Ugqirha olugqibeleleyo kunye neSigaba III kunye neNqanaba IV le-Ovarian Cancer
Kuthetha ntoni "ngokugqibeleleyo" kwindlela yokutshintshela okanye ukuhlinzwa ngokunyanzela umdlavuza we-ovarian?
Ukukhutshwa okanye ukuChengetwa kweDevelopment
Ukuba uye wenziwa utyando lwe-ovarian advanced cancer, enye yeyona mibuzo ebalulekileyo ukuyibuza ugqirha wakho ukuba ingaba ukungahlawulwanga okanye ukuchithwa kwe-cytoreduction kwakulungile. Ngamanye amazwi, uninzi lwe-tumor isuswe?
Yiyiphi "efanelekileyo" yokutshintshisa okanye ukuxhatshazwa
Akusoloko kusetyenziswa ngokusemthethweni ukususa uninzi okanye yonke umdlavuza obonakalayo ngexesha lotyando lomhlaza we-ovarian. Nangona kunjalo, siyazi ukuba ukudibanisa utywala kunye ne-chemotherapy kuye kwakhokelela kwizinga eliphezulu lokunyanga elingaphezu kweminyaka engama-20. Kule minyaka, uhlobo lwe-chemotherapy luye lwatshintsha kwaye kunjalo nencazelo yokuba utyando okanye "uphando" lungenza okanye lufanele.
Ngoku kutshanje nje kwiminyaka eyi-10 eyadlulayo, inkcazo ye "ophambili" yokuhlinzwa yayingu-tumors engekho ngaphezu kweeyentimitha ezimbini ezishiywe ngasemva (malunga ne-¾ yesentimitha). Le nto inokuba yinye, okanye ezimbini okanye izihlamba ezininzi, akukho nanye yazo eyadlula ngaphezu kweesentimitha ezimbini ngobukhulu.
Ngezixhobo ezingcono kunye nobuchule bokugqirha, ngoku siyazi ukuba kunokwenzeka ukuba ubugcisa becala "buyeke" ukushiya ngaphantsi kwe-1 centimeter tumors, ukuya kwi "miliary" (ininzi "yesihlabathi"). kunye nezifo ezincinci (akakwazi ukuzibona okanye uziva emva kokuhlinzwa) kwizigulane ezininzi.
Isimo sakho soPhezulu seMpilo senza umehluko
Akubona zonke izigulane ezidalwe ngokomzimba. Kwezinye iimeko, isigulane sinokuguga kakhulu okanye sigula ukunyamezela iiyure ezingama-4-8 ezingathatha ukuphumeza iziphumo "ezifanelekileyo". Kwakhona, ukuphuma kwegazi okanye ezinye iingxaki kunokunyanzelisa udokotela ogqirha ukuba ayeke ukuhlinzwa ngaphambili kunokuba babekuthanda.
Kwiimeko ezininzi, akuyiyo iminyaka ngokwalo kodwa kunoko iziganeko zonyango ezongezelelweyo ezinokuthi zithatha ixesha elingakanani ukunyamezela.
Ngubani Ogqirha Wakho Owenza Umbahluko
Akunabo bonke oogqirha abadalwa ngokulinganayo. Oku kuyinyaniso kuzo zonke izakhono kunye nazo zonke izakhono zonyango. Ngaphandle kwimizimba ye-oncologists - abo bafanelekile ukuba basebenze kuwe ngenxa yomhlaza we-ovarian - kukho umehluko kwizakhono. Bonke baqeqeshwe kwisinqumo esifanelekileyo kwaye abaninzi banokwenza i-cytoreduction ukufezekisa u-1-2 cm we-"cm" yokuhlinzwa ngokugqithiseleyo kwininzi yezigulane zabo. Okona kuncinci qinisekisa ukuba i-oncologist ye-gynecological is, okanye yayibandakanyeka ekusebenzeni kwakho.
Ngaba Ndiyadinga Okugqithiseleyo Kangakumbi?
Uphando lwezonyango lubonise ukuba ngaphezulu kususwe ngcono xa kufikelelwe ekutyunzeni umdlavuza we-ovari. Akukho ngongoma ngaphaya kokungekho nzuzo engongeziweyo. Nangona kunjalo, ngamanye amaxesha ukufikelela kwi-miliary okanye i-microscopic isifo sidinga ukuhlinzwa ngokugqithisileyo, kubandakanye ukususa iinxalenye zesibindi, i-pleen, imiphunga, indawo ezininzi zeembilini, i-lymph nodes kwiindawo ezinzima nangaphezulu. Akunabo bonke abagulane abanokunyamezela le nto kwaye akubona bonke oogqirha abakhululekile ukuqhuba le nkqubo.
Abanye baye bathi le ngonyango "ye-ultra" -i-cytoreductive operation, apho iinjongo kukufezekisa i-microscopic ukuya kwi-miliary ("isanti").
