Khansara ya m'mimba imatopa mokwanira popanda mantha kuti ikhoza kupita kumadera ena a thupi. Metastasis ndilo kufalitsa kwa khansa. Azimayi pafupifupi 250,000 amapezeka ndi khansa ya m'mawere ndipo pafupifupi 40,000 amafa ndi matendawa chaka chilichonse. Pamene khansa ya m'mawere imapezeka m'mayambiriro oyambirira, amai ambiri amapita ku moyo wopanda khansa.
Komabe kwa ena, matendawa ndi ovuta panthawi yomwe akudziwunikira kapena pambuyo pake akubwereranso. Zimaganizidwa kuti matenda a metastatic ndi omwe amachititsa pafupifupi 90 peresenti ya imfa yomwe imakhudzana ndi khansa ya m'mawere. Kodi khansa ya m'mawere imafalikira motani kapena kubwereranso?
Kusanthula koyamba
Kuopsa koti khansa ya m'mawere idzabwererenso kapena kufalikira ikugwirizana ndi kukula kwa chotupacho ndi kukula kwa kufalikira pa nthawi ya matenda.
Azimayi pafupifupi 20 peresenti, khansa ya m'mawere imapezeka pa nthawi yoyamba kwambiri. Gawo 0 khansa ya m'mawere kapena carcinoma in situ ikuonedwa ngati khansa ya m'mawere isanafike. Popeza kuti khansa yapachiyambi sinafalikire kupitirira chinthu china chotchedwa chipinda chapansi (osasunthira kupyola pamatope), opaleshoni ayenera katswiri kuchiritsa khansa izi.
Enanso 70 peresenti ya anthu amapezeka kuti ali ndi kansa ya m'mawere yomwe imakhala yosawerengeka (kufalikira kwa ziwalo zakutali). Khansa ya m'mawere, yomwe imatengedwa kuti ndi yapakati ya 1 mpaka 3, imatha kufalikira ku maselo a mitsempha koma sichipezeka m'ziwalo zina.
Ndi mankhwala monga opaleshoni , chemotherapy , mankhwala a radiation , mankhwala a hormonal , ndi / kapena mankhwala othandizira, zambiri mwa zotupazi zidzatha. Zowopsa, komabe, kuti zidzawonekera kachiwiri (recur) ndi zazikulu ndi magawo apamwamba ndipo ngati mitsempha yamagulu ikuphatikizidwa.
Amayi ocheperapo 10 pa 100 aliwonse amapezeka kuti khansayo yayamba kufalikira kumadera akutali a thupi.
Khansara ya m'mimba imatha kufalikira mafupa, chiwindi , mapapo, ndi ubongo.
Kubwereza
Ambiri amayamba ndi khansa ya m'mawere yomwe imabwereranso. Kubwereza kungakhale:
- Mderalo: M'kati mwa bere
- Zachigawo: M'makina a minofu kapena khoma la chifuwa
- Kutali: M'ziwalo zakutali
Khansara ya m'mawere ikatuluka patali siipiranso koma imachiritsidwa, ndipo mankhwala amatha kusintha zizindikiro ndikuwonjezera moyo.
Kuopa ndi Kumvetsa
Anthu ambiri amaopa kubwerera kwa khansa ya m'mawere, koma ambiri amatha kupeza bwino pakati pa kudziŵa ndi kukhala opunduka ndi mantha. Ndizochilendo komanso zachilendo kuti mukhale ndi chidwi chowonjezereka ngati mumakhala ndi zizindikiro zotheka kufalikira mutatha khansa ya pachifuwa. Mutu umangokhala mutu wamtundu chabe, koma lingaliro la ubongo la metastases lingathe kukumbukira. Mofananamo, kupweteka kumbuyo kwanu kungakupangitseni kudandaula za masastases a mafupa pamene kuli kovuta kwambiri kuti mugone molakwika.
Ndikofunika kuti mkazi aliyense (ndi mwamuna) amene ali ndi kansa ya m'mawere adziŵe za ziyembekezero zawo. Wachikulire wanu akhoza kukuthandizani kumvetsa izi kuchokera pa khansara yanu, siteji yake, ndi zina.
Kukhala ndi chidwi chowonjezeka kungathandize kuti muzitsatira ndi maulendo oyenera komanso nthawi yoyenera. Ngati mantha akukufooketsani, komabe katswiri wa khansa akhoza kukhala wamtengo wapatali kukuthandizani kukhalabe pakati pa kukhala ndi chikumbumtima ndi mantha.
Mmene Khansara Yamatenda Amafalikira
Khansara ya m'mimba ikhoza kufalikira kumadera ena a thupi m'njira zitatu zoyambirira:
- Kupyolera mu maselo am'mimba: Mitsempha ya m'mawere imatha kuchoka ku chotupa cha m'mawere ndikulowa mitsuko yaying'ono yomwe imapezeka pamabere. Kuchokera kumeneko amatha kunyamula kudzera m'mayendedwe amphamvu kwambiri kupita kumalo osungira thupi. Ndimaliseche yomwe imafalikira yomwe ndi gawo lofunika kwambiri la matenda ndi khansa ya m'mawere. Ngati chotupa chafalikira kuchokera pachifuwa kupita ku mtsempha wamtenda (ngati khansara ili ndi lymph node positive ) yatha "kufotokoza" cholinga chake chofalitsa kupitirira chifuwa. Anthu akhoza kusokonezeka kwambiri akawerenga mauthenga awo . Ngati khansara yafalikira kumalo osungira mafupa oyandikana nawo, lipotili likhoza kunena kuti "maselo amtundu wa minofu." Izi sizikutanthauza kuti muli ndi khansa ya m'mawere, ndipo ngakhale maphunziro oyambirira a khansa ya m'mawere a m'mawere akhoza kukhala ndi matenda a mimba.
- Kudzera m'magazi: Monga momwe zilili ndi zida zazing'ono m'mimba, pali mitsempha yaing'ono yambiri ya magazi. Maselo a khansa akhoza kuwononga mitsempha yaing'ono yamagazi ndipo amatengedwa kudzera m'magazi kupita kumadera akutali, makamaka malo monga mapapo ndi chiwindi omwe ali ndi magazi ambiri.
- Kugonjera kwa m'deralo: Khansa ya pachifuwa ingathenso kufalikira kumatenda oyandikana nawo monga khoma la chifuwa kapena nthiti. Maselo a khansa ndi osiyana ndi maselo obadwa m'njira imeneyi. Matenda a Benign amakula ndikukankhira pamatumba apafupi, nthawi zina amawononga. Koma zotupa za khansa zimayambitsa ziphuphuzi. Ndipotu, mawu akuti "khansa" amachokera ku mawu achigriki otanthauza "nkhanu" pofotokoza zalabu monga kufalikira kwa khansa m'matumba apafupi.
Khansara ya m'mawere ikamapita kuchiwalo china imakali khansa ya m'mawere. Mwachitsanzo, ngati khansara ya m'mawere iyenera kufalikira m'mapapu sikukanatchedwa khansara yamapapo. M'malo mwake, tikhoza kutchula ngati khansa ya m'mawere m'mapapu kapena khansa ya m'mawere ndi masitimu a mapapo. Ngati mutayang'ana maselo a khansa m'mapapu pansi pa microscope iwo adzakhala maselo a khansa ya khansa, osati maselo a mapapo a khansa.
Khansa yomwe yafalikira ku ziphuphu zina zingakhale zosiyana ndi chotupa choyambirira, ndipo izi ndi malo ena osokonezeka. Khansa si khungu chabe la maselo osadziwika omwe amafalitsa mopanda nzeru. M'malo mwake, iwo akusintha mosalekeza ndikusintha kusintha kwatsopano. Pachifukwa ichi, chotupa chomwe chinali estrogen receptor chitsimikizo pamene chipezeka m'mimba chikhoza kukhala estrogen receptor nthenda. MALO ake 2 angasinthe komanso. Izi zimafotokozeranso chifukwa chake zotupa zamatenda nthawi zina zimakhala zowawa kuposa chifuwa choyambirira.
