Chirongwa Chekurapwa Kwemakumbo Makumbo
Kune maitiro akawanda ekurapa kwevanhu vane chirwere chemapapu, asi izvi hazvina kumboitika nguva dzose. Kurapa pachavo-pamwe chete nehupenyu hwehupenyu hunoshamwaridzana navo-hwakagadzirisawo zvinoshamisa mumakore achangobva kupfuura. Kunyange zvazvo izvi zvose zviitiko zvinoshamisa, hazviiti kuti usarudze kuti ndezvipi zvingakunakira iwe zvakanyanya kudzvinyirira.
Kuziva zvakawanda pamusoro pemishonga yemukenza yemapapu inowanikwa, nekuwana rubatsiro rwaunoda, inogona kufamba nenzira yakareba mukukubatsira kuita sarudzo iyi inokosha.
Inogona Kurapwa Kuchengetedza Mungozi Kanzira Here?
Kune vanhu vane kenza yemapapu ekutanga, chirwere chinogona kupa mukana wekurapa. Kunyangwe iwe wakambova nekenza yemapapu emapapu, kune zvakawanda zvekurapa. Kufambira mberi kwemazuva ano kunobvumira vanachiremba kuti vaite zvirwere zvekenza yemapapupa, pamwe nekunyatsonzwisiswa kwekuti masimba edu emagetsi anoshanda sei kurwisana nekenza, zvakanyanya kuwedzera nzira dzatinayo yekurapa chirwere ichi.
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Maitiro Api Anokwanisa Kubatsira Kanzera Mumiriri
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Nhengo dzepanyama uye dzepfungwa dze Yoga yeCarcer Patients
Zvakakosha kutaurira pakarepo kuti kana kenza yepamapapu inobvumirwa nyore nyore kurapa mumatambo ekutanga, pane vapenyu venguva yakareba yepamusoro-soro. Zvakakoshawo kuziva kuti kurapa chirwere chemapapu kunongopfuura kuwedzera kupona chete. Kurapa kwekenza yemaperembudzi kunogona kuita basa rinokosha mukuderedza zviratidzo zvekenza uye kuita kuti zvive nyore kuti vanhu vakawanda vave nehutano hwakanaka hwehupenyu mukurapa.
Mhando dzeUrwere hweLung Cancer
Sezvo pane maitiro mazhinji akasiyana-siyana anowanikwa pamukenza wemapapu, zvinogona kubatsira kubatsira kuparadzwa kwezvipembenene ichi kusvika munzira mbiri huru:
- Local Treatments: Mishonga yepamunharaunda inobata kenza pane yakabva-mune mamwe mazwi, munharaunda. Izvi zvinosanganisira kuvhiyiwa uye kurapa kwemaawa, marapirwo anobvisa chiremera asi asingakwanisi kusvika kumasero akafamba kupfuura nzvimbo yepakutanga yebundu.
- Zvirwere Zvirongwa: Zviratidzo zvinorasika zvinouraya masero emukenza pose paanoitika mumuviri. Izvi zvinosanganisira chemotherapy, zvinotarisirwa kurapwa, uye immunotherapy.
Nenguva yekutanga mapapu emakenza, mishonga yemo inogona kukwana kuedza kuporesa kenza. Apo mutanho wemapapu wakapararira kune lymph nodes kana kune dzimwe nzvimbo dzomuviri, maitiro ehutachiona kazhinji ndiyo nzira yakanakisisa yokurapa.
Izwi rinokanganisa ramungasangana naro nderokuti adjuvant therapy . Dzimwe nguva zvirwere zvinoshandiswa zvinoshandiswa kunyange kana kenza isingaoneki yakapararira. Somuenzaniso, chemotherapy kana chirwere chinorapwa chinogona kupiwa kunyange zvazvo chirwere chakanga chaitwawo. Mishonga yeAdjuvant ndiyo iyo inoitwa kurapa chero masero akapararira kunze kwenzvimbo yekutanga yekenza, asi angave asati aoneka nemuedzo wekufungidzira watinayo iye zvino.
Kuvhiya kweMukondombera
Kana mutanho wemapapu unobatwa mumavambo ekutanga-asati wapararira kupfuura mapapu-chirwere chinogona kunge chichirapa. Kwekutanga-gadziriro, maitiro mashoma echechi mapapu emapapu (kunyanya gadziriro I kusvika padanga re IIIA risati riri duku-kemukirini yemakirini emapapu), chirwere chinowanzoonekwa. Pazviitiko zvisingawanzoitiki, chirwere chinogona kuonekwa sekutanga (zvishoma-gedhi) kenza yemukomana wemapapu.
