Mitundu / chithokomiro / wodwala / chithandizo cha chithokomiro-pdq
Chithandizo cha Khansa ya Chithokomiro (Wamkulu) (®) -Patient Version
Zambiri Zokhudza Khansa ya Chithokomiro
MFUNDO ZOFUNIKA
- Khansara ya chithokomiro ndimatenda momwe maselo owopsa (khansa) amapangika m'matumba a chithokomiro.
- Mitundu ya chithokomiro ndi yofala koma nthawi zambiri si khansa.
- Pali mitundu yosiyanasiyana ya khansa ya chithokomiro.
- Zaka, jenda, komanso kuwonetsedwa ndi radiation kungayambitse 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 kuti apeze (kupeza) ndikupeza khansa ya chithokomiro.
- Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.
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, kamatumba kakang'ono kwambiri, kamalumikiza ma lobes awiriwo. Chithokomiro chopatsa thanzi chimakula pang'ono kuposa kotala. Nthawi zambiri sizimveka kudzera pakhungu.
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 ndi yofala koma nthawi zambiri si khansa.
Dokotala wanu amatha kupeza chotupa mu chithokomiro chanu panthawi yoyezetsa magazi. 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 kachipangizo koyesera singano nthawi zambiri amachitidwa kuti aone ngati ali ndi khansa. Kuyezetsa magazi kuti muwone kuchuluka kwa mahomoni a chithokomiro komanso ma antibodies a antithyroid m'magazi amathanso kuchitidwa kuti muwone mitundu ina ya matenda a 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. Ndi ma bale ochepa okha omwe amapezeka ndi khansa.
Pali mitundu yosiyanasiyana ya khansa ya chithokomiro.
Khansara ya chithokomiro ingafotokozedwe ngati:
- Kusiyanitsa khansa ya chithokomiro, yomwe imaphatikizapo zotupa zosiyanitsidwa bwino, zotupa zosiyanitsidwa bwino, ndi zotupa zosasiyanitsidwa; kapena
- Khansa ya chithokomiro ya medullary.
Zotupa zomwe zimasiyanitsidwa bwino (khansa ya chithokomiro ya papillary ndi khansa ya chithokomiro) imatha kuchiritsidwa ndipo imatha kuchiritsidwa.
Zotupa zosiyanitsidwa bwino komanso zosasiyanitsidwa (kansa ya chithokomiro ya aplastic) sizodziwika kwenikweni. Zotupa zimakula ndikufalikira mwachangu ndikukhala ndi mwayi wosauka. Odwala omwe ali ndi khansa ya chithokomiro ya anaplastic amayenera kuyezetsa maselo kuti asinthe mtundu wa BRAF.
Khansa ya chithokomiro ya Medullary ndi chotupa cha neuroendocrine chomwe chimayamba m'maselo a C a chithokomiro. Maselo a C amapanga mahomoni (calcitonin) omwe amathandiza kukhala ndi calcium yokwanira m'magazi.
Onani chidule cha pa Chithandizo cha Khansa ya Chithokomiro cha Ana kuti mumve zambiri za khansa ya chithokomiro cha ana.
Zaka, jenda, komanso kuwonetsedwa ndi radiation kungayambitse 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 mutha kukhala pachiwopsezo.
Zowopsa za khansa ya chithokomiro ndi izi:
- Kukhala pakati pa 25 ndi 65 wazaka.
- Kukhala wamkazi.
- Kuwonetsedwa ndi radiation kumutu ndi khosi ngati khanda kapena mwana kapena kuwonetsedwa pama radioactive fallout. Khansara imatha kuchitika atangotha zaka 5 atawonekera.
- Kukhala ndi mbiri ya goiter (chithokomiro chokulitsa).
- Kukhala ndi mbiri yabanja yamatenda a chithokomiro kapena khansa ya chithokomiro.
- Kukhala ndi mitundu ina ya chibadwa monga khansa ya medullary chithokomiro (FMTC), ma endocrine neoplasia mtundu wa 2A syndrome (MEN2A), kapena ma endocrine neoplasia type 2B syndrome (MEN2B).
