Mitundu / chithokomiro / wodwala / chithandizo cha chithokomiro cha ana-pdq

Kuchiza Khansa Yaubwana Wa Chithokomiro (®) -Patient Version

Zambiri Zokhudza Khansa ya Chithokomiro ya Ana

MFUNDO ZOFUNIKA

• Khansara ya chithokomiro ndimatenda momwe maselo owopsa (khansa) amapangika m'matumba a chithokomiro.

• Mitundu ya chithokomiro ikhoza kukhala adenomas kapena carcinomas.

• Mitundu ya chithokomiro imatha kupezeka pamayeso azachipatala ndipo nthawi zambiri samakhala khansa.

• Kuwonetsedwa ndi radiation kapena kukhala ndi ma syndromes amtundu wina kumatha kukhudza chiopsezo cha khansa ya chithokomiro.

• Khansa ya chithokomiro ya medullary nthawi zina imayambitsidwa ndi kusintha kwa jini lomwe limadutsa kuchokera kwa kholo kupita kwa mwana.

• Zizindikiro za khansa ya chithokomiro zimaphatikizapo kutupa kapena chotupa pakhosi.

• Kuyesa komwe kumafufuza chithokomiro, khosi, ndi magazi amagwiritsidwa ntchito pozindikira ndikupanga khansa ya chithokomiro.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira).

Khansara ya chithokomiro ndimatenda momwe maselo owopsa (khansa) amapangika m'matumba a chithokomiro.

Chithokomiro ndi chimbudzi chomwe chili pansi pakhosi pafupi ndi trachea (windpipe). Amapangidwa ngati gulugufe, wokhala ndi lobe wakumanja ndi lobe wamanzere. Kachilomboka ndi kanyama kakang'ono kamene kamalumikiza ma lobes awiriwo. Nthawi zambiri sizimveka kudzera pakhungu.

Anatomy ya chithokomiro ndi matenda a parathyroid. Chithokomiro chimakhala pansi pammero pafupi ndi trachea. Chopangidwa ngati gulugufe, chokhala ndi lobe lamanja ndi lobe lakumanzere cholumikizidwa ndi kanyama kakang'ono kotchedwa isthmus. Zotupitsa za parathyroid ndimatumba anayi amakulidwe a nsawawa omwe amapezeka pakhosi pafupi ndi chithokomiro. Chithokomiro ndi mafinya a parathyroid amapanga mahomoni.

Chithokomiro chimagwiritsa ntchito ayodini, mchere womwe umapezeka muzakudya zina ndi mchere wothira madzi, kuthandiza kupanga mahomoni angapo. Mahomoni a chithokomiro amachita izi:

• Chepetsani kugunda kwa mtima, kutentha kwa thupi, komanso momwe chakudya chimasinthira kukhala mphamvu (metabolism).

• Sungani kuchuluka kwa calcium m'magazi.

Mitundu ya chithokomiro ikhoza kukhala adenomas kapena carcinomas.

Pali mitundu iwiri ya mitsempha ya chithokomiro:

• Adenomas: Adenomas amatha kukula kwambiri ndipo nthawi zina amapanga mahomoni. Adenomas si khansa koma imatha kukhala yoyipa (khansa) ndikufalikira m'mapapu kapena ma lymph node m'khosi.

• Carcinomas: Pali mitundu itatu yayikulu ya chithokomiro cha carcinoma mwa ana:

• Papillary. Papillary chithokomiro carcinoma ndiye mtundu wodziwika bwino wa khansa ya chithokomiro mwa ana. Zimachitika kawirikawiri mwa achinyamata. Papillary chithokomiro cha carcinoma nthawi zambiri chimapangidwa ndi ma nodule opitilira umodzi mbali zonse ziwiri za chithokomiro. Nthawi zambiri imafalikira kumatenda am'mitsempha komanso imafalikira kumapapu. Kulosera (mwayi wochira) kwa odwala ambiri ndiabwino kwambiri.

• Otsatira. Chotsatira chithokomiro cha carcinoma nthawi zambiri chimapangidwa ndi nodule imodzi. Nthawi zambiri imafalikira mpaka kumafupa ndi mapapo, koma imafalikira kwambiri kuzinthu zam'mimba m'khosi. Kufotokozera kwa odwala ambiri ndikwabwino.

