Umdlavuza wamaphaphu? Ake sifunde ngomdlavuza wamaphaphu ongewona amaseli amancane (i-NSCLC)!

Ingabe ubhekene nokuphelelwa umoya noma ukukhwehlela okuqhubekayo? Mhlawumbe othile emndenini wakho uke wezwa ngomdlavuza wamaphaphu. Namuhla sizokhuluma ngolunye lwezinhlobo ezivame kakhulu zomdlavuza wamaphaphu. Nakuba lesi kuyisihloko esiyinkimbinkimbi, sizokhuluma ngaso kalula, ngendlela ongayiqonda.

Iyini i-Non-Small Cell Lung Cancer (NSCLC)?

Kalula nje, i-Non-Small Cell Lung Cancer (NSCLC) yilapho amaseli angaphakathi kwamaphaphu akho eqala ukuhlukana futhi akhule ngendlela engavamile futhi engalawuleki. Njengokhula, la maseli azama ukusabalala yonke indawo ngaphandle kokulawula. Kunezinhlobo ezimbili eziyinhloko zomdlavuza wamaphaphu. Enye ibizwa ngokuthi i-NSCLC. Enye ibizwa ngokuthi i- Small Cell Lung Cancer (SCLC) . Lawa magama amabili asekelwe endleleni la maseli omdlavuza abukeka ngayo ngaphansi kwe-microscope. Amaseli ku-SCLC mancane, ayindilinga, futhi amile njengebhola. Amaseli ku-NSCLC makhulu.

I-SCLC ivame ukuba nolaka kakhulu kune-NSCLC, okusho ukuthi isakazeka ngokushesha. Kodwa-ke, yize amaseli e-NSCLC emakhulu, avame ukukhula kancane. Inkinga lapha ukuthi i-NSCLC ingaba nezimpawu ezingabonakali ezigabeni zayo zokuqala . Ngakho-ke, ngesikhathi itholakala, umdlavuza kungenzeka ukuthi usuvele usakazeke (usuvele usakazeke) kwezinye izingxenye zomzimba. Yingakho kubaluleke kakhulu ukuwuthola nokuwelapha kusenesikhathi . Eqinisweni, u-80% kuya ku-85% womdlavuza wamaphaphu yi-NSCLC.

Ingabe zikhona izinhlobo ze-NSCLC?

Yebo, kunezinhlobo eziningana eziyinhloko ze-NSCLC. Odokotela bazibona lezi ngokubheka amangqamuzana omdlavuza ngaphansi kwe-microscope nangokubheka ukubukeka kwawo. Sikhuluma kakhulu ngezinhlobo ezintathu:

• I-Adenocarcinoma: Lolu uhlobo oluvame kakhulu lwe-NSCLC. Luvame ukuvela ezingxenyeni zangaphandle zamaphaphu.
• I-Large cell carcinoma: Lolu hlobo lwamangqamuzana omdlavuza lubonakala lukhulu kunezinye izinhlobo uma lubhekwa ngesibonakhulu. Lungakhula noma kuphi emaphashini.
• I-Squamous cell carcinoma: Lokhu kuvame ukuqala phakathi kwamaphaphu, eduze kwemizila yomoya eyinhloko esiphefumula ngayo.

Ngaphezu kwalezi zinhlobo ezintathu eziyinhloko, kunezinye izinhlobo ezingavamile njenge -sarcomatoid carcinoma kanye ne-adenosquamous carcinoma , kodwa azibonakali njalo.

Ziyini izimpawu zalokhu?

Kulungile, manje cishe uyazibuza ukuthi yiziphi izimpawu ezibangelwa yi-NSCLC. Njengoba kushiwo ngaphambili, ngezinye izikhathi kungase kungabi nazimpawu nhlobo, okuyinto eyesabekayo kakhulu. Kodwa kunezinye izimpawu ezivamile. Uma unesinye noma ngaphezulu kwalezi, ungesabi, kodwa kuwumqondo omuhle ukubona udokotela.

• Ubuhlungu besifuba: Njengomuntu ocindezela isifuba sakho, noma ubuhlungu obuba bubi nakakhulu uma uphefumula, uhleka, noma ukhwehlela.
• Ukukhwehlela okuqhubekayo: Ukukhwehlela okuhlala amasonto, ngezinye izikhathi kuya kuba kubi kakhulu, ngaphandle komkhuhlane.
• Ukukhwehlela igazi: Lokhu kuyisibonakaliso esesabekayo. Uma ukhwehlela igazi noma ukhilimu obomvana, kufanele nakanjani ubone udokotela.
• Ukushintsha kwezwi/ukuhosha: Uma izwi lakho liba nomsindo ngokuzumayo noma lihosha, lokho kufanele kuhlolwe.
• Ukulahlekelwa yisifiso sokudla kanye nokwehla kwesisindo: Ukulahlekelwa yisifiso sokudla, kanye nokwehla kwesisindo ngaphandle kwesizathu esibonakalayo.
• Ukuphelelwa umoya: Ukuzizwa uphelelwa umoya ngisho noma uzikhandla kancane, noma uzizwa ukhathele kakhulu kunokujwayelekile lapho wenza izinto ezifana nokukhwela izitebhisi.
• Ukukhathala/Ukukhathala: Ukuzizwa ukhathele ngaso sonke isikhathi , ngisho nangemva kokulala kahle.
• Ukuphefumula (umsindo wokukhala kwekhwela) lapho uphefumula.
• Izifo ezivame ukwenzeka emaphashini njenge-bronchitis noma i-pneumonia.

Uma unesinye noma ngaphezulu salezi zimpawu, ungesabi ukucabanga ukuthi yi-NSCLC. Ezinye izimo zempilo nazo zingabangela lezi zimpawu. Kodwa uma lezi zimpawu ziqhubeka, kuhlale kungumqondo omuhle ukubona udokotela ukuze akuhlole.

Kungani lo mdlavuza uvela? Yiziphi izinto ezibangela ingozi?

Nokho, kungani lo mdlavuza we-NSCLC ukhula? Eqinisweni, odokotela abakwazi ukusho ngokuqinisekile ukuthi kungani abanye abantu bewuthola kanti abanye abawutholi. Kodwa bathole izici eziningana eziyingozi ezingawuthinta. Isici esiyingozi yinto ekhulisa amathuba akho okuthola lesi sifo.

Isici esiyinhloko nesivame kakhulu sengozi yomdlavuza wamaphaphu ukubhema. Le ngozi iphakeme hhayi nje kuphela kulabo ababhema ugwayi, kodwa nakulabo abasebenzisa izinto ezifana ne-bidis, ugwayi, kanye ne-hookah. Futhi, labo abangabhemi kodwa ababhema intuthu kagwayi (ukubhema ugwayi ongasebenzi / intuthu kagwayi) nabo basengozini.

Cabanga nje, uma ubhema, izinkulungwane zamakhemikhali ayingozi zingena emaphashini akho. Lawa alimaza amangqamuzana amaphaphu futhi angagcina ephenduke amangqamuzana omdlavuza.

Ezinye izinto eziyingozi yilezi:

• Umlando womndeni womdlavuza wamaphaphu: Uma abazali bakho, izingane zakini, noma amanye amalungu omndeni wakho benalesi sifo, kungase kube nethonya lezakhi zofuzo.
• Ukuchayeka ku-asbestos: Ungachayeka kulokhu ezintweni ezifana namashidi e-asbestos asetshenziswa ukwakha ezinye izindlu esikhathini esidlule, noma lapho usebenza ezimbonini ezihlobene ne-asbestos.
• Ukuchayeka othulini lwensimbi nolwezimbiwa: Abantu abasebenza kwamanye amafektri bangase babe sengozini yokuchayeka ezintweni ezifana ne-arsenic, i-chromium, ne-nickel.
• Ukuchayeka ku-radon, igesi ekhipha imisebe yemvelo:Lena igesi evela emhlabathini. Kwezinye izindawo, amazinga ayo angakhuphuka ngaphakathi kwezindlu.
• Ukuba nezifo zokuphefumula ezingamahlalakhona njenge-COPD (Chronic Obstructive Pulmonary Disease) noma i-Pulmonary Fibrosis.
• Uma uke welashwa ngemisebe esifubeni sakho noma esifubeni ngenxa yesinye isifo, njengomdlavuza webele.
• Ukuhlala endaweni enamazinga aphezulu okungcoliswa komoya nakho kungaba nomthelela othile.

Akuwona wonke umuntu onalezi zinto ozoba nomdlavuza. Kodwa kubalulekile ukwazi ukuthi lezi zinto zandisa ingozi yakho. Ukugwema ukubhema kuyindlela engcono kakhulu yokunciphisa ingozi yakho yomdlavuza wamaphaphu.

Yiziphi izinkinga ezingaba khona ze-NSCLC?

