Isizathu sokuba Kungenzeka okanye Kungeke kube yindlela
Ngexesha lomdlavuza wamaphaphu odlulileyo wawucingelwa ukuba "ukuchasene" ngokupheleleyo kokufakelwa kwemiphunga (ukuchasana ngokupheleleyo kuthetha ukuba inkqubo iya kugwenywa ngokupheleleyo) impendulo ayisoloko "ayikho".
Kukho amaxesha, nangona kunqabile, xa ukufakelwa kwemiphunga kungasetyenziselwa unyango kubantu abaneentlobo zemiphunga yomhlaza. Enyanisweni, ukusetyenziswa kwemiphunga yemiphunga yomdlavuza wamaphaphu kuye kwanda kancane kwiminyaka yamuva.
Kutheni ukucetyiswa ukuphuculwa kwemiphunga kukucetyiswa ntoni, uphando luni, kwaye kutheni kungenakucetyiswa kuninzi lwabantu abaphila nomhlaza wemiphunga?
Ngexesha Nini kwaye Kutheni ukuTshintshiselwa akuqhelekanga
Kuba abaninzi abantu abanomdlavuza wamaphaphu, ukufakelwa kwemiphunga (omnye okanye kabini) akukhethi. Esinye isizathu kukuba ukuguquka kwemiphunga kuthathwa njengonyango lwengingqi. Izonyango zengingqi ezifana nokufakelwa kwemiphunga, ukuhlinzwa komhlaza wamaphaphu , kunye neyeza zokwelapha imitha yomhlaza wamaphaphu kuphela ukuphatha iiseli zomhlaza ezigcinwe emipompheni. Ngelishwa, ngenxa yobuninzi babantu abanomdlavuza wamaphaphu, umhlaza usasazeke ngaphaya kwemipuphu ukuya kuma-lymph node kwaye rhoqo kwiindawo ezikude zomzimba. Xa oko kwenzeka, unyango lwenkqubo (unyango olusebenza kumaseli omhlaza kuwo wonke umzimba) njengokhemotherapy, unyango olujoliswe kuyo , kunye ne-immunotherapy zikhethekileyo.
Esinye isizathu esiyinhloko ngumngcipheko wokuphinda umdlavuza wamaphaphu kwindawo yokuphulukiswa komphunga.
Enyanisweni, kwanabantu abangabonakaliyo abangasetyenziselwa ukupakisha imiphunga njengonyango, umhlaza wamaphaphu uphinda uphinde uphuculwe (unikezwe) umphunga.
Xa ukutshintshwa kunokusetyenziswa
Kukho iziganeko ezintathu eziphambili apho ukufakelwa kwemiphunga kunokuqwalaselwa kumntu onomdlavuza wemiphunga. Ezi ziquka abantu abane:
- I-Bronchioloalveolar carcinoma yomphunga (i-BAC) ephakamileyo kunye ne-multifocal (ngaphezulu kommandla omnye womhlaza empompeni okanye emiphakeni.) I-BAC, engasabiwa yi-BAC kwaye esikhundleni sayo i-subtype ye-lung adenocarcinoma, i-akhawunti engama-5 ekhulwini umdlavuza wamaphaphu okanye ngaphantsi, oqhelekileyo kubantu abangabhemi, kubafazi kunye nabantu baseMpuma-Asia.
- Umhlaza wesifo somhlaza wamandulo umxube kunye nesifo sokuphela kwesigaba semiphunga njengeCOPD.
- Umdlavuza weMetastatic kwimipopu evela kwenye indawo yomzimba, leyo kuphela imetastatic kumphunga, kwaye xa umhlaza oyintloko ("umhlaza" wokuqala) ulawulwa kakuhle. Le meko ayinqabile.
Kulezi zicwangciso, ukutshintshwa kwemiphunga kunokuqwalaselwa xa ezinye iindlela ezingekho ngophando zingenako ukubonelela ngokufanelekileyo umhlaza. Ukuze uphumelele, oogqirha kufuneka baqoke ngokucophelela abantu abanokuzuza kwi-transplant emphumeni kwaye baqinisekise ukuba umhlaza utyunjwe ngokukodwa, umzekelo, ukuba iimvavanyo ezifana ne- PET scan kunye ne- endobronchial ultrasound ayibonakali nawuphi na ubungqina bomhlaza sasaza ngaphaya kwamapomphu.
Injongo yoTshintshe lweLung for Cancer Cancer
Ukufakelwa kwemiphunga kungasetyenziswa zombini njengonyango lokunyanga (ngenjongo yokuphilisa eso sifo) kunye nokunyanga (ngenjongo yokwandisa ubomi kodwa kungaphilisi isifo).
Oko kuthethwa nguPhando
Okwangoku, ukutshintshwa kwemiphunga kuye kwaba unyango olungavamile kumdlavuza wamaphaphu, kodwa ukuhlaziywa kwe-United Network ye-Organ Sharing (i-UNOS) ibonisa oku kulandelayo:
Ukususela ngo-1987 ukuya ku-2010 kukho amacala angaphantsi kwama-50 abhalwe phantsi (ngaphantsi kwe-0.1 ekhulwini yamatyala okutshintshwa kwemiphunga) ekutshalweni kwemiphunga kusetyenziswa umhlaza wemiphunga. Kula bantu, izigulane ezingama-29 ziye zaqhubela phambili kwi-BAC (ngoku i-reclassified as form of lung adenocarcinoma).
Ngaphandle kokutshintshwa kwemiphunga, kunye nezokwelapha zendabuko, izinga lokusinda phakathi kwabantu abane-BAC eliphambili ngowama-1 ngonyaka. Kubantu abafumene ukutshintshwa kwemiphunga, inani le-5 lokusinda liyiminyaka engama-50 ekhulwini kwaye lifana nesilinganiso sokusindisa abantu abafumana iimpazamo zemiphunga kwezinye izizathu, njengeCOPD.
Oku kungcono kunokusinda okuchazwe yi-chemotherapy, kodwa ngezo unyango olutsha ezinjengezonyango ezijoliswe kuyo kunye ne-immunotherapy, oku kwaziwa.
Ukuvumelanisa kubonakala ngathi kubantu abakhethiweyo ngokuchanekileyo, ukufakelwa kwemiphunga kungabangela ukuhlala ixesha elide kwabanye abantu abane-BAC.
Ubomi boBomi boBomi
Xa uhlala nomhlaza, akukho nto efana nokuva malunga nabantu "baye belapho." Abaninzi emphakathini womdlavuza wemiphunga baphefumulelwe ngumdlali webhola ekhatywayo yaseKholeji, uJerrold Dash, oye wahamba nohambo lwakhe ekufumaneni ukutshintshwa kwemiphunga emibini kwi-4 BAC.
Kwiblogi yakhe, ulwabelana ngokuwina umdlavuza wakhe wamaphaphu kunye nokufakelwa kwemiphunga. Nanku umgca wexesha lokutshintshwa kwakhe, kunye nesimo sengqondo sakhe somguli kwi-BAC kunye nokufakelwa kwemiphunga.
Izifo eziLungileyo zeziphi iziTshintsho ezinokuthi ziqwalaselwe
Ukufakelwa kwemiphunga kunokuthi kuqwalaselwe abantu abanegciwane lesiphelo sesifo somphunga, xa kungekho zikhetho zonyango ezikhoyo, kwaye xa umntu engenakwenzeka ukuba aphile ngaphezu konyaka kodwa kunempilo enempilo. Ezinye zezi zifo ziquka:
- Izifo eziPhezulu zokuVimbela izifo eziPhezulu (COPD) ezifana ne- emphysema
- Icystic fibrosis
- Pulmonary Fibrosis
- Bronchiectasis
- Ukulimala emiphakathini yemiphunga ngenxa yesiphene senhliziyo
- IDronchopulmonary Dysplasia
- Uluhlu lwe-Alpha-1-Antitrypsin
- Sarcoidosis
- Izifo zengqumbo
- Uxinzelelo lwe-Hypertension
Ngaba Ukudluliswa Kwemigodi Kuphakamisa Ingozi Yengculaza Yengwenya?
Ewe, ngenxa yezizathu ezininzi abantu abaye bafumana ukufakelwa kwemiphunga kwingozi yokunyuka komhlaza wamaphaphu esikhathini esizayo, kunye namanani achaza umngcipheko malunga neepesenti ezingama-2.5 kuye kuxhomekeke kwisifundo.
Okukwintsusa
Ukutshintshwa kwemiphunga ngokuqhelekileyo akuyiyo inketho kubantu abaphila nomhlaza wemiphunga. Ngaphandle kokuba umhlaza uncinci kwaye ungancibilike kumphunga omnye, akunakwenzeka ukuba ukufakelwa kwemiphunga kungenza nto ngaphandle koko kubangele ukukhubazeka kunye nentlungu. Nangona neentsholongwane ezinomdlavuza, amathuba okuphindaphinda awanciphise ithuba lokuba ukufakelwa kwemiphunga kuya kusebenza.
Oko kwathiwa, kubantu abathile abane-lung adenocarcinoma (uhlobo olwalubizwa ngokuba yi-BAC), ukufakelwa kwemiphunga kunokuba yinto efanelekileyo. Nangona kunjalo, ingozi yolu vavanyo, apho kukho ezininzi, kufuneka ilinganiswe ngokucophelela nxamnye nayiphi na inzuzo ekulindelekileyo. Kwiimeko ezinqabileyo, ukufakelwa kwemiphunga kungabakho unyango osebenzayo. Ngethamsanqa, njengoko unyango olutsha olumdlavuza wemiphunga njengemithi ejoliswe kuyo kunye ne-immunotherapy iyafumaneka, kukho ezinye, kwaye ngokuqinisekileyo, iindlela ezinobungozi zokuphatha ezi ngonyama.
Ukuba ucinga ukuba ukufakelwa kwemiphunga kunokuba ukhethe, ungafunda ngaphezulu. Khangela isikhokelo sokudlulisa imiphunga yeCOPD . Nangona kukho ukungafani phakathi kwezinto eziye zenziwa umhlaza wemiphunga kunye neCOPD, iziseko zovavanyo zifana kakhulu.
> Imithombo:
> Ahmad, U. et al. Iziphumo zokufakelwa kwemiphunga yomdlavuza wamaphaphu kwi-United Network ye-Registry Sharing Registry. Ama-Annal of Surgery Thoracic . 2012. 94 (3): 935-40.
> I-Brand, T., kunye ne-B. Haithcock. I-Cancer yeLung ne-Lung Transplantation. Iiklinikhi zeeTraphic Surgery . 2018. 2 (1): 15-18.
> de Perrot, M. et al. Indima yokufakelwa kwemiphunga ekunyanga kwe-carcinomas ye-bronchogenic kwizigulane ezinezifo zesiphelo sesiphelo. Umbhalo we-Clinical Oncology . 2004. 22 (21): 4351-6.
> Garver, R. et al. Ukuphindaphindwa kwe-bronchioloalveolar carcinoma kwimiphunga yokutsalwa. I-New England Journal of Medicine . 1999. 340 (14): 1071-4.
> Machuca, T., kunye no-S. Keshavjee. Ukutshintshela umhlaza womphunga. Iingcamango zangoku kwi-Organ Transplantation . 2012. 17 (5): 479-84.
> Mathew, J., no R. Kratzke. Umhlaza womlenze kunye nokufakelwa kwemiphunga: ukuhlaziywa. Umbhalo we-Thoracic Oncology . 2009. 4 (6): 753-60.
> Raviv, Y. et al. Umdlavuza womlenze kwi-lung plant transplant receptors: amava esibhedlele esiphakeme kunye nokuphononongwa kwincwadi. Cancer Lung . 74 (2): 280-3.
> Zorn, G. et al. Ukufakelwa kwepulmonary ye-bronchioloalveolar carcinoma. I-Journal ye-Thoracic ne-Cardiovascular Surgery . 2003. 125 (1): 45-8.