Types/uterine/patient/endometrial-treatment-pdq

Unyango lweCancer ye-Endometrial Cancer (®) -Patient Version

Ulwazi ngokubanzi malunga neCancer ye-Endometrial

IINGONGOMA EZIPHAMBILI

• Umhlaza we-Endometriya sisifo apho umhlaza (umhlaza) weeseli zenzeka kwizicubu ze-endometrium.

• Ukutyeba kakhulu kunye nokuba nesifo se-metabolic syndrome kunokunyusa umngcipheko womhlaza we-endometrium.

• Ukuthatha i-tamoxifen yomhlaza webele okanye ukuthatha i-estrogen yodwa (ngaphandle kweprogesterone) kunokunyusa umngcipheko womhlaza we-endometrium.

• Iimpawu kunye neempawu zomhlaza we-endometrium zibandakanya ukopha okungaqhelekanga kwilungu lobufazi okanye iintlungu kwi-pelvis.

• Uvavanyo oluvavanya i-endometrium lusetyenziselwa ukufumanisa (ukufumana) kunye nokufumanisa umhlaza we-endometrium.

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

Umhlaza we-Endometriya sisifo apho umhlaza (umhlaza) weeseli zenzeka kwizicubu ze-endometrium.

I-endometrium ngumtya wesibeleko, umngxunya, ilungu lomzimba kwimisipha yamabhinqa. Isibeleko kulapho lukhula khona umbungu. Kwabafazi abaninzi abangakhulelweyo, isibeleko simalunga nee-intshi ezintathu ubude. Isiphelo esisezantsi, esimxinwa sesibeleko ngumlomo wesibeleko, okhokelela kwilungu lobufazi.

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 we-endometrium wahlukile kumhlaza wesihlunu sesibeleko, esibizwa ngokuba yi-sarcoma yesibeleko. Jonga isishwankathelo se- kunyango lwe-Uterine Sarcoma ngolwazi oluthe kratya malunga nesarcoma yesibeleko.

Ukutyeba kakhulu kunye nokuba nesifo se-metabolic syndrome kunokunyusa umngcipheko womhlaza we-endometrium.

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-endometrium.

Imiba yomngcipheko womhlaza we-endometrium ibandakanya oku kulandelayo:

• Ukuthatha kuphela unyango lwe-hormone yonyango (HRT) emva kokuyeka ukuya exesheni.

• Ukuthatha i-tamoxifen ukukhusela okanye ukunyanga umhlaza wamabele.

• Ukutyeba kakhulu.

• Ukuba nesifo se-metabolic syndrome.

• Ukuba nohlobo lwesibini lweswekile.

• Ukubonakaliswa kwezicubu ze-endometrial kwi-estrogen eyenziwe ngumzimba. Oku kunokubangelwa:

• Ungaze ubeleke.

• Ukuba sexesheni esemncinci.

• Ukuqala ukuya exesheni kamva.

• Ukuba ne-polycystic ovarian syndrome.

• Ukuba nembali yosapho yomhlaza we-endometrial kwisihlobo sokuqala (umama, udade, okanye intombi).

• Ukuba neemeko ezithile zofuzo, ezinjengeLynch syndrome.

• Ukuba ne-endometrial hyperplasia.

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

Ukuthatha i-tamoxifen yomhlaza webele okanye ukuthatha i-estrogen yodwa (ngaphandle kweprogesterone) kunokunyusa umngcipheko womhlaza we-endometrium.

Umhlaza we-Endometrium unokukhula kwizigulana ezinomhlaza wamabele anyangwe nge-tamoxifen. Isigulana esithatha eli chiza kwaye siphume ngokungaqhelekanga kwilungu lobufazi kufuneka sibe novavanyo olulandelayo kunye ne-biopsy yelining endometrium xa kufuneka njalo. Abasetyhini abathatha i-estrogen (ihomoni enokuthi ichaphazele ukukhula kweminye imihlaza) iyodwa ikwanomngcipheko okhulayo womhlaza we-endometrium. Ukuthatha i-estrogen edityaniswe neprogesterone (enye ihomoni) ayonyusi umngcipheko kumfazi wokuba nomhlaza kwi-endometrium.

Iimpawu kunye neempawu zomhlaza we-endometrium zibandakanya ukopha okungaqhelekanga kwilungu lobufazi okanye iintlungu kwi-pelvis.

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

• Ukopha kwilungu lobufazi okanye ukukhutshwa akuhambelani nokuya exesheni (amaxesha).

• Ukopha kwilungu lobufazi emva kokuyeka ukuya exesheni.

• Ukuchama kunzima okanye kubuhlungu.

• Intlungu ngexesha lokwabelana ngesondo.

• Ubuhlungu kwindawo ye-pelvic.

Uvavanyo oluvavanya i-endometrium lusetyenziselwa ukufumanisa (ukufumana) kunye nokufumanisa umhlaza we-endometrium.

Ngenxa yokuba umhlaza we-endometrial uqala ngaphakathi kwesibeleko, awuhlali uvela kwiziphumo zovavanyo lwePap. Ngesi sizathu, isampulu yethishu ye-endometrium kufuneka isuswe kwaye ihlolwe phantsi kwemicroscope ukujonga iiseli zomhlaza. Enye yezi nkqubo inokusetyenziswa:

• I-endometrial biopsy: Ukususwa kwethishu kwi-endometrium (ulwelwesi lwangaphakathi lwesibeleko) ngokufaka ityhubhu ebhityileyo, eguqukayo ngomlomo wesibeleko nakwisibeleko. Umbhobho usetyenziselwa ukukrola ngobunono inani elincinci leethishu kwi-endometrium emva koko ususe iisampulu zethishu. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukukhangela iiseli zomhlaza.

• Ukudibanisa kunye nonyango: Inkqubo yokususa iisampulu zethishu kulusu lwangaphakathi lwesibeleko. Umlomo wesibeleko uyahlanjululwa kwaye iyeza lokunyanga (isixhobo esimilise okwecephe) lifakwa kwisibeleko ukususa izicwili. Iisampuli zethishu zihlolwa phantsi kwemicroscope kwimpawu zesifo. Le nkqubo ikwabizwa ngokuba yi-D & C.

Ukwahlula kunye nokunyanga (D no-C). I-speculum ifakwe kwilungu lobufazi ukuyandisa ukuze ujonge umlomo wesibeleko (ipaneli yokuqala). I-dilator isetyenziselwa ukwandisa umlomo wesibeleko (iphaneli esembindini). Iyeza lokunyanga lifakwa emlonyeni wesibeleko ukukhupha izicwili ezingaqhelekanga (iphaneli yokugqibela).

• IHysteroscopy: Inkqubo yokujonga ngaphakathi kwesibeleko kwiindawo ezingaqhelekanga. I-hysteroscope ifakwe kwilungu lobufazi kunye nomlomo wesibeleko kwisibeleko. I-hysteroscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Inokuba nesixhobo sokususa iisampulu zethishu, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza.

Olunye uvavanyo kunye neenkqubo ezisetyenziselwa ukuxilonga umhlaza we-endometrium zibandakanya oku kulandelayo:

• 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 lweTransvaginal ultrasound: Inkqubo esetyenziselwa ukuvavanya ilungu lobufazi, isibeleko, iityhubhu zesibeleko, kunye nesinyi. I-ultrasound transducer (iprobe) ifakwa kwilungu lobufazi kwaye isetyenziselwa ukubetha amaza esandi aphezulu (i-ultrasound) kwizicubu zangaphakathi okanye kwizitho zokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Ugqirha unokuchonga amathumba ngokujonga kwi-sonogram.

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).

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

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

• Isigaba somhlaza (nokuba sikwi-endometrium kuphela, sibandakanya udonga lwesibeleko, okanye sisasazekile kwezinye iindawo emzimbeni).

• Zijongeka njani iiseli zomhlaza phantsi kwemicroscope.

• Nokuba iiseli zomhlaza zichaphazelekile yiprogesterone.

Umhlaza we-Endometrial uhlala unyangeka kuba uhlala ufunyaniswa kwangethuba.

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

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

• Isigaba somhlaza (nokuba sikwi-endometrium kuphela, sibandakanya udonga lwesibeleko, okanye sisasazekile kwezinye iindawo emzimbeni).

• Zijongeka njani iiseli zomhlaza phantsi kwemicroscope.

• Nokuba iiseli zomhlaza zichaphazelekile yiprogesterone.

Umhlaza we-Endometrial uhlala unyangeka kuba uhlala ufunyaniswa kwangethuba.

Amanqanaba eCancer ye-Endometrial

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe isifo somhlaza we-endometrium, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwesibeleko okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manqanaba alandelayo asetyenziselwa umhlaza we-endometrium:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• Umhlaza we-Endometrium unokuthi uqokelelwe kunyango ngolu hlobo lulandelayo:

• Umhlaza womngcipheko ophantsi we-endometrium

• Umhlaza ophezulu we-endometrium

Emva kokuba kufunyaniswe isifo somhlaza we-endometrium, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zisasazekile ngaphakathi kwesibeleko okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza usasazekile ngaphakathi kwesibeleko okanye kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Iimvavanyo ezithile kunye neenkqubo zisetyenziswa kwinkqubo yokubeka inqanaba. I-hysterectomy (ukusebenza apho isibeleko sisuswe khona) kuya kuhlala kwenziwa ukunyanga umhlaza we-endometrium. Iisampulu zeethishu zithathwa kwindawo ejikeleze isibeleko kwaye zijongwa phantsi kwemicroscope ukufumana iimpawu zomhlaza ukunceda ukufumanisa ukuba umhlaza usasazekile na.

Le nkqubo ilandelayo inokusetyenziswa kwinkqubo yokuqokelela:

• 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.

• 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 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.

• 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.

• Ukusasazeka kwe-lymph node: Inkqubo yotyando apho ii-lymph node zisuswe kwindawo ye-pelvic kwaye isampulu yethishu ihlolwe phantsi kwemicroscope kwimpawu zomhlaza. Le nkqubo ikwabizwa ngokuba yi-lymphadenectomy.

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-endometrial usasazeka emiphungeni, iiseli zomhlaza emiphungeni ziiseli zomhlaza ze-endometrium. Esi sifo ngumhlaza we-endometrial umhlaza, hayi umhlaza wemiphunga.

La manqanaba alandelayo asetyenziselwa umhlaza we-endometrium:

Inqanaba I

Inqanaba IA kunye nenqanaba IB umhlaza we-endometrium. Kwinqanaba le-IA, umhlaza uku-endometrium kuphela okanye ungaphantsi kwesiqingatha se-myometrium (umaleko wemisipha wesibeleko). Kwinqanaba le-IB, umhlaza usasazeke phakathi okanye nangaphezulu kwi-myometrium.

Kwinqanaba I, umhlaza ufumaneka esibelekweni kuphela. Inqanaba I lahlulwe ngokwamanqanaba e-IA kunye ne-IB, ngokusekwe kumgama osele usasazekile umhlaza.

• Isigaba IA: Umhlaza ukwindometrium kuphela okanye ungaphantsi kwesiqingatha semyometrium (ungqimba lwezihlunu zesibeleko).

• Isigaba IB: Umhlaza usasazeke phakathi okanye nangaphezulu kwi-myometrium.

Inqanaba II

Isigaba II somhlaza we-endometrium. Umhlaza usasazeke waya kwizicwili zomlomo wesibeleko, kodwa awusasazekanga ngaphandle kwesibeleko.

Kwinqanaba lesibini, umhlaza usasazeke waya kwizicwili zomlomo wesibeleko, kodwa awusasazekanga ngaphandle kwesibeleko.

Inqanaba III

Kwinqanaba lesithathu, umhlaza usasazeke ngaphaya kwesibeleko kunye nomlomo wesibeleko, kodwa awusasazekanga ngaphaya kwepelvis. Isigaba III sahlulwe sangamanqanaba IIIA, IIIB, kunye ne-IIIC, ngokusekwe ekude umhlaza usasazeke kangakanani kwi-pelvis.

• Isigaba IIIA: Umhlaza usasazekile waya kwinqanaba elingaphandle lesibeleko kunye / okanye kwimibhobho yesibeleko, ii-ovari, kunye nemisipha yesibeleko.

Isigaba IIIA somhlaza we-endometrium. Umhlaza usasazeke kumaleko angaphandle esibeleko kunye / okanye kwimibhobho yesibeleko, ii-ovari, okanye iigaments zesibeleko.

• Isigaba IIIB: Umhlaza usasazeke kwilungu lobufazi kunye / okanye kwi-parametrium (izicwili kunye namanqatha ajikeleze isibeleko).

Isigaba IIIB somhlaza we-endometrium. Umhlaza unwenwele kwilungu lobufazi kunye / okanye kwi-parametrium (izicwili kunye namanqatha ajikeleze isibeleko kunye nomlomo wesibeleko).

• Isigaba IIIC: Umhlaza usasazekile kwii-lymph node kwi-pelvis kunye / okanye ujikeleze i-aorta (umthambo omkhulu emzimbeni, ophethe igazi kude nentliziyo).

Isigaba IIIC somhlaza we-endometrium. Umhlaza usasazeke kwii-lymph node kwi-pelvis kunye / okanye ujikeleze i-aorta (owona mthambo mkhulu emzimbeni, ohambisa igazi kude nentliziyo).

Inqanaba IV

Kwinqanaba IV, umhlaza usasazeke ngaphaya kwethambo. Isigaba IV sahlulwe sangamanqanaba e-IVA kunye ne-IVB, ngokusekwe kukude kangakanani ukuba umhlaza usasazekile.

• Isigaba se-IVA: Umhlaza usasazeke kwisinyi kunye / okanye eludongeni lwamathumbu.

Isigaba somhlaza we-endometrial cancer. Umhlaza unwenwele kwisinyi kunye / okanye emathunjini.

• Isigaba IVB: I-Cancer isasazeke kwezinye iindawo zomzimba ngaphaya kwe-pelvis, kubandakanywa isisu kunye / okanye i-lymph nodes kwi-groin.

Inqanaba IVB umhlaza we-endometrium. Umhlaza usasazeke kwiindawo zomzimba ngaphandle kweepelvis, ezinje ngesisu kunye / okanye ii-lymph node kwindawo yokutya.

Umhlaza we-Endometrium unokuthi uqokelelwe kunyango ngolu hlobo lulandelayo:

Umhlaza womngcipheko ophantsi we-endometrium

AmaBakala 1 no-2 amathumba ahlala ejongwa njengomngcipheko ophantsi. Ngokwesiqhelo azisasazeki kwamanye amalungu omzimba.

Umhlaza ophezulu we-endometrium

Izidumba zebanga lesi-3 zithathwa njengomngcipheko omkhulu. Zihlala zisasazeka kwamanye amalungu omzimba. I-uterine papillary serous, iseli ecacileyo, kunye ne-carcinosarcoma zii-subtypes ezintathu zomhlaza we-endometriya ethathwa njengebanga lesi-3.

Umhlaza we-Endometrial Cancer

Umhlaza ophindaphindiweyo we-endometrium ngumhlaza ophindaphindiweyo (ubuyile) emva kokuba unyangiwe. Umhlaza ungabuyela esibelekweni, kwi-pelvis, kwii-lymph node esiswini, okanye kwamanye amalungu omzimba

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza we-endometrium.

• Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Unyango lweHormone

• Unyango ekujoliswe kulo

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lomhlaza we-endometrial lunokubangela iziphumo ebezingalindelekanga.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

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

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza we-endometrium.

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

Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

Ugqirha

Ugqirha (ukususa umhlaza ekusebenzeni) lolona nyango luqhelekileyo lomhlaza we-endometrium. Kungasetyenziswa ezi nkqubo zilandelayo:

• I-hysterectomy iyonke: Utyando lokususa isibeleko, kubandakanya nomlomo wesibeleko. 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.

• I-Bilal salpingo-oophorectomy: Utyando lokususa zombini ii-ovari kunye zombini i-fallopian tubes.

• Radical hysterectomy: Utyando lokususa isibeleko, umlomo wesibeleko, kunye nenxalenye yelungu lobufazi. Ama-ovari, i-fallopian tubes, okanye ii-lymph node ezikufuphi nazo zinokususwa.

• Ukusasazeka kwe-lymph node: Inkqubo yotyando apho ii-lymph node zisuswe kwindawo ye-pelvic kwaye isampulu yethishu ihlolwe phantsi kwemicroscope kwimpawu zomhlaza. Le nkqubo ikwabizwa ngokuba yi-lymphadenectomy.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, ezinye izigulana zinokunikwa unyango ngemitha okanye unyango lwehomoni emva kotyando lokubulala naziphi na iiseli zomhlaza ezisele. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. 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.

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo. Unyango lwangaphandle nolwangaphakathi lusetyenziselwa ukunyanga umhlaza we-endometrium, kwaye lunokusetyenziswa njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba kungokubulala iiseli okanye kukumisa iiseli zahlule. 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.

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. Ezinye iihormoni zinokubangela ukuba ezinye iintlobo zomhlaza zikhule. Ukuba iimvavanyo zibonisa ukuba iiseli zomhlaza zineendawo apho iihormone zinokuncamathisela (ii-receptors), iziyobisi, utyando, okanye unyango lwemitha lusetyenziselwa ukunciphisa ukuveliswa kwehomoni okanye ukubathintela ekusebenzeni.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Ama-antibodies e-monoclonal, mTOR inhibitors, kunye ne-transduction inhibitors zintathu iintlobo zonyango olujolisiweyo olusetyenziselwa ukunyanga umhlaza we-endometrium.

• Unyango lwe-monoclonal antibody yonyango lomhlaza olusebenzisa ii-antibodies ezenziwe elebhu ezivela kuhlobo olunye lweeseli zomzimba. Ezi antibodies zinokuchonga izinto ezikumhlaza iiseli okanye izinto eziqhelekileyo 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 isetyenziselwa ukunyanga inqanaba III, inqanaba IV, kunye nomhlaza ophindaphindiweyo we-endometrium.

• I-mTOR inhibitors ibhloka iprotein ebizwa ngokuba yi-mTOR, enceda ukulawula ukwahlulwa kweseli. I-mTOR inhibitors inokugcina iiseli zomhlaza zingakhuli kwaye kuthintele ukukhula kwemithambo yegazi emitsha ekufuneka ukuba amathumba akhule. I-Everolimus kunye ne-ridaforalimus zisetyenziselwa ukunyanga inqanaba III, inqanaba IV, kunye nomhlaza ophindaphindiweyo we-endometrium.

• Ukutshintshwa kwesiginali inhibitors kuthintela imiqondiso edluliswayo ukusuka kwenye iamolekyuli ukuya kwenye ngaphakathi kweseli. Ukuthintela le miqondiso kunokubulala iiseli zomhlaza. I-Metformin ifundwa ukunyanga inqanaba lesithathu, inqanaba IV, kunye nomhlaza ophindaphindiweyo we-endometrium.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lomhlaza we-endometrial 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

• Isigaba I kunye neSigaba II somhlaza we-Endometrial

• Isigaba III, iSigaba IV, kunye noMhlaza oQhubekayo we-Endometrial

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

Isigaba I kunye neSigaba II somhlaza we-Endometrial

Umhlaza we-endometrial umngcipheko omncinci (iBakala 1 okanye iBakala 2)

Unyango lweqondo lomngcipheko ophantsi I-endometrial cancer kunye nenqanaba II umhlaza we-endometrium unokubandakanya oku kulandelayo:

• Ugqirha (i-hysterectomy iyonke kunye ne-salpingo-oophorectomy yamazwe amabini). Iimpawu ze-lymph kwi-pelvis kunye nesisu zingasuswa kwaye zijongwe phantsi kwe-microscope ukujonga iiseli zomhlaza.

• Utyando (i-hysterectomy iyonke kunye ne-salpingo-oophorectomy yamazwe amabini, kunye okanye ngaphandle kokususwa kwee-lymph node kwi-pelvis kunye nesisu) kulandelwa lonyango lwangaphakathi lwemitha. Kwiimeko ezithile, unyango lwangaphandle lwemitha kwi-pelvis lunokusetyenziswa endaweni yonyango lwemitha lwangaphakathi.

• Unyango ngemitha lodwa kwizigulana ezingenakho ukwenza utyando.

• Uvavanyo lweklinikhi yerejimeni entsha yonyango ngamayeza.

Ukuba umhlaza usasazekile kumlomo wesibeleko, kungenziwa i-hysterectomy enkulu kunye ne-salpingo-oophorectomy yamazwe amabini.

Umhlaza we-endometrial umngcipheko ophezulu (ibanga lesi-3)

Unyango lweqondo lomngcipheko ophezulu I-endometrial cancer kunye nenqanaba II umhlaza we-endometrium unokubandakanya oku kulandelayo:

• Ugqirha (i-radical hysterectomy kunye ne-bilpal salpingo-oophorectomy). Iimpawu ze-lymph kwi-pelvis kunye nesisu zingasuswa kwaye zijongwe phantsi kwe-microscope ukujonga iiseli zomhlaza.

• Utyando (i-radical hysterectomy kunye ne-bilpal salpingo-oophorectomy) elandelwa yi-chemotherapy kwaye ngamanye amaxesha unyango lwemitha.

• Uvavanyo lweklinikhi yerejimeni entsha yonyango ngamayeza.

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, iSigaba IV, kunye noMhlaza oQhubekayo we-Endometrial

Unyango lwesigaba sesithathu somhlaza we-endometrium, inqanaba IV umhlaza we-endometrium, kunye nomhlaza ophindaphindiweyo we-endometrial unokubandakanya oku kulandelayo:

• Utyando (i-radical hysterectomy kunye nokususwa kwee-lymph node kwi-pelvis ukuze zibonwe phantsi kwemicroscope ukujonga iiseli zomhlaza) zilandelwe yi-adjuvant chemotherapy kunye / okanye unyango lwemitha.

• I-Chemotherapy kunye nonyango lwangaphakathi nangaphandle lonyango kwizigulana ezingenakho ukwenza utyando.

• Unyango lweHormone kwizigulana ezingenakho ukwenza utyando okanye unyango ngemitha.

• Unyango olujolise kwi-mTOR inhibitors (i-everolimus okanye i-ridaforolimus) okanye i-monoclonal antibody (bevacizumab).

• Uvavanyo lweklinikhi yerejimeni yonyango entsha enokubandakanya indibaniselwano ye-chemotherapy, unyango olujolisiweyo, njenge-mTOR inhibitor (i-everolimus) okanye umqondiso wokudluliselwa kwe-inhibitor (metformin), kunye / okanye unyango lwehomoni, kwizigulana ezinomhlaza oqhubela phambili okanye ophindaphindwayo.

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 ngeCancer ye-Endometrial

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nomhlaza we-endometrium, bona oku kulandelayo:

• Iphepha Lasekhaya Lomhlaza Wesibeleko

• Uthintelo loMhlaza we-Endometrial

• Uvavanyo loMhlaza we-Endometrial

• Unyango lweHormone loMhlaza weSifuba

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