Umdlavuza wendlala yesinye

Umdlavuza wendlala yesibeletho umdlavuza oqala endlaleni yesinye. Indlala yesinye iyisakhiwo esincane, esimise okwenathi esakha ingxenye yohlelo lokuzala lendoda. Isonga i-urethra, ishubhu elikhipha umchamo emzimbeni.

Umdlavuza wendlala yesibindi yimbangela evame kakhulu yokufa komdlavuza emadodeni angaphezu kweminyaka engama-75. Umdlavuza wendlala yesisu awutholakali emadodeni angaphansi kweminyaka engama-40.

Abantu abasengozini enkulu bafaka:

• Abesilisa base-Afrika baseMelika, abasengozini enkulu yokuthola lo mdlavuza kuyo yonke iminyaka
• Amadoda angaphezu kweminyaka engama-60
• Abesilisa abanobaba noma umfowabo onomdlavuza wendlala yesinye

Abanye abantu abasengozini bafaka:

• Abesilisa abakade bezungeze i-Agent Orange
• Abesilisa abadla ukudla okunamafutha amaningi, ikakhulukazi amafutha ezilwane
• Amadoda akhuluphele

Umdlavuza wendlala yesibeletho uvame kakhulu kubantu abangayidli inyama (abadla inyama).

Inkinga evamile cishe kuwo wonke amadoda njengoba ekhula i-prostate enwetshiwe. Lokhu kubizwa ngokuthi yi-benign prostatic hyperplasia, noma i-BPH. Akuyiphakamisi ingozi yokuba nomdlavuza wendlala yesinye. Kepha, ingakhuphula imiphumela yakho yokuhlolwa kwegazi ye-prostate-specific antigen (PSA).

Ngomdlavuza wokuqala wesinye, kaningi azikho izimpawu.

Ukuhlolwa kwegazi kwe-PSA kungenziwa ukuhlola amadoda umdlavuza wendlala yabesilisa. Imvamisa, izinga le-PSA liyakhuphuka ngaphambi kokuba kube nezimpawu.

Izimpawu ezibalwe ngezansi zingenzeka ngomdlavuza wendlala yabesilisa njengoba ikhula ibe nkulu endlezweni. Lezi zimpawu zingabangelwa ezinye izinkinga ze-prostate:

• Ukubambezeleka noma ukubambezeleka kokuqala kokusakazwa komchamo
• Ukushayela noma ukuvuza komchamo, imvamisa ngemuva kokuchama
• Ukusakaza okuhamba kancane komchamo
• Ukuqina lapho uchama, noma ukungakwazi ukukhipha wonke umchamo
• Igazi kumchamo noma isidoda

Lapho umdlavuza ususabalele, kungahle kube nobuhlungu bethambo noma isisa, imvamisa emathanjeni aphansi nasemathangeni.

Ukuhlolwa okungajwayelekile kwamakholomu edijithali kungaba uphawu kuphela lomdlavuza wendlala yabesilisa.

I-biopsy iyadingeka ukutshela ukuthi unomdlavuza we-prostate. I-biopsy inqubo yokususa isampula lezicubu ku-prostate. Isampuli ithunyelwa ebhodini ukuze ihlolwe. Kuzokwenziwa ehhovisi likadokotela wakho.

Udokotela wakho angancoma i-biopsy uma:

• Uneleveli ephezulu ye-PSA
• Ukuhlolwa kwamakholomu edijithali kuveza indawo eqinile noma engalingani

Umphumela we-biopsy ubikwa usebenzisa lokho okubizwa ngokuthi ibanga le-Gleason kanye nesikolo se-Gleason.

Ibanga likaGleason likutshela ukuthi umdlavuza ungasabalala ngokushesha okungakanani. Ibeka izimila esikalini sika-1 kuye ku-5. Ungaba namabanga ahlukene omdlavuza kusampula eyodwa ye-biopsy. Amabanga amabili ajwayelekile kakhulu afakwa ndawonye. Lokhu kukunikeza amaphuzu weGleason. Ukuphakama kwesilinganiso sakho seGleason, kungenzeka ukuthi umdlavuza usabalale ngaphezu kwe-prostate:

• Izikolo 2 kuya ku-6: Umdlavuza wesibeletho osezingeni eliphansi.
• Isigaba 7: Umdlavuza webanga eliphakathi- (noma phakathi). Iningi lomdlavuza wendlala yesinye liwela kuleli qembu.
• Izikolo 8 kuya ku-10: Umdlavuza osezingeni eliphakeme.

Olunye uhlelo lokugreda, i-5 Grade Group System yenza umsebenzi ongcono wokuchaza ukuthi umdlavuza uziphatha kanjani futhi uzophendula kanjani ekwelashweni:

• Iqembu leBanga 1: Isilinganiso se-Gleason 6 noma ngaphansi (umdlavuza osezingeni eliphansi)
• Iqembu leBanga 2: Isilinganiso se-Gleason 3 + 4 = 7 (umdlavuza osezingeni eliphakathi)
• Ibanga leqembu lesi-3: Isilinganiso se-Gleason 4 + 3 = 7 (umdlavuza osezingeni eliphakathi)
• Ibanga leqembu lesi-4: Isilinganiso se-Gleason 8 (umdlavuza osezingeni eliphakeme)
• Iqembu leBanga lesi-5: Isilinganiso se-Gleason 9 kuya ku-10 (umdlavuza osezingeni eliphakeme)

Iqembu eliphansi likhombisa ithuba elingcono lokwelashwa okuphumelelayo kuneqembu eliphakeme. Iqembu eliphakeme lisho ukuthi amangqamuzana amaningi omdlavuza abukeka ehlukile kumaseli ajwayelekile. Iqembu eliphakeme libuye lisho ukuthi kungenzeka ukuthi isimila sisakazeke ngolaka.

Ukuhlolwa okulandelayo kungenziwa ukuthola ukuthi umdlavuza usakazekile yini:

• Iskena se-CT
• Ukuskena kwamathambo
• Ukuskena kwe-MRI

Ukuhlolwa kwegazi kwe-PSA kuzosetshenziselwa ukuqapha umdlavuza wakho ngemuva kokwelashwa.

Ukwelashwa kuncike ezintweni eziningi, kufaka phakathi isikolo sakho seGleason nempilo yakho yonke. Udokotela wakho uzoxoxa nawe ngezinketho zakho zokwelashwa.

Uma umdlavuza ungasakazekanga ngaphandle kwendlala yesinye, ukwelashwa okuvamile kufaka:

• Ukuhlinzwa (i-radical prostatectomy)
• Ukwelashwa ngemisebe, kufaka phakathi i-brachytherapy ne-proton therapy

Uma usumdala, udokotela wakho angancoma ukumane ubheke umdlavuza ngokuhlolwa kwe-PSA kanye nama-biopsies.

Ukwelashwa kweHormone kusetshenziselwa ikakhulukazi umdlavuza osakazeke ngaphesheya kwesisu. Kuyasiza ukuqeda izimpawu futhi kuvimbele ukukhula okuqhubekayo nokusabalala komdlavuza. Kodwa awuwulaphi umdlavuza.

Uma umdlavuza wendlala yabesilisa usakazeka ngisho nangemva kokuzama ukwelashwa kwehomoni, ukuhlinzwa, noma imisebe, ukwelashwa kungafaka:

• Ukwelashwa ngamakhemikhali
• I-Immunotherapy (umuthi owenza amasosha omzimba ahlasele abulale amangqamuzana omdlavuza)

Ukuhlinzwa, ukwelashwa ngemisebe, kanye nokwelashwa kwamahomoni kungathinta ukusebenza kwakho ngokocansi. Izinkinga ngokulawulwa komchamo kungenzeka ngemuva kokuhlinzwa nokwelashwa ngemisebe. Xoxa ngokukhathazeka kwakho nomhlinzeki wakho wezokunakekelwa kwempilo.

