Iindidi / i-ovari / isigulana / unyango lwe-ovarian-epithelial-pdq

I-Ovarian Epithelial, iTropopian Tube, kunye nePeritoneal Cancer Version

Ulwazi ngokubanzi malunga ne-Ovarian Epithelial, fallopian Tube, kunye nePeritoneal Cancer

IINGONGOMA EZIPHAMBILI

• Umhlaza we-Ovarian epithelial cancer, fallopian tube cancer, kunye nomhlaza wokuqala wesifo se-peritoneal zizifo apho iiseli ezinobungozi (zomhlaza) ezakha izicwili ezigubungela i-ovary okanye zibeka ityhubhu okanye iperitoneum.

• Umhlaza we-Ovarian epithelial cancer, fallopian tube cancer, kunye nepromoneal form yomhlaza oyintloko kuhlobo olunye lwethishu kwaye baphathwa ngendlela efanayo.

• Abasetyhini abanembali yosapho yomhlaza we-ovari basemngciphekweni okhulayo womhlaza we-ovari.

• Ezinye i-ovarian, i-fallopian tube, kunye ne-cancer ephambili ye-peritoneal zibangelwa kukutshintshwa kwemfuza.

• Abasetyhini abanomngcipheko okhulayo womhlaza we-ovari banokujonga utyando ukunciphisa umngcipheko.

• Iimpawu kunye neempawu zesibeleko, ityhubhu, okanye umhlaza we-peritoneal kubandakanya iintlungu okanye ukudumba esiswini.

• Uvavanyo oluvavanya ii-ovari kunye nendawo ye-pelvic zisetyenziselwa ukufumanisa (ukufumana), ukuxilonga, kunye nenqanaba le-ovari, ityhubhu ye-fallopian, kunye nomhlaza we-peritoneal.

• Izinto ezithile zichaphazela ukhetho kunyango kunye nokuxela kwangaphambili (ithuba lokuchacha).

Umhlaza we-Ovarian epithelial cancer, fallopian tube cancer, kunye nomhlaza wokuqala wesifo se-peritoneal zizifo apho iiseli ezinobungozi (zomhlaza) ezakha izicwili ezigubungela i-ovary okanye zibeka ityhubhu okanye iperitoneum.

Ii-ovari zizibini zamalungu kwinkqubo yokuzala yabasetyhini. Zikwisinqe, elinye kwicala ngalinye lesibeleko (umngxunya, ilungu elimile okwepeyari apho kukhula umbungu). Isibeleko ngasinye simalunga nobukhulu kunye nokumila kweamangile. Ama-ovari enza amaqanda kunye neehomoni zabasetyhini (iikhemikhali ezilawula indlela iiseli ezithile okanye amalungu asebenza ngayo).

Imibhobho yesibeleko sisibini seetyhubhu ezinde, ezibhityileyo, kwelinye icala lesibeleko. Amaqanda adlula kwii-ovari, edlula kwimibhobho yesibeleko, esiya esibelekweni. Umhlaza ngamanye amaxesha uqala esiphelweni setyhubhu kufutshane ne-ovary kwaye unwenwe kwi-ovary.

I-peritoneum sisihlunu esigcina udonga lwesisu kwaye sigubungele amalungu esisu. Umhlaza wokuqala wamalungu omhlaza ngumhlaza owenzeka kwi-peritoneum kwaye awusasazekanga apho usuka kwelinye ilungu lomzimba. Umhlaza ngamanye amaxesha uqala kwi-peritoneum kwaye usasazeka kwi-ovary.

I-Anatomy yenkqubo yokuzala yabasetyhini. Amalungu kwinkqubo yokuzala yabasetyhini afaka isibeleko, amaqanda, imibhobho yesibeleko, umlomo wesibeleko, kunye nelungu lobufazi. Isibeleko sinomaleko ongaphandle wemisipha obizwa ngokuba yi-myometrium kunye nelining yangaphakathi ebizwa ngokuba yi-endometrium.

Umhlaza wesifo se-Ovarian epithelial lolunye uhlobo lomhlaza ochaphazela i-ovary. Jonga ezi zishwankathelo zonyango zilandelayo ze- zolwazi malunga nezinye iintlobo zamathumba e-ovari:

• Ii-Ovarian Germ Cell Tumors

• I-Ovarian ephantsi enobungozi

• Umhlaza ongaqhelekanga woNyango lwaBantwana (umhlaza we-ovari ebantwaneni)

Umhlaza we-Ovarian epithelial cancer, fallopian tube cancer, kunye nepromoneal form yomhlaza oyintloko kuhlobo olunye lwethishu kwaye baphathwa ngendlela efanayo.

