Ukuvikela Inhliziyo Yakho Kusuka Kwemisebe Yomdlavuza Ngomdlavuza Webele Wase-Left
Ukwelashwa kwezidakamizwa kungathuthukisa izinga lokusinda kwabanye abantu abanekhansisi yesifuba kodwa kungase kube yingozi yokulimaza inhliziyo yakho uma unomdlavuza webele wesisu. Ukwelashwa kwezidakamizwa enhliziyweni yakho kungase kube nokwanda komonakalo obangelwa ezinye izindlela zokwelashwa ezifana ne-chemotherapy kanye nemithi ehlosiwe. Funda indlela indlela yokuphefumula yokuphefumula nokuphefumula okubambelayo kunganciphisa kakhulu inani lemisebe elithinta inhliziyo yakho, futhi ngokwenza kanjalo unciphise ingozi yesifo senhliziyo.
Ukwelashwa kwezidakamizwa zeCanscer Breast
Abesifazane abaningi baphelelwa ukwelashwa kwemishanguzo yesifo somdlavuza webele , kanti okwamanje, cishe amaphesenti angu-50 abantu abanomdlavuza wesifuba wezinsana zokuqala banamaphilisi. Ukwelashwa kwezibeletho esifubeni kungasetshenziswa ukunciphisa ingozi yokuphindaphinda kwesikhumba ngemuva kwe-lumpectomy. Futhi kunciphisa izinga lokufa komdlavuza webele ngomunye wesithupha.
Imishanguzo ingase isetshenziswe ngemuva kwesifo se-mastectomy, ikakhulukazi kwabesifazane abanama-lymph nodes okwenzelwe lesi sifo. Wonke ama-rayotherapy webele anikezwa ngama-programmende ahlukene kuncike esikhungweni somdlavuza kodwa ngokuvamile uqhubeka nsuku zonke phakathi nesonto amasonto amahlanu kuya kwayisithupha. Izindlela ezintsha zomsakazo nazo zinikeza amazinga aphezulu emisebeni yokuhambela ngezivakashi ezimbalwa ezindaweni ezithile.
Ukwelashwa Kwemithi Nezifo Zenhliziyo
Njengoba izinga lokusinda lomdlavuza wesifuba liphuthumayo ngenxa yokuhlanganiswa okungcono kwamakhemikhali, i-hormone yokwelashwa eqhubekayo iminyaka emihlanu kuya kweyishumi, kanye nemithi yokwelashwa ye-HER2 isifo esihle, ingozi yokuphila isikhathi eside nomdlavuza idinga ukubhekwa.
Esikhathini esedlule, sasingakhathazeki ngemiphumela emibi yesikhathi eside sokwelashwa kwemisebe njengoba nathi namhlanje. Abantu abaningi bangalindelwa ukuba baphile iminyaka eminengi emva kwalokhu ukwelashwa okubangela ukuba sibukeze kakhulu izinkinga ezingase zenzeke emgwaqeni.
Ukwelashwa kwezidakamizwa kuye kwacatshangelwa ezinhlobonhlobo ezahlukene zesifo senhliziyo.
Lokhu kufaka:
- Isifo se-artery Coronary
- Ukwehluleka kwenhliziyo / ukukhululeka kwenhliziyo, ukwehlisa isisu senhliziyo okunciphisa ikhono lenhliziyo ukupompa igazi kuwo wonke umzimba
- Izifo ezihilela amagagasi enhliziyo (isifo senhliziyo senhliziyo)
- Izimo zenhliziyo ezingavamile (arrhythmias)
- Izimo eziphambili: Ukulimala emgodini wenhliziyo (i-pericardium) kungaholela ekwakheni kwamanzi aphakathi kweziqephu zomzimba ezibizwa ngokuthi i- pericardial effusion . I-effusion ye-pericardial yenza kube nzima nakakhulu ukuba imisipha yenhliziyo iqhume futhi ngezinye izikhathi ibe yiphuthumayo yezokwelapha.
- Ukufa kwe-cardiac okungazelelwe
Ucwaningo luye lwathola ukuthi ukunciphisa inani lemisebe elifinyelela enhliziyweni ngesikhathi ukwelashwa kubonakala kunciphisa ubungozi besifo senhliziyo (umonakalo wenhliziyo), kodwa kubaluleke kangakanani lokhu?
Ukubuyekezwa okukhulu kwe-2017 kubheka ingozi yokufa kwenhliziyo kwabesifazane abatholakala benomdlavuza webele phakathi kuka-2010 no-2015. Kusukela kule datha kanye nezinye izifundo, abacwaningi bazama ukulinganisa umthelela wezokwelapha emisebeni yesikhumba senhliziyo esizayo bese uqhathanisa nalokhu izinzuzo zemisebe ekunciphiseni ukufa okuhlobene nokushaywa umdlavuza.
Kutholakale ukuthi izinzuzo zokwelapha imishanguzo emdlalweni wesifo somdlavuza webele ziningi kakhulu ingozi yesifo senhliziyo ehlobene nomswakama.
Kwakukhona okunye okuhlukile, kodwa kubantu ababhemayo ingozi yezinhliziyo zenhliziyo ezihlobene nemisakazo bangaphezu kwezinzuzo zayo zomdlavuza. Konke, ukwelashwa kwama-radiation kwakucatshangelwa ukwandisa ingozi yesifo senhliziyo ngamaphesenti angaba ngu-30.
Ukuphoqa Ukuphefumula: Ingabe Kusebenza?
Ukuphefumula ukuphefumula kuyindlela yokushintsha ukuma kwesifuba ukuze unciphise ukuvezwa kwenhliziyo emisebeni. Ukuphefumula nokuphefumula kuthinta ukwelashwa kwemisebe kuyindlela lapho umuntu ethatha khona umoya omkhulu futhi uyayigcina ngenkathi ibhande lomlilo liqondiswa esifubeni. Lokhu kubamba kwebele kuyadingeka kumasekhondi angaba ngu-20 ukuya kwangu-30, kuphindwe izikhathi eziningana ngesikhathi sokuvakashelwa kwemishanguzo ngayinye.
Ngokwesifundo se-2016, ukukhwabanisa okujulile ukuphefumula kwanciphisa inani lemisebe inhliziyo eyamukelwa (insipho yenhliziyo enamandla) ngamaphesenti angaba ngu-50 kuya kwangu-60 ngokuphathelene nenhliziyo ye-radiation kubantu abaphefumula ngokujwayelekile futhi ngokuzenzekelayo phakathi neseshini. Abanye abantu bakwazi ukulawula ukuphefumula kwabo ngokwanele kangangokuthi bekuncane kakhulu ukuba imisebe engeke ifike enhliziyweni yabo. Kunezinhlobonhlobo eziningana zale nqubo kuhlanganise Ukusebenza Okune-Breathing Control noma uhlelo lwe-ABC.
Ezinye izindlela ziye zazama ukunciphisa umthamo wemisebe enikezwe enhliziyweni, kodwa ngokuvamile kuvumela inani elingaphansi (elingaphansi lokuvikelwa) lemisebe elinikezwa emthonjeni wesifuba nesifuba. Ngokuphefumula nokuphefumula, ama-oncologists emisebe yelanga ayakwazi ukunciphisa umthelela enhliziyweni ngaphandle kokunciphisa umthamo wemisebe.
Yini Ongayilindela Phakathi Nezokwelapha Zakho?
Isinyathelo sokuqala ekuphefumuleni ukuphefumula kuyoba ukuhlela ukwelapha kwakho nge-oncologist yakho yokushisa imisebe ukuthola ukuthi imilaphi izonikezwa nini nokuthi yimuphi umthamo (obizwa ngokuthi i-dosimetric plan). Phakathi nalesi sigaba sokuhlela, i-oncologist yakho yokushisa imisebe izokwenza izilinganiso futhi ihlole ikhono lokubamba ukuphefumula ukunciphisa inani lemisebe enikezwe enhliziyweni yakho.
Le nqubo ibekezelela kahle futhi cishe amaphesenti angu-80 abantu bayakwazi ukulawula ukuphefumula nokubamba umoya wabo isikhathi esidingekayo. Abanye abantu baye bafanisa ukugeza ibhande ehlathini ngaphansi kwamanzi njengoba benza ukuphefumula. Ngesikhathi seseshini yakho, uhlelo lokuphendula njenge-biofeedback elibukwayo oluvame ukubukwa luvame ukusethwa ukuze likutshele ukuthi kufanele uphefumule ngendlela evamile nokuthi nini ukuphefumula.
Ukulinganiselwa kwe-Respiratory Gating ne-Breath Hold
Njengoba kuphawuliwe ekuqaleni, ukugcoba ukuphefumula kuvame ukubekezelela kahle futhi abantu abaningi bayakwazi ukubamba umoya isikhathi eside. Kodwa kukhona ukulinganiselwa, noma kunjalo, futhi kutholakala ukuthi abanye abantu (abangaphansi kwamaphesenti angu-20) bakuthola kunzima ukugcina izinga labo lokuphefumlelwa ngaphakathi kwezinga elikhethiwe.
Okunye Ukwelashwa Kwemdlavuza Okuhlobene Nezifo Zenhliziyo
Ukwelashwa kwezidakamizwa ngomdlavuza webele wesinxele kungakwandisa ingozi yesifo senhliziyo, kodwa ezinye izindlela zokwelapha umdlavuza wesikhumba zinganezela kule ngozi.
Imithi ye-Chemotherapy yomdlavuza wesifuba ingandisa ingozi yesifo senhliziyo, ikakhulukazi isifo senhliziyo nokuhluleka kwenhliziyo, kanti i-oncologist yakho kungenzeka ukuthi yenza ukuhlolwa kwenhliziyo (njenge-scan ye-MUGA) ngaphambi kokuqala i-chemotherapy. I-Adriamycin (i-doxorubicin) iyingozi eyaziwayo yokuhluleka kwenhliziyo futhi isetshenziselwa imikhakha eminingi ye-chemotherapy emdlalweni webele wesifuba. I-Cytoxan (i-cyclophosphamide) ingaba nemiphumela emibi ehlobene nenhliziyo.
Kwabesifazane abane- HER2 imithi ehloselwe umdlavuza webele we-HER2 efana ne-Herceptin (trastuzumab) kanye nezidakamizwa ezihlobene zingasetshenziswa. Amaphesenti angaba ngu-5 abantu abaphathwa nge-HER2-targetedrapies bazobhekana nokuhluleka kwenhliziyo ethile. Kungenzeka ukuthi kwenzeke uma kuhlangene no-Adriamycin futhi kungenzeka ukuthi kunezela engozini yomzimba eyenziwa yi-radiation therapy. I-cardiotoxicity ekhulu kakhulu ihamba kancane futhi isukela kuma-0.6 kuya kwangu-4 amaphesenti.
Kulabo besifazane abane-tumor e-receptor-positive, ukwelashwa kwama-hormone ngomdlavuza wesifuba kungabangela ingozi yesifo senhliziyo. Imithi eyaziwa ngokuthi i-aromatase inhibitors, kuhlanganise ne-Aromasin (i-exemestane), i-Arimidex (i-anastrozole) ne-Femara (i-letrozole), ivame ukusetshenziswa kwabesifazane abanomdlavuza webele we-postmenopausal ngokulandela imithi yamakhemikhali kanye nabesifazane abanomdlavuza webele we-premenopausal abaye bathola ukwelashwa kwe-ovarian.
Ukwelashwa komdlavuza webele akubonakali ukwandisa ingozi yesifo senhliziyo, kepha ubuhlungu noma ubuhlungu obuhlobene nokuhlinzwa kunganciphisa ikhono lakho lokubona izimpawu zesifo senhliziyo.
Ukukhuluma noDokotela wakho Ngezici Zakho Zengozi Yezifo Zenhliziyo
Ngenkathi usuqala ukwelashwa umdlavuza webele, ingqondo yakho cishe igxile kumdlavuza webele kuphela. Kodwa isifo senhliziyo yisisusa esiholela ekufeni kwabesifazane, kanti nesifo senhliziyo, isifo somzimba se-coronary is ajwayelekile kakhulu.
Kubalulekile ukukhuluma nodokotela wakho mayelana nengozi yesifo senhliziyo ehlobene nemithi yokwelashwa kwebele. Ukwengeza ukwelapha umdlavuza webele, ezinye izifo ezingezinhle zesifo senhliziyo kwabesifazane zingabandakanya:
- Umlando womuntu siqu noma womndeni wesifo senhliziyo
- Ukubhema
- Umfutho wegazi ophezulu
- I-cholesterol ephakeme (noma i-HDL ephansi)
- Ukuqapha ngokweqile noma okugqamile
- Isifo sikashukela noma isifo se-metabolic syndrome
Udokotela wakho angase afise ukwenza ukuhlolwa kwegazi okuthiwa i -protein-C esebenzayo (CRP) . Kuye ngomlando wakho, izici eziyingozi, kanye nemithi yokwelashwa, ukuhlolwa okuqhubekayo kunganconywa.
Yazi Izimpawu Zesixwayiso Sezinkinga Zezinhliziyo-Zihlukile Kwabesifazane!
Eminyakeni yamuva, sifundile ukuthi izimpawu zomzimba kwabesifazane ngokuvamile ziyahlukahluka kubantu abesilisa. Lokhu kuyiqiniso ukuhluleka kwenhliziyo kanye nesifo se-artery coronary futhi kucatshangwa ukuthi yisinye sezizathu zokuthi isifo somugqa we-coronary singaba nzima nakakhulu kubantu besifazane. Abesifazane abanesifo senhliziyo banesifo esibhedlela isikhathi eside futhi basengozini yokufa ngaphambi kokuphuma esibhedlela. Kubalulekile ukuqonda izizathu ezikhona zalokhu.
Ukuhluleka kwenhliziyo okuhlobene nokudla komzimba emadodeni kuvame ukuhlanganisa ukuphefumula okuqhubekayo nokukhwehlela ukukhuphuka okuvela emaphashini. Izimpawu zokuhluleka kwenhliziyo kwabesifazane
kungaba okungcolile kakhulu. Izimpawu zingase zihlanganise ukukhathala, ukuphefumula okungase kuchazwe njengokungabekezelelani ngokweqile, nokuvuvukala kwezinyawo nezinyawo.
Kuyafana nokuhlaselwa kwe-angina kanye nenhliziyo. Amadoda athambekele ekutholeni izimpawu zakudala zokuchoboza ubuhlungu besifuba njengendlovu ehlezi esifubeni. U-Angina kwabesifazane ngokuvamile uhlanganisa izimpawu zokufelwa yisisulu nokuhlanza, ukugodla, ukuphefumula, noma ukukhathala okukhulu nokujulile. Ngenkathi abanye besifazane beba nezimpawu "ezivamile" zesifo senhliziyo, izimpawu zesifo senhliziyo kwabesifazane zivame ukuhluka kwala madoda. Abesifazane bangase babe nokushisa okushisayo nokushisayo esifubeni sabo, noma ngisho nesithandwa sokuthinta. Izimpawu ezincane zivame ukuvela amasonto amathathu kuya kwamane ngaphambi kokuhlaselwa kwenhliziyo ekubuyiseleni. Abesifazane bangenaso ubuhlungu besifuba nhlobo uma benesifo senhliziyo! Njengoba ukuhlaselwa kwenhliziyo ekhaya kuvame kakhulu kwabesifazane, ingozi yokufa okungazelelwe iphakeme nakakhulu.
"Ukuthula" ukuhlaselwa kwenhliziyo kuchazwa ngokuthi yilokho okutholakala ekuhlolweni (njenge-electrocardiogram) kodwa kwenzeka ngaphandle kwempawu. Lezi zenzakalo ezithulile zivame kakhulu kubantu besifazane.
Ukuncintisana nezindaba, kokubili abesifazane abanomdlavuza webele kanye nodokotela bazo kungenzeka bacabange ukuthi kungenzeka ukuthi umdlavuza webele unesifo esingakanani kunokuba kungenzeka ukuthi lezi zimpawu zingabonisa isifo senhliziyo. Eziningi zalezi zimpawu kuqala zibangelwa umdlavuza futhi kamuva zitholakala ukuthi zihlobene nesifo senhliziyo.
Ngaphansi Kokuthinteka Ukuphefumula Ukunciphisa Izifo Zenhliziyo Kusuka Kwemithi Yokwelashwa
Ngemva kokufunda ngesifo senhliziyo kwabesifazane, kanye nezinye izifo zokwelapha ezingase zibe yingozi, kulula ukuqonda ukuthi kungani ukunciphisa ukutholakala kwenhliziyo yakho ngesikhathi sokuthola imishanguzo yomdlavuza webele wesokunxele kungase kubalulekile.
Ukugaya ukuphefumula kunganciphisa inani lemisebe enikezwa enhliziyweni kodwa amaphesenti angu-50 kuya ku-60, futhi ngezinye izikhathi kuphelelise lokhu kuvezwa ngokuphelele. Esikhathini esiningi lezi zindlela zokuphefumula zibekezelelwe kahle futhi zingakunika "okuthile okumele ukwenze" ngesikhathi sakho sokushisa imisebe.
Akuzona zonke izikhungo ze-oncology ezihlinzekwa ngama-radiation ezinikeza le nqubo, kodwa iyaba yinto evamile kakhulu ezweni lonke. Njengoba inikezwe inani lemiphumela emibi ehlobene nokuphathwa, kubuye kuqabula ukuba nenqubo engenayo ingozi enkulu.
Okokugcina, nakuba umdlavuza webele usengaphambili emqondweni wakho, yisifo senhliziyo esabulala abesifazane abaningi, kuhlanganise nabesifazane abaningi abaphathwa nge-cancer yomabele. Khuluma nodokotela wakho mayelana nezinkinga zakho kanye nokunye ukuhlolwa okungase kunconywe. Futhi qinisekisa ukuthi ujwayele izimpawu ze-"atypical" zesifo senhliziyo ezijwayelekile kubantu besifazane. Abesifazane bangase bahlupheke ngokungazelelwe, bachithe isikhathi esiningi esibhedlela, bafe ngaphambi kokuba basuke esibhedlela kunabantu abanesifo senhliziyo, isizathu esisodwa sokuthi akuyona ephezulu kwesikrini se-radar sabesifazane noma odokotela babo.
> Imithombo:
> Boda-Heggermann, J., Knopf, A., Simeonova-Chergou, A. et al. I-Deep Inspiration Breath Hold-Based Based Radiation Therapy: Ukubukezwa Kwemitholampilo. I-International Journal ye-Radiation Oncology, i-Biology, ne-Physics . 2016. 94 (3): 478-92.
> Schonecker, S., Walter, F., Freislederer, P. et al. Ukuhlela Ukwelashwa Nokuhlolwa Kwe-Gated Radiotherapy Ngabalandeli Ababelethwe Ngomdlavuza Wase-Left-Side Abasebenzisa uhlelo lwe-Catalyst / Sentinel lwe-Deep Inspiration Breath-Hold (DIBH). I-Radiation Oncology . 2016. 11: 143.
> Taylor, C., Correa, C., Duane, F. et al. Ukulinganisa Izingozi Ze-Cancer Breast Radiotherapy: Ubufakazi Bokuvela KweMisebe Yanamuhla Ukuya Emapulazini Nenhliziyo futhi Kusuka Kwangaphambili KwamaHlingozi. I-Journal ye-Clinical Oncology . 2017. 35 (15): 1641-1649.