Optimal Surgery uye Stage III uye Mutsara IV Ovarian Cancer
Chii chinorehwa ne "optimal" cytoreduction kana chirwere chinokonzera chirwere chekenza yevana?
Cytoreduction kana Debulking Surgery
Kana iwe wakambovhiyiwa nekenza yepamusoro ye ovari, imwe yemibvunzo inokosha zvikuru yekubvunza chiremba wako ndeyekuti kana kwete here kuburitsa kana kuti cytoreduction yakanga yakanaka. Mune mamwe mazwi, pane zvakawanda zvechiremera zvakabviswa chirwere here?
Chii chinonzi "Optimal" Cytoreduction kana Debulking
Hazvisi nguva dzose zvekugona kukwanisa kubvisa kanhi kana yose yekenza inooneka panguva yekuvhiyiwa kwekenza yevana. Zvisinei, takaziva kuti kubatanidza kuvhiringidzwa kwechisimba nechemotherapy kwakakonzera kurapa kwakanakisisa kwemitengo kwemakore anopfuura makumi maviri. Kwemakore, rudzi rwekemotherapi rwakashanduka uye ndizvo zvinoreva tsananguro yekutsvaga kana kuti "kukodzera" kuvhiyiwa kunogona kana kunofanira kuva.
Munguva ichangopfuura semakore gumi apfuura, tsanangudzo ye "chirongwa chakakwana" kuvhiyiwa ndechokuti matamu asina kupfuura 2 centimeteri akasara shure (iyo inenge inenge ¾ ye inch). Izvi zvinogona kuva imwe, kana maviri kana akawanda emakumbo, hapana chimwe chinopfuura 2 masentimita muhukuru.
Nezvishandise zviri nani uye nzira dzokuvhiya, isu zvino tinoziva kuti inonyanya kunakirwa kuti "chirwere chakakwana" chekuvhiya kusiya mushure mamakumbo masendimita masere, kusvika ku "miliary" (maduku "mashoma" ekukura kwekenza mutsara) muzhinji rwevarwere uye kunyange zvirwere zvishoma (hazvioni kana kuzviona mushure mekuvhiyiwa) mune varwere vakawanda.
Chirwere Chako Chokurapa Zvikuru Chinokonzera Kusiyana
Havasi varwere vose vanogadzirwa nepiristologically yakaenzana. Mune zvimwe zviitiko, murwere angave akwegura kana kuti anorwara kuti atsungirire maawa 4-8 ayo angatora kuti awane "zvakakwana" zvawanikwa. Uyezve, kubuda ropa kana zvimwe zvinetso zvinogona kumanikidza chiremba chiremba kuti amise kupererwa kwepakutanga kupfuura zvavanoda.
Muzviitiko zvakawanda, haisi yega pachayo asi pane zvimwe zvehutano zvinogona kuitwa nemurwere zvinotaridzira kuti nguva yakareba sei chirwere chinogona kuvhiringidzwa.
Uyo Chiremba Wenyu Anoita Kusiyana
Havasi vese vanovhiya vanosikwa vakaenzana. Izvi ndezvechokwadi mumabasa ose nezvose zvekurapa. Kunyangwe pakati pegynecologic oncologists - avo vanonyatsokodzera kushanda kwauri nekuda kwekenza yevarivha - pane musiyano mune unyanzvi. Vose vakarovedzwa mukugadzirisa kwekuita kwakanaka uye vazhinji vanogona kuita cytoreduction kuti vabudirire 1-2 cm masara "opera" kuvhiyiwa mune vazhinji vavo varwere. Pachinyanya kuve nechokwadi chekuti gynecologic oncologist, kana kuti, yakabatanidzwa mukuvhiya kwako.
Ndinoda Kuvhiyiwa Kwakanyanya Here?
Zvidzidzo zvezvechiremba zvakaratidza kuti izvo zvakanyanya kubviswa zviri nani kana zvasvika pakuberekwa kwekenza yevana. Hapana chikonzero chinopfuura icho chisina kuwedzerwa kubatsirwa. Zvisinei, dzimwe nguva kusvika kumarayari kana zvirwere zvisingaoneki zvinoda kuvhiyiwa zvakanyanya, kusanganisira kubvisa chikamu chechiropa, spleen, mapapu, nzvimbo dzakawanda dzemahara, lymph nodes munzvimbo dzakaoma uye kupfuura. Havasi varwere vose vanogona kubvumira izvi zvakanaka uye havasi vese vanovhiya vanofarira kuita izvi.
