Iingxaki zeNqanaba 4 I-Cancer Breast
Ukuba uhlala nomhlaza wesifuba esiphambili (imastastasi okanye isigaba 4) mhlawumbi awuhlali ujabule ukuva malunga neengxaki ezinokubakho. Emva koko, akuyiyo impawu okanye umhlaza wakho kunye nemiphumo emibi yonyango elaneleyo? Ngenhlanhla, ngokungafani neziphumo eziqhelekileyo ezichaphazelekayo, ezi zinto zinzima kakhulu, kwaye awukwazi ukufumana ezininzi, nokuba nazo naziphi na ezi ngxaki.
Makhe sijonge ezinye iingxaki ezinxulumene nesayithi yeemetastase, zilandelwa ezinye zeengxaki onokuzifumana ngomhlaza wesibeletho se-metastatic (isigaba se-4 somhlaza wesifuba) ngokubanzi.
Imiphumo emibi kunye neengxaki
Kubalulekile ukwenza ukuhlukana ngaphambi kokuqala. Mhlawumbi uqhelana nemiphumo emibi yonyango lwebele lwebele, ezifana nokulahleka kweenwele kunye ne-chemotherapy, okanye ukukhathala ngemisebe. Ngenjongo yengxoxo yethu siya kujonga kwimiphumo emibi njengeziganeko eziqhelekileyo ezilindeleke.
Ngokwahlukileyo, iingxaki ziingxaki ezinokukuthabatha, kwaye ukuba awuzange ulive ngaphambi kokuphila nomhlaza. Kwakhona simele sigxininise ukuba abaninzi abantu abanakho konke (okanye nakweyiphi na) yezi ngxaki, kwaye sinethemba lokungadikibanga nabani ngokubhala uluhlu lweengxaki. Oku kuthethi, ezininzi zezinto zilapha, kwaye unyango lubaluleke kakhulu xa ziqaliswa ngokukhawuleza kunokuba zenzeke.
Kwezinye iimeko, ukuqonda inkxalabo ngaphambi kwexesha kunokuthintela iingxaki ezinkulu, kwanokukhubazeka okanye ukufa.
Iingxaki eziqhelekileyo zeMastastatic Breast Cancer
Kukho iingxaki eziqhelekileyo ezinxulumene nomdlavuza webele weemetastatic ezithwala umngcipheko kungakhathaliseki ukuba umhlaza wakho usasazeke kangakanani, okanye uhlobo lwezo unyango olulandelayo okanye olwamkelayo ngoku.
Ezi ziquka:
- Iingubo zokuvala igazi: Izinto ezinobungozi kumabhodlela egazi ziquka ukuba nomhlaza wesifo semitha, ezinye zezokwelapha (ezifana ne-chemotherapy) yesifo, indawo yokulala, nokunye. Sifunda ukuba igazi elivuthayo nomhlaza liqhelekileyo, kwaye kubangela ukugula okukhulu kwaye ngamanye amaxesha nokufa. La macala amaninzi aqala kwimilenze okanye kwi-pelvis (i- vein thrombosis ) enokuthi aphule aze ahambe emipapeni ( embolism embolism ). Iimpawu zokuba wazi ukuba ziquka ubomvu, ukuvuvukala, okanye ukunyameka kwemilenze yakho, ukuphefumula ngokukhawuleza, ukuphuphuma kabuhlungu kwesifuba, ukukhawuleza, okanye ukungazi. Xa kubanjwe ngexesha, i-blood thinners ingasetyenziselwa ukuxazulula i-clots.
- Ubuhlungu: Ubuhlungu benomhlaza wesi-metastatic buyahluka kwaye kaninzi buxhomekeka kwindawo yokuhlaselwa kwesifo se-metastatic (jonga amathambo asezantsi). Siyazi, nokuba kunjalo, ukuba intlungu ingaphazamisa umgangatho wobomi, kwaye umgangatho wobomi yinjongo ephambili ekuphatheni umhlaza wesigaba 4. Thetha ugqirha wakho ngokulawulwa kwintlungu kubantu abanomdlavuza . Kukho iindlela ezininzi ezahlukeneyo ezikhoyo, kwaye abaninzi abantu, nangona isifo esiqhelanisiweyo sesigxina, sinokukhululeka.
