Kusuta ndi Kumwa Kowonjezera Kuwonjezera Kowopsa kwa Khansa Yam'malamulo
Mwachidule
Ku United States ndi kuzungulira dziko lapansi, kuchuluka kwa khansa ya m'kamwa, kapena khansara yomwe imakhudza milomo, m'kamwa, ndi mmero, ndi mbali yaikulu chifukwa anthu ambiri amamwa ndi kusuta. Izi zowonjezera chiopsezo, zakumwa ndi kusuta, zimapangitsa kuti pakhale chiopsezo chachikulu chokhala ndi khansa ya m'kamwa - komatu kuposa chiopsezo chomwe chimapangitsa aliyense payekha.
Njira yodziwika kwambiri yothetsera khansa ya m'kamwa ndi kupewa kumwa ndi kusuta; Komabe, tonse tikudziwa kuti kuthawa n'kovuta kwa anthu ambiri omwe amadalira mankhwala osokoneza bongo komanso mowa kapena mankhwala osokoneza bongo komanso mowa.
Ziwerengero
Pafupifupi 85 peresenti ya khansa ya mutu ndi khosi ndi khansa yapakamwa. (Khansa ya mutu ndi khosi ndi yosiyana ndi khansa ya ubongo.) Kuwonjezera apo, ku United States, 3 peresenti ya khansa yowonongeka ya amuna ndi 2 peresenti ya khansa yowopsya ya amayi ndi khansa yapakamwa.
Khansara yam'mimba imakhudza amuna ambiri kusiyana ndi amayi, ndipo amuna a ku America ndi Amamerika ndi ochuluka kusiyana ndi amuna oyera kuti ayambe khansa ya m'kamwa. Pomaliza, khansa ya m'kamwa imapezeka kwambiri kwa anthu a zaka 40 kapena kuposerapo.
Kum'mwera cha Kum'mawa kwa Asia, 40% ya khansa yonse ndi khansa ya m'kamwa. M'mayiko otukuka, kuchuluka kwa khansa yomwe ndi khansa ya m'kamwa imayenda pafupifupi 4 peresenti.
Mpata kuti munthu aliyense akhale ndi kansa ya pakamwa pa nthawi yake yonse ndi pafupifupi 1.1 peresenti.
Chaka chilichonse, khansara ya m'kamwa imapha anthu pafupifupi 8,000 ku United States. Komanso, anthu pafupifupi 42,000 ku United States amapezeka ndi khansa imeneyi chaka chilichonse.
Mu 2012, anthu pafupifupi 300,000 kudutsa ku United States anali ndi khansa ya m'kamwa. Pofuna kuona nambalayi, anthu a Cincinnati ali pafupifupi 300,000.
Ngakhale kuti apititsa patsogolo njira zochizira ndi opaleshoni, chiŵerengero cha anthu omwe ali ndi moyo zaka zisanu pambuyo poti matenda a khansa ya m'kamwa, kapena zaka zisanu zapakati pa moyo wawo, akhala akufanana kwa zaka makumi anai: pakati pa 50 ndi 55 peresenti.
M'mawu ena, pafupifupi theka la anthu omwe amapezeka lero ndi khansa ya m'kamwa adzafa m'zaka zisanu zotsatira. Mtengo wotetezekawu umapezeka chifukwa ngakhale kuti timatha kutenga khansa ya m'kamwa msanga, anthu omwe ali ndi matendawa amapita kuchipatala mtsogolo, ali ndi matenda oopsa komanso oopsa kwambiri.
Matenda a khansa ya m'mimba
Mankhwala ambiri ammimba amakhudza magawo awiri a magawo atatu a lilime. Makamaka, khansa imeneyi imakula kuchokera pansi (pansi) ndi (potsatira) mbali ya lilime. Mbali yapamwamba (yosokoneza) ya lilime lanu ndi yovuta ndi masamba a kukoma. Mbali ya pansi pa lilime lanu ndi yosalala.
Kawirikawiri, khansara ya m'kamwa imakhudza kapena milomo kapena ziwalo za pamlomo kuphatikizapo zotsatirazi:
- mkati mwa masaya (buccal mucosa)
- Denga la pakamwa (cholimba)
- malo ochepa omwe ali kumbuyo kwa nzeru za mano (retromolar trigone)
- mphutsi (gingiva)
Nthawi zina khansa yam'mimba ikhoza kukula kuchokera kumbuyo kwa mmero kapena pharynx . Makamaka, khansa ikhoza kukula kuchokera ku oropharyx ndi hypopharynx .
Mbalameyi ili ndi izi:
- palati yofewa
- mbali ndi kumbuyo makoma a mmero
- kumbuyo gawo limodzi mwa magawo atatu a lilime
- toni
Mankhwalawa ndi mbali ya pansi pammero. Mphunoyi ndi thumba lautali la masentimita asanu lomwe limagwirizanitsa malo enieni pakati pa mphuno ndi khomo la mphuno ndi larynx (windpipe). Chakudya ndi mpweya zimadutsa mumatenda opita kumimba ndi m'mapapo, motero.
Malo a chotupa chakupha (khansa) m'kamwa kapena m'kati mwake ndi kofunika chifukwa malo akhoza kukhudza khalidwe la matenda (matenda) ndi mankhwala.
Pamapeto pake, khansa ya m'kamwa ingakhudze mbali iliyonse ya pakamwa, m'kamwa ndi pamphuno.
Kodi khansa yam'thupi imapangidwa bwanji?
Mankhwala ambiri ammimba ndi odwala khansa yapaderous . Maselo a squamous ndi maselo ofooka, omwe amatha kuika pakamwa pakhomo.
Maselo a squamous amayamba kupanga pambuyo kusintha kumatha pamtundu wa maselo. Maselo oundana atasokonezeka pa maselo a maselo, maonekedwe a maselowa amasintha. Pamene maselo ambiri amasintha maonekedwe, khansara ya m'kamwa imawonekeratu, kapena matenda amayamba kuonekera.
Mankhwala osokoneza bongo amphongo ndi osowa ndipo amatha kuphatikizapo zotupa zamatumbo, ma sarcoma, ndi melanoma.
Zowopsa
Zinthu zoopsa zimatchulidwa ngati khalidwe lililonse kapena kuwonetsetsa komwe kumapangitsa kuti chiopsezo cha matenda chikule.
Nazi zifukwa zina zoopsa za khansa ya m'kamwa:
- mowa
- fodya
- HPV16 (mtundu wa kachilombo ka mtundu wa papilloma 16 womwe umagwirizanitsidwa ndi kuchuluka kwa ma khansa a toni)
- chakudya chosowa zipatso ndi ndiwo zamasamba
- kuwonjezera dzuwa (kumawonjezera ngozi ya khansa ya pakamwa)
- kusamalidwa (kuchepa kwa chitetezo cha m'thupi)
- betel quid chewing (mankhwala osokoneza bongo omwe amapezeka ku Indian subcontinent omwe amamwa ngati fodya wachitsulo ndipo nthawi zambiri amasakaniza ndi fodya)
- kumwa mowa (chikho chakumwera cha ku South America chomwe chimakhala ndi cafine ndi caka ca yerba)
Zizindikiro
Nazi zizindikiro zina zotheka za khansa ya m'kamwa. (FYI: Chizindikiro ndi chowoneka chilichonse cha matenda, koma, chizindikiro ndi chinthu chimene wodwala amadandaula nazo ndipo motero amadzichepetsa.)
- zofiira zoyera mkati mwa kamwa (leukoplakia)
- kupweteka kumene sikuchoka
- nkhanambo (pamlomo) kapena chilonda chomwe sichichoka
- Mphuno mkati mwa pakamwa
- ululu pa kutafuna
- ululu pa kumeza
- zilonda zotupa (zam'mimba)
- kupweteka kwa nsagwada
- ululu wa lilime
- mano otayirira
- zolaula
Zizindikiro zapamwamba za khansa ya m'kamwa ndizo zotsatirazi:
- kulemera
- chifuwa cha magazi
- zovuta kudya (dysphagia)
- zosasangalatsa
- vuto lopuma
Kawirikawiri, anthu omwe ali ndi khansa ya m'kamwa amasonyeza zizindikiro zoyambirira za matendawa ku zifukwa zina. Chifukwa chake, anthuwa ali ndi khansa yachedwa mochedwa pamene matenda akuwopsa kwambiri. Kuonjezerapo, madokotala oyamwitsa osamalidwa (mankhwala achipatala kapena othandizira) nthawi zina amanyalanyaza kufunika kwa zizindikiro za matenda a kansa ya msana.
