Anthu ambiri omwe amakhala ndi khansa yosalala ndi osuta nthawi yaitali.
Asanayambe ndudu zopangidwa ndi misa m'zaka za zana la makumi awiri, khansara ya larynx, kapena khansara ya laryngeal, inali yosawerengeka kwambiri. Komabe, anthu a ku Ulaya ankasuta fodya kumayambiriro kwa zaka za m'ma khumi ndi zisanu ndi chimodzi mphambu khumi ndi zisanu ndi chimodzi, kuyambira pamene adayambitsidwa ku Ulaya ndi oyendayenda ochokera ku New World.
Choncho, pali china chokhudza ndudu zomwe zinapangitsa khansara yowonjezereka patapita zaka 1900, kapena anthu ambiri akusuta fodya pambuyo poyeretsa fodya.
(Kukula kwa misa kumapangitsa kuti mitengo ikhale yotchipa komanso yotsika mtengo kwa aliyense.) Zikuoneka kuti kuphatikizapo zinthu ziwirizi kwawonjezera kuchuluka kwa khansa yowopsa m'zaka 100 zapitazo.
Kodi Laryngeal Khansa N'chiyani?
Khansara ya Larynge ndi khansara yomwe imakhudza mau enieni amamanga (zingwe). Mawu enieni amamveka akugwedezeka kuti apange phokoso ndi kutithandiza kuti tiyankhule. Mosiyana ndi izi, mndandanda wonyenga umakhala pamwamba pa zenizeni zenizeni zenizeni ndipo sizimabweretsa mawu ambiri koma osaganizira (kuganiza kumtima). M'malomwake, mabodza omwe amamveka mwachinyengo ndi mapepala omwe amateteza zitsulo zenizeni.
Khansara ya Larynge ikhoza kumera mwachindunji kuchokera ku zingwe zenizeni zamagulu (zamakono), kapena pamwamba pawo (supraglot) kapena pansi pake (gawo lachigawo).
Matenda ambiri a khansa ndi khansa ya squamous.
Kodi Ndizifukwa Zotani Zopangira Khansa ya Laryngeal?
Kusuta ndi chinthu choopsa kwambiri chokhudzana ndi khansa yowononga.
Mwa kuyankhula kwina, anthu ambiri amene amakhala ndi khansa yowopsa ndi osuta nthawi yaitali.
Zina mwazifukwa zomwe zingayambitse khansa yapakhungu ndi izi:
- kugwiritsa ntchito mowa
- Matenda a HPV (okhala ndi zigawo 16 ndi 18 zoopsa kwambiri)
- poizoni wa asbesito
- mpweya woipa wa mpiru
- kale khosi lamoto
- zofooka za zakudya
Kusuta fodya ndi kumwa mowa mophatikizana kumagwirizanitsa chiopsezo chachikulu. Choncho, anthu omwe amamwa ndikumasuta kwambiri amakhala ndi kansalu yoopsa kwambiri.
Ngakhale akatswiri akuganiza kuti matenda a reflux a gastroesophageal (GERD) angakhalenso chiwopsezo cha khansa yowonongeka, palibe kufufuza mwachindunji komabe kumathandiza kugwirizana kumeneku. Komabe, anthu omwe athandizidwa kale ndi khansa yambiri ndipo amamwa mankhwala kuchiza GERD, Iike PPIs, sakhala ndi khansa yowonjezereka.
Malingana ndi American Cancer Society, mu 2016, padzakhala 13,543 matenda atsopano a khansa ya larynge yomwe imapezeka (amuna 10,550 ndi akazi 2880).
Zizindikiro za khansa ya Laryngeal
Khansara ya Larynge kawirikawiri yoyamba imasonyeza ngati mantha. Ngakhalenso kusintha kochepa kwambiri mu zingwe za mawu kungakhudze mawu. Zindikirani kuti, khansa yapamwamba komanso yonyansa ya khansa-kapena khansa yomwe ili pamwamba ndi pansi pa mawuwo imatuluka, motero-ili ngati hoarseness mochedwa chifukwa zimatengera nthawi kuti zotupa izi zikule mokwanira kuti zisawonongeke mpweya kupyolera muzowona. Choncho, anthu omwe ali ndi khansa yapamwamba komanso yowonongeka nthawi zambiri amapereka kwa dokotala yemwe ali ndi matenda apamwamba kwambiri.
