Kansa ƒe Cachexia: Ðe míaƒo nu tso esia ŋua?

Ne kansa le wò alo ame aɖe si nènya ŋu la, ɖewohĩ ède dzesii be le ɣeyiɣi aɖe megbe la, woƒe ŋutilã va le tsɛ eye woƒe dzedzeme to vovo gɔ̃ hã. Ame geɖe susuna be esia nye kansa la ƒe akpa aɖe ko alo atikewɔwɔa ƒe nugbegblẽ le ame ŋu. Ema ate ŋu anye nyateƒe vaseɖe afi aɖe. Gake nɔnɔme sia ate ŋu anye nane si goglo wu ɣeaɖewoɣi, si nye nɔnɔme si woyɔna be cancer cachexia . Mina míaƒo nu tso esia ŋu tsitotsito egbea, elabena ekpɔa ŋusẽ ɖe kansadɔnɔwo ƒe agbenɔnɔ ƒe nyonyome kple alesi wowɔa nui ɖe atikewɔwɔ ŋu dzi.

Nukae Nye Kansa ƒe Cachexia?

Kpuie ko la, kansa ƒe cachexia nye nugbegblẽ sesẽ aɖe si kansa hena vɛ. Esiae nye ne èbu ƒunukpeƒeŋusẽ kple ŋutilã me ami gbogbo aɖe . Menye lolo dzi ɖeɖeko ŋue wòku ɖo o, ke boŋ lãmeka si naa ŋusẽ hãe. Kpekpeme dzi ɖeɖe kpɔtɔ sia ate ŋu atrɔ wò dzedzeme, ana nàse le ɖokuiwò me, eye wòana wòasesẽ gɔ̃ hã be nànɔ te ɖe kansa dada nu. Ate ŋu akpɔ ŋusẽ ɖe wò agbenɔnɔ ƒe nyonyome hã dzi eye ɣeaɖewoɣi la, ado kplamatse wò ŋutete be nànɔ te ɖe kansa nu.

Eŋutinunyalawo gblɔ be nɔnɔme sia gblẽa nu le kansadɔnɔ siwo ade 50% ŋu. Azɔ hã, woate ŋu akpɔe le ame siwo ƒe kansa kaka la dometɔ siwo ade 75% me , si fia be le kansa ƒe Akpa IV me . Nublanuitɔe la, nɔnɔme sia gbɔe kansa ƒe ku 25% tsona.

Togbɔ be nɔnɔme sia ate ŋu adzɔ le kansa ƒomevi ɖesiaɖe me hã la, ebɔ ɖe amesiwo ŋu kansa ƒomevi siawo le koŋ:

• Dɔdzẽ si le dɔgboa me
• Aklã me dɔdzẽ
• Melanoma, si nye ŋutigbalẽ me kansa ƒomevi aɖe
• Dɔdzẽ si le dɔgboa me

Togbɔ be ɖɔktawo mate ŋu ada kansa ƒe cachexia keŋkeŋ o hã la, atikewɔwɔwo dzea agbagba be yewoadzi nuɖuɖu si nèɖuna ɖe edzi, vevietɔ eye woƒe susu nɔa nuɖuɖu siwo me protein sɔ gbɔ ɖo, siwo me nunyiame sɔ gbɔ ɖo ŋu .

Nukae nye kansa ƒe cachexia ƒe dzesiwo?

Nɔnɔme sia ƒe dzesi vevitɔ si dze ƒã wue nye be wò kpekpeme bliboa ƒe 10% kple edzivɔ dzi ɖe kpɔtɔ le ɣleti 6 va ɖo 12 siwo va yi me . Esia lɔ lãmeka kple ami siaa ɖe eme. Tsɔ kpe ɖe eŋu la, dzesi bubu geɖewo ate ŋu anɔ eŋu:

