Ziyini Izimpawu Zokuqala Zomdlavuza We-Ovarian futhi Uzibona Kanjani?

-Delile

• Uyini umdlavuza we-ovari?
• Ziyini izimpawu zokuqala zomdlavuza we-ovari?
• Izinhlobo zomdlavuza we-ovari
• Ama-cysts ama-ovari
• Izici zobungozi zomdlavuza we-ovari
• Utholakala kanjani umdlavuza we-ovari?
• Ziyini izigaba zomdlavuza we-ovari?
• Isigaba 1
• Isigaba 2
• Isigaba 3
• Isigaba 4
• Uphathwa kanjani umdlavuza we-ovari
• Ukuhlinzwa
• Ukwelashwa okuhlosiwe
• Ukulondolozwa kokuzala
• Ucwaningo kanye nezifundo zomdlavuza we-Ovarian
• Ingabe umdlavuza we-ovari ungavinjelwa?
• Uyini umbono?
• Izinga lokusinda
• Izilinganiso zeminyaka emihlanu yokusinda komdlavuza we-ovari

Ama-ovari yizindlala ezimbili zokuzala ezikhiqiza i-ova, noma amaqanda. Futhi bakhiqiza ama-hormone abesifazane i-estrogen ne-progesterone.

Cishe abesifazane abangama-21,750 e-United States bazothola ukuxilongwa komdlavuza we-ovari ngo-2020, futhi cishe abesifazane abayi-14,000 bazofa ngakho.

Kulesi sihloko uzothola imininingwane ngomdlavuza we-ovari kufaka phakathi:

• izimpawu
• izinhlobo
• izingozi
• ukuxilongwa
• izigaba
• ukwelashwa
• ucwaningo
• amazinga okusinda

Uyini umdlavuza we-ovari?

Umdlavuza we-Ovarian kulapho amaseli angajwayelekile esibelethweni eqala ukwanda ngaphandle kolawulo bese enza isimila. Uma iyekwa ingelashwa, isimila singadlulela nakwezinye izingxenye zomzimba. Lokhu kubizwa ngokuthi umdlavuza we-ovarian metastatic.

Umdlavuza we-Ovarian uvame ukuba nezimpawu zokuxwayisa, kepha izimpawu zokuqala azicaci futhi kulula ukuzichitha. Kutholwe amaphesenti angamashumi amabili omdlavuza we-ovari kusenesikhathi.

Ziyini izimpawu zokuqala zomdlavuza we-ovari?

Kulula ukungazinaki izimpawu zokuqala zomdlavuza wesibeletho ngoba ziyefana nezinye izifo ezivamile noma zivame ukuza zidlule. Izimpawu zokuqala zifaka:

• ukuqunjelwa esiswini, ingcindezi nobuhlungu
• ukusutha okungavamile ngemuva kokudla
• ubunzima bokudla
• ukwanda kokuchama
• isifiso esengeziwe sokuchama

Umdlavuza we-Ovarian ungadala nezinye izimpawu, njenge:

• ukukhathala
• ukugaya ukudla
• isilungulela
• ukuqunjelwa
• ukuhlungu obusemhlane
• ukungahambi kahle esikhathini
• ucansi olubuhlungu
• I-dermatomyositis (isifo esingajwayelekile sokuvuvukala esingadala ukuqubuka kwesikhumba, ubuthakathaka bemisipha, kanye nemisipha evuvukele)

Lezi zimpawu zingavela nganoma yisiphi isibalo sezizathu. Akunjalo ngempela ngenxa yomdlavuza we-ovari. Abesifazane abaningi banezinye zalezi zinkinga ngasikhathi sinye.

Lezi zinhlobo zezimpawu zivame ukuba zesikhashana futhi ziphendule ekwelashweni okulula ezimweni eziningi.

Izimpawu zizoqhubeka uma zibangelwa umdlavuza we-ovari. Izimpawu zivame ukuba nzima kakhulu njengoba isimila sikhula. Ngalesi sikhathi, umdlavuza uvame ukusabalala ngaphandle kwama-ovari, okwenza kube nzima kakhulu ukwelashwa ngempumelelo.

Futhi, umdlavuza welashwa kangcono lapho utholwa kusenesikhathi. Sicela ubonane nodokotela wakho uma uhlangabezana nezimpawu ezintsha nezingavamile.

Izinhlobo zomdlavuza we-ovari

Ama-ovari akhiwa izinhlobo ezintathu zamaseli. Iseli ngalinye lingakhula libe uhlobo oluhlukile lwesimila:

• Izimila ze-Epithelial ifomu kusendlalelo sezicubu ngaphandle kwamaqanda. Cishe amaphesenti angama-90 omdlavuza we-ovari yizicubu ze-epithelial.
• Izicubu ezinamandla zikhula kumaseli akhiqiza ama-hormone. Amaphesenti ayisikhombisa omdlavuza we-ovari yizicubu zomzimba.
• Izimila zamangqamuzana egciwane zikhula kumaseli akhiqiza amaqanda. Izimila zamangqamuzana egciwane azivamile.

Ama-cysts ama-ovari

Ama-cysts amaningi ama-ovari awunawo umdlavuza. Lezi zibizwa ngokuthi ama-cyst benign. Kodwa-ke, inani elincane kakhulu lingaba nomdlavuza.

I-ovarian cyst iqoqo loketshezi noma lomoya okhula ngaphakathi noma eduze kwesibeletho. Ama-cysts amaningi ama-ovari akha njengengxenye ejwayelekile ye-ovulation, okuyilapho i-ovary ikhipha iqanda. Imvamisa zibangela izimpawu ezimnene, njengokuqunjelwa, futhi zihambe ngaphandle kokwelashwa.

Ama-cysts akhathaza kakhulu uma ungavuthisi amaqanda. Abesifazane bayeka ukuphuma kwamaqanda ngemuva kokuya esikhathini. Uma ifomu le-ovarian cyst ngemuva kokunqamuka kokuya esikhathini, udokotela wakho angafuna ukwenza izivivinyo eziningi ukuthola imbangela ye-cyst, ikakhulukazi uma inkulu noma ingahambi ezinyangeni ezimbalwa.

Uma i-cyst ingapheli, udokotela wakho angancoma ukuhlinzwa ukuze kususwe uma kungenzeka. Udokotela wakho akakwazi ukuthola ukuthi unomdlavuza yini aze awususe ngokuhlinzwa.

Izici zobungozi zomdlavuza we-ovari

Imbangela ngqo yomdlavuza wesibeletho ayaziwa. Noma kunjalo, lezi zinto zingakhuphula ubungozi bakho:

• umlando womndeni womdlavuza we-ovari
• ukuguquka kwezakhi zofuzo ezihambisana nomdlavuza we-ovari, njenge I-BRCA1 noma I-BRCA2
• umlando wakho womdlavuza webele, wesibeletho, noma wekoloni
• ukukhuluphala ngokweqile
• ukusetshenziswa kwemithi ethile yokuzala noma yokwelashwa kwamahomoni
• awukho umlando wokukhulelwa
• i-endometriosis

Ukuguga kungenye ingozi. Amacala amaningi omdlavuza we-ovari akhula ngemuva kokuya esikhathini.

Kungenzeka ube nomdlavuza we-ovari ngaphandle kokuba nalezi zinto ezinobungozi. Ngokunjalo, ukuba nezinye zalezi zinto eziyingozi akusho ukuthi uzoba nomdlavuza we-ovari.

Utholakala kanjani umdlavuza we-ovari?

Kulula kakhulu ukwelapha umdlavuza we-ovari lapho udokotela wakho ewuthola usaqala. Kodwa-ke, akulula ukuthola.

Amaqanda akho atholakala ekujuleni kwesisu, ngakho-ke akunakwenzeka ukuthi uzwe isimila. Akunakho ukuhlolwa okujwayelekile kokuxilongwa okutholakalayo komdlavuza we-ovari. Yingakho kubaluleke kakhulu kuwe ukuthi ubike izimpawu ezingavamile noma eziphikelelayo kudokotela wakho.

Uma udokotela wakho ekhathazekile ukuthi unomdlavuza we-ovari, cishe bazoncoma ukuhlolwa kwe-pelvic. Ukwenza ukuhlolwa kwe-pelvic kungasiza udokotela wakho ukuthola okungahambi kahle, kepha izicubu ezincane zama-ovari kunzima ukuzizwa.

Njengoba isimila sikhula, sicindezela isinye kanye nengxenyeni. Udokotela wakho angakwazi ukuthola okungahambi kahle ngesikhathi sokuhlolwa kwe-pelvic pelvic.

Udokotela wakho angenza lezi zivivinyo ezilandelayo:

• I-Transvaginal ultrasound (TVUS). I-TVUS uhlobo lokuhlolwa kwe-imaging olusebenzisa amaza omsindo ukuthola izicubu ezithweni zokuzala, kufaka phakathi ama-ovari. Kodwa-ke, i-TVUS ayikwazi ukusiza udokotela wakho ukuthi anqume ukuthi izicubu zinomdlavuza yini.
• Isisu se-CT esiswini nasesiswini. Uma uxabana nodayi, banga-oda ukuskena kwe-MRI okhalo.
• Ukuhlolwa kwegazi ukukala amazinga omdlavuza we-antigen 125 (CA-125). Ukuhlolwa kwe-CA-125 yi-biomarker esetshenziselwa ukuhlola impendulo yokwelashwa komdlavuza we-ovari kanye neminye imidlavuza yesitho sokuzala. Kodwa-ke, ukuya esikhathini, i-uterine fibroids, nomdlavuza wesibeletho nakho kungathinta amazinga e-CA-125 egazini.
• Isidumbu. I-biopsy ifaka phakathi ukususa isampula elincane lezicubu esibelethweni nokuhlaziya isampula ngaphansi kwesibonakhulu.

Kubalulekile ukuthi wazi ukuthi, yize konke lokhu kuhlolwa kungasiza ukuqondisa udokotela wakho ekuhloleni isifo, i-biopsy ukuphela kwendlela udokotela wakho angaqinisekisa ngayo ukuthi unomdlavuza we-ovari.

Ziyini izigaba zomdlavuza we-ovari?

Udokotela wakho unquma isigaba ngokuya ngokuthi umdlavuza usakaze kangakanani. Kunezigaba ezine, futhi isigaba ngasinye sinezindawo ezingaphansi:

Isigaba 1

Umdlavuza wesigaba 1 se-ovari unezindawo ezintathu:

• Isigaba 1A.Umdlavuza ulinganiselwe, noma ubekwe endaweni ethile, esibelethweni esisodwa.
• Isigaba 1B. Umdlavuza ukuwona womabili amaqanda.
• Isigaba 1C. Kukhona namaseli womdlavuza ngaphandle kwe-ovary.

Isigaba 2

Esigabeni 2, isimila sesisabalalele kwezinye izakhiwo ze-pelvic. Inezikhala ezimbili:

• Isigaba 2A. Umdlavuza ususabalele esibelethweni noma kumashubhu e-fallopian.
• Isigaba 2B. Umdlavuza ususabalele esinyeni noma engxenyeni.

