Kwa anthu ambiri lerolino, chemotherapy amatanthauza mtundu wa cytotoxic, kapena kupha maselo, mankhwala ochizira khansa. Komabe, pachiyambi, chemotherapy ndi mawu omwe anagwiritsidwa ntchito ndi katswiri wa zamagetsi wa ku Germany Paul Ehrlich, amene anagwiritsira ntchito kutanthawuza chabe kugwiritsa ntchito mankhwala kuti athetse matenda. Choncho, "chemotherapy" ingaphatikizepo chirichonse kuchokera ku maantibayotiki kapena ngakhale mankhwala othandizira , omwe ali ndi mankhwala ndipo akugwiritsidwa ntchito pochiza matenda.
Masiku ano, ena amaganizira za " mankhwala opatsirana ndi khansa " pakati pa omwe ali ndi zotsatira zochepa kwambiri. Komabe, nthawi zambiri zimakhala zothandiza kuti mankhwala atsopanowa agwiritsidwe ntchito mogwirizana ndi mankhwala ofanana ndi mankhwala, osati okha. Ndipo, ngakhale kuti mankhwala ochiritsira omwe akuwongolera samakhudza thupi mofananamo ndi omwe amagwiritsira ntchito mankhwala amtundu wa mankhwala, angayambitsenso zotsatirapo. Selo la khansa likhoza kukhala ndi malingaliro ambiri kuposa maselo wathanzi - omwe amawunikira njira zothandizira angagwiritse ntchito mwayi - koma maselo wathanzi angasokonezebe.
The Magic Bullet
Njira yabwino yothandizira khansa ikhoza kukhala ngati zamatsenga, ndipo chifukwa cha ziwanda zambiri, mankhwala abwino salipobe. Chakumapeto kwa zaka za m'ma 1800 ndi kumayambiriro kwa zaka za m'ma 1900, asayansi anayamba kuphunzira za mabakiteriya ndi zomwe zimayambitsa matenda. Paul Ehrlich anali dokotala yemwe ankagwira ntchito ndi mabakiteriya, ndipo amakhulupirira kuti, popeza amatha kuyambitsa mabakiteriya ndikuwawona pansi pa microscope, ayenera kuyesetsa kumenyana ndi majeremusi ngati atapeza mankhwala omwe angadziphatikize ku germ kupha, kusiya china chilichonse chosavulazidwa.
Iye anatcha mankhwala oterowo kuti 'matsenga amatsenga.'
Masiku ano, tili ndi zida zamatsenga zomwe zimatchedwa antibiotics, koma ngakhale mankhwala ochepa kwambiri a antibiotics angakhale ndi zotsatirapo - kapena zoipa kwambiri, zingachititse kuti anthu ena azitengera mchitidwe woopsa wotchedwa hypersensitivity. Izi sizikutanthauza kusiya kupereka lingaliro la matsenga, komabe.
Kulimbana ndi Ukhondo
Mwamwayi, mankhwala othandiza kwambiri a khansa amathandizidwanso ndi poizoni wambiri. Maselo a khansa amachokera ku maselo abwino, omwe ali ndi thanzi omwe apeza zofooka - zomwe zimachititsa kukula kosalamulirika. Iwo ndi osiyana mokwanira kuchokera ku maselo abwino omwe madokotala angagwiritse ntchito mankhwala kuti asokoneze maselo a kansa kwambiri kuposa maselo abwino, koma maselo ena amathanzi amatha kukhudza; ma poizoniwa amathandizidwa ndi odwala ndipo amatsogoleredwa ndi madokotala, mwa chidwi chopha maselo a khansa ndikuyesera kukulitsa moyo wa munthu.
Nthawi zina zimakhala zosiyana pakati pa kukula kwa khansa yowonjezera komanso kuwonjezeka kwauchidakwa. Komabe, asayansi omwe amafufuza zotsatira za mayesero a kachipatala nthawi zonse amayang'ana mfundo zomwe zimawonjezera kuchuluka kwa mankhwala osapindulitsa koma zimagwirizanitsidwa ndi chiopsezo chachikulu. Kawirikawiri, ntchito yolimbitsa thupi yomwe madokotala ndi odwala amachita palimodzi - cholinga chokhala ndi mphamvu yochulukirapo ndi poizoni omwe amavomereza, kuti apeze zotsatira za nthawi yaitali.
Odwala Okalamba
Ngakhale zingakhale zochititsa mantha kwa ambiri, mayesero ena a khansa amagwiritsa ntchito zaka 60 mpaka 65 ngati malo odwala "okalamba".
Mwachiwonekere, mawu okalamba angakhale oyenerera ngati ena mwa iwo omwe ali ndi zaka za m'ma 80 ndi 90 ali ndi thanzi labwino kuposa anthu ambiri omwe ali aang'ono zaka zambiri. Komabe, pamene tikukalamba, timayamba kukhala ndi thanzi labwino, monga kuthamanga kwa magazi. Ndipo impso zathu nthawi zambiri sizothandiza pakuphwanya magazi athu monga kale. Pazifukwazi komanso pazifukwa zina, tikhoza kulekerera mankhwala olimbitsa thupi, pafupipafupi, si abwino pa zaka 85 zomwe ziyenera kuti zinali ndi zaka 20.
Kufalitsa kwambiri B-cell lymphoma (DLBCL) ndi mitundu ina ya khansa kungakhale yofala kwambiri kwa anthu omwe ali okalamba.
Inde, chiwerengero cha anthu a zaka zapakati pa 80 kapena kuposerapo ndi B-cell osakhala Hodgkin lymphoma (B-NHL) yowonjezera yakula mu malo ochizira. Chithandizo cha mankhwala a DLBCL kwa achinyamata amakhala oyenerera kapena okhazikika, mwina pakali pano. Kuyesera kukonzanso kayendetsedwe kogwirizanitsa pakati pa mphamvu ndi poizoni tsopano ikuchitika kwa anthu achikulire, nawonso.
Zochepa Zoopsa
Gulu la asayansi odziwika bwino padziko lonse la kafukufuku wa lymphoma - Groupe d'Etude des Lymphomes de l'Adulte (GELA) - anayesa funso ili kwa anthu omwe ali ndi zaka 80 mpaka 95 za DLBCL. Iwo akufuna kufufuza momwe ntchito ndi chitetezo cha kuchepa kwa mlingo wa CHOP (doxorubicin, cyclophosphamide, vincristine, ndi prednisone) chemotherapy ndi mlingo wodalirika wa rituximab - maselo oyang'anitsitsa a antioclonal antibody omwe ali ndi CD20 'tag' - odwala achikulire omwe ali ndi DLBCL.
Pakalipano, patapita zaka ziwiri, zotsatira zakhala zotsitsimula, ndikuwonetseranso kufunika kwa zifukwa za m "modzi m'magulu awa. Pamene mankhwala opatsirana amadzimadzi apansi, kapena R-"minichOP", amagwiritsidwa ntchito, mphamvu zowoneka ngati zowoneka ngati zaka 2 mpaka mlingo woyenera, koma ndifupipafupi zomwe zimaphatikizapo kuchipatala kuchipatala.
Mayesero opitirirabe akuyang'aniranso funso lakuti ngati kachilombo katsopano kowononga chitetezo cha m'magulu ndi njira zochiritsira zingagwiritsidwe pothandizira kuchepetsa poizoni pamene akuchiza khansa kwa okalamba.
Zotsatira
Peyrade F, Jardin F, Thieblemont C, et al. Groupe d'Etude des Lymphomes of the Adult (GELA) investigators. Kutetezedwa kwa immunochemotherapy regimen (R-miniCHOP) okalamba okalamba okalamba oposa zaka 80 ndi olemera kwambiri B-cell lymphoma: multicentre, mkono umodzi, chiyeso chachiwiri. Lancet Oncol . 2011; 12 (5): 460-8.
Iioka F, Izumi K, Kamoda Y, et al. Zotsatira za okalamba okalamba omwe ali ndi nkhanza zoopsa za B-cell zomwe sizinapangidwe ndi Hodgkin lymphoma zomwe zimagwiritsidwa ntchito ndi mankhwala ochepa. Int J Clin Oncol. 2015 Oct 13. [Epub patsogolo pa kusindikiza]
Sayansi Yogwirizana ndi Sayansi. https://www.sciencebasedmedicine.org/chemotherapy-doesnt-work-not-so-fast-a-lesson-from-history/. Idapezeka mu January 2016.
Kufufuza Mbiri ya Mankhwala. Magic Bullet. Idapezeka mu January 2016.