Types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq

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Ukwelashwa Kwamathumbu Ezimuncu Zesisu (®) –Patient Version

Imininingwane ejwayelekile Mayelana Nezimila Zesisu Sesisu Sesisu

AMAPHUZU ASEMQOKA

  • Isisu somdlavuza wamathumbu ngumdlavuza owakheka kulwelwesi lwesisu.
  • Umlando wezempilo ungathinta ubungozi bamathumba e-carcinoid emathunjini.
  • Ezinye izicubu ze-carcinoid emathunjini azinazimpawu noma izimpawu ezigabeni zokuqala.
  • I-Carcinoid syndrome kungenzeka uma isimila sisakazeka esibindi noma kwezinye izingxenye zomzimba.
  • Ukucwaninga izifundo nokuhlola okuhlola igazi nomchamo kusetshenziselwa ukuthola (ukuthola) nokuxilonga izicubu zomzimba ezisemathunjini.
  • Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Isisu somdlavuza wamathumbu ngumdlavuza owakheka kulwelwesi lwesisu.

Ipheshana lesisu (GI) liyingxenye yohlelo lokugaya ukudla lomzimba. Kuyasiza ukugaya ukudla, kuthatha izakhamzimba (amavithamini, amaminerali, ama-carbohydrate, amafutha, amaprotheni, namanzi) ekudleni okuzosetshenziswa ngumzimba futhi kusiza ukukhipha imfucuza emzimbeni. Ipheshana le-GI lakhiwe yilezi nezinye izitho:

  • Isisu
  • Amathumbu amancane (duodenum, jejunum, neileum).
  • Ikholoni.
  • I-Rectum.
Izicubu zomzimba ezisemathunjini zakha ulwelwesi lwendlela yamathumbu, kaningi esithasiselweni, amathumbu amancane, noma i-rectum.

Izicubu ze-carcinoid emathunjini zivela ohlotsheni oluthile lwe-neuroendocrine cell (uhlobo lweseli olufana neseli lezinzwa neseli elenza ama-hormone). Lawa maseli asakazeke esifubeni nasesiswini kodwa amaningi atholakala kugciwane le-GI. Amaseli we-Neuroendocrine enza ama-hormone asiza ukulawula amajusi wokugaya ukudla kanye nemisipha esetshenziselwa ukuhambisa ukudla esiswini nasemathunjini. Isimila se-GI carcinoid singenza futhi ama-hormone futhi siwakhiphele emzimbeni.

Izicubu ze-carcinoid ze-GI azivamile futhi eziningi zikhula kancane kakhulu. Eziningi zazo zenzeka emathunjini amancane, i-rectum, kanye nesithasiselo. Kwesinye isikhathi kuzokwakhiwa isimila esingaphezu kwesisodwa.

Bona izifinyezo ezilandelayo ze- ukuthola eminye imininingwane ephathelene ne-GI nezinye izinhlobo zamathumba e-carcinoid:

  • Ukwelashwa Komdlavuza Wamaphaphu Ongeyona Emincane.
  • Ukwelashwa kwe-Pancreatic Neuroendocrine Tumors (Islet Cell Tumors).
  • Ukwelashwa Kwe-Rectal Cancer.
  • Ukwelashwa Komdlavuza Omncane Wamathumbu.
  • Umdlavuza Ongajwayelekile Wokwelashwa Kwezingane

Umlando wezempilo ungathinta ubungozi bamathumba e-carcinoid emathunjini.

Noma yini eyandisa amathuba omuntu okuba nesifo 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.

Izici ezinobungozi zamathumba we-GI carcinoid zifaka okulandelayo:

  • Ukuba nomlando womndeni we-multiple endocrine neoplasia type 1 (MEN1) syndrome noma i-neurofibromatosis type 1 (NF1) syndrome.
  • Ukuba nezimo ezithile ezithinta ikhono lesisu lokwenza i-acid esiswini, njenge-atrophic gastritis, i-anemia eyingozi, noma i-Zollinger-Ellison syndrome.

Ezinye izicubu ze-carcinoid emathunjini azinazimpawu noma izimpawu ezigabeni zokuqala.

Izimpawu nezimpawu zingabangelwa ukukhula kwesimila kanye / noma namahomoni akhiwa isimila. Ezinye izicubu, ikakhulukazi izicubu zesisu noma isithasiselo, kungenzeka zingabangeli zimpawu noma zimpawu. Izicubu ze-carcinoid zivame ukutholakala ngesikhathi sokuhlolwa noma ukwelashwa kwezinye izimo.

Izicubu ze-carcinoid emathunjini amancane (i-duodenum, i-jejunum, ne-ileum), i-colon, ne-rectum kwesinye isikhathi zibangela izimpawu noma izimpawu njengoba zikhula noma ngenxa yamahomoni azenzayo. Ezinye izimo zingadala izimpawu noma izimpawu ezifanayo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

UDuodenum

Izimpawu nezimpawu zamathumba we-GI carcinoid ku-duodenum (ingxenye yokuqala yamathumbu amancane, exhuma esiswini) ingafaka okulandelayo:

  • Ubuhlungu besisu.
  • Ukuqunjelwa.
  • Uhudo.
  • Shintsha umbala wendle.
  • Isicanucanu.
  • Ukuhlanza.
  • I-jaundice (kuphuzi kwesikhumba nabamhlophe bamehlo).
  • Isilungulela.

Jejunum neileum

Izimpawu nezimpawu zamathumba e-carcinoid e-GI ku-jejunum (ingxenye emaphakathi yamathumbu amancane) ne-ileum (ingxenye yokugcina yamathumbu amancane, exhuma kukholoni) ingafaka okulandelayo:

  • Ubuhlungu besisu.
  • Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.
  • Ukuzizwa ngikhathele kakhulu.
  • Ukuzizwa uqhakazile
  • Uhudo.
  • Isicanucanu.
  • Ukuhlanza.

Ikholoni

Izimpawu nezimpawu zamathumba we-GI carcinoid kukholoni angafaka okulandelayo:

  • Ubuhlungu besisu.
  • Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

I-Rectum

Izimpawu nezimpawu zamathumba we-GI carcinoid ku-rectum angafaka okulandelayo:

  • Igazi esitulweni.
  • Ubuhlungu ku-rectum.
  • Ukuqunjelwa.

I-Carcinoid syndrome kungenzeka uma isimila sisakazeka esibindi noma kwezinye izingxenye zomzimba.

Ama-hormone enziwa amathumba e-carcinoid emathunjini ngokuvamile abhujiswa ama-enzyme wesibindi egazini. Uma isimila sesisakaze esibindini futhi ama-enzyme wesibindi awakwazi ukuqeda ama-hormone angeziwe enziwa yilesi sifo, amanani aphezulu ala mahomoni angahlala emzimbeni futhi abangele i-carcinoid syndrome. Lokhu kungenzeka futhi uma amangqamuzana e-tumor angena egazini. Izimpawu nezimpawu ze-carcinoid syndrome zifaka okulandelayo:

  • Ububomvu noma umuzwa wemfudumalo ebusweni nasentanyeni.
  • Ubuhlungu besisu.
  • Ukuzizwa uqhakazile.
  • Uhudo.
  • Ukuphefumula noma enye inkinga yokuphefumula.
  • Ukushaya kwenhliziyo okusheshayo.

Lezi zimpawu nezimpawu zingabangelwa amathumba e-carcinoid emathunjini noma ngezinye izimo. Khuluma nodokotela wakho uma unalezi zimpawu noma lezi zimpawu.

Ukucwaninga izifundo nokuhlola okuhlola igazi nomchamo kusetshenziselwa ukuthola (ukuthola) nokuxilonga izicubu zomzimba ezisemathunjini.

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.
  • Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njengamahomoni, akhishwe egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo. Isampula yegazi lihlolwe ukuthi liqukethe i-hormone ekhiqizwa izicubu ze-carcinoid. Lokhu kuhlolwa kusetshenziselwa ukuxilonga i-carcinoid syndrome.
  • Isivivinyo sesimila: Inqubo lapho kuhlolwe khona isampula legazi, umchamo, noma izicubu ukukala inani lezinto ezithile, njenge-chromogranin A, eyenziwe izitho, izicubu, noma amaseli wesimila emzimbeni. I-Chromogranin A iyimpawu yokumila. Ixhunyaniswe nezicubu ze-neuroendocrine lapho itholakala emazingeni akhuphukile emzimbeni.
  • Ukuhlolwa komchamo wamahora angamashumi amabili nane: Isivivinyo lapho kuqoqwa khona umchamo amahora angama-24 ukukala inani lezinto ezithile, njenge-5-HIAA noma i-serotonin (hormone). Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lento kungaba uphawu lwesifo esithweni noma esikhunjeni esisenzayo. Lokhu kuhlolwa kusetshenziselwa ukuxilonga i-carcinoid syndrome.
  • Ukuskena kwe-MIBG: Inqubo esetshenziselwa ukuthola izicubu ze-neuroendocrine, ezinjengezicubu ze-carcinoid. Inani elincane kakhulu lezinto ezinemisebe ebizwa nge-MIBG (metaiodobenzylguanidine) lifakwa emthanjeni futhi lihambe egazini. Izicubu ze-carcinoid zithatha okokusebenza okukhipha imisebe futhi zitholwa yidivayisi ekala imisebe.
  • 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.
  • 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-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 ajwayelekile.
  • I-endoscopic ultrasound (EUS): Inqubo lapho kufakwa khona i-endoscope emzimbeni, imvamisa ngomlomo noma nge-rectum. I-endoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Iphenyo ekugcineni kwe-endoscope isetshenziselwa ukuqhuma amaza omsindo anamandla amakhulu (i-ultrasound) ezicutshini zangaphakathi noma ezithweni, njengesisu, amathumbu amancane, ikholoni, noma i-rectum, nokwenza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Le nqubo ibizwa nangokuthi i-endosonography.
  • I-endoscopy ephezulu: Inqubo yokubheka izitho nezicubu ngaphakathi komzimba ukubheka izindawo ezingajwayelekile. I-endoscope ifakwa ngomlomo bese idlula ngasesiswini. Kwesinye isikhathi i-endoscope nayo idluliselwa kusuka esiswini iye emathunjini amancane. I-endoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa amasampula wezicubu noma ama-lymph node, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zesifo.
  • I-Colonoscopy: Inqubo yokubheka ngaphakathi kwe-rectum ne-colon yama-polyps, izindawo ezingavamile, noma umdlavuza. I-colonoscope ifakwa nge-rectum kukholoni. I-colonoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa ama-polyps noma amasampuli wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • I-Capsule endoscopy: Inqubo esetshenziselwa ukubona wonke amathumbu amancane. Isiguli sigwinya iphilisi eliqukethe ikhamera encane. Njengoba i-capsule ihamba emgodini wamathumbu, ikhamera ithatha izithombe bese izithumela kumamukeli ogqoke ngaphandle komzimba.
  • I-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ukuhlola izimpawu zomdlavuza. Amasampula amathishu angathathwa ngesikhathi se-endoscopy kanye ne-colonoscopy.

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

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

  • Lapho isimila sisemgodini wamathumbu.
  • Usayizi wesimila.
  • Ukuthi umdlavuza ususakazekile kusukela esiswini nasemathunjini uye kwezinye izingxenye zomzimba, njengesibindi noma ama-lymph node.
  • Ukuthi isiguli sine-carcinoid syndrome noma sine-carcinoid heart syndrome.
  • Ukuthi umdlavuza ungasuswa ngokuphelele ngokuhlinzwa.
  • Ukuthi umdlavuza usanda kutholakala yini noma usubuyile.

