Funda ngezimpawu zesayithi jikelele, zesifuba, nesibindi
Izibonakaliso ezithile nezimpawu umuntu angase abe nazo ngomdlavuza wesifuba we-metastatic zingashintsha kakhulu kusuka komuntu oyedwa kuya komunye. Abanye abantu bazoba nezimpawu eziningi, kanti abanye bangase babe nezimpawu ezimbalwa kakhulu noma akekho nhlobo; kanti umdlavuza utholakala ekuhlolweni kwe-imaging njenge-CT scan noma i-PET scan kuphela.
Izimpawu ezithile ozizwayo kanye nobuhlungu buzoxhomeka ezintweni eziningi, kufaka phakathi lapho umdlavuza wakho usakazeke khona , izinga lomdlavuza, kanye nempilo yakho jikelele ngaphambi kokuthuthukiswa komdlavuza webele we-metastatic.
Njengoba ufunda ngezimpawu ezikhona ongase uzizwe, khumbula ukuthi iningi labantu alitholi konke lokhu okukhathazayo. Kunalokho, zibalwe lapha ukukusiza ukuthi ubone ukuthi ungabe uzizwa kanjani futhi uqonde kangcono ukuthi kungani kwenzeka. Siphinde sibhale ezinye zezimpawu ezingenzeka ngenxa yezinkinga zomdlavuza webele we-metastatic.
Eziningi zalezi zibonakaliso azivamile, kepha zikhulunywe ngakho ukuze ube nesimo esingcono sokuqaphela isimo esiphuthumayo uma kufanele kwenzeke.
Izimpawu Ezivamile
Kunezimpawu eziningana ongase uzizwe nomdlavuza we-metastatic ovame ukubonwa nomdlavuza we-metastatic ngokuvamile. Lezi zimpawu zingase zihlotshaniswe nezinguquko zamanzi emzimbeni nezinye izici.
Ukukhathala: Ezinye zezinga lokukhathala lihlangene iningi labantu abanekhanda lomzimba. Ukukhathala komdlavuza kuhluke kunokukhathala okuvamile, futhi kungenzeka ngisho nalapho ukhululekile ngokugcwele futhi ulele kahle.
Ngisho noma lesi sibonakaliso singaphezu kwendawo yonke phakathi kwalabo abaphila nomdlavuza, kusabalulekile kakhulu ukukhuluma nodokotela wakho ngezinga lokukhathala ozizwayo. Ukukhathala, kungakhathaliseki ukuthi kusongela ukuphila, kuphazamisa futhi kubhekwa njengenye yezimpawu ezinzima kakhulu nezicasulayo.
Nakuba ukukhathala akukwazi ukuphathwa ngaso sonke isikhathi, kunezimbangela eziningana ezibangelwa ukukhathala udokotela wakho azofuna ukuzihlola.
Ukulahleka kwesisindo okungenalutho : Ukulahleka kwamaphesenti angaphezu kwamahlanu wesisindo somzimba (cishe amaphesenti ayi-7½ kumuntu onamakhilogremu angu-150) esikhathini esiyizinyanga eziyisithupha kuya kweziyishumi nambili kubizwa ngokuthi ukulahlekelwa isisindo okungenhloso-noma ukulahlekelwa isisindo ngaphandle kokuzama. Ngisho noma ungazihlolisisi njalo, ungabona ukuthi izingubo zakho zihambisana ngokukhululekile, noma ukuthi izihlathi zakho zibonakala zingacacile.
Kunezizathu eziningi zokulahlekelwa isisindo nomdlavuza ophakeme. Enye yalezi zinkinga zomdlavuza , okuyi-syndrome okubandakanya ukulahlekelwa isisindo, ukulahleka kwemisipha nokulahlekelwa ukudla. Kungase kubonakale sengathi udokotela wakho kufanele azi ukuthi ulahlekelwe isisindo, kodwa kubalulekile ukugcina ithrekhi yalokhu wena ngokwakho. Abantu abaningi abanomdlavuza webele we-metastatic bagcina bebona odokotela abaningana, futhi ukulahlekelwa isisindo, ikakhulukazi uma kungcolile, kungaqeda ukulahlekelwa.
Ukulahlekelwa kwesifiso: Ukulahleka kwesidlo kuvamile, futhi kungaba yisimpawu esinzima kakhulu ukubhekana nomdlavuza we-metastatic. Kunezimbangela eziningi zokulahleka kwesidlo, kuhlanganise nokucabangela nokuhlanza, imiphumela emibi yezokwelapha, kanye nemithi yesisu.
Ukucindezeleka: Eminyakeni yamuva sifundile ukuthi ukucindezeleka kuvame kakhulu ngomdlavuza we-metastatic, futhi kungenzeka ukuthi kube uphawu lokuqala lokuphindaphinda kwabanye abantu.
Kungaba nzima ukuhlukanisa phakathi kwesifo esijwayelekile nokucindezeleka komtholampilo. Khuluma nodokotela wakho mayelana nemizwa yakho yokucindezeleka, ngisho noma ukholelwa ukuthi le mizwa evamile inikezwe ngesimo sakho.
Izimpawu zesayithi le-metastatic
Izikhathi eziningi izimpawu zokuqala zomdlavuza webele we-metastatic zihlobene nezifunda zomzimba lapho isifo somdlavuza sisanda khona, noma lapho siphindela khona. Izindawo ezivame kakhulu lapho umdlavuza webele usakazeka khona kufaka amathambo, ubuchopho, isibindi, kanye nephaphu, nakuba umdlavuza webele ungasakazeka cishe noma yiliphi isitho emzimbeni. Kuyinto evamile kubantu abanomdlavuza wesifuba we-metastatic ukuthuthukisa imishanguzo ezindaweni eziningi.
I-metastases ye-Bone: Uphawu oluvame kakhulu lwe- metastasis yethambo lubuhlungu obuqhubekayo futhi buhlungu esifundeni lapho i-metastasis isenze khona. Ngezinye izikhathi abantu abazi ukuthi banamathambo ayisithupha kuze kube yilapho bezwa ukuhlukana okunomsoco omncane. I-Fractures eyenzeka ngamathambo lapho umdlavuza usakaze khona kuthiwa yi-fractures ye-pathologic.
Amagciwane e-liver: Amademastase e-fover ngokuvamile aqale ukusola uma ukuhlolwa kwegazi kubonisa amazinga aphezulu we-enzyme yesibindi. Uma umdlavuza webele usakazeka esibindi kuvamile ukuthi abesifazane (namadoda) bazwe ukushaywa okuvamile, okungaba okukhulu. I-jaundice (i-yellowing yesikhumba kanye nabamhlophe bamehlo) kungenzeka, kanye nokukhathazeka kwesisu, isicashu, nokuhlanza.
Amametasifisi okugcoba: Amagciwane okugaya emdlalweni webelevuza angabangela ukukhwehlela okungapheli nokuphefumula okuqhubekayo, ngokuvamile okuqala kuqala kuphela ngomsebenzi. I-buildup of fluid phakathi kwezingqimba ezifaka amaphaphu (pleural effusion) nayo iyavame futhi ivame ukukhuliswa ngokusheshisa ukuphefumula okusheshayo.
Imizwa ye-Brain: Umdlavuza wesifuba usakazeka ebuchosheni kancane kancane kunamathambo, isibindi, namaphaphu, kodwa kungesabisa kakhulu. Ungase ubheke izinhlungu zekhanda eziqhubekayo, kancane kancane, izinguquko ezibukwayo, isizungu, izinguquko zobuntu, noma ngisho nokuhlukunyezwa. I-metastase ye-Brain ivela kaningi kubantu abanesifo somdlavuza we-HER2 esifanele .
Izimpawu zesisu
Kungenzeka noma ungenayo izibonakaliso zesifuba ezihlobene nomdlavuza wakho, futhi lokhu kuzoxhomekeka ukuthi umdlavuza wakho ungumetastatic uma uqala ukutholwa (umdlavuza we "de novo" ) noma uma ubuyela ngemuva kokwelashwa komdlavuza wesifuba sangaphambili.
Izimpawu zesisu ngesifo somdlavuza wesifuba sezinyosi eziphindaphindiwe: Kubantu abaningi abanomdlavuza webele we-metastatic, ama-metastases abonisa ukuphindaphindiwe komdlavuza webele owawunayo esikhathini esidlule. Ngabe, uma kukhona, izimpawu zesifuba onalo zizoxhomekeka kulokho okukuholela ekutholeni ukuxilongwa kwakho, kanye nezindlela ezisetshenziselwa ukwelapha umdlavuza wakho wokuqala.
Uma une-mastectomy, isibonelo, umdlavuza ungabuya esibindi ngaphandle kwempawu ezihlobene nodonga lwakho lwesifuba noma lwesifuba.
Izimpawu zesisu nge-primary metastatic umdlavuza webele: uma uthola ukuthi unomdlavuza wesifuba we-metastatic ngaphandle komlando wangaphambi komdlavuza webele (de novo emdlalweni wesifuba), kunezibonakaliso eziningi ongase ube nazo.
Abanye abantu babona odokotela babo ngesifuba sezinyosi noma ukuxhaphaza okungavamile, futhi batholakala ukuthi banezibalo ezinjenge-CT scan, scan scan, noma i-PET scan. Ngokuphambene nalokho, ngezinye izikhathi umdlavuza we-metastatic utholakala lapho i-biopsy yesayithi, njenge-isibindi, yembula amangqamuzana omdlavuza webele. Ukuphanga okuqhubekayo kuyobe sekuthola isisu esidala esibelethweni. Ezinye ze-khansa, ezifana nomdlavuza wesifuba wokuvuvukala, zivame ukuba nemetastatic ngesikhathi sokuxilongwa kwangempela.
Ukuphindaphindeka ngokubambisana okuyisisekelo sesibili: Uma isilonda sitholakala esiswini sakho ngemva kwe-lumpectomy, kungase kube nzima okokuqala ukwazi ukuthi ukuphindaphindiwe komdlavuza wakho wokuqala noma umdlavuza wesibili wesibili. Ukuhlolwa kwe-molecular of the tumor kungasetshenziswa ukukhipha lokhu.
Izimpawu Zokucindezeleka
Izimpawu ezihlobene nomdlavuza webele we-metastatic zingase zibandakanye hhayi kuphela lezo ngenxa yomdlavuza uqobo, kodwa izinkinga ezibangelwa umdlavuza. Nakuba lezi zimpawu zizwakala ziyesabisa, akuzona zonke ezivamile. Sibabala lapha ngoba bangase babonise isimo esiphuthumayo, futhi ukwelashwa okusheshayo kweziphuthumayo kubalulekile kokubili izinga lokuphila nokuphila kulabo abanomdlavuza webele we-metastatic.
Umgogodla Wokucindezela: Uma umdlavuza usakazeka emgodleni ophansi ungabangela ukucindezelwa kwama-vertebrae kanye nezinzwa ezivela phakathi kwama-vertebrae. Uma lokhu kwenzeka emgodleni ophansi kungacindezela ngokushesha izinzwa eziya emilenzeni, isilonda, nesinye.
Lesi simo esiphuthumayo ngokuvamile sihlanganisa izimpawu zobuhlungu obuphansi emuva noma ngaphandle kwemisebe emilenzeni nokulahlekelwa kwesilonda nokulawula kwesinye. Ukwelashwa okusheshayo kuyadingeka ukuze kugcinwe umsebenzi wezinzwa.
I-Pleural Effusion: I-exusion effusion, evame ukubhekwa ngokuthi "isakhi samanzi emaphashini," kuyinkinga evamile kubantu abanomdlavuza webele we-metastatic. Isikhala phakathi kwe-linings yamaphaphu (i-pleura) ngokuvamile isincane, equkethe kuphela amathisipuni amathathu.
Ngomdlavuza we-metastatic, inani elikhulu lomthamo (ilitha noma ngaphezulu) lingase liqoqe kule ndawo, okuyinto ephindaphindiwe emaphashini. Izimpawu zingabandakanya ukuphefumula okuphuthumayo okuqhubekayo, futhi ubuhlungu besifuba (ngokuvamile bukhali) ngokuphefumulelwa. Ukwelashwa (okuxoxwa kamuva) kufaka phakathi ukufaka inaliti ukukhipha uketshezi.
Ukunyuka kwe-Pericardial: Njengoba nje uketshezi lungakha phakathi kwezingqimba ezinamapayipi, uketshezi lungase luqoqe ezintanjeni ezihlanganisa inhliziyo (isikhala esiphezulu), esibangela ukucindezeleka kwenhliziyo. Izimpawu zingabandakanya ubuhlungu besifuba (ngokuvamile obukhali noma ukugwaza), ukuphefumula, ukuguquka, futhi ekugcineni, ukulahlekelwa ulwazi.
I-Hypercalcemia: Ukuphuka kwethambo ngenxa ye-metastases yamathambo kungaholela ezingeni eliphezulu le-calcium egazini. Le-hypercalcemia nayo ingabangela amatshe ezinso, ukulimala kwezinso ngokunciphisa ukuvuthwa, ukucabangela nokuhlanza, nokudideka, phakathi kwezinye izimpawu. Lesi simo siyaphathwa, kepha kudingeka ukwelashwa ngokushesha.
I-Febrile Neutropenia: Labo abathola i-chemotherapy banamathuba amaningi okuthuthukisa ukutheleleka, futhi lezi zifo ngokuvamile ziyanzima ukuphatha. Izimpawu zingase zibandakanye umkhuhlane ophakeme, izikhukhula, ukudideka, ukukhwehlela noma ubuhlungu ngokuchama. Ukwelashwa kwezifo eziphathelene nokwelashwa kwe-chemotherapy kuye kwathuthuka kakhulu esikhathini esedlule, kodwa kudinga ukwelashwa ngokushesha.
Ukukhuluma nodokotela wakho
Kubalulekile ukuthi ukhulume ne-oncologist yakho kanye neqembu lokunakekelwa kwezempilo mayelana nanoma yiziphi izimpawu ozibonayo. Ezinye zalezi zimpawu, ezifana nobuhlungu, zingaphathwa kabi kubantu abanomdlavuza we-metastatic. Lokhu akusho ukuthi odokotela abahluleka ukuphatha izimpawu, kodwa ngoba bengazi ukuthi umuntu uhlangabezana nabo.
Ngayo yonke inkulumo ngabantu abanomdlavuza "abanesibindi" noma "abanamandla," ungase unqikaze ukuhlanganyela izimpawu ezingakwenza ube "ukwesaba" noma "obuthakathaka." Kodwa ubhekene nomdlavuza we-metastatic ukwesaba, futhi ukwazi ukwabelana nawe ukukhathazeka kuyisibonakaliso samandla, hhayi ubuthakathaka. Kukhona okuningi okungenziwa ukuze unciphise eziningi zezimpawu zomdlavuza webele we-metastatic, kodwa indlela kuphela ukuthi i-oncologist yakho ingakwazi ukuthi uzizwa kanjani uma "ukhaliphe" ngokwanele ukukhuluma.
Ngaphezu kwalokho, ukwabelana ngezibonakaliso zakho, noma ngabe kungabonakala kungenakuhle kuwe, kungasiza i-oncologist yakho ukuthi ibone kangcono ubukhulu besifo sakho, ilindele ukubhekana nezinkinga ezingase zibe khona, futhi ukhombise izindlela zokwelashwa ezihle kakhulu zesifo sakho.
> Imithombo:
> DeVita, Vincent., Et al. I-Cancer: Izimiso Nokusebenza Kwe-Oncology. Cancer of the Breast. I-Wolters Kluwer, ngo-2016.