Kodi ndi mankhwala otani omwe angapezekanso ndi khansara yowonongeka? Khansara yanga ya mazira ndi yobwerera kapena siinayambe yatha pambuyo pa mankhwala oyamba. Ndiyenera kuchita chiyani tsopano? Limenelo ndilo funso limene odwala ambiri odwala khansa amawafunsa panthawi ina. Mwamwayi, anthu pafupifupi 80% omwe amayamba mankhwala a chemotherapy woyamba, khansa imabwerera.
Yankho la funsoli likudalira momwe matendawa anagwiritsidwira ntchito komanso kuti kutha kwa mankhwala oyamba kumeneku kunatha bwanji.
Kawirikawiri, pali magulu atatu osiyana omwe amanyamula ma prognose atatu ndipo nthawi zambiri amapita ku madongosolo atatu osiyana ochizira. Komabe, kupitirira apo, chonde dziwani kuti ngakhale pali njira yabwino kwambiri yopezera njira zoyamba zothandizira, chithandizo cha kubwereza chimakhala chapadera kwambiri.
Ngakhale pali malangizo abwino kwambiri, palibe malamulo omwe amavomereza. Kawirikawiri, nthawi yochulukirapo isanayambe kubwerekanso bwino mwayi wochiritsidwa kapena kupuma kwachiwiri kwachiwiri. Ndiponso, pali zina zambiri zomwe mungapeze pazomwezi.
Kubwereza Patatha Miyezi Isanu ndi umodzi
Ngati kubwereza kumapezeka patadutsa miyezi isanu ndi umodzi (6) kuchokera kuchipatala (makamaka pafupi ndi chaka), chotupacho chimaonedwa kuti ndi "chodziwika ndi platinamu" ngati mankhwala oyamba ali ndi mankhwala a platinamu (Carbo-platin kapena Cis-platin). Pambuyo pake, kubwereranso pambuyo pa mfundoyi, ndibwino kuti zikhale zomveka kuchita opaleshoni yachiwiri yothandizidwa kuti muchotse khansa yambiri ngati n'kotheka.
Amayi ambiri odwala matenda odwala matendawa amatha kuganizira kwambiri ngati khansayo imatha zaka zingapo pambuyo poyambanso kuchipatala ndipo misa kapena masisitere ali / amawonedwa pawongosoledwe kapena kumverera pamayesero. Komabe, zikhoza kukhala njira yabwino kwambiri musanafike nthawi yomweyi, malingana ndi momwe mulili.
Kuchita opaleshoni yachiwiri ya opaleshoni yowonjezeredwa kapena yosapitirira, opaleshoni ambiri amatha kupereka mankhwala omwe amagwiritsidwa ntchito nthawi yoyamba, makamaka ngati kubwereza kumapezeka patapita chaka chimodzi kuchokera kuchipatala choyamba.
Ngati imapezeka pakati pa miyezi 6 ndi chaka mutatha mankhwala, zosankha zingakhale kuphatikizapo Taxol ndi Cis-Platinum kapena Carbo Platin, kapena kugwiritsa ntchito mankhwala atsopano monga momwe tafotokozera pansipa. Odwala ambiri amatha kugwiritsa ntchito mankhwala atsopano panthawiyi.
Kubwereza M'miyezi Isanu ndi umodzi
Ngati kubwereza kukupezeka patadutsa miyezi 6 kapena kupatula patatha kuchipatala koyamba, chotupacho chimaonedwa kuti ndi "kupinyika kwa platinamu" . Chotupacho chiyenera kuti chinabwerera mmbuyo kumapeto kwa mapeto kapena pambuyo pa mankhwala oyambirira. Muzochitika izi, kubwereza opaleshoni sikunalimbikitsidwenso chifukwa sikungatheke kusintha moyo wautali kapena khalidwe labwino. Pali mankhwala akuluakulu atatu omwe amagwiritsidwa ntchito masiku ano omwe ambiri amapanga mofanana. Zonse zimagwira ntchito mofanana bwino ndipo zingagwiritsidwe ntchito motsatira, imodzi pa nthawi, monga mankhwala amodzi kapena ena amasiya kugwira ntchito. Izi ndi: Doxil, Topotecan ndi Gemzar. Mankhwala ophatikizana akhala akuyesedwa, koma kawirikawiri popanda kupambana kwakukulu bwino ndi zotsatira zoopsa za poizoni. Komabe, mkhalidwe uliwonse ndi wosiyana, choncho chonde funsani dokotala za zonse zomwe mungachite. Ngakhale mankhwala ozunguza bongo ndi mankhwalawa angathe kupitirirabe, muyenera kukumbukira kuti mwayi wochiritsidwa ndi wochepa kwambiri ndipo kusunga khalidwe labwino m'maganizo ndikofunika kwambiri.
Apanso, izi ndizokambirana / phindu ndi dokotala wanu.
Nthawi Yowonjezereka Pambuyo Pambuyo Patatha Chithandizo
Ngati kubwereza kwenikweni ndi kukula kwa khansa pa nthawi yoyamba mankhwala, izi zimatchedwa "platinum refractory", kapena vuto lalikulu la kukana chemotherapy. Mankhwala othandizira ena angaperekedwe, makamaka pogwiritsa ntchito mankhwala omwe atchulidwa pamwambapa, koma mwayi woyankha ndi wotsika kwambiri. Komanso, kumbukirani kuti mankhwala omwe tatchulidwa pamwambawa si OYERA okha omwe amapezeka kuchipatala, amangoonedwa ngati abwino kwambiri kuyesa poyamba. Funsani dokotala wanu za ena ndi mwayi umene angakhale nawo kuti athandizidwe pazochitika zanu.
Izi zikhoza kukhala nthawi yabwino kuti mufunse za zodalirika koma zosankha zosagwiritsidwa ntchito kudzera m'mayesero a zachipatala.
Mayesero Amakono
Pali zovuta zambiri zachipatala zomwe zikuchitika pa khansara ya ovary yomwe yasintha, ndipo kufufuza kuyang'ana zina mwazimenezi ndizolimbikitsa. Lankhulani ndi oncologist wanu za mayesero omwe angakumane ndi vuto lanu, kapena ganizirani lingaliro lachiwiri. Zina mwa njirazi ndizo mankhwala othandizidwa ndi mankhwala omwe amatengera makamaka ma cancer, ndipo mankhwala amodzi a mankhwala osokoneza bongo otchedwa PARP inhibitors amavomerezedwa kuti agwiritsidwe ntchito mu 2015.
Kulimbana ndi Mchitidwe Wopereka Chithandizo
Mawu onena za "opaleshoni yolepheretsa" ndi "miyendo yothandizira". Ngakhale opaleshoni sichikuthandizani kuchipatala nthawi zina, pakhoza kukhala opaleshoni zomwe "palliate" kapena kuthandizira kuthetsa zizindikiro. Nthawi zambiri, izi zikhoza kukhala opaleshoni yoperekera m'mimba kapena kuchotsa malo amodzi otsekedwa m'matumbo (kawirikawiri magawo ambiri amatsekedwa) kuti alole wina kudya chakudya kwa miyezi ingapo. Nthawi zina, izi zingatanthawuze kupaka chubu m'mimba kudzera mu khungu (gastrostomy) kotero kuti kusanza kumatulutsidwa ndipo chubu m'mphuno (NG tube) sichiyenera kukhazikika kwa milungu kapena miyezi.
Nthawi zina mu khansara yambiri, madzi amadziwika m'chifuwa. Njira zosiyanasiyana zowonongeka kwa madzi, kuphatikizapo ma tubes ndi njira zochepetsera (pleurodesis) , zingathandize kuthetsa kapena kuchepetsa chidziwitso ndi kuthandiza ndi kupuma. Izi ndi zitsanzo zingapo, koma pazochitika ndizochitika, njira ina ya opaleshoni kapena njira zowonongeka za radiologically zingakhale zothandiza kwa inu. Ngati muli ndi vuto linalake, funsani ngati njira ina yothandizira kapena yowopsya ingakhale yothandiza.
Pomalizira, ngakhale kuti khansa yosawerengeka, yosavuta imaphatikizapo mafupa anu, nthawi zambiri imapweteka kwambiri. Komanso kawirikawiri imatha kufalikira ku ubongo ndikupweteka. Pazochitika zonsezi, mankhwala odzoza mazira m'deralo angakhale othandiza kuchepetsa kapena kuthetsa zizindikiro.
Chitsime:
National Cancer Institute. Ovarian epithelial, Tube ya Fallopian, ndi Chithandizo chachikulu cha khansa ya Peritoneal Treatment-kwa akatswiri azaumoyo (PDQ®). Kachiwiri kapena Kupitiriza Ovarian Epithelial, Tube ya Fallopian, ndi Chithandizo Choyamba cha Khansa ya Peritoneal. Kusinthidwa 08/21/15. http://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq#section/_82