Izigaba Zamathumbu E-Carcinoid Wamathumbu

AMAPHUZU ASEMQOKA

  • Ngemuva kokutholakala kwesisu somdlavuza wamathumbu, kwenziwa ukuhlolwa ukuze kutholakale ukuthi amangqamuzana omdlavuza asakazekile yini esiswini nasemathunjini noma kwezinye izingxenye zomzimba.
  • Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
  • Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.
  • Uhlelo lokwelashwa komdlavuza luxhomeke lapho kutholakala khona isimila se-carcinoid nokuthi singasuswa yini ngokuhlinzwa.

Ngemuva kokutholakala kwesisu somdlavuza wamathumbu, kwenziwa ukuhlolwa ukuze kutholakale ukuthi amangqamuzana omdlavuza asakazekile yini esiswini nasemathunjini noma kwezinye izingxenye zomzimba.

Isiteji inqubo esetshenziswayo ukuthola ukuthi umdlavuza ususabalale kangakanani. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Imiphumela yokuhlolwa nezinqubo ezisetshenziselwa ukuxilonga izicubu ze-carcinoid emathunjini nazo zingasetshenziselwa ukubeka esiteji. Bheka isigaba solwazi jikelele ukuthola incazelo yalezi zivivinyo nezinqubo. Ukuhlolwa kwamathambo kungenziwa ukubheka 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 lwesimila njengesimila sokuqala. Isibonelo, uma isisu se-carcinoid esiswini (GI) sisakazeka esibindini, amaseli wesimila esesibindi empeleni angamaseli wesisu se-GC carcinoid. Lesi sifo yi-metastatic GI carcinoid tumor, hhayi umdlavuza wesibindi.

Uhlelo lokwelashwa komdlavuza luxhomeke lapho kutholakala khona isimila se-carcinoid nokuthi singasuswa yini ngokuhlinzwa.

Kuma-cancer amaningi kubalulekile ukwazi isigaba somdlavuza ukuze uhlele ukwelashwa. Kodwa-ke, ukwelashwa kwamathumba we-carcinoid emathunjini akususelwa esigabeni somdlavuza. Ukwelashwa kuncike kakhulu ekutheni isimila singasuswa yini ngokuhlinzwa nokuthi isisu sesisakazekile yini.

Ukwelashwa kusekelwe ekutheni isimila:

  • Kungasuswa ngokuphelele ngokuhlinzwa.
  • Isabalale yaya kwezinye izitho zomzimba.
  • Ubuyile ngemuva kokwelashwa. Isimila singabuya esiswini noma emathunjini noma kwezinye izingxenye zomzimba.
  • Akukaze kube ngcono ngokwelashwa.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

  • Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinamathumba e-carcinoid emathunjini.
  • Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:
  • Ukuhlinzwa
  • Ukwelashwa ngemisebe
  • Ukwelashwa ngamakhemikhali
  • Ukwelashwa kweHormone
  • Ukwelashwa kwe-carcinoid syndrome kungadingeka futhi.
  • Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
  • Ukwelashwa okuhlosiwe
  • Ukwelashwa kwamathumba e-carcinoid emathunjini 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 ezahlukahlukene zokwelashwa kweziguli ezinamathumba e-carcinoid emathunjini.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinesisu somdlavuza wamathumbu. 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

Ukwelashwa kwezicubu ze-carcinoid ngokuvamile kufaka ukuhlinzwa. Kungasetshenziswa enye yezinqubo zokuhlinza ezilandelayo:

  • I-endoscopic resection: Ukuhlinzwa ukukhipha isimila esincane esisendlini yangaphakathi yepheshana le-GI. I-endoscope ifakwa ngomlomo futhi idluliswe ngesisu iye esiswini futhi kwesinye isikhathi, i-duodenum. I-endoscope iyinsimbi encane, efana nethubhu enelambu, ilensi yokubuka, kanye nethuluzi lokususa izicubu zomzimba.
  • Ukudonswa kwendawo: Ukuhlinzwa ukukhipha isimila nenani elincane lezicubu ezijwayelekile ezisizungezile.
  • Ukuphinda: Ukuhlinzwa ukususa ingxenye noma isitho ngasinye esinomdlavuza. Ama-lymph node aseduze nawo angasuswa.
  • I-Cryosurgery: Ukwelashwa okusebenzisa ithuluzi lokuqandisa nokubhubhisa izicubu ze-carcinoid tumor. Lolu hlobo lwezokwelapha lubizwa nangokuthi i-cryotherapy. Udokotela angasebenzisa i-ultrasound ukuqondisa ithuluzi.
  • I-Radiofrequency ablation: Ukusetshenziswa kwephenyo ekhethekile enama-electrode amancane akhipha amaza omsakazo anamandla amakhulu (afana nama-microwave) abulala amangqamuzana omdlavuza. Iphenyo ingafakwa ngesikhumba noma ngokusikeka (esisikiwe) esiswini.
  • Ukufakelwa kwesibindi: Ukuhlinzwa ukuze kususwe sonke isibindi bese kufakwa isibindi esinikelwe okunempilo.
  • Ukuhlanganiswa komthambo we-Hepatic: Inqubo yokuhlanganisa (ukuvimba) umthambo we-hepatic, okuyisitsha segazi esikhulu esingenisa igazi esibindini. Ukuvimba ukugeleza kwegazi kuye esibindini kusiza ukubulala amangqamuzana omdlavuza akhula lapho.

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.

Ukwelashwa kwe-Radiopharmaceutical luhlobo lokwelashwa kwemisebe yangaphakathi. Imisebe inikezwa isimila kusetshenziswa isidakamizwa esinezinto ezinemisebe, njenge-iodine I 131, enamathiselwe kuso. Into enemisebe ibulala amangqamuzana isimila.

Ukwelashwa kwemisebe yangaphandle neyangaphakathi kusetshenziselwa ukwelapha izicubu zomzimba ezisemathunjini ezisabalele kwezinye izingxenye zomzimba.

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).

I-Chemoembolization yomthambo we-hepatic uhlobo lwe-chemotherapy yesifunda engasetshenziswa ukwelapha isimila somzimba esiswini esisakaze isibindi. Isidakamizwa se-anticancer sijojelwa emthanjeni we-hepatic nge-catheter (ithubhu elincanyana). Isidakamizwa sixutshwe nento ehlanganisa (ivimbe) umthambo, futhi isike ukugeleza kwegazi kuye kulesimila. Iningi lomuthi olwa nomdlavuza ubhajwe eduze kwesimila futhi inani elincane kuphela lomuthi lifinyelela kwezinye izingxenye zomzimba. Ukuvinjelwa kungaba okwesikhashana noma unomphela, kuya ngento esetshenzisiwe ukuvimba umthambo. Isimila sivinjelwe ekutholeni umoya-mpilo nezakhamzimba esidinga ukuthi sikhule. Isibindi siyaqhubeka sithola igazi elivela emthanjeni we-portatic hepatic, ophethe igazi esiswini nasemathunjini.

Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Ukwelashwa kweHormone

Ukwelashwa kwehormone nge-somatostatin analogue ukwelashwa okuvimba ukwenziwa kwamahomoni angeziwe. Izicubu ze-GI carcinoid ziphathwa nge-octreotide noma i-lanreotide ejojowe ngaphansi kwesikhumba noma emisipheni. I-Octreotide ne-lanreotide nazo zingaba nomthelela omncane ekumiseni ukukhula kwesimila.

Ukwelashwa kwe-carcinoid syndrome kungadingeka futhi.

Ukwelashwa kwe-carcinoid syndrome kungafaka okulandelayo:

  • Ukwelashwa kwehormone nge-somatostatin analogue kumisa ukwenziwa kwamahomoni angeziwe. I-Carcinoid syndrome iphathwa nge-octreotide noma i-lanreotide ukunciphisa ukugeleza nokuhuda. I-Octreotide ne-lanreotide nakho kungasiza ekukhuleni kwesimila okuhamba kancane.
  • Ukwelashwa kwe-Interferon kuvuselela amasosha omzimba ukuthi asebenze kangcono futhi kunciphise ukugeleza nokuhuda. I-Interferon ingasiza futhi ukukhula kancane kwesimila.
  • Ukuthatha umuthi wohudo.
  • Ukuthatha umuthi wokuqubuka kwesikhumba.
  • Ukuthatha umuthi ukuphefumula kalula.
  • Ukuthatha umuthi ngaphambi kokuba ube ne-anesthesia yenqubo yezokwelapha.

Ezinye izindlela zokusiza ekwelapheni i-carcinoid syndrome zibandakanya ukugwema izinto ezibangela ukuqhuma noma ukuphefumula kanzima njengotshwala, amantongomane, ushizi othile nokudla nge-capsaicin, njengopelepele. Ukugwema izimo ezicindezelayo nezinhlobo ezithile zomsebenzi womzimba nakho kungasiza ekwelapheni i-carcinoid syndrome.

Kwezinye iziguli ezine-carcinoid heart syndrome, kungenziwa esikhundleni se-valve yenhliziyo.

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.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile. Izinhlobo eziningi zokwelashwa okuqondisiwe ziyafundwa ekwelapheni izicubu ze-GI carcinoid.

Ukwelashwa kwamathumba e-carcinoid emathunjini 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 Izilonda Zesisu Samathumbu

Kulesi Sigaba

  • AmaCarcinoid Tumors Esiswini
  • AmaCarcinoid Tumors Esiswini Esincane Esisemathunjini
  • AmaCarcinoid Tumors Kusithasiselo
  • Izicubu Zecarinoino eColon
  • AmaCarinoid Tumors kuRectum
  • Ama-Metastatic Gastrointestinal Carcinoid Tumors
  • Izicubu Eziphindaphindekayo Zamathumbu Emathunjini

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

AmaCarcinoid Tumors Esiswini

Ukwelashwa kwamathumbu we-carcinoid esiswini (GI) esiswini kungafaka okulandelayo:

  • Ukuhlinzwa kwe-Endoscopic (resection) yamathumba amancane.
  • Ukuhlinzwa (resection) ukususa ingxenye noma sonke isisu. Ama-lymph node aseduze wezicubu ezinkulu, izicubu ezikhula zijule odongeni lwesisu, noma izicubu ezikhula futhi zisakazeke ngokushesha nazo zingasuswa.

Ezigulini ezinezicubu ze-GI carcinoid esiswini kanye ne-MEN1 syndrome, ukwelashwa kungafaka futhi:

  • Ukuhlinzwa (resection) ukususa izicubu ku-duodenum (ingxenye yokuqala yamathumbu amancane, exhuma esiswini).
  • Ukwelashwa kweHormone.

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.

AmaCarcinoid Tumors Esiswini Esincane Esisemathunjini

Akucaci ukuthi yini ukwelashwa okuhle kakhulu kwezimila ze-GI carcinoid ku-duodenum (ingxenye yokuqala yamathumbu amancane, exhuma esiswini). Ukwelashwa kungafaka okulandelayo:

  • Ukuhlinzwa kwe-Endoscopic (resection) yamathumba amancane.
  • Ukuhlinzwa (ukusikwa kwendawo) ukususa izicubu ezinkudlwana.
  • Ukuhlinzwa (resection) ukususa isimila kanye nama-lymph node aseduze.

Ukwelashwa kwezimila ze-GI carcinoid ku-jejunum (ingxenye emaphakathi yamathumbu amancane) ne-ileum (ingxenye yokugcina yamathumbu amancane, exhuma kukholoni) ingafaka okulandelayo:

  • Ukuhlinzwa (resection) ukususa isimila kanye nolwelwesi oluxhuma amathumbu emuva kodonga lwesisu. Ama-lymph node aseduze nawo asuswa.
  • Ukuhlinzwa kwesibili ukususa ulwelwesi oluxhuma amathumbu emuva kodonga lwesisu, uma kukhona isimila esisele noma isimila siqhubeka nokukhula.
  • Ukwelashwa kweHormone.

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.

AmaCarcinoid Tumors Kusithasiselo

Ukwelashwa kwezimila ze-GI carcinoid esithasiselweni kungafaka okulandelayo:

  • Ukuhlinzwa (resection) ukususa isithasiselo.
  • Ukuhlinzwa (resection) ukususa uhlangothi olungakwesokudla lekholoni kufaka nesithasiselo. Ama-lymph node aseduze nawo asuswa.

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.

Izicubu Zecarinoino eColon

Ukwelashwa kwama-GI carcinoid tumors kukholoni kungafaka okulandelayo:

  • Ukuhlinzwa (resection) ukususa ingxenye yamakholoni kanye nama-lymph node aseduze, ukuze kususwe umdlavuza omkhulu ngangokunokwenzeka.

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.

AmaCarinoid Tumors kuRectum

Ukwelashwa kwezimila ze-GI carcinoid ku-rectum kungafaka okulandelayo:

  • Ukuhlinzwa kwe-Endoscopic (resection) yamathumba amancane kune-1 sentimitha.
  • Ukuhlinzwa (resection) kwezicubu ezikhudlwana kunamasentimitha ama-2 noma ezisabalale ezingqimbeni zemisipha yodonga olungunxande. Lokhu kungaba:
  • ukuhlinzwa ukususa ingxenye yengxenyeni; noma
  • ukuhlinzwa ukuze kususwe ingquza, i-rectum, nengxenye yekholoni ngokusikeka okwenziwe esiswini.

Akucaci ukuthi yini ukwelashwa okuhle kakhulu kwezimila ezingamasentimitha ayi-1 kuye kwezi-2. Ukwelashwa kungafaka okulandelayo:

  • Ukuhlinzwa kwe-Endoscopic (resection).
  • Ukuhlinzwa (resection) ukususa ingxenye yengxenyeni.
  • Ukuhlinzwa (resection) ukususa i-anus, i-rectum, nengxenye yekholoni ngokusebenzisa imbobo eyenziwe esiswini.

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.

Ama-Metastatic Gastrointestinal Carcinoid Tumors

Ama-metastases akude

Ukwelashwa kwama-metastases akude we-GI carcinoid tumors kuvame ukwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo. Ukwelashwa kungafaka okulandelayo:

  • Ukuhlinzwa (resection) ukususa isimila esiningi ngangokunokwenzeka.
  • Ukwelashwa kweHormone.
  • Ukwelashwa kwe-Radiopharmaceutical.
  • Ukwelashwa kwemisebe yangaphandle yomdlavuza osabalalele ethanjeni, ebuchosheni noma emgogodleni.
  • Isivivinyo somtholampilo sokwelapha okusha.

Isibindi se-metastases

Ukwelashwa komdlavuza osulele esibindini kungafaka okulandelayo:

  • Ukuhlinzwa (ukusikwa kwendawo) ukususa isimila esibindini.
  • Ukuhlanganiswa komthambo we-Hepatic.
  • I-Cryosurgery.
  • Ukukhishwa kwe-Radiofrequency.
  • Ukufakelwa kwesibindi.

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.

Izicubu Eziphindaphindekayo Zamathumbu Emathunjini

Ukwelashwa kwezimila eziphindaphindwayo ze-GI carcinoid kungafaka okulandelayo:

  • Ukuhlinzwa (ukusikwa kwendawo) ukususa ingxenye noma sonke isimila.
  • 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.

Ukufunda Okwengeziwe Ngamathumbu E-Carcinoid Wamathumbu

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana nezicubu zomdlavuza wamathumbu, bheka okulandelayo:

  • Ikhasi lasekhaya lezicubu zomzimba emathunjini
  • I-Cryosurgery ekwelashweni komdlavuza
  • Izindlela Zokwelapha Zomdlavuza

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
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