Sankara

Sankara
Description (en)
Iri	disease of cellular proliferation (en) , neoplasm (en) , tumor (en) ; cuta
Specialty (en)	oncology
Sanadi	Dalilan Ciwon Daji; abubuwan dake haifar da ciwon daji
Effect (en)	Zafin Kansa
Age of onset (en)	any age (en)
Suna saboda	crab (en) da Crustacea (en)
Medical treatment (en)
Magani	Prednisolone, dexamethasone (en) , cholecalciferol (en) , prednisone (en) , methylprednisolone (en) , alpha-linolenic acid (en) da antineoplastic (en)
Identifier (en)
ICD-10-CM	C80 da C80.1
ICD-9-CM	199
ICD-10	C00-C97
ICD-O:	8000/3
DiseasesDB	28843
MedlinePlus	001289
eMedicine	001289
Disease Ontology ID	DOID:162

Ciwon Daji rukuni ne na cututtuka da ke tattare da hadakar kwayoyin halitta (cell) mara kyau, tare da yuwuwar mamayewa ko yaduwa zuwa wasu sassan jiki.^[1]^[2] Wadannan sun bambanta da ciwace-ciwacen daji, wanda ba su yaduwa.^[2] Alamun cutar ya hada da dungulewa, zub da jini mara kyau, tari mai tsawo, rama da canji a cikin motsin hanji.^[3] Duk da yake wadannan cuwuka suna iya nuna akamun ciwon daji, suna iya wani cutan na daban.^[3] Akwai sama da nau'ikan ciwukan daji guda 100 da ke shafar mutane.^[2]

Shan taba shine Kuma sanadin kusan kashi 22% na mace-mace ta hanyar cutar daji.^[4] Sauran kashi 10% kuma yana faruwa ne saboda kiba, rashin cin abinci mai kyau, rashin motsa jiki ko yawan shan barasa.^[1]^[5]^[6] Sauran abubuwan sun hada da wasu cututtuka, da fallasa hasken ionizing, da gurbataccen muhalli.^[7] A cikin kasashe masu tasowa, kashi 15 cikin 100 na cututtukan daji na faruwa ne saboda cututtuka irin su Helicobacter pylori, Hepatitis B, Hepatitis C, Human papillomavirus infection, Epstein-Barr virus da Human immunodeficiency virus (HIV). Wadannan abubuwan suna aiki, akalla, ta hanyar canza kwayoyin halittar tantanin halitta. Yawanci, ana bukatar yawan canje-canjen kwayoyin halitta kafin ciwon daji ya taso. Kusan kashi 5-10% na cututtukan daji na faruwa ne saboda illar gado. Ana kuma iya gano cutar sankara ta wasu alamu da alamomi ko gwaje-gwajen tantancewa. Sa'an nan yawanci ana cigaba da bincike ta hanyar hoton asibiti kuma ana tabbatar da shi ta hanyar biopsy.^[8]

Ana iya rage hadarin habakar wasu cututtukan daji ta hanyar rashin shan taba, kiyaye lafiyar kiba, iyakance yawan shan barasa, yawan cin kayan lambu, 'ya'yan itatuwa, da cin sitaci,^[9]^[10] da dukan hatsi, rigakafi da wasu cututtuka masu yaduwa, iyakance cin nama da aka sarrafa da jan name, da iyakance yawan shiga hasken rana kai tsaye.^[11]^[12] Gano cutar da wuri ta hanyar dubawa yana da amfani ga ciwon daji na mahaifa da na launi.^[13] Akwai sabani dangane da muhammancin gwajin cutar sankarar nono.^[14] Yawancin lokaci ana bi da kansa tare da wasu hadewar maganin radiation, tiyata, chemotherapy da maganin da aka yi niyya . Radadi da kulawa da alamu sune muhimmin sashi na kulawa. Kulawa da jin dadi yana da mahimmanci musamman ga mutanen da ke fama da cigaba. Damar tsira ya dogara da nau'in ciwon daji da girman cutar a farkon jiyya. A cikin yara 'yan kasa da shekaru 15 a lokacin ganewar asali, adadin rayuwa na shekaru biyar a cikin duniya da suka cigaba yana kan matsakaicin 80%. Ga ciwon daji a Amurka, matsakaicin adadin rayuwa na shekaru biyar shine 66%.

A cikin 2015, kusan mutane miliyan 90.5 sun kamu da cutar kansa. Ya zuwa 2019, kusan sabbin maganganu miliyan 18 na faruwa a shekara. A kowace shekara, ta yi sanadiyar mutuwar mutane miliyan 8.8 (15.7% na mace-mace ). Mafi yawan nau'in ciwon daji a cikin maza sune ciwon huhu, ciwon prostate, ciwon daji, da ciwon ciki . A cikin mata, nau'o'in da aka fi sani da shi sune ciwon nono, ciwon daji, ciwon huhu, da ciwon mahaifa. Idan ciwon daji na fata banda melanoma ya kasance cikin sabbin cututtukan daji kowace shekara, zai kai kusan kashi 40% na lokuta. A cikin yara, cutar sankarar bargo ta lymphoblastic da kuma ciwace-ciwacen kwakwalwa sun fi yawa, sai dai a Afirka, inda lymphoma ba Hodgkin ke faruwa sau da yawa. A cikin 2012, kimanin yara 165,000 'yan kasa da shekaru 15 sun kamu da ciwon daji. Haarin cutar kansa yana ƙaruwa sosai da shekaru, kuma yawancin cututtukan daji suna faruwa a cikin ƙasashe masu tasowa. Yawan kudi yana karuwa yayin da mutane da yawa ke rayuwa har zuwa tsufa kuma yayin da canje-canjen salon rayuwa ke faruwa a cikin kasashe masu tasowa. A kudi halin kaka na ciwon daji aka kiyasta a 1,16 tiriliyan USD a kowace shekara As of 2010^[update].^[15]

Video summary (script)

Asalin kalma da ma'anoni

Kalmar ta fito daga tsohuwar Girkanci καρκίνος, ma'ana kaguwa da ƙari . Likitocin Girka Hippocrates da Galen, da sauransu, sun lura da kamannin kaguwa da wasu ciwace-ciwacen daji masu kumbura. An gabatar da kalmar a Turanci a ma'anar likitancin zamani a kusa da 1600.

Ciwon daji ya kunshi babban iyali na cututtuka wadanda suka hada da hadakar kwayar sel mara kyau tare da yuwuwar mamayewa ko yaduwa zuwa wasu sassan jiki. Suna samar da wani yanki na neoplasms . Neoplasm ko kari wani rukuni ne na kwayoyin sel wadanda suka sami girma mara tsari kuma galibi za su samar da taro ko dunkule, amma ana iya rarraba su a fili.

Duk kwayoyin kari suna nuna alamomi shida na ciwon daji . Ana buƙatar waɗannan halaye don samar da kwayar cuta mara kyau. Sun hada da:

Girman tantanin halitta da rarrabuwa ba su da sigina masu dacewa
Cigaba da girma da rarrabuwa har ma da aka ba da sigina sabani
Gujewa shirin mutuwar kwayar halitta
Mara iyaka na sassan sel
Haɓaka ginin magudanar jini
Mamaye nama da samuwar metastases

Cigaba daga sel na yau da kullun zuwa sel waɗanda zasu iya samar da adadin da za'a iya ganowa zuwa kansa kai tsaye ya ƙunshi matakai da yawa da aka sani da cigaba mara kyau.

Alamomi da alamomi

Lokacin da ciwon daji ya fara, ba ya haifar da alamun. Alamomi da alamomi suna bayyana yayin da taro ke girma ko ciwon ciki . Sakamakon binciken ya dogara da nau'in ciwon daji da wurin da yake ciki. 'Yan alamun suna da takamaiman . Yawancin lokuta suna faruwa a cikin mutane wadanda ke da wasu yanayi. Ciwon daji na iya zama da wahala a gano shi kuma ana iya daukarsa a matsayin " babban mai koyi ." ^[16]

Mutane na iya zama cikin damuwa ko damuwa bayan an gano cutar. Hadarin kashe kansa a cikin mutanen da ke da ciwon daji ya kusan ninki biyu.

Alamomin gida

Alamomin gida na iya faruwa saboda yawan kwayar cuta ko gyambonta. Alal misali, sakamako mai yawa daga ciwon huhu na huhu zai iya toshe bronchus wanda ke haifar da tari ko ciwon huhu ; Ciwon daji na esophageal zai iya haifar da kunkuntar esophagus, yana sa ya zama mai wuya ko mai radadi don hadiye; kuma ciwon daji na launi na iya haifar da raguwa ko toshewa a cikin hanji, yana shafar dabi'un hanji. Talakawa a cikin kirjin ko kwaya na iya haifar da kullu mai gani. Ulceration na iya haifar da zubar jini wanda zai iya haifar da alamomi kamar tari na jini (ciwon daji), anemia ko zubar da jini na dubura (ciwon daji), jini a cikin fitsari (ciwon mafitsara), ko zubar da jini na al'ada (endometrial ko cervical cancer). Kodayake ciwo na gida yana iya faruwa a cikin ciwon daji mai ci gaba, kwayar farko ba ta da zafi. Wasu ciwon daji na iya haifar da tarin ruwa a cikin kirji ko ciki . ^[16]

Alamomin tsari

Alamun tsarin na iya faruwa saboda amsawar jiki ga ciwon daji. Wannan na iya hadawa da gajiya, asarar nauyi ba da gangan ba, ko canjin fata. Wasu cututtuka na iya haifar da tsarin kumburi na tsarin da ke haifar da asarar tsoka da rauni mai gudana, wanda aka sani da cachexia .

Wasu nau'in ciwon daji kamar cutar Hodgkin, cutar sankarar bargo da ciwon daji na hanta ko koda na iya haifar da zazzabi mai tsayi . ^[16]

Wasu bayyanar cututtuka na ciwon daji suna haifar da hormones ko wasu kwayoyin halitta da kwayar cuta ta haifar, wanda aka sani da paraneoplastic syndromes . Ciwon daji na paraneoplastic na yau da kullun sun haɗa da hypercalcemia wanda zai iya haifar da canjin yanayin tunani, makarkashiya da bushewa, ko hyponatremia wanda kuma zai iya haifar da canjin yanayin tunani, amai, ciwon kai ko faduwa.

Metastasis

Metastasis shine yaduwar cutar kansa zuwa wasu wurare a cikin jiki. Ciwace-ciwacen da aka tarwatsa ana kiran su da ciwace-ciwacen daji, yayin da na asali shi ake kira da ciwon farko. Kusan duk ciwon daji na iya metastasize. Mafi yawan mutuwar ciwon daji na faruwa ne saboda ciwon daji wanda ya daidaita.^[17]

Metastasis na kowa a karshen matakan ciwon daji kuma yana iya faruwa ta hanyar jini ko tsarin lymphatic ko duka biyu. Da hankula matakai a metastasis ne gida mamayewa, intravasation a cikin jini, ko Lymph, wurare dabam dabam a cikin jiki, extravasation cikin sabon nama, yaduwa da kuma angiogenesis . Daban-daban nau'ikan cututtukan daji suna yin kaura zuwa ga wasu gabobin, amma gabadaya wuraren da aka fi sani da metastases su ne huhu, hanta, kwakwalwa da kasusuwa .