Pane zviyano zvishanu zvinotanga kuitwa kuti zvirapwe nemukenza wemapapu:
- Pneumonectomy: Pneumonectomy inoreva kubviswa kwemapapu ose.
- Lobectomy: Mune hobectomy , imwe ye lobes yemapapu inobviswa. (Pepu yakarurama ine marebe matatu, uye pfupa yakasara ine maziso maviri.)
- Kubatanidza Kugadziriswa: Muchikwata chekugadzirisa , bundu racho rinobviswa pamwe chete nemakumbo akafanana nemapapu emapapu akakomberedza chironda chacho.
- Kugadziriswa kweSleeve: Muine sleeve resection, hobe yemapapu, pamwe nechikamu chebronchus (mhepo inotungamirira kumapapu,) inobviswa.
- Segmentectomy: Mu segmentectomy, chikamu chelobe chibviswa. Chiyero chezviviri zvakabviswa nemutambo uyu zvinopfuura wedge resection, asi pasi pe lobectomy.
Zvose zvinokonzerwa nekuvhiyiwa zvinosanganisira zvirwere, kubuda ropa, nekufema kwekufema, zvichienderana nemapapu mushure mekuvhiyiwa uye kuwanda kwemapfupa emapapu kubviswa.
Radiation Therapy yeLung Cancer
Kushandiswa kwemishonga yemapapu emapapu emapapu kunoshandisa simba-refu X-ray inoshandiswa kubva kunze kwemuviri kuuraya masero emukenza. Kune nzira shomanana umo mazairo anoshandiswa kumushonga wemapapu:
- Sechirwere chekuchengetedza chirwere chekurapa chero kenza yemukenza inosara mushure mekuvhiyiwa
- Kubatsira kuderedza ukuru hwechirwere saka kuvhiyirwa kunogona
- Sokurapa kunononoka kuderedza marwadzo kana kuvhiringidzwa kwemhepo kune vanhu vane kanzira isingagoni kurapwa
- Sekurapa kwekurapa: Chimwe chimiro chetachiona chemazuva anozivikanwa se stereotactic body radiotherapy (SBRT) inoshandisa mizinga yakakura inopiwa munzvimbo duku mumapapu. Izvi zvinogona kushandiswa seimwe nzira yekuvhiya kana chirwere chisingaitiki.
Nzira dzakawanda dzinowanzoitwa nehutachiona hwemaawa dzinogona kusanganisira kubwinya uye kutsamwa kweganda, kuneta, uye kuputika kwemapapu (rayation pneumonitis).
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Icho Chemotherapy Inosarudza Zviri nani Kupfuura IV?
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Nzira Yokugadzirisa Neuropathy Kubva Chemotherapy
Chemotherapy
Chemotherapy yemukenza wemapapu inoshandisa mishonga yakagadzirirwa kuuraya masero akaparadzanisa nokukurumidza sekenza masero. Chemotherapy mishonga inogona kushandiswa senzira yokutanga kurapwa kwekenza yemapapu yakamera, mushure mekuvhiyiwa (adjuvant chemotherapy), kana kuti vasati vambovhiyiwa kuderedza ukuru hwechirwere (neoadjuvant therapy.)
Kusanganiswa kwemakemikrasi-kushandisa zvinopfuura imwechete chemotherapy drug panguva imwechete-inowanzoshandiswa. Kusiyana kwemishonga inopindirana nechepakati kupatsanurwa pane zvakasiyana-siyana muchitokisi, uye kutarisa izvi nenzira inopfuura imwechete kunowedzera mikana yekurapa semasero emukenza emapapu sezvinobvira. Mimwe mishonga yemakemikrasi inoshandiswa kuvanhu vane kenza yemapapu inosanganisira:
- Platinol (cisplatin)
- Paraplatin (carboplatin)
- Gemzar (gemcitabine)
- Taxotere (docetaxel)
- Taxol (paclitaxel) naAbraxane (nab-paclitaxel)
- Alimta (pemetrexed)
- Navelbine (vinorelbine)
Nharaunda dzinowanzoitwa chemotherapy dzinosanganisira kukanganiswa kwemafuta emapfupa (kuderedza mumasero matsvuku eropa, masero eropa, uye maplatelet), kurasikirwa nevhu, uye kuneta. Nausea nekurutsa zvinotyisa migumisiro ye chemotherapy, asi nekuonga kutungamirirwa kwezviitiko izvi zvakaipa zvakagadzirisa zvinoshamisa mumakore achangopfuura.
Targeted Therapies
Zvinotarisirwa kuongororwa nemukenza wemapapu zvinodhaka zvakagadzirirwa kurwisa humwe hutano hwemasero ekenza uye, saka, inogona kuva nemigumisiro shomanana kudarika chidimbu chemakemikari.
Zvinonyanya kukosha kuti munhu wese anoonekwa ane kemukamu kadiki isiri duku yemapapu, kunyanya mapapu adenocarcinoma, ane upfumi hwemajeni (kufungidzira kwema molecular) yemarara avo akaitwa. Iwe unogona kunzwa chiremba wako achitaura pamusoro pe "chinotarisirwa" maitiro echinja uye kuchinja kwemashoko. Izvi zvinorevei kuti mamwe masero emukenza emapapu ane maitiro ekuchinja maitiro anokwanisa kutarirwa (uye kurapwa) nemishonga chaiyo inotaura nezvekuchinja uku.
Mishonga yakagamuchirwa kune avo vane EGR mutations, ALK rearrangements , ROS1 rearrangements , uye kunewo kuongororwa kwechiremba kuongororwa mishonga kune dzimwe shanduko uye kuchinja kwemashoko mukenza masero. Iyi nharaunda yesayenzi iri kuchinja zvikuru kwazvo, uye zvinogona kunge zvinangwa zvitsva nemishonga mitsva zvicharamba zvichiwanikwa.
Nepo zvinorapwa zvirwere zvinogona kuva zvakakosha, kurwisana nemishonga iyi kunowedzera nguva. Zvisinei, mishonga yechipiri uye yechitatu madhiragi ikozvino yavapo uye inodzidziswa kana izvi zvichiitika. Mimwe mishonga inotarirwa inobvumirwa nemukenza wemapapu inosanganisira:
- ALK inhibitors - Xalkori (crizotinib), Zykadia (ceritinib), uye Alecensa (alectinib)
- Angiogenesis inhibitors - Avastin (bevacizumab) uye Cyramza (ramucirumab)
- EFGR inhibitors - Tarceva (erlotinib), Gilotrif (afatinib), Iressa (gefitinib), Tagrisso (osimertinib), uye Portrazza (necitumumab)
Immunotherapy
Imwe mhando yemishonga yemukenza yemapapu yakatanga kuwanika muna 2015. Immunotherapy mishonga inoshanda nekunyanya kushandisa maitiro epachiviri chemuviri wako kuti ubatsire kubvisa muviri wako wekenza masero. Kunyangwe tichida kunzwa huwandu hwehupfumi munhau, immunotherapy zvechokwadi ndicho chikonzero chekufadzwa nezveramangwana rekenza yemapapu uye akatumidzwa zita rekurwara kwekliniki ra2016 ra2016 neAmerican Society for Clinical Oncology.
Kunyange zvazvo zvinorapwa zvirwere zvinowanzova zvakakosha kune vanhu vasina kusvuta, immunotherapies inogona kuva yakanyatsobudirira kune vanhu vanoputa uye vane kanzira dzakadai secramus cell cell lung. Immunotherapy mishonga ino inogamuchirwa nemukenza wemapapu inosanganisira:
- Opdivo (nivolumab)
- Keytruda (pembrolizumab)
Alternative Lung Cancer Treatments
Nepo mamwe maitiro ekurapa kwemukenza wemapapu asina kuwanika anobatsira pakuchengetedza chirwere chemapapu zvakanyatsonaka, pane maitiro akawanda ekubatanidza kenza yemukati inogona kubatsira vanhu kurarama zviratidzo zvekenza uye mishonga yekenza. Zvimwe zvezvinhu izvi zvinosanganisira kupora, kurapa kurapa, nekufungisisa.
Chirwere cheMarariya Clinical Trials
I National Cancer Institute inokurudzira kuti munhu wose ane kenza yemapapu aone kuongororwa kwekliniki, uye izvi zvinokosha kupfuura kare. Mushonga mumwe nomumwe watinayo wemukenza wemapapu wakambodzidza sechikamu chechirongwa chekurapa asati agamuchirwa. Kuti kusimbise kukosha kwezviedzo izvi, zvinogona kubatsira kutaura kuti pakati pa2011 na2015, mamwe mushonga mutsva wakagamuchirwa nemukenza wemapapu kupfuura panguva yemakore gumi nemakore asati apfuura.
Taura nachiremba wako pamusoro pekuongororwa kwechipatara uye sarudza kana ichi chinhu chaunoda kuongorora. Mamwe mapoka emakirini emapapu emapapu akaisa pamwe chirwere chemakirini chepamupa chepamuedzo kuedza kushandiswa kunoenderana nehutano umo vashandi vezvehutano vanogona kubatsira kubatanidza zvimwe zviitiko zvekenza yako nemakiriniki ekuedzwa kunoenda kwose kwose munyika.
Kusarudza Yakanakisisa Yakakonzera Kanzira Kurapa Zvokuda Kwawe
Sezvakataurwa pamusoro apa, pangave pane zvingasarudzwa zvakasiyana siyana zvinowanikwa mukurapa kenza yemapapu ako. Kunyange zvazvo izvi zvingaita sezvinotyisa, pane zvinhu zvishomanana zvaunogona kuita kuti kuita sarudzo kuve nyore.
Kana iwe uchangobva kudzidza kuti une kenza yemapapu, tora nguva kuti utarise matanho aya ekutanga kutora kana uchangobva kuongororwa . Zvidzidzo zvinoratidza kuti kudzidza zvakanyanya sezvaunokwanisa pamusoro pemukenza kunobatsira kuderedza kufunganya uye kunogona kukanganisa migumisiro. Dzidza kuti ungatsvakurudza sei kenza yako uye uwane ruzivo rwechokwadi. Iwe unogona kutanga iko kuno.
Chimwe chezvinhu zvakanakisisa zvaunogona kuita kuti uwane kurapa kwakanakisisa ndeyokuwana kenza yepabonde iwe unovimba nayo. Ongorora mazano aya pakusarudza chirwere chekenza yemapapu emapapu pamwe nekukosha kwekutora pfungwa yechipiri nemukenza wemapapu . Tora nguva yekutaura nemhuri yako neshamwari. Iwe unogonawo kufarira kubvunza oncologist yako kwaanenge achitsvaga kurapwa kana akazoonekwa kuti ane kenza yemapapu.
Haikwanisi kusimbiswa zvakakwana kuti ichi ndicho chisarudzo chako. Isu tose tine maonero akasiyana pamusoro pokuti tingazogadzirisa sei kurapwa kwekenza kwatiri, uye manzwiro anogona kumhanya nesimba panguva ino. Gamuchirai mazano kubva kune vaunoda, asi iva nechokwadi chekuita sarudzo kubva pane zvaunofarira uye izvo unonzwa kuti zvakanakisisa kwauri iwe woga.
Shoko Rinobva
Chinhu chinonyanya kukosha chaunogona kuita sezvaunofunga kuti kurapwa ndekuve iwe mumutevedzeri wako mumuchengetedzi wako . Kunyange kana iwe usati uri "butterflies" kana "Internet Geek," kuve nekambani nemapoka ekutsigira kenza yemapapu omuInternet uye musha wekenza yemapapu inokosha zvikuru. Hasi chete nzira idzi dzekuwana rubatsiro kubva kune vamwe "vakavepo" uye vanokwanisa kunzwisisa, asi mapoka aya anogona kukubatsira iwe kudzidza nezvekunzwisisa zviitiko zvekupedzisira mukenza yemapapu. Ita hashtag kukubatsira kuti uwane mharaunda iyi #LCSM, iyo inomirira kenza yemapapu mune zvekugarisana kwevanhu.
Usarega kuora mwoyo kwemukenza wemapapu kana mibvunzo yaungagamuchira pamusoro pehuwandu hwako hwekuputa huchikuvadza iwe. Ani naani ane mapapu anogona kuwana menza yemapapu. Usarega pfungwa yokuti mhavha yemapapu isingatambudziki kupokana. Iwe unogona kukuyeuchidza shamwari dzako kuti izvo zvavakaona nehama dze makore 10 apfuura zvakasiyana zvikuru nekuputira kwekenza yemapapu nhasi. Uye kunyange iwe ungaona micheka yakawanda yemukenza yemapapu emapapu kupfuura kenza yemazamu epazamu, usanyengerwa. Zvakaita musha wemapapu emapapu asina kuwanda muhuwandu iyo inoshandiswa mukudzika. Dzokera kune vanhu vakawanda vanozoita musana wenyu apo iwe unotarisana nechirwere ichi.
Sources:
Masters, G. Immunotherapy muLung Cancer Treatment: Mamiriro Emazuva Ano uye Mangwana Mazano. American Society of Clinical Oncology: ASCO News . https://am.asco.org/immunotherapy-lung-cancer-treatment-current-status-and-future-directions
National Cancer Institute. Non-Small Cell Lung Cancer Treatment (PDQ) - Health Professional Version. http://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq
National Cancer Institute. Muchechi Muduku Kurapa Kanzira (PDQ) - Health Professional Version. Updated 07/07/16. http://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq
Pass, J., Carbone, D., Johnson, D. et al. Nheyo uye Maitiro eKunguru yemuviri . 4th Edition. Williams naWilkins: 2010.
Rocco, G., Morabito, A., Leone, A., Muto, P., Fiore, F., uye A. Budillon. Kutungamirirwa kweMusana-Madiki Masero Anokonzera Kanzera MuEra yeMunhu Akazvimirira. International Journal of Biochemistry uye Cell Biology . 2016. 78: 173-179.