Kutarisa kuvhiyiwa, chiropa chekuisa, uye mishonga yemishonga
Kurapa kwechirwere chechiropa kunoenderana nechikamu chekenza, pamwe chete nemunhu ari pasi pesimba rekushanda.
Kunyange zvazvo chirongwa chinosarudzwa chichibviswa kubviswa kwekenza, vanhu vazhinji havakwanisi kurapwa nemhaka yehutano hwehutano hwavo uye / kana hutano husina hutano hwehuropa hwechiropa. Kunze kwekuvhiyiwa, mamwe maitiro ekurapa anosanganisira chiropa chekuisa, chirongwa chekubvisa, chirapa chekugadzira, uye mishonga yemishonga sezvinodiwa kurapwa, chemotherapy, uye immunotherapy.
Surgery
Kugadziriswa kubviswa kwechirwere cheropa kunoshandiswa kusarudzwa. Dambudziko nekuvhiyiwa, zvisinei, ndeyekuti vanhu vazhinji vane kenza yeropa uye vane chirwere chetrhosis kubva kurwere kwenguva refu.
Nokushaya chiropa chinoshanda kubva ku-cirrhosis (chiropa chakanyanya kuora), kubvisa kunyange chikamu chiduku chechiropa chechiropa pamwe nekenza kunogona kupa chiropa chisina kukwana. Uyezve, zvirwere zvakawanda zvekenza hazvigoni kubviswa zvakanaka nokuti dzakakura kwazvo uye / kana dzakapararira kunze kwechiropa.
Kuongorora
Kuti uone kana munhu asiri mukana wokuvhiya akanaka, chiremba acharaira chirwere chekufungidzira (seT CT scan kana kuti MRI) kuti uongorore huwandu hwekenza, pamwe nehupundu hunoshandiswa ropa . Munhu anonyanya kusarudzwa anenge ari nechirwere chechiropa chisina (multiple) uye akachengeterwa chiropa basa.
Kana iwe kana munhu waunoda ari kurapwa chirwere chekenza, zvinotarisirwa kuti uongorore njodzi dzose uye zvinokonzerwa nemigumisiro nechiremba wako.
Mukuwedzera, usatya kubvunza mibvunzo uye kubvunza nezvechiitiko chako chechiremba.
Migumisiro Yacho Inogona Kuitika
Kugadziriswa kwekubvisa chirwere cheropa kune chirwere chikuru, kunyanya sezvo chiropa chiine mishonga yeropa. Izvi zvinokonzera kubuda ropa panguva yekuvhiyiwa chinonyanya kunetseka.
Zvimwe zvingava nemigumisiro yechipatara inosanganisira:
- Kurwara
- Ropa rinovhara
- Matambudziko ane chokuita neanesthesia
- Pneumonia
Tora yako yezvechiremba ichakucherechedza iwe kuitira kuti uderedze njodzi idzi, uye kupa mirayiridzo ye nzira dzaunogona kuderedza dambudziko rematambudziko pamwe chete.
Liver Transplant
Kunze kwokuvhiyiwa, kurwara nechiropa kune imwe ingangodaro inoporesa kurapwa, pamwe nekubatsirwa kwakanyanya kwokurapa kwete chete kenza asi ye-cirrhosis, zvakare. Munguva yechiropa chekupemha, chirwere chekuvhiya chinoshandura chinobvisa chiropa chinorwara ndokuchiisa panzvimbo yacho nechirwere kubva kune mumwe munhu.
Chiremba anokwanisa kukurudzira chiropa chokupemha kana tumor (s) yechiropa iri duku kana kuti kuvhiyiwa hazvibvira nekuda kwechiropa chisina kunaka.
Chimwe chipingamupinyi chikuru chekuvhara kwechiropa ndiko kusakwanika kwakakwana kwezviputi. Maererano neAmerican Cancer Society, zvinokwana 6 500 mbiriso dzinowanikwa pakufambisa gore roga rega, uye dzakawanda dzadzo dzinoshandiswa kuvanhu vane zvinetso zveropa asi kwete chekenza.
Migumisiro Yacho Inogona Kuitika
Mukuwedzera kune zvinogona kuitika zvinokonzerwa nekuvhiyiwa kweropa (kubuda ropa, hosha, kuvhara ropa, anesthesia zvinetso, uye pneumonia), kune mimwe migumisiro inobatanidza nemishonga munhu inoda kutora mushure mekudhinda.
Iyi mishonga yekudzivirira zvirwere inodzivisa munhu kuti arambe chiropa chake chitsva.
Nemhaka yokuti vanodzivisa masimba enyu ezvirwere, kunyange zvakadaro, vanhu vanowanzoita zvirwere.
Zvimwe zvinogona kukanganiswa nemishonga yekudzivirira zvirwere zvinosanganisira:
- High blood pressure
- High cholesterol
- Zvinetso zvepoyo
- Chirwere cheshuga
- Tsipa kuderedza (inonzi osteoporosis)
Non-Surgical Procedures
Kune vanhu vane kenza yeropa, vasati vashandurirwa, ablation uye / kana kuti maitiro embolization angave ari kurapa kurapa. Izvi zvirwere zvinoderera uye zvichida kuparadza zvipembenene zveropa.
Ablation Therapy
Ablation therapy iyi isiri nzira yekuuraya masero emukenza uye ndiyo inowanzoshandiswa kurapwa muropa yekenza. Iyi nzira inosanganisira kuisa sindete kana tsvina mukati membeu yeropa uye kushandisa nzira dzakasiyana-siyana kuuraya masero.
Mhando dzehutachiona hwemapurisa dzinonzi zita rekushandisa zvinoshandiswa kuparadza masero ekenza:
- Radiofrequency ablation (RFA): High-energy mafungu edhiyo anopisa uye anoponda masero ekenza
- Percutaneous ethanol (doro) kublation: Doro rinopindwa mujecha rekenza
- Cryotherapy : Gasi yakawanda inotonhora inopfuura nepamuviri kuti iomeze masero ekenza
- Microwave ablation: Kuchenesa kubva kuma microwaves kunoparidzirwa mumasero ekenza
Sezvo pane chero nzira, kune njodzi uye zvingava nemigumisiro yekutora kubhadhara. Zvimwe zvezvi zvinosanganisira:
- Kusvina uye kuputika panzvimbo yeganda apo nenyuchi kana probe inowanikwa
- Kukuvadza kwemidziyo yeropa mukati mechiropa kana zvakapoteredza chiropa chechiropa kana nhare kana probe isina kuiswa
- Utachiona, kusanganisira chikwama chechiropa
- Kukuvadza kune bile bile kana dzimwe nhengo
- Tumor seeding (chinetso chisina kujairika umo masero emukenza akapararira pamutsara wetsono)
Embolization Therapy
Munguva yekudzidzira, ropa rinopa chiropa chechiropa rinovharwa saka kenza "inoshayiwa nenzara" uye haigoni kukura. Iyi nzira yekurapa inogona kushandiswa kwezviremara zvechiropa zvakakura uye / kana hazvigoni kubviswa chirwere.
Dzimwe nguva kuumbwa kunosanganiswa nechemotherapy (inonzi chemoembolization) kana kuti rayation (radioembolization).
Zvinyorwa
Mishonga yemishonga inoshandiswa kurapa kenza yepamusoro kana yekupedzisira-yesero yechiropa.
Targeted therapies ndiyo nzira yokutanga yekurapa kwekenza yepamusoro yekenza, inotevera chemotherapy kana immunotherapy semutsara wechipiri.
Targeted Therapies
Zvinodhaka zvinodhaka zvinoshanda nekupindira zvinhu zvinoda kuti kenza ikure. Chirwere chinotenderwa chekutanga chekurapa kenza yemukondombera isingawaniki (inoreva kansa yeropa inenge isingagoni kubviswa chirwere) ndeyeNexavar (sorafenib), iyo inotarirwa nemishonga inogadzirisa iyo inodzivisa chiropa cheropa kubva pakuita mishonga yeropa idzva.
