Ngati mwamvapo kuti khansara yanu kapena ya wokondedwa wanu ndi "osakhulupirika" kodi izi zikutanthauza chiyani? Ndi zifukwa ziti zomwe khansara, makamaka yaing'ono, idzakhala yosasinthika? Kodi opaleshoni ikhoza kuthekeratu kamodzi ngati khansara sichidalirika? Kodi khansa imeneyi imachiritsidwa bwanji?
Tanthauzo
Khansa yosatsutsika imatanthauzidwa ngati imodzi yomwe singathe kuchotsedwa kwathunthu kudzera mu opaleshoni.
Popeza kuti opaleshoni nthawi zambiri imapereka chithandizo chabwino kwambiri chochizira ndi zotupa zamphamvu, izi zikhoza kukhumudwitsa nkhani kuti mumve.
Komabe chifukwa chakuti chotupa sichingatheke sichikutanthauza kuti sichingatheke. Ndikofunika kudziwa kuti pakupita patsogolo kafukufuku wa khansa, sizitsulo zonse zomwe poyamba sizingatheke zidzathabe mpaka kalekale. Izi zikufotokozedwa mozama pansipa.
Zifukwa Zopweteka Zingakhale Zosakanika
Chotupacho chingakhale chosadalirika pa zifukwa zingapo. Ena mwa awa ndi awa:
- Kukula kwa chotupa: Chotupacho chingakhale chachikulu kwambiri kuti chisachoke bwino, kapena chikhoza kutanthauza kuchotsa chofunikira kwambiri chofunikira kuti opaleshoni ichitike.
- Malo a chotupa: Chotupacho chingakhale chosakanikirana ndi mitsempha ya magazi ndi zinthu zina zofunika m'thupi kuti zithetse chitetezo chotheka.
- Kufalikira kwa chotupa kumalo akutali (metastases): Popeza khansara ya metastatic (kansa ya sitiroyo 4) yafalikira kumadera opitirira chifuwacho, kuchotsa chifuwa sikudzaletsa khansala yonse. Mankhwala opanga opaleshoni ndi ma radiation amaonedwa kuti ndi am'deralo, amangochita malo okhawo omwe ali ndi chotupa komanso minofu yambiri. Mosiyana ndi zimenezi, mankhwala a chemotherapy, mankhwala ochizira, mankhwala ochiritsira, ndi ma immunotherapy ndiwo mankhwala ochiritsira-amachititsa maselo a khansa omwe ali paliponse m'thupi (chosiyana ndi chakuti mankhwala ena a mankhwala ndi mankhwala ena savuta mosavuta kupyolera mwazi za ubongo metastases zovuta.)
- Zochitika zina zaumoyo zomwe zingachititse opaleshoni: Monga matenda a mtima, mapapo a m'mapapo, kapena matenda a shuga omwe angachititse opaleshoni kuzipatala zosavomerezeka.
Chithandizo
Ndikofunika kukumbukira kuti chifukwa chakuti chotupa sichingatheke, sichikutanthauza kuti sichivulaza. Mankhwala othandiza-mankhwala omwe amachiza thupi lonse osati malo okha a khansa-akhoza kuwonjezera moyo ndi kusintha zizindikiro za anthu ambiri omwe ali ndi khansa.
Ngakhale kuti timakonda kuchitidwa opaleshoni ndi khansara ya "kuchiza" khansara , zina mwa njira zamakono zatsopano zothandizila zingapereke mwayi wamoyo wamuyaya. Zitsanzo za khansara yamapapo zimakhala ndi matekinoloje atsopano a ma radiation, mankhwala a immunotherapy , ndi mankhwala othandizidwa ndi njira yosinthira kuchipatala china chomwe chimakhala chotsutsana. Ndipotu, chiwerengero cha khansa yapamwamba yambiri ikukula chifukwa cha izi.
Kupatulapo ku Malamulo
Ngakhale kuti panthawi ina panaganiziridwa kuti kusakayikira kunatanthauza kuti sitingathe kukhulupilika, maganizo awa akusintha. Kuwonanso kwa zolembedwa mpaka lero kumasonyeza zitsanzo zambiri za matenda oopsa monga khansa yaing'ono ya m'mapapo ya m'mapapo, khansara yakuda ndi chiwindi metastases, khansa ya chikhodzodzo, exocrine khansa yapakhungu, khansa yapakhungu, ndi zina zambiri, zomwe zimapweteka kwambiri ndi chemotherapy komanso nthawi zina mankhwala (omwe amatchedwa neoadjuvant therapy kapena kuchepetsedwa) adachepetsa kukula kwa chotupa mpaka pamene opaleshoni inkatha; ziphuphu zomwe zinali zosakayikira poyamba zinayamba kusinthika.
Mutu wa Oligometastases
Mfundo ina yatsopano ndi yotsitsimutsa yomwe kale inali khansara yosakayikira ndi lingaliro la oligometastases. Liwu lakuti oligo limatanthauza zochepa, ndipo zomwe izi zikufotokozera ndi chotupa cholimba chomwe chiri ndi malo amodzi kapena ochepa chabe omwe awonetseratu.
Mwachindunji khansa ya metastatic kapena sitiroko 4 ingaganizidwe ngati ikulephera; Kuchita opaleshoni sikungathe kuthana ndi zotupa zonse. Lingaliroli ndilokuti opaleshoniyo idzakhala yosasokonezeka bwino komanso zoopsa ngati sizikanakhala zosiyana kwambiri ndi vutoli. (Tawonani, pali zina zosiyana ndi lamulo ili, mwachitsanzo khansara ya ovarian opaleshoni yokha (cytoreduction) kapena " opaleshoni yowonongeka " ingatengedwe kukhala yaitali kwa moyo.)
Chitsanzo cha mankhwala ogwiritsira ntchito njirayi chikanakhala chithandizo cha kansa yaing'ono yopanda mphamvu ya maselo m'mimba mwa wodwala ndi khansara yamapapo kuphatikizapo imodzi kapena masewera angapo a ubongo.
Panopa pali anthu omwe adachitidwa opaleshoni ya kansa yawo yamapapo komanso kuchotsa mitsempha imodzi kapena ingapo ya ubongo yomwe yakhala ikupulumuka nthawi yaitali.
Pansi
Ngati mwamva kuti chotupa chanu sichiri chosakwanira, mwina mukudandaula, koma kumbukirani kuti khansa yosadalirika ikuchiritsidwabe. Ngakhale kuti nthawi zambiri sichizachiritsidwa (ndi zina zosiyana), mankhwala monga chemotherapy, mankhwala ochiritsira, mankhwala a hormonal, ndi immunotherapy nthawi zambiri akhoza kuwonjezera moyo, kuchepetsa zizindikiro, ndipo, kwa anthu ena, amachititsa kuti matenda awo adziwe nthawi yayitali (yotchedwa yankho lokhazikika la oncologists.)
Kupezeka ndi khansa yosakwanira sikukutanthauza kuti khansa sidzagwira ntchito. Ena khansa amachitapo kanthu pa mankhwala monga chemotherapy ndi mankhwala omwe amawotchedwa radiation ndipo amachepetsedwa kukula kotero kuti opaleshoni ikhoza kutha.
Komanso amadziwika kuti: sagwiritsidwa ntchito
Zitsanzo: Chifukwa cha malo a chifuwa cha John - pokhala pafupi ndi mtima wake - adokotala anamuuza kuti chotupa chake chinali chosadalirika, ndipo kuphatikiza mankhwala a chemotherapy ndi ma radiation ndi njira yabwino kwambiri ya khansara yake.
> Zotsatira:
> Fabre, E. ndi al. Kusinthika kwa mankhwala ophera tizilombo toyambitsa matenda a khansa ya m'kati mwa zaka zingapo zapitazo: Kuyeza opaleshoni. Khansa ya Thoracic . 2015. 6 (6): 731-40.
> Imai, K. et al. Nomogram chifukwa cholosera zam'tsogolo kwa odwala omwe ali ndi kachilombo koyambirira kosakayikira. British Journal of Surgery . 2016 Jan 18. (Epub patsogolo pa kusindikiza).
> Kato, A. et al. Kuchepetsa Chemotherapy Kumayambiriro Kumene Sitingakayikire Kumalo Okwanira Kulimbana ndi Matenda Aakulu Amagulu Odwala Matenda Odwala Omwe Amagwiridwa ndi Gemcitabine Plus Cisplatin Kusakaniza Mankhwala Otsatiridwa ndi Opaleshoni Yaikulu. Zolemba za Oncology Opaleshoni . 2015. Suppl 3: 1093-9.
> Nitsche, U. et al. Kukhalanso Pambuyo pa Mzere Woyamba FOLFIRINOX Poyambirira Osakayikira Kumene Khansara Yapamwamba Kwambiri Pancretic: Chinthu Chokha Chokha. Zolemba za Oncology Opaleshoni . 2015. Pemphani 3: 1212-20.
> Yang, C. ndi al. Zotsatira za Nthawi Zakale za Lobectomy kwa Kachilombo Kakang'ono Kamene Katemera Wothala Pambuyo pa Chithandizo Chakumapeto kwa Mazira. Annals of Surgery Opera . 2015. 99 (6): 1914-20.