Pamene prostate-specific antigen (PSA) ya magazi inavomerezedwa mu 1994 ngati chida choyang'anira kuti adziwe kansa ya prostate, adatamandidwa ngati chipatala chomwe chingapulumutse miyoyo yambiri.
Pambuyo pake, kusowa kwa njira yodziŵika kwabwino kunatanthauza kuti kansa ya prostate nthawi zambiri sinapezeke mpaka itafalikira ku ziwalo zina za thupi, kuwonjezeka kwambiri kuti zikanakhala zakupha.
Chaka chilichonse chiyambireni kuyesedwa kwa PSA, mlingo wa khansa ya prostate yafa, ndipo matenda a khansa ya prostate yapamwamba pa nthawi ya matendawa agwa ndi 75 peresenti.
Kusokonezeka ndi Kutsutsana
Zikumveka ngati nkhani yopambana, chabwino?
Koma patangopita kanthawi kochepa, kuyesa kwa PSA ndikumayambitsa chisokonezo komanso kutsutsana. Zapindula kwambiri ndi kafukufuku wa zachipatala omwe amalimbikitsa kuti asagwiritsidwe ntchito, ndipo zikuwoneka kuti sakugwirizana ndi madokotala ambiri ndi odwala.
Izi zakhala zikuchitika chifukwa chakuti PSA imapeza khansa yapamwamba kwambiri yomwe siikonzedwe kukhala yovulaza, kuwonetsa mosavuta amuna ambiri ku nkhaŵa, mtengo, ndi mavuto omwe angapangidwe ndi khansa.
Tinafika bwanji kuno, ndipo ndi mbali yanji yomwe PSA imakhala nayo poyezetsa kansa ya prostate? Kodi mayesowa ndi ofunika?
Ntchito Yabwino
Yankho lalifupi la funso lomaliza ndilo inde.
Mayeso a PSA angapereke chidziwitso chofunikira pamene agwiritsidwa ntchito bwino.
Ngakhale ine ndi ena orojekiti tikugawana zakuda nkhawa za kugonjetsa khansa yosadzipha, ambirife tikuganiza kuti kutsutsidwa kwa PSA kuyesedwa.
Pogwiritsidwa ntchito mwanjira yowonongeka, mayesero akadali ofunika. Kuti timvetse zomwe ndikutanthauza, tiyeni tibwerere pang'ono ndikuyang'anenso chomwe chimayambitsa mikhalidwe yathu.
Khansa Zachiwawa
Choyamba, ndikofunika kudziwa kuti sikuti khansa yonse ya khansa ya prostate ndi yofanana.
Matenda ambiri amakula pang'onopang'ono kapena ayi, ndipo amachititsa kuti zizindikiro zazing'ono kapena zochepa zikhale zochepa. Mitundu iyi imatchedwa indolent.
Popeza khansara ya prostate imapezeka makamaka kwa amuna achikulire-omwe amakhala ndi zaka zambiri pa matendawa ndi 66-ndipo popeza chithandizo ndi opaleshoni ndi zowonongeka zingakhale ndi zotsatira zosafunikira, monga kuperewera kapena kusalakwitsa, chinthu choyenera kuchita pa zochitika zochepazi khalani maso pa zinthu. Mawu azachipatala chifukwa cha izi ndikuthamangitsidwa, zomwe zikutanthauza kufufuza nthawi ndi kafukufuku wa kukalipa kwa khansa.
Pafupifupi 100 peresenti ya odwala omwe khansa yawo sinafalikira kunja kwa prostate amakhala zaka zosachepera zisanu ataphunzira. Ikani njira ina, nthawi yomwe ingatengere kuti chifuwa cha prostate chimapitirire ndikupweteka kwa odwalawa ngati nthawi zambiri imakhala yaitali kwa nthawi yaitali kuposa nthawi yomwe yatsalayo.
Khansa Zachiwawa
Koma khansa ina ya prostate imakhala yamwano, ikukula mofulumira, ndipo imatha kufa. Amafuna chithandizo cha panthaŵi yake . Zakale zimapezeka, zimakhala zovuta kwambiri.
Odwala omwe kansalu akadakali ndi prostate yawo ndi minofu yapafupi pamene atapezeka kuti ali ndi moyo zaka zisanu.
Koma omwe khansara ya prostate yafalikira kumalo akutali, mafupa, kapena ziwalo zina zimakhala zosokoneza 29 peresenti ya zaka zisanu zomwe zikupitirirabe.
Kotero inu mukhoza kuwona chifukwa chomwe kuyang'ana koyambirira kuli kofunikira. Koma ndi theka la nkhondo. Kukhoza kufotokozera za khansa ya prostate ya wodwalayo-kudziwa ngati ikukula pang'onopang'ono, palibe-chochita-chofunika chokoma, mtundu wowawa, wowonjezereka, kapena chinachake pakati-ndichinso chofunikira.
Kupititsa Kuyesedwa kwa Mng'oma
Kwa zaka zambiri za m'ma 2000, katswiri wa kansalu woyerekeza kansalu yokhayo anali ndi mankhwala omwe ankawombera, omwe ankawombera mphira, kapena kuti DRE.
Kuyesa chiwalo cha zizindikiro za kukulitsa kapena kuphulika kunapereka chitsimikizo ngati chotupa chinalipo. Koma sizinali zotsimikizika, ndithudi sizinali zomasuka, ndipo sizikanakhoza kupereka chidziwitso chilichonse chokhudza khansa. Zida zopangira opaleshoni ndi mayesero ena otsatiridwa anagwiritsidwa ntchito pazomwezo.
Monga momwe mungaganizire, panthawi imene chotupa cha prostate chinali chachikulu kwambiri kuti chidziwike, mwina chinali chonchi, zomwe zikutanthauza kuti sizinachiritsidwe. DRE sinali njira yoyenera yodziwira oyambirira.
Kenaka potsatira panafika mayeso a PSA. Amadziŵa kuchuluka kwa mapuloteni otchedwa prostate-specific antigen omwe amapangidwa ndi maselo a prostate gland ndipo amazungulira m'magazi.
PSA mlingo kawirikawiri imakwera ndi amuna omwe ali ndi kansa ya prostate. Kuphatikizidwa kwa mayeso a DRE ndi PSA kumapangitsa kuti tikhale ndi mphamvu zogwira ziphuphu za prostate msanga.
Zosokoneza PSA Zimaphatikizapo Kugonjetsa Kwambiri
Koma mayeso a PSA ali ndi ziŵerengero zingapo, nayonso.
Choyamba, zinthu zina kuphatikizapo khansa ya prostate zingayambitse ma PSA-osakhala ndi khansa monga kutupa kwa prostate kapena kukulitsa kumene kumachitika ndi ukalamba, mwachitsanzo. Chachiwiri, palibe PSA yomwe imadziwika bwino. Amuna ambiri omwe ali ndi zotsatira zapamwamba za PSA alibe kwenikweni kansa ya prostate, pamene ena omwe ali ndi zochepa zotere amachita. Chachitatu, mayesero a "chinyengo" ndi apamwamba, omwe amawadetsa nkhaŵa mopanda pake kwa odwala omwe alibe kwenikweni khansa. Ndipo potsiriza, mayeso a PSA sangathe kusiyanitsa pakati pa khansa yochepa yomwe ikusowa yopanda chithandizo ndi nkhanza zomwe zimachita.
Kufala kwa chiwerengero cha PSA kuyambira kumayambiriro kwa zaka za m'ma 1990 kunatanthawuza kuti zizindikiro zambiri za khansa ya prostate zidazindikiridwa kumayambiriro, zisanakhale zizindikiro zonse-chinthu chabwino kwa iwo omwe amafunikira chithandizo chamankhwala, koma osati kwa iwo omwe sanatero.
Matenda a khansa ya prostate yawonjezeka, koma momwemonso chiwerengero cha amuna omwe anali ndi ziwalo zopanda chilema zomwe sizinali zofunikira kwambiri, adachitidwa opaleshoni yawo, anapirira ma ARV, ndipo adamva zowawa za njirazi.
Maphunziro awiri akuluakulu amayerekezera kuchuluka kwa khansa ya prostate "kupitirira matenda opatsirana" (kutulukira kwa chotupa chopanda moyo) chifukwa cha zotsatira za mayeso a PSA pakati pa 17 ndi 50 peresenti.
Ndipo ochita kafukufuku sanapeze umboni wowoneka kuti kuwonedwa kwa PSA kawirikawiri kunayambitsa mwachindunji kuchepa kwa khansa zakufa. (Kutaya kwa khansa ya khansa ya prostate yomwe ndinayimilira m'ndime yachiŵiri ya mutu uno ikhoza kukhala chifukwa cha zifukwa zina, kuphatikizapo mankhwala ochiritsira .)
Magulu Omwe Sagwirizane Pazoyesedwa
Kotero madokotala ndi odwala omwe anatsalira kuti azilimbana nawo anali mayeso omwe anali ngati thumba losakanikirana: Anapeza khansa zambiri zam'mbuyo, kaya akufunikira chithandizo kapena ayi, ndipo sizinkawoneka ngati akupanga mankhwala ambiri palinso chiwerengero cha kufa kwa khansa ya prostate.
Pofika chaka cha 2008, bungwe la US Preventive Services Task Force, omwe ali ndi akatswiri odziwika bwino pa chisamaliro chapadera ndi mankhwala opatsirana (koma osati urology kapena khansara), analimbikitsa kuti amuna 75 kapena kuposera asamayang'ane PSA. Mu 2012, gululi linakulitsa uphungu wawo pa PSA kuyesa kuphatikiza amuna a mibadwo yonse, kunena kuti kuwonongeka kwa mayeso kunapindulitsa kwambiri.
Magulu angapo a zamankhwala sanatsutse, akutsutsa kuti odwala omwe ali ndi khansa ya prostate yowonongeka komanso omwe ali ndi chiopsezo chachikulu (monga amuna a ku Africa komanso omwe ali ndi mbiri ya khansa ya prostate) adzapindula ndi kuyesedwa kwa PSA. Iwo adachenjeza kuti kuchepa kwa kuyesa kungayambitse kubwerera masiku omwe khansara ya prostate sinazindikiridwe mpaka nthawi yayitali, yosachiritsika.
