Umhlaza weColorectal (Colon)

Umxholo

• Yintoni umhlaza wemibala?
• Zithini iimpawu zomhlaza obonakala ngokungafaniyo?
• Inqanaba lesi-3 okanye lesi-4 leempawu (zexesha lesifo)
• Ngaba kukho iintlobo ezahlukeneyo zomhlaza obala ngokombala?
• Yintoni ebangela umhlaza wemibala?
• Ngubani osemngciphekweni wesifo somhlaza?
• Izinto ezinobungozi ezihleliweyo
• Izinto ezinobungozi ezinokutshintsha
• Ufumanisa njani umhlaza obomvu?
• Uvavanyo lwelindle
• Uvavanyo lwegazi lwe-fecal occult egazini (gFOBT)
• Uvavanyo lwe-Fecal immunochemical (FIT)
• Uvavanyo lwasekhaya
• Iimveliso ukuzama
• Uvavanyo lwegazi
• Isigmoidoscopy
• Colonoscopy
• X-reyi
• Ukuskena i-CT
• Zithini iindlela zokhetho kunyango lomhlaza?
• Ugqirha
• Unyango ngamayeza
• Imitha
• Amanye amayeza
• Iyintoni inqanaba lokusinda kubantu abanomdlavuza obala?
• Ngaba umhlaza ongaqhelekanga unokuthintelwa?
• Ithini imbonakalo yexesha elide?

Sibandakanya iimveliso esicinga ukuba ziluncedo kubafundi bethu. Ukuba uthenga amakhonkco kweli phepha, sinokufumana ikhomishini encinci. Nantsi inkqubo yethu.

Yintoni umhlaza wemibala?

Umhlaza omdaka ngumhlaza oqala kwikholon (emathunjini amakhulu) okanye kwi-rectum. Omabini la malungu akwicandelo elisezantsi lenkqubo yokwetyisa. I-rectum isekupheleni kwekholoni.

I-American Cancer Society (ACS) iqikelela ukuba malunga ne-1 kumadoda angama-23 kunye no-1 kwabasetyhini abangama-25 baya kuba nomhlaza onomdla ngexesha lokuphila kwabo.

Ugqirha wakho unokusebenzisa isiteji njengesikhokelo sokufumanisa ukuba umhlaza umde kangakanani. Kubalulekile ukuba ugqirha wakho alazi inqanaba lomhlaza ukuze beze nesona sicwangciso sonyango silungileyo kwaye bakunike uqikelelo lwembono yakho yexesha elide.

Inqanaba 0 lomhlaza wolusu elinqanaba lokuqala, kwaye inqanaba lesi-4 lelona nqanaba liphambili:

• Inqanaba 0. Ikwabizwa ngokuba yi-carcinoma in situ, kweli nqanaba iiseli ezingaqhelekanga zikwi-lining yangaphakathi yekholoni okanye i-rectum.
• Inqanaba 1. Umhlaza ungene kumngxunya, okanye kwi-mucosa, kwikholoni okanye kwi-rectum kwaye inokuba ikhule yangumaleko wemisipha. Ayisasazekanga kwii-lymph node ezikufutshane okanye kwamanye amalungu omzimba.
• Inqanaba 2. Umhlaza usasazeke kwiindonga zekolon okanye i-rectum okanye kwiindonga ukuya kwizicubu ezikufutshane kodwa azichaphazelanga ii-lymph node.
• Inqanaba 3. Umhlaza uye wafudukela kwii-lymph node kodwa hayi kwamanye amalungu omzimba.
• Inqanaba 4. Umhlaza usasazeke kwamanye amalungu akude, njengesibindi okanye imiphunga.

Zithini iimpawu zomhlaza obonakala ngokungafaniyo?

