Ukwelashwa kwama-Brain Metastases Kusuka Emdlalweni Webelevuza
Kwenzekani uma umdlavuza wakho webele usakazeka ebuchosheni bakho? Ngezinye izikhathi, i-metastases yebuchopho iyatholakala lapho umdlavuza webele usuqala ukutholakala, kepha iningi lesikhathi, i-metastase yobuchopho ibonakala sengathi iphindaphindiwe kude nomdlavuza webele wesandulela-ngculaza owawuphethwe esikhathini esedlule. Yiziphi izimpawu ezingase zenzeke, futhi yiziphi izinketho zokwelapha ezitholakalayo uma umdlavuza wakho webele usakazeka ebuchosheni bakho?
Ngokuvamile, i-metastases yobuchopho iba ngamaphesenti angu-15 kuya kwangu-24 kwabesifazane abanomdlavuza webele we-metastatic. Njengoba ukusinda kuthuthuka, noma kunjalo, le namba kulindeleke ukuba yande.
Incazelo kanye nokufinyeleleka
Ubuchopho ingenye yezingosi ezivame kakhulu lapho umdlavuza webele usakazeka khona , kanye namathambo , amaphaphu, nesibindi . Uma umdlavuza webele usakazeka ebuchosheni kubhekwa njengesigaba 4 noma umdlavuza webele we-metastatic. Nakuba ingasaphuluki ngalesi sigaba, iyaphathwa, futhi ukwelashwa kungathuthukisa izimpawu, kusize ngekhwalithi yokuphila, futhi ngezinye izikhathi kwandise ukusinda.
Uma umdlavuza webele unesimiso esibuchosheni usengumdlavuza webele. Uma ngabe uzothatha isampula yobuningi noma izixuku ebuchosheni, zizoqukatha amaseli webele omdlavuza, hhayi amangqamuzana obuchopho. Ama-metastases ayengabizwa ngokuthi "umdlavuza womqondo" kodwa kunalokho "umdlavuza webele wesifuba ebuchosheni" noma "umdlavuza webele we-metastases yobuchopho." Ngakho-ke, ukwelashwa yilawo asetshenziselwa umdlavuza webele ophuthumayo, hhayi lawo asetshenziselwa umdlavuza womqondo.
Esikhathini esidlule, i-metastases yobuchopho yayihlale ibhekwa njengesibonakaliso sokungabi namandla futhi umgomo wokwelapha "wawunamafutha," okusho ukulawula izimpawu kodwa hhayi ukuzama ukuphilisa isisu. Eminyakeni yamuva, umqondo we "oligometastases" ukhishwe. Lokhu kungukuthi, lapho umuntu enesisindo esisodwa noma esincane, futhi akukho-metastase ephawulekayo kwezinye izifunda zomzimba, indlela yokwelapha yokuqeda imithi yokugaya imithi ingahlolwa.
Ngamanye amazwi, ngenkathi ukwelashwa kuvame ukuhlala nge-palliative, ikakhulukazi kulabo abanezibalo eziningana noma ezisakazekayo, kwabanye abantu, ukwelashwa okungase kube nokwelashwa kungase kube yindlela yokukhetha.
Izimpawu
Kunezimbonakaliso eziningana ezahlukahlukene ezingahle zitshengise ukutholakala kwe-metastases yobuchopho. Ngezinye izikhathi azikho izimpawu, futhi lezi zindlela zokuthola umzimba zitholakala kuphela uma ukuhlolwa kwe-imaging, njengokuhlola kwe-PET noma i-MRI yobuchopho kwenziwa. Uma izimpawu zikhona zingabandakanya:
- Ukukhanda ikhanda: Izinhlungu ngenxa ye-metastases yobuchopho zingafana nokukhanda ikhanda noma ikhanda le-migraine, kodwa kungahambisane nezinye izimpawu zezinzwa (bheka ngezansi). Esinye isifundo, ikhanda lalikhona ngamaphesenti angu-35 abantu lapho kutholakala ama-metastases ebuchopho. Izikhwehlela ezihlobene nezidakamizwa zobuchopho zivame ukuba zimbi nakakhulu ngokulala phansi, zibi kakhulu ekuseni noma emva kokulala, futhi zibi nakakhulu ngokukhwehlela, ukunyundela, noma ukwehlisa ukuhamba komzimba. Lokho kusho, kungaba nzima ukuhlukanisa phakathi kwekhanda elithi "evamile" kanye nalabo ngenxa yemetastases ngaphandle kokucwaninga izifundo.
