Iindawo eziqhelekileyo ze-Lung Cancer Metastases
Abantu abaninzi abanomdlavuza wamaphaphu bayaqaphela ukuba umhlaza wamaphaphu usasazeka. Phantse ama- 40 ekhulwini alabo bantu abasandul 'ufumane umdla ngomhlaza wamaphaphu sele sele benomdla kumanye amanxalenye omzimba. Indlela kunye nomdlavuza wamaphaphu uphathisa njani, kwaye unokwazi njani ukuba umhlaza wakho usasazeke?
Sibanzi
Amanqamu omhlaza angasasazeka xa iiseli ziphuka kwi-tumor, kwaye zihamba ngegazi okanye i-lymphatics (iinqanawa emzimbeni apho i-lymph kunye neeseli zegazi ezimhlophe zihamba) ziza kwiindawo ezikude zomzimba kwaye zikhule.
Le nkqubo ibizwa ngokuba yi-metastasis.
Kubalulekile ukuhlukanisa phakathi kweprayimari (apho umdlavuza uqala) kunye neekliniki zesibini xa uthetha ngokusasazeka okanye imetastasis yomhlaza. Umdlavuza oyimpompo oyintloko owasasaza kwithambo ubizwa ngokuthi "umhlaza wemiphunga emaphaphu emathambo," hhayi "umhlaza wesifuba." Ngokufanayo, umhlaza wemiphunga osabalalisa ebuchosheni ubizwa ngokuthi "umhlaza wemiphunga wamaphaphasi kwingqondo" kunokuba "ubuchopho" nomhlaza. "
Kulabo bafuna ukwazi ngakumbi malunga nokuba kutheni le nto iyenzeka, nangona emva kokuba i-tumor ibonakale isuswe ngokupheleleyo, unokuziqwalasela la manqaku malunga nendlela umhlaza usasazeka ngayo kunye nokuba kutheni ezinye i-cancer zibuya (kwakhona) .
Kwiindawo eziqhelekileyo
Umdlavuza womlenze ungasasazeka phantse nayiphina indawo yomzimba, kodwa iindawo eziqhelekileyo ziyi- lymph nodes , isibindi, amathambo, ingqondo, kunye neengqungquthela ze-adrenal. Makhe sijonge nganye kule mimandla ngokwahlukileyo.
Ithumba
Uninzi lwamanomdla emiphunga emaphaphu aqala ukusasaza kwi-lymph nodes kwisifuba esiseduze ne-tumor.
Njengoko umdlavuza uqhubeka, iiseli zomhlaza zingasaya kwiindawo ezisesifuba ngokuqhubekayo ukusuka kwisifo sokuqala, size siye kwezinye iindawo zomzimba. Ngokungafani neendlela zokumelana nemimandla kwezinye iindawo zomzimba, ukusasazeka komdlavuza wamaphaphu kwii-lymph nodes akuthethi ukuba kusetyenziswe imastast ( isigaba 4 esingenanto encinci okanye umgca wecala lomhlaza wesifo somnxeba ).
Zonke izigaba zomhlaza wamaphaphu ngaphandle kwecandelo 1 elingekho encinci lomhlaza wesifo somhlaza lungabandakanya umdlavuza ongasasazeka kwii-lymph nodes.
Uninzi lwexesha, ukusasazeka komhlaza wemiphunga kwi-lymph nodes akubanga naziphi na iimpawu. Xa le kancinci iyakwandisa i-lymph nodes ngaphaya kwemiphunga, unokubona isalathweni entanyeni yakho okanye kwisibilini sakho, esifanayo (kodwa ngokuqhelekileyo) kwiingqungqungqungqungqungqungqungqungqungqungquthela ezinokudumala okungenzeka ube nazo ngexesha elidlulileyo ngesifo somqala.
Unyango luqhelekileyo nge- chemotherapy ngaphandle kokuba i-lymph nodes ezibandakanyekayo zi kufuphi ne-tumor yokuqala kwaye zingasuswa ngokuhlinzwa .
I-Bone
Amaphesenti angama-30 ukuya ku-40 abantu abanomdlavuza wamapopayi ophezulu baye basasazeka (i-metastases) amathambo. Amathambo aqhelekileyo anokuchaphazelekayo umgudu (ikakhulukazi i-vertebrae esifubeni kunye nendawo engaphantsi kwesisu), i-pelvis, kunye namathambo angaphezulu kweengalo nemilenze (i-humerus ne-femur). Umdlavuza womlenze uphawuleza ukuba ungasasazeka ezandleni nasezinyaweni.
