Types/kidney/patient/kidney-treatment-pdq

Unyango lweCancer Renal Cancer (®) –Patient Version

Ulwazi Ngokubanzi Ngomhlaza weSeli yeNtso

IINGONGOMA EZIPHAMBILI

• Umhlaza wesifo somhlaza sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwiitubules zezintso.

• Ukutshaya kunye nokusetyenziswa gwenxa kwamayeza athile eentlungu kunokuchaphazela umngcipheko womhlaza wesifo sezintso.

• Iimpawu zomhlaza wesifo sezintso zibandakanya igazi kumchamo kunye neqhuma esiswini.

• Uvavanyo oluvavanya isisu kunye nezintso zisetyenziselwa ukufumanisa isifo somhlaza weeseli.

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

Umhlaza wesifo somhlaza sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwiitubules zezintso.

Umhlaza wesifo somzimba (okwabizwa ngokuba ngumhlaza wezintso okanye i-renal cell adenocarcinoma) sisifo apho iiseli ezinobungozi (umhlaza) zifumaneka kuludwe lweetyhubhu (iityhubhu ezincinci kakhulu) kwizintso. Kukho izintso ezi-2, elinye kwicala ngalinye lomqolo, ngaphezulu kwesinqe. Iityhubhu ezincinci kwizicoca izintso kwaye zicoca igazi. Bakhupha iimveliso zenkunkuma benze umchamo. Umchamo uvela kwizintso nganye ngetyhubhu ende ebizwa ngokuba yi-ureter kwisinyi. Isinyi sibamba umchamo de udlule kwi-urethra kwaye ushiye umzimba.

Inkqubo ye-urinary yamadoda (ipaneli yasekhohlo) kunye nenkqubo yomchamo yabasetyhini (iphaneli esekunene) ebonisa izintso, ureters, isinyi kunye ne-urethra. Umchamo wenziwe ngee-tubules zezintso kwaye uqokelela kwi-renal pelvis yezintso nganye. Umchamo uqukuqela uphuma kwizintso udlula kwizicwili uze uye kwesinye. Umchamo ugcinwe esinyini de ushiye umzimba kwi-urethra.

Umhlaza oqala kwii-ureters okanye kwi-renal pelvis (icandelo lezintso eliqokelela umchamo kwaye liwutyhalele kwii-ureters) lahlukile kumhlaza wesifo sezintso. (Jonga isishwankathelo se- malunga noMhlaza weSeli yeTshintsho ye-Renal Pelvis kunye ne-Ureter Treatment ngolwazi oluthe kratya).

Ukutshaya kunye nokusetyenziswa gwenxa kwamayeza athile eentlungu kunokuchaphazela umngcipheko womhlaza wesifo sezintso.

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.

Izinto ezinobungozi kumhlaza wesifo sezintso zibandakanya oku kulandelayo:

• Ukutshaya.

• Ukusetyenziswa gwenxa kwamayeza athile eentlungu, kubandakanya amayeza eentlungu athengiswayo, ixesha elide.

• Ukutyeba kakhulu.

• Ukuba noxinzelelo lwegazi.

• Ukuba nembali yosapho yomhlaza wesifo sezintso.

• Ukuba neemeko ezithile zofuzo, ezinjengesifo se-von Hippel-Lindau okanye i-papillary renal cell carcinoma.

Iimpawu zomhlaza we-renal cell zibandakanya igazi kumchamo kunye neqhuma esiswini. '

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa ngumhlaza wesifo sezintso okanye ezinye iimeko. Kungangabikho mpawu okanye zimpawu kumanqanaba okuqala. Iimpawu kunye neempawu zinokubonakala njengoko ithumba likhula. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Igazi kumchamo.

• Isigaxa esiswini.

• Intlungu esecaleni engahambiyo.

• Ukuphelelwa ngumdla wokutya.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukunqongophala kwegazi.

Uvavanyo oluvavanya isisu kunye nezintso zisetyenziselwa ukufumanisa isifo somhlaza weeseli.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali yezempilo: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kwizitho zokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Urinalysis: Uvavanyo lokujonga umbala womchamo kunye neziqulatho zawo, ezinje ngeswekile, iproteni, iiseli ezibomvu zegazi kunye neeseli ezimhlophe zegazi.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesisu kunye nesinqe, esithathwe kwiimbombo ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• 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. Ukwenza i-biopsy yomhlaza wesifo sezintso, inaliti encinci ifakwe kwisisu kwaye isampuli yethishu iyarhoxiswa.

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

Ukuxela kwangaphambili kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Inqanaba lesi sifo.

• Iminyaka yesigulana kunye nempilo ngokubanzi.

Amanqanaba omhlaza wesifo seNtsholongwane

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe isifo somhlaza wesifo sezintso, kuvavanyo lwenziwa ukufumana ukuba iiseli zomhlaza zisasazekile ngaphakathi kwezintso okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manyathelo alandelayo asetyenziselwa umhlaza wesisele sezintso:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• Umhlaza wesifo somhlaza unokuphinda ubuye (ubuye) kwiminyaka emininzi emva konyango lokuqala.

Emva kokuba kufunyaniswe isifo somhlaza wesifo sezintso, kuvavanyo lwenziwa ukufumana ukuba iiseli zomhlaza zisasazekile ngaphakathi kwezintso okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza usasazekile ngaphakathi kwezintso okanye kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa kwinkqubo yokubeka esiteji:

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesifuba okanye ingqondo, ethathwe kwiimbombo ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

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

• I-x-ray yesifuba: IX-reyi yamalungu namathambo ngaphakathi kwesifuba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• Ukuskena amathambo: Inkqubo yokujonga ukuba ngaba kukho iiseli ezahlula ngokukhawuleza, ezinje ngeeseli zomhlaza, emathanjeni. Inani elincinci kakhulu lezinto ezisasazeka ngemitha lifakwa emthanjeni kwaye lihamba ngokuhamba kwegazi. Izinto ezinemitha eqhumayo ziqokelela emathanjeni anomhlaza kwaye zifunyenwe siskena.

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 wesifo sezintso usasazeka uye emathanjeni, iiseli zomhlaza ezisethanjeni ziiseli zomhlaza zomhlaza. Esi sifo ngumhlaza wesifo se-metastatic cell, hayi umhlaza wethambo.

La manyathelo alandelayo asetyenziselwa umhlaza wesisele sezintso:

Inqanaba I

Isigaba somhlaza wezintso. Ithumba liziisentimitha ezisi-7 okanye lincinci kwaye lifumaneka kwizintso kuphela.

Kwinqanaba I, ithumba liziisentimitha ezisi-7 okanye lincinci kwaye lifumaneka kwizintso kuphela.

Inqanaba II

Isigaba II somhlaza wezintso. Ithumba likhulu kuneesentimitha ezisi-7 kwaye lifumaneka kwizintso kuphela.

Kwinqanaba II, ithumba likhulu kuneesentimitha ezisi-7 kwaye lifumaneka kwizintso kuphela.

Inqanaba III

Inqanaba lesithathu lomhlaza wezintso. Umhlaza kwizintso nabuphi na ubungakanani kwaye umhlaza usasazekile) i-lymph node ezikufutshane, b) imithambo yegazi ngaphakathi okanye kufutshane nezintso (i-renal vein okanye i-vena cava), c) ukwakheka kwezintso eziqokelela umchamo, okanye Umaleko weethishu enamafutha ejikeleze izintso.

Kwinqanaba le-III, enye yezi zinto zilandelayo ifunyenwe:

• umhlaza kwizintso nabuphi na ubungakanani kwaye umhlaza unwenwele kwii-lymph node ezikufuphi; okanye

• umhlaza usasazeke kwimithambo yegazi ngaphakathi okanye kufutshane nezintso (i-renal vein okanye i-vena cava), kumanqatha ajikeleze izakhiwo kwizintso eziqokelela umchamo, okanye kumaleko enamafutha eethoni ajikeleze izintso. Umhlaza usenokusasazeka kwii-lymph node ezikufutshane.

Inqanaba IV

Isigaba IV somhlaza wezintso. Umhlaza usasazeke a) ngaphaya komaleko weethishu ezinamafutha ejikeleze izintso kwaye inokuba isasazeke kwi-adrenal gland ngaphezulu kwezintso ezinomhlaza, okanye b) kwamanye amalungu omzimba, anje ngengqondo, imiphunga, isibindi, iadrenal gland, ithambo, okanye iindawo ezikude nkovu.

