Umhlaza wePeritoneal: Into ekufuneka uyazi

Umxholo

• Iiprayimari kunye nomhlaza wesibini wesifo somhlaza
• Kwiprayimari
• Esekondari
• Iimpawu zomhlaza we-peritoneal
• Amanqanaba omhlaza we-peritoneal
• Umhlaza wesifo seprayimari
• Umhlaza wesibini we-peritoneal
• Umhlaza wePeritoneal unobangela kunye nemingcipheko
• Ufumanisa njani umhlaza we-peritoneal
• Uwuxelela njani umahluko phakathi komhlaza we-peritoneal kunye nomhlaza we-ovari kwisifo
• Ukunyanga umhlaza we-peritoneal
• Ugqirha
• Unyango ngamayeza
• Unyango ekujoliswe kulo
• Yintoni imbonakalo?
• Amaxabiso okusinda
• Umhlaza wesifo seprayimari
• Umhlaza wesibini we-peritoneal
• Funa inkxaso

Umhlaza wePeritoneal ngumhlaza onqabileyo owakha ubume obuncinci beeseli ze-epithelial ezihambelana nodonga lwangaphakathi lwesisu. Lo mgca ubizwa ngokuba yi-peritoneum.

I-peritoneum ikhusela kwaye igubungele amalungu esiswini sakho, kubandakanya:

• amathumbu
• isinyi
• ingcambu
• isibeleko

I-peritoneum ikwavelisa ulwelo lokuthambisa oluvumela amalungu ukuba ahambe ngokulula ngaphakathi esiswini.

Ngenxa yokuba iimpawu zayo zihlala zingafunyanwa, umhlaza we-peritoneal uhlala ufunyanwa kwinqanaba lokugqibela.

Ityala ngalinye lomhlaza we-peritoneal lahlukile. Unyango kunye nembono ziyahluka ngokwahlukeneyo. Unyango olutsha olwenziwe kumashumi eminyaka adlulileyo luphucule amazinga okusinda.

Iiprayimari kunye nomhlaza wesibini wesifo somhlaza

Ukutyunjwa kweprayimari kunye nesekondari kubhekisela apho umhlaza uqale khona. Amagama awuyiyo imilinganiselo yokuba umhlaza unzima kangakanani.

Kwiprayimari

Umhlaza wokuqala we-peritoneal uqala kwaye ukhule kwi-peritoneum. Ihlala ichaphazela abantu basetyhini kwaye kunqabile ukuba ichaphazele amadoda.

Umhlaza wamabanga aphantsi we-peritoneal unxulumene ngokusondeleyo nomhlaza we-ovarian epithelial. Zombini ziphathwa ngendlela efanayo kwaye zinembono efanayo.

Uhlobo olunqabileyo lomhlaza wokuqala we-peritoneal yi-peritoneal malignant mesothelioma.

Esekondari

Umhlaza wesibini we-peritoneal umhlaza uhlala uqala kwelinye ilungu esiswini kwaye emva koko usasazeke (metastasizes) kwi-peritoneum.

Umhlaza wesibini we-peritoneal cancer ungaqala kwi:

• amaqanda
• Imibhobho
• isinyi
• isisu
• amathumbu amancinci
• ikholoni
• ingcambu
• isihlomelo

Umhlaza wesibini wesifo se-peritoneal unokuchaphazela abesilisa nabasetyhini. Kuqheleke ngakumbi kunomdlavuza wokuqala we-peritoneal.

Oogqirha baqikelela ukuba phakathi kwe-15 kunye ne-20 yeepesenti yabantu abanomdlavuza obala ngokungathandabuzekiyo baya kuphuhlisa i-metastases kwiperitoneum. Phantse iipesenti ezili-15 ukuya kwezi-15 zabantu abanomdlavuza wesisu baya kuphuhlisa i-metastases kwi-peritoneum.

Xa umhlaza udibanisa indawo yokuqala, indawo entsha iya kuba nohlobo olufanayo lweeseli zomhlaza njengendawo yokuqala.

Iimpawu zomhlaza we-peritoneal

Iimpawu zomhlaza we-peritoneal zixhomekeke kudidi kunye nenqanaba lomhlaza. Kumanqanaba ayo okuqala, kungangabikho zimpawu. Ngamanye amaxesha naxa umhlaza we-peritoneal uqhubekile kunokubakho iimpawu.

Iimpawu zokuqala zinokungacaci kwaye kusenokwenzeka zibangelwa zezinye iimeko ezininzi. Iimpawu zomhlaza we-peritoneal zingabandakanya:

• ukudumba kwesisu okanye iintlungu
• isisu esandisiweyo
• ukuziva uxinzelelo esiswini okanye isinqe
• ukugcwala ngaphambi kokuba ugqibe ukutya
• ukuqunjelwa
• isicaphucaphu okanye ukugabha
• amathumbu okanye utshintsho lomchamo
• Ukuphelelwa ngumdla wokutya
• ukunciphisa umzimba okanye ukutyeba
• ukukhutshwa kwilungu lobufazi
• umqolo obuhlungu
• ukudinwa

Njengoko umhlaza uqhubeka, ulwelo olunamanzi lunokuqokelelana kwisisu esiswini (ascites), esinokubangela:

• isicaphucaphu okanye ukugabha
• ukuqhawukelwa ngumphefumlo
• isisu esibuhlungu
• ukudinwa

Iimpawu zomhlaza we-peritoneal emva kwexesha zinokubandakanya:

• Gcwalisa isisu okanye ukuvalwa komchamo
• isisu esibuhlungu
• ukungakwazi ukutya okanye ukusela
• ukugabha

Amanqanaba omhlaza we-peritoneal

Xa iqala ukufunyanwa, umhlaza we-peritoneal uhlelwa ngokobungakanani bayo, isikhundla, nalapho usasazeka khona. Ikwanikwe ibakala, eliqikelela ukuba likhawuleza kangakanani ukusasazeka.

Umhlaza wesifo seprayimari

Umhlaza wamaprayimari oyintloko we-peritoneal uhlelwe ngenkqubo efanayo esetyenziselwa umhlaza we-ovari kuba imihlaza iyafana. Kodwa umhlaza wokuqala we-peritoneal uhlala udweliswa njengenqanaba lesi-3 okanye inqanaba lesi-4 Umhlaza we-Ovarian unezigaba ezibini zangaphambili.

Inqanaba 3 yahlulwe yangamanqanaba amathathu:

• 3A. Umhlaza usasazeke kwii-lymph node ngaphandle kwe-peritoneum, okanye iiseli zomhlaza zisasazeke kumphezulu we-peritoneum, ngaphandle kwe-pelvis.
• 3B. Umhlaza usasazeke kwi-peritoneum ngaphandle kwesinqe. Umhlaza kwi-peritoneum ziisentimitha ezi-2 (cm) okanye zincinci. Isenokusasazeka kwii-lymph node ngaphandle kwe-peritoneum.
• 3C. Umhlaza unwenwele kwi-peritoneum engaphandle kwesinqe kunye. Umhlaza kwi-peritoneum mkhulu kune-2 cm. Isenokusasazeka kwii-lymph node ngaphandle kwe-peritoneum okanye kumphezulu wesibindi okanye udakada.

Kwi Inqanaba 4, umhlaza unwenwele kwamanye amalungu. Eli nqanaba lahlulwe ngakumbi:

• 4A. Iiseli zomhlaza zifumaneka kulwelo olwakheka ngaphakathi kwimiphunga.
• 4B. Umhlaza usasazeke kumalungu nakwizihlunu ezingaphandle kwesisu, ezinjengesibindi, imiphunga, okanye i-groin lymph node.

Umhlaza wesibini we-peritoneal

Umhlaza wesibini we-peritoneal uhlelwe ngokwendawo yokuqala yomhlaza. Xa umhlaza oyintloko usasazeka kwelinye ilungu lomzimba, njenge-peritoneum, ihlala ichazwa njengenqanaba lesi-4 lomhlaza wokuqala.

Ingxelo yokuba phantse iipesenti ezili-15 zabantu abanomdlavuza ocolileyo kunye neepesenti ezingama-40 zabantu abanomdlavuza wesisu wesi-2 ukuya kwe-3 babandakanyeka.

Umhlaza wePeritoneal unobangela kunye nemingcipheko

Isizathu somhlaza we-peritoneal asiyazi.

Umhlaza wokuqala we-peritoneal, umngcipheko ubandakanya:

• Ubudala. Njengoko ukhula, umngcipheko wakho uyanda.
• Imfuza. Imbali yosapho ye-ovarian okanye i-peritoneal cancer inyusa umngcipheko. Ukuthwala i-BRCA1 okanye i-BRCA2 yokutshintsha kwemfuza okanye enye yemfuza yeLynch syndrome nayo inyusa umngcipheko.
• Unyango lweHormone. Ukuthatha unyango lwehomoni emva kokuyeka ukuya exesheni kwandisa umngcipheko.
• Ubunzima nokuphakama. Ukutyeba kakhulu okanye ukutyeba kakhulu kwandisa umngcipheko. Abo bade basemngciphekweni omkhulu.
• Endometriosis. I-Endometriosis inyusa umngcipheko.

Izinto ezinxulumene inciphile Umngcipheko we-peritoneal okanye i-ovarian cancer ibandakanya:

• ukuthatha iipilisi zokulawula inzala
• ukuzala abantwana
• ukuncancisa
• i-tubal ligation, ukususwa kwetyhubhu, okanye ukususwa kwe-ovary

Qaphela ukuba ukususwa kwe-ovary kunciphisa umngcipheko womhlaza we-peritoneal kodwa ungawususi ngokupheleleyo.

Ufumanisa njani umhlaza we-peritoneal

Ukuchongwa komhlaza wamabanga aphantsi kunye nasesekondari kunzima kumanqanaba okuqala. Kungenxa yokuba iimpawu azicacanga kwaye ngokulula zinokubangelwa zezinye izizathu.

Rhoqo umhlaza we-peritoneal ufunyanwa kuphela ngexesha lotyando lokususa ithumba elaziwayo kwenye indawo esiswini.

Ugqirha wakho uya kukuvavanya ngokwasemzimbeni, athathe imbali yezonyango, kwaye akubuze malunga neempawu zakho. Banoku-odola uthotho lweemvavanyo ukumisela isifo.

Uvavanyo olusetyenziselwa ukufumanisa umhlaza we-peritoneal lubandakanya:

• Ukujonga iimvavanyo isisu kunye nesinqe. Oku kunokubonisa ukunyuka okanye ukukhula. Uvavanyo lubandakanya i-CT scan, i-ultrasound, kunye neMRI. Nangona kunjalo, umhlaza we-peritoneal usebenzisa i-CT kunye neMRI scan.
• Uqhaqho yendawo ebonakala ingaqhelekanga kwiskena, kubandakanya ukususwa kolwelo kwii-ascites, ukukhangela iiseli ezinomhlaza. Xoxa ngokulungileyo kunye nokubi koku kunye nogqirha wakho. Inkqubo ikwabeka emngciphekweni wokuhlwayela imbewu eludongeni lwesisu kunye neeseli ezinomhlaza.
• Uvavanyo lwegazi ukujonga iikhemikhali ezinokuphakanyiswa kumhlaza we-peritoneal, njenge-CA 125, ikhemikhali eyenziwe ziiseli zethumba. Isiphawuli segazi esitsha ngu-HE4. Kuncinci kune-CA 125 ukuba inyuswe ngenxa yeemeko ezingenamhlaza.
• I-Laparoscopy okanye i-laparotomy. Ezi ziindlela ezincinci zokungenelela zokujonga ngokuthe ngqo kwi-peritoneum. Zithathwa ngokuba "ngumgangatho wegolide" ekuchongeni.

Uphando ngeendlela ezingcono kunye nezangaphambili zokuchongwa komhlaza we-peritoneal ziyaqhubeka.

Kucetyiswe ukuba kuphuhliswe "ulwelo oluyi-biopsy." Oku kubhekisa kuvavanyo lwegazi olunokujonga indibaniselwano yamathumba. Oku kuya kwenza ukuba unyango lwangaphambili lwabanye abantu.

Uwuxelela njani umahluko phakathi komhlaza we-peritoneal kunye nomhlaza we-ovari kwisifo

Umhlaza wePeritoneal ufana kakhulu nomhlaza opithelial ovarian cancer. Zombini zibandakanya uhlobo olunye lweeseli. Kwenziwe iikhrayitheriya zokwahlula phakathi kwazo.

Kuthathelwa ingqalelo ukuba ngumhlaza wokuqala wesifo somhlaza ukuba:

• amaqanda avela ngesiqhelo
• iiseli ezinomhlaza azikho kumphezulu we-ovary
• Uhlobo lwethumba ubukhulu becala lune-serous (ukuvelisa ulwelo)

uxele ukuba umyinge weminyaka yabantu abanomdlavuza wokuqala we-peritoneal wawumdala kunabo banesifo somhlaza we-ovarian epithelial.

Ukunyanga umhlaza we-peritoneal

Unokuba neqela lonyango kubandakanya:

• ugqirha wotyando
• ugqirha wezomhlaza
• ugqirha wemitha
• ugqirha wezifo
• ugqirha wamazinyo
• ingcali yentlungu
• abongikazi abakhethekileyo
• iingcali zononophelo

Unyango lomhlaza wokuqala we-peritoneal luyafana nolo lomhlaza we-ovari. Kumhlaza wesibini wamabanga aphantsi kunye nasesekondari, unyango lomntu ngamnye luya kuxhomekeka kwindawo kunye nobungakanani besisu kunye nempilo yakho ngokubanzi.

Unyango lomhlaza wesibini we-peritoneal luxhomekeke kwimeko yomhlaza oyintloko kunye nempendulo yakho kunyango lwayo.

Ugqirha

Utyando kuhlala linyathelo lokuqala. Ugqirha uya kuwususa umhlaza kangangoko. Banokususa:

• isibeleko sakho (isibeleko)
• Amaqanda akho kunye neetyhubhu (oophorectomy)
• umaleko weethishu ezinamanqatha kufutshane namaqanda (i-omentum)

Ugqirha wakho uya kususa naziphi na izicubu ezingaqhelekanga kwindawo yesisu ukuze kuvavanywe ngakumbi.

Ukuqhubela phambili ngokuchaneka kweendlela zotyando, ezaziwa ngokuba yi-cytoreductive surge (CRS), kuye kwenza abagqirha basusa ngakumbi izicwili ezinomhlaza. Oku kuyiphucule imbonakalo yabantu abanesifo somhlaza.

Unyango ngamayeza

Ugqirha wakho unokusebenzisa ichemotherapy ngaphambi kotyando ukunciphisa ithumba xa ulungiselela utyando. Banokuyisebenzisa emva kotyando ukubulala naziphi na iiseli ezinomhlaza ezisele.

Indlela entsha yokuhambisa i-chemotherapy emva kotyando inyuse ukusebenza kwayo kwiimeko ezininzi.

Obu buchule busebenzisa ubushushu obudityaniswe nechemotherapy ehanjiswa ngqo kwindawo yomhlaza wesifo somhlaza. Yaziwa ngokuba yi-hyperthermic intraperitoneal chemotherapy (HIPEC). Olu lonyango lwexesha elinye olunikezwe ngokuthe ngqo emva kotyando.

Indibaniselwano yeCRS kunye neHIPEC "iguqule" unyango lomhlaza wamalungu, ngokutsho kwabaphandi abaninzi. Kodwa ayamkelwa ngokupheleleyo njengonyango oluqhelekileyo okwangoku. Kungenxa yokuba azikho izilingo zesigulana ezingahleliwe ngamaqela olawulo.

Uphando luyaqhubeka. I-HIPEC ayikhuthazwa xa kukho i-metastases ngaphandle kwesisu nakwezinye iimeko.

Yonke ichemotherapy ineziphumo ebezingalindelekanga. Xoxa malunga nokuba zeziphi kwaye ungaziphatha njani neqela lakho lonyango.

Unyango ekujoliswe kulo

Ngamanye amaxesha, ichiza ekujoliswe kulo linokusetyenziswa. La machiza ajolise ekupheliseni iiseli zomhlaza ngaphandle kokonzakalisa iiseli eziqhelekileyo. Unyango ekujoliswe kulo lubandakanya oku kulandelayo:

• Amachiza omzimba monoclonal Izinto ekujoliswe kuzo kwiiseli ezikhuthaza ukukhula komhlaza weseli. Ezi zinokudityaniswa nesiyobisi se-chemotherapy.
• I-PARP (poly-ADP ribose polymerase) inhibitors vimba ukulungiswa kweDNA.
• Ii-angiogenesis inhibitors thintela ukukhula kwenqanawa yegazi kumathumba.

Unyango lweHormonal, unyango ngemitha, kunye ne-immunotherapy zinokusetyenziswa kwezinye iimeko zomhlaza wokuqala we-peritoneal.

Yintoni imbonakalo?

Imbonakalo yabantu abanomhlaza wokuqala okanye wesibini wesifo somhlaza ophuculweyo uphuculwe kakhulu kumashumi eminyaka akutshanje ngenxa yenkqubela phambili kunyango, kodwa isengalunganga. Oku ikakhulu kungenxa yokuba umhlaza we-peritoneal uhlala ungafunyaniswa ude ube kwinqanaba eliphambili. Kwakhona, umhlaza ungabuya emva konyango.

Iimpawu kunzima ukuzichaza, kodwa ukuba uneempawu eziqhelekileyo eziqhubekayo, jonga ugqirha wakho. Ukuxilongwa kwangoko kukhokelela kwisiphumo esingcono.

Amaxabiso okusinda

Umhlaza wesifo seprayimari

Ukusukela ngo-2019, izinga lokusinda leminyaka emihlanu labasetyhini ngazo zonke iintlobo ze-ovari, ityhubhu yesifo, kunye nomhlaza we-peritoneal ziipesenti ezingama-47. Eli nani liphezulu kubafazi abangaphantsi kwama-65 (iipesenti ezingama-60) kwaye lingaphantsi kwabasetyhini ngaphezulu kwama-65 (ama-29 epesenti).

Amanani okusinda kumhlaza wokuqala we-peritoneal avela kwizifundo ezincinci kakhulu.

Umzekelo, kwabafazi abangama-29 abanesifo somhlaza wokuqala wamayeza abonisa ixesha lokuphila elingangeenyanga ezingama-48 emva konyango.

Oku kubhetele kakhulu kunesilinganiso seminyaka emihlanu sokusinda esichazwe kuphononongo luka-1990 olwahluka phakathi.

Umhlaza wesibini we-peritoneal

Amanqanaba okusinda kumhlaza wesibini wesifo somhlaza axhomekeke kwinqanaba lesiza sokuqala somhlaza kunye nohlobo lonyango. Inani elincinci lezifundo libonisa ukuba unyango oludibeneyo lweCRS kunye neHIPEC luphucula amazinga okusinda.

Ngokomzekelo, uphando oluchazwe ngo-2013 lujonge abantu abangama-84 abanomdlavuza ogqithisileyo osasazeke kwi-peritoneum. Ithelekise abo bane-chemotherapy yenkqubo kunye ne-CRS kunye ne-HIPEC.

Ukusinda kwiqela le-chemotherapy yayiziinyanga ezingama-23.9 xa kuthelekiswa neenyanga ezingama-62.7 kwiqela elanyangwa ngeCRS kunye neHIPEC.

Funa inkxaso

Unokufuna ukuthetha nabanye abantu abaya kunyango okanye namalungu osapho lwabo.

Umgca wenkxaso yeAmerican Cancer Society uyafumaneka nge-24/7 ngosuku nge-800-227-2345. Banokukunceda ufumane i-intanethi okanye iqela lendawo lenkxaso.

Iqela lakho lonyango linakho ukunceda ngezixhobo.