Matambudziko Kubva pakuvhiya, Chemotherapy, Radiation Therapy, uye Zvimwe
Kana iwe uchitaura nevanhu vazhinji vane kenza yemazamu , iwe uchadzidza kuti kurarama nechirwere chinosanganisira zvinopfuura kungorwisa kenza chete. Kutaura zvazviri, migumisiro yemigumisiro uye zvinetso zvekenza uye kurapwa kwekenza kazhinji zvinonetsa semucheche pachayo. Ndeipi migumisiro yechirwere uye zvinetso zvipi zvinogona kuitika kana iwe uchirasikirwa nekenza yepamuviri yepamuviri?
Ngatitarise nezvezvinetso zvinogona kuitika maererano nekuvhiyiwa, chemotherapy, uye remishonga inonzi radiation, pamwe chete ne "pfungwa" uye zvinetso zvevanhu munzanga.
Migumisiro Yechirwere vs. Matambudziko
Zvakakosha kusiyanisa migumisiro nematambudziko, kunyange tichizokurukura zvose zviri zviviri. Migumisiro yechiratidzo zviratidzo zvisingawanzojairika uye zvinotarisirwa. Chimwe chemugumo wemagetsi ndekushaiwa bvudzi panguva yekemotherapy. Zvinetso, zvakasiyana, hazvisi zvishoma uye hazvitarisirwi, kunyange zvazvo zvichizivikanwa kuti zvinoitika dzimwe nguva. Muenzaniso ungadai uri kukura kwekushaya kwemoyo kana kemukemia nekuda kwechemotherapy.
Kunyange zvazvo zvichida iwe uchava nemigumisiro ine chokuita nemishonga, ramba uchiyeuka kuti vanhu vazhinji havaoni chero dambudziko iri pasi apa. Hatidi kuti urongwa urwu hukutyei, asi tine tariro yokuti kuva neruzivo uku kuchakucherechedza kuti chimwe chinhu chingave chakaipa, kuitira kuti iwe utsvake rubatsiro rwechiremba nokukurumidza sezvinobvira kana zvichidiwa.
Ngatitangei nokutarisa mishonga chaiyo yaungagamuchira.
Migumisiro Yechipfuva uye Zvichida Njodzi dzeUvhiya
Pasinei nokuti une mastectomy kana lumpectomy, unogona kutarisira mamwe madhara. Mushure mekuvhiyiwa, iwe uchange uchitambudzika kwemazuva mazhinji. Kana iwe wakanga uine lymph node dissection, iwe unogona kunge wakachengetedzwa mumashure ako emaoko kwenguva yakati.
Zvechokwadi, kuvhiyiwa kunoreva kuti iwe uchava neharura.
Zvinetso zvinogona kuitika, zvakasiyana, zvinogona kusanganisira:
- Kutapukira: Chero nguva iyo munhu avhiyiwa, pane njodzi yebhakitiriya inopindirwa mukati mekudzivirira kunogona kukonzera utachiona. Chiremba wako achakukumbira kuti utarise zviratidzo chero zvipi zvese, zvakadai sefivha, kubwinya, kana unyoro. Kana uine chirwere chemastectomy kana kuti lymph nodes yakabviswa, iwe unogona kuva nemvura imwe chete kana kuti yakawanda munzvimbo. Kunyange zvazvo izvi zvinopisa zvinogona kuderedza zvimwe zvinetso, zvinogonawo kuva nzira yebhakitiriya kupinda mumuviri wako.
- Kugadzikana kweanesthesia: Kuvhiyiwa kwepabonde kakawanda kunowanikwa pasi peanesthesia yakawanda, uye inotakura dambudziko duku rezvinetso.
- Seroma: Seroma inounganidza mvura inenge yakasvibiswa. Chinangwa chemvura ndechekubvisa ichi chinotyisa, asi, kunyange neine mvura, seroma inogona kuitika dzimwe nguva.
- Hematoma: Kana pane imwe nzvimbo mukunzwa kwako kunoramba ichibuda ropa, hematoma (kuunganidza ropa) inogona kuumba.
- Ropa rinoputika: Kuvhiya chinhu chinokonzera kukanganisa kweropa mumakumbo ako. Kana isingateereri, mabhanhire aya anogona kubuda uye kuenda kumapapu ako (mapaimoni emboli). Kunyange zvazvo usingazivikanwe mushure mekuvhiyiwa kwekenza yepamu, kukwira uye kufamba uye kudzivisa kurara kwenguva refu kunogona kuderedza ngozi yako. (Chemotherapy inowedzerawo mukana wekuvhara ropa.)
Dambudziko remakore refu rinogona kusanganisira:
- Mafudzi akaoma : Vamwe vakadzi vanoita zvishoma nezvishoma kufamba kwavo mufudzi ravo kutevera kurapwa kwekenza yemazamu. Kana kufamba kwacho kuchidzivirirwa, iwe ungaguma nefudzi rakasviba. Kurapa kwepanyama kunoshanda zvikuru mukurapa chiitiko ichi, asi kudzivirira nguva dzose kunobatsira. Vamwe vanachiremba vanokurudzira kuti vakadzi vaone kenza yepamuviri mupfungwa (kunyanya uyo anozivikanwa kuburikidza nehurongwa hweNyeredzi yekenza kugadziriswa) mushure mokunge vaporesa kubva pakuvhiyiwa, kuti vave nechokwadi chokuti havana matambudziko.
- Lymphedema : Lymphedema ndiyo mamiriro ayo midziyo ye lymphatic iri mumakumbo inokuvara panguva yokuvhiyiwa. Inowanzoitika kakawanda apo lymph node dissection yapera. Zviratidzo zvinosanganisira ruoko rwakanyanya kuvhurika kune rumwe. Kusarudza chiremba anovhiya anoita nhamba yakawanda yekuvhiya kwekenza yemazamu kunogona kuderedza ngozi yako, pamwe nekuchenjerera kuti urege kukuvadzwa nemaoko ari kurutivi rwekenza yako yepabonde. Izvo zvinogona kuita lymphedema ndechikonzero nei chiremba wako achikuudza kuti usapinda neropa kana kuti ropa rako riongororwe kune rumwe rutivi rwekenza yako yepabonde.
- Zviito zvinosvibisa zvipfeko : Kunyange zvazvo zvisingaiti chikonzero chinokuvadza mumuviri, zvibereko zvisina kunaka zvinogadzirisa zvinogona kuva zvinonetsa mupfungwa. Kana izvi zvikaitika, pane kazhinji nzira dzakawanda dzevanhu dzekuvandudzwa kwekuvhiya kwavo, pamwe nekugadzirisa zvingasarudzwa.
Matambudziko nekuda kwekuvandudzwa kwemvere:
- Kuvakwazve kunounza mungozi yezvinetso zvakadai sekutanga kurapwa kwepabonde repabonde sekutapukirwa, kubuda ropa, neropa.
- Chibvumirano cheCapsular: Mitumbi yedu inocherechedza kana pane chimwe chinhu chisina kujairika mukati memaviri edu, uye kazhinji kuedza kurusvingo pane izvo zvisina kufanira. Vanachiremba vepurasitiki vave vachitsvaga nzira dzekudzikisa dambudziko rekugadziriswa kwechibvumirano mushure mekudzorerwa kwezamu. Kana ichiitika, chibereko chemuti chinogona kuva chakaoma, chichibva kune dzimwe nyika, uye chine nyoro. Kana iwe ukavandudza chimiro ichi, zvisinei, pane mavhiya anokwanisa kuitwa.
Matambudziko Kubva Chemotherapy
Iyo migumisiro yemakemikrasi yakanyatsozivikanwa. Izvo zvinowanzoitika zvinosanganisira kusuruvara kwebvudzi, kupisa kwemapfupa emapfupa (zvichiita kuti pave nehutachiona hwemasero matsvuku eropa, masero egavha eropa, uye maplatelets), uye nenyuchi. Chemotherapy inouraya masero akaparadzanisa masero akadai sekenza masero, asi masero mumapvudzi ako follicles, bone marrow, uye nzira yekudya inokurumidza kuparadzaniswa.
Pakave nekufambira mberi kwakakosha mukugadzirisa migumisiro yechemotherapy mumakore achangopfuura. Mishonga inowanikwa inogona kuvhara kushushikana uye kurutsa, uye iwe unogona kugamuchira majekiseni eNeulasta kana Neupogen kuchengetedza neutrophil yako kuverenga (rudzi rwechichena chemuviri weropa) rakakwana zvakakwana kuderedza ngozi yako yehutachiona.
Matambudziko, pamwe nemigumisiro inogona kuramba ichirapa mushure mekurapa inosanganisira:
- Zvirwere (febrile neutropenia): Zvipembenene zvakanyanya zvinogona kuitika kana ropa rako rekuyera ropa rakawandisa uye rinoda kushungurudzwa. Utachiona hunokonzerwa nekemotherapy-induced neutropenia ndechimwe chezvinhu zvinokuvadza zvakanyanya mumakemikrapiro.
- Peripheral neuropathy: Peripheral neuropathy inopesana nepini-uye-nenyuchi kunzwa, pamwe nekushaya simba, izvo vakadzi vanogona kuzviona mumaoko avo netsoka. Zvinosuruvarisa, izvi zvinogona kupfuurira kwenguva yakareba mushure mekurapa, asi vatsvakurudzi vari kutsvaga nzira dzekudzikisa ngozi. Inowanzokonzerwa nemishonga ye "taxane" yakadai seTareol (paclitaxel).
- Chemobrain: Zvinonetsa nekunzwisisa kugadzikana, zvakadai sokuderedzwa kwekanguva kwekuyeuka (kurasikirwa nezvipfigiso zvako) uye zvinetso nekuwanda kwevanhu vakawanda kune hanya nevamwe vakadzi (uye varume) mushure mekunge chemotherapy, uye yakagadzirwa " chemobrain ." Iyi nzvimbo iri kuve yakagamuchira zvakawanda, uye vamwe oncologists vanodavira kuti maitiro ekufunga, kunyange kana achingoita crossword puzzles, anogona kubatsira.
- Infertility. Kusapera mushure mokurapa kwekenza kwakajairika, uye vakadzi vazhinji vanomira kuva nenguva yavo mushure memakemikari. Kune vakadzi vaduku, nguva dzinogona kudzoka mushure mechinguva, asi ichi hachisi chivimbo chekubereka. Kana iwe uchifunga kuti unoda kuva nepamuviri mushure mekunge wapedza kurapwa, taura newe oncologist usati watanga. Kune dzimwe nzira dzinogona kuwanikwa, dzakadai sehuvhudzi hwemazamu, izvo zvinobvumira vamwe vakadzi kubereka kunyange mushure mekunge vachitepa kenza yemvere.
Zvimwe zvinetso zvakakomba zvinosanganisira:
- Chirwere chepfungwa: chirwere chemwoyo chinogona kuitika kunyange makumi emakore mushure mekugamuchira chemotherapy. Chirwere Adriamycin (doxorubicin) chinogona kukonzera kukanganisa kwemwoyo muna 1 kusvika 2 kubva kuvakadzikadzi vanowana mushonga. Imwe mishonga inogona kukonzera matambudziko emwoyo ndeye Herceptin (trastuzumab) uye mwoyo wako basa rinofanira kunyatsoongororwa paunenge uchitora. Iwe unogona kunge uine test yemwoyo musati watanga chemotherapy kuti uwane hwaro hwekutanga hunofanira kuenzaniswa. Zviratidzo zvekushushikana kwemoyo zvinosanganisira kupererwa kwepfungwa, kuderedzwa kutsungirira, kupfugama kwemakumbo ako, uye dzimwe nguva kukanganisa rose, rinopisa mvura.
