Kunzima ukusho ngamazwi ukwesaba nokukhathazeka okufika engqondweni yethu lapho sithola ukuthi sinomdlavuza. Okwamanje, umuzwa ungaba mubi nakakhulu uma sizwa ukuthi umdlavuza ususakazekele kwezinye izingxenye zomzimba, ikakhulukazi ubuchopho. Kodwa ungesabi, ungesabi. Namuhla sikhuluma ngomdlavuza osakazekela ebuchosheni, owaziwa ngokwezokwelapha ngokuthi `(Brain Metastases)`. Sizokhuluma ngendlela elula kakhulu, ngendlela ongayiqonda, ngokuthi lesi simo siyini, kungani senzeka, nokuthi yiziphi izindlela zokwelapha ezithuthukisiwe ezitholakalayo manje.
Kuyini ukwakheka kwe-metastases ebuchosheni?
Kalula nje, lokhu kwenzeka lapho umdlavuza uqala kwenye indawo emzimbeni wakho (njengamaphaphu akho, ibele, noma isikhumba) bese usakazekela ebuchosheni bakho. Indawo lapho umdlavuza waqala khona ibizwa ngokuthi umdlavuza oyinhloko . Lapho amanye amangqamuzana omdlavuza ehlukana nalo mdlavuza oyinhloko, ahamba ngemithambo yegazi aye ebuchosheni, lapho akha khona isimila esisha noma amathumba.
Cabanga ngakho njengembewu yokhula engxenyeni eyodwa yengadi, epheshulwa ngumoya, bese ihluma kwenye ingxenye yengadi. Kwenzeka into efanayo lapha. Amangqamuzana omdlavuza ayeyingxenye eyodwa yomzimba, aya ebuchosheni bese eqala ukukhula lapho.
Sivame kangakanani lesi simo?
Eqinisweni, uhlobo oluvame kakhulu lwesimila sobuchopho olubonakala kubantu abadala isimila sobuchopho esisakazeka kalula. Lokhu kusho ukuthi umdlavuza osakazekela ebuchosheni usuka kwenye indawo uvame kakhulu kunomdlavuza oqala ebuchosheni uqobo (umdlavuza wobuchopho oyinhloko). Ucwaningo lusikisela ukuthi phakathi kuka-10% no-30% wabantu abanomdlavuza kwenye indawo emzimbeni basengozini yokuthola umdlavuza wobuchopho ngesikhathi esithile empilweni yabo.
Le ngozi ivame ukwanda ngemva kweminyaka engu-45. Iningi labantu litholakala linalesi simo ngemva kweminyaka engu-65.
Into ebalulekile ukuthi izimila eziningi eziqala ebuchosheni azinawo umdlavuza (azinabungozi). Kodwa izimila ezisakazeka zivela kwenye indawo, ezibizwa ngokuthi "ama-metastases," zihlala zinomdlavuza (ziyingozi).
Ziyini izimpawu zomdlavuza wobuchopho?
Izimpawu zomdlavuza wobuchopho zingahluka kuye ngokuthi isimila sitholakala kuphi ebuchosheni nokuthi sithinta kanjani leyo ndawo. Ake sibheke izimpawu eziyinhloko ezingabonakala.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ikhanda elibuhlungu | Ungase ube nekhanda elibuhlungu elingavamile nelinzima. Ngezinye izikhathi leli khanda lingase lihambisane nesicanucanu nokuhlanza. |
| Ukuquleka | Ukuxhuzula kungavela ngokuzumayo, ngendlela engakaze ibonwe empilweni yakho. |
| Ukulahlekelwa amandla ohlangothini olulodwa lomzimba (i-Hemiparesis) | Ingalo noma umlenze, noma zombili izingalo nemilenze ohlangothini olulodwa lomzimba, zingase zizwe zingakhululekile noma zibuthakathaka. |
| Ubunzima bokucabanga | Ukulahlekelwa yinkumbulo yesikhashana, ukushintshashintsha kwemizwa ngokuzumayo, kanye nokungakwazi ukwenza izinqumo ezifanele kungenzeka. |
| Ubunzima bokukhuluma | Kuba nzima ukwakha amagama, futhi kuba nzima ukuqonda ukuthi abanye bathini. |
| Ukukhubazeka kokubona | Kungase kuzwakale sengathi ulahlekelwa umbono ohlangothini olulodwa lwamehlo akho. |
Njengoba umdlavuza uqhubeka, kungase kuvele izimpawu ezintsha, njengokulahlekelwa ukuzwa, ubunzima bokugwinya, kanye nokubona kabili. Uphawu oluvame kakhulu olubonakala ezigabeni zokugcina ukozela okuqhubekayo .
