Izimpawu, Ukubaluleka, Nokuphathwa Kwe-Cancer Cachexia
I-cachexia iyinkimbinkimbi evamile yomdlavuza (nezinye izimo zezokwelapha ezifana ne-HIV / AIDS) ezithathwa njengesibopho samaphesenti angu-20 okufa komdlavuza e-United States . Lokho kusho ukuthi akutholakali ukutholakala kuze kube yilapho sekukhona isikhathi eside. Yini ngempela i-cachexia, yiziphi izimpawu nezimpawu, kubangelwa yini, futhi iphathwa kanjani?
Sibutsetelo
I-cachexia iyisifo esibhekene nezimpawu zokulahlekelwa kwesisindo esingenhloso, ukulahleka kwemisipha okuqhubekayo nokulahlekelwa ukudla. Ngethuba okungenani amaphesenti angu-50 abantu abanomdlavuza ophakeme, kulinganiselwa ukuthi kunomthelela ngqo kumaphesenti angu-20 okufa komdlavuza .
Ngisho noma izimpawu nezibonakaliso ze-cachexia zivame ukuphawula ngemva kwesikhathi somdlavuza, sifunda ukuthi inqubo eholela ekubhujisweni kwemisipha iqala ngokushesha kakhulu ngemuva kokuthola ukuthi unomdlavuza. Kule ndlela, i-cachexia ivame ukuvela ngaphambi kokulahlekelwa yisisindo.
I-cachexia ngezinye izikhathi ibizwa ngokuthi i- paraneoplastic syndrome , okusho nje ukuthi izimpawu ezibangelwa izinto ezenziwe umdlavuza noma ukusabela komzimba kumdlavuza. Kungase kubonakale sengathi i-cachexia kufanele ilashwe kalula uma kuqala, kodwa ukwelashwa okuphumelelayo kuyasweleka. Lokhu kungenxa yokuthi i-cachexia ingaphezu nje kokuntuleka kwamakholori emzimbeni.
Ukusebenzisana Ne-Cancer
I-cachexia ibonakala kaningi ngomdlavuza kodwa ibonakala nangezifo ezifana ne-AIDS / i-HIV, ukwehluleka kwenhliziyo , ukuphazamiseka kwe-emphysema nokuhluleka kwezinso. Ngokuphathelene nomdlavuza, kubonakala kaningi ngomdlavuza wamaphaphu , umdlavuza we-pancreatic , nomdlavuza wesisu.
I-cachexia ayidabuli kuphela ukusinda kwabantu abanomdlavuza, kodwa iphazamisa izinga lokuphila.
Abantu abane-cachexia abakwazi ukubekezelela imithi yokwelapha, njenge- chemotherapy , futhi kaningi babe nemiphumela emibi kakhulu. Kulabo abahlinzwa , izinkinga zokuhamba emva kwesikhathi zivame kakhulu. I-cachexia ibuye igweme ukukhathala komdlavuza , esinye sezibonakaliso ezidabukisayo kakhulu zomdlavuza.
Izimpawu
Izimpawu ezinkulu ze-cachexia zihlanganisa:
- Ukulahleka kwesisindo (okungenangqondo): Ukulahlekelwa isisindo nge-cachexia kungenasidingo, okusho ukuthi kwenzeka ngaphandle kokuzama. Kodwa kuqhubeka ngaphezu kokulahlekelwa kwesisindo okungenhloso. Ukulahlekelwa kwesisindo kungenzeka noma ngabe uthola inani elanele lamakhilori ekudleni kwakho, futhi uma ikhalori idla kakhulu ukukhipha amandla.
- Imisipha ye-squelette ishabalale: Ukushaywa kwemisipha kuwuphawu oluphawulekayo lwe-cachexia futhi kwenzeka kanye nokulahlekelwa kwamafutha. Kungaba futhi okungalungile. Kubantu abaqine kakhulu ngesikhathi sokuxilongwa kwabo, ukulahleka okukhulu kwemisipha kungenziwa ngaphandle kokubonakala kwangaphandle kokulahlekelwa isisindo.
- I-Anorexia / ukulahlekelwa kwesifiso: Ukulahlekelwa kwesifiso kungenye uphawu lokulondoloza isikhumba, futhi futhi, lesi sibonakaliso sasihlukile kunezimpawu ezivamile zokulahlekelwa yifiso. Nge-cachexia, akusiyo nje ukwehlisa isifiso sokudla, kepha ukulahlekelwa kwesifiso sokudla.
- Ikhwalithi yokunciphisa yokuphila: Ukuhlukumeza ama-muscle kunganciphisa ikhono lakho lokuhamba futhi uhlanganyele emisebenzini engavamile ukuyijabulisa.
Izimbangela
I-cachexia ingabangelwa "izici ezincane" - izinto ezakhiwe futhi zifihliwe yisisu, noma "impendulo yempendulo." Impendulo yesibindi imane nje isho impendulo yomzimba esithombeni. Ukusabela kwesimiso somzimba sokuzivikela kumdlavuza kanye nezinye izimbangela ze-cachexia kuyacwaningwa ukuze uzame futhi uqonde izici ezingezansi ngemuva kwe-cachexia.
I-cachexia ilawulwa yi-catabolism catabolism. Uma ucabanga nge-metabolism evamile ukuba ukwakhiwa kwezicubu kanye nemisipha (i-anabolic metabolism), okuphambene nalokho kuqiniswe ne-cachexia, okuwukuphela kwezinqubo zomzimba ezijwayelekile.
Ukuhlola
Kunezindlela eziningana ukuthi i-cachexia ingahlolwa.
Ezinye zalezi zinyathelo zihlanganisa:
- Inkomba yomzimba womzimba (BMI): Inkomba yomzimba womzimba ayihlosi nje isisindo somzimba esilinganiselwe kodwa singanika ulwazi oluthe xaxa ngesisindo esinempilo. I-BMI ibalwa ngokusebenzisa ifomu lokuphakama nesisindo.
- Ubunzima bomzimba: Ukulinganisa umzimba kungasiza ekunqumeni isilinganiso sobukhulu besisindo somzimba kuya emaqenjini omzimba. Izivivinyo ezisetshenziselwa ukwenza lokhu zingabandakanya amafolda esikhumba kanye nokuhlelwa kwemvelo.
- Idayari yokudla: Ukugcina idayari yokudla kuyisenzo esibalulekile uma ufuna ukuvimbela noma ukubhekana ne-cachexia. Ngesikhathi esifanayo, kubalulekile ukukhumbula ukuthi ukungondleki kwe-cachexia kungenzeka ngisho nokudla okwanele kwama-calories.
- Ukuhlolwa kwegazi: Ezinye izivivinyo zamalebhu eziwusizo ekuhloleni i-cachexia zibandakanya izibalo ze-white cells (WBC), i-album ye-serum, amazinga wokudlulisa, i-uric acid, namamaki okuvuvukala, njenge -pro-protein esebenzayo ye-CP (CRP) .
Ukwelapha
Izindlela zokwelashwa kuze kube yimanje ziye zadumazeka, futhi ngisho nokudla okwanele khalori, kunzima ukuguqula inqubo ye-cachexia. Inhloso yokwelapha ukugqugquzela "izinqubo ze-anabolic" (okungukuthi, isakhiwo sezinsizwa) ngenkathi zivimbela "izinqubo zamathambo" (izenzo ezenza kube nokuhlukunyezwa kwemisipha). Ukwelashwa kungafaka:
- Ukudla: Ngokuphambene nalokho okungase kubonakale kusobala, ukufaka futhi ukubuyisela ama-khalori ekudleni akuzange kwenze umehluko omkhulu ku-syndrome ye-cachexia. Lokho kusho ukuthi kubaluleke kakhulu ukuqiniseka ukuthi abantu ababhekana nomdlavuza (nezimo ezifanayo ezibangela i-cachexia) banokudla okunempilo. Iphuzu elilodwa elibalulekile okufanele likhunjulwe ukuthi uma umuntu engakadli isikhathi eside, ukudla kufanele kwandiswe kancane kancane. Uma ama-khalori aphonswa ngokushesha, umphumela ohlangothini obizwa ngokuthi i- "overfeeding syndrome" ungase uvele. Uma ukudla kungenzeki (noma kunciphile) ngomlomo, ithubhu yokudla inganconywa .
- Izithako zokudla okunomsoco: Kuhle uma izakhi zingatholakala ngokudla, kodwa siyazi ukuthi akuyona into njalo. Amafutha wezinhlanzi ahlolwe ngokukwazi kwawo ukuphatha i-cachexia ngezifundo ezithile (kodwa hhayi konke) ukuphakamisa ukuthi kungasiza. Kwesinye isifundo, wanezela isithasiselo se-powder ye- eicosapentaenoic acid (EPA) , enye ye-omega-3 fatty acids eyinhloko eyinhloko abantu abayithola ekudleni kwabo ngokudla izinhlanzi, ithuthukise amazinga abanikazi bokuvuvukala abahambisana ne-cachexia. Izithako ze-EPA nazo zahlanganiswa nokuhlala okuncane okubhedlela nezifo ezincane nezifo.
- Ukuzivocavoca: Kungase kubonakale kungaqondakali, kodwa umsebenzi owandayo (uma kungenzeka) ungasiza. Inzuzo ecacile yokuzivocavoca yandisa ukudla, kodwa ukuqeqeshwa ukukhuthazela kungadlula imikhuba yokudla ukusiza ukunciphisa ukwehla kwesisindo semisipha esibonwe nge-cachexia.
- Imithi: Imishanguzo eminingi kanye nezithako eziye zazanywa nge-cachexia ngempumelelo encane zifaka:
- I-Megace (megestrol)
- Thalidomide
- I-Zyloprim (allopurinol)
- I-celebrex (i-celecoxib)
- L-Carnitine
- I-Medroxyprogesterone
- Testosterone
- Inyosi yezokwelapha neMarinol
Ikusasa le-Cachexia Treatment
Imithi eminingana imanje evivinyweni zomtholampilo ebonisa isithembiso ekusizeni abantu ukuthi babhekane nezinkinga zokulondoloza i-cachexia. Ezincane zazo manje sezivivinyweni zesigaba sesi-3 - izifundo zokuhlola ezihlola izidakamizwa noma inqubo evele ibhekwa njengendlela ephephile futhi ephumelelayo. Okwamanje, futhi unikezwe ukuthi i-cachexia ivame ukuqala isikhathi eside ngaphambi kokuba kuvelele ekuhlolweni ngokomzimba, kubalulekile ukubhekana nalesi sixazululo kubantu abanezimo ezifana nomdlavuza wamaphaphu ngokushesha ngangokunokwenzeka ngemva kokuxilongwa.
Imithombo:
Blum, D., no-F. Strasser. Amathuluzi wokuhlola we-Cachexia. Izimvo Zamanje Zokusekela Nokunakekelwa Kwama-Palliative . 2011. 5 (4): 350-5.
I-Bonsaeus, I. Ukusekelwa kokudla okunomsoco ekwelapheni okuxubile komdlavuza womdlavuza. Ukondla Ukusekela Ekhanda . 2008. 16 (5): 447-51.
U-Elia, M. et al. Ukungena komlomo noma nge-tube) ukwesekwa okunomsoco kanye ne-eicosapentaenoic acid ezigulini ezine-cancer: ukubuyekezwa okuhlelekile. I-International Journal ye-Oncology . 2006. 28 (1): 5-23.
Fearon, K. et al. Incazelo nokuhlukaniswa komdlavuza womdlavuza: ukuvumelanisa ngamazwe ngamazwe. I-Lancet Oncology . 2011. 12 (5): 489-95.
UDodson, S. et al. Imisipha yokulwa nomdlavuza womdlavuza: impendulo yomtholampilo, ukuxilongwa, kanye namasu okuphulukisa asanda kuvela. Ukubuyekezwa Kwaminyaka Yomuthi . 2011. 62: 265-79.
Kumar, N. et al. I-cachexia ye-Cancer: izindlela zokwelapha zendabuko kanye nezindlela zamakhemikhali ezenzelwe ukwelashwa. Izinketho zamanje ku-Oncology 2010. 11 (3-4): 107-17.
ULira, F. et al. Umthethonqubo wokuvuvukala kwezicubu ze-adipose kumdlavuza womdlavuza: umphumela wokuzivocavoca. Cell Biochemistry kanye Nomsebenzi . 2009. 27 (2): 71-5.
Madeddu, C. et al. Isivivinyo somtholampilo se-Phase III esingenakulinganiswa sokwelashwa okuhlangene ne-carnitine + celecoxib ± megestrol acetate yeziguli ezine-anorexia / i-cachexia syndrome ehlobene nomdlavuza. Ukudla okunomtholampilo . 2011 Oct 31. (Epub ngaphambi kokuphrinta).
Maddocks, M. et al. Ukuthuthukisa ubukhulu be-muscle nokusebenza ku-cachexia: izindlela ezingezona izidakamizwa. Izimvo Zamanje Zokusekela Nokunakekelwa Kwama-Palliative . 2011. 5 (4): 361-4.
I-Mantovani, G. et al. Isivivinyo se-Phase III esasihleliwe esingakahleleki sezingalo eziyisihlanu zokwelapha ezigulini ezingu-332 ezine-cachexia yomdlavuza. Oncologist . 2010. 15 (2): 200-11.
UMurphy, R. et al. Umthelela we-eicosapentaenoic acid supplementation emzimbeni omzimba onomzimba onomdlavuza we-cancer cachexia. I-British Journal of Cancer . 2011. 105 (10): 1469-73.
Op den Kamp, C. et al. I-pre-cachexia ezigulini ezinezigaba I-III umdlavuza ongasona omncane wesifo samaphaphu: Ukuvuvukala kwesistimu nokukhubazeka okusebenzayo ngaphandle kokuqaliswa kwesistimu ye-muscle ubiquitin proteasome. I-Cancer Lung . 2012. 76 (1): 112-7.
Seelaender, M. et al. Ukuvuvukala komdlavuza womdlavuza: Ukuxazulula noma ukuxazulula (yilelo mbuzo>). Ukudla okunomtholampilo . 2012 Feb 18. (i-Epub ngaphambi kokuphrinta)
UShum, A., noP. Polly. I-Cancer Cachexia: Izinjongo zeMolcular and Way for Diagnosis and Intervention Intervention. I-Endocrine, i-Metabolic, Immune Disorders Izidakamizwa Zezidakamizwa . 2012 uMashi 5. (i-Epub ngaphambi kokuphrinta)
Springer, J. et al. Ukuvinjelwa kwe-xanthine oxidase kunciphisa ukuchitha futhi kuthuthukise umphumela kumodeli wesikhwama somdlavuza womdlavuza. I-International Journal of Cancer . 2012 Feb 15. (i-Epub ngaphambi kokuphrinta)