Sei vanachiremba vasingashandisi shoko rokuti 'Kucheneswa' nekenza?
Mubvunzo unowanzobvunzwa ndewekuti, "Ko menza yemapapu ingaporesa here?" Zvakadini kana yakabatwa kare? Kuvhiyiwa kana chemotherapy inoporesa mutsa wemapapu here? Sezvo nemibvunzo yakawanda pamusoro pemukenza wemapapu, mhinduro yakatendeseka pamusoro pekuti kana kana kwete yemukenza yemapapu inogara "ichirapa" inoda kutsanangurwa zvakanyatso.
Uyu mubvunzo wakaoma nokuti mhinduro inogona kuva hongu kana kwete zvichienderana nekuti iwe unotsanangura sei kurapwa.
Usati watsanangura kuti izvi zvinorevei uye nokuti tariro inokosha zvikuru mukugadzirwa kwekenza, zvinokosha kuchengeta mupfungwa zvinhu zvishoma:
- Kurarama kwenguva yakareba nemukenza wemapapu dzimwe nguva zvinogona kuitika, kunyanya kana chirwere chacho chikabatwa mumavambo okutanga, kana kana mukenza wemapapu wakakura unopindira kune zvinorapwa maitiro kana kuti immunotherapy.
- Vamwe vanhu vanopukunyuka makore mazhinji kunyange nechepakati pekenza yemapapu 4.
- Mastastases yakakura, yakadai sepakati pemukenza wemapapu inopararira kuuropi, dzimwe nguva iye zvino inogona kurapwa netariro yekugara kwenguva refu.
- Iko kunonzi zviitiko-asi zvisingawanzo-mumapapu emapapu ane chirwere chekare .
- Kunyange kana kenza yemapapu isingarapiki, inenge inoporesa nguva dzose.
'Chirwere' Chinorevei Nezve 'Makomba Akasimba'?
Muchirevo chakaipisisa chezwi, kenza yemapapu haigone "kurapwa." Izvi zvinoreva kuti pane nguva dzose mukana (pane dzimwe nguva izvi zviduku zvikuru) kuti mukenza wemapapu unogona kudzoka, kunyange makore akawanda kana makumi emakore mushure mekunge watanga kuwanikwa.
Iyo yakareba mumwe munhu anorarama asina uchapupu hwekenza (hapana uchapupu hwekenza dzimwe nguva hunongonzi NED ) inowedzera mukana wekuti ichadzoka.
Iko kune zvidimbu zviduku zvekenza umo vanhu vanogona kuziviswa kuti "vanoporesa" mupfungwa yakachena yeshoko, uye mazhinji eaya ane kenza yakadai yeropa yakafanana nerukemia mune vana.
Kanzira yemaperembudzi, panzvimbo payo, yakafanana nedzimwe "mishonga yakasimba" yakadai sekenza yemazamu nekenza yekoloni umo kunogara kwenguva refu kuregererwa kunogona, asi vanachiremba vanozeza kushandisa shoko rinoporesa.
Muenzaniso wekubatsira kutsanangura ichi ndechokuti vanhu avo vakaponeswa kenza yemapapu kwemakore mashanu vane ngozi inopfurikidza yekufa kubva pamukenza wemapapu kusvikira makore 18 mushure mekunge vaongororwa. Kudzokorora kunowanzove kune avo vane mapapu adenocarcinoma kupfuura chirwere chekamu memapapu chemapapu ; zvichida kana kenza yakapararira kune lymph nodes , uye zvichida kana chirwere chisina kuitwa (nemakumbo asingagoneki .)
Apo Chirwere Chirwere Chingave Chakanzi Charapa?
Chinhu chimwe chete mumabhuku ndechevanhu vane chirwere chekutanga 1A kenza yemapapu isina mhepo inopinda-ichireva kuti chirwere chacho chiduku zvikuru uye hachina kuenderera mumidziyo yega yega. Muchiitiko ichi, kana pasina humwe uchapupu hwekenza shure kwemakore mashanu, zvinoita sokuti shoko rinogona kurapwa rinogona kushandiswa.
Nei Kune Cancers Inogona Kuitika Kwemakore Kana Kuti Makumi Makumi Gare gare?
Hatisingazivi kuti mhavha yemapapu (uye mamwe mishonga yakasimba yakafanana nekenza yemazamu) inogona kuonekwa kuti yakavanza kwemakore akawanda uye inowanikwazve. Imwe nyanzvi ndeyekuti kune hutungamiri hwekenza masero, pamwe nemamwe masero (kanomwe stem cells) ari kunyanya kusagadzikana kurapwa uye kuva nekwanisi kurara zvakasara.
Heino nyaya inogona kubatsira kutsanangura kuti kenza inogona sei kuviga kwemakore kana makumi emakore .
Inogona Kuve Nhanho Yokutanga Mushonga Wemapupa Anoporesa Nokuvhiya Here?
