Umhlaza wedlala lobudoda

Umhlaza wedlala lobudoda ngumhlaza oqala kwilungu lobudoda. IProstate sisakhiwo esincinci esime okomnandwe esenza inxalenye yenkqubo yokuzala yendoda. Isonga i-urethra, ityhubhu ekhupha umchamo ngaphandle komzimba.

Umhlaza wedlala lobudoda ngoyena nobangela uqhelekileyo wokufa komhlaza kumadoda angaphezu kweminyaka yobudala engama-75. Umhlaza wedlala lobudoda awufumaneki kumadoda angaphantsi kweminyaka engama-40.

Abantu abasemngciphekweni omkhulu babandakanya:

• Amadoda ase-Afrika aseMelika, nawo kunokwenzeka ukuba awuphuhlise lo mhlaza kuyo yonke iminyaka
• Amadoda ngaphezulu kweminyaka yobudala engama-60
• Amadoda anotata okanye umntakwabo onomhlaza wedlala lobudoda

Abanye abantu abasemngciphekweni kubandakanya:

• Amadoda ebekade ejikeleze iAgent Orange
• Amadoda atya ukutya okunamafutha amaninzi, ngakumbi amafutha ezilwanyana
• Amadoda atyebileyo

Umhlaza wamadlala awufane uxhaphake kubantu abangayityi inyama (inyama).

Ingxaki eqhelekileyo phantse kuwo onke amadoda njengoko ekhula yiprostate eyandisiweyo. Oku kubizwa ngokuba yi-benign prostatic hyperplasia, okanye i-BPH. Ayiphakamisi umngcipheko womhlaza webele. Kodwa, inokunyusa isiphumo se-antigen (PSA) esiphumo sovavanyo lwegazi.

Ngomhlaza wokuqala wesibeletho, kuhlala kungekho zimpawu.

Uvavanyo lwegazi lwe-PSA lunokwenziwa ukuze kuhlolwe abantu abanesifo somhlaza webele. Rhoqo, inqanaba le-PSA liyenyuka ngaphambi kokuba kubekho naziphi na iimpawu.

Iimpawu ezidweliswe ngezantsi zinokwenzeka ngomhlaza wedlala lobudoda njengoko ikhula inkulu kwiprostate. Ezi mpawu zinokubangelwa zezinye iingxaki zeprostate:

• Ukulibaziseka okanye ukuqala okucothayo komjelo womchamo
• Ukuqhuba okanye ukuvuza komchamo, amaxesha amaninzi emva kokuchama
• Ukucotha komchamo
• Ukucoca xa uchama, okanye ukungabinakho ukukhupha wonke umchamo
• Igazi kumchamo okanye kwisidoda

Xa umhlaza usasazekile, kunokubakho iintlungu zethambo okanye ukuthamba, amaxesha amaninzi kumqolo ongezantsi nangamathambo e-pelvic.

Uvavanyo lwe-digital rectal olungaqhelekanga lunokuba kuphela kophawu lomhlaza wedlala lobudoda.

I-biopsy iyafuneka ukuxelela ukuba unomdlavuza webele. I-biopsy yinkqubo yokususa isampulu yethishu kwi-Prostate. Isampulu ithunyelwa kwilebhu yoviwo. Kuya kwenziwa kwiofisi kagqirha wakho.

Ugqirha wakho unokucebisa i-biopsy ukuba:

• Unenqanaba eliphezulu le-PSA
• Uvavanyo lwe-digital rectal lutyhila indawo enzima okanye engalinganiyo

Isiphumo se-biopsy sichazwa ngokusebenzisa into ebizwa ngokuba yi-Gleason grade kunye ne-Gleason.

Ibakala leGleason likuxelela ukuba umhlaza usasazeka ngokukhawuleza kangakanani. Inamanqanaba tumors kwisikali se-1 ukuya kwi-5. Unokuba namabanga ahlukeneyo omhlaza kwisampulu enye ye-biopsy. Amabakala amabini aqhelekileyo adibene kunye. Oku kukunika amanqaku eGleason. Ukuphakama kwenqaku lakho leGleason, kokukhona umhlaza unokusasazeka ngaphaya kweprotrate:

• Amanqaku 2 ukuya ku-6: Umhlaza webala lobudoda ophantsi.
• Inqaku 7: Ephakathi- (okanye embindini) kumhlaza webanga. Uninzi lwee-cancer zomhlaza wesibeleko ziwela kweli qela.
• Amanqaku 8 ukuya ku-10: Umhlaza kumgangatho ophezulu.

Enye inkqubo yokuhlela, iNkqubo yamaQela amaBakala ama-5 yenza umsebenzi ongcono wokuchaza ukuba umhlaza uza kuziphatha njani kwaye uphendule njani kunyango:

• Iqela leBakala 1: Amanqaku eGleason 6 okanye asezantsi (umhlaza webanga eliphantsi)
• Iqela leBakala 2: Amanqaku eGleason 3 + 4 = 7 (umhlaza okumgangatho ophakathi)
• Iqela leBakala 3: Amanqaku eGleason 4 + 3 = 7 (umhlaza webanga eliphakathi)
• Iqela leBakala 4: Amanqaku eGleason 8 (umhlaza webanga eliphezulu)
• Iqela leBakala 5: Amanqaku eGleason 9 ukuya kwi-10 (umhlaza webanga eliphezulu)

Iqela elisezantsi libonisa ithuba elingcono lonyango olunempumelelo kuneqela eliphezulu. Iqela eliphezulu lithetha ukuba uninzi lweeseli zomhlaza zibonakala zahlukile kwiiseli eziqhelekileyo. Iqela eliphezulu likwathetha ukuba kunokwenzeka ukuba eli thumba lisasazeke ngamandla.

Olu vavanyo lulandelayo lunokwenziwa ukuqinisekisa ukuba umhlaza usasazekile:

• Ukuskena i-CT
• Ukuskena amathambo
• Ukuskena iMRI

Uvavanyo lwegazi lwe-PSA luyakusetyenziselwa ukubeka esweni umhlaza wakho emva konyango.

Unyango luxhomekeke kwizinto ezininzi, kubandakanya amanqaku akho eGleason kunye nempilo yakho iyonke. Ugqirha wakho uza kuxoxa nawe ngeendlela zokhetho.

Ukuba umhlaza awusasazekanga ngaphandle kwendlala yesinye, unyango oluqhelekileyo lubandakanya:

• Utyando (i-radical prostatectomy)
• Unyango lwe-radiation, kubandakanya unyango lwe-brachytherapy kunye neproton

Ukuba umdala, ugqirha wakho unokucebisa ngokujonga nje umhlaza kunye novavanyo lwe-PSA kunye ne-biopsies.

Unyango lweHormone lusetyenziselwa umhlaza osasazeke ngaphaya kweprostate. Inceda ekuthomalaliseni iimpawu kwaye ithintela ukukhula okungaphaya kunye nokusasazeka komhlaza. Kodwa ayinyangi umhlaza.

Ukuba umhlaza wamadlala usasazeka nasemva kokuba unyango lwehomoni, utyando, okanye imitha izamile, unyango lunokubandakanya:

• Unyango ngamayeza
• I-Immunotherapy (iyeza elenza ukuba amajoni omzimba ahlasele abulale iiseli zomhlaza)

Utyando, unyango ngemitha, kunye nonyango lwehomoni kunokuchaphazela ukusebenza kwakho ngokwesondo. Iingxaki kulawulo umchamo kunokwenzeka emva kotyando kunye nonyango radiation. Xoxa ngezinto ezikuxhalabisayo nomboneleli wakho wezempilo.

Emva konyango lomhlaza wedlala lobudoda, uya kujongwa ngononophelo ukuqinisekisa ukuba umhlaza awusasazeki. Oku kubandakanya ukuvavanywa kwesiqhelo, kubandakanya nokuvavanywa kwegazi ngePSA (ihlala iinyanga ezintathu ukuya kunyaka-1).

Unokudambisa uxinzelelo lokugula ngokujoyina iqela lenkxaso yomhlaza webele leprotate. Ukwabelana nabanye abanamava afanayo kunye neengxaki kunokukunceda ungaziva ulilolo.

