Yiziphi zokwelapha ezitholakalayo ukuphindaphinda umdlavuza we-ovarian? Umdlavuza wami we-ovariya uphindela emuva noma awuzange uhambe ngemuva kokusethwa kokuqala kwezokwelapha. Yini okufanele ngiyenze manje? Lona ngumbuzo owawubuzwa iziguli eziningi ze-ovarian ngezikhathi ezithile. Ngeshwa, kubantu abangaba ngu-80% abahamba nge-chemotherapy yokuqala, umdlavuza ubuya.
Impendulo yalo mbuzo incike ekutheni i-diagnostic yokuphindaphindiwe yenziwa kanjani nokuthi sekuphele isikhathi esingakanani ukuphela kokwelashwa kokuqala lokhu kwenzeka.
Ngokujwayelekile, kunezigaba ezintathu ezihlukene eziphethe izilinganiso ezintathu ezihlukene futhi ngokuvamile ziholela ezinhlelweni ezintathu zokwelashwa ezihlukene. Kodwa-ke, ngaphesheya kwalokho, sicela uqaphele ukuthi nakuba kunendlela ehle kakhulu yokukhetha ukwelapha okuqala, ukwelashwa okuphindaphindiwe kubaluleke kakhulu.
Ngenkathi kunemihlahlandlela emihle kakhulu, ayikho imigomo yokusebenza evumelwaneni jikelele. Ngokuvamile, isikhathi esiningi sidlula ngaphambi kokuphindaphinda kungcono amathuba okuthola ukwelashwa noma ukukhululwa kwesibili eside. Kanti futhi, izinketho eziningi zitholakala kule simo.
Ukuphindaphindiwe Ngemva Kwenyanga Eyisithupha
Uma ukuphindaphindiwe kutholakala okungenani izinyanga ezingu-6 ngemuva kokwelapha kokuqala (mhlawumbe kufinyelela unyaka), lesi sifo sithathwa ngokuthi "i-platinum sensitive" uma ukwelashwa kokuqala kunezidakamizwa zeplatinum (i-Carbo-platin noma i-Cis-platin). Ngemuva kokuphindaphindiwe ngemuva kwaleli phuzu, kungase kudingeke ukuba kwenziwe ukuhlinzekwa "kwe-cytoreduction" ukuze uphinde ususe umdlavuza ngangokunokwenzeka.
Abaningi bezinyoni ze-oncologists babezocabangela ngalokhu uma umdlavuza ubuya okungenani iminyaka emibili emva kokwelashwa kokuqala futhi inqwaba noma izixuku / kubonakala ngokuskena noma kuzizwa ekuhlolweni. Noma kunjalo, kungase kube yindlela enhle kakhulu ngaphambi kwalesi sakhiwo sesikhathi futhi, kuye ngesimo sakho esithile.
Kungakhathaliseki ukuthi ukuphinda ukuhlinzekwa kwe-cytoreduction yesibili kwenziwa noma cha, ama-oncologist amaningi angasikisela ukuphatha ngezidakamizwa ezifanayo ngesikhathi esisodwa, ikakhulu uma ukuphindaphindiwe kutholakala okungaphezu konyaka ngemuva kokwelashwa kokuqala.
Uma itholakale phakathi kwezinyanga ezingu-6 nonyaka ngemuva kokwelashwa, izinketho zingase zibandakanye ukwelashwa kabusha ne-Taxol ne-Cis-Platinum noma i-Carbo-Platin, noma ukusebenzisa izidakamizwa ezintsha njengoba kuxoxwe ngezansi. Abaningi be-oncologists bayokwenzela izidakamizwa ezintsha esikhathini esizayo.
Ukuphindaphinda Phakathi Nenyanga Eyisithupha
Uma ukuphindaphindiwe kutholakala izinyanga ezingu-6 noma ngaphansi ngemuva kokwelashwa kokuqala, isisu sinqatshelwe ukuthi "i-platinum resistant" . Kungenzeka ukuthi lesi sifo sabuyela emuva ngasekupheleni noma emva kokusuka kwamakhemikhali. Kulezi zimo, ukuhlinzwa okuphindaphindiwe kuvame ukuphakanyiswa njengoba kungenakwenzeka kakhulu ukuthuthukisa ubude bokuphila noma ikhwalithi yokuphila. Kunezidakamizwa ezintathu eziyinhloko zokwelashwa kwamakhemikhali ezitholakalayo namuhla okuyinto incologists iningi esebenzisa ngokungafani. Konke kusebenza kahle ngokulinganayo futhi kungasetshenziswa ngokulandelana, ngesikhathi esisodwa, njengomuthi owodwa noma omunye oyeka ukusebenza. Lezi yi: Doxil, Topotecan noGemzar. Izindlela zokwelashwa ezihlangene nazo ziye zazama, kodwa ngokuvamile ngaphandle kwempumelelo engcono kakhulu nangemiphumela emibi ye-toxicity. Nokho, isimo ngasinye sihlukile, ngakho-ke sicela ucele udokotela wakho ngazo zonke izindlela ongakhetha kuzo. Ngenkathi i-chemotherapy enobudlova nalezi zidakamizwa zisalokhu ziqhubeka, kufanele uhlale ukhumbule ukuthi amathuba okuphulukiswa amancane kakhulu futhi ukugcina izinga lokuphila engqondweni kubaluleke kakhulu.
Futhi, lokhu kuyinkulumo engozini / yenzuzo nodokotela wakho.
Ukuphindaphindiwe Ngesikhathi Noma Ngokushesha Ngemva Kwokwelashwa
Uma ukuphindaphinda empeleni ukukhula komdlavuza ngesikhathi sokuphulukiswa kokuqala, lokhu kubizwa ngokuthi "i-platinum refractory", noma icala elibi kakhulu lokumelana ne-chemotherapy. Amakhemikhali ekwengeziwe anganikezwa, ikakhulukazi esebenzisa izidakamizwa ezikhulunywe ngenhla, kodwa amathuba okuphendula aphansi kakhulu. Futhi, khumbula ukuthi izidakamizwa okukhulunywe ngenhla akuzona ezona ezitholakalayo zokwelashwa, nje zibhekwa njengezizozakala kakhulu zokuzama kuqala. Buza udokotela wakho mayelana nabanye nokuthi yiziphi amathuba ukuthi bangasiza kuzo.
Lokhu kungase kube yisikhathi esihle sokubuza mayelana nokwethenjwa kepha ongakhetha okungaqinisekisiwe ngokusebenzisa izivivinyo zemitholampilo.
Izivivinyo zemitholampilo
Kunezilingo eziningi zokwelashwa eziqhubekayo emdlalweni we-ovarian obuye wabuyela emuva, futhi ucwaningo olubheka ezinye zalezi zinketho luyakhuthaza. Khuluma ne-oncologist yakho mayelana nokuhlolwa okungase kuhlangabezane nesimo sakho esithile, noma ucabangele umbono wesibili. Ezinye zalezi zinketho zibandakanya imishanguzo yokwelashwa okuhlosiwe - okungukuthi, imishanguzo eyenzelwe ukuqondisa ngokuqondile amaseli omdlavuza, kanye nemithi eyodwa yeklasi elisha lezidakamizwa okuthiwa i-PARP inhibitors lavunyelwe ukusetshenziswa ngo-2015.
I-Palliative vs. Inhloso Yokuphulukisa Ukwelashwa
Igama eliphathelene "nokuhlinzwa okunamandla" nelithi "imisebe ye-palliative". Ngisho noma ukuhlinzwa akuseyona inkinga yokwelapha ngesikhathi esithile ekwelapheni, kungase kube nezinketho zokuhlinza okuthi "palliate" noma ukusiza ukuxazulula noma ukuzola izimpawu. Ezimweni ezingavamile, lokhu kungase kube ukuhlinzeka ngamathambo okugaya emathunjini noma ukususwa kwendawo eyodwa evinjelwe emathunjini (ngokuvamile izingxenye eziningi zivinjiwe) ukuze kuvunyelwe othile ukuba adle ukudla okungenani izinyanga eziningana. Kwezinye izimo, lokhu kungase kusho ukubeka ithubhu ngqo esiswini ngesikhumba (gastrostomy) ukuze ukuhlanza kukhululeke futhi ithubhu ekhaleni (NG tube) akudingeki ibe khona amasonto noma izinyanga.
Ngezinye izikhathi emdlalweni ophakeme, uketshezi luqoqa esifubeni. Izinqubo ezehlukene zokukhipha umthamo, kuhlanganise nezilimo eziyizigaxa kanye nezinqubo zokuqeda (pleurodesis) , zingasiza ekuqedeni noma ekunciphiseni lokhu oketshezi kanye nokusiza ngezinkinga zokuphefumula. Lezi zibonelo ezimbalwa nje kuphela, kodwa esimweni ngesisekelo sokwehluleka, uhlobo oluthile lokuhlinzeka noma inqubo engavumelani ne-radiologically eqondakalayo ingase ikusize. Uma unesifo esithile, buza noma ngabe uhlobo oluthile lwenqubo yokuhlinzeka noma yokuhlasela lungasiza.
Okokugcina, nakuba umdlavuza ongavamile, umdlavuza we-ovarian ungafaka amathambo akho, ngokuvamile uveza ubuhlungu obukhulu. Kanti futhi kungavamile ukuthi isakaze ebuchosheni futhi kutholakale ukuqubuka. Kuzo zombili lezi zimo, ukwelapha imisebe kule ndawo kungasiza kakhulu ekunciphiseni noma ekuqedeni izimpawu.
Umthombo:
I-National Cancer Institute. I-Ovarian Epithelial, I-Tube yama-Fallopian, ne-Primary Peritoneal Treatment Treatment-yezokwelapha (PDQ®). I-Recant or Persistent Ovarian epithelial, iTallopian Tube, kanye nePrithonal Primary Cancer Treatment. Kubuyekezwe 08/21/15. http://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq#section/_82