Abasetyhini abanembali yosapho yomhlaza we-ovari basemngciphekweni okhulayo womhlaza we-ovari.

Nantoni na eyandisa amathuba akho okufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha wakho ukuba ucinga ukuba usengozini yomhlaza we-ovari.

Imiba yomngcipheko womhlaza we-ovari ibandakanya oku kulandelayo:

• Imbali yosapho yomhlaza we-ovari kwisihlobo sokuqala (umama, intombi, okanye udade).

• Utshintsho olwenziwe kwi-BRCA1 okanye i-BRCA2 yemfuza.

• Ezinye iimeko zelifa, ezinje ngomhlaza welifa lomhlaza nonpolyposis (HNPCC; ekwabizwa ngokuba yiLynch syndrome).

• Endometriosis.

• Unyango lwe-Postmenopausal hormone.

• Ukutyeba kakhulu.

• Ubude obude.

Ukwaluphala yeyona nto iphambili kumngcipheko womhlaza. Ithuba lokufumana umhlaza liyonyuka njengokuba usiya ukhula.

Ezinye i-ovarian, i-fallopian tube, kunye ne-cancer ephambili ye-peritoneal zibangelwa kukutshintshwa kwemfuza.

Imfuza ekwiiseli ithwala ulwazi olufunyenwe kubazali bomntu. Umhlaza we-ovari onomdla kwi-20% yazo zonke iimeko zomhlaza we-ovari. Zintathu iipateni zofuzo: umhlaza we-ovari wedwa, umhlaza wesibeleko kunye nomhlaza webele, kunye nomhlaza we-ovari kunye nekholon.

Umhlaza wesifo se-fallopian kunye nomhlaza we-peritoneal unokubangelwa lutshintsho oluthile lofuzo.

Kukho iimvavanyo ezinokubona ukutshintsha kwemfuza. Olu vavanyo lwemfuza ngamanye amaxesha lwenziwa kumalungu eentsapho ezinomngcipheko omkhulu womhlaza. Jonga ezi zishwankathelo zilandelayo ze- ngolwazi oluthe kratya:

• I-Ovarian, iTopopian Tube, kunye nokuThintela uMhlaza wePeritoneal

• I-genetics yebele kunye ne-Gynecologic Cancers (kubaqeqeshi bezempilo)

Abasetyhini abanomngcipheko okhulayo womhlaza we-ovari banokujonga utyando ukunciphisa umngcipheko.

Abanye abantu basetyhini abanomngcipheko okhulayo womhlaza we-ovari banokukhetha ukunciphisa umngcipheko kwi-oophorectomy (ukususwa kwama-ovari asempilweni ukuze umhlaza ungakhuli kubo). Kwabasetyhini abasemngciphekweni omkhulu, le nkqubo ibonakalisiwe ukunciphisa umngcipheko womhlaza we-ovari. (Jonga isishwankathelo se- kwi-Ovarian, iTopopian Tube, kunye nokuThintela uMhlaza wePeritoneal ukuze ufumane ulwazi oluthe kratya.)

Iimpawu kunye neempawu zesibeleko, ityhubhu, okanye umhlaza we-peritoneal kubandakanya iintlungu okanye ukudumba esiswini.

I-Ovarian, ityhubhu ye-fallopian, okanye umhlaza we-peritoneal awunakubangela zimpawu zokuqala okanye iimpawu. Xa iimpawu okanye iimpawu zibonakala, umhlaza uhlala uhambela phambili. Iimpawu kunye neempawu zingabandakanya oku kulandelayo:

• Intlungu, ukudumba, okanye imvakalelo yoxinzelelo esiswini okanye kwi-pelvis.

• Ukopha kwilungu lobufazi okunzima okanye okungaqhelekanga, ngakumbi emva kokuyeka ukuya exesheni.

• Ukukhutshwa kwilungu lobufazi okucacileyo, okumhlophe, okanye umbala ngegazi.

• Iqhuma kwindawo ye-pelvic.

• Iingxaki zesisu, ezinje ngegesi, ukudumba, okanye ukuqhina.

Ezi mpawu kunye neempawu zisenokubangelwa zezinye iimeko hayi nge-ovari, ityopopian tube, okanye umhlaza we-peritoneal. Ukuba iimpawu ziya zisiba mbi okanye azihambi zodwa, jonga kugqirha wakho ukuze nayiphi na ingxaki ifunyanwe kwaye inyangwe ngokukhawuleza.

Uvavanyo oluvavanya ii-ovari kunye nendawo ye-pelvic zisetyenziselwa ukufumanisa (ukufumana), ukuxilonga, kunye nenqanaba le-ovari, ityhubhu ye-fallopian, kunye nomhlaza we-peritoneal.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziselwa ukufumanisa, ukufumanisa isifo, kunye nenqanaba le-ovari, ityhubhu ye-fallopian, kunye nomhlaza we-peritoneal:

• Uvavanyo lomzimba kunye nembali: 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 lwePelvic: Uvavanyo lwelungu lobufazi, umlomo wesibeleko, isibeleko, iityhubhu zesibeleko, ii-ovari, kunye neethanga. I-speculum ifakwe kwilungu lobufazi kwaye ugqirha okanye umongikazi ujonga kwilungu lobufazi kunye nomlomo wesibeleko ngeempawu zesifo. Uvavanyo lomlomo womlomo wesibeleko luqhele ukwenziwa. Ugqirha okanye umongikazi ukwengeza into enye okanye emibini ethanjisiweyo, iminwe egotyiweyo yesandla esinye kwilungu lobufazi aze abeke esinye isandla phezu kwesisu esisezantsi ukuva ubungakanani, imilo, kunye nokuma kwesibeleko kunye namaqanda. Ugqirha okanye umongikazi ukwangenisa umnwe othanjisiweyo, ofakwe iglavu kwi-rectum ukuze uve amaqhuma okanye iindawo ezingaqhelekanga.

Uvavanyo lwePelvic. Ugqirha okanye umongikazi ufaka i-lubricated, iiglavu zeminwe yesandla esinye kwilungu lobufazi kwaye ucinezela emazantsi esisu ngesinye isandla. Oku kwenzelwa ukuziva ubungakanani, imilo, kunye nokuma kwesibeleko kunye namaqanda. Ilungu lobufazi, umlomo wesibeleko, imibhobho yesibeleko, kunye nomqolo nawo ayajongwa.

• Uvavanyo lwe- CA 125: Uvavanyo olulinganisa inqanaba le-CA 125 egazini. I-CA 125 yinto ekhutshwa ziiseli kwigazi. Inqanaba elonyukayo le-CA 125 linokuba luphawu lomhlaza okanye enye imeko enje nge-endometriosis.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kwizitho esiswini, kwaye enza ii-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva.

I-ultrasound yesisu. I-ultrasound transducer edityaniswe kwikhompyuter idlula ngaphezulu komphezulu wesisu. I-transducer ye-ultrasound igxotha amaza esandi kumalungu angaphakathi kunye nezicubu ukwenza ii-echoes ezenza i-sonogram (umfanekiso wekhompyuter).

Ezinye izigulana zinokuba ne-transvaginal ultrasound.

I-ultrasound yangaphantsi. Inkqubo ye-ultrasound eqhagamshelwe kwikhompyuter ifakwe ngaphakathi kwilungu lobufazi kwaye ishukunyiswa ngobumnene ukubonisa amalungu ahlukeneyo. Iprojekhthi igxotha amaza esandi kumalungu angaphakathi kunye nezicubu ukwenza ii-echoes ezenza i-sonogram (umfanekiso wekhompyuter).

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezithathwe kwii-engile 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.

• Ukuskena i-PET (positron emission tomography scan) Inkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci kakhulu leswekile ye-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.

• 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).

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

• Biopsy: Ukususwa kweeseli okanye izicwili ukuze zijongwe ngemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Izicubu zihlala zisuswa ngexesha lotyando ukususa ithumba.

• Izinto ezithile zichaphazela ukhetho kunyango kunye nokuxela kwangaphambili (ithuba lokuchacha).

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Uhlobo lomhlaza wesibeleko kunye nokuba ungakanani umhlaza okhoyo.

• Inqanaba kunye nenqanaba lomhlaza.

• Nokuba isigulana sine-fluid eyongezelelweyo esiswini ebangela ukudumba.

• Nokuba lonke ithumba linokususwa ngotyando.

• Nokuba kukho utshintsho kwi-BRCA1 okanye kwi-BRCA2 yemfuza.

• Iminyaka yesigulana kunye nempilo ngokubanzi.

• Nokuba umhlaza sele ufumanekile okanye ubuyile kwakhona (buyela).

Amanqanaba e-Ovarian Epithelial, fallopian Tube, kunye nePeritoneal Cancer

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyenwe isifo se-ovarian, fallopian tube, okanye peritoneal cancer, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwii-ovari okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manqanaba alandelayo asetyenziselwa i-ovarian epithelial, ityopopian tube, kunye nomhlaza wokuqala we-peritoneal:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• I-Ovarian epithelial, ityopopu ityhubhu, kunye nomhlaza wokuqala we-peritoneal umhlaza uqokelelwe kunyango njengomhlaza kwangoko okanye phambili.

Emva kokuba kufunyenwe isifo se-ovarian, fallopian tube, okanye peritoneal cancer, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwii-ovari okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza unwenwele ngaphakathi kwilungu okanye kwamanye amalungu omzimba ubizwa ngokuba yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Iziphumo zovavanyo ezisetyenziselwa ukufumanisa umhlaza zihlala zisetyenziselwa ukubeka isifo. (Jonga icandelo loLwazi ngokubanzi malunga neemvavanyo kunye neenkqubo ezisetyenziselwa ukuxilonga kunye nenqanaba le-ovari, ityhubhu ye-fallopian kunye nomhlaza we-peritoneal.)

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 we-ovarian epithelial umhlaza usasazeka emiphungeni, iiseli zomhlaza emiphungeni ziiseli zomhlaza ze-ovarian epithelial. Esi sifo ngumhlaza we-ovarian epithelial cancer, hayi umhlaza wemiphunga.

La manqanaba alandelayo asetyenziselwa i-ovarian epithelial, ityopopian tube, kunye nomhlaza wokuqala we-peritoneal:

Inqanaba I

Kwinqanaba le-IA, umhlaza ufunyanwa ngaphakathi kwi-ovary enye okanye ityhubhu ye-fallopian. Kwinqanaba le-IB, umhlaza ufumaneka ngaphakathi kuwo omabini amaqanda okanye kwimibhobho yesibeleko. Kwinqanaba le-IC, umhlaza ufunyanwa ngaphakathi kwesinye okanye zombini ii-ovari okanye iityhubhu ze-fallopian kwaye enye yezi zinto ziyinyani: (a) i-capsule (isimbozo sangaphandle) se-ovary siphukile, (b) umhlaza ufumaneka kumphandle wangaphandle enye okanye zombini ii-ovari okanye i-fallopian tubes, okanye (c) iiseli zomhlaza zifunyenwe kwi-pelvic peritoneum.

Kwinqanaba I, umhlaza ufumaneka kwelinye okanye omabini amaqanda okanye kwimibhobho yesibeleko. Inqanaba I lahlulwe laba ligaba IA, inqanaba IB, kunye nenqanaba IC.

• Isigaba IA: Umhlaza ufunyanwa ngaphakathi kwityhubhu enye ye-ovary okanye ye-fallopian.

• Isigaba IB: Umhlaza ufumaneka ngaphakathi kuwo omabini amaqanda okanye kwimibhobho yesibeleko.

• Isigaba IC: Umhlaza ufunyanwa ngaphakathi kwenye okanye zombini ii-ovari okanye ii-fallopian tubes kwaye enye yezi zinto ziyinyani:

• umhlaza ufumaneka nakumphezulu ongaphandle wenye okanye zombini ii-ovari okanye ii-fallopian tubes; okanye

• I-capsule (isimbozo sangaphandle) se-ovary ruptured (evulekileyo) ngaphambi okanye ngexesha lotyando; okanye

• iiseli zomhlaza zifunyanwa kulwelo lwe-peritoneal cavity (umzimba) oqulethe uninzi lwamalungu esiswini) okanye ekuhlambeni i-peritoneum (izicwili ezigubungele umngxunya we-peritoneal).

Inqanaba II

Kwinqanaba IIA, umhlaza ufunyanwa kwelinye okanye zombini ii-ovari okanye i-fallopian tubes kwaye isasazeke kwisibeleko kunye / okanye kwimibhobho yesibeleko kunye / okanye kwii-ovari. Kwinqanaba le-IIB, umhlaza ufumaneka kwelinye okanye zombini amaqanda okanye kwimibhobho ye-fallopian kwaye isasazekile kwikholoni. Kumhlaza wokuqala we-peritoneal, umhlaza ufumaneka kwi-pelvic peritoneum kwaye awusasazekanga apho usuka kwelinye ilungu lomzimba.

