Uyini umdlavuza womphimbo?

-Delile

• Izinhlobo zomdlavuza womphimbo
• Ukuqaphela izimpawu ezingaba khona zomdlavuza womphimbo
• Izimbangela nezici zobungozi zomdlavuza womphimbo
• Ukuhlonza umdlavuza womphimbo
• Isifo somdlavuza womphimbo
• Ukuhlola ukuhlolwa
• Ukucabanga kwe-Magnetic resonance (MRI)
• I-Positron emission tomography (ukuskena kwe-PET)
• I-computed tomography (i-CT scan)
• Ukugwinya kwe-Barium
• I-X-ray yesifuba
• Izinketho zokwelashwa komdlavuza womphimbo
• Ukuhlinzwa
• Ukwelashwa ngemisebe
• Ukwelashwa ngamakhemikhali
• Ukwelashwa okuhlosiwe
• Ukululama kwangemva kokwelapha
• Umbono wesikhathi eside womdlavuza womphimbo
• Ukuvimbela umdlavuza womphimbo
• Umdlavuza womphimbo: Q & A
• Q:
• A:

Uyini umdlavuza womphimbo?

Umdlavuza uyisigaba sezifo lapho amaseli angajwayelekile ephindaphindeka futhi ehlukane ngokungalawuleki emzimbeni. Lawa maseli angajwayelekile akha iziqu ezimbi ezibizwa ngokuthi izicubu.

Umdlavuza womphimbo usho umdlavuza webhokisi lezwi, izintambo zezwi, nezinye izingxenye zomphimbo, njengamalaka kanye ne-oropharynx. Umdlavuza womlomo uvame ukuhlukaniswa ngezigaba ezimbili: umdlavuza wepharyngeal nomdlavuza we-laryngeal.

Umdlavuza womlomo awujwayelekile uma uqhathaniswa neminye imidlavuza. INational Cancer Institute ilinganisela ukuthi kubantu abadala e-United States:

• cishe amaphesenti angu-1.2 azotholakala ukuthi unomdlavuza womlomo nomdlavuza wepharyngeal esikhathini sokuphila kwabo.
• cishe amaphesenti angu-0.3 azotholakala enomdlavuza we-laryngeal esikhathini sokuphila kwabo.

Izinhlobo zomdlavuza womphimbo

Yize wonke umdlavuza womphimbo uhilela ukukhula nokwanda kwamaseli angajwayelekile, udokotela wakho kufanele abone uhlobo lwakho oluthile ukunquma uhlelo lokwelashwa olusebenza kahle kakhulu.

Izinhlobo ezimbili eziyinhloko zomdlavuza womphimbo yilezi:

• I-squamous cell carcinoma. Lolu hlobo lomdlavuza womphimbo luthinta amaseli ayizicaba aqonde umphimbo. Kungumdlavuza ovame kakhulu womphimbo e-United States.
• I-Adenocarcinoma. Lolu hlobo lomdlavuza womphimbo luthinta amaseli wezindlala futhi aluvamile.

Izigaba ezimbili zomdlavuza womphimbo yilezi:

• Umdlavuza wepharyngeal. Lo mdlavuza uqhamuka kupharynx, okuyishubhu elingenalutho eligijima lisuka ngemuva kwekhala lakho liye phezulu esiqeni sakho somoya. Umdlavuza we-Pharyngeal okhula entanyeni nasemphinjeni ufaka:
  • umdlavuza we-nasopharynx (ingxenye ephezulu yomphimbo)
  • umdlavuza we-oropharynx (ingxenye emaphakathi yomphimbo)
  • umdlavuza we-hypopharynx (ingxenye engezansi yomphimbo)
  • Umdlavuza weLaryngeal. Lo mdlavuza wenzeka emphinjeni, okuyi-voice box yakho.

Ukuqaphela izimpawu ezingaba khona zomdlavuza womphimbo

Kungaba nzima ukuthola umdlavuza womphimbo usaqala. Izimpawu nezimpawu zomdlavuza womphimbo zifaka:

• shintsha ezwini lakho
• inkinga yokugwinya (i-dysphagia)
• ukuncipha komzimba
• Umphimbo obuhlungu
• isidingo sokusula umphimbo wakho njalo
• ukukhwehlela okungapheli (kungakhwehlela igazi)
• ama-lymph node avuvukile entanyeni
• isifuba
• ubuhlungu bendlebe
• ukushaqeka

Yenza ukuqokwa kukadokotela uma unezinye zalezi zimpawu futhi azithuthuki ngemuva kwamasonto amabili kuya kwamathathu.

Izimbangela nezici zobungozi zomdlavuza womphimbo

Abesilisa banamathuba amaningi okuba nomdlavuza womphimbo kunabesifazane.

Imikhuba ethile yokuphila yandisa amathuba okuba nomdlavuza womphimbo, kufaka phakathi:

• ukubhema
• ukuphuza ngokweqile
• ukungondleki kahle
• ukuvezwa kwe-asbestos
• inhlanzeko yamazinyo empofu
• syndromes zofuzo

Umdlavuza womphimbo uhlotshaniswa nezinhlobo ezithile zezifo ze-papillomavirus human (HPV). I-HPV igciwane elidluliselwa ngocansi. Ukutheleleka nge-HPV kuyingcuphe ethile yomdlavuza othile we-oropharyngeal, ngokusho kweCancer Treatment Centers of America.

Umdlavuza womlomo uphinde waxhunyaniswa nezinye izinhlobo zomdlavuza. Eqinisweni, abanye abantu abatholakala benomdlavuza womphimbo batholwa ukuthi banomdlavuza wokuqina, wamaphaphu noma wesisu ngasikhathi sinye. Lokhu kungenzeka ngoba lawa mdlavuza unezici ezifanayo zobungozi.

Ukuhlonza umdlavuza womphimbo

Ekuqokweni kwakho, udokotela wakho uzokubuza ngezimpawu zakho nomlando wezokwelapha. Uma ngabe uhlangabezana nezimpawu ezifana nomphimbo obuhlungu, ukushuba, nokukhwehlela okungapheli ngaphandle kokuthuthuka futhi kungekho enye incazelo, bangasola umdlavuza womphimbo.

Ukuhlola umdlavuza womphimbo, udokotela wakho uzokwenza i-laryngoscopy eqondile noma engaqondile noma uzokuthumela kuchwepheshe wenqubo.

I-laryngoscopy inikeza udokotela wakho umbono oseduze womphimbo wakho. Uma lokhu kuhlolwa kuveza ukungajwayelekile, udokotela wakho angathatha isampula lezicubu (elibizwa ngokuthi yi-biopsy) emphinjeni wakho bese evivinya isampula yomdlavuza.

Udokotela wakho angancoma enye yezinhlobo ezilandelayo ze-biopsies:

• I-biopsy ejwayelekile. Ngale nqubo, udokotela wakho wenza imbobo futhi asuse ucezu lwesicubu sesampula. Lolu hlobo lwe-biopsy lwenziwa egumbini lokusebenza ngaphansi kwe-anesthesia ejwayelekile.
• Isifiso esihle senaliti (i-FNA). Kule biopsy, udokotela wakho ufaka inaliti ezacile ngqo esihlahleni ukuze ususe amasampula amaseli.
• I-endoscopic biopsy. Ukususa isampula lezicubu usebenzisa i-endoscope, udokotela wakho ufaka ithubhu ezacile, ende ngomlomo wakho, ngamakhala, noma ngembobo.

Isifo somdlavuza womphimbo

Uma udokotela wakho ethola amangqamuzana anomdlavuza emphinjeni wakho, bazo-oda ukuhlolwa okwengeziwe ukukhomba isigaba, noma ubukhulu, bomdlavuza wakho. Izigaba zisukela ku-0 ziye ku-4:

• Isigaba 0: Isimila sisezingeni eliphezulu kuphela lamaseli engxenye ethintekile yomphimbo.
• Isigaba 1: Isimila singaphansi kuka-2 cm futhi sikhawulelwe engxenyeni yomphimbo lapho siqale khona.
• Isigaba 2: Isimila siphakathi kuka-2 no-4 cm noma kungenzeka sikhule saba yindawo eseduze.
• Isigaba 3: Isimila sikhulu kuno-4 cm noma sesikhule saba ezinye izakhiwo emphinjeni noma sesisabalalele ku-lymph node eyodwa.
• Isigaba 4: Isimila sisabalalele kuma-lymph node noma ezithweni ezikude.

Ukuhlola ukuhlolwa

Udokotela wakho angasebenzisa izivivinyo ezahlukahlukene ukufaka umdlavuza womphimbo wakho. Ukufanekisa izivivinyo zesifuba, intamo, nekhanda kunganikeza isithombe esingcono sokuqhubeka kwesifo. Lezi zivivinyo zingafaka okulandelayo.

Ukucabanga kwe-Magnetic resonance (MRI)

Lokhu kuhlolwa kwe-imaging kusebenzisa amaza omsakazo nozibuthe abanamandla ukudala izithombe eziningiliziwe ezingaphakathi kwentamo yakho. I-MRI ibheka izicubu futhi inganquma ukuthi umdlavuza ususabalele kwezinye izingxenye zomzimba.

Uzolala eshubhu elincane njengoba umshini udala izithombe. Ubude besivivinyo buyahlukahluka kepha imvamisa abuthathi isikhathi esingaphezu kwehora elilodwa.

I-Positron emission tomography (ukuskena kwe-PET)

Ukuskena i-PET kuhilela ukujova uhlobo lwedayi enemisebe egazini. Iskena senza izithombe zezindawo ezisebenza ngemisebe emzimbeni wakho. Lolu hlobo lokuhlolwa kwe-imaging lungasetshenziswa ezimweni zomdlavuza osezingeni eliphezulu.

I-computed tomography (i-CT scan)

Lokhu kuhlolwa kwe-imaging kusebenzisa ama-X-ray ukwakha isithombe esinqamulelayo somzimba wakho. I-CT scan iphinde ikhiqize izithombe zezicubu ezithambile nezitho.

Lokhu kuskena kusiza udokotela wakho ukuthi anqume ubukhulu besimila. Kuyabasiza nokuthi banqume ukuthi ngabe isimila sesisabalele ezindaweni ezahlukahlukene, njengama-lymph node namaphaphu.

Ukugwinya kwe-Barium

Udokotela wakho angase asikisele ukugwinya kwe-barium uma unenkinga yokugwinya. Uzophuza uketshezi olujiyile ukumboza umphimbo wakho nomphimbo. Lokhu kuhlolwa kudala izithombe ze-X-ray zomphimbo wakho nomphimbo.

I-X-ray yesifuba

Uma udokotela wakho esola ukuthi umdlavuza ususabalele emaphashini akho, uzodinga i-X-ray yesifuba ukuze uhlole ukungajwayelekile.

Izinketho zokwelashwa komdlavuza womphimbo

Kukho konke ukwelashwa, uzosebenza eduze nochwepheshe abahlukahlukene. Lezi zingcweti zifaka:

• i-oncologist, owenza izinqubo zokuhlinza njengokukhishwa kwezicubu
• i-oncologist yemisebe, elapha umdlavuza wakho usebenzisa i-radiation therapy
• udokotela wezifo, ohlola amasampula wezicubu ku-biopsy yakho

Uma une-biopsy noma ukuhlinzwa, uzoba nodokotela obulala izinzwa ophethe i-anesthesia futhi aqaphe isimo sakho ngesikhathi senqubo.

Izinketho zokwelashwa komdlavuza womphimbo zifaka phakathi ukuhlinzwa, ukwelashwa ngemisebe, nokwelashwa ngamakhemikhali. Indlela yokwelashwa enconywe udokotela wakho izoncika ebangeni lesifo sakho, phakathi kwezinye izinto.

Ukuhlinzwa

Uma isimila somphimbo wakho sincane, udokotela wakho angase asuse ngokuhlinzwa isimila. Lokhu kuhlinzwa kwenziwa esibhedlela ngenkathi ungaphansi kwesilaliso. Udokotela wakho angancoma enye yalezi zinqubo zokuhlinza ezilandelayo:

• Ukuhlinzwa kwe-Endoscopic. Le nqubo isebenzisa i-endoscope (ithubhu ende ezacile enesibani nekhamera ekugcineni) lapho izinsimbi zokuhlinza noma ama-lasers kungadluliswa ukwelapha umdlavuza osezingeni lokuqala.
• I-Cordectomy. Le nqubo isusa wonke noma ingxenye yezintambo zakho zezwi.
• I-Laryngectomy. Le nqubo isusa konke noma ingxenye yebhokisi lakho lezwi, kuya ngobukhulu besifo somdlavuza. Abanye abantu bangakhuluma ngokujwayelekile ngemuva kokuhlinzwa. Abanye bazofunda ukukhuluma ngaphandle kwebhokisi lezwi.
• I-Pharyngectomy. Le nqubo isusa ingxenye yomphimbo wakho.
• Ukuhlukaniswa kwentamo. Uma umdlavuza womphimbo usakazeka ngaphakathi kwentamo, udokotela wakho angasusa amanye ama-lymph node akho.

Ukwelashwa ngemisebe

Ngemuva kokukhishwa kwesimila, udokotela wakho angancoma ukwelashwa ngemisebe. Ukwelashwa ngemisebe kusebenzisa imisebe enamandla amakhulu ukubhubhisa amangqamuzana omdlavuza abulalayo. Ikhomba noma yimaphi amangqamuzana anomdlavuza ashiywe yisimila. Izinhlobo zokwelashwa ngemisebe zifaka:

• I-radiotherapy ye-intension-modulated kanye ne-3D-conformal radiation. Kuzo zombili izinhlobo zokwelashwa, imishayo yemisebe yenzelwe isimo sesimila. Le yindlela evame kakhulu ukunikezwa ngemisebe yomdlavuza we-laryngeal kanye ne-hypopharyngeal.
• I-Brachytherapy. Imbewu enemisebe ibekwa ngqo ngaphakathi kwesimila noma eduze kwesimila. Yize lolu hlobo lwemisebe lungasetshenziselwa umdlavuza we-laryngeal kanye ne-hypopharyngeal, akuvamile.

Ukwelashwa ngamakhemikhali

Endabeni yamathumba amakhulu nezimila ezisabalalele kuma-lymph node nakwezinye izitho noma izicubu, udokotela wakho angancoma i-chemotherapy kanye nemisebe. I-Chemotherapy yisidakamizwa esibulala futhi sinciphise ukukhula kwamaseli amabi.

Ukwelashwa okuhlosiwe

Imithi ehlosiwe yimithi emisa ukusabalala nokukhula kwamangqamuzana omdlavuza ngokugxambukela kuma-molecule athile abhekene nokukhula kwesimila. Uhlobo olulodwa lwezokwelapha ezihlosiwe ezisetshenziselwa ukwelapha umdlavuza womphimbo yi-cetuximab (Erbitux).

Ezinye izinhlobo zokwelashwa okuqondisiwe ziyacwaningwa ezivivinyweni zokwelashwa. Udokotela wakho angancoma lokhu kwelashwa kanye ne-chemotherapy ejwayelekile nemisebe.

Ukululama kwangemva kokwelapha

Abanye abantu abanomdlavuza womphimbo badinga ukwelashwa ngemuva kokwelashwa ukuze baphinde bakhulume. Lokhu kungathuthukiswa ngokusebenza nomelaphi wezinkulumo kanye nodokotela owelapha ngokomzimba.

Ngaphezu kwalokho, abanye abantu abanomdlavuza womphimbo babhekana nezinkinga. Lokhu kungafaka:

• ubunzima bokugwinya
• ukonakala kwentamo noma kobuso
• ukungakwazi ukukhuluma
• ukuphefumula kanzima
• ukuqina kwesikhumba entanyeni

Abelaphi basemsebenzini bangasiza ngokugwinya ubunzima. Ungaxoxa ngokuhlinzwa okwakhiwa kabusha nodokotela wakho uma unokukhubazeka kobuso noma kwentamo ngemuva kokuhlinzwa.

Umbono wesikhathi eside womdlavuza womphimbo

Uma utholakale kusenesikhathi, umdlavuza womphimbo unesilinganiso esiphakeme sokusinda.

Umdlavuza womlomo kungenzeka ungelapheki uma amangqamuzana amabi esabalele ezingxenyeni zomzimba ngale kwentamo nasekhanda. Kodwa-ke, labo abatholakala bengaqhubeka nokwelashwa ukwelula impilo yabo nokunciphisa ukuqhubeka kwesifo.

Ukuvimbela umdlavuza womphimbo

Ayikho indlela eqondile yokuvimbela umdlavuza womphimbo, kodwa ungathatha izinyathelo zokunciphisa ubungozi bakho:

• Yeka ukubhema. Sebenzisa imikhiqizo engaphezulu kwekhawunta efana nemikhiqizo yokufaka esikhundleni se-nicotine ukuyeka ukubhema, noma khuluma nodokotela wakho ngemithi kadokotela yokukusiza uyeke.
• Nciphisa ukuphuza utshwala. Abesilisa akufanele baphuze iziphuzo ezidakayo ezingaphezu kwezimbili ngosuku, futhi abesifazane akufanele baphuze okungaphezu koyedwa ngosuku.
• Gcina i indlela yokuphila enempilo. Yidla izithelo, imifino nenyama enamafutha amaningi. Nciphisa ukudla okunamafutha ne-sodium bese uthatha izinyathelo zokwehlisa isisindo esiningi. Zibandakanye ekusebenzeni komzimba okungenani amahora ama-2,5 ngesonto.
• Nciphisa ubungozi bakho I-HPV. Leli gciwane lixhunyaniswe nomdlavuza womphimbo. Ukuze uzivikele, yenza ucansi oluphephile. Futhi khuluma nodokotela wakho ngezinzuzo zomuthi wokugoma we-HPV.

Umdlavuza womphimbo: Q & A

Q:

Ingabe umdlavuza womphimbo ungofuzo?

A:

Iningi lomdlavuza womphimbo ngokuvamile uhlobene nokubhema hhayi ifa, ngaphandle kwalapho amalungu omndeni ethambekele ekubhemeni. Ngaphandle komphimbo, izakhi zofuzo eziningi ezibeka amalungu omndeni engcupheni yokukhula komdlavuza. Abanye abantu bathola ukuguqulwa kwezakhi zofuzo kubazali babo okwandisa kakhulu amathuba abo okuba nomdlavuza othile. Ukuguqulwa okuzuzwe njengefa kwama-oncogene noma izakhi zofuzo ezicindezelayo akuvamile ukudala umdlavuza womphimbo, kepha abanye abantu babonakala bezuza amandla ancishisiwe okudiliza izinhlobo ezithile zamakhemikhali abangela umdlavuza. Laba bantu bazwela kakhulu emiphumeleni ebangelwa umdlavuza ebangelwa intuthu kagwayi, utshwala, namakhemikhali athile ezimboni.