Uyini umlomo wesibeletho?
I-cervix itholakala engxenyeni engezansi yesibeletho, noma engxenyeni engenhla yegciwane. Leli gama elincanyana elibizwa ngokuthi umsele womlomo wesibeletho (noma umgogodla we-endocervical), ophuma emgodini kuya endaweni yangaphakathi yesibeletho. Ngokuvamile kuvaliwe ngokuqinile, kodwa kuvumela ukuba igazi ligeleke esibelethweni ngesikhathi sokuya esikhathini. Futhi ivumela futhi isidoda ukuba singene ngaphakathi uma ucansi. Ivula kakhulu kakhulu ngesikhathi sokubeletha. Ubuso be-cervix buhlanganiswe nohlaka lwamaseli. Kukhona nezinye izilonda ezincane emgqeni womsele womlomo wesibeletho okhiqiza i-mucus.
Yini umdlavuza ngokujwayelekile?
I-Cancer isifo samangqamuzana emzimbeni. Umzimba uqukethe izigidi zamaseli amancane. Kunezinhlobo ezahlukene zamaseli emzimbeni, futhi kukhona izinhlobo eziningi zomdlavuza ezivela ezinhlobonhlobo zamaseli. Zonke izinhlobo zomdlavuza zihlangene yiqiniso lokuthi amangqamuzana omdlavuza ajwayelekile futhi ukukhiqiza kwawo akupheli.
I-tumor ebulalayo iqukethe amangqamuzana omdlavuza aqhubeka nokwanda. Zihlasela izicubu zomakhelwane nezitho zomakhelwane, okwenza kube nomonakalo omkhulu. Izicubu ezimbi zingasakazeka kwezinye izingxenye zomzimba. Lokhu kwenzeka uma amanye amangqamuzana ehlukene nesifo sokuqala (esiyisisekelo) bese ufaka igazi noma i-lymph, futhi ngosizo lwabo kwezinye izingxenye zomzimba. Lawa maqembu amancane amangqamuzana angakwazi ukuphindaphinda izikhathi ezimbalwa ngokumelene nesizinda sezinhlamba "eziyisibili" (amametastases) engxenyeni eyodwa noma ngaphezulu zomzimba. Lezi zicubu ezincane zikhula, zihlasela futhi zilimaze izicubu eziseduze, zisakaze phambili.
Ezinye ze-khansela zinzima kunabanye. Ezinye zazo ziphathwa kangcono, ikakhulukazi uma ukuxilongwa kwenziwa ekuqaleni.
Ngakho-ke, umdlavuza awuwona ukuxilongwa okungaqondakali. Esikhathini ngasinye, kubalulekile ukwazi ukuthi impela umuthi womdlavuza ukhona, ukuthi ubukhulu be-tumor bube bunjani, nokuthi ngabe kunezibalo zokuthi zikhona yini. Lokhu kuzokuvumela ukuba uthole ulwazi oluthembekile mayelana nezinketho zokwelapha.
Uyini umdlavuza wesibeletho?
Kunezinhlobo ezimbili eziyinhloko zomdlavuza wesibeletho.
- I-squamous cell carcinoma yomlomo wesibeletho yiyona ejwayelekile kakhulu. Ivela emangqamuzaneni ekhanda elithinta umlomo wesibeletho. Ngokulandelayo, baba yingozi.
- I-adenocarcinoma yomlomo wesibeletho ayijwayelekile kakhulu. Ivela emangqamuzaneni amancane (amangqamuzana akhiqiza i-mucus) ngaphakathi komsele womlomo wesibeletho, okuba yingozi.
Zombili izinhlobo zitholwa futhi ziphathwa ngendlela efanayo. Ezimweni eziningi, umdlavuza womlomo wesibeletho uqala kwabesifazane eminyakeni engama-30-40. Kwezinye izimo - kulabo asebekhulile nabasencane.
Amacala amasha angaphezu kuka-100 000 omdlavuza wesibeletho atholakala njalo ngonyaka. Noma kunjalo, inani lezinkinga ezihlolwe liyancipha njalo ngonyaka. Lokhu kungenxa yokuthi umdlavuza womlomo wesibeletho ungavinjelwa ukuhlolwa okuvamile (smear) yomlomo wesibeletho - ukuhlaziywa okulula okudluliselwa esikhathini sethu ngabesifazane abaningi.
Kuyini ukuhlolwa kokuhlolwa kwesibeletho?
Abesifazane emhlabeni wonke banikezwa ukuhlolwa kokuhlola okuvamile. Phakathi nokuhlaziywa ngalunye, amanye amaseli athathwa emkhatsini wesibeletho. Lawa maseli athunyelwa ebhokisithri ukuze ahlole ngaphansi kwe-microscope. Ezivivinyweni eziningi, amaseli abukeka evamile. Kodwa ngezinye izikhathi kukhona i-dyskaryosis yomlomo wesibeletho. I-Dyskaryosis akuyona umdlavuza wesibeletho. Lokhu kusho ukuthi amanye amangqamuzana omlomo wesibeletho awavamile, kodwa awawona umdlavuza. Amaseli angajwayelekile angabizwa ngokuthi "ama-precancerous" noma amaseli dysplasia. Ngokuya ngesilinganiso sokungajwayelekile, amaseli womlomo wesibeletho ahlukaniswa ngokuthi:
- I-dyskaryosis elula. Lokhu kungukuthi kukhona izinguquko ezincane kuphela kumaseli. Ngezinye izikhathi lokhu kubizwa ngokuthi i-CIN 1. Lokhu kukhuluma nge-neoplasia ye-intraepithelial yomlomo wesibeletho.
- I-dyskaryosis ejwayelekile (noma i-CIN 2).
- I-dyskaryosis ejulile (noma i-CIN 3). Ngalesi sikhathi, amangqamuzana abukeka engavamile, kodwa angakabi nomdlavuza.
Ezimweni eziningi, amaseli "diskyroid" awaqhubekela phambili kumangqamuzana anomdlavuza. Kwezinye izimo, babuyela ekuphileni okuvamile. Kodwa-ke, kwezinye izimo, ngokuvamile eminyakeni eminingi kamuva, amangqamuzana angavamile ahlaselwa ngamangqamuzana anomdlavuza.
Uma unezinguquko ezingavamile kuphela (ushintsho oluncane noma i-CIN1), ungase uvele unikezwe ukuhlaziywa okunye okunye ngaphambi kwesikhathi - emva kwezinyanga ezimbalwa noma ngaphezulu. Ezimweni eziningi, amangqamuzana amaningana angavamile azobuyela ekusebenzeni okujwayelekile izinyanga ezimbalwa. Ukwelashwa kungenziwa uma i-anomaly iqhubeka. Kwabesifazane abanezinguquko ezingavamile noma ezibi kakhulu, ukuhlanzwa komlomo kusuka kumaseli "angavamile" kungenziwa ngaphambi kokuba kube umdlavuza.
Yini ebangela umdlavuza wesibeletho?
I-Cancer iqala ngeseli elilodwa. Kukholelwa ukuthi okuthile kuguqula izakhi ezithile zomzimba esitokisini. Lokhu kwenza iseli lingavamile futhi ukukhiqiza kwalo kuphelile. Endabeni yomdlavuza wesibeletho, umdlavuza uvela esitokisini esivele singavamile ekuqaleni. Ezimweni eziningi, amangqamuzana angajwayelekile angaphakathi emzimbeni eminyakeni embalwa ngaphambi kokuba aqale ukwanda futhi akhule abe yisifo somdlavuza. Ukuguqulwa kokuqala kwamaseli omlomo wesibeletho kubangelwa ukutheleleka nge-papillomavirus yomuntu.
I-human papillomavirus (HPV) nomdlavuza wesibeletho.
Iningi labesifazane abahlakulela umdlavuza womlomo wesibeletho banesandulela ngculaza ye-HPV ngesikhathi esithile empilweni yabo. Kunezinkinga eziningi zegciwane le-HPV. Abanye babo bahlotshaniswa nomdlavuza wesibeletho.
Kwamanye abesifazane, izinkinga zegciwane le-papilloma ezihlotshaniswa nomdlavuza wesibeletho zibonakala zithinta amangqamuzana afaka umlomo wesibeletho. Lokhu kubanika ithuba elingcono lokuba amangqamuzana angavamile, okuyinto kamuva (ngokuvamile eminyakeni eminingana kamuva) iphendukela amangqamuzana omdlavuza. Kodwa qaphela: iningi labesifazane abafakwe yizifo zegciwane le-papilloma abahlali nomdlavuza. Ezinganeni eziningi, amasosha omzimba aphethwe igciwane ngaphandle kokulimaza umzimba kancane. Kukhona inani elincane labesifazane ababhekene nalezi zinkinga zegciwane le-papilloma eliqhubeka nokuthuthukisa amangqamuzana angavamile, okuyinto kwezinye izimo eziqhubekela emdlalweni wesibeletho somlomo wesibeletho.
Inkinga yegciwane le-papilloma ihlotshaniswa nomdlavuza womlomo wesibeletho, futhi cishe njalo isandulela ngculaza kusuka kumuntu onegciwane. I-HPV ngokuvamile ayibangeli izimpawu. Ngakho-ke, awukwazi ukutshela ukuthi wena noma lowo ocansini naye otheleleke ngenye yalezi zinhlobo ze-papillomavirus yomuntu.
Njengamanje, kwenziwa ukuhlolwa ukuhlola imishanguzo eyenzelwe i-HPV. Uma ukutheleleka kwe-HPV kungavinjelwa ngemigomo, kungenzeka ukuthi ukuthuthukiswa komdlavuza womlomo wesibeletho kuzokuvimbela nayo.
Izinto ezandisa ingozi yokuba nomdlavuza womlomo wesibeletho.
Izinto ezandisa ingozi yomdlavuza wesibeletho zihlanganisa:
- Ukubhema. Amakhemikhali avela kugwayi angena egazini futhi angathinta isimo samangqamuzana kuwo wonke umzimba. Abesifazane ababhemayo bangase bahlushwa izifo kunabangabhemi. Okufanayo kusebenza kwamanye amagciwane, kuhlanganise nomdlavuza wesibeletho. Amakhemikhali ekubhemeni angathinta amasosha omzimba futhi ngezinye izindlela angenza umehluko obuncane emiphumeleni ye-HPV.
- Isisindo somzimba esiqinile. Isibonelo, abantu abanesifo sengculaza kanye nabantu abathatha imithi yokuzivikela banomngcipheko owengeziwe. Isivikelo somzimba sokuzivikela sisisiza ekuvikeleni i-papillomavirus yabantu, futhi kusiza ukubhubhisa amaseli abe "angavamile." Uma amasosha omzimba wakho engasebenzi ngokugcwele, awukwazi ukumelana nokutheleleka kwe-HPV nokuthuthukiswa kwamaseli angavamile, futhi unengozi enkulu yokuthuthukisa umdlavuza wesibeletho.
- Ukusetshenziswa kwamaphilisi okulawula ukubeletha iminyaka emihlanu noma ngaphezulu.
- Ngemuva kokuzalwa kwezingane ezinhlanu noma ngaphezulu.
- Imiphumela yangaphambilini yezifo ezihlukahlukene ezithathelwana ngocansi, njenge-chlamydia.
Ziyini izimpawu zomdlavuza wesibeletho?
Kungenzeka ukuthi awunayo izimpawu ekuqaleni, uma isisu sincane. Uma isisu sikhula, kakhulu ezimweni eziningi, isibonakaliso sokuqala ukuphuma kwegazi elingavamile, njengokuthi:
- Ukuhlwitha phakathi kwemijikelezo.
- Ukwehla emva kocansi.
- Noma yikuphi ukuphaphaza kwamagciwane kwabesifazane emva kokuya esikhathini.
Isiboniso sokuqala kwezinye izimo ukukhishwa kwamagciwane noma ubuhlungu kubulili.
Zonke izimpawu ezingenhla zingabangelwa yimibandela ehlukene. Kodwa uma uthola noma iyiphi yalezi zimpawu, kufanele ukhulume nalokhu nodokotela wakho. Ngokuhamba kwesikhathi, uma umdlavuza usakazeka kwezinye izingxenye zomzimba, ezinye izimpawu ezihlukahlukene zingase zithuthuke.
Umdlavuza wesibeletho utholakala kanjani?
Ukuqinisekiswa kokuxilongwa.
Udokotela uvame ukuhlola ukuvivinya ubulili uma unezimpawu ezingabonisa umdlavuza wesibeletho. Uma usola umdlavuza, ngokuvamile i-colposcopy izokwenziwa. Lokhu kuhlolisiswa okuningiliziwe komlomo wesibeletho. Ngenxa yalesi sivivinyo, isibuko sifakwa ngaphakathi kwesisu, ukuze umlomo wesibeletho uhlolwe ngokucophelela. Udokotela usebenzisa i-glass magnifying (colposcope) ukuhlola umlomo wesibeletho ngokuningiliziwe. Ukuhlolwa kuzothatha cishe imizuzu engu-15. Ku-colposcopy kuvame ukufakwa ucingo lwesicathulo sezinyosi zenhliziyo yesisu (i-biopsy). Isampula bese ihlolwe ngaphansi kwe-microscope ukuhlola ukutholakala kwamangqamuzana omdlavuza.
Ukuhlola ngesilinganiso nokusabalala komdlavuza.
Uma ukuxilongwa kwenziwa, khona-ke ucwaningo oluqhubekayo lungacelwa ukuba luhlole ukuthi umdlavuza usakaze kangakanani. Isibonelo, ukwenza i-CT, i-MRI, i-X-ray esifubeni, i-ultrasound, ukuhlolwa kwegazi, ucwaningo ngaphansi kwe-anesthesia yesisu, isambiso noma i-rectum. Lokhu kuhlolwa kubizwa ngokuthi "ukusungula izinga lomdlavuza". Inhloso yalo ukuthola ukuthi:
- Kungakanani isisu esiye sakhula, kungakhathaliseki ukuthi sithinte ezinye izitho eziseduze, njenge-vesilisa noma i-rectum.
- Kungakhathaliseki ukuthi umdlavuza usakaze ezindaweni zamakhansela zendawo.
- Kungakhathaliseki ukuthi umdlavuza usakaze kwezinye izingxenye zomzimba.
Okuningi kuxhomeke ekuhloleni kokuqala, kanye nemiphumela ye-biopsy. Isibonelo, i-biopsy ingabonisa ukuthi umdlavuza usesikhathini sokuqala futhi uhlala kuphela kumangqamuzana omzimba womlomo wesibeletho. Akunakwenzeka ukuthi uthole kabanzi, futhi akudingeki uhambe ngokusebenzisa ezinye izivivinyo eziningi. Kodwa-ke, uma umdlavuza ubonakala sengathi "unganakiwe" futhi mhlawumbe usakaze phambili - ukuhlolwa nokuhlolwa kungadingeka. Njengoba efunde isigaba somdlavuza, kulula ukuba odokotela banikeze izincomo ngezinketho ezihle kakhulu zokwelapha.
Izinketho zokwelapha umdlavuza wesibeletho.
Izinketho zokwelashwa ezingacatshangwa zihlanganisa ukuhlinzeka, ukwelapha imisebe, i-chemotherapy, noma inhlanganisela yalezi zonyango. Ukwelashwa kunconywa esimweni ngasinye futhi kuncike ezintweni ezihlukahlukene. Isibonelo, isiteleka somdlavuza (ubuningi besifo sikhuphukile nokuthi sisakazeka), kanye nempilo yakho yonke.
Kufanele uxoxisane ngokuningiliziwe kwakho ngokuningiliziwe nomchwepheshe ophethe icala lakho. Uzokwazi ukucacisa izinzuzo nezimo ezimbi zesimo sakho, izinga lokuphumelela, imiphumela emibi kanye neminye imininingwane mayelana nezinketho ezahlukene zokwelapha okwenziwe ngohlobo lwakho nesigaba somdlavuza.
Kufanele uxoxisane nodokotela ngenhloso yokwelapha. Isibonelo:
- Kwezinye izimo, ukwelashwa kuqondiswa ngokuqondile ekuqedeni umdlavuza. Umdlavuza womlomo wesibeletho ungaphulukiswa, ikakhulukazi uma ukwelashwa kusezigaba zokuqala zesifo. Odokotela bavame ukusebenzisa igama elithi "ukukhululwa" esikhundleni segama elithi "ukwelapha". Ukukhululwa kusho ukuthi abukho ubufakazi bomdlavuza ngemuva kokwelashwa. Uma "usethethelelwe" - uphulukiswa okwamanje. Nokho, kwezinye izimo, umdlavuza ubuya ngemva kwezinyanga noma iminyaka. Yingakho ngezinye izikhathi odokotela abafuni ukusebenzisa igama elithi "ukwelapha" lomdlavuza.
- Kwezinye izimo, ukwelashwa kuhloswe ukulawula umdlavuza. Uma ukwelashwa kungenakwenzeka, ngokuvamile kuvame ukunciphisa ukukhula nokusabalalisa komdlavuza ukuze kungaqhubeki ngokushesha. Lokhu kungakugcina ungenazo izimpawu isikhathi esithile.
- Kwezinye izimo, ukwelashwa kuhlose ukunciphisa izimpawu. Isibonelo, uma umdlavuza usufinyelele esiteji sokugcina, isiguli singase sidinge i-anesthesia noma ezinye izindlela zokwelapha ukusiza ukuqeda ubuhlungu nezinye izimpawu.
Ukuhlinzwa.
Ukuhlinzwa ukukhipha isisu (hysterectomy) kuyindlela ejwayelekile yokwelapha. Kwesinye isikhathi, uma umdlavuza usencane kakhulu, ungakwazi ukumane ususe ingxenye yentamo yesisulu somdlavuza ngaphandle kokukhipha isisu sonke.
Uma umdlavuza usakazekele kwezinye izitho, ukungenelela kokuhlinzwa kungasuswa kanye nezinye izindlela zokwelapha. Isibonelo, kwezinye izimo, lapho umdlavuza usakaze kwezinye izitho eziseduze, ukuhlinzeka okukhulu kungaba yinye inketho. Kulesi simo, kubalulekile ukususa umlomo wesibeletho kanye nesibindi ngokwayo, kodwa futhi izingxenye zezinhlaka ezingathinteka. Lokhu kuvame ukwanda kwesinye nesisindo.
Ngisho noma umdlavuza usesiteji sokugcina futhi awukwazi ukwelashwa, izindlela ezithile zokuhlinzwa zingasetshenziswa ukunciphisa izimpawu. Isibonelo, ukusiza ukuvinjelwa kwamathumbu noma umchamo, okubangelwa ukusakazeka komdlavuza.
Ukwelashwa kwamafutha.
Ukwelashwa kwezidakamizwa ukwelashwa okusebenzisa amandla aphezulu okugcoba ama-radiation agxile emathangeni omdlavuza. Ibulala amangqamuzana omdlavuza noma eyeka ukukhiqizwa kwawo. Ukwelashwa kwezidakamizwa kungasetshenziswa kuphela ezinyathelweni zokuqala zomdlavuza womlomo wesibeletho futhi kungase kube enye indlela yokuhlinzwa. Ngezigaba kamuva zomdlavuza, ukwelapha imishanguzo kungenziwa ngaphandle kwezinye izindlela zokwelapha.
Izinhlobo ezimbili zokwelapha imishanguzo zisetshenziselwa umdlavuza wesibeletho: zangaphandle nangaphakathi. Ezimweni eziningi, zombili izinhlobo zisetshenziswa.
- I-radiotherapy yangaphandle. Lapha imisebe iqondiswa kumangqamuzana omdlavuza avela ku-apparatus-emitter ekhethekile. Leli fomu ejwayelekile ye-radiotherapy, esetshenziselwa izinhlobo eziningi zomdlavuza.
- I-radiotherapy yangaphakathi (i-brachytherapy). Lokhu ukwelashwa kuhilela ukubeka umuthi omncane we-radioactive eduze kwesifo somdlavuza okwesikhashana bese usususa. Isikhundla saso sinqunywe ngesiswini.
Ngisho noma umdlavuza awukwazi ukwelashwa, ukwelapha imishanguzo kungenzeka okwamanje ukuze kunciphise izimpawu. Isibonelo, ukwelashwa kwama-radiation kungasetshenziswa ukunciphisa izicubu ezincane ezithuthuka kwezinye izingxenye zomzimba futhi zibangela ubuhlungu.
I-Chemotherapy.
I-Chemotherapy yindlela yokwelapha umdlavuza ngosizo lwemithi elwa nomdlavuza ebulala amangqamuzana omdlavuza noma ayeke ukukhiqiza. I-Chemotherapy inganikezwa ngaphandle kokuthola imishanguzo noma ukuhlinzwa kwezinye izimo ezithile.