Chiberekero ndi chiyani?
Chibelekerochi chili pamunsi mwa chiberekero, kapena kumtunda kwa chiberekero. Iyi ndi ndime yopapatiza yomwe imatchedwa khola lachiberekero (kapena chingwe chotchedwa endocervical canal), chomwe chimachokera mukazi mpaka mkatikati mwa chiberekero. Kawirikawiri imatsekedwa mwamphamvu, koma imalola magazi kutuluka m'chiberekero pa nthawi ya kusamba. Komanso zimalola kuti umuna ufike mkati ngati mutagonana. Amatsegula kwambiri panthawi yobereka. Pamwamba pa chiberekero muli ndi maselo osanjikiza. Palinso zing'onoting'ono zing'onozing'ono m'kamwa mwa khola lachiberekero lomwe limatulutsa ntchentche.
Kodi khansa ndi yani?
Khansara ndi matenda a maselo m'thupi. Thupi liri ndi mamiliyoni a maselo ang'onoang'ono. Pali mitundu yosiyanasiyana ya maselo m'thupi, ndipo pali mitundu yambiri ya khansara yomwe imachokera ku mitundu yosiyanasiyana ya maselo. Mitundu yonse ya khansa imagwirizanitsidwa ndi kuti maselo a khansa ndi achilendo ndipo kubereka kwawo sikungatheke.
Chotupa choipa chimakhala ndi maselo a kansa omwe akuchuluka. Amayambitsa ziwalo ndi ziwalo zoyandikana nazo, zomwe zimapweteka kwambiri. Matenda owopsa angathe kufalikira kumadera ena a thupi. Izi zimachitika ngati maselo ena amasiyana ndi choyamba (choyamba) chotupa ndikulowa mwazi kapena mitsempha, ndi kuthandizira ku ziwalo zina za thupi. Magulu ang'onoang'ono a maselo amatha kuchulukitsa kangapo kutsogolo kwa zotupa "zamphindi" (metastases) m'thupi limodzi kapena ziwalo zina. Ziphuphu izi zimakula, zimathamanga ndi kuwononga minofu yapafupi, ikufalikirabe.
Ena khansa ndi oopsa kuposa ena. Zina mwazirombozi zimachiritsidwa mosavuta, makamaka ngati matendawa amapangidwa msanga.
Choncho, khansara sichidziwika bwino. Pazochitika zonse, ndikofunikira kudziŵa mtundu wa khansara womwe ulipo, kukula kwa chotupacho, komanso ngati pali metastases. Izi zidzakuthandizani kupeza zambiri zokhudzana ndi chithandizo cha mankhwala.
Kodi khansara ya chiberekero ndi chiyani?
Pali mitundu iwiri ikuluikulu ya kansa ya pachibelekero.
- Squamous cell carcinoma ya chiberekero ndilofala kwambiri. Amayamba kuchokera m'maselo a nembanemba omwe amaphimba chiberekero. Pambuyo pake, zimakhala zoipa.
- Cervical adenocarcinoma ndi yochepa kwambiri. Amachokera ku maselo ofiirira (maselo omwe amachititsa chiphalala) mkati mwa ngalande ya chiberekero, yomwe imakhala yoipa kwambiri.
Mitundu yonseyi imapezeka ndi kuchitidwa chimodzimodzi. Kawirikawiri, khansara ya chiberekero ikukula mwazimayi zaka 30 mpaka 40. Nthawi zina - okalamba ndi atsikana.
Matenda oposa 100,000 atsopano a kansa ya pachibelekero amapezeka chaka ndi chaka padziko lapansi. Ngakhale zili choncho, chiwerengero cha matenda omwe amapezeka amachepetsa chaka chilichonse. Izi zili choncho chifukwa khansara ya chiberekero imaletsedwa ndi kuyang'ana nthawi zonse (kachilombo ka HIV).
Kodi chiyeso choyang'anira chikhomo ndi chiyani?