Isigaba 3

Isigaba 3 Umdlavuza we-ovari unezigaba ezingaphansi ezintathu:

• Isigaba 3A. Umdlavuza usabalale ngemicroscopic ngaphesheya kwesikhumba kuya kulwelwesi lwesisu kanye nama-lymph node esiswini.
• Isigaba 3B. Amaseli womdlavuza asabalale ngaphesheya kwesikhumba kuya kulwelwesi lwesisu futhi abonakala ngamehlo kodwa alinganiselwa ngaphansi kuka-2 cm.
• Isigaba 3C. Imali yomdlavuza okungenani u-3/4 wamasentimitha ibonakala esiswini noma ngaphandle kobende noma isibindi. Kodwa-ke, umdlavuza awukho ngaphakathi kwepeni noma isibindi.

Isigaba 4

Esigabeni 4, isimila sine-metastasized, noma sisakazeka, ngaphesheya kwesikhumba, isisu, nama-lymph node kuya esibindini noma emaphashini. Kunezindawo ezimbili ezingaphansi kwesigaba 4:

• Ku- isigaba 4A, amangqamuzana anomdlavuza asemanzini azungeze amaphaphu.
• Ku- isigaba 4B, isigaba esithuthuke kakhulu, amangqamuzana afinyelele ngaphakathi kwengqimba noma isibindi noma ezinye izitho ezikude njengesikhumba noma ubuchopho.

Uphathwa kanjani umdlavuza we-ovari

Ukwelashwa kuncike ekutheni umdlavuza ususabalale kangakanani. Ithimba lodokotela lizonquma uhlelo lokwelashwa ngokuya ngesimo sakho. Izofaka phakathi okubili noma ngaphezulu kokulandelayo:

• ukwelashwa ngamakhemikhali
• ukuhlinzwa ukuze kubekwe umdlavuza futhi kususwe isimila
• ukwelashwa okubhekiswe
• ukwelashwa kwamahomoni

Ukuhlinzwa

Ukuhlinzwa ukwelashwa okuyinhloko komdlavuza we-ovari.

Inhloso yokuhlinzwa ukukhipha isimila, kepha i-hysterectomy, noma ukukhishwa okuphelele kwesibeletho, kuyadingeka njalo.

Udokotela wakho futhi angancoma ukuthi ususe womabili ama-ovari kanye nama-fallopian tubes, ama-lymph node aseduze, nezinye izicubu ze-pelvic.

Ukuthola zonke izindawo ezinesigaxa kunzima.

Kokunye ukuhlola, abacwaningi baphenye izindlela zokuthuthukisa inqubo yokuhlinza ukuze kube lula ukukhipha zonke izicubu zomdlavuza.

Ukwelashwa okuhlosiwe

Imithi ehlosiwe, efana ne-chemotherapy, ihlasela amangqamuzana omdlavuza ngenkathi yenza umonakalo omncane kumaseli ajwayelekile emzimbeni.

Izindlela zokwelashwa ezihlosiwe ezintsha zokwelapha umdlavuza we-epithelial ovarian osezingeni eliphakeme zifaka phakathi i-PARP inhibitors, okuyizidakamizwa ezivimba i-enzyme esetshenziswa amaseli ukulungisa umonakalo ku-DNA yawo.

I-PARP inhibitor yokuqala yamukelwa ngo-2014 ukuthi isetshenziswe kumdlavuza we-ovarian osezingeni eliphezulu obekade welashwa phambilini ngemigqa emithathu ye-chemotherapy (okusho okungenani ukuphindeka kabili).

Ama-inhibitors amathathu e-PARP akhona njengamanje afaka:

• olaparib (Lynparza)
• i-niraparib (Zejula)
• i-rucaparib (Rubraca)

Ukwengezwa komunye umuthi, i-bevacizumab (Avastin), kuphinde kwasetshenziswa ne-chemotherapy ngemuva kokuhlinzwa.

Ukulondolozwa kokuzala

Ukwelashwa komdlavuza, kufaka phakathi i-chemotherapy, i-radiation, nokuhlinzwa, kungalimaza izitho zakho zokuzala, kwenze kube nzima ukukhulelwa.

Uma ufuna ukukhulelwa ngokuzayo, khuluma nodokotela wakho ngaphambi kokuqala ukwelashwa. Bangakwazi ukuxoxa ngezinketho zakho zokulondoloza ukuzala kwakho.

Izinketho zokulondolozwa kokuzala okungenzeka zifaka:

• Ukuqandeka kombungu. Lokhu kuhilela ukuqandisa iqanda elikhulelwe.
• Ukuqandeka kwe-oocyte. Le nqubo ihilela ukuqandisa iqanda elingavundisiwe.
• Ukuhlinzwa ukugcina inzalo. Kwezinye izimo, ukuhlinzwa okususa i-ovary eyodwa kuphela nokugcina i-ovary enempilo kungenziwa. Lokhu kuvame ukwenzeka kuphela kumdlavuza wesibeletho sokuqala.
• Ukulondolozwa kwezicubu ze-ovari. Lokhu kuhilela ukususa nokuqandisa izicubu zama-ovari ukuze zisetshenziswe esikhathini esizayo.
• Ukucindezelwa kwe-Ovarian. Lokhu kufaka ukuthatha ama-hormone ukucindezela ukusebenza kwe-ovarian okwesikhashana.

Ucwaningo kanye nezifundo zomdlavuza we-Ovarian

Izindlela zokwelashwa ezintsha zomdlavuza we-ovari ziyafundwa unyaka nonyaka.

Abaphenyi baphinde bahlole izindlela ezintsha zokwelapha umdlavuza we-ovarian-resistant ovarian. Lapho kwenzeka ukumelana ne-platinum, izidakamizwa ezijwayelekile zomugqa wokuqala zamakhemikhali njenge-carboplatin ne-cisplatin azisebenzi.

Ikusasa le-PARP inhibitors lizoba ekuhlonzeni ukuthi yimiphi eminye imithi engasetshenziswa ngokuhlangana nayo ukwelapha izicubu ezibonisa izici ezihlukile.

Muva nje, ezinye izindlela zokwelapha ezethembisayo seziqale izivivinyo zomtholampilo njengomuthi wokugoma ongaba namandla omdlavuza ophindaphindiwe wama-ovari oveza iprotheni esinda.

NgoMeyi 2020, kwashicilelwa i-anti-drug conjugate (ADC) entsha yokwelapha umdlavuza we-ovarian-resistant ovarian.

Izindlela zokwelashwa ezintsha ezihlosiwe ziyafundwa, kufaka phakathi i-antibody navicixizumab, i-ATR inhibitor AZD6738, ne-Wee1 inhibitor adavosertib. Bonke bakhombise izimpawu zomsebenzi wokulwa nesimila.

khomba izakhi zofuzo zomuntu ukwelapha noma ukwelapha izifo. Ngo-2020, isilingo sesigaba III sokwelashwa kwezakhi zofuzo i-VB-111 (ofranergene obadenovec) saqhubeka nemiphumela ethembisayo.

Ngo-2018, i-FDA yashesha ukusheshisa ukwelashwa kwamaprotheni okubizwa nge-AVB-S6-500 ngomdlavuza we-ovari omelana ne-platinum. Lokhu kuhlose ukuvimbela ukukhula kwesimila nomdlavuza ukusakazeka ngokuvimba indlela ebalulekile yamangqamuzana.

Isilingo somtholampilo esiqhubekayo esihlanganisa i-immunotherapy (esisiza amasosha omzimba womuntu ukulwa nomdlavuza) ngezindlela zokwelapha ezivunyiwe ezikhona sikhombisile isethembiso.

Imithi ehlolwayo ehlolwe kulabo abanezigaba ezithuthuke kakhulu zalo mdlavuza.

Ukwelashwa komdlavuza we-Ovarian kugxile kakhulu ekuhlinzeni ukususa ama-ovari kanye nesibeletho kanye ne-chemotherapy. Ngenxa yalokho, abanye besifazane bazoba nezimpawu zokunqamuka kokuya esikhathini.

I-athikili ka-2015 ibheke ukwelashwa ngamakhemikhali e-intraperitoneal (IP). Lolu cwaningo luthole ukuthi labo abathola ukwelashwa kwe-IP babenezinga eliphakathi lokusinda lezinyanga ezingama-61.8. Lokhu kube ngcono uma kuqhathaniswa nezinyanga ezingama-51.4 zalabo abathole ukwelashwa ngamakhemikhali okujwayelekile.

Ingabe umdlavuza we-ovari ungavinjelwa?

Azikho izindlela eziqinisekisiwe zokuqeda ngokuphelele ingozi yokuba nomdlavuza we-ovari. Kodwa-ke, kunezinyathelo ongazithatha ukwehlisa ubungozi bakho.

Izici ezikhonjisiwe ukwehlisa ubungozi bokuba nomdlavuza we-ovari zifaka:

• uphuza amaphilisi okuvimbela inzalo ngomlomo
• ukuncelisa ibele
• ukukhulelwa
• izinqubo zokuhlinzwa ezithweni zakho zokuzala (njenge-tubal ligation noma i-hysterectomy)

Uyini umbono?

Umbono wakho uncike ezicini ezahlukahlukene, kufaka phakathi:

• isigaba somdlavuza lapho uxilongwa
• impilo yakho yonke
• uphendula kahle kangakanani ekwelashweni

Wonke umdlavuza uhlukile, kepha isigaba somdlavuza siyinkomba ebaluleke kakhulu yokubukwa.

Izinga lokusinda

Izinga lokusinda iphesenti labesifazane abasinda eminyakeni ethile ethile esigabeni esithile sokuxilongwa.

Isibonelo, isilinganiso sokusinda seminyaka emihlanu iphesenti leziguli ezithole ukuxilongwa esigabeni esithile futhi zihlala okungenani iminyaka emihlanu ngemuva kokuthi udokotela wazo ezitholile.

Izinga lokusinda elihlobene nalo libheka nezinga elilindelekile lokufa kwabantu abangenawo umdlavuza.

Umdlavuza we-Epithelial ovarian uhlobo oluvame kakhulu lomdlavuza we-ovari. Amanani okusinda angahluka ngokuya ngohlobo lomdlavuza we-ovari, ukukhula komdlavuza, kanye nentuthuko eqhubekayo ekwelashweni.

I-American Cancer Society isebenzisa imininingwane evela ku-database ye-SEER ukuthi iNational Cancer Institute (NCI) igcina ukulinganisa isilinganiso sokusinda esihlobene salolu hlobo lomdlavuza we-ovari.

Nakhu ukuthi UMBONI uhlukanisa kanjani izigaba ezahlukahlukene njengamanje:

• Kwenziwe kwaba okwasendaweni. Akunasibonakaliso sokuthi umdlavuza usabalale ngaphandle kwama-ovari.
• Okwesifunda. Umdlavuza usabalale ngaphandle kwama-ovari waya ezakhiweni eziseduze noma kuma-lymph node.
• Kude. Umdlavuza usabalalele ezingxenyeni ezikude zomzimba, njengesibindi noma amaphaphu.

Izilinganiso zeminyaka emihlanu yokusinda komdlavuza we-ovari

Umdlavuza we-ovarian epithelial ohlasela

Izimila ze-ovarian stromal

Izimila zamangqamuzana egciwane le-ovary

Qaphela ukuthi le datha ivela ezifundweni ezingaba okungenani iminyaka engu-5 noma ngaphezulu.

Ososayensi njengamanje bacwaninga izindlela ezithuthukisiwe nezethembekile zokuthola umdlavuza we-ovari kusenesikhathi. Intuthuko kwezokwelapha iyathuthuka, futhi ngayo, umbono womdlavuza we-ovari.