Iimpawu, ukuxilongwa, unyango, kunye nokuhlaziya
Ukuba uye watshelwa ukuba uphumelele umdlavuza wamaphaphu, mhlawumbi uziva ukhululekile xa ungakhange ukoyike. Ithetha ntoni le nto? Kuphathwa njani? Yaye unokufumana njani inkxaso oyifunayo?
Sibanzi
Kuthetha ukuthini xa oogqirha bethetha "umhlaza wamaphaphu ophezulu?" Uninzi lwangoku xa oogqirha basebenzisa eli gama bathetha isigaba IIIB kunye nesigaba se-IV IV yomhlaza.
Nangona umdlavuza omncinci wamangqamuzana ungaphumelela, ixesha elininzi apho i-oncologists isebenzisa amagama athi "umhlaza wamaphaphu", abhekiselele kumhlaza ongaphantsi weeseli wamaphaphu , ojongene nemilinganiselo engama-85 engama-cancer yamaphaphu.
Isizathu sokuba umdlavuza wamaphaphu uvame ukuhlukana kwinqanaba lokuqala kwaye isigaba esiphambili kukuba baphathwa ngokwahlukileyo. Ngomdlavuza wokuqala wamaphaphu, utyando luvame ukucetyiswa njengonyango lokuqala, kanti ezinye iindlela ezikhethiweyo zikhethekileyo kwizifo zesigaba esiphambili-ubuncinane ekuqaleni.
Amanqanaba
Njengoko kuphawuliwe ngasentla, ibinzana elithi "isigaba esiphambili" sisoloko sisetyenziselwa ukuchaza isigaba se-IIIB okanye isigaba se-IV esingekho encinane yomhlaza wesifo somhlaza.
- Isigaba IIIB - Isigaba IIIB esingekho esincinci samaseli emiphunga emaphaphu amathumba analuphi na ubungakanani obuye basasazeka kwii-lymph nodes ngaphesheya kwesifuba, kufuphi ne-bone collar, okanye bahlasele ezinye izakhiwo kwisifuba enjengentliziyo okanye isifo.
- Isigaba IV - Isigaba se-IV esingekho esincinci samanqamu emiphunga emaphaphu asemaphandleni asasazeka kwindawo ephakathi kwemigca yokulala emiphakeni ( ukungcoliswa kwamangcwaba embi ) okanye kwenye indawo yomzimba. Umdlavuza womlenze usasazeka kakhulu kumathambo, isibindi, ingqondo, okanye i-adrenal glands.
Iimpawu
Iimpawu zomhlaza wamaphaphu ophezulu zingabhekiswa nobukho bomhlaza emiphakeni, okanye ngenxa yokuhlasela kwamanye amalungu kunye nokusabalalisa (i-metastasis) kwezinye iindawo zomzimba. Iimpawu eziqhelekileyo ezinxulumene nomphunga zingabandakanya ukukhwehlela okungapheliyo, ukuphefumula okufutshane, ukukhwehlela igazi kunye nokujikeleza.
Amagciwane angamakhompa angacinezela kwiisitya ebhokisini esibangeleyo.
Xa umhlaza wemiphunga ukhula ukwanda okanye usasazeka, iimpawu ezinjengokukhathala, ukulahlekelwa kwesisindo esingalindelekanga, kunye nokulahleka kwesidlo kungenzeka. Umhlaza womlenze oye wasasazeka kwingqondo ungabangela intloko, ubunzima beentetho, ukulahlekelwa kwememori kunye nobuthathaka. Umdlavuza womlenze owasasazela esibindi ungabangela intlungu yesisu kunye ne-jaundice. Umdlavuza nomphunga othe wafika emathanjeni ungabangela intlungu emhlane, emahlombe nasesifuba.
Ukuxilongwa
Umhlaza wamaphaphu ophezulu ungatholakala ekuqaleni kwi-x ray okanye CT scan, kodwa uvavanyo olongezelelweyo kunye ne-biopsy imfuneko kuyimfuneko ukuqinisekisa ukuba ingafani nokuba ngumhlaza, nokuba luhlobo luni.
Kwii-cancer eziphambili zeekliniki ezingekho emancinci, kubaluleke kakhulu ukuba iprofayile yefayile (ukuprofilisa i-molecular) yenziwa. Ngexesha lokoqobo, izicubu ezivela kwi-biopsy zifunekayo ukwenza le nkcazelo, ngo-2016 uvavanyo lwe -biopsy lwamanzi luvunyelwe ukuhlolwa kwe-EGFR.
Iintlobo
Umdlavuza omncinci wamaseli omnxeba unokuqhubela phambili kodwa uhlanganiswe kwicandelo elithile. Amanqamu aphezulu amancinci amancinci angaphantsi aquka:
- I-adenocarcinoma ye-Lung - Ngubani ojongene nesiqingatha sala mathambo. Olu uhlobo lomhlaza oqhelekileyo kubasetyhini, abangabhemi, nabaselula abanomdlavuza wamaphaphu.
- I-Squamous cell carcinoma yemiphunga - Eyona nto ixanduva malunga neepesenti ezingama-30 ze-cell non-small cell cancer.
