Umdlavuza Wesibindi

-Delile

• Uyini umdlavuza wesibindi?
• Yiziphi izinhlobo ezahlukahlukene zomdlavuza wesibindi oyinhloko?
• I-hepatocellular carcinoma
• I-Cholangiocarcinoma
• Isibindi angiosarcoma
• I-hepatoblastoma
• Ziyini izimpawu zomdlavuza wesibindi?
• Ngubani osengozini yomdlavuza wesibindi?
• Utholakala kanjani umdlavuza wesibindi?
• I-biopsy yesibindi
• Uphathwa kanjani umdlavuza wesibindi?
• I-hepatectomy
• Ukufakelwa kwesibindi
• Ukususwa kwemali
• Ukwelashwa ngamakhemikhali
• Ukwelashwa ngemisebe
• Ukwelashwa okuhlosiwe
• Ukuhlanganiswa kanye ne-chemoembolization
• Ungavinjelwa kanjani umdlavuza wesibindi?
• Thola umuthi wokugoma i-hepatitis B
• Thatha izinyathelo zokuvimbela i-hepatitis C
• Nciphisa ubungozi bokuqina kwesibindi
• Phuza kuphela utshwala ngokulinganisela
• Gcina isisindo esinempilo
• Ukubhekana nomdlavuza wesibindi

Izithombe zeCavan / i-Getty Izithombe

Uyini umdlavuza wesibindi?

Umdlavuza wesibindi wumdlavuza owenzeka esibindini. Isibindi isitho esiyindlala esikhulu kunazo zonke emzimbeni futhi senza imisebenzi ehlukahlukene ebucayi ukugcina umzimba ungenabo ubuthi nezinto eziyingozi.

Isibindi sitholakala engxenyeni engakwesokudla ephezulu yesisu, ngaphansi kwezimbambo. Inesibopho sokukhiqiza i-bile, okuyinto ekusiza ukuthi ugaye amafutha, amavithamini, nezinye izakhamzimba.

Lesi sitho esibalulekile futhi sigcina izakhamzimba ezinjenge-glucose, ukuze uhlale wondlekile ngezikhathi lapho ungadli khona. Iphinde iphule imithi kanye nobuthi.

Lapho umdlavuza uvela esibindini, ubhubhisa amangqamuzana wesibindi futhi uphazamise amandla esibindi okusebenza kahle.

Umdlavuza wesibindi ngokuvamile uhlukaniswa njengowokuqala noma wesibili. Umdlavuza wesibindi oyinhloko uqala kumaseli wesibindi. Umdlavuza wesibindi wesibili ukhula lapho amangqamuzana omdlavuza avela kwesinye isitho esakazeka esibindi.

Ngokungafani namanye amaseli emzimbeni, amangqamuzana omdlavuza angaqhamuka esizeni sokuqala, noma lapho umdlavuza waqala khona.

Amaseli ahambela ezinye izindawo zomzimba ngegazi noma ngohlelo lwe-lymphatic. Amaseli womdlavuza ekugcineni aqoqa kwesinye isitho somzimba bese eqala ukukhula lapho.

Lo mbhalo ugxile kumdlavuza oyinhloko wesibindi. Uma unomdlavuza kwesinye isitho ngaphambi kokuba ube nomdlavuza wesibindi, sicela ubheke i-athikili yethu mayelana ne-metastasis yesibindi ukuze ufunde kabanzi ngomdlavuza wesibindi wesibili.

Yiziphi izinhlobo ezahlukahlukene zomdlavuza wesibindi oyinhloko?

Izinhlobo ezahlukahlukene zomdlavuza oyinhloko wesibindi zivela kumaseli ahlukahlukene akha isibindi. Umdlavuza wesibindi oyinhloko ungaqala njengesigaxa esisodwa esikhulayo esibindi, noma ungaqala ezindaweni eziningi ngaphakathi kwesibindi ngasikhathi sinye.

Abantu abanokulimala okukhulu kwesibindi kungenzeka babe nezindawo eziningi zokukhula komdlavuza. Izinhlobo eziyinhloko zomdlavuza oyinhloko wesibindi yilezi:

I-hepatocellular carcinoma

I-Hepatocellular carcinoma (HCC), eyaziwa nangokuthi i-hepatoma, uhlobo oluvame kakhulu lomdlavuza wesibindi, olubala amaphesenti angama-75 awo wonke umdlavuza wesibindi.

