Sezvaunoshandisa kuongorora kwako, kufambira mberi nekurapa kunokosha pakugadzirisa hutano hwako nekudzoka. Chirongwa chemunhu chinokonzerwa nekenza yepamusoro chichatsigira pane zvimwe zvinhu, kunyanya chirwere chekenza (iyo yakareba zvakapararira) uye chikamu chekenza (kusasvibiswa kwemasero emukenza anotarisa).
Surgery
Ngatitange nekukurukurirana pamusoro pekugadzirisa kwekenza yekenza yekusangana.
Transurethral Resection Chirwere Tumor (TURBT)
Iro danho rokutanga mukurapa chirwere chisina kusimba chinokonzera chirwere chechirwere-zvinoreva kuti chirwere chiri mukati mechidzitiro uye hachina kupindira mukati mawo musimba mashizha-chirwere chekuvhiya chinonzi transurethral resection kemukari tumor, kana TURBT. Iyi nzira inobvisa tumarara kubva pachikanda.
Munguva yeTURBT, urologist anoisa chiridzwa chakaoma, chine simba chine chiedza uye kamera pairi (resectoscope) kuburikidza nehutachiona hwemunhu muchikamu chake. Iyo resectoscope inosungirirwa netambo inobvumira chiremba kubvisa tumarara.
Iyi nzira inowanzoitwa muimba yekugadzira uye dzimwe nguva yechipiri TURBT inotarisirwa mavhiki mushure mekutanga kuti ave nechokwadi chokuti hapana chechirwere chakarasikirwa. Mashoko akanaka ndeokuti vanhu vazhinji vanogona kuenda kumba musi iwoyo kana zuva raitevera. Uyewo, migumisiro yechirwere, sekubuda ropa kana kunetseka paunenge uchibhururuka, inowanzogara kwenguva pfupi uye unyoro.
Radical Cystectomy
Kurapa kwekenza-inopisa-kenza yekenza-iyo inoreva kuti chirwere chisina kuwanikwa uye chakapinda mukati mechidzitiro chemazamu musinga-chinonzi chirwere chinonzi radical cystectomy. Izvi zvinosanganisira kubvisa nhengo dzomukati uye dzakapoteredza- hupfeko uye seminal vesicles mumarume; chiberekero, chibereko chechirwere, fallopian tubes, mazai, uye chikamu chepamusoro chechikadzi mumadzimai.
Iko dzimwe nguva inonzi cystectomy inokurudzirwa yakakurudzirwa kuti iwane kenza yemukaka iyo isina kumbopinda musimba yakasara asi ine zvimwe zvinoshungurudza, zvinotyisa. Izvo zvinowanzotaurirwa kuvanhu vane chirwere chinoramba chichiramba chisingarevi mushure mushure mekurapwa ne intravesical immunotherapy (ona pasi apa).
Urinary Diversion uye Reconstruction
Mushure mokunge chidzara chibviswa, chiremba anovhiya anofanira kuronga nzvimbo itsva yemuyo kuti ichengetwe. Pane zvimwe zvingasarudzwa zvokufungisisa:
- Chidzva chitsva chinogona kugadzirwa kubva kune chikamu chemukumbo wemunhu (neobladder) icho chinowanirana nemunhu we urethra zvokuti vanogona kurinha sepakutanga.
- Chikwata chinogona kugadzirwa mukati memuviri uchishandisa mishonga kubva mudumbu kana mumatumbo. Chimwe chegumo chinosanganiswa kune ureters uye imwe kumuchero mucheka pamadziro emimba (stoma). Katheti inogona kushandiswa kupedza urini kuburikidza ne stoma mukati mezuva, asi chikwama chinozopedzisira chichichengeta urini, sachidimbu.
- Panzvimbo pehomwe, chidimbu chemukati chakabatanidzwa kune ureters. Nemhando iyi yekuvhiyiwa, urinhi inoputika kubva kuitsvo kuenda kumarereters kuburikidza nechikamu chemukati uye kupinda mu stoma. Pakupedzisira, inodonha muchikwata chiduku chekuunganidza kunze kwemuviri.
Zvichida Njodzi dzokuvhiya
Radical cystectomy nekugadzira chikwata chitsva kana chikwama chinoshandiswa zvakaoma. Mune mamwe mazwi, iyo ibasa guru. Saka, zvakakosha iwe unonzwisisa matambudziko ose uye zvibatsiro zvakabatanidzwa-zvakanaka uye zvakaipa, kutaura.
Nezvo, mikana yekugadzirisa zvinetso zvinotarisana nezvimwe zvinhu, sechiitiko chechiremba, chirwere chemurwere, uye kana murwere ane dambudziko rezvoutano. Kunyange zvakadaro, mienzaniso yezvinetso zvingangodaro zvinoshandiswa zvinosanganisira:
- Bleeding
- Kurwara
- Ropa rakavhara mumapapu
Imwe nyaya yekutaura nechiremba wako chirwere chekuita zvepabonde, sekushanda kwe erectile kana kukwidza zvepabonde, uye kuti ungakunda sei.
Chemotherapy Pamberi Kuvhiya
Kana munhu ane hutano hwakakwana, iye achawanawo chemotherapi asati avhiyiwa kuti awedzere mikana yekupona. Chinangwa che chemotherapy ndechokuuraya masero emukenza ari mumuviri asi asati aonekwa.
Zvirwere zviviri zvinowanzozivikanwa zvinoshandiswa mushure mekuvhiyiwa kwechirwere chechirwere chechirwere ndezvekuti:
- MVAC (methotrexate, vinblastine, doxorubicin, uye cisplatin)
- GC (cisplatin uye gemcitabine)
Wako oncologist, kana chiremba wekenza, achabata izvi chemotherapies mumagetsi. Izvi zvinoreva, kuti mushure mekurapwa kwega kwega, iwe uchazorora uye uchaongororwa kune chero matambudziko anorwadza. Mienzaniso yemigumisiro inogona kuonekwa nemitemo iri pamusoro apa inosanganisira:
- Kuneta
- Kuwedzerwa njodzi yehutachiona
- Kudzorera kana kupwanya nyore nyore
- Kuora bvudzi
- Makuvara emuromo
- Nausea uye kurutsa
- Kunzwa kurasikirwa
- Unhu uye kugunun'una nemaoko kana tsoka
- Ropa mumuguta
Chimwe nechimwe chinotenderera kwemavhiki mashomanana uye, kazhinji, katatu kutenderera kunorumbidzwa vasati vasvitsa chirwere.
Intravesical Therapy
Kunyange zvazvo kuponeswa kwemahara kunofadza kune vanhu vane kenza isingasviki musimba, zvinonyanya kukosha navanachiremba kunyange mushure mekunge bundu racho rabviswa nderekuti:
- Kudzokorora (kenza inodzoka)
- Kufambira mberi (kenza inopararira mumusungo kana kuwedzera mumuviri)
Saka, ngatitarisei zvino zvisarudzo zvisingashandisi kurapa.
Intravesical Chemotherapy
Izvi zviri pamusoro apa zvikonzero nei varwere vakawanda vachirapa mamwe maitiro mushure mekubviswa kwechirwere nekupindira kunonzi intravesical chemotherapy. Nemhando iyi yekurapa, mishonga inotungamirirwa zvakananga muchechi kuburikidza ne catheter. Chinangwa che chemotherapy ndechokuparadza chero zvasara, masero asingaoneki emasera.
Zvichienderana nehutano hwemunhu wekenza yeruzha yekudzoka (iyo chiremba anoongorora sechepasi, ari pakati, kana yakakwirira), iye achawanzogamuchira kana imwe yero panguva yeTURBT yekutanga kana maitiro akawanda pane imwe nguva yevhiki yechitanhatu intravesical chemotherapy.
Mitomycin inowanzonzi chemotherapy yekusarudzwa inoshandiswa. Izvozvo zvinogona kuita kuti vamwe vatsva mumukati pamwe chete uye kazhinji uye / kana kunorwadza.
Intravesical Immunotherapy
Dzimwe nguva, panzvimbo ye intravesical chemotherapy, munhu anogamuchira immravesical immunotherapy inonzi Bacillus Calmette-Guerin (BCG). Izvi zvinorwisa hutachiona hwemunhu kuti uuraye masero emukenza.
Zvinonakidza kuziva kuti Bacillus Calmette-Guerin (BCG) yakatanga kusimbiswa sechirwere chechifuba. Asi, muma1970 nema1980, yakawanikwa kuuraya masero emukenza wekasa, zvakare.
Kunyange zvazvo ichibudirira kwazvo, intravesical BCG inogona kukonzera migumisiro kwemazuva maviri iyo inogona kusanganisira:
- Fever, chills, uye muviri aches
- Kuneta
- Kuwedzereka kunyura
- Ropa mumuguta
- Kurwadziwa kana uchizorora
- Kupisa mukati memukaka
Kazhinji, BCG inogona kupararira kumuviri. Izvi zvinogona kukonzera utachiona hwemuviri, hunogona kuratidzirwa nefivha inowanikwa kwemazuva anopfuura maviri kana fevha isingafadzi nemishonga. Chirwere chemuviri-muviri chinonyanya kukosha uye chinoda kurapwa nokukurumidza.
Kuchengetedzwa Kwechiedza
Pasinei nekunyanyisa kwechirwere chetachiona kuve kushandiswa kwakakwana kwekenza yemusimba-inoputika, dzimwe nguva munhu ane kenza yemahara isina kukwana angave asina kubvisa chikwata chake chose. Pane kudaro, vangave vachibviswa zvishoma pamusana pechifuva chavo kana kuti TURBT yakawedzera. Kufanana nemhando ipi zvayo yekurapa, mumamiriro aya akaenzana, njodzi uye zvipo zvinoda kunyatsoongororwa.
Radiation Therapy
Radiation therapy, iyo inopihwa ne-radiation oncologist, inowanzobatanidzwa ne chemotherapy uye TURBT mumagetsi-kuchengetedza zvirongwa, sezvo zvisingaratidzi kuti ndiyo yakakwana yega yeutachiona. Mishonga inouraya masero emukenza uye zvirongwa zvekurapa zvinowanzopedza mazuva mashanu pavhiki kwevhiki dzinoverengeka.
Kuongorora Pashure Pekurapa
Inenge mwedzi mitatu mushure mekurapwa ne intravesical therapy (uye panguva dzakasiyana pashure pacho), chiremba achaita krisoscopy kuti ave nechokwadi chokuti hapana chirwere chekenza chidzokorora. Kana vari pakati pakati pevanhu vane ngozi yakawanda, urine cytology kutsvaga masero emukenza uye kufungidzirwa kwepamusoro urinary tract (kureva CT scan) inowanzoitwa nguva nenguva seimwe nzira yekuongorora.
Kana nzvimbo inoshusha yechando ichionekwa, inenge ichinyorwa uye ichibviswa neTURBT. Kana kenza yakadzokazve, munhu anowanzoita chirwere chinonzi intravesical kana kuti chikwata chake chibviswa nekuvhiya kwe cystectomy.
Kana pasina humwe uchapupu hwekudzoka, munhu angatora chirwere chekuchengetedza neBBCG kuti arambe achidzivirira chero kenza yekudzoka. Nguva yehutano hwekuchengetedza (somuenzaniso, gore rimwe zvichienderana nemakore matatu) inobva kune ngozi yomunhu, iyo inoongororwa neboka rake rekenza.
Metastatic Bladder Cancer
Nokuda kwekenza yekramha yakapararira kune dzimwe nhengo dzomuviri, semakirini nhengo kana dzimwe nhengo (mapapu, chiropa, uye / kana mapfupa), chemotherapy inogona kunge iri sarudzo yekuderedza kukura kwekenza. Kutsvakurudza ku immunotherapy yekenza yepamusoro yakakosha ikozvino kuongororwa.
Dzimwe nguva, majekiseni anopa kana kuvhiyiwa (TURBT kana cystectomy) inoitwa kune munhu ane kenza yemastrastatic, zvakare. Zvakakosha kunzwisisa, zvisinei, kuti kurapwa uku kunoitwa senzira yekuchengetedza kurapa-nzira yekuchera zviratidzo zvinotambudza zvine chokuita nekenza.
Izvozvo zvakati, mune zvakaitika pamusana wekenza yemukaka, zvakakosha kugara uchitaura kana zvirwere zvakasiyana-siyana zviri kuora mwoyo pane kungovandudza mararamiro ako ehupenyu. Muchiitiko ichi, ziva kuti zvakanaka kuti udzokere pfungwa dzako kumhuri yako uye oncologist .
Mune mamwe mazwi, nguva shomanana yenguva inogona kunge ichizadza kupfuura nguva yakareba yekusagadzikana kurapwa. Izvi, zvechokwadi, ndeyezvisarudzo zvakasarudzwa uye zvakasiyana.
> Sources:
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> America Cancer Society. May 2016. Kurapa Chirwere Cheshuga.
> Babjuk et al. EAU Mirayiridzo pamusoro peusina musimba-inopisa urothelial carcinoma yechipfuva: Ongorora 2016. Eur Urol. 2017 Mar; 71 (3): 447-61.
> Chang et al. Kuongororwa uye kurapwa kwechirwere chisina kuchena chepachivha chechirwere: AUA / SUO mutungamiri. J Urol. 2016 Oct; 196 (4): 1021-9.
> Stephenson AJ. December 2016. Maitiro ekutanga ekutungamira uye kutungamirirwa kwekenza yeukama isingawaniki. Mu: UpToDate, Lerner SP, Ross ME (Eds), UpToDate, Waltham, MA.