Kurapa Zvokudya uye Kurapa
Bhokisi rebhokisi rekudzokazve kenza yemazamu inodzoka mushure mekuita mastectomy . Rusvingo rwechifukidzo ruchidzoka runogona kusanganisira ganda, musuru, uye kufara pasi pesaiti yepamuviri chepamuviri, pamwe nemakirini . Kana kenza inodzoka mudanda rechifuva, inogona kuverengwa sechirongwa chekugara kune dzimwe nyika, kana kuti inogona kuenzaniswa nemasitasisiti ari kure. Kana ruzha rwechifuva ruchidzoka rwunogara ruchidzoka, runotumidzwa sekusagadziriswa kwekenza yepamusoro yepabonde.
Inenge 5 kubva muzana yevakadzi avo vane chirwere chekushaya mastara ichava nekudzoka kwemuganhu kwemakore gumi anotevera.
Inogona kunge inoshamisa kuvhiringidza kutsvakurudza ruvara rwemapuranga ruchidzoka zvakare. Ndezvipi nhamba dzakarurama? Nemhaka yei kurapwa kunoita sekunopesana? Pamusoro pezvinangwa zvechikamu ichi, tiri kutaura nezvevanhu vane chirwere chekuita. Kana kenza inowedzera muzamu mushure me lumpectomy , iyo yakasiyana zvakasiyana.
Zviratidzo
Rusvingo rwechifu chekudzoka runogona kutanga kuonekwa sehosha inenge isingaporese, uye zvichida inopisa. Ikoko kunogona kunge kusina kunaka kana kutora manzwiro.
Kuziva
Kana kudzoka kwako kuoneka, bhiopsy inogona kuitwa kuti ione kana iri kudzoka kwezamu kana kwete. Kana iri yakanaka, oncologists vanokurudzira kudzokorora miedzo kuti uone kana iri estrogen receptor positive, progesterone receptor positive, kana HER2 yakanaka . Izvi zvingaratidzika sechishamisika mushure mekunge izvi zvave zvatoedzwa, asi mukudzoka, mamiriro ekugamuchirwa kwemasero emukenza anogona kuchinja, kunyanya kana ave ave anopfuura gore kana maviri kubva panguva yako yekuita mastectomy.
Mune mamwe mazwi, kana iwe pakutanga waiva nechirwere chekenza chepabonde chakanga chiri estrogen receptor positive, tumora yako masero angave akachinja uye akava estrogen receptor isina. Mune mhuka, izvi zvinonzi "kusawirirana kwechirwere."
Vamwe vanhu vangave vakashamisika kuti biopsy inokurudzirwa kana chiremba wako ane chokwadi kuti kudzoka kwekenza yako yepakutanga.
Izvi zvinokonzera kusawirirana kwekuti izvi zvinoitwa, uye zvinogona kuva nemigumisiro yakawanda mukusarudza nzira dzakanakisisa dzokurapa.
Sezvo kugadziriswa kwemazuva ano kwakafanana nekodhi rusvingo rwekudzoka kunogona kushamwaridzana nemasitosti ari kure, basa-rekugadzira kazhinji rinowanzoitwa uye rinogona kusanganisira PET scan kutarisa kune dzimwe nzvimbo dzakapararira mumuviri.
Mishonga
Kufanana nehutachiona hwepakutanga hwekenza yemazamu, kurapwa kwekudzoka kunowanzobatanidza mishonga shomanana. Mishonga inogona kuputsika mukati:
- Kurapa kwakarongeka: Aya ndiwo mushonga unogarisana nemasero ekenza chero ipi mumuviri wako, uye unosanganisira chemotherapy, zvinotarisirwa kurapwa, hormonal therapies, uye zvimwe zvezvinodiwa zvitsva zvinowanikwa mumakiriniki epirini zvakadai seP PARP inhibitors nezvimwewo.
- Mishonga yemunharaunda: Aya marapirwo anokonzera kenza apo inotanga (kana kupararira) asi haikwanise kugadzirisa kenza yemamwe mavara kune imwe nzvimbo mumuviri. Mienzaniso inosanganisira kurapa kwemazuva, chirwere, uye proton therapy.
Danho rekutanga nderokuona kana chifukidzo chechifu chechipfuva chirikudzoka kwega, kana zvimwe zviitiko zvekudzoka, kunyanya masastases ari kure aripo.
Chest Wall Recurrence Plus Distant Metastases
Kana painewo uchapupu hwemaserasti ari kure, kurapwa kwekenza yemasitema inenge iri ndiyo nzira huru.
Izvi zvinogona kusanganisira. Mishonga yemunharaunda inogonawo kushandiswa kudzora kenza mudanda rechifuva sezvakakurukurwa pasi apa. Maererano nekuongorora kwe2018, inenge 27 kubva muzana yevakadzi vane ruzivo rwezvekugara, sezvakaita chifukidzo chechifu chechifukidzo, chichava nemasikisisiti ekure.
Isolated Chest Wall Metastases (Isinga-Metastatic Recurrence)
Kana pasina humwe humwe hwehutachiona hunosangana nehutachiona hunenge huri kure nekuedza (hapana uchapupu hwekenza yakapararira kumapfupa, mapapu, chiropa, uropi, kana dzimwe nzvimbo), kurapwa kwemukati kubvisa kudzokorora ndiko chinangwa chekurapa. Sezvo chirwere chakapararira kumadziro echifuva chakanyanya "kuzivisa chinangwa chawo" kupararira kune dzimwe nzvimbo dzomuviri, zvirongwa zvehutachiona zvinokosha zvakare.
Usati wapora chirwere chacho, zvinokosha kuti "re-biopsy" inofanira kuitwa kuitira kuti aone mamiriro ekugamuchirwa kwekudzoka. Zvimwe zvinosanganisira:
Chemotherapy
Kana nzvimbo yekudzoka yakazara zvakanyanya kuti ibvise zvachose nekuvhiyiwa, chemotherapy inogona kushandiswa kutanga kuderedza ukuru hwechirwere kuitira kuti kurapwa kwekwanyika kuoneke.
Radiation Therapy
Kana chirwere chemaawa chisina kushandiswa panguva iyo kenza yekare yakarapwa, izvi zvinowanzoshandiswa (pamwe nekuvhiyiwa kana dzimwe nzira dzokubvisa tumarara) kuve nechokwadi kuti yese masero emukenza anobatwa (masero asingagoni kuonekwa pamafungiro asi anofungidzirwa kuitira kuti iwe uvepo.Kana chirwere chemaawa chinoshandiswa kare, remhepo yako ye-oncologist inorema zvingave zvichibatsira kubvunzurudza kuti yakareba kwenguva yakareba sei kubva iwe uine remishonga inonzi radiation, uye kana kuderedzwa kwechirwere kunogona kudiwa.
Surgery
Kuvhiya ndiyo inonyanya kukosha yekurapa kubvisa nzvimbo yekudzoka. Sezvataurwa pamusoro apa, chemotherapy inogona kudiwa kuti kuderedze ukuru hwechirwere chisati chaitwa, uye kurapa kwemaawa kunowanzoshandiswa mushure mekuvhiyiwa.
Chizere chakazara resection chinokurudzirwa kana zvichibvira, uye kana chiitwa kune vanhu avo vakakodzera kugadziriswa, zvakaguma ne 41 muzana yehupenyu hwekuwedzera mushure memakore gumi nemashanu zvichienderana nekudzidza 2018.
Hormonal Therapy
Kana kudzokorora kwaiva nesrogen receptor positive uye yakanga isina kunaka, hormonal therapy ichakurudzirwa. Izvi zvinogona kuva tamoxifen, kune avo vari foremenopausal, kana, kune avo vanonzi postmenopausal kana vari premenopausal uye vakawana kurapwa kwemaawa ovarian, aromatase inhibitor yakadai seAromasin (exemestane), Arimidex (anastrozole), kana Femara (letrozole). Kana chironda chacho chiri estrogen receptor chakanaka uye denda rako rekare raiva estrogen receptor positive, wako oncologist achanyatsoongorora zvaunogona kuita. Apo kudzokorora kunowanikwa kana uri pane chirwere chemahomoni, chironda chinogona kunge chakasagadzikana. Mimwe mishonga inogona kukurudzirwa, kana
Targeted Therapy
Kana bundu rako riri HER2 rakanaka uye chirwere chako chepakutanga chaiva HER2 chakaipa, HER2 inotarirwa mishonga yakadai seHerceptin (trastuzumab) inogona kukurudzirwa. Kana bundu rako riri HER2 rakanaka uye raivewo HER2 rakanaka kare, imwe HER2 inhibitor inogona kushandiswa.
Proton Therapy
Proton therapy inoshandiswa mushonga mushonga, uye hatina zvidzidzo zvakawanda. Chimwe che 2017 chidzidzo chakawana kuti chirongwa cheproton chechipfuva chemasvingo chidzokorora, apo remishonga yehutachiona yakagadzirwa nokuda kwekenza yekutanga, yakanga yakagamuchirwa chepfu. Kuvhiya kumadziro echifuva, zvisinei, pashure pekurapa kweproton, kunogona kuguma nezvinetso zvakakura mukurapa kwekuvadzwa.
Prognosis
Zvose zvine makore gumi nemakumi mashanu ekurarama kwekenza yepese uye kuburitsa rusvingo rwechifuva inenge makumi mashanu kubva muzana, asi izvo zvingave zvichishandura iye zvino nekusarudza kurapa kwakanakisisa. Nguva yakareba yakapfuura pakati pekenza yepabonde yokutanga uye kudzoka kwemazuva ano kunobatsira basa rinokosha mukurarama, nevaya vane chirwere chechifuva chekudzoka mukati memakore matatu ekuongororwa varombo (vanenge 30 muzana), asi avo vanodzokorora mushure memakore matatu , kuponeswa kunogona kunge kuri 70 muzana kana kupfuura.
Kutsungirira
Kana kenza yako yemazamu inodzoka, inogona kunyanya kutyisa kuti kana iwe uchitanga kuonekwa. Chikamu cheizvi ndechokuti 27 muzana yemapfupa emadziro ekudzokorora masvingo anoshamwaridzana nemasitosita kure (metastatic cancer) uye zvinoreva kuti kenza haigone kurapwa. Asi, kunyange kana kenza isiri kurapwa, ichiri kunyangarika, uye pane zvimwe zvingasarudzwa zviripo.
Kune avo vane kugadzikana kwekunze kwemazuva ano, kuzara kwekusvibiswa kwechirwere kunogona kuita kuti vapone kwenguva yakareba kune vakawanda vanozvigadzirira kurapwa uku.
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