Umhlaza wePancreas: Ukuqonda, ukuxilongwa, kunye noKhetho loNyango 

Umhlaza wePancreas sisifo apho iiseli ezinobungozi zenza kwizicubu ze-pancreas, ilungu elibekwe emva kwesisu. Ukufunyaniswa kwangoko kubalulekile kunyango olusebenzayo. Eli nqaku libonelela ngesishwankathelo esibanzi umhlaza wepancreas, egubungela oonobangela bayo, iimpawu, ukuxilongwa, kunye neendlela ezahlukeneyo zonyango, kubandakanywa ukhetho lotyando, ichemotherapy, unyango lwemitha, kunye nonyango olujoliswe kuyo.

Ukuqonda Umhlaza wePancreas

Udakada lidlala elidlala indima ebalulekileyo ekucoleni nasekulawuleni iswekile esegazini. Ivelisa ii-enzymes ezinceda ukuqhekeza ukutya kunye namahomoni afana ne-insulin elawula amanqanaba eglucose. Umhlaza wePancreas kwenzeka xa iiseli kudakada zikhula ngokungalawulekiyo, zenza ithumba. Ezi thumba zinokuphazamisana nomsebenzi oqhelekileyo we-pancreas kwaye zisasazeke kwamanye amalungu omzimba.

Iintlobo ze Umhlaza wePancreas

Olona hlobo luqhelekileyo lwe umhlaza wepancreas yi-adenocarcinoma, ephuma kwiiseli ze-exocrine ezivelisa i-enzymes zokugaya. Iindidi ezinqabileyo ziquka ii-neuroendocrine tumors (NETs), eziphuhla kwiiseli ezivelisa ihomoni. I-NETs zihlala zine-prognosis engcono kune-adenocarcinomas. IZiko loPhando loMhlaza laseShandong Baofa ligxile kuphando lonyango lweentlobo ezahlukeneyo zomhlaza, kubandakanywa iinguqu ezinqabileyo ezifana namathumba e-neuroendocrine.

Imiba yoMngcipheko we Umhlaza wePancreas

Ziliqela izinto ezinokonyusa umngcipheko wokukhula umhlaza wepancreas, kuquka:

• Ukutshaya: Ukutshaya ngumngcipheko obalulekileyo, ukonyusa umngcipheko kabini ukuya kathathu.
• Ukutyeba ngokugqithisileyo: Ukutyeba kakhulu okanye ukutyeba kunxulunyaniswa nomngcipheko ophezulu.
• Isifo seswekile: Abantu abanesifo seswekile, ngakumbi uhlobo lwesi-2, banomngcipheko owongeziweyo.
• I-Pancreatitis engapheliyo: Ukuvuvukala kwexesha elide le-pancreas kunokunyusa umngcipheko.
• Imbali yoSapho: Imbali yosapho lwe umhlaza wepancreas okanye ii-syndromes ezithile zofuzo zinokunyusa umngcipheko.
• Ubudala: Umngcipheko uyanda ngokukhula, kwaye iimeko ezininzi zifunyaniswa emva kweminyaka engama-60.
• I-Genetic Syndromes ezithile: Iimeko ezifana ne-hereditary pancreatitis, i-Lynch syndrome, kunye nokuguqulwa kwe-BRCA.

Ukuqaphela iimpawu ze Umhlaza wePancreas

Kwinqanaba layo lokuqala, umhlaza wepancreas kaninzi ayibangeli iimpawu ezibonakalayo. Njengoko i-tumor ikhula, inokukhokelela ekubeni:

• Ijaundice: Ulusu kunye namehlo luba tyheli, oludla ngokubangelwa lithumba elivale umjelo wenyongo.
• Ubuhlungu besisu: Intlungu engaphezulu kwesisu enokuthi ikhuphe ngasemva.
• Ukunciphisa Ubunzima: Ukulahlekelwa ubunzima obungachazwanga.
• Ukulahlekelwa ngumdla: Ukuziva uhluthi ngokukhawuleza okanye ungafuni ukutya.
• I-nausea kunye nokugabha: Kubangelwa lithumba elicinezela isisu.
• Utshintsho kwimikhwa yamathumbu: Urhudo okanye ukuqhina.
• Isifo seswekile: Isifo seswekile esiqala ngokutsha okanye kunzima ukulawula isifo seswekile esele sikhona.

Ukuxilonga Umhlaza wePancreas

Ukuba umhlaza wepancreas kurhanelwa, iimvavanyo ezininzi zinokwenziwa ukuze kuqinisekiswe ukuxilongwa kunye nokumisela inqanaba lomhlaza. Olu vavanyo lungabandakanya:

• Uvavanyo loMzimba kunye neMbali: Ugqirha uya kukubuza malunga neempawu zakho, imbali yezonyango, kunye nezinto ezinobungozi.
• Uvavanyo lomfanekiso:
  • I-CT Scan: Ibonelela ngemifanekiso ecacileyo ye-pancreas kunye namalungu ajikelezileyo.
  • I-MRI: Isebenzisa imagnethi ukwenza imifanekiso ye-pancreas.
  • I-Endoscopic Ultrasound (EUS): Isebenzisa i-endoscope kunye ne-ultrasound probe ukuze ibone i-pancreas kwaye ifumane iisampuli zezicubu.
• I-Biopsy: Isampuli yethishu ithathwa kwi-pancreas kwaye ihlolwe phantsi kwe-microscope ukuqinisekisa ubukho beeseli zomhlaza. Oku kunokwenziwa ngexesha le-EUS okanye utyando.
• Uvavanyo lwegazi: Uvavanyo lwegazi lunokulinganisa amanqanaba ezinto ezithile, ezifana ne-CA 19-9, enokuthi iphakanyiswe kubantu umhlaza wepancreas. Nangona kunjalo, ezi mvavanyo azisoloko zichanekile kwaye zinokuphakanyiswa kwezinye iimeko.

Iinketho zonyango ze Umhlaza wePancreas

Unyango lwe umhlaza wepancreas kuxhomekeke kwinqanaba kunye nendawo yomhlaza, kunye nempilo yonke yesigulane. Ukhetho lungabandakanya:

Utyando

Utyando lolona nyango lunokufumaneka kwakhona umhlaza wepancreas, oku kuthetha ukuba ithumba linokususwa ngokupheleleyo. Uhlobo lotyando luxhomekeke kwindawo yethumba:

• Inkqubo ye-Whipple (Pancreaticoduodenectomy): Olu tyando olunzima lubandakanya ukususa intloko ye-pancreas, inxalenye yamathumbu amancinci, i-gallbladder, kunye nenxalenye ye-bile duct. Ngokuqhelekileyo isetyenziselwa amathumba kwintloko ye-pancreas.
• I-Distal Pancreatectomy: Olu tyando lubandakanya ukususa umsila we-pancreas, kwaye ngamanye amaxesha udaka. Isetyenziselwa amathumba kumsila we-pancreas.
• I-Pancreatectomy iyonke: Oku kubandakanya ukususa i-pancreas yonke, into enqabileyo eyenziwa ngenxa yempembelelo ebalulekileyo yokugaya kunye nokulawula iswekile yegazi.

Unyango ngamachiza

I-Chemotherapy isebenzisa amayeza ukubulala iiseli zomhlaza. Ingasetyenziswa phambi okanye emva kotyando, okanye njengonyango oluphambili oluphambili umhlaza wepancreas. Amachiza aqhelekileyo e-chemotherapy asetyenziselwa ukunyanga umhlaza wepancreas ziquka i-gemcitabine, i-paclitaxel, kunye ne-fluorouracil (i-5-FU).

Unyango ngemitha

Unyango ngemitha isebenzisa imitha ephezulu yamandla ukubulala iiseli zomhlaza. Ingasetyenziselwa ukucutha amathumba phambi kotyando, ukubulala naziphi na iiseli zomhlaza eziseleyo emva kotyando, okanye ukukhulula iimpawu zokuhambela phambili umhlaza wepancreas. Unyango lwemitha yemitha yangaphandle lolona hlobo luqhelekileyo lonyango lwemitha olusetyenziselwa umhlaza wepancreas.

Unyango ekujoliswe kulo

Amachiza onyango ekujoliswe kuwo ajolise kwiimolekyuli ezithile ezibandakanyekayo ekukhuleni kweeseli zomhlaza kunye nokuphila. La machiza anokusetyenziswa kwiintlobo ezithile ze umhlaza wepancreas ezineenguqu ezithile zemfuza. Ngokomzekelo, i-olaparib yi-PARP inhibitor enokuthi isetyenziswe kwizigulane ezinokuguqulwa kwe-BRCA.

Immunotherapy

I-Immunotherapy inceda amajoni omzimba ukulwa nomhlaza. Ayisetyenziswa ngokuqhelekileyo umhlaza wepancreas kodwa iphandwa kulingo lwezonyango. Iziyobisi ze-Immunotherapy ezifana ne-pembrolizumab (Keytruda) zinokuba luncedo kwiimeko ezinqabileyo ze-MSI-high umhlaza wepancreas.

Ukhathalelo lwePalliative

Ukhathalelo lwePalliative lujolise ekudambiseni iimpawu kunye nokuphucula umgangatho wobomi babantu abahambele phambili umhlaza wepancreas. Isenokuquka ukulawula iintlungu, inkxaso yesondlo, kunye nenkxaso yeemvakalelo. Ukhathalelo lwePalliative lunokunikwa nakweliphi na inqanaba umhlaza wepancreas.

Ukuhlala kunye Umhlaza wePancreas

Ukuhlala kunye umhlaza wepancreas kunokuba lucelomngeni, ngokwasemzimbeni nangokweemvakalelo. Kubalulekile ukuba nenkqubo yenkxaso eyomeleleyo, kuquka usapho, abahlobo, kunye nabasebenzi bezempilo. I-Shandong Baofa Cancer Research Institute ibonelela ngolwazi kunye neendlela zonyango ezinokubakho, nceda udibane nogqirha wakho. Amaqela enkxaso kunye neengcebiso zinokuba luncedo ekujonganeni nemingeni ye umhlaza wepancreas.

Inkxaso yesondlo nayo ibalulekile kubantu abanengxaki umhlaza wepancreas. Udakada lunendima ebalulekileyo ekucoleni ukutya, yaye unyango ludla ngokuchaphazela amandla okwetyisa ukutya kakuhle. Ukusebenza kunye ne-dietitian ebhalisiweyo kunokuncedisa ukulawula imiba yokugaya kunye nokuqinisekisa isondlo esaneleyo.

Uqikelelo lwe Umhlaza wePancreas

Iprognosis ye umhlaza wepancreas iyahluka ngokuxhomekeke kwinqanaba lomhlaza, impilo yesigulane ngokubanzi, kunye nonyango olufunyenweyo. Ukufunyaniswa kwangoko kunye nonyango lubalulekile ekuphuculeni amathuba okuphila. Ngokutsho kwe-American Cancer Society, izinga lokusinda le-5 leminyaka yendawo umhlaza wepancreas imalunga nama-44%, ngelixa izinga lokusinda leminyaka emi-5 kwabaphambili umhlaza wepancreas eye yasasazeka kwizitho ezikude malunga ne-3%. [1]

Iimvavanyo zeklinikhi ze Umhlaza wePancreas

Ulingo lwezonyango luphononongo lophando oluphanda unyango olutsha lwalo umhlaza wepancreas. Ukuthatha inxaxheba kulingo lwezonyango kunokubonelela ngofikelelo kunyango oluphambili olungekafumaneki ngokubanzi. Ukuba unomdla wokufunda ngakumbi malunga nolingo lwezonyango lwe umhlaza wepancreas, thetha nogqirha wakho okanye ukhangele iimvavanyo kwiwebhusayithi yeNational Cancer Institute. [2]

Isishwankathelo

Umhlaza wePancreas sisifo esiyingozi esifuna ukuxilongwa ngokukhawuleza kunye nonyango. Ukuqonda izinto ezinobungozi, iimpawu, kunye nokhetho lonyango lunokunceda abantu benze izigqibo ezinolwazi malunga nokukhathalela kwabo. Uphando oluqhubekayo kunye nokuqhubela phambili kunyango luphucula imbonakalo yabantu abane umhlaza wepancreas.

Iinkcukacha-manani kunye nolwazi olungundoqo

[1] Umbutho womhlaza waseMelika: https://www.cancer.org/cancer/types/pancreatic-cancer/detection-diagnosis-staging/survival-rates.html

[2] Iziko leSizwe loMhlaza: https://www.cancer.gov/about-cancer/treatment/clinical-trials