Izinhlobo / i-prostate / isiguli / i-prostate-treatment-pdq

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Ukwelashwa Kwe-Prostate Cancer Treatment (®) –Patient Version

Imininingwane ejwayelekile Mayelana Nomdlavuza We-Prostate

AMAPHUZU ASEMQOKA

  • Umdlavuza wendlala yesifo kuyisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ze-prostate.
  • Izimpawu zomdlavuza wendlala yesinye zifaka ukugeleza okuncane komchamo noma ukuchama kaningi.
  • Izivivinyo ezihlola indlala yesinye negazi zisetshenziselwa ukuthola umdlavuza wendlala yabesilisa.
  • Kwenziwa i-biopsy ukuthola umdlavuza wendlala yesinye futhi kutholakale izinga lomdlavuza (amaphuzu kaGleason).
  • Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Umdlavuza wendlala yesifo kuyisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ze-prostate.

Indlala yesinye indlala ohlelweni lokuzala lwabesilisa. Ilele ngaphansi nje kwesinye (isitho esiqoqa sithulule umchamo) naphambi kwe-rectum (ingxenye engezansi yamathumbu). Imayelana nosayizi we-walnut futhi izungeze ingxenye yomchamo (ishubhu elikhipha umchamo esinyeni). Indlala yesinye yenza uketshezi oluyingxenye yesidoda.

I-anatomy yezinhlelo zesilisa zokuzala nezomchamo, ezibonisa indlala, amasende, isinye nezinye izitho.

Umdlavuza wendlala yesinye uvame kakhulu emadodeni amadala. E-US, cishe indoda eyodwa kwabahlanu izotholakala inomdlavuza wesinye.

Izimpawu zomdlavuza wendlala yesinye zifaka ukugeleza okuncane komchamo noma ukuchama kaningi.

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

  • Ukugeleza komchamo obuthakathaka noma ophazamisekile ("ukuma-nokuhamba").
  • Isifiso esisheshayo sokuchama.
  • Ukuchama njalo (ikakhulukazi ebusuku).
  • Inkinga yokuqala ukugeleza komchamo.
  • Inkinga yokukhipha isinye ngokuphelele.
  • Ubuhlungu noma ukushisa ngenkathi uchama.
  • Igazi umchamo noma isidoda.
  • Ubuhlungu emuva, okhalweni, noma okhalweni okungapheli.
  • Ukuphefumula okuncane, ukuzwa ukhathele kakhulu, ukushaya kwenhliziyo okusheshayo, isiyezi, noma isikhumba esiphaphathekile okubangelwa i-anemia.

Ezinye izimo zingadala izimpawu ezifanayo. Njengoba amadoda ekhula, i-prostate ingakhula futhi ivimbele i-urethra noma isinye. Lokhu kungadala inkinga yokuchama noma izinkinga zocansi. Lesi simo sibizwa ngokuthi yi-benign prostatic hyperplasia (BPH), futhi yize kungewona umdlavuza, ukuhlinzwa kungadingeka. Izimpawu ze-benign prostatic hyperplasia noma ezinye izinkinga ku-prostate zingafana nezimpawu zomdlavuza wendlala yesinye.

I-prostate ejwayelekile ne-benign prostatic hyperplasia (BPH). Indlala ejwayelekile ayikuvimbeli ukugeleza komchamo esinyeni. I-prostate ekhulisiwe icindezela esinyeni nasesibayeni futhi ivimba ukuphuma komchamo.

Izivivinyo ezihlola indlala yesinye negazi zisetshenziselwa ukuthola umdlavuza wendlala yabesilisa.

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.
  • Ukuhlolwa kwe-rectal rectal (DRE): Ukuhlolwa kwe-rectum. Udokotela noma umhlengikazi ufaka umunwe othanjisiwe, ofakwe igilavu ​​ku-rectum futhi uzwe i-prostate ngodonga olungunxande ngezigaxa noma izindawo ezingejwayelekile.
Ukuhlolwa kwe-digital rectal (DRE). Udokotela ufaka umunwe ovalwe, othanjisiwe ku-rectum futhi uzwe i-rectum, i-anus, ne-prostate (kwabesilisa) ukubheka noma yini engajwayelekile.
  • Isivivinyo se-Prostate-specific antigen (PSA): Isivivinyo esikala izinga le-PSA egazini. I-PSA yinto eyenziwe yi-prostate engatholakala ngamanani aphezulu kunejwayelekile egazini lamadoda anomdlavuza wendlala yesinye. Amazinga e-PSA nawo angaphakama emadodeni ane-infection noma ukuvuvukala kwe-prostate noma i-BPH (i-prostate ekhulisiwe, kepha enganomdlavuza).
  • I-Transrectal ultrasound: Inqubo lapho kufakwa khona iphenyo elingana nosayizi womunwe ku-rectum ukuhlola indlala yesinye. Uphenyo lusetshenziselwa ukuqhuma amaza omsindo aphezulu (i-ultrasound) ezicutshini zangaphakathi noma ezithweni bese wenza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. I-ultrasound elandelanayo ingasetshenziswa ngesikhathi senqubo ye-biopsy. Lokhu kubizwa ngokuthi yi-transrectal ultrasound biopsy eqondisiwe.
I-ultrasound engaguquki. Kufakwa iphenyo ye-ultrasound engxenyeni engaphezulu ukuze kuhlolwe indlala yesinye. I-probe igxuma amaza omsindo ezicutshini zomzimba ukuze yenze ama-echoes akha i-sonogram (isithombe sekhompyutha) se-prostate.
  • I-Transrectal magnetic resonance imaging (MRI): Inqubo esebenzisa uzibuthe onamandla, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Iphenyo ekhipha amagagasi omsakazo ifakwa engxenyeni eseduze ne-prostate. Lokhu kusiza umshini we-MRI ukuthi wenze izithombe ezicace bha ze-prostate nezicubu eziseduze. I-MRI eguquguqukayo yenziwa ukuthola ukuthi ngabe umdlavuza usabalale ngaphandle kwe-prostate waya ezicutshini eziseduze. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI). I-MRI eguquguqukayo ingasetshenziswa ngesikhathi senqubo ye-biopsy. Lokhu kubizwa ngokuthi yi-transrectal MRI eqondiswa nge-biopsy.

