Created at:1/16/2025
Question on this topic? Get an instant answer from August.
Chikwambo chinoshungurudza mumukaka chero chitsva kana chisina kujairika chikamu muchikamu chemukaka chako chinoda kuongororwa nachiremba kuti aone kana chiri chisina ngozi kana kuti chingave chirwere chekenza. Zvikwambo zvizhinji zvemumakaka zvinowanzova zvisina ngozi, asi kuzviongorora nekukurumidza kunobatsira kuchengetedza rugare rwepfungwa dzako nehutano hwako.
Kuwana chikwambo mumukaka wako kunogona kunzwa kunotyisa, uye izvozvo ndizvo zvakajairika. Muviri wako une zvimwe zvinhu uye kusiyana-siyana muchikamu chemukaka, kunyanya panguva yemwedzi wako. Zvisinei, kana chimwe chinhu chichiita kusingafaniri nemafambiro emukaka wako, zvinokosha kuti uve nechiremba achitarisa.
Zvikwambo zvinoshungurudza mumukaka ndizvo zvikamu zvine hunhu hwakati hunoita kuti vanachiremba vade kuzviongorora zvakadzama. Aya makwambo anganzwa akaoma, ane chimiro chisina kujairika, kana kuti anotaridzika akabatanidzwa kune tishu dziri pedyo pane kufamba zvakasununguka.
Zvisinei, kwete chikwambo chega chega chemukaka chinoshungurudza. Zvikwambo zvizhinji zvinhu zvisina ngozi senge cysts dzakazara nemvura kana fibroadenomas, izvo zvakasimba asi zvisina kenza. Musiyano mukuru uri muhunhu hwakati hunoonekwa nevanachiremba panguva yekuongorora.
Zvinoita kuti chikwambo chive “chinoshungurudza” zvinosanganisira zvinhu zvakaita sekunzwa kwayo, kwaari, uye kana kuchinja nekufamba kwenguva. Chiremba wako achafunga nezvemazera ako, nhoroondo yemhuri, nezvimwe zvinokonzera njodzi paanenge achiongorora chero shanduko yemukaka yawakaona.
Zvikwambo zvinoshungurudza mumukaka kazhinji zvine hunhu hwakasiyana hunovasiyanisa netishu dzemukaka dzakajairika kana zvikwambo zvisina ngozi. Heano mamwe mazano aunogona kuona anoda kutarisirwa nachiremba:
Kunze kwebumbiro pachayo, unogona kuona shanduko dzimwe dzinotaura kuti unoda kuongororwa. Izvi zvinogona kusanganisira kubuda kwemukaka kubva pachipfuva kuri neropa kana rakachena, shanduko pakukura kana chimiro chechipfuva, kana ganda rinotaridzika serinenge ganda reorenji.
Yeuka kuti tishu yemukaka inochinja zvakasikwa mukati mekumwedzi kwako nekuda kwekuchinja kwehomoni. Zvisinei, mabumbiro anoramba aripo mushure mekupedza kwemwedzi wako anoda kutarisirwa nachiremba, kunyanya kana anonzwa akasiyana netishu yako yemukaka yakajairwa.
Vanopa utano vanokamura mabumbiro emukaka anotyisa zvichienderana nezvimiro zvawo uye mukana wekuva kenza. Kunzwisisa mapoka aya kunogona kukubatsira kuziva mibvunzo yekubvunza chiremba wako.
Zvikwata zvakasimba zvinomiririra rudzi rumwe rukuru rwebumbiro rinotyisa. Izvi zvinonzwa zvakasimba uye hazvifambi nyore kana ukadzvanya pazviri. Zvinogona kuva fibroadenomas dzakanaka kana zvirwere zvinogona kuva kenza, ndosaka zvinoda kuongororwa nemafomu ekufananidzira uye dzimwe nguva biopsy.
Cysts dzakaoma dzinoumba chikamu chimwe chinoda kutarisirwa. Kusiyana ne cysts dzakapfava dzakazara nemvura dzakanaka, cysts dzakaoma dzine masvingo akakora kana zvikamu zvakasimba zvakasanganiswa nemvura. Izvi zvinhu zvinoita kuti zvikoshi kuongorora zvakadzama kuti ubvise chero shanduko dzinoshamisa.
Mapoka ekuoma kwemasero anooneka pamammograms semadhonhwe madiki machena akaungana. Kunyange zvakawanda zvekuoma kwemasero hazvine ngozi, mamwe maitiro kana maumbirwo anogona kuratidza kuchinja kwekutanga kwemasero kunoda kuongororwa zvakanyanya kuburikidza nekuongororwa kwemifananidzo kana kuitora tishu.
Zvikwambo zvemuviri zvine mhaka zvinoitika kana masero ari muchikamu chemuviri achitanga kukura zvisina kunaka kana tishu dzakajairwa dzichichinja nenzira inotyisa. Zvinokonzera kuchinja uku kazhinji zvinosanganisira kusanganiswa kwezvinhu zvemajini, mahomoni, uye zvakatipoteredza.
Zvinhu zvakati wandei zvinogona kukonzera kukura kwezvikwambo zvine mhaka:
Muenzaniso, chinhu chinoita sekunetsa chingave mamiriro asingakuvadzi anotevedzera matambudziko akakomba. Kuvira, kukuvara kwemuviri, kana kuwanda kukuru kwetumors dzisingakuvadzi dzinoita zvikwambo zvinoita sekunetsa pakutanga asi zvinozoonekwa kuti hazvina ngozi.
Zvakakosha kuyeuka kuti kuva nezvinhu zvinokonzera ngozi hazvirevi kuti iwe uchave nezvikwambo zvine mhaka. Vanhu vakawanda vane zvinhu zvakawanda zvinokonzera ngozi havazombovi nematambudziko emuviri, nepo vamwe vane zvinhu zvishoma zvinokonzera ngozi vangave nezvikwambo zvinoda kuongororwa.
Unofanira kubata nehutano hwako kana uchiona chero chikwambo chitsva kana kuchinja muchikamu chemuviri wako. Kuongororwa pakutanga kunokupa mukana wakanaka wekurapwa kunobudirira kana chimwe chinhu chine mhaka chakawanikwa, uye chinopa rugare rwepfungwa kana chikwambo chacho chisingakuvadzi.
Usatombo mirira kuona kana bofu richapera roga, kunyanya kana richiramba riripo panguva yese yemwedzi. Kunyange zvazvo shanduko dzakawanda dzemabvu dzine chekuita nekuchinja kwehomoni kazhinji, mabofu matsva anoramba aripo anoda kuongororwa nemunyanzvi kuti aone kuti ndeapi.
Tsvaka rubatsiro rwekurapa nekukurumidza kana ukaona chero chimwe chezviratidzo izvi zvinokurumidza pamwe chete nebofu remabvu: ganda rakaita tsvuku, rinopisa, kana kuti rakafuta; mukaka unobuda pazamu uri neropa; kuchinja kwakapfupi kukuru saizi kana chimiro chemazamu; kana mabofu anotaridzika kukura nekukurumidza mukati memazuva kana mavhiki.
Yeuka kuti kuwana bofu hazvirevi kuti une kenza. Mabofu akawanda emabvu ane hutano hwakanaka, asi kuawana aongororwa nekukurumidza kunobatsira kubata chero matambudziko pakutanga apo kurapwa kunonyanya kushanda. Chiremba wako anogona kukutungamira muitiro wekuongorora uye kupindura mibvunzo yako chaiyo.
Zvinhu zvimwe zvinogona kuwedzera mukana wako wekuwana mabofu emabvu anotyisa, kunyange zvazvo kuva nezvinhu izvi zvinokonzera ngozi hazvirevi kuti uchawana matambudziko. Kunzwisisa ngozi yako pachako kunokubatsira kuramba uchiri kunetseka nezvehutano hwemasu uye kuita sarudzo dzakachenjera pamusoro pekuongororwa.
Aya ndiwo makuru makuru ekukonzera ngozi aanoongororwa nevashandi vehutano:
Zvimwe zvinokonzera ngozi zvisingawanzoitika zvinosanganisira zvirwere zvemagwenya zvakaita seLi-Fraumeni syndrome kana Cowden syndrome, izvo zvinoita kuti ngozi yekenza iwedzere zvikuru muzvikamu zvakasiyana-siyana zvemuviri. Kana uine nhoroondo yemhuri yakasimba yekenza dzakasiyana-siyana, mazano emagwenya angakubatsira kuona ngozi yako chaiyo.
Zvinhu zvehupenyu zvinokonzerawo basa, kunyangwe kukanganisa kwazvo kuri shoma pane zvinhu zvemagwenya nezvemahomoni. Kunwa doro nguva dzose, kushaya zvemuviri, uye kuva uremu hwakawandisa mushure memenopause zvinogona kuwedzera zvishoma ngozi yako yekuwana matambudziko emazamu.
Kunetseka kukuru nemichero yemukaka inokonzera hanya ndiko mukana wekuti ingave kenza, ndosaka kuongororwa nekukurumidza kwakakosha kwazvo. Kana yakawanikwa pakutanga, kenza yemukaka ine mwero yakanaka yekurapa, asi kuomerera pakuzivisa kunogona kubvumira matambudziko kuti arambe achifambira mberi.
Kana chidimbu chinokonzera hanya chikazoonekwa sechinokuvadza, matambudziko akawanda anogona kuitika pasina kurapwa kwakakodzera:
Kunyangwe michero isina kukuvadza inogona dzimwe nguva kukonzera matambudziko kana ikakura zvakakwana. Fibroadenomas huru inogona kukonzera kusawirirana kwemukaka kana kusagadzikana, nepo cysts dzakaoma dzinogona kuzara kana kukonzera kurwadziwa kana dzikaputsika.
Kukanganisa kwepfungwa kwekuwana chidimbu chinokonzera hanya hakusi kufanira kuregererwa. Kusagadzikana uye kutya ndizvo zvinhu zvakajairwa, uye manzwiro aya anogona kukanganisa hupenyu hwako hwezuva nezuva nehukama hwako. Kuve nehurongwa hwekutsigira uye kushanda nevanachiremba vanotaurirana zvakajeka kunogona kubatsira kudzora matambudziko aya epfungwa.
Mu zviitiko zvisingawanzoitika, nzira yekuongorora tishu nekuitora (biopsy) pachayo inogona kukonzera matambudziko madiki akadai sekuyerera kweropa, hutachiona, kana kuchinja kwenguva pfupi kunzwa kwemukaka. Zvisinei, njodzi idzi kazhinji dziri shoma kwazvo uye dzinosvika padanho rakakura kupfuura kukosha kwekuwana chirwere chaicho.
Kunyangwe usingakwanisi kudzivirira zvikwambo zvemumawere zvose kuti zvisabude, unogona kutora matanho ekuderedza njodzi yako uye kubata chero matambudziko nekukurumidza sezvinobvira. Kudzivirira kunotarisa pakusarudza mararamiro uye kuramba uchiri kutarisisa kuchinja mune tishu dzemawere ako.
Kuongorora kwako pachako nguva nenguva kunokubatsira kuti uzive kuti mawere ako anonzwa sei kazhinji, zvichiita kuti zvive nyore kuona kana chimwe chinhu chachinja. Ita ongororo idzi kamwe chete pamwedzi, zviri nani mazuva mashoma mushure mekupedza nguva yako apo tishu dzemawere hadzina kutsamwa uye hadzina kuzvimba.
Kuchinja mararamiro kunogona kubatsira kuderedza njodzi yako kunosanganisira:
Kune vanhu vane njodzi yakakwira yezvemagariro, matanho ekudzivirira anogona kusanganisira kuongororwa kwakanyanya neMRI pamwe chete nemamograms, kana kunyange kuvhiya kwekudzivirira mumamiriro ezvinhu akaoma. Mazano ezvemagariro anogona kukubatsira kunzwisisa sarudzo idzi kana uine nhoroondo yakasimba yemhuri.
Yeuka kuti kudzivirira hakuna kukwana, uye zvikwambo zvemumawere zvizhinji zvinoitika kunyangwe uine mararamiro akanaka. Chinhu chikuru ndechekubatanidza nzira dzekuderedza njodzi nekuongororwa nguva nenguva uye kutarisisa nekukurumidza kuchinja chero chero chinhu chaunoona mumawere ako.
Kuongorora zvikwambo zvemumawere zvine mutsindo kunosanganisira matanho akawanda anobatsira chiremba wenyu kuziva chaizvo rudzi rwechikwambo chamunacho uye kana chichida kurapwa. Maitiro acho anowanzo tanga nekuongororwa kwemuviri wozoenda pakutarisa mifananidzo uye zvichida kutora sampuli yetsinga.
Chiremba wenyu achatanga nekuongorora kwakakwana kwemawere, achibata zvikwambo, achiongorora ma lymph nodes, uye achitsvaga chero shanduko inoratidzika paganda remawere enyu kana chimiro. Vachabvunza nezve zviratidzo zvako, nhoroondo yemhuri, uye mishonga ipi zvayo yauri kutora inogona kukanganisa tishu remawere.
Kudzidza kwemifananidzo kunopa mifananidzo yakadzama yetishu remawere ako uye kunobatsira kurondedzera chero zvikwambo zvakawanikwa pakuongororwa:
Kana kudzidza kwemifananidzo kuchiratidza zvinhu zvinotyisa, chiremba wenyu angakurudzira biopsy kuongorora sampuli dzetishu pasi pe microscope. Core needle biopsy ndiyo nzira inonyanya kuzivikanwa, uchishandisa tsono yakasimba kubvisa sampuli diki dzetishu uri kumuka ne local anesthesia.
Muitiro wakasiyana apo needle biopsy haigoneki kana isina kupindura mibvunzo yakajeka, surgical biopsy ingangoda. Izvi zvinosanganisira kubvisa chikwambo chose kana sampuli huru yetishu muitiro we outpatient pasi pe local kana general anesthesia.
Maitiro ese ekuongorora anowanzo tora mavhiki mashoma kubva pakuongororwa kwekutanga kusvika kumigumisiro yekupedzisira. Timu yako yekutarisira utano ichakutungamira mune chimwe nechimwe danho uye ichakubvunza zvaunofanira kutarisira munzira.
Kurapa magaro emuviri anotungamirira kuzvivimbiso kunoenderana zvachose nezvinoratidzwa nemiedzo yekurapa pamusoro pemhando yemukati mako. Kana chigaro chacho chikaonekwa kuti hachina ngozi, ungasada kurapwa kunze kwekutarisa nguva dzose kuti uone kuti hachinjisi nguva nenguva.
Kune magaro asina ngozi anokonzera kusagadzikana kana kunetseka, sarudzo dzekurapa dzinogona kusanganisira:
Kana chigaro chacho chikaonekwa kuti chirwere chekenza, purogiramu yako yekurapa ichagadzirwa zvichienderana nerudzi chaiyo uye nhanho yekenza yakawanikwa. Timu yako ye oncology ichafunga nezvezvinhu zvakaita sahukuru hwetu, mamiriro e receptor yehomoni, uye kana kenza yakapararira kuma lymph nodes.
Kurapa kenza kazhinji kunosanganisira kusanganiswa kwezvinhu zvakaita sekuvhiya kubvisa tumor, chemotherapy kuparadza masero ekenza mumuviri wako wose, radiation therapy kubvisa masero ekenza asara munzvimbo yemukaka, uye hormone therapy kana kenza yako ichipindura kumahomoni.
Mishonga mitsva yakarongedzwa iripo kune mamwe marudzi ekenza yemukaka ine hunhu hwakakosha hwemajini. Mishonga iyi inoshanda zvakasiyana nechemotherapy yakajairwa uye kazhinji ine zvishoma zvinokonzerwa nemigumisiro nepo iine simba rakakura.
Mukati mekurapa, uchasangana nechikwata chevanachiremba vakawanda vanogona kusanganisira vanachiremba vekuvhiya, vanachiremba ve oncology, vanachiremba ve radiation oncology, vanamukoti, uye vashandi vemagariro evanhu vanokosha pakutsigira vanhu mukati mekurapa kenza.
Paunenge uchimirira kuongororwa kwechiremba kana mukati mekurapa, kune zvinhu zvakati wandei zvaunogona kuita pamba kuti ugadzirise kusagadzikana uye utsigire hutano hwako hwese. Zvisinei, kuchengetedza kumba hakufaniri kutsiva kuongororwa kwechiremba uye kurapwa.
Kuti muve vakasununguka mumuviri, munogona kuedza kupfeka bhurugwa rakakodzera, rinotsigira risinganyanyi kudzvinyirira nzvimbo ine zvimbiru. Vamwe vanhu vanoona kuti kushandisa zvinodziya kana zvinotonhora kunobatsira pakurwadziwa, kunyange zvazvo munofanira kubvunza chiremba wenyu kuti tembiricha ipi iri nani munyaya yenyu.