• Ðeɖiteameŋu kple gbɔdzɔgbɔdzɔ si gbɔ eme: Ðewohĩ àse le ɖokuiwò me be ŋusẽ mele ye ŋu be yeawɔ yeƒe gbesiagbedɔwo, akpɔ yeƒe ƒomea dzi, alo awɔ ye ŋutɔ yeƒe aƒemedɔwo gɔ̃ hã o. Ðeko wòle abe ɖe agbe mele ŋuwò o ene.
• Lãmetsiwo ƒe gbegblẽ: Ðɔktawo yɔa esia hã be lãmekawo ƒe gbegblẽ alo lãmekawo ƒe tsɔtsrɔ̃ . Esiae nye lãmekawo ƒe agbɔsɔsɔ si bu kple lãmekawo ƒe gbegblẽ.
• Nuɖuɖumadzroame: Esiae nye ne nuɖuɖu ƒe didi aɖeke megale ŋuwò o, dɔ mewu wò o. Ɣeaɖewoɣi la, mèdina be yeabu nuɖuɖu ŋu gɔ̃ hã o. Gake esia to vovo na nuɖuɖukuxi si woyɔna be anorexia nervosa si ŋu míese nu tsoe.
• Ʋusɔgbɔdɔ: Àte ŋu axɔ ʋusɔgbɔdɔ elabena wò ŋutilã, le dɔdzẽ ƒe dɔwɔwɔ me la, eɖea protein aɖe si kpɔa ŋusẽ ɖe ʋumenugbagbevi dzĩwo ƒe wɔwɔ dzi la doa goe.
• Dɔlékuiwo xɔxɔ enuenu: Kansa ƒe cachexia ate ŋu ana wò dɔlélenutsiŋutete nagbɔdzɔ, si ana be magate ŋu awɔ avu kple dɔléle o. Esia ate ŋu ana wòanɔ bɔbɔe be nàxɔ dɔlékuiwo.

Nukatae kansa ƒe cachexia sia dzɔna?

Susu geɖewo tae wòle alea ɖo. Kansa nana wò lãmenugbagbeviwo ƒe dɔwɔwɔ kabakaba . Esia fia be wò ŋutilã hiã ŋusẽ geɖe wu tso nuɖuɖu me. Le ɣeyiɣi ma ke me la, kansa kple kansa dada hã ate ŋu aɖe wò nuɖuɖudzroame dzi akpɔtɔ. Nusi dona tso emee nye be mèɖua nu fũ o ne wò ŋutilã hiã nunyiame geɖe.

Susu aɖewo siwo kpɔa ŋusẽ ɖe nɔnɔme sia dzi koŋ lae nye esi:

• Cytokines ƒomevi aɖewo: Cytokines nye atike siwo kpɔa alesi míaƒe dɔlélenutsiŋutete wɔa nu ɖe ​​amedzidzelawo abe dɔlékuiwo ene ŋu kple ɣeyiɣi si wòwɔa nui dzi. Le kansa ƒe cachexia me la, wò dɔlélenutsiŋutete ɖea cytokines ƒomevi aɖewo doa goe. Esiawo hea abi vɛ, si wɔnɛ be ale si wò ŋutilã gblẽa ami kple lãmekawo me kabakabae. Kansa hã hea dɔdzẽ vɛ, eye cytokines siawo ate ŋu ana dɔdzẽ ma nagado gã ɖe edzi.
• Kansa ƒe dzesiwo kple eƒe nugbegblẽ le ame ŋu: Vevesese, ʋuʋudedi, kple ʋuʋudedi si kansa hena vɛ ate ŋu ana nàɖu nu vie. Azɔ hã, kansa xɔxɔ ate ŋu ana nàlé blanui eye nuɖuɖu magadzro wò o.
• Kansa dada ƒe nugbegblẽ le ame ŋu: Nuwo abe amekoko, keklẽŋusẽdɔdamɔnu , atikewɔmɔnu , kple opioid vevesesenutsitike aɖewo ate ŋu ana nu mimi nasesẽ alo ado kplamatse ŋutilãa ƒe ŋutete be wòaxɔ nunyiamewo.
• Insulin ƒe dɔlélenutsiŋutete: Esia fia be wò lãmekawo kple ami lãmenugbagbeviwo mewɔa nu ɖe ​​insulin ŋu nyuie o. Insulin ƒe dɔmawɔmawɔ nyuie sia si dzɔna le cachexia me ate ŋu ana lãmekawo nagblẽ ɖe edzi.
• Protein ƒe tɔtrɔ ƒe dzidziɖedzi: Protein ƒe tɔtrɔ nye alesi wotsɔa protein yeyewo ɖɔlia protein xoxo siwo le wò lãmenugbagbeviwo me. Esia dzɔna to protein ƒe gbegblẽ me . Le kansa ƒe cachexia me la, protein siwo le lãmenugbagbeviwo me gblẽna kabakaba akpa be protein yeyewo nate ŋu axɔ ɖe wo teƒe. Esia hã nana lãmekawo gblẽna.

Nukawoe nye kansa ƒe cachexia ƒe kuxiwo?

Nɔnɔme sia ate ŋu ade ame ƒe agbe afɔku me gɔ̃ hã. Le kpɔɖeŋu me, bu cachexia ŋu kpɔ, si nye nu vevitɔ si wua dɔnɔ siwo ŋu dɔdzẽ sesẽ siwo kaka ɖe teƒe bubuwo, abe lãkusi alo ʋuka me dɔdzẽ ene, ƒe 20% va ɖo 25% ne kansa la kaka ɖe ŋutilã ƒe akpa bubuwo .

Kuxi bubuwo ate ŋu anye:

• Ŋusẽ si wòkpɔna ɖe kansa dada dzi: Wò ŋutilã hiã lãmeka kple ami hafi wòahaya tso kansa dada me. Esiawo ƒe bu ate ŋu agblẽ nu le wò ŋutete be nàxɔ kansadɔdada ŋu. Ðewohĩ ŋusẽ maganɔ ŋuwò gɔ̃ hã be nàdo dzi le atikewɔwɔa me o.
• Susu ƒe lãmesẽnyawo: Ne wokpɔ kansa ƒe cachexia le ŋuwò la, ate ŋu afia be ɣleti ʋɛ aɖewo koe susɔ na wò be nànɔ agbe. Sidzedze sia ate ŋu ana nàtsi dzimaɖi vevie ahalé blanui.
• Ŋusẽkpɔɖeamedzi ɖe ƒometɔwo kple xɔlɔ̃wo dzi: Nɔnɔme sia ate ŋu agblẽ nu le wò kple ƒometɔwo kple xɔlɔ̃wo dome ƒomedodo hã ŋu. Menye ɖeko nàte ŋu alé blanui ne èkpɔ tɔtrɔwo le wò ŋutilã me ko o, ke wò dzikpɔlawo hã ate ŋu atsi dzi ɖe wò lãmesẽ ŋu wu. Numekukuwo ɖee fia be ne ƒomea me tɔwo kpɔ dzesi siawo la, woate ŋu azi dɔnɔa dzi wòaɖu nu, le lɔlɔ̃ ta gɔ̃ hã, si ate ŋu ahe masɔmasɔ si mehiã o vɛ eye wòana nɔnɔme si me nuteɖeamedzi le xoxo la nadzi ɖe edzi.

Bu eŋu kpɔ, ne ƒomea me tɔ aɖe le tsɛ le kansa ta eye mete ŋu ɖua nu o la, esɔ be woate tɔ ɖe edzi be, "Taflatse ɖu nu vie, taflatse ɖu esia hã." Gake ema ate ŋu ate ɖe dɔnɔa dzi wu.

Aleke ɖɔktawo wɔa anya kansa ƒe cachexia?

Wò kansadɔdala kple/alo wò kansadɔdala ƒe ƒuƒoƒo ado wò kpɔ le ŋutilã me. Woate ŋu abia tso asiwò be nàkpe nyabiase gbalẽvi aɖe ɖo tso wò nuɖuɖu ŋu, eye woate ŋu awɔ dodokpɔwo hã atsɔ adzidze wò kamedede bliboa kple wò lãmekawo ƒe ŋusẽ.

Tsɔ kpe ɖe eŋu la, woate ŋu akafui be woawɔ CT scan alo DXA scan . DXA scan sia dzidzea lãmeka siwo me ƒu mele o ƒe agbɔsɔsɔ le wò abɔwo kple afɔwo me. Ate ŋu ana kansadɔdala nakpɔ wò lãmekawo ƒe lolome. Dodokpɔ siawo me tsonu akpe ɖe ɖɔktaa ŋu wòanya afisi dɔlélea le.

Nukawoe nye kansa ƒe cachexia ƒe afɔɖeɖewo?

Kansa ƒe cachexia ƒe akpa vevi etɔ̃e li:

• Do ŋgɔ na cachexia: Le afɔɖeɖe sia me la, èle lolo dzi ɖem kpɔtɔ togbɔ be èɖua nu nyuie hã. Ke hã, mèɖe wò kpekpeme bliboa ƒe 5% kple edzivɔ le ɣleti 6-12 siwo va yi me o. Ne èlolo akpa la, ɖewohĩ womade dzesi lolo sia o, gake dodokpɔwo ɖee fia be lãmenugbagbeviwo ƒe dɔwɔwɔ ƒe tɔtrɔwo va eye wò lãmekawo hã le vɔvɔm kpe ɖe ami ŋu.
• Cachexia ƒe dɔléle:Kaka fifia naɖo la, wò kpekpeme dzi ɖe kpɔtɔ wu 5% le ɣleti 6-12 siwo va yi me, alo wò kpekpeme dzi ɖe kpɔtɔ wu 2%, eye wò ŋutilã ƒe lolome ƒe dzesi (BMI) mede 20kg/m2 o. Dodokpɔwo ate ŋu aɖe lãmekawo ƒe gbegblẽ kple dɔdzẽ ƒe dzesiwo afia.
• Refractory cachexia: Le afɔɖeɖe sia me la, èɖe wò kpekpeme si sɔ ƒe 20% kple edzivɔ eye wò BMI mede 27 kg/m2 o (esia adze abe ɖe wòsɔ gbɔ ene, gake esẽna ŋutɔ ne wotsɔe kpe ɖe wò kpekpeme dzi ɖeɖe kpɔtɔ ŋutɔ ŋu). Wò lolo dzi ɖeɖe kpɔtɔ ate ŋu ana nàdze abe ɖe nèle lãmesẽ me ŋutɔ ene eye wòana màte ŋu anɔ te ɖe kansa dada nu o. Le go aɖewo me la, kansadɔdamɔnu ate ŋu adzudzɔ dɔwɔwɔ gɔ̃ hã.

Nukawoe nye kansa ƒe cachexia ƒe atikewo?

Mɔ siwo dzi nàto ana nunyiame nanyo ɖe edzi koŋ ŋue wò atikewɔwɔa ku ɖo . Le kpɔɖeŋu me, wò kansadɔwɔha kple dɔnɔdzikpɔha si kpɔa dɔdzẽ dzi ate ŋu aɖo aɖaŋu na wò be:

• Ƒo nu nyuie: Lé fɔ ɖe nuɖuɖu suewo kple numeɖenu siwo me calorie, ami, kple protein sɔ gbɔ ɖo ɖuɖu ŋu . Nuɖuɖu suewo ɖuɖu akpe ɖe ŋuwò nàkpɔ nuɖuɖumeŋusẽ geɖe. Ƒo nu kple wò nuɖuɖuŋutinunyala tso nuɖuɖu siwo akpe ɖe ŋuwò nàkpɔ viɖe geɖe tso nuɖuɖu ɖesiaɖe si nàɖu me ŋu. Woate ŋu aɖo aɖaŋu be nàtsɔ nuwo abe cheese, bɔta, nukuwo, kple notsi si me wode amii ene akpe ɖe wò nuɖuɖu ŋu.
• Te kpeɖeŋutɔtikewo kpɔ: Bia wò kansadɔdala alo nunyiameŋutinunyala tso nunyiametike siwo nàte ŋu ano alo aɖu le nuɖuɖu dome ŋu. Esiawo ate ŋu ana nunyiame bubuwo nasu ame si.
• De kame vie: Kamedede si mesẽ o ate ŋu akpe ɖe ŋuwò nàɖe lãmekawo ƒe tsɔtsɔ dzi akpɔtɔ, gake atikewɔlawo ƒe aɖaŋuɖoɖo te koe wòle be woawɔ esia.
• Ðo ŋu ɖe wò atikewɔlawo ƒe ƒuƒoƒo ŋu: Wò atikewɔlawo ƒe ƒuƒoƒo si kpɔa dɔlélenutsiŋutete gbɔ ate ŋu akpe ɖe ŋuwò le nuwo abe susu ƒe lãmesẽ kple gbɔgbɔ me kpekpeɖeŋu ene me. Kpekpeɖeŋu ma xɔ asi ŋutɔ le ɣeyiɣi sia me.

Ðe atikewo li woatsɔ ada cachexia?

Menye le ɣeyiɣi sia me o. Togbɔ be numekukuwo ɖee fia be atike aɖe si woyɔna be megestrol acetate ate ŋu ana nuɖuɖu nadzro wò eye wòakpe ɖe ŋuwò nàlolo hã la, U.S. Nuɖuɖu Kple Atike Ŋuti Dɔwɔƒe (FDA) meda asi ɖe edzi be woatsɔ ada kansa ƒe cachexia o. Le go aɖewo me la, wò ɖɔkta ate ŋu aŋlɔ atike si nye corticosteroid ɣeyiɣi kpui aɖe na wò .

Nukae amesi ŋu kansa ƒe cachexia le ate ŋu akpɔ mɔ na?

Enɔ te ɖe wò nɔnɔmea dzi ŋutɔŋutɔ. Eyae nye be, cachexia ƒe akpa ka mee nèle, kansa ƒe akpa ka mee nèle. Gake nublanuitɔe la, ne èdzi nuɖuɖu si nèɖuna ɖe edzi gɔ̃ hã la, màte ŋu atɔ te nusiwo bu la keŋkeŋ alo lãmeka kple ami si bu la nagasu asiwò o.

