Ukwelashwa kwe-Cancer Lung

Uhlolojikelele lwezokwelapha ze-Lung Cancer

Kunezinketho eziningi zokwelapha kubantu abanomdlavuza wamaphaphu, kodwa lokhu akuzange kube njalo. Ukwelapha ngokwabo-kanye nezindleko zokuphila ezihlobene nazo-nazo zithuthuke ngokuphawulekayo eminyakeni yamuva. Yize lokhu kuyizindaba ezinhle kakhulu, akusho ukuthi kufanele ukhethe ukuthi yikuphi okukhethwa kukho okungcono kunakho konke okungaqineki kakhulu.

Ukwazi kabanzi ngemithi yomdlavuza wamaphaphu etholakala, futhi ukuthola ukwesekwa okudingayo, kungakhamba isikhathi eside ekusizeni ukwenza lesi sinqumo esibalulekile.

Ingabe Ukwelashwa Kungakwelapha I-Cancer Lung?

Kubantu abanesifo somdlavuza wamaphaphu esandulela ekuqaleni, ukuhlinzwa kunganikeza ithuba lokuthola ukwelashwa. Ngisho noma unomdlavuza wamaphaphu ophuthumayo, kunezinketho eziningi zokwelapha. Izinqubekela phambili zamuva ezivumela odokotela ukuba benze izifo zokwelashwa kwemiphunga yamaphaphu, kanye nokuqonda kangcono ukuthi amasosha omzimba ethu asebenza kanjani ukulwa nomdlavuza, uye wandisa kakhulu izindlela esinazo zokwelapha lesi sifo.

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Kubalulekile ukusho masinyane ukuthi ngenkathi umdlavuza wamaphaphu wamukelekile kakhulu ukuphatha ezinkathini zokuqala, kunabantu abasinde isikhathi eside ngisho nezinyathelo eziphambili kakhulu. Kubalulekile futhi ukuqaphela ukuthi ukwelapha umdlavuza wamaphaphu akugcini ukwedlula ukuphela kwedwa. Imithi yesifo somdlavuza ingadlala indima ebalulekile ekunciphiseni izimpawu zomdlavuza futhi yenza abantu abaningi babe nemfanelo enhle yokuphila kulo lonke ukwelashwa.

Izinhlobo Zokwelapha I-Cancer Lung

Njengoba kunezinhlobo eziningi zokwelapha ezitholakalayo emdlavuza wamaphaphu, kungaba usizo ukuphula lezi zindlela zokwelapha ngezindlela ezimbili ezinkulu:

• Ukwelashwa Kwendawo: Ukwelapha kwendawo kuyaphatha umdlavuza emthonjeni wayo-ngamanye amazwi, endaweni yangakini. Lezi zihlanganisa ukuhlinzeka ngokuhlinzwa kanye nokwelashwa kwemisebe, imithi esusa isisu kodwa ayikwazi ukufinyelela amangqamuzana ahambe ngaphesheya kwesayithi lokuqala le-tumor.
• Izindlela zokwelashwa zesistimu: Ukwelashwa okuvamile kuyabulala amangqamuzana omdlavuza noma ngabe kuphi emzimbeni. Lezi zokwelapha zibandakanya i-chemotherapy, imithi ehlosiwe, kanye ne-immunotherapy.

Ngesifo samaphavuza emaphasheni esandulela, ukwelashwa kwendawo kungase kube ngokwanele ukuzama ukwelapha umdlavuza. Uma umdlavuza wamaphaphu usakaze kuma-lymph nodes noma kwezinye izifunda zomzimba, ukwelashwa kwesistimu ngokuvamile kuyindlela engcono yokwelapha.

Isikhathi esididekayo ongase uhlangabezane nayo yilona ukwelashwa kwe-adjuvant . Ngezinye izikhathi ukwelashwa kwesistimu kuyasetshenziswa ngisho noma umdlavuza ungabonakali ukuthi usakazekile. Isibonelo, i-chemotherapy noma imithi yokwelashwa okuhlosiwe inganikezwa noma ngabe ukuhlinzekwa kwenziwa. Imithi yokwelapha i-Adjuvant yilezo ezenziwa ukwelapha noma yiliphi amangqamuzana asakaze ngaphesheya kwendawo yokuqala yomdlavuza, kodwa kungenzeka ukuthi angakabonakali ngokuhlolwa kwe-imaging okwamanje.

