Bangaki abesifazane abakhulelwe abakha umdlavuza wamaphaphu? Ingabe abantu bangathola ukwelashwa komdlavuza wamaphaphu ngenkathi bekhulelwe? Ingabe ukukhulelwa kudinga ukuqedwa? Njengoba kubonakala sengathi umdlavuza wamaphaphu kwabesifazane abakhulelwe uyanda, le mibuzo ibalulekile. Khumbula ukuthi noma ubani onamaphaphu angathola umdlavuza wamaphaphu.
I-Cancer Lung Kwabesifazane Abakhulelwe
Abantu abaningi bayamangala lapho bezwa ukuthi abesifazane abakhulelwe bangaba nomdlavuza wamaphaphu.
Iningi labantu lihlobanisa umdlavuza wamaphaphu nalabo asebekhulile futhi sebebhemayo. Kodwa lokho akusiyo njalo njalo.
Umdlavuza wegciwane kungenzeka kubantu abadala futhi ngokungafani nokuncipha kwamuva komdlavuza wamaphaphu kubantu asebekhulile, umdlavuza wamaphaphu kubantu abasha ukhula. Eqinisweni, ngenxa yeqembu elilodwa labantu, isifo somdlavuza wamaphaphu siye sanda kakhulu: abesifazane abasebasha, ababheki nhlobo.
Kodwa ngenkathi umdlavuza wamaphaphu ungenzeka ngesikhathi sokukhulelwa, akuyona into evamile. Asinaso isiqiniseko sokuthi kwenzeke kanjani, kodwa kusukela ngo-2017, kunezimo ezingaphansi kuka-70 zomdlavuza wamaphaphu kwabesifazane abakhulelwe ababebhaliswe ezincwadini zezokwelapha.
Ingabe I-Cancer Lung Ihlukile Kwabesifazane Abakhulelwe?
Abekho abesifazane abakhulelwe abanomdlavuza wamaphaphu ukwenza izifundo ezijulile zalezi zomshukela, kodwa siyazi ukuthi umdlavuza wamaphaphu kubantu abadala abasha ngokuvamile uhlukile emdlavuza wamaphaphu kubantu abadala asebekhulile, ukuthi umdlavuza wamaphaphu kwabesifazane ungase uhluke kumaphaphu umdlavuza emadodeni, nokuthi umdlavuza wamaphaphu kwabangewona abokubhema ngokuvamile uvame ukungafani nalabo abangabhemi.
Ake sibuke amanye alawa mahluko.
Izinhlobo
Kucatshangwa ukuthi i- lung adenocarcinoma , uhlobo lomdlavuza ongasona omncane wesifo samaphaphu, unesibopho samaphesenti angaba ngu-85 wamanqamu amaphaphu atholakala kwabesifazane abakhulelwe. Lona uhlobo lomdlavuza wamaphaphu olutholakala kaningi kubantu abasha futhi abasoze babhema nalesi sifo.
Okwenza Kungaba nzima Ukuzihlola
Isizathu esicacile sokuthi kungani kutholakala umdlavuza wamaphaphu kwabesifazane abakhulelwe kungaba nzima ukuthi ngokuvamile sizama ukugwema ukuvezwa kwemisebe, njengama-lung CT noma ama-x-rays, ngesikhathi sokukhulelwa. Esinye isizathu, Nokho, sibhekene nohlobo oluvame kakhulu lomdlavuza wamaphaphu olutholakala kwabesifazane abakhulelwe okukhulunywe ngenhla.
Kunezigaba ezimbili ezinkulu zomdlavuza wamaphaphu: umdlavuza ongewona omncane wamaphaphu (i-NSCLC) nomdlavuza omncane we-cell lung (SCLC). kanti amaphesenti angama-80 wamanqamu emaphaphu abe yi-NSCLC. Amanqamu amancane amancane amaphaphu amaphaphu aphinde aphule abe amaphapha adenocarcinomas (cishe amaphesenti angu-50 eNSCLC) ama-squamous cell carcinomas yamaphaphu (amaphesenti angu-30 eNSCLC) nomdlavuza omkhulu wamaphaphu omzimba.
Amakhansela amancane amaphaphu wamaphaphu namagciwane e-squamous amaphaphu amaphaphu athambekele ukuba avele eduze nemikhumbi ehamba phambili. Lezi zomshukela zivame ukubangela izimpawu ekuqaleni kokufana nokukhwehlela, ukutheleleka okuphindaphindiwe ngenxa yokuvimbela umoya, noma ukukhwehlela igazi. Ngokuphambene, amaphaphu adenocarcinomas athambekele ekukhuleni emaphashini. Lezi zomshukela zingakhula kakhulu ngaphambi kokuba zidale izimpawu. Ngenxa yendawo yabo, bavame ukudala ukuphefumula okuqhubekayo kancane kancane, ngokuvamile kuvele kuqala ngokuzikhandla. Kungase futhi kubangele ukukhathala.
Njengoba ukuphefumula okuncane nokuphelelwa amandla okuncane kufana nokukhulelwa, abesifazane abaningi baqale ukuxosha izimpawu zabo zomdlavuza wamaphaphu njengokuthi bahlobene nokukhulelwa, ikakhulukazi uma bengakaze baphuze.
I-Gene Mutations
Phakathi kwabantu abadala, abangabhemi, nabesifazane abanomdlavuza wamaphaphu, kunomphumela omkhulu "wezinguquko ezithinta izakhi." Ngamanye amazwi, izicubu kubantu abasha zinamathuba amaningi okuba nezinguquko zofuzo okuzosebenza ngazo. Ngenxa yalesi sizathu, kubaluleke kakhulu kwabesifazane abatholakala ukuthi ngesikhathi sokukhulelwa (kanye nabo bonke abasha abathintekayo abanesifo) ukuba babe nokuprofetha kwamangqamuzana (ukuhlolwa kofuzo) okwenziwe emathunjini abo.
Ezinye zalezi zinguquko zingabandakanya ukuguqulwa kwe-EGFR , ukulungiswa kwe-ALK, ukulungiswa kabusha kwe-ROS1, nokuningi.
Ukuxilongwa
Umdlavuza wamaphaphu ungatholakala kanjani futhi uhlelwe ngendlela eyanciphisa ukuvezwa kwemisebe kumntwana? Kunezinketho zokuhlola umdlavuza wamaphaphu kwabesifazane abakhulelwe. Izivivinyo ezifana ne-MRI ayisebenzisi imisebe futhi zibhekwa njengokuphepha ngokukhulelwa. Izifundo ze-X ezifana ne-CT scan zingenziwa uma kudingekile uma umntwana evikelekile ekuvezeni.
Okwenza I-Cancer Lung Emanzini Abakhulelwe Iyakhula
Kucatshangwa ukuthi isizathu esikhulu esenza umdlavuza wamaphaphu kwabesifazane abakhulelwe ukwanda ukuthi umdlavuza wamaphaphu ukwanda kubantu abasha emhlabeni jikelele. Ngesikhathi esifanayo, ubudala ekukhulelweni kokuqala landa emazweni athuthukile. Kubonakala sengathi imbangela ingaphezu kokungcoliswa kwentuthu yomsizi wesibhamu, kodwa izizathu ezicacile zisisile ngalesi sikhathi. Siyazi ukuthi kukhona ubuhlobo phakathi komdlavuza we-estrogen nomdlavuza kodwa awuqiniseki ukuthi lokhu kungadlala indima kodwa akuqiniseki ukuthi lokhu kungadlala indima
Ukubhekene Nomdlavuza Wegciwane Njengomama Okhulelwe
Ukuxilongwa komdlavuza wamaphaphu ngesikhathi sokukhulelwa kungase kubonakale kuvela ensimini engakwesokunxele. Ulindele ukuzwa amagama "ungumfana" noma "uyintombazane," hhayi "unomdlavuza wamaphaphu."
Uma uthola ukuthi unomdlavuza wamaphaphu ngesikhathi ukhulelwe, kunezinto ezimbalwa okufanele wazi. Abantu bathole ukwelashwa ngesikhathi sokukhulelwa futhi baqhubeka nokuletha izingane ezinempilo. Kungase kusimangaze, kodwa ukwelashwa okunjengezinye izinhlobo ze-chemotherapy kuphephile kakhulu kumntwana ngesikhathi sokugcina sokukhulelwa (hhayi ngesikhathi se-trimester yokuqala).
Ukuphatha kokubili
Ukuthola ukuthi unomdlavuza wamaphaphu ngenkathi ukhulelwe kufana nokuhamba nge-tightrope, kodwa ukuhamba okunamandla kungahamba kangcono uma unolwazi lusiza ezinhlangothini zombili. Kubalulekile ukuthola i-oncologist ekhululekile ukuphatha abesifazane abakhulelwe abanomdlavuza wamaphaphu. Kungase kudingeke uthole umbono wesibili (noma u-3 noma u-4). Ngesikhathi esifanayo, kubalulekile ukuthi umuntu abe nodokotela wezifo ezithintekayo. Lo dokotela angakusiza ukuba ulinganise izingozi zokuqeda isimo sokuqala ngaphambi kokulethwa kokuqala kanye nezingozi zokuqhubeka nokukhulelwa nokudalula ingane ezinyweni ozidingayo.
Izinketho zokwelapha
Ukwelashwa komdlavuza wamaphaphu kunika ithuba lokuthola ukwelashwa kwabesifazane abanesifo sokuqala (isigaba 1, Isigaba 2, nesigaba 3A). Ukuhlinzeka ngokweqile kungenziwa kubantu besifazane abakhulelwe, nakuba kunakekelwa okukhethekile ukuze kuqashwe iziguli zombili. Isisu esisakhulayo singase sibe nezinselelo. Njenganoma yiluphi ukwelashwa ithimba lokunakekela elibandakanya udokotela ohlinzayo, oncologist, kanye nochwepheshe bezinambuzane kuyodingeka basebenze ndawonye ukuze banqume ukunakekelwa okuhle kokubili kokubeletha nomama.
