Iimpawu kunye nokuPhathwa kweeMetastases ezivela kwiCanscer Breast
Ukuba uye wafumanisa ukuba unesifo sesibindi esivela kumdlavuza webele , mhlawumbi uyazibuza ukuba kuza ntoni emva koko. Okanye, endaweni yoko, unokuba nomhlaza wesifuba ngexesha elidlulileyo kwaye uzibuze ukuba iimpawu ozifumanayo zingabonakalisa uphawu lwe-metastasis. Yintoni omele uyayizi malunga neempawu, ukhetho lwezokwelapha olufumanekayo, kunye nokuxela xa umdlavuza webele usasazeka kwisibindi?
I-Cancer Isasazeka kwiNgqumbo - Inkcazo kunye nokuPhepha
Ubunzima bokusasaza (ukusabalalisa umhlaza kwisibindi) kubangelwa kwisiqingatha sabantu abanomdlavuza webele. Isibindi yindawo yesibini exhaphakileyo kwiindawo eziqhelekileyo ezisuka kumdlavuza webele (eziqhelekileyo amathambo).
Umhlaza wesifuba osulela kwisibindi usengumhlaza wesifuba, kwaye oku kungabangela umonakalo omkhulu. Ukuba ufanele uthathe isampuli yamaseli omhlaza kwisibindi uze ubheke phantsi kwe-microscope, uza kubona amangqamuzana esifuba somhlaza. Umhlaza wesifo sesifuba sesifo sesifo sesibindi esinjengomdla wesibindi akabheki njengesifo somhlaza wesibindi. (Umhlaza wesibeleko ngumhlaza oqala kwisibindi, kwaye ngaphantsi kwe-microscope ucinga ukujonga ngeso lengqondo iintsholongwane zesifo somhlaza.) Umhlaza wesifuba usasazeka kwisibindi ubizwa ngokuba "ngumhlaza wesifo se-metastatic kwisibindi."
Isigama sinokudidanisa ngokunjalo, kwaye isifo somhlaza wesifuba sebele sesibindi sinokuthi sihanjiswe njengesigaba se-4 somhlaza webele , okanye umdlavuza wesifuba ophezulu, okanye "umdlavuza wesibindi."
I-Anatomy kunye neMisebenzi yeSibindi
Kunokuba luncedo ekuchazeni iimpawu zesifo seesibindi ukuze uhlaziye ngokufutshane isisu kunye nomsebenzi wesibindi.
Isibindi sisekuhla kwesokudla kwesisu, phantsi kwesithintelo kwaye sisondele ezininzi kwiimbumba eziphambili zesisu (apho zingasicinezela njengoko zikhulisa ukusuka kwi-metastase).
Ngokuqhelekileyo zikhoyo phantsi kwembambo zakho apho ungakwazi ukuzivakalelwa khona, kodwa xa ukhulisa ungaziva ubunzima (kaninzi lukhuni) nje ngaphantsi kwembambo yakho yomnxeba ngakwesokudla. Isibindi sakhiwe nge-lobes esisezantsi. Xa isibindi sanda, sinokubangela ukunweba kwesi sikhwama, esinokubuhlungu.
Isibindi sidlala indima ebalulekileyo emzimbeni . Ezinye zezi ziquka:
- Ukususwa kweetekisi ezisuka kumzimba
- Ukugcina iswekile kunye namavithamini
- Ukuveliswa kwe-bile esetyenziselwa ukuphula ii-fat ukuya kuma-acids acids njengenxalenye yokugaya
- Ukuveliswa kweeprotheni ezincedayo kwi-clotting yegazi
- Ukuveliswa kweeprotheni ezifunekayo ukwenzela ukukhula kweseli kunye nokulungiswa kunye nemisebenzi emininzi emzimbeni
Iimpawu kunye neeMpawu zeMiastastases ezivela kwiCarcer Breast
Unako okanye ungenalo iimpawu ezinxulumene nesibindi se-metastase, kwaye ezi ziyahlukahluka ngokuxhomekeke kwinani leemastastases, ubukhulu bayo, nalapho zifumaneka khona. Ezinye iimpawu ezinokwenzeka ziquka:
- Iintlungu zesisu: Ubuhlungu buvame ukuvalelwa phantsi kwembambo ephezulu kwicala lesisu.