Kwinqanaba lesibini, umhlaza ufunyanwa kwelinye okanye zombini ii-ovari okanye i-fallopian tubes kwaye isasazeke kwezinye iindawo zepelesi, okanye umhlaza wokuqala we-peritoneal ufumaneka ngaphakathi kwe-pelvis. Isigaba II se-ovarian epithelial kunye ne-fallopian tube cancers zahlulwe zangumgangatho IIA kunye nenqanaba IIB.

• Isigaba IIA: Umhlaza usasazekile ukusuka apho waqala khona ukubumba isibeleko kunye / okanye imibhobho yesibeleko kunye / okanye ii-ovari.

• Isigaba IIB: I-Cancer isasazeke kwi-ovary okanye kwi-fallopian tube ukuya kumalungu kwi-peritoneal cavity (indawo equkethe izitho zesisu).

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 III

Kwinqanaba le-III, umhlaza ufumaneka kwi-ovari enye okanye zombini, okanye ngumhlaza wokuqala we-peritoneal, kwaye usasazeke ngaphandle kwe-pelvis kwezinye iindawo zesisu kunye / okanye kwii-lymph node ezikufutshane. Inqanaba III lahlulwe laba linqanaba IIIA, inqanaba IIIB, kunye nenqanaba IIIC.

• Kwinqanaba IIIA, enye yezi zinto ziyinyani:

• Umhlaza unwenwele kwii-lymph node kwindawo engaphandle okanye ngasemva kweperitoneum kuphela; okanye

• Iiseli zomhlaza ezinokubonakala kuphela ngemicroscope zisasazekile kumphezulu we-peritoneum ngaphandle kwesinqe. Umhlaza usenokusasazeka kwii-lymph node ezikufutshane.

Kwinqanaba IIIA, umhlaza ufunyanwa kwenye okanye zombini ii-ovari okanye i-fallopian tubes kwaye (a) umhlaza usasazeke kwii-lymph node kwindawo engaphandle okanye ngasemva kwe-peritoneum kuphela, okanye (b) iiseli zomhlaza ezinokubonakala kuphela ngemicroscope isasaze kwi-omentum. Umhlaza usenokusasazeka kwii-lymph node ezikufutshane.

• Isigaba IIIB: Umhlaza usasazeke kwi-peritoneum ngaphandle kwepelvis kwaye umhlaza kwi-peritoneum ziisentimitha ezi-2 okanye zincinci. Umhlaza unokuthi usasazeke kwii-lymph node emva kweperitoneum.

Kwinqanaba IIIB, umhlaza ufunyanwa kwelinye okanye zombini ii-ovari okanye i-fallopian tubes kwaye isasazeke kwi-omentum, kwaye umhlaza kwi-omentum ziisentimitha ezi-2 okanye zincinci. Umhlaza unokuthi usasazeke kwii-lymph node emva kweperitoneum.

• Isigaba IIIC: Umhlaza usasazekile waya kwi-peritoneum ngaphandle kwesinqe kwaye umhlaza kwi-peritoneum mkhulu kune-2 cm. Umhlaza usenokusasazeka kwii-lymph node emva kwe-peritoneum okanye kumphezulu wesibindi okanye udakada.

Kwinqanaba le-IIIC, umhlaza ufunyanwa kwenye okanye zombini ii-ovari okanye kwimibhobho kwaye usasazeke kwi-omentum, kwaye umhlaza kwi-omentum mkhulu kune-2 cm. Umhlaza usenokusasazeka kwii-lymph node emva kwe-peritoneum okanye kumphezulu wesibindi okanye udakada.

Inqanaba IV

Kwinqanaba IV, umhlaza usasazeke ngaphaya kwesisu ukuya kwamanye amalungu omzimba. Kwinqanaba le-IVA, iiseli zomhlaza zifumaneka kulwelo olongezelelekileyo olwakha malunga nemiphunga. Kwinqanaba le-IVB, umhlaza usasazeke kwizitho kunye nakwizicubu ngaphandle kwesisu, kubandakanya umphunga, isibindi, ithambo, kunye ne-lymph node kwindawo yokugcuma.

Kwinqanaba IV, umhlaza usasazeke ngaphaya kwesisu ukuya kwamanye amalungu omzimba. Inqanaba IV lahlulwe laba yinqanaba le-IVA kunye nele-IVB.

• Isigaba se-IVA: Iiseli zomhlaza zifumaneka kulwelo olongezelelekileyo olwakha malunga nemiphunga.

• Isigaba IVB: I-Cancer isasazeke kwizitho kunye nezicubu ngaphandle kwesisu, kubandakanywa i-lymph nodes kwi-groin.

I-Ovarian epithelial, ityopopu ityhubhu, kunye nomhlaza wokuqala we-peritoneal umhlaza uqokelelwe kunyango njengomhlaza kwangoko okanye phambili.

Inqanaba I-ovarian epithelial kunye ne-fallopian ityhubhu yomhlaza iphathwa njengee-cancer zomqala.

Amanqanaba II, III, kunye ne-IV ovarian epithelial, ityopopi, kunye nomhlaza wokuqala we-peritoneal uphathwa njengee-cancer eziphambili.

Ukuphindaphinda okanye ukuqhubeka kwe-Ovarian Epithelial, iThubhu yeFallopian, kunye neCancer yePeritoneal yePrayimari

Umhlaza ophindayo we-ovarian epithelial, umhlaza webhubhu, okanye umhlaza wokuqala wesifo somhlaza ngumhlaza ophindaphindiweyo (ubuye) emva kokuba unyangiwe. Umhlaza ongapheliyo ngumhlaza ongahambanga nonyango.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza we-ovarian epithelial.

• Zintathu iintlobo zonyango olusetyenziswayo.

• Ugqirha

• Unyango ngamayeza

• Unyango ekujoliswe kulo

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango ngemitha

• Unyango lwe-Immunotherapy

• Unyango lwe-ovarian epithelial, ityopian tube, kunye nomhlaza wokuqala we-peritoneal unokubangela 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-ovarian epithelial.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza we-ovarian epithelial. Olunye unyango lusemgangathweni, kwaye olunye luyavavanywa 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 olusetyenziswayo njengonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni. Izigulana ezinalo naliphi na inqanaba lomhlaza we-ovari zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Zintathu iintlobo zonyango olusetyenziswayo.

Ugqirha

Uninzi lwezigulana zenziwa utyando ukuze kususwe ithumba kangangoko kunokwenzeka. Iindidi ezahlukeneyo zotyando zinokubandakanya:

• IHysterectomy: Utyando lokususa isibeleko kwaye, ngamanye amaxesha, umlomo wesibeleko. Xa kususwe isibeleko kuphela, ibizwa ngokuba yi-hysterectomy. Xa zombini isibeleko kunye nomlomo wesibeleko zisuswe, ibizwa ngokuba yi-hysterectomy iyonke. Ukuba isibeleko kunye nomlomo wesibeleko ukhutshiwe kwilungu lobufazi, utyando lubizwa ngokuba yi-hysterectomy yelungu lobufazi. Ukuba isibeleko kunye nomlomo wesibeleko ukhutshwa ngokusikwa okukhulu (okusikiweyo) esiswini, utyando lubizwa ngokuba sisisu esiswini sisonke. Ukuba isibeleko kunye nomlomo wesibeleko zithathwa ngokusikwa kancinane (okusikiweyo) esiswini kusetyenziswa i-laparoscope, utyando lubizwa ngokuba yi-laparoscopic hysterectomy iyonke.

Uhlobo lweHysterectomy. Isibeleko siyasuswa ngotyando kunye okanye ngaphandle kwamanye amalungu okanye izicwili. Kwi-hysterectomy iyonke, isibeleko kunye nomlomo wesibeleko ziyasuswa. Kwi-hysterectomy iyonke ene-salpingo-oophorectomy, (a) isibeleko kunye nesinye (unilateral) isibeleko kunye ne-fallopian tube ziyasuswa; okanye (b) isibeleko kunye (zombini) iiqanda kunye nemibhobho yesibeleko iyasuswa. Kwi-hysterectomy egqibeleleyo, isibeleko, umlomo wesibeleko, omabini amaqanda, zombini ii-fallopian tubes, kunye nezicubu ezikufutshane ziyasuswa. Ezi nkqubo zenziwa kusetyenziswa ukusika okunqamlezayo okuphantsi okanye ukusikwa okuthe nkqo.

• Unilateral salpingo-oophorectomy: Inkqubo yotyando lokususa i-ovary enye kunye netyhubhu enye ye-fallopian.