Ngesikhathi se-trimester yesibili neyesithathu, i- chemotherapy ayihlotshaniswa nomphumela we-teratogenic, okusho ukuthi i-chemotherapy ayinakwenzeka ukudala ukukhubazeka kokuzalwa. Kukhona ingozi yezingane ezinesisindo sokuzalwa okuphansi kanye nengozi encane yokunciphisa ukukhula kwe-intrauterine.
Ucwaningo lwango-2010 lwathola ukuthi izidakamizwa ezinganeni ezisuka kulesi sifo zenzeke amaphesenti angu-26 esikhathi. Ngenxa yengozi, udokotela wakho wezifo angase acabangele ukuletha ingane yakho kahle ngaphambi kosuku olusemthethweni olufanele. Kwesinye isifundo, kwafunyanwa ukuthi abesifazane besiphathwa nge-chemotherapy ngenkathi bekhulelwe, bekungabikho metastases ku-placenta noma fetus.
Ngokuvamile, izindlela zokwelashwa ezihlosiwe njengeTarceva (erlotinib) zezinguquko ze-EGFR ziyagwenywa ngesikhathi sokukhulelwa. Ezimweni ezimbalwa lapho izidakamizwa ezintathu, iTarceva, Iressa (gefitinib), noma i-Xalkori (crizotinib) zisetshenzisiwe, kwakungekho bufakazi bokuthi kunomphumela kumntwana emva kokubeletha. Okuphawula ukuthi abesifazane abasebasha (labo abangase bakhulelwe) banamathuba amaningi kunesilinganiso sokuba nokuguquguquka okuhloswe ngakho, futhi kufanele bonke babe nokuprofetha kwe-molecular (ukuhlolwa kofuzo) okwenziwe emathunjini abo.
Ukwelapha Emva Kokuphathwa Kwemdlavuza Yengculaza
Uma uhlakulela umdlavuza wamaphaphu ngesikhathi ukhulelwe ungase uzibuze ngokukhulelwa esikhathini esizayo. Kuyiqiniso ukuthi ezinye izidakamizwa ze-chemotherapy zingabangela ukungabi nabantwana, ngakho-ke lezi yizinto ozozibuza ngokushesha uma unethemba lokuba nomunye ingane. Kunezinketho ezifana nemibungu yokuqandisa ngaphambi kokuqala ukwelashwa, okungashiya umnyango uvulekile uma ungathanda ukukhulelwa esikhathini esizayo. Ngaleso sikhathi uzobhekana nesinqumo mayelana nokuthi unempilo ngokwanele yokuthwala umntwana noma uma kufanele ucabangele umuntu othanda ukuhlala naye.
Ngaphansi
Umdlavuza we-Lung ngesikhathi sokukhulelwa usuvame kakhulu. Yize kunezingozi eziningi, abantu abaningi baye baqhubeka nokwelashwa futhi beletha izingane ezinempilo. Ukwelashwa komdlavuza wamaphaphu ngesikhathi ukhulelwe kuncike ekutheni ukhona kangakanani (ubudala bokubeletha kwengane). kanye nezinye izinto eziningi ezifana nohlobo nesigaba somdlavuza wakho, ukuprofetha kwamangqamuzana, nokusekelwa komphakathi.
> Imithombo:
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> Boussios, S., Han, S., Fruscio, R. et al. I-Cancer Lung in Ukukhulelwa: Umbiko Wezinsuku Eziyisishiyagalolunye Ezivela Esifundweni Sezizwe Ezihlangene. I-Cancer Lung . 2013. 82 (3): 499-505.
> Garrido, M., Clavero, J., Huete, A., Sanchez, C., Solar, A., Alvarez, M., no-E. Orellana. Ukusinda Okuqhubekayo Kwesifazane Ophethe Ingculaza Yengculazi Ebonwa Futhi Ephathwa NgokweKhemotherapy Phakathi Nesikhathi sokukhulelwa. Ukubuyekezwa kwamacala okubikiwe. I-Cancer Lung . 2008. 60 (2): 285-90.
> Mitrou, S., Petrakis, D., Fotopoulos, G. et al. I-Cancer Lung During Ukukhulelwa: Ukubukeza Okulandelanayo. I-Journal of Research Advanced . 2016. 7 (4): 571-574.
> Sariman, N., Levent, E., Yener, N., Orki, A., no-A. Saygi. I-cancer yengculazi nokukhulelwa. I-Cancer Lung . 2013. 79 (3): 321-3.
> Whang, B. Ukwelashwa kwe-Thoracic kuMguli Okhulelwe. Imitholampilo yezokwelapha . 2018. 28 (1): 1-7.