Iindidi / intloko-nentamo / isigulana / umntu omdala / unyango lwe-oropharyngeal-pdq

Unyango lweCancer ye-Oropharyngeal (yabantu abadala) (®) -Patient Version

Ulwazi ngokubanzi malunga neCancer Oropharyngeal

IINGONGOMA EZIPHAMBILI

• Umhlaza we-Oropharyngeal sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicubu ze-oropharynx.

• Ukutshaya okanye ukosulelwa yi-human papillomavirus (HPV) kunokunyusa umngcipheko womhlaza we-oropharyngeal.

• Iimpawu kunye neempawu zomhlaza we-oropharyngeal zibandakanya iqhuma entanyeni kunye nomqala obuhlungu.

• Uvavanyo oluvavanya umlomo nomqala lusetyenziselwa ukunceda ekuchongeni nasekuveleni umhlaza we-oropharyngeal cancer.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Umhlaza we-Oropharyngeal sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicubu ze-oropharynx.

I-oropharynx yindawo ephakathi kwe-pharynx (umqala), emva komlomo. Ipharynx yityhubhu engenamphako malunga ne-intshi ezintlanu ubude eqala emva kwempumlo kwaye iphelela apho i-trachea (umbhobho womoya) kunye nomqala (ityhubhu ukusuka emqaleni ukuya esiswini) iqala. Umoya kunye nokutya kudlula kwi-pharynx kwindlela eya kwi-trachea okanye kwi-esophagus.

I-anatomy ye-pharynx (umqala). Ipharynx yityhubhu engenamphambili eqala ngasemva kwempumlo, yehle intamo, kwaye iphele ngaphezulu kwitrachea kunye nomqala. Amacandelo amathathu e-pharynx yi-nasopharynx, oropharynx, kunye ne-hypopharynx.

I-oropharynx ibandakanya oku kulandelayo:

• Inkalakahla ethambileyo.

• Icala kunye neendonga zangasemva zomqala.

• Iitoni.

• Buyela isinye kwisithathu solwimi.

Icandelo le-oropharynx. I-oropharynx ibandakanya inkalakahla ethambileyo, icala kunye nodonga lwangasemva lomqala, iitoni, kunye nomva wesithathu wentsimbi.

Umhlaza we-Oropharyngeal luhlobo lomhlaza wentloko nentamo. Ngamanye amaxesha ngaphezu komhlaza omnye unokuvela kwi-oropharynx nakwezinye iindawo zomlomo womlomo, impumlo, i-pharynx, i-larynx (ibhokisi yezwi), i-trachea, okanye i-esophagus ngexesha elifanayo.

Uninzi lwee-cancer ze-oropharyngeal ziyi-squamous cell carcinomas. Iiseli ze-squamous ziiseli ezomileyo, ezicabalele ngaphakathi ngaphakathi kwi-oropharynx.

Jonga ezi zishwankathelo zilandelayo ze- ngolwazi oluthe kratya malunga nezinye iintlobo zomhlaza wentloko nentamo:

• Unyango lweCypopharyngeal Cancer (yabantu abadala)

• Unyango loMhlaza kunye nomlomo womlomo (kubantu abadala)

• Umlomo womlomo, iPharyngeal, kunye noThintelo loMhlaza waseLaryngeal

• Umlomo womlomo, iPharyngeal, kunye nokuvavanywa komhlaza waseLaryngeal

Ukutshaya okanye ukosulelwa yi-human papillomavirus (HPV) kunokunyusa umngcipheko womhlaza we-oropharyngeal.

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha wakho ukuba ucinga ukuba usengozini.

Ezona zinto zixhaphakileyo kumngcipheko womhlaza we-oropharyngeal zibandakanya ezi zilandelayo:

• Imbali yokutshaya imidiza ngaphezulu kweminyaka eli-10 yokupakisha kunye nokunye ukusetyenziswa kwecuba.

• Ukosulelwa yipapillomavirus yabantu (HPV), ngakumbi uhlobo lwe-HPV 16. Inani lamatyala omhlaza we-oropharyngeal onxulumene nosulelo lwe-HPV luyanda.

• Imbali yobuqu yomhlaza wentloko nentamo.

• Ukusetyenziswa kotywala kakhulu.

• Ukuhlafuna ibetel quid, isikhuthazi esidla ngokusetyenziswa kwiindawo ezithile zaseAsia.

Iimpawu kunye neempawu zomhlaza we-oropharyngeal zibandakanya iqhuma entanyeni kunye nomqala obuhlungu.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa ngumhlaza we-oropharyngeal okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Umqala obuhlungu ongaphumiyo.

• Ingxaki yokuginya.

• Ingxaki yokuvula umlomo ngokupheleleyo.

• Ingxaki yokuhambisa ulwimi.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Intlungu yendlebe.

• Isigaxa esisemva komlomo, umqala, okanye intamo.

• Isiziba esimhlophe elulwimini okanye ulwelwesi lomlomo olungapheliyo.

• Ukukhohlela igazi.

Ngamanye amaxesha umhlaza wamazinyo awubangeli zimpawu zokuqala okanye iimpawu.

Uvavanyo oluvavanya umlomo nomqala lusetyenziselwa ukunceda ekuchongeni nasekuveleni umhlaza we-oropharyngeal cancer.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali yezempilo: Uvavanyo lomzimba ukujonga iimpawu zempilo ngokubanzi, kubandakanya nokujonga imiqondiso yezifo, ezinje ngokuvuvukala kwezidumba entanyeni okanye nayiphi na into ebonakala ingaqhelekanga. Ugqirha okanye ugqirha wamazinyo wenza uvavanyo olupheleleyo lomlomo nentamo kwaye ujonge phantsi kolwimi nasemazantsi omqala ngesipili esincinci, esiphatha ixesha elide ukukhangela iindawo ezingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lwe-Neurological: Uthotho lwemibuzo kunye novavanyo lokujonga ubuchopho, intambo yomqolo kunye nokusebenza kwentliziyo. Uvavanyo lujonga imeko yomntu ngokwengqondo, ulungelelwaniso, kunye namandla okuhamba ngesiqhelo, kunye nendlela esebenza ngayo izihlunu, imizwa kunye nengqondo. Oku kunokubizwa ngokuba luvavanyo lwe-neuro okanye uvavanyo lwe-neurologic.

• Iskena se-PET-CT: Inkqubo edibanisa imifanekiso evela kwiskena se-positron emission tomography (PET) kunye nekhompyuter ye-tomography (CT). Ukuskena i-PET kunye ne-CT kwenziwa ngaxeshanye kumatshini omnye. Izikena ezidityanisiweyo zinika imifanekiso eneenkcukacha ngakumbi yeendawo ezingaphakathi komzimba kunokuba iskena sinikwe sisodwa. Ukuskena i-PET-CT kunokusetyenziselwa ukufumanisa isifo, njengomhlaza, ukucwangcisa unyango, okanye ukufumanisa ukuba lusebenza njani unyango.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjengentloko, intamo, isifuba, kunye ne-lymph node, ezithathwe kwii-angles ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi ifakwe ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicubu zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

Ikhompyuter ye-tomography (CT) yentloko nentamo. Isigulana silele kwitafile etyibilika kwiskena se-CT, esithatha imifanekiso ye-x-ray ngaphakathi kwentloko nentamo.

• Ukuskena i-PET (positron emission tomography scan) Inkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo.

Iskena sePET (positron emission tomography). Isigulana silele etafileni esisilayida ngomatshini wePET. Ukuphumla kwentloko kunye nomtya omhlophe kunceda isiguli ukuba silele. Inani elincinci leswekile ene-radioactive (iswekile) ifakwe kwisitya sesigulana, kwaye iskena senza umfanekiso apho iswekile isetyenziswa khona emzimbeni. Iiseli zomhlaza zibonakala ziqaqambile emfanekisweni kuba zithatha iswekile eninzi kuneseli eziqhelekileyo.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• Biopsy: Ukususwa kweeseli okanye izicwili ukuze zijongwe ngemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. I-biopsy yenaliti elungileyo ihlala isenziwa ukususa isampulu yethishu kusetyenziswa inaliti encinci.

Ezi nkqubo zilandelayo zingasetyenziselwa ukususa iisampulu zeeseli okanye izicwili:

• I-Endoscopy: Inkqubo yokujonga amalungu kunye nezicubu ngaphakathi komzimba ukukhangela iindawo ezingaqhelekanga. I-endoscope ifakwa ngokusikwa (ukusika) eluswini okanye ekuvulekeni emzimbeni, njengomlomo okanye impumlo. I-endoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Inokuba nesixhobo sokususa izicubu ezingaqhelekanga okanye iisampulu ze-lymph node, ezijongwa phantsi kwemicroscope kwimpawu zesifo. Impumlo, umqala, umva wolwimi, umqala, isisu, ingqula, umbhobho womoya, kunye neendlela ezinkulu zomoya ziya kujongwa. Uhlobo lwe-endoscopy lubizwa ngokuba yinxalenye yomzimba ovavanyiweyo. Umzekelo, i-pharyngoscopy luvavanyo lokujonga i-pharynx.

• I-Laryngoscopy: Inkqubo apho ugqirha akhangela khona ilarynx (ibhokisi yelizwi) ngesipili okanye i-laryngoscope ukukhangela iindawo ezingaqhelekanga. I-laryngoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga ngaphakathi komqala kunye nebhokisi yelizwi. Inokuba nesixhobo sokususa iisampulu zethishu, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza.

Ukuba umhlaza ufumanekile, olu vavanyo lulandelayo lunokwenziwa ukufundisisa iiseli zomhlaza:

• Uvavanyo lwe-HPV (uvavanyo lwe-papillomavirus yabantu): Uvavanyo lwaselebhu olusetyenziselwa ukukhangela isampulu yethishu kwiintlobo ezithile zosulelo lwe-HPV, ezinje ngohlobo lwe-HPV 16. Olu vavanyo lwenziwa kuba umhlaza wamazinyo ungabangelwa lusulelo lwe-HPV. Oku kubalulekile kuba umhlaza we-HPV-positive oropharyngeal umhlaza unesifo esingcono kwaye unyangwa ngokwahlukileyo kune-HPV-negative oropharyngeal cancer.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Ukuxelwa kwangaphambili kuxhomekeke koku kulandelayo:

• Nokuba isigulana sine-HPV yosulelo lwe-oropharynx.

• Nokuba isigulana sinembali yokutshaya imidiza iminyaka elishumi okanye nangaphezulu.

• Inqanaba lomhlaza.

• Inani kunye nobungakanani beemfuza ezinomhlaza.

Amathumba e-Oropharyngeal ahambelana nosulelo lwe-HPV anesisifo esingcono kwaye mancinci amathuba okuba iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde iphinde ibuye kwakhona.

Ukhetho lonyango luxhomekeke koku kulandelayo:

• Inqanaba lomhlaza.

• Ukugcina amandla esigulana okuthetha kunye nokuginya njengesiqhelo njengoko kunokwenzeka.

• Impilo yomguli ngokubanzi.

Izigulane ezinomdlavuza we-oropharyngeal zinomngcipheko ophezulu womnye umhlaza entloko okanye entanyeni. Lo mngcipheko unyukile kwizigulana eziqhubeka ukutshaya okanye ukusela utywala emva konyango.

Jonga isishwankathelo se- Ukutshaya icuba: Umngcipheko wezeMpilo kunye nendlela yokuyeka ulwazi ngakumbi.

Amanqanaba oMhlaza weOropharyngeal

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe isifo somhlaza wamathambo, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwi-oropharynx okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manqanaba alandelayo asetyenziselwa umhlaza we-HPV-positive oropharyngeal cancer:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• La manqanaba alandelayo asetyenziselwa umhlaza we-HPV-negative oropharyngeal cancer:

• Inqanaba 0 (iCarcinoma kwiSitu)

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

Emva kokuba kufunyaniswe isifo somhlaza wamathambo, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwi-oropharynx okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ngaphakathi kwe-oropharynx okanye kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Iziphumo zezinye zeemvavanyo ezisetyenziselwa ukufumanisa isifo somhlaza okanye isifo somhlaza zihlala zisetyenziselwa ukubeka isifo.

Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

Umhlaza unokusasazeka ngezicubu, inkqubo ye-lymph, kunye negazi:

• Izicubu. Umhlaza usasazeka ukusuka apho waqala ngokukhula waya kwiindawo ezikufuphi.

• Inkqubo yeLymph. Umhlaza usasazeka ukusuka apho waqala ngokungena kwinkqubo ye-lymph. Umhlaza uhamba ngemithambo ye-lymph ukuya kwamanye amalungu omzimba.

• Igazi. Umhlaza usasazeka ukusuka apho waqala ngokungena egazini. Umhlaza uhamba ngemithambo yegazi uye kwamanye amalungu omzimba.

Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

Xa umhlaza usasazeka kwelinye ilungu lomzimba, ubizwa ngokuba yi-metastasis. Iiseli zomhlaza ziyaphuma apho ziqale khona (ithumba lokuqala) kwaye zihamba ngenkqubo ye-lymph okanye igazi.

• Inkqubo yeLymph. Umhlaza ungena kwinkqubo ye-lymph, uhamba kwiinqanawa ze-lymph, kwaye wenze i-tumor (i-metastatic tumor) kwenye indawo yomzimba.

• Igazi. Umhlaza ungena egazini, uhambe kwimithambo yegazi, kwaye wenze ithumba (metastatic tumor) kwelinye ilungu lomzimba.

I-tumor ye-metastatic yinto efanayo yomhlaza njenge-tumor yokuqala. Umzekelo, ukuba umhlaza wamazinyo usasazeka emiphungeni, iiseli zomhlaza emiphungeni ziyiseli zomhlaza we-oropharyngeal. Esi sifo ngumhlaza we-metastatic oropharyngeal, hayi umhlaza wemiphunga.

La manqanaba alandelayo asetyenziselwa umhlaza we-HPV-positive oropharyngeal cancer:

Inqanaba I

Kwinqanaba I, enye yezi zinto zilandelayo iyinyani:

• I-lymph node enye okanye ezingaphezulu ezinomhlaza yi-HPV p16-positive zifunyenwe kodwa indawo owawuqale kuyo umhlaza ayaziwa. Iindawo ezalatha imithambo-luvo ezinomhlaza ziisentimitha ezi-6 okanye zincinci, kwicala elinye lentamo; okanye

• umhlaza ufumaneka kwi-oropharynx (emqaleni) kwaye ithumba liziisentimitha ezi-4 okanye lincinci. Umhlaza usenokusasazeka kwi-lymph node enye okanye nangaphezulu eziisentimitha ezi-6 okanye ezincinci, kwicala elifanayo lentamo njengesisu sokuqala.

Ubungakanani beethumba zihlala zilinganiswa ngeesentimitha (cm) okanye ii-intshi. Ukutya okuqhelekileyo okunokusetyenziselwa ukubonisa ubungakanani bethumba nge-cm kubandakanya: ipea (1 cm), ipeanut (2 cm), umdiliya (3 cm), i-walnut (4 cm), ikalika (5 cm okanye 2) I-intshi), iqanda (i-6 cm), ipesika (i-7 cm), kunye ne-grapefruit (i-10 cm okanye ii-intshi ezine).

Inqanaba II

Kwinqanaba II, enye yezi zinto zilandelayo iyinyani:

• I-lymph node enye okanye ezingaphezulu ezinomhlaza yi-HPV p16-positive zifunyenwe kodwa indawo owawuqale kuyo umhlaza ayaziwa. Iindawo ezalatha imithambo-luvo ezinomhlaza ziisentimitha ezi-6 okanye zincinci, kwelinye okanye macala omabini entamo; okanye

• I-tumor i-4 centimeters okanye encinci. Umhlaza usasazeke kwii-lymph node ezikwiisentimitha ezi-6 okanye ezincinci, kwelinye icala lentamo njengesisu sokuqala okanye kumacala omabini entamo; okanye

• ithumba likhulu kuneesentimitha ezi-4 okanye umhlaza usasazekile waya phezulu epiglottis (i-flap egubungela i-trachea ngexesha lokuginya). Umhlaza usenokunwenwela kwenye okanye kwii-lymph node ezikwiisentimitha ezi-6 okanye ezincinci, naphina entanyeni.

Inqanaba III

Kwinqanaba le-III, enye yezi zinto zilandelayo iyinyani:

• umhlaza usasazeke kwingqula (ibhokisi yelizwi), indawo engaphambili kuphahla lomlomo, umhlathi ongezantsi, izihlunu ezihambisa ulwimi, okanye kwezinye iinxalenye zentloko okanye zentamo. Umhlaza unokusasazeka kwii-lymph node entanyeni; okanye

• ithumba nabuphi na ubungakanani kwaye umhlaza usenokunwenwa kwingqula, ngaphambili kwophahla lomlomo, emhlathini osezantsi, izihlunu ezihambisa ulwimi, okanye kwamanye amalungu entloko okanye entanyeni. Umhlaza usasazekile kwi-lymph node enye okanye nangaphezulu ezinkulu kuneesentimitha ezi-6, naphina entanyeni.

Inqanaba IV

Kwinqanaba IV, umhlaza usasazeke kwamanye amalungu omzimba, njengomphunga okanye ithambo.

La manqanaba alandelayo asetyenziselwa umhlaza we-HPV-negative oropharyngeal cancer:

Inqanaba 0 (iCarcinoma kwiSitu)

Kwinqanaba le-0, iiseli ezingaqhelekanga zifumaneka kumgca we-oropharynx (umqala). Ezi seli zingaqhelekanga zinokuba ngumhlaza kwaye zisasazeke kwizicubu eziqhelekileyo ezikufutshane. Inqanaba 0 likwabizwa ngokuba yi-carcinoma in situ.

Inqanaba I

Kwinqanaba I, umhlaza wenziwe. I-tumor i-2 centimeters okanye encinci.

Ubungakanani beethumba zihlala zilinganiswa ngeesentimitha (cm) okanye ii-intshi. Ukutya okuqhelekileyo okunokusetyenziselwa ukubonisa ubungakanani bethumba nge-cm kubandakanya: ipea (1 cm), ipeanut (2 cm), umdiliya (3 cm), i-walnut (4 cm), ikalika (5 cm okanye 2) I-intshi), iqanda (i-6 cm), ipesika (i-7 cm), kunye ne-grapefruit (i-10 cm okanye ii-intshi ezine).

Inqanaba II

Kwinqanaba II, ithumba likhulu kuneesentimitha ezi-2 kodwa alikho likhulu kuneesentimitha ezi-4.

Inqanaba III

Kwinqanaba lesithathu, umhlaza:

• inokuba nkulu kuneesentimitha ezi-4 okanye ithe saa phezulu epiglottis (i-flap egubungela i-trachea ngexesha lokuginya); okanye

• nabuphi na ubungakanani. Umhlaza usasazekile kwi-lymph node enye eyi-3 cm okanye encinci, kwicala elifanayo lentamo njenge-tumor yokuqala.

Inqanaba IV

Inqanaba IV lahlulwe ngokwamanqanaba e-IVA, IVB, kunye ne-IVC.

• Kwinqanaba le-IVA, umhlaza:

• isasazeke kwingqula (ibhokisi yelizwi), indawo engaphambili yophahla lomlomo, umhlathi ongezantsi, okanye izihlunu ezihambisa ulwimi. Umhlaza unokusasazeka kwi-lymph node enye eyi-3 iisentimitha okanye ezincinci, kwicala elifanayo lentamo njenge-tumor yokuqala; okanye

• nabuphi na ubungakanani kwaye inokuba isasazeke ngaphezulu kweepiglottis, ingqula, umphambili wenxalenye yomlomo, umhlathi ongezantsi, okanye izihlunu ezihambisa ulwimi. Umhlaza unwenwele koku kulandelayo:

• I-lymph node enye enkulu kuneesentimitha ezi-3 kodwa ingekho ngaphezu kweesentimitha ezi-6, kwicala elifanayo lentamo njenge-tumor yokuqala; okanye

• ngaphezulu kweyodwa i-lymph node eyi-6 cm okanye encinci, naphina entanyeni.

• Kwinqanaba le-IVB, umhlaza:

• isasazeke kwimisipha ehambisa umhlathi ongezantsi, ithambo eliqhotyoshelwe kwimisipha ehambisa umhlathi ongezantsi, isiseko sokhakhayi, okanye indawo esemva kwempumlo okanye ejikeleze umthambo we-carotid. Umhlaza unokusasazeka kwii-lymph node entanyeni; okanye

• inokuba nabuphi na ubungakanani kwaye inokuba isasazeke nakwezinye iindawo zentloko okanye zentamo. Umhlaza usasazeke kwi-lymph node enkulu kuneesentimitha ezi-6 okanye usasazeke kwisigqubuthelo sangaphandle se-lymph node kwizicwili ezikufutshane.

• Kwinqanaba le-IVC, umhlaza usasazeke kwamanye amalungu omzimba, njengomphunga, isibindi, okanye ithambo.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza we-oropharyngeal.

• Izigulana ezinomhlaza we-oropharyngeal kufuneka ukuba unyango lwazo lucwangciswe liqela loogqirha abanobuchule bokunyanga umhlaza wentloko nentamo.

• Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Unyango ekujoliswe kulo

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-Immunotherapy

• Unyango lomhlaza we-oropharyngeal lunokubangela iziphumo ebezingalindelekanga.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza we-oropharyngeal.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza wamazinyo. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kuvavanyo lweklinikhi. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha kwizigulana ezinomhlaza. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Izigulana ezinomhlaza we-oropharyngeal kufuneka ukuba unyango lwazo lucwangciswe liqela loogqirha abanobuchule bokunyanga umhlaza wentloko nentamo.

Unyango lwesigulana luya kujongwa ngugqirha oncologist, ugqirha ogxile ekunyangeni abantu abanomhlaza. Ngenxa yokuba i-oropharynx inceda ekuphefumlweni, ekutyeni nasekuthetheni, abaguli banokufuna uncedo olukhethekileyo ekuhlengahlengiseni iziphumo ebezingalindelekanga zomhlaza kunye nonyango. Ugqirha wezonyango onokuthi athumele isigulana kwezinye iingcali zempilo ngoqeqesho olukhethekileyo kunyango lwezigulana ezinomhlaza wentloko nentamo. Oku kunokubandakanya ezi ngcali zilandelayo:

• Ugqirha wentloko nentamo.

• Imitha ye-oncologist.

• Ugqirha weplastiki.

• Ugqirha wamazinyo.

• Isidlo.

• Ingcali yeengqondo.

• Ingcali yokuvuselela.

• Ingcali yokuthetha.

Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

Ugqirha

Utyando (ukususa umhlaza ekusebenzeni) lunyango oluqhelekileyo kuwo onke amabakala omhlaza we-oropharyngeal. Ugqirha uya kuwususa umhlaza kunye nezinye izihlunu ezisempilweni ezijikeleze umhlaza. Emva kokuba ugqirha ewususile wonke umhlaza onokubonwa ngexesha lotyando, ezinye izigulana zinokunikwa ichemotherapy okanye unyango lweradiation emva kotyando lokubulala naziphi na iiseli zomhlaza ezisele. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo.

Iindidi ezintsha zotyando, kubandakanya utyando lwerobhothi lwethutyana, ziyafundwa kunyango lomhlaza wamazinyo. Utyando lwerobhothi lwethutyana lunokusetyenziselwa ukususa umhlaza kwiindawo ekunzima ukufikelela kuzo emlonyeni nasemqaleni. Iikhamera eziqhotyoshelwe kwirobhothi zinika umfanekiso we-3-dimensional (3D) obonwa ngugqirha. Esebenzisa ikhompyuter, ugqirha ukhokela izixhobo ezincinci kakhulu kwiziphelo zeengalo zerobhothi ukususa umhlaza. Le nkqubo inokwenziwa kwakhona kusetyenziswa i-endoscope.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Unyango lwangaphandle lwemitha lusebenzisa umatshini ongaphandle komzimba ukuthumela imitha kwindawo yomzimba enomhlaza.

Unyango lwe-radiation lwangaphandle lwentloko nentamo. Umatshini usetyenziselwa ukujolisa kwimitha ephezulu yamandla kumhlaza. Umatshini unokujikeleza ujikeleze isigulana, ahambise imitha evela kwii-engile ezahlukeneyo ukubonelela ngonyango oluhambisanayo. Imaski yemaski inceda ukugcina intloko nentamo yesigulana ekuhambeni kwonyango. Iimpawu ezincinci ze-inki zibekwa kwimaski. Amanqaku e-inki asetyenziselwa ukulinganisa umatshini we-radiation kwindawo efanayo phambi konyango ngalunye.

Iindlela ezithile zokunika unyango ngemitha kunokunceda ukugcina imitha ingonakalisi izicubu ezisempilweni ezikufutshane. Ezi ntlobo zonyango lwe-radiation zibandakanya oku kulandelayo:

• Unyango lwe-radiation ye-intension-modulated (IMRT): I-IMRT luhlobo lonyango lwe-3-dimensional (3-D) olusebenzisa ikhompyuter ukwenza imifanekiso yobukhulu kunye nemilo yethumba. Iintsika ezincinci zemitha yokuqina okuhlukeneyo (amandla) zijolise kwithumba kumacala amaninzi.

• Unyango lwe-stereotactic radiation: Unyango lwe-stereotactic radiation luhlobo lonyango lwangaphandle lwemitha. Izixhobo ezikhethekileyo zisetyenziselwa ukubeka isigulana kwindawo enye kunyango ngalunye lwemitha. Kanye ngemini kangangeentsuku ezininzi, umatshini wemitha ujolise kwidosi enkulu kunesiqhelo yemitha ngokuthe ngqo kwi-tumor. Ngokuba nesigulana kwindawo efanayo kunyango ngalunye, akukho monakalo mncinci kwizicubu ezisempilweni ezikufutshane. Le nkqubo ikwabizwa ngokuba yinyango ye-stereotactic yangaphandle ye-radiation kunye nonyango lwe-stereotaxic radiation.

Kumhlaza ophambili we-oropharyngeal, ukwahlula idosi yemihla ngemihla kwimitha yonyango oluncinci kuphucula indlela ithumba eliphendula ngayo kunyango. Oku kubizwa ngokuba unyango lwe-radiation olunamandla.

Unyango ngemitha lungasebenza ngcono kwizigulana eziyekile ukutshaya ngaphambi kokuqala unyango.

Ukuba i-thyroid okanye i-pituitary gland iyinxalenye yonyango lwe-radiation, isiguli sinomngcipheko okhulayo we-hypothyroidism (i-hormone ye-thyroid encinci). Uvavanyo lwegazi lokujonga inqanaba lehomoni yegazi emzimbeni kufuneka lwenziwe ngaphambi nasemva konyango.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy).

Jonga iziyobisi ezivunyiweyo kwiNtloko kunye neCancer Neck ngolwazi oluthe kratya. (Umhlaza we-Oropharyngeal luhlobo lwentloko kunye nomhlaza wentamo.)

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuhlasela iiseli ezithile zomhlaza. Unyango ekujoliswe kulo lubangela ukwenzakala okuncinci kwiiseli eziqhelekileyo kunonyango lwechemotherapy okanye unyango ngemitha. Ama-antibodies e-Monoclonal luhlobo lonyango ekujoliswe kulo olusetyenziselwa unyango lomhlaza we-oropharyngeal.

Unyango lwe-monoclonal antibody yonyango lomhlaza olusebenzisa ii-antibodies ezenziwe elebhu ezivela kuhlobo olunye lweeseli zomzimba. Ezi antibodies zinokuchonga izinto ezikumhlaza iiseli okanye izinto eziqhelekileyo egazini okanye kwizicubu ezinokunceda iiseli zomhlaza zikhule. Amachiza omzimba ancamathele kwizinto kwaye abulale iiseli zomhlaza, athintele ukukhula kwazo, okanye azigcine zisasazeka. Iintsholongwane zeMonoclonal zinikezelwa ngokufakwa. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza.

I-Cetuximab luhlobo lwe-anti-monoclonal antibody esebenza ngokubophelela kwiprotheni ebusweni beeseli zomhlaza kwaye imise iiseli ekukhuleni nasekuhlukaniseni. Isetyenziselwa unyango lomhlaza ophindaphindiweyo kunye ne-metastatic oropharyngeal.

Jonga iziyobisi ezivunyiweyo kwiNtloko kunye neCancer Neck ngolwazi oluthe kratya. (Umhlaza we-Oropharyngeal luhlobo lwentloko kunye nomhlaza wentamo.)

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Eli candelo lesishwankathelo lichaza unyango olufundwayo kuvavanyo lweklinikhi. Isenokungakhankanyi lonke unyango olutsha olufundwayo. Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lwe-Immunotherapy

I-Immunotherapy lunyango olusebenzisa amajoni omzimba omzimba ukulwa nomhlaza. Izinto ezenziwe ngumzimba okanye ezenziwe elebhu zisetyenziselwa ukonyusa, ukuqondisa, okanye ukubuyisela ukhuseleko lwendalo lomzimba kumhlaza.

I-PD-1 inhibitors luhlobo lwe-immunotherapy ebizwa ngokuba lunyango lwe-immune checkpoint inhibitor. I-PD-1 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-PD-1 incamathele kwenye iprotein ebizwa ngokuba yi-PDL-1 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. PD-1 inhibitors zinamathele kwi-PDL-1 kwaye zivumele iiseli ze-T ukuba zibulale iiseli zomhlaza.

I-Pembrolizumab kunye ne-nivolumab ziindidi ze-PD-1 inhibitors ezifundwayo kunyango lomhlaza we-oropharnygeal.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-PD-L1 kwiiseli zethumba kunye ne-PD-1 kwiiseli ze-T, zinceda ukugcina iimpendulo ze-immune zitshekishwe. Ukubopha kwe-PD-L1 ukuya kwi-PD-1 kugcina iiseli ze-T ekubulaleni iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-PD-L1 ukuya kwi-PD-1 nge-immune checkpoint inhibitor (anti-PD-L1 okanye anti-PD-1) ivumela iiseli ze-T ukuba zibulale iiseli zesisu (iphaneli esekunene).

Unyango lomhlaza we-oropharyngeal lunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga ezibangelwa lunyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando ngomhlaza. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba unyango lomhlaza olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lomhlaza lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ukuphucula indlela umhlaza oza kunyangwa ngayo kwixa elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinomhlaza ongakhange ubengcono. Kukwakho nezilingo zeklinikhi ezivavanya iindlela ezintsha zokumisa umhlaza ekubuyeleni (ekubuyeni) okanye ukunciphisa iziphumo ebezingalindelekanga zonyango lomhlaza.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo ukufumanisa umhlaza okanye ukufumanisa inqanaba lomhlaza zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yakho itshintshile okanye ukuba umhlaza ubuyile (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Ukulandela unyango, kubalulekile ukuba ube nononophelo lweemviwo zentloko kunye nentamo ukukhangela imiqondiso yokuba umhlaza ubuyile. Ukuhlolwa kuya kwenziwa rhoqo kwiiveki ezi-6 ukuya kwezi-12 kunyaka wokuqala, rhoqo kwiinyanga ezi-3 kunyaka wesibini, qho kwiinyanga ezi-3 ukuya kwezi-4 kunyaka wesithathu, kwaye rhoqo kwiinyanga ezi-6 emva koko.

Ukhetho lonyango ngeSigaba

Kweli Candelo

• Inqanaba I kunye neNqanaba II Umhlaza weOropharyngeal Cancer

• Inqanaba III kunye neCandelo IV Umhlaza weOropharyngeal Cancer

• Umhlaza weMetastatic kunye nophindaphindayo weCancer Oropharyngeal

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Inqanaba I kunye neNqanaba II Umhlaza weOropharyngeal Cancer

Unyango lwenqanaba elitsha elichongiweyo I kunye nenqanaba II lomhlaza wamazinyo unokubandakanya oku kulandelayo:

• Unyango ngemitha.

• Ugqirha.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Inqanaba III kunye neCandelo IV Umhlaza weOropharyngeal Cancer

Unyango lomhlaza wesifo se-oropharyngeal esanda kufunyaniswa kunye nenqanaba IV lomhlaza wamathambo unokubandakanya oku kulandelayo:

• Kwizigulana ezinomhlaza ekuhlaleni, utyando olulandelwa lonyango lwemitha. I-Chemotherapy nayo inokunikwa ngaxeshanye nonyango lwemitha.

• Unyango ngemitha lodwa kwizigulana ezingenakho ukunyanga ngamayeza.

• I-Chemotherapy enikezwe ngaxeshanye nonyango lwemitha.

• I-Chemotherapy elandelwa lonyango lwe-radiation olunikezwa ngaxeshanye njengonyango oluninzi lwe-chemotherapy.

• Uvavanyo lweklinikhi lwe-chemotherapy olulandelwa lutyando okanye unyango ngemitha.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo (i-nivolumab) kunye ne-chemotherapy enikezwe ngaxeshanye nonyango lwe-radiation kwizigulana ezinomhlaza we-HPV-positive oropharyngeal cancer.

• Uvavanyo lweklinikhi yonyango ngemitha kunye okanye ngaphandle kwonyango.

• Uvavanyo lweklinikhi lotyando lotshintsho olulandelwa lonyango oluqhelekileyo okanye olweedosi ezisezantsi kunye okanye ngaphandle kwonyango ngamayeza kwizigulana ezinomhlaza we-HPV-positive oropharyngeal.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Umhlaza weMetastatic kunye nophindaphindayo weCancer Oropharyngeal

Umhlaza ophindaphindiweyo we-oropharyngeal ubuyile kwi-oropharynx okanye kwamanye amalungu omzimba emva kokuba unyangwe. Unyango lomhlaza we-oropharyngeal oye wasasazeka (usasazeka kwamanye amalungu omzimba) okanye waphinda wabuya kwi-oropharynx unokubandakanya oku kulandelayo:

• Ugqirha, ukuba eli thumba aliphenduli kunyango radiation.

• Unyango ngemitha, ukuba ithumba alizange lisuswe ngokupheleleyo ngotyando kunye nemitha yangaphambili ayinikiwanga.

• Utyando lwesibini, ukuba ithumba alizange lisuswe ngokupheleleyo ngotyando lokuqala.

• I-Chemotherapy kwizigulana ezinomhlaza ophindaphindiweyo ongenakususwa ngotyando.

• Unyango lwe-radiation olunikezwa ngaxeshanye ne-chemotherapy.

• Unyango lwe-stereotactic radiation olunikezwa ngaxeshanye nonyango ekujoliswe kulo (cetuximab).

• Uvavanyo lweklinikhi yonyango ekujolise kulo, unyango lweradiyo yomzimba, okanye unyango lwe-radiation olunoncedo olwenziwe ngexesha elinye njenge-chemotherapy.

• Uvavanyo lweklinikhi lwe-immunotherapy (nivolumab okanye ipembrolizumab).

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukufunda ngakumbi malunga neCancer ye-Oropharyngeal

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nomhlaza wamazinyo, jonga oku kulandelayo:

• Ikhasi lasekhaya leNtloko kunye neCancer Neck

• Umlomo womlomo, iPharyngeal, kunye noThintelo loMhlaza waseLaryngeal

• Umlomo womlomo, iPharyngeal, kunye nokuvavanywa komhlaza waseLaryngeal

• Iingxaki zomlomo zeChemotherapy kunye neNtloko / iNtsholongwane yeNtsholongwane

• I-HPV kunye noMhlaza

• Iziyobisi ezivunyiweyo kwiNtloko kunye noMhlaza weNtamo

• Umhlaza weNtloko kunye neNtamo

• Icuba (kubandakanya uncedo ngokuyeka)

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli