Mhando / chiropa / murwere / mukuru-chiropa-kurapwa-pdq

Munhu Mukuru Primary Chiropa Cancer Kurapa

General Ruzivo nezve Adult Chekutanga Chiropa Kenza

PFUNGWA DZINOKOSHA

• Kenza yechirume yechikuru yechikuru chirwere umo maronda (gomarara) maseru anoumba mumatumbu echiropa.

• Kune mhando mbiri dzevakuru vegomarara rekutanga rechiropa.

• Kuva nehepatitis kana cirrhosis kunogona kukanganisa njodzi yekenza yechiropa yechikuru.

• Zviratidzo nezviratidzo zvevakuru vegomarara rechiropa zvinosanganisira bundu kana kurwadziwa kurudyi.

• Kuyedza kunoongorora chiropa neropa zvinoshandiswa kuona (kuwana) uye kuongorora vanhu vakuru gomarara repachiropa.

• Zvimwe zvinhu zvinokanganisa kufungidzira (mukana wekupora) uye sarudzo dzekurapa.

Kenza yechirume yechikuru yechikuru chirwere umo maronda (gomarara) maseru anoumba mumatumbu echiropa.

Chiropa ndiyo imwe yenhengo huru mumuviri. Iine makobvu maviri uye inozadza nechekumusoro kurudyi kwedumbu mukati membabvu. Matatu emabasa akakosha echiropa ndeaya:

• Sefa zvinhu zvinokuvadza kubva muropa kuitira kuti zvigone kupfuudzwa kubva mumuviri muzvituru uye neweti.

• Kugadzira bile yekubatsira kugaya mafuta anobva mukudya.

• Kuchengeta glycogen (shuga), iyo iyo muviri unoshandisa simba.

Anatomy yechiropa. Chiropa chiri mudumbu repamusoro padyo nedumbu, ura, nduru, uye rwatata. Chiropa chine denderedzwa rerudyi uye reruboshwe. Lobe rimwe nerimwe rakakamurwa kuita zvikamu zviviri (zvisina kuratidzwa).

Kune mhando mbiri dzevakuru vegomarara rekutanga rechiropa.

Iyo mhando mbiri dzevakuru vakuru kenza yechiropa ndeiyi:

• Hepatocellular carcinoma.

• Cholangiocarcinoma (bile duct cancer). (Ona pfupiso ye paBile Duct Cancer (Cholangiocarcinoma) Kurapa kwerumwe ruzivo.)

Rudzi rwakajairika rwevanhu vakuru vegomarara rechiropa hepatocellular carcinoma. Rudzi urwu rwegomarara rechiropa ndicho chechitatu chinokonzera hosha dzine chekuita nekenza pasirese.

Pfupiso iyi ndeyekurapwa kwekenza yechiropa yekutanga (gomarara rinotanga muchiropa). Kurapa kwegomarara kunotanga mune dzimwe nhengo dzemuviri uye ndokupararira kuchiropa hakuna kuvharwa muchidimbu ichi.

Kenza yechiropa yepuraimari inogona kuitika kune vese vakuru nevana. Nekudaro, kurapwa kwevana kwakasiyana pane kurapwa kwevakuru. (Ona pfupiso ye paChidiki Chiropa Cancer Kurapa kuti uwane rumwe ruzivo.)

Kuva nehepatitis kana cirrhosis kunogona kukanganisa njodzi yekenza yechiropa yechikuru.

Chero chipi zvacho chinowedzera mukana wako wekutora chirwere chinonzi njodzi chinhu. Kuva nenjodzi hazvireve kuti uchawana gomarara; kusava nenjodzi hazvireve kuti hauzobatwe negomarara. Taura nachiremba wako kana iwe uchifunga kuti ungave uri panjodzi yekenza yechiropa.

Njodzi dzinokonzera kenza yechiropa dzinosanganisira zvinotevera:

• Kuve nehepatitis B kana hepatitis C hutachiona. Kuve neese hepatitis B uye hepatitis C kunowedzera njodzi zvakanyanya.

Kuve necirrhosis.

• Kunwa doro zvakanyanya. Kunwa doro zvakanyanya uye kuva nehutachiona hwehepatitis B kunowedzera njodzi zvakanyanya.

• Kudya chikafu chakasvibiswa neaflatoxin (chepfu kubva mufungus inogona kukura pane chikafu, senge zviyo nenzungu, zvisina kuchengetwa zvakanaka).

• Kuve neasina kunwa doro steatohepatitis (NASH), mamiriro umo mafuta anovaka muchiropa uye anogona kufambira mberi mukuzvimba kwechiropa uye chiropa chesero kukuvara.

• Kushandisa fodya, senge kuputa fodya.

• Kuva nezvinetso zvakagara nhaka kana zvisingawanzoitika zvinokuvadza chiropa, kusanganisira zvinotevera:

• Hereditary hemochromatosis, chirwere chakagarwa nhaka umo muviri unochengeta iron yakawanda kupfuura yainoda. Iyo yakawedzera iron inowanzo chengetwa muchiropa, moyo, rwatata, ganda, uye majoini.

