Malo Omwe Amagwiritsa Ntchito Mankhwala a Khansa Yam'mimba
Anthu ambiri omwe ali ndi khansara yamapapo amadziwa kuti khansa ya m'mapapo ingafalikire. Pafupifupi 40 peresenti ya anthu omwe amapezeka kumene ali ndi kansa ya m'mapapo kale ali ndi metastases ku mbali zina za thupi. Kodi khansa yamapapu imatha bwanji, ndipo kodi mungadziwe bwanji ngati khansa yanu yafalikira?
Mwachidule
Matenda a khansa amatha kufalikira pamene maselo amatha kuchoka pamimba, ndipo amayenda kudzera m'magazi kapena zamaliseche (zotengera m'thupi zomwe maselo oyera amagazi amayenda) kupita kumadera akutali a thupi ndikukula.
Izi zimatchedwa metastasis.
Ndikofunika kusiyanitsa pakati pa malo oyambirira (kumene khansa imayambira) ndi khansa yachiwiri poyankhula za kufalikira kapena mitsempha ya khansa. Khansa yapakhungu yamapapu yomwe imafalikira ku fupa imatchedwa "khansa yamapapu yamapapu", osati "khansa yapafupa." Mofananamo, khansara yamapapu yomwe imafalikira ku ubongo imatchedwa "khansa yamapapo ya m'mapapo ku ubongo" osati "ubongo" khansa. "
Kwa iwo amene akufuna kudziwa zambiri za momwe ndi chifukwa chake izi zimachitika, ngakhale kuti chotupa chikuoneka kuti chachotsedwa kwathunthu, mungathe kuwona nkhani izi momwe kansa imafalitsira ndi chifukwa chake ena khansa amabwerera (kubwerera) .
Madera Omwe
Khansara ya m'magazi ikhoza kufalikira pafupifupi dera lonse la thupi, koma malo omwe amapezeka kwambiri ndi amphongo , chiwindi, mafupa, ubongo, ndi mazira a adrenal. Tiyeni tiwone mbali iliyonse ya izi mwapadera.
Lymph Nodes
Matenda ambiri a mapapu amayamba kufalikira ku zifuwa pafupi ndi chotupacho.
Pamene khansa ikupita, maselo a khansa akhoza kupita kumadera omwe ali pachifuwa kwambiri kuchokera pachifuwa choyamba, kenako mpaka kumadera ena a thupi. Mosiyana ndi zigawo zina za thupi, kufalikira kwa khansara yamapapu ku maselo am'mimba samatanthawuza kuti ndi masitepe ( siteji 4 yosakhala yaying'ono kapena kansalu yaing'ono ya kansa yamapapo ).
Khansara yonse ya mapapu ya mapapo kusiyana ndi gawo 1 osapangidwira kansalu ya mapapu ya mapapu ingaphatikize khansa yomwe yafalikira ku maselo amphongo.
Nthawi zambiri, kufalikira kwa khansa ya m'mapapo ku maselo am'mimba sizimayambitsa zizindikiro zilizonse. Pamene khansayi imapitirira mpaka kumapapo a mitsempha m'mapapo, mukhoza kuona mtanda wanu m'khosi kapena pamtambo wanu, zofanana (koma nthawi zambiri zowonjezereka) ndi zilonda zotupa zomwe mwinamwake munali nazo m'mbuyomu ndi khosi.
Chithandizo ndi mankhwala amodzi kupatula ngati maselo amphongo omwe ali nawo ali pafupi ndi chotupa choyamba ndipo akhoza kuchotsedwa ndi opaleshoni .
Thupi
Pafupifupi 30 mpaka 40 peresenti ya anthu omwe ali ndi khansara yamapapu yakulitsa (metastases) mafupa. Mafupa ambiri omwe amakhudzidwa ndi msana (makamaka m'mimba ndi m'mimba m'mimba), pakhosi, ndi mafupa apamwamba (mikono ndi miyendo). Khansa ya m'mimba ndi yosiyana kwambiri ndi yomwe imatha kufalikira m'manja ndi mapazi.
Chizindikiro chofala kwambiri cha mafupa a metastases ndi ululu. Kawirikawiri ululu umayamba pang'onopang'ono, kumverera ngati minofu yotulutsa kapena kupsyinjika, ndipo imapweteka kwambiri. Chifukwa cha kufooketsa mafupa ku chifuwacho, anthu ena amayamba kuphulika (zomwe zimapweteka kwambiri ) zomwe zimachitika ndi zovuta kwambiri kapena ngakhale pazochitika za tsiku ndi tsiku.
Ngati khansara yamapapu imafalikira msana, imatha kupanikiza msana wam'mimba (kupanikizika kwa msana) zomwe zingakhale zosavuta kuchipatala. Izi zingachititse kufooka kapena kumangirira m'miyendo yanu kapena kuvutika kuyenda. Khansa yomwe imatha kupweteketsa mafupa imathanso kuwononga mafupa otulutsa calcium m'magazi ( hypercalcemia ) omwe amachititsa zizindikiro za chisokonezo, kufooka kwa minofu, ndi kusowa kwa njala pakati pa ena.
Mayesero oti apeze mafupa a mitsempha angaphatikizepo fupa la fupa , PET scan , CT , kapena MRI . Cholinga chachikulu pa chithandizo cha mafupa a metastases ndi kuchepetsa ululu ndi kukonzanso kapena kuteteza fracture zomwe zimachitika. Zosankha zimaphatikizapo mankhwala opweteka, mankhwala opatsirana pogwiritsa ntchito mankhwala , mankhwala omwe amayesa kuteteza kusweka kwa fupa, ndi opaleshoni kuti zikhazikike mafupa.
Ubongo
Khansa ya m'magazi ndi khansa yowopsa kwambiri imene imafalikira ku ubongo, ndipo pafupifupi 40 peresenti ya anthu omwe ali ndi khansara yamapapu yapamwamba adzakhazikika m'mitsempha ya ubongo nthawi ina pa nthawi ya matenda awo. Kansani yochepa yopanda mapapu ndi khansa yaing'ono yamapapu yamapapu imatha kufalikira ku ubongo. Khansara yaing'ono ya m'mapapo ya mitsempha imatha kufalikira kwa ubongo mofulumira, kawirikawiri asanatulukirepo. Pulolactic iraniation (PCI) , mtundu wa mankhwala opatsirana pogwiritsa ntchito mankhwala, ingagwiritsidwe ntchito pofuna kuteteza izi kuti zichitike.
Khansa ya m'magazi yomwe yafalikira ku ubongo ingayambitse zizindikiro zonse powononga mitsempha ya ubongo ndi kupanga kutupa ndi kutupa komwe kumapangitsa kuti zikhale zolimba mu ubongo. Pafupifupi anthu atatu mwa anthu atatu, palibe zizindikiro.
Zizindikiro zowonjezereka zimaphatikizapo kupweteka mutu, kukhumudwa, kusawonongeka ndi kugwirizanitsa, zovuta poyankhula, kusintha kwa masomphenya, kusintha kwa kukumbukira ndi kusintha kwa umunthu, kufooka kwa mbali imodzi ya thupi, ndi kutopa.
Matenda a khansa ya m'magazi ku ubongo nthawi zambiri amapezeka ndi CT kapena MRI ya ubongo.
Chithandizo chachikulu chimapangidwira, kutanthauza kuti cholinga ndikuteteza zizindikiro komanso kuti asayesetse kuchiza khansa. Steroids ingagwiritsidwe ntchito kuchepetsa kutupa. Mankhwala opweteka komanso mankhwala osokoneza bongo angagwiritsidwe ntchito poletsa kupweteka mutu komanso kupweteka. Thandizo la ma ARV lingakhale lothandiza kuchepetsa zizindikiro za anthu ena.
Ngati kokha kapena ochepa ubongo metastases alipo - chinachake chotchedwa "oligometastase" - mankhwala ndi opaleshoni kapena stereotactic thupi radiotherapy (SBRT) amadziwikanso monga cyber mpeni kapena gamma mpeni, zachititsa kuti nthawi yayitali matendawa kwa anthu ena.
Chiwindi
Khansa ya m'mimba yomwe yafalikira pachiwindi sikungayambitse zizindikiro zonse ndipo imapezeka nthawi zambiri ngati mayesero, monga scan scan, apita kukafuna kufalikira kwa khansa yanu. Ngati zizindikiro zilipo, zimaphatikizapo kupweteka pansi pa nthiti zanu kumbali yoyenera ya thupi lanu, kusowa kwa kudya, ndi mseru. Ngati pali zotupa zambiri mu chiwindi kapena ngati metastases ndi zazikulu zowononga chiwindi mu chiwindi, mukhoza kukhala ndi chikasu (chikasu cha khungu lanu ndi azungu anu).
Mayesero omwe amachitidwa pofuna kuyang'ana kufalikira kwa khansa ya m'mapapo ku chiwindi angaphatikizepo mimba ya m'mimba yotchedwa ultrasound, CT scan of your pregnancy, kapena PET scan.
Chithandizo ndi mankhwala omwe amagwiritsidwa ntchito kuti athetse khansa yoyamba. Nthawi zambiri, ngati chotupa chimodzi kapena zochepa zilipo, opaleshoni ikhoza kutonthozedwa kuchotsa zotupazo. Nthawi zina ndondomeko yotchedwa embolization ingakonzedwenso. Iyi ndi njira yomwe imayimitsa kuthamanga kwa magazi kukhala gawo la chiwindi kotero kuti maselo a khansa omwe alipo sangathe kukhala ndi moyo.
Adrenal Glands
Khansa ya m'magazi imafalikira ku adrenal glands (tizilombo tating'ono tomwe timakhala pamwamba pa impso ndi kutulutsa mahomoni), sizimayambitsa zizindikiro zilizonse, ndipo nthawi zambiri zimapezeka pochitika pokhapokha ngati pulojekiti imachitika kuti ipange khansa.
Kuchiza ndi chemotherapy kwa khansa kungakhale kothandiza. Mu chiwerengero chochepa cha anthu omwe adatha kukhala ndi khansara yamapapu ndipo adakhala ndi malo amodzi okha m'gulu limodzi la adrenal glands, opaleshoni kuchotsa adrenal gland ndi adrenal metastases zachititsa kukhalapo kwa nthawi yaitali.
Madera Ena
Ngakhale zigawo zapamwamba ndi malo omwe amapezeka kwambiri a khansa ya khansa ya m'mapapo, khansa ya m'mapapo nthawi zina imafalikira mmimba, matumbo ang'onoang'ono ndi aakulu, mphuno, diso, khungu, impso, komanso ngakhale bere.
Kuthamangitsani
Zina kuposa kufalikira kwa mitsempha yomwe imakhala ndi magawo oyambirira a matendawa, khansara yamapapu yomwe yafalikira kumadera akutali a thupi imatchedwa kansa ya 4 yopanda khansa ya m'mapapo kapena kansa yaying'ono ya kansa ya m'mapapo. Kachilombo ka zaka zisanu ndi zisanu (5) zomwe zimakhalapo pa siteji ya khansa ya m'mapapo yopanda makapu, ndizosautsa pafupifupi 2 peresenti. Kupulumuka kwapakatikati, ndiko kuchuluka kwa nthawi yomwe theka la anthu akadali amoyo ndipo theka lina lapita, ndi miyezi 8. Kachilombo ka zaka zisanu zapakati pa kansalu kakang'ono ka maselo a kansa yamapapo ndi 2 peresenti. Avereji ya moyo ndi miyezi 6 kapena 12 ndi chithandizo, koma miyezi 2 kapena 4 yokha popanda chithandizo.
Izi zikuti, pali anthu amene apulumuka ndipo akhala bwino kwa zaka zambiri ngakhale atapezeka kuti ali ndi khansa ya m'mapapo yomwe yafalikira. Kuonjezera apo, mankhwala atsopano monga mankhwala omwe amavomerezedwa mu 2015 , amapereka chiyembekezo kuti kwa anthu ena, kukhala ndi moyo kwa nthawi yaitali kungakhale kotheka. Ngakhale mankhwalawa samagwira ntchito kwa aliyense, anthu ena omwe ali ndi khansara yamapapu yapamwamba akhala ndi "yankho lokhazikika" kwa mankhwalawa - kutanthawuza, mwa kuyankhula kwina, kupulumuka kwa nthawi yaitali.
Mfundo Yofunika Kwambiri
Monga tafotokozera pamwambapa, pansi pa mutu wa mbali zina za thupi lomwe khansa ya m'mapapo ingafalikire, ndikuti pali malo ochepa chabe a masastasis, ochizira matendawa ndi cholinga chokhala ndi khansa kwa nthawi yaitali osati kungothamanga angaganizidwe. Ofufuza ambiri tsopano akukhulupirira kuti kupita patsogolo kwa njira zachipatala kwa anthu omwe ali ndi miyeso yochepa chabe yathandiza kuti anthu ena ali ndi oligometastase chifukwa cha khansa ya m'mapapo kuti akhale ndi moyo wautali kwa nthawi yaitali komanso moyo wabwino kwambiri.
> Zotsatira:
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> Peters, S., Bexelius, C., Munk, V., ndi N. Leighl. Zotsatira za ubongo wamtundu wa umoyo, njira yogwiritsira ntchito zogwiritsira ntchito komanso kupulumuka kwa odwala ndi khansa ya m'mimba yopanda matenda. Ndemanga za Chithandizo cha Khansa . 2016. 45: 139-62.
> Stephens, S., Moravan, M., ndi J. Salama. Kusamalira Odwala ndi Oligometastatic Osati Small Cell Lung Cancer. Journal of Practice Oncology . 2018. 14 (1): 23-31.
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