Kwenziwa i-biopsy ukuthola umdlavuza wendlala yesinye futhi kutholakale izinga lomdlavuza (amaphuzu kaGleason).

I-biopsy eguquguqukayo isetshenziselwa ukuthola umdlavuza we-prostate. I-biopsy eguquguqukayo ukususwa kwezicubu ezivela endlaleni ngokufaka inaliti ezacile ngomgogodla kanye nakwindlala yesinye. Le nqubo ingenziwa kusetshenziswa i-transrectal ultrasound noma i-transrectal MRI ukusiza ukuqondisa lapho kuthathwa khona amasampula wezicubu. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza.

I-biopsy eguqukayo. Uphenyo lwe-ultrasound lufakwa engxenyeni ekhombisa ukuthi sikhona kuphi isimila. Ngemuva kwalokho kufakwa inaliti nge-rectum ku-prostate ukuze kususwe izicubu ku-prostate.

Kwesinye isikhathi kwenziwa i-biopsy kusetshenziswa isampula lezicubu ezisuswe ngesikhathi sokuvulwa kabusha kwe-prostate (TURP) ukwelapha i-benign prostatic hyperplasia.

Uma kutholakala umdlavuza, udokotela wezifo uzonikeza umdlavuza izinga. Izinga lomdlavuza lichaza ukuthi amangqamuzana omdlavuza abukeka ngendlela engajwayelekile kanjani ngaphansi kwesibonakhulu nokuthi umdlavuza kungenzeka ukhule futhi usabalale ngokushesha kangakanani. Izinga lomdlavuza libizwa ngokuthi yisikolo seGleason.

Ukunikeza umdlavuza ibanga, udokotela wezifo ezihlola izifo uhlola amasampula endlala yesinye ukuze abone ukuthi izicubu zesimila zifana kangakanani nesicubu sendlala yesinye futhi athole amaphethini amaseli amabili amakhulu. Iphethini eyinhloko ichaza iphethini yezicubu ezivame kakhulu, futhi iphethini yesibili ichaza iphethini elandelayo elandelayo kakhulu. Iphethini ngayinye inikezwa ibanga kusuka ku-3 kuye ku-5, lapho ibanga lesi-3 libukeka njengezicubu ezijwayelekile ze-Prostate kanye nebanga lesi-5 elibukeka njengengajwayelekile kakhulu. Amabanga amabili ayengezwa ukuthola amaphuzu weGleason.

Isilinganiso se-Gleason singaba kusuka ku-6 kuye ku-10. Uma izinga le-Gleason liphakeme, umdlavuza uzokhula futhi usabalale ngokushesha. Isilinganiso se-Gleason se-6 ngumdlavuza osezingeni eliphansi; amaphuzu ayi-7 umdlavuza osezingeni eliphakathi nendawo; futhi amaphuzu ayi-8, 9, noma ayi-10 ngumdlavuza osezingeni eliphezulu. Isibonelo, uma iphethini yezicubu ezivame kakhulu ibanga lesi-3 bese kuthi iphethini yesibili ibanga lesi-4, kusho ukuthi umdlavuza omningi ibanga lesi-3 bese kuthi umdlavuza omncane kube ibanga lesi-4. Amabanga afakwa esigabeni se-Gleason esingu-7, futhi ngumdlavuza osezingeni eliphakathi nendawo. Isikolo seGleason singabhalwa njengo-3 + 4 = 7, uGleason 7/10, noma isibalo esihlanganisiwe seGleason esingu-7.

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

Izinketho zokubikezela nokwelashwa zincike kokulandelayo:

  • Isigaba somdlavuza (izinga le-PSA, amaphuzu kaGleason, iBanga leBanga, ukuthi indlala yesinye ithinteke kangakanani kulo mdlavuza, nokuthi umdlavuza ususabalele nakwezinye izindawo emzimbeni).
  • Iminyaka yesiguli.
  • Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Izinketho zokwelashwa nazo zingancika kokulandelayo:

  • Ukuthi isiguli sinezinye yini izinkinga zempilo.
  • Imiphumela emibi elindelekile yokwelashwa.
  • Ukwelashwa kwangaphambilini komdlavuza wendlala yesinye.
  • Izifiso zesiguli.

Iningi labesilisa okutholakala ukuthi linomdlavuza wendlala yesinye alibulali kulo.

Izigaba Zomdlavuza We-Prostate

AMAPHUZU ASEMQOKA

  • Ngemuva kokutholakala komdlavuza wendlala yesinye, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asabalele ngaphakathi kwendlala noma kwezinye izingxenye zomzimba.
  • Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
  • Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.
  • Izinga leGrade Group ne-PSA lisetshenziselwa ukwenza umdlavuza we-prostate.
  • Kusetshenziswa lezi zigaba ezilandelayo zomdlavuza wendlala yesinye:
  • Isiteji I
  • Isigaba II
  • Isigaba III
  • Isigaba IV
  • Umdlavuza wendlala yesinye ungaphinda ubuye (ubuye) ngemuva kokuba welashwe.

Ngemuva kokutholakala komdlavuza wendlala yesinye, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asabalele ngaphakathi kwendlala noma kwezinye izingxenye zomzimba.