Dalilai

Rabon mutuwar ciwon daji da aka danganta da taba a cikin 2016.^[18]

Babban labarin: Abubuwan da ke haifar da ciwon daji Hoton GHS Hazard don abubuwan cutar kansa Rabon mutuwar ciwon daji da aka danganta da taba a cikin 2016. Yawancin ciwon daji, wasu kashi 90-95% na lokuta, suna faruwa ne saboda sauye-sauyen kwayoyin halitta daga abubuwan muhalli da salon rayuwa. Ragowar kashi 5-10 cikin 100 na gado ne. Muhalli yana nufin duk wani abu da ba a gada ba, kamar salon rayuwa, tattalin arziki, da halaye ba kawai gurbatacce ba[38]. Abubuwan muhalli na gama gari waɗanda ke haifar da mutuwar kansa sun haɗa da shan taba (25-30%), abinci da kiba (30-35%), cututtuka (15-20%), radiation (duka ionizing da rashin ionizing, har zuwa 10%). , rashin motsa jiki, da gurbacewa.[3][39] Danniya na ilimin halin dan Adam baya bayyana a matsayin wani abu mai hadari ga farkon ciwon daji, ko da yake yana iya tsananta sakamako a cikin wadanda ke da ciwon daji. Ba a yiwuwa a gabadaya a tabbatar da abin da ya haifar da wani ciwon daji saboda dalilai daban-daban ba su da takamaiman alamun yatsa. Misali, idan mutumin da ke shan taba ya kamu da cutar kansar huhu, to mai yiwuwa ne ta hanyar amfani da taba, amma da yake kowa yana da dan karamin damar kamuwa da cutar kansar huhu sakamakon gurbataccen iska ko radiation, ciwon daji na iya tasowa saboda daya daga cikin wadannan dalilai. Sai dai cututtukan da ba kasafai suke faruwa ba tare da masu juna biyu da masu ba da gudummawar gabobin jiki lokaci-lokaci, ciwon daji gabadaya ba cuta ce mai iya yaɗuwa ba, duk da haka abubuwan da ka iya haifar da ci gaban ciwon daji na iya yaduwa; irin su oncoviruses kamar hepatitis B, cutar Epstein-Barr da HIV.^[19]

Sinadarai

Sinadaran bkrin bayani: Barasa da ciwon daji da shan taba da ciwon daji Yawan cutar kansar huhu yana da alaqa sosai da shan taba. An danganta bayyanar da wasu abubuwa na musamman da takamaiman nau'in ciwon daji. Wadannan abubuwa ana kiran su carcinogens. Shan taba, alal misali, yana haifar da kashi 90% na cutar kansar huhu. Har ila yau yana haifar da ciwon daji a cikin makogwaro, kai, wuya, ciki, mafitsara, koda, esophagus da pancreas. Hayakin taba ya qunshi fiye da hamsin sanannun ƙwayoyin cuta, gami da nitrosamines da polycyclic aromatic hydrocarbons. Taba yana da alhakin kusan daya cikin biyar na mutuwar cutar kansa a duniya da kusan ɗaya cikin uku a cikin kasashen da suka ci gaba. Yawan mutuwar cutar kansar huhu a Amurka ya yi kama da tsarin shan taba, tare da karuwar shan taba tare da karuwa mai ban mamaki a cikin adadin mutuwar cutar kansar huhu kuma, kwanan nan, raguwar yawan shan taba tun shekarun 1950 ya biyo bayan raguwar mutuwar cutar kansar huhu a cikin maza tun 1990. A Yammacin Turai, kashi 10% na ciwon daji na maza da kashi 3% na ciwon daji na mata ana danganta su da shan barasa, musamman ciwon hanta da na narkewar abinci. Ciwon daji daga bayyanar abubuwan da ke da alaƙa da aiki na iya haifar da tsakanin 2 zuwa 20% na lokuta, yana haifar da aƙalla mutuwar 200,000. Ciwon daji kamar kansar huhu da mesothelioma na iya fitowa daga shakar hayakin taba ko filayen asbestos, ko cutar sankarar bargo daga kamuwa da benzene. Fuskantar perfluorooctanoic acid (PFOA), wanda galibi ake amfani da shi wajen samar da Teflon, an san yana haifar da ciwon daji iri biyu.^[20]

Abinci Da Motsa Jiki

Abinci da motsa jiki: Abinci da ciwon daji Abinci, rashin motsa jiki da kiba suna da alaka da kusan kashi 30-35% na mutuwar ciwon daji. A cikin Amurka, yawan nauyin jiki yana da alaqa da habaka nau'ikan ciwon daji da yawa kuma yana da tasiri a cikin 14-20% na mutuwar ciwon daji.Wani bincike na Burtaniya wanda ya hada da bayanai kan mutane sama da miliyan 5 ya nuna mafi girman kididdigar jiki da ke da alaqa da akalla nau'ikan ciwon daji guda 10 kuma ke da alhakin kusan cututtukan 12,000 kowace shekara a cikin ƙasar.^[21] An yi imanin rashin aiki na jiki yana ba da gudummawa ga hadarin ciwon daji, ba kawai ta hanyar tasirinsa akan nauyin jiki ba har ma ta hanyar mummunan tasiri akan tsarin rigakafi da tsarin endocrine.[54]. Fiye da rabin abin da ke haifar da abinci yana faruwa ne saboda rashin abinci mai gina jiki (cin abinci da yawa), maimakon cin kayan lambu da yawa ko wasu abinci masu lafiya. Wasu takamaiman abinci suna da alaqa da takamaiman cututtukan daji. Cin abinci mai yawan gishiri yana da alaka da ciwon daji na ciki^[22]. Aflatoxin B1, mai yawan gurɓatar abinci, yana haifar da ciwon hanta. Taunar goro na iya haifar da kansar baki. Bambance-bambancen kasa a cikin ayyukan abinci na iya yin bayanin bambance-bambance a cikin abin da ya faru na kansa. Misali, ciwon daji na ciki ya fi zama ruwan dare a Japan saboda yawan abinci mai gishiri yayin da ciwon hanji ya fi yawa a Amurka. Bayanan ciwon daji na bakin haure suna kwatanta na sabuwar kasarsu, sau da yawa a cikin tsara kaya.

Kamuwa Da Cuta

Kamuwa da cuta: Abubuwan da ke kamuwa da cutar daji A duk duniya kusan kashi 18% na mutuwar kansa yana da alaqa da cututtuka masu yaduwa.[Wannan rabo ya tashi daga babban kashi 25% a Afirka zuwa kasa da kashi 10% a cikin kasashen da suka ci gaba.^[23] Kwayoyin cuta sune cututtuka na yau da kullun waɗanda ke haifar da ciwon daji amma kwayoyin cutar kansa da kwayoyin cuta na iya taka rawa. Oncoviruses (kwayoyin cutar da za su iya haifar da ciwon daji) sun hada da papillomavirus na mutum (ciwon daji na mahaifa), cutar Epstein-Barr (cututtukan lymphoproliferative B-cell da nasopharyngeal carcinoma), Kaposi's sarcoma herpesvirus (Kaposi's sarcoma da primary effusion lymphomas), hepatitis B da hepatitis C ƙwayoyin cuta. hepatocellular carcinoma) da kuma ɗan adam T-cell cutar sankarar bargo-1 (T-cell leukemias). Har ila yau ciwon ƙwayoyin cuta na iya kara hadarin ciwon daji, kamar yadda aka gani a cikin ciwon daji na Helicobacter pylori wanda ke haifar da ciwon ciki.[59][60]. Cututtukan da ke da alaƙa da ciwon daji sun hada da Schistosoma haematobium (squamous cell carcinoma of the bladder) da hanta flukes, Opisthorchis viverrini da Clonorchis sinensis (cholangiocarcinoma).^[24]

Radiation

Radiation: Ciwon daji da ke haifar da radiation Fitar da hasken wuta kamar hasken ultraviolet da kayan aikin rediyo abu ne mai hadari ga kansa.^[25] Yawancin cututtukan daji waɗanda ba melanoma ba suna faruwa ne saboda hasken ultraviolet, galibi daga hasken rana.[63] Tushen ionizing radiation sun haɗa da hoton likita da radon gas.[63] Ionizing radiation ba mutagen mai karfi ba ne musamman.[65] Fuskantar wurin zama ga iskar radon, alal misali, yana da hadarin kansa iri daya kamar shan taba.[65] Radiation shine tushen ciwon daji mafi karfi idan aka haɗa shi da sauran abubuwan da ke haifar da cutar kansa, kamar radon da hayakin taba.[65] Radiation zai iya haifar da ciwon daji a yawancin sassan jiki, a cikin dukan dabbobi da kuma kowane shekaru. Yara suna da yuwuwar kamuwa da cutar sankarar bargo wanda ke haifar da radiation sau biyu kamar manya; Fitar da radiation kafin haihuwa yana da tasirin sau goma.^[26] Amfani da likitanci na ionizing radiation karami ne amma girma tushen cututtukan daji da ke haifar da radiation. Ana iya amfani da radiation ionizing don magance wasu cututtuka, amma wannan yana iya, a wasu lokuta, ya haifar da nau'i na ciwon daji na biyu.[65] Hakanan ana amfani da shi a wasu nau'ikan hoton likita.[66] Tsawaita bayyanar da hasken ultraviolet daga rana na iya haifar da cutar sankarau da sauran cututtukan fata.[67] Tabbatacciyar shaida ta tabbatar da hasken ultraviolet, musamman ma matsakaitan igiyar ruwa ta UVB, a matsayin sanadin mafi yawan cututtukan daji na fata wadanda ba melanoma ba, wadanda sune nau'in ciwon daji da aka fi sani a duniya.[67] Rashin ionizing mitar rediyo daga wayar hannu, watsa wutar lantarki da sauran makamantansu an bayyana su a matsayin yiwuwar cutar sankara ta Hukumar Lafiya ta Duniya don Bincike kan Ciwon daji[68]. Hujja kuwa, ba ta goyi bayan wata damuwa ba.^[27] Wannan ya hada da cewa binciken bai sami daidaito tsakanin radiation wayar hannu da haɗarin ciwon daji ba

Gado

Gado: Ciwon daji Mafi yawan ciwon daji ba na gado ba ne (na lokaci-lokaci). Ciwon daji na gado yana haifar da asali ne ta hanyar lahani na gado. Kasa da kashi 0.3 cikin 100 na yawan jama'a sune masu dauke da maye gurbi wanda ke da babban tasiri kan hadarin kansa kuma yana haifar da kasa da kashi 3-10 na cutar kansa.^[28] Wasu daga cikin waɗannan cututtuka sun haɗa da: wasu maye gurbi a cikin kwayoyin halitta BRCA1 da BRCA2 tare da fiye da 75% hadarin ciwon nono da ciwon daji na ovarian, [71] da kuma ciwon daji na nonpolyposis colorectal (HNPCC ko Lynch syndrome), wanda ke cikin kusan 3. % na mutanen da ke fama da ciwon daji, [72] da sauransu. Bisa kididdigar da ciwon daji ke haifar da mafi yawan mace-mace, hadarin kamuwa da cutar kansar launin fata lokacin da aka gano dangi na farko (iyaye, dan'uwa ko yaro) yana da kusan 2.[73]. Hadarin dangi daidai shine 1.5 don kansar huhu, [74] da 1.9 don kansar prostate.[75]. Ga ciwon nono, haɗarin dangi shine 1.8 tare da dangi na farko wanda ya hadaka shi yana da shekaru 50 ko sama da haka, da 3.3 lokacin da dangin ya hadaka shi lokacin yana kasa da shekaru 50.[76]. Mutane masu tsayi suna da haɗarin kamuwa da cutar kansa saboda suna da ƙwayoyin sel fiye da gajerun mutane. Tunda tsayin daka ya kayyade ta hanyar gado mai yawa, mutane masu tsayi suna da haɓakar haɗarin cutar kansa.

Wakilan Jiki

Wakilan jiki Wasu abubuwa suna haifar da cutar kansa ta hanyar zahiri, maimakon sinadarai.[78] Babban misali na wannan shine tsawaita bayyanar da asbestos, filayen ma'adinai da ke faruwa a zahiri wadanda sune babban dalilin mesothelioma (ciwon daji na serous membrane) yawanci serous membrane kewaye da huhu.[78] Sauran abubuwan da ke cikin wannan nau'in, ciki har da abubuwan da ke faruwa a zahiri da kuma sinadarai masu kama da asbestos na roba, irin su wollastonite, attapulgite, ulun gilashi da ulun dutse, an yi imanin suna da irin wannan tasirin.[78] Abubuwan da ba su da fibrous wanda ke haifar da ciwon daji sun haɗa da cobalt na karfe na karfe da nickel da silica crystalline (quartz, cristobalite da tridymite).[78]. Yawancin lokaci, carcinogens na jiki dole ne su shiga cikin jiki (kamar ta hanyar numfashi) kuma suna buƙatar shekaru masu yawa don haifar da ciwon daji.[78]. Rashin raunin jiki da ke haifar da kansa ba ya da yawa.[79] Da'awar cewa karya kasusuwa yana haifar da ciwon daji, misali, ba a tabbatar da hakan ba.[79] Hakazalika, ba a yarda da raunin jiki a matsayin sanadin cutar kansar mahaifa, ciwon nono ko kansar kwakwalwa.[79] Ɗaya daga cikin tushen da aka yarda shine akai-akai, aikace-aikacen dogon lokaci na abubuwa masu zafi zuwa jiki. Mai yiyuwa ne a ce yawan kone-kone da ake yi a sassan jiki guda, kamar wanda ake samar da na’urorin dumama na kanger da na kairo (masu dumin hannu na garwashi), na iya haifar da cutar kansar fata, musamman idan akwai sinadarai masu dauke da cutar sankara.[79] Yawan shan shayi mai zafi yana iya haifar da ciwon daji na hanji[79]. Gabadaya, an yi imanin cewa ciwon daji yana tasowa, ko kuma ana karfafa ciwon daji da ya riga ya kasance, yayin aikin warkarwa, maimakon raunin da ya faru kai tsaye.[79] Koyaya, maimaita raunin da aka samu ga kyallen takarda iri ɗaya na iya hadakar kwayoyin sel da yawa, wanda hakan na iya ƙara yuwuwar maye gurbi mai cutar kansa. An yi hasashen kumburi na yau da kullun don haifar da maye gurbi kai tsaye.[79][80] Kumburi na iya ba da gudummawa ga yaduwa, rayuwa, angiogenesis da ƙaura na ƙwayoyin cutar kansa ta hanyar tasiri microenvironment na tumor.[81][82]. Oncogenes suna gina microenvironment pro-tumorigenic mai kumburi.

Hormones

Hormones Wasu kwayoyin halitta suna taka rawa wajen bunkasa ciwon daji ta hanyar inganta yaduwar kwayar halitta.[84] Abubuwan haɓaka kamar insulin da sunadaran da ke ɗaure su suna taka muhimmiyar rawa wajen yaɗuwar ƙwayoyin cutar kansa, bambance-bambance da apoptosis, suna nuna yiwuwar shiga cikin carcinogenesis.[85]. Hormones sune muhimman abubuwa a cikin cututtukan daji masu alaƙa da jima'i, kamar kansar nono, endometrium, prostate, ovary da testis da kuma ciwon daji na thyroid da kansar ƙashi.[84] Misali, 'ya'yan mata masu fama da ciwon nono suna da adadin isrogen da progesterone da yawa fiye da 'yan matan mata masu ciwon nono. Wadannan matakan hormone masu girma na iya yin bayanin haɗarin da ke tattare da cutar kansar nono, ko da idan babu kwayar cutar kansar nono.[84] Hakazalika, mazan kakannin Afirka suna da matakan girma na testosterone fiye da mazan zuriyar Turai kuma suna da mafi girman matakin cutar kansar prostate.[84] Maza daga zuriyar Asiya, tare da mafi karancin matakan testosterone-activating androstanediol glucuronide, suna da mafi ƙarancin matakan ciwon daji na prostate.[84] Sauran abubuwan da suka dace: masu kiba suna da matakan girma na wasu kwayoyin halittar da ke da alaƙa da ciwon daji da kuma mafi girman adadin wadannan cututtukan.[84]. Matan da suke shan maganin maye gurbin hormone suna da babban hadarin kamuwa da cutar kansar da ke da alaqa da wadannan kwayoyin cutar.[84] A gefe guda kuma, mutanen da suke motsa jiki fiye da matsakaici suna da kananan matakan waɗannan kwayoyin halitta kuma suna rage haɗarin ciwon daji.[84]. Osteosarcoma na iya haɓaka ta hanyar hormones girma.[84] Wasu jiyya da hanyoyin rigakafin suna yin amfani da wannan dalili ta hanyar rage matakan hormone ta hanyar wucin gadi da kuma hana cututtukan daji masu saurin kamuwa da hormone.[84]

Cututtukan autoimmune

Akwai wata gungiya tsakanin cutar celiac da kara hadarin duk ciwon daji. Mutanen da ke fama da cutar celiac da ba a kula da su ba suna da haɗari mafi girma, amma wannan hadarin yana raguwa tare da lokaci bayan ganewar asali da kuma kulawa mai tsanani, mai yiwuwa saboda ƙaddamar da abinci marar yisti, wanda ke da alama yana da rawar kariya daga ci gaban malignancy a cikin mutanen da ke fama da cutar celiac. . Duk da haka, jinkirin ganewar asali da farawa na cin abinci marar yisti yana ƙara haɗarin malignancies.[86] Yawan ciwon daji na gastrointestinal yana karuwa a cikin mutanen da ke fama da cutar Crohn da ulcerative colitis, saboda kumburi na kullum. Har ila yau, immunomodulators da kwayoyin halitta da ake amfani da su don magance wadannan cututtuka na iya inganta hadakar cututtuka na hanji.

Pathophysiology

Pathophysiology: Carcinogenesis Ciwon daji na faruwa ne sakamakon jerin maye gurbi. Kowane maye gurbi yana canza halin tantanin halitta kaɗan. Genetics Babban labarin: Oncogenomics Ciwon daji cuta ce ta asali cuta na tsarin girma na nama. Domin tantanin halitta ya canza zuwa kwayar cutar kansa, dole ne a canza kwayoyin halittar da ke daidaita girma da bambance-bambancen kwayar halitta.[88] Kwayoyin halittar da abin ya shafa sun kasu kashi biyu manya-manya. Oncogenes sune kwayoyin halitta waɗanda ke haɓaka haɓakar ƙwayoyin sel da haifuwa. Kwayoyin da ke hana Tumor su ne kwayoyin halitta waɗanda ke hana rarraba tantanin halitta da rayuwa. Mummunan canji na iya faruwa ta hanyar samuwar novel oncogenes, rashin dacewa kan-bayyanar da kwayoyin oncogenes na yau da kullun, ko ta hanyar bayyanawa ko naƙasa ƙwayoyin ƙwayoyin cuta masu hana kari. Yawanci, ana buƙatar canje-canje a cikin kwayoyin halitta da yawa don canza tantanin halitta ta al'ada zuwa kwayar cutar kansa.[89] Canje-canjen kwayoyin halitta na iya faruwa a matakai daban-daban kuma ta hanyoyi daban-daban. Riba ko asarar dukkanin chromosome na iya faruwa ta hanyar kurakurai a cikin mitosis. Mafi na kowa maye gurbi, wadanda canje-canje ne a cikin jerin nucleotide na DNA na genomic. Manyan maye gurbi sun hada da gogewa ko samun wani yanki na chromosome. Ƙwararrun kwayoyin halitta yana faruwa lokacin da tantanin halitta ya sami kwafi (sau da yawa 20 ko fiye) na ƙaramin wuri na chromosomal, yawanci yana ƙunshe da ɗaya ko fiye da oncogenes da kayan gado na kusa. Juyawa yana faruwa lokacin da yankuna biyu na chromosomal daban-daban suka zama masu haɗuwa da juna, sau da yawa a wani yanayi na musamman. Wani sanannen misalin wannan shine chromosome na Philadelphia, ko fassarar chromosomes 9 da 22, wanda ke faruwa a cikin cutar sankarar jini na myelogenous na kullum kuma yana haifar da samar da furotin BCR-abl fusion protein, wani oncogenic tyrosine kinase. Kananan maye gurbi sun hada da maye gurbi, gogewa, da sakawa, wanda zai iya faruwa a yankin mai tallata kwayar halitta kuma ya shafi maganganunsa, ko kuma yana iya faruwa a cikin jerin lambobin kwayar halittar da kuma canza aiki ko kwanciyar hankali na furotin. Har ila yau, rushewar kwayar halitta guda ɗaya na iya haifar da haduwa da kwayoyin halitta daga kwayar cutar DNA ko retrovirus, wanda ke haifar da bayyanar cututtuka na kwayar cutar kwayar cutar a cikin kwayar cutar da kuma zuriyarsa. Maimaita bayanan da ke cikin DNA na sel masu rai zai haifar da wasu kurakurai (maye gurbi). An gina hadadden gyaran kurakurai da rigakafi a cikin tsari kuma yana kiyaye tantanin halitta daga cutar kansa. Idan babban kuskure ya faru, tantanin da ya lalace zai iya lalata kansa ta hanyar tsarin mutuwar kwayar halitta, wanda ake kira apoptosis. Idan tsarin sarrafa kuskuren ya gaza, to, maye gurbin zai tsira kuma a wuce tare da sel 'ya'ya. Wasu mahalli suna sa kurakurai su iya tasowa da yaduwa. Irin waɗannan mahalli na iya haɗawa da kasancewar abubuwa masu barna da ake kira carcinogens, maimaita rauni na jiki, zafi, ionizing radiation ko hypoxia.[90] Kurakuran da ke haifar da ciwon daji suna hadaka kai da hadakawa, misali: Maye gurbi a cikin injin gyara kura kurai na tantanin halitta na iya sa wannan tantanin halitta da 'ya'yanta su tara kurakurai cikin sauri. Ƙarin maye gurbi a cikin oncogene na iya haifar da tantanin halitta yin haifuwa da sauri da yawa fiye da takwarorinsa na yau da kullun. Karin maye gurbi na iya haifar da asarar kwayar kuma za ta iya rushe hanyar siginar apoptosis da kuma dawwama tantanin halitta. Ƙarin maye gurbi a cikin injin siginar tantanin halitta na iya aika sigina masu haifar da kuskure zuwa sel na kusa. Juyawa tantanin halitta ta al'ada zuwa ciwon daji yana kama da tsarin sarkar da ke haifar da kurakurai na farko, wanda ke hadawa zuwa manyan kurakurai, kowane ci gaba yana barin tantanin halitta damar tserewa ƙarin sarrafawa waɗanda ke iyakance haɓakar nama na yau da kullun. Wannan labari mai kama da tawaye shine tsira da ba a so na mafi dacewa, inda karfin juyin halitta ke aiki da tsarin jiki da aiwatar da tsari. Da zarar ciwon daji ya fara tasowa, wannan tsari mai gudana, wanda ake kira juyin halitta na clonal, yana haifar da ci gaba zuwa matakai masu yawa.[91]. Juyin Halitta na Clonal yana haifar da intra-tumour heterogeneity (kwayoyin ciwon daji tare da maye gurbi daban-daban) wanda ke dagula ƙira ingantattun dabarun jiyya. Halayen iyawar halayen da cututtukan daji ke haɓaka sun kasu kashi-kashi, musamman ƙauracewa apoptosis, wadatar kai a cikin siginar girma, rashin jin daɗi ga siginar haɓaka girma, ci gaba da angiogenesis, yuwuwar kwafi mara iyaka, metastasis, sake fasalin kuzarin kuzari da gujewa lalatawar rigakafi.

Epigenetics

Epigenetics: Ciwon daji epigenetics Matsayin tsakiya na lalacewar DNA da lahani na epigenetic a cikin kwayoyin gyaran DNA a cikin carcinogenesis Ra'ayi na gargajiya game da ciwon daji wani nau'in cututtuka ne waɗanda ke haifar da ci gaba na rashin daidaituwa na kwayoyin halitta waɗanda suka haɗa da maye gurbi a cikin ƙwayoyin cuta masu hana ƙari da oncogenes da rashin daidaituwa na chromosomal. Daga baya an gano rawar da aka samu na sauye-sauye na epigenetic.[92] Canje-canjen Epigenetic gyare-gyaren da suka dace da aiki zuwa ga kwayoyin halitta wadanda ba sa canza jerin nucleotide. Misalan irin wadannan gyare-gyare sune canje-canje a cikin DNA methylation (hypermethylation da hypomethylation), gyare-gyaren histone[93] da canje-canje a cikin gine-ginen chromosomal (wanda ya haifar da rashin dacewa na sunadaran kamar HMGA2 ko HMGA1).[94]. Kowane bayan waɗannan sauye-sauye yana sarrafa maganganun kwayoyin halitta ba tare da canza jerin DNA na asali ba. Waɗannan canje-canjen na iya wanzuwa ta hanyar rarrabuwar sel, suna dawwama ga tsararraki masu yawa kuma ana iya daukar su azaman epimutation (daidai da maye gurbi). Canje-canje na Epigenetic yana faruwa akai-akai a cikin ciwon daji. Alal misali, binciken daya ya lissafa kwayoyin halittar sunadaran sunadaran da aka saba canzawa akai-akai a cikin methylation tare da ciwon daji na hanji. Wadannan sun hada da 147 hypermethylated da 27 hypomethylated genes. Daga cikin kwayoyin halittar hypermethylated, 10 sun kasance hypermethylated a cikin 100% na ciwon daji na hanji kuma wasu da yawa sun kasance hypermethylated a cikin fiye da 50% na ciwon daji na hanji.[95]. Yayin da ake samun sauye-sauye na epigenetic a cikin ciwon daji, sauye-sauye na epigenetic a cikin kwayoyin gyaran DNA, yana haifar da raguwar maganganun sunadarai na gyaran DNA, na iya zama mahimmanci. Ana tsammanin irin waɗannan sauye-sauyen suna faruwa da wuri kafin su ci gaba zuwa cutar kansa kuma suna iya zama sanadin rashin zaman lafiyar kwayoyin halittar cututtukan daji.[96][97][98] Rage bayanin kwayoyin halittar DNA na gyaran DNA yana rushe gyaran DNA. Ana nuna wannan a cikin adadi a mataki na 4 daga sama. (A cikin adadi, jajayen kalmomi suna nuna tsakiyar rawar lalacewar DNA da lahani a cikin gyaran DNA don ci gaba zuwa ciwon daji.) Lokacin da gyaran DNA ya gaza lalacewar DNA ya kasance a cikin sel a matakin sama fiye da yadda aka saba (mataki na 5) kuma yana haifar da kara yawan mitoci. maye gurbi da/ko epimutation (matakin 6). Adadin maye gurbi yana karuwa sosai a cikin ƙwayoyin da ba su da lahani a cikin gyare-gyaren rashin daidaituwa na DNA[99] [100] ko a cikin gyaran hadin gwiwa (HRR).[101] Sabuntawar chromosomal da aneuploidy suma suna karuwa a cikin sel marasa lahani na HRR.[102] Mafi girman matakan lalacewa na DNA yana haifar da karar maye gurbi (gefen siffa na dama) da kara kazanta. Yayin gyaran DNA ninki biyu karya, ko gyara wasu lalacewar DNA, wuraren gyara da ba su cika cika ba na iya haifar da shiru na kwayoyin halitta.[103][104] Rashin bayyanar sunadaran gyaran DNA saboda maye gurbi na iya kara hadarin kansa. Mutanen da ke da nakasar gada a cikin kowane nau'in halittar DNA na 34 (duba labarin DNA gyara-rashi cuta) sun haɓaka haɗarin kansa, tare da wasu lahani suna tabbatar da damar 100% na ciwon daji (misali p53 maye gurbi).[105]. An lura da maye gurbi na gyaran layin DNA a gefen hagu na adadi. Duk da haka, irin wannan maye gurbi (wanda ke haifar da ciwon daji na ciwon daji) shine kawai ke haifar da kusan kashi 1 cikin dari na ciwon daji.[106] A cikin cututtukan daji na lokaci-lokaci, ƙarancin gyare-gyaren DNA na faruwa lokaci-lokaci ta hanyar maye gurbi a cikin kwayar halittar DNA amma galibi ana haifar da su ta hanyar sauye-sauyen epigenetic wadanda ke rage ko yin shuru na maganganun kwayoyin halittar DNA. An nuna wannan a cikin adadi a matakin 3rd. Yawancin binciken da aka yi na carcinogenesis mai nauyin ƙarfe mai nauyi ya nuna cewa irin waɗannan ƙananan karafa suna haifar da raguwa a cikin maganganun gyaran enzymes na DNA, wasu ta hanyar hanyoyin epigenetic. An ba da shawarar hana gyaran DNA don zama babbar hanyar da ke haifar da cutar sankara mai nauyi. Bugu da kari, akai-akai sauye-sauye na epigenetic na lambar jerin DNA don kananan RNAs da ake kira microRNAs (ko miRNAs). miRNAs ba sa kididdige sunadaran sunadaran, amma suna iya “nufa” ƙwayoyin furotin-coded kuma su rage maganganunsu. Ciwon daji galibi suna tasowa ne daga tarin maye gurbi da kwankwasa waɗanda ke ba da fa'idar zabin da ke haifar da haɓaka clonal (duba lahani na ci gaba zuwa kansa). Maye gurbi, duk da haka, bazai zama akai-akai a cikin cututtukan daji kamar sauye-sauyen epigenetic ba. Matsakaicin ciwon daji na nono ko hanji yana iya samun sauye-sauyen furotin da kusan 60 zuwa 70, wanda kusan uku ko hudu na iya zama maye gurbin “direba” sauran kuma na iya zama maye gurbin “fasinja”

Metastasi

Metastasis: Metastasis Metastasis shine yaduwar cutar kansa zuwa wasu wurare a cikin jiki. Ciwace-ciwacen da aka tarwatsa ana kiran su da ciwace-ciwacen daji, yayin da na asali shi ake kira da ciwon farko. Kusan duk ciwon daji na iya daidaitawa.[35] Mafi yawan mutuwar ciwon daji na faruwa ne saboda ciwon daji wanda ya karu.[36] Metastasis na kowa a karshen matakan ciwon daji kuma yana iya faruwa ta hanyar jini ko tsarin lymphatic ko duka biyu. Matakan al'ada a cikin metastasis sune mamayewa na gida, shiga cikin jini ko lymph, wurare dabam dabam ta jiki, haɓaka cikin sabon nama, yaduwa da angiogenesis. Nau'o'in ciwon daji daban-daban suna yin kazamin gabobin jikinsu, amma gabaɗaya wuraren da aka fi samun kazanta su ne huhu, hanta, ƙwaƙwalwa da kasusuwa.[35]

Metabolism

Tumor metabolome Kwayoyin al'ada yawanci suna haifar da kusan kashi 30% na makamashi daga glycolysis, [108] yayin da yawancin ciwon daji ke dogara ga glycolysis don samar da makamashi (Tasirin Warburg).[109][110] [111] Amma tsirarun nau'ikan ciwon daji sun dogara da phosphorylation oxidative a matsayin tushen makamashi na farko, gami da lymphoma, cutar sankarar bargo, da kansar endometrial.[112] Ko da a wadannan lokuta, duk da haka, amfani da glycolysis a matsayin tushen makamashi da wuya ya wuce 60%.[108] Wasu 'yan ciwon daji suna amfani da glutamine a matsayin babban tushen makamashi, wani bangare saboda yana samar da nitrogen da ake bukata don hadin nucleotide (DNA, RNA).[113][108]. Kwayoyin ciwon daji sukan yi amfani da oxidative phosphorylation ko glutamine a matsayin tushen makamashi na farko.[114] Yawancin bincike sun nuna cewa enzyme sirtuin 6 an zabi wanda ba a kunna shi ba a lokacin oncogenesis a cikin nau'ikan ƙari iri-iri ta hanyar haifar da glycolysis.[111] Wani sirtuin, sirtuin 3 yana hana ciwon daji wanda ya dogara da glycolysis, amma yana inganta ciwon daji wanda ya dogara da oxidative phosphorylation.[115]. An ba da shawarar rage cin abinci mai karancin carbohydrate (abinci na ketogenic) a wasu lokuta azaman maganin tallafi don maganin ciwon daji.

Bincike

Bincike (Satumba 2021) aX-ray na kirji yana nuna kansar huhu a cikin huhu na hagu Yawancin ciwon daji ana gane su da farko ko dai saboda bayyanar alamu ko alamun cutar ko ta hanyar dubawa. Babu bayan wadannan da ke haifar da tabbataccen ganewar asali, wanda ke bugatar bincika samfurin nama ta hanyar likitan ilimin cututtuka. Ana bincikar mutanen da ake zargi da ciwon daji tare da gwaje-gwajen likita. Wadannan yawanci sun hada da gwaje-gwajen jini, X-rays, (contrast) CT scans da endoscopy. Binciken nama daga biopsy yana nuna nau'in tantanin halitta da ke yaduwa, darajar tarihinsa, rashin daidaituwa na kwayoyin halitta da sauran siffofi. Tare, wannan bayanin yana da amfani don kimanta tsinkaye da kuma zabar mafi kyawun magani. Cytogenetics da immunohistochemistry wasu nau'ikan gwaje-gwajen nama ne. Wadannan gwaje-gwajen suna ba da bayanai game da sauye-sauyen kwayoyin halitta (kamar maye gurbi, kwayoyin halittar fusion da sauye-sauye na chromosome na lambobi) kuma yana iya nuna hasashen hasashen da mafi kyawun magani. Ciwon daji na iya haifar da damuwa na tunani da kuma shiga tsakani na zamantakewa, kamar maganin magana, na iya taimakawa mutane da wannan.[118]

Rabewa

Karin bayani: Jerin nau'ikan ciwon daji da Jerin sharuddan da suka danganci oncology Ciwon daji ana rarraba su da nau'in tantanin halitta wanda kwayoyin tumor suke kama da shi don haka ana zaton shine asalin kwayar cuta. Waɗannan nau'ikan sun hada da: Carcinoma: Ciwon daji da aka samo daga sel epithelial. Wannan rukunin ya qunshi yawancin cututtukan daji da aka fi sani kuma sun haɗa da kusan duka waɗanda ke cikin nono, prostate, huhu, pancreas da hanji. Sarcoma: Ciwon daji da ke tasowa daga nama mai haɗawa (watau kashi, guringuntsi, mai, jijiya), kowannensu yana tasowa daga kwayoyin halitta da suka samo asali a cikin kwayoyin halitta a waje da kasusuwa. Lymphoma da cutar sankarar bargo: Waɗannan nau'ikan guda biyu suna tasowa ne daga ƙwayoyin hematopoietic (masu samar da jini) waɗanda ke barin bargo kuma sukan yi girma a cikin ƙwayoyin lymph da jini, bi da bi.[119] Ciwon ƙwayar ƙwayar ƙwayar cuta: Ciwon daji da aka samo daga sel masu ƙarfi, galibi suna nunawa a cikin ƙwaya ko kwai (seminoma da dysgerminoma, bi da bi). Blastoma: Ciwon daji da aka samo daga sel "precursor" marasa girma ko nama na amfrayo. Ciwon daji yawanci ana kiransu ta hanyar amfani da -carcinoma, -sarcoma ko -blastoma a matsayin kari, tare da kalmar Latin ko Girkanci ga gabbai ko nama na asali a matsayin tushen. Misali, ciwon daji na parenchyma na hanta da ke tasowa daga sel epithelial masu cutarwa ana kiransa hepatocarcinoma, yayin da mummunan cutar da ke fitowa daga sel precursor na hanta ana kiransa hepatoblastoma kuma ciwon daji da ke fitowa daga kwayoyin kitse ana kiransa liposarcoma. Ga wasu cututtukan daji na yau da kullun, ana amfani da sunan gabobin Ingilishi. Misali, nau'in ciwon daji na nono da aka fi sani shine ake kira ductal carcinoma na nono. Anan, ductal na sifa yana nufin bayyanar cutar daji a ƙarƙashin na'urar hangen nesa, wanda ke nuna cewa ya samo asali ne a cikin magudanar madara. Ciwon daji mara kyau (wadanda ba ciwon daji ba) ana kiran su ta amfani da -oma azaman kari tare da sunan gabobin a matsayin tushen. Alal misali, kwayar tsoka mai santsi ana kiranta leiomyoma (sunan gama gari na wannan kwayar cuta mai saurin faruwa a cikin mahaifa shine fibroid). Abin mamaki, wasu nau'in ciwon daji suna amfani da -noma suffix, misalai ciki har da melanoma da seminoma. Wasu nau'in ciwon daji ana kiran su don girma da siffar sel a karkashin na'urar hangen nesa, kamar giant cell carcinoma, spindle cell carcinoma da kananan-cell carcinoma. Wani ciwon daji na ductal carcinoma na nono (kodadden wuri a tsakiya) kewaye da spikes na farar tabo da nama mai launin rawaya. Ciwon daji mai kaifi mai launi (cibi na sama) a cikin samfurin colectomy Ciwon daji mai squamous-cell (burin farar fata) kusa da bronchi a cikin samfurin huhu. Wani babban ciwon daji na ductal carcinoma a cikin samfurin mastectomy

Wani mugun abu ductal carcinoma na nono (kodadden wuri a tsakiya) kewaye da spikes na farar tabo da nama mai launin rawaya.
Ciwon daji mai kaifi mai launi (cibi na sama) a cikin samfurin colectomy
Ciwon daji mai squamous-cell (burin farar fata) kusa da bronchi a cikin samfurin huhu.
Wani babban ciwon daji na ductal carcinoma a cikin samfurin mastectomy

Rigakafi

Rigakafi Babban labarin: rigakafin ciwon daji An bayyana rigakafin cutar kansa azaman matakan aiki don rage hadarin kansa.[120] Mafi yawan lokuta na ciwon daji na faruwa ne saboda hadarin muhalli. Yawancin waɗannan abubuwan muhalli zabin salon rayuwa ne masu iya sarrafawa. Don haka, ciwon daji gabaɗaya ana iya rigakafinsa[121]. Tsakanin kashi 70% zuwa 90% na cututtukan daji na yau da kullun suna faruwa ne saboda abubuwan muhalli don haka ana iya yin rigakafi.[122] Fiye da kashi 30 cikin 100 na mace-macen cutar daji za a iya kiyaye su ta hanyar guje wa abubuwan haɗari da suka haɗa da: taba, kiba mai yawa, rashin abinci mara kyau, rashin motsa jiki, barasa, cututtukan da ake ɗauka ta hanyar jima'i da gurɓataccen iska.[123] Bugu da ari, ana iya la'akari da talauci a matsayin wani abu mai hatsarin gaske a cikin cututtukan daji na ɗan adam.[124] Ba duk abubuwan da ke haifar da muhalli ba ne ake iya sarrafa su ba, kamar abubuwan da ke faruwa ta zahiri da kuma ciwon daji da ke haifar da cututtukan gado na gado don haka ba a iya yin rigakafi ta hanyar halayen mutum.

Abincin abinci

Abincin abinci da ciwon daji Yayin da aka ba da shawarwarin abinci da yawa don rage haɗarin ciwon daji, shaidar da za ta goyi bayan su ba ta tabbata ba.[14][125] Abubuwan abinci na farko waɗanda ke habaka hadari sune kiba da shan barasa. Abincin da ke da ƙarancin 'ya'yan itatuwa da kayan marmari da jajayen nama suna da alaƙa da alaƙa amma sake dubawa da nazarin meta ba su kai ga daidaito ba.[126][127] Binciken meta-bincike na 2014 bai sami dangantaka tsakanin 'ya'yan itatuwa da kayan marmari da ciwon daji ba.[128] Kofi yana da alaƙa da raguwar haɗarin cutar kansar hanta.[129] Bincike ya danganta yawan shan ja ko naman da aka sarrafa da yawan kamuwa da cutar kansar nono, ciwon hanji da kuma ciwon daji na pancreatic, al’amarin da zai iya kasancewa saboda kasancewar carcinogens a cikin naman da ake dafawa a yanayin zafi.[130][131] A cikin 2015 IARC ta ba da rahoton cewa cin nama da aka sarrafa (misali, naman alade, naman alade, karnuka masu zafi, tsiran alade) kuma, zuwa karamin digiri, jan nama yana da alaƙa da wasu cututtukan daji.[132][133]. Shawarwari na abinci don rigakafin ciwon daji yawanci sun haɗa da ba da fifiko ga kayan lambu, 'ya'yan itace, hatsi gabaɗaya da kifi da kuma nisantar sarrafa nama da jan nama (naman sa, naman alade, rago), kitsen dabbobi, abincin da aka ɗora da ingantaccen carbohydrates.

Magani

Magani Ana iya amfani da magunguna don hana ciwon daji a wasu yanayi kaɗan[134]. A cikin yawan jama'a, NSAIDs suna rage hadarin ciwon daji na launi; duk da haka, saboda illar cututtukan zuciya da jijiyoyin jini, suna haifar da illa gaba daya idan aka yi amfani da su don rigakafi.[135] An gano aspirin yana rage hadarin mutuwa daga cutar kansa da kusan kashi 7%.[136] Masu hana COX-2 na iya rage yawan kwayar polyp a cikin mutanen da ke da polyposis adenomatous iyali; duk da haka, yana da alaka da illa iri ɗaya da NSAIDs.[137] Yin amfani da tamoxifen ko raloxifene kullum yana rage hadarin kamuwa da cutar kansar nono a cikin mata masu haɗari.[138] Amfani da cutarwa ga 5-alpha-reductase inhibitor kamar finasteride bai bayyana ba.[139] Karancin bitamin ba ya bayyana yana da tasiri wajen hana ciwon daji[140]. Yayin da ƙananan matakan bitamin D ke da alaƙa da haɓakar ciwon daji, [141] [142] [143] ko wannan dangantakar tana da dalili kuma ƙarin bitamin D yana da kariya ba a ƙayyade ba.[144][145]. Ɗaya daga cikin bita na 2014 ya gano cewa kari ba shi da wani tasiri mai mahimmanci akan hadarin ciwon daji.[145] Wani bita na 2014 ya kammala cewa bitamin D3 na iya rage hadarin mutuwa daga ciwon daji (kananan mutuwa a cikin mutane 150 da aka yi wa magani sama da shekaru 5), amma an lura da damuwa game da ingancin bayanan.[146] Beta-carotene yana kara yawan ciwon daji na huhu a cikin wadanda ke da haɗari.[147] Kariyar folic acid ba ta da tasiri wajen hana ciwon daji na hanji kuma yana iya ƙara yawan polyps.[148] Ba a nuna ƙarin sinadarin selenium don rage haɗarin cutar kansa ba.[149]

Allurar Rigakafi

An samar da alluran rigakafin da ke hana kamuwa da wasu kwayoyin cuta na carcinogenic.[150] Alurar rigakafin cutar papilloma na dan adam (Gardasil da Cervarix) suna rage haɗarin kamuwa da cutar kansar mahaifa.[150] Alurar rigakafin ciwon hanta na B na hana kamuwa da cutar hanta da kuma haka yana rage haɗarin ciwon hanta.[150] Ana ba da shawarar gudanar da rigakafin cutar papillomavirus da rigakafin hanta B a inda albarkatu suka ba da izini.

Nunawa

Nunawa Babban labarin: Binciken cutar daji Ba kamar yunƙurin gano cutar da alamu da alamun likita ke haifar da shi ba, gwajin cutar kansa ya haɗa da ƙoƙarin gano kansa bayan ya taso, amma kafin bayyanar cututtuka da ake iya gani.[152] Wannan yana iya haɗawa da gwajin jiki, gwajin jini ko fitsari ko hoton likita.[152] Ba a samun gwajin cutar kansa don nau'ikan ciwon daji da yawa. Ko da gwaje-gwajen suna samuwa, kila ba za a ba su shawarar ga kowa ba. Nunawa ta duniya ko tantanin jama'a ya ƙunshi tantance kowa.[153] Zaɓen tantancewa yana gano mutanen da ke cikin hadari mafi girma, kamar mutanen da ke da tarihin iyali.[153] An yi la'akari da abubuwa da yawa don tantance ko fa'idar tantancewar ta zarce kasada da kuma tsadar aikin tantancewar[152]. Wadannan abubuwan sun haɗa da: Lalacewar da za a iya samu daga gwajin nunawa: alal misali, Hotunan X-ray sun haɗa da fallasa zuwa radiation ionizing mai illa. Yiwuwar gwajin gano cutar kansa daidai Yiwuwar ciwon daji ya kasance: Binciken ba ya da amfani ga ciwon daji da ba kasafai ba. Matsalolin da za a iya samu daga hanyoyin biyo baya Ko akwai maganin da ya dace Ko ganowa da wuri yana inganta sakamakon jiyya Ko ciwon daji zai taɓa buƙatar magani Ko gwajin ya kasance karbuwa ga mutane: Idan gwajin gwajin ya yi nauyi (misali, mai tsananin zafi), to mutane za su ki shiga.[153]

Farashin Shawarwari

Rundunar Tsaro ta Amurka gungiyar kwararru ta Amurka (USPSTF) ta ba da shawarwari ga cututtuka daban-daban: Yana ba da shawarar auna cutar kansar mahaifa ga mata masu jima'i kuma suna da mahaifa aqalla har zuwa shekaru 65.[154]. Ya ba da shawarar cewa a yi wa Amirkawa gwajin cutar kansar launin fata ta hanyar gwajin jini na facal, sigmoidoscopy, ko colonoscopy farawa daga shekara 50 har zuwa shekara 75.[155]. Shaidu ba su isa ba don bayar da shawarar don ko hana gwajin cutar kansar fata, [156] ciwon daji na baka, [157] kansar huhu, [158] ko ciwon gurguwar prostate a cikin maza a karkashin 75.[159]. Ba a ba da shawarar yin gwaje-gwaje na yau da kullun don ciwon daji na mafitsara, [160] kansar testicular, [161] cancer ovarian, [162] cancer pancreatic, [163] ko prostate cancer.[164] Yana ba da shawarar mammography don gwajin cutar kansar nono kowane shekara biyu daga shekaru 50-74, amma baya ba da shawarar ko dai a yi gwajin nono ko gwajin nono na asibiti.[165] Wani bita na Cochrane na 2013 ya kammala cewa gwajin cutar kansar nono ta hanyar mammography ba shi da wani tasiri wajen rage mace-mace saboda yawan bincike-bincike da wuce gona da iri.

Gwajin Kwayar Halitta

Gene	Cancer types
BRCA1, BRCA2	Breast, ovarian, pancreatic
HNPCC, MLH1, MSH2, MSH6, PMS1, PMS2	Colon, uterine, small bowel, stomach, urinary tract

Gwajin kwayoyin halitta Duba kuma: Ciwon daji Nau'in Ciwon Kansa BRCA1, BRCA2 Nono, kwai, pancreatic HNPCC, MLH1, MSH2, MSH6, PMS1, PMS2 Colon, uterine, kananan hanji, ciki, urinary fili gungiyoyin da ba na hukuma ba suna ba da shawarar gwajin kwayoyin halitta ga mutane masu hadari na wasu cututtuka. Masu dauke da waɗannan maye gurbi na iya yin ingantacciyar sa ido, maganin rigakafi, ko tiyata don rage hadarinsu na gaba.^[29]^[30] ^[30]

Gudanarwa

Gudanarwa: Gudanar da ciwon daji da ciwon daji Akwai zabubbukan magani da yawa don ciwon daji. Na farko sun hada da tiyata, chemotherapy, radiation far, hormonal far, niyya far da palliative kula. Wadanne magunguna ne ake amfani da su ya dogara da nau'in, wuri da matakin ciwon daji da kuma lafiyar majiyyaci da abubuwan da ake so. Manufar magani na iya ko ba ta zama magani ba.

Chemotherapy

Chemotherapy Chemotherapy shine maganin ciwon daji tare da daya ko fiye cytotoxic anti-neoplastic kwayoyi (chemotherapeutic agents) a matsayin wani bangare na daidaitaccen tsari. Kalmar ta kunshi magunguna iri-iri, waɗanda aka raba su zuwa manyan nau'ikan kamar su alkylating agents da antimetabolites.[168] Magungunan chemotherapeutic na al'ada suna yin aiki ta hanyar kashe ƙwayoyin sel waɗanda ke rarraba cikin sauri, wani abu mai mahimmanci na yawancin kwayoyin kansa. An gano cewa samar da magungunan cytotoxic a hade ya fi magani guda; wani tsari da ake kira haɗin kai; wanda ke da fa'ida a cikin kididdigar rayuwa da martani ga ciwace-ciwacen daji da ci gaban cutar.[169] Wani bita na Cochrane ya kammala cewa hadin gwiwa ya fi tasiri don magance ciwon daji na nono. Koyaya, gabaɗaya ba tabbas ko haɗin chemotherapy yana haifar da ingantacciyar sakamako na lafiya, lokacin da aka yi la'akari da rayuwa da guba.[170] Maganin da aka yi niyya wani nau'i ne na chemotherapy wanda ke kaiwa takamaiman bambance-bambancen kwayoyin halitta tsakanin ciwon daji da kwayoyin al'ada. Magungunan da aka yi niyya na farko sun toshe kwayar mai karkar isrogen, yana hana ci gaban ciwon nono. Wani misali na yau da kullun shine nau'in inhibitors na Bcr-Abl, wadanda ake amfani da su don magance cutar sankarar bargo ta myelogenous (CML).[4] A halin yanzu, maganin da aka yi niyya ya wanzu ga yawancin nau'ikan ciwon daji na yau da kullun, gami da ciwon daji na mafitsara, kansar nono, kansar colorectal, ciwon koda, cutar sankarar bargo, kansar hanta, kansar huhu, lymphoma, kansar pancreatic, kansar prostate, kansar fata, da kansar thyroid kamar da sauran nau’in ciwon daji[171]. Amfanin chemotherapy ya dogara da nau'in ciwon daji da mataki. A hade tare da tiyata, chemotherapy ya tabbatar da amfani a cikin nau'in ciwon daji da suka hada da kansar nono, ciwon daji, ciwon daji na pancreatic, sarcoma osteogenic, ciwon daji na testicular, ciwon daji na ovarian da wasu cututtuka na huhu.[172]. Chemotherapy yana warkar da wasu cututtukan daji, kamar wasu cutar sankarar bargo, [173] [174] marasa tasiri a wasu ciwace-ciwacen kwakwalwa, [175] da rashin buqata a wasu, kamar yawancin cututtukan fata marasa melanoma.[176]. Amfanin chemotherapy sau da yawa yana iyakance ta hanyar guba zuwa wasu kyallen takarda a cikin jiki. Ko da chemotherapy bai ba da magani na dindindin ba, yana iya zama da amfani don rage alamun cututtuka kamar zafi ko rage girman kwayar kwayar cuta da ba ta iya aiki a cikin bege cewa tiyata zai yiwu a nan gaba.

Radiotion

Radiation Jiyya na radiation ya kunshi amfani da ionizing radiation a kokarin ko dai magani ko inganta alamun cututtuka. Yana aiki ta hanyar lalata DNA na nama mai ciwon daji, yana kashe shi. Don adana kyallen takarda na al'ada (kamar fata ko gabobin, wanda radiation dole ne ya wuce ta don magance ciwon daji), nau'ikan radiyo masu siffa suna nufin daga kusurwoyi masu yawa don shiga tsakani a cikin kwayar cuta, suna samar da kashi mafi girma a can fiye da kewaye, nama mai lafiya. . Kamar yadda yake tare da chemotherapy, ciwon daji ya bambanta a cikin martanin su ga maganin radiation.[177][178][179] Ana amfani da maganin radiation a kusan rabin lokuta. Radiation na iya zama ko dai daga tushen ciki (brachytherapy) ko waje na waje. Radiyon shine mafi yawan haskoki na X-ray marasa karfi don magance ciwon daji na fata, yayin da ake amfani da hasken X-ray mai karfi don ciwon daji a cikin jiki.[180] Radiation yawanci ana amfani dashi ban da tiyata da ko chemotherapy. Ga wasu nau'ikan ciwon daji, kamar kansar farkon kai da wuyansa, ana iya amfani da shi kadai[181]. Don kashin kashi mai radadi, an gano yana da tasiri a kusan kashi 70% na marasa lafiya.[181]

Tiyata

Tiyata ita ce hanyar farko ta jiyya ga mafi yawan kebantacce, kwararrun cututtukan daji kuma maiyuwa suna taka rawa wajen daidaitawa da tsawaita rayuwa. Yawanci wani muhimmin sashi ne na tabbataccen ganewar asali da matakan ciwace-ciwacen daji, kamar yadda ake bukatar biopsies yawanci. A cikin ciwon daji na gida, tiyata yawanci yana kokari ya cire gaba daya taro tare da, a wasu lokuta, kwayoyin lymph a yankin. Ga wasu nau'ikan ciwon daji wannan ya isa ya kawar da cutar kansa[172].

Kulawar Jin Dadi

Kulawar jin dadi Kulawa da jin dadi magani ne wanda ke kokarin taimaka wa majiyyaci jin daɗi kuma ana iya hada shi tare da kokarin magance cutar kansa. Kulawa da jin dadi ya hada da aiki don rage damuwa ta jiki, tunani, ruhi da damuwa na zamantakewa. Ba kamar jiyya da ke nufin kashe kwayoyin cutar kansa kai tsaye ba, babban burin kula da jin dadi shine haɓaka ingancin rayuwa. Mutane a kowane mataki na maganin ciwon daji yawanci suna samun wani nau'i na kulawa. A wasu lokuta, gungiyoyin kwararrun likita suna ba da shawarar cewa marasa lafiya da likitoci su amsa cutar kansa kawai tare da kulawar jin dadi.[182] Wannan ya shafi marasa lafiya wadanda: [183] suna nuna karancin aiki, yana nuna iyakacin ikon kula da kansu[182]

1. bai sami fa'ida daga jiyya na tushen shaida ba

2. ba su cancanci shiga kowane gwaji na asibiti da ya dace ba

3. babu wata kwakkwarar hujja da ke nuna cewa magani zai yi tasiri.

Kulawar jin dadi na iya rikicewa tare da asibiti don haka ana nunawa ne kawai lokacin da mutane suka kusanci karshen rayuwa. Kamar kulawar asibiti, kulawar jinya yana ƙoƙarin taimaka wa majiyyaci su jimre da buƙatun su na gaggawa kuma don haɓaka ta'aziyya. Ba kamar kulawar asibiti ba, kulawar kwantar da hankali baya bukatar mutane su daina jiyya da ke nufin cutar kansa. Jagororin kiwon lafiya na ƙasa da yawa sun ba da shawarar kulawa da wuri na gaggawa ga marasa lafiya wadanda ciwon daji ke haifar da alamun damuwa ko waɗanda ke buƙatar taimako don jure rashin lafiyarsu. A cikin marasa lafiya da aka fara gano cutar ta metastatic, ana iya ba da kulawa ta gaggawa nan da nan. Ana nuna kulawar jin daɗi ga marasa lafiya waɗanda ke da tsinkayar ƙasa da watanni 12 na rayuwa har ma an ba su magani mai tsauri.

Immunotherapy

Ciwon daji immunotherapy An fara amfani da nau'o'in hanyoyin kwantar da hankali ta hanyar amfani da immunotherapy, karfafawa ko taimakawa tsarin rigakafi don yaki da ciwon daji, tun daga 1997. Hanyoyi sun haɗa da kwayoyin rigakafi, maganin bincike, da kuma canja wurin kwayar halitta.[187].

Maganin Laser

Maganin Laser: Laser a cikin maganin kansa Laser farfesa Laser yana amfani da haske mai karfi don magance ciwon daji ta raguwa ko lalata ciwace-ciwacen daji ko ci gaba mai saurin kamuwa. An fi amfani da Laser don magance ciwon daji na sama wanda ke saman jiki ko kuma murfin gabobin ciki. Ana amfani da shi don magance ciwon daji na fata na basal cell da farkon matakan wasu kamar su mahaifa, azzakari, farji, vulvar, da kuma ciwon huhu mara karami. Sau da yawa ana haɗa shi tare da wasu jiyya, kamar tiyata, chemotherapy, ko radiation far. Laser-induced interstitial thermotherapy (LITT), ko interstitial Laser photocoagulation, yana amfani da Laser don magance wasu cututtuka ta hanyar amfani da hyperthermia, wanda ke amfani da zafi don rage ciwace-ciwacen kwayoyi ta hanyar lalacewa ko kashe kwayoyin cutar kansa. Laser sun fi dacewa fiye da tiyata kuma suna haifar da karancin lalacewa, zafi, zubar jini, kumburi, da tabo. Rashin lahani shine dole ne likitocin fida su sami horo na musamman. Yana iya zama mafi tsada fiye da sauran magunguna[188].

Madadin Magunguna

Madadin Magungunan karfafawa da madadin maganin cutar kansa rukuni ne daban-daban na jiyya, ayyuka da samfurori waɗanda ba sa cikin magungunan al'ada.[189] “Maganin Ƙarfafawa” yana nufin hanyoyi da abubuwan da ake amfani da su tare da magungunan gargajiya, yayin da “maganin madadin” yana nufin mahadi da ake amfani da su maimakon magungunan gargajiya[190]. Yawancin magungunan da ke da alaqa da ciwon daji ba a yi nazari ko gwada su ta amfani da dabaru na al'ada kamar gwajin asibiti ba. An bincika wasu madadin jiyya kuma an nuna ba su da tasiri amma har yanzu ana ci gaba da tallata su da hadakawa. Wani mai bincike kan cutar daji Andrew J. Vickers ya bayyana cewa, "Lakabin 'wanda ba a tabbatar da shi ba' bai dace da irin waɗannan hanyoyin kwantar da hankali ba; lokaci ya yi da za a tabbatar da cewa yawancin hanyoyin maganin ciwon daji an 'bata'.

Hasashen Dubi

Hasashen Dubi kuma: Yawan tsira da cutar daji, Jerin adadin mace-macen cutar kansa a Amurka, da masu tsira da ciwon daji Matakai uku na mace-macen cutar kansa ta duniya daga 1990 zuwa 2017[192] Yawan tsira ya bambanta da nau'in ciwon daji da kuma matakin da aka gano shi, kama daga rayuwa mai yawa zuwa cikar mace-mace shekaru biyar bayan ganewar asali. Da zarar ciwon daji ya sami metastasized, tsinkaya yakan zama mafi muni. Kimanin rabin marasa lafiya da ke samun maganin ciwon daji (ban da carcinoma a wuri da kuma ciwon daji na fata wanda ba melanoma ba) suna mutuwa daga wannan ciwon daji ko maganinsa.[23] Mafi yawan mutuwar ciwon daji na faruwa ne saboda ƙazamin kwayar cuta ta farko.[193] Rayuwa ya fi muni a kasashe masu tasowa, [23] wani bangare saboda nau'in ciwon daji da aka fi sani a can yana da wuyar magani fiye da wadanda ke da alaƙa da ƙasashen da suka ci gaba.[194] Wadanda suka tsira daga cutar kansa suna kamuwa da kansar farko na biyu da kusan ninki biyu na wadanda ba a gano su ba.[195] An yi imanin cewa haɓakar hadarin ya kasance saboda bazuwar damar haɓaka kowane ciwon daji, yuwuwar tsira daga cutar kansa ta farko, abubuwan haɗari iri ɗaya waɗanda suka haifar da cutar kansa ta farko, illolin da ba'a so na magance cutar kansa ta farko (musamman magungunan radiation), da kuma mafi kyawun yarda da nunawa.[195]. Hasashen tsira na ɗan gajeren lokaci ko na dogon lokaci ya dogara da abubuwa da yawa. Mafi mahimmanci sune nau'in ciwon daji da shekarun majiyyaci da lafiyar jiki gaba daya. Wadanda ke da rauni tare da wasu matsalolin kiwon lafiya suna da karancin rayuwa fiye da sauran mutane masu lafiya. Ba zai yi yuwuwa masu shekaru dari ba su rayu har tsawon shekaru biyar ko da an sami nasarar jiyya. Mutanen da suka ba da rahoton ingancin rayuwa suna dade da rayuwa.[196] Mutanen da ke da karancin ingancin rayuwa na iya shafar bakin ciki da sauran rikice-rikice da / ko ci gaban cuta waɗanda duka biyun suna lalata inganci da adadin rayuwa. Bugu da ƙari, marasa lafiya da ke da mummunan tsinkaya na iya zama cikin bakin ciki ko kuma ba da rahoton rashin ingancin rayuwa saboda sun fahimci cewa yanayin su na iya zama m. Mutanen da ke fama da ciwon daji suna da haɗarin toshewar jini a cikin jijiyoyinsu wanda zai iya yin barazana ga rayuwa.[197] Yin amfani da magungunan kashe jini irin su heparin yana rage hadarin daskarewar jini amma ba a nuna cewa yana ƙara rayuwa ga masu ciwon daji ba.[197] Mutanen da ke shan magungunan kashe jini su ma suna da hadarin zubar jini.[197] Ko da yake yana da wuyar gaske, wasu nau'ikan ciwon daji, ko da daga matakin ci gaba, na iya warkewa nan da nan. Wannan al’amari ana kiransa da gafara ba tare da bata lokaci ba.[198].

Epidemiology

Epidemiology: Ilimin cututtukan daji na cutar kansa Duba kuma: Jerin kasashe ta adadin kansa Duba ko gyara bayanan tushe. Adadin mace-mace masu shekaru daga cutar kansa a cikin mutane 10,000.[199] An kiyasta cewa a cikin 2018, mutane miliyan 18.1 sun kamu da cutar kansa da kuma mutuwar mutane miliyan 9.6 a duniya.[200] Kimanin kashi 20% na maza da 17% na mata za su kamu da cutar kansa a wani lokaci yayin da kashi 13% na maza da kashi 9% na mata za su mutu daga gare ta.[200] A cikin 2008, an gano kimanin mutane miliyan 12.7 na ciwon daji (ban da ciwon daji na fata da ba na melanoma ba da sauran cututtukan da ba sa cutarwa) [23] kuma a cikin 2010 kusan mutane miliyan 7.98 sun mutu.[201]. Ciwon daji na kusan kashi 16% na mace-mace. Mafi yawan kamar na 2018 sune ciwon huhu (mutuwar miliyan 1.76), ciwon daji na launi (860,000) ciwon ciki (780,000), ciwon hanta (780,000), da ciwon nono (620,000).[2]. Wannan ya sanya cutar sankara ta zama babban sanadin mutuwar mutane a kasashen da suka ci gaba kuma na biyu a cikin kasashe masu tasowa.[23] Fiye da rabin lokuta suna faruwa a duniya masu tasowa.[23] Mutuwar cutar kansa ya kai miliyan 5.8 a 1990.[201] Mutuwar tana karuwa da farko saboda tsawon rayuwa da canje-canjen salon rayuwa a cikin kasashe masu tasowa[23]. Babban haɗarin kamuwa da cutar kansa shine shekaru.[202] Ko da yake yana yiwuwa ciwon daji ya buge kowane shekaru, yawancin masu fama da ciwon daji sun haura 65.[202] A cewar Robert A. Weinberg, mai binciken ciwon daji, "Idan mun rayu tsawon lokaci, ba dade ko ba dade dukanmu za mu kamu da ciwon daji." tsawon rayuwa[205] da canje-canje masu alaƙa da shekaru a cikin tsarin endocrine.[206] Tasirin tsufa akan kansa yana da rikitarwa ta hanyar abubuwa kamar lalacewar DNA da kumburi da ke inganta shi da abubuwan kamar tsufa na jijiyoyin jini da canje-canjen endocrin da ke hana shi.[207]. Wasu cututtukan daji masu saurin girma suna da yawa musamman, amma galibi ba sa mutuwa. Nazarin autopsy a Turai da Asiya ya nuna cewa kusan kashi 36 cikin 100 na mutane ba a gano su ba kuma a fili ba su da cutar kansar thyroid a lokacin mutuwarsu kuma kashi 80% na maza suna kamuwa da kansar prostate ta hanyar shekaru 80.[208][209]. Kamar yadda wadannan cututtukan daji ba su haifar da mutuwar majiyyaci ba, gano su da zai wakilci cutar fiye da kima maimakon kulawar likita. Ciwon daji guda uku da aka fi sani da yara sune cutar sankarar bargo (34%), ciwan kwakwalwa (23%) da lymphomas (12%).[210]. A Amurka ciwon daji yana shafar kusan 1 cikin yara 285.[211] Adadin ciwon daji na yara ya karu da kashi 0.6% a kowace shekara tsakanin 1975 zuwa 2002 a Amurka[212] da 1.1% a kowace shekara tsakanin 1978 da 1997 a Turai.[210] Mutuwar cutar kansar yara ta ragu da rabi tsakanin 1975 da 2010 a Amurka.[211]

Tarihi

Tarihi: Tarihin ciwon daji Yin zane tare da ra'ayoyi guda biyu na wata mace ta Holland wadda aka cire mata ciwon daji daga wuyanta a 1689 Ciwon daji ya wanzu ga dukan tarihin ɗan adam.[213]. Rubuce-rubuce na farko game da cutar kansa daga kusan 1600 BC a cikin littafin Edwin Smith Papyrus na Masar kuma ya bayyana kansar nono.[213] Hippocrates (c. 460 BC - c. 370 BC) ya bayyana nau'ikan ciwon daji da yawa, yana nufin su da kalmar Helenanci καρκίνος karkinos (kaguwa ko crayfish).[213]. Wannan suna ya zo ne daga bayyanar da aka yanke na wani kakkauran ciwon daji, tare da “jiyoyin da suka miqe ta kowane bangare kamar yadda dabbar kaguwa ke da kafafunta, daga nan ne aka samo sunanta”[214]. Galen ya bayyana cewa "ana kiran ciwon daji na nono ne saboda kamannin kamanni da kaguwa da aka yi ta hanyar tsawaitawar ciwace-ciwacen daji da jijiyoyin da ke kusa da su".[215]: 738 Celsus (c. 25 BC – 50 AD) da aka fassara. karkinos zuwa cikin Latin kansa, kuma yana nufin kaguwa da shawarar tiyata a matsayin magani.[213]. Galen (karni na biyu AD) bai yarda da yin amfani da tiyata ba kuma ya ba da shawarar abin da ake amfani da shi a maimakon haka[213]. Wadannan shawarwarin sun tsaya tsayin daka tsawon shekaru 1000.[213] A karni na 15, 16, da 17, ya zama karbuwa ga likitoci su rarraba gawarwaki don gano musabbabin mutuwar.[216] Farfesan nan dan kasar Jamus Wilhelm Fabry ya yi imanin cewa ciwon nono na faruwa ne sakamakon wani gudanwar madara a cikin bututun mama. Farfesa dan kasar Holland Francois de la Boe Sylvius, mabiyin Descartes, ya yi imanin cewa dukkanin cututtuka sune sakamakon hanyoyin sinadarai kuma ruwan lemun tsami na acidic shine dalilin ciwon daji. Nicolaes Tulp na zamaninsa ya yi imanin cewa ciwon daji guba ne da ke yaduwa a hankali kuma ya kammala cewa yana yaduwa.[217] Likitan John Hill ya bayyana shakar taba a matsayin sanadin cutar kansar hanci a shekarar 1761.[216] Wannan ya biyo bayan rahoton a shekara ta 1775 na wani likitan fida dan kasar Biritaniya Percivall Pott cewa chimney yana shafan cutar sankarau, ciwon daji na kwankwasa, cuta ce da ta zama ruwan dare tsakanin sharar bututun hayaƙi.[218]. Tare da yaduwar amfani da na'urar hangen nesa a cikin karni na 18, an gano cewa 'dafin ciwon daji' ya yadu daga ƙwayar cuta ta farko ta cikin ƙwayoyin lymph zuwa wasu shafuka ("metastasis"). Wani likitan fiɗa na Ingila Campbell De Morgan ne ya fara tsara wannan ra'ayi na cutar tsakanin 1871 da 1874.

Al'umma Da Al'adu

Al'umma da al'adu Duk da cewa cututtuka da yawa (kamar gazawar zuciya) na iya samun hasashen mafi muni fiye da mafi yawan lokuta na ciwon daji, ciwon daji shine batun tsoro da fargaba. Har ila yau ana amfani da lafazin “kananan rashin lafiya” na bayyana ciwon daji da ke haifar da mutuwa a cikin tarihin mutuwa, maimakon sanya sunan cutar a sarari, yana nuna wani abin kunya da ya bayyana.[220] Har ila yau, ciwon daji ana kiransa "kalmar C";[221] [222] [223] Macmillan Cancer Support yana amfani da kalmar don kokarin rage tsoro game da cutar.[224]. A Najeriya, wani sunan gida na kansa da ake fassarawa zuwa Turanci zuwa “cutar da ba za a iya warkewa ba”[225]. Wannan imani mai zurfi cewa ciwon daji dole ne mai wuyar gaske kuma yawanci cuta mai kisa yana nunawa a cikin tsarin da al'umma suka zaba don tattara kididdigar ciwon daji: mafi yawan nau'in ciwon daji-wanda ba melanoma ba, yana lissafin kusan kashi daya bisa uku na cututtukan daji a duniya, amma kadan kaɗan ne ke mutuwa[226][227]—ba a kebe su daga kididdigar ciwon daji musamman saboda ana samun saukin bi da su kuma kusan koyaushe ana warkar da su, sau da yawa a cikin hanya ɗaya, gajeriyar hanya.[228]. Tunanin yammacin duniya game da haƙƙin marasa lafiya ga mutanen da ke fama da cutar kansa sun haɗa da alhakin bayyana cikakken yanayin lafiyar mutum, da hakkin shiga cikin yanke shawara tare ta hanyar mutunta kimar mutum. A wasu al'adu, an fi son sauran hakkoki da ƙima. Misali, yawancin al'adun Afirka suna daraja iyalai gaba daya maimakon dabi'a. A wasu sassa na Afirka, an fi sanin cutar da a makara ta yadda ba za a iya samun magani ba, kuma idan ana samun magani, za ta yi saurin ruguza iyali. A sakamakon wadannan dalilai, masu ba da kiwon lafiya na Afirka sukan bar 'yan uwa su yanke shawara ko, lokacin da kuma yadda za a bayyana cutar, kuma suna yin hakan sannu a hankali da da'ira, yayin da mutum ya nuna sha'awa da kuma ikon jure wa mummunan labari. [225] Mutane daga kasashen Asiya da Kudancin Amurka suma sun fi son a hankali, rashin gaskiya wajen bayyanawa fiye da yadda aka tsara a Amurka da Yammacin Turai, kuma sun yi imanin cewa wani lokaci zai fi kyau kada a ba da labarin cutar sankara.[225] ] Gabadaya, bayyana cutar ta ya fi yawa fiye da yadda ake yi a karni na 20, amma ba a ba da cikakken bayanin hasashen ba ga yawancin marasa lafiya a duniya.[225] A Amurka da wasu al'adu, ana daukar cutar kansa a matsayin cuta da dole ne a "yaki" don kawo karshen "tashe-tashen hankula"; An ayyana Yaƙi akan Ciwon daji a Amurka. Misalai na soja sun zama ruwan dare musamman a cikin kwatancin illolin cutar kansa, kuma suna jaddada yanayin lafiyar majiyyaci da kuma buƙatar ɗaukar matakan gaggawa da kansa maimakon jinkirtawa, yin watsi ko dogara gaba ɗaya ga wasu. Ƙididdigar soja kuma suna taimakawa wajen tantance tsattsauran ra'ayi, magunguna masu lalata.[229][230] A cikin 1970s, wani sanannen madadin maganin ciwon daji a Amurka wani nau'i ne na maganin magana na musamman, bisa ra'ayin cewa mummunan hali ne ke haifar da kansa.[231] Mutanen da ke da "ɗabi'ar ciwon daji"-masu bakin ciki, dannewa, ƙiyayya da kuma tsoron bayyana motsin zuciyar su-an yi imani da cewa sun bayyana kansa ta hanyar sha'awar tunani. Wasu masu ilimin halayyar dan adam sun ce maganin da zai canza tunanin majiyyaci game da rayuwa zai magance cutar kansa[231]. Daga cikin illolin, wannan imani ya baiwa al'umma damar zargin wanda aka azabtar da shi da ya haddasa cutar daji (ta hanyar "son" ta) ko hana maganinta (ta rashin zama cikakkiyar farin ciki, marar tsoro da ƙauna).[232]. Hakanan yana kara damuwa ga marasa lafiya, yayin da suka yi imani da kuskure cewa motsin rai na bakin ciki, fushi ko tsoro yana rage rayuwarsu.[232] Susan Sontag ta yi wa ra’ayin ba’a, wadda ta buga Illness as Metaphor yayin da take murmurewa daga maganin cutar kansar nono a 1978.[231]. Ko da yake ainihin ra'ayin yanzu gabaɗaya ana daukarsa azaman banza, ra'ayin wani kan pe

Tasirin Tattalin Arziki

Tasirin Tattalin Arziki Jimillar kashe kuɗin kula da lafiya kan cutar daji a Amurka an kiyasta ya kai dala biliyan 80.2 a shekarar 2015.[234] Ko da yake kashe kudin kula da lafiya da ke da alaqa ya karu da cikakkiyar ma'ana a cikin 'yan shekarun nan, rabon kuɗin kiwon lafiya da aka keɓe don maganin cutar kansa ya kasance kusa da 5% tsakanin 1960s da 2004.[235][236]. An yi irin wannan tsari a Turai inda kusan kashi 6% na duk abin da ake kashewa na kula da lafiya ana kashewa wajen maganin ciwon daji[237][238]. Baya ga kashe kuɗin kula da lafiya da guba na kudi, ciwon daji yana haifar da farashi kai tsaye ta hanyar asarar yawan aiki saboda kwanakin rashin lafiya, rashin karfi na dindindin da nakasa gami da mutuwa da wuri a lokacin aiki. Ciwon daji yana haifar da farashi don kulawa na yau da kullun. Farashin kai tsaye da kuma farashin kulawa na yau da kullun ana kiyasta zai wuce ko daidai da kudin kula da lafiya na kansa.[239][238]

Wurin Aiki

an hada ciwon daji a matsayin yanayin kariya ta Hukumar Daidaita Ayyukan Aiki (EEOC), musamman saboda yuwuwar cutar kansa da ke da tasirin wariya ga ma'aikata.[240] Wariya a wurin aiki na iya faruwa idan mai aiki ya yi imanin karya cewa mai ciwon daji ba zai iya yin aiki yadda ya kamata ba, kuma yana iya neman ƙarin izinin rashin lafiya fiye da sauran ma'aikata. Har ila yau, masu ɗaukan ma'aikata na iya yin yanke shawara na haya ko kora bisa rashin fahimta game da nakasa ciwon daji, idan akwai. EEOC yana ba da jagororin tambayoyi ga masu daukar aiki, da kuma jerin abubuwan da za a iya magance su don tantancewa da saukar ma'aikatan da ke fama da cutar kansa.[240]

Bincike

Bincike: Jami'ar Binciken Ciwon daji na Asibitin Cancer na Florida Domin ciwon daji rukuni ne na cututtuka, [241][242] da wuya a sami "maganin ciwon daji" fiye da yadda za a sami magani guda daya don dukkan cututtuka masu yaduwa.[243] An tada tunanin masu hana Angiogenesis ba daidai ba suna da yuwuwar a matsayin maganin "harsashi na azurfa" da ke dacewa da nau'ikan ciwon daji da yawa.[244] Ana amfani da masu hana Angiogenesis da sauran magungunan ciwon daji a hade don rage cutar kansa da mace-mace.[245]. Ana nazarin magungunan ciwon daji na gwaji a cikin gwaje-gwajen asibiti don kwatanta maganin da aka tsara zuwa mafi kyawun magani. Ana iya gwada magungunan da suka yi nasara a nau'in ciwon daji guda ɗaya da sauran nau'ikan.[246] Ana gudanar da gwaje-gwajen bincike don inganta ingantattun hanyoyin kwantar da hankali ga majiyyatan da suka dace, dangane da ilimin halittarsu daya[247]. Binciken ciwon daji yana mai da hankali kan batutuwa masu zuwa: Ma'aikata (misali kwayoyin cuta) da abubuwan da suka faru (misali maye gurbi) wadanda ke haifar ko saukake canje-canjen kwayoyin halitta a cikin ƙwayoyin da aka kaddara su zama ciwon daji. Madaidaicin yanayin lalacewar kwayoyin halitta da kwayoyin halittar da ya shafa. Sakamakon wadancan canje-canjen kwayoyin halitta akan ilimin halitta na tantanin halitta, duka a cikin samar da ma'anar kaddarorin kwayar cutar kansa da kuma saukake ƙarin abubuwan da ke haifar da ci gaban cutar kansa. Ingantacciyar fahimtar ilmin kwayoyin halitta da ilmin halitta saboda binciken cutar kansa ya haifar da sabbin hanyoyin magance cutar kansa tun lokacin da shugaban Amurka Richard Nixon ya ayyana "Yakin Ciwon daji" a 1971. Tun daga wannan lokacin, kasar ta kashe sama da dala biliyan 200 kan binciken cutar kansa, ciki har da albarkatu daga sassa na gwamnati da masu zaman kansu[248]. Adadin mutuwar ciwon daji (daidaita girman da shekarun yawan jama'a) ya ragu da kashi biyar tsakanin 1950 zuwa 2005.[249] Gasar don albarkatun kudi da alama ta danne kirkira, hadin gwiwa, hadarin hadari da tunanin asali da ake bukata don yin bincike na asali, ba tare da kin yarda da bincike mai karancin hadari cikin kananan hadaka havakawa sama da hadari, karin ingantaccen bincike. Sauran sakamakon gasa da alama karatu ne da yawa tare da ikirari masu ban mamaki waɗanda ba za a iya maimaita sakamakon su ba da kuma karkatattun abubuwan karfafawa wadanda ke karfafa cibiyoyin bayar da tallafi don hadaka ba tare da yin isassun jari a cikin ikonsu da wuraren aikinsu ba.[250][251][252][253] Virotherapy, wanda ke amfani da ƙwayoyin cuta, ana nazarin. Sakamakon cutar ta COVID-19, an sami damuwa cewa bincike da jiyya na cutar daji suna raguwa.[254][255]

Juna Biyu

Ciwon daji na Ciwon daji yana shafar kusan 1 cikin 1,000 mata masu juna biyu. Mafi yawan ciwon daji da ake samu a lokacin daukar ciki iri daya ne da na ciwon daji da ake samu a cikin mata marasa ciki a lokacin haihuwa: kansar nono, kansar mahaifa, cutar sankarar mahaifa, lymphoma, melanoma, kansar kwai da kuma ciwon daji[256]. Gano sabon ciwon daji a cikin mace mai ciki yana da wahala, a wani bangare saboda duk wani alamun da aka saba dauka a matsayin rashin jin daɗi na yau da kullun da ke da alaqa da ciki. A sakamakon haka, ciwon daji yawanci ana gano shi a wani dan lokaci kadan fiye da matsakaici. Wasu hanyoyin hoto, irin su MRIs (hoton maganadisu na maganadisu), CT scans, duban dan tayi da mammograms tare da garkuwar tayin ana daukar lafiya yayin daukar ciki; wasu kamar su PET scans, ba su kasance ba.[256] Magani gabaɗaya iri daya ne da na mata marasa ciki. Duk da haka, ana guje wa radiation da magungunan rediyo yayin daukar ciki, musamman idan adadin tayin zai iya wuce 100 cGy. A wasu lokuta, ana jinkirta wasu ko duka jiyya har sai bayan haihuwa idan an gano ciwon daji a karshen ciki. Ana amfani da bayarwa da wuri don ciyar da farkon jiyya. Tiyata gabadaya ba ta da lafiya, amma tiyatar kashin gugu a farkon watanni uku na iya haifar da zubar da ciki. Wasu jiyya, musamman wasu magungunan chemotherapy da aka bayar yayin datsa na farko

Sauran Dabbobi

Likitan dabbobi, wanda ya fi maida hankali kan kuliyoyi da karnuka, kwarewa ce mai girma a cikin kasashe masu arziki kuma ana iya ba da manyan nau'ikan jiyya na dan adam kamar tiyata da rediyo. Mafi yawan nau'ikan ciwon daji sun bambanta, amma nauyin kansar yana da alama aqalla yana da girma a cikin dabbobi kamar na mutane. Dabbobi, yawanci rodents, galibi ana amfani da su wajen bincike kan cutar kansa kuma nazarin cututtukan daji a cikin manyan dabbobi na iya amfanar bincike kan kansar ɗan adam.[257] A cikin wadanda ba mutane ba, an bayyana wasu nau'o'in ciwon daji masu yaduwa, inda ciwon daji ke yaduwa tsakanin dabbobi ta hanyar watsa kwayoyin ciwon daji da kansu. Ana ganin wannan al'amari a cikin karnuka masu ciwon sarcoma na Sticker (wanda kuma aka sani da canine transmissible venereal tumor), da kuma shaidanun Tasmania masu fama da ciwon fuska na shaidan (DFTD).

Manazarta

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↑ ^16.0 ^16.1 ^16.2 Holland Chp. 1
↑ "What is Metastasized Cancer?". National Comprehensive Cancer Network. Archived from the original on 7 July 2013. Retrieved 18 July 2013.
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↑ http://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet#q3
↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388903
↑ "Kwafin ajiya". Archived from the original on 2013-08-02. Retrieved 2022-02-07.
↑ https://en.wikipedia.org/wiki/American_Cancer_Society
↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464778
↑ https://doi.org/10.3322%2Fcaac.20140
↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252065
↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464778
↑ https://web.archive.org/web/20170712114430/http://www.searo.who.int/publications/bookstore/documents/9283204298/en/
↑ https://doi.org/10.1146%2Fannurev-cancerbio-030419-033612
↑ Cite error: Invalid <ref> tag; no text was provided for refs named pmid24176569
↑ ^30.0 ^30.1 Gulati AP, Domchek SM (January 2008). "The clinical management of BRCA1 and BRCA2 mutation carriers". Current Oncology Reports. 10 (1): 47–53. doi:10.1007/s11912-008-0008-9. PMID 18366960. S2CID 29630942.
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