Lesi simo sikhula kuma-hepatocyte, okuyizakhi zeseli ezivelele. Ingasakazeka isuke esibindini iye kwezinye izingxenye zomzimba, njengamanyikwe, amathumbu nesisu.

I-HCC kungenzeka kakhulu ukuthi yenzeke kubantu abanokulimala okukhulu kwesibindi ngenxa yokusebenzisa kabi utshwala.

I-Cholangiocarcinoma

I-Cholangiocarcinoma, eyaziwa kakhulu njengomdlavuza we-bile duct, iqala emibhobho emincane, efana neyeshubhu efana nesibindi esisesibindi. La mapayipi athwala inyongo ayiyise enyameni ukuze isize ekugayeni ukudla.

Lapho umdlavuza uqala engxenyeni yamapayipi angaphakathi kwesibindi, ubizwa ngokuthi yi-intrahepatic bile duct cancer. Lapho umdlavuza uqala engxenyeni yamapayipi angaphandle kwesibindi, ubizwa ngokuthi yi-extrahepatic bile duct cancer.

Umdlavuza we-Bile udala cishe amaphesenti ayi-10 kuye kwangama-20 awo wonke umdlavuza wesibindi.

Isibindi angiosarcoma

I-angiosarcoma yesibindi iyindlela engajwayelekile yomdlavuza wesibindi oqala emithanjeni yegazi yesibindi. Lolu hlobo lomdlavuza luvame ukuthuthuka ngokushesha okukhulu, ngakho-ke lutholakala ngokujwayelekile esigabeni esithuthuke kakhulu.

I-hepatoblastoma

I-Hepatoblastoma uhlobo olungavamile kakhulu lomdlavuza wesibindi. Cishe itholakala njalo ezinganeni, ikakhulukazi lezo ezingaphansi kweminyaka emithathu.

Ngokuhlinzwa nokwelashwa ngamakhemikhali, umbono wabantu abanalolu hlobo lomdlavuza ungaba muhle kakhulu. Lapho kutholakala i-hepatoblastoma kusaqalwa, izinga lokusinda liphakeme kunamaphesenti angama-90.

Ziyini izimpawu zomdlavuza wesibindi?

Abantu abaningi abazitholi izimpawu ezigabeni zokuqala zomdlavuza oyinhloko wesibindi. Lapho izimpawu zivela, zingafaka:

• ukungakhululeki esiswini, ubuhlungu nobumnene
• ukuphuzi kwesikhumba nabamhlophe bamehlo, okubizwa nge-jaundice
• ezimhlophe, izitulo ezi-chalky
• isicanucanu
• ukuhlanza
• ukulimaza noma ukopha kalula
• ubuthakathaka
• ukukhathala

Ngubani osengozini yomdlavuza wesibindi?

Odokotela abaqiniseki ukuthi kungani abanye abantu bethola umdlavuza wesibindi kanti abanye abawutholi. Kodwa-ke, kunezici ezithile ezaziwa ukwanda kwengozi yokuba nomdlavuza wesibindi:

• Umdlavuza wesibindi uvame kakhulu kubantu abangaphezu kweminyaka engama-50.
• Ukutheleleka isikhathi eside kwesifo sokusha kwesibindi kohlobo B noma C kungasilimaza kakhulu isibindi sakho. I-hepatitis isakazeka isuka kumuntu iye komunye umuntu ngokuthinta ngqo uketshezi lomzimba lomuntu onegciwane, njengegazi labo noma isidoda. Kungaphinde kudluliselwe kusuka kumama kuye enganeni ngesikhathi sokubeletha. Unganciphisa ubungozi be-hepatitis B no-C ngokusebenzisa ukuvikelwa ngesikhathi sokuya ocansini. Kukhona nomuthi wokugoma ongakuvikela ku-hepatitis B.
• Ukuba neziphuzo ezidakayo ezimbili noma ngaphezulu nsuku zonke eminyakeni eminingi kwandisa ingozi yokuba nomdlavuza wesibindi.
• I-Cirrhosis iyindlela yokulimala kwesibindi lapho izicubu ezinempilo zithathelwa indawo izicubu ezinesibazi. Isibindi esinesibazi asikwazi ukusebenza kahle futhi ekugcineni singaholela ezinkingeni eziningi, kufaka phakathi umdlavuza wesibindi. Ukuphuza ngokweqile isikhathi eside kanye ne-hepatitis C yizimbangela ezivame kakhulu zesifo sokuqina kwesibindi e-United States. Iningi labantu baseMelika abanomdlavuza wesibindi bane-cirrhosis ngaphambi kokuba babe nomdlavuza wesibindi.
• Ukuvezwa kwe-aflatoxin kuyingozi. I-Aflatoxin iyinto enobuthi ekhiqizwa uhlobo lwesikhunta olungakhula kumakinati, okusanhlamvu nasemmbileni. E-United States, imithetho yokuphathwa kokudla inciphisa ukutholakala okubanzi kwe-aflatoxin. Ngaphandle kwezwe, ukuvezwa kwe-aflatoxin kungaba phezulu.
• Isifo sikashukela nokukhuluphala nakho kuyizinto eziyingozi. Abantu abanesifo sikashukela bavame ukukhuluphala ngokweqile noma ukukhuluphala, okungadala izinkinga zesibindi futhi kwandise ingozi yomdlavuza wesibindi.

Utholakala kanjani umdlavuza wesibindi?

Ukuxilongwa komdlavuza wesibindi kuqala ngomlando wezokwelapha kanye nokuhlolwa komzimba. Qiniseka ukuthi utshela udokotela wakho uma unomlando wokusebenzisa kabi utshwala isikhathi eside noma ukutheleleka okungapheli kwe-hepatitis B noma C.

Ukuhlolwa kokuxilongwa kanye nezinqubo zomdlavuza wesibindi kufaka lokhu okulandelayo:

• Ukuhlolwa kokusebenza kwesibindi kusiza udokotela wakho ukuthi anqume impilo yesibindi sakho ngokulinganisa amazinga wamaprotheni, ama-enzyme wesibindi, kanye ne-bilirubin egazini lakho.
• Ukuba khona kwe-alpha-fetoprotein (AFP) egazini kungaba uphawu lomdlavuza wesibindi. Le phrotheni ivame ukukhiqizwa kuphela esibindini nasesikhuphwini sezingane ngaphambi kokuba zizalwe. Ukukhiqizwa kwe-AFP kuvamisile ukuma ngemuva kokuzalwa.
• Iskena se-CT noma iMRI esiswini sikhiqiza izithombe ezinemininingwane yesibindi nezinye izitho esiswini. Bangavumela udokotela wakho ukuthi akhombe lapho kutholakala khona isimila, anqume ubukhulu baso, futhi ahlole ukuthi asinabele yini kwezinye izitho.

I-biopsy yesibindi

Olunye uvivinyo lokuxilonga olutholakalayo yi-biopsy yesibindi. I-biopsy yesibindi ihilela ukususa isiqeshana esincane sezicubu zesibindi. Kwenziwa njalo kusetshenziswa i-anesthesia ukuvimbela ukuthi ungabuzwa ubuhlungu ngesikhathi senqubo.

Ezimweni eziningi, kwenziwa i-biopsy yenaliti. Phakathi nale nqubo, udokotela wakho uzofaka inaliti encane esiswini sakho nasesibindi sakho ukuthola isampula lezicubu. Isampula bese ihlolwa ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.

I-biopsy yesibindi nayo ingenziwa kusetshenziswa i-laparoscope, eyishubhu ezacile, eguquguqukayo enekhamera enamathiselwe. Ikhamera ivumela udokotela wakho ukuthi abone ukuthi isibindi sibukeka kanjani nokuthi enze i-biopsy enembile.

I-laparoscope ifakwa ngokusika okuncane esiswini. Uma kudingeka amasampula wezicubu ezivela kwezinye izitho, udokotela wakho uzokwenza imbobo enkulu. Lokhu kubizwa ngokuthi yi-laparotomy.

Uma umdlavuza wesibindi utholakala, udokotela wakho uzonquma isigaba somdlavuza. Isiteji sichaza ubunzima noma ubukhulu bomdlavuza. Kungasiza udokotela wakho ukunquma izinketho zakho zokwelashwa nombono wakho. Isigaba 4 yisigaba esithuthuke kakhulu somdlavuza wesibindi.

Uphathwa kanjani umdlavuza wesibindi?

