Mitundu / minofu yofewa-sarcoma / wodwala / wamkulu-wofewa-minofu-mankhwala-pdq

Chithandizo cha Anthu Akuluakulu Opatsirana Matenda a Msana (®) -Patient Version

Zambiri Zokhudza Matenda Akuluakulu Aakulu Sarcoma

Matenda achikulire ofewa sarcoma ndi matenda omwe ma cell oyipa (khansa) amapangidwa m'matumba ofewa amthupi.

Minofu yofewa ya thupi imaphatikizaponso minofu, tendon (magulu a ma fiber omwe amalumikiza minofu ndi mafupa), mafuta, mitsempha yamagazi, mitsempha ya mitsempha, mitsempha, ndi minyewa yozungulira mafupa. Matenda akulu akulu osalala amatha kupanga pafupifupi kulikonse m'thupi, koma amapezeka pamutu, m'khosi, mikono, miyendo, thunthu, pamimba, ndi retroperitoneum.

Mitundu yofewa ya sarcoma imapangidwa munyama zofewa za thupi, kuphatikiza minofu, minyewa, mafuta, mitsempha yamagazi, mitsempha ya mitsempha, mitsempha, ndi minofu mozungulira mafupa.

Pali mitundu yambiri ya sarcoma yofewa. Maselo amtundu uliwonse wa sarcoma amawoneka mosiyana pansi pa microscope, kutengera mtundu wofewa momwe khansayo idayambira.

Onani zidule zotsatirazi za kuti mumve zambiri za ma sarcomas ofewa:

• Chithandizo cha Mwana Wofewa Matenda a Sarcoma

• Kuchiza Chithandizo cha Sarcoma

• Chithandizo cha m'mimba Chotupa Chotupa

• Chithandizo cha Kaposi Sarcoma

• Chithandizo cha Uterine Sarcoma

Kukhala ndi zovuta zina zobadwa nazo kumatha kuwonjezera chiopsezo cha sarcoma wamkulu wofewa.

Chilichonse chomwe chimakulitsa chiopsezo chotenga matenda chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala ngati mukuganiza kuti mutha kukhala pachiwopsezo. Zomwe zimayambitsa ngozi yofewa ya sarcoma ndi izi:

• Retinoblastoma.

• Mtundu wa Neurofibromatosis 1 (NF1; matenda a Recklinghausen).

• Tuberous sclerosis (matenda a Bourneville).

• Wodziwika bwino adenomatous polyposis (FAP; Gardner syndrome).

• Matenda a Li-Fraumeni.

• Matenda a Werner (progeria wamkulu).

• Matenda a Nevoid basal cell carcinoma (matenda a Gorlin).

Zina mwaziwopsezo za zofewa za sarcoma ndi izi:

• Chithandizo cham'mbuyomu chothandizidwa ndi radiation kwa khansa zina.

• Kukumana ndi mankhwala ena, monga Thorotrast (thorium dioxide), vinyl chloride, kapena arsenic.

• Kukhala ndi kutupa (lymphedema) m'manja kapena miyendo kwa nthawi yayitali.

Chizindikiro cha minofu yayikulu yofewa ya sarcoma ndi chotupa kapena kutupa mnofu wofewa wamthupi.

Sarcoma imatha kuwoneka ngati chotupa chopanda ululu pansi pa khungu, nthawi zambiri pamanja kapena mwendo. Ma Sarcomas omwe amayambira m'mimba sangayambitse

Zizindikiro mpaka zikukula kwambiri. Pamene sarcoma ikukula ndikulimbikira ziwalo zapafupi, mitsempha, minofu, kapena mitsempha yamagazi, zizindikilo zimatha kuphatikizira izi:

• Ululu.

• Kuvuta kupuma.

Zinthu zina zimatha kuyambitsa zizindikilo zomwezo. Funsani dokotala wanu ngati muli ndi mavuto amenewa.

Matenda akulu achikulire a sarcoma amapezeka kuti ali ndi biopsy.

Ngati dokotala akuganiza kuti mungakhale ndi sarcoma yofewa, biopsy idzachitika. Mtundu wa biopsy utengera kukula kwa chotupacho komanso komwe kuli mthupi. Pali mitundu itatu ya biopsy yomwe ingagwiritsidwe ntchito:

• Incopal biopsy: Kuchotsa gawo limodzi kapena chotupa cha mnofu.

• Core biopsy: Kuchotsa minofu pogwiritsa ntchito singano yayikulu.

• Chidwi chodabwitsa: Kuchotsa chotupa chonse kapena gawo la mnofu lomwe silikuwoneka bwino.

Zitsanzo zidzatengedwa kuchokera ku chotupa choyambirira, ma lymph node, ndi madera ena okayikira. Katswiri wa matendawa amayang'ana minofu pansi pa maikulosikopo kuti ayang'ane maselo a khansa kuti adziwe kukula kwa chotupacho. Mulingo wa chotupacho umadalira momwe maselo a khansa amawonekera molakwika ndi microscope komanso momwe maselo amagawanira mwachangu. Zotupa zapamwamba kwambiri zimakula ndikufalikira mofulumira kuposa zotupa zochepa.

Chifukwa chakuti minofu yofewa ya sarcoma imatha kukhala yovuta kuzindikira, odwala ayenera kufunsa kuti awonetsetse zitsanzo zamatenda omwe ali ndi chidziwitso chodziwa minofu yofewa ya sarcoma.

Mayesero otsatirawa akhoza kuchitika pa minofu yomwe idachotsedwa:

• Immunohistochemistry: Kuyesa kwa labotale komwe kumagwiritsa ntchito ma antibodies kuti aone ngati ali ndi ma antigen (zolembera) muzitsanzo za minofu ya wodwala. Ma antibodies nthawi zambiri amalumikizidwa ndi enzyme kapena utoto wa fulorosenti. Ma antibodies atagwirizana ndi antigen inayake munthawi ya minofu, enzyme kapena utoto umayambitsidwa, ndipo antigen imatha kuwonedwa ndi microscope. Mayeso amtunduwu amagwiritsidwa ntchito pothandiza kuzindikira khansa ndikuthandizira kudziwa khansa yamtundu wina wa khansa.

• Ma microscopy ya kuwala ndi elektroni: Kuyesa kwa labotale komwe ma cell amtundu wa minofu amawonedwa pansi pa microscopic yanthawi zonse komanso yamphamvu kwambiri kuti asinthe kusintha m'maselo.

• Kusanthula kwa cytogenetic: Kuyesa kwa labotale komwe ma chromosomes am'maselo amtundu wa minofu amawerengedwa ndikuwunika ngati pali kusintha kulikonse, monga kusweka, kusowa, kukonzedwanso, kapena ma chromosomes owonjezera. Kusintha kwa ma chromosomes ena kungakhale chizindikiro cha khansa. Kusanthula kwa cytogenetic kumagwiritsidwa ntchito kuthandizira kuzindikira khansa, kukonzekera chithandizo, kapena kudziwa momwe chithandizo chikuyendera.

• FISH (fluorescence in situ hybridization): Kuyesa kwa labotale komwe kumayang'ana ndikuwerengera majini kapena ma chromosomes m'maselo ndi minofu. Zidutswa za DNA zomwe zimakhala ndi utoto wa fulorosenti zimapangidwa mu labotale ndikuwonjezeredwa muzitsanzo zamaselo a wodwalayo. Zidutswa za DNA zoterezi zikalumikizana ndi majini kapena madera ena a chromosomes mchitsanzo, zimawala zikawonedwa ndi microscope ya fulorosenti. Kuyesa kwa FISH kumagwiritsidwa ntchito kuthandizira kuzindikira khansa ndikuthandizira kukonzekera mankhwala.

