Kuchengetedza Mwoyo Wako Kubva Mirizhonga Yakasarudzwa neBritain-Breed Cancer
Kurapa kwechirwere kunogona kuvandudza hupenyu hwevamwe vanhu vane kenza yemazamu asi inogona kukuvadza mwoyo wako kana iwe wakasiya kenza yepabonde. Kushandiswa kwehuroyi pamwoyo wako kunogonawo kuwedzerwa nekukuvadzwa kunokonzerwa nemamwe mishonga yekenza yakadai sedhemotherapy uye inorapwa mishonga. Dzidza kuti nzira yekufema yekufuridzirwa nekufema kunobata zvakadini kunogona kuderedza zvakanyanya kuwanda kwemhepo inokonzera mwoyo wako, uye mukuita kudaro kuderera dambudziko rako repfungwa yemwoyo.
Radiation Therapy for Breast Cancer
Vakadzi vazhinji vanoenda kuburikidza nehutachiona hwehutachiona hwekenza yepamu , uye iye zvino, inenge 50 kubva muzana yevanhu vane kenza yepabonde yepakutanga vane zvirwere izvi. Kurapa kwechirwere kumapfupa kunogona kushandiswa kuderedza dambudziko rekudzokorora kwemukati mukati mazamu mushure me lumpectomy. Izvo zvinoderedzawo kenza yemafupa emvere yekufa nemumwe wechitanhatu.
Mishonga inogona kushandiswa zvakare mushure mekuita mastectomy, kunyanya kuvakadzi vane lymph nodes positive yechirwere. Iyo yose radiotherapy yepamu inopiwa pamarongwa akasiyana-siyana zvichienderana nechepakati chekenza asi inowanzoitika zuva nezuva mukati mevhiki kwevhiki shanu kusvika matanhatu. Nzira itsva dzehutachiona dzinopawo huwandu hwakawanda hwehuwandu hwemazuva uye kushanya kuduku kune dzimwe nzvimbo.
Radiation Therapy uye Heart Disease
Nehupenyu hwekuchengetedza kenza yepabonde nekuvandudzwa kwekemotherapy kusanganisa, kupfuurira kwema hormone therapy kwemakore mashanu kusvika kune gumi, uye zvinorapwa zvirwere zveHER2 zvirwere zvakanaka, njodzi yekurarama kwenguva yakareba nekenza inoda kutariswa.
Munguva yakapfuura, hatina kufunganya nezvenguva refu nemigumisiro yemishonga yeradio sezvatiri nhasi. Vanhu vazhinji vanogona kutarisirwa kurarama makumi emakumi emakore mushure mekurapa uku kunotitadzisa kutarisisa zvakanyanya zvinetso zvinogona kuitika makore mumugwagwa.
Radiation therapy yakabatanidzwa mumhando dzakasiyana-siyana dzechirwere chemoyo.
Izvi zvinosanganisira:
- Coronary artery disease
- Cardiomyopathy / congestive moyo kusakundikana, kuora mwoyo kwemutsipa wemwoyo kunoderedza kukwanisa kwemoyo kupompa ropa kune imwe muviri wose
- Zvirwere zvinosanganisira zvivharo zvemoyo (valvular heart disease)
- Abnormal moyo rhythms (arrhythmias)
- Pericardial conditions: Kukuvadzwa kwechigadziko chemwoyo (iyo pericardium) kunogona kutungamirira kune yakagadzirwa nemvura inenge iri pakati pezvinyorwa zvinonzi pericardial effusion . A pericardial effusion inoita kuti zvive zvakaoma kuti musuru wemiviri iputire uye dzimwe nguva ingangove yehutano hutsva.
- Kungoerekana kwafa kufa kwemwoyo
Zvidzidzo zvakawana kuti kuderedza huwandu hwemazuva ano kusvika pamwoyo apo kurapwa kunoonekwa kuderedza dambudziko rehutano hwemwoyo (mwoyo kukuvara), asi izvi zvakakosha zvakadini?
Kubvunzurudzwa kukuru kwe 2017 kwakatarisa njodzi yekufa kwemoyo inofanana nevakadzi vanorwara nekenza yemazamu pakati pe2010 na2015. Kubva iyi dheinhe nedzimwewo zvidzidzo, vatsvakurudzi vakaedza kuenzanisa kukanganiswa kwemaawa ekurapa pahutano hwemwoyo uye kubatsira kwemazuva ano mukuderedza kufa kwekenza nekufa kwekenza.
Yakawanikwa kuti kubatsirwa kwehutachiona hwehutachiona pamusana pekuchengetedzwa kwekenza kwepabonde kwakapfuura dambudziko rekufungidzirwa kwechirwere chepfungwa chakabatana nemirairo.
Ikoko kwaiva nemuenzaniso mumwe chete, asi, kune vanhu vanobvuta njodzi yehutano hwemwoyo hunokonzerwa nehutachiona hunogona kupfurikidza nezvibereko zvayo zvekenza. Zvose, chirwere chemaawa chakafungidzirwa kuwedzera njodzi yezvirwere zvepfungwa zvinenge makumi mapfumbamwe kubva muzana.
Kuporesa Gating: Rinoshanda here?
Kufuridzira kuputira inzira inzira yekushandura chimiro chechipfuva kuitira kuti kuderedza kusvibiswa kwemoyo kumayero. Kufuridzirwa nekuputira uye kufema kunobata kurapwa kwemazuva iyo nzira iyo munhu anotora mhepo yakawanda yemhepo uye inoritora apo denderedzwa remhepo rinotungamirirwa pazamu. Ichi chifuva chinobata chinotarisirwa kumaminitsi anenge makumi maviri nemakumi matatu, chinodzokorora kazhinji panguva yehutachiona hwehutachiona hunoshanyira.
Maererano nekudzidza muna 2016, kufema kwakapfurikidza kufema kunobatsira kuwanda kwemhepo yakagamuchirwa mwoyo (inonzi heart dose dose) inenge inenge 50 kusvika ku 60 muzana maererano nemwoyo wemazuva ano muvanhu vakafema nenzira yakawanda uye pakarepo mumusangano. Vamwe vanhu vakakwanisa kudzora kufema kwavo zvakakwana zvokuti pakanga pasina kumira kwemazuva ano kusvika pamwoyo yavo. Kune kusiyana kwakasiyana-siyana kwechigadzirwa kusanganisira Active Breathing Control kana kuti ABC system.
Mamwe maitiro ave akaedzwa kuderedza kuwanda kwemazaisai akaiswa kumwoyo, asi kazhinji kunoguma nechezasi (uye zvishoma kudzivirirwa) chiyero chemazuva ano kuendeswa kumusana wechipfuva uye ruzha rwechifuva. Nokuputika uye kufema, mazhizha emasikirini akakwanisa kuderedza kusvibiswa pamwoyo pasina kudikanwa kwekudzikisa muyero wemasaisai.
Chii Chaunogona Kutarisira Panguva Mishonga Yako?
Nhanho yekutanga mukuputika kunenge iri chirongwa chako chekurapa nehutachiona hwehutachiona hwehutano kuti uone kuti majekesi achapihwa uye paneii (inonzi dosimetric plan). Munguva iyi yekugadzirira, nzvimbo yako yehutachiona inocologist ichaita zviyero uye kuedza kukwanisa kwekupemesa kubvisa kuderedza kuwanda kwemazuva anoendeswa kumoyo wako.
Nzira yacho inobvumirwa zvakanaka uye inenge 80 muzana yevanhu vanogona kudzora kufema kwavo uye vanobata mweya yavo yehuwandu hwenguva inoda. Vamwe vanhu vakazviratidzira ivo kushambira chikwata mune dziva riri pasi pemvura sezvavanoita kufema. Munguva yako yeruzhinji, sarudzo yakadai se-audio-visual biofeedback inowanzogadzirirwa kuti ikuudze nguva yekufema zvakanaka uye nguva yekubata mweya wako.
Kukanganisa kweHupemiti Gating uye Breath Hold
Sezvambotaurwa, kuporesa kuputika kunowanzochengetedzwa zvakanaka uye vanhu vazhinji vanogona kubata mweya yavo kwenguva yakareba. Kune humwe hukakosha, zvisinei, uye zvakawanikwa kuti vamwe vanhu (pasi pe20 muzana) vakawana zvakaoma kuchengetedza huwandu hwekufuridzirwa mukati mehutano hwakasanangurwa.
Zvimwe Zvirwere Zvokurapa Zvisanganiswa neMwoyo Wezvirwere
Kushandiswa kwechirwere chepachirwere chepachifu chebonde chakasara kunogona kuwedzera njodzi yehutano hwemwoyo, asi mamwe mishonga yekenza yemazamu ingawedzera kune iyo ngozi.
Chemotherapy mishonga yekenza yemazamu inogona kuwedzera ngozi yako yepfungwa yemwoyo, kunyanya chirwere chepfungwa uye kusagadzikana kwemoyo, uye oncologist yako ingave yakakwanisa iwe kuedza mwoyo (seMUGA scan) usati watanga chemotherapy. Adriamycin (doxorubicin) inonyanya kuzivikanwa chinokonzera kukanganisa kwemwoyo uye inoshandiswa mune dzakawanda chemotherapy zvinokonzerwa nekenza yepabonde rekutanga. Cytoxan (cyclophosphamide) inogonawo kuva nemigumisiro ine chokuita nemwoyo.
Kune vakadzi vane HER2 chirwere chepachifu chakakonzerwa nemishonga yakadai saHercceptin (trastuzumab) uye mishonga inodhaka inogona kushandiswa. Zvinenge 5 kubva muzana zvevanhu vanobatwa neHER2-inotarisirwa kurapwa ichava nehuwandu hwekushaya mwoyo. Zvinonyanya kuitika kana zvichisanganiswa naAdriamycin uye zvichida zvinowedzera kuipa kwemwoyo kunokonzerwa nehutachiona hwehutachiona. Cardiotoxicity yakawanda yakadzika uye yakasvika kubva ku6 kusvika ku4 muzana.
Kune vakadzi vane tumorini yakagamuchira-estrogen, zvirwere zvehomoni zvekenza yemazamu zvinogona kukonzera njodzi yezvirwere zvepfungwa zvakare. Mishonga inonzi "aromatase inhibitors", kusanganisira Aromasin (exemestane), Arimidex (anastrozole), uye Femara (letrozole), inowanzoshandiswa kune vakadzi vane kenza yemasimopaopausal mushure mekuita chemotherapy uye kune vakadzi vane kenza yepremenopausal yepamu avo vakagamuchira kurapwa kweavarian therapy.
Kuvhiya kwekenza yemazamu hakuratiki kuwedzera kungozi yezvirwere zvepfungwa, asi kurwadziwa kana kusuruvara kwakabatana nekuvhiya kunogona kuderedza kukwanisa kwako kuona zviratidzo zvepfungwa yemwoyo.
Kutaura Nechiremba Wako Nezvehutano Hwako hweMwoyo Wezvirwere
Paunenge uchitarisana nekenza yekurapa kwepabonde pfungwa yako ingangodaro yakanyanya kuve nekenza yebonde chete. Asi chirwere chemwoyo ndicho chinokonzera rufu rwevakadzi, uye chepfungwa yepfungwa, chirwere chegoni chinonyanya kufanana.
Zvakakosha kutaura nachiremba wako pamusoro pehutano hwehutano hwepfungwa hunoenderana nekurapa kwekenza yako. Mukuwedzera kune mishonga yekenza yemvere, zvimwe zvipingamupinyi zvinokonzera chirwere chemoyo muvakadzi zvinogona kusanganisira:
- Nhoroondo yemunhu kana yemhuri yechirwere chemwoyo
- Kusvuta
- High blood pressure
- Yakakura cholesterol (kana pasi HDL)
- Kuwandisa kana kuoma
- Chirwere cheshuga kana chirwere chemagetsi
Chiremba wako angadawo kuedza kuongorora ropa kunonzi C-reactive protein (CRP) . Zvichienderana nezvenhoroondo yako, zvinokonzera njodzi, uye mishonga yekenza ,zve kuedza kunogona kukurudzirwa.
Zivai Zviratidzo Zvokunyevera Zvinetso Zvemwoyo-Vakasiyana Vakadzi!
Mumakore achangobva kupfuura, tadzidza kuti zviratidzo zvemwoyo mukati mevakadzi zvinowanzosiyana kubva kune avo vari varume. Izvi ndezvechokwadi kukanganisa kwemwoyo pamwe nehutachiona hwehutano uye hunofungidzirwa kuti ndechimwe chezvikonzero zvinoita kuti chirwere chetachiona chinogona kuva chakanyanya kuvakadzi. Vakadzi vane chirwere chepfungwa vane nguva refu vachipata zvirwere zvepfungwa uye vanowanzofa vasati vaenda kuchipatara. Zvakakosha kunzwisisa zvikonzero zvinokonzerwa neizvi.
Kutadza kwemoyo kunobatanidza kushaya mwoyo mukati mevarume kunowanzobatanidza kuperevedza kwekufema kwekufema nekukanganisa kubuda kwemapapu kumapapu. Zviratidzo zvekushaya mwoyo kwevakadzi
rinogona kuva rakajeka. Zviratidzo zvinogona kusanganisira kuneta, kupfupika kwefema iyo inogona kurondedzerwa sekuwedzera kusagadzikana kwebasa, nekudzimba kwetsoka nemakumbo.
Izvozvowo ndezvechokwadi kana angina uye mwoyo. Varume vanowanzova nezviratidzo zvekare zvekupwanya kurwadziwa kwepfupa sejovu vagere pamapfupa avo. Angina kuvakadzi kazhinji inosanganisira zviratidzo zvekushungurudza uye kurutsira, indigestion, kupera kwekufema, kana kuneta kwakanyanya uye kwakanyanya. Nepo vamwe vakadzi vane "zviratidzo" zvekurwadziwa kwepfungwa, zviratidzo zvekurwadziwa kwepfungwa kuvakadzi zvinowanzosiyana nemamwe varume. Vakadzi vanogona kuva nechinopisa uye chinopisa mukati mechifuva chavo, kana kunyange kunyorova kubata. Zviratidzo zviduku zvinowanzoitika kwemavhiki matatu kusvika mana mushure mekurwa kwemoyo mukudzoka. Vakadzi vangave vasina chirwere chemapfupa kana vaine chirwere chemwoyo! Sezvo mwoyo unorwiswa pamusha unowanzoonekwa nevakadzi, njodzi yekufa kamwe kamwe yakakwirira zvakare.
"Kunyarara" kurwisa mwoyo kunotsanangurwa seaya anowanikwa pakuedzwa (akadai se electrocardiogram) asi yakaitika pasina zviratidzo. Izvi zviitiko zvisingatauri zvinowanzoonekwa kune vakadzi.
Kuita kuti nyaya dzipfuurire mberi, vose vakadzi vane kenza yemazamu uye vanachiremba vavo vanowanzofunga nezvekwaniso inogona kuita kenza yemazamu kunze kweicho chaicho chokuti zviratidzo izvi zvinogona kureva chirwere chemwoyo. Zvakawanda zvezviratidzo izvi zvinotanga kuonekwa nekenza uye gare gare zvakawanikwa kuti zvine chokuita nehosha yemwoyo.
Pasi Payo Pamusoro Pekuporesa Kuita Kuti Kuderedza Dambudziko reMwoyo Kuchengetedzwa Kwechirwere Chirwere
Mushure mekudzidza nezvechirwere chemwoyo kuvakadzi, pamwe chete nemamwe marapirwo ekurapa anogona kuisa mungozi, zviri nyore kunzwisisa kuti nei kuderedza kusvibiswa kwemoyo wako panguva yehutachiona hwehutachiona hwekenza yengarave yakasara ingave yakakosha.
Kufuridzira kuputira kunogona kuderedza huwandu hwehutachiona hunoendeswa kumwoyo asi 50 kusvika ku60 muzana, uye dzimwe nguva kubvisa kujekesa uku zvachose. Kazhinji yenguva iyo nzira yekufema inobvumirwa zvakanaka uye inogona kukupa "chimwe chinhu chaunofanira kuita" panguva yezvikamu zvemaawa.
Hasi yose inonzi raycation oncology centrals inopa nzira iyi, asi inova yakawanda zvikuru munyika yose. Zvichipiwa nhamba yemigumisiro ine chokuita nehutano, inozorodzawo kuva netsika isina ngozi.
Pakupedzisira, kunyange kenza yemazamu inenge iri mberi kwepfungwa dzako, ndiyo chirwere chemoyo chinouraya vamwe vakadzi, kusanganisira vakadzi vazhinji avo vakabatwa nekenza yengamu. Taura nachiremba wako pamusoro pehutano hwako uye zvimwe zvekuedza zvinogona kukurudzirwa. Uye iva nechokwadi kuti unoziva nezve "zviratidzo zve" atypical "zvepfungwa dzemwoyo zvinowanzozivikanwa nevakadzi. Vakadzi vanowanzosangana nekutambudzika kamwe-kamwe, vanopedza nguva yakawanda muchipatara, uye vanofa vasati vabva muchipatara pane varume vane chirwere chemwoyo, chimwe chikonzero chiri chokuti haisi yepamusoro peyadhi redhidhi yevakadzi kana vanachiremba.
> Sources:
> Boda-Heggermann, J., Knopf, A., Simeonova-Chergou, A. et al. Deep Inspiration Breath Hold-Based Radiation Therapy: A Clinical Review. International Journal of Radiation Oncology, Biology, uye Physics . 2016. 94 (3): 478-92.
> Schonecker, S., Walter, F., Freislederer, P. et al. Chirongwa Chekurapa uye Kuongorora kweGated Radiotherapy muVashandi veChechi-Kurutivi rweCritical Breast Using the Catalyst / Sentinel System for Deep Inspiration Breath-Hold (DIBH). Radiation Oncology . 2016. 11: 143.
> Taylor, C., Correa, C., Duane, F. et al. Kufungidzira Ngozi dzeKenza Chepabonde Radiotherapy: Uchapupu Kubva Mumiririro Mazuva Ano Maitiro Kumapopiro neMwoyo uye Kubvira Kare Randomize Miedzo. Nyaya yeCliniki Oncology . 2017. 35 (15): 1641-1649.