Kenza Rebhara
Pfupiso
Dzidza zvakawanda pamusoro pekenza yeura kubva kuna urologist Mark Tyson, M.D., M.P.H.
Kunyangwe kenza yeura ichigona kuitika kune ani zvake, inokanganisa mapoka akati wandei kupfuura mamwe. Semuenzaniso, vanofuma. Sezvo ura richishanda kubvisa makemikari anokuvadza anodyiwa mukutsva kwesigareti, rinokuvadzwa. Kutaura zvazviri, vanofuma vane mukana wekatatu wekuwana kenza yeura. Vanhu vane makore anopfuura 55 vane njodzi yakawanda, sezviriwo varume, kupfuura vakadzi. Kuonana nema kemikari anokuvadza, kumba kana pabasa, kurapwa kwekare kwekenza, kuzvimba kwenguva refu kweura, kana nhoroondo yemhuri yekenza yeura zvinogona zvakare kutamba basa.
Zviratidzo zvekenza yeura kazhinji zvakajeka uye nyore kuona. Kana chimwe chezviratidzo izvi chiripo, zvingave zvakakosha kuita musangano kuona chiremba: Ropa muurine, kuenda kunzvimbo kazhinji, kurwadziwa pakuenda kunzvimbo kana kurwadziwa kumusana. Chiremba wako angatanga kutsvaga zvikonzero zvakajairika zvechiratidzo chokutanga, kana kuti angakureva kune nyanzvi, senge urologist kana oncologist.
Kuti aone kana une kenza yeura, chiremba wako angatanga ne cystoscopy, uko kamera duku inopfuudzwa ne urethra kuona mukati meura. Kana chiremba wako akawana chimwe chinhu chisingatarisirwi, vanogona kutora biopsy kana sampuli yesero inotumirwa ku laboratori kuti iongororwe. Muzviitiko zvimwe, chiremba wako angaita urine cytology, uko vanoongorora sampuli yeurine pasi pe microscope kuongorora masero ekensa. Kana kuti vangatoita bvunzo dzemafomati emukati meura wako, senge CT urogram kana retrograde pyelogram. Muzviitiko zvese zviviri, dye yakachengeteka inoiswa uye inofamba kuenda kuura rako, ichivhenekera masero ekensa kuitira kuti aoneke mumafoto e-X-ray.
Pakugadzira chirongwa chekurapa kenza yeura, chiremba wako ari kufunga nezvezvinhu zvakati wandei, kusanganisira rudzi uye nhanho yekenza uye zvaunoda kurapwa. Kune marudzi mashanu ekusarudza kurapa kenza yeura: Kuvhiya kubvisa tishu yekenza. Chemotherapy, inoshandisa makemikari anouraya masero ekensa anogona kufamba munzvimbo iri pedyo neura kana mumuviri wose, kana zvichidiwa. Radiation therapy, inoshandisa ma beam ane simba guru re simba kuratidza masero ekensa. Targeted drug therapy inotarisa pakuvhara kushaya simba kwakakosha kuri mumaseru ekensa. Uye immunotherapy, kurapwa kwemishonga kunobatsira sisitimu yako yekudzivirira kuziva masero ekensa uye kuvarwisa.
Kenza yeura kazhinji inotanga mumaseru (urothelial cells) anovhara mukati meura rako. Masero eUrothelial anowanikwawo muitsvo dzako uye matumbo (ureters) anobatanidza itsvo kuenda kuura. Kensa yeUrothelial inogona kuitika muitsvo neureters, zvakare, asi inowanzowanikwa muura.
Kazhinji kenza yeura inoziviswa pane nhanho yekutanga, apo kenza inorapika zvikuru. Asi kunyangwe kenza yeura iri panhanho yekutanga inogona kudzoka mushure mekurapwa kwakabudirira. Nechikonzero ichi, vanhu vane kenza yeura vanoda bvunzo dzekutevera kwemakore mushure mekurapwa kutsvaga kenza yeura inodzokazve.
Zviratidzo
'Zviratidzo nezviratidzo zvekenza yeura yemukati zvinogona kusanganisira: Ropa muurine (hematuria), izvo zvinogona kuita kuti urine ioneke yakatsvukuruka kana ine ruvara rwecola, kunyangwe dzimwe nguva urine ichiita kunge yakajairwa uye ropa richionekwa mu bvunzo yekurabhoritari\nKuenda kujambwa kazhinji\nKurwadziwa pakuenda kujambwa\nKurwadziwa kumusana Kana ukaona kuti une urine ine ruvara risina kujairika uye uchitya kuti inogona kuva neropa, bvunza chiremba wako kuti aione. Bvunzawo chiremba wako kana uine zvimwe zviratidzo kana zviratidzo zvinokunetsa.'
Nguva yekunoona chiremba
Kana ukaona kuti wee yako yakachinja ruvara uye une hanya nekuti ingave ine ropa, bvunza chiremba kuti aiongorore. Zvakare, bvunza chiremba kana uine zvimwe zviratidzo kana zvirwere zvinokunetsa.
Zvinokonzera
Kenza renyama rinokura kana masero ari mubhuru renyama richitanga kukura zvisina kujairika, richigadzira ganda mubhuru renyama.
Kenza renyama rinotanga kana masero ari mubhuru renyama achikura kuchinja (mutations) muDNA yavo. DNA yesero ine mirairo inoudza sero zvekukura. Kuchinja kunoudza sero kuti riwedzere nekukurumidza uye kuti rirambe richirarama apo masero ane hutano aifa. Masero asina kujairika anogadzira ganda rinogona kupinda uye kuparadza tishu dzemuviri dzakajairika. Panguva yakareba, masero asina kujairika anogona kuputsika uye kupararira (metastasize) mumuviri.
Marudzi akasiyana emasero ari mubhuru renyama ako anogona kuva nekenza. Rudzi rwesero rebhuru renyama uko kenza rinotanga rinosimbisa rudzi rwekenza renyama. Vanachiremba vanoshandisa ruzivo urwu kuti vaone kuti mishonga ipi inogona kushanda zvakanaka kwauri.
Marudzi ekenza renyama anosanganisira:
- Urothelial carcinoma. Urothelial carcinoma, yakambozivikanwa se transitional cell carcinoma, inoitika mumasero anovhara mukati mebhuru renyama. Masero eUrothelial anowedzera kana bhuru renyama rakazara uye anodzikira kana bhuru renyama risina chinhu. Aya masero akafanana anovhara mukati meureters neurethra, uye kenza inogona kuumbwa ipapowo. Urothelial carcinoma ndiyo rudzi rwakajairika rwekenza renyama muUnited States.
- Squamous cell carcinoma. Squamous cell carcinoma inobatanidzwa nekutsamwa kwenguva refu kwebhuru renyama — semuenzaniso, kubva kune chirwere kana kubva pakushandisa kwenguva refu kwe catheter yemukati. Squamous cell bladder cancer yakawanda muUnited States. Inowanzoitika munzvimbo dzenyika umo chirwere cheparasite (schistosomiasis) chiri chikonzero chakajairika chekuzara kwebhuru renyama.
- Adenocarcinoma. Adenocarcinoma inotanga mumasero anoumba maglands anoburitsa mvura mubhuru renyama. Adenocarcinoma yebhuru renyama yakawanda.
Mamwe makensa ebhuru renyama anosanganisira rudzi rwakawanda rwesero.
Zvinhu zvinokonzera njodzi
Zvinhu zvinogona kuwedzera njodzi yekenza yeura inosanganisira:
- Kusvuta. Kusvuta fodya, zvigadzirwa zvefodya kana mapaipi kunogona kuwedzera njodzi yekenza yeura nekukonzera kuti makemikari anokuvadza awanike muurine. Kana ukavuta, muviri wako unogadzirisa makemikari ari mufodya uye unobudisa mamwe acho muurine yako. Aya makemikari anokuvadza anogona kukuvadza ganda reura yako, izvo zvinogona kuwedzera njodzi yako yekenza.
- Kuwedzera kwezera. Njodzi yekenza yeura inowedzera sezvaunokura. Kunyangwe ichigona kuitika pazera ripi zvaro, vanhu vakawanda vanorwara nekenza yeura vane makore anopfuura 55.
- Kuva murume. Varume vane mukana mukuru wekurwara nekenza yeura kupfuura vakadzi.
- Kuonekwa nema kemikari chaiwo. Itsvo dzako dzinotambira basa rinokosha mukubvisa makemikari anokuvadza kubva muropa rako uye kuendesa muura yako. Nekuda kweizvi, zvinofungidzirwa kuti kuva pedyo nema kemikari chaiwo kunogona kuwedzera njodzi yekenza yeura. Makemikari akabatana nenjodzi yekenza yeura anosanganisira arsenic nema kemikari anoshandiswa mukugadzira dyes, rabha, ganda, machira nezvigadzirwa zvepende.