- I-cell cell carcinoma - Umhlaza wesifo somhlaza wamaphaphu udala malunga neepesenti ezili-10 zeekliniki ezingamancinci zamagciwane emiphunga .
- Okunye - Usenokuba uqaphele ukuba amanani angentla angabangeli kwi-100. Kungenxa yokuba ezinye izicubu zinempawu ezifunyenwe endaweni ethile emagqabini angentla apha, njenge-"adenosquamous", okanye imimandla eyahlukeneyo i-tumor ingaba neembonakalo ezimbini okanye ezahlukeneyo zesisu.
Unyango
Kubalulekile ekuqaleni ukusho ukuba unyango lomhlaza wamaphaphu ophuculweyo luphucula .
Izinga lokusinda lomdlavuza wamaphaphu ophuculweyo uphuculayo. Ngoko ke, naziphi na iinani ozifundayo, okanye nayiphina inkcazelo yokwaziswa oyifundileyo engasisesikolweni, ingaba nzima kakhulu. Kubalulekile ukuba ufunde oko unokukwazi malunga nesifo sakho, kodwa thabatha umzuzu ukufunda indlela yokuphanda umdlavuza wakho kwi-intanethi . Ngokomzekelo, kwakukho unyango olutsha olwamkelwe umhlaza wamaphaphu ophakamileyo phakathi kwe-2011 no-2015 kunexesha elingama-4 eminyaka ngaphambi ko-2011. Kukho ithemba elininzi.
Iintlobo zonyango
Izigulane ziba zibandakanyeke ngakumbi ekunyamekeleni ngomdlavuza wamaphaphu kunanini ngaphambili. Ngokungafani nobudlelwane besigulane-ogqirha bexesha elidlulileyo, izigulane kunye noogqirha basebenzisane kunye nokuyila isicwangciso esona sonyango esihle. Ingxenye yesi sizathu kukuba kukho ukhetho olungakumbi kunanini ngaphambili, kwaye ezinye izigqibo zinokuthi zibhekiselele ngakumbi kwizinto ozikhethayo-iziphumo eziphambili ozithandayo ukuzinyamezela-kunanoma yiphina inqanaba lezonyango zonyango olunye.
Kunceda ukuqala ngokuphula izibonelelo ezinyango ezi-2 ezisisiseko.
- Ulwaphulo lwengingqi - Iipilisi zendawo zonyango umhlaza apho-kwindawo-kwaye ziquka unyango lwe-radiation kunye nokuhlinzwa.
- Ulwaphulo olusisigxina - Ulwaphulo lwenkqubo lujoliswe ekuphatheni umhlaza naphina emzimbeni wakho. Ezi zibandakanya i-chemotherapy, iipilisi ezijoliswe kuyo, kunye ne-immunotherapy.
Ekubeni umdlavuza wamaphaphu uphambili ungengcaciso engekho ndawo, iindlela zokwelapha iinkqubo zijoliswe kunyango . Abanye abantu bayazibuza ukuba kutheni ukuhlinzwa kungacetyiswa kwinqanaba le-IV kunye nesigaba se-IIIB yomhlaza wesifo. Isizathu kukuba utyando kunye neyeza zonyango kuphela azikwazi ukunyanga umhlaza osele usasazeka. Oku akuthethi ukuba awuyi kutyunjwa. Kukho abantu abanezifo zonyango ezinciphisa isisu sabo kwisayizi apho ukuhlinzwa kuya kusebenza. Ngezinye iisomhlaza, ezifana nomhlaza we-ovari, "ukuxhalabisa" isisu-ukususa abanye kodwa kungabikho konke ngokuhlinzwa-kunokuba luncedo, kodwa akunjalo ukuba ngumhlaza womphunga. Enyanisweni, ukuhlinzwa kunokugxininisa umzimba ngexesha elifanayo ukuba ufuna amandla akho ukuze unyamezele unyango oluya kunceda. Kukhetho lweenkqubo zokwelapha ziquka:
Iipilisi ezijoliswe kuko - Wonke umntu onomdlavuza wesifo somhlaza wamangqamuzana ongeyonto encinci kufuneka abe neprojekthi yetsholongwane ("ukuhlolwa kofuzo") okwenziwe kwisampula. i-targeted ", kunye nokunye okufunyenwe ngawo onke amaxesha. Ukungaqhelekanga okujoliswe kuyo kubhekisela kwisimo esingaqhelekanga kumaseli omhlaza okanye ahlobene nomhlaza wesifo onokujoliswe ngqo ngamachiza. Ukuba une- EGFR ishintsho , i- ALK i-fusion gene , okanye i- ROS1 i-rearrangement , kukho imithi efumanekayo ekujoliswe kuyo -kwaye le ndawo inokunyuka ngokukhawuleza kwiminyaka ezayo. Ukuba "ukufayilila kwimiloyiyali" ayifumanekanga, qiniseka ukuthetha ne-oncologist yakho.
I-Chemotherapy - I-Chemotherapy yinto "eyona nto" yokwenza umdlavuza wamaphaphu , yaye unokwandisa ubomi kubantu abaninzi. Kukho ininzi inhlanganisela yeziyobisi esetyenziswayo, kodwa ezininzi zazo ziquka "iplatinum" iziza ezinjengePlatinol (cisplatin.)
Immunotherapy - Ukuba ubukele iindaba okanye ufunda nayiphi na amaphephancwadi awayenakukuva malunga ne-immunotherapy. Ngokungafani nenye ye-hype esikhathini esidlulileyo, i- immunotherapy yindlela enomdla kakhulu yokuphatha i-cancer ephezulu . Ezi zonyango zinokucingwa nje ngokuba zixhaphaza izixhobo zethu zokuzivikela ekubulaleni iiseli zomhlaza ngeendlela ezahlukeneyo. Iyeza lokuqala lomdlavuza wamaphaphu kulolu hlobo lugunyaziwe ngo-2015, kwaye ezinye ezininzi zivavanywa kwizilingo zeklinikhi.
Uvavanyo lwezonyango - I-National Cancer Institute incoma ukuba wonke umntu onomdlavuza wamapopayi aphezulu aqwalasele iimvavanyo zeclini. Kukho iinkolelo ezininzi malunga nezilingo zekliniki , kodwa ngaphezu kwexesha eliphambi kweemvavanyo zonyango zinganceda abantu abanomdlavuza wamaphaphu ithuba lokufumana unyango olutsha lwesifo. Ngokomzekelo, abantu abaye bathatha inxaxheba kwilingo lekliniki kwi-immunotherapy izidakamizwa ezivunyiweyo ngo-2015 zenza ngcono kakhulu kunezo ezingenalo ithuba. Gcina ukhumbule ukuba zonke iinkatho ezivunyiweyo zomdlavuza wamaphaphu zafundiswa njengenxalenye yesilingo seklinikhi. Kukho iimeko ezingaphezulu kwe-100 zonyango eziqhubekayo ukuvavanya unyango olutsha lomhlaza wemiphunga. Khangela le ngcaciso malunga nendlela yokufumana iimvavanyo zekliniki ngomhlaza wemiphunga, kunye nesilingo se-clinical free matching service enikezelwa ngumzamo odibeneyo phakathi kwemibutho emininzi yomhlaza wemiphunga.
Unyango lweMetastases
Kwixesha elidlulileyo, unyango lomhlaza wemiphunga kunye neemastastases kwakunjalo kubantu bonke. Oku kutshintsha ngandlela-thile. Kwabanye abantu abaneengqondo ze- metastases ezivela kumdlavuza wamaphaphu okanye i- metastases yesibindi ukusuka kumdlavuza wamaphaphu - ukuba zimbalwa nje "izilonda" okanye iindawo zokusabalalisa-into ebizwa ngokuba "i-oligometastases" -ukunyangwa kunye ne- radiotherapy yomzimba okanye ukuhlinzwa kuye kwabangela ukuphucula ukuphucula .
Kubantu abanesifo se- boneastases kumdlavuza wamaphaphu , iziyobisi ezibizwa ngokuba yi-bisphosphonates kunye neyeza zonyango zingakunceda ekulawuleni ubuhlungu, kwaye ngamanye amaxesha, kunokuthi kuphuculwe ukusinda.
Prognosis
Kunzima ukuthetha ngokuxela umhlaza wamaphaphu ophezulu ngoba siza kuthetha malunga neenombolo ezidibeneyo phambi kokuba unyango oluninzi olukhethiweyo lomhlaza wamaphaphu lufikeleleke. Inani lokugqibela liqokelelwe lifumene ukuba ukunyameka kweminyaka emi-5 yomdlavuza wamapopayi oyiphakamiso kwakusizi ngaphantsi kwama-5 ekhulwini. Oko kwathiwa, baninzi abasinde kwixesha elide lomdlavuza wamaphaphu, kwaye elo nani landa.
Ukunyamezela kunye nenkxaso
Into oza kuyenza ngokukhawuleza emva kokufunyaniswa nomhlaza wamaphaphu ophambili ngumhlaza womphunga uthatha uluntu kwaye sisifo sesapho. Fumana kwiintsapho kunye nabahlobo. Funda ukuba ngummeli wakho ekunyamekeleni komhlaza wakho . Cinga ukufikelela kwi- community cancer yomphunga wamaphaphu- uluntu oluye lwafana nosapho kubantu abaninzi abanomdlavuza omkhulu wamaphaphu.
Kwabathandwa
Ukunyamekela umntu obathandayo ngomhlaza wemiphunga kuya kuba mhlawumbi into enzima kunayo yonke into oyenzayo, kodwa eyona nto inomvuzo kunye nokuphila kuzuza. Qinisekisa ukuthatha isikhashana uze ufunde eli nqaku xa umthandayo enomdlavuza wamaphaphu .
> Imithombo:
> INational Cancer Institute. Ukwelashwa kweNtsholongwane yeNtsholongwane yeNcinci ye-Lung - I-Health Professional Version (PDQ). Ukuhlaziywa 01/20/17. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq