Kwayoyin cututtuka, Tsaida, Jiyya, da Fassara
Mene ne yake nufi idan kana da ciwon huhu na 3 da kuma yadda wannan ya bambanta daga wasu matakai? Waɗanne jiyya za a iya bada shawara kuma me ya kamata ka sani don haka zaka iya kasancewa mai bada shawararka a kula da ciwon daji? Mene ne alamar wannan mataki kuma ta yaya wannan canza tare da sababbin jiyya?
Bayani
Stage 3 marasa ciwon huhu na ciwon huhu na kwayoyin halitta shine ƙwayar cuta da ƙwayoyin cuta daban-daban da ke ci gaba da zama a mataki 3A da mataki 3B .
Cibiyar Advanced vs. Advanced Stage 3 Zuciya Ciwon daji
Yana da sauƙi wajen bayyana bambancin mataki na 3 ciwon huhu ta hanyar kwashe dukan ciwon huhu a cikin manyan nau'i biyu.
- Ciwon daji na ciwon huhu na gida - Sashen 3A ana dauke da cutar ciwon huhu na gida. Wadannan ciwace-ciwacen ba su yada zuwa yankuna masu nisa na jiki ba, amma sun yada zuwa ƙwayoyin lymph a gefe ɗaya na jiki kamar ƙwayar cuta. Matsayi na zuwa mataki na 3A ana iya ganin ciwon huhu na "mai aiki" ma'anar cewa tiyata yana ba da damar samun magani.
- Magungunan ciwon daji na ciwon daji - Tare da mataki na 4 na ciwon huhu na huhu, mataki na 3B cutar kanjamau yana dauke da cutar ciwon huhu . Wadannan ciwace-ciwacen sun yada zuwa mataki wanda irin wannan tiyata ba zai yiwu ba (sai dai idan wani lokacin kuma, bayan jiyya da chemotherapy da radiation far.) Wadannan ciwace-ciyen "ba su iya yiwuwa" kuma ba a iya magance su ba, amma suna da kyau, kuma wasu sababbin jiyya sun kasance amince a cikin 'yan shekarun nan.
Tsarin jima'i
Kusan kashi 30 cikin dari na mutanen da ke fama da ciwo na huhu 3 a lokacin ganewar asali, suna barin kashi 30 na mutanen da aka bincikar da su a wani mataki na baya ( mataki na 1 ko mataki na 2 ) da kuma kashi 40 cikin 100 da suka ci gaba da ci gaba da ciwon cutar kanjamau (4) (metastatic) . lokacin ganewar asali.
Tsarin
Ciwon kwakwalwa na ciwon huhu yana da matukar muhimmanci wajen zabar mafi kyawun maganin maganin, musamman yin bambanci tsakanin mataki 3A da mataki 3B.
Stage 3 ciwon huhu na huhu shine mafi kyau aka kwatanta ta hanyar rabuwa da matakai 3A da mataki 3B dabam.
Sashi na 3A ciwon daji ya ƙunshi ciwon daji da yawa kuma sun yada zuwa ƙwayoyin lymph kusa, ko ciwace-ciwacen kowane nau'in da suka yada zuwa ƙananan ƙwayoyin lymph wadanda suke da nisa amma har yanzu a gefe ɗaya na jiki a matsayin ciwon daji.
Sashin ciwon kwakwalwa na 3B an bayyana shi azaman ƙwayar kowane nau'i wanda ya yada zuwa ƙananan ƙwayar lymph ko ya mamaye wasu sifofi a cikin kirji (kamar zuciya ko esophagus .) Tumors da ke ɗauke da mummunan labaran ƙwararru (gina jiki dauke da ciwon daji a cikin rami na tsakiya tsakanin sassan da ke kunshe da huhu) an canza daga mataki 3B zuwa mataki 4 a 2009.
Masu binciken ilimin halitta sunyi amfani da tsarin TNM don kara bayyana ƙananan ciwon daji na huhu. Bayani mai sauƙi na tsarin TNM ya hada da:
T tana nufin girman tumo:
- T1 - Tashin tumatir ya kasa da 3 cm (1 ½ inci) a cikin girman.
- T2 - Tsari ya fi 3 cm.
- T3 - Tsarin zai iya zama kowane girman, amma yana kusa da filin jirgin sama ko ya yada zuwa yankunan gida kamar bangon katako ko diaphragm .
- T4 - Tsari yana da kowane girman, amma yana cikin filin jirgin sama ko ya mamaye hanyoyi na gida kamar zuciya, ko esophagus.
N tana nufin ƙwayoyin lymph:
- N0 - Babu alamar shafi.
- N1 - Zangon ya yada zuwa kusoshi na kusa a gefe ɗaya na jiki.
- N2 - Ciwon sukari ya yadu zuwa nodes gaba daya amma a gefe ɗaya na jiki.
- N3 - Kwayoyin ciwon daji suna cikin ƙwayoyin lymph a gefe ɗaya daga cikin kirji daga kututture, ko a cikin kusurwa kusa da ƙwanƙara ko ƙuƙƙun wuyan wuyansa.
M wakiltar cutar metastatic :
- M0 - Babu ƙananan ƙwayoyin cuta.
- M1 - Ciwon sukari ya yada (metastasized) zuwa wasu yankuna na jiki ko sauran ƙwayar.
Yin amfani da tsarin TNM, mataki na 3A ciwon ciwon huhu ne aka bayyana kamar:
- T1N2M0 - Ciwon sukari ya kasa da 3 cm cikin girman kuma ya yada zuwa ƙananan ƙwayoyin lymph gaba da gaba amma a gefe ɗaya na jiki azaman ƙari.
- T2N2M0 - Tumarin ya fi girma 3 cm kuma ya yada zuwa ƙananan ƙwayar lymph gaba daya amma a gefe ɗaya na jiki.
- T3N1M0 - Tumarin yana da girman amma yana kusa da wani jirgin sama ko ya yadu a gida zuwa wani yanki kamar bangon katako ko diaphragm, kuma ana iya shafa wasu ƙwayoyin lymph a kusa.
- T3N2M0 - Tumarin yana da girman amma yana kusa da wani jirgin sama ko ya yada zuwa gida zuwa wani yanki kamar murfin katako ko diaphragm, da kuma ƙananan ƙwayoyin lymph wanda suke nisa amma a gefe ɗaya na jiki suna shafar.
Yin amfani da tsarin TNM, mataki na 3B an bayyana shi kamar:
- Kowane T, N3, M0 - Tsarin kowane nau'i wanda ya yada zuwa ƙananan lymph a gefe ɗaya daga cikin kirji daga tsutsa ko zuwa kusoshi a kusa da ƙwanƙara ko ƙuƙƙwalwar wuyansa, amma bai yada zuwa yankuna masu nisa na jiki ba.
- T4, Duk N, M0 - Tsarin kowane nau'i wanda yake a cikin hanyoyi, ko ya mamaye hanyoyi na gida kamar su zuciya ko esophagus. Nodes zasu iya ko ba zasu shiga ciki ba, kuma lokacin da ya shafa, zai iya zama kusa da ƙwayar ko ci gaba a cikin kirji ko wuyansa, amma ƙwayar ba ta yada zuwa yankuna masu nisa ba.
Cutar cututtuka
Sakon 3 ciwon daji na ciwon huhu na iya canzawa tun lokacin da mataki na 3 ya hada da ciwon cancers. Cutar cututtuka saboda ciwon daji a cikin huhu kamar kara tari , rashin ƙarfi na numfashi , da kuma maimaita cututtuka irin su ciwon huhu ko mashako, su ne na kowa.
Tallawa ga yankunan kamar murfin katako da diaphragm zai iya haifar da ciwo a cikin kirji, hagu, kafadu, da baya. Tumors dake kusa da hanyoyi na iska na iya haifar da hemoptysis ( yalwata jini ) da kuma raguwa . Lokacin da kututtukan ya shafi yankunan kamar sophagus da sauran nau'in kwakwalwa, dysphagia (wahalar haɗuwa) da kuma hoarseness zai iya faruwa. Pain a baya, kirji, da haƙarƙari na yau da kullum idan an sami nauyin maganganu, wannan zai iya haifar da rashin ƙarfi na numfashi.
Gabalar bayyanar cututtukan ciwon daji irin su gajiya da rashin asarar hasara ba za a iya kasancewa ba.
Jiyya
Yin maganin ciwon huhu 3 na huhu shi ne mafi yawan rikici na dukan ciwon daji na ciwon huhu, wasu saboda wannan rukuni ya bambanta. Saboda rashin lafiyar matalauta, Cibiyar Cancer ta Duniya ta nuna cewa duk wanda ke fama da cutar ciwon huhu 3 zai zama dan takarar don gwaji - nazarin da yayi nazari akan sababbin jiyya ko haɗuwa da jiyya don cutar ciwon huhu.
Sashe na 3A Jiyya
Ga wani mataki 3A kwayar cutar ciwon daji, tiyata za a iya yi don cire ƙwayar cuta kuma yawanci ana biye tare da adjuvant chemotherapy (chemotherapy bayan tiyata). Hoto yana ba da dama don magani amma ba kullum yana yiwuwa tare da ciwace-ciwacen ƙwayar wannan girman ba. Rashin ciwon ciwon huhu na ciwon huhu yana da kyau sosai ga mutanen da ke fama da ciwon huhu na 3A.
Ga wa] anda ke da lafiya, haɗarin chemotherapy ko chemotherapy da radiation far ne sau da yawa shawarar. Idan mutane ba su iya jure cutar chemotherapy, za a iya amfani da maganin radiation kadai don magance cututtuka irin su zafi da rashin ƙarfi na numfashi.
A yanzu an ba da shawarar cewa za a yi amfani da labarun kwayoyin (gwajin gwaji) ga kowa da kowa tare da marasa ciwon huhu na ƙwayar cutar ƙwayar cutar, musamman ma adenocarcinoma . An amince da magunguna don mutane tare da direbobi masu kamfani kamar maye gurbin EGFR , gyare-gyaren ALK , da ROS1 canje-canje , da kuma hanyoyin da za'a tsara don magance cutar. Rikici yakan tasowa lokaci, amma an riga an amince da magunguna na gaba kuma an gwada su a gwajin gwaji don lokacin da wannan ya faru. Ga wadanda ke dauke da kwayar cutar kwayar cutar ta jiki , za a iya amfani da kwayoyin cutar EGFR. Kwalejin gwaji suna nazarin magunguna wanda ke magance sauran canji na kwayar cutar kanjamau.
An amince da sababbin magungunan rigakafi hudu a shekarar 2015 domin maganin cutar kanjamau. Wadannan magunguna suna aiki ne ta hanyar bunkasa ikon da muke da shi don yaki da ciwon daji. Duk da yake ba su yi aiki ga kowa ba, wasu mutane sun sami ciwon da ba su da lafiya na tsawon lokaci. Imfinzi (durvalumab) musamman an amince da ita a watan Fabrairun 2018 domin maganin cutar kanjamau 3 wanda ba a iya aiki ba bayan shan magani da cutar radiation. Lokacin da aka yi amfani da shi a cikin wannan saitin, an samo shi don inganta rayuwar rayuwar ci gaba.
Sashe 3B Jiyya
Saki na 3B, wanda ba kamar mataki 3A ba, ba za'a iya magance shi ba tare da tiyata. A wasu kalmomi, ba za su iya yiwuwa ba- amma ba wanda ba a iya gwadawa ba. Hanyoyi na iya haɗa da chemotherapy, maganin radiation, maganin kwantar da hankali, da kuma immunotherapy kamar yadda cutar ta 3A take.
A wasu lokuta, yin amfani da chemotherapy da radiation na farfadowa zai iya rage yawan ƙwayar cuta don haka tiyata zai yiwu. An yi amfani da cutar shan magani a wannan hanyar "neoadjuvant chemotherapy."
Ga mutanen da ke fama da ciwon huhu 3, za a iya amfani da jiyya azaman magani mai mahimmanci , ma'ana cewa mayar da hankali ga maganin yana taimakawa bayyanar cututtuka irin su zafi da rashin ƙarfi na numfashi maimakon ƙoƙarin sarrafa ciwon daji. A hakika an gano cewa tsarin farfadowa na mutanen da ke fama da ciwon huhu na huhu zai iya bunkasa rayuwa.
Faɗakarwa
Matsayin rayuwa na tsawon shekaru 5 na mataki na 3A ciwon huhu na huhu shine kashi 14, amma zai iya bambanta a yadu. Halin shekaru 5 na rayuwa tare da ciwon kwakwalwa na 3B na ciwon huhu yana baƙin cikin kawai kashi 5 cikin 100 Yana da muhimmanci mu tuna cewa wadannan kididdigar sun dogara ne kan yadda mutane ke fama da ciwon huhu a cikin mahaifa. Tun da akwai wasu magunguna da aka amince da su don maganin cutar kanjamau a tsakanin 2011 da 2015 fiye da shekarun da suka wuce a shekara ta 2011, waɗannan kididdigar ba su da tabbas a cikin ƙayyadaddun rai a yau.
Ciyar da goyon baya
Nazarin ya nuna cewa sanin abin da zaka iya game da ciwon daji ke taimakawa tare da sakamakon. Tambayi tambayoyi. Ku hada da ƙaunatattun ku kuma ku ƙarfafa su su yi tambayoyi. Yi la'akari da shiga ƙungiyar goyon bayan . Koyi game da gwaji na asibiti wanda zai dace da halinka na musamman. Koyo game da ciwon daji da kuma yin tafiya ta hanyar magani zai iya ɗaukar lokaci mai yawa. Tambayi kuma bada izinin abokan ka da abokanka don taimakawa da kuma karfafa maka a cikin tafiya. Kada ku rasa fata-ko da idan wannan begen ya zama mai dadi sosai yayin da kuke jin dadin kamfanonin ku.
Sources
Cibiyar Cancer na Amurka. Ciwon daji na huhu ( ƙananan ƙwayoyin cuta)
Cibiyar hadin gwiwa ta Amirka kan cutar kanjamau. Lung Cancer Tsarin. Edition 7th.
> Antonia, S., Villegas, A., Daniel, D. et al. Durvalumab Bayan Chemoradiotherapy a Stage III Ciwon Ƙwayar Ciwon Kwayoyin Ƙananan Ƙananan Cututtuka. Jaridar New England Journal of Medicine . 2017. 377: 1919-1929.
Edge, S. et al (Eds.). AJCC Canjin Tsarin Kwayar Cancer. Edition 7th. Springer. New York, NY. 2010.
Faithi, A. da J. Brahmer. Chemotherapy don ci gaba da cigaba marasa ciwon kwayar cutar ciwon huhu. Seminars a cikin Thoracic da Tiyata na zuciya . 2008. 20 (3): 210-6.
Cibiyar Cancer ta Kasa. Ƙunƙasar Ciwon Kwayoyin Wutar Cutar Kan Ƙasar Kanana (PDQ) - Shafin Farko na Lafiya.