Zviratidzo, Kuongororwa, Mishonga, uye Kurapa
Kana iwe wakamboudzwa kuti wave nekenza yemukenza yemapapu, unenge uchinzwa wakaneta kana usingatyi zvachose. Izvi zvinorevei? Inobatwa sei? Uye ungawana sei rubatsiro rwaunoda?
Overview
Zvinorevei kana vanachiremba vanoti "kenza yemapapu yakapfuura?" Nguva yakawanda apo vanachiremba vanoshandisa izwi iri vanoreva chirwere chepiri II uye chirwere chemapapu emukati.
Kunyange zvazvo kenza kadiki kadiki yemapapu inogona kuenderera mberi, nguva yakawanda apo incologists inoshandisa mashoko okuti "mupenza wemapapu", iri kureva chemadiki mashoma emukenza wemapapu , iyo inokonzera 85 muzana yemakenza emapapu.
Chikonzero chekuti mutsa wemapapu unowanzowanhurwa kuva kutanga kwekutanga uye chikwata chakareba ndechokuti ivo vanorapwa zvakasiyana. Kwekenza yemapapu epakutanga, chirwere chinowanzokurudzirwa semushonga wekutanga, asi zvimwe zvingasarudzwa zvinoshandiswa pakufambira mberi kwezvirwere-kutanga pakutanga.
Nhanho
Sezvakataurwa pamusoro apa, mutsara wokuti "yakagadzirwa" inowanzoshandiswa kurondedzera chirongwa che IIIB kana chirwere chechitanhatu kwete chediki chekenza yemapapu emapapu.
- Chikamu IIB - Chikamu chechipiri-chechi II kwete chediki kemukari mapapu emapapu mapfupa emakumbo emhando ipi zvayo yakapararira kune lymph nodes kune rumwe rutivi rwechifuva, pedyo nekorori bone, kana akapinda zvimwe zvivako mubhokisi zvakadai semwoyo kana dhiyo.
- Nhanho IV - Gweta IV isiri duku kemukari mapukamusi emapapu zvirwere zvakapararira kune imwe nzvimbo pakati pezvikamu zvinokonzera mapapu ( zvinotyisa zvinokonzera kupusa ) kana kune imwe nzvimbo yomuviri. Kanzera yemaperembudzi kazhinji inopararira kumapfupa, chiropa, uropi, kana adrenal glands.
Zviratidzo
Zviratidzo zvemapapu emapapu akapfuura zvingave zvakabatana nekuvapo kwekenza mumapapu, kana nekuda kwekupinda kweimwe nhengo uye kupararira (metastasis) kune dzimwe nzvimbo dzomuviri. Zviratidzo zvinowanzoonekwa pamapapu zvinogona kusanganisira kuchena kwenguva refu, kufema kwepemuviri, kukwezva ropa, uye kuputika.
Makondombera akaremara anogona kuisa mishonga mumapfupa anoita kuti kuve nehana.
Kana mutanho wemapapu unowedzera kukura kana kupararira, zviratidzo zvakadai sokuneta, kusatarisira kuora kurasikirwa, uye kurasikirwa kwechido kunogona kuitika. Kanzera yemaperembudzi yakapararira kune uropi inogona kukonzera misoro, kutaura zvinetso, kurasikirwa, nekushaya simba. Kenza yemaperembudzi inopararira kuchiropa inogona kukonzera marwadzo emimba uye jaundice. Uye mukenza wemapapu unopararira kumapfupa unogona kukonzera marwadzo kumashure, mapepa, uye chifuva.
Kuziva
Kanzera yakapfuvura yemapapu inogona kutanga inowanikwa pane x-ray kana CT scan, asizve kuongororwa nemapapu emapapiro kunokosha kuti uone kana kusakanganiswa kwechokwadi chiri kenza, uye kuti chii.
Pamusoro pevanhu vasati vaduku vasero mapepa emapapu mapupa, zvinonyanya kukosha kuti kujekesa kwegene (kufungidzira kwemasero) kunoitwa. Nekuda kwetsika, mavara kubva kune chidimbu anodiwa kuti aite izvi, muna 2016 chirongwa chemvura chinonzi biopsy chakabvumirwa kuti EGFR ishandiswe kuchinja.
Aina
Mukomana muduku wemukenza wemapapu ungapfuurirwa asi unofukidzwa mune chikamu chakasiyana. Zvinyorwa zvisiri izvo zviduku zvekerofu mapapu emapapu zvinosanganisira:
- Lung adenocarcinoma - Izvo zvinokonzerwa nehafu yezviremara izvi. Uyu ndiwo mhando yemukenza inowanzoonekwa kune vakadzi, vasati vasvuta, uye vechidiki vechidiki vane mutsa wemapapu.
- Squamous cell carcinoma yemapapu - Ndeipi inokonzera inenge 30 muzana yekasaiti duku kenza yemapapu emapapu.
- Girafu cell carcinoma - Mukomana mukuru wemapapu emapapu unokwira anenge 10 muzana yeasina maduku emukenza emapapu emapapu .
- Zvimwe - Ungave wakacherechedza kuti nhamba dzepamusoro hadziwedzere kusvika ku100. Izvi ndezvokuti mamwe matumire ane maitiro anowanikwa pane imwe nzvimbo yakaoma mukati mezvikamu zvakasarudzwa, zvakadai se "kuonekwa" kusati, kana nzvimbo dzakasiyana ronda racho ringave rine maitiro maviri kana akawanda akasiyana-siyana emarara.
Mishonga
Zvakakosha pakutanga kutaura kuti kurapwa kwemukenza wemapapu wakatanga kufambira mberi .
Kuponeswa kwemitengo yepamusoro yemukenza yemapapu iri kuvandudza. Nokudaro, chero zviverengero zvaunenge uchiverenga, kana kuti chero ruzivo rwehutano hwaunenge uverenga rwakasati rwasvika, hunogona kuodza mwoyo zvikuru. Zvakakosha kudzidza zvaunokwanisa pamusoro pehosha yako, asi tora nguva kuti udzidze kutsvakurudza kenza yako paIndaneti . Semuenzaniso, pakanga mune dzimwe mishonga mitsva inogamuchirwa yemukenza wemapapu wakakura mukati megore ra2011 ne2015 kupfuura panguva yemakumi emakumi mana asati apfuura 2011. Kune tariro yakawanda.
Mishonga Inorapwa
Varwere vari kuwedzera kuve mukubatana kwavo nemukenza wemapapu kupfuura kare. Kusiyana nehutano hwechiremba-chiremba wehutano hwekare, varwere uye vanachiremba vari kushanda pamwe chete kuti vagadzire hurongwa hwakanakisisa hwokurapa hunoita. Chikamu chechikonzero cheizvi ndechekuti kune zvimwe zvisarudzo kupfuura kare, uye mamwe maitiro angarondedzera zvakanyanya kune zvaunofarira-mararamiro aunonyanya kuda kuregerera-kupfuura hupi hupi hwehutano hwehutano huri pamusoro peumwe.
Zvinobatsira kutanga nekuputsa kurapwa muzvikamu zviviri zvinokosha.
- Kurapa Kwemunharaunda - Mishonga yemunharaunda inobata kenza apo inogara-yega-uye inosanganisira remishonga yeradio uye chirwere.
- Utachiona hweSystemic - Therapy therapy inotarisirwa mukurapa kenza chero kupi zvako mumuviri wako. Izvi zvinosanganisira chemotherapy, zvinotarisirwa kurapwa, uye immunotherapy.
Sezvo mhanho yemapapu yakatanga ndeyekutsanangurira kusina nzvimbo, maitiro ehutano ndiwo hutano hwekurapa . Vamwe vanhu vanobvunza kuti nei kuvhiyiwa kusinganzwisisiki muchitsauko IV uye chirwere chechipiri chepabonde IIB. Chikonzero ndechokuti kurapwa uye remishonga yehutachiona chete haikwanisi kurapa kenza yakatopararira. Izvi hazvirevi kuti hauzombovi nekuvhiyiwa. Kune vanhu vane zvirongwa zvekugadzirisa izvo zvinoderedza chiremera chavo kuhukuru apo chirwere chichabudirira. Nevamwe makondombera, akadai sekenza yevana, "kukwikwidza" chiremera-kubvisa zvimwe asi kwete yese nekuvhiya-kunogona kubatsira, asi izvi hazviwanzo zvakadaro nemukenza wemapapu. Kutaura zvazviri, kuve nekuvhiyiwa kwaizomanikidzira muviri panguva imwe chete yaunoda simba rako kuitira kuti ushivirire mishonga inobatsira. Mumagadziriro ekurapa maitiro anosanganisira:
Targeted Therapies - Munhu wese ane kamudiki kadiki kadiki kadiki kemapapu yemapapu anofanira kuve nekujekesa kwema molecular ("maitiro ekuongorora") akaitwa pachirwere chavo. "chinotarisirwa", uye zvimwe zviri kuwanikwa nguva yose.Ichimwe chinhu chisingaoneki chinoreva kukanganisa kwekenza masero kana yakabatana nekenza masero anogona kunyatsotarirwa nemishonga.Kana une EGFR mutation , ALK fusion gene , kana reRrang1 rearrangement , kune mvumo yekurapa inowanikwa-uye nzvimbo iyi inogona kuwedzera nokukurumidza mumakore anotevera.Kana "kufungidzira kwema molecular" isinganzwisisiki, ita nechokwadi chekutaura neoncologist yako.
