Khansa ya chiwindi ndi yachilendo ku United States koma ndi yofala padziko lapansi chifukwa chazirombo monga matenda a hepatitis B ndi matenda a hepatitis C ndi aflatoxin. Zizindikiro zimaphatikizapo jaundice (khungu la chikasu), kupweteka m'mimba pamtunda, kupweteka kwa mapewa, ndi kupweteka. Madokotala amadziwa kuti ali ndi vutoli pogwiritsa ntchito zojambula zojambula ndi kuyesa magazi.
Malinga ndi kukula kwa chotupacho, njira zothandizira mankhwala zingaphatikizepo kuchotsa chotupa, kutsekula kwa chiwindi, chithandizo chochiritsira, chemotherapy, ndi mankhwala enaake.
Khansara ya chiwindi imayambira pachiwindi, chiwalo chomwe chiri pansi pa nthiti zazing'ono kumbali yakanja ya mimba. Ndikofunika kusiyanitsa khansa ya chiwindi chachikulu (hepatocellular carcinoma) ndi kansa ya khansa (cholangiocarcinoma) kuchokera kumatenda omwe amayamba kumalo ena a thupi ndikufalitsidwa ku chiwindi (metastases). Matenda a chiwindi ndi ochuluka kwambiri kuposa khansa yapachiwindi chachikulu ndipo amachiritsidwa m'njira yomwe khansa yapachiyambi (monga khansara yamapapo kapena khansara ya m'mawere) imachiritsidwa, mmalo mwa njira yomwe khansa yaikulu ya chiwindi imathandizira.
Ntchito za chiwindi ndizofunika kudziwa momwe mukuyang'ana zizindikiro zomwe zingatheke. Chiwindi chimagwira ntchito pochotsa zinthu, kusungunula mankhwala kuti athandizire mu chimbudzi ndi kupanga mahomoni omwe ali ofunikira popanga maselo ofiira a magazi.
Kuwonjezera pa khansa zotchulidwa pamwambapa, pali mitundu yochepa ya khansa ya chiwindi. Zina mwa izi ndi monga hepatoblastoma, khansa yochepa ya ana, ndi angiosarcoma pachiwindi. Kuwunika kumeneku kumayang'ana makamaka pa khansara ya chiwindi ndi khansa ya khansa.
Zizindikiro
Zizindikiro za khansa za chiwindi si zachilendo kumayambiriro kwa matendawo pokhapokha ngati chotupacho chiri pafupi ndi imodzi ya ma dope ndipo imayambitsa chilema (ndi zizindikiro zofanana ndi ndulu).
Zizindikiro zingakhalepo:
- Ululu m'mimba pamtunda
- Misa mu mimba yolondola (pansi pa nthiti zanu kapena mwakachetechete)
- Kumva ululu wa tsamba lamanja
- Jaundice , kutuluka kwa chikasu kwa khungu ndi azungu a maso
- Chovala choyera kapena choyera
- Mtsinje wakuda
- Kuyabwa kwakukulu
- Ascites , kumanga madzi m'mimba
- Chiwindi (madigiri 101 kapena apamwamba omwe amakhala kwa masiku angapo popanda zizindikiro zoonekeratu za matenda)
- Kupanda kulemera kosayembekezereka popanda kusintha kwakukulu pa zakudya kapena masewera olimbitsa thupi
- Zizindikiro zosafunikira kwenikweni monga kusowa kwa njala, kutopa, komanso kukhala osagwirizana
Zifukwa ndi Zoopsa
Sitikudziwa bwinobwino zomwe zimayambitsa matendawa, ngakhale tikudziŵa zifukwa zingapo zomwe zimayambitsa khansa ya chiwindi . Zambiri mwazifukwazi zimayambitsa chiwindi cha chiwindi, ngakhale khansara ya chiwindi ikhoza kukhala ndi chibwibwi.
Kawirikawiri chiopsezo chachikulu cha khansa ya chiwindi ndi imodzi mwa mitundu ya matenda a chiwindi. Pamodzi, chiwindi cha hepatitis B ndi hepatitis C akuganiza kuti ndi chifukwa cha pafupifupi 85 peresenti ya khansa ya chiwindi padziko lonse lapansi. Zina mwazifukwazi zimaphatikizapo:
- Mowa umagwiritsa ntchito ndi kusuta: Nthawi zambiri kumwa mowa kwambiri (zakumwa zoposa 3 patsiku) kumagwirizanitsa ndi kukula kwa chiwindi, komanso kumayambitsa khansa ya chiwindi. Kusuta kumawonekeranso kuti kumawopsa, makamaka pamene pali zinthu zina zoopsa, monga chiwindi cha buluu B.
