Kumvetsetsa Matenda Anu Ambiri Ndi Matenda a Hodgkin
Ngati inu kapena wokondedwa wanu mukukhala ndi Hodgkin lymphoma , mwinamwake mumadabwa ndi momwe mitengoyo ikukhalira. Hodgkin lymphoma nthawi zambiri imakhudza achinyamata nthawi zina zomwe zimapindulitsa kwambiri pamoyo wawo. Pakati pa ntchito za juggling komanso monga makolo a ana ang'onoang'ono, anthu ambiri omwe ali ndi matendawa amakhala ndi mafunso okhudza moyo wa "kuyembekezera".
Mwamwayi, matenda a Hodgkin (dzina lokalamba la khansara iyi) ndi limodzi mwa mitundu yambiri yopulumutsidwa ya khansara.
Panthawi imodzimodzi yomwe mwinamwake mukulimbikitsidwa ndi makutu opulumuka ndi Hodgkin lymphoma, n'zosavuta kukhala osakayikira pakumva koma mutu wina womwe umalengeza za "kupita patsogolo" kuchipatala. Uthenga wabwino ndi wakuti-ponena za Hodgkin mwinamwake-izi sizingokhala zachibodza kapena chiyembekezo chonyenga. Tidzakambirana za momwe nthawi ya moyo yakhalira bwino pakapita nthawi, ndipo ndi mankhwala ati omwe apanga kusiyana.
Zina mwa chisokonezo pokambirana za kupulumuka ndi khansa zokhudzana ndi magazi monga Hodgkin lymphoma zimachokera ku zomwe anthu amadziwa za khansa zina, monga khansa ya m'mawere. Kaŵirikaŵiri anthu amadziŵa momwe khansa ya m'mawere ingabwerere zaka zambiri kapena ngakhale patatha zaka makumi ambiri atachiritsidwa. Ndi Hodgkin lymphoma, zambiri zimabwereranso kumayambiriro, ndipo izi zimangobwereza mochedwa. Mwa kuyankhula kwina, awo amene apulumuka zaka zisanu ndi Hodgkin lymphoma amakhala otha msinkhu kupulumuka kusiyana ndi anthu omwe ali ndi ziwalo zolimba kwambiri.
Tiyeni tikambirane za ziwerengero zomwe zikuchitika panthawiyi ndi Hodgkin lymphoma, zomwe zingakhudze moyo wa msinkhu ndi zaka zodziwika, komanso zomwe mungachite kuti mutha kusintha.
Hodgkin Lymphoma: Kubwereza Kwachidule
Hodgkin lymphoma ndi khansa ya mitsempha yoteteza thupi , yomwe ili mbali ya chitetezo cha mthupi .
Nthawi zambiri amapezeka achinyamata omwe ali ndi zibwenzi ziwiri; mmodzi pakati pa zaka 15 ndi 35 ndi wina mwa anthu opitirira zaka 55. Matenda a Hodgkin amayamba ndi kukulitsa zopweteka kwa ma lymph nodes kulikonse m'thupi, koma nthawi zambiri m'khosi. Pali mitundu isanu yosiyana ya Hodgkin lymphoma yomwe imasiyana mosiyanasiyana, gawo la thupi limene limakhudza, ndi momwe amachitira ndi mankhwala.
Zochitika Zakale Ponena za Matenda a Hodgkin Lymphoma
Hodgkin lymphoma ndi imodzi mwa khansa yowopsa kwambiri, koma izi sizinali choncho nthawi zonse. Choyamba anazindikira m'zaka za zana la 19, kufotokozera mpaka pakati pa zaka zapitazi kunali kosauka, ndipo zaka zisanu zapakati pazikhala zosokoneza 10 peresenti.
Pofika poizoni, komanso mankhwala okhudzana ndi mankhwala m'zaka za m'ma 1960, kufotokozera kwa matendawa kunakula kwambiri, ndipo pafupifupi usiku umodzi mwa anthu omwe anapeza kuti anali opulumuka.
Komabe kusintha kwa mankhwala kumapitirira. Kuchokera ku deta yomwe inatulutsidwa ndi National Cancer Institute mu April 2017, zaka zisanu zapakati pa Hodgkin lymphoma (magawo onse pamodzi) zinali 69.9 peresenti mu 1975 ndipo 85.4 peresenti mu 2009. Zambiri zawonjezeka chifukwa cha kupita patsogolo kwa chemotherapy ( monga ABVD chemotherapy , ndi BEACOPP chemotherapy regimen ), mankhwala opatsirana pogwiritsa ntchito mankhwala, komanso mankhwala opangira maselo .
Kupulumuka kumawongolera, ndipo ngakhale mitengo ili yochepa kwambiri kwa iwo omwe amapezeka kuti akalamba kapena omwe ali ndi miyeso yochuluka kwambiri, izi zikukonzanso tsopano. Kugwiritsiridwa ntchito kwa mankhwala a high-dose salvage ndi mankhwala opangidwa ndi maselo osungunuka kwa omwe akuyambiranso kubwezeretsanso kwapulumuka. Kugwiritsidwa ntchito kwa mankhwala opatsirana ndi ma antilodies monoclonal , immunotherapy ndi checkpoint inhibitors , ndi kusintha kosagwiritsidwa ntchito kosagwiritsidwa ntchito kwa mankhwala osapatsirana kumapereka njira zowonjezera zowonjezera zomwe zikuyembekezeka kupititsa patsogolo anthu omwe ali ndi zovuta kwambiri zochizira maimfafe a Hodgkin.
Kasamalidwe kabwino ka mavuto, monga matenda okhudzana ndi chemotherapy-omwe amachititsa neutropenia (kuchepa kwa maselo oyera a magazi), apanganso kusintha.
Kupulumuka sizowonjezera phindu la mankhwala abwino. Chithandizo chochepa cha mankhwala oopsa cha mankhwala ndi mankhwala ochepa omwe amachepetsa ma ARV amachepetsa zotsatirapo za mankhwala ndipo, zikuyembekezeredwa, zotsatira zoopsa za matendawa.
Kupulumuka Ndi Khansa Yogwirizana ndi Magazi ndi Mitsempha Yamphamvu
Kwa omwe amadziwika bwino ndi khansa monga khansa ya m'mawere, ndizothandiza kutenga kamphindi ndikuyankhula momwe masitepe apamwamba (gawo lachitatu III kapena gawo la IV) la matenda a Hodgkin (ndi khansa zina zokhudzana ndi magazi) zimasiyana mosiyana ndi miyendo yambiri ya zilonda zolimba (monga khansa ya m'mawere kapena khansara ya pancreatic).
Matenda a khansa yowonjezera, monga matenda a Hodgkin IV, nthawi zambiri amachiritsidwa. Mosiyana ndi zimenezi, ziphuphu zambiri zapamwamba kwambiri (monga sewero la m'mawere khansa kapena sewero la kanthana la pancreatic IV) sichiritsika. Momwemonso, kufotokoza kwa kachiwiri kwa Hodgkin lymphoma kumakhala bwino kwambiri kuposa kubwereza kwa ziwalo zambiri zolimba.
Kumvetsetsa Zopulumuka Zomwe Mungakwanitse komanso Zomwe Mukuyembekeza Kuyembekezera
Tidzafika ku chiwerengero ndi ziwerengero zomwe zikufotokozera za kupulumuka posachedwa koma tifunikira kufotokozera zomwe ziwerengero izi zikutanthawuza, ndi zina mwa zofooka zomwe zilipo muziwerengerozi.
Kupulumuka kwafupipafupi kumatchulidwa ngati peresenti yotsatiridwa ndi nthawi yambiri. Mwachitsanzo, mukhoza kuona zaka 1, zaka zisanu, kapena zaka 10 zapulumuka. Ngati matendawa ali ndi zaka zisanu zimatanthawuza kuti 50 peresenti ya anthu omwe ali ndi matendawa adzakhala ndi moyo zaka 5 pambuyo poti adziwe kuti ali ndi matenda.
