Ukukhusela Inhliziyo Yakho Ukusuka Kwemitha Yomhlaza Ngomdlavuza Webele Wasekhohlo
Ukunyanga kwamayeza kunokuphucula izinga lokusinda kwabanye abantu abanomdlavuza wesibeleko kodwa unokonakalisa intliziyo yakho ukuba unomdlavuza wesifuba esisekhohlo. Ukunyangwa kwamayeza kwintliziyo yakho kungaphinda kubandakanyeke nomonakalo obangela ezinye unyango lwezonyango ezifana ne-chemotherapy kunye nezonyango ezijoliswe kuyo. Funda indlela indlela yokuphefumula yokuphefumula nokuphefumula ibinokunciphisa kakhulu imirhamo ye-radiation ephazamisa intliziyo yakho, kwaye ngokwenza njalo umngcipheko wesifo senhliziyo.
Ukunyanga kwamayeza omhlaza webele
Abasetyhini abaninzi bafumana unyango lwe-radiation ngomhlaza webele , kwaye okwangoku, malunga nama-50 ekhulwini labantu abanomdlavuza webele wokuqala baye balapha. Ukunyangwa kwamayeza embelelweni kungasetyenziselwa ukunciphisa umngcipheko wokuphindaphinda kwendawo embele emva kwe-lumpectomy. Kananjalo kunciphisa umlinganiselo wesifo somhlaza wesifuba ngesinye sesithandathu.
Izaphulo zingasetyenziselwa emva kwe-mastectomy, ingakumbi kubasetyhini abanesifo se- lymph nest for the disease. I-radiotherapy epheleleyo yesifuba inikezelwa kwiishedyuli ezahlukeneyo kuxhomekeke kwisikhululo somhlaza kodwa ngokuphindaphindiweyo kwenzeka rhoqo ngeveki kwiiveki ezintlanu ukuya ezintandathu. Iindlela ezintsha zemizila ye-radiation nazo zinika iqondo eliphezulu lemitha kunye nokutyelela ambalwa kumaziko athile.
Ukunyanga kwamayeza kunye neSifo seNtsholongwane
Ngokunciphisa izinga lokusasaza umdlavuza webele ngenxa yokuhlanganiswa okungcono kwe-chemotherapy, unyango lwe-hormone oluqhubekayo kwiminyaka emihlanu ukuya kwe-10, kunye neengxaki zonyango ezijoliswe kwi-HER2 positive disease, umngcipheko wokuhlala ixesha elide nomhlaza kufuneka ulungiswe.
Kwixesha elidlulileyo, sasingaxhalabele ngegalelo elide lexesha elide lolwaphulo lwe-radiation njengathi namhlanje. Abantu abaninzi banokulindela ukuba baphile iminyaka emininzi emva kokuba le zonyango zisibangela ukuba sijonge ngokukodwa iingxaki ezinokuthi zenzeke phantsi kweendlela.
Ulwaphulo lwe-radiation lucacisiwe kwiintlobo ezahlukeneyo zesifo senhliziyo.
Ezi ziquka:
- Izifo ze-coronary
- I-cardiomyopathy / congestive heart failure, ukunyanzeliswa kweentliziyo zomzimba ezinciphisa amandla entliziyo ukupompa igazi kuwo wonke umzimba
- Izifo ezibandakanya iipasiti zentliziyo (isifo senhliziyo senhliziyo)
- Iimpawu zentliziyo engavamile (i-arrhythmias)
- Iimeko zePericardial: Ukulimala kwintsimbi yentliziyo (i-pericardium) kunokukhokelela ekuveleni kwamanzi phakathi kweetyhubhu ezibizwa ngokuba yi- pericardial effusion . I-pericardial effusion yenza kube nzima kunesifo senhliziyo ukupompa kwaye ngamanye amaxesha kuyakuba yimeko engxamisekileyo yonyango.
- Ukufa kwantliziyo ngokukhawuleza
Izifundo ziye zafumanisa ukuba ukunciphisa inani le-radiation elifikelela entliziyweni xa unyango lubonakala ukunciphisa umngcipheko wentyhefu yentliziyo (umonakalo wentliziyo), kodwa kubaluleke kangakanani oku?
Ukuhlaziywa okukhulu kwe-2017 kubhekise umngcipheko wokufa kweentliziyo ezijongene neentombi ezifunyanwe nomhlaza wesifuba phakathi kuka-2010 no-2015. Kule datha kunye nezinye iingcaphephe, abaphandi bazama ukuqikelela umphumo wonyango lwe-radiation kwisifo senhliziyo esizayo kwaye uqhathanise oku kunye izibonelelo zemizila ekunciphiseni ukuphindaphinda nokufa kwesifo somhlaza.
Kwafunyaniswa ukuba iinzuzo zonyango lwe-radiation kwi-survival cancer survivors zazingaphezulu komngcipheko wesifo senhliziyo esichaphazelekayo.
Kwakukho uhlobo olulodwa, nangona kunjalo, nakubantu abashisa umngcipheko wezifo zentliziyo ezinxulumene ne-radiation bangaphezu kweenzuzo zabo zomhlaza. Konke, unyango lwamayeza luqikelelwe ukwandisa ingozi yesifo senhliziyo ngama-30 ekhulwini.
Ukuphefumula Ukuphefumula: Ngaba Kusebenza?
Ukuphefumula ngeendlela zokuphefumula yindlela yokuguqula umlo wesifuba ukwenzela ukunciphisa ukutyhila kwintliziyo kwimisebe. Ukuphefumula nokuphefumula kuthintela unyango lwe-radiation yindlela apho umntu athatha umoya ophezulu womoya kwaye uyigcina ngelixa i-radiation bram isetyenziswe kwibele. Ukubamba kwesifuba kuyadingeka malunga nemizuzu engama-20 ukuya kwe-30, ngokuphindaphindiweyo ngamaxesha amaninzi ngexesha lokutyelela kweyeza.
Ngokwezifundo zango-2016, ubungqina obunzulu bokuphefumulela umoya obuncitshisiweyo banciphisa umlinganiselo we-radiation intliziyo efunyenweyo (intliziyo yentliziyo yentliziyo) malunga nama-50 ukuya kuma-60 ekhulwini ngokumalunga nenani lentliziyo ye-radiation kubantu abaphefumula ngokuqhelekileyo kwaye bahamba ngokukhawuleza kwiseseshoni. Abanye abantu babekwazi ukulawula ukuphefumla kwabo ngokwaneleyo kangangokuthi kwakungekho nantoni yokukhanya kwemitha eyafikelela entliziyweni yabo. Kukho iintlobo ezahlukeneyo zobugcisa kubandakanya ukuLawula ukuPhepha kokuPhepha okanye inkqubo ye-ABC.
Ezinye iindlela ziye zazama ukunciphisa umthamo we-radiation eziswe entliziyweni, kodwa ngokukhawuleza kubangele inani elingaphantsi (kunye nelona lingakhuseliyo) lomlambo ohanjiswa kwi-tissue and wall wall. Ngenxa yokuphefumula nokuphefumula, i-radiation oncologists yakwazi ukunciphisa impembelelo entliziyweni ngaphandle kokunciphisa umthamo weemitha.
Yintoni Ongayilindela Ngexesha Lonyango Lwenu?
Isinyathelo sokuqala kwisifo sokuphefumula siya kuba ucwangciso lwenyango lwakho kunye ne-radiation yakho ye-oncologist ukufumanisa apho kuya kunikwa khona umbane kunye nokuba yeyiphi idilesi (ebizwa ngokuba yi-dosimetric plan). Ngethuba le sigaba sokucwangcisa, i-oncologist yakho ye-radiation iya kwenza amanyathelo kwaye ivavanye amandla okuphefumula ukunciphisa inani lemirhumo enikezwe entliziyweni yakho.
Inkqubo iyakunyamezela kakuhle kwaye malunga nama-80 ekhulwini abantu bayakwazi ukulawula ukuphefumla kwabo nokugcina umoya wabo ngexesha elifunekayo. Abanye abantu baye bafanisa ukubhukuda isigqoko kwiqula elingaphantsi kwamanzi njengoko bephefumula. Ngexesha leseshoni yakho, inkqubo yempendulo efana ne-audio-visualbackbackbackback isetyenziselwa ukukuxelela xa uphefumula ngokuqhelekileyo kwaye nini ukuphefumula.
Ukulinganiselwa kweGreat breathing and Breath Hold
Njengoko kuphawuliwe kwangaphambili, ukuphefumula ukuphefumula kuvame ukunyamezela kwaye abantu abaninzi banakho ukugcina umoya wabo ngexesha elifunekayo. Kukho ukulinganiselwa, nangona kunjalo, kwaye kwafunyanwa ukuba abanye abantu (abangaphantsi kwama-20 ekhulwini) bakuthola kunzima ukugcina umgangatho wabo wokuphefumlela phakathi kwendawo ekhethiweyo.
Ezinye iiNyango zeNtsholongwane ezinxulumene neentliziyo zengqondo
Ukwelashwa kwamayeza omhlaza wesifo sangasese kungakhuphula umngcipheko wesifo senhliziyo, kodwa ezinye unyango lwebele lomhlaza zingongeza kweso mngcipheko.
Iziyobisi ze-Chemotherapy zomhlaza wesifuba unokwandisa umngcipheko wesifo senhliziyo, ingakumbi i-cardiomyopathy kunye ne-heart failure, kwaye i-oncologist yakho inokuba neenzame zentliziyo (njenge-MUGA scan) ngaphambi kokuqalisa i-chemotherapy. I-Adriamycin (doxorubicin) yinto eyaziwayo yengozi yokungafezeki kwenhliziyo kwaye isetyenziselwa ezininzi kwiimpawu ze-khemotherapy zesifo sokuqala somhlaza webele. I-Cytoxan (i-cyclophosphamide) ingaba negalelo elichaphazelekayo ngentliziyo.
Kwabesetyhini abane- HER2 esifanelekileyo somhlaza wesibeleko sebele i- Herceptin (trastuzumab) kunye neziyobisi ezinxulumene nazo zingasetyenziswa. Phantse ama-5 ekhulwini labantu abaphathwa nge-HER2-therapy will experience some degree of heart failure. Kungenzeka ukuba kuyenzeka xa kudibaniswa no-Adriamycin kwaye mhlawumbi idibanisa umngcipheko wentliziyo ngenxa yonyango lwe-radiation. I-cardiotoxicity ebonakalayo isezantsi kwaye isuka kwi-0.6 ukuya kwi-4 ekhulwini.
Kwababhinqa abane-tumor e-receptor-positive tumors, ukunyanga kwama-hormone yomhlaza wesibeleko kungabangela ingozi yesifo senhliziyo. Imithi eyaziwa ngokuba yi-aromatase inhibitors, kuquka i-Aromasin (i-exemestane), i-Arimidex (i-anastrozole) kunye ne-Femara (letrozole), isoloko isetyenziselwa abafazi abanomhlaza wesibeletho se-postmenopausal ngokulandela i-chemotherapy kunye nabafazi abanomhlaza wesibeletho se-premenopausal.
Ukuvuthwa komhlaza wesifuba akubonakali kwandisa umngcipheko wesifo senhliziyo, kodwa intlungu okanye ukubola okuhlobene nokuhlinzwa kunokunciphisa ukukwazi kwakho ukuqonda iimpawu zesifo senhliziyo.
Ukuthetha Nogqirha Wakho Ngeziphumo Zengozi Yesifo Sengqondo
Ngelixa uhlaselwa ngumhlaza wengomso ingqondo yakho mhlawumbi igxile kumdlavuza wodwa. Nangona kunjalo isifo senhliziyo sisona sizathu esibangela ukufa kubantu besetyhini, kunye nesifo senhliziyo, isifo se-artery corridary is most common.
Kubalulekile ukuthetha nodokotela wakho ngomngcipheko wesifo senhliziyo esifana nezokwelapha zakho zebele. Ukongeza kwonyango lomhlaza webele, ezinye iingozi zentliziyo yesifo kwabasetyhini zingaquka:
- Imbali yomntu okanye intsapho yesifo senhliziyo
- Ukutshaya
- Igazi elonyukayo
- I-cholesterol ephakamileyo (okanye i-HDL ephantsi)
- Ukugqithisa okanye ukugqithisa
- Isifo sikashukela okanye isifo se-metabolic syndrome
Ugqirha wakho unokunqwenela ukwenza uvavanyo lwegazi olubizwa ngokuba ngu- C-proactive protein (CRP) . Ngokuxhomekeke kwimbali yakho, izinto ezinobungozi, kunye nezokwelapha zonyango, uvavanyo olungaphezulu lunokucetyiswa.
Yazi Iimpawu Zengqondo Zengxaki Zenhliziyo-Zihlukile Kwabesetyhini!
Kwiminyaka yakutshanje, sifunde ukuba iimpawu zentliziyo yabasetyhini zihlala zihluka kwala madoda. Oku kuyinyaniso yokungaphumeleli kwintliziyo kunye nesifo se-coronary disease kwaye kucatshangelwa ukuba esinye sezizathu zokuthi isifo somgubo se-coronary sinokuba nzima kakhulu kubafazi. Abasetyhini abanesifo senhliziyo banesifo esibhedlele ixesha elide kwisifo senhliziyo kwaye banokufa ngaphambi kokuphuma esibhedlele. Kubalulekile ukuqonda izizathu ezinokwenzeka zezi.
Ukungaphumeleli kwintliziyo ehambelana nokuphelelwa yintliziyo emadodeni ngokuqhelekileyo kubandakanya ukuphefumula okuthe gqolo kwaye kukhwehlela ukukhukhuka okuphosa kwimibala emiphakeni. Iimpawu zokuhluleka kwentliziyo kwabasetyhini
inokuzifihla. Iimpawu zingabandakanya ukukhathala, ukuphefumula okufutshane kunokuthi kuchazwe njengento engapheliyo, kunye nokuvuvukala kweenyawo kunye neenyawo.
Kuyafana nokuhlaselwa kwe-angina kunye neentliziyo. Amadoda athambekele ekubeni neempawu eziqhelekileyo zokutyumza intlungu yesifuba njengendlovu ehlezi esifubeni. U-Angina kubasetyhini ngokuqhelekileyo uquka iimpawu zokufudumala kunye nokuhlanza, ukunyanzeliswa, ukuphefumula okufutshane, okanye ukukhathala okunzulu kunye nokukrakra. Nangona abanye abafazi bebonakalisa "iimpawu" zesifo senhliziyo, iimpawu zesifo senhliziyo kwabasetyhini zihlala zihluka kwala madoda. Abasetyhini banokuba nefuthe elitshisayo nelivuthayo esifubeni sabo, okanye nokuba nobubele ukuthintela. Iimpawu ezincinci zihlala zenzeka kwiiveki ezintathu ukuya kwezine ngaphambi kokuhlaselwa kwentliziyo ekubuyiseleni. Abasetyhini abanakho ukutyhubela intlungu esifubeni xa benesifo senhliziyo! Ekubeni ukuhlaselwa kwentliziyo kwindlu kuqhelekileyo kubasetyhini, umngcipheko wokufa ngokukhawuleza uphakamileyo.
Ukuhlaselwa kwintliziyo "ephulile" kuchazwa njengaleyo efunyenweyo ekuvavanyeni (njenge-electrocardiogram) kodwa kwenzeka ngaphandle kwempawu. Ezi ziganeko ezithe cwaka ziqhelekileyo kubasetyhini.
Ukunyanzela izinto ngakumbi, bobabini abafazi abanomdlavuza wesibeleko kunye noogqirha babo banokucinga ukuba kunokwenzeka ukuba ingxaki yomhlaza wesifuba kunokuba kwenzeka ukuba le mpawu ibonisa isifo senhliziyo. Uninzi lwale mpawu luqala ukuba ngumdlavuza kwaye emva koko lufunyaniswe luhambelana nesifo senhliziyo.
Ngaphantsi kwindlela yokuphefumula ukuThola ukuNciphisa izifo zentliziyo ukususela kwi-Radiation Treatment
Emva kokufunda ngesifo senhliziyo kwabasetyhini, kunye nezinye izifo zonyango ezingabangela umngcipheko, kulula ukuqonda ukuba kutheni ukunciphisa ukuvezwa kwentliziyo yakho ngexesha lonyango lomlenze wesifo somhlaza wesinxele kungabalulekile.
Ukuphefumula okunokuphefumula kunokunciphisa inani lemirhumo enikezelwa entliziyweni kodwa ngama-50 kuya kuma-60 ekhulwini, kwaye ngamanye amaxesha ukuphelisa oku kubakho. Uninzi lwexesha lo buchule bokuphefumula luyakunyamezeleka kwaye lunokukunika "into enokuyenza" ngexesha leeseshoni zakho zombane.
Awona onke amaziko e-radiation oncology anikezela ngale ndlela, kodwa iya kuba yinto eqhelekileyo kwilizwe lonke. Njengoko inani lemiphumo echaphazelekayo enxulumene nokunyanga, kuhlaziya kwakhona ukuba nekhono elingenamngcipheko.
Ekugqibeleni, nangona umdlavuza wesifuba mhlawumbi usephambi kwengqondo yakho, sisifo sesifo esibulala abaninzi abantu besetyhini, kubandakanywa nabasetyhini abaninzi abaphethwe ngumhlaza wesibele. Thetha ugqirha wakho malunga nezinto ezinobungozi kunye nawuphi na uphononongo olungaphakanyiswa. Yaye qiniseka ukuba uqhelana neempawu ze-"atypical" zesifo senhliziyo eziqhelekileyo kubasetyhini. Abasetyhini banokuthi bahlupheke ngokungazelelwe, bachithe ixesha elingakumbi esibhedlele, bafe ngaphambi kokuba bashiye isibhedlele kunamadoda anesifo senhliziyo, esinye isizathu sokuba asikho ephakamileyo kwisikrini se-radar kubafazi okanye oogqirha babo.
> Imithombo:
> Boda-Heggermann, J., Knopf, A., Simeonova-Chergou, A. et al. Uphulo olujulile lokuphefumula olusisigxininisa unyango lwe-Radiation: I-Clinical Review. I-International Journal ye-Radiation Oncology, Biology, kunye neFizikiki . 2016. 94 (3): 478-92.
> Schonecker, S., Walter, F., Freislederer, P. et al. UkuCwangciswa koPhuhliso kunye nokuVavanywa kweGated Radiotherapy kwizigulane zeCataltic Breast-Side side Ukusebenzisa isistim seCatalyst / Sentinel soMoya oPhezulu oPhezulu oPhezulu (DIBH). I-Radiation Oncology . 2016. 11: 143.
> Taylor, C., Correa, C., Duane, F. et al. Uqikelelo lweengozi zesifo se-Breast Cancer Radiotherapy: Ubungqina obuvela kwiMitha yeMitha yangoku kwiiLungs and Heart and From the Randomize Trials. Umbhalo we-Clinical Oncology . 2017. 35 (15): 1641-1649.