Kana iwe kana munhu waunoda ari kuongororwa nekenza yemukaka, inogona kuva nguva inonetsa uye inotyisa. Asi nokudzidza zvakanyanya sezvaunogona pamusoro pemamiriro acho ezvinhu, kusanganisira kuedzwa kunoitwa kuti uone, iwe watotora basa rinokosha mukutarisira kwako.
Uyewo, edza kuramba uri wakarongeka sezvinobvira, nyatsotarisa pakusarudza kenza yako yekenza yepamusoro, uye enda kune misangano uye kuongororwa nemumwe wako kana mudiwa waunovimba naye.
Pre-Diagnosis
Kuongororwa kwekenza yekubvisa chirwere kunotanga nekukurukurirana kwakakwana nachiremba wako. Mukuwedzera pakuongorora zviratidzo zvako, chiremba wako angakubvunza iwe mibvunzo nezvekenza yehavha yehavha yezvipembenene , sezvinonzi iwe unoputa fodya (kana une nhoroondo yacho) kana kuti une chero makemikari anowanikwa munzvimbo yebasa.
Chiremba wako achaitawo chiitiko chekuongorora. Kune varume, izvo zvinosanganisira kuongorora rectal uye kuongorora prostate ; kune vakadzi, kuongorora zvekudzokorora kwemadzimai kunoitwa. Chinangwa chekuongororwa uku ndechekuona kana chimwe chinhu chisina kujairika chinogona kunzwika, sechirwere chechimbiso.
Kushandura uye urini tsika inoitwawo kuitira kuti zviratidzo zvako zvisati zviri kubva kune hutachiona, izvo zvinowanzoonekwa kupfuura kenza yemukaka. Kana pasina hutachiona uye / kana kana chimwe chinhu chisina kuenzana nekuedza kwako kana kuongororwa, iwe uchatumirwa kune urologist , chiremba anonyanya kugadzirisa zvirwere zvekuvhenekera nzira (uye yehutano hwehutano).
Dhiyabhorosi Miedzo
Paunoshanyira urologist wako, ivo vachagadzirira kuongororwa kwakaoma kunobatsira kuongorora hutano hwako.
Urine Cytology
Ne urine cytology, chiremba anotarisa pasi pe microscope pamusana wemuenzaniso wevanhu kuti atsvake masero emukenza. Kunyange zvazvo urine cytology yakanaka pakutonga mukenza yemukaka, haisi muedzo wakavimbika wekutonga kenza yerachiva.
Ndicho chikonzero hazvisi kunaka kwekuongorora kuongorora uye kushandiswa kunyanya kune vanhu avo vane zviratidzo kana zviratidzo zvekenza yemukaka.
Urine Tumor Markers
Kune huwandu hweuedzo hunogona kutarisa zvimwe mapuroteni kana zviratidzo mumuguta uri kushungurudza kenza yemukaka. Sezvakaita urine cytology, urine tumor markers vane zvikanganiso zvavo. Iyi miedzo inogona kukanganisa vanhu vane kenza yemukaka kana kuti miedzo inogona kunge isingawanzoitiki kune vanhu vasina kenza, iyo inogona kukonzera kushungurudzika uye kuwedzerwa kusingakosha.
Miedzo yeNzira
Iye zvino, ngatitarisei pane zvakanyanyisa, asi zvisingaiti, zvingasarudzwa.
Cystoscopy
Pamwe pamwe nemuongorori wemukoti, urologist achaita cystoscopy , iyo yegoridhe yero yepamusoro yekuongororwa nekenza yepamusoro. Irostoscopy inowanzoitwa muhofisi yako yeurologist pasi peanesthesia yemunharaunda. Icho chiito chekuisa pangozi, kunyange kubuda ropa uye utachiona zvinogona kuitika. Dzimwe nguva cystoscopy inoitwa mukamuri yekuvhiya pasi peanesthesia yakawanda, zvinoreva kuti iwe ucharara.
Munguva ye cystoscopy, urologist ichaisa cystoscope, inogadziriswa, inogadzirwa-tube-seyo ine chiedza uye duku vhidhiyo kamera, kuburikidza neunrethra yako uye muchando chako. Itarera yako inogona kuvharwa nejeri kana uri muhofisi yechiremba wako.
Nzira isina kuchena inogadziriswa mucheka, naizvozvo inotambanudzwa uye izere. Urologist achazoshandisa cystoscope kuti aone kufara kwemukati kwechiso chako kuti uone kana kune chirwere (kana kuti zviremara zvakawanda) zviripo. Kana pane chirwere, vanogona kuona kuti ndeyei chaizvo, kuti chii chinotaridzika, kuti chakakura sei, uye kana pane chero mucosal isina kunaka.
Transurethral Resection of Bladder Tumor
Munguva ye cystoscopy, kana chiremara kana nzvimbo isingawanzogadziriswa yechipfuva ichionekwa, wako urologist achatora biopsy yaro. Izvi zvinonzi "biopsy" inonzi "transurethral resection" yebladder tumor, kana TURBT, uye inosanganisira chiremba achibvisa chirwere chechirwere pamwe chete chikamu chemasimba murusvingo pedyo nechomuviri.
Kana pasina chirwere chikaonekwa asi chiremba achiri kutinetsa nekenza (urine cytology inogona kuva yakanaka), inogona kutora maitiro akawanda echando. Vachafungawo kutora biopsies yemamwe mativi emuuginho urongwa hwehutano, sewererera uye prostate (kana murume).
Zvadaro, chiremba anonzi chiremba anokwanisa kutarisa biopsy pasi pe microscope uye ona kana kenza masero aripo. Izvi zvinopa kuvimbiswa kwekenza yepachirafu kuongorora. Uye, kana kenza yemukomana yakagadziriswa, chikamu chekenza chinogona kugadziriswa. Kune zvipembenene zviviri zvekenza yemukati:
- Kenza yepamusoro-ganda yekramha: Aya masero emukenza anofanana nemavhesi emukenza emuhara.
- Kenza yepamusoro-ganda yemukaka: Aya masero emukenza haafaniri kutarisa semasero emukenza emuhara.
Pasi pose, kanhi yepamusoro yekodha yekodha inonzi yakashungurudzwa uye saka yakanyanya kuoma kurapa kudarika kero yekodhi yekodha yekenza.
Kufungidzira Miedzo
Kuenzanisa miedzo inofanirwawo kuongorora kenza yepamusoro yekuongorora.
CT kana MRI Scans
A CT urogram chirwere chekufungidzira chinoshandiswa kuongorora itsvo, ureters, uye chikafu. Inogona kupa ruzivo rwakakosha pamusoro pemakumbo ebheya, sekukura kwaro, maitiro, uye nzvimbo uyewo kana kenza yakapararira kunze kwechidzitiro.
MRI urrogram inogonawo kubatsira, kupa humwe ruzivo kubva CT scan. Inoshandiswa zvakare kune vanhu vanoratidzika kuti vaenzanise dye, iyo inoshandiswa muT CT scan , asi kwete MRI.
Mamwe Kufananidza Kuedzwa
Dzimwe nguva mamwe maitiro ekufungidzira anorayirwa, kunyanya kana CT kana MRI kuongorora hazviwanikwi.
- Chirwere chinonzi intravenous pyelogram, kana IVP, inzira inoshandiswa dhayi mujinga remunhu uye ipapo x-ray ye urinary tract system inotorwa. (Tsitsi uye bladder ultrasound hazvidi kuti dhayi yakasiyana kana kuti mihizha, sezvo inoshandisa mazaya akajeka kupa mifananidzo.)
- Bhokisi re x-ray rinoitwa kuti rione kana kenza yakapararira kumapapu.
- Ikopa repafu rinogona kurayirwa kana munhu ane kenza yemukaka ane kurwadziwa kwepfupa.
Staging
Mukuwedzera kune chikamu chemuviri wako, chiremba wako achagadzirisawo danho rayo, zvinoreva kuti kenza yakapararira zvakadini. Kakawanda, mutsara uye girasi remuviri wako unoita basa guru mukurwisa kwekenza yako yechangu uye iwe mukana wako wekuwanazve.
Kurapa kwekenza yekenza yemunhu inowanzogadziriswa kubva pane zvinhu zvitatu:
- Iroopsy / TURBT migumisiro
- Kuongorora kwemuviri kunoitwa nachiremba paanenge pasi peanesthesia (apo TURBT inoshandiswa)
- Kufungidzira zvidzidzo
Nhanho 0 ndiyo gadziriro yekutanga yekenza yekubvisa uye inoreva kuti kenza haina kupararira kuburikidza nekamuri mukati memukati. Nhanho IV ndiyo imwe nzvimbo yakanyanya kufambisa uye inoreva kuti kenza yakapararira kumapapiro, mimba, pedo nhengo dzomukati, uye / kana nzvimbo dziri kure mumuviri.
Chiremba wechirwere chechirwere achashandisa tsamba nhatu (pamwe chete nenhamba mushure mekunyora tsamba) kuti uwedzere kutsanangura chikwata chemunhu:
- T yeKubata: Izvi zvinorondedzera kuti kurema kwebhanyi kwakakura sei. Semuenzaniso, ingave yakakura kuva musimba rusvingo rwechikanda kana kwete.
- N yeNodes: Ichi chinorondedzera kana kenza yakapararira kune chero ipi zvayo yakasvikodhi nodes.
- M yeMetastasis : Chiitiko chino chinotsanangura kana kenza yakapararira kune dzimwe nhengo dzomuviri, sechiropa, mapfupa, kana mapapu.
Iyo yakakwirira nhamba shure kwemashoko aya, mberi kwekenza ndeye uye zvakanyanya kuoma kurapa.
> Sources:
> America Cancer Society. Miedzo yeChanja yeKuvira. May 2016.
> Chang et al. Kuongororwa uye kurapwa kwechirwere chisina kuchena chepachivha chechirwere: AUA / SUO mutungamiri. J Urol. 2016 Oct; 196 (4): 1021-9.
> Chou R et al. Vanogadzira urinary nokuda kwekuongororwa kwekenza yemukaka: Chiitiko chekuongorora uye meta-analysis. Ann Intern Med . 2015 Dec 15; 163 (12): 922-31.
> Lotan Y, Choueiri TK. Dzidzo yevarwere: Kanza yekakavha inorwara uye kuongorora (Beyond the Basics). Mu: UpToDate, Lerner SP (Ed), UpToDate, Waltham, MA.
> Simba NE, Izawa J. Kuenzaniswa kwemashoko pamusana wemusana weusingaoneki mushure mutsva (EAU, CUA, AUA, NCCN, NICE). Bl Cancer. 2016; 2 (1): 27-36.