Umhlaza wesinyi

Umhlaza wesinyi ngumhlaza oqala kwisinyi. Isinyi lilungu lomzimba eligcina likhuphe umchamo. Kusembindini wesisu esisezantsi.

Umhlaza wesinyi usoloko uqala kwiiseli ezingqine isinyi. Ezi seli zibizwa ngokuba ziiseli zotshintsho.

Ezi tumors zihlelwa ngendlela ezikhula ngayo:

• Izidumba zepapillary zikhangeleka ngathi ziintsumpa kwaye ziqhotyoshelwe kwisiqu.
• I-Carcinoma in tum tumors ithe tyaba. Azixhaphakanga kakhulu. Kodwa ziyangena kwaye zineziphumo ezibi.

Oyena nobangela womhlaza wesinyi awaziwa. Kodwa izinto ezininzi ezinokukwenza ukuba ube nakho ukuphuhlisa zibandakanya:

• Ukutshaya icuba - Ukutshaya kuwonyusa kakhulu umngcipheko wokuba nomhlaza wesinyi. Ukufikelela kwisiqingatha sayo yonke imihlaza yomhlaza wesibeleko inokubangelwa ngumsi wecuba.
• Imbali yobuqu okanye yosapho yomhlaza wesinyi - Ukuba nomntu kusapho olunomhlaza wesinyi kwandisa umngcipheko wokukuhlakulela.
• Ukuvezwa kwemichiza emsebenzini-Umhlaza wesinyi unokubangelwa kukudibana neekhemikhali ezibangela umhlaza emsebenzini. Ezi khemikhali zibizwa ngokuba yi-carcinogens. Abasebenzi bedayi, abasebenza ngerabha, abasebenza ngealuminium, abasebenza ngofele, abaqhubi beelori, kunye nabafaki bokubulala izinambuzane basemngciphekweni omkhulu.
• I-Chemotherapy -Ichiza le-chemotherapy iziyobisi i-cyclophosphamide inokunyusa umngcipheko womhlaza wesinyi.
• Unyango lwe-radiation - Unyango lwe-radiation kwingingqi ye-pelvis kunyango lomhlaza we-Prostate, i-testes, umlomo wesibeleko, okanye isibeleko sonyusa umngcipheko wokuba nomhlaza wesinyi.
• Usulelo lwesinyi - Ixesha elide (elingapheliyo) losulelo lwesinyi okanye ukucaphuka kunokukhokelela kuhlobo oluthile lomhlaza wesinyi.

Uphando alibonisanga bungqina bucacileyo bokuba ukusebenzisa iilekese zokufakelwa kukhokelela kumhlaza wesinyi.

Iimpawu zomhlaza wesinyi zingabandakanya:

• Intlungu zesisu
• Igazi kumchamo
• Intlungu yethambo okanye ukuthamba ukuba umhlaza unwenwela kwithambo
• Ukudinwa
• Ukuchama kabuhlungu
• Ukuhamba rhoqo kwi-Urinary kunye nokungxamiseka
• Ukuvuza komchamo (ukungasebenzi)
• Ukuhla ukusinda

Ezinye izifo kunye neemeko zinokubangela iimpawu ezifanayo. Kubalulekile ukubona umboneleli wakho wezempilo ukuba akhuphe zonke ezinye izizathu ezinokubakho.

Umboneleli uya kwenza uvavanyo lomzimba, kubandakanya uvavanyo lwe-rectal kunye ne-pelvic.

Uvavanyo olunokwenziwa lunokubandakanya:

• Isisu kunye ne-pelvic CT scan
• Isiskena seMRI esiswini
• ICystoscopy (kuvavanya ngaphakathi isinyi ngekhamera), kunye ne-biopsy
• Iphiramidi efakwa ngaphakathi - IVP
• Uhlalutyo lomchamo
• Umchamo wecytology

Ukuba iimvavanyo ziqinisekisa ukuba unomhlaza wesinyi, iimvavanyo ezongezelelweyo ziya kwenziwa ukubona ukuba umhlaza usasazekile na. Oku kubizwa ngokuba yistage. Ukubeka esiteji kunceda ukukhokelela kunyango lwexesha elizayo kunye nokulandela kwaye kukunika umbono wokuba ungalindela ntoni kwixesha elizayo.

Inkqubo ye-TNM (ithumba, iindawo, imastastasis) isetyenziselwa ukwenza umhlaza wesinyi:

• Ta - Umhlaza ukwindawo yesinyi kuphela kwaye awusasazekanga.
• I-T1 - Umhlaza udlula kwisambatho sesinyi, kodwa awufikeleli kwimisipha yesinyi.
• I-T2 - Umhlaza usasazeka kwisisipha sesinyi.
• I-T3 - Umhlaza usasazeka ngaphaya kwesinyi kwisicwili esinamafutha esijikeleze sona.
• I-T4 - Umhlaza usasazeke kwizakhiwo ezikufuphi ezifana neprostate gland, isibeleko, ubufazi, i-rectum, udonga lwesisu, okanye udonga lwe-pelvic.

Amathumba aqokelelwe ngokwamaqela ngokusekwe kwindlela abonakala ngayo phantsi kwemicroscope. Oku kubizwa ngokuba kukubeka isisu. Ithumba elikwinqanaba eliphezulu liyakhula ngokukhawuleza kwaye kunokwenzeka ukuba lisasazeke. Umhlaza wesinyi ungasasazeka kwiindawo ezikufuphi, kubandakanya:

• Indawo ezinesinqe
• Amathambo
• Isibindi
• Amaphaphu

Unyango luxhomekeke kwinqanaba lomhlaza, ubungqongqo beempawu zakho, kunye nempilo yakho iyonke.

Inqanaba 0 kunye nam unyango:

• Utyando lokususa ithumba ngaphandle kokususa enye isinyi
• I-Chemotherapy okanye i-immunotherapy ibekwe ngqo kwisinyi
• I-immunotherapy inikwe ngaphakathi nge-pembrolizumab (Keytruda) ukuba umhlaza uyaqhubeka ukubuya emva kwala manyathelo angentla

Unyango lweSigaba II kunye no-III:

• Utyando lokususa isinyi sonke (i-cystectomy) kunye ne-lymph node ezikufutshane
• Utyando lokususa inxenye yesinyi kuphela, ilandelwe yimitha kunye neyeza lokunyanga ngamayeza
• I-Chemotherapy yokunciphisa ithumba ngaphambi kotyando
• Umdibaniso wechemotherapy kunye ne radiation (kubantu abakhetha ukungatyandi okanye abangakwaziyo ukwenza utyando)

Uninzi lwabantu abanesigaba se-IV tumors abanakunyangeka kwaye utyando alufanelekanga. Kulaba bantu, unyango lwe-chemotherapy luhlala luqwalaselwa.

UKUQINISEKISA

I-Chemotherapy inokunikwa abantu abanesifo se-II kunye nesifo se-II ngaphambi okanye emva kotyando ukunceda ukukhusela ithumba ekubuyeni.

Kwizifo zokuqala (amanqanaba oku-0 kunye nam), ichemotherapy ihlala inikwa ngokuthe ngqo kwisinyi.

NGOKUGQIBELA

Iicancer zomhlaza zihlala ziphathwa nge-immunotherapy. Kolu nyango, iyeza libangela amajoni akho omzimba ukuba ahlasele abulale iiseli zomhlaza. I-Immunotherapy yesigaba sokuqala somhlaza wesinyi ihlala isenziwa kusetyenziswa isitofu sokugonya iBacilleCalmette-Guerin (eyaziwa ngokuba yi-BCG). Ukuba umhlaza ubuya emva kokusetyenziswa kwe-BCG, iiarhente ezintsha zinokusetyenziswa.

Njengazo zonke iindlela zonyango, iziphumo ebezingalindelekanga zinokwenzeka. Buza umboneleli wakho ukuba zeziphi iziphumo ebezingalindelekanga onokuzilindela, kunye nokuba wenze ntoni xa zisenzeka.

UKUGQIBELA

Utyando lomhlaza wesinyi lubandakanya:

• Ukuthengiswa ngokutsha kwesinyi (TURB) -Izicubu zomhlaza wesinyi ziyasuswa ngomchamo.
• Ukususwa okungagqibelelanga okanye okupheleleyo kwesinyi - Abantu abaninzi abanesifo somhlaza wesigaba II okanye III banokufuna ukuba isinyi sabo sisuswe (i-cystectomy). Ngamanye amaxesha, kuphela yinxalenye yesinyi esuswe. I-Chemotherapy inokunikwa ngaphambi okanye emva kolu tyando.

Utyando lunokwenziwa ukunceda umzimba wakho ukhuphe umchamo emva kokuba isinyi sisuswe. Oku kunokubandakanya:

• Umjelo we-Ileal - Umthombo omncinci womchamo wenziwe ngotyando kwisiqwengana sethumbu lakho elincinci. I-ureters ekhupha umchamo kwizintso ziqhotyoshelwe kwelinye icala leli qhekeza. Elinye icala likhutshwa ngokuvulwa kolusu (i-stoma). I-stoma ivumela umntu ukuba akhuphe umchamo oqokelelweyo ngaphandle kwedama.
• Ilizwekazi lokugcina umchamo - Ingxowa yokuqokelela umchamo yenziwe ngaphakathi komzimba wakho usebenzisa isiqwenga samathumbu akho. Uya kudinga ukufaka ityhubhu kwindawo evulekileyo kulusu lwakho (stoma) kule bhegi ukukhupha umchamo.
• I-Orthotopic neobladder - Olu tyando luya luxhaphaka kubantu abasuswe isinyi. Icandelo lesisu sakho lisongelwe ukwenza isingxobo esiqokelela umchamo. Iqhotyoshelwe kwindawo esemzimbeni apho umchamo uhlala ukhupha khona kwisinyi. Le nkqubo ikuvumela ukuba ugcine ulawulo lomchamo oqhelekileyo.

Ungaluphelisa uxinzelelo lokugula ngokujoyina iqela lokuxhasa umhlaza. Ukwabelana nabanye abanamava afanayo kunye neengxaki kunokukunceda ungaziva ulilolo.

Emva konyango lomhlaza wesinyi, uya kujongwa ngononophelo ngugqirha. Oku kunokubandakanya:

• Ukuvavanywa kwe-CT ukujonga ukusasazeka okanye ukubuya komhlaza
• Ukubeka iliso kwiimpawu ezinokubonisa ukuba isifo siba nzima, njengokukhathala, ukunciphisa umzimba, ukwanda kwentlungu, ukwehla kwamathumbu kunye nokusebenza kwesinyi, kunye nobuthathaka
• Gcwalisa ubalo lwegazi (CBC) ukubeka esweni i-anemia
• Iimviwo zesinyi rhoqo emva kweenyanga ezi-3 ukuya kwezi-6 emva konyango
• Uhlalutyo lomchamo ukuba khange ususwe isinyi sakho

Ukusebenza kakuhle komntu onomhlaza wesinyi kuxhomekeke kwinqanaba lokuqala kunye nokuphendula kunyango lomhlaza wesinyi.

Umbono wenqanaba 0 okanye lomhlaza ndilungile. Nangona umngcipheko wokubuya komhlaza uphezulu, uninzi lomhlaza wesinyi obuyayo ungasuswa kwaye unyange.

Amanqanaba onyango kubantu abanesifo sethumba esingaphantsi kwe-50%. Abantu abanesifo somhlaza esinyini senqanaba IV kunqabile ukuba baphiliswe.

I-Cancer ye-Bladder ingasasazeka kwizitho ezikufutshane. Banokuhamba ngee-lymph node ze-pelvic kwaye basasazeka kwisibindi, imiphunga kunye namathambo. Ezinye iingxaki zomhlaza wesinyi zibandakanya:

• Ukunqongophala kwegazi
• Ukudumba kweengubo (hydronephrosis)
• Ukunyaniseka kwe-Urreral
• Ukungahambi kakuhle komchamo
• Ukungasebenzi kakuhle kwe-Erectile emadodeni
• Ukungasebenzi ngokwesondo kwabasetyhini
  

Biza umnikezeli wakho ukuba unegazi kumchamo wakho okanye ezinye iimpawu zomhlaza wesinyi, kubandakanya:

• Ukuchama rhoqo
• Ukuchama kabuhlungu
• Imfuneko engxamisekileyo yokuchama

Ukuba uyatshaya, yeka. Ukutshaya kunokunyusa umngcipheko womhlaza wesinyi. Gwema ukubonakaliswa kwimichiza ehambelana nomhlaza wesinyi.

Utshintsho carcinoma iseli wesinyi; Umhlaza womchamo

• ICystoscopy
• Iphecana lomchamo labasetyhini
• Indoda yokuchama

ICumberbatch MGK, Jubber I, PC emnyama, et al. I-Epidemiology yomhlaza wesinyi: uphononongo olucwangcisiweyo kunye nohlaziyo lwangoku lwezinto ezinobungozi kwi-2018. Uol Uur. 2018; 74 (6): 784-795. IINKCUKACHA: 30268659 pubmed.ncbi.nlm.nih.gov/30268659/.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lomhlaza wesinyi (PDQ) -uhlobo lobungcali kwezempilo. www.cancer.gov/types/bladder/hp/bladder-yonyango-pdq. Ukuhlaziywa ngoJanuwari 22, 2020. Ifikeleleke ngoFebruwari 26, 2020.

Iwebhusayithi yeNethiwekhi yeCancer epheleleyo yoMhlaza. Izikhokelo ze-NCCN zonyango kwi-oncology (izikhokelo ze-NCCN): Umhlaza wesinyi. Inguqulelo 3.2020. www.nccn.org/professionals/physician_gls/pdf/bladder.pdf. Ukuhlaziywa ngoJanuwari 17, 2020. Ifikeleleke ngoFebruwari 26, 2020.

USmith AB, uBalar AV, uMilowsky MI, uChen RC. I-Carcinoma yesinyi. 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 80.