Ziziphi iimpawu zokuqala zomhlaza wesibeleko kwaye uzibona njani?

Umxholo

• Yintoni umhlaza wesibeleko?
• Zithini iimpawu zokuqala zomhlaza we-ovari?
• Iindidi zomhlaza wesibeleko
• Ii-cysts ze-Ovarian
• Imingcipheko yomhlaza we-ovari
• Ufumanisa njani umhlaza we-ovari?
• Ngawaphi amanqanaba omhlaza we-ovari?
• Inqanaba 1
• Inqanaba 2
• Inqanaba 3
• Inqanaba 4
• Uphathwa njani umhlaza we-ovari
• Ugqirha
• Unyango ekujoliswe kulo
• Ukugcinwa kokuchuma
• Uphando lomhlaza we-Ovarian kunye nezifundo
• Ngaba umhlaza wesibeleko unokuthintelwa?
• Yintoni imbono?
• Inqanaba lokusinda
• Iminyaka emi-5 yamaxabiso okusinda kwesi sifo somhlaza we-ovari

Ama-ovari ngamadlala okuzala amabhinqa amabini avelisa i-ova, okanye amaqanda. Bavelisa iihomoni zabasetyhini i-estrogen kunye neprogesterone.

Malunga ne-21,750 yabasetyhini e-United States baya kufumana isifo somhlaza kwi-ovari ngo-2020, kwaye malunga ne-14,000 yabasetyhini bayakusweleka kuyo.

Kule nqaku uyakufumana ulwazi malunga nomhlaza we-ovari kubandakanya:

• iimpawu
• iintlobo
• umngcipheko
• ukuxilonga
• amanqanaba
• unyango
• uphando
• amazinga okusinda

Yintoni umhlaza wesibeleko?

Umhlaza we-Ovarian kuxa iiseli ezingaqhelekanga kwi-ovary ziqala ukuphindaphindeka ngaphandle kolawulo kwaye zenze ithumba. Ukuba ishiywe inganyangwa, ithumba linokusasazeka liye kwamanye amalungu omzimba. Oku kubizwa ngokuba ngumhlaza we-ovarian cancer.

Umhlaza we-Ovarian uhlala uneempawu zokulumkisa, kodwa iimpawu zokuqala azicacanga kwaye kulula ukuzilahla. Iipesenti ezingamashumi amabini zomhlaza we-ovari zifunyenwe kwinqanaba lokuqala.

Zithini iimpawu zokuqala zomhlaza we-ovari?

Kulula ukungahoyi iimpawu zokuqala zomhlaza we-ovari kuba ziyafana nezinye izifo eziqhelekileyo okanye zihlala zize zihambe. Iimpawu zokuqala zibandakanya:

• isisu esiswini, uxinzelelo kunye nentlungu
• ukugcwala okungaqhelekanga emva kokutya
• ubunzima bokutya
• ukwanda komchamo
• ukwanda komnqweno wokuchama

Umhlaza we-Ovarian unokubangela ezinye iimpawu, ezinje:

• ukudinwa
• ukuqunjelwa
• isilungulela
• ukuqhina
• umqolo obuhlungu
• izitenxo zokuya exesheni
• iintlobano zesini ezibuhlungu
• I-dermatomyositis (isifo esinqabileyo sokudumba esinokubangela irhashalala, buthathaka kwezihlunu, kunye nezihlunu ezivuthayo)

Ezi mpawu zinokwenzeka nakweliphi na inani lezizathu. Akunjalo ngenxa yomhlaza we-ovari. Abasetyhini abaninzi banazo ezinye zeengxaki ngamanye amaxesha.

Ezi ntlobo zeempawu zihlala zethutyana kwaye ziphendula kunyango olulula kwiimeko ezininzi.

Iimpawu ziya kuqhubeka ukuba zibangelwa ngumhlaza we-ovari. Iimpawu zihlala ziba nzima njengoko ithumba likhula. Ngeli xesha, umhlaza uhlala usasazeka ngaphandle kwama-ovari, usenza ukuba kube nzima ukunyanga ngokufanelekileyo.

Kwakhona, imihlaza inyangwa kakuhle xa ifunyenwe kwangethuba. Nceda uqhagamshelane nogqirha wakho ukuba ufumana iimpawu ezintsha nezingaqhelekanga.

Iindidi zomhlaza wesibeleko

Ama-ovari enziwa ziindidi ezintathu zeeseli. Iseli nganye inokukhula ibe luhlobo oluthile lwethumba:

• Amathumba epithelial bume koluhlu lwethishu ngaphandle kwii-ovari. Malunga neepesenti ezingama-90 zomhlaza womhlaza yi-epithelial tumors.
• Amathumba eStromal zikhula kwiiseli ezivelisa iihomoni. Iipesenti ezisixhenxe zomhlaza womhlaza yi-stromal tumors.
• Izidumba zeseli zentsholongwane zikhula kwiiseli ezivelisa amaqanda. Izidumbu zeseli zeGerm zinqabile.

Ii-cysts ze-Ovarian

Uninzi lwee-cyst ze-ovari alunomhlaza. Ezi zibizwa ngokuba zii-cysts ezinobungozi. Nangona kunjalo, inani elincinci kakhulu linokuba ngumhlaza.

I-ovarian cyst yingqokelela yolwelo okanye umoya okhula ngaphakathi okanye ojikeleze i-ovary. Uninzi lwee-cysts ze-ovari zenza njengesiqhelo se-ovulation, kulapho i-ovary ikhupha iqanda. Ngokuqhelekileyo zibangela iimpawu ezinobumnene, njengokuqunjelwa, kwaye zihambe ngaphandle konyango.

Ii-cysts zixhalabisa ngakumbi ukuba awuyikhupha i-ovulation. Abasetyhini bayeke ukuphuma kwamaqanda emva kokuyeka ukuya exesheni. Ukuba iifom ze-ovarian cyst emva kokuyeka ukuya exesheni, ugqirha wakho unokufuna ukwenza iimvavanyo ezingakumbi ukuze afumane unobangela we-cyst, ngakumbi ukuba inkulu okanye ayihambi kwiinyanga ezimbalwa.

Ukuba i-cyst ayidluli, ugqirha wakho unokucebisa utyando ukuyisusa kwimeko efanelekileyo. Ugqirha wakho akakwazi ukufumanisa ukuba unomhlaza de bawususe ngotyando.

Imingcipheko yomhlaza we-ovari

Oyena nobangela womhlaza wesibeleko awaziwa. Nangona kunjalo, ezi zinto zinokunyusa umngcipheko wakho:

• Imbali yosapho yomhlaza we-ovari
• uguquko kwimfuza ehambelana nomhlaza we-ovari, njenge I-BRCA1 okanye I-BRCA2
• Imbali yobuqu yesifuba, isibeleko, okanye umhlaza wekolon
• ukutyeba kakhulu
• ukusetyenziswa kwamachiza athile okuzala okanye unyango lwehomoni
• akukho mbali yokukhulelwa
• endometriosis

Ukwaluphala yenye into ebangela umngcipheko. Uninzi lweemeko zomhlaza we-ovari zikhula emva kokuyeka ukuya exesheni.

Kuyenzeka ukuba ube nomhlaza wesibeleko ngaphandle kokufumana nayiphi na kwezi zinto zobungozi. Kwangokunjalo, ukuba nayo nayiphi na kwezi zinto zobungozi akuthethi ukuba uyakuba nomhlaza we-ovari.

Ufumanisa njani umhlaza we-ovari?

Kulula kakhulu ukunyanga umhlaza we-ovari xa ugqirha wakho ewuchonga kumanqanaba okuqala. Nangona kunjalo, akukho lula ukuyifumana.

Ama-ovari akho anzulu ngaphakathi kwesisu, ngenxa yoko akunakulindeleka ukuba uve ithumba. Akukho luhlolisiso lwesiqhelo lufumanekayo kumhlaza we-ovari. Kungenxa yoko le nto kubaluleke kakhulu ukuba uxele ugqirha wakho iimpawu ezingaqhelekanga okanye ezingapheliyo.

Ukuba ugqirha wakho ukhathazekile ukuba unomdlavuza we-ovari, baya kuphakamisa uvavanyo lwe-pelvic. Ukwenza uvavanyo lwe-pelvic kunokunceda ugqirha wakho afumane izitenxo, kodwa amathumba amancinci e-ovari kunzima kakhulu ukuziva.

Njengoko ithumba likhula, licinezela ngokuchasene nesinyi kunye ne-rectum. Ugqirha wakho unokukwazi ukufumanisa izitenxo ngexesha lovavanyo lwepelevic.

Ugqirha wakho unokwenza olu vavanyo lulandelayo:

• I-ultrasound yangaphantsi (TVUS). I-TVUS luhlobo lovavanyo lokucinga olusebenzisa amaza esandi ukufumanisa amathumba kumalungu okuzala, kubandakanya ii-ovari. Nangona kunjalo, i-TVUS ayinakunceda ugqirha wakho ukuba abone ukuba ngaba amathumba anomhlaza.
• Isisu kunye ne-pelvic CT scan. Ukuba uxabisa kwidayi, banokuyalela i-MRI ye-pelvic scan.
• Uvavanyo lwegazi ukulinganisa amanqanaba e-antigen 125 (CA-125) yomhlaza. Uvavanyo lwe-CA-125 yi-biomarker esetyenziselwa ukuvavanya impendulo yonyango yomhlaza we-ovari kunye neminye imihlaza yomhlaza wokuzala. Nangona kunjalo, ukuya exesheni, i-uterine fibroids, kunye nomhlaza wesibeleko kunokuchaphazela amanqanaba e-CA-125 egazini.
• Uqhaqho. I-biopsy ibandakanya ukususa isampulu encinci yeethishu kwi-ovary kunye nokuhlalutya isampulu phantsi kwemicroscope.

Kubalulekile ukuba uqaphele ukuba, nangona zonke ezi mvavanyo zinokunceda ukukhokela ugqirha wakho ekufumaneni isifo, i-biopsy kuphela kwendlela ugqirha wakho anokuqinisekisa ngayo ukuba unomdlavuza we-ovari.

Ngawaphi amanqanaba omhlaza we-ovari?

Ugqirha wakho umisela inqanaba ngokujonga ukuba umhlaza usasazeke kangakanani. Kukho amanqanaba amane, kwaye inqanaba ngalinye linendawo yalo:

Inqanaba 1

Inqanaba 1 Umhlaza we-ovari uneendawo ezintathu zokungena:

• Inqanaba 1A.Umhlaza ulinganiselwe, okanye ubekwe kwindawo ethile, kwi-ovary enye.
• Inqanaba 1B. Umhlaza ukuwo omabini amaqanda.
• Inqanaba 1C. Kukho iiseli zomhlaza ngaphandle kwe-ovary.

Inqanaba 2

Kwinqanaba 2, ithumba lisasazeke kwezinye izakhiwo zepelvic. Inezithuba ezibini:

• Inqanaba 2A. Umhlaza unwenwele kwisibeleko okanye kwimibhobho yesibeleko.
• Inqanaba 2B. Umhlaza unwenwele kwisinyi okanye kwi-rectum.

Inqanaba 3

Inqanaba 3 Umhlaza we-ovari unamanqanaba amathathu:

• Inqanaba 3A. Umhlaza usasazeke ngemicroscopic ngaphaya kwepelvis ukuya kumda wesisu kunye ne-lymph nodes esiswini.
• Inqanaba 3B. Iiseli zomhlaza zisasazekile ngaphaya kwethambo lomqolo ukuya kuludwe lwesisu kwaye zibonakala ngeliso lenyama kodwa zilinganise ngaphantsi kwe-2 cm.
• Inqanaba 3C. Iidiphozithi zomhlaza ubuncinci i-3/4 ye-intshi ibonwa esiswini okanye ngaphandle kwepeni okanye isibindi. Nangona kunjalo, umhlaza awukho ngaphakathi kwepeni okanye isibindi.

Inqanaba 4

Kwinqanaba le-4, ithumba liye lasasazeka, okanye lasasazeka, ngaphaya kwethambo lesisu, isisu, kunye ne-lymph node kwisibindi okanye kwimiphunga. Zimbini izinto ezingena endaweni yesibini kwisigaba 4:

• Kwi Inqanaba 4A, iiseli ezinomhlaza zikulwelo olujikeleze imiphunga.
• Kwi Inqanaba 4B, elona nqanaba lihambele phambili, iiseli ziye zafikelela ngaphakathi kudakada okanye kwisibindi okanye nakwamanye amalungu akude njengesikhumba okanye ingqondo.

Uphathwa njani umhlaza we-ovari

Unyango luxhomekeke ekubeni umhlaza usasazeke kangakanani. Iqela loogqirha liya kugqiba ngesicwangciso sonyango ngokuxhomekeke kwimeko yakho. Inokubandakanya ezimbini okanye nangaphezulu koku kulandelayo:

• ichemotherapy
• utyando lokubeka umhlaza kunye nokususa ithumba
• unyango ekujoliswe kulo
• Unyango lwehomoni

Ugqirha

Utyando lolona nyango luphambili kumhlaza we-ovari.

Injongo yoqhaqho kukususa ithumba, kodwa i-hysterectomy, okanye ukususwa ngokupheleleyo kwesibeleko, kuhlala kuyimfuneko.

Ugqirha wakho unokucetyiswa ukuba ususe zombini ii-ovari kunye ne-fallopian tubes, ii-lymph node ezikufuphi, kunye nezinye izicubu ze-pelvic.

Ukuchonga zonke iindawo zethumba kunzima.

Kwisifundo esinye, abaphandi baphande iindlela zokuphucula inkqubo yotyando ukuze kube lula ukususa zonke izicwili zomhlaza.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo, njenge-chemotherapy, uhlasela iiseli zomhlaza ngelixa usenza umonakalo omncinci kwiiseli eziqhelekileyo emzimbeni.

Unyango ekujoliswe kulo ngokutsha ukunyanga umhlaza we-ovarian epithelial advanced lubandakanya i-PARP inhibitors, ezizezamayeza ezithintela i-enzyme esetyenziswa ziiseli ukulungisa umonakalo kwi-DNA yazo.

I-PARP inhibitor yokuqala yamkelwa ngo-2014 ukuba isetyenziswe kumhlaza womhlaza we-ovari owawunyangwa ngaphambili ngemigca emithathu ye-chemotherapy (okuthetha ubuncinci ukuphindeka kabini).

I-PARP inhibitors ezintathu ezikhoyo ngoku zibandakanya:

• olaparib (Lynparza)
• i-niraparib (iZejula)
• irucaparib (Rubraca)

Ukongezwa kwelinye iyeza, i-bevacizumab (Avastin), ikwasetyenziswe kunye ne-chemotherapy emva kotyando.

Ukugcinwa kokuchuma

Unyango lomhlaza, kubandakanya i-chemotherapy, i-radiation, kunye notyando, kunokonakalisa amalungu akho okuzala, okwenza kube nzima ukukhulelwa.

Ukuba ufuna ukukhulelwa kwixa elizayo, thetha nogqirha wakho ngaphambi kokuqala unyango. Banokuxoxa malunga nokhetho lwakho lokugcina ukuzala kwakho.

Izinketho ezinokubakho zokulondolozwa kokuchuma zibandakanya:

• Ukuqanduselwa kombungu. Oku kubandakanya ukuqanda iqanda elichumileyo.
• Ukuqanduselwa kweOocyte. Le nkqubo ibandakanya ukuqanda iqanda elingafakwanga sityalo.
• Ugqirha lokugcina ukuzala. Ngamanye amaxesha, utyando olususa kuphela i-ovary enye kunye nokugcina i-ovary esempilweni inokwenziwa. Oku kuhlala kunokwenzeka kuphela kwinqanaba lokuqala lomhlaza we-ovari.
• Ukugcinwa kwethambo le-Ovarian. Oku kubandakanya ukususa kunye nokuqandisa izicubu ze-ovari ukuze zisetyenziswe kwixesha elizayo.
• Uxinzelelo lwe-Ovarian. Oku kubandakanya ukuthatha iihormoni ukucinezela ukusebenza kwe-ovari okwethutyana.

Uphando lomhlaza we-Ovarian kunye nezifundo

Unyango olutsha lomhlaza we-ovari lufundwa minyaka le.

Abaphandi baphonononga iindlela ezintsha zokunyanga umhlaza we-ovarian-resistant ovarian. Xa ukungqinwa kweplatinam kwenzeka, amachiza asemgangathweni wokuqala we-chemotherapy njenge-carboplatin kunye ne-cisplatin ayisebenzi.

Ixesha elizayo le-PARP inhibitors liya kuba kukuchonga ukuba zeziphi ezinye iziyobisi ezinokusetyenziswa ngokudibeneyo kunye nazo ukunyanga amathumba abonisa iimpawu ezizodwa.

Kutshanje, ezinye iindlela zonyango ezithembisayo ziye zaqala iimvavanyo zeklinikhi ezinje ngesitofu sokulwa nomhlaza we-ovarian oqhelekileyo oveza iprotein esindayo.

Nge-Meyi ka-2020, kwapapashwa into enokubakho kwi-anti-drug conjugate (ADC) enokubakho ukunyanga umhlaza we-ovarian-resistant ovarian cancer.

Amayeza amatsha ekujoliswe kuwo ayafundwa, kubandakanya i-antibody navicixizumab, i-ATR inhibitor AZD6738, kunye ne-Wee1 inhibitor adavosertib. Zonke zibonise iimpawu zomsebenzi wokuchasana nethumba.

jolisa kwimfuza yomntu ukunyanga okanye ukunyanga isifo. Ngo-2020, ulingo lwesigaba sesithathu kunyango lwe-gene VB-111 (ofranergene obadenovec) luqhubekile neziphumo ezithembisayo.

