Types/bladder/patient/bladder-treatment-pdq

Chithandizo cha Khansa ya Chikhodzodzo (®) -Patient Version

Zambiri Zokhudza Khansa ya Chikhodzodzo

MFUNDO ZOFUNIKA

• Khansara ya chikhodzodzo ndimatenda momwe maselo owopsa (khansa) amapangika m'matumba a chikhodzodzo.
• Kusuta kumatha kusokoneza khansa ya chikhodzodzo.
• Zizindikiro za khansa ya chikhodzodzo zimaphatikizapo magazi mkodzo komanso kupweteka pokodza.
• Kuyesa komwe kumayesa mkodzo ndi chikhodzodzo kumagwiritsidwa ntchito kuthandiza kupeza (kupeza) ndikupeza khansa ya chikhodzodzo.
• Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Khansara ya chikhodzodzo ndimatenda momwe maselo owopsa (khansa) amapangika m'matumba a chikhodzodzo.

Chikhodzodzo ndi chiwalo chobowoka m'munsi mwa mimba. Amapangidwa ngati chibaluni chaching'ono ndipo amakhala ndi khoma lolimba lomwe limalola kuti likule kapena kucheperako posungira mkodzo wopangidwa ndi impso. Pali impso ziwiri, imodzi mbali iliyonse ya msana, pamwamba pa chiuno. Timachubu ting'onoting'ono ta impso timasefa ndikuyeretsa magazi. Amatulutsa zonyansa ndikupanga mkodzo. Mkodzo umadutsa kuchokera ku impso iliyonse kudzera mu chubu lalitali lotchedwa ureter kupita m'chikhodzodzo. Chikhodzodzo chimagwira mkodzo mpaka umadutsa mu mtsempha ndi kutuluka mthupi.

Kutengera kwamkodzo wamwamuna (kumanzere) ndi kwamikodzo yachikazi (kumanja) kuwonetsa impso, ureters, chikhodzodzo, ndi urethra. Mkodzo umapangidwa mu ma tubules amphongo ndipo umasonkhanitsa muimpso ya impso iliyonse. Mkodzo umayenda kuchokera ku impso kudzera mu ureters kupita ku chikhodzodzo. Mkodzo umasungidwa mu chikhodzodzo mpaka umachoka mthupi kudzera mu mtsempha wa mkodzo.

Pali mitundu itatu ya khansara ya chikhodzodzo yomwe imayamba m'maselo akhungu la chikhodzodzo. Khansa iyi imadziwika ndi mtundu wamaselo omwe amakhala owopsa (khansa):

• Transitional cell carcinoma: Khansa yomwe imayamba m'maselo mkatikati mwa chikhodzodzo. Maselowa amatha kutambasula pamene chikhodzodzo chadzaza ndikucheperachepera. Khansa yambiri ya chikhodzodzo imayamba m'maselo osinthika. Transitional cell carcinoma imatha kukhala yotsika kapena yotsika kwambiri:

• Kusintha kwakanthawi kochepa kwa carcinoma kumabwereranso (kubwerera) atalandira chithandizo, koma sikumafalikira kwambiri mu chikhodzodzo cha chikhodzodzo kapena mbali zina za thupi.

• Matenda apamwamba a cell carcinoma nthawi zambiri amabwereranso (kubwerera) atalandira chithandizo ndipo nthawi zambiri amafalikira muminyewa ya chikhodzodzo, mbali zina za thupi, ndi ma lymph node. Pafupifupi onse omwe amafa ndi khansa ya chikhodzodzo amachitika chifukwa cha matenda apamwamba.

• Squamous cell carcinoma: Khansa yomwe imayamba m'maselo oopsa (maselo ofooka, osanjikiza omwe amakhala mkati mwa chikhodzodzo). Khansa imatha kupangika mutatenga kachilombo kwa nthawi yayitali kapena kukwiya.

• Adenocarcinoma: Khansa yomwe imayamba m'maselo am'magazi omwe amapezeka mkatikati mwa chikhodzodzo. Maselo am'matumbo mu chikhodzodzo amapanga zinthu monga ntchofu. Uwu ndi mtundu wochepa kwambiri wa khansa ya chikhodzodzo.

Khansa yomwe ili m'mbali mwa chikhodzodzo imatchedwa khansa yapachikhodzodzo. Khansa yomwe yafalikira kupyola mu chikhodzodzo ndipo imalowa mu khoma la chikhodzodzo kapena yafalikira ku ziwalo zapafupi ndi ma lymph node amatchedwa khansa ya chikhodzodzo.

Onani zidule za zotsatirazi kuti mumve zambiri:

• Kuchiza Khansa Yam'magazi Amphongo

• Khansa Yosintha Yamtundu wa Renal Pelvis ndi Ureter Treatment

• Chikhodzodzo ndi Kuwona Khansa Yina ya Urothelial

• Khansa Yachilendo Ya Chithandizo Chaubwana

Kusuta kumatha kusokoneza khansa ya chikhodzodzo.

Chilichonse chomwe chimakulitsa mwayi wanu wodwala chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala ngati mukuganiza kuti mutha kukhala pachiwopsezo cha khansa ya chikhodzodzo.

Zowopsa za khansa ya chikhodzodzo ndi izi:

• Kugwiritsa ntchito fodya, makamaka kusuta ndudu.

