Mhando / dumbu / murwere / dumbu-kurapwa-pdq

Gastric Cancer Kurapa Shanduro

General Ruzivo nezve Gastric Kenza

PFUNGWA DZINOKOSHA

• Gastric gomarara chirwere icho chinotyisa (gomarara) maseru anoumba mukati memudumbu.

• Zera, chikafu, uye chirwere chedumbu chinogona kukanganisa njodzi yekubatwa nekenza yemudumbu.

• Zviratidzo zvegomarara remudumbu zvinosanganisira kuzvimba uye kusagadzikana mudumbu kana kurwadziwa.

• Kuyedza kunoongorora dumbu uye esophagus kunoshandiswa kuona (kuwana) uye kuongorora gomarara remudumbu.

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

Gastric gomarara chirwere icho chinotyisa (gomarara) maseru anoumba mukati memudumbu.

Dumbu inhengo yakaumbwa saJ mudumbu repamusoro. Icho chikamu chegadziriro yekugaya, iyo inogadzira zvinovaka muviri (mavitamini, zvicherwa, makabhohaidhiretsi, mafuta, mapuroteni, uye mvura) muzvikafu zvinodyiwa uye zvinobatsira kupfuudza marara kubva mumuviri. Chikafu chinofamba kubva pahuro kuenda mudumbu kuburikidza negomba, mhasuru chubhu inonzi esophagus. Mushure mekubva mudumbu, chikafu chakanyungurwa-chidimbu chinopinda mudumbu diki ndokuzopinda muura hukuru.

Iyo esophagus uye mudumbu chikamu chepamusoro chedumbu (kugaya) system.

Rusvingo rwemudumbu runoumbwa nematanho mashanu enyama. Kubva pamukatikati memukati kusvika kune yekunze yakaturikidzana, zvidimbu zvedumbu remudumbu ndeizvi: mucosa, submucosa, mhasuru, subserosa (inobatanidza nyama), uye serosa. Gomarara regastric rinotanga mukati memucosa uye rinopararira kuburikidza nematanho ekunze painenge ichikura.

Stromal tumarara dumbu rinotanga mukutsigira rinobatanidza nyama uye vanorapwa zvakasiyana nekenza yemudumbu. Ona pfupiso ye paGastrointestinal Stromal Tumors Kurapa kune rumwe ruzivo.

Kuti uwane rumwe ruzivo nezve kenza yemudumbu, ona inotevera pfupiso:

• Zvisina kujairika Cancers zveVana Kurapa

• Dumbu (Gastric) Kenza Kudzivirira

• Dumbu (Gastric) Kanzera Kuongorora

Zera, chikafu, uye chirwere chedumbu chinogona kukanganisa njodzi yekubatwa nekenza yemudumbu.

Chero chipi zvacho chinowedzera njodzi yako yekuwana 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. Njodzi dzinokonzera kenza yemudumbu inosanganisira zvinotevera:

• Kuve nechero cheanotevera ehutano mamiriro:

• Helicobacter pylori (H. pylori) hutachiona hwemudumbu.

• Chisingaperi gastritis (kuzvimba kwemudumbu).

• Anonemia anemia.

• Intestinal metaplasia (mamiriro mune iyo yakajairwa dumbu yekumira inotsiviwa nemaseru anoteedzera ura).

• Gastric polyps.

• Epstein-Barr hutachiona.

• Mhuri syndromes (inosanganisira yemhuri adenomatous polyposis).

• Kudya chikafu chakazara munyu, chikafu chinopfungairwa uye chakaderera muzvibereko nemiriwo.

• Kudya chikafu chisina kugadzirwa kana kuchengetwa zvakanaka.

• Kuva mukuru kana murume.

• Kusvuta midzanga.

• Kuve naamai, baba, hanzvadzi, kana mukoma ane gomarara remudumbu.

Zviratidzo zvegomarara remudumbu zvinosanganisira kuzvimba uye kusagadzikana mudumbu kana kurwadziwa.

Izvi nezvimwe zviratidzo uye zviratidzo zvinogona kukonzerwa nekenza yemudumbu kana nemamwe mamiriro.

Mumatanho ekutanga ekenza yemudumbu, zvinotevera zviratidzo zvinogona kuitika:

• Kusagadzikana uye kusagadzikana mudumbu.

• Kunzwa kubhururuka mushure mekudya.

• Nyoro svoto.

• Kupererwa nechido.

• Kushungurudza.

Mune mamwe matanho epamberi ekenza yemudumbu, zvinotevera zviratidzo nezviratidzo zvinogona kuitika:

• Ropa muzvigaro.

• Kusvipa.

• Kurera huremu pasina chikonzero chinozivikanwa.

• Dumbu kurwadziwa.

• Jaundice (yero yero uye ganda).

• Ascites (kuvaka-up kwemvura mudumbu).

• Dambudziko kumedza.

Tarisa nachiremba wako kana uine chero eaya matambudziko.

Kuyedza kunoongorora dumbu uye esophagus kunoshandiswa kuona (kuwana) uye kuongorora gomarara remudumbu.

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.

• Ropa kemesitiri zvidzidzo: Maitiro umo muyedzo weropa unoongororwa kuyera huwandu hwezvimwe zvinhu zvakaburitswa muropa nenhengo uye nyama munyama. Chinhu chisina kujairika (chakakwirira kana chakaderera pane zvakajairwa) chiyero chechinhu chinogona kunge chiri chiratidzo chechirwere.

• Yakazara kuverenga kweropa (CBC): Maitiro umo muyenzaniso weropa unodhonzwa nekuongororwa zvinotevera:

• Huwandu hwemasero matsvuku eropa, machena masero eropa, uye maplatelet.

• Huwandu hwehemoglobin (protein inotakura oxygen) mumasero matsvuku eropa.

• Chikamu chemuenzaniso chakaumbwa nemasero matsvuku eropa.

• Kumusoro endoscopy: Maitiro ekutarisa mukati medu, mudumbu, uye duodenum (chikamu chekutanga chemukati mudumbu) kutarisa nzvimbo dzisina kujairika. Endoscope (yakatetepa, yakabatidzwa chubhu) inopfuudzwa kuburikidza nemuromo uye ichidzika nehuro kupinda mudumbu.

Kumusoro endoscopy. Chubhu tete, ine mwenje inoiswa kuburikidza nemuromo kutsvaga nzvimbo dzisina kujairika mudumbu, mudumbu, uye chikamu chekutanga chemukati mudumbu.

• Barium kumedza: Akateedzana e-ray-yegurokuro uye mudumbu. Murwere anonwa mvura ine barium (sirivheri-chena esimbi mukomboni). Iyo yemvura inofukidza esophagus uye mudumbu, uye x-ray inotorwa. Maitiro aya anonzi zvakare epamusoro GI akateedzana.

Barium kumedza kenza yemudumbu. Murwere anomedza bharumarara mvura uye inoyerera nepagurokuro ichipinda mudumbu. X-ray inotorwa kunotsvaga nzvimbo dzisina kujairika.

• CT scan (CAT scan): Maitiro anoita akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri, inotorwa 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.

• Biopsy: Kubviswa kwemasero kana zvinyama kuitira kuti zvionekwe pasi pe microscope kutarisa zviratidzo zvegomarara. Biopsy yemudumbu inowanzoitwa panguva yekupedzisira.

Muenzaniso wetissue unogona kuongororwa kuyera kuti mangani majini eHER2 aripo uye kuti yakawanda sei HER2 protein iri kugadzirwa. Kana paine mamwe maHER2 majini kana mazinga epamusoro eprotein yeHER2 kupfuura zvakajairwa, kenza inonzi HER2 yakanaka. HER2-yakanaka kenza yemudumbu inogona kurapwa ne monoclonal antibody inotarisa iyo HER2 protein.

Muenzaniso wetissue unogona zvakare kuongororwa hutachiona hweHelicobacter pylori (H. pylori).

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

Kufungidzira (mukana wekupora) uye sarudzo dzekurapa dzinoenderana nezvinotevera:

• Chikamu checancer (ingava chiri mudumbu chete kana chakapararira kune lymph node kana dzimwe nzvimbo mumuviri).

• Hutano hwese hwemurwere.

Kana gomarara remudumbu rikawanikwa kare kwazvo, pane mukana uri nani wekupora. Gomarara regastric rinowanzove padanho repamberi kana rikaonekwa. Pamatanho ekupedzisira, gomarara remudumbu rinogona kurapwa asi kashoma rinogona kurapwa. Kutora chikamu mune imwe yemakiriniki miedzo iri kuitwa kunatsiridza kurapwa kunofanirwa kutariswa. Ruzivo nezve inoenderera kiriniki miedzo inowanikwa kubva kuCI webhusaiti

Matanho eGastric Cancer

PFUNGWA DZINOKOSHA

• Mushure mekunge gomarara redumbu raonekwa, kuongororwa kunoitwa kuti uone kana gomarara maseru rapararira mukati medumbu kana kune zvimwe zvikamu zvemuviri.

• Pane nzira nhatu dzinopararira negomarara mumuviri.

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

• Aya anotevera matanho anoshandiswa kune gastric cancer.

• Chikamu 0 (Carcinoma muSitu)

• Chikamu I

• Chikamu II

• Chikamu chechitatu

• Chikamu IV

Mushure mekunge gomarara redumbu raonekwa, kuongororwa kunoitwa kuti uone kana gomarara maseru rapararira mukati medumbu kana kune zvimwe zvikamu zvemuviri.

Maitiro anoshandiswa kutsvaga kana kenza yapararira mukati medumbu 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:

• Endoscopic ultrasound (EUS): Maitiro umo endoscope inoiswa mumuviri, kazhinji kuburikidza nemuromo kana rectum. Endoscope chishoma, chubhu-senge chiridzwa chine mwenje uye lens yekuona. Probe panoperera endosikopu inoshandiswa kubaya mafungu ane simba-ruzha (ultrasound) kubva munyama dzemukati kana mitezo uye kuita maungira. Maungira anoumba mufananidzo wemuviri munyama unonzi sonogram. Maitiro aya anonziwo endosonography.

• CT scan (CAT scan): Maitiro anoita akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri, senge chipfuva, dumbu, kana chiuno, chakatorwa 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.

• 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. PET scan uye CT scan inogona kuitwa panguva imwe chete. Iyi inonzi PET-CT.

• MRI (magnetic resonance imaging) ine gadolinium: Maitiro anoshandisa magineti, masaisai eredhiyo, uye komputa kugadzira akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri. Chinhu chinonzi gadolinium chinopinzwa mutsinga. Iyo gadolinium inounganidza yakatenderedza maseru ekenza kuitira kuti varatidze kupenya mumufananidzo. Iyi nzira inonziwo nyukireya magnetic resonance imaging (NMRI).

• 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. Zvimwe zviridzwa zvinogona kuiswa kuburikidza zvakafanana kana zvimwe zvinoitwa kuita nzira dzakadai sekubvisa nhengo kana kutora masampuli enyama kuti aongororwe pasi pe microscope yezviratidzo zvegomarara. Mhinduro inogona kusukwa pamusoro pechiso chenhengo mudumbu uye yozobviswa kunotora masero. Aya maseru anotariswawo pasi pe microscope kutarisa zviratidzo zvecancer.

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. Kenza inofamba nemumidziyo yema lymph ichienda 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 gomarara remudumbu rikapararira kuchiropa, masero egomarara ari muchiropa ndiwo chaiwo maseru emukenza wegastric. Hosha iyi metastatic gastric cancer, kwete chiropa cancer.

