Izinhlobo / i-ovarian / isiguli / i-ovarian-epithelial-treatment-pdq

I-Ovarian Epithelial, Fallopian Tube, kanye ne-Primary Peritoneal Cancer Version

Imininingwane ejwayelekile Mayelana ne-Ovarian Epithelial, Fallopian Tube, kanye ne-Primary Peritoneal Cancer

AMAPHUZU ASEMQOKA

• Umdlavuza we-ovarian epithelial, umdlavuza we-fallopian tube, kanye nomdlavuza oyinhloko we-peritoneal yizifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ezimboze i-ovary noma efaka ithubhu le-fallopian noma i-peritoneum.

• Umdlavuza we-ovarian epithelial, umdlavuza we-fallopian tube, nefomu lomdlavuza oyinhloko we-peritoneal ngohlobo olufanayo lwezicubu futhi ziphathwa ngendlela efanayo.

• Abesifazane abanomlando womndeni womdlavuza we-ovari basengozini enkulu yomdlavuza we-ovari.

• Amanye ama-ovarian, i-fallopian tube, kanye nomdlavuza oyinhloko we-peritoneal kubangelwa ukuguqulwa kwezakhi zofuzo (ushintsho).

• Abesifazane abanengozi eyengeziwe yomdlavuza we-ovari bangacabanga ukuhlinzwa ukuze banciphise ubungozi.

• Izimpawu nezimpawu ze-ovarian, fallopian tube, noma i-peritoneal cancer zifaka phakathi ubuhlungu noma ukuvuvukala esiswini.

• Ukuhlolwa okuhlola ama-ovaries nendawo ye-pelvic kusetshenziselwa ukuthola (ukuthola), ukuxilonga, kanye nokubeka isigaba se-ovarian, i-fallopian tube, nomdlavuza we-peritoneal.

• Izici ezithile zithinta izinketho zokwelashwa nokubikezela (ithuba lokululama).

Umdlavuza we-ovarian epithelial, umdlavuza we-fallopian tube, kanye nomdlavuza oyinhloko we-peritoneal yizifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ezimboze i-ovary noma efaka ithubhu le-fallopian noma i-peritoneum.

Ama-ovari ayizitho zombili ohlelweni lokuzala lwabesifazane. Zisemathangeni, eyodwa ohlangothini ngalunye lwesibeletho (isitho esime, esinamapheya lapho kukhula umbungu). I-ovary ngayinye icishe ilingane nobukhulu be-alimondi. Amaqanda enza amaqanda namahomoni abesifazane (amakhemikhali alawula indlela amaseli noma izitho ezithile ezisebenza ngayo).

Amashubhu we-fallopian angamashubhu amade, amancane, eyodwa ohlangothini ngalunye lwesibeletho. Amaqanda adlula esibelethweni, adlule kumashubhu e-fallopian, aye esibelethweni. I-Cancer kwesinye isikhathi iqala ekugcineni kweshubhu le-fallopian eduze ne-ovary bese isakazeka esibelethweni.

I-peritoneum izicubu ezibeka udonga lwesisu futhi zimboze izitho esiswini. Umdlavuza oyinhloko we-peritoneal umdlavuza owakheka ku-peritoneum futhi awusakazekanga lapho usuka kwenye ingxenye yomzimba. Umdlavuza kwesinye isikhathi uqala e-peritoneum bese usakazekela esibelethweni.

I-anatomy yohlelo lokuzala lwabesifazane. Izitho ezisehlelweni lokuzala labesifazane zifaka phakathi isibeletho, amaqanda, amashubhu e-fallopian, umlomo wesibeletho, kanye nesitho sangasese sowesifazane. Isibeletho sinolwelwesi olungaphandle lwemisipha olubizwa ngokuthi i-myometrium nolwelwesi lwangaphakathi olubizwa ngokuthi i-endometrium.

Umdlavuza we-ovarian epithelial wuhlobo olulodwa lomdlavuza oluthinta i-ovary. Bona izifinyezo ezilandelayo zokwelashwa kwe- ngolwazi mayelana nezinye izinhlobo zamathumba ama-ovari:

• Ama-Ovarian Germ Cell Tumors

• Izicubu Ezingahle Zibe Ovarian Low Malignant

• Umdlavuza Ongajwayelekile Wokwelashwa Kwezingane (umdlavuza we-ovari ezinganeni)

Umdlavuza we-ovarian epithelial, umdlavuza we-fallopian tube, nefomu lomdlavuza oyinhloko we-peritoneal ngohlobo olufanayo lwezicubu futhi ziphathwa ngendlela efanayo.

Abesifazane abanomlando womndeni womdlavuza we-ovari basengozini enkulu yomdlavuza we-ovari.

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 we-ovari.

Izici zobungozi zomdlavuza we-ovari zifaka okulandelayo:

• Umlando womndeni womdlavuza we-ovari esihlotsheni sokuqala (umama, indodakazi, noma udadewabo).

• Izinguquko ezizuzwe njengefa kuzakhi zofuzo ze-BRCA1 noma ze-BRCA2.

• Ezinye izimo zefa, njengomdlavuza we-nonpolyposis colorectal cancer (HNPCC; obizwa nangokuthi yiLynch syndrome).

• I-Endometriosis.

• Ukwelashwa kwe-Postmenopausal hormone.

• Ukukhuluphala ngokweqile.

• Ubude obude.

Ukuguga kuyisici esiyinhloko sengozi yomdlavuza amaningi. Ithuba lokuthola umdlavuza liyakhula njengoba ukhula.

Amanye ama-ovarian, i-fallopian tube, kanye nomdlavuza oyinhloko we-peritoneal kubangelwa ukuguqulwa kwezakhi zofuzo (ushintsho).

Izakhi zofuzo ezisemangqamuzaneni ziphethe imininingwane etholwe kubazali bomuntu. Umdlavuza we-ovary we-Hereditary wenza cishe ama-20% azo zonke izimo zomdlavuza we-ovari. Kunamaphethini amathathu wefa: umdlavuza we-ovarian wedwa, umdlavuza wama-ovari kanye nowebele, nomdlavuza we-ovarian nowekholoni.

Umdlavuza we-fallopian tube kanye nomdlavuza we-peritoneal nakho kungabangelwa ukuguqulwa okuthile kofuzo.

Kunezivivinyo ezingathola ukuguqulwa kwezakhi zofuzo. Lezi zivivinyo zofuzo kwesinye isikhathi zenzelwa amalungu emindeni anengozi enkulu yomdlavuza. Bona izifinyezo ezilandelayo ze- ukuthola eminye imininingwane:

• I-Ovarian, i-Fallopian Tube, kanye nokuvimbela umdlavuza oyinhloko we-Peritoneal

• I-Genetics yeCancer Yamabele namabele (yabasebenzi bezempilo)

Abesifazane abanengozi eyengeziwe yomdlavuza we-ovari bangacabanga ukuhlinzwa ukuze banciphise ubungozi.

Abanye besifazane abanengozi eyengeziwe yomdlavuza we-ovari bangakhetha ukuba ne-oophorectomy yokunciphisa ingozi (ukususwa kwama-ovari anempilo ukuze umdlavuza ungakhuli kuwo). Kwabesifazane abasengozini enkulu, le nqubo ikhonjisiwe yokwehlisa kakhulu ingozi yomdlavuza we-ovari. (Bheka isifinyezo se- ku-Ovarian, Fallopian Tube, kanye nePreitoneal Cancer Prevention ukuthola eminye imininingwane.)

Izimpawu nezimpawu ze-ovarian, fallopian tube, noma i-peritoneal cancer zifaka phakathi ubuhlungu noma ukuvuvukala esiswini.

I-ovarian, i-fallopian tube, noma umdlavuza we-peritoneal kungenzeka kungabangeli izimpawu noma izimpawu zakuqala. Lapho kuvela izimpawu noma izimpawu, umdlavuza uvame ukuthuthuka. Izimpawu nezimpawu zingafaka okulandelayo:

• Ubuhlungu, ukuvuvukala, noma umuzwa wokucindezela esiswini noma okhalweni.

• Ukopha kwesitho sangasese sowesifazane okunzima noma okungajwayelekile, ikakhulukazi ngemuva kokuyeka ukuya esikhathini.

• Ukukhishwa kwesitho sangasese sowesifazane okucacile, okumhlophe, noma okunemibala enegazi.

• Isigaxa esisendaweni okhalo lwaso.

• Izinkinga zamathumbu, ezifana negesi, ukuqunjelwa, noma ukuqunjelwa.

Lezi zibonakaliso nezimpawu nazo zingabangelwa ezinye izimo hhayi nge-ovarian, fallopian tube, noma umdlavuza we-peritoneal. Uma izimpawu noma izimpawu ziba zimbi kakhulu noma zingapheli zodwa, hlola udokotela wakho ukuze noma iyiphi inkinga itholakale futhi yelashwe ngokushesha ngangokunokwenzeka.

Ukuhlolwa okuhlola ama-ovaries nendawo ye-pelvic kusetshenziselwa ukuthola (ukuthola), ukuxilonga, kanye nokubeka isigaba se-ovarian, i-fallopian tube, nomdlavuza we-peritoneal.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa ukuthola, ukuxilonga, kanye nesigaba se-ovarian, i-fallopian tube, nomdlavuza we-peritoneal:

• 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-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.

• Ukuhlolwa kwe-CA 125: Isivivinyo esikala izinga le-CA 125 egazini. I-CA 125 yinto ekhishwa amaseli egazini. Izinga le-CA 125 elandisiwe kungaba uphawu lomdlavuza noma esinye isimo esinjenge-endometriosis.

• Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho esiswini, bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi.

I-ultrasound yesisu. I-transducer ye-ultrasound exhunywe kukhompyutha idluliswa ngaphezu kwesisu. I-ultrasound transducer igxuma amaza omsindo ezithweni zangaphakathi nezicubu zayo ukuze yenze ama-echoes akha i-sonogram (isithombe sekhompyutha).

Ezinye iziguli zingaba ne-ultrasound engaphandle.

I-ultrasound yangaphambilini. Uphenyo lwe-ultrasound oluxhunywe kwikhompyutha lufakwa esithweni sangasese futhi lushukumiswe ngobumnene ukukhombisa izitho ezahlukahlukene. I-probe iqhuma amaza omsindo ezithweni zangaphakathi nezicubu ukwenza ama-echoes akha i-sonogram (isithombe sekhompyutha).

• 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-PET scan (i-positron emission tomography scan): Inqubo yokuthola amangqamuzana abulalayo omzimba emzimbeni. Inani elincane kakhulu 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.

• 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-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-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. Izicubu zivame ukususwa ngesikhathi sokuhlinzwa ukuze kususwe isimila.

• Izici ezithile zithinta izinketho zokwelashwa nokubikezela (ithuba lokululama).

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Uhlobo lomdlavuza wesibeletho nokuthi ungakanani umdlavuza okhona.

• Isigaba nebanga lomdlavuza.

• Ukuthi isiguli sinoketshezi oluthe xaxa esiswini oludala ukuvuvukala.

• Ukuthi sonke isimila singasuswa ngokuhlinzwa.

• Noma ngabe kukhona ushintsho kuzakhi zofuzo ze-BRCA1 noma ze-BRCA2.

• Iminyaka yesiguli nempilo ejwayelekile.

• Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Izigaba ze-Ovarian Epithelial, Fallopian Tube, kanye ne-Primary Peritoneal Cancer

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala kwe-ovarian, i-fallopian tube, noma umdlavuza we-peritoneal, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekile ngaphakathi kwamaqanda noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Lezi zigaba ezilandelayo zisetshenziselwa i-ovarian epithelial, i-fallopian tube, nomdlavuza oyinhloko we-peritoneal:

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

• Ama-ovarian epithelial, i-fallopian tube, kanye nomdlavuza oyinhloko we-peritoneal aqoqelwe ukwelashwa njengomdlavuza wokuqala noma osezingeni eliphezulu.

Ngemuva kokutholakala kwe-ovarian, i-fallopian tube, noma umdlavuza we-peritoneal, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekile ngaphakathi kwamaqanda noma kwezinye izingxenye zomzimba.

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza usabalale ngaphakathi kwesitho noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa. Imiphumela yokuhlolwa okusetshenziselwa ukuxilonga umdlavuza ivame ukusetshenziselwa ukufaka lesi sifo. (Bheka isigaba soLwazi Olujwayelekile ukuthola izivivinyo nezinqubo ezisetshenziselwa ukuxilonga nokukala i-ovarian, i-fallopian tube kanye nomdlavuza we-peritoneal.)

