Uma udokotela ekutshela noma othile omaziyo ukuthi unomdlavuza, into elandelayo efika engqondweni mhlawumbe ukuhlinzwa ukuze kususwe isimila. Lokho kuvamile. Kodwa bewazi ukuthi ngezinye izikhathi, ngaphambi kwalokhu kuhlinzwa, kukhona ukwelashwa okukhethekile okunganciphisa isimila, kusilawule, futhi kwenze ukuhlinzwa kube lula futhi kuphumelele kakhudlwana? Yilokho esikubiza ngokuthi i-Neoadjuvant Therapy kwezokwelapha. Namuhla, sizokhuluma ngalokhu, kalula kakhulu, ngendlela ongayiqonda.
Kalula nje, kuyini ukwelashwa kwe-Neoadjuvant?
Cabanga ukuthi uzogijima umjaho omkhulu we-marathon. Bekungaba lula kangakanani ukube ubufudumala kancane futhi wenze izivivinyo ezincane (ukufudumeza) ngaphambi kokuthi uqale ukugijima, kunokuba umane ugijime ngokushesha? Kunjalo nalokhu.
Ukwelashwa kwe-Neoadjuvant uhlobo lokwelashwa olunikezwa ukunciphisa isimila ngaphambi kokuhlinzwa ukuze kususwe. Udokotela wakho wezifo zomdlavuza angase futhi akubize ngokuthi "ukwelashwa okwenziwa ngesikhathi sokuhlinzwa" noma "ukwelashwa kokufakelwa." Umgomo oyinhloko walokhu kwelashwa ukunciphisa isimila esikhulu ukuze sisuswe kalula ngokuhlinzwa. Okumangazayo ukuthi ngezinye izikhathi lokhu kwelashwa kungasiqeda ngokuphelele isimila, okwenza ukuhlinzwa kungadingeki.
Yiziphi izinhlobo zalolu hlobo lokwelashwa?
Kunezinhlobo eziningana eziyinhloko zokwelapha ezisetshenziswa njengokwelashwa kwe-neoadjuvant. Udokotela wakho uzonquma ukwelashwa okufanele kakhulu kuwe ngokusekelwe ezicini ezifana nohlobo kanye nesigaba somdlavuza wakho.
| Indlela yokwelapha | Kwenzekani kuyo? |
|---|---|
| Ukwelashwa ngamakhemikhali | Lokhu kwenzelwa ukubhubhisa amangqamuzana omdlavuza ngaphambi kokuba ahlukane futhi isimila sikhule. |
| Ukwelashwa ngama-hormone | Ezinye izinhlobo zomdlavuza (isib. umdlavuza webele, we-prostate) zivuselelwa ama-hormone. Lokhu kwelashwa kusebenza ngokuvimbela ukutholakala kwalawo ma-hormone nokuvimba umdlavuza ukuthi ungakhuli. |
| Ukwelashwa nge-immunotherapy | Lokhu kuvuselela amasosha omzimba wethu futhi kuwenze alwe namaseli omdlavuza. |
| Ukwelashwa Ngemisebe | Lokhu kusebenzisa imisebe, njenge-X-ray enamandla aphezulu, ukubhubhisa amangqamuzana omdlavuza. |
Ngezinye izikhathi, ithimba lakho lezokwelapha lingakunikeza okungaphezu kokukodwa kwalokhu kwelashwa. Isibonelo, ukunikeza i-chemotherapy kanye nokwelashwa ngemisebe ndawonye kubizwa ngokuthi "i-neoadjuvant chemoradiation."
Lesi sikhathi sokwelashwa singahlala kusukela emavikini ambalwa, izinyanga ezimbalwa, noma ngisho nonyaka. Ezimweni eziningi, ukuhlinzwa kwenziwa kungakapheli inyanga kusukela kuqedwe lokhu kwelashwa.
Lolu hlobo lokwelapha lusetshenziselwa ziphi izinhlobo zomdlavuza?
Le ndlela yokwelapha okwamanje isetshenziswa ngempumelelo ezinhlotsheni ezingaphezu kweshumi zomdlavuza. Lezi ezinye zezinhlobo zomdlavuza ezivame kakhulu.
Umdlavuza Webele
Le ndlela ibaluleke kakhulu kumdlavuza webele, ikakhulukazi:
- Uma isimila sikhulu kancane.
- Ezinhlotsheni ezisakazeka ngokushesha ezifana 'nomdlavuza webele ovuvukalayo'.
- Kwezinhlobo ezithile zomdlavuza webele, njenge-'HER2-positive' kanye ne-'triple-negative'.
Lokhu kwelashwa kungase kuvumele ukuhlinzwa okuncane (i-lumpectomy) ukususa isimila kuphela, kunokuhlinzwa okukhulu (i-mastectomy) okususa lonke ibele.
Umdlavuza Wamathumbu Amancane
Uma umdlavuza wamathumbu amakhulu ususakazeke (wasakazeka) kwezinye izindawo, njengesibindi, ukwelashwa ngamakhemikhali kunganikezwa ngaphambi kokuhlinzwa.
Umdlavuza Wamaphaphu
Ukwelashwa ngamakhemikhali noma ngemisebe ye-chemotherapy kuvame ukusetshenziswa kakhulu kumdlavuza wamaphaphu ongeyona iseli elincane othuthukile.
Umdlavuza Wendlala Yesitho Sangasese
Ezinye izinhlobo zalo mdlavuza emadodeni ziqhutshwa yi-hormone i-testosterone. Ngakho-ke ukwelashwa ngama-hormone kunciphisa ukusebenza kwaleyo hormone futhi kulawula isimila.
Umdlavuza We-Rectal
Kuvamile ukunikeza ukwelashwa ngemisebe kanye ne-chemotherapy ndawonye ngomdlavuza we-rectal osusakazekile. Ngezinye izikhathi, i-chemotherapy inikezwa kuqala, kulandelwe yi-chemoradiation, ngendlela ebizwa ngokuthi "i-total neoadjuvant therapy".
Yiziphi izinzuzo ze-Neoadjuvant Therapy?
Kunezinzuzo eziningana isiguli esizitholayo ngale ndlela yokwelapha.
Kalula nje, lokhu kwenzelwa ukubuthakatha isitha (umdlavuza) ngangokunokwenzeka ngaphambi kwempi enkulu ebizwa ngokuthi ukuhlinzwa.
| Inzuzo | Incazelo |
|---|---|
| Izimila zomdlavuza ziyancipha | Izimila ezinkulu zingancishiswa ngobukhulu futhi zisuswe kalula ngudokotela ohlinzayo, okunciphisa ingozi yokulimala emzimbeni ngesikhathi sokuhlinzwa. |
| Ukwenza ukuhlinzwa kube lula | Ngenxa yokuthi isimila sincane, ukusikwa ngesikhathi sokuhlinzwa kuncane. Ngakho-ke, isikhathi sokuphulukiswa sifushane futhi ubuhlungu buncane. |
| Ukulinganisa impumelelo yokwelashwa | Odokotela bangabona ukuthi umdlavuza usabela kanjani ekwelashweni ngaphambi kokuhlinzwa, okungabasiza ukuthi benze izinqumo ezinhle kakhulu mayelana nokwelashwa ngemva kokuhlinzwa. |
| Ukuvimbela ukusabalala komdlavuza | Ngezinye izikhathi, amaseli aphuma esimila somdlavuza futhi ahamba emzimbeni wonke ngezindlela ezincane, ezingabonakali ezibizwa ngokuthi "ama-micrometastases." Lokhu kwelashwa kungabhubhisa nalawo maseli afihliwe emzimbeni. |
| Ukunciphisa ingozi yokuphinda umdlavuza | Ucwaningo luthole ukuthi lokhu kwelashwa kunciphisa ingozi yokuphinda kwezinhlobo ezithile zomdlavuza. |
Masiqaphele nemiphumela emibi.
Njenganoma yikuphi ukwelashwa komdlavuza, lokhu kwelashwa kungabangela imiphumela emibi. Kodwa ukuthi iyini kuncike ohlotsheni lokwelashwa olutholayo. Eminye yemiphumela emibi evame kakhulu ihlanganisa:
- Ukukhathala
- Isicanucanu nokuhlanza
- Isifiso sokudla
- Uhudo
- Ukulahlekelwa ukunambitheka emlonyeni
Kodwa ungakhathazeki. Udokotela wakho uzokufundisa ngemiphumela emibi engaba khona kanye nemithi ongayithatha ukuze uyilawule ngaphambi kokuba uqale ukwelashwa. Ithimba lakho lezokwelapha lizokusiza futhi ukuthi ulawule lezi zimpawu ngezinga elikhulu ngokunakekelwa kokwelapha ubuhlungu.
Kunini lapho udinga ukubonana nodokotela?
Ngesikhathi uthola lokhu kwelashwa, ithimba lakho lezokwelapha lizokuqapha eduze. Kodwa-ke, uma uhlangabezana nanoma yiziphi izinkinga, ungalibali ukuzibika.
Uma kwenzeka noma yikuphi kwalokhu okulandelayo, shayela udokotela wakho ngokushesha:
- Uma imiphumela emibi imibi kakhulu kunalokho obekulindelekile: Isibonelo, uma ungakwazi ukulawula isicanucanu ngisho nangemva kokuthatha imithi, futhi uzizwa ungakhululekile usuku lonke.
- Uma ubona izinguquko ezintsha emzimbeni wakho: Uma uthola noma yiziphi izimpawu ezintsha ezibonisa ukuthi umdlavuza uya uba mubi kakhulu.
Uyini umehluko phakathi kwe-Neoadjuvant kanye ne-Adjuvant Therapy?
La magama amabili angaba yinto edidayo kancane, kodwa umehluko ulula kakhulu.
- Ukwelashwa kwe-Neoadjuvant: Ukwelashwa okunikezwa ngaphambi kokuhlinzwa (njengokuzifudumeza ngaphambi komjaho we-marathon).
- Ukwelashwa Okungeziwe: Ukwelashwa okunikezwa ngemva kokuhlinzwa. Lokhu kwenzelwa ukubulala noma yimaphi amangqamuzana omdlavuza angase ashiywe emzimbeni ngemva kokuhlinzwa nokuvimbela umdlavuza ukuthi ungabuyi. (Njengokuphola ngemva kokugijima ibanga elide).
Ukwelashwa kwe-Neoadjuvant akuyona indlela yokwelapha iziguli zomdlavuza. Kodwa-ke, kuye ngesimo sakho, kungaba yindlela enhle kuwe. Ngakho-ke, khuluma ngokukhululekile ngalokhu nodokotela wakho. Buza yonke imibuzo yakho bese uthola ukuqonda okuhle ngohambo lwakho lokwelashwa.
Umlayezo Wokuya Nawe Ekhaya
- Ukwelashwa kwe-Neoadjuvant kuyindlela yokwelapha enikezwa ngaphambi kokuhlinzwa ukuze kuncishiswe noma kubhujiswe isimila somdlavuza.
- Lokhu kwenza ukuhlinzwa kube lula, kuphephe, futhi kuphumelele kakhudlwana. Ngezinye izikhathi, ukuhlinzwa kungase kungadingeki.
- Izinhlobo ezahlukene zokwelapha ezifana ne-chemotherapy, ukwelashwa ngemisebe, kanye nokwelashwa ngama-hormone ziyasetshenziswa ngaphansi kwalokhu.
- Lokhu kwelashwa kuvumela odokotela ukuthi bathole ukwelashwa okusebenza kahle kakhulu komdlavuza othile.
- Ithimba lakho lezokwelapha lizokusiza ukuthi uphathe imiphumela emibi ngesikhathi sokwelashwa, ngakho ungesabi ukukhuluma nabo nganoma yiziphi izinkinga.
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