Ingqwalasela yeZonyango zengculaza ye-Lung
Kukho iindlela ezininzi zokonyango kubantu abanomdlavuza wamaphaphu, kodwa oku akuzange kube njalo. Amanyango ngokwabo-kunye neentlawulo zokuphila ezidibene nazo-ziye zaphucula ngokuphawulekayo kwiminyaka yamuva. Nangona ezi ziindaba zonke ezimangalisayo, akenzi ukuba ukhethe ukuba zeziphi izinto ezinokuzikhethela zona.
Ukufumana ulwazi oluninzi malunga nemithi yomhlaza yemiphunga ekhoyo, kunye nokufumana inkxaso oyifunayo, unokuhamba ixesha elide ekukuncedeni ukwenza eso sigqibo esibalulekileyo.
Ngaba Unyango Unokunyanga I-Cancer Cancer?
Kubantu abanomhlaza wesifo somhlaza wamaphaphu, ukuhlinzwa kunokunika ithuba lokunyanga. Nangona unomdlavuza wamaphaphu uphambili, kukho iindlela ezininzi zokwenza unyango. Ukuqhubela phambili okwangoku kuvumela oogqirha ukuba benze imithi yokwelashwa kwemiphunga yamaphaphu, kunye nokuqonda okungcono indlela amajoni ethu omzimba asebenza ngayo ukulwa nomhlaza, uye wandisa kakhulu indlela esinokuyiphatha ngayo esi sifo.
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Indlela I-Acupuncture inokunceda ngayo izigulane zeCarcer
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Izinzuzo Zomzimba Nezobubele zeYoga yezilwanyana zamagciwane
Kubalulekile ukuthetha ngokukhawuleza ukuba nangona umdlavuza wamaphaphu ulula kakhulu ukunyanga kumazinga okuqala, kukho abahlala kwixesha elide kwinqanaba eliphambili. Kwakhona kubalulekile ukuba uqaphele ukuba unyango lomhlaza womphunga awukho ngaphezu kokukhula kwedwa. Amanyango omhlaza womlenze angadlala indima ebalulekileyo ekunciphiseni iimpawu zesifo somhlaza kwaye yenza ukuba abantu abaninzi babe nemgangatho omhle wobomi kulo lonke unyango.
Iintlobo Zonyango Zengculaza Yengculaza
Ekubeni kukho iindlela ezahlukeneyo zokwelapha ezikhoyo emdlavuza wemiphunga, kunokukunceda ukuphula le miba phantsi kweendlela ezimbini ezibalulekileyo:
- Iinkonzo zengingqi: unyango lwengingqi luphatha umhlaza kwimvelaphi yalo-ngamanye amagama, endaweni. Ezi ziquka utyando kunye nokunyanga kwamayeza, unyango olususa isisu kodwa alukwazi ukufikelela kwiiseli eziye ngaphaya kwesiza sokuqala se-tumor.
- Ionyango zendlela: Iinkqubo zonyango zibulala amangqambela omhlaza naphi na apho kwenzeka khona emzimbeni. Ezi zonyango ziquka i-chemotherapy, iipilisi ezijoliswe kuyo, kunye ne-immunotherapy.
Ngethuba lokuqala lomdlavuza wamaphaphu, unyango lwendawo lungenako ukuzama ukunyanga umhlaza. Xa umhlaza wamaphaphu usasaze kwii-lymph nodes okanye nakweminye imimandla yomzimba, iindlela zokwelapha zenkqubo zisoloko ziyona ndlela yonyango engcono kakhulu.
Ixesha elididekayo onokujamelana nalo lonyango olusisigxina . Ngamanye amaxesha unyango lwenkqubo lusetyenziswa nangona umhlaza ungabonakali. Ngokomzekelo, i-chemotherapy okanye unyango olujoliswe kunyango lunokunikwa nangona utyando lwenziwa. Ukunyanga kwe-Adjuvant yilezo ezenziwa ukuphatha nayiphi na iseli esasaze ngaphaya kwesiza sokuqala somhlaza, kodwa asengabonakaliyo kwiimvavanyo zengqondo esinazo.
Uphando lwe-Cancer Cancer
Xa umhlaza wemiphunga ubanjwe kwiinqanaba zokuqala-ngaphambi kokusasazeka ngaphaya kwemiphunga-ukuhlinzwa kungabangela unyango. Ekuqaleni kwinqanaba, amancinci amancinci amancinci amancinci (ngokuthe ngqo kwinqanaba le-IIIA engekho encinci yeekliniki zemiphunga yamaphaphu), utyando luvame ukuqwalaselwa. Ngezihlandlo ezingaqhelekanga, utyando lunokuqwalaselwa ngethuba lokuqala (umgca-wecala) umhlaza wesifo somnxeba omncinci.
Kukho iinkqubo ezi-5 eziphambili ezinokukwenziwa ukuphatha umhlaza wamaphaphu:
- I-pneumonectomy : I-pneumonectomy ibhekisela ekususweni komphefumlo wonke.
- I-Lobectomy: Kwi -lobectomy , enye ye-lobes yomphunga isuswe. (Ilungelo lempompo linama-three lobes, kwaye umphunga wesobunxele unama-lobes amabini.)
- Ukuqhawulwa komtshato: Kwi- resection rection , i-tumor isuswe kunye nommandla omeleleko weengxube zamaphaphu ezungeze i-tumor.
- Ukukhutshwa kweSleeve: Kwintlawulelo yomkhono, i-lobe yomphunga, kunye nenxalenye ye-bronchus (i-airways eholele kumphunga,) isuswa.
- I-Sector component: Kwi-sector component, isigaba se-lobe sisuswa. Isixa seethambo ezisuswe yilo mgaqo singaphezulu kwe-resection resection, kodwa ngaphantsi kwe-lobectomy.
Iziphumo eziqhelekileyo zonyango zibandakanya ukusulelwa, ukuphuma kwamanzi kunye nokuphefumula okufutshane, kuxhomekeka kwimisebenzi yemiphunga ngaphambi kokuhlinzwa kwaye inani lemiphunga yemiphunga lisuswe.
Ukunyanga kwamayeza omhlaza weLung Cancer
Ukwelashwa kwemitha yomdlavuza wamaphaphu isebenzisa i-X-rays eneemandla eziphezulu ezisetyenziswa ngaphandle komzimba ukubulala amaseli omhlaza. Kukho iindlela ezimbalwa apho i-radiation isetyenziselwa umhlaza wemiphunga:
- Njengoko unyango olusisigxina ukunyanga nawaphi na amangqamuzana omhlaza asele emva kokuhlinzwa
- Ukuncedisa ukunciphisa ubukhulu besisu, ukwenjenjalo ukuhlinzwa
- Njengoko unyango olunefuthe lokunciphisa intlungu okanye ukuvinjelwa kwamanzi kubantu abanomdlavuza ongakwazi ukuphiliswa
- Njengonyango lokunyanga: Uhlobo oluthile lwenyango ye-radiation ebizwa ngokuba yi- stereotactic body body radiotherapy (i-SBRT) isebenzisa umbane ophezulu owenzelwe indawo encinci emiphakeni. Oku kungasetyenziselwa enye into yokuhlinzwa xa utyando lungenakwenzeka.
Iziphumo eziqhelekileyo zonyango lwe-radiation zingabandakanya ubomvu nokucaphuka kwesikhumba, ukukhathala nokuvuvuka kwemiphunga (i-radiation pneumonitis).
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Ngaba i-Chemotherapy Port isisombululo esingcono kune-IV?
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Indlela yokujamelana ne-neuropathy evela kwi-Chemotherapy
Chemotherapy
I-Chemotherapy yomdlavuza wamaphaphu isebenzisa imishanguzo eyenzelwe ukubulala iiseli ezihlukana ngokukhawuleza ezifana neeseli zomhlaza. Iziyobisi ze-Chemotherapy zingasetyenziswa njengonyango oluphambili lomhlaza wamaphaphu ophezulu, emva kokuhlinzwa (i-acjuvant chemotherapy), okanye ngaphambi kokuhlinzwa ukuba unciphise ubukhulu be-tumor (unyango lwe-neoadjuvant.)
