Ukwelashwa Kwe-Ductal Carcinoma

-Delile

• Ukwelapha i-ductal carcinoma engafuneki
• Ukwelashwa kwasendaweni
• Ukwelashwa okuhlelekile
• I-Chemotherapy ye-ductal carcinoma engahlaseli
• Izindlela zokwelashwa ezihlosiwe
• Ukuthatha

Yini i-invasive ductal carcinoma?

Cishe abesifazane abangama-268,600 e-United States bazotholakala benomdlavuza webele ngo-2019. Uhlobo oluvame kakhulu lomdlavuza webele lubizwa nge-invasive ductal carcinoma (IDC). Inesibopho cishe samaphesenti angama-80 kuko konke ukuxilongwa komdlavuza webele.

I-Carcinoma isho uhlobo lomdlavuza oqala kumaseli esikhumba noma izicubu ezifaka izitho zakho zangaphakathi. I-Adenocarcinomas yizinhlobo ezithile eziqondile ze-carcinomas ezivela ezicutshini eziyindlala zomzimba.

I-invasive ductal carcinoma, eyaziwa nangokuthi ukungena ngaphakathi kwe-ductal carcinoma, ibizwa ngegama layo ngoba iqala emithonjeni ethwala ubisi lwesifuba, bese isakazeka (noma ihlasela) izicubu zesifuba ezizungezile. Izinhlobo ezimbili ezivame kakhulu zomdlavuza webele ongafuneki yilezi:

• I-carcinoma ehlasela i-ductal. Ama-akhawunti amaphesenti angama-80 wokuxilongwa komdlavuza webele. Lolu hlobo luqala futhi lusakazeke kusuka emapayipini obisi.
• I-carcinoma ye-lobular ehlaselayo. Ama-akhawunti wamaphesenti ayi-10 wokuxilongwa komdlavuza webele. Lolu hlobo luqala kuma-lobule akhiqiza ubisi.

Ngenkathi i-IDC ingathinta abesifazane kunoma yisiphi isikhathi, itholakala kakhulu kwabesifazane abaneminyaka engama-55 kuya kwengama-64. Lo mdlavuza webele ungathinta nabesilisa.

Ukwelapha i-ductal carcinoma engafuneki

Uma wena noma othile omaziyo etholwe ene-IDC, qiniseka ukuthi kunezinhlobo eziningi zokwelashwa ezitholakalayo.

Imithi yokwelashwa ye-IDC iwela ezinhlotsheni ezimbili eziyinhloko:

• Ukwelashwa kwasendaweni kwe-IDC kuhlose izicubu zomdlavuza webele nezindawo ezizungezile, njengesifuba nama-lymph node.
• Ukwelashwa okuhleliwe kwe-IDC kusetshenziswa kuwo wonke umzimba, kubhekiswe kunoma yimaphi amaseli okungenzeka ukuthi ahambile futhi asakazeka avela ku-tumor yokuqala. Imithi yokwelashwa iyasebenza ekwehliseni amathuba okuthi umdlavuza ubuye uma usuphethwe.

Ukwelashwa kwasendaweni

Kunezinhlobo ezimbili eziyinhloko zokwelashwa kwasendaweni kwe-IDC: ukuhlinzwa nokwelashwa ngemisebe.

Ukuhlinzwa kusetshenziselwa ukususa isimila somdlavuza futhi kunqume ukuthi umdlavuza ususabalele yini kuma-lymph node. Ukuhlinzwa ngokujwayelekile kuyimpendulo yokuqala kadokotela lapho esebenza ne-IDC.

Kuthatha cishe amasonto amabili ukwelulama ku-lumpectomy namasonto amane noma ngaphezulu ukuthola ku-mastectomy. Izikhathi zokutakula zingaba zinde uma ama-lymph node esusiwe, uma kwakhiwa kabusha, noma uma kunezinkinga ezithile.

Kwesinye isikhathi ukwelashwa ngokomzimba kunganconywa ukusiza ngokululama kulezi zinqubo.

Ukwelashwa ngemisebe kuqondisa imishayo yemisebe enamandla esifubeni, esifubeni, ekhwapheni, noma ethangeni lokubulala noma yimaphi amaseli okungenzeka asendaweni noma eduze kwalesi sifo. Ukwelashwa ngemisebe kuthatha cishe imizuzu eyi-10 ukuphatha nsuku zonke phakathi kwamasonto amahlanu kuya kwayisishiyagalombili.

Abanye abantu abaphathwa ngemisebe bangathola ukuvuvukala noma ukushintsha kwesikhumba. Izimpawu ezithile, njengokukhathala, zingathatha amasonto ayisithupha kuya kwayishumi nambili noma ngaphezulu ukwehla.

