Cutar cututtuka da ci gaba a Ciwon Cancer
Adenocarcinoma na huhu shi ne nau'i na ciwon daji na ƙananan kwayar halitta , wanda yafi yawan ciwon huhu na huhu. Ƙananan ƙwayar cutar kwayar cutar kwayar cuta ta kashi 80 cikin 100 na mummunar cutar huhu, kuma daga cikin wadannan, kimanin kashi 50 cikin dari ne adenocarcinomas.
Adenocarcinoma ne a yau yawan ciwon daji a cikin mata, Asians, da mutanen da ke da shekaru 45 . A fili, yana iya buga wadanda basu taba shan taba (ko dai ba smokers ko tsohon smokers) fiye da mutanen da ke halin yanzu hayaki.
Yayinda lamarin ya ragu a cikin maza da kuma rage mata a cikin mata, lambobin sun ci gaba da tasowa a cikin matasa, mata masu cin mutunci, kuma ba mu da tabbacin abin da ya sa. Yawanci sunyi imani da cewa jinsin, hayaki na biyu , da kuma nunawa ga radon a cikin gida duk suna taimakawa dalilai.
Cutar cututtuka
Adenocarcinomas na huhu yakan fara ne a cikin takalma a kusa da matsanancin sashi na huhu kuma zai iya kasancewa a can na dogon lokaci kafin bayyanar cututtuka sun bayyana. A lokacin da suka bayyana, alamun suna da sau da yawa a bayyane fiye da wasu nau'o'in ciwon huhu na huhu, bayyanar da tsohuwar tari da kututtuka jini kawai a baya, ƙaddarar matakai.
Saboda haka, wasu daga cikin mafi girma, bayyanar cututtuka (kamar gajiya, rashin ƙarfi na numfashi, ko ƙananan baya da ciwon ƙirji) na iya rasa ko an danganta su zuwa wasu dalilai. A sakamakon haka, samfurori suna da yawa marigayi, musamman a tsakanin matasa da masu shan taba ba wanda bazai taba ganin ciwon daji ba kamar barazana.
Sanin asali
Kwayar ciwon huhu a lokuta ne da farko an gano lokacin da aka gani abubuwa masu banƙyama a kan X-ray, yawanci a cikin nau'i mai launi mara kyau . Yayin da yake damuwa, binciken da akayi yana bada dama ga ganewar asali. A cikin kashi 25 cikin 100 na lokuttan da ke fama da cutar kanjamau, kwakwalwar X-ray ba za ta iya gano duk wani rashin daidaituwa ba kuma ya dawo da cikakkiyar asali.
Idan ana jin dadin ciwon daji, wasu, za a iya amfani da ƙididdiga masu mahimmanci, ciki har da:
- Ƙididdigar da aka ƙididdiga (CT scan) , ƙwaƙwalwar kirji wanda zai iya gano ƙananan ƙananan hauka fiye da rayukan rayuka kirji
- Girman hoton Magnetic Resonance (MRI) wanda ke amfani da filayen magnetic don yin hotuna
- Bronchoscopy , hanyar da za'a iya sanya sauƙin sassauci ta cikin cikin magwajin don dubawa mai zurfi a cikin huhu
- Positron watsigraphy (PET scan) wanda zai iya visualize yankunan na rayuwa hyperactivity, kamar su iya faruwa tare da ciwon daji Kwayoyin
Cytology na Sputum , wanda za'a iya amfani da samfurori na launi da ƙuri'a, za'a iya amfani dashi, amma an dauke shi mara amfani a gano cutar kanjamau.
Dangane da sakamakon, likitanku na iya so su samo samfurorin nama don tabbatar da ganewar asali. Bugu da ƙari ga ƙwayar cutar kwayar cutar kwayar halitta , sabon gwajin jini wanda ake kira ruwa mai kwakwalwa zai iya biyo bayan wasu cututtuka na kwayoyin halitta a cikin kwayoyin cutar kanjamau kamar su EGFR maye gurbin.
Farfesa na Farfesa da kuma PD-L1 Gwaji
Ɗaya daga cikin ci gaba mai ban sha'awa shi ne amfani da gwajin kwayoyin zuwa kwayoyin cutar kanjamau. Ta hanyar yin haka, likitoci zasu iya zaɓar jiyya da za su iya magance waɗannan ƙididdigar kwayoyin.
Wannan ƙirar da aka yi niyya ba shi da ƙasa sosai fiye da jiyya na farko da suka kai hari ga kwayoyin lafiya da marasa lafiya, wanda ya haifar da mummunan tasiri.
Sharuɗɗa na yau da kullum sun bada shawarar cewa duk wanda ke ci gaba da gwagwarmaya ko ƙwaƙwalwar ƙwayar ƙwayar ƙwayar cuta ta jiki za a gwada su da kwayoyin halitta kuma suna da gwajin PD-L1 don su bayyana ciwon daji na musamman.
Ƙwararrun musamman suna samuwa ba kawai ga waɗanda suke da maye gurbin EGFR , gyaran ALK , da ROS1 sake fasalin ba , amma BRAF, ERBB2, MET splice maye gurbi da kuma karawa, RET canje-canje, da sauransu. Bugu da ƙari, gwaji na asibiti suna cikin tsari suna kallon karin maye gurbi da kuma maganin kwantar da hankali.
An yi gwajin PD-L1 domin ya hango tasiri na kwayoyin immunotherapy guda uku da aka amince da su don cutar ciwon huhu. Tattaunawa da gwajin kwayoyin ku da gwajin PD-L1 yana daya daga cikin matakai mafi muhimmanci yayin da aka fara bincikar ku da maganin adenocarcinoma, yayin da wannan yanki yake sauyawa. Alal misali, an amince da miyagun ƙwayoyi na rigakafi na farko a shekarar 2015.
Tsarin
Da zarar an tabbatar da ganewar cutar sankara, likita zai magance cutar ta hanyar jigilar gwaje-gwaje. Makasudin yin gyare-gyare shine sanin yadda ciwon daji ke ci gaba, ko ya yada, kuma abin da, idan wani, wasu ƙwayoyin za su iya shiga. Shirye-shiryen yana taimaka wa maganin kai tsaye ta hanyar da ta dace, ba tare da rage mummunan hali ba ko kuma cike da damuwa a ciki kuma ya haddasa mummunan cutar fiye da kyau.
Matakan hudu an kwatanta kamar haka:
- Sashe na 0 : Ciwon daji ba tukuna ba tukuna, amma yana da magunguna-in-wuri .
- Magungunan ciwon daji na ruba: An yi tunanin ciwon daji na tsohuwar wariyar launin fata idan akwai kwayoyin cutar ciwon daji a cikin sputum amma baza a samu ciwon huhu a cikin huhu ba ta hanyar binciken hoto.
- Sashe na 1 : Cutar ciwon daji ne aka gano kuma ba ta yadawa ga kowane ɓangaren lymph. Wannan shine mataki na farko na "ciwo" huhu na huhu.
- Sashe na 2 : Ciwon daji ya yada zuwa ƙananan ƙwayar lymph, mai rufi daga cikin huhu, ko kuma manyan hanyoyi na huhu.
- Sashe na 3 : Ciwon daji ya yada zuwa nama a kusa. Sashe na 3 an sake karya cikin mataki na 3A da mataki na 3B waɗanda aka saba da su sosai.
- Sashe na 4 : Ciwon daji ya yada (metastasized) zuwa wasu sassan jiki ko akwai mummunar lalacewa . Kwayoyin cutar kanjamau na yawancin lokaci sukan yadu zuwa kasusuwa, kwakwalwa, hanta, da kuma glandon kwalliya.
Lokacin da kake koyo game da zaɓuɓɓukan magani za ka ji jin cewa cutar ciwon huhu da aka bayyana a cikin ɗaya daga cikin hanyoyi masu zuwa:
- Magungunan ciwon daji na farko : An yi amfani da lokacin farkon mataki don bayyana ciwon huhu na huhu wanda shine mataki 1, mataki na 2, da mataki 3A. Waɗannan su ne ciwace-ciwacen da za su iya jurewa tare da tiyata.
- Ciwon daji na ciwon huhu na gida: An yi amfani da wannan lokaci don bayyana ciwon daji wanda ke aiki 3A. Za'a iya yiwuwa a tiyata, amma magani na adjuvant da chemotherapy da radiation far ne yawanci ana buƙata don sarrafa tumɓir.
- Magungunan ciwon huhu na ciwon huhu : An yi amfani da maganin ciwon huhu na ciwon huhu da aka yi amfani da ita don cike da 3B da kuma ciwon gwaninta 4, kuma wani mataki ne wanda magungunan marasa lafiya ke da kyau.
Jiyya Zɓk
Dangane da mataki na cutar, magani na iya haɗawa ɗaya ko haɗuwa da wadannan:
- Za a iya yin tiyata a farkon matakai, ko dai shi kadai ko tare da maganin ilimin chemotherapy da / ko radiation.
- Za'a iya amfani da kwayar cutar shan magani kawai, tare da tare da radiation far, ko kafin ko bayan tiyata.
- Magunguna da aka ƙayyade su ne magunguna waɗanda aka tsara don kai farmaki akan wasu maye gurbin kwayoyin halitta. Suna aiki ta hanyar sanin wasu sunadarai masu mahimmanci a kan kwayoyin cutar kanjamau da kuma hana yaduwar kwayar halitta ta yin sauyi. Zabuka sun hada da Tarceva (erlotinib), Iressa (gefitinib), Gilotrif (afatinib), Xalkori (crizotinib), Zykadia (ceritinib), Alectinib (alecnensa), da Tagrisso (osimertinib).
- Za'a iya amfani da farfadowa na radiation ko dai don magance ciwon daji ko kuma kula da bayyanar cututtuka a waɗanda ke da ciwon daji na ƙwayar cuta. Ana iya amfani da wasu nau'o'in magani, wanda aka sani da radiotherapy na stereotactic (SBRT) , ko kuma maganin proton don ƙananan ciwon daji wanda ba tiyata ba.
- Immunotherapy wani nau'i ne na jiyya wanda yake nufin hada da tsarin kwayoyin jiki don yaki da ciwon daji. Zabuka na yanzu sun hada da Opdivo (nivolumab), Keytruda (pembrolizumab), da Tecentriq (atezolizumab).
Kalma Daga
Saboda farkon bayyanar cututtuka na adenocarcinoma ne sau da yawa wuya a gano, yawan shekarun shekaru biyar na rayuwa shine kawai kimanin kashi 18. Ga wadanda aka bincikar da su a farkon matakan, hangen zaman gaba ya fi kyau.
Abin da wannan mahimmanci shine bukatar samun ƙarin sani gameda mahimmancin bayyanar cutar kanjamau. A kan kansu, da alamar cututtuka na iya zama mai sauƙin kuskure. Tare, suna iya haifar da ja ja wanda zai iya haifar da asalin ganewar farko da baya, magani mai mahimmanci.
Kula da cutar adenocarcinoma yana cigaba da hanzari kuma sauye-sauyen rayuwa yana inganta. A wasu lokuta, ko da ciwon daji na cike da ƙwayar cuta za a iya kiyaye su a wani lokaci tare da maganin kwantar da hankali. Don ƙananan yawan mutane, maganin rigakafin rigakafi sun haifar da "amsa mai mahimmanci" ma'ana likitocin sunyi mamaki idan har ma za'a warke. Tare da mahimmancin binciken binciken kwayoyin, yana da matukar taimako ga samun likitan ilimin likita wanda ya kware da ciwon huhu a cikin huhu. Har ila yau, yana da mahimmanci a matsayin mai ba da shawara game da kulawar ciwon daji .
> Sources:
> Cibiyar Ciwon Ƙwayar Yammacin Amirka. "Ciwon daji na huhu (ƙananan ƙwayoyin cuta) Atlanta, Jojiya; sabunta Mayu 16, 2016.
> Chalela, R., Curull, V., Enriquez, C. et al. Lung Adenocarcinoma: Daga Tsarin Magungunan Lafiyar Halitta zuwa Tsarin Gudanar da Ciwon Gida da Immunotherapy. Journal of Thoracic Diseases . 2017. 9 (7): 2142-2158.
> DiBardino, D., Sagi, A., Elvin, J. et al. Yin amfani da Asibiti na Abubuwan Lafiya na Gabatarwa a Tsakanin Masaratai Zaɓaɓɓu Tare Da Lung Adenocarcinoma. Clinic Lung Cancer . 2016 17 (6): 517-522.e3.
> Yanayin Sholl, L. Diagnostics na Ciwon Toshe a Ciwon Gida. Translation na Lung Cancer Research . 2017. 6 (5): 560-569.