Nazi zina mwazizindikiro za khansa ya larynge:
- dysphagia (vuto la kudya)
- ululu wa mmero
- kumva ululu
- kufuna
- Kulepheretsa pandege komanso kusamvana
- Amuna amodzi (pafupifupi amuna asanu amayamba khansa yambiri)
- okalamba (anthu a zaka za m'ma 60 ndi 70)
Kuzindikira kwa Laryngeal Cancer
Dokotala wina akamakayikira khansara yowopsa, amatha kupima mutu ndi khosi. Khansara ya Larynge imatha kuwonetsedwa muofesiyo pogwiritsira ntchito laryngoscopy (ganizani galasi kapena endoscope). Maphunziro ojambula ngati CT ndi x-rays ndi othandiza pamene akuwona kufalikira kwa khansara ku maselo ndi mapapo kapena pamene akufunafuna chitsime cha metastases.
Kuchiza ndi Kugonjetsa kwa Laryngeal Cancer
Pochita khansa yowopsa, akatswiri amatha kuyesetsa kuteteza mitsempha yambiri yamtundu ndi mawu kuti athe kusunga mawu komanso kuchepetsa kulemala. Khansa ya Laryngeal imachiritsidwa ndi opaleshoni ndi mazira. Kafukufuku wochokera ku Duke University akufotokoza kuti chemotherapy ndi yopindulitsa mukamachita khansa yapamwamba kwambiri.
Kansalu ya Laryngeal imatha kuchiritsidwa-makamaka ngati yawonedwa msanga komanso zaka zisanu zapulumuka. Poyamba (siteji I) khansara yamadzimadzi, anthu opitirira 95 peresenti amakhala ndi moyo zaka zisanu pambuyo pozindikira kuti ali ndi khansa. Pambuyo pake khansa ya larynge, 50 mpaka 60 peresenti ya anthu ali moyo zaka zisanu pambuyo pa khansa.
Mwamwayi, ngakhale kusintha kwa njira zopangira opaleshoni komanso njira zothandizira chithandizo m'zaka 30 zapitazo, chiwerengero cha anthu omwe ali ndi khansa sichikuyenda bwino. Komabe, kufooka kwakula bwino, ndi anthu omwe akulandira chithandizo cha khansa yowonongeka ali ndi zizindikiro zochepa komanso matenda okhudzidwa.
Chinthu chothandizira kuti chithandizo cha mankhwala a khansa yapachilombo chitheke ndikumvetsetsa msanga komanso kuchiza. Ngati mukukumana ndi zizindikiro zilizonse zoganizira za khansa yowonongeka-makamaka yowopsya kapena kusintha kwa mawu-chonde pangani msonkhano kuti muwone dokotala wanu. Muyenera kukhala osakayikira ngati mutakhala wosuta nthawi yaitali (komanso mowa mwauchidakwa). Ngakhale kuti munthu aliyense wapatsidwa khansara ndipo amafunikira ntchito yowonjezera ndi chithandizo ndi katswiri (monga dokotala wa opaleshoni wa ENT kapena oncologist ) ndi wotsika, ndi bwino kulakwitsa pambali yochenjeza.
Zosankha Zosankhidwa
Concus AP, Tran TN, Sanfilippo NJ, DeLacure MD. Mutu 31. Malignant Laryngeal Lesions. Mu: Lalwani AK. eds. Kufufuza Koyamba ndi Kuchiritsidwa mu Otolaryngology-Mutu ndi Kuchita Opaleshoni, 3e . New York, NY: Hill ya McGraw; 2012. Idapezeka pa February 28, 2016.
Weinberger PM, Terris DJ. Otolaryngology: Mutu ndi Kuchita Opaleshoni. Mu: Doherty GM. eds. Kufufuza Koyamba ndi Kuchiza: Opaleshoni, 14e . New York, NY: Hill ya McGraw; 2015. Idapezeka pa February 28, 2016.
Mutu wotchedwa "Induction chemotherapy komanso radiation poyerekeza ndi opaleshoni komanso ma radiation kwa odwala omwe ali ndi kansa yapamwamba" ndi GT Wolf ndi olemba mabuku omwe anafalitsidwa ku NEJM mu 1991.