Uma uzwile ukuthi umdlavuza wakho noma owomthandayo "ungenakuphulukiswa" lokho kusho ukuthini lokho? Ziyini izizathu zokuthi umdlavuza, ikakhulukazi omncane, ungasenakuphikiswa? Ingabe ukuhlinzwa kungakwenzeka kamuva uma umdlavuza ungaqaleki? Lezi zidakamizwa ziphathwa kanjani?
Incazelo
Umdlavuza ongaphenduliwe uchazwa njengento engakwazi ukususwa ngokuphelele ngokuhlinzwa.
Njengoba ukuhlinzwa kuvame ukunikeza ithuba elihle lokuthola ukwelashwa ngezicubu eziqinile, lokhu kungadumaza izindaba ukuzwa.
Kodwa ngenxa nje yokuthi isisu singasebenzi kahle akusho ukuthi akuphefumuli Kubalulekile ukuqaphela ukuthi ngokuthuthukiswa kocwaningo lomdlavuza, akuzona zonke izicubu ezingaqaleki ezingenakuphelelwa amandla zizohlala zingasebenzi ngokuphakade. Lokhu kuxoxwa ngokuqhubekayo okujulile ngezansi.
Izizathu Isimungulu Kungase Sibe Singenakugwenyelwa
I-tumor ingahle ingabi nakanjani ngenxa yezizathu eziningana. Ezinye zazo zihlanganisa:
- Ubukhulu besisu: Isifo singase sibe sikhulu kakhulu ukuze sisuse ngokuphepha, noma singadinga ukukhipha isakhi esiningi esibalulekile sokuhlinzwa ukuze senzeke.
- Indawo ye-tumor: I-tumor ingaxhunyaniswa nemithambo yegazi nezinye izakhi ezibalulekile emzimbeni okwenza ukususwa okuphephile kungenzeki.
- Ukusakazeka kwesimila ezindaweni ezikude (imithinja): Njengoba umdlavuza we-metastatic (umdlavuza wesigaba 4) usakazeke ezindaweni ezingaphezu kwesikhumba, ukususwa kwesisu ngeke kulawulwe wonke umdlavuza. Ukwelapha kanye nokwelapha imishanguzo kubhekwa njengokwelashwa kwendawo, baphatha indawo kuphela lapho kutholakala khona isisu nesamba esincane esiseduze. Ngokuphambene, i-chemotherapy, ukwelashwa kwama-hormonal, ukwelashwa okuhlosiwe, kanye nokwelashwa okuyi-immunotherapy kuyi-systemic zokwelapha-bayelapha amangqamuzana omdlavuza atholakala noma kuphi emzimbeni (okuhlukile ukuthi ezinye i-chemotherapy nezinye izidakamizwa azikwazi kalula ukudlula ukwelashwa kwegazi-ubuchopho ukwenza ukwelashwa of metastases ubuchopho kunzima.)
- Ezinye izimo zezempilo ezingabangela ingozi yokuhlinzwa: Efana nesifo senhliziyo, isifo samaphaphu, noma isifo sikashukela esinamandla esiyophakamisa ingozi yokuhlinzwa emazingeni angamukelekile.
Ukwelapha
Kubalulekile ukukhumbula ukuthi ngenxa nje yokuthi isisu singenakuphelelwa yisikhathi asisho ukuthi asiphefumuli. Imithi yokwelapha-izindlela zokwelapha umzimba wonke kunokuba nje isayithi lomdlavuza-zingase zandisa impilo futhi zithuthukise izimpawu zabantu abaningi abaphila nomdlavuza.
Nakuba sivame ukuhlobanisa ukuhlinzekwa ngekhono "lokuphulukisa" umdlavuza , ezinye zezokwelapha ezintsha ezintsha zinganikeza ithuba lokuphila isikhathi eside. Izibonelo zalokhu ngomdlavuza wamaphaphu zihlanganisa ubuchwepheshe obusha bokushisa imithi , imithi ye-immunotherapy , kanye nemithi ehlosiwe ngokukhetha ukushintshela kwelinye ukwelashwa okuhlosiwe lapho isisu sinamandla. Eqinisweni, izinga lokusinda lamansela amaningi asezingeni eliphezulu liyakuthuthuka ngenxa yalezi zinketho.
Ukungahambisani noMthetho
Ngenkathi kwakucatshangwa ngesikhathi esisodwa ukuthi ukungathembeki kwakusho ukungaqiniseki okungapheli, lo mqondo uyashintsha. Ukubuyekezwa kwezincwadi kuze kube yimanje kubonisa izibonelo eziningi zezifo ezinamandla ezifana nomdlavuza ongasona omncane wesifo samaphaphu, umdlavuza we-colorectal nesifo se-metastases yesibindi, umdlavuza wesibeletho, umdlavuza we-exocrine pancreatic, i-melanoma ephakeme, nokuningi, lapho ukwelashwa okunamandla nge-chemotherapy kanye nama-ray ukwelapha (okuthiwa i-neoadjuvant therapy noma ukunciphisa) kuncishise ubukhulu besisu kuya endaweni lapho ukuhlinzeka kwakwenzeka khona; izicubu ezazingenakuphulukiswa ekuqaleni zaqala ukuguqulwa.
I-Concept ye-Oligometastases
Omunye umqondo omusha noqabulayo kulowo owayengumdlavuza ongenakukugwema umqondo we-oligometastases. Igama elithi oligo lisho ambalwa, futhi lokho okuchazayo yisifo esiqinile esinezici ezimbalwa noma ezimbalwa eziye zahlelwa kabusha.
Ngokuchaza umdlavuza we-metastatic noma isigaba somdlavuza wesi-4 kungabhekwa njengengasebenzi; ukuhlinzeka ngeke kukwazi ukuphatha zonke izicubu. Umcabango wukuthi ukuhlinzeka kwakuyoba ukungahambi kahle nokungena engozini uma kungenakwenzeka ngempela ukwenza umehluko phakathi nenkinga. (Qaphela, kukhona okunye okuhlukile kule mithetho, isibonelo kumdlavuza we-ovarian ukuhlinzwa okuyingxenye (i-cytoreduction) noma " ukuhlinzeka nge-debulking " kungase kubhekwe njengokukhulisa ukuphila.)
Isibonelo sokwelashwa esebenzisa le ndlela kwakuzokwelapha lokho okwake kwacatshangwa ukuthi kungenakwenzeka komdlavuza wesifo samangqamuzana omncane wesiguli emgulini womdlavuza wamaphaphu kanye nomunye noma amaminithi ayisithupha echopho.
Kube sekukhona abantu abaye bahlinzwa kokubili umdlavuza wabo wamaphaphu futhi basuse eyodwa noma ambalwa metastase ubuchopho abaye bathola isikhathi eside isikhathi eside.
Ngaphansi
Uma usuzwile ukuthi isisu sakho singenakuphulukiswa, mhlawumbe uzizwa udangele, kodwa khumbula ukuthi i-cancers engenakuphuza isaphila. Nakuba kungavamile ukuphulukiswa (ngezinye izindlela,) ukwelashwa okunjengokhemotherapy, ukwelashwa okuhlosiwe, ukwelashwa kwe-hormonal, kanye ne-immunotherapy kungase kwandise impilo, kuncishiswe izimpawu, futhi kubantu abathile, kubangele ukulawulwa isikhathi eside kwesifo sabo (okubizwa ngokuthi impendulo ehlala njalo yi-oncologists.)
Kutholakala ukuthi unomdlavuza ongenakuphelelwa yisikhathi akusho ukuthi umdlavuza awusoze usebenze. Ezinye zegciwane ziyasabela ezinokwelapha ezifana ne-chemotherapy kanye ne-radiation therapy futhi zinciphisa ngosayizi ukuze kutholakale ukuhlinzwa kamuva.
Futhi eyaziwa ngokuthi: ayikwazi ukusebenza
Izibonelo: Ngenxa yesikhumba sikaJohn - esiseduze nenhliziyo yakhe - udokotela wamtshela ukuthi isisu sakhe sasingenakulungiswa, futhi ukuhlanganisa i-chemotherapy kanye nomswakama kungaba yindlela engcono kakhulu yomdlavuza wakhe.
> Imithombo:
> Fabre, E. et al. Ukuziphendukela kwemvelo kwamakhemikhali ekwelashwa komdlavuza ongasona omncane wamaphaphu eminyakeni engamashumi amathathu edlule: Ukuhlolwa kokuhlolwa. I-Cancer Thoracic . 2015. 6 (6): 731-40.
> Imai, K. et al. I-nomogram yokubikezela ukubikezelwa kweziguli ezinama-metastase wesibindi esingenakubalwa okungekho emthethweni. I-British Journal Yokuhlinzwa . 2016 Jan 18. (Epub ngaphambi kokuphrinta).
> Kato, A. et al. Ukunciphisa I-Chemotherapy Ekuqaleni I-Cancer Engaphinde Yenzeke Ngokwemvelo I-Biliary Tract Cancer Iziguli Eziphathwa Ngama-Gemcitabine Plus I-Cisplatin Inhlanganisela Ukwelashwa Okulandelwa Ukuhlinzwa Okukhulu. Ama-Annal of Oncology Yokuhlinza . 2015. I-Suppl 3: 1093-9.
> Nitsche, U. et al. Ukubukeka Ngemva kwe-First Line Line FOLFIRINOX Ekuqaleni I-Cancellate Advanced Pancreatic Yendawo Engenakuqondakala: I-Experience-Centre Experience. Ama-Annal of Oncology Yokuhlinza . 2015. I-Suppl 3: 1212-20.
> Yang, C. et al. Iziphumo Zesikhathi Eside Ze-Lobectomy ye-Can-Small Cell Lung Cancer Ngemuva kokunakekelwa kwama-Radiation Treatment. Ama-Annal of Surgery Thoracic . 2015. 99 (6): 1914-20.