Ubuhlungu Bokukhulu? Izimpawu, Izimbangela, Nokwelashwa

Ubuhlungu bokukhulu luhlobo lolwempilo oluqala eziseleni zesikhumba esiphethelweni somgudu wakho wokugaya ukudla. Nakuba kungelona oluqhelekile njengamanye ama-cancer, ukuqonda izimpawu zalo nezindlela zokwelapha kungakusiza uzizwe unolwazi futhi ulungile.

Lesi simo sihlupha amangqamuzana ahlanganisa umgudu wakho wokukhulu noma isikhumba esizungezile. Izigameko eziningi zihlanganiswe nokutheleleka okuthile kwe-viral, ikakhulukazi i-human papillomavirus (HPV). Izindaba ezinhle ukuthi uma kubanjwe ngokushesha, ubuhlungu bokukhulu bulapheka kakhulu ngemiphumela emihle kubantu abaningi.

Ziyini izimpawu zokukhulu?

Ubuhlungu bokukhulu obuqalayo ngokuvamile abubangeli izimpawu ezibonakalayo, kungakho ukuhlola okuvamile kubalulekile. Uma izimpawu zivele, ngezinye izikhathi zingaphambanisa nezinye izimo eziqhelekile njenge-hemorrhoids noma i-anal fissures.

Nazi izimpawu umzimba wakho ongazenza uma ubuhlungu bokukhulu buqala ukukhula:

• Ukuphuma kwegazi esibindini sakho noma esikhumbeni sakho, ikakhulukazi ngesikhathi sokuya esikhumulweni
• Ubuhlungu, ukucindezela, noma ukubamba endaweni yakho yokukhulu
• Ukukhahlela noma ukuphuma kwegazi esikhumbeni sakho
• Isiqephu noma isikhumba ongasithola eduze kokuvuleka kwakho kokukhulu
• Ukushintsha emikhwenyoni yakho yokuya esikhumulweni noma esimweni sesitulo sakho
• Ama-lymph nodes awokhayo endaweni yakho yokukhulu noma yeqolo

Ngokungavamile, ungase ube nokuqeda amandla okungavamile noma ukulahlekelwa isisindo okungachazwanga. Lezi zimpawu zingase zivele kancane kancane futhi zingase ziye ziye zibuyele ekuqaleni. Khumbula, ukuba nalezi zimpawu akusho ukuthi une-cancer, njengoba izimo eziningi zingabangela izinkinga ezifanayo.

Ziyini izinhlobo zokukhulu?

Odokotela bahlukanisa ubuhlungu bokukhulu ngokusekelwe ohlotsheni lwamangqamuzana lapho luqala khona. Ukuqonda lezi zinhlobo kusiza iqembu lakho lezokwelapha likhethe indlela yokwelapha efanele isimo sakho esithile.

Uhlobo oluqhelekile kakhulu yi-squamous cell carcinoma, oluqala emangqamuzaneni asele ahlanganisa ingxenye enkulu yomgudu wakho wokukhulu. Lokhu kuhlanganisa cishe u-80-90% wazo zonke izinhlobo zokukhulu futhi ngokuvamile kuphendula kahle ekwelapheni.

I-Adenocarcinoma ayiqhelekile futhi iqala emangqamuzaneni egland yomgudu wakho wokukhulu. Lolu hlobo ngezinye izikhathi lungasakazeka kuma-lymph nodes aseduze futhi lungadinga izindlela ezahlukene zokwelapha.

Ezinye izinhlobo ezingavamile zihlanganisa i-melanoma, eqala emangqamuzaneni akhiqiza i-pigment, ne-small cell carcinoma. Lezi zinhlobo ezingavamile zingase ziphathe ngokuhlukile futhi ngokuvamile zidinga izinhlelo zokwelapha ezikhethekile ezilungiselelwe izici zazo ezihlukile.

Yini ebangela ubuhlungu bokukhulu?