Ne kansa kple cachexia si de ŋgɔ, alo cachexia si mewɔa dɔ ɖe atikewɔwɔ dzi o (refractory cachexia) le ŋuwò la, wò kansadɔdala ate ŋu agblɔ be ègogo wò agbe ƒe nuwuwu. Ne wole cachexia dam na wò la, wò atikewɔlawo ate ŋu ana nyatakaka nyuitɔ kekeake wò tso nusi nàkpɔ mɔ na ŋu.

Nukae nye amesi ŋu kansa ƒe cachexia le ƒe agbenɔƒe?

Agbenɔƒe toa vovo tso ame ɖeka gbɔ yi bubu gbɔ. Togbɔ be zi geɖe la, kansa ƒe cachexia dzea amesiwo ŋu kansa si de ŋgɔ le dzi hã la, àte ŋu adze dzesi siwo do ŋgɔ na cachexia le wò kansa ƒe akpa ɖesiaɖe. Ne edzɔ alea la, àte ŋu anɔ agbe kple kuxiwo abe kansa kple cachexia ene ƒe geɖe. Ke hã, numekukuwo ɖee fia be ne refractory cancer cachexia, si nye kansa ƒomevi aɖe si mewɔa dɔ ɖe atikewɔwɔ dzi o la, ɖea mɔnukpɔkpɔ si li be nàtsi agbe le kansa me dzi kpɔtɔna abe 30% ene.

Kansa ƒe cachexia dzɔna elabena dɔlélea nana wò lãmenugbagbeviwo ƒe dɔwɔwɔ zãa ŋusẽ si tso nuɖuɖu me kabakaba wu alesi wòle dzɔdzɔmee. Tsɔ kpe ɖe eŋu la, kansa kple kansa dada ate ŋu axe mɔ na wò be màgaɖu nu nyuie o. Esia awɔe be wò kpekpeme kple lãmekawo ƒe lolome ate ŋu aɖiɖi ŋutɔ, si akpɔ ŋusẽ ɖe wò dzedzeme (kple bubudede ɖokuiwò ŋu), wò ŋusẽ, kple wò agbenɔnɔ ƒe nyonyome dzi.

Togbɔ be atikewɔwɔ aɖeke meli koŋ na kansa ƒe cachexia o hã la, nanewo li nàte ŋu awɔ atsɔ akpe ɖe ŋuwò nàɖu eƒe dzesiwo dzi. Ne èle esia me tom la, bia wò kansadɔlélawo ƒe ƒuƒoƒoa be woakpe ɖe ŋuwò. Wose kuxi siwo le agbenɔnɔ kple kansa ƒe cachexia me gɔme eye woawɔ nusianu si woate ŋui atsɔ akpe ɖe ŋuwò nàkpɔ wo gbɔ.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

• Kansa ƒe cachexia menye kansa ŋutɔ ƒe akpa aɖeke o, ke boŋ enye nɔnɔme si to vovo si dzi wòle be woakpɔ. Ne wò alo wò lɔlɔ̃tɔ aɖe le lolo dzim ɖe edzi, nuɖuɖu megadzroa wò o, alo ɖeɖi tea ŋuwò vevie la, ƒo nu tso eŋu na wò ɖɔkta.
• Nunyiame le vevie ŋutɔ. Nuɖuɖu suesuesue siwo me nuɖuɖumeŋusẽ kple protein sɔ gbɔ ɖo ɖuɖu enuenu, kple atikewɔlawo ƒe aɖaŋuɖoɖo didi tso nunyiametikewo ŋu ate ŋu akpe ɖe ŋuwò nàɖu nɔnɔme sia dzi.
• Menye wò ɖeka koe o. Kansaŋutinunyalawo, dɔnɔdzikpɔlawo, nuɖuɖuŋutinunyalawo, kple dɔlélenutsiŋutete ƒe ƒuƒoƒowo li be woakpe ɖe ŋuwò le mɔzɔzɔ sia me. Na woƒe kpekpeɖeŋu nasu asiwò.
• Susu ƒe lãmesẽ hã le vevie ŋutɔ. Tsɔ kpe ɖe ŋutilã me tɔtrɔwo ŋu la, blanuiléle hã ate ŋu ado mo ɖa. Ðo dze kple wò atikewɔlawo ƒe ƒuƒoƒo tso esia ŋu eye nàxɔ kpekpeɖeŋu si hiã.

Avuwɔwɔ kple kansa mele bɔbɔe o. Esesẽna be woanɔ te ɖe kuxi bubuwo abe esiawo ene nu. Gake ne wonya nyuie eye wodo alɔ wo nyuie la, woate ŋu aɖu kuxi siawo dzi.

` Kansa cachexia, kansa, gbegblẽ, lãmekawo ƒe gbegblẽ, nunyiame, nuɖuɖumadzroame, kansa dada