Yaya cutar ciwon huhu a tsofaffi da aka bi da ita kuma abin da ya faru ya fi muni fiye da na matasa? Akwai lokacin lokacin da wani ya tsufa don tiyata ko chemotherapy? A wace hanyoyi ne cututtukan huhu na bambanta a cikin tsofaffi, alal misali, waɗanda suka wuce shekaru 80?
Ciwon kwari a tsofaffi
Daya daga cikin tarihin ciwon daji na huhu shine tsofaffi ba su da zaɓuɓɓuka don maganin ciwon daji na huhu da cewa matasa masu fama da ciwon huhu na huhu.
Akwai alama mai mahimmanci cewa tsofaffi ba su iya jure wa illar cutar magani ba, ko kuma wannan magani ya kamata a "yi shiru."
Menene binciken da gaske yake gaya mana? Hakika, muna ji cewa 50 ne sabon 30, kuma 70 ne sabon 50.
Babu cikakkiyar ma'anar abin da shekaru ke nuna "tsofaffi" ko "tsofaffi" marasa lafiya da ciwon daji na huhu, amma yawancin bincike sunyi amfani da lalacewar shekarun haihuwa 70. Idan kun kasance a cikin wannan rukuni, don Allah karanta a kan. Mun gano cewa shekarun zamani ba shi da mahimmanci fiye da sauran dalilai a ƙayyade amsa da iyawa don jure wa jiyya. Har ila yau lokaci ne mai ban sha'awa, yayin da yawancin maganin cututtuka da aka yarda da su don maganin cutar kanjamau, da kuma wadanda aka gwada su a gwajin gwaji, sau da yawa sun fi sauƙi a jurewa fiye da maganin ilimin likitanci.
Sauran karatu suna amfani da kalmar "tsofaffin marasa lafiya" don bayyana wadanda suka wuce shekaru 80.
Koda a cikin binciken da suke amfani da wannan shekarun maimakon yawan shekarun da suka saba da shekaru saba'in don bayyana "tsofaffi" na iya zama mamakin sanin yadda yawancin wadannan mutane zasu iya jure wa jiyya ga ciwon huhu.
Yaya Kwayar Kwayar Cizon Cutar ta Yamma ta kasance a tsofaffi?
A halin yanzu, fiye da kashi 40 cikin dari na mutanen da aka gano da cutar ciwon huhu a cikin shekaru 70 ko tsufa.
Matsaloli tare da Amfani da Tarihin Tarihin Halitta a Zaɓin Jiyya
Akwai matsalolin farko na biyu tare da yin amfani da shekarun tarihin la'akari da maganin cutar kanjamau. Da farko, an gano cewa shekarun ba shi da yawa game da yadda mutum zai jure wa wadannan jiyya. Matsayin aikin , ma'auni na "zaman lafiya" ma yana da talauci a tsinkaya yadda wani zai yi. Magunguna suna kallo wasu hanyoyi don ƙayyade yadda mutum zai jure wa magani, irin su kimanin kariya na geriatric (CGA). Wadannan kayan aikin suna kallon halaye na halayen don suyi hango zaman lafiya ga lafiyar da rayuwa kuma sun hada da:
- Matsayi na gina jiki
- Kasancewar wasu yanayin kiwon lafiya
- Matakan aiki
- Ayyukan rayuwar yau da kullum (ADL)
- Taimakon jama'a
- Yanayin gida
Wani matsala da ke kallon tarihin zamani shine cewa ba mu san wannan ba. Yawancin kwayoyi da jiyya sunyi nazari akan gwaji a kan marasa lafiya.
Yaya Age zai iya shawo kan cutar warkar da ciwon huhu
Yana da mahimmanci a farko da nuna cewa shekarun bazai rage yawan amfanin magani ba, amma magunguna bazai dace da wasu tsofaffi ba. Har ila yau, yarjejeniya ta gaba ɗaya ita ce cewa shekarun da ya kamata bai kamata ya faɗi abin da za a iya ba ko ba za a iya amfani da jiyya ba don ciwon huhu na huhu.
Wannan ya ce, akwai dalilai da dama da yasa wasu marasa lafiyar marasa lafiya suka yi haƙuri ba tare da marasa lafiya ba.
- Mazan tsofaffi suna da alaƙa da samun yanayin kiwon lafiya da yawa (co-morbidities) fiye da marasa lafiya. Tarihin cututtukan zuciya, alal misali, zai iya ƙuntata amfani da wasu magungunan ƙwayar cuta. Hakazalika, yanayin da ya rage aiki na huhu, irin su emphysema, zai iya haifar da tayar da ciwon huhu ta huhu a cikin mafi kyau.