Uphawu oluqhelekileyo lwethambo lwe-metastases lubuhlungu. Ngokuqhelekileyo intlungu iqala ngokuthe ngcembe, ivakalelwa njenge-muscle idonsa okanye ingxaki, kwaye iqhubela phambili intlungu ebuhlungu. Ngenxa yokudakalisa kwethambo kwisisu, abanye abantu bahlakulela amaqhekeza ( iintsholongwane zentsholongwane ) ezenzeka ngentshutshiso encinci okanye kwimihla ngemihla.
Ukuba umhlaza wamaphaphu usasazeka emthonjeni, unokufaka uxinzelelo kumgca womgudu (ukunyanzeliswa kwentambo yomthambo) onokuba yimeko engxamisekileyo yonyango. Oku kunokubangela ubuthathaka okanye ukubetha emilenzeni okanye ukuhamba nzima. Amagciwane anqabile kwisithambo angaphinda aphule ithambo ekhupha i-calcium egazini ( hypercalcemia ) edala iimpawu zokudideka, ubuthathaka obunamahloni kunye nokulahlekelwa kwesidlo phakathi kwabanye.
Uvavanyo lokukhangela amathambo e-boneastases lungabandakanya ukukhangela kwethambo , i- PET scan , i- CT , okanye i- MRI . Injongo ephambili kwonyango lwe- boneastas isifo sokunciphisa intlungu kunye nokulungisa okanye ukuthintela iifracture ezenzekayo. Izinketho ziquka imishanguzo yeentlungu, unyango lwe-radiation , unyango lokuzama ukukhusela ukuphuka kwethambo, kunye nokuhlinzwa ukuze kuzinze amathambo.
Ubunjani
Umhlaza wesifo somhlaza ngumhlaza oqhelekileyo osasazeka kwingqondo, kwaye ubuncinane ubuncinane abangama-40 ekhulwini abantu abanomdlavuza wamapopom Umdlavuza womnxeba wesibini omncinci ongasetyenzana kunye nomhlaza wesifo somhlaza wamasipha angasasazeka kwingqondo. Umdlavuza omncinci wamangqamuzana omnxeba unokusasazeka kwi-brain ngokukhawuleza, kaninzi ngaphambi kokufunyaniswa kwesifo. I-prophylactic irradiation irradiation (PCI) , uhlobo lweyeza lonyango, lunokusetyenziswa ukuzama ukukhusela oku kungenzeki.
Umhlaza womlenze oye wasasazeka kwingqondo ungabangela iimpawu zombini ngokutshabalalisa izicubu zengqondo kunye nokudala ukuvuvukala nokuvuvukala okubeka uxinzelelo kwizakhiwo ezingqondweni. Kwingxenye yesithathu yabantu, akukho zibonakaliso ezikhoyo.
Izimpawu eziqhelekileyo zingabandakanya iintloko, ukutshatyalaliswa, ukulahlekelwa kwemilinganiselo kunye nokulungelelanisa, ubunzima ngokuthetha, utshintsho lombono, ukugujwa kwememori kunye nokuguquka komntu, ubuthathaka kwicala elinye lomzimba kunye nokukhathala.
Umdlavuza we-Lung we-metastatic kwi-brain udla ngo-CT scan okanye i-MRI yengqondo.
Unyango lubaluleke ngokukodwa, oku kuthetha ukuba injongo kukulawula iimpawu kwaye ungazami ukuphilisa umhlaza. I-Steroids ingasetyenziselwa ukunciphisa ukuvuvukala. Amayeza enhlungu kunye namachiza okulwa neentambo zingasetyenziselwa ukulawula i-headaches kunye ne-seizures. Uphulo lwe-radiation lungasebenza kakhulu ekunciphiseni iimpawu zabanye abantu.
Ukuba kuphela enye okanye ubuchopho be-metastase bukhona - into ebizwa ngokuba yi "oligometastase" - unyango kunye notyando okanye i- radiotherapy yomzimba (stereotactic body radiotherapy) (i-SBRT) eyaziwa nangokuthi i-cyber knife okanye i-gamma ibinza, kuye kwabangela ukulawula ixesha elide lesi sifo abanye abantu.
Ibindi
Umdlavuza womlenze oye wasasazeka kwisibindi awukwazi ukubangela nayiphi na impawu kwaye uyafumaneka xa uvavanyo, njenge-CT scan, lwenziwe ukujonga ukusasazeka komhlaza wakho. Xa kukho izibonakaliso, zingabandakanya intlungu phantsi kweembambo zakho ngakwesokudla komzimba wakho, ukulahleka kwesidlo, kunye nesiphithiphithi. Ukuba kukho izilwanyana ezininzi kwisibindi sakho okanye ukuba i-metastases inkulu ngokwaneleyo ukuphazamisa amathanga kwisibindi sakho, unokuhlakulela i- jaundice (umbala obomvu wesikhumba sakho kunye nabamhlophe kwamehlo akho).
Iimvavanyo ezenziwa ukujonga ukusasazeka komhlaza wemiphunga kwisibindi zingabandakanya i-ultrasound esiswini, i-CT scan yakho esiswini, okanye i-PET scan.
Unyango luvame ukwenziwa kwe-chemotherapy eyenzelwe ukunyanga nomhlaza wesiqhelo. Kwiimeko ezinqabileyo, ukuba kuphela isisu esisodwa okanye iimbumba ezimbalwa, utyando lunokucetyiswa ukuba lususe izicubu. Ngamanye amaxesha inqubo ebizwa ngokuba yi-embolization inokukhuthazwa kwakhona. Le nkqubo inqanda ukuhamba kwegazi ibe yinxalenye yesibindi ukuze iiseli zomhlaza ezikhoyo zingenakuphila.
Glands Adrenal
Umdlavuza womlenze usasazeka kwiingqungquthela ze-adrenal (iincinci ezincinci ezihlala phezulu kweentso kunye nokuvelisa ama-hormone), akange kubangele naziphi na iimpawu, kwaye ngokuqhelekileyo zifunyanwe ngeso siganeko xa kuthathwa iskena sokuqalisa umhlaza.
Unyango kunye ne-chemotherapy yomhlaza unokunceda. Kwinqanaba elincinci labantu ababenokukwazi ukuba nomhlaza wabo wamaphaphu basuswe kwaye bekunye kwindawo enye yeengqungquthela ze-adrenal, utyando lokususa i-adrenal gland kunye ne- adrenal metastases kuye kwaphumela ekuphumeni kwexesha elide.
Ezinye iiNdawo
Nangona imimandla engentla iindawo eziqhelekileyo zomhlaza wemiphunga yamaphaphu, umdlavuza wemiphunga ngezinye izihlandlo usasazeka kwisisu, amathumbu amancinci amakhulu, ama-pancreas, iliso, ulusu, iinjongo, kunye nebele.
Prognosis
Ngaphandle kokusasazeka kwii-lymph node ezingabandakanya izigaba zangaphambili zesifo, umhlaza wemiphunga oye wasasazeka kwiindawo ezikude zomzimba uhlelwe njengesigaba se-4 esingasomncinci wesifo somhlaza wamaphaphu okanye umgca omncinci wesifo somhlaza wamangqamuzana. Umlinganiselo wonyaka wesi-5 wokusinda kwisigaba se-4 esingekho esincinci somhlaza wamaphaphu sinesihlungu kuphela malunga neepesenti ezi-2. Ukusinda komlambo, oko kungumnini wexesha emva kokuba isiqingatha sabantu sisaphila kwaye esinye isiqingatha sidlulile, iinyanga ezili-8. Isilinganiso seminyaka emihlanu yokusinda kwisigaba esincinci somhlaza wesifo somhlaza wamaphaphu sinama-2 ekhulwini. Umyinge wokusinda unyaka we-6 ukuya kwe-12 unyango, kodwa iinyanga ezimbini ukuya kwi-4 kuphela ngaphandle kokonyango.
Oko kwathiwa, kukho abantu abaye basinda kwaye benza kakuhle kwiminyaka emininzi nangemva kokuxilongwa komhlaza womphunga oye wasasazeka. Ukongezelela, unyango olutsha, olunjenge- immunotherapy izidakamizwa ezivunyiweyo ngo-2015 , zinikeza ithemba lokuba kwabanye abantu, ukuhlala ixesha elide kunokufumaneka. Nangona la mayeza angasebenzi kuwo wonke umntu, abanye abantu abanomdlavuza ophezulu wamaphaphu baye babe "impendulo eqhubekayo" kule miyeza-intsingiselo, ngamanye amagama, ukusinda ixesha elide.
Ngaphantsi
Njengoko kuphawuliwe ngasentla, phantsi kwesihloko kwimiba ethile yomzimba apho umhlaza womphunga ungasasazeka khona, kukuba xa kusekhona iindawo ezimbalwa zeemetastasis, ukunyanga ezi ziphumo zendlela yokulawula ixesha elide lomhlaza kunokuba nje i-palliation kunokuqwalaselwa. Abaphandi abaninzi ngoku bakholelwa ukuba ukuqhubela phambili kwindlela yokwelapha eya kubantu abaneempawu ezincinci kuye kwabangela ukuba abanye abantu abane-oligometastase ngenxa yomdlavuza wamaphaphu babe nexesha elide lokuphila ngokukhululeka kunye nomgangatho ophezulu wobomi.
> Imithombo:
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