Kutonga kunetseka nekushushikana kwakakoshawo panguva ino:
Chengeta chinyorwa chechinguva chero chipi zvacho chinowanikwa muhukuru, chimiro, kana zviratidzo zvine chekuita nezvimbiru. Nyora mibvunzo sezvinouya kwauri kuitira kuti ugone kukurukura nazvo nevanopa utano hwako pakuona kwako kweramangwana.
Chengeta tsika dzakakodzera senge kudya zvokudya zvine utano, kurara zvakakwana, uye kuramba uchiita zvemuviri sezvinoita simba rako. Aya maitiro anotsigira sisitimu yako yekudzivirira uye kusimba kwese panguva yakaoma.
Kana zvimbiru zvako zvichikupa kusagadzikana, zvinodzora marwadzo zvakaita se ibuprofen kana acetaminophen zvinogona kubatsira. Zvisinei, bvunza chiremba wako usati watora mishonga ipi neipi, kunyanya kana wakarongedzerwa maitiro kana uri kutotora mishonga yakawanda.
Vamwe vanhu vanoona kuti kuderedza kunwa caffeine kunobatsira pakurwadziwa kwepamuviri, kunyange zvazvo uchapupu hwesainzi hwacho hushoma. Kuisa mafuta zvinyoro nyoro munzvimbo iyoyo kunogona kupa nyaradzo, asi usanyanya kudzvinyirira zvimbiru pachayo.
Kuchengetedza zvakanaka usati waenda kuna chiremba kunobatsira kuve nechokwadi chekuti uchaongororwa zvakanaka uye uchanzwisisa zvakajeka nezvebumbiro rako rebvudzi. Kuchengetedza zvakanaka kunokubatsirawo kunzwa uine chivimbo uye uchikwanisa kudzora mamiriro acho, kunyanya kana uri kunetseka.
Usati waenda kuna chiremba, nyora nguva yawakacherechedza bumbiro iri uye chero shanduko dzawakaona kubvira ipapo. Nyora zvakadzama zvakadai sekunge rinorwadza, kana richishanduka nekumwedzi kwako, uye chero shanduko dzakawanda dzebvudzi dzawakaona.
Tora ruzivo rwakakosha kuti ugopa chiremba wako:
Gadzira rondedzero yemibvunzo yaunoda kubvunza chiremba wako. Izvi zvinogona kusanganisira mibvunzo nezve bvunzo dzauchazoda, nguva yemhinduro, zvinoreva zvibereko zvakasiyana-siyana, uye zvaunofanira kutarisa uchitarisira mhinduro.
Kuti uongororwe, pfeka nguo mbiri kuti ugone kubvisa zvipfeko zvako zviri pamusoro. Funga kuuya neshamwari kana nhengo yemhuri kuti ikubatsire uye kukubatsira kuyeuka ruzivo rwakakosha rwakataurwa panguva yekushanya.
Rongedza nguva yako yekushanya kwevhiki mushure mekumwedzi kwako kana uchiri kuwana kumwedzi. Nguva iyi inoita kuti kuongororwa kwemuviri kuve nyore uye kwakanyatsojeka sezvo tishu rebvudzi risina kurwadza uye risina kuzvimba.
Chinhu chakakosha chokurangarira pamusoro pemasumbu emazamu anokonzera hanya ndechekuti kuwana rimwe harurevi kuti une kenza, asi zvinoreva kuti unoda kuongororwa nekukurumidza nachiremba. Masumbu mazhinji emazamu anowanzova asina ngozi, uye kunyangwe kana masumbu ari kenza, kuonekwa pakutanga kunotungamira kumigumisiro yekurapa ine kubudirira kwakanyanya.
Usarega kutya kuchikutadzisa kutsvaka rubatsiro rwehutano. Vanopa utano vane ruzivo mukuongorora masumbu emazamu uye vanonzwisisa kunetseka kwavanokonzera. Vakagadzirirwa kukutungamira kuburikidza nehurongwa hwekuongorora nerutendo neruzivo.
Ramba uchiita zvinhu zvinobatsira hutano hwako hwemukaka nekudzidza kuzviongorora kazhinji, kuchengeta mammography ekutarisa anoenderana nezano, uye nekukurumidza kuudza chiremba wako chero shanduko. Kuchenjera kwako nekuita nekukurumidza ndiwo zvombo zvako zvakanakisa pakuchengetedza hutano hwemukaka.
Rangarira kuti hausi wega mune ino ruzivo. Mamiriyoni evanhu vanoona masumbu emazamu gore rega rega, uye kufambira mberi mune zvechiremba kwakaita kuti kuongororwa nekurapa zvive zvinobudirira uye zvisingakuvadzi kupfuura nakare kose. Vimba nechikwata chako chehutano uye tarisa pakutora zvinhu nhanho nhanho.
Haukwanisi kuona zvakajeka kana gumbo remazamu riri kenza nekuringonzwa chete, ndosaka kuongororwa nachiremba kuchikosha. Zvisinei, hunhu hwakati wandei sekukomba, chimiro chisingaenzani, uye kushayikwa kwekuenda kunogona kuita kuti gumbo rive rine hanya zvikuru uye rinoda kutarisirwa nekukurumidza nachiremba.
Kunyangwe madokota ane ruzivo havaoni kenza kuburikidza nekuongororwa kwemuviri chete. Vanoshandisa ongororo dzemafomu uye kuunganidza tishu kuti vaite kuongororwa kwakajeka, saka usambomuedza kuzviongorora wega zvichienderana nekuti gumbo rinonzwa sei.
Zvikwambo zvinofamba zviri nyore kana wazvibata kazhinji hazvina njodzi kupfuura zvikwambo zvakasimba, asi zvinodawo kuongororwa nachiremba. Zvikwambo zvinofamba kazhinji zvinenge zvirwere zvisina njodzi senge fibroadenomas kana cysts, asi bvunzo chaiyo chete ndicho chinogona kusimbisa rudzi rwazvo.
Usafunge kuti chikwambo chinofamba hachina njodzi. Chero chikwambo chitsva kana chinoramba chiripo muchiuno chinofanira kuongororwa nachiremba chero chinganzwe sei kana kuita sei kana wazvibata.
Hungu, zvimwe zvikwambo zvechiuno nemapazi anokora anogona kuchinja nekumwedzi kwako nekuda kwekuchinja kwehomoni. Kuchinja uku kazhinji kunobatanidzwa ne tishu yechiuno inowanzoita basa ichipindura kumazinga e estrogen ne progesterone mukati memwedzi wako.
Zvisinei, zvikwambo zvinoramba zviripo mushure mekumwedzi kwako kana zvikwambo zvitsva zvisingatarisiri kubatanidzwa nekumwedzi kwako zvinofanira kuongororwa nachiremba. Cherekedza chero zvikwambo zvaunoona uye kuti zvinoshanduka sei mukati memwedzi wese.
Masero asingawanzoitika mu biopsy yechiuno zvinoreva kuti masero anotaridzika asingawanzoitika pasi pemikroskopu asi haasi kenza chaiyo. Mhedzisiro iyi kazhinji inoda kutarisirwa kwakanyanya nekuongororwa kazhinji kana dzimwe nguva kuunganidzwa kwetishu kuwedzera kuti uwane mufananidzo wakajeka.
Kuva nemasero asingawanzoitika hazvirevi kuti une kenza, asi zvinoita kuti njodzi yako iwedzere zvishoma uye zvinoreva kuti chiremba wako achida kukutevera pedyo. Timu yako yekutarisira utano ichakubvunza zvakajeka kuti mhedzisiro yako chaiyo inorevei uye inokurudzira kutarisirwa kwakakodzera.
Kukuvara kwemuviri kuchinono kunogona dzimwe nguva kukonzera zvikwambo nekuda kweropa, kuzvimba, kana kuumbwa kwetsinga. Izvi zvikwambo zvinokonzerwa nekutambudzika kazhinji zvinogona kutaridzika zvine mhosva pane kuongororwa uye zvinoda biopsy kuti zviparadzaniswe nezvimwe zvikwambo.
Kufunganya kwemoyo chete hakukonzere zvakananga zvikwambo muzamu, asi kunogona kukanganisa mahomoni ako uye kungaita kuti unzwisise zvakanyanya kusiyana kwezvinyama zvemazamu zvakajairika. Pasinei nezvikonzero zvinofungidzirwa, zvikwambo zvitsva zvinofanira kugara zvichionwa nachiremba.