Umphukela Wukukhishwa Kwesisu? Izimpawu, Izimbangela, Nokwelashwa

Umphukela Wukukhishwa Kwesisu Ungubani?

Umphukela wesisu uhlobo oluyimfihlo lomdlavuza olukhula endaweni encane lapho umthambo we-bile nomthambo we-pancreas uhlangana khona ngaphambi kokuba ugeleze esibindini sakho esincane. Cabanga ngayo njengendawo ehlanganisa izinto ezibalulekile zokugaya ukudla.

Le ndawo encane kodwa ebalulekile, enkulu njengomqulu wepensile, idlala indima ebalulekile ekugayeni kwakho ngokuvumela i-bile nama-enzyme e-pancreas ukuba angene esibindini sakho. Uma umdlavuza ukhula lapha, ungavinjwa lezi zindlela ezibalulekile futhi uthinte indlela umzimba wakho ugcina ngayo ukudla namasondlo.

Izindaba ezinhle ukuthi umdlavuza wesisu uvamise ukubangela izimpawu ekuqaleni, okusho ukuthi ungabanjwa futhi welashwe ngaphambi kokuba usakaze kwezinye izingxenye zomzimba wakho. Nakuba umelela ngaphansi kuka-1% yazo zonke izifo zomdlavuza wokugaya ukudla, ukuqonda izimpawu zalo kungenza umehluko wangempela emiphumeleni.

Ziyini izimpawu zomdlavuza wesisu?

Isilwane esivamile sokuqala somdlavuza wesisu yi-jaundice, okuyilapho i-bile ingakwazi ukugeleza ngokujwayelekile esibindini sakho. Ungase uqaphele ukuba isikhumba sakho nezinye izingxenye zamehlo akho zibe bomvu, kanye nomchamo omnyama nezisu ezimhlophe.

Abantu abaningi abane-umphukela wesisu baba nezimpawu ezingeziwe:

• Ubuhlungu besisu, ikakhulu endaweni ephezulu ngakwesokudla
• Ukulahlekelwa isisindo okungachazeki emasontweni ambalwa noma izinyanga
• Ukulahlekelwa ukulangazelela ukudla noma ukuzwa ugcwele ngokushesha ngemuva kokudla
• Ukuphefumula nokugabha
• Isikhumba esikhazimulayo ngenxa yokwakheka kwe-bile
• Ukushintsha ekuhambeni kwesisu, kufaka phakathi ukweluka noma izisu ezinamanzi
• Ukukhathala nobuthakathaka

Abanye abantu bangase babe nezimpawu ezingavamile njengobushushu, ubuhlungu emhlane, noma igazi esiswini sabo. Lezi zimpawu zingase zikhule kancane kancane, futhi uqale uzibalekele njengengxaki yokugaya ukudla noma izinkinga ezihlobene nokucindezeleka.

Khumbula ukuthi lezi zimpawu zingaba nezizathu eziningi ngaphandle komdlavuza, ngakho-ke ukuzibona akusho ukuthi une-umphukela wesisu. Noma kunjalo, izimpawu eziqhubekayo, ikakhulukazi i-jaundice, zidinga ukunakekelwa ngokushesha kwezokwelapha.

Yini ebangela umdlavuza wesisu?

Imbangela eqondile yomdlavuza wesisu ayiqondakali ngokuphelele, kodwa ikhula lapho amaseli ajwayelekile esiswini eqala ukukhula nokwahlukanisa ngokungenakulawuleka. Lokhu kwenzeka ngenxa yokushintsha kwe-DNA yale maseli, nakuba ukuthi yini ebangela lezi zinguquko kuyahlukahluka kumuntu ngamunye.

Izici eziningana zingase zifake isandla ekukhuleni komdlavuza wesisu:

• Isimo se-genetic njenge-familial adenomatous polyposis (FAP) noma i-Lynch syndrome
• Ukuvuvukala okuqhubekayo emithambeni ye-bile noma i-pancreas
• Umbhalo wangaphambili wohlobo oluthile lwe-polyps esibindini
• Ukuvezwa ezinto ezithile zekhemikhali noma izinto eziyingozi isikhathi eside
• Ukubhema imikhiqizo yotshwala
• Ukusebenzisa utshwala kakhulu

Kwezinye izimo ezingavamile, umdlavuza wesisu ungase ukhule njengengxenye yezifo zokudluliselwa komdlavuza ezidluliselwa emindenini. Lezi zimo ze-genetic zanda kakhulu ingozi kodwa zimelela kuphela ingxenye encane yezimo.

Abantu abaningi abathuthukisa umdlavuza wesisu abanazo izici eziyingozi ezicacile, okusho ukuthi umdlavuza ubonakala ukhula ngokungahleliwe. Lokhu kungase kuzwakale kuyadumaza, kodwa futhi kusho ukuthi akufanele uzisole uma uthola leli bika.

Ziyini izici eziyingozi zomdlavuza wesisu?

Ubudala yiyona nto ebaluleke kakhulu eyingozi, ngoba izimo eziningi zenzeka kubantu abadala kunama-60. Noma kunjalo, umdlavuza wesisu ungase ukhule kunoma yiliphi isikhathi, kufaka phakathi kubantu abadala abancane, ikakhulu labo abane-genetic predispositions.

Izimo eziningana nezici zokuphila zingase zikhulise ingozi yakho:

• I-Familial adenomatous polyposis (FAP), ebangela i-polyps eminingi esibindini
• I-Lynch syndrome, isimo esidluliselwa ezizukulwaneni esithinta ukulungiswa kwe-DNA
• I-Peutz-Jeghers syndrome, ebangela i-polyps kulo lonke uhlangothi lokugaya ukudla
• I-Chronic pancreatitis noma ukuvuvukala komthambo we-bile
• Ukubhema isigarethi noma ukusebenzisa ezinye imikhiqizo yotshwala
• Ukusebenzisa utshwala ngokweqile iminyaka eminingi
• Ukuba owesilisa, njengoba amadoda ehluleka ukuba naleli bika kuneabesifazane

Abantu abanezinye izimo ze-genetic ezingavamile babhekene nengozi enkulu kakhulu kunabantu abavamile. Uma unembali yomndeni yalezi zifo noma amalungu omndeni amaningi ane-cancer yokugaya ukudla, ukwelulekwa kwe-genetic kungase kube usizo.

Ukuba nento eyodwa noma ngaphezulu yezici eziyingozi akusho ukuthi uzokuthuthukisa umdlavuza wesisu. Abantu abaningi abanezici eziyingozi abazuthuthukisi leli gciwane, kanti abanye abangenazo izici eziyingozi ezaziwayo bayenza.

Kufanele ubona nini udokotela ngomdlavuza wesisu ongaqondakali?

Kufanele uxhumane nodokotela wakho ngokushesha uma uthuthukisa i-jaundice, ikakhulu uma ibonakala kanye nobuhlungu besisu noma ukulahlekelwa isisindo okungachazeki. I-jaundice evela ngokushesha noma ebiyelayo ngokushesha idinga ukunakekelwa kwezokwelapha ngokushesha.

Hlela i-aphoyintimenti phakathi nezinsuku ezimbalwa uma uhlangabezana nezimpawu eziqhubekayo njengobunhlungu besisu obuqhubekayo, ukulahlekelwa isisindo okukhulu ngaphandle kokuzimisela, noma ukushintsha ekuhambeni kwesisu okuphela amasonto ambalwa noma amabili.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uthuthukisa ubuhlungu besisu obukhulu, ubushushu obukhulu kanye ne-jaundice, noma ukugabha okukuvimbela ekuqondeni izinto eziluhlaza. Lezi zimpawu zingase zibonise izinkinga ezidinga ukwelashwa ngokushesha.

Ungalindi ukubona uma izimpawu ziphulukana zodwa, ikakhulu uma unezimpawu eziningi ezivela ndawonye. Ukutholwa kwangaphambi kwesikhathi nokuphathwa komdlavuza wesisu kuphulukisa kakhulu imiphumela, ngakho-ke ukuhlolwa kwezokwelapha ngokushesha kuyikhetho elifanele njalo.

Ziyini izinkinga ezingase zenzeke ngenxa yomdlavuza wesisu?

Uma kushiywa ungaphathwa, umdlavuza wesisu ungabangela izinkinga ezinkulu ngokuvimba ukugeleza kwe-bile namajusi e-pancreas. Ukukhathazeka okukhulu kuvame ukuba yi-jaundice ebuhlungu, engase iholele ezinkingeni zesibindi nokutheleleka.

Izinkinga ezivamile zihlanganisa:

• Ukuvinjwa komthambo we-bile okuholela ekubeni isibi lilimale
• Ukutheleleka emithambeni ye-bile (cholangitis)
• Ukuvinjwa komthambo we-pancreas okubangela ubuhlungu obukhulu
• Ukuphila okungalungile ngenxa yokugaya amafutha okungalungile
• Izinkinga zokugoba igazi
• Ukubhebhetheka komdlavuza ezihlokweni eziseduze njengasesibindini noma ama-lymph nodes

Ezimweni eziphambili, umdlavuza ungase usakaze ezingxenyeni ezikude zomzimba, kufaka phakathi isibi, amaphaphu, noma amathambo. Lokhu kwenza ukwelashwa kube nzima kakhulu kodwa akusilwenzi okungenakwenzeka.

Izindaba ezinhle ukuthi izinkinga eziningi zalezi zingavinjwa noma ziphathwe kahle ngokunakekelwa kwezokwelapha okufanele. Iqembu lakho lezempilo lizokunaka eduze futhi lithathe izinyathelo zokuvimbela izinkinga lapho kungenzeka.

Umphukela wesisu utholakala kanjani?

Ukutholakala komdlavuza wesisu kuvame ukuqala ngezivivinyo zegazi ukuhlola umsebenzi wesibindi nokubuka amamaki abonisa ukuvinjwa komthambo we-bile. Udokotela wakho uzoqhuba futhi ukuhlolwa komzimba futhi akusize ngemibuzo emininingi mayelana nezimpawu zakho.

Izivivinyo zokuthola izithombe zidlalwa indima ebalulekile ekutholeni futhi zingase zihlanganise:

• I-CT scan ukuthola izithombe eziningi zesisu sakho
• I-MRI ukuhlola imithambo ye-bile namalungu aseduze
• I-ERCP (inkqubo ye-endoscopic) ukubuka ngqo esiswini
• I-Ultrasound ukuhlola ukuvinjwa noma ama-masses
• I-PET scan ukuqonda uma umdlavuza usakaze

Ukutholakala okuqinisekile kudinga i-biopsy, lapho i-sample encane yethishu ithathwa ngesikhathi senqubo ye-endoscopic futhi ihlolwe ngaphansi komkhiqizo. Le nqubo ivame ukwenziwa ngenkathi uhlala ukhululekile.

Udokotela wakho angase a-ode izilingo ezengeziwe ukuze aqonde uhlobo oluqondile lomdlavuza wesisu futhi ahlele indlela yokwelapha engcono kakhulu. Le nqubo, ebizwa ngokuthi i-staging, ikusiza ukubikezela ukuthi umdlavuza ungase uziphathe kanjani futhi uphendule ekwelapheni.

Yini ukwelashwa komdlavuza wesisu?

Ukuhlinzwa kuvame ukuba yilona ukwelashwa olukhulu lomdlavuza wesisu, ikakhulu uma umdlavuza ubanjwa ekuqaleni futhi awusakazekanga kwezinye izitho. Inqubo evamile ibizwa ngokuthi i-Whipple operation, esusa isisu kanye nezingxenye ze-pancreas, isisu esincane, nomthambo we-bile.

Izinketho zokwelapha ziyahlukahluka kuye ngesigaba nendawo yomdlavuza wakho:

• Ukususwa ngokuhlinzwa (i-Whipple procedure noma ukukhipha okukude)
• I-Chemotherapy ukunciphisa ama-tumors noma ukuvimbela ukubuyela
• I-Radiation therapy ukuqondisa amaseli omdlavuza
• Izinqubo zokwelapha ukunciphisa izimpawu nokuthuthukisa ikhwalithi yokuphila
• Imithi ye-Targeted therapy yezinhlobo ezithile zomdlavuza
• I-Immunotherapy kwezinye izimo

Uma ukuhlinzwa kungenakwenzeka ngenxa yendawo yomdlavuza noma impilo yakho yonke, iqembu lakho lezokwelapha lizogxila ekwelapheni okungalawula umdlavuza futhi lilawule izimpawu ngokuphumelelayo. Lokhu kungase kuhlanganise ukufakwa kwe-stent ukuze kugcinwe imithambo ye-bile ivulekile.

Uhlelo lwakho lokwelapha luzokwenziwa ngokukhethekile ngesimo sakho, uthathe ingqondo impilo yakho yonke, izici zomdlavuza, kanye nezifiso zakho siqu. Abantu abaningi basebenza neqembu elihlanganisa ochwepheshe bokuhlinzwa, i-oncologists, kanye nochwepheshe abanye.

Ungawuphatha kanjani umdlavuza wesisu ekhaya?

Ukukhathalela wena ekhaya kuyiyingxenye ebalulekile yokuhamba kwakho kokwelashwa. Gxila ekudleni ukudla okuncane, okuvamile okulula ukukugaya, futhi cabanga ukusebenza nochwepheshe wokudla oqonda izinselele zomdlavuza wesisu.

Amasu okunakekelwa ekhaya ahlanganisa:

• Ukuthatha izithasiselo ze-enzyme ezimisiwe ngokudla ukuze kusize ekugayeni
• Ukudla ukudla okuncane, okuvamile kunokudla okukhulu
• Ukugwema ukudla okunamafutha noma okunamafutha okungase kube nzima ukukugaya
• Ukugcina umzimba ugcwele amanzi nezinto ezihlanzekile
• Ukuphumula ngokwanele nokulawula ukukhathala
• Ukuthatha imithi ngokuqondile njengoba kuqokiwe
• Ukuqapha izimpawu zakho nokubika izinguquko eqenjini lakho lezempilo

Ukulawula imiphumela emibi yekwelashwa kubaluleke ngokulinganayo. Uma uhlangabezana nokuphefumula, zama ukudla ukudla okungenamnandi futhi uthathe imithi yokulwa nokuphefumula njengoba kuqokiwe. Ngokukhathala, linganisa umsebenzi ngokuphumula futhi ucele usizo uma udinga.

Hlala uxhumene neqembu lakho lezempilo futhi ungangabazi ukubiza uma unezinkinga mayelana nezimpawu, imiphumela emibi, noma imibuzo yemithi. Bakhona ukuze bakusekele kuzo zonke izinyathelo zokwelashwa kwakho.

Kufanele uzilungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ngaphambi kwe-aphoyintimenti yakho, bhala zonke izimpawu zakho, kufaka phakathi ukuthi zaqala nini nokuthi zishintshe kanjani ngokuhamba kwesikhathi. Yiba uchwepheshe mayelana namanqanaba obuhlungu, ukushintsha kwesisindo, nanoma yiziphi izinkinga zokugaya ukudla ozibonile.

Letha uhlu oluphelele lwemithi, izithasiselo, namavithamini owathatha, kufaka phakathi imithamo. Lungiselela futhi ulwazi mayelana nembali yomndeni wakho yezokwelapha, ikakhulu noma yimiphi imidlavuza noma izimo ze-genetic.

Cabanga ukuletha umngani othembekile noma ilungu lomndeni e-aphoyintimenti yakho ukuze kukusize ukukhumbula ulwazi nokukusekela ngokomzwelo. Bangakusiza futhi ucabange ngemibuzo ongayikhumbula ukubuza.

Bhala phansi imibuzo ngaphambi kwesikhathi ukuze ungayikhohlwa ngesikhathi se-aphoyintimenti. Imibuzo ebalulekile ingase ihlanganise ukubuza ngezinketho zokwelapha, imiphumela emibi, ukubikezela, nokuthi yini okulindelekile ngesikhathi sokuphulukisa.

Yini eyisifundo esiyinhloko mayelana nomdlavuza wesisu?

Umphukela wesisu yisimo esingavamile kodwa esingaphathwa, ikakhulu uma ubanjwa ekuqaleni ngokunaka izimpawu njenge-jaundice. Nakuba ukuthola leli bika kungase kuzwakale kuyadumaza, abantu abaningi abane-umphukela wesisu baqhubeka bephila impilo egcwele, enempilo ngemuva kokwelashwa.

