Ziziphi iindlela zokwelapha ezikhoyo kwi-ovarian cancer? Umhlaza wam ovari wamva okanye awuzange uhambe emva kokuqala kweyeza. Yintoni endiyenzayo ngoku? Lo ngumbuzo owenziwe ngabaguli abaninzi abanomdlavuza wesibeleko ngexesha elithile. Ngelishwa, kuba malunga nama-80% abantu abahamba nge-chemotherapy yokuqala, umhlaza uphindela.
Impendulo yalo mbuzo ixhomekeka kwindlela ukuxilongwa kokuphindaphinda kwenziwe ngayo kwaye kudala kangakanani emva kokuphela kokunyango lokuqala oko kwenzeka.
Ngokuqhelekileyo, kukho iindidi ezintathu ezahlukileyo eziphathekayo ezintathu ezahlukileyo kwaye ngokuqhelekileyo zikhokelela kwizicwangciso ezintathu zonyango ezahlukeneyo. Nangona kunjalo, ngaphaya kwaloo nto, nceda uqaphele ukuba nangona kukho indlela efanelekileyo yokwenza unyango lokuqala, unyango lokuphindaphinda luye lwahlukeneyo.
Nangona kukho izikhokelo ezintle ezilungileyo, akukho miqathango yokusebenza ngokubanzi. Ngokubanzi, ixesha elidlulileyo lidlulayo ngaphambi kokuphindaphinda kube ngcono amathuba okunyanga okanye ukukhululwa kwexesha elide. Kwakhona, ezinye iinketho zikhoyo kule meko.
Ukuphindaphinda emva kweenyanga ezintandathu
Ukuba ukuphindaphinda kufunyanwe ubuncinane ubuncinane kwiinyanga ezili-6 emva kokunyanga kuqala (mhlawumbi kufutshane nomnyaka), i-tumor ibonwa "yi-platinum sensitive" ukuba unyango lokuqala luqukethe i-platinum drug (iCarbo-platin okanye i-Cis-platin). Kamva ukuphindaphinda emva kweli nqaku, kungakumbi kunokuba kunengqiqo ukwenza " uphethiloli wesibini " ukuba uphinde ukhiphe umhlaza omkhulu kangako.
Uninzi lwabazali be-gynecologic oncologists luya kuqwalasela ngolu hlobo ukuba umhlaza uphindaphinda ubuncinane kwiminyaka emibili emva kokuba unyango lokuqala kunye nobuninzi okanye ubuninzi be / kubonakala kwi-scan okanye kuvezwe xa kuhlolwa. Nangona kunjalo, inokuba yinto enhle kakhulu phambi kwexesha elifanelekileyo, ngokuxhomekeke kwimeko ethile.
Ingaba okanye ukuphinda uqhutywe ukuqhutywa kwe-cytoreduction yesibini, i-oncologists ininzi ibonisa ukuba unyango kunye nezidakamizwa ezazisetyenziselwa okokuqala, ngakumbi ukuba ukuphindaphinda kufumaneka ngaphezu konyaka emva kokuba unyango lokuqala.
Ukuba itholakala phakathi kweenyanga ezintandathu kunye nonyaka emva kokunyanga, ukhetho lungabandakanya uphinde unyango kunye ne-Taxol neCis-Platinum okanye iCarbo-Platin, okanye usebenzisa iziyobisi ezintsha njengoko kuxoxwa ngezantsi. Uninzi lwama-oncologists luza kufumana izilwanyana ezintsha kulo xesha.
Ukuphindaphinda kwiinyanga ezi-6
Ukuba ukuphindaphinda kufumaneka kwiinyanga ezili-6 okanye ngaphantsi emva kokuqala unyango, i-tumor ibonwa "yi-platinum resistant" . I-tumor yayingase ibuyele kwinqanaba elithile ukuya ekupheleni okanye emva kwe-chemotherapy yokuqala. Kule meko, ukuphinda ukuhlinzwa akuyicetyiswa kangangoko kuba akunakwenzeka kakhulu ukuphucula ubude bomi okanye umgangatho wobomi. Kukho ezintathu izidakamizwa eziphambili ze-chemotherapy ezitholakalayo namhlanje ezona zininzi ze-oncologists zisetyenziswa ngokungafaniyo. Yonke isebenza ngokulinganayo ngokufanelekileyo kwaye ingasetyenziselwa ngokulandelelana, enye ngexesha, njengesinye isilwanyana okanye enye iyayeka ukusebenza. Ezi ziyi: Doxil, Topotecan kunye neGemzar. Iingxaki zokudibanisa ziye zazama, kodwa ngokubanzi zingenayo impumelelo engcono kakhulu kunye nemiphumo ephezulu yefuthe. Nangona kunjalo, nganye imeko iyahluke, ngoko nceda ucele ugqirha wakho malunga nento enokwenzeka. Nangona i-chemotherapy enobudlova kunye nalezi ziyobisi zinokuqhubeka ziqhubeka, kufuneka uhlale ukhumbule ukuba amathuba okunyanga azincinci kwaye ukugcina umgangatho wobomi engqondweni kubaluleke kakhulu.
