Types/anal/patient/anal-treatment-pdq

Ukwelashwa Komdlavuza We-Anal (®) –Patient Version

Imininingwane ejwayelekile Ngomdlavuza Wamasende

AMAPHUZU ASEMQOKA

• Umdlavuza wesitho sangasese yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zendunu.

• Ukutheleleka nge-human papillomavirus (HPV) kwandisa ingozi yokuba nomdlavuza wendunu.

• Izimpawu zomdlavuza wesitho sangasese zifaka ukopha okuvela endunu noma engxenyeni ethile yesigaxa noma isigaxa esiseduze nendunu.

• Ukuhlolwa okuhlola i-rectum ne-anus kusetshenziselwa ukuthola (ukuthola) nokuthola umdlavuza wendunu.

• Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Umdlavuza wesitho sangasese yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zendunu.

Ingquza ukuphela kwethumbu elikhulu, ngaphansi kwe-rectum, lapho isitokisi (udoti oqinile) ushiya umzimba. Ingquza yakhiwa ngokwengxenye engxenyeni engaphandle yesikhumba somzimba futhi ngokwengxenye ivela emathunjini. Imisipha emibili efana nezindandatho, ebizwa ngemisipha ye-sphincter, ivule futhi ivale ukuvuleka kwendunu bese kudedela indle emzimbeni. Umsele wangemuva, oyingxenye yendunu phakathi kwengxenyeni nokuvulwa kwendunu, ungamasentimitha angu-1-1½ ubude.

I-anatomy yesistimu yokugaya engezansi, ekhombisa ikholoni nezinye izitho.

Isikhumba esizungeze ingaphandle lendunu sibizwa ngokuthi indawo yeperianal. Izimila kule ndawo izicubu zesikhumba, hhayi umdlavuza wendunu.

Ukutheleleka nge-human papillomavirus (HPV) kwandisa ingozi yokuba nomdlavuza wendunu.

Izici zobungozi zifaka okulandelayo:

• Ukutheleleka nge-human papillomavirus (HPV).

• Ukuba nabalingani abaningi ocansini.

• Ukuba nezocansi ezamukelekayo (ucansi lwendunu).

• Ukuba mdala kuneminyaka engama-50.

• Ukubomvu okuvamile, ukuvuvukala nobuhlungu.

• Ukuba nama-fistula anal (ukuvuleka okungavamile).

• Ukubhema osikilidi.

Izimpawu zomdlavuza wesitho sangasese zifaka ukopha okuvela endunu noma engxenyeni ethile yesigaxa noma isigaxa esiseduze nendunu.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa umdlavuza wendunu noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Ukopha kusuka endunu noma engxenyeni.

• Ubuhlungu noma ingcindezi endaweni ezungeze indunu.

• Ukulunywa noma ukukhishwa endunu.

• Isigaxa esiseduze nendunu.

• Ukushintsha kwemikhuba yamathumbu.

Ukuhlolwa okuhlola i-rectum ne-anus kusetshenziselwa ukuthola (ukuthola) nokuthola umdlavuza wendunu.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.

• Ukuhlolwa kwe-digital rectal (DRE): Ukuhlolwa kwe-anus ne-rectum. Udokotela noma umhlengikazi ufaka umunwe othanjisiwe, ofakwe igilavu ​​engxenyeni engezansi ye-rectum ukuzwa izigaxa noma yini enye ebonakala ingajwayelekile.

Ukuhlolwa kwe-digital rectal (DRE). Udokotela ufaka umunwe ovalwe, othanjisiwe ku-rectum futhi uzwe i-rectum, i-anus, ne-prostate (kwabesilisa) ukubheka noma yini engajwayelekile.

• I-Anoscopy: Ukuhlolwa kwe-anus ne-rectum engezansi kusetshenziswa ithubhu emfushane, ekhanyisiwe ebizwa nge-anoscope.

• I-Proctoscopy: Inqubo yokubheka ngaphakathi kwe-rectum ne-anus ukuhlola izindawo ezingavamile, usebenzisa i-proctoscope. I-proctoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka ingaphakathi le-rectum ne-anus. Kungaba futhi nethuluzi lokususa amasampula wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.

• I-Endo-anal noma i-endorectal ultrasound: Inqubo lapho kufakwa khona i-ultrasound transducer (iphenyo) kwi-anus noma i-rectum futhi isetshenziselwe ukubhebhethekisa amaza omsindo aphezulu (i-ultrasound) ezicutshini zangaphakathi noma ezithweni bese yenza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram.

• I-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. Uma indawo engavamile ibonakala ngesikhathi se-anoscopy, i-biopsy ingenziwa ngaleso sikhathi.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Isibikezelo (ithuba lokululama) sincike kokulandelayo:

• Usayizi wesimila.

• Lapho okukhona isimila endunu.

• Ukuthi umdlavuza ususabalele kuma-lymph node.

Izinketho zokwelashwa zincike kokulandelayo:

• Isigaba somdlavuza.

• Lapho okukhona isimila endunu.

• Ukuthi isiguli sine-human immunodeficiency virus (HIV).

• Ukuthi umdlavuza uhlala ngemuva kokwelashwa kokuqala noma ubuyile.

Izigaba Zomdlavuza Wamasende

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala komdlavuza wendunu, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asabalele ngaphakathi kwendunu noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza wendunu:

• Isigaba 0

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

Ngemuva kokutholakala komdlavuza wendunu, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asabalele ngaphakathi kwendunu noma kwezinye izingxenye zomzimba.

Inqubo esetshenziswayo ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwendunu noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa. Ukuhlolwa okulandelayo kungasetshenziswa kunqubo yokubeka iziteji:

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, njengesisu noma isifuba, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography. Ngomdlavuza wangemuva, kungenziwa i-CT scan yamathambo kanye nesisu.

• I-x-ray yesifuba: I-x-ray yezitho namathambo ngaphakathi kwesifuba. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• I-PET scan (i-positron emission tomography scan): Inqubo yokuthola amangqamuzana abulalayo omzimba emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.

• Ukuhlolwa kwe-pelvic: Ukuhlolwa kwesitho sangasese sowesifazane, umlomo wesibeletho, isibeletho, amashubhu e-fallopian, ama-ovari, ne-rectum. Kufakwa i-speculum esithweni sangasese bese udokotela noma umhlengikazi ebheka esithweni sangasese kanye nomlomo wesibeletho ukuthola izimpawu zesifo. Kuvame ukwenziwa ukuhlolwa kwesibeletho sePap. Udokotela noma umhlengikazi uphinde afake umunwe owodwa noma emibili ethanjisiwe, efakwe igilavu ​​yesandla esisodwa esithweni sangasese bese ebeka esinye isandla phezu kwesisu esingezansi ukuze ezwe ubukhulu, ukuma, nokuma kwesibeletho namaqanda. Udokotela noma umhlengikazi uphinde afake umunwe othanjisiwe, ofakwe igilavu ​​ku-rectum ukuzwa izigaxa noma izindawo ezingejwayelekile.

Ukuhlolwa kwepelvic. Udokotela noma umhlengikazi ufaka umunwe owodwa noma emibili ethanjisiwe, efakwe igilavu ​​yesandla esisodwa esithweni sangasese bese ucindezela esiswini esingezansi ngesinye isandla. Lokhu kwenzelwa ukuzwa ubukhulu, ukuma, nokuma kwesibeletho namaqanda. Isitho sowesifazane sangasese, umlomo wesibeletho, amashubhu okuya emithanjeni, kanye nengxenyenamba iyahlolwa.

Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

Umdlavuza ungasakazeka ngezicubu, uhlelo lwe-lymph, kanye negazi:

• Izicubu. Umdlavuza usakazeka lapho uqale khona ngokukhulela ezindaweni eziseduze.

• Uhlelo lweLymph. Umdlavuza usakazeka lapho uqale khona ngokungena ohlelweni lwe-lymph. Umdlavuza udabula imithambo ye-lymph uye kwezinye izingxenye zomzimba.

• Igazi. Umdlavuza usakazeka lapho uqale khona ngokungena egazini. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.

Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Lapho umdlavuza usakazekela kolunye uhlangothi lomzimba, ubizwa ngokuthi yi-metastasis. Amaseli womdlavuza aqhamuka lapho aqale khona (isimila sokuqala) futhi ahamba ngohlelo lwe-lymph noma igazi.