Vamwe vakadana ichi "chiremba" -kuvhiya kwechiroreductive nguva dzose, apo chinangwa ndechokuwana microscopic kune mamiriyoni ("jecha" ukuru) "zvakanakisisa" kuvhiyiwa pazvinenge zvose zvinodhura.
Usati waenderera mberi, izvi zvinoda kukanganisa kukuru / kubatsirana ne gynecologic oncologist yako. Kana iwe ukasarudza kubvumirana nechiyero ichi chekuvhiya, cherechedza mupfungwa kuti havasi vose vanovhiya vakarovedzwa, kana kuti vanoita zviitiko zvakakwana zvokuvhiya zvechirudzi ichi, kuitira kuti vawane zvakakwana chiyero ichi che "chirongwa" chekuvhiya. Zvimwe, vangangodaro vasingatendi kuti chirongwa ichi chinowanikwa pakuvhiya chinonyanya kufarira varwere vavo. Kunyange zvazvo mafungiro akasiyana-siyana akawanda, iyi ichine nzvimbo yakawanda mumabhuku ekurapa.
I "Ultra-Radical" Cytoreduction Proven?
Dzimwe nyanzvi dzinofunga kuti kana "chirwere" -kuvhiya kwenguva refu kuchidikanwa kuti uwane "zvakanakisisa" kuvhiyiwa, izvi zvinoreva kuti mumamiriro ezvinhu emuurwere uyo kenza inowanzova yakaipa zvikuru.
Saka, vanofunga kuti uku kurapwa kwakanyanya hakuiti chinhu chinovandudza mikana yekurapa. Ichokwadi ndechekuti, nezvo izvi zvingava zvechokwadi mune vamwe varwere, isu hatizivi chete kuti ndeupi varwere iyo iyo panguva yekuvhiyiwa, kana kunyange mushure mekuvhiyiwa.
Tsvakurudzo yakabudiswa inoratidza kuti vamwe vakadzi vanobatsirwa kupfuura vamwe kubva pakuvhiyiwa kwakanyanya uye kwakanyanya. Cancers ine maitiro akasiyana-siyana ekunzwisisa chemotherapy, iyo isingataurikiki. Vamwe varwere vanorapwa. Vamwe havazi.
Inodzikira kune chiremba anovhiya achiita sarudzo pakuongorora panguva yaunofamba nayo nekuvhiya kunobva pane zvinyatsogona uye kana vachifunga kuti unogona kutsungirira chirwere chinowedzera. Izvi zvingavewo zvimwe zvichibva pakufungidzira pamusoro pekutsamwisa kwehupenyu hwekenza yako.
Ramba uchiyeuka kuti pane dzimwe nguva zvinenge zvisingakwanisi kusvika kune imwe nzira yakanakisisa ye "yakanaka" pasina, somuenzaniso, kubvisa matumbo ose, izvo zviri pachena kuti hazvienderani nehutano hwehupenyu hwakanaka. Saizvozvowo, sezvambotaurwa kare, mune dzimwe nguva mamiriro ekurapa kana zvinetso zveprasia zvinogona kumanikidza kumira kuvhiyirwa kare pane zvakarongwa kana zvinoda. Asi pane musiyano, wandinotarisira kuti uri kutanga kunzwisisa, pakati pe "zvisingaiti" uye kutonga kunoshevedza kana kusakwanisa unyanzvi hwokuvhiya.
Kana zvichibvira, zvakakosha kuti ukurukure gynecologic oncologist uzivo pamusoro pezvinhu zviri pamusoro PAKAPENZWA kupora. Zvakare, iwe unogona kana usasarudze kuti rwechipiri pfungwa inodiwa. Iwe UNOGONA kuumba ukama hwakasimba ne gynecologic oncologist weunosarudza iwe waunonyanya kuvimba. Kunyange ini ndaizokudzivisa zvakasimba kubva pakusarudza kushambadzira chiremba, kana ukama uhwu husina huno, tsvaga chiremba kuti unogona kukudziridza rudzi urwu hwehukama ne.
Ko Zvakadini neGedhi 4 Ovarian Cancer?
Mashoko mashomanana pamusoro peGweta IV (4) kenza inokosha. Munguva yakapfuura, zvaifungidzirwa kuti kana kenza yeAvari inowanikwa munzvimbo yemapapu kana muchiropa kana chirwere, kufungidzira kwakanga kwakashata zvokuti kuvhiya kwaisazobatsira zvikuru. Zvidzidzo zvenguva pfupi zvinoratidza kuti, apo imwe neimwe mamiriro ezvinhu akasiyana, izvi zvingasava zvechokwadi. Zvirwere zvinogona kunge zvakanyanya kuipa kupfuura Stage III, asi munguva dzakawanda, chirwere chinoshungurudza chinonzi cytoreduction chinofanira kuramba chichifungidzirwa zvakasimba kana inyanzvi inogona kuitika, kana murwere anonzwisisa njodzi kana achibatsirwa uye kana akakwanisa kurapa. Kana chirwere ichi "chakanyanya", chirevo chacho chinogona kuchinja zvikuru uye chinouya pedyo nemigumisiro inowanikwa muChitatu III.
Chidimbu cheKytoreductive Surgery Makomborero
Nenzira yakawanda, chirevo chikuru chekugona kurapwa mumuviri weChitatu II kusvika kuVine chiyero che "zvakanakisisa" cytoreduction inobudirira. Mumakore ose aya, uremu hwakasimba hweuchapupu hwezvokurapa (mapepa akawanda ezvokurapa) anobatsira kubvisa kenza yakawanda sezvinobvira pamberi chemotherapy. Pane dzidziso dzehupenyu, dzandingazopindi mazviri pamusoro, dzinotsigira zvakakosha zvechiroreduction mukuvandudza chemo-mhinduro.
Kunyanya, kurapwa kunoita kuti zvive nyore kuti chemotherapy ishande kuburikidza nekuderedza nhamba yemasero iyo chemotherapy inofanira kuuraya (kubva mabhiriyoni / trillioni kusvika mazana / makumi ezviuru zve ...... kana zvichida zvishoma kana pasina chakaoneka chinosara). Kuvhiyiwa kunobatsirawo masero ose akasara kutanga kutengesa panguva imwechete (kupatsanurwa ndiko kukura kwavanokura), zvichiita kuti zvive nyore chemo kuuraya panguva imwechete muhupenyu hwavo hweupenyu.
Zvichipa ruzivo urwu, kana iwe usina kunge wakagadzirisa "cytoreduction" yakaitwa, dambudziko / kubvunzurudza kunobatsira kunofungidzirwa pamusoro pekushanda kwechipiri kupedza basa iri. Nyaya dzinosanganisira zvikonzero zvehutano uye zvezvechirongwa zve "sub-optimal" cytoreduction, kure kure nekanakisisa zvakanakisisa "zvakanakisisa" zvaunenge uripo, rudzi rwekemotherapy iwe uri kuronga, inguva yakareba sei kubvira pakatanga kuvhiyiwa uye nezvimwe zvinhu .
Nenzira yakawanda, kukurukurirana pamusoro peimwe chirwere kunogona kuve nekukurukurwa kukuru kana chirwere chekutanga chakanga chiri nani kudarika nekuda kwekushaiwa unyanzvi, kana kushaiwa gynecologic oncologist. Semuenzaniso, kana iwe uine chirwere chakakonzerwa zvikuru ne biopsies chete, chirwere chinowedzera chinganzwisisika. Zvisinei, iwe unofanira kufunga kuti chirongwa che chemotherapy chinopindirana sei mumufananidzo wose.
Dzidzo, Kutsigira, uye Kupa simba
Nyora urongwa hwemibvunzo yekubvunza gynecologic oncologist . Uya neshamwari newe - inogara ichiita sekuti kune mumwe munhu anokubatsira kunzwa zvose zvinotaurwa. Tora manotsi. Tsvaga rubatsiro rwekenza yevarivha uye ruzivo rwekambani. Uye tora pfungwa yechipiri kana iwe usati uri 100% chechokwadi chezvisarudzo zvaunosarudza. Haisi kungozvitsigira iwe semukenza wepachirwere achikuisa muchigaro chemufambisi - asi kune vamwe vanhu vane dzimwe kenza, zvakatove zvichiratidzwa nekuvandudza kupona.
Sources:
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Liu, Z., Beach, J., Agdjanian, H. et al. Suboptimal cytoreduction mu ovarian carcinoma inobatanidza nemakemikari nzira dzinoenderana nekuwedzera kwekugadzirisa, Gynecologic Oncology . 2015. 139 (9): 394-400.
Vidal, F., Al Thani, H., Haddad, P. et al. Ndeapi maonero ekugadzirira kusarudza muChirangariro chekusava nekuchengetedza kweOvarian Carcinomatosis: Kupfuura Gross Residual Disease Kufungisisa. Annals of Oncology Surgery . 2016. 23 (2): 434-42.