Umdlavuza We-Peritoneal: Okudingeka Ukwazi

-Delile

• Umdlavuza oyinhloko vs. wesibili peritoneal
• Okuyinhloko
• Okwesibili
• Izimpawu zomdlavuza we-peritoneal
• Izigaba zomdlavuza we-peritoneal
• Umdlavuza oyinhloko we-peritoneal
• Umdlavuza wesibili we-peritoneal
• Umdlavuza wePeritoneal ubangela nezici zobungozi
• Utholakala kanjani umdlavuza we-peritoneal
• Ungawutshela kanjani umehluko phakathi komdlavuza we-peritoneal nomdlavuza we-ovari ekuxilongweni
• Ukwelapha umdlavuza we-peritoneal
• Ukuhlinzwa
• Ukwelashwa ngamakhemikhali
• Ukwelashwa okuhlosiwe
• Uyini umbono?
• Amanani okusinda
• Umdlavuza oyinhloko we-peritoneal
• Umdlavuza wesibili we-peritoneal
• Funa ukwesekwa

Umdlavuza wePeritoneal ngumdlavuza ongajwayelekile owakhiwa ungqimba oluncane lwamaseli we-epithelial agudla udonga lwangaphakathi lwesisu. Lololwelwesi lubizwa nge-peritoneum.

I-peritoneum ivikela futhi ihlanganise izitho esiswini sakho, kufaka phakathi:

• amathumbu
• isinye
• unxande
• isibeletho

I-peritoneum iphinde ikhiqize uketshezi lokuthambisa oluvumela izitho zihambe kalula ngaphakathi esiswini.

Ngenxa yokuthi izimpawu zayo zivame ukungabonakali, umdlavuza we-peritoneal uvame ukutholakala sekwephuzile.

Isimo ngasinye somdlavuza we-peritoneal wehlukile. Ukwelashwa nokubukwa kuyahlukahluka ngakunye. Ukwelashwa okusha okwenziwe emashumini eminyaka adlule kuthuthukise amazinga okusinda.

Umdlavuza oyinhloko vs. wesibili peritoneal

Ukuqokwa kwamabanga aphansi nasesekondari kubhekisa lapho umdlavuza uqale khona. Amagama awasona isilinganiso sokuthi umdlavuza ubucayi kangakanani.

Okuyinhloko

Umdlavuza oyinhloko we-peritoneal uqala futhi ukhule ku-peritoneum. Imvamisa kuthinta abesifazane kuphela futhi kuyaqabukela kuthinte abesilisa.

Umdlavuza oyinhloko we-peritoneal uhlobene kakhulu nomdlavuza we-epithelial ovarian. Bobabili baphathwa ngendlela efanayo futhi banombono ofanayo.

Uhlobo olungavamile lomdlavuza oyinhloko we-peritoneal yi-peritoneal malignant mesothelioma.

Okwesibili

Umdlavuza wesibili we-peritoneal uvame ukuqala kwesinye isitho esiswini bese usakazeka (metastasizes) uye kwi-peritoneum.

Umdlavuza wesibili we-peritoneal ungaqala ku:

• amaqanda
• amashubhu we-fallopian
• isinye
• isisu
• amathumbu amancane
• ikholoni
• unxande
• isithasiselo

Umdlavuza wesibili we-peritoneal ungathinta abesilisa nabesifazane. Kuvame kakhulu kunomdlavuza oyinhloko we-peritoneal.

Odokotela balinganisela ukuthi amaphesenti aphakathi kuka-15 no-20 abantu abanomdlavuza obala ngokobuhlungu bazokwakha imastastase eperitoneum. Cishe amaphesenti ayi-10 kuye kwayi-15 abantu abanomdlavuza wesisu bazokwakha imastastase eperitoneum.

Lapho umdlavuza uhlangana nendawo yawo yokuqala, isiza esisha sizoba nohlobo olufanayo lwamangqamuzana omdlavuza njengesiza sokuqala.

Izimpawu zomdlavuza we-peritoneal

Izimpawu zomdlavuza we-peritoneal zincike ohlotsheni nesigaba somdlavuza. Lapho zisaqala, kungahle kungabikho zimpawu. Kwesinye isikhathi noma ngabe umdlavuza we-peritoneal uthuthukile kungahle kungabikho zimpawu.

Izimpawu zokuqala zingacaci futhi mhlawumbe zibangelwe ezinye izimo eziningi. Izimpawu zomdlavuza we-peritoneal zingafaka:

• ukuqunjelwa noma ubuhlungu besisu
• isisu esikhulisiwe
• umuzwa wengcindezi esiswini noma okhalweni
• ukusutha ngaphambi kokuqeda ukudla
• ukugaya ukudla
• isicanucanu noma ukuhlanza
• izinguquko zamathumbu noma zomchamo
• ukulahlekelwa isifiso sokudla
• ukuncipha noma ukuzuza kwesisindo
• ukukhishwa kwesitho sangasese sowesifazane
• ukuhlungu obusemhlane
• ukukhathala

Njengoba umdlavuza uqhubeka, uketshezi olunamanzi lunganqwabelana emgodini wesisu (ascites), olungadala:

• isicanucanu noma ukuhlanza
• ukuphelelwa umoya
• ubuhlungu besisu
• ukukhathala

Izimpawu zomdlavuza we-peritoneal wesigaba sekwephuzile zingafaka:

• gcwalisa ukuvinjelwa kwamathumbu noma umchamo
• ubuhlungu besisu
• ukungakwazi ukudla noma ukuphuza
• ukuhlanza

Izigaba zomdlavuza we-peritoneal

Lapho kutholakala okokuqala, umdlavuza we-peritoneal uhlelwa ngokobukhulu bawo, isikhundla, nokuthi usakazeka kuphi kusuka. Futhi kunikezwa ibanga, elilinganisela ukuthi likwazi ukusabalala ngokushesha kangakanani.

Umdlavuza oyinhloko we-peritoneal

Umdlavuza oyinhloko we-peritoneal uhlelwe ngohlelo olufanayo olusetshenziselwa umdlavuza we-ovari ngoba umdlavuza uyafana. Kepha umdlavuza oyinhloko we-peritoneal uhlale ubhekwa njengesigaba 3 noma isigaba 4. Umdlavuza we-Ovarian unezigaba ezimbili zangaphambili.

Isigaba 3 ihlukaniswe yaba ezinye izigaba ezintathu:

• 3A. Umdlavuza usabalalele kuma-lymph node ngaphandle kwe-peritoneum, noma amangqamuzana omdlavuza asabalalele ebusweni be-peritoneum, ngaphandle kwe-pelvis.
• 3B. Umdlavuza ususabalele kwi-peritoneum ngaphandle kwesikhumba. Umdlavuza ose-peritoneum ungamasentimitha ama-2 (cm) noma amancane. Kungenzeka futhi ukuthi isakaze kuma-lymph node ngaphandle kwe-peritoneum.
• 3C. Umdlavuza ususabalele kwi-peritoneum ngaphandle kwesikhumba kanye.Umdlavuza ose-peritoneum mkhulu kuno-2 cm. Kungenzeka ukuthi isakaze kuma-lymph node ngaphandle kwe-peritoneum noma ebusweni besibindi noma ubende.

Ku- isigaba 4, umdlavuza ususabalele nakwezinye izitho zomzimba. Lesi sigaba sihlukaniswa ngokwengeziwe:

• 4A. Amaseli womdlavuza atholakala kuluketshezi olwakheka eduze kwamaphaphu.
• 4B. Umdlavuza udlulele ezithweni nakwizicubu ezingaphandle kwesisu, njengesibindi, amaphaphu, noma ama-lymph node.

Umdlavuza wesibili we-peritoneal

Umdlavuza wesibili we-peritoneal uhlelwe ngokusho kwesiza somdlavuza oyinhloko. Lapho umdlavuza oyinhloko usakazekela kwenye ingxenye yomzimba, njenge-peritoneum, uvame ukuhlukaniswa njengesigaba 4 somdlavuza wokuqala.

Umbiko ubike ukuthi cishe amaphesenti ayi-15 abantu abanomdlavuza obala ngokocansi kanye namaphesenti angama-40 abantu abanesifo somdlavuza wesisu esisesiteji 2 kuya ku-3 babebandakanyeka ekusebenzeni komuntu ngamunye.

Umdlavuza wePeritoneal ubangela nezici zobungozi

Isizathu somdlavuza we-peritoneal asikaziwa.

Ngomdlavuza oyinhloko we-peritoneal, izici zobungozi zifaka:

• Ubudala. Njengoba ukhula, ingozi yakho iyanda.
• Izakhi zofuzo. Umlando womndeni womdlavuza we-ovari noma we-peritoneal ukwandisa ingozi yakho. Ukuthwala ukuguqulwa kwezakhi zofuzo kwe-BRCA1 noma i-BRCA2 noma olunye lohlobo lwe-Lynch syndrome nakho kwandisa ubungozi bakho.
• Ukwelashwa kweHormone. Ukuthatha ukwelashwa ngama-hormone ngemuva kokunqamuka kokuya esikhathini kwandisa ingozi yakho.
• Isisindo nokuphakama. Ukhuluphele ngokweqile noma ukhuluphele kwandisa ingozi yakho. Labo abade basengozini enkulu.
• I-Endometriosis. I-Endometriosis ikhulisa ubungozi bakho.

Izici ezihambisana ne- kwehlile Ingozi yomdlavuza we-peritoneal noma i-ovarian ihlanganisa:

• ukuthatha amaphilisi okuvimbela inzalo
• ukuzala izingane
• ukuncelisa ibele
• i-tubal ligation, ukususwa kweshubhu le-fallopian, noma ukususwa kwe-ovary

Qaphela ukuthi ukususwa kwe-ovary kunciphisa ubungozi besifo somdlavuza we-peritoneal kodwa akususi ngokuphelele.

Utholakala kanjani umdlavuza we-peritoneal

Ukuxilongwa komdlavuza we-peritoneal oyinhloko nowesibili kunzima ezigabeni zokuqala. Lokhu kungenxa yokuthi izimpawu azicaci futhi kungabangelwa kalula ngezinye izimbangela.

Imvamisa umdlavuza we-peritoneal utholakala kuphela ngesikhathi sokuhlinzwa ukuze ususe isimila esaziwayo kwenye indawo esiswini.

Udokotela wakho uzokuhlola ngokomzimba, athathe umlando wezokwelapha, akubuze ngezimpawu zakho. Bangayalela uchungechunge lwezivivinyo ukunquma ukuxilongwa.

Ukuhlolwa okusetshenziselwa ukuthola umdlavuza we-peritoneal kufaka:

• Ukuhlola ukuhlolwa kwesisu nesinqe. Lokhu kungakhombisa ukukhuphuka noma ukukhula. Ukuhlolwa kufaka i-CT scan, i-ultrasound, ne-MRI. Kodwa-ke, umdlavuza we-peritoneal usebenzisa ukuskena kwe-CT ne-MRI.
• Isidumbu yendawo ebukeka ingajwayelekile kuskena, kufaka phakathi ukukhishwa koketshezi kuma-ascites, ukufuna amaseli anomdlavuza. Xoxa ngobuhle nobubi balokhu nodokotela wakho. Le nqubo futhi isengozini yokuhlwanyela udonga lwesisu ngamaseli anomdlavuza.
• Ukuhlolwa kwegazi ukubheka amakhemikhali angaphakanyiswa kumdlavuza we-peritoneal, njenge-CA 125, ikhemikhali elenziwa ngamangqamuzana e-tumor. Umaki wegazi omusha ngu-HE4. Mancane amathuba okuthi kuno-CA 125 angaphakanyiswa yizimo ezinganomdlavuza.
• I-laparoscopy noma i-laparotomy. Lawa ngamasu angahlaseli amancane ukubheka ngqo i-peritoneum. Babhekwa njenge "standard yegolide" ekuxilongweni.

Ukucwaninga ngezindlela ezingcono nezangaphambilini zokuxilongwa komdlavuza we-peritoneal kuyaqhubeka.

Kuphakanyiswe ukusungulwa kwe- "biopsy liquid." Lokhu kubhekisela ekuhlolweni kwegazi okungabheka inhlanganisela yama-biomarker we-tumor. Lokhu kuzovumela ukwelashwa kwangaphambilini kwabanye abantu.

Ungawutshela kanjani umehluko phakathi komdlavuza we-peritoneal nomdlavuza we-ovari ekuxilongweni

Umdlavuza wePeritoneal ufana kakhulu nomdlavuza we-epithelial ovarian othuthukile. Kokubili kuhilela uhlobo olufanayo lwamaseli. Kwenziwe imibandela yokuzehlukanisa yi.

Kuthathwa njengomdlavuza oyinhloko we-peritoneal uma:

• amaqanda avele ejwayelekile
• amaseli anomdlavuza awekho ebusweni be-ovary
• Uhlobo lwesimila lukhulu kakhulu (lukhiqiza uketshezi)

ibike ukuthi isilinganiso seminyaka yabantu abanomdlavuza oyinhloko we-peritoneal besindala kunalabo abanomdlavuza we-epithelial ovarian.

Ukwelapha umdlavuza we-peritoneal

Kungenzeka ube neqembu lezokwelapha kufaka phakathi:

• udokotela ohlinzayo
• i-oncologist
• udokotela we-radiologist
• udokotela wezifo
• i-gastroenterologist
• uchwepheshe wezobuhlungu
• abahlengikazi abakhethekile
• ochwepheshe bokunakekelwa okunciphisayo

Ukwelashwa komdlavuza oyinhloko we-peritoneal kuyefana nomdlavuza we-ovari. Kokubili umdlavuza we-peritoneal oyinhloko nowesibili, ukwelashwa ngakunye kuzoya ngendawo nosayizi wesimila nempilo yakho jikelele.

Ukwelashwa komdlavuza wesibili we-peritoneal futhi kuya ngesimo somdlavuza oyinhloko nempendulo yakho ekwelashweni kwawo.

Ukuhlinzwa

Ukuhlinzwa ngokuvamile kuyisinyathelo sokuqala. Udokotela ohlinzayo uzosusa umdlavuza omkhulu ngangokunokwenzeka. Zingasusa futhi:

• isibeletho sakho (i-hysterectomy)
• amaqanda akho kanye namashubhu e-fallopian (oophorectomy)
• ungqimba lwezicubu ezinamafutha eduze kwama-ovari (i-omentum)

Udokotela wakho ohlinzayo uzophinda asuse noma yiziphi izicubu ezibukeka ngendlela engajwayelekile endaweni yesisu ukuze aqhubeke nokuhlolwa.

Intuthuko ngokunemba kwamasu okuhlinza, aziwa nge-cytoreductive surgery (CRS), inike amandla odokotela abahlinzayo ukukhipha izicubu eziningi ezinomdlavuza. Lokhu kuthuthukise umbono wabantu abanomdlavuza we-peritoneal.

Ukwelashwa ngamakhemikhali

Udokotela wakho angasebenzisa i-chemotherapy ngaphambi kokuhlinzwa ukuze anciphise isimila lapho elungiselela ukuhlinzwa. Bangayisebenzisa futhi ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana anomdlavuza asele.

Indlela entsha yokuletha i-chemotherapy ngemuva kokuhlinzwa inyuse ukusebenza kwayo ezimweni eziningi.

Le ndlela isebenzisa ukushisa okuhlanganiswe nekhemotherapy ehanjiswa ngqo kusayithi lomdlavuza we-peritoneal. Kuyaziwa njenge-hyperthermic intraperitoneal chemotherapy (HIPEC). Lokhu ukwelashwa okukodwa okunikezwa ngqo ngemuva kokuhlinzwa.

Inhlanganisela yeCRS neHIPEC "iguqule" ukwelashwa komdlavuza we-peritoneal, ngokusho kwabaphenyi abaningi. Kodwa ayemukelwa ngokuphelele njengokwelashwa okujwayelekile okwamanje. Lokhu kungenxa yokuthi azikho izivivinyo zeziguli ezingahleliwe ngamaqembu wokulawula.

Ucwaningo luyaqhubeka. I-HIPEC ayinconywa lapho kune-metastases ngaphandle kwesisu nakwezinye izimo.

Yonke i-chemotherapy inemiphumela engemihle. Xoxa ngokuthi lokhu kungaba yini nokuthi ungabaphatha kanjani neqembu lakho lokwelashwa.

Ukwelashwa okuhlosiwe

Kwezinye izimo, umuthi wokwelashwa ohlosiwe ungasetshenziswa. Le mithi ihlose ukumisa amangqamuzana omdlavuza ngaphandle kokulimaza amaseli ajwayelekile. Izindlela zokwelashwa ezihlosiwe zifaka okulandelayo:

• Amasosha omzimba angama-monoclonal khomba izinto kumaseli akhuthaza ukukhula komdlavuza weseli. Lokhu kungahlanganiswa nesidakamizwa se-chemotherapy.
• I-PARP (poly-ADP ribose polymerase) inhibitors vimba ukulungiswa kwe-DNA.
• Ama-angiogenesis inhibitors ukuvimbela ukukhula komkhumbi wegazi ezimotweni.

Ukwelashwa kweHormonal, ukwelashwa ngemisebe, kanye ne-immunotherapy nakho kungasetshenziswa kwezinye izimo zomdlavuza oyinhloko we-peritoneal.

Uyini umbono?

Umbono wabantu abanomdlavuza oyinhloko noma wesibili we-peritoneal uye wathuthuka kakhulu emashumini eminyaka amuva ngenxa yentuthuko ekwelashweni, kodwa kusese kubi. Lokhu kungenxa yokuthi umdlavuza we-peritoneal ngokuvamile awutholakali uze ube sesigabeni esithuthukile. Futhi, umdlavuza ungabuya ngemuva kokwelashwa.

Izimpawu kunzima ukuzikhomba, kepha uma unezinye zezimpawu ezijwayelekile eziqhubekayo, ngena nodokotela wakho. Ukuxilongwa kwangaphambilini kuholela emphumeleni ongcono.

Amanani okusinda

Umdlavuza oyinhloko we-peritoneal

Kusukela ngo-2019, izinga lokusinda leminyaka emihlanu labesifazane abanezinhlobo zonke zomdlavuza we-ovari, i-fallopian, nomdlavuza we-peritoneal ngamaphesenti angama-47. Lesi sibalo siphezulu kwabesifazane abangaphansi kweminyaka engama-65 (amaphesenti angama-60) futhi singaphansi kwabesifazane abangaphezu kwama-65 (amaphesenti angama-29).

Izibalo zokusinda zomdlavuza oyinhloko we-peritoneal zivela ezifundweni ezincane kakhulu.

Isibonelo, kwabesifazane abangama-29 abanomdlavuza oyinhloko we-peritoneal babike isikhathi sokusinda esimaphakathi sezinyanga ezingama-48 ngemuva kokwelashwa.

Lokhu kungcono kakhulu kunesilinganiso seminyaka emihlanu sokusinda esabikwa ocwaningweni lwango-1990 olwaluphakathi.

Umdlavuza wesibili we-peritoneal

Amanani okusinda komdlavuza wesibili we-peritoneal nawo ancike esigabeni sesiza somdlavuza oyinhloko nohlobo lokwelashwa. Inani elincane lezifundo likhombisa ukuthi ukwelashwa okuhlanganisiwe kweCRS neHIPEC kuthuthukisa amazinga okusinda.

Isibonelo, ucwaningo olubikwe ngo-2013 lubheke abantu abangama-84 abanomdlavuza obala obusabalele kwi-peritoneum. Kuqhathanise labo ababephethwe ngamakhemikhali e-systemic nalabo ababene-CRS ne-HIPEC.

Ukusinda kweqembu le-chemotherapy kube yizinyanga ezingama-23.9 uma kuqhathaniswa nezinyanga ezingama-62.7 zeqembu elaphathwa ngeCRS neHIPEC.

Funa ukwesekwa

Ungahle ufune ukukhuluma nabanye abantu abelashwa noma namalungu omndeni wabo.

Ulayini wokusekela we-American Cancer Society uyatholakala ngo-24/7 ngosuku ku-800-227-2345. Bangakusiza ukuthi uthole iqembu eliku-inthanethi noma lasendaweni elizokuxhasa.

Ithimba lakho lokwelashwa lingakwazi futhi ukusiza ngezinsizakusebenza.