Kanzera yepabonde inotyisa zvakakwana pasina kutya kuti inogona kuenda kune dzimwe nhengo dzomuviri. Metastasis ndiro izwi rekupararira kwekenza. Vanenge vanenge 250 000 vakadzi vanoonekwa kuti vane kenza yemazamu uye vanenge 40 000 vachafa kubva kurwere gore negore. Apo kenza yemazamu inowanikwa muzvikamu zvekutanga, vakadzi vazhinji vanoramba vachirarama hupenyu husina kenza.
Asi kune vamwe, chirwere chacho chinonzi metastatic panguva yekuongororwa kana kuti gare gare inodzoka. Zvinofungidzirwa kuti chirwere chetastastatic chinokonzera kusvika 90 muzana yevakafa vane chokuita nekenza yemazamu. Ko kenza yemazamu inopararira sei kana kudzokazve?
Kutanga Kuziva
Ngozi yokuti kenza yemazamu ichadzoka kana kupararira yakabatanidzwa nehukuru hwechirwere uye huwandu hwekupararira panguva yekuongororwa.
Kune vanenge makumi maviri kubva muzana yevakadzi, kenza yemazamu inowanikwa pane imwe nguva yekutanga. Chikamu 0 kenza yemazamu kana kuti carcinoma in situ inofungidzirwa kuti isati yakasvibiswa nekenza yemvere. Sezvo izvi zvekare kare zvekenza hazvina kupararira kupfuura chimwe chinhu chinonzi chivako chepasi (havasati vatamira kunze kwemafupa emvere), kuvhiyiwa kunofanirwa kuporesa mahara aya.
Imwe 70 muzana yevanhu inoonekwa kuti ine kenza yemazamu isina kumira iyo isina kumboita zvirwere (kupararira kune nhengo dziri kure). Aya mazamu emukaka, anonzi sendima 1 kusvika ku3 kanzira, angave akapararira kune lymph nodes asi asipo mune dzimwe nhengo.
Nezvirapa zvakadai sekuvhiya , chemotherapy , radiation therapy , hormonal therapy , uye / kana zvinorapwa, vazhinji vezviremara izvi zvicharamba zviripo. Zvisinei, njodzi, kunyange zvakadaro, kuti ichaonekwazve (yakadzoka) yakakura uye yakakwirira uye kana lymph nodes inobatanidzwa.
Pashoma 10 muzana yevakadzi vanoonekwa kuti kana kenza yakatozopararira kune nzvimbo dziri kure dzomuviri.
Kanzera yepabonde inowanzopararira kumapfupa, chiropa , mapapu, uye uropi.
Kudzokorora
Kazhinji kenza yemazamu inonzi metastatic inotanga kuongororwa kuti inotanga-gadziro yemazamu emumukomana anotevera zvakare. Kudzokorora kungave:
- Musha: Muzamu
- Mharaunda: Muine lymph nodes kana pachifuva rusvingo
- Ari kure: Muzvikamu zviri kure
Kana kenza yemazamu inodzokera kune imwe nzvimbo iri kure haisisiri kurapwa asi ichiri kurapwa, uye kurapwa kunogona kusimbisa zviratidzo uye kuwedzera upenyu.
Kutya uye Kunzwisisa
Vanhu vazhinji vanovhunduka nekudzoka kwekenza yemazamu, asi vazhinji vanogona kuwana kuenzana pakati pekuziva uye kuoma mutezo nekutya. Zvakajairika uye zvakajairika kuti uwedzere kuziva kana iwe uine zviratidzo zvekugona kupararira mushure mekunge uine kenza yepamusoro yepamuviri. Musoro unofanirwa kunge uine hutano hwemusoro chete, asi pfungwa yehutano hwemagetsi inogona kuuya mupfungwa. Saizvozvowo, bvudzi riri mushure mako rinogona kukuita kuti unetseke pamusoro pemasitema emapfupa asi zviri nyore kuti iwe wakarara zvakashata.
Zvakakosha kuti mukadzi wese (uye murume) akave nekenza yemazamu ave nezivo pamusoro pezvavanotarisira. Your oncologist inogona kukubatsira kuti unzwisise izvi zvichienderana nekenza yako chaiyo, chikwata chayo, nezvimwe zvinhu.
Kuva nekuziva kwakanyanya kunogona kuvimbisa kuti iwe unotevera nekufamba kwakakodzera uye kuziva nguva yekufonera. Kana kutya kunenge kuchikuvadza mupfungwa, zvakadaro, murapa wekenza anogona kuva yakakosha mukukubatsira kuti urambe uine mutsauko pakati pekuziva nekutya.
Nzira yekuti Bonde Rinopararira sei
Chirwere chepabonde chinogona kupararira kune dzimwe nzvimbo dzomuviri munzira nhatu dzinokosha:
- Kuburikidza neLymph system: Breast tumor cells inogona kubvisa kubva mumarara mukati mezamu uye kupinda midziyo miduku ine lymphatic iyo iripo mukati mazamu. Kubvira ipapo vanogona kutakurwa kuburikidza nemakirini emakirini kusvika kune lymph nodes uye kupfuura. Iro lymphatic inopararira iyo inokosha chikamu chekuongororwa uye kugadziriswa kwekenza yepamu. Kana bundu rakapararira kubva muzamu kuenda kune mutinel lymph node (kana kenza iine lymph node positive ) yakanyanya "kuzivisa" chinangwa chekupararira kupfuura chifuva. Vanhu vanogona kuvhiringidzika zvikuru kana vachiverenga maitiro avo ekurwara . Kana kenza yakapararira kune lymph nodes iri pedyo, mushumo unogona kutaura "metastatic lymph nodes." Izvi hazvirevi kuti une kenza yepamusoro yepabonde, uye kunyange imwe nguva yepakutanga 1B yekenza yemazamu inogona kunge ine lymph node inobatanidzwa.
- Kupfurikidza neropa: Sezvo kune zviduku zviduku zvidhinhe mukati mezamu kune mitsetse yakawanda yeropa. Kanzera dzemawere dzinogona kukonzera midzi midzi midzi yeropa uye inotakurwa kuburikidza neropa kusvika kune nzvimbo dziri kure, kunyanya nzvimbo dzakadai semapapu uye chiropa zvine ropa guru.
- Kupinda kwemuganhu : Kanza yepabonde inogonawo kupararira mumasukisi akadai akadai sedanda rechifuva kana nenyundo nekupinda. Kanzera dzemasero dzakasiyana nemasero anowanzoitwa nenzira iyi. Uturu hwemhondi hunogona kukura uye hunoendesa kune mishonga yakaswedera, dzimwe nguva inokonzera kukanganisa. Asi zvipembenene zvinokonzera kenza zvinopinda mumatumbu aya. Izvozvi, izwi rokuti "kenza" rinobva pashoko rechiGiriki rinoreva kuti "crab" kurondedzera tsvina-yakafanana nekuwedzera kwekenza mune zviduku zvakapoteredza.
Kana kenza yemazamu inopararira kune imwe nhengo inenge ichiri kenza yemazamu. Somuenzaniso, kana kenza yemazamu yaizopararira pamapapu, yaisazoti chirwere chemapapu. Pane kudaro, tinogona kutarisa kwariri sekenza yemazamu inopararira kumapapu kana kenza yemazamu nemapasitasi emapapu. Kana iwe waizotarisa masero emukenza mumapapu pasi pe microscope ivo vaizove nekenza mazamu masero, kwete mapepa emukenza emapenza.
Cancers dzakapararira kune mamwe matukisi dzinogona kunge dzakasiyana nedumbu rekutanga, uye iyi ndeimwe nzvimbo yekuvhiringidzika. Cancers haisi kungofanana nemasero asina kukwana anokanganisa pfungwa. Pane kudaro, ivo vari kuramba vachichinja uye vachivandudza kuchinja mutsva. Nokuda kwechikonzero ichi, chirwere chaiva chestrogen receptor chakanaka kana chikawanikwa muzamu chingangove isrogen receptor isina kunaka. HER 2 chimiro chinogona kuchinja zvakare. Izvi zvinotsanangurawo nei chiremera chemasastatic dzimwe nguva chinosuruvarisa kupfuura chiremara chepakutanga.
Chinoita Kuti Ipararire uye Idzoke
Iwe unogona kunge uchishamisika kuti nei mazamu epazamu echeche achifamba zvachose. Kana kuti, sei masero akajairika asingatambanudzi kupoteredza miviri yedu. Masero eC Cancer akasiyana nemasero akajairika nenzira dzakawanda. Imwe yeiyi iyo masero ezuva ose ane izvo zvinozivikanwa se "kusungirira maserolekisi." Izvi zvinonamatira semirasi inoita seglue uye inochengetedza masero mavari pane imwe chikamu chemuviri.
Masero anowanzovewo ane "miganhu" kana nzira iyo masero anotaurirana. Izvi zvakafanana nenyika imwe tichiti kune umwe "iwe hausi pano." Kanzerini masero, zvakasiyana, haasi kuremekedza mafoni ekukurukurirana, kunyanya kuregeredza "masvingo" pakati pematukisi akasiyana.
Asi imwe nharo inokanganisika painenge ichitaura pamusoro pekupararira kwekenza yepamusoro ndiyo inogona kuitika makore kana makumi emakore gare gare. Tinoziva kuti, kunyanya nekenzaro-receptor-positive kanamisi yepamu, kenza inogona kuonekwa ikanyangarika chete kuti idzoke makore mazhinji mushure mekutanga kwechirwere. Hapana anoziva chaizvoizvo kuti izvi zvinoitika sei, asi pane maonero pamusoro pedzoka anoratidza kuti mamwe masero echepabonde emvere anonyanyisa kupfuura vamwe uye kuti kenza iyi "masero emasero" anogona kukwanisa kurara kunyange nekurapa.
Risk Factors
Hatizivi kuti mishonga yekenza ichadzoka uye inenge isingaiti, asi pane zvimwe zvinhu zvinowedzera dambudziko. Izvi zvinosanganisira:
- Cancers iyo yakadzika matanho (semuenzaniso, danho rechitatu vs nhanho 1)
- Cancers dzakapararira kune lymph nodes
- Cancers inonyanya kurwisa (ine chikwata chepamusoro chepamusoro)
- Cancers inowanikwa kuvasikana vaduku
Zviratidzo
Kana uine metastases iwe unogona kana unenge usina zviratidzo. Zvimwe zvinoshandiswa zvinowanika pakuchenesa zvirwere, zvakadai sekutsvaga pfupa kana PET scan. Sezvo izvi zvidzidzo zvingaona zviratidzo, vakadzi vane kenza yepabonde kwepakutanga vanogona kushamisika kuti chiitiko chekutevera chekuita hachina kuitwa. Chikonzero chacho ndechokuti kunyange matastases angangowanikwa nokukurumidza kuburikidza nekuongorora, kuwana nzvimbo idzi dzekupararira usati waona zviratidzo hazviregi kupona.
Zviratidzo zvechirwere chetachiona chemasamende zvinogona kusanganisira kunzwa kwekugara zvakanaka, kurasikirwa nekurasikirwa , kana kuderera kwechido.
Kana kenza yemazamu inopararira kumapapu inogona kukonzera kufema kufema nekukandira. Chiropa chemasastases nekuda kwekenza yemazamu kunogona kukonzera kusuruvara kwemuviri uye jaundice, kuputika kwechivara kweganda.
Nzvimbo inonyanya kuwanika yepafuti yemasitasasa ndiyo mapfupa, uye zviratidzo zvinowanzobatanidza marwadzo. Dzimwe nguva chiratidzo chekutanga ndechekuputsika kwechirwere , kuputsika kunoitika kuburikidza nenzvimbo yefupa kunokonzerwa nechirwere uye kazhinji kunokonzerwa nokushungurudzika kwakanyanya. Utachiona hwemhando dzepamusoro hunoita kuti zviratidzo zvakadai semusoro, kusvinura, kushaya simba, uye kushaya simba, kana kugumburwa.
Kuziva izvi, vakadzi vakambove nekenza yepabonde kwepabonde vanogona kuva nekutya kana vakakurira chimwe chezviratidzo izvi. Zvakakosha kuyeuka kuti vakadzi vasina kumbove nekenza yepamu vanotora musoro zvakare. Asi iva munyoro newe. Vaya vasina kumbove nekenza yepamu vanogona kukunyengedza pamusoro pekunetseka kwako kunobatanidza nemakwenzi matsva uye marwadzo, asi avo vane chirwere chepachifu vachachiwana. Kana zvichitora kuwana chiratidzo chinotariswa kuitira kuti ugare wakasununguka, iva nechokwadi chokuti uite izvozvo.
Kuziva
Vanachiremba vane nzira dzinoverengeka dzokugadzirisa kana chirwere chakapararira kana kwete. Izvi zvinosanganisira kufungidzira muviri uchishandisa x-rays, bone scans, MRIs, CT scans, kana PET kuongorora. Kuyera ropa kunogona kutarisa mazinga emamwe makemikari muropa, kusanganisira zvipembenene zvakananga zvinosanganiswa ne metastasis.
Uyezve, vanachiremba vanowanzotenderera pane zvinyorwa , izvo zviyero zviduku zvinounganidzwa nekubviswa kushandiswa kana kushandiswa kwetsono. Iyi sampu inobva iongororwa pasi microscope nokuda kwezvakaipa zvemasero zvinoratidza kana kune kuwedzera kwekenza.
Treatment uye Outlook
Kana kenza yemazamu inova danho rechina (metastatic) haritori kurapwa asi richiri kurapwa. Kurapa kwekenza yemasasa inokonzera mishonga inosanganisira chemotherapy, kurapwa kwakagadziriswa, osteoporosis mishonga, hormonal therapy, uye mishonga mitsva yakadai sedzimwe mishonga inogadzirisa zvirwere mumakiriniki. Isolated metastases, yakadai seyai kuuropi, dzimwe nguva inobatwa nekuvhiyiwa kana kuti kupiswa kwemaawa.
Kazhinji, chinangwa chekurapa chakasiyana kwazvo nekenza yemasasa yepabonde kuenzaniswa nezvikamu zvekare zvechirwere. Nevekutanga-gwara chirwere, kurapwa kunowanzova nechisimba nechinangwa chekuporesa chirwere. Nechitambo chechina, zvisinei, zvishoma kunyanya kurapa kurapa chirwere chinowanzova chinangwa. Kugadzirisa zvishoma nechechi chigamba ichi hazvivandudzi zviitiko asi zvinowedzera dambudziko remigumisiro uye hurombo hwehupenyu.
Shoko Rinobva
Chidiki chevakadzi vanove nekenza yepamusoro yepabonde panguva yekuongororwa, asi kazhinji metastases inowanzove yakadzoka kare kare kare. Mukana wekuti kenza ichadzoka inobva pane zvakawanda. Kutya kudzokorora kungaita kuti vamwe vanhu vachinetseka, kunyange zvazvo nguva yakawanda vanhu vachikwanisa kuwana muyero. Zvimwe zvekufunganya zvakakosha pakubatsira vakadzi (uye varume) kutevera kuburikidza nekurapa kunorayirwa nekutevera.
Kanzira inogona kupararira kune imwe nzvimbo kumatavi anenge ari pedyo kana kuburikidza nematumbu uye lopa. Sezvo iri kupararira kwekenza yemazamu iyo inokonzera kufa kwevakawanda kubva muchirwere ichi, vazhinji vanotsvakurudza vari kutarisa zvikonzero nei kenza yemasera inopararira uye chii chingavavhiringidza kuita kudaro.
> Sources
> America Cancer Society. Kanzvadzi yeChechi Chokwadi uye Zvikamu 2017-2018 .
> Muzes, G., uye F. Sipos. Cell Metastatic Dormancy uye Kudzokororazve: Zvakajeka pamusoro peChirongwa cheMorecular Events Zvinokonzerwa neCarcer Relapse. Anticancer Agents muMedicine Chemistry . 2017. 17 (4): 472-482.
> National Cancer Institute. Metastatic Cancer.