Iindidi / idlala lengqula / isigulana / unyango lwe-thyroid-pdq
Unyango lweCancer ye-Thyroid (yabantu abadala) (®) -Patient Version
Ulwazi ngokubanzi malunga nomhlaza wedlala lengqula
IINGONGOMA EZIPHAMBILI
- Umhlaza wamadlala sisifo apho iiseli ezibi (zomhlaza) zeeseli zivela kwinyama yedlala lengqula.
- Amaqhuqhuva e-thyroid aqhelekile kodwa ngesiqhelo awunguwo umhlaza.
- Kukho iintlobo ezahlukeneyo zomhlaza wedlala lengqula.
- Ubudala, isini, kunye nokuvezwa kwimitha kunokuchaphazela umngcipheko womhlaza wedlala lengqula.
- Umhlaza wesifo se-thyroid ngamanye amaxesha ubangelwa lutshintsho kwimfuza edluliselwa ukusuka kumzali kuye emntwaneni.
- Iimpawu zomhlaza wedlala lengqula zibandakanya ukudumba okanye iqhuma entanyeni.
- Uvavanyo oluvavanya idlala lengqula, intamo, kunye negazi zisetyenziselwa ukukhangela (ukufumanisa) kunye nokufumanisa umhlaza wedlala lengqula.
- Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.
Umhlaza wamadlala sisifo apho iiseli ezibi (zomhlaza) zeeseli zivela kwinyama yedlala lengqula.
Idlala lengqula lisisiqalo somqala kufutshane netrachea (umbhobho womoya). Imile okwebhabhathane, ine-lobe yasekunene kunye ne-lobe yasekhohlo. Esi siqwenga somzimba, licwecwana elicekethekileyo lesicwili, elidibanisa ii-lobes ezimbini. Idlala lengqula elinempilo likhulu kancinane kwikota. Ngokwesiqhelo ayinakuva ngesikhumba.
Idlala lengqula lisebenzisa iodine, ityuwa efumaneka kokutya nakwityiwa ene-iodized, ukunceda ukwenza iihomoni ezininzi. Iihomoni zedlala lenza oku kulandelayo:
- Lawula izinga lokubetha kwentliziyo, ubushushu bomzimba, kunye nendlela ukutya okukhawuleza kuguqulwe ngayo kube ngamandla (imetabolism).
- Lawula inani lecalcium egazini.
Amaqhuqhuva e-thyroid aqhelekile kodwa ngesiqhelo awunguwo umhlaza.
Ugqirha wakho unokufumana igaqa (nodule) kwi-thyroid yakho ngexesha lovavanyo oluqhelekileyo lonyango. I-nodule ye-thyroid kukukhula okungaqhelekanga kweeseli ze-thyroid kwi-thyroid. Amaqhuqhuva anokuqina okanye agcwalise ulwelo.
Xa kufunyenwe i-nodule ye-thyroid, i-ultrasound ye-thyroid kunye ne-needle-aspiration aspiration biopsy zihlala zenziwa ukujonga iimpawu zomhlaza. Uvavanyo lwegazi ukujonga amanqanaba ehomoni ye-thyroid kunye ne-antithyroid antibodies egazini kungenziwa kwakhona ukujonga ezinye iintlobo zesifo se-thyroid.
Amaqhuqhuva e-thyroid awanakubangela zimpawu okanye afune unyango. Ngamanye amaxesha amaqhuqhuva edlala lengqula aba makhulu ngokwaneleyo ukuba kunzima ukuginya okanye ukuphefumla kwaye kufuneka iimvavanyo nonyango ngakumbi. Liqaqobana nje lamaqhuqhuva e-thyroid afunyaniswa njengomhlaza.
Kukho iintlobo ezahlukeneyo zomhlaza wedlala lengqula.
Umhlaza we-thyroid ungachazwa nokuba:
- Ukwahlula umdlavuza we-thyroid, obandakanya izicubu ezihluke kakuhle, izicubu ezihluke kakuhle, kunye nezidumbu ezingafaniyo; okanye
- Umhlaza womhlaza wamadlala.
Amathumba ahluke kakuhle (umhlaza wamaphepha omhlaza kunye nomhlaza wedlala lengqula) unokunyangwa kwaye unokunyanga.
Amathumba ahlukileyo ngokungafaniyo kunye nokungafaniyo (umhlaza we-thyroid umhlaza) aqhelekanga. Ezi tumors zikhula kwaye zisasazeka ngokukhawuleza kwaye zinamathuba ahluphekayo okuchacha. Izigulana ezinomhlaza wedlala lengqula kufuneka zibe novavanyo lweemolekyuli zotshintsho kuhlobo lwe-BRAF.
Umhlaza we-Medullary thyroid ngumhlaza we-neuroendocrine okhula kwiiseli ze-C ze-thyroid. Iiseli C zenza ihomoni (calcitonin) enceda ukugcina inqanaba lempilo yecalcium egazini.
Jonga isishwankathelo se- soNyango lweCancer ye-Thyroid yoNyango ngolwazi malunga nomhlaza we-thyroid.
Ubudala, isini, kunye nokuvezwa kwimitha kunokuchaphazela umngcipheko womhlaza wedlala lengqula.
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.
Imingcipheko yomhlaza wedlala lengqula ibandakanya oku kulandelayo:
- Ukuba phakathi kwama-25 nama-65 eminyaka ubudala.
- Ukuba ngumfazi.
- Ukuvezwa kwimitha entlokweni nasentanyeni njengosana okanye umntwana okanye ukuvezwa kukuwa kwemitha. Umhlaza ungenzeka kwakamsinya kwiminyaka emihlanu emva kokuvezwa.
- Ukuba nembali ye-goiter (eyandisiweyo ye-thyroid).
- Ukuba nembali yosapho yesifo se-thyroid okanye umhlaza we-thyroid.
- Ukuba neemeko ezithile zofuzo ezinje ngomhlaza we-medullary cancer cancer (FMTC), endocrine neoplasia type 2A syndrome (MEN2A), okanye multiple endocrine neoplasia type 2B syndrome (MEN2B).
- Ukuba ngumAsia.
Umhlaza wesifo se-thyroid ngamanye amaxesha ubangelwa lutshintsho kwimfuza edluliselwa ukusuka kumzali kuye emntwaneni.
Imfuza ekwiiseli ithwala ulwazi oluvela kubazali luye emntwaneni. Utshintsho oluthile kuhlobo lwe-RET oludluliselwa kumzali luye emntwaneni (njengelifa) kunokubangela umhlaza wedlala yamadlala.
Kukho uvavanyo lofuzo olusetyenziselwa ukukhangela ukutshintsha kwemfuza. Isigulana sivavanywa kuqala ukubona ukuba sinalo na uhlobo olutshintshileyo. Ukuba isiguli sinayo, amanye amalungu osapho anokuvavanywa ukufumanisa ukuba ngaba basemngciphekweni wokuba nomhlaza wedlala lengqula. Amalungu osapho, kubandakanya nabantwana abancinci, abanenguqu eguqulweyo banokuba ne-thyroidectomy (utyando lokususa idlala lengqula). Oku kunganciphisa ithuba lokuphuhlisa umhlaza we-thyroid.
Iimpawu zomhlaza wedlala lengqula zibandakanya ukudumba okanye iqhuma entanyeni.
Umhlaza wedlala lengqula awunakubangela zimpawu zokuqala okanye iimpawu. Ngamanye amaxesha kufunyanwa ngexesha lovavanyo lomzimba oluqhelekileyo. Iimpawu okanye iimpawu zinokwenzeka njengoko ithumba likhula. Ezinye iimeko zinokubangela iimpawu okanye iimpawu ezifanayo. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:
- Isigaqa (iqhuqhuva) entanyeni.
- Ingxaki yokuphefumla.
- Ingxaki yokuginya.
- Intlungu xa uginya.
- Ukurhabaxa.
Uvavanyo oluvavanya idlala lengqula, intamo, kunye negazi zisetyenziselwa ukukhangela (ukufumanisa) kunye nokufumanisa umhlaza wedlala lengqula.
Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:
- Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma (amaqhuqhuva) okanye ukudumba entanyeni, kwibhokisi yelizwi, nakwindawo ezinesibindi, nayo nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.
- I-Laryngoscopy: Inkqubo apho ugqirha ejonga khona i-larynx (ibhokisi yelizwi) ngesipili okanye nge-laryngoscope. I-laryngoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. I-tumor ye-thyroid ingacinezela kwiintambo zezwi. I-laryngoscopy yenziwa ukubona ukuba ngaba iintambo zezwi zihamba ngesiqhelo.
- Izifundo zehomoni yegazi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zehomoni ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lexabiso linokuba luphawu lwesifo kwilungu okanye kwithishu eyenzayo. Igazi linokujongwa kumanqanaba angaqhelekanga e-thyroid-stimulating hormone (TSH). I-TSH yenziwa yidlala yebhinqa kwingqondo. Ikhuthaza ukukhutshwa kwehomoni yedlala lengqula kunye nolawulo lokukhula ngokukhawuleza kweeseli ze-thyroid. Igazi linokujongwa kwakhona kumanqanaba aphezulu ehomoni ye-calcitonin kunye ne-antithyroid antibodies.
- Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinje ngecalcium, ekhutshelwa egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.
- Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kumalungu entanyeni kwaye enze i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva. Le nkqubo inokubonisa ubungakanani be-thyroid nodule nokuba iqinile okanye i-cyst egcwele i-fluid. I-Ultrasound ingasetyenziselwa ukukhokela i-biopsy ye-aspiration aspiration.
- Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjengentamo, ethathwe kwiiangile 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-biopsy ye-aspiration-aspiration ye-thyroid: Ukususwa kwezicubu ze-thyroid usebenzisa inaliti encinci. Inaliti ifakwa kulusu kwi-thyroid. Iisampulu zamathishu ezininzi zisuswe kwiindawo ezahlukeneyo ze-thyroid Ugqirha wezifo ujonga iisampulu zethishu phantsi kwemicroscope ukukhangela iiseli zomhlaza. Ngenxa yokuba uhlobo lomhlaza wedlala lengqula lunokuba nzima ukuluchonga, abaguli kufuneka bacele ukuba iisampulu ze-biopsy zihlolwe ngugqirha wezifo onamava okufumanisa umhlaza wedlala lengqula.
- Utyando lwe-biopsy: Ukususwa kwe-thyroid nodule okanye i-lobe enye ye-thyroid ngexesha lotyando ukuze iiseli kunye nezicubu zijongwe phantsi kwemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Ngenxa yokuba uhlobo lomhlaza wedlala lengqula lunokuba nzima ukuluchonga, abaguli kufuneka bacele ukuba iisampulu ze-biopsy zihlolwe ngugqirha wezifo onamava okufumanisa umhlaza wedlala lengqula.
Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.
Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango luxhomekeke koku kulandelayo:
- Ubudala besigulana ngexesha lokuchongwa.
- Uhlobo lomhlaza wedlala lengqula.
- Inqanaba lomhlaza.
- Nokuba umhlaza ususwe ngokupheleleyo ngoqhaqho.
- Nokuba isigulana sine-endocrine neoplasia yohlobo lwe-2B (MEN 2B).
- Impilo yomguli ngokubanzi.
- Nokuba umhlaza sele ufumanekile okanye ubuyile kwakhona (buyela).
Amanqanaba omhlaza wedlala lengqula
IINGONGOMA EZIPHAMBILI
- Emva kokuba kufunyaniswe umhlaza wedlala lengqula, kuvavanyo kuyenziwa ukufumanisa ukuba iiseli zomhlaza zisasazekile ngaphakathi kwidlala lengqula okanye kwamanye amalungu omzimba.
- Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.
- Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.
- Amanqanaba asetyenziselwa ukuchaza umhlaza we-thyroid ngokusekelwe kuhlobo lomhlaza we-thyroid kunye nobudala besigulane:
- Umhlaza wephepha kunye nomhlaza wedlala lengqula kwizigulana ezingaphantsi kweminyaka engama-55
- Umhlaza wephepha kunye nomhlaza wedlala lengqula kwizigulana ezineminyaka engama-55 nangaphezulu
- Umhlaza wedlala lengqula kwizigulana ezineminyaka yonke
- Umhlaza womhlaza wamadlala kwizigulana ezikwiminyaka yonke
Emva kokuba kufunyaniswe umhlaza wedlala lengqula, kuvavanyo kuyenziwa ukufumanisa ukuba iiseli zomhlaza zisasazekile ngaphakathi kwidlala lengqula okanye kwamanye amalungu omzimba.
Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ngaphakathi kwe-thyroid okanye kwezinye iindawo zomzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukuba wazi ubudala besigulana kunye nenqanaba lomhlaza ukucwangcisa 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, isisu, nengqondo, ezithathwe kwiindawo 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.
