Mavuto omwe ali ndi gawo 4 Khansa ya m'mawere
Ngati mukukhala ndi kansa ya m'mawere (metastatic kapena siteji 4) mwina simusangalala kumva za mavuto omwe mungakumane nawo. Ndipotu, si zizindikiro kapena khansa yanu komanso zotsatira za mankhwala okwanira? Mwamwayi, mosiyana ndi zotsatira zofanana, zotsatirazi zingakhale zosazolowereka, ndipo simungathe kupeza zambiri, kapena mavuto ena.
Tiyeni tiwone zovuta zina zokhudzana ndi siteti ya metastases, ndipo mutha kukumana ndi mavuto ena omwe mungakumane nawo ndi khansa ya m'mawere (stage 4 ya kansa ya m'mawere).
Zotsatira zoyipa ndi zovuta
Ndikofunika kupanga kusiyana musanayambe. Mwinamwake mukudziŵa zotsatira zambiri za mankhwala a khansa ya m'mawere, monga tsitsi lopweteka ndi chemotherapy, kapena kutopa ndi dzuwa. Pa cholinga cha zokambirana zathu tiwona zotsatira za zotsatira ngati zochitika zomwe zimachitika nthawi zambiri .
Mosiyana ndi zimenezo, zovuta ndizovuta zomwe zingakuchititseni kudabwa, komanso kuti simunamvepo musanakhale ndi khansa nokha. Apanso tiyenera kutsindika kuti anthu ambiri alibe mavuto onse (kapena ena), ndipo tikuyembekeza kuti tisakhumudwitse aliyense mwa kutchula mavuto omwe angakhale nawo. Izi zinkati, zambiri mwa izi zimachiritsidwa, ndipo mankhwala amathandiza kwambiri akamayambika posakhalitsa.
Nthaŵi zina, kuzindikira vuto kumayambiriro kungathetse mavuto aakulu, ngakhale kuwalola kapena kufa.
Zovuta Zambiri za Kansa ya Breast Metastatic
Pali zovuta zambiri zomwe zimachitika ndi khansa ya m'mawere yomwe imayambitsa chiopsezo ngakhale kuti khansara yayamba kufalikira, kapena mtundu wa mankhwala omwe munalandira kale kapena mukulandira tsopano.
Izi zikuphatikizapo:
- Zovala za Magazi: Zowopsa kwa mazira a magazi zimaphatikizapo kukhala ndi kansa ya metastatic, zina mwa mankhwala (monga chemotherapy) a matenda, bedi, ndi zina. Tikuphunzira kuti magazi amagawanika ndi khansa ndizofala kwambiri, ndipo amachititsa matenda aakulu komanso nthawi zina ngakhale imfa. Nthawi zambiri magazi amayamba m'milingo kapena m'mimba ( deep vein thrombosis ) ndipo amatha kupita kumapapo ( pulmonary embolism ). Zizindikiro zoyenera kuziphatikizapo zofiira, kutupa, kapena kupsinjika kwa miyendo yanu, kupuma kwadzidzidzi, kupweteka kwa mfupa mwadzidzidzi, kumutu, kapena kupanda kanthu. Akagwidwa pa nthawi, ochepa magazi amatha kugwiritsidwa ntchito kuthetsa kutseka.
- Ululu: Kupwetekedwa ndi khansa ya mthupi imakhala yosiyana ndipo kawirikawiri kumadalira malo omwe ali ndi matenda aakulu (onani mafupa amtundu pansipa). Timadziwa kuti kupweteka kungasokoneze umoyo wanu, ndipo khalidwe la moyo ndilo cholinga chachikulu pakuchiza khansara 4. Lankhulani ndi dokotala wanu za ulamuliro wa kupweteka kwa anthu omwe ali ndi khansa . Pali njira zambiri zosiyana, ndipo anthu ambiri, ngakhale ndi matenda aakulu, amatha kukhala omasuka.
- Cachexia: Khansa ya cachexia ndi vuto lovuta ndi khansa yapamwamba. Ndi matenda a kulemera kwa thupi, kudzichepetsa kwa minofu, ndi kuchepa kwa njala. Zimachepetsa umoyo wa moyo ndipo zimamveka kuti ndizomwe zimayambitsa imfa kwa anthu 20 peresenti ya anthu omwe ali ndi khansa. Matenda a cachexia, ngakhale amadziwika ndi kulemera kwa thupi, amawoneka kuti ayamba ngakhale asanayambe kulemera. Pali zofukufuku zofunikira pakufufuza njira zothandizira ndi kuteteza chachexia. Ngati mukuvutika ndi kusowa kwa njala , kapena mwataya thupi, bweretsani izi ndi dokotala wanu. Kusagwirizana, kuchita zolimbitsa thupi n'kopindulitsa. Cachexia ndi chizindikiro chimodzi cha khansara chomwe chikuwoneka chikuthandizidwa kwambiri ndi mbuta zachipatala ngati izi ziri zovomerezeka m'boma lanu.
Mavuto Okhudzana ndi Matenda a Matenda
Mafupa ndiwo malo ambiri omwe khansa ya m'mawere imafalikira. Kupita patsogolo sikupangidwe kokha pochiza mavitaminiwa koma kuyang'ana njira zothandizira mitsempha ya mafupa pamalo oyamba. Kwa omwe ali ndi khansa ya m'mawere ndi metastases , mafupa atsopano osokoneza mafupa monga bisphosphonates ndi denosumab angachepetse chiopsezo cha mavuto monga zophulika. Zovuta zotheka ndi metastases zamphongo zikuphatikizapo:
- Ululu: Kupweteka chifukwa cha mafupa a metastases kungakhale kovuta, ndipo tikudziwa kuti kupweteka kwakukulu kumachepetsa moyo wa munthu. Pa nthawi yomweyi, mankhwala ambiri omwe timakhala nawo chifukwa chovutika kwambiri amayamba kutopa ndi kugona. Kuwonjezera pa kugwiritsa ntchito mankhwala opweteka, mankhwala odzozereka ndi othandizira kuchepetsa ululu chifukwa cha metastases. Mankhwala osokoneza bongo samachepetsa kupweteka pamlingo wofanana, koma kuphatikiza ndi zomwe zili pamwambazi ndi zothandiza (ndi zifukwa zina).
- Kuphulika kwa mafupa a mitsempha: Kuphulika kwa mafupa kumachitika pamene mafupa amathyoka (kudutsa) kudera lofooka. Malingana ndi malo, kupasuka kwa mtundu umenewu kungachepe kwambiri.
- Kupsinjika kwa msana: Pamene mafupa a mitsempha amapezeka pamtunda, amatha kupangitsa msana kupindikiza ndi kumatulutsa mitsempha yomwe imatithandiza kuti tiziyenda, kukopa, ndi kudutsa matumbo athu. Mtundu wolimba kwambiri wa "microfractures" mumsana umatha kuwombera kumbuyo kumbuyo, kupweteka kwapakati. Pamene maselo a khansa m'dera lino amachititsa kuti mitsempha isokonezeke, vuto linalake lotchedwa cauda equina syndrome limapezeka. Popanda mankhwala mwamsanga kuti athetse msana, munthu amatha kufooka m'munsi mwake kupatulapo kuti sangathe kugwira chikhodzodzo kapena matumbo.
- Hypercalcemia . Pamene chotupa chimathyola mafupa, amachititsa kuti calcium ikamasulidwe m'magazi, chikhalidwe chotchedwa hypercalcemia cha malignancy . (Pali njira zina za khansa zomwe zingapangitse kashiamu m'magazi komanso). Poyamba, izi zingayambitse nkhanza ndi kusanza, kuwonjezeka ludzu, kufooka, ndi minofu ya minofu, koma ikhoza kupitirira kusokonezeka, zizoloŵezi za mtima, zachiwerewere, ndi imfa.
Mavuto Okhudzana ndi Mafuta a Metungase
Mapapu ndi malo achiwiri omwe khansa ya m'mawere imafalikira, ndipo mapiritsi a m'mapapo amachitika nthawi zina pafupifupi pafupifupi atatu mwa anthu omwe ali ndi kansa ya m'mawere. Zizindikiro zimatha kusiyana ndi palibe (pamene mapangidwe a mapapo amapezeka pansalu yokhayokha), kuti apume pang'ono. Kuwonjezera pa chithandizo chamakono cha khansa ya m'mapapo ya m'magazi, mankhwala am'derali tsopano akugwiritsidwa ntchito kwa anthu ena omwe ali ndi zochepa zokha za m'mapapo, ndipo izi zikuwoneka kuti zikulitsa chiyembekezo cha moyo. Zovuta zowopsa m'mapaposi a mapapo ndi awa:
- Kupuma pang'ono: Kupuma pang'ono kumayendetsedwa ndi mankhwala monga morphine. Ngati chotchinga chimayambitsa kupuma, mpweya ukhoza kuikidwa. Chodabwitsa n'chakuti mpweya suoneka kuti siwothandiza kwambiri pofuna kuchepetsa kupuma pang'ono.
- Chibayo: Kukhalapo kwa metastases m'mapapu, makamaka pafupi ndi airways, kungachititse kuti madzi ndi mabakiteriya apitirize m'mapapo. Powonongeka kwa maulendo, anthu amatha kukhala ndi chibayo chosatha. Izi zikhoza kukhala zovuta kwambiri ngati kuchuluka kwa maselo oyera a magazi kumachepetsedwa chifukwa cha chemotherapy, ndipo kawirikawiri kumafuna ma antibayotiki ndi ma antibiotic.
- Kudula magazi: Kudya magazi kungabwere, makamaka pamene metastases ali pafupi ndi misewu yaikulu. Kuwombera ngakhale magazi pang'ono-supuni ya tiyi-imatengedwa ngati mwadzidzidzi wachipatala. Kutaya gawo limodzi mwa magawo atatu a kapu ya magazi ali ndi chiwerengero cha anthu pafupifupi 30 peresenti ya anthu. Mwa kuyankhula kwina, musanyalanyaze magazi aliwonse amene mumatsokomola, ngakhale kuti ndi ochepa chabe. Mukapezeka mwamsanga, njira zowonongeka nthawi zambiri zimasiya magazi, ngakhale atakhala ovuta.
- Kupweteka kwachisokonezo kwachisokonezo : Chisokonezo chopweteka kwambiri ndi chikhalidwe chimene maselo ndi khansa amamanga pakati pa membranes (pleura) yomwe imayendera mapapo. Kukhazikika kumasiyanasiyana malingana ndi kuchuluka kwa mchere wamakono komanso momwe zimakhalira mwamsanga. Kuchokera phokoso laling'ono kungakhale kosafunikira chithandizo chilichonse. Kutentha kwakukulu, komabe, kumapweteka m'mapapo, kumapweteka kwambiri ndi kupuma pang'ono. Choyamba choyamba ndi thoracentesis, imene singano imayikidwa kudzera mu khoma la chifuwa mumalo osungira madzi kuti imwe madzi. Tsoka ilo, madziwa amatha kubwerera. Zosankha zimaphatikizapo kukhetsa, kuikapo mbola kuti anthu athe kukhetsa okha pakhomo pawo, kapena kuchita ndondomeko yotchedwa pleurodesis. M'kati mwa mankhwala, mankhwala amalowetsedwa mu malo omwe amachititsa kutupa, zomwe zimabweretsa "kugwilitsika" pamagulu pamodzi kotero kuti madzi sangathe kudziunjikira.
- Kuchepetsa m'mimba: Kutaya magazi, kapena kutuluka magazi m'mapapo, sikofala, koma kumachitika.
