Izinhlobo / i-pancreatic / isiguli / i-pancreatic-treatment-pdq

Ukwelashwa Kwe-Pancreatic Cancer (Adult) (®) -Patient Version

Imininingwane ejwayelekile Mayelana Nomdlavuza wePancreatic

AMAPHUZU ASEMQOKA

• Umdlavuza wepancreatic yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zepancreas.

• Ukubhema nomlando wezempilo kungathinta ingozi yomdlavuza we-pancreatic.

• Izimpawu nezimpawu zomdlavuza we-pancreatic zifaka i-jaundice, ubuhlungu, kanye nokwehlisa isisindo.

• Umdlavuza wepancreatic kunzima ukuwuthola kusenesikhathi.

• Ukuhlolwa okuhlola amanyikwe kusetshenziselwa ukuxilonga nokukala umdlavuza wepancreatic.

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

Umdlavuza wepancreatic yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zepancreas.

Ama-pancreas yindlala engamasentimitha ayisithupha ubude emise njengepheya elincanyana elele ngohlangothi. Umkhawulo obanzi wamanyikwe ubizwa ngokuthi inhloko, isigaba esiphakathi sibizwa ngomzimba, kuthi ukuphela okuncane kubizwe umsila. Ama-pancreas alala phakathi kwesisu nomgogodla.

I-anatomy yamanyikwe. Ama-pancreas anezindawo ezintathu: ikhanda, umzimba, nomsila. Itholakala esiswini eduze kwesisu, amathumbu, nezinye izitho.

Ama-pancreas anemisebenzi emibili esemqoka emzimbeni:

• Ukwenza amajusi asiza ukugaya (ukudiliza) ukudla.

• Ukwenza ama-hormone, njenge-insulin ne-glucagon, asiza ukulawula amazinga kashukela egazini. Womabili la mahomoni asiza umzimba ukuthi usebenzise futhi ugcine amandla owathola ekudleni.

Amajusi wokugaya ukudla enziwa ngamaseli we-exocrine pancreas futhi ama-hormone enziwa ngamaseli e-endocrine pancreas. Cishe ama-95% omdlavuza we-pancreatic aqala kumaseli we-exocrine.

Lesi sifinyezo simayelana nomdlavuza we-pancreatic wangaphandle. Ngemininingwane mayelana nomdlavuza we-endocrine pancreatic, bheka isifinyezo se- ku-Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment.

Ngemininingwane ngomdlavuza we-pancreatic ezinganeni, bheka isifinyezo se- se-Childhood Pancreatic Cancer Treatment.

Ukubhema nomlando wezempilo kungathinta ingozi yomdlavuza we-pancreatic.

Noma yini enyusa ubungozi bokuthola 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.

Izici ezinobungozi zomdlavuza we-pancreatic zifaka okulandelayo:

• Ukubhema.

• Ukukhuluphala ngokweqile.

• Ukuba nomlando wakho wesifo sikashukela noma i-pancreatitis engapheli.

• Ukuba nomlando womndeni womdlavuza wepancreatic noma i-pancreatitis.

• Ukuba nezimo ezithile zofuzo, njenge:

• Izinhlobo eziningi ze-endocrine neoplasia type 1 (MEN1) syndrome.

• Umdlavuza we-Hereditary nonpolyposis colon (HNPCC; Lynch syndrome).

• I-von Hippel-Lindau syndrome.

• I-Peutz-Jeghers syndrome.

• Isifuba sofuzo nesifo somdlavuza we-ovari.

• Isifo esaziwa kakhulu se-multiple mole melanoma (FAMMM) syndrome.

• I-Ataxia-telangiectasia.

Izimpawu nezimpawu zomdlavuza we-pancreatic zifaka i-jaundice, ubuhlungu, kanye nokwehlisa isisindo.

Umdlavuza wepancreatic kungenzeka ungabangi izimpawu noma izimpawu zakuqala. Izimpawu nezimpawu zingabangelwa umdlavuza wepancreatic noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• I-jaundice (kuphuzi kwesikhumba nabamhlophe bamehlo).

• Izitulo ezinombala okhanyayo.

• Umchamo omnyama.

• Ubuhlungu esiswini esingenhla noma esiphakathi nasemuva.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukuphelelwa isifiso sokudla.

• Ukuzizwa ngikhathele kakhulu.

Umdlavuza wepancreatic kunzima ukuwuthola kusenesikhathi.

Umdlavuza wepancreatic kunzima ukuwuthola uphinde uwuhlolisise ngezizathu ezilandelayo:

• Azikho izimpawu noma izimpawu ezibonakalayo ezinyathelweni zokuqala zomdlavuza we-pancreatic.

• Izimpawu nezimpawu zomdlavuza wepancreatic, uma zikhona, zifana nezimpawu zezinye izifo eziningi.

• Ama-pancreas afihliwe ngemuva kwezinye izitho ezifana nesisu, amathumbu amancane, isibindi, i-gallbladder, ubende, kanye nemibhobho ye-bile.

Ukuhlolwa okuhlola amanyikwe kusetshenziselwa ukuxilonga nokukala umdlavuza wepancreatic.

Umdlavuza wepancreatic uvame ukutholakala unezivivinyo nezinqubo ezenza izithombe zamanyikwe nendawo ezungezile. Inqubo esetshenziselwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi nangaphandle kwamanyikwe ibizwa ngokuthi yisiteji. Ukuhlolwa nezinqubo zokuthola, ukuxilonga, kanye nomdlavuza wepancreatic wesigaba kuvame ukwenziwa ngasikhathi sinye. Ukuze uhlele ukwelashwa, kubalulekile ukwazi isigaba sesifo nokuthi umdlavuza we-pancreatic ungasuswa ngokuhlinzwa noma cha.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando wezempilo: 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, njenge-bilirubin, ekhishelwa egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• Isivivinyo sesimila: Inqubo lapho kuhlolwe khona isampula yegazi, umchamo, noma izicubu ukukala inani lezinto ezithile, njenge-CA 19-9, ne-carcinoembryonic antigen (CEA), eyenziwe izitho, izicubu noma amaseli wesimila. emzimbeni. Izinto ezithile zixhunyaniswe nezinhlobo ezithile zomdlavuza lapho zitholakala emazingeni akhuphukile emzimbeni. Lokhu kubizwa ngokuthi yizimpawu zesimila.

• 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-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-computer ene-tomography, noma i-computer axial tomography. I-CT spiral noma helical helmet yenza uchungechunge lwezithombe ezinemininingwane eminingi yezindawo ezingaphakathi komzimba zisebenzisa umshini we-x-ray ohlola umzimba ngendlela evunguza.

• 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. Ukuskena i-PET ne-CT scan kungenziwa ngasikhathi sinye. Lokhu kubizwa nge-PET-CT.

• I-ultrasound yesisu: Ukuhlolwa kwe-ultrasound okusetshenziselwa ukwenza izithombe zengaphakathi lesisu. I-transducer ye-ultrasound icindezelwe esikhunjeni sesisu futhi iqondisa amaza omsindo we-high-energy (ultrasound) esiswini. Amagagasi omsindo ashaya izicubu nezitho zangaphakathi bese enza ama-echoes. I-transducer ithola ama-echoes bese iwathumela kukhompyutha, esebenzisa ama-echoes ukwenza izithombe ezibizwa ngama-sonograms. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi.

• 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 wamandla aphezulu (i-ultrasound) ezicutshini zangaphakathi noma ezithweni futhi enze ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Le nqubo ibizwa nangokuthi i-endosonography.

• I-Endoscopic retrograde cholangiopancreatography (ERCP): Inqubo esetshenziselwa ukufaka i-x-ray amapayipi (amashubhu) athwala inyongo isuka esibindini iye enyongweni nasenyameni iye emathunjini amancane. Kwesinye isikhathi umdlavuza we-pancreatic ubangela ukuthi la mapayipi anciphise futhi avimbe noma anciphise ukuhamba kwe-bile, kubangele i-jaundice. I-endoscope (ishubhu elincanyana, elikhanyisiwe) idluliselwa emlonyeni, esophagus, nasesiswini engxenyeni yokuqala yamathumbu amancane. Ipayipi (ithubhu elincane) bese lifakwa nge-endoscope lingene emiphakathini yepancreatic. Idayi ijojowe nge-catheter emapayipini bese kuthathwa i-x-ray. Uma amapayipi evinjelwe isimila, ithubhu enhle ingafakwa emgodini ukuze ivulwe. Le tube (noma i-stent) ingashiywa endaweni ukuze kugcinwe umsele uvulekile. Amasampula amathishu nawo angathathwa.

• I-Percutaneous transhepatic cholangiography (PTC): Inqubo esetshenziselwa ukuxilonga imithambo yesibindi neye-bile. Inaliti ezacile ifakwa esikhunjeni ngaphansi kwezimbambo nasesibindi. Idayi ijojowe emgodini wesibindi noma we-bile bese kuthathwa i-x-ray. Uma kutholakala ukuvinjelwa, ishubhu elincane, eliguquguqukayo elibizwa ngokuthi i-stent kwesinye isikhathi lishiywa esibindini ukukhipha inyongo emathunjini amancane noma esikhwameni sokuqoqa ngaphandle komzimba. Lokhu kuhlolwa kwenziwa kuphela uma i-ERCP ingenakwenziwa.

• I-Laparoscopy: Inqubo yokuhlinza ukubheka izitho ezingaphakathi esiswini ukubheka izimpawu zesifo. Ukusikeka okuncane (ukusikeka) kwenziwa odongeni lwesisu bese kufakwa i-laparoscope (ithubhu elincane elikhanyisiwe) kokunye okusikiwe. I-laparoscope ingahle ibe nesiphetho se-ultrasound ekugcineni ukuze igagule amaza omsindo wamandla aphakeme ezithweni zangaphakathi, njengamanyikwe. Lokhu kubizwa nge-laparoscopic ultrasound. Ezinye izinsimbi zingafakwa ngokusebenzisa okufanayo noma okunye ukusikeka ukwenza izinqubo ezifana nokuthatha amasampula wezicubu emanyikwe noma isampula loketshezi esiswini ukuhlola umdlavuza.

• I-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. Kunezindlela eziningi zokwenza i-biopsy yomdlavuza we-pancreatic. Inalidi enhle noma inaliti eyinhloko ingafakwa kuma-pancreas ngesikhathi se-x-ray noma i-ultrasound ukususa amaseli. Izicubu zingasuswa futhi ngesikhathi se-laparoscopy noma ngokuhlinzwa ukuze kususwe isimila.

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

Izinketho zokubikezela nokwelashwa zincike kokulandelayo:

• Ukuthi isimila singasuswa noma cha ngokuhlinzwa.

• Isigaba somdlavuza (ubukhulu besimila nokuthi umdlavuza usabalele ngaphandle kwamanyikwe kuya ezicutshini eziseduze noma kuma-lymph node noma kwezinye izindawo emzimbeni).

• Impilo ejwayelekile yesiguli.

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

Umdlavuza wepancreatic ungalawulwa kuphela uma utholakala ungakasakazeki, lapho ungasuswa ngokuphelele ngokuhlinzwa. Uma umdlavuza ususabalele, ukwelashwa okunciphisayo kungathuthukisa ikhwalithi yempilo yesiguli ngokulawula izimpawu nobunzima balesi sifo.