Umhlaza ongalunganga awunakubakho naziphi na iimpawu, ngakumbi kwinqanaba lokuqala. Ukuba ufumana iimpawu ngexesha lokuqala, zinokubandakanya:

• ukuqhina
• urhudo
• Utshintsho kumbala wesitulo
• Utshintsho kubume besihlalo, esifana nesitulo esimxinwa
• igazi esitulweni
• ukopha kwi-rectum
• irhasi egqithisileyo
• isisu esiswini
• intlungu zesisu

Ukuba uqaphela nayiphi na kwezi mpawu, yenza idinga nogqirha wakho ukuba nixoxe ngokufumana uvavanyo lomhlaza.

Inqanaba lesi-3 okanye lesi-4 leempawu (zexesha lesifo)

Iimpawu zomhlaza ocacileyo zibonakala ngakumbi kwinqanaba lokugqibela (amanqanaba 3 no-4). Ukongeza kwezi mpawu zingasentla, unokufumana:

• ukudinwa kakhulu
• ubuthathaka obungachazwanga
• ukunciphisa umzimba ngempazamo
• utshintsho kwisitulo sakho esihlala ixesha elingaphezulu kwenyanga
• uvakalelo lokuba izibilini zakho aziyi kuba nanto ngokupheleleyo
• ukugabha

Ukuba umdlavuza osasazekayo usasazeka kwamanye amalungu omzimba wakho, unokufumana:

• i-jaundice, okanye amehlo atyheli nolusu
• ukudumba ezandleni okanye iinyawo
• ubunzima bokuphefumla
• intloko engapheliyo
• ukungaboni kakuhle
• amathambo aqhekekile

Ngaba kukho iintlobo ezahlukeneyo zomhlaza obala ngokombala?

Ngelixa umhlaza ongathandabuzekiyo uvakala ungacacanga, kukho ngokwenene ngaphezu kohlobo olunye. Umahluko unento yokwenza neentlobo zeeseli eziguqula umhlaza kunye nokuba zenzeka phi.

Uhlobo oluqhelekileyo lomhlaza obala ngokungafaniyo luqala kwi-adenocarcinomas. Ngokutsho kwe-ACS, i-adenocarcinomas yenza uninzi lweziganeko ezinomhlaza. Ngaphandle kokuba ugqirha wakho akhankanye ngenye indlela, umhlaza wakho onomdla kusenokwenzeka ukuba lolu hlobo.

I-Adenocarcinomas ifom ngaphakathi kweeseli ezenza i-mucus kwi-colon okanye kwi-rectum.

Ngaphantsi kwesiqhelo, umhlaza obalaseleyo ubangelwa zezinye iintlobo zamathumba, ezinje:

• i-lymphomas, ezinokuthi zenze ii-lymph node okanye kwi-colon kuqala
• carcinoids, eziqala kwiiseli ezenza iihomoni ngaphakathi kwamathumbu akho
• ii-sarcomas, ezenza izicwili ezithambileyo ezifana nezihlunu kwikholoni
• isisu esiswini, esinokuqala njengobungozi kwaye emva koko sibe nomhlaza (Bahlala bekwiphepha lokugaya ukutya, kodwa kunqabile kwikholoni.)

Yintoni ebangela umhlaza wemibala?

Abaphandi basaqhubeka nokufunda unobangela wesifo somhlaza.

Umhlaza unokubangelwa kukutshintsha kwemfuza, nokuba kuzuzwe njengelifa okanye kufunyenwe. Olu tshintsho aluqinisekisi ukuba uza kuba nomhlaza, kodwa bayawandisa amathuba akho.

Olunye utshintsho lunokubangela iiseli ezingaqhelekanga ukuba ziqokelele kumngxunya wekholoni, zenze iipolyps. Oku kuncinci ukukhula.

Ukususa oku kukhula ngotyando kunokuba yinto yokuthintela. Iipolyps ezinganyangekiyo zinokuba ngumhlaza.

Ngubani osemngciphekweni wesifo somhlaza?

Kukho uluhlu olukhulayo lwezinto ezinobungozi ezisebenza zodwa okanye ngokudibeneyo ukonyusa amathuba omntu okuba nomhlaza obala ngokombala.

