Izizathu zokusetshenziswa kanye nemiphumela emibi yeCorticosteroids neCanscer
I-steroids isetshenziselwa abantu abanomdlavuza ngenxa yezizathu eziningi. Yini ngempela i-corticosteroids? Iyiphi indima abayidlala ngayo ekwelapheni komdlavuza? Yimiphi eminye imiphumela ejwayelekile yesikhathi esifushane neyesikhathi eside, futhi zingathinta kanjani isimo sakho sengqondo?
Iyini i-Steroids (Corticosteroids)?
Ama-steroids amakhemikhali akhiqizwa emzimbeni wethu ngama-endocrine, okudlala indima ebalulekile ekulawuleni imisebenzi yomzimba.
Ezinye zazo zihlanganisa:
- Umthetho wamanzi nosawoti womzimba
- Umthetho wokushisa komzimba
- Ukulawulwa komfutho wegazi
- I-metabolism yamafutha, ama-carbohydrate, namaprotheni
- Ukulawula "impendulo yokucindezeleka" yomzimba
- Umthetho wokuvuvukala
- Ukuphendula ukutheleleka
- Impendulo yokucindezeleka (bheka ngezansi)
Yimaphi ama-Steroids asetshenziselwa ukwelapha umdlavuza?
Uma sicabanga ngomuntu othatha i-steroids, sivame ukucabangela abagijimi abagijimayo noma abasindayo. I-steroids yokuzilibazisa, njengalezo ezichazwe ngenhla, ibizwa ngokuthi i-anabolic steroids futhi ayisebenzisi ngokujwayelekile emdlalweni wokunakekelwa.
Ngokuvamile, i-steroids esetshenziselwa abantu abanomdlavuza ibizwa ngokuthi i- corticosteroids . I-Corticosteroids yizimakhemikhali ngokwemvelo ezikhiqizwa yizigulane eziyingozi, izingqungquthela ezincane ze-endocrine ezihlala ngaphezu kwezinso. Izibonelo zalezi zinhlobo ze-steroids yizi:
- I-Cortef (i-hydrocortisone)
- I-Deltasone (i-prednisone)
- Gwema (prednisolone)
- I-Decadron (dexamethasone)
- I-Medrol (i-methylprednisolone)
Uma isetshenziselwa umdlavuza, le mithi ivame ukunikezwa ngomlomo noma injected intravenously (ngezinye izimo zingase zibe yingxenye yokulungiselela ama-topical, injected in joints, noma inhaled nge inalysis nasal noma bronchial).
(I-convertic corticosteroid ingasetshenziselwa ukuqhathanisa umthamo wenye yalezi zidakamizwa kwenye.)
Izizathu Zokusebenzisa I-Steroids Emdlalweni We-Cancer Treatment
I-steroids (i-corticosteroids) ingahle isetshenziswe ngezizathu ezihlukahlukene zokwelashwa komdlavuza. Lokhu kungadideka, futhi kubalulekile ukubuza i-oncologist yakho ngenhloso ethize yemithi oyimisiwe.
Ukusetshenziswa okungenzeka kwe-corticosteroids nomdlavuza kufaka:
- Ukuze usize ukuvimbela ukusabela okweqile kumpontshelwa kwemikhiqizo yegazi noma imithi - I-Steroids iyasetshenziswa kakhulu (kanye nama-antihistamine neminye imithi) ukuvimbela ukusabela kwe-allergenic. Ezinye izidakamizwa ze-chemotherapy, ezifana ne-Taxol (paclitaxel) zivame ukubangela ukusabela kokugula. Ukusabela okwenziwe nge-allergen kuya ku-rituximab , uhlobo lwe-thérapie oluhlosiwe elisetshenziselwa i-khansa ehlobene negazi luvame kakhulu. I-steroids ivame ukunikezwa ngesikhathi esisodwa njengoba le mithi iyisilinganiso sokuvimbela.
- Ukusiza ukulawula isicupucu se-chemotherapy-okubangelwe ukuhlanza nokuhlanza - Njengokuthi ukuphikisa, ama-steroids avame ukusetshenziswa kanye neminye imithi yokuvimbela noma yokwelapha isicucu.
- Ukwandisa ukudla - Esikhathini somphakathi wethu wesisindo, sivame ukubheka ukulahlekelwa kwesisindo njengenhlanganisela. Kodwa umdlavuza we-cachexia-i -constellation yezimpawu ezibandakanya ukulahlekelwa kwesisindo okungenasisekelo kanye nokulahleka kwemisipha-unesibopho sezingxenye ezingamaphesenti angu-20 ezibulalayo zomdlavuza, okwenza kube lula ukubhekana nokukhathazeka njengokulahlekelwa kwesidlo kubantu abanomdlavuza .