Ngaphambi kokuqhubela phambili, oku kufuna inkcazo enzulu kakhulu / inzuzo kwingxaki yakho ye-oncologist. Ukuba unquma ukuvumelana nalo mgangatho wokuhlinzwa, khumbula ukuba akubona bonke oogqirha abaqeqeshiwe, okanye benze iimeko ezifanelekileyo zokuvotela olu hlobo, ukuze bafezekise ngokukhuselekileyo le milinganiselo eyongezelelweyo "yokugqithisa". Ngokwahlukileyo, abanakho ukukholelwa ukuba le nqanaba elongezelelweyo lotyando liyilungelelaniso yezigulane zabo. Nangona iimbono ezigqithisileyo zikhona, le ndawo igrey kwiincwadi zonyango.
Ngaba i-"Ultra-Radical" Cytoreduction Proven?
Ezinye iingcali zigcina ukuba ukuba "uphando" olunzulu lufuneka ukuba ufikelele "ekugqibeleni" ukuhlinzwa, oku kuthetha ukuba kwimeko yesigulane umhlaza unobundlobongela.
Ngoko, banomuvo wokuthi ukuhlinzwa okongezelelweyo akukho nto kuphucula amathuba okunyanga. Inyani le nto kukuba, ngelixa le nto inokuba yinyaniso kwezinye izigulane, asiyazi nje ukuba zeziphi izigulane ezithethwa ngexesha lotyando, okanye emva kokuhlinzwa.
Uphando olushicilelwe lubonisa ukuba abanye abafazi bancedwa ngaphezu kweminye kwindlela yokuhlinzwa ngokugqithiseleyo nokugqithiseleyo. Amanqaku anomhlaza ahlukeneyo ahlukeneyo kwi-chemotherapy, engathembekiyo ngokuqinisekileyo. Ezinye izigulane ziphiliswa. Ezinye azinjalo.
Liyisela ugqirha ukwenza isigqibo sobuchule ngexesha lotyando malunga nokuba uhamba kangakanani na ukuhlinzwa ngokusekelwe kwinto eyenziwa ngokusemthethweni kwaye ukuba bacinga ukuba unokunyamezela ukuhlinzwa okuqhubekayo. Oku kunokwakheka ngokuxhomekeke kwisicatshulwa ngokubhekiselele kwintlungu yesifo somhlaza wakho.
Gcina ukhumbule ukuba ngezinye iimeko, akunakwenzeka ukuba ufikelele kumgangatho ophezulu "ophezulu" ngaphandle, umzekelo, ukususa onke amathumbu, okucacileyo ahambelani nomgangatho wobomi obuhle. Ngokufanayo, njengoko kushiwo ngaphambili, kwezinye iimeko imeko zonyango okanye iingxaki ezingenakunyango zinganqanda ukuyeka ukuhlinzwa ngaphambi kokuba kucetywe okanye kuyifunwe. Kodwa kukho umehluko, endiyethembayo ukuba uqala ukuyiqonda, phakathi kobuchule "obungenakwenzeka" kunye nomgwebo okanye ukungafumaneki kwezakhono zobugcisa.
Ukuba kunokwenzeka, kubalulekile ukuxoxa ngengqondo yakho ye-oncologist malunga neengxaki ezingasentla NGAPHAMBI kokuhlinzwa. Kwakhona, unako okanye ungagqibeli ukuba uluvo lwesibini lufunwa. UFANELE uhlakulele ulwalamano oluhle kunye ne-gynecologic oncologist ozikhethayo. Nangona ndiza kukukhuphaza ngamandla ukuba ungabonakali ngethengisa ugqirha, ukuba olu lwalamano lusekho, thola ugqirha ukuba unokuhlakulela olu hlobo lolwalamano.
Kuthiwani NgeSigaba 4 I-Ovarian Cancer?
Amagama ambalwa ngokuphathelele umdlavuza weSigaba IV (4) ubalulekile. Kwixesha elidlulileyo, kwakucatshangelwa ukuba ukuba umdlavuza we-ovariya ubonakala kwindawo yomphunga okanye kwintsholongwane okanye ipeni, ukuxela kwangaphambili kwakubi kakhulu kangangokuba ukuhlinzwa kwakungeke kuncede kakhulu. Uphando olutsha lubonisa ukuba, ngelixa imeko nganye ihluke, oku kungenakwenyaniso. I-prognosis ingaba yimbi ngakumbi kuneSigaba III, kodwa kwiimeko ezininzi, ukuchithwa kwe-cytoreduction enobugwenxa kufuneka kusekho ingqwalasela ngokucacileyo ukuba isakhono sinobuchule, ukuba isiguli siyayiqonda ingozi kunye nokuxhamla kwaye ukuba bayakwazi ukunyamezela. Ukuba utyando "lulungele", ukuhlaziya isenokuphucula kakhulu kwaye kuza kufutshane neziphumo ezibonwe kwiSigaba III.
Isishwankathelo soPhando lwe-Cytoreductive Surgery
Ngokuqhelekileyo, isilungiso esiphezulu sokwenzeka kwonyango kwi-Stage II ukuya kwi-IV yomhlaza ngumlinganiselo apho "i-cytoreduction" iphumelele ngayo. Kule minyaka, ubunzima obunamandla bobugqirha (amaninzi amanqaku ezobugcisa) axhasa ukukhenksa umhlaza omkhulu kangako ngaphambi kokuba uphethwe yi-chemotherapy. Kukho iingcamango zezinto eziphilayo, andiyi kuhamba ngeenkcukacha ngokuphathelele, ezixhasa iinjongo zokutshintshisa ubuqili ekuphuculeni i-chemo-response.
Ngokwenene, utyando lwenza kube lula ukuba i-chemotherapy isebenze ngokunciphisa inani lamaseli aphethwe yi-chemotherapy (kwiibhiliyoni / izigidigidi ukuya kumawaka / amashumi amawaka ...... okanye mhlawumbi ngaphantsi ukuba akukho nto ibonakalayo engabonakaliyo). Utyando luyabangela ukuba zonke iiseli ezishiywe ziqale ukuhlula ngexesha elifanayo (ukuhlukana kukuthi zikhula njani), okwenza kube lula ukuba i-chemo iwabulale ngexesha elifanayo kwi-lifecycle yabo.
Ukunikezela ngolu lwazi, ukuba awuzange ube ne "optimal" eyenziwe nge-cytoreduction eyenziweyo, ingxubusho / ingxubusho yengxowa kufuneka icingelwe malunga nokusebenza kwesibili ukugqiba lo msebenzi. Imiba ibandakanya izizathu zobuchwepheshe kunye nezokwelapha "zokusesikweni esiphezulu" kwindlela yokutshintshwa kwendawo yokucwangcisa, ukuba kukude kangakanani neyona nto ibaluleke kakhulu "ephezulu" sele ukhona, uhlobo lwe-chemotherapy olucwangcisayo, ixesha elide lidlulileyo ukususela ekutyunjweni kokuqala kunye nezinye izinto .
Ngokuqhelekileyo, ingxoxo malunga nolunye utyando lunokuba lunzulu xa kuqhathaniswa nokuhlinzwa okwangoku ngenxa yokungabikho kobuchule, okanye ukungabikho kwengqondo ye-oncologist. Ngokomzekelo, ukuba unokuhlinzwa okwakubaluleke kakhulu kwii-biopsies kuphela, utyando olongezelelweyo lunokuba lunengqiqo. Nangona kunjalo, kufuneka uqwalasele indlela iplato ye - chemotherapy ehambelana ngayo nomfanekiso jikelele.
Imfundo, inkxaso kunye noXhotyiso
Bhala uluhlu lwemibuzo yokubuza i-oncologist yakho ye-gynecological . Yizisa umhlobo kunye nawe - kubonakala ngathi ukuba nomnye umntu kukunceda ukuba uve konke okutshoyo. Thatha umqaphela. Khangela inkxaso ye-ovarian kunye nenkcazelo ye-intanethi. Uze uthole uluvo lwesibini ukuba awuyiyo i-100% eyiyo yezinto ozikhethayo. Akukuphela nje ukuzimela njengomgulane wesigulane kukubeka kwisihlalo somqhubi-kodwa kwabanye abantu abaneengqungquthela ezithile, kuboniswe ukuba kuphuculwe ukusinda.
Imithombo:
Chern, J., noJ. Curtin. Iingcebiso ezifanelekileyo zoLondolozo lwe-Debulking kwiSigaba IV se-Ovarian Cancer. Izinketho zamanje zonyango kwi-Oncology . 2016. 17 (1): 1.
Chiva, L, Lapuente, F., Castellanos, T., Alonso, S., no-A. Gonzalez-Martin. Yintoni esifanele siyilindele emva kokupheliswa kwe-Cytoreduction epheleleyo kwixesha lokuPhepha okanye ukuPhepha koPhando oluPhambili kwi-Cancer Advanced ye-Ovarian? I-Annals ye-Oncology yokugada . 2015 Dec 29. (Epub ngaphambi kokuprinta).
Liu, Z., Ibhitshi, J., Agdjanian, H. et al. I-cytoreduction ehamba phambili kwi-ovarian carcinoma idibene neendlela zamathambo ezinomsebenzi wokunyuka kwe-stromal activation, Gynecologic Oncology . 2015. 139 (9): 394-400.
Vidal, F., Al Thani, H., Haddad, P. et al. Isiphi isimo sokuPhepha esiKhethekileyo ekukhetheni kwi-Context of Non-Resetability ye-Ovarian Carcinomatosis: Ngaphandle kweengxaki eziPhezulu zeMpilo eziPhezulu. I-Annals ye-Oncology yokugada . 2016. 23 (2): 434-42.