• Uhlelo lweLymph. Umdlavuza ungena ohlelweni lwe-lymph, udabule emithanjeni ye-lymph, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

• Igazi. Umdlavuza ungena egazini, udabule emithanjeni yegazi, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

Isigaxa se-metastatic luhlobo olufanayo lomdlavuza njengesimila sokuqala. Isibonelo, uma umdlavuza wendunu usakazekela emaphashini, amangqamuzana omdlavuza asemaphashini empeleni angamaseli omdlavuza wendunu. Lesi sifo umdlavuza we-anal metastatic, hhayi umdlavuza wamaphaphu.

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza wendunu:

Isigaba 0

Esigabeni 0, kutholakala amaseli angajwayelekile ku-mucosa (ungqimba lwangaphakathi) lwe-anus. Lawa maseli angajwayelekile angaba ngumdlavuza futhi asabalale abe izicubu ezijwayelekile eziseduze. Isigaba 0 sibizwa nangokuthi ibanga eliphakeme le-squamous intraepithelial lesion (HSIL).

Osayizi bezicubu bavame ukulinganiswa ngamasentimitha (cm) noma amasentimitha. Izinto zokudla ezijwayelekile ezingasetshenziswa ukukhombisa usayizi wesimila ngo-cm zifaka: ipea (1 cm), iphenathi (2 cm), umvini (3 cm), i-walnut (4 cm), umcako (5 cm noma 2) amasentimitha), iqanda (6 cm), ipentshisi (7 cm), ne-grapefruit (10 cm noma 4 inches).

Isiteji I

Esigabeni I, umdlavuza wakhekile futhi isimila singamasentimitha ama-2 noma sincane.

Isigaba II

Umdlavuza wesigaxa sesibili II uhlukaniswe ngezigaba IIA no-IIB.

• Esigabeni IIA, isimila sikhulu kunamasentimitha ama-2 kepha asisikhulu kunamasentimitha ama-5.

• Esigabeni IIB, isimila sikhulu kunamasentimitha ama-5.

Isigaba III

Umdlavuza wendunu weSigaba III uhlukaniswe ngezigaba IIIA, IIIB, kanye ne-IIIC.

• Esigabeni IIIA, isimila singamasentimitha ama-5 noma sincane futhi sesisabalalele kuma-lymph node eduze ne-anus noma i-groin.

• Esigabeni IIIB, isimila sinanoma yisiphi isayizi futhi sesisakaze ezithombeni eziseduze, njengesitho sangasese sowesifazane, i-urethra, noma isinye. Umdlavuza awusabalalanga kuma-lymph node.

• Esigabeni IIIC, isimila sinanoma yisiphi isayizi futhi kungenzeka ukuthi sidlulele ezithweni eziseduze. Umdlavuza usabalalele kuma-lymph node eduze ne-anus noma i-groin.

Isigaba IV

Esigabeni IV, isimila sinanoma yisiphi isayizi. Umdlavuza kungenzeka usabalalele kuma-lymph node noma ezithweni eziseduze futhi usabalalele nakwezinye izingxenye zomzimba, njengesibindi noma amaphaphu.

Umdlavuza We-Anal Ophindaphindayo

Umdlavuza ophuma kaningi ngumdlavuza ophindwe (wabuya) ngemuva kokuba welashwe. Umdlavuza ungabuyela endunu noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza wendunu.

• Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Ukuhlinzwa

• Ukuba negciwane lokuzivikela komzimba kungathinta ukwelashwa komdlavuza wendunu.

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ama-Radiosensitizers

• Ukwelashwa komdlavuza wendunu kungadala imiphumela emibi.

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

• Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza wendunu.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza wendunu. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Kunezinhlobo ezimbili zokwelashwa ngemisebe:

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni.

• Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuya ngohlobo nesigaba somdlavuza owelashwa. Ukwelashwa kwemisebe yangaphandle neyangaphakathi kusetshenziselwa ukwelapha umdlavuza wendunu.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuvimba amaseli ukuthi angahlukani. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda). Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Ukuhlinzwa

• Ukuthengiswa kabusha kwasendaweni: Inqubo yokuhlinza lapho kusikwa khona isimila kusuka endunu kanye nezinye izicubu ezinempilo ezizungezile. Ukuthengiswa kwendawo kabusha kungasetshenziswa uma umdlavuza umncane futhi ungakasakazeki. Le nqubo ingagcina imisipha ye-sphincter ukuze isiguli sikwazi ukulawula ukuhamba kwamathumbu. Izimila ezakha engxenyeni engezansi ye-anus zingasuswa kaningi ngokususwa kwendawo.

• I-resection ye-Abdominoperineal: Inqubo yokuhlinza lapho i-anus, i-rectum, nengxenye yekholoni ye-sigmoid isuswa ngokusebenzisa imbobo eyenziwe esiswini. Udokotela uthunga ukuphela kwamathumbu embobeni, ebizwa nge-stoma, eyenziwe ebusweni besisu ukuze udoti womzimba uqoqwe esikhwameni esilahlwayo ngaphandle komzimba. Lokhu kubizwa nge-colostomy. Ama-lymph node aqukethe umdlavuza nawo angasuswa phakathi nalokhu kusebenza.

Ukutholwa kabusha kwekholoni nge-colostomy. Ingxenye yekoloni equkethe umdlavuza nezicubu ezinempilo eziseduze kuyasuswa, kwakhiwa i-stoma, bese kufakwa isikhwama se-colostomy ku-stoma.

Ukuba negciwane lokuzivikela komzimba kungathinta ukwelashwa komdlavuza wendunu.

Ukwelashwa komdlavuza kungaphinde kulimaze amasosha omzimba asevele ebuthakathaka eziguli ezinesandulela ngculazi somzimba (i-HIV). Ngalesi sizathu, iziguli ezinomdlavuza wesitho sangasese kanye ne-HIV zivame ukuphathwa ngemithamo ephansi yemithi elwa nomdlavuza nemisebe kunalezo ezingenayo i-HIV.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Lesi sigaba esifingqiwe sichaza izindlela zokwelashwa ezicwaningwa ekuhlolweni kwemitholampilo. Kungenzeka kungasho yonke imishanguzo emisha efundwayo. Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ama-Radiosensitizers

Ama-radiosensitizers yizidakamizwa ezenza amangqamuzana ama-tumor azwele kakhulu ekwelashweni kwemisebe. Ukuhlanganisa ukwelashwa ngemisebe ngama-radiosensitizers kungabulala amangqamuzana amaningi wesimila.

Ukwelashwa komdlavuza wendunu kungadala imiphumela emibi.

Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izinketho Zokwelapha ngeStage

Kulesi Sigaba

• Isigaba 0 (I-Carcinoma eSitu)

• Isigaba I Umdlavuza Wokuhlaziya

• Umdlavuza Ohlaziya Isigaba II

• Isigaba IIIA Somdlavuza Wokuhlaziya

• Isigaba IIIB Cancer Anal

• Umdlavuza Wokuhluza Wasesiteji IV

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Isigaba 0 (I-Carcinoma eSitu)

Ukwelashwa kwesigaba 0 kuvame ukuthengiswa kwendawo kabusha.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Isigaba I Umdlavuza Wokuhlaziya

Ukwelashwa kwesigaba somdlavuza wendunu kungafaka okulandelayo:

• Ukuthengiswa kabusha kwasendaweni.

• Ukwelashwa kwemisebe yangaphandle nge-chemotherapy noma ngaphandle kwayo. Uma umdlavuza uhlala ngemuva kokwelashwa, i-chemotherapy eyengeziwe kanye nokwelashwa ngemisebe kunganikezwa ukugwema isidingo se-colostomy yaphakade.

• Ukwelashwa kwemisebe yangaphakathi.

• Ukuvuselelwa kwesisu, uma umdlavuza uhlala noma ubuya ngemuva kokwelashwa nge-radiation therapy kanye ne-chemotherapy.

• Ukwelashwa kwemisebe yangaphakathi yomdlavuza okusala ngemuva kokwelashwa ngemithi yokwelashwa kwemisebe yangaphandle.

Iziguli ezithole ukwelashwa okusindisa imisipha ye-sphincter zingathola izivivinyo zokulandelela njalo ezinyangeni ezi-3 eminyakeni emibili yokuqala, kufaka phakathi izivivinyo zamakholomu ezine-endoscopy kanye ne-biopsy, njengoba kudingeka.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Umdlavuza Ohlaziya Isigaba II

Ukwelashwa komdlavuza wesitho sangasese sesigaba II kungafaka okulandelayo:

• Ukuthengiswa kabusha kwasendaweni.

• Ukwelashwa kwemisebe yangaphandle nge-chemotherapy. Uma umdlavuza uhlala ngemuva kokwelashwa, i-chemotherapy eyengeziwe kanye nokwelashwa ngemisebe kunganikezwa ukugwema isidingo se-colostomy yaphakade.

• Ukwelashwa kwemisebe yangaphakathi.

• Ukuvuselelwa kwesisu, uma umdlavuza uhlala noma ubuya ngemuva kokwelashwa nge-radiation therapy kanye ne-chemotherapy.

• Isivivinyo somtholampilo sezinketho ezintsha zokwelashwa.

Iziguli ezithole ukwelashwa okusindisa imisipha ye-sphincter zingathola izivivinyo zokulandelela njalo ezinyangeni ezi-3 eminyakeni emibili yokuqala, kufaka phakathi izivivinyo zamakholomu ezine-endoscopy kanye ne-biopsy, njengoba kudingeka.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Isigaba IIIA Somdlavuza Wokuhlaziya

Ukwelashwa komdlavuza wangemuva wesigaba IIIA kungafaka okulandelayo:

• Ukwelashwa kwemisebe yangaphandle nge-chemotherapy. Uma umdlavuza uhlala ngemuva kokwelashwa, i-chemotherapy eyengeziwe kanye nokwelashwa ngemisebe kunganikezwa ukugwema isidingo se-colostomy yaphakade.

• Ukwelashwa kwemisebe yangaphakathi.

• Ukuvuselelwa kwesisu, uma umdlavuza uhlala noma ubuya ngemuva kokwelashwa nge-chemotherapy kanye ne-radiation therapy.

• Isivivinyo somtholampilo sezinketho ezintsha zokwelashwa.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ukwelashwa kwesifo somdlavuza wesigaba IIIB sesigaba IIIB somdlavuza wesitho sangasese kungafaka okulandelayo:

Ukwelashwa kwemisebe yangaphandle nge-chemotherapy. Ukuthengiswa kabusha kwasendaweni noma ukuvuselelwa kwesisu, uma umdlavuza uhlala noma ubuya ngemuva kokwelashwa nge-chemotherapy kanye ne-radiation therapy. Ama-lymph node nawo angasuswa. Isivivinyo somtholampilo sezinketho ezintsha zokwelashwa. Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Umdlavuza Wokuhluza Wasesiteji IV

Ukwelashwa komdlavuza wesigaba sesine IV kungafaka okulandelayo:

• Ukuhlinzwa njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

• Ukwelashwa ngemisebe njengokwelashwa okunciphisayo.

• I-Chemotherapy enokwelashwa kwemisebe njengokwelashwa okunciphisayo.

• Isivivinyo somtholampilo sezinketho ezintsha zokwelashwa.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Izinketho Zokwelapha Umdlavuza Wokuhlaziya Wokuphindaphinda

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Ukwelashwa komdlavuza ophindaphindiwe kungafaka okulandelayo:

• Ukwelashwa ngemisebe nokwelashwa ngamakhemikhali, kokuphindaphinda ngemuva kokuhlinzwa.

• Ukuhlinzwa, kokuphindaphinda ngemuva kokwelashwa ngemisebe kanye / noma ngamakhemikhali.

• Isivivinyo somtholampilo sokwelapha ngemisebe ngamakhemikhali kanye / noma ama-radiosensitizers.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ukufunda Okwengeziwe Ngomdlavuza Wamasende

Ukuthola eminye imininingwane ngeNational Cancer Institute mayelana nomdlavuza wendunu, bheka okulandelayo:

• Ikhasi Lasekhaya Lomdlavuza Wase-Anal

• Ugwayi (uhlanganisa usizo ngokuyeka)

• Amagciwane ePapilloma kanye Nomdlavuza

Ngemininingwane ejwayelekile yomdlavuza nezinye izinsiza ezivela ku-National Cancer Institute, bheka okulandelayo:

• Mayelana Nomdlavuza

• Isiteji

• I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli