Ukuqonda Isibikezelo Sakho Ngezifo ZaseHodgkin
Uma wena noma othandekayo uhlala neHodgkin lymphoma , kungenzeka ukuthi wazibuza ngemali yokuphila isifo. I-Hodgkin lymphoma ivame ukuthinta abantu abasha ngesikhathi sezinye izikhathi ezikhiqizayo kakhulu ekuphileni kwabo. Phakathi kwemisebenzi ye-juggling futhi njengabazali bezingane ezincane, abantu abaningi abanesifo banemibuzo mayelana nokulinda "okulindelwe".
Ngokujabulisayo, isifo se-Hodgkin (igama elidala lale mdlavuza) lingenye yezindlela eziphilisa kakhulu zomdlavuza.
Ngesikhathi esifanayo lapho ukhuthazwa khona ngezindleko zokusinda ngeHodgkin lymphoma, kulula ukuzethemba lapho uzwa futhi esinye isihloko esilandelayo "ukuthuthuka" ekwelapheni. Izindaba ezinhle yilokho-ngokuqondene noHodgkin-lokhu akusiyo nje udoti noma ithemba lamanga. Sizokhuluma ngokuthi isikhathi sokuphila siye sathuthuka kanjani ngokuhamba kwesikhathi, nokuthi yiziphi izifo ezenze umehluko.
Okunye ukudideka lapho ukhuluma ngokuphila ngegazi elihlobene negazi elifana neHodgkin lymphoma livela kulokho abantu abakwaziyo ngamanye amagciwane, njengomdlavuza webele. Abantu bajwayele ukuthi umdlavuza webele ungaziphilisa iminyaka noma amashumi eminyaka emva kokwelapha. Nge-Hodgkin lymphoma, ukuphindaphindiwe okuningi kuvele kusenesikhathi, futhi ukubuyela emuva kwesikhathi sekujwayelekile. Ngamanye amazwi, labo abaye basinda eminyakeni engu-5 neHodgkin lymphoma bangase babe ngabasindile isikhathi eside kunabantu abanesifo esiqinile kakhulu.
Ake sikhulume ngezibalo zamanje zokusinda nge-Hodgkin lymphoma, izici ezingase zithinte isikhathi sokuphila kusukela esiteji kuya eminyakeni lapho kutholakala khona, nokuthi yini ongayenza ukuze ngethemba lokuthi uthuthukise ukubikezela kwakho.
I-Hodgkin Lymphoma: Ukubukeza Okufushane
I-Hodgkin lymphoma ingumdlavuza we- lymphatic system , ingxenye yamasosha omzimba .
Kuvame ukuvela kubantu abadala abasezintabeni ezimbili ezixilongwa; omunye phakathi kweminyaka engu-15 no-35 nomunye kubantu abangaphezu kweminyaka engama-55. Isifo se-Hodgkin ngokuvamile siqala ngokukhuliswa okungenakubuhlungu kwe-lymph nodes noma kuphi emzimbeni, kodwa kaningi entanyeni. Kunezinhlobo eziyisihlanu ezahlukene ze-Hodgkin lymphoma ehlukene ngamavolumu, ingxenye yomzimba ayithintayo, nokuthi isabela kanjani ekwelapheni.
Umbono Wezomlando Ngokubikezelwa Kwe-Hodgkin Lymphoma
I-Hodgkin i-lymphoma ingenye yezinto ezinamandla kakhulu "zokuphulukisa", kodwa lokhu akuzange kube njalo. Okokuqala kwaqaphela ngekhulu le-19, ukubikezelwa kwaze kwaba phakathi kwekhulu leminyaka elidlule kwakungenampofu, kanti isilinganiso seminyaka emihlanu sokusinda saba amaphesenti angu-10 ahlukumezayo.
Njengoba kufika i-radiotherapy, bese kuthiwa i- chemotherapy ehlangene ngawo-1960, ukubikezelwa kwesifo kuthuthukise ngokuphawulekayo, futhi cishe ubusuku okungenani isigamu sabantu abatholakala ukuthi basinda kulolu sifo.
Kodwa ukuthuthukiswa kokwelashwa kuyaqhubeka. Kusukela ekukhululweni kweNational Cancer Institute ngo-Ephreli ka-2017, isilinganiso seminyaka emihlanu yokusinda i-Hodgkin lymphoma (zonke izigaba ezihlanganisiwe) kwaba amaphesenti angu-69.9 ngo-1975 kanye namaphesenti angu-85.4 ngo-2009. Iningi lalokhu kwenyuka ngenxa yokuthuthukiswa kwamakhemikhali njenge- ABVD chemotherapy , kanye ne- BEACOPP chemotherapy regimen ), ukwelashwa kwe-radiation, kanye nokwelashwa kwe-stem cell .
Izinga lokusinda liqhubeka nokuthuthuka, kanti nakuba amazinga aphansi kakhulu kulabo abatholakale bekhulile noma abanezigaba ezithuthukisiwe zesifo, lezi ziphuthumayo manje. Ukusetshenziswa kwe-high-dose salvage chemotherapy kanye nokufakelwa kwe-stem cell kwalabo abathola ukuphindaphindiwe kuye kwaqhubeka ngcono ukuqhubeka nokuphila. Ukusebenzisa ukwelapha okuhlosiwe nge- antiocidal monoclonal , i-immunotherapy ne- checkpoint inhibitors , nokuguqulwa kwe- stem cell cell nonmyeloablative inikeza izindlela ezengeziwe zokwelashwa ezilindeleke ukuthi ziqhubekele phambili ekuthuthukiseni ukusinda kulabo abanezinkinga ezingaphezu kanzima zokuphatha i-Hodgkin lymphomas.
Ukuphathwa okungcono kwezinkinga, ezifana nezifo ezihlobene ne -neutropenia (i-white white cell count count), nayo yenza umehluko.
Ukusinda akuyona kuphela inzuzo yokwelapha okuthuthukisiwe. Ukwelashwa kwe-chemotherapy enobuthi kanye nokwelashwa kwemithi emincane yasensimini kuye kwanciphisa imiphumela emibi yokwelashwa futhi, kuyathemba, imiphumela emibi yesikhathi eside yalesi sifo.
Ukuphunyuka Ngama-Cancers Ahlobene Negazi Nama-Tumor Solid
Kulabo abajwayele ukwelashwa umdlavuza njengengculaza yesifuba, kuyasiza ukuthatha isikhashana futhi ukhulume ngokuthi izigaba ezithuthukile (isigaba III noma isigaba IV) se-Hodgkin isifo (nezinye izifo zomdlavuza ezihlobene negazi) zihlukile ngokulandelana kunalokho izigaba ezithuthukile zezinambuzane eziningi eziqinile (njengomdlavuza webele noma umdlavuza we-pancreatic).
Amanqamu aphezulu ahlobene negazi, njenge-stage IV Hodgkin isifo, ngokuvamile ayelapheka. Ngokuphambene nalokho, izicubu eziningi ezisezingeni eliphezulu (njenge-stage IV yomdlavuza webele noma umdlavuza we-stage IV pancreatic) aziphilwanga. Ngokufanayo, ukubikezelwa kokuphindaphindiwe kweHodgkin lymphoma kungcono kakhulu kunokuphindaphinda kwezicubu eziningi eziqinile.
Ukuqonda Amanani Okusinda Nokulinganiselwa Kwezinto Zokuphila
Sizofika ezinombolweni kanye nezibalo ezichaza ukusinda maduzane kodwa zidinga ukuchaza ukuthi lezi zindleko zisho ukuthini, futhi ezinye zokulinganiselwa ezivela kulezi zibalo.
Izinga lokusinda livame ukuchazwa njengephesenti elilandelwa isikhathi esithile. Isibonelo, ungase ubone iminyaka engu-1, iminyaka emihlanu, noma iminyaka eyishumi yokusinda. Uma isifo sinesilinganiso seminyaka engu-5 sokusinda kusho ukuthi amaphesenti angu-50 abantu abanesifo bazobe besaphila eminyakeni emihlanu emva kokuxilongwa.
Ngezinye izikhathi ungase ubone igama elithi " isilinganiso sokusinda esiphakathi ." Isilinganiso sokusinda esilandelayo silandelwa yisikhathi sesikhathi futhi sikhombisa isikhathi esilandelayo lapho amaphesenti angu-50 abantu abazofa futhi amaphesenti angu-50 abantu asebesaphila. Isibonelo, izinga lokusinda phakathi kwezinyanga ezingu-13 kungaba yisikhathi ngemva kwalokho amaphesenti angu-50 abantu asefile kanti amaphesenti angu-50 asaphila. Ngezifo ezinjengesifo se-Hodgkin, uzobona amazinga okusinda kaningi, kanti, ngokudlavuza okunomdlavuza we-pancreatic noma umdlavuza wamaphaphu, kuvame ukusetshenziselwa ukusinda okuphakathi.
Uma ubheka lezi zindleko, iphuzu elibaluleke kunazo zonke okufanele lizenze ukuthi "yizilinganiso" kanye "nezinombolo." Abantu bangempela abazona izibalo. Lezi zinombolo zichaza ukuthi umuntu ozobhekana nesifo esithile se-Hodgkin isikhathi eside nanoma yiziphi ezinye izici kulindeleke ukuba aphile. Kodwa-ke, ngisho nalapho izinga lokusinda liphulwa phansi ngobudala kanye nesigaba, akunakwenzeka ukubikezela ukuthi umuntu oyedwa uzokwenzani nalesi sifo. Abanye abantu benza kangcono kakhulu kune "isilinganiso" kanti abanye abantu abakwenzi.
Ukulinganiselwa Kwezinga Lokusinda
Njengoba kuphawuliwe ngenhla, enye yezinsizakalo ezinkulu kakhulu zokusinda izinga wukuthi zinikeza isilinganiso esilinganiselwe sokusinda, kodwa akekho umuntu ophakathi. Ngaphezu kwalokho, izinga lokusinda lingadukisa kwezinye izizathu.
Ukubheka amazinga okusinda okuyiminyaka emihlanu kusho ukuthi sibheka abantu abatholiwe okungenani eminyakeni emihlanu eyedlule. Phakathi naleso sikhathi, ukwelashwa okusha kuye kwavame ukwakhiwa. Ngcono kakhulu, amazinga okusinda angakutshela ukuthi umuntu ovamile wenza kanjani esikhathini esidlule ngemuva kokuba aphathwe ngemithi yokwelapha engase isetshenziswe noma ingasetshenziswa nanamuhla. Ngentuthuko eyenziwa ekwelapheni komdlavuza, izinga lokusinda liba nenembile kangako njengokulinganisa esikhathini esidlule. Nakuba lokhu kungenza ukubikezela kunzima kakhulu, kusitshela ukuthi inqubekelaphambili yenziwa.
Ukusinda isikhathi eside kunzima nakakhulu ukubikezela. Ucwaningo oluningi luhlukanisa ukufa ngenxa yesifo soHodgkin nokufa ngenxa yezizathu ezithile, kodwa lezi zinyathelo azibheki njalo ngezimo zezokwelapha ezingahambisani kodwa ngenxa yokwelapha, njengezikhambi zamagciwane.
Amazinga okuPhepha okuPhezulu okuPhezulu kanye nokuKhululeka kokuPhila ngeSigaba
Kunezindlela eziningi ezahlukene zokubheka amazinga okusinda ngeHodgkin lymphoma. Ake sibheke lezi zindlela ezimbalwa.
Izindleko zokusinda jikelele ezinikeza isikhathi sokuphila kubantu abanezigaba ezihlangene zihlanganisa:
- Isilinganiso sokusinda seminyaka engu-1 esiphezulu samaphesenti angu-92
- Inani leminyaka engu-5 yokusinda kwamaphesenti angu-87
- Iminyaka engu-10 isamba sokusinda samaphesenti angu-80
Izinga lokusinda iminyaka emihlanu ngesigaba zihlanganisa:
- Isigaba I-5% sonyaka wokusinda ngamaphesenti angu-90
- Isigaba II isilinganiso seminyaka emihlanu sokusinda singamaphesenti angama-90
- Isigaba III sonyaka wokuphila iminyaka engu-5 ngamaphesenti angu-80
- Izinga le-Stage IV lokuphila iminyaka engu-5 ngamaphesenti angu-65
Kubalulekile ukuqaphela ukuthi la mazinga aphakathi kwabo bonke abantu abanesigaba esithile se-Hodgkin isifo kungakhathaliseki ukuthi baneminyaka engakanani futhi kungakhathaliseki ukuthi yiziphi ezinye izici ezingase zandise noma zinciphise ithuba lokusinda.
Ukusinda Kwesikhathi Eside Ne-Hodgkin Lymphoma
Ukuphila isikhathi eside neHodgkin lymphoma kunzima ukulinganisa, ngenxa yezimo ezinjengezikhondla ezincane ezingase zenzeke emashumini eminyaka emva kokwelapha. Lokho kusho ukuthi izifundo ezahlukene zilinganisela ukuthi phakathi kweminyaka engama-15 no-30 ekukhipheni ukwelashwa, abantu abaye babe ne-Hodgkin lymphoma cishe bafa ngenxa yezizathu ezingahambisani neHodgkin lymphoma kunaseHodgkin. Ngamanye amazwi, emva kwalesi sikhathi sabantu kungenzeka ukuthi bafe ngezimbangela ukuthi umphakathi ophakathi uzofa kusuka.
Izinto Okuthinta Ukusinda Ngezifo ZaseHodgkin
Kunezinhlobo eziningi eziguquguqukayo ezihlotshaniswa nokwanda noma ukwehla amathuba okusinda isifo seHodgkin. Ezinye zazo zihlanganisa:
- Isigaba saleso sifo - Isifo se-Stage I noma II sithatha isifuba esingcono kuneSigaba III noma isigaba IV.
- Ubudala - Abantu abancane bathambekele ekwenzeni okungcono kunalabo asebekhulile (abangaphezu kweminyaka engama-45).
- Ubulili - Abesifazane bavame ukuba nokuphila okuphakeme kunamadoda.
- Ukuba khona kwezimpawu zeB - Ukulahleka kwesisindo, ukukhukhumeza ebusuku, nemifudu, okuthiwa yi- B izimpawu ze-lymphoma , kuhlotshaniswa nokuhlushwa okubi kakhulu (kodwa namanje, abantu abaningi bangakwazi ukufeza isikhathi eside).
- Kungakhathaliseki ukubuyela emuva futhi uma - Kulabo abaphindaphinda ngonyaka olandelayo emva kokwelashwa, ukubikezelwa kuyimpofu.
- Impendulo ekwelapheni - Labo abaphendula emithini yokwelapha yokuqala banokubikezelwa okungcono kunalabo abangekho.
- I-albhamu level - A level albinini ephansi (engaphansi kwezingu-4 g / dL) ihlotshaniswa nokuhlushwa okubi kakhulu.
- Ukubala kwegazi elimhlophe (i-WBC) - Ukubalwa kwamaseli amhlophe wegazi (ngaphezulu kwamangqamuzana egazi angu-15,000 nge mm3) kuhlotshaniswa nokuchazwa okuncane kakhulu.
- Ukubala okuphansi okuphansi kwe-lymphocyte (ALC) - I-lymphocyte ephelele ibalwa ngaphansi kwamangqamuzana angama-600 nge-mm3 ehambisana nokuhlushwa okubi kakhulu.
- Isifo esincane esincane sinesifo esiphezulu se-prognosis.
- I-anemia - I- hemoglobin ephansi (engaphansi kuka-10.5 g / dL) ixhunyaniswe nokuhlushwa okuncane kakhulu kunelabo abanezinga eliphezulu le-hemoglobin.
- Isilinganiso se-Sed - Isilinganiso se- erythrocyte sedimentation (ESR) esingaphezu kwezingama-30 sihlotshaniswa nokuhlushwa okubi kakhulu.
- Uhlobo lwe-Hodgkin lymphoma - Ezinye izinhlobo ze-Hodgkin lymphomas zihlotshaniswa nesilinganiso esingcono sokusinda kunabanye (izinhlobo ze- lymphocyte nodular kanye nezinhlobo ze- nodular sclerosing kunezibikezelo ezingcono kakhulu).
- Impilo jikelele ngesikhathi sokuxilongwa nezinye izimo zezokwelapha
- Kungakhathaliseki ukuthi umdlavuza uvame noma uphumelele
- Umshuwalense wezempilo - Abantu abangenayo umshuwalense wezempilo banezibalo ezimbi kakhulu.
Ukuphindaphindiwe kanye nezinkokhelo zokusinda
Njengoba sibonile ngenhla, isikhathi nokuphindaphinda kokuphindaphindiwe kuhluke kakhulu neHodgkin lymphoma kunomdlavuza webele. Nge-Hodgkin lymphoma, ngaphezu kwengxenye yokuphindaphindiwe kwenzeka eminyakeni engaphansi kwemibili yokwelashwa okuyisisekelo futhi amaphesenti angaba ngu-90 avela ngaphambi komaka oneminyaka emihlanu. Ukutholakala kokuphindaphinda ngemva kweminyaka eyi-10 kungavamile futhi ngemva kweminyaka engu-15 ingozi yokuthuthukisa i-lymphoma ifana nengozi ebantwini abavamile. Kulabo abaye bezwa mayelana namabele ebelethwe emuva ngemuva kweminyaka eminingi, kungase kufike njengokunye okuqinisekisayo ukuthi lokhu akuvamile ne-Hodgkin isifo. Kubalulekile ukuqaphela ukuthi ngisho nokuphindaphindiwe, abantu abaningi abanesifo seHodgkin bazoqhubeka nokuphila impilo ende.
Ukulinganisa Isibikezelo Sakho
Kulabo abafisa ukuba nomqondo ongcono mayelana nokubikezelwa kwabo okulinganisiwe, kukhona ithuluzi elibizwa ngokuthi ithuluzi lika- Hasenclever lokubikezela elisetshenziselwa ukulinganisa ukubikezelwa ngokusekelwe ezicini eziyisikhombisa ezahlukene noma izingozi. Ngalinye yalezi zici eziyisikhombisa kucatshangwa ukunciphisa iminyaka emihlanu ukusinda ngamaphesenti angama-8. Lezi zihlanganisa i-albhamu ye-serum engaphansi kuka-40 g / dL, i-hemoglobin engaphansi kwe-10.5 g / dL, isilisa esesilisa, isigaba se-IV sesifo, isibalo segazi esimhlophe esingaphezu kuka-15,000 / mL, futhi i-lymphocyte ingaphansi kuka-600 / mL.
Kulabo abangenazo zonke lezi zinto ezibeka ingozi, ukulinganiselwa kweminyaka emihlanu (estimation) yokulinganisela (jikelele) ngamaphesenti angama-89, kanti kulabo abanezici ezinobungozi ezinhlanu noma ngaphezulu, isilinganiso sokusinda seminyaka engu-5 singama-56%.
Khumbula ukuthi lamathuluzi asetshenziselwa ukulinganisa "isilinganiso" sokubikezela, futhi akekho umuntu ophakathi. Kubalulekile ukuqaphela ukuthi ngisho noma unezinkinga ezinhlanu noma ezingaphezu kwezinguquko, abantu abaningi abangaphezu kwamaphesenti angu-50-basaphila eminyakeni emihlanu emva kokuxilongwa.
Yini Ongayenza Ukuze Uthuthukise Isibikezelo Sakho?
Ngezingxoxo zonke mayelana nezinketho zokwelashwa, ngezinye izikhathi kulula ukukhohlwa ukuthi kunezinto ezilula ongazenza ngokwakho ukuze uthuthukise ukubikezela kwakho. Kubalulekile ukuthi:
- Yidla okunempilo: Yini oyifaka emzimbeni wakho ingenza umehluko endleleni obekezelela ngayo imithi yokwelashwa nokuthi uzizwa kanjani emva kokwelashwa. Uma unenkinga, cela i-oncologist yakho ukuthi ikusethe nge-oncology nutritionistist.
- Ukuzivocavoca: Manje sinezinqwaba zezifundo eziye zabheka umphumela wokuvivinya umzimba njalo emiphumeleni yezinhlobo eziningi zegciwane, kuhlanganise neHodgkin lymphoma. Ngisho nokuzivocavoca okuncane kungasiza. Khumbula ukuthi kungcono ukuzivocavoca ngokuphindaphindiwe ngemali encane kunokuzivocavoca isikhathi eside.
- Ukulala kahle: Asazi ngemiphumela yokuphazamiseka kokulala esihlokweni se-Hodgkin, kodwa siyazi ukuthi ngomdlavuza wesifuba lezi zimo zinganciphisa ukusinda. Khuluma ne-oncologist yakho uma unomphumela omubi kakhulu wezokwelapha.
- Yakha uhlelo lokunakekelwa komdlavuza: Uma usuqedile ukwelashwa, qiniseka ukuthi wena nodokotela wakho ugcwalisa uhlelo lokunakekelwa kwabasindile. Ingozi yama-khansa yesibili ingokoqobo ngemva kokwelashwa kwe-Hodgkin, futhi ingase ikhule. Udokotela wakho angase ancoma ekuqaleni noma ukuhlolwa okuningi kaningi kwamagciwane efana nesifo somdlavuza webele futhi ulandele izimpawu zamanye amagciwane uma kwenzeka.
I-Hodgkin Lymphoma: Ngokuvamile Iyaphilika, Kodwa Isifo Esiyinselele
Kungase kubonakale kumnandi kumuntu ongakaze abe nesifo somdlavuza, kodwa kunomncintiswano phakathi kwabantu abanezinhlobo ezahlukene zomdlavuza, noma okungenani phakathi kwalabo abanesisindo esiphezulu sokusinda kanye namanqamu aphansi okusinda. Labo abanezincane zomdlavuza abanamaphesenti aphansi okusinda bangase bacabange ukuthi kunezifo ezinomdlavuza ezingasetshenziswa njengengqinamba encane.
Khumbula ukuthi yize iHodgkin lymphoma ingelapheka kakhulu kunezinye izinhlobo eziningi zamanqamuzana, ukubhekana nanoma imuphi umdlavuza uyesabeka. Ukuba nokufa kwakho okuphonswe ebusweni bakho kukhona into abangenayo umdlavuza abangaqondi futhi akunandaba ukuthi umdlavuza unamaphesenti angu-99 okusinda noma isilinganiso sokusinda kwamaphesenti angu-2. Kumele siqaphele ukuthi, ngisho nalapho ephilisa, ukwelashwa ukulawula i-Hodgkin lymphoma kuyinselele kakhulu. I-Chemotherapy ingase iqhubeke isikhathi eside kakhulu, futhi ikakhulukazi nge-stem cell transplants, ngokwezinga elikhulu, kunamanye amaningi kansa. Kukhona futhi inkinga yemiphumela emibi yesikhathi eside ye-Hodgkin lymphoma, efana namagciwane wesibili, okuzodinga ukuqapha impilo yonke.
Njengombhalo wokugcina, uma wena noma othandekayo uphethwe ukwelashwa kwesifo seHodgkin, kubalulekile ukukhuluma nodokotela wakho mayelana nokuphila. Imitholampilo eminingi yomdlavuza manje inezinhlelo zokuvuselela umdlavuza lapho kusetshenziselwa ukwelashwa komdlavuza , okuvela ebuhlungu obungapheli kuze kube nokukhathazeka.
> Imithombo:
> Ahmadzadeh, A., Yekaninejad, M., Jalili, M. et al. Ukuhlola Isilinganiso Sokusinda kanye Nezigebengu Zesibili emva kokuphatha iziguli ze-Hodgkin Lymphoma nge-Chemotherapy Regimens. I-International Journal ye- Hematology Oncology ne-Stem Cell Research . 2014. 8 (2): 21-26.
> I-American Cancer Society. Iqiniso le-Cancer Amanani & Amanani 2017. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html
> Brenner, H., Gondos, A., no D. Pulte. Ukusinda Okulindelwe Iziguli Ezibonwa neHodgkin Lymphoma ngo-2006-2010. I-Oncologist . 2009. 14 (8): 806-813.
> National Cancer Institute. Ukuqapha, i-Epidemiology, nohlelo Lokuphela Lokusebenza. I-SEER Cancer Statistics Review (CSR) 1975-2014. Kukhishwe ngo-Ephreli 14, 2017. https://seer.cancer.gov/csr/1975_2014/