Nthawi zina mumatha kuona mawu oti " kupulumuka kwapakatikati ." Kuchuluka kwa moyo wapakati kumatsatiridwa ndi kuchuluka kwa nthawi ndikuimira nthawi yomwe pambuyo pake 50 peresenti ya anthu idafa ndipo 50 peresenti ya anthu akadali amoyo. Mwachitsanzo, kuchuluka kwa moyo wa miyezi 13 kudzakhala nthawi yomwe pambuyo pake 50 peresenti ya anthu amwalira ndipo 50 peresenti akadali amoyo. Ndi khansa monga matenda a Hodgkin, mudzawona kuchulukitsa kawirikawiri, komabe, khansa monga khansa ya pancreatic kapena khansara yamapapo, kupulumuka kwapakati kumagwiritsidwa ntchito nthawi zambiri.
Poyang'ana mitengoyi, mfundo yofunika kwambiri ndi yakuti iwo ndi "malire" ndi "manambala". Anthu enieni sali owerengeka. Ziwerengerozi zikufotokozera momwe munthu alili ndi gawo lililonse la matenda a Hodgkin ndi zifukwa zina zomwe ayenera kuyembekezera kukhala nazo. Komabe, ngakhale pokhapokha ngati ndalama zowonongeka zimatha chifukwa cha msinkhu komanso msinkhu, sikutheka kufotokozera momwe munthu angapangidwire ndi matendawa. Anthu ena amachita bwino kuposa "owerengeka" ndipo anthu ena samatero.
Zolephera Zopulumuka
Monga tafotokozera pamwambapa, chimodzi mwa zoperewera zazikulu za kupulumuka ndikuti amapereka chiŵerengero cha kupulumuka, koma palibe aliyense. Kuonjezera apo, ndalama zowonjezera zingathe kusocheretsa pa zifukwa zina.
Kuyang'ana pa zaka 5 zapulumuka zimatanthauza kuti tikuyang'ana anthu omwe anapezekapo zaka zisanu zapitazo. Panthawi imeneyo, nthawi zambiri mankhwala atsopano akhala akupangidwa. Zomwe zili bwino, kupulumuka kungakuuzeni momwe munthu wamba amachitira m'mbuyomu atalandira chithandizo chamankhwala chomwe chingagwiritsidwe kapena chosagwiritsidwa ntchito masiku ano. Chifukwa cha kupita patsogolo kwa chithandizo cha khansa, chiwerengero cha kupulumuka chimakhala chochepa kwambiri monga kuyerekezera kale. Ngakhale izi zikhoza kulosera zovuta kwambiri, zimatiuza kuti kupita patsogolo kuli kupangidwa.
Kupulumuka kwa nthawi yayitali kuli kovuta kulosera. Kafukufuku wambiri amasiyanitsa imfa chifukwa cha matenda a Hodgkin ndi imfa chifukwa cha zifukwa zina, komabe izi sizimaganizira nthawi zonse zachipatala zomwe sizikugwirizana koma chifukwa cha chithandizo chamankhwala, monga khansa yachiwiri.
Mipingo Yopulumuka Yonse ndi Mpulumutsi Wosatha
Pali njira zambiri zowonera ndalama zomwe zimakhalapo ndi Hodgkin lymphoma. Tiyeni tiwone izi m'njira zingapo.
Mavuto ochuluka omwe amapereka moyo wosatha kwa anthu omwe ali ndi magawo onse kuphatikizapo:
- Kuchuluka kwa zaka 1 peresenti ya 92 peresenti
- Zaka zisanu ndi zisanu ndi zisanu (87%) zimakhala ndi moyo kwa zaka zisanu
- Zaka 80 zapakati pa moyo wazaka khumi
Zaka 5 zomwe zimakhalapo patsiku ndi izi:
- Gawo I zaka zisanu ndikusunga ndi 90 peresenti
- Gawo lachiwiri lazaka 5 zomwe zikupulumuka ndi 90 peresenti
- Ndondomeko yachitatu ya zaka zisanu ndi zisanu ndi zisanu ndi zitatu
- Gawo la IV zaka zisanu zapakati pa moyo ndi 65 peresenti
Ndikofunika kudziwa kuti mitengoyi ndiyeso ya anthu onse omwe ali ndi gawo lina la matenda a Hodgkin mosasamala kanthu za msinkhu wao ndipo mosasamala kanthu za zina zomwe zingawonjezere kapena kuchepetsa mwayi wopulumuka.
Kukhalitsa Kwanthaŵi Yaitali ndi Hodgkin Lymphoma
Kukhalitsa kwa nthawi yayitali ndi Hodgkin lymphoma n'kovuta kulingalira, chifukwa cha zinthu monga khansa yachiwiri zomwe zingachitike patapita zaka zambiri chithandizo. Izi zinati, kafukufuku wosiyana amalingalira kuti pakati pa zaka 15 ndi 30 kuchokera kuchipatala, anthu omwe ali ndi Hodgkin lymphoma amatha kufa chifukwa chosagwirizana ndi Hodgkin lymphoma kusiyana ndi Hodgkin. Mwa kuyankhula kwina, patapita nthawiyi anthu akhoza kufa chifukwa chomwe anthu ambiri amafa.
Zomwe Zimakhudza Kuteteza Ndi Matenda a Hodgkin
Pali mitundu yambiri yomwe ikukhudzana ndi kuwonjezeka kapena kuchepa kwa mwayi wopulumuka matenda a Hodgkin. Ena mwa awa ndi awa:
- Gawo la matenda - Gawo lachiwiri I kapena II limapereka chithunzithunzi chabwino kuposa gawo la III kapena gawo la IV.
- Zaka - Achinyamata amakonda kuchita bwino kusiyana ndi omwe ali achikulire (oposa zaka 45).
- Kugonana - Akazi amakonda kukhala ndi moyo wapamwamba kusiyana ndi amuna.
- Kukhalapo kwa zizindikiro B - Kutaya thupi, kutuluka kwa usiku, ndi malungo, zomwe zimatchedwa B zizindikiro za lymphoma , zimakhala ndi vuto losauka kwambiri (komabe, anthu ambiri angathe kupulumuka kwa nthawi yayitali).
- Kaya kubwezeretsedwa kumachitika ndi liti - Kwa omwe adabwereranso chaka choyamba akutsata chithandizo, zizindikirozo ndizosauka.
- Yankho lachidziwitso - Anthu omwe amatsatira mankhwala oyamba omwe ali ndi mankhwalawa amakhala ndi chithunzithunzi chabwino kuposa omwe sali.
- Albumin level - A low album albumin level (zosakwana 4 g / dL) imagwirizanitsidwa ndi zizindikiro zosauka.
- Kuwerengera kwa maselo oyera a magazi (WBC) - Kuwerengera kwa maselo oyera (magazi oposa 15,000 pa mm3) kumakhudzana ndi kufotokoza kosauka.
- Low absolute lymphocyte count (ALC) - Mtheradi wamtheradi wa maselo osachepera 600 pa mm3 umagwirizanitsidwa ndi zizindikiro zosauka.
- Matenda ochepa omwe ali ndi vutoli amawoneka bwino.
- Matenda a m'magazi - A hemoglobin otsika (osachepera 10.5 g / dL) amagwirizanitsa ndi matenda osauka kwambiri kuposa omwe ali ndi hemoglobin yapamwamba.
- Zomwe sizingatheke - Mliri wamakono wa ESery) (ESR) woposa 30 umagwirizanitsidwa ndi chiwerengero chosauka.
- Mtundu wa Hodgkin lymphoma - Mitundu ina ya mafupa a Hodgkin imakhala ndi moyo wabwino kwambiri kuposa ena ( nodular lymphocyte mitundu yambiri ndi yotchedwa nodular sclerosing mitundu).
- Umoyo wathanzi pa nthawi ya matenda ndi matenda ena
- Kaya khansara ndi yowonjezereka kapena ikupita patsogolo
- Inshuwalansi ya umoyo - Anthu omwe alibe inshuwaransi ya umoyo ali ndi vuto losauka.
Kubwereranso ndi Zopulumuka
Monga tanenera pamwambapa, nthawi ndi nthawi zambiri zobwereza zimasiyana kwambiri ndi Hodgkin lymphoma kusiyana ndi khansa ya m'mawere. Ndi Hodgkin lymphoma, zoposa theka la recurrences zimachitika mkati mwa zaka ziwiri za mankhwala oyamba ndipo 90 peresenti zimachitika pasanafike zaka zisanu. Zomwe zimachitika pakapita zaka 10 ndizochepa ndipo patapita zaka 15 chiopsezo chokhala ndi lymphoma chifanana ndi chiopsezo cha anthu omwe amakhalapo. Kwa omwe amvapo za khansa ya m'mawere akubwereranso pambuyo pa zaka zambiri, zingakhale zitsimikizo kuti izi si zachilendo ndi matenda a Hodgkin. Ndifunikanso kuzindikira kuti ngakhale anthu ambiri omwe ali ndi matenda a Hodgkin adzakhala ndi moyo wautali.
Kuyeza Matenda Anu
Kwa iwo omwe akufuna kukhala ndi lingaliro labwino ponena za malingaliro awo, akuti pali chida chomwe chimatchedwa chida cha Hasenclever chogwiritsira ntchito chomwe chimagwiritsidwa ntchito kulingalira chiwonongeko chotsatira zochitika zisanu ndi ziwiri zosiyana kapena zoopsa. Zinthu zisanu ndi ziwirizi zimaganiziridwa kuti zichepetse zaka zisanu ndi zisanu ndi zitatu. Izi zimaphatikizapo serum albumin zosachepera 40 g / dL, hemoglobin zosakwana 10.5 g / dL, chiwerewere chamwamuna, sewero la IV, maselo oyera a magazi opitirira 15,000 / mL, ndipo ma lymphocyte amachepera 600 / mL.
Kwa anthu omwe alibe zifukwazi, zaka zisanu ndi zisanu (89%) zimawerengedwa, ndipo kwa iwo omwe ali ndi zifukwa zisanu kapena zingapo zoopsa, zaka zisanu zomwe zimakhalapo ndi 56 peresenti.
Kumbukirani kuti zipangizozi zimagwiritsidwanso ntchito kuti aganizire "pafupifupi" kufotokozera, ndipo palibe wowerengeka. Ndikofunika kudziwa kuti ngakhale mutakhala ndi zifukwa zisanu kapena zingapo zoopsa, ambiri mwa anthu 50 peresenti-akadali ndi moyo zaka zisanu pambuyo poti akudziwunikira.
Kodi Mungatani Kuti Mukhale ndi Matenda Aakulu?
Ndi zokambirana zonse zokhudzana ndi chithandizo, zimakhala zosavuta kuiwala kuti pali zinthu zosavuta zomwe mungadzipangire nokha kuti musinthe. Ndikofunikira kuti:
- Idyani wathanzi: Chimene mumaika m'thupi lanu chingasinthe m'mene mumalekerera chithandizo ndi momwe mumamvera pambuyo pa chithandizo. Ngati muli ndi zovuta zilizonse, funsani a oncologist kuti akukhazikitseni ndi odyetsa zakudya zamagetsi.
- Kuchita masewera olimbitsa thupi: Tsopano tili ndi maphunziro ochulukirapo omwe tawona zotsatira za kuchita masewero olimbitsa thupi pa zotsatira za khansa zambiri, kuphatikizapo Hodgkin lymphoma. Ngakhale zochepa zolimbitsa thupi zothandiza. Kumbukirani kuti ndi bwino kuchita masewera olimbitsa thupi kusiyana ndi kuchita masewera kawirikawiri.
- Kugona bwino: Sitikudziwa za zotsatira za matenda okhudzana ndi matenda a Hodgkin, koma tikudziwa kuti khansa ya m'mawere izi zikhoza kuchepetsa kupulumuka. Lankhulani ndi oncologist wanu ngati muli ndi zotsatira zodziwika kwambiri za mankhwala.
- Pangani ndondomeko yosamalira anthu odwala matenda a khansa: Mukamaliza mankhwala, onetsetsani kuti inu ndi adokotala mudzaze dongosolo la chisamaliro cha opulumuka. Ngozi ya khansa yachiwiri ndi yeniyeni pambuyo pa chithandizo cha Hodgkin, ndipo ingakhale ikuwonjezeka. Dokotala wanu angakulimbikitseni poyamba kapena kufufuza mobwerezabwereza kwa khansa monga khansa ya m'mawere ndi kutsata zizindikiro za khansa zina zikayenera kuchitika.
Hodgkin Lymphoma: Kaŵirikaŵiri Yachiritsidwa, Komabe Matenda Ovuta
Zingamveke zachilendo kwa munthu yemwe sanakumanepo ndi khansara, koma pali mpikisano pakati pa anthu omwe ali ndi mitundu yosiyana ya khansa, kapena pakati pa iwo omwe ali ndi chiwerengero chokwanira chokhala ndi khansa komanso kuchepa kwa khansa. Anthu omwe ali ndi khansa omwe ali ndi kachilombo kochepa angayang'ane khansa yowonjezereka ngati yovuta.
Kumbukirani kuti ngakhale kuti Hodgkin lymphoma imachiritsidwa kuposa ena ambiri khansa, kuyang'anizana ndi khansa iliyonse ndi yochititsa mantha. Kufa kwanu kumaponyedwa pamaso panu ndi ena omwe alibe khansara sangamvetse ndipo ziribe kanthu kuti khansara ili ndi 99 peresenti ya moyo kapena 2 peresenti ya moyo. Tiyeneranso kuzindikira kuti, ngakhale kuchiritsidwa, mankhwala oletsa Hodgkin lymphoma ndi ovuta kwambiri. Chemotherapy ikhoza kukhala motalika kwambiri, makamaka makamaka ndi masentimita osakanikirana a maselo, mochulukirapo, kusiyana ndi ena ambiri khansa. Palinso vuto la zotsatira za nthawi yaitali za Hodgkin lymphoma, monga khansa yachiwiri, yomwe idzafunikanso kuyang'anitsitsa moyo wanu wonse.
Monga chitsimikizo chomaliza, ngati inu kapena wokondedwa wanu mwadutsa kuchipatala cha matenda a Hodgkin, ndikofunikira kuti muyankhule ndi dokotala wanu za kupulumuka. Ambiri a kliniki a khansa tsopano ali ndi mapulogalamu othandizira kukonzanso khansa komwe zotsatira za matenda a khansa , zomwe zimachitika chifukwa cha ululu wopita ku nkhawa, zikufotokozedwa bwino.
> Zotsatira:
> Ahmadzadeh, A., Yekaninejad, M., Jalili, M. et al. Kuwona Zopulumuka ndi Zachirombo Zachiwiri mutatha Kudwala Odwala Hodgkin Lymphoma ndi Chemotherapy Regimens. Magazini ya International Journal ya Hematology Oncology ndi Kafukufuku Wachidule wa Cell . 2014. 8 (2): 21-26.
> American Cancer Society. Khansa Zoona ndi Ziwerengero 2017. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html
> Brenner, H., Gondos, A., ndi D. Pulte. Kupulumuka Chiyembekezo cha Odwala Odziwika ndi Hodgkin Lymphoma mu 2006-2010. Oncologist . 2009. 14 (8): 806-813.
> National Cancer Institute. Kuyang'anitsitsa, Epidemiology, ndi Mapeto a Mapulogalamu. SEER ZOCHITA ZOCHITA ZOCHITA (CSR) 1975-2014. Inatulutsidwa pa April 14, 2017. https://seer.cancer.gov/csr/1975_2014/