High Energy Center (CHE)

Mushure mekunge murwere awanikwa aine kenza inorapa uye abatwa, anoendeswa kucological consultation. Uku kutaurirana nachiremba panguva iyo chirongwa chekurapa chichakurukurwa.Mushure mekunge murwere awanikwa aine kenza inorapa uye abatwa, anoendeswa kucological consultation. Uku kutaurirana nachiremba panguva iyo chirongwa chekurapa chichakurukurwa. Nyanzvi oncologist anozvibata. Iye achakuudza zvese zvaunoda kuti uzive nezvechirwere chako uye nemabatirwo ayo. Nguva yakareba, mhedzisiro, mhinduro dzinotarisirwa, uye zvaunotarisira. Nomuzvarirwo, iwe unogona kubvunza iyo oncologist mibvunzo yako yose.Munguva yekurapa, iwe unobvunzawo wako oncologist, uyo anoongorora kufambira mberi kwekurapa.Yakakurudzirwa    Kenza

Kurapa kwegastric adenocarcinoma inosarudzwa zvichienderana nesaizi yeanoplasm, chiyero chekusiyanisa kwayo, zera remurwere uye mamiriro ake akajairika. Inonyanya kushanda ndeyokuvhiya bundu. Pane marudzi maviri ekuvhiya ayo anogona kuitirwa cancer yemudumbu:    Munguva yepasi rese resetential, neoplasm inobviswa nechikamu chetishu zvine chekuita nekukuvara kana nzvimbo diki yenhengo yacho pachayo;     A gastrectomy inobvisa dumbu rese uye nhengo dzakatenderedza - dunhu lymph node, chikamu cheesophagus uye diki dumbu. Kana pane contraindicationyekupindira kwekuvhiya, masero emukenza anobviswa kuburikidza ne endoluminal laser therapy. Kuti murwere agone kudya ega, madziro anounzwa mudumbu rake (maitiro anonzi endoluminal stening). Usati wavhiya uye mushure mekuvhiyiwa, nzira dzinotevera dzekurapa dzinorayirwa munhu:     Radiation kurapwa. Irradiation inoitwa pamberi pekuvhiya kuti uderedze hukuru hwe bundu, uye zvakare mushure mekuvhiyiwa nzira dzekuparadza maseru ane huturu akasiya mushure mekuvhiyiwa. Kushandisa radiation kunogona kuderedza marwadzo uye kudzivirira kubuda kwemukati.     Chemotherapykunoitwa nerubatsiro rweCisplatin, Bleomycin kana Ftorafur kuderedza neoplasm usati wavhiyiwa uye kuparadzwa kwemasumbu maronda shure kwayo. Kurapa kwemakemikari zvakare kunobatsira kudzikisa njodzi yekudzokororwa kwegomarara.     Immunotherapy Kugadzirira kwemakemikari kwakakanganisa kwete chete bundu maseru, asiwo hutano matishu, saka zvakakosha kuti uwedzere kuzvidzivirira kwemuviri nerubatsiro rwehunyanzvi nzira.Rega chikumbiro pane webhusaiti yedu uye nyanzvi dzedu dzichaonana newe uye dzichakubatsira kusarudza kiriniki yakanakira maererano nenyaya yako yemahara.

nullvhoriyamu yekukuvara kweiyo larynx. Hoarseness yezwi chiratidzo chekutanga kana iyo carcinoma iri panzvimbo yemazwi emadziro, asi inoonekwa mumatanho anotevera kana achiwanikwa munzvimbo dze supraclad uye subclad zvikamu. Varwere vane sublingual cancer vanowanzove nemhepo kuvhiringidzika uye hoarseness chiratidzo chakajairika mumatanho anotevera. Varwere vane pamusoro-ligamentous cancer inowanzove ne dysphagia; zvimwe zviratidzo zvechirwere ichi kuvharika kwemhepo, otalgia, kukura kwechipundu mumutsipa, inzwi rakanzwika. Varwere vane zviratidzo izvi vanofanirwa kutumirwa nekukurumidza kune isina kunanga laryngoscopy.KuongororaLaryngoscopyKuvhiya endoscopy uyenullnullEndoscopic laser resection uye radiation kurapwa, sekutonga, tendera iwe kuti uchengetedze izwi revarwere. Iko kushandiswa kwekurapa kenza ye laryngeal cancer mumatanho ekutanga ekuvhiya kana radiation kurapwa, sekutonga, zvinoenderana nezvido zvevanachiremba vechipatara chekurapa uye murwere.Mune iwo matanho anotevera enzwi renzira carcinoma, iwo asina simba kana kubatanidzwa mukuita kwerimi; varwere vanoratidzwa chemotherapy kana radiation kurapwa. Kana bundu remurwere rakapararira kupfuura larynx kana kuti rakapinda mu cartilage, laryngectomy inopa yakanyanya kunaka oncological mhedzisiro; laryngectomy inowanzo kuwanda, asi mune zvimwe zviitikoendoscopic laser resection ye tumor kana yakavhurika chikamu laryngectomy inogona kushandiswa. Yakawandisa laryngectomy inoshandiswawo zvakanyanya mumamiriro akaoma kuponesa murwere; zvisinei, dzimwe nguva mumamiriro akadaro, endoscopic resection kana yakavhurika chikamu laryngectomy inogona kushandiswa.Mukutanga matanho e-carcinoma yeiyo supraclavicular larynx, radiation kurapwa kana chikamu chidimbu chehoroma chiri kushanda. Iko kushandiswa kwe laser resection mumatanho ekutanga e squamous cell carcinoma yakaratidza mhedzisiro yakanaka. Kana iyo carcinoma ikaramba ichikura, asi isingakanganisi tambo dzezwi chaidzo, ipapo chikamu chemumhino chakasarudzika chinogona kuitwa kuchengetedza izwi uyesphincter ye glottis. Kana murwere ainewo tambo dzinonzwika, laryngectomy pamusoro peiyo cricoid cartilage kana yakazara laryngectomy inodikanwa, kana zvichinge zvafungwa kuita kurapwa kwekuvhiya. Sezvineiwo nenyaya ye laryngocarcinoma, kazhinji nhanho dzinofambira mberi dzegomarara repamusoro rakatanga kurapwa chemotherapy uye neradiation kurapa. Iyo ligamentous mudunhu ine akapfuma lymphatic network, nekudaro, kutarisisa kwakakosha kunofanirwa kupihwa kunharaunda yemutsipa mune varwere vese vane ligamentous cancer.Iine carcinoma yeiyo yakadzika pharynx, kurapwa kwakangofanana nekenza yecarynx. Mumatanho ekutanga, kukuvara kunowanzo kurapwa cheteradiation kurapwa, kana endoscopic resection seimwe nzira. Nekudaro, mune vazhinji varwere vane submaryngeal cancer, kufambira mberi kunosanganisirwa ne asymptomatic chimiro chechirwere uye chinowanzoitika munharaunda kupararira kuburikidza nelimphhatic system; varwere vakadaro vanorapwa zvakanyanya ne chemotherapy uye radiation therapy, uye nekukurumidza - zvinoenderana nezvinokosha zviratidzo.KugadzirisaKugadzirisa kunogona kudikanwa mushure mekurapa kwese kurapwa. Kazhinji, zvinetso zvakakomba zvinomuka nehurongwa hwekumedza chikafu mushure mekemotherapy kana radiation kurapwa, izvo zvinogona kuda kudzikiswa kweesophagus, mune zvakanyanya kurwara - mapurasitiki e pharynx kana kuiswa kwegastrostomy. Munguva yekuvhiyakupindira kunogona zvakare kukanganisa nzira yekumedza, uye kurapwa kunogona kudikanwa, kusanganisira kuwedzera nzira yekumedza.Kuvhiya, kune rumwe rutivi, kunokanganisa kutaura kwakanyanya. Mushure mekuzara laryngectomy, murwere anofanira kugadzira izwi idzva na:    Esophageal izwi    Esophageal tracheal puncture    E-pahuro (electropharynx)Nese maitiro matatu, kutaura kunoumbwa nekudyidzana kwe pharynx, nyoro, rimi, meno nemiromo.Hwaro hwekuumbwa kwe "esophageal izwi" (pseudo-izwi) ndiko kugadzirwa kwepseudo-izwi pengo mune esophagus uye kukura kwayokuvharwa kwekupokana.Ne tracheoesophageal fistula, vharuvhu inoiswa pakati peiyo trachea uye esophagus kuitira kuti iwedzere kufonerwa. Iko vhezheni inobatsira kupomha mweya mukati meesophagus panguva yekurudziro chiito. Varwere vanozobatsirwa pakugadziriswa kwemuviri, makosi pakubata kwekutaura, vanodzidziswa mitemo yekurapa fistula, uye vese varwere vanonyeverwa nezve njodzi yekuishuvira kwechikafu nemvura.Iyo larynx yemagetsi chishandiso-chinoshandiswa nebhatiri chiri pamusoro pemutsipa. Pasinei nekusanzwisisika kunogadzirwa nekusabatana kwemagariro kana kuchinge kupfekedzwa varwere vazhinji, zviri nyore kubata uye hazvidi kudzidziswa kwakakosha.