Kwi-2018, i-FDA ikhawuleze yalandelela unyango lweprotein ebizwa ngokuba yi-AVB-S6-500 yomhlaza we-ovarian-resistant ovarian. Oku kujolise ekuthinteleni ukukhula kwethumba kunye nokusasazeka komhlaza ngokuvimba indlela ephambili yeemolekyuli.

Uvavanyo lweklinikhi oluqhubekayo lokudibanisa i-immunotherapy (enceda amajoni omntu ukulwa umhlaza) kunye nonyango esele luvunyiwe lubonakalisile.

Uvavanyo olujolise kunyango kwabo banamanqanaba aphezulu alo mhlaza.

Unyango lomhlaza we-Ovarian lujolise ikakhulu kutyando lokususa ii-ovari kunye nesibeleko kunye ne-chemotherapy. Ngenxa yoko, abanye abantu basetyhini baya kuba neempawu zokuyeka ukuya exesheni.

Inqaku lika-2015 lajonga i-intraperitoneal (IP) chemotherapy. Olu phononongo lufumanise ukuba abo bafumana unyango lwe-IP babenenqanaba lokusinda eliphakathi kwiinyanga ezingama-61.8. Olu yayiluphuculo xa kuthelekiswa neenyanga ezingama-51.4 kwabo bafumana ichemotherapy esemgangathweni.

Ngaba umhlaza wesibeleko unokuthintelwa?

Akukho ndlela zingqiniweyo zokuphelisa ngokupheleleyo umngcipheko wokuba nomhlaza we-ovari. Nangona kunjalo, kukho amanyathelo onokuwathatha ukunciphisa umngcipheko.

Izinto ezibonisiweyo ukunciphisa umngcipheko wokuba nomhlaza we-ovari zibandakanya:

• ukuthatha iipilisi zokulawula ukuzalwa komlomo
• ukuncancisa
• ukukhulelwa
• iinkqubo zotyando kumalungu akho okuzala (njenge-tubal ligation okanye i-hysterectomy)

Yintoni imbono?

Imbonakalo yakho ixhomekeke kwizinto ezahlukeneyo, kubandakanya:

• isigaba somhlaza ekuchongeni
• impilo yakho iyonke
• uphendula njani kunyango

Wonke umhlaza wahlukile, kodwa inqanaba lomhlaza sisalathiso esibaluleke kakhulu kwimbonakalo.

Inqanaba lokusinda

Inqanaba lokusinda yipesenti yabasetyhini abasindayo kwinani elithile leminyaka kwinqanaba elichongiweyo lokufumanisa isifo.

Umzekelo, inqanaba lokusinda kweminyaka emi-5 yipesenti yezigulana ezifumene isifo kwisigaba esithile kwaye zihlala ubuncinci iminyaka emi-5 emva kokuba ugqirha ezifumanise.

Izinga lokusinda elihambelanayo likwathathela ingqalelo izinga elilindelekileyo lokusweleka kwabantu abangenawo umhlaza.

Umhlaza we-ovarian epithelial lolona hlobo luqhelekileyo lomhlaza we-ovari. Amaxabiso okusinda ahluka ngokuxhomekeka kuhlobo lomhlaza we-ovari, ukukhula komhlaza, kunye nokuqhubela phambili kunyango.

Umbutho waseMelika waseCancer usebenzisa ulwazi kwiziko ledatha le-SEER ukuba iZiko leSizwe loMhlaza (i-NCI) ​​ligcina ukuqikelela inqanaba lokusinda kwesihlobo somhlaza we-ovari.

Nantsi indlela SEER okwangoku ahlela ngayo amanqanaba ahlukeneyo:

• Yenziwe yaNgingqi. Akukho mqondiso wokuba umhlaza usasazeke ngaphandle kwama-ovari.
• Ingingqi. Umhlaza usasazeke ngaphandle kwama-ovari kwizakhiwo ezikufuphi okanye kwii-lymph node.
• Ukude. Umhlaza unwenwele kwiindawo ezikude zomzimba, njengesibindi okanye imiphunga.

Iminyaka emi-5 yamaxabiso okusinda kwesi sifo somhlaza we-ovari

Umhlaza wesifo se-ovarian epithelial

Amathumba e-Ovarian stromal

Izidudu zeseli zeGerm zesibeleko

Qaphela ukuba le datha ivela kwizifundo ezinokuba yiminyaka emi-5 okanye nangaphezulu.

Oososayensi ngoku baphanda iindlela eziphuculweyo nezithembekileyo zokufumana umhlaza we-ovari kwangoko. Inkqubela phambili kunyango iphucula, kwaye ngayo, umbono womhlaza we-ovari.