- Kurapwa kwekenza kare. Kurapwa nechikafu chekurapa kenza cyclophosphamide kuwedzera njodzi yekenza yeura. Vanhu vakagamuchira kurapwa kwemwaranzi kwakatariswa ku pelvis nekuda kwekenza yapfuura vane njodzi yakakwira yekuwana kenza yeura.
- Kutemwa kwenguva refu kweura. Kutemwa kwenguva refu kana kutemwa kwenguva refu kwehutachiona hwehutachiona kana kuzvimba (cystitis), sezvinogona kuitika nekushandisa kwenguva refu kwe catheter yeura, kunogona kuwedzera njodzi yekenza yeura squamous cell. Munzvimbo dzakawanda munyika, squamous cell carcinoma inobatanidzwa nekuzvimba kwenguva refu kweura kunokonzerwa nehutachiona hwehutachiona hunonzi schistosomiasis.
- Nhoroondo yepersonal kana yemhuri yekenza. Kana wakamborwara nekenza yeura, une mukana mukuru wekuwana zvakare. Kana mumwe wemhuri yako — mubereki, munun'una kana mwana — ane nhoroondo yekenza yeura, ungave une njodzi yakawedzera yerwisiso, kunyangwe zvisingawanzoitika kuti kenza yeura iende mumhuri. Nhoroondo yemhuri yeLynch syndrome, inozivikanwawo se hereditary nonpolyposis colorectal cancer (HNPCC), inogona kuwedzera njodzi yekenza muchikamu cheura, pamwe chete nemucolon, uterus, ovaries nemamwe matunhu.
Kudzivirira
Kunyangwe pasina nzira yakavimbika yekudzivirira kenza yeura, unogona kutora matanho ekubatsira kuderedza njodzi yako. Semuenzaniso:
- Usafume. Kana usingafumi, usatange. Kana uchifuma, taura nachiremba wako nezvechirongwa chekukubatsira kurega. Mapihwa ekutsigira, mishonga nezvimwe zvinhu zvinogona kukubatsira kurega.
- Chenjera nezvinhu zvinemakemikari. Kana uchishanda nezvinhu zvinemakemikari, tevera mirairo yese yekuchengetedza kudzivirira kuiswa.
- Sarudza marudzi akasiyana-siyana emichero nemiriwo. Sarudza kudya kwakapfuma mune akasiyana-siyana emichero nemiriwo ine mavara. Antioxidants ari mumichero nemiriwo inogona kubatsira kuderedza njodzi yako yekenza.
Kuongorora
Wana mhinduro dzemibvunzo inonyanya kubvunzwa pamusoro pekenza yeura kubva kuna urologist Mark Tyson, M.D., M.P.H.
Rudzi rwekenza yeura iyo varwere vakawanda vanorwara naro ndiro urothelial carcinoma. Kune mamwe marudzi ekenza yeura, senge adenocarcinomas ne small cell carcinomas, asi urothelial carcinoma ndiyo inonyanya kuwanda. Mamwe urothelial carcinomas ane zvinonzi variant histology, uye aya angave plasmacytoid, micropapillary, microcystic. Aya matumour anowanzo kuwedzera kuita zvakaipa kwe urothelial carcinoma. Asi pamusoro pe rudzi rwesero, unofanirawo kuziva grade nestage yematumour ako. Aya matumour anowanzo graderwa se low grade ne high grade, nekenza ye high-grade iri yakaipa zvikuru. Grade, stage, nerudzi rwekenza zvinoshandiswa kutsanangura rudzi rwekurapa kwaunozowana.
Sarudzo dzekurapa zvinoenderana ne grade nestage yematumour ako. Kana uine high-grade, non-muscle-invasive bladder cancer, tinowanzo kurapa izvozvo ne transurethral resection yematumour eura, ichiteverwa ne intravesicle therapy, kana ne chemotherapy kana immunotherapy, senge BCG. Kana uine invasive carcinoma, senge muscle-invasive cancer, tinowanzo kurapa izvozvo ne upfront cisplatin-based combination chemotherapy, ichiteverwa nekubviswa kweura kana radiation. Kune zvekufunga nezve quality of life ne toxicity nezvese izvo sarudzo, uye zviri kwauri kusarudza kuti ndeipi yakakodzera kwauri. Adjuvant immunotherapy rudzi rwekurapa runopiwa mushure mekuvhiyiwa kubatsira kuderedza njodzi yekudzoka kwekenza gare gare. Varwere vane stage 4 bladder cancer vanowanzo kurapwa ne first-line cisplatin-based combination chemotherapy.