Inqubo esetshenziswayo ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwendlala yesinye 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 wendlala yesinye iphinda isetshenziselwe ukufaka lesi sifo. (Bheka isigaba soLwazi Jikelele.) Emdlavuzeni wendlala yesinye, ukuhlolwa kwesiteji kungenzeka kungenziwa ngaphandle kokuthi isiguli sinezimpawu noma izimpawu zokuthi umdlavuza usakazekile, njengobuhlungu bamathambo, izinga eliphezulu le-PSA, noma amaphuzu aphezulu eGleason.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

  • Ukuskena kwamathambo: Inqubo yokubheka ukuthi kunamaseli ahlukanisa ngokushesha yini, njengamaseli womdlavuza, ethanjeni. Inani elincane kakhulu lezinto ezinomsakazo lifakwa emthanjeni futhi lihambe phakathi kwegazi. Izinto ezinemisebe eqoqa emathanjeni ezinomdlavuza futhi zitholwa isithwebuli.
Ukuskena kwamathambo. Inani elincane le-radioactive lifakwa egazini lesiguli futhi liqoqwe kumaseli angajwayelekile emathanjeni. Lapho isiguli silele etafuleni elishelela ngaphansi kwesithwebuli, kutholakala okokusebenza okukhipha imisebe bese kwenziwa izithombe esikrinini sekhompyutha noma kwifilimu.
  • 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-computerized tomography, noma i-computer axial tomography.
  • I-pelvic lymphadenectomy: Inqubo yokuhlinza ukususa ama-lymph node ku-pelvis. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza.
  • I-seminal vesicle biopsy: Ukususwa koketshezi kuma-vesicles wesidoda (izindlala ezenza isidoda) kusetshenziswa inaliti. Isazi sezifo sibheka uketshezi olungaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza.
  • Iskena seProstaScint: Inqubo yokuhlola umdlavuza osabalale kusuka endlaleni yesinye kuya kwezinye izingxenye zomzimba, njengama-lymph node. Inani elincane kakhulu lezinto ezinomsakazo lifakwa emthanjeni futhi lihambe phakathi kwegazi. Okokusebenza okukhipha imisebe enamathele kumaseli womdlavuza wesinye futhi kutholwa isithwebuli. Izinto ezinemisebe ekhombisa indawo ekhanyayo esithombeni ezindaweni lapho kunamaseli amaningi omdlavuza wendlala yesinye.

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-prostate usakazeka uye emathanjeni, amangqamuzana omdlavuza asethanjeni empeleni angamaseli womdlavuza wendlala yabesilisa. Lesi sifo umdlavuza wendlala yesinye, hhayi umdlavuza wethambo.

I-Denosumab, i-antibody monoclonal, ingasetshenziswa ukuvimbela ama-metastases amathambo.

Izinga leGrade Group ne-PSA lisetshenziselwa ukwenza umdlavuza we-prostate.

Isigaba somdlavuza sisuselwa emiphumeleni yokuhlolwa kwesiteji nokuxilongwa, kufaka phakathi ukuhlolwa kwe-prostate-specific antigen (PSA) neGrade Group. Amasampula wezicubu asuswe ngesikhathi se-biopsy asetshenziselwa ukuthola amaphuzu kaGleason. Isilinganiso se-Gleason sisuka ku-2 kuye ku-10 futhi sichaza ukuthi amaseli womdlavuza ahluke kanjani kumaseli avamile ngaphansi kwesibonakhulu nokuthi kungenzeka kanjani ukuthi isimila sisabalale. Ukwehla kwenombolo, amangqamuzana omdlavuza athe xaxa abukeka njengamaseli ajwayelekile futhi kungenzeka akhule futhi asakazeke kancane.

IGrade Group incike kwisikolo seGleason. Bona isigaba Sokwaziswa Okuvamile ukuthola eminye imininingwane mayelana nesikolo seGleason.

  • Ibanga leBanga 1 yisilinganiso seGleason esingu-6 noma ngaphansi.
  • Ibanga leBanga 2 noma i-3 yisilinganiso se-Gleason esingu-7.
  • IBanga leBanga lesi-4 yisikolo seGleason 8.
  • Ibanga leBanga lesi-5 yisikolo seGleason esingu-9 noma esingu-10.

Ukuhlolwa kwe-PSA kukala izinga le-PSA egazini. I-PSA yinto eyenziwe yi-prostate engatholwa ngenani elikhuphukile egazini lamadoda anomdlavuza wendlala yesinye.

Kusetshenziswa lezi zigaba ezilandelayo zomdlavuza wendlala yesinye:

Isiteji I

Isiteji I umdlavuza wesibeletho. Umdlavuza utholakala endlaleni yesinye kuphela. Umdlavuza awuzwakali ngesikhathi sokuhlolwa kwamakholomu edijithali futhi utholakala ngenaliti biopsy eyenziwe ngezinga eliphakeme le-antigen (PSA) noma kusampula yezicubu ezisuswe ngesikhathi sokuhlinzwa ngenxa yezinye izizathu. Izinga le-PSA lingaphansi kuka-10 kanti iBanga leBanga lingu-1; NOMA umdlavuza uzwakala ngesikhathi sokuhlolwa kwamakholomu edijithali futhi utholakala engxenyeni eyodwa noma engaphansi kolunye uhlangothi lwendlala yesinye. Izinga le-PSA lingaphansi kuka-10 kanti iBanga leBanga lingu-1.
  • ayizwa ngesikhathi sokuhlolwa kwamakholomu edijithali futhi itholakala nge-needle biopsy (eyenziwe ngezinga eliphezulu le-PSA) noma kusampula yezicubu ezisuswe ngesikhathi sokuhlinzwa ngenxa yezinye izizathu (njenge-benign prostatic hyperplasia). Izinga le-PSA lingaphansi kuka-10 kanti iBanga leBanga lingu-1; noma
  • izwakala ngesikhathi sokuhlolwa kwamakholomu edijithali futhi itholakala engxenyeni eyodwa noma engaphansi kolunye uhlangothi lwendlala yesinye. Izinga le-PSA lingaphansi kuka-10 kanti iBanga leBanga lingu-1.

Isigaba II

Esigabeni II, umdlavuza udlulele kakhulu kunasesigabeni I, kepha awusakazekanga ngaphandle kwendlala yesinye. Isigaba II sihlukaniswe ngezigaba IIA, IIB, kanye ne-IIC.

Isigaba IIA umdlavuza wendlala yesinye. Umdlavuza utholakala endlaleni yesinye kuphela. Umdlavuza utholakala engxenyeni eyodwa noma engaphansi kolunye uhlangothi lwendlala yesinye. Izinga le-prostate-specific antigen (PSA) okungenani li-10 kepha lingaphansi kuka-20 kanti iBanga leBanga lingu-1; NOMA umdlavuza utholakala engxenyeni engaphezu kwengxenye yohlangothi olulodwa lwendlala noma kuzo zombili izinhlangothi zesibeletho. Izinga le-PSA lingaphansi kwama-20 kanti iBanga leBanga lingu-1.

Esigabeni IIA, umdlavuza:

  • itholakala engxenyeni eyodwa noma engaphansi kolunye uhlangothi lwendlala yesinye. Izinga le-PSA okungenani li-10 kepha liphansi kune-20 kanti iBanga leBanga lingu-1; noma
  • itholakala engxenyeni engaphezu kwengxenye yohlangothi olulodwa lwe-prostate noma ezinhlangothini zombili ze-prostate. Izinga le-PSA lingaphansi kuka-20 kanti iBanga leBanga lingu-1.
Umdlavuza wesiteji IIB IIB. Umdlavuza utholakala endlaleni yesinye kuphela. Umdlavuza utholakala kohlangothi olulodwa noma kuzo zombili ze-prostate. Izinga le-antigen eliqondene ne-prostate lingaphansi kuka-20 kanti iBanga leBanga lingu-2.

Esigabeni IIB, umdlavuza:

  • itholakala kolunye noma zombili izinhlangothi zesibeletho. Izinga le-PSA lingaphansi kuka-20 kanti iBanga leBanga lingu-2.
Umdlavuza wesigaba se-IIC wesigaba. Umdlavuza utholakala endlaleni yesinye kuphela. Umdlavuza utholakala kohlangothi olulodwa noma kuzo zombili ze-prostate. Izinga le-antigen eliqondene ne-prostate lingaphansi kuka-20 kanti iBanga leBanga lingu-3 noma u-4.

Esigabeni IIC, umdlavuza:

  • itholakala kolunye noma zombili izinhlangothi zesibeletho. Izinga le-PSA lingaphansi kuka-20 kanti iBanga leBanga lingu-3 noma u-4.

Isigaba III

Isigaba III sihlukaniswe izigaba IIIA, IIIB, kanye IIIC.

Umdlavuza wesinye wesigaba IIIA. Umdlavuza utholakala endlaleni yesinye kuphela. Umdlavuza utholakala kohlangothi olulodwa noma kuzo zombili ze-prostate. Izinga le-antigen eliqondene ne-prostate okungenani li-20 kanti iBanga leBanga lingu-1, 2, 3, noma 4.

Esigabeni IIIA, umdlavuza:

  • itholakala kolunye noma zombili izinhlangothi zesibeletho. Izinga le-PSA okungenani li-20 kanti iBanga leBanga lingu-1, 2, 3, noma 4.
Umdlavuza wendlala yesigaba IIIB. Umdlavuza usabalale kusuka endlaleni yesinye kuya ezinhlokweni zesidoda noma ezicutshini noma izitho eziseduze, njenge-rectum, isinye, noma udonga lwe-pelvic. I-antigen eqondene ne-prostate ingaba yinoma yiliphi izinga kanti iBanga leBanga lingu-1, 2, 3, noma 4.

Esigabeni IIIB, umdlavuza:

  • selisabalale lisuka endlaleni yesinye laya ezihlokweni zesidoda noma ezicutshini noma izitho eziseduze, ezinjenge-rectum, isinye, noma udonga lwenqina. I-PSA ingaba yinoma yiliphi izinga futhi iBanga leBanga lingu-1, 2, 3, noma 4.
Umdlavuza wesigaba sesibili IIIC. Umdlavuza utholakala kolunye noma emaceleni womabili wendlala yesinye futhi kungenzeka ukuthi usabalalele kuma-vesicles wesidoda noma ezicutshini noma izitho eziseduze, njenge-rectum, isinye, noma udonga lwe-pelvic. I-antigen eqondene ne-prostate ingaba yinoma yiliphi izinga kanti iBanga leBanga lingu-5.

Esigabeni IIIC, umdlavuza:

  • itholakala kolunye noma emaceleni womabili wendlala yesinye futhi kungenzeka ukuthi isabalalele kuma-vesicles wesilisa noma ezicutshini noma izitho eziseduze, njenge-rectum, isinye, noma udonga lwe-pelvic. I-PSA ingaba yinoma yiliphi izinga kanti iGrade Group ingu-5.

Isigaba IV

Isigaba IV sihlukaniswe ngezigaba ze-IVA ne-IVB.

Umdlavuza wesiteji se-IVA. Umdlavuza utholakala kolunye noma emaceleni womabili wendlala yesinye futhi kungenzeka ukuthi usabalalele kuma-vesicles wesidoda noma ezicutshini noma izitho eziseduze, njenge-rectum, isinye, noma udonga lwe-pelvic. Umdlavuza usabalalele kuma-lymph node aseduze. I-antigen eqondene ne-prostate ingaba yinoma yiliphi izinga kanti iBanga leBanga lingu-1, 2, 3, 4, noma 5.

Esigabeni IVA, umdlavuza:

  • itholakala kolunye noma emaceleni womabili wendlala yesinye futhi kungenzeka ukuthi isabalalele kuma-vesicles wesilisa noma ezicutshini noma izitho eziseduze, njenge-rectum, isinye, noma udonga lwe-pelvic. Umdlavuza usabalalele kuma-lymph node aseduze. I-PSA ingaba yinoma yiliphi izinga futhi iBanga leBanga lingu-1, 2, 3, 4, noma 5.
Umdlavuza wendlala yesigaba IVB. Umdlavuza usabalalele kwezinye izingxenye zomzimba, njengamathambo noma ama-lymph node akude.

Esigabeni IVB, umdlavuza:

  • selisabalele nakwezinye izingxenye zomzimba, njengamathambo noma ama-lymph node akude. Umdlavuza wendlala yesinye uvame ukusakazekela emathanjeni.

Umdlavuza wendlala yesinye ungaphinda ubuye (ubuye) ngemuva kokuba welashwe.

Umdlavuza ungabuya ku-prostate noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

  • Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza wesinye.
  • Izinhlobo eziyisikhombisa zokwelashwa okujwayelekile zisetshenzisiwe:
  • Ukulinda okulindile noma ukubhekwa okusebenzayo
  • Ukuhlinzwa
  • Ukwelashwa ngemisebe nokwelashwa kwe-radiopharmaceutical
  • Ukwelashwa kweHormone
  • Ukwelashwa ngamakhemikhali
  • I-Immunotherapy
  • Ukwelashwa kwe-Bisphosphonate
  • Kunezindlela zokwelashwa kobuhlungu bamathambo obudalwa yimethastase yamathambo noma ukwelashwa kwamahomoni.
  • Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
  • I-Cryosurgery
  • Ukwelashwa kwe-ultrasound okugxile kakhulu
  • Ukwelashwa kwemisebe ye-Proton beam
  • Ukwelashwa kwe-Photodynamic
  • Ukwelashwa komdlavuza wendlala yesinye 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 wesinye.

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

Izinhlobo eziyisikhombisa zokwelashwa okujwayelekile zisetshenzisiwe:

Ukulinda okulindile noma ukubhekwa okusebenzayo

Ukulinda ngokuqapha nokubheka okusebenzayo kuyindlela yokwelashwa esetshenziselwa amadoda amadala angenazo izimpawu noma izimpawu noma anezinye izimo zezokwelapha kanye namadoda anomdlavuza wendlala yesinye otholakala ngesikhathi sokuhlolwa kokuhlolwa.

Ukulinda ngokuqapha kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa kuze kuvele izimpawu noma izimpawu. Ukwelashwa kunikezwa ukunciphisa izimpawu nokuthuthukisa ikhwalithi yempilo.

Ukuqapha okusebenzayo kulandela eduze isimo sesiguli ngaphandle kokunikeza noma yiluphi ukwelashwa ngaphandle kokuthi kube nezinguquko emiphumeleni yokuhlolwa. Isetshenziselwa ukuthola izimpawu zakuqala zokuthi isimo siya ngokuba sibi kakhulu. Ekuqapheni okusebenzayo, iziguli zinikezwa izivivinyo ezithile nokuhlolwa, kufaka phakathi ukuhlolwa kwamakhompiyutha edijithali, ukuhlolwa kwe-PSA, i-transrectal ultrasound, ne-transrectal needle biopsy, ukubheka ukuthi umdlavuza uyakhula yini. Lapho umdlavuza uqala ukukhula, kunikezwa imishanguzo yokwelapha umdlavuza.

Amanye amagama asetshenziselwa ukuchaza ukunganikezi ukwelashwa ukwelashwa umdlavuza wendlala ngemuva kokuxilongwa ukubheka, ukubuka nokulinda, nokuphathwa okulindelekile.

Ukuhlinzwa

Iziguli ezinempilo enhle onesimila esisendlaleni yesinye kuphela zingalashwa ngokuhlinzwa ukuze kususwe isimila. Izinhlobo ezilandelayo zokuhlinzwa ziyasetshenziswa:

  • I-Radical prostatectomy: Inqubo yokuhlinza ukususa i-Prostate, izicubu ezizungezile, nama-vesicles wesilisa. Ukususwa kwama-lymph node aseduze kungenziwa ngasikhathi sinye. Izinhlobo eziyinhloko ze-radical prostatectomy zifaka:
  • I-radical prostatectomy evulekile: Ukusikwa (ukusika) kwenziwa endaweni ye-retropubic (isisu esingezansi) noma i-perineum (indawo ephakathi kwe-anus ne-scrotum). Ukuhlinzwa kwenziwa nge-incision. Kunzima ukuthi udokotela ohlinzayo agweme izinzwa eziseduze ne-prostate noma asuse ama-lymph node aseduze ngendlela ye-perineum.
  • I-radical laparoscopic prostatectomy: Ukuqanjwa okuncane (ukusikeka) kwenziwa odongeni lwesisu. I-laparoscope (insimbi encane, efana nethubhu enelambu nelensi yokubuka) ifakwa ngembobo eyodwa yokuqondisa ukuhlinzwa. Izinsimbi zokuhlinza zifakwa ngokuvuleka okunye ukwenza ukuhlinzwa.
  • I-laparoscopic radical prostatectomy radical: Kusikeka okuncane okuncane odongeni lwesisu, njengase-laparoscopic prostatectomy ejwayelekile. Udokotela ohlinzayo ufaka insimbi enekhamera ngokusebenzisa enye yezindawo ezivulekileyo nezinsimbi zokuhlinza ngokunye ukuvuleka esebenzisa izingalo zerobhothi. Ikhamera inika udokotela ohlinzayo umbono wobuso obuthathu be-prostate nezakhiwo ezizungezile. Udokotela ohlinzayo usebenzisa izingalo ezinjengamarobhothi ukwenza ukuhlinza ngenkathi ehleli kumqapha wekhompyutha eduze kwetafula lokusebenza.
Izinhlobo ezimbili ze-radical prostatectomy. Ku-prostatectomy e-retropubic, i-prostate iyasuswa ngokusikeka odongeni lwesisu. Ku-perineal prostatectomy, i-prostate iyasuswa ngokuqhekeka endaweni phakathi kwesikhwama sendunu kanye nendunu.
  • I-pelvic lymphadenectomy: Inqubo yokuhlinza ukususa ama-lymph node ku-pelvis. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza. Uma ama-lymph node aqukethe umdlavuza, udokotela ngeke asuse indlala futhi angancoma okunye ukwelashwa.
  • I-transurethral resection ye-prostate (TURP): Inqubo yokuhlinza ukususa izicubu ku-prostate usebenzisa i-resectoscope (ithubhu elincane, elikhanyisiwe nethuluzi lokusika) elifakwa nge-urethra. Le nqubo yenziwa ukwelapha i-benign prostatic hypertrophy futhi kwesinye isikhathi kuyenziwa ukukhulula izimpawu ezibangelwa isimila ngaphambi kokuba kunikezwe okunye ukwelashwa komdlavuza. I-TURP nayo ingenziwa emadodeni anesisu esiku-prostate kuphela futhi angenakuba ne-radical prostatectomy.
Ukudluliswa kabusha kwe-prostatethral kwe-prostate (TURP). Izicubu ziyasuswa endlaleni yesinye kusetshenziswa i-resectoscope (ithubhu elincane, elikhanyisiwe nethuluzi lokusika ekugcineni) elifakwa ngomchamo. Izicubu zeprostate ezivimba i-urethra ziyasikwa zisuswe nge-resectoscope.

Kwezinye izimo, izinzwa ezilawula ukwakheka kwe-penile zingagcinwa ngokuhlinzwa okuvikela izinzwa. Kodwa-ke, lokhu kungenzeka kungenzeki emadodeni anezimila ezinkulu noma izicubu ezisondelene kakhulu nezinzwa.

Izinkinga ezingaba khona ngemuva kokuhlinzwa komdlavuza wesinye zifaka okulandelayo:

  • Ukungabi namandla.
  • Ukuvuza komchamo esinyeni noma esihlalweni kusuka kunxande.
  • Ukunciphisa ipipi (amasentimitha ayi-1 kuye kwayi-2). Isizathu esiqondile salokhu asaziwa.
  • Ingwengwe ye-hernia (ukuqubuka kwamafutha noma ingxenye yamathumbu amancane ngemisipha ebuthakathaka iye emgodini). I-hernia ye-Inguinal ingenzeka kaningi emadodeni aphethwe i-radical prostatectomy kunamadoda anezinye izinhlobo zokuhlinzwa kwe-prostate, i-radiation therapy, noma i-prostate biopsy kuphela. Kungenzeka kakhulu ukuthi kwenzeke eminyakeni emibili yokuqala ngemuva kwe-prostatectomy enamandla.

Ukwelashwa ngemisebe nokwelashwa kwe-radiopharmaceutical

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

  • Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke endaweni yomzimba enomdlavuza. Imisebe ye-Conformal wuhlobo lokwelashwa kwemisebe yangaphandle olusebenzisa ikhompyutha ukwenza isithombe esima-3-dimensional (3-D) sesimila futhi silolonge imishayo yemisebe ukuze ivumelane nesimila. Lokhu kuvumela umthamo omkhulu wemisebe ukuthi ufinyelele isimila futhi kubangele ukulimala okuncane ezicutshini eziseduze ezinempilo.

Ukwelashwa ngemisebe ye-Hypofractionated kunganikezwa ngoba kunohlelo lokwelashwa olulula kakhulu. Ukwelashwa kwemisebe ye-Hypofractionated ukwelashwa ngemisebe lapho kunikezwa umthamo omkhulu wemisebe ophakeme kunokujwayelekile kunikezwa kanye ngosuku isikhathi esifushane (izinsuku ezimbalwa) uma kuqhathaniswa nokwelashwa okujwayelekile kwemisebe. Ukwelashwa kwemisebe ye-Hypofractionated kungaba nemiphumela emibi kakhulu kunokwelashwa okujwayelekile kwemisebe, kuya ngamashejuli asetshenzisiwe.

  • Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza. Emdlavuzeni wesigaba sokuqala, imbewu efakwa ngemisebe ifakwa endlaleni yesinye kusetshenziswa izinaliti ezifakwa esikhunjeni phakathi kwesikhwehlela kanye nengxenyeni. Ukubekwa kwembewu enemisebe e-prostate kuqondiswa izithombe ezivela ku-transrectal ultrasound noma i-computed tomography (CT). Izinaliti ziyasuswa ngemuva kokufakwa kwembewu enemisebe ku-prostate.
  • Ukwelashwa kwe-Radiopharmaceutical isebenzisa into enemisebe yokwelapha umdlavuza. Ukwelashwa kwe-Radiopharmaceutical kuhlanganisa okulandelayo:
  • Ukwelashwa kwemisebe ye-Alpha emitter isebenzisa into enemisebe yokwelapha umdlavuza wendlala yabesilisa esesabalalise amathambo. Into efakwa ngemisebe ebizwa ngokuthi i-radium-223 ijojowe emthanjeni futhi ihambe egazini. I-radium-223 iqoqa ezindaweni ezinethambo elinomdlavuza bese ibulala amangqamuzana omdlavuza.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuya ngohlobo nesigaba somdlavuza owelashwa. Ukwelashwa kwemisebe yangaphandle, ukwelashwa ngemisebe kwangaphakathi, kanye ne-radiopharmaceutical therapy kusetshenziselwa ukwelapha umdlavuza wendlala yabesilisa.

Abesilisa abaphathwa ngemithi yokwelashwa ngemisebe yomdlavuza wendlala yabesilisa banengozi eyengeziwe yokuba nomdlavuza wesinye kanye / noma umdlavuza wamathumbu.

Ukwelashwa ngemisebe kungadala ukungabi namandla nezinkinga zomchamo ezingase zibe zimbi ngokukhula.

Ukwelashwa kweHormone

Ukwelashwa kweHormone ukwelashwa komdlavuza okususa ama-hormone noma kuvimbe isenzo sabo futhi kumise amangqamuzana omdlavuza ukuthi angakhuli. AmaHormone yizinto ezenziwe yizindlala emzimbeni futhi zisatshalaliswa egazini. Emdlavuzeni wendlala yesinye, amahomoni ocansi abesilisa angadala ukuthi umdlavuza wendlala yabesilisa ukhule. Izidakamizwa, ukuhlinzwa, noma amanye ama-hormone asetshenziselwa ukunciphisa inani lamahomoni wesilisa noma ukuwavimba ekusebenzeni. Lokhu kubizwa ngokuthi ukwelashwa kokuncishwa kwe-androgen (ADT).

Ukwelashwa kweHormone komdlavuza wendlala yesinye kungafaka okulandelayo:

  • I-Abiraterone acetate ingavimbela amangqamuzana omdlavuza wesibeletho ekwenzeni ama-androgens. Isetshenziswa emadodeni anomdlavuza we-prostate othuthukile ongakatholi ngcono ngolunye ukwelashwa kwamahomoni.
  • I-Orchiectomy inqubo yokuhlinza ukususa elilodwa noma womabili amasende, umthombo oyinhloko wamahomoni wesilisa, njenge-testosterone, ukunciphisa inani lamahomoni enziwa.
  • Ama-Estrogens (ama-hormone akhuthaza izici zobulili besifazane) angavimbela amasende ekwenzeni i-testosterone. Kodwa-ke, ama-estrogens awavamile ukusetshenziswa namuhla ekwelapheni umdlavuza wendlala yabesilisa ngenxa yengozi yemiphumela emibi kakhulu.
  • Ama-agonists akhipha ama-hormone akhulula ama-hormone angamisa amasende ekwenzeni i-testosterone. Izibonelo yi-leuprolide, i-goserelin, ne-buserelin.
  • Ama-antiandrogens angavimba isenzo se-androgens (ama-hormone akhuthaza izici zobulili besilisa), njenge-testosterone. Izibonelo i-flutamide, i-bicalutamide, i-enzalutamide, i-apalutamide, ne-nilutamide.
  • Izidakamizwa ezingavimbela izindlala ze-adrenal ekwenzeni i-androgens zifaka phakathi i-ketoconazole, aminoglutethimide, i-hydrocortisone, ne-progesterone.

Ukushiswa okushisayo, ukungasebenzi kahle kocansi, ukulahlekelwa isifiso sobulili, namathambo abuthakathaka kungenzeka emadodeni aphathwe ukwelashwa ngamahomoni. Eminye imiphumela emibi ifaka phakathi isifo sohudo, isicanucanu, nokulunywa.

Bheka Izidakamizwa ezivunyelwe i-Prostate Cancer ukuthola eminye imininingwane.

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).

Bheka Izidakamizwa ezivunyelwe i-Prostate Cancer ukuthola eminye imininingwane.

I-Immunotherapy

I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Izinto ezenziwe ngumzimba noma ezenziwe elabhoratri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba kumdlavuza. Lokhu kwelashwa komdlavuza uhlobo lwezokwelapha ze-biologic. I-Sipuleucel-T wuhlobo lwe-immunotherapy esetshenziselwa ukwelapha umdlavuza wendlala yabesilisa osusele (osakazeka kwezinye izingxenye zomzimba).

Bheka Izidakamizwa ezivunyelwe i-Prostate Cancer ukuthola eminye imininingwane.

Ukwelashwa kwe-Bisphosphonate

Izidakamizwa ze-bisphosphonate, njenge-clodronate noma i-zoledronate, zinciphisa isifo samathambo lapho umdlavuza ususakazekele ethanjeni. Abesilisa abelashwa ngemithi ye-antiandrogen noma i-orchiectomy basengozini enkulu yokulahleka kwamathambo. Kula madoda, izidakamizwa ze-bisphosphonate zinciphisa ingozi yokuphuka kwamathambo (amakhefu). Ukusetshenziswa kwezidakamizwa ze-bisphosphonate ukuvimbela noma ukubambezela ukukhula kwamathambo emethastase kufundwa ekuhlolweni kwemitholampilo.

Kunezindlela zokwelashwa kobuhlungu bamathambo obudalwa yimethastase yamathambo noma ukwelashwa kwamahomoni.

Umdlavuza wendlala yesifo sowesilisa osabalalele ethanjeni nasezinhlotsheni ezithile zokwelashwa kwamahomoni kungenza amathambo abe buthakathaka futhi kuholele ebuhlungwini bamathambo. Ukwelashwa kobuhlungu bamathambo kufaka lokhu okulandelayo:

  • Umuthi wezinhlungu.
  • Ukwelashwa kwemisebe yangaphandle.
  • IStrontium-89 (iradioisotope).
  • Ukwelashwa okuqondisiwe nge-anti-monoclonal antibody, njenge-denosumab.
  • Ukwelashwa kwe-Bisphosphonate.
  • Ama-Corticosteroids.

Bona isifinyezo se- ku-Pain 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.

I-Cryosurgery

I-Cryosurgery yindlela yokwelapha esebenzisa ithuluzi lokuqandisa nokubhubhisa amangqamuzana omdlavuza wendlala yesinye. I-Ultrasound isetshenziselwa ukuthola indawo ezokwelashwa. Lolu hlobo lwezokwelapha lubizwa nangokuthi i-cryotherapy.

I-cryosurgery ingadala ukungabi namandla nokuvuza komchamo esinyeni noma esitulweni esivela engxenyeni.

Ukwelashwa kwe-ultrasound okugxile kakhulu

Ukwelashwa kwe-ultrasound enamandla amakhulu okugxila kuyindlela yokwelashwa esebenzisa i-ultrasound (amaza omsindo anamandla amakhulu) ukubhubhisa amangqamuzana omdlavuza. Ukwelapha umdlavuza wendlala yesinye, kusetshenziswa i-endorectal probe ukwenza amaza omsindo.

Ukwelashwa kwemisebe ye-Proton beam

Ukwelashwa kwemisebe ye-Proton beam uhlobo lwamandla amakhulu, ukwelashwa kwemisebe yangaphandle okuhlose izicubu ngemifudlana yama-proton (izinhlayiya ezincane, ezikhokhiswa kahle). Lolu hlobo lokwelashwa ngemisebe lufundwa ekwelapheni umdlavuza wendlala yabesilisa.

Ukwelashwa kwe-Photodynamic

Ukwelashwa komdlavuza osebenzisa umuthi nohlobo oluthile lwe-laser light ukubulala amangqamuzana omdlavuza. Umuthi ongasebenzi kuze kube yilapho uvezwa ukukhanya ufakwa emthanjeni. Umuthi uqoqa okuningi kumaseli womdlavuza kunamaseli ajwayelekile. Amashubhu e-fiberoptic asetshenziselwa ukuthwala ukukhanya kwe-laser kumaseli womdlavuza, lapho umuthi usebenza khona bese ubulala amaseli. Ukwelashwa kwe-Photodynamic kubangela ukulimala okuncane kwezicubu ezinempilo. Isetshenziswa kakhulu ekwelapheni izicubu noma ngaphansi kwesikhumba noma kulayini wezitho zangaphakathi.

Ukwelashwa komdlavuza wendlala yesinye 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 Kwe-Stage I-Prostate Cancer

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

Ukwelashwa okujwayelekile komdlavuza wendlala yesinye kungafaka okulandelayo:

  • Ukulinda okulindile.
  • Ukuqapha okusebenzayo. Uma umdlavuza uqala ukukhula, kunganikezwa ukwelashwa ngamahomoni.
  • I-radical prostatectomy, imvamisa ine-lymphadenectomy yokhalo. Ukwelashwa ngemisebe kunganikezwa ngemuva kokuhlinzwa.
  • Ukwelashwa kwemisebe yangaphandle. Ukwelashwa kweHormone kunganikezwa ngemuva kokwelapha ngemisebe.
  • Ukwelashwa kwemisebe yangaphakathi nembewu enemisebe.
  • Isivivinyo somtholampilo sokwelashwa okuphezulu okugxile kakhulu ku-ultrasound.
  • Isivivinyo somtholampilo sokwelashwa kwe-photodynamic.
  • Isivivinyo somtholampilo se-cryosurgery.

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 kweSigaba II Somdlavuza We-Prostate

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

Ukwelashwa okujwayelekile komdlavuza wesigaba sesithathu wendlala kungafaka okulandelayo:

  • Ukulinda okulindile.
  • Ukuqapha okusebenzayo. Uma umdlavuza uqala ukukhula, kunganikezwa ukwelashwa ngamahomoni.
  • I-radical prostatectomy, imvamisa ine-lymphadenectomy yokhalo. Ukwelashwa ngemisebe kunganikezwa ngemuva kokuhlinzwa.
  • Ukwelashwa kwemisebe yangaphandle. Ukwelashwa kweHormone kunganikezwa ngemuva kokwelapha ngemisebe.
  • Ukwelashwa kwemisebe yangaphakathi nembewu enemisebe.
  • Isivivinyo somtholampilo se-cryosurgery.
  • Isivivinyo somtholampilo sokwelashwa okuphezulu okugxile kakhulu ku-ultrasound.
  • Isivivinyo somtholampilo sokwelashwa ngemisebe yeproton.
  • Isivivinyo somtholampilo sokwelashwa kwe-photodynamic.
  • Ukuhlolwa komtholampilo kwezinhlobo ezintsha zokwelashwa, njengokwelashwa kwamahomoni okulandelwa yi-radical prostatectomy.

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-Prostate weSigaba III

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

Ukwelashwa okujwayelekile komdlavuza we-prostate wesigaba III kungafaka okulandelayo:

  • Ukwelashwa kwemisebe yangaphandle. Ukwelashwa kweHormone kunganikezwa ngemuva kokwelapha ngemisebe.
  • Ukwelashwa kweHormone. Ukwelashwa ngemisebe kunganikezwa ngemuva kokwelapha i-hormone.
  • I-radical prostatectomy. Ukwelashwa ngemisebe kunganikezwa ngemuva kokuhlinzwa.
  • Ukulinda okulindile.
  • Ukuqapha okusebenzayo. Uma umdlavuza uqala ukukhula, kunganikezwa ukwelashwa ngamahomoni.

Ukwelashwa ukulawula umdlavuza ose-prostate nokunciphisa izimpawu zomchamo kungafaka okulandelayo:

  • Ukwelashwa kwemisebe yangaphandle.
  • Ukwelashwa kwemisebe yangaphakathi nembewu enemisebe.
  • Ukwelashwa kweHormone.
  • Ukudluliswa kabusha kwe-prostatethral kwe-prostate (TURP).
  • Isivivinyo somtholampilo sezinhlobo ezintsha zokwelashwa ngemisebe.
  • Isivivinyo somtholampilo se-cryosurgery.

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 Wesifo Sendlala Yesigaba IV

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

Ukwelashwa okujwayelekile komdlavuza we-prostate wesigaba IV kungafaka okulandelayo:

  • Ukwelashwa kweHormone.
  • Ukwelashwa kweHormone kuhlangene nokwelashwa ngamakhemikhali.
  • Ukwelashwa kwe-Bisphosphonate.
  • Ukwelashwa kwemisebe yangaphandle. Ukwelashwa kweHormone kunganikezwa ngemuva kokwelapha ngemisebe.
  • Ukwelashwa kwemisebe ye-Alpha emitter.
  • Ukulinda okulindile.
  • Ukuqapha okusebenzayo. Uma umdlavuza uqala ukukhula, kunganikezwa ukwelashwa ngamahomoni.
  • Isivivinyo somtholampilo se-radate prostatectomy nge-orchiectomy.

Ukwelashwa ukulawula umdlavuza ose-prostate nokunciphisa izimpawu zomchamo kungafaka okulandelayo:

  • Ukudluliswa kabusha kwe-prostatethral kwe-prostate (TURP).
  • Ukwelashwa ngemisebe.

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-Prostate Wokuphindaphinda noma We-Hormone

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

Ukwelashwa okujwayelekile komdlavuza we-prostate ophindaphindiwe noma ongazweli kuma-hormone kungafaka okulandelayo:

  • Ukwelashwa kweHormone.
  • I-Chemotherapy yeziguli esevele ziphathwe ngokwelashwa kwe-hormone.
  • Ukwelashwa nge-Biologic nge-sipuleucel-T yeziguli esevele ziphathwe ngemithi yokwelapha i-hormone.
  • Ukwelashwa kwemisebe yangaphandle.
  • I-Prostatectomy yeziguli esevele ziphathwe ngemithi yokwelashwa ngemisebe.
  • Ukwelashwa kwemisebe ye-Alpha emitter.

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 weProstate

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana nomdlavuza wendlala yabesilisa, bheka okulandelayo:

  • Ikhasi lasekhaya lomdlavuza wesibeletho
  • I-Prostate Cancer, Ukudla okunomsoco, kanye Nezithako Zokudla
  • Ukuvimbela umdlavuza wesibeletho
  • Ukuhlolwa Komdlavuza Wendlala Yesinye
  • Izidakamizwa zivunyelwe umdlavuza we-Prostate
  • Ukuhlolwa kwe-Prostate-Specific Antigen (PSA)
  • Ukwelashwa Kwehormone Komdlavuza We-Prostate
  • Izinketho Zokwelashwa Kwamadoda Anomdlavuza WaseProstate Wasekuqaleni Kwesiteji
  • I-Cryosurgery ekwelashweni komdlavuza

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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