Kwa odwala khansa ya prostate, ndondomeko yabwino ya mankhwala ndi chinthu chofunikira kwambiri chokhalira ndi moyo wautali, ndikupeza kuti mankhwala abwino amayamba ndi kulondola molondola. Prostate Cancer Research Institute (PCRI) imapereka zinthu zambiri zothandizira odwala kudziwa ndi kumvetsa masitepe awo. Amagawaniza odwala kukhala masiteji asanu, kugawira aliyense mthunzi wina wa Blue- Sky, Teal, Azure, Indigo kapena Royal.
Gawoli likudziwika poyankha mafunso asanu ndi atatu okhudzana ndi zifukwa zosiyanasiyana - PSA , biopsy, scans, ndi kuwerengera kwapadera ma digito-omwe amapezeka mu chithunzi cha mankhwala. Chiyanjano cha mafunso a PCRI chili pa tsamba la PCRI pa pcri.org.
Chithandizo cha Zamankhwala
Palibe chosowa kuti wodwala asangalale pofunsa dokotala wake kopikira chithunzi cha mankhwala. Odwala ali ndi ufulu wolemba mauthenga awo, ndipo kukhala ndi chidziwitso pamanja kungathandize kuti amvetse bwino khansa yawo, adziwe malo awo, ndipo asankhe ndondomeko yoyenera ya mankhwala. Maofesi ena akhoza kulipira malipiro oyenera, ndipo zingakhale zofunikira kupempha chidziwitso ku ofesi imodzi kuti athe kulemba zonse zofunika. Pomwe wodwalayo ali ndi tchati lake la zamankhwala, adzawona kuti lagawanika kukhala zigawo zolembedwa ndi labotale, matenda, mapulogalamu, komanso radiology. M'zigawo izi odwala adzalandira zenizeni zowunikira kuti adziwe gawo lawo:
Laboratory
Wodwala atalandira tchatichi, ayenera kupanga mbiri ya ma PSA onse. Kwa mafunso, PSA yopambana imalowa. Chinthu chokhacho chingakhale PSA yopanda malire chifukwa cha kusokonezeka kwa prostate. Mwachitsanzo, miyezo ya PSA idzakhala yotalika kwa miyezi iwiri pambuyo pa chingwe cha singano.
PSA ingathenso kukwezedwa kwa maola 24 kapena pambuyo poyezetsa kachidutswa ka digito kapena pambuyo pa kugonana. Chinthu chinanso ndi msinkhu wa testosterone m'magazi. Nthawi zina amuna achikulire omwe ali ndi matupi otsika a testosterone, omwe amanena kuti ndi ochepera 100, adzakhala ndi PSA. Ngati mayeso a testosterone sanachitike, odwala ayenera kuwatchula kwa madokotala awo pa nthawi yoyesera magazi. Potsirizira pake, ngati palibe zolembera zapamwambazi, munthu ayenera kugwiritsa ntchito PSA yopambana powerengera kansa ya kansa.
Matenda
Lipoti la biopsy limasungidwa mu gawo la chithunzichi. Chidziwitso cha prostate chosakanikirana chingaphatikizepo kulikonse kuyambira 6 mpaka 20 kapena kuposa biopsy cores. Chidziwitso kuchokera ku chikhalidwechi chagawidwa m'magulu atatu odziimira. Chigawo chimodzi chikugwirizana ndi kalasi ya kansa, yotchedwa Gleason . Zina ziwiri zikugwirizana ndi kuchuluka kwa khansa yomwe imapezeka. Tiyeni tiyambe kutsegula ndalamazo poyamba:
- Chiwerengero cha mankhwala omwe ali ndi khansara chimapereka mphamvu ya kukula kwa chotupacho. Mwachitsanzo, kukhala ndi ziwalo zinayi za khansa kuchokera m'magazi asanu ndi limodzi kumasonyeza kuti chotupa chabwino kwambiri chikupezeka, popeza theka la mankhwalawa ali ndi khansara. Komabe, chitsanzo china chiyenera kukhala ndi ziwalo ziwiri za khansa zomwe zimachokera ku makutu 20, zomwe zikhoza kutanthauza kuti chotupacho ndi chochepa.
- Ndifunikanso kuganizira momwe khansara imakhalira mkati mwa biopsy core. Kudziwa kuti chiwerengero cha minofu ya khansa pachimake chimathandizira kudziwa kukula kwa chifuwacho (kutanthauza momwe khansa ikukula ndi kufalikira). Wodwala yemwe amayang'ana pachimake ndi microscope angathe kuweruza momwe chiwerengero chake chimayambira ndi khansara ndi momwe zilili zambiri zomwe zimakhala ndi prostate gland minofu. Zambirizi zikhoza kufotokozedwa m'njira ziwiri: Choyamba, zikhoza kuwonetsedwa ngati chiwerengero cha mamilimita a khansa (1 mpaka 18, ndi 18 yomwe ikuyimira kutalika kwa msinkhu wonse). Mwinanso, kuchuluka kwa khansa pachimake kungawonongeke ngati peresenti ya chiwerengero chonse. Kawirikawiri, lipoti la matendawa limapereka chidziwitso ichi monga magawo awiri ndi chiwerengero cha mamilimita. Kotero kuchuluka kwa khansara kumatha kumvetsetsedwa ndi chiwerengero cha mankhwala omwe ali ndi khansara komanso momwe khansa iliyonse imakhalira, monga momwe imafotokozera mulimita kapena peresenti.
- Pamene anthu amaganiza za prostate biopsy, chiwerengero cha Gleason, chomwe chimasonyeza kalasi ya kansa, kawirikawiri ndi chinthu choyamba chimene chikubwera m'maganizo, ndipo ndiko kulingalira kolondola. Kalasi ikuwonetsa momwe maselo a khansa amaonekera, ndipo ndi ofunikira kwambiri kuposa kukula kwa chotupacho. Mwachitsanzo, ndibwino kuti mukhale ndi chotupa chachikulu kwambiri kuposa kalasi yambiri ya kalasi 10.
Gleason grading system yapangidwa zaka zambiri zapitazo, ndipo, motero, ili ndi quirks. Mwachitsanzo, malipiro otsika kwambiri ndi 6 ndipo apamwamba kwambiri ndi 10. Gawo la Gleason limene lidalembedwa ngati 6 lidzalembedwa ngati 3 + 3 = 6. A Gleason nine adzalembedwa ngati 4 + 5 = 9 kapena monga 5 + 4 = 9. Ngati biopsy ili ndi zolemba zambiri, malipoti ochokera ku lipoti ndi omwe ayenera kulowa nawo mafunso.
Gawo | Kufotokozera |
T1 kapena "A" | T1c: Kutupa sikungamvekenso ndi kuwerengera kwa digito |
T2 kapena "B" | Kutupa kumakhala mkati mwa prostate T2a : Tumimba imamva ndi DRE koma yosachepera theka la lobe imodzi T2b : Chotupa chimodzi chokha chomwe chinamveka ndi DRE chophatikizapo theka la lobe imodzi T2c : Chotupa chamtundu umodzi chinamvekedwa m'malalo onse awiri |
T3 kapena "C" | Kutupa kumamveka ndi DRE yomwe imadutsa mu capsule ya prostate T3a : Kutambasula kwa Extracapsular T3b : Kutupa kumamverera ndi DRE yomwe imayambitsa mitsempha ya seminal (s) |
T4 | Kutupa kumamverera ndi DRE yomwe imayambitsa rectum kapena chikhodzodzo |
Zotsatira Zowonjezera
Zotsatira kuchokera ku mayesero a prostate, omwe amawatcha kuti digiti ya digito, kapena " DRE ", amatchedwa siteji yachipatala kapena T. Pakati penipeni pamakalata opita patsogolo, kawirikawiri kumalo omwe amadziwika kuti "Kuyeza Thupi," adokotala adzalemba ngati akumva ngati ali ndi nkhono. Ndondomeko ya chiwerengero imene madokotala amagwiritsa ntchito kulembetsa zomwe anapeza mu tchatiyi akuwonetsedwa mu tebulo ili m'munsiyi. Kuti muyankhe mafunsowa muyenera kudziwa T yanu.
Malipoti a Radiology (Imaging Studies)
Kufotokozera za malingaliro alionse omwe wodwalayo ali nawo kudzapezeka mu Radiology gawo la tchati. Mauthengawa amalembedwa ndi katswiri wa zamagetsi, katswiri wodziwa kuwerenga. Chidziwitso chofunika kwambiri chomwe chili mu lipoti la mauthenga a radiology chafotokozedwa mwachidule mu gawo lotchedwa "Kusindikiza." Kuti cholinga cha mafunsowo, mfundo zofunika kwambiri zowonongeka kuchokera ku lipoti la prostate MRI ndi kukhalapo kwa chimodzi kapena zingapo zotsatirazi: extracapsular kutambasula, kuthamanga kwa mthupi, kapenanso kufalikira kwa mitsempha.
Zojambula zina, kawirikawiri phokoso la fupa kapena CT scan ya m'mimba ndi pelvis (kufunafuna mitsempha yotambasula), ikhoza kuchitidwa, makamaka mwa amuna omwe PSA ili pamwamba pa khumi kapena omwe Gleason ali ndipamwamba kuposa 6. Pamene CT kapena Kugwiritsira ntchito fupa kumatenda a kansa ya mitsempha, ndikofunika kuzindikira malo a metastases komanso, ngati metastases ali m'magulu a mitsempha kapena m'madera ena a thupi. Chowongolera chatsopano chotchedwa Axumin chimagwiritsa ntchito positron emission tomography (PET) ndipo ndi yolondola kwambiri kuposa CT. Pamene zinthu zikuyima panopo, Axumin ndizovomerezedwa ndi FDA pokhapokha ngati anthu akuyambiranso matenda (PSA ikuphuka) pambuyo poti opaleshoni kapena mazira.
