Ukwelashwa okuphelele kanye nesigaba se-III nesigaba se-IV se-Ovarian Cancer
Kutjho ukuthini nge-" cytoreduction " noma ukuhlinzekwa kwe-debulking yomdlavuza we-ovarian?
Ukukhishwa kwe-Cytoreduction noma Ukuhlinzwa Kwe-Debulking
Uma uhlinzekwe ukuhlinzwa komdlavuza we-ovarian ophuthumayo, omunye wemibono ebaluleke kunazo zonke ongayibuza udokotela wakho kungakhathaliseki ukuthi i-debulking noma i-cytoreduction yayilungile noma cha. Ngamanye amazwi, iningi le-tumor lisuswe ngokuhlinzwa?
Kuyini "Ukulungiswa" kwe-Cytoreduction noma i-Debulking
Akusiyo njalo ukuthi kungenzeka ukuthi ususe umdlavuza obonakalayo ngesikhathi sokuhlinzwa komdlavuza we-ovarian. Kodwa-ke, sazi ukuthi ukuhlanganisa ukuhlukunyezwa ngonyawo nge-chemotherapy kuye kwaholela emalini amazinga angcono kakhulu okwelapha iminyaka engaphezu kwengu-20. Kule minyaka edlule, uhlobo lwe-chemotherapy luye lwashintsha futhi nencazelo yokuthi ukuhlinzwa okunonya noma "okuhle" kungaba noma kufanele kube.
Ngokusanda kudala eminyakeni eyishumi edlule, incazelo yokuhlinzekwa "okuhle" yukuthi izicubu ezingekho ngamasentimitha angu-2 ezishiywe ngemuva (okungaba ngu-¾ of intshi). Lokhu kungase kube eyodwa, noma ezimbili noma eziningi izicubu, akekho okwakungaphezu kuka-2 amasentimitha ngobukhulu.
Ngamathuluzi angcono namasu okuhlinzeka, manje sazi ukuthi kungenzeka ukuthi ukuhlinzekwa "okulungile" kungase kube khona ukushiya ngaphansi kwezicathumitha ezingamamitha angu-1, ukuya "kumarida" (ama-nodules amancane "emanzini" omncane "wesihlabathi") eziningi zeziguli futhi ngisho nezifo ezincane (azikwazi ukukubona noma ukuzizwa ngemva kokuhlinzwa) ezigulini eziningi.
Isimo Sakho Sezokwelapha Esivamile Senza umehluko
Akuzona zonke iziguli ezidalwe ngokomzimba. Kwezinye izimo, isiguli singase sigule kakhulu noma sigule ukubekezelela amahora angu-4-8 angathatha ukufeza imiphumela "enhle". Futhi, ukuphuma kwamanzi noma ezinye izinkinga kungase kuphoqele udokotela ohlinzayo ukuba ayeke ukuhlinzwa ngaphambili kunalokho ababekuthandayo.
Ezimweni eziningi, akuyona iminyaka yobudala ngokwayo kodwa kunalokho izimo zokwelashwa ezingeziwe isiguli esingase sibe nazo esichaza ukuthi kungakanani isikhathi sokuhlinzwa esingavunyelwa ukuhlinzwa.
Ubani Ohlinzayo Wakho Owenza Umqondo Ohlukile
Akuwona wonke odokotela abahlinzayo abadalwa alinganayo. Lokhu kuyiqiniso kuzo zonke izisebenzi kanye nazo zonke izidingo zezokwelapha. Ngisho naphakathi kwamagciwane e-gynecologic - okufanelekile ukusebenzela kuwe ngomdlavuza we-ovarian - kukhona umehluko kumakhono. Bonke baqeqeshwe ekwenzeni izinqumo ezifanele futhi iningi lingenza i-cytoreduction ukuze kufinyelele u-1-2 cm we-"resial" ukuhlinzwa ngokugcwele kuningi leziguli zabo. Okungenani uqiniseke ukuthi i-oncologist yezinkinga zokubeletha, noma, yayihilelekile ekuhlinzekeni kwakho.
Ingabe Ngidinga Ukuhlinzwa Okwengeziwe?
Ucwaningo lwezokwelapha luye lwabonisa ukuthi okuningi okususwe ngcono uma kuziwa ekuhlinzekeni komdlavuza we-ovarian. Ayikho iphuzu elingaphezu kwalokho okungekho inzuzo eyengeziwe. Kodwa-ke, ngezinye izikhathi ukuthola izifo zamabhiliyoni noma ezincane kudinga ukuhlinzwa okunonya, kufaka phakathi ukususa izingxenye zesibindi, uhlangothi, amaphaphu, izindawo eziningi zamathumbu, izitho zamakamelo ezindaweni ezinzima nangaphezulu. Akuzona zonke iziguli ezikwazi ukubekezelela lokhu futhi akuwona wonke odokotela abahlinzayo abakhululekile ukwenza lezi zinqubo.
