Umgxuma Wokwephukutheleni? Izimpawu, Izimbangela, Nokwelashwa

Umgxuma wokwephukutheleni uqala lapho amaseli ezikhukhuleni zakho eqala ukukhula ngokungaphelile, enza iziphumu ezingaphazamisa umsebenzi ojwayelekile wezikhukhulu zakho. Izikhukhulu zakho yizitho ezimbili ezinobukhulu be-bean, ezinobukhulu beqhaza lakho, eziqheleke ngakwesokunxele nesokudla kwesigxobo sakho ngaphansi kwamabhabha akho. Zisebenza usuku lonke ukuhlanza udoti egazini lakho futhi zenze umchamo, ngakho-ke lapho umgxuma ukhula lapha, ungaphazamisa le nqubo ebalulekile yokuhlanza umzimba wakho oyiqondayo.

Umgxuma wokwephukutheleni yini?

Umgxuma wokwephukutheleni uqala lapho amaseli aphilile ekhukhuleni eba ngamasela angajwayelekile futhi azale ngokungaphelile. Iningi lemigxuma yokwephukutheleni liqala ezimpompeni ezincane ezikhukhuleni zakho ebizwa ngokuthi ama-nephrons, afana nezigidi zama-filters ezincane ezicoca igazi lakho.

Uhlobo oluvamile kakhulu yi-renal cell carcinoma, olukwakha cishe u-85% wabo bonke umgxuma wokwephukutheleni. Cabanga ngalo njengohlobo “oluyinhloko” odokotela abalubona kakhulu. Kukhona nawo amanye ama-types angavamile njenge-transitional cell carcinoma ne-Wilms tumor, ehlala ihlasela abantwana.

Okwenza umgxuma wokwephukutheleni ube nzima kakhulu ukuthi ukhula ngokuthula ngaphandle kwezimpawu ezicacile ezigabeni zokuqala. Izikhukhulu zakho zihlala zifihliwe ngaphakathi komzimba wakho, ngakho-ke iziphumu ezincane zingakhula ngaphandle kokuthi uzizwe uhlukile ekuqaleni.

Ziyini izimpawu zomgxuma wokwephukutheleni?

Umgxuma wokwephukutheleni oqala ngokuvamile awubangeli izimpawu ezibonakalayo, kungakho ngezinye izikhathi ubizwa ngokuthi “ugula oluthule.” Lapho izimpawu ziveleka, zingaba zimbi futhi zingabonakala zihambisana nezinye izimo ezingathandeki.

Nazi izimpawu ongazihlangabezana nazo, kusukela ezivamile kakhulu kuya kulabo abangavamile:

• Igazi emchameni wakho, okungenza ubukeke pinki, obomvu, noma olukhulu njenge-cola
• Ubuhlungu ohlangothini noma emuva olungapheli
• I-lump noma i-mass ongayizwa ohlangothini noma emuva
• Ukwehla kwesisindo okungachazeki emasontweni noma ezinyangeni eziningi
• Ukukhathala okungaphuli ngokuphumula
• Ukuvuvukala okuza nokuphela ngaphandle kwesizathu esicacile
• Ukwehla kwesifiso sokudla okuphela izinsuku ezimbalwa

Abanye abantu nabo bahlangabezana nezimpawu ezingavamile njengokuvuvukala ezinyaweni, ukucindezeleka kwegazi okuvela ngokuzumayo, noma i-anemia. Lokhu kwenzeka ngoba umgxuma wokwephukutheleni ngezinye izikhathi ungaphazamisa indlela umzimba wakho ophatha ngayo amanzi futhi wenze ama-hormones athile.

Khumbula, ukuba nesimpawu esisodwa noma ngaphezulu akusho ukuthi unemgxuma wokwephukutheleni. Izimo eziningi zingabangela izimpawu ezifanayo, kodwa kufanele uhlole nodokotela wakho uma uqaphela noma yiziphi izinguquko eziqhubekayo.

Ziyini izinhlobo zomgxuma wokwephukutheleni?

Kukhona izinhlobo eziningi zomgxuma wokwephukutheleni, ngayinye iqala ezingxenyeni ezahlukene zekhukhulu lakho. Ukuqonda uhlobo kusiza udokotela wakho ukuhlela indlela yokwelapha engcono kakhulu yesimo sakho esithile.