• Zolemba. Medullary chithokomiro carcinoma amachokera ku parafollicular C cell mu chithokomiro. Nthawi zambiri imalumikizidwa ndi kusintha kwina komwe kumachokera mu mtundu wa RET ndi mitundu yambiri ya endocrine neoplasia type 2 (MEN 2) syndrome. Zimapezeka kawirikawiri kwa ana azaka 4 kapena kupitilira apo ndipo mwina zimafalikira mbali zina za thupi panthawi yodziwika. Ana omwe ali ndi matenda a MEN2 atha kukhala pachiwopsezo chotenga pheochromocytoma kapena hyperparathyroidism.

Khansa ya chithokomiro ya papillary ndi follicular nthawi zina imatchedwa khansa ya chithokomiro. Khansa ya chithokomiro ya medullary ndi anaplastic nthawi zina imatchedwa khansa ya chithokomiro yosiyanitsidwa bwino. Khansa ya chithokomiro ya Anaplastic ndiyosowa kwambiri mwa ana ndipo sinafotokozedwe mwachidule.

Mitundu ya chithokomiro imatha kupezeka pamayeso azachipatala ndipo nthawi zambiri samakhala khansa.

Dokotala wa mwana wanu atha kupeza chotupa mu chithokomiro panthawi yoyezetsa magazi, kapena mutu ungawonekere poyesa kujambula kapena panthawi yochita opaleshoni ina. Nthenda ya chithokomiro ndikukula kosazolowereka kwamaselo a chithokomiro. Mitsempha yamagazi imatha kukhala yolimba kapena yodzaza madzi.

Matenda a chithokomiro akapezeka, ma ultrasound a chithokomiro ndi ma lymph node m'khosi amapangidwa. Chidziwitso chabwino cha singano chitha kuchitidwa kuti muwone ngati pali khansa. Kuyezetsa magazi kuti muwone kuchuluka kwa mahomoni a chithokomiro komanso ma anti-chithokomiro m'magazi amathanso kuchitidwa. Izi ndikuti muwone mitundu ina yamatenda amtundu wa chithokomiro.

Mitundu ya chithokomiro nthawi zambiri siyimayambitsa matenda kapena imafunikira chithandizo. Nthawi zina timinofu tam'mimba timakulira mokwanira mpaka kumavuta kumeza kapena kupuma ndipo pamafunika mayeso ndi chithandizo chambiri. Mmodzi yekha mwa mitsempha isanu ya chithokomiro amakhala khansa.

Kuwonetsedwa ndi radiation kapena kukhala ndi ma syndromes amtundu wina kumatha kukhudza chiopsezo cha khansa ya chithokomiro.

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 mwana wanu akhoza kukhala pachiwopsezo.

Zowopsa za khansa ya chithokomiro chaubwana ndi izi:

• Kuwonetsedwa ndi radiation, monga kuyesedwa kwa matenda, chithandizo cha radiation, kapena radiation m'deralo.

• Kukhala ndi ma syndromes ena, monga awa:

• Matenda angapo a endocrine neoplasia mtundu wa 2A (MEN2A).

• Matenda angapo a endocrine neoplasia mtundu wa 2B (MEN2B).

• Kukhala ndi mbiri ya banja ya khansa ya chithokomiro, kuphatikiza izi:

• Polcosis yokhudzana ndi APC.

• Matenda a DICER1.

• Zovuta za Carney.

• Matenda a PTEN hamartoma chotupa.

• Matenda a Werner.

Khansa ya chithokomiro ya medullary nthawi zina imayambitsidwa ndi kusintha kwa jini lomwe limadutsa kuchokera kwa kholo kupita kwa mwana.

Majini omwe ali m'maselo amanyamula choloŵa kuchokera kwa kholo kupita kwa mwana. Kusintha kwina mu mtundu wa RET womwe umadutsa kuchokera kwa kholo kupita kwa mwana (wobadwa nawo) kumatha kuyambitsa khansa yamatenda a medullary.

Pali mayeso obadwa nawo omwe amagwiritsidwa ntchito poyang'ana mtundu wosinthika. Wodwala amayesedwa kaye kuti aone ngati ali ndi jini losintha. Ngati wodwalayo ali nawo, abale ena amathanso kuyesedwa kuti adziwe ngati ali ndi chiopsezo chowonjezeka cha khansa ya chithokomiro. Achibale, kuphatikiza ana ang'onoang'ono, omwe asintha jini atha kukhala ndi thyroidectomy (opareshoni yochotsa chithokomiro). Izi zitha kuchepetsa mwayi wokhala ndi khansa yamatenda a medullary.