Abanye baye bathi lolu hlelo lokusebenza "lwe-ultra" -ukuhlinzwa okujwayelekile kakhulu, lapho umgomo ukufezekisa okuncane kakhulu kumabhalane (isayizi "yesihlabathi") "ukuhlinzwa okuphelele" cishe zonke izindleko.
Ngaphambi kokuqhubeka, lokhu kudinga ingxoxo enkulu kakhulu engozini / yenzuzo nge-oncologist yakho yezinkinga zokubeletha. Uma unquma ukuvumelana nalesi sifo sokuhlinzwa, khumbula ukuthi akuwona wonke odokotela abahlinzayo abaqeqeshwe, noma benze amacala ahlinzekwa ngokwanele aloluhlobo, ukuze bafeze ngokuphepha lesi silinganiso esengeziwe sokuhlinzwa "okulungile". Ngakolunye uhlangothi, bangase bangakholelwa ukuthi leli zinga eliphakeme lokuhlinza liyabasiza kakhulu iziguli zabo. Yize imibono ehlukene ehlukene, lokhu kuyindawo eluhlaza kulezi zincwadi zezokwelapha.
Ingabe i-"Ultra-Radical" Cytoreduction ikhonjisiwe?
Abanye ochwepheshe balondoloza ukuthi uma kudingeka "ukuhlinzwa" okuvamile ukuze kufike ekuhlinzekeni "okuhle", lokhu kusho ukuthi esimweni sesiguli umdlavuza unamandla kakhulu.
Ngakho-ke, banomuzwa wokuthi lokhu kuhlinzwa okungeziwe kwenza lutho ukuthuthukisa amathuba okuphulukiswa. Okuyiqiniso ukuthi, nakuba lokhu kungase kwenzeke kwezinye iziguli, asazi ukuthi iziphi iziguli ezizohlinzwa ngesikhathi sokuhlinzwa, noma ngisho nangemva kokuhlinzwa.
Ucwaningo olushicilelwe lubonisa ukuthi abanye besifazane bayazuza kakhulu kunabanye kusukela ekuhlinzeni okukhulu kakhulu futhi okukhulu kakhulu. I-Cancer inezinhlamvu ezihlukahlukene zokuzwela ekhemotherapy, okungenakuqiniseka ukuthi ingabonakala. Ezinye iziguli zelashwa. Ezinye azikho.
Itsela udokotela ohlinzayo okwenza isinqumo sesazi ngesikhathi sokuhlinzwa mayelana nokuthi uhambe kangakanani nokuhlinzwa ngokusekelwe kulokho okusemandleni akho futhi uma ucabanga ukuthi ungakwazi ukubekezelela ukuhlinzwa okuqhubekayo. Lokhu kungase kube yingxenye ngokusekelwe ekucabangeni mayelana nokuhlukunyezwa kwegazi lomdlavuza wakho othize.
Khumbula ukuthi kwezinye izimo akunakwenzeka ukuthi kungenakwenzeka ukuba ufike "esilinganisweni" ngaphandle, isibonelo, ukususa wonke amathumbu, okusobala ukuthi awahambisani nekhwalithi elihle yokuphila. Ngokufanayo, njengoba kukhulunywe ngaphambili, kwezinye izimo izimo zezokwelapha noma izinkinga zangaphakathi ezingase zenzeke zingase ziphoqele ukuyeka ukuhlinzwa ngaphambi kokuhlelwa noma okufisiwe. Kodwa kukhona umehluko, engithemba ukuthi usuqala ukuwuqonda, phakathi kokuthi "akunakwenzeka" nokwahlulela okwenziwe noma ukungabi namakhono okuhlinzeka.
Uma kungenzeka, kubalulekile ukuxoxa ngefilosofi yakho ye-gynecologic oncologist mayelana nezindaba ezingenhla ngaphambi kokuba uhlinzekwe. Futhi, ungase ungenze noma unganqume ukuthi imibono yesibili iyadingeka. Kumane uFANELE uhlakulele ubudlelwane obukhulu ne-oncologist yezinkinga zokubeletha ozikhethela ngokugcwele. Ngenkathi ngingadikibela kakhulu ekuthengeni udokotela ongakhethi, uma lobu buhlobo bungekho, thola udokotela ukuthi ungahlakulela lolu hlobo lobuhlobo naye.
Kuthiwani NgeSigaba 4 I-Ovarian Cancer?
Amagama ambalwa ngokuphathelene nomdlavuza weSigaba IV (4) kubalulekile. Esikhathini esidlule, kwakucatshangwa ukuthi uma umdlavuza we-ovarie ubonakala endaweni yamapayipi noma esibindi noma ngepeni, ukubikezela kwakumpofu kakhulu kangangokuthi ukuhlinzeka ngeke kusebenze kakhulu. Ucwaningo lwamuva lubonisa ukuthi, ngenkathi isimo ngasinye sihlukile, lokhu kungase kungabi yiqiniso. I-prognosis ingase ibe yimbi kakhulu kuneSigaba III, kodwa ezimweni eziningi, ukukhishwa kwama-cytoreduction okudangele kufanele kusacatshangelwe kakhulu uma kungenzeka ukuthi kungenzeka ukuthi isiguli siyasiqonda ingozi futhi sizuze futhi uma sikwazi ukuyibekezelela imithi. Uma ukuhlinzeka "kulungile", ukubikezela kungathuthukisa kakhulu futhi kufike eduze kwemiphumela eboniswe eSiteji III.
Isifinyezo sezinzuzo zokuhlinza nge-Cytoreductive
Ngokuvamile, isandulela se-MAJOR sokuthi kungenzeka ukwelashwa ku-Stage II kuya kumdlavuza we-IV yizinga lapho "i-cytoreduction" ephumelele khona. Phakathi neminyaka, isisindo esinamandla sobufakazi bezokwelapha (amaphepha amaningi wezokwelapha) asekela ukususa umdlavuza omkhulu ngangokunokwenzeka ngaphambi kokomethripi. Kukhona imibono yezinto eziphilayo, engingeke ngifake kuzo imininingwane, exhasa izinzuzo ze-cytoreduction enobudlova ekuthuthukiseni i-chemo-response.
Ngokuyinhloko, ukuhlinzeka kwenza kube lula ukuthi i-chemotherapy isebenze ngokunciphisa inani lamaseli amakhemikhali okumele awabulale (kusuka ezigidigidi / trillion kuya kwamakhulu / amashumi ezinkulungwane ...... noma mhlawumbe amancane uma kungabonakali lutho). Ukuhlinzekwa nakho kuphoqa wonke amaseli asele ukuba aqale ukuhlukanisa ngesikhathi esifanayo (ukuhlukana indlela abakhula ngayo), okwenza kube lula ukuba i-chemo ibabule ngesikhathi esisodwa empilweni yabo yokuphila.
Njengoba unikeziwe ngalolu lwazi, uma ungazange ube ne-"optimal" ye-cytoreduction eyenziwe, ingxoxo engozini / inzuzo kufanele icatshangelwe mayelana nokusebenza kwesibili ukuqedela lo msebenzi. Izinkinga zibandakanya izizathu zobuchwepheshe kanye nezokudokotela ze-cytoreduction ye-"sub-optimal", ukuthi ikude kangakanani ne-best-quality "enhle" osuvele ukhona, uhlobo lwe-chemotherapy ohlelayo, sekuyisikhathi esingakanani kusukela ukuhlinzwa kokuqala nezinye izinto ezicatshangelwayo .
Ngokuvamile, ingxoxo ngokuphathelene nokunye ukuhlinzeka ingase ibe nokucatshangelwa okukhulu uma ukuhlinzeka kokuqala kwakuncane kakhulu ngenxa yokuntuleka kobuchwepheshe, noma ukungabi khona kwe-oncologist yokugula. Isibonelo, uma uhlinzekwa ngokuyinhloko kuma-biopsies kuphela, ukuhlinzekwa okwengeziwe kungase kudingeke. Kodwa-ke, kufanele ucabange ukuthi uhlelo lwe- chemotherapy lungena kanjani esithombeni sonke.
Imfundo, Ukusekelwa, nokunika amandla
Bhala uhlu lwemibuzo yokubuza i-oncologist yakho yegazi . Letha umngane wakho - njalo kubonakala sengathi ukuba nomunye umuntu kukusiza ukuba uzwe konke okushiwoyo. Thatha amanothi. Sesha ukwesekwa komdlavuza we-ovarian nolwazi oluku-inthanethi. Futhi uthole umbono wesibili uma ungenayo i-100% isiqiniseko sezinketho ozikhethayo. Akukhona nje ukuthi ukuzimela njengesiguli sesifo somdlavuza kukubeka esihlalweni somshayeli - kodwa kwabanye abantu abane-kansa, kuboniswe ngisho nokuthuthukisa ukusinda.
Imithombo:
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Chiva, L, Lapuente, F., Castellanos, T., Alonso, S., no-A. Gonzalez-Martin. Yini Okufanele Siyilindele Ngemuva Kokuqeda I-Cytoreduction Ephelele Esikhathini Sokuvinjelwa Kweqanda Noma Ukuhlinzwa Okuyisisekelo Kwe-Cancer Advanced Ovarian? Ama-Annal of Oncology Yokuhlinza . 2015 Dec 29. (Epub ngaphambi kokuphrinta).
Liu, Z., Beach, J., Agdjanian, H. et al. Ukwenziwa kwe-cytoredtimtion e-ovarian carcinoma kuhlotshaniswa nezinyathelo zamangqamuzana okuphawulekayo kokusebenza kwe-stromal eyengeziwe, i- Gynecologic Oncology . 2015. 139 (9): 394-400.
Vidal, F., Al Thani, H., Haddad, P. et al. Isiphi Isimo Sokuzikhethela Sokuzikhethela Ngokwemibandela Yokungabi Nokwethenjelwa Kwe-Ovarian Carcinomatosis: Ngaphandle Kokucatshangelwa Kwezifo Ezihlala Emzimbeni Omkhulu. Ama-Annal of Oncology Yokuhlinza . 2016. 23 (2): 434-42.