Isigaba III-Cancer Lung - Incazelo, Ukwelapha, Nokuguqulwa
Isigaba 3B Umdlavuza wamaphaphu omncane ongewona omncane ubhekwa njengomdlavuza omkhulu wamaphaphu kanye nesigaba 4, kanti nakuba kungavamile ukuphulukiswa, uyaphathwa. Abantu abangamaphesenti angaba ngu-20 banomdlavuza wesifo se-3B ngesikhathi sokuxilongwa, kanti abanye abangamaphesenti angu-40 asebevele beqhubekela phambili esigabeni 4 .
Sibutsetelo
Isigaba 3B Umdlavuza wamaphaphu uchazwa njengesifo sokudla kwanoma yisiphi isayizi esasakazekele kumalthididi asekude noma sahlasela ezinye izakhiwo esifubeni (njengenhliziyo noma isifo.)
I-oncologists isebenzisa isimiso se- TNM sokuqhubeka sichaza izigaba zomdlavuza wamaphaphu. Incazelo elula yesistimu ye-TNM ihlanganisa:
T ekhuluma ngobukhulu besisu:
- I-T1 : I-tumor ingaphansi kuka-3 cm (1 ½ amasentimitha) ngobukhulu.
- I-T2 : I-tumor ingaphezulu kuka-3 cm kepha ingaphansi kwe-7 cm.
- I-T3 : I-tumor ikhulu kunama-7 cm noma ihlasela ngokuqondile noma yikuphi kwalokhu okulandelayo: udonga lwesifuba, umqubuzelo , isisindo esilungisa umdwebo (i-phrenic nererve), i-membrane ehlanganisa isikhala esiphakathi kwamaphaphu amabili (i-pleura) inhliziyo (i- parietal pericardium ); noma i-tumor e- bronchus eyinhloko okungenani u-2 cm ngaphansi kwe-carina; noma lihlotshaniswa nokuwa kwayo yonke amaphaphu noma ama-nodule ama-tumor (s) we-tumor (s) e-lobe efanayo yamaphaphu.
- I-T4 : I-Tumor yanoma yisiphi isayizi esihlasela noma yikuphi kwalokhu okulandelayo: isikhala esiphakathi kwamaphaphu ( mediastinum ), inhliziyo, izitsha ezinkulu, i- trachea , enye yezinzwa ezigcina izintambo zamagama (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 : Azikho izakhi ezithintekayo.
- I-N1 : I-tumor isakaze emaqenjini aseduze ohlangothini olufanayo lwesifuba.
- I-N2 : I-tumor isakazeke kuma-nodes okude kakhulu 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 :
- M0 : Ayikho imetastases ekhona.
- I-M1 : I-tumor isakazekile (i-metastasized) kwezinye izifunda zomzimba noma enye emaphaphu.
Ukusebenzisa i-TNM System Stage 3B kuchazwa ngokuthi:
- Noma iyiphi i-T, i-N3, i-M0 : Yisho isisu esinoma yisiphi isayizi esasakazeka kuma-lymph nodes ngakolunye uhlangothi lwesifuba esivela ku-tumor noma kuya emagqumeni eduze kwe-collarbone noma imisipha yentamo, kodwa ayizange isakaze ezindaweni ezikude zomzimba.
- T4, noma yikuphi N, M0 : Okusho isisu esinoma yisiphi isayizi esisezintweni zomoya, uye wahlasela izakhiwo zendawo ezifana nenhliziyo noma isifo noma une-effusion engalungile yesikhalazo. Ama-node angase ahlanganyele noma angabandakanyeki, futhi uma ethintekile, angasondeza isisu noma aqhubeke esesifubeni noma entanyeni, kepha isisu asizange sisakaze ezindaweni ezikude zomzimba.
Izimpawu
Izimpawu ezivamile zesigaba 3 somdlavuza wamaphaphu zihlanganisa ukukhwehlela okuqhubekayo nokuphefumula . Izicubu eduze nemimoya yomoya zingabangela i-hemoptysis ( ukukhwehlela igazi ). Uma lesi sifo sihilela izindawo ezinjengezakhiwo nezinye izakhiwo zesifuba, i-dysphagia (ubunzima bokugwinya) nokukhathazeka kungenzeka. Ubuhlungu ngemuva, isifuba, kanye nezimbambo kuvamile uma kutholakala inhlanzi ye-pleural, futhi lokhu kungaholela ekwenzeni ukuphefumula okwenyukayo.
Izimpawu ezijwayelekile zomdlavuza ezifana nokukhathala nokulahlekelwa kwesisindo okungenhloso kungase kube khona.
Ukwelapha
Ngaphandle kokungavamile, isigaba somdlavuza we-3B wesifo somdlavuza sibhekwa singasebenzi ( ukuhlinza ngeke kuphulukiswe umdlavuza), kodwa kungenakugula. Kulabo abanempilo enhle, inhlanganisela ye- chemotherapy noma i-chemotherapy kanye nokwelashwa kwemisebe ngokuvamile kuvuswa. Uma abantu bengakwazi ukubekezelela i-chemotherapy, ukwelashwa kwemisebe kungasetshenziswa yedwa. Nakuba ukwelapha imishanguzo ngokuvamile kungenziwa ngenhloso yokwelapha umdlavuza, kungasiza ekunakekeleni izimpawu ezifana nobuhlungu, ukuphefumula, nokukhwehlela.
