Pancreas amapanga zinthu zomwe zimathandiza kugaya chakudya chomwe timadya komanso kutulutsa timadzi timene timayendetsa insulini. Kuyamba kwa khansa mu kapamba kumachitika pamene maselo a m'chiwalochi amakula osalamulirika ndikulepheretsa maselo athanzi. Chifukwa chake, pali mitundu iwiri ya khansa ya kapamba. Chofala kwambiri chinali khansa yomwe idapangidwanso m'maselo a exocrine. Ngakhale sizodziwika, ndizotheka kuti khansa iyambenso m'maselo a endocrine. Kuzindikira ndi kuchiza mitundu iwiriyi ya khansa ndi yosiyana. Pachifukwa ichi, ndikofunikira kudziwa mtundu wa khansa yomwe muli nayo.
Zizindikiro za Khansa ya Pancreatic
chikasu m'maso mwanu
Chikopa Chofewa
Mutha kukhala ndi mkodzo wakuda kapena chimbudzi chotuwa kuposa wamba.
kuwonda popanda kuyesa
kumva wotopa
kutentha kwakukulu
kumva ngati kapena kukhala ndi chimfine
kutsegula m'mimba kapena kudzimbidwa
kupweteka m'mimba mwako komanso msana
kupweteka kwambiri podya kapena kugona
Kudzikuza
Matenda a Khansa ya Pancreatic
Gawo 0: Palibe kufalitsa. Khansara ya pancreatic imangokhala m'maselo apamwamba a pancreatic ducts. Khansara ya kapamba ndi yosawoneka pamayesero azithunzi kapena ngakhale ndi maso. Gawo IA: Khansara ya kapamba imangokhala ndi kapamba, koma yakula osakwana 2 cm Gawo IB: Kuposa 2 cm, koma osapitirira 4 cm Gawo II: Khansara ya kapamba ndi yayikulu kuposa ma centimita 4 ndipo imangokhala kapamba kapena imafalikira ku ma lymph nodes omwe ali pafupi, pomwe khansayo idakula kunja kwa kapamba. Gawo Lachitatu: Chotupacho chikhoza kufalikira ku mitsempha yayikulu yapafupi kapena mitsempha. Gawo IV: Khansara ya kapamba yafalikira ku ziwalo zakutali.
Zomwe Zimayambitsa Khansa ya Pancreatic
Zomwe zimayambitsa khansa zambiri sizikudziwika. Choncho, chifukwa chenicheni cha khansa pancreatic sizinganenedwe. Komabe, ngati tifunika kulankhula za mapangidwe a khansa ya pancreatic, tikhoza kunena kuti DNA ya maselo a pancreatic yawonongeka. DNA imalamula selo kuti lichite. Nthawi zina izi zimasintha ndipo DNA imapereka lamulo lolakwika. Izi zimapangitsa kuti maselo akule ndikuyenda modabwitsa.
Kuzindikira khansa ya kapamba kumapangidwa ndi njira zowonera, monganso m'makhansa ena ambiri. Kumbali inayi, kujambula kwa biopsy ndi endoscopic kungathandizenso kuzindikira khansa ya kapamba. Njira zomwe zimagwiritsidwa ntchito pozindikira khansa ya kapamba;
ultrasound
computer tomography (CT)
Kujambula kwa magnetic resonance (MRI)
Nthawi zina positron emission tomography (PET)
Endoscopic ultrasound (EUS)
Kodi Khansa ya Pancreatic Ingachiritsidwe
Yankho la funsoli limasiyanasiyana malinga ndi siteji yomwe khansa yapezeka. Ngakhale kuti akhoza kuchiritsidwa mu magawo 0, 1 ndi 2, mwayi umenewu ndi wotsika kwambiri mu magawo 3. Komano, mwatsoka, palibe chithandizo cha khansa ya pancreatic 4. Njira zochizira zomwe zimaperekedwa m’njira imeneyi nthawi zambiri zimakhala zochepetsera ululu wa wodwalayo komanso kuti wodwalayo amve bwino.
Komabe, kuti athandizidwe bwino, wodwalayo ayenera kuthandizidwa m'dziko labwino. Siziyenera kungokhala pamankhwala a m'dziko lake lokha, koma afufuze njira ndi machiritso ena. Mwanjira imeneyi, adzatha kupeza zotsatira zopambana komanso zachangu ndi chithandizo chomwe adzalandira m'dziko lopambana.
Opaleshoniyi nthawi zambiri imakhala yochotsa zotupa m'mutu mwa kapamba. Panthawi ya opaleshoni, mutu komanso nthawi zina thupi la kapamba limachotsedwa. Izi zikuphatikizanso: Kuchotsa mbali yaing`ono intestine, mbali ya ya ndulu, ndulu, mwanabele pafupi kapamba, ndipo nthawi zina mbali ya m`mimba.
Zotsalira za bile ndi kapamba zimalumikizidwa ndi matumbo ang'onoang'ono kotero kuti ma enzymes a bile ndi digestive amatha kupitabe m'matumbo aang'ono. Zidutswa zakumapeto kwa matumbo aang'ono zimalumikizidwanso kuti chakudya chidutse m'mimba. Ngakhale kuti opaleshoniyo kaŵirikaŵiri imafunika kudulidwa kwakukulu pamimba, madokotala ena amatha kupereka chithandizo ndi njira ya laparoscopic, popanga zilonda zing’onozing’ono zingapo m’mimba.
Njira ya Whipple ndi ntchito yovuta kwambiri yomwe imafuna dokotala wa opaleshoni yemwe ali ndi luso komanso luso. Pachifukwa ichi, ndikofunikira kuti odwala azikonda maopaleshoni opambana. Kupanda kutero, chiopsezo cha imfa mwachindunji chifukwa cha opaleshoni ndichokwera kwambiri. Musaiwale kuti mutha kupanganso zosankha zanu za opaleshoni kunja kwa dziko lanu. Pazifukwa izi, ngati simunapeze dokotala wochita bwino m'dziko lanu kapena simungadalire kupambana kwake, mutha kuphatikizanso madokotala ochita opaleshoni ku Turkey pakati pa zomwe mumakonda. Madokotala amtundu wa maopaleshoni ndi odziwa maopaleshoni omwe ali ndi luso lamanja.
Distal Pancreatectomy
Opaleshoniyi imaphatikizapo kuchotsa mbali yomaliza ndipo nthawi zina thupi la kapamba. Nthawi zambiri ndulu imachotsedwa nthawi yomweyo. Popeza kuti ndulu imatilola kuti tisamenyane ndi matenda, kuchotsa kumatanthauza kuti sitingathe kulimbana ndi matenda ena. Pachifukwachi, ena katemera nthawi zambiri chofunika pamaso pa opareshoni. Motero, wodwalayo sadzavulazidwa chifukwa cha matenda alionse.
Total Pancreatectomy
Opaleshoniyi ikhoza kukhala njira ngati khansa yafalikira ku kapamba koma imatha kuchotsedwabe. Mu opaleshoniyi, kuwonjezera pa kapamba onse, ndulu, m'mimba, gawo la matumbo aang'ono ndi ndulu zimachotsedwanso. Komabe, opaleshoni yamtunduwu sagwiritsidwa ntchito mocheperapo kuposa maopaleshoni ena chifukwa palibe phindu lalikulu pakuchotsa kapamba wonse. Kumbali inayi, zotsatira zomwe zingatheke ndizofala kwambiri.
Ndizotheka kukhala popanda kapamba. Koma kapamba wonse akachotsedwa, anthu amasowa maselo amene amatulutsa insulini ndi mahomoni ena amene amathandiza kuti shuga m’magazi asamayende bwino. Anthuwa amayenera kukhala ndi moyo wodalira insulini ndipo ayenera kupitiriza moyo wawo ndi mankhwala ena a mahomoni.
Khansa ya Pancreatic Chemotherapy
Chemotherapy mu khansa ya kapamba imatha kutchulidwa m'njira ziwiri; Musanachite opaleshoni (neoadjuvant chemotherapy): Amaperekedwa asanachite opaleshoni kuti achepetse chotupacho. Neoadjuvant chemotherapy nthawi zambiri amagwiritsidwa ntchito pochiza khansa yomwe ndi yayikulu kwambiri kuti isachotsedwe ndi opaleshoni.
Pambuyo pa opaleshoni (adjuvant chemotherapy): Amagwiritsidwa ntchito pambuyo pa opaleshoni kupha maselo a khansa omwe amasiyidwa kapena akufalikira koma osawoneka. Ngati maselowa aloledwa kukula, amatha kupanga zotupa zatsopano kwina kulikonse m'thupi. Mankhwala amtunduwu amachepetsa mwayi woti khansayo ibwererenso pambuyo pake.
Kwa khansa yapamwamba ya pancreatic: Itha kugwiritsidwa ntchito ngati khansayo yapita patsogolo ndipo singathe kuchotsedwa ndi opaleshoni ndipo khansayo yafalikira ku ziwalo zina.
Zotsatira Zake Za mankhwala amphamvu
nseru
kusanza
Kutaya njala
kupweteka tsitsi
zilonda mkamwa
kutsekula
kudzimbidwa
Kuchepa kwa thupi kukana matenda
Kutuluka Magazi M'thupi
kuvulala pathupi
kutopa
kupuma movutikira
Khansa ya Pancreatic Radiotherapy
Pambuyo pa opaleshoni (adjuvant) radiation: Itha kuperekedwa kuyesa kuchepetsa mwayi wa khansa kubwerera. Ma radiation nthawi zambiri amaperekedwa limodzi ndi chemotherapy, yotchedwa concomitant chemoradiotherapy.
Chithandizo cha radiation musanachite opaleshoni: Kwa zotupa zotuluka m'malire, zimaperekedwa asanachite opaleshoni kuti achepetse chotupacho ndikuthandizira kuchotsa kwathunthu.
Chithandizo cha radiation chophatikiza ndi chemotherapy: Itha kugwiritsidwa ntchito ngati gawo la chithandizo chachikulu kwa anthu omwe khansa yawo yadutsa kapamba ndipo sangathe kuchotsedwa ndi opaleshoni.
Nthawi zina, ma radiation amaperekedwa kuti wodwalayo amve bwino komanso kuti achepetse ululu wake panthawi ya khansa yomwe sichitha kuchiritsidwa nthawi zina.
Zotsatira za Radiotherapy
kuthamanga kwa khungu
khungu matuza
kusenda khungu
nseru
kusanza
kutsekula
kutopa kwambiri
Kutaya njala
kuwonda
Khansa ya Metastatic Pancreatic
Khansara ya kapamba nthawi zambiri imafalikira pamimba ndi chiwindi. Amathanso kufalikira kumapapu, mafupa, ubongo, ndi ziwalo zina.
Izi zikutanthauza kuti makhansa afalikira kutali kuti achotsedwe ndi opaleshoni. Zili choncho chifukwa ngakhale kuti madokotala amaona maselo a khansa m’ziŵalo zoŵerengeka chabe, maselo aang’ono a khansa afalikira ku tizigawo tosiyanasiyana ta thupi. Pamenepa, mankhwala ena osakaniza amaperekedwa kwa wodwala amene sangathe kuchiritsidwa, ndipo ma radiotherapy amagwiritsidwa ntchito kuti athetse ululu.
Chithandizo chamankhwala chomwe chimadziwika kuti chemotherapy nthawi zina chimatha kuyimitsa kapena kuchedwetsa kukula kwa makhansawa kwakanthawi ndikuthandizira anthu kukhala ndi moyo wautali, koma sayembekezereka kuchiza khansa. Mankhwala ndi kuphatikiza mankhwala omwe amagwiritsidwa ntchito ndi awa; Gemcitabine ndi imodzi mwa mankhwala omwe amagwiritsidwa ntchito kwambiri. Itha kugwiritsidwa ntchito yokha (makamaka kwa anthu omwe ali ndi thanzi labwino) kapena kuphatikiza ndi mankhwala ena monga albumin-dependent paclitaxel (Abraxane), capecitabine (Xeloda), kapena erlotinib (Tarceva).
Njira ina kwa anthu omwe ali ndi thanzi labwino ndi kuphatikiza mankhwala a chemotherapy otchedwa FOLFIRINOX. Amakhala ndi 4 mankhwala: 5-FU, leucovorin, irinotecan (Camptosar) ndi oxaliplatin (Eloxatin). Mankhwalawa angathandize anthu kukhala ndi moyo wautali kusiyana ndi kumwa gemcitabine yekha, koma akhoza kukhala ndi zotsatira zoopsa kwambiri.
Kumbali ina, chithandizo cha radiation kapena mtundu wina wa mitsempha ungagwiritsidwe ntchito kuthetsa ululu wa khansa. Komanso, palibe mankhwala odziwika a khansa ya kapamba pakadali pano. Ichi ndichifukwa chake mutha kuyesa mankhwala atsopano potenga nawo mbali pamayesero azachipatala.
Dziko la Turkey ndi dziko lomwe layamba kudzipangira mbiri ngati malo ochizira khansa. Kuphatikiza pa teknoloji yomwe imagwiritsidwa ntchito mu chithandizo cha khansa ku Turkey, chifukwa cha madokotala ochita bwino komanso aluso a ku Turkey, Cancer ndi dziko lomwe limatsimikizira kuti odwala ake amalandira chithandizo chamankhwala chopambana. Chifukwa chake, popitiliza zomwe talemba, muwona momwe Turkey imachitira bwino pamankhwala a khansa.
Madokotala Opambana Oncology
Madokotala ochita bwino komanso odziwa bwino oncology amafunikira pochiza khansa ya kapamba. Chithandizo chomwe mudzalandire ku Turkey chidzaperekedwa ndi akatswiri ochita bwino pankhani ya oncology. Musaiwale kuti mudzalandira chithandizo chabwino kwambiri ndi madokotala omwe ali ndi dipatimenti ya oncology. Mudzakumana ndi madotolo anu mukalandira chithandizo ku Turkey, komwe kumakhala kosavuta kufikira akatswiri. Ngati muli ndi nkhawa, mutha kugawana ndi madokotala ndikufunsa mafunso okhudza chithandizocho. Ndiye mudzagawana nkhawa zanu.
