Izinketho Zokwelapha Umdlavuza we-Ovarian

-Delile

• Ukuhlinzwa komdlavuza we-ovari
• I-Chemotherapy yomdlavuza we-ovari
• Ngomdlavuza we-epithelial ovarian
• Ngomdlavuza we-ovari oqala kumaseli wegciwane
• Ngomdlavuza we-ovari oqala kumaseli we-stromal
• Ezinye izindlela zokwelapha ezijwayelekile zamakhemikhali
• Imisebe yomdlavuza we-ovari
• Ukwelashwa kweHormone komdlavuza we-ovari
• Ukwelashwa okubhekiswe kumdlavuza we-ovari
• Ukuhlolwa kwemitholampilo ngomdlavuza we-ovari
• Imithi ehambisanayo yomdlavuza we-ovari
• Umbono

Ukwenza uhlelo lokwelashwa

Kunezindlela eziningi zokusondela ekwelashweni komdlavuza we-ovari. Kwabesifazane abaningi, kusho ukuhlinzwa. Lokhu kuvame ukuhlanganiswa nokwelashwa ngamakhemikhali, ukwelashwa kwamahomoni, noma ukwelashwa okuhlosiwe.

Ezinye izinto ezisiza ukuqondisa ukwelashwa yilezi:

• uhlobo lwakho oluthile lomdlavuza we-ovari
• isigaba sakho lapho uxilongwa
• noma ngabe ungaphambi kokuya esikhathini noma ngemuva kokuyeka ukuya esikhathini
• ngabe uhlela ukuba nezingane

Funda kabanzi ukuze ufunde kabanzi mayelana nokwelashwa komdlavuza we-ovari nokuthi yini okubandakanya.

Ukuhlinzwa komdlavuza we-ovari

Izinketho zokuhlinzwa zincike ekutheni umdlavuza wakho ususabalale kangakanani.

Ngomdlavuza we-ovari wesigaba sokuqala, kungenzeka ukugcina inzalo. Kubalulekile ukubonisana nodokotela wakho ngaphambi kokuhlinzwa.

Uma umdlavuza utholakala esibelethweni esisodwa kuphela, udokotela wakho angawususa futhi asuse neshubhu le-fallopian exhunywe kulo. Usazovula futhi uye esikhathini ngenxa ye-ovary yakho esele, ugcine inketho yakho yokukhulelwa.

Lapho umdlavuza utholakala kuwo womabili amaqanda, amaqanda akho womabili kanye nawo womabili amashubhu we-fallopian angasuswa. Lokhu kuzodala ukunqamuka kokuya esikhathini. Izimpawu zingafaka ukushisa okushisayo, ukujuluka ebusuku, nokoma kwesitho sangasese sowesifazane. Udokotela wakho futhi angakweluleka ukuthi kususwe isibeletho sakho.

Esikhathini sokuqala somdlavuza we-ovari, ukuhlinzeka nge-laparoscopic okungajwayelekile kungaba yindlela. Lokhu kwenziwa ngekhamera yevidiyo kanye nezinsimbi ezinde, ezincanyana ezifakwe ngemisiko emincane.

Ukuze uthole umdlavuza we-ovari ophakeme kakhulu, ukuhlinzeka isisu okuvulekile kuyadingeka.

Inqubo ebizwa nge-debulking cytoreductive surgery isetshenziselwa ukwelapha umdlavuza wesigaba 4 we-ovari. Kubandakanya ukususwa kwamaqanda akho namashubhu e-fallopian, kanye nezinye izitho ezithintekile. Lokhu kungafaka:

• isibeletho nomlomo wesibeletho
• ama-lymph node
• izicubu ezihlanganisa amathumbu akho nezitho zangaphansi zesisu
• ingxenye diaphragm yakho
• amathumbu
• ubende
• isibindi

Uma unoketshezi endaweni yakho yesisu noma okhalweni, kungasuswa futhi kuhlolwe namaseli omdlavuza futhi.

I-Chemotherapy yomdlavuza we-ovari

I-Chemotherapy uhlobo lokwelashwa okuhlelekile. Lezi zidakamizwa ezinamandla zihamba emzimbeni wakho wonke ukufuna nokubhubhisa amangqamuzana omdlavuza. Isetshenziswa ngaphambi kokuhlinzwa ukunciphisa izigaxa noma ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele.

Le mithi inganikezwa ngemithambo (IV) noma ngomlomo. Zingabuye zifakwe ngqo esiswini sakho.

Ngomdlavuza we-epithelial ovarian

Umdlavuza we-Epithelial ovarian uqala kumaseli engxenyeni engaphandle yama-ovari akho. Ukwelashwa ngokuvamile kubandakanya okungenani imishanguzo emibili ye-IV. Banikezwa izikhathi ezintathu kuya kweziyisithupha, imvamisa amasonto amathathu kuya kwamane ehlukene. Inhlanganisela ejwayelekile yezidakamizwa i-cisplatin noma i-carboplatin kanye ne-paclitaxel (Taxol) noma i-docetaxel (Taxotere).

Ngomdlavuza we-ovari oqala kumaseli wegciwane

Kwesinye isikhathi umdlavuza we-ovari uqala kumaseli akho wegciwane. Lawa ngamangqamuzana agcina akha amaqanda. Inhlanganisela yezidakamizwa esetshenziselwa izicubu zegciwane leseli yi-cisplatin (Platinol), etoposide, ne-bleomycin.

Ngomdlavuza we-ovari oqala kumaseli we-stromal

Umdlavuza we-Ovarian nawo ungaqala kumaseli we-stromal. Lawa ngamaseli akhipha ama-hormone futhi axhumanise izicubu zama-ovari. Le nhlanganisela yezidakamizwa kungenzeka ukuthi isetshenziselwe okufanayo izicubu zegciwane lesigciwane.

Ezinye izindlela zokwelapha ezijwayelekile zamakhemikhali

Amanye ama-chemotherapies womdlavuza we-ovari yilawa:

• i-albhamuin-bound paclitaxel (Abraxane)
• i-altretamine (Hexalen)
• i-capecitabine (Xeloda)
• i-cyclophosphamide (iCytoxan)
• i-gemcitabine (iGemzar)
• ifosfamide (Ifex)
• i-irinotecan (Camptosar)
• i-liposomal doxorubicin (Doxil)
• i-melphalan (Alkeran)
• pemetrexed (Alimta)
• I-topotecan (Hycamtin)
• i-vinblastine (Velban)
• i-vinorelbine (i-Navelbine)

Imiphumela emibi iyehluka ngokuya ngomthamo kanye nokuhlanganiswa kwezidakamizwa. Zingafaka:

• isicanucanu nokuhlanza
• ukulahlekelwa isifiso sokudla
• ukukhathala
• ukulahleka kwezinwele
• izilonda zomlomo noma izinsini ezophayo
• ingozi ephezulu yokutheleleka
• ukopha noma ukulimaza

Eminingi yale miphumela engemihle ingeyesikhashana. Udokotela wakho angasiza ekunciphiseni. Eminye imiphumela emibi, njengokulimala kwezinso, ingaba yimbi kakhulu futhi ihlale isikhathi eside. Noma ngabe usenaso esinye samaqanda akho, i-chemotherapy ingaholela ekunqamukeni kokuya esikhathini ekuqaleni.

Imisebe yomdlavuza we-ovari

Imisebe yindlela yokwelashwa ehlosiwe esebenzisa imisebe enamandla amakhulu ukubhubhisa izicubu. Ingalethwa ngaphandle noma ngaphakathi.

Imisebe ayiyona indlela yokwelapha eyinhloko yomdlavuza we-ovari. Kepha kwesinye isikhathi ingasetshenziswa:

• ukusiza ekwelapheni ukuphindeka okuncane okwenziwe endaweni
• ukudambisa izinhlungu kwizicubu ezinkulu ezingamelani nokwelashwa ngamakhemikhali
• njengenye indlela uma ungakwazi ukubekezelela ukwelashwa ngamakhemikhali

Ngaphambi kokwelashwa kwakho kokuqala, uzodinga iseshini yokuhlela ukuze unqume ukuma kwakho ngqo. Umgomo ukushaya isimila ngenkathi kunciphisa ukulimala kwezicubu ezinempilo. Amaphoyinti wokukhomba kwesinye isikhathi asetshenziselwa ukumaka unomphela isikhumba sakho.