Ukuhlinzwa kwe-Cancer Cancer

Lapho umdlavuza wamaphaphu ubanjwe ekuqaleni kwezinyathelo-ngaphambi kokuba usakaze ngaphezu kwamaphaphu-ukuhlinzwa kungase kube ukwelapha. Ngesikhathi sokuqala, ama-cancer angaphazamisa amangqamuzana amaphaphu amaphaphu (ikakhulukazi isiteji sokuya esiteji IIIA ezingekho ezincane zamangqamuzana emaphaphu amaphaphu), ukuhlinzwa kuvame ukucatshangelwa. Ngezikhathi ezingavamile, ukuhlinzwa kungacatshangelwa ekuqaleni (okulinganiselwe-esiteji) umdlavuza omncane wamaphaphu weseli.

Kunezinqubo ezinhlanu eziyinhloko ezingase zenziwe ukuphatha umdlavuza wamaphaphu:

• I-pneumonectomy : I-pneumonectomy ibhekisela ekususweni kwephazi lonke.
  
• I-lobectomy: Ku -lobectomy , enye ye-lobes yamaphaphu isusiwe. (Iphaphu elilungile linama-lobes amathathu, futhi ipulaphu lesobunxele linama-lobes amabili.)
  
• Ukwenyuka komshado: Ukuthengiswa komgodla , isisu sisuswa kanye nendawo enamakhadi amathishu emaphaphu azungeze isisu.
  
• Ukususwa Kwemikhono: Ukuthengiswa kwemikhono, i-lobe yamaphaphu, kanye nengxenye ye-bronchus (i-airways eholela emaphashini,) isusiwe.
  
• I -segmentectomy : Esikhathini segmentectomy, ingxenye ye-lobe isusiwe. Inani lemisipha elisuswe yile nqubo lingaphezu kokuthengiswa komkhawulo, kodwa ngaphansi kwe-lobectomy.

Imiphumela engavamile yokuhlinza ihlanganisa ukutheleleka, ukuphuma kwegazi, nokuphefumula, kuye ngokuthi umsebenzi wamaphaphu ngaphambi kokuhlinzwa futhi inani lesisindo samaphaphu sisusiwe.

I-Radiation Therapy for Cancer Cancer

Ukwelapha imithi yomdlavuza wamaphaphu isebenzisa i-X-ray enamandla esetshenziswe ngaphandle komzimba ukubulala amangqamuzana omdlavuza. Kunezindlela ezimbalwa lapho imisebe isetshenziselwa umdlavuza wamaphaphu:

• Njengendlela yokwelapha i-adjuvant yokwelapha noma yimaphi amangqamuzana omdlavuza asele ngemuva kokuhlinzwa
• Ukusiza ukunciphisa ubukhulu besisu ngakho ukuhlinzwa kungenzeka
• Njengendlela yokwelapha elula ukunciphisa ubuhlungu noma ukuvinjelwa kwamanzi kubantu abanomdlavuza ongenakwelashwa
• Njengokwelashwa okunomsoco: Uhlobo oluthile lwemithi yokwelashwa olubizwa ngokuthi i- stereotactic body radiotherapy (i-SBRT) isebenzisa imisebe ephakeme ephezulu eyenziwe endaweni encane emaphashini. Lokhu kungasetshenziswa njengenye indlela yokuhlinza lapho ukuhlinzwa kungenzeki.

Imiphumela emibi evamile yokwelashwa kwemisebe ingabandakanya ukubomvu nokucasula kwesikhumba, ukukhathala nokuvuvukala kwamapayipi (i-radiation pneumonitis).

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I-Chemotherapy

I-Chemotherapy yomdlavuza wamaphaphu isebenzisa imithi eyenzelwe ukubulala amangqamuzana ahlukanisa ngokushesha njengama-cell cell. Imithi ye-chemotherapy ingase isetshenziswe njengokwelapha okuyisisekelo yomdlavuza wamapapu ophuthumayo, ngemva kokuhlinzwa (i-adjuvant chemotherapy), noma ngaphambi kokuhlinzwa ukunciphisa ubukhulu besisu (i-neoadjuvant therapy.)