Izinhlobo ezahlukene zokuhlinzwa nezindlela zokwelapha ngemisebe ezitholakalayo zokwelapha le-IDC zifaka:

• i-lumpectomy, noma ukususwa kwesimila
• i-mastectomy, noma ukukhishwa kwebele
• i-lymph node dissection nokususwa
• imisebe engaphandle, lapho imishayo yemisebe igxila kuyo yonke indawo yebele
• imisebe yangaphakathi yebele, lapho kufakwa khona izinto ezinemisebe eduzane nesiza se-lumpectomy
• imisebe yangaphandle yesifuba esinqunyiwe, lapho imishayo yemisebe ikhomba ngqo indawo yokuqala yomdlavuza

Ukwelashwa okuhlelekile

Ukwelashwa okuhleliwe kunganconywa ngokuya ngezici zomdlavuza, kufaka phakathi ezimeni lapho usuvele usabalele ngaphesheya kwesifuba noma usengozini enkulu yokusabalala kwezinye izingxenye zomzimba.

Ukwelashwa okuhleliwe okunjalo ngamakhemikhali kunganikezwa ukunciphisa izicubu ngaphambi kokuhlinzwa, noma kunganikezwa ngemuva kokuhlinzwa, ngokuya ngesimo.

Izindlela zokwelashwa ze-IDC zifaka:

• ukwelashwa ngamakhemikhali
• ukwelashwa kwe-hormonal
• izindlela zokwelashwa eziqondisiwe

I-Chemotherapy ye-ductal carcinoma engahlaseli

I-Chemotherapy inemithi elwa nomdlavuza ethathwa ifomu lephilisi noma ifakwa egazini. Kungathatha izinyanga eziyisithupha noma ngaphezulu ngemuva kokuba ukwelashwa sekwehlile ukuze welulame emiphumeleni emibi eminingi, njengokulimala kwemizwa, ubuhlungu bamalunga, nokukhathala.

Kunezinhlobo eziningi zemithi yokwelapha ngamakhemikhali yokwelapha i-ICD efana ne-paclitaxel (Taxol) ne-doxorubicin (Adriamycin). Khuluma nodokotela wakho mayelana nokuthi yini ekufanele.

Ukwelashwa kwe-Hormonal ye-carcinoma ehlaselayo ye-ductal

Ukwelashwa kweHormonal kusetshenziselwa ukwelapha amangqamuzana omdlavuza ngama-receptors we-estrogen noma i-progesterone, noma womabili. Ukuba khona kwala mahomoni kungakhuthaza amangqamuzana omdlavuza webele ukuthi ande.

Ukwelashwa kwehormonal kususa noma kuvimbe la mahomoni ukusiza ukuvimbela umdlavuza ekukhuleni. Ukwelashwa kwe-Hormonal kungaba nemiphumela engemihle engafaka phakathi ukushisa nokukhathala, nokuthi kuthatha isikhathi esingakanani ukuthi imiphumela engemihle yehle ngemuva kokuqeda ukwelashwa kungahluka ngokuya ngomuthi nobude bokuphatha.

Eminye imishanguzo yokwelashwa kwamahomoni ithathwa njalo iminyaka emihlanu noma ngaphezulu. Imiphumela emibi ingathatha noma kuphi ukusuka ezinyangeni ezimbalwa kuya onyakeni noma ngaphezulu ukucisha uma ukwelashwa kumile.

Izinhlobo zokwelashwa kwamahomoni zifaka:

• ama-modulators we-estrogen-receptor reaction, avimba umphumela we-estrogen ebeleni
• ama-aromatase inhibitors, anciphisa i-estrogen kwabesifazane abalandela ukuya esikhathini
• ama-estrogen-receptor down-regulators, anciphisa ama-estrogen receptors atholakalayo
• imishanguzo yokucindezela ama-ovari, emisa okwesikhashana ama-ovari ekukhiqizeni i-estrogen

Izindlela zokwelashwa ezihlosiwe

Izindlela zokwelashwa ezihlosiwe zisetshenziselwa ukubhubhisa amangqamuzana omdlavuza webele ngokuphazamisa amaprotheni athile ngaphakathi kweseli athinta ukukhula. Amaprotheni athile ahlosiwe yile:

• HER2
• I-VEGF

Ukuthatha

I-ductal carcinoma ehlaselayo uhlobo oluvame kakhulu lomdlavuza webele. Uma kukhulunywa ngokwelashwa, kunezindlela zokwelapha zasendaweni ezikhomba izingxenye ezithile zomzimba kanye nezindlela zokwelapha ezithinta umzimba wonke noma amasistimu amaningi omzimba.

Izinhlobo ezingaphezu kweyodwa zokwelashwa zingadingeka ukwelapha ngempumelelo umdlavuza webele. Khuluma nodokotela wakho ngohlobo lwezokwelapha olulungele wena nokuthi yini efanele isigaba sakho somdlavuza webele.