Sezvaunofamba nemishonga yekenza yemasitemiti, chiremba wako anorayira miedzo yakawanda kuti aone kana kenza yako yafambira mberi kana kana iri kupindura kurapwa. Ndeipi miedzo inowanzoitwa, uye iwe unogona sei kurarama nekuedza kunetseka kunounza ?
Zvimwe zvezviongorori zvekufungidzira uye maitiro ekuraira zvinoshandiswa zvose kana mumwe munhu akaonekwa kuti ane chirwere chekare-kare kana chetachiona chemasamende, asi vamwe vanogona kuva vatsva kwamuri sezvavanonyanya kushandiswa kuongorora kurapwa kwekenza yepamusasa yepabonde.
Makomba Anogona Kuchinja Sei?
Isu tinowanzofunga nezvekenza sechisingashanduki, semasero ezvisikwa mumazamu edu asingashanduki zvakanyanya kupfuura nguva. Asi kanzura inogara ichichinja. Iko kushanduka uku mumakumbo, chaizvoizvo, izvo zvinokonzera kushorwa kwatinotarisa kumarapirwo akadai semishonga yemapirmoni , inotarisirwa kurapwa, uye chemotherapy munguva.
Iko molecular manzwiro echirwere inogona kuchinja, pamwe chete nemamiriro ekugamuchira kwemasero masero. Cancers inoramba ichichinja kune yakakomberedza, kazhinji ichigadzira mapuroteni matsva kuti adzivirire masimba edu ezvirwere uye kuchinja maitiro avo kuti vabatsire kupona kwavo.
Chirwere chingangodaro chaiva chestrogen chinonzwisisika apo iwe wakatanga kuongororwa, asi inogona kuva estrogen receptor isina kunaka apo inowanikwa mumapapu ako. Chirwere chinogona kuva CHIKAMU 2 chakanaka kana chokutanga chakaonekwa, asi HER 2 chakaipa gare gare. Iko kushanduka kwakajairika, uye kusvika pa5 kubva muzana yeHER 2 matumbo akanaka anova HER 2 asina kunaka gare gare.
Mukuwedzera kune kuchinja mumatumbu ndeye pfungwa yehutachi hterogenicity. Panzvimbo pokuva masero emasero ose akafanana, zvikamu zvakasiyana zvechirwere zvinogona kuva nezvimwe zvakasiyana nezvimwe, zvichienderana nekuchinja uku. Dzimwe nguva chikamu chimwe chemuviri pamusoro-chinoratidza HER 2, asi imwe chikamu chemuviri, kana metastasis mune imwe nzvimbo, haiti.
Iyi inotsanangurwa zvisinganzwisisiki yezvinoitika, asi inogona kubatsira kutsanangura kuti kese yepamuti yepamuviri yakasiyana sei.
Biopsies
Chimwe chezvinhu zvakakosha zvikuru kuongororwa ibhiopsy yemukenza wako. Chikonzero chimwe chikonzero chiremba wako anoda kujekesa tsvina yako ndeyekuti ave nechokwadi chekuti chirwere chepachifu chemasasa chinenge chichirwere chisina kuwirirana. Asi chikonzero chinonyanya kukosha chebiopsy, kana "re-biopsy," ndechekuona kuti kanzira yako ingave yakashanduka sei kubva panguva yawakatanga kuonekwa.
Imaging Studies
Iko kufungidzira kunoona kuti chiremba wako anokurudzira ichabva pane zvinhu zvakawanda kubva panzvimbo yemamota ako kumishonga inoshandiswa. Miedzo yakajairika (sezvakambotaurwa kare) inosanganisira:
- X-ray yenharaunda dzaunofungidzirwa kuva nemasasa magetsi
- Bhudzi rinotarisa: Pfupa rinopinza rinosanganisa kuvhara mhepo inopisa, iyo inozoongororwa nemifananidzo. Tora zvidzidzo zvinogona kubatsira pakuongorora masasa magetsi.
- PET inoongorora : PET scan ndiyo chiitiko chinokosha chekuziva kuti nzvimbo uye nzvimbo dzezvivi zvomuviri wako zvakadini. Kusiyana neT CT scans uye MRI inoongorora iyo inotarisa kunyanya pane zvigadzirwa, PET scan inotarisa basa remasero mumuviri wako. Shuga inokonzerwa nehutachiona yakakonzerwa muropa rako uye inotorwa nemasukisi anokura zvakadai sekenza masero. Kufungidzira zvidzidzo zvinogona kubvumira radiologists kuti vaone uye vanoona nzvimbo idzi mumuviri. Mukuwedzera pakubatsira kuongorora kuwanda kwekenza yako, kuongorora kwePET kunobatsira pakusiyanisa nzvimbo dzakadai sedare tissue uye fibrosis kubva pamakumbo anonyanya kukura.