Chemotherapy - Chemotherapy is "mainstay" yemapapu emapapu akapfuura , uye inogona kuwedzera upenyu hwevanhu vakawanda. Kune zvakawanda zvinoshandiswa zvinodhaka zvinoshandiswa, asi zvizhinji zvezvi zvinosanganisira "platinum" zvinodhaka zvakadai sePlatinol (cisplatin.)
Immunotherapy - Kana wakanga uchicherechedza nyaya kana kuverenga magazini chero ipi zvayo wave uchinzwa zvakanyanya nezvema immunotherapy. Kusiyana nedzimwe dzehupi munguva yakapfuura, immunotherapy ndiyo nzira inonakidza zvikuru yekurapa mazera epamusoro . Izvi zvinogona kufungidzirwa sezviri kunyanya kubatanidza maitiro edu ezvirwere zvekudzivirira zvirwere zvekenza nenzira dzakasiyana. Mushonga wekutanga wemukenza wemapapu mune izvi wakagamuchirwa muna 2015, uye mamwe akawanda ari kuongororwa mumakiriniki ekuedzwa.
Mishonga yemakiriniki - National Cancer Institute inokurudzira kuti munhu wese ane cancer yakapfupa yemapapu anofunge nezvemakiriniki emakiriniki. Pane zvakawanda zvenhema pamusoro pemakiriniki emakiriniki , asi kupfuura kupfuura kare kare maikiriniki anokwanisa kupa vanhu vane kenza yemapapu mukana wekuwana mishonga mitsva yechirwere. Semuenzaniso, vanhu vakapinda muchirongwa chechipatara kwema immunotherapy yemvumo yakagamuchirwa muna 2015 vakaita zvakanaka kupfuura avo vasina mukana. Ramba uchifunga kuti kurapa kwose kwakagamuchirwa kwekenza yemapapu kwakambodzidza sechikamu chekuongororwa kwekliniki. Iko kune ikozvino mishonga yemakirini inopfuura 100 inoenderera mberi kuongororwa mushonga mutsva wekenza yemapapu. Tarisa ruzivo urwu nezvekuwana zvirwere zvemakiriniki yemukenza wemapapu, pamwe chete nekuedza kwekliniki yepamusoro inobatanidza nheyo inopiwa nemubatanidzwa wekubatana pakati pemapoka evanhu vemakirini emapapu akawanda.
Kurapa kweMetastases
Munguva yakapfuura, kurapwa kwemukenza wemapapu nematasisita zvaive zvakafanana kune vose. Icho chiri kuchinja zvimwe. Kune vamwe vanhu vane hutano hwemashuga kubva pamukenza wemapapu kana kuti metastases yechiropa kubva mumukemapu wemapapu - kana pane zvishomanana "zvipembenene" kana nzvimbo dzekupararira-chimwe chinonzi "oligometastases" -kurwisana ne stereotactic body body radiotherapy kana kuvhiyiwa kwakaguma nekuvandudza kupona .
Kune vanhu vane pfupa metastases kubva mumukenza wemapapu , zvinodhaka zvinonzi bisphosphonates pamwe nekurapa kwemaawa zvinogona kubatsira mukurwadziwa, uye mune dzimwe nguva, inogona kuwedzera kupona.
Prognosis
Zvakaoma kutaura pamusoro pekufananidzira kwemukenza wemapapu wakakura nokuti tichave tichitaura pamusoro pehuwandu hwakaunganidzwa zvisati zvaitika maitiro akawanda ekurapa kwekenza yemapapu yakatanga kuwanikwa. Nhamba dzekupedzisira dzakasangana dzakawana kuti makore mashanu ekupona kwemukenza wemapapu akapfuura aisuruvara asiri pasi pe5 muzana. Izvo zvakati, kune vasara venguva refu vanopukunyuka yemukenza wemapapu akapfuura, uye iyo nhamba iri kukura.
Kutsungirira uye Kutsigira
Zvaunokurumidza kudzidza mushure mekunge uongororwa nemukenza wemapapu wakagwinya ndeyekuti mutsa wemapapu unotora chikamu uye kuti chirwere chemhuri. Svika kumhuri neshamwari. Dzidza kuva iwe mumutevereri wako mukuchengetedzwa kwekenza . Funga kufambira mberi kune musha wemukenza wemapapu muInternet -mharaunda yave yakafanana nemhuri kune vanhu vazhinji vane mukenza wemapapu yakakura.
Kune Vadiwa
Kuchengetera unodiwa nekenza yemapapu ingangodaro chinhu chakanyanya kuoma iwe wati wamboita, asi iyo inobatsira zvikuru uye hupenyu hunobatsirawo zvakare. Iva nechokwadi chekutora kanguva uye verenga nyaya iyi apo apo mudiwa wako ane kenza yemapapu .
> Sources:
> National Cancer Institute. Non-Small Cell Chirwere Chekushaya Kanzera - Health Professional Version (PDQ). Updated 01/20/17. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq