Ukuqonda Ukuxhamla Kwakho Nge-Hodgkin Disease
Ukuba wena okanye othandekayo uhlala neHodgkin lymphoma , mhlawumbi uzibuza ngezinga lokusinda esi sifo. I-Hodgkin lymphoma ihlala ichaphazela abantu abatsha ngexesha lezona zihlandlo ezibalaseleyo zobomi babo. Phakathi kwamathuba omsebenzi kunye nabazali bezingane ezincinci, abaninzi abantu abanesi sifo banemibuzo malunga nexesha elindelekileyo lokuphila.
Ngombulelo, isifo seHodgkin (igama elidala lomhlaza) linye yeendlela eziphilisa kakhulu zomhlaza.
Ngethuba elifanayo ukuba mhlawumbi ukhuthazwa yizinga lokusinda kwiHodgkin lymphoma, kulula ukungazithembi xa uvale enye enye isihloko esichazela "ukuqhubela phambili" kunyango. Iindaba ezilungileyo kukuba-ngokubhekiselele kuHodgkin-oku akusiyo nje i-hype okanye ithemba lobuxoki. Siza kuthetha ngethuba lobomi bexesha elide liphuculwe ngaphezu kwexesha elidlulileyo, kwaye zeziphi unyango ezenze umehluko.
Olunye udideko xa uthetha ngokusinda ngeengcingo ezinxulumene negazi ezifana neHodgkin lymphoma zivela kulokho abantu abaziyo malunga namanye amachiza, njengengculaza yesifuba. Abantu bahlala beqhelana nendlela umhlaza wesifuba unokubuyela ngayo kwiminyaka okanye emva kwamashumi eminyaka emva kokonyango. NgeHodgkin lymphoma, ukuphindaphinda kwexesha kusenokwenzeka kwangaphambili, kwaye ukuphindaphinda kwexesha ngokukhawuleza akuqhelekanga. Ngamanye amazwi, abo baye basinda kwiminyaka emihlanu kunye neHodgkin lymphoma banokuba ngabahlali abasinde ixesha elide kunabantu abanobunzima obukhulu.
Makhe sithethe malunga neenkcukacha zokuphila ezikhoyo kunye neHodgkin lymphoma, izinto ezinokuchaphazela ukuhlala kwexesha ukusuka kwinqanaba ukuya kwixesha lokuxilongwa, kwaye oko ungakwenza ngokwakho ngethemba lokuphucula ukuhlaselwa kwakho.
IHodgkin Lymphoma: Ukuhlaziywa okufutshane
I-Hodgkin lymphoma ngumhlaza wesimiso se- lymphatic , inxalenye yesistim somzimba .
Ngokuqhelekileyo kubakho kubantu abadala abancinci abaneengxaki zokuxilongwa; omnye phakathi kweminyaka eyi-15 no-35 kunye nomnye kubantu abangaphezu kweminyaka yobudala engama-55. Isifo se-Hodgkin ngokuqhelekileyo siqala ngokuphuhliswa kwentlungu ye-lymph noyiphi na emzimbeni, kodwa kaninzi entanyeni. Kukho iintlobo ezintlanu ezahlukeneyo zeHodgkin lymphoma ezahlukileyo kwixesha, inxalenye yomzimba echaphazelayo, nendlela abaphendula ngayo kunyango.
Umbono woMlando kwiNgqungquthela yeHodgkin Lymphoma
I-Hodgkin lymphoma yenye yezona zigulo "ezinonyango" zonyango, kodwa oku akuzange kube njalo. Okokuqala yaqatshelwa ngekhulu le-19, ukuxela kwangaphambili ukuya kwinqanaba lokugqibela leminyaka elidlulileyo.
Ngokuza kwe-radiotherapy, kunye ne- chemotherapy edibeneyo kwiminyaka yama-1960, ukugqitywa kwesi sifo kuphuculwe ngokugqithiseleyo, kwaye phantse ubusuku ubuncinane abantu abafumene ukuba bahlala besisifo.
Nangona kunjalo ukuphuculwa kwonyango kuyaqhubeka. Kusuka kwidata ekhutshwe yiNational Cancer Institute ngo-Ephreli ka-2017, izinga lokusinda iminyaka emi-5 leHodgkin lymphoma (zonke izigaba ezidibeneyo) zaziyi-69.9 ekhulwini ngo-1975 kunye nama-85.4 ekhulwini ngo-2009. Uninzi lwalo lwandiso lubangelwa ukuqhubela phambili kwi-chemotherapy ( njenge- ABVD chemotherapy , kunye ne- BEACOPP i-chemotherapy regimen ), unyango lwe-radiation, kunye ne- stem yonyango .
Izinga lokusinda liqhubeka liphucula, kwaye nangona amaxabiso aphantsi kakhulu kulabo bafunyanwe kwixesha elide okanye abanamazinga aphakamileyo esi sifo, ezi ziphuculweyo ngoku. Ukusetyenziswa kwe-chemotherapy ephezulu ye-dose salvage kunye ne-stem cell transplantation kulabo abafumana ukuphindaphinda kwakhona baye baphucula ngokuqhubekayo. Ukusetyenziswa kolwaphulo olujoliswe kwi- antiocidal monoclonal , i-immunotherapy kunye ne- check inhibitors , kunye ne- nonemyeloablative stem cell transplants zinika iindlela ezongezelelweyo zonyango ezilindeleke ukuba zenze ngcono uphuculo kulabo abanenkinga yokuphatha i-Hodgkin lymphomas.
Ulawulo olungcono lweengxaki, ezinjengezonyango ezinxulumene ne-neutropenia (i-white white cell count count), iye yenze umehluko.
Ukusinda akusiyo kuphela inzuzo yokuphuculwa kwonyango. I-chemotherapy encinci yonyango kunye neyeza ezincinci zonyango ziye zanciphisa imiphumo emibi yonyango kwaye, ithemba, igalelo elide lexesha elide lesi sifo.
Ukusinda NgamaKhansela anxulumene negazi kunye neMisongo eQinisekile
Kulabo baqhelana nezifo ezinomdlavuza ezifana nesifo somhlaza webele, kuyakunceda ukuthatha isikhashana kwaye uthethe ngendlela amazinga aphambili (isigaba III okanye isigaba IV) se-Hodgkin isifo (kunye nezinye i-cancer ezihlobene negazi) zihluke ngokugqithisileyo kunokuba Amanqanaba aphakamileyo amaninzi omzimba (njengomhlaza wesifuba okanye umdlavuza we-pancreatic).
Amagciwane anxulumene negazi aphezulu, afana nesigaba se-IV Hodgkin isifo, ahlala esaphila. Ngokwahlukileyo, amaninzi amanqanaba aphezulu ephambili (njengomdlavuza webele wesigaba se-IV okanye umdlalo we-stage IV pancreatic) awaphilwanga. Ngokufanayo, ukugxekwa kwakhona kwe-Hodgkin lymphoma kulunge ngakumbi kunokuphindaphinda kwezicubu ezinamandla.
Ukuqonda iiRhafu zokuPhucula kunye noLwabiwo lokuLindelwa koBomi
Siza kufumana amanani kunye neenkcukacha ezichazwa ngokuphila kungekudala kodwa kufuneka zichaze ukuba zezi zithini iirhafu, kwaye ezinye zeemilinganiselo ezikhoyo kule nkcukacha.
Amazinga okusinda aqhelekileyo achazwa njengepesenti elandelwa lixesha elithile. Ngokomzekelo, unokubona unyaka oneminyaka eli-1, iminyaka emi-5, okanye iminyaka eyi-10 yokusinda. Ukuba isifo sinomlinganiselo weminyaka emihlanu yokusindisa kuthetha ukuba ama-50 ekhulwini abantu abanesi sifo baya kuphila iminyaka emihlanu emva kokuxilongwa.
Ngamanye amaxesha usenokuthi ubone igama elithi " izinga lokusinda kwamanzi ." Izinga lokusinda komzimba lilandelwa lixesha lexesha kwaye limele ixesha emva koko i-50 ekhulwini labantu bebefile kwaye ama-50 ekhulwini abantu basaphila. Ngokomzekelo, izinga lokusinda phakathi kweenyanga ezili-13 liza kuba lixesha emva koko i-50 ekhulwini labantu sele befile kwaye i-50 ekhulwini isaphila. Ngomdlavuza onjenge-Hodgkin isifo, uza kubona amaxesha amaninzi okuphila, kodwa, nangomdlavuza we-pancreatic okanye umdlavuza wamaphaphu, ukusukela kwindoda eqhelekileyo kusetyenziswa rhoqo.
Ekujongeni la maxabiso, inqaku elibaluleke kakhulu ukuba lenze ukuba "lingumlinganiselo" kunye "namanani." Abantu abayinyani azinabalo. La manani achaza ixesha elide lomntu onalo naluphi na umgangatho wesifo seHodgkin kunye naziphi na izinto ezilindeleke ukuba ziphile. Nangona kunjalo, nangona xa amazinga okusinda aphulwa ngumdala kunye nesigaba, akunakwenzeka ukuqikelela indlela umntu oza kwenza ngayo ngesifo. Abanye abantu benza okungcono kunokuba "umyinge" kwaye abanye abantu abenzi.
Imida yokuPhulwa kweeRhafu
Njengoko kuphawuliwe ngasentla, enye yeyona mingcipheko enkulu yokusinda kwamazinga kukuba inika uqikelelo oluqhelekileyo lokusinda, kodwa akukho mntu ophakathi. Ukongezelela, amazinga okusinda angakhohlisa ezinye izizathu.
Ukujonga amazinga okusinda eminyaka emi-5 kuthetha ukuba sibheke abantu abaye bafumanisa ubuncinane ubuncinane iminyaka emi-5 edlulileyo. Ngelo xesha, uphuhliso olutsha luye lwaphuhliswa. Eyona ndlela, amazinga okuphila angakuxelela indlela umntu oqhelekileyo akwenzileyo ngaphambili emva kokuba aphathwe ngezonyango ezinokuthi zingasetyenziswa nanamhlanje. Ngentuthuko eyenziwa ngonyango lomhlaza, isantya sokusinda siya kuba nechanekileyo kangangoko njengoko kuqikelelwe kwixesha elidlulileyo. Nangona oku kungenza izibikezelo zibe nzima, zisitsho ukuba inkqubela phambili yenziwe.
Ukuphila ixesha elide kunzima kakhulu ukuqikelela. Izifundo ezininzi zihlukanisa ukufa ngenxa yesifo seHodgkin kunye nokufa ngenxa yezinye izizathu, kodwa le miqathango ayisoloko iqwalasela iimeko zonyango ezingahambelaniyo kodwa ngenxa yonyango, njengeekliniki zesibini.
Iindleko zokuPhezulu eziPhezulu kunye neNqanaba lokuPhucula ngeSigaba
Kukho iindlela ezahlukeneyo zokujonga iindleko zokuphila kunye neHodgkin lymphoma. Makhe sijonge ezi ndlela ezimbalwa.
Izinga lokusinda ngokubanzi elinika ithuba lokuphila kubantu abanezigaba ezidibeneyo ziquka:
- Umyinge we-1 weminyaka jikelele yokuphila kwama-92 ekhulwini
- Iminyaka engama-5 yokuphila komlinganiselo weepesenti ezingama-87
- Iminyaka engama-10 yokuphila komyinge wama-80 ekhulwini
Izinga lokusinda iminyaka emi-5 ngelixesha zibandakanya:
- Isigaba esiyiminyaka emihlanu yokusinda kwimizuzu engama-90
- Isigaba II isantya seminyaka emihlanu yokusinda i-90 ekhulwini
- Isigaba III Isilinganiso sokusinda iminyaka emi-5 ngama-80 ekhulwini
- Isigaba IV isithuba seminyaka emihlanu yokusinda ngama-65 ekhulwini
Kubalulekile ukuba uqaphele ukuba le mivuzo ingumlinganiselo wabo bonke abantu abanesigaba esithile sesifo seHodgkin kungakhathaliseki ubudala babo kwaye kungakhathaliseki ukuba yintoni enye into enokunyusa okanye yokunciphisa amathuba okuphila.
Ukusukela ixesha elide kunye neHodgkin Lymphoma
Ukuphila ixesha elide kunye neHodgkin lymphoma kunzima ukuqikelela, ngenxa yeemeko ezifana neekliniki zesibini ezenzeka emva kweminyaka emininzi unyango. Oko kwathiwa, izifundo ezahlukileyo ziqikelela ukuba phakathi kweminyaka eyi-15 no-30 ngaphandle kokonyango, abantu abaye bafumana i-Hodgkin lymphoma banokufa ngenxa yezizathu ezingahambelani neHodgkin lymphoma kunokuba baseHodgkin. Ngamanye amazwi, emva kwexesha eli xesha abantu banokufa ngenxa yezizathu ukuba abantu abaphakathi baya kufa.
Izinto ezichaphazelayo ukusinda kunye ne-Hodgkin Disease
Kukho iinguqu ezininzi ezidibeneyo kunye nokunyuka okanye ukunciphisa amathuba okuphila kwisifo seHodgkin. Ezinye zezi ziquka:
- Isigaba sesi sifo - Isifo se-I okanye sesi-II sithatha isigwebo esingcono kunesigaba III okanye isigaba IV.
- Ubudala - Abantu abancinci bavame ukwenza okungcono kunabo abadala (abangaphezu kweminyaka engama-45).
- Ukwabelana ngesondo - Abasetyhini banomdla wokuphila ophezulu kunamadoda.
- Ubunzima bezimpawu zeB - Ukulahleka kwesisindo, ukukhupha ebusuku, kunye neentsholongwane, iimpawu ze- B ezibizwa ngokuba yi -lymphoma , zidibaniswa kunye nesifo esiluhlaza (kodwa ke, uninzi lwabantu lunokuphumelela ukusinda ixesha elide).
- Ingaba ukuphindaphinda kwenzeka kwaye xa - Kwalabo abaphinda baphinde babuye kunyaka wokuqala emva kokonyango, ukuxela kubangelwa.
- Ukuphendula kwonyango - Abo baphendula kwithayibrari yokuqala bafumana isilathiso esingcono kunezo ezingenayo.
- I-albumin level - Iqondo eliphantsi le-albumin (ngaphantsi kwe-4 g / dL) lidibaniswa nomntu oswelekileyo.
- Ukubalwa kweeseli zegazi (i-WBC) - Inani eliphezulu legazi lamhlophe (ngaphezulu kweeseli zegazi ezingama-15 000 nge mm3) lidibaniswa nomntu oswelekileyo.
- Inani elincinane lymphocyte count (ALC) - I-lymphocyte ephelele engaphantsi kwama-600 i-cell3 nganye inxulumene nomntu oswelekileyo.
- Isifo esincinci se-bulky sinokuhlaselwa ngcono.
- I-anemia - I- hemoglobin ephantsi (ngaphantsi kwe-10.5 g / dL) inxulunyaniswa kunye nesifo esibi kakhulu kunabantu abanomgangatho ophezulu we-hemoglobin.
- Isantya se-Sed - Isantya se- erythrocytes sedimentation (ESR) esingaphezu kwe-30 sidibene nomntu oswelekileyo.
- Uhlobo lwe-Hodgkin lymphoma - Ezinye iintlobo ze-Hodgkin lymphomas zidibene nomlinganiselo wokuphila okungcono kunabanye (i- nodular lymphocyte iindidi kunye ne- nodular sclerosing iintlobo zineziganeko ezingcono ngokubanzi).
- Impilo jikelele ngexesha lokuxilongwa kunye nezinye iimeko zonyango
- Ingaba umhlaza unjalo okanye uqhubeka
- Intshuwalense yezempilo - Abantu abangenayo i-inshorensi yempilo banesiphene.
Ukuphindaphinda kunye neeRhafu zokuPhucula
Njengoko sikhankanywe ngasentla, ixesha kunye nexesha lokuphindaphinda lihluke kakhulu neHodgkin lymphoma kunomdlavuza webele. NgeHodgkin lymphoma, ngaphezu kwesigamu sokuphindaphinda kwenzeka kwiminyaka emi-2 yonyango lokuqala kunye neepesenti ezingama-90 zenzeka ngaphambi kokuba umaka oneminyaka emi-5. Ukwenzeka kokuphindaphinda emva kweminyaka eyi-10 kuyinto engavamile kwaye emva kweminyaka engama-15 umngcipheko wokuphuhlisa i-lymphoma ifana nomngcipheko kubantu abaqhelekileyo. Kulabo baye bakuva malunga neengcambu zebele eziphindaphindiweyo emva kweminyaka emininzi, kungathi kungaqinisekiswa ukuba oku akuqhelekanga kunye nesifo seHodgkin. Kwakhona kubalulekile ukuqaphela ukuba nangakumbi ngokuphindaphinda, abantu abaninzi abanesifo seHodgkin baya kuqhubeka ubomi ubomi obude.
Ukuqikelela ukuxhamla kwakho
Kuba abo banqwenela ukuba nombono ongcono malunga nokuxelongwa kwabo, kukho isixhobo esibizwa ngokuba yi- Hasenclever isilathiso sokuxela esetyenzisiweyo ukuqikelela ukuhlaziya ngokusekelwe kwimibandela eyahlukileyo. Ngalunye lwezi zinto ezi sixhenxe kucatshangelwa ukunciphisa iminyaka emi-5 ukusinda ngeepesenti ezisibhozo. Ezi ziquka i-album i-albin engaphantsi kwe-40 g / dL, i-hemoglobin engaphantsi kwe-10.5 g / dL, isondo lesilisa, isigaba se-IV sesifo, isibalo segazi elimhlophe ngaphezu kwe-15,000 / mL, kwaye i-lymphocyte ibalwa ngaphantsi kwe-600 / mL.
Kulabo abangenayo nayiphi na ingozi, u-5-year estimation prognosis (jikelele) i-89 pesenti, kunye nalabo abanemiba engozi emi-5 okanye ngaphezulu, ubuncinane bokulinganiselwa kweminyaka emi-5 ngama-56 ekhulwini.
Gcina ukhumbule ukuba ezi zixhobo sele zisetyenziselwa ukuqikelela "umyinge" wokugxekwa, kwaye akukho namnye ophakathi. Kwakhona kubalulekile ukuba uqaphele ukuba nangona unemiba engama-5 okanye ngaphezulu engozi, ininzi-engaphezu kwe-50 ekhulwini labantu-isaphila iminyaka emihlanu emva kokuxilongwa.
Yintoni Ongayenza Ukuze Uphuculise I-Prognosis?
Ngazo zonke iingxoxo malunga neendlela zokwenza unyango, ngamanye amaxesha kulula ukulibala ukuba kukho izinto ezilula ozenzayo ukuze uphucule ukuhlaselwa kwakho. Kubalulekile ukuba:
- Yidla impilo: Into oyifakayo emzimbeni wakho ingenza umehluko kwindlela onyamezela ngayo unyango kunye nendlela oziva ngayo emva kokunyanga. Ukuba unobunzima, cela i-oncologist yakho ukukumisela kunye ne-oncology nutritionistist.
- Ukuzivocavoca: Ngoku sinenkqutyana yezifundo eziye zajonga umphumo wokuzivocavoca rhoqo kwisiphumo seengcambu ezininzi ezahlukeneyo, kuquka iHodgkin lymphoma. Nokuba amanani amancinci omzimba ayanceda. Gcina ukhumbule ukuba kungcono ukusetyenziswa rhoqo kwiimali ezincinci kunokuba usebenzise ixesha elide kangangoko.
- Ukulala kakuhle: Asazi malunga nemiphumo yokulala kwi-Hodgkin, kodwa siyazi ukuba ngomhlaza wesibeleko le miqathango inokunciphisa ukusinda. Thetha kwi-oncologist yakho ukuba unolu hlobo oluqhelekileyo lwefuthe lonyango.
- Yenza isicwangciso sokunyamekela ngomhlaza: Xa usenziwa ngonyango, qiniseka ukuba wena kunye nogqirha wakho nigcwalisa icebo lokukhathalela losindayo. Umngcipheko weekliniki zesekondari zinyani emva kokunyangwa kweHodgkin, kwaye unokwanda. Ugqirha wakho unokuncoma kwangaphambili okanye ngokuphindaphindiweyo ukuhlolwa kwimihlaza yentsholongwane njengengculaza yesifuba kwaye ulandelelanise iimpawu zenye i-khansa ukuba zenzeke.
I-Hodgkin Lymphoma: Ngokuqhelekileyo Iphilisa, Kodwa iZifo Ezicelomngeni
Kungabonakala kumhle kumntu ongazange abe nomhlaza, kodwa kukho phantse ukhuphiswano phakathi kwabantu abaneendlela ezahlukeneyo zomhlaza, okanye ubuncinci phakathi kwala manani aphezulu okusinda kunye namanqanaba e-survival rate. Abo abanomdlavuza abanamazinga athile okuphila basenokuthi baqwalasele ezinye iidlers ezinokuphila ezinzima.
Khumbula ukuba nangona iHodgkin i-lymphoma iphilisa ngakumbi kunezinye iindiza ezinomdlavuza, ejongene nayo nayiphi na umdlavuza iyatshisa. Ukuba nokufa kwakho kuphonswe ebusweni bakho into into abangenayo umdlavuza abanako ukuqonda kwaye akukho nto ukuba umhlaza unamazinga angama-99 okusinda okanye i-2% yezinga lokusinda. Sifanele siqaphele ukuba, nangona xa unyango, unyango olulawula i-Hodgkin lymphoma lunzima kakhulu. I-Chemotherapy inokuqhubeka ixesha elide, kwaye ngokukodwa i-stem cell transplants, kwizinga eliphezulu, kunezinye ezininzi i-cancer. Kukho umba weempembelelo zexesha elide le-Hodgkin lymphoma, ezinjengeekliniki zesekondari, eziza kufuna ukubeka iliso ngonaphakade.
Njengengxelo yokugqibela, ukuba wena okanye othandekayo uye wafumana unyango lwe-Hodgkin isifo, kubalulekile ukuthetha nodokotela wakho ngokusinda. Uninzi lweeklinikhi zomhlaza ngoku sele zineenkqubo zokulungisa izifo zomhlaza, apho iziphumo zokugqibela zonyango lomhlaza , ezivela kwiintlungu ezingapheliyo ukuxhalabisa, zijongene ngokupheleleyo.
> Imithombo:
> Ahmadzadeh, A., Yekaninejad, M., Jalili, M. et al. Ukuvavanya iMilinganiselo yokuPhumela kunye neziTyala eziPhezulu emva kokuphatha i-Hodgkin Lymphoma izigulane kunye neeRimotherapy Regimens. I-International Journal ye- Hematology Oncology kunye noPhando lweeStem Cell . 2014. 8 (2): 21-26.
> I-American Cancer Society. I-Cancer Iinkcukacha & Amanani 2017. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html
> Brenner, H., Gondos, A., kunye noD. Pulte. Ukusinda kwezilindele zezigulane ezifunyaniswe neHodgkin Lymphoma ngo-2006-2010. I-Oncologist . 2009. 14 (8): 806-813.
> INational Cancer Institute. Ukuqwalaselwa, i-Epidemiology, kunye neNkqubo yokuPhumela kweZiphumo. I-SEER Cancer Assessment Review (CSR) 1975-2014. Kukhutshwa ngo-Apreli 14, 2017. https://seer.cancer.gov/csr/1975_2014/