Qeb Mob Qog Noj Cancer: Lawv Txhais Li Cas?

Zoo Siab

• Yuav paub dab tsi txog cov theem mob cancer
• Theem ntawm tes ua thiab tawv ncauj ntawm tes ua cancer ntawm daim tawv nqaij
• Cov kev kho mob xaiv
• Melanoma theem
• Kev kho mob Melanoma
• Hauv qab kab

Kab mob qog nqaij hlav qhia txog qhov loj ntawm thawj qog thiab ntau npaum li cas cancer tau kis los ntawm qhov chaw nws pib. Nws muaj ntau qib cov txheej txheem sib txawv rau ntau hom mob qog noj ntshav.

Staging muab cov ntsiab lus ntawm qhov yuav tau tshwm sim. Koj tus kws kho mob yuav siv cov ntaub ntawv no los kho txoj kev kho mob zoo tshaj plaws rau koj.

Hauv tsab xov xwm no, peb yuav los saib kom tob li cas ntawm cov xov tooj ntawm duav, lub ntsej muag ntsej muag, thiab cov qog nqaij hlav melanoma tau sim.

Yuav paub dab tsi txog cov theem mob cancer

Kabmob yog ib yam kabmob uas pib tshwm rau thaj chaw me me ntawm lub cev, zoo li tawv nqaij. Yog tias nws tsis tau kho thaum ntxov, nws yuav kis mus rau lwm qhov ntawm lub cev.

Cov kws kho mob siv cov ntaub ntawv sau tseg kom nkag siab:

• ntau npaum li cas mob cancer yog nyob rau hauv tus neeg lub cev
• mob cancer nyob qhov twg
• seb puas yuav kis tau tus mob cancer uas kis dhau qhov uas nws pib
• yuav kho tus mob qog noj ntshav li cas
• qhov kev xam pom lossis kev kwv yees yog dab tsi

Txawm hais tias mob qog nqaij hlav sib txawv rau txhua tus neeg, kev mob qog nqaij hlav nrog tib theem raug kho nrog tib txoj kev thiab feem ntau muaj kev xav zoo ib yam.

Cov kws kho mob siv cov cuab yeej lub npe hu ua TNM kev faib tawm rau theem ua ntau hom mob qog nqaij hlav. Cov kab mob qog noj ntshav yuav koom nrog peb yam hauv qab no:

• T:tme me luaj li cas thiab tob npaum li cas nws tau zus rau hauv daim tawv nqaij
• N: qog node kev koom tes
• M:metastasis lossis seb mob cancer kis mus

Cov tawv nqaij qog nqaij hlav tau nce txij 0 txog 4. Raws li txoj cai dav dav, tus lej qis dua qis dua, tsawg dua kev mob kis.

Piv txwv, theem 0, lossis carcinoma hauv situ, txhais tau tias lub hlwb tsis zoo, uas muaj peev xwm ua rau mob qog noj ntshav, yog tam sim no. Tab sis cov qe no nyob twj ywm rau hauv cov hlwb uas lawv tau tsim ua ntej. Lawv tsis tau loj hlob mus rau hauv cov nqaij mos uas nyob ze lossis kis mus rau lwm thaj chaw.

Theem 4, ntawm qhov tod tes, yog qhov nce qib tshaj plaws. Nyob rau theem no, cancer tau kis rau lwm yam kabmob lossis qee qhov ntawm lub cev.

Theem ntawm tes ua thiab tawv ncauj ntawm tes ua cancer ntawm daim tawv nqaij

Cov ntawv teev feem ntau tsis tas yuav muaj mob qog nqaij hlav cell. Yog vim hais tias cov mob khees xaws no feem ntau kho ua ntej lawv kis mus rau lwm thaj chaw.

Cov ntsej muag yuag yuag ntawm daim tawv nqaij muaj feem ntau ntawm kev kis tus kab mob, txawm hais tias qhov kev pheej hmoo tseem nyob qis qis.

Nrog rau cov qog nqaij hlav tawv nqaij no, qee qhov tshwj xeeb tuaj yeem ua rau cov kab mob qog nqaij hlav sib kis lossis xa rov qab yog tias nws raug tshem tawm. Cov kev pheej hmoo siab muaj xws li:

• carcinoma (qog hlwb) thicker ntau dua 2 hli (millimeters)
• kev nkag rau hauv cov leeg hauv qhov tawv nqaij
• kev ntxeem tau mus rau hauv txheej qis ntawm daim tawv nqaij
• qhov chaw ntawm daim di ncauj lossis pob ntseg

Cov ntsej muag qog ua kua thiab ntawm tes tawv nqaij tawv nqaij ua pob yog ua raws li hauv qab no:

• Theem 0: Cov qog hlwb tsuas yog tshwm sim hauv txheej sab saud ntawm daim tawv nqaij (daim npog epidermis) thiab tsis kis mus rau daim tawv nqaij ntau ntxiv.
• Theem 1: Cov qog 2 cm (ntev) lossis luv dua, tsis kis mus rau cov leeg nyob ze, thiab muaj ib lossis tsawg dua qhov kev pheej hmoo siab.
• Theem 2: Cov qog ntawd ntev li 2 txog 4 cm, tsis kis mus rau cov qog ntshav nyob ze, lossis lub qog loj los sis qhov loj me thiab muaj ob lossis ntau dua cov kev pheej hmoo siab.
• Theem 3: Cov kabmob loj dua 4 cm, lossis nws tau kis tawm rau ib qho ntawm cov hauv qab no:
  • subcutaneous cov ntaub so ntswg, uas yog qhov tob tshaj plaws, sab hauv txheej ntawm daim tawv nqaij uas suav nrog cov hlab ntshav, cov leeg ntawm cov hlab, thiab cov hauv paus plaub hau.
  • pob txha, qhov twg nws tau ua rau muaj kev puas tsuaj me me
  • nyob ze ze ntawm lub zes
• Theem 4: Cov qog tuaj yeem yog qhov loj me thiab tau kis mus rau:
  • ib lossis ntau lub lymph node, uas loj dua 3 cm
  • pob txha los yog pob txha pob txha
  • lwm yam kabmob hauv lub cev

Cov kev kho mob xaiv

Yog tias yws yws qog lossis cell cell mob khees xaws tau thaum ntxov, nws yuav kho tau. Cov txheej txheem phais sib txawv feem ntau siv los tshem cov qog ntshav.

Cov txheej txheem phais mob no feem ntau yuav ua nyob hauv tus kws kho mob lub chaw haujlwm lossis chaw kho mob sab nraud raws li cov tshuaj loog hauv zos. Qhov no txhais tau tias koj yuav tsaug zog, thiab tsuas yog thaj tsam ib ncig ntawm daim tawv nqaij tawv nqaij yuav loog. Hom kev phais mob uas tau ua yuav nyob ntawm:

• hom tawv nqaij ua tawv nqaij
• qhov loj ntawm qog
• mob cancer nyob qhov twg

Yog tias mob qog nthuav tawm tob tob rau hauv cov tawv nqaij lossis muaj kev pheej hmoo siab tshaj tuaj, lwm yam kev kho mob tuaj yeem xav tau tom qab kev phais mob, xws li hluav taws xob lossis tshuaj tua hluav taws xob.

Qee qhov kev xaiv kev kho mob feem ntau rau cov nqaij hlav tawv dawb los yog daim tawv nqaij tawv nqaij muaj xws li hauv qab no:

• Kev Cia Siab: Nrog kev tshaj tawm, koj tus kws kho mob yuav siv rab chais lossis cov tawv taub hau kom tshem tau cov qog nqaij hlav thiab qee cov nqaij zoo noj ncig nws. Cov ntaub so ntswg uas raug muab tshem tawm yuav muab xa mus rau qhov chaw kuaj ntshav kuaj kom pom.
• Kev siv tshuab hluav taws xob: Kuj tseem paub tias yog cov tawv nqaij kho thiab tso hluav taws xob, tus txheej txheem no tau zoo tshaj plaws rau cov kabmob kheesxaws ntawm daim tawv nqaij uas nyob rau sab saud ntawm daim tawv nqaij. Koj tus kws kho mob yuav siv ib qho cuab yeej tshwj xeeb hu ua tus kho los tshem tawm cov mob qog nqaij hlav. Daim tawv nqaij yog tom qab ntawd hlawv nrog ib qho hluav taws xob hauv hluav taws xob los rhuav tshem cov qog nqaij hlav twg. Cov txheej txheem no feem ntau yog rov ua ob peb zaug thaum tib lub sijhawm mus ntsib hauv chav ua haujlwm kom paub tseeb tias txhua tus kabmob tawm.
• Kev phais Mohs: Nrog txoj kev ua no, koj tus kws kho mob siv ib daim phuam los ua tib zoo tshem cov tawv nqaij txaij hauv cov kab rov tav nrog rau qee cov nqaij mos uas nyob ib puag ncig. Daim tawv nqaij tau tshuaj ntsuam hauv lub tshuab tsom kab mob sai li sai tau thaum nws tshem tawm. Yog tias pom cov kab mob qog ntshav, lwm txheej ntawm daim tawv nqaij raug tshem tawm tam sim ntawd kom txog thaum tsis pom cov kab mob qog nqaij hlav ntxiv.
• Cryosurgery: Nrog cryosurgery, kua nitrogen tau siv los khov thiab rhuav tshem cov qog nqaij hlav cancer. Qhov kev kho mob no rov qab ua dua ob peb zaug thaum tib lub sijhawm mus ntsib hauv chav ua haujlwm kom ntseeg tau tias txhua tus mob qog nqaij hlav tau raug puas tsuaj.

Melanoma theem

Txawm hais tias mob melanoma tsawg dua li cell cell los yog squamous cell mob qog nqaij hlav, nws muaj kev txhoj puab heev. Qhov no txhais tau hais tias nws kis tau yooj yim dua kis mus rau cov ntaub so ntswg nyob ze, cov qog ntshav, thiab lwm qhov hauv lub cev, piv nrog cov qog nqaij tawv nqaij nonmelanoma.

Melanoma yog staged raws li nram no:

• Theem 0: Cov qog hlwb tsuas yog tshwm sim hauv txheej sab nraud ntawm daim tawv nqaij thiab tsis txhob ua rau cov nqaij mos nyob ze. Nyob rau theem no uas tsis yog txawv txav, cov qog nqaij hlav tuaj yeem tshem tawm los ntawm kev phais ib leeg.
• Theem 1A: Cov qog tsis ntev dua 1 hli tuab. Tej zaum nws yuav los yog tsis muaj qhov ua paug (ib qho ntawm daim tawv nqaij uas tso cai rau cov nqaij hauv qab no qhia pom).
• Theem 1B: Lub qog tuab tuab yog li 1 txog 2 hli, thiab tsis muaj qhov txhab.
• Theem 2A: Lub qog yog 1 mus rau 2 hli tuab thiab mob hnyav, lossis nws ntawm 2 txog 4 hli thiab tsis ua kiav txhab.
• Theem 2B: Lub qog yog 2 mus rau 4 hli tuab thiab mob hnyav, lossis nws ntau dua 4 hli thiab tsis ua kiav txhab.
• Theem 2C: Cov nqaij hlav ntau tshaj li 4 hli tuab thiab mob ntau dua.
• Theem 3A: Lub qog tuab tsis ntau dua li 1 hli thiab muaj qhov mob tshwm sim, lossis nws li 1 txog 2 hli thiab tsis ua kom kiav txhab. Cov kab mob khees xaws raug pom nyob hauv 1 txog 3 qhov mob qog ua haujlwm.
• Theem 3B: Cov qog loj dua li 2 hli tuab nrog qhov mob, lossis 2 txog 4 hli yam tsis muaj kev mob plab, ntxiv rau mob qog mis yog ib qho ntawm cov no:
  • ib mus txog peb lub quag
  • nyob rau hauv tej pawg me me ntawm cov qog hlwb, hu ua microsatellite hlav, nyob ze rau thawj qhov hlav
  • hauv cov pab pawg me ntawm cov qog cov hlwb li 2 cm ntawm thawj lub qog, hu ua qog cov hlav
  • nyob rau hauv cov hlwb uas tau kis mus rau cov lymph hlab ntsha ze, hu ua in-trans metastases
• Theem 3C: Cov qog nce txog 4 hli tuab nrog qhov ua mob, lossis 4 hli lossis loj dua yam tsis muaj kev mob, ntxiv rau mob qog mis yog ib qho ntawm no:
  • ob rau peb lub qog ntshav
  • ib lossis ntau qhov txuas, ntxiv nrog muaj qog microsatellite, qog cov qog, lossis hauv kis uas pauv tau
  • plaub los sis ntau dua ntawm cov ntshav lossis ib qho naj npawb ntawm fused nodes
• Theem 3D: Lub qog tuab tshaj li 4 hli thiab nws yog ulcerated. Cov kab mob qog noj ntshav muaj nyob rau ib qho ntawm cov chaw no:
  • plaub lossis ntau dua cov qog ntshav lossis ib qho naj npawb ntawm cov fused
  • ob los sis ntau qhov ntswg lossis ib qho xov tooj ntawm cov fused, ntxiv rau muaj cov qog microsatellite, cov qog qog loj, lossis hauv cov tsheb xa mus los
• Theem 4: Cov kabmob kheesxaws tau kis mus rau thaj chaw ntawm lub cev. Qhov no suav nrog cov qog ntshav lossis kabmob hauv nruab nrog xws li lub siab, lub ntsws, pob txha, lub hlwb, lossis lub plab zom mov.

Kev kho mob Melanoma

Rau cov mob melanoma, txoj kev kho yuav loj nyob ntawm theem thiab qhov chaw ntawm kev mob qog noj ntshav ntau ntxiv. Txawm li cas los xij, lwm yam kuj tseem yuav txiav txim siab siv hom kev kho mob twg.

• Theem 0 thiab 1: Yog tias pom tus mob melanoma thaum ntxov, kev phais mob qog thiab cov nqaij mos uas nyob ib puag ncig feem ntau yog qhov xav tau. Kev soj ntsuam daim tawv nqaij raws sij hawm yog qhov pom zoo kom paub meej tias tsis muaj mob qog nqaij hlav cancer.
• Theem 2: Qhov mob melanoma thiab puag ncig cov nqaij mos yuav raug tshem tawm.Koj tus kws kho mob kuj tseem yuav hais kom tso cov hlab ntshav me me kom paub meej tias tus kabmob kheesxaws tsis kis mus rau cov qog ntshav nyob ze. Yog tias cov qog ntshav kuaj lub qog ntshav, koj tus kws kho mob yuav pom zoo kom tshem tawm cov qog ntshav ntawm thaj chaw ntawd. Qhov no hu ua mob qog ua kua dissection.
• Theem 3: Qhov mob melanoma yuav raug tshem tawm nrog rau qhov ntau dua ntawm cov nqaij mos. Vim hais tias mob cancer tau kis rau cov qog ntshav los ntawm qib no, txoj kev kho mob tseem yuav suav nrog cov lymph node dissection. Tom qab phais, kev kho ntxiv yuav raug pom zoo. Lawv suav nrog:
  • cov tshuaj tiv thaiv kab mob uas pab txhawb koj lub cev tsis muaj zog tiv thaiv kev mob qog noj ntshav
  • Cov hom phiaj kho kho cov tshuaj uas thaiv qee cov protein, cov enzymes, thiab lwm yam tshuaj uas pab cov kabmob loj hlob
  • Kev siv hluav taws xob uas yog tsom rau thaj chaw uas tshem tawm cov qog ntshav
  • raug rho tawm cov tshuaj kho mob, uas cuam tshuam nrog thaj chaw uas muaj mob qog noj ntshav
• Theem 4: Kev phais mob tawm ntawm qog thiab cov qog ntshav tau txais kev pom zoo. Vim hais tias mob cancer tau kis mus rau cov kabmob sib txawv, kev kho ntxiv yuav zoo xws li ib lossis ntau tshaj ntawm cov hauv qab no:
  • txhaj tshuaj tiv thaiv kab mob hu ua checkpoint inhibitors
  • tsom cov tshuaj kho mob
  • kev kho tshuaj

Hauv qab kab

Kab mob qog nqaij tawv tuaj yeem qhia koj ntau yam txog tias tus kab mob tau vam meej mus txog hnub twg. Koj tus kws kho mob yuav txiav txim siab txog hom mob cancer ntawm daim tawv nqaij tshwj xeeb thiab theem kom txiav txim kev kho mob rau koj.

Ntxov paub thiab kho mob thaum ntxov muab txoj kev xav zoo tshaj. Yog tias koj muaj kev pheej hmoo mob qog nqaij hlav lossis pom tias muaj tej yam txawv txawv ntawm koj cov tawv nqaij, teem sijhawm kuaj mob tawv nqaij sai li sai tau.