Umhlaza wedlala lobudoda luhlobo lomhlaza okhula kwidlala lengqula, elilidlala elincinane elimile okwe-walnut elibekwe ngaphantsi kwesinyi naphambi kombhobho emadodeni. Idlala lobudoda lidlala indima ebalulekileyo kwinkqubo yokuzala yamadoda ngokuvelisa ulwelo lwamadlozi, olulondla luze luthuthe amadlozi xa ephuma. Umhlaza wedlala lobudoda ubakho xa iiseli eziqhelekileyo kwidlala lengqula ziguquka kwaye ziqalise ukukhula ngokungalawulekiyo, zenza ithumba. Ukuba ayiphathwanga, iiseli zomhlaza wesibeleko zinokusasazeka (metastasize) kwizicubu ezikufutshane kunye namalungu, anje nge-seminal vesicles, isinyi, kunye ne-rectum, kunye nakwiindawo ezikude emzimbeni, njengamathambo, i-lymph nodes, okanye amanye amalungu. .
Iintlobo zomhlaza wedlala lobudoda
Umhlaza weProstate unokwahlulwa ngokubanzi ube ziindidi ezimbini eziphambili:
a. Adenocarcinoma
I-Adenocarcinoma lolona hlobo luxhaphakileyo lomhlaza wedlala lesinyi, ebalelwa malunga ne-99% yazo zonke iimeko. Olu hlobo lomhlaza lusuka kwiiseli zedlala ngaphakathi kwidlala lengqula. Idlala lobudoda livelisa incindi yamadlozi, eyondla kwaye ithuthe amadlozi ngexesha lokuphuma. I-Adenocarcinoma ye-prostate ikhula kancinci, kwaye kwiimeko ezininzi, inokuhlala ivalelwe kwi-prostate gland ixesha elide ngaphambi kokuba isasazeke kwamanye amalungu omzimba.
b. Iintlobo ezinqabileyo
Ngelixa i-adenocarcinoma ibangela uninzi lwezehlo zomhlaza wedlala lobudoda, zikwakho neentlobo ezininzi ezinqabileyo zomhlaza wedlala lesinyi, nganye ineempawu ezahlukeneyo ze-histological kunye neempawu zeklinikhi. Ezi ntlobo zinqabileyo ziquka:
- I-cell carcinoma encinci: I-cell carcinoma encinci ye-prostate luhlobo olunobundlongondlongo oluquka inxalenye encinci yezehlo zomhlaza wedlala lobudoda. Ivame ukukhula ngokukhawuleza kwaye idibene ne-prognosis ehlwempuzekileyo xa kuthelekiswa ne-adenocarcinoma.
- I-Sarcomas: I-Prostate sarcomas zithumba ezinqabileyo ezisuka kwizicubu ezidibeneyo (umzekelo, izihlunu, ithambo, imithambo yegazi) ngaphakathi kwedlala lesinyi. La mathumba adla ngokuba ndlongondlongo kwaye anokufuna iindlela zonyango ezikhethekileyo.
- I-Neuroendocrine tumors: I-Neuroendocrine tumors ye-prostate ayinqabile kwaye i-aggressive tumors evela kwiiseli ze-neuroendocrine ngaphakathi kwe-prostate gland. Zisenokuthi zenzeke nge-novo okanye ziphuhlise ngenxa yokunganyangeki kwonyango kwizigulane ezinomhlaza we-prostate ophezulu.
- Transitional cell carcinomas: Transitional cell carcinoma, ekwaziwa ngokuba yiurothelial carcinoma, luhlobo olunqabileyo lomhlaza wedlala lobudoda osuka kwiiseli zenguqu ze-epithelial ezisecaleni kwendlela yomchamo. Inokuthi yenzeke ngaxeshanye nomhlaza wesinyi okanye njengesifo sesibini kwi-prostate gland.
Oonobangela bomhlaza wedlala lobudoda
Umhlaza wedlala lobudoda, njengezinye iintlobo ezininzi zomhlaza, uvela kunxibelelwano oluntsonkothileyo lwemfuza, indalo, kunye nendlela yokuphila. Ngelixa oyena nobangela womhlaza wedlala lesidoda uhlala ungekho, zininzi izinto ezinobungozi ezichongiwe ezinokuthi zibe negalelo ekuphuhlisweni kwayo. Ukuqonda le miba yomngcipheko kubalulekile kuthintelo kunye nokubhaqwa kwangoko.
a. Ubudala
Ubudala ngowona mngcipheko ubalulekileyo womhlaza wedlala lesinyi. Amathuba okuba nomhlaza wedlala lesidoda onyuka kakhulu xa ukhula, ngakumbi emva kweminyaka engama-50. Uninzi lwezehlo zomhlaza wedlala lobudoda zifunyaniswa kumadoda angaphezu kweminyaka engama-65 ubudala. kakuhle, nangona ngaphantsi rhoqo.
b. Imbali yosapho kunye nemfuzo
Imbali yosapho yomhlaza wedlala lesidlala ngomnye umngcipheko obalulekileyo. Amadoda anesalamane senqanaba lokuqala (utata, umntakwethu) ofunyenwe enomhlaza wedlala lesinyi asengozini eyongeziweyo ngokwawo. Umngcipheko uphezulu nangakumbi ukuba amalungu amaninzi osapho achaphazeleka okanye ukuba isizalwane safunyaniswa sisemncinci. Ukongezelela, ukuguqulwa kwezakhi zofuzo ezithile, ezifana ne-BRCA1 kunye ne-BRCA2, ezaziwa kakhulu ngokunxulumana kwazo nomhlaza webele kunye ne-ovarian kwabasetyhini, ziye zadityaniswa nomngcipheko wokwanda komhlaza wesibeleko emadodeni.
c. Ubuhlanga kunye nobuzwe
Izehlo zomhlaza wedlala lobudoda kunye namazinga okusweleka ahluka kakhulu phakathi kweentlanga ezahlukeneyo kunye neentlanga. Njengokuba; Amadoda ase-Afrika aseMelika awona mngcipheko mkhulu wokuba nomhlaza wedlala lobudoda kwaye kusenokwenzeka ukuba afunyanwe sele ekwinqanaba eliphezulu xa kuthelekiswa namadoda olunye uhlanga nemvelaphi yobuzwe. Ukongeza, amadoda ase-Afrika aseMelika athande ukuba neendlela ezinobundlobongela zomhlaza wesibeleko kunye namazinga aphezulu okufa. Izizathu zoku mahluko zintsonkothile kwaye kusenokwenzeka ukuba zibandakanya indibaniselwano yemfuza, indalo esingqongileyo, kunye neemeko zentlalo noqoqosho.
d. Imiba yejografi kunye nokusingqongileyo
Iiyantlukwano zejografi kwizehlo zomhlaza wedlala lobudoda ziye zabonwa kwihlabathi jikelele, ngamazinga aphezulu axeliweyo kuMntla Merika, eYurophu, naseOstreliya xa kuthelekiswa neAsia neAfrika. Ngelixa izizathu ezichanekileyo zomahluko wejografi aziqondwa ngokupheleleyo, iimeko zokusingqongileyo ezifana nokutya, indlela yokuphila, ukuvezwa kwetyhefu yendalo, kunye nokufikelela kukhathalelo lwempilo kunokudlala indima. Ngokomzekelo, ukutya okunenyama ebomvu eninzi nokutya okugayiweyo, iziqhamo eziphantsi nemifuno, kunye namafutha amaninzi kuye kwanxulunyaniswa nomngcipheko omkhulu wokuba nomhlaza wedlala lesinyi.
e. Imiba yokuphila
Izinto ezininzi eziguquguqukayo zokuphila ziye zabandakanyeka kumngcipheko womhlaza wedlala lesinyi. Ezi ziquka:
- Ukutya: Ukutya okunamafutha amaninzi, inyama ebomvu, ukutya okugayiweyo kunye neziqhamo eziphantsi, imifuno, kunye nefiber kunokunyusa umngcipheko wokuba nomhlaza wedlala lesinyi. Kwelinye icala, ukutya okuneziqhamo, imifuno, ukutya okuziinkozo, namafutha asempilweni kunokukhusela.
- Umsebenzi woMzimba: Ukuzivocavoca rhoqo kunye nokusebenza ngokomzimba kuye kwadibaniswa nomngcipheko oncitshisiweyo womhlaza wesibeletho. Ukuthatha imizuzu engama-30 ubuncinane ukwenza umthambo obukhali ukuya kutsho ngamandla kwiintsuku ezininzi zeveki kunokunceda ukunciphisa umngcipheko.
- Ukutyeba ngokugqithisileyo: Ukutyeba kakhulu kuye kwanxulunyaniswa nomngcipheko owongezelelweyo wokuba nomhlaza wedlala lesinyi. Ukugcina ubunzima obunempilo ngokutya kunye nokuzilolonga kunokunceda ukunciphisa umngcipheko.
- Ukutshaya: Nangona ubungqina obudibanisa ukutshaya kumngcipheko womhlaza we-prostate bungabonakali ngokucacileyo xa kuthelekiswa namanye ama-cancer, ukutshaya kuye kwadibaniswa nomngcipheko wokufa ngenxa yomhlaza wesibeletho phakathi kwamadoda afunyanwe enesifo.
f. Izinto zeHormonal
Izinto zeHormonal, ngakumbi indima ye-androgens (ihomoni zamadoda), kukholelwa ukuba zidlala indima ebalulekileyo ekuphuhliseni nasekuqhubeleni phambili komhlaza wesinyi. I-Androgens, njenge testosterone, ivuselela ukukhula kunye nomsebenzi we-prostate gland. Amanqanaba aphezulu e-androgens okanye ukuguqulwa kwe-androgen metabolism kunokufaka isandla ekuphuhliseni umhlaza we-prostate. Unyango lweHormone, olujolise ekunciphiseni amanqanaba e-androgen okanye ukuvimba iziphumo zabo, lunyango oluqhelekileyo lomhlaza we-prostate.
g. Ukuvuvukala kunye nempilo ye-prostate
Ukuvuvukala okungapheliyo kwe-prostate gland, edla ngokubizwa ngokuba yi-prostatitis, kuye kwacetyiswa njengento enokuthi ibe ngumngcipheko womhlaza we-prostate. Nangona ubudlelwane obuchanekileyo phakathi kokuvuvukala kunye nomhlaza wesifo seprotate akuqondwa ngokupheleleyo, ukuvuvukala okuqhubekayo kunokufaka isandla ekuguqulweni kofuzo, umonakalo weselula, kunye nokuguqulwa kwi-microenvironment ekhuthaza ukuphuhliswa komhlaza. Ukongeza, i-benign prostatic hyperplasia (BPH), ukwanda okungenawo umhlaza kwedlala lengqula elidla ngokubonwa kumadoda asele likhulile, liye lanxulunyaniswa nomngcipheko owonyukayo womhlaza wedlala lesinyi.