Zizindikiro za khansa ya chithokomiro zimaphatikizapo kutupa kapena chotupa pakhosi.

Nthawi zina zotupa za chithokomiro sizimayambitsa zizindikilo. Zizindikiro ndi zizindikilozi zimatha kubwera chifukwa cha khansa yapachilombo ya papillary kapena follicular kapena zina.

Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Chotupa pakhosi.

• Kuvuta kupuma.

• Vuto kumeza.

• Kuuma kapena kusintha mawu.

Zizindikiro ndi zizindikilozi zimatha kubwera chifukwa cha khansa ya chithokomiro kapena matenda ena.

Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Ziphuphu pamilomo, lilime, kapena zikope zomwe sizipweteka.

• Kuvuta kupanga misozi.

• Kudzimbidwa.

• Matenda a Marfan (kukhala wamtali komanso wowonda, wokhala ndi mikono, miyendo, zala, ndi zala zazitali).

Kuyesa komwe kumafufuza chithokomiro, khosi, ndi magazi amagwiritsidwa ntchito pozindikira ndikupanga khansa ya chithokomiro.

Kuyesedwa kumachitika kuti mupeze khansa komanso siteji. Khansa itapezeka, amayesedwa kwambiri kuti apeze ngati maselo a khansa afalikira kumadera oyandikira kapena mbali zina za thupi. Izi zimatchedwa staging. Kuyesedwa komwe kwachitika kuti apeze ngati maselo a khansa afalikira asanatuluke chotupacho ndi opaleshoni kumatchedwa preoperative staging. Ndikofunika kudziwa ngati khansara yafalikira kuti mukonzekere mankhwala abwino.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuyezetsa thupi komanso mbiri yaumoyo: Kuyesedwa kwa thupi kuti muwone zizindikilo zaumoyo, kuphatikiza kuwunika kwa matenda, monga zotupa (zotupa) kapena kutupa pakhosi, mawu amawu, ndi ma lymph node, ndi china chilichonse chomwe chimawoneka chachilendo. . Mbiri yokhudzana ndi thanzi la wodwalayo komanso matenda am'mbuyomu komanso chithandizo chamankhwala adzachitidwanso.

• Kuyesa kwa chithokomiro: Magazi amafufuzidwa ngati ali ndi mahomoni osokoneza bongo (TSH). TSH imapangidwa ndi vuto la pituitary muubongo. Zimathandizira kutulutsa mahomoni a chithokomiro ndikuwongolera momwe maselo amtundu wa chithokomiro amakulira. Mwazi amathanso kufufuzidwa ngati mulingo wambiri wa calcitonin (mahomoni opangidwa ndi chithokomiro omwe amachepetsa calcium pamwazi).

• Kuyesa kwa Thyroglobulin: Magazi amafufuzidwa kuti aone kuchuluka kwa thyroglobulin, puloteni yopangidwa ndi chithokomiro. Maseŵera a Thyroglobulin ndi otsika kapena kulibe matenda a chithokomiro koma amatha kukhala ndi khansa ya chithokomiro kapena zina.

• RET gene test: Kuyesa kwa labotale komwe kuyesa magazi kapena minofu kumayesedwa kuti isinthe mumtundu wa RET. Kuyesaku kumachitika kwa ana omwe atha kukhala ndi khansa yamatenda a medullary.

• Kuyesa kwa Ultrasound: Njira yomwe mafunde amawu amphamvu (ultrasound) amachotsedwa pamatumba kapena ziwalo zamkati m'khosi ndikupanga ma echo. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Chithunzicho chimatha kusindikizidwa kuti chiwonedwe pambuyo pake. Njirayi imatha kuwonetsa kukula kwa chotupa cha chithokomiro komanso ngati chili cholimba kapena chotupa chodzaza madzi. Ultrasound ingagwiritsidwe ntchito kutsogolera zabwino-singano aspiration biopsy. Kuyezetsa kwathunthu kwa khosi kumachitika musanachite opaleshoni.