• I-Bilal salpingo-oophorectomy: Inkqubo yotyando lokususa ii-ovari kunye zombini iityhubhu ze-fallopian.

• I-Omentectomy: Inkqubo yotyando lokususa i-omentum (izicwili kwi-peritoneum equlathe imithambo yegazi, imithambo-luvo, imithambo ye-lymph, kunye ne-lymph node).

• I-lymph node biopsy: Ukususwa kwayo yonke into okanye inxalenye ye-lymph node. Ugqirha wezifo ujonga izicubu ze-lymph node phantsi kwemicroscope ukujonga iiseli zomhlaza.

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). Xa i-chemotherapy ibekwa ngqo kwi-cerebrospinal fluid, ilungu, okanye indawo yomzimba efana nesisu, iziyobisi zichaphazela kakhulu iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi).

Uhlobo lwe-chemotherapy yengingqi esetyenziselwa ukunyanga umhlaza we-ovari yi-intraperitoneal (IP) chemotherapy. Kwi-IP chemotherapy, amayeza e-anticancer aqhutywa ngokuthe ngqo kwi-peritoneal cavity (isithuba esinezitho zesisu esiswini) ngombhobho omncinci.

I-Hyperthermic intraperitoneal chemotherapy (HIPEC) lunyango olusetyenziswa ngexesha lotyando olufundelwa umhlaza we-ovari. Emva kokuba ugqirha esusile izicubu zamathumba kangangoko kunokwenzeka, i-chemotherapy eshushu ithunyelwa ngqo kwi-peritoneal cavity.

Unyango lweziyobisi ezingaphezu kwesinye lubizwa ngokuba yindibaniselwano yemichiza.

Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo.

Jonga iziyobisi ezivunyiweyo kwi-Ovarian, iTopopian Tube, okanye iPeritoneal Cancer yolwazi oluthe kratya.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo.

Unyango lwe-monoclonal antibody luhlobo lonyango ekujoliswe kulo olusebenzisa ii-antibodies ezenziwe elebhu, ukusuka 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.

I-Bevacizumab yi-monoclonal antibody enokusetyenziswa kunye ne-chemotherapy ukunyanga umhlaza we-ovarian epithelial cancer, fallopian tube cancer, okanye umhlaza wokuqala we-peritoneal umhlaza obuye wabuya (buyela).

I-Poly (ADP-ribose) i-polymerase inhibitors (i-PARP inhibitors) zijolise kunyango lwamayeza oluvimba ukulungiswa kwe-DNA kwaye kunokubangela ukuba iiseli zomhlaza zife. I-Olaparib, i-rucaparib, kunye ne-niraparib zii-PARP inhibitors ezinokuthi zisetyenziselwe ukunyanga umhlaza we-ovari. I-Rucaparib inokusetyenziselwa unyango lokunyanga umhlaza we-ovarian epithelial cancer, fallopian tube cancer, okanye umhlaza wokuqala wesifo somhlaza ophindaphindiweyo. IVeliparib yi-PARP inhibitor efundwayo ukunyanga umhlaza we-ovari ophambili.

I-Angiogenesis inhibitors ijolise kunyango lwamachiza anokuthintela ukukhula kwemithambo yegazi emitsha ekufuneka ukuba amathumba akhule kwaye anokubulala iiseli zomhlaza. I-Cediranib yi-angiogenesis inhibitor efundwayo kunyango lomhlaza ophindaphindeneyo we-ovari.

Jonga iziyobisi ezivunyiweyo kwi-Ovarian, iTopopian Tube, okanye iPeritoneal Cancer yolwazi oluthe kratya.

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 ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Abanye abantu basetyhini bafumana unyango olubizwa ngokuba yi-intraperitoneal radiation therapy, apho ulwelo olunemitha ye-radioactive lubekwa ngqo esiswini nge-catheter. Unyango lwe-Intraperitoneal radiation lufundiswa ukunyanga umhlaza we-ovari.

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 i-immunotherapy.

Unyango lwe-Vaccine lunyango lomhlaza olusebenzisa into okanye iqela lezinto ukukhuthaza amajoni omzimba ukuba afumane ithumba alibulale. Unyango lwe-Vaccine luyafundwa ukunyanga umhlaza we-ovari oqhubela phambili.

Unyango lwe-ovarian epithelial, ityopian tube, kunye nomhlaza wokuqala we-peritoneal unokubangela 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.

Ukhetho lonyango ngeSigaba

Kweli Candelo

• Umhlaza we-Ovarian Epithelial kunye ne-Fallopian Tube Cancer

• I-Ovarian Epithelial ePhambili, iThubhu yeFallopian, kunye neCancer yePeritoneal

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

Umhlaza we-Ovarian Epithelial kunye ne-Fallopian Tube Cancer

Unyango lomhlaza wokuqala we-ovarian epithelial okanye umhlaza wesifo se-fallopian tube unokubandakanya oku kulandelayo:

• I-Hysterectomy, i-salpingo-oophorectomy yamazwe amabini, kunye ne-omentectomy. Iimpawu ze-lymph kunye nezinye izicubu kwi-pelvis kunye nesisu zisuswe kwaye zihlolwe phantsi kwe-microscope yeeseli zomhlaza. I-Chemotherapy inokunikwa emva kotyando.

• Unilateral salpingo-oophorectomy inokwenziwa kwabasetyhini abathile abanqwenela ukuba nabantwana. I-Chemotherapy inokunikwa 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.

I-Ovarian Epithelial ePhambili, iThubhu yeFallopian, kunye neCancer yePeritoneal

Unyango lwe-ovarian advanced epithelial cancer, fallopian tube cancer, okanye i-peritoneal cancer yokuqala inokubandakanya oku kulandelayo:

• I-Hysterectomy, i-salpingo-oophorectomy yamazwe amabini, kunye ne-omentectomy. Iimpawu ze-lymph kunye nezinye izicubu kwi-pelvis kunye nesisu zisuswe kwaye zihlolwe phantsi kwe-microscope ukujonga iiseli zomhlaza. Ugqirha lulandelwa yenye yezi zinto zilandelayo:

• I-chemotherapy efakwa ngaphakathi.

• Unyango lwe-chemraperitoneal chemotherapy.

• I-Chemotherapy kunye nonyango ekujoliswe kulo (bevacizumab).

• I-Chemotherapy kunye nonyango ekujoliswe kulo nge-poly (ADP-ribose) polymerase (PARP) inhibitor.

• I-Chemotherapy elandelwa luqhaqho (mhlawumbi lulandelwe yi-intraperitoneal chemotherapy).

• I-Chemotherapy yodwa kwizigulana ezingenakho ukwenza utyando.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo nge-PARP inhibitor (olaparib, rucaparib, niraparib, okanye veliparib).

• Uvavanyo lweklinikhi lwe-hyperthermic intraperitoneal chemotherapy (HIPEC) ngexesha lotyando.

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.

Ukhetho kunyango lwe-Ovarian Epithelial, iTopopian Tube, kunye nePeritoneal Cancer

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

Unyango lomhlaza ophindayo we-ovarian epithelial, umhlaza webhubhu yomhlaza, okanye umhlaza wokuqala we-peritoneal unokubandakanya oku kulandelayo:

• Chemotherapy usebenzisa ichiza elinye okanye nangaphezulu.

• Unyango olujolise kwi-poly (ADP-ribose) polymerase (PARP) inhibitor (olaparib, rucaparib, niraparib, okanye cediranib) kunye okanye ngaphandle kwe-chemotherapy.

• I-Chemotherapy kunye / okanye unyango olujolisiweyo (bevacizumab).

• Uvavanyo lweklinikhi lwe-hyperthermic intraperitoneal chemotherapy (HIPEC) ngexesha lotyando.

• 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.

Ukufunda ngakumbi malunga ne-Ovarian Epithelial, iTropopian Tube, kunye nePeritoneal Cancer

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga ne-ovarian epithelial, ityopopian tube, kunye nomhlaza wokuqala wesifo somhlaza, bona oku kulandelayo:

• I-Ovarian, iTyhubhu yeFallopian, kunye neKhaya laseKhaya lePeritoneal Cancer

• I-Ovarian, iTopopian Tube, kunye nokuThintela uMhlaza wePeritoneal

• I-Ovarian, iTyhubhu yeFallopian, kunye nokuPhononongwa kweCancer yePeritoneal

• Umhlaza ongaqhelekanga woNyango lwaBantwana

• Iziyobisi ezivunyiweyo kwi-Ovarian, Tube ye-fallopian, okanye iPeritoneal Cancer

• Iithagethi zoMhlaza ezijolise kuko

• Utshintsho lwe-BRCA: Umngcipheko woMhlaza kunye novavanyo lweMfuzo

• Uvavanyo lweMfuzo kwii-Syndromes eziSebenzayo zoMhlaza

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