Kansar Mahaifa

**Ciwon daji** na mahaifa shi ne kansar da ke tasowa a cikin ƙwaya, wani ɓangare na tsarin haihuwa na namiji . Alamun na iya haɗawa da dunƙule a cikin gwano, ko kumburi ko zafi a cikin maƙarƙashiya . Jiyya na iya haifar da rashin haihuwa . 

Abubuwan haɗari sun haɗa da gwajin da ba a taɓa yin ba, tarihin iyali na cutar, da tarihin ciwon daji na testicular na baya. Nau'in da aka fi sani shine ciwace-ciwacen ƙwayoyin cuta waɗanda suka kasu zuwa seminomas da nonseminomas . Sauran nau'o'in sun haɗa da ciwace-ciwacen jini na igiyar jima'i da lymphomas . Ana gano cutar yawanci akan gwajin jiki, duban dan tayi, da gwajin jini . Daga nan sai a yi fida a cire maniyyi tare da bincike a karkashin na’ura mai kwakwalwa don tantance nau’in.

Ciwon daji na hanji ana iya magance shi sosai kuma yawanci ana iya warkewa. Zaɓuɓɓukan jiyya na iya haɗawa da tiyata, farfaɗowar radiation, chemotherapy, ko dashen sel mai tushe .  Ko da a cikin lamuran da ciwon daji ya yadu sosai, chemotherapy yana ba da ƙimar warkewa fiye da 80%.

Ciwon daji na testicular a duniya ya shafi mutane kusan 686,000 a cikin shekarar 2015.  A wannan shekarar ta yi sanadiyar mutuwar mutane 9,400 daga 7,000, da suka mutu a shekarar alif 1990. Farashin ya yi ƙasa a cikin masu tasowa fiye da ƙasashen da suka ci gaba . Farkon farawa ya fi faruwa a cikin maza masu shekaru 20 zuwa 34, da wuya kafin shekaru 15.   Adadin rayuwa na shekaru biyar a Amurka shine kusan kashi 95%.  Sakamakon ya fi kyau idan cutar ta kasance a cikin gida.

## Alamomi da alamomi

Ɗaya daga cikin alamun farko na ciwon daji na ƙwanƙwasa sau da yawa shi ne kullu ko kumburi a cikin gwangwani. Ayyukan rigakafin masu rigakafi na Amurka (USPSF) ya ba da shawarar kan dukiyar yau da kullun don cutar kansa mai lalacewa a cikin matashi a cikin matashi a cikin matashi a cikin matashi.  Sai dai kungiyar masu fama da cutar daji ta Amurka ta nuna cewa ya kamata wasu mazaje su rika duba al’aurarsu a kowane wata, musamman idan suna da tarihin iyali na ciwon daji, kuma kungiyar Uroloji ta Amurka ta ba da shawarar a rika yi wa dukkan samari gwajin kansa a kowane wata.

Alamomin na iya haɗawa da ɗaya ko fiye daga cikin masu zuwa:

* dunƙule a cikin gwaji ɗaya wanda maiyuwa ko ba zai yi zafi
* zafi mai kaifi ko rashin jin daɗi a cikin ƙasan ciki ko maƙarƙashiya 
* wani jin da ake kwatanta shi da "nauyi" a cikin maƙarƙashiya
* tsantsar maniyyi 
* haɓakar nono ( gynecomastia ) daga tasirin hormonal na β-hCG 
* ƙananan ciwon baya (lumbago) saboda ciwon daji da ke yaduwa zuwa ƙwayoyin lymph tare da baya 

Ba ya zama ruwan dare gama gari don yaɗuwar kansar ƙwaya zuwa wasu gabobin, ban da huhu. Idan yana da, duk da haka, alamun alamun zasu iya kasancewa:

* shortness na numfashi ( dyspnea ), tari ko tari sama da jini ( hemoptysis ) daga metastatic yada zuwa huhu
* kumburi a wuya saboda metastases ga nodes na lymph

Ciwon daji na Testicular, cryptorchidism, hypospadias, da rashin ingancin maniyyi sun hada da ciwon da aka sani da ciwon dysgenesis na testicular .

