Khansa ya m'mapapo yosowa kwambiri (Pleural Mesothelioma): Tiyeni tikambirane izi

Kodi mumakhala ndi ululu pachifuwa nthawi zonse kapena mukuvutika kupuma? Mwina munakumanapo ndi asbestos kuntchito muli aang'ono. Lero tikulankhula za khansa yosowa koma yoopsa kwambiri yomwe ingayambike patatha zaka zambiri chifukwa cha matendawa. Izi zimatchedwa Pleural Mesothelioma m'mawu azachipatala. Ngakhale dzinalo lingamveke lovuta, tiyeni tipitirizebe kulimvetsa.

Kodi Pleural Mesothelioma ndi chiyani kwenikweni?

Mwachidule, pali nembanemba yopyapyala, ngati chophimba, kuzungulira khoma lamkati la mapapo athu ndi m'mimba mwa chifuwa. Ichi ndi chomwe timachitcha pleura mu zamankhwala. Nembanemba iyi imapangidwa ndi mtundu wapadera wa selo wotchedwa mesothelium . Chifukwa chake khansa ikayamba m'maselo a mesothelium awa, imatchedwa Pleural Mesothelioma (kapena malignant pleural mesothelioma).

Chifukwa chachikulu komanso chofala kwambiri cha izi ndi kupezeka kwa mchere wotchedwa asbestos . Mwina mukudziwa kuti kale, mapepala a asbestos ankagwiritsidwa ntchito ngati zipangizo zomangira, makamaka padenga. Asbestos iyi ikawola, kusweka, kapena kugwiritsidwa ntchito, tinthu tating'onoting'ono kwambiri tosaoneka timatulutsidwa mumlengalenga. Tinthuti tikapumidwa, timapita m'mapapo ndikukhazikika. Choopsa kwambiri ndichakuti thupi lathu silingathe kusungunuka kapena kuchotsa tinthuti. Chifukwa chake pakapita zaka zambiri, zimawononga nembanemba yozungulira mapapo, zomwe zimayambitsa kutupa, ndipo pamapeto pake zimasinthasintha maselo ndikusanduka khansa.

Kodi pali mitundu ikuluikulu ya khansa iyi?

Inde, bungwe la World Health Organization (WHO) lagawa khansa iyi m'magulu atatu akuluakulu kutengera mtundu wa maselo a khansa. Mitundu ina imafalikira mofulumira, pomwe ina imakula pang'onopang'ono. Mankhwala amasiyananso kutengera mtundu wake.

Dokotala wanu akadziwa mtundu weniweni wa mankhwala omwe muli nawo, adzatha kukupatsani lingaliro labwino la mankhwala omwe ali abwino kwa inu komanso zomwe zidzachitike mtsogolo.

Kodi zizindikiro za matendawa ndi ziti?

Vuto limodzi ndi izi ndilakuti zizindikiro zimawonekera pang'onopang'ono kwambiri . Zingatenge zaka 20, 30, kapena 50 mutagwiritsa ntchito asbestos kuti zizindikiro ziwonekere. Zizindikiro zoyamba zimafanana ndi za chimfine wamba kapena matenda ena ang'onoang'ono, kotero anthu ambiri sazilabadira kwambiri. Ndi pokhapokha ngati matendawa akukula pang'ono ndipo amapita kwa dokotala.

Zizindikiro ziwiri zazikulu ndi izi:

• Kupweteka pachifuwa kosalekeza
• Kuvuta kupuma (kupuma movutikira)

Komanso, mukhoza kuona zizindikiro izi:

• Chifuwa chosalekeza komanso mawu osamveka bwino
• Kuvuta kumeza (dysphagia)
• Kupweteka kwa msana
• Kutupa kwa nkhope ndi manja
• Kuchepetsa thupi popanda chifukwa
• Thukuta la usiku
• Kutopa
• Malungo omwe amakupangitsani kumva kufooka

Kodi pali zifukwa zina kupatula asbestos?

Kupezeka ndi asbestos ndi komwe kumayambitsa 70% ya milandu yomwe yapezeka. Komabe, nthawi zina, anthu omwe sanakumane ndi asbestos amathanso kudwala khansa iyi. Asayansi akufufuzabe izi. Zina mwa zifukwa zomwe zingachitike ndi izi:

• Atalandira kale chithandizo cha radiation kudera la pachifuwa.
• Kusintha kwa majini komwe kumachitika chifukwa cha cholowa (mwachitsanzo, kusakhalapo kwa jini BAP1).
• Kukumana ndi zinthu zotchedwa carbon nanotubes (zomwe tsopano zimagwiritsidwa ntchito kulimbitsa zinthu monga magalimoto ndi zida zamasewera).

Ndani amene ali pachiwopsezo chachikulu?

Matendawa nthawi zambiri amapezeka mwa anthu omwe akhala akugwira ntchito ndi asbestos kwa zaka zambiri. Ambiri mwa anthuwa tsopano apuma pantchito (oposa zaka 65). Ankagwira ntchito zokhudzana ndi asbestos ali aang'ono, malamulo okhudza kuopsa kwa asbestos asanayambe kugwira ntchito.

Ngakhale ku Sri Lanka, anthu amene amagwira ntchito zotere ali pachiwopsezo chachikulu:

• Anthu omwe akugwira ntchito yomanga ndi kugwetsa nyumba
• Anthu ogwira ntchito m'malo opangira zombo
• Anthu ogwira ntchito m'magaraji ndi m'mafakitale
• Opanga ndi okhazikitsa zipangizo zotetezera kutentha
• Ozimitsa moto
• Opanga mapaipi
• Ogwira ntchito m'migodi

Kuphatikiza apo,

• Anthu omwe amakhala m'nyumba imodzi ndi munthu amene amagwiritsa ntchito asbestos nawonso ali pachiwopsezo, chifukwa tinthu timeneti tingalowe m'nyumbamo kuchokera ku zovala ndi nsapato zawo.
• Anthu omwe amakhala pafupi ndi mgodi wa asbestos kapena komwe nyumba zakale zokhala ndi asbestos zikugwetsedwa nawonso ali pachiwopsezo.

Kodi mungazindikire bwanji matendawa?

Mukapita kukaonana ndi dokotala, iye adzakufunsani kaye za zizindikiro zanu, mbiri yanu yachipatala, makamaka za ntchito yanu komanso momwe mungakhudzire ndi asbestos. Kenako, angakulangizeni mayeso ena, monga:

• Mayeso ojambulira: X-ray ya pachifuwa imatha kuwona kusintha kwa mapapo, kukhuthala kwa pleura, kapena madzi ozungulira mapapo (pleural effusion). Kuphatikiza apo, MRI, CT scan, kapena PET scan ingapemphedwe kuti ione komwe chotupacho chili komanso ngati khansa yafalikira.
• Kuyezetsa magazi: Kuyezetsa magazi kwina kumayang'ana kuchuluka kwa zinthu zina zomwe zimagwirizana ndi khansa iyi (monga fibulin-3 ndi ma peptide osungunuka a mesothelin) m'magazi.
• Thoracentesis: Izi zimaphatikizapo kuchotsa madzi pang'ono m'mapapo ndikuyesa maselo a khansa. Izi zingathandize kuchepetsa kulimba kwa chifuwa ndi kupuma movutikira.
• Kuyesa kwa biopsy:

Kodi magawo a khansa ndi ati?

Monga khansa ina iliyonse, imagawidwa m'magawo 1 mpaka 4 kutengera kufalikira kwa matendawa. Chithandizo chimakonzedwa kutengera gawoli.

Kodi mankhwala ochizira izi ndi otani?

Pleural mesothelioma ndi khansa yovuta kuchiza chifukwa imatha kufalikira mosavuta kudzera m'mitsempha, mitsempha yamagazi, ndi minofu. Chifukwa chake, madokotala a khansa nthawi zambiri amakonza chithandizo pogwiritsa ntchito njira zosiyanasiyana.

• Opaleshoni: Opaleshoni ikhoza kuchitidwa kumayambiriro kwa matendawa. Izi zingaphatikizepo kuchotsa mapapo onse omwe ali ndi khansa (extrapleural pneumonectomy - EPP) kapena kuchotsa minofu ya khansa ndi pleura yokha (pleurectomy yokhala ndi decortication - P/D).
• Chithandizo cha Radiation: Uku ndi kugwiritsa ntchito kuwala kwamphamvu kwambiri kuwononga maselo a khansa. Chithandizochi chimagwiritsidwa ntchito kupha maselo otsala pambuyo pa opaleshoni kapena kuchepetsa zizindikiro (monga kupweteka pachifuwa).
• Mankhwala a Chemotherapy: Izi zimaphatikizapo kupatsa thupi mankhwala omwe amapha maselo a khansa kapena kuwaletsa kukula. Pemetrexed, carboplatin, ndi cisplatin ndi mankhwala omwe amagwiritsidwa ntchito kwambiri.
• Chithandizo cha Immunotherapy: Iyi ndi njira yatsopano yochiritsira yomwe imalimbikitsa chitetezo chathu cha mthupi kuzindikira ndikuwononga maselo a khansa.
• Chisamaliro Chochepetsa Kupweteka: Cholinga chake si kuchiritsa khansa. M'malo mwake, ndikuwongolera zizindikiro za wodwalayo (ululu, kupuma movutikira) ndikupanga moyo watsiku ndi tsiku kukhala womasuka komanso wopanda ululu momwe angathere.
• Mayeso a Zachipatala: Awa ndi maphunziro omwe amayesa chitetezo ndi kugwira ntchito kwa mankhwala atsopano. Izi zimagwiritsidwa ntchito poyesa mankhwala atsopano, monga chithandizo cha majini. Mutha kulankhula ndi dokotala wanu ngati mungathe kutenga nawo mbali mu imodzi mwa mayeserowa.

Kodi pali njira yopewera matendawa?

Njira yabwino komanso yokhayo yopewera pleural mesothelioma ndikupewa kupuma tinthu ta asbestos. Ngakhale mayiko ambiri tsopano aletsa kugwiritsa ntchito asbestos, ikhoza kukhalabe m'nyumba zakale ndi magalimoto omangidwa isanafike 1980. Mutha kuchita izi kuti muchepetse chiopsezo chanu:

• Ngati muli ndi asbestos yakale m'nyumba mwanu, ifufuzeni ndi katswiri wodziwa bwino musanakonze chilichonse.
• Ngati mukuchotsa asbestos, ikani ntchitoyi kwa kampani yophunzitsidwa bwino. Musayesere kuchita nokha.
• Ngati mukukumana ndi asbestos kuntchito kwanu, onetsetsani kuti mwavala zovala zoyenera zodzitetezera komanso zophimba nkhope. Samalani kuti musanyamule tinthu tating'onoting'ono tomwe timayamwa pa zovala kapena nsapato zanu mukapita kunyumba mukamaliza ntchito.