Enye yezinto eziyingozi kakhulu ngomdlavuza ofana ne-NSCLC ukuthi ungasakazeka (usakazeke) kwezinye izingxenye zomzimba. Uma usakazeka, isimo siba nzima nakakhulu. Nazi ezinye zezindawo ezivame kakhulu lapho i-NSCLC ingasakazeka khona:

• Izindlala ze-adrenal (lezi yizindlala ezincane ezitholakala phezu kwezinso)
• Amathambo
• Ubuchopho
• Isibindi
• Ama-lymph node (njengamaqhubu)
• Isikhumba

Uma isakazeka ngale ndlela, izimpawu zingavela ezithweni ezahlukene zomzimba. Isibonelo, uma isakazeka emathanjeni, ingabangela ubuhlungu obukhulu emathanjeni, kanti uma isakazeka ebuchosheni, ingabangela ikhanda elibuhlungu kanye nokuxhuzula.

Odokotela bakubona kanjani lokhu?

Kulungile, manje usunezimpawu. Wazi kanjani ukuthi yi-NSCLC uma uya kudokotela?

Okokuqala, udokotela uzokubuza ngezimpawu zakho, umlando womndeni, kanye nemikhuba yakho (njengokubhema). Ngemuva kwalokho uzokwenza ukuhlolwa ngokomzimba futhi alalele amaphaphu akho.

Ngemuva kwalokho, uma kukhona okusolwayo nge-NSCLC, bazoyala ukuhlolwa okuningana ukuze kuqinisekiswe futhi bathole ukuthi umdlavuza ukusiphi isigaba.

Ukuhlolwa okuvame kakhulu yile:

• I-biopsy yamaphaphu: Lokhu kuhilela ukuthatha ingxenye encane yezicubu endaweni esolisayo yamaphaphu bese uyihlola ngaphansi kwe-microscope. Lokhu kungabona kahle ukuthi kukhona yini amangqamuzana omdlavuza nokuthi aluhlobo luni. Kunezindlela ezahlukene zokwenza i-biopsy. Kungenziwa ngesikhathi se-bronchoscopy, noma ngokufaka inalithi encane esifubeni (i-biopsy yenaliti).
• I-Bronchoscopy: Kulokhu, ithubhu elincane elifakwe ikhamera lidluliselwa emlonyeni noma ekhaleni, liye phansi embhobho womoya, liye emaphashini. Lokhu kuvumela udokotela ukubona ngaphakathi kwamaphaphu futhi, uma kudingeka, athathe isampula (i-biopsy).
• Ukuhlolwa kwezithombe:Lezi zithatha izithombe zengaphakathi lomzimba bese zibheka izinto ezifana nendawo umdlavuza okhona kuyo, ubukhulu bawo, nokuthi ngabe ususakazeke yini.
• I-X-ray yesifuba: Lokhu ukuhlolwa okuyisisekelo.
• I-CT scan: Lokhu kungathatha izithombe ezicacile, ezihlanganisa izingxenye ezahlukene kune-X-ray.
• Ukuskena kwe-PET: Lokhu kusiza ukuthola izindawo lapho amangqamuzana omdlavuza esebenza khona.
• Ukuskena kobuchopho nge-MRI: Lokhu kusetshenziselwa ukubona ukuthi umdlavuza ususakazekele ebuchosheni.
• Ukuhlinzwa kwesifuba okusizwa yividiyo (VATS): Lokhu futhi kuyindlela encane yokubheka ngaphakathi kwesifuba. Ikhamera namathuluzi kufakwa ngokusikwa okuncane ukuze kuhlolwe futhi, uma kudingeka, kuthathwe i-biopsy.

Ngokusekelwe olwazini olutholwe kulezi zivivinyo, udokotela unquma ukuthi une-NSCLC, uma kunjalo, ukuthi isakazeke kangakanani (ukulinganisa), kanye nohlobo luni lokwelashwa olufanele.

Yiziphi izindlela zokwelapha?

Abantu abaningi bayesaba uma bezwa igama elithi umdlavuza, futhi lokho kuyinto evamile. Kodwa manje kunezindlela zokwelapha ezithuthuke kakhulu ze-NSCLC. Uhlobo lokwelashwa olutholayo luncike ezintweni eziningi, okuhlanganisa uhlobo lomdlavuza, isigaba sawo, ukuthi ngabe kukhona yini izinguquko zofuzo emangqamuzaneni omdlavuza, kanye nempilo yakho iyonke.

• Ukuhlinzwa: Uma umdlavuza uphelela emaphashini, okusho ukuthi awukasabalali kwezinye izindawo (ezigabeni zokuqala), ukuhlinzwa kuyindlela yokuqala. Lokhu kuhilela ukususa umdlavuza kanye nenani elincane lezicubu ezinempilo ezizungezile. Ngezinye izikhathi, kuye ngokuthi umdlavuza ususabalale kangakanani, ingxenye yamaphaphu (i-lobectomy) noma lonke iphaphu (ukususwa kwamaphaphu / i-pneumonectomy) kungadingeka.

