Uma udokotela wakho ekutshela noma othandekayo wakho ukuthi unomdlavuza, kuvamile ukuzizwa wesaba futhi ukhathazekile kancane uma uzwa amagama athi "ukwelashwa ngemisebe" lapho ukhuluma ngokwelashwa okulandelayo. Uma sizwa igama elithi "ukwelashwa ngemisebe", kufika isithombe esesabekayo engqondweni yethu. Kodwa empeleni, ngobuchwepheshe banamuhla, lokhu kwelashwa kuthuthukile kakhulu futhi kuphephile. Ngakho-ke namuhla, ake sixoxe ngendlela eyinhloko nesetshenziswa kakhulu yokwelashwa ngemisebe, `Ukwelashwa Ngemisebe Yangaphandle` noma `(EBRT)`. Ngiyaqiniseka ukuthi ngesikhathi uqeda ukufunda lesi sihloko, uzobe usulahlekelwe ukwesaba kwakho ngalokhu futhi uzoba nokuqonda okucacile.
Kalula nje, kuyini i-External Beam Radiation Therapy (EBRT)?
Kulula kakhulu. Lolu uhlobo oluyinhloko lokwelashwa ngemisebe olusetshenziswa ukulwa nomdlavuza. Luhilela ukuthi ulale embhedeni okhethekile kanye nomshini omkhulu othumela umsebe wemisebe olawulwa kahle kakhulu kumdlavuza.
Into ebaluleke kakhulu ukuthi, lo mshini awushayi ndawo emzimbeni wakho . Usebenza kude. Uma sikhuluma iqiniso, lo mshini wenzelwe ukubhubhisa amangqamuzana omdlavuza kuphela, ngenkathi unciphisa umonakalo kumaseli anempilo.
Cabanga ukuthi amangqamuzana omdlavuza angaphakathi emzimbeni wakho ayizisulu ezincane. Lo mshini we-EBRT ufana nesibhamu esikhulu esingadubula kulowo mgomo ngokunemba okukhulu. Ubhubhisa isisulu ngaphandle kokulimaza amangqamuzana angenacala (aphilile) azungezile.
Lokhu kwelashwa kusebenza kanjani emzimbeni?
Lokhu kwelashwa kusebenzisa imishayo enamandla aphezulu. Le mishayo ingadala izinhlayiya ezinamandla, ezishaje kakhulu ezingabulala amangqamuzana omdlavuza. Ezinye izinhlobo zemishayo zingangena zijule emzimbeni wakho, zithinte amangqamuzana omdlavuza kanye namaseli aphilile aseduze. Kodwa umgomo oyinhloko wodokotela ukuqondisa amangqamuzana omdlavuza kuphela ngenkathi kunciphisa ukulimala kwezicubu ezinempilo.
Kunezinhlobo eziningana eziyinhloko zezinhlayiya ezisetshenziswa kulokhu. Ake sibheke ukuthi ziyini.
| Uhlobo Lwezinhlayiya Ezisetshenzisiwe | Incazelo elula |
|---|---|
| Ama-photon - isib. ama-X-ray, imisebe ye-gamma | Lezi yizona ezisetshenziswa kakhulu. Zingangena zijule emzimbeni futhi zibhubhise amangqamuzana omdlavuza. |
| Ama-Proton | Lokhu kuyayeka lapho kufika esimila somdlavuza. Ngakho-ke, umonakalo ezicutshini ezizungezile eziphilile mncane kakhulu. Kodwa-ke, lobu buchwepheshe busatholakala ezindaweni ezimbalwa emhlabeni kuphela. |
| Ama-electron | Lezi azingeni kakhulu emzimbeni, ngakho-ke zisetshenziswa kakhulu ukwelapha umdlavuza wesikhumba noma umdlavuza ongaphandle kwesikhumba. |
Iningi lezindlela zokwelapha ze-EBRT zisebenzisa umshini obizwa ngokuthi i-`linear accelerator` (LINAC).
Yiziphi izimo ezisetshenziswa ukwelashwa kwe-EBRT?
Odokotela basebenzisa le ndlela yokwelapha ngezinjongo eziningana eziyinhloko.
- Kubhubhisa amangqamuzana omdlavuza noma kuvimbele ukusabalala kwezinye izingxenye zomzimba.
- Njengesengezo kwezinye izindlela zokwelapha. Isibonelo, ukunciphisa isimila ngaphambi kokuhlinzwa, noma ukuqeda ngokuphelele noma yimaphi amangqamuzana omdlavuza asele ngemva kokuhlinzwa noma ukwelashwa ngamakhemikhali.
