Mitundu / chiwindi / wodwala / wamkulu-chiwindi-chithandizo-pdq

Kuchiza Khansa Yaikulu Ya Akuluakulu

Zambiri Za Khansa Yaikulu Yaikulu Ya Chiwindi

MFUNDO ZOFUNIKA

• Khansa yayikulu ya chiwindi ndi matenda omwe ma cell owopsa (khansa) amapangidwa m'matumba a chiwindi.

• Pali mitundu iwiri ya khansa yoyamba ya chiwindi.

• Kukhala ndi hepatitis kapena cirrhosis kumatha kukhudza chiwopsezo cha khansa yayikulu yayikulu ya chiwindi.

• Zizindikiro za khansa yayikulu ya chiwindi yayikulu imaphatikizapo chotupa kapena zopweteka kumanja.

• Kuyesa komwe kumayesa chiwindi ndi magazi amagwiritsidwa ntchito kuti apeze (kupeza) ndikuzindikira khansa yayikulu ya chiwindi.

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

Khansa yayikulu ya chiwindi ndi matenda omwe ma cell owopsa (khansa) amapangidwa m'matumba a chiwindi.

Chiwindi ndi chimodzi mwa ziwalo zazikulu kwambiri mthupi. Ili ndi ma lobes awiri ndipo imadzaza kumanja chakumanja kwa mimba mkati mwa nthiti. Ntchito zitatu zofunika kwambiri m'chiwindi ndi izi:

• Sefa zovulaza zamagazi kuti zitha kupitsidwira m'thupi ndi mkodzo.

• Kupanga bile kuti izithandiza kugaya mafuta omwe amabwera kuchokera pachakudya.

• Kusunga glycogen (shuga), yomwe thupi limagwiritsa ntchito mphamvu.

Thupi la chiwindi. Chiwindi chili pamimba chapafupi pafupi ndi m'mimba, matumbo, ndulu, ndi kapamba. Chiwindi chili ndi lobe lamanja ndi lobe lamanzere. Lobe iliyonse imagawika m'magawo awiri (osawonetsedwa).

Pali mitundu iwiri ya khansa yoyamba ya chiwindi.

Mitundu iwiri ya khansa yoyamba ya chiwindi ndi iyi:

• Matenda a hepatocellular carcinoma.

• Cholangiocarcinoma (khansa ya bile). (Onani chidule cha pa Bile Duct Cancer (Cholangiocarcinoma) Chithandizo kuti mumve zambiri.)

Mtundu wodziwika bwino wa khansa yoyamba ya chiwindi ndi hepatocellular carcinoma. Mtundu wa khansa ya chiwindi ndiwachitatu womwe umayambitsa matenda opatsirana khansa padziko lonse lapansi.

Chidulechi ndi cha chithandizo cha khansa yoyamba ya chiwindi (khansa yomwe imayamba m'chiwindi). Chithandizo cha khansa chomwe chimayambira mbali zina za thupi ndikufalikira ku chiwindi sichinafotokozedwe mwachidule.

Khansa yoyamba ya chiwindi imatha kupezeka mwa akulu ndi ana. Komabe, chithandizo cha ana ndichosiyana ndi chithandizo cha akulu. (Onani chidule cha pa Chithandizo cha Khansa ya Chiwindi cha Ana kuti mumve zambiri.)

Kukhala ndi hepatitis kapena cirrhosis kumatha kukhudza chiwopsezo cha khansa yayikulu yayikulu ya chiwindi.

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 chiwindi.

Zowopsa za khansa ya chiwindi ndi izi:

• Kukhala ndi matenda a hepatitis B kapena hepatitis C. Kukhala ndi hepatitis B ndi hepatitis C kumawonjezera ngozi.

Kukhala ndi cirrhosis.

• Kumwa mowa kwambiri. Kumwa mowa kwambiri komanso kukhala ndi matenda a hepatitis B kumawonjezera ngozi.

