Izinhlobo / amasende / isiguli / amasende-ukwelashwa-pdq

Uhlobo Lokulashwa Komdlavuza Wobufakazi

Imininingwane Jikelele Ngomdlavuza Wamasende

AMAPHUZU ASEMQOKA

• Umdlavuza wamasende yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zesende elilodwa noma womabili.

• Umlando wezempilo ungathinta ingozi yomdlavuza wamasende.

• Izimpawu nezimpawu zomdlavuza wamasende zifaka ukuvuvukala noma ukungaphatheki kahle esikhwameni.

• Ukuhlolwa okuhlola amasende negazi kusetshenziselwa ukuthola (ukuthola) nokuthola umdlavuza wamasende.

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

• Ukwelashwa komdlavuza wamasende kungadala ukungabi nenzalo.

Umdlavuza wamasende yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zesende elilodwa noma womabili.

Amasende yizindlala ezi-2 ezimise okweqanda ezitholakala ngaphakathi kwesikhotha (isaka lesikhumba elixegayo elilele ngaphansi ngqo kwepipi). Amasende agcinwa ngaphakathi kwesikhotha ngentambo yesidoda, equkethe nama-vas deferens nemithambo nezinzwa zamasende.

I-anatomy yezinhlelo zesilisa zokuzala nezokuchama, ekhombisa amasende, indlala yesinye, isinye nezinye izitho.

Amasende yizindlala zocansi zesilisa futhi akhiqiza i-testosterone nesidoda. Amaseli wegciwane ngaphakathi kwamasende akhiqiza isidoda esingavuthiwe esihamba ngenethiwekhi yamatubules (amashubhu amancane) namashubhu amakhulu aye ku-epididymis (ithubhu elide elihlanganisiwe eduze kwamasende) lapho isidoda sikhula khona sigcinwe.

Cishe yonke imidlavuza yamasende iqala kumaseli wegciwane. Izinhlobo ezimbili eziyinhloko zamathumba ezinhlayiya zamasende angama-testin angama-seminomas nama-nonseminomas. Lezi zinhlobo ezi-2 zikhula futhi zisakazeka ngokuhlukile futhi ziphathwa ngendlela ehlukile. Ama-nonseminomas ajwayele ukukhula nokusabalala ngokushesha okukhulu kunama-seminomas. Ama-Seminomas azwela kakhulu emisebeni. Isigaxa samasende esiqukethe womabili amaseminoma namaseli we-nonseminoma siphathwa njenge-nonseminoma.

Umdlavuza wamasende wumdlavuza ovame kakhulu emadodeni aneminyaka engama-20 kuya kwengama-35 ubudala.

Umlando wezempilo ungathinta ingozi yomdlavuza wamasende.

Noma yini enyusa amathuba 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. Izici zobungozi zomdlavuza wamasende zifaka:

• Njengoba ngibe nesende elingalindelwanga.

• Ukuba nokukhula okungajwayelekile kwamasende.

• Ukuba nomlando womuntu siqu womdlavuza wamasende.

• Ukuba nomlando womndeni wesifo somdlavuza wamasende (ikakhulukazi kubaba noma kumfowenu).

• Ukuba mhlophe.

Izimpawu nezimpawu zomdlavuza wamasende zifaka ukuvuvukala noma ukungaphatheki kahle esikhwameni.

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

• Isigaxa esingenabuhlungu noma ukuvuvukala kusende ngalinye.

• Ushintsho ekutheni isende lizizwa kanjani.

• Ukuqaqamba esiswini esingezansi noma emgodini.

• Ukwakhiwa okungazelelwe koketshezi esikhwameni.

• Ubuhlungu noma ukungaphatheki kahle esendeni noma esikhwameni.

Ukuhlolwa okuhlola amasende negazi kusetshenziselwa ukuthola (ukuthola) nokuthola umdlavuza wamasende.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Amasende azohlolwa ukubheka izigaxa, ukuvuvukala, noma ubuhlungu. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.

• Ukuhlolwa kwe-Ultrasound kwamasende: Inqubo lapho amagagasi omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram.

• Isivivinyo se-serum tumor marker: Inqubo lapho kuhlolwa khona isampula yegazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho, izicubu, noma amaseli wesimila emzimbeni. Izinto ezithile zixhunyaniswe nezinhlobo ezithile zomdlavuza lapho zitholakala emazingeni akhuphukile egazini. Lokhu kubizwa ngokuthi yizimpawu zesimila. Omaka abalandelayo be-tumor basetshenziselwa ukuthola umdlavuza wamasende:

• I-Alpha-fetoprotein (AFP).

• I-Beta-human chorionic gonadotropin (β-hCG).

Amazinga omaki we-tumor alinganiswa ngaphambi kwe-inguinal orchiectomy ne-biopsy, ukusiza ukuthola umdlavuza wamasende.

• I-orchiectomy ye-Inguinal: Inqubo yokususa lonke amasende ngokuqhekeka emgodini. Isampula lezicubu ezivela esendeni libe selibhekwa ngaphansi kwesibonakhulu ukuhlola amaseli omdlavuza. (Udokotela ohlinzayo akasikezi esikhaleni samasende angene esendeni ukuze asuse isampula lezicubu ze-biopsy, ngoba uma umdlavuza ukhona, le nqubo ingadala ukuthi usabalalele emgodleni nakuma-lymph node. Kubalulekile ukukhetha udokotela ohlinzayo onolwazi ngalolu hlobo lokuhlinzwa.) Uma umdlavuza utholakala, uhlobo lweseli (seminoma noma i-nonseminoma) luyanqunywa ukuze lusize ukuhlela ukwelashwa.

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

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Isigaba somdlavuza (noma ngabe usesendeni noma eduze kwawo noma ususabalalele kwezinye izindawo emzimbeni, namazinga egazi e-AFP, β-hCG, ne-LDH).

• Uhlobo lomdlavuza.

• Usayizi wesimila.

• Inombolo nosayizi wama-lymph node we-retroperitoneal.

Umdlavuza wamasende ungalapheka ezigulini ezithola i-adjuvant chemotherapy noma i-radiation therapy ngemuva kokwelapha kwazo okuyinhloko.

Ukwelashwa komdlavuza wamasende kungadala ukungabi nenzalo.

Ukwelashwa okuthile komdlavuza wamasende kungadala ukungabi nenzalo okungaba unomphela. Iziguli ezingafisa ukuba nezingane kufanele zicabangele ukubekisa isidoda ngaphambi kokwelapha. I-Sperm banking inqubo yokuqandisa isidoda nokuyigcina ukuze isetshenziswe kamuva.

Izigaba Zomdlavuza Wamasende

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala komdlavuza wamasende, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asabalale ngaphakathi kwamasende noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• I-orchiectomy ye-inguinal yenziwa ukuze kwaziwe isigaba sesifo.

• Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza wamasende:

• Isigaba 0

• Isiteji I

• Isigaba II

• Isigaba III

Ngemuva kokutholakala komdlavuza wamasende, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asabalale ngaphakathi kwamasende noma kwezinye izingxenye zomzimba.

Inqubo esetshenziswayo ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwamasende noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

• I-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-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, njengesisu, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, ezifana nesisu. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• I-lymph node disdominal dissection: Inqubo yokuhlinza lapho kukhishwa khona ama-lymph node esiswini bese kuhlolwe isampula lezicubu ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza. Le nqubo ibizwa nangokuthi i-lymphadenectomy. Ezigulini ezine-nonseminoma, ukususa ama-lymph node kungasiza ekunqandeni ukusabalala kwezifo. Amaseli womdlavuza kuma-lymph node weziguli ze-seminoma angalashwa nge-radiation therapy.

