Umdlavuza we-Endometrial

Umdlavuza we-Endometrial umdlavuza oqala ku-endometrium, ulwelwesi lwesibeletho (isibeletho).

Umdlavuza we-Endometrial uhlobo oluvame kakhulu lomdlavuza wesibeletho. Imbangela ngqo yomdlavuza we-endometrium ayaziwa. Izinga elikhulisiwe le-estrogen hormone lingadlala indima. Lokhu kuvuselela ukwakheka kolwelwesi lwesibeletho. Lokhu kungaholela ekukhuleni okungavamile kwe-endometrium nomdlavuza.

Izimo eziningi zomdlavuza we-endometrial zenzeka phakathi kweminyaka yobudala engama-60 nengama-70. Amacala ambalwa angenzeka ngaphambi kweminyaka yobudala engama-40.

Izici ezilandelayo ezihlobene namahomoni akho zikhulisa ubungozi bakho ngomdlavuza we-endometrium:

• Ukwelashwa kwe-Estrogen ngaphandle kokusebenzisa i-progesterone
• Umlando wama-polyps endometrial
• Izikhathi ezingavamile
• Ungalokothi ukhulelwe
• Ukukhuluphala ngokweqile
• Isifo sikashukela
• I-Polycystic ovary syndrome (i-PCOS)
• Ukuqala ukuya esikhathini usemncane (ngaphambi kweminyaka eyi-12)
• Ukuqala ukuya esikhathini emva kweminyaka yobudala engama-50
• I-Tamoxifen, umuthi osetshenziselwa ukwelashwa komdlavuza webele

Abesifazane abanezimo ezilandelayo nabo babonakala besengozini enkulu yomdlavuza we-endometrium:

• Umdlavuza wekoloni noma webele
• Isifo se-gallbladder
• Umfutho wegazi ophezulu

Izimpawu zomdlavuza we-endometrial zifaka:

• Ukopha okungavamile esithweni sangasese, kufaka phakathi ukopha phakathi kwezikhathi noma ukubona / ukopha ngemuva kokuya esikhathini
• Iziqephu ezinde kakhulu, ezisindayo, noma ezejwayelekile zokopha kwesitho sangasese sowesifazane ngemuva kweminyaka engama-40
• Ubuhlungu besisu esingezansi noma ukuqunjelwa okhalo

Ngesikhathi sokuqala kwezifo, ukuhlolwa kwe-pelvic kuvame ukujwayelekile.

• Ezigabeni ezithuthukile, kungahle kube nezinguquko ngosayizi, ukuma, noma imizwa yesibeletho noma izakhiwo ezizungezile.
• I-Pap smear (ingakhuphula ukusola ngomdlavuza we-endometrial, kepha ayiwutholi)

Ngokuya ngezimpawu zakho nokunye okutholakele, ezinye izivivinyo zingadingeka. Ezinye zingenziwa ehhovisi lomhlinzeki wakho wezokunakekelwa kwempilo. Okunye kungenziwa esibhedlela noma esikhungweni sokuhlinzwa:

• I-Endometrial biopsy: Kusetshenziswa ipayipi elincane noma elincanyana (ishubhu), izicubu zithathwa kulwelwesi lwesibeletho (endometrium). Amaseli ahlolwa ngaphansi kwesibonakhulu ukubona ukuthi akhona abonakala engajwayelekile noma anomdlavuza.
• IHysteroscopy: Kufakwa umshini omncane wesibonakude onqenqemeni lobulili nokuvuleka komlomo wesibeletho. Ivumela umhlinzeki ukuthi abuke ingaphakathi lesibeletho.
• I-Ultrasound: Amagagasi omsindo asetshenziselwa ukwenza isithombe sezitho zangasese. I-ultrasound ingenziwa esiswini noma sangasese. I-ultrasound inganquma ukuthi ulwelwesi lwesibeletho lubonakala lungajwayelekile noma lujiyile.
• I-Sonohysterography: Uketshezi lufakwa esibelethweni ngokusebenzisa ithubhu elincanyana, kuyilapho izithombe ze-vaginal ultrasound zenziwa esibelethweni. Le nqubo ingenziwa ukuthola ukuthi kukhona noma yisiphi isisindo esingajwayelekile sesibeletho okungaba inkomba yomdlavuza.
• I-Magnetic resonance imaging (MRI): Kulesi sivivinyo sokuthatha izithombe, kusetshenziswa ozibuthe abanamandla ukwakha izithombe zezitho zangaphakathi.

Uma umdlavuza utholakala, ukuhlolwa kwe-imaging kungenziwa ukubona ukuthi umdlavuza ususabalalele yini kwezinye izingxenye zomzimba. Lokhu kubizwa ngokuthi isiteji.

Izigaba zomdlavuza we-endometrial yilezi:

• Isigaba 1: Umdlavuza usesibeletho kuphela.
• Isigaba 2: Umdlavuza usesibeletho nasemlomo wesibeletho.
• Isigaba 3: Umdlavuza usabalale ngaphandle kwesibeletho, kodwa hhayi ngaphesheya kwendawo ye-pelvis yangempela. Umdlavuza ungabandakanya ama-lymph node ethangeni noma eduze ne-aorta (umthambo omkhulu esiswini).
• Isigaba 4: Umdlavuza usabalalele engxenyeni engaphakathi yamathumbu, isinye, isisu, noma ezinye izitho.

