Pamene mukudutsa khansa ya m'mawere, dokotala wanu adzalangiza mayeso ambiri kuti awone ngati khansara yako yayenda kapena ngati ikuyankha mankhwala. Ndi mayesero ati omwe amachitidwa, ndipo mungatani kuti muthane ndi mayesero a nkhawa ?
Zina mwazofukufukuzi ndi mayeso ogwiritsira ntchito ma labata zimagwiritsidwa ntchito pokhapokha ngati wina atapezeka kuti ali ndi khansa ya m'mawere, pomwe ena angakhale atsopano kwa inu monga momwe amagwiritsira ntchito poyang'anira matenda a kansa ya m'mawere.
Momwe Maselo Angasinthire
Nthawi zambiri timaganiza za khansa yosasinthika, monga maselo omwe ali pachifuwa chathu osasintha kwambiri nthawi. Komabe khansa nthawi zonse imasintha. Ndi kusintha kwa matendawa, makamaka, omwe amachititsa kutsutsa komwe timawawona kuchipatala monga mankhwala ochizira , mankhwala ochiritsira, ndi chemotherapy pa nthawi.
Maselo a maselo a chotupa angasinthe, komanso momwe zimakhalira ndi maselo otupa. Khansa imakhala ikuyendetsa malo awo, nthawi zambiri amapanga mapuloteni atsopano kuti ateteze ma chitetezo a mthupi lathu ndi kusintha maonekedwe awo kuti athandize kupulumuka kwawo.
Chotupacho chiyenera kuti chinali estrogen chodziwika pamene iwe unayamba kupezedwa, koma icho chingakhale chosowa cha estrogen pamene icho chikupezeka mu mapapo ako. Chotupacho chingakhale CHACHIWIRI 2 pamene choyamba chikupezeka, koma kenako CHINENERO chachiwiri. Kusintha kumeneku ndi kofala, ndipo mpaka asanu mwa magawo asanu a HER 2 okhala ndi zotupa zowonongeka zimakhala zovuta zowonjezera.
Kuwonjezera pa kusintha kwa zotupa ndi lingaliro la chiphuphu chokhachokha. M'malo mokhala maselo onse ofanana, ziwalo zosiyana za chotupa zingakhale ndi makhalidwe osiyana kusiyana ndi ena, malingana ndi kusintha kumeneku. Nthawi zina gawo limodzi la chotupa pamwamba-limalongosola HER 2, pamene gawo lina la chotupa, kapena metastasis pamalo osiyana, sali.
Izi ndizofotokozera mosavuta zomwe zimachitika, koma zingakuthandizeni kufotokoza momwe khansa iliyonse ya m'mawere ilili yapadera.
Zizindikiro
Chimodzi mwa mayesero oyamba oyambirira ndi chithunzithunzi cha khansa yanu. Chifukwa chimodzi chomwe dokotala akufuna kuti adziwe chifuwa chanu ndichoonetsetsa kuti ndi khansa ya m'mawere m'malo mwa chotupa chosagwirizana. Komabe, chifukwa chofunikira kwambiri chokhazikika, kapena "kubwereza kachiwiri," ndiko kudziwa mmene kansa yanu ingasinthire kuyambira pamene munayamba mutapezeka.
Zojambula Zoganizira
Chithunzicho chikuyesa dokotala wanu akuvomereza kuti chidzadalira zinthu zambiri kuchokera kumalo a zotupa zanu ku mankhwala omwe amagwiritsidwa ntchito. Mayesero ofanana (monga momwe tafotokozera kale) ndi awa:
- Zithunzi za malo omwe mukuganiza kuti muli ndi metastases
- Kugwiritsira ntchito fupa : Kugwiritsira ntchito fupa kumaphatikizapo kuyiritsa mafilimu, omwe amafufuzidwa ndi mafano. Mafupa a mafupa angakhale othandiza pofufuza mafupa a mitsempha.
- PET imawunika : Kuyezetsa PET ndi mayeso ofunikira kuti mudziwe kuchuluka kwake ndi malo omwe mumakhala thupi lanu. Mosiyana ndi CT scans ndi MRI scans zomwe zimawoneka makamaka pa zigawo, PET kujambulidwa amayang'ana ntchito ya maselo m'thupi lanu. Shuga yowonjezera mavitamini imayikidwa mumagazi anu ndipo imatengedwa ndi ziphuphu zomwe zikukula monga khansa. Kafukufuku woganiza amatha kulola ma radiologist kuti aganizire ndi kupeza malo awa m'thupi. Kuphatikiza pa kuthandizira kuyeza kuchuluka kwa khansa yanu, PET kufufuza ndiwothandiza kusiyanitsa madera monga zilonda zam'mimba ndi fibrosis kuchokera ku zotupa zomwe zikukula.
- CT ikuyang'ana : Ikani kanema kuti muyang'ane pamimba, pamphuno mwanu, pachifuwa chanu, kapena mutu wanu
- MRIs: MRIs angakhoze kuchitidwa kuti ayang'ane molondola pa zovuta zilizonse mu ubongo wanu kapena zigawo zina za thupi lanu.
Ndizothandiza kugawana zinthu zochepa zokhudzana ndi zojambula zojambula ndi zolephera zawo pa khansa yotsatira yomwe yasokoneza ena ndi kansa ya m'mawere:
- Zosintha zowonongeka zikhoza kuchedwa - Ngati mutangomaliza mankhwala monga chemotherapy , mukhoza kukhumudwa ngati kanthani kansa yanu sikasinthidwe kukula. Ndizothandiza kumvetsetsa kuti kusintha pa mayesero a kujambula kungatenge nthawi yosonyeza. Mwachitsanzo, kuchepa kwa kukula kwa chotupa chifukwa cha mankhwala sikungasonyeze poyeso mpaka masabata angapo kapena miyezi mutatha mankhwala.
- Zithunzi sizingwiro - Zilibe kanthu mtundu wanji wa scan, muli ndi mwayi "udzapeza" chinachake chomwe sichikanakhala chovuta. Mukakhala ndi mayesero owonjezereka, nthawi zambiri izi ziyenera kuchitika. Chitsanzo chimaphatikizapo mitsempha yambiri ya chiwindi yomwe imapezeka pamimba ya CT yomwe imakhala yovuta kusiyanitsa ndi khansa.
- Kufufuza zina osati za PET sizingakuuzeni ngati "malo" akukula " Zingakhale zovuta pachiyeso monga CT kuthandizira ngati" malo "akuimira khansara yomwe ikukula, kapena minofu yochepa chabe yatsala pambuyo pa malo a khansa yaperekedwa. Kufufuza kwa PET kungathandize kusiyanitsa khansa yowonjezereka kuchokera ku njira zowonongeka, koma ingakhalenso ndi "zabwino zabodza" - malo okhudzidwa omwe sakhala kanthu.
- Kusintha pang'ono pa kukula kwa chotupa kungakhale kopanda phindu - Anthu ena amadwala ngati chotupa chikuwoneka ngati centimita chachikulu pa sewero kusiyana ndi momwe zinalili kale. Ngati mukukumana ndi chinthu chonga ichi, funsani katswiri wanu wa zokhudzana ndi zovuta za mtundu womwe mumakhala nawo. Nthawi zina, chotupa chomwe "chingayambe" kukhala chachikulu kapena chaching'ono, chikhoza kukhala chosasintha kukula ngati mutatha kuyeza khansara.
Zojambula Zosamalidwa (Zojambula)
Zolemba zamagazi kapena zinyama zam'madzi ndi mapuloteni omwe amadziwika ndi chotupa kapena thupi poyankha chotupa. Mayeso a magazi kuti muone ngati mapuloteniwa angapangidwe kuti muzitsatira chitukuko chanu ndi khansa ya m'mawere.
Mofanana ndi mayesero ojambula, mayeserowa sali angwiro. Sikuti khansa yonse ya m'mawere imayambitsa kukwera kwamtunduwu, ndipo ikakwera, ikhoza kukhala chifukwa cha matenda ena osati khansa. Kusintha m'magulu a zizindikirozi, monga momwe zimakhalira, zimatha kuchedwa patapita masabata angapo chifuwa chikuwonjezeka kapena kuchepa kukula.
Mayeserowa sagwiritsidwa ntchito pokhapokha kuti ayang'ane kukula kwa khansa ya m'mawere ndipo amathandiza kwambiri pamene magulu amatsatiridwa pa nthawi. Zomwe zimapangitsa kuti dokotala wanu ayerenge ndizo:
- Antigen ya khansa 15-3 (CA 15-3) - CA 15-3 ndi mapuloteni opangidwa ndi khansa ya m'mawere. Zitha kupezeka pakati pa 50 ndi 90 mwa anthu 100 alionse omwe ali ndi kansa ya m'mawere, koma ndi 30 peresenti ya anthu omwe ali ndi khansa ya m'mawere. Maseŵera a chilengedwechi amayamba kukhala okwera kwambiri kwa iwo omwe ali ndi mafupa a chifuwa kapena chiwindi. CA 15-3 akhoza kuyesedwa kuti azindikire momwe kansa yanu ikuyankhira mankhwala, koma kusintha msinkhu sikungakhoze kuchitika kwa masabata angapo (nthawi zambiri pakadala anayi kapena asanu) pambuyo pa chotupa chimayankha mankhwala kapena chikupita patsogolo.
- Kansa antigen ya 27.29 (CA 27.29 ) - CA 27.29 ndi mapuloteni (a monoclonal antibody) omwe amapangidwa ndi jini lotchedwa MUC-1. Mapuloteniwa amapezeka pamwamba pa maselo a kansa ya m'mawere. Mosiyana ndi zizindikiro zina, CA 27.29 ndi mapuloteni okha omwe amasonyeza kuti kukhalapo kwa maselo a khansa ya m'mawere. Ngakhale mayesowa sakugwiritsidwa ntchito poyang'anira akazi omwe ali ndi khansa ya m'mawere oyambirira, amalingalira kuti kukwera kumachitika patatha miyezi isanu munthu asanamve kuti khansara yayambiranso. Monga momwe zilili ndi CA 15-3, pali zinthu zina osati khansa ya m'mawere yomwe ingayambitse mapuloteni, ndipo mapiri angakhalepo kwa nthawi yochulukirapo (miyezi iwiri kapena itatu) ngakhale khansayo ikaperekedwa bwino. Dokotala wanu akhoza kulamula CA 15-3 kapena CA 27.29, koma osati kaŵirikaŵiri.
- Carcinoembryonic antigen (CEA) - CEA ndi mapuloteni osakanikirana omwe angakhale okwera kwa anthu omwe ali ndi khansara, koma akhoza kukwezedwa chifukwa cha zovuta zina, kuphatikizapo kusuta.
- Kuchulukitsa maselo a zotupa - Kuwunika magazi pofuna kuyendetsa maselo a m'mimba (maselo otupa kapena ziwalo za maselo otupa omwe achoka ku chotupa ndi kulowa m'magazi) ndi njira yatsopano yowunika ndikutsatira khansa ya mthupi. Ngakhale akadali kufufuza, mayesero amodzi ayamba kuvomerezedwa kuti agwiritsidwe ntchito kwa amayi omwe ali ndi khansa ya m'mawere.
Kulimbana ndi Scanxiety
Anthu ambiri amadzimva kuti ali ndi nkhawa kwambiri pamene akudikira zotsatira za mayeso kapena mayeso a labotale, mosasamala kanthu pa nthawi yomwe chithandizochi chinachitidwa. Ndi khansara ya m'mawere, makamaka, pali zotsatira zambiri zoyesera kuyembekezera.
Siinu nokha ngati malingaliro anu akukula ndikukweza zochitika zoopsya za zotsatira zake-ndipo chofunikira kwambiri, zomwe akutanthauza.
Mungathe kuchita zinthu zingapo kuti mupirire "zovuta."
- Funsani za nthawi ya zotsatira zanu ndi m'mene mudzakhalire.
- Khalani osasamala za nthawi yomwe mumasulira. Ngati zilipo kale tsiku lomwe likhoza kuwerengedwa kumapeto kwa tsikulo, ndikupulumutsani usiku wonse. Kumayambiriro kwa sabata kungatanthauze kupulumutsa nkhawa pamapeto a sabata.
- Afunseni wina kuti agwirizane nawe pamene mukupita kukayezetsa, ngati chisokonezo.
- Kuseka. Onetsani kanema wamakono wokondweretsa, kupita kuwonetsero wokondweretsa, kapena yesetsani chirichonse chomwe chingakupangitseni kumwetulira.
Zotsatira:
Graham, L., Shupe, M., Schneble, E. et al. Zomwe Zilipo Pakadali ndi Mavuto Poyang'anira Chithandizo Chakumayankhidwa mu Khansa ya M'bwere. Journal of Cancer . 2014. 5 (1): 58-68.
> DeVita, Vincent., Et al. Khansara: Mfundo ndi Zochita za Oncology. Khansa ya pachifuwa. Wolters Kluwer, 2016.
> Liedtke, C., ndi H. Kolberg. Thandizo labwino la Khansa yapamwamba / Metastatic Breast Breast-Umboni Weniweni ndi Malingaliro Amtsogolo. Care Care . 2016. 11 (4): 275-281.