Types/uterine/patient/endometrial-treatment-pdq

Chithandizo cha Khansa ya Endometrial (®) -Patient Version

Zambiri Zokhudza Khansa ya Endometrial

MFUNDO ZOFUNIKA

• Khansa ya Endometrial ndi matenda omwe ma cell owopsa (khansa) amapangidwa m'matumba a endometrium.

• Kunenepa kwambiri komanso kukhala ndi matenda amadzimadzi kumatha kuwonjezera ngozi ya khansa ya endometrial.

• Kutenga tamoxifen ya khansa ya m'mawere kapena kutenga estrogen yokha (popanda progesterone) kumatha kuwonjezera ngozi ya khansa ya endometrial.

• Zizindikiro za khansa ya endometrial imaphatikizapo kutuluka mwazi kwachilendo kapena kupweteka m'mimba.

• Kuyesa komwe kumayesa endometrium kumagwiritsidwa ntchito kuzindikira (kupeza) ndikuzindikira khansa ya endometrium.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Khansa ya Endometrial ndi matenda omwe ma cell owopsa (khansa) amapangidwa m'matumba a endometrium.

Endometrium ndikulumikiza kwa chiberekero, chibowo, chotupa m'mimba mwa mkazi. Chiberekero ndipamene mwana amakula. Amayi ambiri osakhala ndi pakati, chiberekero chimakhala pafupifupi mainchesi atatu. Mbali yakumunsi, yopapatiza ya chiberekero ndi khomo pachibelekeropo, lomwe limalowera kumaliseche.

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

Cancer ya endometrium ndiyosiyana ndi khansa ya minofu ya chiberekero, yotchedwa sarcoma ya chiberekero. Onani chidule cha pa Uterine Sarcoma Treatment kuti mumve zambiri za uterine sarcoma.

Kunenepa kwambiri komanso kukhala ndi matenda amadzimadzi kumatha kuwonjezera ngozi ya khansa ya endometrial.

Chilichonse chomwe chimakulitsa mwayi wanu wodwala chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala ngati mukuganiza kuti mutha kukhala pachiwopsezo cha khansa ya endometrial.

Zowopsa za khansa ya endometrial ndi izi:

• Kutenga estrogen-only hormone replacement therapy (HRT) mutatha kusamba.

• Kutenga tamoxifen kuteteza kapena kuchiza khansa ya m'mawere.

• Kunenepa kwambiri.

• Kukhala ndi matenda amadzimadzi.

• Kukhala ndi matenda ashuga amtundu wa 2.

• Kuwonetsa minofu ya endometrial ku estrogen yopangidwa ndi thupi. Izi zitha kuyambitsidwa ndi:

• Osabereka konse.

• Msambo adakali aang'ono.

• Kuyambira kusamba msinkhu pambuyo pake.

• Kukhala ndi matenda a polycystic ovarian.

• Kukhala ndi mbiri yabanja ya khansa ya endometrial mu wachibale woyamba (amayi, mlongo, kapena mwana wamkazi).

• Kukhala ndi zikhalidwe zina, monga matenda a Lynch.

• Kukhala ndi endometrial hyperplasia.

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

Kutenga tamoxifen ya khansa ya m'mawere kapena kutenga estrogen yokha (popanda progesterone) kumatha kuwonjezera ngozi ya khansa ya endometrial.

Khansa ya Endometrial imatha kukhala ndi odwala khansa ya m'mawere omwe amachiritsidwa ndi tamoxifen. Wodwala yemwe amamwa mankhwalawa ndipo ali ndi magazi osazolowereka kumaliseche ayenera kuyezetsa magazi ndikutsata koyambira kwa endometrial ngati kuli kofunikira. Amayi omwe amatenga estrogen (mahomoni omwe angakhudze kukula kwa khansa) nawonso ali ndi chiopsezo chowonjezeka cha khansa ya endometrial. Kutenga estrogen pamodzi ndi progesterone (mahomoni ena) sikuwonjezera chiwopsezo cha mayi cha khansa ya endometrial.

Zizindikiro za khansa ya endometrial imaphatikizapo kutuluka mwazi kwachilendo kapena kupweteka m'mimba.

Izi ndi zizindikilo ndi zina zimatha chifukwa cha khansa ya endometrium kapena zina. Funsani dokotala ngati muli ndi izi:

• Kutuluka kumaliseche kapena kutuluka kosagwirizana ndi msambo (kusamba).

• Ukazi ukazi pambuyo kusamba.

• Kukodza kovuta kapena kowawa.

• Zowawa panthawi yogonana.

• Ululu m'chiuno.

