Kuwona opaleshoni, kuika chiwindi, ndi mankhwala osokoneza bongo
Chithandizo cha khansa ya chiwindi chimadalira pa siteji ya khansa, komanso chizolowezi cha chiwindi cha munthu.
Ngakhale kuti mankhwala opangidwa ndi opaleshoni ndi opaleshoni yochotsa khansa, anthu ambiri safuna opaleshoni chifukwa cha matenda awo komanso / kapena thanzi labwino la chiwindi. Kuwonjezera pa opaleshoni, njira zina zothandizira mankhwala ndi kuphatikiza kwa chiwindi, kupatsira ablation, mankhwala othandizira, komanso mankhwala ochiritsira monga mankhwala opatsirana, chemotherapy, ndi immunotherapy.
Opaleshoni
Kufukulidwa kwa khansa ya chiwindi ndi njira yopangira chisankho. Vuto ndi opaleshoni, komabe, ndikuti anthu ambiri omwe ali ndi khansa ya chiwindi amakhala ndi matenda a chiwindi kuchokera ku matenda a chiwindi a nthawi yaitali.
Ali ndi chiŵerengero chochepa cha chiwindi kuchokera ku chiwindi (chiwindi ndi chowopsya), kuchotsa ngakhale kachigawo kakang'ono ka minofu ya chiwindi komanso khansara ikhoza kupereka chiwindi kugwira ntchito moperewera. Komanso, khansa zambiri za chiwindi sizingathetsedwe bwino chifukwa zimakhala zazikulu komanso / kapena zimafalitsa kunja kwa chiwindi.
Kufufuza
Pofuna kudziwa ngati munthu ali ndi mwayi wopanga opaleshoni yabwino, adokotala adzayesa kuyerekezera (monga CT scan kapena MRI) kuti adziwe kuchuluka kwake kwa khansa komanso matenda a chiwindi . Wopanga opaleshoni yabwino kwambiri ndi munthu amene ali ndi chiwindi chimodzi (osati zambiri) ndipo amatetezedwa ndi chiwindi.
Ngati inu kapena wokondedwa wanu mukuchitidwa opaleshoni ya khansa ya chiwindi, nkofunika kuti muone zoopsa zonse zomwe zingatheke ndi dokotala wanu.
Kuonjezerapo, musaope kufunsa mafunso ndikufunsanso za chithandizo cha dokotala wanu.
Zotsatira Zowonongeka Zotheka
Kufukulidwa kwa khansa ya chiwindi ndi opaleshoni yaikulu, makamaka popeza chiwindi chili ndi mitsempha yambiri yamagazi. Izi zimapangitsa magazi kuchitidwa opaleshoni yaikulu.
Zotsatira zina zowonjezera za opaleshoni zimaphatikizapo:
- Kutenga
- Magazi amatha
- Mavuto okhudzana ndi anesthesia
- Chibayo
Gulu lanu lachipatala lidzakuyang'anirani kuti kuchepetseni zoopsazi, ndi kupereka malangizo a njira zomwe mungachepetsere pangozi ya mavuto.
Kusindikiza Chiwindi
Kuwonjezera pa opaleshoni, kuika chiwindi ndi njira ina yothandizira kuchiritsidwa, ndi phindu linalake losamalira khansara komanso matenda a chibwibwi. Pakuwotcha chiwindi, dokotala wochita opaleshoni amachotsa chiwindi cha matenda ndikuchichotsa ndi munthu wathanzi kuchokera kwa munthu wina.
Dokotala angalimbikitse kuika chiwindi ngati chotupa cha chiwindi chaching'ono kapena ngati opaleshoni sizotheka chifukwa cha chiwindi chosachiritsika.
Chinthu chachikulu chomwe chimayambitsa chiwindi cha chiwindi ndi kuchepa kwa chiwindi. Malingana ndi American Cancer Society, pafupifupi maola 6,500 okha ndi omwe amawathandiza kuti azipaka chaka chilichonse, ndipo ambiri amagwiritsidwa ntchito kwa anthu omwe ali ndi vuto la chiwindi osati khansa.
