Isigaba II I-Cancer Cancer - Inkcazo, unyango, kunye nePrognosis
Umgangatho wesi-2 wesifo somhlaza wesifo samangqamzana esichazwa ngumzimba wesifo somhlaza sichazwa ngokuthi " umhlaza wendawo ," oko kukuthi, ubhekisela kwisisu esivela empompo kwaye sinokusasazeka kwii- lymph nodes zendawo , kodwa asasazekanga. Izidumbu eziye zadlula ngaphaya kwezi ndawo zibhekiswa "njengeengqungquthela eziphezulu." Phantse iipesenti ezingama-30 zamanomdlavuza emiphunga afunyaniswa xa zikwinqanaba 1 okanye 2, kwaye ukugqitywa (umphumo wesikhathi eside) kulunge ngakumbi kunezigaba ezilandelayo zesifo.
Kwenzeka njani ukuba umhlaza wemiphunga uyisigaba sesi-2 (isigaba II), kwaye njani le nqanaba lomdlavuza wamaphaphu uphathwe ngayo?
Sibanzi
Ukumisela isigaba somdlavuza wemiphunga kubaluleke kakhulu ekukhetheni unyango olufanelekileyo.
Isigaba II sihlukaniswe ngamagatya IIA kunye ne-IIB. Isigaba IIA kunye ne-IIB nganye iyahlula ngamacandelo amabini ngokuxhomekeke kubukhulu besisu, apho i-tumor ifunyenwe khona, nokuba ingaba nomhlaza kwi-lymph nodes.
Isigaba IIA
(1) I-Cancer iye yasasazeka kwii-lymph nodes kwicala elifanayo kwesifuba njenge-tumor. I-lymph nodes nomhlaza zingaphakathi kumphunga okanye kufuphi ne- bronchus , kwaye enye okanye ngaphezulu kwezi zinto zilandelayo:
- I-tumor ayikhudlwana kune-5 cm.
- I-Cancer iye yasasazeka kwi-bronchus eyona nto kwaye ubuncinane ubuncinane bama-2 centimitha ngaphantsi apho i- trachea ijoyina i-bronchus.
- I-Cancer iye yasasazeka kwinqanaba eliphambili lomlenze elibandakanya umphunga.
- Ingxenye yomphunga iye yawa okanye yavelisa i-pneumonitis (ukuvuvukala kwemiphunga) kwindawo apho i-trachea ijoyina i-bronchus kodwa ayifaki imiphunga.
okanye
(2) I-Cancer ayizange isasaze kwi-lymph node kwaye enye okanye ngaphezulu kwezi zinto zilandelayo:
- I-tumor ikhulu kunama-cmenti angama-5 kodwa ingabi ngaphezu kwama-7 centimitha.
- I-Cancer iye yasasazeka kwi-bronchus eyona nto kwaye ubuncinane ubuncinane bama-2 centimitha ngaphantsi apho i-trachea ijoyina i-bronchus.
- I-Cancer iye yasasazeka kwinqanaba eliphambili lomlenze elibandakanya umphunga.
- Ingxenye yomphunga iye yawa okanye yavelisa i-pneumonitis (ukuvuvukala kwempompo) kwindawo apho i-trachea ijoyina i-bronchus kodwa ayibandakanyi yonke imiphunga; kwaye
Isigaba IIB
(1) I-Cancer isasaze kwii-lymph nodes ezikufutshane kwipfuba njenge-tumor. I-lymph nodes nomhlaza ziphakathi komphunga okanye kufuphi ne-bronchus. Kwakhona, enye okanye ngaphezulu kwezi zinto zilandelayo:
- I-tumor ikhulu kunama-cmenti angama-5 kodwa ingabi ngaphezu kwama-7 centimitha.
- I-Cancer iye yasasazeka kwi-bronchus eyona nto kwaye ubuncinane ubuncinane bama-2 centimitha ngaphantsi kwendawo apho i-trachea ijoyina i-bronchus.
- I-Cancer iye yasasazeka kwinqanaba eliphambili lomlenze elibandakanya umphunga.
- Ingxenye yomphunga iye yawa ( atelectasis ) okanye i-pneumonitis ephuhlisiwe (ukuvuvukala kwemiphunga) kwindawo apho u-trachea ujoyina i-bronchus.
okanye
(2) I-Cancer ayizange isasaze kwi-lymph node kwaye enye okanye ngaphezulu kwezi zinto zilandelayo:
- Isisu sinkulu kunama-centimitha ayi-7.
- I-cancer iyasasazeka kwi-bronchus eyintloko (kwaye ingaphantsi kwamasentimitha angama-2 kufuphi nesiza apho i-trachea ijoyina i-bronchus kodwa ayibandakanyi indawo yokuhlangana), udonga lwesifuba, isithsaba, okanye i-nervous elawula i-diaphragm.
- I-Cancer iye yasasazeka kwi-membrane ejikeleze intliziyo (i- pericardium ) okanye idibanisa isigodlo sesifuba.
- Kukho iimvumi enye okanye ezininzi ezihlukeneyo kwi-lobe efanayo yomphunga.
Ukucwangcisa
I-Oncologists ixoxa ngamagatya omhlaza wemiphunga esekelwe kwinto ebizwa ngokuba yi- TNM . Kule nkqubo, T ibhekisela kubukhulu be-tumor, i-N ibhekisela ekubandakanyekeni kwanoma yiyiphi i-lymph nodes nalapho ikhona khona, kwaye i-M ibonisa ukuba kukho nayiphi na i- metastases , oko kukuthi, ukusasazeka kwe-tumor kwezinye iindawo zomzimba . Ukusebenzisa inkqubo ye-TNM, isigaba somhlaza wesi-2 somhlaza sichazwa ngokuthi:
- 2A - T1A / 1BN1M0 - Itsho i-tumor ingaphantsi kwe-3 cm (1½½ intshi) ngobukhulu, kwaye isasazeka kwii-lymph nodes eziseduze.
- 2A - T2AN1M0 - I-tumor inkulu kune-3 cm, kodwa ingaphantsi kwama-5 cm, ngobukhulu, okanye umhlaza usasazeke kwi-bronchus eyona nto kwaye ubuncinane ubuncinane be-2 cm ngaphantsi kwe-carina, okanye umhlaza usasazeke kwibala umphunga; kwaye isasaze kwii-lymph nodes eziseduze.
- 2B - T2N1M0 - I-tumor inkulu kune-3 cm, kodwa ingaphantsi kwe-7 cm, ngobukhulu, kwaye isasazeka kwii-lymph nodes zendawo.
- 2B-T3N0M0 - I-tumor ingaphezu kwe-7 cm ngobukhulu kwaye ayizange isasaze kwi-lymph nodes, kodwa isendaweni yomoya okanye isasazeka kwiindawo zendawo ezifana nodonga lwesifuba okanye isithintelo.
Profilation
Enye yentuthuko yakutshanje kwonyango lomdlavuza wamaphaphu ibe yikhono lokunyanga ezinye zala makhansela ngokuthi "ukujolisa" ukuguqulwa kwesisu. Ngokubhekiselele ekubalulekeni kwesisu esincike kwisayizi kunye nokuba sele sisabele kangakanani, i-oncologists ngoku isebenzisa ukuhlolwa kofuzo (umfuziselo we-molecular) yomhlaza wemiphunga ukuqhubela phambili "ukuzenza umntu" ukuxilongwa. Kuze kube kutshanje, ukuvavanywa kwakugcinwe ikakhulu kubantu abanezigaba eziphambili zesifo, kodwa ngokuqhubela phambili kunyango, mhlawumbi abo banesifo sesigaba sesi-2, ngokukodwa abantu abanomphunga adenocarcinoma , lo vavanyo luya kuba yinto eqhelekileyo.
Iimpawu
Iimpawu eziqhelekileyo zesigaba 2 somhlaza womphunga ngumkhuhlane oqhubekayo , ukukhwehlela igazi (i-hemoptysis), ukuphefumula okufutshane , intlungu kwisifuba okanye ngasemva , okanye izifo ezinokuphindaphindiweyo ezifana ne-pneumonia okanye i-bronchitis. Ukususela kumgca wesi-2 umhlaza wamaphaphu awunakulinganiswa (ukusasazeka) ngaphaya kwemiphunga, iimpawu ezifana nokulahlekelwa kwesisindo esingenasenzo kunye nokukhathala akuqhelekanga kunezigaba eziphambili.
Unyango
Izinyango zokwelapha kwisigaba 2 somhlaza wamaphaphu zihlala ziquka ukudibanisa kwezonyango. Ezi ziquka:
- Ugqirha: Ugqirha yonyango olukhethiweyo kwisigaba 2 somhlaza wamaphaphu, unikezela ithuba elikhulu lokunyanga kwinqanaba lesi sifo. Kukho iintlobo ezi-3 ezisemgangathweni zonyango lomhlaza wamaphaphu ezenziwa ngumhlaza wamaphaphu, kwaye ukhetha inkqubo efanelekileyo kukuxhomekeke apho i-tumor yakho ikhona kwaye imeko yakho jikelele yezempilo. Kwiminyaka yakutshanje uhlobo oluthile olungenayo lokuhlinzwa olubizwa ngokuba yi-VATS) olwenziwe ngonyango olwenziwe ngevidiyo. Ngalolu cwangciso, inxalenye yomphunga ingasuswa ngento encinci kwindonga yesifuba. Kungaba bubulumko ukuqwalasela imbono yesibini xa usenza isigqibo malunga nokuhlinzwa komhlaza wamaphaphu . Uphononongo lubonisa ukuba abantu abanezi nkqubo ezenziwe kwizibhedlele ezenza umthamo omkhulu walezi zonyango ziphumo ezingcono.
- I-Chemotherapy: Uninzi lwe-oncologists lincoma i- acrovant chemotherapy (i-chemotherapy emva kokuhlinzwa) kulabo abaqhutyelwa ukuhlinzwa kwisigaba 2 somhlaza wamaphaphu. Ingcamango enolu hlobo lwe-chemotherapy "ukuhlambulula" nayiphi na iseli yomhlaza ongasasazeka ngaphaya kwemiphunga (i-metastasized) kodwa engabonakali nakweyiphi na imvavanyo yokucinga. Ngokuxhomekeka kwindawo ohlala ngayo, ezinye i-oncologists zinokuthi zenze i-neoadjuvant chemotherapy-chemotherapy eyenziwe ngaphambi kokuhlinzwa ukuze unciphise ubukhulu besisu kunye nokususa i-tumor lula.
- Ukunyanga kwamayeza okuxhatshazwayo: Ukunyangwa kwamayeza akuqhelekanga kusetyenziswa isigaba somhlaza wesi-2 somdlavuza kodwa ukhetho kulabo abangenakho ukuhlinzwa ngenxa yokuba i-tumor okanye ukukhathazeka kwezempilo jikelele ( umdlavuza ongaphazamisekiyo ). Kule ndawo, imisebe ngamanye amaxesha ingabangela unyango. Ezinye iindlela ezifana nesipilisi sophotho lweproton ziphononongwa kwisigaba sesi-2 sesifo.
Uvavanyo lweZliniki
Ngokutsho kweNational Cancer Institute, abantu abanomdlavuza wemiphunga kufuneka bathabathe inxaxheba kwiimvavanyo zonyango . Intuthuko emininzi ekwelapheni umhlaza womphunga uye wenziwa, kwaye ngeli xesha phakathi kuka-2011 no-2015, kwakukho amayeza amaninzi avunywe ngumhlaza wemiphunga kuneminyaka engama-40 ngaphambi ko-2011.
Izilingo ezininzi zeekliniki ziyaqhubeka kwisigaba 2 somhlaza wesifo somhlaza esibhekisele kwiindlela zokugonywa ezincinci, iindlela ezintsha zonyango, kunye nezonyango ezinjengezilwanyana ezijoliswe kuyo kunye ne- immunotherapy kule nqanaba yesifo.
Ingozi yokuphindaphinda
Izinga eliphindaphindiweyo lokuphindaphinda (mhlawumbi kwindawo okanye kwimihlaba yomzimba) yomhlaza wesifo somdlavuza (isigaba soku-1 kunye nesigaba sesi-2) phakathi kwama-20 ukuya kuma-50 ekhulwini. Ukuba umhlaza wemiphunga uphinde uphucule, ukhetho olungakumbi lunokufumaneka kunyango. Ezi zibandakanya i-radiation kunye okanye ngaphandle kwe-chemotherapy, okanye enye yezilwanyana zonyango ezijoliswe kuzo okanye ezichongiweyo zonyango ezihlolwayo kwiinkampu ezininzi zeeklinikhi. Funda kabanzi malunga nokuphindaphinda komhlaza wamaphaphu .
Umlinganiselo wokuSinda
Isilinganiso seminyaka emi-5 yokusinda singama-30 ekhulwini kwinqanaba lesi-2 esingenanto encinci yomhlaza wamaphaphu. Kwiimeko ezithile, le nombolo ngezinye izihlandlo ingahlukahluka , kuxhomekeke kwisisu sakho kunye nempilo yakho jikelele. Gcina ukhumbule ukuba iinkcukacha malunga nokusinda zihlala ziyiminyaka emininzi ubudala, kwaye unyango olutsha oluye lwavunywa lungenakufumaneka xa loo manani ebhalwe.
Ukujamelana
Izifundo zibonisa ukuba ukufunda ngesifo sakho kunokuphucula isiphumo sakho. Buza imibuzo. Funda malunga nezilingo zesikliniki ezinokuba zifanelekile kuwe. Ukuba usanda kutshatyalaliswa ngumhlaza wemiphunga , thabatha umzuzwana ukuba uphefumle kwaye ucinge ngenyameko malunga nemeko yakho yangoku. Uninzi lwezigqibo ngomhlaza womphunga awunxamnye, kwaye unokuthi uthathe ixesha elifutshane ukuvavanya ngokupheleleyo amanyathelo akho alandelayo.
Ngandlela-thile, ungazivakalelwa kukuba ulahlekelwe ngumlawuli wobomi bakho, kodwa kukho ezinye izinto onokuzenza ukuba uphucule nokuphila nomhlaza wemiphunga.
Ukuphila nomhlaza kunokuthatha idolophana. Vumela abantu ukuba bancede. Eli akusiyo ixesha lokuba "oqinileyo," kwaye umdlavuza unokuba lunzima nangona uncedo. Ukuba ungumhlobo wakho oye wafumanisa ukuba unomdlavuza, khangela le nqaku, " Xa umthandayo enomdlavuza wamaphaphu. "
Nangona unenkxaso yothando yentsapho kunye nabahlobo, ukuhlala nomhlaza kunokusasazeka. Khangela kumaqela enkxaso kuluntu lwakho nakwi-Intanethi . Kukho umdlavuza omangalisayo wamaphaphu kwi-intanethi apho abantu abaninzi abanomdlavuza wamaphaphu bafumana inkxaso, ngeli xesha befunda malunga nenkqubela phambili yomdlavuza wamaphaphu.
Imithombo:
American Cancer Society. Imiba kunye neengxelo zeCans 2014 . I-Atlanta: I-American Cancer Society; 2014. http://www.cancer.org/acs/groups/content/@research/documents/webcontent/acspc-042151.pdf
American Cancer Society. I-Cancer Cancer (I-Cell-Non-Small Small.) I-Cell-Non-Small Small Cell Lung Cancer Survival Rates. Ukuhlaziywa 02/08/16. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-sall-cell-lung-cancer-survival-rates
IKomidi eliManyeneyo yaseMerika kwiCancer. I-Cancer Stage. I-7 Edition. Fi kelele 01/13/16. https://cancerstaging.org/references-tools/quickreferences/Documents/LungMedium.pdf
Edge, S. et al (Eds.). Umqulu we-AJCC weScanscer Staging Manual. I-7 Edition. Springer. ENew York, NY. 2010.
Hotta, K. et al. Indima ye-chemotherapy ene-adjuvant kwizigulane ezinomdlavuza ongaphantsi-omncinci womhlaza wamapayipi: kuphinda uphononongwe ngoluhlu lweemeta lweengxaki ezilawulwa ngokungapheliyo. Umbhalo we-Clinical Oncology . 2004. 22 (19): 3850-7.
Kelsey, C. et al. Ukuphindaphinda kwendawo emva kokuthengiswa kokuqala kwe-NSCLC: i-salvage inokwenzeka nge-radiation. Cancer . 2006. 12 (4): 283-8.