Mitundu / ovarian / wodwala / ovarian-epithelial-treatment-pdq

Ovarian Epithelial, Fallopian Tube, ndi Primary Peritoneal Cancer Version

Zambiri Zokhudza Ovarian Epithelial, Fallopian Tube, ndi Khansa Yaikulu ya Peritoneal

MFUNDO ZOFUNIKA

• Khansara yam'mimba yam'mimba, khansa ya m'mimba, komanso khansa yoyambira ndi matenda am'mimba ndimatenda omwe ma cell owopsa (khansa) amapangidwa minyewa yotsekera ovary kapena kuyala chubu cha fallopian kapena peritoneum.

• Khansa ya ovarian epithelial, khansa ya mazira, komanso mawonekedwe a khansa ya peritoneal mumtundu womwewo ndipo amachitiranso chimodzimodzi.

• Amayi omwe ali ndi mbiri yapa khansa yamchiberekero ali pachiwopsezo chachikulu cha khansa yamchiberekero.

• Ena mwa mazira, mazira, ndi khansa yoyamba ya peritoneal imayamba chifukwa cha kusintha kwa majini (kusintha).

• Azimayi omwe ali ndi chiopsezo chowonjezeka cha khansa yamchiberekero angaganize opaleshoni kuti achepetse ngozi.

• Zizindikiro za mazira, mazira, kapena khansa ya peritoneal zimaphatikizapo kupweteka kapena kutupa m'mimba.

• Kuyesa komwe kumayesa thumba losunga mazira ndi m'chiuno kumagwiritsidwa ntchito kuti mupeze (kupeza), kuzindikira, ndi kukula kwa ovari, chubu, komanso khansa ya peritoneal.

• Zinthu zina zimakhudza njira zamankhwala zamankhwala komanso zamankhwala (mwayi wochira).

Khansara yam'mimba yam'mimba, khansa ya m'mimba, komanso khansa yoyambira ndi matenda am'mimba ndimatenda omwe ma cell owopsa (khansa) amapangidwa minyewa yotsekera ovary kapena kuyala chubu cha fallopian kapena peritoneum.

Thumba losunga mazira ndi ziwalo ziwiri mu njira yoberekera yaikazi. Amakhala m'chiuno, mbali imodzi ya chiberekero (dzenje, lopangidwa ndi peyala pomwe mwana amakula). Ovary iliyonse imakhala pafupifupi kukula ndi mawonekedwe a amondi. Thumba losunga mazira limapanga mazira ndi mahomoni achikazi (mankhwala omwe amayang'anira momwe maselo kapena ziwalo zina zimagwirira ntchito).

Timachubu tating'onoting'ono timachubu tating'ono, tating'ono, chimodzi mbali iliyonse ya chiberekero. Mazira amadutsa m'mimba mwake, kudzera mumachubu, kupita pachiberekero. Khansa nthawi zina imayamba kumapeto kwa chubu pafupi ndi ovary ndipo imafalikira ku ovary.

Peritoneum ndiye minofu yomwe imayala khoma la m'mimba ndikuphimba ziwalo zam'mimba. Khansa yoyamba ya peritoneal ndi khansa yomwe imapangika mu peritoneum ndipo siyinafalikire pamenepo kuchokera mbali ina ya thupi. Khansa nthawi zina imayamba mu peritoneum ndikufalikira ku ovary.

Kutengera kwa ziwalo zoberekera zazimayi. Ziwalo zam'mimba zoberekera zazimayi zimaphatikizapo chiberekero, thumba losunga mazira, timachubu, ziwalo zoberekera, ndi nyini. Chiberekero chimakhala ndi chingwe chakunja chotchedwa myometrium komanso mkati mwake chotchedwa endometrium.

Khansara yamatenda amtundu wamtundu wamtundu wamtundu umodzi wa khansa yomwe imakhudza ovary. Onani mafupikitsidwe otsatirawa a kuti mumve zambiri zamatenda ena ovuta:

• Ovarian Germ Cell Tumors

• Ovarian Low Malignant Potors Zotupa

• Khansa Yachilendo ya Chithandizo cha Ana (khansa ya m'mimba mwa ana)

Khansa ya ovarian epithelial, khansa ya mazira, komanso mawonekedwe a khansa ya peritoneal mumtundu womwewo ndipo amachitiranso chimodzimodzi.