Chifukwa Chake Iwo Akufalikira ndi Kukhalanso
Mwinamwake mukudabwa kuti chifukwa chiyani maselo a khansa ya m'mawere amayenda nonse. Kapena, chifukwa chiyani maselo achibadwa samatha kufalikira pozungulira matupi athu. Maselo a khansa amasiyana ndi maselo ochibadwa m'njira zosiyanasiyana. Chimodzi mwa izi ndi maselo achibadwa omwe amadziwika kuti "ma molekyulu." Mamolekyu awa amathandiza ngati guluu ndi kusunga maselo omwe ali mbali ya thupi.
Maselo ozolowereka ali ndi "malire" kapena njira zomwe maselo amalankhulana. Izi zikufanana ndi dziko lina ndikuuza wina "simuli pano." Maselo a khansa, mosiyanitsa, samalemekeza mauthenga a mafoni, makamaka kunyalanyaza "mipanda" pakati pa matenda osiyanasiyana.
Nkhani ina yosokoneza poyankhula za kufalitsa khansa ya m'mawere ndichifukwa chake zikhoza kuchitika zaka kapena makumi angapo pambuyo pake. Tikudziwa kuti, makamaka ndi khansa ya m'mawere yotchedwa estrogen, khansara ikhoza kuwonekera kokha kuti idzabwererenso zaka zambiri pambuyo pa chotupa choyambirira. Palibe amene amadziwa bwino momwe izi zimachitikira, koma pali ziphunzitso zokhudzana ndi kubwereza zomwe zimasonyeza kuti maselo a kansa ya m'mawere ndi owopsa kuposa ena ndipo kuti "maselo a khansa" amatha kukhala ochepa ngakhale mwachipatala.
Zowopsa
Sitikudziwa kuti ndi khansa ya m'mawere iti yomwe idzabwererenso ndi zomwe sizidzatero, koma pali zina zomwe zimapangitsa chiopsezo. Izi zikuphatikizapo:
- Khansa yomwe ili miyeso yapamwamba (mwachitsanzo, siteji 3 vs siteji 1)
- Khansa yomwe yafalitsidwa ku maselo am'mimba
- Khansa yomwe ili yowopsya (ili ndi digiri yapamwamba kwambiri )
- Khansa yomwe imapezeka kwa atsikana
Zizindikiro
Ngati muli ndi metastases mungakhale kapena mulibe zizindikiro zilizonse. Mavitamini ena amapezeka pamayesero owonetsetsa, monga phokoso la fupa kapena PET. Popeza mayeserowa amatha kuona kuti maseŵera amatha, amayi omwe ali ndi khansa ya m'mawere oyambirira angadabwe kuti ndichifukwa chiyani zochitika zowonongeka nthawi zonse sizichitika. Chifukwa chake ndikuti ngakhale metastases ikhoza kuzindikiridwa posachedwa poyang'ana, kupeza malowa kufalikira musanakhale ndi zizindikiro ziribe kusintha.
Zizindikiro zowopsa za khansa ya m'mawere imakhala ndi kumverera kosalekeza, kutaya thupi mwangozi , kapena kuchepa kwa njala.
Pamene khansa ya m'mawere imafalikira kumapapo imatha kupangitsa mpweya ndi chifuwa. Matenda a chiwindi chifukwa cha khansa ya m'mawere ingabweretse vuto la m'mimba ndi jaundice, kutuluka kwa khungu kwa khungu.
Malo ambiri omwe amapezeka pamatumbo ndi mafupa, ndipo zizindikiro zimakhala ndi ululu. Nthawi zina chizindikiro choyamba ndi kupweteka kwa matenda , kupasuka kumene kumachitika m'fupa kumachepa ndi chotupa ndipo nthawi zambiri chimakhala ndi vuto lalikulu. Mitsempha ya ubongo ingayambitse zizindikiro monga mutu, kuwona masomphenya, kufooka, ndi kufooka, kapena kugwa.
Podziwa izi, amai omwe ali ndi kansa ya m'mawere oyambirira angakhale amanjenje ngati atakhala ndi zizindikiro izi. Ndikofunika kukumbukira kuti amayi omwe sali ndi khansa ya m'mawere amadwala mutu. Koma khalani wofatsa ndi inu nokha. Anthu omwe sakhala ndi khansa ya m'mawere akhoza kukunyengererani chifukwa cha nkhawa zanu zokhudzana ndi mabala ndi ululu watsopano, koma omwe ali ndi khansa ya m'mawere adzalandira. Ngati zimatengera chizindikiro kuti mutha kusuka, onetsetsani kuti mutero.
Kudziwa
Madokotala ali ndi njira zingapo zodziwira ngati khansara yayamba kapena ayi. Izi zimaphatikizapo kujambula thupi pogwiritsira ntchito x-ray, fupa la fupa, MRIs, CT, kapena PET. Mayeso a magazi amatha kuyang'ana ma makina ena m'magazi, kuphatikizapo zizindikiro zowonongeka zogwirizana ndi metastasis.
Komanso, madokotala amakhulupirira kwambiri zinthu zomwe zimakhalapo, zomwe zimasonkhanitsidwa ndi kuchotsa opaleshoni kapena kuchotsa singano. Zitsanzo zimenezi zimayang'aniridwa ndi microscope kuti ziwonongeke zam'manja zomwe zimasonyeza ngati pali chiwerengero cha khansa.
Chithandizo ndi Zochitika
Khansara ya m'mawere imakhala gawo 4 (metastatic) silimachira koma imachiritsidwa. Mankhwala opatsirana pogonana ndi khansa ya m'mawere imaphatikizapo chemotherapy, mankhwala opatsirana, mankhwala opatsirana mitsempha, mahomoni, komanso mankhwala atsopano monga mankhwala osokoneza bongo. Matenda otsekedwa, monga a ubongo, nthawi zina amachizidwa ndi opaleshoni kapena mankhwala opatsirana.
Kawirikawiri, cholinga cha chithandizo n'chosiyana kwambiri ndi kansa ya m'mawere poyerekeza ndi magawo oyambirira a matendawa. Ndi matenda oyambirira, nthawi zambiri mankhwala amawopsa ndi cholinga chochiza khansa. Pogwiritsa ntchito siteji yachinayi, chiwerengero cha mankhwala ochepetsera matendawa ndi cholinga. Kuwongolera mofulumira masitepewa sikungowonjezera zotsatira koma kumawonjezera chiopsezo cha zotsatirapo ndi umoyo wosauka.
Mawu Ochokera
Azimayi ochepa ali ndi kansa ya m'mawere panthawi ya matenda, koma nthawi zambiri metastases imakhala ikuyenda mofulumira kwambiri. Mpata kuti khansa idzabwererenso imadalira zifukwa zambiri. Kuopa kubwereza kungachititse anthu ena kukhala ndi nkhawa, ngakhale kuti nthawi zambiri anthu amatha kupeza bwino. Kusamala kwina kuli kofunika pothandiza amayi (ndi amuna) kutsatila ndi mankhwala ovomerezedwa ndi kuwatsata.
Khansara ikhoza kufalitsa m'deralo kumatenda apafupi kapena kudzera m'magazi ndi magazi. Popeza ndi kufalikira kwa khansa ya m'mawere yomwe imapangitsa anthu ambiri kufa ndi matendawa, ofufuza ambiri akuyang'ana pa zifukwa zomwe maselo a khansa angafalikire komanso zomwe zingawalepheretse kuchita zimenezo.
> Zosowa
> American Cancer Society. Khansa ya m'mimba Zolemba ndi zizindikiro 2017-2018 .
> Muzes, G., ndi F. Sipos. Cell Metastatic Dormancy ndi Kubwezeretsanso: Zowonjezereka pa Zambiri za Zochitika Zakale Zowopsa kwa Khansa Kubwerera. Anticancer Agents mu Medicinal Chemistry . 2017. 17 (4): 472-482.
> National Cancer Institute. Khansa ya Metastatic.