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Ukwelashwa Kwe-Vulvar Cancer (®) –Patient Version

Imininingwane Ejwayelekile Mayelana Nomdlavuza We-Vulvar

AMAPHUZU ASEMQOKA

  • Umdlavuza we-Vulvar yisifo esingajwayelekile lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zomzimba womuntu.
  • Ukuba ne-vulvar intraepithelial neoplasia noma ukutheleleka kwe-HPV kungakhuphula ingozi yomdlavuza we-vulvar.
  • Izimpawu zomdlavuza we-vulvar zifaka ukopha noma ukulunywa endaweni ye-vulvar.
  • Ukuhlolwa okuhlola imomozi kusetshenziselwa ukuthola umdlavuza we-vulvar.
  • Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Umdlavuza we-Vulvar yisifo esingajwayelekile lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zomzimba womuntu.

Umdlavuza we-Vulvar wakha esithweni sangasese sowesifazane sangaphandle. I-vulva ihlanganisa:

  • Izindebe zangaphakathi nangaphandle zesifazane.
  • Clitoris (izicubu ezizwelayo phakathi kwezindebe).
  • Ukuvulwa kwesitho sangasese sowesifazane nezindlala zaso.
  • I-Mons pubis (indawo eyindilinga ephambi kwamathambo e-pubic embozwa izinwele lapho uthomba).
  • IPerineum (indawo ephakathi kwesitho sangasese sangasese kanye nendunu).
I-anatomy yesitho sangasese. I-vulva ifaka ama-mons pubis, i-clitoris, ukuvuleka kwe-urethral, ​​izindebe zangaphakathi nezangaphandle zesitho sangasese sowesifazane, ukuvulwa kwesitho sangasese sowesifazane, ne-perineum.

Umdlavuza we-Vulvar uvame ukuthinta izindebe zangasese zangaphandle. Ngaphansi kokuvamile, umdlavuza uthinta izindebe zangasese zangaphakathi, i-clitoris, noma izindlala zangasese.

Umdlavuza we-Vulvar uvame ukwakheka kancane eminyakeni eminingi. Amaseli angajwayelekile angakhula ebusweni besikhumba se-vulvar isikhathi eside. Lesi simo sibizwa nge-vulvar intraepithelial neoplasia (VIN). Ngoba kungenzeka ukuthi i-VIN ibe ngumdlavuza we-vulvar, kubalulekile ukuthola ukwelashwa.

Ukuba ne-vulvar intraepithelial neoplasia noma ukutheleleka kwe-HPV kungakhuphula ingozi yomdlavuza we-vulvar.

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 we-vulvar zifaka okulandelayo:

  • Ukuguga.
  • Ukuba nokutheleleka nge-human papillomavirus (HPV).
  • Ukuba ne-vulvar intraepithelial neoplasia (VIN).
  • Ukuba nomlando wezinsumpa zangasese.

Ezinye izinto ezingaba yingozi zibandakanya okulandelayo:

  • Ukuba nabalingani abaningi ocansini.
  • Ukuya ocansini okokuqala usemncane.
  • Ukuba nomlando wokuhlolwa okungajwayelekile kwe-Pap (Pap smears).

Izimpawu zomdlavuza we-vulvar zifaka ukopha noma ukulunywa endaweni ye-vulvar.

Umdlavuza we-Vulvar kaningi awubangeli izimpawu noma izimpawu zakuqala. Izimpawu nezimpawu zingabangelwa umdlavuza we-vulvar noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

  • Isigaxa noma ukukhula esithweni sangasese esibukeka njengentethe noma isilonda.
  • Ukulunywa endaweni ye-vulvar engapheli.
  • Ukopha akuhlobene nokuya esikhathini (izinkathi).
  • Ubuhlungu endaweni ye-vulvar.

Ukuhlolwa okuhlola imomozi kusetshenziselwa ukuthola umdlavuza we-vulvar.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

  • Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukubheka izimpawu ezijwayelekile zempilo, kufaka phakathi nokubheka imomozi yezimpawu zesifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.
  • Ukuhlolwa kwe-pelvic: Ukuhlolwa kwesitho sangasese sowesifazane, umlomo wesibeletho, isibeletho, amashubhu e-fallopian, ama-ovari, ne-rectum. Kufakwa i-speculum esithweni sangasese bese udokotela noma umhlengikazi ebheka esithweni sangasese kanye nomlomo wesibeletho ukuthola izimpawu zesifo. Kuvame ukwenziwa ukuhlolwa kwesibeletho sePap. Udokotela noma umhlengikazi uphinde afake umunwe owodwa noma emibili ethanjisiwe, efakwe igilavu ​​yesandla esisodwa esithweni sangasese bese ebeka esinye isandla phezu kwesisu esingezansi ukuze ezwe ubukhulu, ukuma, nokuma kwesibeletho namaqanda. Udokotela noma umhlengikazi uphinde afake umunwe othanjisiwe, ofakwe igilavu ​​ku-rectum ukuzwa izigaxa noma izindawo ezingejwayelekile.
Ukuhlolwa kwepelvic. Udokotela noma umhlengikazi ufaka umunwe owodwa noma emibili ethanjisiwe, efakwe igilavu ​​yesandla esisodwa esithweni sangasese bese ucindezela esiswini esingezansi ngesinye isandla. Lokhu kwenzelwa ukuzwa ubukhulu, ukuma, nokuma kwesibeletho namaqanda. Isitho sowesifazane sangasese, umlomo wesibeletho, amashubhu okuya emithanjeni, kanye nengxenyenamba iyahlolwa.
  • Ukuhlolwa kwe-Pap: Inqubo yokuqoqa amaseli ebusweni bomlomo wesibeletho nowesifazane. Ucezu lukakotini, ibhulashi, noma induku encane yokhuni kusetshenziselwa ukukhuhla ngobumnene amaseli omlomo wesibeletho nowesifazane. Amaseli abhekwa ngaphansi kwesibonakhulu ukuthola ukuthi awajwayelekile yini.
  • Ukuhlolwa kwe-human papillomavirus (HPV): Ukuhlolwa kwelabhorethri okusetshenziselwa ukuhlola i-DNA noma i-RNA ngezinhlobo ezithile zokutheleleka nge-HPV. Amaseli aqoqwa ku-vulva ne-DNA noma i-RNA emangqamuzaneni ayahlolwa ukuze kutholakale ukuthi ingabe ukutheleleka kubangelwa uhlobo lwe-papillomavirus yomuntu exhumene nomdlavuza we-vulvar. Lokhu kuhlolwa kungenziwa kusetshenziswa isampula lamaseli akhishwe ngesikhathi sokuhlolwa kwePap. Lokhu kuhlolwa kungenziwa futhi uma imiphumela yokuhlolwa kwe-Pap ikhombisa amaseli athile we-vulvar angajwayelekile.
  • I-Biopsy: Ukususwa kwamaseli noma izicubu esithweni sangasese ukuze zibukwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuze ahlole izimpawu zomdlavuza.
  • IColposcopy: Inqubo lapho kusetshenziswa khona i-colposcope (ithuluzi elikhanyisiwe, elikhulisayo) ukuhlola isitho sangasese sowesifazane nomlomo wesibeletho ezindaweni ezingejwayelekile. Amasampula amathishu angathathwa kusetshenziswa i-curette (insimbi emise okwe-spoon) noma ibhulashi futhi kuhlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zesifo.
  • 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-PET scan (i-positron emission tomography scan): Inqubo yokuthola amangqamuzana abulalayo omzimba emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.

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

Izinketho zokubikezela nokwelashwa zincike kokulandelayo:

  • Ukuthi umdlavuza ususabalele ezindaweni eziseduzane noma kwezinye izingxenye zomzimba.
  • Ukuthi umdlavuza ususabalele kuma-lymph node.
  • Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Izigaba ze-Vulvar Cancer

AMAPHUZU ASEMQOKA

  • Ngemuva kokutholakala komdlavuza we-vulvar, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asakaze ngaphakathi kwesitho sangasese noma kwezinye izingxenye zomzimba.
  • Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
  • Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.
  • Ku-vulvar intraepithelial neoplasia (VIN), amangqamuzana angajwayelekile atholakala ebusweni besikhumba se-vulvar.
  • Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-vulvar:
  • Isiteji I
  • Isigaba II
  • Isigaba III
  • Isigaba IV
  • Umdlavuza ophindaphindiwe we-vulvar ngumdlavuza ophindile (wabuya) ngemuva kokuba welashwe.

Ngemuva kokutholakala komdlavuza we-vulvar, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asakaze ngaphakathi kwesitho sangasese noma kwezinye izingxenye zomzimba.

Inqubo esetshenziswayo ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwesitho sangasese 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-cystoscopy: Inqubo yokubheka ngaphakathi kwesinye kanye nomchamo ukubheka izindawo ezingajwayelekile. I-cystoscope ifakwa nge-urethra iye esinyeni. I-cystoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa amasampula wezicubu, ahlolwe ngaphansi kuka-a ukuthola izimpawu zomdlavuza.
  • I-Proctoscopy: Inqubo yokubheka ngaphakathi kwe-rectum ne-anus ukuhlola izindawo ezingavamile, usebenzisa i-proctoscope. I-proctoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka ingaphakathi le-rectum ne-anus. Kungaba futhi nethuluzi lokususa amasampula wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • I-x-ray yesifuba: I-x-ray uhlobo lwensimbi yamandla engangena emzimbeni ifike kwifilimu, yenze isithombe sezindawo ezingaphakathi komzimba. Ukwenza umdlavuza we-vulvar, ama-x-ray angathathwa ezithweni nasemathanjeni ngaphakathi kwesifuba.
  • I-intravenous pyelogram (IVP): Uchungechunge lwama-x-ray wezinso, ama-ureters, nesinye ukuthola ukuthi umdlavuza ususabalele kulezi zitho. Idayi ehlukile ifakwa emthanjeni. Njengoba udayi wokuqhathanisa uhamba ngezinso, ama-ureters kanye nesinye, ama-x-ray ayathathwa ukubona ukuthi kukhona yini ukuvinjelwa. Le nqubo ibizwa nangokuthi i-intravenous urography.
  • I-Biopsy: Ukususwa kwamangqamuzana noma izicubu esinyeni noma engxenyeni ukuze zikwazi ukubukwa ngaphansi kwesibonakhulu ngudokotela wezifo ukuze ahlole izimpawu zomdlavuza, uma kusolwa ukuthi umdlavuza ususabalele lapho.

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

Ku-vulvar intraepithelial neoplasia (VIN), amangqamuzana angajwayelekile atholakala ebusweni besikhumba se-vulvar.

Lawa maseli angajwayelekile akuwona umdlavuza. I-Vulvar intraepithelial neoplasia (i-VIN) ingaba ngumdlavuza bese isakazeka izicubu eziseduze. I-VIN kwesinye isikhathi ibizwa ngesigaba 0 noma i-carcinoma in situ.

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-vulvar:

Isiteji I

Esigabeni I, umdlavuza wakhekile. Isimila sitholakala kuphela ku-vulva noma i-perineum (indawo ephakathi kwengxenyeni kanye nesitho sangasese sowesifazane). Isigaba I sihlukaniswe izigaba IA ne-IB.

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).
  • Esigabeni IA, isimila singamasentimitha ama-2 noma sincane futhi sisakaze imilimitha elingu-1 noma ngaphansi kwezicubu ze-vulva noma i-perineum. Umdlavuza awusabalalanga kuma-lymph node.
  • Esigabeni IB, isimila sikhulu kunamasentimitha ama-2 noma sisakaze ngaphezu kwamamilimitha ayi-1 kuzicubu ze-vulva noma i-perineum. Umdlavuza awusabalalanga kuma-lymph node.
Amamilimitha (mm). Iphoyinti elibukhali elicishe libe yi-1 mm, iphoyinti elisha lekhrayoni cishe lingu-2 mm, futhi i-eraser entsha yepensela icishe ibe yi-5 mm.

Isigaba II

Esigabeni II, isimila sinanoma yisiphi isayizi futhi sinabele engxenyeni engezansi yomchamo, engxenyeni engezansi yesitho sangasese sowesifazane, noma endunu. Umdlavuza awusabalalanga kuma-lymph node.

Isigaba III

Esigabeni III, isimila sinanoma yisiphi isayizi futhi kungenzeka ukuthi sisakaze engxenyeni engezansi yomchamo, engxenyeni engezansi yesitho sangasese sowesifazane, noma endunu. Umdlavuza usabalalele kolunye noma ngaphezulu ama-lymph node. Isigaba III sihlukaniswe izigaba IIIA, IIIB, kanye IIIC.

  • Esigabeni IIIA, umdlavuza utholakala kuma-lymph node ayi-1 noma ama-2 amancane kunamamilimitha amahlanu noma ku-lymph node eyodwa engamamilimitha amahlanu noma ngaphezulu.
  • Esigabeni IIIB, umdlavuza utholakala kuma-lymph node ama-2 noma ngaphezulu angama-millimitha ama-5 noma amakhulu, noma kuma-lymph node ama-3 noma ngaphezulu amancane kunamamilimitha amahlanu.
  • Esigabeni IIIC, umdlavuza utholakala kuma-lymph node futhi usabalalele engxenyeni engaphandle yama-lymph node.

Isigaba IV

Esigabeni IV, isimila sesisabalalele engxenyeni engenhla yomchamo, engxenyeni engenhla yesitho sangasese sowesifazane, noma kwezinye izingxenye zomzimba. Isigaba IV sihlukaniswe ngezigaba ze-IVA ne-IVB.

  • Esigabeni IVA:
  • umdlavuza usabalele emgqeni womchamo ongaphezulu, isitho sangaphezulu sangaphezulu, isinye, noma i-rectum, noma unamathele ethanjeni le-pelvic; noma
  • umdlavuza usabalalele kuma-lymph node aseduze futhi ama-lymph node awanyakazi noma akhe isilonda.
  • Esigabeni IVB, umdlavuza usabalalele kuma-lymph node ku-pelvis noma kwezinye izingxenye zomzimba.

Umdlavuza ophindaphindiwe we-vulvar ngumdlavuza ophindile (wabuya) ngemuva kokuba welashwe.

Umdlavuza ungabuyela esithweni sangasese noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

  • Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza we-vulvar.
  • Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:
  • Ukuhlinzwa
  • Ukwelashwa ngemisebe
  • Ukwelashwa ngamakhemikhali
  • I-Immunotherapy
  • Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
  • Ukwelashwa komdlavuza we-vulvar kungadala imiphumela emibi.
  • Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.
  • Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.
  • Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza we-vulvar.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza we-vulvar. 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 ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa kuyindlela yokwelashwa ejwayelekile kakhulu ye-vulvar intraepithelial neoplasia (VIN) nomdlavuza we-vulvar.

Enye yezinhlobo ezilandelayo zokuhlinzwa ingenziwa ukwelapha i-VIN:

  • Ukuhlukaniswa okuhlukile kwesilonda: Inqubo yokuhlinza ukususa i-lesion yokukhathazeka.
  • Ukudonswa kwendawo okubanzi: Inqubo yokuhlinza ukususa indawo yesikhumba ethintwe yi-VIN nezinye izicubu ezijwayelekile ezisizungezile.
  • Ukuhlinzwa nge-Laser: Inqubo yokuhlinza esebenzisa umsebe we-laser (umsebe omncane wokukhanya okukhulu) njengommese ukwenza ukusikeka ngaphandle kwegazi ezicutshini noma ukususa isilonda esingaphezulu njengesimila.
  • Isifiso sokuhlinzwa se-Ultrasound: Inqubo yokuhlinza yokwephula isimila sibe yizicucu ezincane kusetshenziswa ukudlidlizela okuhle kakhulu. Izingcezu ezincane zesimila ziyagezwa zisuswe ngokudonswa. Le nqubo idala ukulimala okuncane kwezicubu eziseduze.
  • I-Skinning vulvectomy: Isendlalelo esiphezulu sesikhumba se-vulvar lapho kutholakala khona i-VIN siyasuswa. Okuthathelwa esikhunjeni okuvela kwezinye izitho zomzimba kungadingeka ukumboza indawo lapho isikhumba sisuswe khona.

Inhloso yokuhlinzwa komdlavuza we-vulvar ukususa wonke umdlavuza ngaphandle kokulahlekelwa umsebenzi wezocansi wowesifazane. Enye yezinhlobo ezilandelayo zokuhlinzwa ingenziwa ukwelapha umdlavuza we-vulvar:

  • Ukuqothulwa kwendawo yonke: Inqubo yokuhlinza ukususa umdlavuza kanye nezinye izicubu ezivamile ezungeze umdlavuza.
  • Ukuqothulwa kwendawo okunamandla: Inqubo yokuhlinza ukususa umdlavuza nenqwaba yezicubu ezijwayelekile ezizungezile. Ama-lymph node aseduze emgodini nawo angasuswa.
  • I-Vulvectomy: Inqubo yokuhlinza ukususa ingxenye noma yonke isitho sangasese:
  • Kushintshwe i-radical vulvectomy: Ukuhlinzwa ukukhipha iningi le-vulva. Ama-lymph node aseduze nawo angasuswa.
  • I-Radical vulvectomy: Ukuhlinzwa ukususa yonke imomozi. Ama-lymph node aseduze nawo asuswa.
  • Ukuqina kwepelvic: Inqubo yokuhlinza ukususa ikholoni engezansi, i-rectum, nesinye. Umlomo wesibeletho, isitho sangasese sowesifazane, ama-ovari, nama-lymph node aseduze nawo ayasuswa. Ukuvulwa kokufakelwa (stoma) kwenzelwa umchamo nesitulo ukugeleza kusuka emzimbeni kuya esikhwameni sokuqoqa.

Ngemuva kokuthi udokotela awususe wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, ezinye iziguli zinganikezwa i-chemotherapy kanye / 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. Ukwelashwa kwemisebe yangaphandle isebenzisa umshini ongaphandle komzimba ukuthumela imisebe ngasendaweni yomzimba onomdlavuza.

Ukwelashwa kwemisebe yangaphandle kungasetshenziswa njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

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). I-topical chemotherapy yomdlavuza we-vulvar ingasetshenziswa esikhunjeni ukhilimu noma i-lotion. Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Bheka Izidakamizwa Kuvunyelwe Ukwelapha I-Vulvar 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. Lolu hlobo lokwelashwa komdlavuza lubizwa nangokuthi i-biotherapy noma i-biologic therapy.

I-Imiquimod iyisiguquli sokuphendula komzimba esetshenziselwa ukwelapha izilonda ze-vulvar futhi sisetshenziswa esikhumbeni kukhilimu.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa komdlavuza we-vulvar 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.

Kubalulekile ukuba nezivivinyo zokulandelela ezijwayelekile ukubheka umdlavuza we-vulvar ophindaphindiwe.

Ukwelashwa kwe-Vulvar Intraepithelial Neoplasia (VIN)

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

Ukwelashwa kwe-vulvar intraepithelial neoplasia (VIN) kungafaka okulandelayo:

  • Ukuhlinzwa kungaba okunye kwalokhu okulandelayo:
  • Ukukhishwa okuhlukile kwezilonda.
  • Ukusikwa okubanzi kwendawo.
  • Ukuhlinzwa kwe-Laser.
  • Isifiso sokuhlinzwa se-Ultrasound.
  • Isikhumba se-vulvectomy.
  • I-immunotherapy ene-imiquimod yama-topical.

Ukwelashwa Kwezigaba I no-II Umdlavuza we-Vulvar

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

Ukwelashwa komdlavuza wesigaba I-vulvar kanye nomdlavuza wesigaba II we-vulvar kungafaka okulandelayo:

  • Ukuhlinzwa (ukusikwa kwendawo okubanzi).
  • Ukuhlinzwa (ukusikwa kwendawo okunamandla ngokususwa kwama-lymph node ku-groin nasethangeni eliphezulu).
  • Ukuhlinzwa (i-radical vulvectomy eguquliwe noma i-radical vulvectomy ngokususwa kwama-lymph node ku-groin nasethangeni eliphezulu). Ukwelashwa ngemisebe kunganikezwa.
  • Ukuhlinzwa (ukusikeka okunamandla kwendawo nokususwa kwe-sentinel lymph node) kulandelwe ukwelashwa ngemisebe kwezinye izimo.
  • Ukwelashwa ngemisebe kukodwa.

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

Ukwelashwa kwe-Stage III Vulvar Cancer

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

Ukwelashwa komdlavuza we-vulvar wesigaba III kungafaka okulandelayo:

  • Ukuhlinzwa (i-radical vulvectomy eguquliwe noma i-radical vulvectomy ngokususwa kwama-lymph node ku-groin nasethangeni eliphezulu) noma ngaphandle kwemithi yokwelashwa ngemisebe.
  • Ukwelashwa ngemisebe noma i-chemotherapy ne-radiation therapy kulandelwa ukuhlinzwa.
  • Ukwelashwa ngemisebe noma ngaphandle kwamakhemikhali.

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

Ukwelashwa Kwe-Stage IVA Vulvar Cancer

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

Ukwelashwa komdlavuza wesigaba se-IVA vulvar kungafaka okulandelayo:

  • Ukuhlinzwa (i-radical vulvectomy noma i-pelvic exenteration).
  • Ukwelashwa nokuhlinzwa ngemisebe.
  • Ukwelashwa ngemisebe noma i-chemotherapy ne-radiation therapy kulandelwa ukuhlinzwa.
  • Ukwelashwa ngemisebe noma ngaphandle kwamakhemikhali.

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

Ukwelashwa kwe-Stage IVB Vulvar Cancer

Akukho ukwelashwa okujwayelekile komdlavuza wesigaba se-IVB vulvar. I-Chemotherapy iye yafundwa futhi ingasetshenziswa uma isiguli sikwazi ukuyibekezelela.

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 Ophindaphinda We-Vulvar

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

Ukwelashwa komdlavuza we-vulvar ophindaphindiwe kungafaka okulandelayo:

  • Ukuhlinzwa (ukusikwa kwendawo okubanzi) noma ngaphandle kwemithi yokwelashwa ngemisebe.
  • Ukuhlinzwa (i-radical vulvectomy kanye ne-pelvic exenteration).
  • I-Chemotherapy kanye ne-radiation therapy noma ngaphandle kokuhlinzwa.
  • Ukwelashwa ngemisebe noma ngaphandle kwamakhemikhali.
  • Ukwelashwa ngemisebe nokuhlinzwa.
  • Ukwelashwa ngemisebe njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

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-Vulvar

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana nomdlavuza we-vulvar, bona okulandelayo:

  • Ikhasi Lasekhaya Lomdlavuza weVulvar
  • Ama-Lasers ekwelashweni komdlavuza
  • Izidakamizwa Zivunyelwe Ukwelapha I-Vulvar Cancer
  • I-HPV neCancer
  • I-Computed Tomography (CT) Iskena Nomdlavuza
  • I-Immunotherapy Yokwelapha 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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