Khansa ya Peritoneal: Zomwe Muyenera Kudziwa

Zamkati

• Khansa yoyamba komanso yachiwiri ya peritoneal
• Choyambirira
• Sekondale
• Zizindikiro za khansa ya peritoneal
• Magawo a khansa ya peritoneal
• Khansa yoyamba ya peritoneal
• Khansa yachiwiri ya peritoneal
• Khansa ya Peritoneal imayambitsa komanso zoopsa
• Khansa ya peritoneal imapezeka bwanji
• Momwe mungadziwire kusiyana pakati pa khansa ya peritoneal ndi khansa ya m'mimba pozindikira
• Kuchiza khansa ya peritoneal
• Opaleshoni
• Chemotherapy
• Chithandizo chofuna
• Maganizo ake ndi otani?
• Mitengo yopulumuka
• Khansa yoyamba ya peritoneal
• Khansa yachiwiri ya peritoneal
• Funafunani chithandizo

Khansara ya Peritoneal ndi khansa yosawerengeka yomwe imapangidwa m'maselo ochepera am'mimba omwe amayenda khoma lamkati mwamimba. Mzerewu umatchedwa peritoneum.

Peritoneum imateteza ndikuphimba ziwalo m'mimba mwanu, kuphatikiza:

• matumbo
• chikhodzodzo
• rectum
• chiberekero

Peritoneum imapanganso madzi otsekemera omwe amalola ziwalo kuyenda mosavuta mkati mwa mimba.

Chifukwa chakuti zizindikilo zake sizimadziwika, khansa ya peritoneal imapezeka nthawi yayitali.

Nkhani iliyonse ya khansa ya peritoneal ndiyosiyana. Chithandizo ndi malingaliro zimasiyanasiyana payekhapayekha. Mankhwala atsopano omwe apangidwa mzaka makumi zapitazi apititsa patsogolo kuchuluka kwa moyo.

Khansa yoyamba komanso yachiwiri ya peritoneal

Mayina a pulayimale ndi sekondale amatanthauza komwe khansa idayambira. Mayina sindiye mulingo woti khansa ili yayikulu bwanji.

Choyambirira

Khansa yoyamba ya peritoneal imayamba ndikukula mu peritoneum. Nthawi zambiri zimakhudza azimayi komanso zimakonda kukhudza amuna.

Khansa yapachiyambi ya peritoneal imagwirizana kwambiri ndi khansa ya epithelial ovarian. Onsewa amachitiridwa chimodzimodzi ndipo amakhala ndi malingaliro ofanana.

Mtundu wosavuta wa khansa ya peritoneal yoyamba ndi peritoneal malignant mesothelioma.

Sekondale

Khansara yachiwiri ya peritoneal nthawi zambiri imayamba m'chiwalo china m'mimba kenako imafalikira (metastasizes) kupita ku peritoneum.

Khansara yachiwiri ya peritoneal ikhoza kuyamba mu:

• thumba losunga mazira
• machubu
• chikhodzodzo
• m'mimba
• matumbo aang'ono
• m'matumbo
• rectum
• zowonjezera

Khansa yachiwiri ya peritoneal imatha kukhudza amuna ndi akazi. Ndizofala kwambiri kuposa khansa yoyamba ya peritoneal.

Madokotala amaganiza kuti pakati pa 15 ndi 20 peresenti ya anthu omwe ali ndi khansa yoyipa amayamba metastases mu peritoneum. Pafupifupi 10 mpaka 15 peresenti ya anthu omwe ali ndi khansa yam'mimba amatulutsa metastases mu peritoneum.

Khansara ikamafika pamalo ake oyamba, tsamba latsopanoli lidzakhala ndi maselo amtundu wofanana ndi oyamba aja.

Zizindikiro za khansa ya peritoneal

Zizindikiro za khansa ya peritoneal zimadalira mtundu ndi gawo la khansa. Kumayambiriro kwake, sipangakhale zizindikiro. Nthawi zina ngakhale khansa ya peritoneal itapita patsogolo sipangakhale zizindikilo.

Zizindikiro zoyambirira zimatha kukhala zosamveka komanso mwina chifukwa cha zinthu zina zambiri. Zizindikiro za khansa ya peritoneal imatha kuphatikiza:

• Kutupa m'mimba kapena kupweteka
• kukulitsa mimba
• kumverera kwapanikizika pamimba kapena m'chiuno
• chidzalo musanamalize kudya
• kudzimbidwa
• nseru kapena kusanza
• matumbo kapena kusintha kwamikodzo
• kusowa chilakolako
• kuonda kapena kunenepa
• ukazi kumaliseche
• kupweteka kwa msana
• kutopa

Khansara ikamapita, madzi amadzi amatha kudziunjikira m'mimba (ascites), zomwe zingayambitse:

• nseru kapena kusanza
• kupuma movutikira
• kupweteka m'mimba
• kutopa

Zizindikiro zakumapeto kwa khansa ya peritoneal imatha kuphatikiza:

• kumaliza kutsekeka kwa matumbo kapena kwamikodzo
• kupweteka m'mimba
• kulephera kudya kapena kumwa
• kusanza

Magawo a khansa ya peritoneal

Akayamba kupezeka, khansa ya peritoneal imakhazikika malinga ndi kukula kwake, malo ake, komanso komwe amafalikira. Amaperekedwanso kalasi, yomwe imayesa momwe imatha kufalikira mofulumira.

