Ngaba uneentlungu zamagxa kunye nobuthathaka bengalo? Isenokuba yiPancoast Tumor!

Ngaba ukhe uve iintlungu zegxalaba ezingachazekiyo, ngamanye amaxesha ecaleni kwentamo yakho, kunye nentlungu esezantsi kwengalo yakho, ukungacaci esandleni sakho? Ngamanye amaxesha sinokucinga ukuba kukukruneka nje okanye ukuxinana kwemithambo-luvo. Nangona kunjalo, ezi mpawu ngamanye amaxesha zinokuba luphawu lwento enzulu ngakumbi. Leyo yimeko esiza kuthetha ngayo namhlanje, ebizwa ngokuba yiPancoast Tumor.

Yintoni iPancoast Tumor? Ngamafutshane...

Cinga ngayo, i-Pancoast tumor luhlobo lomhlaza wemiphunga . Kodwa iyamangalisa kancinci. Kuba yakheka phezulu kakhulu kwimiphunga yakho, ngaphezulu kwembambo yakho yokuqala, kwincopho. Ngokungafaniyo neminye imiphunga yemiphunga, i-Pancoast tumor ayibangeli ukukhwehlela okanye iintlungu zesifuba . Endaweni yoko, abantu abanale tumor badla ngokuba neentlungu ezinkulu zamagxa kunye nobuthathaka bengalo . Oogqirha babiza olu didi lweempawu ngokuthi "yi-Pancoast syndrome." I-Pancoast syndrome ayibangeli iimpawu zomhlaza wemiphunga oqhelekileyo, ngoko ke kungathatha ixesha ukufumanisa ezi tumor. Kwiimeko ezininzi, ukuxilongwa okuqinisekileyo akwenziwa de umhlaza usasazeke kwimithambo-luvo kunye nemithambo yegazi ekufutshane. Iitumor zePancoast zibizwa ngegama le-radiologist eyaqala ukuzichaza ekuqaleni kwenkulungwane yama-20. Elinye igama lazo yi-superior sulcus tumor.

Ngaba kukho iintlobo zezi?

Ewe, kukho iintlobo ezahlukeneyo zeethumba zasePancoast. Ezona ziphambili zezi:

• Umhlaza wemiphunga ongengoweeseli ezincinci - umzekelo, ii-adenocarcinomas kunye ne-squamous cell carcinomas.
• Umhlaza wemiphunga weeseli ezincinci.

Uninzi lwee-tumor zasePancoast luhlobo lomhlaza olubizwa ngokuba yi-adenocarcinomas . Ezi cancer ziqala kulwelo lweendlela zakho zomoya kunye ne-alveoli (iingxowa zomoya ezincinci ezikwimiphunga yakho), ngakumbi kwiiseli ze-glandular ezenza i-mucus.

Ixhaphake kangakanani le meko?

Iithumba zasePancoast azixhaphakanga kakhulu , zingaphantsi kwe-5% yazo zonke iithumba zemiphunga.

Zithini iimpawu zoku? Makhe sijonge ngokusondeleyo!

I-brachial plexus yakho ichatshazelwa yi-Pancoast tumor.Olu nxubelelwano lwemithambo-luvo lunokucinezelwa. Olu nxubelelwano lwemithambo-luvo luhamba ukusuka esifubeni sakho esingaphezulu ludlule entanyeni yakho luye ezingalweni zakho. Xa olu xinzelelo lusetyenziswa, kunokwenzeka ukuba kubekho uluhlu oluthile lweempawu. Yiyo loo nto oogqirha belubiza ngokuba yiPancoast syndrome okanye iPancoast-Tobias syndrome. Ezi mpawu zenzeka kwicala elifanayo nethumba . Umzekelo, ukuba ithumba likwimiphunga yakho yasekunene, iimpawu ziya kuchaphazela necala lasekunene lomzimba wakho. Iimpawu zethumba lasePancoast zingabandakanya:

• Intlungu ebuhlungu yegxalaba : Oku kungabandakanya intlungu kwi-blade yegxalaba lakho.
• Intlungu ephuma engalweni: Le ntlungu isenokuphela esihlahleni, ngaphezulu nje komnwe omncinci.
• Ubuthathaka esandleni nasengalweni.
• Intlungu yentamo.
• Intlungu kwinxalenye ephezulu yeembambo.
• Ukudumba kwengalo engasentla.
• Ukulahlekelwa bubuchule ezandleni nakwiminwe.
• Ukurhawuzelela okanye ukuba ndindisholo esandleni.
• Ukudinwa.
• Ukuxinana kwesifuba.
• Ukunciphisa umzimba ngaphandle kwesizathu.

Malunga nama-50% abantu abanee-tumor zasePancoast nabo banesifo esibizwa ngokuba yiHorner's syndrome , esinokubangela iimpawu ezifana nezi:

• Ukuhlamba ubuso.
• Ijwabu eligobileyo (i-ptosis).
• Iinkophe ezijika zijonge ngaphakathi (enophthalmos).
• Ukungabi namanzi (anhidrosis).

Yintoni ebangela oku? Zithini izinto ezibangela umngcipheko?

Izizathu kunye nezinto ezibangela umngcipheko wee-tumor zasePancoast ziyafana nezinye iintlobo zomhlaza wemiphunga. Ezona zinto zibangela umngcipheko zezi:

• Ukutshaya .
• Ukuchanabeka kumsi ophuma komnye umntu.
• Ukuvezwa ixesha elide kwizinto ezithile ezifana ne-asbestos, igesi ye-radon, kunye neesinyithi ezinzima.

Khawucinge nje, ngokuzichanaba kwezi zinto, singazi, sonakalisa imiphunga yethu. Ngoko ke kubaluleke kakhulu ukuba silumke ngale nto.

Isasazeka njani le nto?

Umhlaza usasazeka xa iiseli zomhlaza ziphuma kwithumba lokuqala, zihamba kwinkqubo yakho yegazi okanye kwinkqubo ye-lymph, kwaye zenze iithumba ezintsha kwezinye iindawo zomzimba wakho. Iithumba zasePancoast zinokusasazeka ukusuka kwinxalenye ephezulu yemiphunga ukuya kwiindawo ezilandelayo:

• Isifuba esingaphezulu.
• Ijonge emazantsi amantla angaphezulu.
• Iimbambo zesifuba.
• Imithambo yegazi ekufutshane nezandla.

Oku kusasazeka komhlaza kwiindawo ezikude kubizwa ngokuba yi-metastasis .

Ifunyaniswa njani le nto?

Kwinqanaba lokuqala, iithumba zasePancoast azibonakali lula kwi-X-ray eqhelekileyo yesifuba enobukhulu obubini. Yiyo loo nto kunokuba nzima ukuzifumanisa. Ukuba ugqirha urhanela ukuba kukho ithumba lasePancoast ngokusekelwe kwiimpawu zakho, unokucebisa ezinye iimvavanyo zokuxilonga, ezifana nezi:

• Ezinye iimvavanyo zokuthatha imifanekiso.
• I-biopsy yenaliti.
• Utyando lwe-thoracoscopy oluncediswa yividiyo (VATS).
• Utyando lweThoracotomy.

Uvavanyo lokufota

Ubuchwepheshe obuphambili bokufota bunokunceda ugqirha wakho ukuba afumane umfanekiso ocacileyo wemiphunga yakho. Angayalela uvavanyo olufana nolu:

• I-CT scan (CT - i-computed tomography scans).
• I-PET scan (i-positron emission tomography scans).
• I-MRI scan (i-MRI - i-magnetic resonance imaging).

Olu hlobo lweskeni lunokubonelela ngolwazi oluninzi, njengobungakanani bethumba, indawo elikuyo, kunye nokuba sele lisasazeke na kwezinye iindawo.

i-biopsy yenaliti

Kwi-biopsy yenaliti, ugqirha uthatha isampuli yolwelo, izicubu, okanye iiseli kwiqhubu elingaqhelekanga. Emva koko isampuli ithunyelwa kwilabhoratri yezifo ukuze ivavanywe ngakumbi. Kulapho kuphela apho sinokuqiniseka khona ukuba ngumhlaza kwaye loluphi uhlobo lwawo.

Utyando lwe-thoracoscopy oluncediswa yividiyo (VATS)

Ngexesha le nkqubo, ugqirha wenza umngxuma omncinci esifubeni sakho aze afake i-thoracoscope (ityhubhu encinci enekhamera encinci kuyo). Oku kumvumela ukuba ajonge ngaphakathi esifubeni sakho aze ajonge iithumba okanye ezinye izinto ezingaqhelekanga. Ukuba zifunyenwe, isampuli yezicubu iyathathwa ize ithunyelwe kwilebhu ukuze ivavanywe.

I-Thoracotomy

Kwezinye iimeko, ugqirha unokufuna ukwenza i-thoracotomy. Kule meko, benza i-incision kwicala lasekunene okanye lasekhohlo lesifuba sakho, phakathi kweembambo. Oku kubavumela ukuba babone kakuhle umphunga ochaphazelekayo baze bathathe i-biopsy yezicubu ezingaqhelekanga. Kwiimeko ezininzi, baya kususa nethumba ngaxeshanye. Oku kuya kukusindisa ekubeni wenze utyando oluninzi.

Masifunde ngesigaba somhlaza.

Njengezinye iintlobo zomhlaza wemiphunga, oogqirha bahlulahlula iithumba zasePancoast besebenzisa inkqubo yokulinganisa umhlaza . Basebenzisa amanani amaRoma (I, II, III, IV) kunye nee-subtypes (A, B) ukuchaza ukuba iqhubile kangakanani ithumba kwaye isasazeke kangakanani. Kwiithumba zasePancoast, oogqirha basebenzisa oonobumba u-T, u-N, u-M kunye namanani u-1, u-2, u-3, u-4 ukubonisa ubunzulu bemeko:

• Unobumba u-T ubhekisa kubungakanani bethumba lakho kunye nokuba lisasazeke kangakanani.
• Unobumba u -N ubhekisa ekubeni umhlaza usasazeke na kwii -lymph nodes zakho.
• Unobumba u-M ubonisa ukuba umhlaza usasazeke kwiindawo ezikude zomzimba (i-metastasis) .

Zifumaneka kwinqanaba lini iithumba zasePancoast?

Ngenxa yokuba iithumba zasePancoast kunzima ukuzibona kwizigaba zokuqala, uninzi lwazo lufunyaniswa kwisigaba se-T3 okanye se-T4. I-T3 ithetha ukuba umhlaza usasazeke eludongeni lwesifuba sakho okanye kwiimithambo-luvo zakho ezisebenzisana ne-sympathetic. I-T4 ithetha ukuba umhlaza usasazeke nakwezinye izakhiwo, njengemithambo-luvo yakho ye-brachial okanye i-spinal cord. Le yimeko enzulu ngakumbi.

Luthini unyango?

Oku kuxhomekeke ekubeni ithumba likuphi na kwaye umhlaza usasazeke kangakanani. Kukho iindlela ezahlukeneyo zonyango:

• Unyango lwe-Chemoradiation kunye notyando.
• I-Chemoimmunotherapy kunye notyando.
• I-Chemoradiation kunye ne-immunotherapy.
• Unyango ngemitha.
• Unyango olujoliswe kulo.

Unyango lwe-Chemoradiation kunye notyando

Utyando lolona nyango lungcono nanini na xa kunokwenzeka. Nangona kunjalo, ngaphambi kotyando, oogqirha banokukunika i-chemoradiation - indibaniselwano ye-chemotherapy kunye ne-radiation therapy - ukunciphisa ithumba. Utyando lokususa ithumba lasePancoast lunokuba nzima ngakumbi. Ngokwesiqhelo, ugqirha wotyando kuya kufuneka asuse iimbambo zakho ezimbini eziphezulu. Kusenokufuneka asuse umthambo omkhulu aze awutshintshe nge -vascular graft - ityhubhu yokwenziwa evumela ukuba igazi lihambe. Ugqirha wakho wotyando uya kukuchazela konke oku ngaphambi kotyando.

I-Chemoimmunotherapy kunye notyando

Kwezinye iimeko, oogqirha banokucebisa utyando kunye ne -chemoimmunotherapy.– oko kukuthi, indibaniselwano ye-chemotherapy kunye ne-immunotherapy – iyasetyenziswa. Nangona i-chemotherapy ibulala iiseli zomhlaza kwaye icothisa ukukhula kwethumba, i-immunotherapy ivuselela inkqubo yakho yomzimba yokuzikhusela ukuze incede ekulweni nomhlaza.

I-Chemoradiation kunye ne-immunotherapy

Ngamanye amaxesha, utyando alunakwenzeka. Kwiimeko ezinjalo, iqela lakho lezonyango linokucebisa umxube we-chemoradiation kunye ne-immunotherapy.

Unyango ngemitha

Ukuba utyando alunakwenzeka kwaye umhlaza usasazeke kwamanye amalungu omzimba, ugqirha wakho unokucebisa unyango lwe-radiation kuphela ukulawula ukukhula komhlaza. Le ndlela yokunyamekela exhasayo inokunciphisa umhlaza kwaye inciphise iimpawu zakho.

Unyango olujoliswe kulo

Abanye abantu bayazuza kunyango olujoliswe kulo . Olu nyango lujolise kwiinguqu zemfuza ezibangela ukuba iiseli eziphilileyo zibe ziiseli zomhlaza. Ukuze afumanise ukuba ungumntu ofanelekileyo na kunyango olujoliswe kulo, ugqirha uza kuvavanya iiseli zakho zomhlaza ukuze abone ukuba zinazo na ii-receptors ezithile zeeproteni ezithile. Ukuba unemibuzo malunga noku, thetha nogqirha wakho.

Ngaba oku kungathintelwa?

Nangona iithumba zasePancoast zingenakuthintelwa ngokupheleleyo, kukho izinto onokuzenza ukunciphisa umngcipheko wakho wokufumana olu hlobo lomhlaza:

• Kuphephe ukutshaya nezinye iimveliso zecuba. Ukuba uyatshaya, thetha nogqirha wakho ukuze akuncede uyeke.
• Kuphephe ukuchanabeka kumsi womntu otshayayo kangangoko kunokwenzeka.
• Qinisekisa ukuba indawo okuyo ayinazo iikhemikhali eziyingozi ezifana ne-asbestos .

Nangona ezi zinto zingabonakala zincinci, zinokuba nefuthe elikhulu kwimpilo yakho ekuhambeni kwexesha.

Ukongeza, ukuba kukho umntu kusapho lwakho onembali yomhlaza wemiphunga, okanye ukuba usemngciphekweni omkhulu wokuba nomhlaza wemiphunga, kungcono ukubuza ugqirha wakho malunga nokuhlolwa komhlaza okuthintelayo .

Yintoni onokuyilindela ukuba une-tumor yasePancoast?

Ukuba ufunyaniswe une-tumor yasePancoast, ugqirha wakho uza kuhlanganisa iqela lonyango elilungiselelwe iimfuno zakho ezithile. Iqela lakho lonyango lingabandakanya:

• Oogqirha besifuba.
• Iingcali zotyando lwengqondo.
• Iingcali zomhlaza , oko kukuthi, iingcali zomhlaza zonyango, iingcali zomhlaza zotyando, kunye neengcali zomhlaza wemitha.

Iqela lakho lezonyango liza kucebisa unyango olusekelwe kubukhulu bethumba lasePancoast, indawo elikuyo, kunye nokuba umhlaza usasazeke na kwezinye iindawo.

Zikhula ngokukhawuleza kangakanani ezi nati?

Uninzi lwexesha, iithumba zasePancoast zikhula kancinci . Nangona kunjalo, kunqabile kakhulu, ithumba linokukhula ngokukhawuleza. Ugqirha wakho uza kujonga ukukhula kwethumba rhoqo ngaphambi, ngexesha, nasemva konyango.

Ingakanani ixesha lokuphila?

Kwiminyaka embalwa edlulileyo, inkqubela phambili kwezobuchwepheshe ikhokelele ekwandeni kancinci kwenani labantu abanyangwa kwiithumba zasePancoast. Kodwa kusekho okuninzi ekufuneka kufundwe ngesi sifo. Izinga lokusinda iminyaka emihlanu kubantu abaneethumba zasePancoast ezinyangwayo kwangethuba liphakathi kwe-30% kunye ne-50% . Oko kuthetha ukuba malunga nesiqingatha sabantu abafunyaniswe beneethumba zasePancoast kwangethuba basaphila emva kweminyaka emihlanu bexilongiwe. Kodwa kubalulekile ukukhumbula: La mazinga okusinda aqikelelwa nje. Abakuxeleli ukuba uza kuphila ixesha elingakanani okanye ukuba unyango oluthile luza kusebenza kakuhle kangakanani kuwe. Thetha nogqirha wakho ukuze uqonde indlela lo mhlaza okuchaphazela ngayo.

Ufanele ufune nini ingcebiso kagqirha?

Ukuba uneentlungu ezinkulu zamagxa, iintlungu zengalo, ubuthathaka bengalo, okanye ezinye iimpawu zethumba lasePancoast, kufuneka ubone ugqirha ngoko nangoko. Ukufunyanwa kwangoko kubalulekile.

Yeyiphi imibuzo omele uyibuze ugqirha?

Ukuba wena okanye umntu omthandayo nifunyaniswa ukuba ninesifo sePancoast, ningathanda ukubuza ugqirha wenu le mibuzo:

• Iphi ithumba?
• Ingaba isasazeke kwizicwili ezingqongileyo?
• Ingaba isasazeke kwiindawo ezikude zomzimba?
• Leliphi inqanaba lomhlaza endinalo?
• Ziziphi iindlela zonyango endinazo?
• Ngaba ndiza kukwazi ukusebenza ngexesha lonyango?
• Unyango ludla ngokuthatha ixesha elingakanani?
• Injani indlela endijonga ngayo izinto?

Ingaba le yi-tumor yasePancoast okanye yi-nerve exineneyo?

Abanye abantu abanee-tumor zasePancoast bathi iimpawu zabo ziqale ngokuziva "ucinezelekile kwimithambo-luvo" . Ukuba unentlungu enjalo kwaye ihlala ixesha elingaphezu kweeveki ezimbini, yazisa ugqirha. Isenokungabi yinto eqhelekileyo.

Umyalezo Wokugqibela Wokuya Ekhaya

Iithumba zasePancoast ziqala kwinxalenye ephezulu yemiphunga yakho. Zahlukile kwezinye iintlobo zeethumba zemiphunga kuba kunzima ukuzibona kwizigaba zokuqala. Ukufumanisa ukuba unesifo sePancoast kunokuba ngamava adidayo kakhulu. Kunokuba nzima ukucwangcisa into oza kuyenza ngokulandelayo.

Kodwa khumbula, ugqirha wakho ukho ukukunceda. Mcele ulwazi oluthe kratya malunga nemeko yakho ethile. Ukuba unako, joyina iqela lenkxaso, nokuba ubuqu okanye kwi-intanethi. Ukuthetha nabanye abadlula kwizinto ezifanayo nawe odlula kuzo kunokuba luncedo kakhulu kwimpilo yakho yengqondo, yeemvakalelo, neyokomoya. Ungaze uhlupheke wedwa.

 Ithumba lasePancoast, umhlaza wemiphunga, iintlungu zamagxa, iimpawu zomhlaza, unyango lomhlaza, umhlaza wemiphunga, iintlungu zamagxa