Kodi Khansa Zambiri Zimagwirizana Bwanji ndi Matenda a Hodgkin?
Ngati mutangoyamba kumene kapena muli pakati pa mankhwala a Hodgkin lymphoma , kukambirana za khansa ina ndi chinthu chomaliza chimene mukufuna kumva. Musanayambe kukambirana za chiwopsezo ndi chiwopsezo cha khansa yachiwiri ndizofunika kudziwa kuti chiwopsezo cha zotsatira zochepa monga khansa yachiwiri ndizopambana kwambiri ndi phindu la mankhwala. Kwa zaka makumi asanu ndi limodzi zapitazi, chiwerengero cha zaka 5 za Hodgkin lymphoma chinachoka pa 10 peresenti kufika pafupifupi 90 peresenti, ndipo munthu wodwala matendawa angathe kuyembekezera kuchiritsidwa.
Kuzindikira kuti kuthekera kwa khansa yachiwiri kumakhala kofunika kwambiri kwa iwo omwe alowa zomwe zapangidwa ndi gawo la khansara. Ngakhale chinthu chofunikira kwambiri kuti mupulumutsidwe ndi kuphunzira kuchoka pa udindo wanu monga "wodwala khansa" ndikusiya kufotokozedwa ndi khansara, muyenera kumvetsetsa chiopsezo chachikulu choterechi.
Tiyeni tiwone momwe chiopsezochi chingakhalire chochuluka, chiwerengero cha khansa zina zokhudzana ndi mankhwala ogwiritsidwa ntchito pa matenda a Hodgkin, ndipo chofunika kwambiri, yang'anani momwe mungasinthire thanzi lanu labwino nthawi yaitali mutatha kuchipatala mwa kuyang'ana msanga ndi kuchepetsa chiopsezo.
Kodi Chimachitika N'chiyani Ngati Khansa Yachiwiri?
Khansara yachiwiri pambuyo pa matenda a Hodgkin amatanthauzidwa ngati chitukuko cha khansa yachiwiri yosagwirizana ndi khansa yanu yoyamba. Matenda a Hodgkin omwe amabwera-kubwereranso-satengedwa ngati khansa yachiwiri koma m'malo mobwerezabwereza matendawa.
Kansara yachiwiri nthawi zina ingatchulidwe ngati khansara yachiwiri yoyamba , kutsindika kuti khansa yachiwiri ndi yosagwirizana ndi yoyamba.
Mankhwala opatsirana khansa monga chemotherapy ndi mankhwala ochizira mazira amatha kuchiza Hodgkin lymphoma, koma panthaŵi imodzimodziyo, ndi matenda a khansa. Kuwonongeka kwa mankhwalawa kumayambitsa DNA m'maselo kungagwiritse ntchito mochititsa chidwi kuti achotse maselo a khansa, komanso akhoza kuwononga maselo ochizira, maselo wathanzi, nthawi zina kuyambitsa kusintha komwe kungayambitse chitukuko cha khansa.
Khansa yachiwiri imatha kukhala miyezi kwa zaka makumi angapo pambuyo pa khansara yanu yoyamba.
Kodi Khansa Yachiwiri Ndi Yotani Pambuyo pa Hodgkin Lymphoma?
Kodi ndi chiopsezo chotani kuti mukhale ndi khansara yachiwiri ngati muli ndi matenda a Hodgkin? Yankho lanu lidzakhala losiyana malinga ndi chithandizo chimene munali nacho, msinkhu wanu kuti mudziwe, ndi zinthu zina zambiri. Ngakhale tili ndi malingaliro omwe khansa ingathe kuchitika ndipo chifukwa chake ndi kovuta kufufuza chiwopsezo chenicheni kwa munthu aliyense. Kafukufuku ayang'ana magulu a anthu omwe ali ndi Hodgkin lymphoma m'kupita kwa nthawi, koma anthuwa adalandira mankhwala osiyanasiyana osiyanasiyana. Popeza mmodzi mwa amuna awiri ndi mmodzi mwa amayi atatu akuyembekezeka kukhala ndi khansa m'moyo wawo ngakhale kuti alibe matenda a Hodgkin, zimakhala zovuta kwambiri kudziwa momwe zingakhalire zoopsa.
Pamene tikulankhula za zoopsa ndi mitengo, kumbukirani kuti izi ndizochokera kwa anthu omwe ali ndi matenda a Hodgkin. Komabe anthu enieni sakhala ochepa.
Zonsezi, akuganiza kuti 20 mpaka 30 peresenti ya anthu omwe apulumuka ku Hodgkin lymphoma adzakhala ndi khansa yachiwiri. Kuopsa kwa imodzi mwa khansa (osati mitundu yonse ya khansa yowonjezera) imakhala pafupifupi 4.6 nthawi yomwe anthu ambiri amakhalapo.
Phunziro la 2015 mu The New England Journal of Medicine linawoneka pa opitirira 3900 odwala matenda a Hodgkin pafupifupi zaka 20.
Ambiri a zaka zomwe anapeza kuti anthuwa anali ndi zaka 28. Ena mwa opulumukawa anali ndi chemotherapy, ena anali ndi ma radiation, ndipo pafupifupi 60 peresenti analandira mankhwala onsewa. Mwa anthu awa, anthu 908 anayamba khansa yachiwiri.
Phunziro lina linayang'ana anthu omwe ali ndi Hodgkin lymphoma omwe anali ndi zaka 35 kapena kupitirira. Kuopsa kwa khansara yachiwiri zaka 30 ndi 33.2 peresenti (poyerekezera ndi 9.6 peresenti mwa anthu ambiri) ndipo 48.5 peresenti pazaka 40 (poyerekezera ndi 19 peresenti mwa anthu ambiri).
Kodi Ndi Zipatala Ziti Zimene Zimayambitsa Mavuto a Khansa Zachiwiri?
Monga tafotokozera pamwambapa, tikudziwa kuti mankhwala a chemotherapy ndi ma radiation akhoza kuwononga maselo wathanzi, koma mankhwala ena ndi ovuta kuposa ena kuti awononge chiopsezo cha khansa.
Mankhwala opatsirana pachifuwa kwa Hodgkin lymphoma akhala akugwirizanitsa ndi ngozi yowonjezera ya khansa ya m'mawere , kansa ya m'mapapo , ndi khansa ya chithokomiro. M'mbuyomu, mlingo wa ma radiation ndi kuchuluka kwa minofu yowoneka bwino inali yaikulu kwambiri. Pakalipano, mankhwalawa amagwiritsidwa ntchito kawirikawiri kuti athetse Hodgkin lymphoma, ngakhale kuti imagwiritsidwabe ntchito nthawi zambiri kumayambiriro kwa matenda. Mafunde omwe akugwiritsidwa ntchito panopa amaperekedwanso kumalo osapita m'mbali, omwe amatha kukhala ndi makoswe omwe amachititsidwa ndi Hodgkin lymphoma ( miyendo yamoto ).
Mafunde omwe amapezeka pamunsimu, ndi mosiyana ndi chifuwa, amawonjezera chiopsezo cha khansa, pancreatic, ndi colon.
Chemotherapy imachititsanso kuti maselo awonongeke, koma magulu ena a mankhwala a chemotherapy amatha kuwononga mavuto omwe angayambitse khansa yachiwiri. Gawo la mankhwala lotchedwa alkylating agents limakhala ndi chiopsezo chachikulu (makamaka procarbazine). Mavitamini otchedwa alkylating amagwirizana kwambiri ndi chiopsezo chowonjezereka cha lymphoma yomwe si ya Hodgkin .
Procarbazine ilipo mu BEACOPP chemotherapy regimen ndi dacarbazine, wina wothandizira ndi imodzi mwa zigawo za ABVD chemotherapy .
Kodi Kuopsa kwa Khansa Zachiwiri Kuwonjezeka Kapena Kutha?
Zambiri zapita patsogolo zakhala zikuchitika pa chithandizo cha Hodgkin lymphoma patapita nthawi. Monga taonera, zina mwazikuluzikulu zomwe zimayambitsa khansa yachiwiri zimachokera ku mankhwala a radiation ndi chemotherapy ndi othandizira alkylating.
Ngakhale zili bwino kuti chiopsezo cha khansa yachiwiri chikhoza kuchepa, popeza kugwiritsa ntchito mankhwala ambiri omwe akugwirizana kwambiri ndi khansa yachiwiri akuchepa, palibe umboni wosonyeza kuti izi zikuchitika, ndipo maphunziro ena amasonyeza ngakhale kuwonjezeka kochepa pa chiopsezo.
Mankhwala Omwe Ambiri Ambiri Amene Amapezeka Pambuyo pa Chithandizo cha Hodgkin Lymphoma
Amayi ambiri omwe ali ndi Hodgkin lymphoma ndi awa:
- Khansara ya m'mimba - Khansa ya pachifuwa ndiyo khansa yambiri yachiwiri yomwe imapezeka mwa anthu amene amathandizidwa ndi Hodgkin lymphoma. Pali malangizo othandizira (onani m'munsimu) kuti muyambe kuyang'ana khansa ya m'mawere yomwe imadalira zaka zomwe mwapezeka kuti muli ndi matenda a Hodgkin ndi mitundu ya mankhwala omwe mwalandira. Mwachitsanzo, amayi omwe alandira ma radiation a Hodgkin lymphoma (chifuwa chamoto) mpaka pachifuwa asanakwanitse zaka makumi atatu (30) ayenera kukhala ndi MRI ndi ma ARV poyambira ali ndi zaka 30. Amayi ambiri omwe amachiritsidwa ndi Hodgkin lymphoma ayenera kuyamba nthawi zonse Kuyezetsa khansa ya m'mawere ali ndi zaka 40 posachedwa. Kumbukirani kuti amuna akhoza kutenga khansa ya m'mawere.
- Non-Hodgkin lymphoma - Monga taonera pamwamba, si-Hodgkin lymphoma imagwirizana kwambiri ndi mankhwala a chemotherapy omwe akuphatikizapo altlanting agents monga procarbazine.
- Khansara ya m'magazi - Mankhwala othandizira pachifuwa chifukwa cha matenda a Hodgkin pamwamba pa mimba ndi khansara yachiwiri yamba. Ofufuza ambiri amakhulupirira kuti njira zamakono zowonongeka zimadzetsa ochepa khansa yachiwiri.
- Khansara ya Colon - Pali chiopsezo chowonjezereka cha khansa yoyipa kwambiri, makamaka kwa omwe akhala ndi ma radiation pansi pa chithunzithunzi pamodzi ndi chemotherapy zomwe zikuphatikizapo procarbazine. Kafukufuku akupitiriza kuyesa kupeza njira yabwino yosonyezera anthu omwe ali ndi Hodgkin lymphoma omwe ali ndi mankhwalawa onsewa.
- Khansara yotchedwa Pancreatic - Khansara ya Pancreatic imagwirizana kwambiri ndi kuwala kwapafupi pansi pa chithunzithunzi.
- Khansara ya m'mimba - Monga khansara ya pancreatic, khansa ya m'mimba nthawi zambiri imagwirizanitsidwa ndi mbiri yolandira chithandizo cha mankhwala pansi pa chithunzithunzi.
- Mitsempha ya m'mitsempha yambiri - Khansa ya m'magazi monga khansa yachiwiri si yowoneka ngati yomwe imaganiziridwa kale, komabe chiopsezo chikukwerabe kwa opulumuka ku matenda a Hodgkin. monga kuganizira kale. Mankhwala monga cytoxan (cyclophosphamide) amakhala ndi chiopsezo chachikulu. Cytoxan ndi imodzi mwa mankhwala mu BEACOPP chemotherapy.
Khansa Zina Zowonjezera Anthu Omwe Ali ndi Hodgkin Lymphoma
- Melanoma
- Myelodysplastic Syndrome (MDS)
- Khansara ya pakamwa kapena m'chinenero, khansa yosalala
- Kansa ya chiwindi
- Kansalu ya khansa
- Khansara ya mafupa ndi khansa yofewa
- Khansa ya chiberekero
- Khansara ya chithokomiro
- Kaposi sarcoma
Kodi Kuopsa kwa Khansa Zachiwiri Kumatha Kutalika Motalika Motani?
Sitikudziwa kuti chiopsezo cha khansa yachiwiri chikhoza kupitirira liti, ngakhale kuti chiwopsezo chimakhala chokwera kwa moyo wotsala. Kawirikawiri, zikuwoneka kuti chiopsezo chachikulu cha khansa yachiwiri chikuchitika m'zaka khumi ndikutsatira mankhwala.
Malangizo Othandizira Kuyeza Khansa Zachiwiri
Pakalipano pali njira zowunikira ma khansara ena achiwiri. Malangizo omwe apulumukawa amapereka malingaliro apadera okhudzana ndi msinkhu wanu, matenda omwe mwalandira, ndi kutalika kwa nthawi yomwe mwatsiriza mankhwala. Ndikofunika kwa aliyense yemwe wakhala ndi matenda a Hodgkin kuti ayang'ane ndondomekoyi ndikukambirana nawo ndi oncologist wawo. Zowonjezera pazitsogozozi ziyenera kukhala zifukwa zina zoopsa kapena mbiri ya banja ya khansara yomwe muli nayo.
Kuwunika ndi Kuzindikira koyambirira ndi Kuzindikiritsa zizindikiro
Ngakhale kuti pali njira zina zomwe zimakhazikitsidwa poyambirira kwa khansa yachiwiri, ndizofunikira kuti tiwonetsetse kuti panopa sakuyesa mayesero omwe angapezeke kwa khansa zambiri zomwe zawonjezeka kwa iwo omwe ali ndi Hodgkin lymphoma.
Mwachitsanzo, tilibe njira iliyonse yowonera anthu nthawi zonse kuti asakhale a Hodgkin lymphoma, khansa yowopsa pambuyo pa chithandizo. Pakalipano, zingakhale zomveka kuti anthu omwe ali Hodgkin lymphoma ayenera kudziwa zizindikiro za sanali a Hodgkin lymphoma ndipo ayambe kuchipatala ngati zizindikiro izi ziyenera kuchitika.
Kwa khansa yomwe muli malangizo, mukhoza kuyembekezera kusintha. Tangoyamba kumvetsa kuopsa kwa khansa yachiwiri, ndipo kufufuza kwakukulu kumakhala koyenera kuchitidwa.
Kufunika Kuthandizidwa Kwachipatala Pambuyo pa Hodgkin Lymphoma
Kuphatikiza pa kutsatiridwa kulikonse komwe akulimbikitsidwa ndi wanu oncologist pozindikira koyambirira kwa khansa yachiwiri, ndikofunikira kuti muwonetsetse kuti mwakhala mukulimbana ndi mayeso "ovuta".
Nthaŵi zambiri mukamachita khansa, mavuto ena azachipatala amakankhidwa kumoto wam'mbuyo (kapena kuchoka potoyi). Mayesero oyeza ngati colonoscopy akhoza kutsika. Kwa anthu ambiri, chinthu chomaliza chimene akufuna kuchita pambuyo pomaliza mankhwala ndi kukhala ndi mayesero owonetsera omwe angayang'ane khansa ina!
Pazinthu zina, mutha kukhala ndi chizindikiro choyambirira cha khansara, koma chogwirizana ndi zomwe mwakhala mukudutsa, chizindikiro chanu sichiwoneka ngati chofunika kwambiri. Anthu omwe ali ndi khansa amaphunzira kukhala ndi ululu kapena kupweteka, ndipo pafupifupi aliyense amaphunzira kukhala ndi kutopa. Zingakhale zovuta kusiyanitsa kutopa chifukwa cha vuto latsopano kuchokera ku kutopa kumene kumawoneka ngati kwanthawizonse pambuyo pa chithandizo cha khansa. Mvetserani thupi lanu ndikudalira matumbo anu. Ngati chinachake chikuwoneka mosiyana, lankhulani ndi dokotala wanu.
Kodi Mungatani Kuti Muchepetse Vuto Lanu la Khansa Yachiwiri?
Kuwonjezera pa kuyesa kuyezetsa dokotala wanu akuvomereza kuti, kukhala ndi moyo wathanzi kumachepetsa chiopsezo chokhala ndi khansa yachiwiri. Izi zikuphatikizapo:
- Kudya zakudya zabwino
- Kusunga kulemera kwathanzi
- Kupewa fodya
- Kuchita nthawi zonse
- Kuletsa kumwa mowa
- Zotsatira zikulimbikitsidwa kukonza zaumoyo ndi ndondomeko zowunika
Kuonjezera apo, mungafune kufufuza malangizo awa pothana ndi chiopsezo cha kansa ya coloni , malingaliro amenewa pofuna kuchepetsa chiopsezo cha khansa ya m'mapapo , ndi malingaliro awa pochepetsa chiopsezo cha khansa ya m'mawere .
Mawu Ochokera
Zingakhale zoopsa kuphunzira kuti pali ngozi ya khansa yachiwiri pambuyo pa mankhwala a Hodgkin lymphoma, koma palinso zinthu zambiri zomwe mungachite kuti muchepetse chiopsezo chanu. Moyo wathanzi ungathandize kuchepetsa ngozi za khansa komanso matenda omwe amapezeka pakati pa anthu onse. Ndikofunika kulankhula ndi a oncologist anu za machitidwe owonetseredwa pogwiritsa ntchito mankhwala omwe mwakhala nawo. Ndimalingaliro abwino kuti zizindikiro zatsopano zithetsedwe mwamsanga. Kuphatikizapo kuchepetsa chiopsezo chanu komanso kuonjezera mwayi wopezera khansara m'magulu ochiritsira oyambirira angapite patsogolo kuti mukhale ndi Hodgkin lymphoma yabwino "yatsopano."
> Zotsatira:
> Keegan, T., Bleyer, A., Rosenerg, A., Li, Q., ndi M. Goldfarb. Zachiwiri Zopweteka Zopweteka Zoopsa ndi Kupulumuka kwa Omwe Achinyamata Okalamba Ndi Odwala Khansa. JAMA Oncology . 2017 Apr 20. (Epub patsogolo pa kusindikiza).
> Norval, E., ndi E. Raubenheimer. Malingaliro Ochiwiri Achidwi ku Hodgkin Matenda: Kubwereza za Zolemba ndi Lipoti la Nkhani ndi Lymphoma ya Lennert ya Sekondi. Journal of Oral and Maxillofacial Pathology . 2014. 18 (Suppl 1): S90-5.
> Radford, J., ndi D. Longo. Khansa Yachiŵiri pambuyo pa Chithandizo cha Hodgkin Lymphoma - Kupitirirabe Chifukwa Chodera nkhaŵa. The New England Journal of Medicine . 2015. 373: 2572-2573.
> Rigter, L., Spaander, M., Moon, L. et al. Kuwongolera Kansalu Kwambiri ku Hodgkin Lymphoma Opulumuka pa Ngozi Yowonjezereka ya Kansa Yoyamba Yogwiritsa Ntchito Mankhwala: Study Design. BMC Khansa . 2017. 17 (1): 112.
> Schaapveld, M., Aleman, B., van Eggermond, A. et al. Kachiwiri Kachiwiri Kwazaka Zaka 40 Kuchiza Chithandizo cha Hogkin's Lymphoma. The New England Journal of Medicine . 2015. 373: 2499-2511.