• Kukhala ndi mbiri yapa khansa ya chikhodzodzo.

• Kukhala ndi kusintha kwakuthupi komwe kumalumikizidwa ndi khansa ya chikhodzodzo.

• Kuwululidwa ndi utoto, utoto, zitsulo, kapena zopangidwa ndi mafuta kuntchito.

• Chithandizo cham'mbuyomu chothandizidwa ndi cheza m'chiuno kapena ndi mankhwala ena a anticancer, monga cyclophosphamide kapena ifosfamide.

• Kutenga Aristolochia fangchi, zitsamba zaku China.

• Kumwa madzi pachitsime chomwe chili ndi arsenic yambiri.

• Kumwa madzi omwe amathandizidwa ndi chlorine.

• Kukhala ndi mbiri ya matenda a chikhodzodzo, kuphatikizapo matenda a chikhodzodzo omwe amayamba ndi Schistosoma haematobium.

• Pogwiritsa ntchito makina opangira mkodzo kwa nthawi yayitali.

Ukalamba umakhala pachiwopsezo cha khansa zambiri. Mwayi wokhala ndi khansa ukuwonjezeka mukamakula.

Zizindikiro za khansa ya chikhodzodzo zimaphatikizapo magazi mkodzo komanso kupweteka pokodza.

Zizindikiro ndi zizindikilozi zimatha kubwera chifukwa cha khansa ya chikhodzodzo kapena zina. Funsani dokotala ngati muli ndi izi:

• Magazi mkodzo (dzimbiri pang'ono pang'ono mpaka utoto wofiyira).

• Kukodza pafupipafupi.

• Ululu pokodza.

• Kuchepetsa kupweteka kwa msana.

Kuyesa komwe kumayesa mkodzo ndi chikhodzodzo kumagwiritsidwa ntchito kuthandiza kupeza (kupeza) ndikupeza khansa ya chikhodzodzo.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuwunika kwakuthupi ndi mbiri : Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikiza kuyang'ana ngati pali matenda, monga zotupa kapena china chilichonse chomwe chikuwoneka chachilendo. Mbiri yokhudzana ndi thanzi la wodwalayo komanso matenda am'mbuyomu komanso chithandizo chamankhwala adzachitidwanso.

• Kuyesa kwamkati : Kuyezetsa kumaliseche ndi / kapena rectum. Dokotala amalowetsa zala zopaka mafuta, zotsekedwa mu nyini ndi / kapena rectum kuti mumve zotupa.

• Urinalysis : Kuyesa kuyesa mtundu wa mkodzo ndi zomwe zili mkatimo, monga shuga, mapuloteni, maselo ofiira, ndi maselo oyera amwazi.

• Urine cytology : Kuyesa kwa labotale komwe mayeso amkodzo amayang'aniridwa ndi microscope yama cell osazolowereka.

• Cystoscopy : Njira yoyang'ana mkati mwa chikhodzodzo ndi urethra kuti muwone ngati pali zovuta zina. Cystoscope imayikidwa kudzera mu urethra kupita mu chikhodzodzo. Cystoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu, yomwe imayang'aniridwa ndi microscope ngati ili ndi khansa.

Zojambulajambula. Chombo chotchedwa cystoscope (chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera) chimayikidwa kudzera mu mtsempha kulowa mu chikhodzodzo. Madzi amagwiritsidwa ntchito kudzaza chikhodzodzo. Dokotala amayang'ana chithunzi cha khoma lamkati la chikhodzodzo pamakina owonera makompyuta.

Intravenous pyelogram (IVP): Mndandanda wa ma x-ray a impso, ureters, ndi chikhodzodzo kuti mudziwe ngati khansa ilipo m'ziwalozi. Utoto wosiyana umabayidwa mumtsempha. Pamene utoto wosiyanitsa umadutsa mu impso, ureters, ndi chikhodzodzo, ma x-ray amatengedwa kuti awone ngati pali zotchinga zilizonse.

Biopsy: Kuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwalayo kuti aone ngati ali ndi khansa. Chidziwitso cha khansara ya chikhodzodzo chimachitika nthawi ya cystoscopy. Zitha kukhala zotheka kuchotsa chotupa chonse nthawi ya biopsy.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Kulosera (mwayi wochira) zimatengera izi:

• Gawo la khansara (kaya ndi la khansa kapena lachikhodzodzo, kapena ngati lafalikira m'malo ena m'thupi). Khansara ya chikhodzodzo koyambirira imatha kuchiritsidwa.

• Mtundu wa maselo a khansa ya chikhodzodzo komanso momwe amawonekera pansi pa microscope.

• Kaya kuli carcinoma in situ mbali zina za chikhodzodzo.

• Msinkhu wa wodwalayo komanso thanzi lake lonse.

Ngati khansara ndichachidziwikire, kuyerekezera kumatengera izi:

• Pali zotupa zingati.

• Kukula kwa zotupa.

• Kaya chotupacho chayambiranso (kubwerera) mutalandira chithandizo.

Njira zamankhwala zimadalira gawo la khansa ya chikhodzodzo.

Magawo a Khansa ya Chikhodzodzo

MFUNDO ZOFUNIKA

• Khansa ya chikhodzodzo itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa chikhodzodzo kapena mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

• Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

• Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya chikhodzodzo:

• Gawo 0 (Noninvasive Papillary Carcinoma ndi Carcinoma ku Situ)

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

Khansa ya chikhodzodzo itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa chikhodzodzo kapena mbali zina za thupi.

Njira yomwe amagwiritsidwa ntchito pofufuza ngati khansara yafalikira mkati mwa chikhodzodzo ndi minofu kapena mbali zina za thupi amatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo. Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito pokonza:

• CT scan (CAT scan) : Njira yomwe imapanga zithunzi zingapo zamatupi amthupi, zojambulidwa mosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography. Pofuna kupanga khansa ya chikhodzodzo, CT scan ikhoza kujambula chifuwa, pamimba, ndi m'chiuno.

• MRI (magnetic resonance imaging) : Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kuti ipange zithunzi zingapo za magawo amkati mwa thupi, monga ubongo. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

• PET scan (positron emission tomography scan) : Njira yopezera maselo oyipa mthupi. Gulu laling'ono la shuga (radio) limabayidwa mumtsempha. Chojambulira cha PET chimazungulira thupi ndikupanga chithunzi cha komwe glucose imagwiritsidwa ntchito mthupi. Maselo otupa owopsa amawonekera pachithunzichi chifukwa amakhala otanganidwa ndipo amatenga shuga wambiri kuposa momwe maselo amachitira. Izi zimachitika kuti muwone ngati pali zotupa m'matumbo.

• X-ray pachifuwa: X-ray ya ziwalo ndi mafupa mkati mwa chifuwa. X-ray ndi mtundu wa mphamvu yamphamvu yomwe imatha kupyola thupi ndikupita mufilimu, ndikupanga chithunzi cha madera omwe ali mthupi.

Kujambula mafupa: Njira yowunika ngati pali magawo omwe amagawa mwachangu, monga maselo a khansa, m'mafupa. Katundu wocheperako kwambiri wa jakisoni amalowetsedwa mumtsempha ndikuyenda m'magazi. Zinthu zowononga nyukiliya zimasonkhanitsa m'mafupa omwe ali ndi khansa ndipo imadziwika ndi sikani.

Pali njira zitatu zomwe khansa imafalikira mthupi.

Khansa imatha kufalikira kudzera mu minofu, ma lymph system, ndi magazi:

• Minofu. Khansara imafalikira kuchokera pomwe idayamba ndikukula kupita kumadera oyandikana nawo.

• Lymph dongosolo. Khansara imafalikira kuchokera pomwe idayamba polowa m'mitsempha. Khansara imadutsa m'mitsempha yamafuta kupita mbali zina za thupi.

Magazi. Khansara imafalikira kuchokera pomwe idayamba ndikulowa m'magazi. Khansara imadutsa m'mitsempha yamagazi kupita mbali zina za thupi.

Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

Khansa ikafalikira mbali ina ya thupi, imatchedwa metastasis. Maselo a khansa amachoka pomwe adayamba (chotupa choyambirira) ndikuyenda mumitsempha kapena magazi.

• Lymph dongosolo. Khansara imalowa mumitsempha, imadutsa m'mitsempha yamafuta, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

• Magazi. Khansara imalowa m'magazi, imadutsa m'mitsempha yamagazi, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

Chotupa cha metastatic ndi khansa yofanana ndi chotupa chachikulu. Mwachitsanzo, ngati khansara ya chikhodzodzo ifalikira mpaka fupa, maselo a khansa omwe ali m'mafupawo ndi omwe amakhala ndi khansa ya chikhodzodzo. Matendawa ndi khansa ya chikhodzodzo, osati khansa ya m'mafupa.

Imfa yambiri ya khansa imayamba khansa ikamachoka pachotupa choyambirira ndikufalikira kumatenda ena ndi ziwalo. Izi zimatchedwa khansa ya m'matumbo. Makanema ojambulawa amawonetsa momwe ma cell a khansa amayendera kuchokera mthupi momwe adapangidwira kumadera ena amthupi.

Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya chikhodzodzo:

Gawo 0 (Noninvasive Papillary Carcinoma ndi Carcinoma ku Situ)

Khansa 0 khansa ya chikhodzodzo. Maselo achilendo amapezeka mumkati mwa chikhodzodzo. Gawo 0a (lomwe limatchedwanso noninvasive papillary carcinoma) limawoneka ngati zophuka zazitali, zopyapyala zomwe zimakula kuchokera pachikhodzodzo. Gawo 0is (lomwe limadziwikanso kuti carcinoma in situ) ndi chotupa chathyathyathya pamisempha yomwe ili mkati mwa chikhodzodzo.

Pa gawo 0, maselo osadziwika amapezeka mumisempha mkati mwa chikhodzodzo. Maselo achilendowa amatha kukhala khansa ndikufalikira m'minyewa yabwinobwino. Gawo 0 lagawidwa magawo 0a ndi 0is, kutengera mtundu wa chotupacho:

• Gawo 0a limatchedwanso noninvasive papillary carcinoma, lomwe lingawoneke ngati zophuka zazitali, zopyapyala zomwe zimamera kuchokera pachikhodzodzo.

• Gawo 0is limatchedwanso carcinoma in situ, lomwe ndi chotupa chathyathyathya paminyewa yomwe ili mkati mwa chikhodzodzo.