Izigaba Zomdlavuza wePancreatic

AMAPHUZU ASEMQOKA

• Ukuhlolwa nezinqubo zokwenziwa komdlavuza wepancreatic kuvame ukwenziwa ngasikhathi sinye nokuxilongwa.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-pancreatic:

• Isigaba 0 (I-Carcinoma eSitu)

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

• Amaqembu alandelayo asetshenziselwa ukuhlela ukwelashwa:

• Umdlavuza we-pancreatic obonakalayo

• Umdlavuza wepancreatic onqunyelwe emngceleni

• Umdlavuza we-pancreatic osendaweni

• Umdlavuza we-pancreatic we-metastatic

• Umdlavuza ophindaphindiwe wepancreatic

Ukuhlolwa nezinqubo zokwenziwa komdlavuza wepancreatic kuvame ukwenziwa ngasikhathi sinye nokuxilongwa.

Inqubo esetshenziswayo ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwamanyikwe noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba sesifo ukuze uhlele ukwelashwa. Imiphumela yolunye uvivinyo olusetshenziselwa ukuxilonga umdlavuza wepancreatic luvame ukusetshenziselwa ukufaka lesi sifo. Bona isigaba soLwazi Jikelele ukuthola eminye imininingwane.

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-pancreatic usakazekela esibindi, amangqamuzana omdlavuza wesibindi empeleni angamaseli omdlavuza we-pancreatic. Lesi sifo umdlavuza we-pancreatic we-metastatic, hhayi umdlavuza wesibindi.

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-pancreatic:

Isigaba 0 (I-Carcinoma eSitu)

Isigaba 0 umdlavuza we-pancreatic. Amaseli angajwayelekile atholakala kulwelwesi lwamanyikwe. Lawa maseli angajwayelekile angaba ngumdlavuza futhi asabalale abe izicubu ezijwayelekile eziseduze.

Esigabeni 0, kutholakala amaseli angajwayelekile kulwelwesi lwamanyikwe. Lawa maseli angajwayelekile angaba ngumdlavuza futhi asabalale abe izicubu ezijwayelekile eziseduze. Isigaba 0 sibizwa nangokuthi i-carcinoma in situ.

Isiteji I

Isigaba I umdlavuza wepancreatic. Umdlavuza utholakala kumanyikwe kuphela. Esigabeni IA, isimila singamasentimitha ama-2 noma sincane. Esigabeni IB, isimila sikhulu kunamasentimitha ama-2 kepha asisikhulu kunamasentimitha ama-4.

Esigabeni I, umdlavuza wakhekile futhi utholakala kumanyikwe kuphela. Isigaba I sihlukaniswe ngezigaba IA ne-IB, kuya ngosayizi wesimila.

• Isigaba IA: Isigaxa singamasentimitha ama-2 noma sincane.

• Isigaba IB: I-tumor inkulu kunamasentimitha amabili kepha ayinkulu kunamasentimitha angu-4.

Isigaba II

• Isigaba II sihlukaniswe ngezigaba IIA no-IIB, kuya ngosayizi wesimila nokuthi umdlavuza usabalale kuphi.

Isigaba IIA: Isigaxa sikhulu kunamasentimitha amane.

Isigaba IIA umdlavuza we-pancreatic. Isimila sikhulu kunamasentimitha ama-4.

• Isigaba IIB: I-tumor yinoma yisiphi isayizi nomdlavuza usakaze ku-1 kuya ku-3 ama-lymph node aseduze.

Isigaba IIB umdlavuza wepancreatic. Isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele ku-1 kuya ku-3 ama-lymph node aseduze.

Isigaba III

Umdlavuza wepancreatic wesigaba III. Isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele ku (a) 4 noma ngaphezulu ama-lymph node aseduze; noma (b) imithambo yegazi emikhulu eduze kwamanyikwe. Lokhu kufaka phakathi umthambo we-portal, umthambo ovamile we-hepatic, i-celiac axis (trunk), nomthambo ophakeme we-mesenteric.

Esigabeni III, isimila sinanoma yisiphi isayizi nomdlavuza ususabalalise:

• ama-lymph node amane noma ngaphezulu aseduze; noma

• imithambo yegazi emikhulu eduze kwamanyikwe.

Isigaba IV

Umdlavuza wepancreatic wesigaba IV. Isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele kwezinye izingxenye zomzimba, njengephaphu, isibindi, noma umgodi we-peritoneal (umgodi womzimba oqukethe izitho eziningi esiswini).

Esigabeni IV, isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalalise kwezinye izingxenye zomzimba, njengesibindi, amaphaphu, noma umgodi we-peritoneal (umgodi womzimba oqukethe izitho eziningi esiswini).

Amaqembu alandelayo asetshenziselwa ukuhlela ukwelashwa:

Umdlavuza we-pancreatic obonakalayo

Umdlavuza we-pancreatic obonakalayo ungasuswa ngokuhlinzwa ngoba awukakhuli ube yimithambo yegazi ebalulekile eduze kwesimila.

Umdlavuza wepancreatic onqunyelwe emngceleni

Umdlavuza we-pancreatic ongasetshenziswanga emngceleni ukhule waba ngumthambo omkhulu wegazi noma izicubu noma izitho eziseduze. Kungenzeka ukukhipha isimila, kodwa kunengozi enkulu yokuthi wonke amangqamuzana omdlavuza ngeke asuswe ngokuhlinzwa.

Umdlavuza we-pancreatic osendaweni

Umdlavuza wepancreatic othuthukile endaweni usukhule waba noma useduze kwama-lymph node noma imithambo yegazi eseduzane, ngakho ukuhlinzwa akukwazi ukuwususa ngokuphelele umdlavuza.

Umdlavuza we-pancreatic we-metastatic

Umdlavuza we-pancreatic we-metastatic ususabalele kwezinye izitho, ngakho-ke ukuhlinzwa akukwazi ukuwususa ngokuphelele umdlavuza.

Umdlavuza ophindaphindiwe wepancreatic

Umdlavuza ophindaphindiwe we-pancreatic uphinde wabuya (ubuya) ngemuva kokuthi welashwe. Umdlavuza ungabuya emanyikwe noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza we-pancreatic.

• Izinhlobo ezinhlanu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Ukwelashwa kwe-Chemoradiation

• Ukwelashwa okuhlosiwe

• Kukhona ukwelashwa kobuhlungu obubangelwa umdlavuza we-pancreatic.

• Iziguli ezinomdlavuza we-pancreatic zinezidingo ezikhethekile zokudla okunempilo.

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa komdlavuza we-pancreatic 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-pancreatic.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza we-pancreatic. 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 ezinhlanu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Enye yezinhlobo ezilandelayo zokuhlinzwa ingasetshenziselwa ukukhipha isimila:

• Inqubo ye-Whipple: Inqubo yokuhlinza lapho kukhishwa khona ikhanda lamanyikwe, i-gallbladder, ingxenye yesisu, ingxenye yamathumbu amancane kanye nomgudu wenyongo. Ama-pancreas anele asele ukukhiqiza ujusi wokugaya ukudla ne-insulin.

• Ingqikithi ye-pancreatectomy: Lo msebenzi ususa wonke amanyikwe, ingxenye yesisu, ingxenye yamathumbu amancane, umgudu ovamile we-bile, i-gallbladder, ubende, nama-lymph node aseduze.

• I-Distre pancreatectomy: Ukuhlinzwa ukususa umzimba kanye nomsila wamanyikwe. Ubende bungasuswa futhi uma umdlavuza usakaze ubende.

Uma umdlavuza usabalele futhi ungeke ususwe, lezi zinhlobo ezilandelayo zokuhlinzwa okunciphisayo zingenziwa ukunciphisa izimpawu nokwenza ngcono impilo:

• Ukudlula kwe-biliary: Uma umdlavuza uvimba i-bile duct futhi i-bile yakha ku-gallbladder, kungenzeka ukwenziwa kwe-biliary bypass. Ngalesi sikhathi sokuhlinzwa, udokotela uzosika i-gallbladder noma i-bile duct endaweni ngaphambi kokuvaleka bese eyithungela emathunjini amancane ukudala indlela entsha ezungeze indawo evinjiwe.

• Ukubekwa kwe-endoscopic stent: Uma isimila sivimba umgudu we-bile, ukuhlinzwa kungenziwa ukufaka i-stent (ithubhu elincanyana) ukukhipha ibile elakhiwe endaweni. Udokotela angafaka i-stent nge-catheter efaka i-bile esikhwameni ngaphandle komzimba noma i-stent ingazungeza indawo evinjiwe bese ichitha inyongo emathunjini amancane.

• Ukudlula esiswini: Uma isimila sivimba ukuhamba kokudla kusuka esiswini, isisu singathungathwa ngqo emathunjini amancane ukuze isiguli siqhubeke nokudla ngokujwayelekile.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke endaweni yomzimba enomdlavuza.

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). Inhlanganisela yamakhemikhali ukwelashwa kusetshenziswa izidakamizwa ezingaphezu kwesisodwa ze-anticancer.

Bheka Izidakamizwa Ezivunyelwe I-Pancreatic Cancer ukuthola eminye imininingwane.

Ukwelashwa kwe-Chemoradiation

Ukwelashwa kweChemoradiation kuhlanganisa ukwelashwa ngamakhemikhali nokwelashwa ngemisebe ukukhulisa imiphumela yakho kokubili.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lwezokwelapha olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amaseli womdlavuza athile. Izindlela zokwelashwa ezihlosiwe zingadala ukulimala okuncane kumaseli ajwayelekile kunokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe. Ama-Tyrosine kinase inhibitors (ama-TKIs) yimithi yokwelapha ehlosiwe evimba amasiginali adingekayo ukuze izimila zikhule. I-Erlotinib uhlobo lwe-TKI olusetshenziselwa ukwelapha umdlavuza we-pancreatic.

Bheka Izidakamizwa Ezivunyelwe I-Pancreatic Cancer ukuthola eminye imininingwane.

Kukhona ukwelashwa kobuhlungu obubangelwa umdlavuza we-pancreatic.

Ubuhlungu bungavela lapho isimila sicindezela izinzwa noma ezinye izitho eziseduze ne-pancreas. Lapho umuthi wezinhlungu unganele, kunezindlela zokwelapha ezisebenza ezinzwa esiswini ukudambisa izinhlungu. Udokotela angajova umuthi endaweni ezungeze izinzwa ezithintekile noma angasika izinzwa ukuvimba umuzwa wobuhlungu. Ukwelashwa ngemisebe nge-chemotherapy noma ngaphandle kwayo nakho kungasiza ekudambiseni ubuhlungu ngokunciphisa isimila. Bona isifinyezo se- ku-Cancer Pain ukuthola eminye imininingwane.

Iziguli ezinomdlavuza we-pancreatic zinezidingo ezikhethekile zokudla okunempilo.

Ukuhlinzwa okususa amanyikwe kungathinta ikhono layo lokwenza ama-enzyme e-pancreatic asiza ukugaya ukudla. Ngenxa yalokhu, iziguli zingaba nezinkinga ukugaya ukudla futhi zimunce izakhi zomzimba. Ukuvimbela ukungondleki kahle, udokotela angahle anikeze imishanguzo ethatha indawo yalezi enzyme. Bona isifinyezo se- mayelana neNutrition in Cancer Care 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 komdlavuza we-pancreatic 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.

Ukwelashwa Komdlavuza We-Pancreatic Obonakalayo noma Wemingcele

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

Ukwelashwa komdlavuza we-pancreatic ovuselelekayo noma owenziwe emngceleni kungafaka okulandelayo:

• Ukwelashwa ngamakhemikhali noma ngemithi yokwelashwa ngemisebe noma ngaphandle kwayo kulandelwa ukuhlinzwa.

• Ukuhlinzwa.

• Ukuhlinzwa kwalandelwa ukwelashwa ngamakhemikhali.

• Ukuhlinzwa kulandelwa yi-chemoradiation.

• Isivivinyo somtholampilo se-chemotherapy kanye / noma i-radiation therapy ngaphambi kokuhlinzwa.

• Isivivinyo somtholampilo ngezindlela ezahlukahlukene zokunikeza ukwelashwa ngemisebe.

Ukuhlinzwa ukususa isimila kungafaka inqubo ye-Whipple, i-pancreatectomy ephelele, noma i-distal pancreatectomy.

Ukwelashwa nge-palliative kungaqalwa kunoma yisiphi isigaba sesifo. Bona isigaba se-Palliative Therapy ukuze uthole imininingwane mayelana nokwelashwa okungenza ngcono impilo noma kukhulule izimpawu ezigulini ezinomdlavuza we-pancreatic.

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

Ukwelashwa Komdlavuza WasePancreatic Wendawo Othuthukile

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

Ukwelashwa komdlavuza we-pancreatic othuthukile endaweni kungafaka okulandelayo:

• I-Chemotherapy enokwelashwa okuhlosiwe noma ngaphandle kwayo.

• I-Chemotherapy kanye ne-chemoradiation.

• Ukuhlinzwa (inqubo ye-Whipple, i-pancreatectomy ephelele, noma i-distre pancreatectomy).

• Ukuhlinzwa okunconywayo noma ukubekwa kwesitentimenti ukudlula ezindaweni ezivinjiwe emapayipini noma emathunjini amancane. Ezinye iziguli zingathola futhi i-chemotherapy kanye ne-chemoradiation ukunciphisa isisu ukuze kuvunyelwe ukuhlinzwa.

• Isivivinyo somtholampilo sokwelapha okusha kwe-anticancer kanye ne-chemotherapy noma i-chemoradiation.

• Isivivinyo somtholampilo sokwelapha ngemisebe okunikezwe ngesikhathi sokuhlinzwa noma kwelashwa kwemisebe yangaphakathi.

Ukwelashwa nge-palliative kungaqalwa kunoma yisiphi isigaba sesifo. Bona isigaba se-Palliative Therapy ukuze uthole imininingwane mayelana nokwelashwa okungenza ngcono impilo noma kukhulule izimpawu ezigulini ezinomdlavuza we-pancreatic.

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

Ukwelashwa Komdlavuza We-Pancreatic We-Metastatic or Recurrent

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

Ukwelashwa komdlavuza wepancreatic osetshenzisiwe noma ophindaphindiwe ungafaka okulandelayo:

• I-Chemotherapy enokwelashwa okuhlosiwe noma ngaphandle kwayo.

• Ukuhlolwa kwemitholampilo kwama-ejenti amasha we-anticancer noma ngamakhemikhali noma ngaphandle kwawo.

Ukwelashwa nge-palliative kungaqalwa kunoma yisiphi isigaba sesifo. Bona isigaba se-Palliative Therapy ukuze uthole imininingwane mayelana nokwelashwa okungenza ngcono impilo noma kukhulule izimpawu ezigulini ezinomdlavuza we-pancreatic.

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

Ukwelashwa Kwe-Palliative

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

Ukwelashwa nge-palliative kungathuthukisa ikhwalithi yempilo yesiguli ngokulawula izimpawu nezinkinga zomdlavuza wepancreatic.

Ukwelashwa kwe-palliative komdlavuza we-pancreatic kufaka lokhu okulandelayo:

• Ukuhlinzwa okunconywayo noma ukubekwa kwesitentimenti ukudlula ezindaweni ezivinjiwe emapayipini noma emathunjini amancane.

• Ukwelashwa ngemisebe ye-Palliative ukusiza ukuqeda ubuhlungu ngokuncipha isimila.

• Umjovo womuthi wokusiza ekudambiseni izinhlungu ngokuvimba izinzwa esiswini.

• Okunye ukunakekelwa kwezokwelapha okunciphisayo kukodwa.

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 wePancreatic

Ngeminye imininingwane evela ku-National Cancer Institute mayelana nomdlavuza we-pancreatic, bheka okulandelayo:

• Ikhasi Lasekhaya Lomdlavuza wePancreatic

• Ukwelashwa Komdlavuza We-Pancreatic Wengane

• Izidakamizwa zivunyelwe i-Pancreatic Cancer

• 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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