Ndezvipi zvirwere zvinowanikwa mukenza yekare inowanikwa? Kenza yangu yevarivha yakadzoka kana kuti haina kumbobvira yapera mushure mekutanga kwerapa. Ndingaitei zvino? Ichocho mubvunzo wakabvunzwa neavoan ovarian varwere vakawanda pane imwe nguva munguva. Zvinosuruvarisa, kuti vanenge 80% yevanhu vanoenda mumishonga ekutanga chemotherapy, kenza inodzoka zvakare.
Mhinduro kumubvunzo uyu inobva pakuti maitiro ekudzoka kwekudzoka akaita sei uye kwenguva yakareba sei mushure mekupera kokutanga kurapwa izvi zvakaitika.
Kazhinji, kune zvitatu zvakasiyana zvakasiyana zvinotakura mitemo mitatu yakasiyana uye kazhinji zvinotungamirira kune zvitatu zvakasiyana-siyana zvirongwa zvekurapa. Zvisinei, kunze kweiyo, tapota cherechedza kuti kunyange zvazvo pane nzira yakanakisisa yekutarisa kwekutanga kurapa kurapwa, kurapwa kwekudzoka kunonyanya kuenzaniswa.
Kunyange zvazvo kune mazano akanaka akanaka, hapana maonero akafanana-evhu-maitiro ekuita. Pakawanda, nguva yakawanda isati yasvika mushure mekudzokorora zviri nani mikana yekurapa kunogona kuitika kana kuti kwechipiri chekuregererwa. Uyezve, mamwe mazano anowanika munyaya iyi.
Kudzokorora Pashure pemwedzi mitanhatu
Kana kudzokorora kunowanikwa kanenge mwedzi mitanhatu mushure mekutanga kurapwa (zvichida kusvika pedyo negore), chironda chacho chinoonekwa se "platinum senzwi" kana mushonga wokutanga waiva nechirwere cheplatinum (Carbo-platin kana Cis-platin). Iyo gare gare kudzokorora mushure meiyi pfungwa, kunyanya zvingave zvine musoro kuita chirongwa che " cytoreduction" yechipiri kubvisa zvakare kenza yakawanda sezvinogona.
Vakawanda vanoita gynecologic oncologists vaizofungisisa zvakanyanya izvi kana kenza inowedzera makore maviri mushure mekutanga kurapwa uye uwandu kana masasa ndeye / inoonekwa pane kuongorora kana kunzwa paunongororwa. Zvisinei, inogona kuva yakasarudzo yakanaka pamberi pemazuva ano, zvakare, zvichienderana nemamiriro ako ezvinhu.
Zvichida kana kuti kwete kudzokorora chirongwa chechipiri yekuvhiya kunoitwa, vazhinji veoncologists vangati vanorapwa nemishonga imwechete yakashandiswa panguva yekutanga, kunyanya kana kudzoka kunowanikwa kanopfuura gore pashure pokutanga kurapwa.
Kana ikawanikwa pakati pemwedzi mitanhatu negore mushure mekurapa, zvisarudzo zvinogona kusanganisirazve kurapwa neTareol neCis-Platinum kana Carbo-Platin, kana kushandisa madhiragi matsva sezvakakurukurwa pasi apa. Vazhinji ve oncologists vaizofarira mishonga mitsva munguva ino.
Kudzokorora Mumwedzi mitanhatu
Kana kudzokorora kunowanikwa kune mwedzi mitanhatu kana kudarika mushure mokurapa kwokutanga, chironda chinonzi "platinum resistant" . Dumbu racho rinogona kunge rakakura zvakare pane imwe nguva kusvika kumagumo kana mushure mokutanga chemotherapy. Mune mamiriro ezvinhu aya, kudzokorora kuvhiyiwa hakuwanzokurudzirwa sezvo zvisingakwanisi kupedza urefu hwehupenyu kana hupenyu hwehupenyu. Pane matatu mishonga inokonzera mishonga inowanikwa nhasi iyo yakawanda inocologists inoshandisa zvakasiyana. Zvose zvinoshanda zvakafanana zvakaenzana uye zvinogona kushandiswa mukuenzanisa, imwe panguva, sechimwe chirwere kana chimwe chichirega kushanda. Aya ndiwo: Doxil, Topotecan uye Gemzar. Mishonga inobatanidza yakave yakaedzwawo, asi kazhinji pasina kubudirira kunoshamisa zvikuru uye nehuwandu hwehuwandu hwehuwandu hwezvakaipa. Zvisinei, mamiriro ese ezvinhu akasiyana, saka tapota bvunza chiremba wako pamusoro pezvose zvinogona kusarudzwa. Kunyange zvazvo chirwere chemakemikari chinokanganisa nemishonga iyi ichiri kuenderera mberi, unofanira kufungisisa kuti mikana yekurapa yakanyanya kuduku uye kuchengetedza hupenyu hwepfungwa mupfungwa hunokosha.