Ubuhlungu bokukhulu buqala lapho amangqamuzana ajwayelekile eziseleni zakho yokukhulu enza ushintsho oluwenza akhule ngokungaphatheki. Nakuba singakwazi njalo ukubona ukuthi kwenzekani lokhu, abacwaningi baye baqonda izici eziningana ezibalulekile ezandisa amathuba.

Imbangela eyinhloko ukutheleleka yi-human papillomavirus (HPV), ikakhulukazi izinhlobo 16 no-18. I-HPV iwuvayirasi oluqhelekile kakhulu oluthwalwa ngokuxhumana okusondelene kwesikhumba nesikhumba. Abantu abaningi abane-HPV abazitholi i-cancer, kodwa ukutheleleka okuqhubekayo ngezinye izikhathi kungabangela ushintsho lwamangqamuzana eminyakeni eminingi.

I-immune system yakho idlala indima ebalulekile ekunqobeni ukukhula kwe-cancer. Uma i-immune system yakho iyancipha ngezimo ezinjenge-HIV/AIDS noma imithi ecindezela i-immunity, umzimba wakho ungase ulwe nokususa ukutheleleka kwe-HPV ngokuphumelelayo.

Ukuvuvukala okuqhubekayo endaweni yakho yokukhulu okuvela ezimweni ezinjenge-anal fistulas noma isifo sokuvuvukala somathumbu kungase futhi kuhlanganyele engozini ye-cancer ngokuhamba kwesikhathi. Ngaphezu kwalokho, ukubhema kubonakala sengathi kukhulisa ingozi yakho, mhlawumbe ngokunciphisa impendulo yakho ye-immune futhi kuthinte indlela umzimba wakho ugcina ngayo i-HPV.

Nini kufanele ubona udokotela ngezinkinga zokukhulu?

Kufanele uxhumane nodokotela wakho uma uqaphela izimpawu eziqhubekayo ezingaphuli phakathi kwamasonto ambalwa. Ukuhlolwa okusheshayo kungasiza ukwahlukanisa phakathi kokukhulu nezinye izimo ezilapheka ezibangela izimpawu ezifanayo.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nokuphuma kwegazi esibindini, ikakhulukazi uma kusha noma kuhlukile kwalokho obekukuhlangabezana nakho ngaphambili. Nakuba ukuphuma kwegazi ngokuvamile kubangelwa yi-hemorrhoids noma ezinye izimo ezilungile, kubalulekile ukuhlolwa kahle.

Ungaliqedi ukufuna ukunakekelwa uma uqaphela isiqephu esisha noma isikhumba endaweni yakho yokukhulu, ubuhlungu obuqhubekayo obuphazamisa imisebenzi yansuku zonke, noma ukushintsha okukhulu emikhwenyoni yakho yokuya esikhumulweni. Lezi zimpawu zidinga ukuhlolwa kwabasebenzi bezokwelapha ukuze kuqondwe imbangela yazo.

Uma unezingozi ezinjenge-HIV infection, umlando wezinye izinhlobo ze-cancer ezihlobene ne-HPV, noma uthatha imithi ecindezela i-immune system, xoxani ngokuhlolwa okuvamile nodokotela wakho. Bangakuncoma ukuqapha okufanele ngokusekelwe ekuhlangenwe nakho kwakho siqu.

Ziyini izingozi zokukhulu?

Izici eziningana zingakhuphula amathuba akho okukhula kokukhulu, nakuba ukuba nezingozi akusho ukuthi uzoba nalesi sifo. Ukuqonda lezi zici kusiza wena nodokotela wakho ukwenza izinqumo ezilwazi mayelana nokukhethwa kwesikrini nokuvimbela.

Nazi izici eziyinhloko ezingase zikhulise ingozi yakho:

• Ukutheleleka kwe-HPV, ikakhulukazi ngezinhlobo eziyingozi ezinjenge-HPV 16 no-18
• Ukutheleleka kwe-HIV noma ezinye izimo ezincipha i-immune system yakho
• Ukuthatha imithi ecindezela i-immune system yakho
• Ukuba nabalingani abaningi bobulili noma uqala umsebenzi wobulili ebuntwaneni
• Umlindo we-cancer yeqolo, i-vaginal, noma i-vulvar
• Ukubhema utshaba
• Ukuba ngaphezu kweminyaka engu-50
• Ukuvuvukala okungapheli noma ukuvuvukala kokukhulu

Abesifazane kubonakala sengathi banengozi encane kunamadoda, nakuba izizathu zingacaci ngokuphelele. Ngaphezu kwalokho, abantu abenza ubulili besikhumba ngemuva bangase babe nokukhishwa okukhulu kwe-HPV, nakuba ubuhlungu bokukhulu bungase buvele kunoma ubani kungakhathaliseki ukuziphatha kobulili.

Ziyini izinhlanganisela ezingase zibe khona zokukhulu?

Uma kutholakala futhi kuphathwa ngokushesha, abantu abaningi abane-cancer yokukhulu bahlangabezana nemiphumela emihle ngemiphumela embalwa yesikhathi eside. Noma kunjalo, ukuqonda izinhlanganisela ezingase zibe khona kusiza wena neqembu lakho lezokunakekelwa kwezempilo ukwenza noma ukuphatha ngokuphumelelayo.

Uma kushiywa kungaphathwa, ubuhlungu bokukhulu bungasakazeka kuma-lymph nodes aseduze e-pelvis naseqolo. Lesi sakhazo sendawo ngokuvamile sisalapha kakhulu, kodwa kungadinga izindlela zokwelapha ezinzima kakhulu.

Ezigamekeni eziphambili, i-cancer ingasakazeka ezitho ezikude ezinjenge-liver, amaphaphu, noma amathambo. Nakuba lokhu kungavamile, kubonisa isimo esinzima esidinga ukunakekelwa kwe-cancer okukhethekile nohlelo oluphelele lokwelapha.

Izinhlanganisela ezihlobene nokwelapha zingase zihlanganise izinkinga zesikhashana zokulawula izibindini, ukuvuvukala kwesikhumba endaweni ephiliwe, noma ukuqeda amandla ngesikhathi sokwelashwa nge-radiation. Iningi lale miphumela lilawuleka futhi ngokuvamile liyaphucula kakhulu ngemuva kokuphela kokwelapha.

Ubuhlungu bokukhulu bungavimbeka kanjani?

Nakuba ungakwazi ukuvimbela zonke izigameko zokukhulu, amasu ambalwa anganciphisa kakhulu ingozi yakho. Indlela ephumelela kakhulu ihlanganisa ukugonywa, ukuziphatha okuvikelekile, nokunakekelwa okuvamile kwezempilo.

Ukugonywa kwe-HPV kunikeza isivikelo esihle kakhulu ezinhlotsheni zevusi ezinokwenzeka kakhulu ukubangela ubuhlungu bokukhulu. I-vaccine isebenza kangcono uma inikezwa ngaphambi kokukhishwa kwe-HPV, ngokuvamile eminyakeni yobudala, kodwa isenokunikeza izinzuzo kubantu abadala kuze kube eminyakeni engu-45.

Ukuziphatha kobulili obuvikelekile ngokusebenzisa ama-condoms nokulinganisela inani labalingani bakho bobulili kunganciphisa ingozi yokudluliselwa kwe-HPV. Noma kunjalo, khumbula ukuthi i-HPV ingasakazeka ngokuxhumana kwesikhumba nesikhumba, ngakho ama-condoms awanikezi isivikelo esiphelele.

Uma ubhema, ukuyeka kungathuthukisa ikhono le-immune system yakho lokulwa nokutheleleka kwe-HPV. Udokotela wakho angakunikeza izinsiza nokusekela ukuze akusize uyeke ngempumelelo.

Ukuhlolwa okuvamile kubalulekile ikakhulu uma une-HIV noma ezinye izimo ze-immune system. Udokotela wakho angakuncoma isikhathi esifanele sokuhlolwa ngokusekelwe ezingozini zakho siqu.

