Khansara yamchiberekero

Khansara yamchiberekero ndi khansa yomwe imayamba m'mimba mwake. Thumba losunga mazira ndi ziwalo zoberekera zazimayi zomwe zimatulutsa mazira.

Khansara yamchiberekero ndi khansa yachisanu pakati pa amayi. Imapha anthu ambiri kuposa khansa ina iliyonse yazimayi yoberekera.

Zomwe zimayambitsa khansa ya m'mimba sizidziwika.

Kuopsa kokhala ndi khansa yamchiberekero ndi izi:

• Kuchuluka kwa ana omwe mayi amakhala nawo komanso pambuyo pake pakubereka, kumawonjezera chiopsezo chake cha khansa ya m'mimba.
• Amayi omwe adakhalapo ndi khansa ya m'mawere kapena omwe ali ndi mbiri ya khansa ya m'mawere kapena yamchiberekero ali ndi chiopsezo chowonjezeka cha khansa ya m'mimba (chifukwa cha zolakwika zamtunduwu monga BRCA1 kapena BRCA2).
• Amayi omwe amatenga m'malo mwa estrogen okha (osati ndi progesterone) kwa zaka 5 kapena kupitilira apo akhoza kukhala ndi chiopsezo chachikulu cha khansa ya m'mimba. Mapiritsi oletsa kubereka, amachepetsa chiopsezo cha khansa ya m'mimba.
• Mankhwala obereketsa mwina sawonjezera chiopsezo cha khansa yamchiberekero.
• Azimayi achikulire ali pachiwopsezo chachikulu chotenga khansa yamchiberekero. Ambiri omwe amafa ndi khansa yamchiberekero amapezeka azimayi azaka 55 kapena kupitilira apo.

Zizindikiro za khansa ya m'mimba nthawi zambiri zimakhala zosamveka bwino. Amayi ndi madotolo awo nthawi zambiri amaimba mlandu zizindikirizi pazinthu zina, zomwe zimafala. Pofika nthawi yomwe khansa imapezeka, chotupacho chimakhala chikufalikira kupitirira thumba losunga mazira.

Onani dokotala wanu ngati muli ndi zizindikiro zotsatirazi tsiku lililonse kwa milungu ingapo:

• Kutupa kapena kutupa m'mimba
• Kulephera kudya kapena kumva kukhuta msanga (kukhuta msanga)
• Pelvic kapena kupweteka m'mimba (dera limatha kumva "lolemera")
• Ululu wammbuyo
• Kutupa ma lymph node mu kubuula

Zizindikiro zina zomwe zingachitike:

• Kukula kwakukulu kwa tsitsi komwe kumakhala kopindika komanso kwamdima
• Kufuna mwadzidzidzi kukodza
• Kufunika kukodza pafupipafupi kuposa nthawi zonse (kuchuluka kwamikodzo kapena kufulumira)
• Kudzimbidwa

Kuyesedwa kwakuthupi nthawi zambiri kumakhala koyenera. Ndi khansa yayikulu yamchiberekero, adokotala amatha kupeza mimba yotupa nthawi zambiri chifukwa chodzaza madzimadzi (ascites).

Kuyezetsa magazi m'chiuno kumatha kuwonetsa dzira lamimba kapena m'mimba.

Kuyezetsa magazi kwa CA-125 sikuwoneka ngati kuyesa kwabwino kwa khansa ya m'mimba. Koma, zitha kuchitika ngati mayi ali ndi:

• Zizindikiro za khansa yamchiberekero
• Anapezeka kuti ali ndi khansara ya ovari kuti adziwe momwe mankhwala akugwirira ntchito

Mayesero ena omwe angachitike ndi awa:

• Kuwerengera kwathunthu kwa magazi ndi magazi
• Mayeso apakati (seramu HCG)
• CT kapena MRI ya m'chiuno kapena pamimba
• Ultrasound m'chiuno

Kuchita opaleshoni, monga laparoscopy kapena laparotomy yowunikira, kumachitika nthawi zambiri kuti mupeze chomwe chimayambitsa zizindikilo. A biopsy adzachitika kuti athandizire kupeza matendawa.

Palibe mayeso a labu kapena zojambula zomwe zawonetsedwa kuti zitha kuwunika bwino khansa yamchiberekero idangoyamba kumene, kotero palibe mayeso oyeserera omwe akulimbikitsidwa pano.

Opaleshoni imagwiritsidwa ntchito pochiza magawo onse a khansa yamchiberekero. Kumayambiriro koyambirira, opaleshoni ndiyo njira yokhayo yofunikira yothandizira. Kuchita opaleshoni kumatha kuphatikizira kuchotsa thumba losunga mazira ndi mazira, chiberekero, kapena zina m'mimba kapena m'chiuno. Zolinga za opareshoni ya khansa yamchiberekero ndi:

• Zitsanzo za malo omwe amapezeka kuti awone ngati khansa yafalikira (staging)
• Chotsani madera aliwonse otupa (debulking)

Chemotherapy imagwiritsidwa ntchito pambuyo pochita opaleshoni kuti ithetse khansa iliyonse yomwe yatsala. Chemotherapy itha kugwiritsidwanso ntchito ngati khansara ibwerera (kubwerera). Chemotherapy nthawi zambiri amapatsidwa kudzera m'mitsempha (kudzera mu IV). Ikhozanso kulowetsedwa m'kati mwa m'mimba (intraperitoneal, kapena IP).

Mankhwala a radiation sagwiritsidwa ntchito kangapo pochiza khansa yamchiberekero.

Pambuyo pa opaleshoni ndi chemotherapy, tsatirani malangizo a momwe muyenera kuwonera dokotala ndi mayeso omwe muyenera kukhala nawo.

Mutha kuchepetsa nkhawa zamankhwala ndikulowa nawo gulu lothandizira khansa. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha.

Khansara yamchiberekero imapezeka kawirikawiri kumayambiriro. Nthawi zambiri zimakhala zotsogola kwambiri nthawi yomwe matenda amapezeka:

• Pafupifupi theka la azimayi amakhala ndi zaka zoposa 5 atazindikira
• Ngati matenda apangidwa koyambirira kwa matendawa ndipo mankhwala amalandiridwa khansa isanatuluke kunja kwa ovary, zaka 5 zapulumuka ndizokwera

Lumikizanani ndi omwe amakuthandizani ngati ndinu mzimayi wazaka 40 kapena kupitilira apo yemwe sanayesedweko m'chiuno. Mayeso am'chiuno nthawi zonse amalimbikitsidwa kwa azimayi onse azaka 20 kapena kupitilira apo.

Funsani nthawi yokumana ndi omwe amakupatsani ngati muli ndi matenda a khansa ya m'mimba.

Palibe malingaliro oyenera owunikira azimayi opanda zizindikilo (asymptomatic) za khansa yamchiberekero. Pelvic ultrasound kapena kuyezetsa magazi, monga CA-125, sikunapezeke kothandiza ndipo sikuvomerezeka.

Kuyesedwa kwa majini kwa BRCA1 kapena BRCA2, kapena majini ena okhudzana ndi khansa, atha kulimbikitsidwa kwa azimayi omwe ali pachiwopsezo chachikulu cha khansa ya m'mimba. Awa ndi azimayi omwe ali ndi mbiri ya banja kapena ya khansa ya m'mawere kapena yamchiberekero.

Kuchotsa thumba losunga mazira ndi mazira ndipo mwina chiberekero mwa amayi omwe asintha mtundu wa BRCA1 kapena BRCA2 kumachepetsa chiopsezo chokhala ndi khansa yamchiberekero. Koma, khansara yamchiberekero imatha kupitilirabe m'malo ena am'mimba.

Khansa - thumba losunga mazira

• Kutulutsa m'mimba - kutulutsa
• Chemotherapy - zomwe mungafunse dokotala wanu
• Kutulutsa kwapakati - kutulutsa

• Matupi achikazi oberekera
• Ascites ndi khansa yamchiberekero - CT scan
• Khansa ya Peritoneal ndi yamchiberekero, CT scan
• Matenda a khansa yamchiberekero
• Kukula kwamchiberekero kumabweretsa nkhawa
• Chiberekero
• Khansara yamchiberekero
• Matenda a khansa yamchiberekero

Coleman RL, Liu J, Matsuo K, Thaker PH, Westin SN, Sood AK. Carcinoma ya thumba losunga mazira ndi mazira. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 86.

Coleman RL, Ramirez PT, Gershenson DM. Matenda otupa m'mimba ovuta: kuyezetsa magazi, zotupa zamatenda oyipa komanso zotupa zamatenda am'mimba, zotupa zogonana. Mu: Lobo RA, Gershenson DM, Lentz GM, Valea FA, olemba. Gynecology Yambiri. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 33.

Tsamba la National Cancer Institute. Kusintha kwa BRCA: chiopsezo cha khansa komanso kuyesa majini. www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet. Idasinthidwa Novembala 19, 2020. Idapezeka pa Januware 31, 2021.