Ukunakwa ngokucophelela kukhokhelwa ekubekeni isikhathi ngasinye. Yize lokho kungathatha isikhashana, ukwelashwa uqobo kuthatha imizuzu embalwa. Imisebe ayibuhlungu, kepha idinga ukuthi uhlale unganyakazi ngokuphelele. Ukwelashwa kunikezwa izinsuku ezinhlanu ngesonto amasonto amathathu kuya kwamahlanu.

Imiphumela emibi ivame ukuxazululwa lapho ukwelashwa kuphela kodwa kungafaka:

• isikhumba esibomvu, esicasukile
• ukukhathala
• isifo sohudo
• ukuchama kaningi

Ukwelashwa kweHormone komdlavuza we-ovari

Umdlavuza we-Epithelial ovarian awuphathwa ngokwelashwa nge-hormone therapy. Isetshenziselwa kakhulu umdlavuza we-stromal.

Ama-agonists akhipha i-Luteinizing-hormone-akhulula ama-agonists asetshenziselwa ukwehlisa ukukhiqizwa kwe-estrogen kwabesifazane be-premenopausal. Amabili alawa yi-goserelin (iZoladex) ne-leuprolide (Lupron). Banikezwa ngomjovo njalo ezinyangeni ezintathu kuya kwezintathu. Le mithi ingadala izimpawu zokunqamuka kokuya esikhathini. Uma kuthathwe iminyaka, anganciphisa amathambo akho futhi kubangele ukukhumuzeka kwamathambo.

I-Estrogen ingakhuthaza ukukhula kwesimila. Umuthi obizwa nge-tamoxifen ugcina i-estrogen ingavuseleli ukukhula. Lesi sidakamizwa singadala nezimpawu zokunqamuka kokuya esikhathini.

Abesifazane abane-postmenopausal bangathatha i-aromatase inhibitors, njenge-anastrozole (Arimidex), i-exemestane (i-Aromasin), ne-letrozole (i-Femara). Avimba i-enzyme eguqula amanye ama-hormone abe yi-estrogen. Le mithi yomlomo ithathwa kanye ngosuku. Imiphumela emibi ifaka phakathi:

• ukushisa okushisayo
• Ubuhlungu bamalunga nemisipha
• ukuncipha kwamathambo akho

Ukwelashwa okubhekiswe kumdlavuza we-ovari

Izidakamizwa ezihlosiwe zithola futhi zishintshe izici ezithile zamangqamuzana omdlavuza ezingatholakali kumaseli enempilo. Azilimazi kakhulu izicubu ezinempilo kune-chemotherapy noma ukwelashwa ngemisebe kwangaphandle.

Izimila zidinga imithambo yegazi ukuze ikhule futhi isabalale. Umuthi we-IV obizwa nge-bevacizumab (Avastin) wenzelwe ukumisa izicubu ekwakheni imithambo yegazi emisha. Inikezwa njalo emavikini amabili kuya kwamathathu.

Ucwaningo lukhombisa ukuthi i-bevacizumab inganciphisa izicubu noma ikhuphuke kancane umdlavuza we-epithelial ovarian cancer. Imiphumela emibi engaba khona ibandakanya:

• umfutho wegazi ophakeme
• ukubalwa kwamaseli egazi amhlophe aphansi
• isifo sohudo

I-Poly (ADP-ribose) polymerase (PARP) inhibitors yimithi yokwelapha ngomlomo. Zisetshenziswa lapho umdlavuza we-ovari uhlotshaniswa I-BRCA ukuguquka kwezakhi zofuzo.

Okubili kwalokhu, i-olaparib (i-Lynparza) ne-rucaparib (i-Rubraca), kungasetshenziselwa umdlavuza wama-ovari wesikhathi esizayo ngemuva kokuzama i-chemotherapy. I-Olaparib ibuye isetshenziselwe ukwelapha umdlavuza ophindaphindayo wama-ovari kwabesifazane abangenawo noma abangenawo I-BRCA ukuguquka kwezakhi zofuzo.

Enye i-PARP inhibitor, i-niraparib (i-Zejula), inganikezwa abesifazane abanomdlavuza ophindaphindiwe we-ovarian, noma ngaphandle I-BRCA ukuguquka kwezakhi zofuzo, ngemuva kokuzama ukwelashwa ngamakhemikhali.

Imiphumela emibi yale mithi ingafaka:

• isicanucanu
• i-anemia
• ubuhlungu bemisipha namalunga

Ukuhlolwa kwemitholampilo ngomdlavuza we-ovari

Izilingo zomtholampilo ziqhathanisa ukwelashwa okujwayelekile nemithi yokwelapha emisha engakavunyelwa ukusetshenziswa ngokujwayelekile. Ukuhlolwa kwemitholampilo kungabandakanya abantu abanoma yisiphi isigaba somdlavuza.

Buza i-oncologist yakho ukuthi ukuhlolwa komtholampilo kuyindlela enhle kuwe. Ungavakashela futhi ne-database engasesheka ku-ClinicalTrials.gov ukuthola eminye imininingwane.

Imithi ehambisanayo yomdlavuza we-ovari

Ungakuthola kuwusizo ukwengeza ukunakekelwa komdlavuza wakho ngemithi ehambisanayo. Abanye abantu bathola ukuthi bathuthukisa ikhwalithi yempilo. Ezinye ongazibheka yilezi:

• I-Aromatherapy. Amafutha abalulekile angathuthukisa imizwa yakho futhi anciphise ukucindezeleka.
• Ukuzindla. Izindlela zokuphumula zingasiza ekunciphiseni ubuhlungu nasekuthuthukiseni ukulala.
• Ukwelashwa kokubhucunga umzimba. Lokhu kwelashwa komzimba wakho kungasiza ekunciphiseni ukucindezeleka futhi kunciphise ukukhathazeka nobuhlungu.
• I-Tai chi ne-yoga. Izenzo zomzimba womqondo we-Nonaerobic ezisebenzisa ukunyakaza, ukuzindla, nokuphefumula kungakhuthaza umuzwa wakho wenhlalakahle.
• Ukwelashwa kwezobuciko nokwelashwa komculo. Izitolo zokudala zingakusiza ukubhekana nezici ezingokomzwelo zomdlavuza nokwelashwa.
• Ukuthoma. Leli fomu lomuthi waseShayina lapho izinaliti zibekwe khona ngamasu lingadambisa izinhlungu nezinye izimpawu.

Buza udokotela wakho ngaphambi kokuzama izindlela ezintsha zokwelapha, ikakhulukazi izithako zokudla noma amakhambi. Lokhu kungasebenzisana nemithi yakho noma kubangele ezinye izinkinga.

Ungase futhi uthande ukubonisana nodokotela wokunakekelwa okunciphisayo. Lezi zingcweti zisebenza nethimba lakho le-oncology ukuhlinzeka ukukhululeka kwezimpawu nokuthuthukisa ikhwalithi yempilo.

Umbono

Isilinganiso seminyaka emihlanu sokusinda komdlavuza we-ovari singamaphesenti angama-45.

Amanani okusinda ayahluka ngokuya ngohlobo oluthile lomdlavuza, isigaba sokuxilongwa, nobudala. Isibonelo, lapho umdlavuza ubanjwa ngaphambi kokuba usabalale ngaphandle kwamaqanda akho, izinga lokusinda lingamaphesenti angama-92.

Futhi, izibalo zokusinda azibandakanyi amacala akamuva kakhulu, lapho kungenzeka kusetshenziswe ukwelashwa okusha.

Udokotela wakho uzokunika umbono wokuthi yini ongayilindela ngokuya ngemininingwane yohlelo lwakho lokuxilongwa nokwelashwa.