- Secondary kanzira dzakadai sekemukemia: Chemotherapy remishonga inoshandiswa pakenza mvere inonziwo kancinogen (kanzvadzi-causing agents). Kunyange zvazvo kune ngozi shomanana (1 mu100) yekuvandudza kenza yechipiri (kazhinji kacho kaviri kacho sarcoma kana yakaoma myelogenous leukemia kana AML), zvinobatsira zvekemotherapy zvinowanzopfuura zvinetso izvi.
Panewo zvishoma, asi dzimwe nguva migumisiro yakareba yemhemotherapy .
Matambudziko Kubva kuHormonal Therapy
Vose tamoxifen (yevakadzi vanotangira-menopausal) uye aromatase inhibitors (yevakadzi vanonzi postmenopausal kana kuti vakadzi vepremenopausal avo vane chirwere chekuvhara maawa) zvinogona kukonzera kupisa kunopisa. Pane musiyano pakati pezviviri, zvisinei, se tamoxifen ine esrogen-yakafanana nemigumisiro kune mamwe maviri uye anti-estrogen migumisiro kune vamwe.
Aromatase inhibitors , zvakasiyana, kuderedza kuumbwa kweesrogen mumuviri uye saka zviratidzo zvakawanda ndezvokushaiwa kweserogen. Mishonga inotsanangurwa se aromatase inhibitors inosanganisira Arimidex (anastrozole), Femara (letrozole), uye Aromasin (exemestane).
Zvose zvikamu zvemishonga zvinogona kukonzera kupisa kunopisa, kuomeswa kwemadzimai, uye kusagadzikana. Tamoxifen inogona kukonzera marwadzo emisumbu, asi aromatase inhibitors inonyatsozivikanwa nekukonzera musuru uye marwadzo akabatana mukati inenge hafu yevanhu vachishandisa mishonga. Nezvakanaka, mapoka maviri emishonga inoderedza dambudziko rekudzoka kwekenza yepamusoro nehafu. Uye, kana izvo zvinopisa zvinopisa zvinokufambisa zvishoma zvishoma, unogona kusunungurwa kuziva kuti kune chekuvhara sirivha, uye kupisa kunopisa kunobatanidza nehuwandu hunoponesa kune vanhu vanoshandisa hormonal therapy.
Matambudziko kubva ku tamoxifen angasanganisira:
- Utachiona hweUterine: Kusiyana nemuviri wemazamu, tamoxifen inogona kukurudzira uterine (maitiro ekupedzisira endometrial). Maererano neAmerican Cancer Society, njodzi yekenza yeukiteri yakadzika, iyo inenge 1 muna 500 mushure memakore makumi mashanu, uye inogona kuonekwa mumatangiro ekutanga kana ikaitika. Chiratidzo chinowanzozivikanwa ndechekubuda ropa.
- Ropa rinoputika: Zvose ropa rinowanikwa mumakumbo (yakadzika mutsara thrombosis) uye mishonga inoputika (ropa rinosvika kumapapu) rinowanzoitika.
- Kushungurudza: Nenzira yakajeka, chirwere chinoratidzika chiri nyore nyore kurapa nekuvhiya.
Matambudziko kubva kune aromatase inhibitors angasanganisira:
- Osteopenia uye osteoporosis. Aromatase inhibitor inokonzera kurasikirwa kwemafupa, uye kazhinji kuputika kunokonzerwa nekurasikirwa kwepfupa mumupfupa, hip, nedzimwe nzvimbo. Kuwedzerwa kwezvinobudiswa kwe bisphosphonates (yakadai seZometa) kune kurapa kwevakadzi vamwe kunogona kuderedza ngozi iyi munguva yemberi.
- Zvinetso zvemwoyo. Zvinetso zvemwoyo zvakadai semwoyo wehutano hwehutano, zvinetso zvepfungwa dzemagetsi, uye pericarditis zvinowanzoonekwa kune vakadzi pane aromatase inhibitors, asi hapana ngozi yakawedzerwa yezvinetso zvakakomba uye zvinoparadza upenyu sekurwadziwa kwemwoyo uye kurohwa.
Matambudziko Kubva Radiation Therapy
Radiation therapy inowanzoshandiswa kutevera lumpectomy, kana kuvakadzi vane chirwere chemastectomi ine nhengo dzakanaka dzemaitiro. Migumisiro yakajairika inosanganisira kubwinya kweganda nemashes, uye kuneta.
Matambudziko ehutachiona hwemishonga angasanganisira:
- Zvirwere: Rutsvuku uye kunyange blister zvinogona kunge zvakagadzikana, asi maronda akazaruka anogona kuwedzera mungozi yekudzivirira hutachiwana hwehutachiwana. Vaya vane mazairo mushure mekuvhiyiwa kwekurumidza kwekuvandudza vari mudambudziko guru rekudzivirira utachiona.
- Fibrosis: Therapy inonzi radidiation inoshandura kugadzirwa kweganda kuitira kuti isanyanya kuchinja. Izvi zvinogona kuguma nekuchinja mazamu ako (fibrosis), uye chipsular chibvumirano kana iwe wakatanga kuvakazve. Mishonga inogona kukonzera kuputira mumapapu (radiation pneumonitis) iyo inogona kutungamirira ku pulmonary fibrosis .
- Chirwere chepfungwa: Kurapa kwechirwere kunogona kukuvadza mwoyo, kunyange majekesa ekurapa anoedza kuenzanisa marwadzo aunogamuchira kuti uderedze kuisa mwoyo wako. Imwe nzira itsva inodanwa kuporesa gating inogona kuderedza kufungidzirwa kwemoyo kune miviri yakawanda zvikuru, kuburikidza nekushandiswa kwekufema kunodzora. Kubatanidzwa kwemigumisiro inokonzerwa nemwoyo yemirairo uye iyo nekuda kwechemotherapy inofanira kufungwa. Vamwe veongcologist vanodavira kuti vakadzi vane zvirwere izvi (kunyanya kusanganiswa kwechemotherapy neAdriamycin uye kupiswa kwezuva pashure pekuita mastectomy) vanofanira kubvunza chiremba, kunyanya kana vachikura zviratidzo zvinogona kuratidza chirwere chemwoyo.
Kunewo zvimwe zvishoma asi zvinoenderana nezvenguva refu yemigumisiro yemishonga inonzi radiation , sekuwedzera kwemawere emapapu uye esophageal. Kunyange zvazvo kazhinji kacho kubatsirwa kwehutachiona hwehutachiona kuchiwedzerwa pangozi yezvinetso izvi, chidzidzo che 2017 chakaratidza kuti kune vakadzi vanopfungaira, njodzi dzemazuva ano pamwe chete nekusvuta zvinogona kupfuura zvikwereti. Vaya vanosvuta vanofanira kurega kusati kwatanga remishonga inonzi radiation, uye kana zvisingaiti, vanofanira kutaura zvakanyatsotarisana nehuroti yavo yeocologist pamusoro pehuchenjeri mukuita mahara.
Psychological / Social Side Effects uye Matambudziko
Kuonekwa kuti une kenza yemazamu ndiko kuchinja kukuru kwepfungwa. Zvidzidzo zvinoratidza kuti hazvibatsiri kana une chirwere chiduku chinoporesa, kana chikuru, chepamusoro chepamuviri; kugamuchira kuongororwa kwe "C izwi" kunoshandura hupenyu hwako mumasekondi.
Ukama hunowanzochinja, uye shamwari dziri kure dzinogona kuva pedyo, asi dzimwe shamwari dzako dzepedyo dzinogona kupera. Munhu wose anobata kenza mumunhu waanoda nenzira yakasiyana.
Dzimwe nguva kenza inokonzera kuora mwoyo, uye mukana wekuzviuraya uri mukuru kune vanhu vane kenza kupfuura vanhu vakawanda. Kuwedzera manzwiro aya kurwara kwekenza , uye kurwisana nekenza kwakaoma.
Tirikudzidza kuti hutano hwakasimba hwehutano hwevanhu hunokosha zvakakwana zvokuti hwakatove hwakabatanidzwa nekupona kwekenza yepazamu, uye inofanira kutaridzirwa zvakanyanya sekushushikana kwepanyama iwe unogona kuva nako. Vanhu vazhinji vanoona kuti kutaura nechiremba kunobatsira panguva yekugadzirisa. Iva nechokwadi chokuti unotaura nachiremba wako kana uri kuoma kukunda.
Kuderedza Dambudziko Rako reMatambudziko
Zvakakosha kucherechedza kuti kune zvinhu zvakawanda zvaunogona kuita kuderedza dambudziko rako rekukurira matambudziko munguva yekutanga-kutanga kenza yepabonde yepabonde.
Kana iwe utsi, siya. Kusvuta kunovhiringidza kuporesa kwemaonda uye kunowedzera ngozi yako yehutachiona (uye zvose zvinofamba pamwe nehutachiwana). Inowedzerawo chero hutano hwemwoyo hunokonzerwa nekurapa.
Ita maitiro ekudzivirira hutachiwana panguva yechemotherapy . Kunyange kana iwe uchigamuchira mishonga kuti uchengetedze ropa rako rekuyera, chenjerera kushambidza maoko ako, kudzivisa nzvimbo dzakazara, uye ugare kure nevanhu vanorwara.
Gara uchienzanisa nekutsvakurudza kwakapfuura pamusoro pekenza yemvere. Nevanhu vakawanda vari vapenyu, tiri kudzidza zvakawanda pamusoro pezvenguva yakareba nyaya dzine chokuita nekurapwa, uyewo kuti vangaderedza sei ngozi yavo.
Ngwarira muviri wako uye chero zviratidzo zvaunazvo. Zvakawanda zvezvinetso zvekenza yepabonde zvinorapwa, uye kurapwa kunowanzobudirira paunotanga nokukurumidza pane mberi.
Cancer Kuvandudza
Nevanhu vakawanda vari kurarama nekenza, tiri kudzidza kuti vazhinji vanopukunyuka kenza vari kurarama nekuguma kwekurapa. Mumakore achangopfuura, purogiramu yakave yakagadzirirwa inonzi "Purogiramu Yenyeredzi yeKarudzo yekuvandudza kenza." Iyi purogiramu ikozvino inowanikwa kune vazhinji vanorwara nekenza. Yakagadzirirwa kuderedza chero nguva yakareba yemigumisiro yekenza, nekukubatsira kutarisa chero zviratidzo zvepanyama kana zvepfungwa zvinokuchengetedza kubva paupenyu hwako hwe "hupenyu hutsva".
Shoko Rinobva
Tichitarisa pane zvingangodaro zvinetso zvekenza kurapwa, kunze kwemigumisiro yaunogona kutarisira, inogona kutyisidzira. Yeuka kuti zvinetso izvi hazvishamisi, uye iwe unowanzoita kuti uwane kuburikidza nekurapa kwako usingatauri vakawanda kana chimwe cheizvi. Chinhu chakakosha, kunyange kana pane zvipingamupinyi, ndezvokuti zviongorori zvakaona kuti zvibatsiro zvezvirapa izvi mukuchengeta kenza yako kure zvakanyanya kupfuura zvingangova nengozi.
> Sources:
> American Society of Clinical Oncology. Cancer.Net. Breast Cancer Treatment Options. Updated 04/07. https://www.cancer.net/cancer-types/breast-cancer/treatment-options
> Hurria, A., Uya, S., naL. Pierce. Maitiro ekudzokazve uye Matambudziko akareba kwenguva refu ekurapa muBroast Survivors. UpToDate . Yashandurwa 08/15/17.
> Rakhra, S., Bethke, K., Strauss, J. et al. Njodzi Zvinokonzera Kusangana Nezvinetso MuKutanga-Nhanho Kenza Yemazamu Inotevera Breast-Conserving Surgery uye Intraoperative Radiotherapy. Annals of Oncology Surgery . 2017. 24 (5): 1258-1261.