Ung Th Xng

Bone Cancer

U xng c tnh

Bc s Nguyn Xun Cm bin son O.B.E.

Hi Tm Thn Vit Nam Serving the mental health needs & promoting wellbeing of people from Vietnam

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Ung Th Xng (Bone Cancer) Ung th xng l mt bnh t gp, xy ra mi la tui, nhng a s l tr em, thanh thiu nin. V t l mc phi th phi nam cao hn n. Tt c xng trong c th (trn 200 ci) u c th b ung th ving thm, nhng nhiu nht l xng tay v chn (ti phn trn xng cnh tay, phn di xng i, phn trn xng cng chn, gn u gi). Mt s trng hp ung th hp s, xng sng, vng sn, xng chu cng c ghi nhn. Ung th xng gm hai loi: 1. ung th bt ngun t xng, gi l ung th nguyn pht (sarcoma), t thy. 2. ung th th pht, t ung th ca mt b phn c th di cn n. Nguyn nhn Cha c sang t. Cc nh khoa hc ch nu mt s gi thuyt v nguyn nhn ca chng bnh: bt thng v di truyn nh tng hoc lon sn

xng. B bnh Paget, mt loi bnh xy ra cho ngi c

tui, thng thy hp s, ct sng, xng chu, tay chn. Xng dy ln, cu trc thay i.

tng tip xc vi x tr cha cc bnh khc. Triu chng

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Triu chng ung th xut hin chm, xy ra khc nhau ty tng loi xng b nh hng v v tr ca n trong c th, v ty kch c ca khi u. au nhc trin min v cao , nht l vo ban

m khi cc c bp th gin, ti vng xng b bnh,

Xung quanh vng xng b bnh sng v ln. Tuy nhin, tnh trng ny khng nht thit l lun lun c, v v u xng nm su trong cc m tht.

C ng khp b gii hn, nu u xng nm gn khp.

U xng nu ct sng c th to sc p ln cc dy thn kinh ti , gy au nhc, yu v c khi c t lit chi na.

Gy xng khng c nguyn nhn, hoc sau khi b va chm nh.

Suy nhc c th, xanh xao thiu mu, ra nhiu m hi, d nhim trng.

Cc triu chng trn khng c hiu ca bnh ung th, nn nu ai b au thng xuyn trong nhiu ngy ti mt vng ca chn ty th nn n khm bc s chuyn khoa xng khp. Chn on Ngoi vic hi thm v tin s ca bnh nhn v gia nh, khm lm sang ton din, bc s cn cho lm thm nhng xt nghim nh:

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Th mu, th nc tiu Chp tia X vng xng b bnh, c th cho thy kch

thc, hnh dng ca n: u lnh thng trn, b u r nt; u ung th c nhiu hnh dng, b u khng u. Ngoi ra, bnh nhn cn c chp phi kim tra xem ung th di cn n cha.

Lm scan xng vi cht ng v phng x tim vo tnh mch. T bo xng, nu b ung th, s thu ht nhiu cht ny hn bnh thng, v mt hnh nh ni bt s hin trn phim. phng x rt thp, v bin khi c th trong vi gi.

Sinh thit (biopsy), ly t bo xng xt nghim di knh hin vi, bng cch: 1. dng kim ht cc t bo ny. 2. m h ly mt mu u xng.

Lm CT scan, MRI scan ton c th. Trong phn chn on, vic nh mc v phn giai on ca chng bnh cng c tin hnh. V mc , bnh c chia ra l nh (cp 1), trung bnh (cp 2) v nng (cp 3). V giai on ca chng bnh th ty vo kch c ca ung th, s lan trn ca n sang cc b phn khc ca c th c nh gi nng nh.

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U ung Th

Xng mi mc

U Xng Lnh Tnh U Xng c Tnh

Cha Tr Cha tr ung th xng c nhiu phng cch: Ha tr (chemotherapy) vi thuc chng ung th nh

melphalan, cyclophosphamide, methotrexate, doxorubicin, vincristine, adriamycin v.v. Thng cc thuc ny c cp phi hp t 3 th tr ln, di dng vin ung, tim tht hay tnh mch. Hin nay, mt s thuc khng th ang c th nghim trong phn cha tr.

X tr (radiotheraphy), phi hp vi ha tr. Gii phu: 1. ct b khi u c tnh v ghp xng t

than hoc xng ca ngi hin tng. 2. ct b chi. Ngoi ra, bnh nhn c th c truyn mu, ung/tim khng sinh, hng dn v dinh dng ng cch v t vn v tinh thn. Cc loi ung th xng 1. Ung th nguyn pht

Gm c: U xng c tnh (osteosarcoma): loi ny xy ra la

tui 10-20, cn ngi gi l do bin chng ca bnh Paget ni trn. U phn ln pht sinh ti cc xng di tay v chn, gn gi xa khuu, di cn rt nhanh thng l n phi.

Nu c chn on v cha tr sm, tin liu rt kh quan, t l sng trn 5 nm cao.

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U sn c tnh (chondrosarcoma): xy ra ti cc xng di ca ngi c tui, pht trin chm, t u sn lnh tnh hoc t xng bnh thng. c tnh ca u khng cao, nn c th cha khi bng cch m b i phn ung th, phi hp vi x tr; cn vic on chi t khi c t ra.

U c tnh Ewing (Ewings sarcoma): tui mc phi

l t 10-20, nam gii nhiu hn ph n. U thng pht sinh phn gia tay hay chn, i khi xng sn, gy au nhc v sng ln, xanh xao thiu mu, st cao.

U Ewing rt nhy cm vi x tr v thuc chng ung th, kt qu cha tr rt kh quan.

U x c tnh (fibrosarcoma): xy ra ti nguyn bo

si ca xng. Mi la tui u c th mc phi, tin liu bnh tt hn u xng c tnh.

U ty xng (multiple myeloma): xy ra cho ngi

gi, ti vng ty to ra cc huyt cu. U c th pht sinh ti nhiu xng, gy au nhc nhiu ni. Cha tr vi x tr phi hp vi ha tr, i khi bng gii phu.

2. Ung th th pht

Do t bo ung th t cc b phn ca c th di cn n, thng nht l t v, phi, tuyn tin lit, tuyn gip trng (thyroid gland). Cha tr ty theo loi ung th v gm c: x tr kt hp vi ha tr v gii phu.

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200

1. sarcoma2.

(Paget disease of bone)

6

8

()

biopsy1. 2.

(CT scan) (MRI scan)

() () ()

chemotherapy melphalan, cyclophosphamide, methotrexate, doxorubicin, vincristine, adriamycin v.v.

(radiotheraphy)

1. (2.

/

.

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osteosarcoma 10-20

5

chondrosarcoma

Ewings sarcoma 10-20

fibrosarcoma

multiple myeloma

.

thyroid gland

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Hi Tm Thn Vit Nam Serving the mental health needs & promoting wellbeing of people from Vietnam

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This booklet is published with the support of:

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City & Hackney NHS