Yiziphi izindlela zokwelapha umdlavuza wekholoni wesigaba sesine?

Kunzima ukusho ngamazwi ukwesaba nokushaqeka okuhambisana nokutholwa unomdlavuza weSigaba sesi-4. Kuvamile ukuzibuza, "Ingabe konke sekuphelile manje?" Kodwa ake ngikutshele, akuphelile. Isayensi yezokwelapha isithuthuke kakhulu. Ngisho nakulesi sigaba, kunezindlela eziningi zokwelapha ezingakusiza uphile isikhathi eside, ulawule izimpawu zakho, futhi uhlale uphilile. Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda.

Kuyini 'Isigaba IV'?

Kalula nje, iSigaba IV sisho ukuthi umdlavuza ususakazeke ngale kwekholoni , lapho waqala khona. Lokhu kuvame kakhulu esibindini . Ungasakazeka futhi emaphashini, olwelwesini lwesisu, noma kuma-lymph node kwenye indawo emzimbeni.

Kungaba nzima ukuthola ukwelashwa okuphelele kulesi sigaba. Kodwa-ke, uma umdlavuza ususakazekele ezindaweni ezimbalwa kuphela, ngezinye izikhathi ukuhlinzwa kungenziwa ukuze kususwe ngokuphelele lezo zindawo futhi kwelashwe lesi sifo. Ngakho-ke, kungcono ukubona udokotela ochwepheshe ekwelapheni lolu hlobo lwesimo. Ukwelashwa okutholayo kuzonqunywa yizici eziningi, njengendawo yomdlavuza, iminyaka yakho, kanye nempilo yakho iyonke.

Kunezindlela eziningana zokwelapha eziyinhloko ezisetshenziswayo:

• Ukuhlinzwa
• Ukwelashwa ngamakhemikhali
• Ukwelashwa ngemisebe
• Ukwelashwa nge-Ablation kanye ne-cryotherapy
• Ukwelashwa okuqondiwe
• Ukwelashwa nge-immunotherapy

Ngokuvamile, unikezwa okungaphezu kokukodwa kwalokhu kwelashwa, noma inhlanganisela yezindlela eziningana.

Kwenziwani ngokuhlinzwa?

Uma umdlavuza ususakazekele esibindini noma emaphashini akho, ukuhlinzwa kungenziwa ngezinye izikhathi. Njengoba ngishilo ekuqaleni, uma umdlavuza ulinganiselwe, ukuhlinzwa kungawususa futhi ungalulama ngokugcwele . Kwezinye izimo, ukuhlinzwa kungaba wusizo ekunciphiseni izimpawu ezibangelwa umdlavuza, njengobuhlungu nokuvaleka kwamathumbu.

Ngesikhathi sokuhlinzwa, udokotela ususa ingxenye yamathumbu amakhulu, isibindi, noma iphaphu lapho umdlavuza ukhona khona. Ngesikhathi esifanayo, ama-lymph node azungezile ayasuswa. Lokhu kungenxa yokuthi amangqamuzana omdlavuza angasakazeka kalula kwezinye izingxenye zomzimba ngalezi lymph node.

Ngemva kokususa ingxenye yomdlavuza yekholoni, udokotela uzoxhumanisa kabusha iziphetho ezimbili zekholoni esele. Ngemuva kwalokho ungaba nokunyakaza kwamathumbu ngokujwayelekile. Kodwa-ke, ngezinye izikhathi uma lokhu kuxhumana kungenzeki, kungadingeka ukuthi wenze i-colostomy . Lokhu kuhilela ukuxhuma ingxenye eyodwa yekholoni nomgodi owenziwe esikhumbeni sesisu. Indle iphuma ngaleyo mbobo. Indle iqoqwa esikhwameni esinamathiselwe kuso.

Ngezinye izikhathi, uma ingxenye enkulu yekholoni isuswa, ingxenye yokugcina yamathumbu amancane ixhumene nesikhumba sesisu. Lokhu kubizwa ngokuthi i-ileostomy . Kodwa-ke, kungase kube nobuhlungu ngemva kokuhlinzwa. Ungase futhi uzwe isifo sohudo noma ukuqunjelwa. Le miphumela emibi izophela ngemva kwesikhashana.

Uma amathumbu evalwe umdlavuza, kungafakwa ithubhu elincane elibizwa ngokuthi i- stent ukuze lihlale livulekile.

Kuyini ukwelashwa ngamakhemikhali?

Ukwelashwa ngamakhemikhali, noma 'i-chemo' njengoba sikubiza kanjalo, uhlobo olunamandla lomuthi olunikezwa ukubulala amangqamuzana omdlavuza. Lo muthi unganikezwa ngemithambo noma njengephilisi.

Ukwelashwa ngamakhemikhali kunikezwa ngezindlela eziningana eziyinhloko:

• Ngaphambi kokuhlinzwa, izimila ezinomdlavuza zingancishiswa ukuze kube lula ukuzisusa.
• Ngemva kokuhlinzwa, bhubhisa noma yimaphi amangqamuzana omdlavuza angase ahlale emzimbeni.
• Njengokwelashwa okuyinhloko kwalabo abangakwazi ukuhlinzwa.

Kunezinhlobo eziningana zemithi ye-chemo enikezwa umdlavuza wamathumbu wesigaba sesi-4. Ngezinye izikhathi imithi engaphezu kweyodwa inikezwa ngokuhlangene. Futhi, i-chemo inikezwa ngokuhlangene 'nokwelashwa okuqondiwe', esizoxoxa ngakho kamuva.

Into eyodwa abantu abaningi abayesabayo uma bezwa nge-chemo ukulahlekelwa izinwele zabo. Kodwa-ke,Ukwelashwa ngamakhemikhali komdlavuza wamathumbu ngokuvamile akubangeli ukulahleka kwezinwele. Ungakhathazeki ngale miphumela emibi. Udokotela wakho angakusiza ukuthi uyilawule futhi ayenze ikhululeke kakhudlwana. Le miphumela emibi izophela kancane kancane uma ukwelashwa kwakho sekuphelile.

Uma umdlavuza ususakazekele esibindini, i-chemotherapy inganikezwa kusetshenziswa indlela ekhethekile ebizwa ngokuthi "i-hepatic artery infusion chemotherapy." Lokhu kuhilela ukufaka i-chemotherapy ngqo emthanjeni wegazi oyinhloko ohlinzeka ngegazi esibindini kusetshenziswa iphampu. Ngenxa yokuthi umuthi uya ngqo esibindini kunokuba uhambe emzimbeni wonke, le ndlela inganciphisa imiphumela emibi futhi inikeze umthamo ophezulu womuthi.

Ukwelashwa ngemisebe nezinye izindlela

Ukwelashwa Ngemisebe

Lokhu kuhilela ukusebenzisa ama-X-ray anamandla amakhulu ukubhubhisa amangqamuzana omdlavuza. Nakuba lokhu kwelashwa kungenakwenzeka ukuthi kwelaphe ngokuphelele umdlavuza wesigaba sesi-4, kungasiza ekunciphiseni isimila futhi kunciphise izimpawu ezifana nobuhlungu . Lokhu kwelashwa kuvame ukunikezwa izinsuku ezi-5 ngesonto amasonto amaningana.

Ukwelashwa Kokukhuculula kanye Nokucryotherapy

Zombili lezi zindlela zivame ukusetshenziswa kakhulu ukubhubhisa amangqamuzana omdlavuza asakazekele esibindini. I-Ablation isebenzisa ukushisa , kuyilapho i-cryotherapy isebenzisa ukubanda okukhulu . Esebenzisa i-CT noma i-ultrasound scan, udokotela uthumela ithuluzi elincane elifana nenaliti esigaxeni bese elifudumeza noma aliqandise ukuze abhubhise amangqamuzana omdlavuza.

Ukwelashwa Okuqondiwe kanye Nokwelashwa Ngezifo Ezingahlosiwe - Ukwelashwa Okusezingeni Eliphezulu

Lezi izindlela ezimbili ezintsha neziphumelela kakhulu ekwelapheni umdlavuza.

Ukwelashwa Okuqondiwe

Kalula nje, le mithi ihlasela ngqo amangqamuzana omdlavuza. Ivimba izinto amangqamuzana omdlavuza azidingayo ukuze akhule futhi asakazeke. Lokhu kubangela umonakalo omncane kakhulu kumangqamuzana anempilo.

• Imithi yokulwa ne-angiogenesis: Le mithi isebenza ngokuvimbela ukukhula kwemithambo yegazi emisha ephakela umdlavuza. Kufana nokuvimbela umdlavuza ekudleni. I-Bevacizumab (Avastin) kanye ne-Ramucirumab (Cyramza) yimithi enjalo.
• Ama-inhibitor e-EGFR: Imithi efana ne-Cetuximab (Erbitux) kanye ne-Panitumumab (Vectibix) ivimba iphrotheni ebizwa nge-EGFR esiza amangqamuzana omdlavuza ukuba akhule. Kodwa-ke, ukuze le mithi isebenze, umdlavuza kumele ube nokuguqulwa kwezakhi zofuzo ezithile (i-KRAS, i-NRAS, i-BRAF). Udokotela wakho uzohlola ukuze abone ukuthi le mithi ikulungele yini.
• Eminye imithi: Imithi yesimanje efana ne-Encorafenib (Braftovi) kanye ne-Entrectinib (Rozlytrek) nayo iyatholakala namuhla, ihlose umdlavuza onezinguquko ezithile zofuzo njenge-BRAF, NTRK, kanye ne-RET.

Ukwelashwa nge-immunotherapy

Lokhu kuyindlela yokwelapha emangalisayo kakhulu. Okwenzayo lapha ukuvuselela amasosha omzimba wakho bese uwasebenzisa ukulwa namaseli omdlavuza.

Isimiso sethu somzimba sokuzivikela sinamaprotheni abizwa ngokuthi i-PD-1 asebenza njengamabhuleki. Amaseli omdlavuza asebenzisa la mabhuleki ukuze agweme isimiso somzimba sokuzivikela. Imithi yokuvimbela amasosha omzimba efana ne-Nivolumab (Opdivo) kanye ne-Pembrolizumab (Keytruda) isebenza ngokuvala la mabhuleki. Lokhu kuvumela isimiso somzimba sokuzivikela ukuthi siqaphele futhi sihlasele umdlavuza.

Uhlelo lwakho lokwelashwa

Uhlobo lokwelashwa olutholayo luncike ezintweni eziningi. Udokotela wakho uzokwakha uhlelo lokwelashwa oluqondene nawe ngqo, ecabangela izici ezifana nokuthi umdlavuza usakazeke kuphi, ubudala bakho, impilo yakho iyonke, kanye nezici zofuzo zomdlavuza.

Ungase futhi ube nethuba lokubamba iqhaza ezivivinyweni zemitholampilo ezihlola imithi emisha kanye nokwelashwa emhlabeni jikelele. Leli yithuba elihle lokuzama ukwelashwa okusha. Khuluma nodokotela wakho ngalokho futhi.