Cholangiocarcinoma (Kanseri Y'Inzira Y'Umusemburo Wa Bile)

Umwijima uba ufite umusemburo w'icyatsi kibisi, umwijima ukora, witwa bile. Bile iva mu mwijima ijya mu mwima. Ihumura mu mwima kugeza igihe ikenewe mu gusya ibiryo. Mu gihe cyo kurya, umwijima urekura bile mu muyoboro wa bile. Uwo muyoboro utwara bile mu gice cyo hejuru cy'umwanya muto, witwa duodenum, kugira ngo afashe mu gusenya amavuta ari mu biryo.

Cholangiocarcinoma ni ubwoko bwa kanseri ikura mu myanya myiza (imiyoboro ya bile) itwara umusemburo wa bile usya ibiryo. Imiyoboro ya bile ihuza umwijima wawe n'umwijima wawe n'umwanya muto.

Cholangiocarcinoma, izwi kandi nka kanseri y'imiyoboro ya bile, ikunda kugaragara mu bantu barengeje imyaka 50, nubwo ishobora kugaragara mu kigero icyo ari cyo cyose.

Abaganga bagabanya cholangiocarcinoma mu bwoko butandukanye hashingiwe aho kanseri iba mu mihombo ya bile:

• Intrahepatic cholangiocarcinoma iba mu bice by'imiyoboro ya bile iri mu mwijima, kandi rimwe na rimwe ihabwa ubwoko bwa kanseri y'umwijima.
• Hilar cholangiocarcinoma iba mu mihombo ya bile iri hanze gato y'umwijima. Ubwo bwoko buzwi kandi nka perihilar cholangiocarcinoma.
• Distal cholangiocarcinoma iba mu gice cy'umuyoboro wa bile kiri hafi y'umwanya muto. Ubwo bwoko buzwi kandi nka extrahepatic cholangiocarcinoma.

Cholangiocarcinoma ikunze kuvurwa iyo imaze gutera imbere, bituma kuvura neza bigorana.

Ibiranga kandi bikagaragaza kanseri ya cholangiocarcinoma birimo:

• Umuhondo ku ruhu no ku mboni z'amaso (jaundice)
• Gukorora cyane
• Ingobyi zera
• Kwumva unaniwe
• Kubabara mu nda iburyo, hepfo gato y'amaguru
• Kugabanya ibiro utihatira
• Gufata umuriro
• Kumira ijoro
• Inkari z'umukara

Jya kwa muganga niba ufite umunaniro udashira, ububabare mu nda, ingaruka z'umwijima, cyangwa ibindi bimenyetso n'ibibazo bikubangamira. Ashobora kukwerekeza ku muguzi w'indwara z'igogora (gastroenterologue). Kanda hano wiyandikishe ubuntu, ubone igitabo cyuzuye ku bijyanye no guhangana na kanseri, ndetse n'amakuru afatika y'uko wakwemererwa guhabwa igitekerezo cya kabiri. Urashobora gukuramo izina ryawe igihe icyo ari cyo cyose. Igikoresho cyawe cyuzuye ku guhangana na kanseri kizaba kiri muri inbox yawe mu kanya gato. Uzabona kandi

Cholangiocarcinoma ibaho iyo seli ziri mu myanya y'inzira y'umusemburo zihinduye ADN yazo. ADN ya seli ikubiyemo amabwiriza abwira seli icyo ikora. Izi mpinduka zibwira seli kwishima mu buryo butagengwa, zigakora ikibyimba (tumor) gishobora kwangiza no kurimbura imyanya y'umubiri ikora neza. Ntabwo birasobanutse icyateza impinduka zitera cholangiocarcinoma.

Ibintu bishobora kongera ibyago byo kwibasirwa na kanseri ya cholangiocarcinoma birimo:

• Cholangite sclerose primaire. Iyi ndwara itera gukomera no gukomera kw'inzira z'umusemburo.
• Indwara y'umwijima ikaze. Gukomera kw'umwijima guterwa n'amateka y'indwara y'umwijima ikaze byongera ibyago byo kwibasirwa na kanseri ya cholangiocarcinoma.
• Ibibazo by'inzira z'umusemburo biriho kuva ku ivuka. Abantu bavutse bafite choledochal cyst, itera inzira z'umusemburo kwaguka no kudakora neza, bafite ibyago byiyongereye byo kwibasirwa na kanseri ya cholangiocarcinoma.
• Udukoko two mu mwijima. Mu turere two mu majyepfo y'uburasirazuba bwa Aziya, kanseri ya cholangiocarcinoma ifitanye isano n'ubwandu bw'udukoko two mu mwijima, bishobora kubaho binyuze mu kurya amafi atatetse cyangwa atetse nabi.
• Izabukuru. Kanseri ya cholangiocarcinoma igaragara cyane mu bantu bakuru barengeje imyaka 50.
• Itabi. Itabi rifite isano n'ibyago byiyongereye byo kwibasirwa na kanseri ya cholangiocarcinoma.
• Diabete. Abantu barwaye diabete yo mu bwoko bwa 1 cyangwa 2 bashobora kugira ibyago byiyongereye byo kwibasirwa na kanseri ya cholangiocarcinoma.
• Uburwayi bumwe na bumwe bwa gakondo. Ihinduka rimwe na rimwe rya ADN rikomoka ku babyeyi ku bana riteza uburwayi bwongera ibyago byo kwibasirwa na kanseri ya cholangiocarcinoma. Ingero z'izo ndwara harimo cystic fibrosis na syndrome ya Lynch.

Kugira ngo ugabanye ibyago byo kwibasirwa na kanseri ya cholangiocarcinoma, urashobora:

• Kureka kunywa itabi. Kunywa itabi bifitanye isano n'ibyago byiyongereye byo kwibasirwa na kanseri ya cholangiocarcinoma. Niba unywa itabi, reka. Niba warigeze ugerageza kureka kandi ntibyakubayeho, vugana na muganga wawe ku buryo bwo kugufasha kureka.
• Gukuraho ibyago byo kurwara indwara z'umwijima. Indwara z'umwijima zidakira zifitanye isano n'ibyago byiyongereye byo kwibasirwa na kanseri ya cholangiocarcinoma. Bimwe mu bintu biterwa n'indwara z'umwijima ntibishobora kwirindwa, ariko ibindi bishobora. Komeza kwita ku mwijima wawe. Urugero, kugira ngo ugabanye ibyago byo kwibasirwa n'uburwayi bw'umwijima (cirrhosis), nywa inzoga mu rugero, niba uhisemo kunywa. Ku bantu bakuze bafite ubuzima bwiza, bisobanura inzoga imwe ku munsi ku bagore n'inzoga ebyiri ku munsi ku bagabo. Komereza ku kureba ibiro byawe. Iyo ukorana na chemicals, komeza amabwiriza y'umutekano. Gukuraho ibyago byo kurwara indwara z'umwijima. Indwara z'umwijima zidakira zifitanye isano n'ibyago byiyongereye byo kwibasirwa na kanseri ya cholangiocarcinoma. Bimwe mu bintu biterwa n'indwara z'umwijima ntibishobora kwirindwa, ariko ibindi bishobora. Komeza kwita ku mwijima wawe. Urugero, kugira ngo ugabanye ibyago byo kwibasirwa n'uburwayi bw'umwijima (cirrhosis), nywa inzoga mu rugero, niba uhisemo kunywa. Ku bantu bakuze bafite ubuzima bwiza, bisobanura inzoga imwe ku munsi ku bagore n'inzoga ebyiri ku munsi ku bagabo. Komereza ku kureba ibiro byawe. Iyo ukorana na chemicals, komeza amabwiriza y'umutekano.

Endoscopic retrograde cholangiopancreatography (ERCP) ikoresha ibara ryerekana inzira z'umusemburo ku mashusho ya X-ray. Umuyoboro muto, woroshye ufite kamera ku mpera, witwa endoscope, unyura mu mazuru ukagera mu ruhago rwo hasi. Ibara rinjira mu mitsi binyuze mu muyoboro muto utoboka, witwa catheter, unyura muri endoscope. Ibikoresho bito binyura muri catheter bishobora kandi gukoreshwa mu gukuraho amabuye y'umusemburo.

Mu gihe cyo gukoresha endoscopic ultrasound, muganga wawe ashyiramo umuyoboro muremure, woroshye (endoscope) munsi y'amazuru akagera mu nda yawe. Igikoresho cya ultrasound kiri ku mpera y'umuyoboro gitanga ibishushanyo by'amajwi bikora amashusho y'imiterere iri hafi.

Niba muganga wawe akeka cholangiocarcinoma, ashobora kugusaba gukora ibizamini bimwe cyangwa byinshi bikurikira:

• Ibizamini byo gukora kw'umwijima. Ibizamini by'amaraso bipima imikorere y'umwijima bishobora guha muganga wawe ibimenyetso by'icyo gitera ibimenyetso na ibimenyetso byawe.
• Ikizamini cyo gusuzuma umusemburo wawe ufite kamera nto. Mu gihe cya endoscopic retrograde cholangiopancreatography (ERCP), umuyoboro muto, woroshye ufite kamera nto unyura munsi y'amazuru yawe unyuze mu nzira yawe yo kugogora ukagera mu ruhago rwo hasi. Kamera ikoreshwa mu gusuzuma ahantu imitsi yawe y'umusemburo ihurira n'uruhago rwawe rwo hasi. Muganga wawe ashobora kandi gukoresha ubu buryo mu gushyiramo ibara mu mitsi y'umusemburo kugira ngo bifashe kugaragara neza ku bipimo byo kubona amashusho.
• Ibizamini byo kubona amashusho. Ibizamini byo kubona amashusho bishobora gufasha muganga wawe kubona imyanya y'imbere y'umubiri wawe no gushaka ibimenyetso bya cholangiocarcinoma. Uburyo bukoreshwa mu kuvura kanseri y'umusemburo harimo ultrasound, computerized tomography (CT) scans na magnetic resonance imaging (MRI) bifatanije na magnetic resonance cholangiopancreatography (MRCP). MRCP ikoreshwa cyane nk'uburyo budakora cyane ugereranije na ERCP. Itanga amashusho ya 3D idakeneye ibara kugira ngo yongere amashusho.
• Uburyo bwo gukuraho igice cy'umubiri kugira ngo ucukumbuzwe. Biopsy ni uburyo bwo gukuraho igice gito cy'umubiri kugira ngo ucukumbuzwe munsi ya microscope.

Niba agace gakekwa kari hafi cyane aho umusemburo uhurira n'uruhago rwo hasi, muganga wawe ashobora kubona igice cya biopsy mu gihe cya ERCP. Niba agace gakekwa kari mu mwijima cyangwa hafi yawo, muganga wawe ashobora kubona igice cy'umubiri ashingira umugozi muremure unyura mu ruhu rwawe ukagera aho kibabaza (fine-needle aspiration). Ashobora gukoresha ikizamini cyo kubona amashusho, nka endoscopic ultrasound cyangwa CT scan, kugira ngo ayobore umugozi ahantu nyabwo.

Uburyo muganga wawe akuriramo igice cya biopsy bishobora kugira ingaruka ku buryo bwo kuvura buhari kubera wowe nyuma. Urugero, niba kanseri y'umusemburo wawe ikurwaho na fine-needle aspiration, ntuzongera kubona ubuvuzi bwo kubaga umwijima. Ntugatinye kubabaza muganga wawe ubunararibonye afite mu kuvura cholangiocarcinoma. Niba ufite impungenge, shaka undi muganga.

Ikizamini cy'ibimenyetso by'uburwayi. Kureba urwego rwa carbohydrate antigen (CA) 19-9 mu maraso yawe bishobora guha muganga wawe ibimenyetso by'inyongera ku kuvura kwawe. CA 19-9 ni poroteyine ikorwa cyane na kanseri y'umusemburo.

Urwego rwo hejuru rwa CA 19-9 mu maraso yawe ntibisobanura ko ufite kanseri y'umusemburo. Iyi ngaruka ishobora kandi kuba mu zindi ndwara z'umusemburo, nko gutukura kw'umusemburo no kubuzwa kw'umusemburo.

Uburyo bwo gukuraho igice cy'umubiri kugira ngo ucukumbuzwe. Biopsy ni uburyo bwo gukuraho igice gito cy'umubiri kugira ngo ucukumbuzwe munsi ya microscope.

Niba agace gakekwa kari hafi cyane aho umusemburo uhurira n'uruhago rwo hasi, muganga wawe ashobora kubona igice cya biopsy mu gihe cya ERCP. Niba agace gakekwa kari mu mwijima cyangwa hafi yawo, muganga wawe ashobora kubona igice cy'umubiri ashingira umugozi muremure unyura mu ruhu rwawe ukagera aho kibabaza (fine-needle aspiration). Ashobora gukoresha ikizamini cyo kubona amashusho, nka endoscopic ultrasound cyangwa CT scan, kugira ngo ayobore umugozi ahantu nyabwo.

Uburyo muganga wawe akuriramo igice cya biopsy bishobora kugira ingaruka ku buryo bwo kuvura buhari kubera wowe nyuma. Urugero, niba kanseri y'umusemburo wawe ikurwaho na fine-needle aspiration, ntuzongera kubona ubuvuzi bwo kubaga umwijima. Ntugatinye kubabaza muganga wawe ubunararibonye afite mu kuvura cholangiocarcinoma. Niba ufite impungenge, shaka undi muganga.

Niba muganga wawe yemeza ko ufite cholangiocarcinoma, agerageza kumenya urugero (icyiciro) cya kanseri. Akenshi ibi bikubiyemo ibizamini byinyongera byo kubona amashusho. Icyiciro cya kanseri yawe gifasha kumenya uko bizagenda (prognosis) n'uburyo bwo kuvura.

Ubuvuzi bwa kanseri ya cholangiocarcinoma (kanseri y'inzira z'umusemburo) bushobora kuba burimo:

• Ubuganga. Iyo bishoboka,abaganga bagerageza gukuraho kanseri nyinshi uko bashoboye. Ku kanseri nto cyane y'inzira z'umusemburo, ibi bisobanura gukuraho igice cy'inzira y'umusemburo no guhuza impera zaciwe. Ku kanseri y'inzira z'umusemburo ikomeye, imyenda y'umwijima iri hafi, imyenda ya pancreas cyangwa lymph nodes na byo bishobora gukurwaho.
• Gusimbuza umwijima. Ubuganga bwo gukuraho umwijima wawe no kuwusimbuza uwavuye ku muntu utanga (gusimbuza umwijima) bishobora kuba amahitamo mu bihe bimwe na bimwe ku bantu bafite kanseri ya hilar cholangiocarcinoma. Kuri benshi, gusimbuza umwijima bishobora kuba igisubizo cya kanseri ya hilar cholangiocarcinoma, ariko hari ikibazo cy'uko kanseri ishobora kugaruka nyuma yo gusimbuza umwijima.
• Chimiothérapie. Chimiothérapie ikoresha imiti yo kwica selile za kanseri. Chimiothérapie ishobora gukoreshwa mbere yo gusimbuza umwijima. Ishobora kandi kuba amahitamo ku bantu bafite kanseri ya cholangiocarcinoma ikomeye kugira ngo ifashe kugabanya indwara no kugabanya ibimenyetso n'ibibazo. Imiti ya Chimiothérapie ishobora gusukwa mu mutsi kugira ngo igende mu mubiri wose. Cyangwa imiti ishobora gutangwa mu buryo bwo kuyigeza ku selile za kanseri.
• Radiothérapie. Radiothérapie ikoresha imirasire y'ingufu nyinshi iva mu ziko nka X-rays na protons yo kwica selile za kanseri. Radiothérapie ishobora kuba irimo imashini ituma imirasire igana ku mubiri wawe (external beam radiation). Cyangwa ishobora kuba irimo gushyira ibintu bya radioactive mu mubiri wawe hafi y'aho kanseri yawe iri (brachytherapy).
• Ubuvuzi bwibanze ku miti. Ubuvuzi bwibanze ku miti bugerwa ku bintu bidasanzwe biri mu selile za kanseri. Mu kuburizamo ibyo bintu bidasanzwe, ubuvuzi bwibanze ku miti bushobora gutuma selile za kanseri zipfa. Muganga wawe ashobora gupima selile zawe za kanseri kugira ngo arebe niba ubuvuzi bwibanze ku miti bushobora kugira akamaro kuri cholangiocarcinoma yawe.
• Immunothérapie. Immunothérapie ikoresha ubudahangarwa bwawe mu kurwanya kanseri. Ubudahangarwa bwawe bw'umubiri buhangana n'indwara bushobora kutakora ku kanseri yawe kuko selile za kanseri zikora poroteyine zibafasha kwihisha mu selile z'ubudahangarwa. Immunothérapie ikora mu kuburizamo uwo mucyo. Kuri cholangiocarcinoma, immunothérapie ishobora kuba amahitamo ku kanseri ikomeye iyo ubundi buvuzi butabashije gufasha.
• Gusya selile za kanseri. Radiofrequency ablation ikoresha umuriro w'amashanyarazi gusya no kurimbura selile za kanseri. Ukoresheje ikizamini cy'amashusho nk'umuyobozi, nka ultrasound, muganga ashyira umunyu umwe cyangwa mirenge mu dukombe duto mu nda yawe. Iyo ibyo byuma bigera kuri kanseri, bishyushye hamwe n'umuriro w'amashanyarazi, bikarimbure selile za kanseri.
• Photodynamic therapy. Muri photodynamic therapy, ikintu gifite ubushobozi bwo kwakira umucyo cyinjizwa mu mutsi kandi gikusanyiriza mu selile za kanseri zikura vuba. Umucyo wa laser ugana kuri kanseri utera isesengura ry'imiti mu selile za kanseri, bikazica. Ubusanzwe uzakenera ubuvuzi bwinshi. Photodynamic therapy ishobora kugufasha kugabanya ibimenyetso n'ibibazo, kandi ishobora kandi kugabanya ukurura kwa kanseri. Uzakenera kwirinda izuba nyuma y'ubuvuzi. Kuko cholangiocarcinoma ari ubwoko bukomeye cyane bwa kanseri kuvura, ntutinye kubaza ubunararibonye bw'umuganga wawe mu kuvura iyo ndwara. Niba ufite impungenge, shaka undi muganga. Igeragezwa rya kliniki ni ubushakashatsi bwo kugerageza ubuvuzi bushya, nka imiti mishya n'uburyo bushya bw'ubuganga. Niba ubuvuzi buri kwigwa bugaragara ko butekanye kandi bugira umumaro kurusha ubuvuzi buriho, bushobora kuba uburyo bushya bwo kuvura. Igeragezwa