Amasayithi avamile we-Metastases kaLung Cancer
Abantu abaningi abanomdlavuza wamaphaphu bayazi ukuthi umdlavuza wamaphaphu ungasakazeka. Amaphesenti angaba ngu- 40 alabo bantu abasanda kutholakala ukuthi banomdlavuza wamaphaphu sebevele benamathemikhali kwezinye izingxenye zomzimba. Umdlavuza we-lungs uphatheka kanjani futhi kuphi, futhi ungazi kanjani uma umdlavuza wakho usakazeke?
Sibutsetelo
Amanqamu angamaqanda angasakazeka uma amaseli ehlukana nesisu, bese ehamba ngegazi noma i-lymphatics (izitsha emzimbeni lapho i-lymph namaseli amhlophe ehamba khona) ziya ezindaweni ezikude zomzimba futhi zikhule.
Le nqubo ibizwa ngokuthi i-metastasis.
Kubalulekile ukuhlukanisa phakathi komphakathi oyinhloko (lapho umdlavuza uqala khona) kanye namagciwane wesibili lapho ukhuluma ngokusakaza noma imetastasis yomdlavuza. Umdlavuza wamaphaphu oyinhloko owasaka emathanjeni ubizwa ngokuthi "umdlavuza wamaphaphu wamaphaphu," hhayi "umdlavuza wethambo." Ngokufanayo, umdlavuza wamaphaphu ohlakazeka ebuchosheni ubizwa ngokuthi "umdlavuza wamaphaphu emaphashini" kunokuba "ubuchopho" umdlavuza. "
Kulabo abafisa ukwazi okwengeziwe nokuthi kungani kwenzeka lokhu, ngisho nangemva kokuba isisu sibonakala sisusiwe ngokuphelele, ungabheka lezi zihloko ukuthi umdlavuza usakazeka kanjani nokuthi kungani amanye amantombazane ebuyela emuva (ephindaphinda) .
Izindawo ezivamile
Umdlavuza wegciwane ungasakazeka cishe kunoma yisiphi isifunda somzimba, kodwa izindawo ezivame kakhulu ziyi- lymph nodes , isibindi, amathambo, ubuchopho, nama-gland adrenal. Ake sibheke ngayinye yalezi zindawo ngokwehlukana.
I-Lymph Nodes
Amanqamu amaningi emaphaphu aqala ukusabalala kuma-lymph nodes esifubeni esiseduze ne-tumor.
Njengoba umdlavuza uqhubeka, amangqamuzana omdlavuza angaya ezindaweni ezifubeni ngokuqhubekayo kusukela ekuthomeni kokuqala, bese uya kwezinye izifunda zomzimba. Ngokungafani nama-metastase kwezinye izifunda zomzimba, ukusakazeka komdlavuza wamaphaphu kuma-lymph nodes akusho ukuthi kuyisisitrasi ( isigaba 4 esingeyona encane noma isifo somdlavuza omncane wamaphaphu omncane ).
Zonke izigaba zomdlavuza wamaphaphu ngaphandle kwesigaba 1 umuthi wesifo samangqamuzana ongasona omncane ungabandakanya umdlavuza wegazi osuke usakazeka kuma-lymph nodes.
Esikhathini esiningi, ukusakazeka komdlavuza wamaphaphu kuma-lymph nodes akubanga neze izimpawu. Uma lezi zanshukela zikhula ezingeni lymph naphezu kwamapayipi, ungase ubone inhla entanyeni yakho noma i-armpit yakho, efana (kodwa ngokuvamile ejwayelekile) ezigulini ezivuvukala okungenzeka wazidela ngazo esikhathini esidlule ngesifo somzimba.
Ukwelashwa ngokuvamile kuvame ukwelashwa ngamakhemikhali ngaphandle kokuthi amantombazane angama-lymph ahilelekile aseduze nesikhumba sokuqala futhi angasuswa ngokuhlinzwa .
I-Bone
Amaphesenti angaba ngu- 30 kuya kwangu-40 abantu abanomdlavuza wamapapu asezingeni eliphezulu baye basakaza (ama-metastases) amathambo. Amathambo avame kakhulu ukuthi angathinteka yiwona umgogodla (ikakhulukazi ama-vertebrae esifubeni nasezindaweni eziphansi zesisu), i-pelvis, namathambo angaphezulu wezingalo nemilenze (i-humerus ne-femur). Umdlavuza we-Lung uhlukile nakakhulu ngoba ungasakazeka ezandleni nasezinyaweni.
Uphawu oluvame kakhulu lwe-metastases yethambo lubuhlungu. Ngokuvamile ubuhlungu buqala kancane kancane, buzwa njenge-muscle pull or strain, futhi buya phambili ebuhlungu obukhulu. Ngenxa yokubuthakathaka kwethambo emzimbeni, abanye abantu bahlakulela ama-fractures (ama- fractures ) okuvela ngokuhlukunyezwa okuncane noma ngisho nasemisebenzini evamile yansuku zonke.
Uma umdlavuza wamaphaphu usakazeka emgodleni, ungafaka ingcindezi emthonjeni womgogodla (ukucindezelwa komgogodla) okungaba yiphuthumayo kwezokwelapha. Lokhu kungabangela ubuthakathaka noma ukugoqa emilenzeni yakho noma kunzima ukuhamba. Amanqamu aphethwe ngamathambo angaphinda aphule ithambo elikhipha i-calcium egazini (i- hypercalcemia ) edala izimpawu zokudideka, ubuthakathaka bemisipha, nokulahlekelwa kwesifiso phakathi kwabanye.
Izivivinyo zokubheka amathambo ayisithupha zingase zibandakanye ukuskena kwethambo , i- PET scan , i- CT , noma i- MRI . Umgomo oyinhloko ekwelapheni kwe- metastases yamathambo ukunciphisa ubuhlungu nokulungisa noma ukuvimbela ukuqhuma okwenzekayo. Izinketho zihlanganisa imithi yobuhlungu, ukwelapha imishanguzo , imithi yokuzama ukuvimbela ukuwohloka kwethambo, nokuhlinzwa ukuze kuqiniswe amathambo.
Ubuchopho
Umdlavuza we-Lung ngumdlavuza ovame kakhulu osaba khona ebuchosheni, kanti okungenani amaphesenti angu-40 abantu abanomdlavuza wamapapu ophakeme bazoba nobuchopho be-metastases ngesikhathi esithile phakathi nesifo sabo. Kokubili umdlavuza omncane wamangqamuzana omaphaphu nomdlavuza omncane wamaphaphu angasakazeka ebuchosheni. Umdlavuza wamaphaphu omncane ungasakazeka ebuchosheni ngokushesha, kaningi ngaphambi kokuba kutholakale ukuxilongwa. I-prophylactic irradiation cranial (PCI) , uhlobo lwe-radiation therapy, lingasetshenziswa ukuzama ukuvimbela lokhu ukuthi kwenzeke.
Umdlavuza we-Lung oye wasakazeka ebuchosheni ungabangela izimpawu zombili ngokubhubhisa izicubu zobuchopho nangokudala ukuvuvukala nokuvuvukala okubeka ukucindezela kwezakhiwo ebuchosheni. Ezingxenyeni ezintathu kwezintathu zabantu, azikho izimpawu ezikhona.
Izimpawu ezivamile zingabandakanya ukukhanda ikhanda, ukuhluleka, ukulahlekelwa ukulinganisela nokuhlanganisa, ubunzima ngokukhuluma, izinguquko zombono, ukuguqulwa kwememori kanye nokushintsha komuntu, ubuthakathaka ohlangothini olulodwa lomzimba nokukhathala.
Umdlavuza wegciwane lesifo samangqamuzana ebuchosheni ngokuvamile utholakala nge-CT scan noma i-MRI yobuchopho.
Ukwelashwa ngokuyinhloko kuyinkimbinkimbi, okusho ukuthi umgomo ukulawula izimpawu futhi ukuzama ukuphilisa umdlavuza. I-steroids ingasetshenziselwa ukunciphisa ukuvuvukala. Imithi yokwelapha kanye nemithi yokulwa ne-anti-seizure ingasetshenziselwa ukulawula ukukhanda ikhanda nokuhlukunyezwa. Ukwelashwa kwezidakamizwa kungasebenza kakhulu ekunciphiseni izimpawu zabanye abantu.
Uma ngabe kukhona okunye noma okuncane okuyi- metastases yobuchopho obukhona - into ebizwa ngokuthi "i-oligometastase" - ukwelashwa ngokuhlinzwa noma i- radiotherapy yomzimba (stereotactic radiotherapy body) (i-SBRT) eyaziwa ngokuthi i-cyber ummese noma ummese we-gamma, iholele ekulawuleni isikhathi eside lesi sifo abanye abantu.
Isibindi
Umdlavuza we-Lung oye wasakazeka esibindi kungase kungabangeli noma yiziphi izimpawu futhi kuvame ukutholakala uma kuhlolwa, njenge-CT scan, kwenziwa ukubhebhetheka komdlavuza wakho. Uma izimpawu zikhona, zingabandakanya ubuhlungu ngaphansi kwezimbambo zakho ngakwesokudla komzimba wakho, ukulahlekelwa ukudla, kanye nesicashu. Uma kunama-tumor amaningi esibindi sakho noma uma i-metastases inkulu ngokwanele ukuvimbela amadokodo esibindi sakho, ungase uhlakulele i- jaundice (umbala ophuzi wesikhumba sakho nabamhlophe bamehlo akho).
Izivivinyo ezenziwa ukuze zibheke ukusakazwa komdlavuza wamaphaphu esibindi kungase zibandakanye i-ultrasound yesisu, i-CT scan yesisu sakho, noma i-PET scan.
Ukwelashwa ngokuvamile kuvamise ukwelashwa kwemithi eklanyelwe ukuphatha umdlavuza oyinhloko. Ezimweni ezingavamile, uma kuphela isisu esisodwa noma izicubu ezimbalwa ezikhona, ukuhlinzwa kungase kunconywe ukususa izicubu. Ngezinye izikhathi inqubo ebizwa ngokuthi i-embolization inganconywa futhi. Lena inqubo evimbela ukugeleza kwegazi kube yingxenye yesibindi ukuze amangqamuzana omdlavuza akhona angeke aphile.
Ama-Glands adrenal
Umdlavuza we-Lung usakazeka ezigulini eziyingozi (izilonda ezincane ezihlala phezulu kwezinso futhi zikhiqize ama-hormone), ngokuvamile azibangeli izimpawu, futhi ngokuvamile zivame ukutholakala lapho kwenzeka iskena ukusungula umdlavuza.
Ukwelashwa ngekhemotherapy yomdlavuza kungasiza. Ngesibalo esincane kakhulu sabantu abakwazi ukukhishwa umdlavuza wabo wamaphaphu futhi babe nomunye owodwa kwesinye sezigulane eziyingozi, ukuhlinzekwa ukukhipha i-adrenal gland kanye ne- metastase ye-adrenal kuye kwaholela ekusinde isikhathi eside.
Ezinye izindawo
Ngenkathi izifunda ezingenhla ziyizindawo ezivame kakhulu zomdlavuza we-lungs, umdlavuza wamaphaphu uvame ukusabalala esiswini, amathumbu amancane namakhulu, ama-pancreas, iso, isikhumba, izinso, ngisho nesifuba.
Isibikezelo
Ngaphandle kokusakazeka kumakhansela amancane angabandakanya izigaba zangaphambili zesifo, umdlavuza wamaphaphu osakaze ezindaweni ezikude zomzimba uhlukaniswa njengomdlavuza wesigaba samangqamuzana omncane ongasona omncane noma umdlavuza omncane wamangqamuzana wamaphaphu omncane. Isilinganiso seminyaka engu-5 sokusinda esigabeni sesine esingenasincane samangqamuzana emaphaphu siyadabukisa kuphela ngamaphesenti amabili kuphela. Ukuphila okuphakathi, okungukuthi isikhathi esilandelayo lapho isigamu sabantu sisaphila kanti esinye isigamu sidlulile, izinyanga ezingu-8. Isilinganiso seminyaka emihlanu yokusinda emdlalweni omncane wesifo somdlavuza wamaphaphu wamaphesenti angu-2. Ukuphila okuphakathi kwezinyanga ezingu-6 kuya kwezingu-12 ukwelashwa, kodwa kuphela izinyanga ezimbili kuya kwezingu-4 ngaphandle kokwelashwa.
Lokho kusho ukuthi kunabantu abaye basinda futhi benza kahle iminyaka eminingi ngisho nangemva kokuxilongwa komdlavuza wamaphaphu osakazekile. Ngaphezu kwalokho, ukwelashwa okusha, okufana nezidakamizwa ze-immunotherapy ezamukelwa ngo-2015 , zinikeza ithemba lokuthi kwabanye abantu, ukuhlala isikhathi eside kungenzeka. Ngesikhathi lezi zidakamizwa zingasebenzi kuwo wonke umuntu, abanye abantu abanomdlavuza wamaphaphu ophakeme baye baba nokuphendula "okuqinile" kule mithi - okusho, ngamanye amazwi, ukusinda isikhathi eside.
Okubalulekile
Njengoba kuphawuliwe ngenhla, ngaphansi kwesihloko sezindawo ezithile zomzimba lapho umdlavuza wamaphaphu ungasakazeka khona, kungukuthi lapho kunezingosi ezimbalwa ze-metastasis ezikhona, ukuphatha lezi zindlela zokulawula umzimba ngenhloso yokulawula isikhathi eside umdlavuza kunokuba nje u-palliation kungacatshangwa. Abacwaningi abaningi manje bakholelwa ukuthi ukuthuthukiswa kwezinqubo zokwelapha kubantu abane-metastases ezimbalwa kuye kwenza abanye abantu abane-oligometastases ngenxa yomdlavuza wamaphaphu babe nokuphila isikhathi eside isikhathi eside sokuphila mahhala nekhwalithi elihle kakhulu yokuphila.
> Imithombo:
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> Peters, S., Bexelius, C., Munk, V., noN. Leighl. Impact of Brain Metastasis on Quality of Life, Ukusetshenziswa Kwemithombo kanye Nokusinda Kwabagulayo abane-Non-Small-Cell Cell Lung Cancer. Ukubuyekezwa kweCanscer Treatment . 2016. 45: 139-62.
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