Ngemuva kokwelashwa komdlavuza wendlala yabesilisa, uzobhekwa eduze ukuze uqiniseke ukuthi umdlavuza awusabalali. Lokhu kufaka ukubhekwa okujwayelekile, kufaka phakathi ukuhlolwa kwegazi kwe-PSA (imvamisa njalo ezinyangeni ezintathu kuya onyakeni owodwa).

Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokusekelwa komdlavuza wesinye. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa.

Ukwenza kahle kwakho kuncike ekutheni umdlavuza usabalale ngaphandle kwendlala yesinye nokuthi amaseli womdlavuza angajwayelekile kangakanani (isilinganiso seGleason) lapho utholakala.

Ikhambi lingenzeka uma umdlavuza ungakasakazeki. Ukwelashwa kweHormone kungathuthukisa ukusinda, noma ngabe ukwelashwa kungenzeki.

Xoxa ngobuhle nobubi bokuhlolwa kwe-PSA nomhlinzeki wakho wezokunakekelwa kwempilo.

Khuluma nomhlinzeki wakho mayelana nezindlela ezikhona zokwehlisa ingozi yokuba nomdlavuza wesinye. Lokhu kungafaka izindlela zokuphila, njengokudla nokuvivinya umzimba.

Ayikho imithi evunyelwe yi-FDA yokuvimbela umdlavuza wendlala yabesilisa.

Umdlavuza - i-prostate; I-biopsy - i-prostate; I-prostate biopsy; Isikolo sikaGleason

• Imisebe ye-pelvic - ukukhishwa
• I-prostate brachytherapy - ukukhipha
• Ukwelashwa ngemisebe - imibuzo ongayibuza udokotela wakho
• I-radical prostatectomy - ukukhishwa

• I-anatomy yokuzala yowesilisa
• Umgudu womchamo wabesilisa
• BPH
• Umdlavuza wendlala yesinye
• Ukuhlolwa kwegazi kwe-PSA
• I-Prostatectomy - Uchungechunge
• Ukuthengiswa kabusha kwe-prostate (TURP) - Uchungechunge

Iwebhusayithi yeAmerican Urological Association. Ukuhlolwa kwe-PSA kwesiteji sangaphambi kokwelashwa kanye nokuphathwa kwangemva kokwelashwa komdlavuza wesinye www.auanet.org/guidelines/prostate-specific-antigen-(psa)-best-practice-statement. Kufinyelelwe ngoDisemba 5, 2019.

Iwebhusayithi yeAmerican Urological Association. Ukutholwa kokuqala komdlavuza wesibeletho (2018): umhlahlandlela womtholampilo. www.auanet.org/guidelines/prostate-cancer-early-detection- guideline. Kufinyelelwe ngo-Agasti 22, 2019.

Iwebhusayithi yeNational Cancer Institute. Uhlobo lwezempilo lwe-Prostate cancer treatment (PDQ). www.cancer.gov/types/prostate/hp/prostate-treatment-pdq. Kubuyekezwe uSepthemba 20, 2019. Kufinyelelwe kuDisemba 5, 2019.

Iwebhusayithi ye-National Comprehensive Cancer Network. Imikhombandlela ye-NCCN yokwenza imitholampilo ku-oncology (imihlahlandlela ye-NCCN): umdlavuza wendlala yabesilisa. Inguqulo 4.2019. www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Kubuyekezwe u-Agasti 19, 2019. Kufinyelelwe ngo-Septhemba 4, 2019.

UNelson WG, u-Antonarakis ES, uCarter HB, uDe Marzo AM, uDeWeese TL. Umdlavuza wendlala yesinye. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 81.

UStephenson AJ, uKlein EA. I-Epidemiology, i-etiology, nokuvimbela umdlavuza we-prostate. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ama-eds. ICampbell-Walsh Urology. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2016: isahluko 107.

I-US Preventive Services Task Force, uGrossman DC, uCurry SJ, et al. Ukuhlolisiswa umdlavuza wendlala yesinye: isitatimende sezincomo se-US Preventive Services Task Force. JAMA. I-2018; 319 (18): 1901-1913. I-PMID: 29801017 www.ncbi.nlm.nih.gov/pubmed/29801017.