Umhlaza wemiphunga? Masifunde ngoMhlaza wemiphunga ongengoweeseli ezincinci (i-NSCLC)!

Ngaba unengxaki yokuphefumla okanye ukukhohlela okungapheliyo? Mhlawumbi kukho umntu kusapho lwakho okhe weva ngomhlaza wemiphunga. Namhlanje siza kuthetha ngolunye lwezona ntlobo zixhaphakileyo zomhlaza wemiphunga. Nangona le yingongoma enzima, siza kuthetha ngayo ngokulula, ngendlela onokuyiqonda.

Yintoni i-Non-Small Cell Lung Cancer (NSCLC)?

Ngamafutshane, iNon-Small Cell Lung Cancer (NSCLC) kuxa iiseli ezingaphakathi kwimiphunga yakho ziqala ukwahlukana kwaye zikhule ngendlela engaqhelekanga kwaye ingalawulekiyo. Njengokhula, ezi seli zizama ukusasazeka kuyo yonke indawo ngaphandle kolawulo. Kukho iintlobo ezimbini eziphambili zomhlaza wemiphunga. Enye ibizwa ngokuba yi-NSCLC. Enye ibizwa ngokuba yi -Small Cell Lung Cancer (SCLC) . La magama mabini asekelwe kwindlela ezi seli zomhlaza ezibonakala ngayo phantsi kwe-microscope. Iiseli kwi-SCLC zincinci, zijikelezile, kwaye zimile njengebhola. Iiseli kwi-NSCLC zinkulu.

I-SCLC idla ngokuba nolaka ngakumbi kune-NSCLC, oko kuthetha ukuba isasazeka ngokukhawuleza. Nangona kunjalo, nangona iiseli ze-NSCLC zinkulu, zihlala zikhula kancinci. Ingxaki apha kukuba i-NSCLC inokuba neempawu ezingabonakaliyo kwizigaba zayo zokuqala . Ke ngoko, ngexesha lokufunyaniswa kwayo, umhlaza usenokuba sele usasazekile (ususele usasazeka) kwezinye iindawo zomzimba. Yiyo loo nto kubaluleke kakhulu ukuwufumanisa nokuwunyanga kwangethuba . Enyanisweni, i-80% ukuya kwi-85% yomhlaza wemiphunga yi-NSCLC.

Ngaba kukho iintlobo ze-NSCLC?

Ewe, kukho iintlobo ezininzi eziphambili ze-NSCLC. Oogqirha bazichonga ezi ngokujonga iiseli zomhlaza phantsi kwemakroskopu nangokusekwe kwinkangeleko yazo. Sithetha kakhulu ngeentlobo ezintathu:

• I-Adenocarcinoma: Olu lolona hlobo luqhelekileyo lwe-NSCLC. Ihlala ikhula kwiindawo ezingaphandle zemiphunga.
• I-Large cell carcinoma: Olu hlobo lweeseli zomhlaza lubonakala lukhulu kunezinye iintlobo xa lujongwa nge-microscope. Lunokuvela naphi na emiphungeni.
• I-Squamous cell carcinoma: Oku kudla ngokuqala phakathi kwemiphunga, kufutshane neendlela eziphambili zomoya esiphefumla ngazo.

Ukongeza kwezi ntlobo zintathu ziphambili, kukho ezinye iintlobo ezingaqhelekanga ezifana ne -sarcomatoid carcinoma kunye ne-adenosquamous carcinoma , kodwa azibonakali rhoqo.

Zithini iimpawu zoku?

Kulungile, ngoku mhlawumbi uyazibuza ukuba zeziphi iimpawu ezibangelwa yi-NSCLC. Njengoko bekutshiwo ngaphambili, ngamanye amaxesha kusenokungabikho zimpawu konke konke, eyona nto yoyikekayo. Kodwa kukho ezinye iimpawu eziqhelekileyo. Ukuba unenye okanye ezingaphezulu kwezi, ungoyiki, kodwa licebo elihle ukubona ugqirha.

• Intlungu yesifuba: Njengomntu ocinezela isifuba sakho, okanye intlungu eba mandundu xa uphefumla, uhleka, okanye ukhohlela.
• Ukukhohlela okungapheliyo: Ukukhohlela okuhlala iiveki, ngamanye amaxesha kube kubi ngakumbi, ngaphandle komkhuhlane.
• Ukukhohlela igazi: Olu luphawu oluyoyikisayo. Ukuba ukhohlela igazi okanye umhluzi opinki, ngokuqinisekileyo kuya kufuneka ubone ugqirha.
• Ukutshintsha kwelizwi/ukurhawuzelela: Ukuba ilizwi lakho lirhawuzelela ngequbuliso okanye lirhawuzelela, nalo kufuneka lijongwe.
• Ukulahlekelwa yinkanuko kunye nokuncipha kwesisindo: Ukulahlekelwa yinkanuko, kunye nokuncipha kwesisindo ngaphandle kwesizathu esicacileyo.
• Ukuphefumla kancinci: Ukuziva uphelelwa ngumphefumlo nokuba usebenza kancinci, okanye uzive udiniwe ngaphezu kwesiqhelo xa usenza izinto ezifana nokunyuka izinyuko.
• Ukudinwa/Ukudinwa: Ukuziva udiniwe ngalo lonke ixesha , nokuba sele ulele kakuhle.
• Ukuphefumla (isandi sokukhala) xa uphefumla.
• Izifo ezixhaphakileyo zemiphunga ezifana ne-bronchitis okanye i-pneumonia.

Ukuba unenye okanye ngaphezulu kwezi mpawu, ungoyiki ukucinga ukuba yi-NSCLC. Nezinye iimeko zempilo zinokubangela ezi mpawu. Kodwa ukuba ezi mpawu ziyaqhubeka, kusoloko kuyinto elungileyo ukubona ugqirha ukuze akuhlole.

Kutheni le nto lo mhlaza uvela? Zithini izinto ezibangela umngcipheko?

Kaloku, kutheni lo mhlaza we-NSCLC uvela? Enyanisweni, oogqirha abanakutsho ngokuqinisekileyo ukuba kutheni abanye abantu bewufumana kanti abanye abawufumani. Kodwa bachonge izinto ezininzi ezinokubangela umngcipheko . Umngcipheko yinto eyonyusa amathuba akho okufumana esi sifo.

Eyona nto iphambili neyona ixhaphakileyo ebangela umhlaza wemiphunga kukutshaya. Le ngozi iphezulu kungekuphela nje kwabo batshaya icuba, kodwa nakwabo basebenzisa izinto ezifana ne-bidis, icuba, kunye ne-hookah. Kwakhona, abo bangatshayiyo kodwa bachaphazeleka ngumsi osetyenziswa ngomnye umntu (ukutshaya ngaphandle kokutshaya / umsi osetyenziswa ngomnye umntu) nabo basengozini.

Khawucinge nje, xa utshaya, amawaka eekhemikhali eziyingozi angena emiphungeni yakho. Ezi zinto zonakalisa iiseli zemiphunga kwaye ekugqibeleni zinokuguquka zibe ziiseli zomhlaza.

Ezinye izinto ezinobungozi zezi:

• Imbali yosapho yomhlaza wemiphunga: Ukuba abazali bakho, abantakwenu, okanye amanye amalungu osapho lwakho bake baba nesi sifo, kunokubakho nefuthe lemfuza.
• Ukuchatshazelwa yi-asbestos: Ungachatshazelwa koku kwizinto ezifana namaphepha e-asbestos awayesetyenziswa ukwakha ezinye izindlu kwixesha elidlulileyo, okanye xa usebenza kwimizi-mveliso enxulumene ne-asbestos.
• Ukuvezwa kuthuli lwesinyithi nolweeminerali: Abantu abasebenza kwiifektri ezithile banokuba semngciphekweni wokuvezwa zizinto ezifana ne-arsenic, i-chromium, kunye ne-nickel.
• Ukuvezwa kwi-radon, igesi ye-radioactive eyenzeka ngokwendalo:Le yigesi evela emhlabeni. Kwezinye iindawo, amanqanaba ayo anokunyuka ngaphakathi emakhayeni.
• Ukuba nezifo zokuphefumla ezingapheliyo ezifana neCOPD (Chronic Obstructive Pulmonary Disease) okanye iPulmonary Fibrosis.
• Ukuba ukhe wanyangwa ngemitha yebele okanye esifubeni sakho ngenxa yesinye isifo, esifana nomhlaza webele.
• Ukuhlala kwindawo enomoya ongcolileyo ophezulu nako kunokuba nefuthe elithile.

Asinguye wonke umntu onayo le nto oza kuba nomhlaza. Kodwa kubalulekile ukwazi ukuba ezi zinto ziyandisa umngcipheko wakho. Ukuphepha ukutshaya yeyona ndlela ilungileyo yokunciphisa umngcipheko wakho wokuba nomhlaza wemiphunga.

Ziziphi iingxaki ezinokubakho ze-NSCLC?

Enye yezona zinto ziyingozi kakhulu ngomhlaza ofana ne-NSCLC kukuba unokusasazeka (ukwandisa i-metastasize) uye kwezinye iindawo zomzimba. Xa usasazeka, imeko iba nzima nangakumbi. Nazi ezinye zeendawo eziqhelekileyo apho i-NSCLC inokusasazeka khona:

• Ii-adrenal glands (ezi zii-glands ezincinci eziphezu kwezintso)
• Amathambo
• Ingqondo
• Isibindi
• Ama-lymph nodes (njengeziqwenga)
• Ulusu

Xa isasazeka ngolu hlobo, iimpawu zinokwenzeka kwizitho ezahlukeneyo zomzimba. Umzekelo, ukuba isasazeka iye emathanjeni, inokubangela iintlungu eziqatha emathanjeni, kwaye ukuba isasazeka iye engqondweni, inokubangela iintloko ezibuhlungu kunye nokuxhuzula.

Oogqirha bayibona njani le nto?

Kulungile, ngoku uneempawu. Uyazi njani ngokuqinisekileyo ukuba yi-NSCLC xa usiya kugqirha?

Okokuqala, ugqirha uza kukubuza ngeempawu zakho, imbali yosapho lwakho, kunye nemikhwa yakho (efana nokutshaya). Emva koko uza kwenza uvavanyo lomzimba aze amamele imiphunga yakho.

Emva koko, ukuba kukho ukurhanelwa kwe-NSCLC, baya kuyalela iimvavanyo ezininzi ukuqinisekisa oko baze bafumane ukuba umhlaza ukuliphi inqanaba.

Iimvavanyo ezixhaphakileyo zezi:

• I-biopsy yemiphunga: Oku kuquka ukuthatha iqhekeza elincinci lesicubu kwindawo erhanelekayo yemiphunga uze ulihlolisise phantsi kwe-microscope. Oku kunokubonisa ukuba kukho iiseli zomhlaza kwaye zeziphi iintlobo zazo. Kukho iindlela ezahlukeneyo zokuthatha i-biopsy. Oku kungenziwa ngexesha le-bronchoscopy, okanye ngokufaka inaliti encinci esifubeni (i-needle biopsy).
• I-Bronchoscopy: Kule nto, ityhubhu encinci eneekhamera idluliselwa ngomlomo okanye empumlweni, iye kwi-windpipe, ize iye kwimiphunga. Oku kuvumela ugqirha ukuba abone ngaphakathi kwimiphunga aze, ukuba kuyimfuneko, athathe isampuli (i-biopsy).
• Uvavanyo lomfanekiso:Aba bathatha imifanekiso yangaphakathi emzimbeni baze bajonge izinto ezifana nendawo ekuyo umhlaza, ubungakanani bawo, kunye nokuba usasazekile na.
• I-X-ray yesifuba: Olu luvavanyo olusisiseko.
• I-CT scan: Oku kungathatha imifanekiso ecacileyo, enqamlezileyo kune-X-ray.
• I-PET scan: Oku kunceda ekufumaneni iindawo apho iiseli zomhlaza zisebenza khona.
• I-MRI scan yobuchopho: Oku kusetyenziswa ukubona ukuba umhlaza usasazeke na engqondweni.
• Utyando lwesifuba oluncediswa yividiyo (VATS): Olu lutyando oluncinci lokujonga ngaphakathi esifubeni. Ikhamera kunye nezixhobo zifakwa ngokusebenzisa imingxunya embalwa emincinci ukuze kuhlolwe kwaye, ukuba kuyimfuneko, kuthathwe i-biopsy.

Ngokusekelwe kulwazi olufunyenwe kwezi mvavanyo, ugqirha ugqiba ukuba ngaba une-NSCLC, ukuba kunjalo, ukuba isasazeke kangakanani (ukulinganisa), kunye nohlobo lonyango olufanelekileyo.

Zithini iindlela zonyango?

Abantu abaninzi bayoyika xa besiva igama elithi umhlaza, kwaye oko kuqhelekile. Kodwa ngoku kukho unyango oluphambili kakhulu lwe-NSCLC. Uhlobo lonyango olufumanayo luxhomekeke kwizinto ezininzi, kubandakanya uhlobo lomhlaza, inqanaba lawo, nokuba kukho naluphi na utshintsho kwimfuza kwiiseli zomhlaza, kunye nempilo yakho iyonke.

• Utyando: Ukuba umhlaza uphela emiphungeni, oko kuthetha ukuba awukasasazeki kwezinye iindawo (kwinqanaba lokuqala), utyando lolona khetho lokuqala. Oku kubandakanya ukususa umhlaza kunye nenani elincinci lezicubu eziphilileyo eziwujikelezileyo. Ngamanye amaxesha, kuxhomekeke ekubeni umhlaza usasazeke kangakanani, icandelo lomphunga (lobectomy) okanye umphunga wonke (lung resection / pneumonectomy) linokufuneka.

Khawucinge nje, kukho ukhula emyezweni. Olu tyando lufana nokulukhupha kuqala. Kodwa ayinguye wonke umntu onokwenza utyando, kufuneka ube ufanelekile kulo.

• Unyango lweKhemotherapy: Usenokuba ukhe weva ngale nto. Oku kuquka ukunika umzimba amayeza abulala iiseli zomhlaza. La mayeza anokunikwa njengeenaliti okanye njengeepilisi. Olu lolona nyango luqhelekileyo kwi-NSCLC. Unyango lweKhemotherapy lunokunikwa lodwa, ukunciphisa ithumba ngaphambi kotyando, ukubulala naziphi na iiseli eziseleyo emva kotyando, okanye kunye nonyango lwemitha.

• Unyango lwe-Immunotherapy: Olu lonyango olutsha, kodwa olusebenzayo kakhulu. Lubandakanya ukuvuselela amajoni omzimba wakho ukuba aqaphele kwaye atshabalalise iiseli zomhlaza. Kufana nokuqeqesha amajoni akho ukulwa nomhlaza. Ayisebenzi kuzo zonke iintlobo ze-NSCLC, kwaye kwenziwa uvavanyo olukhethekileyo ngenxa yoko.

• Unyango olujoliswe kulo:Olu lunyango olukhethekileyo kakhulu. Lusebenzisa amayeza ajolise kwiinguqu ezithile zemfuza okanye iiproteni ezinceda iiseli zomhlaza zikhule kwaye zisasazeke. Inzuzo yoku kukuba ayibangeli monakalo mkhulu kwiiseli ezisempilweni kune-chemotherapy. Kwakhona, kufuneka uvavanye iiseli zakho zomhlaza ukuze ubone ezo nguqu zikhethekileyo.

• Unyango lwemitha: Oku kusebenzisa ii-X-reyi ezinamandla aphezulu ukubulala iiseli zomhlaza. Le mitha ijoliswe kwindawo echanekileyo yomhlaza. Oku kunokunikwa kunye ne-chemotherapy, yodwa, okanye ngaphambi okanye emva kotyando. Ngamanye amaxesha, olu nyango lukwasetyenziselwa ukunciphisa iintlungu.

Amaxesha amaninzi, ngenxa yokuba i-NSCLC ayinakubonwa kwangethuba, oogqirha baya kusebenzisa olunye okanye ngaphezulu kwezi ndlela zonyango kunye (unyango oludibeneyo). Ugqirha wakho we-oncologist uya kuphuhlisa isicwangciso sonyango esilungele wena.

Kuthatha ixesha elingakanani ukuphiliswa?

Ixesha lokuchacha emva konyango lwe-NSCLC liyahluka kumntu nomntu. Kuxhomekeke kwizinto ezininzi, kuquka ubungakanani bomhlaza, apho ukhoyo, uhlobo lonyango olufumeneyo (njengotyando, i-chemotherapy, i-radiation), kunye nokukwazi komzimba wakho ukuphiliswa. Abanye abantu banokuchacha kwiinyanga ezimbalwa. Abanye bangathatha iminyaka, kwaye banokufuna ukulandelelwa. Ngoko ke, kungcono ukubuza ugqirha wakho ukuba kuza kuthatha ixesha elingakanani kwaye yintoni onokuyilindela ngokusekelwe kwimeko yakho.

Ufanele uye nini kugqirha?

Ukuba unyangwa i-NSCLC, okanye usandul’ ukugqiba unyango, kukho amaxesha apho unokufuna ukubona ugqirha ngokukhawuleza. Qaphela ezi zinto:

• Kulungile ukuba uphefumla kancinci okanye ukuba ukuphefumla kwakho kancinci kuya kuba mandundu.
• Ukuba unomkhuhlane ongaphezulu kwe-100.4 degrees Fahrenheit (38 degrees Celsius), ingakumbi xa ufumana i-chemotherapy.
• Ukuba ufumana iintlungu eziqatha (umz., esifubeni, emathanjeni) ezingapheli nangona usela amayeza.
• Ukuba kuvela iimpawu ezintsha (umz., ubunzima bokuthetha, ukulahlekelwa zingqondo, intloko ebuhlungu kakhulu), okanye ukuba iimpawu ezikhoyo ziba nzima,
• Ukuba usoloko uhlanza okanye urhudo.

Kwimeko enjalo, yazisa ugqirha wakho womhlaza okanye iqela lakhe ngoko nangoko. Ukuba akunjalo, yiya kwicandelo likaxakeka lesibhedlele esikufutshane.

Buza kuba njani ubomi kule meko?

Usenokuba uzibuza, "Ubomi bunjani xa unesifo esinjalo?" Enyanisweni, ubude bexesha onokuphila ngalo ne-NSCLC (ubude bobomi) buxhomekeke kwizinto ezininzi, kuquka inqanaba lomhlaza ekuxilongweni, uhlobo lwe-NSCLC, kunye nempilo yakho iyonke.

Umzekelo, i-NSCLC yesigaba sokuqala (eyenzelwe indawo)Kwimeko yomhlaza wemiphunga, izinga lokusinda iminyaka emihlanu limalunga nama -65% . Oku kuthetha ukuba abantu abangama-65 kwabayi-100 abafunyaniswe benale meko baya kusaphila emva kweminyaka emihlanu.

Ukuba umhlaza usasazeke kwizicubu ezikufutshane okanye kwi-lymph nodes (i-NSCLC yengingqi) , eli nani limalunga ne- 37% . Ukuba umhlaza usasazeke kwiindawo ezikude emzimbeni (umz., isibindi, ubuchopho, amathambo) (i-metastatic / i-NSCLC ekude) , izinga lokusinda kweminyaka emihlanu limalunga ne -9% .

Kodwa khumbula: La mazinga okusinda axhomekeke kwidatha evela kwiqela elikhulu labantu. Abakuxeleli ukuba uza kuphila ixesha elingakanani okanye ukuba umzimba wakho uza kusabela njani kunyango. Uhambo lomntu wonke lwahlukile. Ngoko ke kubalulekile ukuthetha nogqirha wakho malunga nendlela ezi zibalo ezikuchaphazela ngayo.

Kutshanje, la mazinga okusinda aye aphucuka ngenxa yonyango olutsha (ingakumbi unyango olujoliswe kulo kunye nonyango lwe-immunotherapy).

I-NSCLC sisifo esinokunyangeka, ingakumbi ukuba sifunyenwe kwaye sinyangwa kwangethuba. Nangona kunjalo, izinto ezifana nohlobo lomhlaza, inqanaba lawo, kunye nempilo yakho iyonke zimisela isiphumo (ukuxela kwangaphambili).

Nangona i-NSCLC ingenakunyangwa, kwiimeko ezininzi inokulawulwa kwaye iimpawu zinokuncitshiswa (zinganyangeka). Abantu abaninzi abane-NSCLC bayazilawula ngempumelelo iimpawu zabo kwaye baphila ubomi obusemgangathweni.

Eyona nto ibalulekileyo ekufuneka siyikhumbule kukuba

Ukufumanisa ukuba unomhlaza kunokuba yenye yezona zinto zinzima oza kujongana nazo. Kuqhelekile ukuziva usoyika, uxhalabile, kwaye udanile. Nokuba unasiphi na isigaba somhlaza wemiphunga ongengoweeseli ezincinci (i-NSCLC), unyango lunokunceda ukunciphisa iimpawu zakho kwaye luphucule umgangatho wobomi bakho.

Thetha nogqirha wakho malunga neendlela onokukhetha kuzo, isicwangciso sonyango, kunye nemiphumo emibi enokubakho. Musa ukoyika ukubuza imibuzo. Ngeli xesha lokungaqiniseki, kunokuba luncedo ukuthetha nosapho lwakho, abahlobo, kwaye, ukuba kuyimfuneko, nomcebisi okanye unontlalontle.

Kwakhona, ukujoyina iqela lenkxaso, nokuba likwi-intanethi okanye kwindawo okuyo, kunokukunceda uzive ungedwa kangako, ufunde kumava abanye, kwaye ufumane amandla. Khumbula, awuwedwa kule mfazwe.

Umhlaza wemiphunga, i-NSCLC, Umhlaza wemiphunga ongengoweeseli ezincinci, iimpawu zomhlaza, unyango lomhlaza, ukutshaya, izifo zokuphefumla