Zviratidzo, Zvirwere, uye Kufuratira Kwemadiki Masero Anokonzera Kanzera
Overview
Chirwere chediki chemapapu emapapu chinokwana 15 muzana yemakenza emapapu. Kusiyana neinozivikanwa isiri duku duku rekenza maperembudzi , kamudiki kemapapu emapapu inokura nokukurumidza asi kazhinji inopindura zvakanaka chemotherapy pakutanga. Zvinosuruvarisa, zvinowanzodzoka shure kwekurapa kwokutanga uye kuwedzera kukunda kune inotevera chemotherapy inorapwa.
Diti duku rekenza maperembudzi anowanzotanga mumigwagwa huru yemhepo ( bronchi ) yemapapu, asi anopararira mangwanani, kazhinji kuuropi.
Izvo zvakaputsika muzvikamu zviviri chete, zvisingakwanisi uye yakazara shato duku chekenza yemapapu emapapu. 60 kusvika ku70 muzana yevanhu vatove vane chirwere chakakura chechirwere panguva yekuongororwa.
Mukomana muduku wemukenza wemapapu zvakanyatsobatanidzwa nekusvuta, kunyange zvazvo zvimwe zvinhu zvakadai sokutsvaga radononi uye asbestos zvinosanganiswawo nekamudiki kemukirini yemapapu. Mhando iyi yemukenza wemapapu inowanzoonekwa kune varume kupfuura vakadzi, uye ndiyo inowanzojairika yemukenza yemapapu ine zviratidzo zvinonzi separaneoplastic syndrome - ndiko kuti, zviratidzo zvinokonzerwa nemahomoni akavanzwa nechirwere kana kuti nemuviri wezvirwere zvemuviri kusvika kumarara.
Zviratidzo
Zviratidzo zvemukomana muduku wekenza yemapapu zvinogona kusanganisira:
- Kuramba uchikanganiswa
- Kushungurudza ropa ( hemoptysis )
- Kukurira muchiso nemutsipa
- Kupfupika kwemhepo
- Wheezing
- Zvakaitika zvakare zvikamu zvepneumonia kana bronchitis
- Hoarseness
- Kuneta
- Unexplained kuora kurasikirwa
Zviratidzo zvekupararira kwemukenza wemapapu kune dzimwe nzvimbo dzomuviri.
Nzvimbo dzinowanzozivikanwa apo kechidiki chekenza yemapapu inopararira inosanganisira:
- Uropi - Mastasine yeBrain yemukenza wemapapu inogona kuitika mangwanani, uye inogona kunge iri chiratidzo chekutanga chekenza. Izvi zvinosanganisira misoro, maziso anochinja, kushaya simba, kana kukanganisa.
- Mabhuna - Bone metastases inogona kukonzera marwadzo kumashure, mahudyu, chifuva, mapfudzi, kana mbabvu.
- Chiropa - Chiropa chinokonzera chiropa chinogona kukonzera marwadzo emimba, kubvongodza, uye kuchena kwechivara cheganda chinonzi jaundice.
- Izvo zvinonzi adrenal glands - Adrenal metastases inowanzowanikwa paT CT scan panzvimbo pezviratidzo, asi inogona kukonzera marwadzo emimba.
Mukomana muduku wemukenza wemapapu unogonawo kukonzera zviratidzo zvakasiyana-siyana zvakakonzerwa neparaneoplastic syndromes . Zvimwe zvezvi zvinosanganisira:
- Utachiona husina simba mumakumbo epamusoro, maonero anochinja, uye kuoma kukumedza ( Lambert-Eaton myasthenic syndrome )
- Kushaya simba, kuneta, uye yakadzika pasi sodium muropa ( syndrome isina kukodzera antidiuretic hormone secretion (SIADH) )
- Kurasikirwa kwekubatana uye kuoma kutaura (paraneoplastic cerebellar degeneration)
- Kubata (kukomberedza) kweminwe
Nhanho
Pane zvikamu zviviri zvemukomana muduku wemukenza wemapapu:
- Kakawanda Chikamu Chirwere Chepachivande - Chikwereti chidiki chekenza yemukenza yemapapu chinotsanangurwa semukenza wekero kadiki uripo mumapapu mumwechete uye ungave wakapararira kune (pedraclavicular) lymph nodes kana kuti nzvimbo pakati pemapapu ( mediastinum ), asi haana kupararira ( metastasized ) kune dzimwe nzvimbo dzomuviri.
- Yakawedzerwa Stage Lung Cancer - Mukatikati-shanho rekenza kemukiramu kadiki yemapapu, kenza yakapararira (mastasized) kune imwe nzvimbo yomuviri, yakadai seimwe chirobe chemapapu kana uropi.
Mishonga
Kurapa kwemukenza mutsva wemapapu mumapapu kunowirirana zvichienderana nesero rekenza pamwe nezvimwe zvinhu.
Kuvhiya - Kazhinji chirwere hachiitikanwi nekenza yemukomana mutsvuku (inowanzoonekwa isingabviri,) asi kuvhiyiwa kunowanzotaridzirwa kana gumbo duku rinowanikwa muchiitiko che X-ray kana CT scan (nokuda kwokutanga kwekamukati kenza kanzira.) Adjuvant chemotherapy (chemotherapy mushure mekuvhiyiwa) inowanzokurudzirwa kana chirwere ichi chichiitwa nekenza yengano duku yemapapu.
Chemotherapy - Kurapa kwezvishoma uye yakawandisa chirwere chetachiwanzo kunowanzobatanidzwa nekusanganiswa kwemakemikirwo uye remishonga inonzi radiation.
Mukomana muduku wemukenza wemapapu kazhinji unobata zvakanaka chemotherapy pakutanga, asi kupikisa kunowedzera. Zvakawanikwa kuti kurapa kunyange nzvimbo yakakura yekenza yemukenza yemapapu ine chemotherapy inomutsa kuponesa kwemuviri nechimwe chechina kana chechi 5 maererano nekushaya kurapwa. Kazhinji chemotherapy anoshandiswa anoshandiswa anosanganisira kusanganiswa kwecisplatin (Platinol) kana carboplatin (Paraplatin) ne etoposide (VePesid.)
Radiation therapy - Kune zvose zvisingakwanisi uye zvakakura zvechirwere chekenza, chirwere chemaawa . inowanzoshandiswa pamwe chete nechemotherapy.
Prophylactic cranial irradiation (PCI) - Muvarwere vanopindura zvakanaka kurapwa uye vanopindurwa zvakakwana, prophylactic cranial irradiation (PCI) - kudzivirira maharavirai emishonga kuropi - inorayirwa kuitira kuti kuderedze njodzi dzehutano hwemashupusi, nzvimbo yakajairika yekenza yekudzoka.
Mishonga yemakiriniki - Makiriniki emakiriniki anotarisa ari munzvimbo achitsvaga kurapwa kwakanakisisa kwekenza yemukemenzura kadikidiki. Kunyanya, zvirwere zviviri zvema immunotherapy , Opdivo (nivolumab) uye Keytruda (pembrolizumab), iyo yakagamuchirwa muna 2015 kune vanhu vane kenza yemukenza isina mapoka, ikozvino iri kuongororwa kuti ione kana ichinobudirira kurwisa kenza yemukomana kadiki zvakare . ICancer Cancer Institute inorumbidza kuti vanhu vane kenza yemapapu vanofunga kuti vanotora chikamu mumakiriniki emakiriniki. Kutaura, mapoka emakenza emapapu akawanda anoisa chirongwa chekurapa chepachipiro chakasangana nekubatsira kwevarwere vemapapu emapapu , umo mutyairi anogona kukubatsira kuti uone kana Zvirwere zvemakiriniki zviri kuenderera mberi zvinogona kufanana nemarara uye zvishuwo zvako.
Kurapa kwemazuva ano - Mukuwedzera pakurapa kenza, nzira dzakadai seyradio inorapwa inowanzoshandiswa kubatsira kutarisa zviratidzo zvekenza duku yengero yemapapu. Mishonga inogona kubatsira pakugadzirisa zviratidzo zvakadai sekurwadziwa kwepfupa pamusana pemasitasase emapfupa, misoro uye kushaya simba kunokonzerwa neuropi metastases, kubuda kubva pamapapu, nekufema kwekufema kunokonzerwa nokudzimwa kwemhepo.
Prognosis
Kuwanda kwehupenyu hwekenza yemukirini yemapapu yakasiyana zvakasiyana zvichienderana nesiteji. Pari zvino, mavhareji emakore mashanu ekupukunyuka kwechidiki chekenza yemapapu emapapu (zvikamu zvose) ndeye 5 kusvika ku10 muzana
Zviitiko izvo zvinobatanidzwa nekuvandudza kupona zvinosanganisira vakadzikadzi, uye hutano huri nani - huri hutano huri nani panguva iyo yekuongororwa. Kupfuurira kusvuta kunogona kuderedza kupona. Sezvo kenza kaduku kemapapu yemapapu inokura nokukurumidza, uye sezvo tauya nemararamiro akawanda nemamwe kenza inokura nokukurumidza seyeukemia, inotarisirwa kuti mishonga yakanaka inowanikwa munguva yemberi.
Kutsungirira
Zvidzidzo zvinoratidza kuti kudzidza zvaunogona pamusoro pemukenza wako wepapu kunogona kuvandudza hupenyu hwako, uye zvichida kunyange zvakaguma. Bvunza mibvunzo. Dzidza nezvemakiriniki ekuedzwa izvo zvingave zvakakodzera kwauri, uye kuti uve sei mumutsigiri wako mukuchengetedzwa kwekenza.
Vanhu vazhinji vanozviona zvichibatsira kuti tibatanidzwe muboka rekutsigira kana munharaunda yekutsigira. Kumbira uye kubvumira vadiwa venyu kuti vabatsire. Uye rambira pane tariro. Kurapa kwemapapu emapapu-uye mararamiro ehupenyu-zviri kuwedzera shure kwemakore mazhinji ezvakaita sechishanduko chiduku. Kune tariro yakawanda.
Sources:.
National Cancer Institute. Muchechi Muduku Kurapa Kanzira (PDQ) - Health Professional Version. Yapindurwa 02/18/16. https://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq
Sher, T. et al. Mukomana muduku wekenza yemapapu. Mayo Clinic Proceedings . 2008. 83 (3): 355-67.