- Kuwonongedwa kwa kayendetsedwe ka ndege: Pamene metastases ikukula pafupi kapena mumlengalenga, zingayambitse. Izi zingachititse kupuma pang'ono, ndi matenda monga chibayo. Ngati chitetezo chili chovuta, madokotala akhoza kuika mphepo pamsewu kuti ikhale yotseguka.
Mavuto Okhudzana ndi Matenda a Chiwindi
Matenda a chiwindi sangayambitse zizindikiro zilizonse pokhapokha ngati mitsempha yayandikira pafupi ndi ziwiya zazikulu ndi mazira a chiwindi. Ngati muli ndi zizindikiro, mukhoza kuona kutuluka kwa chikasu khungu lanu ndi azungu a maso anu (ululu wa m'mimba), ululu m'mimba, ululu wa m'mapiko, ndi hiccups. Kawirikawiri, mbali yaikulu ya chiwindi imafunika kuti m'malo mwa chifuwacho pakhale zizindikiro zazikulu. Zowonongeka zochepa zingaphatikizepo:
- Ascites: Chifukwa cha chiwindi chosagwira ntchito, madzi amadzimadzi amatha kumanga m'matope ( ascites ). Ngati mimba yanu imasokonezeka kwambiri, ikhoza kukhala yopweteka komanso imapangitsa kuti mpweya ukhale wochepa (makamaka ngati muli ndi mitsempha yamapapu). Madokotala akhoza kuchita ndondomeko yotchedwa paracentesis ndi imene singano imayikidwa kudzera mu khungu komanso m'mimba kuti imachotse madzi.
- Kusokonezeka: Pokhala ndi metastase wambiri, chisokonezo ndi kutha msinkhu zingayambitse, chifukwa chakumanga kwa poizoni m'thupi.
- Kusuta: Chiwindi chimayambitsa kupanga zinthu. Ngati chiwindi chimakhala chosagwira ntchito, sizingatheke kuchuluka kwa zinthuzi zomwe zingapangitse kuti magazi ndi magazi akule.
- Kuwomba : Simungaganize kuti kuyabwa ndi vuto lalikulu, koma kuyabwa komwe kumayendera limodzi ndi chiwindi cha metastases kungakhale kovuta. Kuyabwa kumachitika chifukwa cha kumanga kwa acidi acid m'magazi ndi khungu. Kuwonjezera pa kufunsa okondedwa anu kuti akubwezeretseni zikopa, pali mankhwala omwe angachepetse chizindikiro ichi.
Mavuto okhudzana ndi ubongo wa Metastases
Ubongo ndi malo wamba a khansa ya m'mawere kufalikira, ndipo maselo a ubongo angabweretse chiwerengero chilichonse cha zizindikiro; zina zomwe zingakhale zowopsya. Mwina simukudziwa kuti khansa yanu ya m'mawere yafalikira ku ubongo wanu, kapena mmalo mwanu, mungakumane ndi zovuta za matenda a ubongo. Ena mwa awa ndi awa:
- Zokhumudwitsa: Mwinamwake mumadziwa bwino kugwidwa ndi vuto lalikulu, kapena mtundu wa tonic-clonic, mtundu umene munthu amadziŵa ndipo zotsatira zake zimagwedezeka mwamphamvu. Nthawi zina kugwidwa kumalo kumalo amodzi a thupi. Kugonjetsa kwina kungayambitse zizindikiro monga munthu akuyang'ana mumlengalenga akuwoneka kuti sakuwona chirichonse.
- Kugwa: Mitsempha ya ubongo ingayambitse kufooka, kufooka, ndi kusalephera. Ngati ubongo wa ubongo ulipo, ndikofunika kukhala osamala kwambiri za kupewa kugwa.
- Mavuto owonetsa : Mavuto owonetsa ngati mawonedwe awiri, kapena ngakhale kutayika kwa masomphenya angachitike. Anthu amachenjezedwa kuti asayendetse galimoto kapena kugwiritsa ntchito zinthu zomwe zingakhale zoopsa.
- Kusintha kwadzidzidzi m'maganizo : Kusintha kwa chikhalidwe cha m'maganizo, kusintha kwa umunthu, kapena kutaya chidziwitso kungachitike.
Chithandizo cha zovuta zosiyanasiyana za ubongo metastases kawirikawiri zimakhala zowonongeka. Ngati kamodzi kokha, kapena masewases ochepa chabe alipo, njira ina yapadera yothandizira ma radiation yotchedwa stereotactic body radiotherapy (SBRT) ingagwiritsidwe ntchito pofuna kuthetsa mitsempha.
Mavuto Chifukwa cha Mavitamini Ena
Khansara ya m'mimba ikhoza kufalikira pafupifupi dera lililonse la thupi, ndipo ngati muli ndi zizindikiro, ngakhale ngati zikuwoneka kuti sizikugwirizana ndi khansara yanu, onetsetsani kuti mulankhule ndi oncologist wanu. Zovuta zina zokhudzana ndi zigawo zina za kufalitsa zikuphatikizapo:
- Kulephera kwa impso: Kulephera kwa impso kungayambe osati chifukwa cha metastases ndi impso (osati malo osadziwika) koma chifukwa cha mankhwala omwe mumatenga, kutaya thupi, ndi zina zambiri.
- Kuchulukira kwachirombo: Monga momwe khansara ya m'mawere imatha kufalikira kumalo amapapu, imatha kufalikira pamtima. Pamene madzi amadziwika pakati pa nembanemba yowononga mtima (zimakhala zovuta) zimapangitsa kuti zikhale zovuta kwambiri kuti mtima ugule (kuthamanga kwa mtima kumathamanga mofulumira kuti phokoso laling'ono liponyedwe ku thupi lonse). Ngati madzi amadziwika mofulumira kapena ataliatali, angayambe kukhala ndi chidziwitso chodziwika bwino kwambiri (zomwe zimapangitsa mtima kukhala wosatheka kwambiri). Pamene matendawa amapezeka chifukwa cha khansa ya metastases, gawo limodzi mwa magawo atatu a anthu amamwalira asanayambe kupezeka ndi kuchiritsidwa. Izi si zachilendo, koma chifukwa choyenera kuyankhula ndi dokotala ngati muwona kuti mpweya uliwonse ukucheperapo kapena kuthamanga kwa mtima mwamsanga.
- Kuvulala kwa Brachial plexus : Pamene khansara imafalikira m'magazi pansi pa mkono, ikhoza kuwononga gulu la mitsempha yotchedwa brachial plexus. Izi zingachititse kufooka kapena ziwalo ku mbali imodzi. Kusokonezeka maganizo kwa chifuwa chifukwa cha khansa ya m'mawere kumakhudza akazi amodzi okha mwa 200 koma nthawi zambiri kumakhala kovuta kwambiri.
Zovuta Chifukwa Chakuchiritsidwa kwa Khansa Yamtundu Wakale ndi Watsopano
Zovuta zina zomwe zingachitike ndi zofanana ndi zomwe nthawi zina zimachitika kwa anthu omwe ali ndi khansa ya m'mawere. Zina mwazoopsa ndizo:
- Matenda a mtima: Makina onse a chemotherapy ndi mankhwala opatsirana ndi khansa ya m'mawere angawononge mtima. Matenda a mtima angawoneke patapita zaka zambiri kuchokera kuchipatala choyamba ndipo akhoza kuchoka ku matenda a mitsempha ya m'mimba, mtima wolephera, ku mavuto a valve. Chofala kwambiri ndi kuperewera kwa mtima, komwe kawirikawiri kumadzitcha ndi zizindikiro za mpweya wochepa, kutupa kwa mapeto, ndi kukhwima pinki, sputum.
- Matenda: Ngati muli pa chemotherapy, adokotala anu akukuchenjezani za kukhala ndi malungo (kutentha kwa neutropenia). Malungo omwe sangawopsyeze, akhoza kuika moyo pachiswe. Pamene chitetezo chanu cha mthupi chitetezedwa, simungokhala ndi kachilombo koyambitsa matenda, komabe kuthekera kwanu kumenyana ndi matenda omwe mumagwira nawo ndi osokonezeka. Ngakhale matenda ochepa angapangitse kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda komanso tizilombo toyambitsa matenda. Ngati mukukhulupirira kuti muli ndi kachilombo, musayembekezere. Itanani wanu oncologist.
Zomwe Zimayambitsa Kutha Kwachangu
Mukakhala ndi khansa ya m'mawere 4, mumakhala mankhwala ambiri. Izi zingakhale mbali ya mankhwala anu, komanso mankhwala oletsa zizindikiro zanu. Chimene anthu ena sazindikira ndi chakuti ngakhale mutatenga mankhwala kasanu ndi kawiri, mlingo wotsatira umene mumatenga ukhoza kuchititsa vuto lalikulu.
Choyenera, aliyense ayenera kudziwa zizindikiro za anaphylaxis, zomwe zimawopsa kwambiri, chifukwa izi zingawononge moyo. Ngati muwona khosi lanu, lilime, kapena nkhope yanu, kutukula kwa mng'oma, kapena kumutu, funani kuchipatala.
Mavuto a Psychological
Anthu kawirikawiri amaganiza za opulumuka kansalu monga kulimbika kwambiri, koma palinso nthawi imene opulumuka akufooka kwambiri. Kupsinjika maganizo kumatha kulowa. Ndipo ndi kupsinjika maganizo, anthu ena amadzipha. Kuopsa kwa kudzipha ndi khansara kumakhala kochepa kwambiri mu khansa ya m'mawere kusiyana ndi khansa zina, koma chiopsezo chilipobe. Monga momwe zilili ndi zizindikiro zowonjezereka pamwambapa, simungaganize za kuvutika maganizo monga vuto la khansa yamatenda, koma ndi yofunika kwambiri. Cholinga cha chithandizo ndikulitsa moyo ndikukupatsani moyo wabwino kwambiri. Ngati pali zosokoneza zomwe mungathe kuti muzisangalala ndi banja lanu ndi abwenzi, ziyenera kuyankhulidwa, mwina ndi a oncologist, madokotala ena monga katswiri wothandizira, kapena katswiri wa khansa.
Mawu Ochokera
Tinapereka mavuto ena omwe angaperekedwe ndi khansa ya m'mawere, ngakhale pali zina zomwe simungakumane nazo. Mfundo yofunikira ndiyo kudziwa thupi lanu ndikuyankhula ndi oncologist wanu ndi nkhawa iliyonse. Kukhala ndi khansa ya sitepe 4 si nthawi yokhala wolimba mtima. Kawirikawiri, mavuto aakulu angathe kuchiritsidwa ngati atapezeka m'nthawi yake.
Kumbukirani kuti anthu ambiri samakumana ndi mavutowa. Pali anthu ambiri omwe amakhala ndi khansa ya m'mawere 4 omwe akukhala moyo wokhutira komanso wokhutiritsa, ngakhale kuti sakudziwa zam'tsogolo.
> Zotsatira:
> Hurria, A., Come, S., ndi L. Pierce. Zitsanzo Zobwerezabwereza ndi Zomwe Zimakhalapo Kwanthaŵi Zambiri M'mapulumuka a khansa ya m'mawere. Kupititsa patsogolo . Kusinthidwa 08/15/17.
> National Cancer Institute. Cannabis ndi Cannabinoids (PDQ) -Health Professional Version. Kusinthidwa 11/30/17. https://www.cancer.gov/about-cancer/treatment/cam/hp/cannabis-pdq#link/_45_toc