Isigaba 4 I-Renal Cell Carcinoma: I-Metastasis, Amanani Okusinda, Nokwelapha

-Delile

• Yini i-renal cell carcinoma?
• Isakazeka kanjani?
• Isiteji se-TNM kanye nezigaba zomdlavuza wezinso
• Uyini umbono?
• Yiziphi izinketho zokwelashwa?
• Ukuthatha

Yini i-renal cell carcinoma?

I-Renal cell carcinoma (RCC), ebizwa nangokuthi umdlavuza we-renal cell noma i-renal cell adenocarcinoma, uhlobo oluvamile lomdlavuza wezinso. I-Renal cell carcinomas i-akhawunti cishe yamaphesenti angama-90 awo wonke umdlavuza wezinso.

I-RCC imvamisa iqala njengesimila esikhula kwesinye sezinso zakho. Ingabuye ikhule kuzo zombili izinso.Lesi sifo sivame kakhulu emadodeni kunabesifazane.

Isakazeka kanjani?

Uma kutholakala isimila somdlavuza kwesinye sezinso zakho, ukwelashwa okujwayelekile ukukhipha ingxenye noma zonke izinso ezithintekile ngokuhlinzwa.

Uma isimila singasuswa, maningi amathuba okuthi umdlavuza usabalalele kuma-lymph node noma kwezinye izitho zakho. Ukusabalala komdlavuza kubizwa ngokuthi yi-metastasis.

Endabeni ye-RCC, isimila singangena emthanjeni omkhulu ophuma ezinso. Ingasakazeka futhi ohlelweni lwe-lymph nakwezinye izitho. Amaphaphu asengozini ikakhulukazi.

Isiteji se-TNM kanye nezigaba zomdlavuza wezinso

Umdlavuza wezinso uchazwa ngezigaba lapho i-American Joint Committee on Cancer yathuthuka khona. Uhlelo lwaziwa kangcono njengohlelo lwe-TNM.

• "T" Kusho isimila. Odokotela babela i- "T" ngenombolo esuselwe kubukhulu nokukhula kwesimila.
• "N" ichaza ukuthi umdlavuza ususabalele kunoma yiziphi izigaxa ohlelweni lwe-lymph.
• "M" kusho ukuthi umdlavuza ususetshenzisiwe.

Ngokuya ngezici ezingenhla, odokotela babela i-RCC isigaba. Isiteji sisuselwe kubukhulu besimila nokusabalala komdlavuza.

Kunezigaba ezine:

• Izigaba 1 no-2 chaza umdlavuza lapho isimila sisesezinso. Isigaba 2 sisho ukuthi isimila sikhulu kunamasentimitha ayisikhombisa ngaphesheya.
• Izigaba 3 no 4 Kusho ukuthi umdlavuza ususabalele emthanjeni omkhulu noma izicubu eziseduze noma kuma-lymph node.
• Isigaba 4 uhlobo oluphambili kakhulu lwesifo. Isigaba sesi-4 sisho ukuthi umdlavuza ususabalele kwi-adrenal gland noma usabalalele kuma-lymph node akude noma kwezinye izitho. Ngoba indlala ye-adrenal inamathele ezinso, umdlavuza uvame ukusabalala lapho kuqala.

Uyini umbono?

Izinga lokusinda leminyaka emihlanu lomdlavuza wezinso lisuselwa kumaphesenti abantu abaphila okungenani iminyaka emihlanu benesifo ngemuva kokutholakala kwaso.

I-American Cancer Society (ACS) ibika iphesenti labantu abaphila iminyaka engu-5 noma ngaphezulu ngemuva kokuxilongwa ngokwezigaba ezintathu ezincike emininingwaneni evela kuNational Cancer Institute.

Lezi zigaba yilezi:

• okwenziwe kwasendaweni (umdlavuza awusakazekanga ngale kwezinso)
• esifundeni (umdlavuza usakazeke eduze)
• kude (umdlavuza usakazekele ezingxenyeni ezikude zomzimba)

Ngokuya nge-ACS, amazinga okusinda e-RCC asuselwa kulezi zigaba ezintathu yile:

• okwenziwe kwasendaweni: Amaphesenti angama-93
• kwesifunda: Amaphesenti angama-70
• kude: Amaphesenti ayi-12

Yiziphi izinketho zokwelashwa?

Uhlobo lokwelashwa olutholayo luxhomeke kakhulu esigabeni somdlavuza wakho. Isigaba 1 i-RCC ingelashwa ngokuhlinzwa.

Kodwa-ke, ngesikhathi umdlavuza usudlulele esigabeni sesi-4, ukuhlinzeka kungenzeka kungabi yindlela.

Uma isimila kanye ne-metastasis kungahlukaniswa, ukususwa kokuhlinzwa kwezicubu zomdlavuza kanye / noma ukwelashwa kwesimila se-metastatic ngokususa noma ezinye izinqubo ezinjenge-stereotactic therapy yomzimba noma i-thermal ablation kusengenzeka.

Uma unesigaba 4 se-RCC, udokotela wakho uzocubungula indawo nokusabalala komdlavuza wakho nempilo yakho yonke ukunquma ukufaneleka kwakho ngokuhlinzwa.

Uma ukuhlinzwa kungeyona inketho engokoqobo yokwelapha isigaba 4 RCC, udokotela wakho angancoma ukwelashwa kwesistimu kusetshenziswa inhlanganisela yemithi.

Isampula lesimila sakho, elibizwa ngokuthi yi-biopsy, lingatholwa ukusiza ukunquma ukwelashwa okungcono kohlobo oluthile lomdlavuza. Ukwelashwa kungaxhomeka ekutheni unamaseli acacile noma ayi-clear RCC cell.

Ukwelashwa okuhlosiwe kanye ne-immunotherapy, kufaka phakathi i-tyrosine kinase inhibitors kanye ne-anti-PD-1 antibodies monoclonal, kungasetshenziswa ukwelapha isigaba 4 RCC. Umuthi othile unganikezwa wedwa noma uhlanganiswe nomunye umuthi.

Ukwelashwa kungafaka:

• i-axitinib + pembrolizumab
• pazopanib
• sunitinib
• ipilimumab + nivolumab
• cabozantinib

Imithi emisha ingatholakala ngokuhlolwa komtholampilo. Ungaxoxa ngenketho yokubhalisa nodokotela wakho.

Udokotela wakho futhi angancoma ukwelashwa okusekelayo ukusiza nganoma yimiphi imiphumela emibi noma izimpawu.

Ukuthatha

Uma utholwe unesigaba 4 se-RCC, khumbula ukuthi amanani okusinda ashicilelwe ayizilinganiso.

Isibikezelo sakho ngasinye sincike ohlotsheni oluthile lomdlavuza nokuthi luthuthuke kangakanani, ukuphendula ekwelashweni, nasempilweni yakho yonke.

Ukhiye uku:

• landela iseluleko sikadokotela wakho
• iya kuma-aphoyintimenti akho
• thatha imithi yakho

Futhi, qiniseka ukuthi ulandela nganoma yiziphi iziphakamiso zokwelashwa noma izinguquko zendlela yokuphila ukubhekana nanoma imiphi imiphumela emibi nezimpawu. Lokhu kungasiza ukusekela impilo yakho yonke kanye nokuphila kahle ngenkathi uthola ukwelashwa.