Izinkinga Ezivela Kuzokwelapha, I-Chemotherapy, Ukwelashwa Kwemithi, Nokuningi
Uma ukhuluma nabantu abaningi abanomdlavuza webele , uzofunda ukuthi ukubhekana nalesi sifo kuhilela okuningi kunokulwa nomdlavuza wedwa. Eqinisweni, imiphumela emibi kanye nezinkinga zomdlavuza nomdlavuza kaningi kunzima njengomdlavuza ngokwawo. Yimiphi imiphumela emibi nokuthi yiziphi izinkinga ezingase zenzeke uma uphathwa isifo somdlavuza webele wesandulela?
Ake sibheke izinkinga ezingase zihlobene nokuhlinzwa, i-chemotherapy, kanye nokwelashwa kwemisebe, kanye "nezingqondo" nezinkinga zomphakathi ongase uzizwe.
Imiphumela emibi ngokumelene nezinkinga
Kubalulekile ukuqhathanisa imiphumela emibi kanye nezinkinga, nakuba sizoxoxa ngakho kokubili. Imiphumela emibi yizimpawu ezingavamile futhi ngokuvamile kulindeleke. Isibonelo somphumela wecala ukulahlekelwa izinwele ngesikhathi samakhemikhali. Izinkinga, ngokuphambene, azivamile futhi azilindelekile, nakuba ziyaziwa ukuthi zenzeka ngezikhathi ezithile. Isibonelo kungaba ukuthuthukiswa kwehluleka kwenhliziyo noma i-leukemia ngenxa ye-chemotherapy.
Yize kungenzeka ukuthi uzoba nemiphumela emibi ephathelene nokuphathwa, gcina engqondweni ukuthi abantu abaningi abahlangabezane nanoma yiziphi izinkinga ezingezansi. Asifuni ukuthi lolu hlu lukuthumele, kodwa lithemba ukuthi lolo lwazi luzokuphawula ukuthi kukhona okungalungile, ukuze ufune usizo lwezokwelapha ngokushesha uma kunesidingo.
Ake siqale ngokubheka ukwelashwa okuqondile ongayithola.
Imiphumela emibi kanye nezinengozi zokuhlinzwa
Kungakhathaliseki ukuthi une-mastectomy noma i-lumpectomy, ungalindela eminye imiphumela emibi. Ngemuva kokuhlinzwa, uzobe usukuma izinsuku ezimbalwa. Uma ngabe une-dissection ye-lymph node, cishe uzokhawulelwa ukunyakaza kwezingalo zakho isikhathi esithile.
Yiqiniso, ukuhlinzeka kusho ukuthi uzoba nobunzima.
Izinkinga ezingenzeka, ngokuphambene, zingabandakanya:
- Ukutheleleka: Noma nini lapho umuntu ehlinzwa khona, kunengozi yokuthi amabhaktheriya aqaliswe ekufakweni okubangelwa ukutheleleka. Udokotela wakho ohlinzayo uzokucela ukuba ubukele noma yiziphi izimpawu, ezifana nomkhuhlane, ubomvu noma ithenda. Uma ngabe ususwe isisu noma i-lymph nodes, ungase ube ne-drain eyodwa noma eminingana endaweni. Nakuba lezi zidonsa zinganciphisa ezinye izinkinga, zingase zibe yindlela yokuba amabhaktheriya angene emzimbeni wakho.
- Ukubhekana ne-anesthesia: Ukuhlinzwa komdlavuza webele kuningi kwenziwa ngaphansi kwe-anesthesia jikelele, futhi kuthatha ingozi encane yezinkinga.
- I-seroma: I- seroma iqoqo lomswakama endaweni lapho izicubu zakho zesifuba zisusiwe khona. Inhloso yamanzi ukukhipha lokhu okuketshezi, kodwa, ngisho nangamanzi, i-seroma ingase ivele ngezinye izikhathi.
- I-Hematoma: Uma kukhona indawo ekufakeni kwakho okuqhubekayo ukuphuma, i-hematoma (iqoqo legazi) lingase lifake.