• Kudya zakudya zodetsedwa ndi aflatoxin (poizoni wochokera kubowa yemwe amatha kumera pazakudya, monga mbewu ndi mtedza, zomwe sizinasungidwe bwino).

• Kukhala ndi nonatoxic steatohepatitis (NASH), momwe mafuta amapangidwira m'chiwindi ndipo amatha kupita patsogolo mpaka kutupa kwa chiwindi ndi kuwonongeka kwa khungu.

• Kugwiritsa ntchito fodya, monga kusuta ndudu.

• Kukhala ndi zovuta zina zobadwa nazo kapena zosowa zomwe zimawononga chiwindi, kuphatikizapo izi:

• Hereditary hemochromatosis, matenda obadwa nawo momwe thupi limasungira chitsulo chochuluka kuposa momwe chimafunira. Chitsulo chowonjezeracho chimasungidwa m'chiwindi, mtima, kapamba, khungu, ndi zimfundo.

• Kulephera kwa Alpha-1 antitrypsin, matenda obadwa nawo omwe angayambitse matenda a chiwindi ndi m'mapapo.

• Matenda osungira Glycogen, matenda obadwa nawo omwe amakumana ndi mavuto momwe mtundu wa shuga (shuga) wotchedwa glycogen umasungidwa ndikugwiritsidwa ntchito m'thupi.

• Porphyria cutanea tarda, matenda osowa omwe amakhudza khungu ndipo amachititsa matuza opweteka mbali zina za thupi zomwe zimawonetsedwa ndi dzuwa, monga manja, mikono, ndi nkhope. Mavuto a chiwindi amathanso kuchitika.

• Matenda a Wilson, matenda obadwa nawo omwe thupi limasungira mkuwa wambiri kuposa momwe amafunikira. Mkuwa wowonjezerayo umasungidwa m'chiwindi, ubongo, maso, ndi ziwalo zina.

Ukalamba ndiwo chiopsezo chachikulu cha khansa yambiri. Mwayi wokhala ndi khansa ukuwonjezeka mukamakula.

Zizindikiro za khansa yayikulu ya chiwindi yayikulu imaphatikizapo chotupa kapena zopweteka kumanja.

Izi ndi zizindikilo ndi zina zimatha chifukwa cha khansa yayikulu ya chiwindi kapena zina. Funsani dokotala ngati muli ndi izi:

• Bulu lolimba kumanja kumunsi kwenikweni kwa nthiti.

• Kusokonezeka pamimba kumtunda kumanja.

• Mimba yotupa.

• Ululu pafupi ndi tsamba lamapewa lamanja kapena kumbuyo.

• Jaundice (chikasu chachikopa ndi azungu amaso).

• Kuvulaza kosavuta kapena kutuluka magazi.

• Kutopa kapena kufooka kosazolowereka.

• Nseru ndi kusanza.

• Kutaya chilakolako kapena kukhutira mutadya pang'ono.

• Kuchepetsa thupi popanda chifukwa chodziwika.

• Kutuluka, matumbo osalala ndi mkodzo wakuda.

• Malungo.

Kuyesa komwe kumayesa chiwindi ndi magazi amagwiritsidwa ntchito kuti apeze (kupeza) ndikuzindikira khansa yayikulu ya chiwindi.

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.

• Kuyezetsa magazi kwa seramu: Njira yomwe magazi amayesedwa kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo, zotupa, kapena zotupa m'thupi. Zinthu zina zimalumikizidwa ndi mitundu ina ya khansa ikapezeka m'magazi ochulukirapo. Izi zimatchedwa zolembera zotupa. Kuwonjezeka kwa alpha-fetoprotein (AFP) m'magazi kungakhale chizindikiro cha khansa ya chiwindi. Khansa zina ndi zina zomwe sizimayambitsa khansa, kuphatikizapo matenda a chiwindi ndi chiwindi, zitha kuwonjezera kuchuluka kwa AFP. Nthawi zina mlingo wa AFP ndi wabwinobwino ngakhale pali khansa ya chiwindi.

