Boka duku revarwere haambotombozivi kuti kenza yaro yakatanga sei
Kansa yepabonde. Chirwere cheprostate. Kanononi yeColon. Varwere vane kenza vanonyorwa zvichibva pakatanga kwezvakaipa zvavo. Iyi nhengo inoshanda chinangwa chaicho: chimwe chezvinhu zvinokosha zvikuru pakugadzirisa kusarudzwa kwehutano uye kufungidzira ndiko kwakabva kenza, iyo "primary tumor" site.
Asi kune vanenge vatatu kune 100 varwere vanorwara nekenza, nzvimbo yekutanga yekenza haina kuwanikwa.
Izvi zvinoreva kuti murwere anopa zviratidzo zvitsva (zvakadai sokurwadziwa kana kubuda ropa kana bundu) kana kuti kushaya muviri (hakuchina zviratidzo) asi kunowanikwa pakuongorora muviri, nguva dzose X-ray, kana chimwe chidzidzo kuti uve nekenza. Chii chinonyatsoonekwa kuti chirwere chekenza - chirwere (kana zvipembenene) zvakakura zvichibva kumasero akafamba kubva kune zvino-asingagoni kuzivikanwa nekenza huru uye akapinda mune imwe nzvimbo (kana nzvimbo) mukati memuviri. Mastasis inogadzirwa, kenza inoonekwa, uye tsvakurudzo inokonzerwa nechirwere chepakutanga, tsanangudzo yakazara inowanzoenderana zvikuru nezvidzidzo zvekuongorora mafungiro emagetsi sezvakaita CT scans. Asi chepakutanga chiremara chinonyangadza hachiwaniki. Uye tipei kuti tinoratidzira vose varwere vekenza, boka iri rakasiyana rinonzi rinotambura ne "kenza yevasingazivikanwi inotangira (CUP)."
Saka, zvinokwanisika sei kuti urege kuwana chirwere chekutanga chekenza? Mushure mezvose, kunyange kune varwere vane kenza yakatova nemasikirwo kune dzimwe nzvimbo (zvakadai seropa, mapapu, bone, uye / kana uropi), mhedzisiro yemasisitasi, chiremera chekutanga, inowanzo yakakura uye inogara ichitsanangurwa sehukuru pane mammamiro, chigunun'una pane kuongorora kweprostate, kukura kunowanika panguva yekolonoscopy.
Saka chiremara chikuru chinonyangarika sei? Pane zvinotsanangurwa zvinogona kuitika. Zvimwe zvikamu zvepamuviri zvinogona kuwedzera ropa razvo uye kufa kana kukanganisa nekukura kusingaoneki, kunyangarika apo metastase yekenza iri kure yakaramba ichikura. Mune vamwe varwere, chirwere chisingaverengeki chinonyanya kuonekwa chinogona kubudiswa chirwere panguva yekurapa chirwere chemuviri.
Semuenzaniso, Chakudya neDrug Administration munguva pfupi yapfuura chakaodza mwoyo kushandiswa kwechidiki chinoputika ("laparoscopic") shanduro yekushandisa inoshandiswa mukushanda kwe hysterectomy (kubviswa kwechibereko) kune zvipembenene zvinotapira zvinonzi fibroids. Icho chinopera kuti, asingazivikanwe kune ani panguva iyoyo, mumwe wevakadzi makumi maviri nevana vari kushaya hysterectomy nokuda kwechirwere chisina kenza chinokonzera chirwere chekuberekwa chinonzi sarcoma, uye kushandiswa kwechirongwa ichi chinoshandiswa (morcellator) chinogona kuparadzira masero ekenza asingatauriki , kunoparadza murwere.
Asi zvine hanya here kana kenza yekutanga isingawaniki? Zvinosuruvarisa kuti vaCUP varwere, zvinokosha zvikuru. Zvakare, mhedzisiro chaiye yekenza yemumwe munhu inokosha zvikuru maererano nemasarudzo ekurapa uye kufungidzira (kusanganisira kupona). Nokudaro, nepo huwandu hwekenza huchibva mumhando dzakasiyana dzematukisi (somuenzaniso, mazamu, utachiona, prostate, uye mamwe makondombera ose anosimbiswa kubva mumakumbo akaoma), pane zvakakosha uye zvechiremba zvinokonzera kusiyana kwemasvini pakati pezvinyorwa zvemavara (mazamu nehutachiona, muenzaniso).
Muchirwere cheCUP, tinotanga nekugadzirisa masero emukenza mune rimwe remapoka mana kubva pane maitiro avo uye mamwe majekiseni: Adenocarcinoma (glandular tissues; inenge 60% yeCUP mhosva); Zvisina Kusiyaniswa Kusiyana kweCarcinoma (ine hutsinye hunokonzera kenza dzisingatsanangiri zvakajeka chero mhando dzemhando dzemaviri; anenge 20% kusvika 30% emhosva dzeCUP); Squamous Carcinoma (inobhadhara maitiro mashoma anodarika 10% eCUP; yakafanana neganda nemasero akavhara dzimwe nhengo); uye Neuroendocrine Carcinoma (zvisingawanzo; masero akafanana neaya anopararira mumuviri wose unobudisa mahomoni).
Uye nhasi, isu tinogonawo kuisa masero emukenza kuburikidza nemitambo yakawanda yemayerosiyumu, kutsvaga kuburikidza neDNA yavo yezvinyorwa zvezvinyorwa zvinowedzera zvakajeka kuti ivo chaivo vanobva kupi.
Neine ruzivo rwakawanda pamusoro pechipfuva chemajeri sezvinobvira, vanachiremba vanachiremba vanoita manyore akadzidziswa sekurapa kurapwa kunowanzokonzera kenza uye kunobatsira murwere weCUP. Zvinosuruvarisa, sezvo CUP netsanangudzo ine chirwere chemasastatic (spread), uye ichitaura kuti hatizivi nechokwadi chaiyo chaiyo mutevedzeri wemurwere weCUP, kunyanya kufungidzira kwakaipa kwazvo. Kupona kwemaMedhia (hafu inopona kwenguva refu nehafu) kwevarwere veCUP isingapera mwedzi mina; kune rimwe gore mushure mekuongororwa, varwere vashoma vanopfuura 25% vari kurarama, uye pamakore mashanu, pasi pe10%.
Saka chii chaunofanira kuita kana iwe kana munhu waunoda akawanikwa ane kenza, asi kunyanya kuuraya hakugone kuonekwa? Nenguva isipi tungamira kutarisira kwechirwere chekenza huru (chirwere chekenza chichizivikanwa munyika yose kana chivako chikuru chezvidzidzo) .CUP inowanzoshata yakadikanwa inoda ruzivo, unyanzvi, uye teknolojia yekuongorora uye kubata, uye kereke dzinochengetwa dzizere nezvakawanda, unyanzvi, uye teknolojia. Sangano rakadaro richaita zvidzidzo zvekufungidzira zvemashupiramu uye mapurojekiti ekuedza kuedza kuziva chiremera chikuru uye kutarisira kurapa kwakakosha. Uye kana kuongororwa kweCUP kusina kuchinjwa, masangano ekenza anopa mukana wakawanda wehutano hwakanaka uye hunokosha, kutarisira tsitsi kune murwere weCUP uye vadiwa vavo.