Gawo 4 Renal Cell Carcinoma: Metastasis, Mitengo ya Kupulumuka, ndi Chithandizo

Zamkati

• Kodi renal cell carcinoma ndi chiyani?
• Zimafalikira motani?
• Kuwonetsa kwa TNM ndi magawo a khansa ya impso
• Maganizo ake ndi otani?
• Kodi njira zamankhwala ndi ziti?
• Kutenga

Kodi renal cell carcinoma ndi chiyani?

Renal cell carcinoma (RCC), yotchedwanso renal cell khansa kapena renal cell adenocarcinoma, ndi mtundu wamba wa khansa ya impso. Renal cell carcinomas amawerengera pafupifupi 90 peresenti ya khansa yonse ya impso.

RCC nthawi zambiri imayamba ngati chotupa chokula mu impso yanu. Ikhozanso kukula mu impso zonse ziwiri.Matendawa amapezeka kwambiri mwa amuna kuposa akazi.

Zimafalikira motani?

Ngati chotupa cha khansa chikupezeka mu impso yanu, mankhwala ochiritsira ndikuchotsa gawo kapena impso zonse zomwe zakhudzidwa.

Ngati chotupacho sichichotsedwa, ndiye kuti khansara imafalikira ku ma lymph node kapena ziwalo zina. Kufalikira kwa khansa kumatchedwa metastasis.

Pankhani ya RCC, chotupacho chitha kuwukira mtsempha waukulu wotuluka mu impso. Ikhozanso kufalikira ku ma lymph system ndi ziwalo zina. Mapapu ali pachiwopsezo chachikulu.

Kuwonetsa kwa TNM ndi magawo a khansa ya impso

Khansara ya impso imafotokozedwa magawo omwe American Joint Committee on Cancer idapanga. Njirayi imadziwika bwino ngati dongosolo la TNM.

• "T" amatanthauza chotupa. Madokotala amapereka "T" yokhala ndi nambala yozikidwa kukula ndi kukula kwa chotupacho.
• "N" imafotokoza ngati khansara yafalikira kumadera aliwonse am'mimba.
• "M" amatanthauza kuti khansara yasintha.

Kutengera mawonekedwe omwe ali pamwambapa, madokotala amapatsa RCC gawo. Masewerowa amatengera kukula kwa chotupacho komanso kufalikira kwa khansa.

Pali magawo anayi:

• Gawo 1 ndi 2 Fotokozani za khansa yomwe chotupacho chidali mu impso. Gawo 2 limatanthauza kuti chotupacho chimakhala chachikulu kuposa masentimita asanu ndi awiri kudutsa.
• Gawo 3 ndi 4 amatanthauza kuti khansara imafalikira mumtambo waukulu kapena minofu yapafupi kapena ku ma lymph node.
• Gawo 4 ndiye mtundu wapamwamba kwambiri wamatendawa. Gawo 4 limatanthauza kuti khansara yafalikira ku adrenal gland kapena yafalikira kumatenda akutali kapena ziwalo zina. Chifukwa chakuti adrenal gland imalumikizidwa ndi impso, khansa imafalikira pamenepo koyamba.

Maganizo ake ndi otani?

Kuchuluka kwa zaka zisanu za khansa ya impso kumadalira kuchuluka kwa anthu omwe amakhala zaka 5 ali ndi matendawa atapezeka.

American Cancer Society (ACS) imafotokoza kuchuluka kwa anthu omwe akukhala zaka 5 kapena kupitilira apo atapezeka molingana ndi magawo atatu kutengera ndi kafukufuku wa National Cancer Institute.

Magawo awa ndi awa:

• kutalikirana (khansa siyinafalikire kupitirira impso)
• m'deralo (khansa yafalikira pafupi)
• kutali (khansa yafalikira kumadera akutali a thupi)

Malinga ndi ACS, kupulumuka kwa RCC kutengera magawo atatu awa ndi:

• zakunja: 93 peresenti
• chigawo: 70 peresenti
• kutali: 12 peresenti

Kodi njira zamankhwala ndi ziti?

Mtundu wa chithandizo chomwe mumalandira chimadalira gawo la khansa yanu. Gawo 1 RCC itha kuchiritsidwa ndi opaleshoni.

Komabe, pofika nthawi yomwe khansa idafika pagawo 4, kuchitidwa opaleshoni sikungakhale kosankha.

Ngati chotupacho ndi metastasis zitha kudzipatula, kuchotsa opareshoni yamatenda a khansa ndi / kapena kuchiza chotupa cha metastatic pochotsa kapena njira zina monga stereotactic radiation radiation kapena kutentha kwa mafuta kungakhale kotheka.

Ngati muli ndi gawo la 4 RCC, dokotala wanu adzawona komwe kufalikira kwa khansa yanu komanso thanzi lanu lonse kuti muwone ngati mukuyenera kuchitidwa opaleshoni.

Ngati opaleshoni si njira yabwino yochizira siteji ya 4 RCC, dokotala wanu angakulimbikitseni njira zochiritsira zogwiritsa ntchito mankhwala osakaniza.

Chitsanzo cha chotupa chanu, chotchedwa biopsy, chingapezeke kuti chithandizire kupeza chithandizo chabwino kwambiri cha khansa yanu. Chithandizocho chimadalira ngati muli ndi khungu loyera kapena khungu losadziwika bwino RCC.

Njira zochiritsira ndi immunotherapy, kuphatikiza tyrosine kinase inhibitors ndi anti-PD-1 monoclonal antibodies, zitha kugwiritsidwa ntchito pochiza gawo 4 RCC. Mankhwala ena akhoza kuperekedwa okha kapena kuphatikiza mankhwala ena.

Chithandizo chitha kukhala:

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

Mankhwala atsopano atha kupezeka kudzera m'mayesero azachipatala. Mutha kukambirana zakusankha kulembetsa ndi dokotala wanu.

Dokotala wanu angalimbikitsenso chithandizo chothandizira kuti muthandizire ndi zovuta zilizonse kapena zizindikilo.

Kutenga

Ngati mwapezeka kuti muli ndi gawo la 4 RCC, kumbukirani kuti mitengo yopulumuka yomwe yasindikizidwa ndiyowerengera.

Kudziwitsa kwanu kumadalira mtundu wanu wa khansa komanso kutalika kwake, mayankho ake kuchipatala, ndi thanzi lanu lonse.

Chinsinsi chake ndi:

• tsatirani malangizo a dokotala wanu
• pitani kumalo anu osankhidwa
• tengani mankhwala anu

Komanso, onetsetsani kuti mukutsatira malangizowo kapena kusintha kwa moyo wanu kuti athane ndi zovuta zilizonse. Izi zitha kuthandiza kuthandizira thanzi lanu lonse mukamalandira chithandizo chamankhwala.