Kodi Zizindikiro Zoyambilira Za Khansa Yamchiberekero Ndi Zotani Zomwe Mumazizindikira?

Zamkati

• Kodi khansa ya m'mimba ndi chiyani?
• Kodi zizindikiro zoyambirira za khansa yamchiberekero ndi ziti?
• Mitundu ya khansa yamchiberekero
• Ziphuphu zamchiberekero
• Zowopsa za khansa yamchiberekero
• Kodi khansa ya m'mimba imapezeka bwanji?
• Kodi magawo a khansa yamchiberekero ndi ati?
• Gawo 1
• Gawo 2
• Gawo 3
• Gawo 4
• Momwe khansa yamchiberekero imathandizidwira
• Opaleshoni
• Chithandizo chofuna
• Kusunga chonde
• Kafukufuku wa khansa ya ovarian ndi maphunziro
• Kodi khansa yamchiberekero ingapewe?
• Kodi malingaliro ake ndi otani?
• Chiwerengero cha opulumuka
• Zaka zisanu zapakati pa khansa yamchiberekero

Thumba losunga mazira ndi tiziwalo timene timabereka tomwe timatulutsa mazira. Amapanganso mahomoni achikazi a estrogen ndi progesterone.

Pafupifupi azimayi 21,750 ku United States alandila matenda a khansa yamchiberekero mu 2020, ndipo azimayi pafupifupi 14,000 adzafa nawo.

Munkhaniyi mupeza zambiri zokhudzana ndi khansa yamchiberekero kuphatikiza:

• zizindikiro
• mitundu
• zoopsa
• matenda
• magawo
• chithandizo
• kufufuza
• mitengo yopulumuka

Kodi khansa ya m'mimba ndi chiyani?

Khansara yamchiberekero ndi pamene maselo osadziwika m'chiberekero amayamba kuchulukana ndikupanga chotupa. Chotupacho chikapanda kuchiritsidwa, chitha kufalikira mbali zina za thupi. Izi zimatchedwa khansa ya m'mimba yamchiberekero.

Khansara yamchiberekero nthawi zambiri imakhala ndi zizindikiro zochenjeza, koma zizindikiro zoyambirira zimakhala zosamveka komanso zosavuta kuzitsutsa. Makumi awiri pa zana a khansa yamchiberekero amapezeka msanga.

Kodi zizindikiro zoyambirira za khansa yamchiberekero ndi ziti?

Ndikosavuta kunyalanyaza zisonyezo zoyambirira za khansa yamchiberekero chifukwa ndizofanana ndi matenda ena wamba kapena amakonda kubwera ndikupita. Zizindikiro zoyambirira zimaphatikizapo:

• Kutupa m'mimba, kupanikizika, ndi kupweteka
• kukhuta mokwanira atadya
• kuvuta kudya
• kuwonjezeka pokodza
• chilakolako chowonjezeka chokodza

Khansara yamchiberekero ingayambitsenso zizindikiro zina, monga:

• kutopa
• kudzimbidwa
• kutentha pa chifuwa
• kudzimbidwa
• kupweteka kwa msana
• kusasamba kwa msambo
• kugonana kowawa
• dermatomyositis (matenda osowa kwambiri omwe angayambitse khungu, kufooka kwa minofu, ndi minofu yotupa)

Zizindikirozi zimatha kuchitika pazifukwa zingapo. Sizi chifukwa cha khansa ya m'mimba. Amayi ambiri amakhala ndi ena mwa mavutowa nthawi ina.

Zizindikiro zamtunduwu nthawi zambiri zimakhala zosakhalitsa ndipo zimayankha mankhwala osavuta nthawi zambiri.

Zizindikiro zimapitilira ngati zikuchitika chifukwa cha khansa ya m'mimba. Zizindikiro nthawi zambiri zimakula kwambiri ngati chotupacho chimakula. Pakadali pano, khansara imakonda kufalikira kunja kwa thumba losunga mazira, zomwe zimapangitsa kuti zikhale zovuta kwambiri kuchiza bwino.

Apanso, khansa imathandizidwa bwino mukazindikira msanga. Chonde funsani dokotala wanu ngati mukukumana ndi zachilendo komanso zachilendo.

Mitundu ya khansa yamchiberekero

Thumba losunga mazira limapangidwa ndi mitundu itatu yamaselo. Selo lirilonse limatha kukhala chotupa china:

• Zilonda zaminyewa mawonekedwe osanjikiza a minofu kunja kwa thumba losunga mazira. Pafupifupi 90 peresenti ya khansa yamchiberekero ndi zotupa zaminyewa.
• Zotupa zam'mimba amakula m'maselo opanga ma hormone. Asanu ndi awiri mwa khansa yamchiberekero ndi zotupa.
• Zilonda zam'magazi amakula m'maselo opanga dzira. Zilonda zamtundu wa majeremusi ndizochepa.

Ziphuphu zamchiberekero

Ma cysts ambiri samakhala ndi khansa. Izi zimatchedwa chotupa chosaopsa. Komabe, ochepa kwambiri amatha kukhala ndi khansa.

Chotupa chamchiberekero ndimadzi am'madzi kapena mpweya womwe umatuluka mkati kapena mozungulira ovary. Ma cyst ambiri amakhala ovary, pomwe ovary imatulutsa dzira. Nthawi zambiri zimangoyambitsa kuziziritsa pang'ono, monga kuphulika, ndi kupita popanda chithandizo.

Ziphuphu zimakhudzidwa kwambiri ngati simukuwotcha. Azimayi amasiya kutulutsa mazira pambuyo pa kusamba. Ngati chotupa cha ovarian chimatha mutatha kusamba, dokotala wanu angafune kuyesa zambiri kuti adziwe chomwe chimayambitsa chotupacho, makamaka ngati ndi chachikulu kapena sichitha miyezi ingapo.

Ngati chotupacho sichikutha, dokotala wanu angakulimbikitseni kuchitidwa opaleshoni kuti muchotseko ngati zingachitike. Dokotala wanu sangathe kudziwa ngati ali ndi khansa mpaka atachotsa opaleshoni.

Zowopsa za khansa yamchiberekero

Zomwe zimayambitsa khansa ya m'mimba sizidziwika. Komabe, izi zingakulitse chiopsezo chanu:

• mbiri ya banja la khansa yamchiberekero
• masinthidwe amtundu wa majini okhudzana ndi khansa ya m'mimba, monga Zamgululi1 kapena Zamgululi
• mbiri yaumwini ya khansa ya m'mawere, ya chiberekero, kapena ya m'matumbo
• kunenepa kwambiri
• kugwiritsa ntchito mankhwala ena obereketsa kapena mankhwala ochiritsira mahomoni
• palibe mbiri ya mimba
• endometriosis

Ukalamba ndi chinthu chinanso choopsa. Matenda ambiri a khansa yamchiberekero amakula atatha kusamba.

Ndizotheka kukhala ndi khansa yamchiberekero popanda kukhala ndi zoopsa izi. Momwemonso, kukhala ndi chilichonse mwaziwopsezo sizitanthauza kuti mudzakhala ndi khansa ya m'mimba.

Kodi khansa ya m'mimba imapezeka bwanji?

Ndikosavuta kuchiza khansa yamchiberekero dokotala atazindikira kuti akuyamba kumene. Komabe, sikophweka kuzindikira.

Mazira anu amakhala mkatikati mwa m'mimba, motero simungathe kumva chotupa. Palibe zochitika zowunika za khansa yamchiberekero. Ndicho chifukwa chake kuli kofunika kwambiri kwa inu kuti mufotokozere dokotala wanu zizindikiro zosazolowereka kapena zosalekeza.

Ngati dokotala akuda nkhawa kuti muli ndi khansa ya m'mimba, mwina angakupatseni mayeso m'chiuno. Kuyesa m'chiuno kumatha kuthandiza dokotala kuti azindikire zosagwirizana, koma zotupa zazing'ono zam'mimba ndizovuta kumva.

Chotupacho chikamakula, chimakanikizira chikhodzodzo ndi rectum. Dokotala wanu amatha kuzindikira zosayenerera pakuwunika kwamitsempha yam'mbali.

Dokotala wanu amathanso kuyesa izi:

• Transvaginal ultrasound (TVUS). TVUS ndi mtundu wamayeso ojambula omwe amagwiritsa ntchito mafunde akumva kuti azindikire zotupa m'ziwalo zoberekera, kuphatikiza thumba losunga mazira. Komabe, TVUS sichingathandize dokotala kudziwa ngati zotupa zili ndi khansa.
• Mimba ndi m'mimba mwa CT scan. Ngati matupi anu sagwirizana ndi utoto, amatha kuyitanitsa sikelo ya MRI ya m'chiuno.
• Kuyezetsa magazi kuyeza milingo ya khansa ya antigen 125 (CA-125). Kuyezetsa kwa CA-125 ndi chida chomwe chimagwiritsidwa ntchito poyesa momwe angayankhire khansa ya m'mimba ndi khansa zina za ziwalo zoberekera. Komabe, kusamba, uterine fibroids, ndi khansa ya chiberekero imathanso kukhudza milingo ya CA-125 m'magazi.
• Chisokonezo. Biopsy imaphatikizapo kuchotsa pang'ono tinthu tating'onoting'ono kuchokera m'chiberekero ndikuwunika mtunduwo pogwiritsa ntchito microscope.

Ndikofunika kuzindikira kuti, ngakhale mayesero onsewa atha kuthandiza kutsogolera dokotala kuti adziwe, biopsy ndiyo njira yokhayo yomwe dokotala angatsimikizire ngati muli ndi khansa ya m'mimba.

Kodi magawo a khansa yamchiberekero ndi ati?

Dokotala wanu amatsimikizira sitejiyo malingana ndi momwe khansara yafalikira. Pali magawo anayi, ndipo gawo lililonse limakhala ndi magawo:

Gawo 1

Gawo 1 khansa yamchiberekero ili ndi magawo atatu:

• Gawo 1A.Khansara ndi yocheperako, kapena yakomweko, ku ovary imodzi.
• Gawo 1B. Khansara ili m'mimba mwake.
• Gawo 1C. Palinso maselo a khansa kunja kwa ovary.

Gawo 2

Gawo lachiwiri, chotupacho chafalikira kuzinthu zina zam'mimba. Ili ndi magawo awiri:

• Gawo 2A. Khansara yafalikira m'chiberekero kapena m'mimba yamatumba.
• Gawo 2B. Khansara yafalikira ku chikhodzodzo kapena rectum.

Gawo 3

Gawo 3 khansa yamchiberekero ili ndi magawo atatu:

• Gawo 3A. Khansara yafalikira mopyola muyeso kupitirira mafupa a chiuno mpaka pamimba pamimba ndi ma lymph node m'mimba.
• Gawo 3B. Maselo a khansa afalikira kupitirira mafupa a chiuno mpaka pamimba pamimba ndipo amawoneka ndi maso koma osakwana 2 cm.
• Gawo 3C. Malo osungira khansa osachepera 3/4 inchi amawoneka pamimba kapena kunja kwa ndulu kapena chiwindi. Komabe, khansara siili mkati mwa ndulu kapena chiwindi.

Gawo 4

Pa gawo 4, chotupacho chasintha, kapena kufalikira, kupitirira mafupa, pamimba, ndi ma lymph node kupita pachiwindi kapena m'mapapu. Pali magawo awiri m'malo 4:

• Mu siteji 4A, maselo a khansa ali mumadzimadzi ozungulira mapapo.
• Mu siteji 4B, gawo lotsogola kwambiri, maselowa afika mkatikati mwa ndulu kapena chiwindi kapena ziwalo zina zakutali monga khungu kapena ubongo.

Momwe khansa yamchiberekero imathandizidwira

Mankhwalawa amadalira kutalika kwa khansara. Gulu la madokotala lidzasankha dongosolo la chithandizo kutengera momwe zinthu ziliri. Zikhala ndi ziwiri kapena zingapo zotsatirazi:

• chemotherapy
• Kuchita opaleshoni ya khansa ndikuchotsa chotupacho
• chithandizo chothandizira
• mankhwala a mahomoni

Opaleshoni

Opaleshoni ndiyo njira yayikulu yothandizira khansa yamchiberekero.

Cholinga cha opaleshoni ndikuchotsa chotupacho, koma kuchotsa chiberekero, kapena kuchotseratu chiberekero, nthawi zambiri kumakhala kofunikira.

Dokotala wanu angakulimbikitseninso kuchotsa mazira ambiri ndi mazira, mazira apafupi, ndi minofu ina ya m'chiuno.

Kuzindikira malo onse otupa ndi kovuta.

Pakafukufuku wina, ofufuza adasanthula njira zopititsira patsogolo opaleshoni kuti zikhale zosavuta kuchotsa minofu yonse ya khansa.

Chithandizo chofuna

Njira zochiritsira, monga chemotherapy, zimaukira ma cell a khansa pomwe sizikuwononga maselo abwinobwino amthupi.

Njira zatsopano zochiritsira khansa yapachimake yotulutsa mazira ndi PARP inhibitors, omwe ndi mankhwala omwe amaletsa ma enzyme omwe amagwiritsidwa ntchito ndimaselo kuti akonzenso kuwonongeka kwa DNA yawo.

PARP inhibitor yoyamba idavomerezedwa mu 2014 kuti igwiritsidwe ntchito mu khansa yayikulu yamchiberekero yomwe idachiritsidwa kale ndi mizere itatu ya chemotherapy (kutanthauza osachepera kawiri).

Ma PARP inhibitors atatu omwe akupezeka pano ndi awa:

• Olaparib (Lynparza)
• niraparib (Zejula)
• chisokonezo (Rubraca)

Kuwonjezera kwa mankhwala ena, bevacizumab (Avastin), kwagwiritsidwanso ntchito ndi chemotherapy pambuyo pa opaleshoni.

Kusunga chonde

Mankhwala a khansa, kuphatikizapo chemotherapy, radiation, ndi opaleshoni, zitha kuwononga ziwalo zanu zoberekera, zomwe zimapangitsa kuti zikhale zovuta kutenga pakati.

Ngati mukufuna kutenga pakati mtsogolo, lankhulani ndi dokotala musanayambe kumwa. Atha kukambirana zomwe mungasankhe kuti muteteze chonde chanu.

Zosankha zoteteza kuberekazi ndi izi:

• Kuzizira kwa mazira. Izi zimaphatikizapo kuzizira dzira la umuna.
• Kuzizira kwa oocyte. Njirayi imaphatikizapo kuzizira dzira losakhwima.
• Opaleshoni kuti asunge chonde. Nthawi zina, opaleshoni yomwe imangochotsa ovary imodzi ndikusunga ovary yathanzi imatha kuchitika. Izi nthawi zambiri zimatheka kokha kumayambiriro kwa khansa yamchiberekero.
• Kuteteza minofu yamchiberekero. Izi zimaphatikizapo kuchotsa ndi kuzizira minofu yamchiberekero kuti mugwiritse ntchito mtsogolo.
• Kupondereza kwamchiberekero. Izi zimaphatikizapo kutenga mahomoni kuti achepetse ntchito yamchiberekero kwakanthawi.

Kafukufuku wa khansa ya ovarian ndi maphunziro

Mankhwala atsopano a khansa yamchiberekero amaphunziridwa chaka chilichonse.

Ochita kafukufuku akufufuzanso njira zatsopano zothandizira khansa ya ovari yosagwira platinamu. Kukana kwa platinamu kumachitika, mankhwala wamba a chemotherapy monga carboplatin ndi cisplatin sagwira ntchito.

Tsogolo la zoletsa za PARP likhala pozindikira kuti ndi mankhwala ati omwe angagwiritsidwe ntchito limodzi nawo kuchiza zotupa zomwe zimawonetsa mawonekedwe apadera.

Posachedwa, njira zina zamankhwala zodalirika zidayesa mayeso azachipatala monga katemera woteteza khansa ya khansa yam'mimba yomwe imapezekanso pamapuloteni.

Mu Meyi 2020, adasindikizidwa kuti apange mankhwala oteteza ku anti-drug conjugate (ADC) kuti athetse khansa ya ovari yosagwira platinamu.

Njira zatsopano zamankhwala zikuwerengedwa, kuphatikiza antibody navicixizumab, ATR inhibitor AZD6738, ndi Wee1 inhibitor adavosertib. Onse awonetsa zizindikiro za ntchito yoteteza zotupa.

yang'anani chibadwa cha munthu kuti achiritse kapena kuchiritsa matenda. Mu 2020, gawo lachitatu la mayeso amtundu wa VB-111 (ofranergene obadenovec) lidapitilira ndi zotsatira zabwino.

Mu 2018, a FDA adatsata mwachangu mankhwala omwe amatchedwa AVB-S6-500 a khansa ya ovari yosagwira platinamu. Izi cholinga chake ndikuletsa kukula kwa chotupa ndi kufalikira kwa khansa potseka njira yayikulu yamaselo.

Kuyesedwa kwamankhwala kopitilira muyeso kuphatikiza immunotherapy (komwe kumathandiza chitetezo chamthupi cha munthu kulimbana ndi khansa) ndimankhwala omwe avomerezedwa kale kwawonetsa kulonjeza.

Anayesedwa chithandizo chamankhwala kwa iwo omwe ali ndi magawo apamwamba a khansara.

Chithandizo cha khansa yamchiberekero chimangoyang'ana pa opaleshoni kuchotsa mazira ndi chiberekero ndi chemotherapy. Zotsatira zake, azimayi ena amakhala ndi vuto lakutha msambo.

Nkhani ya 2015 idayang'ana mankhwala a intraperitoneal (IP) chemotherapy. Kafukufukuyu anapeza kuti omwe adalandira chithandizo cha IP anali ndi moyo wapakatikati wa miyezi 61.8. Uku kunali kusintha poyerekeza ndi miyezi 51.4 kwa iwo omwe adalandira chemotherapy wamba.

Kodi khansa yamchiberekero ingapewe?

Palibe njira zotsimikizika zothetseratu chiopsezo chanu chokhala ndi khansa yamchiberekero. Komabe, pali zomwe mungachite kuti muchepetse chiopsezo chanu.

Zinthu zomwe zawonetsedwa kuti zimachepetsa chiopsezo chanu chokhala ndi khansa ya m'mimba ndi monga:

• kumwa mapiritsi oletsa kubereka
• kuyamwitsa
• mimba
• njira zochitira ziwalo zanu zoberekera (monga tubal ligation kapena hysterectomy)

Kodi malingaliro ake ndi otani?

Maganizo anu amatengera zinthu zingapo, kuphatikiza:

• siteji ya khansa ikazindikira
• thanzi lanu lonse
• momwe mumayankhira kuchipatala

Khansa iliyonse ndiyapadera, koma gawo la khansa ndiye chisonyezo chofunikira kwambiri pakuwonera.

Chiwerengero cha opulumuka

Chiwerengero cha opulumuka ndi gawo la azimayi omwe amakhala ndi moyo zaka zingapo panthawi inayake yodziwitsa.

Mwachitsanzo, kupulumuka kwa zaka 5 ndiye kuchuluka kwa odwala omwe adalandira matenda awo panthawi inayake ndipo amakhala zaka 5 atawapeza.

Kuchuluka kwa kupulumuka kumaganiziranso kuchuluka kwaimfa ya anthu omwe alibe khansa.

Khansa ya Epithelial ovarian ndi mtundu wofala kwambiri wa khansa yamchiberekero. Ziwerengero za opulumuka zimatha kusiyanasiyana kutengera mtundu wa khansa yamchiberekero, kukula kwa khansa, komanso kupita patsogolo kwamankhwala.

American Cancer Society imagwiritsa ntchito zidziwitso kuchokera ku nkhokwe ya SEER yomwe National Cancer Institute (NCI) imalingalira kuchuluka kwakupulumuka kwa khansa yamchiberekero.

Umu ndi momwe SEER amagawira magawo osiyanasiyana motere:

• Zapafupi Palibe chizindikiro choti khansara yafalikira kunja kwa thumba losunga mazira.
• Zachigawo. Khansa yafalikira kunja kwa thumba losunga mazira kumalo oyandikira kapena ma lymph node.
• Kutali. Khansa yafalikira kumadera akutali a thupi, monga chiwindi kapena mapapo.

Zaka zisanu zapakati pa khansa yamchiberekero

Khansa yowopsa ya epithelial ovarian

Zotupa zam'mimba zam'mimba

Majeremusi am'mimba zotupa m'mimba mwake

Dziwani kuti izi zimachokera ku maphunziro omwe atha kukhala osachepera zaka 5 kapena kupitilira apo.

Asayansi pano akufufuza njira zabwino komanso zodalirika zodziwira khansa yamchiberekero koyambirira. Kupita patsogolo kwamankhwala kumayenda bwino, ndipo nako, chiyembekezo cha khansa yamchiberekero.