Funda malunga neempawu eziqhelekileyo zesifuba, isifuba kunye nesimo esithile
Impawu kunye neempawu ezithile zomntu umntu anokuba nomdlavuza webele we-metastatic ziyahlukahluka kakhulu kumntu omnye ukuya kwelinye. Abanye abantu baya kuba nemiqondiso emininzi, kanti abanye banokuba nemiqondiso embalwa kakhulu okanye akukho nanye; kunye nomhlaza ofunyenweyo kwiimvavanyo zengcamango ezifana ne-CT scan okanye iPET scan kuphela.
Iimpawu ezithile ozifumanayo kunye nobuxhakaxhaka ziya kuxhomekeka kwiimeko ezininzi, kubandakanywa apho umhlaza wakho usasazeke khona , ubungakanani bomhlaza, kunye nempilo yakho jikelele ngaphambi kokuphuhlisa umhlaza wesibeletho se-metastatic.
Njengoko ufunda malunga neempawu ezinokuthi unako ukuzenza, qhubeka ukhumbula ukuba uninzi lwabantu alufumani zonke ezi nkxalabo. Kunoko, zidweliswe apha ukukunceda ukuba ubone ukuba unokuziva njani kwaye uqonde ukuba kutheni kwenzeka ntoni. Siphinde sibhale ezinye zeempawu ezinokuthi zenzeke ngenxa yeengxaki zesifo somhlaza we-metastatic.
Ininzi yale miqondiso ayiqhelekanga, kodwa ikhankanywe ukwenzela ukuba ube kwindawo efanelekileyo yokuqonda imeko engxamisekileyo xa kufuneka kwenzeke.
Iimpawu eziqhelekileyo
Kukho iimpawu ezininzi onokuzifumana ngomhlaza wesifo se-metastatic edlalwa ngumdlavuza we-metastatic ngokubanzi. Ezi zimpawu zinokudityaniswa nokutshintshwa kwemizimba emzimbeni kunye nezinye izinto.
Ukukhathala: Elinye izinga lokukhathala lifumana uninzi lwabantu abanomdlavuza wesifo semitha. Ukukhathala komhlaza kuyahluke kunokuba ukhathele ngokuqhelekileyo, kwaye kunokuthi kwenzeke nangona uphumule ngokupheleleyo kwaye ulala kakuhle.
Nangona le mpawu iphela ngokubanzi phakathi kwalabo abaphila nomhlaza, kubalulekile kakhulu ukuthetha nodokotela wakho ngezinga lokudinwa ozivelayo. Ukukhathala, nangona kungasongela ubomi, kuphazamiseka kwaye kuthathwa njengenye yeempawu ezinzima kunye nezixhalabisayo.
Nangona ukukhathala akukwazi ukuphathwa rhoqo, kukho iziganeko ezinokubangela ukukhathala ukuba ugqirha wakho uya kufuna ukuvavanya.
Ukulahlekelwa kwesisindo esingenalutho: Ukulahlekelwa kweepesenti ezingaphezu kweesithandathu zomzimba (ubunzima beepiki eziyi-7½ kwi-150 kwipilisi yomntu) kwiinyanga ezili-6 ukuya kweyeshumi elinesibhozo kubhekiselwa ekulahlekelweni kwesisindo-okanye ukulahlekelwa kwesisindo ngaphandle kokuzama. Nangona ungaziqhathanisi rhoqo, unokwazi ukuba iimpahla zakho zihambelana ngokukhululekile, okanye ukuba izihlathi zakho zibonakala zingacacanga.
Kukho izizathu ezininzi zokulahleka kwesisindo kunye nomhlaza ophezulu. Enye yale ngxaki yomhlaza wecaxia , okuyi-syndrome kuquka ukulahleka kwesisindo, ukuxhatshazwa kwemisipha kunye nokulahleka kwesidlo. Kungathi ngathi ugqirha wakho kufuneka azi ukuba ulahlekelwe isisindo, kodwa kubalulekile ukuba ulandele oku ngokwakho. Abantu abaninzi abanomdlavuza webele we-metastatic bagcina bebona oogqirha abaninzi, kunye nokulahlekelwa ubunzima, ngokukodwa xa bubuqilima, banokuphelelwa kukuphela.
Ukuphelelwa kwesidlo: Ukulahleka kwesidlo kuqhelekileyo, kwaye kunokuba ngumqondiso onzima kakhulu ukujongana nomhlaza wesifo semitha. Kukho ezininzi ezinokubangela ukulahleka kwesidlo, kubandakanya ukucwenga, nokuhlanza, iziphumo ezichaphazelekayo zonyango lomhlaza, kunye nesisu somzimba.
Ukudandatheka: Kwiminyaka yamuva sifunde ukuba ukudakumba kuxhamla nomdlavuza weemetastatic, kwaye ingaba ngumqondiso wokuqala wokuphindaphinda kwabanye abantu.
Kunokuba nzima ukuhlula phakathi kwentlungu evamile kunye nokudakumba kwengqondo. Thetha nogqirha wakho malunga neemvakalelo zakho, nangona ukholelwa ukuba le mivakalelo iyinto evamile inikwe imeko yakho.
Iimpawu zeMetastatic Site
Amaxesha amaninzi iimpawu zokuqala zomhlaza wesibeletho se-metastatic zihambelana nemimandla yomzimba apho isifo somhlaza wesifuba sisasazeka khona, okanye apho siphindela khona. Iindawo eziqhelekileyo apho umdlavuza webele usasazeka khona kubandakanya amathambo, ingqondo, isibindi kunye nemiphunga, nangona umdlavuza webele usasazeka phantse nayiphi na into emzimbeni. Kuqhelekileyo kubantu abanomdlavuza webele we-metastatic ukuphucula izidumbu kwiindawo ezininzi.
I-Bone metastases: Uphawu oluqhelekileyo lwesifo se- metastasis lubuhlungu obuqhubekayo kunye nokuphazamiseka kwindawo apho i-metastasis yenzeke khona. Ngamanye amaxesha abantu abaqapheli ukuba banamathambo ama-boneastases ade bafumane ukuphuka nokuxhwaleka. Izahlulo ezenzeka ngamathambo apho umhlaza usasazeka khona kuthiwa yi-fractures pathologic.
Ubungqina bezilwanyana: Iingqumbo zesibindi zihlala zikhankanywa xa ukuhlolwa kwegazi kubonisa amanqanaba aphakamileyo enzymes. Xa umhlaza wesifuba usasazeka kwisibindi kuqhelekileyo kubafazi (kunye namadoda) ukuvavanya ngokubanzi, okungaba nzima. I-jaundice (i-yellowing yesikhumba kunye nabamhlophe bamehlo) angenzeka, kunye nokukhathazeka kwesisu, isicupunu kunye nokuhlanza.
I-metastase ye-Lung: I- metastase ye-lung ephuma emdlalweni wentsholongwane ingabangela ukukhwehlela okungapheliyo nokuphefumula okuqhubekayo, ngokuqhelekileyo kuvele kuqala ngomsebenzi. I-buildup ye-fluid phakathi kweembumba ezithwala imiphunga (ukukhulelwa kwamanzi) ziqhelekile kwaye zivame ukunyuswa ngokunyuka ngokukhawuleza kokuphefumula.
I-Brain metastases: Umhlaza wesifuba usasazeka kwiqondo engaphantsi kaninzi kunamathambo, isibindi kunye nemiphunga, kodwa inokubakhokisayo. Unokwazi ukuqwalasela intloko, ukuguqulwa kwezinto ezibonakalayo, ukutshatyalaliswa kwemvelo, ukuguquka komntu, okanye ukutshatyalaliswa. I-Brain metastase ivela ngokuqhelekileyo kubantu abanomdlavuza webele we-HER2 .
Izibilini zesisu
Unako okanye ungenayo impawu zebele ezihlobene nomhlaza wakho, kwaye oku kuya kuxhomekeka ekubeni ingaba umhlaza wakho unemetastatic xa ufumanisa kuqala ( "de novo" umdlavuza webele ) okanye ukuba ubuyaphinda emva kokonyangwa komhlaza wesifuba sangaphambili.
Izimpawu zesifuba kunye nomdlavuza webele we-metastatic: Kwabaninzi babantu abanomdlavuza webele we-metastatic, i-metastases ibonisa ukuphindaphinda komhlaza wesifuba owawube nawo ngaphambili. Kutheni, ukuba kukho, iimpawu zebele eziya kuxhomekeka kwizinto ezakukhokelela ekufumaneni ukuxilongwa kwakho, kunye neendlela ezisetyenziselwa ukunyanga umdlavuza wakho wokuqala.
Ukuba unomastectomy, umzekelo, umhlaza unokubuyela kwisibindi ngaphandle kwempawu ezinxulumene nodonga lwakho lwesifuba okanye esifuba.
Izimpawu zesisu zomhlaza wesibeletho: Ukuba ufumene unomdlavuza webele we-metastatic ngaphandle kwemphambili yomhlaza webele (de novo umdlavuza webele), kukho ezininzi iimpawu ezinokuthi unakho.
Abanye abantu babona oogqirha babo ngesifuba se-breast or abmormal mammogram, kwaye bafunyaniswa ukuba baneemastastases ngelixa besetyenziselwa i-CT scan, i-scan scan, okanye i-PET scan. Ngokwahlukileyo, umdlavuza weemetastatic ngezinye amaxesha ufunyenwe xa i-biopsy yesayithi, njengesibindi, ibonisa iiseli zomhlaza zesifuba. Ukuqhubela phambili kuya kubakho ukufumana isisu sokuqala esiswini. Ezinye iintsholongwane, ezifana nesifo somhlaza wesifuba esivuthayo, zidla ngokukhawuleza ngexesha le-diagnostic yokuqala.
Ukuphindaphindeka ngokumalunga nomgangatho wesibini: Ukuba isalathisi senzeke sakho emva kwe-lumpectomy, kunokuqala kunzima ukwazi ukuba ngaba ukuphindaphinda komhlaza wakho wokuqala okanye umhlaza wesibini wesiqhelo. Ukuvavanywa kwe-molecular ye-tumor kungasetyenziselwa ukubonisa oku.
Iimpawu zeengxaki
Iimpawu ezinxulumene nomhlaza wesibeletho se-metastatic zingabandakanyi kuphela ezo ngenxa yomhlaza ngokwawo, kodwa iingxaki ezibangelwa ngumhlaza. Nangona ezi zibonakalisa zivalo, ziyizona zonke eziqhelekileyo. Siyabalula apha ngenxa yokuba bangabonakalisa imeko engxamisekileyo, kwaye unyango lwangxamisekileyo lubalulekile kubomgangatho wobomi kunye nokuphila kwabo banomdlavuza webele we-metastatic.
Ukugqitywa kweNtsalane: Xa umhlaza usasazeka kumqolo ongaphantsi ungabangela ukunyanzeliswa kwama-vertebrae kunye neentsholongwane ezivela phakathi kwama-vertebrae. Xa oku kwenzeka kwintlambo engaphantsi kungancinciza ngokukhawuleza iimbilini eziya emilenzeni, emathunjini, nasesiswini.
Ezi ngxakeko zihlala ziquka iimpawu zentlungu ephantsi emva okanye ngaphandle kwemisebe emilenzeni kunye nokulahlekelwa kwesilonda kunye nokulawulwa kwesisu. Ukunyanga okukhawulezayo kuyadingeka ukuze kugcinwe umsebenzi weentsholongwane.
Ukuxhamla kwe-Pleural Effusion: Ukutshatyalaliswa kwesigxina, okubizwa ngokuba "yintsimbi yomphunga emiphakeni," kuyinkxalabo eqhelekileyo kubantu abanomdlavuza webele. Isithuba esiphakathi kweengxube zemiphunga (i-pleura) ngokuqhelekileyo imancinci, iqukethe ezintathu kuphela ezine ezinezipuni zamanzi.
Ngomdlavuza we-metastatic, umlinganiselo omkhulu wetsholongwane (ilitha okanye ngaphezulu) unokuqokelela kule ndawo, leyo leyo, iyancipha imiphunga. Iimpawu zingabandakanya ukuphefumula okufutshane ngokukhawuleza, kunye nentlungu yesifuba (ngokukhawuleza ubukhali) ngokuphefumlelwa. Utyando (oluxutyushwa kamva) luquka ukufaka inaliti ukucima umbane.
I-Pericardial Effusion: Njengoko umkhuhlane unokwakhiwa phakathi kweembrane ezifaka imiphunga, i-fluid inokuqokelela kwiimfucu ezithintela intliziyo (indawo ye-pericardial), ebangela ukunyaniseka kwentliziyo. Iimpawu zingabandakanya intlungu yesifuba (ngokuphindaphindiweyo okanye ukugwaza), ukuphefumula okufutshane, ukuphalaza, kwaye ekugqibeleni, ukulahleka kwengqondo.
I-hypercalcemia: Ukuchithwa kwethambo ngenxa yesifo se-metastase kungakhokelela ekwandeni kwe calcium egazini. Le hypercalcemia inokuthi iholele kwiintso zeentso, umonakalo wezintso kunye nokunciphisa ukucoca, isicupunu kunye nokuhlanza, kunye nokudideka, phakathi kwezinye iimpawu. Le meko iyayiphatha, kodwa kuyadingeka ukuba unyango lwezempilo luyimfuneko.
I-Febrile Neutropenia: Abo bafumana i-chemotherapy bayakwazi ukufumana izifo, kwaye ezi zifo ziba nzima ukunyanga. Iimpawu zingabandakanya umkhuhlane ophezulu, ukubola, ukudideka, ukukhwehlela, okanye intlungu ngokuvuthwa. Unyango lwe-chemotherapy oluchaphazelekayo luye lwaphuculwa kakhulu kwixesha elidlulileyo, kodwa ludinga unyango olushushu.
Ukuthetha noDokotela wakho
Kubalulekile ukuba uthethe kwi-oncologist yakho kunye neqela lokunakekelwa kwezempilo malunga nayiphi na zonke iimpawu ozifumanayo. Ezinye zeempawu, ezinjengeentlungu, zingaphathwa kakubi kubantu abanomdlavuza wemetastatic. Oku kungenxa yokuba oogqirha bahluleka ukunyanga iimpawu, kodwa kuba bengazi ukuba umntu ulwa nabo.
Ngayo yonke intetho ngabantu abanomdlavuza "abanesibindi" okanye "banamandla," unganqikaza ukwabelana ngeempawu ezingenza uvele "ukwesaba" okanye "ubuthathaka." Nangona ujongene nomdlavuza wemetastatic ukwesabisa, kwaye ukwazi ukwabelana ukukhathazeka ngumqondiso wamandla, kungekhona ubuthathaka. Kuninzi enokuyenza ukuze unciphise ezininzi iimpawu zesifo somhlaza wesisu se-metastatic, kodwa indlela kuphela yendlela i-oncologist yakho inokwazi ngayo oko uvakalelwa kukuba "ukhaliphe" ngokwaneleyo ukuthetha.
Ukongeza, ukwabelana ngeempawu zakho, nokuba ngaba zibonakala zingenakucingela kuwe, zinokukunceda i-oncologist yakho ibe ngcono ukuqonda ubungakanani besifo sakho, ulindele ukuxhatshazwa, kwaye uphakamise unyango olungcono kakhulu lwesifo sakho.
> Imithombo:
> DeVita, Vincent., Et al. I-Cancer: Imigaqo kunye nokuSebenza kwe-Oncology. Ngomhlaza we Breast. Wolters Kluwer, 2016.