Ukwelashwa okusha okufana nezinqubo ezithintekayo kanye nemithi yokuzivikela kwenza umehluko kubantu abanezigaba eziphambili zomdlavuza wamaphaphu. Wonke umuntu onomdlavuza wesifo samangqamuzana ongewona omncane kufanele abe nokuprofetha kwamangqamuzana (ukuhlolwa kofuzo) okwenziwe ngesisu sakhe. Imithi yokwelapha izinguquko ze-EGFR , ukulungiswa kabusha kwe-ALK , nokulungiswa kabusha kwe-ROS1 kuvunyelwe, futhi izidakamizwa ezibhekisele kwezinye izinguquko zifundiswa ekuvivinyweni kwemitholampilo. Kwezinye izimo, lezi zokwelapha ziye zavumela abantu ukuba baphile nomdlavuza wamaphaphu cishe njengesimo sesifo esingelapheki.
I-Immunotherapy iyindlela yokuthakazelisa , kanti izidakamizwa zokuqala zivunyelwe ngo-2015. Lezi zidakamizwa ziye zaholela "ekuphenduleni okuqhubekayo" -i-term oncology engachazwa ngokuthi ukusho isikhathi eside isikhathi eside - kwabanye abantu abanomdlavuza wamaphaphu. Ezinye zalezi zidakamizwa nazo zisetshenziselwa ukuhlanganisa izigaba eziphambili kakhulu zomdlavuza wamaphaphu. Ngo-2018 umuthi owodwa we-immunotherapy, i-Imfinzi (durvalumab) ivunyelwe ngokukhethekile ukwelashwa kwesigaba esingenakuphulukiswa 3 umdlavuza ongasona omncane wamaphaphu. It isetshenziswa emva chemotherapy kanye nokwelapha imishanguzo, futhi watholakala ukuthuthukisa ukuqhubeka-mahhala ukusinda.
Ngenxa yokuthi imiphumela yezokwelapha iyimpofu , i-National Cancer Institute ithi bonke abantu abanomdlavuza wamaphaphu wesigaba 3 kufanele babhekwe njengabantu abafuna ukwelashwa kwemithi- izifo ezihlola izindlela ezintsha zokwelashwa nemithi yokwelapha yomdlavuza wamaphaphu.
Isibikezelo
Isilinganiso seminyaka emihlanu yokusinda ngesigaba 3B somdlavuza wamaphaphu sinesihlungu kuphela ngamaphesenti amahlanu kuphela. Isikhathi sokusinda esiphakathi (isikhathi lapho amaphesenti angu-50 esaphila futhi amaphesenti angu-50 adlulile) cishe izinyanga ezingu-13 ngokuphathwa. Khumbula ukuthi lezi zibalo ziyizinombolo ezitholakalayo ngaphambi kwezidakamizwa ezintsha-njengamanye ama-cured and immunotherapy-ayevunyelwe ukwelashwa komdlavuza wamaphaphu.
Ukusekela
Ucwaningo lubonisa ukuthi ukufunda lokho ongakwenza mayelana nomdlavuza wakho kusiza umphumela. Kukhona ulwazi oluningi lwe-intanethi, kodwa kungaba nzima ukwazi ukuthi ungabheka kuphi ulwazi oluhle. Hlola lawa macebiso wokuthola ulwazi lomdlavuza othembekile ku-intanethi . Kungenzeka into ebaluleke kakhulu ongayenza ukufunda ukuba ngummeli wakho ekunakekeleni umdlavuza wakho . Ukwelashwa komdlavuza wamaphaphu kuyashintsha ngokushesha, futhi kungaba nzima ngisho nochwepheshe bekhanda lomaphaphu ukungahambisani nakho konke ucwaningo.
Indlela enhle yokufuna kokubili ulwazi olusekelwayo kanye nolwazi oluhle ukubandakanya emphakathini wokusekela umdlavuza wamaphaphu noma umphakathi wokusekela .Ungase uzwe okungenani ngamaqembu omdlavuza wamaphaphu kunokuba uthi, amaqembu omdlavuza webele, kodwa ukuthi lawa maqembu ayinani ngamanani abanayo ngokujula. I-hashtag #LCSM imele umdlavuza wesifo sezenhlalo zomphakathi. Ngaphezu kwakho konke, ungalahlekelwa ithemba. Kokubili ukwelashwa kanye nesilinganiso sokusinda komdlavuza wamaphaphu kuye kwaba ngcono. Ngonyaka wezi-2015 kwakunezokwelapha eziningi ezintsha ezivunyelwe umdlavuza wamaphaphu kunanini ngaphambili, kanti ezinye izindlela zokwelapha ziyahlolwa ezivivinyweni zomtholampilo.
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