I-chemotherapy yokuhlanganiswa-ukusebenzisa izidakamizwa ezingaphezu kwesisodwa ngesikhathi esisodwa-isetshenziswa kakhulu. Imithi ehlukene iphazamisa ukuhlukaniswa kwamaseli ngamaphoyinti ahlukene emjikelezweni weseli, futhi ukukhomba le nqubo ngezindlela ezingaphezu kweyodwa kwandisa amathuba okuphatha amangqamuzana amaningi omdlavuza wamaphaphu ngangokunokwenzeka. Amanye amakhemikhali e-chemotherapy asetshenziselwa abantu abanomdlavuza wamaphaphu afaka:

• I-Platinol (i-cisplatin)
• I-Paraplatin (i-carboplatin)
• I-Gemzar (gemcitabine)
• I-taxotere (i-docetaxel)
• I-Taxol (paclitaxel) no-Abraxane (nab-paclitaxel)
• I-Alimta (pemetrexed)
• I-Navelbine (i-vinorelbine)

Imiphumela emibi evamile ye-chemotherapy ihlanganisa ukuxoshwa kwamathambo (ukunciphisa amangqamuzana egazi abomvu, amangqamuzana egazi amhlophe, namaplatelets), ukulahlekelwa izinwele, nokukhathala. I-nausea nokuhlanza kuyadala imiphumela emibi ye-chemotherapy, kodwa ngokubonga ukuphathwa kwale miphumela emibi kuye kwaba ngcono kakhulu eminyakeni yamuva.

Imithi ehlosiwe

Imithi ehlosiwe yomdlavuza wamaphaphu yizidakamizwa ezifanelwe ukuhlasela ezinye izici zamangqamuzana omdlavuza futhi, ngakho-ke, zingase zibe nemiphumela emibi kakhulu kunezokhambi zamasiko.

Kubaluleke kakhulu ukuthi wonke umuntu otholakala enomdlavuza we-cell wamaphaphu angewona omncane, ikakhulukazi i-lung adenocarcinoma, ane- profiling gene (ukuprofiliswa kwamagciwane) we-tumor yabo eyenziwa. Ungase uzwe udokotela wakho akhulume ngokushintshashintsha kwezakhi zofuzo kanye nezinguquko zofuzo. Lokho kusho ukuthi amanye amangqamuzana omdlavuza wamaphaphu anezinguquko zofuzo ezingabhekiswa (futhi ziphathwe) nemithi ethile ekhuluma ngalezi zinguquko.

Ukwelashwa kuvunyelwe kulabo abanokuguqulwa kwe-EGR, ukulungiswa kabusha kwe-ALK , ukulungiswa kabusha kwe- ROS1 , futhi kukhona nokuhlolwa okusemtholampilo okutadisha imithi yezinye izinguquko kanye nezinguquko zofuzo emangqamuzaneni yomdlavuza. Le ndawo yesayensi iyashintsha kakhulu, futhi kungenzeka ukuthi amathenda amasha nemithi emisha izoqhubeka itholakale.

Nakuba izindlela zokwelashwa ezihlosiwe zingasebenza kakhulu, ukumelana nalezi zindlela zokwelapha kuvame ukuqhubeka ngokuhamba kwesikhathi. Kodwa-ke, izidakamizwa zesizukulwane sesibili nesikwesithathu sezikhona futhi zifundiswa uma lokhu kwenzeka. Eminye imithi ehlosiwe evunyelwe umdlavuza wamaphaphu ihlanganisa:

• I-ALK inhibitors - i-Xalkori (crizotinib), iZykadia (ceritinib), no-Alecensa (alectinib)
• Angiogenesis inhibitors - i-Avastin (bevacizumab) ne-Cyramza (ramucirumab)
• I-EFGR inhibitors - I-Tarceva (erlotinib), i-Gilotrif (afatinib), i- Iressa (gefitinib), i-Tagrisso (i-osimertinib) ne-Portrazza (necitumumab)

Immunotherapy

Uhlobo olusha lwezokwelapha lomdlavuza wamaphaphu luyatholakala ngo-2015. Izidakamizwa ze-immunotherapy zisebenza ngokubambisana nesistimu yakho yokuzivikela emzimbeni ukuze isuse umzimba wakho wamangqamuzana omdlavuza. Nakuba sivame ukuzwa ama-hype amaningi ezindabeni, i- immunotherapy iyisizathu sokuthokozela ngekusasa lomdlavuza wamaphaphu futhi wabizwa ngokuthi ukuthuthukiswa komdlavuza we-2016 wonyaka we-American Society for Clinical Oncology.

Nakuba izindlela zokwelashwa ezihlosiwe zivame ukuphumelela kakhulu kubantu abangazange baphuze, imithi ye-immunotherapi ingase iphumelele nakakhulu kubantu ababhema futhi abanomdlavuza njengesifo somdlavuza we-cell wamaphaphu. Imithi ye-Immunotherapy okwamanje evunyelwe umdlavuza wamaphaphu ihlanganisa:

• I-Opdivo (nivolumab)
• I-Keytruda (i-pembrolizumab)

Okunye Ukwelashwa Kwemdlavuza Yengculaza

Nakuba ezinye izindlela zokwelapha umdlavuza wamaphaphu azitholakali zizuzisa ekwelapheni umdlavuza wamaphaphu ngokuqondile, kunezinhlobo eziningi zokwelapha zomdlavuza ezingabasiza abantu ukuthi babhekane nezinkinga zomdlavuza kanye nokwelapha umdlavuza. Eminye yalezi zibandakanya ukukhwabanisa, ukukhipha imithi yokwelapha, nokuzindla.

Izilingo Zomtholampilo We-Lung Cancer

I-National Cancer Institute itusa ukuthi wonke umuntu onomdlavuza wamaphaphu uthathe isilingo somtholampilo, futhi lokhu kubaluleke kunanini ngaphambili. Njalo ukwelashwa esinakho ngomdlavuza wamaphaphu bekuye kwacwaningwa njengengxenye yesilingo semitholampilo ngaphambi kokuvunywa. Ukuze kugcizelele ukubaluleka kwalezi zivivinyo, kungasiza ekubaleni ukuthi phakathi kuka-2011 no-2015, ukwelashwa okusha okuningi kwamukelwa umdlavuza wamaphaphu kunanoma yiminyaka eyishumi leminyaka ngaphambi kwalokho.

Khuluma nodokotela wakho mayelana nokuhlolwa kwemitholampilo bese unquma ukuthi lokhu kuyinto ongathanda ukuyihlola. Izinhlangano eziningana zomdlavuza wamaphaphu zihlanganise ndawonye umkhankaso wokulinganisa umtholampilo we-cancer womtholampilo wamahhala lapho abasebenzi bezempilo bengasiza ukufanisa izici ezithile zomdlavuza wakho ngokuhlolwa kweklinikhi okuqhubekayo noma kuphi emhlabeni.

Ukukhetha Izinketho Zokuhlinzeka Ngokwelashwa Okungcono Kwengculaza Kuwe

Njengoba kuphawuliwe ngenhla, kungase kube nezinketho eziningi ezihlukahlukene zokwelapha umdlavuza wakho wamaphaphu. Nakuba lokhu kungabonakala kunzima, kunezinto ezimbalwa ongayenza ukwenza inqubo yokwenza izinqumo ibe lula.

Uma usanda kuthola ukuthi unomdlavuza wamaphaphu, thatha isikhashana ukubuka lezi zinyathelo zokuqala ozithathe uma usanda kutholakala . Ucwaningo lubonisa ukuthi ukufunda okuningi ngangokunokwenzeka mayelana nomdlavuza kusiza ukunciphisa ukukhathazeka futhi kungathinta nemiphumela. Funda ukuthi ucwaninga kanjani umdlavuza wakho futhi uthole ulwazi oluthembekile. Ungaqala khona lapha.

Enye yezinto ezinhle kakhulu ongayenza ukuze uthole ukwelashwa okungcono ukuthola indawo yomdlavuza oyithembayo. Buyekeza lawa mathiphu ekukhetheni isikhungo sezokwelashwa somdlavuza wamaphaphu kanye nokubaluleka kokuthola umbono wesibili ngomdlavuza wamaphaphu . Thatha isikhathi sokukhuluma nomndeni wakho nabangani. Ungase ufise ukubuza i-oncologist yakho lapho ezofuna khona ukwelashwa uma ingatholakala ukuthi unomdlavuza wamaphaphu.

Ngeke kugcizelelwe ngokwanele ukuthi lesi yisinqumo sakho. Sonke sinemibono ehlukene mayelana nendlela esizobhekana ngayo nokwelashwa kwemithi, futhi imizwelo ingaba namandla ngalesi sikhathi. Siyakwamukela okuvela kubathandekayo bakho, kodwa qiniseka ukuthi wenze isinqumo ngokusekelwe kulokho okhululekile ngakho nokuthi uzizwa kangcono kuwe wedwa.

Izwi elivela

Into ebaluleke kakhulu ongayenza njengoba ucabangela ukwelashwa ukuba ummeli wakho siqu ekunakekeleni umdlavuza wakho . Ngisho noma awuyena "butterfly" noma "i-geek ye-inthanethi," ukubandakanyeka namaqembu okusekela umdlavuza we-inthanethi wamaphaphu nemiphakathi yomdlavuza wamaphaphu kuyigugu kakhulu. Akukhona kuphela lezi zindlela zokuthola ukuxhaswa kwabanye "ababekhona" futhi bangaqonda, kepha la maqembu angakusiza ukuba ufunde futhi uqonde ukuthuthukiswa kwamuva kumdlavuza wamaphaphu. I-hashtag ukukusiza ukuthola le miphakathi i-#LCSM, emele umdlavuza wamaphaphu ezweni lomphakathi.

Ungavumeli inhlamba yomdlavuza wamaphaphu noma imibuzo ongayithola mayelana nesimo sakho sokubhema ikulimaza. Noma ubani onamaphaphu angathola umdlavuza wamaphaphu. Ungavumeli umqondo wokuthi umdlavuza wamaphaphu awunakugula ungaphazamisa noma. Kungase kudingeke ukhumbuze abangani bakho ukuthi lokho abakuthola ngezihlobo eminyakeni eyishumi eyedlule kuhluke kakhulu kunendlela umdlavuza wephaphu uphathwa ngayo namuhla. Futhi nakuba ungase ubone amathrekhi omdlavuza wamaphaphu omhlophe ambalwa kunomdlavuza webele wesifuba, ungakhohliswa. Okushiwo umphakathi womdlavuza wamaphaphu kunenombolo okwenza ngokujulile. Finyelela kubantu abaningi abazobuyela emuva uma ubhekene nalesi sifo.

_Imithombo:

_{Masters, G. Immunotherapy kuLung Cancer Treatment: Isimo samanje neziqondiso zesikhathi esizayo. I-American Society of Clinical Oncology: ASCO News . https://am.asco.org/immunotherapy-lung-cancer-treatment-current-status-and-future-dictions}

_{I-National Cancer Institute. Ukunakekelwa Kwemdlavuza Yamangqamuzana Angewona Amancane (PDQ) - I-Health Professional Version. http://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq}

_{I-National Cancer Institute. Ukwelashwa Kwemdlavuza Yamangqamuzana Amancane (PDQ) - I-Health Professional Version. Kubuyekezwe 07/07/16. http://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq}

_{Dlula, J., Carbone, D., Johnson, D. et al. Izimiso Nezenzo Ze-Cancer Lung . I-4th Edition. UWilliams noWilkins: ngo-2010.}

_{Rocco, G., Morabito, A., Leone, A., Muto, P., Fiore, F., no-A. Budillon. Ukuphathwa kwe-Can-Small Cell Lung Cancer Ngesikhathi Sokwelashwa Okuzimele. I-International Journal ye-Biochemistry ne-Cell Biology . 2016. 78: 173-179.}