- I-Cachexia: I- cachexia yomhlaza yinkinga enzima ngumhlaza ophezulu. Yisifo sengxaki yokulahlekelwa ngumzimba, ukuchithwa kwemizimba kunye nokunciphisa ukutya. Iyanciphisa umgangatho wobomi kwaye ivakalelwa kukuba iyona nto ibangela ukufa ngenxa yeepesenti ezingama-20 zabantu abanomdlavuza. I-syndrome ye-cachexia, nangona eyaziwayo ngokulahlekelwa kwesisindo, ibonakala iqala ngaphambi kokuba ilahleko ilahlekelwe. Kukho uphando olubalulekileyo kwinkqubo yokukhangela iindlela zozo zombini zothintela uphinde uphathe i-cachexia. Ukuba unenkxalabo yokulahlekelwa ngumdla , okanye ulahlekelwe isisindo, khupha oku kunye nogqirha wakho. Ukuxhomekeka, ukusetyenziswa ngokufanelekileyo kunceda. I-Cachexia enye uphawu lomhlaza obonakala ngathi uncedwa kakhulu ngonyango yonyango ukuba oku kusemthethweni kwimeko yakho.
Iingxaki ezinxulumene neT Bone Metastases
Amathambo yindawo eqhelekileyo apho umdlavuza webele usasazeka khona. Inkqubela ayiyenziwa kuphela ekuphatheni le mizila kodwa ukhangele iindlela zokuthintela i-metastases yamathambo kwindawo yokuqala. Kwalabo abanomdlavuza wesibeleko kunye namathambo e-boneastases , izidakamizwa ezitsha zokutshintsha amathambo ezifana ne-bisphosphonates kunye ne-denosumab zinganciphisa ingozi yeengxaki ezinjengeziqhekeko. Imiba enokwenzeka kunye neethambo zesistim ziquka:
- Ubuhlungu: Intlungu ngenxa ye-boneastas i-boneastas inokuba yinto ebalulekileyo, kwaye siyazi ukuba intlungu iyanciphisa umgangatho wobomi bomntu. Ngexesha elifanayo, amaninzi amayeza esinayo ngenxa yobuhlungu obukhulu kubangela ukukhathala nokulala. Ukongezelela ekusebenziseni amayeza enhlungu, unyango lwe-radiation lusebenza kakhulu ekunciphiseni intlungu ngenxa yale mizila. Izidakamizwa eziguqula umzimba azinciphisi ubuhlungu kwizinga elifanayo, kodwa ngokubambisana nale ingentla ziyanceda (kunye nezinye izizathu).
- Ukuphulwa kwegazi: I- fragrance pathological occurs xa ithambo liphuka (ikhefu) ngendawo ebuthathaka. Ngokuxhomekeka kwindawo leyo, ukuphulwa kwelo hlobo kunganciphisa kakhulu ukuhamba.
- Ukunyanzeliswa kwentambo yomtya: Xa i-boneastas i-boneast ivela kwintlambo engaphantsi, inokubangela ukuba umgudu uphawulezele kwaye ucinezele kwiimbilini ezibalulekileyo ekusizeni ukuhamba, ukuvuthwa, nokugqithisa amathambo ethu. Ifom enkulu kakhulu "ye-microfractures" emgodini ungakhokelela kwi-vertebrae emhlane emva kokuwa phantsi kwabo, i-contraction break. Xa umhlaza wesininzi kule ndawo kubangela ukunyanzeliswa kwemizwa, iimeko ezixakekayo zonyango ezibizwa ngokuba yi-cauda equina syndrome zenzeka. Ngaphandle kokunyanga okukhawuleza ukuzinzisa intambo yomgogodla, umntu unokuphela ekukhubazekileyo kwimida engezantsi ngaphezu kokungakwazi ukumbamba isisu okanye amathambo.
