Chemotherapy inoshandiswa senzira yekurapa vanhu vazhinji vane kenza yemasitemasi yepabonde pane imwe nguva. Kunyangwe inoshandiswa mutsara wokutanga kana kwete zvichienderana nemamiriro ako ekugamuchira, marapirwo apfuura, nezvimwe zvinhu.
Chemotherapy inoshandiswa nenzira inoshandiswa iyo inokonzera kenza masero pose painoitika mumuviri. Chimwe chete kune izvi, zvisinei, ihwohwo huropi, pamwe nekupfuura kwezvizhinji zvezvinodhaka izvi zvinokonzerwa nokuvapo kweropa-uropi hunodzivirira.
Iyo Inoshanda Sei
Chemotherapy inoshanda nekurwisa masero anokurumidza kukura akadai sekenza masero . Mazhinji emishonga yemakemikari inopindira nekenza masero pane imwe nguva mukuparadzanisa, asi zvikamu zvakasiyana zvechitokisi zvinopesana nemishonga yakasiyana.
Sezvo izvi zvipatara zvinokanganisa masero anenge achikura nokukurumidza, anowanzokonzera masero ezvakanaka mumuviri akadai seaya ari mudumbu rekudya ( keusea ), bvudzi follicles (bvudzi rinosakara), uye bone marrow (anemia uye low white blood cell count).
Apo Inoshandiswa
Ko nokukurumidza chemotherapy inokurudzirwa kurapwa kunowanzoenderana nemhando chaiyo yekenza yepamu iwe unayo, kana kuti kwete chirwere chako ndecheestrogen receptor kana HER 2 receptor positive , uye kana kana kwete mishonga inormonal inobatsira chiremera chako.
Chemotherapy inowanzokurudzirwa mutsara wokutanga (sokutanga kurapwa kwekenza yemasita):
- Kune vakadzi vane tumorini yakagadziriswa eestrogen iyo yakave isinganzwisisiki nemishonga yehomoni yakadai se tamoxifen kana aromatase inhibitors.
- Kune vakadzi vane HER2 matumbo akanaka (pamwe chete nechirwere chinotarisirwa chakadai saHerceptin) icho chinonzi estrogen receptor negative.
- Kune vakadzi vane tumuramu iyo yese isrogen receptor uye HER2 isina kunaka (katatu nenyuchi dzekenza dzemazamu).
- Iyo inogona kushandiswa pamwe chete nemishonga inonzi hormonal therapies kune avo vane estrogen receptor vane tumarara dzakanaka zvinoshandiswa kune mishonga yehomoni kana kukurumidza kunonoka kwechirwere kuchidikanwa.
Frequency
Chemotherapy inowanzopiwa mumakwikwi ayo akaparadzaniswa mazuva 21 kusvika ku28 ari oga. Nhamba yezvakatenderera iwe unogamuchira inobva pane zvinhu zvakawanda, kusanganisira mhinduro yako kumushonga kana zvinodhaka.
Chemotherapy inogona kushanda zvakanaka kwazvo pamusana wekenza yemasitema, kunyange zvazvo zvipembenene zvinowanzova zvinopesana nemishonga chero ipi zvayo kana kusanganiswa kwemishonga panguva. Hazvishamisi kuti vanhu vawane zvirwere zvitatu zvakasiyana-siyana zvemakemikari panguva yekurapa.
Chemotherapy nokuda kwekenza yemasasa inogona kupiwa nguva dzose (kumwe kusanganiswa kwezvinodhaka pashure peimwe pasina kupera) kana mukatikati uye pane zvinotsigira uye zvinopera kune imwe nzira. Zvave zvichiwanikwa kuti chirwere chemotherapy chinopfuurira chinogona kukonzera kukura kwekenza zvimwe zvakanyanya kubudirira kupfuura chirwere chinopindirana, kunyange zvazvo zvisingaoneki sehope huru mukupona kwehupenyu hwose.
Kusiyana neizvi, avo vanowana kurapwa kwepakati pekare vanowanzova nehuwandu hwehupenyu hwose. Izvi ndezvikonzero zvakawanda zvakadai sokuti iwe oncologist unoda kunzwisisa zvaunofarira pamusoro pekugadzirisa kenza yako.
Zvinangwa
Zvinangwa zvekemotherapy kurapwa kwekenza yemasasa inowanzosiyana zvakasiyana nezvinangwa zvekemotherapy kurapwa kwechirwere chetachiona, uye izvi zvinogona kuvhiringidza zvikuru.
Kwekenza-pwere-kamu yekenza yepese, chemotherapy inowanzopiwa nechinangwa chokurapa chirwere chacho. Semuenzaniso, apo chemotherapy inopiwa mushure mekuvhiyiwa kwekenza yemazamu, inotarisirwa kuti mishonga iyi icharwisa chero sarudzo dzese dzinoramba dziri mumuviri (izvo zvisingagoni kuonekwa pane zvidzidzo zvekufungidzira,) mune tariro yokuti kenza icharapa. Inoshandiswa nenzira iyi, chemotherapy inonzi inonzi adjuvant therapy.
Chemotherapy inogonawo kushandiswa kwekenza yepabonde yepamuviri yekutanga kuti kuderedze ukuru kwechirwere kuitira kuti kuvhiya ikozvino kunogoneka. Inoshandiswa nenzira iyi, chemotherapy inonzi "neoadjuvant therapy," uye chinangwa chachowo chirwere.
Chemotherapy nokuda kwekenza yemasitema yemasasa, zvisinei, inoshandiswa nezvinangwa zvakasiyana. Izvi zvinangwa ndezvi:
- Kuwedzera hupenyu hwako
- Kuvandudza hupenyu hwako
- Kuchengetedza zviratidzo zvako
Mune mamwe mazwi, kusiyana kwekemotherapy kune kenza yepamuviri yepakutanga, chemotherapy yekenza yemasitema inenge isati yapiwa nechinangwa chokurapa chirwere chacho, asi panzvimbo yekudzivirira chirwere ichi kwenguva yakareba.
Sei Hachirapa Chinangwa?
Zvinogona kuva zvinorwadza uye zvinotyisa kana iwe ukazosvika pakunzwisisa kusiyanisa pakati peiyo chemotherapy inogona kupa chekutanga chepakati chekenza yemazamu uye izvo zvingagadzirisa pakuita kemukari yemasasa.
Hazvirevi kuti vanachiremba havadi kuedza kurapa kenza yepamusoro yepamu uye chemotherapy. Vanoita. Izvo chete nemishonga yatinayo iye zvino, uye kupikisa kunowedzera kwekufamba kwenguva, zvinokonzerwa nekemotherapy kuporesa yakakonzerwa nekenza zvakanyanya kwazvo. Izvi ndezvechokwadi kunyange dai iwe waifanira kutarisirwa nepamusoro zvakanyanya uye zvinotyisa zvezvizhinji zvemishonga iyi.
Zvinosuruvarisa, maererano neongororo, vakadzi vazhinji (nevarume) vari kutarisira mhinduro yakasiyana pane yevaycologists, uye vari kutarisira kuti chemotherapy inoporesa kenza yavo ye metastatic. Tinogovera izvi kuti tisabvisa tariro yako. Kune vamwe vanhu vanopindura uye vanoramba vachipindura chemotherapy kwenguva yakareba. Asi, zvakakosha kunzwisisa kuti chemotherapy inogona sei uye haigone kuita nemishonga yatinayo iye zvino.
Kana iwe uchiri kutarisira mushonga, taura nachiremba wako. Panguva ino hapana mararamiro anogamuchirwa anogona kuporesa mastrasi yemasitamende, asi mishonga mitsva inogara ichiongororwa mumakiriniki. Kune vanhu vashomanana, mamwe emishonga iyi mitsva, yakadai semishonga inorwisa mishonga, inogona (asi isu hatizivi uye ndicho chikonzero ivo vari kudzidza) inopa mukana mukuru wekugara kwenguva refu.
Panguva imwe chete, zvisinei, pane izvo zvisingazivikanwi, uye kusvikira mishonga inogamuchirwa hatigoni kuva nechokwadi kuti havazogadziri zvinhu zvakanyanya.
Chemotherapy Zvinodhaka
Kana kenza yako ichidzoka uye iwe wakanga uine chemotherapy nguva yekutanga, zvakasiyana-siyana zvinowanzoshandiswa. Zvinofungidzirwa kuti kenza dzemasere dzakaramba dzichipfuura kupfuura iwe kutanga kurapwa zvingangove dzisingakanganisi kumishonga. Mune mamwe mazwi, chemotherapy inogona kunge yakauraya vakawanda mazai ekenza asi masero akasara akanga asingakwiriri nemishonga akasara shure.
Hazvisi zvisizvo kuti mumwe munhu ave nezvimwe zvitatu zvakasiyana-siyana zvemakemikrapa zvinoshandiswa kurapa kenza yavo. Kuti kuparadzanise mishonga iyi, oncologists kazhinji inoreva chemotherapy regimen seyokutanga, mutsara wechipiri, wechitatu mutsara, zvichingodaro. Chemotherapy inotanga kusanyanya kushanda kwekufamba kwenguva sezvinoita mitemo yakawanda inodiwa.
Zvikamu zveMishonga
Kune mhando dzakasiyana dzakasiyana dzemishonga inogona kushandiswa. Mamwe mashoma emishonga iyi yemakemikrasi inoshandiswa pamusana wekemiti yemasitema yakaputsika mune zvikamu zvinosanganisira:
- Anthracyclines - Adriamycin (doxorubicine), Ellence (epirubicine)
- Alkylating agents - Cytoxan (cyclophosphamide)
- Mitero - Taxol (paclitaxel), Taxotere (docetaxel)
- Mitotic inhibitors - Halaven (eribulin)
- Nucleoside analog drugs - Gemzar (gemcitabine) uye DNA synthesis inhibitors Xeloda (capecitabine)
- Antimetabolite - methotrexate
- Microtubule inhibitors - Ixempra (ixabepilone), Navelbine (vinorelbine)
- Platinum drugs - Platinol (cisplatin), Paraplatin (carboplatin)
- Topoisomerase drugs - etoposide
Single vs. Kusanganiswa Therapy
Kusiyana nehutachiona hwechirwere chekenza yepabonde-kutanga iyo inowanzosanganisira kushandiswa kusanganiswa kwezvinodhaka, kushandiswa kwema-single-agent iyo inowanzoshandiswa kumusana wekematomu wematenda. Kushandiswa kwekemokrasi inosanganiswa kazhinji inowanikwa nguva apo kenza inokurumidza kufambira mberi kuitira kuti iwane utachiona hwechirwere.
Mamwe mashoma anosanganiswa anowanzoshandiswa anosanganisira Xeloda (capecitabine) uye Taxotere (docetaxel) uye Gemzar (gemcitabine) uye Taxol (paclitaxel).
Brain Metastases
Kunyange zvazvo chemotherapy inokwanisa kubata mishonga yemukenza inenge pose pose mumuviri, akawanda mishonga yemakemikari haigone kusvika kuuropi. Izvi zvinokonzerwa nechepamusoro-soro remakumbo e-capillari anozivikanwa sehutano-uropi hwepfungwa.
Ropa-uropi huripo hunogadzirirwa kuchengetedza utsi hwekupinda kupinda maitiro akaoma europi nemutsipa wesipinha, asi zvinosuruvarisa, zvinogona kudzivirira chemotherapy mishonga kubva pakuwana rusununguko zvakare. Zvimwe zvirongwa zvekurapa, zvakadai sehupi hupi hwehurootherapi, inogona kudiwa kurapa kenza yemvere yakapararira kune uropi.
Nharaunda Dzakabatana
Vanhu vazhinji vanoziva kuti chemotherapy zvinowanzova nemigumisiro. Kunyange zvazvo ichi chiri chokwadi, pane kuve nekufambira mberi kwakakosha mukugadzirisa migumisiro yechemotherapy mumakore achangobva kupfuura, kunyanya zviratidzo zvakadai sekunyadzisa uye kurutsira.
Mimwe migumisiro yemigumisiro yemishonga yakasiyana-siyana inogona kusiyana, uye zvakakosha kutaurira chiremba wako pamusoro pezvinoitika zvinoshungurudza iwe unogona kutarisira.
Kuneta - Kuneta ndechimwe chezvinowanzojairika chemotherapy nemigumisiro, uye chimwe chezvinonyanya kuodza mwoyo. Kunyange zvazvo tisati tine mishonga chaiyo yokuneta, sezvatinoita nokuda kwekushungurudza, kune zvinhu zvakawanda zvaunogona kuita kuti zvive nyore.
Miitiro yakajeka, yakadai sekuzvinyima nezuva, kuisa mberi zvinhu, uye kudzidza kudzidza, zvinogona kubatsira zvikuru. Ramba uchiyeuka kuti panguva imwechete sewe uri kuneta, vadiwa vako vangave vachitambura nekunzwa kusabatsiri. Kudzidza kugovera vamwe, uye kukumbira uye kugamuchira rubatsiro kunogona kukubatsira kwete nekuneta kwako asi kunobvumira vadiwa vako nzira yekugadzirisa manzwiro avo ekushaya rubatsiro.
Kusuruvara kwevhudzi - Mvereredzwa yemvere inowanikwa nevakawanda chemotherapy remishonga. Kune avo vaiva nechikwereti chemotherapy "kokutanga nguva dzakapoteredza" izvi zvinogona kunge zvakaoma zvikuru nguva ino zvakapoteredza. Uye kusiyana nemakemikirini adjuvant, kazhinji haisi kuguma kwakakwana mumaziso.
Kana iwe usina kuisa mari mukati me wig pamberi, iyi ingava nguva yakanaka yekuita saizvozvo. Inishuwarenzi inowanzogovera chikamu cheizvi, uye masangano akawanda anopa mahwende asingabhadharwi kubva kune vhudzi rakapiwa. Zvipfeko uye hatso zvakare ndezvokusarudza, uye kazhinji zviri nyore.
Pakave nekutsvakurudza mumakore achangobva kutarisa maitiro ekudzivirira vhudzi kurasikirwa. Kunyange zvazvo nzira idzi, dzakadai sekupfeka chivharo mukati mekudzivirira kwako, dzinogona kuderedza vhudzi rako rinorasikirwa, dzinogona kunge dzisina kunaka.
Nausea uye kurutsira - Kunyange zvazvo mishonga inoshandiswa pamakumbo emasasa anokonzera mvere inogona kukonzera kushungurudza uye kurutsa, pane nzira dzakawanda dzekutarisa izvi. Kutaura zvazviri, kune vanhu vakawanda vanoona zvishomanana kana kusatombofungidzirwa zvine chokuita nekurapa.
Kune mhando dzakasiyana dzakasiyana dzemishonga inoshandiswa, zvimwe izvo zvakagadzirirwa kuchengetedza kushungurudza kwepakutanga, uye zvimwe zvinogona kushandiswa kurapa tsvina. Iva nechokwadi chekutaura nachiremba wako kana iwe uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge waita.
Kunyange zvazvo kune mishonga yakawanda, vamwe vanoshanda zviri nani kune vamwe vanhu kupfuura vamwe, uye zvinogona kuva zvakaoma kuziva kuti mishonga inopesana nenyasi inoshanda zvakadini kune munhu mumwe nomumwe. Iwe unogona kunzwa vanhu vachitaura nezvemajoka e-acupressure, ginger, uye mamwe anonzi "mamwe" kurapa kwechemotherapy-induced nausea.
Kunyange zvazvo zviyero izvi zvingava nemigumisiro, inofanira kushandiswa chete sekuwedzera kune-anti-nausea mishonga, uye kwete sechinotsiva.
Dhairrhea inogonawo kuratidza sechikamu chemazuva. Shingai nachiremba wenyu kuti muongorore izvo zvamungagona kuita kuderedza izvi.
Irosa marora kuderedza - Chiitiko che chemotherapy mishonga pamapfupa emapfupa chinogona kutungamirira kuhuwandu hwemhando dzose dzemasero eropa anobudiswa mumapfupa emapfupa. Izvi zvinogona kusanganisira masero matsvuku eropa (anemia), machena masero eropa (leukopenia kana neutropenia), uye platelets thrombocytopenia.
Dambudziko guru rinokonzerwa nekudyiwa kwemafuta emapfupa ndeyero tsvuku yakawanda yeropa rekuverenga. Izvi zvinogona kukugadzirisai kune zvirwere nemaabhakitiriya izvo zvisiri izvo zvinowanzova zvisina maturo, uye zvinoita kuti zvive zvakaoma kurwisana nehutachiona kana yaitika. Kana iwe ukava nefivha paine chemotherapy (kunyange imwe yakaderera se 100.5) zvakakosha kudana chiremba wako pakarepo.
Zvizhinji zvezvirwere izvi zvinoporesa zvikuru, asi kurapwa nokukurumidza kunogona kuita kusiyana kukuru. Chiremba wako achakutaurira nezvenzira dzekudzivirira utachiona, uye zvakakosha kudzokorora izvi. Vanhu vane chemotherapy-ingave kana kwete yavo yeropa rekuyera nhamba yakaderera-vanowanzotaurirwa kuti varege nzvimbo dzakazara (kunyanya mukati memwedzi yechando uye nguva yezvirwere) uye kuderedza kushamwaridzana nevanodiwa avo vanorwara. Neimwe chemotherapy yemishonga, chiremba wako anogona kupa mishonga kuti uwedzere ropa rako rekuyera ropa.
Kuora muviri kunogona kuita kuti utye. Taura nachiremba wako nezve hemoglobin yako uye paanenge achifunga kubata chirwere chakadzika. A low platelet count inogona kuwedzera njodzi yekubuda ropa. Kana uwandu hwako hwakadzika, chinhu chakanaka chekudzivirira zvinhu zvinogona kuguma nekubuda ropa kana kupwanya.
Peripheral neuropathy - Mimwe chemhemotherapy mishonga, inogona kukonzera kusagadzikana kusanganiswa kwezviratidzo zvinozivikanwa seperiipheral neuropathy. Zviratidzo zvinogona kusanganisira kupisa, kutengesa, uye kushaya simba kunowanikwa mu "kugovera uye kugadzira girafu" pamaoko nemakumbo.
Sezvo kuora kwekunze kwetsoka dzako kunogona kukanganisa kufamba uye kuenzanisa, vanhu vanoshandisa mishonga iyi vanofanira kutarisa pedo nemamiriro avo epamba kuitira kuti vaderedze mikana yekuwa, vadzivisa kushandiswa kwezvipingamupinyi zvakadai sokukanda mabheji uye kuchenjerera paunofamba muchando nechando . Nepo chirwere cheuropathy chinogona kukura nekufamba kwenguva, zvimwe zvezviratidzo izvi zvingaguma zvisingaperi mushure mekurega kurapwa.
> Sources:
> DeVita, Vincent., Et al. Kanzira: Mitemo & Practice of Oncology. Kanzira yeBretiti. Wolters Kluwer, 2016.
> Liedtke, C., naH. Kolberg. Utachiona hweChirongwa Chekuwedzera / Metastatic Breast Cancer-Iyezvino Uchapupu uye Ramangwana Dhana. Breast Care . 2016. 11 (4): 275-281.