Izinhlobo / i-thyroid / isiguli / ukwelashwa kwe-thyroid-pdq

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Ukwelashwa Komdlavuza We-Thyroid (Abadala) (®) –Patient Version

Imininingwane Ejwayelekile Mayelana Nomdlavuza We-thyroid

AMAPHUZU ASEMQOKA

  • Umdlavuza wegilo yisifo lapho amangqamuzana abulalayo (umdlavuza) akhiwa khona ezicutshini zendlala yegilo.
  • Amaqhuqhuva endlala yegilo ajwayelekile kodwa imvamisa akuwona umdlavuza.
  • Kunezinhlobo ezahlukene zomdlavuza wegilo.
  • Ubudala, ubulili, nokuchayeka emisebeni engathinta ingozi yomdlavuza wegilo.
  • Umdlavuza we-thyroid we-medullary kwesinye isikhathi ubangelwa ukuguqulwa kwesakhi esidluliselwa kusuka kumzali kuye enganeni.
  • Izimpawu zomdlavuza wegilo zifaka ukuvuvukala noma isigaxa entanyeni.
  • Ukuhlolwa okuhlola i-thyroid, intamo, negazi kusetshenziselwa ukuthola (ukuthola) nokuthola umdlavuza wegilo.
  • Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Umdlavuza wegilo yisifo lapho amangqamuzana abulalayo (umdlavuza) akhiwa khona ezicutshini zendlala yegilo.

Indlala yegilo yindlala engezansi komphimbo eduze kogwele (uqhoqhoqho). Yakheke njengovemvane, ilobe lakwesokudla no-lobe wesobunxele. Lesi siqeshana, isiqeshana somzimba esincanyana, sihlanganisa ama-lobes amabili. I-thyroid enempilo ikhudlwana kancane kunekota. Imvamisa ayinakuzwakala ngesikhumba.

I-anatomy ye-thyroid kanye nezindlala ze-parathyroid. Indlala yegilo ilele ngaphansi komphimbo eduze koqhoqhoqho. Yakheke njengovemvane, ne-lobe yangakwesokudla ne-lobe yesobunxele exhunywe ngocezu oluncane lomzimba olubizwa ngokuthi i-isthmus. Izindlala ze-parathyroid ziyizitho ezine ezisayizi wepea ezitholakala entanyeni eduze kwendlala yegilo. Izindlala ze-thyroid ne-parathyroid zenza ama-hormone.

Indlala yegilo isebenzisa iodine, okuyiminerali etholakala kokunye ukudla nasosawoti one-iodized, ukusiza ukwenza ama-hormone amaningi. Amahomoni wegilo enza lokhu okulandelayo:

  • Lawula ukushaya kwenhliziyo, ukushisa komzimba, nokuthi ukudla kuguqulwa masinyane kanjani kube ngamandla (imetabolism).
  • Lawula inani le-calcium egazini.

Amaqhuqhuva endlala yegilo ajwayelekile kodwa imvamisa akuwona umdlavuza.

Udokotela wakho angathola isigaxa ku-thyroid yakho ngesikhathi sokuhlolwa kwezokwelapha okuvamile. I-nodule ye-thyroid ukukhula okungavamile kwamangqamuzana e-thyroid. Amaqhubu angaqina noma agcwale uketshezi.

Lapho kutholakala i-nodule ye-thyroid, kwenziwa i-ultrasound ye-thyroid kanye ne-biopsy ye-aspirin-aspiration biopsy ukuhlola izimpawu zomdlavuza. Ukuhlolwa kwegazi ukuhlola amazinga ama-hormone e-thyroid kanye nama-antibodies e-antithyroid egazini kungenziwa futhi ukubheka ezinye izinhlobo zezifo ze-thyroid.

Amaqhuqhuva e-thyroid ngokuvamile awazibangeli izimpawu noma adinga ukwelashwa. Kwesinye isikhathi amaqhubu endlala yegilo aba mkhulu ngokwanele ukuthi kube nzima ukugwinya noma ukuphefumula futhi kudingeka izivivinyo nokwelashwa okwengeziwe. Zimbalwa kuphela izigaxa ze-thyroid ezitholwa njengomdlavuza.

Kunezinhlobo ezahlukene zomdlavuza wegilo.

Umdlavuza wegilo ungachazwa ngokuthi:

  • Umdlavuza we-thyroid ohlukile, ofaka izicubu ezihlukaniswe kahle, izicubu ezihlukaniswe kabi, nezicubu ezingafani; noma
  • Umdlavuza we-thyroid we-medullary.

Izicubu ezihlukaniswe kahle (umdlavuza wegilo le-papillary kanye nomdlavuza we-thyroid) zingelashwa futhi ngokujwayelekile zingelashwa.

Izicubu ezihlukaniswe kabi nezingafani nhlobo (umdlavuza wegilo le-anaplastic) azijwayelekile kakhulu. Lezi zicubu zikhula futhi zisakazeke ngokushesha futhi zinethuba elibi lokululama. Iziguli ezinomdlavuza wegilo we-anaplastic kufanele zihlolwe ngamangqamuzana ukuthola ushintsho kuhlobo lwe-BRAF.

Umdlavuza we-thyroid we-medullary uyisigaxa se-neuroendocrine esikhula kumaseli we-C wegilo. Amaseli we-C enza i-hormone (calcitonin) esiza ukugcina izinga le-calcium esempilweni egazini.

Bona isifinyezo se- ku-Childhood Thyroid Cancer Treatment ukuze uthole ulwazi mayelana nomdlavuza we-thyroid wengane.

Ubudala, ubulili, nokuchayeka emisebeni engathinta ingozi yomdlavuza wegilo.

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 zobungozi zomdlavuza wegilo zifaka okulandelayo:

  • Ukuba phakathi kweminyaka engama-25 nengama-65 ubudala.
  • Ukuba ngowesifazane.
  • Ukuvezwa ngemisebe ekhanda nasentanyeni njengengane noma ingane noma ukuvezwa ekuweni okukhipha imisebe. Umdlavuza ungavela ngemuva nje kweminyaka emi-5 ngemuva kokuvezwa.
  • Ukuba nomlando we-goiter (i-thyroid ekhulisiwe).
  • Ukuba nomlando womndeni wesifo se-thyroid noma umdlavuza we-thyroid.
  • Ukuba nezimo ezithile zofuzo ezifana nomndeni medullary thyroid cancer (FMTC), multiple endocrine neoplasia type 2A syndrome (MEN2A), or multiple endocrine neoplasia type 2B syndrome (MEN2B).
  • Ukuba wase-Asia.

Umdlavuza we-thyroid we-medullary kwesinye isikhathi ubangelwa ukuguqulwa kwesakhi esidluliselwa kusuka kumzali kuye enganeni.

Izakhi zofuzo ezisemangqamuzaneni zithwala imininingwane yofuzo kusuka kumzali iye enganeni. Ushintsho oluthile kuhlobo lwe-RET oludluliswa lusuka kumzali luye enganeni (olutholwe njengefa) lungadala umdlavuza wegilo we-medullary.

Kukhona ukuhlolwa kofuzo okusetshenziselwa ukuhlola ufuzo olushintshiwe. Isiguli sihlolwa kuqala ukubona ukuthi sinalo yini ufuzo olushintshile. Uma isiguli sinaso, amanye amalungu omndeni nawo angahlolwa ukuze kutholakale ukuthi asengozini enkulu yomdlavuza wegilo we-medullary. Amalungu omndeni, kufaka phakathi izingane ezincane, ezinezakhi zofuzo ezishintshiwe zingaba ne-thyroidectomy (ukuhlinzwa ukususa i-thyroid). Lokhu kunganciphisa ithuba lokuthuthukisa umdlavuza we-thyroid we-medullary.

Izimpawu zomdlavuza wegilo zifaka ukuvuvukala noma isigaxa entanyeni.

Umdlavuza wegilo awunakubangela izimpawu noma izimpawu zakuqala. Kwesinye isikhathi kutholakala ngesikhathi sokuhlolwa komzimba okujwayelekile. Izimpawu noma izimpawu zingavela lapho isimila sikhula. Ezinye izimo zingadala izimpawu noma izimpawu ezifanayo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

  • Isigaxa (isinqe) entanyeni.
  • Ukuphefumula kanzima.
  • Inkinga yokugwinya.
  • Ubuhlungu lapho ugwinya.
  • Ukungahambi kahle.

Ukuhlolwa okuhlola i-thyroid, intamo, negazi kusetshenziselwa ukuthola (ukuthola) nokuthola umdlavuza wegilo.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

  • Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi ukuhlola izimpawu zesifo, njengezigaxa (amaqhuqhuva) noma ukuvuvukala entanyeni, ebhokisini lezwi, nakuma-lymph node, nanoma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.
  • I-Laryngoscopy: Inqubo lapho udokotela ehlola i-larynx (ibhokisi lezwi) ngesibuko noma nge-laryngoscope. I-laryngoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Isimila segilo singacindezela ezintanjeni zezwi. I-laryngoscopy yenziwa ukubona ukuthi izintambo zezwi zihamba ngokujwayelekile yini.
  • Izifundo zehomoni yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lamahomoni athile akhishwe egazini ngezitho nezicubu zomzimba. Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lento kungaba uphawu lwesifo esithweni noma esikhunjeni esisenzayo. Igazi lingahlolwa amazinga angajwayelekile wehomoni ekhuthaza i-thyroid (TSH). I-TSH yenziwa yindlala yobuchopho ebuchosheni. Kuvuselela ukukhishwa kwehomoni yegilo futhi kulawule ukuthi amangqamuzana e-follicular wegilo akhula ngokushesha kangakanani. Igazi lingabuye lihlolwe amazinga aphezulu we-hormone calcitonin kanye ne-antithyroid antibodies.
  • Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njenge-calcium, ekhishwe egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.
  • Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho entanyeni futhi enze ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi. Le nqubo ingakhombisa ubukhulu be-nodule yegiloji nokuthi iqinile noma i-cyst egcwele uketshezi. I-Ultrasound ingasetshenziselwa ukuhola i-biopsy ye-aspiration-needle.
  • I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, ezifana nentamo, 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.
Iskena sekhompiyutha (CT) sekhanda nentamo. Isiguli silele etafuleni elishibilika ngesithwebuli se-CT, esithatha izithombe ze-x-ray ezingaphakathi kwekhanda nentamo.
  • I-fine-needle aspiration biopsy ye-thyroid: Ukususwa kwezicubu ze-thyroid usebenzisa inaliti encane. Inaliti ifakwa esikhunjeni igilo. Amasampula amaningana ezicubu asuswa ezingxenyeni ezihlukene zegilo. Isazi sezifo sibuka amasampula ezicubu ngaphansi kwesibonakhulu ukuze afune amangqamuzana omdlavuza. Ngenxa yokuthi uhlobo lomdlavuza wegilo kungaba nzima ukuluxilonga, iziguli kufanele zibuze ukuthi amasampula e-biopsy ahlolwe ngudokotela wezifo onolwazi lokuthola umdlavuza wegilo.
  • I-biopsy yokuhlinza: Ukususwa kwe-nodule yegilozi noma i-lobe eyodwa yegilo ngesikhathi sokuhlinzwa ukuze amaseli nezicubu kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. Ngenxa yokuthi uhlobo lomdlavuza wegilo kungaba nzima ukuluxilonga, iziguli kufanele zibuze ukuthi amasampula e-biopsy ahlolwe ngudokotela wezifo onolwazi lokuthola umdlavuza wegilo.

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

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

  • Iminyaka yesiguli ngesikhathi sokuxilongwa.
  • Uhlobo lomdlavuza wegilo.
  • Isigaba somdlavuza.
  • Ukuthi umdlavuza ususwe ngokuphelele yini ngokuhlinzwa.
  • Ukuthi isiguli sine-endocrine neoplasia type 2B (MEN 2B) eminingi.
  • Impilo ejwayelekile yesiguli.
  • Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Izigaba zomdlavuza wegilo

AMAPHUZU ASEMQOKA

  • Ngemuva kokutholakala komdlavuza we-thyroid, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kwe-thyroid noma kwezinye izingxenye zomzimba.
  • Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
  • Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.
  • Izigaba zisetshenziselwa ukuchaza umdlavuza wegilo ngokuya ngohlobo lomdlavuza wegilo kanye nobudala besiguli:
  • Umdlavuza we-Papillary no-follicular ezigulini ezingaphansi kweminyaka engama-55
  • Umdlavuza we-Papillary ne-follicular wegciwane ezigulini ezineminyaka engama-55 nangaphezulu
  • Umdlavuza wegilo we-Anaplastic ezigulini zeminyaka yonke
  • Umdlavuza wegciwane le-medullary ezigulini zeminyaka yonke

Ngemuva kokutholakala komdlavuza we-thyroid, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kwe-thyroid noma kwezinye izingxenye zomzimba.

Inqubo esetshenziselwa ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwe-thyroid noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi iminyaka yesiguli nesigaba somdlavuza ukuhlela ukwelashwa.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

  • I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, njengesifuba, isisu, nobuchopho, 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.
  • Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi.
  • 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.
  • 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.
  • I-Sentinel lymph node biopsy: Ukususwa kwe-sentinel lymph node ngesikhathi sokuhlinzwa. I-sentinel lymph node iyisakhi sokuqala se-lymph eqenjini lama-lymph node ukuthola i-lymphatic drainage evela ku-tumor yokuqala. Kuyi-lymph node yokuqala umdlavuza ongahle usabalale uye kusukela kusimila sokuqala. Kufakwa into enemisebe kanye / noma udayi oluhlaza okwesibhakabhaka eduze kwesimila. Into noma udayi ugeleza ngemigudu ye-lymph uye kuma-lymph node. I-lymph node yokuqala yokwamukela into noma udayi iyasuswa. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza. Uma amangqamuzana omdlavuza engatholakali, kungahle kungadingeki ukususa ama-lymph node amaningi.

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-thyroid usakazeka uye emaphashini, amangqamuzana omdlavuza asephashini empeleni angamaseli omdlavuza wegilo. Lesi sifo umdlavuza wegilo we-metastatic, hhayi umdlavuza wamaphaphu.

Izigaba zisetshenziselwa ukuchaza umdlavuza wegilo ngokuya ngohlobo lomdlavuza wegilo kanye nobudala besiguli:

