Ukusetyenziswa kakubi kwegama elithi "umhlaza" kunempembelelo embi. Iingqingo zangempela zidinga isenzo, ukungenelela ngonyango olunomdla ngenjongo yokulondoloza ubomi. Kodwa qwalasela ingozi ekhoyo eyenziwa ngokuxelela umntu onomhlaza xa engekho. Le ntlekele enyukayo iyenzeka kumadoda ayi-100 000 minyaka yonke eUnited States kumadoda anesifo senalope kwaye ayaziswa ukuba unomdlavuza wesibeletho kunye neGleason 6.
Kodwa cingela impembelelo: Kuthiwani ukuba umdlavuza we-prostate u- Gleason 6 awusiwo umhlaza?
Gleason 6 kunye neCarcer?
Isigqibo sokuhlukanisa iGleason 6 njengomhlaza wenziwa emva kweminyaka yama-1960; ngoko oogqirha babuye bacinga ukuba iiseli zabukeka zikhanyela phantsi kwe-microscope. Ngoku inyaniso yokuba iBanga 6 ayiyiyo ngumhlaza. Nangona kunjalo, ukuguqula ingqondo malunga nento ebizwa ngokuba ngumhlaza kusukela kuma-1960 kuye kwaba nzima. Amagqirha amaninzi kwimveliso yeprostate iyaqhubeka nokucebisa unyango olukhulu kwiGleason 6.
IBanga lesi-7 kunye nangaphezulu iCancer Real
Ingxenye yokudideka ihambelana nenyaniso ecacileyo yokuba amanye amabakala omhlaza wesibeletho (i- Gleason 7 nangaphezulu ) ngokuqinisekileyo ikhona kwaye ngezinye izihlandlo iyingozi. Ubume obungasetyenziswanga bukaGleason 6 buhlala budideka kunye neekresi eziphezulu, ezikhokelela ekufeni kubantu abangama-30,000 amadoda ngonyaka.
Ingxaki kuye kwaba ukungabikho kovavanyo lwezenzululwazi olunyamekelelwe ukuba ludibanise ngokucacileyo isiqalo sokuqala seGleason, esinqunywe ngexesha lokuxilongwa, ekufeni kokufa komhlaza esoloko kubakho ngaphezu kweminyaka elishumi kamva.
Ngenxa yokungabi nalwazi lokuba ingxaki ikhona, kukho ixesha elide lokulibala ekuqhubeni izifundo eziyimfuneko.
Ukulibaziseka kwakhona kuyingxenye ngenxa yobunzima bokukhula komhlaza wesibeletho. Ngaphandle kweqela labantu abafa ngumhlaza wesibeletho bahlala kunye nayo iminyaka elishumi ukuya kwimashumi mabini ngaphambi kokuba bahlulwe.
Ngexesha elide elininzi phakathi kokuxilongwa nokufa, abaphandi abazange bajonge i-subtype ye-prostate yomhlaza engabangela ukufa. Ngoko ke, iziphumo zezi zifundo zifumaneka ngoku.
Liyintoni Lizwi Lokuba "Ingqumbo" Ngokwenene?
Ekubeni sizama ukwenza ulwahlulo oluchanekileyo phakathi kwe- Gleason 6 kunye nohlobo oluphezulu lwe-prostate umdlavuza ucacisa ukuba igama elithi "umhlaza" lithetha ukuthini ngokwenene: iiseli zesintu ezinamandla okwenza i-metastase ziba nomhlaza. Iiseli ze-Cancer ezinokukwazi ukusasaza ngaphandle kweprotrate kwaye zibe kwelinye iqumrhu li- metastatic . Emva kokuba iiseli zeemetastatic zifike kwelinye iqumrhu, ziqala ukwandisa kwaye zandise kwiimvumi. Xa ezi zicubu zifikela ubukhulu abathile, ziqala ukubangela ukungasebenzi kwelo lungu. Xa isalathiso singasebenzi, inkqubo iya kuba yingozi.
Iifayili zeeKhansela ezahlukeneyo
Amanqaku e-Cancers ahlelwa yindawo yabo yemvelaphi, indlela enkulu ngayo i-tumor ikhule, kunye nebanga labo. Ngokomzekelo, umphunga, ubuchopho, kunye ne-prostate khancer all behave ezahlukeneyo ngenxa yokuba zivela kwizitho ezahlukeneyo. Kungakhathaliseki ukuba yiyiphi idilesi esiyithethayo, inkulu i-tumor, yingozi nakakhulu ukuba iya kuziphatha.
Izibilini ezinkulu ziyingozi kakhulu kuba zinokuba nzima ukugcina izinto eziphezulu.
Izicubu ezinzima zineempawu ezahlukileyo eziza kubonakala zivela kwiiseli ze-tumor eziphantsi. Le nkonzo iyenziwa ngugqirha oqeqeshiwe obizwa ngokuba ngu-pathologist.
"Ibanga" lihlalutyo lobugcisa bokubonakala kwimizimba yomhlaza phantsi kwe-microscope. Ukubamba kungasetyenziselwa ukuxela ubungakanani beemastastases ezizayo. Le mihla, ukuchaneka kokumisela ibakala kuya kuphuculwa ngakumbi kunye nokusetyenziswa kweemvavanyo zofuzo ezibonisa ukuba izakhi zofuzo ezithile eziyaziwayo zihambelana nokuziphatha okunobundlobongela.
Ukuguqulwa kwezinto ezikhoyo ngoku malunga neCarstate Cancer
Ngaphambi kokuba iPSA ihlolwe kwaye i-biopsy intsalane yanda kakhulu kwiminyaka yee-1990, umdlavuza weprotate wawuvame ukufunyanwa emva kokuba sele ulungelelaniswa.
Umdlavuza we-Metastatic prostate ungenakwenzeka kwaye uyingozi. Kwiminyaka emininzi yokunyamekela amadoda anomdlavuza wesifo seprotate, oogqirha bahlakulela ingqondo yokuzikhusela: ixhaphake yonke into ebandakanyekayo malunga nobukhulu bomdlavuza wesibeletho. Ngokwemvelo, esi simo sengqondo sokuxhalabisa ngokubhekiselele kwisimo sabo sengqondo ngomhlaza wesifo seprotate xa usuqala ukuqhutyelwa ngenxa yokusetyenziswa kwePSA yokucoca kunye ne-needle biopsies. Ngoko, iminyaka emininzi, oogqirha baye bacinga ngokungekho nto ukuba zonke iintsholongwane ze-prostate zonyango ziya kuba yimastast if i-unastated.
Sinokukwazi Njani ukuba iGleason 6 Subtype yeCarstate Cancer Isingasasazi?
Izifundo ukuvavanya umphumo wexesha elide lamadoda aseGleason 6 ecocekileyo sele igqityiwe. Ezi zifundo kwakufuneka zenziwe kwizigulane zokugqirha kuba ukukhishwa kogqirha kweprotate kwenza ukuba uphononongo olunzulu lwe-gland. Ugqirha yindlela kuphela yokuqinisekisa ukuba i-needle ye-original biopsy ebonisa iBakala 6 yayilungile kwaye ukuba indawo ye-grade grade ephezulu yayingabikho.
Ukususa lonke iprotrhe ukuze ihlolwe ngokugqithisileyo ngumntu ongu-pathologist yindlela kuphela yokuqiniseka ukuba i-100 ekhulwini lomhlaza wesibeleko yiBakala 6. Ngoku, uphando oluthile lophando olulandelayo olubandakanya amawaka amadoda lubukele ngaphezu kwe-10 emva kokusebenza, sele kugqityiwe. Ukufunyaniswa okuqhubekayo kukuba iBakala 6 ayinakulinganiswa.
Ngaba oogqirha benza i-Big Mistake?
Umhlaza wesifo seprotate ufunyaniswa ngumgaqo ongaqhelekanga kunye neyodwa. Ezilishumi ezilishumi elinambini-ezilawulwa ngeenalope ze-biopsies zibethelwa ngodonga oluyi-rectal kwi-prostate ngaphandle kokuzama ukujolisa okungaqhelekanga. Le nkqubo engaqhelekanga isebenze ngokufanelekileyo kuba iprotrate yincinci encinci, malunga nobukhulu beelnut. Umphumo kukuba ngenxa yokuba ukugwaza kungabonakaliyo, bangaphuthelwa ngumhlaza wesibeletho esiphezulu (Gleason 7 okanye ngaphezulu).
Umdlavuza weprotate udla ngokubanzi; oku kuthetha ukuba izicubu zinokufumaneka kwindawo engaphezu kwesinye seprotate. Ezi zithambo ezahlukeneyo zingaba ngamabakala ahlukeneyo. Ummandla omnye unokuthi ube nguGleason 6 kunye nomnye ummandla ungabonisa uGleason 8. Ngoko ke, xa izilingo zifakwe kwi-gland, kunokwenzeka ukuba i-biopsy ikwazi ukubona i-Gleason 6 kuphela xa i-Gleason 8 ikhona. Izifundo ezenziwe okwangoku zibonisa ukuba malunga namadoda angama -4 aqhuba kakuhle i-12-core nucleal needle biopsy ebonisa iGleason 6 ngokwenene ayifumananga nesifo esiphezulu kwiprostate kwenye indawo.
Ukuxhomekeka kuphela kule nkqubo ye-biopsy engahleliyo, oogqirha banakho ukukhohliswa ekubeni bakholelwe isigulane sineGleason 6 kuphela xa ngamanye amaxesha ibakala liphezulu. Lo ngumthombo woqobo wenkolelo yenkohlakalo yokuba iGleason 6 inokuthi ifumaneke. Amadoda afunyaniswe "noGleason 6," oye waphathwa unyango, kwaye kamva waba nomdlavuza kwakhona, waholela oogqirha ukuba bakholelwe ukuba iiselintshi ze-Gleason 6 ziye zazinqanda. Ngoku siyazi ukuba i-recurrences, ezo kwacatshangelwa ukuba zivela kwi-Gleason 6, zenzelwe kuphela kumadoda ayenomdlavuza we-Gleason 7 okanye ophezulu weprotate owawufihlakele kwenye indawo yeprotate kwaye ayizange ifumaneke yi-prostate biopsy .