Ngezinye izikhathi, lezi zimila zobuchopho zingabangela isifo sohlangothi. Kodwa-ke, izimpawu zohlangothi zivela ngokuzumayo. Kodwa-ke, izimpawu eziningi zalezi zimila zomdlavuza ziqala kancane futhi kancane kancane zanda ngokuhamba kwesikhathi .
Kungani umdlavuza usakazekela ebuchosheni kanje?
Lokhu kungenxa yokuthi amanye amangqamuzana avela esimila somdlavuza kwenye indawo emzimbeni ayaphuka, angene egazini, bese eya ebuchosheni kanye negazi. Ucwaningo lusaqhubeka mayelana nokuthi kungani izinhlobo ezithile zomdlavuza zisakazeka ngale ndlela.
Lezi zinhlobo zomdlavuza zivame ukusabalala ziye ebuchosheni:
- Umdlavuza wamaphaphu: Cishe ingxenye yabantu abanomdlavuza wamaphaphu usakazekela ebuchosheni. Lokhu kuvame kakhulu ngohlobo olubizwa ngokuthi "umdlavuza wamaphaphu weseli elincane."
- Umdlavuza webele: Cishe u-10% kuya ku-15% wabantu abanomdlavuza webele osakazekile bazohlushwa umdlavuza wobuchopho. Lesi simo sivame kakhulu kumdlavuza webele we-HER2+ kanye nomdlavuza webele one-triple-negative.
- I-Melanoma: Lolu uhlobo lomdlavuza wesikhumba olubi kakhulu. Cishe ingxenye yabantu abane-melanoma bazosabalala umdlavuza uye ebuchosheni.
Ngaphezu kwalokho, umdlavuza wezinso, umdlavuza wamathumbu amakhulu, kanye nomdlavuza we-thyroid ngezinye izikhathi ungasakazekela ebuchosheni.
Udokotela usithola kanjani lesi simo ngokunembile?
Uma usuvele unomdlavuza futhi ubhekene nezimpawu ezishiwo ngenhla, udokotela wakho uzokuhlolela wona. Ngezinye izikhathi, noma ungenazo izimpawu, udokotela wakho angase akuhlolele uhlobo lomdlavuza olusengozini yokusabalala ebuchosheni.
Ukuhlolwa okuyinhloko okwenziwe kulokhu yile:
| Ukuhlolwa | Kwenzekani? |
|---|---|
| Ukuhlolwa kwe-neurological | Udokotela uzohlola ibhalansi yakho, ukuhlangana kwemisipha, isimo sengqondo, ukuzwa, umbono, kanye nokusabela komzimba. Lezi zinguquko zingakunikeza umbono wokuthi isimila sikuphi ebuchosheni. |
| Ukuhlolwa kwegazi | Ezinye izinhlobo zomdlavuza zikhipha izinto ezikhethekile (izimpawu zomdlavuza) egazini. Lokhu kungatholakala ngokuhlolwa kwegazi. |
| Ukuskena kwe-MRI | Lokhu kungathatha izithombe ezicacile zobuchopho. Ikakhulukazi, ama-MRI asebenzisa uhlobo lodayi olubizwa ngokuthi i-contrast angabonisa izindawo zomdlavuza ngokucacile. |
| Ukuhlolwa kwebhayoloji | Uma ezinye izivivinyo zinganele, kuthathwa ingxenye encane yezicubu esigaxeni bese ihlolwa ngaphansi kwe-microscope. Lokhu kuvame ukwenziwa ngesikhathi sokuhlinzwa ukuze kususwe isigaxa. |
Yiziphi izindlela zokwelapha umdlavuza osusakazekele ebuchosheni?