Pamusoro pfupi ndeyekuti hazvina basa chaizvo. Zvingave wakaita kuvhiyiwa kwakavhurwa kana kuti wakaita robotically, migumisiro inenge yakafanana. Iri ibasa guru uye varwere vachava muchipatara kwemazuva mashoma mushure mekuvhiyiwa uye vanoda mavhiki mashoma kuti vapone, pasinei nokuti kuvhiyiwa kwacho kwakaitwa sei. Nekushandiswa kwe robotic, zvisinei, pane ma incisions madiki e laparoscopic. Uye kazhinji, pane ropa shoma rinorasika uye zvichida zvishoma zvishoma zvinetso zvekuvhiyiwa. Nekushandiswa kwakavhurwa, kuvhiyiwa kunokurumidza, asi kunobatanidzwa neropa rakawanda rinorasika. Uye ndinokurudzira varwere kuti vashandise kuvhiyiwa kunonzwa kwakakodzera kwavari.
Neobladder rudzi rwe urinary diversion rinoitwa panguva yekuvhiyiwa kubvisa ura. Saka, patino bvisa ura, tinofanira kutungamira urine kune imwe nzvimbo. Uye zvatinoita ndekutora tsoka imwe yeura duku, inonzi ileum, uye tinoidzikisa, kana kuti kuivhura. Tinoiita kuva bhora. Uye ipapo tinobatanidza pasi ku urethra uye ipapo tinobatanidza itsvo mairi. Uye zvakanaka nekuti zvese zvinhu, saka kutaura, zviri mukati memumuviri. Hapana bhegi rekudonha kunze kwe urine, sekune ileal conduit. Asi kune zvimwe zvinokanganisa ne neobladder. Hazvishande zvakakwana. Semuenzaniso, anenge 25% yevarume vachava neimwe mwero yekusagadzikana kwenguva refu, uye anenge 30% vevakadzi. Anenge 10% yevarume vachada catheterize kuti vadurure neobladder yavo uye anenge 25% vevakadzi vachadawo. Uye aya mafungiro akakosha sezvo mumwe munhu achisarudza pakati pe neobladder ne conduit.
Ileal conduit imhando ye urinary diversion uko kune bhegi rekudonha kunze. Kusiyana ne neobladder uko tinogadzira ura idzva uye tinobatanidza itsvo ku urethra uye zvese zviri mukati memumuviri, ileal conduit inotungamira urine kunze kwemuviri. Saka kurudyi kwemudumbu mako kuchave ne stoma, senge ostomy, inodonha mubhegi. Kune varwere vakawanda, iyi ndiyo sarudzo yakanaka. Iri nyore uye iri nyore kudzidza kushandisa. Hapana kumuka usiku kushandisa imba yekugezera. Hapana kumira kana uri kutyaira. Uye chero chinhu chawaiita usati wavhiyiwa, unogona kuita mushure. Izvi zvinosanganisira scuba diving, skydiving, water skiing, golfing, hiking, biking. Varwere vakawanda vanobvunza mubvunzo wekuti ndeipi diversion yakakodzera kwandiri? Uye zvinoenderana chete nemunhu. Kune vanhu vari kutsvaga nyore, ileal conduit ndiyo sarudzo yakakodzera.
Quality of life chimiro chakakosha chakakosha pakusarudza kuti ndeapi maitiro ekurapa ari nani kwauri. Kune non-muscle-invasive bladder cancer, tinowanzo kurapa ne intravesicle therapy. Asi kune migumisiro yekurapa: Kupisa kurwadziwa nekuita weti, kuwanda, kuomesa, ropa muweti. Zvinosanganisirawo catheterizations uye zvinogona kurwadza panguva yekupa. Kune varwere vane muscle-invasive disease, uye vari kuedza kusarudza pakati pekuti vaite cystectomy, iyo kubviswa kwakakwana kweura, kana radiation therapy, kune nhamba yemigumisiro ye quality of life ipapowo.
Varwere vanobatanidzwa mukutarisirwa kwavo ndivo vanonyanya kuoma kutarisira. Dzidza zvakawanda sezvinobvira. Uye rangarira, tiri mune timu imwe chete. Usambofa wakarega kubvunza timu yako yezvokurapa chero mibvunzo kana zvinetso zvaunazvo. Kuva neruzivo kunoita musiyano wose. Tinokutendai nekanguva kwenyu uye tinokushuvira zvakanaka.
Cystoscopy inobvumira mushandi wehutano kuti aone nzira yepasi ye urinary tract kutsvaga matambudziko, senge dombo reura. Zvishandiso zvekuvhiya zvinogona kupfuudzwa kuburikidza ne cystoscope kurapa mamiriro ezvinhu e urinary tract.
Cystoscopy inobvumira mushandi wehutano kuti aone nzira yepasi ye urinary tract kutsvaga matambudziko mu urethra neura. Zvishandiso zvekuvhiya zvinogona kupfuudzwa kuburikidza ne cystoscope kurapa mamiriro ezvinhu e urinary tract.
Kuongororwa nekuita kwinoshandiswa kuona kenza yeura kunogona kusanganisira:
- Kushandisa scope kuongorora mukati meura rako (cystoscopy). Kuita cystoscopy, chiremba wako anopinda chubhu diki, yakatetepa (cystoscope) kuburikidza ne urethra yako. Cystoscope ine lens inobvumira chiremba wako kuona mukati me urethra yako neura, kuongorora aya maumbirwo ekutsvaga zviratidzo zverwere. Cystoscopy inogona kuitwa muhofisi yechiremba kana muchipatara.
- Kubvisa sampuli yetsinga yekuongorora (biopsy). Panguva yecystoscopy, chiremba wako anogona kupfuudza chishandiso chakakosha kuburikidza nescope uye mukati meura rako kuunganidza sampuli yesero (biopsy) yekuongorora. Iyi nzira inonzi dzimwe nguva transurethral resection yematumour eura (TURBT). TURBT inogona kushandiswawo kurapa kenza yeura.
- Kuongorora sampuli yeweti (urine cytology). Sampuli yeweti yako inongororwa pasi pe microscope kuongorora masero ekenza mune nzira inonzi urine cytology.
Kuongorora kwemuenzaniso. Kuongorora kwemuenzaniso, senge computerized tomography (CT) urogram kana retrograde pyelogram, inobvumira chiremba wako kuongorora maumbirwo e urinary tract yako.
Panguva ye CT urogram, dye inopinda muchiuno chako chemaoko inopinda muitsvo, ureters neura. Mifananidzo ye-X-ray yakatorwa panguva yekuongorora inopa maonero akakwana e urinary tract yako uye inobatsira chiremba wako kuziva chero nzvimbo dzisingave kenza.
Retrograde pyelogram ndiro bvunzo ye-X-ray inoshandiswa kuwana maonero akakwana e urinary tract yepamusoro. Panguva yebvunzo iyi, chiremba wako anopinda chubhu yakatetepa (catheter) kuburikidza ne urethra yako uye mukati meura rako kuisa dye mu ureters yako. Dye inopinda muitsvo ako nepo mifananidzo ye-X-ray ichitorwa.
Mushure mekusimbisa kuti une kenza yeura, chiremba wako anogona kukurudzira bvunzo dzakawanda kuti aone kana kenza yako yakapararira kune lymph nodes yako kana kune dzimwe nzvimbo dzemuviri wako.
Kuongorora kunogona kusanganisira:
- CT scan
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
- Bone scan
- Chest X-ray
Chiremba wako anoshandisa ruzivo kubva kune aya maitiro kuti aise kenza yako stage. Stages dzekenza yeura dzinoonekwa neRoman numerals kubva pa 0 kusvika ku IV. Stages dzakaderera dzinoratidza kenza iri muma layers mukati meura uye isina kukura kuti ikanganise muscular bladder wall. Stage yepamusoro — stage IV — inoratidza kenza yakapararira ku lymph nodes kana nhengo munzvimbo dzakasiyana dzemuviri
Kenza yeura inotsanangurwa zvakare zvichienderana nekuti masero ekenza anoita sei kana akaonekwa ne microscope. Izvi zvinozivikanwa se grade, uye chiremba wako anogona kurondedzera kenza yeura se low grade kana high grade:
- Low-grade bladder cancer. Rudzi urwu rwekenza rune masero ari pedyo mukuonekwa nekugadzirwa kumasero akajairika (well differentiated). Tumour ye low-grade inowanzo kukura zvishoma uye ine mukana wakaderera wekupinda mumuscular wall yeura kupfuura tumour ye high-grade.
- High-grade bladder cancer. Rudzi urwu rwekenza rune masero asinganzwisisiki uye asina kufanana nema tissues akajairika (poorly differentiated). Tumour ye high-grade inowanzo kukura zvakanyanya kupfuura tumour ye low-grade uye inogona kunge ine mukana wakakura wekupararira kumuscular wall yeura nedzimwe tissues nenhengo.
Kurapa
Sarudzo dzekurapa kenza yeura inotsamira pazvinhu zvakawanda, kusanganisira rudzi rwekenza, giredhi rekenza uye nhanho yekenza, izvo zvinofungwa pamwe nehutano hwako hwese uye zvaunoda kurapwa.
Kurapa kenza yeura kunogona kusanganisira:
- Kuvhiya, kubvisa masero ekenza
- Chemotherapy muura (intravesical chemotherapy), kurapa kenza dziri mukati meura asi dzine njodzi yakakwira yekudzoka kana kuenda kune imwe nhanho yepamusoro
- Chemotherapy kumuviri wese (systemic chemotherapy), kuwedzera mukana wekurapa munhu ari kuvhiyiwa kubvisa ura, kana sechirongwa chikuru chekurapa kana kuvhiya kusiri sarudzo
- Radiation therapy, kuparadza masero ekenza, kazhinji sechirongwa chikuru chekurapa kana kuvhiya kusiri sarudzo kana kusina kuda
- Immunotherapy, kutanga sisitimu yemuviri yekurwisa masero ekenza, kana muura kana mumuviri wese
- Targeted therapy, kurapa kenza yakakura kana kurapwa kwakasiyana kusina kubatsira
Sangano rezvirongwa zvekurapa rinogona kukurudzirwa nachiremba wako nevanhu vari muchikwata chako chekutarisira.
Panguva yekuita ileal conduit, chiremba anoita chubhu itsva kubva kune chikamu cheura chinoita kuti itsvo dzibvise mvura uye weti ibve mumuviri kuburikidza nehwindo duku rinonzi stoma.
Nzira dzekuvhiya kenza yeura dzinogona kusanganisira:
- Transurethral resection yeura tumor (TURBT). TURBT ndiyo nzira yekuongorora kenza yeura uye kubvisa kenza dziri mumativi epamusoro eura — idzo dzisati dzava kenza inopinda mumasumbu. Panguva yekuita izvi, chiremba anopfuudza tambo yetsitsi kuburikidza necystoscope uye kupinda muura. Simba remagetsi mutambi rinobviswa kana kupiswa kenza. Kana zvakadaro, laser ine simba rakakura inogona kushandiswa.
Nekuti vanachiremba vanoita nzira kuburikidza neurethra, hauzove nemakadzika (incisions) mudumbu rako.
Sechikamu cheTURBT nzira, chiremba wako anogona kukurudzira jekiseni rimwe chete re mushonga unouraya kenza (chemotherapy) muura rako kuparadza masero ekenza asara uye kudzivirira kenza kudzoka. Mushonga unoramba uri muura rako kwenguva uye wobva wadururwa.
- Cystectomy. Cystectomy kuvhiya kubvisa chikamu cheura kana chikamu chose. Panguva yekuita partial cystectomy, chiremba wako anobvisa chikamu cheura chine tumor imwe chete yekenza.
Radical cystectomy ibasa rekuvhiya kubvisa ura rose ne lymph nodes dziri pedyo. Varume, radical cystectomy kazhinji inosanganisira kubviswa kwe prostate ne seminal vesicles. Muvakadzi, radical cystectomy inogona kusanganisira kubviswa kwechibereko, maovari nechikamu chevagina.
Radical cystectomy inogona kuitwa kuburikidza nekucheka pazasi pedumbu kana nekucheka duku duku uchishandisa robotic surgery. Panguva yerobotic surgery, chiremba anogara pane imwe console uye anoshandisa maoko ekudzora kufambisa zvishandiso zvekuvhiya zve robotic zvakanyatsonaka.
- Neobladder reconstruction. Mushure me radical cystectomy, chiremba wako anofanira kuita nzira itsva yekuti weti ibve mumuviri wako (urinary diversion). Sarudzo imwe yekuita urinary diversion ndeye neobladder reconstruction. Chiremba wako anoita reservoir ine chimiro chebhora kubva kune chikamu cheura rako. Iyi reservoir, inowanzonzi neobladder, inogara mumuviri mako uye yakabatana neurethra yako. Neobladder inobvumira vanhu vazhinji kuita weti zvakajairwa. Vamwe vanhu vane dambudziko rekuzadza neobladder uye vanogona kuda kushandisa catheter nguva nenguva kubvisa weti yese kubva muneobladder.
- Ileal conduit. Kune iyi mhando ye urinary diversion, chiremba wako anoita chubhu (ileal conduit) uchishandisa chikamu cheura rako. Chubhu inomhanya kubva ku ureters yako, inobvisa itsvo dzako, kunze kwemuviri wako, uko weti inodonha mupoto (urostomy bag) yaunopfeka mudumbu rako.
