Iimpawu, izizathu, ukuxilongwa, kunye neZonyango
Umdlavuza we-Endometrial ngumhlaza ochaphazela umbane wesisu kwaye oqhelekileyo kubasetyhini emva kokumisa umva. Ukukhathazeka kukuba lolu hlobo lomhlaza luye landa eNyakatho Melika naseYurophu. Yintoni omele uyayizi malunga neempawu, ukuxilongwa, kunye nonyango lomhlaza?
I-Endometrial Cancer-Inkcazo
Umdlavuza we-Endometrial, owaziwa nangokuthi ungumhlaza wesifo somhlaza, ngumhlaza okhula kwiiseli ezibandakanya isisu (i- endometrium ) kwaye uhlobo oluqhelekileyo lomhlaza luchaphazela umzimba wesisu.
I-endometrium iyasebenza kakhulu kumjikelezo wesini wesini kunye nokukhulelwa. Ngethuba lesibini sokuqala umjikelezo wokuya esikhathini, i-estrogen ibangela ukuba i-endometrium yakha ekulungiseleleni ukufakwa kokukhulelwa. Ukuba ukukhulelwa akukwenzeka, i-progesterone ikhokelela ekuphahleni kwezi zicubu, eziza kutyalwa ngexesha lenyanga yowesifazane.
Omnye umdlavuza oqhelekileyo wesibeleko, i-uterine sarcoma, uqala kwi-tissue ephantsi kwe-endometrium ebizwa ngokuba yi-myometrium (isisu se-uterus).
Kukho inani leengqungquthela zomdlavuza we-endometri, njenge-adenocarcinoma, i-adenosquamous, i-carcinoma, icaccin cell cellcin, nabanye. Uninzi lwama-cancer afunyaniswa ngaphambili, kwinqanaba xa utyando linika ithuba elihle lokunyanga. Oko kwathiwa, izinto ezinobungozi eziphakamisa umngcipheko wokuphuhliswa kwala manqweno enomdlavuza ukwanda njengoko unani lokuxilonga ngamnye ngonyaka kumazwe athuthukile.
I-Endometrial ngokumelene neCervical Cancer
Umehluko phakathi komhlaza we-endometrial kunye nomhlaza wesibeleko unokudideka kuba umlomo wesibeleko ngowona nto inxalenye yezantsi. Ngelixa elinye iqela lichaphazelekayo, kukho izinto ezahlukeneyo ezibalulekileyo ezivela kwi-screening kwizizathu ezibalulekileyo zale khansela.
Ingxenye ephezulu yesisu iquka umzimba okanye i-fundus, kanti umlomo wesibeleko uyinxalenye engaphantsi kwesibeleko, ehlangene nomfazi.
Ingozi yeCometerrial Cancer
Umdlavuza we-Endometrial uqikelelwe ukuthintela abafazi abangama-61,380 ngo-2017, okubangelwa ukufa kwa-10,920 kwaba bafazi. Kufunyenwe ukuba umdlavuza we-endometrial ukwanda kwiminyaka yakutshanje, ngakumbi eMntla Melika naseYurophu. Kucingelwa ukuba oku kuhambelana nokunyuka kwimiba yengozi kwiminyaka yamuva nje, njengento yokukhuluphala, abafazi abanabantwana abancinci, kunye nokulibala ukubeletha. Nangona umdlavuza we-endometrial wawungaphantsi kakhulu kubomama base-Afrika baseMerika kunabamhlophe eUnited States, iziganeko ziyafana ngoku.
Izimpawu kunye neMpawu
Ekuqaleni, umfazi angenayo nayiphi na impawu ngomdlavuza we-endometrial. Xa iimpawu zikhula, eziqhelekileyo zitshintsho kwi-uterine bleeding. Oku kungaphalala emva kokuba umfazi sele edlulile kwimizi yokupheliswa komzimba kwaye akanakho ixesha. Ukuphuma kwegazi ngaphambili, umdlavuza we-endometrial ungabangela ukuphuma kwintsholongwane engavamile , njengokuphuma kwegazi kunye nokubonakala phakathi kwamaxesha. Abanye abafazi abanalo ukuphuma kwamanzi kodwa kunoko baqaphele umjelo ocacileyo okanye owenziwe ngegazi. Abanye abesifazana banakho ukuhlakulela i- anemia (inani elibomvu leeseli legazi) ngenxa yokuphuma kwamanzi.
Ezinye iimpawu ezinokuthi ziquka ubuhlungu beplavic okanye ubunzima be-pelvic. Xa umhlaza uphuthukile, iimpawu ezinjengokulahlekelwa kwesisindo esingenasenzo , ukukhathala, okanye isilwanyana kunye nezinguquko zesibhanki zingaqatshelwa.
Izizathu kunye neengozi
Nangona singaqinisekanga ngezona zinto ezibangela umdlavuza we-endometrial, kukho izinto ezinobungozi eziye zafunyanwa. Eyaziwayo kunye nemingcipheko enokuthi iquka:
- Ubudala: Umdlavuza we-Endometrial uqhelekileyo kubasetyhini abangaphantsi kweminyaka yobudala.
- Amanqanaba e-estrogen aphakamileyo (ngaphandle kokuphakanyiswa kweprogesterone): Naluphi na umqathango owandisa ama- estrogen ngaphandle kokunyuka okufanayo kwiprogektone kunokunyusa umngcipheko.
- Ukusetyenziswa komlomo ngomlomo: Ukusetyenziswa kwemithi yokukhulelwa ngomlomo okungenani omnye unyaka kunciphisa umngcipheko. Ukunciphisa umngcipheko kubaluleke kakhulu kwabasetyhini abasebenzisa iipilisi zokulawula ukuzalwa ngexesha elide kwaye baqhubeka nokunciphisa ingozi kwiminyaka emininzi emva kokuba iipilisi ziyeke.
- I-hormone yonyango yokuguqula (HRT): i-HRT ene-estrogen kodwa ngaphandle kwe-progesterone (unyango lwe-estrogen engakhuselekanga) landisa ingozi yomdlavuza we-endometrial.
- Iziphumo zokuzala: Abafazi abaneminyaka engapheliyo yokuzala, njengaleyo abaqala ukuhamba ngesantya okanye abo bahamba ngokukhawuleza emva kwesikhathi basengozini enkulu. Abasetyhini abangenabantwana basengozini enkulu kunabo abanabantwana.
- Imbali yokungabikho
- Imbali ye- endometrial hyperplasia
- Ukunyaniseka: Ukugqithisa ngokuphindaphindiweyo kwengozi yokuphuhlisa eso sifo.
- I-Polycystic ovarian syndrome (i-PCOS): I-PCOS iphakamisa umngcipheko wokwakha umdlavuza we-endometrial nakuba ezinye zonyango kwi-PCOS, njenge-metformin, zinganciphisa umngcipheko.
- Isifo sikashukela: Umngcipheko womdlavuza we-Endometrial unamaxesha amane phezulu kwabesetyhini abanesifo sikashukela.
- IUD isebenzise: Ukusebenzisa i- IUD kunciphisa umngcipheko wesifazane wesifo somhlaza we-endometri.
- I-Tamoxifen: Ukusetyenziswa kwe- tamoxifen ukunciphisa umngcipheko wokuphindaphinda okanye ukunciphisa umngcipheko wokuvelisa umdlavuza webele kunokwandisa umngcipheko wokwakha umdlavuza we-endometrial.
- Ezinye izicubu ze-ovari ezifana ne-granulosa cell tumor secrete estrogen kwaye inokuphakamisa umngcipheko womhlaza we-endometri.