- 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. Umfanekiso unokuprintwa ukuze ujongwe kamva.
- 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.
- I-Sentinel lymph node biopsy: Ukususwa kwe-sentinel lymph node ngexesha lotyando. I-lymph node ye-sentinel yindawo yokuqala ye-lymph kwiqela le-lymph node ukufumana i-lymphatic drainage kwi-tumor yokuqala. Yeyona nkovu node yokuqala ukuba umhlaza kunokwenzeka ukuba usasazeke ukusuka kwithumba lokuqala. Into ene-radioactive kunye / okanye idayi eblowu ifakwe kwisitofu kufutshane nethumba. Isixhobo okanye idayi ihamba ngee-lymph ducts ukuya kwii-lymph nodes. I-lymph node yokuqala yokufumana into okanye idayi isuswe. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukukhangela iiseli zomhlaza. Ukuba iiseli zomhlaza azifumaneki, kusenokungabikho mfuneko yokususa ii-lymph node.
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 wedlala lengqula usasazeka ukuya emiphungeni, iiseli zomhlaza emiphungeni ziyiseli zomhlaza wedlala lengqula. Esi sifo ngumhlaza wedlala lengqula, hayi umhlaza wemiphunga.
Amanqanaba asetyenziselwa ukuchaza umhlaza we-thyroid ngokusekelwe kuhlobo lomhlaza we-thyroid kunye nobudala besigulane:
Umhlaza wephepha kunye nomhlaza wedlala lengqula kwizigulana ezingaphantsi kweminyaka engama-55
- Isigaba I: Kwinqanaba I-papillary kunye ne-follicular cancer ye-thyroid, i-tumor nayiphi na ubukhulu kwaye inokuthi isasazeke kwizicubu ezikufutshane kunye ne-lymph nodes. Umhlaza awusasazekanga kwamanye amalungu omzimba.
- Isigaba II: Kwinqanaba II umhlaza wephepha kunye nomhlaza womhlaza we-thyroid, i-tumor nayiphi na ubukhulu kunye nomhlaza unokusasazeka kwizicubu ezikufutshane kunye ne-lymph nodes. Umhlaza usasazekile usuka kwidlala lengqula uye kwamanye amalungu omzimba, anje ngemiphunga okanye amathambo.
Umhlaza wephepha kunye nomhlaza wedlala lengqula kwizigulana ezineminyaka engama-55 nangaphezulu
- Isigaba I: Kwinqanaba I-papillary kunye ne-follicular cancer ye-thyroid, umhlaza ufumaneka kwi-thyroid kuphela kwaye i-tumor i-4 centimeters okanye encinci.
- Isigaba II: Kwinqanaba lesibini lomhlaza wephepha kunye nomhlaza wesifo somhlaza, enye yezi zinto zilandelayo ifunyenwe:
- umhlaza ufumaneka kwi-thyroid kwaye i-tumor i-4 centimeters okanye encinci; umhlaza unwenwele kwii-lymph node ezikufutshane; okanye
- umhlaza ufumaneka kwidlala lengqula, ithumba likhulu kuneesentimitha ezi-4, kwaye umhlaza usenokunwenwela kwii-lymph node ezikufuphi; okanye
- ithumba nabuphi na ubungakanani kwaye umhlaza usasazekile usuka kwidlala lengqula uye kwimisipha ekufuphi entanyeni kwaye inokuthi isasazeke kwii-lymph node ezikufutshane.
- Isigaba III: Kwinqanaba III papillary kunye nomhlaza wesifo somhlaza, ithumba nayiphi na ubungakanani kwaye umhlaza usasazekile ukusuka kwidlala lengqula ukuya kwinyama ethambileyo phantsi kolusu, umqala, itrachea, ingqula, okanye imithambo-luvo ephindaphindayo yelungu kwingqula). Umhlaza unokusasazeka kwii-lymph node.
- Inqanaba IV: Inqanaba IV papillary kunye nomhlaza womhlaza we-thyroid wahlulwe ngokwamanqanaba e-IVA kunye ne-IVB.
- Kwinqanaba le-IVA, ithumba nabuphi na ubungakanani kwaye umhlaza usasazeke kwiithishu phambi komqolo okanye ujikeleze umthambo we-carotid okanye imithambo yegazi kwindawo ephakathi kwemiphunga. Umhlaza unokusasazeka kwii-lymph node.
- Kwinqanaba le-IVB, ithumba nabuphi na ubungakanani kwaye umhlaza usasazeke kwamanye amalungu omzimba, anje ngemiphunga okanye amathambo. Umhlaza unokusasazeka kwii-lymph node.
Umhlaza wedlala lengqula kwizigulana ezineminyaka yonke
Anaplastic umhlaza wedlala lengqula ukhula ngokukhawuleza kwaye uhlala usasazeka ngaphakathi entanyeni xa ufumaneka. Umhlaza wegciwane le-thyroid uthathwa njengowomhlaza we-thyroid. Isigaba IV somhlaza we-thyroid umhlaza uhlukaniswe ngamanqanaba e-IVA, IVB, kunye ne-IVC.
- Kwinqanaba le-IVA, umhlaza ufumaneka kwi-thyroid kuphela kwaye i-tumor ingaba nayiphi na ubukhulu.
- Kwinqanaba le-IVB, enye yezi zinto zilandelayo ifunyenwe:
- umhlaza ufumaneka kwi-thyroid kwaye i-tumor ingaba nayiphi na ubukhulu; umhlaza unwenwele kwii-lymph node ezikufutshane; okanye
- ithumba nabuphi na ubungakanani kwaye umhlaza usasazekile ukusuka kwidlala lengqula ukuya kwezihlunu ezikufuphi entanyeni kwaye inokuba isasazeke kwii-lymph node ezikufuphi; okanye
- ithumba nabuphi na ubungakanani kwaye umhlaza usasazekile ukusuka kwidlala lengqula ukuya kwizihlunu ezithambileyo phantsi kolusu, umqala, itrachea, ingqula, imithambo-luvo ephindaphindayo yelungu (umthambo oya kwilarynx), okanye ithishu phambi komqolo, okanye ungqonge umthambo we-carotid okanye imithambo yegazi kwindawo ephakathi kwemiphunga; umhlaza unokusasazeka kwii-lymph node.
- Kwinqanaba le-IVC, ithumba nabuphi na ubungakanani kwaye umhlaza usasazeke kwamanye amalungu omzimba, njengemiphunga okanye amathambo. Umhlaza unokusasazeka kwii-lymph node.
Umhlaza womhlaza wamadlala kwizigulana ezikwiminyaka yonke
- Isigaba I: Kwinqanaba I medullary umhlaza we-thyroid, umhlaza ufumaneka kwi-thyroid kuphela kwaye i-tumor i-2 centimeters okanye encinci.
- Isigaba II: Kwinqanaba II umhlaza we-thyroid umhlaza, enye yezi zinto zilandelayo zifunyenwe:
- umhlaza ukwidlala lengqula kuphela kwaye ithumba likhulu kuneesentimitha ezi-2; okanye
- Ithumba nabuphi na ubungakanani kwaye umhlaza usasazekile ukusuka kwidlala lengqula ukuya kwimisipha ekufuphi entanyeni.
- Isigaba III: Kwinqanaba le-III umhlaza womhlaza we-thyroid, i-tumor nayiphi na ubukhulu kunye nomhlaza usenokusasazeka kwi-thyroid ukuya kwiimisipha eziseduze entanyeni. Umhlaza unwenwele kwii-lymph node kwelinye okanye kumacala omabini etrachea okanye kwingqula.
- Isigaba IV: Isigaba se-IV somhlaza we-thyroid umhlaza uhlukaniswe ngamanqanaba e-IVA, IVB kunye ne-IVC.
- Kwinqanaba le-IVA, enye yezi zinto zilandelayo iyafumaneka:
- ithumba nabuphi na ubungakanani kwaye umhlaza usasazekile ukusuka kwidlala lengqula ukuya kwizihlunu ezithambileyo phantsi kolusu, umqala, itrachea, ingqula, okanye imithambo-luvo ephindaphindayo yomqala (imithambo-luvo eya kwingqula); umhlaza unokusasazeka kwii-lymph node kwelinye okanye kumacala omabini entamo; okanye
- ithumba nabuphi na ubungakanani kwaye umhlaza usenokusasazeka ukusuka kwidlala lengqula ukuya kwezihlunu ezikufutshane entanyeni; umhlaza usasazeke kwii-lymph node kwelinye okanye kumacala omabini entamo.
- Kwinqanaba le-IVB, ithumba nabuphi na ubungakanani kwaye umhlaza usasazeke kwizicwili phambi komqolo okanye kumqolo okanye ujikeleze umthambo we-carotid okanye imithambo yegazi kwindawo ephakathi kwemiphunga. Umhlaza unokusasazeka kwii-lymph node.
- Kwinqanaba le-IVC, ithumba nabuphi na ubungakanani kwaye umhlaza usasazeke kwamanye amalungu omzimba, anje ngemiphunga okanye isibindi. Umhlaza unokusasazeka kwii-lymph node.
Umhlaza weTyroid oqhelekileyo
Umhlaza we-thyroid ophindaphindiweyo ngumhlaza oye wabuya (ubuye) emva kokuba unyangiwe. Umhlaza wedlala lengqula ungabuyela kwi-thyroid okanye kwamanye amalungu omzimba.
Unyango ngoKhetho lonyango
IINGONGOMA EZIPHAMBILI
- Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza wedlala lengqula.
- Iindidi ezintandathu zonyango zisetyenziswa:
- Ugqirha
- Unyango lwe-radiation, kubandakanya unyango lwe-iodine radioactive
- Unyango ngamayeza
- Unyango lwehormone
- Unyango ekujoliswe kulo
- Ukulinda ulindile
- Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.
- Unyango lwe-Immunotherapy
- Unyango lomhlaza wedlala lengqula 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 wedlala lengqula.
Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza wedlala lengqula. 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 ezintandathu zonyango zisetyenziswa:
Ugqirha
Utyando lolona nyango luqhelekileyo kumhlaza wedlala lengqula. Enye yezi nkqubo inokusetyenziswa:
- I-Lobectomy: Ukususwa kwe-lobe apho umhlaza we-thyroid ufumaneka khona. Iimpawu ze-lymph ezikufutshane nomhlaza zingasuswa kwaye zihlolwe phantsi kwe-microscope kwiimpawu zomhlaza.
- Phantse i-thyroidectomy iyonke: Ukususwa kwazo zonke kodwa kuyinxalenye encinci ye-thyroid. Iimpawu ze-lymph ezikufutshane nomhlaza zingasuswa kwaye zihlolwe phantsi kwe-microscope kwiimpawu zomhlaza.
- Iyonke i-thyroidectomy: Ukususwa kwe-thyroid yonke. Iimpawu ze-lymph ezikufutshane nomhlaza zingasuswa kwaye zihlolwe phantsi kwe-microscope kwiimpawu zomhlaza.
- I-Tracheostomy: Utyando lokwenza ukuvula (stoma) kumbhobho womoya ukukunceda uphefumle. Ukuvulwa ngokwako kungabizwa ngokuba yi-tracheostomy.
Unyango lwe-radiation, kubandakanya unyango lwe-iodine radioactive
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. Ngamanye amaxesha i-radiation ijolise ngqo kwi-tumor ngexesha lotyando. Oku kubizwa ngokuba lonyango lwe-radiation ye-intraoperative.
- Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo okanye kufutshane nomhlaza.
Unyango lwe-radiation lunokunikwa emva kotyando ukubulala nayiphi na iiseli zomhlaza we-thyroid ezingakhange zisuswe. Umhlaza wesifo somhlaza kunye nepapillary somhlaza ngamanye amaxesha uphathwa ngonyango lwe-iodine (RAI). I-RAI ithathwa ngomlomo kwaye iqokelelwe nakweyiphi na inyama eseleyo ye-thyroid, kubandakanya iiseli zomhlaza wedlala lengqula ethe yanwenwela kwezinye iindawo emzimbeni. Kuba ziiseli zedlala kuphela ezithatha iodine, iRAI itshabalalisa izicwili kunye nomhlaza wamadlala ngaphandle kokulimaza ezinye izicwili. Phambi kokuba kunikwe idosi yonyango epheleleyo ye-RAI, kunikwa idosi encinci yokuvavanya ukuba ngaba eli thumba lithatha iodine kusini na.
Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo. Unyango lwangaphandle lwemitha kunye nonyango lwe-radioactive iodine (RAI) lusetyenziselwa ukunyanga umhlaza wedlala lengqula.
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).
Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo.
Jonga iziyobisi ezivunyiweyo zeCancer ye-Thyroid ngolwazi olungakumbi.
Unyango lwehormone
Unyango lweHormone lunyango lomhlaza olususa iincindi zamadlala okanye ibhlokhe isenzo sabo kwaye luyekise iiseli zomhlaza ekukhuleni. IiHormone zizinto ezenziwe ngamadlala emzimbeni kwaye zijikelezwa kwigazi. Xa kunyangwa umhlaza wedlala lengqula, kunokunikwa iziyobisi ukuthintela umzimba ekwenzeni i-hormone ekhuthaza idlala lengqula (i-TSH), ihomoni enokunyusa amathuba okuba umhlaza we-thyroid ukhule okanye uphinde ubuye.
Kwakhona, ngenxa yokuba unyango lomhlaza we-thyroid lubulala iiseli ze-thyroid, i-thyroid ayikwazi ukwenza i-hormone ye-thyroid eyaneleyo. Izigulana zinikwa iipilisi zokutshintsha kwehomoni yedlala lengqula.
Unyango ekujoliswe kulo
Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Kukho iintlobo ezahlukeneyo zonyango olujolisiweyo:
- Ityrosine kinase inhibitor. Unyango lweTyrosine kinase inhibitor thintela imiqondiso efunekayo ukuze kukhule amathumba. I-Sorafenib, i-lenvatinib, i-vandetanib, kunye ne-cabozantinib zisetyenziselwa ukunyanga iintlobo ezithile zomhlaza we-thyroid. Iindidi ezintsha ze-tyrosine kinase inhibitors ziyafundwa ukunyanga umhlaza we-thyroid.
- Iprotein kinase inhibitor. Iprotein kinase inhibitor yonyango ithintela iiprotein ezifunekayo ekukhuleni kweseli kwaye zinokubulala iiseli zomhlaza. I-Dabrafenib kunye ne-trametinib zisetyenziselwa ukunyanga i-anaplastic cancer ye-thyroid kwizigulana ezinokutshintsha okuthile kuhlobo lwe-BRAF.
Jonga iziyobisi ezivunyiweyo zeCancer ye-Thyroid ngolwazi olungakumbi.
Ukulinda ulindile
Ukuhlala ulindile kubeka esweni imeko yesigulana ngaphandle kokunikezela ngonyango de kuvele iimpawu okanye utshintsho.
Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.
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. I-Immunotherapy ifundwa njengonyango lomhlaza wedlala lengqula.
Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.
Unyango lomhlaza wedlala lengqula 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.
Ukhetho lonyango ngeSigaba
Kweli Candelo
- Amanqanaba I, II, kunye no-III Papillary kunye ne-Follicular Cancer Cancer (yeNdawo / yeNgingqi)
- Inqanaba IV Papillary kunye neFollicular Cancer Cancer (Metastatic)
- Ukuphindaphindeka kwePapillary kunye neFollicular Cancer Cancer
- Umhlaza wedlala lengqula
- Umhlaza wedlala lengqula
Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.
Amanqanaba I, II, kunye no-III Papillary kunye ne-Follicular Cancer Cancer (yeNdawo / yeNgingqi)
Unyango lwenqanaba I (elingaphantsi kweminyaka engama-55; iminyaka engama-55 nangaphezulu), inqanaba II (elingaphantsi kweminyaka engama-55; iminyaka engama-55 nangaphezulu), kunye nenqanaba III lomhlaza wephepha kunye nomhlaza wesifo somhlaza onokuthi ubandakanye oku kulandelayo:
- Utyando (i-thyroidectomy okanye i-lobectomy).
- Unyango lwe-iodine.
- Unyango lwehormone ukuthintela umzimba ekwenzeni ihomoni ekhuthaza idlala lengqula (TSH).
- Unyango lwangaphandle lwemitha.
Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.
Inqanaba IV Papillary kunye neFollicular Cancer Cancer (Metastatic)
Xa umhlaza usasazekile kwezinye iindawo emzimbeni, ezinje ngemiphunga kunye nethambo, unyango aluwunyangi umhlaza, kodwa lunokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi. Unyango lwenqanaba IV papillary kunye nomhlaza wedlala lengqula unokubandakanya oku kulandelayo:
Kwizilonda ezithatha iodine
- Iyonke i-thyroidectomy.
- Unyango lwe-iodine.
- Unyango lwehormone ukuthintela umzimba ekwenzeni ihomoni ekhuthaza idlala lengqula (TSH).
Amathumba angathathi iodine
- Iyonke i-thyroidectomy.
- Unyango lwehormone ukuthintela umzimba ekwenzeni ihomoni ekhuthaza idlala lengqula (TSH).
- Unyango olujolise kwi-tyrosine kinase inhibitor (sorafenib okanye lenvatinib).
- Utyando lokususa umhlaza kwiindawo osele usasazeke kuzo.
- Unyango lwe-radiation lwangaphandle.
- Uvavanyo lweklinikhi lwe-chemotherapy.
- Uvavanyo lweklinikhi yonyango ekujoliswe kulo.
- Uvavanyo lwezonyango lwe-immunotherapy.
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.
Ukuphindaphindeka kwePapillary kunye neFollicular Cancer Cancer
Unyango lomhlaza ophindaphindwayo kunye nomhlaza wedlala lengqula unokubandakanya oku kulandelayo:
- Ugqirha lokususa ithumba kunye okanye ngaphandle kwonyango lwe-iodine.
- Unyango lwe-iodine ye-radioactive xa umhlaza unokufunyanwa kuphela ngokuvavanywa kwe-thyroid kwaye awunakuva ngexesha lovavanyo lomzimba.
- Unyango olujolise kwi-tyrosine kinase inhibitor (sorafenib okanye lenvatinib).
- Unyango lwangaphandle lwemitha okanye unyango lwe-radiation ye-intraoperative njengonyango lokunyanga ukukhupha iimpawu kunye nokuphucula umgangatho wobomi.
- Unyango ngamayeza.
- Uvavanyo lweklinikhi yonyango ekujoliswe kulo.
- Uvavanyo lwezonyango lwe-immunotherapy.
Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.
Umhlaza wedlala lengqula
Umhlaza wamathambo we-medullary we-medullary use-thyroid kuphela kwaye unokusasazeka kwiimisipha ezikufutshane entanyeni. Umhlaza wamadlala we-thyroid uqhubele phambili kwaye usasazeke nakwamanye amalungu entanyeni okanye kwamanye amalungu omzimba.
Unyango lwe-medullary cancer ye-medullary cancer inokubandakanya oku kulandelayo:
- Iyonke i-thyroidectomy ukuba umhlaza awusasazekanga kwamanye amalungu omzimba. Iimpawu ze-lymph ezikufutshane nomhlaza nazo zisuswe.
- Unyango lwangaphandle lwemitha kwizigulana ezinomhlaza ophindaphindiweyo kwi-thyroid.
Unyango lomhlaza we-thyroid ohamba phambili / we-metastatic medullary unokubandakanya oku kulandelayo:
- Unyango olujolise kwi-tyrosine kinase inhibitor (vandetanib okanye cabozantinib) yomhlaza osasazeke kwamanye amalungu omzimba.
- I-Chemotherapy njengonyango olunyangayo lokunciphisa iimpawu kunye nokuphucula umgangatho wobomi kwizigulana ezinomhlaza osasazeke kwamanye amalungu omzimba.
Unyango lwe-iodine olusasaza imitha alusetyenziswanga ukunyanga umhlaza we-thyroid.
Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.
Umhlaza wedlala lengqula
Unyango lunokubandakanya oku kulandelayo:
- Iyonke i-thyroidectomy njengonyango lokunyanga ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi kwizigulana ezinomhlaza ngaphakathi okanye kufutshane nedlala lengqula.
- I-Tracheostomy njengonyango lokunyanga ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi.
- Unyango lwangaphandle lwemitha.
- Unyango ngamayeza.
- Ukunyanga okujolise kuko ngeprotein kinase inhibitors (dabrafenib kunye ne-trametinib) kwizigulana ezinokutshintsha okuthile kuhlobo lwe-BRAF.
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 neCarcer Cancer
Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nomhlaza wedlala lengqula, bona oku kulandelayo:
- Ikhasi lasekhaya leCancer Cancer
- Unyango lweCancer ye-Thyroid
- Iziyobisi ezivunyiweyo zomhlaza wedlala lengqula
- Iithagethi zoMhlaza ezijolise kuko
- 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
Nika amandla ukuphinda uzihlaziye izimvo