- Ukuncintisana: Ukuvuthwa (noma ngaphandle kwesivinini) kwakuyisibonakaliso sesibili esivame kakhulu se-metastases ebuchosheni kwisifundo esisodwa. Kungase kwenzeke ngokuzumayo ngaphandle kwesicoco esandulele futhi ngokuvamile sibi kakhulu ngemva kokulala phansi futhi ekuseni. Ukuvuthwa ngenxa ye-metastases yobuchopho kubonakala kuba kubi nakakhulu kaningi ngokuhamba kwesikhathi.
- Ukuntula kohlangothi olulodwa lomzimba, ukuphazamiseka, noma ukuxosha emaphethelweni: Hemiparesis, ubuthakathaka noma ukukhubazeka kolunye uhlangothi lomzimba, kwakuyisifo sesithathu esinesifo se-metastases ebuchosheni esisodwa.
- Izinguquko zombono : Izinkinga ezifana nemibono kabili, umbono obonakalayo, ukubona ukukhanya kokukhanya, noma ukulahlekelwa umbono kungase kwenzeke.
- Ukuqothulwa: Ukuzizwa kungase kube i-tonic-clonic (inkulu enkulu) lapho umzimba wonke uphazamisa khona futhi umuntu ulahlekelwa ukuqwashisa, ukuhlukunyezwa okuyingxenye, lapho umlenze, njengengalo yokugubha, noma ezinye izinhlobo zokuwa, isibonelo umuntu ubonakala ebuka endaweni engaboni.
- Ukulahlekelwa ibhalansi: Ukulahlekelwa ibhalansi kungase kubonakale sengathi kuyinkimbinkimbi, ngokusebenza ngezibalo noma ukufaka ama-benders njengezimpawu.
- Izinguquko zengqondo: Izinguquko zomuntu, izinguquko zokuziphatha, izinguquko zemizwelo, noma isinqumo esingalungile singase senzeke.
Izingozi / Amabangela Wengozi
Akekho oqinisekisayo ukuthi kungani abanye abantu behlaziya i-metastases yobuchopho nabanye abangekho. Siyazi ezinye zezinto ezibeka ingozi, kodwa-ke, okuyinto ebikezela ukuthi yiziphi abantu nokuthi yiziphi izicubu ezingase zikwazi ukusabalalisa ebuchosheni. Ama-metastases enesibindi angenzeka kakhulu kubesifazane abasha abanekhanda lomdlavuza , kanti lezi zimo ziphakeme kakhulu kulabo abatholwa ngaphambi kokuba baneminyaka engama-35. Izicubu ezingase zisakazeke ebuchosheni zihlanganisa nalabo abanezinga eliphakeme le- tumor , labo abano-HER2 positive futhi i-estrogen receptor negative, futhi lokho okungavumelekile kathathu.
Ama-metastase enesibindi cishe angenzeka kulabo abanezinambuzane ezinkulu (ngaphezulu kuka-2 cm ububanzi), kanye nabantu abanezitho zamakhansela amahle ngesikhathi sokuxilongwa kwabo kokuqala. Isikhathi esifushane phakathi komdlavuza wokuqala wesigaba sokuqala kanye nokuphindaphindiwe kuhlanganiswe nengozi enkulu ye-metastases yobuchopho.
Ukuxilongwa
Ucwaningo lokucwaninga oluvame ukubona ukuthi i-metastase yobuchopho ihlanganisa ama-MRIs obuchopho nama-PET. I-CT izihloko zekhanda zingase zisetshenziselwe labo abangakwazi ukuba ne-MRI eyenziwa (isibonelo, labo abanezinhlungu ze-pacemaker), kodwa ukuhlolwa kwe-CT akuphumelelanga kakhulu ekunqumeni ubukhona be-metastases yobuchopho. Ukuxilongwa ngokuvamile kwenziwa ngokusekelwe ekutholeni ukucabanga kanye nomlando wesifo somdlavuza webele, kepha kungadingeka i-biopsy. Njengoba isimo se-receptor singashintsha (kungakhathaliseki ukuthi i-tumor is receptor receptor, i-progesterone receptor, noma i-HER2 positive) nge-metastase, i-biopsy ingadingeka ukuze ukhethe okukhethwa kukho okwelashwa okufanele kakhulu.
Indawo ejwayelekile kunazo zonke ze-metastases yobuchopho yi-cerebellum (ingxenye yengqondo elawula ukulinganisela) kanye ne- lobes yangaphambili . Okungenani isigamu sabantu abathintekayo abanama-brainstorms ekhanda lomdlavuza webele kumele babe nama-metastase amaningi.
Ukwelapha
Izinketho zokwelashwa eziphathelene nemithambo yezobuchopho zingahle ziphulwe zibe izifo zokwelashwa, lezo ezenza umdlavuza noma kuphi emzimbeni, kanye nokwelashwa kwendawo, lezo ezibhekana ngqo nama-metastases ebuchopho. Ngaphandle kokwelapha okusetshenziselwa ukubhekana nomdlavuza ngokwawo, i-steroids ivame ukusetshenziselwa ukunciphisa ukuvuvukala kobuchopho, kanti ngezinye izikhathi kunganciphisa kakhulu imiphumela emibi.
Enye inkinga ebalulekile ekunakekeleni i-metastases yobuchopho ukuthi izidakamizwa eziningi azikwazi ukungena emkhakheni wegazi. Isivinini segazi-ingqondo inethiwekhi enamandla yama-capillari eyenzelwe ukugcina ubuthi obuphuma ebuchosheni. Ngeshwa, kubuye kuphumelele kakhulu ekugcineni imithi yokwelapha i-chemotherapy, kanye neminye imithi ephuma ebuchosheni. Izifundo okwamanje zibheke izindlela zokwandisa ukuguqulwa kwesithiyo se-brain-brain.
Ngaphandle kwe-steroids kanye nokwelashwa kwesistimu noma kwendawo ye-metastases yobuchopho, kubalulekile ukubhekana nezinye izimpawu ezihlobene nomdlavuza we-metastatic, ukukhathala okunjalo, ukulahlekelwa ukudla, ukucindezeleka, nokuningi. I-oncologist yakho ingancoma ukubonisana nokunakekelwa kokunakekelwa , futhi lokhu kungethusa uma ungajwayele insimu. Ukunakekelwa kwe-palliative akufani ne-hospice, kodwa kuyindlela yokwelashwa esetshenziselwa ukuphatha izimpawu zomzimba, ezingokomzwelo nezingokomoya ezihambisana nokuxilongwa komdlavuza. Ukunakekelwa kwe-palliative kungasiza ngisho nangama-tumor aphilile kakhulu.
Izinketho zesistimu
Izinketho zokwelashwa ezihlelekile yizo ezisetshenziselwa ukubhekana nomdlavuza webele wakho kungakhathaliseki ukuthi zitholakala emzimbeni wakho. Kungakhathaliseki ukuthi unayo yini yokwelapha yendawo ebuchosheni bakho be-brainstorms, imithi yokwelashwa okuyisisekelo ngokuvamile yilezi zokwelapha. Imithi yokwelapha yomdlavuza webele we-metastatic ingafaka:
I-Chemotherapy
I-Chemotherapy ivame ukusetshenziselwa umdlavuza webele we-metastatic, ngokuvamile usebenzise izidakamizwa ezihlukile kunakho uma ngabe une-chemotherapy ngaphambili. Kunezinketho eziningi ezahlukene noma "imigqa" yokwelapha engasetshenziswa. Njengoba kuphawuliwe, ama-agent amaningi e-chemotherapy ayangena emkhakheni wegazi-kodwa, kodwa ngokuvamile ama-metastase aya kwezinye izifunda ezikhona kanye nama-metastases ebuchopho. Kungasiza futhi ukunciphisa ingozi yokuthola imishanguzo eminye ebuchosheni.