Iimpawu zomhlaza wedlala lesinyi
Umhlaza wedlala lobudoda udla ngokubizwa ngokuba “sisifo esithe cwaka” kuba usenokungabangeli zimpawu zibonakalayo, ngakumbi kumanqanaba okuqala awo. Nangona kunjalo, njengoko umhlaza ukhula okanye usasazeka, unokukhokelela kwiimpawu ezahlukeneyo ezifuna uphando olungakumbi. Kubalulekile ukuqaphela ukuba uninzi lwezi mpawu zinokubangelwa ziimeko ezingenawo umhlaza, ezifana ne-benign prostatic hyperplasia (BPH) okanye i-prostatitis. Nangona kunjalo, naziphi na iimpawu eziqhubekayo okanye malunga neempawu kufuneka zihlolwe ngokukhawuleza ngumsebenzi wezempilo.
a. Ukutshintsha kokuchama
- Ubunzima bokuqalisa ukuchama okanye ukuphuma komchamo obuthathaka: Umhlaza wedlala lobudoda unokubangela ukuvaleka kwe-urethra (ityhubhu ethwala umchamo ukusuka kwisinyi ukuya kwilungu lobudoda), okukhokelela kubunzima bokuqalisa ukuchama okanye umjelo obuthathaka womchamo.
- Ukuchama rhoqo, ngakumbi ebusuku (nocturia): Ukunyuka rhoqo kokuchama, ngakumbi ebusuku, kunokuba luphawu lomhlaza wesibeleko. Olu phawu ludla ngokukhatshwa yimvo yongxamiseko.
- Ubunzima bokukhupha isinyi ngokupheleleyo: Umhlaza wedlala lesinyi unokuphazamisana nokuphuma okuqhelekileyo kwesinyi, nto leyo ekhokelela ekuvakaleni kokungapheleli ngokupheleleyo emva kokuchama.
- Intlungu okanye ukungonwabi ngexesha lokuchama (dysuria): Amanye amadoda anomhlaza wesibeleko anokuba neentlungu, ukutshisa, okanye ukungakhululeki xa uchama.
b. Igazi kumchamo okanye amadlozi
- I-Hematuria: Igazi kumchamo (hematuria) lingenzeka ngenxa yezizathu ezahlukahlukeneyo, kubandakanywa nomhlaza wesifo seprotate. Ngelixa igazi kumchamo lingasoloko liphawu lomhlaza, kufuneka livavanywe yingcali yezempilo ukufumanisa oyena nobangela.
- I-Hematospermia: Igazi kwi-semen (i-hematospermia) ayixhaphakanga kangako kodwa inokunxulunyaniswa nomhlaza wedlala lobudoda. Njenge-hematuria, i-hematospermia kufuneka iphandwe ngumboneleli wezempilo.
c. Ukungasebenzi kakuhle kwe-Erectile
Umhlaza weProstate unokuchaphazela umsebenzi we-erectile, okhokelela ekubeni ubunzima bokuphumelela okanye ukugcina i-erection (erectile dysfunction). Ngelixa I-erectile dysfunction inokuba nezizathu ezininzi, kubandakanywa iminyaka kunye nezinye iimeko zempilo, inokunxulunyaniswa nomhlaza wesibeleko kwezinye iimeko.
d. Intlungu okanye ukungakhululeki
- Ubuhlungu kumqolo ophantsi, i-pelvis, i-hips, okanye amathanga: Umhlaza we-Prostate oye wasasazeka emathanjeni (i-bone metastases) inokubangela intlungu yethambo okanye ukungahambi kakuhle, ngokuqhelekileyo kumqolo ophantsi, i-pelvis, i-hips, okanye amathanga. Intlungu yethambo inokuba nzima kakhulu ebusuku okanye ngokunyakaza kwaye inokuhamba kunye nokuqina okanye ubuthathaka.
- I-ejaculation ebuhlungu: Amanye amadoda anomdlavuza we-prostate anokufumana intlungu okanye ukungahambi kakuhle ngexesha lokukhupha, nangona le mpawu ingaqhelekanga.
e. Ukwehla kobunzima obungachazwanga
Umhlaza wedlala lobudoda obukwinqanaba eliphezulu unokubangela ukwehla kobunzima obungaqondanga, ngokufuthi ngenxa yendibaniselwano yezinto ezinjengokuncipha komdla wokutya, utshintsho kwimetabolism, kunye nokudumba okunxulumene nomhlaza.
f. Ukudinwa
Ukudinwa, okanye ukudinwa ngokugqithiseleyo, luphawu oluqhelekileyo olufunyanwa ngabaguli abaninzi abanomhlaza, kuquka abo banomhlaza wedlala lesinyi. Ukudinwa kunokunxulumana nomhlaza ngokwawo, kunye nonyango olunjengotyando, unyango lwemitha, ichemotherapy, okanye unyango lwehomoni.
g. Ukuvuvukala kwemilenze okanye indawo ye-pelvic
Kwiimeko eziphambili zomhlaza wesibeleko, umhlaza unokusasazeka kwii-lymph nodes ezikufutshane okanye ucinezele imithambo yegazi, ekhokelela ekudumbeni (i-edema) emilenzeni okanye kwindawo ye-pelvic.
Amanqanaba omhlaza wedlala lesinyi
Inqanaba lomhlaza wedlala lobudoda ngumba obalulekileyo wokuxilongwa kunye nokucwangciswa konyango, njengoko inceda ababoneleli bezempilo ukuba babone ubungakanani bomhlaza kwaye bakhethe esona sicwangciso sifanelekileyo solawulo. Inkqubo yeqonga edla ngokusetyenziswa kumhlaza wedlala lobudoda yi-TNM system, emele iTumor, Node, kunye neMetastasis. Le nkqubo ihlela umhlaza wesibeleko ngokusekwe kubungakanani kunye nobungakanani bethumba (T), nokuba umhlaza usasazeke kwii-lymph nodes ezikufutshane (N), nokuba sele i-metastasized (M) kwiindawo ezikude emzimbeni. Indibaniselwano yale miba imisela inqanaba elipheleleyo lomhlaza.
Isigaba I
- I-Tumor (T): I-tumor ivalelwe kwi-prostate gland kwaye ayikwazi ukuvakala ngexesha lokuhlolwa kwe-digital rectal (DRE) okanye ibonwe kwiimvavanyo ze-imaging ezifana ne-ultrasound okanye i-MRI.
- I-Node (N): Umhlaza awusasazekanga kwii-lymph nodes ezikufutshane.
- I-Metastasis (M): Akukho bungqina be-metastasis ekude.
- Iimpawu: Inqanaba lokuqala lomhlaza wesibeleko lithathwa njengelihlala kwindawo, kunye nethumba elihlala lincinci kwaye livalelwe kwidlala lengqula. Ihlala ifunyanwe ngengozi ngexesha le-prostate biopsies eyenzelwe amanqanaba aphezulu e-prostate-specific antigen (PSA) okanye iziphumo ezingaqhelekanga ze-DRE.
Isigaba II
- I-Tumor (T): I-tumor isavalelwe kwi-prostate gland kodwa ingaba nkulu ngobukhulu xa ithelekiswa neSigaba I.
- I-Node (N): Umhlaza awusasazekanga kwii-lymph nodes ezikufutshane.
- I-Metastasis (M): Akukho bungqina be-metastasis ekude.
- Iimpawu: Inqanaba lesibini lomhlaza wesifo seprotate likwajongwa njengelizwe, kodwa i-tumor inokuthi iqhubele phambili kwaye ingaba nomngcipheko ophezulu wokuqhubela phambili xa kuthelekiswa neSigaba I. Ukhetho lonyango lunokwahluka ngokusekelwe kwizinto ezifana nobukhulu be-tumor, ibakala, kunye nokukhethwa kwesigulane.
Isigaba III
- I-Tumor (T): Umhlaza usasazeke ngaphaya kwe-prostate gland kwaye unokubandakanya izicubu ezikufutshane okanye amalungu, njenge-seminal vesicles.
- I-Node (N): Umhlaza unokuba okanye awusasazeki kwii-lymph nodes ezikufutshane.
- I-Metastasis (M): Akukho bungqina be-metastasis ekude.
- Iimpawu: Inqanaba lesithathu lomhlaza wesibeleko lithathwa njengeliphambili kwindawo, kunye nethumba elidlulela ngaphaya kwemida yedlala lengqula. Inokuthi idibaniswe neempawu ezibalulekileyo kunye nomngcipheko ophezulu weengxaki xa kuthelekiswa nezigaba zangaphambili. Unyango lusenokubandakanya indibaniselwano yotyando, unyango ngemitha, unyango ngehomoni, okanye ezinye iindlela.
Isigaba IV
- I-Tumor (T): Umhlaza usasazeke ngaphaya kwe-prostate gland kwaye unokubandakanya izicubu ezikufutshane, amalungu, okanye izakhiwo, ezifana ne-bladder, i-rectum, i-pelvic sidewall, okanye i-pelvic lymph nodes.
- I-Node (N): Umhlaza unokuba okanye awusasazeki kwii-lymph nodes ezikufutshane.
- I-Metastasis (M): Umhlaza usasazeke kwiindawo ezikude emzimbeni, njengamathambo, isibindi, imiphunga, okanye amanye amalungu.
- Iimpawu: Inqanaba le-IV lomhlaza wedlala lobudoda lithathwa njengeliphambili okanye i-metastatic, kunye neeseli zomhlaza ezisasazeka kwiindawo ezikude zomzimba. Inokubangela iimpawu ezinjengeentlungu zamathambo, iingxaki zokuchama, okanye ukudinwa. Unyango lujolise ekulawuleni ukusasazeka komhlaza, ukunciphisa iimpawu, kunye nokuphucula umgangatho wobomi. Iinketho zonyango zinokubandakanya unyango lwe-hormone, i-chemotherapy, unyango lwe-radiation, unyango olujoliswe kuyo, i-immunotherapy, okanye amanyathelo okunyamekela axhasayo.
Ukuthintelwa komhlaza wedlala lobudoda
Izicwangciso zokuthintela umhlaza wedlala lobudoda zijolise ikakhulu ekunciphiseni izinto ezinobungozi kunye nokwamkela indlela yokuphila enempilo. Nangona akusoloko kunokwenzeka ukukhusela umhlaza we-prostate ngokupheleleyo, ukuphumeza le miqathango yokukhusela kunokunceda ukunciphisa amathuba okuba nesifo okanye ukulibazisa ukuqala kwayo.
a. Gcina ubunzima obunempilo
Ukutyeba kakhulu kuye kwanxulunyaniswa nomngcipheko owongeziweyo womhlaza wedlala lesinyi, ngakumbi iindlela ezinobundlobongela zesi sifo. Ukugcina ubunzima obusempilweni ngokutya okunesondlo kunye nokuzilolonga rhoqo kunokunceda ukunciphisa umngcipheko. Ijolise kwi-index mass body (BMI) ngaphakathi koluhlu oluqhelekileyo (18.5 ukuya kwi-24.9) kwaye ugweme ukuzuza ubunzima obuninzi, ngakumbi malunga ne-waistline.
b. Landela ukutya okunempilo
Ukutya kudlala indima ebalulekileyo kumngcipheko womhlaza wedlala lesinyi. Ukutya okutyebileyo ngeziqhamo, imifuno, ukutya okuziinkozo, namafutha asempilweni (njengalawo afumaneka kumandongomane, iimbewu, neentlanzi ezinamafutha) kusenokunceda ukunciphisa ingozi yomhlaza wedlala lesinyi. Kwelinye icala, ukutya okunenyama ebomvu eninzi, ukutya okugayiweyo, namafutha achumileyo kunokwandisa umngcipheko. Ukunciphisa ukusetyenziswa kwenyama ebomvu kunye neproceded, kunye neziselo ezinoshukela kunye ne-calories snacks.
c. Yandisa umsebenzi womzimba
Ukuzilolonga rhoqo kuye kwadityaniswa nomngcipheko oncitshisiweyo womhlaza wedlala lesinyi. Zimisele ubuncinci imizuzu eyi-150 yomthambo ophakathi okanye imizuzu engama-75 yomthambo onamandla wokuqina kwemithambo iveki nganye, kunye nemisebenzi yokomeleza izihlunu kwiintsuku ezimbini okanye ngaphezulu ngeveki. Umsebenzi womzimba awuncedi kuphela ukugcina ubunzima obunempilo kodwa unokuba neziphumo ezithe ngqo kumanqanaba ehomoni kunye nokusebenza komzimba okunokuthi kuthobe umngcipheko womhlaza.
d. Yeka ukutshaya
Ukutshaya kuye kwanxulunyaniswa nomngcipheko wokwanda komhlaza wedlala lesinyi kunye nokufa kwesi sifo. Ukuba uyatshaya, ukuyeka lelinye lawona manyathelo abalulekileyo onokuwathatha ukuphucula impilo yakho yonke kunye nokunciphisa umngcipheko wokuba nomhlaza. Funa inkxaso kubaboneleli bezempilo, iinkqubo zokuyeka ukutshaya, okanye amaqela enkxaso ukuze akuncede uyeke ngempumelelo.
e. Nciphisa ukusetyenziswa kotywala
Ukusetyenziswa kotywala ngokugqithiseleyo kuye kwanxulunyaniswa nomngcipheko okhulayo womhlaza wedlala lesinyi. Nciphisa iziselo ezinxilisayo zibe kumanqanaba aphakathi, achazwa njengesiselo esinye ngosuku emadodeni. Ukuba ukhetha ukusela utywala, yenza oko ngokumodareyitha kwaye ucinge ngezinye iindlela ezinempilo ezifana newayini ebomvu, equlethe i-antioxidants enokubonelela ngeenzuzo ezithile zokukhusela.
f. Qwalasela izongezo zokutya
Olunye uhlolisiso lubonisa ukuba ezinye izongezo zokutya, ezifana nevithamin E, i<em>selenium, ne<em>lycopene (efumaneka kwiitumato), zinokuba nomphumo wokukhusela kumhlaza wedlala lesinyi. Nangona kunjalo, ubungqina malunga nokusebenza kwezi zongezo zixutywe, kwaye uphando olungakumbi luyafuneka ukuze kuqinisekiswe indima yabo ekuthinteleni umhlaza wedlala lesinyi. Thetha nomboneleli wakho wezempilo ngaphambi kokuba uqalise naziphi na izongezo zokutya ukuqinisekisa ukuba zikhuselekile kwaye zifanelekile kuwe.
g. Fumana uvavanyo rhoqo
Nangona ukuhlolwa okuqhelekileyo komhlaza we-prostate kuhlala kuyimpikiswano, ngokukodwa malunga neenzuzo kunye nobungozi bovavanyo lwe-prostate-specific antigen (PSA), kubalulekile ukuxoxa ngeendlela zokuhlola kunye nomboneleli wakho wezempilo, ngakumbi ukuba usengozini enkulu ngenxa yezinto ezifana nobudala, imbali yosapho, okanye ubuhlanga Afrika American. Ukwenziwa kwezigqibo ekwabelwana ngazo phakathi kwezigulane kunye nababoneleli kunokunceda ukumisela eyona ndlela ifanelekileyo yokuhlola esekelwe kwimiba yomngcipheko ngamnye, izinto ezikhethwayo kunye nemilinganiselo.
h. Gcina ulandelelwano rhoqo kunye nababoneleli bezempilo
Ukuhlolwa rhoqo kunye notyelelo lonyango lothintelo lubalulekile ekubekeni iliso kwimpilo ngokubanzi kunye nokufumanisa naziphi na iimpawu okanye iimpawu zomhlaza wedlala lesinyi kwangethuba. Thatha inyathelo malunga nokuxoxa ngazo naziphi na izinto ezikuxhalabisayo okanye iimpawu kunye nomboneleli wakho wezempilo kwaye ulandele iingcebiso zabo zovavanyo lomhlaza kunye nokhathalelo lothintelo.
Ukuchongwa komhlaza wedlala lobudoda
Ukufunyaniswa komhlaza wedlala lesinyi kudla ngokubandakanya indibaniselwano yovavanyo lwembali yonyango, uvavanyo lomzimba, iimvavanyo zaselabhoratri, izifundo zokucinga, kunye neenkqubo ze-biopsy. Ukufunyaniswa kwangoko ngundoqo kunyango oluyimpumelelo kunye neziphumo eziphuculweyo.
a. Imbali yezonyango kunye nokuhlolwa komzimba
- Ababoneleli bezempilo baqala ngokuthatha imbali yonyango eneenkcukacha, kubandakanya ulwazi malunga neempawu, izinto ezinobungozi (ezifana nobudala, imbali yentsapho kunye nobuhlanga), kunye naziphi na iimeko zonyango ezifanelekileyo okanye amayeza.
- Uvavanyo olucokisekileyo lomzimba lungabandakanya uvavanyo lwe-digital rectal (DRE), apho umboneleli wezempilo efaka iglavu, umnwe othanjiswe kwi-rectum ukuva i-prostate gland ngayo nayiphi na into engaqhelekanga, enjengamaqhuma, amaqhuqhuva, okanye ukwanda.
b. Uvavanyo lweProstate-Specific Antigen (PSA).
- Uvavanyo lwe-PSA luvavanyo lwegazi olulinganisa inqanaba le-prostate-specific antigen, iprotheyini eveliswa lidlala lesinyi, egazini.
- Amanqanaba e-PSA aphakanyisiweyo angabonisa ubukho bomhlaza we-prostate, nangona ezinye izinto ezifana nobudala, ubukhulu be-prostate, ukuvuvukala, ukusuleleka, kunye nokuphuma kwamva nje kunokuchaphazela amanqanaba e-PSA.
- Uvavanyo lwe-PSA luqhele ukusetyenziswa kuvavanyo lomhlaza wedlala lesinyi, ngakumbi kumadoda aneminyaka engama-50 nangaphezulu okanye lawo asemngciphekweni omkhulu ngenxa yezinto ezifana nembali yosapho okanye ubuhlanga.
c. Izifundo zokufanekisa
Uvavanyo lokucinga lunokwenziwa ukuvavanya idlala lengqula kunye nezicubu ezingqongileyo kunye nokufumanisa nakuphi na ukungaqhelekanga okunokuthi kubonise ubukho bomhlaza wedlala lesinyi.
- I-Transrectal ultrasound (TRUS): Olu vavanyo lokucinga lusebenzisa amaza omsindo ukwenza umfanekiso wedlala lengqula kunye nezicubu ezijikelezileyo. Inokunceda ekuchongeni nayiphi na imimandla ekrokrisayo enokufuna ukuphononongwa ngakumbi.
- I-Magnetic Resonance Imaging (MRI): I-MRI scans ye-prostate gland inokunika imifanekiso ecacileyo ye-prostate kunye nezakhiwo ezijikelezileyo, inceda ukufumanisa nayiphi na into engaqhelekanga okanye izilonda ezikrokrelayo.
- I-Computed Tomography (CT) Iskena: Izikena ze-CT zingasetyenziselwa ukuvavanya ubungakanani bomhlaza wedlala lesinyi ukuya kwii-lymph nodes ezikufutshane okanye amanye amalungu, ngakumbi kwiimeko zesifo esihamba phambili.
- I-Bone Scan: Ukuhlolwa kwethambo kunokwenziwa ukuhlola ukuba ngaba umhlaza we-prostate usasazekile (i-metastasized) emathanjeni, indawo eqhelekileyo ye-metastasis kumhlaza we-prostate ophezulu.
- I-Positron Emission Tomography (PET) Iskena: I-PET ihlola ngeetracers ezithile ze-radioactive, ezifana ne-choline okanye i-prostate-specific membrane antigen (PSMA) tracers, ingasetyenziselwa ukufumanisa i-prostate cancer metastases, ngakumbi kwiimeko zokuphindaphinda kwe-biochemical (ukunyuka kwamanqanaba ePSA emva kokuqala unyango).
d. Iinkqubo zeBiopsy
Ukuba kufunyaniswe izinto ezingaqhelekanga ngexesha leemvavanyo zovavanyo okanye kuphononongo lwe-imaging, i-prostate biopsy inokucetyiswa ukuze kuqinisekiswe ukuxilongwa komhlaza wedlala lesinyi. Ngexesha le-prostate biopsy:
- I-Transrectal Prostate Biopsy ekhokelwa yi-Ultrasound: Le yeyona ndlela iqhelekileyo ye-biopsy yokuxilongwa komhlaza wedlala lesinyi. Inaliti encinci ifakwe kwi-rectum kwaye ikhokelwa yi-ultrasound ye-transrectal ukufumana iisampulu ezincinci zezicubu (ii-cores) ezivela kwiindawo ezahlukeneyo ze-prostate gland.
- I-Prostate Biopsy ekhokelwa yi-MRI: Kwezinye iimeko, imifanekiso ye-MRI ingasetyenziselwa ukukhokela inaliti ye-biopsy kwiindawo ezithile ezikrokrelayo ezichongiweyo kwi-MRI scan, ukwandisa ukuchaneka kwe-biopsy.
- I-Transperineal Prostate Biopsy: Le ndlela ye-biopsy ibandakanya ukufakela inaliti ye-biopsy kwi-perineum (indawo ephakathi kwe-scrotum kunye ne-anus) ukufumana iisampulu zethishu kwidlala lesinyi. Ingasetyenziswa kwiimeko apho i-transrectal biopsy ingenzeki okanye ijolise kwiindawo ezithile ezichongiweyo kumfanekiso.
e. Uvavanyo lwePathology
Iisampulu zezicubu ezifunyenwe kwi-prostate biopsy zithunyelwa kwilebhu ye-pathology ukuze zihlolwe phantsi kwe-microscope ngugqirha wezifo. Ingxelo ye-pathology ibonelela ngolwazi malunga nobukho, ibakala, kunye nobungakanani bomhlaza wesinyi ngokusekwe kwezi zinto zilandelayo:
- Inqaku leGleason: Inqaku leGleason yinkqubo yokuhlela esetyenziselwa ukuvavanya ubundlongondlongo bomhlaza wedlala lesinyi ngokusekwe kwinkangeleko encinci yeeseli zethumba. Isuka kwi-6 (umhlaza womgangatho ophantsi) ukuya kwi-10 (umhlaza womgangatho ophezulu), kunye namanqaku aphezulu abonisa i-tumor enobudlova.
- IBanga le-Tumor kunye neSigaba: I-Pathologists ivavanya ubungakanani, ubungakanani, kunye neempawu zeeseli ze-tumor ukumisela ibakala kunye nenqanaba lomhlaza we-prostate, onceda ukukhokela izigqibo zonyango.
f. Iimvavanyo ezongezelelweyo kunye neemvavanyo
Ngokuxhomekeke kwimeko yomntu kunye nobungakanani besifo, iimvavanyo ezongezelelweyo okanye iimvavanyo zinokwenziwa ukuvavanya imeko yonke yempilo, ukuvavanya iindlela zonyango, kunye nokubeka iliso kwinkqubela phambili yesifo. Oku kunokubandakanya:
- Izifundo ezongezelelweyo zokucinga (umzekelo, i-MRI, i-CT scan, i-bone scan) ukuvavanya ukusasazeka kwesifo kunye nokubeka iliso kumpendulo yonyango.
- Uvavanyo lwe-Biomarker ukuvavanya abamakishi bethumba okanye uguquko lwemfuza olunxulunyaniswa nobundlongondlongo bomhlaza wedlala lesidoda kunye nempendulo yonyango.
- Ukubeka iliso kumanqanaba e-prostate-specific antigen (PSA) ekuhambeni kwexesha ukulandelela ukuqhubela phambili kwesifo kunye nokuphendula kunyango.
- Ukubonisana neqela leengcali ezininzi zononophelo lwezempilo, kubandakanywa ii-urologists, i-oncologists ye-radiation, i-oncologists yezonyango, kunye nezinye iingcali, ukuphuhlisa isicwangciso sonyango lomntu ngamnye.
Unyango lomhlaza wedlala lesinyi
Unyango lomhlaza wedlala lobudoda luxhomekeke kwizinto ezininzi, kubandakanywa inqanaba kunye nenqanaba lomhlaza, impilo yesigulana kunye nezinto azikhethayo, kunye neziphumo ebezingalindelekanga zonyango. Olona khetho luphambili lonyango lomhlaza wedlala lobudoda lubandakanya ukucupha okusebenzayo, utyando, unyango lwemitha, unyango lwehomoni, ichemotherapy, unyango olujoliswe kuyo, kunye ne-immunotherapy. Kwiimeko ezininzi, indibaniselwano yolu nyango isenokusetyenziswa.
a. Ucupho olusebenzayo
- Ukucupha okusebenzayo, okwakwaziwa njengokulinda okulindileyo, kunokucetyiswa kumadoda anomngcipheko ophantsi okanye wenqanaba lokuqala lomhlaza wedlala lesidoda ekungenakwenzeka ukuba ubangele iimpawu okanye usasazeke ngamandla.
- Ngexesha lokucupha okusebenzayo, ukubeka iliso rhoqo kumanqanaba e-PSA, iimviwo zedijithali ze-rectal (DREs), kunye neemvavanyo ze-imaging (ezifana ne-MRI okanye i-ultrasound) ukuze kubekwe iliso elibukhali ukuqhubeka komhlaza.
- Ukuba kukho iimpawu zokuqhubela phambili kwesifo okanye ukuba umhlaza uba ndlongondlongo ngokuhamba kwexesha, unyango olusebenzayo lunokuqaliswa.
b. Utyando
- I-Radical Prostatectomy: Utyando lokususa yonke i-prostate gland kunye nezicubu ezijikelezileyo ziyaziwa ngokuba yi-radical prostatectomy. Le nkqubo inokwenziwa kusetyenziswa utyando oluvulelekileyo lwesintu okanye ubuchule obungangeneleli kangako obufana ne-laparoscopic okanye utyando oluncediswa ngerobhothi.
- I-Radical prostatectomy idla ngokucetyiswa kumadoda anomhlaza wasekhaya wedlala ledlala elihlala ixesha elide kwaye asempilweni entle.
- Iziphumo ezinokwenzeka zotyando zinokubandakanya ukungaphumeleli komchamo, ukungasebenzi kakuhle kwe-erectile, kunye notshintsho ekusebenzeni kwamathumbu.
c. Unyango ngemitha
- I-Beam Radiation Therapy yangaphandle (EBRT): Unyango lwe-radiation lusebenzisa imiqadi ephezulu yamandla ukujolisa nokutshabalalisa iiseli zomhlaza. I-EBRT inokuhanjiswa kusetyenziswa umatshini ongaphandle komzimba, ojolise kwidlala lengqula kunye nezicubu ezingqongileyo.
- I-Brachytherapy: Ikwabizwa ngokuba lunyango lwangaphakathi lweradiation, ibrachytherapy ibandakanya ukubekwa kwezifakelo zeradioactive ngqo kwidlala lengqula. Oku kuvumela ukuhanjiswa okujoliswe kuko kwi-radiation kwi-tumor ngelixa unciphisa umonakalo kwiithishu eziphilileyo ezijikelezileyo.
- Unyango ngemitha lunokusetyenziswa njengonyango lokuqala lomhlaza wedlala lesinyi okanye ngokudityaniswa nolunye unyango olunjengotyando okanye unyango lwehomoni.
- Iziphumo ebezingalindelekanga zonyango lwemitha zinokubandakanya iimpawu zokuchama (ezinje ngokuphindaphindiweyo, ukungxamiseka, kunye nokutshisa), utshintsho lwamathumbu, ukungasebenzi kakuhle kwe-erectile, kunye nokudinwa.
d. Unyango lweHormone
- Unyango lweHormone, olukwabizwa ngokuba yi-androgen deprivation therapy (ADT), lujolise ekunciphiseni amanqanaba eehomoni zesilisa (androgens) emzimbeni, ezinokuphembelela ukukhula kweeseli zomhlaza wedlala lesinyi.
- Unyango lweHormone lunokusetyenziswa lodwa okanye ludityaniswe nolunye unyango lomhlaza wedlala lobudoda obuphambili okanye obumetastatic.
- Imiphumo emibi yonyango lwe-hormone ingabandakanya ukukhanya okutshisayo, ukunciphisa i-libido, ukungasebenzi kakuhle kwe-erectile, ukulahleka kwemisipha, i-osteoporosis, kunye nokukhathala.
e. Unyango ngamachiza
- I-Chemotherapy isebenzisa amayeza ukubulala iiseli zomhlaza okanye ukucothisa ukukhula kwazo. Ngokuqhelekileyo isetyenziselwa umhlaza we-prostate ophezulu okanye we-metastatic ongakhange uphendule kunyango lwe-hormone.
- Unyango ngamachiza lunokusetyenziswa ngomthambo okanye ngomlomo, njenge-agent enye okanye zidityaniswe namanye amachiza.
- Iziphumo ebezingalindelekanga ze-chemotherapy zinokubandakanya isicaphucaphu, ukuhlanza, ukulahleka kweenwele, ukudinwa, ukonyuka komngcipheko wosulelo, kunye nokuncipha kweeseli zegazi.
f. Unyango ekujoliswe kulo
- Amachiza onyango ekujoliswe kuwo ajolise ngokukodwa kwiimolekyuli ezithile okanye iindlela ezibandakanyekayo ekukhuleni komhlaza kunye nokuqhubela phambili. La machiza anokusetyenziswa yedwa okanye adityaniswe nolunye unyango lomhlaza wedlala lesinyi.
- Imizekelo yamachiza onyango ekujoliswe kuwo kumhlaza wedlala lobudoda ibandakanya i-abiraterone acetate, enzalutamide, apalutamide, kunye ne-darolutamide.
- Imiphumo emibi yonyango olujoliswe kuyo ingabandakanya ukudinwa, urhudo, isicaphucaphu, uxinzelelo lwegazi, kunye nobutyhefu besibindi.
g. Immunotherapy
- Amachiza e-Immunotherapy asebenzisa amajoni omzimba ukuba aqaphele kwaye ahlasele iiseli zomhlaza. Zisenokusetyenziswa kwiimeko ezithile zomhlaza wedlala lobudoda ongakhange uphendule kolunye unyango.
- I-Sipuleucel-T ngumzekelo weyeza le-immunotherapy elivunyiweyo kunyango lwe-metastatic castration-resistant prostate cancer.
- Iziphumo ebezingalindelekanga ze-immunotherapy zinokubandakanya iimpawu ezinjengomkhuhlane, ukudinwa, umkhuhlane, ukubanda, kunye nokuphendula ngokufakwa.
isiphelo
Umhlaza wedlala lobudoda yinkxalabo enkulu yempilo yamadoda kwihlabathi liphela, kodwa ngokufunyanwa kwangoko kunye nonyango olufanelekileyo, imbonakalo yezigulane ezininzi ilungile. Ukuqonda iintlobo, izizathu, iimpawu, izigaba, izicwangciso zokuthintela, iindlela zokuxilonga, kunye nokukhethwa kwonyango lomhlaza wesibeleko kubalulekile kuzo zombini izigulane kunye nababoneleli bezempilo. Ngokuhlala enolwazi kwaye ekhuthele, amadoda anokuthatha amanyathelo okunciphisa umngcipheko wokuba nomhlaza wedlala lesinyi kunye nokuphucula amathuba awo onyango oluyimpumelelo kunye nokuphila. Ukuhlolwa rhoqo kunye nonxibelelwano oluvulekileyo kunye nababoneleli bezempilo ngundoqo kumlo ochasene nomhlaza wedlala lesinyi.