Ukwelashwa komdlavuza wesibindi kuyahlukahluka. Kuya nge:

• inani, usayizi, nendawo yamathumba esibindi
• ukuthi isibindi sisebenza kahle kanjani
• noma ngabe i-cirrhosis ikhona
• ngabe isimila sesisabalalele yini kwezinye izitho

Uhlelo lwakho lokwelashwa oluthile luzosuselwa kulezi zinto. Ukwelashwa komdlavuza wesibindi kungafaka okulandelayo:

I-hepatectomy

I-hepatectomy yenziwa ukususa ingxenye ethile yesibindi noma sonke isibindi. Lokhu kuhlinzwa kuvame ukwenziwa lapho umdlavuza ugcinwe esibindini. Ngokuhamba kwesikhathi, izicubu ezinempilo ezisele zizokhula kabusha bese zithatha ingxenye elahlekile.

Ukufakelwa kwesibindi

Ukufakelwa kwesibindi kuhilela ukufaka sonke isibindi esinezifo ngesibindi esinempilo esivela kumnikeli ofanele. Ukufakelwa kungenziwa kuphela uma umdlavuza ungakasakazeki kwezinye izitho. Imithi yokuvikela ukwenqatshwa inikezwa ngemuva kokufakelwa kabusha.

Ukususwa kwemali

I-Ablation ifaka ukusetshenziswa komjovo wokushisa noma we-ethanol ukuqeda amangqamuzana omdlavuza. Kwenziwa kusetshenziswa i-anesthesia yendawo. Lokhu kufiphaza indawo ukukuvimbela ekubeni uzwe ubuhlungu. I-Ablation ingasiza abantu abangavotelwa ukuhlinzwa noma ukufakelwa.

Ukwelashwa ngamakhemikhali

I-Chemotherapy iyindlela enolaka yokwelashwa kwezidakamizwa ebulala amangqamuzana omdlavuza. Imithi ijojowe ngemithambo, noma ngomthambo. Ezimweni eziningi, i-chemotherapy inganikezwa njengokwelashwa kweziguli.

I-Chemotherapy ingasebenza ekwelapheni umdlavuza wesibindi, kepha abantu abaningi baba nemiphumela engemihle ngesikhathi sokwelashwa, kufaka phakathi ukuhlanza, ukuncipha kwesifiso sokudla, nokubanda. I-Chemotherapy ingakhuphula nobungozi bokutheleleka.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe kuhilela ukusetshenziswa kwemishayo yamandla emisebe ephezulu ukubulala amangqamuzana omdlavuza. Ingalethwa ngemisebe yangaphandle yesigxobo noma ngemisebe yangaphakathi.

Kumisebe yegongolo yangaphandle, imisebe ibhekiswe esiswini nasesifubeni. Imisebe yangaphakathi ifaka phakathi ukusebenzisa ipayipi lokufaka umjovo ukuze kufakelwe imisebe emincane emisebeni ye-hepatic.

Imisebe bese ibulala umthambo we-hepatic, umthambo wegazi onikeza igazi esibindini. Lokhu kunciphisa inani legazi eligeleza ku-tumor. Lapho umthambo we-hepatic uvaliwe, umthambo we-portal uyaqhubeka nokondla isibindi.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe kubandakanya ukusetshenziswa kwemithi eyenzelwe ukushaya amangqamuzana omdlavuza lapho esengozini khona. Zinciphisa ukukhula kwesimila futhi zisize ukuvala ukunikezwa kwegazi kulesimila.

I-Sorafenib (Nexavar) ivunyelwe njengokwelashwa okubhekiswe kubantu abanomdlavuza wesibindi. Ukwelashwa okuhlosiwe kungasiza kubantu abangabhaliselwa ukufakelwa i-hepatectomy noma ukufakelwa kwesibindi.

Ukwelashwa okuhlosiwe, noma kunjalo, kungaba nemiphumela emibi kakhulu.

Ukuhlanganiswa kanye ne-chemoembolization

Ukuhlanganiswa kanye ne-chemoembolization kuyizinqubo zokuhlinzwa. Sekwenziwe ukuvimba umthambo we-hepatic. Udokotela wakho uzosebenzisa izipanji ezincane noma ezinye izinhlayiya ukwenza lokhu. Lokhu kunciphisa inani legazi eligelezela esihlahleni.

E-chemoembolization, udokotela wakho ujova izidakamizwa ze-chemotherapy emthanjeni we-hepatic ngaphambi kokuba izinhlayiya zijojowe. Ukuvinjelwa okwenziwe kugcina imishanguzo ye-chemotherapy esibindi isikhathi eside.

Ungavinjelwa kanjani umdlavuza wesibindi?

Umdlavuza wesibindi awukwazi ukuvinjelwa ngaso sonke isikhathi. Kodwa-ke, unciphisa ingozi yokuba nomdlavuza wesibindi ngokuthatha izinyathelo zokuvimbela ukuthuthukiswa kwezimo ezingaholela kumdlavuza wesibindi.

Thola umuthi wokugoma i-hepatitis B

Kunomuthi wokugomela i-hepatitis B okufanele zonke izingane uzithole. Abantu abadala abasengozini enkulu yokutheleleka (njengalabo abasebenzisa kabi imithambo yegazi) nabo kufanele bagonywe.

Ukugoma kuvamise ukunikezwa ngochungechunge lwemijovo emithathu esikhathini esiyizinyanga eziyisithupha.

Thatha izinyathelo zokuvimbela i-hepatitis C

Awukho umuthi wokugomela i-hepatitis C, kepha unganciphisa ubungozi bokuthola ukutheleleka ngokwenza okulandelayo:

• Sebenzisa ukuvikelwa. Njalo yenza ucansi oluphephile ngokusebenzisa ikhondomu nabo bonke abantu ozibandakanya nabo ocansini. Akufanele neze uhlanganyele ocansini olungaphephile ngaphandle kokuthi uqinisekile ukuthi umlingani wakho akangenwe yi-hepatitis noma olunye ugculazi oludluliselwa ngocansi.
• Ungasebenzisi izidakamizwa ezingekho emthethweni. Gwema ukusebenzisa izidakamizwa ezingekho emthethweni, ikakhulukazi lezo ezingafakwa, njenge-heroin noma i-cocaine. Uma ungakwazi ukuyeka ukusebenzisa izidakamizwa, qiniseka ukuthi usebenzisa inaliti eyinyumba njalo uma uzijova. Ungalokothi wabelane ngezinaliti nabanye abantu.
• Qaphela ama-tattoo nokubhoboza umzimba. Iya esitolo esithembekile noma nini lapho uthola ukubhoboza noma ukudweba umzimba. Buza abasebenzi ngemikhuba yabo yokuphepha futhi uqiniseke ukuthi basebenzisa izinaliti eziyinyumba.

Nciphisa ubungozi bokuqina kwesibindi

Unganciphisa ubungozi be-cirrhosis ngokwenza okulandelayo:

Phuza kuphela utshwala ngokulinganisela

Ukunciphisa inani lotshwala obuphuzayo kungasiza ekuvimbeleni ukulimala kwesibindi. Abesifazane akufanele baphuze isiphuzo esingaphezu kwesisodwa ngosuku, futhi abesilisa akufanele baphuze iziphuzo ezingaphezu kwezimbili ngosuku.

Gcina isisindo esinempilo

Ukuzivocavoca imizuzu engama-30 okungenani kathathu ngeviki kungakusiza ugcine isisindo sakho.

Ukudla ukudla okunomsoco kubalulekile ekuphathweni kwesisindo. Qiniseka ukuthi ufaka amaprotheni anciphile, okusanhlamvu okuphelele, nemifino noma izithelo ekudleni kwakho okuningi.

Uma udinga ukunciphisa umzimba, khulisa inani lokuzivocavoca okwenzayo usuku ngalunye futhi wehlise inani lama-calories owadlayo.

Ungase futhi uthande ukucabangela ukuhlangana nesazi sokudla. Bangakusiza ukuthi wakhe uhlelo lokudla nokuzivocavoca umzimba okukuvumela ukuthi ufeze izinhloso zakho zokwehlisa isisindo ngokushesha okukhulu.

Uma usuvele unenye yalezi zimo futhi ukhathazekile ngengozi yomdlavuza wesibindi, khuluma nodokotela wakho ngokuhlolwa komdlavuza wesibindi.

Ukubhekana nomdlavuza wesibindi

Ukuxilongwa komdlavuza wesibindi kungaba nzima kakhulu. Kubalulekile ukuba nenethiwekhi yokusekela eqinile engakusiza ukubhekana nanoma yikuphi ukucindezeleka noma ukukhathazeka okungenzeka ukuthi uzizwa.

Ungahle uthande ukubona umeluleki ongakusiza ubhekane nemizwa yakho. Ungahle uthande ukucabanga ngokujoyina iqembu elisekela umdlavuza lapho ungaxoxa khona ngokukhathazeka kwakho nabanye abangakwazi ukuqondana nalokho obhekene nakho.

Buza udokotela wakho ngamaqembu okusekela endaweni yangakini. Ungathola futhi imininingwane ngamaqembu okusekela kumawebhusayithi e-American Cancer Society.