Uma sizwa ukuthi sinomdlavuza, bese sikhuluma ngokwelashwa, sivame ukwesaba, akunjalo? Ikakhulukazi ngemiphumela emibi. Kodwa indlela yokwelapha esizokhuluma ngayo namuhla, ebizwa ngokuthi i-immunotherapy, ihluke kancane ezindleleni zendabuko ezifana ne-chemotherapy. Isebenzisa ibutho lakho, okungukuthi, isimiso somzimba sokuzivikela, ukulwa namaseli omdlavuza. Ngakho ake sibheke lokhu kwelashwa okuhle kanye nemiphumela emibi engaba khona, kalula, ukuze uqonde.
Kuyini ukwelashwa nge-immunotherapy?
Kalula nje, i-immunotherapy iwukwelashwa okusebenzisa uhlelo lokuzivikela lwemvelo lomzimba wakho, uhlelo lokuzivikela, ukuthola nokubhubhisa amangqamuzana omdlavuza. Cabanga ngakho njengombutho wamaphoyisa ngaphakathi emizimbeni yethu. Umsebenzi wawo ukuthola nokubhubhisa izinto eziyingozi njengamagciwane, amagciwane, kanye namangqamuzana angajwayelekile akhula emizimbeni yethu, okusigcina siphilile.
Kodwa amangqamuzana omdlavuza awuhlobo lweseli olunobuqili kakhulu. Angacasha kulesi simiso sokuzivikela komzimba ngaphandle kokubanjwa. Njengoba nje isela licasha emaphoyiseni. Uma selicashile kanjalo, lihlukana ngokushesha, lisakazeke, futhi libangele inkinga enkulu.
Ngakho-ke lokho okwenziwa yi-immunotherapy ukunikeza amasosha omzimba wakho ukuqeqeshwa okukhethekile kanye nokukhuthaza , okwenza abe namandla okulwa namaseli omdlavuza. Lokhu kungenzeka ngezindlela ezimbili:
- Kuvuselela amasosha omzimba wakho futhi kuwenze akhiqize amaseli amaningi alwa nomdlavuza.
- Kusiza amangqamuzana omzimba akhona ukuthi abone futhi abhubhise ngokunembile amangqamuzana omdlavuza afihliwe.
Ngenxa yokuthi iqinisa isimiso sokuzivikela somzimba wakho, ukwelashwa nge-immunotherapy sekuyindlela yokwelapha ephumelela kakhulu yezinhlobo eziningi zomdlavuza.
Kungani ukwelashwa nge-immunotherapy kubangela imiphumela emibi?
Njenganoma yikuphi ukwelashwa, ukwelashwa nge-immunotherapy kungaba nemiphumela emibi. Isizathu salokhu silula. Njengoba sishilo ngaphambili, lokhu kwelashwa kusebenza ngokushaja kakhulu amasosha omzimba. Ngakho-ke, lawa maseli omzimba asebenza ngokweqile ngezinye izikhathi angaqala ngephutha ukuhlasela hhayi amangqamuzana omdlavuza kuphela, kodwa namaseli akho aphilile .
Cabanga ngakho njengonogada oshisekayo kakhulu ohlasela ngephutha omunye wakhe, ecabanga ukuthi yisitha.
Lokhu kuhlasela kwezicubu ezinempilo kubizwa ngokuthi `umphumela omubi ohlobene nokuzivikela komzimba (irAE).` Yilokhu okubangela ukuvuvukala kwezicubu ezinempilo, bese uqala ukukuzwa ngesimo semiphumela emibi eyahlukahlukene.
Zivame kangakanani lezi zinkinga?
Ungakhathazeki ngalokhu. Akuwona wonke umuntu othola imiphumela emibi. Cishe ama-20% abantu abathatha i-immunotherapy bahlangabezana nalolu hlobo lwe-'irAE'. Futhi, imiphumela eminingi emibi eyenzeka ilula kakhulu futhi kulula ukuyilawula.
Kodwa into ebaluleke kakhulu ukutshela udokotela wakho ngokushesha nganoma yiziphi izinguquko oziqaphelayo emzimbeni wakho, kungakhathaliseki ukuthi ngesikhathi noma ngemva kokwelashwa nge-immunotherapy. Akunandaba ukuthi kuncane kangakanani, kungcono ngaso sonke isikhathi ukwaziwa.
Ungase ube namathuba amaningi okuba nemiphumela emibi uma uthatha imithi eminingi yokwelapha nge-immunotherapy ngesikhathi esisodwa, noma uma usuvele unesifo sokuzivikela komzimba. Isifo sokuzivikela komzimba yisimo lapho amasosha omzimba wakho ehlasela khona ngephutha izicubu zakho ezinempilo.
Yimiphi imiphumela emibi evame kakhulu?
Imiphumela emibi evame kakhulu yile:
- Ukukhathala: Ukuzizwa ukhathele kakhulu kuze kube sezingeni lokungakwazi ukwenza lutho.
- Ukuqhuma okulumayo: Ukuqhuma okubomvu, okulumayo esikhumbeni.
- Uhudo: Ukunyakaza kwamathumbu.
- Ukucanuzela nokuhlanza: Ukuzizwa ugula futhi uhlanza.
- Ukwehla kwamazinga e-hormone ye-thyroid: Ukusebenza kahle kwe-thyroid gland.
Ukwelashwa nge-immunotherapy kuthinta kanjani izitho ezahlukene zomzimba?
Njengoba amasosha omzimba ethu evikela umzimba wonke, lolu hlelo, oluqiniswa yi-immunotherapy, lungathinta noma yisiphi isitho emzimbeni. Nakuba iningi lalezi zimpawu lincane, ezinye zingaba zimbi kakhulu. Ngakho-ke, kubalulekile ukwazisa udokotela wakho nganoma yiziphi izimpawu .
Ukuze kube lula ukuqonda, ake sihlukanise le miphumela ngezinhlelo zomzimba lapho ingenzeka khona.
| Uhlelo/isitho somzimba esingase sithinteke | Imiphumela/izimpawu ezingaba khona |
|---|---|
| Isikhumba | Kungaba njengokusabela kokungezwani komzimba esikhumbeni. Kungabangela ukubomvu, ukulunywa, amaqhubu, ukuqhekeka, izilonda ezibuhlungu, kanye nokuzwela ukukhanya kwelanga. |
| Isistimu Yesibindi Nesisu | Amazinga e-enzyme yesibindi angakhuphuka. Ngezinye izikhathi, i-hepatitis ingavela, okubangela ukuphuzi kwamehlo, umchamo omnyama, ubuhlungu besisu ohlangothini lwesokudla, ukuhlanza, kanye nengozi eyengeziwe yokopha. I-Colitis nayo ingavela, okubangela uhudo, indle enegazi, kanye nobuhlungu besisu. |
| Amaphaphu | Akuvamile ukuthi kube nokuvuvukala kwamaphaphu (i-pneumonia) . Izimpawu zifaka phakathi ukukhwehlela, ubuhlungu besifuba, kanye nobunzima bokuphefumula. |
| Uhlelo lwe-thyroid kanye ne-Endocrine | Izindlala ezikhiqiza ama-hormone zingathinteka, ikakhulukazi indlala ye-thyroid. Kungaba nokukhiqizwa okunganele kwama-hormone (i-Hypothyroidism) noma, ngokungavamile, ukukhiqiza ngokweqile (i-Hyperthyroidism) . Izimpawu zingase zihlanganise ukulahleka kwezinwele, isiyezi, ikhanda elibuhlungu, ukushintsha kwesisindo, ukujuluka ngokweqile, ukushaya kwenhliziyo okwandayo, kanye nendlala/ukoma okwandayo. |
| Ubuchopho kanye neSistimu Yezinzwa | Lokhu nakho akuvamile kakhulu. I-Encephalitis ingabangela umkhuhlane, ukuziphatha okungavamile, ukuqina kwentamo, kanye nokuxhuzula. I-neuropathy ingabangela ukungazweli, ukuqaqamba, noma ubuthakathaka ezingalweni, emilenzeni, noma ebusweni. |
| Isistimu Yenhliziyo Nemithambo Yenhliziyo | Ukusebenza kwenhliziyo kungathinteka. Ukushaya kwenhliziyo okungajwayelekile (i-Arrhythmia) , ukuvuvukala kwemisipha yenhliziyo (i-Myocarditis) , kanye nokuvuvukala kwemithambo yegazi (i-Vasculitis)Izimo ezinjalo zingase zenzeke kaningi. |
| Amalunga | I-arthritis ingabangela ukuvuvukala nobuhlungu emalungeni. |
Ingabe imiphumela emibi iyahlukahluka kuye ngohlobo lwe-immunotherapy?
Yebo, imiphumela emibi ongase uyizwe ingahluka kuye ngohlobo lwe-immunotherapy olutholayo. Ake sibheke ezinye zezinhlobo eziyinhloko.
Ama-Immune Checkpoint Inhibitors (ICI)
Lolu uhlobo oluvame ukusetshenziswa kakhulu. Le mithi isebenza ngokuvimba 'izibonakaliso' ezisetshenziswa amangqamuzana omdlavuza ukuze acashe kumaseli omzimba (amaseli e-T). Lokhu kusho ukuthi amangqamuzana omdlavuza awasakwazi ukufihla. Imiphumela emibi evame kakhulu yalolu hlobo ukukhathala, uhudo, kanye nokuqubuka kwesikhumba.
Ukwelashwa Kwamaseli Okutholwa (ukwelashwa kokudluliselwa kwamaseli e-T)
Lena inqubo eyinkimbinkimbi kancane. Okwenzayo lapha ukukhipha ama-T-cell (amaseli alwa nomdlavuza) emzimbeni wakho, uwashintshele elebhu, "uwaqeqeshe" ukuthi aqaphele kangcono amaseli omdlavuza, bese uwabuyisela emzimbeni wakho.
- Ohlotsheni lokwelashwa kwe-CAR T-cell , isimo esibizwa ngokuthi i-'Cytokine Release Syndrome (CRS)' singavela. Kulokhu, isimiso somzimba sokuzivikela sisebenza ngokweqile ngokuzumayo, okubangela izimpawu ezifana nomkhuhlane, ikhanda elibuhlungu, kanye nobunzima bokuphefumula. Kodwa odokotela bakho bayazi ukuthi bangasiphatha kanjani lesi simo.
Ama-Antibodies e-Monoclonal
Lawa amaprotheni akhethekile enziwa elebhu. Aklanyelwe ukuhlasela nokuhlasela ubuthakathaka obuthile emangqamuzaneni omdlavuza. Angabangela izimpawu ezifana nomkhuhlane njengomkhuhlane, izinhlungu zomzimba, izinguquko ekucindezelweni kwegazi, kanye nezilonda zesikhumba.
Imithi Yokwelapha
Lokhu kufana nemithi yokugoma esiyithola ngaphambi kokuba sigule. Kodwa le mithi isetshenziswa ngemva kokuba umdlavuza usuvele. Le mithi yokugoma "ifundisa" amasosha omzimba ukuqaphela nokubhubhisa amangqamuzana omdlavuza. Ingabangela izinto ezifana nezimpawu ezifana nomkhuhlane kanye nomfutho wegazi ophakeme.
Ama-Modulator Esistimu Yokuzivikela Emzimbeni
Le mithi isebenza ngokushintsha indlela amasosha omzimba asebenza ngayo, okubangela ukuthi alwe nomdlavuza. Eminye imithi ingabangela imiphumela emibi njengokukhathala, ukulimala kwemizwa (i-neuropathy), kanye nokuqhekeka kwegazi.
Le miphumela emibi iqala nini futhi iphela nini?
Akukho usuku noma isikhathi esiqondile salokhu. Ukwelashwa nge-immunotherapy kuthatha isikhathi ukusebenza. Ngakho-ke, kungathatha izinyanga, ngezinye izikhathi ngisho nangaphezulu konyaka, ukuthi imiphumela emibi ivele. Futhi, eminye imiphumela emibi ivela ngaphezu konyaka ngemuva kokuqala kokwelashwa.
Imiphumela eminingi emibi ingeyesikhashana. Kodwa akuvamile, ingaba nemiphumela yesikhathi eside. Ngezinye izikhathi, ungase ube nemiphumela emibi isikhashana ngemva kokuqeda ukwelashwa. Lokhu kungenxa yokuthi i-immunotherapy akuyona imithi esebenza kuphela lapho isemzimbeni wakho. Yenza izinguquko zesikhathi eside ohlelweni lwakho lokuzivikela komzimba.
Ungayiphatha kanjani imiphumela emibi?
Into ebaluleke kakhulu ukutshela udokotela wakho nganoma yiziphi izimpawu ozizwayo, kungakhathaliseki ukuthi zincane kangakanani . Ngezinye izikhathi, noma ngabe zibonakala zijwayelekile kuwe, zingaba uphawu lokuqala lwesimo esibucayi.
Udokotela wakho angashintsha ukwelashwa kwakho noma akunike eminye imithi yokulawula imiphumela emibi. Lokhu kuvame ukwenziwa yi:
- Ukwelashwa kuyamiswa okwesikhashana futhi amasosha omzimba anikezwa isikhathi "sokuzola" kancane.
- Imithi inikezwa ukunciphisa ukusebenza kwesimiso somzimba sokuzivikela. Isibonelo, imithi efana nama-steroids noma ama-immunosuppressants .
Ingabe ukuvela kwemiphumela emibi kusho ukuthi ukwelashwa kuyaphumelela?
Lona umbuzo abantu abaningi abawubuzayo. Ezinye izifundo zikhombisile ukuthi ukuvela kwemiphumela emibi kungaba uphawu lokuthi ukwelashwa kuyawubhubhisa ngempumelelo umdlavuza.
Kodwa lokhu akuwona umthetho. Into ebalulekile ukuthi ukuthi awunayo imiphumela emibi akusho ukuthi ukwelashwa akusebenzi .
Ngakho ungakhathazeki ngokuntuleka kwemiphumela emibi. Okuwukuphela kwendlela yokwazi ngokuqinisekile ukuhlolwa okwenziwa udokotela wakho.
Ngakho-ke yiziphi izinzuzo ze-immunotherapy?
Uma ukhuluma ngemiphumela emibi, ungase uzibuze, "Ingabe lokhu kwelashwa kuyakufanelekela?" Kodwa futhi sidinga ukuqonda izinzuzo zokwelapha nge-immunotherapy.
- Kwandisa amathuba okusinda isikhathi eside ezinhlotsheni eziningi zomdlavuza.
- Kuyasiza ekubhubhiseni izimila ezinomdlavuza futhi kuvimbele umdlavuza ukuthi ungabuyi .
- Kungavimbela umdlavuza ukuthi ungasabalali kwezinye izingxenye zomzimba.
- Ngisho nangemva kokuyeka ukwelashwa, amasosha omzimba wakho aqinile ayaqhubeka nokulwa namaseli omdlavuza .
- Uma kuqhathaniswa nokwelashwa kwendabuko njengokwelashwa ngamakhemikhali, imiphumela emibi yokwelashwa ngamasosha omzimba ngokuvamile ayibi kakhulu .
Ekugcineni, ukwelashwa nge-immunotherapy akuyona indlela yokwelapha eyodwa efanelana nazo zonke izinhlobo. Kuncike ezintweni eziningi, okuhlanganisa uhlobo lomdlavuza onawo kanye nempilo yakho iyonke. Ngakho-ke, khuluma nodokotela wakho ngezinzuzo kanye nokungalungi kwalokhu kwelashwa bese wenza isinqumo esikulungele wena.
Umlayezo Wokuya Nawe Ekhaya
- I-immunotherapy iyindlela yokwelapha yesimanje esebenzisa amasosha omzimba wakho ukulwa nomdlavuza.
- Imiphumela emibi iyenzeka ngoba isimiso somzimba sokuzivikela esisebenza ngokweqile sihlasela ngephutha amaseli anempilo.
- Okubaluleke kakhulu: Bika noma yiziphi izimpawu ezintsha ozizwayo, kungakhathaliseki ukuthi zincane kangakanani, kudokotela wakho ngokushesha, ngesikhathi noma ngemva kokwelashwa.
- Akuwona wonke umuntu obhekana nemiphumela emibi. Ukungabikho kwemiphumela emibi akusho ukuthi ukwelashwa kwehlulekile.
- Imiphumela eminingi emibi ilula futhi ingalawulwa kahle ngudokotela wakho, ngakho ungakhathazeki.
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