Ukwelashwa Komdlavuza We-pancreatic: Umhlahlandlela Ophelele 

Ukwelashwa komdlavuza we-pancreatic izinketho zincike esiteji nendawo yomdlavuza, kanye nempilo yonke yesiguli. Ukwelashwa okujwayelekile kuhlanganisa ukuhlinzwa, i-chemotherapy, ukwelashwa ngemisebe, nokwelashwa okuhlosiwe. Ngokuvamile, inhlanganisela yalezi zindlela isetshenziselwa ukuzuza umphumela omuhle kakhulu. Ukuqonda lezi zinketho kubalulekile ekwenzeni izinqumo unolwazi.

Ukuqonda Umdlavuza We-Pancreatic

I-pancreas iyisitho esitholakala ngemuva kwesisu esidlala indima ebalulekile ekugayeni ukudla nasekulawuleni ushukela wegazi. Umdlavuza we-pancreatic kwenzeka lapho amangqamuzana kumanyikwe ekhula ngokungalawuleki, akhe isimila. Kunezinhlobo ezimbili eziyinhloko ze umdlavuza we-pancreatic: i-adenocarcinoma (uhlobo oluvame kakhulu) kanye nezimila ze-neuroendocrine (PNETs).

Izingozi Zomdlavuza wePancreatic

Ziningana izici ezingandisa ingozi yokuthuthuka umdlavuza we-pancreatic, okuhlanganisa:

• Ukubhema
• Isifo sikashukela
• Ukukhuluphala ngokweqile
• I-pancreatitis engapheli
• Umlando womndeni we umdlavuza we-pancreatic
• Ama-syndromes athile ofuzo

Izimpawu ze-Pancreatic Cancer

Ezigabeni zokuqala, umdlavuza we-pancreatic ngokuvamile ayinazo izimpawu eziphawulekayo. Njengoba umdlavuza ukhula, izimpawu zingase zihlanganisa:

• Ubuhlungu besisu
• I-Jaundice (isikhumba namehlo aphuzi)
• Ukuncipha kwesisindo
• Ukulahlekelwa ukudla
• Isicanucanu nokuhlanza
• Ukushintsha kwemikhuba yamathumbu
• Isifo sikashukela esisanda kuqala

Ukuxilongwa Kwe-Pancreatic Cancer

Uma umdlavuza we-pancreatic kusolwa, udokotela uzokwenza ukuhlolwa ngokomzimba futhi ahlele ukuhlolwa okuhlukahlukene, okuhlanganisa:

• Ukuhlolwa kwegazi: Ukuhlola ukusebenza kwesibindi nezimpawu zesimila.
• Ukuhlolwa kwesithombe: Okufana ne-CT scan, i-MRI scan, ne-endoscopic ultrasound (EUS), ukuze ubone ngeso lengqondo amanyikwe nezakhiwo ezizungezile.
• I-Biopsy: Ukuqinisekisa ukuxilongwa nokunquma uhlobo lwe umdlavuza we-pancreatic.

Izinketho Zokwelashwa Kwe-Cancer Pancreatic

Ukwelashwa kwe umdlavuza we-pancreatic kuncike ezicini eziningana, okuhlanganisa isigaba somdlavuza, indawo yawo, kanye nempilo yonke yesiguli. Izinketho zokwelashwa eziyinhloko zichazwe ngezansi. I-Shandong Baofa Cancer Research Institute edumile inikeza ukunakekelwa okuphelele komdlavuza; ungakwazi funda okwengeziwe lapha mayelana nendlela yabo.

Ukuhlinzwa

Ukuhlinzwa kuvame ukuba wukwelashwa komugqa wokuqala umdlavuza we-pancreatic uma isimila sisendaweni futhi singasakazeki kwezinye izitho. Izinqubo ezihlukene zokuhlinzwa zingasetshenziswa kuye ngendawo yesimila:

• Inqubo ye-Whipple (pancreaticoduodenectomy): Lokhu kuhilela ukukhipha ikhanda le-pancreas, ingxenye yamathumbu amancane, i-gallbladder, nengxenye ye-bile duct.
• I-Distal pancreatectomy: Lokhu kuhilela ukususa umsila we-pancreas futhi kungase kuhlanganise nobende.
• I-pancreatectomy ephelele: Lokhu kuhilela ukukhipha wonke amanyikwe, ubende, inyongo, ingxenye yesisu, kanye nengxenye yamathumbu amancane. Lokhu akuvamile.

Ukuthi isimila singasuswa ngempumelelo kuncike endaweni kanye nesiteji saso. Lokhu kuyisici esibalulekile ekunqumeni izinketho zokwelapha. Ubuchwepheshe bokuhlinzwa bungaba nomthelela omkhulu emiphumeleni, kwenze izikhungo ezifana neShandong Baofa Cancer Research Institute zibe yizinsiza ezibalulekile ezigulini.

I-Chemotherapy

I-Chemotherapy isebenzisa izidakamizwa ukubulala amangqamuzana omdlavuza. Ingase isetshenziswe ngaphambi kokuhlinzwa (i-neoadjuvant chemotherapy), ngemva kokuhlinzwa (i-adjuvant chemotherapy), noma njengokwelashwa okuyinhloko kwezinga eliphezulu. umdlavuza we-pancreatic. Imithi ejwayelekile ye-chemotherapy esetshenziselwa ukwelapha umdlavuza we-pancreatic zihlanganisa:

• Gemcitabine
• I-FOLFIRINOX (inhlanganisela ye-fluorouracil, leucovorin, irinotecan, ne-oxaliplatin)
• I-Abraxane (izinhlayiya eziboshwe ngamaprotheni e-paclitaxel)

Ukwelashwa ngamakhemikhali kungabangela imiphumela engemihle, njengokucanuzela kwenhliziyo, ukuhlanza, ukukhathala nokulahlekelwa izinwele. Le miphumela engemihle ingalawuleka ngemithi nokunakekelwa okusekelayo.

Ukwelapha Ngemisebe

Ukwelashwa ngemisebe kusebenzisa imisebe enamandla amakhulu ukubulala amangqamuzana omdlavuza. Ingasetshenziswa ngaphambi kokuhlinzwa, ngemva kokuhlinzwa, noma njengokwelashwa okuyinhloko umdlavuza we-pancreatic. Izinhlobo zokwelashwa ngemisebe zihlanganisa:

• Ukwelashwa ngemisebe yangaphandle (EBRT): Imisebe ihanjiswa emshinini ongaphandle komzimba.
• I-Brachytherapy: Imbewu enemisebe ifakwa ngqo ngaphakathi noma eduze kwesimila.

Ukwelashwa ngemisebe kungabangela imiphumela engemihle, njengokuluma kwesikhumba, ukukhathala, nesicanucanu.

Ukwelapha Okuhlosiwe

Ukwelashwa okuhlosiwe kusebenzisa izidakamizwa eziqondise ama-molecule athile abandakanyeka ekukhuleni kweseli lomdlavuza kanye nokuphila. Izibonelo zezindlela zokwelapha ezihlosiwe ezisetshenziselwa ukwelapha umdlavuza we-pancreatic zihlanganisa:

• I-Erlotinib: Iqondise i-epidermal growth factor receptor (EGFR).
• I-Olaparib: Iqondise i-enzyme ye-PARP ezigulini ezinezinguquko ze-BRCA.

I-Immunotherapy

I-Immunotherapy isiza amasosha akho omzimba ukulwa nomdlavuza. Ngokuvamile ayisetshenziswa njengokwelashwa komugqa wokuqala umdlavuza we-pancreatic kodwa kungase kube inketho ezimweni ezithile. I-Pembrolizumab (Keytruda) iyisidakamizwa se-immunotherapy esingase sisetshenziselwe umdlavuza we-pancreatic iziguli ezinezinguquko ezithile zofuzo.

I-Palliative Care

Ukunakekelwa kwe-Palliative kugxile ekudambiseni izimpawu kanye nokwenza ngcono izinga lempilo yeziguli ezinezifo ezimbi kakhulu, njenge umdlavuza we-pancreatic. Ukunakekelwa kwe-palliative kungabandakanya ukuphathwa kobuhlungu, ukwesekwa okunomsoco, nokusekelwa ngokomzwelo.

Izigaba Zomdlavuza We-pancreatic kanye Nezindlela Zokwelashwa

Umdlavuza we-pancreatic kuhlelwa ukuze kunqunywe izinga lomdlavuza kanye nezinqumo zokwelashwa eziqondisayo. Izigaba zisukela esigabeni 0 (umdlavuza usendaweni) kuye esigabeni IV (umdlavuza we-metastatic). Ithebula elilandelayo lifingqa izindlela zokwelapha zesigaba ngasinye:

Ukuphila Nomdlavuza Wamanyikwe

Ukuhlala ne umdlavuza we-pancreatic kungaba inselele, kodwa kunezinsiza ezitholakalayo zokusiza iziguli kanye nemindeni yazo ukuba zibhekane nazo. Amaqembu okusekela, ukwelulekwa, nezinhlelo zemfundo zinganikeza usizo olubalulekile. Ukugcina indlela yokuphila enempilo, kuhlanganise nokudla okulinganiselayo nokuzivocavoca njalo, kungathuthukisa izinga lempilo.

Iqhaza Lezilingo Zomtholampilo

Izivivinyo zemitholampilo ziyizifundo zocwaningo ezihlola ezintsha ukwelashwa komdlavuza we-pancreatic izindlela. Ukubamba iqhaza ocwaningweni lomtholampilo kungase kunikeze ukufinyelela kumakhambi asezingeni eliphezulu futhi kube nengxenye ekuthuthukisweni kokunakekelwa komdlavuza. Iziguli ezinentshisekelo ekuhlolweni kwemitholampilo kufanele zixoxe ngalokho okungenzeka nethimba lazo lokunakekelwa kwezempilo.

Isiphetho

Ukwelashwa komdlavuza we-pancreatic iyinkimbinkimbi futhi idinga indlela ehlukahlukene. Ukuqonda izinketho zokwelashwa ezitholakalayo, izigaba, kanye nezinsiza zokunakekela ezisekelayo kunganikeza iziguli amandla okwenza izinqumo ezinolwazi futhi zithuthukise imiphumela yazo. Hlala uthintana nomhlinzeki wakho wokunakekelwa kwezempilo ukuze unqume indlela yokwelashwa engcono kakhulu yesimo sakho esithile. Nethimba elizinikele eShandong Baofa Cancer Research Institute, iziguli ziqinisekile ukuthi zizonakekelwa ngozwelo nangobuchwepheshe.

Ukuzihlangula: Lesi sihloko sinikeza ulwazi olujwayelekile mayelana ukwelashwa komdlavuza we-pancreatic futhi akufanele kubhekwe njengeseluleko sezokwelapha. Hlala uthintana nochwepheshe bezempilo abaqeqeshiwe ukuze uthole ukuxilongwa kanye nezincomo zokwelashwa.

Izithenjwa:

1. I-National Cancer Institute. I-Pancreatic Cancer Treatment (PDQ?)–Inguqulo Yesiguli
2. I-American Cancer Society. Mayelana Nomdlavuza We-pancreatic