## Dalilai
Babban haɗari ga ci gaban ciwon daji na testis shine cryptorchidism (ƙwayoyin da ba a kwance ba). An yi imani da cewa kasancewar ƙwayar cuta yana taimakawa ga cryptorchidism; lokacin da cryptorchidism ya faru a hade tare da ciwon daji to ciwon yakan zama babba. Sauran abubuwan haɗari sun haɗa da hernias inguinal, ciwo na Klinefelter, da  mumps orchitis . Ayyukan jiki yana da alaƙa da raguwar haɗari kuma salon rayuwa yana da alaƙa da haɗarin haɗari. Farkon farkon halayen maza yana haɗuwa da haɗarin haɗari. Wadannan na iya yin nuni da kwayoyin halitta na endogenous ko muhalli.

An danganta karuwar cutar sankara ta hanji a kasashen yamma da amfani da tabar wiwi.   

## Makanikai
Yawancin ciwace-ciwacen ƙwayoyin ƙwayoyin cuta suna da chromosomes da yawa, kuma galibi suna da triploid zuwa tetraploid . Wani isochromosome 12p ( gajeriyar hannu na chromosome 12 a bangarorin biyu na centromere daya) yana cikin kusan kashi 80% na cututtukan daji na testicular, haka ma sauran cututtukan daji galibi suna da ƙarin kayan daga wannan hannu na chromosome ta hanyar wasu hanyoyin haɓakawa na genomic.

## Bincike

Babban hanyar gano ciwon daji na ƙwanƙwasa ita ce ta dunƙule ko taro a cikin majiyai. Gabaɗaya, idan matashi ko matashi yana da girma guda ɗaya, wanda zai iya zama mai zafi ko ba zai yi zafi ba, wannan ya kamata ya ba likitoci dalili na zargin ciwon daji na testicular.

Wasu yanayi kuma na iya samun alamomi masu kama da ciwon daji na testicular:

* Epididymitis ko epididymoorchitis
* Hematocele
* Varicocele
* Orchitis
* Cutar cututtuka ko kumburi ( prostatitis ), cututtuka na mafitsara ko kumburi ( cystitis ), ko koda (renal) cututtuka ( nephritis ) ko kumburi wanda ya yadu zuwa kuma ya haifar da kumburi a cikin tasoshin ƙwanƙolin ko ƙwanƙwasa.
* Ragewar jini ko hernia
* Kamuwa da cuta, kumburi, retroperitonitis, ko wasu yanayi na Lymph nodes ko tasoshin kusa da scrotum, tesicles, pubis, anorectal yankin, da makwancin gwaiwa.
* Ciwace-ciwacen ciwace-ciwace ko raunuka daga cikin majiyoyin
* Metastasis zuwa ƙwanƙwasa daga wani, rukunin farko (s) ƙari.

Halin kowane nau'i mai laushi a cikin ƙwanƙwasa ana ƙididdige shi ta hanyar duban dan tayi, wanda zai iya ƙayyade ainihin wuri, girman, da wasu halaye na dunƙule, irin su cystic vs m, uniform vs heterogeneous, sharply circumscribed ko matalauta bayyana. Ana kimanta girman cutar ta hanyar CT scans, waɗanda ake amfani da su don gano metastases .

Bambance-bambancen ciwon daji na ƙwanƙwasa yana buƙatar yin nazarin tarihin nama da aka samo daga wani orchiectomy na inguinal - wato, cirewar tiyata na dukan kwayoyin halitta tare da tsarin da aka haɗe ( epididymis da igiyar maniyyi ) . Bai kamata a yi biopsy ba, saboda yana haifar da haɗarin yada ƙwayoyin kansa a cikin maƙarƙashiya.

Inguinal orchiectomy ita ce hanyar da aka fi so saboda tana rage haɗarin ƙwayoyin cutar kansa da ke tserewa. Wannan shi ne saboda tsarin lymphatic na scrotum, ta hanyar da fararen jini (da kuma, yiwuwar, kwayoyin ciwon daji) ke gudana a ciki da waje, suna haɗi zuwa ƙananan sassan, yayin da na ƙwanƙwasa yana haɗi zuwa bayan rami na ciki ( retroperitoneum ). ). Tsarin biopsy na transscrotal ko orchiectomy zai yuwu ya bar ƙwayoyin kansa a cikin ƙwanƙwasa kuma ya haifar da hanyoyi guda biyu don ƙwayoyin kansa don yaduwa, yayin da a cikin inguinal orchiectomy kawai hanyar retroperitoneal ta wanzu.

Ana kuma amfani da gwaje-gwajen jini don ganowa da auna alamomin ƙari (yawanci sunadaran da ke cikin jini) waɗanda ke keɓance ga kansar ƙwanƙwasa. Alpha-fetoprotein, ɗan adam chorionic gonadotropin ("hormone na ciki"), da LDH-1 sune alamun ciwace-ciwacen ƙwayar cuta da ake amfani da su don gano ciwace-ciwacen ƙwayoyin ƙwayoyin cuta.

Ana iya amfani da gwajin ciki don gano manyan matakan gonadotropin chorionic; duk da haka, alamar farko ta ciwon daji na hanji yawanci dunƙule ne mara zafi. Lura cewa kawai kusan 25% na seminomas sun haɓaka gonadotropin chorionic, don haka gwajin ciki ba shi da mahimmanci don fitar da ciwon daji na testicular. 

### Nunawa
Cibiyar Nazarin Likitocin Iyali ta Amurka ta ba da shawarar a kan tantance mazaje ba tare da alamun cutar kansar ƙwaya ba. 

### Tsayawa
Bayan cirewa, an gyara maniyyi tare da maganin Bouin saboda yana da kyau ya adana wasu cikakkun bayanai game da yanayin halitta kamar haɓakar makaman nukiliya. Sa'an nan kuma ƙwararru kuma ta tsara ta bisa ga TNM Classification of Malignant Tumors kamar yadda aka buga a cikin littafin AJCC Cancer Staging Manual. An rarraba kansar mahaifa a matsayin yana cikin ɗaya daga cikin matakai uku ( waɗanda ke da rarrabuwa ). Girman ciwace-ciwacen da ke cikin ƙwanƙwasa ba shi da mahimmanci ga tsarawa. A cikin fa'ida, ana aiwatar da kansar ɗigon jini kamar haka:

* Mataki na I: ciwon daji ya kasance a cikin ma'auni .
* Mataki na II: ciwon daji ya haɗa da gwajin jini da kuma metastasis zuwa retroperitoneal da / ko ƙananan ƙwayoyin lymph na paraaortic ( ƙwayoyin lymph a ƙarƙashin diaphragm ).
* Mataki na III: ciwon daji ya haɗa da ƙwanƙwasa da ƙwayar cuta fiye da retroperitoneal da ƙananan ƙwayoyin lymph na paraaortic. Mataki na 3 an ƙara raba shi zuwa mataki na 3 mara nauyi da girma na 3.

Ƙarin bayani game da cikakken tsarin tsarin yana samuwa a kan shafin yanar gizon Ƙungiyar Ciwon daji na Amirka .

### Rabewa
Ko da yake ana iya samun ciwon daji na jini daga kowane nau'in tantanin halitta da aka samu a cikin ƙwayayen, fiye da kashi 95% na ciwon daji na ƙwanƙwasa ƙwayoyin ƙwayoyin ƙwayoyin cuta (GCTs). Yawancin sauran 5% sune ciwace-ciwacen jima'i – gonadal stromal ciwace-ciwacen da aka samo daga ƙwayoyin Leydig ko ƙwayoyin Sertoli . Daidaitaccen ganewar asali ya zama dole don tabbatar da mafi inganci da magani mai dacewa. Har zuwa wani lokaci, ana iya yin hakan ta hanyar gwaje-gwajen jini don alamomin ƙari, amma ganewar asali na ainihi yana buƙatar bincika tarihin ƙididdiga daga likitan ilimin cututtuka .

Yawancin masu ilimin cututtuka suna amfani da tsarin rarrabawa Hukumar Lafiya ta Duniya don ciwace-ciwacen jini:

* **Ciwon ƙwayar ƙwayar cuta**
** *Precursor raunuka*
*** Intratubular germ cell neoplasia
**** Nau'in Unclassified ( Cancinoma in Situ )
**** Ƙayyadaddun nau'ikan
** *Ciwon daji na nau'in tarihi guda ɗaya (tsararrun siffofin)*
*** Seminoma
**** Bambanci - Seminoma tare da sel syncytiotrophoblastic
*** Ciwon daji na spermatocytic
**** Bambance-bambancen - spermatocytic ƙari tare da sarcoma
*** Ciwon daji na Embryonal
*** Ciwon gwaiduwa
*** Trophoblastic ciwace-ciwacen daji
**** Choriocarcinoma
***** Bambance-bambancen - monophasic choriocarcinoma
**** Placental site trophoblastic ƙari
**** Cystic trophoblastic ƙari
*** Teratoma
**** Bambanci - Dermoid cyst
**** Bambanci - Epidermoid cyst
**** Bambance-bambancen - Monodermal teratoma ( Carcinoid ), Primitive neuroectodermal tumor (PNET), Nephroblastoma -kamar ƙari, wasu.
**** Bambance-bambancen - Teratomic tare da nau'in malignancy
** *Ciwon daji na nau'in tarihi fiye da ɗaya (gauraye nau'i)*
*** Ciwon daji na Embryonal da teratoma
*** Teratoma da seminoma
*** Choriocarcinoma da teratoma.embryonal carcinoma
*** Wasu
* **Igiyar jima'i/Gonadal ciwace-ciwace**
** Leydig cell ciwon daji
** Sertoli cell ciwon daji
*** Bambancin wadataccen lipid
*** Scleriosing bambancin
*** Bamban lissafin lissafin tantanin halitta
*** Intratubular sertoli cell neoplasia a cikin ciwo na Peutz-Jeghers
** Granulosa ciwon daji
*** Nau'in manya
*** Nau'in matasa
** Kungiyar Thecoma fibroma
*** Thecoma
*** Fibroma
** Igiyar Jima'i/Ciwon Ciwon Jiki na Gonadal - wanda bai cika ba
** Igiyar Jima'i/Ciwon Ciwon Jiki - Gauraye iri
* **Cakudadden ƙwayar ƙwayar cuta da igiyar jima'i/cututtukan stromal**
** Gonadoblastoma
** Ciwon ƙwayar ƙwayar ƙwayar ƙwayar cuta-jima'i / kumburin gonadal, wanda ba a tantance shi ba
* **Ciwon daji daban-daban na majiyoyi**
** Lymphomas
*** Na farko tesicular yaduwa babban B-cell lymphoma
*** Mantle cell lymphoma na testes
*** extranodal gefe zone B cell lymphoma na testes
*** Extranodal NK/T-cell lymphoma, nau'in hanci na tes
*** Na gefe T-cell lymphoma na testes
*** activin receptor-like kinase-1-korau anaplastic babban cell lymphoma na testes
*** na yara-nau'in follicular lymphoma na testes
** Carcinoid
** Ciwon daji na nau'in epithelial na ovarian
*** Ciwon daji mai tsanani na rashin lafiyar iyaka
*** Cutar sankarau
*** To bambance-bambancen ciwon daji na endometrioid
*** Ciwon daji na cystadenoma
*** Mucinous cystadenocarcinoma
*** Brenner ciwon daji
** Nephroblastoma
** Paraganglioma
* **Ciwon daji na Hematopoietic**
* **Ciwon daji na tara ducts da rete**
** Adenoma
** Ciwon daji
* **Ciwon daji na tsarin paratesticular**
** Adenomatoid ciwon daji
** M da benign mesothelioma
** Adenocarcinoma na epididymis
** Papillary cystadenoma na epididymis
** Melanotic neuroectodermal ciwon daji
** Desmoplastic ƙananan ƙwayar ƙwayar ƙwayar cuta
* **Ciwon daji na mesenchymal na igiyar maniyyi da kuma adnexae testicular**
** Lipoma
** Liposarcoma
** Rhabdomyosarcoma
** Angiomyxoma mai tsanani
** Angiofibroblastoma-kamar ƙari (duba Myxoma )
** Fibromatosis
** Fibroma
** Ciwon ƙwayar cuta kaɗai
** Wasu
* **Ciwon sukari na biyu na maniyyi**

