Types/bladder/patient/bladder-treatment-pdq

Ukwelashwa Komdlavuza Wesinye (®) –Patient Version

Imininingwane ejwayelekile ngomdlavuza wesinye

AMAPHUZU ASEMQOKA

• Umdlavuza wesinye yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zesinye.
• Ukubhema kungaphazamisa ingozi yomdlavuza wesinye.
• Izimpawu nezimpawu zomdlavuza wesinye zifaka igazi emchameni kanye nobuhlungu ngesikhathi uchama.
• Izivivinyo ezihlola umchamo nesinye zisetshenziselwa ukusiza ukuthola (ukuthola) nokuthola umdlavuza wesinye.
• Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Umdlavuza wesinye yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zesinye.

Isinye isitho esingenalutho engxenyeni engezansi yesisu. Yakhelwe njengebhaluni elincane futhi inodonga lwemisipha oluyivumela ukuthi ikhule noma ibe ncane ukugcina umchamo owenziwe izinso. Kunezinso ezimbili, eyodwa ohlangothini ngalunye lomgogodla, ngenhla kwesinqe. Amashubhu amancane ezinso ahlunga futhi ahlanze igazi. Bakhipha imfucuza benze umchamo. Umchamo udlula usuka ezinso ngalunye ngebhubhu ende ebizwa nge-ureter iye esinyeni. Isinye sigcina umchamo uze udlule kumchamo bese ushiya umzimba.

I-anatomy yesistimu yomchamo wesilisa (iphaneli yesobunxele) nohlelo lwabesifazane lokuchama (iphaneli langakwesokudla) olubonisa izinso, ama-ureters, isinye, ne-urethra. Umchamo wenziwa kuma-tubules wezinso futhi uqoqwa ku-pelvis ye-renal yenso ngalinye. Umchamo ugeleza kusuka ezinso udabule ureters uye esinyeni. Umchamo ugcinwa esinyeni uze ushiye umzimba ngomchamo.

Kunezinhlobo ezintathu zomdlavuza wesinye oqala kumaseli kulwelwesi lwesinye. Lawa mdlavuza abizwa ngohlobo lwamaseli ababa yingozi (anomdlavuza):

• Transitional cell carcinoma: Umdlavuza oqala kumaseli engxenyeni yezicubu zangaphakathi zesinye. Lawa maseli ayakwazi ukwelula uma isinye sigcwele futhi anciphe lapho echithwa. Iningi lomdlavuza wesinye uqala kumaseli wesikhashana. I-Transitional cell carcinoma ingaba ibanga eliphansi noma ibanga eliphakeme:

• I-low-grade transitional cell carcinoma ivame ukubuyela emuva (ibuye emuva) ngemuva kokwelashwa, kepha kuyaqabukela isabalale ingqimba yemisipha yesinye noma kwezinye izingxenye zomzimba.

• I-high-grade transitional cell carcinoma ivame ukubuya (ibuye emuva) ngemuva kokwelashwa futhi ivame ukusabalala engqimbeni yemisipha yesinye, kwezinye izingxenye zomzimba, nakuma-lymph node. Cishe bonke abantu ababulawa ngumdlavuza wesinye kungenxa yezifo ezisezingeni eliphakeme.

• I-squamous cell carcinoma: Umdlavuza oqala kumaseli angama-squamous (amangqamuzana amancane, ayizicaba afaka ngaphakathi kwesinye). Umdlavuza ungakheka ngemuva kokutheleleka isikhathi eside noma ukucasuka.

• I-Adenocarcinoma: Umdlavuza oqala kumaseli wezindlala atholakala kulwelwesi lwesinye. Amaseli endlala esinyeni enza izinto ezinjengefinyila. Lolu uhlobo olungavamile kakhulu lomdlavuza wesinye.

Umdlavuza osemgqeni wesinye ubizwa ngokuthi ngumdlavuza wesinye phezulu. Umdlavuza osabalele ngaphakathi kolwelwesi lwesinye futhi uhlasele odongeni lwemisipha lwesinye noma osusabalele ezithweni ezisondelene nakuma-lymph node ubizwa ngokuthi ngumdlavuza wesinye wesisu.

Bona izifinyezo ezilandelayo ze- ukuthola eminye imininingwane:

• Ukwelashwa Komdlavuza Wesifo Sezinso

• Umdlavuza Wamaseli Wenguqu we-Renal Pelvis kanye ne-Ureter Treatment

• Isinye nokunye ukuhlolwa komdlavuza we-Urothelial

• Umdlavuza Ongajwayelekile Wokwelashwa Kwezingane

Ukubhema kungaphazamisa ingozi yomdlavuza wesinye.

Noma yini eyandisa amathuba akho okuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola umdlavuza; ukungabi nezici zobungozi akusho ukuthi ngeke uthole umdlavuza. Khuluma nodokotela wakho uma ucabanga ukuthi ungaba sengozini yomdlavuza wesinye.

Izici zobungozi zomdlavuza wesisu zifaka okulandelayo:

• Kusetshenziswa ugwayi, ikakhulukazi ukubhema osikilidi.

• Ukuba nomlando womndeni wesifo somdlavuza wesinye.

• Ukuba nezinguquko ezithile kwizakhi zofuzo ezixhunyaniswe nomdlavuza wesinye.

• Ukuvezwa ngopende, odayi, izinsimbi, noma imikhiqizo kaphethiloli emsebenzini.

• Ukwelashwa okwedlule ngemithi yokwelapha ngemisebe okhalweni noma ngemithi ethile elwa nomdlavuza, njenge-cyclophosphamide noma ifosfamide

• Ukuthatha u-Aristolochia fangchi, umuthi waseChina.

• Ukuphuza amanzi emthonjeni onamazinga aphezulu e-arsenic.

• Amanzi okuphuza aphethwe nge-chlorine.

• Ukuba nomlando wokutheleleka kwesinye, kufaka phakathi ukutheleleka kwesinye okubangelwa yiSchistosoma haematobium.

• Usebenzisa ama-catheters we-urinary isikhathi eside.

Ukuguga kuyingcuphe yomdlavuza omningi. Ithuba lokuthola umdlavuza liyakhula njengoba ukhula.

Izimpawu nezimpawu zomdlavuza wesinye zifaka igazi emchameni kanye nobuhlungu ngesikhathi uchama.

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

• Igazi emchameni (ngokugqwala okumbala obomvu ngokugqamile ngombala obomvu).

• Ukuchama njalo.

• Ubuhlungu ngesikhathi sokuchama.

• Ubuhlungu obuphansi emuva.

Izivivinyo ezihlola umchamo nesinye zisetshenziselwa ukusiza ukuthola (ukuthola) nokuthola umdlavuza wesinye.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

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

• Ukuhlolwa kwangaphakathi : Ukuhlolwa kwesitho sangasese sowesifazane kanye / noma i-rectum. Udokotela ufaka iminwe ethanjisiwe, efakwe amagilavu ​​esithweni sangasese kanye / noma ku-rectum ukuzwa izigaxa.

• I-Urinalysis : Isivivinyo sokubheka umbala womchamo nokuqukethwe kuwo, njengoshukela, amaprotheni, amaseli abomvu egazi namaseli amhlophe egazi.

• I-urine cytology : Isivivinyo selabhorethri lapho kuhlolwe khona isampula lomchamo ngaphansi kwesibonakhulu ukuthola amaseli angajwayelekile.

• I-cystoscopy : Inqubo yokubheka ngaphakathi kwesinye kanye nomchamo ukubheka izindawo ezingajwayelekile. I-cystoscope ifakwa nge-urethra iye esinyeni. I-cystoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa amasampula wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.

I-cystoscopy. I-cystoscope (insimbi encane, efana nethubhu enokukhanya nelensi yokubuka) ifakwa ngomchamo ungene esinyeni. Uketshezi lusetshenziselwa ukugcwalisa isinye. Udokotela ubheka isithombe sodonga lwangaphakathi lwesinye kumqapha wekhompyutha.

I-intravenous pyelogram (IVP): Uchungechunge lwama-x-ray wezinso, ama-ureters, nesinye ukuthola ukuthi umdlavuza ukhona yini kulezi zitho. Idayi ehlukile ifakwa emthanjeni. Njengoba udayi wokuqhathanisa uhamba ngezinso, ama-ureters, nesinye, ama-x-ray ayathathwa ukubona ukuthi kukhona yini ukuvinjelwa.

I-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. I-biopsy yomdlavuza wesinye ivame ukwenziwa ngesikhathi se-cystoscopy. Kungenzeka ukukhipha sonke isimila ngesikhathi se-biopsy.

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

Isibikezelo (ithuba lokululama) sincike kokulandelayo:

• Isigaba somdlavuza (noma ngabe ungowaphezulu noma ongenasifo somdlavuza wesinye, nokuthi ususabalele nakwezinye izindawo emzimbeni). Umdlavuza wesinye emabangeni okuqala ungalapheka.

• Uhlobo lwamaseli womdlavuza wesinye nokuthi abukeka kanjani ngaphansi kwesibonakhulu.

• Noma ngabe kukhona i-carcinoma in situ kwezinye izingxenye zesinye.

• Iminyaka yesiguli nempilo ejwayelekile.

Uma umdlavuza ungaphezulu, ukubikezela futhi kuncike kokulandelayo:

• Zingaki izimila ezikhona.

• Usayizi wamathumba.

• Ukuthi isimila sesiphindile yini (sibuya) ngemuva kokwelashwa.

Izinketho zokwelashwa zincike esigabeni somdlavuza wesinye.

Izigaba zomdlavuza wesinye

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala komdlavuza wesinye, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asabalele esinyeni noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza wesinye:

• Isigaba 0 (I-Noninvasive Papillary Carcinoma neCarcinoma eSitu)

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

Ngemuva kokutholakala komdlavuza wesinye, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asabalele esinyeni noma kwezinye izingxenye zomzimba.

Inqubo esetshenziselwe ukuthola ukuthi umdlavuza ususabalele ngaphakathi kolwelwesi lwesinyama nasemisipha noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa. Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

• I-CT scan (i-CAT scan) : Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, 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. Ukwenza umdlavuza wesinye, i-CT scan ingathatha izithombe zesifuba, isisu, nesikhumba.

• I-MRI (imaging resonance imaging) : Inqubo esebenzisa uzibuthe, amagagasi omsakazo nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, njengobuchopho. 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. Le nqubo yenziwa ukuze kubhekwe ukuthi ngabe kukhona yini amangqamuzana amabi esigaxa kuma-lymph node.

• 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.

Ukuskena kwamathambo: Inqubo yokubheka ukuthi kunamaseli ahlukanisa ngokushesha yini, njengamaseli womdlavuza, ethanjeni. Inani elincane kakhulu lezinto ezinomsakazo lifakwa emthanjeni futhi lihambe phakathi kwegazi. Izinto ezinemisebe eqoqa emathanjeni ezinomdlavuza futhi zitholwa isithwebuli.

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 wesinye usakazeka uye ethanjeni, amangqamuzana omdlavuza asethanjeni empeleni angamaseli omdlavuza wesinye. Lesi sifo umdlavuza wesinye wesisu, hhayi umdlavuza wethambo.

Ukufa komdlavuza okuningi kubangelwa lapho umdlavuza usuka esiswini sokuqala futhi usakazekela kwezinye izicubu nezitho. Lokhu kubizwa ngokuthi umdlavuza we-metastatic. Lokhu kugqama kukhombisa ukuthi amangqamuzana omdlavuza ahamba kanjani esuka emzimbeni lapho aqala khona ukwakheka kwezinye izingxenye zomzimba.

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza wesinye:

Isigaba 0 (I-Noninvasive Papillary Carcinoma neCarcinoma eSitu)

Isigaba 0 somdlavuza wesinye. Amangqamuzana angajwayelekile atholakala ezicutshini ezingaphakathi kwesinye. Isigaba 0a (esibizwa nangokuthi i-papillary carcinoma engavuseleleki) singabukeka njengokukhula okude, okuncane okukhulela emgqeni wesinye. IStage 0is (esibizwa nangokuthi i-carcinoma in situ) yisimila esicaba esicutshini esisengaphakathi kwesinye.

Esigabeni 0, amangqamuzana angajwayelekile atholakala ezicutshini ezingena ngaphakathi kwesinye. Lawa maseli angajwayelekile angaba ngumdlavuza futhi asabalale abe izicubu ezijwayelekile eziseduze. Isigaba 0 sihlukaniswe ngezigaba 0a no-0is, kuya ngohlobo lwesimila:

• ISigaba 0a sibizwa nangokuthi i-papillary carcinoma engavuleki, engabukeka njengokumila okude, okuncane okukhulela emgqeni wesinye.

• ISigaba 0is sibizwa nangokuthi i-carcinoma in situ, okuyisigaxa esicaba esicutshini esisengaphakathi kwesinye.

Isiteji I

Isigaba I umdlavuza wesinye. Umdlavuza usabalalele ezingqimbeni zezicubu eziseduze nolwelwesi lwangaphakathi lwesinye.

Esigabeni I, umdlavuza wakhekile futhi wasakazeka ezingqimbeni zezicubu ezixhuma eduze kolwelwesi lwangaphakathi lwesinye.

Isigaba II

Umdlavuza wesinye wesigaba II. Umdlavuza usabalalele ezingqimbeni zezicubu zemisipha yesinye.

Esigabeni II, umdlavuza ususabalele ezingxenyeni zezicubu zemisipha yesinye.

Isigaba III

Isigaba III sehlukaniswe ngezigaba IIIA ne-IIIB.

• Esigabeni IIIA:

• umdlavuza usabalale esinyeni uye eluqwembeni lwamafutha azungeze isinye futhi kungenzeka ukuthi usabalalele nasezithweni zokuzala (i-prostate, ama-vesicles wesilisa, isibeletho, noma isitho sangasese sowesifazane) kanti umdlavuza awusabalalanga uye kuma-lymph node; noma

• umdlavuza usabalale esinyeni uye kwesinye se-lymph node ethangeni eliseduze nemithambo ye-iliac ejwayelekile (imithambo emikhulu ethangeni).

Umdlavuza wesinye wesigaba IIIA. Umdlavuza usabalale esinyeni uye ku- (a) ungqimba lwamafutha azungeze isinye futhi kungenzeka ukuthi usabalalele endlaleni yesinye kanye / noma kuma-vesicles wesilisa emadodeni noma esibelethweni kanye / noma esithweni sangasese sabesifazane, kanti umdlavuza awusabalalanga uye kuma-lymph node; noma (b) i-lymph node eyodwa ethangeni eliseduze nemithambo ye-iliac ejwayelekile.

• Esigabeni IIIB, umdlavuza usabalale esinyeni uye ngaphezu kwe-lymph node engaphezu kweyodwa ethangeni eliseduze nemithambo ye-iliac ejwayelekile noma okungenani i-lymph node eyodwa eseduze nemithambo ejwayelekile ye-iliac.

Isigaba IIIB umdlavuza wesinye. Umdlavuza usabalale esinyeni uye ku- (a) ngaphezu kweyodwa i-lymph node ethangeni eliseduze nemithambo yegazi ejwayelekile; noma (b) okungenani i-lymph node eyodwa eseduze nemithambo ye-iliac ejwayelekile.

Isigaba IV

Isigaba somdlavuza wesinye i-IVA ne-IVB. Esigabeni IVA, umdlavuza usabalale kusuka esinyeni kuya (a) odongeni lwesisu noma ukhalo; noma (b) ama-lymph node ngaphezu kwemithambo ye-iliac ejwayelekile. Esigabeni IVB, umdlavuza usabalalele (c) kwezinye izingxenye zomzimba, njengephaphu, isibindi noma ithambo.

Isigaba IV sihlukaniswe ngezigaba ze-IVA ne-IVB.

• Esigabeni IVA:

• umdlavuza usabalale esinyeni uye odongeni lwesisu noma ukhalo; noma

• umdlavuza usabalalele kuma-lymph node angaphezulu kwemithambo ejwayelekile ye-iliac (imithambo emikhulu ethangeni).

• Esigabeni IVB, umdlavuza usabalalele kwezinye izingxenye zomzimba, njengephaphu, ithambo, noma isibindi.

Umdlavuza Wesinye Ophindaphindayo

Umdlavuza wesinye ophindaphindiwe wumdlavuza obuye wabuya (ubuye) ngemuva kokuba welashwe. Umdlavuza ungabuya esinyeni noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza wesinye.

• Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• I-Immunotherapy

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa komdlavuza wesinye 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 wesinye.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza wesinye. 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 ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

Ukuhlinzwa

Enye yalezi zinhlobo zokuhlinzwa zingenziwa:

• I-Transurethral resection (TUR) ngokugcwaliswa: Ukuhlinzwa lapho kufakwa khona i-cystoscope (ithubhu elincane elikhanyisiwe) esinyeni ngokusebenzisa umchamo. Ithuluzi elinezintambo ezincane zocingo ekugcineni liyasetshenziswa ukususa umdlavuza noma ukushisa isimila ngogesi onamandla amakhulu. Lokhu kwaziwa njengokugcwalisa.

• I-Radical cystectomy: Ukuhlinzwa ukususa isinye nanoma yimaphi ama-lymph node nezitho eziseduze ezinomdlavuza. Lokhu kuhlinzwa kungenziwa lapho umdlavuza wesinye uhlasela udonga lwemisipha, noma lapho umdlavuza ongaphezulu ubandakanya ingxenye enkulu yesinye. Emadodeni, izitho eziseduze ezisusiwe yi-prostate nama-vesicles wesilisa. Kwabesifazane, kukhishwa isibeletho, amaqanda, nengxenye yesitho sangasese sowesifazane. Kwesinye isikhathi, lapho umdlavuza ususabalele ngaphandle kwesinye futhi ungeke ususwe ngokuphelele, ukuhlinzwa ukuze kususwe isinye kuphela kungenziwa ukunciphisa izimpawu zomchamo obangelwa umdlavuza. Lapho kufanele kususwe isinye, udokotela ohlinzayo udala enye indlela yokuthi umchamo uphume emzimbeni.

• I-cystectomy engaphelele: Ukuhlinzwa ukususa ingxenye yesinye. Lokhu kuhlinzwa kungenziwa ezigulini ezinesimila esisezingeni eliphansi esihlasele udonga lwesinye kodwa silinganiselwe endaweni eyodwa yesinye. Ngoba kususwa ingxenye yesinye kuphela, iziguli ziyakwazi ukuchama ngokwejwayelekile ngemuva kokululama kulokhu kuhlinzwa. Lokhu kubizwa nangokuthi i-cystectomy eyingxenye.

• Ukuphambukisa komchamo: Ukuhlinzwa ukwenza indlela entsha yokuthi umzimba ugcine futhi udlulise umchamo.

Ngemuva kokuthi udokotela awususe wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, ezinye iziguli zinganikezwa i-chemotherapy ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwa ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

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 kusetshenziselwa ukwelapha umdlavuza wesinye.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. 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). Ngomdlavuza wesinye, i-chemotherapy yesifunda ingaba nge-intravesical (efakwa esinyeni ngokusebenzisa ithubhu efakwe ku-urethra). Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa. Inhlanganisela yamakhemikhali ukwelashwa kusetshenziswa izidakamizwa ezingaphezu kwesisodwa ze-anticancer.

Bheka Izidakamizwa Ezamukelwe Umdlavuza Wesinye ukuthola eminye imininingwane.

I-Immunotherapy

I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Izinto ezenziwe ngumzimba noma ezenziwe elabhoratri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba kumdlavuza. Lolu hlobo lokwelashwa komdlavuza lubizwa nangokuthi i-biotherapy noma i-biologic therapy.

Kunezinhlobo ezahlukene ze-immunotherapy:

• Ukwelashwa kwe-immune checkpoint inhibitor therapy: Ama-PD-1 inhibitors awuhlobo lwe-immune checkpoint inhibitor therapy esetshenziswa ekwelapheni umdlavuza wesinye. I-PD-1 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba womzimba zihloliwe. Lapho i-PD-1 inamathela kwenye iprotheni ebizwa nge-PDL-1 kuseli lomdlavuza, iyeka i-T cell ekubulaleni iseli lomdlavuza. Ama-PD-1 inhibitors anamathisela ku-PDL-1 futhi avumela amaseli we-T ukuthi abulale amangqamuzana omdlavuza. I-Pembrolizumab, i-atezolizumab, i-nivolumab, i-avelumab, ne-durvalumab yizinhlobo ze-PD-1 inhibitors.

Isithiyo sokuhlola izivikeli mzimba. Amaprotheni wokuhlola, njenge-PD-L1 kumaseli we-tumor ne-PD-1 kumaseli we-T, asiza ukugcina izimpendulo ze-immune zihlolwe. Ukubopha kwe-PD-L1 kuya ku-PD-1 kugcina amaseli we-T ekubulaleni amangqamuzana omzimba emzimbeni (iphaneli engakwesobunxele). Ukuvimba ukubopha kwe-PD-L1 kuya ku-PD-1 nge-immune checkpoint inhibitor (i-anti-PD-L1 noma i-anti-PD-1) ivumela amaseli we-T ukuthi abulale amangqamuzana wesimila (iphaneli elifanele).

I-Immunotherapy isebenzisa amasosha omzimba ukulwa nomdlavuza. Le animation ichaza uhlobo olulodwa lwe-immunotherapy olusebenzisa amasosha omzimba okuhlola izivikeli mzimba ukwelapha umdlavuza.

• I-BCG (i-bacillus Calmette-Guérin): Umdlavuza wesinye ungaphathwa nge-immunotherapy ye-intravesical ebizwa nge-BCG. I-BCG inikezwa ngesisombululo esifakwa ngqo esinyeni kusetshenziswa ipayipi (ithubhu elincanyana).

I-Immunotherapy isebenzisa amasosha omzimba ukulwa nomdlavuza. Le-animation ichaza uhlobo olulodwa lwe-immunotherapy olubizwa ngokuthi yi-nonspecific immune stimulation esetshenziselwa ukwelapha umdlavuza.

Bheka Izidakamizwa Ezamukelwe Umdlavuza Wesinye ukuthola eminye imininingwane.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa komdlavuza wesinye 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.

Umdlavuza wesinye uvame ukubuya (ubuye ubuye), noma umdlavuza ungaphezulu. Ukubhekwa kwepheshana le-urinary ukubheka ukuphindaphinda kuyinto ejwayelekile ngemuva kokutholakala komdlavuza wesinye. Ukuqapha kusibhekisisa isimo sesiguli kepha kunganikezi ukwelashwa ngaphandle kokuthi kube nezinguquko emiphumeleni yokuhlolwa ekhombisa ukuthi isimo siya ngokuya siba sibi. Ngesikhathi sokubhekwa okusebenzayo, izivivinyo ezithile nokuhlolwa kwenziwa ngohlelo olujwayelekile. Ukuqapha kungafaka ukuhlolwa kwe-ureteroscopy kanye ne-imaging. Bona ukuhlolwa kwesiteji, ngenhla.

Izinketho Zokwelapha ngeStage

n Lesi Sigaba

• Isigaba 0 (I-Noninvasive Papillary Carcinoma neCarcinoma eSitu)
• I-Stage I Cancer Yesinye
• Izigaba II no-III Cancer Cancer
• Umdlavuza Wesisu IV
• Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Isigaba 0 (I-Noninvasive Papillary Carcinoma neCarcinoma eSitu)

Ukwelashwa kwesigaba 0 (nonacvas papillary carcinoma kanye necarcinoma in situ) kungafaka okulandelayo:

• Ukuthengiswa kabusha kwe-Transurethral ngokugcwaliswa ngokuphelele. Lokhu kungalandelwa ngokulandelayo:

• I-intravesical chemotherapy enikezwe ngemuva nje kokuhlinzwa.
• I-intravesical chemotherapy enikezwa ngemuva nje kokuhlinzwa bese ilashwa njalo nge-intravesical BCG noma i-intravesical chemotherapy.

• I-cystectomy engaphelele.
• I-cystectomy enamandla.
• Isivivinyo somtholampilo sokwelapha okusha.

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.

I-Stage I Cancer Yesinye

Ukwelashwa komdlavuza wesinye esiteji I kungafaka okulandelayo:

• Ukuthengiswa kabusha kwe-Transurethral ngokugcwaliswa ngokuphelele. Lokhu kungalandelwa ngokulandelayo:

  I-intravesical chemotherapy enikezwe ngemuva nje kokuhlinzwa.

  I-intravesical chemotherapy enikezwa ngemuva nje kokuhlinzwa bese ilashwa njalo nge-intravesical BCG noma i-intravesical chemotherapy.

• I-cystectomy engaphelele.
• I-cystectomy enamandla.
• Isivivinyo somtholampilo sokwelapha okusha.

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.

Izigaba II no-III Cancer Cancer

Ukwelashwa komdlavuza wesinye wesigaba II no-III kungafaka okulandelayo:

• I-cystectomy enamandla.
• Inhlanganisela yamakhemikhali elandelwa yi-cystectomy enamandla. Ukuphambukiswa komchamo kungenziwa.
• Ukwelashwa kwemisebe yangaphandle nge-chemotherapy noma ngaphandle kwayo.
• I-cystectomy eyingxenye noma engenayo i-chemotherapy.
• Ukuthengiswa kabusha kwe-Transurethral ngokugcwaliswa ngokuphelele.
• Isivivinyo somtholampilo sokwelapha okusha.

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 Wesisu IV

Ukwelashwa komdlavuza wesigaba sesithathu IV ongakaze usabalalele kwezinye izingxenye zomzimba kungabandakanya okulandelayo:

• Ukwelashwa ngamakhemikhali.

• I-radical cystectomy iyodwa noma ilandelwa ngamakhemikhali.

• Ukwelashwa kwemisebe yangaphandle nge-chemotherapy noma ngaphandle kwayo.

• Ukuphambukisa kwe-Urinary noma i-cystectomy njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

Ukwelashwa komdlavuza wesigaba sesine IV osakazekele kwezinye izingxenye zomzimba, njengephaphu, ithambo, noma isibindi, kungafaka okulandelayo:

• I-Chemotherapy noma ingekho ukwelashwa kwasendaweni (ukuhlinzwa noma ukwelashwa ngemisebe).

• I-Immunotherapy (i-immune checkpoint inhibitor therapy).

• Ukwelashwa kwemisebe yangaphandle njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

• Ukuphambukisa kwe-Urinary noma i-cystectomy njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

• Isivivinyo somtholampilo semithi emisha elwa nomdlavuza.

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 Wesisu Ojwayelekile

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

Ukwelashwa komdlavuza wesinye ophindaphindayo kuncike ekwelashweni kwangaphambilini nalapho umdlavuza ubuye khona. Ukwelashwa komdlavuza wesisu ophindaphindiwe kungafaka okulandelayo:

• Inhlanganisela chemotherapy.
• I-Immunotherapy (i-immune checkpoint inhibitor therapy).
• Ukuhlinzwa kwamathumba angenhla noma asendaweni. Ukuhlinzwa kungalandelwa ukwelashwa kwe-biologic kanye / noma i-chemotherapy.
• Ukwelashwa ngemisebe njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.
• Isivivinyo somtholampilo sokwelapha okusha.

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.

Ukuze ufunde kabanzi Ngomdlavuza wesinye

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

• Ikhasi lasekhaya lomdlavuza wesinye
• Isinye nokunye ukuhlolwa komdlavuza we-Urothelial
• Umdlavuza Ongajwayelekile Wokwelashwa Kwezingane
• Izidakamizwa zivunyelwe umdlavuza wesinye
• Ukwelashwa Kwemvelo Komdlavuza
• Ugwayi (uhlanganisa usizo ngokuyeka)

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

Mayelana Nesi Sifinyezo se-

Mayelana ne-

I-Physician Data Query () yi-National Cancer Institute's (NCI's) yemininingwane ephelele yomdlavuza. Idathabheyisi ye- iqukethe ukufingqwa kolwazi olushicilelwe lwakamuva ngokuvikela umdlavuza, ukuthola, ufuzo, ukwelashwa, ukunakekelwa okusekelayo, kanye nomuthi ohambisanayo neminye. Ukufingqa okuningi kuza ngezinhlobo ezimbili. Izinhlobo zezempilo zinemininingwane ebhalwe ngolimi lobuchwepheshe. Izinhlobo zesiguli zibhalwe ngolimi olulula ukuluqonda nolungebona ubuchwepheshe. Zombili izinguqulo zinolwazi lomdlavuza olunembile nolusesikhathini futhi izinhlobo eziningi ziyatholakala ngeSpanishi.

I- iyinsizakalo ye-NCI. I-NCI iyingxenye yeNational Institutes of Health (NIH). I-NIH iyisikhungo sikahulumeni wesifundazwe sokucwaninga ngemvelo. Ukufingqwa kwe- kusekelwe ekubuyekezweni okuzimele kwemibhalo yezokwelapha. Akuzona izitatimende zenqubomgomo ze-NCI noma i-NIH.

Inhloso yalesi Sifinyezo

Lesi sifinyezo solwazi lomdlavuza se- sinemininingwane yamanje mayelana nokwelashwa komdlavuza wesinye. Yenzelwe ukwazisa nokusiza iziguli, imindeni, nabanakekeli. Ayinikezi imihlahlandlela esemthethweni noma izincomo zokwenza izinqumo mayelana nokunakekelwa kwezempilo.

Ababuyekezi nezibuyekezo

Amabhodi Wokuhlela abhala izifinyezo zolwazi lomdlavuza we- futhi azigcine zisesikhathini. Lawa maBhodi akhiwe ngochwepheshe bezokwelapha umdlavuza nezinye izinto ezihlobene nomdlavuza. Ukufingqwa kubuyekezwa njalo futhi kwenziwa izinguquko uma kunolwazi olusha. Idethi yesifinyezo ngasinye ("Kubuyekezwe") idethi yoshintsho lwakamuva kakhulu.

Imininingwane ekulesi sifinyeto sesiguli ithathwe enguqulweni yezempilo, ebuyekezwa njalo futhi ivuselelwe njengoba kudingeka, yiBhodi labahleli bezokwelashwa kwe- Adult Treatment.

Imininingwane Yesivivinyo Somtholampilo

Isivivinyo somtholampilo yisifundo sokuphendula umbuzo wesayensi, njengokuthi ngabe ukwelashwa okukodwa kungcono yini kunokunye. Izilingo zisuselwa ezifundweni ezedlule nakulokho okufundiwe elebhu. Isivivinyo ngasinye siphendula imibuzo ethile yesayensi ukuze kutholakale izindlela ezintsha nezingcono zokusiza iziguli ezinomdlavuza. Ngesikhathi sokuhlolwa kwemitholampilo yokwelashwa, ulwazi luyaqoqwa ngemiphumela yokwelashwa okusha nokuthi kusebenza kanjani kahle. Uma ukuhlolwa komtholampilo kukhombisa ukuthi ukwelashwa okusha kungcono kunalokho okusetshenziswayo njengamanje, ukwelashwa okusha kungaba "okujwayelekile." Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Ukuhlolwa kwemitholampilo kungatholakala ku-inthanethi kuwebhusayithi ye-NCI. Ngeminye imininingwane, shayela iCancer Information Service (CIS), isikhungo sokuxhumana se-NCI, ku-1-800-4-CANCER (1-800-422-6237).

Imvume yokusebenzisa lesi sifinyezo

I- wuphawu lokuhweba olubhalisiwe. Okuqukethwe kwemibhalo ye- kungasetshenziswa ngokukhululeka njengombhalo. Ayikwazi ukubonwa njengesifinyezo solwazi lomdlavuza se-NCI ngaphandle kokuthi sonke isifinyezo sikhonjiswe futhi sibuyekezwa njalo. Kodwa-ke, umsebenzisi angavunyelwa ukuthi abhale umusho onjengokuthi “Isifinyezo solwazi lomdlavuza se-NCI sika-NCI mayelana nokuvinjelwa umdlavuza webele sichaza izingozi ngale ndlela elandelayo: [faka nengcaphuno yesifinyezo].”

Indlela enhle yokusho lesi sifinyezo se- yile:

Izithombe ezikulesi sifinyezo zisetshenziswa ngemvume yombhali, yomculi, kanye / noma yomshicileli ukuze zisetshenziswe kwizifinyezo ze- kuphela. Uma ufuna ukusebenzisa isithombe kusuka kusifinyezo se- futhi awusisebenzisi isifinyezo sonke, kufanele uthole imvume kumnikazi. Ayikwazi ukunikezwa yiNational Cancer Institute. Imininingwane yokusebenzisa izithombe ezikulesi sifinyezo, kanye nezinye izithombe eziningi ezihlobene nomdlavuza zingatholakala ku-Visuals Online. I-Visuals Online iqoqo lezithombe zesayensi ezingaphezu kuka-3,000.

Ukuzikhulula

Imininingwane ekulezi zifinyezo akufanele isetshenziselwe ukwenza izinqumo mayelana nokubuyiselwa kwemali yomshuwalense. Imininingwane engaphezulu ngokutholakala komshuwalense iyatholakala kuCancer.gov ekhasini elithi Managing Cancer Care.

Xhumana nathi

Imininingwane engaphezulu ngokuxhumana nathi noma ukuthola usizo ngewebhusayithi yeCancer.gov ingatholakala ekhasini lethu Xhumana nathi ukuze uthole usizo. Imibuzo ingathunyelwa nakuCancer.gov nge-imeyili Ewebhusayithi yethu.