• Flow cytometry: Kuyesa kwa labotale komwe kumayeza kuchuluka kwa maselo munzitsanzo, kuchuluka kwa maselo amoyo pachitsanzo, ndi mawonekedwe ena amamaselo, monga kukula, mawonekedwe, ndi kupezeka kwa zotupa (kapena zina) pamwamba pa khungu. Maselo ochokera pagazi la wodwalayo, m'mafupa, kapena minofu ina amadetsedwa ndi utoto wa fulorosenti, amaikidwa mumadzimadzi, kenako nkuwudutsa kamodzi mwa kuwala. Zotsatira zakuyesa zimadalira momwe maselo omwe adadetsedwa ndi utoto wa fluorescent amatengera kuwala kwa kuwala.

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

Njira zochiritsira komanso malingaliro ake (mwayi wochira) zimadalira izi:

• Mtundu wa sarcoma yofewa.

• Kukula, msinkhu, ndi gawo la chotupacho.

• Maselo a khansa akukula mwachangu ndikugawa.

• Komwe chotupacho chili mthupi.

• Kaya chotupacho chimachotsedwa ndi opaleshoni.

• Msinkhu wa wodwalayo komanso thanzi lake lonse.

• Kaya khansara yabwereranso (kubwerera).

Magawo a Matenda Aakulu Omwe Amasamba Sarcoma

MFUNDO ZOFUNIKA

• Pambuyo poti matenda akuluakulu a sarcoma apezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa minofu yofewa kapena mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

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

• Mulingo wa chotupacho umagwiritsidwanso ntchito kufotokoza khansa ndikukonzekera chithandizo.

• Kwa akulu achikulire ofewa sarcoma ya thunthu, mikono, ndi miyendo, magawo awa amagwiritsidwa ntchito:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Kwa achikulire ofewa minofu sarcoma ya retroperitoneum, magawo awa amagwiritsidwa ntchito:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Palibe njira yokhazikika ya sarcoma yofewa ya mutu, khosi, chifuwa, kapena mimba.

Pambuyo poti matenda akuluakulu a sarcoma apezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa minofu yofewa kapena mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa yafalikira mkati mwa minofu yofewa kapena mbali zina za thupi imatchedwa staging. Kukhazikika kwa minofu yofewa ya sarcoma kumayeneranso pamlingo ndi kukula kwa chotupacho, komanso ngati chafalikira kumatenda am'mimba kapena ziwalo zina za thupi. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito pokonza:

• 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.

• 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.

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

• Kuwerengera kwathunthu kwa magazi (CBC): Njira yomwe magazi amatengedwa ndikuwunika zotsatirazi:

• Chiwerengero cha maselo ofiira, maselo oyera amwazi, ndi ma platelet.

• Kuchuluka kwa hemoglobin (puloteni yomwe imanyamula mpweya) m'maselo ofiira amwazi.

• Gawo la magazi lomwe limapangidwa ndi maselo ofiira.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga mapapo ndi pamimba, 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.

Zotsatira zamayesowa zimawonedwa limodzi ndi zotsatira za chotupa chotupa kuti mupeze gawo la sarcoma yofewa mankhwala asanaperekedwe. Nthawi zina chemotherapy kapena radiation radiation imaperekedwa ngati chithandizo choyambirira ndipo pambuyo pake minofu yofewa ya sarcoma imayambiranso.

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 minofu yofewa ya sarcoma imafalikira m'mapapu, maselo am'mapapo m'mapapo ndimaselo ofewa a sarcoma. Matendawa ndi metastatic zofewa minofu sarcoma, osati khansa yamapapo.

Mulingo wa chotupacho umagwiritsidwanso ntchito kufotokoza khansa ndikukonzekera chithandizo.

Mulingo wa chotupacho umafotokozera momwe ma cell a khansa amawonekera modabwitsa ndi microscope komanso momwe chotupacho chimakula ndikufalikira mofulumira. Kalasi yotsika, kalasi yapakatikati, komanso magiredi apamwamba amagwiritsidwa ntchito pofotokoza minofu yofewa sarcoma:

• Kalasi yocheperako: M'magulu otsika otsika a sarcoma, ma cell a khansa amawoneka ngati maselo abwinobwino pansi pa microscope ndipo amakula ndikufalikira pang'onopang'ono kuposa sarcoma yapakatikati komanso yapamwamba.

• Pakati pakatikati: Pakatikati pa kalasi yofewa ya sarcoma, maselo a khansa amawoneka osazolowereka pansi pa microscope ndikukula ndikufalikira mwachangu kuposa ma sarcoma ochepetsetsa.

• Kalasi yayikulu: M'magulu ofunikira a sarcoma, maselo a khansa amawoneka osazolowereka pansi pa microscope ndikukula ndikufalikira mwachangu kuposa sarcoma yofewa komanso yapakatikati.

Kwa akulu achikulire ofewa sarcoma ya thunthu, mikono, ndi miyendo, magawo awa amagwiritsidwa ntchito:

Gawo I

Gawo I sarcoma yofewa ya thunthu, mikono, ndi miyendo imagawidwa m'magawo IA ndi IB:

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).

• Pa siteji IA, chotupacho chili ndi masentimita 5 kapena ocheperako ndipo ndi otsika kapena kalasiyo sichidziwika.

• Pachigawo cha IB, chotupacho chimakhala chachikulu kuposa masentimita 5 ndipo chimakhala chotsika kapena kalatayo sikudziwika.

Gawo II

Mu gawo lachiwiri lanyama yofewa ya sarcoma ya thunthu, mikono, ndi miyendo, chotupacho chili ndi masentimita 5 kapena ocheperako ndipo chili pakati kalasi kapena chapamwamba.

Gawo III

Gawo lachitatu lanyama yofewa ya sarcoma ya thunthu, mikono, ndi miyendo imagawidwa m'magawo IIIA ndi IIIB:

• Pa gawo IIIA, chotupacho chimakhala chachikulu kuposa masentimita 5 koma sichoposa masentimita 10 ndipo chimakhala chapakatikati kapena chapamwamba.

• Pa gawo IIIB, chotupacho chimakhala chachikulu kuposa masentimita 10 ndipo chimakhala chapakatikati kapena chapamwamba.

Gawo IV

Mu gawo IV wamkulu wa minofu yofewa ya thunthu, mikono, ndi miyendo, chimodzi mwazotsatira chimapezeka:

• chotupacho ndi chachikulu, mulingo uliwonse, ndipo chafalikira kumatenda apafupi; kapena

• chotupacho ndi kukula kwake, kalasi iliyonse, ndipo mwina chafalikira kumatenda apafupi. Khansa yafalikira mbali zina za thupi, monga mapapo.

Kwa achikulire ofewa minofu sarcoma ya retroperitoneum, magawo awa amagwiritsidwa ntchito:

Gawo I

Gawo I wamkulu minofu yofewa sarcoma ya retroperitoneum imagawidwa m'magawo IA ndi IB:

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).

• Pa siteji IA, chotupacho chili ndi masentimita 5 kapena ocheperako ndipo ndi otsika kapena kalasiyo sichidziwika.

• Pachigawo cha IB, chotupacho chimakhala chachikulu kuposa masentimita 5 ndipo chimakhala chotsika kapena kalatayo sikudziwika.

Gawo II

Mu gawo lachiwiri lanyama yofewa ya sarcoma ya retroperitoneum, chotupacho chili ndi masentimita 5 kapena ocheperako ndipo chili pakati kapena kalasi yayikulu.

Gawo III

Gawo lachitatu lanyama yofewa ya sarcoma ya retroperitoneum imagawidwa m'magawo IIIA ndi IIIB:

• Pa gawo IIIA, chotupacho chimakhala chachikulu kuposa masentimita 5 koma sichoposa masentimita 10 ndipo chimakhala chapakatikati kapena chapamwamba.

• Mu gawo IIIB, chimodzi mwazotsatira zimapezeka:

• chotupacho chimakhala chachikulu kuposa masentimita 10 ndipo chimakhala chapakatikati kapena chapamwamba; kapena

• chotupacho ndi kukula kwake, kalasi iliyonse, ndipo chafalikira kumatenda apafupi.

Gawo IV

Munjira yachinayi yayikulu yofewa ya sarcoma ya retroperitoneum, chotupacho ndi kukula kwake, mulingo uliwonse, ndipo chikhoza kufalikira ku ma lymph node apafupi. Khansa yafalikira mbali zina za thupi, monga mapapo.

Palibe njira yokhazikika ya sarcoma yofewa ya mutu, khosi, chifuwa, kapena mimba.

Matenda Aakulu Aakulu Opepuka a Sarcoma

Matenda a sarcoma achikulire omwe amapezeka mobwerezabwereza ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Khansara ikhoza kubwerera mthupi lofewa lomwelo kapena mbali zina za thupi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi minofu yofewa ya akulu sarcoma.

• Mitundu itatu yamankhwala ogwiritsidwa ntchito imagwiritsidwa ntchito:

• Opaleshoni

• Thandizo la radiation

• Chemotherapy

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chemotherapy m'chigawo

• Kuchiza kwa khungu lofewa la sarcoma kumatha kuyambitsa zovuta.

• Odwala angaganize zopita nawo kukayezetsa.

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

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi minofu yofewa ya akulu sarcoma.

Pali mitundu ingapo ya mankhwala kwa odwala omwe ali ndi minofu yofewa ya akulu. 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 itatu yamankhwala ogwiritsidwa ntchito imagwiritsidwa ntchito:

Opaleshoni

Opaleshoni ndi mankhwala omwe amapezeka kwambiri kwa akulu akulu ofewa sarcoma. Kwa ma sarcomas ena ofewa, kuchotsedwa kwa chotupacho pakuchita opaleshoni kungakhale chithandizo chokha chofunikira. Njira zotsatirazi zingagwiritsidwe ntchito:

Mohs microsurgery: Njira yomwe chotupacho chimadulidwira pakhungu pang'onopang'ono. Pochita opareshoni, m'mbali mwa chotupacho ndi chotupa chilichonse chotulutsidwa chimayang'aniridwa kudzera pa microscope kuti mufufuze ma cell a khansa. Zigawo zikupitilirabe kuchotsedwa mpaka pomwe sipadzakhalanso maselo a khansa. Opaleshoni yotereyi imachotsa minofu yabwinobwino momwe ingathere ndipo imagwiritsidwa ntchito pomwe mawonekedwe amafunikira, monga pakhungu.

Mohs opaleshoni. Njira yochotsera zotupa zowoneka pakhungu m'njira zingapo. Choyamba, kansalu kakang'ono ka khansa kamachotsedwa. Kenako, chingwe chachiwiri chochepa kwambiri chimachotsedwa ndikuwonedwa pansi pa microscope kuti aone ngati ali ndi khansa. Magawo ena amachotsedwa kamodzi mpaka minofu yowonedwa pansi pa microscope ikuwonetsa kuti palibe khansa yotsalira. Opaleshoni yamtunduwu imagwiritsidwa ntchito pochotsa minofu yabwinobwino momwe angathere.

• Kudula kwina: Kuchotsa chotupacho pamodzi ndi minofu yabwinobwino pozungulira. Pazotupa zam'mutu, khosi, pamimba, ndi thunthu, minofu yaying'ono momwe ingathere imachotsedwa.

• Kuchita opaleshoni yopulumutsa ziwalo: Kuchotsa chotupacho m'manja kapena mwendo popanda kudulidwa, ndiye kuti ntchito ndi mawonekedwe a chiwalocho amapulumutsidwa. Chithandizo cha radiation kapena chemotherapy chingaperekedwe koyamba kuti muchepetse chotupacho. Chotupacho chimachotsedwa pamadera ambiri m'deralo. Minofu ndi mafupa omwe amachotsedwa amatha kulowetsedwa m'malo olumikizidwa ndi minofu ndi mafupa otengedwa kuchokera ku gawo lina la thupi la wodwalayo, kapena ndi choikapo monga fupa lopangira.

• Kudulira: Kuchita opaleshoni kuchotsa gawo kapena chiwalo chilichonse, monga mkono kapena mwendo. Kudulidwa sikugwiritsidwa ntchito kangapo pochiza sarcoma yofewa ya mkono kapena mwendo.

• Lymphadenectomy: Njira yochizira momwe ma lymph node amachotsedwera ndikuyesedwa kwa minofu pansi pa microscope ngati pali zizindikiro za khansa. Njirayi imatchedwanso kuti lymph node dissection.

Chithandizo cha radiation kapena chemotherapy chitha kuperekedwa asanafike kapena pambuyo pa opaleshoni kuchotsa chotupacho. Mukapatsidwa opaleshoni musanachite opareshoni, mankhwala a radiation kapena chemotherapy amachititsa kuti chotupacho chikhale chocheperako ndikuchepetsa kuchuluka kwa minofu yomwe imafunika kuchotsedwa pakuchita opaleshoni. Chithandizo choperekedwa asanachite opareshoni chimatchedwa neoadjuvant therapy. Mukaperekedwa pambuyo pochitidwa opaleshoni kuti muchotse chotupa chonse chomwe chingawoneke, mankhwala a radiation kapena chemotherapy amapha maselo amtundu uliwonse a khansa. Chithandizo chomwe chimaperekedwa pambuyo pa opareshoni, kuti muchepetse chiopsezo kuti khansa ibwererenso, amatchedwa adjuvant therapy.

Thandizo la radiation

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

Mphamvu ya radiation-modulated radiation (IMRT) ndi mtundu wa 3-dimensional (3-D) chithandizo chama radiation chomwe chimagwiritsa ntchito kompyuta kupanga zithunzi za kukula ndi mawonekedwe a chotupacho. Mitsinje yoonda ya mphamvu zosiyanasiyana (mphamvu) imapangidwira chotupacho m'makona ambiri. Mankhwalawa ochokera kunja amawononga pang'ono minofu yabwinobwino ndipo samayambitsa mkamwa wouma, kuvutikira kumeza, komanso kuwononga khungu.

Momwe mankhwala a radiation amaperekedwera zimadalira mtundu ndi gawo la khansa yomwe ikuthandizidwa. Mankhwala a radiation akunja ndi ma radiation amkati amatha kugwiritsidwa ntchito pochiza sarcoma wamkulu wofewa.

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

Onani Mankhwala Ovomerezeka a Soft Tissue Sarcoma 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.

Chemotherapy m'chigawo

Mayesero azachipatala akuphunzira njira zothetsera mphamvu ya chemotherapy pama cell a chotupa, kuphatikiza izi:

• Therapy hyperthermia therapy: Chithandizo chomwe minofu yozungulira chotupacho imawonekera kutentha kwambiri kuti iwononge ndikupha ma cell a khansa kapena kupangitsa ma cell a khansa kutengeka ndi chemotherapy.

• Kutsekemera kwa miyendo yokhayokha: Njira yomwe imatumiza chemotherapy molunjika kumanja kapena mwendo momwe khansara yapangira. Kutuluka kwa magazi kupita kumalekezero kumayimitsidwa kwakanthawi ndi tchuthi, ndipo mankhwala oletsa khansa amaikidwa mwachindunji m'magazi a chiwalocho. Izi zimatumiza mankhwala ambiri pachotupacho.

Kuchiza kwa khungu lofewa la sarcoma kumatha kuyambitsa zovuta.

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

Odwala angaganize zopita nawo kukayezetsa.

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

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

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

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

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

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

Mayeso otsatirawa angafunike.

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

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

Njira Zothandizira Kuchiza Matenda Aakulu Osalala Sarcoma

M'chigawo chino

• Gawo I Munthu Wamkulu Wofewa Matenda a Sarcoma

• Gawo Lachiwiri Lofewa Matenda a Sarcoma ndi Gawo lachitatu Akuluakulu a Matenda Aakulu Omwe Sanafalikire ku Lymph Node

• Gawo lachitatu la minofu ya achikulire yofewa yomwe yafalikira ku Lymph Node (Advanced)

• Gawo IV Wamkulu Wofewa Matenda a Sarcoma

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

Gawo I Munthu Wamkulu Wofewa Matenda a Sarcoma

Chithandizo cha siteji yofewa ya sarcoma ingaphatikizepo izi:

• Kuchita opaleshoni kuti ndichotse chotupacho, monga Mohs microsurgery yama sarcomas ang'onoang'ono pakhungu, kudulidwa kwapafupi, kapena opaleshoni yopulumutsa ziwalo.

• Thandizo la radiation asanafike kapena / kapena atachitidwa 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.

Gawo Lachiwiri Lofewa Matenda a Sarcoma ndi Gawo lachitatu Akuluakulu a Matenda Aakulu Omwe Sanafalikire ku Lymph Node

Kuchiza kwa siteji yachiwiri ya minofu yofewa ya sarcoma ndi gawo lachitatu la khungu lofewa lomwe silinafalikire ku ma lymph node kungaphatikizepo izi:

• Kuchita opareshoni kuti muchotse chotupacho, monga kudulira kwina kulikonse kapena opaleshoni yopulumutsa ziwalo.

• Thandizo la radiation asanafike kapena pambuyo pa opaleshoni.

• Thandizo la radiation kapena chemotherapy musanachite opaleshoni yopulumutsa ziwalo. Mankhwalawa amatha kuperekedwanso pambuyo pochitidwa opaleshoni.

• Chithandizo champhamvu cha radiation kwa zotupa zomwe sizingachotsedwe ndi 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.

Gawo lachitatu la minofu ya achikulire yofewa yomwe yafalikira ku Lymph Node (Advanced)

Chithandizo cha gawo lachitatu la minofu yofewa ya sarcoma yomwe yafalikira ku ma lymph node (patsogolo) itha kuphatikizira izi:

• Opaleshoni (yotakata m'deralo) ndi lymphadenectomy. Mankhwalawa amatha kuperekedwanso pambuyo pochitidwa opaleshoni.

• Kuyesedwa kwachipatala kwa opaleshoni komwe kumatsatiridwa ndi chemotherapy.

• Kuyesedwa kwachipatala kwa mankhwala opatsirana a hyperthermia.

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 Wamkulu Wofewa Matenda a Sarcoma

Kuchiza kwa gawo lachiwiri lachinyama chofewa cha sarcoma kungaphatikizepo izi:

• Chemotherapy.

• Opaleshoni yochotsa khansa yomwe yafalikira m'mapapu.

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 Matenda Aakulu Omwe Ali Ndi Matenda Aakulu

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

Chithandizo cha tinthu tofewa tambiri tambiri tating'ono titha kukhala izi:

• Opaleshoni (yotakata m'deralo) ndikutsatira mankhwala a radiation.

• Opaleshoni (kudula pakati; osachita kawirikawiri).

• Opaleshoni yochotsa khansa yomwe yabwereranso m'mapapu.

• Chemotherapy.

• Kuyesedwa kwachipatala kwamiyendo yolumikizidwa mwendo.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kuti mudziwe zambiri Zokhudza Matenda Akuluakulu Aakulu Sarcoma

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

• Tsamba Lofewa la Tissue Sarcoma

• Chithandizo cha Mwana Wofewa Matenda a Sarcoma

• Kuchiza Chithandizo cha Sarcoma

• Chithandizo cha m'mimba Chotupa Chotupa

• Chithandizo cha Kaposi Sarcoma

• Chithandizo cha Uterine Sarcoma

• Mankhwala Ovomerezeka a Soft Tissue Sarcoma

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