Kodi Chithandizo Chamtundu Choyamba cha Khansa ya Prostate?
Chinthu chotsiriza chomwe mungaganizire mukatenga mafunso a PCRI ndi ngati pakhala pali chithandizo chamtundu wa kansa ya prostate. Amuna amene adzizidwa kale ndi opaleshoni, ma radiation, cryotherapy, kapena blockade omwe amachititsa kuti PSA ikule bwino, amakhala ndi khansa ya prostate yowonjezereka ndipo amapatsidwa gawo losiyana. Komabe, sikuti nthawi zonse zimakhala zovuta kudziwa zomwe zimayambitsa khansa. PSA yowonjezera kawirikawiri ndi chizindikiro cholondola, koma odwala ayenera kudziŵa zina mwachinsinsi za khansa yobwezeretsanso.
PSA Inayamba Patapita Opaleshoni
Kuwunika PSA pambuyo pochita opaleshoni ndi kosavuta. PSA, pambuyo pake, ikuyembekezeka kukhala zero kamodzi kokha prostate gland yatachotsedwa kwathunthu. Komabe, kuchotsedwa kwathunthu kwa mankhwalawa si kophweka ndipo pang'ono puloteni ingasiyidwe mmbuyo. Izi zikachitika, PSA ikhoza kuima mpaka kalekale mpaka pa 0,1 mpaka 0.3, ngakhale palibe khansa. Amuna omwe ali ndi zipsyinjo zochepa kwambiri za PSA pambuyo pa opaleshoni angathe kulingalira zachangu mwamsanga mankhwala ndi kuyang'anira PSA yawo mosamala kuti awone ngati pali zakunja. Chithandizo chingalephereke ngati PSA ikukhazikika. Pamene PSA imakhala yokhazikika, PSA ikhoza kuwonjezereka chifukwa cha kupweteka kwa prostate gland m'malo mwa khansara.
PSA ikukwera pambuyo pa mazira
Kuwunika PSA pambuyo pa ma radiation kungakhale kovuta. Monga chiyambi chovuta, ganizirani PSA kukwera pamwamba pa 1.0 kukhala "yachilendo." Koma pali zosiyana. N'zotheka kukhala ndi PSA pamwamba pa 1.0 ndikukhalabe wopanda khansa. Mitambo ya PSA yosasunthika imapezeka makamaka kawirikawiri pambuyo poizoni, makamaka pambuyo poizoni. Zokwera izi zimatchedwa "PSA bounce." Kupweteka kumakhulupirira kuti kumabwera chifukwa cha kutupa kwa prostate, kutanthauza, prostatitis . Ndikumangoganizira, chofunikira kwambiri ndicho kusiyanitsa ndi khansara. Njira yodalirika kwambiri yochitira izi ndiyo kuyang'ana galasi lopitirira la ma PSA angapo omwe atengedwa nthawi. PSA kuchokera ku khansa yowonongeka imaonetsa kuti ndi yosalala, yosasunthika, yopita patsogolo. Popeza kupwetekedwa kumayambitsidwa ndi kutupa, ma PSA awa amawoneka sera ndipo amawombera, oscillating mmwamba ndi pansi pa grafu muzithunzi za zig-zag, kapangidwe ka spiking.
Kuwunika Hormonal Therapy
Kuthamanga kwa mahomoni kumatanthawuza kuti PSA yowonjezereka ngakhale kuti m'matumbo a testosterone ndi otsika kwambiri. Maseŵera a PSA ayenera kuwonedwanso panthawi yoyamba ya mankhwala a mahomoni komanso mosalekeza. Kuzindikira kusamvana kwa hormone blockade ndi kosavuta chifukwa PSA iyenera kuchepa nthawi yosachepera 0.1 mkati mwa miyezi 6 mpaka 8 yoyamba kutuluka kwa hormone blockade. Ngati izi sizikuchitika, nthawi zambiri zikutanthauza kuti PSA idzayamba kudzera posachedwa.
Kutsiliza
Pamene mukuganizira njira zosiyanasiyana za chithandizo chamankhwala, muyenera kupenda chithunzi chanu chachipatala ndikukwaniritsa mafunso a PCRI kuti mudziwe malo omwe mukudwala khansa. Kumvetsetsa momwe mungapangire kansera yanu nokha kudzakumanga ndi kuzindikira koyenera kuti musankhe njira yabwino yothandizira ndikuthandizani kuti mukhale ndi moyo wabwino komanso kuti mukhale ndi moyo wathanzi.