Khansa yoyamba ya peritoneal

Khansa yapachiyambi ya peritoneal imapangidwa ndimachitidwe omwewo omwe amagwiritsidwa ntchito pa khansa yamchiberekero popeza khansa ndi yofanana. Koma khansa yoyamba ya peritoneal imakhala ngati gawo 3 kapena gawo 4. Khansa ya ovari ili ndi magawo awiri oyamba.

Gawo 3 yagawika magawo ena atatu:

• 3A. Khansara yafalikira ku ma lymph node kunja kwa peritoneum, kapena maselo a khansa afalikira pamwamba pa peritoneum, kunja kwa mafupa.
• 3B. Khansara yafalikira ku peritoneum kunja kwa mafupa a chiuno. Khansara mu peritoneum ndi 2 sentimita (cm) kapena yaying'ono. Zitha kukhalanso zofalikira kuma lymph node kunja kwa peritoneum.
• 3C. Khansara yafalikira ku peritoneum kunja kwa chiuno ndi. Khansara mu peritoneum ndi yayikulu kuposa 2 cm. Zitha kufalikira kumatenda am'mimba kunja kwa peritoneum kapena pamwamba pa chiwindi kapena ndulu.

Mu siteji 4, khansa yafalikira ku ziwalo zina. Gawo ili ligawanikanso:

• 4A. Maselo a khansa amapezeka mumadzimadzi omwe amapezeka m'mapapu.
• 4B. Khansara yafalikira ku ziwalo ndi zotupa kunja kwa mimba, monga chiwindi, mapapo, kapena ma lymph node.

Khansa yachiwiri ya peritoneal

Khansara yachiwiri ya peritoneal imachitika malinga ndi tsamba loyamba la khansa. Khansa yoyamba ikafalikira mbali ina ya thupi, monga peritoneum, nthawi zambiri imadziwika kuti ndi gawo 4 la khansa yoyambirira.

Lipoti loti pafupifupi 15% ya anthu omwe ali ndi khansa yamtundu wamtundu wamtundu ndipo pafupifupi 40% ya anthu omwe ali ndi khansa ya m'mimba yapa 2 mpaka 3 amatenga nawo mbali.

Khansa ya Peritoneal imayambitsa komanso zoopsa

Chifukwa cha khansa ya peritoneal sichidziwika.

Kwa khansa yoyamba ya peritoneal, zifukwa zoopsa ndizo:

• Zaka. Mukamakula, chiopsezo chanu chimakulirakulira.
• Chibadwa. Mbiri ya banja la ovarian kapena khansa ya peritoneal imawonjezera ngozi. Kunyamula kusintha kwa majini a BRCA1 kapena BRCA2 kapena chimodzi mwazomwe zimayambitsa matenda a Lynch kumakulitsanso ngozi.
• Thandizo la mahomoni. Kutenga mankhwala a mahomoni mutatha kusamba kumawonjezera chiopsezo chanu.
• Kulemera ndi kutalika. Kulemera kwambiri kapena kunenepa kwambiri kumawonjezera ngozi. Omwe ali amtali ali pachiwopsezo chowonjezeka.
• Endometriosis. Endometriosis imawonjezera chiopsezo chanu.

Zinthu zomwe zimakhudzana ndi kuchepa chiopsezo cha khansa ya peritoneal kapena yamchiberekero ndi awa:

• kumwa mapiritsi olera
• kubala ana
• kuyamwitsa
• tubal ligation, kuchotsa mazira, kapena kuchotsa ovary

Dziwani kuti kuchotsa mchiberekero kumachepetsa chiopsezo cha khansa ya peritoneal koma sikuchotseratu.

Khansa ya peritoneal imapezeka bwanji

Kuzindikira kwa khansa yoyamba komanso yachiwiri ya peritoneal kumakhala kovuta kumayambiriro. Izi ndichifukwa choti zizindikirazo sizimveka bwino ndipo zimatha kuchitika chifukwa cha zifukwa zina.

Nthawi zambiri khansa ya peritoneal imangopezeka panthawi yochita opaleshoni kuti ichotse chotupa chodziwika kwinakwake pamimba.