Zvakare, uku ndiko kukurukurirana kwengozi / kubatsiro nachiremba (s) wako.
Kudzokorora Pamwe Kana Pakarepo Mushure mekurapa
Kana kudzokorora kuri kunyanya kukonzera kenza panguva yekurapa kwokutanga, izvi zvinonzi "platinum refractory", kana chiitiko chakakomba chokuramba chemotherapy. Kuwedzera chemotherapy kunogona kupiwa, kunyanya kushandiswa kwemishonga inokurukurwa pamusoro, asi mikana yekupindura yakaderera. Uyewo, chengetedza mupfungwa kuti mishonga inotaurwa pamusoro apa HAI chete inowanika kurapwa, inongoratiwa seyakanakisisa kuedza kutanga. Kumbira chiremba wako nezvevamwe uye kuti ndeipi mikana iyo iyo inogona kubatsira munyaya yako.
Izvi zvingavewo nguva yakanaka yekubvunza nezvekuvimbisa asi zvisarudzo zvisina kuvimbiswa kuburikidza nemakiriniki ezvirwere.
Clinical Trials
Kune mishonga yakawanda yekliniki inoenderera mberi nekenza yevavhisi yakadzoka zvakare, uye kutsvakurudza kutarisa zvimwe zvekusarudza izvi kunokurudzira. Taura newe oncologist pamusoro pemuedzo unogona kusangana nemamiriro ako chaiwo, kana kufunga nezvechipiri pfungwa. Zvimwe zvezvinhu izvi zvinosanganisira kurapwa mushonga wemishonga - iyo, mishonga yakagadzirirwa kunyatsotsvaga kenza masero, uye imwe mishonga yechikwata chechirwere chemishonga chinonzi PARP inhibitors chakanga chabvumirwa kushandiswa muna 2015.
Kupera kwechipiri vs. Curative Treatment Chinangwa
Izwi rinotaura nezve "chirwere chinopisa" uye "kupisa kwemavara". Kunyangwe kana chirwere ichi chisisati chiri chekuporesa pane dzimwe nguva kurapwa, pangave nekusarudza nzira dzinoshandiswa "palliate" kana kubatsira kubvisa kana kudzikama zviratidzo. Muzviitiko zvisingawanzoitiki, izvi zvinogona kuva chirwere chemukati chekuvhima kana kubviswa kweimwe nzvimbo yakadzivirirwa yemukumbo (kazhinji zvikamu zvakawanda zvakadzivirirwa) kuitira kuti munhu atendere kudya kwekunge mwedzi yakawanda. Mune dzimwe nguva, izvi zvinogona kureva kuisa huputi mukati mudumbu kuburikidza neganda (gastrostomy) kuitira kuti kurutsa kununurwa uye tube iri mumhino (NG tube) haifaniri kuva munzvimbo kwevhiki kana mwedzi.
Dzimwe nguva mumukenza wakakura, mvura inotonhora inowedzera mubhokisi. Nzira dzakasiyana-siyana dzokudzikisa mvura inosvibisa, kusanganisira tubes uye kupora (pleurodesis) , inogona kubatsira kubvisa kana kuderedza izvi zvinoshandiswa uye kubatsira nematambudziko ekufema. Iyi inongova mitezo mizhinji, asi pane imwe nyaya nemhosva, mamwe maitiro ekuvhiya kana maitiro anonzi radiologically akatungamirirwa nekuvhiringidza angave akakubatsira iwe. Kana iwe uri kutambura nechiratidzo chaicho, bvunza kana kana kwete rudzi rwekuvhiya kana kusapinda kunogona kubatsira.
Pakupedzisira, kunyange zvazvo isingawanzoiti, kenza yemuviri inogona kusanganisira mapfupa ako, kazhinji inotambura kwazvo. Uyewo kazhinji inogona kupararira kune uropi uye kubvisa kukanganisa. Mune zvose izvi, mishonga inonzi radiation panzvimbo iyo inogona kubatsira zvikuru kuderedza kana kubvisa zviratidzo.
Kunobva:
National Cancer Institute. Ovarian Epithelial, Fallopian Tube, uye Primary Peritoneal Cancer Treatment-yevashandi vehutano (PDQ®). Kudzokorora kana kuomerera kweOvarian Epithelial, Fallopian Tube, uye Primary Primary Peritoneal Cancer Treatment. Yashandurwa 08/21/15. http://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq#section/_82