Malignant neoplasms yeiyo gallbladder. Chirwere ichi ndechimwe chirwere chisingawanzo, kazhinji vakadzi vane makore makumi mashanu zvichikwira.Zviratidzo zvenduruChiratidzo chikuru chinoratidzira chinosanganisira kusvotwa uye kurutsa, jaundice, kurwadziwa mudenga rechitatu repadumbu, fivha, fivha, kuderera kwemuviri, kuderera kwekuda kudya, kutumbuka, uye kukura kwemapundu mumudumbu. Sezvo mutemo, mumatanho ekutanga echirwere, murwere haana chero kusagadzikana, izvo zvinoderedza zvakanyanya mikana yemurwerekupora.Kuongororwa kwechirwere chegallbladderKuverengeka kwema laboratori uye kunobatsira ongororo kunoitwa: weropa bvunzo, yeropa biochemistry, x-ray yematumbu nhengo, magnetic resonance diagnosticosis yematumbu nhengo, percutaneous transhepatic cholangiography, biopsy yeiyo gallbladder iinezve nhoroondo nhoroondo yekuongororwa kwemasampula ehutu dzakakanganiswa.Gallbladder Cancer KurapaKurapa kwechirwere ichi, sekurwadzisa kwakanyanya neoplasms, kunosanganisira kuvhiyiwa kwekubvisa bundu uye cervervative therapy. Nzira huru yekurapa ndeyekuvhiya, iyo yakakurumbira cholecystectomy. Nhasi, inoitwa nenzira yakapfava yekushanda.- laparoscopic nzira. Munguva yekurapa kwakaomarara, radiation therapy uye chemotherapy inoshandiswa, uye varwere vanogadziriswawo radiosensitizer gadziriso ine zvikamu zvinoshanda zvinowedzera kunzwa kweasypical maseru kune mamwe marudzi e radiation.Kudzivirira kweGallbladder KenzaIko hakuna nzira dzakananga dzekudzivirira kwemaitiro aya. Kukurudzira kwakawanda kunosanganisira: kuremerwa kwezvibodzwa zveuremu, kudya kwakakodzera, kuderera kwehuwandu hwekudya kwemhuka dzinobva uye kuwedzera kwekudya kwemiriwo nemichero. Zvinokurudzirwawo kusiya zvakaipa maitiro, kurovedzera muviri nguva dzose, uye kupisa muviri.

Kenza yeganda idambudziko rakanyanya. Munyika, Australia, New Zealand uye USA vanotungamira muhuwandu hwezviitiko zvitsva zve melanoma zvakashumwa pagore. MuRussia, sedzimwe nzvimbo munyika, huwandu hwehupfumi huri kukura.Maererano neWorld Health Organisation, zviitiko zvitsva 132,000 zvitsva zve melanoma zvinonzi zvinoraswa gore rega rega. Vazhinji varwere vanhu vakwegura, mushure memakore makumi mashanu nhamba yevanorwara varwere yakawedzera kaviri kupfuura vakadzi. Asi mujaya nemhandara, cancer yeganda inokura kazhinji. Maererano nenyanzvi dzezvirwere zvechirwere, izviKenza muRussia ndeyechipiri kune kenza yemapapu, cancer uye mazamu cancer. Mune mamwe mazwi, izvi hazvisi pamusoro peimwe chirwere chinoshamisa, asi nezvekutyisidzira chaiko kune hutano.Mhando dzeganda oncologyZvakajairika ganda ganda zvinosanganisira:Basal cell carcinoma - bundu iri rinoonekwa muzvirwere zvinomwe zvegomarara reganda kubva pagumi. Basalioma inoita senge nodule kana banga reblue-brown kana ruvara rwepink, inowanzoonekwa pachiso. Neoplasm inogona dzimwe nguva kurira, kukuvara kana kubuda ropa - zvishoma nezvishoma inowedzera muhukuru,pasina kukonzera munhu kuratidza kusagadzikana, ndosaka kushanya kwachiremba kunogona kunonoka. Neraki, ichi bundu hariwanzopararira mumuviri wese (inopa metastases), saka, iyo prognosis yevarwere inowanzo farirwa.Squamous cell carcinoma yeganda (squamous cell carcinoma) inowanzo fanika mushwa mune chimiro: muviri unotenderera uine gumbo rakatetepa. Bundu iri rakafanana newadhi: kazhinji inowanikwa pamusoro pechiso, mudunhu remuromo wakadzika. Mune mamwe marudzi e squamous cell carcinoma, neoplasm inogona kucherechedzwa chete nekushandurwa kweruvara rweganda: munharaunda yepfungwa.Anotaridzika kana kuti ari kurwadziwa. Mumatanho anotevera, carcinoma inotungamira pakuumbwa kwemastastases uye dzimwe nguva isingarapike.Melanoma imhando ine ngozi kwazvo bundu iro rinokonzera kufa kwakawanda kukenza yeganda. Iyo inokura kazhinji kubva kumahombera - kuunganidzwa kwemasero e pigment, melanocyte, asi kwete chete: melanoma inogona zvakare kukanganisa iyo retina, mucous membranes (muromo mucity, vagina, rectum). Iyi neoplasm inoonekwa nekukura nekukurumidza uye inokonzeresa kuumbwa kwemasideti mazhinji ari kure - mumapfupa, pfungwa, mapapu, chiropa. Kunyangenekurapwa kwenguva, varwere vane melanoma vanowanzo vadzokorora - yakadzokororwa tumor kukura mushure memakore akati wandei.Pane nzira dzinoverengeka dzakakosha dzekurwisa cancer yeganda.Kuvhiya ndiyo nzira inodhura yekubvisa bundu. Iko kushanda kukuru kwekuvhiya kunoonekwa mumatanho ekutanga, apo iyo neoplasm haina kukanganisa lymph node uye dzimwe nhengo uye nhengo. Mushure mekubvisa bundu, chiremba anovhiya anoita cauterization (electrocoagulation) pamwe neyepatreti (therapyttage) yeganda repasirose kuti iparadze maseru ekenza masero. Sezvo gomarara reganda rinowanzo kukura pachiso, pane kupindira kwakapfava,izvo zvinoderedza urema hwekuremara. Izvi zvinosanganisira cryodestruction, mune iro bundu rakaomeswa neyetsijeni nitrogen uye rinobviswa pasina kukuvara kwakasimba kwetoni. Nekudaro, izvo zvinofanirwa kunzwisiswa kuti mune zviitiko zvine hukasha marudzi ekenza - squamous cell carcinoma uye melanoma - hazvibviri kuita sarudzo uchifarira hushoma hwekuvhiyiwa. Kuvhiya micrographic, senzira ye MOHS (Mohsa), inonzi ndiyo yakachengeteka uye yakanyanyisa nzira yemazuva ano yekupindira kwegomarara reganda. Nayo, ganda rine tumor cell rinobviswa mumatafura, pasi pekutonga kwe microscope, uye rimwe nerimwe danga rakananga mukatipanguva yekuvhiya inotumirwa kuti iongororwe zvakare kuchipatara. Chiremba anovhiya anomisa kupindira panguva imwe chete apo histologists inosimbisa kuti ronda harina maseru ane huturu.Radiotherapy inoshandiswa sechienzanisiro kune nzira yekuvhiya. Radiation inokuvadza maseru anofarira kukurumidza kukura, saka, mirayiridzo yakatemerwa ionizing radiation inogona kuderedza hukuru hwebundu, pamwe nekuparadza iwo maseru anotyisa akararama mushure mekuvhiyiwa. Nguva yenguva ye radiotherapy zvikamu uye radiation dheti ndeye munhu kumurwere wega wega.Chemotherapy yakarongeka uye yemuno. Nekugadzwa kwemaitiro aya, cytotoxic (inokuvadza kunamasero) kemikari inoiswa mutserendende kana kuiswa zvakananga ku tumor. Maitiro akadaro akakosha zvakanyanya pakuzivisa metastases kana iyo chinangwa chegomarara chiri kunze kwekusvika kwevanachiremba.Photodynamic kurapwa kunosanganisira kuparadzwa kwe bundu ne laser beam mushure yekutanga photosensitization (kuwedzera kuwedzera kwekunzwa kwemasero kujekesa). Iyi nzira iri nyowani, uye kushandiswa kwayo pasina kuvhiya kunoitwa pakukurukurirana. Nekudaro, kuvandudzwa kwetekinoroji kunopa chokwadi chekuti Photodynamic Therapy iri kuiswa zvishoma nezvishoma mune tsika yekiriniki yemasangano ekurapa.Kugwinya uye kurapwa kwakatemerwa - hunyanzvi uye hwakavimbika nzira dzinobatanidza dzakanangwa kutarisana.tumor nekusimudzira immune system kana kuiswa kwemishonga yakagadzirwa zvakananga kune imwe mhando yekenza zvichibva pane yega genetic maitiro emurwere. Dzimwe nyanzvi dzine chokwadi chekuti nekufamba kwenguva nzvimbo ino iri oncology ichatsiva dzimwe dzese nzira dzekurapa neoplasms, asi kusvika pari zvino, hutachiona hwekuzvidzivirira uye hwekutarisirwa hunoshandiswa mukubatana nemamwe maitiro uye nekudzivirira kwekudzoka.Rega chikumbiro pane webhusaiti yedu uye nyanzvi dzedu dzichaonana newe uye dzichakubatsira kusarudza kiriniki yakanakira maererano nenyaya yako yemahara.

Kenza yemapundu iri kusvika kune imwe yeanowanzoitika marudzi ekukuvadza neoplasms. Paavhareji, kune makumi mana emapapu vanorwara nekenza pamunhu zviuru zana, uyezve, varume vanoonekwa vaine chirwere ichi kakapetwa kagumi kupfuura vanhukadzi, uye chikamu chevagari vemumaguta mune zvese zviitiko chakapetwa kakawanda kupfuura vanhu vemusha. Nekudaro, mushonga wemazuva ano une simba rekurongedza kurapa rudzi urwu rwe oncology: nekuwana nguva yekubatsira, inonyanya mukana kwete kungomisa kukura kwechirwere, asi zvakare kukanganwa nezvazvo zvachose.Kenzalung: chirwere chechirwere uye prognosis yekurapaVanosvika mamirioni mashanu vanofa nekenza yemapapu gore rega rega munyika. Rudzi rwekenza urwu runonzi zvakare bronchogenic carcinoma, kana bronchogenic cancer. Bundu rinokura kubva kueficliary epithelium ye mucous membrane ye bronchi, alveoli uye epithelium yebronchial gland. Kunyangwe chokwadi chekuti etiology yechirwere ichi ichiri kujekesa, zvikonzero zvikuru zvekuvapo kwayo zvinosanganisira: kuputa; kuratidzwa kwe radon uye mamwe makatuni (asbestos mineral ndiyo ine ngozi kumapapu); mamwe marudzi ehutachiona; kuwedzera kusungwa kwevhu guruva mumhepo. Pathogeneis yekenza yemapapu panenullnullmapapu.Stage 1 yemapapu kenza inoonekwa ne bundu kusvika pakureba kwemasendimita matatu, isati yatomboita metastasize. Iyo neoplasm inowanikwa muchikamu chimwe chepapu kana mukati mechikamu chebronchus.Nhanho yechipiri - bundu rinosvika pamasendimita matanhatu riri muchikamu chimwe chepapu kana mukati mechikamu chebronchus. Imwe metastases mune pulmonary uye bronchopulmonary lymph node inoonekwa.Nhanho 3 - bundu rakakura kupfuura 6 cm richichinja kuenda padyo nepamuromo pekupfira kana kumera kweanogarisana nebronchus kana main bronchus. Metastases inowanikwa mune bifurcation, tracheobronchial, paratracheal lymph node.4nhanho yekenza yemapapu inoratidzirwa ne metastases mune kure masisitimu uye nhengo, pleurisy uye / kana pericarditis inobatana. Kugadziriswa uku kunoshanda chete kune squamous cell carcinoma. Panyaya yekenza diki yegomarara, inokura nekukurumidza, zviyero zviviri chete ndizvo zvinosiyaniswa. Yekutanga - danho risingapfuure - inoperekedzwa nekusvikirwa kwemasero pathogenic mune rimwe mapapu uye padyo netishu. Muchikamu chechipiri, bundu racho rinosangana nenzvimbo iri kunze kwemapapu uye kune nhengo dziri kure.Lung kenza kurapwaKuongororwa kwakanaka kwepulmonary oncology kwakanyanya kukosha, nekuti kusarudzwa kwemaitiro ekurapa kwakanaka kunoenderana nazvo. Nzira huru dzirikuvhiya kupindira, chemo neradiation kurapa. Nekuda kwekuvandudza kwekurumidza kwehunyanzvi hwekurapa, nzira idzi dziri kuve dzakachengeteka uye dzichibudirira.1. Kurapa kwekuvhiya kunoshandiswa squamous cell carcinoma. Munguva yekuvhiya, bundu rese re cancer rinorwara kana chikamu charo chakaparurwa chakabviswa. Kukura kwehutu kubviswa kunoenderana nechimiro che tumor nenzvimbo yacho. Ikozvino maitiro ekurapa kwegomarara remapapu ndiko kushandiswa kwenzira dzisingapindike, dzinogadzirwa uchishandisa miniature vhidhiyo kamera. Iyi nzira inonzi Vhidhiyo-Yakabatsira Thoracoscopic Surgery (VATS). Kuita kwakadaro kunofambidzana nemarwadzo asingatauriki, uye maitiro ekugadzirisa mushure mavo anoenderera nekukurumidza.2. Chemotherapy- Kurapa kukuru kwevarwere vazhinji vane kenza yemapapu. Hwaro hwayo huri mukutora mishonga inoparadza cancer maseru.3. Yakatarisana (yakanangwa) kurapa kwegomarara remapapu. Mishonga yakadaro inocherekedza maseru ane humwe hunhu hwayo ndokudziparadza, zvichikanganisa mabasa akakosha (kukura, kupatsanura). Uye zvakare, zvinodhaka zvakadaro zvinokanganisa kuwanikwa kweropa kune bundu. Chinangwa (chakanangwa) chekurapa chinogona kuve chakagadziriswa senzira yekuzvimirira yekurapa kana mukubatana ne chemotherapy kuitira kuti uwedzere kushanda kwekurapa.4. Immunological kurapwa kwegomarara remapapu inzira itsva uye inovimbisa kwazvo mukatikuchengetedza oncology. Kurapa kwakadaro kunokubvumira kuti uise masero esyako immune system kurwisa cancer cancer uye "target" inongobata tumor cell.5. Radiotherapy. Irradiation ye tumor neine danda rine simba re gamma rays, semhedzisiro iyo masero emukenza anofa (vanomisa kukura uye kubereka). Kutakurirwa neiri kure kana yakakwirira-nzira nzira. Nekurapa kweradiation kurapwa, zvose tumor pachayo uye matunhu ematunhuasis anoratidzwa neradiation. Radiation kurapwa inoshandiswawo kune diki cancer kenza.Rega chikumbiro pane webhusaiti yedu uye nyanzvi dzedu dzichaonana newe uye dzichakubatsira kusarudza kiriniki yakanakira maererano nenyaya yako yemahara.

Chinhu chekutanga icho varwere nemukadzi wese vanofanirwa kuziva nezvegomarara rezamu (sekuti, zvechokwadi, chero mhando yekenza): nhasi ichi hachisi mutsara, yekutanga nhanho yechirwere, yakakwira mikana yekukunda kenza zvachose. Uye kunyange mumatanho anotevera, kune mikana yakawanda uye yakawanda yekurwisa zvinobudirira chirwere ichi nekuda kwekuuya kwenzira dzemazuva ano dzekurapa (ona pasi apa).Ndiani ari panjodzi? Kenza yemazamu chirwere chinoshungurudza neoplasm iyo inowanikwa mune imwechete mune gumi vakadzi. Kenza yemazamu inogona kucherechedzwa pazera ripi neripi, asi mushure memakore makumi matanhatu nematanhatu, njodziKuumbwa kwemamoriyamu kwakapetwa kakapetwa kashanu kupfuura zera rino. Vanotsvaga vanoona zvinotevera zvinokonzera kukura kwechirwere.1) kuremerwa nhaka: kana hama, kunyanya padumbu revakadzi, vakawanikwa vaine kenza yemazamu, nhengo dzechikadzi, uye zvimwe zvirwere zvekurwara, ipapo njodzi yekurwara nekenza yemazamu inowedzera;2) kutanga kwekuenda kumwedzi (kusvika pamakore gumi nemaviri) uye kunonoka kwekuenda kumwedzi (mushure memakore makumi manomwe nemashanu);3) kusununguka kubereka, kunonoka kuberekwa kwekutanga (mushure memakore makumi matatu), kushomeka kwechibereko kana kuti kwenguva pfupi yekuyamwisa, yepashure yekumuka kwepashure;4) husina kujairika hupenyu hwepabonde;5) kukuvara kwemamary gland;6) kuongororwa kwe "dishormonalmammary gland hyperplasia ”;7) kufutisa;8) kudonhedzwa kwechibereko;9) hormone kutsiva kurapa.Zviratidzo zveCancer Cancer Muchiitiko chekurapa, bundu riri mumamary gland mune akawanda mamiriro ezvinhu anoonekwa nemukadzi kana mukadzi, zvinoitikawo. Bundu rinogona kuwonekwa pakuongororwa nachiremba mammologist, gynecologist, chiremba wekuvhiya, kana kuve netsaona munguva yekuongorora.Zviratidzo zvipi zvinofanirwa kunyevera:    Pamusoro pekunzwa dzidzo pazamu, mukadzi anogona kuona shanduko mumhapa: ulceration, retraction, seeging from the nipple. Iyi inguva yekukumbira chiremba pakarepo.     mune inotevera nhanho chiratidzokukura kushaya simba, kushomeka kwehutano, kukosora, kupfupika kwakanyanya kwekufema, kurwadziwa kwepfupa kunogona kuitika.Mabhachi eKenza Marapirwo Kurapa kenza yemazamu kunoitwa mumatanho akati wandei uchishandisa nzira dzakasiyana siyana. Nhatu nzira huru dzinoshandiswa nhasi:Mushonga antitumor kurapwa.Kune akatiwandei marudzi ekurapa kwakadaro, anoti:* chemotherapy: mune ino kesi, zvinodhaka zvine chinangwa chekuparadzwa kwe tumor cell zvinoshandiswa;* kurapa kwehomoni, iko kuti, kushandiswa kwemishonga inodzvinyirira ihmori chiitiko chechipundu nemuviri;* Kurapwa kwakanangwa inzira itsva, nzira iyo mishonga yacho "yakapiswa" pane chinangwa chemasumbu tumor uye zvakanyanya kukanganisa hutanotishu yemunhu;* Immunotherapy ndiyo nzira itsva kwazvo, iyo nhasi pamakorinendi epasirese oncologists inonzi imwe yedzakanakisa nzira dzinokurudzira nzira dzekurwisa marudzi akasiyana ekenza. Iko kukosha kwe immunotherapy kuri mune chaiyo purogiramu yemaseru ekudzivirira emurwere. Nekuda kwehunyanzvi hwavo chaihwo, vanoshandura kuita chishandiso chine simba chinogona kuziva nekuparadza maseru ekenza chaizvo.Nekuongororwa kwegomarara remazamu, kurapwa kwekuvhiya uye radiation kurapwa kunoshandiswawo.Rega chikumbiro pane webhusaiti yedu uye nyanzvi dzedu dzichaonana newe uye dzichakubatsira kusarudza kiriniki yakanakira maererano nenyaya yako yemahara.

