Types/kidney/patient/kidney-treatment-pdq

Chithandizo cha Cancer Cell Cancer (®) -Patient Version

Zambiri Zokhudza Khansa Yam'magazi Amphongo

MFUNDO ZOFUNIKA

• Khansa ya m'mitsempha yamagulu ndi matenda omwe ma cell owopsa (khansa) amapangika m'matubu a impso.

• Kusuta ndi kugwiritsa ntchito molakwika mankhwala ena opweteka kumatha kukhudza chiopsezo cha khansa ya m'mitsempha ya m'mitsempha.

• Zizindikiro za khansara yamphongo yamphongo zimaphatikizapo magazi mkodzo ndi chotupa m'mimba.

• Kuyesa komwe kumayang'ana pamimba ndi impso kumagwiritsidwa ntchito pozindikira khansa ya m'mitsempha ya impso.

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

Khansa ya m'mitsempha yamagulu ndi matenda omwe ma cell owopsa (khansa) amapangika m'matubu a impso.

Khansara ya renal (yomwe imadziwikanso kuti khansa ya impso kapena a renal cell adenocarcinoma) ndi matenda omwe amapezeka m'maselo owopsa (khansa) m'matope a timachules (timachubu tating'ono kwambiri) mu 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.

Khansa yomwe imayamba mu ureters kapena aimpso pelvis (gawo la impso lomwe limasonkhanitsa mkodzo ndikuwatsanulira kwa ureters) ndiyosiyana ndi khansa ya m'mitsempha ya impso. (Onani chidule cha chokhudza Khansa ya Transitional ya Renal Pelvis ndi Ureter Treatment kuti mumve zambiri).

Kusuta ndi kugwiritsa ntchito molakwika mankhwala ena opweteka kumatha kukhudza chiopsezo cha khansa ya m'mitsempha ya m'mitsempha.

Chilichonse chomwe chimakulitsa chiopsezo chotenga matenda 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.

Zowopsa za khansa ya m'mitsempha ya m'mimba ndi izi:

• Kusuta.

• Kugwiritsa ntchito molakwika mankhwala ena opweteka, kuphatikizapo mankhwala owawa owawa, kwa nthawi yayitali.

• Kukhala wonenepa kwambiri.

• Kukhala ndi kuthamanga kwa magazi.

• Kukhala ndi mbiri yabanja ya khansa yapamtima yamafuta.

• Kukhala ndi zikhalidwe zina, monga matenda a von Hippel-Lindau kapena cholowa cha papillary renal cell carcinoma.

Zizindikiro za khansa ya impso zimaphatikizapo magazi mkodzo komanso chotupa m'mimba. '

Izi ndi zizindikilo ndi zina zimatha kuyambitsidwa ndi khansa ya m'mitsempha kapena matenda ena. Sipangakhale zisonyezo kumayambiriro. Zizindikiro zimatha kuoneka ngati chotupacho chimakula. Funsani dokotala ngati muli ndi izi:

• Magazi mkodzo.

• Chotupa m'mimba.

• Kupweteka kumbali komwe sikumatha.

• Kutaya njala.

• Kuchepetsa thupi popanda chifukwa chodziwika.

• Kuchepa kwa magazi m'thupi.

Kuyesa komwe kumayang'ana pamimba ndi impso kumagwiritsidwa ntchito pozindikira khansa ya m'mitsempha ya impso.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuyezetsa thupi komanso mbiri yaumoyo: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikizapo 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 kwa Ultrasound: Njira yomwe mafunde amawu amphamvu (ultrasound) amachotsedwa pamatumba kapena ziwalo zamkati ndikupanga mawonekedwe. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram.

• Kafukufuku wamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zakumwamba kapena zochepa) kungakhale chizindikiro cha matenda.

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

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga pamimba ndi m'chiuno, 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 nuclear magnetic resonance imaging (NMRI).

• Biopsy: Kuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwalayo kuti aone ngati ali ndi khansa. Kuti apange kachilombo ka khansa ya m'mimba, singano yopyapyala imayikidwa mu chotupacho ndipo mtundu wina wa minofu umachotsedwa.

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

Njira zakulosera zamankhwala ndi chithandizo zimadalira izi:

• Gawo la matenda.

• Msinkhu wa wodwalayo komanso thanzi lake lonse.

Magawo a Khansa Yam'magazi Amphongo

MFUNDO ZOFUNIKA

• Khansa ya khungu la renal itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa impso 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 m'mimba:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Khansa ya m'mitsempha yamagulu imatha kubwereranso (kubwerera) zaka zambiri mutalandira chithandizo choyambirira.

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

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa yafalikira mkati mwa impso kapena mbali zina za thupi imatchedwa 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 zamkati mwa thupi, monga chifuwa kapena ubongo, 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 magawo amkati mwa thupi, monga ubongo. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

• 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 yamphongo ya impso imafalikira mpaka fupa, maselo a khansa omwe ali m'mafupawo amakhala ndi khansa ya impso. Matendawa ndi khansa ya m'mitsempha ya m'mitsempha, osati khansa ya mafupa.

Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya m'mimba:

Gawo I

Khansa ya khansa ya impso. Chotupacho chili ndi masentimita 7 kapena ocheperako ndipo chimapezeka mu impso zokha.

Pachigawo choyamba ine, chotupacho chili ndi masentimita 7 kapena ocheperako ndipo chimapezeka mu impso zokha.

Gawo II

Khansa yachiwiri ya impso. Chotupacho chimakhala chachikulu kuposa masentimita 7 ndipo chimapezeka mu impso zokha.

Gawo lachiwiri, chotupacho chimakhala chachikulu kuposa masentimita 7 ndipo chimapezeka mu impso zokha.

Gawo III

Khansa ya impso ya Gawo lachitatu. Khansara ya impso ndi kukula kulikonse ndipo khansara yafalikira ku a) ma lymph node, b) mitsempha yamagazi mkati kapena pafupi ndi impso (a renal vein or vena cava), c) ziwalo zomwe zili mu impso zomwe zimasonkhanitsa mkodzo, kapena d ) wosanjikiza wamafuta ozungulira impso.

Mu gawo lachitatu, chimodzi mwazinthu izi chimapezeka:

• khansara ya impso ndi kukula kulikonse ndipo khansara yafalikira ku ma lymph node apafupi; kapena

• Khansara yafalikira kumitsempha yamagazi mkati kapena pafupi ndi impso (aimpso vein kapena vena cava), kwa mafuta ozungulira ziwalo za impso zomwe zimasonkhanitsa mkodzo, kapena wosanjikiza wamafuta ozungulira impso. Khansa ikhoza kufalikira ku ma lymph node apafupi.

Gawo IV

Khansa ya impso ya Gawo IV. Khansara yafalikira a) kupitirira mafuta osanjikiza ozungulira impso ndipo atha kufalikira kumtunda wa adrenal pamwamba pa impso ndi khansa, kapena b) mbali zina za thupi, monga ubongo, mapapo, chiwindi, adrenal gland, fupa, kapena ma lymph node akutali.

Mu gawo IV, chimodzi mwazinthu izi chimapezeka:

• khansara yafalikira kupitirira mafuta omwe ali pafupi ndi impso ndipo mwina ifalikira kumtunda wa adrenal pamwamba pa impso ndi khansa kapena ma lymph node apafupi; kapena

• khansara yafalikira mbali zina za thupi, monga mafupa, chiwindi, mapapo, ubongo, adrenal gland, kapena ma lymph node akutali.

Khansa ya m'mitsempha yamagulu imatha kubwereranso (kubwerera) zaka zambiri mutalandira chithandizo choyambirira.

Khansara ikhoza kubwerera mu impso kapena mbali zina za thupi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi khansa ya m'mitsempha yamafuta.

• Mitundu isanu yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

• Opaleshoni

• Thandizo la radiation

• Chemotherapy

• Chitetezo chamatenda

• Chithandizo chofuna

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo cha khansa yamphongo yamphongo chingayambitse 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 kwa odwala omwe ali ndi khansa ya m'mitsempha yamafuta.

Pali mitundu ingapo yamankhwala othandizira odwala khansa yamphongo yamafuta. 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 isanu yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

Opaleshoni

Opaleshoni yochotsa gawo kapena impso zonse nthawi zambiri imagwiritsidwa ntchito pochiza khansa ya m'mitsempha yamafuta. Mitundu yotsatirayi ingagwiritsidwe ntchito:

• Partial nephrectomy: Njira yochotsera khansa mkati mwa impso ndi zina mwa ziwalozo. Nephrectomy yapadera imatha kuchitidwa kuti isataye ntchito ya impso pamene impso zina zawonongeka kapena zachotsedwa kale.

• Nephrectomy yosavuta: Njira yochotsera impso kokha.

• Radical nephrectomy: Njira yochotsera impso, adrenal gland, minofu yozungulira, ndipo, nthawi zambiri, ma lymph node oyandikira.

Munthu atha kukhala ndi gawo la impso imodzi yogwira ntchito, koma ngati impso zonse zichotsedwa kapena sizikugwira ntchito, munthuyo adzafunika dialysis (njira yoyeretsera magazi pogwiritsa ntchito makina kunja kwa thupi) kapena kumuika impso (m'malo mwa wathanzi impso zoperekedwa). Kuika impso kumatha kuchitika ngati matendawa ali mu impso zokha ndipo impso zoperekedwa zitha kupezeka. Wodwala akamadikirira impso, amalandira chithandizo china ngati angafunikire.

Ngati opaleshoni yochotsa khansa sichingatheke, chithandizo chotchedwa arterial embolization chitha kugwiritsidwa ntchito pochepetsa chotupacho. Kung'amba pang'ono kumapangidwa ndipo catheter (chubu chochepa) imayikidwa mumtsuko wamagazi waukulu womwe umatsikira ku impso. Zidutswa zazing'ono za siponji yapadera ya gelatin zimabayidwa kudzera mu catheter mumtsuko wamagazi. Masiponji amaletsa magazi kupita ku impso ndikuletsa maselo a khansa kuti asalandire mpweya komanso zinthu zina zomwe amafunikira kuti zikule.

Dokotala atachotsa khansa yonse yomwe imawonekera panthawi yochitidwa opaleshoniyi, odwala ena atha kupatsidwa chemotherapy kapena radiation pochita opaleshoni kuti aphe maselo aliwonse a khansa omwe atsala. Chithandizo chomwe chimaperekedwa pambuyo pa opareshoni, kuti muchepetse chiopsezo kuti khansa ibwererenso, 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. Thandizo la radiation lakunja limagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chakuthupi ndi khansa. Thandizo la radiation lakunja limagwiritsidwa ntchito pochiza khansa ya m'mitsempha yamafuta, ndipo itha kugwiritsidwanso ntchito ngati mankhwala ochepetsa nkhawa kuti muchepetse zizindikiritso ndikukhalitsa moyo wabwino.

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).

Onani Khansa Yovomerezeka Ndi Impso (Renal Cell) Khansa 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.

Mitundu yotsatirayi ya immunotherapy ikugwiritsidwa ntchito pochiza khansa ya m'mimba:

• Mankhwala oteteza ku chitetezo cha mthupi: Mitundu ina yamaselo amthupi, monga ma T cell, ndi ma cell ena a khansa ali ndi mapuloteni ena, omwe amatchedwa checkpoint protein, kumtunda kwawo omwe amayang'anira kuyankha kwa chitetezo cha mthupi. Maselo a khansa ali ndi mapuloteni ambiri, samenyedwa ndikuphedwa ndi ma T. Chitetezo cha chitetezo cha mthupi chimatseka mapuloteniwa ndipo kuthekera kwa maselo a T kupha ma cell a khansa kumakulitsidwa. Amagwiritsidwa ntchito pochiza odwala ena omwe ali ndi khansa yaposachedwa kwambiri ya khungu lomwe silingachotsedwe ndi opaleshoni.

Pali mitundu iwiri ya chitetezo cha chitetezo cha mthupi:

• CTLA-4 inhibitor: CTLA-4 ndi mapuloteni pamwamba pa ma T omwe amathandiza kuti chitetezo cha mthupi chitetezedwe. CTLA-4 ikamangirira puloteni ina yotchedwa B7 pa khungu la khansa, imayimitsa T cell kuti isaphe khungu la khansa. CTLA-4 inhibitors amadziphatika ku CTLA-4 ndikulola ma T maselo kupha ma cell a khansa. Ipilimumab ndi mtundu wa CTLA-4 inhibitor.

