Kenza yeropa haina kujairika muUnited States asi inowanikwa pasi rose nekuda kwezvipingamupinyi zvakadai sekusava nechirwere chepachipatara B uye hepititis C kutapukirwa uye aflatoxin kubuda. Zviratidzo zvinogona kusanganisira jaundice (kuchenesa kweganda), kurwadziwa mumumusoro kumusoro, bundu rebandauko remakumbo, uye kuora kurasikirwa. Vanachiremba vanoongorora chirwere ichocho vachishandisa kuenzanisa kwekuongorora zviratidzo uye kuongorora ropa.
Zvichienderana nehukuru hwechirwere, kusarudzwa kunogona kusanganisira kubviswa kwechirwere, chiropa chekushandura, chinotarisirwa kurapwa, chemotherapy, uye dzimwe nguva remishonga inonzi radiation.
Chirwere chechiropa chinomuka muchiropa, nhengo iri pasi pembambo dzako dziri pasi kurutivi rworudyi rwemuviri wako. Zvakakosha kusiyanisa kenza yepamusoro yeropa (hepatocellular carcinoma) uye bile duct chirwere (cholangiocarcinoma) kubva mumatumbu anotanga kune dzimwe nzvimbo dzomuviri uye anopararira kuchiropa (chiropa metastases). Chiropa chinonzi metastases chinonyanya kuwanzana kupfuura chepachiropa chechiropa uye chinorapwa nenzira iyo kenza yepamusoro (yakadai semukenza wemapapu kana kenza yemvere) inobatwa, pane nzira iyo kenza yepamusoro yechiropa inobatwa.
Mabasa echiropa anokosha kuziva kuti unotarisa zviratidzo zvinogona kuitika zvechirwere. Chiropa chinotamba basa mukudzivisa zvinhu, kuchengetedza bheri kuti ibatsire mukudya uye kuita mahomoni anokosha mukugadzirwa kwemasero matsvuku eropa.
Mukuwedzera kune mararamiro ataurwa pamusoro apa, pane maitiro mashoma evanhu vane kenza yeropa. Mamwe mashoma aya anosanganisira hepatoblastoma, chimiro chisingawanzo kenza yevana, uye angiosarcoma yechiropa. Kuongorora uku kuchakurukura zvikuru pamusana pekenza yeropa yechiropa uye chirwere chedu chendaneti.
Zviratidzo
Zviratidzo zvekenza zvechiropa hazvishamisi muzvikamu zvekutanga zvechirwere kunze kwekuti chironda chacho chiri pedyo neimwe ye-bile ducts uye chinokonzera kugadziriswa (ane zviratidzo zvakafanana nehondo yehondo).
Zviratidzo zvinogona kusanganisira:
- Pain in right right upper abdomen
- Muviri uri mudumbu rakarurama (iri pasi pemibvu dzako kana kuti inogona kuderera)
- Kurwadziwa kwemafudzi ekurudyi
- Jaundice , kuputika kwechivara kweganda uye vatsvene vemaziso
- Pale kana chichena chigaro
- Mvura yakasviba
- Kuchenesa zvakanyanya
- Ascites , kuvaka-fluid mudumbu
- Fever (101 degrees kana yakakwirira iyo inogara kwemazuva mashoma pasina zviratidzo zvakajeka zvehutachiona)
- Unintentional kurasikirwa kwekurema pasina kuchinja kukuru mukudya kana maitiro
- Zviratidzo zvisingaoneki zvakadai sokurasikirwa kwechido, kuneta, uye pfungwa yakawanda yekusanyarara
Zvinokonzera uye Zviitiko Zvengozi
Hatina chokwadi chaicho chinokonzera chirwere ichi, kunyange tichiziva nezvezviitiko zvakasiyana-siyana zvinokonzera kenza yeropa . Zvizhinji zvezviitiko izvi zvinokonzera kukonzera (cirrhosis) yechiropa, kunyange zvazvo kenza yeropa inogonawo kukura pasina cirrhosis.
Inonyanya kuisa njodzi yekenza yeropa ndeimwe yemhando yehepatitis. Pamwe chete, hepatitis B uye hepatitis C zvinofungidzirwa kuti ndizvo zvinokonzera kupoteredza 85 muzana yekenza yeropa mukati rese. Zvimwe zvezviitiko zvinopinza zvinosanganisira:
- Doro rinoshandisa uye kusvuta: Doro rinoshandiswa doro rinoshandiswa (zvinopfuura 3 zvinwiwa pazuva) zvinonyatsobatanidzwa nekuvandudzika kwechirhosis, uye zvinogonawo kukonzera njodzi yekenza yeropa. Kusvuta kunoratidzikawo kunokonzera njodzi, kunyanya kana ichibatanidzwa nedzimwe njodzi dzinokonzerwa nehepatitis B.
- Nhoroondo dzemhuri uye zvirwere zvepabonde: Kana uine nhengo yemhuri ine kenza yeropa, njodzi yako yakareba kudarika mavhareji. Dambudziko racho rinowedzerawo kune avo vane zvirwere zvepabonde zvakadai sa hemochromatosis uye chirwere cheWilson.
- Mishonga: Mishonga inowedzera njodzi yekenza yeropa inosanganisira primary sclerosing cholangitis, primary biliary cirrhosis, isiri iyo inodhaka mafuta mafuta echiropa , uye chirwere cheshuga.
- Aflatoxin exposure: Kazhinji muUnited States, asi inowanikwa munyika yose, kufanana neaflatoxins-inxinesi yakabudiswa nefungi inokura pamakwenzi asina kuchengetwa nemiti-inokonzerwa nekenza yeropa.
Kuziva
Avo vane zviratidzo zvekenza yechiropa kana kuti zvipingamupinyi zvinokonzera kuti chirwere chacho chive chichifanira kuona chiremba wavo. Chiremba anogona kutora nhoroondo yakanyatsocherechedza nekuita kuongorora mumuviri. Kune vamwe, kuongorora miedzo kunogona kufungwa. Zvichienderana nehuongorori, kuongororwa kweropa rekuongorora nekufungidzira kunogona kuitwawo.
- Mavharesi uye miedzo: Basa reRopa (rakadai seshupenzi chekuedza kuongorora ), hepatitis panel, uye tumor markers inowanzotanga matanho ekuongorora chirwere cheropa. Chimwe chiedza chaiyo, alpha-fetoprotein tumor marker test (AFP), inogona kurairwa kuvhara zvirwere zvechiropa.
- Kufananidza: Muedzo wokutanga wekufungidzira unowanzoitwa unonzi ultrasound. Dzimwe mimwe miedzo inogona kubatsira pakuongorora inosanganisira MRI neT CT scans. Chiratidzo chechiropa chinogona kukurudzirwa zvakare.
- Nyuchi: Kusiyana nehuwandu hwekenza, kuongororwa kwekenza yeropa kunowanzogadzirwa zvichienderana nekufungidzira kwekufungidzira pane kungofanana nehupopi. Bhiopsy haigoni kudiwa kunze kwekukakosha kunzwisisa ma molecular maitiro echirwere, zvakadai sechirwere chetachiona.
Kurapa
Maitiro ekurapa anowanikwa nekenza yeropa anobva pachirwere chechirwere, hutano hwako hwose, nezvimwe zvakawanda. Kurapa kunosvika mumisasa miviri:
Mishonga Inorapwa
Izvi zvinobata masero emukenza pose paanoitika uye ndiyo inonyanya kusarudzwa yekenza yepamusoro yeropa.
Zvimwe zvinosanganisira:
- Chemotherapy: Kune mikana yakasiyana-siyana yemakemikrasira inodhaka inogona kupiwa nokuda kwekenza yeropa. Chemotherapy inoshanda nekurwisa masero mashoma muviri. Zvinosuruvarisa, kune masero mashoma mumuviri anokamhanya nokukurumidza zvakare, izvo zvinoita kuti zvive nemigumisiro yakajeka yemakemotherapy, akadai sekushaya bvudzi uye kuwedzerwa ngozi yehutachiona. Chemoembolization ndiyo nzira iyo chemotherapy inopiwa zvakananga mune arteri huru (transarterial) inopinda muchiropa. Chemoembolization inogona kushandiswa semushonga mukuru, asi inoshandiswawo kuedza kunonoka kukura kwechiremera apo munhu ari kumirira kuwedzerwa kwechiropa.
- Targeted T herapy: Targeted therapy drugs inopesana nekemotherapy mune kuti "inotarisa" imwe nzira munzira yekukura kwekenza yesero. Nexavar (sorafenib), Lenvima (lenvatinib), uye Sivorga (regorafenib) vose vanovandudza kupona uye iye zvino vari kurapa kwakakwana kune vanhu vane kenza yepamusoro yeropa.
Local Therapies
Izvi zvinobata kenza apo inotangira. Zvisarudzo zvingafungidzirwa zvinosanganisira:
- Chikamu chinokonzera hepatectomy: Ichi ndicho chokubviswa kwechirwere chekenza uye zvimwe zvipembenene zvakapoteredza. Izvi zvingava sarudzo yezviremara zviduku zviduku (zvisingasviki masendimita mashanu paupamhi), zvichienderana nenzvimbo yavo.
- Chiropa chokuputika: Chiropa chinorwara chinobviswa uye chinotsiviwa nechikamu kana chiropa chose chakarembera. Izvi zvingava sarudzo yakanaka kune avo vane chirwere chakakura kana avo vakaderedza chiropa kusakundikana asi kune imwe nzira mune hutano hwakanaka.
- Radiation therapy: Izvi zvingasanganisira kunze kwemaharare radiation therapy (kurapa nzvimbo huru yebundu, kazhinji kuderedza zviratidzo kana kuwedzera hupenyu, kwete kuporesa tsvina); muviri we stereotactic radiotherapy, kana SBRT (uchishandisa mizinga yakakura yemirairo panzvimbo shoma yezvigunwe kuti ibvise chiremera); kana brachytherapy (kuisa radioactive inowira muchiropa).
- Radiofrequency ablation (RFA): Uku ndiko kushandiswa kwepurogiramu ine magetsi mashoma anoparadza kenza yemukenza.
- Cryotherapy: Izvi zvinosanganisira kupisa hutachiona hutachiona.
- Inokonzerwa neEthanol injection: Izvi zvinosanganisira kuvhara doro muchiropa uye inenge yakachengeteka nzira yemakumbo maduku, asi yakanyanya kuchinjwa nehuwandu hwemhepo inopera mumakore achangopfuura.
Pasinei nokuti urongwa hwehupi hwehutano iwe uye chiremba wako wakasarudza, iwe unofanirwa kuziva zvose zvinoshandiswa zviripo. ICancer Cancer Institute inokurudzirawo kufungisisa kusarudzwa kwekuongororwa kwekliniki . Vakawanda vari kuenderera mberi uye vari kutarisa kuenzaniswa kwezvinyorwa zvepamusoro, pamwe chete nemishonga mitsva yakadai saangiogenesis inhibitors , immunotherapy approaches, nezvimwe.
Kuchengetedza kwepakati
Kunyatsotarisirwa kunosanganisira kurapa zviratidzo zvekenza uye mishonga yekenza, panzvimbo yekenza pachayo. Kusiyana nekuchengetwa kwekuchengetwa kwekuchengetedza, kushandiswa kwepamusoro kunogona kushandiswa kunyange kune vanhu vane kanzura inoporesa zvikuru. Mukuwedzera pakunatsiridza hupenyu hwehupenyu, chidzidzo che 2018 chinoratidza kuti rudzi urwu rwekutarisira rungagadzirisa migumisiro yevanhu vane kenza yeropa.
Kudzivirira
Kana zvinouya pakudzivirira kenza yeropa , imwechete yekudzivirira inokodzera mapaundi emishonga-uye kudzivirira hepatitis B neC inokosha zvikuru. Kana iwe unogona kudzivisa kuwedzera zvirwere izvi, kana kuti kugamuchira kurapwa kana iwe unazvo, iwe unogona kuderedza ngozi yako yekenza yeropa nechikwereti kusvika 90 muzana. Kunyange kune avo vanotakura zvirwere izvi, kune marapirwo anogona kuderedza dambudziko rekusimudzirwa kwechirwere cheprhosis, uye pamwe nekenza yeropa.
Deredza kudhakwa kwako, uye kana ukasvuta, siya. Tora nguva yekudzidza pamusoro pehupenyu hwemhuri yako yehupi hwehutano, kunyanya izvo zvinokonzera zvinetso zveropa. Uye edza kungwarira nemakemikari aunosangana nawo kubasa, sezvo mamwe aya anozivikanwa kuti anokonzera kenza yechiropa.
Kutsungirira
Kana iwe kana munhu waunoda akaonekwa kuti ane kenza yeropa, iwe unganzwa sokuti nyika yako yakashandurwa. Asi, pane zvinhu zvaunogona kuita izvo zvingakubatsira iwe kunzwa sokuti iwe unogona kukwanisa kufema. Dzidza zvose zvaunokwanisa pamusoro pemukenza, asi chenjerera kuti utarise ruzivo rwezvino-up-to-date. Mishonga uye kuponeswa kwehuwandu zviri kuwedzera, uye ruzivo rwakadaro kunyange makore mashomanana ekare harungarati kuchinja ikoko. Izvo zvinoenda kune zvinyorwa zvekupona.
Kubatana nekenza yemagariro eropa kunogona kubatsira vose kubva pakuona kwekutsigirwa mupfungwa uye senzira yekudzidza pamusoro pekutsvakurudza kwekupedzisira pamusoro pekenza yeropa. Vanhu vari kurarama nehosha iyi vanokurudzirwa uye vanowanzoziva zvakawanda kudarika kunyange vamwe vakuru vezvecologist pamusoro pemishonga yemazuva ano. Iwe unogona kutsvaga boka rekutsigira munharaunda yako, kana kuwana sarudzo yekenza yepabonde paIndaneti. Kuti uwane vanhu vakarurama, edza kushandisa ma-hashtag #livercancer uye #livertumor.
Dzokera kumhuri neshamwari uye ugamuchire rubatsiro rwavanogona kupa. Kurwisana nechirwere chechiropa zvechokwadi kunotora musha.
Caregiving
Vanhu vashomanana vanova nekenza muga woga, uye kurwisana nechirwere cheropa kunogona kunge kwakaoma kune vanochengeta mhuri kune avo vanorarama nechirwere. Chimwe chezvikamu zvakaoma zvikuru zvekuchengetedza ndiyo pfungwa yekushaya rubatsiro iwe unganzwa, asi kune nzira dzokuti iwe mose mugone kubatsira mubatsiri wenyu uye kurarama nemanzwiro aya. Kudzidza zvakawanda pamusoro pekenza yeropa kune nzvimbo yakanaka yekutanga.
Kurwisana kunowanzoitika apo vanhu vane kenza nevanodikanwa vavo vanosiyana nemaitiro avanoenda nayo kurapwa. Ipa pfungwa dzako, asi ramba uchifunga kuti iyi ndiyo rwendo rwomunhu waunoda iye anofanira kufamba nenzira yake.
Pakupedzisira, zvakakosha kudarika kare kuti uzvichengete iwe semutarisiri zvakare. Izvi zvingaita sezvisingabviri pane dzimwe nguva, asi kutora nguva yekuona kuti zvaunoda zvaunosangana zvichakubatsirawo kuti urambe wakagwinya sezvaunokwanisa apo iwe unotarisira mudiwa wako.
Shoko Rinobva
Kana iwe unonetseka kuti unogona kuva nekenza yeropa, taura nachiremba wako. Mishonga inonyanya kushanda mumatanho ekutanga echirwere ichi, uye kubata ma kancita kutanga kunopa mukana wekurapa.
Kune avo vakaonekwa kuti vane kenza yeropa, kune tariro. Mishonga iri kuwedzera, uye mushonga mutsva unowanikwa mumakiriniki ekuedzwa. Iva nechokwadi chekuita chikamu chinoshanda chekuchengetedzwa kwekenza. Dzidza kuti ungava sei murevereri wako, kana kuwana shamwari kana mudiwa anogona kukurudzira iwe. Kuzvikurudzira, kana iwe une kenza, hazvina kungowanikwa chete kuderedza kuzvidya mwoyo asi dzimwe nguva kunogona kugadzirisa migumisiro.
> Sources:
> Forner, A., Reig, M., uye J. Bruix. Hepatocellular Carcinoma. Lancet . 2018 Jan 4. (Epub mberi kwekudhinda).
> National Cancer Institute. Primary Liver Cancer Treatment (PDQ) -Health Professional Version. Updated -2/06/18. https://www.cancer.gov/types/liver/hp/adult-liver-treatment-pdq
> Woodrell, C., Hansen, L., Schiano, T., naN. Goldstein. Kuchengetedza Kwevanhu Kune Hepatocellular Carcinoma, uye Zvibatsiro Zvakananga zveVakuru Vakwegura. Clinical Therapeutics . 2018 Mar 20. (Epub mberi kwekudhinda).