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 we-ovarian epithelial usakazeka uye emaphashini, amangqamuzana omdlavuza asephashini empeleni angamaseli omdlavuza we-ovarian epithelial. Lesi sifo umdlavuza we-ovarian epithelial, hhayi umdlavuza wamaphaphu.

Lezi zigaba ezilandelayo zisetshenziselwa i-ovarian epithelial, i-fallopian tube, nomdlavuza oyinhloko we-peritoneal:

Isiteji I

Esigabeni IA, umdlavuza utholakala ngaphakathi kweshubhu elilodwa le-ovary noma le-fallopian. Esigabeni IB, umdlavuza utholakala ngaphakathi kwawo womabili amaqanda noma amashubhu e-fallopian. Esigabeni IC, umdlavuza utholakala ngaphakathi kowodwa noma womabili amaqanda noma amashubhu we-fallopian futhi okunye kwalokhu okuyiqiniso: okukodwa noma womabili amaqanda noma amashubhu e-fallopian, noma (c) amangqamuzana omdlavuza atholakala ku-pelvic peritoneum.

Esigabeni I, umdlavuza utholakala kwesinye noma zombili amaqanda noma amashubhu e-fallopian. Isigaba I sihlukaniswe isigaba IA, isigaba IB, nesigaba IC.

• I-Stage IA: I-Cancer itholakala ngaphakathi kweshubhu elilodwa le-ovary noma le-fallopian.

• Isigaba IB: I-Cancer itholakala ngaphakathi kokubili ama-ovari noma amashubhu e-fallopian.

• Isigaba IC: I-Cancer itholakala ngaphakathi kweyodwa noma womabili amaqanda noma amashubhu we-fallopian kanti okunye kwalokhu okuyiqiniso kuyiqiniso:

• umdlavuza utholakala nangaphandle kwendawo eyodwa noma womabili amaqanda noma amashubhu e-fallopian; noma

• i-capsule (isembozo sangaphandle) se-ovary ruptured (break open) ngaphambi noma ngesikhathi sokuhlinzwa; noma

• amangqamuzana omdlavuza atholakala kuketshezi lwe-peritoneal cavity (umgodi womzimba oqukethe izitho eziningi esiswini) noma ekuhlanzweni kwe-peritoneum (izicubu ezifaka umgodi we-peritoneal).

Isigaba II

Esigabeni IIA, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu we-fallopian futhi usabalale waya esibelethweni kanye / noma kumashubhu we-fallopian kanye / noma kuma-ovari. Esigabeni IIB, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu e-fallopian futhi usabalalele kukholoni. Emdlavuzeni oyinhloko we-peritoneal, umdlavuza utholakala ku-pelvic peritoneum futhi awusakazekanga lapho kusuka kwenye ingxenye yomzimba.

Esigabeni II, umdlavuza utholakala kwesinye noma zombili ama-ovari noma amashubhu we-fallopian futhi usabalalele kwezinye izindawo zesikhumba, noma umdlavuza oyinhloko we-peritoneal utholakala ngaphakathi kwesikhumba. I-Stage II ovarian epithelial and fallopian tube cancer ihlukaniswe yaba isigaba IIA nesigaba IIB.

• Isigaba IIA: Umdlavuza usabalale usuka lapho waqala khona ukwakha esibelethweni kanye / noma amashubhu e-fallopian kanye / noma ama-ovari.

• Isigaba IIB: Umdlavuza usabalale kusuka esibelethweni se-ovary noma se-fallopian kuya ezithweni ezisemgodini we-peritoneal (isikhala esiqukethe izitho zesisu).

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).

Isigaba III

Esigabeni III, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu e-fallopian, noma umdlavuza oyinhloko we-peritoneal, futhi usabalale ngaphandle kwesikhumba kwezinye izingxenye zesisu kanye / noma kuma-lymph node aseduze. Isigaba III sihlukaniswe isigaba IIIA, isigaba IIIB, nesigaba IIIC.

• Esigabeni IIIA, okunye kokulandelayo kuyiqiniso:

• Umdlavuza usabalalele kuma-lymph node endaweni engaphandle noma ngemuva kwe-peritoneum kuphela; noma

• Amaseli womdlavuza angabonakala nge-microscope kuphela asabalale ebusweni be-peritoneum ngaphandle kwesikhumba. Umdlavuza kungenzeka usabalalele kuma-lymph node aseduze.

Esigabeni IIIA, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu we-fallopian futhi (a) umdlavuza usabalalele kuma-lymph node endaweni engaphandle noma ngemuva kwe-peritoneum kuphela, noma (b) amangqamuzana omdlavuza angabonakala nge-microscope kuphela isakaze ku-omentum. Umdlavuza kungenzeka usabalalele kuma-lymph node aseduze.

• Isigaba IIIB: Umdlavuza usabalalele ku-peritoneum ngaphandle kwesikhumba futhi umdlavuza ku-peritoneum ungamasentimitha ama-2 noma amancane. Umdlavuza kungenzeka usabalalele kuma-lymph node ngemuva kwe-peritoneum.

Esigabeni IIIB, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu we-fallopian futhi usabalale waya ku-omentum, kanti umdlavuza ku-omentum ungamasentimitha ama-2 noma amancane. Umdlavuza kungenzeka usabalalele kuma-lymph node ngemuva kwe-peritoneum.

• Isigaba IIIC: Umdlavuza ususabalele kwi-peritoneum ngaphandle kwesikhumba futhi umdlavuza ose-peritoneum mkhulu kunamasentimitha ama-2. Umdlavuza kungenzeka usabalalele kuma-lymph node ngemuva kwe-peritoneum noma ebusweni besibindi noma ubende.

Esigabeni IIIC, umdlavuza utholakala koyedwa noma womabili amaqanda noma amashubhu we-fallopian futhi usabalale waya ku-omentum, kanti umdlavuza ku-omentum mkhulu kunamasentimitha ama-2. Umdlavuza kungenzeka usabalalele kuma-lymph node ngemuva kwe-peritoneum noma ebusweni besibindi noma ubende.

Isigaba IV

Esigabeni IV, umdlavuza usabalalele ngaphesheya kwesisu waya kwezinye izingxenye zomzimba. Esigabeni se-IVA, amangqamuzana omdlavuza atholakala kuketshezi oluthe xaxa olwakha azungeze amaphaphu. Esigabeni IVB, umdlavuza ususabalele ezithweni nakwizicubu ezingaphandle kwesisu, kufaka phakathi iphaphu, isibindi, ithambo nama-lymph node emgodini.

Esigabeni IV, umdlavuza usabalalele ngaphesheya kwesisu waya kwezinye izingxenye zomzimba. Isigaba IV sihlukaniswe ngezigaba IVA nesigaba IVB.

• Isigaba IVA: Amaseli womdlavuza atholakala kuketshezi oluthe xaxa olwakha azungeze amaphaphu.

• Isigaba IVB: Umdlavuza usabalalele ezithweni nakwizicubu ezingaphandle kwesisu, kufaka phakathi ama-lymph node ku-groin.

Ama-ovarian epithelial, i-fallopian tube, kanye nomdlavuza oyinhloko we-peritoneal aqoqelwe ukwelashwa njengomdlavuza wokuqala noma osezingeni eliphezulu.

Isigaba I-ovarian epithelial kanye ne-fallopian tube cancers ziphathwa njengomdlavuza wokuqala.

Izigaba II, III, kanye ne-IV ovarian epithelial, ithubhu le-fallopian, kanye nomdlavuza oyinhloko we-peritoneal uphathwa njengomdlavuza osezingeni eliphakeme.

I-Ovarian Epithelial ephindaphindayo noma eqhubekayo, i-Fallopian Tube, nomdlavuza oyinhloko we-Peritoneal Cancer

Umdlavuza ovamile we-ovarian epithelial, umdlavuza we-fallopian tube, noma umdlavuza oyinhloko we-peritoneal umdlavuza ophindile (wabuya) ngemuva kokuba welashwe. Umdlavuza oqhubekayo ngumdlavuza ongapheli nokwelashwa.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza we-ovarian epithelial.

• Kusetshenziswa izinhlobo ezintathu zokwelashwa okujwayelekile.

• Ukuhlinzwa

• Ukwelashwa ngamakhemikhali

• Ukwelashwa okuhlosiwe

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa ngemisebe

• I-Immunotherapy

• Ukwelashwa kwe-ovarian epithelial, fallopian tube, kanye nomdlavuza oyinhloko we-peritoneal 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 ezinomdlavuza we-ovarian epithelial.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza we-ovarian epithelial. Ezinye izindlela zokwelapha zijwayelekile, 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 okusetshenziswa njengokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli ezinanoma isiphi isigaba somdlavuza we-ovari zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Kusetshenziswa izinhlobo ezintathu zokwelashwa okujwayelekile.

Ukuhlinzwa

Iziguli eziningi ziyahlinzwa ukuze kususwe isimila ngangokunokwenzeka. Izinhlobo ezahlukene zokuhlinzwa zingafaka:

• I-Hysterectomy: Ukuhlinzwa ukususa isibeletho futhi, kwesinye isikhathi, nomlomo wesibeletho. Lapho kususwa kuphela isibeletho, kubizwa ngokuthi yi-hysterectomy engaphelele. Lapho kokubili isibeletho nomlomo wesibeletho kususwa, kubizwa ngokuthi yi-hysterectomy ephelele. Uma isibeletho nomlomo wesibeletho kukhishwa ngesitho sangasese sowesifazane, ukuhlinzwa kubizwa nge-hysterectomy yesitho sangasese sowesifazane. Uma isibeletho nomlomo wesibeletho kukhishwa ngokusebenzisa ukusikeka okukhulu esiswini, ukuhlinzwa kubizwa ngokuthi yi-hysterectomy ephelele yesisu. Uma isibeletho nomlomo wesibeletho kukhishwa ngesikezi esincane (esisikiwe) esiswini kusetshenziswa i-laparoscope, ukuhlinzwa kubizwa ngokuthi yi-laparoscopic hysterectomy ephelele.

I-Hysterectomy. Isibeletho sisuswa ngokuhlinzwa noma ngaphandle kwezinye izitho noma izicubu. Ku-hysterectomy ephelele, isibeletho nomlomo wesibeletho kuyasuswa. Ku-hysterectomy ephelele ene-salpingo-oophorectomy, (a) kukhishwa isibeletho kanye ne-one (unilateral) ovary kanye ne-fallopian tube; noma (b) kukhishwe isibeletho kanye nawo womabili (amabhilidi) amaqanda kanye namashubhu e-fallopian. Ku-hysterectomy enamandla, kukhishwa isibeletho, umlomo wesibeletho, womabili amaqanda, amashubhu womabili, nezicubu eziseduze. Lezi zinqubo zenziwa kusetshenziswa imbobo ephansi enqamulelayo noma imbobo ebheke phezulu.

• Unilateral salpingo-oophorectomy: Inqubo yokuhlinza ukususa i-ovary eyodwa kanye ne-fallopian tube eyodwa.

• I-Bilateral salpingo-oophorectomy: Inqubo yokuhlinza ukususa womabili amaqanda kanye namashubhu womabili.

• I-Omentectomy: Inqubo yokuhlinza ukususa i-omentum (izicubu ezise-peritoneum equkethe imithambo yegazi, izinzwa, imithambo ye-lymph, nama-lymph node).

• I-lymph node biopsy: Ukususwa kwakho konke noma ingxenye ye-lymph node. Isazi sezifo sibheka izicubu ze-lymph node ngaphansi kwesibonakhulu ukuhlola amaseli omdlavuza.

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).

Uhlobo lwe-chemotherapy yesifunda esetshenziselwa ukwelapha umdlavuza we-ovari yi-intraperitoneal (IP) chemotherapy. Ku-IP chemotherapy, imishanguzo elwa nomdlavuza ithwalwa iye ngqo emgodini we-peritoneal (isikhala esiqukethe izitho zesisu) ngethumbu elincanyana.

I-Hyperthermic intraperitoneal chemotherapy (HIPEC) iyindlela yokwelashwa esetshenziswa ngesikhathi sokuhlinzwa efundelwa umdlavuza we-ovari. Ngemuva kokuthi udokotela ohlinzayo esuse izicubu zomzimba ngangokunokwenzeka, i-chemotherapy efudumele ithunyelwa ngqo emgodini we-peritoneal.

Ukwelashwa ngezidakamizwa ezingaphezu kweyodwa ze-anticancer kubizwa ngokuthi inhlanganisela yamakhemikhali.

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

Bheka Izidakamizwa ezivunyelwe i-Ovarian, i-Fallopian Tube, noma i-Primary Peritoneal Cancer ukuthola eminye imininingwane.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile.

I-monoclonal antibody therapy luhlobo lokwelashwa okuqondisiwe olusebenzisa amasosha omzimba enziwe elebhu, kusuka ohlotsheni olulodwa lwamaseli omzimba. La ma-antibody angakhomba izinto kumaseli womdlavuza noma ezintweni ezijwayelekile ezingasiza amangqamuzana omdlavuza ukuthi akhule. Amasosha omzimba anamathela ezintweni futhi abulale amangqamuzana omdlavuza, avimbe ukukhula kwawo, noma awagcine ekusakazekeni. Ama-antibody e-monoclonal anikezwa ngokumnika. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi, noma okokukhipha imisebe ngqo emangqamuzaneni omdlavuza.

I-Bevacizumab iyi-anti-monoclonal antibody engasetshenziswa ukwelashwa ngamakhemikhali ukwelapha umdlavuza we-ovarian epithelial, umdlavuza we-fallopian tube, noma umdlavuza oyinhloko we-peritoneal obuye wabuya (buyela).

I-Poly (ADP-ribose) polymerase inhibitors (i-PARP inhibitors) yimithi yokwelapha ehlosiwe evimba ukulungiswa kwe-DNA futhi ingadala ukuthi amangqamuzana omdlavuza afe. I-Olaparib, i-rucaparib, ne-niraparib ngama-PARP inhibitors angasetshenziswa ukwelapha umdlavuza we-ovarian osezingeni eliphakeme. I-Rucaparib ingasetshenziselwa ukwelashwa kwesondlo ukwelapha umdlavuza we-ovarian epithelial, umdlavuza we-fallopian tube, noma umdlavuza oyinhloko we-peritoneal ophindaphindiwe. IVeliparib iyi-PARP inhibitor efundwayo ukwelapha umdlavuza we-ovarian osezingeni eliphakeme.

Ama-angiogenesis inhibitors yimithi yokwelashwa ehlosiwe engavimbela ukukhula kwemithambo yegazi emisha okudingeka ukuthi izicubu zikhule futhi ingabulala amangqamuzana omdlavuza. I-Cediranib iyi-angiogenesis inhibitor efundwayo ekwelapheni umdlavuza ovamile we-ovari.

Bheka Izidakamizwa ezivunyelwe i-Ovarian, i-Fallopian Tube, noma i-Primary Peritoneal Cancer ukuthola eminye imininingwane.

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 ngemisebe

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Abanye besifazane bathola ukwelashwa okubizwa nge-intraperitoneal radiation therapy, lapho uketshezi olunemisebe efakwa khona ngqo esiswini nge-catheter. Ukwelashwa kwemisebe ye-Intraperitoneal kuyacutshungulwa ukwelapha umdlavuza we-ovarian othuthukile.

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-immunotherapy.

Ukwelashwa ngokugoma ukwelashwa komdlavuza okusebenzisa into noma iqembu lezinto ukukhuthaza amasosha omzimba ukuthi athole isimila asibulale. Ukwelapha umuthi wokugomela kuyacutshungulwa ukwelapha umdlavuza we-ovarian osezingeni eliphezulu.

Ukwelashwa kwe-ovarian epithelial, fallopian tube, kanye nomdlavuza oyinhloko we-peritoneal 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

• Umdlavuza Wokuqala We-Ovarian Epithelial and Fallopian Tube

• I-Advanced Ovarian Epithelial, Fallopian Tube, kanye Nomdlavuza Oyinhloko We-Peritoneal

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

Umdlavuza Wokuqala We-Ovarian Epithelial and Fallopian Tube

Ukwelashwa komdlavuza wokuqala we-ovarian epithelial noma umdlavuza we-fallopian tube kungafaka okulandelayo:

• I-Hysterectomy, i-bilpal salpingo-oophorectomy, ne-omentectomy. Ama-lymph node nezinye izicubu ezinqeni nasesiswini ziyasuswa futhi zihlolwe ngaphansi kwesibonakhulu ukuthola amangqamuzana omdlavuza. I-Chemotherapy inganikezwa ngemuva kokuhlinzwa.

• I-unilateral salpingo-oophorectomy ingenziwa kwabesifazane abathile abafisa ukuba nezingane. I-Chemotherapy inganikezwa ngemuva kokuhlinzwa.

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-Advanced Ovarian Epithelial, Fallopian Tube, kanye Nomdlavuza Oyinhloko We-Peritoneal

Ukwelashwa komdlavuza we-ovarian epithelial ohamba phambili, umdlavuza we-fallopian tube, noma umdlavuza oyinhloko we-peritoneal kungafaka okulandelayo:

• I-Hysterectomy, i-bilpal salpingo-oophorectomy, ne-omentectomy. Ama-lymph node nezinye izicubu ezinqeni nasesiswini kuyasuswa futhi kuhlolwe ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza. Ukuhlinzwa kulandelwa ngokulandelayo:

• Ukwelashwa ngamakhemikhali ngomjovo.

• Ukwelashwa ngamakhemikhali kwe-Intraperitoneal.

• I-Chemotherapy kanye nokwelashwa okuhlosiwe (bevacizumab).

• I-Chemotherapy kanye nokwelashwa okuhlosiwe nge-poly (ADP-ribose) polymerase (PARP) inhibitor.

• I-Chemotherapy ilandelwa ukuhlinzwa (mhlawumbe kulandelwe i-intraperitoneal chemotherapy).

• I-Chemotherapy iyodwa yeziguli ezingakwazi ukuhlinzwa.

• Isivivinyo somtholampilo sokwelapha okuqondisiwe nge-PARP inhibitor (olaparib, rucaparib, niraparib, noma i-veliparib).

• Isivivinyo somtholampilo se-hyperthermic intraperitoneal chemotherapy (HIPEC) ngesikhathi sokuhlinzwa.

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 Ukwelashwa Kwe-Ovarian Epithelial, I-Fallopian Tube, kanye Nomdlavuza Oyinhloko We-Peritoneal

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

Ukwelashwa komdlavuza we-ovarian epithelial ophindaphindiwe, umdlavuza we-fallopian tube, noma umdlavuza oyinhloko we-peritoneal kungafaka okulandelayo:

• I-Chemotherapy isebenzisa umuthi owodwa noma ngaphezulu we-anticancer.

• Ukwelashwa okuhlosiwe nge-poly (ADP-ribose) polymerase (PARP) inhibitor (olaparib, rucaparib, niraparib, noma i-cediranib) noma ngaphandle kwe-chemotherapy.

• I-Chemotherapy kanye / noma ukwelashwa okuhlosiwe (bevacizumab).

• Isivivinyo somtholampilo se-hyperthermic intraperitoneal chemotherapy (HIPEC) ngesikhathi sokuhlinzwa.

• 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 Nge-Ovarian Epithelial, Fallopian Tube, kanye Nomdlavuza Oyinhloko We-Peritoneal

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana ne-ovarian epithelial, fallopian tube, kanye nomdlavuza oyinhloko we-peritoneal, bona okulandelayo:

• I-Ovarian, iThubhu le-Fallopian, nekhasi lasekhaya lomdlavuza oyinhloko we-Peritoneal

• I-Ovarian, i-Fallopian Tube, kanye nokuvimbela umdlavuza oyinhloko we-Peritoneal

• I-Ovarian, iThubhu le-Fallopian, kanye nokuhlolwa komdlavuza oyinhloko we-Peritoneal

• Umdlavuza Ongajwayelekile Wokwelashwa Kwezingane

• Izidakamizwa zivunyelwe i-Ovarian, Fallopian Tube, noma i-Primary Peritoneal Cancer

• Izindlela Zokwelapha Zomdlavuza

• Izinguquko ze-BRCA: Ubungozi Bomdlavuza Nokuhlolwa Kofuzo

• Ukuhlolwa Kofuzo Kwezifo Ezizuzwayo Zokuthola Umdlavuza

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