Matenda a khansa ya m'mimba

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Mavuto a Khansa ya M'magazi Aliyense Ayenera Kudziwa

Khansara ya m'mimba ndi yovuta popanda kuwonjezera mavuto. Komabe kukhala ndi chidziwitso pang'ono kungapite patsogolo kuti mutsimikizire kuti mungapeze chisamaliro chabwino kwambiri mukachifuna. Kuchokera m'magazi kupita ku zonyansa zofuula, mavutowa sangathe kuchepetsa umoyo wanu koma akhoza kuopseza ngati sakusiyidwa.

Kodi mukudziwa zomwe zimakhala zoopsa ndi khansara yamapapo ? Tengani kamphindi kuti muwerenge zina mwa zizindikiro izi ndi kukonza njira ndi banja lanu muyenera kuchitika mwadzidzidzi. Kenaka dzidziwitse mwachidule ndi zovuta 10 zotsatirazi zomwe zimachitika kawirikawiri kwa anthu omwe ali ndi khansa ya m'mapapo.

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Zoipa Zopweteka

Kupwetekedwa kwachisokonezo kumatanthawuza kukhalapo kwachisembwere (phokoso la madzi m'kati mwa malo) pamene maselo a khansa alipo. Izi zimachitika pafupifupi 30 peresenti ya anthu omwe ali ndi khansara yamapapu ndipo amafotokoza khansara ngati kansa ya 4 (metastatic) ya khansa ya m'mapapo .

Madokotala angaganize kuti mukuwombera modzidzimutsa chifukwa cha zizindikiro zanu kapena phunziro la kujambula monga chifuwa cha TB, CT scan, kapena MRI.

Chizindikiro chofala kwambiri ndi kupuma pang'ono , koma zizindikiro zina zikhoza kukhalapo. Izi zimaphatikizapo chifuwa chomwe nthawi zambiri chimakhala bwino (chifuwa chimakhala chabwino kapena choipa malinga ndi malo omwe mwakhala kapena mukugona) ndi kupweteka pachifuwa.

Ngati dokotala akudandaula kuti ali ndi zifukwa zomveka bwino, pogwiritsa ntchito zizindikiro ndi zofufuza, akhoza kunena kuti thoracentesis. Mwa njirayi, singano yaitali imayikidwa kudzera mu khoma la chifuwa ndi malo opempherera (malo omwe ali pakati pa ziwalo zowonjezereka m'mapapo.) Madzi amachotsedwa kuti athandizidwe ndi zizindikiro komanso kufufuza pogwiritsa ntchito microscope.

Kukhalapo kwa maselo a khansa mu mchere wodandaula kumawoneka ngati kupweteketsa kwachisokonezo, koma sizinthu zonse zopempherera anthu omwe ali ndi khansa ya m'mapapo ndizoipa. Mosiyana, theka la zovuta, ngakhale anthu omwe ali ndi khansara yamapapu, ali abwino.

Kwa anthu ambiri omwe ali ndi vuto lopweteketsa mtima, kuthamangidwanso kumatuluka mwamsanga. Ngati izi zikusokoneza umoyo wanu dokotala akhoza kukupatsani njira yotchedwa pleurodesis . Mwa njirayi, mankhwala (talc) amalowetsedwa kudzera mu thora yotchedwa thoracotomy mu chipinda chopempha. Talc imayambitsa kutupa, potsiriza kuyambitsa magawo awiri a pleura kuti awombere limodzi kuti madzi asathenso kudziunjikira mu danga.

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Zovala za Magazi (Deep Venous Thrombosis) ndi Pulmonary Emboli

Mwazi umagwera pamilingo kapena pamphuno zimachitika pa 3 peresenti mpaka 15 peresenti ya anthu omwe ali ndi kansa ya m'mapapo ndipo amachititsa mavuto aakulu. Zovala zomwe zili pamlendo zingayambitse kupweteka ndi kutupa, zomwe zingakhale zoopsa pokhapokha ngati chovalacho chikachoka ndikupita kumapapo ( pulmonary emboli .)

Zinthu zoopsa zimaphatikizapo opaleshoni, chemotherapy, kusagwira ntchito, komanso kuyenda ngati galimoto kapena ndege.

Zizindikiro zimaphatikizapo kufiira kapena kutupa m'matanthwe kapena miyendo, koma pafupifupi osachepera atatu mwa anthu omwe ali ndi khansa ya m'mapapo, palibenso zizindikiro. Pamene mapulaneti ayamba kukula, anthu akhoza kuyamba kupweteka pachifuwa komanso kupuma pang'ono.

Kumbukirani kuti mazira a magazi sagwiritsidwa ntchito kwa anthu omwe ali ndi khansa yapamwamba komanso yapamwamba. Ndipotu, chiwerengero cha mitsempha ya magazi ndi chachikulu ngakhale m'matenda atsopano omwe ali ndi khansara yamapapo.

Onetsetsani malangizo awa pozindikira ndi kupewa kuteteza magazi pa nthawi ya khansa .

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Mphepete mwachitsulo

Kupsinjika kwa msana kumatha kuchitika kwa anthu omwe ali ndi khansa ya m'mapapo pamene khansara imafalikira ku fupa ( mafupa a mitsempha ) yomwe imayambitsa kufooketsa ndi kugwa kwa mafupa a msana.

Zizindikiro kawirikawiri zimayambira ndi ululu m'khosi kapena kutsitsa mmbuyo ndipo zingapite patsogolo kufooka ndi kutaya mtima kumapeto. Ngati chingwe cha msana chikuwonongeka pamtunda, msanga wodwala wotchedwa cauda equina syndrome ukhoza kuyamba. Izi zikachitika, anthu akhoza kuyamba kutaya chikhodzodzo ndi matumbo kuphatikizapo ululu waukulu. Chithandizo chamwadzidzidzi n'chofunika kuti zisunge ntchito zambiri momwe zingathere.

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Superior Vena Cava Syndrome (SVC Syndrome)

Chovuta chomwe chimadziwika kuti vena cava syndrome (SVC syndrome) chikupezeka pafupifupi 2 peresenti mpaka 4 peresenti ya anthu omwe ali ndi kansa ya m'mapapo, makamaka ndi zotupa zomwe zimapezeka m'mapapu apamwamba. Ziphuphuzi zimatha kukanikiza pa vena cava yapamwamba - mitsempha yaikulu yomwe imabweretsanso magazi kuchokera kumtunda mpaka pamtima - kutsekereza magazi ndi kutulutsa zizindikiro.

Zizindikirozi zingaphatikizepo kutukumula kwa nkhope, mikono, ndi thupi, kufalikira kwa mitsempha m'khosi ndi chifuwa, kupuma pang'ono, kuvutika kukumeza, ndi mantha.

Chithandizochi chimathandiza kuchepetsa kupweteka kwa chifuwa, nthawi zambiri pogwiritsira ntchito chemotherapy kapena radiation, komanso kugwiritsa ntchito magazi operekera magazi kuti asamawonongeke.

Chithandizo chowopsa chikufunika ngati vena cava syndrome ikukula. Musati dikirani. Itanani 911.

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Kuchepetsa Mitsempha

Ziphuphu zotuluka m'mimba zimatha kutuluka mkati m'mapapo, komanso ku bronchi. Chizindikiro cha kutsokomola magazi ndi khansara yamapapo kungakhale chithandizo chamankhwala mwamsanga, ndipo ngakhale magazi pang'ono ayenera kufufuzidwa bwinobwino. Pang'ono ndi pang'ono supuni ya magazi imaonedwa ngati yodzidzimutsa kwachipatala.

Mankhwala otchedwa hemoptysis (kuthamanga magazi) amaonedwa kuti ndi oposa 100 pc ya magazi, kapena 1/3 ya chikho. Izi zikachitika chiwerengero cha imfa chikhoza kukhala chapamwamba kuposa 30 peresenti.

Chifukwa cha kusamalidwa mwamsanga, madokotala amatha kupeza malo omwe amachokera ndikuyimitsa magazi, koma nthawi ndi yofunika kwambiri. Musati dikirani. Itanani 911.

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Hypercalcemia

Mankhwala oopsa a khansa (kansalu yowonjezereka m'magazi) ndi ovuta kupeza, omwe amapezeka 10 peresenti mpaka 15 peresenti ya anthu omwe ali ndi khansa yambiri.

Zizindikiro za hypercalcemia m'magulu a khansa zingakhale zowawa minofu ndi kuphatikizana, kupwetekedwa mtima, kufooka, ndi kusokonezeka. Osadziwika, matendawa angabweretsere, ndipo pamapeto pake imfa.

Pali njira zingapo zomwe anthu omwe ali ndi khansara amatha kukhala ndi hypercalcemia. Chimodzi mwa kupatula kashiamu kuchoka ku fupa la metastases. Izi zikhoza kuvulazidwa ndi kupweteka kwa impso pamene impso sizilephera kuchotsa calcium m'magazi moyenera. Ziphuphu zina zingatulutsenso zinthu zomwe zimathandiza kuchotsa kashiamu ku mafupa. Ngakhale kuti zizindikiro siziri zenizeni ndipo zingasokonezeke ndi zikhalidwe zina, matendawa ndi osavuta kupanga ndi kuyesa magazi mosavuta.

Njira zochiritsira zimadalira mlingo wa kashiamu m'magazi ndipo zimaphatikizapo madzi a IV, steroids, mankhwala otchedwa bisphosphonates, ndi nthawi zina dialysis pamene zizindikiro zili zovuta.

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Febrile Neutropenia

Anthu ambiri amvapo kuti chemotherapy ikhoza kuchepetsa kuchuluka kwa maselo oyera a magazi omwe amabweretsa chiopsezo chotenga kachilombo, koma nthawi zonse sadziwa kuti izi zingakhale zotani. Tili ndi maantibayotiki abwino omwe alipo tsopano kuti athetse ntheropenia (mtundu wochepa wa maselo oyera a magazi omwe amachititsidwa ndi chemotherapy) omwe amachititsa matenda, koma anthu ochuluka kwambiri sali kuchiritsidwa mpaka atachedwa .

Kuchiza matendawa nthawi zambiri kumafuna mankhwala osiyanasiyana, ndipo ndizofunika kuti dokotala azidziwa kuti muli mankhwala a chemotherapy ngati mukupereka matenda.

Phunzirani za neutropenia panthawi ya chemotherapy , zodzitetezera zomwe mungatenge, komanso pamene muitanitse dokotala wanu. Aliyense amene ali ndi kansa ya m'mapapo ndi yosiyana, choncho onetsetsani kuti mufunse anu oncologist kuti mukhale ndi zifukwa zenizeni zowonetsera, ndi nthawi yoyenera.

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Matenda a Mtima

Mankhwalawa amawaika pamtima, ndipo nkhawa za mtima ndi chimodzi mwa zotsatira zofunikira kwambiri za mankhwala a chemotherapy .

Mankhwala osiyana amatha kukhala ndi mitundu yosiyanasiyana ya mtima, kaya matenda a mitsempha yamakono, matenda a valve, kapena mtima wosalimba.

Lankhulani ndi dokotala wanu ndipo funsani za chiopsezo cha matenda a mtima okhudzana ndi mankhwala anu. Kodi pali zizindikiro zina zomwe muyenera kuziyang'anira? Kodi pali mayesero omwe muyenera kukhala nawo kuti muwone mtima wanu? Munda wa mtima wa oncology ukufalikira, koma anthu ambiri samadziwa za kuthekera kwa mavutowa. Khalani wochonderera wathu, funsani mafunso, ndipo musataye zizindikiro zirizonse zomwe zimakudetsani nkhawa.

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Kusokonezeka maganizo ndi kudzipha pa odwala khansa

Kusokonezeka maganizo sikungamveke ngati vuto linalake lodzidzimutsa polimbana ndi mavuto ena omwe takambirana pano, koma ndi. Kuvutika maganizo kwa odwala matenda a khansa kumachepetsa moyo, komabe kafukufuku akusonyeza kuti kuvutika maganizo kumagwirizana ndi kuchepa kwapakati pa matendawa.

Zingakhale zovuta kupatulira matenda ovutika maganizo kuchokera ku chisoni. Ndani samamva chisoni akamadziwa kuti ali ndi khansara? Komabe kupanikizika kumapita patsogolo pang'onopang'ono. Zizindikiro zokhudzidwa zikuphatikizapo kukhala opanda chiyembekezo, kusowa thandizo, mphamvu zosauka, ndi kusasamala.

Pafupifupi 15 peresenti mpaka 25 peresenti ya anthu omwe ali ndi matenda a kansa. Nambalayi ikuwoneka kuti ikukwera kwambiri kwa anthu omwe ali ndi khansa ya m'mapapo, monga manyazi a matendawa amatha kukhumudwa.

Kuwonjezera pa kuvutika maganizo, kudzipha ndikofunika kwambiri kwa anthu omwe ali ndi khansa. Kuopsa kwa kudzipha kumakhala kwakukulu kwambiri kwa amuna, makamaka akulu. Chimene chingadabwe ndi inu kuti kuvutika maganizo ndi kudzipha nthawi zambiri sizinaganizidwe ngati mankhwala akulephera. Ndipotu, chiopsezo chachikulu cha kudzipha chikuwoneka kuti chiri chaka choyamba, makamaka sabata yoyamba pambuyo pa matenda. Chifukwa cha izi, muyenera kudziwa chiyani za khansara komanso kudzipha ?

> _Zotsatira:

> _{American Society of Clinical Oncology. Cancer.net. Zotsatira Zotalika za Chithandizo cha Khansa.}

> _{Chen, M. et al. Zizindikiro Zoopsa Pachiyambi Choyamba cha Chemotherapy Chilengeze Kufa kwa Odwala Amene Ali ndi Matenda Osakanikirana Ndi Aang'ono Osagwira Ntchito. Thandizo Lothandiza ku Khansa . 2011. 19 (11): 1705-11.}

> _{Cho, J. et al. Kugwirizana pakati pa Stigma ya Khansa ndi Kuvutika Maganizo Pakati pa Oopsya a Khansa: Kafukufuku Wadziko lonse ku Korea. Psychooncology . 2013 June 20. (Epub patsogolo pa kusindikiza)}

> _{Connolly, G. et al. Kukula ndi Kufunika Kwachipatala Kufunika kwa Odwala ndi Odwala Kachilomboka Chotupitsa Chithokomiro M'thupi mwa odwala Khansa ya M'mimba. Khansara Yam'mimba Yamakono . Lofalitsidwa pa Intaneti 29 July 2013.}

> _{de Naurois, J. et al. Kusamalira Kachilombo ka Neutropenia: Malangizo Othandizira Omwe Amagwiritsidwa Ntchito ku Clinical ESMO. Annals of Oncology . 2010. 21 (suppl 5): v252-v256.}

> _{Johns Hopkins Mankhwala. Mphepete mwachitsulo.}

> _{Misono, S. et al. Kuchuluka kwa Kudzipha Kwa Anthu Amene Ali ndi Khansa. Journal of Clinical Oncology . 2008. 26 (29): 4731-8.}

> _{National Cancer Institute. Syndromes ya Cardiopulmonary. PDQ. Zoipa Zowononga Pleural Effusions. Kusinthidwa 9/02/15.}

> _{National Cancer Institute. Syndromes ya Cardiromulmonary (PDQ). Superior Vena Cava Syndrome. Kusinthidwa 09/02/15.}

> _{National Cancer Institute. Kusokonezeka maganizo (PDQ). Kupha Modzidzimutsa kwa Odwala Khansa. Health Professional Version. Kusinthidwa 06/30/11.}

> _{Reagan, P., Rani, A., ndi M. Rosner. Njira Yodziwiratu ndi Chithandizo cha Hypercalcemia kwa Odwala ndi Malignancy. Magazini Achimereka a Matenda a Impso . 2013 Sep 7. (Epub patsogolo pa kusindikiza).}

> _{Spencer, R. et al. Kachilombo Kachilombo ka Maganizo Odzipha Odwala Odwala Amene Ali ndi Khansa Yapamwamba. American Journal of Geriatric Psychiatry . 2012. 20 (4): 327-36.}

> _{Tagalakis, V. High Risk of Vein Deep Thrombosis kwa Odwala Ndi Osakhala aang'ono Cell Lung Cancer: Gulu Phunziro 493 Odwala. Journal of Thoracic Oncology . 2007. 8: 729-34.}

> _{Walji, N. Common Common Acute Oncological Emergencies: Kuzindikira, Kufufuza, ndi Kulamulira. Medicine Journal ya Postgraduate . 2008. 84 (994): 418-27.}

> _{Zhang, Y. et al. Kukula ndi Mgwirizano wa VTE mwa Odwala Amene Ali ndi Khansa Yam'mimba Yatsopano. Chifuwa . 2014. 146 (3): 650-8.}