C) mot so vung tren the giai, ung thu thirc quan la mot benh tuang d6i ph6 biSn, nhimg tai My, ung thu thuc quan
Tien liet tuyen la gi?
Tien liet tuygn la mot ca quan nam a bung duai hay c6 bang quang. La tuyen bao quanh doan dau cua nieu dao. Nieu dao dan nuac tieu t u bang quang ra den dau duang vat. Mot chuc nang ciia tien liet tuyen la giiip kiem soat nuac tieu bang each tao ap lire true tiep doi vai ph^n nieu dao ma tien liet tuyen bao quanh. Mot chuc nang khac eua tien liet tuyen la san xuat mot so chat c6 trong tinh djch nhu muoi khoang va duofng. Tinh dich la chat dich c6 chua tinh triing. Tuy nhien tinh djch con dugc san xuat khong phai hoan toan tir tien liet tuyen.(xem phan phau thuat dieu tri ung thu tien liet tuyen).
C) nam giai con tre, kich thuac ti^n liet t u y i n bang nhu qua 6c cho. Tuy nhien tien liet tuyen Ian len theo tuoi. Tien liet t u y i n to len theo tuoi dugc goi la phi dgi tien liet tuyen lanh tinh, benh nay khong phai la ung thu ukn liet tuyln.Ca hai win 6Q phi dai lanh tinh (hay goi la u xa) tien liet t u y i n va ung thu ti^n liet tuy§n c6 t h i la cung nguyen nhan cua
ykn d6 a nguai dan ong Ian tuoi. Chang han tien liet tuyen Ian CO t h i gay chen ep hay gay anh huang den cho thoat nuac t i l u cua bang quang hay nieu dao, gay t i l u kho. Ket qua la t i l u lau, lat nhat, tieu phai ran, tieu nhieu Ian, dac biet ve ban dem hay di tieu.
Ung thir tien liet tuyen la gi?
Ung thu tihn liet tuySn la khoi u ac tinh phat tri6n tir t6 bao cua ti6n liet tuy6n. Kh6i u thuang phat t r i l n cham va keo dai trong nhiku nam. Trong suot thai gian nay, khoi u thuang CO rat it hoac khong c6 trieu chung hoac c6 hiku
hien trieu chung ( b i t thuang khi kham benh).
Tuy nhien, khi ung thu t i l n triSn, ung thu Ion len va xam l§n sang mo xung quanh (Ian rong tai cho). Han niia, ung thu cung c6 the di can (Ian xa han) den cac vung khac cua ca th^ nhu xuang, ph6i, gan.Trieu chung a nhung nai di can den thuang kk hop vai trieu chung cua ung thu tien
liet t u y l n .
T a i sao ung thu" tien liet tuyen lai quan trong?
Nam 1999, c6 185.000 truang hgp ung thu tikn liet tuygn mai dugc c h i n doan tai M y . Trong so do c6 han 31.000 truang hgp t u vong c6 lien quan den benh ung thu tidn liet t u y i n nam 2000. V i vay, ung thu tien liet tuyen la mot benh ac tinh thuang gap a dan ong M y , nguyen nhan tu vong thu 2 ciia benh ung thu, sau ung thu phoi. Da so nhiJng nha chuyen mon de nghi rang tat ca nhttng nguai dan ong tir 40 tu6i tra di nen tkm soat ung thu tien liet tuyen moi nam mot Ian.
Nguyen nhan nao gay ra nh ung thu* tien liet tuyen?
Nguyen nhan gay ra ung thu ti^n liet tuyen v i n chua ro, ung thu tien liet tuy^n khong lien quan den phi dai tien
liet tuyen lanh tinh. Cac yeu t6 nguy ca bj ung thu tien liet tuyen bao gom: Tuoi cao, di truy8n, anh huang cua noi tiet t6, cung nhu doc ch4t trong moi truang, hoa chit va cac san pham cong nghiep. Nguy ca bi ung thu tien li^t tuyen tang theo tuoi. V i vay, ung thu tien liet tuyen cue ky hiem gap a nguai dual 40 tu6i, trong khi ung thu ti^n liet tuydn lai rk thuang gap a dan ong tren 80 tuoi. Mot so nghien cuu cho thay 50-80% dan ong tren 80 tu6i bi ung thu tign liet t u y l n . D i truyen cung la yeu t6 nguy ca bi ung thu tien liet tuygn.
Chang han, nguai dan ong M y da den c6 nguy ca bi ung thu tien liet tuyen cao han dan ong Nhat hay nguai M y da trang. Moi truang, che do Sn u6ng va mot s6 ySu t6 khac chua ro cung CO the lam thay doi ban chit di truy^n.ChSng han, ung thu ti^n liet tuyin thuang it gap a nh&ng nguai dan ong Nhat song tai chinh quoc. Tuy nhien, neu nhiing nguai Nhat nay khi qua M y song thi ty le bi ung thu tien liet tuyin tang len dang ke.Ung thu tien liet tuyen ciing thuang xay ra a gia dinh ma nguai cha, ong cua hg bi thi hg se c6 nguy ca bi ung thu tien liet tuyen cao.
Tuy nhien, cho den hien gia, nguai ta v i n chua c6 nhan djnh chinh xac dugc gen nao gay ra benh nay.(gen nam trong nhiem sac the, c6 chua cac nucleotic cua te bao, gen la thanh ph4n hoa hgc quyet dinh cac dac tinh di truyen ciia ca the).
Testosterone la mot ngi tiet to nam, kich thich true tiep su phat t r i l n ca tuyen tien liet binh thuang Ian tien liet tuyen ung thu. Tuy nhien, khong c6 gi phai ngac nhien khi ma hormon nay c6 lien quan den sir tang truang va phat trien cua ung thu tien liet tuyen.Moi lien quan chinh ve vai tro cua
hormon nay la khi lugng hormon trong mau giam xu6ng se uc
ch6 sir phat trien cua ung thu ti&n liet tuyen.
Y8u t6 moi truong nhu hut thu6c la, an nhi6u ma bao hoa se lam tang nguy ca bi ung thu ti^n liet tuyen. Tat ca nhOmg
chk hay doc t6 trong moi truong hay tir chSt thai cua nganh cong nghiep nang c6 thk khai phat benh ung thu ti6n liet
tuyen. Tuy nhien nguyen nhan van con chua ro.
Trieu chihig cua ung thu* tien liet tuyen la gi?
Vao giai doan s6m, ung thu tien liet tuyen thuang khong gay ra trieu chung trong suot vai nam. Ung thu tien liet tuyen thuang dugc phat hien dau tien bai nhimg bat thuang trong xet nghiem mau (xet nghiem chat PSA, xin xem ben duai) hoac so thSy mot kh6i cung a tien liet tuyen. Truac tien,theo thong le nguai bac sT se diing ngon tay tro dua vao true trang,
qua do moi so thSy dugc ti€n liet tuySn, tien liet tuyen nam
truac true trang. Khi khoi ung thu Ion gay chen ep vao nieu dao lam cho nguai benh kho di tieu, tieu lat nhat, phai ran. Nguai benh c6 the c6 cam giac tieu rat, tieu ra mau. Neu khoi ung thu ti8n liet tuyen tiSp tuc phat trien c6 the gay bi tieu hoan toan, lam cho nguai benh dau vung bung duai, bang quang cang to vi khong the di tieu dugc.
We sau, khoi ung thu tien liet tuyen xam Ian sang cac ca
quan Ian can, hay di xa hem den cac hach bach huyet viing chau. Khi do ung thu c6 the Ian xa han(c6n ggi la di can) den cac vung khac cua ca the.Bac sT kham true trang doi luc c6 the phat hien dugc sir xam Ian tai cho sang cac mo Ian can. Ung thu nay sa thiy cung, khong di dong. Ung thu tien liet
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tuyen thuang di can den cac d6t song that lung thap hay xuang chau (la xuang tilp n6i vai vai phan thap cua xuang s6ng vai hang), la nguyen nhan gay ra dau lung hay dau viing
chau. Ung thu c6 thk Ian d8n gan, phoi. Di cSn ung thu den
gan gay ra dau bung va vang da (da nhugm mau vang) khong phai la khong gap. Ung thu di cSn den phoi gay ra dau nguc va ho.
Tarn soat benh ung thu- tien liet tuyen nhu* the nao?
Tam soat ung thu tien liet tuy^n la thuc hien thuang xuyen, each deu nham phat hien ung thu tien liet tuyin giai doan sam. Neu ket qua tam soat binh thuang, thi coi nhu
hien tai khong mac benh. Neu k i t qua xet nghiem c6 hit thuang thi nghi ngo c6 benh khi do can lam them mot s6
xet nghiem khac de chuan doan (cQng giup chan doan phan
biet). Khi c6 mot hoac hai xet nghiem tam soat c6 b4t
thuang thi ung thu tien liet liet tuyen dugc nghi nga truac tien. Cac tham kham tam soat nay bao gom kham tien li?t
tuyin bang tay va do chk PSA(khang nguyen dac hieu cua
tien liet tuyen). Bac sT diing ngon tay tro dua qua nga hau
mon d l kham, nhim phat hien nhiing bat thuofng cua tien
liet tuyen nhu sa thay cung, ba khong deu, tat ca nhimg
dau hieu nay nghi nga ung thu tien liet tuyen. V i v^y, bac
sT thuang khuyen nguai dan ong tren 40 nen dugc kham ti6n li?t tuyin bang tay m6i nam mot Ian.
Xet nghiem PSA la xet nghiem dan gian, d6 thuc hien
va tuong d6i chinh xac. Xet nghiem nay diing dk phat hien
mot loai protein (khang nguyen dac hieu ciia tien liet tuyen) dugc phong thich tir tien liet tuyen vao mau. Dieu quan