Ukusebenza kakuhle kwakho kuxhomekeke ekubeni umhlaza usasazekile ngaphandle kweprotrate gland kunye nokuba ziqhele kangakanani iiseli zomhlaza (inqaku leGleason) xa ufunyanisiwe.

Unyango lunokwenzeka ukuba umhlaza awusasazekanga. Unyango lwehormone lunokuphucula ukusinda, nokuba unyango alunakwenzeka.

Xoxa ngoncedo kunye nokungalunganga kokuvavanywa kwePSA nomboneleli wakho wezempilo.

Thetha nomboneleli wakho malunga neendlela ezinokuthi zinciphise umngcipheko womhlaza webele. Oku kunokubandakanya amanyathelo okuphila, njengokutya kunye nokuzilolonga.

Akukho mayeza avunyiweyo yi-FDA yokuthintela umhlaza wedlala lobudoda.

Umhlaza - iprostate; I-Biopsy - iprotrate; Iprostate biopsy; Amanqaku kaGleason

• Imitha yepelvic - ukukhutshwa
• Prostate brachytherapy - ukukhutshwa
• Unyango ngemitha- imibuzo oza kuyibuza ugqirha wakho
• I-radical prostatectomy-ukukhutshwa

• I-anatomy yokuzala eyindoda
• Indoda yokuchama
• BPH
• Umhlaza wedlala lobudoda
• Uvavanyo lwegazi lwePSA
• Uthotho lweprostatectomy
• Ukuthengiswa ngokutsha kweprostate (TURP) -Uluhlu

Umbutho weAmerican Urological Association. Ukuvavanywa kwe-PSA yeseti yonyango lwangaphambi kokunyangwa kunye nolawulo lwasemva kwesifo somhlaza wedlala lobudoda: Uhlaziyo luka-2013 lweNkcazo yeNkqubo eNgcono ka-2009. www.auanet.org/guidelines/prostate-specific-antigen-(psa)-best-practice-statement. Kufunyenwe ngoDisemba 5, 2019.

Umbutho weAmerican Urological Association. Ukufunyanwa kwangoko komhlaza wesibeletho (2018): isikhokelo seklinikhi. www.auanet.org/guidelines/prostate-cancer-early-detection-guideline. Ifunyenwe ngo-Agasti 22, 2019.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lweprostate lomhlaza (PDQ) yinguqulelo yezempilo. www.cancer.gov/types/prostate/hp/prostate-kunyanga-pdq. Ukuhlaziywa kweSeptemba 20, 2019. Ifikeleleke ngoDisemba 5, 2019.

Iwebhusayithi yeNethiwekhi yeCancer epheleleyo yoMhlaza. Izikhokelo ze-NCCN zokuziqhelanisa neklinikhi kwi-oncology (izikhokelo ze-NCCN): umhlaza webele Inguqulelo 4.2019. www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Ukuhlaziywa kwe-Agasti 19, 2019. Ifikeleleke ngoSeptemba 4, 2019.

UNelson WG, uAntonarakis ES, uCarter HB, uDe Marzo AM, uDeWeese TL. Umhlaza wedlala lobudoda. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, ii-eds. I-Oncology yeklinikhi yase-Abeloff. Umhla wesi-6. IPhiladelphia, PA: Elsevier; 2020: isahl 81.

UStephenson AJ, uKlein EA. I-Epidemiology, i-etiology, kunye nokuthintela umhlaza wedlala lesinyi. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ii-eds. UCampbell-Walsh Urology. Ngomhla we-11. IPhiladelphia, PA: Elsevier; Ngo-2016: isahluko 107.

Umsebenzi woKhuseleko kwi-US, uGrossman DC, uCurry SJ, et al. Ukuvavanywa komhlaza wedlala lobudoda: Ingxelo yengcebiso yamandla okhuseleko e-US. JAMA. 2018; 319 (18): 1901-1913. IINKCUKACHA: 29801017 www.ncbi.nlm.nih.gov/pubmed/29801017.