Cabanga nje, kukhona ukhula engadini. Lokhu kuhlinzwa kufana nokulukhipha kuqala. Kodwa akuwona wonke umuntu ongakwenza lokhu kuhlinzwa, kufanele ube ufanelekile.

• Ukwelashwa ngamakhemikhali: Kungenzeka ukuthi uke wezwa ngalokhu. Lokhu kuhilela ukunikeza umzimba imithi ebulala amangqamuzana omdlavuza. Le mithi inganikezwa njengomjovo noma njengamaphilisi. Lena yindlela yokwelapha evame kakhulu ye-NSCLC. Ukwelashwa ngamakhemikhali kunganikezwa yodwa, ukunciphisa isimila ngaphambi kokuhlinzwa, ukubulala noma yimaphi amangqamuzana asele ngemva kokuhlinzwa, noma kuhlanganiswe nokwelashwa ngemisebe.

• Ukwelashwa Ngezifo Ezithathelwana Ngomzimba: Lokhu kuyindlela yokwelapha entsha, kodwa ephumelela kakhulu. Kuhilela ukuvuselela amasosha omzimba wakho ukuze aqaphele futhi abhubhise amangqamuzana omdlavuza. Kufana nokuqeqesha amasosha akho ukulwa nomdlavuza. Akusebenzi kuzo zonke izinhlobo ze-NSCLC, futhi kwenziwa izivivinyo ezikhethekile ngalokho.

• Ukwelashwa okuqondiwe:Lokhu futhi kuyindlela yokwelapha eqondile kakhulu. Isebenzisa imithi ehlose ukuguquka kwezakhi zofuzo noma amaprotheni asiza amangqamuzana omdlavuza ukuba akhule futhi asakazeke. Inzuzo yalokhu ukuthi kubangela umonakalo omncane kakhulu kumaseli anempilo kune-chemotherapy. Futhi, udinga ukuhlola amangqamuzana akho omdlavuza ukuze uthole lezo zinguquko ezithile.

• Ukwelashwa ngemisebe: Lokhu kusebenzisa ama-X-ray anamandla amakhulu ukubulala amangqamuzana omdlavuza. Le misebe ihloselwe indawo eqondile yomdlavuza. Lokhu kunganikezwa kanye ne-chemotherapy, yodwa, noma ngaphambi noma ngemva kokuhlinzwa. Ngezinye izikhathi, lokhu kwelashwa kusetshenziselwa ukunciphisa ubuhlungu.

Ngokuvamile, ngenxa yokuthi i-NSCLC ayitholakali kusenesikhathi, odokotela bazosebenzisa eyodwa noma ngaphezulu yalezi zindlela zokwelapha ndawonye (ukwelashwa okuhlanganisiwe). Udokotela wakho wezifo zomdlavuza uzokwakha uhlelo lokwelapha olukulungele kangcono.

Kuthatha isikhathi esingakanani ukuphulukiswa?

Isikhathi sokululama ngemva kokwelashwa kwe-NSCLC siyahlukahluka kuye ngomuntu nomuntu. Kuncike ezintweni eziningi, okuhlanganisa ubukhulu bomdlavuza, ukuthi ukuphi, uhlobo lokwelashwa olutholile (njengokuhlinzwa, ukwelashwa ngamakhemikhali, imisebe), kanye nekhono lomzimba wakho lokuphulukisa. Abanye abantu bangase balulame ezinyangeni ezimbalwa. Abanye bangase bathathe iminyaka, futhi kungadingeka ukuthi balandelelwe. Ngakho-ke, kungcono ukubuza udokotela wakho ukuthi kuzothatha isikhathi esingakanani nokuthi yini ongayilindela ngokusekelwe esimweni sakho.

Kufanele ubonane nini nodokotela?

Uma welashwa i-NSCLC, noma usanda kuqeda ukwelashwa, kunezikhathi lapho kungadingeka ukuthi ubonane nodokotela ngokushesha. Qaphela lezi zinto:

• Kulungile uma uphefumula kanzima noma uma uphefumula kanzima njengamanje kuba kubi kakhulu.
• Uma unomkhuhlane ongaphezu kwama-degrees Celsius angu-38 (100.4 degrees Fahrenheit), ikakhulukazi ngenkathi uthola ukwelashwa ngamakhemikhali.
• Uma uzwa ubuhlungu obukhulu (isib. esifubeni, emathanjeni) lokho akupheli naphezu kokuthatha imithi.
• Uma kuvela izimpawu ezintsha (isib. ubunzima bokukhuluma, ukulahlekelwa ukwazi, ikhanda elibuhlungu kakhulu), noma uma izimpawu ezikhona ziba zimbi kakhulu,
• Uma uhlanza noma uhudo oluqhubekayo.

Esimweni esinjalo, yazisa udokotela wakho womdlavuza noma ithimba lakhe ngokushesha. Uma kungenjalo, iya emnyangweni wezimo eziphuthumayo wesibhedlela esiseduze.

Impilo izoba njani ngalesi simo?

Ungase uzibuze, "Impilo injani uma unalesi simo?" Eqinisweni, ubude besikhathi ongasiphila ne-NSCLC (ubude besikhathi sokuphila) buxhomeke ezintweni eziningi, okuhlanganisa isigaba somdlavuza lapho uxilongwa, uhlobo lwe-NSCLC, kanye nempilo yakho iyonke.

Isibonelo, i-NSCLC yesigaba sokuqala (eyendawo)Uma kwenzeka umdlavuza wamaphaphu, izinga lokusinda iminyaka emihlanu licishe libe ngu -65% . Lokhu kusho ukuthi abantu abangu-65 kwabayi-100 abatholakale benalesi simo basazophila ngemva kweminyaka emihlanu.

Uma umdlavuza ususakazekele ezicutshini eziseduze noma kuma-lymph node (i-NSCLC yesifunda) , lesi sibalo singaba ngu- 37% . Uma umdlavuza ususakazekele ezindaweni ezikude emzimbeni (isib., isibindi, ubuchopho, amathambo) (i-metastatic / i-NSCLC ekude) , izinga lokusinda kweminyaka emihlanu lingaba ngu -9% .

Kodwa khumbula: Lawa mazinga okusinda ayizilinganiso nje ezisekelwe kudatha evela eqenjini elikhulu labantu. Awakutsheli ukuthi uzophila isikhathi esingakanani noma ukuthi umzimba wakho uzosabela kanjani ekwelashweni. Uhambo lwawo wonke umuntu luhlukile. Ngakho-ke kubalulekile ukukhuluma nodokotela wakho mayelana nokuthi lezi zibalo zikuthinta kanjani.

Muva nje, la mazinga okusinda abelokhu ethuthuka ngenxa yokwelashwa okusha (ikakhulukazi ukwelashwa okuqondiwe kanye nokwelashwa nge-immunotherapy).

I-NSCLC iyisifo esingelapheka, ikakhulukazi uma sitholakale futhi selashwa kusenesikhathi. Kodwa-ke, izici ezifana nohlobo lomdlavuza, isigaba sawo, kanye nempilo yakho iyonke kunquma umphumela (ukubikezela).

Nakuba i-NSCLC ingelapheki, ezimweni eziningi ingalawulwa futhi izimpawu zingancishiswa (zingelapheka). Abantu abaningi abane-NSCLC baphatha ngempumelelo izimpawu zabo futhi baphila impilo enhle.

Into ebaluleke kakhulu okudingeka siyikhumbule ukuthi

Ukuthola ukuthi unomdlavuza kungaba ngenye yezinto ezinzima kakhulu oyoke ubhekane nazo. Kujwayelekile ukuzizwa wesaba, ukhathazekile, futhi ukhungathekile. Kungakhathaliseki ukuthi unasiphi isigaba somdlavuza wamaphaphu ongewona amaseli amancane (i-NSCLC), ukwelashwa kungasiza ekunciphiseni izimpawu zakho futhi kuthuthukise ikhwalithi yokuphila kwakho.

Khuluma nodokotela wakho mayelana nezinketho zakho, uhlelo lokwelashwa, kanye nemiphumela emibi engaba khona. Ungesabi ukubuza imibuzo. Phakathi nalesi sikhathi esingaqinisekile, kungaba usizo ukukhuluma nomndeni wakho, abangane, kanye, uma kudingeka, nomeluleki noma isisebenzi sezenhlalakahle.

Futhi, ukujoyina iqembu lokusekelana, kungaba ku-inthanethi noma endaweni yakini, kungakusiza uzizwe ungedwa kangako, ufunde kokuhlangenwe nakho kwabanye, futhi uthole amandla. Khumbula, awuwedwa kule mpi.

Umdlavuza wamaphaphu, i-NSCLC, Umdlavuza wamaphaphu ongewona amaseli amancane, izimpawu zomdlavuza, ukwelashwa komdlavuza, ukubhema, izifo zokuphefumula