- Mbiri ya banja ndi matenda opatsirana: Ngati muli ndi wachibale wanu yemwe ali ndi khansa ya chiwindi, chiopsezo chanu n'choposa kuposa. Vutoli limapitsidwanso kwa anthu omwe ali ndi matenda opatsirana monga hemochromatosis ndi matenda a Wilson.
- Zochitika zachipatala: Mavuto azachipatala omwe amawonjezera chiopsezo cha khansa ya chiwindi ndizopangira sclerosing cholangitis, matenda oyambirira a biliary, matenda osamwa mowa a chiwindi , ndi shuga.
- Kutulutsa Aflatoxin: Kawirikawiri ku United States, koma kawirikawiri padziko lapansi, yomwe imawoneka ndi poizoni zotulutsidwa ndi bowa zomwe zimakula pa mbewu zosasungidwa ndi mtedza-ndizo zimayambitsa khansa ya chiwindi.
Kudziwa
Amene ali ndi zizindikiro za khansa ya chiwindi kapena zifukwa zomwe zingayambitse matendawa ayenera kuwona dokotala wawo. Dokotala akhoza kutenga mbiri yosamala ndikuyesera thupi. Kwa ena, kuyezetsa kuyesa kungaganizidwe. Malingana ndi kuyesedwa, kuphatikiza kwa mayeso a magazi ndi masewero a kujambula angapangidwenso.
- Maphunziro ndi mayeso: Ntchito yamagazi (monga chiwindi cha ntchito ya chiwindi ), chiwindi cha hepatitis, ndi zizindikiro zamatenda nthawi zambiri ndizo zoyamba zowononga khansa ya chiwindi. Chiyeso chimodzi, mayeso a alpha-fetoprotein tumor marker (AFP), akhoza kulamulidwa kuwonetsa matenda a chiwindi.
- Kujambula: Chitsanzo choyambirira cha kujambula chomwe chimagwiritsidwa ntchito ndi ultrasound. Mayesero ena omwe angakhale othandiza pakufufuza ndi monga MRI ndi CT scans. Chizindikiro cha chiwindi chingathenso kutonthozedwa.
- Chiwopsezo: Mosiyana ndi khansa zambiri, matenda a khansa ya chiwindi nthawi zambiri amapangidwa pogwiritsa ntchito zojambula zojambula m'malo mojambulira. Nthendayi siingayesedwe pokhapokha ngati n'kofunika kumvetsetsa maonekedwe a maselo a chifuwa, monga kuyesedwa kwachipatala.
Chithandizo
Njira zomwe mungapeze matenda a khansa ya chiwindi zimadalira matenda, matenda anu, ndi zina zambiri. Njira zochizira zimakhala m'misasa iwiri:
Mankhwala Ochiritsira
Izi zimapangitsa maselo a khansa kulikonse kumene angakhale ndipo ndizofunikira kwambiri kwa khansa yapachiwindi.
Zosankha zikuphatikizapo:
- Chemotherapy: Pali mankhwala osiyanasiyana omwe amatha kuperekedwa chifukwa cha khansa ya chiwindi. Chemotherapy amagwira ntchito mwa kuyambitsa kugawidwa mofulumira maselo m'thupi. Mwamwayi, pali maselo omwe ali m'thupi omwe amagawanika mofulumira, omwe amachititsa zotsatira zodziwika za chemotherapy, monga kupweteka kwa tsitsi komanso kuwonjezeka kwa chiopsezo cha matenda. Chemoembolization ndi njira yomwe chemotherapy imaperekedwa mwachindunji mumatope akuluakulu (transterterial) omwe amalowa m'chiwindi. Chemoembolization ikhoza kugwiritsidwa ntchito monga chithandizo chachikulu, koma imagwiritsidwanso ntchito kuyesa kuchepetsa kukula kwa chotupa pamene munthu akudikira kuika chiwindi.
