Iindidi / ithishu ethambileyo-isarcoma / isigulana / unyango lwabantu abadala-ithambo-unyango-pdq

Unyango lwabadala beTisue Sarcoma Treatment (®) -iPatient Version

Ulwazi ngokubanzi malunga neTissue Sarcoma yabantu abadala

I-sarcoma yabantu abadala ethambileyo sisifo apho iiseli ezinobungozi (zomhlaza) zenza izicwili ezithambileyo zomzimba.

Izicubu ezithambileyo zomzimba zibandakanya izihlunu, imisipha (imitya yefayibha edibanisa izihlunu namathambo), amanqatha, imithambo yegazi, imithambo yegazi, imithambo-luvo, kunye nezicubu ezijikeleze amalungu. Ii-sarcomas zamathambo abantu abadala ezinqabileyo zinokwenza phantse naphi na emzimbeni, kodwa zixhaphake kakhulu entlokweni, entanyeni, ezingalweni, emilenzeni, esiqwini, esiswini, nakwi-retroperitoneum.

Iifom ze-sarcoma zeethishu ezithambileyo kwiithishu ezithambileyo zomzimba, kubandakanya izihlunu, imisipha, amanqatha, imithambo yegazi, imithambo ye-lymph, imithambo-luvo kunye nezicubu ezijikeleze amalungu.

Zininzi iintlobo zesarcoma yethishu ethambileyo. Iiseli zohlobo ngalunye lwe-sarcoma zijongeka ngokwahlukileyo phantsi kwemicroscope, ngokusekwe kuhlobo lwethishu ethambileyo apho umhlaza waqala khona.

Jonga ezi zishwankathelo zilandelayo ze- ngolwazi oluthe kratya malunga neesarcomas zethambo ezithambileyo:

• Unyango lwe-Tissue Sarcoma yoBuntwana

• Unyango lwe-Ewing Sarcoma

• Unyango lwamathumbu esisu

• Unyango lweKaposi Sarcoma

• Unyango lwesibeleko

Ukuba neengxaki ezithile ezizuzwe njengelifa kunokunyusa umngcipheko wesarcoma yabantu abadala.

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. Imiba yomngcipheko wesarcoma yethishu ethambileyo ibandakanya oku kulandelayo:

• I-Retinoblastoma.

• Uhlobo lwe-Neurofibromatosis 1 (NF1; isifo seRecklinghausen).

• Isifo sokuqina kwemithambo (isifo seBourneville).

• I-adenomatous polyposis eqhelekileyo (i-FAP; isifo sikaGardner).

• Isifo seLi-Fraumeni.

• Isifo seWerner (iprogeria yabantu abadala).

• Isifo seNevoid basal cell carcinoma syndrome (Gorlin syndrome).

Eminye imingcipheko yomzimba we-tissue sarcoma ibandakanya oku kulandelayo:

• Unyango oludlulileyo kunye nonyango lwemitha kwiicancer ezithile.

• Ukuvezwa kwimichiza ethile, enjengeThorotrast (thorium dioxide), ivinyl chloride, okanye iarsenic.

• Ukuba nokudumba (i-lymphedema) ezingalweni okanye emilenzeni ixesha elide.

Uphawu lwe-sarcoma yabantu abadala ethambileyo sisigaqa okanye ukudumba kwizihlunu ezithambileyo zomzimba.

I-sarcoma inokubonakala njengeqhuma elingenabuhlungu phantsi kolusu, rhoqo engalweni okanye emlenzeni. IiSarcomas eziqala esiswini azinakubangela

iimpawu okanye iimpawu de zibe nkulu kakhulu. Njengoko i-sarcoma ikhula ngakumbi kwaye icinezela kwizitho ezikufuphi, imithambo-luvo, izihlunu, okanye imithambo yegazi, iimpawu kunye neempawu zinokubandakanya:

• Intlungu.

• Ingxaki yokuphefumla.

Ezinye iimeko zinokubangela iimpawu kunye neempawu ezifanayo. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi ngxaki.

I-sarcoma yabantu abadala ethambileyo ifunyaniswa ine-biopsy.

Ukuba ugqirha wakho ucinga ukuba unokuba ne-sarcoma yethishu ethambileyo, kuya kwenziwa i-biopsy. Uhlobo lwe-biopsy luya kusekelwa kubungakanani be-tumor nalapho ikhoyo emzimbeni. Zintathu iintlobo zebhayoloji enokusetyenziswa:

• I-incisional biopsy: Ukususwa kwenxalenye yesigaxa okanye isampulu yethishu.

• I-biopsy engundoqo: Ukususwa kwezicubu kusetyenziswa inaliti ebanzi.

• I-biopsy ekhethekileyo: Ukususwa kwesigaxa esipheleleyo okanye indawo yeethishu engabonakali njengeqhelekileyo.

Iisampulu ziya kuthathwa kwi-tumor yokuqala, i-lymph nodes kunye nezinye iindawo ezikrokrelayo. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukukhangela iiseli zomhlaza kunye nokufumana inqanaba lethumba. Umgangatho wethumba uxhomekeke kwindlela engaqhelekanga ngayo iiseli zomhlaza ezibonakala phantsi kwemicroscope kunye nokuba iiseli zahlula ngokukhawuleza kangakanani. Izidumba ezikumgangatho ophakamileyo zihlala zikhula kwaye zisasazeka ngokukhawuleza kunakwizicwili ezikumgangatho ophantsi.

Ngenxa yokuba ithambo le-sarcoma ethambileyo kunokuba nzima ukuyixilonga, abaguli kufuneka bacele ukuba iisampulu zeethishu zihlolwe ngugqirha wezifo onamava okufumanisa isifo sarcoma.

Olu vavanyo lulandelayo lunokwenziwa kwizicubu ezazisuswe:

• I-Immunohistochemistry: Uvavanyo lwaselebhu olusebenzisa ii-antibodies ukukhangela ii-antigen ezithile (iimpawu) kwisampulu yesicwili somguli. Amachiza omzimba ahlala enxulunyaniswa ne-enzyme okanye idayi ye-fluorescent. Emva kokuba ii-antibodies zibophelela kwi-antigen ethile kwisampulu yethishu, i-enzyme okanye idayi iyasebenza, kwaye i-antigen iya kuthi emva koko ibonwe phantsi kwemicroscope. Olu hlobo lovavanyo lusetyenziselwa ukufumanisa isifo somhlaza kunye nokunceda uxelele olunye uhlobo lomhlaza kolunye uhlobo lomhlaza.

• Ukukhanya kunye ne-electron microscopy: Uvavanyo lwelabhoratri apho iiseli kwisampulu yethishu zijongwa phantsi kwemicroscopes eqhelekileyo kunye nephakamileyo ukujonga utshintsho oluthile kwiiseli.

• Uhlalutyo lweCytogenetic: Uvavanyo lwaselebhu apho ii-chromosomes zeeseli kwisampulu yethishu zibalwa kwaye zijongwa kulo naluphi na utshintsho, njengokwaphuka, ukulahleka, ukulungiswa ngokutsha, okanye ii-chromosomes ezongezelelweyo. Utshintsho kwii-chromosomes ezithile kunokuba luphawu lomhlaza. Uhlalutyo lweCytogenetic lusetyenziselwa ukunceda ekuchongeni umhlaza, ukucwangcisa unyango, okanye ukufumanisa ukuba lusebenza njani unyango.

• I-FISH (i-fluorescence in situ hybridization): Uvavanyo lwaselebhu olusetyenziselwa ukujonga nokubala ii-genes okanye ii-chromosomes kwiiseli nakwizicubu. Amacandelo e-DNA aqukethe idayi ye-fluorescent yenziwa elebhu kwaye yongezwa kwisampulu yeeseli zomguli okanye izicwili. Xa ezi ziqwenga zeDNA zidayiweyo zinamathela kwimfuza ethile okanye kwiindawo zechromosomes kwisampulu, ziyakhanya xa zijongwa phantsi kwemicroscope ebengezelayo. Uvavanyo lwe-FISH lusetyenziselwa ukunceda ekuchongeni umhlaza kunye nokunceda ekucwangciseni unyango.