- Njengengxenye yemithi yakho ye- chemotherapy .
- Ukwehlisa ukuvuvukala.
- Ukuphatha ubuhlungu.
- Ukuphatha ukusabela kwesikhumba.
- Ukwelapha ukuphefumula emdlalweni ophezulu.
- Ukwehlisa ukuvuvukala lapho umdlavuza usakazeka ebuchosheni (nge- metastases yobuchopho ).
- Ukunciphisa ukuvuvukala ekucindezelweni komgogodla - Ukucindezela komgogodla kuyinkimbinkimbi kubonakala njalo nge- myeloma kanye namanye amakhansela asakaze emathanjeni (amathambo ayisisindo).
- Ukwelapha isivinini esikhulu se-vena cava (isifo somdlavuza).
- Ukusiza ukuphazamisa isisu somzimba (njengengcindezi yomdlavuza).
- Ukwelapha isifo se-graft-versus-host (GVHD) esilandelayo ngokulandela ukufakelwa kwe-cell stem .
Ukuqonda i-Cortisol nokuphendula kwe-Stress
Ukuze uqonde ukuthi i-steroids ingasetshenziswa kanjani abantu abanomdlavuza, kuyasiza ukucabangela ukuthi i-steroids "yemvelo" isebenza kanjani emzimbeni kanye nokubaluleka kokusebenzisa le mithi njengoba kuqondiswe.
Lapho imizimba yethu igxilile-kungaba ngokomzimba noma ngokomzwelo-isignali ithunyelwa kumgogodla we-pituitary, isitho esincane se-endocrine ebuchosheni. I-pituitary gland ithumela i-hormone ebizwa ngokuthi i-adrenocorticotropic hormone (ACTH). I-ACTH, nayo, iyala ama-gland adrenal (izinhlayiya ezincane ze-endocrine ezihlala phezulu kwezinso) ukukhulula i-cortisol, "i-steroid yemvelo."
I-Cortisol idlala ingxenye ebalulekile ekuphatheni ukucindezeleka, ngokushintsha ukuvuvukala, ukuphendula ukutheleleka, neminye imisebenzi eminingi. kusukela ekulawuleni ukucindezelwa kwegazi kuya ekulawuleni ushukela wegazi.
Ama-synthetic steroids akhiqizwa ngokwemithi enza okuningi njenge-cortisol. Le mithi enamandla isetshenziswe kakhulu kwezokwelapha futhi iyisici esibalulekile ekwelapheni i-khansa ehlobene negazi, njenge-leukemia, i-lymphoma, ne-myeloma, kanye ne-cancer eqinile.
Imiphumela emibi yokusetshenziswa kwe-steroid
Imithelela emibi ye-steroid iba yimbi nakakhulu uma ithathwa ngamanani aphakeme nangesikhathi eside. Uma ufunda ngemiphumela emibi, ungase uthole udidekile, ngoba imiphumela emibi abantu abayibona ekuqaleni uma ukuthatha le mithi ngokuvamile ihluke nemiphumela emibi ehlangene nokusebenzisa isikhathi eside. Ekuqaleni kwakho ungabona ukukhula kwamandla kwi-steroids, kodwa ngaphezu kwesikhathi eside, ungabona ubuthakathaka.
Ukuqonda "i-feedback loops" ekukhiqizeni amahomoni emvelo emzimbeni kungasiza ukuchaza lokhu. Ukuqaphela "i-feedback loops" nakho kungakusiza uqonde ukuthi kungani ungazami ngokuzumayo lezi zidakamizwa noma wehlisa umthamo wakho ngokushesha uma usuwathathe isikhathi eside.
Ekuqaleni lapho uthatha lezi zidakamizwa (amahomoni), ungacabanga ngokucacile ngemithi ngokuthi "ukufakazela" ukukhiqizwa komzimba wakho we-corticosteroids. Ngokuhamba kwesikhathi, umzimba wakho uyaqaphela ukuthi uthola yonke i-corticosteroids oyidingayo ngepilisi noma ifomu eliyinkimbinkimbi, futhi umzimba wakho uthumela umlayezo ukuyeka ukukhiqiza i-corticosteroids yakho yemvelo. Uma lezi zidakamizwa zima ngokuzumayo, awugcini nje kuphela ukuthola imithi, kepha kungathatha isikhathi esiningi ngaphambi kokuba umzimba wakho uqaphele ukuthi kudingeka uyenze kabusha i-corticosteroids.
Imiphumela emibi yesikhathi esifushane (imiphumela emibi eyenzeka kusenesikhathi noma lapho i-steroids isetshenziselwa isikhathi esifushane) kufaka:
- Ukuqwashisa - Kunezimbangela eziningi zokungalali komdlavuza, kodwa lokho okuhambisana ne-steroids, ikakhulukazi labo abanikezwa ngesikhathi samakhemikhali, kungaba nzima kakhulu.
- Ukusabela okwenziwe nge-allergenic - Ngokuvamile, nakuba ama-steroids asetshenziselwa ukusabela okweqile, abanye abantu bangase babe nomthelela we- steroids .
- I-Delirium - Ukudideka, ne-delirium kungenzeka, ikakhulukazi uma ihlanganiswa nemithi yokwelapha i-narcotic kubantu abanomdlavuza ophakeme.
Imiphumela emide yesikhathi eside ye-steroids iyinto evamile futhi ingafaka:
- Ukucindezelwa kwamagciwane kanye nezifo - I-Steroids yedwa ingabangela ukucindezelwa kwe-immune okuyinto, uma isetshenziselwa ukuxoshwa komnyoba ngenxa yomdlavuza emlonyeni noma ekhemotherapy, ingaba nzima. Lokhu kungandisa ingozi yakho yokutheleleka noma kubangele ukuthi izifo zibe zimbi kakhulu.
- Inzuzo yesisindo - Abantu abasebenzisa i-steroids isikhathi esiningi bavame ukuphela nalokho okubizwa ngokuthi "ama-moon facies" lapho amafutha engeziwe akhiwa khona ohlangothini lobuso.
- Ubuthakathaka (ikakhulukazi ubuthakathaka obuthakathaka bemisipha).
- I-Psychosis noma i-mood swings (bheka ngezansi).
- Izilonda zesisu ne-gastritis - Ngezinye izikhathi abantu abathandana ne-steroids banikezwa imithi yokwelapha ukunciphisa amathuba okuthuthukisa izilonda.
- Ukuphakama kwengcindezi yegazi.
- Ukuphazamiseka kokulala.
- Ishukela ephakeme egazini (okubaluleke kakhulu uma unesifo sikashukela) - Kuvamile uma ama-steroids aphakeme kakhulu asetshenziselwa umuntu ukuba abe "okwesikhashana" nesifo sikashukela futhi adinga ukwelashwa kwe-insulin ( isifo sikashukela steroid ).
- I-osteoporosis (amathambo ahlambalazayo) - Ngisho nokusetshenziswa isikhathi esifushane kwe-steroids kungaholela ekulahlekelweni okukhulu kwamathambo, okungase kube nokwandisa ingozi yezinsalela.
- Ukuguqa izandla noma izinyawo ngenxa yamanzi nokugcinwa usawoti.
- I-cataract.
- I-acne.
Ezinye imiphumela emibi ingase ibe emihle noma embi kuye ngokuthi isimo somtholampilo somuntu. Isibonelo, ukwanda kwesidlo nesisindo somzimba kungasiza kubantu abangaphansi kwesifo somdlavuza abanomdlavuza.
Ukuthatha imithi yakho ngokudla kungasiza ngezinye zezinkinga ukuthi i-steroids ingabangela indlela yokugaya. Ungakhetha futhi ukuthatha lezi zinhlobo zemithi ekuqaleni kosuku ukuze zingabi nethonya lokulala kwakho ebusuku.
Njengemiphumela emibi yemithi eminingi, i-oncologist yakho, umhlengikazi, noma umakhemikhali angakwazi ukukunikeza amasu okusiza ukulawula noma ukunciphisa. Qinisekisa ukuthi uvumele udokotela wakho wazi uma uthola noma yiziphi izimpawu noma imiphumela emibi.
Impact ye-Steroids ku-Mood
Nakuba kungenzeka ukuthi uzwile inkulumo ethi "ukufutheka okuthukuthele," okusetshenziselwa ukuchaza ukuziphatha okuthukuthele nokuqhuma kwabantu abathatha ama-anabolic steroids, kubalulekile ukuqaphela ukuthi i-corticosteroids ingabuye ibe nemiphumela emibi emzimbeni.
Imiphumela emibi engokwengqondo ye-corticosteroids ingahle ihluke ekucaseni, ukuphumula, nentukuthelo yonke indlela eya e-paranoia, ukudideka, ne-mania. Ngakolunye uhlangothi, akuvamile ukuba nomoya ophansi noma ngisho nokucindezeleka ngemuva kokuyeka le mithi.
Ngeshwa, nakho konke okuqhubekayo empilweni yakho nomdlavuza, kungase kube nzima ukunquma umthombo wale mizwa. Yebo, usu-steroids, kodwa nawe uthola ukwelashwa ngomdlavuza futhi uzama ukuqhubeka nokuphila okuvamile. Kuvamile ukuzwa imizwelo eminingi lapho ulwa nomdlavuza .
