Njira Zomwe Zingateteze Khansa ya Amuna ndi Lynch Syndrome
Kodi mungatani kuti muteteze khansa mu ziwalo zachikazi (khansa za amayi) ngati muli ndi matenda a Lynch?
Ngakhale mwatsoka tilibe njira zoteteza khansara kwa anthu omwe ali ndi Lynch Syndrome-kapena popanda Lynch syndrome pankhaniyi-tikudziwa zina zomwe mungathe kuchita zomwe zingachepetse chiopsezo chanu chokhala ndi khansa ya mazira ndi chiberekero .
Timadziwanso njira zowunikira khansa yazimayi, ndipo pochita zimenezi, chiyembekezo chopeza khansa m'mayendedwe akale kwambiri.
Mwachidule
Matenda a Lynch amadziwikanso ngati nthenda yopanda matenda ya nonpolyposis yoipa ya khansa (HNPCC) . Ndilo choloŵa choloŵa chobadwa chomwe zimakhala zovuta mu majini zomwe zingaperekedwe kuchokera ku mibadwomibadwo.
Matendawa akugwirizana ndi kusintha kwa majini anayi: MLH1, MSH2, MSH6, ndi PMS2. Zosintha za majinizi zimachokera ku maonekedwe a autosomal, kutanthauza kuti mumangofunikira kulandira geni ya mutated kuchokera kwa kholo lanu kuti mukumane ndi chiopsezo chachikulu cha matenda. Matenda a Lynch amachititsa kuti awiri kapena asanu peresenti ya khansa ya coloni, ndipo pafupifupi zaka zakubadwa za khansa ya coloni ndi 45 mwa munthu amene ali ndi matenda a Lynch.
Ngozi za Khansa
Zowopsa za khansa kwa anthu omwe ali ndi matenda a Lynch ndi awa:
- Khansara ya Colon - 80 peresenti
- Khansara ya m'mimba - 11 mpaka 18 peresenti
- Chiwindi ndi khansa ya khansa ya khansa - 2 mpaka 7 peresenti
- Khansayo ndi khansara ya impso - 4.5 mpaka 5 peresenti
- Khansara ya m'mimba - 1 mpaka 4 peresenti
- Khansara ya ubongo - 1 - 3 peresenti
Ngozi ya khansa yaikazi yaikazi ikuphatikizapo:
- Khansara ya chiberekero - amayi 20 mpaka 60%
- Khansara ya ovarian - azimayi 9 mpaka 12%
Matendawa amachititsa anthu ku khansa zina, monga khansa ya m'mawere .
Kuchepetsa Ngozi ya Khansa
Poyankhula za kuchepetsa chiopsezo, nkofunika kuti muyambe kusiyanitsa. Mayesero ambiri owonetsetsa omwe mudzamva nawo ndi mawonekedwe oyambirira. Mayeserowa samapewa khansa, kapena kuchepetsa chiopsezo choti mudzakhala ndi khansa. M'malo mwake, amachulukitsa mwayi kuti khansa idzadziwika ngati yaying'ono. Ndipo khansa zambiri zimachiritsidwa, ndipo mwina zimachiritsidwa, zikadali zochepa.
Mosiyana, pali zinthu zomwe anthu angathe kuchita kuti achepetse chiopsezo chokhala ndi khansa. Kudya zakudya zowonongeka komanso kuchita masewera olimbitsa thupi kumakhala gawo ili. Kuyezetsa khansa ya Colon , komabe, ndi yosiyana kwambiri ndi mayeso oyeza khansa. Amapereka mwayi wopezera khansa kumayambiriro koyambirira-koma angathandizenso kupewa, pamene zotupa zowoneka bwino , zimachotsedwa, zisanakhale khansa.
Njira Zopewera Khansa Zambiri
Ndikofunika kuzindikira kuti amayi omwe ali ndi matenda a Lynch, kuphatikizapo njira zina zomwe zidzakambidwe, ayenera kuyesedwa mayeso omwe amayi opanda matenda a Lynch amalandira. Ndipotu izi ndi zofunika kukumbukira, popeza ndikofunikira kusamalira zaumoyo zomwe zingachitike ngati mulibe matenda a Lynch.
Mwachitsanzo, amayi omwe ali ndi khansa ya m'mawere nthawi zina amakhala otetezeka kwambiri pa matenda a khansa ya m'mawere kuti amaiwala kutsatira njira yowonetsera kansa ya kanseri pamene ikuwoneka "yosafunikira."
Kuyika izi m'maganizo ndikofunika kuti amayi omwe ali ndi matenda a Lynch akambirane ndi dokotala wawo za mavuto azachipatala osagwirizana ndi matenda a Lynch. Mwachitsanzo, ndi kofunika kulankhula za kupewa matenda a mtima ngakhale kuti matendawa sali ndi vuto la matenda a mtima, chifukwa aliyense ali pangozi.
Zowonjezera Zowonjezera kwa Akazi omwe ali ndi Lynch Syndrome
Kuti muwone njira zomwe zingatengedwe pofuna kuchepetsa mwayi wokhudzidwa ndi kuwonjezeka kwa chibadwa cha matenda a Lynch syndrome, ofufuza ayang'ana momwe angapindule ndi mayesero angapo owonetsera.
Kuchepetsa Vuto la Ovarian ndi Uterine Khansa
Pali njira zosiyanasiyana zochepetsera chiopsezo chofa chifukwa cha ovari kapena khansa ya uterine kwa amayi omwe ali ndi matenda a Lynch.
Mu kafukufuku wa 2006 wofalitsidwa mu New England Journal of Medicine , ofufuza anapeza prophylactic hysterectomy ndi salpingo-oophorectomy yapakati ndi njira yothandiza yoteteza matenda a endometrial (uterine) ndi khansa ya ovari m'mayi omwe ali ndi matenda a Lynch. Kafukufuku wa 2011 wokhudzana ndi kufufuza mtengo kwa njira zosiyana siyana, kuchitidwa opaleshoni yochepetsera chiopsezo kukhala njira yopindulitsa kwambiri.
Popeza kukhala wotsogolera wanu ndikofunika kwambiri kuti athe kupeza chithandizo chabwino koposa, zingakhale zothandiza kudziŵa kuti zina mwazinthuzi zikuchokera. Ndiye, ndipo poyerekeza zosankha zosiyana ndi zofuna zanu, mukhoza kupanga chisankho chomwe chili chabwino kwa inu nokha.
Ochita kafukufuku ayang'ana njira zosiyanasiyana zochepetsera chiopsezo chofa ndi khansa. Zinthu zina zomwe zayesedwa zikuphatikizapo:
- Kuyezetsa magazi kwa chaka ndi chaka
- Kuwonetsa pachaka pogwiritsa ntchito biopsy , transvaginal ultrasonography, ndi serum CA 125
- Kutsegula kwa chiberekero, mazira ndi mazira omwe ali ndi zaka 30 (kapena osachepera zaka 35)
Ofufuzawo anaganiza kuti njira yowopsya kwambiri (opaleshoni) inachititsa kuti vuto la khansa laling'ono kwambiri komanso njira yosakondera (mayesero apachaka) apangitse ngozi yaikulu ya khansa. Izi zinkakhala zoona kwa onse ovari ndi odwala khansa. Koma, moyo wonse sunasinthe kwambiri. Kawirikawiri, amayi omwe anali ndi chiberekero, mazira ndi mazira omwe amachotsedwa ali ndi zaka 30 anakhala zaka zitatu kuposa omwe anali ndi mayeso a pachaka a gynecologic.
Kwenikweni, khansara ya ovariya inkachitika pa asanu ndi atatu mwa amayi omwe adayesedwa chaka ndi chaka, anayi omwe anayesedwa chaka ndi chaka, ndipo osachepera 1/10 mwa amayi omwe anachitidwa opaleshoni. Khansa ya chiberekero inapezeka mu 49 peresenti ya amayi amene adayesedwa chaka ndi chaka, 18 peresenti omwe ankawonetsa chaka ndi chaka, ndipo osachepera 1/10 pa 100 alionse omwe anachitidwa opaleshoni. Ngakhale zikuwoneka kuti sizingasinthe, ndi kotheka kuti amayi adziwe khansa ya ovari kapena chiberekero pamene ziwalozo zachotsedwa. Chitsanzo ndi peritoneal carcinoma.
Azimayi omwe anali ndi mayesero apachaka amakhala pafupifupi 77, omwe ankawonetsa pachaka amakhala pafupifupi 79, ndipo omwe anachitidwa opaleshoni anakhalapo pafupifupi 80.
Kuchepetsa Ngozi Zina za Khansa
Pali zambiri zomwe zimawonetsa anthu omwe ali ndi matenda a Lynch kuti azindikire kaye kanseri. Mwachitsanzo, chaka chilichonse kapena biyearly colonoscopies akulimbikitsidwa kuyambira ali ndi zaka 20 mpaka 25 kapena zaka zisanu zosakwana zaka zomwe wachibale wake amakula. Lankhulani ndi dokotala wanu za mayesero owonetsetsawa kuti mudziwe zomwe ziri zoyenera kwa inu.
Zotsatira:
American Society of Clinical Oncology. Khansa.Net Lynch Syndrome. 12/2004. http://www.cancer.net/cancer-types/lynch-syndrome
Bonis, P., Ahnen, D., ndi L. Axell. Lynch syndrome (khansara yosabadwa ya nonpolyposis yosalala): Kuwunika ndi kuyang'anira. Kupititsa patsogolo . Kusinthidwa 05/12/16.
Chen, L., Yang, K., Little, S., Cheung, M., ndi A. Caughey. Kupewa Kanseri Kwambiri pa Lynch Syndrome / Hereditary Nonpolyposis Mayi Odwala Khansa Yoyamba. Matenda a m'mimba komanso ma Gynecology . 2007. 110 (1): 18-25.
Schmeier, K., Lynch, J., Chen, L. et al. Kuchita Opaleshoni Kuletsa Kuopsa kwa Khansa ya Gynecologic mu Lynch Syndrome. New England Journal of Medicine . 2006. 354 (3): 261-9.
Vasen, H., Ignacio, B., Aktan-Collan, K. et al. Ndondomeko zowonongeka za kayendedwe kachipatala ka Lynch syndrome (HNPCC): zokambirana ndi gulu la akatswiri a ku Ulaya. Kutha . 2013. 62 (6): 812-23.
Yang, K., Caughey, A., Little, S., Cheung, M., ndi L. Chen. Kufufuza Kwambiri Momwe Mungagwiritsire Ntchito Kuchita Opaleshoni Yopanga Mavitamini Kulimbana ndi Kuwonetseredwa kwa Amayi kwa Akazi Ochokera ku Mayi Ochokera Kumalo Osungulumwa Osakhala a Polyposis Colorectal Cancer (HNPCC). Khansa Yodziwika bwino . 2011. 10 (3): 535-43.