Cutar cututtuka, dalilai, ganewa, da jiyya
Ciwon daji na endometrial shine ciwon daji wanda ke shafar mahaɗarin cikin mahaifa kuma ya fi kowa a cikin mata bayan menopause. Abin damuwa ita ce irin wannan ciwon daji ya karu a Arewacin Amirka da Turai. Mene ne ya kamata ka san game da bayyanar cututtuka, ganewar asali, da jiyya ga wannan ciwon daji?
Endometrial Cancer-Definition
Ciwon daji na endometrial, wanda aka fi sani da ciwon daji na uterine, shine ciwon daji wanda ke tasowa a cikin kwayoyin da ke rufe mahaifa ( endometrium ) kuma shine mafi yawan yawan ciwon daji don shafar jikin jikin mahaifa.
Abun ƙarewa yana da matukar aiki a cikin hawan mata da kuma ciki. A lokacin rabi na farko na juyayi, isrogen yana haifar da endometrium don tsarawa don aiwatar da ciki. Idan ciki bai faru ba, progesterone yana haifar da raguwa da wannan nau'in, wanda aka zubar lokacin lokacin mata.
Wani ciwon daji na kasa da kasa na mahaifa, sarcoma na uterine, ya fara a cikin Layer nama a ƙarƙashin endometrium da ake kira myometrium (tsoka na mahaifa).
Akwai adadin cututtuka na ciwon daji na endometrial, irin su adenocarcinoma, adenosquamous, carcinoma, ƙarancin cell cellcin, da sauransu. Yawancin wadannan cututtuka an gano su da wuri, a wani mataki lokacin da tiyata yana ba da damar samun magani. Wannan ya ce, abubuwan da ke tattare da hadarin da ke haifar da haɗarin bunkasa waɗannan ciwon sukari sun karu kamar yadda yawancin bincikar gwagwarmaya a kowace shekara a kasashe masu tasowa.
Endometrial vs. Cervical Ciwon daji
Bambanci tsakanin ciwon daji na endometrial da ciwon jijiyoyin mahaifa na iya zama rikicewa tun lokacin cervix shine ainihin ƙananan mahaifa. Duk da yake kwayar ta shafi wannan kwayar halitta, akwai wasu bambanci da yawa waɗanda ke dauke da nunawa ga mahimman abubuwan da suka haifar da wadannan cututtuka.
Sashin ɓangaren na mahaifa ya ƙunshi jiki ko asusun, yayin da cervix shine ƙananan ɓangaren mahaifa, wanda ya haɗa zuwa farji.
Damawar Ciwon Cutar Endometrial
An kiyasta ciwon daji na endometrial ya shafi mata 61,380 a 2017, sakamakon mutuwar 10,920 daga cikin wadannan mata. An gano cewa ciwon daji na endometrial yana karuwa a cikin 'yan shekarun nan, musamman a Arewacin Amirka da Turai. Ana tsammanin cewa wannan yana iya alaka da karuwa a cikin halayen haɗari a cikin 'yan shekarun nan, irin su kiba, mata marasa' ya'ya, da jinkiri haihuwa. Duk da yake ciwon daji na endometrial ya kasance sau ɗaya ba a cikin matan Amurka na Amurka fiye da fata a Amurka, halin da ake ciki yanzu ya kama.
Alamai da cututtuka
Da farko, mace ba ta da wata alamar cututtuka da ciwon daji na endometrial. Yayin da bayyanar cututtuka suka ci gaba, mafi yawan al'ada shine canji a yaduwar jini. Wannan zai iya zub da jini bayan da mace ta shiga cikin mazauni kuma ba ta da lokaci. A cikin zubar da jini na farko, ciwon daji na endometrial zai iya haifar da zubar da jini na mahaifa , kamar zub da zubar da jini a tsakanin lokaci. Wasu mata ba su da zub da jini daban-daban, amma a maimakon haka suna lura da alamar mai zurfin jini. Wasu mata na iya ciwon anemia (ƙananan jinin jini) saboda sakamakon jini.
Wasu yiwuwar bayyanar cututtuka sun hada da ciwon pelvic ko wani pelvic taro. Lokacin da ciwon daji ya ci gaba, ana iya lura da alamun bayyanar cututtuka irin su rashin asarar rashin nauyi , gajiya, ko juyayi da mafitsara.
Dalili da Dalili Dama
Duk da yake ba mu da tabbaci game da ainihin dalilai na ciwon daji na endometrial, an gano matsala masu yawa. Abubuwan da aka sani da kuma yiwuwar sun hada da:
- Shekaru: Ciwon daji na Endometrial yafi kowa a cikin mata fiye da shekarun mazaunawa.
- Matakan estrogen wadanda aka haɓaka (ba tare da haɗuwa da haɗari ba a cikin progesterone): Duk wani yanayin da ya kara yawan matakan estrogen ba tare da karuwa irin wannan ba a cikin progesterone na iya ƙara haɗarin.
- Yin amfani da maganin jiyya: Amfani da maganin ƙwaƙwalwar jiyya na akalla shekara guda yana rage hadarin. Raguwa a cikin hadarin ya fi girma ga matan da suke amfani da kwayoyin maganin haihuwa don tsawon lokaci kuma ya ci gaba da rage haɗarin na shekaru da yawa bayan an dakatar da kwayoyin.
- Hanyoyin sauyawa (HRT): HRT tare da estrogen amma ba tare da progesterone (maganin ciwon estrogen ba) yana ƙara haɗarin ciwon daji na endometrial.
- Abubuwa masu haifa: Mata da ke da shekaru masu haihuwa, irin su wadanda suka fara yin al'ada da wuri ko wadanda suka shiga cikin jima'i suna da hatsari. Mata da ba su da yara suna da hatsari fiye da wadanda suke da yara.
- Tarihin rashin haihuwa
- Tarihin endometrial hyperplasia
- Kiba: Kasancewa ƙananan obese haɗarin haɓaka cutar.
- Ƙunƙwarar cutar ovarian (PCOS): PCOS na ƙara yawan haɗarin bunkasa ciwon daji na endometrial ko da yake wasu jiyya ga PCOS, kamar metformin, na iya rage haɗarin.
- Ciwon sukari: Rashin ciwon ciwon daji na Endometrial shine sau hudu mafi girma a mata da ciwon sukari.
- IUD yayi amfani da su: Yin amfani da IUD na rage rashin lafiyar mata na ciwon daji na endometrial.
- Tamoxifen: Yin amfani da tamoxifen don rage haɗarin sake dawowa ko ƙananan haɗarin bunkasa ciwon nono zai iya ƙara haɗarin haɓaka ciwon daji na endometrial.
- Wasu ciwon tumakin ovarian kamar yaduwar ciwon sukarin granulosa cell ne kuma zai iya haifar da hadarin ciwon daji na endometrial.
- Tarihin ciwon ciwon daji kamar su nono ko ciwon daji na ovarian
- Samun tarihin iyali na ciwon daji na endometrial ko ciwon daji
- Mutanen da ke fama da ciwon daji na rashin ciwon daji irin su Lynch ciwon (ciwon daji wanda ba shi da nasaba da ciwon daji ko kuma HNPCC)
- Tarihin radiation zuwa ƙashin ƙugu a matsayin wani ɓangare na maganin ciwon daji
- Samun salon rayuwa
- Cin abinci mai cin gashi
Binciken / Gano Farko
Ba kamar ciwon sankarar mahaifa ba, babu wani gwaji na yau da kullum don nunawa ga ciwon daji na endometrial. Mata masu fama da mummunan haɗari don ci gaba da cutar, irin su waɗanda suke da tarihin iyali, rashin ciwo da ciwo da ciwon daji irin su Lynch syndrome, ko waɗanda suke amfani da tamoxifen don magance ko rage hadarin ciwon nono ya kamata su yi magana da likita game da nunawa. Ga wasu mata, gwaje-gwaje irin su biopsy endometrial da / ko yaduwar tarin daji na iya ɗauka don kara yawan damar gano cutar nan da wuri.
Binciken asalin Ciwon daji na Endometrial
Ana iya ɗaukar ganewar asali daga ginin Pap, amma fassarar Pap ba kayan aiki ba ne na illa ga cutar. Sanin ganewa yakan fara ne tare da jarrabawar pelvic, ko da yake farkon cututtuka ba su da yawa.
Idan kuna da ciwon jini na hanzari akwai wasu gwaje-gwajen da likitanku zasuyi la'akari. Kyakkyawan duban dan tayi (wani samfurin dan tayi ta hanyar saka sautin duban dan tayi a cikin farjinka) za'a iya yin shi don duba lokacin kauri daga endometrium. Za a iya sanya bayani mai salin a cikin mahaifa (sonohysterogram) kafin hanyar da za a inganta bayyanuwar duk wani mummunan abu.
Kyakkyawan hysteroscopy hanya ce wadda aka sanya "na'urar tabarau" ta hanyar cervix a cikin mahaifa don ganin hoton mahaifa.
Nazarin na yau da kullum shi ne biopsy endometrial. A cikin wannan ofishin, an saka kayan aiki ta hanyar farjinka don samun shinge na cikin mahaifa don kimantawa a cikin lab. Kwararka zai iya bayar da shawara ga dilation da curettage (D da C) wanda aka saba yi a cikin dakin aiki a ƙarƙashin ƙwayar cuta. Tare da ciwon daji da dilation daga cikin jikin ku, za a iya samun samfurin mafi kyau na jikin kuɗin ciki.
Idan ana jin dadin cutar ciwon endometrial, ana bukatar biopsy don tabbatar da ganewar asali da kuma kara bayyana halaye na ƙwayar.
Tsarin
Don ƙayyade mafi kyawun maganin kulawa, daidaitattun ladabi yana da matukar muhimmanci bayan ganewar asali. Ana yin gyare-gyare ta hanyar kallon girman ƙwayar cutar, yana da mummunan aiki bisa ga bayyanar da yake a karkashin ƙananan microscope (ƙananan matakan daga 1 zuwa 3), da kuma gwada don ganin idan ciwon daji ya mamaye ko yada zuwa ga takalma a waje da mahaifa.
Hakazalika da sauran cututtuka, ana ba da wannan ciwon sukari a matsayin "TNM" wanda T yake tsaye a kan girman ƙwayar cuta (da wasu lokuta wasu halaye), N yana nufin ƙaddamar da ƙwayoyin lymph mai kusa ko kusa, kuma M wakiltar metastases, ko yada zuwa gabobi masu nisa.
Idan akwai damar cewa ciwon daji ya mamaye ko yada zuwa wasu kwayoyin, wasu gwaje-gwaje na iya haɗa da cystoscopy da / ko proctoscopy don neman duk wani shaida na yadawa zuwa mafitsara ko madaidaiciya, da kuma CT, MRI, da / ko PET don bincika nesa da yaduwa.
Kamar sauran ƙwayoyin ciwon daji, ciwon daji na endometrial ya rushe zuwa 4 matakai (kamar yadda watan Janairu 2018 babu mataki 0). Wadannan sun haɗa da:
- Sashe na 1: Ciwon daji ya iyakance ga mahaifa, kuma ba ya yada zuwa cervix, wasu bangarori na kwaskwarima, ko gabobin da ke nisa.
- Sashe na 2: Ciwon sukari ya yada zuwa cervix, amma ba ga sauran sassan jiki ba.
- Sashe na 3: Ciwon ya yada fiye da mahaifa, amma duk yankunan yada har yanzu suna cikin yankin pelvic.
- Mataki na 4: Ciwon daji ya yada zuwa magungunan magungunan, madauri, ko wurare masu nisa na jiki.
Wadannan matakai sun kara raguwa cikin abubuwa (kamar mataki 2A da 2B) dangane da wasu halaye na ƙwayar.
Zaɓuɓɓukan magani don Endometrial Kankara
Mafi kyawun maganin zafin jiki na ciwon daji na endometrial ya dogara ne akan mataki na cutar, da alamar cututtuka, da sauran dalilai kamar lafiyar lafiya. Zabuka sun haɗa da:
Tiyata: Tiyata shi ne hanyar da ta fi dacewa ta magance ciwon daji na endometrial. A wannan tiyata an cire mahaifa cikin jiki ( hysterectomy ), mafi yawancin lokaci tare da tubes da ovaries (salpingo-ophorectomy). Ga matan da suka gama yin haihuwar haihuwa, wannan ba yawancin lokaci ba ne yake fuskantar matsala ba tare da hadarin tiyata ba. Ga wadanda suke da ƙananan yara kuma suna son su haifi ɗa ko fiye da yara, duk da haka, wannan zai iya zama damuwa.
Magungunan radiation: Rashin gyaran gyare-gyaren yanayi shine magani ne na gida wanda za'a iya amfani da shi idan akwai yiwuwar wasu kwayoyin cutar ciwon daji sun yada bayan da aka cire yankin tare da tiyata.
Hormone far: Anyi amfani da maganin gaggawa don rage yawan isrogen ko ƙara adadin progesterone a jiki. Hanyoyin magani mafi yawan sun hada da daya daga cikin nau'i na progesterone. Ga ciwace-ciwacen da suka kasance mafi girma ko kuma sun sake dawowa, wasu cututtuka da suka dace sun hada da tamoxifen, luteinizing releaseing hormones agonists, da kuma wadanda suka hana masu aromatase.
Chemotherapy: Ba a bugun ƙwayoyin cutar shan magani a farkon lokaci. Domin cututtuka da suka yadu ko sake dawowa, duk da haka, ana amfani da chemotherapy.
Gwaje-gwaje-gwaje: Dukkanin jiyya na ciwon daji wanda aka samo a yanzu an yi nazari a gwaje-gwajen asibiti. Akwai gwaje-gwaje na gwaji don ciwon daji na endometrial neman hanyoyin da zasu bunkasa rayuwa da rage yawan tasirin da ke tattare da jiyya.
Ciyarwa
Samun ganewar asibiti na ciwon daji ko da kuwa irin ko mataki ne mai firgita. Ilimi yana ƙarfafawa, kuma koyo game da ciwon daji zai iya taimaka maka ka zama mai ba da shawara a cikin kulawa. Ɗauki ɗan lokaci don koyo game da yadda za a samu bayanan ciwon daji a kan layi . Taimako yana da muhimmanci. Wani ganewar asibiti na ciwon daji shine lokaci mai kyau don tattara tsarin goyon baya naka. Mutane da yawa suna taimakawa wajen shiga ƙungiyar goyon baya a cikin al'ummarsu ko kuma shiga cikin ɗaya daga cikin ƙungiyoyin tallafin layi ko tallafawa al'ummomin ciwon daji na endometrial.
Faɗakarwa
Binciken gaba ɗaya ga ciwon daji na endometrial a Amurka yana da kyau, saboda yawancin wadannan cututtuka ana samuwa da wuri. Wasu sababbin nau'in ciwon daji na endometrial kamar su carcinoma cell ne mafi tsanani kuma suna da mummunar ganewa.
Rawan da ke cikin shekaru 5 na rayuwa shine kashi 75-88 na mataki na cutar, kashi 69 cikin dari na mataki na II, kashi 47-58 na mataki na III, kuma kashi 15-17 na mataki na IV. Yana da mahimmanci a lura cewa kididdigar sau da yawa shekaru da yawa kuma ba suyi sabani da sababbin maganin da aka amince da su tun lokacin.
Kalma Daga
Ciwon daji na endometrial shine ciwon daji na mahaifa wanda shine rashin karuwa a Amurka da Turai. Mafi yawan abin da aka fi sani dashi (kimanin kashi 90 cikin dari na mata) shi ne mai yaduwar jini. Yawanci da yawa mata suna neman magani idan suna da lokutta masu hauka ko kuma suna zubar da jini bayan haifaffen mazauni, kuma yawancin wadannan ciwon sukari ne aka gano a farkon su. Mafi kyau magani ya danganta da mataki na ganewar asali.
Idan an gano ku tare da ciwon daji na endometrial abu mafi mahimmanci da za ku iya yi shi ne ya zama mai ba da shawara a cikin kulawa. Tambayi tambayoyi da yawa. Yi la'akari da samun ra'ayi na biyu. Kuma koyi game da cutarka.
> Sources:
> Lortet-Tiuelent, J., Ferlay, J., Bray, F. et al. Abubuwan da ke faruwa a duniya da kuma Trend in Endometrial Cancer Incidence, 1978-2013. Journal of the National Cancer Institute . 16 Oktoba 2017.
> Cibiyar Cancer ta Kasa. Endometrial Cancer Treatment (PDQ) -Kamarin Kasuwanci. An sabunta 08/18/17. https://www.cancer.gov/types/uterine/hp/endometrial-treatment-pdq
> Tang, Y., Zhu, L., Li, Y. et al. Amfani da Metformin an hade shi tare da rage yawan haɗari da ingantaccen farfadowa na ciwon cututtuka na Endometrial: Meta-Analysis. BioMed Research International . 2017. 2017: 5905384.