Izimpawu, Ukuxilongwa, Ukwelashwa, Nokuguqulwa
Uma utshelwe ukuthi unomdlavuza wamaphaphu ophuthumayo, mhlawumbe uzizwa ukhululekile uma ungesabi kakhulu. Kusho ukuthini lokhu? Kuphathwa kanjani? Futhi ungathola kanjani usizo oludingayo?
Sibutsetelo
Kusho ukuthini uma odokotela bethi "umdlavuza wamaphaphu ophuthumayo?" Iningi lesikhathi lapho odokotela basebenzisa leli gama basho isigaba IIIB nomdlavuza wesigaba se-IV.
Nakuba umdlavuza wamaphaphu omncane ungathuthuka, isikhathi esiningi lapho ama-oncologists asebenzisa amagama athi "umdlavuza wamaphaphu", abhekisela kumdlavuza ongasona omncane wesifo samaphaphu , okuyinto enesibopho samaphesenti angama-85 emdlavuza wamaphaphu.
Isizathu sokuthi umdlavuza wamaphaphu uvame ukuhlukaniswa zibe yisigaba sokuqala futhi isigaba esithuthukile ukuthi baphathwa ngendlela ehlukile. Ngomdlavuza wamaphaphu okuqala, ukuhlinza kuvame ukuphakanyiswa njengendlela yokwelashwa kokuqala, kuyilapho ezinye izinketho zithandwa izifo ezisezingeni eliphezulu-okungenani ekuqaleni.
Izigaba
Njengoba kuphawuliwe ngenhla, inkulumo ethi "isiteji esithuthukisiwe" ivame ukusetshenziselwa ukuchaza isigaba IIIB noma isigaba se-IV esingeyona encane yomdlavuza wamaphaphu.
- Isigaba IIIB - I- Stage IIIB ingane-encane yamangqamuzana amaphaphu amaphaphu ayizinhlayiya kwanoma yisiphi isayizi esesakaze kuma-lymph nodes ngakolunye uhlangothi lwesifuba, eduze kwethambo lekholomu, noma ahlasela ezinye izakhiwo esifubeni njengenhliziyo noma isifo.
- Isigaba IV - I- Stage IV engeyona encane yamangqamuzana emaphaphu amaphaphu ayizinambuzane eziye zasakazeka esikhaleni phakathi kwezingxenye zokufaka emaphashini ( ukususwa kwamapulanka okulimazayo ) noma kwesinye isifunda somzimba. Umdlavuza womlenze uvame ukusabalalisa amathambo, isibindi, ubuchopho, noma izigulane eziyingozi.
Izimpawu
Izimpawu zomdlavuza wamaphaphu ophakeme kungenzeka zihlobene nokuba khona komdlavuza emaphashini, noma ngenxa yokuhlasela kwezinye izitho nokusabalalisa (imetastasis) kwezinye izifunda zomzimba. Izimpawu ezivamile zamapayipi ahlobene nazo zingahlanganisa ukukhwehlela okungapheli, ukuphefumula, ukukhwehlela igazi, nokushaya.
Amagciwane okugaya angase agxile emithanjeni esifubeni esibangela ukuphazamiseka.
Lapho umdlavuza wamaphaphu ukhula ukwanda noma usakazeka, izimpawu ezinjengokukhathala, ukulahlekelwa isisindo esingalindelekile, nokulahlekelwa kwesidlo kungenzeka. Umdlavuza we-Lung oye wasakazeka ebuchosheni ungabangela ukukhanda ikhanda, ubunzima bezinkulumo, ukulahlekelwa inkumbulo, nobuthakathaka. Umdlavuza we-Lung ohlakazeka esibindi ungabangela ubuhlungu besisu kanye ne-jaundice. Futhi umdlavuza wamaphaphu owendlala emathanjeni ungabangela ubuhlungu ngemuva, emahlombe nasesifuba.
Ukuxilongwa
Umdlavuza wamaphaphu ophakeme ungatholakala okokuqala ku-ray ray noma ku-CT, kepha ukuhlolwa okuqhubekayo nge-lung biopsy kuyadingeka ukuze kunqunywe ukuthi ukungajwayelekile kungumdlavuza yini, nokuthi luhlobo luni.
Ukuze uthole amakhemikhali amaphaphu amaphaphu angaphambilini, kubaluleke kakhulu ukuthi ukuprofetha kwezakhi zofuzo (okushicilelwa kwamangqamuzana) kwenziwa. Ngokwejwayelekile, izicubu ezivela kwi-biopsy ziyadingeka ukwenza lokhu kufakwa, ngo-2016 ukuhlolwa kwe-biopsy yamanzi kwamukelwe ukuhlolwa kwe-EGFR yokuguqulwa komzimba.
Izinhlobo
Umdlavuza wamaphaphu omncane ungase uthuthuke kodwa uhlanganiswe kwesigaba esithile. Amaphansela amaphaphu amaphaphu aphakeme angasetshenziswanga afaka:
- I-adenocarcinoma ye-Lung - Yikuphi okuphethwe cishe ingxenye yalezi zicubu. Lona uhlobo lomdlavuza ovame kakhulu kubantu besifazane, abangewona abokubhema, nabasemusha abanomdlavuza wamaphaphu.
- I-Squamous cell carcinoma yamapayipi - Okuyiwona obhekene namaphesenti angaba ngu-30 omdlavuza ongasona omncane wesifo samaphaphu.
- I-cell cell carcinoma - Umdlavuza omkhulu wamangqamuzana wamangqamuzana wenza cishe amaphesenti ayishumi ama-cancer angamancane amaphaphu amaphaphu .
- Okunye - Kungenzeka ukuthi uqaphele ukuthi izinombolo ezingenhla azifaki kufike ku-100. Lokhu kungenxa yokuthi ezinye izicubu zinemikhakha etholakala endaweni ethile endaweni emnyama phakathi kwezigaba ezingenhla, njengokubukeka "okungajwayelekile" noma izindawo ezihlukene i-tumor ingaba nokubonakala kwezinhlobo ezimbili noma ngaphezulu ezihlukene zesisu.
Ukwelapha
Kubalulekile ekuqaleni ukusho ukuthi ukwelashwa komdlavuza wamaphaphu ethuthukile kuyathuthuka .
Izinga lokusinda lomdlavuza wamaphaphu ethuthukile ziyathuthuka. Ngakho-ke, noma yiziphi izibalo ozifundile, noma noma yiluphi ulwazi lwezokwelapha ozifundile olungasesikhathini, lungadangalisa kakhulu. Kubalulekile ukuthi ufunde lokho ongakwenza mayelana nesifo sakho, kodwa uthathe isikhashana ufunde ukuthi ucwaninga kanjani umdlavuza wakho ku-intanethi . Isibonelo, kunezindlela ezintsha zokwelashwa ezivunyelwe umdlavuza wamapapu ophuthumayo phakathi kuka-2011 no-2015 kunezinsuku ezingamashumi amane ngaphambi kuka-2011. Kunethemba elikhulu.
Izinhlobo zokwelashwa
Iziguli ziyazibandakanya kakhulu ekunakekeleni kwabo ngomdlavuza wamaphaphu kunanini ngaphambili. Ngokungafani nobudlelwane besiguli-odokotela bokudlulela esikhathini esedlule, iziguli nodokotela basebenzisana ndawonye ukuklama uhlelo olungcono lokunakekelwa kungenzeka. Ingxenye yesizathu salokhu ukuthi kunezinketho eziningi kunanini ngaphambili, kanti ezinye izinqumo zingase zibhekise ngokwengeziwe ezintweni ozikhethayo-imiphumela emibi ozimisele kakhulu ukubekezelela-kunanoma yikuphi ukuphakama kwezokwelapha kokwelashwa okulodwa kwesinye.
Kuwusizo ukuqala ngokuphulukisa ukwelapha zibe izinhlobo ezimbili eziyisisekelo.
- Ukwelashwa kwendawo - Ukwelashwa kwendawo kulapha umdlavuza lapho-endaweni-futhi uhlanganisa ukwelashwa kwama-radiation nokuhlinzwa.
- Ukwelashwa okuyisimiso - Ukwelashwa okuhlelekile kuhloswe ukwelapha umdlavuza noma kuphi emzimbeni wakho. Lokhu kufaka phakathi i-chemotherapy, imithi ehlosiwe, kanye ne-immunotherapy.
Kusukela umdlavuza wamapapu ophuthumayo ngukuchazwa akusekho wendawo, ukwelapha okuhlelekile kuyindlela yokwelapha . Abanye abantu bayazibuza ukuthi kungani ukuhlinzeka kungavunyelwe isigaba IV nesigaba se-IIIB yomdlavuza wamaphaphu. Isizathu siwukuthi ukwelashwa nokwelashwa kwemisebe yodwa akukwazi ukuphatha umdlavuza osevele usakazekile. Lokhu akusho ukuthi awusoze wahlinzwa. Kukhona abantu abanezinqubo zokwelapha ezinciphisa isisu sabo esayizi lapho ukuhlinzwa kuzosebenza khona. Njengoba kunezinye izinhlobo zomdlavuza, ezifana nomdlavuza we-ovarian, "ukukhipha imfucumfucu" isisu-ukususa ezinye kodwa hhayi konke ngokuhlinzwa-kungasiza, kepha ngokuvamile akuyona into ngomdlavuza wamaphaphu. Eqinisweni, ukuhlinzwa kungagcizelela umzimba ngesikhathi esifanayo ukuthi udinga amandla akho ukuze ubekezelele ukwelashwa okuzosiza. Ngaphakathi kwezinqubo zokwelashwa ezihleliwe zihlanganisa:
Imithi ehlosiwe - Wonke umuntu onomdlavuza wesifo samapayipi angasemncane kufanele abuye abe nokuprofetha kwamangqamuzana ("ukuhlolwa kofuzo") okwenziwe esihlakalweni sakhe. Lokhu kuvame ukuqhutshwa kwisampuli ye-biopsy. Manje sekukhona okungavamile kwe-chromosomal kanye nezinguquko zegciwane kumaseli omdlavuza "okuhloswe", nokunye okutholakala ngaso sonke isikhathi. Ukungajwayelekile okubhekiswe kuzo kubhekisela ekungajwayelekile emangqamuzaneni omdlavuza noma okuhlobene namangqamuzana omdlavuza ongabhekiswa ngqo ngemithi. Uma une- EGFR ishintsho , i- ALK fusion yegeni , noma i- rearrangement ye-ROS1 , kunezindlela zokwelashwa ezihlosiwe ezitholakalayo-futhi le ndawo ingase yande ngokushesha eminyakeni elandelayo. Uma "ukufomula kwamangqamuzana" kungacacile, qiniseka ukukhuluma ne-oncologist yakho.
I-Chemotherapy - I- Chemotherapy iyinhloko "yomgogodla" womdlavuza ophuthumayo wamaphaphu , futhi ingangandisa impilo yabantu abaningi. Kunezinhlanganisela eziningi zezidakamizwa ezisetshenzisiwe, kodwa eziningi zazo zihlanganisa izidakamizwa ze "platinum" njengePlatinol (cisplatin).
I-Immunotherapy - Uma ubuke izindaba noma ufunda noma yikuphi omagazini okungenzeka uke wazizwa nge-immunotherapy. Ngokungafani nenye ye-hype esikhathini esidlule, i- immunotherapy iyindlela ejabulisayo kakhulu yokwelapha amagciwane aphezulu . Lezi zindlela zokwelashwa zingacatshangwa njengokuthi zihlolisise amasosha ethu omzimba ukubulala amangqamuzana omdlavuza ngezindlela ezahlukene. Imithi yokuqala yomdlavuza wamaphaphu kulesi sigaba ivunyiwe ngo-2015, kanti ezinye eziningana ziyahlolwa ezivivinyweni zomtholampilo.
Izivivinyo zemitholampilo - I-National Cancer Institute incoma ukuthi wonke umuntu onomdlavuza wamaphaphu aphezulu ahlole ukuhlolwa kwemitholampilo. Kuningi lwezinganekwane mayelana nokuhlolwa kwemitholampilo , kodwa kunanini ngaphambili ngaphambi kokuhlolwa kwamagciwane kunganikeza abantu ngomdlavuza wamaphaphu ithuba lokuthola ukwelapha okusha kwalesi sifo. Isibonelo, abantu ababambe iqhaza ekuvivinyweni komtholampilo we-immunotherapy izidakamizwa ezivunyelwe ngo-2015 benza kangcono kakhulu kunabo abangenalo ithuba. Khumbula ukuthi yonke imithi yokwelashwa yomdlavuza wamaphaphu ike yafundiswa njengengxenye yesilingo somtholampilo. Kukhona okwamanje izilingo ezingaphezu kuka-100 zokwelashwa eziqhubekayo zihlola izindlela ezintsha zomdlavuza wemaphaphu. Hlola lolu lwazi lokuthi ungathola kanjani izivivinyo zemitholampilo ngomdlavuza wamaphaphu, kanye nokuhlolwa kwemitholampilo yamahhala ehambisana nomsebenzi ohlinzekwa ngumzamo ohlangene phakathi kwezinhlangano eziningana zomdlavuza wamaphaphu.
Ukwelashwa kwamaMetastases
Esikhathini esedlule, ukwelashwa komdlavuza wamaphaphu nama-metastases kwakunjalo kubantu bonke. Lokho kushintsha kancane. Kubantu abathile abane- metastases yobuchopho kusuka kumdlavuza wamaphaphu noma ama- metastase wesibindi kusuka kumdlavuza wamaphaphu - uma kukhona "izilonda" ezimbalwa kuphela noma amabala okusabalalisa-okuthiwa "ama-oligometastases" -ukuhlukunyezwa nge- radiotherapy emzimbeni wesifo somzimba noma ukuhlinzwa kuye kwaholela ekusindeni okuqhubekayo .
Kubantu abanesifo samathambo emdlavuza wamaphaphu , izidakamizwa ezibizwa ngokuthi i-bisphosphonates kanye nokwelapha imisebe zingasiza ekulawuleni ubuhlungu, futhi kwezinye izikhathi, zingase zithuthukise ukusinda.
Isibikezelo
Kunzima ukukhuluma ngokuchazwa kwemdlavuza wamaphaphu ethuthukile ngoba sizobe sibheka ngezibalo ezahlanganiswa ngaphambi kokwelashwa okukhethiwe okwenziwe umdlavuza wamaphaphu ethuthukile. Izibalo zokugcina zabuthana zathola ukuthi ukusinda kweminyaka emihlanu yomdlavuza wamaphaphu ethuthukile kwakudabukisayo ngaphansi kwamaphesenti amahlanu. Lokho kusho ukuthi kunabantu abasinde isikhathi eside umdlavuza wamaphaphu, futhi lelo nani likhula.
Ukubhekana nokusekela
Lokho ozokufunda masinyane ngemuva kokuthola ukuthi unomdlavuza wamaphaphu ethuthukile ukuthi lowo mdlavuza wamaphaphu uthatha umphakathi nokuthi yisifo somndeni. Finyelela emndenini nabangani. Funda ukuba ummeli wakho siqu ekunakekeleni umdlavuza wakho . Cabanga ukufinyeleleka emphakathini womdlavuza wamapayipi we-inthanethi-umphakathi oye waba njengomndeni kubantu abaningi abanomdlavuza wamaphaphu.
Kwabathandekayo
Ukunakekela othandekayo ngomdlavuza wamaphaphu kuyoba yinto enzima kunazo zonke owake wakwenza, kodwa okuzuzisa kakhulu nokuphila kuzuza kanye. Qiniseka ukuthi uthatha isikhashana futhi ufunde lesi sihloko lapho umthande wakho enomdlavuza wamaphaphu .
> Imithombo:
> National Cancer Institute. Ukwelashwa Kwemdlavuza Yengculazi Engenayo Amancane - I-Health Professional Version (PDQ). Kubuyekezwe 01/20/17. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq