Umdlavuza Webele Usakaze Esibindi

Izimpawu kanye nokwelashwa kwama-Metastase we-Liver kusuka e-Breast Cancer

Uma uthola ukuthi unesifo se-foastus esibindiwe emdlalweni webele wesifuba cishe uyazibuza ukuthi yini ezayo ngokulandelayo. Noma, esikhundleni salokho, kungenzeka ukuthi wayenomdlavuza wesifu esikhathini esidlule futhi uzibuza ukuthi izimpawu onayo zingabe ziwuphawu lwe-metastasis. Yini okufanele ukwazi ngezimpawu, izindlela zokwelashwa ezitholakalayo, nokubikezelwa lapho umdlavuza webele usakazeka esibindi?

Umdlavuza Webele Usakaze Esibindi - Incazelo kanye nokufinyeleleka

Izidakamizwa zesibindi (ukusakazeka komdlavuza esibindi) zenzeka cishe engxenyeni yabantu abanomdlavuza webele wesisu. Isibindi isayithi yesibili ejwayelekile kakhulu yezinsalela ezikude ezivela emdlalweni webele webele (okuvame kakhulu amathambo).

Umdlavuza wesibeletho osakaze esibindi kusekhona umdlavuza webele, futhi lokhu kungaba umthombo wokudideka okukhulu. Uma ngabe uthatha isampula yamaseli omdlavuza esibindi bese ubheka ngaphansi kwe-microscope, uzobona amangqamuzana ebelethwe umdlavuza. Umdlavuza webele we-Breast kuya esibindi akubhekwa njengomdlavuza wesibindi. (Umdlavuza wesibindi ngumdlavuza oqala esibindi, futhi ngaphansi kwe-microscope ubheka ngeso lengqondo amangqamuzana omdlavuza wesifo somdlavuza.) Umdlavuza wesifuba usakaze esibindi ubizwa ngokuthi "isifo somdlavuza wesifuba esifubeni."

I-terminology ingase idideke futhi, futhi isifo somdlavuza wesifuba sebele esifubeni singabuye sibhekwe njengesiteji sesine sebele sesifuba , noma umdlavuza webele wesifuba, noma "umdlavuza wesibeletho wesibindi."

Anatomy kanye Nemisebenzi yeBindi

Kungasiza ekuchazeni izimpawu ze-metastase yesibindi ukuze ubuyekeze kancinci ukuthambo nokusebenza kwesibindi.

Isibindi sisekugcineni kwesokudla kwesisu, ngaphansi kwe-diaphragm futhi siseduze neziningi zezigungu ezisemathunjini (okungenzeka ukuthi ziphikisana nazo njengoba zikhula kusuka ekusetshenzisweni kwemithi).

Ngokuvamile zikhona ngaphansi kwezimbambo zakho lapho ungakwazi ukuzizwa khona, kodwa uma zikhuliswa ungase uzizwe ubuningi (ngokuvamile zikhuni) nje ngaphansi kwezintambo zakho zombhebhe ngakwesokudla. Isibindi sakhiwa nge-lobes esisezingeni elimnandi. Lapho isibindi sanda, singabangela ukunwetshwa kwalesi sikhwama, okungaba buhlungu kakhulu.

Isibindi sidlala indima ebalulekile emzimbeni . Ezinye zazo zihlanganisa:

• Ukususwa kwe-toxins emzimbeni
• Isitoreji soshukela namanye amavithamini
• Ukukhiqizwa kwe-bile okuyinto isetshenziselwa ukwephula amafutha phansi kwamafutha acids njengengxenye yokugaya
• Ukukhiqizwa kwamaprotheni asiza ekuguleni igazi
• Ukukhiqizwa kwamaprotheni adingekayo ekukhuleni kwamaselula nokulungiswa kanye nemisebenzi eminingana emzimbeni emzimbeni

Izimpawu kanye nezimpawu zeMetastase ye-Liver Kusuka Cancer Breast

Ungase ube noma ungenalo izimpawu ezihlobene nesibindi se-metastase, futhi lezi zingahlukahluka ngokuya kwenani lama-metastase, ubukhulu bawo, nokuthi ziphi. Ezinye izimpawu ezikhona zingabandakanya:

• Ubuhlungu besisu: Ubuhlungu buvame ukuzwa ngaphansi kwezimbambo ngakwesokudla kwesisu esiswini.
• Ubuhlungu obunamahlombe: Ukucindezeleka kwezinzwa ezihamba eduze kwesigqabha sesibindi se-metastase kungase kubangele uzizwe ubuhlungu ehlombe lakho lokunene.
• I-nausea: I-nausea ingenzeka ngenxa yokucindezela kwesibindi esandisiwe kwezinye izakhiwo zesisu nangokwakhiwa kwama-toxini egazini lapho isibindi singasebenzi ngendlela evamile.

• Ukulahlekelwa kwesifiso
• Ama-Hiccups: Uma isibindi sanda futhi siqhubekela phambili ngokumelene ne-diaphragm, singabangela ama-hiccups.
• Ukunambitheka (pruritis): Ukushaywa okuhambisana ne-metastases yesibindi kungaba nzima. Isizathu sokubamba ama-bile acids esingakha esikhumbeni sakho. Abanye abantu abanomdlavuza wesifuba bakuthola lokhu njengenye yezimpawu ezicasulayo (futhi uma othandekayo wakho enenkinga ngalokhu (noma) angase acele ukubuzwa okuphindaphindiwe emuva).
• Ama-Ascite : Ama- flux akha emathuneni ngenxa yokusebenza okungalungile kwesibindi kubhekiselwa njenge-ascites.
• I-Jaundice: Ukuzihlukanisa okwesibhakabhaka kwesikhumba kanye nabamhlophe bamehlo , i- jaundice , kungase kube yinto encane ekwakheni i-bile acid esikhumbeni. Ngokuvamile kwenzeka uma kukhona ukubandakanya okukhulu kwesibindi noma ukuvinjelwa kwe-bile duct ngesisu.

• Ukwandiswa kwesibindi kungase kubonakale njengesisindo esiswini sakho.
• Ukwehla: Ukuntuleka kwezinto zokuqeda ngenxa yokungasebenzi kwesibindi kungabangela ukuphuma kwegazi. Ukweqa, nakho, kungaholela ekudleni kwegazi.
• Izithukuthuku ebusuku
• Ukudideka nokuphelelwa amandla

Isibindi singasetshenziswa ngokuyinhloko ngesisu ngaphambi kokuba izimpawu ezibalulekile zenzeke (kuye ngokuthi indawo ye-metastases). Isibindi sikwazi ukuvuselelwa ngokuphawulekayo ngemuva kokwelashwa kwe-metastase yesibindi (ngokungafani nezinye izifunda ezifana nobuchopho).

Ukuthola iMastastases ye-Liver

Izidakamizwa zesibindi zingatholakala eziningana ngezindlela ezahlukene. Ama-metastase angase atholakale ngezinye izikhathi ngaphambi kokuba noma yiziphi izimpawu ezikhona lapho kukhishwa iziklomelo zesiteji. Bangase basolwe uma umsebenzi wegazi wembula ukuhlolwa kwemisebenzi engavamile .

Uma izimpawu zikhona kunezindlela eziningi lapho lezi zingatholakala, kuhlanganise ne-CT, i-MRI, i-ultrasound yesisu, noma i-PET scan. Ngezinye izikhathi ingxenye engenhla yesibindi ingatholakala ukuthi ine-metastases esifubeni CT.

I-Cancer Breast Isakazela kanjani Esibindi?

Indlela lapho umdlavuza webele usakazeka khona esibindi akuqondakali kanye nalokho okwenziwe ngamathambo ayisifo samathambo namaphaphu, kodwa ucwaningo luyaqhubeka. Kuthemba ukuthi ukuqonda okungcono izindlela ezithinta imithi yesibindi kuzosiza abacwaningi ukuba bakhethe ukwelashwa okungcono, kanye nezindlela ezikhona zokuvimbela ama-metastase yesibindi. Lokho esikufundayo ukuthi "i- microenvironment " yesibindi idlala indima ebalulekile ukuthi ngabe i-metastases yesibindi iyenzeka yini.

