Kunzwisisa Zviratidzo uye Zviitiko Zvengozi
Laryngeal kenza chirwere chekenza chinokanganisa marinha, iyo nhengo yatinoziva nayo sezwi izwi. Vanenge 13 000 vekuAmerica vanorwara nekenza yeary gore negore, iyo inofungidzirwa kuti 3 500 ichafa nehosha.
Anatomy
Iroorikine ine tambo dzezwi uye yakakamurwa kuita zvikamu zvitatu:
- iyo glottis, iyo yechokwadi inowedzera inzwi, iyo iyo inenge 60 muzana yekenza inokura
- iyo supraglotti, iri kumusoro kweglottis, umo 35 muzana yekenza inowanikwa
- iyo subglottis, inenge iri pasi peglottis
Nzvimbo yemarara inogona kuita zviratidzo zvakasiyana uye inoda nzira dzakasiyana dzokurapa.
Risk Factors
Kunyange zvazvo tisingazivi chinokonzera kukonzera kenza, tinoziva izvo zvinowanzoitika kune ngozi kune. Laryngeal kenza ndeimwe yemhando dzakawanda dzekenza-yakabatana nekusvuta .
Kunyange zvazvo inogona kuitika kune vasina kusvuta, humwe uchapupu hwave hwakanyatsoisa fodya semunhu mumwe chete, mukuru kune ngozi kune chirwere chacho. Kusvuta uye kudhakwa zvinodhaka pamwe chete kunowedzera dambudziko risati rawedzera.
Pakati pezvimwe zvinhu zvinokosha:
- akwegura (45 uye pamusoro)
- varumekadzi (zvichienderana muchikamu chepamusoro chekusvuta mumarume)
- nhoroondo yemukati wemusoro neyemutsipa (kusanganisira kusvikirwa kumusoro kana kumitsipa yemitsipa)
- kunwisa doro kushandisa
- kushandiswa kwemashandiro eesbestos, marasha, kana formaldehyde
- zvikafu zvakakwirira mumhuka uye / kana kushandiswa nyama
- genetics uye nhoroondo yemhuri
- kuvhara muviri, kusanganisira nhengo dzomuviri uye vanhu vane HIV
- nhangemutange (pamwe nevamwe vakawanda vomuAfrica vachiwana kenza yakawanda kupfuura vatsvene)
GERD, HPV, uye Laryngeal Cancer Risk
Zvimwe zvidzidzo zvakabatanidza kenza yearyngeal kumagunha yemvura reflux (GERD) . Kunyange zvazvo sangano richiri kuonekwa sine kukakavadzana, kunyange iyo American Cancer Society yakasununguka kusvika pamigumisiro yehupenyu hunoramba huchida kurwara nekenza.
Saizvozvowo, papillomavirus yevanhu (HPV) , hutachiona hunobatanidzwa nepamapfumbamwe makumi mapfumbamwe kubva pamapfumbamwe emakemikari emukondombera, inogonawo kuwedzera kungozi yekenza yakawanda. Kunyange zvazvo mamwe mapoka achifunga kuti njodzi iri pasi, zvimwe zvidzidzo zvakaratidza kuti 25 muzana yelaryngeal carcinomas harbor HPV chirwere (kusanganisira HPV yakanyanya kuisa mifananidzo 16 ne18).
Zviratidzo
Chimwe chezviratidzo zvakajairika zvekushaya chirwere chepachirwere ndechekuramba kuripo kwezwi . Chimwe chinhu chisingaendi mushure mamavhiki maviri chinofanira kuudzwa kune chiremba wako. Kunyange zvazvo chirwere chacho chinogona kukonzerwa nechinhu chero chipi zvacho kubva pamakemikari echinyakare kusvika pakuchengetedza maruva, kushivirira kwekutya kunofanira kugara kuri kunetseka chero chii chinokonzera.
Dzimwe zviratidzo zvinogona kusanganisira:
- kuoma kunomedza (dysphagia)
- kurwadziwa kana kupisa pazvinomedza
- manzwiro ezvokudya ari kubatwa muhuro mako
- kupfuurira kunoramba kusinganzwisisiki nekutonhora kana kutora uye kunogara kwevhiki dzinopfuura masere
- bundu pamutsipa wakakomberedza bhokisi rezwi
- huro inorwadza
- earaches
- choking on food
- kupfuurira kuipa kufema (halitosis)
- kutadza kukanganisa kukanganisa kwemazana mashanu kubva muzana mukati memwedzi gumi nemaviri
Chiremera chemavara uye nzvimbo ndezvimwe zvikonzero zvikuru mukugadzirisa zviratidzo zvipi zvingawanikwa nomunhu. Kana chirwere chinowedzera mumaketani ezwi, kuchinja kwezwi uye kutyisa kwakajairika.
Apo mishonga inokura kumusoro kana pasi pemaketani ezwi, zviratidzo zvakasiyana zvakadai seye earache kana zvinetso zvekufema zvinogona kuitika.
Kuziva
Laryngeal chirwere inoratidzwa neyokutanga kuedza kuongorora mumuviri kuti unzwe kune zvipuka chero chipi zvacho kana kusakanganiswa mumutsipa. Kuti uwane kutarisana kwakanaka mukati, chiremba angakurudzira kana chisinganzwisisiki kana kuti chengetedzo yakananga:
- An indirect laryngoscopy inosanganisira yakarembedzwa nhumbi ine mirirusi inowanikwa mumuromo mako kuti uone kutarisa zvakananga pa larynx yako.
- Muchirangaridzo inonzi laryngoscopy, spray inotanga kushandiswa kupedza muromo, mushure mokunge fiberoptic yakawanda inodyiswa mukati kuti iwedzere kutarisa kumashure kwehuro mako, larynx, uye mutsara. Muenzaniso wezvinyorwa (biopsy) unogona kutorwa kana chero chinhu chinofungidzirwa chiripo.
Mamwe maitiro okuongorora anosanganisira magnetic resonance imaging (MRI), computerize tomography (CT scan), X-ray barium swallow, kana positron emission tomography (PET scan).
Staging
Kana kenza inowanikwa, chiremba wako achaedza kuratidza ukuru uye huwandu hwekenza. Uyu ndiwo mushonga unonzi staging. Chikamu chekenza yemarara chinobatsira kuziva nzira yekurapa yakakosha iwe iwe somunhu.
Vanachiremba vanoita izvi nokutanga kushandisa TNM system. Munyika iyi:
- T inomirira chiremera uye inomiririra ukuru hwechirwere chako kubva paT1 (inopinda chikamu chiduku cheraryx) kusvika kuT4 (kupararira mberi kwelarynx).
- Nini inomirira lymph node uye inomiririra kuti mutana unowanikwa sei mumakirini ako emakirini anobva kuN0 (pasina kenza) kusvika kuN3 (kupararira mberi kwemakirini node).
- M inomiririra metastasis uye inomiririra kuti kenza yakapararira sei (yakaita mamastasi) kune nhengo dziri kure kubva kuM0 (kwete metastasis) kusvika M1 (metastasis).
Kubva pane izvi kuongororwa, kenza yako yaizopiwa danho:
- Nhanho 0 (kana kuti carcinoma in situ ) makondombera anofungidzirwa kuti haasviki.
- Nhanho I ine kansari iri pane imwe chikamu chemuviri.
- Chikamu chechipiri mapepa anonyanya kuwanikwa asi akafambira mberi.
- Chigadziko chechitatu makondombera ayo anowanikwawo uye ari mberi asi anofungidzirwa zvakanyanya.
- Chikamu chechina ndechekenza dzakagadziriswa.
Kurapa
Kuvhiya uye remishonga inonzi radiation ndiyo nzira yakakwana yekurapa kwekenza yehairi. Izvi zvinogona kusanganisira zvinotevera:
- kuvhara muviri, kubudiswa kwebhanhire rose (izvo zvingaita kuti munhu asakwanisa kutaura asingashandisi chigadzirwa chemagetsi)
- kusanganisa kwakasarudzwa kunobatanidza kubviswa kwepakati penharaunda yehararyx
- supraglottic laryngectomy inobatanidza kubviswa kwelarynx pasi pemaketani ezwi
- cordectomy inosanganisira kubudiswa kwechibvumirano chimwe chete kana kuti zvose zvemashoko ezwi
Dzimwe nzira dzinosanganisira:
- chirwere chemazuva ano chinopiwa sepakutanga kurapwa kana kushandiswa mushure mekuvhiyiwa kubvisa chero masero emukenza anoramba aripo
- lymph node dissection ine chokuita nekuvhiya lymph nodes pedyo nenzvimbo yechirwere
- chemotherapy inowanzoshandiswa seineoadjuvant therapy (kuti ichinje chiremera chisati chavhiyiwa) kana kuti adjuvant therapy (kuti iparadze mamwe masero emukenza anenge asara mushure mekuvhiyiwa)
Migumisiro inogona kusiyana kubva kumunhu kumunhu. Mutemo mukuru wegunwe ndewokuti kare iwe unorapwa uye unorapwa, mukana mukuru iwe uchave wekuporesa. Pakutanga chirwere chinosanganisira chirwere chekutanga, 2, uye 3 kanzira.
Shoko Rinobva
Kuonekwa kuti une kenza kunogona kuita kuti hupenyu hwako huderedze pasi kunyange muzvikamu zvekutanga zvechirwere. Kumbira rubatsiro, uye bvumira vanhu kukubatsira. Paridza kune vamwe. Funga nezvekubatana neboka rekuchengetedza kenza kana iri panzvimbo yemunharaunda kana paIndaneti.
Mishonga inokurumidza kuchinja uye kuva murevereri wako haingobatsiri kuti unzwe uchitungamirirwa zvakare, inogona kukubatsira kuita zvisarudzo zviri nani nezvehutano hwako. Izvi zvinosanganisira mhando dzeutano hwaunosarudza.
Kusarudza kana kuve nokuvhiyiwa - kana kunyange kuwanda kwekuvhiyiwa kwako - isarudzo yega chaiyo. Unhu hwehupenyu hunogona kuchinjwa, saka zvakakosha kushandisa nguva yakawanda yekudzidza nezvechirwere chako uye zvinotora kuti upore. Chinhu chakakosha ndechokuita sarudzo yakasarudzwa kubva pakunzwisisa kwako kwakanakisisa kwezvaunogona kuita.
Sources
- Blanchard, P., Volk, R., Ringash, J., Peterson, S., Hutcheson, K., uye S. Frank. "Kuongorora Musoro uye Mucheche Kanzera Mwoyo Unoda Zvirwere uye Zvaunotarisira: Ongororo Yakarongeka." Oral Oncology . 2016. 62: 44-53.
- National Cancer Institute. "PDQ Cancer Information Summarie s." Laryngeal Cancer Treatment (PDQ): Health Professional Version. Bethesda, Maryland: 2002 (yakavandudzwa muna December 2016).
- Salvador-Coloma, C., uye Cohen, E. "Kuwanda Kwemhando yeLaryngeal Cancer." Nhamba yeOncology Practice . 2016; 12 (8): 717-24.