Yeka ukuthi amakhondomu ajwayelekile ajwayelekile kangakanani anezifo ze-Hodgkin?
Uma uqala nje noma uphakathi kokwelashwa kwe- Hodgkin lymphoma , ukukhuluma ngomunye umdlavuza kungaba yinto yokugcina oyifisa ukuyizwa. Ngaphambi kokuxoxa ngengozi kanye namanani ekhondomu yesibili kubalulekile ukuqaphela ukuthi ingozi yemiphumela ephuthumayo njengama-khansa yesibili ngokuvamile ayedlula kakhulu izinzuzo zokwelashwa. Eminyakeni engamashumi amahlanu edlule, izinga lokusinda iminyaka engu-5 le-Hodgkin lymphoma liye laphuma ngamaphesenti ayishumi kuya kwamaphesenti angaba ngu-90, kanti umuntu ojwayelekile onesifo manje angalindela ukwelashwa.
Ukuqaphela ukuthi kungenzeka ukuthi umdlavuza wesibili ubaluleke kakhulu kulabo abafakile lokho okuye kwahlanganiswa isigaba "sokusinda" somdlavuza. Ngenkathi ingxenye ebalulekile yokusinda ukufunda ukushiya indima yakho ngokuthi "umdlavuza isiguli" futhi uyeke ukuchazwa ngumdlavuza wakho, kuzodingeka uqonde le ngozi engenzeka futhi ebonakalayo yesikhathi eside.
Ake sikhulume ukuthi lokhu kungaba yingozi kangakanani, amazinga e-khansa ethile ahlobene nezindlela zokwelashwa ezisetshenziselwa isifo seHodgkin, futhi okubaluleke kakhulu, bheka ukuthi ungayithuthukisa kanjani impilo yakho yesikhathi eside ngemuva kokwelashwa ngokutholakala kokuqala nokunciphisa ingozi.
Yini Okucatshangwa Ngomdlavuza Wesibili?
Umdlavuza wesibili ngemva kwesifo seHodgkin uchazwa ngokuthi ukuthuthukiswa komdlavuza wesibili okungafani nomdlavuza wakho wokuqala. Isifo se-Hodgkin esabuyela emuva-asibhekwa njengomdlavuza wesibili kodwa kunalokho ukuphindaphinda kwesifo.
Umdlavuza wesibili ngezinye izikhathi ungadluliselwa njengomdlavuza wesibili oyinhloko , ugcizelela ukuthi umdlavuza wesibili awuhambisani nomuntu wokuqala.
Imithi yokwelashwa njengekhemotherapy kanye nokwelapha imisebe ingase iphulukise i-Hodgkin lymphoma, kodwa ngesikhathi esifanayo, i- carcinogens (ekwenzeni umdlavuza) ngokwabo. Umonakalo lezi zindlela zokwelapha ezibangela ukuba i-DNA emasethini ingasebenzisa ngokumangalisayo ukuqeda umzimba wakho wamangqamuzana omdlavuza, kodwa ingalimaza futhi izinto eziphilayo zofuzo, amangqamuzana aphilile, ngezinye izikhathi ukuqala izinguquko ezingabangela ukuthuthukiswa komakhalekhukhwini wesifo somdlavuza.
Amakhansela wesibili angase avele izinyanga emashumini eminyaka emva komdlavuza wakho wokuqala.
Yeka ukuthi i-Cancers yesibili ejwayelekile kanjani emva kwe-Hodgkin Lymphoma?
Iyini ingozi yokuba nomdlavuza wesibili uma unesifo seHodgkin? Impendulo izohluka ngokususelwa kokwelashwa okwenziwe, iminyaka yakho yokuxilongwa, nezinye izinto eziningi. Nakuba sineminye imibono engenzeka ukuthi i-cancer ingenzeka futhi kungani kunzima ukuhlola ingozi ngqo yimuphi umuntu oyedwa. Ucwaningo lubuke amaqembu abantu abaneHodgkin lymphoma ngokuhamba kwesikhathi, kodwa laba bantu bathole izindlela eziningi ezahlukene zokwelapha. Njengoba owesilisa oyedwa kwababili nabesifazane abathathu kulindeleke ukuba bahlakulele umdlavuza ngesikhathi sabo sokuphila ngisho nangaphandle kokuba benesifo seHodgkin, kunzima nakakhulu ukucacisa izingozi eziqondile.
Njengoba sikhuluma ngengozi kanye namazinga, khumbula ukuthi lezi ziyisilinganiso esekelwe kumuntu ojwayelekile onesifo seHodgkin. Kodwa abantu bangempela abavamile ukulinganisa.
Ngokuvamile, kucatshangwa ukuthi amaphesenti angu-20 kuya ku-30 abantu abasinda eHodgkin lymphoma bazokwakha umdlavuza wesibili. Ingozi yenye yalezi zomshukela (akuzona zonke ukwelashwa okwenyuka) cishe izikhathi ezingu-4.6 ingozi yabantu abaningi.
Ucwaningo luka-2015 e -New England Journal of Medicine lubuke abangaphezu kuka-3900 abasindile isifo se-Hodgkin cishe eminyakeni engaba ngu-20.
Isilinganiso seminyaka ngesikhathi sokuxilongwa kwalaba bantu kwakungu-28. Abanye balaba basindile babe ne-chemotherapy, abanye babenemisebe, futhi cishe amaphesenti angu-60 bathola kokubili lezi zelashwa. Kulaba bantu, abantu abangu-908 bakhulisa umdlavuza wesibili.
Olunye ucwaningo lwabheka abantu abaneHodgkin lymphoma ababeneminyaka engama-35 noma ngaphezulu ngaphandle kokwelashwa. Ingozi yomdlavuza wesibili iminyaka engama-30 iphuma ngamaphesenti angu-33.2 (uma kuqhathaniswa namaphesenti angu-9,6 emphakathini jikelele) kanye namaphesenti angu-48.5 eminyakeni engu-40 (uma kuqhathaniswa namaphesenti angu-19 kubantu abaningi).
Iziphi Ukwelashwa Okuphakamisa Ingozi Yamanqamu Asekondari?
Njengoba kuphawuliwe ngenhla, siyazi ukuthi kokubili ukwelashwa kwe-chemotherapy kanye nokwelashwa kwemisebe kungaphazamisa amangqamuzana aphilile, kodwa ezinye izindlela zokwelapha ziningi kunezinye zokubeka ingozi yomdlavuza.
Ukwelapha imithi esifubeni seHodgkin lymphoma sekuyisikhathi eside kuhlotshaniswa nengozi eyengeziwe yomdlavuza webele , umdlavuza wamaphaphu , nomdlavuza wegciwane. Esikhathini esidlule, noma kunjalo, ukulinganisa kwemisebe kanye nobukhulu bezicubu ezivamile bebukwe kakhulu. Ngesikhathi samanje, ukwelapha imishanguzo kuyasetshenziswa kaningi ukuphatha i-Hodgkin lymphoma, nakuba kusetshenziselwa njalo izifo zesigaba sokuqala. Imishanguzo okwamanje isetshenzisiwe iphinde ikhululwe endaweni ecacile kakhulu, ekhawulwe amathishu aphethwe yiHodgkin lymphoma ( imisebe yensimu emhlophe ).
I-radiation ihlinzekwe ngezansi kwe-diaphragm, ngokungafani nemisebe yesifuba, yandisa ingozi yomdlavuza wesisu, i-pancreatic, ne-colon.
I-Chemotherapy nayo ibangele ukulimala kwamangqamuzana, kepha ezinye izigaba zemithi yokwelashwa yi-chemotherapy zingase zidale umonakalo ongabangela umdlavuza wesibili. Isigaba semithi eyaziwa ngokuthi ama-alkylating agent sinezingozi ezinkulu (ikakhulukazi i-procarbazine). Ama-alkylating agents agxila kakhulu kunengozi enkulu ye- non-Hodgkin lymphoma .
I-Procarbazine ikhona ku- BEACOPP chemotherapy regimen kanye ne-dacarbazine, enye i-agent e-alkylating ingenye yezingxenye ze- ABVD chemotherapy .