Zvose zvinowanzoitika zveNexavar dzinosanganisira:
- Kuneta
- Mapundu
- Kufirwa kwechido
- Diarrhea
- High blood pressure
- Hand-foot foot reaction
Kune vanhu vasingakwanisi kubvumira Nexavar, kana seimwe nzira yekurapa kwekutanga-line, mushonga wakafanana unonzi Lenvima ( lenvatinib ) unogona kufungwa.
Muchikamu chechitatu chekudzidza, Lenvima (paakaenzaniswa neNexavar) aiva nehuwandu hwekuchengetedza hupenyu (13,6 mwedzi zvichienderana ne12.3), kuwedzera kwehuwandu hwemhinduro (24 muzana kusvika 9 muzana), uye nguva yakakwirira pakuwedzera kwezvirwere (7.4 mwedzi zvichienderana nemwedzi 3.7 ).
Maitiro akawandisa anowanzoitwa naLenvima ndeaya:
- High blood pressure
- Diarrhea
- Kuderedza kudya mwoyo
- Kuonda
- Kuneta
Imwe mishonga inoshandiswa Stivarga (regorafenib) inodzivirira mapuroteni anobatsira kenza yekenza yekuropa kukura. Ichi chiremba ikozvino chinoshandiswa sechipiri-line therapy (zvinoreva kana Nexavar kana Lenvima vachirega kushanda).
Migumisiro yakajairika inosanganisira:
- Kuneta
- Kurasikirwa kwechido uye kuora kurasikirwa
- Rash pamaoko netsoka
- High blood pressure
- Fever uye zvirwere
- Diarrhea
- Kutambudzika kweBelly
Chemotherapy
Chemotherapies imishonga inouraya kenza yemukenza. Kunyange zvazvo "chemo" inowanzotorwa nemuromo kana kuti nemuviri, mune chirwere chechiropa, inogona kuendeswa mukati memuchiropa kuburikidza nehepatic artery (inonzi hepatic artery infusion).
Zvichienderana nemhando uye chirwere chemhemotherapy yakapiwa, munhu angava nemigumisiro yemigumisiro yakadai seyi:
- Kurasikirwa kwebvudzi
- Makuvara emuromo
- Nausea, kurutsa, uye / kana chirwere
- Kurasikirwa nekurema kubva pakuderera kwechido
Sezvo mishonga ye chemo inofanirwa kuparadzanisa masero (nokukurumidza masero emukenza anokura), masero mumapfupa emunhu anowanzoparadzwa. Izvi zvinogona kutungamirira kune zviratidzo zvinenge nyore nyore kugunun'una uye kubuda ropa, uyewo kuneta uye ngozi yakakura yehutachiona.
Immunotherapy
Immunotherapy inofadza zvikuru, kushanduka kurapwa kusarudzwa kwakashandura chiso chekenza kutarisirwa. Izvo zvinokonzerwa ne immunotherapy ndezvokuti zvinokurudzira muviri wemunhu kudzivirira maitiro emukenza.
Nokuda kwekenza yeropa, immunotherapy drug Opdivo (nivolumab) inobata nekuvhara puroteni yekuzvidzivirira mumuviri inonzi programmed death 1 (PD-1). Iyi protein inonyengedzwa yakagadzirwa nekenza masero ekudzivirira zvirwere zvemuviri zvemunhu kubva pakuzviziva sevatorwa. Saka, nekudzivirira PD-1, kenza inogona kuonekwa nekurwiswa.
Opdivo inopiwa kuburikidza nemuviri, vhiki mbiri. Zvimwe zvinogona kukanganiswa zvinosanganisira:
- Kuneta kana kushaya simba
- Fever
- Kukosora
- Nausea uye kurasikirwa kwechido
- Itching uye ganda rinoputika
- Uturu kana hutano hutano
- Kuvhara kana kubuda
Mamwe emigumisiro yakakomba inosanganisira kugadziriswa kwekukanganiswa (kufanana neanoratidzika zvinogadziriswa) kana kuitika kwemagetsi, umo muviri wemunhu unotanga kurwisa nhengo dzakanaka (somuenzaniso, mapapu).
Complementary Medicine (CAM)
Usati washandisa mishonga chero ipi zvayo kana zvokudya, iva nechokwadi chekuti chiremba wako azive. Izvi zvichatibatsira kudzivirira chero zvipi zvingadikanwa nemigumisiro nekubatana.
Sho-saiko-to
Imwe mishonga yemishonga inonzi Sho-saiko-ku (inonziwo Xiao Chai Hu Tang), iyo inosanganiswa yezvinomwe botanicals, kusanganisira ginseng, ginger, uye licorice, yakashandiswa kurapa chirwere chehepatitis uye cirrhosis.
Imwe tsvakurudzo inoratidza kuti izvi zvemishonga yemishonga inogonawo kubatsira kubvisa kushandiswa kwekenza yeropa mune vanhu vane cirrhosis, kunyange zvazvo nzira yakarurama yekuita isiri pachena. Kunyange zvazvo Sho-saiko-kuti inofungidzirwa kuti inonyatsotenderwa, inogona kukonzera kukanganisa uye kuora kwechiropa, saka inofanira kungotorwa pasi pekutungamirirwa kwachiremba.
Holy Basil
Imwe mishonga inonzi Ocimum sanctum L kana "Holy Basil" inomera ine phytochemicals inokurudzira chiropa hutano. Iyo inewo inopesana nekenza zvinhu. Izvi zvinomera zvemavara dzimwe nguva zvinoshandiswa mumutauro weThai. Iyo haina zivo yemigumisiro.
Milk Thistle
Silymarin ( Silybum marianum ), anonziwo mukaka mutsva , anoshandiswa mune dzimwe nyika (kufanana neGermany) sekutsigira kurapa kwechirwere chisingaperi chechiropa. Inofanirwawo kuti inopesana nekenza uye ine unhu hwakanaka hwekuchengeteka, kunyange hunoita kuti zvirwere zvinenge zvichiitika kana zviratidzo zvekudya zvishoma.
Zvokudya Zvakasikwa
Kunze kwemishonga, zvokudya zvepanyama zvinogonawo kudzivirira kudzivirira kenza yechiropa. Ikofi inowanikwa mupfuma we antioxidants uye inobatanidzwa nehuwandu huripo hwese hwechirwere nechirwere cheropa. Zvisinei, hapana huchapupu hwezvesayenzi huri kuwedzera yako ikozvino kofi yekushandisa (kana kutanga kunwa kofi kana usati wambove) inobatsira.
Chimwe chikafu chechisikigo, resveratrol, chinowanikwa mu mulberries, mazambiringa matsvuku, uye mapeji, angave ane anti-kanzvadzi zvinokonzerwa nekuwedzera kudzivirira kune vasiri doro rinodhaka chirwere chechiropa .
> Sources:
> America Cancer Society. (nd). Kurapa Chiropa Cancer
> Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet. 2018 Mar 31; 391 (10127): 1301-14.
> Kim JW et al. Kutsika-shandiswa kwe-Ultrasound kweropa rekusvibiswa kwekubvisa kubatwa kweropa: Tinozviita sei zvakachengeteka uye zvakakwana. Korean J Radiol . 2015 Nov-Dec; 16 (6): 1226-39.
> Kudo M et al. Lenvatinib uye sorafenib mukurapa kwokutanga-mutsva kwevarwere vasina kugadzikana hepatocellular carcinoma: randomized > phase 2 isina-inferiority trial. Lancet. 2018 Mar 24; 391 (10126): 1163-73.
> Waghray A, Murali AR, Menon KVN. Hepatocellular carcinoma: Kubva kuongororwa kunorapwa. World J Hepatol. 2015 May 18; 7 (8): 1020-29.