Zizindikiro, Kuzindikira, Kuchiza, ndi Kugonjetsa
Ngati mwauzidwa kuti mwakhala ndi khansa ya m'mapapo, mukuganiza kuti mukudandaula ngati simuwopa kwambiri. Kodi izi zikutanthauza chiyani? Kodi amachizidwa bwanji? Ndipo mungapeze bwanji thandizo lomwe mukufuna?
Mwachidule
Kodi zikutanthauzanji pamene madokotala amati "khansa yapakhungu yamapapu?" Nthawi zambiri pamene madokotala amagwiritsa ntchito mawu awa amatanthauza gawo la IIIB ndi khansa ya mapulaneti a IV.
Ngakhale khansara yaing'ono ya m'mapapo ingapite patsogolo, nthawi zambiri pamene odwala oncologists amagwiritsa ntchito mawu akuti "khansa ya m'mapapo", akukamba za khansa yaing'ono ya m'mapapo ya m'mapapo , yomwe imayambitsa 85 peresenti ya khansa ya m'mapapo.
Chifukwa chake khansa ya m'mapapo nthawi zambiri imagawanika msinkhu ndipo msinkhu wapamwamba ndi wakuti amachiritsidwa mosiyana. Kwa khansa ya m'mapapo yoyambirira, nthawi zambiri opaleshoni imatchulidwa ngati chithandizo choyamba, pamene njira zina ndizofunika kwambiri pa matenda apakati-poyamba.
Miyendo
Monga tafotokozera pamwambapa, mawu akuti "msinkhu wapamwamba" amagwiritsidwa ntchito polongosola gawo la IIIB kapena gawo lachisanu ndichinayi la khansa ya m'mapapo yopanda makapu.
- Gawo IIIB - Gawo lachiwiri lachilendo lachilombo cha khansa lapachilombo la khansa ndi mapiritsi a kukula kwake komwe kwafalikira ku minofu kumbali ina ya chifuwa, pafupi ndi fupa lamtundu wa mafupa, kapena kulowa mu chifuwa monga chifuwa kapena mtima.
- Gawo lachinayi - Gawo lachinayi lapachilendo mapangidwe a khansa ndi maphuphu omwe afalikira pakati pa zigawo zomwe zimakhala m'mapapu ( chiwonongeko chopweteka kwambiri ) kapena dera lina la thupi. Khansa ya m'magazi imafalikira kwa mafupa, chiwindi, ubongo, kapena adrenal glands.
Zizindikiro
Zizindikiro za khansa ya m'mapapo yapamwamba zingagwirizane ndi kukhalapo kwa khansa m'mapapo, kapena chifukwa cha kuukiridwa kwa ziwalo zina ndi kufalitsa (metastasis) ku madera ena a thupi. Zizindikiro zokhudzana ndi mapapo amodzi zimaphatikizapo chifuwa chachikulu, kupuma pang'ono, kukopa magazi, ndi kuwomba.
Khansa ya m'magazi ingapangitse mitsempha mu chifuwa chochititsa mantha.
Khansara ya m'mapapo ikakula kapena ikufalikira, zizindikiro monga kutopa, kutaya thupi kosayembekezeka, ndi kusowa kwa njala kumachitika. Khansara ya m'mimba yomwe imafalikira ku ubongo ingayambitse mutu, kuyankhula mavuto, kukumbukira kukumbukira, ndi kufooka. Khansa ya m'magazi yomwe imafalikira ku chiwindi imayambitsa ululu wamimba ndi jaundice. Ndipo khansa ya m'mapapo yomwe imafalikira ku mafupa ikhoza kupweteka kumbuyo, kumapewa, ndi pachifuwa.
Kudziwa
Khansara ya m'mapapo yapamwamba ikhoza kupezeka pa x-ray kapena CT scan, koma kuyesedwa kwina ndi mapiritsi a mapapu ndikofunikira kudziwa ngati ayi kapena ayi ndi khansara, ndipo ndi mtundu wanji.
Kwazomwe zing'onozing'ono zopanda khansa mapapu, ndizofunika kwambiri kuti kufotokozera kwa jini (molecule kufotokoza) kumachitika. Ngakhale mwachizolowezi, minofu yochokera ku chidziwitso ndi yofunika kuti izi zitheke, mu 2016 kuyezetsa magazi kwavomerezedwa kwa EGFR kuyesa kusintha kwa thupi.
Mitundu
Khansara yaing'ono ya m'mapapo ya m'mapapo ikhoza kupita patsogolo koma imayikidwa mugawo losiyana. Zapangidwe zosachepera zazing'ono zamapiritsi mapiritsi zimaphatikizapo:
- Lung adenocarcinoma - Amene ali ndi udindo wa pafupifupi theka la zotupazi. Uwu ndi mtundu wa khansara umene umapezeka mwa amayi, osasuta, komanso achinyamata omwe ali ndi kansa ya m'mapapo.
- Squamous cell carcinoma m'mapapo - Amene ali ndi udindo wa pafupifupi 30 peresenti ya khansa ya m'mapapo yopanda maselo.
- Khungu lalikulu la khansa - Khansara yaikulu yamapapo ya m'mapapo imapanga pafupifupi 10 peresenti ya khansa yaing'ono ya mapapo .
- Zina - Mwinamwake mwawona kuti nambala zapamwambazi sizinawonjezere kufika pa 100. Izi ndi chifukwa chakuti zotupa zina zili ndi makhalidwe omwe amapezeka kwinakwake pamtunda pakati pa magulu apamwambawa, monga "mawonekedwe osaoneka" kapena malo osiyana chotupacho chikhoza kukhala ndi maonekedwe a mitundu iwiri kapena yowonjezera yambiri.
Kuchiza
Ndikofunika kumayambiriro kunena kuti mankhwala opatsirana khansa ya m'mapapo ikupita patsogolo .
Mavuto a kansa yamapapu apamwamba akukwera. Choncho, ziŵerengero zilizonse zomwe mukuwerenga, kapena chidziwitso chilichonse cha mankhwala omwe mukuwerenga chomwe sichikuchitika, chingakhale chokhumudwitsa kwambiri. Ndikofunika kuphunzira zomwe mungathe ponena za matenda anu, koma tengani kamphindi kuti mudziwe momwe mungafufuzire khansa yanu pa intaneti . Mwachitsanzo, pali mankhwala ena atsopano omwe amavomereza khansara yamapapu yapamwamba pakati pa 2011 ndi 2015 kusiyana ndi zaka makumi anai zisanayambe 2011. Pali chiyembekezo chochuluka.
Mitundu ya Chithandizo
Odwala akuyamba kugwira ntchito yawo mosamala ndi khansa ya m'mapapo kuposa kale lonse. Mosiyana ndi maubwenzi odwala odwala omwe adakalipo kale, odwala ndi madokotala akugwira ntchito limodzi kuti apange dongosolo labwino la mankhwala. Chifukwa chimodzi cha izi ndi chakuti pali zosankha zambiri kuposa kale lonse, ndipo zosankha zina zikhoza kukhala zogwirizana kwambiri ndi zokonda zanu-zotsatirapo zomwe mumakonda kupirira-kuposa kupambana kulikonse kwachipatala cha mankhwala ena.
Ndizothandiza kuyamba ndi kuswa mankhwala m'zigawo ziwiri zofunikira.
- Kuchiza kwapanyumba - Mankhwala am'derali amachiza khansara kumene kuli-kumaloko-ndipo amaphatikizapo chithandizo cha ma radiation ndi opaleshoni.
- Thandizo labwino - Thandizo lachidule limayesedwa pofuna kuchiza khansa kulikonse m'thupi lanu. Izi zimaphatikizapo mankhwala a chemotherapy, mankhwala othandizira, ndi ma immunotherapy.
Popeza khansara yamapapu yapamwamba ndi kutanthauzira kuti palibe njira zamakono, njira zothandizira zothandizira . Anthu ena amadzifunsa kuti n'chifukwa chiyani opaleshoni sichivomerezedwa ku gawo la IV ndi kansa ya IIIB yamapiko. Chifukwa chake ndikuti opaleshoni ndi mankhwala opangira mavitamini okhawo satha kuchiza khansara yomwe yafalikira kale. Izi sizikutanthauza kuti simudzachita opaleshoni. Pali anthu omwe ali ndi mankhwala omwe amachepetsa chifuwa chawo mpaka kukula kumene opaleshoni idzagwira ntchito. Ndi khansa zina, monga khansara ya ovari, "kudula" chotupa-chochotsa ena koma osati zonse ndi opaleshoni-zingakhale zothandiza, koma sizingakhale choncho ndi khansara yamapapo. Ndipotu, kuchitidwa opaleshoni kungakhumudwitse thupi panthawi yomweyo kuti mufunike mphamvu yanu kuti mulekerere mankhwala omwe angakuthandizeni. Mu njira zothandizila zowonjezera ndizo:
Kachilombo Kafukufuku - Aliyense amene ali ndi khansa yapakhungu yopanda makapu yapamwamba ayenera kukhala ndi ma projekisamu ("kuyesa kwa majeremusi") yomwe imachitidwa pamatumbo awo. "Zolinga", ndi zina zambiri zikupezeka nthawi zonse. Zovuta zowonongeka zimatanthauzira kusalongosoka kwa maselo a khansa kapena zokhudzana ndi maselo a khansa omwe angathe kutsogoleredwa ndi mankhwala. Ngati muli ndi kusintha kwa EGFR , ALK fusion gene , kapena rearrangement ya ROS1 , pali mankhwala ovomerezeka omwe alipo-ndipo malowa akhoza kukula mofulumira zaka zotsatira. Ngati "mafilimu" asamveke bwino, onetsetsani kuti mulankhule ndi oncologist wanu.
Chemotherapy - Chemotherapy ndi "yopambana" ya khansa ya m'mapapo yapamwamba , ndipo ikhoza kuwonjezera moyo kwa anthu ambiri. Pali mitundu yambiri yogwiritsira ntchito mankhwala, koma zambiri mwazi ndi monga "platinamu" mankhwala monga Platinol (cisplatin).
Immunotherapy - Ngati mwakhala mukuyang'ana nkhani kapena kuwerenga magazini alionse omwe mwinamwake munamvapo za immunotherapy. Mosiyana ndi zina za m'mbuyomu, immunotherapy ndi njira yokondweretsa kwambiri yopatsira khansa yapamwamba . Mankhwalawa amatha kuganiziridwa kuti amagwiritsa ntchito maselo athu a chitetezo kupha maselo a khansa m'njira zosiyanasiyana. Chithandizo choyamba cha khansa ya m'mapapo m'derali chinavomerezedwa mu 2015, ndipo zina zambiri zikuyesedwa m'mayesero a zamankhwala.
Zilonda zam'chipatala - National Cancer Institute ikulangiza kuti aliyense amene ali ndi khansara yamapapu yapamwamba ayang'ane mayesero. Pali nthano zambiri zokhudzana ndi mayesero a kachipatala , koma kuposa kale lonse mayesero a zachipatala angapereke anthu omwe ali ndi khansara yamapapo mwayi wopeza mankhwala atsopano kwa matendawa. Mwachitsanzo, anthu omwe adayesedwa kuchipatala cha mankhwala omwe amavomerezedwa mu 2015 adapambana kwambiri kuposa omwe sanakhale nawo mwayi. Kumbukirani kuti mankhwala onse ovomerezeka a khansara yamapapo anali ataphunzira kale ngati gawo la mayesero a zachipatala. Pakali pano pali mayesero oposa 100 omwe akuyambitsa matenda a kansa yamapapo. Onani zambiri zokhudza momwe mungapezere mayesero a kachipatala kwa khansa ya m'mapapo, komanso kuyesedwa kwaulere kwaulere komwe kumaphatikizidwa ndi mgwirizano pakati pa mabungwe angapo a kansa yamapapo.
Kuchiza kwa Metastases
Kale, mankhwala a kansa yamapapo ndi metastases anali ofanana kwa aliyense. Izo zikusintha pang'ono. Kwa anthu ena omwe ali ndi kansa ya m'mapapo kapena khansa ya m'mapapo ndi khansa ya m'mapapo - ngati pali "zilonda" kapena mawanga ochepa chabe omwe amatchedwa "oligometastase" -kuzunzidwa ndi ma radiotherapy kapena opaleshoni yapamwamba yowonjezera .
Kwa anthu omwe ali ndi mitsempha ya mafupa kuchokera ku khansa ya m'mapapo , mankhwala omwe amadziwika kuti bisphosphonates komanso mankhwala othandizira poizoni amawathandiza kupweteka, ndipo nthawi zina amatha kupulumuka.
Kuthamangitsani
Ndizovuta kunena za kutsekula kwa khansa yamapapu yapamwamba chifukwa tidzakhala tikukamba za ziwerengero zomwe zinasonkhanitsidwa musanapange mankhwala ambiri opangidwa ndi khansara yamapapu yapamwamba. Ziŵerengero zotsiriza zasonkhana zapeza kuti zaka zisanu zopulumuka kwa khansara yamapapu yakumapeto zinali zopweteka zosakwana 5 peresenti. Izi zinati, pali opulumuka nthawi yaitali a khansara yamapapu, ndipo nambalayo ikukula.
Kulimbana ndi Kuthandizidwa
Chimene mumaphunzira mwamsanga mukamapezeka kuti muli ndi khansara yamapapu yapamwamba ndi khansa ya m'mapapo imatenga anthu komanso kuti ndi matenda a m'banja. Pitani kwa achibale ndi abwenzi. Phunzirani kukhala wothandizira anu pa chisamaliro chanu cha khansa . Ganizirani zofikira pamtundu wa khansa ya m'mapapo ya m'mapapo - mderalo womwe wakhala ngati banja kwa anthu ambiri omwe ali ndi khansara yamapapu.
Kwa Okondedwa
Kusamalira wokondedwa ndi khansara yamapapo ndi mwina chinthu chovuta kwambiri chomwe iwe umachita, koma kupindulitsa kopambana komanso moyo wopindulitsa. Onetsetsani kuti mutenge kanthawi ndikuwerenga nkhaniyi pamene wokondedwa wanu ali ndi kansa ya m'mapapo .
> Zotsatira:
> National Cancer Institute. Mankhwala Osakaniza Amtundu Wopanda Khansa - Health Professional Version (PDQ). Kusinthidwa 01/20/17. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq