Kutarisana neAdrenal Metastases Kubva kuLung Cancer
Kana wakamboudzwa kuti kenza yemapapu yako (kana imwe kenza) yakapararira kune adrenal glands (adrenal metastases) unogona kunge uchinetseka. Kusiyana nekupararira kwekenza kune dzimwe nzvimbo, zvakadai sechiropa, kupararira kune adrenal glands haitauri nezvazvo kakawanda. Izvozvo zvakati, adrenal metastase yakajairika zvikuru nemukenza wemapapu. Ndeipi majozi adrenal uye zvinorevei kana kenza yemapapu yako ichipararira kune ino?
Dzidza kuti nei metastases kune zvinyorwa zvinonzi adrenal zvinogona kunge zviri nani kudarika zvimwe zvivako zvemasastases, kunyanya kana zvikaitika kune rumwe rutivi rwemuviri sekenza.
Overview
Izvo zvinonzi grenal glands zvidiki zviduku zvakapetwa katatu zvakagadzirwa pamusoro pepiro imwe neimwe. Aya magland endocrine anokonzera kuchengetedza mahomoni, kusanganisira "mahomoni anokonzera" akadai sa cortisol, epinephrine (adrenaline), uye norepinephrine.
Cancers Inopararira Kuda Kuwedzera Glands
Anenge chero kenza chero ipi zvayo inogona kupararira kune zvinonzi adrenal glands, asi zvimwe zvipembenene zvinowedzera kune vamwe kuti vashandise munzvimbo ino. Mune rumwe ruzivo, kenza yakawanda inowanzobatwa nemakemikari adrenal yaiva mapapu (35 kubva muzana) yakateverwa nekenza yepamu (14 muzana) kenza yepopugeal (12 muzana) uye chirwere cheropa / bile duct (10 muzana). Zvimwe zvirwere zvinowanzopararira munzvimbo ino zvinosanganisira chirwere chepfungwa, melanoma, kenza yemazamu, kenza yemaroni, uye lymphoma.
Kana kenza yemapapu yakapararira kune zvinoratidzira, inoonekwa sechikamu chechina chekenza yemukenza yemapapu (kana yakazara ganda rekenza yemapapu memapapu). Munguva yakapfuura, pakanga pasina zvishoma zvokuita kana kenza yepamapapu yemapapu yakanga yakasvibiswa. Mumakore achangobva kupfuura, zvakadaro, zvakave zvichinzi kune vamwe vanhu-kunyanya avo vane dambudziko rekudzivirira rinodhaka rematasal-chirwere chisimba chokuvhiya chemasastasis chingaguma nekugara kwenguva refu.
Sezvakakurukurwa zvakare pasi apa, iyo inofanirwa kuti adrenal metastases yemukenza wemapapu inogona kunge iri nani kudarika kufungidzira kwemamwe metastases - akadai seaya kuchiropa, uropi, uye mapfupa.
Kuwedzera kweAdrenal Metastases
Kusvika kusvika makumi mana kubva muzana yevanhu vane kenza yemapapu vachaita zvirwere zverenrenal panguva imwechete, uye muzana 10 muzana yevanhu vasina kamudiki kenza yemapapu emapapu, chirwere ichi chinopararira kune zvose zvinyorwa zvemazamu. Izvi zvinokonzera 2 kusvika ku3 muzana yevanhu panguva yekuongororwa, uye pazviitiko zvisingaoneki chiratidzo chekutanga chekenza yemapapu.
Zviratidzo
Nguva yakawanda apo kenza inopararira kune zvinonzi adrenal glands hapana zviratidzo. Ichokwadi, mune imwe chidzidzo chete 5 muzana yevanhu vane adrenal metastase vane zviratidzo. Vanhu vanowanzowanzoziva nezvemastastasti nekuda kwehutoriology zvidzidzo zvakadai seT CT scan, MRI, kana PET scan.
Apo zviratidzo zviripo, zvinogona kusanganisira:
- Dambudziko rekudzokera shure (iri pakati pekumabvazuva).
- Marwadzo emudumbu.
- Kusvetuka mukati memimba (kushaya ropa).
- Chirwere cheAdisonal ( chirwere cheAdisonison ): Zviratidzo zvechirwere cheAdisonison zvinogona kusanganisira kushaya simba, kuderera kweropa (hypotension), shuga yakaderera yeropa ( hypoglycemia ), iyo yakadzika yezinga reyamu muropa (hyponatremia), uye nepamusoro ye potassium level ( hyperkalemia ).
Kuziva
Kana iwe uine peji yekufungidzira kweadrenal metastases, haungatombodi kuti upfuurire mberi, kunyanya kana uine mastase kune dzimwe nzvimbo dzomuviri wako. Mune zvimwe zviitiko, chiremba wako angada kuva nechivimbo chokuti mashoma muudrenal yako yegrenti inokonzerwa nekenza yemasita, uye inokurudzira CT-inotungamirirwa biopsy.
Kurapa
Mushonga unorayirwa kuti adrenal metastase inogona kusiyana zvichienderana nezvimwe zvinhu. Kune vanhu vose vanotsigira kutarisira kunokosha. Muvanhu vane zviratidzo zvakadai sekushaya ropa, zvirwere zvakadai sokuvhiya zvinogona kudiwa kuti zvironge zviratidzo. Mune vamwe vanhu, kurapwa nechinangwa chekuporesa chirwere kunogona kunge kuripo.
Kutsigira Kunobatsira: Kana iwe uye chiremba wako musarudza kana iwe uye chiremba wako musarudzo yekuwedzera kurapwa kwekenza yako kana adrenal metastases, kutarisira zviratidzo zvako zvinoramba zvakakosha. Vanhu vane kenza vanofanirwa nekurwadziwa nekugadziriswa nekugadzirisa dzimwe zviratidzo zvine chokuita nekenza.
Kurapa Kwezviratidzo: Sezvataurwa pamusoro apa, adrenal metastase kazhinji haisi kukonzera zviratidzo. Kana chirwere chemasastasis chiri kubuda ropa (kuora ropa) kana chiri pangozi yakakura yekubuda ropa, kuvhiyiwa kubvisa tumarara uye adrenal gland (adrenalectomy) inogona kukurudzirwa. Kana iyo metastasis yakaguma nekushaya kukwana, kurapa nesteroid inogona kudiwa. Kana kurwadziwa kwemuviri kana kurwadziwa kwemuviri kuchiitika, izvi zvinofanira kurapa.
Kurapa Kwepamuviri Pamuviri uye Mimwe Mastasisita: Kuchengetedza chirwere chemukati wemukenza wemapapu 4 kunogona kusanganisira chemotherapy, inotarisirwa kurapa, immunotherapy, uye / kana remishonga inonzi radiation. Vamwe vanhu vanobatanidzwawo mumatambudziko emakiriniki vachidzidza mishonga nemishonga. Kuwedzerwa kwezvirwere zvinorapwa uye immunotherapy, zvakashandura chiso chemupenza wemapapu wakagadzirwa nevanhu vakawanda mumakore achangopfuura. Kana zviitiko zvinotarisana zviripo zviripo, zvinodhaka zvinodhaka dzimwe nguva zvinobvumira vanachiremba kuti vatore chirwere chemukati wemapapu emapapiro sekare sechirwere chisingagumi. Kunyange zvazvo kushorwa kunoitika kune mishonga iyi munguva, mune dzimwe nguva chizvarwa chechipiri uye zvino chizvarwa chechitatu chemishonga chinowanikwa chinofanira kuitika. Immunotherapy, kana ichishanda, pane dzimwe nguva yakaguma ne "mhinduro yakasimba," ine mutanha wemapapu mukutarisa nguva yakareba. Sezvo mutengesi wekutanga munharaunda iyi wakagamuchirwa chete muna 2015, isu tisati taziva kana zvikomborero zvatinoona zvichange zvichiitika, kana kuti zvingave zvakaguma kwenguva yakareba sei.
Kurapa Nechinangwa Chokuratidzira: Kune vanhu vane mahara adrenal metastasis, kurapa kunogona kuguma nekugara kwenguva refu. Zvimwe zvinosanganisira:
- Kuvhiya: Zvose zvinozaruka uye laparoscopic adrenalectomy (kubviswa kwehutachiona hwedrenal) kunogona kuitwa nechinangwa chokurapa kune vamwe vanhu.
- SBRT: Kana chirwere chisingaitike, zvidzidzo zvinoratidza kuti stereotactic body radiotherapy (SBRT) inogona kushanda uye inoregererwa zvakanaka. SBRT inosanganisira kushandisa mizinga yakakura yemirairo kune imwe nzvimbo duku, uye dzimwe nguva kune zvigaro zvakafanana nekuvhiya.
- Ablation: Mufananidzo wakatungamirirwa nekutengesa kune imwe nzira ndiyo imwe nzira. Chirongwa che 2018 chakawana kuti, kunyange zvazvo kupona kwaiva varombo kune avo vasina kamudiki kemukirini yemapapu emapapu avo vakawana nzira iyo pane mamwe mamwe kanzira, kutungamirirwa kwezvifananidzo-kutungamirirwa kwezvinhu zvinowedzera maitiro kunogona kuwedzera kupararira kwekugara-kusina kusununguka pamwe chete nekupona kwese. Muchidzidzo chacho, muvhareji wehupenyu hwose (hwemhando dzose dzepamuviri dzakabatanidzwa) pa1, 3, uye nemakore mashanu aiva 82, 44, uye 34 muzana zvichienderana nekuita.
Prognosis
Pasina kurapwa, kupona kwemazuva mashomanana mushure mekuongororwa kwemarenastases adrenal kwaingova mwedzi mitatu chete muchidzidzo chimwe. Izvozvo zvakati, uye zvakasiyana nemasitema kune dzimwe nzvimbo dzomuviri, kurapwa kwemasimisita aya muvanhu vakasarudzwa vane chesi duku duku rekenza yemapapu kwakaguma nekugara kwenguva refu. Izvi zvinyorwa zvekupona zvakanyorwa zvakare vasati vatsva kurapwa kwakadai sekuzivikanwa kwema immunotherapy, uye mazhinji emishonga inotarisirwa isu iye zvino, yakagamuchirwa nekenza yemapapu.
Zvidzidzo zvishomanana zvishoma zvekuongorora kurapwa kwematokisi adrenal vave vachikurudzira. Semuenzaniso, mune imwe chidzidzo chevanorwara 37, kuponeswa kwese kwaive 34 muzana kune avo vairwara vakavhiyiwa, asi 0 muzana kune avo vasina kuvhiyiwa. Imwe yongororo yakawanikwa yakawana kuti kupona kwenguva yakareba kwaigona kuitika mu 25 muzana yevatori vechikamu avo vakabatwa nokuda kwezvinyorwa zvisingabatsiri.
Nekenza kaduku kemapapu emapapu , chidzidzo chakawana kuti, kusiyana nemasikisitiri kusvika pachiropa, uropi, pfupa, uye chirema chemvura, metastases kune chirwere chedrenal chakanga chisingaratidzi chiratidzo chisina kunaka.
Nei Zvingaita Kuti Zvirwere Zvirambe Zviri Nani Nokuda KwemaAdastal Metastase Kupfuura Zvimwe Mastasisita?
Mhinduro kumubvunzo wekuti nei adrenal metastases ane hutachiona hwepamusoro, inogona kunge iri mune kuti kanha inopararira sei kuti isvike pazvinyorwa zvinonzi adrenal. Kanzera inopararira nenzira 3 dzinokosha. Imwe inzvimbo iri pedyo neyemarara. Chimwe ndechokushandisa lymphatics. Uye chechitatu ndedze ropa. Apo kenza yemasero inopinda muropa iro inofamba mumuviri wose. (Vamwe vatsvakurudzi vanodavira kuti mukenza wemapapu unogona kupararira kune imwe nzvimbo, kana kuti kuburikidza nemhepo.)
Mune kumwe kuongorora kuongororwa kubudirira kwerrenalectomy mukurarama, zvakawanikwa kuti ne "ipsilateral chirwere" -kureva, kupararira kwekenza kune chirwere chedrenal kune rumwe rutivi rwemuviri sekenza yemapapu-makore mashanu ekupona yaiva 83 muzana. Kusiyana neizvi, kurarama kwemakore mashanu ehupenyu hwevanhu vane "mastastaal metastases" -adrenal metastases kune rumwe rutivi rwomuviri kubva mumukenza wemapapu, makore mashanu ekupona uye chirwere chaiva zero.
Zvinofungidzirwa kuti kana mutanho wemapapu unopararira kune adrenal gland kune rumwe rutivi rwomuviri, unosvika kune drenal adhereal nenzira ye lymphatic system. Kusiyana neizvi, kana chirwere chedrenal kune rumwe rutivi rwomuviri chakabatwa, zvinogona kufamba nenzira yeropa (kupararira kwemafupa) kuti ifike kune zvipembenene zvakanyanya uye mhedzisiro haisi yakanaka.
Shoko Rinobva
Izvo zvinotaridzika nematastatic (chikamu chechina) kenza yemapapu haisi izvo zvatinoda. Izvozvo zvakati, pane dzose nzvimbo dzemaitiro, zvirwere zvinowanzoitika zvinowanzova nehuwandu huri nani (uye sezvakataurwa, kufungidzira kwakatonyanya kunaka kana iyo inosanganisira adrenal gland iri kune rumwe rutivi rwemuviri sekenza yemapapu). Mukuwedzera, maitiro ekurapwa uye kuponeswa kwemukenza wemapapu wakamera mune zvese zviri kuwedzera zvishoma nezvishoma, kunyanya apo zvinorapwa zvirwere zvekuchinja kwema genetic kana immunotherapy mishonga zvinogona kushandiswa kurapa tumarara.
Kana wakamboonekwa kuti une chirwere chemukati wemapapu 4 uye yematastases, tora nguva yekudzidza nezvekenza yako. Kubatanidzwa mumagariro emukenza yemapapu paIndaneti kunobatsira chaizvo. Mishonga mitsva iri kuwedzera kukura kwehupenyu, asi kurapwa kwemukenza wemapapu kuri kuchinja zvakakurumidza izvo zvakaoma kuti munhu upi zvake arambe ari pamusoro pezviwanikwa zvitsva. Kana iwe uri kunetseka kuti ungawana sei vanhu vari mu "kukanganisa" kwekutsvakurudza kwemapapu emapapu, kushandisa hashtag #lcsm yemukenza yemapapu social media inokosha.
Iwe unogona kufungidzira pfungwa yechipiri pane imwe yenyika huru yeCancer Cancer Institute-mishonga yemukenza yakasarudzwa, apo oncologists vanoita mumapapu emapapu vane ruzivo rwekutsvakurudza kwezvino uye kuongororwa kwechipatara. Chinonyanya kukosha, tora chikamu chekushingaira mukutarisira kwako uye uve iwe mutongi wako . Tirikudzidzira kuti kuzvikudza (kana kuva neshamwari kana kuda iwe anogona kutsvakurudza iwe chirwere uye kukurudzira iwe), kwete kungoita kuderedza kuzvidya mwoyo uye kunobatsira iwe kunzwa zvakanyanya mukudzora chirwere chako, asi kunogona kuvandudza migumisiro zvakare.
> Sources:
> Bastian, S. et al. Kugadziriswa kweKutsvaga kweIndaneti Yakakonzerwa neAdrenal Metastases muVachipatara Vasiri Muchechi Muchengeterwo Kanzera: A Single-Institution Experience uye Kudzokorora kweMabhuku. Onkologie . 2011. 34 (12): 665-70.
> Bazhenova, L. et al. Adrenal Metastases muLung Cancer: Clinical Implications yeMathematic Model. Nyaya yeTraracic Oncology . 2014. 9 (4): 442-6.
> Frenk, N., Daye, D., Tuncali, K. et al. Kudzora Kwemunharaunda uye Kuponeswa Pashure Pekufananidzira-Kutungamirirwa nePercutaneous Ablation yeAdrenal Metastases. Zvinyorwa zveV Vascular uye Interventional Radiology . 2018. 29 (2): 276-284.
> Hwang, E. et al. Prognostic Zvikonzero zvekudzokorora-Kusina uye Kuparara Kwakakwana Pashure peAdrenalectomy yeMetastatic Carcinoma: A Retrospective Cohort Pilot Study. BMC Urology . 2014. 14:41.
> Nakazawa, K. et al. Mamwe maMastastase eEgrim uye Kupona muMusana Madiki Kurapa kenza. Oncology Tsamba . 2012. 4 (4): 617-620.
> Raz, D. et al. Migumisiro yevarwere neIsolated Adrenal Metastasis Kubva Pasina Madzimai Masero Anonzi Lung Cancer. Annals of Thoracic Surgery . 2011. 92 (5): 1788-92.
> Riiimaki, M. et al. Metastatic Sites uye Kupona muLung Cancer. Lung Cancer . 2014 Aug 2. Epub mberi kwekunyora.