Chitetezo cha chitetezo cha mthupi. Mapuloteni a checkpoint, monga B7-1 / B7-2 pama cell antigen-presenting cell (APC) ndi CTLA-4 pama cell a T, amathandizira kuteteza mayankho a chitetezo cha mthupi. T-cell receptor (TCR) ikamangirira ku antigen komanso mapuloteni akuluakulu a histocompatibility complex (MHC) pa APC ndi CD28 amamangiriza ku B7-1 / B7-2 pa APC, T cell imatha kuyatsidwa. Komabe, kumangiriza kwa B7-1 / B7-2 mpaka CTLA-4 kumapangitsa kuti ma T maselo akhale osagwira ntchito kotero kuti sangathe kupha ma cell am'mimba mthupi (kumanzere). Kuletsa kumangiriza kwa B7-1 / B7-2 mpaka CTLA-4 yokhala ndi chitetezo cha chitetezo cha mthupi (anti-CTLA-4 antibody) kumalola ma T kuti azitha kugwira ntchito ndikupha ma cell a chotupa (gulu lamanja).

• PD-1 inhibitor: PD-1 ndi mapuloteni pamwamba pa ma 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. Nivolumab, pembrolizumab, ndi avelumab 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).

• Interferon: Interferon imakhudza kugawanika kwa maselo a khansa ndipo imatha kuchepetsa kukula kwa chotupa.

• Interleukin-2 (IL-2): IL-2 imathandizira kukula ndi magwiridwe antchito am'magazi ambiri amthupi, makamaka ma lymphocyte (mtundu wa maselo oyera amwazi). Ma lymphocyte amatha kuwononga ndikupha ma cell a khansa.

Onani Khansa Yovomerezeka Ndi Impso (Renal Cell) Khansa kuti mumve zambiri.

Chithandizo chofuna

Chithandizo chomwe akuyembekezerachi chimagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuukira maselo amtundu wa khansa osavulaza maselo abwinobwino. Chithandizo choyenera chothandizidwa ndi ma antiangiogenic wothandizila chimagwiritsidwa ntchito pochiza khansa yaposachedwa kwambiri ya cell. Ma antiangiogenic othandizira kuti mitsempha yamagazi isapangike chotupa, ndikupangitsa chotupacho kufa ndi njala ndikusiya kukula kapena kuchepa.

Ma antibodies a monoclonal ndi kinase inhibitors ndi mitundu iwiri ya ma antiangiogenic agents omwe amagwiritsidwa ntchito pochiza khansa yapamtima ya cell.

• Thandizo la monoclonal antibody limagwiritsa ntchito ma antibodies opangidwa mu labotore, kuchokera ku mtundu umodzi wa chitetezo chamthupi. Ma antibodies awa amatha kuzindikira zinthu zomwe zili m'maselo a khansa kapena zinthu zabwinobwino zomwe zingathandize ma cell a khansa kukula. Ma antibodies amalumikizana ndi zinthuzo ndikupha ma cell a khansa, amalepheretsa kukula kwawo, kapena amalepheretsa kufalikira. Ma antibodies a monoclonal amaperekedwa mwa kulowetsedwa. Angagwiritsidwe ntchito okha kapena kunyamula mankhwala osokoneza bongo, poizoni, kapena zinthu zowononga radio kupita kuma cell a khansa. Ma antibodies a monoclonal omwe amagwiritsidwa ntchito pochiza khansa ya m'mitsempha yamafuta yolumikizidwa ndikuletsa zinthu zomwe zimapangitsa mitsempha yatsopano kupanga zotupa. Bevacizumab ndi antioclonal antibody.

• Kinase inhibitors amaletsa maselo kuti asagawikane ndipo amatha kulepheretsa mitsempha yatsopano yomwe zotupa zimayenera kukula.

Vascular endothelial growth factor (VEGF) inhibitors ndi mTOR inhibitors ndi kinase inhibitors omwe amagwiritsidwa ntchito pochiza khansa ya m'mitsempha yamagazi.

• VEGF inhibitors: Maselo a khansa amapanga chinthu chotchedwa VEGF, chomwe chimayambitsa mitsempha yatsopano yamagazi (angiogenesis) ndikuthandizira khansa kukula. Ma VEGF inhibitors amaletsa VEGF ndikuletsa mitsempha yatsopano yopanga. Izi zitha kupha ma cell a khansa chifukwa amafunikira mitsempha yatsopano yamagazi kuti ikule. Sunitinib, pazopanib, cabozantinib, axitinib, sorafenib, ndi lenvatinib ndi VEGF inhibitors.

• mTOR inhibitors: MT ndi mapuloteni omwe amathandiza maselo kugawanika ndikupulumuka. MTOR inhibitors amaletsa mTOR ndipo amatha kuteteza maselo a khansa kuti asakule ndikuletsa kukula kwa mitsempha yatsopano yomwe zotupa zimayenera kukula. Everolimus ndi temsirolimus ndi mTOR inhibitors.

Onani Khansa Yovomerezeka Ndi Impso (Renal Cell) Khansa kuti mumve zambiri.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chithandizo cha khansa yamphongo yamphongo chingayambitse 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.

Kuchiza kwa Khansa Yama cell Yam'magazi I

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

Chithandizo cha khansa yapachigawo cha khansa ingaphatikizepo izi:

• Opaleshoni (radical nephrectomy, nephrectomy yosavuta, kapena pang'ono nephrectomy).

• Thandizo la radiation ngati mankhwala ochepetsa nkhawa kuti athetse zovuta mwa odwala omwe sangathe kuchitidwa opaleshoni.

• Kuphatikizika kwamitsempha ngati mankhwala othandizira.

• 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.

Kuchiza kwa Khansa Yapanja Yam'magazi II

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

Chithandizo cha khansa ya khansa ya m'magazi ya gawo II chingaphatikizepo izi:

• Opaleshoni (kwakukulu nephrectomy kapena tsankho nephrectomy).

• Opaleshoni (nephrectomy), isanachitike kapena itatha mankhwala a radiation.

• Thandizo la radiation ngati mankhwala ochepetsa nkhawa kuti athetse zovuta mwa odwala omwe sangathe kuchitidwa opaleshoni.

• Kuphatikizika kwamitsempha ngati mankhwala othandizira.

• 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.

Kuchiza kwa Khansa ya Cell ya Renal Cell ya Stage III

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

Chithandizo cha khansa ya khansa ya m'magazi ya gawo lachitatu chingaphatikizepo izi:

• Opaleshoni (kwakukulu nephrectomy). Mitsempha yamagazi ya impso ndi ma lymph node amathanso kuchotsedwa.

• Kuphatikizika kwamitsempha kotsatiridwa ndi opaleshoni (radical nephrectomy).

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

• Kuphatikizika kwamitsempha ngati mankhwala othandizira.

• Opaleshoni (nephrectomy) ngati mankhwala opatsirana.

• Thandizo la radiation musanachite opaleshoni kapena pambuyo pake (nephrectomy yayikulu).

• Kuyesedwa kwachipatala kwa mankhwala a biologic pambuyo pa opaleshoni.

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.

Kuchiza kwa Gawo IV ndi Khansa Yaposachedwa Yam'mimba

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

Chithandizo cha siteji IV komanso khansa yapawiri yabwinobwino ingaphatikizepo izi:

• Opaleshoni (kwakukulu nephrectomy).

• Opaleshoni (nephrectomy) kuchepetsa kukula kwa chotupacho.

• Chithandizo chotsata ndi chimodzi kapena zingapo zotsatirazi: sorafenib, sunitinib, temsirolimus, pazopanib, everolimus, bevacizumab, axitinib, cabozantinib, kapena lenvatinib.

• Immunotherapy ndi chimodzi kapena zingapo zotsatirazi: interferon, interleukin-2, nivolumab, ipilimumab, pembrolizumab, kapena avelumab.

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

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 Zokhudza Khansa Yam'magazi Amphongo

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

• Tsamba La Khansa Ya Impso

• Mankhwala Ovomerezeka a Khansa ya Impso (Renal Cell) Khansa

• Immunotherapy Kuchiza Khansa

• Njira Zochizira Khansa

• Angiogenesis Inhibitors

• Kuyesedwa Kwachibadwa kwa Ma Syndromes Obadwa Ndi 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

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