Into ebaluleke kakhulu ongayenza ukusebenza eduze neqembu lakho lezempilo futhi ulandele uhlelo lwakho lokwelapha. Ungangabazi ukubuza imibuzo, ubonise ukukhathazeka, noma ucele imibono yesibili uma uzizwa ungaqiniseki nganoma yiliphi izingxenye zokunakekelwa kwakho.

Khumbula ukuthi ukwelashwa komdlavuza wesisu kuye kwaqhubeka kuthuthuka eminyakeni yamuva, futhi ucwaningo oluqhubekayo luyaqhubeka luthuthukisa izindlela ezintsha nezinhle kakhulu. Gxila ekuthatheni izinto isinyathelo ngesinyathelo futhi ugubhe izinqoba ezincane endleleni.

Imibuzo evamile ebuzwa mayelana nomdlavuza wesisu

Ingabe umdlavuza wesisu udluliselwa ezizukulwaneni?

Izimo eziningi zomdlavuza wesisu azidluliselwa ezizukulwaneni futhi zikhula ngokungahleliwe. Noma kunjalo, abantu abanezinye izimo ze-genetic njenge-familial adenomatous polyposis (FAP) noma i-Lynch syndrome banengozi enkulu. Uma unembali yomndeni yalezi zimo noma imidlavuza eminingi yokugaya ukudla emndenini wakho, ukwelulekwa kwe-genetic kungase kube usizo ekuqondeni ingozi yakho.

Iyini izinga lokuphila komdlavuza wesisu?

Izinga lokuphila lomdlavuza wesisu lilvame ukuba lihle kunezinye izifo zomdlavuza wokugaya ukudla, ikakhulu uma ubanjwa ekuqaleni. Izinga lokuphila kweminyaka emihlanu lingase lihluke kusuka ku-20% kuya ku-80% kuye ngesigaba sokutholakala nokukwazi yini ukususa umdlavuza ngokuphelele ngokuhlinzwa. Udokotela wakho angakunikeza ulwazi oluqondile olusekelwe esimweni sakho siqu.

Ingabe umdlavuza wesisu ungavinjwa?

Alikho ikhetho eliqinisekisiwe lokuvimbela umdlavuza wesisu ngoba izimo eziningi zikhula ngaphandle kwezizathu ezicacile. Noma kunjalo, unganciphisa ingozi yakho ngokungabhemi, ukulinganisela ukusetshenziswa kotshwala, nokulondoloza impilo enempilo. Abantu abanezinye izimo ze-genetic ezandisa ingozi kufanele basebenze nodokotela babo ngamasu afanele okuhlola nokuqapha.

Kuthatha isikhathi esingakanani ukuphulukisa ngemuva kokuhlinzwa komdlavuza wesisu?

Isikhathi sokuphulukisa sihlukahluka kuye ngohlobo lokuhlinzwa nempilo yakho yonke ngaphambi kwenqubo. Abantu abaningi bahlala esibhedlela izinsuku eziyi-7 kuya kweziyi-14 ngemuva kwenqubo ye-Whipple, futhi ukuphulukisa okuphelele kungathatha izinyanga eziningi. Iqembu lakho lokuhlinzwa lizonikeza isiqondiso esithile mayelana nokuvinjelwa kwemisebenzi, ukushintsha kokudla, nokunakekelwa okulandelayo ngesikhathi sakho sokuphulukisa.

Ngizodinga yini ukwelashwa okuqhubekayo ngemuva kokuhlinzwa komdlavuza wesisu?

Abantu abaningi bathola ukwelashwa okwengeziwe ngemuva kokuhlinzwa, njenge-chemotherapy noma i-radiation therapy, ukunciphisa ingozi yokubuyela komdlavuza. Ngisho noma ukwelashwa kuphelile, uzodinga i-aphoyintimenti yokulandelela njalo kanye nezivivinyo zokuthola izithombe ukuze uqaphe noma yiziphi izimpawu zokubuyela. Iqembu lakho le-oncology lizokwenza uhlelo lokuqapha oluqondene nesimo sakho siqu nokuphendula kokwelashwa.