- Mankhwala oyembekezeredwa: Mankhwala opatsirana amachilendo amasiyana ndi mankhwala a chemotherapy chifukwa "amawunikira" njira inayake pakukula kwa kansalu ya khansa. Nexavar (sorafenib), Lenvima (lenvatinib), ndi Sivorga (regorafenib) zonse zimapangitsa kuti apulumuke ndipo panopa ndizo mankhwala ochizira anthu omwe ali ndi khansa yambiri ya chiwindi.
Zochiritsira zapanyumba
Izi zimachiza khansara kumene zimachokera. Zosankha zomwe zingaganizidwe zikuphatikizapo:
- Hepatectomy yochepa: Iyi ndi njira yotulutsira khansara ndi zina zozungulira. Izi zikhoza kukhala zosankha za ziŵeto zing'onozing'ono za chiwindi (zosakwana 5 masentimita), malingana ndi malo awo.
- Kuwedza kwa chiwindi: Chiwindi cha matenda chimachotsedwa ndipo chimachotsedwa ndi gawo kapena chiwindi chonse chamoyo. Izi zikhoza kukhala njira yabwino kwa iwo omwe ali ndi matenda aakulu kapena omwe asokoneza chiwindi kusalimba koma ali ndi thanzi labwino.
- Thandizo la mazira: Izi zingaphatikizepo mankhwala othandizira mazira (kutulutsa chifuwa chachikulu, nthawi zambiri kuchepetsa zizindikiro kapena kupititsa moyo, kuti asachiritse chotupa); thupi la poizoni la radiotherapy, kapena SBRT (pogwiritsa ntchito mlingo waukulu wa ma radiation m'dera laling'ono la minofu kuti athetse chotupa); kapena brachytherapy (kuyika ma radioactive mu chiwindi).
- Kuperewera kwa madzi: Kugwiritsa ntchito kafukufuku yemwe ali ndi timagulu ting'onoting'ono towononga khansa.
- Cryotherapy: Izi zimaphatikizapo kuzizira minofu ya khansa.
- Jekeseni wa ethanol yochuluka: Izi zimaphatikizapo jekeseni wa mowa m'chiwindi ndipo ndi njira yodalirika ya zotupa zazing'ono, koma zakhala zikutsatiridwa ndi kupuma kwapadera kwa zaka zaposachedwapa.
Mosasamala mtundu wa mankhwala omwe inu ndi dokotala mumasankha, muyenera kudziwa zonse zomwe mungapeze. Nyuzipepala ya National Cancer Institute imalimbikitsanso kuganizira momwe mungayankhire mayesero . Ambiri akuyendera ndipo akuyang'ana njira zochiritsira zomwe zili pamwambapa, komanso mankhwala atsopano monga angiogenesis inhibitors , njira zochizira matenda , ndi zina zambiri.
Chisamaliro chosakanikirana
Kusamalirana kumaphatikizapo kuchiza zizindikiro za khansa ndi mankhwala a kansa, osati khansa yokha. Mosiyana ndi chisamaliro cha chipatala, chisamaliro chosamalidwa chingagwiritsidwe ntchito ngakhale kwa anthu omwe ali ndi khansa yathanzi kwambiri. Kuwonjezera pa kukweza umoyo wa moyo, phunziro la 2018 likusonyeza kuti kusamalira kotereku kungapangitse zotsatira za anthu omwe ali ndi khansa ya chiwindi.
Kupewa
Pankhani yothetsa khansa ya chiwindi , nthawi imodzi yothandizira imayenera kulemera makilogalamu-ndipo kuteteza chiwindi cha B ndi C ndikofunika kwambiri. Ngati mungapewe kutenga matendawa, kapena kulandila mankhwala ngati muli nawo, mukhoza kuchepetsa chiopsezo cha khansa ya chiwindi ndi 90 peresenti. Ngakhale kwa iwo omwe ali ndi matendawa, pali mankhwala omwe angachepetse chiopsezo chokhala ndi ma cirrhosis, ndi mwina khansa ya chiwindi.
Pewani kumwa mowa, ndipo ngati mumasuta, musiye. Tengani nthawi yophunzira mbiri ya banja lanu za matenda aliwonse, makamaka omwe amabweretsa mavuto a chiwindi. Ndipo samalani ndi mankhwala aliwonse amene mumapezeka nawo kuntchito, monga ena amadziwika kuti amachititsa khansa ya chiwindi.