Umdlavuza ubuye uchazwe njengebanga loku-1, lesi-2, noma lesi-3. IBanga 1 yilona elinolaka omncane, kanti ibanga lesi-3 yilona elinolaka kakhulu. Ukuba nolaka kusho ukuthi umdlavuza uyakhula futhi usakazeke ngokushesha.

Izinketho zokwelashwa zifaka:

• Ukuhlinzwa
• Ukwelashwa ngemisebe
• Ukwelashwa ngamakhemikhali

Ukuhlinzwa ukususa isibeletho (i-hysterectomy) kungenziwa kwabesifazane abanomdlavuza wokuqala wesigaba sokuqala. Udokotela futhi angasusa amashubhu nama-ovari.

Ukuhlinzwa okuhlangene nokwelashwa ngemisebe kungenye indlela yokwelashwa. Kuvame ukusetshenziselwa abesifazane abane:

• Isifo seSigaba 1 esinethuba eliphakeme lokubuya, sesisabalalele kuma-lymph node, noma siyibanga lesi-2 noma lesi-3
• Isifo sesigaba 2

I-Chemotherapy noma i-hormonal therapy ingacatshangelwa kwezinye izimo, imvamisa kulabo abanesifo sesigaba 3 no-4.

Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokusekela umdlavuza. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa.

Umdlavuza we-Endometrial uvame ukutholakala usaqala.

Uma umdlavuza ungakasakazeki, abesifazane abangama-95% bayaphila ngemuva kweminyaka emihlanu. Uma umdlavuza ususabalele ezithweni ezikude, cishe ama-25% abesifazane basaphila ngemuva kweminyaka emihlanu.

Izinkinga zingafaka noma yikuphi okulandelayo:

• I-anemia ngenxa yokulahleka kwegazi (ngaphambi kokuxilongwa)
• Ukugcotshwa (umgodi) wesibeletho, okungenzeka ngesikhathi se-D no-C noma i-endometrial biopsy
• Izinkinga ezivela ekuhlinzweni, emisebeni, nasekhemotherapy

Shayela i-aphoyintimenti nomhlinzeki wakho uma unokunye kwalokhu okulandelayo:

• Noma yikuphi ukuphuma kwegazi noma ukubonwa okwenzeka ngemuva kokuqala kokunqamuka kokuya esikhathini
• Ukopha noma ukubeka amabala ngemuva kocansi noma i-douching
• Ukopha kuhlala isikhathi eside kunezinsuku eziyi-7
• Imijikelezo yokuya esikhathini engajwayelekile eyenzeka kabili ngenyanga
• Ukukhishwa okusha ngemuva kokunqamuka kokuya esikhathini
• Ubuhlungu be-pelvic noma i-cramping engapheli

Akukho ukuhlolwa okuphumelelayo kokuhlolwa komdlavuza we-endometrial (uterine).

Abesifazane abanezici eziyingozi zomdlavuza we-endometrial kufanele balandelwe eduze odokotela babo. Lokhu kufaka phakathi abesifazane abathatha:

• Ukwelashwa kokufaka i-Estrogen ngaphandle kokwelapha i-progesterone
• I-Tamoxifen iminyaka engaphezu kwengu-2

Ukuhlolwa okuvamile kwamathambo, i-Pap smears, ama-ultrasound wesitho sangasese sowesifazane, kanye ne-endometrial biopsy kungacatshangelwa kwezinye izimo.

Ingozi yomdlavuza we-endometrial incishiswe ngu:

• Ukugcina isisindo esivamile
• Usebenzisa amaphilisi okulawula ukubeletha isikhathi esingaphezu konyaka

I-endometrial adenocarcinoma; Isibeletho adenocarcinoma; Umdlavuza wesibeletho; I-Adenocarcinoma - i-endometrium; Adenocarcinoma - isibeletho; Umdlavuza - isibeletho; Umdlavuza - i-endometrium; Umdlavuza wesibeletho

• I-Hysterectomy - isisu - ukuphuma
• Ukukhishwa kwe-Hysterectomy - laparoscopic -
• I-Hysterectomy - ukukhishwa kwesitho sangasese sowesifazane
• Imisebe ye-pelvic - ukukhishwa

• I-laparoscopy yomzimba
• I-anatomy yokuzala yabesifazane
• D no-C
• I-Endometrial biopsy
• I-Hysterectomy
• Isibeletho
• Umdlavuza we-Endometrial

U-Armstrong DK. Umdlavuza we-Gynecologic. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 189.

IBoggess JF, Kilgore JE, iTran AQ. Umdlavuza wesibeletho. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 85.

UMorice P, uLeary A, uCreutzberg C, u-Abu-Rustum N, umdlavuza ka-Darai E. Endometrial. I-Lancet. 2016; 387 (10023): 1094-1108. I-PMID: 26354523 pubmed.ncbi.nlm.nih.gov/26354523/.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa komdlavuza we-Endometrial treatment (PDQ) -inguqulo yezempilo. www.cancer.gov/types/uterine/hp/endometrial-treatment-pdq. Kubuyekezwe uDisemba 17, 2019. Kufinyelelwe ngoMashi 24, 2020.

Iwebhusayithi ye-National Comprehensive Cancer Network. Imikhombandlela ye-NCCN yokwenza imitholampilo ku-oncology (imihlahlandlela ye-NCCN): ama-neoplasms wesibeletho. Inguqulo 1.2020. www.nccn.org/professionals/physician_gls/pdf/uterine.pdf. Kubuyekezwe ngoMashi 6, 2020. Kufinyelelwe ngoMashi 24, 2020.