Azimayi kuzungulira dziko lapansi amapatsidwa mayesero owonetsera nthawi zonse. Pa kafukufuku uliwonse, maselo ena amachotsedwa pamwamba pa chiberekero. Maselo ameneŵa amatumizidwa ku labotale kuti afufuze pa microscope. Mu mayesero ambiri, maselo amawoneka bwino. Koma nthawizina pali cervical dyskaryosis. Dyskaryosis si khansara ya chiberekero. Izi zimangotanthauza kuti maselo ena a chiberekero ndi achilendo, koma samakhala ndi khansa. Maselo osadziwika nthawi zina amatchedwa "precancerous" maselo kapena selo dysplasia. Malingana ndi mlingo wa kusayenerera, maselo a chiberekero amagawidwa monga:
- Zosavuta dyskaryosis. Izi ndi pamene pali kusintha kochepa m'maselo. Nthawi zina izi zimatchedwa CIN 1. Izi zimayankhula za intraepithelial neoplasia ya chiberekero.
- Dyskaryosis yochepa (kapena CIN 2).
- Deep dyskaryosis (kapena CIN 3). Panthawiyi, maselo amawoneka osalimba, koma akadalibe khansa.
Nthaŵi zambiri, maselo a diskyroid sapita ku maselo a khansa. Nthawi zina, amabwerera ku moyo wabwino. Komabe, nthawi zina, zaka zambiri pambuyo pake, maselo osadziwika amatha kukhala maselo a khansa.
Ngati muli ndi kusintha kochepa kokha (mild dyskaryosis kapena CIN1), mukhoza kungoperekedwanso kafukufuku wina kwambiri kuposa kale - patatha miyezi ingapo kapena apo. Nthaŵi zambiri, maselo osadziwika angabwererenso kuntchito kwa miyezi ingapo. Chithandizo chingaperekedwe ngati vutoli likupitirirabe. Kwa amayi omwe ali ndi kusintha kosasintha kapena koopsa, kuyeretsa kwa chiberekero kuchokera ku "maselo osazolowereka" kungapangidwe asanakhale khansara.
Kodi chimayambitsa khansara ya chiberekero?
Khansa imayamba ndi selo limodzi. Zimakhulupirira kuti chinachake chimasintha majini ena mu selo. Izi zimapangitsa selo kukhala losazolowereka komanso kubereka kwake sikungatheke. Pankhani ya khansara ya chiberekero, khansara imayamba kuchokera ku selo yomwe ili kale yachilendo poyamba. Nthaŵi zambiri, maselo osadziwika ali m'thupi zaka zingapo asanayambe kuchulukana ndikukula kukhala chotupa cha khansa. Kusintha kwa maselo oyambirira a chiberekero kawirikawiri kumayambitsidwa ndi matenda ndi papillomavirus yaumunthu.
Mankhwala a papillomavirus (HPV) ndi khansara ya chiberekero.
Amayi ambiri omwe amakhala ndi khansa ya chiberekero amakhala ndi kachilombo koyambitsa matenda a HPV pa nthawi ina. Pali matenda ambiri a HPV. Ena mwa iwo ali ndi khansa ya pachibelekero.
Kwa amayi ena, matenda a papilloma omwe ali ndi khansa ya pachibelekero amawoneka kuti amakhudza maselo omwe ali pachibelekero. Izi zimawapatsa mwayi wabwino kukhala maselo osadziwika, omwe amatha (patapita zaka zingapo pambuyo pake) kukhala maselo a khansa. Koma samverani: Amayi ambiri omwe ali ndi kachilomboka kameneka pamtenda wa papilloma samakhala ndi khansa. M'matenda ambiri, chitetezo cha mthupi chimayambanso ndi kachilombo kosavulaza thupi. Pali amayi owerengeka okha omwe ali ndi matendawa a kachilombo ka papilloma omwe amapitiriza kukhala ndi maselo osadziwika, omwe nthawi zina amapita ku khansara ya chiberekero.
Matenda a papilloma amagwiritsidwa ntchito ndi khansara ya chiberekero, ndipo nthawi zambiri nthawi zambiri ndi opatsirana pogonana kuchokera kwa munthu wodwala matenda. HPV kawirikawiri siyimayambitsa zizindikiro. Choncho, simungadziwe ngati inu kapena amene munagonana nawo muli ndi vuto limodzi la papillomavirus ya munthu.
Pakali pano, akuyezetsa mayeso kuti ayesetse katemera omwe apangidwa chifukwa cha HPV. Ngati matenda a HPV angathe kupezedwa ndi katemera, ndiye kuti chitukuko cha khansara ya chiberekero chidzachititsanso.
Zomwe zimawonjezera chiopsezo cha khansa ya chiberekero.
Zomwe zimawonjezera chiopsezo cha khansara ya chiberekero ndi izi:
- Kusuta. Mankhwala ochokera kwa ndudu amalowa m'magazi ndipo amakhudza momwe maselo amathandizira thupi lonse. Akazi osuta amavutika kwambiri ndi matenda kusiyana ndi osasuta. Zomwezo zimagwiranso ntchito kwa khansa zina, kuphatikizapo khansara ya chiberekero. Mankhwala ochokera ku kusuta angakhudze chitetezo cha mthupi ndipo mwanjira zina zimakulepheretsani kugonjetsa zotsatira za HPV.
- Kufooka kwa chitetezo cha mthupi. Mwachitsanzo, anthu omwe ali ndi Edzi komanso anthu omwe amatenga ma immunosuppressants ali ndi chiopsezo chachikulu. Chitetezo cha mthupi chimateteza kuteteza papillomavirus yaumunthu, komanso kumathandizira kuwononga maselo omwe amakhala "osazolowereka." Ngati chitetezo chanu cha mthupi sichitha kugwira ntchito mwathunthu, simungathe kulimbana ndi matenda a HPV komanso kukula kwa maselo osadziwika, ndipo muli ndi chiopsezo chachikulu chokhala ndi khansa ya pachibelekero.
- Kugwiritsa ntchito mapiritsi oletsa kubereka kwa zaka zisanu kapena kuposerapo.
- Pambuyo pa kubadwa kwa ana asanu kapena kuposerapo.
- Zotsatira za matenda osiyanasiyana opatsirana pogonana, monga chlamydia.
Kodi zizindikiro za khansara ya chiberekero ndi chiyani?
Mwina simungakhale ndi zizindikiro poyamba, pamene chotupacho n'chochepa. Pamene chotupacho chikukula, nthawi zambiri, chizindikiro choyamba ndi magazi osadziwika, monga:
- Kusuntha pakati pakati pa maselo.
- Kusuta pambuyo pa kugonana.
- Magazi amodzi mwa amayi amatha kusamba.
Chizindikiro choyambirira m'mayesero ena ndi kumaliseche kwa amayi kapena kupweteka mu kugonana.
Zonsezi zikhoza kuchitidwa ndi zikhalidwe zosiyanasiyana. Koma ngati mutakumana ndi zizindikiro izi, muyenera kukambirana ndi dokotala wanu. Pakapita nthawi, ngati khansara imafalikira kumbali zina za thupi, zizindikiro zina zingathe kukhalanso.
Kodi khansa ya pachilombo imapezeka bwanji?
Umboni wa matendawa.
Kawirikawiri dokotala amayamba kugonana ngati muli ndi zizindikiro zomwe zingasonyeze kuti khansa ya pachibelekero. Ngati mukuganiza kuti ndi khansara, kawirikawiri colposcopy idzachitidwa. Izi ndizofukufuku wambiri wa chiberekero. Pachiyeso ichi, galasi imalowetsedwa mu chiberekero, kotero kuti chiberekero chikhoza kufufuzidwa mosamala. Dokotala amagwiritsa ntchito galasi lamakono (colposcope) kuti afufuze chiberekero mwatsatanetsatane. Kuyesa kumatenga pafupi mphindi 15. Pa colposcopy kawirikawiri mpanda wa chikopa cha chiberekero (biopsy) wapangidwa. Chitsanzocho chimayang'aniridwa ndi microscope kuti muone ngati pali maselo a khansa.
Kuunika kwa kukula ndi kufalikira kwa khansa.
Ngati matendawa apangidwa, ndiye kuti kufufuza kwina kungapemphedwe kuyesa kuchuluka kwa khansara. Mwachitsanzo, kupanga CT, MRI, chifuwa cha X-ray, ultrasound, kuyesera magazi, kufufuza pansi pa mankhwala oopsa a chiberekero, chikhodzodzo kapena kachilombo. Kufufuza kumeneku kumatchedwa "kukhazikitsa digiri ya khansa". Cholinga chake ndicho kudziwa kuti:
- Kodi chotupacho chakula bwanji, kaya chakhudza ziwalo zina zapafupi, monga chikhodzodzo kapena kachilomboka.
- Kaya khansara yayamba kufalikira ku maselo am'deralo.
- Kaya khansara yayamba kufalikira kumbali zina za thupi.
Zambiri zimadalira kuunika koyambirira, komanso zotsatira za zochitikazo. Mwachitsanzo, chiwonetserochi chingasonyeze kuti khansara ili pachiyambi kwambiri ndipo imakhalabe m'maselo apachiberekero a chiberekero. N'zosatheka kuti ukhale wochulukirapo, ndipo simukuyenera kuyesedwa mayeso ena ambiri. Komabe, ngati khansa ikuwoneka kuti "yanyalanyazidwa" ndipo mwina ikufalikirabe - mayeso ndi mayesero angafunike. Pambuyo pophunzira chithandizo cha khansa, n'zosavuta kuti madokotala apereke malangizo pa njira zabwino kwambiri zothetsera matenda.
Zosankha zothandizira khansa ya pachibelekero.
Njira zothandizira zomwe zingaganizidwe monga opaleshoni, mankhwala othandizidwa ndi ma radiation, chemotherapy, kapena kuphatikiza kwa mankhwalawa. Chithandizo chilimbikitsidwa nthawi iliyonse ndipo zimadalira zinthu zosiyanasiyana. Mwachitsanzo, siteji ya khansa (kuchuluka kwa chotupa chawonjezeka komanso kaya chikufalikira), komanso thanzi lanu lonse.
Muyenera kufotokozera mwatsatanetsatane zomwe mukupeza ndi katswiri yemwe akuyang'anira mlandu wanu. Adzatha kudziwa ubwino ndi zovuta za mkhalidwe wanu, kuchuluka kwa zotsatira zake, zotsatira zowonjezereka za njira zosiyanasiyana zochiza chithandizo cha mtundu wanu.
Muyeneranso kukambirana ndi katswiri payekha. Mwachitsanzo:
- Nthawi zina, mankhwala amatsogoleredwa mwachindunji pakuchotsa khansa. Khansara ya chiberekero ikhoza kuchiritsidwa, makamaka ngati mankhwalawa ali pachiyambi cha matendawa. Madokotala amagwiritsa ntchito mawu oti "kukhululukira" m'malo mwa mawu oti "machiritso". Kukhululukidwa kumatanthauza kuti palibe umboni wa khansara pambuyo pa chithandizo. Ngati muli "mukukhululukira" - mumachiritsidwa panthawiyi. Komabe, nthawi zina, khansa imabwerera pambuyo pa miyezi kapena zaka. Ndi chifukwa chake madokotala nthawi zina samafuna kugwiritsa ntchito mawu oti "machiritso" a khansa.
- Nthawi zina, mankhwala amawongolera kugonjetsa khansa. Ngati mankhwala sangatheke, nthawi zambiri zimatheka kuchepetsa kukula ndi kufalikira kwa khansara kuti zisapite msanga msanga. Izi zingakulepheretseni kukhala ndi zizindikiro kwa nthawi ndithu.
- Nthawi zina, mankhwalawa amathandiza kuchepetsa zizindikiro. Mwachitsanzo, ngati khansara yatha kale, wodwalayo angafunike kupweteka kapena mankhwala ena kuti athetse ululu ndi zizindikiro zina.
Opaleshoni.
Kuchita opaleshoni kuchotsa chiberekero (hysterectomy) ndi njira yodziwika yothandizira. Nthawi zina, pamene khansara ili pachiyambi, mungathe kuchotsa mbali imodzi ya khosi la khansa popanda kuchotsa chiberekero chonse.
Ngati khansara yayamba kufalikira kwa ziwalo zina, njira zothandizira opaleshoni zingakhoze kulandiridwa pamodzi ndi zina zothandizira. Mwachitsanzo, nthawi zina, khansara ikafalikira ku ziwalo zina zapafupi, opaleshoni yaikulu ingakhale njira imodzi. Pankhaniyi, m'pofunika kuchotsa chibelekero komanso chiberekero chokha, komanso ziwalo za ziwalo zomwe zingakhudzidwe. Izi nthawi zambiri zimakhala chikhodzodzo ndi / kapena chikhodzodzo.
Ngakhale khansayo ili pamapeto ndipo sichizachiritsidwa, njira zina zopaleshoni zingagwiritsidwe ntchito kuthetsa zizindikiro. Mwachitsanzo, pofuna kuthetsa kutseka kwa matumbo kapena tsamba la mkodzo, lomwe linayambitsidwa ndi kufalikira kwa khansa.
Kuchiza ma ARV.
Mankhwalawa ndi mankhwala omwe amagwiritsa ntchito mphamvu zapamwamba zowonongeka ndi matenda a khansa. Amapha maselo a khansa kapena amasiya kubereka. Mankhwala othandizira mazira angagwiritsidwe ntchito pamayambiriro a khansa ya pachibelekero ndipo angakhale njira ina yopaleshoni. Kwa magawo ena a khansa, mankhwala opatsirana pogwiritsa ntchito mankhwalawa angaperekedwe kupatula njira zina zamankhwala.
Mitundu iwiri ya mankhwala opatsirana pogwiritsa ntchito mankhwala a khansa yapakhungu: kunja ndi mkati. Nthaŵi zambiri, mitundu yonseyi imagwiritsidwa ntchito.
- Kunja kwa radiotherapy. Apa ma radiation amatumizidwa ku maselo a khansa kuchokera ku chipangizo chapadera. Iyi ndiyo njira yofala ya radiotherapy, yomwe imagwiritsidwa ntchito mu mitundu yambiri ya khansa.
- Internal radiotherapy (brachytherapy). Chithandizochi chimaphatikizapo kuyika kachilombo kamene kamakhala pafupi ndi khansa ya kanseri kwa kanthawi kenaka ndikuchotsa. Udindo wake umakhazikitsidwa kudzera mukazi.
Ngakhale khansayo sichichiritsidwa, mankhwala opatsirana pogwiritsa ntchito mankhwalawa akhoza kupitilirabe kuchepetsa zizindikiro. Mwachitsanzo, mankhwalawa akhoza kugwiritsidwa ntchito kuchepetsa kupweteka kwachiwiri komwe kumachitika m'madera ena a thupi ndikupweteka.
Chemotherapy.
Chemotherapy ndi mankhwala a khansa mothandizidwa ndi mankhwala oletsa khansa omwe amapha maselo a kansa kapena kuleka kubereka kwawo. Chemotherapy ingaperekedwe kuwonjezera pa mankhwala opangira ma radiation kapena opaleshoni nthawi zina.