Kulimbana
Ngati inu kapena wokondedwa wanu mwapezeka kuti muli ndi khansa ya chiwindi, mungamve ngati dziko lanu lasokonekera. Komabe, pali zinthu zomwe mungachite zomwe zingakuthandizeni kuti muzimva ngati mukutha kupuma. Phunzirani zambiri momwe mungathere ndi khansara, koma samalani kuti muwone zambiri zamakono. Kuchiza ndi chiwerengero cha kupulumuka chikusintha, ndipo chidziwitso chomwe chiri ngakhale zaka zingapo sizingasinthe kusintha kumeneku. Zomwezo zimapita ku ziwerengero za moyo.
Kuyanjana ndi chiwindi cha khansa ya chiwindi kungakhale othandizira potsata chithandizo cha maganizo komanso ngati njira yophunzirira kafukufuku waposachedwapa wa khansa ya chiwindi. Anthu omwe ali ndi matendawa ndi ofunikira ndipo nthawi zambiri amadziwa zambiri kusiyana ndi ena ambiri oncologists za mankhwala atsopano. Mukhoza kuyang'ana gulu lothandizira kumudzi wanu, kapena kupeza chiopsezo cha khansa ya chiwindi pa intaneti. Kuti mupeze anthu olondola, yesani kugwiritsa ntchito ma hashtag #livercancer ndi #livertumor.
Yesetsani kwa abwenzi ndi abwenzi ndikulandira chithandizo chimene angapereke. Kulimbana ndi khansa ya chiwindi kumatenga mudzi.
Kusamalira
Ndi anthu ochepa chabe omwe amakumana ndi khansa yokha, ndipo kuthana ndi khansa ya chiwindi kungakhale kovuta kwa osamalira mabanja ngati omwe akudwala matendawa. Mbali imodzi yovuta kwambiri yokhudza kusamalidwa ndi lingaliro la kusowa thandizo komwe mungamve, komabe pali njira zomwe mungathandizire wokondedwa wanu ndikumana ndikumverera. Kuphunzira zambiri za khansa ya chiwindi ndi malo abwino kuyamba.
Kusagwirizana kumakhala kofala pamene anthu omwe ali ndi khansa komanso okondedwa awo amasiyana ndi momwe angayendere ndi mankhwala. Perekani malingaliro anu, koma kumbukirani kuti uwu ndi ulendo wa wokondedwa wanu amene akufunikira kuyenda m'njira yake.
Pomalizira, ndikofunika kwambiri kuposa kale kuti muzisamalire nokha monga wosamalira. Izi zingawoneke zosatheka nthawi zina, koma kutenga nthawi kuti mutsimikizire zosowa zanu zomwe zikukuthandizani kudzakuthandizani kuti mukhale okhwima ngati mukusamalira wokondedwa wanu.
Mawu Ochokera
Ngati muli ndi nkhawa kuti mukhonza kukhala ndi khansa ya chiwindi, lankhulani ndi dokotala wanu. Mankhwala amathandiza kwambiri pamayambiriro a matendawa, ndipo kugwira mapiritsiwa kumayambiriro kumapereka chithandizo cha mankhwala.
Kwa omwe apezeka ndi khansa ya chiwindi, palinso chiyembekezo. Mankhwala akukula, ndipo mankhwala atsopano amapezeka m'mayesero a kachipatala. Onetsetsani kukhala mbali yogwira ntchito ya chisamaliro chanu cha khansa. Phunzirani momwe mungakhalire mutetezi wanu, kapena mupeze mnzanu kapena wokondedwa amene angakhale akukuyimirani. Kudzivomereza nokha, pamene muli ndi khansa, sikupezeka kokha kuchepetsa nkhaŵa koma nthawi zina zingathe kuwongolera zotsatira.
> Zotsatira:
> Forner, A., Reig, M., ndi J. Bruix. Hepatocellular Carcinoma. Lancet . 2018 Jan 4. (Epub patsogolo pa kusindikiza).
> National Cancer Institute. Primary Primary Cancer Treatment (PDQ) -Health Professional Version. Kusinthidwa -2/06/18. https://www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq
> Woodrell, C., Hansen, L., Schiano, T., ndi N. Goldstein. Kusamalira Anthu Odwala Matenda a Hepatocellular Carcinoma, ndi Mapindu Amodzi Okalamba Achikulire. Clinical Therapeutics . 2018 Mar. 20. (Epub patsogolo pa kusindikiza).