Yintoni umhlaza wesinyi?

Umhlaza wesinyi luhlobo lomhlaza oluqala kwiiseli zesinyi—ilungu elingenanto elisezantsi kwesisu eligcina umchamo ngaphambi kokuba uphume emzimbeni. Lo ngomnye wemimhlaza eqhelekileyo kwihlabathi liphela, ingakumbi kubantu abadala. E-United States kuphela, amatyala amatsha angaphezu kwama-80,000 afunyanwa minyaka le.

Iindaba ezimnandi zezokuba uninzi lwemihlaza yesinyi ifunyanwa kwangethuba, xa kulula ukuyinyanga. Ukufunyanwa kwangethuba kunokwenza umahluko omkhulu ekusindeni nasekuphuculeni ubomi. Nangona kunjalo, umhlaza wesinyi udla ngokubuya nokuba emva konyango oluphumeleleyo, oko kuthetha ukuba ukhathalelo oluqhubekayo lwexesha elide lubaluleke kakhulu.

Ziziphi iintlobo zomhlaza wesinyi?

Kukho iintlobo ngeentlobo zomhlaza wesinyi. Ukuqonda umahluko kunceda oogqirha bakhethe isicwangciso sonyango esifanelekileyo.

• I-Urothelial carcinoma (i-transitional cell carcinoma): Uhlobo oluqhelekileyo (malunga ne-90% yazo zonke iimeko). Luqala kwiiseli ze-urothelial ezijikeleze isinyi.
• I-squamous cell carcinoma: Inxulunyaniswa nokucaphuka kwesinyi ixesha elide, ngamanye amaxesha okubangelwa zizifo ezingapheliyo okanye ukusetyenziswa kwe-catheter ixesha elide. Ayixhaphakanga kangako kodwa inokuba yingozi.
• i-adenocarcinoma: Inqabile kakhulu (malunga ne-1–2% yeemeko). Iqala kwiiseli ze-glandular kwi-bladder lining.
• I-cell carcinoma encinci: Ayiqhelekanga kakhulu. Ikhula ngokukhawuleza kwaye idla ngonyango nge-chemotherapy kunye ne-radiation.
• ISarcoma: Uhlobo olungaqhelekanga. Luqala kwiiseli zemisipha yesinyi.

Zithini Izizathu Zomhlaza Wesinye?

Umhlaza uvela xa i-DNA engaphakathi kwiiseli zesinyi itshintsha (itshintsha), nto leyo ebangela ukuba iiseli zikhule ngendlela engalawulekiyo. Nangona unobangela ungacaci rhoqo, zininzi izinto ezinokubangela oku:

• Ukusetyenziswa kwecuba: Ukutshaya yeyona nto ibangela ukuba kubekho iikhemikhali ezikutshaya icuba. Iikhemikhali ezikutshaya icuba zingena egazini, zihluzwe zizintso, zize ziphele zisemchameni, zizonakalisa ngokuthe ngqo iiseli zesinyi.
• Ukuvezwa kwemichiza: Ukudibana ixesha elide neekhemikhali ezithile zoshishino, ingakumbi iidayi kunye nezinyibilikisi, kunokunyusa umngcipheko.
• Ukurhawuzelelwa sisinyi okungapheliyo: Usulelo oluqhubekayo, amatye esinyini, okanye ukusetyenziswa rhoqo kwe-catheter ngamanye amaxesha kunokukhokelela kumhlaza.
• Utshintsho lwemfuza: Ezinye iinguqu ezizuzwe njengelifa okanye ezifunyenweyo zonyusa umngcipheko womhlaza.

Ziziphi Izinto Ezibangela Umngcipheko Womhlaza Wesinye?

Usenokuba semngciphekweni omkhulu womhlaza wesinyi ukuba:

• Iimeko zendlela yokuphila:
  • Ukutshaya (iicuba, iicuba, iipayipi).
  • Ukuchanabeka kakhulu kwiikhemikhali ezithile emsebenzini (umz., kwimizi-mveliso yerabha, yesikhumba, yokushicilela, okanye yepeyinti).
• Imbali yonyango:
  • Umhlaza wesinyi wangaphambili (umngcipheko ophezulu wokuphinda ubekho kwakhona).
  • Usulelo lomchamo okanye amatye ixesha elide.
  • Ikhemotherapy yangaphambili okanye imitha ye-pelvic.
• Ubudala kunye nesini:
  • Uninzi lwezigulane zingaphezulu kweminyaka engama-55 ubudala.
  • Amadoda anamathuba aphindwe kathathu ukuya kane okuba nomhlaza wesinyi kunabafazi.
• Imbali yentsapho: Ukuba nezalamane ezisondeleyo ezinomhlaza wesinyi kunyusa kancinci umngcipheko.
• Izinto ezibangela ukusela amanzi: Ukuvezwa kwe-arsenic ixesha elide emanzini okusela kuye kwanxulunyaniswa nomhlaza wesinyi kwezinye iindawo.

Zithini Iimpawu zoMhlaza weSinyi?

Umhlaza wesinyi uhlala ubonisa iimpawu zokulumkisa kwangethuba. Ukuba uyazibona, kubalulekile ukubona ugqirha ngoko nangoko.

Iimpawu zokuqala:

• Igazi kumchamo (i-hematuria) – lisenokubonakala lipinki, libomvu, okanye limdaka.
• Ukuchama rhoqo.
• Iintlungu okanye ukutshisa ngelixa uchama.
• Ungxamiseko (imfuneko enamandla, ngequbuliso yokuchama).

Iimpawu eziphambili:

• Intlungu yomqolo okanye yesinqe.
• Ukungakwazi ukuchama.
• Ukuphulukana nobunzima obungachazwanga.
• Ukudinwa okanye ubuthathaka.
• Ukudumba emilenzeni.

Ngenxa yokuba uninzi lwezi mpawu zinokubangelwa zizifo zomchamo okanye amatye ezintso, uvavanyo lwezonyango lubalulekile.

Ufunyaniswa Njani Umhlaza Wesinye?

Oogqirha basebenzisa uthotho lweemvavanyo ukuqinisekisa umhlaza wesinyi:

• Cystoscopy: Ugqirha ufaka isixhobo esincinci, esifana netyhubhu esibizwa ngokuba yi-cystoscope nge-urethra singene kwisinyi ukuze sibone ngqo ulwelo lwesinyi. Ulwelo lusetyenziselwa ukuzalisa isinyi, nto leyo evumela ugqirha ukuba abone iindawo ezingaqhelekanga.
• Uvuko: Ukuba kufunyenwe iindawo ezikrokrisayo ngexesha le-cystoscopy, kuthathwa iisampulu zezicubu (ii-biopsy). Ezi sampuli emva koko zihlolwa phantsi kwe-microscope yingcali yezifo ukuqinisekisa ukuba kukho iiseli zomhlaza.
• I-Cytology yomchamo: Isampulu yomchamo ihlolwa phantsi kwe-microscope ukujonga naziphi na iiseli ezingaqhelekanga okanye ezinomhlaza.
• Ukuvavanya iimvavanyo: I-CT Urogram isebenzisa i-X-reyi kunye nedayi yokwahlulahlula ukwenza imifanekiso eneenkcukacha zesinyi kunye nezinye izakhiwo zendlela yomchamo, inceda ekuchongeni ubungakanani bomhlaza kunye nendawo okuyo. I-MRI kunye ne-ultrasound zibonelela ngemibono eneenkcukacha zendlela yomchamo.
• Hlaziya iPyelogram: Uvavanyo lomfanekiso apho kufakwa idayi kwindlela yomchamo ukuze izakhiwo zibonakale ngakumbi kwi-X-ray.

Ukuhlaselwa kweSinyi soMhlaza

Emva kokuxilongwa, oogqirha bafumanisa ukuba umhlaza uqhubele phambili kangakanani. Oku kunceda ekukhokeleni izigqibo zonyango.

Ukucwangcisa

• Inqanaba 0: Umhlaza kuphela kwingqiniba yesinyi.
• Inqanaba lokuQala: Sasaza kwizicubu ezinxibelelanayo ezingaphantsi kwelaphu.
• Inqanaba lesiBini: Ukufikelela kwizihlunu zesinyi.
• Inqanaba lesi-3: Isasazeka kumafutha akufutshane okanye kwizitho ezikufutshane.
• Inqanaba lesi-4: Isasazeka kwii-lymph nodes, emathanjeni, okanye kwizitho ezikude.

UkuGcina

• Ii-tumor ezikumgangatho ophantsi: Iiseli zibukeka ngathi ziiseli eziqhelekileyo; zihlala zikhula kancinci.
• Iithumba ezikumgangatho ophezulu: Iiseli zibonakala zingaqhelekanga kwaye zinokwanda kakhulu.

Iindlela Zonyango Lomhlaza Wesinye

Ukuhlinzwa:

• Ukuqhambuka kwe-Transurethral yeTumor yesinyi (TURBT): Kwimidlaza engaphezulu, kwenziwa i-TURBT ukususa ithumba ngokulikrwela eludongeni lwesinyi, ngamanye amaxesha kulandele i-fulguration ukuze kutshiswe izicubu eziseleyo.
• Ukususwa kweCystectomy okuNgaphelelanga okanye okuGqibeleleyo: Kwimidlaza ekumgangatho ophezulu, engangenisi zihlunu, okanye ehlaselayo, i-partial or radical cystectomy (ukususwa kwenxalenye okanye yonke i-bladder) kunokufuneka. Ukususwa komchamo kwenziwa ukuze kudalwe indlela entsha yokuba umchamo uphume emzimbeni emva kwe-radical cystectomy.