Zotsatira Zowonongeka Zotheka
Kuwonjezera pa zotsatira zowonjezereka zomwe zimayambitsidwa ndi opaleshoni ya chiwindi (kutuluka magazi, matenda, mazira a magazi, mavuto a anesthesia, ndi chibayo), pali zotsatira zina zomwe zingagwiritsidwe ntchito ndi mankhwala omwe munthu ayenera kuwatenga pambuyo pake.
Mankhwalawa amateteza munthu kuti asakane chiwindi chawo chatsopano.
Chifukwa chakuti amaletsa chitetezo cha mthupi lanu, komabe anthu amakhala ndi kachilombo ka HIV.
Zina zomwe zingayambitse zotsatira za mankhwala osokoneza bongo ndi awa:
- Kuthamanga kwa magazi
- Cholesterol Chokwera
- Matenda a impso
- Matenda a shuga
- Thupi lofooka (lotchedwa osteoporosis)
Njira Zopanda Opaleshoni
Kwa anthu omwe ali ndi matenda a khansa ya chiwindi omwe sali opaleshoni, kuperekera kwa mankhwala ndi / kapena mankhwala opangira mankhwala angakhale chithandizo cha mankhwala. Mankhwalawa amawongolera ndipo mwina amawononga zivundi za chiwindi.
Thandizo la Ablation
Thandizo la ablation ndi njira yopanda opaleshoni yopha maselo a khansa ndipo ndiyo mankhwala omwe amagwiritsidwa ntchito kawirikawiri pa khansa ya chiwindi. Njirayi imaphatikizapo kuika singano kapena kufufuza mu chifuwa cha chiwindi ndikugwiritsa ntchito njira zosiyanasiyana kupha maselo.
Mitundu ya mankhwala opatsirana pogwiritsa ntchito amatchulidwa pogwiritsa ntchito njira zowononga maselo a kansa:
- Ma Radiofrequency ablation (RFA): Mafunde amphamvu a ma radio amawotcha ndikupha maselo a khansa
- Mafuta oledzeretsa (alcohol) ablation: Mowa umayikidwa mu maselo a khansa
- Cryotherapy : Mitambo yozizira kwambiri imadutsa mu chotupa kuti iwononge maselo a kansa
- Kuchulukitsa kwa microwave: Kutentha kwa microwaves kumafalitsidwa m'maselo a kansa
Monga momwe zilili, pali ngozi ndi zotsatirapo zowonjezereka pokhala ndi zotsatira. Ena mwa awa ndi awa:
- Kutsekemera ndi kuvulaza pamalo a khungu kumene singano kapena kafukufuku amaikidwa
- Kuwonongeka kwa mitsempha ya magazi m'chiwindi kapena minofu yoyandikana ndi chiwindi ngati singano kapena ndondomeko imayikidwa mosayenera
- Kutenga, kuphatikizapo abscess ya chiwindi
- Kuwonongeka kwa mankhwala a bile kapena ziwalo zina
- Kutulutsa mimba (chinthu chosadziwika chomwe maselo a khansa amwazikana pambali pa singano)
Thandizo la Embolization
Pakati pa kuyambira, magazi opatsirana khansa ya chiwindi amaletsedwa kotero khansara "ikusowa njala" ndipo sangathe kukula. Njirayi imatha kugwiritsidwa ntchito pa zivomezi za chiwindi zazikulu komanso / kapena sizichotsedwa opaleshoni.
Nthawi zina zimakhala zojambulidwa ndi chemotherapy (yotchedwa chemoembolization) kapena radiation (radioembolization).
Malemba
Mankhwalawa amagwiritsidwa ntchito pofuna kuthana ndi khansa yapamtunda kapena yotha.
Mankhwala ochiritsidwa ndiwo njira yoyamba yopatsira khansa yapamwamba ya chiwindi, kenaka ndi chemotherapy kapena immunotherapy ngati njira yachiwiri.
Zotsatira Zothandizira
Mankhwala ogwiritsidwa ntchito amachititsa kuti asokoneze zinthu zofunika kuti khansa ikule. Chithandizo chovomerezeka choyamba chochiza khansara yosatetezedwa (yomwe imatanthawuza khansa ya chiwindi yomwe siingakhoze kuchotsedwa opaleshoni) ndi Nexavar (sorafenib), yomwe ndi mankhwala omwe amaletsa omwe amaletsa chiwindi cha chiwindi popanga mitsempha yatsopano ya magazi.
Zotsatira zoyipa za Nexavar zikuphatikizapo:
- Kutopa
- Rash
- Kutaya njala
- Kutsekula m'mimba
- Kuthamanga kwa magazi
- Manja othamanga manja
Kwa anthu omwe sangathe kulekerera Nexavar, kapena ngati njira ina yoyamba yothandizira, mankhwala omwewo amatchedwa Lenvima ( lenvatinib ) angaganizidwe.
Phunziro la III, Lenvima (poyerekeza ndi Nexavar) anali ndi phindu lapamwamba lopulumuka (13.6 miyezi kupitirira 12.3), kuchuluka kwa mayankhidwe (24 peresenti ndi 9 peresenti), komanso nthawi yochulukirapo kwa matenda (7.4 miyezi ndi 3.7 miyezi ).
Zotsatira zofala za Lenvima ndi izi:
- Kuthamanga kwa magazi
- Kutsekula m'mimba
- Kuchepetsa kudya
- Kutaya thupi
- Kutopa
Mankhwala ena omwe amachititsa kuti Stivarga (regorafenib) amaletse mapuloteni omwe amathandiza maselo a khansa ya chiwindi kukula. Mankhwalawa tsopano akugwiritsidwa ntchito monga mankhwala achiwiri (kutanthauza ngati Nexavar kapena Lenvima ayima kugwira ntchito).
Zotsatira zoyipa zambiri zimaphatikizapo:
- Kutopa
- Kutaya njala ndi kuchepa kwa thupi
- Kuvala m'manja ndi mapazi
- Kuthamanga kwa magazi
- Chiwopsezo ndi matenda
- Kutsekula m'mimba
- Kupweteka kwa mimba
Chemotherapy
Chemotherapies ndi mankhwala omwe amapha khansa. Ngakhale kuti "chemo" nthawi zambiri imatengedwa ndi pakamwa kapena pamsana, pamatenda a khansa ya chiwindi, imatha kuperekedwa chiwindi mwachindunji kupyolera mu mitsempha yotchedwa hepatic artery infusion).
Malingana ndi mtundu ndi mlingo wa chemotherapy woperekedwa, munthu akhoza kukhala ndi zotsatira zosiyana monga:
- Kutaya tsitsi
- Zilonda zamkati
- Nsupa, kusanza, ndi / kapena kutsekula m'mimba
- Kuchepetsa kutaya kwa kuchepa kwa njala
Popeza mankhwala osokoneza bongo amachititsa kuti maselo a khansa akule bwino (maselo a khansa amakula mofulumira), maselo omwe amapezeka m'mafupa a munthu nthawi zambiri amawonongedwa. Izi zingachititse kuti zizindikiro zikhale zophweka komanso kutaya magazi, komanso kutopa komanso chiopsezo chotenga matenda.
Immunotherapy
Immunotherapy ndi chinthu chosangalatsa kwambiri, chosintha chithandizo chomwe chatsintha nkhope ya chisamaliro cha khansa. Zomwe zimayambitsa matenda a immunotherapy ndizochititsa kuti chitetezo cha mthupi chiteteze maselo a khansa.
Chifukwa cha khansa ya chiwindi, Opinivo (nivolumab) ya immunotherapy amagwira ntchito poteteza chitetezo cha m'thupi chomwe chimatchedwa imfa 1 (PD-1). Mapuloteniwa amapangidwa mwachinyengo ndi maselo a kansa kuti chitetezo cha mthupi cha munthu chisadziwe kuti ndi chachilendo. Choncho, poletsa PD-1, khansara ikhoza kuzindikiridwa ndi kuukira.
Opdivo amaperekedwa kupyolera mu mitsempha, milungu iwiri iliyonse. Zotsatira zake zingakhalepo:
- Kutopa kapena kufooka
- Fever
- Kukuda
- Nausea ndi kusowa kwa njala
- Kuwotcha komanso kuthamanga khungu
- Kupweteka kwa minofu kapena kuphatikiza
- Kutsekula kapena kutsekula m'mimba
Zotsatira zowopsa kwambiri zimaphatikizapo zomwe zimakhudzidwa ndi kulowetsedwa (zofanana ndi zomwe zimachitika) kapena njira yowonongeka, yomwe chitetezo cha mthupi chimayambitsa ziwalo zathanzi (mwachitsanzo, mapapo).
Mankhwala Ophatikiza (CAM)
Musanagwiritse ntchito zitsamba kapena chakudya, onetsetsani kuti adziwe dokotala wanu. Izi zidzakuthandizani kupewa zotsatira zosafunika zina ndi zochitika.
Sho-saiko-ku
Dokotala wina wotchedwa Sho-saiko-to (wotchedwanso Xiao Chai Hu Tang), womwe ndi osakaniza zisanu ndi ziwiri botanicals, kuphatikizapo ginseng, ginger, ndi licorice, wakhala akugwiritsidwa ntchito pochizira matenda a chiwindi ndi matenda a chiwindi.
Kafukufuku wina amasonyeza kuti mankhwala osokoneza bongo amathandizanso kuthetsa khansa ya chiwindi mwa anthu omwe ali ndi matenda a chibwibwi, ngakhale kuti njira yake yeniyeni siyikudziwika bwino. Ngakhale kuti Sho-saiko-kukhulupilira kuti imaloledwa bwino, ikhoza kuvulaza kupha mapapo ndi chiwindi, choncho zimangotengedwa motsogoleredwa ndi dokotala.
Holy Basil
Chitsamba china chotchedwa Ocimum sanctum L kapena "Holy Basil" ndi chomera chokhala ndi phytochemicals chomwe chimalimbikitsa thanzi la chiwindi. Amakhalanso ndi zotsutsana ndi khansa. Nthawi zina masamba obiriwirawa amagwiritsidwa ntchito m'ma Thai. Zilibe zotsatira zoyipa.
Nthata Yamadzi
Silymarin ( Silybum marianum ), wotchedwanso mkaka nthula , amagwiritsidwa ntchito m'mayiko ena (monga Germany) ngati chithandizo chochirikiza matenda aakulu a chiwindi. Amakhulupiriranso kuti ali ndi zotsutsana ndi khansa komanso amakhala ndi chitetezo chabwino, ngakhale kuti akhoza kuyambitsa matenda kapena kuchepa kwa zizindikiro.
Zakudya Zachilengedwe
Kuwonjezera pa zitsamba, zakudya zachilengedwe zingathandizenso kuteteza khansa ya chiwindi. Kafi ndi gwero la antioxidants ndipo likugwirizana ndi kuchepa kwa chiwopsezo cha khansa ya chiwindi ndi chiwindi. Komabe, palibe umboni wa sayansi umene ukuwonjezera kuchuluka kwanu kwa khofi (kapena kuyamba kumwa khofi ngati mulibe) ndi kopindulitsa.
Chakudya china chachilengedwe, resveratrol, chomwe chimapezeka mulberries, mphesa zofiira, ndi nthanga, zingakhale ndi zotsatira zotsutsa khansa kuphatikizapo kutetezera ku matenda omwe sichimwa mowa .
> Zotsatira:
> American Cancer Society. (nd). Kuchiza Khansa ya Chiwindi
> Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet. 2018 Mar 31; 391 (10127): 1301-14.
> Kim JW et al. Kutsogoleredwa kwa ultrasound komwe kumapangitsa kuti ziwombankhanga zisawonongeke: Momwe timachitira zimenezi bwinobwino. Korean J Radiol . 2015 Nov-Dec; 16 (6): 1226-39.
> Kudo M et al. Lenvatinib ndi sorafenib mu chithandizo choyamba cha odwala omwe ali ndi matenda osatetezeka a hepatocellular carcinoma: mwambo wapakati > gawo 2 losayesedwa. Lancet. 2018 Mar 24; 391 (10126): 1163-73.
> Waghray A, AR Murali, Menon KVN. Hepatocellular carcinoma: Kuchokera kuchipatala kuchipatala. World J Hepatol. 2015 May 18; 7 (8): 1020-29.