- CT inoongorora : CT scan ingaitwa kuti utarise mudumbu rako, pfupa rako, chifuva chako, kana musoro wako
- MRIs: MRIs inogona kuitwa kuti uone kutarisisa zvakanyanya kune zvipi zvese zvinokanganisa muuropi yako kana dzimwe nzvimbo dzomuviri wako.
Zvinobatsira kugovera zvinhu zvishoma nezvekufungidzira zviedzo uye kukwana kwavo mukutevera kenza yakavhiringidza vamwe nekenza yematenda emuviri:
- Kuchinja pane kuverenga kunogona kunonoka - Kana wakangopedza kurapa yakadai sedhemotherapy , unogona kunzwa uora mwoyo kana kuongorora kenza yako kusina kuchinja muhukuru. Zvinobatsira kunzwisisa kuti kuchinja pane test imaging kunogona kutora nguva kuratidza. Semuenzaniso, kuderera kwekukura kwechiremera nekuda kwekurapa hakugone kuratidzira pane kupera kusvikira vhiki shomanana kana kunyange mwedzi mushure mekunge kurapwa kwako kwapera.
- Zviyero hazvina kukwana - Hazvina mhosva kuti une scan ye mtundu ipi, kune mukana iyo "ichawana" chimwe chinhu chakanga chisingave chinetso. Kunyanya kuedzwa kwaunako, zvinowanzoitika kuti izvi zviitike. Muenzaniso unosanganisira vazhinji vanorwara chiropa chinonzi nodules chinowanika pamakumbo eC scans izvo zvingava zvakaoma kusiyanisa nekenza.
- Inoongorora zvimwe kunze kwePET inoongorora haigoni kukuudza kana "nzvimbo" iri "kukura" - Zvingave zvakaoma mumuedzo wakafanana neT CT scan kuti uone kana "chivara" chinomirira kenza iri kukura, kusara shure mushure meimwe nzvimbo yekenza yakarapwa. PET kuongorora kunogona kubatsira kusiyanisa zvirwere zvinokonzera kukura kubva kune bhinzi, asi zvinogonawo kuva ne "mafungiro enhema" - nzvimbo dzekutambudzika dzinenge dzisina kuva chinhu.
- Shanduko shomanana muhukuru hwechirwere chinogona kunge chisina maturo - Vamwe vanhu vanoodzwa mwoyo kana tumarara inenge ichiita sendimita yakawanda pane kuongorora pane yaive yakaitwa pane yakamboedzwa. Kana iwe unotarisana nechimwe chinhu chakadai, bvunza radiologist yako pamusoro pekukwanisa kwekutsvaga kwawakaita. Mune zvimwe zviitiko, chirwere chinogona "kuonekwa" chikuru kana chiduku, chinogona kunge chisina kuchinjwa muhukuru kana wakakwanisa kuyera kenza zvakananga.
Tumor Markers (Biomarkers)
Kumhanyirira zvipfeko kana zviyo zvinokonzera mapuroteni zvinogona kunge zvakavanzika nechirwere kana kuti nemuviri mukupindura kumarara. Ropa kuongororwa kuti uone kuti mapuroteni aya anogona kuitwa kuti atevere kufambira mberi kwako nekenza yemasitamende yemazamu.
Sezvo nekufungidzira miedzo, izvi zviedzo hazvina kukwana. Hasi dzose dzekenza dzemazamu dzinokonzera kukwirira mune izvi, uye kana dzakasimudzirwa, zvingave zvichibva kune imwe mamiriro asiri kenza. Kushandurwa muhuwandu hwezvikwangwani izvi, sezvinongoita zvikwangwani, zvinogona kunonoka nemavhiki mashoma mushure mokunge tumarara inowedzera kana kuderera muhukuru.
Aya maedzo haawanzoshandiswa oga kuti aone kufambira mberi kwekenza yemvere uye inobatsira zvikuru apo mazinga anoteverwa nenguva. Kunyunyisa zviremba chiremba wako anogona kuenzanisa:
- Cancer antigen 15-3 (CA 15-3) - CA 15-3 ipuroteni yakagadzirwa nekenza yemazamu. Inogona kuwanikwa mu50 kusvika ku90 muzana yevanhu vane kenza yemasasa, asi 30 muzana yevanhu vane kenza yepabonde pekutanga. Nhamba dzeiyo biomarker dzinowanzove dzakanyanya kukwirira kune avo vane bone kana chiropa chemasastases. CA 15-3 inogona kuyerwa kuti iongorore kugadzirisa kwekenza yako kurapwa, asi kuchinja kwemazinga kunogona kuitika kwemavhiki mashomanana (kanowanzova mana kusvika matanhatu) mushure mokunge tumarara inopindura mishonga kana inobudirira.
- Kanjini antigen 27.29 (CA 27.29 ) - CA 27.29 ipuroteni (a monoclonal antibody) inobudiswa nejeni inonzi MUC-1. Iyi proteinino inowanikwa pamusoro pemamwe masero emukenza wemvere. Kusiyana nemamwe mavara, CA 27.29 ndiyo puroteni chete iyo inonyatsoratidza kuvapo kwemasero epenza rebere. Kunyange zvazvo muedzo uyu usingashandiswi kutarisa vakadzi vane mazamu echeperi-kutanga kwekudzoka, zvinofungidzirwa kuti kukwirira kunogona kuitika kumwedzi mishanu asati munhu aziva kuti kenza yavo yakadzoka zvakare. Sezvo neC CA 15-3, kune mamiriro ezvinhu kunze kwekenza yemucheche iyo inogona kukonzera kukwirira mumapuroteni aya, uye kukwirira kunogona kuramba kwechinguva chakawanda (mwedzi miviri kusvika mitatu) kunyange mushure mokunge kenza yakanyatsorapwa. Chiremba wako angarayira kana CA 15-3 kana CA 27.29, asi kwete kazhinji.
- Carcinoembryonic antigen (CEA) - CEA inonzi protein isingececific iyo inogona kukwidziridzwa kune vanhu vane kenza, asi inogona kukwidziridzwa mune dzimwe mimwe mitemo zvakare, kusanganisira kusvuta.
- Kupararira tumor cells - Kuchengeta ropa kwekupararira tumor cells (tumor cells kana kuti zvikamu zvemuviri masamu izvo zvakaputsika kubva mumarara uye zvakapinda muropa remvura) inzira itsva yekuongorora uye kutevera kenza yemasita. Kunyange zvazvo ichiri kunyanya kuongororwa, imwe muedzo yakagamuchirwa kuti ishandiswe kuvakadzi vane kenza yemasitamende yepabonde.
Kutsungirira Scanxiety
Vanhu vazhinji vanozonzwa hutano hwekuzvidya mwoyo pavanenge vakamirira migumisiro yekuongorora kana kuongorora kwebhroreta, zvisinei pasinei nenyaya ipi pakurapwa kwaiitwa. Nekenza yemasitatimendi yepfupa, kunyanya, pane dzakawanda mhinduro dzekuedza kuti zvamirire.
Iwe hausi woga kana pfungwa yako ichikura uye ichikurira zvinhu zvinotyisa zvekuti zvinogumisirei-uye zvinonyanya kukosha, izvo zvinorevei.
Iwe unogona kuita zvinhu zvakasiyana-siyana kuti utsungirire "scanxiety."
- Bvunza nezve nguva yezviwanikwa zvako uye kuti iwe uchave uchivagamuchira sei.
- Iva akasarudza pamusoro penguva ye scan yako. Kana iri kare muzuva rainogona kuverengwa nekuguma kwezuva, kukuponesa kushungurudzika usiku husiku. Pakutanga muvhiki zvinogona kureva kuponesa kunetseka pamusoro pevhiki.
- Kumbira mumwe munhu kuti akubatane newe paunenge uchienda kuongororo, sechinhu chinokanganisa.
- Anoseka. Tarisa firimu inonakidza inonakidza, enda kumutambo wemakwikwi, kana edza chero chii chichaita kuti unyemwe.
Sources:
Graham, L., Shupe, M., Schneble, E. uye al. Nzira Inoenderana Nezvinetso Pakutarisa Kurapa Mhinduro dzinopindurwa muBear Cancer. Journal of Cancer . 2014. 5 (1): 58-68.
> 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.