Kunzima ukusho ngamazwi ukuthi uzizwa kanjani uma uthola ukuthi wena noma umuntu omthandayo unomdlavuza. Kuvamile ukuzizwa wesaba futhi unelukuluku lapho udokotela wakho ekutshela ngokwelashwa okusha, njenge-PRRT, okuyigama elingajwayelekile. Kodwa ungakhathazeki. Nakuba lesi kuyisihloko esiyinkimbinkimbi, namuhla sizokhuluma ngokuthi iyini i-PRRT, ukuthi yenzani, nokuthi yiziphi izinzuzo nezinkinga zayo, ngendlela elula kakhulu ongayiqonda.
Kusho ukuthini nje i-PRRT?
Kalula nje, i-PRRT iyindlela yokwelapha ethuthuke kakhulu ehlose, ifune, futhi ibhubhise amangqamuzana omdlavuza, njenge -'missile eqondiswayo' . Isetshenziswa ngqo ukwelapha uhlobo lomdlavuza olubizwa ngokuthi 'ama-Neuroendocrine Tumors (ama-NET).'
Isici esikhethekile salokhu kwelashwa ukuthi izinto ezikhipha imisebe (i-radioactivity) ezikhishwa yiyo ziya ngqo emangqamuzaneni omdlavuza bese ziwabhubhisa. Ngakho-ke, umonakalo emangqamuzaneni aphilile mncane kakhulu kunokwelashwa ngemisebe okuvamile.
Lokhu kwelashwa kusebenza kanjani emzimbeni?
Ukuze siqonde lokhu, ake sisebenzise isibonelo esilula. Cabanga ukuthi amangqamuzana akho omdlavuza ayiminyango enezimbobo eziningi ezikhethekile ('ama-receptor'). Umnyango ngamunye ungena kuphela ukhiye onesimo esithile.
Lo muthi, obizwa ngokuthi i-PRRT, wenziwa ngokuhlanganisa izingxenye ezimbili:
1. Isihluthulelo: Lesi yiprotheni. Lesi sihluthulelo singangena kuphela 'embobeni yokhiye' yamaseli omdlavuza. Asingeni emaseli anempilo.
2. Umgibeli Osebenzisa Imisebe: Lesi sihluthulelo sinesakhi esincane kakhulu esisebenzisa imisebe (`i-radionuclide`) esinamathiselwe kuso.
Ngakho-ke, uma unikeza lo muthi emzimbeni wakho, lo 'khiye' uhamba emzimbeni wonke, uthole 'izimbobo zokhiye' emaseli omdlavuza, bese uzinamathela kuwo. Ngemuva kwalokho, 'umgibeli we-radioactive' okhiye ungena ngaphakathi kweseli lomdlavuza, ulimaza i-DNA yalelo seli, bese ubhubhisa iseli ngaphakathi.
Le ndlela ivumela ukubhujiswa okukhethwayo kwamangqamuzana omdlavuza kuphela, ngaphandle kokubangela umonakalo omkhulu kumaseli anempilo. Lena inzuzo enkulu yalokhu kwelashwa.
Umuthi we-PRRT osetshenziswa kakhulu namuhla yi-`lutetium Lu 177 dotatate (LUTATHERA®)`.
Ukwelashwa kwe-PRRT kunconywa bani?
Lokhu kwelashwa akufaneleki kubo bonke abantu abanomdlavuza. Njengamanje, kunconywa kakhulu kumdlavuza obizwa ngokuthi 'ama-gastroenteropancreatic NETs', okuyimidlavuza yomgudu wokugaya ukudla (amathumbu, isisu, i-rectum) kanye ne-pancreas. Kunezimo eziningana lapho lokhu kwelashwa kungakufanelekela khona.
| Isimo | Incazelo |
|---|---|
| Akufanelekile ukuhlinzwa | Uma umdlavuza ususakazeke ( ususakazeke kakhulu ) ezingxenyeni eziningi zomzimba, ukuhlinzwa kukodwa akunakwenzeka ukuthi kunikeze ikhambi eliphelele. Abantu abaningi abane-NET kungenzeka ukuthi sebevele bawusakaze umdlavuza lapho bexilongwa. |
| Ezinye izindlela zokwelapha aziphumelelanga | Ezimweni lapho ukuhlinzwa kungenzeki khona, izinto ezifana nokwelashwa ngama-hormone ziyanikezwa. Kodwa ngezinye izikhathi, lezo zindlela zokwelapha zibangela ukuba amangqamuzana omdlavuza aqhubeke nokukhula ngendlela engalawuleki. Kulabo bantu, i-PRRT iyindlela enhle. |
| Amaseli omdlavuza analo 'umgodi wokhiye' | Lokhu kuyinto ebaluleke kakhulu. Ukuze umuthi we-PRRT ufinyelele 'kukhiye' futhi uxhumeke, kumele kube 'nama-keyholes' abizwa ngokuthi ama-somatostatin receptors ebusweni bamaseli omdlavuza. Udokotela wakho uzokwenza ukuskena okukhethekile, njenge -octreotide scan noma i -PET scan , ukuze abone ukuthi amaseli akho omdlavuza anazo yini lezi zinto. |
Kwenzekani ngaphambi nangesikhathi sokwelashwa?
Ngaphambi kokwelashwa
Uma uthatha eminye imithi ye-NETs (ikakhulukazi ama-somatostatin analogues), udokotela wakho cishe uzokweluleka ukuthi uyeke ukuyithatha amasonto ambalwa ngaphambi kwe-PRRT. Udokotela wakho cishe uzophinde enze ukuhlolwa kwegazi cishe isonto ngaphambi kokwelashwa kwakho ukuze ahlole ukusebenza kwezinso zakho kanye nokubalwa kwamaseli egazi ukuqinisekisa ukuthi umzimba wakho usesimweni esihle sokuthola ukwelashwa.
Ngosuku lokwelashwa
Lokhu kwelashwa kuvame ukunikezwa njalo ezinyangeni ezimbili izikhathi ezine esikhathini esiyizinyanga eziyi-8. Lena inqubo yokulaliswa esibhedlela, ngaphandle kokuhlala esibhedlela. Yonke inqubo ithatha cishe amahora ama-5-6.
- Okokuqala, ithubhu elincane (i-cannula) lifakwa emthanjeni osengalweni yakho bese kudalwa umugqa we-saline.
- Cishe ihora ngaphambi kokuqala kokwelashwa, kunikezwa imithi yokuvimbela isicanucanu nokuhlanza.
- Ngemuva kwalokho, uzonikezwa isisombululo sikasawoti esiqukethe ama-amino acid ukuvikela izinso zakho cishe amahora amane. Lokhu kubaluleke kakhulu.
- Cishe imizuzu engama-30 ngemuva kokuba ama-amino acid eqale ukunikezwa, umuthi we-PRRT unikezwa emzimbeni nge-saline isikhathi esingangemizuzu engama-30-45.
- Uma yonke i-saline isifakiwe, ipayipi elingalweni liyasuswa.
Ngosuku olulandelayo ngemuva kokwelashwa, uzobe usuphinde wahlolwa ukuze uhlole ukuthi umuthi onemisebe uye kuphi emzimbeni wakho, ikakhulukazi lapho kukhona khona izimila zomdlavuza.
Yiziphi imiphumela emibi kanye nezingozi?
Njenganoma yikuphi ukwelashwa, kungase kube nemiphumela emibi.
Imiphumela emibi evame kakhulu:
Imiphumela emibi evame kakhulu isicanucanu nokuhlanza , kodwa lokhu kungalawulwa kakhulu ngokwelashwa kusenesikhathi.
Ezinye izinkinga ezingaba khona:
- Noma yimuphi umthelela ekusebenzeni kwezinso noma kwesibindi.
- Ukwehla kwenani lamaseli egazi (amaseli amhlophe egazi, amaseli abomvu egazi, ama-platelet). Lokhu kungabangela ubunzima bokuphefumula, ukwanda kokuthambekela ekuthelelekeni, kanye nengozi eyengeziwe yokopha noma ukuklwebheka.
- Akuvamile kakhulu ukuba kube nengozi encane kakhulu yokuthola eminye imidlavuza yegazi efana ne-myelodysplastic syndrome noma i-leukemia.
Udokotela wakho uzoqapha amazinga akho egazi njalo phakathi nokwelashwa kwakho. Uma kuvela izinkinga, angase anqume ukushintsha umthamo noma ayeke ukwelashwa kwakho.
Isimo esibucayi kakhulu esidinga ukunakwa ngokushesha!
Inkinga ye-carcinoid yisimo esingavamile kodwa esingasongela ukuphila esingase senzeke phakathi nalokhu kwelashwa. Sibangelwa ukukhishwa okungazelelwe kwama-hormone amaningi avela kumaseli omdlavuza aye egazini. Izimpawu zingabonakala emahoreni okuqala angu-48 okuthola ukwelashwa.
Uma unezinye zalezi zimpawu, iya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha noma ushayele u-1990:
* Ubunzima bokuphefumula
* Ububomvu bobuso noma intamo, ukuzizwa kushisa noma kushisa emzimbeni (Ukusha)
* Ukwehla kwengcindezi yegazi ngokuzumayo (ukuzizwa unesizungu)
* Ukushaya kwenhliziyo
* Uhudo olubi kakhulu
Impilo yansuku zonke ngemva kokwelashwa
Iningi labantu liyakubekezelela lokhu kwelashwa kahle futhi lilulame ngokushesha.
Ukusebenza kwemisebe kanye nokuphepha:
Ukwelashwa kusebenzisa inani elincane kakhulu lemisebe. Lokhu kuzodluliselwa emzimbeni wakho ngomchamo wakho kanye nendle yakho ezinsukwini ezimbalwa ezizayo. Phakathi nalesi sikhathi, udokotela wakho uzokunikeza imiyalelo yokuvimbela abanye ukuthi bangachayeki emisebeni.
- Kubaluleke kakhulu ukuhlala kude nabesifazane abakhulelwe nezingane ezincane izinsuku ezimbalwa.
- Geza izandla zakho kahle ngensipho ngemva kokusebenzisa indlu yangasese.
Ukuhamba:
Kungase kube khona inani elincane kakhulu lemisebe emzimbeni wakho kuze kube yizinyanga ezi-3 ngemva kokwelashwa kwakho. Lokhu kungase kubangele ukuthi kutholakale imisebe ezikhumulweni zezindiza noma emingceleni. Ngakho-ke, hlala ugcina ikhadi elikhethekile olithola esibhedlela kanye nemininingwane yakho yokwelashwa. Lokhu kubaluleke kakhulu ukugwema noma yikuphi ukuphazamiseka lapho uhamba.
Umlayezo Wokuya Nawe Ekhaya
- I-PRRT iyindlela yokwelapha ethuthukisiwe enikeza imisebe eqondiswe ngqo kumaseli omdlavuza. Isetshenziswa ngqo kuma-Neuroendocrine Tumors (ama-NET).
- Nakuba lokhu kungesona ukwelashwa okwelapha umdlavuza ngokuphelele, kusiza ukunciphisa noma ukumisa ukukhula kwezimila, ukulawula izimpawu, nokuthuthukisa ikhwalithi yokuphila ngokwandisa isikhathi sokusinda.
- Ezinsukwini ezimbalwa ngemva kokwelashwa, landela imiyalelo enikeziwe ukuze uvikele abanye emisebeni (ikakhulukazi ukuhlala kude nezingane ezincane nabesifazane abakhulelwe).
- Qaphela izimpawu zenkinga ye -carcinoid (ubunzima bokuphefumula, ukuhlanza, uhudo olunzima, ukushaya kwenhliziyo okwandayo). Uma uhlangabezana nanoma yiziphi zalezi zimpawu, iya ku -ETU yesibhedlela ngokushesha.
- Unganqikazi ukukhuluma nodokotela wakho nganoma yimiphi imiphumela emibi noma izinkinga ongase ubhekane nazo.
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