Izinto ezinobungozi ezihleliweyo

Ezinye zezinto ezonyusa umngcipheko wokuba nomhlaza ongathandabuzekiyo azinakuphepheka kwaye azinakutshintshwa. Ubudala yenye yazo. Amathuba akho okuphuhlisa lo mhlaza ayonyuka emva kokuba ufike kwiminyaka engama-50.

Eminye yemingcipheko emiselweyo yile:

• Imbali yangaphambili ye-colon polyps
• Imbali yangaphambili yezifo zamathumbu
• Imbali yosapho yomhlaza ongalunganga
• ukuba ne-syndromes ethile yemfuza, enjenge-adenomatous polyposis (FAP)
• Ukuba ngumYuda waseMpuma Yurophu okanye umAfrika

Izinto ezinobungozi ezinokutshintsha

Eminye imingcipheko inokuphetshwa. Oku kuthetha ukuba ungabatshintsha ukunciphisa umngcipheko wokuba nesifo somhlaza. Izinto ezinobungozi ezinokuthintelwa zibandakanya:

• ukutyeba kakhulu okanye ukutyeba kakhulu
• ukutshaya
• ukusela kakhulu
• ukuba nohlobo lwesibini lweswekile
• ukuba nokuhlala phantsi
• Ukutya ukutya okuphezulu kwiinyama ezigqityiweyo

Ufumanisa njani umhlaza obomvu?

Ukufunyaniswa kwangoko komhlaza ongalunganga kukunika elona thuba lihle lokuwunyanga.

Ikholeji yaseMelika yoGqirha (ACP) icebisa ukuhlolwa kwabantu abaneminyaka engama-50 ukuya kwengama-75 ubudala, kumngcipheko ophakathi wale meko, kwaye banokuphila iminyaka eli-10 ubuncinci.

Ukucebisa ukuhlolwa kwabantu abaneminyaka engama-50 ukuya kuma-79 ubudala kunye nomngcipheko weminyaka eyi-15 yokuphucula imeko ubuncinci yipesenti ezintathu.

Ugqirha wakho uya kuqala ngokufumana ulwazi malunga nembali yakho yezonyango kunye neyosapho. Kananjalo baya kwenza uvavanyo lomzimba. Banokucinezela kwisisu sakho okanye benze uvavanyo lwe-rectal ukumisela ukuba kukho amaqhuma okanye iipolyps.

Uvavanyo lwelindle

Unokufumana uvavanyo lwelindle rhoqo kwiminyaka emi-1 ukuya kwemi-2. Uvavanyo lwe-Fecal lusetyenziselwa ukufumana igazi elifihliweyo kwisitulo sakho. Zimbini iintlobo eziphambili, uvavanyo lwe-guaiac-based fecal occult test (gFOBT) kunye novavanyo lwe-fecal immunochemical (FIT).

Uvavanyo lwegazi lwe-fecal occult egazini (gFOBT)

I-Guaiac sisixhobo esisekwe kwisityalo esisetyenziselwa ukunxiba ikhadi eliqukethe isampulu yakho yendle. Ukuba kukho naliphi na igazi kwisitulo sakho, ikhadi liya kutshintsha umbala.

Kuya kufuneka uphephe ukutya okuthile kunye namayeza, afana nenyama ebomvu kunye neziyobisi ezichasayo (ii-NSAID), phambi kolu vavanyo. Banokuphazamisa iziphumo zakho zovavanyo.

Uvavanyo lwe-Fecal immunochemical (FIT)

I-FIT ifumanisa ihemoglobin, iprotein efumaneka egazini. Kuthathelwa ingqalelo ngokuchanekileyo ngakumbi kuvavanyo olusekwe kwi-guaiac.

Kungenxa yokuba i-FIT ayinakulindeleka ukuba ibone ukopha kumazantsi esisu (uhlobo lokopha olungafane lubangelwe ngumhlaza obomvu). Ngaphezu koko, iziphumo zolu vavanyo azichaphazeleki kukutya kunye namayeza.

Uvavanyo lwasekhaya

Ngenxa yokuba kufuneka iisampuli ezininzi zokugcina ezi mvavanyo, ugqirha wakho uya kukubonelela ngeekiti zovavanyo oza kuzisebenzisa ekhaya ngokuchasene nokuba ube nokuvavanywa eofisini.

Zombini ezi mvavanyo zinakwenziwa ngeekiti zovavanyo lwasekhaya ezithengwe kwi-Intanethi kwiinkampani ezinje ngeLetsGetChecked kunye ne-Everlywell.

Iikiti ezininzi ezithengiweyo kwi-Intanethi zifuna ukuba uthumele isampuli esitulweni kwilebhu yovavanyo. Iziphumo zakho zovavanyo kufuneka zifumaneke kwi-Intanethi ngaphakathi kweentsuku ze-5 zeshishini. Emva koko, uya kuba nenketho yokubonisana neqela lonyango malunga neziphumo zakho zovavanyo.

Isibini sesiZukulwana se-FIT sinokuthengwa kwakhona kwi-Intanethi, kodwa isampulu yestool akufuneki ithunyelwe elebhu. Iziphumo zovavanyo ziyafumaneka kwisithuba semizuzu emi-5. Olu vavanyo luchanekile, luvunyiwe yi-FDA, kwaye luyakwazi ukubona iimeko ezongezelelweyo ezinjenge-colitis. Nangona kunjalo, akukho qela lokhathalelo lonyango onokufikelela kulo ukuba unemibuzo malunga neziphumo zakho.

Iimveliso ukuzama

Uvavanyo lwasekhaya lunokusetyenziselwa ukufumana igazi esitulweni, uphawu olubalulekileyo lomhlaza onobala. Thenga kubo kwi-Intanethi:

• Uvavanyo lweLetsGetChecked Colon Cancer Testing
• Uvavanyo lokuvavanywa komhlaza weColon
• Isizukulwana sesiBini i-FIT (Uvavanyo lwe-Fecal Immunochemical Test)

Uvavanyo lwegazi

Ugqirha wakho unokuqhuba uvavanyo lwegazi ukuze ufumane umbono ongcono wento ebangela iimpawu zakho. Uvavanyo lomsebenzi wesibindi kunye nokubala okupheleleyo kwegazi kunokulawula ezinye izifo kunye nokuphazamiseka.

Isigmoidoscopy

Ukungeniswa kancinci, i-sigmoidoscopy ivumela ugqirha wakho ukuba ahlole icandelo lokugqibela lekholoni yakho, eyaziwa njenge-sigmoid colon, ngokuchasene nokungaqheleki. Inkqubo, ekwabizwa ngokuba yi-sigmoidoscopy eguqukayo, ibandakanya ityhubhu eguqukayo enokukhanya kuyo.

I-ACP icebisa i-sigmoidoscopy rhoqo kwiminyaka eli-10, ngelixa i-BMJ icebisa isigmoidoscopy sexesha elinye.

Colonoscopy

I-colonoscopy ibandakanya ukusebenzisa ityhubhu ende enekhamera encinci eqhotyoshelweyo. Le nkqubo ivumela ugqirha wakho ukuba abone ngaphakathi kwikholoni kunye ne-rectum ukukhangela nantoni na engaqhelekanga. Ihlala yenziwa emva kovavanyo oluncinci olungenasiphelo lubonisa ukuba unokuba nomhlaza obomvu.

Ngexesha le-colonoscopy, ugqirha wakho unokususa izicubu kwiindawo ezingaqhelekanga. Ezi sampuli zethishu zinokuthunyelwa elebhu ukuba zihlolwe.

Ngaphandle kweendlela esele zikhona zokuchonga isifo, ii-sigmoidoscopies kunye neekolonoscopies zezona zisebenza ngokukuko ekukhuleni okunesibindi okunokuthi kukhule kube ngumhlaza wolusu.

I-ACP icebisa ikholonoscopy qho emva kweminyaka eli-10, ngelixa iBMJ icebisa ukuba ibe lixesha elinye ikolonoscopy.

X-reyi

Ugqirha wakho unoku-odola iX-reyi esebenzisa isisombululo sokuqhekeka kwemitha esiqukethe imichiza yebarium.

Ugqirha wakho ufaka olu lwelo emathunjini akho ngokusebenzisa i-enema ye-barium. Nje ukuba isendaweni, isisombululo se-barium sombathisa udaka lwekholoni. Oku kunceda ukuphucula umgangatho wemifanekiso ye-X-ray.

Ukuskena i-CT

Izikena ze-CT zinika ugqirha wakho umfanekiso ocacileyo wekholoni yakho. Iskena se-CT esisetyenziselwa ukuxilonga umhlaza wombala ngamanye amaxesha sibizwa ngokuba yi-colonoscopy ebonakalayo.

Zithini iindlela zokhetho kunyango lomhlaza?

Unyango lwecolorectal cancer luxhomekeke kwizinto ezahlukeneyo. Imeko yempilo yakho iyonke kunye nenqanaba lomhlaza wakho oncomekayo uya kunceda ugqirha wakho enze isicwangciso sonyango.

Ugqirha

Kumanqanaba okuqala omhlaza ongalunganga, kunokwenzeka ukuba ugqirha wakho ukuba awususe iipolyps zomhlaza ngotyando. Ukuba i-polyp ayincamathisanga eludongeni lwamathumbu, uya kuba nembonakalo entle.

Ukuba umhlaza wakho usasazekile kwiindonga zakho zamathumbu, ugqirha wakho ugqirha unokufuna ukususa isahlulo sekholoni okanye i-rectum kunye nazo naziphi na ii-lymph node ezikufutshane. Ukuba kunokwenzeka, ugqirha wakho wotyando uya kuncamathisela isahlulo eseleyo sekholoni kwi-rectum.

Ukuba oku akunakwenzeka, banokwenza i-colostomy. Oku kubandakanya ukudala ukuvula eludongeni lwesisu ukuze kususwe inkunkuma. I-colostomy inokuba yeyethutyana okanye isigxina.

Unyango ngamayeza

I-Chemotherapy ibandakanya ukusetyenziswa kweziyobisi ukubulala iiseli zomhlaza. Kubantu abanomhlaza onomdla, i-chemotherapy ihlala yenzeka emva kotyando, xa isetyenziselwa ukutshabalalisa naziphi na iiseli ezinomhlaza. I-Chemotherapy ikwalawula ukukhula kwamathumba.

Amachiza e-Chemotherapy asetyenziselwa ukunyanga umhlaza wecolorectal abandakanya:

• capecitabine (Xeloda)
• iflourouril
• oxaliplatin (Eloxatin)
• irinotecan (Camptosar)

I-Chemotherapy ihlala iza neziphumo ebezingalindelekanga ekufuneka zilawulwe ngamayeza ongezelelweyo.

Imitha

Imitha isebenzisa umqadi onamandla, ofanayo nalowo usetyenziswa kwiX-reyi, ukujolisa kunye nokutshabalalisa iiseli ezinomhlaza ngaphambi nasemva kotyando. Unyango ngemitha luqhele ukwenzeka kunye nekhemotherapy.

Amanye amayeza

Unyango ekujoliswe kulo kunye ne-immunotherapies inokucetyiswa. Iziyobisi ezivunyiweyo nguLawulo lwezoKutya kunye noLawulo lweziyobisi (i-FDA) ukunyanga umhlaza ongalunganga kubandakanya:

• I-bevacizumab (Avastin)
• i-ramucirumab (iCyramza)
• ziv-aflibercept (Zaltrap)
• i-cetuximab (i-Erbitux)
• ipanitumumab (Vectibix)
• regorafenib (Stivarga)
• ipembrolizumab (Keytruda)
• i-nivolumab (iOpdivo)
• ipilimumab (Yervoy)

Banokunyanga umhlaza we-metastatic, okanye wokugqibela, womhlaza ongaphenduliyo kwezinye iintlobo zonyango kwaye usasazeke kwamanye amalungu omzimba.