Popanda kutsatiridwa, madokotala ndi odwala anagwidwa pakati. Nthawi zambiri madokotala amasiya chisankho kwa odwala awo. Kuyeza kwa PSA kunagwa, ndipo momwemonso anapeza matenda oyambitsa matenda a prostate (ndipo mosakwanira).
Chodabwitsa n'chakuti, kafukufuku waposachedwapa ananena kuti chiwerengero cha matenda opatsirana khansa yapamwamba ya prostate yakula kwambiri kuyambira 2007. Ngakhale kuti pakhala pali kutsutsa njira za phunziroli, sizowona kuti kuchepetsa kansa ya prostate kumatanthawuza milandu yambiri ya Mankhwala oyenera komanso ochiritsidwa sangagwidwe mpaka atafalikira.
Njira Yogwirizana ndi Kuyesedwa kwa PSA
Kotero mu malo osokoneza awa, kodi wodwalayo ayenera kuchita chiyani? Mwamunthu, wina angapange mayeso oyenerera owonetsetsa-omwe samangoganizira kokha kansa ya prostate koma akhoza kulongosola molondola njira yake, kufotokozera kaya ndi njira yotani.
Mwamwayi, pali kuyesedwa koyesera bwino muipi, komanso zochitika zina zomwe ziyenera kuthandizira kukonza molondola.
Pakalipano, apa pali njira yowunika kwa PSA Ndikulangiza ndikugwiritsa ntchito ndi odwala anga:
- Pezani "PSA" yoyamba pazaka 50. Dokotala wanu akhoza kuitanitsa mayeso ndikukambirana zotsatirazi ndi inu. Ngati zotsatira za mayeso, kuphatikizapo mbiri yanu ya zachipatala ndi mauthenga ena a chithandizo cha kuchipatala amasonyeza kuti pangakhale chiopsezo chachikulu chokhazikitsa kansa ya prostate, kuyesedwa kwa PSA kuyenela kubwerezedwa pakatha zaka zisanu.
- Ngati mayeso anu oyambirira a PSA ndi chithandizo chamankhwala ali ndi zaka 50 akuwonetsa chiopsezo chokwanira cha khansa ya prostate koma mulibe zizindikiro, muyenera kuyesedwa chaka chilichonse pogwiritsa ntchito mayesero a magazi omwe ndatchula kale (mayesero a 4Kscore kapena Prostate Health Index) ), ndipo mwinamwake kuyesa kwa MRI kwa prostate. Lankhulani ndi dokotala wanu zazomwe mungasankhe. Malingana ndi zotsatira zotsatira zotsatira za mayeserowa, inu ndi dokotala wanu mungasankhe pamodzi njira zina, ngati zilipo, zofunikira.
- Ngati pakadutsa zaka 60 PSA yanu ili pansi pa nanogram 2 pa mililita, mwayi wanu wokhala ndi khansa yaukali ya prostate m'zaka zapakati pa moyo ndi wochepa kwambiri-1 kapena 2 peresenti. Panthawi imeneyo, ndi bwino kubwereza mayeso a PSA mocheperapo kuposa zaka zisanu kapena kusiya kuyesedwa palimodzi.
Ndi njira yowonongeka imeneyi, tikhozabe kutenga khansa yapamwamba yomwe imafuna chithandizo komanso kuchepetsa mwayi wopezera zochepa zomwe zimakhala zovulaza koma zingayambitse nkhawa ndi mankhwala osayenera.
Dr. Klein ndi Pulezidenti wa Glickman Urological & Impney Institute, Cleveland Clinic, mtundu wa 2 wa urology pulogalamu yomwe ikuyikidwa ndi US News & World Report.
> Zotsatira:
> Barocas DA, Mallin K, Graves AJ, et al. Zotsatira za USPSTF DB D Recommendation against Screening kwa Khansa ya Prostate pa Kupezeka kwa Khansa ya Prostate Cancer ku United States. J Urol . 2015 Dec; 194 (6): 1587-93.
> Barry MJ, Nelson JB. Maganizo Otsutsana: Odwala Amakhala ndi Khansara Yowonjezera Kwambiri Yopuma kuyambira ku USPSTF Screening Recommendations. J Urol . 2015 Dec; 194 (6): 1534-6.
> Catalona WJ, D'Amico AV, Fitzgibons WF, et al. Zomwe bungwe la US Services Preventive Service linasowa mu ndondomeko yake yowunikira kansa ya prostate. Ann Intern Med . 2012 Jul 17; 157 (2): 137-8.
> Moyer VA, LeFevre ML, Siu AL, et al. Kuyeza kansa ya prostate: Mawu a US Prevention Services Task Force. Ann Intern Med . 2012 Jul 17; 157 (2): 120-34.
> Kuonerera, Epidemiology, ndi End Results (SEER) Mapulogalamu Ambiri Mapepala: Khansara ya Prostate. National Cancer Institute. Zapezeka pa http://seer.cancer.gov/statfacts/html/prost.html