Apo prostate-specific antigen (PSA) yeropa rakatenderwa muna 1994 sechinhu chekucherechedza chekuonekwa kwekutanga kwekenza yeprotate, yakakurumbidzwa senzira yekurapa iyo yaizoponesa upenyu husingaperi.
Nguva iyoyo isati yasvika, kusava netsika yakagadziriswa yekucherechedza kwaireva kuti kenza yeprotate yakanga isingawanikwi kusvikira yapararira kune dzimwe nhengo dzomuviri, zvichiwedzera zvikuru mikana yaizofa.
Mugore rimwe nerimwe kubvira pakatanga kushambadzira kwePSA, uwandu hwekenza yekenza yeprostate yakaderera, uye mhaka dzekenza yepamusoro ye prostate panguva yekuongororwa yakawa ne75 muzana.
Kuvhiringidzika uye Kurwisana
Inonzwika sebudiriro yenyaya, chaiko?
Asi pasina chizvarwa chakazotevera, kuongorora kwePSA ndiyo nyaya yekuvhiringidzika kukuru uye kukakavara. Yakawana gwaro risina kusimba kubva kune imwe nyanzvi yezvekurapa yezvechiremba iyo yakakurudzira pamusoro pekushandiswa kwayo nguva dzose, uye inoratidzika kunge yakasarirwa nevakawanda nevarwere.
Izvo zvakaitika munharaunda yakawanda nokuti PSA inowanikwa yakawanda yekenza yepamusoro yekenza isingafananidzi kuva yakakuvadza, kuisa pachena kuisa varume vakawanda kuzvidya mwoyo, mari, uye zvingangodaro zvinetso zvekurapa kenza.
Takawana sei pano, uye chii chinoshanda, kana chiripo, chinonzi PSA ine kenza yekenza yeprostate? Chirwere ichi chiri chakanaka here?
Kushandisa Zvakakodzera
Mhinduro shomanana kumubvunzo wokupedzisira iho hongu.
Kuyera kwePSA kunogona kupa ruzivo runokosha kana ruchishandiswa zvakanaka.
Nepo ini nevamwewo maurogi munyaya dzehuroyi muchigovera zvinetso pamusoro pekuwedzera kudarika maitiro evanhu vasina kuuraya prostate, vazhinji vedu tinofunga kuti kutsoropodzwa kwePSA kuve kwakanyanyisa.
Kana yakashandiswa nenzira inonzwisisika, muedzo unove uchikosha. Kuti ndinzwisise zvandiri kureva, ngatidzokerei zvishoma uye tiongorore chii chakaita kuti tive nemamiriro edu ezvinhu.
Kanzuru Dzisimba
Chokutanga, zvakakosha kuziva kuti havasi marariya ose e prostate akafanana.
Matumbu mazhinji anokura zvishoma nezvishoma kana kwete, uye anokonzera zvishoma kana zvisipo zviratidzo . Izvozvi marudzi emamota anonzi indolent.
Sezvo kenza yeprotate inonyanya kuitika kune varume vakwegura-yega yezera yemakore ekuongororwa ibasa 66-uye sezvo kurapwa nekuvhiyiwa uye miviri inogona kuva nemigumisiro isina kudikanwa, yakadai sokusava nesimba kana kusagadzikana, chinhu chinonzwisisika chekuita mumatambudziko aya anowedzera kukurumidza ndeyekuti Ramba uine ziso pazvinhu. Izwi rezvechiremba nokuda kweizvi rinoshingaira kuongororwa, izvo zvinoreva nguva nenguva kuongororwa nekudzokorora zvakare kwekurwa kwekenza.
Inenge 100 muzana yevarwere vane kenza haina kupararira kunze kweprostate yavo vanorarama makore mashanu mushure mekunge vaongororwa. Isa imwe nzira, nguva iyo yaizotora kuti indorent prostate tumor ipfuurire mberi uye inokonzera kukuvadza mune varwere ava kana ikamboita nguva yakareba kupfuura nguva yakasara yeupenyu.
Kanzuru Dzachirwere
Dzimwe hutachiona hwe prostate, zvisinei, hutsinye, hunokurumidza kukura, uye hunogona kuuraya. Vanoda kurapwa panguva yakakodzera . Izvo zvekare zvinowanikwa, zviri nani matambudziko ekubudirira.
Varwere vane kenza inenge iine inowanikwa muprostate yavo uye nemapfupa ari pedyo apo vanoongororwa vanenge vava kuda kuva vapenyu mumakore mashanu.
Asi avo vane kenza yeprostate yakapararira kune mirefu yakakura, mapfupa, kana dzimwe nhengo dzakashata 29 kubva muzana makore mashanu ekupona.
Saka iwe unogona kuona kuti nei kuchera kwokutanga kuchikosha. Asi iyo hafu yehondo. Kuva akakwanisa kufanotaura nzira yemukirwere wepirate yeprostate-kuziva kana ichinonoka-kukura, kwete-chiito-chinoda chimiro, mutsa une hasha, unokurumidza kupararira, kana chimwe chinhu chiri mukati-zvakare chakakosha.
