Zachidule za Zochiza Khansa ya M'mimba
Pali njira zambiri zothandizira anthu omwe ali ndi khansara yamapapu, koma izi sizinachitike nthawi zonse. Chithandizo chawo-kuphatikizapo chiwerengero cha moyo chomwe chikugwirizana nawo-chatsintha bwino kwambiri m'zaka zaposachedwapa. Ngakhale izi ndizochitika zabwino kwambiri, sizikupangitsani kuti musankhe zosankha zomwe zingakuthandizeni kwambiri.
Kudziwa zambiri za mankhwala a khansa yamapapo omwe alipo, komanso kupeza thandizo limene mukufunikira, lingakuthandizeni kupanga chisankho chofunika kwambiri.
Kodi Mankhwala Angachiritse Khansa Yam'mimba?
Kwa anthu omwe ali ndi khansara yamapapo oyambirira, opaleshoni ikhoza kupereka mpata wochiritsidwa. Ngakhale mutakhala ndi khansa ya m'mapapo yapamwamba, pali njira zambiri zothandizira. Zomwe zikuchitika posachedwapa zomwe zimapereka madokotala kuti adziwonetsere matenda a khansa yamapapo, komanso kumvetsetsa momwe ma chitetezo a mthupi lathu amagwirira ntchito polimbana ndi khansa, zawonjezereka njira zomwe tili nazo zothandizira matendawa.
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Mmene Tizilomboti Tingawathandizire Odwala Matenda a Khansa
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Phindu la Thupi la Yoga kwa Odwala Khansa
Ndikofunikira kunena nthawi yomweyo kuti ngakhale kansa ya m'mapapo ndi yosavuta kuigwira kumayambiriro oyambirira, pali opulumuka nthawi yaitali ngakhale magawo apamwamba kwambiri. Ndikofunika kudziwa kuti kuchiza khansa ya m'mapapo sikungowonjezereka kupulumuka nokha. Mankhwala opatsirana khansa angathandize kwambiri kuchepetsa zizindikiro za khansara ndikupangitsa kuti anthu ambiri akhale ndi moyo wabwino nthawi zonse.
Mitundu ya Chithandizo cha Khansa ya M'mimba
Popeza pali mankhwala osiyanasiyana omwe amapezeka ku khansa ya m'mapapo, zingakhale zothandiza kuthetsa mankhwalawa mpaka njira ziwiri zikuluzikulu:
- Zokhazikika M'deralo: Mankhwala am'deralo amachiza khansara pamtundu wake-mwazinthu zina, kwanuko. Izi zikuphatikizapo opaleshoni ndi mankhwala opangira mavitamini, mankhwala omwe amachotsa zotupa koma sangathe kufika ku maselo omwe apita kupyola malo oyambirira a chotupacho.
- Mankhwala Ochiritsira: Mankhwala othandiza amawononga maselo a kansa kulikonse kumene amakhalapo m'thupi. Mankhwalawa amaphatikizapo mankhwala a chemotherapy, mankhwala ochiritsira, ndi immunotherapy.
Poyamba mapapo a khansa, mankhwala am'deralo angakhale okwanira kuti athe kuchiza khansa. Khansara yamapapu ikafalikira ku maselo am'mimba kapena m'madera ena a thupi, njira zamankhwala zothandizira ndizo njira yabwino kwambiri yothandizira.
Mawu osokoneza omwe mungakumane nawo ndi adjuvant therapy . Nthawi zina mankhwala amatha kugwiritsa ntchito ngakhale khansayo sawonekera. Mwachitsanzo, mankhwala ophera tizilombo toyambitsa matenda kapena mankhwala opatsirana angaperekedwe ngakhale kuti opaleshoni inkachitidwanso. Mankhwala a adjuvant ndiwo omwe amachitika kuti athetse maselo onse omwe afalikira kupitirira malo oyambirira a khansara, koma sangathe kudziwika ndi mayesero ojambula omwe tili nawo panopa.
Opaleshoni ya khansa ya m'mimba
Khansara ya m'mapapo ikamenyedwa kumayambiriro oyambirira-isanayambe kufalikira kupitirira mapapo-opaleshoni ikhoza kukhala yowononga. Poyambira msinkhu, osati maselo ang'onoang'ono a mapiritsi a khansa (mwachindunji ndondomeko I kuti ndikalowe IIIA osakhala ang'onoang'ono mapepala a khansa mapapu), opaleshoni nthawi zambiri amaganiziridwa. Nthawi zambiri, opaleshoni ikhoza kuganiziridwa kuti ndi kansalu yaing'ono ya khungu yam'mbuyo.
Pali njira zisanu zomwe zingapangidwe pofuna kuchiza khansa ya m'mapapo:
- Pneumonectomy: Pneumonectomy imatanthawuza kuchotsedwa kwa mapapo onse.
- Lobectomy: Mu lobectomy , imodzi mwa mapafu a mapapo imachotsedwa. (Mapapu abwino ali ndi malabe atatu, ndipo mapepala akumanzere ali ndi zikopa ziwiri.)
- Chiyanjano cha Mkwati: Pa khosi resection , chotupacho chimachotsedwa pamodzi ndi malo omwe ali ngati mapepala a mapapo pafupi ndi chotupacho.
- Kutsegula Msoko: M'masukidwe a manja, chiphuphu cha m'mapapo, pamodzi ndi mbali ya bronchus (yomwe imatsogolera kumapapo,) imachotsedwa.
- Segmentectomy: Mu gawo la segmentectomy, gawo la lobe lichotsedwa. Kuchuluka kwa minofu yotsekedwa ndi njirayi sikungokhala mphero resection, koma pansi pa lobectomy.
Zotsatira zoyipa za opaleshoni zimaphatikizapo matenda, kutuluka kwa magazi, ndi kupuma pang'ono, malingana ndi mapapo omwe amagwira ntchito asanayambe opaleshoni komanso kuchuluka kwa matenda a m'mapapo.
Mankhwala othandizira mavitamini a khansa ya khansa
Mankhwala opatsirana pogwiritsa ntchito khansa ya m'mapapo amagwiritsa ntchito mphamvu zamphamvu za X-ray zochokera kunja kwa thupi kuti aphe maselo a kansa. Pali njira zingapo zomwe zimagwiritsidwa ntchito ndi khansa ya m'mapapo:
- Monga chithandizo chamankhwala kuchiza khansa iliyonse yotsalira itatha opaleshoni
- Pofuna kuchepetsa kukula kwa chotupa kotero opaleshoni n'zotheka
- Monga mankhwala opatsirana kuti achepetse ululu kapena kutsekeka kwa anthu omwe ali ndi khansa yomwe satha kuchiritsidwa
- Monga mankhwala ochizira: Njira yeniyeni ya mankhwala omwe amatchedwa radiotherapy (stereotactic body radiotherapy) (SBRT) imagwiritsira ntchito miyezo yapamwamba ya dzira yoperekedwa kudera laling'ono m'mapapu. Izi zingagwiritsidwe ntchito ngati njira ina yopaleshoni pamene opaleshoni sizingatheke.
Zotsatira zoyipa za mankhwala opatsirana pogwiritsa ntchito mankhwalawa zimaphatikizapo kufiira ndi kukwiya kwa khungu, kutopa, ndi kutupa kwa mapapo (radiation pneumonitis).
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Mmene Mungalimbanire ndi Matenda Okhudza Khunyu Ku Chemotherapy
Chemotherapy
Chemotherapy ya kansa ya m'mapapo imagwiritsa ntchito mankhwala omwe amachititsa kuti azigawidwa mofulumira maselo monga khansa. Mankhwala a chemotherapy angagwiritsidwe ntchito ngati chithandizo chachikulu cha khansa yapakhungu yamapapu, atatha opaleshoni (adjuvant chemotherapy), kapena asanachitidwe opaleshoni kuti achepetse kukula kwa chifuwa (neoadjuvant therapy.)
Chemotherapy kuphatikizapo kugwiritsa ntchito mankhwala osokoneza bongo amodzi panthaŵi yomweyo-imagwiritsidwa ntchito kwambiri. Mankhwala osiyana amachititsa kuti magawo osiyanasiyana azigawidwa pazipangizo zosiyanasiyana, ndipo kulumikiza njirayi m'njira yowonjezera kumawonjezera mwayi wodwala maselo ambiri a khansa yamapapo ngati n'kotheka. Mankhwala enaake omwe amagwiritsidwa ntchito kwa anthu omwe ali ndi kansa ya m'mapapo ndi awa:
- Platinol (cisplatin)
- Paraplatin (carboplatin)
- Gemzar (gemcitabine)
- Taxotere (docetaxel)
- Taxol (paclitaxel) ndi Abraxane (nab-paclitaxel)
- Alimta (pemetrexed)
- Navelbine (vinorelbine)
Zotsatira zofala za chemotherapy ndi kuphwanya mafupa (kuchepetsa maselo ofiira ofiira, maselo oyera a magazi, ndi mapuloletsiti), kutaya tsitsi, ndi kutopa. Nsowa ndi kusanza zili ndi zotsatira zoopsa za mankhwala a chemotherapy, koma zikondwerero zoyendetsa zotsatirazi zapita patsogolo kwambiri.
Zotsatira Zothandizira
Zotsatira za mankhwala opatsirana khansa ya m'mapapo ndi mankhwala omwe amayenera kuwononga zizindikiro zina za maselo a khansa ndipo, motero, akhoza kukhala ndi zotsatira zochepa kuposa mankhwala a chibadwa.
Ndikofunikira kwambiri kuti aliyense amene amapezeka kuti ali ndi khansa ya m'mapapo yopanda mapapu, makamaka mapapu adenocarcinoma, ali ndi ma profini (genetic profiling) a chotupa chawo. Mungamve dokotala wanu akulankhula za "zowonongeka" kusintha kwa majini ndi kusintha kwa majini. Izi zikutanthauza kuti maselo ena a khansa yamapapo ali ndi kusintha kwa majini omwe angathe kuwalingalira (ndi kuwachitira) ndi mankhwala ena omwe amatha kusintha izi.
Kuchiza kwavomerezedwa kwa iwo omwe ali ndi kusintha kwa EGR, ALK rearrangements , ROS1 rearrangements , ndipo palinso mayesero a zachipatala pophunzira mankhwala a kusintha kwa zina ndi kusintha kwa majini ku maselo a kansa. Mbali iyi ya sayansi ikusintha mofulumira kwambiri, ndipo mwinamwake zolinga zatsopano ndi mankhwala atsopano zidzapitiriza kupezeka.
Ngakhale mankhwala ochiritsidwa angakhale othandiza kwambiri, kukana mankhwalawa nthawi zambiri kumakula pakapita nthawi. Komabe, mankhwala osokoneza bongo achiwiri ndi atatu akupezeka tsopano ndikuphunziridwa ngati izi zikuchitika. Mankhwala ena omwe amavomereza khansara yamapapo ndi awa:
- ALK inhibitors - Xalkori (crizotinib), Zykadia (ceritinib), ndi Alecensa (alectinib)
- Angiogenesis inhibitors - Avastin (bevacizumab) ndi Cyramza (ramucirumab)
- EFGR inhibitors - Tarceva (erlotinib), Gilotrif (afatinib), Iressa (gefitinib), Tagrisso (osimertinib), ndi Portrazza (necitumumab)
Immunotherapy
Njira yatsopano yothandizira khansa ya m'mapapo inayamba kupezeka mu 2015. Mankhwala osokoneza bongo amathandiza kwambiri kuti chitetezo cha thupi lanu chiteteze thupi lanu. Ngakhale kuti timakonda kumva zambiri mu nkhani, kugwiritsidwa ntchito mozizira ndi chifukwa chokhalira okondwera ndi tsogolo la khansara yamapapo ndipo adatchedwa kuti kansera ya 2016 yopititsa patsogolo kansa ya American Society for Clinical Oncology.
Ngakhale mankhwala ochiritsidwa amayamba kukhala ogwira mtima kwambiri kwa anthu osasuta, mavitamini angakhale othandiza kwambiri kwa anthu omwe amasuta komanso omwe ali ndi khansa monga kansa yapakhungu yamapapu. Mankhwala osokoneza bongo omwe amavomereza khansa yamapapo ndi awa:
- Opdivo (nivolumab)
- Keytruda (pembrolizumab)
Njira Zochiritsira Zopangitsira Khansa Zina
Ngakhale mankhwala ena opatsirana khansa ya m'mapapo sapezeka kuti ndi opindulitsa pa matenda a kansa ya m'mapapo, palinso mankhwala ena othandizira khansa omwe angathandize anthu kuthana ndi zizindikiro za khansa ndi mankhwala a kansa. Zina mwa zinthuzi ndi kuphatikizapo mankhwala, kupaka misala, ndi kusinkhasinkha.
Mayendedwe a khansa ya m'mimba
Nyuzipepala ya National Cancer Institute imalimbikitsa kuti aliyense amene ali ndi kansa ya m'mapapo ayang'ane mayesero a chipatala, ndipo izi ndi zofunika kwambiri kuposa kale lonse. Chithandizo chilichonse chomwe timakhala nacho kwa khansara yamapapo chinaphunzitsidwa kale ngati gawo la mayesero a chipatala musanavomerezedwe. Pofuna kutsindika kufunika kwa mayeserowa, zingathandize kutchula kuti pakati pa 2011 ndi 2015, mankhwala atsopano adavomerezedwa ndi khansara yamapapo kusiyana ndi zaka khumi ndi zinayi izi zisanachitike.
Lankhulani ndi dokotala wanu za mayesero a kachipatala ndikusankha ngati ichi ndi chinachake chomwe mukufuna kuti mufufuze. Mabungwe angapo a khansa ya m'mapapo aika palimodzi ntchito yofanana ya kansa ya mapiritsi ya mapiritsi a mapapu omwe amatha kuwathandiza kuti agwirizane ndi zotsatira za khansara yanu ndi mayesero am'chipatala akuyenda paliponse padziko lapansi.
Kusankha Njira Yabwino Yothetsera Khansa Yamtundu Wanu Kwa Inu
Monga tafotokozera pamwambapa, pakhoza kukhala njira zosiyanasiyana zochizira khansa ya m'mapapo. Ngakhale izi zingawoneke zovuta, pali zinthu zingapo zimene mungachite kuti kupanga zofuna kupanga zosavuta kukhale kosavuta.
Ngati mwangophunzira kumene kuti muli ndi khansara yamapapu, tengani kamphindi kuti muyang'ane njira zoyamba zomwe mungatenge pamene mwatulukira kumene . Kafukufuku akusonyeza kuti kuphunzira zambiri momwe mungathere ndi khansa kumathandiza kuchepetsa nkhawa komanso zotsatira zake. Phunzirani momwe mungafufuzire khansa yanu ndikupeza zambiri zowona. Inu mukhoza kuyamba pomwe pano.
Chimodzi mwa zinthu zabwino zomwe mungachite kuti mupeze chithandizo chabwino ndicho kupeza malo opatsirana khansa omwe mumadalira. Onaninso malangizo awa posankha chithandizo cha khansa ya m'mapapo komanso kufunika kokhala ndi lingaliro lachiwiri ndi khansara yamapapo . Tengani nthawi yolankhula ndi achibale anu ndi abwenzi anu. Mwinanso mutha kufunsa wanu oncologist komwe angafune chithandizo ngati atapezeka kuti ali ndi khansara yamapapo.
Sizingaganizidwe mokwanira kuti ichi ndi chisankho chanu. Tonsefe tili ndi malingaliro osiyana pa momwe tingathetsere matenda a kansalu kwa ife tokha, ndipo maganizo amatha kukhala amphamvu pa nthawi ino. Landirani zopereka kuchokera kwa okondedwa anu, koma onetsetsani kuti mupange chisankho chozikidwa pa zomwe mumakhala bwino ndi zomwe mumamva kuti ndi zabwino kwa inu nokha.
Mawu Ochokera
Chinthu chofunika kwambiri chomwe mungachite ngati mukuganiza kuti mankhwala akuchiritsidwa ndikuti mukhale wothandizira pa chisamaliro chanu cha khansa . Ngakhale mutakhala "butterfly" kapena "internet geek," kugwirizana ndi magulu othandizira khansa ya m'mapapo ndi mapepala a khansa yamapapo ndi ofunika kwambiri. Osati njira zokhazo zopezera chithandizo kuchokera kwa ena omwe "akhalapo" ndipo amatha kumvetsa, koma maguluwa angakuthandizeni kuphunzira ndi kumvetsa zomwe zakhala zikuchitika mu khansa ya m'mapapo. Thehtagag kukuthandizani kupeza malowa ndi #LCSM, yomwe imayimira khansara yamapapu mudziko lachikhalidwe.
Musalole kuti manyazi a khansara yamapapo kapena mafunso omwe mungalandire za fodya wanu akuwonetsani inu. Aliyense yemwe ali ndi mapapo akhoza kutenga khansa ya m'mapapo. Musalole kuti lingaliro lakuti khansara yamapapo ikhale yosasokonezeka mwina. Muyenera kukumbutsani anzanu kuti zomwe adakumana nazo ndi achibale zaka khumi zapitazo ndi zosiyana kwambiri ndi momwe khansa ya m'mapapo imathandizira lero. Ndipo ngakhale mutakhala ndi machungwa ang'onoang'ono a khansa yamapapu ochepa kuposa khansa ya kansa ya m'mawere, musanyengedwe. Chimene chiwombankhanga cha m'mapapo sichikupezeka mu chiwerengero chomwe chimapanga mozama. Pewani kwa anthu ambiri amene adzakupatseni msana pamene mukukumana ndi matendawa.
Zotsatira:
Masters, G. Immunotherapy mu Chithandizo cha khansa ya m'magazi: Makhalidwe Amakono ndi Matsogolomu. American Society of Clinical Oncology: ASCO News . https://am.asco.org/immunotherapy-lung-cancer-treatment-current-status-and-future-directions
National Cancer Institute. Mankhwala Osakaniza Amtundu Wambiri Wopanda Khansa (PDQ) - Health Professional Version. http://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq
National Cancer Institute. Mankhwala Ochepetsa Kachilombo ka Cell Cell (PDQ) - Health Professional Version. Kusinthidwa 07/07/16. http://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq
Pass, J., Carbone, D., Johnson, D. et al. Makhalidwe Abwino a Khansa ya M'magazi . 4th Edition. Williams ndi Wilkins: 2010.
Rocco, G., Morabito, A. Leone, A., Muto, P., Fiore, F., ndi A. Budillon. Kusamalira Kachilombo Kakang'ono Kamene Kameneka Kameneka Kameneka M'masiku Omwe Amasankhidwa Mankhwala. International Journal ya Biochemistry ndi Cell Biology . 2016. 78: 173-179.