• Ukuhamba kwe-cytometry: Uvavanyo lwelebhu olulinganisa inani leeseli kwisampulu, ipesenti yeeseli eziphilayo kwisampulu, kunye neempawu ezithile zeeseli, ezinje ngobungakanani, imilo, kunye nobukho beempawu zethumba (okanye ezinye) umphezulu weseli. Iiseli ezivela kwisampulu yegazi lesigulana, umongo wethambo, okanye ezinye izicwili zinamabala edayi ye-fluorescent, ibekwe kulwelo, emva koko idlulise nganye nganye kwitampu yokukhanya. Iziphumo zovavanyo zisekwe kwindlela iiseli ezazinebala ledayi ye-fluorescent zisabela njani kwimbonakalo yokukhanya.

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

Unyango kunye noqikelelo (ithuba lokufumana kwakhona) zixhomekeke koku kulandelayo:

• Uhlobo lwe-sarcoma yethishu ethambileyo.

• Ubungakanani, inqanaba, kunye nenqanaba lethumba.

• Ukukhawuleza kweeseli zomhlaza kukhula kwaye kwahlulwe.

• Apho ithumba likhona emzimbeni.

• Nokuba lonke ithumba lisuswe ngotyando.

• Iminyaka yesigulana kunye nempilo ngokubanzi.

• Nokuba umhlaza ubuyile (buyela umva).

Amanqanaba eSisue Sarcoma yabantu abadala

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe isifo, sarcoma yabantu abadala.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• Inqanaba lethumba lisetyenziselwa ukuchaza umhlaza kunye nocwangciso lonyango.

• Kwizicubu zomzimba ezithambileyo zabantu abadala, iingalo kunye nemilenze, kusetyenziswa la manqanaba alandelayo:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• Amanqanaba abantu abadala athambileyo sarcoma retroperitoneum:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• Akukho nkqubo yokumisela esemgangathweni ye-sarcoma ethambileyo yentloko, intamo, isifuba, okanye isisu.

Emva kokuba kufunyaniswe isifo, sarcoma yabantu abadala.

Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ngaphakathi kwithishu ethambileyo okanye kwamanye amalungu omzimba kuthiwa yistage. Ukufakwa kwe-sarcoma yeethishu ethambileyo ikwasekwe kwinqanaba kunye nobungakanani be-tumor, nokuba ithe yasasazeka kwii-lymph node okanye amanye amalungu omzimba. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa kwinkqubo yokubeka esiteji:

• 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.

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

• 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.

• Gcwalisa ubalo lwegazi (i-CBC): Inkqubo apho kuthathwa khona isampulu yegazi kwaye ihlolwe oku kulandelayo:

• Inani leeseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neeplatelets.

• Isixa sehemoglobin (iprotein ethwala ioksijini) kwiiseli ezibomvu zegazi.

• Inxalenye yesampulu yegazi eyenziwe ziiseli ezibomvu zegazi.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngemiphunga kunye nesisu, 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).

• 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.

Iziphumo zolu vavanyo zijongwa kunye neziphumo ze-tumor biopsy ukufumana isigaba se-sarcoma yesikhumba esithambileyo ngaphambi kokuba kunikwe unyango. Ngamanye amaxesha ichemotherapy okanye unyango ngemitha lunikezelwa njengonyango lokuqala kwaye emva koko ithambo le-sarcoma ethambileyo iphinda ibekwe kwakhona.

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 ithishu ethambileyo yesarcoma isasazeka emiphungeni, iiseli zomhlaza emiphungeni ziyiseli zeseli zethishu ezithambileyo. Esi sifo siyi-metastatic soft tissue sarcoma, hayi umhlaza wemiphunga.

Inqanaba lethumba lisetyenziselwa ukuchaza umhlaza kunye nocwangciso lonyango.