• Alpha-1 antitrypsin kushomeka, chirwere chakagarwa nhaka chinogona kukonzera chiropa nemapapu chirwere.

• Glycogen kuchengetedza chirwere, chirwere chinogarwa nhaka umo mune matambudziko nemaitiro eglucose (shuga) inonzi glycogen inochengetwa uye kushandiswa mumuviri.

• Porphyria cutanea tarda, chisingawanzoitika chirwere chinokanganisa ganda uye chinokonzera maronda anorwadza pazvikamu zvemuviri zvinoratidzwa nezuva, senge maoko, maoko, uye kumeso. Zvinetso zvechiropa zvinogona zvakare kuitika.

• Chirwere cheWilson, hosha isingawanzo kuwanikwa nhaka iyo muviri unochengeta mhangura yakawanda kupfuura yainoda. Iyo yekuwedzera mhangura inochengetwa muchiropa, huropi, maziso, uye dzimwe nhengo.

Kukwegura ndiyo njodzi huru kune vakawanda kanzira. Mukana wekubata cancer unowedzera paunenge uchikura.

Zviratidzo nezviratidzo zvevakuru vegomarara rechiropa zvinosanganisira bundu kana kurwadziwa kurudyi.

Izvi uye zvimwe zviratidzo nezviratidzo zvinogona kukonzerwa negomarara rekutanga rekenza yechiropa kana nemamwe mamiriro. Tarisa nachiremba wako kana iwe uine chero chinotevera:

• Bundu rakaomarara kurudyi pazasi pembabvu chete.

• Kusagadzikana mudumbu repamusoro kurudyi.

• Dumbu rakazvimba.

• Marwadzo padyo nebendekete rerudyi kana kumashure.

• Jaundice (yero yeganda uye machena eziso).

• Kupwanya kuri nyore kana kubuda ropa.

• Kuneta zvisina kujairika kana kushaya simba.

• Kusvotwa uye kurutsa.

• Kupererwa kwechido kana kunzwa kwekuzara mushure mekudya chidiki chikafu.

• Kurera huremu pasina chikonzero chinozivikanwa.

• Pale, chalky ura kufamba uye nerima weti.

• Kupindwa nechando.

Kuyedza kunoongorora chiropa neropa zvinoshandiswa kuona (kuwana) uye kuongorora vanhu vakuru gomarara repachiropa.

Iyi inotevera bvunzo uye maitiro anogona kushandiswa:

• Kuongorora kwepanyama uye nhoroondo: Kuongororwa kwemuviri kutarisa zviratidzo zvehutano, kusanganisira kuongorora zviratidzo zvehosha, zvakadai semapundu kana chero chinhu chinoratidzika sechisina kujairika. Nhoroondo yemaitiro ehutano hwemurwere uye kurwara kwakapfuura uye kurapwa kuchatorwawo.

• Serum tumor marker bvunzo: Maitiro umo muyenzaniso weropa unoongororwa kuyera huwandu hwezvimwe zvinhu zvakaburitswa muropa nenhengo, zvinyama, kana maseru emota mumuviri. Zvimwe zvinhu zvinosunganidzwa kune chaiwo marudzi ekenza kana akawanikwa mune akawedzera mwero muropa. Aya anonzi mamarara mamark. Yakawedzera nhanho yealpha-fetoprotein (AFP) muropa inogona kunge iri chiratidzo checancer yechiropa. Mimwe kanzira uye mamwe mamiriro asina cancer, anosanganisira cirrhosis uye hepatitis, anogona zvakare kuwedzera AFP mazinga. Dzimwe nguva iyo AFP nhanho yakajairika kunyangwe paine kenza yechiropa.

• Chiropa basa bvunzo: Maitiro umo muyedzo weropa unoongororwa kuyera huwandu hwezvimwe zvinhu zvaburitswa muropa nechiropa. Iyo yakakwira kupfuura yakajairwa huwandu hwechinhu inogona kuve chiratidzo chekenza yechiropa.

• CT scan (CAT scan): Maitiro anoita akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri, senge dumbu, rakatorwa kubva kumakona akasiyana. Mifananidzo yacho inogadzirwa nekombuta yakabatana neiyo x-ray muchina. Dhayi inogona kuiswa jekiseni kana kumedzwa kubatsira nhengo kana zvinyama kuratidza zvakajeka. Iyi nzira inonziwo computed tomography, computerized tomography, kana komputa axial tomography. Mifananidzo inogona kutorwa katatu katatu mushure mekunge dhayi yajowa, kuti utore mufananidzo wakanaka wenzvimbo dzisina kujairika muchiropa. Izvi zvinonzi katatu-chikamu CT. Iyo yemhepo kana helical CT scan inogadzira yakateedzana yakajeka mifananidzo yenzvimbo dziri mukati memuviri uchishandisa x-ray muchina unoongorora muviri munzira inotenderera.

• MRI (magnetic resonance imaging): Maitiro anoshandisa magineti, masaisai eredhiyo, uye komputa kugadzira yakateedzana mifananidzo yakajeka yenzvimbo dziri mukati memuviri, senge chiropa. Iyi nzira inonziwo nyukireya magnetic resonance imaging (NMRI). Kugadzira mifananidzo yakadzama yemitsipa yeropa mukati uye pedyo nechiropa, dhayi inobaiwa mutsinga. Maitiro aya anonzi MRA (magnetic resonance angiography). Mifananidzo inogona kutorwa katatu katatu mushure mekunge dhayi yajowa, kuti utore mufananidzo wakanaka wenzvimbo dzisina kujairika muchiropa. Izvi zvinonzi katatu-chikamu MRI.

• Ultrasound bvunzo: Maitiro umo ma-high-energy ruzha mafungu (ultrasound) anodonhedzwa kubva mukati memukati nyama kana nhengo uye anoita maungira. Maungira anoumba mufananidzo wemuviri munyama unonzi sonogram. Mufananidzo wacho unogona kudhindwa kuti utariswe gare gare.

• Biopsy: Kubviswa kwemasero kana zvinyama kuitira kuti vagone kutariswa pasi pe microscope nachiremba wekutarisa zviratidzo zvecancer. Maitiro anoshandiswa kuunganidza muyero wemasero kana zvinyama anosanganisira anotevera:

• Yakanakira-tsono yekutsvaira biopsy: Kubviswa kwemasero, tishu kana fluid uchishandisa tsono yakatetepa.

• Core tsono biopsy: Kubviswa kwemasero kana zvinyama uchishandisa tsono yakafararira.

• Laparoscopy: Maitiro ekuvhiya kutarisa nhengo dziri mukati medumbu kutarisa zviratidzo zvehosha. Zvidiki zvidiki (kucheka) zvinogadzirwa mumadziro emimba uye laparoscope (mutete, turu turi) inoiswa mune chimwe cheicho chinochekwa. Chimwe chiridzwa chinoiswa kuburikidza neiyo imwechete kana imwe incision yekubvisa iwo matissue sampuli.

Biopsy haigare ichidikanwa kuti iongorore vanhu vakuru kenza yechiropa.

Zvimwe zvinhu zvinokanganisa kufungidzira (mukana wekupora) uye sarudzo dzekurapa.

Kufungidzira (mukana wekupora) uye sarudzo dzekurapa dzinoenderana nezvinotevera:

• Chikamu checancer (saizi yemota, ingave inobata chikamu kana chiropa chose, kana yakapararira kune dzimwe nzvimbo mumuviri).

• Chiropa chiri kushanda zvakadii.

• Hutano hwese hwemurwere, kusanganisira kana paine cirrhosis yechiropa.

Nhanho dzeVakuru Chekutanga Chiropa Kenza

PFUNGWA DZINOKOSHA

• Mushure mekunge munhu mukuru gomarara rechiropa raonekwa, kuongororwa kunoitwa kuti uone kana gomarara maseru apararira mukati mechiropa kana kune zvimwe zvikamu zvemuviri.

• Pane nzira nhatu dzinopararira negomarara mumuviri.

• Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.

• Iyo Barcelona Clinic Chiropa Cancer Inoratidzira Sisitimu inogona kushandiswa kuratidza vakuru vakuru gomarara rechiropa.

• Aya mapoka anotevera anoshandiswa kuronga kurapwa.

• BCLC nhanho 0, A, uye B

• BCLC nhanho C uye D

Mushure mekunge munhu mukuru gomarara rechiropa raonekwa, kuongororwa kunoitwa kuti uone kana gomarara maseru apararira mukati mechiropa kana kune zvimwe zvikamu zvemuviri.

Maitiro anoshandiswa kutsvaga kana gomarara rapararira mukati mechiropa kana kune dzimwe nhengo dzemuviri inonzi staging. Ruzivo rwakaunganidzwa kubva munzira yekugadzwa rinotara danho rechirwere. Izvo zvakakosha kuti uzive nhanho kuitira kuronga kurapwa. Iyi inotevera bvunzo uye maitiro anogona kushandiswa mune yekuratidzira maitiro:

• CT scan (CAT scan): Maitiro anoita akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri, senge chipfuva, dumbu, uye pelvis, zvakatorwa kubva kumakona akasiyana. Mifananidzo yacho inogadzirwa nekombuta yakabatana neiyo x-ray muchina. Dhayi inogona kuiswa jekiseni kana kumedzwa kubatsira nhengo kana zvinyama kuratidza zvakajeka. Iyi nzira inonziwo computed tomography, computerized tomography, kana komputa axial tomography.

• MRI (magnetic resonance imaging): Maitiro anoshandisa magineti, masaisai eredhiyo, uye komputa kugadzira yakateedzana mifananidzo yakajeka yenzvimbo dziri mukati memuviri. Iyi nzira inonziwo nyukireya magnetic resonance imaging (NMRI).

• PET scan (positron emission tomography scan): Iyo nzira yekuwana yakaipa malonda maseru mumuviri. Chishoma che radioactive glucose (shuga) inoiswa mutsinga. Iyo PET scanner inotenderera yakatenderedza muviri uye inogadzira mufananidzo wepo glucose iri kushandiswa mumuviri. Malignant tumarara maseru anoratidza kupenya mumufananidzo nekuti anoshanda uye anotora glucose yakawanda kupfuura zvinoita maseru akajairwa.

Pane nzira nhatu dzinopararira negomarara mumuviri.

• Kenza inogona kupararira kuburikidza nematinji, iyo lymph system, uye neropa:

• Tishu. Kenza inopararira kubva kwayakatanga nekukura ichipinda munzvimbo dziri pedyo.

• Lymph maitiro. Kenza inopararira kubva kwayakatanga nekupinda muiyo lymph system. Gomarara rinofamba nemumidziyo yema lymph kuenda kune dzimwe nhengo dzemuviri Ropa. Kenza inopararira kubva payakatanga nekupinda muropa. Kenza inofamba nemidzi yeropa ichienda kune dzimwe nhengo dzemuviri.

Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.

Kana kenza ikapararira kune chimwe chikamu chemuviri, inonzi metastasis. Cancer maseru anotsemuka kubva kwaakatanga (iro bundu rekutanga) uye achifamba kuburikidza neye lymph system kana ropa.

• Lymph maitiro. Gomarara rinopinda mu "lymph system", rinofamba nemumidziyo ye "lymph", uye rinogadzira bundu (metastatic tumor) mune chimwe chikamu chemuviri.

• Ropa. Kenza inopinda muropa, inofamba nemutsinga dzeropa, yoita bundu (metastatic tumor) mune chimwe chikamu chemuviri.

Iyo metastatic bundu irwo rudzi rwecancer seyakanyanya bundu. Semuenzaniso, kana kenza yechiropa yekutanga ichipararira kuenda kumapapu, masero emukenza mumapapu ndiwo masero ekenza echiropa. Hosha iyi metastatic cancer cancer, kwete yemapapu cancer.

Iyo Barcelona Clinic Chiropa Cancer Inoratidzira Sisitimu inogona kushandiswa kuratidza vakuru vakuru gomarara rechiropa.

Iko kune akati wandei masisitimu masisitimu ekenza yechiropa. Iyo Barcelona Clinic Chiropa Cancer (BCLC) Staging System inoshandiswa zvakanyanya uye inotsanangurwa pazasi. Iyi sisitimu inoshandiswa kufanotaura mukana wemurwere wekupora uye kuronga kurapwa, zvichibva pane zvinotevera:

• Kunyangwe kenza yapararira mukati mechiropa kana kune zvimwe zvikamu zvemuviri.

• Chiropa chiri kushanda zvakadii.

• Hutano hwese uye kugwinya kwemurwere.

• Zviratidzo zvinokonzerwa nekenza.

Iyo BCLC yekugadzika sisitimu ine matanho mashanu:

• Stage 0: Kwayedza kwazvo

• Chikamu A: Pakutanga

• Chikamu B: Pakati

• Chikamu C: Yakafambiswa

• Chikamu D: Kupera-nhanho

Aya mapoka anotevera anoshandiswa kuronga kurapwa.

BCLC nhanho 0, A, uye B

Kurapa kwekurapa kenza kunopihwa BCLC nhanho 0, A, uye B.

BCLC nhanho C uye D

Kurapa kubvisa zviratidzo zvinokonzerwa nekenza yechiropa uye kugadzirisa hupenyu hwemurwere kunopihwa BCLC nhanho C uye D. Mishonga haigone kurapa kenza.

Kudzokororwa Kwevakuru Kwechiropa Cancer

Anowanzoitika munhu mukuru gomarara rechiropa igomarara rakadzokazve (kudzoka) mushure mekurapwa. Gomarara rinogona kudzoka muchiropa kana mune mamwe mativi emuviri.

Kurapa Sarudzo Kuongorora

PFUNGWA DZINOKOSHA

• Kune mhando dzakasiyana dzekurapa kwevarwere vane vakuru vekenza chiropa kenza.

• Varwere vane gomarara rechiropa vanorapwa nechikwata chevanyanzvi vanove nyanzvi pakurapa gomarara rechiropa.

• Mhando misere yekurapa kwakajairika inoshandiswa:

• Kuongorora

• Kuvhiya

• Chiropa chinotamisa

• Kurapa kweablation

• Embolization kurapwa

• Targeted kurapwa

• Immunotherapy

• Radiation kurapa

• Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

• Kurapa kwevakuru gomarara rekutanga rechiropa kunogona kukonzera mhedzisiro.

• Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki.

• Varwere vanogona kupinda mumakiriniki miedzo vasati, panguva, kana mushure mekutanga kwavo kenza kurapwa.

• Yekutevera-bvunzo inogona kudikanwa.

Kune mhando dzakasiyana dzekurapa kwevarwere vane vakuru vekenza chiropa kenza.

Mhando dzakasiyana dzekurapa dzinowanikwa kune varwere vane vanhu vakuru vane gomarara rekutanga reropa Mamwe marapirwo akajairwa (iko kurapwa kwazvino kwashandiswa), uye kumwe kuedzwa mumakiriniki ekuedzwa A kurapwa kiriniki kuyedzwa chidzidzo chekutsvaga chakaitirwa kubatsira kuvandudza marapirwo azvino kana kuwana ruzivo marapirwo matsva evarwere vane gomarara. Kana kiriniki miedzo ikaratidza kuti kurapwa kutsva kuri nani pane kwese kurapwa, kurapwa kutsva kunogona kuve kwakajairwa kurapwa. Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki. Mimwe miedzo yekiriniki yakavhurwa chete kune varwere vasina kutanga kurapwa.

Varwere vane gomarara rechiropa vanorapwa nechikwata chevanyanzvi vanove nyanzvi pakurapa gomarara rechiropa.

Kurapa kwemurwere kuchazotarisirwa nachiremba oncologist, chiremba uyo ane hunyanzvi hwekurapa vanhu vane gomarara. Wekurapa oncologist anogona kuendesa murwere kune vamwe vashandi vehutano vane hunyanzvi hwekudzidzisa pakurapa varwere vane gomarara rechiropa. Izvi zvinogona kusanganisira vanachiremba vanotevera:

• Hepatologist (nyanzvi mune chirwere chechiropa).

• Kuvhiya oncologist.

• Kuisa chiremba.

• Radiation oncologist.

• Inopindirana radiologist (nyanzvi inoongorora nekurapa zvirwere uchishandisa imaging uye zvidiki zvidiki zvinogoneka).

• Nyanzvi yezvirwere.

Mhando misere yekurapa kwakajairika inoshandiswa:

Kuongorora

Kuongororwa kwemaronda madiki pane 1 sentimita yakawanikwa panguva yekuongorora. Kutevera-mwedzi yega yega kwakajairika.

Kuvhiya Chikamu chehepatectomy (kuvhiya kubvisa chikamu chechiropa panowanikwa gomarara) kunogona kuitwa. Chidimbu chemucheka, chiuno chakazara, kana chikamu chakakura chechiropa, pamwe chete nezvimwe zvidimbu zvine hutano zvakakomberedza zvinobviswa. Izvo zvasara zvinyama zvechiropa zvinotora pamusoro pechiropa uye zvinogona kudzoka zvakare.

Chiropa chinotamisa

Mukuchinjika kwechiropa, chiropa chose chinobviswa chotsiviwa nechiropa chakapihwa chine hutano. Kuisirwa chiropa kunogona kuitwa kana chirwere chiri muchiropa chete uye chiropa chakapihwa chinogona kuwanikwa. Kana murwere achifanira kumirira chiropa chakapihwa, kumwe kurapwa kunopihwa sekudikanwa.

Kurapa kweablation

Kurapa kweablation kunobvisa kana kuparadza nyama. Mhando dzakasiyana dzeablation kurapa dzinoshandiswa kenza yechiropa:

• Radiofrequency ablation: Iko kushandiswa kwesingano dzakakosha dzinoiswa dzakananga kuburikidza neganda kana kuburikidza nekukwiridzwa mudumbu kusvika kune bundu. Yepamusoro-simba redhiyo mafungu anopisa tsono uye bundu iro rinouraya cancer maseru.

• Microwave Therapy: Rudzi rwekurapa umo bundu rinoratidzwa nekupisa kwakanyanya kunoitwa nema microwaves. Izvi zvinogona kukuvadza uye kuuraya cancer maseru kana kuita kuti zvinyanye kukanganiswa nemhedzisiro yemwaranzi uye mimwe mishonga inorwisa cancer.

• Percutaneous ethanol jekiseni: Mushonga wekenza umo tsono diki inoshandiswa kubaya ethanol (yakachena doro) yakananga muchibundu kuuraya cancer maseru. Mimwe mishonga ingangodiwa. Kazhinji anesthesia yemuno inoshandiswa, asi kana murwere aine mamota mazhinji muchiropa, general anesthesia inogona kushandiswa.

• Cryoablation: Kurapa kunoshandisa chishandiso kutonhora uye kuparadza gomarara maseru. Mhando iyi yekurapa inonziwo cryotherapy uye cryosurgery. Chiremba anogona kushandisa ultrasound kutungamira chishandiso.

• Electroporation Therapy: Kurapa kunotumira magetsi kuburikidza ne electrode yakaiswa mune bundu kuuraya cancer maseru. Electroporation kurapwa kuri kuongororwa mumakiriniki ekuedzwa.

Embolization kurapwa

Embolization kurapwa ndiko kushandiswa kwezvinhu kuvharira kana kudzikisira kuyerera kweropa kuburikidza neye hepatic arteri kune bundu. Kana bundu rikasawana iyo oxygen uye zvinovaka muviri zvarinoda, harizoramba richikura. Embolization therapy inoshandiswa kune varwere vasingakwanise kuvhiyiwa kuti vabvise bundu kana kurapa kweablation uye vane bundu risina kupararira kunze kwechiropa.

Chiropa chinogamuchira ropa kubva kune hepatic portal vein uye iyo hepatic arteri. Ropa rinouya muchiropa kubva kune hepatic portal vein rinowanzoenda kune hutano chiropa tishu. Ropa rinobva mutsinga ine hepatic kazhinji rinoenda kubundu. Kana iyo hepatic artery yakavharwa panguva yekumisikidza kurapwa, hutano hweropa nyama inoramba ichitambira ropa kubva kune hepatic portal vein.

Kune maviri epamhando mikuru yekurapa embolization:

• Transarterial embolization (TAE): Chidiki chidiki (cheka) chinoitwa mukati mechidya uye catheter (yakatetepa, inochinjika chubhu) inoiswa uye yakasungirirwa mudenga re hepatic. Kana catheter yangove panzvimbo, chinhu chinovharira tsinga ine hepatic uye inomisa kuyerera kweropa kune bundu chinojowa.

• Transarterial chemoembolization (TACE): Iyi nzira yakafanana neTAE kunze kwekuti anticancer drug inopihwa zvakare. Maitiro acho anogona kuitwa nekubatanidza mushonga weanticancer kune mabhudu madiki anoiswa mukati meiyo hepatic arter kana kubaya iyo anticancer mushonga kuburikidza nekatheta mukati meiyo hepatic arter uyezve jekiseni chinhu ichivhara iyo hepatic arteri. Mazhinji emushonga weacancer akabatwa padhuze nebundu uye hushoma chete hwemushonga hunosvika kune dzimwe nhengo dzemuviri. Iyi mhando yekurapa inonziwo chemoembolization.

Targeted kurapwa

Targeted Therapise kurapwa kunoshandisa zvinodhaka kana zvimwe zvinhu kuti zvione uye nekurwisa chaiwo maseru ekenza pasina kukuvadza zvakajairika maseru. Tyrosine kinase inhibitors rudzi rwekurapa kwakanangwa kunoshandiswa pakurapa kenza yechiropa yechikuru.

Tyrosine kinase inhibitors madiki-mamorekuru madhiragi ayo anodarika nepanhengo yesero uye anoshanda mukati memukenza maseru kuvharira masaini ekuti cancer maseru anoda kukura nekukamurwa. Mamwe tyrosine kinase inhibitors zvakare ane angiogenesis inhibitor mhedzisiro. Sorafenib, lenvatinib, uye regorafenib mhando dze tyrosine kinase inhibitors.

Ona Zvinodhaka Zvinotenderwa Chiropa Kenza kuti uwane rumwe ruzivo.

Immunotherapy

Immunotherapy kurapwa kunoshandisa immune system yemurwere kurwisa gomarara. Zvinhu zvinogadzirwa nemuviri kana kugadzirwa murabhoritari zvinoshandiswa kusimudzira, kunongedza, kana kudzorera kudzivirira kwemuviri kurwisa kenza. Rudzi rwekurapa kenza urwu rwunonziwo biotherapy kana biologic therapy.

Immune checkpoint inhibitor therapy rudzi rwe immunotherapy.

• Immune checkpoint inhibitor therapy: PD-1 ipuroteni iri pamusoro peT maseru ayo anobatsira kuchengetedza mhinduro dzemumuviri. Kana PD-1 yakanamatira kune imwe protein inonzi PDL-1 pane kenza kenza, inomisa iyo T cell kuuraya kenza kenza. PD-1 inhibitors inonamira kuPDL-1 uye inobvumira iwo maseru eT kuuraya maseru ekenza. Nivolumab rudzi rwe immune checkpoint inhibitor.

Immune checkpoint inhibitor. Checkpoint mapuroteni, akadai sePD-L1 pane maseru emota uye PD-1 pane T maseru, anobatsira kuchengetedza mhinduro dzemumuviri. Iko kusungwa kwePD-L1 kusvika PD-1 kunoita kuti masero eT arege kuuraya tumarara maseru mumuviri (kuruboshwe pani). Kuvhara kusunga kwePD-L1 kusvika PD-1 ine immune checkpoint inhibitor (anti-PD-L1 kana anti-PD-1) inobvumira iwo maseru eT kuuraya matumbo maseru (kurudyi pani).

Ona Zvinodhaka Zvinotenderwa Chiropa Kenza kuti uwane rumwe ruzivo.

Radiation kurapa

Radiation kurapa kurapwa kenza iyo inoshandisa yakakwira-simba x-rays kana mamwe marudzi e radiation kuuraya cancer maseru kana kuachengeta iwo kuti asakure. Kune mhando mbiri dze radiation radiation:

• External radiation therapy inoshandisa muchina uri kunze kwemuviri kutumira radiation kune kenza. Dzimwe nzira dzekupa mishonga ye radiation dzinogona kubatsira kuchengetedza mwaranzi kubva mukukuvadza nyama iri pedyo ine hutano. Aya marudzi erapi radiation ekunze anosanganisira anotevera:

• Conformal radiation therapy: Conformal radiation kurapwa rudzi rwekunze radiation radiation iyo inoshandisa komputa kugadzira 3-dimensional (3-D) pikicha yebundu uye inoumba iwo mamirioni matanda kuti akwane bundu. Izvi zvinobvumidza mwero wepamusoro wemwaranzi kuti usvike pachironda uye unokonzeresa kukuvara kudiki kune hutano hwakanaka.

• Stereotactic muviri radiation radiation: Stereotactic muviri radiation radiation rudzi rwekunze radiation radiation. Zvishandiso zvakakosha zvinoshandiswa kuisa murwere munzvimbo imwechete kune imwe neimwe radiation kurapwa. Kamwe pazuva kwemazuva akati wandei, muchina we radiation unovavarira mwero wakakura kupfuura wenguva dzose wemwaranzi yakananga pabundu. Nekuva nemurwere munzvimbo imwechete yekurapwa kwega kwega, pane kukuvara kudiki kune zvinyama zviri pedyo zvine hutano. Maitiro aya anonziwo stereotactic ekunze-beam radiation kurapwa uye stereotaxic radiation kurapwa.

• Proton beam radiation Therapy: Proton-beam kurapa rudzi rweakakwira-simba, ekunze radiation kurapwa. Mushini wekurapa nemwaranzi unovavarira nzizi dzemapurotoni (zvidiki, zvisingaonekwe, zvine mutsindo) mumasero ekenza kuvauraya. Rudzi urwu rwekurapa rwunokonzeresa kukuvara kudiki kune hutano huri padyo

• Yemukati radiation kurapwa kunoshandisa radioactive chinhu chakavharirwa mune tsono, mhodzi, waya, kana makateti anoiswa akananga mukati kana padyo nekenza.

Maitiro ekurapwa nemwaranzi anoenderana nerudzi uye nhanho yekenza iri kurapwa. External radiation therapy inoshandiswa kurapa kenza yechiropa yechikuru.

Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

Ruzivo nezve kiriniki miedzo inowanikwa kubva kuNCI webhusaiti.

Kurapa kwevakuru gomarara rekutanga rechiropa kunogona kukonzera mhedzisiro.

Kuti uwane ruzivo nezve mhedzisiro inokonzerwa nekurapwa kwegomarara, ona yedu Side Mhedzisiro peji.

Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki.

Kune vamwe varwere, kutora chikamu mumuedzo wekiriniki inogona kunge iri sarudzo yekurapa yakanyanya kunaka. Kliniki miedzo chikamu chekenza tsvagiridzo. Zvemakiriniki miedzo inoitwa kuti uone kana marapirwo matsva egomarara akachengeteka uye achishanda kana zvirinani pane akajairwa kurapwa.

Mazhinji emazuva ano marapirwo akajairwa ekenza akavakirwa pamavambo emakiriniki ekuedzwa. Varwere vanotora chikamu mukuyedzwa kwekiriniki vanogona kuwana kurapwa kwakaringana kana kuve pakati pevekutanga kurapwa kutsva.

Varwere vanotora chikamu mumiedzo yekiriniki zvakare vanobatsira kugadzirisa marapirwo achaitwa kenza mune ramangwana. Kunyangwe kana miedzo yemakiriniki isinga tangire kumarapirwo matsva anoshanda, anowanzo pindura mibvunzo yakakosha uye anobatsira kufambisira mberi kutsvagurudza.

Varwere vanogona kupinda mumakiriniki miedzo vasati, panguva, kana mushure mekutanga kwavo kenza kurapwa.

Mimwe miedzo yekiriniki inosanganisira chete varwere vasati vagamuchira kurapwa. Mimwe miedzo yekuedza kurapwa kwevarwere vane kenza haina kuve nani. Kune mamwezve emakiriniki miedzo inoedza nzira nyowani dzekumisa cancer kubva kudzokororazve (kudzoka) kana kudzikisira mhedzisiro yemakenza kurapwa.

Kuedzwa kwemakiriniki kuri kuitika munzvimbo zhinji dzenyika. Ruzivo nezve kiriniki miedzo inotsigirwa neNCI inogona kuwanikwa paNCI yekiriniki miedzo yekutsvaga peji rewebhu. Kliniki miedzo inotsigirwa nemamwe masangano inogona kuwanikwa pane yeClinicalTrials.gov webhusaiti.

Yekutevera-bvunzo inogona kudikanwa.

Mimwe miedzo yakaitwa kuongorora gomarara kana kutsvaga danho rekenza inogona kudzokororwa. Dzimwe bvunzo dzinodzokororwa kuitira kuti vaone kuti kurapa kuri kushanda sei. Sarudzo nezvekuti uenderere mberi, shandura, kana kumisa kurapwa kunogona kunge kuchibva pamhedzisiro yeiyi bvunzo.

Mimwe bvunzo ichaenderera ichiitwa nguva nenguva mushure mekunge kurapwa kwapera. Mhedzisiro yeiyi bvunzo inogona kuratidza kana mamiriro ako achinja kana kana gomarara radzoka (dzoka). Iyi bvunzo dzimwe nguva inonzi yekuteedzera-bvunzo kana kuongorora-kumusoro.

Kurapa Sarudzo dzeVakuru Chekutanga Chiropa Kenza

Muchikamu chino

• Matanho 0, A, uye B Adult Chekutanga Chiropa Cancer

• Matanho C uye D Adult Chekutanga Chiropa Cancer

Kuti uwane ruzivo nezve marapirwo akanyorwa pazasi, ona iyo Chikamu Sarudzo Yekutarisa Chikamu.

Matanho 0, A, uye B Adult Chekutanga Chiropa Cancer

Kurapa kwematanho 0, A, uye B vakuru kenza yechiropa yekutanga inogona kusanganisira zvinotevera:

• Kuongororwa kwezvironda zvidiki pane 1 sentimita.

• Chikamu hepatectomy.

• Yakazara hepatectomy uye chiropa kuisirwa.

• Kubvisa bundu uchishandisa imwe yeiyi nzira dzinotevera:

• Radiofrequency ablation.

• Microwave kurapa.

• Percutaneous ethanol jekiseni.

• Cryoablation.

• Kuongororwa kwekiriniki yeelectroporation kurapwa.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Matanho C uye D Adult Chekutanga Chiropa Cancer

Kurapa kwematanho C uye D vanhu vakuru kenza yechiropa inogona kusanganisira zvinotevera:

• Kubatanidza kurapwa uchishandisa imwe yedzinotevera nzira:

• Transarterial embolization (TAE).

• Transarterial chemoembolization (TACE).

• Targeted Therapy ine tyrosine kinase inhibitor.

• Immunotherapy.

• Radiation kurapa.

• Kuongororwa kwekiriniki yekurapa kwakanangwa mushure mechemoembolization kana kusanganiswa nekemotherapy.

• Kuongororwa kwekiriniki kwemishonga mitsva yakanangwa yekurapa.

• Kuongororwa kwekiriniki kweyemunotherapy.

• Kuongororwa kwekiriniki yemununotherapy kusanganiswa netrapi yakanangwa.

• Kuongororwa kwekiriniki ye stereotactic muviri radiation kurapwa kana proton-beam radiation radiation.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Kurapa kweRecentrent Adult Chekutanga Chiropa Cancer

Kuti uwane ruzivo nezve marapirwo akanyorwa pazasi, ona iyo Chikamu Sarudzo Yekutarisa Chikamu.

Kurapa sarudzo yeanowanzoitika munhu mukuru kenza yechiropa inogona kusanganisira zvinotevera:

• Yakazara hepatectomy uye chiropa kuisirwa.

• Chikamu hepatectomy.

• Kubvisa

• Transarterial chemoembolization uye yakanangwa kurapwa ne sorafenib, senge palliative kurapa kubvisa zviratidzo uye nekuvandudza hupenyu hwehupenyu.

• Kuongororwa kwekiriniki kwekurapwa kutsva.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Kuti Udzidze Zvakawanda Pamusoro peVakuru Chekutanga Chiropa Kenza

Kuti uwane rumwe ruzivo kubva kuNational Cancer Institute nezve vakuru vakuru kenza yechiropa, ona zvinotevera:

• Chiropa uye Bile Duct Kenza Peji Peji

• Chiropa (Hepatocellular) Kenza Kudzivirira

• Chiropa (Hepatocellular) Cancer Kuongorora

• Cryosurgery muCancer Kurapa

• Zvinodhaka Zvinotenderwa Chiropa Kenza

• Targeted Cancer Therapies

Kuti uwane ruzivo rwekenza uye zvimwe zviwanikwa kubva kuNational Cancer Institute, ona zvinotevera:

• Nezve Kenza

• Stage

• Chemotherapy uye Iwe: Tsigiro Yevanhu Vane Kenza

• Radiation Therapy uye Iwe: Rutsigiro rweVanhu Vane Kenza

• Kurarama neCancer

• Mibvunzo Yekubvunza Wako Chiremba nezveCancer

• Kune Vakapona uye Vanotarisira