- Continent urinary reservoir. Panguva yekuita iyi mhando ye urinary diversion, chiremba wako anoshandisa chikamu cheura kuita poto duku (reservoir) yekuchengeta weti, iri mumuviri mako. Unodurura weti kubva ku reservoir kuburikidza nehwindo mudumbu rako uchishandisa catheter kanenge katatu pazuva.
Transurethral resection yeura tumor (TURBT). TURBT ndiyo nzira yekuongorora kenza yeura uye kubvisa kenza dziri mumativi epamusoro eura — idzo dzisati dzava kenza inopinda mumasumbu. Panguva yekuita izvi, chiremba anopfuudza tambo yetsitsi kuburikidza necystoscope uye kupinda muura. Simba remagetsi mutambi rinobviswa kana kupiswa kenza. Kana zvakadaro, laser ine simba rakakura inogona kushandiswa.
Nekuti vanachiremba vanoita nzira kuburikidza neurethra, hauzove nemakadzika (incisions) mudumbu rako.
Sechikamu cheTURBT nzira, chiremba wako anogona kukurudzira jekiseni rimwe chete re mushonga unouraya kenza (chemotherapy) muura rako kuparadza masero ekenza asara uye kudzivirira kenza kudzoka. Mushonga unoramba uri muura rako kwenguva uye wobva wadururwa.
Cystectomy. Cystectomy kuvhiya kubvisa chikamu cheura kana chikamu chose. Panguva yekuita partial cystectomy, chiremba wako anobvisa chikamu cheura chine tumor imwe chete yekenza.
Radical cystectomy ibasa rekuvhiya kubvisa ura rose ne lymph nodes dziri pedyo. Varume, radical cystectomy kazhinji inosanganisira kubviswa kwe prostate ne seminal vesicles. Muvakadzi, radical cystectomy inogona kusanganisira kubviswa kwechibereko, maovari nechikamu chevagina.
Radical cystectomy inogona kuitwa kuburikidza nekucheka pazasi pedumbu kana nekucheka duku duku uchishandisa robotic surgery. Panguva yerobotic surgery, chiremba anogara pane imwe console uye anoshandisa maoko ekudzora kufambisa zvishandiso zvekuvhiya zve robotic zvakanyatsonaka.
Chemotherapy inoshandisa mishonga kuuraya masero ekenza. Kurapa kwe chemotherapy kenza yeura kazhinji kunosanganisira mishonga miviri kana kupfuura yechemotherapy inoshandiswa pamwe chete.
Mishonga yeChemotherapy inogona kupiwa:
- Kuburikidza neura (intravenously). Intravenous chemotherapy inoshandiswa kazhinji usati wabvisa ura kuwedzera mikana yekurapa kenza. Chemotherapy inogona kushandiswawo kuuraya masero ekenza anogona kunge asara mushure mekuvhiya. Mumamiriro ezvinhu akati, chemotherapy inogona kusanganiswa ne radiation therapy.
- Mukati meura (intravesical therapy). Panguva ye intravesical chemotherapy, chubhu inopfuudzwa kuburikidza neurethra yako zvakananga kuenda kuura rako. Chemotherapy inochengetwa muura kwenguva yakatarwa usati wadururwa. Inogona kushandiswa sechirongwa chikuru chekurapa kenza yeura iri pamusoro, uko masero ekenza anokanganisa chete lining yeura kwete tishu dzakadzika dzemhasuru.
Radiation therapy inoshandisa magetsi ane simba, akadai se X-rays ne protons, kuparadza masero ekenza. Radiation therapy kenza yeura kazhinji inopiwa kubva muchina unofamba mumuviri wako, uchitungamira magetsi kumapundu chaiwo.
Radiation therapy dzimwe nguva inosanganiswa ne chemotherapy kurapa kenza yeura mumamiriro ezvinhu akati, akadai kana kuvhiya kusiri sarudzo kana kusina kuda.
Immunotherapy mushonga unobatsira sisitimu yako yekudzivirira kurwisa kenza.
Immunotherapy inogona kupiwa:
- Mukati meura (intravesical therapy). Intravesical immunotherapy inogona kukurudzirwa mushure meTURBT kenza duku dzeura dzisina kukura muma layers akadzika emhasuru yeura. Kurapa uku kunoshandisa bacillus Calmette-Guerin (BCG), yakagadzirwa sevaccine inoshandiswa kudzivirira tuberculosis. BCG inokonzera kuita kwesisitimu yekudzivirira inotungamira masero anorwisa zvipembenene kuenda kuura.
