Uma odokotela bekuthola ukuthi unomdlavuza webele, udokotela wakho angase akuncome ukuthi usebenzise i-chemotherapy. Kuvamile ukuzizwa wesaba futhi ukhathazekile kancane uma uzwa lokhu. Kodwa uma unolwazi olufanele ngalezi zindlela zokwelapha , ungakunqoba lokho kwesaba. Kunezinhlobo ezahlukene zokwelapha nge-chemotherapy. Ama-alkylating agents angenye yezinhlobo eziyinhloko zemithi esetshenziselwa umdlavuza webele. Ngakho-ke, ake sixoxe ngalokhu ngokuningiliziwe nangokulula namuhla.
Lezi zidakamizwa ezibizwa ngokuthi ama-Alkylating Agents zisebenza kanjani ngempela?
Ukuze siqonde lokhu, sidinga kuqala ukucabanga ngamaseli omdlavuza. Amaseli omdlavuza amaseli ahlukana futhi aphindaphindeke ngokushesha kakhulu ngaphandle kokulawulwa. Ama-alkylating agents ayengomunye wemithi yokuqala eyatholakala yokulwa nomdlavuza. Asasetshenziswa kabanzi nanamuhla.
Kalula nje, lolu hlobo lomuthi lusebenza ngokuvimbela amangqamuzana omdlavuza ukuthi azenzele amakhophi awo, okungukuthi, ekuhlukaneni nasekukhuleni. Lokhu lukwenza ngokuthi:
Iseli ngalinye linohlelo oluphelele, noma "uhlelo lwesakhiwo," lwalelo seli. Lokhu sikubiza ngokuthi i-DNA. Lokho okwenziwa yi-alkylating agents ukuya ngqo ku-DNA yeseli lomdlavuza bese uzinamathisela. Njengoba nje ukhiye owodwa ungasebenzi uma uwunamathisela kwenye, lapho lo muthi ubopha ku-DNA, lelo seli alikwazi ukuhlukana.
Uma ukuhlukaniswa kwamaseli kuyeka ngale ndlela, amaseli omdlavuza ayafa kancane kancane. Kwezokwelapha, le nqubo siyibiza ngokuthi i-apoptosis . Okusho ukuthi, ukufa kwamaseli okuhleliwe.
Esinye isici esiyingqayizivele sale mithi ukuthi ingahlasela futhi ibhubhise iseli lomdlavuza kunoma yisiphi isigaba somjikelezo walo wokuphila. Lokhu kubizwa ngokuthi 'isigaba somjikelezo weseli esingaqondile'. Ngakho-ke, zisebenza kahle kakhulu ezinhlotsheni eziningi zomdlavuza, ikakhulukazi lezo ezikhula ngokushesha.
Lomuthi ungawunikwa njengephilisi noma njengesixazululo sikasawoti ngomthambo (IV - ngemithambo). Ngokuvamile, udokotela wakho uzokunikeza lo muthi kanye neminye imithi ye-chemotherapy (ukwelashwa okuhlanganisiwe).
Yiziphi izinhlobo zama-Alkylating Agents?
Leli qembu lemithi lihlukaniswe ngamaqembu amaningana amakhulu. Nakuba amagama alawa eyinkimbinkimbi kancane, kuhle ukwazi ngoba ungase uthole elinye lalawa libhalwe ekhasini lakho lemithi.
| Iqembu Lezidakamizwa | Imithi engaphansi kwaleso sigaba (Izibonelo) |
|---|---|
| Ama-mustard e-nitrogen | i-bendamustine, i-chlorambucil, i-cyclophosphamide , i-ifosfamide, i-mechlorethamine, i-melphalan |
| I-Ethylenamine kanye ne-methylenamine derivatives | i-altretamine, i-thiotepa |
| Ama-alkyl sulfonates | i-busulfani |
| Ama-Triazene | i-dacarbazine, i-procarbazine, i-temozolomide |
| Ama-ejenti aqukethe iplatinum | i-carboplatin , i-cisplatin, i-oxaliplatin |
| I-Nitrosoureas | i-carmustine, i-lomustine, i-streptozocin |
Phakathi kwalezi, uhlobo lwemithi ebizwa ngokuthi i-Nitrosoureas lukhethekile kancane. Ngoba le mithi ingawela ungqimba oluvikelayo olubizwa ngokuthi 'isithiyo segazi nobuchopho' esivikela ubuchopho bethu. Imithi eminingi ayikwazi ukuwela lo mkhawulo. Ngakho-ke, ibalulekile lapho yelapha umdlavuza ohlobene nobuchopho.
Yiziphi izinhlobo ezivame ukusetshenziswa kakhulu kumdlavuza webele?
Imithi esezigabeni ze-'Nitrogen Mustards' kanye ne-'Ethylenamine kanye ne-methylenamine derivatives' ivame ukusetshenziswa ekwelapheni izigaba ezahlukene zomdlavuza webele.
I-Cytoxan (i-Cyclophosphomide)
Lona umuthi ongoweqembu lemithi ebizwa ngokuthi i-'Nitrogen mustard'. Ungawuthatha njengephilisi noma uwufake emthanjeni nge-IV. Ngokuvamile usetshenziselwa:
- Vimbela umdlavuza osesigabeni sokuqala ukuthi ungabuyi ngemva kokuhlinzwa.
- Uma umdlavuza usukhulile, nciphisa iqhubu ngaphambi kokuhlinzwa.
- Yelapha umdlavuza osuthuthukile ngemva kokuhlinzwa kanye nezinye izindlela zokwelapha.
I-Thiotepa
Lokhu kususelwa ku-`Ethylenamine`. Ngokuvamile kunikezwa ngemithambo yegazi. Kusetshenziselwa:
- Esigabeni sokuqala somdlavuza, nciphisa ingozi yokuphinda ubuye .
- Yelapha umdlavuza osesigabeni esithuthukile.
I-Carboplatin
Lona umuthi oqukethe iplatinum. Nguwo kuphela umuthi weplatinum ovunyelwe ukwelapha umdlavuza webele. I-'Carboplatin' ivame ukunikezwa umdlavuza othuthukile, futhi ihlanganiswe neminye imithi ye-chemotherapy. Iphinde inikezwe njenge-IV.
Iyini imiphumela emibi yalo muthi?
Enye yezinselele ezinkulu nge-chemotherapy ukuthi ayikwazi ukuhlukanisa phakathi kwamangqamuzana omdlavuza namaseli anempilo. Le mithi ihlose amangqamuzana ahlukana ngokushesha. Amangqamuzana omdlavuza, njengamanye amangqamuzana anempilo emizimbeni yethu (isibonelo, amangqamuzana akha izinwele zethu, amangqamuzana azungeze ulwelwesi lomlomo wethu namathumbu, kanye namaseli egazi), ahlukana ngokushesha kakhulu. Ngakho-ke le mithi ithinta nalawo maseli anempilo, yingakho ibangela imiphumela emibi.
Le miphumela emibi ayenzeki kubo bonke ngendlela efanayo. Abanye abantu bangase babe nokuningi, abanye bangase babe mbalwa. Ungakhathazeki ngalokhu. Udokotela wakho angakusiza ukuthi uphathe iningi lalezi zinto.
| Uhlobo lomphumela ongemuhle |
|---|
| Imiphumela emibi evamile abantu abaningi abangase bayizwe |
| Isicanucanu nokuhlanza, ukuphelelwa yisifiso sokudla, ukwehla kwesisindo, ubuhlungu besisu, isifo sohudo |
| Ukukhathala |
| Ukulahlekelwa izinwele, izilonda emlonyeni noma olimini |
| Izinguquko embaleni wesikhumba, umbala noma ukukhula kwezinzipho zeminwe nezezinzwane |
| Ukwehla kwenani lamaseli amhlophe egazi (lokhu kungandisa ingozi yokutheleleka) |
| Imijikelezo yokuya esikhathini engajwayelekile kwabesifazane |
| Izimpawu ezinkulu okufanele zibikwe kudokotela wakho ngokushesha |
| Umkhuhlane, ukubanda, umphimbo obuhlungu (izimpawu zokutheleleka) |
| Ukuphola kancane kwamanxeba, ukuklwebheka okungavamile noma ukopha |
| Indle emnyama noma ephuzile, ubuhlungu lapho uchama, noma igazi emchameni |
| Ukuqubuka kwesikhumba, amaqhubu, ukulunywa |
| Ubunzima bokuphefumula noma ukugwinya, ukuphelelwa umoya, ukukhwehlela |
| Ukuvuvukala kwemilenze, amaqakala, noma izinyawo, ubuhlungu besifuba |
| Ukuphuzi kwesikhumba noma amehlo (izimpawu ze-jaundice) |
Isimo esiphuthumayo!
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, iya eMnyangweni Wezimo Eziphuthumayo wesibhedlela esiseduze (i-ETU) ngokushesha noma ushayele isevisi ye-ambulensi ka-1990:
* Izihlalo ezimnyama
* Ukopha okungenakuvinjelwa
* Ubunzima obukhulu bokuphefumula
* Ubuhlungu besifuba
* Izimpawu zokusabela okukhulu kokungezwani komzimba (njengokuvuvukala kobuso, izindebe)
Akuvamile kakhulu, lezi zinto ezibangela i-alkylating zingalimaza umongo wethu wamathambo. Umongo wamathambo yilapho umzimba wethu udala khona amangqamuzana egazi amasha. Kunengozi encane kakhulu yokuthola olunye uhlobo lomdlavuza, njenge-leukemia, ngenxa yalo monakalo. Le ngozi ivame ukwanda kancane njengoba umthamo womuthi ukhuphuka. Ungakhathazeki ngalokhu ngokungadingekile.Ngaphambi kokuqala ukwelashwa, khuluma nodokotela wakho ngokukhululekile ngezindlela zokunciphisa ingozi yokuba nomdlavuza wesibili onjengalona. Uzokunikeza zonke izeluleko ozidingayo.
Ezinye izinto okufanele uzicabangele lapho uphathwa
Ngenxa yokuthi le mithi inamandla kakhulu, kubalulekile ukutshela udokotela wakho umlando wakho wezokwelapha ophelele ukuze akwazi ukuhlela uhlelo lokwelashwa oluzofanela wena futhi anciphise imiphumela emibi. Qiniseka ukuthi uxoxa ngalokhu okulandelayo nodokotela wakho:
- Mayelana nanoma yikuphi ukungezwani komzimba onakho (imithi, ukudla).
- Mayelana nanoma yimaphi amavithamini, izithasiselo, noma imithi yamakhambi oyisebenzisayo.
- Mayelana nezimo zakho zezinso noma zesibindi .
- Uma uke wathola ukwelashwa nge-chemotherapy ngaphambilini, sitshele ngakho.
- Uma ukhulelwe, uncelisa, noma uhlela ukuba nomntwana maduze .
- Uma kukhona ukuhlinzwa okufanele ukwenze esikhathini esizayo, khuluma ngakho.
Landela imiyalelo kadokotela wakho ngqo, ikakhulukazi uma uphuza amaphilisi. Uma ukhohlwa ukuthatha umthamo, thatha umthamo olandelayo njengoba kuhleliwe. Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ubuyisele umthamo ophuthelwe. Njalo khuluma nodokotela wakho ngaphambi kokuyeka ukwelashwa.
Umlayezo Wokuya Nawe Ekhaya
- Ama-alkylating agents uhlobo lomuthi onamandla we-chemotherapy olimaza i-DNA yamaseli omdlavuza futhi uwavimbele ukuthi ahlukane.
- Ngenxa yokuthi le mithi ithinta amangqamuzana omdlavuza kanye nokuhlukanisa ngokushesha amangqamuzana anempilo, ingabangela imiphumela emibi njengesicanucanu nokulahlekelwa izinwele. Lokhu kungalawulwa.
- Kubaluleke kakhulu ukukhuluma ngokukhululekile nodokotela wakho ngomlando wakho wezokwelapha ophelele, eminye imithi oyithathayo, kanye nokungezwani komzimba.
- Uma uba nezimpawu ezinkulu njengobunzima bokuphefumula noma ukopha okukhulu, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela ngokushesha.
- Akufanele neze ushintshe umthamo wemithi noma uyeke ukwelashwa ngaphandle kweseluleko sikadokotela wakho.
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