- Mazan tsofaffi suna iya rage yawan aikin koda ko aikin hanta, kuma yawancin kwayoyi da ake amfani da su don magance ciwon daji suna tace ta cikin kodan ko hanta.
- Maganin tsofaffi suna da ƙananan ƙarfin jiki na jiki, suna sa su kasa da hakuri da asarar hasara tare da wasu jiyya, da kuma ƙari ga cachexia .
- Maganin tsofaffi suna da ƙananan ragowar kashi na kasusuwa, suna haifar da hadarin matsalolin da suka shafi maye gurbin kashi daga ɓarkewar kwayar cuta daga chemotherapy .
Bayyana yadda Yara zai shafi Jiyya
Mazan tsofaffi suna fuskantar haɗari ga duka rashin jin dadin jiki saboda tsoron tsoran halayyar magani, da kuma guba saboda rashin lafiya. Yana da mahimmanci lokacin zabar magani don kiyaye abubuwa biyu: la'akari da sakamakon, kuma la'akari da tsammaninka a matsayin mai haƙuri.
Jiyya a tsofaffi
Don duba zabin maganin, wannan labarin zai rushe ciwon daji na huhu a cikin kututtuka da ciwon huhu na huhu, tsofaffin ciwon huhu na ciwon huhu, da kuma mataki na 4 (ciwon gishiri) . Yayinda yake da wuya mutane da ƙwayar cutar ciwon huhu na kananan kwayoyi suna da 'yan takara don tiyata, cutar shan magani shine yawancin magani.
An yi tunani a tsakanin wasu daga cikin jama'a cewa mutane fiye da wasu shekaru ba za su so su bi mummunan magani ba, kuma za su kasance suna "kulawa" kawai, amma wannan ba ze zama ba. Lokacin da aka yi tambaya game da tiyata a cikin binciken daya, kashi 50 cikin dari na marasa lafiya marasa lafiya sun sanya fifiko mafi girma a kan rayuwa fiye da gudunmawar alama.
Sakon Farko Cutar Kanjamau a tsofaffi
- Tiyata Tafiya da Rayuwa - Yayinda yake jin cewa jama'a za su tiyata domin cutar ciwon huhu na iya zama mai hatsari ga marasa lafiya, marasa karatu ba su goyi bayan wannan ba. A gaskiya ma, babu wani bambanci na rayuwa tsakanin tsofaffin marasa lafiya da marasa lafiya marasa lafiya wanda ke da tiyata don cutar ciwon huhu na kananan ƙananan ƙwayoyin cuta. A saman wannan, yawan hawan tiyata da aka haɓaka suna haɓaka da haɓakar rayuwa ga marasa lafiya da tsofaffin marasa lafiya da cutar kutsawa da wuri.
- Kwayoyin Cutar Canjin Kankara - Duk da yake akwai yiwuwar samun ci gaba ga marasa lafiya da suka kamu da cutar kanjamau, ba dukkanin tiyata ba don ciwon huhu na mahaifa ne. Binciken da ke kallo a cikin layi ko tsinkaye a matsayin magani ya gano cewa yawancin tsofaffi sun sami damar jure wa aikin tiyata sosai. Bayanan binciken sun sami wata mace mai girma (mutuwar mutuwa) ga tsofaffi masu karɓar pneumonectomy (cire dukan kwayar cutar,) ko da yake yana da muhimmanci a ce waɗannan binciken suna ba da kididdiga, kuma a wasu lokuta, likitan likita zai iya tunanin wani tsofaffi tsofaffi za su amfana daga wannan hanya. VATS (bidiyo ta taimaka wa tiyata) shi ne hanya mara izuwa don cire lobe ko ɓangare na lobe kuma zai iya kasancewa mai kyau a cikin marasa lafiya da aka zaɓa (wannan hanya ba zai yiwu ba tukuna. Binciken 2018 ya sake tabbatar da cewa tsofaffi (a kan shekarun 80) suna da jure wa tiyata don ciwon huhu da kuma matasan ƙananan yara, amma sun gano cewa ana rarraba kashi-kashi (tsaka-tsalle) tare da sakamako mafi kyau.
- SBRT / Radiofrequency Ablation - Ga mutanen da ke fama da ciwon huhu na huhu da ba shi da amfani ko kuma idan wani ba ya so ya tafi ta hanyar tiyata, wani lokaci ana yin amfani da radiotherapy na jiki (SBRT) ko kuma ablation na rediyo don gwada maganin ciwon huhu. Rayuwar rayuwa ga tsofaffi tare da SBRT ba kasa da aikin tiyata amma mafi alheri fiye da yadda zai kasance tare da kulawa na musamman. Rashin raguwar radiation (ƙonewa daga cikin huhu da ke haifar da radiation) yafi kowa a cikin marasa lafiya marasa lafiya tare da wannan hanya amma yawanci ana iya tatsuwa.
- Gyaran Hanyoyin Gyara - Tsarin gwiwar rigakafi kafin ko bayan tayar da ciwon huhu na huhu zai iya zama da amfani ga mutanen da ke cikin shekaru daban-daban, amma musamman ga tsofaffi.
Ciwon Kwayar Ciwon Kwayar Wuta a Yanki a tsofaffin marasa lafiya
Abun da ba shi kadai ba shi ne ƙyama (dalili ba zai yi ba) don kawar da ciwon huhu na huhu (resection) da kuma chemotherapy adjuvant (chemotherapy da aka tsara don kawar da jiki na micrometastases-ciwon daji wanda zai iya kasancewa amma suna da ƙananan don a gani akan gwajin hoto. .) Ga tsofaffin marasa lafiya da mataki 1 , mataki na 2 , da ciwon daji na 3A , za a iya gwada aikin tiyata (duba a sama a kan ciwon daji na farko a kan tiyata).
Bugu da ƙari ga tiyata, aduvant chemotherapy ne sau da yawa shawarar ga mutanen da ciwon daji ciwon daji na gida. Akwai ƙananan shaidar cewa adjuvant chemotherapy don mataki 2 ko mataki 3A ciwon huhu na huhu zai iya inganta rayuwa a cikin marasa lafiya da aka zaɓa da aka zaɓa. Nazarin, duk da haka, ba su gano cewa radiation ba na da tasirin gaske a wannan rukuni. (Har ila yau, yana da mahimmanci a bayyana cewa waɗannan ƙididdiga ne, kuma akwai wasu dalilai masu kyau da likita zai bada shawarar maganin radiation.)
Advanced ko Metastatic (Stage 4) Ciwon huhu a cikin tsofaffin tsofaffi
Tun lokacin da ciwon huhu na 4 na huhu ya bayyana a cikin ƙwayoyin cutar, ba a ba da shawarar ba tukuna.
Ga mutanen da suka sami ciwon huhu , kuma mutanen da ba su taɓa shan taba ba tare da kowane irin ciwon huhu na huhu, ilimin kwayoyin (gwajin kwayoyin) don nema ga maye gurbin mutun mai sauƙi yana da matukar muhimmanci. Ga mutanen dake da maye gurbin EGFR , gyaran ALK ( ALK-tabbatacciyar ciwon huhu na huhu ) ko gyarawa na ROS1 , maganin kwantar da hankalin zai iya inganta rayuwa mai ci gaba, kuma magungunan da wadannan magunguna suke da ita sun fi sauƙi da kuma rashin lafiya da maganin gargajiya na chemotherapy.
Chemotherapy yawanci shine magunguna don maganin ciwo na ciwon huhu 4, kuma tare da marasa lafiya, masu haɗari biyu na likitanci suna amfani da su. Yawancin marasa lafiya marasa lafiya ba a bi da su ba tare da shan magani, duk da haka akwai amfani mai mahimmanci ga rayuwa ga waɗanda suka sami damar jure wa abubuwan da ke faruwa. Bugu da ƙari, yin amfani da magungunan magunguna biyu na iya haifar da rashin lafiyar rayuwa fiye da yin amfani da ƙwayar ƙwayar cuta guda daya kawai.
Immunotherapy
An riga an amince da maganin rigakafin rigakafin rigakafin rigakafi na rigakafi a shekarar 2015 da sauransu ana nazarin kwayoyin gwaji. Magungunan rigakafi na Immunotherapy za a iya tunanin su a hankali kamar yadda kwayoyi da suke mayarwa da kuma kunna ikon mu na iya yaki da ciwon daji. Wadannan magunguna ba su aiki ga kowa da kowa da ciwon huhu na huhu, dauki lokaci don fara aiki, amma idan yana da tasiri, wani lokaci zai haifar da kulawa na tsawon lokaci har ma da ciwon huhu. Ana samun sauƙin sauƙin sauƙin maganin likitoci na gargajiya na gargajiya.
Idan Kayi Tsohon Matashi da Ciwon Cutar Kyau
Idan kun wuce shekarun 70 ko 80 tare da ciwon huhu na huhu, ku tuna cewa shekarun da kuke "aiki" da "jin" yana da mahimmanci fiye da shekaru da kuka cika a kan bayanan likita. A lokaci guda kuma, masu sana'a na likita wadanda ba su san ka ba, kamar yadda ka san kanka na iya ganin shekarun da aka rubuta akan sakonka mafi muhimmanci. Duk abin da suke da aiki tare.
Abin da wannan ke nufi, musamman ma a cikin tarihin yau da kullum cewa tsofaffi ba za su iya jure wa maganganun magani ba, shi ne cewa dole ne ka sami kyakkyawan dangantaka da likitanka. Tabbatar cewa tana da masaniya cewa kana da shekaru 85 da haihuwa amma kana jin kamar kana 70. Abin godiya muna rayuwa ne a wani zamanin lokacin da jiyya ke ci gaba da zama da keɓaɓɓun mutum, kuma ana bambanta bambance-bambance tsakanin marasa lafiya. Wannan ya ce, karɓar lokaci don koyon yadda za ku kasance mai ba da shawara a kan ciwon daji na zai taimaka maka kullun tare da kalubale na rayuwa tare da ciwon daji da kuma maganin ciwon daji a mafi alhẽri, amma ƙila ma yana taka muhimmiyar rawa a sakamakonka.
> Sources:
> Blanco, R. et al. Binciken kula da marasa lafiyar marasa lafiya da marasa ciwon daji. Annals na Oncology . 2015. 26 (3): 451-463.
> Chambers, A., Routledge, T., Pilling, J. da M. Scarci. A cikin tsofaffin marasa lafiya da ke fama da ciwon huhu a cikin mahaukaci ana iya samun daidaituwa a cikin yanayin rashin lafiya, mace da mace da kuma rayuwa na rayuwa? . Hanyoyin Cutar Kodin Tsarin Hoto da Tashin Ciki . 2010. 10 (6): 1015-21.
> Davidoff, A., Tang, M., Seal, B. da M. Edelman. Chemotherapy da Tanadin Rayuwa a cikin marasa lafiya da marasa lafiya da marasa lafiya. Journal of Clinical Oncology . 2010. 28 (13): 2191-2197.
> Gaira, A. Ad A. Jatoi. Ƙunƙasar Ciwon Cutar Kwayoyin Cikin Ƙananan Ƙananan Cikin Tsoro Kan Marasa lafiya: A Tattaunawa game da Jiyya Zɓk. Journal of Clinical Oncology . An buga ta yanar gizo kafin a buga Yuli 28, 2014.
> Gridelli, C. et al. Jiyya na marasa lafiya marasa lafiya da marasa ciwon ƙwayar cutar ciwon ƙwayar cuta: Sakamakon wani Ƙwararrun Kwararrun Ƙwararru na Ƙasashen waje na Ƙungiyar Italiya ta Thoracic Oncology. Clinic Lung Cancer . 2015 Mar 7. (Epub gaba na buga)
> Maione, P. et al. Yin maganin ciwon daji marasa ciwon ƙwayar cuta a cikin tsofaffi. Harkokin Lafiyar Kwayoyin lafiya a ilimin Kimiyyar Lafiya . 2010. 2 (4): 251-260.
> Quiox, E. Optimal Pharmacotherapeutic dabarun na tsofaffi marasa lafiya tare da ci gaba da ba kananan cell kwayar cutar ciwon daji. Drugs & Aging . 2011. 28 (11): 885-94.
> Rivera, C. et al. Gudanar da miki da sakamako na marasa lafiya tsofaffi tare da kututtukan ƙwayar cutar ciwon ƙwayar cutar ƙanƙan ƙwayar cuta: wani binciken nazari-rikici. Chest . 2011. 140 (4): 874-80.
> Stamenovic, D., Messerschmidt, A., da T. Schneider. Tawaita don Tumatir Tumatir a cikin Tsofaffi: Nazarin Jakadancin Yammacin Bayanai game da Ƙarar Girma (fiye da Shekaru 80) a kan Ƙaddamar Matsala ta Amfani da Tsarin Tsarin Gyara. Jaridar Duniya na Tarkon . 2018. 52: 141-148.