Izinhlobo eziyinhloko zihlanganisa:

• Renal cell carcinoma - uhlobo oluvamile kakhulu, oluqala ezimpompeni zokuhlola zekhukhulu
• Transitional cell carcinoma - iqala lapho ikhukhulu lakho lixhumana khona ne-ureter
• Renal sarcoma - uhlobo olungavamile oluqala e-connective tissue yekhukhulu
• Wilms tumor - ihlasela ikakhulu abantwana abaneminyaka engaphansi kwengu-5
• Lymphoma - lapho i-lymph tissue ekhukhuleni iba ngumgxuma

I-renal cell carcinoma inezinhlobo eziningi, nge-clear cell iyona evamile kakhulu. Udokotela wakho angakwazi ukuthola uhlobo oluqondile nge-biopsy nezivivinyo zokwenza izithombe. Uhlobo ngalunye luphatha ngokuhlukile futhi luphendula ezinye izindlela zokwelapha, kungakho kubalulekile ukuthola ukuxilongwa okuqondile.

Yini ebangela umgxuma wokwephukutheleni?

Umgxuma wokwephukutheleni ukhula lapho okuthile kulimaza i-DNA ngaphakathi kwamaseli ekhukhulu, kubangela ukuba akhule futhi ahlukanise ngokungaphelile. Nakuba singazi ngaso sonke isikhathi ukuthi yini ebangela le nguquko, abacwaningi baye baqaphela izinto eziningi ezingandisa ingozi.

Izinto eziyinhloko ezingozi zihlanganisa:

• Ukubhema utsha, okwanda kabili ingozi yakho uma kuqhathaniswa nabantu abangabhemi
• Ukukhuluphala, ikakhulukazi ukuphatha isisindo esengeziwe ngaphakathi komzimba wakho
• Ukucindezeleka kwegazi okuphezulu okuye kwaba khona iminyaka eminingi
• Umlando womndeni womgxuma wokwephukutheleni kubazali noma abafowabo
• Izimo ezithile ze-genetic njenge-von Hippel-Lindau disease
• Ukwelashwa okuqhubekayo kwe-dialysis ngenxa yokwehluleka kwezikhukhulu
• Ukuvezwa ezimweni ezithile ze-chemicals njenge-asbestos noma i-cadmium

Iminyaka nayo idlala indima, ngoba iningi lemigxuma yokwephukutheleni liqala kubantu abadala kuno-45. Amadoda athola umgxuma wokwephukutheleni kancane kunabesifazane, nakuba odokotela bangaqiniseki ngokuphelele ukuthi kungani lokhu kwenzeka.

Kubalulekile ukwazi ukuthi ukuba nezinto ezingozi akusho ukuthi uzoba nomgxuma wokwephukutheleni. Abantu abaningi abanazo izinto eziningi ezingozi abazutholi le gciwane, kanti abanye abangenazo izinto ezaziwayo ezingozi bayazithola.

Nini okufanele ubona udokotela ngezimpawu zomgxuma wokwephukutheleni?

Kufanele uxhumane nodokotela wakho uma uqaphela igazi emchameni wakho, ngisho noma kwenzeka kanye kuphela. Lesi simpawu sihlale sifuna ukunakekelwa kwezokwelapha, kungakhathaliseki ukuthi uzwa ubuhlungu noma ezinye izimpawu.

Futhi xhumana nodokotela wakho uma uhlangabezana nobuhlungu obuqhubekayo emuva noma ohlangothini obungaphuli ngokuphumula noma izindlela ezijwayelekile zokunciphisa ubuhlungu. Ubuhlungu obuvusa ebusuku noma obukhula ngokuhamba kwesikhathi kubaluleke kakhulu ukuxoxa ngakho.

Ungalindi ukufuna ukunakekelwa uma uhlangabezana nokwehla kwesisindo okungachazeki kanye nokukhathala, ikakhulukazi uma uqaphele nezinguquko esifisweni sakho sokudla. Nakuba lezi zimpawu zingaba nezizathu eziningi, kungcono ukuzihlola ngokushesha kunokuba ulibale.

Uma unomlando womndeni womgxuma wokwephukutheleni noma izimo ze-genetic ezaziwayo ezikhuphula ingozi yakho, xoxa nodokotela wakho ngezinhlelo ezifanele zokuhlola. Ukutholwa kwangaphambi kwesikhathi kwenza ukwelashwa kube nomphumela kakhulu.

Ziyini izinto ezingozi zomgxuma wokwephukutheleni?

Izinto eziningi zingandisa amathuba akho okuthola umgxuma wokwephukutheleni, nakuba ukuba nalezi zinto ezingozi akusho ukuthi uzoba nale gciwane. Ukuqonda lezi zinto kungakusiza wenze izinqumo ezinolwazi ngempilo yakho nokuhlolwa.

Izinto ezingozi ezihlobene nendlela yokuphila ongazithinta zihlanganisa:

• Ukubhema ugebengu noma ukusebenzisa amanye imikhiqizo yetubha
• Ukuba sisindo esikhulu noma ukukhuluphala
• Ukuba nokucindezeleka kwegazi okuphezulu okungalawulwa kahle
• Ukudla ukudla okunamafutha amaningi nokunciphisa izithelo nemifino

Izinto zezokwelapha neze-genetic ongenakuzilawula zihlanganisa:

• Ukuba yindoda (amadoda anezikhathi ezimbili ezinamathuba okuthola umgxuma wokwephukutheleni)
• Iminyaka engaphezu kuka-45, ingozi ikhuphuka njalo
• Umlando womndeni womgxuma wokwephukutheleni
• Izimo eziwumfuzo njenge-von Hippel-Lindau syndrome
• Ubuhlungu bekhukhulu obude obufuna i-dialysis
• Ukwelashwa kwangaphambili ngemithi ethile

Ukuvezwa emsebenzini ezintweni ezifana ne-asbestos, i-cadmium, noma amanye amasolvendi e-organic nako kungandisa ingozi. Uma usebenza emikhakheni lapho lezi zinto zingase zivele khona, kulungile ukulandela izinqubo zokuphepha nokusebenzisa imishini yokukhuselwa.

Ziyini izinhlanganisela ezingaba khona zomgxuma wokwephukutheleni?

Umgxuma wokwephukutheleni ungabangela izinhlanganisela eziningi, kokubili umgxuma ngokwawo futhi ngezinye izikhathi ngokwelashwa. Ukuqonda lezi zinto kungakusiza ukwazi ukuthi yini okufanele uyilinde futhi nini okufanele ufuna ukunakekelwa kwezokwelapha okwengeziwe.

Izinhlanganisela ezihlobene ngqo nomgxuma zihlanganisa:

• Izinkinga zomsebenzi wekhukhulu uma umgxuma uthinta indlela izingqimba zakho ezihlanza igazi
• Ukucindezeleka kwegazi okuphezulu kusuka eziphumwini ezithinta imithambo yegazi
• I-Anemia lapho umgxuma uthinta ukukhiqizwa kwamaseli e-red blood cell
• Ukusabalala komgxuma kwezinye izitho njengemiphunga, amathambo, noma isibindi
• I-blood clots ezinyaweni noma emiphungeni

Izinhlanganisela ezihlobene nokwelashwa zingaba izinhlanganisela zokuthunga njengokuphuma kwegazi noma ukutheleleka, imiphumela emibi yemithi, noma ukuguqulwa okwesikhashana komsebenzi wekhukhulu. Iqembu lakho lezokwelapha liqapha eduze lezi zinkinga futhi linezindlela zokuzilawula.

Izindaba ezinhle ukuthi izinhlanganisela eziningi zingavikeleka noma ziphathwe kahle uma zitholakala ngokushesha. Ukuvakasha okuqhubekayo kokulandelela kuvumela iqembu lakho lezokwelapha ukubona futhi kulungise izinkinga ngaphambi kokuba zibe nzima.

Umgxuma wokwephukutheleni ungavikeleka kanjani?

Nakuba ungakwazi ukuvimba wonke amacala omgxuma wokwephukutheleni, ungathatha izinyathelo zokunciphisa ingozi yakho. Izindlela ezisebenzayo kakhulu zokuvimbela zigxile ezinguqukweni zendlela yokuphila ezisekela impilo enhle yekhukhulu.

Nazi izinto ezibaluleke kakhulu ongazenza:

• Yekela ukubhema noma ungaqali - le nguquko yodwa inganciphisa ingozi yakho ngengxenye
• Gcina isisindo esinempilo ngokudla okulinganiselayo nokuzivocavoca njalo
• Lawula ukucindezeleka kwegazi lakho ngokudla, ukuzivocavoca, nemithi uma kudingeka
• Dla izithelo nemifino eminingi ngenkathi ugcina ukudla okucutshungulwayo
• Hlala uthambile ngokunisela okwanele usuku lonke
• Limita ukusetshenziswa kotshwala emazingeni aphansi

Uma usebenza ne-chemicals noma emikhakheni enezingozi ezingaba khona zomgxuma wokwephukutheleni, hlala ulandela izinqubo zokuphepha. Gqoka imishini yokukhuselwa futhi uqinisekise ukuthi kukhona umoya omuhle endaweni yakho yokusebenza.

Kubantu abanazo izimo ze-genetic ezikhuphula ingozi yomgxuma wokwephukutheleni, ukusebenza nomxhumanisi we-genetic nokulandela izinhlelo zokuhlola ezinikeziwe kubaluleke kakhulu. Lezi zinyathelo zokuzinakekela zingasiza ekutholeni noma yiziphi izinkinga ezigabeni zokuqala, ezilula kakhulu zokwelapha.

Umgxuma wokwephukutheleni utholakala kanjani?

Ukuthola umgxuma wokwephukutheleni ngokuvamile kuqala ngodokotela wakho ebuza ngezimpawu zakho nomlando wakho wezokwelapha, okulandelelwa yi-physical exam. Uma kukhona ukungabaza ngomgxuma wokwephukutheleni, ukuhlolwa okuningi kusiza ekuqinisekiseni ukuxilongwa nokuthola isigaba somgxuma.

Inqubo yokuxilongwa ngokuvamile ihlanganisa lezi zinyathelo:

1. Izivivinyo zegazi nomchamo ukuhlola umsebenzi wekhukhulu nokubheka ukungalungi
2. Ukuhlola izithombe njenge-CT noma i-MRI ukubona izithombe eziningi zezikhukhulu zakho
3. I-ultrasound ukuhlukanisa phakathi kweziphumu eziqinile ne-cysts ezigcwele amanzi
4. Ngezinye izikhathi i-biopsy, lapho isampula encane yethishu isuswa ukuhlolwa
5. Ukuhlola okwengeziwe ukuhlola uma umgxuma usabalale kwezinye izingxenye zomzimba wakho

I-CT scans ngokuvamile iyona i-imaging test yokuqala esetshenziswayo ngoba ingabonisa iziphumu zekhukhulu ngokucacile. Udokotela wakho angase asebenzise i-contrast dye ukwenza izithombe zibe nemininingwane engaphezulu, okusiza ekuhlukaniseni umgxuma ne-tissue yekhukhulu ejwayelekile.

Ngokuthakazelisayo, umgxuma wokwephukutheleni ngezinye izikhathi utholakala ngengozi ngesikhathi sokuhlola okwenziwe ngezizathu ezithile. Lezi “zitholakala” ngezinye izikhathi zibamba umgxuma ezigabeni zokuqala, ezilula kakhulu zokwelapha.

Yini ukwelashwa komgxuma wokwephukutheleni?

Ukwelashwa komgxuma wokwephukutheleni kuncike ezintweni eziningi ezihlanganisa usayizi womgxuma, indawo, isigaba, nempilo yakho yonke. Izindaba ezinhle ukuthi imingxuma eminingi yokwephukutheleni ingaphathwa ngempumelelo, ikakhulukazi uma itholakala ngokushesha.

Ukuhlinzwa kusala ukwelashwa okuyinhloko kwemingxuma eminingi yokwephukutheleni. Udokotela wakho angase asuse kuphela isiphumu nezinye izicubu ezizungezile (i-partial nephrectomy) noma ikhukhulu lonke (i-radical nephrectomy). Iningi lalezi zinqubo zokuthunga manje lingenziwa ngezindlela ezincane zokuthunga ngezinsiza ezincane.

Ezinye izindlela zokwelapha zihlanganisa:

• Imithi ye-targeted therapy ehlasela izici ezithile zamaseli omgxuma
• I-immunotherapy ukusiza isimiso sakho sokuvikela ukulwa nomgxuma
• I-radiation therapy yemingxuma esabalale noma engasuswa ngokuhlinzwa
• I-ablation techniques efriza noma eshisa amaseli omgxuma ukuwabhubhisa
• Ukuqapha okuqhubekayo kwiziphumu ezincane kakhulu, ezikhula kancane

Iqembu lakho lokwelapha lizohlangana nawe ukukhetha indlela engcono kakhulu ngesimo sakho esithile. Abantu abaningi benza kahle kakhulu ngokwelashwa, ikakhulukazi lapho umgxuma wokwephukutheleni utholakala ngaphambi kokuba usabalale ngaphandle kwekhukhulu.

Indlela yokuphatha izimpawu ekhaya ngesikhathi sokwelashwa komgxuma wokwephukutheleni?

Ukuphatha izimpawu nemiphumela emibi ekhaya kudlala indima ebalulekile ehlelweni lakho lokwelashwa lonke. Izindlela ezilula zingakusiza uzizwe ukhululekile futhi ugcine amandla akho ngesikhathi sokwelashwa.

Ukuze uthole induduzo jikelele nokuphathwa kwamandla:

• Phumula uma kudingeka, kodwa zama ukuhlala usebenza kancane ngokuhamba okuqinile
• Dla ukudla okuncane, okuvamile uma isisindo sakho sokudla sinciphile
• Hlala uthambile ngaphandle kokuthi udokotela wakho akuyale ngenye indlela
• Thatha imithi ebhaliwe ngokuqondile njengoba kuyalwe
• Gcina idayari yesimpawu ukuqapha izinguquko nokwabelana neqembu lakho lezokwelapha

Ukuphathwa kobuhlungu kungase kuhlanganise ukusebenzisa imithi ebhaliwe yokuhlanza ubuhlungu njengoba kuyalwe, ukufaka i-heat noma i-cold packs ezindaweni ezibuhlungu, nokwenza izindlela zokuphumula njengokuphefumula okujulile. Unganqikazi ukuxhumana neqembu lakho lezokwelapha uma ubuhlungu bube nzima ukulawula.

Gcina uxhumano nomndeni nabangane, njengoba ukwesekwa ngokomzwelo kuchaphazela kakhulu indlela ozizwa ngayo ngesikhathi sokwelashwa. Abantu abaningi bathola ukuthi amaqembu wokwesekwa awusizo ekuhlanganiseni nabanye abaqonda lokho abakubhekana nakho.

Kufanele ulungiselele kanjani i-appointment yakho yodokotela?

Ukulungiselela i-appointment yakho kusiza ekuqinisekiseni ukuthi uthola okuningi ngesikhathi sakho neqembu lezokwelapha. Ukuba uhleliwe kukuvumela ukumboza konke ukukhathazeka kwakho futhi kusiza udokotela wakho ukunikeza ukunakekelwa okungcono kakhulu.

Ngaphambi kwe-appointment yakho, buza le mininingwane ebalulekile:

• Uhlu lwazo zonke izimpawu zakho zamanje, kufaka phakathi ukuthi zaqala nini
• Yonke imithi oyithathayo, kufaka phakathi imithi yokuthengwa ngaphandle komthetho kanye ne-supplements
• Umlando wakho womndeni wezokwelapha, ikakhulukazi noma yimiphi imingxuma
• Amarekhodi ezokwelapha wangaphambili nemiphumela yokuhlola uma ubona udokotela omusha
• Ulwazi lwakho loku-inshorensi nokubonakala

Bhala imibuzo yakho ngaphambi kwesikhathi ukuze ungakhohlwa ukuyibuza. Imibuzo ebalulekile ingase ihlanganise ukubuza ngokuxilongwa kwakho, izindlela zokwelapha, imiphumela emibi okulindeleke, nokuthi ukwelashwa kungase kuthinte kanjani impilo yakho yansuku zonke.

Cabanga ukuletha ilungu lomndeni omethembayo noma umngane e-appointment yakho. Bangakusiza ukukhumbula ulwazi oluxoxiwe futhi banikeze ukwesekwa ngokomzwelo. Abantu abaningi bathola ukuthi kuwusizo ukuthatha amanothi noma ukubuza uma bangarekhoda izingxenye ezibalulekile zengxoxo.

Iyini into ebalulekile ngomgxuma wokwephukutheleni?

Into ebaluleke kakhulu okumele uyiqonde ngomgxuma wokwephukutheleni ukuthi ukutholwa kwangaphambi kwesikhathi nokwelashwa kuphumelela kakhulu. Nakuba umqondo womgxuma ungase ube nzima, abantu abaningi abanomgxuma wokwephukutheleni bayaqhubeka bephila impilo egcwele, enempilo ngemuva kokwelashwa.

Qaphela umzimba wakho futhi ungawadeli izimpawu eziqhubekayo, ikakhulukazi igazi emchameni noma ubuhlungu emuva obungachazeki. Lezi zimpawu zinezizathu eziningi ezingaba khona, kodwa zihlale zidinga ukuhlolwa kwezokwelapha ukuze kuvinjwe izimo ezinzima.

Khumbula ukuthi unokulawula okuningi ngengozi yakho yomgxuma wokwephukutheleni kunalokho ongakucinga. Izinqubo ezilula zendlela yokuphila njengokungabhemi, ukugcina isisindo esinempilo, nokulawula ukucindezeleka kwegazi kunganciphisa kakhulu amathuba akho okuthola le gciwane.

Uma uthola ukuxilongwa komgxuma wokwephukutheleni, yazi ukuthi izindlela zokwelapha ziye zaphucuka kakhulu eminyakeni yamuva. Sebenza eduze neqembu lakho lezokwelapha, buza imibuzo, futhi unganqikazi ukufuna imibono yesibili ngezinqumo ezinkulu zokwelapha. Awuwedwa kule ndlela.

Imibuzo evamile ebuzwayo ngomgxuma wokwephukutheleni

Ungaphila impilo evamile ngekhukhulu elilodwa?

Yebo, ungaphila impilo evamile ngokuphelele ngekhukhulu elilodwa eliphilisayo. Ikhukhulu lakho elisele lizokhula libe likhulu futhi lisebenze nzima ukuhlanganisa leli lingasekho, ngokuvamile lilawula yonke imisebenzi yokuhlanza umzimba wakho edingekayo. Abantu abaningi abaziboni ngisho nokuhluka ekuzizweni kwabo nsuku zonke ngemuva kokuhlinzwa kokususwa kwekhukhulu.

Ingabe umgxuma wokwephukutheleni ngokuvamile ubulawa?

Umgxuma wokwephukutheleni ngokuvamile awubuli mali, ikakhulukazi uma utholakala ngokushesha. Izinga lokuphila iminyaka emihlanu lomgxuma wokwephukutheleni ongaphulanga ngaphandle kwekhukhulu lingaphezu kuka-90%. Ngisho noma umgxuma usabalale ezindaweni eziseduze, abantu abaningi baphila iminyaka eminingi ngempilo enhle ngokwelashwa kwamanje.

Ubuhlungu bomgxuma wokwephukutheleni buzwakala kanjani?

Ubuhlungu bomgxuma wokwephukutheleni ngokuvamile buzwakala njengokuhlungu okuthambile noma ukungakhululeki okuqhubekayo ohlangothini, emuva, noma endaweni yeflank. Ngokungafani nobuhlungu bamasikazi obuza nokuphela, lobu buhlungu buhlala bukhona futhi abuphuli ngokushintsha isikhundla noma ukuphumula. Abanye abantu bayichaza njengomuzwa ojulile, ohlala ukhula kunokuba ubuhlungu obukhulu noma obukhulu.

Umgxuma wokwephukutheleni usabalala ngokushesha kangakanani?

Izinga lokukhula komgxuma wokwephukutheleni liyahlukahluka kakhulu kuye ngohlobo nezinto zomuntu siqu. Eminye imingxuma yokwephukutheleni ikhula kancane kakhulu eminyakeni eminingi, kanti amanye angasabalala ngokushesha ezinyangeni ezimbalwa. Iningi le-renal cell carcinomas likhula ngesivinini esilinganiselayo, kungakho ukuqapha okuqhubekayo nokwelashwa ngesikhathi esifanele kuwumsebenzi.

Umgxuma wokwephukutheleni ungabuya yini ngemuva kokwelashwa?

Umgxuma wokwephukutheleni ungabuya ngemuva kokwelashwa, kungakho ukuvakasha okuqhubekayo kokulandelela kubalulekile. Noma kunjalo, amazinga okuphinda avele aphansi ngezindlela ezithuthukisiwe zokuthunga nokwelashwa okungcono. Iningi lokuphinda kuvela eminyakeni embalwa yokuqala ngemuva kokwelashwa, futhi amaningi angaphathwa ngempumelelo futhi uma etholakala ngokushesha ngokuqapha.