Mitundu ya Mankhwala Opatsirana Ndi Mavitamini Ndiponso Kugwiritsira Ntchito Khansa Yam'mimba
Mankhwalawa ndi njira zamankhwala zomwe zimagwiritsa ntchito kutulutsa mphamvu zamagetsi kuti ziphe maselo a khansa ndi kuchepetsa zotupa.
Kodi Zimagwira Ntchito Bwanji?
Mazira amphamvu kwambiri amawononga DNA m'maselo, kuwapangitsa kufa kapena kusiya kulekanitsa. Popeza maselo a khansa amagawanika mobwerezabwereza kuposa maselo ozolowereka, amatha kuwonongeka. Maselo a thanzi angathe kuthandizidwa komanso atha kukonza zowonongeka.
Kodi Zimagwiritsidwa Ntchito Liti?
Maselo ang'onoang'ono ndi osakhala ang'onoang'ono ammapiritsi am'kamwa amachizidwa kawirikawiri ndi mankhwalawa, omwe nthawi zambiri amakhala pamodzi ndi chemotherapy , opaleshoni kapena onse awiri. Pafupifupi theka la omwe amapezeka ndi khansa ya m'mapapo yopanda maselo adzalandira chithandizo cha mankhwala nthawi zina pamene akuchiritsidwa. Malingana ndi mtundu ndi siteji ya khansara yanu yamapapu , mankhwalawa akhoza kugwiritsidwa ntchito:
- Pambuyo pa opaleshoni - Kuchiza maselo aliwonse a khansa omwe angakhalebe m'deralo atatha opaleshoni.
- Asanachite opaleshoni - Kuchepetsa kukula kwa chotupa ndi kupanga opaleshoni kwambiri.
- Kuchiza khansa - Ndi zotupa zazing'ono, komanso odwala omwe sangathe kuchitidwa opaleshoni chifukwa cha msinkhu, malo a chotupa kapena mankhwala ena, mankhwalawa akhoza kupereka mpata wochiritsira.
- Kuchiza kansa ya m'mapapo - Zonse zapafupi, monga zam'mimba zapafupi, ndi mbali zina za thupi, monga ubongo.
- Kuchita zizindikiro (mankhwala opatsirana kwambiri) - Pamene chotupa chikuyambitsa zizindikiro monga kupuma pang'ono ndi kupweteka, nthawi zina mankhwalawa amagwiritsidwa ntchito kuchepetsa kukula kwa chotupa kuti achepetse zizindikiro.
- Kuchita khansa ya m'mapapo metastases - SBRT (onani m'munsimu) nthawi zina ingagwiritsidwe ntchito yochizira amodzi kapena ochepa chabe a ubongo kapena metastases ya chiwindi kuchokera ku khansa ya m'mapapo.
- Kupewa - Mu kansa ya m'mapapo ya m'mapapo, mankhwala opatsirana pogwiritsa ntchito mailesi ku ubongo nthawi zina amapatsidwa kuti aphe maselo alionse omwe afalikira ku ubongo koma sakuwoneka ndi ma scans. Izi zimatchedwa Prophylactic Cranial Irradiation (PCI) .
Zapatsidwa Motani?
Mankhwala opatsirana pogwiritsa ntchito khansa ya m'mapapo nthawi zambiri amaperekedwa tsiku lililonse, Lolemba mpaka Lachisanu, kwa milungu isanu ndi umodzi. Musanayambe mankhwala, mudzapatsidwa chimodzi kapena zingapo "zizindikiro," zizindikiro zosatha zokhudzana ndi kukula kwa phokoso loyendetsa chotupa m'mapapo anu. Chimodzimodzi chimagwiritsidwa ntchito. Panthawiyi, mufunika kukhala bodza kwambiri patebulo pomwe ma radiation oncologist akuwunikira komwe angayende poizoni. Dokotala wa radiation amatha kuyeza mlingo wa miyeso (yomwe imayikidwa mu Gy, yotchedwa grays ) yomwe idzaperekedwa pa nthawi ya mankhwala anu.
Mitundu
Mankhwalawa akhoza kuperekedwa kunja kapena mkati kuti athetse khansa yamapapo. Njira zamagwiritsidwe ntchito zikuphatikizapo:
Njira yothandizira kutentha kwa dzuwa - Izi zimagwiritsidwa ntchito kwambiri ndipo zimaphatikizapo kugwiritsa ntchito makina akunja omwe amapereka miyezi yapamwamba. Mitundu yowonjezereka ya mankhwala akunja ndi awa:
- Mankhwala ochiritsira (awiri-dimensional).
- Mankhwala othandizira mazira a 3D - Mankhwalawa amawonjezera mankhwala ochiritsira pogwiritsira ntchito computed tomography (CT) - mankhwala othandizira kuyang'ana chotupacho mu miyeso itatu. Cholinga chake ndi kutsogolera mazira kwambiri makamaka ku chifuwacho ndi kusunga matenda ozungulira.
- Mphamvu Yothandizira Mazira (IMTR) - Mankhwalawa amapereka mlingo wapatali wa ma radiation ochokera kumbali zosiyanasiyana. Kafukufuku akhala akupeza kuti mankhwala oyambirira ndi amphamvu kwambiri othandizidwa ndi ma radiation omwe amaperekedwa kwafupipafupi angapangitse kuti apulumuke apitirizebe kupulumuka, koma amathandizanso kuwonjezeka kwa poizoni, makamaka kutupa kwa dothi (radiation esophagitis.)
Mazira a mkati - Nthawi zina ma radiation amaperekedwa mkati mwa khansa ya m'mapapo. Miyendo yamkati imatchedwanso brachytherapy . Panthawiyi, tizilombo toyambitsa pulasitiki timapangidwe panthawi ya bronchoscopy . Zida zochepa zowonjezera mavitamini zimatha kupyolera mu chubu, kuti mankhwala athe kuperekedwa kumalo enieni.
Chubu imachotsedwa pambuyo pa chithandizo.
Thupi la radiotherapy (stereotactic body radiotherapy) (SBRT) - Thupi la radiotherapy kapena la SBRT la khansa ya m'mapapo ndi njira yomwe misala yapamwamba imaperekedwera kumalo ochepa kwambiri pofuna kuyesa kuchotsa khansa. Mosiyana ndi mitundu ina yothandizira ma radiation, nthawi zina SBRT imagwiritsidwa ntchito ndi cholinga chochepetsera khansa yamapapo. Kwa anthu ena omwe ali ndi khansara yamapapo oyambirira omwe amaonedwa kuti sangathe kugwira ntchito, SBRT ikhoza kupereka zotsatira zofanana ndi opaleshoni. SBRT ingagwiritsenso ntchito, nthawi zina, khansa yamapapu yomwe yafalikira . Pokhapokha ngati matenda a kansa yamapapu alipo mu ubongo kapena chiwindi, SBRT nthawi zina imakhala ndi mphamvu yothetsera matendawa kwa nthawi yaitali.
Zidzandikhudza Bwanji?
Anthu ambiri amatha kuchita ntchito tsiku ndi tsiku panthawi yachipatala, ngakhale kuti kutopa ndi kofala ndipo kumawopsa kwambiri pakapita mankhwala. Ndi mankhwala opatsirana kunja, simukuyenera kudera nkhawa kuti dzuwa lidzakhudza anthu omwe akuzungulira iwe, monga momwe amathandizira ena khansa.
Zotsatira Zotsatira
Kutentha kwa khungu, kuphatikizapo kufiira ndi kupukuta, kawirikawiri kumayamba sabata yoyamba kapena mankhwala awiri. Wachikulire wanu angakupatseni kirimu kwa inu ndipo kusamala kwambiri pakusamalira khungu n'kofunika. Kutopa kumakhala kofala ndipo kungapitirire kwa milungu ingapo kupitirira mankhwala. Kupweteka kapena kuvutika ndi kumeza (matenda opatsirana) amatha kuchitika ndipo ndi chifukwa cholankhulana ndi oncologist wanu. Zizindikiro zam'mbuyomu monga kuwonongeka kwa mpweya wa m'magazi zingathe kuchitika, koma nthawi zambiri, phindu la mankhwala limaposa kuopsa kwa mavutowa.
Ndikofunika kuti mudziwe bwino zotsatira zowonjezereka za mankhwalawa popanda kulandira mankhwalawa. Zotsatira zoyipa monga radiation pneumonitis - kutupa kwa mapapo chifukwa cha mankhwalawa - amatha kuchiritsidwa, koma kukhoza kuchititsa kuti pulmonary fibrosis - yopseza kosalekeza - ngati sichipezeka ndi kupatsidwa mwamsanga.
Pamene kupulumuka kwa khansa ya m'mapapo kumachitika bwino, nkofunikanso kuzindikira zina mwa zotsatira za nthawi yaitali za mankhwala omwe angayambe ndikumapitirira mwezi kapena chaka chithandizo cha mankhwalawa chikuperekedwa.
Tsatirani Pambuyo pa Kutuluka kwa Mpweya
Thandizo la ma ARV lingatenge nthawi pang'ono kuti liyambe kugwira ntchito koma limapitiriza kugwira ntchito kwa nthawi yaitali chithandizo chitatha. Katswiri wanu wa zamagetsi a m'madzi akudziwitsani ngati ziyeso zotsatila ziyenera kuchitidwa kuti muone ngati mukupita patsogolo.
Zotsatira:
De Ruysscher, D., Lueza, B., Le Pechoux, C. et al. Zotsatira za Thoracic Radiotherapy Nthawi Imene Imakhala ndi Mavuto Ochepa Omwe Ali ndi Matenda Aakulu a Khansa: Kugwiritsa Ntchito Mmodzi Wodwala Deta. Annals of Oncology . 2016 Jul 19. (Epub patsogolo pa kusindikiza).
Giaj-Levra, N., Ricchetti, F., ndi F. Alongi. Kodi Kusintha kwa Radiotherapy kwa Chithandizo cha Zakale Zambiri Zam'mimba Zomwe Zili ndi Matenda a Khansa? Kupenda. Kafukufuku wa Khansa . 2016. 34 (2): 80-93.
Maquilan, G., ndi R. Timmerman. Mankhwala Opatsirana Omwe Amagwiritsa Ntchito Thupi la Khansa Yam'mimba Yoyamba Kumayambiriro. Khansa Journal . 2016. 22 (4): 274-9.
Stevens, R., Macbeth, F., Toy, E., Coles, B., ndi J. Lester. Mankhwala Odzichepetsa Amathandiza Odwala Odwala Amtundu Wachizindikiro Kuchokera ku Kansa Yapang'ono Osakanikirana ndi Cell. Dongosolo la Cochrane la Zosintha Zogwirizana . 2015. 1: CD002143.
Zheng, M., Sun, H., Xu, J. et al. Kuphatikiza Ubongo Wonse Radiotherapy ndi Gefitinib / Erlotinib kwa Ubongo Metastase Kuchokera ku Non-Small-Cell Cell Lung Cancer: A Meta-Analysis. BioMed Research International . 2016. 2016: 5807346.