- Hypercalcemia . Xa i-tumor iphula i-bone, ibangela ukukhululwa kwe-calcium kwigazi, imeko ebizwa ngokuba yi- hypercalcemia yesifo . (Kukho nezinye iindlela zomhlaza ongakwandisa ikhalsiyamu kunye negazi). Ekuqaleni, oku kunokubangela isicarucu kunye nokuhlanza, ukwanda ukoma, ubuthathaka, kunye nemisipha yomzimba, kodwa kunokuqhubela phambili ukudideka, izitho zentliziyo ezingavamile, i-coma, nokufa.
Iingxaki ezinxulumene ne-Lung Metastases
Imiphunga yindawo yesibini eqhelekileyo apho isifo somhlaza wesifuba sisasazeka khona, kunye neemiphunga zamaphaphu zenzeka ngethuba elithile kwisantya sabantu abanomdlavuza webele. Iimpawu ziyakwazi ukuhluka kumnye (xa i-lungast metastases ifumaneka kwi-scan kuphela), ekuphefumleleni okufutshane. Ukongezelela kwonyango oluqhelekileyo lomhlaza wemiphunga yamathambo, unyango lwangoku lusetyenziselwa abantu abathile abaneempawu ezimbalwa zeemiphunga, kwaye oku kubonakala kukuphucula ixesha lokuphila. Iingxaki ezinokwenzeka zeemiphunga zamaphaphu ziquka:
- Ukuphefumula okufutshane: Ukuphefumula kufumaneke ukulawulwa ngamachiza afana ne-morphine. Ukuba isithintelo sikhokelela ekuphefumla okufutshane, i-stent ingafakwa. Okumangalisa kukuba, i-oksijini ayibonakali iyincedo kakhulu ekunciphiseni ukuvakalelwa kokuphefumula.
- I-pneumonia: Ubukho beemastastim emiphakeni, ngokukodwa kufuphi ne-airways, kunokubangela ukuqokelela kwamanzi kunye neebhaktheriya ezinzulu kwimiphunga. Ngokunciphisa i-airways, abantu banokuphuhlisa i-pneumonia ephindaphindiweyo. Oku kunokuba lukhulu ngakumbi ukuba inani lakho lamhlophe yegazi liyancitshiswa ngenxa ye-chemotherapy, kwaye kaninzi kufuna i-hospitalization kunye ne-antibiotics.
- Ukuhlamba igazi: Ukukhupha igazi kungenzeka, ngakumbi xa i-metastase ifuphi i-airways enkulu. Ukuhlamba ixabiso elincinci legazi-i-teaspoon-ithathwa njengongxamiseko lwezonyango. Ukukhupha isahlulo sesithathu kwendebe yegazi kunenani lokufa elimalunga nama-30 ekhulwini. Ngamanye amagama, musa ukuyihoxisa nayiphi na igazi okhwehlelayo, nangona ixabiso elincinci kuphela. Xa ifunyanwe ngokukhawuleza, inkqubo inokuyeka ukuyeka igazi, nangona kunzima.
- Ukutshatyalaliswa kwamangcwaba okubi : I- effusion engalungile yomsindo yimeko apho iiseli zomhlaza kunye nomhlaza zakha phakathi kweembrane (i-pleura) ezenza umgca. Ubunzima buhluka ngoxhomekeke kumlinganiselo wezinto ezikhoyo kunye nokuba kwenzeka ngokukhawuleza kangakanani. Ukunciphisa amancinci amancinci akufuneki naluphi na unyango. Ukuxhamla okukhulu kwesikhalazo, nangona kunjalo, kunokunyanzelisa imiphunga, ekhokelela entlungu ebuhlungu kunye nokuphefumula okufutshane. Isinyathelo sokuqala sivame ukuba yi-thoracentesis, apho inaliti ifakwe kwisalathisi sesifuba kwisithuba sombindi ukukhupha umkhuhlane. Ngelishwa, i-fluid idla ngokuphindaphindiweyo. Izinketho zibandakanya ukucoca ngokuphindaphindiweyo, kufaka isiteti ukuze abantu bakwazi ukukrazula ngokwabo ekhaya, okanye ukwenza inkqubo ebizwa ngokuba yi-pleurodesis. Kwi-pleurodesis, ikhemikhali ifakwe kwisithuba sokudabuka esibangela ukuvuvukala, okubangela ukuba "i-gluing" yeembrane kunye ukuze i-fluid ingakwazi ukuqokelela kwakhona.
- I-pulmonary hemorrhage: I- pulmonary hemorrhage, okanye iphuma kumiphaphu, ayiqhelekanga, kodwa inokwenzeka.
- Ukuvalwa kwemimoya yomoya: Xa i-metastases ikhula kufuphi okanye ingena e-airways, inokubangela ukuphazamiseka. Oku kunokukhokelela kokuphefumula kokuphefumula, kunye nezifo ezifana ne-pneumonia. Ukuba ukukhuseleka kunzima, oogqirha banokubeka i-stent kwi-airway ukuyivula.
Iingxaki ezinxulumene ne-Liver Metasase
Ubungqina bezilwanyana ezingenakubangela ukuba nayiphi na impawu ngaphandle kokuba i-metastase ifuphi iinqanawa ezinkulu kunye neengcambu zesibindi. Ukuba unempawu, unokwazi ukugqithisa okwesibhakabhaka kwesikhumba sakho kunye nabamhlophe kwamehlo akho (i-jaundice), intlungu yesisu, intlungu yesahlombe kunye ne-hiccups. Amaxesha aphindaphindiweyo, inxalenye enkulu yesibindi kufuneka ithathelwe indawo yi-tumor ukuba ibangele iimpawu ezibalulekileyo. Iingxaki ezimbalwa ezinokuthi zibandakanya:
- Ama-Ascites: Ngesibindi sokungasebenzi, utywala buyakwazi ukwakha kwi-peritoneal cavity ( ascites ). Ukuba isisu sakho sithinteka kakhulu, sinokubuhlungu kwaye siphumelele ukuphefumla (ngakumbi ukuba unayo i-metastases). Oogqirha banokwenza inkqubo ebizwa ngokuba yi-paracentesis yinto leyo inaliti ifakwa ngesikhumba kunye nasesigxini sokususa esiswini sokukhupha umkhuhlane.
- Ukudideka: Ngeentlobo ezinzulu zeemetastases, ukudideka kunye nokuxhamla kungabangela, ngenxa yokwakhiwa kwezinto ezinobuthi emzimbeni.
- Ukuqhekeza: Ibindi sinomsebenzi wokwenza izinto zokuvala. Ukuba isibindi sininzi esingasebenziyo, isixa esaneleyo sale migaqo sinokuveliswa ukukhokelela ekuphumeni kwegazi kunye nokuphazamiseka kwegazi.
- Ukubambisa : Awuyi kucinga ukubetha njengenkxalabo enzulu, kodwa ukubetheka okungahamba kunye nesibindi semastasi sinokuba nzima. Ukubetheka kwenzeka ngenxa yokwakhiwa kwe-acid acids egazini nasesikhumbeni. Ukongeza kokucela ukuba abathandekayo bakho bakubuyisele imirhubhe, kukho imishanguzo enganciphisa le mpawu.
Iingxaki ezinxulumene neBrain Metastases
Ingqondo yindawo eqhelekileyo yomhlaza wesifuba ukusasazeka, kunye neengqondo zesifo sengqondo zingabangela nayiphi na inani leempawu; ezinye ezingasongela ubomi. Unokuba ungaqapheli ukuba umdlavuza wakho webele usasazeke kwingqondo yakho, okanye endaweni yoko, unokufumana ubunzima beengxaki zeengqondo. Ezinye zezi ziquka:
- Ukuxhatshazwa: Unokuba uqhelana nobunzima obukhulu, okanye i-tonic-clonic seizures, uhlobo apho umntu engenazi nto kwaye iingqumbo zakhe zithuthuzela. Ngamanye amaxesha ukuhluthwa kwamanzi kuya kwindawo ethile yomzimba. Ezinye iziganeko zingabangela iimpawu ezinjengomntu okhangela kwindawo engabonakali nantoni na.
- I-Falls: I- Brain metastases ingakhokelela ekubuthathaka, ukuphazamiseka, kunye nokulahlekelwa kwemilinganiselo. Ukuba ubuchopho be-metastases bukhona, kubalulekile ukuba uqaphele ngakumbi ngokuthintela ukuwa.
- Iingxaki ezibonakalayo: Iingxaki ezibonakalayo ezifana nombono ombini, okanye ukulahleka kombono kunokwenzeka. Abantu baqatshelwa ngokushayela okanye ukusebenzisa izinto ezinokuba yingozi.
- Utshintsho olukhawulezileyo kwisimo sengqondo : Utshintsho kwisimo sengqondo, utshintsho lomntu, okanye ukulahlekelwa yintliziyo.
Unyango lweengxaki ezahlukeneyo zesifo sengqondo se-metastases idlalwa ngamayeza. Ukuba kukho enye, okanye i-metastases embalwa kuphela, uhlobo oluthile lwe-radiation ye-radiation ebizwa ngokuba yi-stereotactic body body radiotherapy (i-SBRT) isenokusetyenziswa kwisilingo sokuphelisa i-metastasis.
Iingxaki ngenxa yezinye iiMetastases
Umhlaza wesifuba ungasasazeka malunga nantoni nayiphi na indawo yomzimba, kwaye ukuba unayo impawu, nangona ubonakala ungahambelani nomhlaza wakho, qiniseka ukuthetha ne-oncologist yakho. Ezinye iingxaki ezinxulumene neminye imimandla yokusasazeka ziquka:
- Ukuhluleka kweengso: Ukungaphumeleli kweentso kungabikho nje ngenxa yeemastastas ezintsheni (kungekhona isayithi engaqhelekanga) kodwa ngenxa yemichiza oyithathayo, ukukhulelwa kwamanzi kunye nokunye.
- Ukuxhamla kwe-Pericardial: Kanye nje ngomhlaza wesifuba ungasasazeka kumbindi weemiphunga, unokusasazeka kwintsimbi yentliziyo. Xa uketshezi ukwakhiwa phakathi kweembumba ezifake intliziyo (i- pericardial effusion ) yenza kube nzima ukuba intliziyo ibetha (inqanaba lentliziyo lidla ngokukhawuleza ukwenzela ukuba umthamo omncinci uphelelwe emzimbeni wonke). Ukuba umbane uyakha ngokukhawuleza okanye ububanzi, kunokukhokelela kwimeko eyaziwa ngokuba yi-tamponade ye-pericardial (ngokukhawuleza inqanda intliziyo kangangokuba ayikwazi ukushaya). Xa le meko ivela ngenxa yomhlaza wesifo somhlaza, umntu wesithathu wabantu bafa ngaphambi kokufunyanwa kwaye baphathwe. Oku akuqhelekanga, kodwa sinesizathu sokuthetha nodokotela wakho ukuba uyaphawula nayiphi na ukuphefumula okufutshane okanye ukukhawuleza kwentliziyo.
- Ukulimala kwe-Brachial plexus : Xa umdlavuza usasazeka kwiishukela phantsi kweengalo, inokulimaza iqela leentambo ze-nerve ezibizwa ngokuba yi-plexus brachial. Oku kunokubangela ubuthathaka okanye ukukhubazeka kwicala elifanayo. I-Brachial plexopathy ngenxa yesifo somhlaza wesifuba ichaphazela kuphela i-1 kwabasetyhini abangama-200 kodwa ngokuqhelekileyo iyinkxalabo ephazamisayo.
Iingxaki Ngenxa Yonyango Lwemhlaza Yengama-Breast Old and New
Ezinye iingxaki ezinokuthi zenzeke ziyafana nalawo maxa wambi ayenzeka kubantu abanomdlavuza wesibele. Eminye yezona zimbalwa zibandakanya:
- Isifo senhliziyo: Kokubili i-chemotherapy kunye neyeza zokwelapha imitha yomhlaza wesifuba kungonakalisa intliziyo. Isifo senhliziyo singabonakala kwiminyaka emininzi emva kokunyanga kokuqala kwaye sinokuvela kwi-coronary disease artery, ukunyamekela ukuhluleka, kwiingxaki ze-valve. Eyona nto iqhelekileyo yintsilelo yokungaphumeleli kwintliziyo, esoloko iyazibonakalise ngeempawu zokuphefumula, ukuvuvukala kwemida, nokukhwehlela i-pink, frothy sputum.
- Izifo: Ukuba usuhlobo lwe-chemotherapy, ugqirha wakho usenokukuxwayisa ngokuphuhlisa umkhuhlane (umkhuhlane we-neutropenia). Umkhuhlane ongeke ube ngowothusayo, ungasongela ubomi. Xa isistim somzimba sakho sisigxina, awukho nje ukutheleleka kwiintsholongwane, kodwa ukukwazi kwakho ukulwa nesifo osisigxina utyeshelwe. Nokuba izifo ezincinci zingadinga izibhedlele kunye neziza-antibiotics. Ukuba ukholwa ukuba unesifo, musa ukulinda. Shayela i-oncologist yakho.
Ukuphendulwa kwemizwa
Xa uhlala nesigaba 4 somhlaza webele, uya kudla ukusebenzisa amayeza amaninzi. Ezi zinokuba yinxalenye yonyango lwakho, kunye namachiza okulawula iimpawu zakho. Oko abanye abantu abangaziqondi kukuba nangona uthabathe amayeza ngamaxesha angama-100, umthamo olandelayo owathatha ungabangela ukuphendulwa komzimba.
Ngokufanelekileyo, wonk 'ubani kufuneka aqonde iimpawu ze-anaphylaxis, isisombululo esinamandla, njengoko oku kungasongela ubomi. Ukuba ubona ukunyuka kwentamo yakho, ulwimi, okanye ubuso, ukuphuhliswa kwemihlathi, okanye ukukhanya okulula, kufuna unyango.
Iingxaki zeengqondo
Abantu badla ngokucinga ngabaxhasi bamagciwane njengolukulwano olunzima, kodwa kukho namaxesha apho abasindileyo bedimazekile kakhulu. Ukudandatheka kunokungena kuyo. Nangokuxinezeleka, abanye abantu baze bazibulale. Umngcipheko wokuzibulala nomdlavuza uncinci kumdlavuza webele kunamanye amachiza, kodwa umngcipheko usekhona. Njengoko ezinye zeempawu "ezinamandla" apha ngasentla, awukwazi ukucinga ukuxinezeleka njengengxaki yomsana wesifo semitha, kodwa kubaluleke kakhulu. Injongo yonyango kukunyusa ubomi ngelixa kukunika umgangatho obalulekileyo wokuphila. Ukuba kukho konke okuphazamisayo ukukwazi ukuzonwabisa lwakho nosapho kunye nabahlobo, kufuneka kulandelwe, mhlawumbi nge-oncologist yakho, amanye amagqirha anjengeengcali zokunyamekela, okanye umhlaza weengxaki zomhlaza.
ILizwi
Senze ezinye zeengxaki ezinokuthi zihambe kunye nokuxilongwa komhlaza wesifo se-metastatic, nangona kukho nezinye izinto ezinokungaqhelekanga ongabhekana nazo. Ingongoma ebalulekileyo kukuba uqaphele umzimba wakho kwaye uthethe nge-oncologist yakho nayiphi na inkxalabo. Ukuphila nomdlavuza wesigaba 4 akusona ixesha lokuba ligorha. Ngokuqhelekileyo, ingxaki enzulu ingaphathwa xa itholakala ngexesha elifanelekileyo.
Gcina ukhumbule ukuba abantu abaninzi abanakufumana ezi ngxaki. Kukho abantu abaninzi abahlala nesigaba somhlaza wesibeleko se-4 abahlala ubomi obupheleleyo kunye obuvuyisayo, nangona kukho ukungaqiniseki ngekamva.
> Imithombo:
> Hurria, A., Woza, S., noL. Pierce. Iipatheni zokubuyela kwakhona kunye neengxaki zesikhathi eside kwi-Breast Cancer Survivors. UpToDate . Ukuhlaziywa 08/15/17.
> INational Cancer Institute. I-Cannabis kunye ne-Cannabinoids (PDQ) -I-Professional Professional Version. Ukuhlaziywa 11/30/17. https://www.cancer.gov/about-cancer/treatment/cam/hp/cannabis-pdq#link/_45_toc