Iyintoni inqanaba lokusinda kubantu abanomdlavuza obala?

Ukufumana isifo somhlaza ongalunganga kunokuba nexhala, kodwa olu hlobo lomhlaza luyanyangeka kakhulu, ngakumbi xa lubanjwe kwangethuba.

Inqanaba lokusinda leminyaka emi-5 kuwo onke amabakala omhlaza wekolon liqikelelwa ukuba libe ngama-63 eepesenti ngokusekwe kwidatha ukusuka ku-2009 ukuya ku-2015. Ngomhlaza womhlaza, iminyaka emi-5 yokusinda ngama-67 epesenti.

Inqanaba lokusinda kweminyaka emi-5 libonisa ipesenti yabantu abasindayo ubuncinci iminyaka emi-5 emva kokuxilongwa.

Amanyathelo onyango nawo aye ahamba indlela ende yamatyala aphucukileyo omhlaza wekolon.

NgokweYunivesithi yaseTexas Southwestern Medical Centre, ngo-2015, ixesha eliphakathi lokusinda kwinqanaba lesine lomhlaza wekolon lalimalunga neenyanga ezingama-30. Ngeminyaka yoo-1990, i-avareji yayiziinyanga ezi-6 ukuya kwezi-8.

Kwangelo xesha, oogqirha ngoku babona umhlaza wolusu kubantu abancinci. Ezinye zezi zinto zinokubangelwa kukhetho lokuphila olungenampilo.

Ngokwe-ACS, ngelixa ukubulawa ngumhlaza ngokobuhlanga kuye kwehla kubantu abadala, ukusweleka kwabantu abangaphantsi kweminyaka engama-50 ubudala kwanda phakathi kuka-2008 no-2017.

Ngaba umhlaza ongaqhelekanga unokuthintelwa?

Imingcipheko ethile yomhlaza wecolorectal, njengembali yosapho kunye nobudala, ayinakuthintelwa.

Nangona kunjalo, izinto zokuphila ezinokuthi zibe negalelo kumhlaza ongalunganga are Inokuthintelwa, kwaye inokunceda ukunciphisa umngcipheko opheleleyo wokuba nesi sifo.

Ungathatha amanyathelo ngoku ukunciphisa umngcipheko ngoku:

• ukunciphisa inani lenyama ebomvu oyityayo
• ukunqanda ukutya okwenziweyo, njengezinja ezishushu kunye nenyama yokutya
• ukutya ukutya okusekwe kwizityalo
• ukunciphisa amanqatha okutya
• ukuzilolonga yonke imihla
• ukunciphisa umzimba, ukuba ugqirha uyacebisa
• ukuyeka ukutshaya
• ukunciphisa ukusetyenziswa kotywala
• ukunciphisa uxinzelelo
• Ukulawula isifo seswekile esele sikhona

Elinye inyathelo lokuthintela kukuqinisekisa ukuba ufumana i-colonoscopy okanye omnye uvavanyo lomhlaza emva kweminyaka yobudala engama-50. Okukhona umhlaza ubhaqwe kwangethuba, kokukhona umphumo ungcono.

Ithini imbonakalo yexesha elide?

Xa ibanjwe kwangethuba, umhlaza onombala uyanyangeka.

Ngokufunyanwa kwangoko, uninzi lwabantu luhlala ubuncinci kwiminyaka emi-5 emva kokuxilongwa. Ukuba umhlaza awubuyi ngelo xesha, kunethuba eliphantsi kakhulu lokuphindaphinda, ngakumbi ukuba ubunesifo sokuqala.