- Ukuqeda izimpawu. Ngezinye izikhathi, lokhu kwelashwa kusetshenziselwa ukunciphisa izimila ezibangela ubuhlungu noma okunye ukungakhululeki futhi kunikeze isiguli impumuzo. Lokhu sikubiza nangokuthi 'ukunakekelwa kobuhlungu'.
Lokhu kwelashwa kusetshenziselwa kakhulu umdlavuza otholakala endaweni ethile noma ezindaweni eziningi. Isibonelo:
- Umdlavuza webele, wamathumbu amakhulu, wamaphaphu, we-prostate, wesibeletho, kanye nowekhanda nentamo
- Umdlavuza ofana ne-leukemia kanye ne-'Non-Hodgkin lymphoma'
Ingabe kunezinhlobo ezahlukene zokwelapha nge-EBRT?
Yebo. I-EBRT ihlukaniswe ngezindlela eziningana zokwelapha ngokusekelwe endleleni umsebe wemisebe owakhiwe ngayo, oqondiswa ngayo, futhi oqondiswe ngayo. Lezi zinobuchwepheshe obuthile, kodwa uma uziqonda kalula, zizokusiza kakhulu.
| Igama lendlela yokwelapha | Kwenzekani ngalokhu? |
|---|---|
| Ukwelashwa ngemisebe ye-3D conformal | Kusetshenziswa into efana ne-CT scan, kudalwa imodeli yesimila enezinhlangothi ezintathu (3D). Ngemuva kwalokho, imisebe eminingana evela ema-engeli ahlukene iyalungiswa ukuze ifane nesimo sesimila bese ihlaselwa. |
| Ukwelashwa ngemisebe okuguquliwe ngamandla (i-IMRT) | Lena indlela ethuthuke kakhulu. Isebenzisa imisebe esizwa yikhompyutha enamandla ahlukahlukene ukuze ilethe umthamo omkhulu wemisebe esigaxeni somdlavuza ngenkathi isindisa izicubu ezinempilo. |
| Ukwelashwa ngemisebe okuqondiswa yizithombe (IGRT) | Ngesikhathi sokwelashwa, amasu okuthwebula izithombe afana nokuskena asetshenziswa ukunquma ngokunembile indawo yesimila. Uma indawo yesimila ishintsha kancane, umsebe uyalungiswa ngokufanele ukuqinisekisa ukuthi uqondiswe endaweni efanele. |
| Ukwelashwa nge-Tomotherapy | Indlela lapho imisebe yemisebe iqondiswa khona esimila ngendlela ejikelezayo njengoba uhamba ngomshini ofana nedonathi. |
| Ukuhlinzwa kwe-Stereotactic radiosurgery | Nakuba igama lithi "ukuhlinzwa," lokhu akusikho ukuhlinzwa empeleni. Kuyindlela yokunikeza imithamo ephezulu yemisebe ezinhlamvini ezincane ebuchosheni, ngaphandle kokuhlinzwa. |
| Ukwelashwa ngemisebe yomzimba ye-stereotactic (SBRT) | Lokhu kufana nendlela okukhulunywe ngayo ngenhla, kodwa isetshenziselwa izimila ezingaphandle kobuchopho, kwezinye izingxenye zomzimba (isib. amaphaphu, isibindi, umgogodla). Lokhu kuwusizo kakhulu ezimweni lapho ukuhlinzwa kungenzeki khona. |
| Imisebe Yesikhathi Sokuhlinzwa (IORT) | Lokhu kwelashwa kunikezwa ngesikhathi sokuhlinzwa. Kuletha imisebe ngqo ezindaweni zomdlavuza ezazingenakukwazi ukususwa ngokuphelele, kuyilapho kulondolozwa izicubu ezinempilo ezizungezile. |
Kwenzekani ngaphambi kokwelashwa? Ukulungiselela (Ukulingisa)
Ngaphambi kokuba ukwelashwa kwakho kuqale, kunesigaba sokuhlela esibizwa ngokuthi 'ukulingisa.' Lokhu kwenzelwa ukuqinisekisa ukuthi konke kuhlelwe kahle ngesikhathi sokuqala sokwelashwa nokukunikeza ukuqonda okucacile kwalokho okuzokwenzeka.
Kulokhu 'kulingisa', izinto ezilandelayo zenzeka:
- Indawo olaliswa kuyo: Indawo olaliswa kuyo ngesikhathi sokwelashwa yindawo efanayo olaliswa kuyo namanje.
- Ukuskena: Kwenziwa i-CT, i-MRI, noma i-PET scan ukuthola indawo eqondile yesimila sakho nokunquma i-engeli lapho imisebe yemisebe kufanele iqondiswe khona.
- Ukumaka isikhumba: Ukuze kutholakale ukuthi umsebe wemisebe uzoqondiswa kuphi, kufakwa uphawu oluncane kakhulu, olufana namachashazi esikhumbeni sakho, olufana ne-tattoo. La machashazi azohlala endaweni yawo kuze kube sekupheleni kwesikhathi sokwelashwa.
- Izinto ezisiza ekubekeni: Izinto ezifana nemaski noma i-cast zingenziwa ukuze zikulingane ukuze zikusize uhlale unganyakazi ngesikhathi sokwelashwa.
Lokhu 'kulingisa' kungathatha isikhathi eside kuneseshini yokwelashwa evamile, kusukela kumaminithi angu-30 kuya emahoreni amabili. Bese kuthi, ezinsukwini noma emavikini ambalwa, ithimba lakho lezokwelapha lisebenzise lolu lwazi ukudala uhlelo lokwelashwa oluqondene nawe ngqo.
Kwenzekani ngempela ngesikhathi sokwelashwa?
I-EBRT akuyona inqubo yokulaliswa esibhedlela, okusho ukuthi ungaya ekhaya ngalolo suku othola ngalo ukwelashwa.
Nakhu ongakulindela ngesikhathi seseshini ngayinye yokwelashwa:
1. Uzobekwa endaweni efanayo naleyo owawukuyo ekulingiseni. Uzosekelwa njengoba kudingeka ukuze uhlale uthule futhi ukhululekile.
2. Ngemva kokuthi ubekwe endaweni efanele, uchwepheshe (uchwepheshe wezokwelapha) uzophuma egumbini avule umshini.
3. Ungakhathazeki! Ukubhekile usebenzisa i-monitor. Ungakhuluma naye nge-'intercom'.
4. Umshini uhambahamba eduze kwakho buthule, uqondisa imisebe yemisebe ngqo esimila somdlavuza.
5. Kubaluleke kakhulu ukuthi uhlale unganyakazi phakathi nalesi sikhathi. Kodwa ungaphefumula ngendlela evamile.
6. Imisebe ayinikezwa njalo, kodwa inikezwa ngokushesha okukhulu.
Ingabe lokhu kuyalimaza?
Cha. Ngeke uzwe imisebe. Kodwa ungase uzwe umsindo othi "chofoza" noma umsindo wokushaya umlozi ovela emshinini. Ungase ubone ukukhanya (ikakhulukazi lapho welapha ubuchopho). Ungase futhi uzwe iphunga elingavamile. Konke lokhu kujwayelekile futhi akulona ingozi.
Kuthatha isikhathi esingakanani ukwelashwa?
Uhlelo lwakho lokwelashwa luzoncika ohlotsheni, usayizi, kanye nendawo yomdlavuza wakho. Ukwelashwa kuvame ukunikezwa nsuku zonke (izinsuku ezinhlanu ngesonto) amasonto amaningana. Udokotela wakho womdlavuza wemisebe uzochaza ngokucacile uhlelo lwakho lokwelashwa kanye nobude besikhathi.
Yiziphi izinzuzo kanye nemiphumela engemihle engaba khona yalokhu kwelashwa?
Ukwelashwa ngemisebe sekusetshenziswe iminyaka engaphezu kweyikhulu. Ngobuchwepheshe obutholakalayo namuhla, sekuphephile futhi kunembe kakhulu. Izinzuzo eziyinhloko zokwelashwa nge-EBRT yilezi:
- Ukubhubhisa amangqamuzana omdlavuza.
- Ukuvimba noma ukulawula ukukhula kwezimila ezinomdlavuza.
- Ukuvimbela umdlavuza ukuthi ungabuyi.
- Ukuqeda izimpawu futhi uthuthukise ikhwalithi yokuphila.
Kodwa njengakwelinye icala lemali, amangqamuzana aphilile eduze kwendawo elashwa ngemisebe nawo angathinteka. Yingakho kuvela imiphumela emibi.
Umphumela ovame kakhulu ukukhathala . Eminye imiphumela emibi incike endaweni yomzimba wakho ophathwayo. Eminye yayo ihlanganisa:
- Isicanucanu noma ukuhlanza
- Isifiso sokudla
- Ikhanda elibuhlungu
- Ukulahlekelwa izinwele (kuphela endaweni ephathwayo)
- Ubunzima bokugwinya
- Ubunzima bokuphefumula
- Ukubomvu, ukulunywa, noma ubuhlungu esikhumbeni (njengokushiswa yilanga)
- Ukuvuvukala noma ukuvuvukala endaweni yokwelashwa
Into ebaluleke kakhulu: Akuwona wonke umuntu othola le miphumela emibi. Ngisho nabantu ababili abanomdlavuza ofanayo bangathola imiphumela emibi ngendlela ehlukile. Ithimba lakho lezokwelapha lizokusiza ukuthi ulawule lokhu.
Kuzongithatha isikhathi esingakanani ukuthi ngilulame?
Lokhu kuyahlukahluka kuye ngomuntu nomuntu. Abanye abantu bangaqhubeka nemisebenzi yabo evamile ngenkathi bethola ukwelashwa. Abanye bangadinga izinsuku zokuphumula, ikakhulukazi uma bezizwa bekhathele kakhulu.
Imiphumela emibi ivame ukwanda ngokuhamba kwesikhathi. Lokhu kungenxa yokuthi amangqamuzana omdlavuza awafi ngokushesha ngemva kokukhishwa kwemisebe. Kuthatha izinsuku noma amasonto ukuthi aqale ukufa. Ngakho-ke ungase ungazizwa ungakhululekile ekuqaleni, kodwa kancane kancane ungase uzizwe ukhathele njengoba ukwelashwa kuqhubeka.
Ngisho nangemva kokwelashwa, izikhathi zokululama ziyahlukahluka. Abanye abantu bayalulama phakathi namasonto ambalwa. Kwabanye, kungathatha izinyanga eziningana.
Yini engingayenza ukuze ukwelashwa kube lula?
Cela ithimba lakho lezokwelapha iseluleko esithile esisekelwe ohlelweni lwakho lokwelashwa. Ngokuvamile, lezi zinto zizokusiza:
- Phumula ngokwanele. Ukukhathala kuyimbangela enkulu yalolu hlobo lokwelashwa. Ngakho-ke lala futhi uphumule ngangokunokwenzeka.
- Yidla ukudla okunomsoco.Ukudla okunempilo kubalulekile ukuze umzimba ululame.
- Phuza amanzi amaningi. Kubalulekile ukuvimbela ukuphelelwa amanzi emzimbeni.
- Lalela umzimba wakho. Uma ukhathele, sebenza kancane. Yenza kuphela lokho ongakwenza.
Tshela ithimba lakho lezokwelapha nganoma yiziphi izimpawu ozizwayo. Bakhona ukukusiza ukuthi uphathe imiphumela emibi futhi bakwenze uzizwe ukhululekile ngangokunokwenzeka.
Kufanele ngishayele nini udokotela wami ucingo?
Ngaphambi kokuqala ukwelashwa, khuluma nodokotela wakho mayelana nemiphumela emibi ongayilindela, kanye nanoma yiziphi izimpawu ezingaba yinkinga. Ngokuvamile, tshela udokotela wakho ngokushesha uma uhlangabezana nanoma yikuphi kwalokhu okulandelayo:
- Uma kuvela izimpawu ezingalindelekile noma ezinzima .
- Uma imiphumela emibi iba mibi ngokuzumayo.
- Uma ubonisa izimpawu zokutheleleka, njengomkhuhlane, ukubanda, nokuthuthumela .
- Uma unenkinga yokuphefumula noma ubuhlungu esifubeni .
Ukusekelwa kwakho okungcono kakhulu yithimba lakho lezokwelapha. Unganqikazi ukukhuluma nabo nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho, ngesikhathi noma ngemva kokwelashwa kwakho.
Umlayezo Wokuya Nawe Ekhaya
- Ukwelashwa Ngemisebe Yangaphandle (i-EBRT) kuyindlela yokwelapha enembile kakhulu futhi ephumelelayo esetshenziswa kabanzi kumdlavuza.
- Akukho ubuhlungu ngesikhathi sokwelashwa, kodwa imiphumela emibi efana nokukhathala kanye noshintsho lwesikhumba ingase ivele.
- Kubaluleke kakhulu ukukhuluma ngokukhululekile nodokotela wakho noma ithimba lezokwelapha nganoma yikuphi ukungakhululeki noma imiphumela emibi ongase ube nayo.
- Kubalulekile ukuphumula ngokwanele, ukudla ukudla okunomsoco, nokuphuza amanzi anele phakathi nalesi sikhathi.
- Kuvamile ukwesaba ukwelashwa komdlavuza. Kodwa khumbula, ngenxa yobuchwepheshe obuthuthukisiwe banamuhla, lokhu kwelashwa kuphephile kakhulu kunakuqala. Ithimba lakho lezokwelapha lihlala likulungele ukukusiza.
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