Zizindikiro, Zimayambitsa, Kuzindikira, ndi Chithandizo
Khansara ya ovarian yakhazikitsidwa ndi "wakupha wakupha" chifukwa cha kusowa kwa zizindikilo zozizwitsa mpaka mkhalidwe uli bwino kwambiri pamene ungayambitse kugonana, kupweteka kosawerengeka, ndi zina zambiri. Kawirikawiri chiopsezo cha moyo wa khansa iyi ndi 1.6 peresenti, koma chifukwa chakuti nthawi zambiri matendawa sapita patsogolo mpaka kufika pamayendedwe apamwamba, ndilo chifukwa chachisanu chomwe chimayambitsa kufala kwa khansa kwa amayi.
Mankhwala monga opaleshoni ndi chemotherapy angagwiritsidwe ntchito, ngakhale kuti kupambana kwawo kumachepetsa kuti matendawa apitirire kwambiri.
Mitundu
Mchitidwe wa kubereka wamwamuna umakhala ndi umuna, chiberekero (chiberekero cha m'mimba), chiberekero, mazira awiri, ndi mazira awiri. Mankhwalawa amapezeka kukula kwa amondi ndipo amachititsa kuti dzira lizikula komanso kutuluka kwa dzira. Iwo amachitanso kupanga mahomoni estrogen ndi progesterone .
Khansara ya ovarian imayamba m'kati mwa chigoba choyandikana kwambiri pafupi ndi ovary ndiyeno kufalikira kwa ovary. Matendawa nthawi zina amayamba mu peritoneum, nembidzi zimayendayenda m'mimba, ndiyeno zimafalitsidwa ku ovary. Chifukwa chake, khansara ya ovari, khansa ya mazira, ndi khansa yoyamba ya piritoneal nthawi zambiri imagulukana pokambirana za khansa.
Palinso magulu atatu a khansa ya ovari (ngakhale pali zoposa 30 subtypes). Mitundu yosiyanayi ingaperekedwe m'njira zosiyanasiyana, ikhale yosiyana, ndipo imapezeka mwa amayi a mibadwo yosiyanasiyana.
- Mitsempha ya m'magazi imachokera kumalo osungira maselo (epithelial layer) yowonjezerapo mazira ndi mazira omwe amapezeka m'magazi ndi 90 peresenti mpaka 95 peresenti ya khansa ya ovari. Kuopsa kwa khansa imeneyi kumawonjezeka ndi msinkhu, ndipo anthu ambiri ndi omwe amachititsa kuti asamangidwe. Mankhwalawa amadziwika kwambiri monga endometrioid, mucinous, ndi serous tumors, ndipo ambiri amakhala aakulu. Ziphuphu zamtundu ndi zam'mimba zimakhala zofala kwambiri kwa amayi osakwana zaka 40.
- Matenda opatsirana amatha kukhala oopsa kapena oyipa ndikuyamba mu stroma, minofu yomwe imayang'ana dzira ndipo imakhala ndi mazira ochuluka. Izi zimaphwanyidwa m'magulu angapo, kuphatikizapo granulosa maselo-omwe ali ovuta mu mawonekedwe a achinyamata, omwe amapezeka pakati pa kubadwa ndi zaka 20, koma nthawi zambiri sakhala achiwawa mu mawonekedwe achikulire-ndi maselo a Sertoli.
- Zilonda zajeremusi zimatha kukhala zowononga kapena zovulaza ndipo ndizofala kwambiri pa khansara ya ovini mwa anthu oposa 30. Ambiri amapezeka kuti ali pakati pa zaka 10 ndi 30. Izi zimayamba m'maselo obereka (dzira) ndi akaunti pafupifupi 3 peresenti za khansa ya ovari. Zilonda zajeremusi zimapezeka nthawi yayitali koma zimakula kukula mofulumira. Zina mwazing'ono zimaphatikizapo dysgerminomas, zotupa zotchedwa endodermal sinus, ndi maatatas ochepa .
- Kawirikawiri khungu la carcinoma la ovary ndilosazolowereka, ndipo limangokhala kokha 0,1 peresenti ya khansa ya mazira.
Zomwe zimakhalapo pakati pa khansa yapamwamba ya ovary (ma phase onse pamodzi) ndi zaka zisanu, koma pafupifupi 15 peresenti ya anthu omwe amapezeka kuti ali ndi moyo pambuyo pa zaka 10. Ofufuza tsopano akuphunzira izi "zopita kunja" akuyembekeza kupeza njira zabwino zothandizira matendawa. Kugonjera kwa anthu kumadalira zinthu zambiri, monga msinkhu, siteji ndi matenda a kansa, yankho la mankhwala, ndi zina zambiri.
Zizindikiro
Zizindikiro za khansara ya ovari nthawi zambiri zimakhala zabodza komanso zosavuta kumayambiriro kwa matendawa ndipo nthawi zambiri zimakhala ndi zovuta zina. Ngakhale kuti pafupifupi 80 peresenti ya khansa iyi yayamba kale kupita patsogolo, kafukufuku waposachedwapa watulukira zizindikiro zinayi zomwe zimapezeka kale. Izi zikuphatikizapo:
- Kusintha kwa zizolowezi zamatumbo, monga kuvomereza kapena kutsekula m'mimba
- Kupweteka kwa majeremusi kapena kupanikizika
- Kawirikawiri amayenera kukodza kapena kufulumira
- Kutupa kapena kutupa m'mimba
Zizindikiro zina za khansara ya ovari nthawi zambiri sizimawoneke mpaka matendawa apitirira. Izi zingaphatikizepo ululu panthawi yogonana, kupuma kosalekeza, kupweteka m'mimba kapena kupuma kwa madzi (ascites), pakati pa ena.
Zizindikiro zina zimachokera makamaka ku mahomoni opangidwa ndi chotupacho, kuphatikizapo kuwonjezeka kwa mawu, kuphuka tsitsi kwa nkhope, ndi kutuluka magazi kosadziwika.
Zifukwa ndi Zoopsa
Tsoka ilo, sitingathe kudziwa chomwe chimayambitsa khansara ya ovari, koma ofufuza apeza zidziŵitso zingapo zomwe zimadziwika kuti zingawathandize. Ngakhale kuti zoopsa ndizofunika, ndibwino kukumbukira kuti mazira a ovary amapezeka mwa anthu omwe alibe chiopsezo kapena mbiri yakale ya banja.
Zinthu zoopsa zimaphatikizapo, koma sizingatheke, kukalamba; Mtundu wa Caucasus; mbiri ya banja ya khansa ya mazira, mawere, kapena khansa; kunenepa kwambiri ; komanso mankhwala osakanizidwa otchedwa estrogen.
Zinthu zomwe zimagwiridwa ndi chiopsezo chochepa cha khansa ya ovari zimaphatikizapo, koma sizingokhala ndi mwana asanakwanitse zaka 26, kuyamwa, kugwiritsa ntchito njira za kulera, kupaleshoni kwa tubal, ndi hysterectomy.
Khansara ya ovariya imakhala yofala kwambiri kwa atsikana. Izi zikachitika, kawirikawiri pamakhala mbiri ya banja ndipo nthawi zambiri zimakhudzana ndi zobadwa monga BRCA1 kapena BRCA2 kusintha. Khansara ya ovarian ndi yachisanu ya khansa yomwe imapezeka pa nthawi ya mimba ndipo imapezeka m'mimba mwa amayi 18,000.
Kudziwa
Khansara ya ovariya siimawonetsedwa kawirikawiri. Kuzindikira khansara ya ovari nthawi zambiri kumafuna chiwerengero chachikulu cha dandaulo pa dokotala kuti ayambe kulamulira zojambulajambula ndi mayeso omwe angasonyeze matendawa.
Madokotala amagwiritsa ntchito njira yowonjezereka ya ultrasound ndi kuyesa magazi a CA-125 choyamba, ngakhale kumapeto kwake kungakhale kozoloŵera kwa anthu ena omwe ali ndi khansara oyambirira ndipo akhoza kukwezedwa ndi matenda ena ambiri. Dokotala akhoza kuyambitsa mayeserowa atachita kayezetsedwe kameneka, kapenanso munthu angapereke zizindikiro za matenda kapena mitsempha yomwe imayambitsa izi.
Zojambula zina zamaganizo, monga CT, MRI, ndi PET zimawunika, pamodzi ndi mayesero ena a magazi amatha kulamulidwa (makamaka kuti awone ngati khansara, ngati ilipo, yayamba). Chidziwitso n'chofunika kuti atsimikizidwe kuti ali ndi khansa ya ovari.
Pambuyo poyezetsa matenda, kupatsirana kwa chotupa n'kofunika kwambiri kuti mudziwe njira zoyenera zothandizira mankhwala. Izi zikhoza kuchitika ndi kuphatikiza zovuta zowonongeka pazitsanzo za biopsy ndi zojambula, koma nthawi zambiri zimafuna opaleshoni.
Chithandizo
Njira zothandizira khansa ya ovari zimadalira mtundu, masitepe, ndi kalasi ya khansa ya ovari, komanso zinthu zina monga msinkhu komanso thanzi labwino.
Pali njira zitatu zoyamba zothandizira khansa ya ovari. Kuchita opaleshoni kuphatikizapo mankhwala a chemotherapy ndi njira yochiritsira kwambiri kwa onse koma magawo oyambirira a matendawa. Mankhwalawa samagwiritsidwa ntchito kawirikawiri koma akhoza kutonthozedwa kwa amayi ena omwe ali ndi metastases ambiri m'mimba mwawo.
- Opaleshoni: Kuchotsedwa kwa ovary ndi fallopian tube kumbali imodzi kungalingaliridwe kwa iwo amene akuyembekeza kusunga kubereka kwawo . Opaleshoni ya Debulking kapena cytoreduction ingatengedwe kuti imachotsa chotupa chachikulu (ndi metastases) ngati n'kotheka kuti pakhale mphamvu ya chemotherapy.
- Chemotherapy: Chemotherapy amagwiritsidwa ntchito kuthetsa maselo a kansa omwe atsala opaleshoni, kapena kuchepetsa chiopsezo cha kubwereza pamene palibe khansa yeniyeni yoonekera. Ikhoza kuperekedwanso yokha ngati mankhwala othandizira kuchepetsa zizindikiro.
- Thandizo lothandizira: Izi zimaphatikizapo mankhwala ndi mankhwala omwe akuwongolera njira zenizeni mu kukula kwa maselo a khansa. Chifukwa cha kuyang'ana kwawo, nthawi zambiri, koma nthawi zonse, amakhala ndi zotsatira zochepa kusiyana ndi mankhwala ochiritsira a mankhwala amodzi. Pali mitundu iwiri ya mankhwala othandizira: omwe cholinga chake ndi kulepheretsa mapangidwe atsopano a magazi ndi zotupa, komanso zomwe zimayendetsa njira ya khansa.
Zilonda zachipatala zikupitiriza kuphunzira kuyanjana kwa chithandizochi, komanso mankhwala atsopano, monga mankhwala osokoneza bongo . Malingana ndi National Cancer Institute, anthu amene amapezeka kuti ali ndi khansara ya ovari ayenera kuganizira kutenga nawo mbali m'kuyezetsa magazi.
Mawu Ochokera
Pakalipano, matenda opatsirana ambiri omwe amapezeka m'thupi mwawo amapezeka m'zigawo zina za matendawa. Popeza tilibe mayesero olimbitsa thupi, ndi bwino kudziŵa zizindikirozo ndi kupita kuchipatala ngati mutakumana ndi aliyense wa iwo-ngakhale mukuganiza kuti mwina palibe.
Ngati inu kapena wokondedwa wanu mwapezeka posachedwapa ndi khansa ya ovari, mungathe kuchita mantha mukamawona ziwerengero za matendawa. Ngakhale kuti pali ziwerengero zodetsa nkhawa, chithandizo cha matendawa chikukulirakulira monga momwe zimakhalira ndikupulumuka, ndipo ambiri mwa mayesero amasiku ano akuyang'ana njira zatsopano komanso zabwino zothandizira odwala.
> Zotsatira:
> Hoppenot, C., Eckert, M., Tienda, S., ndi E. Lengyel. Kodi Anthu Othawa Kwambiri Kwambiri Akuluakulu a Serous Ovarian Cancer Ndi Ndani? . Gynecologic Oncology . 2018. 148 (1): 204-212.
> National Cancer Institute. Ovarian epithelial, Tube Fallopian, ndi Primary Primary Peritoneal Treatment Treatment (PDQ) -Achilengedwe Professional Version. Kusinthidwa 01/19/18. https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq