Nzvimbo Dzakakurumbira dzeLung Cancer Metastases
Vanhu vazhinji vane kenza yemapapu vanozivawo kuti kanha yemapapu inogona kupararira. Inenge makumi mana kubva muzana yevanhu ivavo vachangobva kuongororwa nekenza yemapapu vatova nemasikisi kune dzimwe nhengo dzomuviri. Ndeipi uye kupi mutsva wemapapu kunokonzera, uye ungaziva sei kana kenza yako yakapararira?
Overview
Makondombera akaremara anogona kupararira kana masero achibuda kubva mumarara, uye achifamba neropa kana kuti lymphatics (midziyo mumuviri inoshandiswa neropa nemasero eropa ropa) kunzvimbo dziri kure dzomuviri uye kukura.
Izvi zvinonzi metastasis.
Zvakakosha kusiyanisa pakati pekutanga (apo kenza inotanga) uye kachipiri kenza pakutaura pamusoro pekupararira kana mastasis yekenza. Mushonga mukuru wemapapu wemapapu unopararira kune pfupa unonzi "chirwere chemapapu chemapapu", kwete "kenza yemapfupa." Saizvozvowo, kenza yemapapu inopararira kuuropi inonzi "chirwere chemapapu chemasipitendi kuuropi" pane "ubongo" kenza. "
Kune avo vanoda kuziva zvakawanda nezvekuti nei uye nei izvi zvichiitika, kunyange mushure mokunge tumarara ichiita seine kubviswa zvachose, unogona kuongorora nyaya idzi pamusoro pekuti kanaya inopararira sei uye nei mamwe kanzira inodzoka (dzokare) .
Nzvimbo Dzose
Kansa yemaperembudzi inogona kupararira kusvika kunharaunda ipi zvayo yemuviri, asi nzvimbo dzinowanzozivikanwa ndeye lymph nodes , chiropa, mapfupa, uropi, uye adrenal glands. Ngatitarisei pane imwe neimwe yezvi nzvimbo zvakasiyana.
Lymph Nodes
Kazhinji kenza yemapapu inotanga kupararira kune lymph nodes mubhokisi riri pedyo nechirwere.
Sezvo kenza inofambira mberi, kenza dzemasere dzinogona kuenda kune dzimwe nzvimbo mubhokisi zvichibva kune chekutanga, uyezve kune dzimwe nzvimbo dzomuviri. Kusiyana nemitambo kune dzimwe nzvimbo dzomuviri, kupararira kwekenza yemapapu kune lymph nodes hazvirevi kuti inonzi metastatic ( chigadziko 4 chisina cheki duku kana kuti yakareba shato duku chekenza yemapapu ).
Mitezo yese yemukenza yemapapu pane imwe nhanho 1 isiri duku duku yemukenza yemapapu inogona kuisa kanzira dzakapararira kune lymph nodes.
Kazhinji yenguva, kupararira kwekenza yemapapu kune lymph nodes hakuiti chero zviratidzo. Kana aya kanzura achiwedzera kune lymph nodes kumativi emapapu, unogona kuona bundu mumutsipa wako kana pamakumbo ako, akafanana (asi kazhinji firmer) kune zvidumbu zvekudzimba zvaungave wakave nazvo munguva yakapfuura nehuro.
Mishonga inowanzoitwa chemotherapy kunze kwekuti lymph nodes iyo inobatanidzwa iri pedyo nekumarara kwekutanga uye inokwanisa kubviswa nechokuvhiyiwa .
Bone
Inenge 30 kusvika ku40 kubva muzana yevanhu vane mukenza wemapapu wakakura vakapararira (metastases) kumapfupa. Mafupa akawanda anonyanya kuonekwa ndiwo musana (kunyanya vertebrae mubhokisi uye pasi pasi pemimba), mapepa, uye mapfupa epamusoro emakumbo nemakumbo (humerus uye femur). Kanza yemaperembudzi yakasiyanawo neimwe yekuti inogona kupararira kumaoko nemaoko.
Chiratidzo chinowanzozivikanwa chesepa metastases chinorwadza. Kazhinji kurwadziwa kunotanga zvishoma nezvishoma, kunzwa semusumbu inodhonza kana kushungurudza, uye inoenderera mberi kunorwadza zvakanyanya. Pamusana pokuderedza kwepafupa kubva mumarara, vamwe vanhu vanoita kuputika ( kuputika kweputika ) kunoitika nekushungurudzika kwakanyanya kana kunyange mumabasa ezuva nezuva.
Kana kenza yemapapu inopararira kumucheto, inogona kuisa dambudziko kumutsipa wepelinha (spinal cord compression) iyo inogona kuve yakaoma mune zvehutano. Izvi zvinogona kukonzera utera kana kumira mumakumbo ako kana kuoma kufamba. Cancers iyo inokonzera kupfupa inogonawo kuputsa bone kubudisa calcium muropa ( hypercalcemia ) inokonzera zviratidzo zvekuvhiringidzika, kushaya simba kwepfungwa, uye kurasikirwa kwechido pakati pevamwe.
Miedzo yekutsvaga mapfupa emasasa anogona kuisa pfupa , pET scan , CT , kana MRI . Icho chinangwa chikuru mukurapa kwemasitasita emapfupa ndechekudzikisa marwadzo uye kugadzirisa kana kudzivirira kuputika kunoitika. Zvisarudzo zvinosanganisira mishonga inorwadza, remishonga inonzi radiation , mishonga yekuedza kudzivisa kuparara kwemapfupa, uye kuvhiyiwa kunatsigisa mapfupa.
Ubongo
Kenza yemaperembudzi ndiyo kenza inowanzopararira kune uropi, uye makumi mana kubva muzana yevanhu vane cancer yemapapu yakakura ichaita uropi hutachiona humwe nguva munguva yezvirwere zvavo. Zvose zvisingasviki masero emukenza wemapapu uye mutana muduku wemukenza wemapapu unogona kupararira kune uropi. Mukomana muduku wemukenza wemapapu unogona kupararira kune uropi nokukurumidza, kazhinji kusati kwaonekwa. Prophylactic cranial irradiation (PCI) , rudzi rwehutachiona hwemaawa, hunogona kushandiswa kuedza kudzivirira izvi kuti zvirege kuitika.
Kenza yemaperembudzi yakapararira kuuropi inogona kukonzera zviratidzo zvose nekuparadza hutachiona uye nekuumba nekuputika kunokonzera kushandiswa kune zvivako muuropi. Muchikamu chetatu chevanhu, hapana zviratidzo zviripo.
Zviratidzo zvinowanzowanzobatanidza misoro, kugumburwa, kurasikirwa uye kuwirirana, kunetseka nekutaura, maonero anochinja, kurasika kwechirangaridzo uye humwe humwe hunochinja, kusimba kune rumwe rutivi rwemuviri, uye kuneta.
Chirwere chemarara chinokonzerwa nemaperembudzi kuuropi kazhinji chinonzi chinonzi CT scan kana MRI yeuropi.
Kurapa kunonyanya kukonzera , zvinoreva kuti chinangwa ndechekudzivirira zviratidzo uye kwete kuedza kuporesa kenza. Steroid inogona kushandiswa kuderedza kuzvimba. Mishonga yemarwadzo uye mishonga inorwisa-seizure inogona kushandiswa kudzora misoro yepamusoro uye kugumburwa. Radiation therapy inogona kuva yakakosha mukuderedza zviratidzo zvevamwe vanhu.
Kana imwechete kana mashomanana emakumbo e-metastases aripo - chimwe chinhu chinonzi "oligometastases" - kurapwa kana chirwere kana kuti stereotactic body radiotherapy (SBRT) inozivikanwa seye cyber knife kana gamma knife, yakaguma nekudzora kwenguva refu chirwere che vamwe vanhu.
Chiropa
Kanzera yemaperembudzi yakapararira kuchiropa haigone kuisa zviratidzo uye inowanzoonekwa apo muedzo, wakafanana neT CT scan, wakaitwa kutarisa kupararira kwekenza yako. Kana zviratidzo zviripo, zvinogona kusanganisira kurwadziwa pasi pemibvu dzako kune rumwe rutivi rwomuviri wako, kurasikirwa kwechido, uye kushungurudzika. Kana pane zviremara zvakawanda muropa rako kana kuti metastases yakawanda zvakakwana kuti ivhare mapundu muropa rako, unogona kukura jaundice (ruvara rweganda rako uye vatsvene vemaziso ako).
Miedzo iyo inoitwa kutarisa kupararira kwemapapu emapapu pachiropa kunogona kusanganisira chibereko chemuviri chechirwere, CT scan yemimba yako, kana PET scan.
Mishonga inowanzoitwa chemotherapy yakagadzirirwa kurapa kenza yepamusoro zvakare. Muzviitiko zvisingawanzoitiki, kana bedzi bundu rimwe chete kana mamiviri mashomanana aripo, kuvhiyiwa kunogona kukurudzirwa kubvisa matumbo. Dzimwe nguva nzira inonzi "embolization" inogona kukurudzirwa zvakare. Iyi ndiyo nzira inodzivisa kuteura kweropa kusvika kune chikamu chechiropa kuitira kuti masero emukenza aripo haagoni kupona.
Adrenal Glands
Kanza yemaperembudzi yakapararira kune zvinonzi adrenal glands (zviduku zviduku zvinogara pamusoro peitsvo uye kubereka mahomoni), hazviwanzokonzera zviratidzo, uye zvinowanzowanikwa muchiitiko apo shanduro inoitwa kupinza kanza.
Kurapa nechemotherapy yekenza kunogona kubatsira. Mune nhamba shomanana yevanhu vaikwanisa kuva nekenza yemapapu avo vakabviswa uye vaiva nenzvimbo imwe chete mune imwe yezvinyorwa zvinonzi adrenal, chirongwa chokubvisa grenzi reAdrenal uye adrenal metastases zvakaguma nekugara kwenguva refu.
Dzimwe Nzvimbo
Kunyange zvazvo nzvimbo dziri kumusoro dziri nzvimbo dzakawanda kwazvo dzemapapu emapapu emapapu, kenza yemapapu pane dzimwe nguva inopararira kumudumbu, maduku uye makuru mazamu, pancreas, ziso, ganda, itsvo, uye kunyange bvudzi.
Prognosis
Zvimwe pane kupararira kune lymph nodes zvinogona kusanganisira zvikamu zvepakutanga zvechirwere, kenza yemapapu yakapararira kune nzvimbo dziri kure dzomuviri inoratidzirwa seyero 4 risina duku rekenza yemapapu emapapu kana chirwere chakawanda chekenza yemapapu emapapu. Zvose zvinokwana makore mashanu ekupukunyuka kwechikamu chechina chechina chema kenza yemapapu emapapu zvinosuruvarisa chete kusvika 2 muzana. Kupona kwemazuva mashoma, iyo ndiyo nguva yakatevera iyo hafu yevanhu vachiri vapenyu uye imwe hafu yapfuura, ndeye mwedzi 8. Zvose zvinokwana makore mashanu ekupukunyuka kwechikamu chakawanda chekenza yemukenza wemapapu chikamu 2 muzana. Avhareji kupona ndeye mwedzi 6 kusvika ku12 nekurapa, asi mwedzi miviri kusvika ku4 pasina kurapwa.
Izvozvo zvakati, pane vanhu vakapona uye vakaita zvakanaka kwemakore mazhinji kunyange mushure mekuongororwa kwekenza yemapapu yakapararira. Mukuwedzera, mushonga mutsva, wakadai semuviri wemishonga unogamuchirwa muna 2015 , unopa tariro yokuti kune vamwe vanhu, kurarama kwenguva refu kunogona kuitika. Kunyange zvazvo mishonga iyi isingashandisi munhu wose, vamwe vanhu vane kenza yemapapu yakakura vave ne "mhinduro yakasimba" kumishonga iyi - kureva, mune mamwe mazwi, kurarama kwenguva refu.
The Bottom Line
Sezvakataurwa pamusoro apa, pasi pemusoro wezvikamu zvakasiyana zvemuviri uyo mutapu wemapapu unogona kupararira, ndeyekuti kana mashomanana masayiti emasastasis aripo, achirapa zviratidzo izvi nechinangwa chekugara kwenguva refu chekenza kwete kungoita inogona kuonekwa. Vakawanda vatsvakurudzi iye zvino vanofunga kuti kufambira mberi mukurapa kwevanhu vane maitiro mashoma emasitasiti kwakaita kuti zvive nyore kune vamwe vanhu vane oligometastases nekuda kwekenza yemapapu kuva nenguva refu yekurwara kusununguka kusununguka nehupenyu hwakanaka hwehupenyu.
> Sources:
> Miller, D., uye M. Krasna. Local Therapy Zviratidzo mumutungamiri wevarwere neOligometastatic Non-Small Cell Lung Cancer. Mapiritsi Anopikisa Inocology eNorth America . 2016. 25 (3): 611-20.
> Peters, S., Bexelius, C., Munk, V., uye N. Leighl. The Impact of Brain Metastasis pamusoro pehutano hwehupenyu, kushandiswa kwemishonga uye kuchengetedza varwere nevasina-duku-cell lung lungenza. Cancer Treatment Reviews . 2016. 45: 139-62.
> Stephens, S., Moravan, M., uye J. Salama. Kutarisa Mishonga NeOligometastatic Isina-Small Cell Lung Cancer. Nhamba yeOncology Practice . 2018. 14 (1): 23-31.
> Suzuki, J., naI Yoshino. Nzira yeOligometastasis muMusana-Small Cell Lung Cancer. Jeneral Thoracic and Cardiovascular Surgery . 2016. 64 (4): 192-6.