Ingabe Ingozi Yamanqamu Asekondari Ukwandisa Noma Ukunciphisa?
Ukuthuthukiswa okuningi kuye kwenzeka ekwelapheni i-Hodgkin lymphoma ngokuhamba kwesikhathi. Njengoba nje kuphawuliwe, ezinye zezinto ezibaluleke kakhulu ezingozini zekhansayini yesibili zivela ekwelashweni kwama-radiation kanye ne-chemotherapy nama-alkylating agents.
Nakuba kungengqondo ukuthi ingozi yamagciwane e-secondary izokwehla, ngoba ukusetshenziswa kwezokwelapha okuhlobene kakhulu ne-khansa yesibili kunciphisa, abukho ubufakazi bokuthi lokhu kwenzeka, kanti ezinye izifundo ziphakamisa ngisho nokwanda okuncane engozini.
I-Cancers Yonke Ejwayelekile Eyenzeka Ngemuva Kokuphathwa Kwe-Hodgkin Lymphoma Treatment
Amagciwane wesibili ajwayelekile kunazo zonke abantu abaye baba neHodgkin lymphoma zihlanganisa:
- Umdlavuza wesibeletho - Umdlavuza wesibeletho ngumdlavuza wesibili ovame ukutholakala kubantu abaye baphathwa ngeHodgkin lymphoma. Kunemihlahlandlela enconywayo (bheka ngezansi) ukuhlolwa kokuqala komdlavuza webele okuxhomeke eminyakeni yobudala lapho uthola khona ukuthi unesifo se-Hodgkin kanye nezinhlobo zokwelashwa ozitholile. Isibonelo, abesifazane abathola imishanguzo yeHodgkin lymphoma (emisebeni yensimu emhlophe) ngaphambi kwesiguli ngaphambi kokuba baneminyaka engama-30 kufanele babe nemibuzo ye-MRI ngonyaka kanye nokuhlolwa kwebele emtholampilo kusukela ekuqaleni kweminyaka engama-30. Ngokuvamile, abesifazane abaye baphathwa ngeHodgkin lymphoma kumele baqale njalo Ukuhlolwa komdlavuza wesifuba kuneminyaka engu-40 ngesikhathi sakamuva. Khumbula ukuthi amadoda angathola umdlavuza webele.
- I-non-Hodgkin lymphoma - Njengoba kuphawuliwe ngenhla, i-non-Hodgkin lymphoma ixhunyaniswe kakhulu nemikhiqizo yamakhemikhali ehlanganisa ama-alkylating agents ezifana ne-procarbazine.
- Umdlavuza we-Lung - Ukwelashwa kwezidakamizwa esifubeni se-Hodgkin isifo ngaphezu kwesisu kuyinto umdlavuza wesibili ovamile. Abacwaningi abaningi bakholelwa ukuthi amasu amasha okushisa ama-radiation azoholela emancinini amancane ekhanda.
- Umdlavuza weColon - Kukhona ingozi yokwanda komdlavuza we-colorectal, ikakhulukazi kulabo abaye babe nemisebe engaphansi kwe-diaphragm kanye ne-chemotherapy ehlanganisa i-procarbazine. Ucwaningo luqhubeka luzama ukuthola indlela engcono kakhulu yokubukisa abantu abaye baba ne-Hodgkin lymphoma abaye baba nazo zombili lezi zelashwa.
- Umdlavuza we-Pancreatic - Umdlavuza we-Pancreatic uxhunyaniswe kakhulu kakhulu nemisebe engaphansi kwe-diaphragm.
- Umdlavuza wesisu - Njengomdlavuza we-pancreatic, umdlavuza wesisu uvame ukuhlotshaniswa nomlando wokwamukela ukwelashwa kwemisebe ngaphansi kwe-diaphragm.
- I-myeloid leukemia enamandla kakhulu - I- leukemia njengomdlavuza wesibili ayiyona into evamile njengoba kwacatshangwa, kepha ingozi isakhulunywa nakakhulu ekusindisweni kwezifo zeHodgkin. njengoba ucabanga esikhathini esidlule. Izidakamizwa ezifana ne-Cytoxan (cyclophosphamide) zithwala ingozi enkulu kunazo zonke. I-Cytoxan ingenye yezidakamizwa ku-BEACOPP chemotherapy.
