Ngati khansara yako ya m'mawere yayamba kufalikira kumatenda anu opanga mankhwala anu nthawi zambiri amakhala okhwima. Ndili ndi khansa ya m'mawere, sititha kudziwa kuti khansa ingafalikire bwanji. Popeza kuti metastases ndi amene amachititsa 90 peresenti ya imfa ya khansa ya m'mawere, kudziwa nthawi yoyenera kuchitira nkhanza, ndipo pamene mankhwala a adjuvant monga chemotherapy angakhale operewera, ndi ofunika.
Pamene khansara ya m'mawere imafalikira ku maselo am'mimba amatsimikizira kuti "cholinga chake" chakumana ndi matendawa. Mankhwalawa, ngati atasiyidwa okha, akhoza kufalikira thupi lonse ndipo pamapeto pake amachititsa imfa.
Kodi mankhwala opatsirana khansa ya m'mawere afala bwanji ku maseĊµera olimbitsa thupi, ndipo izi zikutanthauzanji kuti mukhale ndi vutoli?
Chifukwa cha Lymph Nodes Ndizofunikira pa khansa ya m'mawere
Khansara ya m'mimba imayamba ndi maselo angapo, omwe amasonkhana pamodzi m'matumbo anu. Iwo akhoza kumanga msasa mu machitidwe kumene mkaka wa m'mawere umatulutsidwa: mazira anu a mkaka ndi lobes. Pamene maselowa akukula ndikugawanitsa, amatha kupewanso minofu yoyandikana nayo.
Chotupa chochulukirachi chingayambe selo kapena maselo ambiri. Selo ya khansa yokhayokha ingagwiritse ntchito magazi anu kapena maselo a mitsempha ngati misewu ya misewu kotero kuti ikhoza kuyenda mu thupi lanu lonse. Mmene thupi lanu limayendera limagwiritsidwa ntchito pozungulira magazi kuti mupereke zakudya m'maselo anu onse, komanso kuchotsa zonyansa zamagetsi.
Mitsempha yam'mimbayi ndi "dzenje lakuya" pa msewu waukuluwu, kumene amadzimadzimadzi amadzimadzimadzimadzimadzi, osakaniza ndi maselo a mthupi (lymphocytes), ndipo amabwerera mmbuyo mumthambo wanu.
Choncho, ngati selo lopanda khansa limapangitsa maselo anu, ndizotheka kuti kansa ikhoza kutumizidwa limodzi ndi ziwalo zina za thupi lanu.
Ngati mukumva matenda, mitsempha yanu pafupi ndi malo okhudzidwa akhoza kutupa chifukwa iwo atenga majeremusi. Ndipo ngati mukuyamba khansa ya m'mawere, maselo am'mimba mumtundu wanu wam'mimba ndi malo omwe anthu ambiri amatha kukhala ndi khansa, zomwe zimapangitsa kuti ziwalozo zivule.
Kuzindikira Kugwiritsa Ntchito Sentinel Lymph Node Biopsy
Minofu ya m'mawere imakhala ndi ma lymph node, yomwe imayambitsa madzi am'mimba ndipo imadutsa. Matenda a pachifuwa amayamba kuthamangira kwa axilla kapena malo opondereza. Kufufuza malo omwe ali ndi kachilombo koyambitsa matendawa kameneka kumafunika kukhala mbali ya matenda opatsirana pogonana, komanso mawere omwe amadzipenda . Kutupa kwa mitsempha ya mitsempha kungakhale umboni wakuti khansara yayamba kufalikira pamtunda wanu, koma njira yokhayo yodziwira zowona ndiyo kuti iwo achoke ndi kuyesedwa.
Pali njira ziwiri zogwiritsira ntchito maselo am'mimba. Mu kansalu kamene kamakhala ndi mitsempha yambiri , dafi ndi chizindikiro chowonetsera mavitamini mumayikidwa mu khansa ya m'mawere. Ntho yoyamba kapena nambala yomwe daye imayendera imatchedwa kuti maselo amtundu wa sentinel-nambala yoyamba yomwe khansa iyenera kuyendera.
Njira ina yothandizana ndi matendawa amachititsa kuti thupi liziyenda bwino. Mwa njirayi, maselo onse a mitsempha omwe angapezekedwe m'kamwa mwanu amachotsedwa.
Taphunzira kuti kupeza maselo a khansa m'magulu anu a fetinel ndi njira yabwino kwambiri yodziwira ngati khansa iliyonse idzakhalapo kapena ayi.
Mafupa amtundu wambiri amakhala malo oyamba omwe khansa ya m'mawere imafalikira koma pali zosiyana. Matenda a khansa pakati pa chifuwa chanu amatha kutsuka ku mafupa pakati pa mabere anu. Pamene maselo am'thupi amachotsedwa amatumizidwa ku dipatimenti yoyang'anira matenda kuti ayang'ane pamaso ndi pansi pa microscope.
Maonekedwe a Lymph Node
Lipoti la matenda okhudzana ndi maselo a mthupi lanu limatchula ngati palibe chizindikiro chilichonse cha khansara chomwe chilipo m'matenda anu omwe amachotsedwa.
Mungamve mawu monga macrometastases kapena micrometastases pamene dokotala wanu akukambirana node zanu. Macrometastases amatanthawuza kufalikira kwa khansara ku mitsempha yambiri yomwe ikuwoneka kwa maso. Micrometastases m'malo mwake amatanthawuza umboni wa khansara m'makina a mitsempha omwe angakhoze kuwonedwa pansi pa microscope.
Ngati minofu yanu ili ndi khansara, mkhalidwe wanu wamakono umatchedwa zoipa ndipo umawerengedwa N0 molingana ndi TNM stage ya khansa ya m'mawere. Ngati muli ndi chotupa chaching'ono ndi mfundo zomveka bwino, nkosavuta kuti mupeze mankhwala a chemotherapy.
Ngati muli ndi maselo a khansa m'matenda anu, khansara yanu ikhoza kuonedwa kuti ndi yamaliseche . Malinga ndi TNM stage, chotupa chanu chikanatchedwa N1, N2, kapena N3 pogwiritsa ntchito ma lymph nodes omwe ali ndi maselo a khansa komanso kutalikirana ndi chifuwacho node zabwino zimapezeka.
Zofunika Zina Zofunika pa Chithandizo ndi Kugonjetsa
Mavuto a khansa ya mitsempha ndi imodzi mwa zifukwa zazikulu popanga zisankho zokhudzana ndi khansa ya m'mawere, koma palinso mayesero ena omwe amachititsa kuti azitsatiridwa komanso athandizidwe. Izi zikuphatikizapo:
- Kukula kwa chiberekero: Kukula kwa mimba kumathandiza kwambiri poyendetsa khansa ya m'mawere .
- Udindo wamtundu wa homoni : Makoseni anu a khansa ayesedwa kuti azindikire malo anu ovomerezeka a hormone , ndiko kuti, kaya maselo anu a kansa ali ndi receptors kwa estrogen kapena progesterone pamtunda, chifukwa zimathandiza kutsogolera chithandizo.
- Chikhalidwe cha H2: Kukula kwa anthu m'thupi la epidermal receptor 2 , ngati muli ndi maselo a khansa, kumathandizanso kuti mupeze chithandizo ndi mankhwala.
- Mapulogalamu a m'mimba: Kutupa msinkhu ndiyeso ya khansara ndipo mayesowa akhoza kutsogolera chithandizo cha mankhwala.
- Kukhalapo kwa metastases iliyonse: Ngati khansara yanu yafalikira kumadera ena a thupi, mwachitsanzo, mafupa anu kapena mapapu anu, izi ndizofunikira posankha chithandizo cha mankhwala.
Kuchiza kwa Anthu Okhala ndi Node Zabwino
Ngati muli ndi nthenda yodzitetezera ndipo ndi yoipa, simungayambe kukhala ndi lymph node dissection. Mosiyana ndi zimenezo, ngati muli ndi maselo a khansa mumtundu wanu wamatenda, mitsempha yothandizana nayo imatha kuphatikizapo opaleshoni yanu ya khansa ya m'mawere. Ngati ma lymph nodes anu ali othandiza, muyenera kukambirana njira zina zothandizira chithandizo ndi oncologist wanu mutatha opaleshoni.
Kuphatikizana ndi maselo a khansa kumasonyeza kuti khansara yasonyeza kuti ili ndi mphamvu yofalikira kupitirira chifuwa chanu ndipo mudzalangizidwa kukhala ndi mankhwala adjuvant monga chemotherapy kupha maselo ena a khansa omwe amapitirira mu thupi lanu. Chithandizo cha adjuvant chimatanthauza chithandizo chimene chimaperekedwa osati chifukwa khansara imawoneka, koma chifukwa akuganiza kuti pangakhale maselo ena a khansa omwe alipo.
Kwa omwe ali ndi zotupa zotchedwa estrogen, mankhwala opangidwa ndi mahomoni amawalimbikitsa zaka 5 mpaka 10 mutatha kuchiza. Izi zikhoza kukhala tamoxifen kwa anthu omwe ali ndi ammopaopausal ndi aromatase inhibitor kwa omwe ali pambuyo poopseza mimba. Azimayi omwe amatha kumwa mankhwalawa omwe amagwiritsa ntchito mankhwala a aromatase inhibitor, mankhwala a bisphosphate Zometa amalimbikitsidwa komanso amawoneka kuti amachepetsa chiopsezo chokhazikitsa mafupa a mafupa. Mafupa ndiwo malo ovomerezeka kwambiri a metastases ndi khansa ya m'mawere.
Mankhwalawa akhoza kapena sangakonzedwe malinga ndi chiwerengero cha minofu yomwe ili yabwino, ndi zina zomwe zimapeza za chotupa chanu.
Kuthamangitsani
Kugonjetsa, komwe kumatchedwanso maonekedwe, ndi njira imodzi imene dokotala akulankhulira za momwe zingakhalire kuti mutha kukwanitsa kukuthandizani mukamaliza mankhwala. Kumbukirani, kukhala ndi khungu imodzi yokha ya khansa m'thupi lanu ndi yambiri. Chithandizo chakonzedwa kuti chipha ambiri, ngati si onse, a maselo a khansa.
Ngati mutakhala ndi ziwalo zochepa komanso zochepa, chotupa chanu chitatha chithandizo chabwino. Pa mapeto ena a masewerawa, ngati mutakhala ndi ziwalo zingapo zogonana kapena chotupa chachikulu, mankhwala anu angakhale ovuta kwambiri, ndipo maganizo anu adzakhala ovuta kudziwa mpaka mutatha mankhwala onse. Nkhani ina yofalitsidwa ku New England Journal of Medicine imasonyeza kuti pangakhale vuto lalikulu la kubwereza kwa odwala omwe ali ndi mitsempha yambiri kapena yowonjezera yabwino. Ndiponso. kukula kwa chotupa ndi chinthu chovomerezeka chodziimira.
Ziribe kanthu komwe matenda anu akugwiritsidwa ntchito pazomwezi, chonde dziwani kuti mitengo yowonjezera ikukula, mankhwala amayamba kukhala opambana komanso ogwira mtima, ngakhale ngakhale khansa ya m'mawere imatha kuthandizidwa kwa nthawi yaitali.
Lymph Node Rating
| Lymph Node Rating | Malingaliro a Kuwerengera |
| N0 | Zoipa kapena zomveka - ziribe khansa komanso micrometastasis |
| N1, 2, 3: Zokwanira (zosakhudzidwa) zamagulu | |
| N1 | Khansara imapezeka mu 1-3 minofu pansi pa mkono kapena mitsempha mkati mwa bere |
| N2 | Khansara imapezeka m'magulu a 4-9 pansi pa mkono kapena mitsempha mkati mwa bere |
| N3 | Khansara imapezeka mu maselo 10 kapena kuposerapo pansi pa mkono kapena imafalikira pansi kapena pamwamba pa collarbone. Mwinamwake mwapezeka mu nthiti zosagonjetseka komanso mitsempha yam'mimba mkati mwa bere |
Mfundo Yofunika Kwambiri
Ngati muli ndi ma lymph node ndi khansa ya m'mawere oyambirira, mankhwala amatha kukhala oopsa komanso amachititsa mankhwala enaake, mankhwala omwe amachititsa anthu omwe ali ndi HIV, komanso ma radiation. Izi zati, anthu ambiri omwe ali ndi khansara yokhala ndi chithokomiro amakhalabe osagwidwa ndi khansa pambuyo pochiritsidwa, ndipo maonekedwe abwino a mliri sangathe kutanthauza kuti khansara ikhoza kubwerera.
Zotsatira:
Laronga, C. Patient Information: Buku la khansa ya m'mawere kuti mudziwe ndi chithandizo (kupatulapo zofunikira). Zaposachedwa.