rya kliniki ntirishobora guhamya igisubizo, kandi rishobora kugira ingaruka mbi cyangwa zidatateganijwe. Ku rundi ruhande, igeragezwa rya kanseri rikurikiranwa hafi kugira ngo rikorwe neza uko bishoboka. Bitanga uburyo bwo kuvura butari kuboneka. Ganira n'umuganga wawe ku bijyanye n'ibigeragezwa bya kliniki bishobora kukubereye. Ubuvuzi bwo kworoshya ni ubuvuzi bw'abaganga bubanze ku kugabanya ububabare n'ibindi bibazo by'indwara ikomeye. Abahanga mu buvuzi bwo kworoshya bakorana nawe, umuryango wawe n'abandi baganga bawe kugira ngo batange ubufasha bwiyongereye bujyana n'ubuvuzi bwawe buriho. Ubuvuzi bwo kworoshya bushobora gukoreshwa mugihe ukora ubuvuzi bukomeye, nko kubaga. Iyo ubuvuzi bwo kworoshya bukoreshwa hamwe n'ubundi buvuzi bukwiye — ndetse no nyuma gato y'uburwayi bwawe — abantu bafite kanseri bashobora kumva bameze neza kandi bashobora kubaho igihe kirekire. Ubuvuzi bwo kworoshya butangwa n'itsinda ry'abaganga, abaforomo n'abandi bahanga mu by'ubuvuzi. Aya matsinda agamije kunoza imibereho y'abantu bafite kanseri n'imiryango yabo. Ubuvuzi bwo kworoshya si kimwe no kwita ku barwayi cyangwa kwita ku barwayi bari mu mpera z'ubuzima. Kwandikisha ubuntu kandi ubone igitabo cyimbitse cyo guhangana na kanseri, hamwe n'amakuru afatika yo kubona undi muganga. Urashobora guhagarika kwandikisha kuri link yo guhagarika kwandikisha muri email. Igishushanyo cyawe cyimbitse cyo guhangana na kanseri kizaba mu bujye bwawe vuba. Uzabona kandi Kumenya ko ufite indwara itera urupfu bishobora kubabaza cyane. Ntuzasanga ibisubizo byoroshye byo guhangana na cholangiocarcinoma, ariko bimwe mu byifuzo bikurikira bishobora kugufasha:
• Menya ibyo ukeneye kumenya kuri kanseri yawe. Baza muganga wawe kuri kanseri yawe, harimo ubwoko n'icyiciro cya kanseri yawe, amahitamo yawe yo kuvura, kandi, niba ushaka, uko bizakugenda. Uko uziga byinshi kuri cholangiocarcinoma, ushobora kugira icyizere cyinshi mu gufata ibyemezo byo kuvura. Baza ku zindi nkomoko zizwi neza z'amakuru yongeyeho.
• Komeza inshuti n'umuryango wawe hafi. Kugumana umubano wa hafi bizagufasha guhangana na kanseri yawe. Incuti n'umuryango bashobora gutanga ubufasha ukeneye, nko kugufasha kwita ku rugo rwawe niba uri mu bitaro. Kandi bashobora kuba ubufasha bwo mu mutima iyo wumva uhagaze.
• Shaka umuntu wo kuvugana na we. Nubwo inshuti n'umuryango bashobora kuba inshuti zawe nziza, mu bihe bimwe na bimwe bagira ikibazo cyo guhangana n'igitutu cy'uburwayi bwawe. Muri ibyo bihe, kuvugana n'umujyanama, umukozi w'imibereho mu bitaro, cyangwa umujyanama wa pastoral cyangwa uw'idini bishobora kugufasha. Baza muganga wawe kugira ngo aguhe umuntu.
• Huza n'abandi barokotse kanseri. Ushobora kubona ihumure mu kuganira n'abandi barokotse kanseri. Suhuza n'ishami ryawe rya American Cancer Society kugira ngo ubone amatsinda y'ubufasha kuri kanseri mu karere kawe.
• Tegura imigambi ku bintu bitazwi. Kugira indwara itera urupfu, nka kanseri, bisaba ko witegura uburyo ushobora gupfa. Kuri bamwe, kugira ukwizera gukomeye cyangwa ikintu gikomeye kurusha bo biroroshya kwiyumvisha indwara itera urupfu. Baza muganga wawe ku bijyanye n'amabwiriza mbere y'igihe n'ibyifuzo byo kubaho kugira ngo ugufashe gutegura kwita ku mpera z'ubuzima, niba ubikeneye. Tegura imigambi ku bintu bitazwi. Kugira indwara itera urupfu, nka kanseri, bisaba ko witegura uburyo ushobora gupfa. Kuri bamwe, kugira ukwizera gukomeye cyangwa ikintu gikomeye kurusha bo biroroshya kwiyumvisha indwara itera urupfu. Baza muganga wawe ku bijyanye n'amabwiriza mbere y'igihe n'ibyifuzo byo kubaho kugira ngo ugufashe gutegura kwita ku mpera z'ubuzima, niba ubikeneye.