Umdlavuza we-Papillary no-follicular ezigulini ezingaphansi kweminyaka engama-55

  • Isigaba I: Esigabeni I-papillary kanye ne-follicular cancer yomdlavuza, isimila sinanoma yisiphi isayizi futhi kungenzeka ukuthi sisabalalele ezicutshini eziseduze nakuma-lymph node. Umdlavuza awusabalalanga kwezinye izingxenye zomzimba.
Isigaba I umdlavuza wegilo we-papillary ne-follicular ezigulini ezingaphansi kweminyaka engama-55. Isimila sinanoma yisiphi isayizi kanti umdlavuza kungenzeka usabalalele ezicutshini eziseduze nakuma-lymph node. Umdlavuza awusabalalanga kwezinye izingxenye zomzimba.
  • Isigaba II: Esigabeni II somdlavuza wesigaxa se-papillary kanye ne-follicular, isimila sinobuphi ubukhulu nomdlavuza kungenzeka ukuthi usabalalele ezicutshini eziseduze nakuma-lymph node. Umdlavuza usabalale kusuka endlaleni yegilo uye kwezinye izingxenye zomzimba, njengamaphaphu noma amathambo.
Isigaba II somdlavuza we-thyroid wesifo se-papillary kanye ne-follicular ezigulini ezingaphansi kweminyaka engama-55. Isimila sinanoma yisiphi isayizi kanti umdlavuza kungenzeka usabalalele ezicutshini eziseduze nakuma-lymph node. Umdlavuza usabalale kusuka endlaleni yegilo uye kwezinye izingxenye zomzimba, njengamaphaphu noma amathambo.

Umdlavuza we-Papillary ne-follicular wegciwane ezigulini ezineminyaka engama-55 nangaphezulu

  • Isigaba I: Esigabeni I-papillary kanye ne-follicular cancer yomdlavuza, umdlavuza utholakala ku-thyroid kuphela futhi isimila singamasentimitha angu-4 noma sincane.
Isiteji I-papillary kanye ne-follicular cancer yomdlavuza ezigulini ezineminyaka engama-55 nangaphezulu. Umdlavuza utholakala endlaleni yegilo kuphela kuthi isimila sibe ngamasentimitha amane noma ngaphansi.
  • Isigaba II: Esigabeni II somdlavuza wesifo se-papillary kanye ne-follicular, kutholakala okukodwa kokulandelayo:
  • umdlavuza utholakala endlaleni yegilo kuthi isimila sibe ngamasentimitha ama-4 noma ngaphansi; umdlavuza usakazekele kuma-lymph node aseduze; noma
  • umdlavuza utholakala kwindlala yegilo, isimila sikhulu kunamasentimitha ama-4, kanti umdlavuza kungenzeka usabalalele kuma-lymph node aseduze; noma
  • isimila sinobukhulu buphi kanti umdlavuza ususabalele kusuka endlaleni yegilo waya ezicutshini eziseduze entanyeni futhi kungenzeka ukuthi usabalalele kuma-lymph node aseduze.
Isigaba II somdlavuza we-papillary kanye ne-follicular cancer (1) ezigulini ezineminyaka engama-55 nangaphezulu. Umdlavuza utholakala endlaleni yegilo kuthi isimila sibe ngamasentimitha amane noma ngaphansi. Umdlavuza usabalalele kuma-lymph node aseduze.
  • Isigaba III: Esigabeni III somdlavuza we-papillary kanye ne-follicular cancer, isimila sinanoma yisiphi isayizi futhi umdlavuza usabalale kusuka ku-thyroid kuya ezicutshini ezithambile ngaphansi kwesikhumba, i-esophagus, i-trachea, i-larynx, noma i-nerve laryngeal ephindayo (inzwa ehambayo kumphimbo). Umdlavuza kungenzeka usabalalele kuma-lymph node.
Umdlavuza wegciwane lesigaba sesithathu se-papillary kanye ne-follicular ezigulini ezineminyaka engama-55 nangaphezulu. Isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele kusuka endlaleni yegilo kuya ezicutshini ezithambile ngaphansi kwesikhumba, i-esophagus, i-trachea, i-larynx, noma i-laryngeal nerve ephindaphindayo (i-nerve eya ku-larynx). Umdlavuza kungenzeka usabalalele kuma-lymph node.
  • Isigaba IV: Umdlavuza wegilo wesigaba IV kanye nowomlomo wesikhumba uhlukaniswe ngezigaba ze-IVA ne-IVB.
  • Esigabeni IVA, isimila sinobukhulu buphi kanti umdlavuza ususabalele ezicutshini phambi komgogodla noma uzungeze umthambo we-carotid noma imithambo yegazi endaweni ephakathi kwamaphaphu. Umdlavuza kungenzeka usabalalele kuma-lymph node.
Umdlavuza wesigaba se-IVA papillary kanye ne-follicular womdlavuza ezigulini ezineminyaka engama-55 nangaphezulu. Isimila sinanoma yisiphi isayizi kanti umdlavuza (a) usabalalele ezicutshini phambi komgogodla; noma (b) ezungeze umthambo we-carotid; noma (c) ezungeze imithambo yegazi endaweni ephakathi kwamaphaphu. Umdlavuza kungenzeka usabalalele kuma-lymph node.
  • Esigabeni IVB, isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele kwezinye izingxenye zomzimba, njengamaphaphu noma amathambo. Umdlavuza kungenzeka usabalalele kuma-lymph node.
Umdlavuza wesigaba se-IVB papillary kanye ne-follicular umdlavuza ezigulini ezineminyaka engama-55 nangaphezulu. Isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele nakwezinye izingxenye zomzimba, njengamaphaphu noma amathambo. Umdlavuza kungenzeka usabalalele kuma-lymph node.

Umdlavuza wegilo we-Anaplastic ezigulini zeminyaka yonke

Umdlavuza wegilo we-Anaplastic ukhula ngokushesha futhi uvame ukusabalala ngaphakathi kwentamo lapho utholakala. Umdlavuza wegilo we-Anaplastic uthathwa njengomdlavuza wesigaba IV we-thyroid. Isigaba IV somdlavuza we-thyroid we-anaplastic wehlukaniswe ngezigaba ze-IVA, IVB, ne-IVC.

  • Esigabeni IVA, umdlavuza utholakala ku-thyroid kuphela futhi isimila singaba usayizi.
Isigaba IVA anaplastic umdlavuza wegilo. Umdlavuza utholakala endlaleni yegilo kuphela kanti isimila singaba bukhulu buphi.
  • Esigabeni IVB, okukodwa kokulandelayo kuyatholakala:
  • umdlavuza utholakala endlaleni yegilo kanti isimila singaba bukhulu buphi; umdlavuza usakazekele kuma-lymph node aseduze; noma
Isigaba IVB umdlavuza wegilo we-anaplastic thyroid (1). Umdlavuza utholakala endlaleni yegilo kanti isimila singaba bukhulu buphi. Umdlavuza usabalalele kuma-lymph node aseduze.
  • isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele kusuka endlaleni yegilo waya ezicutshini eziseduze entanyeni futhi kungenzeka ukuthi usabalalele kuma-lymph node aseduze; noma
Isigaba IVB somdlavuza we-thyroid we-anaplastic (2). Isimila sinobukhulu buphi kanti umdlavuza ususabalele kusuka endlaleni yegilo waya ezicutshini eziseduze entanyeni. Umdlavuza kungenzeka usabalalele kuma-lymph node aseduze.
  • isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele kusuka endlaleni yegilo kuya ezicutshini ezithambile ngaphansi kwesikhumba, i-esophagus, i-trachea, i-larynx, i-nerve laryngeal ephindaphindayo (i-nerve eya ku-larynx), noma izicubu phambi komgogodla, noma uzungeze umthambo we-carotid noma imithambo yegazi endaweni ephakathi kwamaphaphu; umdlavuza kungenzeka usabalalele kuma-lymph node.
Isigaba IVB umdlavuza wegilo we-anaplastic thyroid (3). Isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele kusuka endlaleni yegilo kuya ezicutshini ezithambile ngaphansi kwesikhumba, i-esophagus, i-trachea, i-larynx, i-nerve laryngeal ephindayo (inzwa eya ku-larynx), noma izicubu eziphambi komgogodla; noma umdlavuza uzungeze umthambo we-carotid noma imithambo yegazi endaweni ephakathi kwamaphaphu. Umdlavuza kungenzeka usabalalele kuma-lymph node.
  • Esigabeni IVC, isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele kwezinye izingxenye zomzimba, njengamaphaphu noma amathambo. Umdlavuza kungenzeka usabalalele kuma-lymph node.
Isigaba somdlavuza wegilo we-IVC we-anaplastic thyroid. Isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele nakwezinye izingxenye zomzimba, njengamaphaphu noma amathambo. Umdlavuza kungenzeka usabalalele kuma-lymph node.

Umdlavuza wegciwane le-medullary ezigulini zeminyaka yonke

  • Isigaba I: Esigabeni I medullary cancer cancer, umdlavuza utholakala ku-thyroid kuphela futhi isimila singamasentimitha ama-2 noma sincane.
Isiteji I-medullary cancer yomdlavuza. Umdlavuza utholakala endlaleni yegilo kuphela kuthi isimila sibe ngamasentimitha amabili noma ngaphansi.
  • Isigaba II: Esigabeni II somdlavuza we-thyroid we-medullary, okukodwa kokulandelayo kutholakala:
  • umdlavuza usegulini kuphela futhi isimila sikhulu kunamasentimitha ama-2; noma
  • isimila sinobukhulu buphi kanti umdlavuza ususabalele kusuka endlaleni yegilo kuya ezicutshini eziseduze entanyeni.
Umdlavuza wegilo wesigaba II. Umdlavuza (a) utholakala kugilo kuphela kanti isimila sikhulu kunamasentimitha ama-2; noma (b) usabalale kusuka endlaleni yegilo kuya ezicutshini eziseduze entanyeni kanti isimila sinobukhulu buphi.
  • Isigaba III: Esigabeni III somdlavuza we-thyroid we-medullary, isimila sinanoma yisiphi isayizi nomdlavuza kungenzeka ukuthi usakaze kusuka ku-thyroid kuya ezicutshini eziseduze entanyeni. Umdlavuza usabalalele kuma-lymph node kolunye noma ezinhlangothini zombili zethrachea noma yomphimbo.
Umdlavuza wegilo wesigaba III medullary. Isimila sinanoma yisiphi isayizi kanti umdlavuza kungenzeka ukuthi usabalale kusuka endlaleni yegilo kuya ezicutshini eziseduze entanyeni. Umdlavuza usabalalele kuma-lymph node kolunye noma ezinhlangothini zombili zethrachea noma yomphimbo.
  • Isigaba IV: Umdlavuza wegilo we-medullary wesigaba IV uhlukaniswe ngezigaba ze-IVA, IVB, ne-IVC.
  • Esigabeni IVA, noma yikuphi kokulandelayo kuyatholakala:
  • isimila sinoma yibuphi usayizi kanti umdlavuza ususabalele kusuka endlaleni yegilo kuya ezicutshini ezithambile ngaphansi kwesikhumba, i-esophagus, i-trachea, i-larynx, noma i-laryngeal nerve ephindaphindayo (i-nerve eya ku-larynx); umdlavuza kungenzeka usabalalele kuma-lymph node kolunye noma ezinhlangothini zombili zentamo; noma
  • isimila sinobukhulu buphi kanti umdlavuza kungenzeka ukuthi usabalale kusuka endlaleni yegilo kuya ezicutshini eziseduze entanyeni; umdlavuza usabalalele kuma-lymph node kolunye noma ezinhlangothini zombili zentamo.
Isigaba somdlavuza wegilo we-IVA medullary. Isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele kusuka endlaleni yegilo kuya ezicutshini ezithambile ngaphansi kwesikhumba, i-esophagus, i-trachea, i-larynx, noma i-laryngeal nerve ephindaphindayo (i-nerve eya ku-larynx), kanti umdlavuza kungenzeka usabalalele ku-lymph ama-node ohlangothini olulodwa noma zombili entanyeni; noma umdlavuza kungenzeka usabalale kusuka endlaleni yegilo kuya ezicutshini eziseduze entanyeni, kanti umdlavuza ususabalele kuma-lymph node kolunye noma ezinhlangothini zombili zentamo.
  • Esigabeni IVB, isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele ezicutshini phambi komgogodla noma emgogodleni noma uzungeze umthambo we-carotid noma imithambo yegazi endaweni ephakathi kwamaphaphu. Umdlavuza kungenzeka usabalalele kuma-lymph node.
Umdlavuza we-thyroid wesigaba IVB medullary. Isimila sinanoma yisiphi isayizi kanti umdlavuza (a) usabalalele ezicutshini phambi komgogodla noma emgogodleni; noma (b) ezungeze umthambo we-carotid; noma (c) ezungeze imithambo yegazi endaweni ephakathi kwamaphaphu. Umdlavuza kungenzeka usabalalele kuma-lymph node.
  • Esigabeni IVC, isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele kwezinye izingxenye zomzimba, njengamaphaphu noma isibindi. Umdlavuza kungenzeka usabalalele kuma-lymph node.
Isigaba somdlavuza wegilo we-IVC medullary. Isimila sinanoma yisiphi isayizi kanti umdlavuza ususabalele nakwezinye izingxenye zomzimba, njengephaphu noma isibindi. Umdlavuza kungenzeka usabalalele kuma-lymph node.

Umdlavuza We-Thyroid Ophindaphindayo

Umdlavuza we-thyroid ophindaphindiwe wumdlavuza obuye wabuya (ubuye) ngemuva kokuba welashwe. Umdlavuza wendlala yegilo ungabuya endlaleni yegilo noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

  • Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza wegilo.
  • Izinhlobo eziyisithupha zokwelashwa okujwayelekile zisetshenzisiwe:
  • Ukuhlinzwa
  • Ukwelashwa ngemisebe, kufaka phakathi ukwelashwa kwe-iodine enemisebe
  • Ukwelashwa ngamakhemikhali
  • Ukwelashwa kwehomoni yegilo
  • Ukwelashwa okuhlosiwe
  • Ukulinda okulindile
  • Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
  • I-Immunotherapy
  • Ukwelashwa komdlavuza wegilo 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 wegilo.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza wegilo. 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 eziyisithupha zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa ukwelashwa okuvame kakhulu komdlavuza wegilo. Enye yezinqubo ezilandelayo ingasetshenziswa:

  • I-Lobectomy: Ukususwa kwe-lobe lapho kutholakala khona umdlavuza we-thyroid. Ama-lymph node aseduze nomdlavuza nawo angasuswa futhi ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • I-thyroidectomy eseduze-ingqikithi: Ukususwa kwazo zonke izingxenye ezincane kakhulu ze-thyroid. Ama-lymph node aseduze nomdlavuza nawo angasuswa futhi ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • Ingqikithi ye-thyroidectomy: Ukususwa kwe-thyroid yonke. Ama-lymph node aseduze nomdlavuza nawo angasuswa futhi ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • I-Tracheostomy: Ukuhlinzwa ukudala ukuvula (i-stoma) ku-windpipe ukukusiza uphefumule. Ukuvulwa uqobo kungabizwa nangokuthi i-tracheostomy.

Ukwelashwa ngemisebe, kufaka phakathi ukwelashwa kwe-iodine enemisebe

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. Kwesinye isikhathi imisebe ibhekiswe ngqo kulesimila ngesikhathi sokuhlinzwa. Lokhu kubizwa ngokuthi ukwelashwa ngemisebe ye-intraoperative.
  • Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Ukwelashwa ngemisebe kunganikezwa ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza we-thyroid angasuswanga. Amagciwane omdlavuza we-Follicular ne-papillary kwesinye isikhathi aphathwa ngemithi yokwelashwa enemisebe ye-iodine (RAI). I-RAI ithathwa ngomlomo futhi iqoqwe kunoma yiziphi izicubu ze-thyroid ezisele, kufaka phakathi amangqamuzana omdlavuza wegilo asabalele kwezinye izindawo emzimbeni. Njengoba izicubu ze-thyroid kuphela ezithatha i-iodine, i-RAI ibhubhisa izicubu zomdlavuza wegciwane nomdlavuza ngaphandle kokulimaza ezinye izicubu. Ngaphambi kokunikezwa umthamo ophelele wokwelashwa we-RAI, kunikezwa umthamo omncane wokuhlola ukubona ukuthi isimila siyayithatha yini iodine.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuya ngohlobo nesigaba somdlavuza owelashwa. Ukwelashwa kwemisebe yangaphandle ne-radioactive iodine (RAI) therapy kusetshenziselwa ukwelapha umdlavuza wegilo.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda).

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

Bheka Izidakamizwa ezivunyelwe i-Cancer Cancer ukuthola eminye imininingwane.

Ukwelashwa kwehomoni yegilo

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. Ekwelapheni umdlavuza we-thyroid, izidakamizwa zinganikezwa ukuvimbela umzimba ekwenzeni i-hormone evuselela i-thyroid (TSH), i-hormone engandisa amathuba okuthi umdlavuza we-thyroid ukhule noma uphinde ubuye.

Futhi, ngoba ukwelashwa komdlavuza we-thyroid kubulala amangqamuzana e-thyroid, i-thyroid ayikwazi ukwenza i-hormone yegilo eyanele. Iziguli zinikezwa amaphilisi wokushintsha ama-hormone e-thyroid.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile. Kunezinhlobo ezahlukene zokwelashwa okuqondisiwe:

  • I-Tyrosine kinase inhibitor. Ukwelashwa kweTyrosine kinase inhibitor kuvimba amasiginali adingekayo ukuze izimila zikhule. I-Sorafenib, i-lenvatinib, i-vandetanib, ne-cabozantinib isetshenziselwa ukwelapha izinhlobo ezithile zomdlavuza wegilo. Izinhlobo ezintsha ze-tyrosine kinase inhibitors ziyafundwa ukwelapha umdlavuza we-thyroid osezingeni eliphezulu.
  • Amaprotheni kinase inhibitor. Ukwelashwa kwamaphrotheni kinase inhibitor kuvimba amaprotheni adingekayo ekukhuleni kwamaseli futhi kungabulala amangqamuzana omdlavuza. I-Dabrafenib ne-trametinib zisetshenziselwa ukwelapha umdlavuza we-thyroid we-anaplastic ezigulini ezinokuguquka okuthile kuhlobo lwe-BRAF.

Bheka Izidakamizwa ezivunyelwe i-Cancer Cancer ukuthola eminye imininingwane.

Ukulinda okulindile

Ukulinda ngokuqapha kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa kuze kuvele izimpawu noma izimpawu.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

I-Immunotherapy

I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Izinto ezenziwe ngumzimba noma ezenziwe elabhoratri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba kumdlavuza. Lolu hlobo lokwelashwa komdlavuza lubizwa nangokuthi i-biotherapy noma i-biologic therapy. I-Immunotherapy ifundwa njengokwelashwa komdlavuza wegilo.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa komdlavuza wegilo kungadala imiphumela emibi.

Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

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

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izinketho Zokwelapha ngeStage

Kulesi Sigaba

  • Izigaba I, II, no-III I-Papillary ne-Follicular Cancer Cancer (Yasendaweni / Yesifunda)
  • Isigaba IV Papillary and Follicular Thyroid Cancer (Metastatic)
  • Umdlavuza We-Thyroid Ophindaphindayo Nolandelanayo
  • I-Medullary Cancer Cancer
  • Umdlavuza Wegilo Lwe-Anaplastic

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

Izigaba I, II, no-III I-Papillary ne-Follicular Cancer Cancer (Yasendaweni / Yesifunda)

Ukwelashwa kwesigaba I (esingaphansi kweminyaka engama-55; iminyaka engama-55 nangaphezulu), isigaba II (esingaphansi kweminyaka engama-55; esineminyaka engama-55 nangaphezulu), nesigaba sesithathu somdlavuza we-papillary kanye nowomlomo wesibeletho kungafaka okulandelayo:

  • Ukuhlinzwa (i-thyroidectomy noma i-lobectomy).
  • Ukwelashwa kwe-iodine enemisebe.
  • Ukwelashwa kwehormone ukuvimbela umzimba ekwenzeni i-hormone ekhuthaza i-thyroid (TSH).
  • Ukwelashwa kwemisebe yangaphandle.

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 IV Papillary and Follicular Thyroid Cancer (Metastatic)

Lapho umdlavuza ususabalalele kwezinye izindawo emzimbeni, njengamaphaphu namathambo, ukwelashwa imvamisa akuwulaphi umdlavuza, kepha kungadambisa izimpawu futhi kuthuthukise izinga lempilo. Ukwelashwa komdlavuza wegciwane lesigaba IV we-papillary kanye ne-follicular kungafaka okulandelayo:

Ngezicubu ezithatha iodine

  • Ingqikithi ye-thyroidectomy.
  • Ukwelashwa kwe-iodine enemisebe.
  • Ukwelashwa kwehormone ukuvimbela umzimba ekwenzeni i-hormone ekhuthaza i-thyroid (TSH).

Yezimila ezingathathi iodine

  • Ingqikithi ye-thyroidectomy.
  • Ukwelashwa kwehormone ukuvimbela umzimba ekwenzeni i-hormone ekhuthaza i-thyroid (TSH).
  • Ukwelashwa okuqondisiwe nge-tyrosine kinase inhibitor (sorafenib noma i-lenvatinib).
  • Ukuhlinzwa ukususa umdlavuza ezindaweni lapho ususabalale khona.
  • Ukwelashwa kwemisebe yangaphandle.
  • Isivivinyo somtholampilo se-chemotherapy.
  • Isivivinyo somtholampilo sokwelapha okubhekiswe kukho.
  • Isivivinyo somtholampilo se-immunotherapy.

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 We-Thyroid Ophindaphindayo Nolandelanayo

Ukwelashwa komdlavuza we-thyroid ophindaphindiwe kanye nowomlomo kungafaka okulandelayo:

  • Ukuhlinzwa ukukhipha isimila noma ngaphandle kwemishanguzo ye-iodine enemisebe.
  • Ukwelashwa kwe-iodine enemisebe lapho umdlavuza utholakala kuphela ngokuskena kwe-thyroid futhi ungezwakala ngesikhathi sokuhlolwa komzimba.
  • Ukwelashwa okuqondisiwe nge-tyrosine kinase inhibitor (sorafenib noma i-lenvatinib).
  • Ukwelashwa kwemisebe yangaphandle noma ukwelashwa ngemisebe ye-intraoperative njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.
  • Ukwelashwa ngamakhemikhali.
  • Isivivinyo somtholampilo sokwelapha okubhekiswe kukho.
  • Isivivinyo somtholampilo se-immunotherapy.

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

I-Medullary Cancer Cancer

Umdlavuza we-medullary we-medullary we-localized usegreyini kuphela futhi kungenzeka ukuthi usabalalele emisipheni eseduzane entanyeni. Umdlavuza we-thyroid osuthuthukile wakule ndawo ususabalalele nakwezinye izingxenye zentamo noma kwezinye izingxenye zomzimba.

Ukwelashwa komdlavuza we-thyroid we-medullary we-medullary kungafaka okulandelayo:

  • I-thyroidectomy ephelele uma umdlavuza ungazange usabalalele kwezinye izingxenye zomzimba. Ama-lymph node aseduze nomdlavuza nawo ayasuswa.
  • Ukwelashwa kwemisebe kwangaphandle kweziguli ezinomdlavuza ophindile ku-thyroid.

Ukwelashwa komdlavuza we-thyroid othuthukile / we-metastatic medullary kungafaka okulandelayo:

  • Ukwelashwa okuhlosiwe nge-tyrosine kinase inhibitor (vandetanib noma i-cabozantinib) yomdlavuza osakazekele kwezinye izingxenye zomzimba.
  • I-Chemotherapy njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo yeziguli ezinomdlavuza osakaze kwezinye izingxenye zomzimba.

Ukwelashwa kwe-iodine enemisebe akusetshenziswanga ukwelapha umdlavuza wegilo we-medullary.

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 Wegilo Lwe-Anaplastic

Ukwelashwa kungafaka okulandelayo:

  • Ingqikithi ye-thyroidectomy njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo yeziguli ezinomdlavuza ongaphakathi noma oseduze kwendlala yegilo.
  • I-Tracheostomy njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.
  • Ukwelashwa kwemisebe yangaphandle.
  • Ukwelashwa ngamakhemikhali.
  • Ukwelashwa okuhlosiwe ngama-protein kinase inhibitors (dabrafenib kanye ne-trametinib) yeziguli ezinokuguquka okuthile kuhlobo lwe-BRAF.

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 We-thyroid

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

  • Ikhasi Lasekhaya Lomdlavuza We-Thyroid
  • Ukwelashwa Komdlavuza We-Thyroid
  • Izidakamizwa ezivunyelwe i-Cancer Cancer
  • Izindlela Zokwelapha Zomdlavuza
  • Ukuhlolwa Kofuzo Kwezifo Ezizuzwayo Zokuthola Umdlavuza

Ngemininingwane ejwayelekile yomdlavuza nezinye izinsiza ezivela ku-National Cancer Institute, bheka okulandelayo:

  • Mayelana Nomdlavuza
  • Isiteji
  • I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza
  • Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza
  • Ukubhekana Nomdlavuza
  • Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza
  • Kwabasindile Nabanakekeli


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