• Chithokomiro jambulani: A pang'ono chinthu nyukiliya ndi kuwameza kapena jekeseni. Zinthu zowononga nyukiliya zimasonkhanitsa m'maselo a chithokomiro. Kamera yapadera yolumikizidwa ndi kompyuta imazindikira ma radiation omwe apatsidwa ndikupanga zithunzi zosonyeza momwe chithokomiro chikuwonekera komanso momwe chimagwirira ntchito komanso ngati khansayo yafalikira kupitirira chithokomiro. Ngati kuchuluka kwa TSH m'magazi a mwana ndikotsika, kusanthula kuti apange zithunzi za chithokomiro asanachitike opaleshoni.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga khosi, chifuwa, mimba, ndi ubongo, 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.

Kujambula kwa tomography (CT) pamutu ndi khosi. Mwanayo wagona patebulo lomwe limadutsa pa CT scanner, lomwe limatenga zithunzi za x-ray zamkati mwa mutu ndi khosi.

• MRI (magnetic resonance imaging) yokhala ndi gadolinium: Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, komanso kompyuta kuti ipange zithunzi zingapo za malo amkati mwa thupi, monga khosi ndi chifuwa. Chinthu chotchedwa gadolinium chimalowetsedwa mumtsempha. Gadolinium imasonkhanitsa mozungulira maselo a khansa kuti athe kuwonekera pachithunzichi. 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.

• Chida chabwino cha singano: Kuchotsa minofu ya chithokomiro pogwiritsa ntchito singano yopyapyala. Singano imayikidwa kudzera pakhungu kupita mu chithokomiro. Zitsanzo zingapo za minofu zimachotsedwa m'malo osiyanasiyana a chithokomiro. Katswiri wazamankhwala amawonera zitsanzo za minofu pansi pa microscope kuti ayang'ane maselo a khansa. Chifukwa mtundu wa khansa ya chithokomiro imatha kukhala yovuta kupeza, odwala ayenera kufunsa kuti awonetsetse kuti adziwe ngati ali ndi khansa ya chithokomiro. Ngati sizikudziwika ngati khansara ilipo, kuyezetsa magazi kumatha kuchitidwa.

• Biopsy ya opaleshoni: Kuchotsa chithokomiro chotupa kapena lobe imodzi ya chithokomiro panthawi yochita opaleshoni kuti maselo ndi ziphuphu zitha kuwonedwa pansi pa microscope ndi wodwala kuti aone ngati ali ndi khansa. Chifukwa mtundu wa khansa ya chithokomiro imatha kukhala yovuta kupeza, odwala ayenera kufunsa kuti awonetsetse kuti adziwe ngati ali ndi khansa ya chithokomiro.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira).

Kulosera kumatengera izi:

• Zaka za mwana panthawi yodziwitsa.

• Mtundu wa khansa ya chithokomiro.

• Kukula kwa khansa.

• Kaya chotupacho chafalikira kumatenda am'mimba kapena mbali zina za thupi panthawi yodziwitsa.

• Kaya khansayo idachotsedwa kwathunthu ndi opareshoni.

• Thanzi labwino la mwanayo.

Magawo a Khansa ya Chithokomiro ya Ana

MFUNDO ZOFUNIKA

• Khansayo itachotsedwa ndi opareshoni, amayesedwa kuti apeze ngati maselo a khansa amakhalabe mthupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

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

• Nthawi zina khansara wa chithokomiro amapitilira kukula kapena kubwerera pambuyo poti amuthandize.

Kuyezetsa kumachitika pambuyo pochitidwa opaleshoni kuti mupeze ngati ma cell a khansa atsalira ndikudziwa ngati pakufunika chithandizo china. Izi zimatchedwa sitepe ya postoperative.

Mayesero ndi njira zotsatirazi zitha kuchitika patatha milungu 12 mutachitidwa opaleshoni:

• Kuyesa kwa Ultrasound: Njira yomwe mafunde amawu amphamvu (ultrasound) amachotsedwa pamatumba kapena ziwalo zamkati m'khosi ndikupanga ma echo. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Chithunzicho chimatha kusindikizidwa kuti chiwonedwe pambuyo pake. Njirayi imatha kuwonetsa kukula kwa chotupa cha chithokomiro komanso ngati chili cholimba kapena chotupa chodzaza madzi. Ultrasound ingagwiritsidwe ntchito kutsogolera zabwino-singano aspiration biopsy. Kuyezetsa kwathunthu kwa khosi kumachitika musanachite opaleshoni.

