Enye yeendlela eziqhelekileyo ekuphatheni izigulane ngomhlaza we-thyroid-emva kokususwa kwe-thyroid, kwaye kwezinye iimeko i-iodine ye-radioactive (i-RAI) -kuba imisele i-thyroid i-hormone yokutshintsha iindiza ezithintela i -roid ye-hormone (TSH) . Okubalulekileyo, izigulane zinikezwa amayeza aphezulu aphezulu (ezaziwa ngokuba yi-supra-physiologic doses) ukwenzela ukuvelisa aphantsi, amancinci angabonakaliyo amanqanaba e-TSH.
Ukugcina izigulane kumanqanaba acatshangelwayo kwinqanaba le-hyperthyroid kunokuthintela ukuphindaphinda komdlavuza we-thyroid.
Ucwaningo lophando olwenziwe ngo-2017 lwe-Cancer Survivorship Symposium lucelomngeni lo mkhuba osemgangathweni ngokuqinisekisa ubungqina bokuba kukho iingozi zentliziyo ebudeni bexesha elide elihambisana nalo mkhuba.
I-Hyperthyroidism engengekelwe ngenxa yonyango isele ikhona ingozi eyaziwayo ye-fibrillation ye-atrial kunye ne-stroke ye-ischemic. Kwakhona kudibaniswa nosizi lwe-angina kunye nokuhlaselwa kwentliziyo kwizigulane ezisele ziphantsi kweemeko zentliziyo.
Kulo pho nonongo, abaphandi balinganise impembelelo yomzimba ye-hyperthyroidism ngenxa yokunyanzeliswa kwe- levothyroxine , uhlobo oluthile lwe-thyroxine (T4) hormone, kwizigulane ezingama-182,000 ezine-cancer ye-thyroid. Baye bafumanisa ukuba i-levothyroxine yokunyanzelisa i-levothyroxine yandisa ingozi yesifo senhliziyo kunye nesifo sengqondo esichengeni somdlavuza we-thyroid.
Ngokukodwa, bafumene:
- Emva komhlaza we-thyroid, kukho izinga elandisiweyo leentliziyo zesifo kunye nesifo
- Umngcipheko wawuphezulu kwizigulane ezafumana i-thyroidectomy yakho yonke
- Umngcipheko wawusenyuka kulabo bathatha umlinganiselo ophezulu we-levothyroxine (kwaye ngoko ke ubani owayenqanaba eliphantsi le-TSH)
- Kwakukho umngcipheko ophezulu we-fibrillation ye-atrial, ehambelana namaqondo aphezulu e-levothyroxine
Ngokwabaphandi, kuphela inxalenye encinci yengozi yokuphazamiseka komzimba ngenxa yezinga lokunyuka kwamafayilifayili. Kunoko, amandla e-hyperthyroidism okubangela ukuba uxinzelelo lwegazi oluphezulu kunye nokutshintsha kwintliziyo-phakathi kweminye imiba-bebegweba.
Olunye uvavanyo lwango-2013 lubhekiselele engozini yesifo kwizigulane ezahlula umdlavuza we-thyroid. Uphando lwafumanisa ukuba i-19 ekhulwini yezigulane zafa ngenxa yeengxaki zentliziyo-kuquka ukuhlaselwa kwentliziyo, isifo, isisu kunye ne-pulmonary embolisms-xa kuthelekiswa nama-7.4 ekhulwini abulawa ngumdlavuza we-thyroid. Umngcipheko wokufa kwisifo senhliziyo wawuhambelana namanqanaba e-TSH: I-lower level ye-TSH, iphakamileyo ingozi.
Iimpembelelo zePhrojektic Cancer Patients
Ezi ziphumo zibalulekile kwizigulane zomhlaza we-thyroid , ngokukodwa xa ujongene ne- thyroidectomy yakho yonke , okanye u-okanye ugqirha wakho uyakhuthaza-i-levothyroxine emva kokuhlinzwa.
Okokuqala, ekubeni uphando lubonakalise umngcipheko omkhulu ochaphazelekayo kunye ne-thyroidectomy yakho yonke, kufuneka uxoxe ukuba i-thyroidectomy iyonke iyimfuneko njengengxenye yonyango lomhlaza we-thyroid. Uphando olutsha luye lwabonisa ukuba utyando lwe-lobectomy ukususa i-lobe eyodwa kuphela ye-thyroid gland - yonyango olukhethiweyo lwe-thyroid yomhlaza , uhlobo oluqhelekileyo lomdlavuza we-thyroid.
Okwesibini, iingcali ezininzi zikholelwa ukuba akukho nzuzo kwi-TSH yokunciphisa. Izikhokelo zangoku ezivela kwi-American Thyroid Association kunye ne-European Thyroid Association zincoma i-TSH ukunyanzelisa kuphela xa isigulane "sinezikhwelisi ezinomzimba okanye sinexuku elibi kakhulu esaphathwa ngokuhlinzwa kunye ne-iodine." Ngokwamabini omabini:
Phantse i-85% yezigulane zingabonakaliswa ukuba zikhululekile izifo emva kokunyanga kwe-tumor yokuqala ngokuvavanya umgangatho wegulane we-patient ye-serrog thyroglobulin kunye nokwenza intamo ye-ultrasonography. Xa isigulane sivakalelwa ukuba sikhululekile kwesi sizathu, izikhokelo ze-ATA kunye ne-ETA zibonisa ukugcina igazi le-TSH kwizinga eliqhelekileyo eliqhelekileyo.
Qaphela ukuba nangona kukho izikhokelo kunye neziphakamiso, oogqirha abaninzi basoloko beqhuba i-thyroidectomi yakho yonke i-cancer ye-thyroid, kwaye banika izidakamizwa ezixhasayo ngokugqithiseleyo kuzo zonke izigulane zomhlaza we-thyroid.
Okwesithathu, sibona ukunyuka okubalulekileyo kwizinga le-cancer ye-thyroid. Nangona ezinye iingcali zikholelwa ukuba kukho ukwanda okwenene kwiziganeko zomhlaza we-thyroid, le nto ingumpikiswano, njengokuba abanye bakholelwa ukuba ukunyuswa kwamazinga kubangelwa ukugqithiswa kweengxaki ze-thyroid. Ngenxa yokusetyenziswa ngokubanzi kweemvavanyo zengcamango, kuninzi inani elincinci, lomhlaza, kodwa "eliqhelekileyo" elikhulayo "eliqhelekileyo". Kukho ukungqubuzana nokuba ngaba loo maqhuqhuva afuna ukubonwa, kunokuba unyango olushushu lomhlaza esiyaziyo ngoku luyakwandisa ingozi yentliziyo.
Ekugqibeleni, ukuba unembali yomdlavuza we-thyroid, kufuneka uqinisekise ukuba ugqirha wakho uvavanya rhoqo kwaye uhlolisise intliziyo yakho.
> Imithombo:
> Klein Hesselink EN, Klein Hesselink MS, de Bock GH, et al. Ukufa kwexesha elide kunye neentliziyo ezigulane kwizigulane ezine-differentiated thyroid carcinoma: i-study observation. J Clin Oncol. 2013; 31 (32): 4046-4053. i-doi: 10.1200 / JCO.2013.49.1043.
> Shin DW, Suh B, Yoon JM, et al. Ingozi ye-coronary disease ye-coronary and stroke isifo sengqondo kwisigulane somhlaza we-thyroid esithatha i-levothyroxine. J Clin Oncol. 2017; 35 (umxhasi 5S;
> "I-Thyroid Yokukhuthaza IHormone (TSH) Ukunciphisa." Umbutho weChrown Cancer Survivors Association. http://thyca.org/pap-fol/more/tsh-suppression/