Yayin da kake aiwatar da ganewar asali, tafiya gaba tare da lura yana da mahimmanci don inganta lafiyarka da kuma dawowa. Tsarin maganin ciwon daji na musamman na mutum zai dogara ne akan wasu dalilai, musamman ma kan ciwon ciwon daji (yadda yaduwar ya yadu) da kuma ciwon ciwon daji (yadda mahaukaciyar kwayoyin halitta ke gani).
Tiyata
Bari mu fara da tattauna hanyoyin da za a bi don maganin ciwon magunguna.
Tashin Binciken Magungunan Bincike Mai Girma (TURBT)
Mataki na farko a zalunta da ciwon ciwon magungunan ƙwayar cuta ba jiki-ma'anar cewa ciwon sukari yana cikin cikin mafitsara kuma bai shiga cikin murfin tsoka ba - wani nau'in tiyata wanda ake kira ciwon magungunan ƙwayar cuta, ko TURBT. Wannan hanya ta kawar da kututture daga mafitsara.
A lokacin TURBT, wani likitan ilimin likitancin jiki yana sanya kayan aiki mai haske, mai haske da haske da kyamara akan shi (resectoscope) ta hanyar urethra ta mutum a cikin mafitarta. Kayan aiki yana ƙunshe da madogarar waya wadda ta ba da damar likita don cire tumɓin.
Ana yin wannan hanya a cikin dakin aiki kuma wani lokaci ana bukatar TURBT na biyu bayan makonni bayan da farko don tabbatar da cewa babu wani ɓacin da aka rasa. Bishara shine yawancin mutane zasu iya komawa gida a wannan rana ko rana mai zuwa. Har ila yau, illa mai lalacewa, kamar jini ko rashin jin daɗi lokacin urinating, yawanci gajere ne kuma m.
Tsarin Cystectomy
Maganin daidaituwa na ciwon magungunan ciwon magungunan ƙwayoyin cuta - ma'anar cewa ƙwayar ciwon ba ta kunshe ba kuma ta shiga cikin tsokawar tsokawar tsokawar jiki - shine tiyata da ake kira cystectomy mai radical. Wannan hanya ta ƙunshi kawar da mafitsara da ɓangarorin da ke kewaye- prostate da seminal vesicles a cikin maza; mahaifa, cervix, fallopian tubes, ovaries, da kuma babba na farjin a cikin mata .
Wani lokaci ne mai amfani da kwayar cutar mai cike da ƙwayar cuta don maganin ciwon daji wanda bai kai mamaye tsoka ba tukuna amma yana da wasu matsaloli masu ban tsoro. Ana kuma bada shawara ga mutanen da ke da ciwon daji ko ciwon magungunan ƙwayar cuta ba tare da tsoka ba bayan jiyya tare da maganin immunotherapy (duba ƙasa).
Ƙungiyar Urinary da Girma
Bayan an cire mafitsara, dole ne likitan likita ya ƙaddamar da sabon wuri don tsaftacewa. Akwai 'yan zaɓuɓɓuka don bincika:
- Za'a iya haifar da sabon mafitsara daga ɓangaren hankalin mutum (neobladder) wanda ke hade da urethra mutum don su iya urinate kamar yadda aka riga.
- Ana iya yin jaka a cikin jiki ta amfani da nama daga ciki ko intestines. Ɗaya daga cikin alaƙa tana haɗawa da ureters kuma ɗayan zuwa bude a cikin fata a kan bango na ciki (stoma). Za a iya amfani da kullun don zubar da fitsari ta hanyar stoma a lokacin rana, amma kwakwalwan yana kwantar da fitsari, kamar mafitsara.
- Maimakon kwakwalwa, an yi amfani da wasu hanyoyi a cikin mahaukaci. Tare da irin wannan tiyata, fitsari yana gudana daga kodan zuwa ga ureters ta wurin ƙananan hanji da kuma cikin cikin stoma. A ƙarshe, shi yana motsawa cikin wani jakar jakar da ke waje da jiki.
Risks da dama na Tiyata
Tsarin gwaninta da kuma haifar da sabon mafitsara ko jakar baya shine aikin tiyata. A takaice dai, babban abu ne. Don haka, yana da mahimmanci ka fahimci duk hadarin da kuma amfanin da suke ciki-masu kyau da mummuna, don haka su yi magana.
Tare da wannan, yiwuwar ƙwayar cuta ta dogara da dalilai masu yawa, kamar kwarewar likita, shekarun mai haƙuri, da kuma ko mai haƙuri yana da matsalolin lafiya. Duk da haka, misalan matsalolin matsalolin haɗari sun haɗa da:
- Bleeding
- Kamuwa da cuta
- Yin zubar jini a cikin huhu
Wata matsala don magancewa tare da likitan likitanka shine yiwuwar samun illa ga jima'i, kamar lalacewa marar kyau ko haɗuwa da jima'i, da kuma yadda za a magance shi.
Chemotherapy Kafin Tayarwa
Idan mutum yana da lafiya, zai koyon chemotherapy kafin aikin tiyata don inganta rayuwarsa. Dalilin chemotherapy shine kashe kwayoyin cutar kanjamau da ke cikin jiki amma har yanzu basu gani ba.
Kwayoyin cutar guda biyu da ake amfani da su kafin yin aikin tiyata don cutar shan magani na urothelial sune:
- MVAC (methotrexate, vinblastine, doxorubicin, da cisplatin)
- GC (Cisplatin da Gemcitabine)
Kwararren likitan ku, ko likitan kwari, zai jagoranci wadannan chemotherapies a cikin hawan keke. Wannan yana nufin, cewa bayan kowace magani, za ku huta kuma za a kula da ku saboda duk wani sakamako mai ban tsoro. Misalan sakamakon lalacewar da za a iya gani tare da tsarin da aka sama sun hada da:
- Wulo
- Ƙarin haɗarin kamuwa da cuta
- Yin bugun jini ko ƙusarwa da sauƙi
- Asarar gashi
- Ƙuƙƙan ƙuta
- Nuna da zubar
- Rabawar ji
- Ƙidaya da tingling a hannun ko ƙafa
- Jinin cikin fitsari
Kowace juyayi na tsawon makonni ne, kuma, a kowane lokaci, ana amfani da haɗin guda uku kafin aikin tiyata.
Intravesical Far
Kodayake lambobin rayuwa suna gamsu da mutanen da ba tare da tsokawar ciwon magungunan ciwon magungunan ƙwayar cuta ba, manyan matsalolin biyu da likitoci suke ciki har ma bayan da aka cire tumo su ne:
- Komawa (ciwon daji ya dawo)
- Ci gaba (ciwon daji yana yada cikin tsoka ko kara cikin jiki)
Don haka, bari yanzu mu dubi hanyoyin ba da magani.
Intravesical Chemotherapy
Dalilin dalilai guda biyu shine dalilin da ya sa mafi yawan marasa lafiya suna samun ƙarin farfadowa bayan ƙwaƙwalwar ƙwayar ƙwayar cuta tare da wani yunkurin da ake kira chemotherapy na intravesical. Tare da irin wannan farillar, ana amfani da magani a kai tsaye a cikin mafitsara ta hanyar kullun. Dalilin chemotherapy shine ya hallaka duk wani lalacewa, kwayoyin cutar ciwon da ba a gani ba.
Dangane da hadarin mutum na ciwon magungunan ciwon huhu (wanda likita ya yi la'akari da matsayin low, matsakaici, ko babba), shi ko ita za su karbi ko wane lokaci ne kawai a lokacin TURBT na farko ko kuma magunguna a tsawon mako shida na intravesical chemotherapy.
Mitomycin ne sau da yawa maganin ƙwayar cuta na zaɓin da aka gudanar. Yana iya haifar da wasu konewa a cikin mafitsara da kuma sau da yawa da / ko tayi zafi.
Intravesical Immunotherapy
Wasu lokuta, maimakon likitan kwayar cutar, mutum zai karbi magungunan immunotherapy mai suna Bacillus Calmette-Guerin (BCG). Irin wannan farfesa yana haifar da tsarin rigakafi na mutum don kashe ciwon daji.
Yana da ban sha'awa a lura cewa an fara kirkiro Bacillus Calmette-Guerin (BCG) a matsayin maganin alurar rigakafi don tarin fuka. Amma, a cikin shekarun 1970 zuwa 1980, an gano shi don kashe kwayoyin cutar kanjamau, kuma.
Yayinda yake da tasirin gaske, BCG mai banƙyama zai iya haifar da sakamako mai lalacewa har zuwa kwana biyu wanda zai haɗa da:
- Fever, jin zafi, da jiki jiki
- Wulo
- Tsarin urination
- Jinin cikin fitsari
- Pain lokacin urinating
- Shanuwa a cikin mafitsara
Kadan, BCG zai iya yada zuwa jiki. Wannan zai iya haifar da kamuwa da jiki duka, wadda za a iya nunawa ta hanyar zazzabi wanda ya faru fiye da kwana biyu ko zazzabi wanda bai inganta da magani ba. Ciwon kamuwa da jiki duka shine gaggawa gaggawa na gaggawa kuma yana buƙatar gaggawa gaggawa.
Ajiye Bladder
Duk da ciwon daji na nakasassu shine maganin maganin ciwon magungunan ƙwayar tsoka, wani lokaci wani mutum da ke fama da ciwon magungunan ciwon magungunan ciwon magungunan ƙwayar cuta bazai daina cire dukkan magungunan su. Maimakon haka, za su iya ɗaukar nauyin mafitar su ko kuma karin TURBT. Kamar kowane nau'i na magani, a cikin waɗannan sharuɗɗa na musamman, haɗari da wadata suna buƙata a bincika a hankali.
Radiation Far
Magungunan radiation, wanda wani mai ilimin likitancin jini ya kawo, an hada shi tare da chemotherapy da TURBT a cikin ladabi na tsare-tsare, saboda ba a ɗauke shi da hanyar maganin ba. Radiation ya kashe ciwon daji da kuma lokutan jiyya yawanci kwanaki biyar a mako guda na makonni.
Kulawa Bayan Jiyya
Kimanin watanni uku bayan jiyya tare da maganin kutsawa (da kuma a wasu lokuta bayan haka), likita zai yi cystoscopy don tabbatar da cewa babu ciwon daji na ciwon magunguna. Don matsakaici ga marasa lafiya mai tsanani, cytology na fitsari don neman kwayoyin cututtuka da kuma hotunan urinary fili (watau CT scan) za a yi sau da yawa akai-akai don ƙarin hanyar kulawa.
Idan an gani wani wuri mai tsami na mafitsara, zai zama biopsied kuma an cire shi tare da TURBT. Idan ciwon daji ya sake dawowa, mutum zai ci gaba da karuwa fiye da ƙwayar cuta ko kuma ya cire mafitar su tare da aikin tiyata.
Idan babu shaida na komawa, mutum zai iya shawo kan maganin BCG domin ya hana ci gaba da ciwon daji. Lokaci na farfadowa (alal misali, shekara guda zuwa shekaru uku) ya dogara da haɗarin mutum, wadda jaririnta ya gano.
Ciwon magungunan ƙwayar cuta
Domin ciwon daji wanda ya yada zuwa wasu sassa na jiki, kamar ƙwayoyin lymph ko wasu kwayoyin halitta (huhu, hanta, da / ko ƙasusuwa), chemotherapy na iya zama wani zaɓi don rage jinkirin ciwon daji. Bincike a cikin rigakafin rigakafi don ciwon daji na ciwon magunguna yanzu ana binciken.
Wani lokaci, ana bayar da radiation ko tiyata (TURBT ko cystectomy) akan mutumin da ke fama da ciwon magungunan ƙwayar cuta. Yana da mahimmanci a fahimta, duk da haka, ana maganin wannan wariyar ne a matsayin hanyar kulawa mai ban tsoro-hanyar da za ta sauke abubuwan da ke nuna damuwa game da ciwon daji.
Wannan ya ce, a game da ciwon daji na ƙwayar cuta, yana da muhimmanci a ci gaba da magance magunguna daban-daban da suka shafi rayuwa fiye da inganta rayuwarka. A wannan misali, san cewa yana da kyau don yaɗa tunaninka ga iyalinka da likitan ilimin likita .
A takaice dai, lokacin da ya fi guntu zai iya zama mafi cika fiye da tsawon lokacin jin daɗi. Wannan, ba shakka, wani yanke shawara ne na musamman da na musamman.
> Sources:
> Abt D, Bywater M, Engeler DS, Schmid HP. Hanyoyin maganin warkewa na hematuria a cikin ciwon ciwon daji. Int J Urol. 2013 Jul, 20 (7): 651-60.
> Cibiyar Ciwon Ƙwayar Yammacin Amirka. Mayu 2016. Yin maganin Ciwon Magunguna.
> Babjuk et al. Jawabin EAU akan mahaukacin urothelial wanda ba shi da ƙwayar cuta na magunguna: Update 2016. Eur Urol. 2017 Mar; 71 (3): 447-61.
> Chang et al. Binciken da kuma maganin ciwon magungunan ciwon magungunan ƙwayar cuta ba: AUA / SUO jagora. J Urol. 2016 Oktoba 196 (4): 1021-9.
> Stephenson AJ. Disamba 2016. Bayani game da tsarin farko da kuma kula da ciwon daji na urothelial ciwon daji. A cikin: UpToDate, Lerner SP, Ross ME (Eds), UpToDate, Waltham, MA.