Kuyesa komwe kumayesa endometrium kumagwiritsidwa ntchito kuzindikira (kupeza) ndikuzindikira khansa ya endometrium.

Chifukwa khansa ya endometrium imayamba mkati mwa chiberekero, sizimawoneka pazotsatira za mayeso a Pap. Pachifukwa ichi, mtundu wa minofu ya endometrial uyenera kuchotsedwa ndikuyang'aniridwa ndi microscope kuti ayang'ane ma cell a khansa. Imodzi mwa njira izi itha kugwiritsidwa ntchito:

• Endometrial biopsy: Kuchotsa minofu ku endometrium (mkatikati mwa chiberekero) poyika chubu locheperako, losinthasintha kudzera pachibelekero mpaka m'chiberekero. Chubu chimagwiritsidwa ntchito kupukuta pang'ono pang'ono minofu kuchokera ku endometrium ndikuchotsa zitsanzozo. Wodwala amayang'ana minofu pansi pa microscope kuti ayang'ane maselo a khansa.

• Kuchepetsa ndi kuchiritsa: Njira yochotsera zitsanzo zamkati mwa chiberekero. Khomo lachiberekero limakhuthala ndipo mankhwala olumikizira kupangira (chida chooneka ngati supuni) amalowetsedwa m'chiberekero kuti muchotse minofu. Zoyeserera za minofu zimayang'aniridwa ndi microscope ngati pali matenda. Njirayi imatchedwanso D&C.

Kuchulukana ndi machiritso (D ndi C). A speculum amalowetsedwa mumaliseche kuti afutukule kuti ayang'ane khomo lachiberekero (gulu loyamba). Chopukutira chimagwiritsidwa ntchito kukulitsa chiberekero (chapakati). Therttte imayikidwa kudzera pachibelekeropo kulowa m'chiberekero kuti muchotse minofu yachilendo (gawo lomaliza).

• Hysteroscopy: Njira yoyang'ana mkati mwa chiberekero m'malo osazolowereka. Hysteroscope imayikidwa kudzera mu nyini ndi khomo lachiberekero mumchiberekero. Hysteroscope ndi chida chochepa, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu, yomwe imayang'aniridwa ndi microscope ngati ili ndi khansa.

Mayesero ena ndi njira zomwe zimagwiritsidwa ntchito pozindikira khansa ya endometrial ndi izi:

• 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.

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

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

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Gawo la khansa (kaya lili mu endometrium kokha, limakhudza khoma la chiberekero, kapena lafalikira m'malo ena m'thupi).

• Momwe ma cell a khansa amawonekera pansi pa microscope.

• Kaya maselo a khansa amakhudzidwa ndi progesterone.

Khansa ya endometrium imatha kuchiritsidwa chifukwa imapezeka msanga.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Gawo la khansa (kaya lili mu endometrium kokha, limakhudza khoma la chiberekero, kapena lafalikira m'malo ena m'thupi).

• Momwe ma cell a khansa amawonekera pansi pa microscope.

• Kaya maselo a khansa amakhudzidwa ndi progesterone.

Khansa ya endometrium imatha kuchiritsidwa chifukwa imapezeka msanga.

Magawo a Khansa ya Endometrial

MFUNDO ZOFUNIKA

• Khansa ya endometrial itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira m'chiberekero kapena mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

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

• Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya endometrial:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Khansara ya Endometrial ikhoza kukhala m'magulu azithandizo motere:

• Khansa ya endometrial yoopsa

• Khansa ya endometrial yowopsa kwambiri

Khansa ya endometrial itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira m'chiberekero kapena mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansara yafalikira mkati mwa chiberekero kapena mbali zina za thupi imatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo. Mayeso ndi njira zina zimagwiritsidwira ntchito pokonza. Hysterectomy (ntchito yomwe chiberekero chimachotsedwa) nthawi zambiri imachitika kuti ithetse khansa ya endometrial. Zitsanzo za minofu zimatengedwa kuchokera kumadera ozungulira chiberekero ndikuyang'aniridwa ndi microscope ngati pali zizindikiro za khansa zothandiza kudziwa ngati khansayo yafalikira.

Njira zotsatirazi zitha kugwiritsidwa ntchito pokonza:

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

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

• 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.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamatupi amthupi, zojambulidwa mosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

• 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.

• Lymph node dissection: Njira yochitira opaleshoni yomwe ma lymph node amachotsedwa m'chiuno ndipo zitsanzo za minofu zimayang'aniridwa ndi microscope ngati pali zizindikiro za khansa. Njirayi imatchedwanso lymphadenectomy.

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 endometrial imafalikira m'mapapu, maselo a khansa m'mapapo alidi maselo a khansa ya endometrial. Matendawa ndi khansa ya m'mapapo, osati khansa ya m'mapapo.

Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya endometrial:

Gawo I

Gawo IA ndi khansa ya IB endometrial khansa. Pa gawo IA, khansa ili mu endometrium kokha kapena yochepera theka kudzera mu myometrium (minofu yosanjikiza ya chiberekero). Mu gawo IB, khansa yafalikira theka kapena kupitilira mu myometrium.

Pa gawo I, khansa imapezeka mchiberekero kokha. Gawo I lagawidwa m'magawo IA ndi IB, kutengera momwe khansara yafalikira.

• Gawo IA: Khansa ili mu endometrium kokha kapena yochepera theka kupyola myometrium (minofu yosanjikiza ya chiberekero).

• Gawo IB: Khansa yafalikira theka kapena kupitilira mu myometrium.

Gawo II

Khansa yachiwiri ya endometrial khansa. Khansara yafalikira mumtundu wa chiberekero, koma sikufalikira kunja kwa chiberekero.

Gawo lachiwiri, khansa yafalikira m'mimba yolumikizira chiberekero, koma siyinafalikire kunja kwa chiberekero.

Gawo III

Gawo lachitatu, khansara yafalikira kupitirira chiberekero ndi khomo pachibelekeropo, koma siyinafalikire kupitirira m'chiuno. Gawo lachitatu lagawidwa magawo IIIA, IIIB, ndi IIIC, kutengera momwe khansara yafalikira mkati mwa mafupa a chiuno.

• Gawo IIIA: Khansa yafalikira kunja kwa chiberekero ndi / kapena kumatumba, mazira, ndi mitsempha ya chiberekero.

Gawo IIIA khansa ya m'mapapo. Khansara yafalikira kunja kwa chiberekero ndi / kapena kumachubu, mazira, kapena mitsempha ya chiberekero.

• Gawo IIIB: Khansa yafalikira kumaliseche ndi / kapena ku parametrium (minofu yolumikizana ndi mafuta ozungulira chiberekero).

Gawo lachiwiri khansa ya endometrial. Khansa yafalikira kumaliseche ndi / kapena ku parametrium (minofu yolumikizana ndi mafuta ozungulira chiberekero ndi khomo pachibelekeropo).

• Gawo IIIC: Khansa yafalikira ku ma lymph node m'chiuno ndi / kapena mozungulira aorta (mtsempha waukulu kwambiri m'thupi, womwe umachotsa magazi kuchokera pamtima).

Khansa II endometrial khansa. Khansara yafalikira ku ma lymph node mumchiuno ndi / kapena mozungulira aorta (mtsempha waukulu kwambiri mthupi, womwe umachotsa magazi kuchokera pamtima).

Gawo IV

Gawo lachitatu, khansa yafalikira kupitirira mafupa a chiuno. Gawo IV limagawika magawo a IVA ndi IVB, kutengera momwe khansara yafalikira.

• Gawo IVA: Khansa yafalikira pachikhodzodzo ndi / kapena m'matumbo.

Khansa ya endometrial khansa ya IVA. Khansa yafalikira mu chikhodzodzo ndi / kapena matumbo.

• Gawo IVB: Khansa yafalikira mbali zina za thupi kupitirira mafupa a chiuno, kuphatikiza pamimba ndi / kapena ma lymph node m'mimba.

Khansa ya endometrial khansa ya IVB. Khansara yafalikira mbali zina za thupi kunja kwa mafupa, monga pamimba ndi / kapena ma lymph node m'mimba.

Khansara ya Endometrial ikhoza kukhala m'magulu azithandizo motere:

Khansa ya endometrial yoopsa

Zotupa zamagulu 1 ndi 2 nthawi zambiri zimawoneka kuti ndizowopsa. Nthawi zambiri samafalikira kumadera ena amthupi.

Khansa ya endometrial yowopsa kwambiri

Zotupa za grade 3 zimaonedwa ngati zowopsa. Nthawi zambiri zimafalikira mbali zina za thupi. Uterine papillary serous, cell clear, ndi carcinosarcoma ndi magawo atatu a khansa ya endometrial yomwe imadziwika kuti ndi 3.

Khansa Yam'mapapo Yam'mbuyo ya Endometrial

Khansa yaposachedwa ya endometrial ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Khansara imatha kubwerera mchiberekero, m'chiuno, m'matenda am'mimba, kapena mbali zina za thupi

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi khansa ya endometrial.

• Mitundu isanu yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

• Opaleshoni

• Thandizo la radiation

• Chemotherapy

• Thandizo la mahomoni

• Chithandizo chofuna

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo cha khansa ya endometrial 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 kwa odwala omwe ali ndi khansa ya endometrial.

Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi khansa ya endometrial. 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 yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

Opaleshoni

Opaleshoni (kuchotsa khansa mu opareshoni) ndi njira yodziwika kwambiri yothandizira khansa ya endometrial. Njira zotsatirazi zingagwiritsidwe ntchito:

• Chiwombankhanga chonse: Opaleshoni yochotsa chiberekero, kuphatikizaponso khomo pachibelekeropo. Ngati chiberekero ndi khomo lachiberekero atulutsidwa kudzera mu nyini, opaleshoniyi amatchedwa kachilombo ka nyini. Ngati chiberekero ndi khomo pachibelekeropo atulutsidwa kudzera pachobvala chachikulu pamimba, opaleshoniyi amatchedwa kuti kutsekeka m'mimba kwathunthu. Ngati chiberekero ndi khomo lachiberekero amatulutsidwa kudzera pang'amba pang'ono pamimba pogwiritsa ntchito laparoscope, opaleshoniyi amatchedwa laparoscopic hysterectomy.

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

• Bilateral salpingo-oophorectomy: Opaleshoni yochotsa thumba losunga mazira onse komanso machubu oyambira.

• Radical hysterectomy: Opaleshoni yochotsa chiberekero, khomo pachibelekeropo, ndi gawo lina la nyini. Mimba, mazira, mazira oyandikira, kapena ma lymph node apafupi amathanso kuchotsedwa.

• Lymph node dissection: Njira yochitira opaleshoni yomwe ma lymph node amachotsedwa m'chiuno ndipo zitsanzo za minofu zimayang'aniridwa ndi microscope ngati pali zizindikiro za khansa. Njirayi imatchedwanso lymphadenectomy.

Dokotala atachotsa khansa yonse yomwe imawonekera panthawi yochitidwa opaleshoniyi, odwala ena amatha kupatsidwa mankhwala a radiation kapena mankhwala a mahomoni atachitidwa opareshoni kuti aphe maselo aliwonse a khansa omwe atsala. 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.

Momwe mankhwala a radiation amaperekedwera zimadalira mtundu ndi gawo la khansa yomwe ikuthandizidwa. Thandizo la radiation lakunja ndi lamkati limagwiritsidwa ntchito pochiza khansa ya endometrial, ndipo itha kugwiritsidwanso ntchito ngati mankhwala ochepetsa nkhawa kuti muchepetse zizindikiritso ndikukhalitsa moyo wabwino.

Chemotherapy

Chemotherapy ndi chithandizo cha khansa chomwe chimagwiritsa ntchito mankhwala kuletsa kukula kwa maselo a khansa, mwina popha ma cell kapena poyimitsa ma cell 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.

Thandizo la mahomoni

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. Mahomoni ena amatha kupangitsa khansa kukula. Ngati kuyesa kukuwonetsa kuti ma cell a khansa ali ndi malo omwe mahomoni amatha kulumikiza (receptors), mankhwala osokoneza bongo, opareshoni, kapena mankhwala a radiation amagwiritsidwa ntchito pochepetsa mahomoni kapena kuwaletsa kugwira ntchito.

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. Ma monoclonal antibodies, mTOR inhibitors, ndi ma sign transduction inhibitors ndi mitundu itatu yamankhwala ogwiritsidwa ntchito pochiza khansa ya endometrial.

• Mankhwala a monoclonal antibody ndi mankhwala a khansa omwe amagwiritsa ntchito ma antibodies opangidwa mu labotale kuchokera ku mtundu umodzi wamthupi. Ma antibodies awa amatha kuzindikira zinthu zomwe zili m'maselo a khansa kapena zinthu zabwinobwino zomwe zingathandize ma cell a khansa kukula. Ma antibodies amalumikizana ndi zinthuzo ndikupha ma cell a khansa, amalepheretsa kukula kwawo, kapena amalepheretsa kufalikira. Ma antibodies a monoclonal amaperekedwa mwa kulowetsedwa. Angagwiritsidwe ntchito okha kapena kunyamula mankhwala osokoneza bongo, poizoni, kapena zinthu zowononga radio kupita kuma cell a khansa. Bevacizumab imagwiritsidwa ntchito pochiza gawo lachitatu, gawo IV, komanso khansa yapakatikati ya endometrial.

• MTOR inhibitors amaletsa mapuloteni otchedwa mTOR, omwe amathandiza kuchepetsa magawano am'maselo. MTOR inhibitors amatha kuteteza maselo a khansa kuti asakule ndikuletsa kukula kwa mitsempha yatsopano yomwe zotupa zimayenera kukula. Everolimus ndi ridaforalimus amagwiritsidwa ntchito pochiza gawo lachitatu, gawo lachinayi, ndi khansa yapakatikati ya endometrial.

• Ma signature transduction inhibitors amaletsa zikwangwani zomwe zimadutsa kuchokera molekyulu imodzi kupita mzake mkati mwa selo. Kuletsa izi kumatha kupha ma cell a khansa. Metformin akuwerengedwa kuti athetse gawo lachitatu, gawo lachinayi, ndi khansa yapakatikati ya endometrial.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chithandizo cha khansa ya endometrial 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

• Gawo I ndi Khansa Yachiwiri ya Endometrial

• Gawo lachitatu, Gawo lachinayi, ndi khansa yaposachedwa ya Endometrial

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

Gawo I ndi Khansa Yachiwiri ya Endometrial

Khansa ya endometrial yoopsa kwambiri (kalasi 1 kapena kalasi 2)

Chithandizo cha gawo lowopsa la khansa ya endometrial ndi khansa yachiwiri ya endometrial ikhoza kukhala ndi izi:

• Opaleshoni (hysterectomy yathunthu ndi bilpal salpingo-oophorectomy). Matenda am'mimba m'mimba ndi m'mimba amathanso kuchotsedwa ndikuwonedwa pansi pa microscope kuti muwone ngati pali khansa.

• Kuchita maopareshoni (kuchuluka kwa ma hysterectomy ndi ma bilpal salpingo-oophorectomy, kapena osachotsa ma lymph node m'chiuno ndi pamimba) kutsatiridwa ndi mankhwala amkati amkati. Nthawi zina, mankhwala ochokera kunja kwa mafupa a chiuno angagwiritsidwe ntchito m'malo mwa mankhwala amkati amkati.

• Mankhwala a radiation okha kwa odwala omwe sangathe kuchitidwa opaleshoni.

• Kuyesedwa kwachipatala kwa mtundu wa chemotherapy regimen.

Ngati khansa yafalikira kuberekero, kachilombo koyambitsa matenda opatsirana pogwiritsa ntchito salpingo-oophorectomy ikhoza kuchitidwa.

Khansa ya endometrial yowopsa kwambiri (kalasi 3)

Chithandizo cha chiopsezo chachikulu cha khansa ya endometrial ndi khansa yachiwiri ya endometrial ikhoza kukhala ndi izi:

• Opaleshoni (radical hysterectomy ndi bilateral salpingo-oophorectomy). Matenda am'mimba m'mimba ndi m'mimba amathanso kuchotsedwa ndikuwonedwa pansi pa microscope kuti muwone ngati pali khansa.

• Opaleshoni (radical hysterectomy and bilateral salpingo-oophorectomy) kenako ndi chemotherapy ndipo nthawi zina mankhwala a radiation.

• Kuyesedwa kwachipatala kwa mtundu wa chemotherapy regimen.

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, Gawo lachinayi, ndi khansa yaposachedwa ya Endometrial

Chithandizo cha khansa ya endometrial ya gawo lachitatu, khansa ya endometrial ya gawo IV, ndi khansa yapakatikati ya endometrial ikhoza kuphatikiza izi:

• Opaleshoni (hysterectomy yayikulu ndikuchotsa ma lymph node m'chiuno kuti athe kuwonedwa pansi pa microscope kuti ayang'ane ma cell a khansa) kenako adjuvant chemotherapy ndi / kapena radiation radiation.

• Chemotherapy ndi mankhwala amkati ndi akunja a radiation kwa odwala omwe sangathe kuchitidwa opaleshoni.

• Thandizo la mahomoni kwa odwala omwe sangathe kuchitidwa opaleshoni kapena mankhwala a radiation.

• Chithandizo chojambulidwa ndi mTOR inhibitors (everolimus kapena ridaforolimus) kapena antiococonal antibody (bevacizumab).

• Kuyesedwa kwamankhwala kwamankhwala atsopano omwe atha kuphatikizira chemotherapy yophatikiza, mankhwala olimbana nawo, monga mTOR inhibitor (everolimus) kapena sign transduction inhibitor (metformin), ndi / kapena mankhwala a mahomoni, kwa odwala omwe ali ndi khansa yapakatikati kapena yabwinobwino ya endometrial.

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 Endometrial

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

• Tsamba La Khansa Ya Chiberekero

• Kupewa Khansa ya Endometrial

• Kuyeza Khansa ya Endometrial

• Thandizo la Hormone la Khansa ya m'mawere

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