Types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq

Chithandizo cha m'mimba cha Carcinoid Tumors Treatment (®) -Patient Version

Zambiri Zokhudza zotupa za m'mimba za m'mimba

MFUNDO ZOFUNIKA

• Chotupa cha khansa m'mimba ndi khansa yomwe imapangidwa m'mbali mwa m'mimba.

• Mbiri yazaumoyo imatha kukhudza chiwopsezo cha zotupa za m'mimba za khansa.

• Zotupa zina za m'mimba zam'mimba sizikhala ndi zizindikilo koyambirira.

• Matenda a Carcinoid amatha kuchitika ngati chotupacho chikufalikira chiwindi kapena ziwalo zina za thupi.

• Kujambula maphunziro ndi mayeso omwe amayesa magazi ndi mkodzo amagwiritsidwa ntchito kuti azindikire (kupeza) ndikuzindikira zotupa za m'mimba za khansa.

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

Chotupa cha khansa m'mimba ndi khansa yomwe imapangidwa m'mbali mwa m'mimba.

Thirakiti la m'mimba (GI) ndi gawo lam'magazi amthupi. Amathandiza kugaya chakudya, amatenga michere (mavitamini, michere, chakudya, mafuta, mapuloteni, ndi madzi) pachakudya choti thupi lizigwiritsa ntchito ndikuthandizira kutaya zonyansa mthupi. Thirakiti la GI limapangidwa ndi ziwalozi ndi ziwalo zina:

• Mimba

• Matumbo ang'ono (duodenum, jejunum, ndi ileum).

• Colon.

• Kuchuluka.

Zotupa za m'mimba zimapangidwa mkati mwa gawo la m'mimba, nthawi zambiri muzowonjezera, m'matumbo ang'onoang'ono, kapena m'matumbo.

Zotupa za m'mimba zimachokera ku mtundu wina wa neuroendocrine cell (mtundu wamaselo omwe ali ngati khungu lamitsempha komanso khungu lopanga mahomoni). Maselowa amabalalika m'chifuwa ndi m'mimba koma ambiri amapezeka mu thirakiti la GI. Maselo a Neuroendocrine amapanga mahomoni omwe amathandiza kuchepetsa timadziti ta m'mimba ndi minofu yomwe imagwiritsidwa ntchito posunthira chakudya m'mimba ndi m'matumbo. Chotupa cha khansa ya GI amathanso kupanga mahomoni ndikuwamasulira mthupi.

Zotupa za GI carcinoid ndizochepa ndipo zambiri zimakula pang'onopang'ono. Ambiri mwa iwo amapezeka m'matumbo ang'onoang'ono, m'matumbo, ndi zowonjezera. Nthawi zina pamakhala chotupa chopitilira chimodzi.

Onani zowerengera zotsatirazi za kuti mumve zambiri zokhudzana ndi GI ndi mitundu ina ya zotupa za khansa:

• Chithandizo cha Khansa ya M'mapapo Yaying'ono.

• Chithandizo cha Pancreatic Neuroendocrine Tumors (Islet Cell Tumors).

• Chithandizo cha Khansa Yamatenda.

• Chithandizo Chaching'ono cha Khansa Yam'mimba.

• Khansa Yachilendo Ya Chithandizo Chaubwana

Mbiri yazaumoyo imatha kukhudza chiwopsezo cha zotupa za m'mimba za khansa.

Chilichonse chomwe chimakulitsa mwayi wamunthu woti atenge matenda chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala wanu ngati mukuganiza kuti mutha kukhala pachiwopsezo.

Zowopsa pazotupa zamagulu a GI zimaphatikizapo izi:

• Kukhala ndi mbiri yabanja yamatenda angapo a endocrine neoplasia type 1 (MEN1) kapena neurofibromatosis type 1 (NF1) syndrome.

• Kukhala ndimikhalidwe ina yomwe imakhudza kutha kwa m'mimba kupanga asidi m'mimba, monga atrophic gastritis, kuchepa kwa magazi m'thupi, kapena matenda a Zollinger-Ellison.

Zotupa zina za m'mimba zam'mimba sizikhala ndi zizindikilo koyambirira.

Zizindikiro zimatha chifukwa cha kukula kwa chotupacho komanso / kapena mahomoni omwe chotupacho chimapanga. Zotupa zina, makamaka zotupa m'mimba kapena zowonjezera, sizimatha kuyambitsa zizindikilo. Zotupa za khansa nthawi zambiri zimapezeka pakuyesa kapena kuchiza matenda ena.

Zotupa za carcinoid m'matumbo ang'ono (duodenum, jejunum, ndi ileum), colon, ndi rectum nthawi zina zimayambitsa zizindikilo akamakula kapena chifukwa cha mahomoni omwe amapanga. Zinthu zina zimatha kuyambitsa zizindikilo zomwezo. Funsani dokotala ngati muli ndi izi:

Duodenum

Zizindikiro za zotupa za GC carcinoid mu duodenum (gawo loyamba la m'mimba, lomwe limalumikizana ndi m'mimba) liphatikizira izi:

• Kupweteka m'mimba.

• Kudzimbidwa.

• Kutsekula m'mimba.

• Sinthani mtundu wapando.

• Nseru.

• Kusanza.

• Jaundice (chikasu chachikopa ndi azungu amaso).

• Kutentha pa chifuwa.

Jejunum ndi ileum

Zizindikiro za zotupa za GI carcinoid mu jejunum (pakati pakatumbo kakang'ono) ndi ileamu (gawo lomaliza la m'matumbo ang'ono, omwe amalumikizana ndi khola) atha kuphatikizira izi:

• Kupweteka m'mimba.

• Kuchepetsa thupi popanda chifukwa chodziwika.

• Kumva kutopa kwambiri.

• Kumva kutupa

• Kutsekula m'mimba.

• Nseru.

• Kusanza.

Colon

Zizindikiro za zotupa za carcinoid m'matumbo zimatha kuphatikizira izi:

• Kupweteka m'mimba.

• Kuchepetsa thupi popanda chifukwa chodziwika.

Kuchuluka

Zizindikiro za zotupa za GI carcinoid mu rectum zitha kuphatikizira izi:

• Magazi mu chopondapo.

• Ululu mu rectum.

• Kudzimbidwa.

Matenda a Carcinoid amatha kuchitika ngati chotupacho chikufalikira chiwindi kapena ziwalo zina za thupi.

Mahomoni opangidwa ndi zotupa za m'mimba zam'mimba nthawi zambiri zimawonongedwa ndi michere ya chiwindi m'magazi. Ngati chotupacho chafalikira pachiwindi ndipo mavitamini a chiwindi sangathe kuwononga mahomoni owonjezera omwe amapangidwa ndi chotupacho, mahomoni ambiri amatha kukhala mthupi ndikupangitsa matenda a carcinoid. Izi zitha kuchitika ngati ma cell a chotupa alowa m'magazi. Zizindikiro za matenda a carcinoid ndi izi:

• Kufiira kapena kumverera kwa kutentha pankhope ndi m'khosi.

• Kupweteka m'mimba.

• Kumva kutupa.

• Kutsekula m'mimba.

• Kupuma kapena vuto lina kupuma.

• Kugunda kwamtima.

Zizindikirozi zimatha chifukwa cha zotupa za m'mimba kapena zotupa zina. Lankhulani ndi dokotala wanu ngati muli ndi zizindikiro izi.

Kujambula maphunziro ndi mayeso omwe amayesa magazi ndi mkodzo amagwiritsidwa ntchito kuti azindikire (kupeza) ndikuzindikira zotupa za m'mimba za khansa.

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.

• Maphunziro a chemistry yamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina, monga mahomoni, omwe amatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zakumwamba kapena zochepa) kungakhale chizindikiro cha matenda. Sampulo yamagazi imafufuzidwa kuti iwone ngati ili ndi mahomoni opangidwa ndi zotupa za carcinoid. Kuyesaku kumagwiritsidwa ntchito kuthandizira kuzindikira matenda a khansa.

• Chizindikiro cha chotupa: Njira yoyeserera magazi, mkodzo, kapena minofu kuti mupimitse kuchuluka kwa zinthu zina, monga chromogranin A, yopangidwa ndi ziwalo, zotupa, kapena zotupa m'mthupi. Chromogranin A ndi chikhomo chotupa. Amalumikizidwa ndi zotupa za neuroendocrine zikapezeka m'magulu owonjezeka m'thupi.

• Kuyezetsa mkodzo kwa maola 24 : Kuyesedwa komwe mkodzo umasonkhanitsidwa kwa maola 24 kuti muyese kuchuluka kwa zinthu zina, monga 5-HIAA kapena serotonin (hormone). Kuchuluka kwazinthu zosazolowereka (zapamwamba kapena zotsika kuposa zachilendo) zitha kukhala chizindikiro cha matenda m'chiwalo kapena minofu yomwe imapangitsa. Kuyesaku kumagwiritsidwa ntchito kuthandizira kuzindikira matenda a khansa.

• MIBG scan: Njira yomwe imagwiritsidwa ntchito popeza zotupa za neuroendocrine, monga zotupa za khansa. Zinthu zochepa kwambiri zamagetsi zotchedwa MIBG (metaiodobenzylguanidine) zimalowetsedwa mumtsempha ndikuyenda m'magazi. Zotupa za carcinoid zimatenga zinthu zowononga ma radio ndipo zimadziwika ndi chida chomwe chimayeza ma radiation.

• 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.

• MRI (magnetic resonance imaging): Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kuti ipange zithunzi zingapo za malo amkati mwa thupi. Njirayi imatchedwanso kuti kujambula kwa nyukiliya yamagetsi

• 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 bwino pachithunzichi chifukwa amakhala otakataka ndipo amatenga shuga wambiri kuposa maselo wamba.

• Endoscopic ultrasound (EUS): Njira yomwe endoscope imayikidwa mthupi, nthawi zambiri kudzera pakamwa kapena m'matumbo. Endoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Kafukufuku kumapeto kwa endoscope amagwiritsidwa ntchito kuphulitsa mafunde amphamvu kwambiri (ultrasound) kumatenda amkati kapena ziwalo, monga m'mimba, m'matumbo ang'onoang'ono, m'matumbo, kapena m'matumbo, ndikupanga ma echoes. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Njirayi imatchedwanso endosonography.

• Pamwamba endoscopy: Ndondomeko yoyang'ana ziwalo ndi zotupa mkati mwa thupi kuti muwone ngati pali zovuta zina. Endoscope imalowetsedwa kudzera pakamwa ndikudutsa pammimba. Nthawi zina endoscope imadutsanso kuchokera m'mimba kupita m'matumbo ang'onoang'ono. Endoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu kapena ma lymph node, omwe amayang'aniridwa ndi microscope ngati ali ndi matenda.

• Colonoscopy: Njira yoyang'ana mkati mwa rectum ndi colon ya polyps, madera achilendo, kapena khansa. Colonoscope imalowetsedwa kudzera m'matumbo mpaka kumtunda. Colonoscope ndi chida choonda ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chotsitsira ma polyps kapena minofu, yomwe imayang'aniridwa ndi microscope ngati ili ndi khansa.

• Capsule endoscopy: Njira yomwe imagwiritsidwa ntchito kuwona m'matumbo onse ang'onoang'ono. Wodwalayo ameza kapisozi komwe kali ndi kamera yaying'ono. Kapisozi ikamadutsa m'mimba, kamera imatenga zithunzi ndikuzitumiza kwa wolandila yemwe wavala kunja kwa thupi.

• Biopsy: Kuchotsa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope kuti aone ngati ali ndi khansa. Zitsanzo zamatenda zimatha kutengedwa nthawi ya endoscopy ndi colonoscopy.

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

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Kumene chotupacho chili m'matumbo.

• Kukula kwa chotupacho.

• Kaya khansara yafalikira kuchokera m'mimba ndi matumbo kupita mbali zina za thupi, monga chiwindi kapena ma lymph node.

• Kaya wodwalayo ali ndi matenda a carcinoid kapena ali ndi khansa ya mtima.

• Kaya khansayo itha kuchotsedwa kwathunthu ndi opareshoni.

• Kaya khansa yapezeka kumene kapena yayambiranso.

Magawo Amatumbo Am'mimba Am'mimba

MFUNDO ZOFUNIKA

• Pambuyo papezeka chotupa cha khansa m'mimba, amayesedwa kuti apeze ngati maselo a khansa afalikira m'mimba ndi m'matumbo kapena mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

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

• Dongosolo lothandizira khansa limadalira komwe chotupa cha khansa chimapezeka komanso ngati chingachotsedwe ndi opaleshoni.

Pambuyo papezeka chotupa cha khansa m'mimba, amayesedwa kuti apeze ngati maselo a khansa afalikira m'mimba ndi m'matumbo kapena mbali zina za thupi.

Kuyika masitepe ndi njira yomwe imagwiritsidwa ntchito kuti mudziwe momwe khansara yafalikira. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Zotsatira za mayeso ndi njira zomwe zimagwiritsidwa ntchito pozindikira zotupa zam'mimba (GI) zamatenda am'magazi zitha kugwiritsidwanso ntchito popanga magawo. Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi. Kusanthula mafupa kumatha kuchitidwa kuti muwone ngati pali magawo omwe amagawa mwachangu, monga khungu la 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.

Chotupacho chimakhala chotupa chimodzimodzi. Mwachitsanzo, ngati chotupa cha m'mimba (GI) chafalikira m'chiwindi, zotupa m'chiwindi ndimaselo otupa a khansa ya GI. Matendawa ndi chotupa cha khansa ya GI, osati khansa ya chiwindi.

Dongosolo lothandizira khansa limadalira komwe chotupa cha khansa chimapezeka komanso ngati chingachotsedwe ndi opaleshoni.

Kwa khansa zambiri ndikofunikira kudziwa gawo la khansa kuti akonzekere chithandizo. Komabe, chithandizo cha zotupa za khansa m'mimba sichikhazikitsidwa pagawo la khansa. Chithandizo chimadalira makamaka ngati chotupacho chingachotsedwe ndi opaleshoni komanso ngati chotupacho chafalikira.

Chithandizo chimatengera ngati chotupacho:

• Itha kuchotsedwa kwathunthu ndi opareshoni.

• Yafalikira ku ziwalo zina za thupi.

• Wabweranso atalandira chithandizo. Chotupacho chimatha kubwerera m'mimba kapena m'matumbo kapena mbali zina za thupi.

• Sanakhale bwino ndi chithandizo.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi zotupa za m'mimba.

• Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

• Opaleshoni

• Thandizo la radiation

• Chemotherapy

• Thandizo la mahomoni

• Chithandizo cha matenda a carcinoid chingafunikirenso.

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo chofuna

• Kuchiza kwa zotupa za khansa m'mimba kumatha kuyambitsa zovuta.

• 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 omwe ali ndi zotupa za m'mimba.

Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi chotupa cha m'mimba. 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

Chithandizo cha zotupa za GI carcinoid nthawi zambiri chimaphatikizapo opaleshoni. Imodzi mwa njira zotsatirazi zingagwiritsidwe ntchito:

• Endoscopic resection: Opaleshoni yochotsa chotupa chaching'ono chomwe chili mkatikati mwa kapepala ka GI. Endoscope imalowetsedwa pakamwa ndikudutsa pamimba mpaka m'mimba ndipo nthawi zina, duodenum. Endoscope ndi chida chopyapyala, chonga chubu chokhala ndi kuwala, mandala owonera, komanso chida chothandizira kuchotsa zotupa.

• Kudodometsa kwanuko: Kuchita opaleshoni kuti muchotse chotupacho komanso pang'ono pathupi pozungulira.

• Kubwezeretsa: Kuchita opaleshoni kuchotsa gawo kapena chiwalo chonse chomwe chili ndi khansa. Ma lymph node apafupi amathanso kuchotsedwa.

• Cryosurgery: Chithandizo chomwe chimagwiritsa ntchito chida chozizira ndi kuwononga minofu yotupa ya khansa. Mankhwalawa amatchedwanso cryotherapy. Dokotala atha kugwiritsa ntchito ultrasound kuti awongolere chidacho.

• Kuchepetsa ma Radiofrequency: Kugwiritsa ntchito kafukufuku wapadera wokhala ndi maelekitirodi ang'onoang'ono omwe amatulutsa mafunde amphamvu zamagetsi (ofanana ndi ma microwave) omwe amapha ma cell a khansa. Kafukufukuyu amatha kulowetsedwa kudzera pakhungu kapena kudzera pobowola pamimba.

• Kuika chiwindi: Opaleshoni kuti muchotse chiwindi chonse ndikuisintha ndi chiwindi chopatsa thanzi.

• Kuphatikiza kwamitsempha yam'mimba: Njira yothetsera (kutseka) mtsempha wamagazi, womwe ndi magazi otengera magazi omwe amabweretsa magazi m'chiwindi. Kuletsa magazi kuthamangira pachiwindi kumathandiza kupha maselo a khansa omwe amakula pamenepo.

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.

Thandizo la Radiopharmaceutical ndi mtundu wa mankhwala amkati amkati. Chotupacho chimaperekedwa ku chotupacho pogwiritsa ntchito mankhwala omwe ali ndi mankhwala a radioactive, monga ayodini I 131, wolumikizidwa nawo. Mankhwalawa amatha kupha zotupa.

Mankhwala akunja amkati ndi amkati amagwiritsidwa ntchito pochizira zotupa za m'mimba zomwe zafalikira mbali zina za thupi.

Chemotherapy

Chemotherapy ndi chithandizo cha khansa chomwe chimagwiritsa ntchito mankhwala kuletsa kukula kwa maselo a khansa, mwina popha ma cell kapena poyimitsa ma cell 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).

Chemoembolization ya mitsempha ya chiwindi ndi mtundu wa chemotherapy m'chigawo chomwe chitha kugwiritsidwa ntchito pochizira chotupa cha m'mimba chomwe chafalikira pachiwindi. Mankhwala oletsa khansa amabayidwa mumitsempha ya hepatic kudzera mu catheter (chubu chochepa). Mankhwalawa amasakanikirana ndi chinthu chomwe chimaphatikizira (kutseka) mtsempha wamagazi, ndikuchepetsa magazi mpaka chotupa. Mankhwala ambiri a anticancer atsekedwa pafupi ndi chotupacho ndipo pang'ono pokha mankhwalawo amafika mbali zina za thupi. Kutsekeka kumatha kukhala kwakanthawi kapena kosatha, kutengera chinthu chomwe chimagwiritsa ntchito kutseka mtsempha. Chotupacho chimalephera kupeza mpweya ndi michere yomwe imafunikira kukula. Chiwindi chimapitilizabe kulandira magazi kuchokera pamitsempha yotsegula, yomwe imanyamula magazi kuchokera m'mimba ndi m'matumbo.

Momwe chemotherapy imaperekedwa imadalira mtundu ndi gawo la khansa yomwe ikuchitidwa.

Thandizo la mahomoni

Thandizo la mahomoni ndi somatostatin analogue ndi mankhwala omwe amaletsa mahomoni owonjezera kuti asapangidwe. Zotupa za GI carcinoid zimathandizidwa ndi octreotide kapena lanreotide omwe amabayidwa pansi pa khungu kapena muminyewa. Octreotide ndi lanreotide amathanso kukhala ndi vuto lochepetsera kukula kwa chotupa.

Chithandizo cha matenda a carcinoid chingafunikirenso.

Chithandizo cha matenda a carcinoid chingaphatikizepo izi:

• Mankhwala a mahormone okhala ndi somatostatin analogue amaletsa mahomoni owonjezera kuti asapangidwe. Matenda a Carcinoid amachiritsidwa ndi octreotide kapena lanreotide kuti achepetse kuthamanga ndi kutsegula m'mimba. Octreotide ndi lanreotide amathanso kuthandizira kukula kwa chotupa.

• Mankhwala a Interferon amalimbikitsa chitetezo cha mthupi kuti chizigwira ntchito bwino komanso chimachepetsa kutsekula m'mimba. Interferon ingathandizenso kuchepa kwa chotupa.

• Kumwa mankhwala otsekula m'mimba.

• Kutenga mankhwala a zotupa pakhungu.

• Kutenga mankhwala kuti mupume mosavuta.

• Kumwa mankhwala musanalandire mankhwala ochititsa dzanzi kuti mukalandire mankhwala.

Njira zina zothanirana ndi matenda a carcinoid ndi monga kupewa zinthu zomwe zimayambitsa kutuluka kapena kupuma movutikira monga mowa, mtedza, tchizi zina ndi zakudya ndi capsaicin, monga tsabola. Kupewa zovuta ndi mitundu ina ya masewera olimbitsa thupi kumathandizanso kuthana ndi matenda a carcinoid.

Kwa odwala ena omwe ali ndi matenda am'mimba a carcinoid, amatha kusintha ma valavu amtima.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Gawo lachiduleli likufotokoza zamankhwala omwe akuwerengedwa m'mayesero azachipatala. Sizingatchule chithandizo chilichonse chatsopano chomwe akuphunzira. Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chithandizo chofuna

Chithandizo choyenera ndi mtundu wa mankhwala omwe amagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuukira maselo amtundu wa khansa osavulaza maselo abwinobwino. Mitundu ingapo yamankhwala omwe akuwunikiridwa akuwerengedwa pochiza zotupa za GC carcinoid.

Kuchiza kwa zotupa za khansa m'mimba kumatha kuyambitsa zovuta.

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.

Njira Zothandizira Pazotupa za m'mimba za m'mimba

M'chigawo chino

• Zotupa Zam'mimba M'mimba

• Zotupa Zam'mimba M'matumbo Aang'ono

• Zotupa za Carcinoid Zakumapeto

• Zotupa za Carcinoid mu Colon

• Zotupa za Carcinoid mu Rectum

• Matumbo a m'mimba Amatumbo a khansa yam'mimba

• Zotupa Zam'mimba Zam'mimba Zomwe Zimapezekanso

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

Zotupa Zam'mimba M'mimba

Chithandizo cha zotupa za khansa m'mimba zitha kukhala izi:

• Opaleshoni ya endoscopic (resection) ya zotupa zazing'ono.

• Opaleshoni (resection) kuchotsa gawo kapena m'mimba monse. Ma lymph node apafupi azotupa zazikulu, zotupa zomwe zimakulira mkati mwa khoma la m'mimba, kapena zotupa zomwe zikukula ndikufalikira mwachangu zitha kuchotsedwa.

Kwa odwala omwe ali ndi zotupa za GC carcinoid m'mimba ndi MEN1 syndrome, chithandizo chitha kuphatikizanso:

• Opaleshoni (resection) kuchotsa zotupa mu duodenum (gawo loyamba la m'mimba, lomwe limalumikizana ndi m'mimba).

• Thandizo la mahomoni.

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.

Zotupa Zam'mimba M'matumbo Aang'ono

Sizikudziwika kuti mankhwala abwino kwambiri ndi otani a GI carcinoid mu duodenum (gawo loyamba la m'mimba, lomwe limalumikizana ndi m'mimba). Chithandizo chingaphatikizepo izi:

• Opaleshoni ya endoscopic (resection) ya zotupa zazing'ono.

• Opaleshoni (kudulira kwapafupi) kuti achotse zotupa zokulirapo.

• Opaleshoni (resection) kuchotsa chotupacho ndi ma lymph node apafupi.

Chithandizo cha zotupa za GI carcinoid mu jejunum (pakati pakatumbo kakang'ono) ndi ileamu (gawo lomaliza la m'matumbo ang'ono, omwe amalumikizana ndi khola) atha kuphatikizira izi:

• Opaleshoni (resection) kuchotsa chotupa ndi nembanemba zomwe zimalumikiza matumbo kumbuyo kwa khoma lamimba. Ma lymph node apafupi nawonso amachotsedwa.

• Opaleshoni yachiwiri yochotsa nembanemba yomwe imalumikiza matumbo kumbuyo kwa khoma lam'mimba, ngati chotupa chilichonse chatsalira kapena chotupacho chikukula.

• Thandizo la mahomoni.

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.

Zotupa za Carcinoid Zakumapeto

Chithandizo cha zotupa za GI za khansa zowonjezera ndizophatikizira izi:

• Opaleshoni (resection) kuchotsa zakumapeto.

• Opaleshoni (resection) kuchotsa mbali yakumanja ya colon kuphatikiza zowonjezera. Ma lymph node apafupi nawonso amachotsedwa.

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.

Zotupa za Carcinoid mu Colon

Chithandizo cha zotupa za GI za khansa m'matumbo zitha kuphatikizira izi:

• Opaleshoni (resection) kuchotsa gawo la m'matumbo ndi ma lymph node apafupi, kuti achotse khansa yambiri momwe angathere.

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.

Zotupa za Carcinoid mu Rectum

Chithandizo cha zotupa za GI carcinoid mu rectum zitha kuphatikizira izi:

• Opaleshoni ya Endoscopic (resection) ya zotupa zomwe ndizochepera kuposa sentimita imodzi.

• Opaleshoni (resection) ya zotupa zomwe zimakhala zazikulu kuposa masentimita awiri kapena zomwe zafalikira kumtunda wa minofu ya khoma lammbali. Izi zikhoza kukhala:

• opaleshoni kuchotsa gawo la rectum; kapena

• Kuchotsa anus, rectum, ndi gawo linalake la m'matumbo kudzera mu cheka m'mimba.

Sizikudziwika bwinobwino kuti mankhwala abwino ndi otani omwe ali 1 mpaka 2 sentimita. Chithandizo chingaphatikizepo izi:

• Opaleshoni ya endoscopic (resection).

• Opaleshoni (resection) kuchotsa gawo la rectum.

• Opaleshoni (resection) kuchotsa anus, rectum, ndi gawo la koloni kudzera mu mpangidwe wopangidwa m'mimba.

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.

Matumbo a m'mimba Amatumbo a khansa yam'mimba

Masamba akutali

Kuchiza kwa ma metastases akutali a GI zotupa chifukwa cha khansa nthawi zambiri kumathandiza kuti muchepetse zizolowezi komanso kuti mukhale ndi moyo wabwino. Chithandizo chingaphatikizepo izi:

• Opaleshoni (resection) kuti achotse chotupacho momwe zingathere.

• Thandizo la mahomoni.

• Thandizo la Radiopharmaceutical.

• Thandizo la radiation lakunja la khansa lomwe lafalikira kumafupa, ubongo, kapena msana.

• Kuyesedwa kwachipatala kwa chithandizo chatsopano.

Chiwindi metastases

Chithandizo cha khansa yomwe yafalikira pachiwindi ndi awa:

• Opaleshoni (kudulira kwapafupi) kuchotsa chotupa pachiwindi.

• Kuphatikiza kwamitsempha yamatenda.

• Kuchiza opaleshoni.

• Kuchotsa ma Radiofrequency.

• Kuika chiwindi.

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.

Zotupa Zam'mimba Zam'mimba Zomwe Zimapezekanso

Kuchiza kwa zotupa za khansa ya khansa nthawi zambiri kungaphatikizepo izi:

• Kuchita maopareshoni (kuchotsa m'deralo) kuchotsa gawo kapena chotupa chonse.

• 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 zam'mimba zotupa m'mimba

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza zotupa za m'mimba, onani izi:

• Tsamba Lam'mimba Zotupa Zamkatimu Tsamba

• Cryosurgery mu Chithandizo cha Khansa

• Njira Zochizira Khansa

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