• Kuyesa kwa chiwindi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi chiwindi. Kuchuluka kwazinthu zambiri kungakhale chizindikiro cha khansa ya chiwindi.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga pamimba, 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. Zithunzi zitha kutengedwa katatu pambuyo poti utoto wabayidwa, kuti mumve bwino za madera omwe ali pachiwindi. Izi zimatchedwa CT-phase CT. Kujambula kwa CT kapena kozungulira kumapangitsa kujambula zithunzi mwatsatanetsatane zamkati mwathupi pogwiritsa ntchito makina a x-ray omwe amayang'ana thupi mozungulira.

• MRI (magnetic resonance imaging): Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, komanso kompyuta kuti ipange zithunzi zingapo za magawo amkati mwa thupi, monga chiwindi. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI). Kuti apange utoto wazithunzi zamitsempha yamagazi mkati ndi pafupi ndi chiwindi, utoto umalowetsedwa mumtsempha. Njirayi imatchedwa MRA (magnetic resonance angiography). Zithunzi zitha kutengedwa katatu pambuyo poti utoto wabayidwa, kuti mumve bwino za madera omwe ali pachiwindi. Izi zimatchedwa MRI yamagawo atatu.

• Kuyesa kwa Ultrasound: Njira yomwe mafunde amawu amphamvu (ultrasound) amachotsedwa pamatumba kapena ziwalo zamkati ndikupanga mawonekedwe. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Chithunzicho chimatha kusindikizidwa kuti chiwonedwe pambuyo pake.

• Biopsy: Kuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwalayo kuti aone ngati ali ndi khansa. Njira zomwe zimagwiritsidwa ntchito posonkhanitsa maselo kapena ziphuphu zimaphatikizapo izi:

• Chida chabwino cha singano: Kuchotsa maselo, minofu kapena madzi pogwiritsa ntchito singano yopyapyala.

• Core singano biopsy: Kuchotsa maselo kapena minofu pogwiritsa ntchito singano yotakata pang'ono.

• Laparoscopy: Njira yochitira opaleshoni yoyang'ana ziwalo zamkati mwa mimba kuti muwone ngati pali matenda. Tizinthu tating'onoting'ono (todulira) timapangidwa pakhoma pamimba ndipo laparoscope (chubu chowonda, chowunikira) imayikidwa mchimodzi mwazinthuzo. Chida china chimayikidwa kudzera pachimodzimodzi kapena china kuti atulutse zitsanzo za minofu.

Chidziwitso sichimafunika nthawi zonse kuti mupeze khansa yayikulu ya chiwindi.

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

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Gawo la khansa (kukula kwa chotupacho, ngakhale chikukhudza gawo kapena chiwindi chonse, kapena chafalikira m'malo ena m'thupi).

• Chiwindi chikugwira ntchito bwino.

• Thanzi labwino la wodwalayo, kuphatikiza ngati pali chiwindi cha chiwindi.

Magawo a Khansa Yaikulu Ya Chiwindi Ya Akuluakulu

MFUNDO ZOFUNIKA

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

• Pali njira zitatu zomwe khansa imafalikira mthupi.

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

• Dongosolo la Cancer Stage Cancer Stage lingagwiritsidwe ntchito kukhazikitsa khansa yayikulu yayikulu ya chiwindi.

• Magulu otsatirawa amagwiritsidwa ntchito pokonzekera chithandizo.

• BCLC magawo 0, A, ndi B

• BCLC magawo C ndi D

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

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa yafalikira mkati mwa chiwindi 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, pamimba, ndi m'chiuno, zochokera mbali zosiyanasiyana. 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).

• 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.

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 mumitsempha yam'magazi 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 khansa yoyamba ya chiwindi imafalikira m'mapapu, maselo a khansa m'mapapo alidi maseli a khansa ya chiwindi. Matendawa ndi khansa ya chiwindi, osati khansa yamapapu.

Dongosolo la Cancer Stage Cancer Stage lingagwiritsidwe ntchito kukhazikitsa khansa yayikulu yayikulu ya chiwindi.

Pali magawo angapo a khansa ya chiwindi. Stage System ya Barcelona Clinic Liver Cancer (BCLC) imagwiritsidwa ntchito kwambiri ndipo yafotokozedwa pansipa. Njirayi imagwiritsidwa ntchito kuneneratu mwayi wodwalayo wochira ndikukonzekera chithandizo, kutengera izi:

• Kaya khansara yafalikira mkati mwa chiwindi kapena mbali zina za thupi.

• Chiwindi chikugwira ntchito bwino.

• Thanzi labwino komanso thanzi la wodwalayo.

• Zizindikiro zomwe zimayambitsa khansa.

Makina owonetsera a BCLC ali ndi magawo asanu:

• Gawo 0: molawirira kwambiri

• Gawo A: Kumayambiriro

• Gawo B: Wapakati

• Gawo C: Zotsogola

• Gawo D: Gawo lomaliza

Magulu otsatirawa amagwiritsidwa ntchito pokonzekera chithandizo.

BCLC magawo 0, A, ndi B

Chithandizo chothandizira khansa chimaperekedwa pamanambala a BCLC 0, A, ndi B.

BCLC magawo C ndi D

Chithandizo chothanirana ndi zomwe zimayambitsidwa ndi khansa ya chiwindi ndikusintha moyo wa wodwalayo chimaperekedwa kwa magawo a BCLC a C ndi D. Chithandizo sichingathetse khansa.

Khansa Yaikulu Ya chiwindi Ya Akuluakulu

Khansa yoyambira pachiwindi ya akulu ndi khansa yomwe yabwereranso (itachiritsidwa) itachiritsidwa. Khansara imatha kubwerera m'chiwindi kapena mbali zina za thupi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi khansa yoyamba ya chiwindi.

• Odwala khansa ya chiwindi amathandizidwa ndi gulu la akatswiri omwe ndi akatswiri othandiza khansa ya chiwindi.

• Mitundu isanu ndi itatu yamankhwalawa amagwiritsidwa ntchito:

• Kuwunika

• Opaleshoni

• Kuika chiwindi

• Thandizo la Ablation

• Mankhwala othandizira

• Chithandizo chofuna

• Chitetezo chamatenda

• Thandizo la radiation

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo cha khansa yayikulu yamchiwindi yayikulu ingayambitse 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 khansa yoyamba ya chiwindi.

Pali mitundu ingapo yamankhwala othandizira odwala omwe ali ndi khansa yoyamba ya chiwindi. 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.

Odwala khansa ya chiwindi amathandizidwa ndi gulu la akatswiri omwe ndi akatswiri othandiza khansa ya chiwindi.

Chithandizo cha wodwalayo chidzayang'aniridwa ndi a oncologist wazamankhwala, dokotala yemwe amachita bwino ntchito yothandiza anthu omwe ali ndi khansa. Dokotala wa oncologist atha kutumiza wodwalayo kwa akatswiri ena azaumoyo omwe amaphunzitsidwa mwapadera pochiza odwala khansa ya chiwindi. Izi zingaphatikizepo akatswiri awa:

• Hepatologist (katswiri wa matenda a chiwindi).

• Oncologist wa opaleshoni.

• Dokotala wochita opaleshoni.

• Wofufuza oncologist.

• Othandizira ma radiologist (katswiri yemwe amapeza ndikuchiza matenda pogwiritsa ntchito kulingalira ndi zochepetsetsa zochepa).

• Wodwala.

Mitundu isanu ndi itatu yamankhwalawa amagwiritsidwa ntchito:

Kuwunika

Kuyang'anitsitsa zotupa zazing'ono kuposa 1 sentimita zomwe zimapezeka pakuwunika. Kutsata miyezi itatu iliyonse ndikofala.

Kuchita Opereta hepatectomy pang'ono (opaleshoni yochotsa gawo la chiwindi pomwe khansa imapezeka) itha kuchitidwa. Minofu, lobe wathunthu, kapena gawo lalikulu la chiwindi, limodzi ndi minofu yabwinobwino yozungulira imachotsedwa. Matenda otsala a chiwindi amatenga ntchito za chiwindi ndipo amatha kubwerera.

Kuika chiwindi

Pakumuika chiwindi, chiwindi chonse chimachotsedwa ndikusinthidwa ndi chiwindi chopatsa thanzi. Kuika chiwindi kumatha kuchitika pomwe matendawa ali m'chiwindi chokha ndipo chiwindi choperekedwa chitha kupezeka. Ngati wodwalayo ayenera kudikirira chiwindi chomwe wapereka, amalandiranso chithandizo pakafunika kutero.

Thandizo la Ablation

Thandizo la Ablation limachotsa kapena kuwononga minofu. Mitundu yosiyanasiyana yamankhwala amachiritso amagwiritsidwa ntchito pa khansa ya chiwindi:

• Kuchotsa ma radiofrequency: Kugwiritsa ntchito singano zapadera zomwe zimayikidwa kudzera pakhungu kapena kudzera pachimake pamimba kuti chifike pachotupacho. Mafunde a wailesi yamphamvu kwambiri amatenthetsa singano ndi chotupa chomwe chimapha ma cell a khansa.

• Thandizo la microwave: Mtundu wa mankhwala omwe chotupacho chimakumana ndi kutentha komwe kumapangidwa ndi ma microwaves. Izi zitha kuwononga ndikupha ma cell a khansa kapena kuwapangitsa kuti azitha kuzindikira zotsatira za radiation ndi mankhwala ena opha khansa.

• Jekeseni wamagetsi: Mankhwala a khansa momwe singano tating'onoting'ono timagwiritsira ntchito jakisoni (mowa weniweni) mwachindunji mu chotupa chopha ma khansa. Mankhwala angapo angafunike. Kawirikawiri anesthesia am'deralo amagwiritsidwa ntchito, koma ngati wodwalayo ali ndi zotupa zambiri m'chiwindi, anesthesia wamba amatha kugwiritsidwa ntchito.

• Cryoablation: Chithandizo chomwe chimagwiritsa ntchito chida chozizira ndi kuwononga maselo a khansa. Mankhwalawa amatchedwanso cryotherapy ndi cryosurgery. Dokotala atha kugwiritsa ntchito ultrasound kuti awongolere chidacho.

• Thandizo lamagetsi: Chithandizo chomwe chimatumiza zimagetsi zamagetsi kudzera pa maelekitirodi oyikidwa mu chotupa kuti aphe ma khansa. Thandizo lamagetsi likuwerengedwa m'mayesero azachipatala.

Mankhwala othandizira

Chithandizo chothandizira ndi kugwiritsa ntchito zinthu zoletsa kapena kuchepetsa kutuluka kwa magazi kudzera mumitsempha yotupa yotupa. Ngati chotupacho sichipeza mpweya ndi michere yomwe imafunikira, sichipitilira kukula. Chithandizo chothandizira chimagwiritsidwa ntchito kwa odwala omwe sangathe kuchitidwa opaleshoni kuti achotse chotupacho kapena chithandizo chobwezeretsa komanso omwe chotupa chawo sichinafalikire kunja kwa chiwindi.

Chiwindi chimalandira magazi kuchokera pamitsempha ya hepatic portal ndi mtsempha wamagazi. Magazi omwe amabwera m'chiwindi kuchokera mumitsempha yotupa nthawi zambiri amapita kumatumba a chiwindi. Magazi omwe amachokera kumtsempha wamagazi nthawi zambiri amapita pachotupacho. Mitsempha ya hepatic itatsekedwa panthawi yopanga mankhwala, minofu yabwinobwino ya chiwindi imapitilizabe kulandira magazi kuchokera pamitsempha yotupa.