• Isivivinyo se-serum tumor marker: Inqubo lapho kuhlolwa khona isampula yegazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho, izicubu, noma amaseli wesimila emzimbeni. Izinto ezithile zixhunyaniswe nezinhlobo ezithile zomdlavuza lapho zitholakala emazingeni akhuphukile egazini. Lokhu kubizwa ngokuthi yizimpawu zesimila. Omaka abathathu abalandelayo be-tumor basetshenziselwa ukufaka umdlavuza wamasende wokulinganisa:

• I-Alpha-fetoprotein (AFP)

• I-Beta-human chorionic gonadotropin (β-hCG).

• I-Lactate dehydrogenase (LDH).

Amanothi wokumaka aphinda alinganiswe futhi, ngemuva kwe-inguinal orchiectomy kanye ne-biopsy, ukuze kunqunywe isigaba somdlavuza. Lokhu kusiza ukukhombisa ukuthi ngabe wonke umdlavuza ususiwe yini noma uma kudingeka ukwelashwa okwengeziwe. Amazinga wokumaka kwe-tumor nawo alinganiswa ngesikhathi sokulandelwa njengendlela yokubheka ukuthi umdlavuza ubuyile yini.

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 wamasende usakazeka uye emaphashini, amangqamuzana omdlavuza amaphaphu empeleni angamaseli omdlavuza wamasende. Lesi sifo umdlavuza wamasende we-metastatic, hhayi umdlavuza wamaphaphu.

I-orchiectomy ye-inguinal yenziwa ukuze kwaziwe isigaba sesifo.

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza wamasende:

Isigaba 0

Esigabeni 0, kutholakala amaseli angajwayelekile kuma-tubules amancane lapho amaseli wesilisa eqala ukukhula khona. Lawa maseli angajwayelekile angaba ngumdlavuza futhi asabalale abe izicubu ezijwayelekile eziseduze. Wonke amazinga omaka we-tumor ajwayelekile. Isigaba 0 sibizwa nangokuthi yi-germ cell neoplasia in situ.

Isiteji I

Esigabeni I, umdlavuza wakhekile. Isigaba I sihlukaniswe izigaba IA, IB, ne-IS.

• Esigabeni IA, umdlavuza utholakala esendeni, kufaka phakathi i-rete testis, kepha awusakazekanga emithanjeni yegazi noma emithanjeni ye-lymph esendeni.

Wonke amazinga omaka we-tumor ajwayelekile.

• Esigabeni IB, umdlavuza:

• itholakala esendeni, kufaka phakathi i-rete testis, futhi isakaze emithanjeni yegazi noma emithanjeni ye-lymph esendeni; noma

• selisabalalele ezicutshini ezithambile ze-hilar (izicubu ezenziwe ngemicu kanye namafutha anemithambo yegazi nemithambo yegazi), i-epididymis, noma ulwelwesi lwangaphandle oluzungeze isende; noma

• isakaze entanjeni yesidoda; noma

• isabalale yafika esikhwameni.

Wonke amazinga omaka we-tumor ajwayelekile.

• Esigabeni IS, umdlavuza utholakala noma kuphi esendeni futhi kungenzeka ukuthi usabalalele entanjeni yesidoda noma esikhaleni.

Amazinga wokumaka we-tumor asukela kokuncane ngaphezulu kokujwayelekile kuya phezulu.

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 II

Isigaba II sihlukaniswe ngezigaba IIA, IIB, kanye ne-IIC.

• Esigabeni IIA, umdlavuza utholakala noma kuphi kusende futhi kungenzeka ukuthi usabalalele entanjeni yesidoda noma esikhaleni. Umdlavuza usabalalele ku-1 kuya ku-5 ama-lymph node aseduze futhi ama-lymph node angamasentimitha ama-2 noma amancane.

Wonke amazinga omaka we-tumor ajwayelekile noma athe chithi xha kancani kunokujwayelekile.

• Esigabeni IIB, umdlavuza utholakala noma kuphi kusende futhi kungenzeka ukuthi usabalalele entanjeni yesidoda noma esikhaleni. Umdlavuza usabalalele ku:

• 1 i-lymph node eseduze ne-lymph node inkulu kunamasentimitha ama-2 kepha ayinkulu kunamasentimitha ama-5; noma

• ngaphezu kwama-lymph node aseduze nama-lymph node awekho ngaphezu kwamasentimitha ama-5; noma

• i-lymph node eseduze nomdlavuza usabalale ngaphandle kwe-lymph node.

Wonke amazinga omaka we-tumor ajwayelekile noma athe chithi xha kancani kunokujwayelekile.

• Esigabeni IIC, umdlavuza utholakala noma kuphi esendeni futhi kungenzeka ukuthi usabalalele entanjeni yesidoda noma esikhaleni. Umdlavuza usabalalele ku-lymph node eseduze futhi i-lymph node inkulu kunamasentimitha ama-5.

Wonke amazinga omaka we-tumor ajwayelekile noma athe chithi xha kancani kunokujwayelekile.

Isigaba III

Isigaba III sihlukaniswe izigaba IIIA, IIIB, kanye IIIC.

• Esigabeni IIIA, umdlavuza utholakala noma ikuphi kusende futhi kungenzeka ukuthi usabalalele entanjeni yesidoda noma esikhaleni. Umdlavuza kungenzeka usabalalele kolunye noma ngaphezulu ama-lymph node. Umdlavuza usabalalele kuma-lymph node akude noma emaphashini.

Wonke amazinga omaka we-tumor ajwayelekile noma athe chithi xha kancani kunokujwayelekile.

• Esigabeni IIIB, umdlavuza utholakala noma kuphi kusende futhi kungenzeka ukuthi usabalalele entanjeni yesidoda noma esikhaleni. Umdlavuza usabalale:

• ku-lymph node eyodwa noma ngaphezulu eseduze futhi ayizange isakaze kwezinye izingxenye zomzimba; noma

• kuma-lymph node eyodwa noma amaningi aseduze. Umdlavuza usabalalele kuma-lymph node akude noma emaphashini.

Izinga lesimaki esisodwa noma eziningi ze-tumor ngokulinganisela ngaphezu kokujwayelekile.

• Esigabeni IIIC, umdlavuza utholakala noma kuphi kusende futhi kungenzeka ukuthi usabalalele entanjeni yesidoda noma esikhaleni. Umdlavuza usabalale:

• ku-lymph node eyodwa noma ngaphezulu eseduze futhi ayizange isakaze kwezinye izingxenye zomzimba; noma

• kuma-lymph node eyodwa noma amaningi aseduze. Umdlavuza usabalalele kuma-lymph node akude noma emaphashini.

Izinga lesimaki esisodwa noma eziningi ze-tumor liphezulu.

noma

Umdlavuza utholakala noma kuphi esendeni futhi kungenzeka ukuthi usabalalele entanjeni yesidoda noma esikhaleni. Umdlavuza awusabalalisanga kuma-lymph node noma amaphaphu akude, kepha usabalalele nakwezinye izingxenye zomzimba, njengesibindi noma ithambo.

Amazinga wokumaka we-tumor angahluka kusuka kokujwayelekile kuya phezulu.

Umdlavuza Wamasende Ovamile

Umdlavuza ophindaphindiwe wamasende wumdlavuza ophindeke (wabuya) ngemuva kokuba welashwe. Umdlavuza ungabuya eminyakeni eminingi ngemuva komdlavuza wokuqala, kwesinye isende noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza wamasende.

• Izicubu zamasende zihlukaniswe ngamaqembu ama-3, kuya ngokuthi izimila kulindeleke ukuthi ziphendule kahle kangakanani ekwelashweni.

• Isibikezelo Esihle

• Isibikezelo Esiphakathi

• Isibikezelo Esibi

• Izinhlobo ezinhlanu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Ukuqapha

• I-chemotherapy ephezulu ene-stem cell transplant

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa komdlavuza wamasende kungadala imiphumela emibi.

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

• Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza wamasende.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza wamasende. 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.

Izicubu zamasende zihlukaniswe ngamaqembu ama-3, kuya ngokuthi izimila kulindeleke ukuthi ziphendule kahle kangakanani ekwelashweni.

Isibikezelo Esihle

Ku-nonseminoma, konke lokhu okulandelayo kufanele kube yiqiniso:

• Isimila sitholakala kuphela esendeni noma ku-retroperitoneum (indawo engaphandle noma ngemuva kodonga lwesisu); futhi

• Isimila asisabalalanga ezithweni ngaphandle kwamaphaphu; futhi

• Amazinga azo zonke izimpawu zesimila angaphezulu kokujwayelekile.

Okwe-seminoma, konke lokhu okulandelayo kufanele kube yiqiniso:

• Isimila asisabalalanga ezithweni ngaphandle kwamaphaphu; futhi

• Izinga le-alpha-fetoprotein (AFP) livamile. I-Beta-human chorionic gonadotropin (β-hCG) ne-lactate dehydrogenase (LDH) ingaba kunoma yiliphi izinga.

• Isibikezelo Esiphakathi

Ku-nonseminoma, konke lokhu okulandelayo kufanele kube yiqiniso:

• Isimila sitholakala esendeni elilodwa kuphela noma ku-retroperitoneum (indawo engaphandle noma ngemuva kodonga lwesisu); futhi

• Isimila asisabalalanga ezithweni ngaphandle kwamaphaphu; futhi

• Izinga lanoma yisiphi esinye sezimpawu zesimila lingaphezu kancane kokujwayelekile.

Okwe-seminoma, konke lokhu okulandelayo kufanele kube yiqiniso:

• Isimila sesinabele ezithweni ezingewona amaphaphu; futhi

• Izinga le-AFP livamile. I-β-hCG ne-LDH kungaba kunoma yiliphi izinga.

Isibikezelo Esibi

Ku-nonseminoma, okungenani okukodwa kokulandelayo kufanele kube yiqiniso:

• Isimila sisenkabeni yesifuba phakathi kwamaphaphu; noma

• Isimila sesinabele ezithweni ezingewona amaphaphu; noma

• Izinga lanoma yimuphi umaka wesimila liphakeme.

Akukho ukuqoqwa kwesifo esibi kwamathumba wamasende e-seminoma.

Izinhlobo ezinhlanu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa ukususa i-testicle (i-inguinal orchiectomy) kanye namanye ama-lymph node kungenziwa ekuxilongweni nasekusitebhisini. (Bheka izigaba zalesi Sifinyezo Sokwaziswa Okuvamile Nezigaba.) Izicubu ezisabalalele kwezinye izindawo emzimbeni zingasuswa ngokwengxenye noma ngokuphelele ngokuhlinzwa.

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

Ukwelashwa ngemisebe

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

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni.

• Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuya ngohlobo nesigaba somdlavuza owelashwa. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha umdlavuza wamasende.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuvimba amaseli ukuthi angahlukani. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda). Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Bheka Izidakamizwa Ezamukelwe Umdlavuza Wamasende ukuthola eminye imininingwane.

Ukuqapha

Ukuqapha kulandela eduze isimo sesiguli ngaphandle kokunikeza noma yiluphi ukwelashwa ngaphandle kokuthi kube nezinguquko emiphumeleni yokuhlolwa. Isetshenziselwa ukuthola izimpawu zokuqala ukuthi umdlavuza ubuyile (buyela emuva). Ekugadweni, iziguli zinikezwa izivivinyo ezithile kanye nokuhlolwa esimisweni esijwayelekile.

I-chemotherapy ephezulu ene-stem cell transplant

Imithamo ephezulu yokwelashwa ngamakhemikhali inikezwa ukubulala amangqamuzana omdlavuza. Amaseli aphilile, kufaka phakathi amaseli akha igazi, nawo abhujiswa ukwelashwa komdlavuza. Ukufakelwa kwe-stem cell ukwelashwa ukufaka amaseli akha igazi. Ama-stem cells (amangqamuzana egazi angavuthiwe) ayasuswa egazini noma emnkantsheni wethambo wesiguli noma womnikeli futhi afriziwe futhi agcinwe. Ngemuva kokuthi isiguli siqede i-chemotherapy, amangqamuzana eziqu agciniwe ancibilika abuyiselwa esigulini ngokumnika. Lawa maseli wesiqu abuyisiwe akhula abe (futhi abuyisele) amangqamuzana egazi omzimba.

Bheka Izidakamizwa Ezamukelwe Umdlavuza Wamasende ukuthola eminye imininingwane.

Ukufakelwa kwe-stem cell. (Isinyathelo 1): Igazi lithathwa emthanjeni osengalweni yomnikeli. Isiguli noma omunye umuntu kungaba umnikeli. Igazi ligeleza ngomshini osusa ama-stem cells. Ngemuva kwalokho igazi libuyiselwa kumnikeli ngomthambo okwenye ingalo. (Isinyathelo 2): Isiguli sithola i-chemotherapy yokubulala amaseli akha igazi. Isiguli singathola ukwelashwa ngemisebe (okungakhonjisiwe). (Isinyathelo 3): Isiguli sithola ama-stem cells nge-catheter efakwa emthanjeni wegazi esifubeni.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa komdlavuza wamasende 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.

Abesilisa abake baba nomdlavuza wamasende basengozini enkulu yokuba nomdlavuza kwesinye isende. Isiguli siyelulekwa ukuthi sihlole njalo elinye isende bese sibika noma yiziphi izimpawu ezingavamile kudokotela ngokushesha.

Izivivinyo zomtholampilo zesikhathi eside zibaluleke kakhulu. Isiguli mhlawumbe sizohlolwa njalo ngonyaka wokuqala ngemuva kokuhlinzwa futhi kaningi emva kwalokho.

Izinketho Zokwelapha ngeStage

Kulesi Sigaba

• Isigaba 0 (Testicular Intraepithelial Neoplasia)

• Isigaba I Cancer Yamasende

• Umdlavuza Wamasende Wesigaba II

• Umdlavuza Wamasende Wesigaba III

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

Isigaba 0 (Testicular Intraepithelial Neoplasia)

Ukwelashwa kwesigaba 0 kungafaka okulandelayo:

• Ukwelashwa ngemisebe.

• Ukuqapha.

• Kuhlinzwa ukukhipha isende.

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.

Isigaba I Cancer Yamasende

Ukwelashwa komdlavuza wesiteji I wamasende kuncike ekutheni umdlavuza uyi-seminoma noma yi-nonseminoma.

Ukwelashwa kwe-seminoma kungafaka okulandelayo:

• Kuhlinzwa ukukhipha isende, kulandelwe ukubhekwa.

• Ezigulini ezifuna ukwelashwa okusebenzayo kunokuqashwa, ukwelashwa kungafaka:

• Kuhlinzwa ukukhipha isende, kulandele ukwelashwa ngamakhemikhali.

Ukwelashwa kwe-nonseminoma kungafaka okulandelayo:

• Ukuhlinzwa ukususa i-testicle, ngokulandelwa kwesikhathi eside.

• Ukuhlinzwa ukususa i-testicle nama-lymph node esiswini, ngokulandela isikhathi eside.

• Ukuhlinzwa okulandelwa ukwelashwa ngamakhemikhali kweziguli ezisengozini enkulu yokuphindeka, ngokulandelwa kwesikhathi eside.

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

Umdlavuza Wamasende Wesigaba II

Ukwelashwa komdlavuza wamasende wesigaba II kuncike ekutheni umdlavuza uyi-seminoma noma yi-nonseminoma.

Ukwelashwa kwe-seminoma kungafaka okulandelayo:

• Lapho isimila singamasentimitha ama-5 noma sincane:

• Ukuhlinzwa ukususa i-testicle, kulandelwe ukwelashwa ngemisebe kuma-lymph node esiswini nasesinqeni.

• Inhlanganisela chemotherapy.

• Ukuhlinzwa ukususa i-testicle nama-lymph node esiswini.

• Lapho isimila sikhulu kunamasentimitha ama-5:

• Ukuhlinzwa ukususa i-testicle, kulandelwe inhlanganisela yokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe kuma-lymph node esiswini nasesinqeni, ngokulandela isikhathi eside.

Ukwelashwa kwe-nonseminoma kungafaka okulandelayo:

• Ukuhlinzwa ukususa i-testicle nama-lymph node, ngokulandela isikhathi eside.

• Ukuhlinzwa ukususa i-testicle nama-lymph node, kulandelwe ukuhlanganiswa kwamakhemikhali nokulandelwa kwesikhathi eside.

• Ukuhlinzwa kususwe isende, kulandelwe inhlanganisela yamakhemikhali nokwelashwa kwesibili uma umdlavuza usale, kulandelwa isikhathi eside.

• Inhlanganisela yamakhemikhali ngaphambi kokuhlinzwa kususwe i-testicle, yomdlavuza osakazekile futhi kucatshangwa ukuthi usongela impilo.

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

Umdlavuza Wamasende Wesigaba III

Ukwelashwa komdlavuza wamasende wesigaba III kuncike ekutheni umdlavuza uyi-seminoma noma yi-nonseminoma.

Ukwelashwa kwe-seminoma kungafaka okulandelayo:

• Ukuhlinzwa ukukhipha isende, kulandelwe inhlanganisela yamakhemikhali. Uma kunezimila ezisele ngemuva kwe-chemotherapy, ukwelashwa kungaba okunye kwalokhu okulandelayo:

• Ukuqashwa ngaphandle kokwelapha ngaphandle kokuthi izimila zikhule.

• Ukuqashwa kwezimila ezingaphansi kwamasentimitha ama-3 nokuhlinzwa ukukhipha amathumba amakhulu kunamasentimitha ama-3.

• I-PET scan izinyanga ezimbili ngemuva kokwelashwa ngamakhemikhali nokuhlinzwa ukuze kususwe izicubu ezibonakala ngomdlavuza esikrinini.

• Isivivinyo somtholampilo se-chemotherapy.

Ukwelashwa kwe-nonseminoma kungafaka okulandelayo:

• Ukuhlinzwa ukukhipha isende, kulandelwe inhlanganisela yamakhemikhali.

• Inhlanganisela yamakhemikhali elandelwa ukuhlinzwa ukukhipha isende nazo zonke izimila ezisele. Ukwelashwa ngamakhemikhali okwengeziwe kunganikezwa uma izicubu zesimila zisusiwe ziqukethe amangqamuzana omdlavuza akhulayo noma uma ukuhlolwa kokulandelela kukhombisa ukuthi umdlavuza uqhubeka.

• Inhlanganisela yamakhemikhali ngaphambi kokuhlinzwa kususwe i-testicle, yomdlavuza osakazekile futhi kucatshangwa ukuthi usongela impilo.

• Isivivinyo somtholampilo se-chemotherapy.

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 Zokwelashwa Komdlavuza Wamasende Ovela Njalo

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

Ukwelashwa komdlavuza wamasende ophindaphindiwe kungafaka okulandelayo:

• Inhlanganisela chemotherapy.

• I-chemotherapy ephezulu kanye ne-stem cell transplant.

• Ukuhlinzwa ukususa umdlavuza onokuthi:

• abuye ngaphezu kweminyaka emi-2 ngemuva kokuxolelwa ngokuphelele; noma

• ibuya endaweni eyodwa kuphela futhi ayiphenduli ekwelashweni ngamakhemikhali.

• Isivivinyo somtholampilo sokwelapha okusha.

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

Ukuze ufunde kabanzi Ngomdlavuza wamasende

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

• Ikhasi Lasekhaya Lomdlavuza Wamasende

• Ukuhlolwa Komdlavuza Wamasende

• Izidakamizwa zivunyelwe umdlavuza wamasende

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