Unyango lwezonyango:

• I-Intravesical Chemotherapy: Inikwa ngqo kwisinyi ukuze kuthintelwe umhlaza wesinyi ongangenisi ntsholongwane ukunciphisa umngcipheko wokuphinda ubuye.
• Inkqubo yeKhemotherapy: Inikwa ngemithambo yegazi yomhlaza ohlaselayo, rhoqo ngaphambi kotyando lokunciphisa ithumba okanye njengenxalenye yokudibanisa nonyango lwemitha.
• I-Immunotherapy: Iqinisa amajoni omzimba ukulwa nomhlaza. I-Bacillus Calmette-Guérin (BCG) sisithako sonyango olusetyenziswa kakhulu kumhlaza wesinyi ongangenisi izihlunu ukunciphisa ukuphinda ubuye. Amayeza asetyenziswa kwinkqubo yenkqubo efana ne-pembrolizumab kunye ne-nivolumab anokusetyenziswa ukunyanga umhlaza wesinyi oqhubele phambili okanye ukuthintela ukuphinda ubuye emva kotyando.
• Unyango ngemitha: Imitha enamandla aphezulu itshabalalisa iiseli zomhlaza. Isetyenziswa rhoqo xa utyando lungenzeki okanye ukunciphisa iithumba ngaphambi kotyando.

Unyango lweProton: lusebenza nini?

Unyango lweProton luhlobo lwemitha esebenzisa imisebe yeproton endaweni ye-X-ray. Kunyango lomhlaza wesinyi, le ndlela inika ithuba lokugcinwa ngcono kwesinyi, ulawulo lwasekuhlaleni oluphuculweyo, kunye neziphumo ebezingalindelekanga ezincitshisiweyo xa kuthelekiswa nemitha ye-photon (X-ray) eqhelekileyo, nto leyo eyenza ukuba ibe luncedo ngakumbi kwizigulana ezinomhlaza wesinyi ohlaselayo ezingafanelekiyo utyando. Inokuba luncedo kwiimeko ezithile ukunciphisa umonakalo kwizitho ezingqongileyo, nangona ingelulo unyango oluqhelekileyo lomhlaza wesinyi.

Yintoni Isibikezelo Somhlaza Wesinye?

Ukusinda komhlaza wesinyi kuxhomekeke kwinqanaba, ibanga, kunye nempilo iyonke.

• Umhlaza okwinqanaba lokuqala (Inqanaba 0 kunye nelokuqala): Amanqanaba aphezulu okusinda ngonyango olufanelekileyo.
• Inqanaba lesiBini nelesiThathu: Amathuba okuphiliswa aphantsi kodwa asenokwenzeka ngonyango oluqatha.
• Inqanaba lesi-4: Kunzima ukunyanga, kodwa unyango lwanamhlanje lunokwandisa ubomi kwaye luphucule umgangatho wobomi.

Ngokomndilili, izinga lokusinda kweminyaka emi-5 lomhlaza wesinyi e-US limalunga ne-77%, kodwa oku kuyahluka kakhulu ngokwesigaba.

Ukuhlolwa kunye nokuthintela umhlaza wesinyi

Akukho vavanyo lokuhlola umhlaza wesinyi oluqhutywa rhoqo kuluntu ngokubanzi. Nangona kunjalo, abantu abasengozini enkulu banokungenelwa kuvavanyo lomchamo oluqhelekileyo okanye i-cystoscopy.

Iingcebiso zokuthintela:

• Yeka ukutshaya.
• Nciphisa ukuvezwa ziikhemikhali emsebenzini.
• Sela ulwelo oluninzi (lunciphisa izinto eziyingozi kumchamo).
• Nyanga izifo zesinyi ngokukhawuleza.

Yezigulana zamazwe ngamazwe

Abantu abavela kwihlabathi liphela beza kwiZibhedlele zaseApollo ukuze banyangwe umhlaza wesinyi. Iqela lethu leenkonzo zezigulane zamazwe ngamazwe liza kukukhokela ukususela ekufuneni i-intanethi yokuqala ukuya kunyango eIndiya uze ubuyele ekhaya emva konyango.

Iinkonzo ziquka:

• Izimvo zonyango kunye nocwangciso
• Uphononongo lwezonyango lokufika kwangaphambili kweengxelo kunye nemifanekiso.
• Ukuhamba kunye nokulungiselela
• Uncedo ngeeleta zesimemo se-visa, ukudluliselwa kwisikhululo seenqwelomoya, kunye neendawo zokuhlala ezikufutshane.
• Abaququzeleli besigulane bamazwe ngamazwe abazinikeleyo ukuba bakhokele kwinqanaba ngalinye.
• Inkxaso yolwimi nenkcubeko
• Iinkonzo zokutolika kwiilwimi ezininzi.
• Iingcaciso ezicacileyo, ezilula kuzo zonke izigaba ezinezicwangciso zokhathalelo olubhaliweyo.
• Ulungelelwaniso lwemali
• Uqikelelo lonyango oluselubala kunye neepakethe xa kunokwenzeka.
• Inkxaso ngeendlela zokuhlawula kumazwe ngamazwe kunye nokulungelelaniswa kwe-inshurensi.
• Ukuqhubeka kokhathalelo
• Iirekhodi ekwabelwana ngazo, umfanekiso, kunye nezishwankathelo zonyango koogqirha basekhaya.
• Ukulandelwa kweTelemedicine ukuze kube lula emva kokubuyela ekhaya.