Mitundu / ovarian / wodwala / ovarian-germ-cell-treatment-pdq

Ovarian Germ Cell Tumors Treatment Version

Zambiri Zokhudza Ovarian Germ Cell Tumors

MFUNDO ZOFUNIKA

• Chotupa chamagulu amtundu wa ovarian ndi matenda omwe ma cell owopsa (khansa) amapangika m'matumba am'mimba (dzira) a ovary.

• Zizindikiro za chotupa cha majeremusi otupa m'mimba ndikutupa kwa m'mimba kapena magazi akumaliseche mukatha kusamba.

• Kuyesa komwe kumayang'ana thumba losunga mazira, m'chiuno, magazi, ndi thumba losunga mazira kumagwiritsidwa ntchito kuti mupeze (kupeza) ndikuzindikira chotupa cha khungu la ovari.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira ndi chithandizo).

Chotupa chamagulu amtundu wa ovarian ndi matenda omwe ma cell owopsa (khansa) amapangika m'matumba am'mimba (dzira) a ovary.

Zotupa zam'magazi zimayamba m'maselo oberekera (dzira kapena umuna) mthupi. Zotupa zamagulu amtundu wa ovarian nthawi zambiri zimachitika mwa atsikana achichepere kapena atsikana ndipo nthawi zambiri zimakhudza ovary imodzi yokha.

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.

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.

Chotupa cha majeremusi a ovarian ndi dzina lodziwika lomwe limagwiritsidwa ntchito pofotokoza mitundu ingapo ya khansa. Chotupa chofala kwambiri cha kachilombo ka ovari chotchedwa dysgerminoma. Onani zidule zotsatirazi za kuti mumve zambiri zamatenda ena ovuta:

• Ovarian Epithelial, Fallopian Tube, ndi Primary Peritoneal Cancer Treatment

• Chithandizo cha Ovarian Low Malignant Potential Chotupa

Zizindikiro za chotupa cha majeremusi otupa m'mimba ndikutupa kwa m'mimba kapena magazi akumaliseche mukatha kusamba.

Zotupa zamagulu amtundu wa ovarian zimakhala zovuta kuzindikira (kupeza) koyambirira. Nthawi zambiri sipakhala zisonyezo kumayambiliro, koma zotupa zimatha kupezeka pamayeso azachipatala (omwe amafufuza). Funsani dokotala ngati muli ndi izi:

• Kutupa pamimba kopanda kunenepa m'mbali zina za thupi.

• Kutuluka magazi kuchokera kumaliseche mutatha kusamba (pamene simusiyanso kusamba).

Kuyesa komwe kumayang'ana thumba losunga mazira, m'chiuno, magazi, ndi thumba losunga mazira kumagwiritsidwa ntchito kuti mupeze (kupeza) ndikuzindikira chotupa cha khungu la ovari.

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: 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.

• Laparotomy: Njira yochitira opareshoni yomwe imadulidwa pakhoma pamimba kuti ayang'ane mkati mwa mimba ngati muli ndi matenda. Kukula kwa katemera kumadalira chifukwa chomwe laparotomy ikuchitidwira. Nthawi zina ziwalo zimachotsedwa kapena zitsanzo za minofu zimatengedwa ndikufufuzidwa pa microscope ngati pali matenda.

• 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.

• Chiyeso cha serum tumor marker: Njira yomwe magazi amayang'aniridwa kuti athe kuyeza 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) kapena chorionic gonadotropin (HCG) m'magazi kumatha kukhala chizindikiro cha chotupa cha majeremusi oyambira.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira ndi chithandizo).

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Mtundu wa khansa.

• Kukula kwa chotupacho.

• Gawo la khansa (ngakhale limakhudza gawo lina la ovary, limakhudza ovary lonse, kapena lafalikira m'malo ena mthupi).

• Momwe ma cell a khansa amawonekera pansi pa microscope.

• Thanzi labwino la wodwalayo.

Zotupa zamagulu amtundu wa ovarian nthawi zambiri zimachiritsidwa zikapezeka ndikuthandizidwa msanga.

Magawo a Ovarian Germ Cell Tumors

MFUNDO ZOFUNIKA

• Pambuyo papezeka chotupa cha majeremusi m'thupi, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa ovary 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 pazotupa zamagulu oyambira m'mimba:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

Pambuyo papezeka chotupa cha majeremusi m'thupi, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa ovary kapena mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa yafalikira mkati mwa ovary kapena mbali zina za thupi imatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Pokhapokha ngati dokotala akudziwa kuti khansara yafalikira kuchokera m'mimba mwake kupita mbali zina za thupi, opareshoni yotchedwa laparotomy imachitika kuti awone ngati khansayo yafalikira. Dokotala ayenera kudula m'mimba ndikuyang'anitsitsa ziwalo zonse kuti awone ngati ali ndi khansa. Adotolo adula tiziduswa tating'ono kuti athe kuyang'aniridwa ndi microscope ngati ali ndi khansa. Dokotala amathanso kutsuka m'mimba ndi madzimadzi, omwe amawunikanso pansi pa microscope kuti awone ngati ili ndi maselo a khansa. Nthawi zambiri adotolo amachotsa khansa ndi ziwalo zina zomwe zili ndi khansa mkati mwa laparotomy.

Mayeso ambiri omwe amagwiritsidwa ntchito pozindikira chotupa cha majeremusi am'thupi amagwiritsidwanso ntchito popanga magawo. Mayeso ndi njira zotsatirazi zitha kugwiritsidwanso ntchito popanga magawo:

• 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.

• 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).

• Transvaginal ultrasound test: Njira yogwiritsira ntchito nyini, chiberekero, machubu, ndi chikhodzodzo. Chotulutsa ma ultrasound (kafukufuku) chimalowetsedwa kumaliseche ndipo chimagwiritsa ntchito mafunde amphamvu kwambiri (ultrasound) pamatumba amkati kapena ziwalo ndikupanga mawonekedwe. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Dokotala amatha kuzindikira zotupa poyang'ana pa sonogram.

Pali njira zitatu zomwe khansa imafalikira mthupi.

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

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

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

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

Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

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

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

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

Chotupacho chimakhala chotupa chimodzimodzi. Mwachitsanzo, ngati chotupa cha kachilombo koyambitsa matenda chikufalikira m'chiwindi, zotupa m'chiwindi ndimaselo a khansa ya m'mimba. Matendawa ndi chotupa cha kachilombo koyambitsa matendawa, osati khansa ya chiwindi.

Magawo otsatirawa amagwiritsidwa ntchito pazotupa zamagulu oyambira m'mimba:

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, khansa imapezeka m'modzi kapena m'mimba mwake. Gawo I lagawidwa mu gawo IA, gawo IB, ndi gawo IC.

• Gawo IA: Khansa imapezeka mkati mwa ovary imodzi.

• Gawo IB: Khansa imapezeka mkati mwa mazira ambiri.

• Gawo IC: Khansa imapezeka mkati mwa mazira ambiri ndipo zonsezi ndi zoona:

• khansara imapezekanso panja pa malo amodzi kapena onse awiri; kapena

• kapisozi (chophimba chakunja) cha ovary chaphulika (chotseguka); 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 yafalikira kumadera ena a chiuno. Gawo II lidagawika gawo IIA, gawo IIB, ndi gawo IIC.

• Gawo IIA: Khansa yafalikira m'chiberekero ndi / kapena mazira (mazira otalikirapo omwe mazira amadutsa kuchokera m'mimba mwake kupita ku chiberekero).

• Gawo IIB: Khansa yafalikira ku minofu ina m'chiuno.

• Gawo IIC: Khansa imapezeka mkati mwa imodzi kapena m'mimba mwake ndipo yafalikira ku chiberekero ndi / kapena mazira, kapena kuzinthu zina m'chiuno. Komanso, chimodzi mwazinthu izi ndi chowonadi:

• khansa imapezeka panja pa dzira limodzi kapena onse awiri; kapena

• kapisozi (chophimba chakunja) cha ovary chaphulika (chotseguka); 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).

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 ndipo imafalikira kunja kwa mafupa a ziwalo zina zam'mimba ndi / kapena ma lymph node oyandikira. Gawo lachitatu lagawidwa gawo IIIA, gawo IIIB, ndi gawo IIIC.

• Gawo IIIA: Chotupacho chimapezeka m'chiuno mokha, koma ma cell a khansa omwe amatha kuwoneka ndi microscope afalikira pamwamba pa peritoneum (minofu yomwe imayala khoma la m'mimba ndikuphimba ziwalo zonse m'mimba), matumbo ang'onoang'ono, kapena khungu lomwe limalumikiza matumbo ang'onoang'ono ndi khoma lamimba.

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 ndipo khansa mu peritoneum ndi 2 sentimita kapena yaying'ono.

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 ndipo khansa mu peritoneum ndi yayikulu kuposa masentimita awiri ndipo / kapena khansa yafalikira kumatenda am'mimba.

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.

Khansa yomwe yafalikira pachiwindi imawonekeranso kuti khansa ya ovari ya gawo III

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.

Pa gawo IV, khansa yafalikira kupyola pamimba kupita mbali zina za thupi, monga mapapo kapena minofu mkati mwa chiwindi.

Maselo a khansa mumadzimadzi ozungulira mapapo amawonedwanso kuti khansa ya ovari ya gawo IV.

Zotupitsa za Ovarian Germ Cell Tumors

Chotupa cham'mimba cham'mimba cham'mimba ndi khansa yomwe yabwereranso (itabwerera) itachiritsidwa. Khansara imatha kubwerera mchiberekero china kapena mbali zina za thupi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi zotupa zamagulu a ovari.

• Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

• Opaleshoni

• Kuwona

• Chemotherapy

• Thandizo la radiation

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Mankhwala apamwamba a chemotherapy ndi kuika mafupa m'mafupa

• Njira zatsopano zamankhwala

• Chithandizo cha zotupa zamagulu a ovari chimatha kuyambitsa zovuta.

• Odwala angaganize zopita nawo kukayezetsa.

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

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi zotupa zamagulu a ovari.

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

Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

Opaleshoni

Opaleshoni ndiyo njira yodziwika bwino kwambiri yothetsera chotupa cha majeremusi m'mimba. Dokotala atha kutulutsa khansa pogwiritsa ntchito njira izi.

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

• Chiwombankhanga chonse: Njira yochotsera chiberekero, kuphatikizapo khomo pachibelekeropo. 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.

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

• Tumor debulking: Njira yochitira opareshoni yomwe chotupa chochuluka momwe angathere chimachotsedwa. Zotupa zina sizingachotsedwe kwathunthu.

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.

Pambuyo pa chemotherapy ya chotupa cha majeremusi ya ovarian, laparotomy yowoneka yachiwiri itha kuchitidwa. Izi ndizofanana ndi laparotomy yomwe imachitika kuti mupeze gawo la khansa. Ma laparotomy owoneka kwachiwiri ndi njira yochitira opaleshoni kuti mudziwe ngati maselo am'mimba atsala atalandira chithandizo chamankhwala choyambirira. Pochita izi, adotolo amatenga ma lymph node ndi ziwalo zina m'mimba kuti awone ngati khansa yatsala. Njirayi siyidachitike kwa ma dysgerminomas.

Kuwona

Kuyang'anitsitsa kumayang'anitsitsa matenda a wodwalayo osamupatsa chithandizo chilichonse pokhapokha ngati zizindikilo zosintha kapena kusintha.

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). Kuphatikiza kwa chemotherapy ndi chithandizo chogwiritsa ntchito mankhwala opatsirana ambiri opatsirana khansa. 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.

Thandizo la radiation

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

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

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

Momwe mankhwala a radiation amaperekedwera zimadalira mtundu ndi gawo la khansa yomwe ikuthandizidwa. Thandizo la radiation lakunja limagwiritsidwa ntchito pochiza zotupa zamagulu a ovari.

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.

Mankhwala apamwamba a chemotherapy ndi kuika mafupa m'mafupa

Mankhwala a chemotherapy apamwamba ndi kupatsirana m'mafupa ndi njira yoperekera mankhwala amphamvu kwambiri a chemotherapy ndikusintha maselo omwe amapanga magazi omwe awonongedwa ndi khansa. Maselo oteteza magazi (maselo a magazi omwe sanakhwime) amachotsedwa m'mafupa a wodwalayo kapena woperekayo ndipo amaundana ndi kusungidwa. Chemotherapy ikamalizidwa, maselo osungidwa amasungunuka ndikubwezeretsedwanso mwa kulowetsedwa. Maselo amtundu wobwezeretsansowa amakula (ndikubwezeretsanso) maselo amthupi.

Njira zatsopano zamankhwala

Kuphatikiza kwa chemotherapy (kugwiritsa ntchito mankhwala opitilira khansa opitilira umodzi) kumayesedwa m'mayesero azachipatala.

Chithandizo cha zotupa zamagulu a ovari chimatha kuyambitsa zovuta.

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

Odwala angaganize zopita nawo kukayezetsa.

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

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

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

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

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

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

Mayeso otsatirawa angafunike.

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

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

Njira Zothandizira Pachigawo

M'chigawo chino

• Gawo I Ovarian Germ Cell Tumors

• Gawo Lachiwiri Ovarian Germ Cell Tumors

• Gawo lachitatu Ovarian Germ Cell Tumors

• Gawo IV Ovarian Germ Cell Tumors

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

Gawo I Ovarian Germ Cell Tumors

Chithandizo chimadalira ngati chotupacho ndi dysgerminoma kapena mtundu wina wa chotupa cha majeremusi oyambira.

Chithandizo cha dysgerminoma chingaphatikizepo izi:

• Unilateral salpingo-oophorectomy kapena wopanda lymphangiography kapena CT scan.

• Unilateral salpingo-oophorectomy yotsatira ndikuwona.

• Unilateral salpingo-oophorectomy yotsatira ndi radiation radiation.

• Unilateral salpingo-oophorectomy yotsatiridwa ndi chemotherapy.

Chithandizo cha zotupa zina za m'mimba zotsekemera mwina ndi izi:

• unilateral salpingo-oophorectomy yotsatiridwa ndikuwonetsetsa; kapena

• unilateral salpingo-oophorectomy, nthawi zina kutsatiridwa ndi kuphatikiza chemotherapy.

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.

Gawo Lachiwiri Ovarian Germ Cell Tumors

Chithandizo chimadalira ngati chotupacho ndi dysgerminoma kapena mtundu wina wa chotupa cha majeremusi oyambira.

Chithandizo cha dysgerminoma mwina ndi ichi:

• kuchuluka kwa m'mimba hysterectomy ndi bilateral salpingo-oophorectomy kutsatiridwa ndi radiation radiation kapena kuphatikiza chemotherapy; kapena

• unilateral salpingo-oophorectomy yotsatiridwa ndi chemotherapy.

Chithandizo cha zotupa zina za m'mimba zotsekemera zimatha kuphatikizira izi:

• Unilateral salpingo-oophorectomy yotsatiridwa ndi kuphatikiza chemotherapy.

• Kuyang'ana kwachiwiri kwa laparotomy (opareshoni itachitika mutalandira chithandizo chamankhwala choyambirira kuti muwone ngati zotupa zimatsalira).

• 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.

Gawo lachitatu Ovarian Germ Cell Tumors

Chithandizo chimadalira ngati chotupacho ndi dysgerminoma kapena mtundu wina wa chotupa cha majeremusi oyambira.

Chithandizo cha dysgerminoma chingaphatikizepo izi:

• Kuchulukitsa kwam'mimba kwathunthu komanso salpingo-oophorectomy wapawiri, ndikuchotsa khansa yambiri m'chiuno ndi pamimba momwe zingathere.

• Unilateral salpingo-oophorectomy yotsatiridwa ndi chemotherapy.

Chithandizo cha zotupa zina za m'mimba zotsekemera zimatha kuphatikizira izi:

• Kuchulukitsa kwam'mimba kwathunthu komanso salpingo-oophorectomy wapawiri, ndikuchotsa khansa yambiri m'chiuno ndi pamimba momwe zingathere. Chemotherapy idzaperekedwa asanafike kapena / kapena atachitidwa opaleshoni.

• Unilateral salpingo-oophorectomy yotsatiridwa ndi chemotherapy.

• Kuyang'ana kwachiwiri kwa laparotomy (opareshoni itachitika mutalandira chithandizo chamankhwala choyambirira kuti muwone ngati zotupa zimatsalira).

• 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.

Gawo IV Ovarian Germ Cell Tumors

Chithandizo chimadalira ngati chotupacho ndi dysgerminoma kapena mtundu wina wa chotupa cha majeremusi oyambira.

Chithandizo cha dysgerminoma chingaphatikizepo izi:

• Chiwopsezo cha m'mimba chonse ndi salpingo-oophorectomy yotsatiridwa ndi chemotherapy, ndikuchotsa khansa yambiri m'chiuno ndi pamimba momwe zingathere.

• Unilateral salpingo-oophorectomy yotsatiridwa ndi chemotherapy.

Chithandizo cha zotupa zina za m'mimba zotsekemera zimatha kuphatikizira izi:

• Kuchulukitsa kwam'mimba kwathunthu komanso salpingo-oophorectomy wapawiri, ndikuchotsa khansa yambiri m'chiuno ndi pamimba momwe zingathere. Chemotherapy idzaperekedwa asanafike kapena / kapena atachitidwa opaleshoni.

• Unilateral salpingo-oophorectomy yotsatiridwa ndi chemotherapy.

• Kuyang'ana kwachiwiri kwa laparotomy (opareshoni itachitika mutalandira chithandizo chamankhwala choyambirira kuti muwone ngati zotupa zimatsalira).

• 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.

Njira Zothandizira Pazotupitsa Zam'mimba Zam'mimba Zomwe Zimapezekanso

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

Chithandizo chimadalira ngati chotupacho ndi dysgerminoma kapena mtundu wina wa chotupa cha majeremusi oyambira.

Chithandizo cha dysgerminoma chingakhale:

• Chemotherapy kapena wopanda radiation radiation.

Chithandizo cha zotupa zina za m'mimba zotsekemera zimatha kuphatikizira izi:

• Chemotherapy.

• Kuchita opaleshoni kapena popanda chemotherapy.

• Kuyesedwa kwachipatala kwa chemotherapy yayikulu kwambiri ndikutsatiridwa kwa mafupa.

• 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 zamatenda am'mimba mwa ovarian ger

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza zotupa zamagulu a ovari, onani izi:

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

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

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