Phn 1.

GII THIU CHUNG V UNG TH MU Trong iu kin bnh thng, s phn chia, sinh trng v bit ha ca mi t bo trong c th u c thc hin theo cc chng trnh di truyn mt cch chnh xc di s kim sot, iu chnh ca mt h thng phc tp ca nhng sn phm do b gen chi phi. Qua phn bo cc c quan, cc b phn ca c th ln n mt mc quy nh ri dng li, duy tr cu trc n nh ca c th. Bnh ung th mu xut hin 300.000 ca bnh mi mi nm trn th gii (chim 2,8% trong s tt c cc bnh ung th) v 220,000 ngi cht v bnh ung th mu hng nm. Nhiu nghin cu cho rng, vi vic s dng in thoi di ng qu nhiu l nguyn nhn dn n cn bnh ung th mu ngy cng gia tng. Sng in thoi di ng tc ng ln ty xng trong vng no ngi lm tng t l bch cu nhiu hn t l hng cu. y cng l cnh bo chung cho cc nc ang pht trin trong khu vc ng Nam vi thi quen s dng in thoi di ng. 1.1.Ung th mu l g? http://vi.wikipedia.org/wiki/Ung_th%C6%B0 1.1.1.Khi nim v ung th mu Ung th bch cu hay cn c tn gi ngn gn l bnh ung th mu hay bnh bch cu, thuc loi ung th c tnh, l ung th ca c quan to ra cc huyt cu nh ty xng v h thng bch huyt. Cn bnh ny l hin tng khi bch cu trong c th ngi bnh tng t bin. Nguyn nhn ca bnh cha c xc nh nhng c th l do cc tc ng ca mi trng nh nhim ha hc hay nhim cht phng x hoc cng c th l do di truyn. Bch cu trong c th vn m nhn nhim v bo v c th nn chng cng kh "hung d", c bit khi loi t bo ny b tng s lng mt cch t bin s lm chng thiu "thc n" v c hin tng n hng cu. Hng cu s b ph hy dn dn, v vy ngi

bnh s c du hiu b thiu mu dn n cht. y cng l cn bnh ung th duy nht khng to ra u (ung bu). Hin nay cn bnh ny c mt s bin php iu tr nhng hiu qu khng cao. Ngi dn cc vng nhim phng x thng c t l b bnh ny rt cao (nh 2 thnh ph Hiroshima v Nagasaki sau thi chin tranh nh th gii Nht).

Hnh thi t chc ca m t dng bnh thng n khi pht trin thnh khi u

1.1.2. Ngun gc ca ung th (enternet)Trong mt s trng hp, do tc ng ca mt s tc nhn khc nhau, thuc ni mi hoc mi trng bn ngoi gy t bin ADN, t bin NST lm cho t bo mt kh nng kim sot chu k t bo dn n ri lon tng sinh, ri lon bit ha, hoc ri lon cht theo chng trnh, dn n hnh thnh t bo t bin, t to nn khi u. Nh vy, ngun gc cho mi khi u u bt ngun t ri lon vt cht di truyn trong t bo. Cc t bo khi u u xut pht t mt t bo khi ngun, to nn tnh cht n dng (mono clonal) ca khi u. Cc t bin gy u c th xy ra t bo sinh dng (soma) hoc cc t bo giao t (germline cell).

Khi u c th lnh tnh hoc c tnh. Khi u c th biu hin cc c quan, cc b phn khc nhau ca c th. Nh vy, ung th l mt nhm bnh c c im chung l mt kh nng kim sot chu k t bo. Phn chia t bo (tng sinh) l qu trnh sinh l xy ra trong nhng iu kin nht nh hu ht cc m trong c th sinh vt a bo. Bnh thng s cn bng gia tc ca qu trnh tng sinh v qu trnh cht ca t bo c iu ha mt cch cht ch m bo cho tnh ton vn ca c quan v m. Khi cc t bo xy ra nhng t bin trong DNA, chng c th ph v c ch iu khin ny v dn n ung th. S tng sinh khng kim sot v thng l nhanh chng ca t bo s to thnh cc khi u lnh tnh hay khi u c tnh (ung th). Nhng khi u lnh tnh khng lan trn n nhng ni khc trong c th hay xm ln vo cc m khc, v chng him khi e da n tnh mng tr khi chng chn p n cc cu trc sng cn. Cc khi u c tnh c th xm ln vo cc c quan khc, lan n nhng ni xa hn (di cn) v tr nn e da n tnh mng. Ni chung ung th mu chia lm 2 dng cp tnh v mn tnh. - Ung th mu cp tnh c triu chng sm, tin trin nhanh, nu khng chn on v iu tr sm s a n t vong nhanh. - Ung th mu loi mn tnh c tin trin chm, thng khng c hay c t triu chng trong nhiu nm. 1.1.3. c im chung ca t bo ung th(internet) c im chung nht ca t bo ung th l mt kh nng kim sot chu k t bo do vy t bo phn chia mt cch hn lon, phn chia khng ngng.

Tnh cht di truyn: t mt t bo ung th khi ngun, c hnh thnh sau mt qu trnh chn lc, cc t bo con sinh ra t t bo y mang b gen t bin. Kt qu l mt dng t bo c kiu gen t bin c hnh thnh, to nn khi u. Tnh c th chuyn ghp: t bo ung th c chuyn ghp vo ng vt th nghim thch hp c th to nn khi u ng vt . Tnh t bit ha hoc khng bit ha: t bo ung th thng khng th hin nhng nt c trng ca t bo bnh thng bao quanh khi u, v d t baod da ung th khng dt nh t bo da bnh thng. Mt tnh c ch tip xc: t bo ung th khng pht trin thnh tng lp ma t bo c th pht trin chng ln nhau to thnh dng khi. Tnh xm ln: t bo ung th c kh nng xm lnh n m bn cnh. T bo u lnh tnh khng c c im ny. Tnh di cn: t mt m ny, b phn ny ca c th, t bo ung thu c th di chuyn n m khc, n c quan khc ca c th theo ng mu hoc ng bch huyt v to khi u . T bo u lnh khng c c im ny. Cc tnh cht c trng ca t bo c tnh Trnh c apoptosis (cht theo chng trnh) Kh nng pht trin v hn (bt t) T cung cp cc yu t pht trin Khng nhy cm i vi cc yu t chng tng sinh Tc phn bo gia tng Thay i kh nng bit ha t bo Khng c kh nng c ch tip xc

Kh nng xm ln m xung quanh Kh nng di cn n ni xa Kh nng tng sinh mch mu Kh nng di truyn ca cc loi khi u Mi loi ung th l bnh do ri lon vt cht di truyn gy ra. Cc t bin gy ung th c th xy ra t bo sinh dng hoc t bo giao t. Nu t bin xy ra t bo sinh dng t pht sinh khi u th loi t bin ny khng di truyn cho th h sau, bnh ch biu hin c th mang t bin. Nu t bin xy ra t bo giao t, loi t bin ny di truyn cho th h sau. i a s cc ung th l khng di truyn cho th h sau, tc l khng c tnh cht gia nh, pht sinh do cc t bin soma xy ra trong qu trnh pht trin c th. Tuy nhin, trn thc t c nhiu thnh vin ca cng gia nh u cng b mt bnh ung th.

1.1.4. Triu chng http://www.vatgia.com/hoidap/4205/197103/xin-hoi-bieu-hien-cuabenh-ung-thu-mau-cac-dau-hieu-sau-co-phai-ung-thu-mau-khong.html Ban u, hu ht bnh nhn ung th khng c triu chng lm sng r rng. Khi xut hin triu chng r rt thng l khi bnh tin trin trm trng. Thng thng,ung th c thi gian bnh (tc l thi gian t khi mt t bo b t bin thnh t bo ung th n khi cc triu chng ca bnh c bc l) kh di, khong 10 nm hoc hn na ty th loi ung th. Do cch phng v iu tr ung th hiu qu nht c khuyn co l nn i khm sc khe nh k 6 thng mt ln. Do ung th l tp hp ca nhiu dng bnh ung th khc nhau nn triu chng ca ung th rt a dng v khc nhau ty th bnh ung th. i khi, triu chng ca ung th c phn lm ba nhm chnh:

Triu chng ti ch: cc khi u bt thng hay ph n, chy mu (hemorrhage), au v/hoc lot (ulcer). Chn p vo m xung quanh c th gy ra cc triu chng nh vng da. Triu chng ca di cn (lan trn): hch bch huyt ln ln, ho, ho ra mu, gan to, au xng, gy xng nhng xng b tn thng v cc triu chng thn kinh. au c th gp ung th giai on tin trin, nhng thng thng khng phi l triu chng u tin. Triu chng ton thn: st cn, chn n v suy mn, tit nhiu m hi ( m hi trm), thiu mu v cc hi chng cn u c hiu, l tnh trng c bit c gy ra bi ung th ang hot ng, chng hn nh huyt khi (thrombosis) hay thay i ni tit t.

Cc triu chng ca ung th mu thng khng r rt trong thi gian u, ch tng t nh cm cm. Khi triu chng tr nn r rt th tp trung vo 3 yu t: - Nhim trng : do cc bch cu(c nhim v chng nhim trng ) b ung th

Thiu

mu

do

cc

hng

cu

hy

hoi.

- Chy mu : do cc tiu cu b hy hoi.

Khi dng bch cu ung th pht trin nhanh trong ty lm au nhc, ng thi chim ch v lm gim nhn sc cng ph s pht c trong trin th ty: bnh ng nhng t c st, cm bo mu nhng lnh, bnh au thng chng u, khc. sau: khp.

Bnh Do

Do thiu hng cu: mt mi, yu sc, da i thnh mu trng nht. Do Do bch gim kh cu nng khng lm thng: mu: chy hay mu b nu nhim rng, d trng. bm.

bing

n,

st

k.

Nu bnh nhn l n th s c hin tng ra m hi v ban m. Cc triu chng thng thy trong ung th mu : mt mi thng xuyn,nng st hay b lnh run, hay b nhim trng, ni hch(thng hch c,nch, hng bn ),km n, mt cn, au nhc cc khp xng,d b chy mu nh chy mu di da , chy mu rng, mi. Gan v l lch c th to ra,. th cp tnh, nht l tr em ( tr em ung th mu thung dng cp tnh) hay di cn n no nn c th c nhng triu chng nh nhc u, kinh git, gim th gic. nn, i..

Tc pht trin ca ung th cng ty thuc vo tng giai on + Giai on sm (insitu, giai on I) ung th tin trin chm. + Giai on mun (giai on 3,4) ung th tin trin nhanh. + Ung th ngi cng tr tin trin cng nhanh.

Phn 2. C CH PHT SINH TH 2.1. C ch gy ung th (sch) Nm 1969 Huebner v Todaro a ra gi thuyt cho rng tn ti cc gen c kh nng chuyn t bo bnh thng thnh t bo ung th, gi l gen ung th nm trn nhim sc th ca t bo. Cui thp k 70, Bshop v Warmus thuc i hc California ti San Francisco nh v c cc gen ung th rt nhiu loi, t rui gim cho n con ngi.iu lm cho chng ta kinh ngc hn l h pht hin c cc gen ging nh th t rt

nhiu virut khc nhau v cho rng n c th tn ti tt c cc virut. R rng cc gen ung th khng phi bt ngun t virut m chnh l ti sn di truyn ca mi t bo sng. Gii thng Nobel dnh cho h vo nm 1989. Vic khm ph ra gen ung th khch l cc nh nghin cu tch AND t khi u v s dng chng bin t bo bnh thng thnh t bo ung th thc nghim, v d on rng c l ch do mt gen quyt nh. Cui cng nm 1981 ba nhm nghin cu khc nhau cng b tch c gen ung th t khi u ca ngi. Ngy nay hn 60 gen ung th khc nhau c xc nh. Hin nay l thuyt v gen ung th c xem xt v sa i i cht. H cho rng cc gen bnh thng gi l gen tin ung th. Chc nng quan trng ca gen ny l iu tit s sinh trng v nguyn phn ca t bo. Khi chu tc ng ca nhn t ung th (virut, ha cht, chiu x) hoc do s ph v v sp xp l nhim sc th, m gen tin ung th bin thnh gen ung th. Khi nhim vo t bo virut c th trng thi sinh tan. AND hoc ARN (thng qua AND) ca virut s gn vo nhim sc th ca t bo di dng provirut. S gn ny lm cc gen tin ung th chuyn v tr t th nhim sc s 8 sang v tr th nhim sc 14. V tr mi ny nm rt xa v tr chu nh hng ca cc gen iu khin. Mt on AND t th nhim sc 14 thay th cho gen tin ung th t th nhim sc s 8. Cc gen tin ung th lc ny tr thnh gen ung th, m ha cho protein ung th. Nm 1984 Wigler tch c protein ny v khi tim vo t bo bnh thng, ch trong vi gi c tn hiu chuyn bin thnh t bo ung th. a s cc proto-oncogen m ha cho cc thnh phn tham gia vo c ch iu ha c im tp on ca cc t bo trong c th, c bit l iu ha h thng tn hiu t cc t bo cn pht ra thc y chng phn chia, bit ha hay cht i. C 3 cch ch yu bin i gen tin ung th thnh gen ung th:

Mt on, chuyn on hay t bin im trnh t m ha (AND-> ARN -> protein) to ra protein siu hot vi s lng bnh thng. Khuyt i gen trong c protein bnh thng c siu sn xut Cu trc li nhim sc th dn n: a) Cc on tng cng y mnh siu sn xut protein bnh thng. b) Dung hp gen phin m mnh siu sn xut protein dung hp hoc sn xut protein dung hp siu hot. C th cng c cc gen c ch ung th c ch khng cho gen tin ung th tr thnh gen ung th. pht hin 2 gen:

Gen Rb to protein retinoblastoma c ch mt dng ung th nguyn bo vng mc. Protein ny cng c ch mt s dng ung th khc. Gen P53 to protein P53 tham gia vo sa cha nhiu sai st ca t bo ang phn chia v do c ch nhiu dng ung th.

2.2. Khng nguyn ung th Dng cc tc nhn gy ung th tc ngvo chut, chng s b ung th v cht. Nu dng dao ct b khi u (kh cha di cn) hoc dng dy tht li khong cho mu i ti, khi u s teo dn v con vt s sng. Nu ghp mnh ung th hoc tim t bo ung th t chut 1 sang chut 2 th chut 2 s b ung th. Nu ly mnh ghp hoc t bo ung th ca chut 2 ghp hoc tim cho chut 1 th mnh ghp bong, chut 1 khng b ung th v c min dch. Nu dng t bo ung th cht cho chiu x ca chut 1 tim vo chut 3 gy min dch, sau mt thi gian, ghp u mi vo th mnh ghp b bong. Ung th khng pht trin. Th nghim trn l bng chng v p ng min dch trong ung th thc nghim.

Trn b mt cc t bo ung th c tnh xut hin cc khng nguyn mi m cc t bo bnh thng khng c. Cc khng nguyn ny tuy c th c mt c nhng t bo bnh thng nhng chng khng c biu hin m ch c biu hin cc t bo ung th c tnh. Sau y l mt vi khng nguyn ung th: -Khng nguyn ghp c hiu ung th: (TSTA Tumour Specific Transplantation Antigen) hay cn gi khng nguyn c hiu ung th (TSA Tumour Specific Antigen) l khng nguyn xut hin cc t bo ung th m khong c cc t bo thng. Nu ghp m ung th ca mt con vt ny vo con vt khc ng chng th m ghp s b thi loi. l do khng nguyn c hiu kch thch c th nhn p ng min dch chng li ung th ghp. Trong ung th thc nghim, a s cc khng nguyn c hiu ung th do virus c tnh c hiu ph thuc vo chng virus m khng ph thuc vo loi m. iu c ngha l d ung th xut hin cc mo khc nhau nhng nu do cng mt loi virus cm ng th a s khng nguyn biu hin tnh c hiu ging nhau. Tri li nu ung th do ha cht cm ng th ph thuc vo loi m m khng ph thuc vo loi ha cht. iu c ngha l d ung th do cng mt loi ha cht cm ng nhng xut hin cc m khc nhau, ngay trn cng mt c th, th a s khng nguyn biu hin tnh c hiu khc nhau v ty thuc vo tng loi m. Chiu x lm bt hot khi u do virus SV 40 (1) cm ng, sau tim vo chut gy min dch. Mt na s chut min dch c th thch kh nng min dch bng cch tim t bo ung th sng SV 40 (2). Na cn li tim t bo ung th do virus polyma cm ng. Kt qu l na u khng b ung th, cn na sau b ung th. iu ny chng t khi u do cng mt loi virus cm ng th c chung khng nguyn. Sau th li kh nng min dch ca cc con chut v tim bng ung th CM1, CM2 (khi u do CM khc cm ng) v khi u do virus polyma. Kt qu min dch ch c hiu vi khi u CM1. iu ny chng t khi u do cng mt loi ha cht cm ng th khng c chung khng nguyn vi cc ung th do virus cm ng.

- Khng nguyn kt hp ung th: TTA (Tumour Associated Transplantation Antigen) l khng nguyn pht hin c trong cc loi ung th m khng c hoc c rt t trong cc t bo m bnh thng. ngi khng nguyn ny c xc nh bng khng th n dng. Khng nguyn bo thai ung th (CEA Carcino Embryonic Antigen) v protein thai ( Foetoproteine) cng thuc loi ny. Khng nguyn CEA l glicoprotein ch xut hin trong thi k bo thai, n khi trng thnh th b mt hoc c vi s lng rt t nn khng pht hin c. bnh nhn carcinoma (ung th biu b) c bit l rut v phi, khng nguyn CEA thy xut hin trong mu m l ra n ch c trong rut v bo thai. FP l protein khi in di nm vng globulin , c nng cao trong huyt thanh bo thai v khng pht hin thy trong mu c th trng thnh bng cc k thut km nhy. Khi b ung th gan tim pht hay u c, cht ny ti xut hin trong mu vi nng d cao. 2.3. p ng min dch ung th 2.3.1. p ng min dch dch th Trong min dch chng ung th dng nh vai tr ca min dch dch th khng ln. Trong a s trng hp ngi ta khng pht hin ra khng th. Trong mt s trng hp c th pht hin thy khng th c trong huyt thanh, tuy nhin chng c kh nng ph hy trc tip t bo ung th hay ch thng qua cc t bo c th th Fc nh t bo K v i thc bo dit t bo ung th th cha cn r. Khi khng th c hnh thnh c th to phc hp vi khng nguyn ung th lm cho t bo Tc khng tiu dit c, do ph v p ng min dch t bo. 2.3.2. p ng min dch qua trung gian t bo a- Min dch t nhin: Xy ra nh cc t bo c kh nng phn hy khi u mt cch t nhin, nh t bo NK, i thc bo v bch cu u axit.

T bo dit t nhin NK: l cc t bo khng c tr nh min dch, khng c gii hn bi MHC v c kh nng tit peforin chc thng t bo ung th. Hot ng ca t bo NK nm di s iu khin ca t bo T. Chng c tng cng nh s kch thch ca Cytokin do t bo lympho T v i thc bo tit ra nh IL-2 v IFN. IL-2 thc y s hot ha v tng sinh tin t bo NK thnh t bo NK, cn IFN kch thch s biu hin th th dnh cho IL-2 trn b mt tin t bo NK. Tuy nhin IFN c th tc ng tr li lm gim hot ng ca t bo T. i thc bo: Cng vi t bo NK, i thc bo c coi l t bo hiu ng (Efecto) quan trng ca min dch t nhin. Hot ng ca i thc bo chng khi u theo 2 cch: -i thc bo nhn din khng nguyn ung th thng qua khng th. Khng th lm nhim v opsonin va gn vo khng nguyn ca t bo ung th va gn vo th th Fc R ca i thc bo. - Mt s t bo ung th mt s c ch sinh trng do tip xc nh thng c t bo bnh thng th trn b mt c cc khng nguyn dnh cho th th R ca i thc bo. i thc bo gy c t bo do tit ra protease phn hy t bo, H2O2 v cc cht trung gian lm gim O2. Tuy nhin i thc bo i khi cng cn tr chc nng min dch bng cch hn ch s tng sinh ca cc t bo lympho. 16.4.2.2. Min dch t bo c hiu: Mun c p ng min dch t bo c hiu th i hi phi hot ha t baofTc CD8 bi cc t bo trnh din khng nguyn c mang MHC lp I v cc cytokin tng ng (IL-2, IL-4). Nhiu nghin cu ng vt thc nghim chng minh vai tr ca t bo Tc trong phn hy t bo u. Tuy nhin mt s t bo ung th khng biu hin MHC lp I m l MHC lp II Gim st min dch ung th: H thng min dch ca c th cng c trch nhim theo di v kim sot s hot ng ca cc t bo. Nu t bo xut hin khng nguyn l

th h thng min dch s xut hin v tiu dit. Burnet cho rng gim st min dch l c ch rt quan trng trong chng ung th. S gim st c th xy ra trong sut qu trnh pht sinh ung th hoc sau khi ung th pht trin l ty thuc vo loi ung th v tc nhn gy ung th. H thng min dch m trc ht la min dch qua trung gian t bo s lam chm pht trin hoc c ch ung th.

iu tr Hin ti cc phng php iu tr bnh ung th mu ch yu vn l thay ty xng ca ngi bnh vi ty xng ca mt ngi hin c ty xng ph hp (thch hp nht l ngi c chung huyt thng vi ngi bnh) thay th phn ty xng b h hng v kch thch sinh ra hng cu cng nh km hm s gia tng t bin ca bch cu. Tuy nhin, d c iu tr bng phng php no th kh nng thnh cng cng rt thp, ch khong 10% v d cho c thnh cng th kh nng bnh ti pht cng rt ln (khong t 3 n 5 thng) Hin nay ngoi cch ghp ty (cung rn, cy t bo gc....) cn c th dng ha tr liu, cho ti nay cch dng ha tr vn c trin vng rt tt cho cc bnh nhn. Ngoi ra i vi dng Lympho cn c th x tr mng no, ngn nga t bo pht trin ln no. i vi nhng bnh nhn c qu trnh iu tr bnh tt, sc khng tt, thch nghi vi mi trng tt v nm trong khong thi gian iu tr t 3-5 nm c th bnh phc hon ton - Ha tr: s dng thuc tiu dit cc t bo ung th mu bng cc phng php nh thuc ung, thuc tim, thuc truyn, hoc tim vo dch no ty theo tng chu k.

Mi chu k c mt khong thi gian iu tr v ngh ngi bnh nhn c th phc hi sc khe. - iu tr nhm vo mc tiu: s dng thuc chn s tng trng ca cc t bo ung th bch cu. iu tr bnh bch cu cp bng thuc

Tc dng ph ca ho tr liu ph thuc ch yu vo loi thuc bnh nhn s dng. Ngoi ra, cng nh cc phng php tr liu khc, tc dng ph mi ngi s khc nhau. Thng th thuc chng ung th tc ng ln cc t bo ang trong giai on phn chia. Cc t bo ung th c c im phn chia nhiu hn t bo bnh thng nn b tc ng bi ho tr liu nhiu hn. Tuy nhin mt s t bo bnh thng cng b ph hu. Cc t bo thng hay phn chia gm t bo mu; t bo gc lng, tc hay ng tiu ho thng d b ph hu. Khi ho tr liu nh hng ln t bo bnh thng n s lm gim sc khng ca bnh nhn i vi tnh trng nhim trng v bnh nhn c th mt nng lng v d b bm tm hay chy mu. a s cc tc dng ph s ht t t trong giai on hi phc gia cc t iu tr v sau khi ngng iu tr.

Mt s loi thuc chng ung th c th nh hng n kh nng sinh sn ca bnh nhn. Kinh nguyt c th b ri lon hay ngng hn v ph n c th b triu chng mn kinh nh nhng cn nng bng v kh m o. Nam gii c th ngng to tinh trng. V cc bin i ny c th l vnh vin nn mt s n ng chn cch gi tinh trng ng lnh. Hu ht tr em c iu tr ung th mu c kh nng sinh sn bnh thng khi chng ln ln. Tuy nhin tu theo loi thuc v liu lng s dng cng nh tui m mt s tr em trai v gi khng th c con khi h trng thnh.

- Liu php iu tr sinh hc: truyn cht khng th n dng vo ngi bnh git cht cc t bo ung th mu, ci thin kh nng khng t nhin ca c th chng li bnh hoc c th lm chm s tng trng ca t bo ung th mu. - X tr: S dng cc chm tia nng lng cao tiu dit cc t bo ung th mu. - Thay ty/Cy t bo gc: sau khi p dng ha tr, x tr ngi bnh s c cy nhng t bo gc khe mnh thng qua mt tnh mch ln. Nhng t bo mu mi pht trin t t bo gc (ca chnh c th ngi bnh hoc ca bt k thnh vin no trong gia nh) c cy vo v n s thay th nhng t bo b hy dit trong qu trnh iu tr trc . Tc dng ph trong vic iu tr ung th mu: - Khi iu tr ung th mu bng cc phng php khc nhau dn n gim mc ca cc t bo mu khe mnh, bn c nhiu kh nng b nhim khun, b thm tm hoc chy mu mt cch d dng, cm thy rt yu v mt mi, rng tc, chn n, bun nn, tiu chy, co rt bp tht, pht ban, au u, suy nhc c th. - Mt s loi ha tr c th gy ra v sinh (c th xy ra nu iu tr cho bnh nhn di 15 tui) - C th lm hng hoc bin i cc t bo tinh trng nam gii. Nu nam gii ang tui sinh sn h nn lu tr tinh trng ti ngn hng trc khi iu tr. - i vi n gii c th thay i chu k kinh nguyt, hng bung trng, km rng trng, tnh tnh nng ny - Vic cy/ ghp t bo gc c th dn n mt s phn ng chng li cc m bnh thng ca ngi bnh. Mt s m cn c th b o thi hoc nh hng nh gan, da, tiu ha iu tr ung th c rt nhiu tc dng ph. Chng ph thuc ch yu vo loi phc cng nh thi gian iu tr. Mi ngi s c nhng phn ng khc nhau v thm ch trn cng mt bnh nhn phn ng ph t iu tr ny c th khc nhng t khc. N lc

ca

cc

nh

chuyn

mn

gim

tc

dng

ph

mc

ti

thiu.

Cc bc s v y t c th gii thch nhng tc dng ph cho bnh nhn bit v hng dn h thay i thuc, ch n ung hay cc bin php no khc i ph.

Bnh nhn b x tr c th rt mt mi cho nn ngh ngi l quan trng nhng cc bc s li khuyn bnh nhn vn duy tr hot ng nh trc.

Khi c x tr trc tip ln u th bnh nhn thng b rng tc. X tr c th lm cho da u ti vng chiu x b , kh, gin v nga. Bnh nhn nn c hng dn cch chm sc da u sch s. H khng nn s dng bt c loi nc hoa hay kem thoa ln vng da chiu x m khng tham kho kin ca bc s. X tr c th gy bun nn, nn v mt cm gic ngon ming. Nhng tc dng ph ny l tm thi v cc bc s v y t c th ngh cch kim sot chng cho n khi hon tt iu tr. Tuy nhin mt s tc dng ph c th ko di. T

r em (m c bit l nhng tr nh tui) c chiu x no c th nh hng n vic hc tp. V l do ny m cc bc s s dng liu x tr thp nht c th c v ch p dng cho nhng tr khng th iu tr bng ho tr n l. X tr tinh hon c th nh hng n kh nng sinh sn cng nh vic sn xut hormon. Hu ht nhng b trai b x tr tinh hon khng th c con sau ny v tr cn phi s dng hormon thay th. xng

Ghp

tu

Bnh nhn ghp tu xng i din vi nguy c nhim trng, chy mu v cc tc dng khc do c ho tr v x tr vi mt liu lng ln.

Ngoi ra bnh k ch thi ghp c th xy ra ngi nhn tu ghp t mt ngi khc

cho. Trong bnh ny tu ca ngi cho phn ng chng li m ca k ch (thng l gan, da v ng tiu ho). Bnh ny c th t mc nh n trm trng v c th xy ra vo bt c thi im no sau khi ghp (thp ch vi nm sau). C th cho thuc lm gim nguy c bnh ny v iu tr nhng bin chng do n gy ra. dinh dng nhn ung th

Vn

cho

bnh

Mt s bnh nhn ung th rt kh n ung, h c th mt cm gic ngon ming. Ngoi ra h cn mc phi nhng bin chng thng gp trong qu trnh iu tr nh bun nn, nn, au ming nn vic n ung c th tr nn kh khn. Mt vi bnh nhn thay i cm gic i vi thc n (ni thm: c th trc y h thch n mt loi thc n no nhng by gi li khng thch thm ch thy s loi thc n na). Hn na khi kh chu v mt mi th chng ai thch Copyright 2003-2011

medicinemodernlife.com

Bnh thng, nhng t bo mu c sn sinh theo trt t, c kim sot theo cch khi thn Bnh th cn chng. Qu trnh ny bch gi cho chng ta mnh kho. cu

Khi bnh bch cu pht trin, c th sn sinh mt s ln nhng t bo mu bt thng. Trong a s cc kiu bnh ung th mu, nhng t bo d thng l nhng bch cu. T bo bnh bch cu (thng thng nhn khc vi t bo mu bnh thng v chng khng thc hin ng chc ung nng ca th chng). mu?

Ti

sao

Cho n hin nay, chng ta vn cha bit nguyn nhn v sao gy ra ung th mu. Nhng nh nghin cu ang c gng gii quyt vn ny. Nhng nghin cu cho thy rng, ung th mu thng gp nam hn n v nhng ngi da trng thng mc bnh hn nhng ngi da en. Tuy nhin, ngi ta vn cha th gii thch ti sao ngi ny th b cn ngi kia li khng.

Qua vic nghin cu s lng ln ngi trn khp th gii, nhng nh nghin cu tm thy nhng yu t nguy c nht nh lm tng nguy c pht trin bnh bch cu. V d, s tip xc vi mt lng ln bc x nng lng cao s lm tng nguy c b bnh bch cu. Cc cht phng x ny thng c sn sinh sau v n bm nguyn t Nht Bn trong thi gian chin tranh Th Gii th 2. Trong nhng nh my nng lng ht nhn, nhng quy tc an ton tuyt i nhmbo v cng nhn v cng ng trnhtip xc vi khi lng bc x c hi.

Nghin cu gi rng s tip xc trong nhng lnh vc in t l mt yu t nguy cho bnh bch cu (nhng lnh vc in t l mt kiu ca bc x nng lng thp n t dy in v thit b in). Tuy nhin, nhiunghin cu hn cn thit chng minh mi lin kt ny.

Mt s tnh trng di truyn c th tng thm nguy c cho bnh bch cu. l hi chng Down. Tr con sinh ra vi hi chng ny c bnh bch cu cao hn so vi tr khc. Nhng cng nhn tip xc vi ha cht nht nh, trong c mt thi k di s c nguy c cao b ung th mu. Benzen l mt trong s ha cht ny. ng thi, vi thuc s dng iu tr cc loi ung th khc c th tng thm nguy c cho con ngipht trin bnh bch cu. Tuy nhin, nguy c ny rt nh so vi li ch m m ho tr liu mang li. Cc nh khoa hc xc nh c loi virut c kh nng lm tng thm nguy c mc

ung th mu. Nhng nh khoa hc khp th gii tip tc nghin cuvirut v nguy c c th khc cho bnh bch cu. Bng vic nghin cu v sau b ung th mu, t cc nh khoa hc hy vng hiu r hn phng php ngn chn v iu tr bnh bch cu. ung th mu no ?

nhng

loi

C vi loi bnh bch cu. Chng c sp xp li theo hai cch. Mt cch l theo spht trin nhanh chng ra sao v ti t i nh th no. Cch khc bi kiu t bo mu b nh hng. Bnh bch cu hoc l cp hoc kinh nin. Trong bnh bch cu cp, nhng t bo mu d thng l nhng t bo non cn lu gi c tnh cha trng thnh v khng th thc hin nhng chc nngbnh thng ca chng. S lng ca t bo non tng thm nhanh chng, v bnh tr thnh xu hn i nhanh chng.

Trong bnh bch cu kinh nin, mt s t bo non c mt, nhng ni chung, nhng t bo ny th trng thnh hn v c th thc hin mt s chc nngbnh thng ca chng. Bnh bch cu c th xut hin trong c hai kiu bch cu chnh : Nhng t bo bch huyt hoc nhng t bo ty. Khi bnh bch cu nh hng nhng t bo bch huyt, n c gi bnh bch cu t bo lymph.Khi nhng t bo ty b nh hng, bnh c gi ty y l xng nhng hoc kiu bnh chung nht bch ca cu bnh to bch cu ty. :

Bnh bch cu dng lympho cp l th thng gp nht ca bnh bch cu tr em. Bnh ny cng gy ra ngi ln, c bit l tui 65 hoc gi hn. Bnh bch cu dng tu hu ht thng nh hng n ngi ln tui hn 55. N thng xy ra ngi tr hn, nhng hu nh khng bao gi gy bnh tr em.

Bnh bch cu dng tu mn ch yu xy ra ngi ln. Rt t tr em pht trin bnh ny. Bnh bch cu t bo lng l mt th khng binh thng ca bnh bch cu mn. Th loi ny v loi bt thng khc ca bnh bch cu khng c bn n y. Dch v thng tin ung th c th cung cp thng tin v chng.

Bnh ny cng nh hng n ngi ln, c bit nhng ngi tui 65 v gi hn. Cc triu chng ca bnh bch cu l g?

Nhng t bo bnh bch cu l d thng khng th lm vic bnh thng m nhng t bo mu lm. Chng khng th gip c th u tranh chng li bnh truyn nhim. V l do ny, nhng ngi mc bnh bch cu thng d b nhim trng v st. ng thi, nhng ngi b bnh bch cu thng c s lng hng cu v tiu cu t hn ngi bnh thng. Kt qu l khng c hng cu mang oxy ti khp cc c quan trong c th. iu kin ny, c gi l s thiu mu, nhng bnh nhn c th trng nht nht v cm thy yu v mt. Khi khng c tiu cu, ngi bnh d b chy mu, bm tm da.

Nh tt c cc t bo mu, nhng t bo bnh bch cu cng i khp c th. Ph thuc vo s lng t bo d thng v ni mnhng t bo ny tp trung, nhng bnh nhn bnh bch cu c th c mt s triu chng.

Trong bnh bch cu cp, nhng triu chng xut hin v tr nn ti hn nhanh chng. Nhng ngi mc bnh ny thng n khm bc s v h cm thy m i nhanh chng. Trong bnh bch cu kinh nin, nhng triu chng c th khng xut hin trong mt thi

gian di. Khi nhng triu chng xut hin, lc u nh, sau xu dn i. Bc s pht hin bnh bch cu kinh nin khi khm v lm xt nghim mu thng qui, mc d trc ngi bnh khng c bt k nhng triu chng no. III. C TH PHNG NGA C NHIU LOI UNG TH Do bit c nguyn nhn gy ung th ch yu do mi trng ngoi (80%) nn c th ch ng phng nga c bng cc bin php tch cc nh: - Ngn chn cc tc nhn tc ng t bn ngoi - Ngng ht thuc l. - Ch dinh dng v sinh an ton hp l. - Chng lm dng cc ha cht cng nghip, nhim mi trng, phng cc bnh ngh nghip. - Mt s ung th c lin quan n virt, co th phng nga bng tim vaccine c bit l vaccine phng vim gan B. - Tch cc iu tr cc tn thng tin ung th. - Sng lc pht hin sm iu tr giai on sm cc ung th nh ung th v, c t cung, khoang ming, i trc trng.