- Imbali yokuba neekliniki ezifana nomhlaza wesifuba okanye umdlavuza we-ovari
- Ukuba nomlando weentsapho zomdlavuza we-endometrial okanye umhlaza womgulon
- Abantu abane-syndrome ezifana ne- Lynch syndrome (i-non-poyposis yomhlaza okanye i-HNPCC)
- Imbali yomsakazo kwi-pelvis njengenxalenye yonyango lomhlaza
- Ukuba neendlela zokuphila
- Ukutya ukutya okunamafutha aphezulu
Ukuqwalaselwa / UkuQaphela kwangaphambili
Ngokungafani nomhlaza womlomo wesibeleko, akukho uvavanyo oluqhelekileyo lokuphonononga umdlavuza we-endometrial. Abasetyhini abanomngcipheko okhulayo wokuphuhlisa eso sifo, njengalezo zembali yentsapho, i-syndrome yesifo somdlavuza njengeLynch syndrome, okanye abasebenzisa i-tamoxifen ukunyanga okanye ukunciphisa ingozi yomhlaza wesibele kufuneka bathethe nodokotela wabo malunga nokuhlola. Kwabesifazana abathile, iimvavanyo ezifana ne-endometrial biopsy kunye / okanye i-uterine ultrasound zinokucingwa ukuba zandise ithuba lokufumana isifo ngokukhawuleza.
Ukufumanisa i-Endometrial Cancer
Ukuxilongwa kusenokukrokra kwi-Pap smear, kodwa i-Pap smears ayikho isisombululo esisebenzayo sesi sifo. Ukuxilongwa ngokuqhelekileyo kuqala ngokuhlolwa kweplavic, nangona i-cancer yepilisi ayinakwenzeka.
Ukuba unesifo esingaqhelekanga sokuphuma kwamanzi kukho iimvavanyo eziliqela apho ugqirha wakho angakuqwalasela. I-ultrasound engapheliyo (i-ultrasound eyenziwa ngokufaka ipowuni ye-ultrasound kwisisu sakho) inokwenziwa ukujonga ubukhulu be-endometrium yakho. Isisombululo se-saline sinokuthi singeniswe kwisibeleko sakho (sonohysterogram) phambi kwenkqubo yokuphucula ukubonakaliswa kwazo naziphi na izinto ezingaqhelekanga.
I-hysteroscopy yinkqubo apho "i-telescope" ifakwe kwisibeleko sakho kwisibeletho ukuze ubone ngeso lengqondo i-uterine.
Isifundo esivamile sisiphelo se-endometrial biopsy. Kule nkqubo yeofisi, isixhobo sifakwa kwisiswini sakho ukuze ufumane ukutshitshiswa ngaphakathi kwesibeleko sakho ukuvavanya kwibhuyibhile. Ugqirha wakho unokucetyiswa nokuxilwa kunye nokuhluthwa (D noC) edlalwa kwigumbi lokusebenza phantsi kwe-anesthetic jikelele. Nge-anesthesia kunye nokuhluthwa komlomo wakho wesibeleko, isampuli engcono yesinyibililo sakho se-uterine ifumaneka.
Ukuba isifo somhlaza wesifo se-endometrial sikhankanywe, i-biopsy iyadingeka ukuqinisekisa ukuxilongwa kunye nokuchaza ngakumbi iimpawu zesisu.
Ukucwangcisa
Ukuchonga okukhethwa kukho unyango olungcono, isiteji esilungileyo sisinyathelo esibalulekileyo emva kokuxilongwa. Isitatimende senziwa ngokujonga ubukhulu besisu, ubugwenxa obusekelwe kumbonakalo walo phantsi kwe-microscope (amanani omzimba osuka kwi-1 ukuya ku-3), kunye nokuvavanya ukubona ukuba umhlaza uye wangena okanye wasasazeka naziphi na izicubu ngaphandle kwesibeleko.