- Iintlungu zentlungu: Ukunyanzeliswa kwezibilini ezihamba kufuphi neengqungquthela zesibindi zintlungu zingenza ube neentlungu ehlombe lakho lasekunene.
- Isisindo: I-nausea inokuvela ngenxa yobuninzi bebindi ekunyongweni kwezinye izakhiwo zesisu nangokwakhiwa kwezixhepha egazini xa isibindi singasebenzi ngokuqhelekileyo.
- Ukuphelelwa kwesidlo
- Iingqungquthela: Xa isibindi siphuthunyiswa kwaye siqhutyelwa kwi-diaphragm, kunokubangela i-hiccups.
- Ukubambisa (pruritis): Ukutshiza okuhambelana nesibindi semastasi kunokuba nzima. Isizathu sokubamba i-bile acids engayakha kwesikhumba sakho. Abanye abantu abanomdlavuza wesibeleko bafumanisa ukuba enye yeempawu ezixhalabisayo (kwaye ukuba umthandi wakho unzima nale nto (okanye yena) unokucela ukuphindaphinda kwakhona.
- Ama-Ascites : Ukwakhiwa kwamanzi kwiisisu ngenxa yokusebenza kakubi kwesibindi kubhekiselwa njenge-ascites.
- I-jaundice: Ukuqhekeka okwesibhakabhaka kwesikhumba kunye nabamhlophe kwamehlo, i- jaundice , inokuthi ibe yintsibini ukuya kwakha i-bile acids elukhumbeni. Ngokuqhelekileyo kwenzeka xa kukho ukubandakanyeka okukhulu kwesibindi okanye ukukhutshwa kwe-bile duct ngesisu.
- Ukwandiswa kwesibindi ngamanye amaxesha kunokubonakala ngathi bunzima besisu sakho.
- Ukuhlamba: Ukungabikho kwezinto eziqhawulayo ngenxa yokungahambi kakuhle kwesibindi kunokubangelwa ukuphuma kwegazi. Ukuhlamba, kwakhona, kunokukhokelela ekudleni kwegazi.
- Ukukhupha ebusuku
- Ukudideka nokunyaniseka
Isibindi sinokuthi sitshintshwe ngokuyinhloko ngesisu ngaphambi kokuba iimpawu ezibalulekileyo zenzeke (kuxhomekeke kwindawo ekuthiwa i-metastase). Isibindi sinakho ukuvuselelwa ngokuphawulekayo emva kokunyanga kwesibindi semastases (ngokungafani kwezinye iindawo ezifana nobuchopho).
Ukuchonga iMetastases
Ubunzima bezilwanyana zingabonwa ngeendlela ezahlukeneyo. Ngamanye amaxesha i-Metastases ifunyanwe phambi kokuba kukho naziphi iimpawu xa kukho izicatshulwa zokucwangcisa. Basenokukrokrelwa ukuba umsebenzi wegazi ubonisa iimvavanyo zentsholongwane engavamile .
Ukuba izibonakaliso zikhoyo kukho iindlela ezininzi eziza kufunyanwa, ezibandakanya i-CT, i-MRI, i-ultrasound, okanye i-PET. Ngamanye amaxesha isahlulo esiphezulu sesibindi sinokufunyanwa sibe neemitha zesifo kwi-TB esifubeni.
I-Cancer Breast Isasazeka njani kwisibindi?
Indlela eyahlula ngayo umdlavuza webele weesibindi ayiqondakali kunye neyomzimba kunye namathambo, kodwa uphando luqhubeka. Kuthemba ukuba ukuqonda okungcono kweendlela ezisemva kwe-metastase yesibindi kuya kunceda abaphandi baqulunqe unyango olulungileyo, kwaye mhlawumbi iindlela zokuthintela i-metastases yesibindi. Oko sikufundayo kukuba "i- microenvironment " yesibindi idlala indima ebalulekileyo enoba i-metastases yesibindi ivela.
Unyango lweMiastas
Unyango lwe-metastases yesibindi luquka ukudibanisa kweendlela. Umhlaza wesifuba oye wasasazeka kwisibindi awukwazi ukuphiliswa, ngoko injongo yonyango ukunyusa ubomi kunye nokunciphisa iimpawu. Unyango luquka:
- Iipilisi zokunceda abantu bajamelane neempawu zesibindi semastasi ezifana ne-ascites, intlungu kunye nokubetha.
- Iingonyango eziqhelekileyo ezisetyenziselwa ukuhlasela iiseli zomhlaza zesifuba naphi na emzimbeni (unyango lwenkqubo). Ubume beReceptor kufuneka buhlolwe kwakhona njenge-receptor ye-estrogen, i-progesterone receptor, kunye ne-HER2 / neu imeko ingatshintsha (ngamanye amagama, nangona i-tumor yaqala ukuba yi-estrogen receptor, ngoku kungenayo i-estrogen receptor negative).
- Imithi ekhethekileyo yeMetastasis, ejongene nemimandla yomhlaza kwisibindi ngokuthe ngqo. Ezi zingasetyenziselwa ukunciphisa umthamo we-metastases ukunciphisa iimpawu, okanye ngamanye amaxesha, xa kunokuphela kwezilonda zesibindi okanye ezimbalwa, unyango lunokuzama ukuqeda i-metastases yesibindi ngokupheleleyo.
Makhe sijonge ngolu hlobo ngalunye lweentlobo zonyango.
Unyango lweZimpawu ngenxa ye-Metastases ye-Liver
Ukongeza kwonyango olujoliswe ukujongana nomhlaza, unyango lokulawula iimpawu lubaluleke kakhulu. Oku kungabandakanya unyango lokubamba . unyango (njenge- paracenteis esiswini , usebenzisa inaliti ukurhoxisa umkhuhlane) ukunciphisa ubunzima ngenxa ye-ascites, kunye nokulawula intlungu kunye neentlanzi. Kwakhona kubalulekile ukuba uqaphele izinto (ezinjengeemithi) ezinokudambisa ukusebenza kwesibindi xa kukho i-metastase, kwaye ezi zixutyushwa ngezantsi.
Iingcali eziqhelekileyo zeMetastatic Cancer
Isinyathelo sokuqala esibalulekileyo kubantu abaneemastastases, nokuba isibindi yedwa okanye kwenye indawo, kukuhlaziya isimo se-receptor. Abantu abaninzi bayothuka xa befumanisa ukuba imeko ye-receptor yomhlaza wesifuba ephindela kwindawo ekude ingaba nempawu ezahlukileyo kunomdlavuza wesifuba sangasese kwibele. Ngokomzekelo, i-tumor engummkeli we-estrogen oyilungileyo ngoku ingaba ne-estrogen receptor engafanelekiyo, kwaye i-tumor esekuqaleni i-HER2 / neu emihle ingaba yi-HER2 / neu engafanelekanga kwaye ngokufanayo.
Izifo zonyango eziqhelekileyo ezenzelwe umhlaza wesibeletho se-metastatic zixhomekeke kule mimpawu yesisu kwaye zingabandakanya i- chemotherapy , i-endocrine imithi, iipilisi ezijoliswe ku- HER2 / neu umhlabeleli webele webele , kunye nezinye iindlela zokwelapha.
Ngokungafani nomdlavuza webele webele, apho iinjongo zisoloko zinobugwenxa bokuthintela ukuphindaphinda, umgomo kunye nomdlavuza webele we-metastatic ngokuqhelekileyo unokusebenzisa nje unyango oluncinane ukulawula eso sifo. (Kungenzeka kubekho ngaphandle kwalabo abahlala bodwa okanye amancinci ambalwa kwindawo ethile.)
Unyango oluchanekileyo kwii-Metastases zesibindi
Ukongezelela kwonyango olwenzelwe umhlaza wesifo semitha ngokubanzi, kukho iindlela ezininzi zokuphatha i-metastases yesibindi ngokuthe ngqo. Ukusetyenziswa kwezi zonyango kuyahlukahluka kuxhomekeke kwiimeko ezininzi ezibandakanya uhlobo lomhlaza, ubukho bezinye iisayithi zeemastastases, inani kunye nobukhulu beemastastases, kunye nendawo yezi zilonda. Ezi zonyango zingasetyenziselwa ngethambo elincinci (ikakhulukazi ekubeni i-chemotherapy ayisebenzisayo ngokubhekiselele kwi-metastases yesibindi) okanye kumzamo wokufezekisa ukusinda kwexesha elide.
Uphuhliso oluqhelekileyo: Utyando lwe-radiation kwisibindi lusetyenziswa ngokuqhelekileyo njengonyango olusisigxina, njengoko lunokubangela ukuba kuncinci ukunciphisa ubukhulu be-metastases yesibindi, kwaye ngoko ke iimpawu.
Unyango lwe- oligometastases kwisibindi: Xa isibindi sisona kuphela isifo sesifo se-metastatic kunye nomhlaza wesifuba, kwaye kukho enye kuphela (okanye embalwa kuphela) i-metastases, unyango olungapheliyo lunokuzama ukulindela ngethemba lokuhlala ixesha elide. Igama elithi "oligometastases" lisetyenziselwa ukuchaza le meko ngegama elithi "oligo" lithetha elincinci. Le nto ingathunyelwa ngokunjalo negama elithi "unyango lwengingqi." Indlela yokwelapha ethile ixhomekeke kubukhulu, imo, kunye nendawo yeemastastase Ezi zonyango zisebenza kakuhle kwiimvumi ezinamithamitha amahlanu (malunga no-2 ½ intshi) ngobukhulu okanye ngaphantsi, kwaye ukuba ukuphindaphinda kwesibindi kwenzeka okungenani ngonyaka okanye ezimbini emva komhlaza wesifuba sokuqala.
- Ugqirha: Ezinye izicubu zesisu ziyakususwa ngokugqithisela ngenkqubo ebizwa ngokuba yi " metastasectomy ." Olu unyango luye lwaphumela ekuphumeni kwexesha elide kubantu abakhethiweyo.
- Ukuqulunqwa kwezinto: Ukusetyenziswa kwemithi yokuguqulwa kwamathambo angasetyenziswa. Ezi ziquka ukuhlanganiswa kwe-transarterial (TAE), i- chemoembolization kunye ne- radioembolization . Ezi zixhobo zingasebenza kwiimvumi ezingenakufikeleleka lula ngokuhlinzwa.
- Ukuxhoma kwe-tumor ehamba phambili yesikhombiso (i-radiofrequency ablation, i-microwave energy ablation okanye i-cryoablation (ifriji) ingasetyenziswa kwezinye iimeko.
- I-radiotherapy yomzimba (Stereotactic body radiotherapy (SBRT): I- SBRT isebenzisa umbane ophezulu kakhulu onikwe amandla kwindawo echanekileyo yesikhumba kwisilingo sokutshatyalalisa ngokupheleleyo indawo encinci yesisu (njengobindi okanye i-metastases yengqondo).
Ukuqapha kunye neendlela zokuPhila kweNdlela Xa Unesibindi seMetastases
Ukuqapha okufuneka uyenze ukuyithatha kuya kuxhomekeka kwisilinganiselo semastastases unayo isibindi sakho. Kwabanye abantu, i-metastases ziyabonwa ngokuskena kodwa iimvavanyo zentsholongwane zihlala ziqhelekileyo kwaye akukho zibonakaliso. Ngakolunye uhlangothi, abanye abantu banesicingo somsebenzi wesibindi esingaqhelekanga okanye iimpawu ezibalulekileyo ezinxulumene nomthwalo omkhulu wesisu kwisibindi.
Nangona unemigodi embalwa kuphela, ke, ukuqwalasela ezinye zezi meko kubalulekile:
- Ukusela utywala: Abantu abanesibindi esikhulu samathambo badla ngokucetyiswa ukuba bagweme utywala. Isizathu salesi sibini. Ukuba isibindi sakho asisebenzi ngokupheleleyo kwi-throttle, awuyi kukwazi ukuxilisa utywala njengokuba uqhelekile. Oku kungakhokelela ekwakheni utywala kunye nokuqhubekayo kwinkqubo yakho. Ukusuka ngombono ohlukileyo, siyazi ukuba utywala lunokuba yingozi kwiiseli zesibindi, kwaye ukongeza oku kwiiseli eziye zatshatyalaliswa zingonakalisa nantoni na isifo esiyingozi.
- Amachiza athatyiswa ngesibindi: Uninzi lwamachiza lunokuthi ludibaniswe (luphulwe phantsi) ngesibindi okanye kwiintso. Kukho ezininzi iinkqubo zokonyango kubandakanya zombini iyeza ezixutywe ngesibindi kunye nezinye zilungiswe zizifo. Xa olu khetho lufumaneka, ugqirha wakho uya kuncoma unyango oluthatyathwa yizintso (ngokungakhathaliseki ukuba ungenalo okungaqhelekanga kwimisebenzi yakho yezintso ngokunjalo). Xa unyango olujongene nesibindi kufuneka lusetyenziswe (njengamachiza amaninzi e-chemotherapy), umthamo ungadinga ukutshintshwa ngokusekelwe kwinqanaba lokungasebenzi kwesibindi.
- Ngaphezulu kwamalungiselelo kunye nokulungiselela izityalo: Kubalulekile ukuba uqaphele ukuba kukho ezininzi zokulungiselela kunye nokulungiswa kwamagqabhagqabha anesibindi kunye nesibindi. Umzekelo ubandakanya ngaphezulu kokunciphisa intlungu. I-Tylenol (i-acetaminophen) isetyenziselwa kwisibindi (kwaye kufuneka igwenywe kubantu abanesibindi sokungasebenzi) kanti amaninzi amaninzi angaboniyo-steroidal agent-inflammatory like Advil (ibuprofen) asetyenziswe ngokutsha ngeentso. Kubalulekile ukuba uqaphele ukuba kungekuphela nje ukulungiswa kwamanye ama-counter-a-counter ayingxaki ukuba unesifo sesibindi ngenxa ye-metabolism, kodwa ezinye izithako ze-vitamin kunye nezamaminerali zingaphazamisa i-chemotherapy , ngokunjalo.
Ukuxhalabisa / Ukulindela Ubomi be-Breast Cancer Eye isasaza kwisibindi
I-Metastase kwisibindi ixhepha kakhulu, kwaye ukusinda kunokuhluka kakhulu phakathi kwabantu abahlukeneyo. Ukulindela ubomi komhlaza wesifuba nesifo sesibindi ngaphandle kokuba unyango luphela nje kwiinyanga ezine ukuya kwezibhozo, kodwa abaninzi abantu bafuna unyango. Ngonyango, isilinganiso seminyaka emihlanu yokusindisa abantu abaneemastastas ezikude ezinxulumene nomhlaza wesisu ngama-23 ekhulwini.
Ngomnye umgca wembonakalo, kubantu abakhethwe ngokuchanekileyo abanesifo sesibindi samathambo (i-oligometastatic disease) esaphathwa nge-chemotherapy kunye ne-resection (okanye i-ablation) ye-metastase yesibindi, i-rates yokusinda iminyaka emi-5 ingaba phezulu kuma-40 ekhulwini.
Ukuxhalabisa kunzima kulabo abaneempendulo ezingalunganga kwi-chemotherapy kunye nalabo abanesifo se-estrogen-negative response.
Ngaphantsi kwiCanscer Breast nge-Liver Metasase
Nangona umdlavuza wesifuba usasazeke kwisibindi okwangoku awuphilwanga, ukhetho lwezokwelapha lufumanekayo olungagcini nje ukunciphisa iimpawu kodwa lunokunyusa kakhulu amathuba okuphila nesifo. Okwamanje siyazi kakuhle malunga neendlela ezisetyenziselwa i-metastases yesibindi kunezinye iisayithi zeemastastases, kodwa oku kunika ithemba lokuba amatsha amatsha kunye nonyango oya kufunyanwa kokubili ukunyanga nokuthembela ukukhusela i-metastases yesibindi kwixesha elizayo.
Ukujamelana ne-Canast Metastatic kwi-Myster
Ukufunda ukuba unomdlavuza wesifo semitha kunokuba kukutshatyalaliswa ngokupheleleyo. Ukuba unesifo somhlaza wesifuba esasesikhatyweni ngaphambili, zakho sele zijongene nesifo esingenako ukuphilisa, kwaye ngokufuthi sifuna uhlobo oluthile lonyango ubomi bakho bonke.
Hlalani nikhumbule ukuba nangona i-metastases, unyango luphucula. Njengoko kuphawulwe phantsi kweendlela zokonyango zesibindi sokuhlaselwa kwesibindi ngasentla, kukho iindlela ezahlukeneyo zokwelapha ezisetyenziswayo nangakumbi kwiimvavanyo zeclini. Kukho nethemba lokuba uphando olujongene nendima ye-microenvironment yomdlavuza kwisibindi iya kunika ezinye iindlela zokwenza unyango.
Kubalulekile ukuba ufunde ngomhlaza wakho kwaye ube ngummeli wakho ekunyamekelweni komhlaza wakho . Fumana kwiintsapho kunye nabahlobo uze ubavumele ukuba bancede. Ukubandakanyeka kwinqanaba leenkxaso okanye kwiinkxaso zentlalo ngokubhekiselele kubantu abanomdlavuza webele we-metastatic kunokuba luncedo olukhulu, kungekhona nje ekuboneleleni ngenkxaso-mvakalelo (ukukwazi ukuthetha nomntu "oye wahlala khona") kodwa ekunxibelelaneni Funda malunga nophando lwakutshanje. Thatha umzuzwana ukuba ufunde malunga neentlalo zoluntu kunye nomhlaza wesifuba , kunye neProjekthi yeCataltic Breast yeMastastism . Izifundo zisitshela ukuba ukuba yingxenye esebenzayo yeqela lakho lezonyango kukhokelela ekubandezelekeni okuncinci kwaye kunokukwenza umehluko isiphumo sakho. Uloyiko kwaye lukrakra ukuba ufunde ukuba unomdlavuza we-metastatic, kodwa kukho ithemba elininzi, kwaye zombini unyango kunye namazinga okusinda aphucula minyaka yonke.
> Imithombo:
> UCriscitiello, C., Andre, F., Thompson, A. et al. Ukuqinisekiswa kwe-Biopsy yeeMetastatic Sites kwi-Cancer Abaguli: Impembelelo yeCliniki kunye neengxaki zexesha elizayo. Uphando lweCascer Breast . 2014. 16 (2): 205.
> I-Golse, N. Intsholongwane yeMastastase Ukususela kwiCanscer Breast: Iyiphi Indima Yokuhlinzwa? Imiqondiso kunye neziphumo. Cancer Clinic . 2017. INGXELO: okanye / 10.1016 / j.clbc.2016.12.012.
> Ma, R., Feng, Y., Shuang, L. et al. Iinkqubo ezibandakanya kwi-Breast Cancer Liver Metasasis. Umbhalo weMicrosoft Medicine . 2015. 13:64.
> Weinrich, <., Wieb, C., Schuld, J., no B. Rau. Ukuxhatshazwa Kwebindi I-Metastasis Enesibindi Kwi-Cancer Breast: Iziphumo kunye Nezizathu Zokuxhoma Kweengxaki. HPB . 2014. ID 893829.