Kwakhona, le ngxubusho yengozi / inzuzo kunye nodokotela wakho.
Ukuphindaphinda ngexesha okanye ngokukhawuleza emva kokunyanga
Ukuba ukuphindaphinda ngokwenene ukukhula komhlaza ngexesha lokuqala unyango, oku kubizwa ngokuthi "iplatinum refractory", okanye imeko enzima yokuchasene ne-chemotherapy. I-chemotherapy eyongezelelweyo inokunikezwa, ngokukodwa kusetyenziswa iziyobisi ezixutywe ngasentla, kodwa amathuba okuphendula aphantsi kakhulu. Kwakhona, gcinani engqondweni ukuba iziyobisi ezikhankanywe ngasentla azi-kuphela ezifumanekayo kunyango, zithathwa nje ngokuba zona zilungele ukuzama kuqala. Buza oogqirha bakho malunga nabanye kunye nantoni na amathuba anokukunceda kwimeko ethile.
Oku kunokuba yinto elungileyo yokubuza malunga nokuthembisa kodwa ezingenakuvunywa kwiinkqubo zonyango.
Uvavanyo lweZliniki
Kukho uninzi lwezilingo zeklinikhi eziqhubekayo ngumhlaza womhlaza we-ovarian oye waphinda, kwaye uphando olubheke kwezinye zezi zikhetho lukhuthaza. Thetha kwi-oncologist yakho malunga nezilingo ezinokuhlangabezana nemeko ethile, okanye ucinge ngombono wesibini. Ezinye zezi zikhethi zibandakanya imishanguzo yonyango ekujoliswe kuyo-oko kukuthi, imishanguzo eyenzelwe ukujolisa ngqo kwiiseli zomhlaza, kunye neyeza elithile kwiklasi elitsha lamachiza ebizwa ngokuthi i-PARP inhibitors livunyelwe ukusetyenziswa ngo-2015.
I-Palliative vs. Intsebenzo Yonyango Yokunyanga
Igama elithetha "ukuhlinzwa ngokunyanzelisayo" kunye "nokusabalalisa kwelanga". Nangona ukuba utyando alusekho ukhetho lokukhusela ngexesha elithile kwonyango, kunokukhethwa kwindlela yokuhlinzwa eyenziwa "i-palliate" okanye uncede ukuxazulula okanye ukulalisa izimpawu. Kwiimeko ezinqabileyo, oku kunokwenzeka ukuba utyando lwangaphakathi lwamathumbu okanye ukutshatyalaliswa kwendawo ekhuselekile yamathumbu (ngokuqhelekileyo amacandelo amaninzi avinjelwe) ukuze avumele umntu ukuba adle ukutya ubuncinane ubuninzi beenyanga. Kwezinye iimeko, oku kungathetha ukubeka ityhubhu ngqo kwisisu ngesikhumba (gastrostomy) ukwenzela ukuba ukuhlanza kukhululeke kwaye ityhubhu ekhaleni (NG tube) ayifanele ibe khona iiveki okanye iinyanga.
Ngamanye amaxesha emdlalweni ophezulu, umkhuhlane uqokelela kwisifuba. Iinkqubo ezahlukeneyo zokucima umbane, kubandakanywa nezibatho kunye neenkqubo zokuqhawula (pleurodesis) , kunokukunceda ukuphelisa okanye ukunciphisa olu lukhuni kunye nokunceda ngeengxaki zokuphefumla. Le mizekelo nje emininzi, kodwa kwimeko yimeko yecala, uhlobo oluthile lotyando okanye inkqubo echanekileyo ekhokelelwa ngumoya inokuba luncedo kuwe. Ukuba unesifo esithile, buza ukuba mhlawumbi uhlobo oluthile lotyando okanye olungenayo luya kunceda.
Ekugqibeleni, nangona umdlavuza onqabile, umhlaza wesifo somzimba ungabandakanya amathambo akho, kaninzi uvelisa ubuhlungu obukhulu. Kwakhona kanqabileyo kunokusasazeka kwingqondo kwaye kuvelise ukuthotywa. Kuzo zombini kwezi zimo, unyango lwe-radiation kuloo ndawo lunokuba luncedo kakhulu ekunciphiseni okanye ekupheliseni iimpawu.
Umthombo:
National Cancer Institute. I-Ovarian Epithelial, iTallopian Tube, kunye ne-Primary Peritoneal Cancer Treatment-kwiingcali zempilo (PDQ®). I-Recurrent okanye eqhubekayo ye-Ovarian Epithelial, iTallopian Tube, kunye ne-Primary Peritoneal Cancer Treatment. Ukuhlaziywa 08/21/15. http://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq#section/_82