Ubuhlungu bokukhulu butholakala kanjani?

Ukutholakala kokukhulu ngokuvamile kuqala ngodokotela wakho ebuza ngezimpawu zakho futhi enze ukuhlolwa komzimba. Lokhu kuhlolwa kokuqala kusiza ukuqonda ukuthi yiziphi ezinye izivivinyo ezingase zidingeke.

Udokotela wakho cishe uzokwenza ukuhlolwa kwe-digital rectal, ngokungenisa ngobumnene umunwe ogqokile isicathulo esibindini sakho ukuze uzwe noma yiziphi izikhumba ezingavamile noma izindawo ezinobuhlungu. Nakuba lokhu kungase kuzwakale kungekuhle, kufushane futhi kunikeza ulwazi oluwusizo.

I-anoscopy ivumela udokotela wakho ukuba abone ngqo umgudu wakho wokukhulu usebenzisa i-tube encane, enezibani ebizwa nge-anoscope. Le nqubo ikusiza ukuthola noma yiziphi izinto ezingavamile eziqondakalayo futhi ingaqondisa izinqumo mayelana nokuqoqwa kweziseleni.

Uma kutholakala izindawo ezinobuhlungu, udokotela wakho uzokwenza i-biopsy, asuse isiqephu esincane seselini sokuhlaziywa kwelebhu. Yilona kuphela indlela yokutholakala ngokuqinisekile i-cancer nokuqonda uhlobo lwayo oluthile nezici zayo.

Ezinye izivivinyo ezinjenge-CT scans, i-MRI, noma i-PET scans zingase zinconywe ukuze kubonwe ukuthi i-cancer isakazeke yini kwezinye izindawo. Lezi zifundo zokutholakala zisiza iqembu lakho lezokwelapha ukwenza uhlelo lokwelapha olufanele isimo sakho.

Yini ukwelashwa kokukhulu?

Ukwelashwa kokukhulu kuye kwathuthuka kakhulu eminyakeni eminingi, ngabantu abaningi bezuza ukukhululeka okuphelele. Uhlelo lwakho lokwelapha luzolungiswa ngesimo sakho esithile, kufaka phakathi isigaba se-cancer, indawo, nempilo yakho yonke.

Indlela yokwelapha ejwayelekile ihlanganisa i-chemotherapy ne-radiation therapy, ngokuvamile ebizwa nge-chemoradiation. Lo mhlanganiso usebenza ngokubambisana, nge-chemotherapy yenza amangqamuzana e-cancer abe nomuzwa kakhulu we-radiation ngenkathi i-radiation ihlose i-tumor ngokuqondile.

I-Chemotherapy ngokuvamile ihlanganisa imithi enikezwa nge-IV noma ngomlomo emasontweni ambalwa. Imithi evamile ihlanganisa i-mitomycin C ne-5-fluorouracil, esebenza ngokuphazamisa ukukhula kwamangqamuzana e-cancer nokuhlukaniswa.

I-Radiation therapy isebenzisa imisebe yamandla aphezulu ukubhubhisa amangqamuzana e-cancer ngenkathi inciphisa ukonakala kweziseleni ezempilo. Amathuluzi amanje avumela ukuqondiswa okuqondile kwendawo ye-tumor, kunciphisa imiphumela ebi kunezinye izindlela ezindala.

Ukuhlinzwa ngokuvamile kugcinelwe izimo lapho i-chemoradiation ingayiqedi ngokuphelele i-cancer noma uma i-cancer ibuya ngemuva kokwelashwa kokuqala. Ezimeni ezingavamile, lokhu kungase kuhlanganise ukususa ingxenye yokukhulu nomgudu, kodwa lokhu kungavamile kakhulu kunangaphambili.

Indlela yokuphatha izimpawu ngesikhathi sokwelashwa kokukhulu

Ukuphatha imiphumela ebi ngesikhathi sokwelapha kusiza ugcine ikhwalithi yakho yokuphila futhi uqhubeke nehlolo lakho lokwelapha. Iqembu lakho lezokunakekelwa kwezempilo lizokusebenza eduze nawe ukuvimbela nokubhekana nanoma yiziphi izinkinga ezivela.

Ukukhathalela isikhumba kuba kubalulekile kakhulu ngesikhathi sokwelashwa nge-radiation, njengoba indawo ephiliwe ingase ivuvukale noma ibe nomuzwa. Sebenzisa izinto zokuhlanza ezimnene, ezingenamphunga nezithambisayo ezinconywe yiqembu lakho lokunakekelwa, futhi ugcine izifebe noma imikhiqizo eqinile.

Ukuguqulwa kokudla kungasiza ukuphatha ukushintsha kwesibindini ngesikhathi sokwelapha. Udokotela wakho angase akuncome ukudla okune-fiber encane ekuqaleni, okulandelelwa ukwanda kancane njengoba uhlelo lwakho luqondana. Ukugcina umzimba ugcwele amanzi kubalulekile ikakhulu.

Ukuqeda amandla kuvamile ngesikhathi sokwelapha, ngakho hlela ukuphumula okwengeziwe futhi ungangabazi ukucela usizo ngemisebenzi yansuku zonke. Ukuzivocavoca okulula njengokuhamba okufushane kungasiza ukugcina amazinga akho amandla uma uzizwa ukhona.

Izinketho zokulawula ubuhlungu zihlanganisa imithi yokuthengwa ngaphandle komthetho kuya kwezinketho zokubhalwa uma kudingeka. Iqembu lakho lokunakekelwa lingakuncoma indlela engcono kakhulu ngokusekelwe ezimpawu zakho nehlolo lakho lokwelapha.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukulungiselela i-appointment yakho kusiza uqinisekise ukuthi uthola okuningi ngesikhathi sakho nomhlinzeki wakho wezokunakekelwa kwezempilo. Ukuba uhleli futhi unolwazi kuvumela ukuxoxisana okusebenzayo ngezinkinga zakho nezindlela zokwelapha.

Bhala zonke izimpawu zakho, kufaka phakathi ukuthi zaqala nini, zingaki zivele, nokuthi yini ezenza zibe ngcono noma zimbi. Faka imininingwane mayelana nanoma yikuphi ukushintsha emikhwenyoni yakho yokuya esikhumulweni, amazinga obuhlungu, noma ezinye izinkinga oziqaphelayo.

Letha uhlu lwemithi yonke oyithathayo, kufaka phakathi imithi yokuthengwa ngaphandle komthetho, izithambisi, nemithi yemifino. Futhi, qokelela umlando wakho wezokwelapha, kufaka phakathi noma yikuphi i-cancer yangaphambili, izimo ze-immune system, noma ukuhlinzwa.

Lungisa imibuzo ofuna ukuyibuza udokotela wakho. Cabanga ukubuza ngokutholakala kwakho, izinketho zokwelapha, imiphumela ebi, nokuthi yini okulindelekile ngesikhathi sokuphulukana. Ungakhathazeki ngokubuza imibuzo eminingi kakhulu - udokotela wakho ufuna ukuba unolwazi oluphelele.

Cabanga ukuletha umngani othembekile noma ilungu lomndeni e-appointment yakho. Bangakunikeza ukusekela ngokomzwelo futhi bakusize ukukhumbula ulwazi oluqakathekile oluxoxiswe ngesikhathi sokuvakasha kwakho.

Iyini into ebalulekile mayelana nokukhulu?

Ubuhlungu bokukhulu, nakuba bukhulu, bulapheka kakhulu uma kubanjwa ngokushesha, ngabantu abaningi bezuza ukuphulukana okuphelele. Okubalulekile ukungaliqedi ukufuna ukunakekelwa kwezokwelapha uma uqaphela izimpawu eziqhubekayo ezikukhathazayo.

Ukuvimbela ngokugonywa kwe-HPV nokuhlolwa okuvamile kwabantu abanobungozi obukhulu kunikeza isivikelo esihle kakhulu ekuthuthukiseni ubuhlungu bokukhulu. Uma uthola ukuxilongwa, khumbula ukuthi imiphumela yokwelapha iye yathuthuka kakhulu eminyakeni yamuva.

Iqembu lakho lezokunakekelwa kwezempilo liyi-ally yakho eqinile kulolu hambo. Banolwazi olukhulu lokwelapha ubuhlungu bokukhulu futhi bazokusebenza nawe ukwenza uhlelo lokwelapha oluqondana nezidingo zakho zezokwelapha nezinkinga zekhwalithi yokuphila.

Hlala uxhumene nesisekelo sakho, landela uhlelo lwakho lokwelapha, futhi ungangabazi ukuxhumana neqembu lakho lezokwelapha nganoma yiziphi izinkinga. Ngokunakekelwa okuhle nokusekela, abantu abaningi abane-cancer yokukhulu baqhubeka bephila impilo egcwele, enempilo.

Imibuzo evamile ebuzwa mayelana nokukhulu

Ingabe ubuhlungu bokukhulu bufana ne-colorectal cancer?

Cha, ubuhlungu bokukhulu ne-colorectal cancer ziyizinhlobo ezahlukene ze-cancer ezivela ezindaweni ezahlukene zomgudu wakho wokugaya ukudla. Ubuhlungu bokukhulu buqala ekukhuleni, ngenkathi i-colorectal cancer iqala e-colon noma esibindini. Zinimbangela ezahlukene, izingozi, nezindlela zokwelapha, nakuba zombili zilapheka kakhulu uma zitholakala ngokushesha.

Ingabe ubuhlungu bokukhulu bungaphuliwa ngokuphelele?

Yebo, ubuhlungu bokukhulu ngokuvamile bungaphuliwa ngokuphelele, ikakhulukazi uma kubanjwa ezigabeni zokuqala. Izinga lokuphila iminyaka emihlanu le-cancer yokukhulu ehlala endaweni liphezu kuka-80%. Abantu abaningi abaphathwa ngokudideka kwe-chemotherapy ne-radiation therapy bafeza ukukhululeka okuphelele futhi bahlala bengena-cancer isikhathi eside.

Ingabe ngizodinga ukuhlinzwa uma ngine-cancer yokukhulu?

Abantu abaningi abane-cancer yokukhulu abadingi ukuhlinzwa njengokwelashwa kwabo okuyinhloko. Indlela ejwayelekile isebenzisa i-chemotherapy ne-radiation therapy ndawonye, okuphumelela kakhulu. Ukuhlinzwa ngokuvamile kucabangelwa kuphela uma i-cancer ingaphenduli ngokuphelele ekwelapheni kokuqala noma uma ibuya ngemuva kokwelapha.

Ukwelashwa kokukhulu kuthatha isikhathi esingakanani?

Ukwelashwa ngokuvamile kuthatha amasonto angu-6-8, nge-chemotherapy ne-radiation therapy enikezwa ngesikhathi esifanayo. Ngokuvamile uzothola i-radiation therapy izinsuku ezinhlanu ngesonto phakathi nalesi sikhathi, nge-chemotherapy enikezwa ngezinsuku ezithile. Ihlelo lakho lokwelapha eliqondile lizoqondana nehlolo lakho lokwelapha siqu nokuthi uphendula kanjani ekwelapheni.

Ngingavimbela ubuhlungu bokukhulu uma ngisena-HPV?

Yebo, usengathatha izinyathelo zokunciphisa ingozi yakho ngisho noma une-HPV. I-immune system yakho ngezinye izikhathi ingasusa ukutheleleka kwe-HPV ngokwemvelo, futhi ukugcina impilo enhle yonke kusiza le nqubo. Ukuyeka ukubhema, ukuhlolwa okuvamile, nokulandela izincomo zokuhlolwa kungasiza ukuthola noma yikuphi ukushintsha ngokushesha lapho kulula kakhulu ukuliphatha.