Pane zvipingamupinyi zvakawanda zvekuwana zvakakwana kutarisira kenza yeprostate . Chokutanga pane zvose, sezvatichaona pakuguma kwechinyorwa ichi, kenza yeprotate yakanyanyisa, izvo zvinoreva kusarudza kurapa kwakakodzera kunogona kuva kwakaoma. Chechipiri, ruzhinji rwekusagadziriswa uye kunze kwezuva-ruzivo rweIndaneti inotyisa uye haigoneki. Vanachiremba , musarega varwere, vakuvara.
Chechitatu, nguva yekutarisana pakati pevarwere uye vanachiremba iri kuramba ichiderera nekuda kwekuwedzera kwebhizimisi guru uye hurumende mune zvekurapa. Pamusoro pematambudziko aya, funga kuti madzimai anenge asinganzwisisiki mukusarudzwa kwemishonga . Vanongorongedza mune zvekuvhiya kana kupisa kwemazuva, saka kuita sarudzo kunosara kumurwere.
Vashandi Vanofanira Kuda Kusarudza Hurongwa Hwekurapa Here?
Vanachiremba vanotarisira varwere vekenza yeprostate vanocherechedza zvikanganiso zvakanyorwa pamusoro apa. Uye vanoziva kuti kune zvimwe zvinetso zvakare. Yokutanga ndechokuti vanachiremba vane kukakavara kukuru kwekufarira. Vanobhadharwa kuti vaite rudzi rumwe chete rwerapi, chirwere kana mahara . Somugumisiro, ivo havakwanisi kupa simba rinokurudzira mazano. Ndeapi kangani varwere vakanzwa kubva kunachiremba wavo, "Iwe unoda kuva iwe unosarudza"?
Chechipiri, kufanotaura kuti kuoma kwekenza yemurwere hakuna kukanganiswa nekenza yeprostate inowanzoreruka -kukura .
Zvinotora makore gumi kuitira kukanganisa kwechisarudzo chekurapa chinofanira kuitwa. Kufanotaura kunowedzera kusakanganiswa nevakuru vakwegura vevarwere vekenza yeprotate. Kufa kubva pakwegura kunowanzova njodzi huru kupfuura kenza pachayo. Pakupedzisira, muchirevo chechirwere ichi chinononoka, chinokurumidza, kukanganiswa kwehutano hwehuhu-hwe-hupenyu-zvinhu sekusava nesimba kana kusagadzikana-zvinogona kunge zvakakura kudarika zvinokonzera kupona.
Ndiani ari nani kuenzanisa mararamiro ehupenyu nehupenyu kupfuura murwere?
Kuziva Nhanho Yako
Kubatanidzwa mukusarudzwa kwekurapa naizvozvo hazvibviri kudzivirirwa nevarwere vekenza ye prostate. Kusarudzwa kwehutano kunosangana nechepakati pekenza yemukenza, zera remurwere, uye nehupenyu hwake hwehupenyu. Somugumisiro, kuziva chikamu chekenza kunokosha:
- Iyo inoderedza nhamba yezvokurapa zvekurapa uye inodzivisa chido chekutsvaga nemhando yakawanda yemashoko asina kukodzera.
- Iyo inovandudza murwere-chiremba kutaurirana. Vanachiremba vanogona kutamba pamusoro pezvinotsanangurwa pamusoro pemazamu ezvo vobva vauya kune imwe hurukuro inofananidzwa pamusoro pemishonga inowanzoshandiswa kumunhu mumwe chete.
- Iyo ndiyo nzira yakanakisisa yekuwana maonero akarurama pamusoro pemukana wekenza uye kukurumidza (kana kusakwanisa kwacho) kwekuwedzera kurapwa (ona pasi apa).
Zvitsva Zvishanu zveBlue
Pane zvikamu zvishanu zvekenza yeprostate- Sky, Teal, Azure, Indigo, Royal- yeach ine matatu subtypes inonzi Low, Basic uye High , yezvikamu gumi nemashanu. Mitezo mitatu yokutanga, Denga, Teal, uye Azure , yakafanana zvikuru nehuwandu hwehutachiwana hweHaid , Intermediate, uye High-Risk zvirwere zvakagadzirwa naAnthony D'Amico weHarvard Medical School.
Indigo uye Royal vanomiririra zvakare kurwara uye kenza yepamusoro ye prostate , maererano. Kune humwe humwe hutano huripo, asi ivo vose vane zvikanganiso. Nhanho chete dzeBluu dzinomiririra huwandu hwekenza yeprostate.
Dambudziko rekufa kubva kuKenza yeProstate
Chimwe chezvinyanyokosha zvikuru zvekutaura ndezvekuti inopa ruzivo rwekukura kwechirwere ichi, ndicho chimwe chezvinhu zvinokosha pakugadzirisa kurapa kwakakwana. Kurapwa kwakanyanya kunofanira kunge kwakapesana nekutsamwa kwechirwere. Muchidiki ane kenza anokodzera kunyatsorapwa. Kanzera ine utsinye inoda kurapwa kwechisimba.
Kutsungirira kurapwa-kunokonzerwa nemigumisiro yakagamuchirwa haigamuchirwe kana kenza iine unyoro, asi mamwe matambudziko anogona kugamuchirwa apo zvirwere zvinotyisa zviripo. Terefu 1 inoratidza kuti ingozi yekufa inopesana pakati pezvikamu.
Dhiyabhorosi 1: Ngozi yekufa Pakati
Chikamu cheBlue | Degree of Treatment Yakagadzirirwa | Dambudziko rekufa | % yeNewly-Diagnosed per Stage |
Sky | Hapana | <1% | 50% |
Teal | Moderate | 2% | 30% |
Azure | Maximal | 5% | 10% |
Indigo | Mod. Kuna Max. | <50% | 0% |
Royal | Maximal | > 50% | 10% |
Chinyorwa Chinokosha: Tafura iri kumusoro inoratidza kuti chiremba chekurapa kwakakurudzirwa kusvika 80 muzana yevarume avo vachangobva kuonekwa ( Sky and Teal ) inenge yakananga kana isina.
Nguva Yekutadza Kubva kuKenza yeProstate
Kenza yeprostate inoita zvakasiyana zvikuru nedzimwe kenza, kunyanya pakukura kwayo. Somuenzaniso, kufa kwekenza yemapapu kana kancreatic kanzira inogona kuitika mukati megore rokutanga rekuongororwa. Kuziva kwedu nemhando idzi dzinotyisa dzekenza kunotsanangura kuti nei izwi rokuti "kenza" rinokonzera kudengenyeka kwakanyanya. Kanzera, tinofunga, inofananidzwa nekufa kwava pedo. Asi tarisai kuti nhamba dziri muTebhandi 2 dzinoratidze sei kusiyana kwekenza yeprotate inozvibata.
Dhiyabhorosi 2: Kuponeswa Kwemitengo yeChete-Inowanikwa Inonzi Cancer Prostate
Survival Rate | Zuva Rokutanga Rokuziva | |
5 Gore | 99% | 2012 |
10 Gore | 98% | 2007 |
15 Gore | 94% | 2002 |
Anopfuura makore gumi nemashanu | 86% | Mangwanani ekuma 1990 |
Chimbofunga kuti kuponeswa kwemazinga kunongogadziriswa chete nekufamba kwenguva; Kufa kwemakore gumi kunogona kuverengerwa kune varume avo vakaonekwa kuti vakadzoka muna 2007, uye nemazuva ano, kurapwa panguva iyoyo kwainge kusati kwaitika. Nokudaro, nhamba dzehupenyu dzinotenderera kune teknolojia yakare dzingangodaro dzisingagoni kuratidzira tarisiro yemurwere ari kurapwa nhasi. Kupona mazinga zvicharamba zvichivandudza nenguva, uye, kana chero chinhu, varume vane kenza yeprostate inokurumidza kukura vane nguva.
Mamwe maitiro ekugadzirisa zvinhu haana kukwana
Apo varume vanobvunza vanachiremba vavo, "Ndechipi chikwata ndiri ini?" Kazhinji havazivi kuti pane maitiro akasiyana-siyana akasiyana-siyana anoshandiswa. Ngatimbokurukurai muchidimbu mamwe maitiro emitambo:
- Chipatara (A, B, C, uye D) inorondedzera zvakananga kuti iyo prostate inonzwa sei pamudhidhi rectal test (DRE). Iyi nzira yakagadzirwa pamberi pePSA yakaumbwa uye inoshandiswa nevarapi vekuvhiya kuti vaone kana kushanda kwe prostatectomy yakakura kunogamuchirwa (Ona Table 3).
- Pathologic staging inopindirana nehuwandu hwekenza yakagadzirwa nekuvhiyiwa kana nehupopi.
- TNM Staging inobatanidza mashoko kubva kuna 1 uye 2 uyewo mashoko akawanikwa kubva ku bone bone kana CT scans.
- Dambudziko rekuisa mararamiro, iro rinoparadzanisa varume vatsva vanowanikwa muzvikamu zvakaderera, zviri pakati, uye nepamusoro-soro, vanoshandisa mashoko kubva 1 uye 2 pamwe nePSA level.
Terefu 3: Clinical Stage (DRE Stage)
Stage | Tsanangudzo |
T1 : | Tumhanho iyo haigoni kunzwiwa zvachose neDRE |
T2 : | Tumhonyo yakavharwa mukati me prostate T2a: Kumhanyira mu <50% yeimwe rebe T2b: Kumhanyira mu> 50% yeimwe rabe asi kwete zvose zviri zviviri T2c: Kumhanyira kwakanzwa mukati mavobe maviri |
T3 : | Tumhanyi inopfuurira kuburikidza neprostate capsule T3a: Extracapsular extension T3b: Tumha inopinda seminal vesicle (s) |
T4 : | Kumhanyira kunopinda muchechi kana chikwata |
Zvikamu zveNhanho dzeBlue
Nzira yeBlue system inoshandisa mamwe maitiro emitambo (1, 2, 3 ne4 dzakanyorwa pamusoro), pamwe chete inosanganisira ruzivo pamusoro pekunge chirwere chakare kana kupiswa kwemaawa kwave kuchiitwa.
- Digital rectal kuongorora: Kazhinji vs. gurusa vs. mass
- Gleason chikamu : 6 vs. 7 vs. 8-10
- PSA: <10 vs. 10-20 vs. 20
- Biopsy cores: Vashomanana vachienzanisa nemwero wakaenzana nevakawanda
- Kuporesa kwakapera: Hungu vs. kwete
- Kufananidza: Nhamba yezvirwere, ingave iri mumakirinikodhi kana mapfupa
Iwe unogona kutsanangurira nzvimbo yako paIndaneti pawebsite yePCRI kuburikidza kupindura mibvunzo pfupi mubvunzo pa stagingprostatecancer.org.
Chii Chakaipa Nenjodzi-Chikwata Chekushandisa?
Izvo zvinokonzerwa nehuwandu hwemutsara, iyo inoumbwa nepamusoro pezvinhu zvitatu mumutsara wakanyora pamusoro apa, hauna kusanganisira zvizhinji zvezvinhu zvinokosha zvitsva zvinowedzera kukurudzira kwekutarisa:
- Multiparametric-MRI zvakawanikwa
- Izvo zvikamu zvebiopsy-cores ine kenza
- PET scan information
Pamusoro peiyo, chirwere-chekuita sangano hachirevi varume avo vakadzokazve zvirwere, varume vane kurwisa kwehomoni, kana varume vane metastases mumapfupa.
Kana Wakaziva Nhanho Yako, Ndeupi Murairo Wakanakisisa?
Kunyanya kukosha kwekuziva imwe nhandare ndeyokuti inobvumira varwere navanachiremba kuti vawane zero pane zvingasarudzwa zvinoshandiswa pakurapa. Mukusara kwenyaya ino, imwe shanho-yakasarudzwa nzira dzokurapa inoratidzwa kune imwe neimwe yezvikamu.
Sky
Sezvo Sky (Low-Risk) isiri chinhu chisingabatsiri, uye sezvo isu zvino tava kuziva kuti Gleason 6 haana kumbogadzirisa matanho, kunyoresa kuti "kenza" ndeyekusagadzikana kwakakwana. Zvakanaka, Sky inenge ichitumidzwa sechirwere chinotapira panzvimbo pekenza. Nokudaro, zvese zvitatu zvakasiyana-siyana zveZvi , ( Low, Basic uye High) zvinotarisirwa nekutarisa kushanda. Dambudziko guru revarume muShoko nderokundikana kuona simba rezvemashiripiti. Saka kushingaira kutarisa neMRI multiparametric kumusana wekenza unoziva kunonzwisisa.
Teal
Teal (Intermediate-Risk) chirwere chepamusoro-grade uye yakanakisisa yekugara kwenguva yakareba kutarisira. Zvisinei, varume vakawanda vanoda chirwere. Chimwe chinhu chiri Low-Teal , iyo inotarisa kuongorora inogamuchirwa. Kuti uwane seBlack-Teal the Gleason inofanira kunge iri 3 + 4 = 7, kwete 4 + 3 = 7, kukosha kweBanga 4 mune biopsy inofanira kuva pasi pe20 muzana, 3 chete kana kuti zvishomanana biopsy cores inogona kuva nekenza, hapana inogona kuva inopfuura 50 kubva muzana yakatsiviwa nekenza, uye iyo yose yekuwana inofanirwa kunge yakaita seSwede .
Basic-Teal ine mamwe mapepa ane kenza kupfuura Low-Teal, asi achiri pasi pe50 aripo. Varume vane Basic-Teal ndivo vanonzwisisika kune imwe sarudzo yemishonga pamwe chete chero ipi zvayo yemazuva ano mamwe maitiro ekurapa, kusanganisira mbeu inoshandiswa, IMRT, Proton therapy, SBRT, hormone therapy, uye chirwere.
High-Teal inobatanidza chero zvikamu zvezvirongwa zvemuviri weTeal asingakodzeri muBlack kana Basic . High-Teal inonyanya kurwisa uye inofanira kurapwa nemishonga inosanganiswa iyo inosanganisira IMRT, mbeu, uye mwedzi mina-kusvika mwedzi yemwedzi weHermone therapy.
Azure
Azure (High-Risk) inewo matatu subtypes. Low-Azure is Gleason 4 + 4 = 8 ine maviri kana kuti mashoma ane biopsy cores, hapana nhengo ye biopsy inopfuura 50% inobatanidzwa nekenza, uye zvimwe zvinhu zvakadai seSwede . Varume vane Low-Azure vanobatwa nenzira yakafanana neHigh-Teal.
Chinyorwa-Azure ndiyo inowanzosiyana yeAzure uye inomiririra chero chinhu chiri muAzure chikwata chinokundikana kuwirirana nemitemo yeChose kana yeHurumende. Basic-Azure inobatwa nemirairo, mbeu, uye hormone therapy kwemwedzi gumi nemana.
High-Azure inorondedzerwa seimwe kana kupfuura pane zvinotevera: PSA inopfuura 40, Gleason 9 kana 10, inopfuura 50 muzana biopsy cores, kana kenza mumasinical vesicles kana kuti mapepa epelvic. High-Azure inobatwa zvakafanana neChechi-Azure, kunyange zvichida nekuwedzera kweZytiga, Xtandi, kana Taxotere.
Indigo
Indigo inotsanangurwa sekuti kenza inodzokerazve shure kwekuvhiyiwa kana kupiswa kwezuva. Pasinei nokuti Indigo ishoma , Basic kana High inotsanangurwa nehuwandu hwekenza inopararira munharaunda dzepelvic. Low-Indigo inoreva kuti njodzi yakaderera. Kuti uwane seBlack-Indigo, PSA inofanira kuva <0.5 pashure pokuvhiyiwa kwapfuura kana <5.0 shure kwemaawa akare apfuura. Uyewo, nguva yePSA inopetwa inofanira kuva> mwedzi 8. Mukuwedzera, iyo yepakutanga Stage yeBlue vasati vambovhiyiwa kana kuti kupisa kwemaawa kwaifanira kunge kwaiva Sky kana Teal . Kurapa kweA Low-Indigo kunogona kuve nemirasiyo (pashure pokuvhiyiwa kwekare) kana salvage cryotherapy (mushure memazuva akapfuura).
Basic-Indigo inoreva kuti kuongororwa uye kuwanikwa kwezvirwere hakuratidzi masero ekugadzirisa (anozivikanwa semvura), asi nzira dzakanaka dzinotaurwa pamusoro apa yeA Low-Indigo hadzina kukwana. Mune mamwe mazwi, chimwe kana zvimwe zvezvinhu zvakasiyana-siyana zvinoratidza kuti microscopic mitsetse yepilvic inowanzovapo. Pamusoro peChangu-Indigo , chirwere chinoshungurudza chisingaiti nemishonga inonzi radiation kune nhengo dzepelvic uye hormonal therapy inofanira kushandiswa.
High-Indigo zvinoreva mashizha anoratidza kuti aripo mumakirini emakumbo emapirvic. Kurapa kweHigh-Indigo kwakafanana neChitsuwa - Indigo kunze kwekuti mamwe mazano eZytiga, Xtandi, kana Taxotere anogona kuonekwa.
Royal
Varume muRoyaline vane hormonal-resist (a PSA inowedzera nechepasi testosterone) kana kuti mastasimasi kupfuura kana kunze kweiyo nhengo dzepelvic (kana kuti zvose). Low-Royal is "pure" hormone kupikisa pasina masitasita anowanikwa. Varume ava vanenge vaine zvishoma zvirwere zvemasastatic asi zvinogona kunge zvisingaiti kuonekwa nehutachifu hwetsika kana CT sc scans. Zvitsva, zvine simba zvikuru PET inoongorora zvakadai saAxumin, PSMA, kana Carbon 11 inogona kudiwa kuti iwane metastases. Kana imwechete iyo metastases iripo, kurapwa kuchave kwakafanana neChe-Royal .
Chechi-Royal ndeyekusaziva kwakakwana kwechirwere chemasastatic (kunze kwemapanga) asi nhamba yose ye metastases ichishanu kana pasi. Mishonga yeChe-Royal ndeyekubatanidzwa kweSBRT kana IMRT kune yese nzvimbo dzinozivikanwa nezvirwere, Inopa immunotherapy, pamwe neZytiga kana Xtandi.
High-Royal inoreva kuti zvinopfuura zvishanu zvinoshandiswa zvinowanikwa. SBRT kana IMRT nemasitosita akawanda kazhinji haabatsiri. Kana chirwere chacho chisingafambi chichifambira mberi kana chinorwadza, kurapwa kunofanira kuva neZvirevo zvinotevera Zytiga kana Xtandi. Chirwere chinorwadza kana chinokurumidza chinofambira chinofanira kutarisirwa neTareotere.
> Sources:
> D'amico, Anthony V., et al. "Mhedzisiro inobva pakugadzirwa kwechipatara kune adenocarcinoma yemunharaunda yeprostate." Journal of urology 158.4 (1997): 1422-1426.
> Frank, Steven J., et al. "Chirongwa chechipiri chekutsvaga kwechigarire mbeu inogadziriswa prostate brachytherapy yepakati-panjodzi yekenza yekenza prostate: kushanda, kutyisa, uye hupenyu hwehupenyu." International Journal of Radiation Oncology * Biology * Physics (2017).
> Prostate Cancer Statistics 2017. https://www.cancer.net/cancer-types/prostate-cancer/statistics
> Sylvester, John E., et al. "15-Gore remakore rinokonzerwa nehutachiona hwezvekushaya hupenyu mukurapa muchechi Chetachiona T1-T3 kenza yeprotate inotevera kusanganiswa kwekunze radiotherapy uye brachytherapy; Seattle ruzivo." International Journal of Radiation Oncology * Biology * Physics 67.1 (2007): 57-64.