- Kuburikidza neura (intravenously). Immunotherapy inogona kupiwa intravenously kenza yeura yakakura kana inodzoka mushure mekurapwa kwekutanga. Mishonga yakawanda ye immunotherapy iripo. Mishonga iyi inobatsira sisitimu yako yekudzivirira kuziva uye kurwisa masero ekenza.
Mishonga yeTargeted therapy inotarisa pane zvakashata zviripo mukati memasero ekenza. Nekutarisa zvakashata izvi, kurapwa kwemishonga yakatarwa kunogona kuita kuti masero ekenza afe. Masero ako ekenza anogona kuyedzwa kuona kana targeted therapy ichangobvira kubatsira.
Targeted therapy inogona kuva sarudzo yekurapa kenza yeura yakakura kana kurapwa kwakasiyana kusina kubatsira.
Mu mamiriro ezvinhu akati, vanhu vane kenza yeura inopinda mumasumbu avo vasina kuda kuvhiyiwa kubvisa ura vanogona kufunga kuedza sangano rezvirongwa zve kurapa panzvimbo. Inozivikanwa se trimodality therapy, nzira iyi inosanganisa TURBT, chemotherapy ne radiation therapy.
Kutanga, chiremba wako anoita TURBT nzira kubvisa kenza yakawanda sezvinobvira kubva muura rako uchichengeta basa reura. Mushure meTURBT, unoita chemotherapy pamwe chete ne radiation therapy.
Kana, mushure mekuedza trimodality therapy, kenza yese isina kuenda kana uine kudzoka kwekenza inopinda mumasumbu, chiremba wako anogona kukurudzira radical cystectomy.
Kenza yeura inogona kudzoka, kunyangwe mushure mekurapwa kwakabudirira. Nekuda kweizvi, vanhu vane kenza yeura vanoda kuongororwa kwemakore mushure mekurapwa kwakabudirira. Kuongororwa kwauchaita uye kakawanda kunotsamira marudzi ekensa yeura uye maitiro ayo akarapwa, pakati pezvimwe zvinhu.
Kazhinji, vanachiremba vanokurudzira bvunzo yekutarisa mukati me urethra yako neura (cystoscopy) mwedzi mitatu kusvika mitanhatu yemakore ekutanga mushure mekurapwa kenza yeura. Mushure memakore mashoma ekutarisa pasina kuona kudzoka kwekensa, unogona kuda bvunzo ye cystoscopy kamwe chete pagore. Chiremba wako anogona kukurudzira bvunzo dzakasiyana-siyana nguva nenguva zvakare.
Vanhu vane kenza ine simba vanogona kuongororwa kazhinji. Avo vane kenza isina simba vanogona kuongororwa zvishoma.
Kurarama nekunetseka kuti kenza yako yeura inogona kudzoka kunogona kukusiya uchifunga sekunge hauna simba pane ramangwana rako. Asi pasina nzira yekuvimbisa kuti kenza yako yeura haizodzoki, unogona kutora matanho ekudzora kushushikana.
Nekufamba kwenguva uchawana zvinokushandira, asi kusvika ipapo, unogona:
- Tora purogiramu yekuongororwa kwekuenderera mberi uye enda kumisangano yese. Kana wapedza kurapwa kenza yeura, bvunza chiremba wako kuti agadzire purogiramu yakasarudzika yekuongororwa kwekuenderera mberi. Pamberi pebvunzo yega yega ye cystoscopy, tarisira kuva nekunetseka. Unogona kutya kuti kenza yakadzoka kana kunetseka nezve bvunzo isina kunyaradza. Asi usarega izvi zvichikumisa kuenda kumusangano wako. Pane kudaro, ronga nzira dzekukunda zvinokunetsa. Nyora pfungwa dzako mubhuku, taura neshamwari kana kushandisa nzira dzekuzorora, senge kufungisisa.
- Tarisa hutano hwako kuti ugadzirire kurwisa kenza kana ikadzoka. Tarisa hutano hwako nekugadzirisa kudya kwako kusanganisira michero yakawanda, miriwo nemagorosi ese. Ita maekisesaizi kwemaminitsi makumi matatu zuva nezuva. Rorora zvakakwana kuti umuke uchizorora.
- Taura nevamwe vakapona kenza yeura. Bata nevamwe vakapona kenza yeura vari kunetseka nezvinhu zvimwe chete zvaunonetseka nazvo. Bata chikamu chemunharaunda ye American Cancer Society kubvunza nezvemapoka ekutsigira munzvimbo yako.