Gawo I

Gawo khansa ya chikhodzodzo. Khansara yafalikira mpaka m'mbali zamagulu olumikizirana pafupi ndi mkanda wamkati mwa chikhodzodzo.

Pachigawo choyamba ine, khansara yakhala ikufalikira ndikufalikira mpaka kumapeto kwa minofu yolumikizana pafupi ndi mkatikati mwa chikhodzodzo.

Gawo II

Khansara yachiwiri ya chikhodzodzo. Khansara yafalikira ku zigawo za minofu ya chikhodzodzo.

Gawo lachiwiri, khansa yafalikira mpaka minyewa ya chikhodzodzo.

Gawo III

Gawo lachitatu lagawidwa magawo IIIA ndi IIIB.

• Mu gawo IIIA:

• khansara yafalikira kuchokera mu chikhodzodzo mpaka mafuta osanjikiza chikhodzodzo ndipo mwina yafalikira ku ziwalo zoberekera (prostate, zotupa zam'mimba, chiberekero, kapena kumaliseche) ndipo khansa siyinafalikire ku ma lymph node; kapena

• Khansara yafalikira kuchokera mu chikhodzodzo kupita ku lymph node imodzi m'chiuno yomwe siili pafupi ndi mitsempha yodziwika bwino (mitsempha yayikulu m'chiuno).

Khansa ya chikhodzodzo IIIA Khansara yafalikira kuchokera ku chikhodzodzo kufika (a) mafuta ozungulira chikhodzodzo ndipo atha kufalikira ku prostate ndi / kapena zotupa m'mimba mwa abambo kapena chiberekero ndi / kapena nyini mwa akazi, ndipo khansa siyinafalikire ku ma lymph node; kapena (b) lymph lymph node in the pelvis that is not near the common iliac mishipa.

• Gawo IIIB, khansara yafalikira kuchokera mu chikhodzodzo kupita ku mitsempha yopitilira imodzi m'mimba yomwe siili pafupi ndi mitsempha yodziwika bwino ya mitsempha kapena kwa lymph node imodzi yomwe ili pafupi ndi mitsempha yodziwika bwino.

Khansa IIIB khansa ya chikhodzodzo. Khansa yafalikira kuchokera mu chikhodzodzo kupita ku (a) ma lymph node opitilira m'mimba mwake omwe sakhala pafupi ndi mitsempha yodziwika bwino ya iliac; kapena (b) lymph node imodzi yomwe ili pafupi ndi mitsempha yodziwika bwino ya iliac.

Gawo IV

Khansa ya chikhodzodzo IVA ndi IVB. Pa gawo la IVA, khansa yafalikira kuchokera mu chikhodzodzo kupita (a) kukhoma pamimba kapena m'chiuno; kapena (b) ma lymph node pamwamba pamitsempha yodziwika bwino ya iliac. Pa gawo IVB, khansa yafalikira ku (c) ziwalo zina za thupi, monga mapapo, chiwindi, kapena fupa.

Gawo IV limagawika magawo a IVA ndi IVB.

• Mu gawo IVA:

• khansara yafalikira kuchokera mu chikhodzodzo mpaka khoma la pamimba kapena m'chiuno; kapena

• Khansara yafalikira ku ma lymph node omwe ali pamwamba pa mitsempha yodziwika bwino (mitsempha yayikulu m'chiuno).

• Pa gawo IVB, khansa yafalikira mbali zina za thupi, monga mapapo, fupa, kapena chiwindi.

Khansa Yachikhodzodzo Yobwerezabwereza

Khansara yabwinobwino yamchikhodzodzo ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Khansara imatha kubwereranso mu chikhodzodzo kapena mbali zina za thupi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya chikhodzodzo.

• Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

• Opaleshoni

• Thandizo la radiation

• Chemotherapy

• Chitetezo chamatenda

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo cha khansa ya chikhodzodzo chingayambitse mavuto.

• Odwala angaganize zopita nawo kukayezetsa.

• Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya chikhodzodzo.

Pali mitundu yosiyanasiyana ya mankhwala kwa odwala khansa ya chikhodzodzo. Mankhwala ena ndi ofanana (mankhwala omwe akugwiritsidwa ntchito pano), ndipo ena akuyesedwa m'mayesero azachipatala. Kuyesedwa kwachipatala ndi kafukufuku wofufuza wothandizira kusintha chithandizo chamakono kapena kupeza zidziwitso zamankhwala atsopano kwa odwala khansa. Pamene mayesero azachipatala awonetsa kuti chithandizo chatsopano ndichabwino kuposa chithandizo chamankhwala, chithandizocho chitha kukhala chamankhwala wamba. Odwala angaganize zopita nawo kukayezetsa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

Opaleshoni

Imodzi mwa mitundu yotsatirayi ya opaleshoni ingachitike:

• Transurethral resection (TUR) yokwaniritsa: Opaleshoni momwe cystoscope (chubu chowonda kwambiri) imayikidwa mchikhodzodzo kudzera mu mtsempha. Chida chokhala ndi zingwe zazing'ono kumapeto chimagwiritsidwa ntchito kuchotsa khansara kapena kuwotcha chotupacho ndi magetsi amphamvu. Izi zimadziwika ngati kukwaniritsidwa.