• Kuyesa kwa Thyroglobulin: Chiyeso chomwe chimayeza kuchuluka kwa thyroglobulin m'magazi. Thyroglobulin ndi mapuloteni opangidwa ndi chithokomiro. Maseŵera a Thyroglobulin ndi otsika kapena kulibe matenda a chithokomiro koma amatha kukhala ndi khansa ya chithokomiro kapena zina.

• Kujambula chithokomiro cha thupi lonse: Kanthu kakang'ono ka radioactive kumamezedwa kapena kubayidwa. Zinthu zowononga nyukiliya zimasonkhanitsa minofu iliyonse ya chithokomiro kapena maselo a khansa omwe atsalira pambuyo pochitidwa opaleshoni. Ayodini wama radioactive amagwiritsidwa ntchito chifukwa ndimaselo a chithokomiro okha omwe amatenga ayodini. Kamera yapadera imazindikira cheza choperekedwa ndi khungu la chithokomiro kapena maselo a khansa, omwe amatchedwanso kuti radioactive iodine scan kapena RAI scan.

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 ya chithokomiro imafalikira m'mapapu, maselo am'mapapo m'mapapo mwake ndimaselo a khansa ya chithokomiro. Matendawa ndi khansa ya chithokomiro, osati khansa ya m'mapapo.

Nthawi zina khansara wa chithokomiro amapitilira kukula kapena kubwerera pambuyo poti amuthandize.

Khansara yopita patsogolo ya chithokomiro ndi khansa yomwe imapitilira kukula, kufalikira, kapena kukulira. Matenda opita patsogolo atha kukhala chizindikiro kuti khansara yasintha.

Khansa yamatenda yabwinobwino ndi khansa yomwe yabwereranso (kubwerera) mutalandira chithandizo. Khansayo ikhoza kubwerera ku chithokomiro kapena mbali zina za thupi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya chithokomiro.

• Ana omwe ali ndi khansa ya chithokomiro ayenera kukonzekera kukonzekera ndi gulu la madokotala omwe ndi akatswiri othandiza khansa ya ana.

• Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

• Opaleshoni

• Mankhwala othandizira ayodini

• Chithandizo chofuna

• Thandizo m'malo mwa mahomoni

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo cha khansa ya chithokomiro chaubwana chingayambitse zovuta.

• Odwala angaganize zopita nawo kukayezetsa.

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

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya chithokomiro.

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.

Chifukwa khansa mwa ana ndiyosowa, kutenga nawo mbali pakuyesa kwachipatala kuyenera kuganiziridwa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Ana omwe ali ndi khansa ya chithokomiro ayenera kukonzekera kukonzekera ndi gulu la madokotala omwe ndi akatswiri othandiza khansa ya ana.

Chithandizo chidzayang'aniridwa ndi oncologist wa ana, dokotala yemwe amadziwika bwino pochiza ana omwe ali ndi khansa. Katswiri wa oncologist amagwira ana ndi akatswiri ena azaumoyo a ana omwe ndi akatswiri pochiza ana omwe ali ndi khansa komanso omwe amadziwika bwino pamankhwala ena. Izi zingaphatikizepo akatswiri awa ndi ena:

• Dokotala wa ana.

• Dokotala wa ana.

• Wofufuza oncologist.

• Wodwala.

• Katswiri wa namwino wa ana.

• Wogwira ntchito.

• Katswiri wokonzanso.

• Katswiri wa zamaganizo.

• Katswiri wa moyo wa ana.

Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

Opaleshoni

Opaleshoni ndi njira yodziwika bwino yothandizira khansa ya chithokomiro. Imodzi mwa njira izi itha kugwiritsidwa ntchito:

• Matenda onse a thyroidectomy: Kuchotsa chithokomiro chonse. Matenda am'mimba pafupi ndi khansa amathanso kuchotsedwa ndikuyang'aniridwa ndi microscope ngati ali ndi khansa.

• Pafupifupi kuchuluka kwa thyroidectomy: Kuchotsa zonse koma gawo laling'ono kwambiri la chithokomiro. Matenda am'mimba pafupi ndi khansa amathanso kuchotsedwa ndikuyang'aniridwa ndi microscope ngati ali ndi khansa.

Kwa ana, thyroidectomy yathunthu imachitika.

Mankhwala othandizira ayodini

Khansa ya chithokomiro yotsatira komanso papillary nthawi zina imachiritsidwa ndi mankhwala a radioactive ayodini (RAI). Chithandizo cha RAI chingaperekedwe kwa ana atachitidwa opaleshoni kuti aphe maselo aliwonse a khansa ya chithokomiro omwe sanachotsedwe kapena ana omwe chotupa chawo sichingachotsedwe ndi opaleshoni. RAI imatengedwa pakamwa ndikusonkhanitsa minofu iliyonse yotsala ya chithokomiro, kuphatikiza maselo a khansa ya chithokomiro omwe afalikira m'malo ena m'thupi. Chifukwa ndi minofu ya chithokomiro yokha yomwe imatenga ayodini, RAI imawononga minofu ya chithokomiro ndi khansa ya chithokomiro popanda kuvulaza minofu ina. Asanapatsidwe mankhwala okwanira a RAI, amapatsidwa kayezedwe kochepa kuti aone ngati chotupacho chimatenga ayodini.

Chithandizo chofuna

Chithandizo chomwe mukufuna ndi mtundu wamankhwala omwe amagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuwukira maselo ena a khansa. Njira zochiritsira zomwe zimayang'aniridwa sizimavulaza maselo wamba kuposa chemotherapy kapena radiation.

Tyrosine kinase inhibitor therapy (TKI) ndi mtundu wa mankhwala omwe amalimbana ndi zotupa kuti zikule. Larotrectinib ndi TKI yomwe imagwiritsidwa ntchito pochiza ana omwe ali ndi khansa ya chithokomiro yomwe ikupita patsogolo kapena mobwerezabwereza. Vandetanib ndi TKI yomwe imagwiritsidwa ntchito pochiza ana omwe ali ndi khansa ya chithokomiro ya medullary. Selpercatinib ndi TKI yomwe imagwiritsidwa ntchito pochiza ana omwe ali ndi khansa ya chithokomiro chapamwamba kapena metastatic.

Chithandizo chofunikira chikuwerengedwa pochizira khansa ya chithokomiro yaubwana yomwe yabwereranso (kubwerera).

Thandizo m'malo mwa mahomoni

Mahomoni ndi zinthu zopangidwa ndi tiziwalo timene timatuluka m'thupi ndipo timafalikira m'magazi. Atalandira chithandizo cha khansa ya chithokomiro, chithokomiro sichimatha kupanga mahomoni okwanira. Odwala amapatsidwa mapiritsi a chithokomiro m'malo mwa moyo wawo wonse.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chithandizo cha khansa ya chithokomiro chaubwana chingayambitse zovuta.

Kuti mumve zambiri zamankhwala oyambilira omwe amayamba mukalandira chithandizo cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

Zotsatira zoyipa za mankhwala a khansa omwe amayamba atalandira chithandizo ndikupitilira kwa miyezi kapena zaka amatchedwa zotsatira zakuchedwa. Zotsatira zakumwa kwa khansa ya khansa ya chithokomiro yaubwana imatha kuphatikizira izi:

• Mavuto athupi, monga kusintha kwamatenda amate, matenda, kapena kupuma movutikira.

• Kusintha kwa malingaliro, malingaliro, kuganiza, kuphunzira, kapena kukumbukira.

• Khansa yachiwiri (mitundu yatsopano ya khansa).

Zotsatira zina mochedwa zimatha kuthandizidwa kapena kuwongoleredwa. Ndikofunika kulankhula ndi madotolo a mwana wanu zamankhwala omwe khansa imatha kukhala nawo pamwana wanu. (Onani chidule cha pa Zotsatira Zotsiriza za Chithandizo cha Khansa ya Ana kuti mumve zambiri.)

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.

Zimakhala zachilendo kuti khansara ya chithokomiro ibwererenso (kubwerera), makamaka kwa ana ochepera zaka 10 komanso omwe ali ndi khansa muma lymph node. Ultrasound, kusanthula thupi lonse, ndi mayeso a thyroglobulin amatha kuchitidwa nthawi ndi nthawi kuti aone ngati khansa yabwereranso. Kutsata kwa moyo wonse kwamahomoni a chithokomiro m'magazi ndikofunikira kuti muwonetsetse kuchuluka kwa mankhwala obwezeretsa mahomoni (HRT) akuperekedwa. Lankhulani ndi dokotala wa mwana wanu kuti mudziwe kuti mayeserowa ayenera kuchitidwa kangati.

Kuchiza kwa Khansa Yaubwana Papillary ndi Follicular Khansa ya Chithokomiro

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

Chithandizo cha papillary ndi follicular chithokomiro cha carcinoma mwa ana chingaphatikizepo izi:

• Kuchita opaleshoni kuti muchotse chithokomiro chonse kapena nthawi zambiri ndipo nthawi zina ma lymph node pafupi ndi chithokomiro. Mankhwala othandizira ayodini amatha kuperekedwanso ngati maselo a khansa ya chithokomiro atsalira pambuyo pochitidwa opaleshoni. Hormone replacement therapy (HRT) imaperekedwa kuti ipangire mahomoni otayika a chithokomiro.

Pakadatha milungu 12 kuchitidwa opareshoni, amayesa kuti adziwe ngati khansa ya chithokomiro imatsalira mthupi. Izi zingaphatikizepo kuyesa kwa thyroglobulin ndikuwunika chithokomiro cha thupi lonse. Kuyeza kwa chithokomiro cha thupi lonse kumachitika kuti mupeze madera omwe matupi a khansa ya chithokomiro omwe sanachotsedwe pakuchita opaleshoni atha kugawanika mwachangu. Ayodini wama radioactive amagwiritsidwa ntchito chifukwa ndimaselo a chithokomiro okha omwe amatenga ayodini. Ochepa kwambiri ayodini woyamwa amameza, kuyenda m'magazi, ndikusonkhanitsa m'minyewa ya chithokomiro ndi khansa ya chithokomiro kulikonse m'thupi. Ngati khansara ya chithokomiro ikadalipo, mlingo waukulu wa ayodini wa radioactive amapatsidwa kuti awononge maselo ena aliwonse a khansa ya chithokomiro. Kujambula thupi lonse SPECT (single photon emission computed tomography) kumatha kuchitidwa masiku 4 mpaka 7 mutalandira chithandizo chamankhwala kuti muwone ngati maselo onse a khansa awonongedwa.

• Mankhwala othandizira ayodini okha angaperekedwe kwa ana omwe chotupa chawo sichingachotsedwe ndi opaleshoni. Hormone replacement therapy (HRT) imaperekedwa kuti ipangire mahomoni otayika a chithokomiro.

Onani chidule cha pa Childhood Multiple Endocrine Neoplasia (MEN) Syndromes Treatment kuti mumve zambiri.

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.

Chithandizo cha Khansa ya Chithokomiro ya Mwana Wambiri

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

Chithandizo cha medullary chithokomiro carcinoma mwa ana chingaphatikizepo izi:

• Opaleshoni kuchotsa khansara.

• Chithandizo choyenera cha tyrosine kinase inhibitor (vandetanib kapena selpercatinib) cha khansa yomwe yapita patsogolo kapena yafalikira mbali zina za thupi.

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

Kuchiza kwa Khansa ya Chithokomiro Yopita Patsogolo Kapena Yobwerezabwereza

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

Chithandizo cha chithokomiro chopitilira patsogolo kapena chobwerezabwereza cha ana chitha kukhala ndi izi:

• Thandizo la radioactive iodine (RAI).

• Chithandizo choyenera ndi tyrosine kinase inhibitor (larotrectinib kapena selpercatinib).

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

• Kuyesedwa kwachipatala kwa tyrosine kinase inhibitor therapy (vemurafenib kapena selpercatinib).

Chithandizo cha chithokomiro cha ana chotsogola kapena chobwerezabwereza mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

• Kuyesedwa kwachipatala kwa tyrosine kinase inhibitor therapy (selpercatinib).

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

Kuti mudziwe zambiri za khansa ya chithokomiro

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

• Tsamba Loyambira Khansa Yamtundu

• Njira Zochizira Khansa

• Kuyesedwa Kwachibadwa kwa Ma Syndromes Obadwa Ndi Khansa

• MyPART - Chotupa Changa Chotengera Ana ndi Achikulire

• Computed Tomography (CT) Zithunzi ndi Khansa

Kuti mumve zambiri za khansa yaubwana ndi zina zothandiza za khansa, onani izi:

• Za Khansa

• Khansa Za Ana

• Cure Search for Cancer ya Ana Tulukani Chodzikanira

• Zotsatira Zochedwetsa Khansa Yaana

• Achinyamata ndi Achinyamata Achikulire ndi Khansa

• Ana omwe ali ndi khansa: Upangiri wa Makolo

• Khansa mwa Ana ndi Achinyamata

• Kusinthana

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira

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