Muzhinji, kuvhiyiwa kunopa mukana wakanakisisa wekugara kwenguva refu kubva mumukenza wemapapu. Sezvambotaurwa pamusoro apa, apo upiyona huri kuitwa chero ipi zvayo yekutanga, hauna kupararira kune lymph nodes kana mitsipa yeropa, vanachiremba dzimwe nguva vanoshandisa shoko rinorapwa.
Kuvhiya kunogona kuitwa kune avo vane danho rekutanga , chigamba chechipiri uye chikamu chechitatu 3A chisati chidiki chekenza yemapapu emapapu. Mukudzidza kukuru, pakati pevanhu vane chirwere chekutanga 1A kenza yemapapu, 16 muzana yakanga ichidzokorora mumakore mashanu okutanga, uye pangozi yekudzoka shure kwemakore mashanu ari 4.8 muzana.
Mune imwe dzidzo, 87 kubva muzana yevanhu avo vakabudirira kuvhiyiwa ne lymph node dissection, uye vakanga vari vapenyu makore mashanu mushure mekunge vaongororwa, vakapona mamwe makore mashanu kanzira pasina. Pakati peboka iri:
- Kune vanhu vane N0 chirwere (hapana kupararira kwekenza kune lymph nodes maererano neTNM system yekenza yemapapu emapapu ), 89 muzana vakaramba vasina kenza.
- 84 muzana yevanhu vane chirwere cheN1 (kupararira kwekenza kune lymph nodes pedyo nekumarara kwekutanga) kwakanga kusina kenza.
- 65 muzana yeavo vane chirwere cheN2 (kupararira kwekenza kune lymph nodes mberi kwechirwere) kwakanga kusina zvirwere.
Ko Chemotherapy Inogona Kurapa Mungozi Here?
Kazhinji, chemotherapy haina kushandiswa nehutano hwevanhu vane cancer yemapapu. Pane zvikonzero zviviri zvinoita kuti chemotherapy ishandiswe. Imwe yakafanana nehutachiona hwechirongwa. Semuenzaniso, kana mumwe munhu ane chirwere chemapapu emapapu, chemotherapy inogona kupiwa sehuwandu hwehutano apo chero mimwe mapepa emapapu emapapu akapararira kune dzimwe nzvimbo dzomuviri-asi haakwanisi kuonekwa nekuongorora zvidhori. Aya masero anogona kunge akapararira asi asingaonekwi anonzi ma micrometastases.
Imwe chinangwa chikuru che chemotherapy nemukenza wemapapu ndechokurapa kwepamusoro. Uyu ndiwo mushonga unopiwa kuwedzera hupenyu kana kuderedza zviratidzo, asi hazvirevi kuporesa chirwere.
Basa re chemotherapy yemukenza wemapapu rinokosha zvikuru kunzwisisa. Chidzidzo che2014 chakawana kuti vanenge makumi manomwe kubva muzana yevanhu vane kenza yemapapu vakanga vasinganzwisisi kuti chemotherapy yakanga isingamboiti kurapa kenza yavo. Vanhu vazhinji vane tarisiro yenhema kuti zvichida chemotherapy inoshanda kushandura kenza yavo, asi izvi hazvigoneki kune mumwe munhu ane chirwere chemasasatic.
Kana chiremba wako achitaura pamusoro pekudzivirira chemotherapy, iva nechokwadi chokuti unoziva zvaari kutaura uye zvinangwa zvake ndezvipi. Chirwere chemhemotherapy chinogadziriswa chinopiwa nechinangwa chakasiyana mupfungwa kuti chidimbu chemotherapy. Mune mamwe mazwi, kana iwe uri kutarisira zvechokwadi mukana wekuporesa, unogona kufunga nezvechirwere chechirwere kana kuti sarudzo yakadai seyununotherapy.
Unogona Kurapa Kanzera Kurapa Nemazai?
Sterootactic body radiotherapy (SBRT) , inozivikanwa zvikuru se "cyber knife" nzira, inogona kuva nekubudirira kwakafanana nekuvhiyiwa mune vamwe vanhu vane kenza yemapapu ekutanga, uye avo vana kanzira haigoni kurapwa nekuvhiyiwa. Muchidzidzo chiduku chevarwere vakapona makore mashanu achitevera SBRT, 25 muzana vakanga vachidzokorora zvakare chirwere chavo.
Kushandiswa kwemazuva ano kwemazuva ano kunowanzoshandiswa kana kuti chirongwa chemakiritsi (sechika chemotherapy), kuparadzira hupenyu, kana kuderedza zviratidzo zvemapapu emapapu zvakadai sekurwadziwa kwemapfupa kana kuvharirwa kwepasi.
Inogona Kuongororwa Mishonga kana Immunotherapy Mushonga Chirwere Chirwere
Nekenza yemapapu iyo iri danho rechina (kana kuti ganhuro 3B ), chinangwa chekurapa hachisi kazhinji kuporesa, asi kunowedzera hupenyu uye zviratidzo zvinodzora. Izvozvo zvakati, uye kunyanya nedzimwe dzezvitsva zvinotarisirwa mishonga yemukenza wemapapu seTarceva erlotinib) kana Xalkori (crizotinib) vamwe vanhu vanogona kurarama kwenguva yakareba, dzimwe nguva makore akawanda pavanorapa kenza yavo sezvavanoita imwe zvirwere zvisingaperi chirwere chepvo kana chirwere cheshuga.