Inqanaba lethumba lichaza indlela ezingaqhelekanga ngayo iiseli zomhlaza ezibonakala phantsi kwemicroscope kunye nokuba ikhawuleze njani ukuba ikhule ize isasazeke. Ibanga eliphantsi, ibanga eliphakathi, kunye nenqanaba eliphezulu lisetyenziselwa ukuchaza i-sarcoma yethishu ethambileyo:

• Umgangatho ophantsi: Kwi-sarcoma yethishu ekumgangatho ophantsi, iiseli zomhlaza zijongeka njengeeseli eziqhelekileyo phantsi kwemicroscope kwaye zikhula kwaye zisasazeke kancinci kunaphakathi kunye naphakathi kunye nebanga eliphakamileyo le-sarcoma.

• Kwibanga eliphakathi: Kwibanga eliphakathi kwinqanaba le-tissue sarcoma, iiseli zomhlaza zijongeka zingaqhelekanga ngakumbi phantsi kwemicroscope kwaye zikhule kwaye zisasaze ngokukhawuleza ngakumbi kunakwizinga eliphantsi le-sarcoma.

• Umgangatho ophakamileyo: Kwi-sarcoma yethishu ekumgangatho ophakamileyo, iiseli zomhlaza zijongeka zingaqhelekanga ngakumbi phantsi kwemicroscope kwaye zikhula kwaye zisasaze ngokukhawuleza kunakwisigaba esisezantsi kunye naphakathi.

Kwizicubu zomzimba ezithambileyo zabantu abadala, iingalo kunye nemilenze, kusetyenziswa la manqanaba alandelayo:

Inqanaba I

Isigaba I-sarcoma yabantu abadala abathambileyo be-trunk, iingalo, kunye nemilenze yahlulwe yangamanqanaba e-IA kunye ne-IB:

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).

• Kwinqanaba le-IA, ithumba liziisentimitha ezi-5 okanye lincinci kwaye linqanaba eliphantsi okanye inqanaba alaziwa.

• Kwinqanaba IB, ithumba likhulu kuneesentimitha ezi-5 kwaye linqanaba eliphantsi okanye inqanaba alaziwa.

Inqanaba II

Kwinqanaba II i-sarcoma yabantu abadala ethambileyo yesisu, iingalo, kunye nemilenze, ithumba liziisentimitha ezi-5 okanye lincinci kwaye liphakathi kwinqanaba okanye kwinqanaba eliphezulu.

Inqanaba III

Inqanaba lesithathu le-sarcoma yabantu abadala abathambileyo be-trunk, iingalo, kunye nemilenze yahlulwe yangamanqanaba IIIA kunye ne-IIIB:

• Kwinqanaba le-IIIA, ithumba likhulu kuneesentimitha ezi-5 kodwa alikho likhulu kuneesentimitha ezili-10 kwaye liphakathi kwinqanaba okanye kwinqanaba eliphezulu.

• Kwinqanaba IIIB, ithumba likhulu kuneesentimitha ezili-10 kwaye liphakathi kwinqanaba okanye kwinqanaba eliphezulu.

Inqanaba IV

Kwinqanaba le-IV yabantu abadala i-sarcoma yesikhumba somzimba, iingalo kunye nemilenze, enye yezi zinto zilandelayo ifunyenwe:

• ithumba nabuphi na ubungakanani, naliphi na ibakala, kwaye inwenwele kwiindawo ezikufutshane; okanye

• I-tumor nayiphi na ubukhulu, nayiphi na ibakala, kwaye inokuthi isasazeke kwii-lymph node ezikufutshane. Umhlaza unwenwele nakwamanye amalungu omzimba, njengomphunga.

Amanqanaba abantu abadala athambileyo sarcoma retroperitoneum:

Inqanaba I

Isigaba I-sarcoma yabantu abadala ethambileyo ethambileyo ye-retroperitoneum yahlulwe yangamanqanaba e-IA kunye ne-IB:

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).

• Kwinqanaba le-IA, ithumba liziisentimitha ezi-5 okanye lincinci kwaye linqanaba eliphantsi okanye inqanaba alaziwa.

• Kwinqanaba IB, ithumba likhulu kuneesentimitha ezi-5 kwaye linqanaba eliphantsi okanye inqanaba alaziwa.

Inqanaba II

Kwinqanaba II i-sarcoma yabantu abadala ethambileyo yeethroperitoneum, ithumba liziisentimitha ezi-5 okanye lincinci kwaye liphakathi kwinqanaba okanye kwinqanaba eliphezulu.

Inqanaba III

Inqanaba lesithathu le-sarcoma yabantu abadala abathambile be-retroperitoneum yahlulwe yangamanqanaba e-IIIA kunye ne-IIIB:

• Kwinqanaba le-IIIA, ithumba likhulu kuneesentimitha ezi-5 kodwa alikho likhulu kuneesentimitha ezili-10 kwaye liphakathi kwinqanaba okanye kwinqanaba eliphezulu.

• Kwinqanaba IIIB, enye yezi zinto zilandelayo ifunyenwe:

• ithumba likhulu kuneesentimitha ezili-10 kwaye liphakathi kwinqanaba okanye kwinqanaba eliphezulu; okanye

• I-tumor nayiphi na ubukhulu, nayiphi na ibakala, kwaye isasazeka kwii-lymph node ezikufutshane.

Inqanaba IV

Kwinqanaba le-IV yabantu abadala abathambileyo be-sarcoma ye-retroperitoneum, ithumba nabuphi na ubungakanani, naliphi na ibakala, kwaye inokuba isasazeke kwii-lymph node ezikufutshane. Umhlaza unwenwele nakwamanye amalungu omzimba, njengomphunga.

Akukho nkqubo yokumisela esemgangathweni ye-sarcoma ethambileyo yentloko, intamo, isifuba, okanye isisu.

Ukuphindaphinda iTissue Sarcoma yabantu abadala

Isarcoma yomntu opholileyo opholileyo ngumhlaza ophindaphindiweyo (ubuyile) emva kokuba unyangiwe. Umhlaza ungabuya ubuye kwinyama efanayo ethambileyo okanye kwamanye amalungu omzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-sarcoma yabantu abadala.

• Zintathu iintlobo zonyango olusetyenziswayo:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwemichiza yengingqi

• Unyango lwe-sarcoma yabantu abadala ethambileyo inokubangela 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 ezine-sarcoma yabantu abadala.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezine-sarcoma yabantu abadala. 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.

Zintathu iintlobo zonyango olusetyenziswayo:

Ugqirha

Utyando lolona nyango luxhaphakileyo kwisarcoma yabantu abadala. Kwezinye iisarcomas zethishu ethambileyo, ukususwa kwesisu kuqhaqho inokuba kuphela kwonyango olufunekayo. Kungasetyenziswa ezi nkqubo zilandelayo:

I-Mohs microsurgery: Inkqubo apho ithumba lisikwa khona kulusu kumaleko amancinci. Ngexesha lotyando, imiphetho yethumba kunye noluhlu ngalunye lwethumba elisusiweyo lijongwa ngemicroscope ukujonga iiseli zomhlaza. Iingqimba ziyaqhubeka zisuswe kude kungabikho iiseli zomhlaza. Olu hlobo lotyando lususa izicwili ezincinci njengesiqhelo kwaye zihlala zisetyenziswa apho ukubonakala kubalulekile, njengasesikhumbeni.

Mohs. Inkqubo yotyando ukususa isilonda esibonakalayo kulusu kumanyathelo aliqela. Okokuqala, umaleko omncinci wamathambo omhlaza uyasuswa. Emva koko, umaleko wesibini weethambo uyasuswa kwaye ujongwe phantsi kwemicroscope ukukhangela iiseli zomhlaza. Amanqanaba angaphezulu asuswa ngexesha elinye de izicwili ezijongwe ngemicroscope zingabonakali umhlaza oseleyo. Olu hlobo lotyando lusetyenziselwa ukususa izicwili eziqhelekileyo kangangoko kunokwenzeka.

• Ukusasazeka ngokubanzi kwendawo: Ukususwa kwethumba kunye nezicubu eziqhelekileyo ezijikelezileyo. Kwiithumba zentloko, intamo, isisu, kunye nesiqu, kuncitshiswa izicubu eziqhelekileyo eziqhelekileyo.

• Utyando lokugcina amalungu: Ukususa ithumba engalweni okanye emlenzeni ngaphandle kokunqunyulwa, ngoko ke ukusetyenziswa kunye nokubonakala kwelungu kuyagcinwa. Unyango lwemitha okanye ichemotherapy inokunikwa kuqala ukunciphisa ithumba. I-tumor iyasuswa kwindawo ebanzi yendawo. Amathambo kunye nethambo elisusiweyo linokufakwa endaweni yegraft kusetyenziswa izicwili kunye nethambo elithathwe kwelinye ilungu lomzimba wesigulana, okanye ngokumiliselwa okufana nethambo lokuzenzela.

• Ukunqunyulwa: Utyando lokususa inxenye okanye onke amalungu okanye isihlomelo, esifana nengalo okanye umlenze. Ukunqunyulwa kunqabile ukuba kusetyenziswe ukunyanga izicubu ezithambileyo zengalo okanye umlenze.

• I-Lymphadenectomy: Inkqubo yotyando apho ii-lymph node zisuswe kwaye isampulu yethishu ihlolwe phantsi kwemicroscope ngeempawu zomhlaza. Le nkqubo ikwabizwa ngokuba yi-lymph node dissection.

Unyango ngemitha okanye ichemotherapy inokunikwa ngaphambi okanye emva kotyando ukususa ithumba. Xa unikwe ngaphambi kotyando, unyango lweradiology okanye ichemotherapy luyakwenza ithumba lincinci kwaye linciphise inani lezihlunu ekufuneka zisuswe ngexesha lotyando. Unyango olunikwa ngaphambi kotyando lubizwa ngokuba lonyango lwe-neoadjuvant. Xa unikwe emva kotyando ukususa lonke ithumba elinokubonwa, unyango ngemitha okanye ichemotherapy iya kubulala nayiphi 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. Zimbini iintlobo zonyango lwe-radiation:

• Unyango lwangaphandle lwemitha lusebenzisa umatshini ngaphandle komzimba ukuthumela imitha kumhlaza.

• Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo okanye kufutshane nomhlaza.

Unyango lwe-radiation ye-intension-modulated (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. Olu hlobo lonyango lwemitha lwangaphandle lubangela umonakalo omncinci kwizicubu ezisempilweni ezikufutshane kwaye kunqabile ukuba lubangele umlomo owomileyo, ingxaki yokuginya kunye nokonakala kolusu.

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo. Unyango lwangaphandle lwemitha kunye nonyango lwangaphakathi lwemitha lunokusetyenziselwa ukunyanga isarcoma yabantu abadala.

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

Jonga iziyobisi ezivunyiweyo zeTissue Tissue Sarcoma ngolwazi 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 lwemichiza yengingqi

Uvavanyo lwezonyango lufunda iindlela zokuphucula isiphumo se-chemotherapy kwiiseli zethumba, kubandakanya oku kulandelayo:

• Unyango lwe-hyperthermia yommandla: Unyango apho izicubu ezijikeleze ithumba zichaphazeleka kumaqondo obushushu aphezulu ukonakalisa nokubulala iiseli zomhlaza okanye ukwenza iiseli zomhlaza zibuthathaka ngakumbi kwi-chemotherapy.

• Ukuhluthwa kwamalungu: Inkqubo ethumela i-chemotherapy ngqo engalweni okanye emlenzeni apho umhlaza wenziwe khona. Ukuhamba kwegazi ukuya nokubuya kwilungu kumiswa okwexeshana ngetyelelo, kwaye amayeza e-anticancer afakwa ngqo kwigazi lelungu. Oku kuthumela idosi ephezulu yamachiza kwithumba.

Unyango lwe-sarcoma yabantu abadala ethambileyo inokubangela 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 kunyango lweTissue Sarcoma yabantu abadala

Kweli Candelo

• Isigaba I-Tissue Sarcoma yabantu abadala

• Isigaba II saBantu abaDala beTishu eSarcoma kunye neSigaba III saBantu abaDala beTisue Sarcoma esingasasazekanga kwiiLymph Node

• Isigaba III seScissue Tissue Sarcoma esiSasazeke kwiiLymph Node (eziPhambili)

• Isigaba IV seTissue Sarcoma yabantu abadala

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

Isigaba I-Tissue Sarcoma yabantu abadala

Unyango lwenqanaba I-sarcoma yethishu ethambileyo inokubandakanya oku kulandelayo:

• Utyando lokususa ithumba, njenge-Mohs microsurgery ye-sarcomas encinci yolusu, utyando lwendawo ebanzi, okanye utyando lokugcina amalungu.

• Unyango ngemitha ngaphambi kunye / okanye 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.

Isigaba II saBantu abaDala beTishu eSarcoma kunye neSigaba III saBantu abaDala beTisue Sarcoma esingasasazekanga kwiiLymph Node

Unyango lwe-sarcoma yabantu abadala abancinci kunye nenqanaba III le-sarcoma yabantu abadala abangasasazekanga kwii-lymph node banokubandakanya oku kulandelayo:

• Utyando lokususa ithumba, njengokucocwa ngokubanzi kwendawo okanye utyando lokugcina amalungu.

• Unyango ngemitha ngaphambi okanye emva kotyando.

• Unyango ngemitha okanye unyango ngamayeza ngaphambi kokuhlinzwa. Unyango ngemitha lunokunikwa emva kotyando.

• Unyango lwe-radiation ephezulu yedosi yamathumba angenakususwa ngotyando.

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.

Isigaba III seScissue Tissue Sarcoma esiSasazeke kwiiLymph Node (eziPhambili)

Unyango lwe-sarcoma yenqanaba lesithambo esidala senqanaba lesithathu eliye lasasazeka kwii-lymph node (eziphambili) zinokubandakanya oku kulandelayo:

• Utyando (ukusikwa ngokubanzi kwendawo) kunye ne-lymphadenectomy. Unyango ngemitha lunokunikwa emva kotyando.

• Uvavanyo lweklinikhi lotyando olulandelwa yichemotherapy.

• Uvavanyo lweklinikhi yonyango lwehyperthermia yommandla.

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.

Isigaba IV seTissue Sarcoma yabantu abadala

Unyango lwe-IV sarcoma yabantu abadala abathambileyo abanokubandakanya oku kulandelayo:

• Unyango ngamayeza.

• Utyando lokususa umhlaza onwenwele emiphungeni.

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 lweTissue Sarcoma yabantu abadala

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

Unyango lwe-sarcoma yabantu abadala abaphindaphindayo inokubandakanya oku kulandelayo:

• Utyando (ukusikwa okubanzi kwalapha ekhaya) kulandelwa lunyango ngemitha.

• Utyando (ukunqunyulwa, kunqabile ukwenziwa).

• Utyando lokususa umhlaza ophindaphindiweyo emiphungeni.

• Unyango ngamayeza.

• Uvavanyo lweklinikhi lokuthanjiswa kwamalungu.

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.

Ukuze ufunde okungakumbi malunga neTissue Sarcoma yabantu abadala

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nesarcomas yethishu ethambileyo, jonga oku kulandelayo:

• Iphepha lasekhaya leTissue Tissue Sarcoma

• Unyango lwe-Tissue Sarcoma yoBuntwana

• Unyango lwe-Ewing Sarcoma

• Unyango lwamathumbu esisu

• Unyango lweKaposi Sarcoma

• Unyango lwesibeleko

• Iziyobisi ezivunyiweyo zeTissue Tissue Sarcoma

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