Umthetho jikelele wesithupha ngukuthi uma isimo sakho sengqondo sishintsha sithinta izinga lakho lokuphila noma impilo yobuhlobo bakho, kufanele ukhulume neqembu lakho le-oncology. Uma imizwa yakho inzima, kungase kudingeke ufune usizo olusheshayo.
Amaphuzu Okubalulekile Ngokuthatha I-Steroids
Njengoba kunemithi eminingi yokwelapha yomdlavuza, kubalulekile ukuthatha i-steroid njengoba nje udokotela wakho echaza. Nazi eminye imibuzo emihle yokubuza ithimba lakho lokunakekelwa ngezempilo mayelana ne-steroids yakho ngaphambi kokuthi uqale:
- Ngizobe ngilindele isikhathi esingakanani ukuthatha le mithi?
- Ngingaxhumana nobani uma nginomthelela omkhulu kulo muthi?
- Kuthiwani uma ngiphuthelwa umthamo? (Musa nje ukuthatha umthamo owengeziwe wemithi).
- Kuthiwani uma ngihlanza imithi yami?
- Imiphi imiphumela emibi ovame ukuyibona nale mithi ethile kokubili isikhathi esifushane kanye nokusebenzisa isikhathi eside?
Gwema ukuyeka okungahleliwe kwe-Steroids
Njengoba kuphawuliwe ekuqaleni, ukuthatha imithi ye-steroid inomthelela ekutheni isakhi steroid yemvelo umzimba wakho uveza kanjani. Ngenxa yalesi sizathu, uma i-steroids yakho ingasadingeki njengengxenye yokwelashwa kwakho, udokotela wakho uzovame ukufaka umthamo ngaphandle kokumisa ngokushesha. Kubaluleke kakhulu ukuthi ungayeki ukuthatha le mithi ngaphandle kokuthi utshelwe udokotela wakho. Ezimweni ezingavamile, ukuyeka i-steroid kungavele kungaholela enkingeni yokufaka ukuphila engozini.
Ngisho noma ulandela isimiso se-tapering, vumela udokotela wakho wazi uma izimpawu zakho ziba nzima. Abanye abantu kufanele baphethwe kule mithi kancane kancane esikhathini esingamasonto noma ngisho nezinyanga.
Ngezansi kuma-Steroids e-Cancer Treatment
I-Steroids yiziqhawe ezingenakulinganiswa zokunakekelwa komdlavuza. Ngenkathi i-chemotherapy, ukwelapha imishanguzo, ikakhulukazi imithi yokwelashwa entsha kanye ne- immunotherapy ithola lonke udumo ngomdlavuza wokubulala, i-steroid isebenza ngokuthula, ivikele futhi iyanciphisa izinkinga futhi yenza ezinye izindlela zokwelapha zisebenze kangcono. Yingakho zidlala indima enkulu ekwelapheni kokubili umdlavuza wegazi kanye nezicubu eziqinile.
Lokho kusho ukuthi lezi zidakamizwa zinenani elibalulekile lemiphumela emibi yesikhathi esifushane neyesikhathi eside, okunye okungaba yingozi. Qinisekisa ukuthi ubuza imibuzo futhi ukhulume nganoma yiziphi izimpawu ozizwayo, noma ngabe "kuphela" ukukhathala. Yiba ngummeli wakho siqu ekunakekeleni umdlavuza wakho .
Imithombo
- Kasper, uDennis L .., u-Anthony S. Fauci, noStephen L .. Hauser. Izimiso zikaHarrison zeMithi yangaphakathi. ENew York: Mc Graw Hill Education, 2015. Phrinta.
- ULeppert, W., noT. Buss. Umsebenzi we-Corticosteroids ku-Treatment of Pain in Cancer Patients. Imibiko Yamanje Yobuhlungu Nezinhloko . 2012. 16 (4): 307-13.
- Matsuo, N., Morita, T., Matsuda, Y. et al. Izibikezelo zezimpendulo ku-Corticosteroids ye-Anorexia kuma-Advanced Cancer Patients: Isifundo Esibucayi Esibucayi Esibucayi. Ukondla Ukusekela Ekhanda . 2017. 25 (1): 41-50.
- Matsuo, N., Morita, T., Matsuda, Y. et al. Izibikezelo zika-Delirium kuma-Corticosteroid-Aphethwe Iziguli ezine-Cancer Advanced: I-Exploratory, Multicenter, Prospective, Observational Study. Journal of Medicine Palliative
- Mori, M., Shirado, A., Morita, T. et al. Izibikezelo Zokuphendula Nge-Corticosteroids ye-Dyspnea Esigulini Sengculazi Esihambile: Isifundo Esiqakathekileko Esihambelana Nokuhlola Okubhekayo. Ukondla Ukusekela Ekhanda . 2017. 25 (4): 1169-1181.