Umgomo oyinhloko wokwelashwa lapha ukumisa noma ukulawula ukukhula kwesimila sobuchopho nokunciphisa izimpawu zakho. Izindlela zokwelapha zingahlukaniswa ngezigaba ezintathu eziyinhloko.
1. Imithi yokulawula izimpawu
Okokuqala, udokotela wakho uzokuqala ngemithi yokulawula izimpawu zakho, njengekhanda elibuhlungu. Isibonelo, bangakunikeza ama-corticosteroids ukunciphisa ukuvuvukala ebuchosheni (i-edema) nokulawula ikhanda elibuhlungu. Bangakunikeza imithi yokubulala izinzwa ukuze balawule ukuxhuzula.
2. Ukwelashwa ngemisebe kanye nokuhlinzwa
Lezi yizindlela eziyinhloko ezisetshenziswa ukususa noma ukubhubhisa amantongomane.
- Ukuhlinzwa kwe-Stereotactic Radiosurgery / Gamma Knife® radiosurgery: Lolu uhlobo oluthuthuke kakhulu lokwelashwa ngemisebe. Njengomdubuli wesibhamu, umsebe onamandla wemisebe uqondiswe ngqo esimila , ugweme ukulimala kwezinye izingxenye zobuchopho. Lokhu kwelashwa kungaqedwa ngosuku olulodwa.
- Ukwelashwa Ngemisebe Yobuchopho Obuphelele: Uma unezimila eziningi ebuchosheni bakho, noma uma umdlavuza ususakazekele ezimbozeni ezimboze ubuchopho bakho (isifo se-leptomeningeal), ukwelashwa ngemisebe kunikezwa ubuchopho bakho bonke. Lokhu kwenziwa ngezikhathi ezingaba yi-10-15 emavikini amabili kuya kwamathathu.
- Ukuhlinzwa kobuchopho: Kwezinye izimo, odokotela banquma ukwenza ukuhlinzwa ukuze kususwe isimila noma izimila.
3. Imithi ethile yomdlavuza
Ngaphezu kokuhlinzwa noma ukwelashwa ngemisebe, lokhu kwelashwa ngemithi kunganconywa kuye ngohlobo lomdlavuza wakho oyinhloko.
- Ukwelashwa ngamakhemikhali: Imithi eminingi yamakhemikhali ayikwazi ukungena ebuchosheni ngoba ubuchopho bethu buvikelwe yisithiyo esibizwa ngokuthi isithiyo segazi nobuchopho. Kodwa-ke, uma umdlavuza ususakazekele oketshezini oluzungeze ubuchopho, i-chemotherapy ingafakwa ngqo kulolo ketshezi.
- Ukwelashwa okuqondiwe: Le mithi isebenza ngokuphazamisa izinqubo ezithile ezisetshenziswa amangqamuzana omdlavuza ukuze ahlukane futhi akhule. Le ndlela itholakale isebenza kahle kwezinye izinhlobo zomdlavuza wamaphaphu nowebele osusakazekele ebuchosheni.
- Ukwelashwa Ngezifo Ezingalawuleki: Le mithi isiza amasosha omzimba wakho ukuthola nokubhubhisa amangqamuzana omdlavuza. Lokhu kwelashwa kusetshenziselwa ezinye izinhlobo zomdlavuza wamaphaphu kanye ne-melanoma ezisakazekele ebuchosheni.
Yini ongayilindela esimweni esinjengalesi?
Uma umdlavuza usakazekela ebuchosheni, abantu abaningi bacabanga ukuthi konke sekuphelile. Kodwa akunjalo. Kwezinye izimo, lesi simo singalapheka ngokuphelele . Nakuba singelapheki ngokuphelele, ukwelashwa okuthuthukisiwe okutholakalayo manje kungakusiza uphile isikhathi eside futhi ube nempilo engcono .
Esikhathini esidlule, isilinganiso sesikhathi sokusinda salolu hlobo lomdlavuza kwakucatshangwa ukuthi singaphansi kwezinyanga eziyisithupha. Kodwa ngemithi emisha, abantu abaningi manje baphila isikhathi eside kakhulu futhi izimpawu zabo zilawulwa kahle. Eqinisweni, abantu abaningi abanomdlavuza osakazekele ebuchosheni abafi ngenxa yesimila sobuchopho uqobo.
Khumbula, udokotela wakho okwelaphayo kuphela ongakunikeza ulwazi olunembile kakhulu ngesimo sakho kanye nesibikezelo esihle kakhulu. Isimo sakho sizoncika ezintweni eziningi, okuhlanganisa uhlobo lomdlavuza oyinhloko onawo, ukuthi zingaki izimila zobuchopho onazo, kanye nendlela osabela ngayo ekwelashweni.
Kufanele ngimbone nini udokotela? Kufanele ngiye nini e-ETU?
Uma uthola izimpawu ezintsha noma uma uphawu olukhona luba lubi kakhulu , kungakhathaliseki ukuthi luhlobene nomdlavuza wakho okhona noma isimila esisakazekele ebuchosheni bakho, tshela udokotela wakho ngokushesha. Kubalulekile ukuthi udokotela wakho aqaphele lezi zinguquko.
Kukhona nezikhathi lapho kudingeka uye eMnyangweni Wezimo Eziphuthumayo (i-ETU). Isimila sobuchopho sisengozini enkulu yezinkinga zemizwa ezisheshayo njengokuquleka kanye nokulahlekelwa yizitho zomzimba. Futhi, uma uvele waba nezimpawu zesifo sohlangothi ngokuzumayo, kufanele uye ku-ETU ngokushesha. Lezi zimpawu zifaka:
- Ukulahlekelwa ibhalansi ngokuzumayo ngenkathi uhamba
- Izinguquko embonweni
- Ukuguquka kwendaba
- Ubuthakathaka ohlangothini olulodwa lomzimba
Yimiphi imibuzo okufanele uyibuze udokotela wakho?
Uma uphila nomdlavuza, kuvamile ukuba nemibuzo eminingi engqondweni yakho uma uthola ukuthi ususakazekele ebuchosheni bakho. Ungesabi noma ungabaze ukubuza udokotela wakho le mibuzo. Izokusiza uqonde isimo.
- Lo mdlavuza wobuchopho uzoyithinta kanjani impilo yami?
- Yikuphi ukwelashwa ongincomayo?
- Iyini imiphumela emibi yalezo zindlela zokwelapha?
- Uma umdlavuza ususakazekele ebuchosheni bami, ingabe lokho kusho ukuthi ungasakazekela kwezinye izingxenye zomzimba wami?
- Zikhona yini ezinye izinhlangano noma izinsizakalo engingathola usizo kuzo? (isib. ukunakekelwa kwe-palliative)
- Ungathini ngekusasa ngokusekelwe esimweni sami?
Ukuthola ukuthi umdlavuza ususakazekele ebuchosheni kungaba sengathi uwela emhubheni omnyama. Kodwa khumbula, awuwedwa. Unethimba lezokwelapha kanye nabathandekayo bakho abazokusekela. Ungesabi ukukhuluma nodokotela bakho. Buza ngokukhululekile ngalokho ongakulindela ekwelashweni kanye nemiphumela emibi. Ngemuva kwalokho ungenza izinqumo ezinhle kakhulu kuwe.
Umlayezo Wokuya Nawe Ekhaya
- `Ukwanda kobuchopho` ukusabalala komdlavuza ebuchosheni okwaqala kwenye indawo emzimbeni (njengamaphaphu, amabele).
- Uma uhlangabezana nezimpawu ezifana nekhanda elibuhlungu elingavamile, ubuthakathaka ohlangothini olulodwa lomzimba, ubunzima bokukhuluma, noma ukuxhuzula, yazisa udokotela wakho ngokushesha.
- Manje kunezindlela eziningi zokwelapha eziphumelela kakhulu nezithuthukile (njengokwelashwa ngemisebe, ukwelashwa okuqondiwe) ukulawula lesi simo nokuthuthukisa ikhwalithi yempilo yakho.
- Khuluma nodokotela wakho ngokukhululekile nangokwethembeka mayelana nezinketho zakho zokwelashwa, imiphumela yazo emibi, nokuthi yini ongayilindela. Ungesabi ukubuza imibuzo.
- Awuwedwa kule mpi. Thola ukwesekwa eqenjini lakho lezokwelapha, umndeni, kanye nabangani.
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