Kutheni oogqirha bengasebenzisi igama elithi 'Philiswa' nomhlaza?
Umbuzo uvame ukucelwa ukuba, "Ngaba umhlaza wemiphunga ungaphiliswa?" Kuthekani ukuba ibanjwe kusasa? Ngaba utyando okanye i-chemotherapy iya kunyanga umhlaza wamaphaphu? Njengemibuzo emalunga nomdlavuza wamaphaphu, impendulo ethembekileyo malunga nokuba umhlaza okanye imiphunga emaphaphu "iphilisa" idinga ingcaciso ecacileyo.
Lo ngumbuzo onzima kuba impendulo ingaba nguwe ewe okanye akukho kuxhomekeke kwindlela ochaza ngayo unyango.
Ngaphambi kokuba uchaze oko kuthetha ntoni kwaye ngenxa yokuba ithemba libaluleke kakhulu ekumiseni umdlavuza, kubalulekile ukukhumbula engqondweni izinto ezimbalwa:
- Ngexesha elide ukusinda nomhlaza wamaphaphu, ngamanye amaxesha kunokwenzeka, ngakumbi xa eso sifo sibanjwe kumanyathelo okuqala, okanye ukuba umhlaza wemiphunga ophakamileyo uphendule kwiipilisi okanye kwi-immunotherapy.
- Abanye abantu baphila iminyaka emininzi nangomdlavuza wesibeleko wesigaba 4.
- Iimitha ezithintekayo eziqhelekileyo, njengokuba umdlavuza wamaphaphu usasazeka kwingqondo, ngamanye amaxesha unokuphathwa ngethemba lokuhlala ixesha elide.
- Kukho iingxelo ezixeliweyo-nangona zincinane-apho umdlavuza wamaphaphu usuphethwe ngokukhawuleza .
- Nangona umhlaza wemiphunga awuphilwanga, phantse uhlala unyango.
Yintoni 'Ukunyanga' Ethethayo Ngokuphathelele 'Izidumbu Eziqinileyo'?
Ngomxholo onzima kakhulu welizwi, umhlaza wemiphunga awukwazi "ukuphiliswa." Oko kuthetha ukuthini ukuba kukho ithuba elihle (kwezinye iimeko le ncinane kakhulu) ukuba umhlaza wemiphunga unokuphindaphinda, kwaneeminyaka emininzi okanye emashumi emva kokufunyanwa okokuqala.
Xa umntu esaphila engenawo ubungqina bomdlavuza (akukho ubungqina bomhlaza ngamanye amaxesha kuthiwa yi- NED ) ngezantsi kunokwenzeka ukuba kuza kubuya.
Kukho imincinci emancinci apho abantu bangabhengezwa "bayaphiliswa" ngendlela ecacileyo yelizwi, kwaye ezininzi zazo zinomdlavuza onxulumene negazi ezifana ne-leukemia kubantwana.
Umdlavuza womlenze, endaweni yoko, ufana nezinye "izicubu ezinzima" ezifana nomhlaza wesifuba kunye nomdlavuza wekolon apho ukukhululelwa kwexesha elide kunokwenzeka, kodwa oogqirha bayanqikaza ukusebenzisa igama eliphilileyo.
Umzekelo wokunceda ukuchaza oku kukuba abantu abaye basinda kumdlavuza wemiphunga iminyaka emihlanu banomngcipheko wokufa komdlavuza wamaphaphu ukuya kwiminyaka eyi-18 emva kokuba baxilongwa. Ukuphindaphinda kunokwenzeka kulabo abane- lungen adenocarcinoma kunomdlavuza wesifo somhlaza wamasipha ; kunokwenzeka ukuba umhlaza usasazeke kwii-lymph nodes , kwaye mhlawumbi ukuba ukuhlinzwa akukwenziwanga ( ngeentsholongwane ezingasebenzi .)
Xa I-Cancer Cancer Ingabizwa Yonyango?
Ngaphandle kweencwadi ngaba bantu abanomdlavuza we-1A yomhlaza wamaphaphu abangenazo i-vascular invasion-oko kuthetha ukuba i-tumor yincinci kakhulu kwaye ayizange ifakwe kuyo nayiphi na imithwalo yegazi. Kule meko, ukuba akukho bubungqina bomsana emva kweminyaka emihlanu, kubonakala ukuba igama lokunyanga lingasetyenziswa.
Kutheni Unokuthi Unomdla Wokunyuka Kwemdlavuza?
Asazi kakuhle ukuba umhlaza wamaphaphu (kunye nezinye izicubu ezinzima ezifana nomhlaza wesifuba) zingabonakala zifihla iminyaka emininzi kwaye ziphinde zibuye ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde zivele. Enye inkolelo kukuba kukho ubukhulu bomzimba wamaseli omhlaza, kunye nezinye iiseli (amangqamuzana omhlaza wesibeleko) ezixhatshazwayo kunyango kwaye unakho ukulala.
Nantsi inqaku elinokukunceda uchaze ukuba umhlaza ungaphila iminyaka okanye kwamashumi eminyaka .
Ngaba I-Cancer Stage Can Can Cure With Surgery?
Ngokubanzi, utyando lunikeza ithuba elihle lokusinda ixesha elide kumdlavuza wamaphaphu. Njengoko kuphawuliwe ngasentla, xa utyando lwenziwa nakweyiphi na inqanaba lokuqala, aluzange lisasaze kwii-lymph nodes okanye kwimithambo yegazi, oogqirha bangase basebenzise igama eliphilileyo.
Ukuhlinzwa kungenziwa kubantu abanesigaba 1 , isigaba sesi-2 kunye nesigaba se-3A esingasomncinci wesifo somhlaza wamaphaphu. Kwisifundo esikhulu, phakathi kwabantu abane-stage 1A umdlavuza wemiphunga, iipesenti ezili-16 zaphinda ziphindaphinda kwiminyaka emihlanu yokuqala, ingozi yokuphindaphinda emva kweminyaka emihlanu ibe yi-4.8 ekhulwini.
Kwesinye isifundo, ama-87 ekhulwini abantu ababenomsebenzi ogqithwe ngempumelelo kunye ne-lymph node dissection, kwaye bephila iminyaka emihlanu emva kokuxilongwa kwabo, basinda eminye iminyaka emihlanu yomhlaza. Kule qela:
- Kubantu abanesifo se-N0 (akukho kusasazeka komhlaza kwi-lymph nodes ngokohlelo lwe - TNM lomhlaza wesifo somdlavuza ), iipesenti ezingama-89 zaba ngumhlaza ongenazo .
- Amaphesenti angama-84 abantu abane-N1 isifo (ukusasazeka komhlaza kwi-lymph nodes kufuphi ne-tumor yokuqala) babengenasifo somhlaza.
- Iipesenti ezingama-65 zalabo abane-N2 isifo (ukusasazeka komhlaza kwi-lymph node kude nomdlavuza) babengenasifo.
Ngaba I-Chemotherapy Iphilisa I-Cancer Cancer?
Ngokuqhelekileyo, i-chemotherapy ayisetyenziselwa ukunyanga kwabantu abanomdlavuza wamaphaphu. Kukho izizathu ezibini eziphambili ze-chemotherapy ezinokusetyenziswa. Omnye unjengonyango olusisigxina. Ngokomzekelo, ukuba umntu unomdlavuza womhlaza, i-chemotherapy inokunikezelwa njengonyango olongezelelweyo xa kwenzeka nayiphi na iseli somdlavuza wamaphaphu kwenye imimandla yomzimba-kodwa ayikwazi ukufunyanwa kwizifundo zokucinga. Ezi iiseli ezinokusasazeka kodwa ezingabonakaliyo zibizwa ngokuba yi-micrometastases.
Enye injongo ephambili yekhemotherapy nomhlaza wamaphaphu unjengonyango oluthile. Le yonyango olunikezelwa ukwandisa ubomi okanye ukunciphisa iimpawu, kodwa kungenjongo yokuphilisa isifo.
Indima ye- chemotherapy yomdlavuza wamaphaphu ibaluleke kakhulu ukuqonda. Uphononongo olwenziwe ngo-2014 lubonise ukuba malunga nama-70 ekhulwini abantu abanomdlavuza wamaphaphu abazange baqonde ukuba i-chemotherapy yayingekho yonke into yokuphilisa umdlavuza wabo. Abantu abaninzi banethemba elilindelekileyo lokuba mhlawumbi i-chemotherapy iya kusebenza ukuphilisa umdlavuza wabo, kodwa akunakwenzeka ukuba umntu unesifo se-metasatic.
Ukuba ugqirha wakho uthetha malunga ne-chemotherapy enesifo, qiniseka ukuba uyazi ukuba uthetha ntoni kunye neenjongo zakhe. I-chemotherapy ehambayo yanikezwa ngeenjongo ezahlukeneyo kwingqondo yokuba i-chemotherapy yendabuko. Ngamanye amazwi, ukuba unethemba lokwenene lokufumana unyango, unokufuna ukujonga isilingo seklinikhi okanye ukhetho olunjenge-immunotherapy.
Ingaba I-Cancer Cancer Can Cure With Radiation?
I-radiotherapy yomzimba we-Stereotactic (SBRT) , eyaziwa ngokuba yi-"cyber knife", inokuthi ibe nokusebenza okufana nokuhlinzwa kwabanye abantu abanomdlavuza wamaphaphu, kwaye abo abanomdlavuza abakwazi ukunyangwa ngokuhlinzwa. Kwisifundo esincinane sezigulane ezasinda kwiminyaka emihlanu emva kwe-SBRT, ama-25 ekhulwini abuye aphinde aphinde ahlawule isifo.
Ulwaphulo lwemizila yemveli lusetyenziswa ngokusetyenziswa kwindlela yokwenza unyango (njengokwenza i-chemotherapy), ukwandisa ubomi, okanye ukunciphisa iimpawu zomhlaza wemiphunga njengentlungu yesifo okanye ukuvinjelwa kwamanzi.
Unokuthathwa ngonyango okanye kwi-Immunotherapy
Ngomdlavuza wamaphaphu unqanaba lesi-4 (okanye isigaba 3B ), injongo yokunyanga ayidlaphi unyango, kodwa kunokwandisa ubomi kunye neempawu zokulawula. Oku kuthethi, kwaye ngokukodwa kwezinye zezilwanyana ezijoliswe ngumdlavuza njengomphunga wamaphaphu ezifana neTarceva erlotinib) okanye i-Xalkori (crizotinib) abantu abathile bayakwazi ukuhlala ixesha elide, ngamanye amaxesha emininzi xa bephethe umhlaza wabo njengoko babeya kwesinye isifo esingapheliyo isifo sesifo okanye isifo sikashukela.
Kubalulekile ukuba wonk Ukongezelela kwonyango olwamkelweyo kubantu abanokuguqulwa kwe-EGFR , ukulungiswa kwe-ALK, ukulungiswa kwe- ROS1 kunye nezinye iinguqu zofuzo kumaseli esifo somhlaza kukho ukuvavanywa kweeklinikhi ukuvavanya ezinye iimpawu zamanqaku eminye yamaseli omhlaza wamaphaphu.
I-Immunotherapy iphinda iphefumle isithembiso sobomi bexesha elide elingenasifo ngenxa yobuncinane abantu abathile abanomdlavuza omkhulu wamaphaphu. Akuyena wonke umntu ophendula kule zonyango, kodwa xa esebenzayo angakhokelela ekuphumeni kwexesha elide kwabanye abantu. Ngo-2015 izidakamizwa ezimbini zokuqala zamagciwane, i-Opdivo (nivolumab) kunye ne-Keytruda (pembrolizumab) yavunywa ukuba unyango lomhlaza wamaphaphu kunye neminye imichiza kule klasi, kunye nokudibanisa, zivavanywa kwizilingo zonyango .
Unyango lwe-Oligometastases
Nangona ngezinye iimeko ezinokudlulayo, ukuhlala ixesha elide kunokwenzeka nangona xa umdlavuza wamaphaphu usasazeke. Kukho iingxelo zabantu abangaphezu kweshumi elinanye abaye baphila iminyaka eli-10 okanye ngaphezulu emva kokuba i- brainast metastases ivela kumdlavuza wamaphaphu. Ingxelo yakutshanje iphinda ibonise ukuba unyango lweeastastas kwiindawo ezininzi kunye ne-stereotactic body radiotherapy ingaba yindlela yokuphucula ixesha elide lokuphila kwabanye abantu abanomdlavuza womhlaza wesigaba 4 kwixesha elizayo.
Funda kabanzi malunga neendlela zokwelapha umhlaza wamaphaphu kunye neethambo zesifo se- bone , i- adrenal gland i-metastases , kunye ne- foasted liver .
Kuthiwani Ngokunyanga Kwemvelo?
I-intanethi igxininise neengqungquthela ezibizwa ngokuthi "ukunyanga kwemvelo" ngomhlaza. Ngelishwa, izifundo ukuya kumhla zikwahluleka ukubonisa inzuzo yokusindisa nayiphi na le ndlela. Eyona nto ingcono, ezinye zeemveliso zingancedisa iimpawu ezinxulumene nomhlaza wamaphaphu kunye nonyango lwazo, kodwa kunzima kakhulu, zinokuphazamisa i-chemotherapy, inokukhupha izigulane ezingumdlavuza, kwaye, xa zisetyenziselwa indawo yokwelapha, zinganciphisa ubomi kulindeleke.
Ngenhlanhla ukuba izigulana kunye neentengiso zonyani ziye zanciphisa ezinye iindlela zonyango ngeendlela ezininzi. Ukulawulwa ngabaqeqeshi abanelayisenisi abaxhomekeke kwiiyeza zokudibanisa ezinye zezi zonyango, ezifana nokucwenga okanye i- ginger ye-cerebral-provoked nausea , kunokunceda abantu bajamelane neempawu zonyango lwonyango lomhlaza, kwaye ukwenza oko, kuphucula umgangatho wobomi. Funda kabanzi ngezinye iindlela zokwelapha umhlaza womphunga ongakunceda ukujamelana neempawu zesifo.
Ukujamelana nokungaqiniseki
Ukujamelana nokungaqiniseki ngomhlaza ngumnye wezinto ezinzima kakhulu zokusinda . Ukubandakanya emphakathini womdlavuza wemiphunga uye wabancedisa abantu abaninzi ukuba babhekane ne-scanxiety kunye nokwesaba ukuphindaphindwa komhlaza kunye nokuqhubela phambili , njengoko uqaphela ukuba kungekhona nje kuphela wena ongeyodwa kodwa unokufumana intsikelelo kwabanye abafumene ukuba banesifo.
Ngethuba sisazi ukuba ngamanye amaxesha abantu abenza yonke into efanelekileyo benokuqhubeka nokukhula komhlaza wabo, kukho izinto ezimbalwa onokuzenza zona ezinokuphucula ubomi . Sifunda kwakhona ukuba ukutya ukutya okunempilo kunokudlala indima ekunciphiseni ukuphindaphinda, kwaye unokufuna ukukhangela olu luhlu lomdlavuza wamaphaphu-ukutya ukutya okuye kwavavanywa ukuze kubone ukuba yintoni, nokuba ikhona, isiphumo esinokuyenza kwimiphunga iiseli zomhlaza ngokuthe ngqo.
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