Umdlavuza Wendlala Yesinye

Umdlavuza Wendlala Yesinye Ukukhula okungalawuleki kwezicubu zomzimba, indlala iba phakathi nezitho zokuzala zabesilisa kanye nesinya. Ukukhula okungajwayelekile kwezicubu zesinye kuvame ukutholakala ngokuhlolwa, ngokujwayelekile, ukuhlolwa kwegazi okuhlola amazinga e-antigen ye-prostate (PSA). Labo abanezinga eliphakeme le-PSA egazini labo basengozini enkulu yokuthola umdlavuza wendlala yesinye. Ukuxilongwa kudinga ukuhlolwa kwe-biopsy ye-prostate. Uma umdlavuza ukhona, udokotela wezifo unikeza i-Gleason score, futhi amaphuzu aphezulu amele isimila esiyingozi kakhulu. Izithombe zezokwelapha zenziwela ukubheka umdlavuza osungaphandle kwendlala yesinye. Ngokusekelwe kumaphuzu kaGleason, amazinga e-PSA, kanye nemiphumela yokuthwebula izithombe, isimo somdlavuza sinikezwa isigaba 1 kuya ku-4. Isigaba esiphakeme sisho isifo esiphambili, esesiyingozi kakhulu.

Izimila eziningi zendlal yesinye zihlale zincane futhi azibangi izinkinga zempilo. Lezi ziphathwa ngokuqapha okusebenzayo, ukuqapha isimila ngokuhlolwa njalo ukuqinisekisa ukuthi asikhuli. Izimila ezingase zibe yingozi kakhulu zingabhujiswa nge-radiation therapy noma zisuswe ngokuhlinzwa nge-I-<b>radical prostatectomy</b>. Labo abanomdlavuza odlulela ngalé kwendlala yesinye belashwa nge-I-<b>hormone</b> ehlisa amazinga ama<b>-androgen</b> (ama-hormone obulili abesilisa) amangqamuzana e-prostate ayadingeka ukuze uphile. Ekugcineni, amangqamuzana omdlavuza angakhula amelane nokwelashwa. Lesi sigaba esiphakeme kakhulu sesifo, esibizwa ngokuthi umdlavuza wendlala yesinye , welashwa ngokwelashwa kwama-hormone okuqhubekayo kanye nesidakamizwa se-docetxel. Ezinye izimila zisakazeka kwezinye izingxenye zomzimba, ikakhulukazi <b>amathambo</b> nAma-lymph nodes. Lapho, izimila zibangela ubuhlungu obukhulu bamathambo, ubuthakathaka bemilenze noma ukukhubazeka, futhi ekugcineni zikubulale. ukubekezelela umdlavuza wendlala yesinye kuncike ekutheni umdlavuza ususakazeke kangakanani ngesikhathi utholakala ngaso. Amadoda amaningi atholakala anezimila ezise-prostate; amaphesenti anga-99 awo aphila iminyaka engaphezu kweyishumi ekuxilongweni kwawo. Izimila ezisakazeke ezindaweni ezikude zomzimba ziyingozi kakhulu, amazinga okusinda kweminyaka emihlanu angu-30-40.

Ingozi yokuthola umdlavuza we-prostate iyakhula ngokuhamba kweminyaka; isilinganiso seminyaka yokuxilongwa inga-67. Labo abanomlando womdlavuza emndenini wanoma yimuphi umdlavuza banamathuba amaningi okuba nomdlavuza wendlala yesinye, ikakhulukazi labo abawuthola njengefa.Izinhlobo ezihlobene nomdlavuza zezakhi zofuzo ze-BRCA2. Unyaka ngamunye kutholakala iziguli eziyizigidi eziyizigidi ezingu-1.2 zomdlavuza wendlala yesinye, futhi abayizinkulungwane ezinga-350,000 bayafa ngenxa yalesi sifo, okwenza kube yimbangela yesibili sokufa emadodeni.[2] Indoda eyodwa kwabayisishiyagalombili itholakala inomdlavuza wendlada yesinye ngesikhathi sokuphila kwayo futhi eyodwa kwabangamashumi amane iyafa ngenxa yalesi sifo.[3] Izimila ze-prostate zaqala ukuchazwa maphakathi nekhulu le-19, ngesikhathi sokuhlinzwa kwamadoda anezinkinga zokuchama. Ekuqaleni, i-prostatectomy kwakuyindlela eyinhloko yokwelapha umdlavuza we-prostate. Maphakathi nekhulu lama-20, ukwelashwa ngemisebe kanye nokwelashwa kwama-hormone kwasungulwa ukuze kuthuthukiswe ukwelashwa komdlavuza we-prostate. Ukusungulwa kwezokwelapha kwama-hormone omdlavuza we-prostate kwaqashelwa nge-Nobel Prize ka-1966 kUCharles B. Huggins kanye ne-Prix ka-1977 kU-Andrzej W. Schally.

Izimpawu

Umdlavuza wokuqala we-prostate ngokuvamile awubangeli izimpawu. Njengoba umdlavuza uqhubeka, ungabangela Ukungasebenzi kahle kwe-erectile, igazi emchamweni noma isidoda, noma inkinga yokuchama - ngokuvamile kufaka ukuchama njalo kanye nokugeleza umchamo kancane noma okuncane. Amadoda angaphezu kwengxenye aneminyaka engaphezu kwengu-50 abhekana nohlobo oluthile lwenkinga yokuchama, ngokuvamile ngenxa yezinkinga ngaphandle komdlavuza we-prostate njenge-benign prostatic hyperplasia (ukwanda kwe-prostate okungenawo umdlavuza).[5]

Izimila ze-prostate eziphambili zingase zisakazeke kuma-lymph nodes namathambo aseduze, ikakhulukazi emathunjini, ezindololwaneni, emgogodleni, ezimbonini, ekhanda, nasentanyeni.[6] Lapho zingabangela Ukukhathala, ukwehla kwesisindo okungachazeki, nobuhlungu beqolo noma bamathambo obungathuthuki ngokuphumula.[7] Ama-metastasis angalimaza amathambo azungezile, futhi cishe ingxenye eyodwa kwezine yalabo abanomdlavuza we-prostate we-metastatic baqala Ukuphuka kwamathambo.[9] Ukwanda kwe-metastasis kungacindezela umgogodla okubangela ubuthakathaka emilenzeni nasezinyaweni, noma ukukhubazeka kwemilenze.[10][11]

Ukuhlolwa

Izimo eziningi zomdlavuza we-prostate zitholakala ngokuhlolwa, lapho izimila zincane kakhulu ukuba zibangele noma yiziphi izimpawu. Lokhu kwenziwa ngokuhlolwa kwegazi ukuze kulinganiswe amazinga e-prostate-specific antigen (PSA), ephakanyisiwe kulabo abane-prostate enkulu, kungaba ngenxa yomdlavuza we-prostate noma i-benign prostatic hyperplasia.[12] Igazi lomuntu ovamile linama-nanogram angu-1 (ng) e-PSA nge-milliliter (mL) yegazi elihlolwe.[14] Labo abanezinga le-PSA elingaphansi kwesilinganiso cishe ngeke babe nomdlavuza we-prostate oyingozi eminyakeni engu-8 kuya kwengu-10 ezayo.[14] Amadoda anezinga le-PSA elingaphezu kuka-4 ng/mL asengozini eyengeziwe - cishe u-1 ku-4 uzoba nomdlavuza we-prostate - futhi avame ukubhekiselwa ekuhlolweni kwe-prostate.[16]  Amazinga e-PSA angaphezu kuka-10 ng/mL abonisa ingozi ephakeme kakhulu: amadoda angaphezu kwengxenye kuleli qembu athola umdlavuza we-prostate.  Amadoda anezinga eliphakeme le-PSA avame ukutuswa ukuba aphinde ukuhlolwa kwegazi emasontweni amane kuya kwayisithupha kamuva, njengoba amazinga e-PSA engashintsha ngaphandle kokuhlobana nomdlavuza we-prostate.[17] I-benign prostatic hyperplasia, ukutheleleka kwe-prostate, ukuchitheka kwamuva, kanye nezinye izinqubo ze-urological kungandisa amazinga e-PSA; ukuthatha Ama-inhibitors e-5α-reductase kunganciphisa amazinga e'PSA.