Kwinqanaba IV, enye yezi zinto zilandelayo ifunyenwe:

• umhlaza usasazeke ngaphaya kwethambo lamafutha anqumlayo kwizintso kwaye unokuthi usasazeke kwi-adrenal gland ngaphezulu kwezintso ezinomhlaza okanye kwii-lymph node ezikufutshane; okanye

• Umhlaza usasazeke kwamanye amalungu omzimba, anjengamathambo, isibindi, imiphunga, ingqondo, iadrenal gland, okanye ii-lymph node ezikude.

Umhlaza wesifo somhlaza unokuphinda ubuye (ubuye) kwiminyaka emininzi emva konyango lokuqala.

Umhlaza ungabuyela kwizintso okanye kwamanye amalungu omzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza wesifo sezintso.

• Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Unyango lwe-Immunotherapy

• Unyango ekujoliswe kulo

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lomhlaza wesifo sezintso 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 wesifo sezintso.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza wesifo sezintso. 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.

Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

Ugqirha

Ugqirha lokususa inxenye okanye zonke izintso zihlala zisetyenziselwa ukunyanga umhlaza weeseli. Ezi ndidi zilandelayo zotyando zinokusetyenziswa:

• Nephrectomy ekhethekileyo: Inkqubo yotyando yokususa umhlaza ngaphakathi kwizintso kunye nezinye izicwili ezijikeleze yona. I-nephrectomy ekhethekileyo inokwenziwa ukuthintela ukuphulukana nomsebenzi wezintso xa esinye sezintso sonakele okanye sele sisusiwe.

• I-nephrectomy elula: Inkqubo yotyando yokususa izintso kuphela.

• Radical nephrectomy: Inkqubo yotyando yokususa izintso, i-adrenal gland, izicubu ezijikelezileyo, kwaye, ngesiqhelo, ii-lymph node ezikufuphi.

Umntu unokuhlala nenxalenye yezintso ezi-1 ezisebenzayo, kodwa ukuba zombini izintso ziyasuswa okanye azisebenzi, umntu uyakufuna i-dialysis (inkqubo yokucoca igazi kusetyenziswa umatshini ongaphandle komzimba) okanye ukufakelwa kwezintso (ukubuyisela endaweni esempilweni izintso ezinikelwe). Ukufakelwa kwezintso kunokwenziwa xa isifo sikwezintso kuphela kwaye kunokufunyanwa intso. Ukuba isigulana kufuneka silinde izintso ezinikelweyo, olunye unyango luyanikwa xa kufuneka njalo.

Xa utyando lokususa umhlaza lungenakwenzeka, unyango olubizwa ngokuba yi-arterial embolization lungasetyenziselwa ukunciphisa ithumba. Kusenziwa intwana yokucheba kwaye kufakwe ipayipi (ityhubhu ebhityileyo) kulomthambo wegazi ophambili oya kwizintso. Iziqwenga ezincinci zesiponji esikhethekileyo se-gelatin zijongwa nge-catheter kwisitya segazi. Iiponji zivimba ukuhamba kwegazi kwizintso kwaye zithintela iiseli zomhlaza ekufumaneni ioksijini kunye nezinye izinto ekufuneka zikhulile.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala 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.

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 lwangaphandle lwemitha lusetyenziselwa ukunyanga umhlaza weeseli, kwaye lunokusetyenziswa njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

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 kwizintso (i-Renal Cell) Umhlaza ngolwazi oluthe kratya.

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. Olu hlobo lonyango lomhlaza lukwabizwa ngokuba yi-biotherapy okanye unyango lwe-biologic.

Ezi ndidi zilandelayo ze-immunotherapy ziyasetyenziswa kunyango lomhlaza wesifo sezintso:

• Unyango lwe-immune checkpoint inhibitor: Ezinye iintlobo zeeseli zomzimba, ezinje ngeeseli ze-T, kunye nezinye iiseli zomhlaza zineeproteni ezithile, ezibizwa ngokuba ziiprotein zokujonga, kumphezulu wazo ezigcina iimpendulo zomzimba zijongiwe. Xa iiseli zomhlaza zinezixa ezikhulu zezi proteni, aziyi kuhlaselwa zibulawe ziiseli T. Amajoni okuvavanywa kwamajoni omzimba athintela ezi proteni kwaye amandla eeseli T okubulala iiseli zomhlaza ayonyuswa. Zisetyenziselwa ukunyanga ezinye izigulana ezinomhlaza wesifo sezintso eziphambili ezingenakususwa ngotyando.

Zimbini iintlobo zonyango lwe-immune checkpoint inhibitor.

• I-CTLA-4 inhibitor: I-CTLA-4 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-CTLA-4 incamathele kwenye iprotein ebizwa ngokuba yi-B7 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. I-CTLA-4 inhibitors inamathela kwi-CTLA-4 kwaye ivumela iiseli ze-T ukuba zibulale iiseli zomhlaza. I-Ipilimumab luhlobo lwe-CTLA-4 inhibitor.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-B7-1 / B7-2 kwiiseli ezibonisa i-antigen (APC) kunye ne-CTLA-4 kwiiseli ze-T, zinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-T-cell receptor (TCR) ibophelela kwi-antigen kunye ne-histocompatibility complex (MHC) protein kwi-APC kunye ne-CD28 ebopha kwi-B7-1 / B7-2 kwi-APC, iseli ye-T inokusebenza. Nangona kunjalo, ukubopha kwe-B7-1 / B7-2 ukuya kwi-CTLA-4 kugcina iiseli ze-T zikwimeko yokungasebenzi ukuze bangakwazi ukubulala iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-B7-1 / B7-2 ukuya kwi-CTLA-4 nge-immune checkpoint inhibitor (anti-CTLA-4 antibody) ivumela iiseli ze-T ukuba zisebenze kwaye zibulale iiseli zesisu (iphaneli esekunene).

• I-PD-1 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-Nivolumab, i-pembrolizumab, kunye ne-avelumab ziindidi ze-PD-1 inhibitors.

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).

• I-Interferon: I-Interferon ichaphazela ukwahlulwa kweeseli zomhlaza kwaye inokunciphisa ukukhula kwethumba.

• I-Interleukin-2 (IL-2): I-IL-2 yonyusa ukukhula kunye nokusebenza kweeseli ezininzi zomzimba, ngakumbi ii-lymphocyte (uhlobo lweseli emhlophe yegazi). I-lymphocyte inokuhlasela kwaye ibulale iiseli zomhlaza.

Jonga iziyobisi ezivunyiweyo kwizintso (i-Renal Cell) Umhlaza ngolwazi oluthe kratya.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo lusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Unyango ekujoliswe kulo kunye neearhente ze-antiangiogenic zisetyenziselwa ukunyanga umhlaza wesifo se-renal. Iiarhente ze-antiangiogenic zigcina imithambo yegazi ingenzi ithumba, ibangele ukuba ithumba lilambe kwaye liyeke ukukhula okanye ukuncipha.

Ama-antibodies e-Monoclonal kunye ne-kinase inhibitors ziindidi ezimbini zee-antiangiogenic agents ezisetyenziselwa ukunyanga umhlaza weseli wentso.

• Unyango lwe-monoclonal antibody lusebenzisa ii-antibodies ezenziwe elebhu, ezivela kuhlobo olunye lweeseli zomzimba. Ezi antibodies zinokuchonga izinto ezikumhlaza iiseli okanye izinto eziqhelekileyo 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. Ama-antibodies e-Monoclonal asetyenziselwa ukunyanga umhlaza we-renal cell unamathele kwaye uvimbele izinto ezibangela ukuba imithambo yegazi emitsha yenze amathumba. I-Bevacizumab yi-monoclonal antibody.

• I-Kinase inhibitors iyeka iiseli ekwahlukaneni kwaye inokuthintela ukukhula kwemithambo yegazi emitsha ekufuneka ukuba amathumba akhule.

Ukukhula kwe-Vascular endothelial factor (VEGF) inhibitors kunye ne-mTOR inhibitors zii-kinase inhibitors ezisetyenziselwa ukunyanga umhlaza wesifo sezintso.

• I-VEGF inhibitors: Iiseli zomhlaza zenza into ebizwa ngokuba yi-VEGF, ebangela ukuba imithambo yegazi emitsha ibumbe (angiogenesis) kwaye incede umhlaza ukuba ukhule. I-VEGF inhibitors iyayithintela i-VEGF kwaye iyeke imithambo yegazi emitsha ukuba ingenzeki. Oku kunokubulala iiseli zomhlaza kuba zifuna imithambo yegazi emitsha ukukhula. I-Sunitinib, pazopanib, cabozantinib, axitinib, sorafenib, kunye nelenvatinib zii-VEGF inhibitors.

• I-mTOR inhibitors: i-mTOR yiprotein enceda iiseli zahlule kwaye zisinde. I-MTOR inhibitors ibhloka ye-MTOR kwaye inokugcina iiseli zomhlaza zingakhuli kwaye kuthintele ukukhula kwemithambo yegazi emitsha ekufuneka ukuba amathumba akhule. I-Everolimus kunye ne-temsirolimus zi-mTOR inhibitors.

Jonga iziyobisi ezivunyiweyo kwizintso (i-Renal Cell) Umhlaza ngolwazi oluthe kratya.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lomhlaza wesifo sezintso 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.

Unyango lweSigaba soMhlaza woMhlaza weSeli

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

Unyango lwenqanaba lomhlaza wesifo somhlaza singabandakanya oku kulandelayo:

• Utyando (i-nephrectomy egqibeleleyo, i-nephrectomy elula, okanye i-nephrectomy ekhethekileyo).

• Unyango lwe-radiation njengonyango lokuthomalalisa ukukhupha iimpawu kwizigulana ezingenakho ukwenza utyando.

• Ukudityaniswa kwearterial njengonyango lokunyanga.

• Uvavanyo lweklinikhi yonyango olutsha.

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.

Unyango lweCandelo II lomhlaza weseli yomhlaza

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

Unyango lwesigaba sesibini somhlaza wesibindi sinokubandakanya oku kulandelayo:

• Utyando (i-nephrectomy egqibeleleyo okanye i-nephrectomy ekhethekileyo).

• Utyando (nephrectomy), ngaphambi okanye emva konyango lwemitha.

• Unyango lwe-radiation njengonyango lokuthomalalisa ukukhupha iimpawu kwizigulana ezingenakho ukwenza utyando.

• Ukudityaniswa kwearterial njengonyango lokunyanga.

• Uvavanyo lweklinikhi yonyango olutsha.

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.

Unyango lweCancer III yeRenal Cell Cancer

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

Unyango lwesigaba somhlaza sesifo senqanaba lesithathu lunokubandakanya oku kulandelayo:

• Utyando (i-nephrectomy egqibeleleyo). Imithambo yegazi yezintso kunye nezinye ii-lymph node zinokususwa.

• Ukudityaniswa kwearterial kulandelwa lutyando (i-nephrectomy egqibeleleyo).

• Unyango lwe-radiation njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Ukudityaniswa kwearterial njengonyango lokunyanga.

• Utyando (nephrectomy) njengonyango lokunyanga.

• Unyango ngemitha ngaphambi okanye emva kotyando (i-nephrectomy egqibeleleyo).

• Uvavanyo lweklinikhi yonyango lwe-biologic emva kotyando.

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.

Unyango lweNqanaba IV kunye noMhlaza weSeli oPhindayo

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

Unyango lwenqanaba IV kunye nomhlaza ophindaphindiweyo wesifo somhlaza unokubandakanya oku kulandelayo:

• Utyando (i-nephrectomy egqibeleleyo).

• Utyando (nephrectomy) ukunciphisa ubungakanani beethumba.

• Unyango olujolise kuyo enye okanye ezingaphezulu kwezi zilandelayo: sorafenib, sunitinib, temsirolimus, pazopanib, everolimus, bevacizumab, axitinib, cabozantinib, okanye lenvatinib.

• I-Immunotherapy ngolunye okanye nangaphezulu koku kulandelayo: interferon, interleukin-2, nivolumab, ipilimumab, pembrolizumab, okanye avelumab.

• Unyango lwe-radiation njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

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 nomhlaza weseli yomnxeba

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nomhlaza wesifo sezintso, bona oku kulandelayo:

• Ikhasi Lasekhaya Lomhlaza Wezintso

• Iziyobisi ezivunyiweyo kwizintso (i-Renal Cell) Umhlaza

• Unyango lwe-Immunotherapy ukunyanga uMhlaza

• Iithagethi zoMhlaza ezijolise kuko

• I-Angiogenesis Inhibitors

• Uvavanyo lweMfuzo kwii-Syndromes eziSebenzayo zoMhlaza

• 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

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