Bladder cancer kenza yechina inonyanya kuzivikanwa pakati pevanhurume; mune vakadzi, izvo zvishoma. Sezvo mutemo, bundu rebundu rinokura zvishoma, uye rinogona kunyatsobudirira pasina kuvhiyiwa kukuru. Uyezve, kazhinji kenza yegomarara, njodzi yekukuvarira bundu rinoisa hupenyu mudiki idiki kwazvo. Kutanga kuongororwa uye kuongororwa nguva dzose kwakakosha pakubudirira kwekurapa.Bladder cancer cancerChikwangwani chinowanzozivikanwa chekenza yemabhonzo ndiko kuoneka kweropa mumwena. Dzimwe nguva inogona kuoneka neziso rakashama, asi kazhinji kuvepo kwemasero eropa kunogona chete kuonekwa panguva yakavanzikaurinalysis. Kuonekwa kweropa mumubhino kunogona kuperekedzwa nemanzwiro asiri ekunakisa panguva yekupenda (kazhinji kunotsanangurwa se "kupisa"). Mukuwedzera, kuyera kunogona kuve kwakawanda uye kuchikurumidza kupfuura zvakajairwa. Mumatanho ekutanga echirwere, zvimwe zviratidzo zvisipo. Naizvozvo, kana paine iropa mune urini kana kuti mune yekukanganisa kupinda mukati, kuongororwa kunofanira kutorwa pakarepo. Izvo zvakakosha kuti urangarira kuti izvi zviratidzo hazvireve kuratidza kuvepo kwe bundu - zvinogonawo kukonzerwa nematombo, kuzvimba kweiyo urethra, yakawedzera prostate, nezvimwe. Chero mamiriro ezvinhu, chikonzero cheizvi zviratidzo chinofanira kutanga chanyatsotsanangurwa.SeiUnowanikwa uine kenza yemabhonzo?Kana ropa rikawanikwa mune urini, bvunzo dzinoverengeka dzinofanira kuitwa kusabvisa bundu rechironda. Ichi chirwere ibasa reurology, saka kunyangwe iwe wanga uri kuna chiremba wemhuri, unofanirwa kushanyira urologist. Mushure mekujekesa nhoroondo yekurapa uye kuongororwa kwemuviri, iwe uchafanirwa kuenda nekuwongorora akati wandei, kazhinji usingade kuchipatara.Munguva ye cystoscopy, endrosope yakaonda inoiswa kuburikidza neurethra (urethra) mubhedhuru. Nayo, iwe unokwanisa kunyatsoongorora nzvimbo yemukati yemabheji uye kutarisa tumors kana zvimwe zvirwere. Iwe unogona zvakare kutora sampuli kubva kumadziro.bhebhi (biopsy). Kuongororwa kunoitwa pakarara pasi, pasi peanesthesia yemuno, uye hazvidi kuchipatara. Mushure me cystoscopy, kunzwa kupisa zvishoma panguva yekurumwa kunogoneka, uko kuchapfuura mushure mezuva kana maviri. Kunwa yakawanda yemvura iyi mazuva ano zvinokurudzirwa.CT urography ndeye computed tomography scan panguva iyo musiyano mumiririri akaiswa mukati memuviri uye nekukurumidza inosimbisa mu urethra. Mushure meizvozvi, computer tomography inoratidza mamiriro eitsvo, ureters uye bhudhi. Kana murwere aine chirwere cheasthma kana kuti allergic kune zvinodhaka kana iodini, mishonga yakakosha inofanira kutorwa pamberi penzira yekudzivirira iyo isinganetseke. Izvo zvakakosha kuti uzive iyo ultrasound uye computed tomographyitsvo hadzi dzakakwanira kupa tsanangudzo inopedza simba uye isingaite yezvikonzero zveropa mumhino.Bladder cancer kurapwaNhanho yekutanga kubvisa bundu. Iyo minwe yakabviswa inotumirwa kuchipatara kuti itarise mhando yebundu uye kudzika kwaro mukati maro mumadziro emabhonzo. Kubviswa kwe bundu (kana resection yayo) kazhinji kunoitika panguva yekuchipatara. Iyo resection inoitwa pasi peanesthesia uchishandisa cystoscope-senge zvishandiso zvakaiswa mukati meiyo urethra (urethra), pasina incways kana kuvhura dumbu. Muzhinji, mushure mekunge bundu raonekwa, murwere anokokwa kuvhiyiwa kwakarongwa. Nekudaro, mune zviitiko apo bundu rinotungamirakugara uchibuda ropa, nekukurumidza kuvhiya kunodiwa. Sezvo mutemo, tumor resection inotungamira kumira kwekubuda ropa. Dzimwe nguva kubviswa kwakakwana kwe bundu hakugone nekuda kwehukuru hwayo kana kudzika kwekupinda mumadziro emabhonzo. Mune zviitiko zvakadaro, biopsy ichaitwa kuti itarise mhando yehuputi uye kudzika kwekupinda kwayo, mushure meizvozvo dzimwe nzira dzekurapa dzichashandiswa. Mushure mekuvhiyiwa, catheter inosara mu bladder kuburikidza ne urethra kwemazuva akati wandei kuti ronda rekuvhiya ripore. Mumazuva ekutanga mushure mekuvhiyiwa, panogona kunge paine kubuda ropa zvishoma kubva pamabhonzo, ayo anofanira kumira zvishoma nezvishoma. Mushure mekubviswa kwe catheterkunzwa kukurumidza uye kupisa, kana kurwadziwa kana uchitsvaga. Kazhinji, kupindira uku ndekwenguva pfupi. Muzhinji, murwere anozokwanisa kudzokera kune zvakajairika kushanda kumba mazuva maviri matatu mushure mekuvhiyiwa. Iyo sarudzo yekuenderera mberi nekurapa inoenderana nemhedzisiro yeye histological kuongororwa (tumor rudzi uye kupenya kwakadzika).Chikamu chechipiri chekurapa chinogona kusanganisira sarudzo nhatu.    Zvepamusoro tumor, kwete kupinda mukati kupfuura inochinja epithelium. Mune ino kesi, kuenderera kurapwa hakudiwi. Pasinei neizvi, maronda akadaro anowanzoitika zvakare, kunyanya mumakore ekutanga mushure mekuvhiyiwa. Neichi chikonzero, kunyanyaIzvo zvakakosha kuti uongororwe nguva dzose mukiriniki yekurapa.     Bundu rakapinda mukati meiyo epithelium inochinja, asi haina kupinda muswe. Mune ino kesi, isu tiri kutaurawo nezve chepamusoro chepundu, asi kuwedzera kurapwa kunodiwa. Semutemo, mishonga yakakosha inoiswa mubhedhuru. Mushonga wakanyanya uye unoshanda anonzi BCG. Chinangwa chayo ndechekuvandudza mhinduro yemuviri yekudzivirira. Cytotoxic zvinodhaka zvinouraya cancer maseru zvinoshandiswawo. Icho chinangwa cheBGG uye zvimwe zvinodhaka ndechekudzivirira tumor kudzokorora mushure mekupamhazve. Iyi kurapwa inokurudzirwazve mune zviitiko zvakadai sekuvapo kweakawanda anoputika tumor.kana kukurumidza kudzosera bundu mwedzi yakati wandei mushure mekuvhiyiwa. Mushonga uyu unopihwa kamwe chete pasvondo kweanenge mavhiki matanhatu, mukiriniki yekurapa, uchishandisa catheter yakaonda iyo inoiswa mubhedhuru. Mushure mekurapa mushonga, murwere anokumbirwa kuti arege kuyama kwemaawa maviri. Murwere anogona kusangana nekunzwa kupisa kana uchitsvaga uye kusanakidzwa kwekunzwa mudumbu rakadzika, zvisinei, vanokurumidza kupfuura.     Bundu rakapinda mukati merimwe musumbu, rakadzika mukati memadziro emabhonzo. Mune ino kesi, resection ye tumor kuburikidza ne urethra haina kukwana. Kazhinji, iwe unofanirwa kubvisa bhebhi rese pamberikuvhura dumbu. Chinangwa chekutanga bhebhi ndechokubvisa zvachose maseru emukenza kubva mumuviri kuti apore.     Mushure mekupamhidzwazve kwebhedhi, kutsiva kunofanirwa kuumbwa kuti kumubvumidze kupuruzira. Pane zvisarudzo zvinoverengeka zvekutsiva izvi:    Urini inopinda yakananga muhombodo yakabatanidzwa kumadziro emudumbu.     Kugadzira imwe muhomwe yekurongedza muhari yemukati (inoda kuiswa kweye catheter kanoverengeka pazuva pazuva kuti uburitse muhomwe yewaini).     Imwe homwe yekurapa muhombodo yemuviri inobvumira yakajairwa yekubaya kuburikidza ne urethra.ZvimwePane kupora kwakazara here?Mhinduro yacho haina kujeka: ehe. Mazhinji maronda ebhedhi ingori bundu repamuromo. Kubviswa kwe bundu kuburikidza ne urethra (dzimwe nguva mubatanidzwa nekuiswa kweCBG mumabheji) kunotungamira mukutsakatika kwayo kwakakwana. Kazhinji, mushure menguva yakati, bundu rinodzokororazve, asi nekugara uchiongorora, unogona kuriona achiri mudanho uye nekubudirira kuriramba. Kuongororwa kwekiriniki kunosanganisira urinalysis, cystoscopy uye computer tomography ye urethra. Nguva yakawanda yafamba kubva pakurapwa kwekupedzisira, zvishoma pane zvaunofanira kuongororwa. Izvo zvakakosha kuti iweuke kuti kuputa kunowedzera njodzi yako.kudzokorora kwe bundu bundu; saka, kana iwe uchiputa, iwe unofanirwa kurega iyi yakaipa tsika.Tumors inopinda zvakadzika mumadziro emabhedhi inogonesa kupora zvizere nerubatsiro rwe resection. Muzviitiko zvakawanda, zvinokwanisika kugadzira imwe bladder iyo inobvumira yakajairwa kukurudzira kuburikidza ne urethra. Nekuda kweizvi, murwere haagone chete kupora zvakakwana, asi zvakare kudzokera kune zvakajairika kushanda izvo zvakajairika kwaari.Rega chikumbiro pane webhusaiti yedu uye nyanzvi dzedu dzichaonana newe uye dzichakubatsira kusarudza kiriniki yakanakira maererano nenyaya yako yemahara.

Kenza yeganda chirwere chakakomba chine huwandu hwevanhu vafa. Mushure mekuonekwa kweanoplasm, mhedzisiro inouraya inogona kuitika mushure memwedzi mishoma. Oncology inogona kuitika muma lobes echiropa kana bile ducts. Iyo bundu inoratidzirwa nekukurumidza kuwedzera uye kuumbwa kwemastastases, pamwe nekudzikira kwekumanikidzwa kurapwa. Munguva yekuongorora, nhanho yechirwere inosimbiswa. Kune mana akazara, kuiswa kunoenderana ne morphological maitiro, tumor nzvimbo uye huwandu hwekukuvara:Yekutanga (I). Bundu rinogona kunge rakakura zvakasiyana, asi riri mukati memuviri, hapana hutachiona mumidziyo, lymph node uyedzimwe nhengo. Kubata kunoitika zvizere. Panguva yepakutanga, zviratidzo zvekutanga zvechiropa chegomarara ndiko kupera simba, kushaya simba, kuderera kwekuita uye kusagadzikana kumusoro kwekurudyi kurudyi. Mushure memavhiki mashoma, pane kuwedzera kwechiropa muhukuru.Yechipiri (II). Kuumbwa kwacho kunowedzera kusvika pamasendimita mashanu, nepo kunzwa kwekushungurudzika uye kushungurudzika kana kurwadza kwemukati mudumbu kunowedzerwa kune zviripo zviratidzo. Pakutanga, kunzwa kunorwadza kunoratidzika sepisodically panguva yekunyanyisa kwomuviri, ipapo kunova kwakanyanya uye kunogara. Muchikamu chechipiri, pane zviratidzo zvekugaya-gumbuka, sekurasikirwa kwekuda kudya, kubata kumeso, kusvotwa,kurutsa, manyoka. Murwere anotanga kukurumidza kuderedza uremu.Yetatu (III). Kukura kwakashata kunokura, dzimwe tarisiro dzekugadziriswa kwema cell pathological anooneka. Kenza inowanzoonekwa pane ino nhanho nekuda kwekuti zviratidzo zviri kuramba zvichitaurwa.Pane matatu akatsiva chirwere:    IIIa. Bundu rinopararira pamwe chete nemakanda echiropa uye zvakanyanya kuwedzera muhukuru. Kumera kunoitika mumapfudzi akakura, asi hapana akapararira kumitezo iri kure uye ma lymph node.    IIIb. Iko kusanganiswa kwemasero ane hutsinye ane nhengo dzakadzipamimba dzakasungwa uye membrane yekunze kwechiropa inoonekwa. Mukuita kwetebhedhi inosanganisirwa.    IIIc. Iyo chiropa inokanganiswa zvakanyanya, ichipararira kune lymph node. Basa reiyo nhengo rinokanganisa, rinobata mamiriro emuviri. Murwere anokura edema, icteric ganda toni, spider veins, ascites, uye kunzwa kwekuzara mudumbu. Basa re endocrine glands rinokanganiswa uye tembiricha yemuviri inokwira. Kurera huremu hunosanganisira kupinza kweziso uye kuderera kwekusimba kweganda. Marwadzo anova akasimba uye anogara achiitika. Panguva ino, panowanzo kuve nemhino uye yemukati-mudumbu kubuda ropa.    Chechina (IV). Stage 4 chirwere chechiropa chinofungidzirwamaitiro asingadzoreke. Metastases ane lymph uye kuyerera kweropa kwakapararira mumuviri wese, zvichikanganisa kukanganisa kwemabasa emitezo uye masisitimu. Kune maviri matanho echiropa chekenza 4 degrees:    IVA. Kukuvadza kune iyo nhengo yese kunoonekwa, bundu rinokura kuva nhengo dzakatenderedza uye midziyo. Mumitezo iri kure, metastases haina kuonwa.     IVB. Nhengo dzese uye masisitimu anokanganiswa nemaseru anorwara. Kune akawanda neoplasms ehukuru hwakasiyana. Giredhi 4 gomarara rechiropa nemastastases rinoperekedzwa nekuwedzera kwemapundu mumuti, kupukunyuka, kurwadziwa kwakanyanya, kusagadzikana kwepfungwa nepfungwa, kushomeka kwekukurumidza, kurasikirwa kukurukurema, kuwedzera mudumbu muhukuru. Kana iwe uchitarisa pamapikicha evarwere vane giredhi rechina chirwere chechiropa, unogona kuona kutaridzika kweganda, kusaonda kusapora nemafupa anobuda uye kuzvimba kwakanyanya kwemuviri.Oncology inokweretesa pachayo kurapwa mumatanho maviri ekutanga, saka haichakwanisi kupora. Oncologists anogona chete kunyatsoratidza chiratidzo kurapwa kuderedza mamiriro uye kudzoreredza kurwadziwa kwakanyanya.Paakabvunzwa kuti vanogara kwenguva yakareba sei neprote 4 chirwere chechiropa, hapana mhinduro imwechete. Zvese zvinhu zvinoenderana nehuremu hwekukuvara uye maitiro emurwere pakurapwa.KurapaMurwere uye nharaunda dzaanogara vanogaraunonetsekana kana chirwere chechiropa chiri kurapwa kana kuti kwete? Mubvunzo uyu unogona kupindurwa chete nachiremba aripo, iye ane ruzivo nezve mhedzisiro yebvunzo uye yekuongorora. Kana uchisarudza nzira yekurapa yegomarara rechiropa, zvine basa:   - kukura tumor;    - Localization yedzidzo;    - degree rekukuvara;    - tumor inoshanda;    - kuvapo kwemastastases;    - mamiriro akajairwa nemurwere.Iyi inotevera nzira dzekurapa dzinoshandiswa kuderedza kukura kwe tumor, kutenderera kwayo uye kuwedzera hupenyu hwehupenyu muchiropa oncology:    Mushonga wekurapa.KumurwereNexavar neSorafenib zvakatemwa, izvo zvinhu zvinoshanda izvo zvine chepfu pamasero akanganisa. Nekuda kweiyo yakanangidzirwa pamhedzisiro yedzidzo, hutano husina hutano hahunokuvadzwa. Chemotherapy yechinyakare inenge isingabatsire nekenza yeganda.Radiation kurapwa.Iko kushandiswa kweiyo yakatarisana ne-x-ray mumadhidhi makuru inobatsira kusimbisa bundu, kuderedza marwadzo uye kutamisa chirwere ichi kukanganwirwa. Inokodzera kurapwa kwe oncology chero nguva.    KubvisaIyi nzira kuparadzwa kweanoplasm nekuunza ethanol muchizvaro, pamwe nekushandiswa kwemagineti radiation, ane simba radio radio, uye cryodestruction. Kurapa pasina kuvhiyiwapane chiropa ne oncology inopa mhedzisiro yakanaka kana bundu racho riine dhayamita isingasviki 3 cm.    Vascular embolization.Nekuda kwekuiswa kwemishonga yakakosha mumidziyo yechiropa, kuwanikwa kweropa kune neoplasm yakavharwa, nekudaro ichikonzera kuderera kwehukuru hwayo. Nzira yacho ine zvadzinoita pamhuno ine diameter inosvika kusvika ku5 cm .. Inonyanya kushandiswa pakubatanidzwa neablation, chemotherapy uye radiation therapy.Kenza yechiropa ingarapwa nekuvhiyiwa here? Muzhinji, kurapwa kwekuvhiya kunokubvumira kuti utarise kune ramangwana uine chivimbo. Kubvisa kweTumor kana kuwedzera chiropa kunowedzera zvakanyanya mikana yemurwere wekuregererwa kwenguva refu. Mamiriro ekuvhiya kupindira ndeye tumor inoshanda, imwechete yakagadzirirwa metastases uye kusavapo kweancological maronda kunze kwechiropa. Nzira yekurapa chirwere chechiropa kana bundu risingabvumike? Muchiitiko ichi, kuiswa kwe cytostatics zvakananga mumidziyo mikuru yechiropa uye kushandiswa kwenzira dzinopesana zvishoma dzinoratidzwa.Izvo zvinofanirwa kuyeukwa kuti hapana chishamiso chekuporesa cancer, asi unofanirwa kugara uchitenda kupora. Paunobvunzwa kana chirwere chechiropa chiri kurapwa, kazhinji, oncologists vanopindura zvakanaka. Mu kiriniki yedu, timu ine hushamwari yevanachiremba vane zvikamu zvepamusoro zvekurapa nemazita ezvesayenzi anobatsira kuwana hutano.

nullmushonga uye neradiation kurapwa yakabatana kune kuvhiya. Kusarudzwa kwenzira inotungamira yekurapa inotsanangurwa nehukuru uye nenzvimbo yeiyo tumor, mamiriro emurwere uye zvirwere zvinosangana.Iine bundu diki kwazvo risingamere mucosa, mucosa chete ine pasi inouyaniswazve ne gastroscope, uye mhedzisiro yekurapa yakanaka kwazvo.Padanho I - II yekenza, chikamu cheesophagus chakabviswa, hurema hwakazadzwa nechikamu chedumbu kana kutihubhu hwakaumbwa kubva mudumbu. Nhasi zvinokwanisika kushandisa endoscopic zvishandiso pane izvi mashandiro.Nekupararira kwe bundu mukati memukati mesumbu uye zvakare, kuvhiya kunoitwa, asi izvinullDzimwe nguva chemoradiotherapy inoitwa nekusakwanira kuvhiyiwa kwakanyanya. Chemotherapy inogona kuitwa kana kuvhiyiwa kusingaite, kana bundu racho rakanyanya, kana aine bundu diki, asi paine general contraindication yekuvhiya. Mune iyi sarudzo yekuchengetedza, kupona kunofanana nekurapa kwekuvhiya. Mukuvapo kwe fistulas, chemoradiotherapy haigoneke. Chemotherapy inogona kuve yakaomeswa neye acute kuzvimba kwe mucous membrane yesophagus, iyo inoda chikafu kuburikidza ne anodonhedza.Rega chikumbiro pane webhusaiti yedu uye nyanzvi dzedu dzichaonana newe uye dzichakubatsira kusarudza kiriniki yakanakira maererano nenyaya yako yemahara.

nullmamota ese eitsvo anoonekwa pasina nguva, aine yakarongeka ultrasound nekushayikwa kwakakwana kwezviratidzo.Zviratidzo zvechirwere zvino zvave kushomeka.    1. Ropa mune urini (hematuria). Kutaridzika kwake kunogona kungoerekana kwaitika uye ndokufungidzira.     2. Kurwadziwa mumashure uye kuderera kumashure: izvi zvichemo zvinosanganiswa nekutumbuka kwe bundu mumidziyo yepedyo kana kuvharika kwe ureter.     3. Kuisa chisimbiso mudumbu (palpation palpates bundu).     4. Kuwedzera kwekushisa uye kudzvinyirira kweropa (iyo yekupedzisira inogona kukonzerwa nekumanikidza kwemitsipa kana kugadzirwa kwe renin tumor).5. Varicocele.     6. Kupererwa nehuremu, kushaya simba kwakawanda, kushomoka kwemhepo, sweats husiku, uye kuneta zvakanyanya.Nehurombo, kazhinji zviratidzo zvegomarara re itsvo hazviwoneki pakarepo, chirwere chinobuda muchimiro cheasymptomatic kwenguva yakareba. Ndokusaka zvichikosha kuti uongororwe kudzivirira nguva dzose, ita bvunzo dzehutachiona uye utore ropa uye urini kuongororwa.Kuongororwa kwegomarara re itsvoKuongororwa chirwere chegomarara re itsvo kunosanganisira huwandu hwese hwakasiyana hwezvinyoro, izvo zvinokutendera kuti utange kuongororwa kwakanyatsorongeka.   1. Inonyanya kubhadhara nzira yekuziva nzira ndeye ultrasound.    2. Iyo yegoridhe chiyero chekuongororwa kweanowanikwa tumors itsvo komputatomography nemusiyano. Yakatungamirwa tomography inopa mufananidzo wakakwana wechinzvimbo che tumor, kukura kwayo, nhanho yekiriniki uye kukura kwe tumorume mumitezo yepedyo.   3. A urinalysis inoratidza kuvapo kwekusachena kweropa mumhino.   4. Kuongororwa ropa kunokubvumidza kuti uone zvisina kujeka zviratidzo zvechirwere: anemia, yakakwirira manhamba ealkaline phosphatase, urea muropa, nezvimwewo.   5. MRI yekuongororwa kwematumbu eitsvo anoshandiswa kushoma kazhinji kupfuura CT, chiratidzo chikuru chekuita MRI kukanganisa kuita CT.   6. A biopsy yemapundu etsvo inoitirwa kusimbisa chirwere ichi.uye kusarudza imwezve nzira yekurapa. Nehurombo, mune dzimwe nguva, biopsy yehosha yeitsvo haisi-inopinda, nekuda kweichi, chidzidzo ichi chaitwa zvino kashoma.  7. Kuti uone metastases mumapapu nemapfupa ematehwe, chest x-ray uye osteoscintigraphy anoshandiswa.  8. Renal angiography - kuongororwa kweX-ray kune mumiririri akasiyana.Zvichienderana nezviratidziro zvegomarara re itsvo, mamiriro emurwere uye nemhedzisiro yekuongororwa kwekutanga, chiremba anosarudza dzimwe nzira dzekuti aongorore chirwere chegomarara re itsvo kuti iite mufananidzo wakanyanya.Matanho ekenza yemenoKune mana matanho ekenza yemazino ane hunhu hwakasiyana siyananullkana bundu rinopararira kune renal vein / vena cava.     4. Itsvo kenza yemazamu grade 4. Bundu rinosuka muchetura weitsvo.Kurapa kenza yeitsvoKurapa kenza yeitsvo kunoenderana nenzira dzinoverengeka dzinogamuchirwa dzinoshandiswa mumwe nemumwe kana zvakazara. Chiremba arikupinda, zvichienderana nerudzi rwe bundu, nhanho yekiriniki yezera remurwere uye hutano hwakanaka, zvinopesana zviripo nezvimwe zvinhu, anogona kutendeukira kunzira dzakasiyana siyana dzokurapwa. Nzira inoshanda yekurapa chirwere chegomarara ndeyekuvhiya bundu. Radical nephrectomy ndiko kubviswa kwakakwana kweuyo akanganisa itsvo, kazhinji pamwe chete neyezvinotenderera perirenal tishu, lymph node, uye dzimwe nguvaadrenal gland. Kana ukuru hwe bundu risingapfuuri 7 cm, kusarudzika kwetsvo kunoitwa. Pamwe chete neyechinyakare nzira, umo kubviswa kwe itsvo kana rese rese kwaro kuitwa kuburikidza hombe incision, pane laparoscopic imwe. Muchiitiko ichi, bundu rinobviswa kana kuiswazve uchishandisa zviridzwa zvakaiswa mukati mehudumbu kuburikidza nepadiki (2 cm) nzira laparoscopic inosanganiswa neyekudzikira kwekumanikidza. Mukuwedzera, kugadzirisa kwevarwere kunokurumidza. Imwe nzira yekurapa kweanodzora itsvo ndeye cryoablation. Iko kukosha kwenzira ndeyokusunungura bundu nerubatsiro rweyakakosha kiropidhi yakaiswa mukati mebundu. Tumorkuiswa kune imwezve kufungisa uye thawing, iyo pakupedzisira inotungamira kurufu rwekenza maseru. Iyi nzira ndiyo inoshungurudza murwere uye inoratidzwa kana kuvhiyiwa kusingaite, tumor reitsvo mbiri uye bundu reitsvo imwechete. Kurapa kwezvinodhaka (chemotherapy, hormone therapy kana immunotherapy) inodomwa kana chirwere chechipfuva chechipfuo chaonekwa (nhanho 4), kana kuvhiyiwa hakugoneki.Dziviriro Chemukenza KenzaKuti udzivise kenza yemeno, zvakakosha kurega kuputa, kudzora uremu uye kudya zvine hutano (zvine predominance yemichero nemiriwo). Saka, mararamiro ane hutano ndiyo nzira huru yekudzivirira chirwere ichi.

Prostate cancer kenza yechitatu inonyanya kuzivikanwa pakati pevarume muRussia mushure megomarara remapapu uye cancer yemudumbu. Inowanikwa mune imwe yevarume gumi nemashanu vanopfuura makore makumi mana. Gore roga roga pasi rose, maronda anorwadza eprostate anowanikwa muvanhu vane mamirioni, uye anenge mumwe muzvitatu wavo anofa nekuda kweiyo pathology.Nei kenza yeprostate ichikura?Izvo zvinozivikanwa kuti izvi zvinosanganisirwa nekushandurwa kwehormonal kumashure, genetic predisposition, kushaya chikafu zvinovaka uye kukurudzira kwezvimwe zvinhu, iro basa rayo risati ranyatsosimbiswa. Kubva panguva yekutanga cancermasero isati yatanga kukura kwezviratidzo zvinotungamira murume kune kubvunzana nachiremba kazhinji zvinotora makore akati wandei. Neichi chikonzero, kazhinji murwere anoonekwa neanocologist aine asina hanya, yakawedzera tumor iyo yakaoma kuporesa. Pakazara, itsika kusiyanisa ina nhanho dzekenza yeprostate:Nhanho 1 inoratidzwa nehukuru hushoma hwe tumor, kusavapo kwekubatanidzwa kwe lymph node mune pathological process (masero ekenza anogona kusvika ipapo nekuyerera kwe lymph) uye kugara zvakanaka kwemurwere. Sezvo mutemo, panguva ino, kenza yeprostate inoonekwa nemukana - panguva yekurapwa kweimwe chirwere chegland. Hutano hwehupenyu hwomurwere hwanaka,nullnullkubatsirwa kwemaitiro akapfava ekurapa ayo anowedzera hupenyu nekurerutsa kutambudzika kwemurwere, kunyangwe izvo zvisiri kuzobatsira kukunda cancer.Prostate Kenza KurapaMaitiro ekurapa kenza yeprostate achaenda kwete chete pachikamu chechirwere. Rudzi rwe tumor rwakakosha - rwunotemerwa ne biopsy, kutora masampula emapundu akati wandei ndokuawongorora pasi pehomwe. Dzimwe mhando dzekenza - semuenzaniso polymorphic cell carcinoma ye prostate gland - inokonzeresa kukurumidza kukurumidza kukura, kukura kwevamwe kunopindirwa nemahormone. Anologist aripo oncologist anofunga zvese izvi mamiriro, pamwe nemaonero emurwere iye pachake, asati atorachisarudzo pane zvekurapa maitiro.Basa rakakosha rinoitwa nehunyanzvi hwekushandisa mukiriniki. Haisi chakavanzika kuti tekinoroji dzanhasi nemishonga zvinongowanikwa munzvimbo dzekenza yemumba kana vari padanho rekushandisa. Uye nzira dzechinyakare dzakadai sekubviswa kweshangu yeprostate dzinogona kusiyana zvakanyanya, izvo zvinokanganisa kwete chete kubudirira kwekurapwa, asiwo hupenyu hwomurwere.Kuvhiya kurapaIyo Prostate gland inhengo yakakosha, asi murume wechikuru anokwanisa kurarama pasina iyo. Naizvozvo, kana kenza yacho isina kupararira kune nhengo dzepedyo uye nhengo, uye mamiriro emurwere anotenderaoparesheni, oncologist inokurudzira radical prostatectomy kumurume - kubviswa kweprostate. Mune matanho ekutanga echirwere, nzira iyi inokuitisa kuti upore zvakakwana munguva pfupi (kugara muchipatara kunotora anenge mazuva manomwe).Zvichakadaro, zvakakosha kuyeuka kuti tiri kutaura pamusoro pekukanganisa kwakanyanya nemuviri, izvo zvinosanganiswa nenjodzi kuhupenyu, uye zvakare zvinotungamira kumimwe mhedzisiro isina kunaka. Nekudaro, varwere vanowanzoona matambudziko nekuromba kwemwedzi yakawanda mushure mekuvhiyiwa, vanopfuura hafu yevarume vanogunun'una nekutsakatika kweerection.Chinhu chakapfava chekurapa kurapwa kwekenza yeprostate ndiko kweparoscopic kuvhiya, mukatiIyo prostate inobviswa kuburikidza neyemukati midiki - angori mamirimita mashoma akareba. Nekudaro, njodzi yekunetseka kwepashure inoderedzwa, uye maitiro pachawo anoshivirirwa nemurwere zviri nyore.CryosurgeryImwe nzira yekuvhiyiwa kwechinyakare inogona kuva yeprostate tumor cryosurgery. Iyi nzira inoshanda mumatanho ekutanga echirwere, apo kenza haisati yapfuura nhengo. Munguva yekushandura, tsono dzakakosha dzinoiswa mukati meProstate kuburikidza nemurwere, mukati mayo inonamigon kana nitrogen inopinda. Kupisa kwakaderera kunoparadza tishu dzemukati, uye chiremba, achishandisa ultrasound, anodzora kuti mhedzisiro yacho haikuvadze nhengo dzinovakidzana. Nekuda kweizvozvo, ironhaufanire kubviswa (nyangwe mabasa ayo achikanganisika). Mumakore achangopfuura, cryosurgery yakawedzera kupihwa kurapwa kukuru kwegomarara reprostate, iro rinokodzera varwere veese mazera.RadiosurgeryImwe yenzvimbo dzepamberi pakurapwa dzinogona kuita kenza yeprostate. Izvo zvinosanganisira kushandiswa kweCyber-Knife system. Iyo nzira ndeye pamusoro pemhedzisiro yeganda rakatarisana neredhiyo pane tumor, inotungamira mukuparadzwa kwayo kwenzvimbo ichichengetedza kutendeka kwematehwe ari padyo. Mukana wakakosha weiyi nzira ndeyekusarwadziwa kwayo zvachose uye kusiri kukuvara: pakarepo mushure mehurongwa, murwere anogona kubva muchipatara.RadiotherapyKana bundu racho riine hutsinye kana kuti rakura kunze kweprostate,uye zvakare mune zviitiko apo murwere asina kusimba pakuvhiya, iyo radiation yekurapa zvishandiso inogona kuve imwe nzira yekukanganisa. Chekutanga pane zvese, ma-X-rays anouraya anokamura masero - uye maseru emukenza anowanzo kukura nekusagadziriswa. Nekudaro, panguva dzechirongwa che radiotherapy, bundu rinoderera, uye mitezo yakakanganiswa nemaseru inorasika "inoshambidzwa".Radiation kurapwa inorayirwa senzira yekurapa zvakasiyana, uye sechiwedzera pakuvhiya: kana kana mushure mekupindira. Tinogona kutaura nezve ese ekunze radiotherapy (kana murwere akarara pasi pe emitter) uye yemukati radiation kurapwa, riinhimawadhi redhiyo anokosha anounzwa mumuviri wemurwere.Kunze radiation kurapwa kunewo yayo mhando. Oncologists vanotsvaga kuderedza zvakakanganisika mhedzisiro ye radiation pane masisitimu emuviri, saka vanoedza kutungamira beam rekuwonekwa kune radior kune bundu zvakanyanya sezvinobvira. Ivo vanobatsirwa nemaitiro senge 3D chakavanzika radiation therapy, modured intensity radiation therapy (IMRT), stereotoxic radiation therapy (SBRT), uye proton radiation therapy. Imwe neimwe yenzira idzi ine zvakanakira uye zvisina kunaka. Radiotherapy inowanzo kutungamira mukusagadzikana kwekukanganisa urination uye erectile dysfunction.Yemukati radiation kurapwa (brachytherapy) zvakanyanya kuwedzera mhedzisiro ye radiation nekudzorachinhambwe kubva kunowanikwa maseru ekenza. Iyo radioactive granules inoshandiswa muitiro iine radioactive iodine, palladium uye mamwe makemikari anogona kukanganisa yakatenderedza tishu kwenguva yakareba. Zvichienderana nenzira, aya magirazi anogona kuve mumuviri kwemwedzi yakawanda (inopfuurira brachytherapy) kana chete panguva dzekurapwa (zvenguva pfupi brachytherapy).ChemotherapyChemotherapy inoshandiswa, sekutonga, mumamiriro ezvinhu kana cancer ichinge yazara mumuviri wese, saka unofanirwa kubata nechirwere pasi rese. Zvinodhaka zvinoshandiswa kurapa tummentate prostate tumors zvakatemwa mumakosi, zvichitevera mhedzisiro yekurapa nekuvandudza kwemhedzisiro.Chemotherapeutic vamiririri vane maitiro akaipa kwete chete pane kenza, asiwo kune hutano matishu. Naizvozvo, varwere vari kurapwa zvakadaro vanowanzove vaine hutachiona hwekugaya, kushaya simba, kurasikirwa nevhudzi uye chirwere chinotapukira.Kurapa hutachionaMhando iyi yekurapa inoitirwa kurisimudzira kusasimba kwemurwere. Cancer masero ari kunze kwemuviri wedu, asi nekuda kwehunyanzvi hunoshanda mashandiro, ivo vanokwanisa kunzvenga mhinduro yekudzivirira.Kugadzirira kurapa kwekudzivirira kunoitwa mumwe nemumwe - murabhoritari, maseru eropa emurwere "anodzidziswa" kuziva bundu, mozotanga mushonga unopinda mumuviri. Zvine kusuwa, oncologists haasati akwanisa kuwana yakakwirirakushanda kweiyi nzira, nekudaro, kazhinji kazhinji kuno shandiswa seyokubatsira, uyezve mumatanho ekupedzisira echirwere.Hormone kurapwa kweprostate kenzaSezvo kukura kwe tumor kunowanzokonzerwa nekuita kwehomoni dzechirume dzechirume, mumatanho epamberi pekenza yeprostate, vanachiremba vanogona kunyora mishonga inovhara synthesis yezvinhu izvi. Kazhinji isu tiri kutaura pamusoro pehupenyu hwese hutongi hwemishonga yemishonga. Kurapa kwakadaro kunoreva kurasirwa kwachiremba: kuita zvepabonde kunoora kunopesana nekwaakabva. Mukubatana nedzimwe nzira - semuenzaniso, radiotherapy - kutora mahormoni kunogona kutungamira kuchirwere chakakwana kune varwere vari contraindicated mune yakanyanya prostatectomy. Panguva imwe chetekurapwa kudzorerwa kunochinjika - mushure mekubviswa kwezvinodhaka.Idzi nzira dzekurapa dzekenza yeprostate dzakasiyana, uye gore rega rega pane ruzivo nezvenzira nyowani dzinoshanda. Mune mamwe mazwi, pane angangoita asina tariro kana mushonga usina simba rekubatsira murwere. Izvo zvakakosha kuti uwane chiremba anosarudza nzira inoshanda yekurapa. Usaore mwoyo - kukunda kwegomarara kuri zvakanyanya kwauri.Rega chikumbiro pane webhusaiti yedu uye nyanzvi dzedu dzichaonana newe uye dzichakubatsira kusarudza kiriniki yakanakira maererano nenyaya yako yemahara.

Nzira dzakasiyana-siyana dzinoshandiswa kurapa cancer ye rectum kana diki dumbu, inozivikanwawo senge colorectal cancer, zvinoenderana nenzvimbo yegomarara uye nhanho yechirwere. Kenza inoitika kana muromo unowoneka wemaseru uchicherechedzwa, izvo zvinoita kuti maseru atange kupatsanuka uye kupararira nekukurumidza, panzvimbo yekufa nekugadzira nzvimbo yemasero matsva.Chemotherapy, kana systemicapy, inoitwa kwemwedzi yakati wandei. Mamwe makemikari anogona kuderedza kana kukanganisa kukanganisa kwemasero ekenza. Nguva dzekutora chemotherapy (makosi),inotsiviwa nekumbomira kwevhiki dzinoverengeka kudzoresa muviri.Zvichienderana nekemotherapy, kurapwa kwakanangwa kunogona kuitwa, uko kunotendera mishonga kurwisa tumor maseru nenzira yakatarwa, zvobva zvaratidza kushomeka kwakashata mumuviri wemurwere.Radiotherapy inokutendera kuti uparadze cancer maseru uchishandisa dosed uye yakatariswa radiation kudzidza.Iyo kuronga uye nguva yekurapa inoenderana nehuwandu hwekuvandudzwa kwekenza uye hutano hwakajairika hwemurwere.Yakakurudzirwa    Colon kenza     Colorectal cancer     Colorectal cancer

Paavhareji, shanduko kubva ku precancer kuva kenza inorwara inotora kubva pamakore maviri kusvika gumi nemashanu. Iyo inotevera inoshanduka kubva pachikamu chekutanga chegomarara kune yekupedzisira inotora makore 1-2.Cervical cancer idumbu rinokuvadza, iro maererano nehuwandu hwekurapa pakati pezvirwere zvecancer zvinowanikwa muhupombwe, zvinotora nzvimbo yechina (mushure megomarara remudumbu, ganda uye mammary gland).Kunobva kenza yemuchibereko maseru akajairika anovharira cervix. Anodarika zviuru mazana matanhatu ezviuru izvi zvinoonekwa gore rimwe nerimwe.varwere. Kunyangwe chirwere checancer checervical chinowanzoitika pakati pemakore makumi mana-60, asi, zvinosuruvarisa, nguva pfupi yadarika kuva idiki kwazvo.Kurapa kwegomarara remuromo wechibereko kunosanganisirwa uye kunosanganisira kuvhiya, chemotherapy neradiation radiation. Panguva imwe neimwe, kurapwa kunorongwa mumwe nemumwe, zvinoenderana nedanho rechirwere, chirwere chinowoneka, mamiriro emuromo wechibereko, uye kuvapo kwezvirwere zvinozvimba panguva ino.Panguva yekuvhiya, bundu rinogona kubviswa nechikamu checervix, kubvisa bundu pamwecervix, uye dzimwe nguva nechizvaro pachayo. Kazhinji, kuvhiyiwa kunoitwa pamwe nekubviswa kwe lymph node ye pelvis (kana masero ekenza akagona kuzvijaira). Iyo nyaya yekubviswa kwe ovarian kazhinji inogadziriswa zvakasiyana (mumatanho ekutanga ekenza muvakadzi vadiki, ovary inogona kuchengetedzwa).Mushure mekuvhiyiwa, kana zvichidikanwa, varwere vanopihwa radiation therapy. Kurapa ne ionizing radiation kunogona kuwedzeredza kurapwa kwekurapa, uye kunogona kuiswa zvakasiyana. Mukurapa kwegomarara remuromo wechibereko, chemotherapy, mishonga inokosha inomisa kukura inogona kushandiswa.uye kenza cell kupatsanurana. Nehurombo, mukana wekuti chemotherapy chirwere ichi ishoma.Kubudirira kwechirwere chegomarara remuchibereko kunoenderana nezera remurwere, chokwadi chekusarudzwa kwekurapa, uye, zvinonyanya kukosha, pakurasika kwechirwere. Kana chirwere chegomarara remuchibereko chaonekwa mudanho repamberi, chirwere chechipfuva chakanakisa uye chirwere chinogona kurapwa nemaitiro ekuvhiya chete.Rega chikumbiro pane webhusaiti yedu uye nyanzvi dzedu dzichaonana newe uye dzichakubatsira kusarudza kiriniki yakanakira maererano nenyaya yako yemahara.

nullvazviratidze mumatanho ekutanga echirwere (kunze kwekutenderera).Zvinhu zvakakosha panjodzi zvinosanganisira:     zera repamberi - sekutonga, chirwere chinokura muvakadzi mushure mekuenda kumwedzi, vane makore makumi mashanu kusvika makumi matanhatu (makumi masere pamatanho gumi);      vakadzi vane kutanga kwekuenda kumwedzi (kusvika pamakore gumi nemaviri) uye kunonoka kuenda kumwedzi (mushure memakore makumi mashanu nemashanu);      kuputa      kufutisa      kutora zvinodhaka zvekusabereka uye hormone kutsiva kurapa;      polycystic;      endometriosis (kusapindirana kwakawedzera kwechikonzero chomukati chechibereko);herederal factor (genetic predisposition) - kuvapo kwehama dzepedyo dze ovarian, zamu, kana colorectal cancer.Vakadzi vasina vana uye vasina kumboyamwisa vane njodzi zvakare.Matanga uye mhando dzekenza yemazayaKune mana matanho:    Padanho 1, lesion inowanikwa mune imwe kana ese mairi mazai. Iyo inopfuurira ndeyechokwadi, kurapa kwakanaka, varwere vazhinji vanoenda mukuregererwa kwakasimba vasingadzose chirwere.    Panhanho yechipiri, iyo neoplasm inopararira kune dzimwe nzvimbo dze pelvic cavity. Kazhinji, uye panguva ino, fungidziro iyi yakanaka, zvichienderana nehuwandu mumakore mashanu ezerenullzvinoenderana nehukuru hwehosha:    kirasi A (kuderera kwakashata) - bundu rinokura zvishoma, maseru ane madiki anomalies (akasarudzika kwazvo);     kirasi B (zvine mwero malignancy) - inonyanya kutaurwa morphological shanduko mumatumbu masero zvichienzaniswa zvikuru yakasiyaniswa;     kirasi C (yakanyanya kudzvinyirira) - bundu rinokurumidza kukura, mashure-egiredhi maseru.Ovarian Kenza KurapaMusanganiswa kurapa unowanzobatanidza kusangana kweiyo nzira yekuvhiya (kuvhiya) uye chemotherapy.KuvhiyaSemutemo, panguva yekuvhiyiwa kweganda remuvhiya, nhengo dzese mbiri dzakabatanidzwa, iyo fallopian machubhu uye chiberekero, lymph node dziri pedyo uye mitezo yeadipose tishu mumudumbu mucity inobviswa,kune iyo kenza yakapararira.Kana mukadzi mudiki achigona kuona chirwere pakutanga, (panhanho 1), mune dzimwe nguva kupindira kwekuvhiya kunoitwa nekubvisa ovary ne fallopian tube kune rimwe divi. Mukuwedzera kune chokwadi chekuti chinzvimbo chekurapa pakurapa mune ichi chiitiko, izvi zvinokutendera kuti uchengete tariro yemimba.Kuti uderedze kushungurudzika uye mikana yekunetseka, pamwe nezvinangwa zvekurongedza, kuvhiyiwa kwegomarara remazamu kunogona kuitwa uchishandisa iyo Robot da Vinci yakangwara robhoti system.ChemotherapyChemotherapy yekenza yecancer inowanzotemwa mushure mekuvhiyiwa sechikamu chekurapa kwakaomarara. Zvinodhaka zvinowanzotumirwakupinda mutsinga kana zvakananga mudumbu, inosanganisirwa nzira idzi dzinoshandiswawo.Mumatanho anotevera, chemotherapy inogona kusarudzwa senzira huru yekurapa.Radiation kurapwaMune zviitiko zvisingawanzoitika (nekurwadziwa kwakanyanya, kubuda ropa kubva pachibundu), radiation yekunze yekurapa kana brachytherapy (yekumonana neradiation) inosanganisirwa mune yekurapa regimen yekenza yemazamu.Kupora mushure mekurapwaNenzira yakajairika yekudzoreredza, kupora zvakakwana mushure mekurapa kenza ye ovari mune vakadzi kunotora kusvika kumavhiki matanhatu. Kana chiberekera chakabviswa, mukati memavhiki matatu - mashanu zvakakodzera kuti ubve pabonde. Mune zvimwe zviitiko, chiremba wako anogona kukupa mahormone uye vitamini D.

Chemotherapy kurapwa kwakachengetedzwa kwegomarara nemishonga yemakemikari. Chemotherapy inogona kuve chimwe chezvinhu zvinosanganisa kurapa uye inogona kusangana neradiation kurapwa kana kuvhiyiwa kubvisa bundu. Chinangwa che chemotherapy chingangove kuparadza kwakazara kwechirwere chegomarara uye nekudzikira kwekukura uye kubereka kwemasero ane cancer. Kuderedza kukura uye kubereka kwemaseru kunotungamira mukudzikira kwehukuru hwebundu uye nekuvandudzwa muhupenyu hwevarwere uye, mune dzimwe nguva, kunowedzera mikana yekubudirira kwakakwana kubvisa bundu.Yakakurudzirwa    Kurapa kenza     Kenza Hupenyu