Mwatsoka, kusowa kozindikira koyambirira ndi chifukwa chachikulu cha khansa ya m'kamwa imapha pafupifupi theka la anthu omwe akulemetsa. Matenda omwe amagwidwa mofulumira ndi ochiritsira kwambiri.
Kudziwa
Ngati dokotala kapena dokotala amawona zilonda zokayikitsa, kapena pakamwa panu, kapena pakamwa panu mutatha kuchita mayeso, thupi lanu limapangidwa kuti mudziwe zomwe zilondazi zili. Ndi chiwopsezo, timapepala ting'onoting'ono timadulidwa kuchokera ku gwero ndi kufufuza pogwiritsa ntchito microscope mu labu.
Kuphatikiza pa chidziwitso, njira zina zogwiritsira ntchito zingagwiritsidwe ntchito kuthandiza kuthandizira khansa ya m'kamwa kapena kudziwa ngati zafalitsidwa. Mayesero awa ndi awa:
- MRI
- CT scan
- Kufufuza PET (zabwino pozindikira metastases kapena kufalikira)
- chifuwa ndi mano a x-rays
- endoscopy (chubu yothamanga ndi kamera ndi kuwala pamapeto kumaganiziridwa mkati mwa thupi lanu)
- Bamamu am'meza (m'mimba mwa ma x-rays a m'mimba ndi m'mimba)
Kusinthana
Gawolo , kapena kuuma, kwa khansara ya m'kamwa limayambira pazitsulo za TNM.
T mu TNM imatanthawuza kuti chifuwa chachikulu cha anatomic. Mwa kuyankhula kwina, T imatanthawuza momwe kukula kwa chifuwa chachikulu cha khansa ya m'kamwa kumakulira kumalo ozungulira.
Kenako N mu TNM amaimira mitsempha yambiri yomwe imafalitsidwa ndi khansa ya m'kamwa. (Mitsempha yotchedwa lymph nodes ikhoza kufalitsa chotupa chonse m'thupi mwa njira yamagulu.)
Pomalizira pake, M M TNM amaimira metastases kapena kukhalapo kwachilombo choyipa kwambiri m'maselo omwe amapezeka kutali kwambiri ndi malo oyambirira.
Pali magawo asanu akuluakulu a khansa ya m'kamwa: Gawo 0, I, II, III ndi IV. Zindikirani, Gawo lachinayi likugawanika kukhala magawo atatu-IVA, IVB ndi IVC-zomwe sitidzakambirana momveka bwino kuti zinthu zikhale zophweka.
Kusinthanitsa kungakhale kovuta. Komabe apa pali zidule mwachidule za khansa zam'mlomo zomwe zimagwera mu magawo asanu akuluakulu.
- Gawo 0 khansa ya m'kamwa imatanthauza carcinoma in situ , kapena khansara yomwe siinayambe kufalikira ndipo yakhala pomwepo pomwe idayambira. Gawo 0 khansa ndi yotheka kwambiri.
- Gawo I Khansara ya m'kamwa imatchula chotupa chimene sichinafalikire ku maselo am'mimba kapena malo otalikirana ndi malo omwe ali kutali kwambiri ndi kukula kwake pa masentimita awiri kapena kuposerapo.
- Gawo lachiwiri la khansa ya m'kamwa limatchula chotupa chimene sichinafalikire ndipo chiri pakati pa 2 ndi 4 masentimita pambali yake yaikulu.
- Gawo lachitatu Khansara ya m'kamwa ingatanthauzire kukula kwa chotupa chachikulu chomwe chimatha kapena sichimafalikira ku maselo am'mimba.
- Malinga ndi gawo laling'ono, khansa ya Stage IV ingatanthauzire kukula kwa chotupa chachikulu ndi minofu ndi ma metastases akutali.
Pofuna chithandizo choyenera, kuika chotupa pogwiritsa ntchito njira zozindikiritsira ndizofunikira. Kuphatikizanso kumagwiritsidwiritsidwanso ntchito kudzinenera, kapena maonekedwe, kwa omwe ali ndi khansa.
Chithandizo
Malingana ndi kukula, malo ndi malo, khansara ya m'kamwa ingachiritsidwe pogwiritsa ntchito opaleshoni, radiotherapy ndi chemotherapy.
Maphunziro a zachipatala omwe amachititsa odwala ali ndi khansa ya m'kamwa ndi akatswiri osiyanasiyana azaumoyo omwe amapereka chithandizo chamankhwala monga mazinyo, uphungu, kuthandiza anthu komanso kulandira uphungu.
Pamene chotupa chachikulu cha khansa ya m'kamwa chimayendetsedwa bwino, kapena chodziwika bwino, ndi kupezeka, katswiri wa ENT (katswiri wamphuno, mphuno ndi khosi kapena otolaryngologist) adzachichotsa opaleshoni.
Nthawi zina, zimakhala zovuta kuti mufike pachimake kapena chotupacho chafalikira, kapena chimachepetsa, ku maselo am'mimba ndi kupitirira. Zikatero, chemotherapy ndi radiotherapy zingagwiritsidwe ntchito. Kuwonjezera apo, mankhwala a chemotherapy ndi radiotherapy angagwiritsidwe ntchito monga mankhwala owonjezera, kapena othandizira, omwe amathandiza opaleshoni ndi kuchepetsa kufalikira kwa khansa.
Anthu amene amalandira chithandizo cha khansa ya m'kamwa ayenera kutsatira mwatsatanetsatane kufufuza mokwanira miyezi 6 iliyonse. Mpata kuti khansara ya m'kamwa idzabwerera pakati pa 3 peresenti ndi 7 peresenti pachaka.
Kuthamangitsani
Gawo I ndi Gawo lachiwiri la khansa la mankhwala likhoza kuchiritsidwa kwambiri ndi zaka zisanu zopitirira 90 peresenti. Mwachidule, chiŵerengero cha anthu omwe ali ndi moyo zaka zisanu pambuyo poyambitsidwa ndi Stage I ndi Stage II khansa ya pamlomo ndi yaikulu kuposa 90 peresenti.
Ndondomeko yachitatu ndi khansa ya m'kati mwa IV imakhala ndi zaka zisanu zochepa zomwe zimapulumuka: pakati pa 23 ndi 58 peresenti.
Pomaliza, ngati inu kapena wokondedwa wanu mukuganiza kuti khansa ya m'kamwa ndi chifukwa china chilichonse, nkofunika kuti mupange msonkhano wanu ndi dokotala mwamsanga. Chifukwa chakuti zizindikiro zoyambirira za khansa ya m'kamwa ndizosafunikira, muyenera kugawana nawo nkhawa zanu za khansa ya m'kamwa ndi dokotala wanu. Mukhozanso kupempha kuti mutumizedwe kwa katswiri, kapena ENT, kuti mupitirize kuwunika. Khansara yam'mimba ndi matenda aakulu omwe ayenera kuchiritsidwa msanga kuti apulumuke.
Zotsatira
Kim ES, Gunn G, William W, Jr., Kies MS. Mutu 16. Mutu ndi Khansa ya Khanda. Mu: HM Kantarjian, Wolff RA, Koller CA. eds. Buku la MD Anderson la Oncology Medical, 2e . New York, NY: Hill ya McGraw; 2011. Kufikira pa March 17, 2016.
Nkhani yotchedwa "TNM Staging Cancers ya Mutu ndi Nkhosa: Kuyesetsa Kugwirizana Pakati pa Zosiyanasiyana" ndi SG Patel ndi JP Shah yofalitsidwa ku CA: Cancer Journal for Clinicians mu 2005
Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. Chaputala 43. Oropharyngeal Cancer. Mu: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. eds. The Atlas of Family Medicine, 2e . New York, NY: Hill ya McGraw; 2013. Kufikira pa March 16, 2016.