Mukembudzi wepoyo unovhiringidza zvirwere zvishomanana zvakasiyana, asi renal cell carcinoma ndiyo inowanikwa zvikuru. Nhoroondo yekare, zviratidzo zvehuturu hwemapapiro (marwadzo kumucheto uye kumucheto kumashure), masimba emimba, neropa mumuguta zvaive zviratidzo zvinowanzoonekwa, asi nhasi zvinowanzofungidzirwa apo munhu anoumba anemia , kana se "njodzi" kana kufungidzira kuedzwa kunoitwa kune imwe mamiriro ezvinhu.
A CT scan ndiyo inonyanya kuongororwa kuongorora, kunyange zvimwe zvidzidzo zvekufungidzira zvingaitwawo zvakare. Chirwere chepemhi chakasiyana nevamwe mukuvhiya uku kunogona kuitwa kunyange nemakumbo makuru. Zvose zvinoshandiswa pakurapa uye immunotherapy mishonga inogona kushandiswa, nekemotherapy uye remishonga inonzi radiation ichiita zvishoma kudarika kune mamwe maikenza.
Kune mhando dzakasiyana dzekenza yemutsvo dzinosanganisira:
- Renal cell carcinoma: Renal cell carcinomas ndiyo inonyanya kufanana nemararamiro epfungwa uye nhoroondo yepfumbamwe pamatambudziko gumi emaronda empfungwa.
- Transitional cell carcinoma: Transitional cell carcinomas account yevanenge 7 muzana yemaronda eputsvo. Dzinomuka kubva mumhando imwechete yemasero anokonzerwa nekenza yemukaka, uye transitional cell carcinoma inorapwa zvakanyanya sekenza yemukomana kupfuura renal cell carcinoma.
- Chirwere chaWilm: Chirwere chaWilm chirwere chinowanzokura pahuduku, uye pakati pehuduku hwekenza, hazvina kufanira.
- Renal sarcoma: Sarcoma yeinso isati inonyanya kurara iyo inotanga muhutano hwehuputi hwehvo.
Iyi nhaurirano ichatarisa kunyanya pamusoro pe renal cell carcinoma.
Iropi Anatomy uye Basa
Kuziva zvishomanana nezvemaitiro uye kushanda kweputsvo kunogona kukubatsira kuti unzwisise zviratidzo zvako, uye unonzwisisa kuti kanhara munharaunda ino inogona kukukanganisa sei muviri wako.
Itsvo dzinoumbwa nhengo mbiri dzakagadzirwa nenyuchi, maererano nehukuru hwechidiki. Tsitsi imwe neimwe iri kumashure kwezviviri zvemuviri, kune rumwe rutivi rwemupenya, maererano. Vamwe vanhu vane hove imwechete, semugumisiro wekuremara kwekuberekwa kana kurwara. Vanogona kurarama zvakanaka neminwe imwechete, chero bedzi iyo tsitsi iyo inoshanda.
Nheyo huru dzeiyo tsvina ndeyekusvina zvakasvibiswa, kubvisa mishonga yakawanda uye munyu, uye kubvisa mvura yakawanda kubva muropa redu; izvo zvose zvakanyanyiswa mumugini. Inenge mamiriyoni makumi mana (anenge makirogiramu makumi mana nemashanu) eropa inonatswa kuburikidza neitsvo dzedu zuva rega roga, kuti ibudise anenge 1 kusvika 2 makiritsi emuti. Muti wacho unofamba uchidzika pasi, unonzi ureters, uye unochengetwa muchokuta kusvikira uchida (urination).
Mumakumbo mune zvinopfuura mamiriyoni nephrons, basa rinoshanda rehvo. Nephrononi imwe neimwe inoumbwa ne glomerulus uye tubule. Murefu wepoyo (renal cell carcinoma) inofungidzirwa kuti inomuka kubva mumatube emapinephrons.
Zviratidzo
Zvinosuruvarisa kuti, zviratidzo zvepabonde zvepfungwa hazvisati dzaonekwa kusvikira chirwere chichifambira mberi. Ichokwadi, chiratidzo chinonyanya kuonekwa chemukembudzi wepyoyo ndechepasi tsvuku yeropa rekuyera ( anemia ). Kana zviratidzo zvikaitika, dzimwe dzei dzinogona kusanganisira:
- Ropa mumuguta , kana kuonekwa mushure mekunge uchizora kana microscopically.
- Chiyero kune rumwe rutivi rwemuviri (flank mass).
- Pain padivi kana pasi rezasi (flank region).
- Fivhiri.
- High blood pressure.
- Unintentional kurasikirwa kwekurema .
Zvinokonzera uye Zvimwe Ngozi dzeKein Cancer
Kunyange zvazvo tisingazivi nezvezvinokonzera zvikonzero, vatsvakurudzi vakaona huwandu hunokonzerwa nekenza yeperesi . Zvimwe zvezvi zvinosanganisira:
- Zera: Njodzi yekenza yeperesi inowedzera nekukwegura, uye yakawanda renal cell carcinomas inopfuura makore makumi mana. (Kusiyana, chirwere cheWilm chinowanzoshamisa kuvana.)
- Zvepabonde: Kanzera yepoyi inowanzoonekwa kune varume kupfuura vakadzi.
- Mhangemutange: Kanzera yemuyo inowanzova yakajairika muvatema uye maIndia vokuAmerica.
- Kusvuta: Vanhu vanosvuta vane ngozi yekenza yempfungwa.
- Basa: Kubasa kunoshanda kumakemikari nezvinhu zvakadai seasbestos, benzene, nezvimwewo.
- Kuwedzera muviri .
- Imwe mhuri inotarirwa nemararamiro eesvini kana mamwe mazamu eti genetic syndromes.
- Mamwe mishonga.
Kuongororwa Kwenyi Kanzer
Kuongororwa kwekenza yeminyo inogona kunyunyuta kuburikidza neanemia, ropa mumuginho, zviratidzo zvepanyama, uye mamwe maitiro ekuongorora kwemaitiro, uye inowanzoitwa nekubatanidzwa kwekuongorora mifananidzo. Kazhinji, kuwanikwa kwemazana pachidzidzo chemashoko, zvakadai se X-ray, CT scan kana MRI, panguva yekutsvaga chimwe chiitiko kunogona kutungamirira chiremba kunyungira kenza yempfungwa.
Chiyero chekutanga apo kenza yeminyo inofungidzirwa inowanzova ultrasound. An ultrasound inoshandisa mazaya ane simba kuti aumbe mufananidzo, uye anogona kusiyanisa tumarara yakasimba kubva kuma cysts. CT (computerized tomography) ingangodaro kuedzwa kunobatsira uye inogona kushandiswa pakuona nekugadzirisa kenza yempfungwa. CT inoshandisa mutsara we x-rays kuti ugadzire mufananidzo we-3-dimensional mukati memuviri. MRI (magnetic resonance imaging) inogona kuitirwa vanhu vasingakwanisi kuva neCCT (nemhaka yemishonga inokonzera kuTT zvinhu zvakasiyana-siyana kana kusagadzikana kwepfungwa basa). MRI inoshandisa maginist imaging panzvimbo ye x-rays. MRI inobatsirawo kana bundu rinofungidzirwa kuti rakapararira mumasvini pedyo neitsvo. Dzimwe nguva pET scan kana bone scan inoitwa kubatsira nekugadzira chirwere chepfungwa.
Kusiyana nemamota akawanda, bhiopsy haisi inowanzodiwa kuti uongorore chirwere chepfungwa. Bhiopsy, kana zvichidiwa, inogona kuitwa nenzira shomanana dzakasiyana, uye inobvumira pathologist kutarisa kuvapo kwekenza masero pasi pe microscope. Zviratidzo zvekenza yemutsvo zvinobatsira chaizvo mukuronga kurapwa nemishonga inotarisirwa, asi inowanzowanikwa panguva yekuvhiyiwa kurapa kenza, panzvimbo yepakati pekuongorora chirwere.
Staging
Kana kenza inowanikwa, kuongororwa kwakawanda kungada kuitwa kuti uone kana chirwere chepfungwa chepfungwa chakapararira kune mimwe michina kana dzimwe nhengo. Izvi zvinonzi kudongedza. Muchirwere wepyiyo unotarirwa nekuyera ukuru hwechirwere, pamwe nehupi uchapupu hwekupararira kune mishonga iri pedyo, kana nzvimbo dziri kure dzomuviri.
Kurapa Kwechipi Kanora
Mishonga yemukembudzi wepoyo inoenderana nechikamu chechirwere, pamwe chete nezvimwe zvinhu zvakawanda, zvakadai sehutano hwako huzhinji, nzvimbo yekenza muinso, nezvimwewo.
Vanhu vazhinji vane kenza yeminyovo vachave nerumwe rudzi rwekuvhiya. Vaya vane kenza yemukomana yepamuvambo ndivo vanonyanya kutsvaga kwekuvhiyiwa, asi chirwere chepfungwa ndeimwe yezvishoma masumbu ane simba umo kuvhiwa kunogona kubatsira kunyange nehutachiona hwepamusoro (chirwere 4). Nepo kuvhiyiwa ndiko kurapa kwekusarudzwa kwekenza dzakawanda dzeputsvo, izvi zvinogona kuva zvakaoma kuvanhu vakwegura zvakanyanya kana avo vane zvirwere zvakakomba zvakanyanya. Kune avo vasingadi kubvumira kuvhiyiwa, kurapa kwakadai sekikiyoguru (kupisa gumbo racho), kana kupisa kwemafirofrequency (kupisa tumarara), zvingasarudzwa.
Mishonga yakawanda yakarongwa nemishonga yakagamuchirwa kuti ishandiswe mune vamwe vanhu vane kenza yepamusoro yeperesi. Iyi mishonga inovhara uye inodzivirira kukura nekupararira kwemasero akaipa. Vanoita izvi nekupindira zvakananga nenzira inobatanidzwa mukukura kwekenza, kana nekudzivirira kukura kwemitsipa yeropa inofanirwa kugovera chiremara nemune mishonga (inhibit angiogenesis ). Migumisiro yemigumisiro yemishonga iyi yakasiyana nedzimwe chemotherapy, uye kazhinji zviri nani kubvumira.
Immunotherapy , inozivikanwawo sebiologic therapy, ndiyo nzira itsva yekurapa kwekenza, iyo inoshandisa nyore nyore kuburikidza nekukurudzira muviri wemuviri wechirwere kuti urwise kenza masero. Iko kune mashoma mashoma emhando yemishonga iyi iyo yakawanikwa ichibudirira kwekenza yempfungwa.
Mukuwedzera kune nzira dzakagamuchirwa dzokurapa dzinowanika, pane ikozvino mimwe miedzo yekliniki inofambira mberi, kutsvaga mushonga mutsva kana kuti nani kurapa chirwere chepfungwa. Kusiyana nemanzwiro emakiriniki emakirini vakawanda vakawanda vakanzwa, mamwe ematambudziko aya iye zvino anopa vanhu mukana wekushandisa mushonga unogona kuvandudza zvabuda. Zvinogona kubatsira kuti tirambe tichifunga kuti kurapa kwose kwataive nako kwekenza kwakambodzidza muchechi yekutengesa, uye panguva yemazuva ano, marapirwo maviri, uye mararamiro kubva kubva, chirwere chepfungwa chinowedzera.
Mishonga isingawanzoshandiswa sechirwere chekenza yempfungwa, asi inogona kushandiswa "palliatively," kuti isunungure kusagadzikana kunokonzerwa nemigumisiro yekenza kupararira. Chemotherapy ine simba shoma rinopesana ne renal cell carcinoma.
Kuchengetedza kwepamusoro, kutarisira kunotarisa mukurapa zviratidzo zvekenza nekuvandudza mararamiro ehupenyu, zvinokosha zvikuru, kunyange kune vanhu vane maperembudzi ekutanga-tanga ayo angangoporesa.
Shoko Rinobva
Kuti uwane musha weperesi mumatambo ekutanga, zvichikosha kuti vanhu vazive zviratidzo zvechirwere, pamwe chete nematambudziko avo. Kana uchitaridzika, pane zvakawanda zvino maitiro ekurapa.
Izvozvo zvakati, rimwechete rekudzivirira rinokonzera pound remurapa, uye kune zvinhu zvakawanda zviri nyore vanhu vanogona kuita kuderedza dambudziko ravo. Rega kusvuta kana usati watanga, sezvo ichi chiri chakanyanya kuipa. Dambudziko rinoderera paunenge urega, saka hausi kumbopera, uye kune zvikonzero zvakawanda zvekurega kusvuta pashure pokunge uongororwa nekenza kunyange kana wakamboonekwa uine chirwere. Tora nguva yekudzidza nezvemhando ipi yemakemikari kana zvimwe zvinhu zvaunosangana nazvo kubasa, uye tevera mazano okurudzirwa. Pakupedzisira, kudya kudya kwakanaka kuti urambe uine hutano hwakakosha kunokosha, sezvo kuneta kunokonzerwa nehuwandu hwekenza yakawanda, kwete kenza yemangwana.
> Sources:
> American Society of Clinical Oncology. Cancer.Net. Kidney Cancer.
> Bast, R., Croce, C., Hait, W. et al. Holland-Free Cancer Medicine. Wiley Blackwell, 2017.
> National Cancer Institute. Renal Cell Cancer Treatment (PDQ) -Health Professional Version. Updated 04/05/18.