- Ama-blood clots: Ukwelashwa kuyisici esiyingozi ekuthuthukiseni ama- blood clots emilenzeni yakho. Uma ungaphenduliwe, lawa macwecwe angahle ahambe futhi ahambe aye emaphashini akho (amapulmary emboli). Nakuba kungavamile ngemuva kokuhlinzwa komdlavuza webele, ukuvuka nokuhamba nokugwema ukuphumula okulele isikhathi eside kunganciphisa ingozi yakho. (I-Chemotherapy ibuye ikhulise ingozi yezindwangu zegazi.)
Izinkinga zesikhathi eside zingabandakanya:
- Ihlombe elinyanyisiwe : Abesifazane abathile bathuthuka ukunyakaza okukhawulelwe emahlombe abo emva kokuhlinzwa komdlavuza webele. Uma ukunyakaza kuvinjelwe kakhulu, ungaphetha ngehlombe elifriziwe. Ukwelashwa ngokwemvelo kuyasebenza kakhulu ekuphatheni lesi simo, kodwa ukuvimbela njalo kuhamba phambili. Abanye odokotela abahlinzayo bancoma ukuthi abesifazane babone umdlavuza womzimba wesifo somdlavuza webele (ikakhulukazi oqinisekisiwe ohlelweni lweNkanyezi yokuvuselela umdlavuza) ngemuva kokuphulukiswa kusukela ekuhlinzekeni, ukuqinisekisa ukuthi abanenkinga.
- I-Lymphedema : I- Lymphedema yisimo lapho izitsha ze-lymphism ezisekhondweni zonakaliswa ngesikhathi sokuhlinzwa. Kuyenzeka kaningi lapho i-dissection ye-lymph node isenziwa. Izimpawu zihlanganisa ingalo eyodwa evuvukala ngaphezu kwesinye. Ukukhetha udokotela ohlinzayo owenza inqwaba yokuhlinza umdlavuza webele kunganciphisa ingozi yakho, futhi uqaphele ukugwema ukulimala kwengalo eceleni komdlavuza wakho webele. Ikhono le-lymphedema yingakho udokotela wakho ohlinzayo uzokutshela ukuthi ugweme ukuba negazi lidonsa noma ukucindezelwa kwegazi kuhlolwe ohlangothini lomdlavuza wakho webele.
- Imiphumela emibi yokwenza izimonyo : Nakuba kungeyona inkinga yokulimaza ngokomzimba, imiphumela emihle yokuzicabangela ingaba inselele ngokomzwelo. Uma lokhu kwenzeka, ngokuvamile kuningi ongakhetha kukho abantu abazobukeza ukuhlinzwa kwabo, kanye nezinketho zokuvuselela.
Izinkinga ngenxa yokuvuselelwa kwebele:
- Ukwakhiwa kabusha kubeka ingozi yezinkinga ezifanayo njengokuhlinzwa komdlavuza webele webele, njengokutheleleka, ukuphuma kwegazi kanye negazi.
- Isivumelwane se-Capsular: Imizimba yethu iyaqaphela uma kunokuthile okungajwayelekile ezingxenyeni zethu, futhi ngokuvamile sizama ukususa udonga lokho okungavamile. Abahlinza abahlinzayo basePlastiki bebebheke ngezindlela zokunciphisa ingozi yokuvumelanisa kwe- capsular ngemuva kokuvuselelwa kwebele. Uma kwenzeka, ukufakelwa kwebele kungase kube nzima, kuthuthekile, futhi kuthenda. Uma uthuthukisa lesi simo, noma kunjalo, kukhona ukuhlinzwa okungenziwa.
Izinkinga ezivela Chemotherapy
Imiphumela emibi ye-chemotherapy iyaziwa kahle. Imiphumela evamile kakhulu ihlanganisa ukulahlekelwa izinwele, ukucindezelwa komnyoba we-bone (okwenza kube nezinga eliphansi lamaseli abomvu obomvu, amangqamuzana egazi amhlophe, namaplatelets), kanye nesicashu. I-Chemotherapy ibulala izingqamuzana ezihlukanisa ngokushesha ezifana namangqamuzana omdlavuza, kodwa amangqamuzana ezinwele zezinwele zakho, umnkantsha wesifuba, kanye nomgudu wokugaya umzimba ahlukana ngokushesha.
Kube nokuthuthuka okuphawulekayo ekulawuleni imiphumela emibi ye-chemotherapy eminyakeni yamuva. Imithi enikezwa ingavame ukuvimbela izinambuzane nokuhlanza, futhi ungathola izijovo ze-Neulasta noma i-Neupogen ukugcina isibalo sakho se-neutrophil (uhlobo lomhlophe wegazi eliphakeme) okwanele ngokwanele ukunciphisa ingozi yokutheleleka.
Izinkinga, kanye nemiphumela emibi engase iqhubeke ngemuva kokwelashwa ihlanganisa:
- Izifo (i-febrile neutropenia): Izifo ezinzima zingenzeka uma isibalo sakho segazi elimhlophe siphansi kakhulu futhi sidinga ukwelashwa okunonya. Izifo ngenxa ye -neutropenia eyenziwa yi-chemotherapy- enye ingenye yemiphumela emibi kakhulu kulo lonke ukwelashwa kwamakhemikhali.
- I-peripheral neuropathy: I- peripheral neuropathy yizikhonkwane ezicindezelayo-nezinsizi zokuzwa, kanye ne-numbness, ukuthi abesifazane bangabhala ngezandla nangezinyawo. Ngeshwa, lokhu kungaqhubeka isikhathi eside ngemuva kokwelapha, nakuba abacwaningi bebheke izindlela zokunciphisa ingozi. Ngokuvamile kubangelwa izidakamizwa "zamatekisi" ezifana ne-Taxol (paclitaxel).
- I-Chemobrain: Kunzima ngomsebenzi wokuqonda, njengokunciphisa inkumbulo yesikhashana (ukulahlekelwa okhiye bakho) kanye nezinkinga zokuxoshwa kwabantu abaningi ukukhathazeka ngabesifazane abathile (kanye namadoda) emva kwe-chemotherapy, futhi kuhlanganiswe "i- chemobrain ." Le ndawo iye yathola ukunakwa okuningi, kanti ezinye ze-oncologists zikholelwa ukuthi ukuzivocavoca kwengqondo, ngisho noma nje kwenza nje i-crossword puzzle, kungasiza.
- Ukungenzi lutho. Ukungabi nalutho emva kokulashwa komdlavuza kuvamile, futhi abesifazane abaningi bayeke ukuba nezikhathi zabo emva kwe-chemotherapy. Kwabesifazane abasha, izikhathi zingabuya ngemva kwesikhathi, kodwa lokhu akusiqinisekiso sokuzala. Uma ucabanga ukuthi ungathanda ukukhulelwa emva kokwelashwa okuphelele, khuluma ne-oncologist yakho ngaphambi kokuba uqale. Kunezinketho ezitholakalayo, njengama-embryo okuqandisa, okuvumela abanye besifazane ukuba babelethe ngisho nangemva kokwelapha umdlavuza webele.
Izinkinga ezinkulu kakhulu zihlanganisa:
- Isifo senhliziyo: Isifo senhliziyo singase senzeke ngisho nangamashumi eminyaka emva kokuthola i-chemotherapy. Isidakamizwa i- Adriamycin (doxorubicin) singabangela ukuhluleka kwenhliziyo kwabangu-1 kuya kwezingu-2 kwabesifazane abathola lesi sidakamizwa. Esinye isidakamizwa esingabangela izinkinga zenhliziyo yi-Herceptin (trastuzumab) futhi umsebenzi wakho wenhliziyo kufanele uqashwe ngokucophelela ngenkathi usithatha. Kungenzeka ube nokuhlolwa kwenhliziyo ngaphambi kokuqala i-chemotherapy ukuze uthole isisekelo sokuqhathanisa. Izimpawu zokuhluleka kwenhliziyo zihlanganisa ukuphefumula, ukukhuthazela okunciphise, ukuvuvukala kwemilenze yakho, futhi ngezinye izikhathi ukukhwehlela uphethiloli obomvu, obunamafutha.
- Amanqamu asemqoka afana ne-leukemia: Imithi ye-chemotherapy esetshenziselwa umdlavuza webele ibuye yaziwa ngamagciwane (ama-agent-causing agents). Ngenkathi kunengozi encane (1 ku-100) yokuthuthukisa umdlavuza wesibili (ngokuvamile u-tissue sarcoma noma i-acute myelogenous leukemia noma i-AML), izinzuzo ze-chemotherapy zivame kakhulu ngaphezu kwalezi zingozi.
Kukhona futhi okungajwayelekile, kodwa ngezikhathi ezithile imiphumela emibi ye-chemotherapy .
Izinkinga Ezivela Ezokwelapha ZamaHormonal
Bobabili i-tamoxifen (yabesifazane besandulela ngculaza) kanye ne-aromatase inhibitors (yabesifazane be-postmenopausal noma abesifazane besandulela ngculazi abaye baphelelwa ukwelashwa kwe-ovarian) kungabangela ukushisa okukhulu. Kukhona umehluko phakathi kwalaba ababili, kodwa-ke, njengoba i-tamoxifen inemiphumela efana ne-estrogen kwezinye izicubu kanye nemiphumela yokulwa ne-estrogen kwabanye.
Ama-aromatase inhibitors , ngokuphambene, anciphisa ukwakheka kwe-estrogen emzimbeni ngakho-ke izimpawu eziningi zingezokuntuleka kwe-estrogen. Imithi ebizwa ngokuthi i-aromatase inhibitors ihlanganisa i-Arimidex (i-anastrozole), i-Femara (i-letrozole), ne-Aromasin (i-exemestane).
Zombili izigaba zemithi zingabangela ukushisa okushisayo, ukomile kwesisu, nokungahambi kahle. I-Tamoxifen ingabangela ubuhlungu obukhulu be-muscle, kodwa i-aromatase inhibitors eyaziwa kakhulu ngokubangela ubuhlungu bomzimba nobuhlungu obuphakathi cishe nesigamu sabantu abasebenzisa le mithi. Ngakolunye uhlangothi, zombili izigaba zemithi ukunciphisa ingozi yokuphindaphinda umdlavuza webele. Futhi, uma lezo zitshalo ezishisayo zikushayela kancane, ungakhululeka ukwazi ukuthi kunezinsimbi zesiliva, futhi ukukhanya okushisayo kuhlobene namazinga aphakeme okusinda kubantu abasebenzisa ukwelashwa kwe-hormone.
Izinkinga ezivela ku-tamoxifen zingabandakanya:
- Umdlavuza wesibeletho: Ngokungafani nezicubu zesifuba, i-tamoxifen ingashukumisa uterine (izicubu ze-endometrial). Ngokusho kweMelika Cancer Society, ingozi yomdlavuza we-uterine iphansi, cishe u-1 ngo-500 ngemuva kweminyaka engama-50, futhi ingavame ukutholakala ezinkathini zokuqala uma kwenzeka. Uphawu oluvame kakhulu ukuphuma kwegazi.
- Ama-clots egazi: Kokubili ama-clots egazi emilenzeni (i-vein thrombosis ejulile) kanye ne-pulmonary emboli (ama-blood clots ahamba emaphashini) angajwayelekile.
- I-cataracts: Ngenhlanhla, i-cataracts kulula kakhulu ukuphatha ngokuhlinzwa.
Izinkinga ezivela ku-aromatase inhibitors zingabandakanya:
- I-osteopenia kanye nokwehla kwamathambo. I-Aromatase inhibitors ibangela ukulahleka kwethambo, futhi ngokuvamile iqhuma ngenxa yokulahlekelwa kwethambo emgodleni, emlonyeni, nakwezinye izindawo. Ukwengezwa kwamuva kwe-bisphosphonates (njenge-Zometa) yokwelashwa kwabanye besifazane kunganciphisa le ngozi esikhathini esizayo.
- Izinkinga zenhliziyo. Izinkinga zenhliziyo ezifana nezinkinga zenhliziyo, izinkinga ze-valve yenhliziyo, kanye ne-pericarditis zivame kakhulu kubantu besifazane kwi-aromatase inhibitors, kodwa ayikho ingozi ekhulayo yokubhekana nezinkinga ezinkulu futhi ezisongela ukuhlasela kwenhliziyo nokushaya.
Izinkinga Ezivela Emthonjeni Wezokwelapha
Ukwelashwa kwezidakamizwa kuvame ukusetshenziselwa ukulandela i-lumpectomy, noma kwabesifazane ababenomzimba wokushaya imithi nge-lymph nodes enhle. Imiphumela emibi evamile ihlanganisa ukubomvu kwesikhumba kanye nokuhlukunyezwa, kanye nokukhathala.
Izinkinga zemithi yokwelashwa zingabandakanya:
- Izifo: Ukubomvu ngisho nezibhansela kungaba nomphumela ovamile, kodwa izilonda ezivulekile zingandisa ingozi yokuthuthukisa isifo esibi kakhulu. Labo abanemishanguzo emva kokuhlinzwa okusheshayo ngokushesha kunengozi enkulu yokuthuthukisa isifo.
- I-Fibrosis: Ukwelashwa kwe-radiation kushintsha ukuthungwa kwesikhumba ukuze kungabi nezimo ezincane. Lokhu kungaholela ekuguqulweni kwezicubu zakho zesifuba (fibrosis), kanye nesivumelwano se-capsular uma uqale kabusha. I-radiation ingase ibangele ukuvuvukala emaphashini (i-radiation pneumonitis) engabangela i -fibrosis ye-pulmonary .
- Isifo senhliziyo: Ukwelashwa kwezidakamizwa kungalimaza inhliziyo, nakuba izidakamizwa zama-radiation zizama ukuvumelanisa imisebe oyothola ukuze unciphise ukuvezwa kwenhliziyo yakho. Inqubo entsha ebizwa ngokuthi ukuqhuma ukuphefumula kunganciphisa ukuvezwa kwenhliziyo emisebeni enkulu nakakhulu, ngokusebenzisa ukuphefumula okulawulwayo. Inhlanganisela yemiphumela ehlobene nenhliziyo yemisebe futhi lokho ngenxa ye-chemotherapy kufanele kucatshangelwe. Abanye oncologists bakholelwa ukuthi abesifazane abaye laba lezo zokwelashwa (ikakhulukazi ukuhlanganiswa chemotherapy ne-Adriamycin kanye nemisebe emva mastectomy) kufanele babonisane cardiologist, ikakhulukazi uma zikhula noma yiziphi izimpawu ezingase ziphakamise isifo senhliziyo.
Kukhona okungavamile kakhulu kodwa ngokuphathelene nemiphumela emibi yesikhathi eside yelashwa emisebeni , njengokwanda okwenziwe ngamaphasinapha emaphaphu kanye nesifo somzimba. Nakuba iningi lezinzuzo zokwelapha imishanguzo lidlula ingozi yalezi zinkinga, isifundo se-2017 sasikisela ukuthi kwabesifazane ababhemayo, izingozi zemisakazo ehlangene nokubhema zingaphezu kwezinzuzo. Labo ababhema kufanele bayeke ngaphambi kokwelashwa kwe-radiation, futhi uma kungenakwenzeka, kufanele bakhulume ngokucophelela nge-oncologist yabo ye-radiation mayelana nokuhlakanipha kokwenza imishanguzo.
Imiphumela Yengqondo Nezenhlalo Nezimo Ezibucayi
Ukuthola ukuthi unesifo somdlavuza webele isisindo esikhulu sengqondo. Ucwaningo lubonisa ukuthi akunandaba ukuthi une-tumor encane kakhulu ephilisa, noma i-tumor enkulu, ethuthukile yesiteji; ukuthola ukuxilongwa kwegama elithi "C" kushintsha impilo yakho ngemizuzwana.
Ubudlelwane buvame ukushintsha, futhi abangane abangaseduze bangase basondele, kanti abanye abangane bakho abaseduze bangase basuke. Wonke umuntu uphatha umdlavuza othandekayo ngendlela ehlukile.
Ngezinye izikhathi umdlavuza uholela ekucindezelekeni, futhi izinga lokuzibulala liphakeme kubantu abanomdlavuza kunabantu abaningi. Ukwengeza le mizwa ukukhathala komdlavuza , futhi ukubhekana nomdlavuza kuyinselele.
Sifunda ukuthi uhlelo oluqinile lokusekela umphakathi lubalulekile ngokwanele ukuthi luye lwaxhunyaniswa nokusinda komdlavuza wesifuba, futhi kufanele lubhekiswe ngokukhathazeka ngokomzimba okungenzeka ube nakho. Abantu abaningi bathola ukuthi ukukhuluma nodokotela kuyasiza ngesikhathi sokulungisa. Qinisekisa ukuthi ukhuluma nodokotela wakho uma unenkinga yokubhekana.
Ukunciphisa Ingozi Yakho Yezinkinga
Kubalulekile ukuqaphela ukuthi kunezinto eziningana ongazenza ukuze unciphise ingozi yakho yokuthuthukisa izinkinga ngesikhathi ukwelashwa umdlavuza webele esifushane.
Uma ubhema, shiya. Ukubhema kuphazamisa ukuphulukiswa kwesilonda futhi kwandisa ingozi yakho yokutheleleka (nakho konke okuhambisana nokutheleleka). Ibuye ithuthukise noma iyiphi ingozi yenhliziyo ngenxa yokwelapha.
Hlaziya ukuvimbela ukutheleleka ngesikhathi se-chemotherapy . Ngisho noma uthola imithi yokugcina igazi lakho elimhlophe liphakeme, qaphela ukugeza izandla zakho, ugweme izindawo ezigcwele, futhi uhlale kude nabantu abagulayo.
Hlala uqhathanisa nocwaningo lwamuva ngomdlavuza webele. Njengoba abantu abaningi besinda, sifunda kabanzi mayelana nezindaba zesikhathi eside ezihlobene nokwelashwa, kanye nendlela yokunciphisa ingozi.
Qaphela umzimba wakho nazo zonke izimpawu onayo. Izinkinga eziningi ezingase zibe khona zokwelapha umdlavuza webele ziyakwelashwa, kanti ukwelashwa kuvame ukusebenza kakhulu uma kuqalile ngokushesha kunokuba kamuva.
Ukuvuselelwa Kwemdlavuza
Njengoba sinabantu abaningi abasinda umdlavuza, sifunda ukuthi abaningi abasinda emdlalweni bahlangabezana nemiphumela yokuphulukiswa kwesikhathi. Eminyakeni yamuva, uhlelo luhlelwe ngokuthi "Uhlelo Lwezinkanyezi Zokuvuselela I-Cancer." Lolu hlelo selutholakala ezindaweni eziningi zomdlavuza. Yenzelwe ukunciphisa noma yimuphi umphumela wesikhathi eside womdlavuza, futhi ikusize ukubhekana nanoma yiziphi izimpawu zomzimba noma ezingokomzwelo ezikuvimbela empilweni yakho "evamile".
Izwi elivela
Uma ubheka uhlu lwezinkinga ezingase zibe khona zokwelashwa komdlavuza, ngaphezu kwemiphumela emibi ongayilindela, ingasabisa. Khumbula ukuthi lezi zinkinga azivamile, futhi kungenzeka kakhulu ukuthi uphumelele ukwelashwa kwakho ngaphandle kokuthola eziningi noma ezinye zazo. Okubalulekile, ngisho nalapho kunezingozi, yilokho ucwaningo luye lwabona ukuthi izinzuzo zalezokwelapha ekugcineni umdlavuza wakho kude kakhulu kunezingozi ezingase zibe khona.
> Imithombo:
> Society of American of Clinical Oncology. I-Cancer.Net. Izinketho zokwelapha umdlavuza webele. Kubuyekezwe 04/07. https://www.cancer.net/cancer-types/breast-cancer/treatment-options
> Hurria, A., Woza, S., noL. Pierce. Amaphethini Wokuphindaphindiwe Nezimo Zesikhathi Eside Zokwelapha Abasinda Ngomdlavuza Webele. UpToDate . Kubuyekezwe 08/15/17.
> Rakhra, S., uBethke, K., Strauss, J. et al. Izingozi Zengozi Eholela Ekucindezelweni Esikhathini Esisisuka Esikhathini I-Cancer Breast Elandela Ukwelashwa Kwebese-Conserving kanye ne-Intraoperative Radiotherapy. Ama-Annal of Oncology Yokuhlinza . 2017. 24 (5): 1258-1261.