Iindlela zeNdabuko zokuXhobisa ukungaqiniseki kwe-Biopsy
Ukuqinisekisa ukuba ukufa komdlavuza wesifo se-prostate kuncitshisiwe, indlela yokuziphatha iphakanyisiwe ukuba iphakamise ukuhlinzwa ngokugqithiseleyo okanye imisebe kuwo wonke umntu, "ukuze ukhuseleke." Ukunyanga wonke umntu ugqithise ngokugqithiseleyo ukufumana izifo eziphezulu ezingabonakaliyo kwaye uphephe uxanduva lwezonyango ukuba ugqibe Ukubuyela kuphinda kwenzeka nakwixesha elizayo. Ngelishwa, ngaphezu kweminyaka engama-20 edlulileyo, lo mgaqo-nkqubo okhohlakeleyo uye wabangela unyango olungadingekile kumadoda angaphezu kwezigidi ezibini kwaye unyango lunokubangela ukungabi namandla nokungabikho.
Ngoku ukuba oogqirha bayaziqonda iingxaki zokucebisa unyango wonke umntu, enye inketho ebizwa ngokuba yi- surveillance esebenzayo iye yafumana ukwamkelwa. Ngaphezulu kweminyaka eyi-10 edlulileyo, ukuhlola okusebenzayo kuye kwamkelwa ngokwengeziwe njengendlela efanelekileyo yokulawula amadoda akhethwe ngumdlavuza we-Gleason 6. Ukuqwalaselwa okusebenzayo kwamkelwa yiNational Care Network (NCCN), i-American Society ye-Clinical Oncology (ASCO) kunye ne-American Urological Association (AUA) njengeendlela eziqhelekileyo zokuphatha uGleason 6.
Amadoda athatyathwa okokuqala ukuba abe neBakala 6 ahlolisiswe ngokukhawuleza ngokujonga rhoqo kwi-PSA yabo. Baye bafumana i- 12-core corele biopsies rhoqo kwiminyaka embalwa emzame ukufumana nayiphi na isifo esiphezulu esingazange siphuthelwe kwi-biopsy yokuqala. Umgaqo-nkqubo we-PSA vavanyo kunye ne-biopsies ngezikhathi ngokuqinisekileyo awuyikuthintela, kodwa unyango olugqithisileyo kunye nokutyalwa kwemitha kunemiphumo embi kakhulu. Nangona kunjalo, nje kutshanje, iindlela ezintsha zokuskena ziyafumaneka zibonelela ngezinye iindlela ze-biopsy.
I-MRI Imaging kunye ne-Biopsy
I-Biopsies ayimnandi kwaye ngamanye amaxesha ibangela izifo ezisongela ubomi okanye ukuphuma kwegazi. Nangona i-biopsy engahleliweyo iye yaqwalaselwa njengomgangatho wegolide wokuxilongwa komhlaza wesifo seprotate, uyayithelekisa njani nakwiimifanekiso zanamhlanje nge-MRI ezininzi?
Lo mbuzo uvivinywe ngokubanzi kwisifundo esikhulu esabandakanya amadoda angama-600 anamazinga aphakamileyo ePSA azinikele ngokuzithandela ukufumana iMRI ye-parametric, i-biopsy engahlawuliyo kunye ne-biopsy ukuzalisa ukuba yiyiphi indlela echanileyo (ukuhlaziywa kwe-biopsy kuquka i-++ iprotrate phantsi kwe-anesthesia kwaye yindlela echanekileyo yokufumanisa umdlavuza we-prostate). Xa kuthelekiswa ne-biopsy ye-saturation, i-biopsy engaqhelekanga yabonwa ngamaphesenti angama-75 amadoda aphethe izifo eziphezulu. I-MRI ye-multi-parametric ifunyenwe ngamaphesenti angama-90 amadoda ayenomdlavuza omkhulu wesifo somhlaza.
Olu pho nononophelo lubonisa ngokucacileyo ukuba iMRI ehamba kakuhle ichanekile ngokuchanekileyo ngakumbi kunokwenziwa kwe- biopsy . Ngelishwa, uninzi lwama-urologists , uhlobo loogqirha abathweswe uxanduva lokulawula abaviwa abajongene nokuhlola, baqeqeshelwa kuphela kwindlela yokwenza i-biopsy engaqhelekanga yokugada nokujonga umhlaza wesibeletho.
Isiphelo
Amadoda kunye neGleason 6 abanomdlavuza ngokwenene. Akukho mngcipheko we- metastasizing . Kuze kube kutshanje, i-drawback enkulu yokongamela ngokukhawuleza kuye kwaba yimfuneko yokuphinda i-biopsy ngezikhathi ezithile. Ukufika kweMRI eyahlukeneyo kubonakala kuyindlela ephezulu kakhulu. Le mihla, indoda efunyenwe yiGleason 6 inokukhetha ukuqala kwinkqubo yohlolo ngaphandle kwemfuneko yexesha le-12-core coreal biopsies.