Amanye ama-Cancers Okuyanda Kulabo Abano-Hodgkin Lymphoma
- I-Melanoma
- I-Myelodysplastic syndrome (MDS)
- I-Cancer ye-lip noma ulimi, umdlavuza we-gay
- Umdlavuza wesibindi
- Umdlavuza we-anal
- Umdlavuza we-Bone kanye namanqamu amancane omzimba
- Umdlavuza wesibeletho
- Umdlavuza we-Thyroid
- I-sarcoma yeKapa
Ingozi YamaKhansela Okufunda Kuphela Kangakanani?
Akuqiniseki ukuthi ingozi yengculaza yesibili iphikelela kangakanani, nakuba kungenzeka ukuthi ingozi ihlala iphakanyisiwe kuze kube yimpilo esele. Ngokuvamile, kubonakala sengathi ubungozi obukhulu kakhulu bekhansali yesibili kwenzeka eminyakeni eyishumi elandela ukwelashwa.
Imihlahlandlela Yokuhlolwa Kwemikhakha Yesibili
Kukhona okwamanje iziqondiso endaweni yokuhlola ezinye zegciwane lesikhumba. Lezi zikhombandlela zokusinda zihlanganisa izincomo ezithile ezisekelwe eminyakeni yakho ekuxilongweni, izinhlobo ezithile zokwelashwa ozitholile, nobude besikhathi kusukela usuqedile ukwelashwa. Kubalulekile kuwo wonke umuntu oye waba ne-Hodgkin isifo sokubuyekeza lezi ziqondiso futhi uxoxe ngazo nge-oncologist yabo. Ukwengezwa kule mihlahlandlela kufanele kube yiziphi ezinye izici eziyingozi noma umlando womndeni womdlavuza onayo.
Ukuqapha Nokuqaphela Kwangaphambili Nokuqwashisa Izimpawu
Ngenkathi kuneziqondiso ezithile endaweni yokutholakala kokuqala kwamagciwane ekhanda, kubalulekile ukukhomba ukuthi akukhona okwamanje ukuhlola izivivinyo ezitholakalayo eziningi zamanomdlavuza okwandiswa kulabo abane-Hodgkin lymphoma.
Isibonelo, asinayo indlela yokuhlola abantu njalo nge-non-Hodgkin lymphoma, umdlavuza ovamile ngemuva kokwelashwa. Njengamanje, kubonakala kungengqondo ukuthi labo abaku-Hodgkin lymphoma kumele baqaphele izimpawu ze-non-Hodgkin lymphoma futhi bafune ukwelashwa uma kukhona noma iyiphi yalezi zimpawu kufanele ivele.
Kulawo mdlavuza lapho iziqondiso zikhona, ungalindela ushintsho. Sisaqala ukuqonda izingozi zamanqamuzana wesibili, futhi ucwaningo oluningi lusele lwenziwa.
Ukubaluleka Kokunakekelwa Kwamanje Kwokwelashwa Emva kweHodgkin Lymphoma
Ngaphezu kwanoma yikuphi ukulandelwa okuphakanyiswe yi-oncologist yakho ukutholakala kokuqala kwamagciwane ekhondomu, kubalulekile ukuqinisekisa ukuthi usesikhathini "ukuhlola" okujwayelekile.
Izikhathi eziningi lapho ubhekene nomdlavuza, ezinye izinkinga zezokwelapha ziphoqelelwa kumshini wokushisa emuva (noma ususe isitofu ngokuphelele). Izivivinyo zokuhlola njenge-colonoscopy zingase ziweqe. Kubantu abaningi, into yokugcina abafisa ukuyenza emva kokuqeda ukwelashwa ukuhlolwa kokuhlola okungase kutholakale omunye umdlavuza!