Ukwelashwa kwama-Metastase we-Liver

Ukuphathwa kwe-metastases yesibindi kuhlanganisa inhlanganisela yezindlela. Umdlavuza wesibeletho osakaze esibindi asikwazi ukwelashwa, ngakho umgomo wokwelapha ukwandisa impilo kanye nokunciphisa izimpawu. Ukwelapha kungafaka:

• Ukwelapha ukusiza abantu ukuthi babhekane nezinkinga zesifo se-foam, njenge-ascites, ubuhlungu, nokushaya.
• Izindlela zokwelapha ezijwayelekile ezisetshenziselwa ukuhlasela amangqamuzana omdlavuza wesifu noma kuphi emzimbeni (ukwelashwa okuhlelekile). Isimo somamukeli sidinga ukuhlolwa kabusha njenge-receptor ye-estrogen, i-progesterone receptor, nesimo se-HER2 / neu singashintsha (ngamanye amazwi, noma ngabe isifo se-estrogen sasitholile ekuqaleni, manje kungenzeka ukuthi isamukeli se-estrogen asibi).
• Imithi ekhethekile ye-Metastasis, ekhuluma ngezindawo zomdlavuza esibindi ngokuqondile. Lezi zingasetshenziswa ukunciphisa ivolumu ye-metastases ukunciphisa izimpawu, noma ngezinye izikhathi, lapho kuphela izilonda zinezinso ezimbalwa noma ezimbalwa, ukwelashwa kungazama ukuqeda ngokuphelele imishanguzo yesibindi.

Ake sibheke ngayinye yalezi zinhlobo zokwelashwa.

Ukwelashwa Kwezimpawu Ngenxa Yamatastases Wesibindi

Ngaphandle kwemithi eyenzelwe ukubhekana nomdlavuza, ukwelashwa ukulawula izimpawu kubaluleke kakhulu. Lokhu kungabandakanya imithi yokwelapha . ukwelashwa (njengokwenziwa kwesisu esiswini , usebenzisa inaliti ukuhoxisa uketshezi) ukunciphisa ukungakhululeki ngenxa ye-ascites, nokulawula ubuhlungu kanye nokucabangela. Kubalulekile nokuba uqaphele izinto (ezifana nemithi) okungadala ukusebenza kwesibindi uma kutholakala imitha yokushisa, futhi lokhu kuxoxwe ngezansi.

I-General Treatment for Cancer Metastatic

Isinyathelo sokuqala esibalulekile kubantu abane-metastase, kungakhathaliseki ukuthi isibindi yedwa noma kwenye indawo, ukuphinda uhlole isimo se-receptor. Abantu abaningi bayamangala lapho bezwa ukuthi isimo sokuthola umdlavuza wesifuba esibuyele endaweni esingaba kude singaba nezici ezihlukile kunomdlavuza wesifuba sangempela esifubeni. Isibonelo, isisu esise-estrogen se-receptor esivela ekuqaleni singakwazi ukuba nesitoreji se-estrogen, futhi isisu esivela ku-HER2 / neu positive manje singaba ngu-HER2 / neu negative futhi ngokuphambene nalokho.

Imithi yokwelapha yokuqala eyenzelwe umdlavuza wesifuba we-metastatic ixhomeke kulezi zici zesisu futhi ingabandakanya imithi yokwelashwa, i-endocrine zokwelapha, imithi ehlosiwe yomdlavuza webele we- HER2 / neu , nezinye izifo.

Ngokungafani nesifo somdlavuza webele wezinyosi zakuqala, lapho umgomo uvame ukwelashwa okunamandla ukuvimbela ukuphindaphindiwe, umgomo ngomdlavuza webele we-metastatic ngokuvamile uvame ukusebenzisa ukwelashwa okuncane ngangokunokwenzeka ukulawula lesi sifo. (Kungase kube khona ngaphandle kwalabo abanezimboni ezizimele noma ezimbalwa kuphela esifundeni esisodwa.)

Ukwelapha Okucacile KweMetastases Yezingulube

Ngaphandle kokwelashwa oklanyelwe umdlavuza we-metastatic ngokuvamile, kunezinketho eziningana zokwelapha i-metastases yesibindi ngokuqondile. Ukusetshenziswa kwalezi zindlela zokwelapha kuyahlukahluka kuye ngokuthi kunezici eziningi ezibandakanya uhlobo lomdlavuza, ukutholakala kwamanye amasayithi we-metastase, inombolo kanye nobukhulu be-metastases, nendawo yalezi zilonda. Lezi zindlela zokwelapha zingasetshenziswa ngendlela ephathekayo (ikakhulukazi njengoba i-chemotherapy ingasebenzi kahle ngokumelene nesifo samathambo) noma ngomzamo wokufinyelela isikhathi eside sokuphila.

Ukwelapha okuvamile: Ukwelashwa kwezidakamizwa esibindi isetshenziswa ngokujwayelekile njengendlela yokwelashwa okulula, njengoba kungase kunciphise kakhulu ubukhulu be-metastase yesibindi, futhi ngenxa yalokho izimpawu.

Ukwelashwa kwama- oligometastase esibindi: Uma isibindi singesinye isifo se-metastatic isifo somdlavuza webele, futhi kunomuthi owodwa (noma ambalwa kuphela) we-metastases, ukwelashwa okuphazamisayo kungalingwa nethemba lokuphila isikhathi eside. Igama elithi "oligometastases" lisetshenziselwa ukuchaza lesi simo ngegama elithi "oligo" elisho okumbalwa. Lokhu kungase kubhekiswe futhi ngokuthi igama elithi "ukwelashwa kwendawo yendawo." Indlela yokwelashwa ethize ixhomeke kubukhulu, ukuma, kanye nendawo ye-metastases Lezi zindlela zokwelashwa zisebenza kangcono ukuthi izicubu zibe ngamasentimitha amahlanu (cishe u-2 ½ amasentimitha) ngobukhulu noma ngaphansi, futhi uma ukuphindaphindiwe kwesibindi kwenzeka okungenani ngonyaka noma amabili emva komdlavuza wesifuba wokuqala.

• Ukwelashwa: Ezinye izicubu zesimiso zingasuswa ngokuhlinzwa ngenqubo ebizwa ngokuthi "i- metastasectomy ." Le ukwelashwa kuye kwaholela ekusinde isikhathi eside kubantu abakhethiwe ngokucophelela.
• Ukwenziwa komzimba: Izindlela zokwelapha zokwelapha ezithathelwana ngama-transarterial zingase zisetshenziswe. Lezi zihlanganisa ukuhlanganiswa okungahambisani nomzimba (TAE), i- chemoembolization , kanye ne- radioembolization . Lezi zindlela zingase zisebenzise izicubu ezingenakufinyeleleka kalula ngokuhlinzwa.
• Ukukhishwa kwe-tumor yokuguqulwa kwesithombe (Perfectaneous image-guided ablation ablation), ukukhishwa kwe-microwave energy noma cryoablation (ukushisa) kungasetshenziswa kwezinye izimo.
• I-radiotherapy yomzimba ebizwa ngokuthi i-stereotactic (SBRT): I- SBRT isebenzisa imisebe ephakeme kakhulu yamandla ehanjiswa endaweni eqondile yezincubu emzamweni wokubhubhisa ngokuphelele indawo encane yezicubu (njenge-isibindi noma imetastases yobuchopho).

Izinyathelo zokuqapha kanye nezindlela zokuphila uma Unesibindi se-Liver

Ukuqapha okungase kudingeke uthathe kuzoxhomeka ezingeni le-metastases kufanele ube nesibindi sakho. Kwababantu abathile, ama-metastases ayaziwa ngokuskena kodwa izivivinyo zomsebenzi wesibindi zihlala zijwayelekile futhi azikho izimpawu. Ngakolunye uhlangothi, abanye abantu banesisindo sokusebenza kwesibindi okuyizinto ezingavamile noma eziphawulekayo ezihlobene nomthwalo omkhulu we-tumor esibindi.

Ngisho noma unezibalo ezimbalwa kuphela, noma kunjalo, ukuqaphela ezinye zalezi zinyathelo kubalulekile:

• Utshwala udla: Abantu abanezidakamizwa ezinkulu zesibindi bavame ukululeka ukuba bagweme utshwala. Isizathu salokhu sibili. Uma isibindi sakho singasebenzi ngokuphefumula okugcwele, ngeke ukwazi ukugcoba utshwala ngendlela ojwayelekile ngayo. Lokhu kungaholela ekwakhekeni kotshwala nokuphikelela ohlelweni lwakho. Ngokombono ohlukile, siyazi ukuthi utshwala bungaba yingozi kulowo maseli, futhi ukungeza lokhu kumasethini asevele akwehlisiwe kungadambisa ubunzima besibindi onakho.
• Imithi isetshenziswe ngesibindi: Imithi eminingi ingasetshenzisiwe (ihlehliwe) ngesibindi noma izinso. Kuningi okukhethwa kukho ukwelashwa kufaka phakathi kokubili imithi ehlanjululwa yisibindi kanye nezinye zixilongwa izinso. Uma lolu khetho luyatholakala, udokotela wakho kungenzeka ancoma ukwelashwa okusetshenziselwa izinso (uma nje ungenalo okungajwayelekile emisebenzini yakho yezinso). Uma imithi esetshenziselwa isibindi kufanele isetshenziswe (njengezidakamizwa eziningi zamakhemikhali), umthamo ungadinga ukuguqulwa ngokuya ngesilinganiso sokukhubazeka kwesibindi okwamanje.
• Ngaphezu kwamakhemikhali namalungiselelo omuthi: Kubalulekile ukuqaphela ukuthi kunezinto eziningi ezingaphezu kwe-counter-the-counter kanye nama-herbal amalungiselelo ahlanganiswa nesibindi kanjalo. Isibonelo sibandakanya ngaphezulu kokunciphisa ubuhlungu be-counter. I-Tylenol (i-acetaminophen) isetshenziselwa isibindi (futhi kufanele igwenywe kubantu abanesifo sokukhubazeka kwesibindi) kanti amanxusa amaningi angenayo i-steroidal anti-inflammatory afana ne-Advil (ibuprofen) esikhundleni salokho ahlaziywe izinso. Kubalulekile ukuthi uqaphele ukuthi ukulungiswa kwamanye ama-counter-to-counter kungaba inkinga uma unesifo se-foam ngenxa yesimetabolism, kodwa ezinye izithako ezinamavithamini nezamaminerali zingaphazamisa ne-chemotherapy .

Isibikezelo / Ukulindela Ukuphila Kwe-Cancer Isifo Esasakaze Esibilini

Ama-metastases kuya esibindi aphezulu kakhulu, futhi ukusinda kungahluka kakhulu phakathi kwabantu abahlukene. Ukulinda komdlavuza wesifuba ngesifo sesibindi ngaphandle kokunakekelwa kwezinyanga ezine kuphela kuya kweziyisishiyagalombili, kodwa abantu abaningi bafuna ukwelashwa. Ngokwelashwa, izinga lokusinda iminyaka engu-5 labantu abanezimpawu ezisemuva ezihlobene nomdlavuza webele kuyinto amaphesenti angu-23.

Ngakolunye uhlangothi lwesigamu, kubantu abakhethwe ngokucophelela abane-metastases yesibindi kuphela (isifo se-oligometastatic) esiphathwe nge-chemotherapy kanye nokuthengiswa (noma ablation) we-metastases yesibindi, amazinga okusinda angama-5 angaba ngaphezu kwamaphesenti angu-40.

Ukuphazamiseka kubi kubi kakhulu kulabo abanomthelela omubi ekhemotherapy nalabo abanesifo se-estrogen-negative-negative.

Ngezansi Ngomdlavuza Webele Ngama-Metastases Amagciwane

Nakuba umdlavuza webele usakazeke esibindi njengamanje awuphilwanga, ukhetho lwezokwelapha luyatholakala okungagcini nje kuphela ukwehlisa izimpawu kepha lungandisa kakhulu ukulinda kwesikhathi nesifo. Njengamanje sazi kancane ngezindlela ezithinta imishanguzo yesibindi kunamanye amasayithi we-metastases, kodwa lokhu kunikeza ithemba lokuthi izindlela zokwelapha ezintsha nezinhle zizotholakala kokubili ukuphatha futhi ngethemba lokuthi zizovimbela imitha yesibindi esikhathini esizayo.

Ukubhekana Ne-Canast Metastatic Esibilini

Ukufunda ukuthi unomdlavuza we-metastatic kungaba ukushaqeka okuphelele. Uma ngabe unesifo somdlavuza webele esifundeni esedlule, manje usubhekene nesifo esingelapheki, futhi ngokuvamile sidinga uhlobo oluthile lwezokwelapha empilweni yakho yonke.

Khumbula ukuthi ngisho ne-metastases, ukwelashwa kuyaqhubeka. Njengoba kuphawuliwe ngaphansi kokukhethwa kokwelashwa kwesibindi se-metastases ngenhla, kunezinhlobo eziningi zokwelapha ezisetshenziswayo ngisho nangaphezulu ekuvivinyweni kwemitholampilo. Kukhona nethemba lokuthi ukucwaninga okubheka indima ye-microenvironment yomdlavuza esibindi kuzohlinzeka ngezindlela zokwelapha ezengeziwe.

Kubalulekile ukuthi ufunde ngomdlavuza wakho futhi ube ngummeli wakho ekunakekelweni komdlavuza wakho . Finyelela emndenini nabangani futhi uvumele ukuba basize. Ukubandakanya eqenjini lokusekela noma umphakathi wokusekela ngokuqondile kubantu abanomdlavuza webele we-metastatic kungaba usizo olukhulu, hhayi kuphela ekuhlinzekeni ukusekelwa ngokomzwelo (ukukwazi ukukhuluma nomuntu oye "waba khona") kodwa ekuxhumaneni okumele funda ngokucwaninga kwakamuva. Thatha isikhashana ufunde mayelana nomphakathi wezenhlalo kanye nomdlavuza webele , kanye neProject ye-Metastatic Breast Cancer . Izifundo zisitshela ukuthi ukuba yingxenye esebenzayo yethimba lakho lezokwelapha kuholela ekuhluphekeni okuncane futhi kungenza umehluko umphumela wakho. Kuyasabisa futhi kuyashaqisa ukufunda ukuthi unomdlavuza we-metastatic, kodwa kukhona ithemba elikhulu, futhi kokubili ukwelashwa nezinga lokusinda ziyathuthuka njalo ngonyaka.

> Imithombo:

> Criscitiello, C., Andre, F., Thompson, A. et al. Ukuqinisekiswa kwe-Biopsy yezindawo ze-Metastatic ezigulini ze-Cancer Breast: Impact Clinic kanye Nezimo Ezizayo. Ucwaningo lweCanscer Breast . 2014. 16 (2): 205.

> I-Golse, N. I-Metastase ye-Breast Cancer: Iyini Indima Yokuhlinzwa? Izinkomba nemiphumela. I-Cancer Clinical Cancer . 2017. DOI: nomag / 10.1016 / j.clbc.2016.12.012.

> Ma, R., Feng, Y., Shuang, L. et al. Izindlela Ezithintekayo E-Breast Cancer Liver Metastasis. Journal of Medicine Medicine . 2015. 13:64.

> Weinrich, <., Wieb, C., Schuld, J., noBau Rau. Ukuvimbela Isibindi Se-Metastasis Esine-Isolated Liver in Breast Cancer: Imiphumela kanye Nezizathu Zokuthi Kungenzeka Ukubikezela. Ukuhlinzwa kwe-HPB . 2014. ID 893829.