Chirongwa Chekutanga Kutarisa Utachiona Ongororo yeMastastatic Breast Cancer
Usati wataura pamusoro pemishonga chaiyo yose yaunogona kusarudza yekenza yemasasa , inobatsira kutaura pamusoro pemhando dzemishonga, zvinangwa zvekurapa, uye zvipi zvinorapwa zvinowanzoshandiswa kutanga kugadzirisa kenza yemasita.
Iwe unogona kunge uri kunetseka kuti unogona sei kunzwisisa kuti zvipi kurapa zvakanakisisa kana iwe usina ruzivo mukurapa, asi zvinoita kuti udzidze zvakakwana kuti uite zvisarudzo zvakakunakira iwe somunhu oga.
Zvinangwa Zvokurapa
Kusiyana nekutanga kwepabonde kwekenza yekenza, hazvibviri kuporesa mastrasi yemasitamende yepfupa, asi zvichiri kukosha kufunga nezvezvinangwa zvako mukurapa.
Somuenzaniso, vamwe vanhu vanoda kuedza kurarama kwenguva yakareba sezvinobvira nekenza yavo pasinei nemigumisiro. Vamwe vanogona kunge vachinzwa hupenyu hwehupenyu hwavo hwakakosha kudarika huwandu, uye vanosarudza kurapwa nemaitiro mashoma.
Tinoshuva kuti munhu wese ave nechinangwa chokurarama kwenguva yakareba nekenza yemasitema, asi zvichida ikozvino, iyo haisi yevanhu vakawanda. Uine kenza yemasitima, unhu hwako hwehupenyu hunokosha zvikuru, asi izvo zvinoreva izvi zvinogona kusiyana zvikuru kubva kune munhu kumunhu.
Sezvaunofunga nezvesarudzo dzako, funga nezvezvinangwa izvi:
- Ko kurapa uku kunowedzera hupenyu hwangu here?
- Ko kurapwa uku kunonoka kukurumidza kufambira mberi kwekenza yangu here?
- Izvi zvinoshandisa sei hupenyu hwangu? Zvinotarisirwa kuvandudza zviratidzo zvandinosangana nazvo here?
- Kana pane mimwe migumisiro, ndeipi migumisiro yemaitiro ingangowanikwa yakareruka uye isingakanganwiki?
Mhando dzeZirwere
Kunyange zvazvo isu iye zvino tine mhando dzakawanda dzokurapa kwekenza, idzi dzinogona kuputsika kusvika mumapoka maviri makuru.
Local Treatments
Mishonga yemunharaunda inotaura nekenza munzvimbo iyo inotanga (kana mune imwechete metastasis kune nhengo.) Mishonga iyi inosanganisira:
- Surgery
- Radiation therapy
Mishonga Inorapwa
Kusiyana neizvi, marapirwo aya anotaura nezvemasero emukenza pose paanoitika mumuviri. Izvi zvinosanganisira:
Nekenza yemasitrasi yemasitema, zvirongwa zvehutachiona zvinoita basa guru pane kurapwa. Mishonga yemunharaunda yakadai sekuvhiyiwa kana kupiswa kwemaawa kunoshandiswa kunyanya kurapa mastasisita apo izvi zvinokonzera zviratidzo, zvakadai semasitosita emapfupa anokonzera njodzi yezviputi kana masastases kurusvingo rweganda kana bhokisi rinobuda uye rinorwadza.
Vanhu vakawanda vanoshamisika kuti sei kuitirwa mazamu akadai se- lumpectomy kana mastectomy hazviwanzoitike kune vanhu vane kenza yepamusoro yepabonde, kunyanya kune makumi mashanu kusvika gumi kubva muzana yevanhu vane kenza yemasitara panguva yekuongororwa. Chikonzero cheizvi ndechekuti nemasitosita, kenza yakatopararira zvakanaka mberi kwezamu.
Izvi zvinorapwa hazvikwanise kuporesa kenza yakapararira. Pane kudaro, kuvhiyiwa-nekuda kwekudzorera nguva nekudzivirirwa kwezvirwere zvekudzivirira-zvinogona kureva kunonoka kwehutachiona hwehutachiona, iyo inozopedzisira ichine basa guru mukurapa kenza yako.
Mitsara Yokurapa
Iwe unogona kunge uchinzwa chiremba wako achitaura nezve "kutanga mushonga wokurapa," "kurapa kwechipiri," nezvakadaro.
Izwi iri rinongoreva kurapwa kokutanga kana kurapwa, marapirwo echipiri, uye nezvimwe zvinogona kushandiswa sequentially kuporesa kenza yako.
Inonyanya kufanana nekenza yemasitatimendi yepamuviri kuti ive ne "mitsara" yakasiyana-siyana yekurapa. Mutsara wokutanga mushonga unowanzosarudzwa zvichienderana nemishonga ipi inowanzobudirana nemashoma emigumisiro, asi pane zvakawanda zvingasarudzwa.
Zviratidzo Zvokutanga Zvokurapa
Munhu wose ane kenza yemasitini yakasiyana, uye kenza yese yakasiyana naizvozvo zvakaoma kutaura nezve "kazhinji" kenza kurapwa. Izvozvo zvakati, mishonga yekutanga yakasarudzwa nokuda kwekenza yemasitadhi inowanzobatana nemamiriro ehomoni ekugamuchira kenza yako.
Aya maitiro ekurapa achaenderana nemamiriro ako ekugamuchira kana mushure me " rebiopsy " yemarara yako kana metastasis, kwete izvo mamiriro ako ekugamuchirwa kwaive apo iwe wakatanga kuongororwa kuti kana bundu rako riri kudzokorora. Kana kenza yako yepakutanga yaiva estrogen receptor positive, ikozvino ingave isina kunaka, uye pamwe chete.
Zvakare zvakakosha kucherechedza kuti chinangwa chekurapa kwekenza yemasitini inowanzoshandisa shanduko shomanana yekurapa inogona kuitika kugadzirisa nekudzivirira chirwere chacho. Izvi zvakasiyana nedzimwe nzira "yekurapa" inoshandiswa nehutanho hwekutanga kwekenza yekenza.
Mienzaniso yezvinyorwa zvitsva zvinotanga kuwanikwa kubva pane zvakagadziriswa zvinosanganisira:
Estrogen Receptor (ER) Yakanaka Metastatic Breast Cancer
Mushonga wokutanga weestrogen receptor chine kenza yemazamu inowanzotarisa hormonal therapy, uye izvi zvinowanzoshandiswa chete. Kusarudzwa kwezvinodhaka kunotenderera kana iwe wakanga uine hutachiona apo kenza yako yakadzoka.
Kune vakadzi ve-premenopausal, tamoxifen inodiwa sezvo ruzhinji rweesrogen inoberekwa nemuviri inobva mavhavha. Zvichida, kudzvinyirirwa kwemaawa kana Zoladex (goserelin) kana kuti zvisiri zvishoma, kubviswa kweivhai, inogona kuteverwa nemishonga pamwe ne tamoxifen kana imwe yearomatase inhibitors.
Pamadzimai anokonopaopausal, imwe yearomatase inhibitors inowanzoshandiswa yoga, kunze kwekuti kudzokorora kwakaitika pachinenge chimwe chezviyo mishonga. Kana chirwere chako chichidzoka apo paine aromatase inhibitor , sarudzo yakasiyana ingave iri kushandisa mushonga unorwisa-estrogen Faslodex (fulvesrant).
Kana chirwere chako chiri chestrogen receptor chakanaka asi chiri kufambira mberi nokukurumidza, pane zvimwe zvingasarudzwa. Kana chirwere chako chiriwo HER 2 chine utano, HER 2 inotarisirwa kurapwa inogona kuwedzerwa kune hormonal therapy. Chemotherapy inogonawo kushandiswa mukuwedzera kune hormonal therapy kune avo vane zviremera zviri kukura nokukurumidza.
Kana uine zviratidzo zvakakura zvine chokuita nemasitasi, zvimwe zvirwere zvinogona kuwedzerwawo zvakare. Kwemasitasase emapfupa, remishonga inonzi radiation kana kuti mishonga inogadzirisa pfupa inogona kushandiswa kuderedza ngozi yekuputsika, kugona kwemutsipa, kana kurwara kurwadza kwakanyanya.
Saizvozvowo, metastases kusvika kumapapu zvichikonzera kubuda ropa kana kuvhiringidzika, kana zvirwere zveuropi zvinokonzera zviratidzo zvikuru zvinogonawo kurapwa nemishonga yemunharaunda yakadai sedhidzo kana chirwere.
HER2 Chine Mastastatic Breast Cancer
Kana iwe une dumbu rinonzi estrogen receptor rakanaka uye HER 2 rakanaka, mushonga wekutanga unogona kutanga nehutachiona hwega chete kana kusanganiswa kwemishonga yehomoni uye HER 2 mishonga yakanaka.
Mutsara wokutanga mushonga weHER 2 wepachimiro chepachibereko chemazamu hunobatsirawo unofunga kuti kana iwe hausi kurapwa nemumwe wemishonga iyi pawakaona kudzokorora. Kana kenza yako ichidzoka paHercceptin, imwe yemamwe Mishonga 2 inogona kushandiswa. Kana chirwere chako chichikura nokukurumidza, chemotherapy inogona kuonekwa.
Sezvo neestrogen receptor positive tumorum, zviratidzo zvemasastase zvinogona kudikanwa nekutapwa kwekune imwe nzvimbo zvakare. Semuenzaniso, marwadzo anorwadza mafupa kana masastases anowedzera dambudziko rekuti iwe unogona kuputsa pfupa rinogona kurapwa nehutachiona hwemaawa kana hutachiona-hunogadzirisa.
Chirwere Chechitatu Chetachiona Chechirwere
Chirwere chetatu chetastastastastatic pain is difficult to treat, in general than breast cancer which is estrogen receptor or HER 2 positive, but there are still options.
Chemotherapy inowanzoshandiswa kutanga mutsetse wekodha, uye kusarudzwa kwemishonga kunowanzoenderana nokuti chemotherapy yakashandiswa kare.
For Men
Chirwere chematenda cheMastastatic muvarume ine kusiyana kwakasiyana-siyana kunokosha, asi kazhinji, nzira imwechete inotorwa. Mishonga inogona kutanga ne tamoxifen kune avo vane estrogen receptor vane tumarara, kana chemotherapy.
The Best Treatment
Chii chaunoda kuziva kuti uite zvisarudzo zvakanakisisa pamusoro pemishonga yako?
Danho rokutanga kuzvidzidzisa pamusoro pehosha yako. Verenga kuburikidza neruzivo rwakapiwa pano, uye chero ruzivo rwawakagamuchira kubva kunzvimbo yako yekenza.
Ramba uine mhando yemibvunzo yaunogona kubvunza yako oncologist, uye uuye navo pamwe newe pakugadzwa kwega. Kana uchiri kuwana zvakaoma kunzwisisa chimwe chinhu, bvunza zvakare.
Pane ruzivo rwakawanda rwekutsvaga kwenguva shoma, uye pamwe chete nemanzwiro akaoma anowanikwa nematenda ekurapa kuongorora, wako oncologist haazogumburwi kana uchida kubvunza mibvunzo yakafanana kakawanda. Izvozvo zvinowanzoitika.
Vanhu vazhinji vanozviona zvichibatsira kutaurirana nevanhu "vakave varipo." Pamusoro pemapoka ekutsigira munharaunda , isu iye zvino tine rubatsiro rwe 24/7 rubatsiro rwunopiwa nemapato ekusimbiswa kwekenza yepaIndaneti. Kune dzimwe nzvimbo dzinoumbwa nevanhu chete vane kenza yemasasa, iyo inogona kubatsira zvikuru apo iwe unotarisana nezvisarudzo izvi.
Taura neshamwari dzako nemhuri yako, uye ukumbire zvavanenge vaita, asi zvisarudzo zvekupedzisira zviri kwauri. Izvi zvinogona kuva nguva yakaoma, kunyanya kana nhengo dzemhuri yako isingabvumirani nemisarudzo yako.
Teerera kune vadikanwa vako uye uvatendese nokuda kwezvavanoita, asi vakuyeuchidze, kana zvichidiwa, kuti iwe unoda kusarudza nzira inokudza zvakanyanya zvaunoda uye zvido zvekutarisira kwako.
Zvinokonzera Kufurirwa Kunoita
Pane zvinhu zvakawanda zvinogona kutaridzirwa mukusarudza kurapa kwakakodzera kwekenza yako, zvose pakutanga, uye nguva inopfuurira. Zvimwe zvezvi zvinosanganisira:
- Chinogamuchirwa chemuviri
- Mishonga inopera (mazamu emucheto kazhinji anoramba asingagadziri kurapwa kwenguva)
- Tumor mutoro (kuti yakakura sei maronda ako (s) uye kuti yakakura sei)
- Zviratidzo zvakananga zvawakataura nekenza yako uye kuti zvinotambudza izvi ndezvipi kwauri
- Kukura kwekenza kwakanyanya sei
- Zvaunoda iwe pachako kuitira nyore nyore kurapwa (muromo vs IV muenzaniso), uye kushivirira kwemigumisiro (vamwe vanhu vanoona mamwe madambudziko anoshungurudza kupfuura vamwe)
- Zvichida kana iwe usati uri kutora chikamu chekuongorora kliniki
Mibvunzo Yokuzvibvunza
Pachava nemibvunzo yakawanda inobvunzwa pamusoro pemishonga chaiyo, asi kune mimwe mibvunzo yaunoda kutanga kutarisa kunyange usati waita zvisarudzo zvakasiyana.
- Ndeipi kupi waunoda kugamuchira kwako?
- Unoda here kuenda kuchipatara kuongororwa kana zvichidiwa, kana iwe unofarira kuva pedo neimba yako?
- Kana iwe ukasarudza kufamba, pane imwe nzvimbo yekenza iri pedyo neshamwari kana mhuri yaunogona kugara?
- Ungaenda kupi neinishuwarenzi yako?
- Kana iwe uri kufunga nezvevashandisi vemagetsi, izvi zvinorevei kwauri iwe nezvemari?
- Unofunga kuti iwe unotora chikamu mumuedzo wechipatara (zvipatara zvinokonzerwa nekenza yepamusoro yepabonde zvinokurukurwa gare gare.)
- Ndezvipi shamwari dziripo kuti dzikubatsire nenyaya dzakadai sokuchengeta vana uye zvimwe?
Zviratidzo Zvisina Kuita Ne / Pasina Kurapa
Vamwe vanhu vanoda kuziva maitiro avo; izvo "chiyero" chinogumira kune mumwe munhu ane chirwere chavo. Vamwe vanhu havadi kuziva, uye izvi zvakanaka zvakare. Ichokwadi ndechokuti hatigoni kunyatsotaura kuti munhu mumwe chete achaita sei mushure mekunge vaongororwa nekenza yemasitamende yepabonde.
Tine zviverengero zvinogona kutipa pfungwa pamusoro pemabatiro anoita munhu nemumwe mushonga, asi kune matambudziko akawanda nehuwandu. Imwe ndiyo iyo nhamba nhamba, kwete vanhu. Tinogona kutaura pamusoro pehuwandu hwevanhu, paavhareji, vanorarama gore kana makore gumi nekenza yemasasa, asi hatina nzira ipi yekufanotaura kuti vanhu ivavo vachave ani.
Chimwe chikonzero chiverengero chinotishungurudza ndechokuti ivo chiyero chekuti vanhu vakaita sei munguva yakapfuura. Kurapa kwekenza yemasasa kunowedzera, uye hatinyatsozivi kuti mumwe munhu achaita sei nemishonga itsva. Mazhinji ematarenda atinoshandisa kutonga kufungidzira anenge makore mashanu. Kunyange zvakadaro mishonga inowanikwa yekenza yemasasa yakasakara haina kuwanikwa makore mashanu akapfuura.
Panguva ino yazvino (yakatangwa, yekuti, pane zvinyorwa, kuponeswa kwemuviri kwekenza yemasitema (iyo inosanganisira marudzi ose) nekurapwa kunoonekwa semwedzi 18 kusvika 24. Izvi zvinoreva kuti mwedzi makumi maviri nemashure mushure mekuongororwa, hafu yevanhu ichave akafa uye hafu ichave ichiri kurarama.Iyo makore mashanu ekupukunyuka kwekenza yemasasa inokonzera mazamu ndeye 22 muzana.Pano panewo vanhu vakawanda vave vachirarama nekenza yemasitema yepamuviri kwemakore gumi kana kupfuura.
Pfungwa yekupedzisira yekuyeuka mupfungwa ndeyokuti tiri kunyatsofambira mberi mukurapa kenza yepamusoro yepabonde. Matambudziko emakiriniki achidzidza zvose kubva ku immunotherapy kune zvirwere zvekenza zvekenza yemvere dziri kuitika iye zvino. Zvinotarisirwa kuti mitsva iyi mitsva yemishonga ichakurumidza kushandura nhamba yekare pamusoro pekenza yemazamu.
Kuzvikurudzira Iwe pachako
Nzvimbo yakanakisisa kutanga iwe kutaura pamusoro pemishonga ibasa rako senhengo inokosha yeboka rako rekutarisira utano. Iwe zvichida wakatove wakanzwa kuti zvakakosha kuva mupepeti wako mukutarisira kwako, asi izvi zvinorevei chaizvoizvo?
Kuva iwe mutungamiri wako kunoreva kutora chikamu chakakosha muzvisarudzo zvinoenda pamwe nekurapa kwako. Zvinoreva kubvunza mibvunzo kana iwe usinganzwisisi chimwe chinhu, uye uchiramba uchibvunza kusvikira iwe uchinzwisisa.
Apo patinotaura pamusoro pekuve iwe mutongi wega nekenza hatisi kureva kuti iwe uchava neukama hunopikisana neoncologist yako uye dzimwe nhengo dzeboka rako rehutano hwehutano . Kusiyana neizvi, kuva mutongi wako pachako kunoita kuti iwe ubatsire wako oncologist kunzwisisa izvo zvinokosha kwauri iwe somunhu.
Munguva yakapfuura, kazhinji kacho kwaive kashoma kusarudzwa kwevanhu vakawanikwa vane kenza yemastast. Izvi zvakachinja zvakanyanya mumakore achangobva kupfuura, uye iko zvino zvingava nenzira dzakasiyana-siyana dzakasiyana dzingakwanisa kufanana nechinangwa chekurapa.
Iwe haugoni kukumbirwa kusarudza pakati pemishonga inotarisirwa kushanda zvakanaka nemisungo miviri uye iyo isingashandisi kana ine migumisiro mikuru. Ichokwadi ndechokuti dzakawanda zvezvisarudzo izvi dzichasvika pakusiyana kwezvinhu zvako pachako.
Somuenzaniso, iwe unogona kusarudza pakati pekugamuchira kurapwa pedo neimba yako kana kune kenza yemukati kunze kweguta, kana kuti zvichida uite sarudzo pakati pemasere maviri akasiyana emigumisiro.
Vamwe vanhu vanozviwana zvakaoma kupfuura vamwe kuti vatsigirire ivo pachavo. Kana iwe kazhinji uchitaura zvinyoro-nyoro uye wakanyarara-muve norugare zvichida-ungawana zvakaoma kubvumira boka rako rekuchengetedza hutano kuziva kana zvinhu zvisingaitiki sezvaungada. Kana izvi zvichienderana nehutano hwako, zvinowanzobatsira kusarudza shamwari kana nhengo yemhuri kuti ave mutsigiri wako uye anogona kubvunza chero mibvunzo yakaoma yaungawana zvakaoma kubvunza.
Shoko Rinobva
Mienzaniso yezvinobvira mishonga yepamusoro yepamusoro inongova mienzaniso, uye oncologist yako inogona kukurudzira nzira yakasiyana inobva pane zvinofananidzira zvechirwere chako chakasiyana. Mishonga yakawanda iri kuongororwa mumakiriniki ekuedzwa, uye imwe yemigwagwa iyi inogona kupa nzira yakasiyana.
Chinhu chinokosha ndechekutaura nachiremba wako pamusoro pekuti sei zvimwe zvinodhaka zvinenge zvichisarudzwa uye kuti uchinzwisise izvi zvisarudzo pamwe chete nezvimwe zvinogona kuitwa. Vanhu vazhinji vanoona zvichibatsira kubvunza pamusoro pemishonga inogona kukurudzirwa kana iri regimen isingagoni kudzora tsvina yavo.
Kuve nhanho imwe chete mberi kwepfungwa dzako kunogona kukubatsira kuti utsungirire zvishoma zvishoma nekuzvidya mwoyo kwakabatana nezvisingazivikanwi mberi.
Sources:
Hayes, D. Dzidzo yevarwere: Kurapwa kwekenza yemasasa (Beyond the Basics). UpToDate .
> 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.