Amayi omwe ali ndi mbiri yapa khansa yamchiberekero ali pachiwopsezo chachikulu cha khansa yamchiberekero.

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 yamchiberekero.

Zowopsa za khansa yamchiberekero ndi izi:

• Mbiri ya banja la khansa yamchiberekero mwa wachibale woyamba (amayi, mwana wamkazi, kapena mlongo).

• Zosintha zobadwa mu majini a BRCA1 kapena BRCA2.

• Mavuto ena obadwa nawo, monga khansa ya nonpolyposis colorectal cancer (HNPCC; yotchedwanso Lynch syndrome).

• Endometriosis.

• Thandizo la Postmenopausal hormone.

• Kunenepa kwambiri.

• Kutalika kwambiri.

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

Ena mwa mazira, mazira, ndi khansa yoyamba ya peritoneal imayamba chifukwa cha kusintha kwa majini (kusintha).

Majini omwe ali m'maselo amanyamula choloŵa chomwe amalandira kuchokera kwa makolo a munthu. Khansa yotengera m'mimba yam'mimba imapanga pafupifupi 20% yamatenda onse a khansa yamchiberekero. Pali mitundu itatu ya cholowa: khansa yamchiberekero yokha, khansa yam'mimba ndi khansa ya m'mawere, komanso khansa ya m'mimba ndi khansa.

Khansara ya fallopian tube ndi khansa ya peritoneal amathanso kuyambitsidwa ndi kusintha kwa majini obadwa nawo.

Pali mayeso omwe amatha kuzindikira kusintha kwa majini. Mayesero amtunduwu nthawi zina amachitika kwa mabanja omwe ali ndi chiopsezo chachikulu cha khansa. Onani zidule za zotsatirazi kuti mumve zambiri:

• Ovarian, Fallopian Tube, ndi Primary Peritoneal Cancer Prevention

• Genetics of Cancer ya m'mawere ndi Gynecologic (ya akatswiri azaumoyo)

Azimayi omwe ali ndi chiopsezo chowonjezeka cha khansa yamchiberekero angaganize opaleshoni kuti achepetse ngozi.

Amayi ena omwe ali ndi chiopsezo chowonjezeka cha khansa ya m'mimba amatha kusankha kukhala ndi oophorectomy yochepetsera chiopsezo (kuchotsa mazira abwino kuti khansa isakule). Mwa amayi omwe ali pachiwopsezo chachikulu, njirayi yawonetsedwa kuti ichepetsa kwambiri chiopsezo cha khansa yamchiberekero. (Onani chidule cha pa Ovarian, Fallopian Tube, ndi Primary Peritoneal Cancer Prevention kuti mumve zambiri.)

Zizindikiro za mazira, mazira, kapena khansa ya peritoneal zimaphatikizapo kupweteka kapena kutupa m'mimba.

Ovarian, fallopian chubu, kapena khansa ya peritoneal sizingayambitse zizindikiritso zoyambirira. Zizindikiro zikayamba kuoneka, khansa imakula kwambiri. Zizindikiro zingakhale ndi izi:

• Ululu, kutupa, kapena kumverera kwapanikizika m'mimba kapena m'chiuno.

• Kutaya magazi kumaliseche komwe kumalemera kapena kosasinthasintha, makamaka atatha kusamba.

• Kutulutsa kumaliseche komwe kumveka koyera, koyera, kapena kofiira ndi magazi.

• Bulu m'chiuno.

• Mavuto am'mimba, monga mpweya, kuphulika, kapena kudzimbidwa.

Zizindikirozi zimayambanso chifukwa cha zinthu zina osati chifukwa cha ovarian, fallopian chubu, kapena khansa ya peritoneal. Ngati zizindikilo zikuwonjezereka kapena sizikutha zokha, pitani kuchipatala kuti vuto lililonse lizitha kupezeka ndikuchiritsidwa msanga.

Kuyesa komwe kumayesa thumba losunga mazira ndi m'chiuno kumagwiritsidwa ntchito kuti mupeze (kupeza), kuzindikira, ndi kukula kwa ovari, chubu, komanso khansa ya peritoneal.

Mayesero ndi njira zotsatirazi zitha kugwiritsidwa ntchito kuti mupeze, kuzindikira, komanso kukula kwa ovari, chubu, komanso khansa ya peritoneal:

• 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: Kuyesa kumaliseche, khomo pachibelekeropo, chiberekero, machubu, mazira, ndi thumbo. A speculum amalowetsedwa mumaliseche ndipo dokotala kapena namwino amayang'ana kumaliseche ndi chiberekero ngati ali ndi matenda. Kuyezetsa magazi kwa khomo pachibelekeropo kumachitika nthawi zambiri. Dotolo kapena namwino amalowetsanso chala chimodzi kapena ziwiri zopaka mafuta, zokutira zanja lamanja kumaliseche ndikuyika dzanja linalo pamimba pamunsi kuti mumve kukula, mawonekedwe, ndi malo oberekera komanso thumba losunga mazira. Dotolo kapena namwino amalowetsanso chala chopaka mafuta, chopukutira mu rectum kuti amve ziphuphu kapena malo abwinobwino.

Kuyesa kwapelvic. Dokotala kapena namwino amalowetsa chala chimodzi kapena ziwiri zopaka mafuta, zokutidwa ndi dzanja limodzi kumaliseche ndikudina pamimba pamunsi ndi dzanja linalo. Izi zachitika kuti mumve kukula, mawonekedwe, ndi mawonekedwe a chiberekero ndi thumba losunga mazira. Nyini, khomo pachibelekeropo, machubu opatsira mazira oyenda, ndi thumbo timayang'ananso.

• CA 125 kuyesa: Kuyesa komwe kumayeza mulingo wa CA 125 m'magazi. CA 125 ndi chinthu chomwe chimatulutsidwa ndimaselo m'magazi. Mulingo wowonjezeka wa CA 125 ukhoza kukhala chizindikiro cha khansa kapena vuto lina monga endometriosis.

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

M'mimba ultrasound. Transducer ya ultrasound yolumikizidwa ndi kompyuta imadutsa pamimba. Transducer ya ultrasound imaponya mafunde akumveka mkati ndi ziwalo zamkati kuti apange ma echo omwe amapanga sonogram (chithunzi cha pakompyuta).

Odwala ena atha kukhala ndi transvaginal ultrasound.

Kutuluka kwa ultrasound. Pulojekiti ya ultrasound yolumikizidwa ndi kompyuta imayikidwa mu nyini ndipo imasunthidwa modekha kuti iwonetse ziwalo zosiyanasiyana. Kafukufukuyu amatulutsa mafunde am'mimba ndi ziwalo zamkati kuti apange ma echo omwe amapanga sonogram (chithunzi cha pakompyuta).

• 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.

• PET scan (positron emission tomography scan): Njira yopezera maselo oyipa mthupi. Gulu lochepa kwambiri la shuga (radio) imayikidwa mumtsinje. 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.

• 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).

• 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.

• Biopsy: Kuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwalayo kuti aone ngati ali ndi khansa. Minofu nthawi zambiri imachotsedwa pakuchita opaleshoni kuti ichotse chotupacho.

• Zinthu zina zimakhudza njira zamankhwala zamankhwala komanso zamankhwala (mwayi wochira).

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Mtundu wa khansa yamchiberekero ndi kuchuluka kwa khansa yomwe ilipo.

• Gawo ndi khansa.

• Kaya wodwalayo ali ndimadzimadzi owonjezera m'mimba omwe amachititsa kutupa.

• Kaya chotupacho chitha kuchotsedwa pochitidwa opaleshoni.

• Kaya pali kusintha kwa majini a BRCA1 kapena BRCA2.

• Msinkhu wa wodwalayo komanso thanzi lake lonse.

• Kaya khansa yapezeka kumene kapena yabwereranso (bwererani).

Magawo a Ovarian Epithelial, Fallopian Tube, ndi Khansa Yaikulu ya Peritoneal

MFUNDO ZOFUNIKA

• Pambuyo papezeka ovarian, fallopian chubu, kapena khansa ya peritoneal, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa mazira 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 ovarian epithelial, fallopian chubu, ndi khansa yoyamba ya peritoneal:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Ovarian epithelial, fallopian chubu, ndi khansa yoyambira ya peritoneal imagawidwa kuti ichiritsidwe ngati khansa yoyambirira kapena yayikulu.

Pambuyo papezeka ovarian, fallopian chubu, kapena khansa ya peritoneal, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa mazira kapena mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa yafalikira m'chiwalo kapena mbali zina za thupi imatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo. Zotsatira za mayeso omwe amagwiritsidwa ntchito pozindikira kuti ali ndi khansa nthawi zambiri amagwiritsidwanso ntchito kuthana ndi matendawa. (Onani gawo la General Information kuti mupeze mayeso ndi njira zomwe zingagwiritsidwe ntchito pozindikira ndi kukula kwa mazira, mazira, ndi khansa ya peritoneal.)

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 khansa yamchiberekero imafalikira m'mapapu, maselo a khansa m'mapapo kwenikweni ndi maselo a khansa ya m'mimba. Matendawa ndi khansa yaminyewa yam'mimba yaminyewa, osati khansa yamapapo.

Magawo otsatirawa amagwiritsidwa ntchito pa ovarian epithelial, fallopian chubu, ndi khansa yoyamba ya peritoneal:

Gawo I

Pa gawo IA, khansa imapezeka mkati mwa chiberekero chimodzi kapena mazira. Pa siteji IB, khansa imapezeka mkati mwa mazira ambiri kapena mazira. Munthawi ya IC, khansa imapezeka mkati mwa thumba losunga mazira kapena mazira ndipo chimodzi mwa izi ndi chowonadi: (a) kapisozi (chophimba chakunja) cha ovary chaphulika, (b) khansa imapezekanso kunja kwa chimodzi kapena zonse ziwiri kapena mazira ambiri, kapena (c) ma cell a khansa amapezeka mchiuno mwa peritoneum.

Pachigawo choyamba ine, khansa imapezeka m'modzi kapena m'mimba mwa mazira onse. Gawo I lagawidwa mu gawo IA, gawo IB, ndi gawo IC.

• Gawo IA: Khansa imapezeka mkati mwa chubu limodzi kapena mazira.

• Gawo IB: Khansa imapezeka mkati mwa mazira ambiri kapena mazira.

• Gawo IC: Khansa imapezeka mkati mwa imodzi kapena mazira ambiri kapena machubu ndipo chimodzi mwa izi ndi chowonadi:

• khansara imapezekanso panja pa malo amodzi kapena onse awiri m'mimba mwake kapena machubu; kapena

• kapisozi (chophimba chakunja) cha chibelekero chinaphulika (chinatseguka) asanachitike kapena nthawi ya opareshoni; kapena

• Maselo a khansa amapezeka mumadzimadzi am'mimbamo (thupi lomwe lili ndi ziwalo zambiri m'mimba) kapena kutsuka kwa peritoneum (minofu yolumikizira pakhosi la peritoneal).

Gawo II

Mu gawo lachiwiri la IIA, khansa imapezeka m'modzi kapena m'mimba mwake ndipo imafalikira ku chiberekero ndi / kapena machubu ndi / kapena thumba losunga mazira. Mu gawo lachiwiri la IIB, khansa imapezeka m'modzi kapena m'mimba mwake ndipo imafalikira kumtunda. Mu khansa yoyamba ya peritoneal, khansa imapezeka m'chiuno cha peritoneum ndipo siyinafalikire pamenepo kuchokera mbali ina ya thupi.

Gawo lachiwiri, khansa imapezeka m'modzi kapena m'mimba mwake ndipo imafalikira m'malo ena am'mimba, kapena khansa yoyambira ya peritoneal imapezeka m'chiuno. Khansa ya khansa ya m'mimba yachiwiri ya epithelial ndi fallopian imagawika gawo IIA ndi gawo IIB.

• Gawo IIA: Khansa yafalikira kuchokera pomwe idayamba mpaka pachiberekero ndi / kapena timachubu ta mazira ndi / kapena thumba losunga mazira.

• Gawo IIB: Khansa yafalikira kuchokera pachiberekero cha ovary kapena fallopian kupita ku ziwalo za peritoneal cavity (malo omwe ali ndi ziwalo zam'mimba).

Kukula kwa zotupa nthawi zambiri kumayeza masentimita (cm) kapena mainchesi. Zakudya zodziwika bwino zomwe zitha kugwiritsidwa ntchito posonyeza kukula kwa chotupa mu cm zimaphatikizapo: nsawawa (1 cm), chiponde (2 cm), mphesa (3 cm), mtedza (4 cm), laimu (5 cm kapena 2) mainchesi), dzira (6 cm), pichesi (7 cm), ndi manyumwa (masentimita 10 kapena mainchesi 4).

Gawo III

Gawo lachitatu, khansa imapezeka m'modzi kapena m'mimba mwake, kapena khansa yoyamba ya peritoneal, ndipo yafalikira kunja kwa chiuno kumadera ena am'mimba ndi / kapena ma lymph node apafupi. Gawo lachitatu lagawidwa gawo IIIA, gawo IIIB, ndi gawo IIIC.

• Mu gawo IIIA, chimodzi mwa izi ndi chowonadi:

• Khansa yafalikira ku ma lymph node mdera lakunja kapena kuseri kwa peritoneum kokha; kapena

• Maselo a khansa omwe amatha kuwoneka ndi microscope afalikira pamwamba pa peritoneum kunja kwa mafupa. Khansa ikhoza kufalikira ku ma lymph node apafupi.

Mu gawo lachiwiri la IIIA, khansa imapezeka m'modzi kapena m'mimba mwake ndipo (a) khansa yafalikira ku ma lymph node mdera lakunja kapena kuseri kwa peritoneum kokha, kapena (b) ma cell a khansa omwe amatha kuwoneka ndi microscope okha kufalikira ku omentum. Khansa ikhoza kufalikira ku ma lymph node apafupi.

• Gawo IIIB: Khansa yafalikira ku peritoneum kunja kwa mafupa a chiuno ndipo khansa mu peritoneum ndi 2 sentimita kapena yaying'ono. Khansa ikhoza kufalikira ku ma lymph node kuseri kwa peritoneum.

Mu gawo IIIB, khansa imapezeka m'modzi kapena m'mimba mwake ndipo imafalikira ku omentum, ndipo khansa mu omentum ndi 2 masentimita kapena ocheperako. Khansa ikhoza kufalikira ku ma lymph node kuseri kwa peritoneum.

• Gawo IIIC: Khansa yafalikira ku peritoneum kunja kwa mafupa a chiuno ndipo khansa mu peritoneum ndi yayikulu kuposa masentimita awiri. Khansa itha kufalikira kumatenda am'mimba kuseri kwa peritoneum kapena kumtunda kwa chiwindi kapena ndulu.

Mu gawo IIIC, khansa imapezeka m'modzi kapena m'mimba mwake ndipo imafalikira ku omentum, ndipo khansa mu omentum ndi yayikulu kuposa 2 masentimita. Khansa itha kufalikira kumatenda am'mimba kuseri kwa peritoneum kapena kumtunda kwa chiwindi kapena ndulu.

Gawo IV

Mu gawo IV, khansa yafalikira kupyola pamimba kupita mbali zina za thupi. Mu gawo la IVA, maselo a khansa amapezeka mumadzimadzi owonjezera omwe amakhala m'mapapu. Pa gawo IVB, khansa yafalikira ku ziwalo ndi zotupa kunja kwa mimba, kuphatikiza m'mapapo, chiwindi, mafupa, ndi ma lymph node m'mimba.

Mu gawo IV, khansa yafalikira kupyola pamimba kupita mbali zina za thupi. Gawo IV limagawika gawo la IVA ndi gawo IVB.

• Gawo IVA: Maselo a khansa amapezeka mumadzimadzi owonjezera omwe amakhala m'mapapu.

• Gawo IVB: Khansara yafalikira ku ziwalo ndi ziwalo kunja kwa mimba, kuphatikizapo ma lymph nodes m'mimba.

Ovarian epithelial, fallopian chubu, ndi khansa yoyambira ya peritoneal imagawidwa kuti ichiritsidwe ngati khansa yoyambirira kapena yayikulu.

Gawo khansa yamchiberekero yamankhwala am'mimba ndimayendedwe am'mimba amathandizidwa ngati khansa yoyambirira.

Magawo II, III, ndi IV ovarian epithelial, fallopian chubu, ndi khansa yoyambira ya peritoneal amathandizidwa ngati khansa yayikulu.

Epithelial ya Ovarian Yobwerezabwereza kapena Yolimba, Khansa ya Fallopian, ndi Khansa Yaikulu ya Peritoneal

Khansa yaposachedwa ya ovarian epithelial, khansa ya m'mimba, kapena khansa yoyamba ya khansa ndi khansa yomwe yabwereranso (itabweranso) itachiritsidwa. Khansa yolimbikira ndi khansa yomwe sichitha ndi chithandizo.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi khansa ya ovari epithelial.

• Mitundu itatu yamankhwala ogwiritsidwa ntchito imagwiritsidwa ntchito.

• Opaleshoni

• Chemotherapy

• Chithandizo chofuna

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Thandizo la radiation

• Chitetezo chamatenda

• Chithandizo cha ovarian epithelial, fallopian chubu, ndi khansa yoyamba ya peritoneal imatha kubweretsa 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 ya ovari epithelial.

Pali mitundu ingapo yamankhwala othandizira odwala omwe ali ndi khansa ya ovari epithelial. Mankhwala ena ndi ofanana, 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 mankhwala omwe akugwiritsidwa ntchito pakadali pano, chithandizocho chitha kukhala chovomerezeka. Odwala omwe ali ndi gawo lililonse la khansa yamchiberekero angafune kuganiza zokachita nawo zoyeserera zamankhwala. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Mitundu itatu yamankhwala ogwiritsidwa ntchito imagwiritsidwa ntchito.

Opaleshoni

Odwala ambiri amachitidwa opareshoni kuti achotse chotupacho momwe angathere. Mitundu yosiyanasiyana ya opaleshoni ingaphatikizepo:

• Hysterectomy: Kuchita opaleshoni kuchotsa chiberekero ndipo, nthawi zina, khomo pachibelekeropo. Chiberekero chokha chimachotsedwa, chimatchedwa hysterectomy. Chiberekero ndi khomo lachiberekero zikachotsedwa, amatchedwa hysterectomy yathunthu. Ngati chiberekero ndi khomo lachiberekero atulutsidwa kudzera mu nyini, opaleshoniyi amatchedwa kachilombo ka nyini. Ngati chiberekero ndi khomo pachibelekeropo atulutsidwa kudzera pachobvala chachikulu pamimba, opaleshoniyi amatchedwa kuti kutsekeka m'mimba kwathunthu. Ngati chiberekero ndi khomo lachiberekero amatulutsidwa kudzera pang'amba pang'ono pamimba pogwiritsa ntchito laparoscope, opaleshoniyi amatchedwa laparoscopic hysterectomy.

Kutsekemera. Chiberekero chimachotsedwa mwa opaleshoni kapena popanda ziwalo zina kapena zotupa. Chiberekero chonse, chiberekero ndi khomo pachibelekeropo zimachotsedwa. Mchiberekero chonse chokhala ndi salpingo-oophorectomy, (a) chiberekero kuphatikiza chubu chimodzi (chimodzi) chokhala ndi mazira ndi mazira chimachotsedwa; kapena (b) chiberekero kuphatikiza tinthu tambirimbiri tating'onoting'ono tating'onoting'ono tating'onoting'ono tating'onoting'ono tating'onoting'ono tating'onoting'ono timatulutsidwa. Mu hysterectomy yowopsa, chiberekero, khomo pachibelekeropo, mazira onse awiri, machubu, komanso minofu yoyandikana nayo imachotsedwa. Njirazi zimagwiritsidwa ntchito podula pang'ono kapena kuwongolera mozungulira.

• Unilateral salpingo-oophorectomy: Njira yochotsera ovary ndi chubu chimodzi.

• Bilateral salpingo-oophorectomy: Njira yochitira opaleshoni yochotsa thumba losunga mazira ndi machubu onse awiri.

• Omentectomy: Njira yochotsera omentum (minofu mu peritoneum yomwe imakhala ndi mitsempha yamagazi, misempha, zotengera zam'mimba, ndi ma lymph node).

• Lymph node biopsy: Kuchotsa zonse kapena gawo la mwanabele. Katswiri wazachipatala amawona minofu yamagulu pansi pa microscope kuti aone ngati ali ndi khansa.

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 ngati pamimba, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo (chemotherapy am'madera).

Mtundu wa chemotherapy wam'madera omwe amagwiritsidwa ntchito pochiza khansa ya m'mimba ndi intraperitoneal (IP) chemotherapy. Mu IP chemotherapy, mankhwala a anticancer amatengeredwa molunjika mu peritoneal cavity (danga lomwe lili ndi ziwalo zam'mimba) kudzera mu chubu chochepa.

Hyperthermic intraperitoneal chemotherapy (HIPEC) ndi mankhwala omwe amagwiritsidwa ntchito pa opaleshoni yomwe ikuphunziridwa ndi khansa ya m'mimba. Dokotalayo atachotsa zotupa zambiri momwe angathere, chemotherapy yotenthedwa imatumizidwa molunjika m'mimbamo ya peritoneal.

Chithandizo cha mankhwala opitilira khansa angapo amatchedwa kuphatikiza chemotherapy.

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

Onani Mankhwala Ovomerezeka a Ovarian, Fallopian Tube, kapena Primary Peritoneal Cancer kuti mumve zambiri.

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.

Thandizo la monoclonal antibody ndi mtundu wamankhwala omwe amalimbana nawo omwe amagwiritsa ntchito ma laboratory opangidwa 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.

Bevacizumab ndi anti-monoclonal antibody yomwe ingagwiritsidwe ntchito ndi chemotherapy pochiza khansa ya ovarian epithelial cancer, fallopian tube khansa, kapena khansa yoyambira ya peritoneal yomwe yabwereranso (kubwerera).

Poly (ADP-ribose) polymerase inhibitors (PARP inhibitors) ndi mankhwala opatsirana omwe amaletsa kukonza kwa DNA ndipo amatha kupangitsa kuti maselo a khansa afe. Olaparib, rucaparib, ndi niraparib ndi ma PARP inhibitors omwe atha kugwiritsidwa ntchito kuchiza khansa ya ovari. Rucaparib itha kugwiritsidwanso ntchito ngati njira yothandizira kuchiza khansa ya m'mimba, khansa ya m'mimba, kapena khansa yoyambira ya peritoneal yomwe yabwereranso. Veliparib ndi PARP inhibitor yomwe ikuwerengedwa kuti ithetse khansa yayikulu yamchiberekero.

Angiogenesis inhibitors amalimbana ndi mankhwala omwe angalepheretse kukula kwa mitsempha yatsopano yomwe zotupa zimafunikira kukula ndipo zitha kupha ma cell a khansa. Cediranib ndi angiogenesis inhibitor yomwe imaphunziridwa pochiza khansa yapachimake yamchiberekero.

Onani Mankhwala Ovomerezeka a Ovarian, Fallopian Tube, kapena Primary Peritoneal Cancer kuti mumve zambiri.

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.

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. Amayi ena amalandira chithandizo chotchedwa intraperitoneal radiation therapy, momwe madzi amadzimadzi amaikidwa mwachindunji m'mimba kudzera mu catheter. Mankhwala opangira ma radiation a Intraperitoneal akuwerengedwa kuti athetse khansa ya m'mimba.

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 immunotherapy.

Chithandizo cha katemera ndi mankhwala a khansa omwe amagwiritsa ntchito chinthu kapena gulu lazinthu zolimbikitsa chitetezo cha mthupi kuti chipeze chotupacho ndikuchipha. Chithandizo cha katemera chikuwerengedwa kuti chithetse khansa yayikulu yamchiberekero.

Chithandizo cha ovarian epithelial, fallopian chubu, ndi khansa yoyamba ya peritoneal imatha kubweretsa 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 ndi Gawo

M'chigawo chino

• Khansa Yoyambirira ya Ovarian Epithelial and Fallopian Tube

• Epithelial Advanced Ovarian, Fallopian Tube, ndi Khansa Yaikulu ya Peritoneal

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

Khansa Yoyambirira ya Ovarian Epithelial and Fallopian Tube

Chithandizo cha khansa yoyambira yamatenda oyambilira kapena khansa ya mazira ingaphatikizepo izi:

• Hysterectomy, bilpal salpingo-oophorectomy, ndi omentectomy. Zilonda zam'mimba ndi zotupa zina m'chiuno ndi m'mimba zimachotsedwa ndikuyang'aniridwa ndi microscope yamaselo a khansa. Chemotherapy ingaperekedwe pambuyo pa opaleshoni.

• Unilateral salpingo-oophorectomy itha kuchitidwa mwa azimayi ena omwe akufuna kukhala ndi ana. Chemotherapy ingaperekedwe 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.

Epithelial Advanced Ovarian, Fallopian Tube, ndi Khansa Yaikulu ya Peritoneal

Chithandizo cha khansa yapachimake yam'mimba yam'mimba, khansa ya m'mimba, kapena khansa yoyambira ya peritoneal itha kuphatikizira izi:

• Hysterectomy, bilpal salpingo-oophorectomy, ndi omentectomy. Zilonda zam'mimba ndi zotupa zina m'chiuno ndi m'mimba zimachotsedwa ndikuyang'aniridwa ndi microscope kuti ayang'ane ma cell a khansa. Opaleshoni imatsatiridwa ndi chimodzi mwa izi:

• Kulowetsa mkati mwa chemotherapy.

• Mankhwala osokoneza bongo.

• Chemotherapy ndi chithandizo chofunikira (bevacizumab).

• Chemotherapy ndi mankhwala olimbana ndi poly (ADP-ribose) polymerase (PARP) inhibitor.

• Chemotherapy kenako opaleshoni (mwina yotsatiridwa ndi intraperitoneal chemotherapy).

• Chemotherapy yokha kwa odwala omwe sangathe kuchitidwa opaleshoni.

• Kuyesedwa kwachipatala kwa mankhwala olimbana ndi PARP inhibitor (olaparib, rucaparib, niraparib, kapena veliparib).

• Kuyesedwa kwachipatala kwa hyperthermic intraperitoneal chemotherapy (HIPEC) panthawi yochita 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.

Njira Zothandizira Kuchiza Ovarian Epithelial, Fallopian Tube, ndi Khansa Yaikulu ya Peritoneal

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

Chithandizo cha khansa yaposachedwa ya ovarian epithelial, khansa ya chubu ya fallopian, kapena khansa yoyamba ya peritoneal itha kuphatikizira izi:

• Chemotherapy pogwiritsa ntchito mankhwala amodzi kapena angapo anticancer.

• Chithandizo chomwe mukufuna ndi poly (ADP-ribose) polymerase (PARP) inhibitor (olaparib, rucaparib, niraparib, kapena cediranib) kapena chemotherapy.

• Chemotherapy ndi / kapena chithandizo chofunikira (bevacizumab).

• Kuyesedwa kwachipatala kwa hyperthermic intraperitoneal chemotherapy (HIPEC) panthawi yochita opaleshoni.

• 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 Ovarian Epithelial, Fallopian Tube, ndi Primary Peritoneal Cancer

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza ovarian epithelial, fallopian tube, ndi primary peritoneal cancer, onani izi:

• Ovarian, Fallopian Tube, ndi Tsamba Loyambira la Cancer Peritoneal Cancer

• Ovarian, Fallopian Tube, ndi Primary Peritoneal Cancer Prevention

• Ovarian, Fallopian Tube, ndi Kuunika Kwambiri kwa Khansa ya Peritoneal

• Khansa Yachilendo Ya Chithandizo Chaubwana

• Mankhwala Ovomerezeka a Ovarian, Fallopian Tube, kapena Primary Peritoneal Cancer

• Njira Zochizira Khansa

• Kusintha kwa BRCA: Kuopsa kwa Khansa ndi Kuyesa Kwachibadwa

• Kuyesedwa Kwachibadwa kwa Ma Syndromes Obadwa Ndi 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