Njengamanye amachiza, ezi zihlamba zihlala zinikwa i-"TNM" apho iT emela ubukhulu be-tumor (kwaye ngamanye amaxesha ezinye iimpawu), N imele ukubandakanyeka kwee-lymph nodes eziseduze okanye ezikude, kwaye iM imelela i-metastases, okanye isasazeka kwizitho ezikude.
Ukuba kukho ithuba lokuba umhlaza uye wangena okanye usasazeka kwezinye izitho, ezinye iimvavanyo zingabandakanya i-cystoscopy kunye / okanye i-proctoscopy ukujonga naluphi na ubungqina bokusasaza kwi-vestile okanye i-rectum, kunye ne-CT, iMRI, kunye / okanye iPET ukujonga ukusabalala okukude kwe-tumor.
Njengamanye amanxeba aqinile, umdlavuza we-endometrial uhlahlelwe kwiinqanaba ezi-4 (ngoJanuwari 2018 akusekho isigaba 0). Ezi ziquka:
- Isigaba se-1: Umhlaza uphelelwe kwisibeleko, kwaye awuzange usasaze kwisibeleko, kwezinye iindawo zeeplavis, okanye izitho ezikude.
- Isigaba sesi-2: I-tumor isasazeke kwisibeleko, kodwa kungekhona kwezinye iindawo zomzimba.
- Isigaba sesi-3: I-tumor isasaze ngaphaya kwesibeleko, kodwa zonke iindawo zokusasazeka zisasemaphandleni.
- Isigaba sesi-4: Umhlaza usasazeke kwi-bladder, rectum, okanye kwiindawo ezikude zomzimba.
Ezi zigaba zigqitywa kwakhona zibe ngamagatya (njengesiqendu 2A no-2B) kuxhomekeke kwezinye iimpawu zesisu.
Izinyango zokwelapha kwi-Endometrial Cancer
Izinyathelo ezingcono kakhulu zokonyango zomhlaza we-endometrial zixhomekeke kwisigaba sesifo, iimpawu, kunye nezinye izinto ezifana nempilo jikelele. Khetha ziquka:
Ugqirha: Ugqirha yindlela eqhelekileyo yokunyanga umdlavuza we-endometri. Kulo vavanyo isisu sisuswe ( hysterectomy ), ngokuqhelekileyo kunye neethubhu kunye nama-ovari (salpingo-ophorectomy). Kubasetyhini abagqibile ukuzala abantwana, oku akwenzeki ukubonisa ezininzi iingxaki ngaphandle komngcipheko wokuhlinzwa. Kulabo abaselula kwaye banqwenela ukuba nomntwana okanye abanye abantwana, nangona kunjalo, oku kuya kuncwina.
Uphulo lwe-radiation: unyango lwamayeza lonyango olungasetyenziselwa ukuba kunokwenzeka ukuba ezinye iiseli zomhlaza zisasazeka ngaphaya kommandla osuswe ngokuhlinzwa.
I-hormone yokwelapha: I- hormone therapy ingasetyenziselwa ukunciphisa inani le-estrogen okanye ukwandisa inani leprogesterone emzimbeni. Iinkqubo eziqhelekileyo zonyango ziquka enye yeentlobo zeprogesterone. Ngenxa yezidumbu ezisezingeni eliphezulu okanye zibuye zibuyele, ezinye iindlela zonyango ziquka i-tamoxifen, i-luteinizing ukukhulula i-hormone agonists kunye ne-aromatase inhibitors.
I-Chemotherapy: I-Chemotherapy ayidla ngokufunekayo kwi-cancer ye-endometrial. Ngama-khancer asele okanye aphindaphinda, kunjalo, i-chemotherapy isetyenziswa rhoqo.
Uvavanyo lwezonyango: Zonke iindlela zokwelapha umdlavuza we-endometrial ezikhoyo ngoku ziye zafundwa kwiimvavanyo zeclini. Kukho izilingo eziqhubekayo zekliniki yomdlavuza we-endometrili efuna iindlela zokuphucula kokubili ukusinda nokunciphisa imiphumo emibi kunye nokuphazamiseka kwonyango.
Ukujamelana
Ukufumanisa ukuxilongwa komhlaza kungakhathaliseki ukuba uhlobo okanye isiteji esoyisa. Imfundo inika amandla, kwaye ukufunda ngomhlaza wakho kunokukunceda ube ngummeli wakho ekunyamekeleni kwakho. Thatha isikhashana ufunde malunga nendlela yokufumana ulwazi olungumhlaza lomnatha kwi-intanethi . Inkxaso nayo ibalulekile. Ukuxilongwa komhlaza yithuba elifanelekileyo lokuqokelela inkqubo yakho yokuxhasa ecaleni kwakho. Abantu abaninzi bakuthola kuncedo ukujoyina iqela lokuxhasa kuluntu lwabo okanye ukuthatha inxaxheba kwelinye lamaqela enkxaso ye-intanethi okanye inkxaso yoluntu ngomdlavuza we-endometrial.
Prognosis
Ukuxeliswa ngokubanzi komdlavuza we-endometrial eUnited States kulungile, njengoko amaninzi ala ma-cancer afunyenwe ekuqaleni. Ezinye iintlobo ezingavamile zesifo somhlaza we-endometrial ezifana nesicaccin cell carcinoma zinobudlova kwaye zineempembelelo ezihluphekayo.
Amanqanaba angama-5 eqhubekayo okusinda angama-75-88 ekhulwini kwisiganeko sesifo, iipesenti ezingama-69 kwinqanaba lika II, ama-47-58 ekhulwini kwinqanaba lesi-III, kunye neepesenti ezingama-15 ukuya kwi-IV. Kubalulekile ukuba uqaphele ukuba amanqaku amaninzi aneminyaka emininzi ubudala kwaye ayibonakali unyango olutsha kunye nolunefuthe oluye lwavunywa ukususela ngelo xesha.
ILizwi
Umdlavuza we-Endometrial ngumhlaza wesibeleko okwenzeka ngelanga kwanda eMelika naseYurophu. Uphawu oluqhelekileyo (malunga namaphesenti angama-90 lwabasetyhini) aluqhelekanga ukuphuma kwintsholongwane. Ngethamsanqa abaninzi abafazi bafuna unyango ukuba bafumana ixesha elingavamile okanye baphala ngegazi emva kokuphuma kwimizi, kwaye ezininzi zezi zicubu ziyafunyaniswa kwizigaba zangaphambili. Uphulo olungcono kakhulu luxhomekeke kwisigaba sokuxilongwa.
Ukuba uye wafumanisa ukuba unomdlavuza we-endometrial into ebaluleke kakhulu ongayenza kukuba ube ngummeli wakho ekunyamekeleni kwakho. Buza imibuzo eninzi. Cinga ukufumana umbono wesibini. Ufunde ngesifo sakho.
> Imithombo:
> I-Lortet-Tiuelent, J., Ferlay, J., Bray, F. et al. Iimpawu Zamazwe ngamazwe kunye neMigudu ye-Endometrial Cancer Incidence, ngo-1978-2013. Umbhalo weNational Cancer Institute . 16 Oktobha 2017.
> INational Cancer Institute. I-Endometrial Cancer Treatment (PDQ) -Ingxelo yeNgcali yezobugcisa. Ukuhlaziywa 08/18/17. https://www.cancer.gov/types/uterine/hp/endometrial-treatment-pdq
> Tang, Y., Zhu, L., Li, Y. et al. Usetyenziso lweMetformin ludibaniswe neZiphumo eziNcitshiswayo kunye nokuPhucula okuPhucukisiwe kweCometerrial Cancer: Uhlalutyo lweMeta. BioMed Research International . 2017. 2017: 5905384.