Isigaba II I-Cancer Cancer - Incazelo, Ukwelapha, Nokuguqulwa
Isigaba 2 somdlavuza wesifo samangqamuzana ongasona omncane uchazwa ngokuthi " umdlavuza wendawo ," okungukuthi, ubhekisela ku-tumor ekhona emaphashini futhi kungenzeka isakaze kuma- lymph nodes asendaweni, kodwa ayizange isakaze phambili. Izidumbu eziye zadlulela ngalezi zindawo zibizwa ngokuthi "amagciwane aphezulu." Amaphesenti angaba ngu-30 wamanqamu wamaphaphu atholakala uma esesiteji soku-1 noma sesi-2, futhi ukubikezela (umphumela wesikhathi eside) kungcono kakhulu kunezigaba kamuva zesifo.
Kunqunywa kanjani ukuthi umdlavuza wamaphaphu uyisiteji sesi-2 (isigaba II), nokuthi lesi sigaba somdlavuza wemaphaphu siphathwa kanjani?
Sibutsetelo
Ukunquma isigaba somdlavuza wamaphaphu kubaluleke kakhulu ekukhetheni ukwelashwa okufanele kakhulu.
Isigaba II sihlukaniswe ngezigaba IIA kanye ne-IIB. Isigaba IIA ne-IIB ngasinye sihlukaniswe ngezigaba ezimbili kuye ngobukhulu besisu, lapho kutholakala khona i-tumor, nokuthi ngabe kukhona umdlavuza emanzini omzimba.
Isiteji IIA
(1) I-Cancer iye yasakazeka kuma-lymph nodes ohlangothini olufanayo lwesifuba njenge-tumor. Ama-lymph nodes nomdlavuza angaphakathi kwamaphaphu noma eduze kwe- bronchus , futhi okukodwa noma okungaphezulu kwalokhu okulandelayo kuyiqiniso:
- I-tumor ayikhudlwana kunezingamamitha angu-5.
- I-Cancer iye yasakazeka ku-bronchus eyinhloko futhi okungenani amasentimitha angama-2 ngezansi lapho i- trachea ijoyina i-bronchus.
- I-Cancer iye yasakazeka engxenyeni yangaphakathi yekhanda elihlanganisa iphaphu.
- Ingxenye yamaphaphu iye yawa noma yahlakulela i-pneumonitis (ukuvuvukala kwamaphaphu) endaweni lapho i-trachea ijoyina i-bronchus kodwa ayifaki emaphashini.
noma
(2) I-Cancer ayizange isakaze kuma-lymph nodes futhi okukodwa noma ngaphezulu kwalokhu okulandelayo kuyiqiniso:
- I-tumor ingaphezu kwamamitha angu-5 kepha ayikho ngaphezu kwamamentimitha angu-7.
- I-Cancer iye yasakazeka ku-bronchus eyinhloko futhi okungenani amasentimitha angama-2 ngezansi lapho i-trachea ijoyina i-bronchus.
- I-Cancer iye yasakazeka engxenyeni yangaphakathi yekhanda elihlanganisa iphaphu.
- Ingxenye yamaphaphu iye yawa noma yahlakulela i-pneumonitis (ukuvuvukala kwamaphaphu) endaweni lapho i-trachea ijoyina i-bronchus kodwa ayifaki lonke iphaphu; futhi
Isiteji IIB
(1) I-Cancer isakaze emaceleni omzimba oseduze eseceleni esifubeni njenge-tumor. Ama-lymph nodes nomdlavuza angaphakathi kwamaphaphu noma eduze ne-bronchus. Futhi, okukodwa noma okungaphezulu kokulandelayo kuqinisile:
- I-tumor ingaphezu kwamamitha angu-5 kepha ayikho ngaphezu kwamamentimitha angu-7.
- I-Cancer iye yasakazeka ku-bronchus eyinhloko futhi okungenani amasentimitha amabili ngaphansi kwe-ndawo lapho i-trachea ijoyina i-bronchus.
- I-Cancer iye yasakazeka engxenyeni yangaphakathi yekhanda elihlanganisa iphaphu.
- Ingxenye yamaphaphu iye yawa ( atelectasis ) noma i-pneumonitis ithuthukile (ukuvuvukala kwamapayipi) endaweni lapho i-trachea ijoyina i-bronchus.
noma
(2) I-Cancer ayizange isakaze kuma-lymph nodes futhi okukodwa noma ngaphezulu kwalokhu okulandelayo kuyiqiniso:
- Lesi sifo sikhulu kunama-centimitha angu-7.
- I-Cancer iye yasakazeka ku-bronchus eyinhloko (futhi ingaphansi kwamamentimitha angu-2 eduze nesayithi lapho i-trachea ijoyina khona i-bronchus kodwa ayifaki indawo yokuhlangana), udonga lwesifuba, isifenqemeni, noma isisindo esilawula isikhalazo.
- I-Cancer isakazekele embundeni nxazonke zenhliziyo (i- pericardidium ) noma ihlanganisa udonga lwesifuba.
- Kukhona izicubu ezilodwa noma eziningi ezihlukile ku-lobe efanayo yamaphaphu.
Isiteji
Ama-oncologists akhuluma ngezigaba zomdlavuza wamaphaphu esekelwe kokuthile okuthiwa uhlelo lwe-TNM . Kulesi simiso, i-T ibhekisela ebukhulu be-tumor, i-N ibhekisela ekubandakanyekeni kwanoma yiziphi izitho zomzimba zesikhumba futhi lapho zitholakala khona, kanti M ibonisa ukuthi kukhona yini izidakamizwa , okungukuthi, ukusabalalisa isisu kwezinye izifunda zomzimba . Ukusebenzisa uhlelo lwe-TNM, umdlavuza wamaphaphu wesigaba 2 uchazwa ngokuthi:
- 2A - T1A / 1BN1M0 - Okusho ukuthi lesi sifo singaphansi kuka-3 cm (1 ½ amasentimitha) ngobukhulu, futhi sesakaze ema-lymph nodes eseduze.
- I-2A - T2AN1M0 - I-tumor ingaphezu kuka-3 cm, kodwa ingaphansi kuka-5 cm, ngosayizi, noma umdlavuza usakazekile kwi-bronchus eyinhloko futhi okungenani u-2 cm ngaphansi kwe-carina, noma umdlavuza usakaze emgqeni umphunga; futhi isakaze kuma-lymph nodes eseduze.
- 2B - T2N1M0 - I-tumor ingaphezu kuka-3 cm, kodwa ingaphansi kuka-7 cm, ngobukhulu, futhi isakaze kumakhansela wendawo.
- I-2B-T3N0M0 - I-tumor ingaphezu kuka-7 cm usayizi futhi ayisakaze kuma-lymph nodes, kodwa isendaweni yomoya noma isakaze ezindaweni zendawo ezifana nodonga lwesifuba noma i- diaphragm.
Ukufometha kwamakhemikhali
Enye yentuthuko yakamuva yonyango lomdlavuza wamaphaphu bekuyikhono lokuphatha ezinye zalezi zomshukela ngokuthi "zibhekise" ekuguquleni kwesisu. Ngokuhambisana nezibalo zesisu esekelwe usayizi nokuthi usakazeke kangakanani, i-oncologists manje isebenzisa ukuhlolwa kofuzo (ukuprofetha kwamangqamuzana) yomdlavuza wamaphaphu ukuqhubeka "ukuzenzela" ukuxilongwa. Kuze kube muva nje, ukuhlolwa kwakugcinwe ikakhulukazi kubantu abanezigaba ezithuthukisiwe zesifo, kodwa ngokuthuthukiswa kokwelapha, kungenzeka ukuthi labo abanesifo sesigaba 2, ikakhulukazi abantu abane- lung adenocarcinoma , lokhu kuhlolwa kuzoba yisimiso.
Izimpawu
Izimpawu ezivame kakhulu zesigaba 2 somdlavuza wamaphaphu kukhona ukukhwehlela okuqhubekayo , ukukhwehlela igazi (i-hemoptysis), ukuphefumula , ubuhlungu esifubeni noma emuva , noma izifo eziphindaphindiwe ezifana ne-pneumonia noma i-bronchitis. Njengoba isifo somdlavuza wamaphaphu sesigaba sesibili asizange sibe nesisindo (ukusakaza) ngaphesheya kwamapayipi, izimpawu ezifana nokulahlekelwa kwesisindo esingenasisekelo nokukhathala akuvamile kakhulu kunezigaba eziphambili.
Ukwelapha
Izinketho zokwelashwa zesigaba 2 somdlavuza wamaphaphu ngokuvamile zihlanganisa inhlanganisela yezokwelapha. Lokhu kufaka:
- Ukuhlinzwa: Ukwelapha ukwelashwa okukhethiwe kumdlavuza wesigaba 2 wamaphaphu, unikezela ithuba elikhulu kunazo zonke zokwelashwa ngalesi sigaba sesifo. Kunezinhlobo ezintathu eziyinhloko zokuhlinza umdlavuza wamaphaphu ezenziwa umdlavuza wamaphaphu, futhi ukukhetha ukuthi iyiphi inqubo engcono kakhulu kuncike lapho i-tumor yakho ikhona khona kanye nesimo sakho sezempilo jikelele. Eminyakeni yamuva indlela yokuhlinzeka encane yokuhlinzwa ebizwa ngokuthi ukuhlinzwa kwe-thoracoscopic (VATS) esebenze ngevidiyo isitholakale. Ngalolu lwazi, ingxenye yamaphaphu ingasuswa ngemibono emincane edongeni lesifuba. Kungaba ukuhlakanipha ukucabangela umbono wesibili lapho unquma ukuhlinzwa komdlavuza wamaphaphu . Ucwaningo lubonisa ukuthi abantu abanalezi zinqubo ezenziwe ezibhedlela ezenza umthamo omkhulu walezi zindlela nemiphumela emihle.
- I-Chemotherapy: Oncologists abaningi batusa i- adjuvant chemotherapy (i-chemotherapy ngemuva kokuhlinzwa) kulabo abahlinzwa ukuhlinzeka ngomdlavuza wesigaba 2 wamaphaphu. Umqondo onalo hlobo lwe-chemotherapy ukuwuhlanza "noma yiliphi amangqamuzana omdlavuza okungenzeka asakaze ngaphesheya kwamapayipi (amisiwe) kodwa angakabonakali kunoma yiziphi izivivinyo zokucabanga. Kuye indawo yesikhumba sakho, ezinye ze-oncologists zingase zibe esikhundleni se-neoadjuvant chemotherapy-chemotherapy ezinikezwe ngaphambi kokuhlinzwa ukuze unciphise ubukhulu besisu futhi zisuse kalula isisu.
- Ukwelashwa Kwemithi Yezingculazi ezingasebenzi: Ukwelashwa kwezidakamizwa akuvame ukusetshenziselwa umdlavuza wamaphaphu wesigaba 2 kodwa kuyindlela kulabo abangakwazi ukuhlinzwa ngenxa yokuthi i-tumor noma ukukhathazeka kwezempilo jikelele ( umdlavuza ongasebenzi ). Kulesi silungiselelo, imisebe ngezinye izikhathi ingabangela ukwelashwa. Amanye amasu afana nokwelashwa kwe-proton ukuhlolwa ngesigaba sesi-2.
Izivivinyo zemitholampilo
Ngokusho kweNational Cancer Institute, abantu abanomdlavuza wamaphaphu kufanele bacabange ukuthi bahlanganyele ekuvivinyweni kwemitholampilo . Ukuthuthukiswa okuningi ekwelapheni umdlavuza wamaphaphu kwenziwa, futhi phakathi nenkathi phakathi kuka-2011 no-2015, kwakukhona imithi emisha eminingi eyamukelwa umdlavuza wamaphaphu kunenkathi yeminyaka engama-40 ngaphambi kuka-2011.
Izilingo eziningi zokwelapha ziyaqhubeka ngomdlavuza wesigaba 2 wamaphaphu zibheke izindlela zokuhlinza ezingenasidingo, izindlela ezintsha zokushisa imisebe, kanye nezindlela ezintsha zokwelashwa ezifana nezinqubo ezithintekile zokwelapha kanye nokuzivikela okumele kulesi sigaba sesifo.
Ingozi Yokuphindaphinda
Izinga eliphindaphindiwe lokuphindaphinda (noma endaweni yangakini noma kwezinye izifunda zomzimba) yomdlavuza wendawo wamaphaphu (isigaba 1 nesigaba 2) uphakathi kwamaphesenti angu-20 no-50. Uma umdlavuza wamaphaphu uphindela, ukhetho olwengeziwe luyatholakala ekwelapheni. Lokhu kungabandakanya imishanguzo noma ngaphandle kwemithi yokwelashwa, noma enye yemithi yokwelashwa emisha noma imithi yokuzivikela ehlolwayo ezinhlolweni eziningi zokwelashwa. Funda kabanzi mayelana nokuphindaphinda komdlavuza wamaphaphu .
Isilinganiso sokusinda
Isilinganiso seminyaka engu-5 sokusinda singamaphesenti angaba ngu-30 esiteji sesi-2 esingeyona encane yomdlavuza wamaphaphu wesifo. Ezimweni ezihlukile, le nombolo ngezinye izikhathi ingahlukahluka , kuye ngokuthi i-tumor yakho kanye nempilo yakho jikelele. Khumbula ukuthi izibalo ngokusinda zivame ukuba neminyaka eminingana ubudala, kanti izindlela ezintsha ezamukelekile kungenzeka ukuthi azizange zitholakale lapho lezo zinombolo zibhalwa.
Ukubhekana
Ucwaningo lubonisa ukuthi ukufunda ngesifo sakho kungathuthukisa umphumela wakho. Buza imibuzo. Funda mayelana nokuhlolwa kwemitholampilo okungase kukufanele. Uma usanda kutholakala nomdlavuza wamaphaphu , thatha isikhashana ukuphefumula futhi ucabange ngokucophelela ngesimo sakho samanje. Izinqumo eziningi ngomdlavuza wamaphaphu aziphuthumayo, futhi ungathatha isikhathi esincane ukuhlola ngokugcwele izinyathelo zakho ezilandelayo.
Ngandlela-thile, ungase uzizwe sengathi ulahlekelwe ukulawula impilo yakho, kodwa kunezinye izinto ongenza ngazo ukuthi ngisho nokuthuthukisa ukusinda nomdlavuza wamaphaphu.
Ukuphila nomdlavuza kungathatha indawo. Vumela abantu ukukusiza. Lesi akusona isikhathi sokuba "esinamandla," futhi umdlavuza ungaba ukhathala ngisho nosizo. Uma ngabe othandekayo wakho etholwe ukuthi unomdlavuza, hlola lesi sihloko, " Uma othandekayo wakho enomdlavuza wamaphaphu. "
Ngisho noma unesisekelo sothando somndeni nabangane, ukuhlala nomdlavuza kungase kube yinto ehlelekile. Bheka amaqembu asekela emphakathini wakho kanye naku-intanethi . Kukhona umdlavuza omuhle wamaphaphu emphakathini lapho abantu abaningi abanomdlavuza wamaphaphu bathola ukusekelwa, ngenkathi ngesikhathi esifanayo befunda ngenqubekela phambili yakamuva emdlavuza wamaphaphu.
Imithombo:
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Ikomidi elihlangene laseMelika leCancer. Ukunyatheliswa komdlavuza we-Lung. I-7th Edition. Ifinyelele ngo-01/13/16. https://cancerstaging.org/references-tools/quickreferences/Documents/LungMedium.pdf
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