Inqanaba 4 I-Renal Cell Carcinoma: I-Metastasis, amaRhafu okusinda, kunye nonyango

Umxholo

• Yintoni i-renal cell carcinoma?
• Isasazeka njani?
• Ukulinganisa kwe-TNM kunye namanqanaba omhlaza wezintso
• Yintoni imbonakalo?
• Zithini iindlela zokhetho zonyango?
• Ukuthatha

Yintoni i-renal cell carcinoma?

I-renal cell carcinoma (RCC), ekwabizwa ngokuba ngumhlaza weseli okanye i-renal cell adenocarcinoma, luhlobo oluqhelekileyo lomhlaza wezintso. I-akhawunti ye-Renal cell carcinomas malunga neepesenti ezingama-90 zazo zonke iintsholongwane zomhlaza.

I-RCC ihlala iqala njengethumba elikhula kwenye yezintso zakho. Inokuphinda ikhule kuzo zombini izintso.Esi sifo sixhaphake kakhulu emadodeni kunabafazi.

Isasazeka njani?

Ukuba kufunyenwe ithumba elinomhlaza kwesinye sezintso zakho, unyango oluqhelekileyo kukususa ngotyando okanye zonke izintso ezichaphazelekayo.

Ukuba ithumba alisuswanga, kunokwenzeka ukuba umhlaza usasazeke kwii-lymph node zakho okanye kwamanye amalungu. Ukusasazeka komhlaza kuthiwa yi-metastasis.

Kwimeko ye-RCC, ithumba linokuhlasela umthambo omkhulu ophuma kwizintso. Inokusasazeka kwinkqubo ye-lymph kunye namanye amalungu. Imiphunga iba sesichengeni ngokukhethekileyo.

Ukulinganisa kwe-TNM kunye namanqanaba omhlaza wezintso

Umhlaza wezintso uchazwe ngokwamanqanaba aphuculwe yiKomiti eDibeneyo yaseMelika yoMhlaza. Inkqubo yaziwa ngcono njengenkqubo ye-TNM.

• "T" ibhekisa kwi-tumor. Oogqirha babela u "T" ngenani elisekwe kubungakanani kunye nokukhula kwethumba.
• "N" ichaza ukuba ngaba umhlaza unwenwele nakweyiphi na indawo kwinkqubo ye-lymph.
• "M" kuthetha ukuba umhlaza uphelisile.

Ngokusekwe kwiimpawu ezingentla, oogqirha babela i-RCC inqanaba. Inqanaba lisekwe kubungakanani besisu kunye nokusasazeka komhlaza.

Kukho amanqanaba amane:

• Amanqanaba 1 no-2 Chaza umhlaza apho ithumba lisekho kwizintso. Inqanaba 2 lithetha ukuba ithumba likhulu kuneesentimitha ezisixhenxe ngokunqamlezayo.
• Amanqanaba 3 no-4 Kuthetha ukuba umhlaza usasazeke waya kwimithambo enkulu okanye kwizicubu ezikufuphi okanye kwii-lymph node.
• Inqanaba 4 lolona hlobo luphambili kwesi sifo. Inqanaba lesi-4 lithetha ukuba umhlaza usasazeke kwi-adrenal gland okanye usasazeke kwii-lymph node ezikude okanye kwamanye amalungu. Ngenxa yokuba i-adrenal gland iqhotyoshelwe kwizintso, umhlaza uhlala usasazeka khona kuqala.

Yintoni imbonakalo?

Iminyaka emihlanu yokusinda komhlaza wezintso isekwe kwipesenti yabantu abaphila ubuncinci iminyaka emi-5 nesi sifo emva kokuba sifunyenwe.

Umbutho weAmerican Cancer Society (ACS) uxela ipesenti yabantu abaphila iminyaka emi-5 okanye nangaphezulu emva kokuxilongwa ngokwamanqanaba amathathu ngokusekwe kwidatha evela kwiNational Cancer Institute.

La manqanaba ngala:

• Indawo (umhlaza awusasazekanga ngaphaya kwezintso)
• yengingqi (umhlaza usasazekile kufutshane)
• kude (umhlaza usasazeke kwiindawo ezikude zomzimba)

Ngokwe-ACS, amazinga okusinda eRCC asekwe kula manqanaba mathathu ngala:

• ibalulwe: Iipesenti ezingama-93
• yengingqi: Iipesenti ezingama-70
• kude: Iipesenti ezili-12

Zithini iindlela zokhetho zonyango?

Uhlobo lonyango olufumanayo luxhomekeke kwinqanaba lomhlaza wakho. Inqanaba 1 i-RCC inokunyangwa ngoqhaqho.

Nangona kunjalo, ngelixa umhlaza sele uqhubekile waya kwinqanaba 4, utyando alunakuba lolukhetho.

Ukuba ithumba kunye ne-metastasis zinokubekwa bucala, ukususwa ngotyando kunye / okanye unyango lwesifo se-metastatic ngokususwa okanye ezinye iinkqubo ezinje nge-stereotactic radiation radiation okanye i-thermal ablation isenokwenzeka.

Ukuba unenqanaba le-4 RCC, ugqirha wakho uya kuqaphela indawo kunye nokusasazeka komhlaza wakho kunye nempilo yakho iphela ukumisela ukufaneleka kwakho kotyando.

Ukuba utyando ayisiyondlela yokwenyani yokunyanga inqanaba le-4 RCC, ugqirha wakho unokucebisa unyango lwenkqubo usebenzisa indibaniselwano yamachiza.

Isampuli yesisu sakho, esibizwa ngokuba yi-biopsy, sinokufunyanwa ukunceda ukumisela olona nyango lulungileyo kuhlobo lwakho lomhlaza. Unyango luxhomekeke ekubeni uneseli ecacileyo okanye i-RCC engacacanga.

Unyango ekujoliswe kulo kunye ne-immunotherapy, kubandakanya i-tyrosine kinase inhibitors kunye ne-anti-PD-1 antibodies monoclonal, inokusetyenziselwa ukunyanga inqanaba le-4 RCC. Iyeza elithile linokunikwa lodwa okanye lidityaniswe nelinye ichiza.

Unyango lunokubandakanya:

• axitinib + pembrolizumab
• pazopanib
• sunitinib
• ipilimumab + nivolumab
• cabozantinib

Unyango olutsha lunokufumaneka kuvavanyo lweklinikhi. Ungaxoxa ngenketho yokubhalisa kugqirha wakho.

Ugqirha wakho unokucebisa unyango oluxhasayo ukunceda naziphi na iziphumo ebezingalindelekanga okanye iimpawu.

Ukuthatha

Ukuba ufunyaniswe unesigaba se-4 RCC, khumbula ukuba amazinga okusinda apapashiweyo aqikelelwa.

Ukuxelwa kwangaphambili kwakho kuxhomekeke kuhlobo oluthile lomhlaza kunye nokuba sele uqhubele phambili kangakanani, ukuphendula kunyango, kunye nempilo yakho iyonke.

Isitshixo kuku:

• landela iingcebiso zikagqirha wakho
• yiya kwiindawo zakho zokubonana
• thatha amayeza akho

Kwakhona, qiniseka ukuba ulandele naziphi na iingcebiso zonyango okanye utshintsho kwindlela yokuphila ukulungisa naziphi na iziphumo kunye neempawu. Oku kunokukunceda ukuxhasa impilo yakho yonke kunye nokuphila kakuhle ngelixa uhamba unyango.