Kutheni Iingonyango Zengingqi Zinako Ukusetyenziswa Kancinci kwi-Canast Metastatic Breast Cancer
Izaphulo kunye nokuhlinzwa kuthiwa yindlela yokwelapha yasekhaya, kwaye ngenxa yoko unomsebenzi ongaphelelanga kubantu abanomdlavuza webele. Kunoko, unyango lwenkqubo-unyango olunjengezonyango ze- hormonal , i- chemotherapy , iipilisi ezijoliswe kuyo , kunye ne-immunotherapy, ejongene nomhlaza naphina apho kwenzeka khona emzimbeni-iyona nto yonyango.
Ukuba i- metastases kumathambo akho, isibindi, imiphunga, okanye ingqondo ayibangeli iimpawu, okanye ukuba abayikubeka ingozi kwiingxaki ezinjenge-fracture, zivame ukuphathwa njengengxenye yonyango lwakho jikelele ngomhlaza webele kunye neenkqubo zonyango .
Ngabe Ziyasetyenziswa Ziphi Iingonyango Zengingqi?
Kukho amaxesha, nangona kunjalo, xa unyango oluchanekileyo lwe-metastases kunye nokuhlinzwa, unyango lwe-radiation okanye ezinye iindlela zonyango luncedo. Izizathu ezi zonyango zingasetyenziswa ziquka:
- Ukulawula intlungu (ngakumbi kunye neethambo zesifo)
- Ukuqhawula okanye ukuphazamiseka kwindlela yokuhamba emoyeni ebangelwa yimiphunga yeemiphunga
- I-Boneastast ye-Bone ephakamisa umngcipheko wokuphuka okanye ingabangela ukunyanzeliswa kwentambo yomgudu
- Iibhonastases zeBrain ezinempawu kakhulu, ezinjengezo zibangelwa iintloko, ukuguquka komntu, ukuphazamiseka okubonakalayo, okanye ukutshatyalaliswa (umqobo wegazi-ingqondo inqanda imithi enjengezonyango zamachiza ekungeneni kwengqondo okanye intambo yomgogodla)
- Ukususa i-metastases ezibuhlungu kumdonga wesikhumba okanye esifubeni
- Unyango lwe-Oligometastase - i-Oligometastases ligama elisetyenziselwa ukuchaza enye okanye iindawo ezimbalwa zezifo ze-metastatic. Ngokuqhelekileyo umdlavuza webele unomdla wokusabalalisa kwiindawo ezininzi zommandla omnye. Kwiimeko ezinqabileyo, unyango kunye notyando, unyango lwe-radiation, ukuchithwa kwe-radiofrequency (RFA), okanye i-microembolization inokuqwalaselwa ngalabo abanomnye (okanye mhlawumbi ambalwa) ama-metastases kuphela.
Ngoxa le nto ingazange iboniswe ukuphucula ukusinda kwabasetyhini kunye namadoda anomhlaza wesibeletho se-metastatic, kuye kwaboniswa, kwiimeko ezinqabileyo, ukuphucula ukusinda kubantu abaneemastastas ezihlobene nezinye izicubu ezinzima.
I-Bone Metastases
Ukunyangwa kwethambo lwe-boneastases kumdlavuza webele kuncike kwizinga leemetastases, iimpawu abazibangelayo, kunye nezinye izifo oyazitholayo. Iimithi zokwelapha ze-hormonal, iipilisi ezijoliswe kuyo, kunye ne-chemotherapy zinokunciphisa zonke iimpawu ezisuka kumhlaza wesifuba oye wasasazeka amathambo.
Sekunjalo, ngamanye amaxesha, ezi zonyango eziqhelekileyo azanele. Izonyango zengingqi ezifana nokunyangwa kwe-radiation zingasetyenziselwa intlungu engalawulwa kakuhle kunye neenkqubo zonyango, okanye ukuthintela i-fractures okanye intambo yomgudu wokunyanzeliswa ngenxa yesifo se-metastases. Ugqirha wakho unokuncoma uhlobo lweemitha okanye iziyobisi ezibizwa ngokuthi "i-agents modification agents". Iinketho ziquka:
- Ulwaphulo lwe-Radiation - Ulwaphulo lwe-radiation lisetyenziselwa ukhathaza i-metastases yomhlaza wesifuba kwithambo eyanciphisa ithambo kwaye iphakamisa umngcipheko wokuphuka.
- I-Radiopharmaceutics - I- Radiopharmaceutics yilezi ziyobisi ezithwala ii-particle e-radioactive ngqo kumathambo. Umzekelo ngu strontium 89.
- Ama-Bone-Modifying Agents - Kukho iindidi ezimbini zee-agents eziguqula amathambo ezingasetyenziselwa amathambo. Ezinye zezi zinto zisetyenziselwa abantu abane-osteoporosis. Njengoko unyango lwe-radiation, lunokusetyenziswa ukukhusela i-fractures, ukuthintela ukunyanzeliswa kwentambo yomthambo, nokunyanga izinga eliphezulu le-calcium egazini ngenxa yokuphuka kwethambo kunye ne-boneastas (i-hypocalcemia of malignancy).
Imizekelo ye-bisphosphonates iquka:
- Aredia (pamidronate)
- Zometa (zolendronic acid)
- Boniva (ibandronate)
I-RANK (i-receptor activator yenkampani ye-nyukliya kappa B) i-ligand inhibitors iquka:
- Xgeva (denosumab)
Liast Metastases
Ubungqina bezilwanyana ezingenakho kubangele naziphi na izimpawu, kwaye uyazi kuphela ezi zinto ngenxa yokunyuka kwimivavanyo yokusebenza kwesibindi kwiimvavanyo zakho zegazi okanye ngokufumana ezi zivavanyo zomfanekiso.
Xa ziyimpawu zonyango, unyango lwengingqi ezifana nophando okanye unyango lwe-radiation lunokuqwalaselwa ngokungakumbi kwizonyango jikelele malunga nomhlaza wesifo se-metastatic.
I-Lung Metastases / Pleural Effusions
Njengoko kunye nezinye izitifiketi ze-metastase, unyango lweemiphunga zamaphaphu luquka unyango lwe-metastatic cancer yomhlaza ngokubanzi. Ngamanye amaxesha, iimitha zesifo semiphunga zingabangela ukuvinjelwa kwamanzi okanye ukuphuma kumoya.
Xa oko kwenzeka, unyango lwe-radiation lungasebenza kwimimiselo yokunciphisa.
Ukusebenza kwamanzi (ukwakheka kwe-fluid phakathi kweembrane ezifaka imiphunga) ziqhelekile nomhlaza wesisu se-metastatic. Ukususwa kwalo mkhuhlane kunye nenaliti (thoracentesis) kunokunciphisa kakhulu impawu, kodwa ukuphinda kuhlaziywe kwakhona. Xa oko kwenzeka, i-stent ingafakwa kwisigxina esinyanisiweyo esixhunywe yiphubhu ukuya ngaphandle komzimba wakho (ngodonga lwakho lwesifuba) evumela ukuba amanzi aphephe.
Abantu abaninzi abanesifo esiphezulu bayavunyelwa ukucoca umbane ngokwabo ekhaya (ngoncedo lomntu othandekayo) xa umkhuhlane ukwandisa imihla ngemihla impawu.
Brain Metastases
I-Brainastas yobunzima ingabunzima ukunyanga ngomhlaza wesibeletho se-metastatic amaninzi amayeza e-khemotherapy akakwazi ukungena ebuchosheni nasemthonjeni. I-network of capillaries ezinamaqabunga ngokugqithiseleyo kwintliziyo ebizwa ngokuba yintambo yeengcambu zeengqondo yenzelwe ukukhusela i-toxins yokungena kwinkqubo ye-nervous central. Ngelishwa, le mqobo inokuthi ikhusele izidakamizwa zemhlaza ekufikeleleni kule ndawo.
Kukho izicwangciso ezimbini apho unyango okanye utyando olwenziwe ngonyango lunokuqwalaselwa ukuphatha i-metastases yengqondo.
- Iimpawu ze-Symptomatic - Ukuba ubuchopho bakho be-metastases bubangela iimpawu ezibalulekileyo, unyango lwengingqi lunokuphucula umgangatho wobomi. Oku kungabandakanya lonke uphando lwe-radiation ye-radiation ye-metastas ehlukeneyo kunye neendawo ezininzi, okanye ngaphezulu kwimizila emiseleyo yendawo kunye nemimandla ephezulu yamanzi.
- Iimetastases eziqhelekileyo - Kwiimetastases ezinkulu ezinokubangela iimpawu, okanye ukuba unomnye (okanye ezimbalwa) ze-metastases zobuchopho kodwa akukho ubungqina beemastastases kwenye indawo emzimbeni wakho, iintlobo ezikhethekileyo zemilayezo eyaziwa ngokuba yi-radiotherapy yomzimba (SBRT okanye i-Cyberknife) okanye i-stereotactic body body radiotherapy okanye ukusetyenziswa kwe-radiofrequency ablation (RFA) ingasetyenziswa. Ezi zonyango zihambelana nomlinganiselo ophezulu weemithayo kwiindawo ezichanekileyo kwingqondo. Endaweni yoko, utyando lunokuqwalaselwa ukuphatha ezi ziphumo.
Ezinye iiNyango
Kukho ezinye iindlela zokonyango ezihlolwayo malunga nonyango oluthile lwe-metastases ngenxa yesifo somhlaza. Iinkqubo ezinjenge-microembolization kunye nokunye zingabonisa unyango olungcono kwixesha elizayo. Kukho izilingo zamanyango ekliniki okwangoku ziqhubeka nokufunda unyango lweemastastases.
UkuLawula Iimpawu Zecala
Ukunyangwa kwamayeza, njengamanye unyango lomhlaza, kunokubangela iziphumo ezibi. Iimpembelelo ezithile kunye nendlela ukukhathazeka ngayo kuya kuhluka kuye kuxhomekeke kwizinto ezininzi ezibandakanya ummandla womzimba wakho ofumana i-radiation. Ezinye zeempembelelo eziqhelekileyo ziquka:
- Ukucaphukisa isikhumba - Ummandla onokufumana unyango lwe-radiation ungakha ubomvu kwaye ngamanye amaxesha uphazamise, okufana nokutshiswa kwelanga. I-oncologist yakho yomsakazo iya kuthetha nawe malunga neempawu zokubukela kwaye inokumisela i-lotion ukuba uyisebenzise.
- Ukukhathala - Ukukhathala yiphumo eliqhelekileyo lefuthe le-radiation unyango, elichaphazela abantu abaninzi abanezonyango kwizinga elithile. Ukudinwa kubangele kuhluthe kwaye kudlula ixesha.
Njengokukhathala okuhlobene ne-chemotherapy, ezi zimpawu zingabangela iingxaki eziguquguqukayo (ezifana ne-anemia) kwaye kubalulekile ukuthetha ne-oncologist yakho ngezinga lakho lokukhathala.
Ingonyango engcono yokhathala kukuba ngokuyinhloko ukufumana iindlela zokujamelana nokukhathala. Cela uncedo uze uvumele abanye ukuba bancede. Phumla xa ufuna. Yaye uthetha ugqirha wakho malunga naluphi na ubunzima bokulala obubangela ukuba ukhathele. - Ukulahleka kweenwele - Ukulahleka kweenwele kwisibini kwipilisi ye-radiation ihluke kwiintlungu ezilahlekileyo ezinxulumene ne-chemotherapy, ngokuba inokuhlala isigxina. Ukulahleka kweenwele kuxhomekeke kummandla womzimba apho ufumana unyango lwe-radiation.
Ngokomzekelo, ukugqithiswa kwengqondo yakho kwintloko yakho kunokubangela ukulahlekelwa kweenwele entloko yakho, kanti i-radiation esifubeni sakho, ngenxa yemitha ye-lungastas, iya kubangela ukulahlekelwa kweenwele esifubeni sakho. - Ukungasebenzi kwengqondo - Ukunyanga kwamayeza kwintsholongwane, ingakumbi ingqondo ye-radiotherapy, ingabangela iimpawu ezifana neengxaki zememori kunye nobunzima bokunqongophala (ukungasebenzi kwengqondo.) Kubalulekile ukuba uqikelele ngokucacileyo inzuzo yonyango lwemitha kwingqondo malunga nale miphumo emibi yonyango .
Uphulo lwe-radiation kwingqondo lubeka ingozi yomonakalo kwizakhiwo eziqhelekileyo kwiisishu zeengqondo apho i-radiation idlulayo.
> Imithombo:
> DeVita, Vincent., Et al. I-Cancer: Imigaqo kunye nokuSebenza kwe-Oncology. Ngomhlaza we Breast. Wolters Kluwer, 2016.
> Liedtke, C., noH. Kolberg. Ulwaphulo lwe-Systemic lwe-Advanced / Metastatic Breast Cancer-Ubungqina Bokukhoyo kunye Neengcinga Zomso. Unakekelo lwebele . 2016. 11 (4): 275-281.