Inkcazo, iziganeko, unyango, kunye nokuhlaziya kwesigaba IIIA
Umdla we-3A umhlaza wesifo somhlaza wamangqamuzana unomdla wesifo somdlavuza, "esichaza ukuba i-tumor ayizange isasaze kwiindawo ezikude zomzimba kodwa isasazeka kwii- lymph nodes kwicala elinye lomzimba njenge-tumor. Amaphesenti angama-10 abantu abanomdlavuza wesi-3A ngomhlaza ngexesha lokuxilongwa, kunye nama-60 ekhulwini abantu abanezigaba eziphambili zesifo.
Sibanzi
Isigaba 3A Umhlaza wemiphunga uquka izicubu ezinkulu kwaye zisasaza kwii-lymph nodes ezikufuphi, okanye iiswini zaso nawaphi na ubungakanani obuye basasazeka kwii-lymph nodes ezide zide kodwa zihlala kwicala elifanayo lomzimba njengomhlaza.
I-Oncologists isebenzisa inkqubo ye- TNM ukuchaza ngakumbi izigaba zomhlaza wemiphunga. Inkcazo elula yenkqubo ye-TNM ibandakanya:
T - Oko kubhekisela kwisayizi somzimba:
- I-T1 - I-tumor ingaphantsi kwe-3 cm (1 ½ intshi) ngobukhulu.
- I-T2 -I-tumor inkulu kune-3 cm kodwa ingaphantsi ko-7 cm ubukhulu.
- I-T3 - I-tumor iyinkulu kune-7 cm okanye ihlaselwa ngokukhawuleza naluphi na olu lulandelayo: udonga lwesifuba, isithsaba, inambuzane engabonakaliyo isithwathwa (imbindi ye-phrenic), iimbumba ezifihla indawo phakathi kwemipuphu emibini (i-pleura). iimbumba ezigubungela intliziyo yeparietal pericardium); okanye i-tumor ye- bronchus eyinhloko ubuncinane ubuncinane be-2 cm phantsi kwe-carina; okanye idibaniswa nokuwa (i- atelectasis ) yomphepha wonke okanye ihlule izidumbu zamathambo kwi-lobe efanayo yomphunga.
- I-T4 - Ukuxhamla kwanoma yibuphi ubukhulu obuza kuhlasela naluphi na olu lulandelayo: indawo phakathi kwemiphunga ( mediastinum ), intliziyo, iinqanawa ezinkulu, i-trachea, enye yeentsholongwane ezingenayo intambo yezwi (i-laryngeal nererve), isifo , umzimba we-vertebral okanye indawo apho i- trachea iyahlukana kwi-bronchi ebalulekileyo (carina); okanye uhlule izigulane zamathambo kwi-lobe eyahlukeneyo kwicala elifanayo.
N ibhekisela kuma-lymph nodes:
- I-N0 - Akunakho i-lymph nodes ezichaphazelekayo.
- I-N1 - I-tumor isasazeke kwiindawo ezikufutshane kwicala elinye.
- I-N2 - I-tumor isasaze kwiindawo ezinokuthi zihambe ngaphandle kodwa kwicala elifanayo lwesifuba.
- I-N3 - Iiseli zentsholongwane zikhoyo kwi-lymph nodes ngaphesheya kwesifuba esivela kwi-tumor, okanye kwiindawo ezikufutshane ne-collarbone okanye imisipha yentamo.
M imela izifo ze-metastatic :
- I-M0 - Ayikho i-metastase ikhona i-M0-I-tumor isasazeke (i-metastasized) kwezinye iindawo zomzimba okanye enye imiphunga.
Ukusebenzisa i-TNM System, isigaba se-3A umdlavuza wamaphaphu uchazwa ngokuthi:
- I-T1N2M0 - Itsho i-tumor ingaphantsi kwama-3 cm ngobukhulu kwaye isasazeka kwii-lymph node kude kodwa ngaphandle kwelinye icala lomzimba njenge-tumor.
- I-T2N2M0 - I-tumor inkulu kune-3 cm kodwa ingaphantsi kwe-7 cm, kwaye isasazeka kuma-lymph nodes kude kodwa ngaphandle kwelinye icala lomzimba.
- I-T3N1M0 - I-tumor iyinkulu kune-7 cm okanye isasazeka kwindawo yangasese njengodonga lwesifuba okanye i-diaphragm, kwaye i-lymph node eziseduze zichaphazelekayo. (khangela ngentla ngentsimi ye-T3.) I-tumor inkulu kune-7 cm okanye isasazeka kwindawo yangasese njengodonga lwesifuba okanye i-diaphragm, kunye ne-lymph nodes ezide kude kodwa kwicala elifanayo lomzimba zichaphazelekayo. Isisu sinaluphi na ubukhulu kodwa sisondele kwindlela ehamba ngumoya okanye sisasaza kwindawo efana nesodonga sesifuba okanye isithsaba, kunye nezilwanyana ezikude kodwa kodwa kwicala elifanayo lomzimba zichaphazelekayo (jonga inkcazelo ngentla ye-T3.)
- I-T3N2M0 - I-tumor nayiphi na ubukhulu kodwa isondele kwindlela yomoya okanye isasaze kwindawo yangasese efana nodonga lwesifuba okanye i-diaphragm, kunye ne-lymph nodes ezide kude kodwa kwicala elifanayo lesifuba sichaphazelekayo.
Iimpawu
Iimpawu zesigaba 3A Umhlaza wesifo somdlavuza uyahlukahluka ukususela kwinqanaba lesi-3A kubandakanya uluhlu olubanzi lweekhensa. Iimpawu ezibangelwa ngumhlaza kwimiphunga efana nokukhwehlela okuqhubekayo , ukuphefumula okufutshane , kunye nezifo eziphindaphindiweyo ezifana ne-pneumonia okanye i-bronchitis, ziqhelekile. Ukusa kwiindawo ezinjengodonga lwesifuba kunye nesigxobhozo kunokubangela intlungu esifuba, iimbambo, amahlombe, nangemuva. Iziphakamiso ezikufutshane nomoya womoya zingabangela i-hemoptysis ( ukukhwehlela igazi ), ukugubha kunye nokuhlambalaza .
Unyango
Ukunyangwa kwinqanaba le-3A yomdlavuza wemiphunga yinto ephikisanayo nayo yonke imilinganiselo yomdlavuza wamaphaphu, ngenxa yokuba eli qela lihluke kakhulu. Ngenxa yesantya sokusinda, i-National Cancer Institute ithi wonke umntu onomdlavuza wesifo somhlaza wesi-3A kufuneka aqwalaselwe njengomviwa kwizonyango zonyango - uphando olucwangcisa unyango olutsha okanye ukudibanisa unyango lomhlaza wamaphaphu.
Kwezinye iimeko, ukuhlinzwa kungenziwa ukuze kususwe i-tumor, kwaye ngokuqhelekileyo kulandelwa i-acrovant chemotherapy (i-chemotherapy emva kokuhlinzwa). I-chemotherapy engaphambili ye-preoperative (i-chemotherapy phambi kokuhlinzwa) ifunyenwe ukuphucula ukusinda kwizifundo ezimbalwa. I-chemotherapy yokudibanisa (kusetyenziswa ukudibanisa imithi ye-chemotherapy) kunye neyeza zonyango okanye enye unyango isetyenziswa rhoqo ukuba isigaba se-3A somhlaza wemiphunga sithathwa njengingenakwenzeka ngenxa yendawo yokuhlala kuyo, ingaba sele isasazeka kangakanani, okanye ukuba impilo yakho jikelele iya kwenza ukwenziwa kobuchopho. Kulabo abangakwazi ukunyamezela ukuhlinzwa okanye i-chemotherapy, unyango lwamayeza luhlala lukhethwa.
Kubalulekile ukuba wonke umntu onomdlavuza wamangqamuzana ongeyomncinci, ikakhulukazi umphunga adenocarcinoma unokuhlolwa kofuzo (ukuprofilisa i-molecular) . Kukho ezininzi "ezinokuguqulwa" ezinjengeenguquko ze- EGFR , ukulungiswa kwe-ALK kunye ne- ROS1 zokulungiswa kwakhona eziye zaguqula ezinye iisifo zomhlaza wamaphaphu esichengeni kwisifo esingapheliyo.
I-Immunotherapy yinto enomdla kwabanye abantu , kunye ne-arhente yokuqala kuloluhlu oluvunyelwe unyango lomhlaza wamaphaphu ngo-2015, kukho izibane ezikhoyo. Nangona ezi zonyango zingasebenzi kuwo wonke umntu, abanye abantu baye balawula ixesha elide kwisifo sabo ngala mayeza. Isiza se-Infinzi (durvalumab) savunywa ngo-2018 ngokukodwa kunyango lwe-3 yesifo somhlaza wesifo somhlaza ongasetyenziswanga. Xa isetyenziselwa ukulandela i-chemotherapy kunye ne-radiation, yafunyanwa ekuphuculeni ukuqhubekeka kokusasazeka.
Prognosis
Umlinganiselo wesi-5 weminyaka yokusinda kunye nesigaba se-3A umdlavuza wamaphaphu u-14 ekhulwini, kodwa oku kuhluka kakhulu phakathi kwee-cancer ezihlukeneyo ezichazwe njengeSigaba 3A. Gcina ukhumbule ukuba iinkcukacha zixelela indlela abantu abaye benza ngayo kwiminyaka eyadlulileyo, kwaye kukho intuthuko eninzi eyenziwa kunyango lomhlaza wamaphaphu kwiminyaka embalwa edlulileyo. Kukho indawo eninzi yokwenza nethemba kwonyango lomhlaza wemiphunga.
Inkxaso
Uphononongo lubonisa ukuba ukufunda oko unokukwazi ngomhlaza wakho kunceda kwisiphumo. Kuzo zonke izigaba zomhlaza wemiphunga, isigaba se-3A sisona sitshintsha kakhulu kwaye sinenani elikhulu kakhulu lokukhetha unyango. Buza imibuzo. Yibandakanye nabathandekayo bakho kwaye ubakhuthaze ukuba babuze imibuzo. Cinga ukujoyina iqela lokuxhasa . Funda malunga nezilingo zamachiza ezinokuthi zilungele imeko ethile. Ukufunda ngomhlaza wakho kunye nokwenza unyango kunokuthatha ixesha elininzi. Cela, kwaye vumela abathandekayo bakho nabahlobo ukuba bancede kwaye bakhuthaze uhambo lwakho. Thatha isikhashana ukujonga ezi ngcebiso malunga nendlela yokuba ngummeli wakho kwinkathalo yakho yomhlaza . Kwaye zilapha ezinye iingcebiso malunga nezindlela zokuphucula umhlaza womphunga wamaphaphaza ukuba ugqirha wakho angaluthetha.
Xa Umthande Wakho Unomdlavuza Weengculaza
Ukuba ngumntu wakho othandekayo oye wafumanisa ukuba unomdlavuza wamaphaphu, mhlawumbi uloyiko olufanayo, kwaye ukuba ngumntu onoxanduva lomntu onesi sifo kunokushiya ucinezelekile kwaye ungenakunceda. Thatha isikhashana uze uqaphele eli nqaku elibizwa ngokuthi " xa umthandayo unomdlavuza wamaphaphu " ukuva oko abantu abanomdlavuza wamaphaphu bathemba ukuba abo bathandekayo bayazi. Nazi ezinye iingcebiso kunye nokuxhasa othandayo ngomhlaza .
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