Incazelo, Izimpawu, Ukwelashwa, Nokuguqulwa Kwesigaba IIIA I-Cancer Lung
Isiteleka se-3A somdlavuza wesifo samangqamuzana esincane , kubhekwa njengomdlavuza "wangaphambili", okusho ukuthi i-tumor ayizange isakaze ezindaweni ezikude zomzimba kodwa isakaze kuma- lymph nodes ohlangothini olufanayo lomzimba njenge-tumor. Abantu abangamaphesenti angu-10 banomdlavuza wesifo se-3A ngesikhathi sokuxilongwa, ngamaphesenti angu-60 abantu abanezigaba eziphambili zesifo.
Sibutsetelo
Isigaba 3A Umdlavuza wamaphaphu uhlanganisa izicubu ezinkulu futhi zisakaze ezithombeni eziseduzane, noma izicubu zanoma yisiphi isayizi eziye zasakazeka kuma-lymph nodes ezikude kodwa zisehlangothini olufanayo lomzimba njengomdlavuza.
I-oncologists isebenzisa isimiso se- TNM sokuqhubeka sichaza izigaba zomdlavuza wamaphaphu. Incazelo elula yesistimu ye-TNM ihlanganisa:
T - Lokho kubhekisela kwisayizi yethambo:
- I-T1 - I-tumor ingaphansi kuka-3 cm (1 ½ amasentimitha) ngobukhulu.
- I-T2 -I-tumor ingaphezu kuka-3 cm kepha ingaphansi kuka-7 cm ngesayizi.
- I-T3 - I-tumor ikhulu kunama-7 cm noma ihlasela ngokuqondile noma yikuphi okulandelayo: udonga lwesifuba, umqubuzelo, isisindo esilungisa umdwebo (i-phrenic nererve), i-membrane ehlanganisa isikhala esiphakathi kwamaphaphu amabili (i-pleura ye-mediastinal), noma enye izibungu zimboza i-heart parietal pericardium); noma i-tumor ye- bronchus eyinhloko okungenani i-2 cm ngaphansi kwe-carina; noma kuhlotshaniswa nokuwa ( atelectasis ) wephasi lonke noma ama-nodule noma ama-tumor (s) omzimba ahlukile kumlobe ofanayo wamaphaphu.
- I-T4 - Ukugcoba kwanoma yisiphi isayizi esihlasela noma yikuphi kwalokhu okulandelayo: isikhala esiphakathi kwamaphaphu ( mediastinum ), inhliziyo, izitsha ezinkulu, i-trachea, enye yezinzwa ezibhebhethekisa intambo yezwi (i-laryngeal nererve), isifo , umzimba we-vertebral, noma indawo lapho i- trachea ihlukanisa khona i-bronchi eyinhloko (i-carina); noma i-nodule yama-tumor (s) ehlukile kumaphaphu e-lobe ngakwesinye isifuba esifubeni.
N ibhekisela kuma-lymph nodes:
- N0 - Awekho ama-lymph nodes athintekile.
- I-N1 - I-tumor isakaze emaqeleni aseduze ohlangothini olufanayo lwesifuba.
- I-N2 - I-tumor isakazelele kumagqabha ngokuqhubekayo kodwa ngaphandle kolunye uhlangothi lwesifuba.
- I-N3 - Amangqamuzana omdlavuza akhona ema-lymph nodes ngakolunye uhlangothi lwesifuba esivela ku-tumor, noma ezindaweni eziseduze ne-collarbone noma imisipha yentamo.
M imelela isifo se-metastatic :
- I-M0 - Ayikho i-metastases ekhona i-M0 - I-tumor isakazeke (i-metastasized) kwezinye izifunda zomzimba noma enye emaphaphu.
Ukusebenzisa uhlelo lwe-TNM, isigaba se-3A somdlavuza wamaphaphu uchazwa ngokuthi:
- I-T1N2M0 - Isho ukuthi lesi sifo singaphansi kuka-3 cm ngobukhulu futhi sesakazeka kuma-lymph nodes ngokuqhubekayo kodwa ngaphandle kolunye uhlangothi lomzimba njenge-tumor.
- I-T2N2M0 - I-tumor ikhulu kunama-3 cm kepha ingaphansi kwe-cm 7, futhi isakaze kuma-lymph nodes ngokuqhubekayo kodwa ngaphandle kolunye uhlangothi lomzimba.
- I-T3N1M0 - I-tumor ikhulu kunama-7 cm noma isakaze endaweni yangakini njengodonga lwesifuba noma i-diaphragm, futhi amantombazane angama-lymph eseduze athintekile. (bheka incazelo echazwe ngenhla ye-T3.) Isidumbu sikhulu kunama-7 cm noma sisakaze endaweni efana nodonga lwesifuba noma i-diaphragm, nama-lymph nodes asekude kakhulu kodwa ohlangothini olufanayo lomzimba athintekile. I-tumor yinoma yisiphi isayizi kepha iseduze nendawo yomoya noma isakaze endaweni endaweni efana nodonga lwesifuba noma i-diaphragm, nama-lymph nodes asekude kakhulu kodwa ohlangothini olufanayo lomzimba athintekile (bheka incazelo ephezulu ye-T3.)
- I-T3N2M0 - I-tumor yinoma yisiphi isayizi kodwa iseduze nomoya womoya noma isakaze endaweni yangakini njengodonga lwesifuba noma i-diaphragm, ne-lymph nodes ezikude kodwa kodwa ezihlangothini ezifanayo zesifuba ziyathinteka.
Izimpawu
Izimpawu zesigaba 3A Umdlavuza wamaphaphu ziyahlukahluka kusukela isigaba 3A sihlanganisa inqwaba yamagciwane. Izimpawu ngenxa yomdlavuza emaphashini afana nokukhwehlela okuqhubekayo , ukuphefumula , kanye nokutheleleka okuphindaphindiwe okufana ne-pneumonia noma i-bronchitis, kuvamile. Ukusabalalisa ezindaweni ezifana nodonga lwesifuba kanye nesibindi kungabangela ubuhlungu esifubeni, izimbambo, amahlombe, nangemuva.Izikhalazo eziseduze nemikhumbi yezindiza zingabangela i-hemoptysis ( ukukhwehlela igazi ), ukugubha , nokwesaba .
Ukwelapha
Ukwelashwa kwesigaba 3A somdlavuza wamaphaphu kuyinkinga enkulu kunazo zonke izigaba zomdlavuza wamaphaphu, ngenxa yokuthi leli qembu lihlukile kakhulu. Ngenxa yesilinganiso sokusinda empofu, i-National Cancer Institute ithi wonke umuntu onomdlavuza wesifo se-3A wesigaba somzimba kufanele abhekwe njengomuntu ozokhethwa ukuhlolwa kwemitholampilo - izifundo ezihlola ukwelashwa okusha noma ukuhlanganiswa kokwelashwa komdlavuza wamaphaphu.
Kwezinye izimo, ukuhlinzwa kungenziwa ukuze kususwe isisu, futhi kuvame ukulandelwa nge-adjuvant chemotherapy (i-chemotherapy ngemuva kokuhlinzwa). I-chemotherapy ye-preoperative (i-chemotherapy ngaphambi kokuhlinzwa) itholakale ukuthuthukisa ukusinda ezifundweni ezimbalwa. I-chemotherapy yokuhlanganiswa (ukusebenzisa imithi yokwelapha i-chemotherapy) kanye nokwelashwa kwe-radiation noma omunye ukwelashwa kuvame ukusetshenziswa uma isigaba 3A umdlavuza wamaphaphu kubhekwa singasebenzi ngenxa yendawo, ukuthi isakazeke kangakanani, noma ngabe impilo yakho jikelele ingenza ukuhlinzwa okuyingozi. Kulabo abangakwazi ukubekezelela ukuhlinzwa noma i-chemotherapy, ukwelashwa kwemisebe kuyindlela yokukhetha.
Kubalulekile ukuthi wonke umuntu onomdlavuza wesifo samangqamuzana ongewona omncane, ikakhulukazi i-lung adenocarcinoma, ahlolwe ukuhlolwa kwezakhi zofuzo . Kunezinguquko eziningana "eziphathekayo" ezifana nokuguqulwa kwe- EGFR , ukulungiswa kabusha kwe-ALK , nokulungiswa kabusha kwe-ROS1 okuphendulele amanye amavaysiza emaphaphu aphethwe yisifo esingapheli.
I-Immunotherapy iyindlela yokuthakazelisa kwabanye abantu , ne-agent yokuqala kulesi sigaba esivunyelwe ekwelapheni umdlavuza wamaphaphu ngo-2015, manje kukhona izidakamizwa ezine ezikhona. Nakuba lezi zindlela zingasebenzi kuwo wonke umuntu, abanye abantu baye balawula ukugula kwesikhathi eside ngalezi zidakamizwa. Isidakamizwa i-Infinzi (durvalumab) samukelwa ngo-2018 ngokukhethekile ukwelashwa kwesigaba sesithathu somdlavuza wesifo samangqamuzana esingenasincane esingenakwenzeka. Uma isetshenziselwa ukulandela i-chemotherapy nemisebe, itholakale ekuthuthukiseni ukusinda okungahambisani nokuqhubeka.
Isibikezelo
Isilinganiso seminyaka engu-5 sokusinda ngesigaba 3A somdlavuza wamaphaphu singamaphesenti angu-14, kodwa lokhu kuhlukahluka kakhulu phakathi kwamanqamu ahlukene ahlukaniswa njengesigaba 3A. Khumbula ukuthi izibalo zisitshela indlela abantu abazenza ngayo eminyakeni edlule, futhi intuthuko eminingi yenzeke ekwelapheni umdlavuza wamaphaphu eminyakeni embalwa edlule. Kukhona indawo engaphezulu yethemba ekwelapheni umdlavuza wamaphaphu kufana nalokhu esikhathini esidlule.
Ukusekela
Ucwaningo lubonisa ukuthi ukufunda lokho ongakwenza mayelana nomdlavuza wakho kusiza umphumela. Kuzo zonke izigaba zomdlavuza wamaphaphu, isigaba sesi-3A sinezinga eliguquguqukayo kakhulu futhi linenani elikhulu kunazo zonke lokukhethwa kokwelashwa. Buza imibuzo. Hlanganisa abathandekayo bakho futhi ukhuthaze ukuba babuze imibuzo futhi. Cabanga ngokujoyina iqembu lokusekela . Funda mayelana nokuhlolwa kwemitholampilo okungase kuhambisane nesimo sakho. Ukufunda ngomdlavuza wakho nokwelashwa kungathatha isikhathi esiningi kakhulu. Cela, futhi uvumele abathandekayo bakho nabangani ukuthi bakusize futhi bakukhuthaze ohambweni lwakho. Thatha isikhashana ukuhlola lawa macebiso wokuthi ungaba kanjani ummeli wakho ekunakekelweni komdlavuza wakho . Futhi nanka amanye amathiphu ezindleleni zokuthuthukisa ukusinda komdlavuza wamapayipi udokotela wakho angase angakhulumi.
Lapho Othandekayo Enomdlavuza Wegazi
Uma kungumthandi wakho oye watholakala ukuthi unomdlavuza wamaphaphu, mhlawumbe unesimo esifanayo, futhi ube ngumnakekeli womndeni womuntu onesifo angakushiya uzizwe ucindezelekile futhi ungenasici. Thatha isikhashana uphinde uhlole lesi sihloko esithi " uma othandekayo wakho anomdlavuza wamaphaphu " ukuzwa ukuthi abantu abanomdlavuza wamaphaphu babethemba ukuthi abathandekayo babo bayakwazi. Nanka amathiphu kanye nokusekela othandekayo ngomdlavuza .
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