovavanyo lwe-PSA, izinga lomdlavuza womhlaza wesifo seprotate liye layeka, kwaye iziganeko zomhlaza wesifo seprotate ngexesha lokuxilonga ziye zawa ngama-75 ekhulwini.
Ukudideka nokuphikisana
Uvakala ngathi ibali lempumelelo, akunjalo?
Kodwa kungekudala isizukulwana, uvavanyo lwe-PSA luyinkxalabo enkulu kunye nokuphikisana. Ufumene ibakala elingaphumeleli kwiplanethi yokuhlaziya yezonyango ecebisa ngokubhekiselele ekusebenziseni kwayo rhoqo, kwaye kubonakala ngathi ayikho into eyenziwa ngabagqirha kunye nezigulane ezininzi.
Oku kwenzeke kakhulu kwinxalenye yokuba i-PSA ifumana amanqaku amaninzi eekreleksi ezingezantsi ezingenakulungele ukulimaza, ukubonisa ngokungafunekiyo amadoda amaninzi kwiinkxalabo, indleko kunye neengxaki ezinokuthi zonyango lomhlaza.
Sifike njani apha, kwaye yintoni indima, ukuba ikhona, i-PSA enokhenketho yomhlaza wesibeletho? Ngaba uvavanyo luyafaneleka?
Ukusetyenziswa okufanelekileyo
Impendulo emfutshane kumbuzo wokugqibela nguwewe.
Uvavanyo lwe-PSA lunokunika ulwazi oluxabisekileyo xa lisetyenziswe kakuhle.
Nangona mna kunye nabanye ooloji be-urologists babelana ngezinto ezixhalabisa ngokugqithisa izidlo ezingenayo i-prostate cancer, abaninzi bethu bacinga ukuba ukugxekwa kovavanyo lwe-PSA kuye kwagqithiswa.
Xa isetyenziswe ngendlela engqiqweni, uvavanyo luyaxabiseka. Ukuze ndiqonde oko ndiyithethayo, masibuye siphinde sihlolisise oko kubangele imeko yethu yangoku.
Cancer
Okokuqala, kubalulekile ukwazi ukuba akuzona zonke i-prostate cancer.
Iimvumi ezininzi zikhula ngokukhawuleza okanye kungekhona, kwaye zibangele iimpawu ezincinane okanye ezingekho . Ezi ntlobo zezidumbu zibizwa ngokuba yi-indolent.
Ekubeni umdlavuza weprotate uvela ikakhulu kumadoda amadala-ixesha eliqhelekileyo lokuxilongwa li-66-kwaye ekubeni unyango kunye nokutyalwa kwemitha kungabangela iimpembelelo ezingafunekiyo, ezifana nokungafuneki okanye ukungabikho komsebenzi, into enengqiqo yokwenza kwezi ziko ezikhulayo Gcina iso kwizinto. Ixesha lesigqirha solu hlobo lugxininiso olusebenzayo, oku kuthetha ukuhlolisiswa ngezikhathi kunye nokuhlaziywa kwakhona komdlavuza.
Phantse i-100 ekhulwini yezigulane ezingenasasazeka ngaphandle komhlaza weprotate zihlala iminyaka engamahlanu emva kokuxilongwa. Faka enye indlela, ixesha eliza kuthatha i-tumorent prostate tumor to progress and causing harm in these patients if it's a long time for their lifetime.
Khancergressive Agers
Ezinye i-prostate cancers, ke, zinobudlova, zikhula ngokukhawuleza, kwaye zinokubulala. Bafuna unyango olufike ngexesha . Ekuqaleni bafunyanwa, bhetele iimeko zokuphumelela.
Izigulane ezinesifo somhlaza esasifumaneka kwi-prostate yazo kunye nezicubu eziseduze xa zifunyaniswa ukuba zifuna ukuba ziphile iminyaka emihlanu.
Kodwa abo abanomdlavuza wesibeletho basasaze kwi-lymph node, amathambo, okanye ezinye izitho zinokukhubazeka ezingama-29 ekhulwini leminyaka emihlanu.
Ngoko uyabona ukuba kutheni ukufumanisa kwangaphambili kubalulekile. Kodwa isahlulo sokulwa. Ukukwazi ukuchaza isifundo somhlaza wesifo somhlaza wesigulane-ukuba uyazi ukuba ingaba yinto ehamba ngokukhawuleza, akukho-action-efunekayo, uhlobo olushushu, olusasazekayo, okanye into ephakathi-nayo ibalulekile.
Ukuphucula uvavanyo lweMinwe
Ngeyona nkulungwane ye-20 leminyaka, ityhilo kuphela yesikhokelo somhlaza wesifo seprotate, oogqirha babenombilini wabo, isicatshulwa se-rubber-gloved-test exam rectal, okanye i-DRE.
Ukucinga i-organ for signs of expansion or lumps yanikezela into yokuba i-tumor yayikho. Kodwa kwakungenakucacisa, ngokuqinisekileyo kwakungekho mnqabileyo, kwaye ayikwazi ukubonelela nayiphi na inkcazelo malunga nenkambo yesifo somhlaza. I-biopsy ye-tissue kunye neyezinye iimvavanyo zokulandelelana zisetyenziselwa eso sigqibo.
Njengoko unokucinga, ngexesha le-prostate isifo esaneleyo ukuba sivelelwe, mhlawumbi sasiqhubele phambili, oko kwakuthetha ukuba kwakungenakuphiliswa. I-DRE yayingeyona ndlela efanelekileyo yokufumanisa kwangaphambili.
Emva koko kwafika uvavanyo lwePSA. Ifumanisa inani leprotheni ebizwa ngokuba yi-prostate-specific antigen eyenziwa yiiseli ze-prostate gland kwaye ijikeleza ngegazi.
Inqanaba le-PSA lisoloko liphakanyiswe kumadoda anomdlavuza wesibeletho. Ukuhlanganiswa kwe-DRE kunye novavanyo lwe-PSA kuphuculise ngokukhulu ukukwazi kwethu ukubamba izicubu ze-prostate ekuqaleni.
I-PSA's Drawbacks ifaka i-Overdiagnosis
Kodwa u vavanyo lwe-PSA linamanani amaninzi, kwakhona.
Okokuqala, ezinye izinto ngaphandle komhlaza wesibeletho zingabangela ukuba amazinga e-PSA aphakamise-imeko ezingekho komhlaza ezifana nokunyuka kweprotate okanye ukukhulisa okwenzeka ngokuguga, umzekelo. Okwesibini, akukho nqanaba "eliqhelekileyo" le-PSA. Amadoda amaninzi aneempembelelo eziphezulu ze-PSA ayenawo umhlaza wesibeletho, ngelixa amanye amanqanaba aphantsi ayenzayo. Okwesithathu, ukulinganisa "amaxabiso angamanga" kuphakamileyo, kubangela ukukhathazeka okungenasiphelo kwizigulane ezingenomdlavuza. Kwaye ekugqibeleni, uvavanyo lwePSA alukwazi ukwahlula phakathi kweekratshi ezikhula ngokukhawuleza ezingadingi unyango kunye nezobudlova ezenzayo.
Ukuphunyezwa ngokubanzi kwenkqubo yovavanyo lwe-PSA ukususela kwiminyaka ye-1990 kwakuthetha ukuba amaninzi amaninzi e-prostate afunyenwe ekuqaleni, ngaphambi kokuba nayiphi na impawu-into enhle kulabo abafuna unyango olukhawulezileyo, kodwa kungenjalo kwabo bangenalo.
Izinga lokusasaza umhlaza weprostate landa, kodwa nenani lamadoda anesifo se-indolent ezingenasidingo senziwa yi-biopsies, aphethwe yi-prostate, wanyamezela unyango lwe-radiation, waza wafumana iziphumo ezibi zentlekele zale nkqubo.
Izifundo ezimbini ezinkulu ziqikelele umlinganiselo wesifo somhlaza wesifo se-prostate "i-overdagnostic" (ukufunyaniswa kwesifo esingasongela ubomi) ngenxa yeziphumo zovavanyo lwe-PSA phakathi kwama-17 no-50 ekhulwini.
Kwaye abaphandi bafumananga ubungqina obucacileyo bokuthi ukuhlolwa kwe-PSA rhoqo kwakunobangela obunobangela bokulahla okuphawulekayo ekufeni kwabantu ababulawa ngumhlaza. (Ukunciphisa umlinganiselo wokufa komhlaza wesibeletho ndikhankanywe kumhlathi wesibini wale nqaku ungabangelwa kwezinye izinto, kubandakanywa unyango oluphuculweyo .)
Amaqela angavumelaniyo malunga novavanyo
Ngoko ke oogqirha kunye nezigulane ezishiywe ukulwa nazo kwakuyi vavanyo ebonakalayo njengengxowa exubekileyo: Ifumene amaninzi e-cancer-stage, ingaba ayifunayo unyango okanye ayikho, kwaye yayingabonakali yenza into eninzi ngokwazo kwinani le-cancer yesifo somhlaza.
Ngo-2008, i-US Preventive Services Task Force, iqela elichaphazelayo ngononophelo olusisiseko kunye neyeza lokukhusela (kodwa kungekhona urolo okanye umhlaza), linconywa ukuba amadoda angama-75 nangaphezulu angaphantsi kwe-PSA yokuhlola. Ngo-2012, iphaneli yandisa isiluleko sayo malunga nokuhlolwa kwe-PSA ukubandakanya amadoda abo bonke ubudala, besithi ukulimala kweemvavanyo kukugqithisileyo.
Amanye amaqela ezonyango ayengavumelani, ephikisa ukuba izigulane ezincinci ezineengcingo ezinonyango ezinokuphilisa kunye nalabo abasengozini enkulu (njengamadoda aseAfrika kunye nembali yengane yomhlaza wesibeletho) baya kuzuza kwi-PSA yokuhlola rhoqo. Baye balumkisa ukuba ukuhla kwe-screening kungabangela ukubuya kwiintsuku xa umhlaza wesifo somhlaza wesifo awuzange ufunyanwe kude kube yinqanaba eliphambili, elingenakuphilisa.
Ngaphandle kwezikhokelo ezivunyelwene ngazo, oogqirha kunye nezigulane babanjwe phakathi. Oogqirha babesoloko beshiya isigqibo sokuvavanya kwizigulane zabo. Iifom ze-PSA zokuhlaziya zawa, kwaye kunjalo nokufumanisa i-diagnostic ye-early stage (kwaye mhlawumbi kungenakho ukunyanzelisa) i-prostate cancer.
Ngokukrakra kukuba, uphando olutshanje luchaza ukuba inani leengxaki ezisanda kutshatyalaliswa ngumhlaza womhlaza wesifo seprotate uye wavuka ngokukhawuleza ukususela ngowama-2007. Nangona kukho ukugxekwa kwendlela yokufunda, akusilo ukulula ukuba ucinge ukuba ukuhlolwa komhlaza wesifo seprotate kuthetha amatyala amaninzi Iimpawu zomdlavuza ezibalulekileyo kwaye eziphathekayo aziyi kubanjwa zize zi sasaze.
Indlela yokuqonda kwi-PSA Test
Ngoko kule ndawo edidekayo, yintoni isiguli esimele siyenze? Ngokufanelekileyo, umntu uza kufaka uvavanyo lokuhlola ukucokisa-olunokuthi luthembele kuphela ngokucacileyo umhlaza wesifo seprotate kodwa ungakwazi ukuchaza ngokuchanekileyo inkambo yayo, ukucacisa ukuba kwaye uphathwe njani.
Ngethamsanqa, kukho iimvavanyo zokuphonononga eziphuculweyo kwipayipi, kunye nezinye izinto ezifunekayo ekuncedeni ukuphucula ukuchaneka kokuxilonga.
Okwangoku, nantsi indlela yokuhlolwa kwe-PSA Ndiyincoma kwaye ndiyisebenzisa kunye nezigulane zam:
- Thola "uphawu lokuqala" lwe-PSA kwiminyaka engama-50. Ugqirha wakho unokuyalela umvavanyo kwaye axoxe ngeziphumo nawe. Ukuba umphumo wokuvavanya, ukudibanisa nembali yakho yonyango kunye nolunye ulwazi lweklinikhi lubonisa umngcipheko omncinci wokuvelisa umdlavuza we-prostate, ukuhlolwa kovavanyo lwe-PSA kufuneka kuphindwe rhoqo emva kweminyaka emihlanu.
- Ukuba uvavanyo lwakho lokuqala lwe-PSA kunye nolwazi lwezokwelapha kwiminyaka engama-50 lubonisa ingozi ephakamileyo yomhlaza wesibeletho kodwa ungenayo impawu, kufuneka ube nokuhlolwa kwimihla yonke eminye usebenzisa enye yeemvavanyo zegazi ezintle endichazile ngaphambili (ii-4Kscore okanye i-Prostate Health Index) ), mhlawumbi ne-MRI scan of prostate. Thetha nogqirha wakho malunga nale ndlela. Ngokusekelwe kwiziphumo zokulandelelana kwezi mvavanyo, wena kunye nogqirha wakho unokugqiba isisombululo kunye kunye nawaphi amanyathelo angaphezulu, ukuba kukho na.
- Ukuba uneminyaka engama-60 iNqanaba le-PSA lingaphantsi kwe-2 nanogram nge-milliliter, ithuba lakho lokuvelisa umdlavuza we-prostate enobudlova kwintshona yobomi incinci-1 okanye i-2 ekhulwini. Ngelo xesha, kukhuselekile ukuphinda ukuvavanywa kwe-PSA kaninzi kangangoko kuninzi kwiminyaka emihlanu okanye ukuyeka ukuvavanywa ngokupheleleyo.
Ngeendlela eziqhelekileyo zengqondo, sinokubamba iidanga zamabanga aphezulu afuna unyango ngeli xesha kunciphisa amathuba okufumanisa izicubu ezincinci ezingabonakaliyo kodwa zingabangela uxhalaba kunye nonyango olungenasiphelo.
UDkt. Klein nguSihlalo we-Cleveland Clinic ye-Glickman ye-Urological & Kidney Institute, isizwe sikaNombolo 2 se-urology program njengoko sikhethwe ngu- US News & World Report.
> Imithombo:
> Barocas DA, Mallin K, Amangcwaba AJ, et al. Impembelelo ye-USPSTF yeBakala D Isiphakamiso malunga nokuCandwa kweCarstate Cancer kwiNkcazo yeCatal Prostate Diagnoses e-United States. J Urol . NgoDisemba ka-2015; 194 (6): 1587-93.
> UBarry MJ, uNelson JB. Ukujonga okuphikisanayo: Izigulana zihamba ngeCreater Advanced Prostate Cancer ukususela kwi-USPSTF Screening Recommendations. J Urol . NgoDisemba ka-2015; 194 (6): 1534-6.
> Catalona WJ, D'Amico AV, amaFitzgibons WF, et al. Into eyenziwa yi-US Force Preventive Services Task Force ephosakeleyo kwisichengululo sayo somhlaza weprotate. Ann Intern Med . 2012 Julayi 17; 157 (2): 137-8.
> Moyer VA, LeFevre ML, Siu AL, et al. Ukuhlola i-prostate cancer: I-US Preventive Services Task Force statement statement. Ann Intern Med . 2012 Julayi 17; 157 (2): 120-34.
> Ukuqwalaselwa, i-Epidemiology, kunye neziphumo zokuphela (SEER) Inkcazo yeeNkcazo zeeNkcukacha: I-Cancer Cancer. National Cancer Institute. Kufumaneka kwi http://seer.cancer.gov/statfacts/html/prost.html