## Magani
Nau'o'in jiyya guda uku sune tiyata, maganin radiation, da chemotherapy .

Ana yin tiyata ta hanyar urologists ; radiation farfesa ana gudanar da radiation oncologists ; kuma chemotherapy aikin likitocin likitanci ne . A yawancin marasa lafiya da ciwon daji na ƙwanƙwasa, ana warkar da cutar da sauri tare da ƙarancin cututtuka na dogon lokaci. Yayin da nasarar jiyya ya dogara da mataki, matsakaicin adadin rayuwa bayan shekaru biyar yana kusa da 95%, kuma mataki na 1 ciwon daji, idan an kula da shi yadda ya kamata, yana da ainihin adadin rayuwa 100%. 

### Cire majiyoyi
Maganin farko don ciwon daji na ƙwanƙwasa shine tiyata don cire ƙwayar da aka shafa ( orchiectomy ). Duk da yake yana iya yiwuwa, a wasu lokuta, don cire ciwace-ciwacen daji na testicular daga cikin majiyai yayin barin aikin gwajin, wannan kusan ba a taɓa yin shi ba, saboda ƙwayar da ta shafa yawanci tana ɗauke da ƙwayoyin da suka rigaya kafin kamuwa da cutar sankara waɗanda ke bazuwa cikin duka ɗigon. Don haka cire ƙwayar cuta ita kaɗai ba tare da ƙarin magani ba yana ƙara haɗarin cewa wani ciwon daji zai haifar a cikin wannan ƙwayar.

Tun da gwajin gwaji guda ɗaya kawai ake buƙata don kula da haihuwa, samar da hormone, da sauran ayyuka na maza, ana cire ƙwanƙwaran da ke fama da ita gaba daya a cikin hanyar da ake kira inguinal orchiectomy . (Kusan ba a taɓa cire ƙwayar ƙwayar cuta ta cikin ƙwanƙwasa ba; ana yin wani yanki a ƙarƙashin layin bel ɗin a cikin yankin inguinal. ) A cikin Burtaniya, ana kiran hanyar da radical orchidectomy.

### Retroperitoneal Lymph node dissection
A cikin yanayin nonseminomas waɗanda suka bayyana a matsayin mataki na I, ana iya yin tiyata a kan nodes na retroperitoneal / paraaortic lymph nodes (a cikin wani aiki daban) don tantance daidai ko ciwon daji yana cikin mataki na I ko mataki na II da kuma rage haɗarin da ke da mummunar cutar. Kwayoyin ciwon daji waɗanda ƙila sun sami metastasized zuwa ƙwayoyin lymph a cikin ƙananan ciki. Ana kiran wannan tiyatar retroperitoneal lymph node dissection (RPLND). Koyaya, wannan hanyar, yayin da daidaitattun wurare a wurare da yawa, musamman Amurka, ba ta da ni'ima saboda tsadar kayayyaki da ƙwarewar da ake buƙata don yin nasara tiyata. Ana yawan gudanar da aikin banki na maniyi kafin a fara aikin (kamar yadda ake yin chemotherapy), saboda akwai haɗarin cewa RPLND na iya lalata jijiyar da ke tattare da fitar maniyyi, yana haifar da fitar maniyyi a ciki a cikin mafitsara maimakon a waje.

Yawancin marasa lafiya suna zabar sa ido, inda ba a sake yin tiyata ba sai dai idan gwaje-gwaje sun nuna cewa ciwon daji ya dawo. Wannan hanyar tana kiyaye ƙimar magani mai girma saboda haɓaka daidaiton dabarun sa ido.

### Adjuvant magani
Tun da ciwon daji na ƙwanƙwasa na iya yaɗuwa, yawanci ana ba wa marasa lafiya magani adjuvant - ta hanyar chemotherapy ko radiotherapy - don kashe duk wani sel mai cutar kansa wanda zai iya kasancewa a waje da abin da ya shafa. Nau'in maganin adjuvant ya dogara da yawa akan tarihin tarihin ƙwayar cuta (watau girman da siffar sel a ƙarƙashin na'urar hangen nesa) da matakin ci gaba a lokacin tiyata (watau nisan sel sun 'kure' daga majiyar, mamayewa. abin da ke kewaye da shi, ko yada zuwa ga sauran jikin). Idan ciwon kansa bai ci gaba ba musamman, ana iya ba marasa lafiya sa ido ta hanyar duban CT na lokaci-lokaci da gwaje-gwajen jini, a madadin magani.

Kafin 1970, adadin tsira daga ciwon daji na ƙwaya ya yi ƙasa kaɗan. Tun lokacin da aka gabatar da maganin chemotherapy na adjuvant, musamman magungunan platinum kamar cisplatin da carboplatin, hangen nesa ya inganta sosai. Ko da yake 7000 zuwa 8000 sababbin kamuwa da cutar sankara na hanji na faruwa a Amurka kowace shekara, maza 400 ne ake sa ran za su mutu da cutar.

A cikin Burtaniya, irin wannan yanayin ya samo asali: tun lokacin da aka inganta jiyya, adadin rayuwa ya tashi da sauri don warkar da sama da 95%.

### Radiation far
Ana iya amfani da radiation don magance ciwon daji na mataki na II na seminoma, ko kuma a matsayin maganin rigakafi (mai hanawa) a cikin yanayin mataki I seminomas, don rage yiwuwar cewa ƙananan ciwace-ciwacen ƙwayar cuta sun wanzu kuma zasu yada (a cikin inguinal da para-aortic lymph ). nodes ). Radiation ba shi da tasiri a kan haka don haka ba a taɓa amfani da shi azaman jigon farko don nonseminoma .

### Chemotherapy

#### Ba Seminoma ba
Chemotherapy shine ma'auni na maganin marasa ilimin seminoma lokacin da ciwon daji ya yadu zuwa wasu sassan jiki (wato, mataki na 2B ko 3). Madaidaicin ka'idar chemotherapy uku, ko wasu lokuta hudu, zagaye na Bleomycin - Etoposide - Cisplatin (BEP). Farfesa Michael Peckham ya fara ba da rahoton BEP a matsayin magani na farko a cikin 1983. Gwajin da aka buga a cikin 1987 wanda ya kafa BEP a matsayin mafi kyawun magani wanda Dokta Lawrence Einhorn ya gudanar a Jami'ar Indiana .  Wani madadin, daidai da ingantaccen magani ya ƙunshi amfani da zagaye huɗu na Etoposide - Cisplatin (EP).

Hakanan za'a iya yin tiyatar kumburin Lymph bayan chemotherapy don cire yawan jama'a da aka bari a baya (mataki na 2B ko mafi haɓaka), musamman a cikin manyan cututtukan da ba su da tushe .

#### Seminoma
A matsayin magani na adjuvant, amfani da chemotherapy a matsayin madadin maganin radiation a cikin maganin seminoma yana karuwa, saboda radiation far ya bayyana yana da tasiri mai mahimmanci na dogon lokaci (misali, tabo na ciki, karuwar haɗari na malignancies na biyu, da dai sauransu). ). Magunguna guda biyu, ko lokaci-lokaci guda ɗaya na carboplatin, yawanci ana isar da su makonni uku baya, yana tabbatar da zama ingantaccen magani na adjuvant, tare da sake dawowa a cikin jeri iri ɗaya kamar na radiotherapy . Manufar carboplatin a matsayin magani guda ɗaya ya samo asali ne daga Tim Oliver, Farfesa Farfesa Oncology a Barts da Makarantar Medicine da Dentistry na London .  Koyaya, bayanai na dogon lokaci akan ingancin carboplatin adjuvant a cikin wannan saitin basu wanzu.

Tun da seminoma na iya sake dawowa shekaru da yawa bayan an cire ƙwayar cuta ta farko, marasa lafiya da ke karɓar maganin chemotherapy ya kamata su kasance a faɗake kuma kada su ɗauka sun warke shekaru 5 bayan jiyya.