• Radical cystectomy: Kuchita opaleshoni kuchotsa chikhodzodzo ndi ma lymph node ndi ziwalo zilizonse zomwe zili ndi khansa. Kuchita opaleshoniyi kumatha kuchitidwa khansa ya chikhodzodzo ikalowetsa khoma la minofu, kapena khansa yakunja ikakhala gawo lalikulu la chikhodzodzo. Mwa amuna, ziwalo zapafupi zomwe zimachotsedwa ndi prostate ndi ma seminale vesicles. Mwa amayi, chiberekero, thumba losunga mazira, ndi gawo la nyini zimachotsedwa. Nthawi zina, khansara ikafalikira kunja kwa chikhodzodzo ndipo siyingathe kuchotsedwa, kuchitidwa opaleshoni kuti muchotse chikhodzodzo kokha kungachepetse zizindikiro za mkodzo zomwe zimayambitsa khansa. Pamene chikhodzodzo chiyenera kuchotsedwa, dokotalayo amapanga njira ina kuti mkodzo utuluke mthupi.

• Tsankho cystectomy: Opaleshoni kuchotsa gawo la chikhodzodzo. Kuchita opaleshoniyi kumatha kuchitidwa kwa odwala omwe ali ndi chotupa chotsika chomwe chalowa khoma la chikhodzodzo koma chimangokhala gawo limodzi la chikhodzodzo. Chifukwa mbali imodzi yokha ya chikhodzodzo imachotsedwa, odwala amatha kukodza bwinobwino atachira ku opaleshoniyi. Izi zimatchedwanso segmental cystectomy.

• Zosokoneza mkodzo: Kuchita opaleshoni yopangira njira yatsopano kuti thupi lizisunga ndikudutsa mkodzo.

Dokotala atachotsa khansa yonse yomwe imawonekera panthawi yochitidwa opaleshoniyi, odwala ena amatha kupatsidwa chemotherapy atachitidwa opareshoni kuti aphe maselo aliwonse a khansa omwe atsala. Chithandizo chomwe chimaperekedwa atachitidwa opareshoni, kuti muchepetse chiopsezo kuti khansayo ibwereranso, amatchedwa adjuvant therapy.

Thandizo la radiation

Thandizo la radiation ndi chithandizo cha khansa chomwe chimagwiritsa ntchito ma x-ray amphamvu kapena mitundu ina ya radiation kuti iphe ma cell a khansa kapena kuti asakule. Pali mitundu iwiri ya mankhwala a radiation:

• Mankhwala ochiritsira akunja amagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chaku khansa.

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.

Momwe mankhwala a radiation amaperekedwera zimadalira mtundu ndi gawo la khansa yomwe ikuthandizidwa. Thandizo la radiation lakunja limagwiritsidwa ntchito pochiza khansa ya chikhodzodzo.

Chemotherapy

Chemotherapy ndi mankhwala a khansa omwe amagwiritsa ntchito mankhwala oletsa kukula kwa maselo a khansa, mwina popha ma cell kapena kuwaletsa kuti asagawane. Chemotherapy ikamamwa pakamwa kapena kulowetsedwa mumtsempha kapena minofu, mankhwalawa amalowa m'magazi ndipo amatha kufikira ma cell a khansa mthupi lonse (systemic chemotherapy). Chemotherapy ikaikidwa molunjika m'matumbo a cerebrospinal, chiwalo, kapena thupi monga pamimba, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo (chemotherapy am'madera). Kwa khansara ya chikhodzodzo, chemotherapy m'deralo imatha kukhala intravesical (ikani chikhodzodzo kudzera mu chubu cholowetsedwa mu urethra). Momwe chemotherapy imaperekedwa imadalira mtundu ndi gawo la khansa yomwe ikuchitidwa. Kuphatikiza kwa chemotherapy ndi chithandizo chogwiritsa ntchito mankhwala opatsirana ambiri opatsirana khansa.

Onani Mankhwala Ovomerezeka a Khansa ya Chikhodzodzo kuti mumve zambiri.

Chitetezo chamatenda

Immunotherapy ndi chithandizo chomwe chimagwiritsa ntchito chitetezo cha mthupi cha wodwalayo kuthana ndi khansa. Zinthu zomwe thupi limapanga kapena zopangidwa mu labotale zimagwiritsidwa ntchito kukulitsa, kuwongolera, kapena kubwezeretsa chitetezo chamthupi cha khansa. Chithandizo cha khansa choterechi chimatchedwanso biotherapy kapena biologic therapy.

Pali mitundu yambiri ya immunotherapy:

• Immune checkpoint inhibitor therapy: PD-1 inhibitors ndi mtundu wa mankhwala oletsa chitetezo cha mthupi omwe amagwiritsidwa ntchito pochiza khansa ya chikhodzodzo. PD-1 ndi puloteni pamwamba pamaselo a T omwe amathandiza kuti chitetezo cha mthupi chitetezedwe. PD-1 ikamangirira puloteni ina yotchedwa PDL-1 pakhungu la khansa, imayimitsa T cell kuti isaphe khungu la khansa. PD-1 inhibitors amadziphatika ku PDL-1 ndikulola ma T maselo kupha ma cell a khansa. Pembrolizumab, atezolizumab, nivolumab, avelumab, ndi durvalumab ndi mitundu ya PD-1 inhibitors.

Chitetezo cha chitetezo cha mthupi. Mapuloteni owunika, monga PD-L1 pama cell a chotupa ndi PD-1 pama cell a T, amathandizira kuyang'anira mayankho amthupi. Kumanga kwa PD-L1 mpaka PD-1 kumapangitsa kuti ma T asaphe ma cell am'mimba (gulu lakumanzere). Kuletsa kumangiriza kwa PD-L1 mpaka PD-1 yokhala ndi chitetezo chodzitetezera (anti-PD-L1 kapena anti-PD-1) kumalola ma T maselo kupha ma cell a chotupa (gulu lamanja).

Immunotherapy imagwiritsa ntchito chitetezo cha mthupi kuthana ndi khansa. Makanema ojambulawa amafotokoza mtundu umodzi wa ma immunotherapy omwe amagwiritsa ntchito zida zowonetsetsa chitetezo cha mthupi pochiza khansa.

• BCG (bacillus Calmette-Guérin): Khansara ya chikhodzodzo imatha kuthandizidwa ndi intravesical immunotherapy yotchedwa BCG. BCG imaperekedwa mu yankho lomwe limayikidwa molunjika mu chikhodzodzo pogwiritsa ntchito catheter (chubu chowonda).

Immunotherapy imagwiritsa ntchito chitetezo cha mthupi kuthana ndi khansa. Makanema ojambulawa amafotokoza mtundu umodzi wa ma immunotherapy otchedwa nonspecific immune stimulation omwe amagwiritsidwa ntchito pochiza khansa.

Onani Mankhwala Ovomerezeka a Khansa ya Chikhodzodzo kuti mumve zambiri.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chithandizo cha khansa ya chikhodzodzo chingayambitse mavuto.

Kuti mumve zambiri zamankhwala obwera chifukwa cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

Odwala angaganize zopita nawo kukayezetsa.

Kwa odwala ena, kutenga nawo mbali pakuyesa chithandizo chachipatala kungakhale njira yabwino kwambiri yothandizira. Mayesero azachipatala ndi gawo limodzi la kafukufuku wa khansa. Mayesero azachipatala amachitika kuti apeze ngati mankhwala atsopano a khansa ndi otetezeka komanso ogwira ntchito kapena abwinoko kuposa mankhwala wamba.

Njira zambiri zamankhwala zochiritsira khansa zimachokera kumayeso am'mbuyomu azachipatala. Odwala omwe amatenga nawo mbali pachipatala atha kulandira chithandizo chofananira kapena kukhala oyamba kulandira chithandizo chatsopano.

Odwala omwe amatenga nawo mbali pazoyeserera zamankhwala amathandizanso kukonza momwe khansa idzathandizire mtsogolo. Ngakhale mayesero azachipatala satsogolera kuchipatala chatsopano, nthawi zambiri amayankha mafunso ofunikira ndikuthandizira kupititsa patsogolo kafukufuku.

Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

Mayesero ena azachipatala amangophatikizapo odwala omwe sanalandire chithandizo. Mayesero ena amayesa chithandizo kwa odwala omwe khansa yawo sinakhale bwino. Palinso mayesero azachipatala omwe amayesa njira zatsopano zothetsera khansa kuti isabwererenso (kubwerera) kapena kuchepetsa zovuta zoyambitsidwa ndi khansa.

Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayeso azachipatala othandizidwa ndi NCI zitha kupezeka patsamba lofufuza zamankhwala la NCI. Mayesero azachipatala othandizidwa ndi mabungwe ena amapezeka patsamba la ClinicalTrials.gov.

Mayeso otsatirawa angafunike.

Ena mwa mayesero omwe adachitika kuti apeze khansa kapena kuti adziwe momwe khansa iliri angabwerezedwenso. Mayesero ena adzabwerezedwa kuti awone momwe mankhwalawa akugwirira ntchito. Zisankho zakuti mupitilize, kusintha, kapena kusiya kulandira chithandizo zitha kutengera zotsatira za mayeso awa.

Kuyesaku kumangopitilira kuchitika nthawi ndi nthawi mankhwala atatha. Zotsatira zamayesowa zitha kuwonetsa ngati vuto lanu lasintha kapena ngati khansa yabwereranso (bwererani). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Khansara ya chikhodzodzo nthawi zambiri imabwereranso (imabwereranso), ngakhale khansayo itangopeka. Kuyang'anitsitsa kwamikodzo kuti muwone ngati mukubwereranso ndikofunikira pambuyo poti mwapezeka khansa ya chikhodzodzo. Kuyang'anitsitsa kumayang'anitsitsa momwe wodwalayo alili koma osapereka chithandizo chilichonse pokhapokha pakakhala zosintha pazotsatira zomwe zikuwonetsa kuti vutoli likuipiraipira. Mukamayang'aniridwa mwakhama, mayeso ena ndi mayeso amachitika nthawi zonse. Kuyang'anitsitsa kungaphatikizepo kuyesa kwa ureteroscopy ndi kujambula. Onani mayeso oyeserera, pamwambapa.

Njira Zothandizira ndi Gawo

n Chigawo chino

• Gawo 0 (Noninvasive Papillary Carcinoma ndi Carcinoma ku Situ)
• Khansa I Khansa ya Chikhodzodzo
• Khansa II ya Chikhodzodzo II
• Khansa IV Khansa ya Chikhodzodzo
• Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Gawo 0 (Noninvasive Papillary Carcinoma ndi Carcinoma ku Situ)

Chithandizo cha gawo 0 (noninvasive papillary carcinoma and carcinoma in situ) chingaphatikizepo izi:

• Kutulutsa kwa transurethral ndikokwanira. Izi zikhoza kutsatiridwa ndi chimodzi mwa izi:

• Intravesical chemotherapy yoperekedwa atangochitidwa opaleshoni.
• Intravesical chemotherapy yoperekedwa atangochita opaleshoni kenako ndikuchiritsidwa pafupipafupi ndi intravesical BCG kapena intravesical chemotherapy.

• Tsankho la cystectomy.
• Wopanga cystectomy.
• Kuyesedwa kwachipatala kwa chithandizo chatsopano.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Khansa I Khansa ya Chikhodzodzo

Chithandizo cha khansa ya chikhodzodzo cha siteji ingaphatikizepo izi:

• Kutulutsa kwa transurethral ndikokwanira. Izi zikhoza kutsatiridwa ndi chimodzi mwa izi:

  Intravesical chemotherapy yoperekedwa atangochitidwa opaleshoni.

  Intravesical chemotherapy yoperekedwa atangochita opaleshoni kenako ndikuchiritsidwa pafupipafupi ndi intravesical BCG kapena intravesical chemotherapy.

• Tsankho la cystectomy.
• Wopanga cystectomy.
• Kuyesedwa kwachipatala kwa chithandizo chatsopano.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Khansa II ya Chikhodzodzo II

Chithandizo cha magawo a khansa ya chikhodzodzo II ndi III chingaphatikizepo izi:

• Wopanga cystectomy.
• Kuphatikiza kwa chemotherapy kutsatiridwa ndi cystectomy yayikulu. Kusokonekera kwamikodzo kumatha kuchitika.
• Thandizo la radiation lakunja kapena chemotherapy.
• Tsankho la cystectomy kapena chemotherapy.
• Kutulutsa kwa transurethral ndikokwanira.
• Kuyesedwa kwachipatala kwa chithandizo chatsopano.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Khansa IV Khansa ya Chikhodzodzo

Chithandizo cha khansa ya khansa ya chikhodzodzo yomwe siyinafalikire mbali zina za thupi ingaphatikizepo izi:

• Chemotherapy.

• Wopanga cystectomy yekha kapena wotsatira chemotherapy.

• Thandizo la radiation lakunja kapena chemotherapy.

• Kusintha kwamikodzo kapena cystectomy ngati mankhwala ochepetsa nkhawa kuti athetse zofooka ndikukhala ndi moyo wabwino.

Chithandizo cha khansara ya chikhodzodzo IV yomwe yafalikira mbali zina za thupi, monga mapapo, fupa, kapena chiwindi, ingaphatikizepo izi:

• Chemotherapy kapena popanda chithandizo cham'deralo (opaleshoni kapena mankhwala a radiation).

• Immunotherapy (chitetezo cha chitetezo cha mthupi).

• Thandizo la radiation lakunja ngati mankhwala ochepetsa nkhawa kuti athetse zofooka ndikukhalitsa moyo.

• Kusintha kwamikodzo kapena cystectomy ngati mankhwala ochepetsa nkhawa kuti athetse zofooka ndikukhala ndi moyo wabwino.

• Kuyesedwa kwachipatala kwa mankhwala atsopano a anticancer.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Njira Zothandizira Khansa ya Chikhodzodzo Yopezekanso

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha khansa yapafupipafupi ya chikhodzodzo chimadalira mankhwala am'mbuyomu komanso komwe khansayo yabwereranso. Chithandizo cha khansa yapafupipafupi chingaphatikizepo izi:

• Kuphatikiza chemotherapy.
• Immunotherapy (chitetezo cha chitetezo cha mthupi).
• Kuchita maoparesi apamwambamwamba kapena am'deralo. Opaleshoni imatha kutsatiridwa ndi biologic therapy ndi / kapena chemotherapy.
• Thandizo la radiation ngati mankhwala ochepetsa nkhawa kuti athetse zofooka ndikukhala ndi moyo wabwino.
• Kuyesedwa kwachipatala kwa chithandizo chatsopano.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kuti mudziwe zambiri za khansa ya chikhodzodzo

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza khansa ya chikhodzodzo, onani izi:

• Khansa ya Chikhodzodzo Tsamba
• Chikhodzodzo ndi Kuwona Khansa Yina ya Urothelial
• Khansa Yachilendo Ya Chithandizo Chaubwana
• Mankhwala Ovomerezeka a Khansa ya Chikhodzodzo
• Njira Zachilengedwe za Khansa
• Fodya (kuphatikizapo chithandizo chosiya)

Kuti mumve zambiri za khansa ndi zinthu zina zochokera ku National Cancer Institute, onani izi:

• Za Khansa
• Kusinthana
• Chemotherapy and You: Kuthandiza Anthu Omwe Ali Ndi Khansa
• Thandizo la Radiation ndi Inu: Thandizo kwa Anthu Omwe Ali ndi Khansa
• Kulimbana ndi khansa
• Mafunso oti mufunse dokotala wanu za khansa
• Kwa Opulumuka ndi Owasamalira

Za Chidule cha

Za

Physician Data Query () ndi nkhokwe ya National Cancer Institute's (NCI's) yokhudza zambiri za khansa. Database ya ili ndi chidule cha zomwe zatulutsidwa posachedwa popewa khansa, kuzindikira, ma genetics, chithandizo, chisamaliro chothandizira, komanso mankhwala othandizira komanso othandizira. Zambiri mwachidule zimabwera m'mitundu iwiri. Omasulira akatswiriwa ali ndi zambiri zolembedwa mchilankhulo chaukadaulo. Mitundu ya odwala imalembedwa m'njira yosavuta kumva, yopanda ukadaulo. Mabaibulo onsewa ali ndi chidziwitso cha khansa chomwe ndicholondola komanso chaposachedwa ndipo matembenuzidwe ambiri amapezekanso m'Chisipanishi.

ndi ntchito ya NCI. NCI ndi gawo la National Institutes of Health (NIH). NIH ndiye likulu la kafukufuku waboma. Zidule za zimakhazikitsidwa pakuwunika kodziyimira pawokha zolemba zamankhwala. Sindiwo malingaliro a NCI kapena NIH.

Cholinga cha Chidule ichi

Chidule cha chidziwitso cha khansa ya chili ndi zambiri zamankhwala am'khansa ya chikhodzodzo. Zimatanthauza kudziwitsa ndi kuthandiza odwala, mabanja, ndi osamalira. Sichipereka malangizo kapena malingaliro apadera popanga zisankho pazokhudzaumoyo.

Owunikanso ndi Zosintha

Mamembala Olemba amalemba zidule za khansa ya ndikuziwongolera. Ma board awa amapangidwa ndi akatswiri azithandizo zamatenda a khansa ndi zina zapadera zokhudzana ndi khansa. Zowombazi zimawunikiridwa pafupipafupi ndipo amasintha pakakhala zatsopano. Deti pachidule chilichonse ("Kusinthidwa") ndi tsiku losintha posachedwa kwambiri.

Zomwe zili pachidule ichi zidatengedwa kuchokera ku mtundu wa akatswiri azaumoyo, womwe umawunikidwa pafupipafupi ndikusinthidwa momwe zingafunikire, ndi Adult Treatment Editorial Board.

Zambiri Zoyesa Zachipatala

Kuyesedwa kwachipatala ndi kafukufuku woti ayankhe funso lasayansi, monga ngati mankhwala amodzi aposa ena. Mayesero amatengera maphunziro am'mbuyomu ndi zomwe taphunzira mu labotale. Chiyeso chilichonse chimayankha mafunso ena asayansi kuti apeze njira zatsopano komanso zabwino zothandiza odwala khansa. Mukamayesedwa azachipatala, zambiri zimasonkhanitsidwa pazokhudza chithandizo chatsopano ndi momwe chimagwirira ntchito. Ngati kuyesa kwachipatala kukuwonetsa kuti chithandizo chatsopano ndichabwino kuposa chomwe chikugwiritsidwa ntchito pano, chithandizo chatsopano chitha kukhala "chovomerezeka". Odwala angaganize zopita nawo kukayezetsa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Mayesero azachipatala amapezeka pa intaneti patsamba la NCI. Kuti mumve zambiri, imbani Cancer Information Service (CIS), malo olumikizirana ndi NCI, ku 1-800-4-CANCER (1-800-422-6237).

Chilolezo Chogwiritsa Ntchito Chidule Ichi

ndi dzina lolembedwa. Zomwe zili mu zikalata za zitha kugwiritsidwa ntchito momasuka ngati zolemba. Sizingadziwike kuti ndi chidule cha khansa ya NCI pokhapokha chidule chonse chikuwonetsedwa ndikusinthidwa pafupipafupi. Komabe, wogwiritsa akhoza kuloledwa kulemba chiganizo monga "Chidule cha chidziwitso cha khansa ya PDI ya NCI chokhudza kupewa khansa ya m'mawere chimanena zoopsa zake motere: [onaninso mwachidule mwachidule]."

Njira yabwino yolongosola chidule cha ndi:

Zithunzi pazidulezi zimagwiritsidwa ntchito ndi chilolezo cha wolemba, wojambula, ndi / kapena wofalitsa kuti azigwiritsidwa ntchito pazidule za zokha. Ngati mukufuna kugwiritsa ntchito chithunzi kuchokera pachidule cha ndipo simukugwiritsa ntchito chidule chonse, muyenera kupeza chilolezo kuchokera kwa mwininyumba. Sizingaperekedwe ndi National Cancer Institute. Zambiri zogwiritsa ntchito zithunzizi mwachidule, komanso zithunzi zina zambiri zokhudzana ndi khansa zitha kupezeka mu Visuals Online. Zowoneka paintaneti ndi zithunzi zoposa 3,000 zasayansi.

Chodzikanira

Zomwe zidafotokozedwazi siziyenera kugwiritsidwa ntchito popanga chisankho chobwezera inshuwaransi. Zambiri pazokhudza inshuwaransi zikupezeka ku Cancer.gov patsamba la Managing Care Care.

Lumikizanani nafe

Zambiri zokhudzana ndi kulumikizana nafe kapena kulandira thandizo patsamba la Cancer.gov zitha kupezeka patsamba Lumikizanani nafe kuti tithandizidwe. Mafunso amathanso kuperekedwa ku Cancer.gov kudzera pa Tsamba Lakutumiza la Imelo.