Iingxaki ezivela kuBucholo, i-Chemotherapy, iTradioation Treatment, kunye neNinzi
Ukuba uthetha kubantu abaninzi abanomdlavuza wesibeleko , uya kufunda ukuba ukujamelana nesifo kufaka ngaphezulu kunokulwa nomhlaza wodwa. Enyanisweni, iimpembelelo kunye neengxaki zomhlaza kunye nomhlaza wempatho zihlala zicelomngeni njengoko umhlaza ngokwawo. Yiyiphi imiphumo emibi kunye naziphi iingxaki ezinokuthi zenzeke xa uphathwa unyango lomhlaza webele?
Makhe sijonge iingxaki ezinxulumene nokuhlinzwa, i-chemotherapy, kunye neyeza zonyango, kunye "neengqondo" kunye neengxaki zentlalo onokuzifumana.
Imiphumo emibi kunye neengxaki
Kubalulekile ukuchasana nemiphumo emibi kunye neengxaki, nangona siza kuxubusha zombini. Imiphumo emibi yimpawu eziqhelekileyo kwaye zilindeleke. Umzekelo wempembelelo yecala ulahlekelwa yintlungu ngexesha le-chemotherapy. Iingxaki, ngokuphambene, aziqhelekanga kwaye azilindelekanga, nangona ziyaziwayo ukuba zenzeke ngamanye amaxesha. Umzekelo uya kuba kukuphuhliswa kwesifo senhliziyo okanye i-leukemia ngenxa ye-chemotherapy.
Nangona kunokwenzeka ukuba uya kuba nemiphumo emibi ephathelele unyango, khumbula ukuba abantu abaninzi abanakufumana naziphi na iingxaki ezingezantsi. Asifuni ukuba olu luhlu lukwesabise, kodwa nethemba lokuba olu lwazi luza kukuphawula ukuba kukho into engafanelekanga, ukuze ufune uncedo lwezokwelapha ngokukhawuleza xa kunokwenzeka.
Masiqale ngokujonga kwizonyango ezithile oza kuzifumana.
Iimpembelelo eziPhakathi kunye neengozi zokuPhengela
Ingaba unomastectomy okanye i-lumpectomy, ungalindela ezinye iziphumo ezibi. Emva kokuhlinzwa, uya kuba nesifo emva kweentsuku eziliqela. Ukuba unayo i-lymph node dissection, mhlawumbi uya kuhlonyelwa kwizandla zakho zengalo ixesha elithile.
Enyanisweni, utyando lithetha ukuba uya kuba nebala.
Iingxaki ezinokwenzeka, ngokuchaseneyo, zingaquka:
- Usulelo: Naliphi na ixesha umntu utyunjwa, kukho umngcipheko wee-bhakteria ezaziswa kwi-incision engabangela ukuba sulele. Udokotela wakho ugqirha uza kukucela ukuba ubukele naziphi na izimpawu, ezinjengomkhuhlane, ubomvu, okanye ukunyusa. Ukuba unesistim okanye i-lymph node esususwanga, unokuba neyodwa okanye iindawo ezincinci zokuhambisa. Ngeli xesha le mijelo inokunciphisa ezinye iingxaki, ingaba yindlela yokuba ibhaktheriya ingene emzimbeni wakho.
- Ukuphendula kwi-anesthesia: Uninzi lomhlaza webele we-breast isenziwa phantsi kwe-anesthesia jikelele, kwaye inomngcipheko omncinci weengxaki.
- I-Seroma: I- seroma yinto eqokelelwa kuyo amanzi apho indawo yakho isuswe khona. Injongo yamanzi iyakususa lo mkhuhlane, kodwa, nangomdaka, i-seroma ingase ivele ngezinye iimeko.
- I-Hematoma: Ukuba kukho indawo ekuqhubekeni kwakho okuqhubekayo kuphuma igazi, i-hematoma (ukuqokelela kwegazi) inokwenza.
- Amacandelo egazi: Ukuhlinzwa kuyingozi yokuphuhliswa kwamacandelo egazi kwimilenze yakho. Ukuba ungakhange uxoxwe, la maqhekeza angaphula kwaye ahambe emiphakeni yakho (i-pulmonary emboli). Nangona ingaqhelekanga emva kokuhlinzwa kwengqondo yomhlaza, ukunyuka nokuhamba nokukhusela ukulala ixesha elide kunokunciphisa umngcipheko wakho. (I-Chemotherapy iphinda ikhulise umngcipheko wegazi.)
Iingxaki zexesha elide zingabandakanya:
- Ihlombe elinyanzelisiweyo : Abanye abafazi bahlakulela ukunyanzeliswa kwemigudu emagxeni abo emva kokuhlinzwa kwengqondo yomhlaza. Ukuba ukunyuka kuncitshiswe ngakumbi, ungaphetha ngegxala eligcwebileyo. Ulwaphulo lwezonyango lusebenza kakhulu ekuphatheni le meko, kodwa ukukhusela kuhlale kukulungele. Abanye oogqirha bancomela ukuba abafazi babone umdlavuza webele womzimba (ikakhulukazi oqinisekisiwe kwinkqubo yeNkanyezi yokuvuselela umhlaza) emva kokuba baphilise ekusebenzeni, ukuba baqiniseke ukuba abanakho iingxaki.
- I-Lymphedema : I- Lymphedema yimeko apho izitya ze-lymph in the armpit zonakaliswe ngexesha lotyando. Kwenzeka ngokuphindaphindiweyo xa i-lymph node dissection yenziwe. Iimpawu ziquka ingalo enye evuvuke ngaphezu kwesinye. Ukukhetha udokotela ogqirha owenza inani elikhulu lomdlavuza webele lwebele uya kunciphisa umngcipheko, kunye nokunyamekela ukukhusela ukulimala kwingalo ecaleni lomdlavuza wakho webele. Ubuchule be-lymphedema yintoni eyenza ukuba ugqirha wakho akuxelele ukuba ugwebe ukuba negazi litsalwe okanye ukuba uxinzelelo lwegazi luhlolwe kwicala lomdlavuza wakho webele.
- Iziphumo eziphambene nezimonyo : Nangona kungekhona ukuxhalabisa ngokwenyama, iziphumo ezinononophelo ezingcolileyo zingabomngeni. Ukuba oku kwenzeka, kukho ezininzi iinketho ezininzi abantu abanokuzihlaziywa ngokuhlinzwa kwabo, kunye neendlela zokwakha kwakhona.
Iingxaki ngenxa yokuvuselelwa kwebele:
- Ukuhlaziywa kwakhona kubeka ingozi yeengxaki ezifana neyokuqala ukuhlinzwa ngomhlaza njengesifo sokusuleleka, ukuphuma kwegazi kunye negazi.
- Inkontileka yeCapsular: Imizimba yethu iyaqaphela ukuba kukho into engavumelekanga kwiisisu zethu, kwaye kaninzi sizama ukuluhlula udonga. Abagqirha beeplastiki baye bajonga iindlela zokunciphisa umngcipheko wesivumelwano se- capsular emva kokuvuselelwa kwebele. Xa kwenzeka, ukufakelwa kwebele kungabakho nzima, ukufuduka, kunye nethenda. Ukuba uhlakulela le meko, kunjalo, kukho uphando olungenziwa.
Iingxaki ezivela kwi-Chemotherapy
Imiphumo emibi yekhemotherapy iyaziwa kakuhle. Iimpembelelo eziqhelekileyo ziquka ukulahleka kweenwele, ukunyanzelwa komongo we-bone (kubangela izinga eliphantsi leeseli ezibomvu zegazi, iiseli zegazi ezimhlophe kunye neeplatelets), kunye neentlanzi. I-Chemotherapy iyabulala ngokukhawuleza iiseli ezinjengeeseli zeengqamzana, kodwa iiseli ezinweleni zezinwele zakho, umongo we-bone, kunye neendlela zokugaya ukutya ziyahlukana ngokukhawuleza.
Kuye kwaba nefuthe eliphambili ekulawuleni imiphumo emibi yechemotherapy kwiminyaka yamuva. Amachiza anikwayo anokuthintela ukukhwabanisa kunye nokuhlanza, kwaye unokufumana i-injection ye-Neulasta okanye i-Neupogen ukugcina inani lakho le-neutrophil (uhlobo lwe-white cell cell) ephakamileyo ngokwaneleyo ukunciphisa umngcipheko wakho wokusuleleka.
Iingxaki, kunye nemiphumo engapheliyo emva kokuba unyango lubandakanya:
- Izifo (i-febrile neutropenia): Izifo ezinzulu ziyakwenzeka xa inani lakho legazi elimhlophe liphantsi kakhulu kwaye lifuna unyango olunzima. Izifo ngenxa ye -neutropenia eyenziwa yi-chemotherapy yinto echaphazelekayo xa kukho unyango lwe-chemotherapy.
- I-peripheral neuropathy: I-peripheral neuropathy iyisiphelo esicasulayo-ne-needles feelings, kunye ne-numbness, ukuba abafazi bayayiqonda kwizandla zabo nangeenyawo. Ngelishwa, le nto inokuqhubeka ixesha elide emva kokonyango, nangona abaphandi bajonga iindlela zokunciphisa umngcipheko. Ngokuqhelekileyo kubangelwa "iirhafu" izidakamizwa ezifana ne-Taxol (paclitaxel).
- I-Chemobrain: Uluhlu olunomsebenzi wokuqonda, ezifana nokunciphisa imemori yesikhashana (ukulahlekelwa iitshixo zakho) kunye neengxaki ze-multitasking yinkxalabo yabasetyhini abathile (kunye namadoda) emva kwe-chemotherapy, kwaye sele iqulunqwe "i- chemobrain ." Le ndawo iye yafumana ingqwalasela eninzi, kwaye ezinye i-oncologists zikholelwa ukuba ukuqeqeshwa kwengqondo, nokuba ngaba yenza nje i-crossword puzzles, kunokunceda.
- Ukungenzi lutho. Ukungabi nalutho emva kokuba unyango lwemhlaza luqhelekile, kwaye abaninzi abafazi bayeka ukuhamba kwabo emva kwekhemotherapy. Kubafazi abaselula, amaxesha angabuya emva kwexesha, kodwa oku akusiqinisekiso sokuzala. Ukuba ucinga ukuba ungathanda ukukhulelwa emva kokuba uzalise unyango, khuluma ne-oncologist yakho ngaphambi kokuba uqale. Kukho iindlela ezikhoyo, ezinjengama-embrosi epholiweyo, avumela abanye abafazi ukuba babeleke nangona emva kokunyangwa komhlaza webele.
Iingxaki ezinzulu ngakumbi ziquka:
- Isifo senhliziyo: Isifo senhliziyo sinokuvela emva kwamashumi eminyaka emva kokufumana i-chemotherapy. Isiyobisi i- Adriamycin (doxorubicin) sinokubangela ukuba ukuhluleka kwentliziyo ku-1 ukuya kwezi-2 kwabasetyhini abafumana iziyobisi. Esinye isiyobisi esinokubangela iingxaki zeentliziyo ngu-Herceptin (trastuzumab) kunye nomsebenzi wakho wentliziyo kufuneka uhlolwe ngokusondeleyo ngelixa uthabatha. Uza kuba novavanyo lwentliziyo ngaphambi kokuba uqalise i-chemotherapy ukuze ufumane isiseko sokuthelekisa. Iimpawu zokuhluleka kwentliziyo ziquka ukuphefumula, ukunyamezela, ukunyakaza kwemilenze yakho, kwaye ngamanye amaxesha ukukhwehlela i-pink, liquidly frothy.
- Amachiza ekondlo afana ne-leukemia: Iziyobisi ze-chemotherapy ezisetyenziselwa umdlavuza webele zikwaziwa ngokuba ne-carcinogens (i-agent-causing agents). Nangona kunomngcipheko omncinci (1 kwi-100) wokuphuhlisa umdlavuza wesibili (ngokuqhelekileyo i-sarcoma okanye i-AML ye-myelogenous acute) okanye i-AML), iinzuzo ze-chemotherapy zihlala zidlula kakhulu ezi ngozi.
Kukho izinto eziqhelekileyo, kodwa iziphumo ezide zangexesha elide ze-chemotherapy .
Iingxaki ezivela kwi-Hormonal Therapy
Bobabini i-tamoxifen (yabasetyhini ababengaphambi kwe-menopausal) kunye ne-aromatase inhibitors (kubafazi be-postmenopausal okanye kubafazi be-premenopausal abanesifo soxinzelelo lwe-ovari) bangabangela ukutshisa okukhulu. Kukho umahluko phakathi kwezi zibini, nangona kunjalo, njengokuba i-tamoxifen ineempembelelo ezinjenge-estrogen kwezinye iiscuko kunye nemiphumela yokulwa ne-anti-estrogen kwabanye.
I-Aromatase inhibitors , ngokuchaseneyo, ukunciphisa ukubunjwa kwe-estrogen emzimbeni kwaye ngoko ezininzi iimpawu zizo zokungabikho kwe-estrogen. Amayeza ahlukaniswe njenge-aromatase inhibitors afaka i-Arimidex (i-anastrozole), i-Femara (i-letrozole) kunye ne-Aromasin (i-exemestane).
Ezi zombini iindidi zonyango zingabangela ukutshisa okutshisayo, ukomama wesisu, kunye nokuphazamiseka. I-Tamoxifen inokubangela intlungu ye-muscle, kodwa i-aromatase inhibitors iyaziwa ngokubangela iintlungu zesisundu kunye kunye kunye kunye nesiqingatha sabantu besisebenzisa imithi. Kwimeko elungileyo, zombini iindidi zamachiza ukunciphisa umngcipheko wokuphindaphinda umdlavuza webele. Kwaye, ukuba ezo ziphazamiso ezitshisayo zikuqhubela nje ukuphosa nje, unokukhululeka ukwazi ukuba kukho i-silver lining, kunye nokutshisa okutshisayo kudibaniswa nemilinganiselo ephezulu yokuphila kubantu abasebenzisa unyango lwe-hormonal.
Iingxaki ezivela kwi-tamoxifen zingaquka:
- Umhlaza wesibeletho: Ngokungafani nezicubu zesifuba, i-tamoxifen ingakhuthaza i-uterine (i-endometrial tissue). Ngokutsho kwe-American Cancer Society, umngcipheko wesifo somhlaza wesifo somhlaza siphantsi, malunga no-1 ngo-500 emva kweminyaka yobudala engama-50, kwaye iyakwazi ukufunyanwa kwinqanaba lokuqala xa kwenzeka. Uphawu oluqhelekileyo luyigazi lokuphuma kwamanzi.
- Amacwecwe egazi: zombini igazi elimilenze emilenzeni (inzulu ye-vein thrombosis) kunye ne-pulmonary emboli (iingubo zegazi eziya emiphakeni) zingenakwenzeka ngokuqhelekileyo.
- I-Cataracts: Ngenhlanhla, i-cataract ilula ukuyiphatha kunye nokuhlinzwa.
Iingxaki ezivela kwi-aromatase inhibitors zingabandakanya:
- I-Osteopenia kunye ne-osteoporosis. I-Aromatase inhibitors ibangela ukulahleka kwethambo, kwaye kaninzi kuphuka ngenxa yokulahleka kwethambo emgodini, emlonyeni, nakweminye imimandla. Ukongezwa kwangoko kwe-bisphosphonates (njengeZometa) kwonyango kwabanye abafazi kunokunciphisa umngcipheko kwixesha elizayo.
- Iingxaki zeentliziyo. Iziphazamiso zentliziyo ezifana neengxaki zentliziyo, iingxaki zentliziyo ye-valve, kunye ne-pericarditis zixhaphake kakhulu kubasetyhini kwi-aromatase inhibitors, kodwa akukho mngcipheko weengxaki ezinzulu kunye nobomi obufana nokuhlaselwa kwintliziyo kunye nokubetha.
Iingxaki Ezivela Kwiyeza Zonyango
Ukusetyenziswa kweyeza ngokuqhelekileyo kusetyenziswa ngokulandela i-lumpectomy, okanye kwabasetyhini abane-mastectomy ne-lymph nodes. Iziphumo eziqhelekileyo ziquka ubomvu kunye nokuxhala.
Iingxaki zonyango lwamayeza zingabandakanya:
- Izifo: Ubomvu kunye nezibhanti zingaba ngumphumo wecala oqhelekileyo, kodwa izilonda ezivulekileyo zinokunyusa umngcipheko wokuhlawula isifo esinzulu. Abo bafumana imirhumo emva kokuhlinzwa ngokutsha ngokukhawuleza kunomngcipheko omkhulu wokuhlawula isifo.
- I-Fibrosis: Utyando lwe-radiation lushintsha ukubunjwa kwesikhumba ukuze kungabi lula. Oku kungakhokelela ekutshintsheni kwiisifuba zakho zebele (fibrosis), kunye nekhontrakthi ye-capsular ukuba uye waqala ukuvuselelwa kwakhona. I-radiation ingabangela ukuvuvukala kwimiphunga (i-radiation pneumonitis) engakhokelela kwi -fibrosis ye-pulmonary .
- Isifo senhliziyo: Ukunyanga kwamayeza kunokuyonakalisa intliziyo, nangona iiphilisi zemilambo zizama ukulungelelanisa umbane oya kufumana ukunciphisa ukuvezwa kwentliziyo yakho. Inkqubo entsha ebizwa ngokuthi ukuphefumula kunokunciphisa ukuvezwa kwentliziyo kwimisebe ngakumbi, ngokusebenzisa ukuphefumula okulawulwayo. Ukudibanisa iziphumo ezinxulumene neentliziyo zemisebe kunye nokuba ngenxa ye-chemotherapy kufuneka kuqwalaselwe. Abanye abane-oncologists bakholelwa ukuba abafazi abaye bafumana le mizimba (ngokukodwa ukudibanisa i-chemotherapy ne-Adriamycin kunye ne-radiation emva kwe-mastectomy) kufuneka babonane ne-cardiologist, ngakumbi ukuba bahlakulela nayiphina impawu ebonisa ukuba isifo senhliziyo.
Kukho izinto ezincinci kodwa ngokubhekiselele kwimiphumo yecala lexesha elide lolwaphulo lwe-radiation , njengokwenyuka kweemeko zamaphapha kunye ne-esophageal. Nangona amaninzi amaninzi inzuzo yonyango lwe-radiation iphakamisa umngcipheko walezi ngxaki, uhlolo lwe-2017 lucebise ukuba kubasetyhini abashunayo, ingozi yomlilo kunye kunye nokutshaya ingaba ngaphezu kweenzuzo. Abo bashiya umsila kufuneka bayeke phambi kokuba unyango lwe-radiation, kwaye ukuba akunakwenzeka, kufuneka bathethe ngokucophelela nge-radiation yabo ye-oncologist malunga nobulumko ekwenzeni imisebe.
Iingqondo zengqondo / Iimpawu zentlalo kunye neengxaki
Ukufunyaniswa ukuba nomhlaza wesifuba kukuguqulwa kwengqondo. Uphando lubonisa ukuba akunandaba ukuba unesifo esincinci kakhulu esinokuphilisa, okanye i-tumor enkulu, ehamba phambili; ukufumana ukuxilongwa kwegama elithi "C" utshintsha ubomi bakho ngemizuzwana.
Ubudlelane budla ngokutshintsha, kwaye abahlobo abasondeleyo basenokusondela, ngelixa abanye bakho ubuhlobo obusondeleyo buya kuhamba. Wonke umntu uhambisa umdlavuza kumntu othandekayo ngendlela eyahlukileyo.
Ngamanye amaxesha umhlaza uholela ekudakaleni, kwaye izinga lokuzibulala liphezulu kubantu abanomhlaza kunabantu bonke. Ukongeza le mvakalelo ekukhathala komhlaza , kwaye ukujamelana nomhlaza kunzima.
Sifunda ukuba inkqubo enenkxaso yoluntu ibalulekileyo ngokwaneleyo ukuba idibaniswe nokusinda komhlaza wesifuba, kwaye kufuneka iqwalaselwe ngokubhekiselele kwizinto ezinokukhathazeka ngokomzimba onokuba nazo. Abantu abaninzi bafumanisa ukuba ukuthetha nomncedisi kunceda ngexesha lokuhlengahlengiswa. Qiniseka ukuba uthetha ugqirha ukuba unobunzima bokujamelana.
Ukunciphisa Ingozi Yakho Yeengxaki
Kubalulekile ukuba uqaphele ukuba kukho izinto ezininzi ongayenza ukuze unciphise umngcipheko wakho wokuhlakulela iingxaki ngexesha lokuqala unyango lomhlaza webele.
Ukuba ubhema, shiya. Ukubhema kukuphazamisa ukuphulukiswa kwesilonda kwaye kwandisa ingozi yokusuleleka (kunye nayo yonke into ehamba kunye nesifo). Kwakhona kwandisa nantoni na isifo sengqondo ngenxa yonyango.
Ziqhelise ukuthintela ukuthintela ukuthintela ngexesha le-chemotherapy . Nangona ufumana iyeza ukuba ugcine igazi lakho elimhlophe liphezulu, qaphela ukuba uhlambe izandla zakho, ugweme iindawo ezininzi kunye nokuhlala kude nabantu abagulayo.
Hlala uqhelana nophando olusandul 'umdla ngomhlaza webele. Xa abantu abaninzi besaphila, sifunda ngakumbi malunga nexesha elide elichaphazelekayo kunyango, kwakunye nendlela yokunciphisa umngcipheko.
Qaphela umzimba wakho kunye naziphi na izimpawu onayo. Uninzi lweengxaki ezinokuthi unyango lwebele lwentliziyo lunonyango, kwaye unyango lubonakala lunempumelelo xa luqala ngokukhawuleza kunokuba ludlule.
Ukubuyiswa komhlaza
Xa kunabantu abaninzi basinda umdlavuza, sifunda ukuba abaninzi abasindiswa ngumhlaza bajongana nemiphumo emiselweyo yonyango. Kwiminyaka yakutshanje, inkqubo isetyenzisiwe ebizwa ngokuba yiNkqubo yeNkwenkwe yoLungiso lweCarcer. Le nkqubo ngoku ifumaneka kumaziko amaninzi emhlaza. Yenzelwe ukunciphisa nayiphi na imiphumo emide yomdlavuza, kwaye unokunceda ukujongana nayiphi na impawu yenyama okanye yeemvakalelo ezikugodla ebomini bakho "obuqhelekileyo".
ILizwi
Ukujonga uluhlu lweengxaki ezinokuthi unyango lwemhlaza, ngaphezu kweemiphumo ezingalindelekanga, lunokubangela ukwesatshiswa. Khumbula ukuba ezi ngxaki aziqhelekanga, kwaye unako ukufumana unyango lwakho ngaphandle kokufumana ezininzi okanye ezinye zazo. Umgca, nangona kukho iingozi, ngaba iifundo zifumene ukuba izibonelelo zonyango ngokugcina umhlaza wakho kude kunzima kakhulu.
> Imithombo:
> I-American Society of Clinic Oncology. Cancer.Net. Izinketho zokwelapha umdlavuza webele. Updated 04/07. https://www.cancer.net/cancer-types/breast-cancer/treatment-options
> Hurria, A., Woza, S., noL. Pierce. Iipatheni zokubuyela kwiNkcazo kunye neNkxaso yexesha elide leNyango kwiBaster Brever. UpToDate . Ukuhlaziywa 08/15/17.
> Rakhra, S., iBethke, K., Strauss, J. et al. Izinto ezinobungozi ezibangela iingxaki kwiCatter-Stage Cancer Breast Ukulandela Unyango Wokulondoloza Ubomi kunye ne-Intraoperative Radiotherapy. I-Annals ye-Oncology yokugada . 2017. 24 (5): 1258-1261.