## Hasashen
Maganin ciwon daji na ƙwanƙwasa ɗaya ne daga cikin nasarorin labarun magungunan zamani, tare da ci gaba da mayar da martani ga jiyya fiye da kashi 90% na lokuta, ba tare da la'akari da mataki ba. A cikin 2011 gabaɗayan adadin maganin fiye da 95% an ba da rahoton, da 80% don cututtukan metastatic-mafi kyawun amsa ta kowane ƙaƙƙarfan ƙwayar cuta, tare da ingantaccen rayuwa ana danganta shi da farko ga ingantaccen chemotherapy. A shekara ta 2013 sama da kashi 96 cikin 100 na maza 2,300 da aka gano a kowace shekara a Burtaniya an yi zaton sun warke, wanda ya karu da kusan kashi uku tun daga shekarun 1970, haɓakar da aka danganta da cisplatin na chemotherapy.  A Amurka, lokacin da aka yi maganin cutar yayin da har yanzu ana cikin gida, fiye da 99% na mutane suna rayuwa shekaru 5. 

### Sa ido
Ga yawancin marasa lafiya da ke da ciwon daji na mataki na, maganin adjuvant (na rigakafi) bayan tiyata bazai dace ba kuma marasa lafiya za su yi sa ido a maimakon haka.  Tsarin da wannan sa ido ya ɗauka, misali nau'i da yawan bincike da kuma tsawon lokacin da ya kamata a ci gaba, zai dogara ne akan nau'in ciwon daji ( wanda ba seminoma ko seminoma ), amma manufar ita ce don kauce wa jiyya maras muhimmanci a cikin yawancin marasa lafiya da ke fama da ciwon daji. sun warke ta hanyar tiyatar su, kuma a tabbatar da cewa duk wani sake dawowa da metastases (ciwon daji na biyu) an gano shi da wuri kuma an warke. Wannan hanya tana tabbatar da cewa chemotherapy da ko radiotherapy ana ba da ita kawai ga majinyatan da suke buƙatarsa. Adadin majinyatan da a ƙarshe suka warke iri ɗaya ne ta amfani da sa ido kamar jiyya na “adjuvant” bayan tiyata, amma dole ne majinyata su kasance cikin shiri don bin dogon lokaci na ziyara da gwaje-gwaje.

Ga duka waɗanda ba seminomas da seminomas ba, gwaje-gwajen sa ido gabaɗaya sun haɗa da gwajin jiki, gwajin jini don alamomin ƙari, x-ray na ƙirji da CT scanning . Koyaya, abubuwan da ake buƙata na shirin sa ido sun bambanta bisa ga nau'in cuta tunda, ga marasa lafiya na seminoma, sake dawowa na iya faruwa daga baya kuma gwajin jini bai yi kyau ba wajen nuna koma baya.

Ana yin gwajin CT a cikin ciki (wani lokaci kuma ƙashin ƙugu) da kuma ƙirji a wasu asibitoci. X-ray na ƙirji ana ƙara fifita ga huhu yayin da suke ba da cikakkun bayanai hade tare da ƙarancin ƙimar ƙimar ƙarya da ƙarami ƙarami fiye da CT.

Yawaitar sikanin CT yayin sa ido ya kamata a tabbatar da cewa an gano koma-baya a matakin farko yayin da ake rage hasashe.

Ga marasa lafiya da aka bi da su don mataki na I ba seminoma ba, gwajin da aka bazu ( Majalisar Bincike ta Likita TE08) ya nuna cewa, lokacin da aka haɗa tare da daidaitattun gwaje-gwajen da aka kwatanta a sama, 2 CT scans a 3 da 12 months sun kasance masu kyau kamar 5 akan 2. shekaru wajen gano koma-baya a matakin farko.

Ya kasan ce kuma ga majinyatan da aka yi musu magani ga matakin I seminoma waɗanda suka zaɓi sa ido maimakon yin jiyya na adjuvant, ba a yi gwajin bazuwar don tantance mafi girman yawan dubawa da ziyarta, kuma jadawalin ya bambanta sosai a duk faɗin duniya, kuma a cikin ƙasashe ɗaya. A cikin Burtaniya akwai gwaji na asibiti mai gudana mai suna TRISST.  Wannan yana kimanta sau nawa ya kamata a yi sikanin da ko ana iya amfani da hoton maganadisu (MRI) maimakon CT scans. Ana binciken MRI saboda baya nuna majiyyaci zuwa radiation kuma don haka, idan an nuna cewa yana da kyau a gano sake dawowa, zai iya zama mafi kyau ga CT.

Don ƙarin matakan ci gaba na ciwon daji na testicular, da kuma waɗancan lokuta da aka gudanar da maganin radiation ko chemotherapy, yawan sa ido (gwaji) bayan jiyya zai bambanta bisa ga yanayin, amma ya kamata a yi har tsawon shekaru biyar a lokuta marasa rikitarwa. kuma na tsawon lokaci a cikin waɗanda ke da haɗarin sake dawowa.

### Haihuwa
Mutumin da ya saura ƙwaya ɗaya na iya kula da haihuwa. Koyaya, banki na maniyyi na iya dacewa da maza waɗanda har yanzu suna shirin haifuwa, tunda ilimin chemotherapy da/ko radiotherapy na iya cutar da haihuwa. Mutumin da ya rasa ƙwayayen biyu ba zai iya haihuwa ba bayan an gama aikin, ko da yake yana iya zabar maniyyi mai amfani, wanda ba shi da ciwon daji kafin aikin.

## Epidemiology
Cutar sankarar mahaifa ta duniya ta haifar da mutuwar mutane 8,300 a cikin 2013 daga 7,000 da suka mutu a 1990. Ciwon daji na mata ya fi yaduwa a Amurka da Turai, kuma ba a saba gani ba a Asiya da Afirka.  Abubuwan da suka faru a duniya sun ninka tun cikin shekarun 1960, tare da mafi girman adadin yaɗuwa a Scandinavia, Jamus, da New Zealand .

Ko da yake ciwon daji na testicular ya fi kowa a tsakanin maza masu shekaru 15-40, yana da kololuwa uku: jariri har zuwa shekaru hudu a matsayin teratomas da yolk sac ciwace-ciwacen daji, shekaru 25-40 shekaru a matsayin seminomas post-pubertal da nonseminomas, kuma daga shekaru 60 kamar yadda spermatocytic ciwace-ciwacen daji. 

Ciwon daji na kwayoyin cuta na ƙwaya shine cutar kansa da aka fi sani da samari tsakanin shekaru 15 zuwa 35. 

### Amurka
A Amurka, ana gano cutar kusan 8,900 a shekara.  Haɗarin ciwon daji na ƙwanƙwasa a cikin fararen maza yana kusan sau 4-5 na haɗarin maza baƙar fata, kuma fiye da sau uku na mazan Asiya Amurkawa .  Hadarin ciwon daji na testicular a cikin Latinos da Indiyawan Amurka yana tsakanin na fararen fata da maza na Asiya.  Ba a san musabbabin wadannan bambance-bambance ba. 

### Ƙasar Ingila
A Burtaniya, kusan mutane 2,000 ne ake kamuwa da cutar a shekara.  A tsawon rayuwa, haɗarin yana kusan 1 cikin 200 (0.5%).  Shi ne na 16 mafi yawan ciwon daji a cikin maza. Yana da lissafin ƙasa da 1% na mutuwar ciwon daji a cikin maza (kusan maza 60 sun mutu a 2012). 

## Sauran dabbobi
Ciwon daji na mahaifa ya kasan ce yana faruwa kuma a cikin wasu dabbobi. A cikin dawakai, waɗannan sun haɗa da ciwace-ciwacen ƙwayoyin cuta da teratomas. Yawanci, ana samun na farko a cikin tsofaffin kantunan (wasannin da abin ya shafa na iya zama mummuna, yana nuna yawan samar da androgen ), kuma ana samun na ƙarshe a cikin matasa dawakai kuma suna da girma. 

## Manazarta

## Hanyoyin haɗi na waje

* Ball Checker, app na jarrabawar kai daga Ƙungiyar Ciwon Ciwon Jiki
* Ciwon daji  na Gwaji - cikakken jagora daga Ƙungiyar Ciwon daji ta Amirka
* Ciwon daji  na Gwaji - Bayanin Sabis na Kiwon Lafiya na Kasa da shafi (Birtaniya)
* Kididdigar ciwon daji na jini daga Cancer Research UK