Zvakakosha kuti munhu wose ane kenza yemapapu yakakurumbira ane kufungidzirwa kwema molecular (profiling gene) yakaitwa pamakumbo avo. Pamusoro pemishonga iyo ikozvino inogamuchirwa kuvanhu vane EGFR mutations , rearrangements ALK, rearrangements ROS1 , uye zvimwewo maitiro ekuchinja mumasero ekenza pane kuongororwa kwekliniki kuongororodza mamwe maitiro anoverengeka emamwe masero emukenza emapapu.
Immunotherapy inofemawo chivimbiso chehupenyu hwemazuva akawanda husina hutano hwevamwe vanhu vane cancer yemapapu yakakura. Haasi munhu wese anopindura mazano aya, asi kana aine hutano anogona kutungamirira kune nguva yakareba kupona kune vamwe vanhu. Muna 2015 maviri ekutanga immunotherapy mishonga, Opdivo (nivolumab) uye Keytruda (pembrolizumab) vakabvumirwa kuitira kurapwa kwekenza yemapapu nemimwe mishonga mukirasi ino, uyewo kusanganiswa, vari kuongororwa muchipatara .
Kurapa kweOligometastases
Kunyange zvazvo zvisingawanzoitiki, kupona kwenguva refu kwenguva inogona kuitika kunyange kana mutsa wemapapu wakapararira. Kune mitsara yevanhu vanopfuura gumi nevaviri vakararama kwemakore 10 kana kupfuura mushure mehutachiona hwemakumbo kubva mumukenza wemapapu. Mushumo wemazuva ano zvakare unoratidza kuti kubata mishonga panzvimbo dzakasiyana-siyana ne stereotactic body radiotherapy inogona kuva nzira yekuvandudza kupona kwenguva refu kwevamwe vanhu vane chirwere chepaneti yemapapu 4 mune ramangwana.
Dzidza zvakawanda nezvekurapa kwemapapu emapapu nemasitasase emapfupa , adrenal gland metastases , uye chiropa chechiropa .
Ko Zvakadini Nezvirwere Zvepanyama?
Indaneti inopararira nehukama kune izvo zvinonzi "kurapwa kwepanyama" kwekenza. Zvinosuruvarisa, zvidzidzo zvekugadzira zera zvinokundikana kuratidzira kubatsirwa kwehupenyu kune chero ipi zvayo nzira. Zvakanakisisa, zvimwe zvezvigadzirwa zvinogona kubatsira nezviratidzo zvine chokuita nekenza yemapapu uye marapirwo ayo, asi kana zvakanyanya kuipa, zvinogona kupindira nekemotherapy, inogona kuvhara varwere vane chirwere chemararamiro avo, uye kana ikashandiswa panzvimbo yekurapa, inogona kupfupisa upenyu kutarisira.
Zvinosuruvarisa kuti kushandiswa kwemishonga uye kushambadzira kwenhema kwakaderedza dzimwe nzira dzokurapa nenzira dzakawanda. Inotarisirwa nevadzidzisi vane mvumo vanoita basa remishonga inobatanidza zvimwe zvezvirapa izvi, zvakadai sokugadziriswa kana kuti ginger kwekemotherapy-induced nausea , inogona kubatsira vanhu kukunda zviratidzo zvekurapa kwechirwere chekenza, uye mukuita kudaro, kuvandudza hupenyu hwehupenyu. Dzidza zvakawanda nezvedzimwe nzira dzokurapa dzemukenza wemapapu dzinogona kukubatsira kuti utsungirire zviratidzo zvechirwere.
Kurarama Nokusava nechokwadi
Kurarama nekusava nechokwadi nekenza ndeimwe yezvinhu zvakaoma zvikuru zvekupona . Kubatanidzwa munharaunda yemukenza yemapapu kwakabatsira vanhu vazhinji kurarama nekutengesa uye kutya kwekenza nekudzoka nekufambira mberi , sezvo iwe uchiona kuti kwete chete iwe hausi iwe woga asi unogona kuva chikomborero kune vamwe vakaonekwa kuti vane chirwere.
Kunyangwe tichiziva kuti pane dzimwe nguva vanhu vanoita zvinhu zvose vachiri kuve nekufambira mberi kwekenza yavo, pane zvinhu zvishomanana zvaunogona kuzviita iwe izvo zvingaita kuti uwedzere kupona . Tirikudzidzawo kuti kudya kudya kwakanaka kunogona kuita chimwe chinhu mukuderedza kudzokorora, uye iwe ungada kuongorora urongwa hwemapapu ekumapapu-kurwisa izvo zvakaongororwa kuti zvionei, kana zvipi, zvingave zvingava nazvo pamapapu masero emukenza zvakananga.
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