Dokotala wanu amakuyesani, atenga mbiri yakuchipatala, ndikufunsani za zomwe mukudwala. Atha kuyitanitsa mayeso angapo kuti adziwe ngati ali ndi matenda.

Mayeso omwe amagwiritsidwa ntchito pozindikira khansa ya peritoneal ndi awa:

• Kuyesa mayeso pamimba ndi m'chiuno. Izi zitha kuwonetsa kukwera kapena kukula. Kuyesa kumaphatikizapo CT scan, ultrasound, ndi MRI. Komabe, khansa ya peritoneal imagwiritsa ntchito makina a CT ndi MRI.
• Chisokonezo ya dera lomwe limawoneka lachilendo pakuwunika, kuphatikiza kuchotsa madzimadzi kuchokera ku ascites, kufunafuna maselo a khansa. Kambiranani zabwino ndi zoyipa za izi ndi dokotala wanu. Njirayi imakhalanso pachiwopsezo chobzala khoma la m'mimba ndimaselo a khansa.
• Kuyesa magazi kuyang'ana mankhwala omwe atha kukwezedwa ndi khansa ya peritoneal, monga CA 125, mankhwala omwe amapangidwa ndi zotupa. Chikhomo chamagazi chatsopano ndi HE4. Ndizochepa kuposa CA 125 kuti ikwezedwe chifukwa cha zosafunikira.
• Laparoscopy kapena laparotomy. Izi ndi njira zocheperako zowonera pa peritoneum. Amatengedwa ngati "mulingo wagolide" pakuwunika.

Kafufuzidwe ka njira zabwino komanso zoyambirira zodziwira khansa ya peritoneal ikupitilira.

Lingaliro loti pakhale "biopsy yamadzi." Izi zikutanthauza kuyesa magazi komwe kungayang'ane kuphatikiza zotupa zamafuta. Izi zitha kuthandiza anthu ena chithandizo cham'mbuyomu.

Momwe mungadziwire kusiyana pakati pa khansa ya peritoneal ndi khansa ya m'mimba pozindikira

Khansara ya Peritoneal ndiyofanana kwambiri ndi khansa yapachimake yamatenda owopsa. Zonsezi zimakhudza mtundu womwewo wamaselo. Zolinga zapangidwa kuti ziwasiyanitse ndi.

Amadziwika kuti ndi khansa yoyamba ya peritoneal ngati:

• thumba losunga mazira limawoneka labwinobwino
• Maselo a khansa sali pamtunda
• chotupa chimakhala chachikulu (chimatulutsa madzi)

adanenanso kuti zaka zapakati pa anthu omwe ali ndi khansa yoyamba ya peritoneal anali achikulire kuposa omwe ali ndi khansa ya m'mimba yaminyewa.

Kuchiza khansa ya peritoneal

Muyenera kukhala ndi gulu lazachipatala kuphatikiza:

• dokotalayo
• oncologist
• katswiri wa zamagetsi
• wodwala matenda
• gastroenterologist
• katswiri wazopweteka
• anamwino apadera
• akatswiri othandizira chisamaliro

Kuchiza kwa khansa yapachiyambi ya peritoneal ndikofanana ndi khansa ya m'mimba. Kwa khansa yapachiyambi ndi yachiwiri ya peritoneal, chithandizo chamankhwala chimadalira komwe kukula kwa chotupacho komanso thanzi lanu.

Chithandizo cha khansa yachiwiri ya peritoneal chimadaliranso momwe khansa yayikulu ilili komanso kuyankha kwanu kuchipatala.

Opaleshoni

Opaleshoni nthawi zambiri ndiyo gawo loyamba. Dokotala wochita opaleshoni amachotsa khansa yambiri momwe angathere. Atha kuchotsanso:

• chiberekero chako (hysterectomy)
• thumba losunga mazira anu ndi mazira (oophorectomy)
• wosanjikiza wamafuta pafupi ndi thumba losunga mazira (omentum)

Dokotala wanu adzachotsanso minofu yowoneka bwino pamimba kuti ayesenso.

Kupita patsogolo kwatsatanetsatane wa njira zopangira maopareshoni, zotchedwa cytoreductive upasuaji (CRS), zathandiza ochita opaleshoni kuchotsa zambiri za khansa. Izi zasintha malingaliro a anthu omwe ali ndi khansa ya peritoneal.

Chemotherapy

Dokotala wanu amatha kugwiritsa ntchito chemotherapy asanafike opaleshoni kuti achepetse chotupacho pokonzekera opaleshoni. Angagwiritsenso ntchito pambuyo pochita opareshoni kupha maselo aliwonse a khansa otsala.

Njira yatsopano yoperekera chemotherapy pambuyo pa opaleshoni yakhala ikugwira ntchito nthawi zambiri.

Njirayi imagwiritsa ntchito kutentha kuphatikiza ndi chemotherapy yomwe imaperekedwa mwachindunji kumalo a khansa ya peritoneal. Amadziwika kuti hyperthermic intraperitoneal chemotherapy (HIPEC). Imeneyi ndi chithandizo chanthawi imodzi chomwe chimaperekedwa pambuyo pa opaleshoni.

Kuphatikiza kwa CRS ndi HIPEC "kwasinthiratu" chithandizo cha khansa ya peritoneal, malinga ndi ofufuza ambiri. Koma sichilandiridwa kwathunthu ngati chithandizo chamankhwala panobe. Izi ndichifukwa choti palibe mayesero amtundu wa wodwala omwe ali ndi magulu olamulira.

Kafukufuku akupitilira. HIPEC siyikulimbikitsidwa pakakhala ma metastases kunja kwa mimba ndi zina.

Chemotherapy yonse imakhala ndi zovuta zina. Kambiranani zomwe zingakhale izi ndi momwe mungazigwirire ndi gulu lanu lachipatala.

Chithandizo chofuna

Nthawi zina, mankhwala olimbikitsidwa amatha kugwiritsidwa ntchito. Mankhwalawa cholinga chake ndi kuyimitsa maselo a khansa popanda kuwononga maselo abwinobwino. Njira zochiritsira zomwe zikutsatiridwa ndi izi:

• Ma antibodies a monoclonal Chotsani zinthu pamaselo omwe amalimbikitsa kukula kwa khansa. Izi zitha kuphatikizidwa ndi mankhwala a chemotherapy.
• PARP (poly-ADP ribose polymerase) zoletsa lembani kukonza kwa DNA.
• Angiogenesis zoletsa kupewa magazi chotengera kukula zotupa.

Thandizo la mahormonal, radiation radiation, ndi immunotherapy zitha kugwiritsidwanso ntchito nthawi zina khansa yoyamba ya peritoneal.

Maganizo ake ndi otani?

Maganizo a anthu omwe ali ndi khansa yapachiyambi kapena yachiwiri ya peritoneal yakula bwino mzaka zaposachedwa chifukwa cha kupita patsogolo kwa chithandizo chamankhwala, komabe sichabwino. Izi zili choncho makamaka chifukwa cha khansa ya peritoneal nthawi zambiri sichipezeka mpaka itafika pachimake. Komanso, khansayo imatha kubwerera atalandira chithandizo.

Zizindikiro zimakhala zovuta kudziwa, koma ngati muli ndi zina mwazizindikiro zomwe zikupitilira, funsani dokotala wanu. Kuzindikira koyambirira kumabweretsa zotsatira zabwino.

Mitengo yopulumuka

Khansa yoyamba ya peritoneal

Kuyambira mu 2019, zaka zisanu zapakati pa amayi omwe ali ndi mitundu yonse ya ma ovari, fallopian chubu, ndi khansa ya peritoneal ndi 47 peresenti. Chiwerengerochi ndichokwera kwambiri kwa azimayi ochepera 65 (60%) ndikotsika kwa azimayi opitilira 65 (29%).

Ziwerengero za kupulumuka kwa khansa yapachiyambi ya peritoneal zimachokera ku maphunziro ochepa kwambiri.

Mwachitsanzo, mwa azimayi 29 omwe ali ndi khansa yapachiyambi ya peritoneal adanenanso kuti amakhala ndi miyezi pafupifupi 48 atachiritsidwa.

Izi ndizabwinoko kuposa kuchuluka kwa zaka zisanu kupulumuka komwe kunanenedwa mu kafukufuku wa 1990 yemwe anali pakati.

Khansa yachiwiri ya peritoneal

Kuwonjezeka kwa khansa yachiwiri ya peritoneal kumadaliranso pagawo la khansa yoyamba komanso mtundu wa chithandizo. Kafukufuku wocheperako akuwonetsa kuti chithandizo chophatikizika cha CRS ndi HIPEC chimathandizira kupulumuka.

Mwachitsanzo, kafukufuku yemwe adalengezedwa mu 2013 adayang'ana anthu 84 omwe ali ndi khansa yoyipa yomwe idafalikira ku peritoneum. Inkafanizira omwe anali ndi systemic chemotherapy ndi iwo omwe anali ndi CRS ndi HIPEC.

Kupulumuka kwa gulu la chemotherapy kunali miyezi 23.9 poyerekeza ndi miyezi 62.7 ya gululi lomwe lidalandira CRS ndi HIPEC.

Funafunani chithandizo

Mutha kuyankhula ndi anthu ena omwe amalandira chithandizo chamankhwala kapena ndi abale awo.

Mzere wothandizira wa American Cancer Society umapezeka 24/7 patsiku pa 800-227-2345. Amatha kukuthandizani kuti mupeze gulu la intaneti kapena kwanuko kuti muthandizidwe.

Gulu lanu lachipatala litha kuthandizanso pazinthu zothandizira.