Khansara yapancretic si yachilendo, koma popeza ambiri mwa khansa ali pamayendedwe apamwamba pa nthawi ya matenda, ndilochinayi chomwe chimayambitsa matenda a khansa ku United States. Zizindikiro zingaphatikizepo kupweteka kwapweteka, kupweteka kwa m'mimba, kutaya thupi, ndi nthawi zina kuyembekezera kwa shuga. Mayesero monga CT ndi endoscopic ultrasound amagwiritsidwa ntchito kuti azindikire vutoli.
Njira zochizira zimaphatikizapo opaleshoni, chemotherapy, mankhwala ochiritsira, mankhwala ochizira matenda, ndi mayesero a chipatala.
Kumvetsa Pancreas
Nkhumbayi ndi chiwalo chomwe chili pafupi mainchesi sikisi, masentimita awiri m'lifupi ndipo amawoneka ngati peyala wochepa pambali pake. Mapeto onse a mphukira amatchedwa mutu, pamene chigawo chapakati chimatchedwa thupi, ndipo mchirawo umatha. Khansa ndizofala kwambiri pamutu.
Mitunduyi imayambira kumbuyo kwa mimba patsogolo pa msana. Silingamveke panthawi ya kuunika kwa thupi monga kuzungulira ndi ziwalo zina, monga m'mimba, chiwindi, nthata, ndulu, ndi matumbo aang'ono, kupanga kupatsirana ndi opaleshoni zovuta.
Nkhanzazi zimakhala ndi mitundu iwiri ya maselo omwe angapangitse mitundu ya khansa. Ma khansa ambiri (adenocarcinomas) amayamba m'maselo omwe amadziwika kuti maselo a exocrine omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda. Mavitaminiwa amatumizidwa m'matumbo kuti athandize mapuloteni, chakudya, ndi mafuta.
Zochepa kwambiri ndi khansa (neuroendocrine tumors) yomwe imabwera mu maselo a endocrine . Maselo amenewa amapanga mahomoni monga insulini, glucagon, ndi somatostatin zomwe zimayendera njira kuchokera ku shuga wa magazi mpaka kuchuluka kwa asidi mmimba.
Zowonongekazi zikugwiritsidwa ntchito pa khansa yapakhungu yoopsa.
Zizindikiro
Zizindikiro zoyambirira za khansa ya pancreatic ikhoza kukhala yochenjera komanso yosadziwika, ndipo ikhoza kuthetsedwa mosavuta chifukwa cha vuto linalake.
Zina mwazizindikiro zowonjezera ndizo:
- Khungu la khungu ndi azungu a maso ( jaundice ) chifukwa cha kumanga bilirubin
- Pale, zitsulo zadothi, mitsempha yamdima, ndi kuyabwa, zimakhalanso chifukwa cha kusungunuka kwa bilirubin m'magazi
- Kupweteka kwa m'mimba kwambiri kumene kumawonekera kumbuyo
- Kutaya kolemera kosayembekezeka
- Nsupa, kusanza, kapena kutsekula m'mimba
- Kutaya njala
- Kuyamba kosayembekezereka kwa shuga kwa munthu amene alibe zifukwa zoopsa
Zizindikiro za zovuta zotchedwa pancreatic tumors (neuroendocrine tumors) nthawi zambiri zimakhudzana ndi mahomoni omwe amapanga ndipo zimaphatikizapo zizindikiro monga zomwe zimapezeka ndi shuga wotsika kapena wokwera kwambiri kapena shuga wambiri wamagazi.
Zizindikiro zonsezi zimapereka chithandizo choyenera cha zachipatala-ndipo kachiwiri, ngati simukupeza mayankho omveka kwa inu.
Zifukwa ndi Zoopsa
Ngakhale ochita kafukufuku sakudziwa kuti chomwe chimayambitsa matendawa ndi chiyani, pali zifukwa zina za khansa ya pancreatic yomwe yadziwika:
- Zaka: Ambiri amachititsa khansa yapakati pa 55 (ngakhale amatha kuchitanso achinyamata).
- Mpikisano: Anthu akuda ali ndi chiwerengero chapamwamba cha khansa ya pancreatic kuposa mafuko ena. Mavutowa ndi apamwamba kwambiri kwa anthu a Ashkenazi Jewish heritage, ngakhale kuti izi zikuganiziridwa kuti zikugwirizana ndi kuchuluka kwa BRCA2 kusintha kwa jini .
- Kugonana: Kuwonjezeka kwa chiwerengero ndi kufa kwa amuna kumakhala kochepa kuposa amuna.
- Kusuta fodya: Ichi ndi choopsa chachikulu ( kusuta kumawonjezera chiopsezo cha khansa zambiri ) ndipo amalingalira kuti amachititsa kuti pakhale gawo limodzi mwa magawo atatu a khansa ya pancreatic.
- Matenda apamwamba kwambiri ( periodontitis ) ndi chiwonongeko cha dzino (kusintha kwambiri)
- Mbiri ya banja la khansara ya pancreatic kapena matenda enaake a syndromes: Izi zikuganiza kuti ndizo zimayambitsa 5 peresenti mpaka 10 peresenti ya khansa iyi.
- Mbiri yaumwini ya shuga
- Kutupa kosatha kwa kapangidwe ( pancreatitis )
- Kuyambira nthawi yaitali, kumwa mowa kwambiri, makamaka pamene mukuphatikizapo kusuta
- Kunenepa kwambiri: Kukhala woposa kunenepa kwambiri kapena kunenepa kwambiri kumaganiziridwa kukhala koyambitsa pafupifupi mmodzi mwa khansa zisanu ndi zitatu za khansa.
Kudziwa
Kufufuza kwa matenda a khansa ya pancreatic kumayambira ndi mbiri yosamala yofufuza zoopsa, komanso kuyerekezera kwa thupi kufunafuna umboni uliwonse wa jaundice, mimba ya mimba, kapena kulemera kwake.
Kafukufuku woganizira ndipamene amadziwika kwambiri, makamaka CT opaleshoni yokonzekera khansa ya pancreatic (pancreatic protocol CT). Nthawi zambiri m'mimba mwachisawawa zimakhala zothandiza kuthetsa mavuto ena a m'mimba koma sizitha kudziwa kuti khansa ya pancreatic imachokera m'matumbo.
Mmalo mwake, endoscopic ultrasound-imene chubu yomwe ili ndi nsonga ya ultrasound imayikidwa pakamwa ndipo imagwera mpaka kumunsi kwa m'mimba kapena kumtunda kwa matumbo aang'ono-ikhoza kukhala chithandizo chothandiza. Mayesero ena omwe amagwiritsidwa ntchito nthawi zina ndi ERCP (endoscopic retrograde cholangiopancreatography) ndi MRI.
Sikuti nthawi zonse zimakhala zofunikira kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda, koma ngati (ngati ngati opaleshoni ikuyang'aniridwa) pali njira zazikulu ziwiri: zabwino zabwino za singano ndi laparoscopic biopsy.
Mayeso a magazi ndi ofunika kwambiri ndi khansara ya pancreatic koma ingakhale yothandiza pokhudzana ndi zovuta zina. Ngati jaundice ilipo, mayesero kuti adziwe mitundu yosiyanasiyana ya bilirubin ndi othandiza.
Malingana ndi zotsatira za kuyesera zojambula ndi zina zomwe zapeza, khansayi imapatsidwa malo pakati pa 0 (precancerous) ndi siteji yachinayi kapena imaikidwa ngati khansara yamatsenga.
Kuchiza
Njira zothandizira khansa ya pancreatic zimadalira pa siteji ya matenda ndi malo a khansara m'makoswe.
Kwa khansa yapakatikati, makamaka omwe ali pamutu wa chiphalaphala, opaleshoni imapereka mpata wochiza matendawa. Mwamwayi, anthu 15 kapena 20 peresenti yokha ndi omwe amafunidwa opaleshoni (kwa otsalira, khansara yafalikiranso kutali kwa opaleshoni kuti apulumuke).
Njira yowonjezereka yomwe imachitika amadziwika kuti Whipple ndipo imaphatikizapo kuchotsa mutu wa ziphuphu, chiwalo chodziwika bwino, gawo la m'mimba, chiwalo cha m'mimba, nthata, ndi ma lymph. Pali kusiyana pakati pa ndondomekoyi, kuphatikizapo opaleshoni yomwe imachotsa makoswe onse, koma izi zimachitidwa mochepa. Izi ndizochita opaleshoni zazikuru, ndikuonetsetsa kuti opaleshoni ndi yotheka (monga laparoscopic biopsy ndi mayesero ena) ndilofunikira.
Chemotherapy pogwiritsira ntchito mankhwala osokoneza bongo amachititsa kuti pakhale kanthawi kochepa kokha kupulumuka kwa kanthaŵi kochepa koma ingakhale yothandiza kwambiri pokhudzana ndi mankhwala monga chithandizo chokhudzidwa ndi / kapena mankhwala opatsirana.
Njira zochiritsira ndizochiritso zatsopano zomwe "zimawongolera" zosavuta kwenikweni pa kukula kwa khansa. Mankhwala amodzi, Tarceva (erlotinib), ndi othandiza kwa anthu ena, nthawi zambiri kuphatikizapo chemotherapy.
Zilonda zam'chipatala zikuyang'ana njira zochiritsira zomwe tazitchula pamwambapa komanso njira zatsopano zogwiritsira ntchito mankhwala monga immunotherapy.
Kulimbana
Ngati inu kapena wokondedwa wanu mumapezeka kuti muli ndi kansa ya pancreatic, mutengere nthawi kuti mudziwe za matenda anu ndipo mutenge nawo gawo lanu mwakhama monga wothandizira anu . Kuchita zimenezi sikungothandiza kuchepetsa nkhaŵa koma kungapangitse kusiyana kwa zotsatira kwa anthu ena.
Malingaliro ena omwe angathandize:
- Tengani kamphindi kuti muphunzire za momwe mungafufuzire khansa yanu pa intaneti .
- Taganizirani kupeza lingaliro lachiwiri, makamaka pa imodzi mwa zikuluzikulu za National Cancer Institute-malo osankhidwa ndi khansara.
- Lankhulani ndi oncologist wanu za mayesero alionse omwe angakhale oyenera kwa inu, kapena ganizirani kufufuza kwaufulu komwe mukuyesa kuyezetsa kuchipatala komwe kumapereka oyendetsa anthawi omwe angagwirizane ndi zochitika zanu kumayesero am'chipatala akuchitika kulikonse padziko lapansi.
Anthu ena amapezanso kuti zimathandiza kuti agwire nawo gulu lothandizira. Ngati gululi silipezeka m'deralo, zomwe zingakhale ngati kansa ya pancreatic ndi yachilendo, midzi yothandizira pa intaneti ingakhale njira yabwino yopezera ena omwe akukumana ndi mavuto omwewo.
Pezani kwa abwenzi ndi abwenzi ndikuwalola kuti akuthandizeni. Khansara imatenga mudzi. Ambiri omwe ali ndi khansa amaperekanso njira zothandizira maganizo, kuchokera ku uphungu wa khansa ku magulu othandizira odwala matenda opatsirana omwe amalankhula ndi munthu, thupi, maganizo, ndi moyo. Gwiritsani ntchito njira izi zomwe mukukhulupirira kuti zingakuthandizeni. Nthawi zina chinthu cholimba chimene anthu angachite ndi kuvomereza kuti akusowa thandizo komanso thandizo.
Mawu Ochokera
Ngati inu kapena wokondedwa wanu mwapezeka kuti muli ndi kansa ya pancreatic, kapena mukuganiza kuti mungakhale ndi zizindikiro, palibe kukayikira kuti mungakhale ndi nkhawa kwambiri. Khansara yapancretic ili ndi mbiri yomwe ambiri amadziwa. Komabe monga momwe mankhwala amathandizira ena khansa, ikupita patsogolo pa matendawa, nawonso. Malo ena akuluakulu azachipatala akuchitidwa opaleshoni kwa khansa omwe poyamba ankawoneka kuti sangathe kugwira ntchito. Ndipo ngakhale ndi matenda aakulu, mankhwala atsopano monga mankhwala opatsirana ndi immunotherapy angasinthe nkhope ya khansa ya pancreatic, monga momwe aliri ndi khansa zina.
Ngakhale kuti chithandizo sichimene ife tikufuna kuti iwo akhale lero, mapulaneti afika pautali kwambiri poyang'anira zizindikiro ndi zodetsa nkhaŵa zokhudzana ndi khansara kuti anthu athandize kwambiri nthawi yawo ndi achibale awo ndi abwenzi ziribe kanthu nthawi yayitali bwanji yasala.
> Zotsatira:
> Zochitika Zamakono Komanso Zowoneka M'matenda a Pancreatic, Springer Verlag, 2017.
> De la Cruz, M., Young, A., ndi M. Ruffin. Kuzindikira ndi Kusamalira Khansa ya Pancretic. American Family Physician . 2014. 89 (8): 626-632.
> National Cancer Institute. Chithandizo cha khansa ya Pancreatic (PDQ) -Health Professional Version. Kusinthidwa 01/26/18. https://www.cancer.gov/types/pancreatic/hp/pancreatic-treatment-pdq
> Rosenberg, A., ndi D. Mahalingam. Immunotherapy mu Pancreatic Adenocarcinoma-Kugonjetsa Zopinga Kuyankha. Journal of Zovomerezeka pa Oncology . 2018. 9 (1): 143-159.