Aya anotevera matanho anoshandiswa kune gastric cancer.

Chikamu 0 (Carcinoma muSitu)

Muchikamu che0, masero asina kujairika anowanikwa mu mucosa (yemukati-mukati) yemadziro emudumbu. Aya maseru asina kujairika anogona kuva cancer uye achipararira mune zvinyama zviri pedyo. Chikamu 0 chinonziwo carcinoma in situ.

Zvidimbu zvemadziro emudumbu. Rusvingo rwemudumbu rwunoumbwa neiyo mucosa (yemukati-kati nhete), submucosa, tsandanyama layer, subserosa, uye serosa (yekunze kwekumusoro). Dumbu inhengo iri mudumbu repamusoro.

Chikamu I

Chikamu I chakakamurwa muzvikamu IA uye IB.

• Stage IA: Kenza yakaumbwa mukati memukati (mukati-kati mechikamu) yemudumbu madziro uye inogona kunge yakapararira kune iyo submucosa (nhindi yetishu padhuze nemucosa).

• Chikamu IB: Kenza:

• yakagadzira mu mucosa (mukati-kati-soro) yemadziro emudumbu uye inogona kunge yakapararira kune iyo submucosa (nhindi yenyama iri padyo nemucosa). Kenza yakapararira kusvika kune 1 kana maviri mairi lymph node; kana

• yakagadzira mune mucosa yemadziro emudumbu uye yakapararira kune mhasuru yakatenderera.

Chikamu II

Stage II kenza yemudumbu yakakamurwa muzvikamu IIA uye IIB.

• Chikamu IIA: Kenza:

• inogona kunge yakapararira kune iyo submucosa (nhindi yenyama iri padyo nemucosa) yemadziro edumbu. Kenza yakapararira kusvika kune matatu kusvika kumatanhatu emakirini ari pedyo; kana

• yakapararira kune mhasuru yakatetepa yemadziro emudumbu. Kenza yakapararira kusvika kune 1 kana maviri mairi lymph node; kana

• yakapararira kune iyo subserosa (dura rezvibatanidza mativi padyo nemhasuru yemhasuru) yemadziro emudumbu.

• Chikamu IIB: Kenza:

• inogona kunge yakapararira kune iyo submucosa (nhindi yenyama iri padyo nemucosa) yemadziro edumbu. Gomarara rapararira kusvika kumamiriyoni manomwe kusvika gumi nemashanu ari pedyo noutachiona; kana

• yakapararira kune mhasuru yakatetepa yemadziro emudumbu. Kenza yakapararira kusvika kune matatu kusvika kumatanhatu emakirini ari pedyo; kana

• yakapararira kune iyo subserosa (dura rezvibatanidza mativi padyo nemhasuru yemhasuru) yemadziro emudumbu. Kenza yakapararira kusvika kune 1 kana maviri mairi lymph node; kana

• yakapararira kune serosa (yekumusoro kwekunze) yemadziro emudumbu.

Chikamu chechitatu

Stage III kenza yemudumbu yakakamurwa muzvikamu IIIA, IIIB, uye IIIC.

• Stage IIIA: Kenza yakapararira:

• kune iyo tsandanyama nhete yedumbu madziro. Gomarara rapararira kusvika kumamiriyoni manomwe kusvika gumi nemashanu ari pedyo noutachiona; kana

• kune subserosa (rukoko rwekubatanidza matishu padhuze nemhasuru yemhasuru) yedumbu remadziro. Kenza yakapararira kusvika kune matatu kusvika kumatanhatu emakirini ari pedyo; kana

• kune iyo serosa (yekumusoro yakaturikidzana) yemadziro emudumbu. Kenza yakapararira kusvika kune 1 kusvika ku6 lymph node dziri pedyo; kana

• kunhengo dziri padyo, senge spleen, colon, chiropa, diaphragm, pancreas, dumbu madziro, adrenal gland, itsvo, kana dumbu ura, kana kuseri kwedumbu.

• Chikamu IIIB: Kenza:

• inogona kunge yakapararira kune iyo submucosa (rukoko rwechitunha padhuze nemucosa) kana kune mhasuru yakatetepa yemadziro emudumbu. Kenza yakapararira kusvika kumatanho makumi matanhatu kana kupfuura ari pedyo; kana

• yakapararira kune iyo subserosa (dura rezvinobatanidza zvinyama padhuze nemhasuru yemhasuru) kana kune iyo serosa (yekumusoro yakatetepa) yemadziro emudumbu. Gomarara rapararira kusvika kumamiriyoni manomwe kusvika gumi nemashanu ari pedyo noutachiona; kana

• yakapararira kubva mudumbu kuenda kunhengo dziri padhuze, senge spleen, colon, chiropa, diaphragm, pancreas, dumbu madziro, adrenal gland, itsvo, kana dumbu ura, kana kuseri kwedumbu.

Kenza yakapararira kusvika kune imwe kusvika kumatanhatu emakirini ari pedyo.

• Chikamu IIIC: Kenza yapararira:

• kune subserosa (rukoko rwekubatanidza matishu padhuze nemhasuru yemhasuru) kana kune serosa (yekumusoro yakatetepa) yemadziro edumbu Kenza yakapararira kusvika kumatanho makumi matanhatu kana kupfuura ari pedyo; kana

• kubva mudumbu kuenda kunhengo dziri padyo, senge spleen, colon, chiropa, diaphragm, pancreas, dumbu madziro, adrenal gland, itsvo, kana dumbu ura, kana kuseri kwedumbu. Gomarara rapararira kusvika kumatanhatu kana kupfuura ma lymph node.

Chikamu IV

Muchikamu IV, gomarara rapararira kune dzimwe nhengo dzemuviri, senge mapapu, chiropa, lymph node dziri kure, uye nyama inodzika madziro edumbu.

Kakawanda Gastric Cancer

Gomarara repachizvaro regomarara igomarara rakadzokazve (radzoka) mushure mekurapwa. Gomarara rinogona kudzoka mudumbu kana mune zvimwe zvikamu zvemuviri zvakaita sechiropa kana lymph node.

Kurapa Sarudzo Kuongorora

PFUNGWA DZINOKOSHA

• Kune akasiyana marudzi ekurapa kwevarwere vane gastric cancer.

• Mhando nomwe dzekurapwa kwakajairika dzinoshandiswa:

• Kuvhiya

• Endoscopic mucosal resection

• Chemotherapy

• Radiation kurapa

• Chemoradiation

• Targeted kurapwa

• Immunotherapy

• Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

• Kurapa kenza yemudumbu 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 akasiyana marudzi ekurapa kwevarwere vane gastric cancer.

Mhando dzakasiyana dzekurapa dzinowanikwa kune varwere vane gomarara repamuviri. 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.

Mhando nomwe dzekurapwa kwakajairika dzinoshandiswa:

Kuvhiya

Kuvhiya kurapwa kwakajairika kwematanho ese ekenza yemudumbu. Aya anotevera marudzi ekuvhiya anogona kushandiswa:

• Subtotal gastrectomy: Kubviswa kwechikamu chedumbu chine kenza, lymph nodes iri padyo, uye zvikamu zveimwe nyama uye nhengo padhuze nebundu. Iyo spleen inogona kubviswa. Iyo spleen inhengo inogadzira maLymphocyte, inochengeta masero matsvuku eropa uye maLymphocyte, inozadza ropa, uye nekuparadza masero eropa ekare. Iyo spleen iri kuruboshwe kuruboshwe kwedumbu padyo nedumbu.

