Iindidi / ubufazi / isigulana / unyango lobufazi-pdq

Unyango loMhlaza welungu lobufazi (®) -Unguqulelo lwePatient

Ulwazi Ngokubanzi Ngomhlaza Wesibeleko

IINGONGOMA EZIPHAMBILI

• Umhlaza welungu lobufazi sisifo apho iiseli ezinobungozi (zomhlaza) zenzeka kwilungu lobufazi.

• Ukwaluphala kunye nokuba nosulelo lwe-HPV zizinto ezinobungozi kumhlaza welungu lobufazi.

• Iimpawu kunye neempawu zomhlaza welungu lobufazi zibandakanya iintlungu okanye ukopha ngokungaqhelekanga kwilungu lobufazi.

• Uvavanyo oluvavanya ubufazi kunye namanye amalungu esinqeni asetyenziselwa ukufumanisa isifo somhlaza kwilungu lobufazi.

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

Umhlaza welungu lobufazi sisifo apho iiseli ezinobungozi (zomhlaza) zenzeka kwilungu lobufazi.

Ubufazi ngumjelo okhokelela kumlomo wesibeleko (ukuvulwa kwesibeleko) uye ngaphandle komzimba. Ekuzalweni, umntwana uphumela ngaphandle kwelungu lobufazi (ekwabizwa ngokuba ngumjelo wokuzalwa).

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 welungu lobufazi awuqhelekanga. Zimbini iintlobo eziphambili zomhlaza welungu lobufazi:

• I-squamous cell carcinoma: Umhlaza owenzeka kwiiseli ezibhityileyo nezicaba ezigqale ngaphakathi ngaphakathi kwilungu lobufazi. Iseli lomhlaza lobufazi lwesibeleko lisasazeka kancinci kwaye lihlala lihlala kufutshane nelungu lobufazi, kodwa linokuthi lisasazeke kwimiphunga, isibindi, okanye ithambo. Olu lolona hlobo luqhelekileyo lomhlaza welungu lobufazi.

• I-Adenocarcinoma: Umhlaza oqala kwiiseli zedlala. Iiseli ze-glandular kumngxunya welungu lobufazi zenza kwaye zikhuphe ulwelo olunje nge-mucus. I-Adenocarcinoma inokwenzeka ngakumbi kunesifo somhlaza weseli esasasazekayo ukuya kwimiphunga kunye ne-lymph node. Uhlobo olunqabileyo lwe-adenocarcinoma (cacisa iseli adenocarcinoma) inxulunyaniswa nokuvezwa kwi-diethylstilbestrol (DES) ngaphambi kokuzalwa. I-Adenocarcinomas engadibananga nokubonakaliswa kwi-DES ixhaphake kakhulu kwabasetyhini emva kokuyeka ukuya exesheni.

Ukwaluphala kunye nokuba nosulelo lwe-HPV zizinto ezinobungozi kumhlaza welungu lobufazi.

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 womhlaza welungu lobufazi ibandakanya oku kulandelayo:

• Ukuba neminyaka engama-60 okanye ngaphezulu.

• Ukuba nosulelo lwe-papilloma virus (HPV). I-squamous cell carcinoma (SCC) yelungu lobufazi inxulunyaniswe nosulelo lwe-HPV kwaye inezinto ezininzi ezinobungozi obufanayo ne-SCC yomlomo wesibeleko.

• Ukuvezwa kwi-DES ngelixa usesiswini sikanina. Ngama-1950, ichiza le-DES lanikwa abanye abasetyhini abakhulelweyo ukukhusela ukukhulelwa kwesisu (ukuzalwa kwangoko komntwana ongekhe uphile). Oku kunxulunyaniswa nefom enqabileyo yomhlaza welungu lobufazi ekuthiwa yicell cell adenocarcinoma. Amanqanaba esi sifo ayephezulu phakathi kwiminyaka yoo-1970, kwaye kunqabile kakhulu ngoku.

• Ukuba ne-hysterectomy yamathumba ayebungozi (hayi umhlaza) okanye umhlaza.

Iimpawu kunye neempawu zomhlaza welungu lobufazi zibandakanya iintlungu okanye ukopha ngokungaqhelekanga kwilungu lobufazi.

Umhlaza welungu lobufazi uhlala ungazibonakalisi iimpawu okanye iimpawu zokuqala. Inokufunyanwa ngexesha lovavanyo oluqhelekileyo lwe-pelvic kunye novavanyo lwePap. Iimpawu kunye neempawu zisenokubangelwa ngumhlaza welungu lobufazi okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ukopha okanye ukukhupha okungahambelani nokuya exesheni.

• Intlungu ngexesha lokwabelana ngesondo.

• Ubuhlungu kwindawo ye-pelvic.

• Iqhuma kwilungu lobufazi.

• Intlungu xa uchama.

• Ukuqunjelwa.

Uvavanyo oluvavanya ubufazi kunye namanye amalungu esinqeni asetyenziselwa ukufumanisa isifo somhlaza kwilungu lobufazi.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

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

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

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

• Uvavanyo lwePap: Inkqubo yokuqokelela iiseli kumphezulu womlomo wesibeleko nakwilungu lobufazi. Isiqwenga somqhaphu, ibrashi, okanye intonga encinci esetyenziselwa ukukrwela ngobunono iiseli zomlomo wesibeleko kunye nelungu lobufazi. Iiseli zijongwa phantsi kwemicroscope ukufumanisa ukuba aziqhelekanga. Le nkqubo ikwabizwa ngokuba yiPap smear.

Uvavanyo lwePap. I-speculum ifakwe kwilungu lobufazi ukuyandisa. Emva koko, ibrashi ifakwe kwilungu lobufazi ukuqokelela iiseli zomlomo wesibeleko. Iiseli zijongwa phantsi kwemicroscope kwimpawu zesifo.

• Uvavanyo lwe-human papillomavirus (HPV): Uvavanyo lwaselebhu olusetyenziselwa ukukhangela i-DNA okanye i-RNA kwiintlobo ezithile zosulelo lwe-HPV. Iiseli ziqokelelwa kumlomo wesibeleko kunye ne-DNA okanye i-RNA kwiiseli zijongwa ukufumanisa ukuba ngaba usulelo lubangelwa luhlobo lwe-HPV olunxulunyaniswa nomhlaza womlomo wesibeleko. Olu vavanyo lunokwenziwa kusetyenziswa iisampulu zeeseli ezisuswe ngexesha lovavanyo lwePap. Olu vavanyo lunokwenziwa kwakhona ukuba iziphumo zovavanyo lwePap zibonisa iiseli ezithile zomlomo wesibeleko ezingaqhelekanga.

• IColposcopy: Inkqubo apho icolposcope (isixhobo esikhanyisiweyo nesikhulisayo) isetyenziselwa ukukhangela ubufazi kunye nomlomo wesibeleko kwiindawo ezingaqhelekanga. Iisampuli zethishu zinokuthathwa kusetyenziswa isiciko sokunyanga (isixhobo esimilise okwecephe) okanye ibrashi kwaye ihlolwe ngemicroscope kwimpawu zesifo.

• Biopsy: Ukususwa kweeseli okanye izicwili kwilungu lobufazi nakumlomo wesibeleko ukuze zibonwe phantsi kwemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Ukuba uvavanyo lwePap lubonisa iiseli ezingaqhelekanga kwilungu lobufazi, i-biopsy inokwenziwa ngexesha le-colposcopy.

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

Ukuxelwa kwangaphambili kuxhomekeke koku kulandelayo:

• Inqanaba lomhlaza (nokuba kukwilungu lobufazi kuphela okanye unwenwele nakwezinye iindawo).

• Ubungakanani bethumba.

• Inqanaba leeseli zethumba (ukuba zahluke njani kwiiseli eziqhelekileyo phantsi kwemicroscope).

• Apho umhlaza ungaphakathi kwilungu lobufazi.

• Nokuba zikhona iimpawu okanye iimpawu xa kufunyaniswa isifo.

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

Ukhetho lonyango luxhomekeke koku kulandelayo:

• Inqanaba kunye nobukhulu bomhlaza.

• Nokuba umhlaza usondele kwamanye amalungu anokonakaliswa lunyango.

• Nokuba eli thumba lenziwe ziiseli ezi-squamous okanye yi-adenocarcinoma.

• Nokuba isigulana sinesibeleko okanye sine-hysterectomy.

• Nokuba ngaba isigulana siye sanonyango lwasemva kwemitha kwi-pelvis.

Amanqanaba omhlaza wesini

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe isifo somhlaza welungu lobufazi, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zinwenwele ngaphakathi kwilungu lobufazi okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• Kwi-vaginal intraepithelial neoplasia (VaIN), iiseli ezingaqhelekanga zifumaneka kwithishu efakwe ngaphakathi kwilungu lobufazi.

• La manqanaba alandelayo asetyenziselwa umhlaza welungu lobufazi:

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• Umhlaza welungu lobufazi unokuphinda ubuye (ubuye) emva kokuba unyangiwe.

Emva kokuba kufunyaniswe isifo somhlaza welungu lobufazi, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zinwenwele ngaphakathi kwilungu lobufazi okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza usasazekile ngaphakathi kwilungu lobufazi okanye kwamanye amalungu omzimba ubizwa ngokuba yistage. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Le nkqubo ilandelayo inokusetyenziswa kwinkqubo yokuqokelela:

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

• I-CT scan (i-CAT scan): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni ezinje ngesisu okanye isinqe, 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.

• ICystoscopy: Inkqubo yokujonga ngaphakathi kwesinyi kunye nerethra ukujonga iindawo ezingaqhelekanga. I-cystoscope ifakwe kwi-urethra kwisinyi. I-cystoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Inokuba nesixhobo sokususa iisampulu zethishu, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza.

ICystoscopy. I-cystoscope (isixhobo esincinci, esifana ne-tube-like with light and lens for viewing) sifakwa kwi-urethra kwisinyi. Ulwelo lusetyenziselwa ukugcwalisa isinyi. Ugqirha ujonge umfanekiso wodonga lwangaphakathi lwesinyi kwisohlo sekhompyuter.

• Iproctoscopy: Inkqubo yokujonga ngaphakathi kwi-rectum kunye ne-anus ukujonga iindawo ezingaqhelekanga, usebenzisa iproctoscope. Iproctoscope sisixhobo esibhityileyo, esifana netyhubhu esinesibane kunye neelensi zokujonga ngaphakathi kwe-rectum kunye ne-anus. Inokuba nesixhobo sokususa iisampulu zethishu, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza.

• I-Biopsy: I-biopsy inokwenziwa ukufumanisa ukuba umhlaza usasazekile kumlomo wesibeleko. Isampulu yethishu iyasuswa kumlomo wesibeleko kwaye ijongwe phantsi kwemicroscope. I-biopsy esusa isixa esincinci sezicubu zihlala zenziwa kwiofisi kagqirha. I-cone biopsy (ukususwa kwesicwili esikhudlwana, esimile okwe-cone kumlomo wesibeleko kunye nomjelo womlomo wesibeleko) kuhlala kwenziwa esibhedlele. I-biopsy ye-vulva inokwenziwa kwakhona ukubona ukuba umhlaza usasazekile apho.

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 welungu lobufazi unwenwela emiphungeni, iiseli zomhlaza emiphungeni ziiseli zomhlaza welungu lobufazi. Esi sifo ngumhlaza welungu lobufazi, hayi umhlaza wemiphunga.

Kwi-vaginal intraepithelial neoplasia (VaIN), iiseli ezingaqhelekanga zifumaneka kwithishu efakwe ngaphakathi kwilungu lobufazi.

Ezi iiseli zingaqhelekanga azingomhlaza. I-vaginal intraepithelial neoplasia (VaIN) iqokelelwe ngokusekwe kwindlela ezinzulu ngayo iiseli ezingaqhelekanga ezikwiithishu ezikwelilungu lobufazi:

• I-VaIN 1: Iiseli ezingaqhelekanga zifumaneka kwindawo engaphandle kwisinye kwisithathu sezicubu ezingaphakathi kwilungu lobufazi.

• I-VaIN 2: Iiseli ezingaqhelekanga zifunyanwa ngaphandle kwesibini esithathwini sesicwili esingaphakathi kwilungu lobufazi.

• I-VaIN 3: Iiseli ezingaqhelekanga zifunyanwa ngaphezulu kwesibini esithathwini sesicwili eselungu lobufazi. Xa izilonda ze-VaIN 3 zifunyenwe kubukhulu obupheleleyo beethishu ezingene kwilungu lobufazi, ibizwa ngokuba yi-carcinoma in situ.

I-Vain ingaba ngumhlaza kwaye isasazeka eludongeni lobufazi.

La manqanaba alandelayo asetyenziselwa umhlaza welungu lobufazi:

Inqanaba I

Kwinqanaba I, umhlaza ufumaneka kuphela kudonga lobufazi.

Inqanaba II

Kwinqanaba lesibini, umhlaza usasazeke eludongeni lobufazi ukuya kwizicubu ezijikeleze ubufazi. Umhlaza awusasazekanga eludongeni lwe-pelvis.

Inqanaba III

Kwinqanaba le-III, umhlaza usasazeke eludongeni lwe-pelvis.

Inqanaba IV

Inqanaba IV lahlulwe laba yinqanaba le-IVA kunye nele-IVB:

• Isigaba se-IVA: Umhlaza usenokusasazeka kwenye okanye kwezi ndawo zilandelayo:

• Umbane wesinyi.

• Umbane we-rectum.

• Ngaphandle kwendawo ye-pelvis ene-bladder, isibeleko, ii-ovari kunye nomlomo wesibeleko.

• Isigaba IVB: Umhlaza usasazeke kwiindawo zomzimba ezingekho kufutshane nelungu lobufazi, njengomphunga okanye ithambo.

Umhlaza welungu lobufazi unokuphinda ubuye (ubuye) emva kokuba unyangiwe.

Umhlaza ungabuyela kwilungu lobufazi okanye kwamanye amalungu omzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza kwilungu lobufazi.

• Zintathu iintlobo zonyango olusetyenziswayo:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-Immunotherapy

• Radiosensitizers

• Unyango lomhlaza welungu lobufazi 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 kwilungu lobufazi.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza welungu lobufazi. 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

Ugqirha lukhetho oluqhelekileyo lonyango kuzo zombini i-vaginal intraepithelial neoplasia (VaIN) kunye nomhlaza welungu lobufazi.

Ezi ntlobo zilandelayo zotyando zingasetyenziselwa ukunyanga i-VaIN:

• Utyando lwe-Laser: Inkqubo yotyando esebenzisa umqadi we-laser (umqadi omxinwa wokukhanya okukhulu) njengemela yokusika ngaphandle kwegazi kwizicwili okanye ukususa isilonda somhlaba esifana nethumba.

• Ukucandwa kwendawo yonke: Inkqubo yotyando ethatha umhlaza kunye nezinye izihlunu ezisempilweni.

• I-Vaginectomy: Utyando lokususa yonke into okanye inxenye yelungu lobufazi. Ukufakelwa kwesikhumba kwamanye amalungu omzimba kunokufuneka ukuba uvuselele ubufazi.

Ezi ndidi zilandelayo zotyando zinokusetyenziselwa ukunyanga umhlaza welungu lobufazi:

• Ukucandwa kwendawo yonke: Inkqubo yotyando ethatha umhlaza kunye nezinye izihlunu ezisempilweni.

• I-Vaginectomy: Utyando lokususa yonke into okanye inxenye yelungu lobufazi. Ukufakelwa kwesikhumba kwamanye amalungu omzimba kunokufuneka ukuba uvuselele ubufazi.

• 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 kancinci 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-lymph node dissection: Inkqubo yokuhlinzwa apho i-lymph nodes isuswe khona kwaye isampuli yezicubu ihlolwe phantsi kwe-microscope kwiimpawu zomhlaza. Le nkqubo ikwabizwa ngokuba yi-lymphadenectomy. Ukuba umhlaza ukwindawo ephezulu yelungu lobufazi, iiseli zangasemva zelungu zingasuswa. Ukuba umhlaza ukwelungu lobufazi elingezantsi, i-lymph nodes kwindawo yokuthambisa ingasuswa.

• Ukugqithiswa kwepelvic: Utyando lokususa ikholoni engezantsi, i-rectum, isinyi, umlomo wesibeleko, ubufazi, kunye namaqanda. I-lymph node ezikufutshane nazo ziyasuswa. Ukuvulwa kwezinto ezingezizo (stoma) kwenzelwa umchamo kunye nelindle ukuba liphume emzimbeni liye kwingxowa yokuqokelela.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, ezinye izigulana zinokunikwa unyango ngemitha 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 ongaphandle komzimba ukuthumela imitha kwindawo yomzimba enomhlaza.

• 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 welungu lobufazi, kwaye lunokusetyenziswa njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokuchaphazela iiseli 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.

I-chemotherapy ye-topical ye-squamous cell yomhlaza wesini inokusetyenziswa kwilungu lobufazi kwikrimu okanye into yokuthambisa.

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 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-Imiquimod sisiguquli sokuphendula komzimba esifundwayo ukunyanga izilonda zangasese kwaye sisetyenziswa kulusu kwikrimu.

Radiosensitizers

IiRadiosensitizers ngamachiza enza ukuba iiseli zethumba zibuthathaka ngakumbi kunyango lwemitha. Ukudibanisa unyango lwemitha kunye neeradiosensitizers kunokubulala iiseli ezininzi zethumba.

Unyango lomhlaza welungu lobufazi 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.

Unyango lwe-Vaginal Intraepithelial Neoplasia (VaIN)

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

Unyango lwe-neparasia ye-intraepithelial neoplasia (VaIN) inokubandakanya oku kulandelayo:

• Utyando (utyando lwe-laser emva kwe-biopsy).

• Utyando (ukusikwa okubanzi kwendawo) ngolusu lwegrafti.

• Utyando (inxenye okanye iyonke i-vaginectomy) kunye okanye ngaphandle kokumiliselwa kwesikhumba.

• I-chemotherapy yamacandelo.

• Unyango lwangaphakathi lwemitha.

• Uvavanyo lweklinikhi lwe-immunotherapy (imiquimod) efakwe kulusu.

Unyango lweNqanaba I-Cancer yeVaginal

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

Unyango lwenqanaba I squamous cell umhlaza kwilungu lobufazi izilonda ezingaphantsi kwe-0.5 yeesentimitha ukutyeba kunokubandakanya oku kulandelayo:

• Unyango lwangaphandle lwemitha, ngakumbi amathumba amakhulu okanye ii-lymph node ezikufutshane nethumba kwindawo esezantsi yelungu lobufazi.

• Unyango lwangaphakathi lwemitha.

• Utyando (ukusikwa okubanzi kwendawo okanye ubufazi ngokuvuselelwa kwelungu lobufazi). Unyango ngemitha lunokunikwa emva kotyando.

Unyango lwenqanaba I squamous cell izilonda zomhlaza kwilungu lobufazi elingaphezulu kwe-0.5 yeesentimitha ukutyeba kunokubandakanya oku kulandelayo:

• Utyando:

• Kwizilonda kwinxalenye yesithathu ephezulu yelungu lobufazi, ubufazi kunye ne-lymph node dissection, kunye okanye ngaphandle kokwakha ubufazi.

• Kwizilonda ezikwindawo yesithathu esezantsi yelungu lobufazi, i-lymph node dissection.

• Unyango ngemitha lunokunikwa emva kotyando, olunokubandakanya:

• Unyango lwangaphandle lwemitha kunye okanye ngaphandle kwonyango lwangaphakathi lwemitha.

• Unyango lwangaphakathi lwemitha.

• Kwizilonda ezikwindawo yesithathu esezantsi yelungu lobufazi, unyango ngemitha lunokunikezelwa kwii-lymph node ezikufutshane namathumba.

Unyango lwenqanaba I lobufazi adenocarcinoma inokubandakanya oku kulandelayo:

• Ugqirha (lobufazi kunye ne-hysterectomy ene-lymph node dissection). Oku kunokulandelwa kukwakhiwa kwakhona kwesini kunye / okanye unyango lwemitha.

• Unyango lwangaphakathi lwemitha. Unyango lwangaphandle lwemitha lunokunikwa ii-lymph node ezikufutshane nethumba kwindawo esezantsi yelungu lobufazi.

• Indibaniselwano yonyango enokuthi ibandakanye ukusikwa okubanzi kwendawo kunye okanye ngaphandle kwe-lymph node dissection kunye nonyango lwangaphakathi lwemitha.

Unyango lweSigaba II, iSigaba se-III, kunye neSigaba se-IVa somhlaza wesifo sangasese

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

Unyango lwenqanaba II, inqanaba III, kunye nenqanaba IVa lomhlaza welungu lobufazi liyafana kwisifo somhlaza weseli kunye ne-adenocarcinoma. Unyango lunokubandakanya oku kulandelayo:

• Unyango lwangaphakathi kunye / okanye lwangaphandle kwimitha yelungu lobufazi. Unyango ngemitha lunokunikezelwa kwii-lymph node ezikufutshane nethumba kwindawo esezantsi yelungu lobufazi.

• Ugqirha (lobufazi okanye isinqe) kunye okanye ngaphandle kwonyango lwemitha.

• I-Chemotherapy inikwe unyango lwe-radiation.

Unyango lweSigaba IVb somhlaza wesifo sangasese

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

Unyango lwesigaba somhlaza wesini somfazi kwilungu lesini elifanayo kwiscamous cell cancer kunye ne-adenocarcinoma. Unyango lunokubandakanya oku kulandelayo:

Unyango ngemitha njengonyango lokuthomalalisa, ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi. I-Chemotherapy inokunikwa kwakhona. Nangona kungekho ziyobisi zichaphazela umhlaza welungu lesini lobufazi zihlala ixesha elide, zihlala zinyangwa ngeerejimeni ezisetyenziselwa umhlaza womlomo wesibeleko. (Jonga isishwankathelo se- kunyango lomhlaza wesibeleko.)

Unyango loMhlaza obuBufazi obuQhubekayo

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

Unyango lomhlaza ophindaphindwayo wesini sangasese unokubandakanya oku kulandelayo:

• Utyando (ingqumbo yethambo lomqolo).

• Unyango ngemitha.

Nangona kungekho ziyobisi zichasene nomhlaza eziye zaboniswa zinceda abaguli abanomhlaza ophindaphindwayo wesini ukuba baphile ixesha elide, bahlala bephathwa ngeerejimeni ezisetyenziselwa umhlaza womlomo wesibeleko. (Jonga isishwankathelo se- kunyango lomhlaza wesibeleko.)

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukufunda ngakumbi malunga noMhlaza weSini sangasese

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nomhlaza welungu lobufazi, bona oku kulandelayo:

• Iphepha Lasekhaya Lomhlaza Wesini

• Iphepha Lasekhaya Lomhlaza Wesibeleko

• I-Lasers kunyango lomhlaza

• Ikhompyuter yeTomography (CT) kunye noMhlaza

• Iithagethi zoMhlaza ezijolise kuko

• Iimodyuli zeNkqubo yokuZikhusela

• I-HPV kunye noMhlaza

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli

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