Zvikonzero Zvokuvhiya Ngazvirege Kushanda uye Zvimwe Zvimwe Zvimwe
Kana chiremba wako akuudza iwe kuti mupenza wemapapu yako haikwanisi, chii chaicho chinoreva? Tichatsanangura kuti nei zvirwere zvekenza zvemapapu zvakawanda zvisingakwanisi, asiwo nei izvi zvisingatauri kuti kenza haigoni kushaya simba kana kuti kupona kwenguva refu hakugoneki.
Mishonga yemukenza wemapapu yakashandura zvinoshamisa mumakore mashoma apfuura. Uye ikozvino pane zvakawanda zvingasarudzwa zvekutarisa chirwere kunyange kana chirwere chisingaitiki.
Overview
Rimwe remashoko anonyanyisa anoshandiswa patinenge tichikurukura nezvekenza yemapapu ndiro izwi "risingabviri." Izwi rinogona kubatsira mumishonga, sezvo rinobatsira vanachiremba vanoisa vanhu muboka. Inoperable zvinoreva kuti kurapwa kwekenza yemapapu hazvioneki kuti ndiyo nzira yakanakisisa yokurapa.
Asi, kune avo vanorarama nemukenza wemapapu semurwere, mazwi aya anogona kunzwika zvakasiyana zvachose. Icho chinogona kunge chakaita sechinhu chinotyisa chechimiro chekuguma.
Kunyange zvazvo "kenza yemapapu isingagoneki" inotakura zvirwere zvakashata pane zvirwere zvepapu zvinogona kurapwa nekuvhiyiwa, nguva zhinji kune dzimwe mishonga inogona kushandiswa. Mishonga yakadaro dzimwe nguva inogona kutora nguva yakareba kurapa kwechirwere chakafanana neicho chekuvhiyiwa.
Zvakakosha kuziva kuti kunyange kana kenza yemapapu isingagoni kushanda, inogona kushanda mune ramangwana. Dzimwe nguva chemotherapy uye remishonga inonzi radiation inoderedza hukuru kana nzvimbo yechipfuva kuitira kuti chirwere chinogoneke gare gare.
Apo chemotherapy inoshandiswa nenzira iyi, inonzi "neoadjuvant chemotherapy."
Kufungisisa
Kuvhiya kungasava yakakodzera kurapwa kwemukenza wemapapu kune zvikonzero zvakawanda. Izvi zvinogona kusanganisira:
- Type-Surgery inowanzoitwa nokuda kwekusava duku kwekenza yemapapu emapapu . Mukomana muduku wekenza yemapapu inotanga kupararira nokukurumidza uye kuvhiyiwa kunowanzoongororwa chete pamakumbo maduku.
- Stage-Surgery inowanzoonekwa semutambo wekutanga , chigamba chechipiri nechikamu chechitatu 3A kwete chediki chemapapu emapapu emapapu. Chikamu chechitatuB uye chirwere chemapapu 4 emapapu emaperembudzi kakawanda inorapwa nemishonga isiri nzira yekuvhiya, yakadai semakemotherapy, inotarisirwa kurapwa, inonzi immunotherapy, uye remishonga inonzi radiation.
- Nzvimbo-Kana chirwere chemapapu chiri pedyo nemigwagwa inokosha, yakadai semwoyo, maitiro ekurapa kunze kwekuvhiyiwa inowanzodiwa.
- Jedhi Utano-Nokuda kwezvipingamupinyi zvine chokuita nekuvhiyiwa kwemapapu uye aneshehesia yakawanda, mamwe marapirwo angaita kuti kuvhiyiwa kuve nengozi.
- Nhengo yeMakumbo-Kana kufema kwave kuchikanganisa nemamiriro ezvinhu akadai sechirwere chinokonzera chirwere chemapapu (COPD) kana zvimwe zvirwere zvemapapu, kuvhiyiwa kunogona kuderedza mapapu ekushanda.
Mishonga
Kunyange zvazvo mutsa wemapapu unofungidzirwa usingabviri, dzimwe nzira dzakawanda dzokurapa dzinogona kuwanikwa.
Chemotherapy
Mapepa akawanda emapapu anopindura, zvichida zvishoma, chemotherapy .
Radiation Therapy
Mishonga inogona kushandiswa kuderedza chiremera uye, dzimwe nguva, kuporesa kenza. Nzira idzva dzehutachiona hwehutachiona (stereotactic rayation kana cyber knife) dzimwe nguva dzinoshandiswa nekenza yemapapu emapurogiramu epakuvamba nemigumisiro yakafanana yakafanana neyo inowanikwa nekuvhiyiwa. Zvinotarisirwa kuti izvi zvingava zvakanyanya zvekusarudza munguva yemberi.
Stereotactic body radiotherapy (SBRT), inonziwo gamma knife kana cyber knife, inowedzera kushandiswa kugadzirisa oligometastases. Oligometastatses ishoko guru rinongoreva kungoita mashoma mashoma.
Somuenzaniso, kana munhu ane zvirwere zvitatu muuropi hwake kubva mumukenza wemapapu, vangangodaro vanogamuchira SBRT kuti vararame zvirwere izvi. Zvichakadaro, zvimwe zvirwere, zvakadai semakemotherapy, zvinotarisirwa kurapwa, kana kuti immunotherapy zvinoshandiswa kudzora kenza mumuviri wose.
Targeted Therapies
Targeted therapies mishonga yakagadzirirwa kurwisa kenza zvakananga kana kupindira neropa rekuisa kumarara.
Chimwe chekurapa kwakakonzerwa nemukenza wemapapu ndiko kushandiswa kwe erlotinib kweEGFR mutations kana crizotinib yeAl-positive pamukenza wemapapu kana kuti ROS1 yakanaka yemapapu emapapu .
Izvi zvinongova muenzaniso wezvishomanana zvekuchinja kunotarisana kunowanika kune vanhu vane mutsa wemapapu. Kunyatsoti munhu wese ane kero kaduku kadiki kemapapu yemapapu inofanira kuva nehuwandu hwekuongorora (genetic testing) yakaitwa pachirwere chavo kuti uone kana ivo vakagadzirirwa chero ipi zvayo yemishonga iyi.
Immunotherapy
Immunotherapy inzira inofadza yekurapa kwemapapu emapapu, ine chirwere chekutanga mumutambo uyu wakagamuchirwa nemukenza wemapapu muna 2015. Mamwe madhiragi ave akawanikwa kubvira panguva iyo nemimwe mishonga inodzidzwa mumakiriniki-zvichida kana pamwe chete mamwe mishonga kubva kumakemikrasira kusvika kumazuva ano kusvika kushandiswa kwekubatanidzwa kwemishonga inorwisa mishonga.
Immunotherapy inoshanda kuburikidza nekuita muviri wemuviri wega kuti urwise kenza uye inogona kushanda kunyange nekenza yepamusoro yepamusoro. Kunyange zvazvo immunotherapy inongoshanda chete iye zvino kune 20 kusvika ku30 muzana yemakenza emapapu, inogona kuva yakakosha zvikuru kuvanhu ava. Kubudirira zvakakwana zvokuti vamwe oncologists vari kushamisika kana immunotherapy ichakwanisa kuporesa vamwe vanhu vane chirwere chemukati wemapapu 4, shoko risati rambotaurwa kare pavanokurukura nezvekenza yemapapu yakapfuura.
Clinical Trials
Vanhu vazhinji vanoonekwa kuti vane kenza yemapapu isina kukodzera vanosarudza kuzvinyoresa kuongorori-tsvakurudzo dzinoongorora mishonga mitsva kana nzira inenge isati yavapo yakawanda pakurapa kenza yemapapu. Ivo ruzivo rwemhando uye zvikamu zvekuongororwa kwemakiriniki , urongwa hwemibvunzo yekufungisisa, nekubatanidza kwemashoko eInternet uye kushandiswa kwemasangano ekuedzwa kwechiremba (izvi zviri pachena) zvinogona kukubatsira kuti uone kana kliniki yekutongwa yakakodzera iwe.
Maererano neNational Cancer Institute, munhu wose ane chirwere chemapapu anofanira kufunga nezvekushandiswa kwekliniki. Zvinogona kubatsira kuchengeta mupfungwa kuti mishonga yose uye nzira yatinayo yekurapa yakamboongororwa muchipatara chekuedza.
Matambudziko akawanda emakiriniki ari kuenderera mberi, achivimbisa kuwedzera kumwe kuvandudzwa mukurapa nekupona kwechirwere ichi. Funga kuti pakati pe2011 na2015 mimwe mishonga mitsva yakagamuchirwa kuitira kurapwa kwemukenza wemapapu kupfuura yakabvumidzwa munguva yemakore makumi mana kusvika gore ra2011. Pane tariro yakawanda.
Shoko Rinobva
Kana iwe uri kutarisira mudiwa nemukenza usingabviri wemapapu, ungangonzwa uchingotya asiwo usingabatsiri. Tarisa nyaya iyi apo apo waunoda ane chirwere chemapapu umo vanhu vane kenza yemapapu vakagovana zvavanoda kuti vadiwa vavo vazive nezvirwere zvavo nemafungiro avo nemanzwiro avo. Uye kana iwe uchangobva kuongororwa nemukenza wemapapu , zvakakosha kuti udzidze zvaunokwanisa pamusoro peswere chako, zvakare.
> Kwakabva:
> American Society of Clinical Oncology. Chirwere Chechirwere-Isina Muchiri Mutsana: Kurapa Zvimwe. 6/16.