• Yese gastrectomy: Kubvisa dumbu rese, ma lymph node ari padyo, uye zvikamu zvegurokuro, ura hudiki, uye mamwe matukisi padyo nebundu. Iyo spleen inogona kubviswa. Ziso rakabatana netumbo diki saka murwere anogona kuramba achidya nekumedza.

Kana bundu richivharira dumbu asi gomarara risingakwanise kubviswa zvachose nekuvhiyiwa kwakajairika, zvinotevera nzira dzinogona kushandiswa:

• Endoluminal stent placement: Maitiro ekuisa stent (yakatetepa, inowedzerwa chubhu) kuitira kuchengetedza nzira (senge arteri kana esophagus) yakavhurika Kune mamota anovhara nzira inopinda kana kubuda mudumbu, kuvhiyiwa kunogona kuitwa kuisa stent kubva mudumbu kuenda mudumbu kana kubva mudumbu kuenda mudumbu dumbu kubvumira murwere kudya zvakajairika.

• Endoluminal laser therapy: Maitiro umo endoscope (yakatetepa, yakavhenekerwa chubhu) ine laser yakasungirirwa inoiswa mumuviri. Laser ndiyo danda rakasimba rechiedza iro rinogona kushandiswa sebanga.

• Gastrojejunostomy: Kuvhiya kuti ubvise chikamu chedumbu nekenza iri kutadzisa muburi kupinda mudumbu. Dumbu rakabatana nejejunum (chikamu chemuura mudiki) kubvumira chikafu nemushonga kuti zvipfuure zvichibva mudumbu zvichipinda mumatumbu madiki.

Endoscopic mucosal resection

Endoscopic mucosal resection inzira inoshandisa endoscope kubvisa kenza yekutanga-danho uye nekukurumidza kukura kubva padenga reti yekugaya pasina kuvhiyiwa. Endoscope chishoma, chubhu-senge chiridzwa chine mwenje uye lens yekuona. Inogona zvakare kusanganisira maturusi ekubvisa kukura kubva mumutsara wedumbu rekugaya.

Chemotherapy

Chemotherapy mushonga wekenza unoshandisa mishonga kumisa kukura kwemasero ekenza, kungave nekuuraya maseru kana nekuamisa iwo kubva pakupatsanuka. Kana chemotherapy ikatorwa nemuromo kana kujowa mutsinga kana mhasuru, mishonga inopinda muropa uye inogona kusvika masero emukenza mumuviri wese (systemic chemotherapy). Kana chemotherapy ikaiswa yakanangana necerebrospinal fluid, nhengo, kana dumbu remuviri senge dumbu, mishonga inonyanya kukanganisa maseru ekenza munzvimbo idzodzo (chemotherapy yedunhu). Nzira iyo chemotherapy inopihwa inoenderana nerudzi uye nhanho yekenza iri kurapwa.

Rudzi rwemakemikari enharaunda ari kudzidziswa kurapa gomarara remudumbu ndiyo intraperitoneal (IP) chemotherapy. MuIP chemotherapy, iyo anticancer mishonga inotakurwa yakananga mukati me peritoneal mhango (iyo nzvimbo ine nhengo dzemudumbu) kuburikidza netete chubhu.

Hyperthermic intraperitoneal chemotherapy (HIPEC) mushonga unoshandiswa panguva yekuvhiya iyo iri kuongororwa nekenza yemudumbu. Mushure mekunge chiremba anovhiya abvisa tumarara turu sezvinobvira, chemhemotherapy inodziirwa inotumirwa yakanangana neparitoneal mhango.

Ona Zvinodhaka Zvinotenderwa Dumbu (Gastric) 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.

• 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 cancer yegastric.

Chemoradiation

Chemoradiation therapy inosanganisa chemotherapy uye radiation radiation kuwedzera mhedzisiro yezvose. Chemoradiation yakapihwa mushure mekuvhiyiwa, kudzikisa njodzi yekuti gomarara richadzoka, inonzi adjuvant therapy. Chemoradiation yakapihwa usati wavhiyiwa, kudzikisa bundu (neoadjuvant therapy), iri kuongororwa.

Targeted kurapwa

Targeted therapy mhando yekurapa inoshandisa zvinodhaka kana zvimwe zvinhu kuti zvione uye kurwisa chaiwo maseru ekenza pasina kukuvadza zvakajairika maseru. Monoclonal antibodies uye multikinase inhibitors mhando dzeanorapwa marapirwo anoshandiswa pakurapa kenza yemudumbu.

• Monoclonal antibody therapy: Rudzi urwu rwekurapa runoshandisa antibodies akagadzirwa murabhoritari kubva kune imwechete mhando ye immune immune cell. Aya ma antibodies anokwanisa kuona zvinhu pane cancer cancer kana zvakajairika zvinhu zvinogona kubatsira gomarara maseru kukura. Masoja ekudzivirira chirwere anonamira pazvinhu uye anouraya maseru egomarara, anovharira kukura kwawo, kana kuti aachengetedze kubva pakupararira. Monoclonal antibodies inopihwa nekumisirwa. Inogona kushandiswa yoga kana kutakura zvinodhaka, chepfu, kana zvinhu zvine radioactive zvakanangana nemasero ekenza.

Kune mhando dzakasiyana dze monoclonal antibody zvinodhaka:

• Trastuzumab inovhara mhedzisiro yeiyo yekukura factor protein HER2, iyo inotumira zviratidzo zvekukura kumaseru emukenza emudumbu.

• Ramucirumab inovhara mhedzisiro yemamwe mapuroteni, kusanganisira vascular endothelial kukura chinhu. Izvi zvinogona kubatsira kuchengetedza maseru ekenza kubva mukukura uye anogona kuvauraya. Izvo zvinogona zvakare kudzivirira kukura kwemidzi mitsva yeropa iyo mamota anoda kukura.

Trastuzumab uye ramucirumab zvinoshandiswa pakurapa nhanho IV gastric cancer uye gastric cancer isingakwanise kubviswa nekuvhiyiwa kana kudzokazve.

• Multikinase inhibitors: Aya madiki-mamorekuru madhiragi anopfuura nepanhengo yesero uye anoshanda mukati memasero ekenza kuvharidzira akawanda mapuroteni masaini ekenza maseru anofanirwa kukura nekuparadzaniswa. Mamwe multikinase inhibitors zvakare ane angiogenesis inhibitor mhedzisiro. Angiogenesis inhibitors inomisa kukura kwemitsipa yeropa mitsva iyo mamota anoda kukura.

Kune mhando dzakasiyana dzemultikinase inhibitor zvinodhaka:

• Regorafenib ndeye multikinase inhibitor uye angiogenesis inhibitor inovhara mhedzisiro yemapuroteni mazhinji mukati memasero emota. Regorafenib iri kuongororwa mukurapa kwechato IV gastric gomarara uye gomarara repamuviri risingakwanise kubviswa nekuvhiyiwa kana kudzokazve.

Ona Zvinodhaka Zvinotenderwa Dumbu (Gastric) 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. Pembrolizumab 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 Dumbu (Gastric) Kenza kuti uwane rumwe ruzivo.

Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

Ruzivo nezve kiriniki miedzo inowanikwa kubva kuNCI webhusaiti.

Kurapa kenza yemudumbu 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.

Mimwe bvunzo inogona kuitwawo:

• Carcinoembryonic antigen (CEA) kuyedza uye CA 19-9 kuyedza: Maitiro umo sampuli tishu inoongororwa kuyera huwandu hwezvimwe zvinhu zvinogadzirwa nenhengo, nyama, kana tumarara masero mumuviri. Zvimwe zvinhu zvinosunganidzwa kune chaiwo marudzi ekenza kana akawanikwa mune akawedzera mwero mumuviri. Aya anonzi mamarara mamark. Yakakwirira kupfuura zvakajairika mazinga ecarcinoembryonic antigen (CEA) uye CA 19-9 zvinogona kureva kuti gastric cancer yakadzoka mushure mekurapwa.

Kurapa Sarudzo nedanho

Muchikamu chino

• Chikamu 0 (Carcinoma muSitu)

• Chikamu I Gastric Kenza

• Matanho II uye III Gastric Cancer

• Stage IV Gastric Cancer, Gastric Cancer Iyo Isingakwanise Kubviswa Nekuvhiya, uye Dzokororo Gastric Cancer

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

Chikamu 0 (Carcinoma muSitu)

Kurapa kwedanho 0 kunogona kusanganisira zvinotevera:

• Kuvhiya (yakazara kana subtotal gastrectomy).

• Endoscopic mucosal resection.

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.

Chikamu I Gastric Kenza

Kurapa kwedanho I gastric cancer inogona kusanganisira zvinotevera:

• Kuvhiya (yakazara kana subtotal gastrectomy).

• Endoscopic mucosal resection yevamwe varwere vane danho IA gastric cancer.

• Kuvhiya (yakazara kana subtotal gastrectomy) inoteverwa nekemoradiation kurapwa.

• Kuongororwa kwekiriniki kwechemoradiation kurapwa kwakapihwa usati wavhiyiwa.

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 II uye III Gastric Cancer

Kurapa kwedanho II gastric cancer uye danho III gastric cancer inogona kusanganisira zvinotevera:

• Kuvhiya (yakazara kana subtotal gastrectomy).

• Chemotherapy yakapihwa usati wavhiyiwa.

• Kuvhiya (yakazara kana subtotal gastrectomy) inoteverwa nekemoradiation kurapa kana chemotherapy.

• Kuongororwa kwekiriniki kwechemoradiation kurapwa kwakapihwa usati wavhiyiwa.

• Kuongororwa kwekiriniki kwechemotherapy yakapihwa usati wavhiyiwa.

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.

Stage IV Gastric Cancer, Gastric Cancer Iyo Isingakwanise Kubviswa Nekuvhiya, uye Dzokororo Gastric Cancer

Kurapa kwedanho IV gomarara repamuviri, gomarara repamuviri risingakwanise kubviswa nekuvhiyiwa, kana gomarara remudumbu repamusana rinogona kusanganisira zvinotevera:

• Chemotherapy senzira yekurapa yekurapa kubvisa zviratidzo uye nekuvandudza hupenyu.

• Targeted Therapy ine monoclonal antibody ine kana isina chemotherapy.

• Immunotherapy.

• Endoluminal laser therapy kana endoluminal stent kuiswa kuti ubvise kuvhara mudumbu, kana gastrojejunostomy kupfuudza iko kuvhara.

• Radiation kurapa senge palliative kurapa kumisa kubuda kweropa, kubvisa marwadzo, kana kudzora bundu riri kuvhara dumbu.

• Kuvhiya senge palliative kurapa kumisa kubuda kweropa kana kudzora bundu riri kuvhara dumbu.

• Kuongororwa kwekiriniki kwemasanganiswa matsva emakemotherapy senge palliative kurapa kubvisa zviratidzo uye kugadzirisa hupenyu.

• Kuongororwa kwekiriniki yekurapa kwakanangwa ine multikinase inhibitor.

• Kuongororwa kwekiriniki kwekuvhiyiwa uye hyperthermic intraperitoneal chemotherapy (HIPEC).

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 Nezve Gastric Cancer

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

• Dumbu (Gastric) Kanzera Kumba Peji

• Dumbu (Gastric) Kenza Kudzivirira

• Dumbu (Gastric) Kanzera Kuongorora

• Zvisina kujairika Cancers zveVana Kurapa

• Lasers muCancer Kurapa

• Mishonga Inotenderwa Dumbu (Gastric) Kenza

• Fodya (inosanganisira rubatsiro nekurega)

• Helicobacter pylori neCancer

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