Pali mitundu iwiri yayikulu yamankhwala ophatikizira:

• Transarterial embolization (TAE): Chotupitsa chaching'ono (chodulidwa) chimapangidwa mu ntchafu yamkati ndipo catheter (yopyapyala, chubu losinthasintha) imalowetsedwa ndikulowetsedwa mumtsempha wopatsa chidwi. Catheter ikakhala kuti ilipo, chinthu chomwe chimatseka mtsempha wamagazi ndikuletsa magazi kutuluka chotupa chimayikidwa.

• Transarterial chemoembolization (TACE): Njirayi ili ngati TAE kupatula mankhwala oletsa khansa amaperekedwanso. Njirayi itha kuchitika pophatikiza mankhwala a anticancer ndi mikanda ing'onoing'ono yomwe imayikidwa mumtsempha wa hepatic kapena mwa kubaya mankhwala a anticancer kudzera mu catheter mumtsempha wa hepatic kenako ndikubaya mankhwalawo kuti atseke mtsempha wamagazi. Mankhwala ambiri a anticancer atsekedwa pafupi ndi chotupacho ndipo pang'ono pokha mankhwalawo amafika mbali zina za thupi. Mankhwalawa amatchedwanso chemoembolization.

Chithandizo chofuna

Chithandizo choyenera ndi chithandizo chomwe chimagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti zizindikire ndikuukira maselo amtundu wa khansa osavulaza maselo abwinobwino. Tyrosine kinase inhibitors ndi mtundu wa mankhwala omwe amagwiritsidwa ntchito pochiza khansa yayikulu ya chiwindi.

Ma Tyrosine kinase inhibitors ndi mankhwala ang'onoang'ono omwe amapyola mu selo ndipo amagwira ntchito mkati mwa maselo a khansa kuti aletse zikwangwani kuti maselo a khansa ayenera kukula ndikugawana. Ma tyrosine kinase inhibitors ena amakhalanso ndi angiogenesis inhibitor zotsatira. Sorafenib, lenvatinib, ndi regorafenib ndi mitundu ya tyrosine kinase inhibitors.

Onani Mankhwala Ovomerezeka a Khansa ya Chiwindi 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.

Mankhwala oteteza chitetezo cha mthupi ndi mtundu wa immunotherapy.

• Mankhwala oteteza ku chitetezo cha mthupi: 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 ndi mtundu wa immune checkpoint inhibitor.

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).

Onani Mankhwala Ovomerezeka a Khansa ya Chiwindi kuti mumve zambiri.

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 zina zoperekera mankhwala a radiation zitha kuthandiza kuti ma radiation asawononge minofu yabwinobwino yapafupi. Mitundu iyi yothandizira ma radiation yakunja imaphatikizapo izi:

• Conformal radiation therapy: Conformal radiation Therapy ndi mtundu wa mankhwala akunja a radiation omwe amagwiritsa ntchito kompyuta kupanga chithunzi cha 3-dimensional (3-D) chotupa ndikupanga ma radiation kuti agwirizane ndi chotupacho. Izi zimalola kuchuluka kwa radiation kuti ifike pachotupacho ndipo imawononga pang'ono minofu yabwinobwino yapafupi.

• Mankhwala opatsirana pogwiritsa ntchito mphamvu ya stereotactic: Mankhwala opatsirana pogwiritsa ntchito mphamvu ya stereotactic ndi mtundu wa mankhwala owonekera kunja. Zipangizo zapadera zimagwiritsidwa ntchito kuyika wodwalayo pamalo omwewo pachithandizo chilichonse cha radiation. Kamodzi patsiku kwa masiku angapo, makina opanga ma radiation amayang'ana kuchuluka kwa radiation poyerekeza ndi chotupacho. Pokhala ndi wodwala pamalo omwewo pachithandizo chilichonse, pamakhala kuchepa pang'ono pamatenda athanzi oyandikira. Njirayi imatchedwanso stereotactic kunja kwa dothi radiation mankhwala ndi stereotaxic radiation therapy.

• Thandizo la ma proton beam radiation: Thandizo la Proton-beam ndi mtundu wa mphamvu yayikulu, mankhwala owunikira kunja. Makina othandizira ma radiation amayang'ana mitsinje yama proton (tinthu tating'onoting'ono, tosaoneka, tomwe timayikidwa bwino) m'maselo a khansa kuti tiwaphe. Chithandizo chamtunduwu sichimawononga pang'ono minofu yabwinobwino yapafupi.

• 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 yayikulu yoyamba ya chiwindi.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chithandizo cha khansa yayikulu yamchiwindi yayikulu ingayambitse 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 Khansa Yaikulu Yaikulu Ya Chiwindi

M'chigawo chino

• Gawo 0, A, ndi B Khansa Yaikulu Ya Chiwindi Ya Akuluakulu

• Magawo C ndi D Khansa Yaikulu Ya Chiwindi Ya Akuluakulu

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

Gawo 0, A, ndi B Khansa Yaikulu Ya Chiwindi Ya Akuluakulu

Chithandizo cha magawo 0, A, ndi B khansa yoyamba ya chiwindi chachikulu ingaphatikizepo izi:

• Kuyang'anira zilonda zazing'ono kuposa 1 sentimita.

• Chiwindi hepatectomy.

• Kuchulukitsa kwa hepatectomy ndi chiwindi.

• Kuchotsa kwa chotupacho pogwiritsa ntchito njira izi:

• Kuchotsa ma Radiofrequency.

• Mankhwala a microwave.

• Majekeseni amtundu wa ethanol.

• Cryoablation.

• Kuyesedwa kwachipatala kwa mankhwala opangira magetsi.

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.

Magawo C ndi D Khansa Yaikulu Ya Chiwindi Ya Akuluakulu

Chithandizo cha magawo C ndi D khansa yayikulu yamchiwindi yayikulu ingaphatikizepo izi:

• Mankhwala othandizira kuphatikiza imodzi mwa njira izi:

• Kupititsa patsogolo kwa Transarterial (TAE).

• Transarterial chemoembolization (TACE).

• Chithandizo choyenera ndi tyrosine kinase inhibitor.

• Chitetezo chamatenda.

• Thandizo la radiation.

• Kuyesedwa kwachipatala kwa chithandizo chamankhwala atatha chemoembolization kapena kuphatikiza chemotherapy.

• Kuyesedwa kwachipatala kwa mankhwala osokoneza bongo.

• Kuyesedwa kwachipatala kwa immunotherapy.

• Kuyesedwa kwachipatala kwa immunotherapy kuphatikiza ndi chithandizo chamankhwala.

• Kuyesedwa kwachipatala kwa mankhwala opatsirana pogwiritsa ntchito ma radiation kapena mankhwala a proton-beam radiation.

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 Yaikulu Ya Chiwindi Ya Akuluakulu

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

Njira zochiritsira khansa yayikulu yabwinobwino ya chiwindi ingaphatikizepo izi:

• Kuchulukitsa kwa hepatectomy ndi chiwindi.

• Chiwindi hepatectomy.

• Kuchotsa

• Transarterial chemoembolization ndi chithandizo cholunjika ndi sorafenib, ngati mankhwala ochepetsa nkhawa kuti athetse zizindikiritso ndikukhalitsa 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 yayikulu ya chiwindi ya achikulire

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

• Khansa Yam'mimba Yamatenda a Chiwindi ndi Mitsempha

• Kupewa Khansa ya Chiwindi (Hepatocellular)

• Kuwunika Khansa ya Chiwindi (Hepatocellular)

• Cryosurgery mu Chithandizo cha Khansa

• Mankhwala Ovomerezeka a Khansa Ya Chiwindi

• 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