- Kukhala waku Asia.
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 pachiwopsezo chachikulu 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.
Khansa ya chithokomiro siyimatha kuyambitsa zizindikilo zoyambirira. Nthawi zina zimapezeka mukamayesedwa. Zizindikiro zimatha kupezeka kuti chotupacho chimakula. Zinthu zina zimatha kuyambitsa zizindikilo zomwezo. Funsani dokotala ngati muli ndi izi:
- Khosi (nodule) m'khosi.
- Kuvuta kupuma.
- Vuto kumeza.
- Ululu mukameza.
- Kuopsa.
Kuyesa komwe kumafufuza chithokomiro, khosi, ndi magazi amagwiritsidwa ntchito kuti apeze (kupeza) ndikupeza khansa ya chithokomiro.
Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:
- Kuunika kwakuthupi ndi mbiri: Kuyesedwa kwa thupi kuti muwone zizindikiritso 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.
- Laryngoscopy: Njira yomwe dokotala amafufuzira kholingo (mawu amawu) ndi galasi kapena laryngoscope. Laryngoscope ndi chida chochepa, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Chotupa cha chithokomiro chimatha kupanikiza zingwe zamawu. Laryngoscopy yachitika kuti muwone ngati zingwe zamawu zikuyenda bwino.
- Maphunziro a mahomoni amwazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa mahomoni ena omwe amatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zapamwamba kapena zotsika kuposa zachilendo) zitha kukhala chizindikiro cha matenda m'chiwalo kapena minofu yomwe imapangitsa. Magazi amatha kufufuzidwa ngati mulibe timadzi tomwe timayambitsa matenda a chithokomiro (TSH). TSH imapangidwa ndi vuto la pituitary muubongo. Zimathandizira kutulutsa mahomoni a chithokomiro ndikuwongolera momwe maselo amtundu wa chithokomiro amakulira. Magazi amathanso kufufuzidwa ngati mulingo wambiri wa mahomoni a calcitonin ndi ma antithyroid antibodies.
- Kafukufuku wamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina, monga calcium, yotulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zakumwamba kapena zochepa) kungakhale chizindikiro cha matenda.
- 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.
- CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga khosi, 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.
- Chida chabwino cha singano chithokomiro: 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.
- 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) ndi njira zamankhwala.
Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:
- Zaka za wodwalayo panthawi yodziwitsa.
- Mtundu wa khansa ya chithokomiro.
- Gawo la khansa.
- Kaya khansayo idachotsedwa kwathunthu ndi opareshoni.
- Kaya wodwalayo ali ndi endocrine neoplasia mtundu wa 2B (MEN 2B).
- Thanzi labwino la wodwalayo.
- Kaya khansa yapezeka kumene kapena yabwereranso (bwererani).
Magawo a Khansa ya Chithokomiro
MFUNDO ZOFUNIKA
- Khansa ya chithokomiro itapezeka, amayesedwa kuti adziwe ngati maselo a khansa afalikira mkati mwa chithokomiro kapena mbali zina za thupi.
- Pali njira zitatu zomwe khansa imafalikira mthupi.
- Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.
- Magawo amagwiritsidwa ntchito kufotokoza khansa ya chithokomiro kutengera mtundu wa khansa ya chithokomiro komanso zaka za wodwalayo:
- Khansa ya chithokomiro ya papillary ndi follicular ya odwala ochepera zaka 55
- Khansa ya chithokomiro cha papillary ndi follicular mwa odwala azaka 55 kapena kupitilira apo
- Khansa ya chithokomiro ya Anaplastic kwa odwala azaka zonse
- Khansa ya chithokomiro ya Medullary mwa odwala azaka zonse
Khansa ya chithokomiro itapezeka, amayesedwa kuti adziwe ngati maselo a khansa afalikira mkati mwa chithokomiro kapena mbali zina za thupi.
Njira yomwe amagwiritsidwa ntchito pofufuza ngati khansara yafalikira mkati mwa chithokomiro kapena mbali zina za thupi amatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa zaka za wodwalayo komanso gawo la khansa kuti akonzekere chithandizo.
Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito pokonza:
- CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga 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.
- Kuyesa kwa Ultrasound: Njira yomwe mafunde amawu amphamvu (ultrasound) amachotsedwa pamatumba kapena ziwalo zamkati ndikupanga mawonekedwe. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Chithunzicho chimatha kusindikizidwa kuti chiwonedwe pambuyo pake.
- 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.
- Kujambula mafupa: Njira yowunika ngati pali magawo omwe amagawa mwachangu, monga maselo a khansa, m'mafupa. Katundu wocheperako kwambiri wa jakisoni amalowetsedwa mumtsempha ndikuyenda m'magazi. Zinthu zowononga nyukiliya zimasonkhanitsa m'mafupa omwe ali ndi khansa ndipo imadziwika ndi sikani.
- Sentinel lymph node biopsy: Kuchotsa kwa sentinel lymph node panthawi yochita opareshoni. Sentinel lymph node ndiye njira yoyamba yam'magulu am'magazi kuti alandire madzi m'mimba kuchokera pachotupa choyambirira. Ndi lymph node yoyamba yomwe khansa imafalikira kuchokera ku chotupa choyambirira. Mankhwala a radioactive ndi / kapena utoto wabuluu amabayidwa pafupi ndi chotupacho. Katunduyu kapena utoto umadutsa m'mitsempha yam'mimba kupita kumalo am'mimba. Nthenda yoyamba yolandila mankhwala kapena utoto imachotsedwa. Wodwala amayang'ana minofu pansi pa microscope kuti ayang'ane maselo a khansa. Ngati maselo a khansa sapezeka, mwina sikofunikira kuchotsa ma lymph node ambiri.
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.
Magawo amagwiritsidwa ntchito kufotokoza khansa ya chithokomiro kutengera mtundu wa khansa ya chithokomiro komanso zaka za wodwalayo:
Khansa ya chithokomiro ya papillary ndi follicular ya odwala ochepera zaka 55
- Gawo I: Pa khansa yoyamba ya khansa ya papillary ndi follicular, chotupacho chimakhala chachikulu ndipo chitha kufalikira kumatenda ndi ma lymph node. Khansa siinafalikire mbali zina za thupi.
- Gawo lachiwiri: Mu khansa yachiwiri ya khansa ya khansa ya khansa, chotupacho ndi kukula kwake ndipo khansa ikhoza kufalikira kumatenda oyandikira ndi ma lymph node. Khansara yafalikira kuchokera ku chithokomiro kupita kumadera ena a thupi, monga mapapo kapena mafupa.
Khansa ya chithokomiro cha papillary ndi follicular mwa odwala azaka 55 kapena kupitilira apo
- Gawo I: Pa khansa yoyamba ya khansa ya papillary ndi follicular, khansa imapezeka mu chithokomiro chokha ndipo chotupacho chili 4 sentimita kapena ocheperako.
- Gawo II: Pa khansa yachiwiri ya khansa ya khansa ya papillary ndi follicular, chimodzi mwa izi ndi izi:
- khansa imapezeka mu chithokomiro ndipo chotupacho chili ndi masentimita 4 kapena ocheperako; khansa yafalikira ku ma lymph node apafupi; kapena
- khansa imapezeka mu chithokomiro, chotupacho chimakhala chachikulu kuposa masentimita 4, ndipo khansa ikhoza kufalikira kumatenda oyandikira; kapena
- chotupacho chimakhala chachikulu ndipo khansa yafalikira kuchokera ku chithokomiro kupita kuminyewa yapafupi m'khosi ndipo imafalikira kumatenda oyandikira.
- Gawo lachitatu: Gawo lachitatu la khansa ya chithokomiro ya papillary ndi follicular, chotupacho chimakhala chachikulu ndipo khansara yafalikira kuchokera ku chithokomiro kupita kuzinyalala zofewa pakhungu, kholingo, kholingo, kholingo, kapena mitsempha yokhazikika yamitsempha (mitsempha yomwe imapita ku kholingo). Khansa ikhoza kufalikira ku ma lymph node.
- Gawo IV: Khansara yapa chithokomiro ya papillary ndi follicular imagawidwa m'magawo a IVA ndi IVB.
- Pa gawo la IVA, chotupacho chimakhala chachikulu ndipo khansa yafalikira kumatenda kutsogolo kwa msana kapena yazungulira mtsempha wama carotid kapena mitsempha yamagazi mdera lamapapo. Khansa ikhoza kufalikira ku ma lymph node.
- Mu gawo la IVB, chotupacho ndi kukula kwake ndipo khansa yafalikira mbali zina za thupi, monga mapapo kapena mafupa. Khansa ikhoza kufalikira ku ma lymph node.
Khansa ya chithokomiro ya Anaplastic kwa odwala azaka zonse
Khansa ya chithokomiro ya Anaplastic imakula mwachangu ndipo nthawi zambiri imafalikira m'khosi mukapezeka. Khansa ya chithokomiro ya Anaplastic imawerengedwa kuti khansa ya chithokomiro ya gawo IV. Khansa ya khansa ya chithokomiro ya m'magazi IV imagawidwa m'magawo a IVA, IVB, ndi IVC.
- Pa gawo la IVA, khansa imapezeka mu chithokomiro chokha ndipo chotupacho chimatha kukula.
- Mu gawo la IVB, chimodzi mwazinthu izi chimapezeka:
- khansa imapezeka mu chithokomiro ndipo chotupacho chimatha kukula; khansa yafalikira ku ma lymph node apafupi; kapena
- chotupacho chimakhala chachikulu ndipo khansa yafalikira kuchokera ku chithokomiro kupita kuminyewa yapafupi m'khosi ndipo itha kufalikira kumatenda oyandikira; kapena
- chotupacho chimakhala chachikulu ndipo khansara yafalikira kuchokera ku chithokomiro kupita ku minofu yofewa pansi pa khungu, kummero, trachea, kholingo, mitsempha yokhazikika (khosi lomwe limapita kumphako), kapena minofu kutsogolo kwa msana, kapena wazungulira mtsempha wama carotid kapena mitsempha yamagazi mdera lamapapo; khansa ikhoza kufalikira ku ma lymph node.
- Pa gawo la IVC, chotupacho ndi kukula kwake ndipo khansa yafalikira mbali zina za thupi, monga mapapo kapena mafupa. Khansa ikhoza kufalikira ku ma lymph node.
Khansa ya chithokomiro ya Medullary mwa odwala azaka zonse
- Gawo I: Pakatikati pa medullary khansa ya chithokomiro, khansa imapezeka mu chithokomiro chokha ndipo chotupacho chili 2 sentimita kapena ocheperako.
- Gawo II: Mu gawo lachiwiri khansa ya chithokomiro ya medullary, chimodzi mwazinthu izi chimapezeka:
- khansa ili mu chithokomiro chokha ndipo chotupacho chimakhala chachikulu kuposa masentimita awiri; kapena
- chotupacho chimakhala chachikulu ndipo khansa yafalikira kuchokera ku chithokomiro kupita kuminyewa yapafupi m'khosi.
- Gawo lachitatu: Gawo lachitatu la khansa ya chithokomiro, chotupacho chimakhala chachikulu ndipo khansa imatha kufalikira kuchokera ku chithokomiro kupita kuminyewa yapafupi m'khosi. Khansa yafalikira kumatenda am'mimba mbali imodzi kapena mbali zonse ziwiri za trachea kapena larynx.
- Gawo IV: Khansa yamatenda a chithokomiro ya Gawo IV imagawidwa m'magawo a IVA, IVB, ndi IVC.
- Mu gawo la IVA, chimodzi mwazinthu izi chimapezeka:
- chotupacho chimakhala chachikulu ndipo khansara yafalikira kuchokera ku chithokomiro kupita kuminyewa yofewa pansi pa khungu, kummero, trachea, kholingo, kapena mitsempha yabwinobwino ya kholingo (mitsempha yomwe imapita kumphako); khansa ikhoza kufalikira kumatenda am'mimba mbali imodzi kapena mbali zonse ziwiri za khosi; kapena
- chotupacho chimakhala chachikulu ndipo khansa ikhoza kufalikira kuchokera ku chithokomiro kupita kufupi ndi khosi; khansara yafalikira ku ma lymph node mbali imodzi kapena mbali zonse ziwiri za khosi.
- Pa gawo IVB, chotupacho ndi kukula kwake ndipo khansa yafalikira kumatenda kutsogolo kwa msana kapena msana kapena yazungulira mtsempha wama carotid kapena mitsempha yamagazi mdera lamapapo. Khansa ikhoza kufalikira ku ma lymph node.
- Pa gawo la IVC, chotupacho ndi kukula kwake ndipo khansa yafalikira mbali zina za thupi, monga mapapo kapena chiwindi. Khansa ikhoza kufalikira ku ma lymph node.
Khansa Yamtundu wa Kachilombo Yobwereza
Khansa yamatenda yabwinobwino ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Khansara ya chithokomiro imatha kubwerera ku chithokomiro kapena mbali zina za thupi.
Chithandizo Chosankha Mwachidule
MFUNDO ZOFUNIKA
- Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya chithokomiro.
- Mitundu isanu ndi umodzi yamankhwalawa amagwiritsidwa ntchito:
- Opaleshoni
- Thandizo la radiation, kuphatikiza mankhwala a ayodini okhudzana ndi radioactive
- Chemotherapy
- Chithandizo cha mahomoni a chithokomiro
- Chithandizo chofuna
- Kudikira kudikira
- Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.
- Chitetezo chamatenda
- Chithandizo cha khansa ya chithokomiro chingayambitse mavuto.
- 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.
Pali mitundu yosiyanasiyana ya mankhwala kwa 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. Odwala angaganize zopita nawo kukayezetsa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.
Mitundu isanu ndi umodzi yamankhwalawa amagwiritsidwa ntchito:
Opaleshoni
Opaleshoni ndi njira yodziwika bwino yothandizira khansa ya chithokomiro. Imodzi mwa njira izi itha kugwiritsidwa ntchito:
- Lobectomy: Kuchotsa lobe komwe kumapezeka khansa ya chithokomiro. 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.
- Matenda onse a thyroidectomy: Kuchotsa chithokomiro chonse. Matenda am'mimba pafupi ndi khansa amathanso kuchotsedwa ndikuyang'aniridwa ndi microscope ngati ali ndi khansa.
- Tracheostomy: Opaleshoni kuti apange chitseko (stoma) mu phewa kuti zikuthandizeni kupuma. Kutsegula komweko kumatchedwanso tracheostomy.
Thandizo la radiation, kuphatikiza mankhwala a ayodini okhudzana ndi radioactive
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. Nthawi zina radiation imalunjika pachotupa nthawi ya opaleshoni. Izi zimatchedwa chithandizo cha radiation cha intraoperative.
- Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.
Thandizo la radiation lingaperekedwe pambuyo pa opareshoni kuti aphe maselo aliwonse a khansa ya chithokomiro omwe sanachotsedwe. Khansa ya chithokomiro yotsatira komanso papillary nthawi zina imachiritsidwa ndi mankhwala a radioactive ayodini (RAI). RAI imatengedwa pakamwa ndikusonkhanitsa minofu iliyonse yotsala ya chithokomiro, kuphatikiza maselo a khansa ya chithokomiro omwe afalikira m'malo ena m'thupi. Popeza ndi minofu ya chithokomiro yokha yomwe imatenga ayodini, RAI imawononga minofu ya chithokomiro ndi maselo a khansa ya chithokomiro popanda kuvulaza minofu ina. Asanapatsidwe mankhwala okwanira a RAI, amapatsidwa kayezedwe kochepa kuti awone ngati chotupacho chimatenga ayodini.
Momwe mankhwala a radiation amaperekedwera zimadalira mtundu ndi gawo la khansa yomwe ikuthandizidwa. Thandizo la radiation la kunja ndi mankhwala a radioactive ayodini (RAI) amagwiritsidwa ntchito pochiza khansa ya chithokomiro.
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).
Momwe chemotherapy imaperekedwa imadalira mtundu ndi gawo la khansa yomwe ikuchitidwa.
Onani Mankhwala Ovomerezeka a Chithokomiro Khansa kuti mumve zambiri.
Chithandizo cha mahomoni a chithokomiro
Thandizo la mahomoni ndi mankhwala a khansa omwe amachotsa mahomoni kapena amalepheretsa zochita zawo ndikuletsa maselo a khansa kuti asakule. Mahomoni ndi zinthu zopangidwa ndi tiziwalo timene timatuluka m'thupi ndipo timafalikira m'magazi. Pochiza khansa ya chithokomiro, mankhwala amatha kuperekedwa kuti ateteze thupi kupanga mahomoni otulutsa chithokomiro (TSH), mahomoni omwe angapangitse mwayi woti khansa ya chithokomiro ikule kapena kuyambiranso.
Komanso, chifukwa chithandizo cha khansa ya chithokomiro chimapha ma cell a chithokomiro, chithokomiro sichimatha kupanga hormone yokwanira ya chithokomiro. Odwala amapatsidwa mapiritsi obwezeretsa mahomoni a chithokomiro.
Chithandizo chofuna
Chithandizo choyenera ndi mtundu wa mankhwala omwe amagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuukira maselo amtundu wa khansa osavulaza maselo abwinobwino. Pali mitundu yosiyanasiyana ya mankhwala omwe akulimbana nawo:
- Tyrosine kinase inhibitor. Chithandizo cha Tyrosine kinase inhibitor chimatseka zikwangwani zofunika kuti zotupa zikule. Sorafenib, lenvatinib, vandetanib, ndi cabozantinib amagwiritsidwa ntchito pochiza mitundu ina ya khansa ya chithokomiro. Mitundu yatsopano ya tyrosine kinase inhibitors ikuwerengedwa kuti ithetse khansa yayikulu ya chithokomiro.
- Mapuloteni kinase inhibitor. Mapuloteni kinase inhibitor therapy amatseka mapuloteni ofunikira kuti maselo akule ndipo amatha kupha ma cell a khansa. Dabrafenib ndi trametinib amagwiritsidwa ntchito pochiza khansa ya chithokomiro yaaplastic kwa odwala omwe ali ndi vuto linalake mumtundu wa BRAF.
Onani Mankhwala Ovomerezeka a Chithokomiro Khansa kuti mumve zambiri.
Kudikira kudikira
Kuyembekezera mwachidwi kumayang'anitsitsa matenda a wodwalayo osamupatsa chithandizo chilichonse mpaka zizindikilo kapena zizindikiritso zikuwoneka kapena kusintha.
Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.
Chitetezo chamatenda
Immunotherapy ndi chithandizo chomwe chimagwiritsa ntchito chitetezo cha mthupi cha wodwalayo kuthana ndi khansa. Zinthu zomwe thupi limapanga kapena zopangidwa mu labotale zimagwiritsidwa ntchito kukulitsa, kuwongolera, kapena kubwezeretsa chitetezo chamthupi cha khansa. Chithandizo cha khansa choterechi chimatchedwanso biotherapy kapena biologic therapy. Immunotherapy ikuwerengedwa ngati chithandizo cha khansa ya chithokomiro.
Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.
Chithandizo cha khansa ya chithokomiro chingayambitse mavuto.
Kuti mumve zambiri zamankhwala obwera chifukwa cha khansa, onani tsamba lathu la Zotsatira Zotsatira.
Odwala angaganize zopita nawo kukayezetsa.
Kwa odwala ena, kutenga nawo mbali pakuyesa chithandizo chachipatala kungakhale njira yabwino kwambiri yothandizira. Mayesero azachipatala ndi gawo limodzi la kafukufuku wa khansa. Mayesero azachipatala amachitika kuti apeze ngati mankhwala atsopano a khansa ndi otetezeka komanso ogwira ntchito kapena abwinoko kuposa mankhwala wamba.
Njira zambiri zamankhwala zochiritsira khansa zimachokera kumayeso am'mbuyomu azachipatala. Odwala omwe amatenga nawo mbali pachipatala atha kulandira chithandizo chofananira kapena kukhala oyamba kulandira chithandizo chatsopano.
Odwala omwe amatenga nawo mbali pazoyeserera zamankhwala amathandizanso kukonza momwe khansa idzathandizire mtsogolo. Ngakhale mayesero azachipatala satsogolera kuchipatala chatsopano, nthawi zambiri amayankha mafunso ofunikira ndikuthandizira kupititsa patsogolo kafukufuku.
Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.
Mayesero ena azachipatala amangophatikizapo odwala omwe sanalandire chithandizo. Mayesero ena amayesa chithandizo kwa odwala omwe khansa yawo sinakhale bwino. Palinso mayesero azachipatala omwe amayesa njira zatsopano zothetsera khansa kuti isabwererenso (kubwerera) kapena kuchepetsa zovuta zoyambitsidwa ndi khansa.
Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayeso azachipatala othandizidwa ndi NCI zitha kupezeka patsamba lofufuza zamankhwala la NCI. Mayesero azachipatala othandizidwa ndi mabungwe ena amapezeka patsamba la ClinicalTrials.gov.
Mayeso otsatirawa angafunike.
Ena mwa mayesero omwe adachitika kuti apeze khansa kapena kuti adziwe momwe khansa iliri angabwerezedwenso. Mayesero ena adzabwerezedwa kuti awone momwe mankhwalawa akugwirira ntchito. Zisankho zakuti mupitilize, kusintha, kapena kusiya kulandira chithandizo zitha kutengera zotsatira za mayeso awa.
Kuyesaku kumangopitilira kuchitika nthawi ndi nthawi mankhwala atatha. Zotsatira zamayesowa zitha kuwonetsa ngati vuto lanu lasintha kapena ngati khansa yabwereranso (bwererani). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.
Njira Zothandizira ndi Gawo
M'chigawo chino
- Magawo I, II, ndi III Papillary and Follicular Thyroid Cancer (Localized / Regional)
- Gawo la IV Papillary and Follicular Chithokomiro Khansa (Metastatic)
- Khansa Yapakhungu Yapakhungu Yotsatira ndi Papepala
- Khansara ya Chithokomiro ya Medullary
- Khansa Yapakhungu Yapakhungu
Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.
Magawo I, II, ndi III Papillary and Follicular Thyroid Cancer (Localized / Regional)
Kuchiza kwa gawo I (ochepera zaka 55; wazaka 55 kapena kupitirira), gawo II (ochepera zaka 55; wazaka 55 kapena kupitilira apo), ndipo gawo lachitatu khansa ya khansa ya khansa ya m'mimba ndi follicular ingaphatikizepo izi:
- Opaleshoni (thyroidectomy kapena lobectomy).
- Mankhwala othandizira ayodini.
- Thandizo la mahomoni kuteteza thupi kuti lisapangitse timadzi tomwe timayambitsa matenda a chithokomiro (TSH).
- Thandizo la radiation lakunja.
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 la IV Papillary and Follicular Chithokomiro Khansa (Metastatic)
Khansa ikafalikira m'malo ena mthupi, monga mapapo ndi mafupa, chithandizo nthawi zambiri sichichiza khansa, koma chimatha kuthetsa zizindikilo ndikukhalitsa moyo wabwino. Chithandizo cha khansa yapachilombo ya khansa ya khansa ya m'mimba komanso yotsatira ingaphatikizepo izi:
Kwa zotupa zomwe zimatenga ayodini
- Chiwerengero cha thyroidectomy.
- Mankhwala othandizira ayodini.
- Thandizo la mahomoni kuteteza thupi kuti lisapangitse timadzi tomwe timayambitsa matenda a chithokomiro (TSH).
Kwa zotupa zomwe sizitenga ayodini
- Chiwerengero cha thyroidectomy.
- Thandizo la mahomoni kuteteza thupi kuti lisapangitse timadzi tomwe timayambitsa matenda a chithokomiro (TSH).
- Chithandizo choyenera ndi tyrosine kinase inhibitor (sorafenib kapena lenvatinib).
- Opaleshoni yochotsa khansa kumadera komwe yafalikira.
- Thandizo la kunja kwa ma radiation.
- Kuyesedwa kwachipatala kwa chemotherapy.
- Kuyesedwa kwachipatala kwa chithandizo chamankhwala.
- Kuyesedwa kwachipatala kwa immunotherapy.
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.
Khansa Yapakhungu Yapakhungu Yotsatira ndi Papepala
Chithandizo cha khansa yapachimake ya papillary ndi follicular ikhoza kukhala ndi izi:
- Opaleshoni yochotsa chotupacho kapena popanda mankhwala a ayodini.
- Mankhwala a radioactive ayodini pomwe khansa imapezeka kokha ndi chithokomiro ndipo sichimveka poyesedwa.
- Chithandizo choyenera ndi tyrosine kinase inhibitor (sorafenib kapena lenvatinib).
- Thandizo la radiation lakunja kapena ma radiation opraoperative ngati mankhwala ochepetsa ululu kuti athetsetse zizindikiritso ndikukhalitsa moyo wabwino.
- Chemotherapy.
- Kuyesedwa kwachipatala kwa chithandizo chamankhwala.
- Kuyesedwa kwachipatala kwa immunotherapy.
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.
Khansara ya Chithokomiro ya Medullary
Khansara ya medullary ya medullary yomwe ili m'thupi ili mu chithokomiro chokha ndipo imatha kufalikira ku minofu yapafupi m'khosi. Khansara ya chithokomiro yomwe yatsogola kwambiri imafalikira mbali zina za khosi kapena mbali zina za thupi.
Chithandizo cha khansa ya chithokomiro ya medullary yomwe mungakhale nayo itha kuphatikizira izi:
- Matenda onse a thyroidectomy ngati khansara sanafalikire mbali zina za thupi. Matenda am'mimba pafupi ndi khansa amachotsedwanso.
- Thandizo la radiation lakunja kwa odwala omwe khansa yabwereranso ku chithokomiro.
Chithandizo cha khansa ya chithokomiro yapakatikati / metastatic medullatic imatha kuphatikizira izi:
- Chithandizo choyenera cha tyrosine kinase inhibitor (vandetanib kapena cabozantinib) cha khansa yomwe yafalikira mbali zina za thupi.
- Chemotherapy ngati mankhwala ochepetsa nkhawa kuti athetse matenda ndikuwongolera moyo wa odwala omwe khansa yafalikira mbali zina za thupi.
Mankhwala othandizira ayodini sagwiritsidwa ntchito pochiza khansa ya chithokomiro ya medullary.
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.
Khansa Yapakhungu Yapakhungu
Chithandizo chingaphatikizepo izi:
- Matenda onse a thyroidectomy ngati mankhwala ochepetsa nkhawa kuti athetse vuto ndikukhala ndi moyo wabwino kwa odwala omwe ali ndi khansa yomwe ili mkati kapena pafupi ndi chithokomiro.
- Tracheostomy ngati mankhwala ochepetsa nkhawa kuti athetse vuto ndikukhala ndi moyo wabwino.
- Thandizo la radiation lakunja.
- Chemotherapy.
- Chithandizo choyenera ndi protein kinase inhibitors (dabrafenib ndi trametinib) kwa odwala omwe asintha mwanjira inayake mu jini la BRAF.
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
- Chithandizo cha Khansa ya Chithokomiro cha Ana
- Mankhwala Ovomerezeka a Khansa ya Chithokomiro
- Njira Zochizira Khansa
- Kuyesedwa Kwachibadwa kwa Ma Syndromes Obadwa Ndi Khansa
Kuti mumve zambiri za khansa ndi zinthu zina zochokera ku National Cancer Institute, onani izi:
- Za Khansa
- Kusinthana
- Chemotherapy and You: Kuthandiza Anthu Omwe Ali Ndi Khansa
- Thandizo la Radiation ndi Inu: Thandizo kwa Anthu Omwe Ali ndi Khansa
- Kulimbana ndi khansa
- Mafunso oti mufunse dokotala wanu za khansa
- Kwa Opulumuka ndi Owasamalira
Thandizani kutsitsimutsa kwama ndemanga