Malo amtundu wa prostate gland , omwe ali mkati mwa mammita a chikhodzodzo ndi kachilomboka, amatanthauza kuti orologists sangathe kudula chigawo chachikulu pamtunda. Kupaka chikhodzodzo kapena chikhodzodzo sichoncho. Mwamwayi, ngati khansa ya wodwalayo ikukula kupyola mu capsule, osati kudula khansara, dotoloyo adzakakamizidwa kudula khansa pamene akuyesera kuchotsa mkaka.
Izi zikachitika zimatchedwa "zabwino pamtunda."
Kusiya khansara kumakhala kolephera kwambiri. Ndipotu, ngati khansara sichichotsedweratu, n'chifukwa chiyani opaleshoniyi imachotsedwa? Chowonadi n'chakuti musanayambe kugwira ntchito nthawi zonse mumakhala osatsimikiza za kukula kwa khansa. Pa opaleshoni, matenda ochepa kwambiri omwe ali kunja kwa prostate ndi osaoneka ndi maso. Kumbukirani kuti kalembedwe ka prostate kachipatala kanapangidwa kale pamene onse khansa ankaonedwa kuti kuika moyo ndi opaleshoni ndiyo njira yokhayo yomwe ilipo. Kalelo, teknoloji ya ma radiation inali yochepa kwambiri. Machiritso ochiritsira anali otsika kwambiri ndi ma radiation ndi zotsatira zowopsa zinali zoipitsitsa.
Kujambula kwamakono ndi MRI ya 3T yambiri imayambitsidwa opaleshoni, ngakhale yopanda ungwiro, ikhoza kuthetsa kupanga opaleshoni kwambiri. Mwamwayi, ndi ochepa chabe mwa amuna 70,000 omwe akuchitidwa opaleshoni chaka chilichonse popindula ndikukonza opaleshoni asanachite opaleshoni.
Tikukhulupirira, mfundo iyi idzasintha.
Chifukwa cha matendawo omwe tatchulidwa pamwambapa, khansara, pafupipafupi, yatsalira m'mthupi la wodwala kulikonse kuyambira 10 mpaka 50 peresenti ya nthawiyo. Njira yoyamba imabwera kwa wodwalayo masiku angapo pambuyo pa opaleshoniyo. Pambuyo pochotsedwa, prostate imafufuzidwa mu labotale ndi dokotala wapadera wotchedwa katswiri wa zachipatala.
Prothate imakonzedwa kuti iwonongeke pang'ono pokhapokha mwaiyikamo mu botolo la inki kuti mbali yonse yakunja ya gland iphimbidwe. Kenaka chidebecho chimachepetsedwa kumalo oonda kwambiri ndi kupatsidwa malire ku malo omwe khansayo ili. Wodwalayo amamvetsera kwambiri pamphepete mwa chigoba mwa kuigwiritsa ntchito pansi pa microscope. Ngati chotupachi chikuwonetseredwa kuti "chowongolera" pa malo osakanikirana, zikutanthauza kuti scalpel ya opaleshoni imadulidwa kupyolera mu chifuwa panthawi ya opaleshoni, kusiya chotupa kumbuyo kwa thupi la wodwalayo.
Kukhalapo kwa malire abwino kungakhale kovuta kwambiri malinga ndi chiwerengero cha Gleason ndi kukula kwake kwazitali. Pakati pa gululo, chiopsezo chachikulu cha kubwerera kwa khansa m'tsogolo mwa amuna omwe ali ndi mizere yabwino ndi pafupifupi 50 peresenti. Komabe, pamene chiwerengero cha Gleason chiri chapamwamba kapena ngati m'mphepete mwachitsulo ndizowonjezereka, chiopsezo cha kubwerera m'tsogolo chikhoza kufika pafupifupi 100 peresenti.
Chithandizo Chamankhwala Pamene Mitsinje Ili Yabwino
Kusankha chithandizo chamankhwala pambuyo pa opaleshoni pamene ma margins ali abwino zingakhale zovuta. Njira imodzi ndiyo kungoona zomwe zikuchitika pamene kuyang'anitsitsa mayendedwe a PSA. Njirayi ndi yokongola kwambiri pamene chiwerengero cha Gleason chiri chocheperapo ndipo m'mitsinje yowonjezera ilipobe.
Amuna omwe akhalabe mu chikhululukiro amatha kupewa zotsatira zokhudzana ndi chithandizo kuchokera ku dzuwa. Komanso, mu nthawi ino ya sayansi yamakono yopititsa patsogolo, amuna omwe amayamba kuchepetsa chithandizo cha zaka za PSA zomwe zikukwera pansi pamsewu akhoza kukhala agogo aamuna m'nthaŵi yabwino ya mankhwala omwe alibe poizoni ndi ogwira mtima.
Kwa amuna omwe amasankha kufufuza, PSA kuwunika ayenera kuchitidwa ndi teknoloji yopanda mphamvu. Ndiye, ngati PSA ikukwera, chithandizo chikhoza kuyambika posachedwa, pamene PSA ili yosakwana 0.1. Mankhwalawa ndi abwino kwambiri pamene mankhwala ayambitsidwa pamunsi wa PSA.
Pamene mapulogalamu opangira opaleshoni ali abwino, kafukufuku wambiri amasonyeza kuti nthawi yomweyo ma radiation ndi prostate fossa amachepetsa kuchepa kwa chiwerengero chake ndipo amatha kusintha pang'ono zaka khumi zopulumuka. Komabe, popeza anthu 50 peresenti amatha kubwerera m'mbuyo, kuyembekezera umboni wa kuphulika kwa PSA musanayambe kutuluka kwa dzuwa kungakhale njira yowonjezera. Kawirikawiri, ntchito yofufuzira ili ndi kufufuza PSA miyezi itatu iliyonse. Mazira amayamba ngati PSA ikukwera pamwamba pa 0.1 kapena 0.2.
Mayeza ndi omwe amachititsa kuti anthu azitha kuchitidwa opaleshoni. Pamene ma radiation nthawi zambiri amagwira ntchito, kuthekera kwa maselo osakanikirana ochepa kunja kwa prostate fossa kumalo ena a thupi kumayenera kuganiziridwa. Kuwala kwa fossa yekha sikungakhale kochepetsera ngati matendawa afalikira. Mwatsoka, chotsimikizirika chomaliza pa kukhalapo kapena kupezeka kwa maselo osakanikirana kwambiri sichidziwikiratu. Palibe sayansi yamakono imene imazindikira kuti matenda aakulu ndi 100 molondola.
Akatswiri odziwa bwino maphunziro adziŵa mwazidziwitso kuti miyeso yaying'ono kwambiri imakhalapo pamene chiwerengero cha Gleason chili ndipamwamba komanso kuti mapiritsi opangira opaleshoni ali ochuluka kwambiri. Muzochitika izi, munda wa radiation uyenera kuti uwonjezeke kuti uphimbe mitsempha yam'mimba. Mankhwala opanga mahomoni ndi Lupron amakhalanso akulimbikitsidwa.
Makhalidwe Abwino Ambiri
Kuwunika khansara ya prostate popanda chithandizo chamankhwala sikuyenera kwa amuna omwe ali ndi mizere yambiri. Mipata yambiri imatanthawuza kuti khansara yoyamba inali yaikulu komanso yapamwamba. Pulojekiti yowunika pazifukwa izi si yoyenera chifukwa khansa yaukali idzabwereranso nthawi ina. Kuchepetsa chithandizo kumangowonjezera nthawi yambiri kuti khansa ikule ndi kufalikira.
Amuna omwe ali ndi mitsempha yambiri pambuyo poti opaleshoni ayenera kuyang'aniridwa ndi njira yothandizira multimodality yomwe imaphatikizapo ma radiation, mankhwala a mahomoni komanso mwinamwake ngakhale chemotherapy. Kwenikweni, ndi nthawi yopanga nkhanza, yomaliza pofuna kuchiza matenda. Pali kusiyana kwakukulu pakati pa akatswiri pankhani yeniyeni yowonjezera. Komabe, kawirikawiri, mapulogalamu amachilombo amayamba kufanana ndi momwe matenda omwe angoyambitsidwira amatha kuyang'aniridwa (onani m'munsimu). Mapulojekiti amachitiranso kuwonjezera pa mavitamini amphamvu monga Xtandi kapena Zytiga kapena kuwonjezera tizilombo toyambitsa matenda ndi mankhwala otchedwa Taxotere.
Ndibwino kudikira miyezi ingapo mutangoyamba kumene ntchito musanayambe kumwa mankhwala. Izi zimapereka nthawi yowuchiritsa ndipo mwachiyembekezo zimathandiza kuti kubwezeretsa mkodzo musanayambe kumwa mankhwala. Powonjezereka, pakuyembekeza kuti ntchito yokhala erectile idzayambiranso, njira yomwe ingafunikire kwa zaka ziwiri, kawirikawiri siyongokhala yochenjera. Poganiza kuti panalibe mavuto omwe sanaganizidwe, mankhwala a hormone ndi Lupron ndi Casodex ayambitsidwa ndipo anapitiriza kwa miyezi 12-18. Kuyankhulana ndi katswiri wothandizidwa ndi mawotchi, omwe ali ndi chidziwitso chochiza nthendayi yamatumbo, amapezedwanso.
Malangizo omwe nthawi zambiri amapereka kwa amuna omwe ali ndi mizere yambiri, ndiyotayira mankhwala omwe amawaika pa prostate fossa ndi mitsempha yamimba. Nthata za m'mimba ndizoyamba kudumphira pa khansara ngati ikufalikira. Dzuwa limayamba pafupifupi masiku 60 kuchokera pamene Lupron ndi Casodex zinayambika. (Mankhwala otchedwa hormone akugwiritsidwa ntchito ndi zotsatira zina zingapo, zina zomwe zingathe kuchepetsedwa ndi mankhwala, zakudya ndi masewero olimbitsa thupi.) Ndikulangiza kuti anthu onse akulingalira kuwerenga nkhani yomwe ndalemba pa mutu uwu.
Pambuyo pomaliza mankhwala opangidwa ndi ma radiation ndi mahomoni, kuyang'anira nthawi zonse n'kofunika. Maselo a Testosterone ndi PSA amayang'aniridwa miyezi itatu iliyonse kwa zaka ziwiri, ndiye miyezi sikisi iliyonse kwa zaka zitatu zotsatira. Kuunika kwa Testosterone kungayime kamodzi kawiri kawiri kawiri kawiri. Amuna onse amene akhala ndi ma radiation, ngakhale omwe adachiritsidwa, adzafunikanso kuwunikira chaka chilichonse chifukwa cha chiopsezo cha zilonda zam'mimba za chikhodzodzo kapena chikhodzodzo. Ngakhale kuti zotupazi ndizosawerengeka, kuyambira msanga kumatulutsa mankhwala ochepa kwambiri, owopsa kwambiri.