Kuvandudza Muedzo Wezvinyorwa
Kwemazana ezana remakore rechi20, karo chete yekenza yekuongorora kwechiremba chiremba vanachiremba vakanga vaine mafuta avo, rubber-gloved index finger-iyo inotyisa yekuongorora rectal, kana DRE.
Kuongorora chirongwa chezviratidzo zvekuwedzera kana mavhinga kwakapa pfungwa yekuti chiremara chaivepo. Asi zvakanga zvisingagadziri, zvechokwadi zvakanga zvisina kunaka, uye hazvigone kupa chero ruzivo rwekenza ingangodaro. Chirwere chekuvhiya uye mimwe miedzo yekutevera yakashandiswa pakugadzirisa.
Sezvaunogona kufungidzira, panguva iyo tumorama yeprostate yakanga yakakura zvakakwana kuti inzwe, zvichida yakange yakanyatsofambira mberi, iyo yaireva kuti ingadai isina kurapwa. DRE yakanga isiri nzira yakakodzera yekuziva-kutanga.
Zvadaro pakauya kuedzwa kwePSA. Iyo inoona huwandu hweprotheni inonzi prostate-specific antigen iyo inogadzirwa nemasero eprostate gland uye inopararira muropa remvura.
Nhamba yePSA inowanzokwidziridzwa mune varume vane kenza yeprostate. Kubatanidzwa kweDRE uye PSA kuongorora kunoshamisa kwakagadzirisa kukwanisa kwedu kubata zvipfeko zveprostate kutanga.
PSA's Drabacks Include Overdiagnosis
Asi kuedza kwePSA kune maitiro akawanda, zvakare.
Kutanga, zvimwe zvinhu kunze kwekenza yeprotate zvinogona kuita kuti PSA dzisimbe-dzisiri dzomukati dzakadai sehupirate kuvhiringidza kana kuwedzera kunoitika nekukwegura, somuenzaniso. Chechipiri, hapana chakajeka-chakacheka "chinowanzo" PSA level. Varume vakawanda vane chikwata chepamusoro chePSA havakwanisi kuva nekenza yeprostate, asi vamwe vane maitiro akaderera vanoita. Chechitatu, kuedzwa kwe "nhema-positive" yakawanda, inokonzera kushushikana kusingabatsiri kune varwere vasina kuve nekenza. Uye pakupedzisira, kuongororwa kwePSA hakugoni kusiyanisa pakati pekukura kwekenza ine simba inotoda kurapwa uye nehasha kune iyo.
Kupararira kwakapararira kwemuedzo wePSA kutanga muma1990 kwakaratidza kuti mazamu akawanda emarariya e prostate akaonekwa panguva yekutanga, zvisati zvaitika zviratidzo-chinhu chakanaka kune avo vanoda kurapwa nokukurumidza, asi hazvina kunaka kune avo vasina.
Chirwere chepenza cheprostate chakawedzera, asiwo nhamba yevarume vane tumorum indolent avo vasina kukodzera kuita zvirwere, vakashandura prostate yavo, vakatsungirira kurapwa kwemaawa, uye vakaona marwadzo akaipa emitemo iyoyo.
Ongororo mbiri mbiri dzakaenzanisa chiyero chekenza yeprostate "kunyanya kuongororwa" (kuonekwa kwechirwere chisina upenyu) chinokonzerwa nemigumisiro yePSA yechiratidzo pakati pe17 ne50 muzana.
Uye vatsvakurudzi havana kuwana humwe uchapupu hwakajeka hwokuti nguva dzose PSA kuongorora kwaiva nekutarisana zvakananga nekuderera kukuru kwekufa kwekenza. (Kuderera kwekenza yeprostate kufa maitiro ataurwa mundima yechipiri yenyaya ino inogona kunge yakakonzerwa nedzimwe zvimwe zvinhu, kusanganisira kurapwa kwakanaka .)
Mapoka Anopesana Nezvekuedzwa
Saka izvo vanachiremba nevarwere vakasiiwa kurwisana navo waiva muedzo wakaratidzika sehomwe yakasanganiswa: Wakawana mishonga yakawanda yekutanga-stancer, ingave yaida kurapwa kana kwete, uye yakange isina kuita kunge ichiita zvakawanda pachake muhuwandu hwekufa kwekenza yeprostate.
Pakazosvika gore ra2008, US Preventive Services Task Force, nhengo inoshandiswa inyanzvi mukuchengetedza kwekutanga uye mishonga yekudzivirira (asi kwete urology kana kenza), yakakurudzirwa kuti varume 75 nevekare vasapindira PSA kuongorora. Muna 2012, boka racho rakawedzera mazano aro pamusoro pekuongororwa kwePSA kusanganisira varume vezera rose, vachiti kuedza kwekuedzwa kwakapfuura zvayo.
Mamwe mapoka emakirini akasiyana haana kubvumirana, achikakavadzana kuti varwere vaduku vane zvirwere zvinogona kuporesa prostate zvinokonzera uye avo vari pangozi yakawanda (yakadai sevarume vekuAfrica uye avo vane mhuri yekenza yeprostate) vacharamba vachiwana kubva pakuongorora PSA nguva dzose. Vakanyevera kuti kuderera kwekuongorora maitiro kunogona kukonzera kudzokera kumazuva apo kenza yeprotate yakanga isina kuonekwa kusvikira yakakwirira, isingaregi.
Pasina kubvumirana-pamusoro pemirayiridzo, vanachiremba nevarwere vakabatwa mukati. Vanachiremba vanowanzosiya chirongwa chekuedza kuvarwere vavo. PSA kuongororwa kwehuwandu kwakawira, uye ndizvo zvakaitawo kuongororwa kwekutanga-gadziriro (uye zvichida haigoneki) kanzira dzekenza ye prostate.
Zvinoshungurudza, zvakadaro, kuongorora kwechangobva kuitika kwakashuma kuti nhamba yezviitiko zvechangobva kuongororwa zvekenza yepamusoro yeprostate yakakura zvakanyanya kubva muna 2007. Kunyange zvazvo pane kuve nekutsoropodza nzira dzekudzidza, hazvirevi kufunga kuti chirwere chiduku chekenza yeprostate chinoreva mamwe maitiro e makondombera anokosha uye anoporesa haazobatwi kusvikira apararira.
Inyanzvi yeRational Testing PSA Test
Saka munzvimbo ino yakavhiringidza, chii murwere anofungidzirwa kuita? Zvakanaka, mumwe munhu aizogadzira kuongorora kunyanisa-imwe iyo isingatauri chete inoratidza kanzira yekare yekenza yeprotate asi inogona kunyatsofanotaura nguva yayo, kujekesa kana uye nzira yekurapa sei.
Nenzira yakanaka, pane kuongororwa kuongororwa kuongororwa kwepayipi, pamwe chete nezvimwe zviitiko zvinofanirwa kubatsira kubatsiridza kuongorora kuongorora.
Panguva iyi, pano ndiyo nzira yekuedzwa kwePSA ndinorumbidza uye kuti ndinoshandisa nevarwere vangu:
- Tora "yekutanga" PSA pazera remakore makumi mashanu. Chiremba wako anogona kuraira kuedza uye kukurukura nemigumisiro newe. Kana muongorori wekutsvaga, pamwe chete nemakore ekurapa uye mamwe mazwi ehutachiona anoratidza dambudziko rakanyanya rekudzidzira kenza ye prostate, kutevera PSA kuedza kunofanira kudzokororwa kwemakore ose mashanu.
- Kana kuongororwa kwako kwePSA uye ruzivo rwezvechiremba pazera remakore makumi mashanu kuratidzira njodzi yakakwirira yekenza yeprotate asi iwe hauna zviratidzo, iwe unofanirwa kuva nekuongorora gore rimwe nerimwe uchishandisa imwe yeropa risiri rutsva rwandakataura kare (4Kscore kana Prostate Health Index kuongororwa ), uye zvichida MRI scan ye prostate. Taura nachiremba wako pamusoro pezvizvi. Kubva pane zviitiko zvinotevera zvezviedzo izvi, iwe nachiremba wako unogona kusarudza pamwechete kuti zvipi zvinowedzera, kana zviripo, zvinodiwa.
- Kana kana wava nemakore makumi matanhatu (60) PSA yako iri pasi pe2 nanograms pamamiriyoni, mukana wako wekutsvaga kenza yechisimba yeprostate muzvisikwa zvehupenyu zvishoma-1 kana 2 muzana. Panguva iyoyo, zvakachengeteka kudzokorora kuongororwa kwePSA kakawanda kudarika makore ose mashanu kana kupedza kuongororwa zvachose.
Nenzira iyi yechiratidzo, tinogona kugamuchira kanhi dzekodhi dzepamusoro dzinoda kurapwa asiwo kuderedza mikana yekuwana maitiro echechi-pasi asingakuvadzi asi inokonzera kushungurudzika kusina basa uye kurapwa.
Dr. Klein ndiye Sachigaro weCleveland Clinic's Glickman Urological & Kidney Institute, chirongwa cheNyika 2 urology yenyika sarudzo yakatarwa neU.S. News & World Report.
> Sources:
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> Barry MJ, Nelson JB. Kushorwa Maonero: Varwere Vanouya neKupfurikidza Kwakawanda Kwechirwere cheProstate kubvira kuSUPSTF Screening Recommendations. J Urol . 2015 Dec; 194 (6): 1534-6.
> Catalona WJ, D'Amico AV, Fitzgibbons WF, et al. Izvo zveSouth Preventive Services Task Force yakashaikwa mukenza yayo yekuongorora maitiro ekurongedza. Ann Intern Med . 2012 Jul 17; 157 (2): 137-8.
> Moyer VA, LeFevre ML, Siu AL, et al. Kuongorora kwekenza yeprostate: US Preventive Services Task Force kukurudzira chirevo. Ann Intern Med . 2012 Jul 17; 157 (2): 120-34.
> Kuongororwa, Epidemiology, uye End End Results (SEER) Program Stat Zvechokwadi Mapepa: Kenza yeprostate. National Cancer Institute. Inowanika pa http://seer.cancer.gov/statfacts/html/prost.html