Zviratidzo, Zvirwere & Prognosis
Kansa yemaperembudzi inopararira (metastatic) kuchiropa inosuruvara zvikuru. Inenge 40 muzana yevanhu vane chirwere chemapapu vane zvirwere kune imwe nzvimbo iri kure kwomuviri panguva yekuongororwa. Chii chaunogona kutarisira kana kenza yemapapu yako yakapararira kuchiropa chako?
Overview
Kanzera yemaperembudzi yakapararira kuchiropa inonzi "mapapu emapapu emasitasitiri kusvika pachiropa" (kusiyana nematenda emuropa echiropa, ayo aizotaura nezvekenza yakatanga muchiropa uye ichipararira kune imwe nzvimbo yomuviri).
Kune vanhu vane kenza isiri duku yemapapu emapapu , kupararira kwekenza kuchiropa kunogona kuitanidza sechitambo chekenza kane. Nekenza kaduku kemapapu memapapu , inenge ichitsanangurwa senzvimbo yakakura .
Kenza yemaperembudzi inogona kupararira kune chero nzvimbo yomuviri, asi inowanzopararira kuchiropa, lymph nodes, uropi, mapfupa, uye adrenal glands. Kazhinji kenza yemapapu ichapararira kunopfuura imwe nzvimbo yomuviri. Semuenzaniso, zvinowanzova nehuviri hwemashupusi uye hutano hwemagetsi.
Ngatitarisei zviratidzo zvechiropa chemasastases uye kuti izvi zvinoshandiswa sei. Iwe unogonawo kufarira kudzidza pamusoro pekutungamira kwe:
- Utachiona hwemabhonasi kubva mumukenza wemapapu
- Bone metastases kubva mumukenza wemapapu
- Adrenal gland metastases kubva mumukenza wemapapu
Zviratidzo
Kana mukenza wako wemapapu wakapararira kuchiropa chako, iwe ungasava nezviratidzo zvachose. Ichokwadi, kupararira (metastasis) inowanzowanikwa apo muedzo, wakafanana neT CT scan kana PET scan yakaitwa kuti uone danho rekenza yako.
Kana iwe uine zviratidzo, izvi zvinogona kusanganisira kurwadziwa pasi pemibvu dzako kana mudumbu rako kurudyi rwemuviri wako, uye zviratidzo zvakadai, sekurasikirwa kwechido uye kuora mwoyo. Kana uine mishonga yakawanda muropa rako kana kuti metastasis yakakura zvakakwana kuti inopesana yako ye-bile ducts, unogona kukura jaundice, kuputika kwechivara cheganda rako uye chikamu chemaziso ako.
Chiropa chinonzi metastases chinokanganisawo metabolism ye bile inokonzera kuvakwa kwe-bile salt muganda. Izvi zvinogona kuguma nekukuvadza uye kuora mwoyo.
Kuziva
Miedzo inogona kuitwa kutarisa chiropa chechiropa kubva pamukombe wemapapu chinosanganisira:
- CT kuongorora mimba
- Abdominal ultrasound
- MRI yedumbu
- PET scan
Kusatenda kweChiropa Kuwana Kunowanikwa
Zvakakosha kuona kuti zvisizvo zvisinganzwisisiki zvakajairika kana zvikwangwani zvaitwa pachiropa, uye dzimwe nguva zvingava zvakaoma kuziva kana nzvimbo kana mavara ari muchiropa ndeyekupararira kwekenza kana chimwe (chinokonzera) chikonzero. Kana chiremba wako asinganzwisisi kuti kana kusakanganiswa muropa rako kwakabatana nekenza yako, uye nzira yekurapa inogona kusiyana zvichienderana nemigumisiro, inogona kukurudzira chiropa cheopsy kuitira kuti utarise mhuka kuti uve nechokwadi chekuongorora kwako.
Zvinogona kuvhiringidza kana chiremba wako asina chokwadi nezvekuwana muropa rako, uye izvi zvinogona kuita kuti unzwe uchinetseka uye usina chokwadi chekutarisira kwako. Zvinogona kubatsira kuti uzive kuti izvi zvakajairika uye kuti kune zvakawanda zvakapindirana pakati pe "zvinowanzoitika" zvisina kukodzera muropa uye chiropa chechiropa.
Kurapa
Nhoroondo yekare, kurapwa kwekenza yemapapu yakapararira kuchiropa kwainyanya kufadza, zvinoreva kuti chinangwa chekurapa ndechokubvisa zviratidzo pane kuedza kuporesa chirwere chacho.
Chemotherapy inogona kushandiswa kuporesa danho rechina munawo.
Kugamuchirwa kwezvinhu zvose zvinorapwa mushonga wemishonga (zvinodhaka zvinoshandura EGFR mutations , ALK rearrangements , uye ROS1 rearrangements pakati pevamwe) uye immunotherapy inotanga kuchinja iyo paradigm, uye mune dzimwe nguva, mishonga iyi inogona kuguma nekudzora kwenguva yakareba mutachiona wemapapu wemapapu .
Kurapa kwechirwere kunopfuurira kuve kunonyanya kushandiswa apo vazhinji vane metastases yeropa, asi kune avo vane maitiro mashoma-chimwe chinhu chinonzi "oligometastase" -kuchinja.
Metastases Specific Treatment
Munguva yakapfuura, kana chete metastasis imwe chete yaive iri muchiropa, chirwere chakanga chisingawanzofungidzirwa kuti chibvise chironda chacho, asi mishonga yemahara yemazuva ano ichivandudzwa pane izvi.
Kune avo vane oligometastases, inotsanangurwa seye chete kana kuti mashomanana "mavara" ezvirwere zvinonzi metastatic, kunyanya avo vane chinangwa chinogadziriswa pakugadzirwa kwegene , maitiro maviri ehutachiona hukuru akaratidzwa kuti awedzere kuguma mune imwe sarudzo yevaswere. Izvi zvinosanganisira:
- SBRT - Stereotactic body radiotherapy (SBRT) inzira inoshandiswa nehuwandu hwehutachiona hwehutachiona hunoendeswa kunzvimbo duku uye yakananga ine tariro yekubvisa mastases.
- SABR - Stereotactic radiation ablative imwe nzira inonzi radiology inoshandiswa ku "ablate" kana kuparadza zvachose nzvimbo duku yakadai semasitasisiti.
Kuenzaniswa nekuvhiyiwa, zvose izvi zvinonzi (zvinonzi metastasectomy) zviri pangozi shoma uye dzine mazinga akakwirira ekugadzirisa masimba. NeSBRT mitsva yekutanga yakaratidza kuponeswa kwepakati pemvura (nguva iyo hafu yevanhu iri vapenyu uye hafu yakafa) uye inenge 25 muzana yehupenyu kwenguva refu mukunyatsosarudzwa nevarwere. Mishonga yemakiriniki iri kuenderera mberi ichiongorora kukosha kwemasastasectomy kune oligometastases nekenza yeropa, uye kuchinja kweparaji mukurapa kwechiitiko ichi chiri kuitika.
Vanhu vane zviitiko zviri nani nemhando iyi yekurapa vanosanganisira avo vane mashoma mashoma, avo mavari munhu anotarisirwa kune ose anozivikanwa ane kenza, uye kune avo vane nguva refu dzisina zvirwere.
Prognosis
Kenza yemaperembudzi yakapararira kuchiropa, zvinosuruvarisa, ine chirwere chisina kunaka. Kupona kwemazuva mashoma kwevanhu vanorarama nechitsauko chechina chesipi (metastatic) chepenza yemapapu inenge maminitsi masere chete, kunyange kune tariro yokuti mitsva itsva inobva kuvanhu uye zvishomanana zvirwere zvinosanganisa chiropa zvinoshandiswa nemasikirwo emagetsi matsva zvichaguma nekupona kwepamusoro. Ivhareji yekurarama kwenguva yevanhu vane mazamu mashoma emasero (metastatic) yemukenza yemapapu mwedzi miviri kusvika mana pasina kurapwa uye mwedzi mitanhatu kusvikira pagore nemishonga.
Support
Zvinogona kuva zvinoparadza kuziva kuti kenza yako yakagadziriswa. Uye pamusoro pekushungurudzika kwako, pane kazhinji zvinhu zana zvaunonzwa uchida kuita. Kutanga kubva, ramba uchifunga kuti kurapwa kwemukenza wemapapu kunovandudzika-kunyange kune zvikamu zvakanyanya kupfuura. Kana iwe uchinzwa zvakanaka uye uine maitiro mashomanana chete, taura nachiremba wako pamusoro pemishonga iye zvino iripo. Kune mishonga yakawanda itsva, asi zvinosuruvarisa, izvi zvinoshanduka zvakakurumidza zvokuti zvakaoma kune munhu wese kuti arambe achienzanisa nekufambira mberi.
ICancer Cancer Institute inorumbidza kuti vanhu vane kenza yemapapu yakakurumbira vanofunga kutora chikamu muchipatara chekuedzwa. Inogona kunge ichikuvadza kuedza kufamba nenzira iyi iwe pachako, asi kuvonga mamiriyoni emasangano makuru emakenza emapapu akashanda pamwechete kuti ape kanzuru yemapapu yemukiriniki kuedza kutarisa kushanda , umo mufambisi anogona kubatsira kufanana nekenza yako yemapapu nemakiriniki emakirini anowanikwa kupi munyika.
Kana kenza isingagoni kuporeswa kana hupenyu hunowedzera, kune zvimwe zvakawanda zvingasarudzwa zvekuchengetedza vanhu vakasununguka zvakakwana kuti vanakidzwe nemazuva avo ekupedzisira nevadikanwa. Tarisa mazano aya ekutarisana nekenza yemuviri.
> Sources:
> Bergsma, D. et al. Kuchinja Kwakaitwa Radiotherapy Mukurapa kweOligometastatic NSCLC. Ongororo Ongororo muAnticancer Therapy . 2015. 15 (12): 1459-71.
> Guerrero, E., uye M.Ahmed. Basa reSterotactic Ablative Radiotherapy (SBRT) mumutungamiri weOligometastatic Non-Small Cell Lung Cancer. Lung Cancer . 2016. 92: 22-8.
> Rusthoven, C., Yeh, N., naL. Gaspar. Radiation Therapy yeOligometastatic Non-Small Cell Kurwara Kanzira: Dzidziso uye Kuita. Cancer Journal . 2015. 21 (5): 404-12.
> Salama, J., uye S. Schild. Radiation Therapy yeOligometastatic Non-Small Cell Lung Cancer. Cancer Metastasis Review . 2015. 34 (2): 183-93.
> Ueda, J. et al. Kugadziriswa Kwekuchengetedzwa Kwezvokuchengetedza Zvimwe Zvirwere zveMastastatic Tumor Inobva KuLung Cancer: A Case Series. Hepatogastroenterology . 2012. ini: 10.5753 / hge12000. (Epub mberi kwekudhinda).