Tanthauzo ndi Kufunika kwa Metastases Ndi Khansa
Kodi mawu akuti metastasis amatanthauzanji? Kodi khansa imafalikira bwanji kumadera ena a thupi, chifukwa chiyani imafalikira (mosiyanitsa ndi zotupa zowonongeka,) ndi malo ati omwe amapezeka kwambiri a metastases?
Tanthauzo la Metastasis
Matenda a metastasis amatanthauza kufalikira kwa maselo a khansa kuchokera kumalo awo oyambirira (chiwalo chimene khansa inayamba) ku dera lina la thupi.
Khansara yomwe yafalikira motere imatchedwa kansa ya metastatic.
Khansara ya metastatic imatchulidwa kuchokera pa tsamba limene khansa inayamba. Mwachitsanzo, ngati khansara yamapapu imafalikira mafupa, sichidzatchedwa "kansa ya mafupa" koma makamaka "khansa yamapapo ya m'mapapo mafupa." Pankhaniyi, pamene maselo a maselo amatha kuyang'aniridwa pansi pa microscope angakhale mapaipi a khansa maselo, osati maselo a mafupa.
Ma khansa ena amatha kupweteka, pamene ena amatha kukhala ndi metastatic pambuyo pa khansara, kapena kubwerera. Khansara ikachoka (kapena yosatheka kupezeka ndi mayeso) kenako ikabwereranso pamalo osachokera ku khansa yapachiyambi, imatchedwa "kutalikanso." Mu khansa ya stage, chotupa chimene chachitapo kanthu chimaonedwa ngati gawo 4.
Kufunika kwa Metastases
Kukwanitsa kuchepetsa matendawa ndi chinthu chimodzi chokha chimene chimasiyanitsa zotupa zoipa (khansa) kuchokera ku zotupa (osati khansa) zotupa.
Ziphuphu zina zowonongeka zimatha kukhala zazikulu, ndipo zimayambitsa mavuto aakulu, makamaka ngati ali mu malo ozungulira monga ubongo. Koma zotupazi sizifalitsidwa kumadera ena a thupi.
Metastases ndi omwe amachititsa 90 peresenti ya kufa kwa khansa, ndipo kafukufuku wopambana akuyang'anitsitsa njira zonse zothandizira mavitamini ndi njira zothandizira kuti izi zisamveke poyamba.
Kodi khansa imatha bwanji kuchepetsa (kufalikira)?
Maselo a kansa amasiyana ndi maselo ochibadwa m'njira zingapo , imodzi mwa iwo ndi yakuti maselo a khansa amatha kuwachotsa ku maselo oyandikana nawo kuti awonongeke ndi kufalikira ku zida zina. Maselo ozoloŵera amapanga mamolekyu othandizira omwe amakhala ngati guluu, akugwira maselo ofanana palimodzi. Selo la khansa silikusowa mamolekyumu awa omwe amawalola kuti amasule ndi kuyenda. Kusiyanitsa kwina ndikuti maselo achibadwa amalumikizana ndi maselo ena oyandikana-makamaka, akukumbutsidwa malire awo. Selo la khansa lakonza njira zosanyalanyaza zizindikiro izi. Kamodzi kansalu ya kansa ndi "yotayirira" ndipo imayenda, imatha kuyenda. Pali njira zingapo zomwe maselo a khansa amafalikira :
- Kumaloko (kumadera): Pamene matumbo am'thupi amakula amachititsa kuti akhale olimba, ngati pali malire omveka omwe ali nawo. Mosiyana ndi zimenezi, maselo a khansa amayambitsa zida zozungulira zomwe zimawoneka ngati zovuta. Ndipotu, kufalikira kwa kansalu kumatenda ena kumene kumachokera dzina; khansa yochokera ku liwu lachi Greek la claw.
- Kudzera m'magazi: maselo a khansa akhoza kulowa m'magazi ndikupita kumadera ena a thupi.
- Kupyolera mu mafilimu: Lymphatic system ndi njira ina yomwe maselo a khansa amayenda.
Kudzera m'mlengalenga (khansa ya m'mapapo): Kuphatikiza pa njira zamatenda a pamwamba, kafukufuku waposachedwapa amasonyeza kuti khansa ya m'mapapo, imatha kufalikira m'mapapo (mitsempha yodabwitsa kwambiri), ndipo izi zingakhale zofunikira kwambiri kuposa magazi a metastasis anthu omwe ali ndi mapapu adenocarcinoma .
Kamodzi kansara ikafalikira, pali njira zina zofunika kuti maselo a khansa apitirize kukula. Chinthu chofunikira ndicho kupanga mapangidwe atsopano a magazi kuti adye chotupa chatsopano, njira yotchedwa angiogenesis .
Mankhwala otchedwa angiogenesis inhibitors amagwira ntchito kuti asokoneze njirayi, zomwe zimapangitsa kuti zikhale zovuta kuti zotupa zikhazikike m'malo atsopano.
Kodi Khansa Amafalikira Kuti?
Ambiri khansa amatha kufalikira kumadera aliwonse a thupi, koma malo ena a metastases ndi ofala kuposa ena.
Ma site a masastasiti onse ndi mitundu yambiri ya khansa ndi awa:
- Malo otchuka kwambiri a metastasis onse amaphatikizapo mafupa, chiwindi, ndi mapapo.
- Malo odziwika kwambiri a khansa ya m'mawere kuti awonongeke ndi mafupa, ubongo, chiwindi, ndi mapapo.
- Malo odziwika kwambiri a khansa ya m'mapapo kufalikira ndi ma glands adrenal, mafupa, ubongo, chiwindi, ndi kwina m'mapapu.
- Malo ambiri omwe ali ndi kansa ya colon kuti awonongeke ndi chiwindi, mapapo, ndi peritoneum.
- Malo ambiri omwe kansa ya prostate imafalitsidwa ndi adrenal glands, fupa, chiwindi, ndi mapapo.
Zizindikiro za Metastases
Zizindikiro za khansa yamtunduwu imatha kukhala yokhudzana ndi kukhala ndi chotupa m'madera ena a thupi lomwe khansa yafalikira, komanso zizindikiro zosadziwika bwino monga kutaya kwadzidzidzi ndi kutopa. Zizindikiro zina zingaphatikizepo izi:
- Mankhwalawa amatha kupweteka, kupuma pang'ono, kapena kupweteka pachifuwa.
- Mitsempha ya ubongo ingayambitse kupweteka kwa mutu, kuwonongeka kwa masomphenya, kugunda, kupweteka kapena kufooka kwa mikono kapena miyendo, ndi kusawonongeka.
- Matenda a metastases amatha kupweteka m'madera omwe mafupa omwe amathyokawo amakhalapo, kuphatikizapo kashiamu okwezeka m'magazi (hypercalcemia of malignancy.) Pamene khansara ili pamphupa, ikhoza kuphwanya, ndipo chizindikiro choyamba Mitsempha ya mafupa imatha kukhala kutaya kwa thupi (kupweteka kupyolera mu fupa lowonongeka ndi chotupa.) Pamene khansara imafalikira kumtsempha, ikhoza kuyambitsa kupweteka kwa msana kwa kupweteka kwa miyendo ndi kupweteka kwa chifuwa kapena chikhodzodzo.
- Matenda a chiwindi angayambitse jaundice (kutuluka kwa khungu khungu,) kupweteka, kupweteka m'mimba, ndi kuwonongeka kwa thupi.
- Mankhwala a adrenal gland nthawi zambiri amakhala ochepa koma okhudzana ndi chithandizo.
Kuchiza kwa Khansa ya Metastatic
Chithandizo cha kansa ya mthupi chidzadalira malo a chotupa chachikulu. Khansara ya metastatic sichikhoza kuchiritsidwa, koma imachiritsidwa. Mankhwala atsopano monga mankhwala ochiritsira ndi omwe amachititsa kuti thupi lawo likhale labwino limapangitsa kuti anthu ena azikhala ndi khansa yambiri, ndipo mankhwala ambiri akuwerengedwa m'mayesero a kachipatala omwe amachititsa kuti chiwerengero cha mankhwala odwala matenda a khansa apitirire.
Madera ena a metastases ndi ovuta kwambiri kuposa ena. Chifukwa cha makina ovuta kwambiri ogwiritsidwa ntchito kwambiri omwe amatchedwa kuti ubongo wa ubongo, cholepheretsa kupewa poizoni kuti asalowe m'katikati mwa mitsempha ya mankhwala, mankhwala ambiri a mankhwala a chemotherapy, ndi zina zochiritsira zosagwiritsidwa ntchito zimalephera kufika kumadera a metastases mu ubongo . Kafukufuku akupitiriza kuyang'ana mankhwala omwe angathe kulowa mu ubongo, komanso njira zina zochizira matendawa.
Kwa anthu ena omwe ali ndi malo amodzi kapena ochepa chabe a metastase (oligometastases,) kuchotsa masastasis ndi opaleshoni kapena ma radiation akhoza kupulumuka. Mawu akuti metastasectomy amagwiritsidwa ntchito polongosola kuchotsedwa kwa metastase ndipo akhoza kuganiziridwa ndi mitundu ina ya khansara yokhala ndi masabata pang'ono okha ku ubongo, chiwindi, kapena mapapo.
> Zotsatira:
> American Cancer Society. Kodi Metastasis ndi chiyani? Kusinthidwa 12/15/16. http://www.cancer.org/treatment/understandingyourdiagnosis/bonemetastasis/bone-metastasis-what-is-bone-mets
> Gaikwad, C. et al. Metastases Yodziwika bwino: Maseŵero Othandizira Kusintha mu Kufufuza ndi Kuyang'anira Mapulogalamu Oyambirira Adungocarcinoma. American Journal of Roentgenology . 2014. 203 (6): 570-82.
> National Cancer Institute. Khansa ya Metastatic. Kusinthidwa 02/06/17. https://www.cancer.gov/types/metastatic-cancer