Omunye wemikhuba yokuziphatha ekuphatheni iziguli ngomdlavuza we-thyroid-ngemuva kokususwa kwe-thyroid, kanti kwezinye izimo i-iodine ye-radioactive (i-RAI) -kubeka izinga lemithi ye-hormone ephindaphindiwe ye- thyroid eyaphazamisa izinga le-hormone le-TSH) . Ngokuyinhloko, iziguli zinikezwa imithi ephakeme yemithi (eyaziwa njenge-supra-physiologic doses) ukuze kuveliswe amazinga aphansi angatholakali e-TSH.
Ukugcina iziguli ezingeni elibhekwa njengezinhlamba ze-hyperthyroid kungavimbela ukuphindaphinda komdlavuza wegciwane.
Ucwaningo olwenziwe ngo-2017 Cancer Survivorship Symposium luyinselele kulo mkhuba ojwayelekile ngokuqinisekisa ubufakazi bokuthi kunezinkinga zengqondo zesikhathi eside ezihlobene nalolu mkhuba.
I-Hyperthyroidism engesiyo ngenxa yemithi isivele isifo esaziwayo se -fibrillation ye-atrial kanye nesifo se-ischemic. Iphinde ihlotshaniswe nobuhlungu be-angina nokuhlaselwa kwenhliziyo ezigulini ezinesimo senhliziyo esivele sezikhona.
Kulolu cwaningo, abacwaningi balinganisa umthelela womzimba we-hyperthyroidism ngenxa yokwehlisa umzimba kwe- levothyroxine , uhlobo oluthile lwe-thyroxine (T4) hormone, ezigulini ezingaphezu kuka-182,000 ezine-cancer yomdlavuza. Baye bathola ukuthi ukucindezeleka kwe-levothyroxine kwandisa ingozi yesifo senhliziyo kanye nokushaywa ischemic emdlalweni wezingane.
Ngokuqondile, bathole:
- Ngemuva komdlavuza wegciwane, kwaba nesilinganiso senani lesifo senhliziyo nesifo sohlangothi
- Ingozi yayiphezulu kuziguli ezazitholile i-thyroidectomy yakho yonke
- Ingozi yayiphakeme kulabo abathatha isisindo esiphezulu se-levothyroxine (futhi obani ababenezinga eliphansi le-TSH)
- Kwakukhona ingozi ephezulu ye-fibrillation ye-atrial, ehlobene nokulinganisa okuphakeme kwe-levothyroxine
Ngokusho kwabacwaningi, ingxenye encane yengozi yokushaywa yisifo ngenxa yokunyuka kwamazinga e-fibrillation e-atrial. Esikhundleni salokho, ikhono le-hyperthyroidism lokubangela ukucindezela kwegazi eliphezulu nokushintsha kwenhliziyo-phakathi kwezinye izici-kwakufanele kubekwe icala.
Enye isifundo se-2013 sabheka ingozi yesifo kwizifo ezahlukanisa umdlavuza we -roid. Ucwaningo lubuthole ukuthi amaphesenti angu-19 eziguli afela ngenxa yezinkinga zenhliziyo-kuhlanganise nokuhlaselwa yinhliziyo, ukushaya isisu, ukuhlukunyezwa kwe-aortic esiswini, kanye nokuhlanganiswa kwamapulmoni-kuqhathaniswa namaphesenti angu-7.4 abulawa ngumdlavuza we-thyroid. Ingozi yokufa isifo senhliziyo yayihambisana namazinga e-TSH: Izinga eliphansi le-TSH, liphakeme kakhulu engozini.
Izimpikiswano zegciwane lesifo se-Thyroid
Lokhu kutholakala kubalulekile ezigulini zomdlavuza we- thyroid , ikakhulukazi uma ubhekene nesifo sakho se- thyroidectomy , noma u-noma udokotela wakho uyancoma-ukucindezeleka kwe-levothyroxine ngemuva kokuhlinzwa.
Okokuqala, njengoba ucwaningo lubonisa ingozi enkulu ehlobene ne-thyroidectomy yakho yonke, kufanele uxoxe ukuthi ingabe i-thyroidectomy yakho iyadingeka njengengxenye yokwelapha kwakho komdlavuza we-thyroid. Ucwaningo lwamuva lubonise ukuthi ukwelashwa kwe-lobectomy ukususa i-lobe eyodwa kuphela yegciwane lengculazi - ukwelashwa okukhethwa ukukhetha umdlavuza wegciwane le-papillary , uhlobo oluvame kakhulu lomdlavuza we-thyroid.
Okwesibili, ochwepheshe abaningi bakholelwa ukuthi ayikho inzuzo ekucindezelweni kwe-TSH enonya. Imikhombandlela yamanje evela ku-American Thyroid Association kanye ne-European Thyroid Association ikhuthaza ukuxoshwa kwe-TSH kuphela lapho isiguli "sinomzimba ovuthiwe noma une-tumor enesihluku kakhulu esaphathwa ngokuhlinzeka nge-iodine emisebeni." Ngokusho kwamaqembu womabili:
Cishe iziguli ezingu-85% zingaboniswa ukuthi zikhululekile izifo ngemuva kokwelashwa kokuqala kwe-tumor ngokuhlola amazinga wegciwane le-serum thyroglobulin nokwenza intambo ye-ultrasonography. Uma isiguli sizwa singenaso isisu ngenxa yalesi sizathu, iziqondiso ze-ATA kanye ne-ETA ziphakamisa ukugcina igazi le-TSH ezingeni eliphansi elivamile.
Qaphela ukuthi naphezu kwemikhombandlela nezincomo, odokotela abaningi basoloko benza isifo se-thyroidectomi esiphelele kuzo zonke izinhlobo zegciwane lesidakamizwa, futhi banikeze amanani okucindezela ngokucindezelayo kuzo zonke iziguli zomdlavuza we-thyroid.
Okwesithathu, sibona ukunyuka okuphawulekayo emazingeni e-diagnostic ye-thyroid. Nakuba ezinye izazi zikholelwa ukuthi kunokunyuka okwenzekayo emdlalweni wegciwane lesifo se-thyroid, lokhu kuyinkinga ephikisanayo, njengoba abanye bakholelwa ukuthi izinga lokukhuphuka libangelwa ukunqwabelana ngokweqile "kwama-nodules" ekhanda lomdlavuza. Ngenxa yokusetshenziswa kakhudlwana kwezivivinyo ze-imaging, kunezinombolo eziningi ezincane, ezinomdlavuza, kodwa eziphuza kakhulu "eziyingozi" ezitholakele. Kukhona ukungqubuzana ngokuthi ngabe lezo zinhlayiya zifuna ukubonwa, kunokuba ukwelashwa komdlavuza okhathazayo esiyazi manje kungandisa izinkinga zenhliziyo.
Okokugcina, uma unomlando wesifo somdlavuza we-thyroid, kufanele uqiniseke ukuthi udokotela wakho uhlola futhi ahlolisise impilo yakho yenhliziyo ngezikhathi ezithile.
> Imithombo:
> Klein Hesselink EN, Klein Hesselink MS, de Bock GH, et al. Ukufa kwe-long-term cardiovascular in patients abane-carcinoma yegciwane ehlukile: isifundo sokuhlola. J Clin Oncol. 2013; 31 (32): 4046-4053. doi: 10.1200 / JCO.2013.49.1043.
> Shin DW, Suh B, Yoon JM, et al. Ingozi ye-coronary disease ye-coronary kanye nokushaywa ischemic emdlalweni wegciwane lesifo se-levothyroxine. J Clin Oncol. 2017; 35 (ukusekela 5S; ukubeka phansi 105).
> "I-Thyroid Yokuvuselela IHormone (TSH) Ukunciphisa." I-Association of Survivors Association. http://thyca.org/pap-fol/more/tsh-suppression/