Ngenye inothi, ungase ube nalokho okungaba uphawu lokuqala lomdlavuza, kodwa ngokuhambisana nalokho okuye kwenzeka, isibonakaliso sakho singase singabonakali konke okuphawulekayo. Abantu abanomdlavuza bafunda ukuhlala nobuhlungu obukhulu noma ukunganaki, futhi cishe wonke umuntu ufunda ukuhlala ekukhathala. Kungaba nzima kakhulu ukuhlukanisa ukukhathala ngenxa yenkinga entsha ekukhathaleni okuqhubeka kubonakala njalo emva kokulashwa komdlavuza. Lalela umzimba wakho futhi uthembe umthambo wakho. Uma kukhona okungafani, khuluma nodokotela wakho.
Ungayinciphisa Kanjani Ingozi Yakho Yomdlavuza Wesibili?
Ngaphandle kokuhlola ukuhlolwa kwakho udokotela wakho uyancoma, ukwamukela imikhuba yokuphila enempilo kunganciphisa ingozi yokuthuthukisa umdlavuza wesibili. Lokhu kuhlanganisa:
- Ukudla ukudla okunempilo
- Ukugcina isisindo esinempilo
- Gwema ugwayi
- Ukusebenzisa njalo
- Ukunciphisa ukusetshenziswa kotshwala
- Ukulandela ukunakekelwa kwezempilo okunconyiwe kanye nemihlahlandlela yokuhlola
Ngaphezu kwalokho, ungase ufise ukuhlola lezi zeluleko ngokunciphisa ingozi yomdlavuza wekolon , lawa macebiso ekunciphiseni ingozi yomdlavuza wamaphaphu , kanye nale mibono ekunciphiseni ingozi yomdlavuza webele .
Izwi elivela
Kungaba ukwesaba ukufunda ukuthi kukhona ingozi yamagciwane wesibili ngemuva kokwelashwa kwe-Hodgkin lymphoma, kodwa kunezinto eziningi ongayenza ukuze unciphise ingozi yakho. Indlela yokuphila enempilo ingasiza ukunciphisa ingozi yalezi zomshukela kanye nezimo zezokwelapha ezivamile emphakathini jikelele. Kubalulekile ukukhuluma ne-oncologist yakho mayelana nokuhlola okunconywe ngokusekelwe ezinyweni oye wazenza. Kungumqondo omuhle wokuba nezimpawu ezintsha zihlolwe ngokushesha. Le nhlanganisela yokunciphisa ingozi yakho futhi ukwandisa ithuba lokuthi uzothola umdlavuza ezinyathelweni zokuqala ezingaphatheki kahle zingase zihambe ngendlela ende ekubhekaneni nokuphila kwakho neHodgkin lymphoma "okuhle okuvamile".
> Imithombo:
> Keegan, T., Bleyer, A., Rosenerg, A., Li, Q., noMnu Goldfarb. I-Second Primary Neodlastic Neoplasms and Survival In Survival Adolescent and Young Adult Survivors. I-JAMA Oncology . 2017 Apr 20. (Epub ngaphambi kokuphrinta).
> Norval, E., no-E. Raubenheimer. Ukuhlukumeza okwesibili ku-Hodgkin Isifo: Ukubukezwa Kwezincwadi Nokubika Kwesihloko NgeLymphoma yesiLennert yesibili. I-Journal ye-Oral and Maxillofacial Pathology . 2014. 18 (Suppl 1): S90-5.
> Radford, J., noDongo Longo. Amakhansela wesibili emva kokwelashwa kwe-Hodgkin Lymphoma - Isinyathelo esiqhubekayo sokukhathazeka. I-New England Journal of Medicine . 2015. 373: 2572-2573.
> Rigter, L., Spaander, M., Moon, L. et al. I-Colorectal Cancer Surveillance ku-Hodgkin Lymphoma Abasinda Ngengozi Ekhulayo Ye-Treatment-Related Colorectal Cancer: Study Design. I-BMC Cancer . 2017. 17 (1): 112.
> Schaapveld, M., Aleman, B., van Eggermond, A. et al. Ingozi Yesibili Yomdlavuza WezeMinyaka Engu-40 Ngemuva Kokwelashwa kwe-Hogkin's Lymphoma. I-New England Journal of Medicine . 2015. 373: 2499-2511.