Ukwelashwa kwamahomoni
Imithi yokwelashwa ye- hormonal yomdlavuza wesifuba we-metastatic inganconywa uma isisu sakho singumamukela we-estrogen. Ukusetshenziswa kwalezi zidakamizwa kuxhomeke ekutheni ngabe ususethempelini ye-hormone ngaphambilini, futhi uma kunjalo, yimiphi imithi owayithatha. Uma umdlavuza webele unesimiso esivamile ukuba isimo se-receptor sishintshe, isibonelo, isisu esiphezulu se-receptor se-receptor esingahle sibe se-estrogen samukelekile futhi ngokuphambene nalokho. Ngokuvamile ucatshangwa ukuthi uma uphethwe ukwelashwa kwe-hormonal ethile uma umdlavuza wakho unqamuke, ukuthi lesi sifo simelana nalolo muthi. Ngokungafani nezinketho eziningi zokwelapha, i-tamoxifen ne- aromatase inhibitors zibonakala ziwela ukuvinjelwa kwegazi-ingqondo
Imithi ehlosiwe
Izinketho zokwelashwa zomdlavuza webele we-HER2 we- metastatic othembekile kuxhomeke kulokho, uma kukhona, imithi owawuyiyo lapho isisu sakho senziwe khona. Njengesimo se-estrogen se-receptor, isimo se-HER2 singashintsha, ngakho-ke isisu esiyi-HER2 esiphila ngaphambili singase sibe yi-HER2 negative lapho sisakazeka ebuchosheni futhi ngokuphambene nalokho. Kulabo abangakaze bathole ukwelapha okuhlosiwe kwe-HER2, ukwelashwa nge-Herceptin (trastuzumab) noma i-Perjecta (pertuzumab) kungenza ngcono ukusinda. Uma i-metastases yobuchopho ithuthuka ngenkathi umuntu ethatha i-Herceptin (noma ezinyangeni ezingu-12 zokumisa lesi sidakamizwa), isidakamizwa T-DM1 (trastuzumab emtansine) sitholakale sithuthukisa ngokuphawulekayo ukusinda. Ngeshwa, i-HER2 ethintekayo imithi yokwelapha ngokuvamile ayiweleki umkhawulo wegazi-ubuchopho.
Ukuhlanganiswa kweTykerb (lapatinib) ne-Xeloda (capecitabine) kungasetshenziswa futhi, kodwa kubonakala kuholele ekuthuthukiseni okuncane okuncane kakhulu ne-toxicity enkulu (nakuba lezi zidakamizwa zibonakala ziwela ukuvinjelwa kwegazi). Kubonakala sengathi iTykerb ingase isebenze kangcono uma ihlangene ne-Xeloda kunokuba isetshenziswe yedwa.
Izivivinyo zemitholampilo
Ukuhlanganiswa kwezikwelapha ezingenhla, kanye nezigaba ezintsha zezidakamizwa ezifana nezidakamizwa ze- immunotherapy kanye ne-PARP inhibitors, ziyacutshungulwa ekuvivinyweni kwemitholampilo yesigaba sesine somdlavuza webele
Izinketho zendawo
Izindlela zokwelapha zendawo zenzelwe ukwelapha ubuchopho be-metastases ngokuqondile futhi zivame ukuphakanyiswa uma imithi ye-brainstas ibangela izimpawu ezibalulekile, noma uma kuphela amaminerase amancane abekhona ngenhloso yokuqeda imishanguzo. Lapho kutholakala imithi eminingi, umgomo ukunciphisa izimpawu (i-palliative). Ngama-metastases ambalwa kuphela, ukuqedwa kwe-metastases kungase kuhlolwe ngomgomo wokuthuthukisa ukusinda (ngenhloso yokunciphisa). Ngokuvamile, kubonakala sengathi ukwelapha okunamandla kakhulu kwendawo (njengokuthi i-SBRT kanye ne-metastasectomy) kufanele kubhekwe ngokuyinhloko kulabo bantu kulindeleke ukuthi baphile ezinyangeni ezingaphezu kuka-6 kuya kwezingu-12.
I-Whole Brain Radiotherapy (WBRT)
Ubuchopho obuphelele be-radiotherapy buye buthaka eminyakeni yamuva ngenxa yemiphumela emibi. Kuvame ukuphakanyiswa manje kubantu abano-metastases ababa nobuchopho obubanzi obangela izimpawu ezibalulekile. Izinguquko ezingqondweni, ezifana nezinkinga zememori, ukukhumbula ngokushesha, nokukhuluma ngokuzwakalayo zivame kakhulu, futhi zikhungathekisa labo okufanele babhekane nalezi zimpawu. Njengoba izinga eliphezulu lokuphila ngokuvamile liwumgomo obaluleke kunazo zonke ekwelapheni umdlavuza webele we-metastatic, ukusetshenziswa kwe-WBRT kudinga ukulingwa ngokucophelela mayelana nezinzuzo nezingozi. Muva nje, ukusebenzisa i-Namenda (i-memantine) kanye ne-WBRT itholakale ukunciphisa ukuncipha kwengqondo okubonakala njalo.
Ukuhlinzwa (i-Metastasectomy)
Ukuhlinzwa ukukhipha imithi embalwa noma embalwa kuphela (ebizwa ngokuthi i-metastasectomy) isetshenziswe eminyakeni yamuva futhi ingathuthukisa ukusinda uma isetshenziselwa abantu abakhethiweyo abalungile kule nqubo (banezibalo ezimbalwa kuphela futhi banempilo enhle). Ukuhlinzwa kungaba yindlela engcono kakhulu (kune-SBRT ngezansi) yamatastases amakhulu (amakhulu kunama-3 cm ububanzi). Ngokungafani ne-SBRT, ukuhlinza kunemiphumela ngokushesha okunganciphisa ukuvuvukala kobuchopho. Kodwa-ke, kukhona ingozi enkulu yokulimala kwegazi, kanye nobungozi bokuthi "i-tumor spill" (ekusakazeni amangqamuzana omdlavuza ebuchosheni) ngokuhlinzwa.
I-Stereotactic Body Radiotherapy (i-SBRT)
Okunye okubhekwa ngokuthi "i-Cyberknife" noma "i-gamma umese," i-radiotherapy yomzimba ebizwa ngokuthi i-stereotactic radiotherapy noma i- SBRT isebenzisa umthamo ophezulu wokushisa imisebe endaweni encane yezicubu ukuze uzame ukuqeda ama-metastases. Kuvame ukusetshenziswa uma kutholakala amaminithi ambalwa kuphela, kodwa ezinye izikhungo ziye zaphatha abantu abanamaphesenti ayishumi ngesikhathi. Le nqubo ingabuye iphindwe ukuze iphathe imithi ephakeme ekhona noma ekhona ngokuhamba kwesikhathi. I-SBRT ingaba inketho engcono kunezokuhlinzekwa kwe-metastase ejulile ebuchosheni, noma ezindaweni ezibucayi lapho ukuhlinzwa kungabangela umonakalo omkhulu emathisini obuchopho obucholile. Iphumelela kakhulu nge-metastases encane, futhi ukuhlinzwa kungase kube yindlela engcono kakhulu ye-metastase engaphezu kuka-3 cm ububanzi. Kuncipha kokuncipha okubonakalayo okubonwe nge-SBRT kunokuba ne-radiotherapy yonke yobuchopho, nakuba neminye imiphumela emibi, njenge-necrosis yemisebe, ingahle ivele.
Ezinye izinketho ezingenzeka
Ezinye zokwelashwa ezingase zenzeke emasethini asetshenziselwa ubuchopho ezingazange zenziwe kahle zibandakanya ukukhishwa kwe-radiofrequency (RFA) ne-hyperthermia.
Ama-metastases angaphezu kwesifunda esisodwa
Ngesikhathi esidlule, ukwelashwa kwendawo ye-metastases ebuchosheni kwakuvame ukucatshangelwa ukuthi ngabe kwakungekho amanye amasayithi we-metastasis, abanye bakholelwa ukuthi ukwelashwa kwama-oligometastases ezingaphezu kwesayithi eyodwa kungabangela nokusinda okuthuthukisiwe. Lezo zokwelapha, ezibhekwa ngokuthi "imishanguzo enamandla kakhulu" yokwelashwa komdlavuza webele we-oligometastatic, manje zihlolwa ngezivivinyo zokwelashwa. Kuze kube manje, kucatshangwa ukuthi, kubantu abakhethwe ngokufanele, ukusinda okuqhubekayo okuqhubekayo okungenasifo esinobuthi obuncane kungase kwenzeke kwabanye abantu abanezindlela ezimbalwa ezihamba ngamasayithi ezindaweni ezahlukene ezihlanganisa ubuchopho, amaphaphu, amathambo nesibindi.
Isibikezelo
Ukuchazwa kwesifo somdlavuza webele wesigaba se-4 esasakazeka ebuchosheni akusikho esikufisa, ikakhulukazi uma kutholakala imitha ephezulu ye-metastases. Lokho kusho ukuthi i-metastases ebuchosheni ngenxa yesifo somdlavuza webele sinesifo esingcono kakhulu kunomqondo we-brain metastases ngenxa yezinye izinhlobo eziningana zomdlavuza.
Ngokomlando, ukusinda ngamathambo ayisimo sebuchopho kwakungangezinyanga ezingu-6 kuphela kodwa lokhu kuyashintsha. Ucwaningo lwango-2017 lwathola ukuthi ukusinda komdlavuza webele we-metastases (zonke izinhlobo ezihlangene) kwakuyiminyaka engaphezu kwengu-2, okulindeleke ukuthi kube neminyaka emi-3 kulabo abanezinambuzane ezinhle ze-HER2. Kuyashesha kakhulu ukwazi ukuthi lokhu kuzoshintsha kanjani ngezokwelapha ezifana neSBRT kanye ne-metastasectomy, kodwa izifundo zakuqala zithembisa. Kubalulekile ukuqaphela ukuthi kunabantu abasinde isikhathi eside, kanti cishe amaphesenti angu-15 abantu abanomdlavuza webele we-metastatic bahlala okungenani iminyaka engu-10.
Ukubhekana
Ukubhekana nokunciphisa ubuchopho kungaba yinselele kokubili ngokubona komdlavuza webele we-metastatic, kanye nezimpawu ezingabangela. I-oncology iyashintsha ngokushesha, futhi kuyasiza ukufunda konke ongakwenza mayelana nesifo sakho ukuze ukwazi ukudlala indima esebenzayo ekunakekeleni kwakho. Buza imibuzo eminingi. Thatha isikhashana ukufunda ukuthi ucwaninga kanjani umdlavuza wakho . Buza mayelana nanoma yikuphi ukuvivinywa komtholampilo okungatholakala. Kukhona futhi ukulingana kwamacala okuhlolwa komtholampilo atholakalayo lapho abahlengikazi bezinambuzane bengakusiza ukuthi unqume (mahhala) uma kunoma yiziphi izilingo zokwelapha noma kuphi emhlabeni ongase usebenze kumdlavuza wakho othize. Njengoba kuphawuliwe ngenhla, ezinye izifundo zithola ukuthi ukusinda isikhathi eside kungenzeka ngisho nangokwenziwe ngamathambo, kepha eziningi zezindlela ezintsha zisacatshangwa ukuhlolwa. Kubalulekile ukuba ummeli wakho siqu ekunakekeleni umdlavuza wakho.
Kubalulekile ukuzinakekela ngokwakho ngokomzwelo kanye. Cela usizo, futhi uvumele abantu ukukusiza. Akekho ongabhekana nomdlavuza we-metastatic wedwa. Cabanga ukuthi uyingxenye eqenjini lezokusekela noma ujoyine omunye wemiphakathi yokulondoloza umdlavuza webele we-metastatic . Abantu abaningi abanomdlavuza webele we-metastatic bakuthola kuwusizo ukuthola amaqembu agxile ikakhulukazi emdlalweni we-metastatic, kunabanye abandakanya abantu abanezigaba zomdlavuza webele. Kulabo ababhekene nomdlavuza webele we-metastatic nezingane ezincane, khumbula ukuthi kunamaqembu okusekela (kanye namakamu kanye nama-retreats) kubantwana abanomzali ophila nomdlavuza.
Ngesinye isikhathi ama-metastase ebuchopho avulekile noma ahambisana nama-metastases amaningi kwezinye izindawo. Ngisho noma ukwelapha umdlavuza wakho webele akusekho umqondo, ukunakekelwa kokunakekelwa kwezilwane ukulawula izimpawu zakho futhi kukunikeze izinga eliphezulu lokuphila ngesikhathi osishiyile kusabalulekile kakhulu. Siye safunda ukuthi izingxoxo zokubhekana nokuphela kokukhathazeka kokuphila nomdlavuza webele we-metastatic kwenzeka kakhulu kakhulu. Ngeshwa, abantu abanomdlavuza ophakeme nabanakekeli bomndeni wabo bavame ukuqala lezi zingxoxo.
Ukukhetha ukuyeka ukwelashwa akusho ukuthi ushiya. Kunalokho, kusho ukuthi ukhetha ukuba nekhwalithi engcono kakhulu yokuphila ekupheleni kohambo lwakho. Uma ngabe othandekayo wakho onomdlavuza wesifuba, ukuthatha isikhashana ukufundela ekunakekeleni othandekayo ngomdlavuza webele we-metastatic kungenza kube lula ukuhamba ngezinsuku.
Izwi elivela
Uma uthola ukuthi unesifo se-brainstorms, cishe uzwa ukwesaba futhi udidekile. Ama-metastase we-Brain avame ukuvela ngokuphindaphindiwe okulandelayo ngemva komdlavuza wesifuba esandulela ekuqaleni. Ukuzwa ukuthi umdlavuza wakho ubuye futhi awusasaphuluki kuyisifo esibuhlungu.
Zombili izindlela zokwelashwa zesistimu nezendawo zitholakalayo ukuze zisebenzise izidakamizwa zobuchopho. Uma kuphela imithi emincane ekhona futhi uma impilo yakho ejwayelekile ihamba kahle, ukwelapha izidakamizwa ngezinqubo ezifana ne-SBRT noma ukuhlinzwa kungase kuthuthukise ukusinda. Uma imetastases yakho inkulu, kusekhona izinto eziningi ezingenziwa ukuze kuthuthukiswe ikhwalithi yakho yokuphila nanoma yisiphi isikhathi osishiyile.
Uhambo lomuntu wonke luhlukile, futhi yini efanele kuwe kungase kungabi yilokukhetha omunye ongayenza. Qinisekisa ukuhlonipha izifiso zakho ezinqumweni ozenzayo. Siyakwamukela okuvela kwabanye, kodwa khumbula ukuthi lolu luhambo lwakho .
> Imithombo:
> Brown, P., Jaeckle, K., Ballman, K. et al. Imiphumela ye-Radiosurgery Alone vs Radiosurgery Ne-Whole Brain Treatment Radiation Therapy on Operational Cognitive in Patients With 1 to 3 Brain Metastases. Isivivinyo Somtholampilo Esingahleliwe. I-JAMA . 2016. 316 (4): 401-409.
> Polivka, J., Kralickova, M., Polivka, J. et al. Imfihlakalo ye-Brain Matastatic Disease In Breast Cancer Iziguli: Ukuqiniswa Patient Stratification, Ukubikezela Izifo kanye Ukuvimbela Okubhekiswe on Horizon? . I-EPMA Journal . 2017. 8 (2): 119-127.
> Rostami, R., Mittal, S., Rostami, P., Tavassoli, F., no B. Jabbari. I-Brain Metastasis e-Breast Cancer: Ukubuyekezwa Kwamabhuku Aphelele. Journal of Neurooncology . 2016. 127 (3): 407-14.
> Trovo, M., Furlan, C., Polesel, J. et al. Ukwelapha Okunzima Kwemithi Ye-Oligometastatic Breast Cancer: Imiphumela ye-Prospective Phase II Trial. I-Radiotherapy ne-Oncology . 2018. 126 (1): 177-180.
> I-Library Kazwelonke Kazwelonke Yezokwelapha. I-Medline Plus. Lapho Ukwelashwa Kwemdlavuza Kuyeka Ukusebenza. Kubuyekezwe ngo-08/15/06. https://medlineplus.gov/ency/patientinstructions/000851.htm