I-chemotherapy yokudibanisa-isebenzisa izidakamizwa ezingaphezulu kweyodwa kwixesha elifanayo-isetyenziswa kakhulu. Amachiza ahlukeneyo aphazamisa ukwahlukana kwesellu kumaphulo ahlukeneyo kumjikelezo weseli, kwaye ukujolisa kule nkqubo ngendlela engaphezulu kweyodwa kwandisa amathuba okunyanga amaninzi omhlaza wamaphaphu emiphunga njengoko kunokwenzeka. Amanye amayeza e-chemotherapy asetyenziswa abantu abanomdlavuza wamaphaphu abandakanya:
- Platinol (cisplatin)
- Iparaplatin (i-carboplatin)
- Gemzar (gemcitabine)
- I-Taxotere (docetaxel)
- I-Taxol (paclitaxel) kunye no-Abraxane (nab-paclitaxel)
- Alimta (pemetrexed)
- I-Navelbine (vinorelbine)
Iziphumo eziqhelekileyo zemiphumo ye-chemotherapy ziquka ukunqandwa komnyo wethambo (ukunciphisa amaseli obomvu, amaseli egazi amhlophe kunye neeplatelets), ukulahleka kweenwele kunye nokukhathala. Ukukhathazeka kunye nokuhlanza kubangelwa yimiphumo emibi yechemotherapy, kodwa ngokubulela ukulawulwa kwezi ziphumo ezimbi kuye kwaphucula kakhulu kwiminyaka yamuva.
Iipilithi ezijoliswe
Imithi ejoliswe kumdlavuza wemiphunga yilezi ziyobisi ezilungele ukuhlasela ezithile iimpawu zesifo somhlaza kwaye, ngenxa yoko, kunokuba nemiphumo embalwa yecala kune-chemotherapy yendabuko.
Kubaluleke kakhulu ukuba wonke umntu onokufumanisa ukuba unomdlavuza wesifo somhlaza ongaselula, ngokukodwa umphunga adenocarcinoma, unokufumanisa i- gene profiling (i-molecular profiling) ye-tumor. Unokuva ugqirha wakho uthetha ngokutshintshwa kwezinto eziphathekayo kunye nokuguquka kwemfuza. Oko kuthetha ukuthini ukuba ezinye iiseli zomdlavuza zamaphaphu zinokutshintshwa kweemfuyo ezinokujoliswa (kwaye ziphathwe) ngamachiza athile ajongene nale nguqulelo.
Unyango luvunyiwe kulabo abaneenguquko ze-EGR, ukulungiswa kwe-ALK, ukulungiswa kwakhona kwe- ROS1 , kwaye kukho ukuvavanywa kweekliniki ekufundeni imishishini yezinye iinguqu kunye nokutshintsha kwemizimba kumaseli omhlaza. Le ndawo yenzululwazi iyatshintsha ngokukhawuleza, kwaye mhlawumbi iithagethi ezintsha kunye namachiza amatsha ziya kuqhubeka zifunyanwa.
Nangona iipilisi ezijoliswe kuzo ziyakwazi ukusebenza kakuhle, ukuchasana kwezi zonyango kudla ngokuqhubeka kwexesha. Nangona kunjalo, izidakamizwa zezizukulwana zesibini kunye neyesithathu ziyafumaneka kwaye zifundiswa xa kwenzeka. Ezinye iziyeza ezijoliswe kumhlaza womphunga ziquka:
- I-ALK inhibitors- Xalkori (crizotinib), iZykadia (ceritinib), kunye ne-Alecensa (alectinib)
- Angiogenesis inhibitors - i-Avastin (bevacizumab) kunye ne-Cyramza (ramucirumab)
- I-EFGR inhibitors - i-Tarceva (erlotinib), i-Gilotrif (afatinib), i-Iressa (gefitinib), i-Tagrisso (i-osimertinib) kunye ne-Portrazza (necitumumab)
Immunotherapy
Uhlobo olutsha lwenyango yomdlavuza wamaphaphu lwafumaneka ngo-2015. Izidakamizwa ze-immunotherapy zisebenza ngokubambisa ngokunyanisekileyo isistim somzimba wakho wokuzivikela ekuncedeni ukulahla umzimba wakho wesifo somhlaza. Nangona sivame ukuva utywala oluninzi kwiindaba, i- immunotherapy iyona sizathu sokwenza uvuyo ngekamva lomdlavuza wamaphaphu kwaye wabizwa ngokuba ngu-2016 ukukhula komhlaza wonyango ngomnyaka we-American Society for Clinical Oncology.
Nangona iipilisi ezijoliswe kuzo zivame ukuphumelela ngakumbi kubantu abangazange bavume, i-immunotherapi inokusebenza ngakumbi kubantu ababhema kunye nabanomdlavuza njengomhlaza wesifo somhlaza wamangqamuzana. Amachiza e-Immunotherapy okwangoku avunyelwe umhlaza wemiphunga aquka:
- Opdivo (nivolumab)
- I-Keytruda (pembrolizumab)
Iindlela zonyango lweengculaza
Nangona unyango oluthile lwemiphunga yomdlavuza alufumaneki luncedo ekuphatheni umhlaza womphunga ngokukodwa, kukho iindlela ezininzi zokwelapha umdlavuza onokunceda abantu bajamelane neempawu zesifo somhlaza kunye nomhlaza wonyango. Ezinye zazo zibandakanya ukukhwabanisa, ukuxilisa unyango, nokucamngca.
Izilingo zeKliniki yeLung Cancer
I-National Cancer Institute incoma ukuba wonke umntu onomdlavuza wamaphaphu ujonge ityala leklinikhi, kwaye oku kubaluleke kunanini ngaphambili. Yonke inyango esinayo yomdlavuza wamaphaphu yayifundwa njengenxalenye yesilingo seklinikhi phambi kokuvunywa. Ukugxininisa ukubaluleka kwezi zilingo, kunokunceda ukukhankanya ukuba phakathi kuka-2011 ukuya ku-2015, unyango olutsha luye lwavunyelwa umhlaza wemiphunga ngaphezu kwexesha elishumi leminyaka ngaphambi kokuba.
Thetha ugqirha malunga nezilingo zekliniki kwaye unqume ukuba le nto ungathanda ukuyihlola. Amaninzi emibutho yomdlavuza yemiphunga ahlanganise ndawonye umlingo we-kliniki yemiphunga ye-klinikhi yokulinganisa inkonzo ehambelana nendawo apho oogqirha bezempilo abanokukunceda ukufanisa iimpawu ezithile zomhlaza wakho kunye novavanyo lweklinikhi oluqhubekayo naphi na emhlabeni.
Ukukhetha Iindlela zokuPhepha kweMhlaza yokuLungisa iLungile
Njengoko kuphawuliwe ngasentla, kunokukho iindlela ezininzi ezahlukahlukeneyo zokufumana umhlaza wakho wemiphunga. Nangona oku kubonakala kunzima, kukho izinto ezimbalwa ongayenza ukwenza inkqubo yokwenza izigqibo ibe lula.
Ukuba usanda kufunda ukuba unomdlavuza wamaphaphu, thabatha umzuzu ukujonga kula ma nyathelo okuqala ukuthatha xa usandululwazi olutsha . Uphando lubonisa ukuba ukufunda ngokusemandleni akho ngomdlavuza kunceda ukunciphisa uxhalaba kwaye kunokuchaphazela neziphumo. Funda indlela yokuphanda umhlaza wakho kwaye ufumane ulwazi oluchanekileyo. Ungaqala khona apha.
Enye yezona zinto ezintle ongayenza ukuze ufumane unyango olungcono kukuba ufumane isikhungo somhlaza osithembayo. Ukuphonononga ezi ngcebiso malunga nokukhetha isikhungo sempilo yomhlaza wamaphaphu kunye nokubaluleka kokufumana umbono wesibini ngomdlavuza wamaphaphu . Thatha ixesha lokuthetha kunye nosapho kunye nabahlobo bakho. Ungaphinda ucele i-oncologist yakho apho uya kufuna khona unyango ukuba wayenokufunyanwa ngumhlaza wemiphunga.
Ayikwazi ukugxininiswa ngokwaneleyo ukuba le yisigqibo sakho. Sonke sinemibono eyahlukileyo malunga nendlela esinokuyilungisa ngayo unyango lomhlaza, kwaye iimvakalelo zinokusebenza ngamandla ngeli xesha. Yamkele igalelo evela kubathandekayo bakho, kodwa qi ni sekise ukwenza isigqibo esekelwe kwizinto oziva ukhululekile kunye noko uvakalelwa kukuba kukulungele wena wedwa.
ILizwi
Into ebaluleke kakhulu ongayenza njengoko uhlola unyango kukuba ube ngummeli wakho kumnonophelo wakho womhlaza . Nokuba awukho "ibhathaneli yentlalo" okanye "i-intanethi ye-intanethi," ukubandakanyeka kumaqela enkxaso yomhlaza wemiphunga e-intanethi kunye nemiphakathi yomdlavuza wamaphaphu ayixabanga. Akunjalo nje kuphela ezi ndlela zokufumana inkxaso evela kwabanye "abaye khona" kwaye banokuqonda, kodwa la maqela anokukunceda ukuba ufunde malunga nokuqonda ukuphucuka kwangoko kumdlavuza wamaphaphu. I-hashtag kukukunceda ukuba ufumane le mimandla yi-#LCSM, emele umdlavuza wamaphaphu kwihlabathi leendaba ezentlalo.
Ungavumeli ukuba umdlavuza womdlavuza okanye imibuzo onokuyifumana malunga nesimo sakho sokutshaya. Nabani ophethe imiphunga angafumana umdlavuza wamaphaphu. Ungavumeli ukuba ummangalo wamaphaphu awuphazamiseki. Unokudinga ukukhumbuza abahlobo bakho ukuba oko bahlangabezana nazo kwiintsapho ezili-10 kwiminyaka eyadluleyo kuhluke kakhulu kunokuba umdlavuza wamaphaphu uphathwa njani namhlanje. Kwaye nangona ubona amancinci amancinci omhlaza omphunga omhlophe kunamacwecwe omhlaza webele omnyama, musa ukukhohliswa. Oko umphakathi wesizwe somdlavuza wemiphunga ungabi nakubalo manani owenzela ubunzulu. Finyelela kubantu abaninzi abaya kuba nomqolo wakho xa ujongene nesi sifo.
Imithombo:
Masters, G. Immunotherapy kwi-Lung Cancer Treatment: Iimeko zangoku kunye neZikhokelo zexesha elizayo. I-American Society ye-Clinical Oncology: I-ASCO News . https://am.asco.org/immunotherapy-lung-cancer-treatment-current-status-and-future-directions
National Cancer Institute. Ukwelashwa kweNtsholongwane yeNtsholongwane yeeLungile (PDQ) - I-Health Professional Version. http://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq
National Cancer Institute. Ukwelashwa kweNcinci yeCatal Lung Cancer (PDQ) - I-Health Professional Version. Updated 07/07/16. http://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq
Ukupasa, J., Carbone, D., Johnson, D. et al. Iimigaqo kunye nokuSebenza kweCarcer Lung . 4 Edition. UWilliams noWilkins: ngo-2010.
Rocco, G., Morabito, A., Leone, A., Muto, P., Fiore, F., kunye no-A. Budillon. Ukulawulwa kweNcinci yeSifo seLungile esingekho encinci kwi-Era yoMuthi woLuntu. I-International Journal ye-Biochemistry ne-Cell Biology . 2016. 78: 173-179.