Cutar da Ciwon Cizon Ƙari Daga Cutar Cancer
Idan an gaya maka cewa ciwon huhu na huhu (ko wani ciwon daji) ya yada zuwa glandarka (adresal metastases) zaka iya jin damuwa. Ba kamar yaduwar cutar ciwon daji a sauran wurare, kamar hanta, yada zuwa ga glandan bala'i ba'a magana game da akai-akai. Wancan ya ce, ƙwayoyin ganyayyaki ne na al'ada da ciwon huhu. A ina ne ƙyamar daji da kuma abin da yake nufi idan cutar tajinka ta yadu zuwa wannan wuri?
Koyi dalilin da yasa metastases zuwa gland yana iya kasancewa mafi alhẽri a cikin wasu tashoshin metastases, musamman ma lokacin da suke faruwa a gefe ɗaya na jiki a matsayin ciwon daji.
Bayani
Glandan raguwa sune ƙananan nau'in nau'i mai nau'in triangular wanda ke samuwa a saman kowane koda. Wadannan glandocin endocrin suna da alhakin ɓoye kwayoyin hormones, ciki har da "hormones mai tsanani" kamar cortisol, epinephrine (adrenaline), da kuma norepinephrine.
Ciwon daji da ke Yadawa zuwa Gudun Adrenal
Kusan duk wani ciwon daji zai iya yadawa zuwa gland, amma wasu ciwon sukari sun fi dacewa da wasu zuwa metastasize zuwa wannan yanki. A cikin binciken daya, yawancin ciwon daji wanda ke da alhakin ƙwayar ganyayyaki na jiki shine kwayar huhu (kashi 35 cikin 100) da ciwon daji ke ciki (kashi 14) na ciwon daji na asibiti (kashi 12) da ciwon hanta / bile duct (kashi 10). Sauran cututtuka na yau da kullum da suka yada zuwa wannan yanki sun hada da ciwon daji, melanoma, ciwon nono, ciwon daji, da lymphoma.
Idan cutar kanjamau ta yadu zuwa gland, za a dauki mataki na 4 wanda ba shi da kananan kwayoyin cutar ciwon huhu (ko kuma karamin ciwon ƙwayar cutar kanjamau). A baya, akwai kadan da za a yi saurin cutar kanjamau a lokacin da aka gaji. A cikin 'yan shekarun nan, duk da haka, an lura cewa ga wasu mutane-musamman ma wadanda ke fama da ƙananan ƙwayoyin cuta-mikiyar zubar da ƙwayar ƙwayoyin cuta zasu iya haifar da rayuwa mai tsawo.
Kamar yadda aka tattauna a kasa, Sakamakon maganin ciwon daji na ƙwayar cuta na jiki zai iya zama mafi alhẽri fiye da bayyanar da wasu matakan metastases - irin su waɗanda suke hanta, kwakwalwa da kasusuwa.
Dama akan Adastal Metastases
Kimanin kashi 40 cikin dari na mutanen da ke fama da ciwon huhu na huhu za su ci gaba da cin zarafi a wasu lokuta, kuma cikin kashi 10 cikin dari na mutanen da ke fama da ciwon daji na marasa ciwon ƙwayar cutar, cutar ta yada zuwa ga gilashi. Wadannan ganyayyaki sun kasance a cikin kashi 2 zuwa 3 cikin mutane a lokacin ganewar asali, kuma a lokuta da dama sune alamun farko na cutar kanjamau.
Cutar cututtuka
Yawancin lokaci lokacin da ciwon daji ya yadu zuwa ga glanden da ba a samu ba. A gaskiya, a cikin binciken daya kawai Kashi 5 cikin dari na mutanen da ke da ƙwayar ƙarancin ƙwayar cuta suna da alamun bayyanar cututtuka. Mutane sun fi sani kawai da waɗannan masarauta saboda ilimin rediyo irin su CT scan, MRI, ko PET.
Lokacin da bayyanar cututtuka sun kasance, sun haɗa da:
- Raunin baya (a tsakiyar yankin baya).
- Abun ciki na ciki.
- Buga cikin ciki (zubar jini).
- Cutar da ke ciwon cuta ( Addison's disease ): Cutar cututtuka na Addison ta iya haɗa da rauni, rage jini (hypotension), jini mai zurfin jini ( hypoglycemia ), matakin sodium low (hyponatremia), da kuma matsakaitan potassium ( hyperkalemia ).
Sanin asali
Idan kana da wani mahimmanci mai kyau don ƙananan metastases, ba za ku buƙaci wani ƙarin kimantawa ba, musamman idan kuna da metastases zuwa wasu yankuna na jikinku. A wasu lokuta, likitanku na iya so a tabbata cewa wani taro a glandarka ta jiki ne saboda ciwon daji na ƙwayar cuta, kuma ya bada shawara ga biopsy mai kula da CT.
Jiyya
Gwargwadon da aka ba da shawara don ƙaddarar ganyayyaki zai iya bambanta dangane da dalilai da dama. Don duk taimakon jama'a yana da mahimmanci. A cikin mutanen da ke da alamun bayyanar cututtuka irin su ciwon jini, jiyya kamar aikin tiyata na iya zama dole don kula da bayyanar cututtuka. A wasu mutane, magani tare da manufar maganin ciwon daji na iya zama yiwuwar.
Taimako na tallafi: Ko dai kai da likitanka sunyi shawara akan ci gaba da maganin ciwon daji ko ƙananan ƙwayar jikinka, kula da bayyanar cututtuka yana ci gaba. Mutanen da ke fama da ciwon daji sun cancanci kulawa da kyau da kuma kula da sauran cututtuka da suka shafi ciwon daji.
Jiyya na cututtukan cututtuka: Kamar yadda muka gani a sama, adadar ƙwayoyin cuta na da wuya ya haifar da bayyanar cututtuka. Idan matakan da ake zubar da jini (zubar da jini) ko kuma yana da haɗarin jini, tiyata don cire ƙwayar ƙwayar jikin mutum da glandon adrenal (adrenalectomy) za'a iya bada shawarar. Idan matakan ƙaddarar sun haifar da rashin lafiya, ba za a iya kula da maganin steroid ba. Idan ciwo ko ciwo na ciki ya faru, wannan ya kamata a bi da shi.
Jiyya na Tumatir na Farko da Sauran Metastases: Yin maganin mataki na 4 na ciwon huhu na mahaifa zai iya haɗa da chemotherapy, maganin kwantar da hankali, immunotherapy, da / ko radiation far. Wasu mutane sun shiga cikin gwaji na asibitocin nazarin sababbin kwayoyi da hanyoyin. Bugu da ƙari da maganin kwantar da hankali da kuma rigakafi, sun canza yanayin ciwon ciwon huhu na tsofaffin mahaifa a cikin 'yan shekarun nan. Lokacin da maye gurbin kayan lambu ya kasance, ƙwayoyin magungunan da ake amfani da su a wasu lokutan suna iya ba da izinin likitoci su bi da cutar ciwon huhu 4 kamar yadda cutar ta kamu da cutar. Yayin da juriya take faruwa a wadannan kwayoyi a lokaci, a wasu lokuta na biyu ƙarni kuma yanzu samfurori na uku suna samuwa idan wannan ya faru. Immunotherapy, lokacin da tasiri, wani lokaci ma ya haifar da "amsa mai daɗi," da ciwon ciwon huhu na huhu a cikin bincike na tsawon lokaci. Tun lokacin da aka ba da izinin farko a cikin wannan rukunin a shekarar 2015, ba mu sani ba idan gafarar da muke gani za ta ƙare, ko abin da za a samu na tsawon lokaci.
Jiyya Tare da Turar Curative: Ga mutanen da ke da ƙwayar maganin ƙwararrun ƙwayar jiki, magani zai iya haifar da rayuwa mai tsawo. Zabuka sun haɗa da:
- Hoto: Dukkanin budewa da laparoscopic adrenalectomy (cire glanden gwal) na iya yin aiki tare da wasu manufofi.
- SBRT: Idan tiyata ba zai yiwu ba, nazarin ya nuna cewa tsarin rediyo na stereotactic (SBRT) zai iya zama tasiri da kuma jurewa. SBRT ya haɗa da yin amfani da wani babban kashi na radiation zuwa wani karamin yanki, kuma wani lokacin yana da sakamakon kama da tiyata.
- Ablation: Hoton da aka ba da jagorancin jagorancin hoto shi ne wani zaɓi. Wani bincike na shekara ta 2018 ya gano cewa, kodayake rashin lafiyar ya fi talauci ga wadanda ke fama da ciwon huhu a cikin ƙwayoyin cutar daji wadanda suka yi aiki fiye da wasu cututtukan da suka dace, wanda ya jagorantar halayen adonal metastases na iya kara yawan rayuwa da ci gaba da rayuwa. A cikin binciken, matsakaicin yawan rayuwa (ga dukkan nau'o'in ciwon sukari hade) a 1, 3, da shekaru 5 sun kasance 82, 44, da kashi 34 cikin 100 bayan bin hanyar.
Faɗakarwa
Ba tare da maganin ba, magani na tsakiyar bayan bin ganewar asali na adastal metastases shine kawai watanni 3 a cikin binciken daya. Wannan ya ce, kuma ba kamar ƙananan ƙwayoyin jiki zuwa sauran sassan jiki ba, maganin wadannan ganyayyaki a cikin mutanen da aka zaɓa tare da cutar ciwon huhu na kananan yara ba su haifar da rayuwa mai tsawo ba. Wadannan kididdigar rayuwa sun hada su ne kafin sababbin jiyya irin su immunotherapy, da kuma magungunan da aka tsara a yanzu, sun yarda da cutar kanjamau.
Ƙananan binciken da ake yin nazari game da maganin ƙwayoyin ƙwayoyin cuta sunyi ƙarfafawa. Alal misali, a cikin nazarin guda daya game da marasa lafiya 37, yawancin rayuwa ya kasance kashi 34 cikin dari na marasa lafiya wadanda ke da tiyata, amma kashi 0 cikin 100 na wadanda basu da tiyata. Wani bincike na baya-bayan nan ya gano cewa rayuwa mai yiwuwa a cikin kashi 25 cikin dari na masu halartar da ake bi da su don cin zarafi.
Tare da ciwon ciwon huhu na kananan ƙwayoyin cuta , binciken ya gano cewa, ba kamar metastases ga hanta, kwakwalwa, kasusuwa, da guraben ruwa ba, metastases zuwa glanden gilashi ba alamu ba ne.
Me yasa yaduwar hangen nesa zai zama mafi kyau ga ƙananan ƙarancin jini fiye da sauran ƙananan ƙwayoyin cuta?
Amsar wannan tambayar game da dalilin da yasa salutattun ƙwayoyin ƙwayar cuta suna da matsala mafi kyau, na iya kasancewa a kan yadda ciwon daji ke yadawa don ya isa gland. Ciwon daji ya yada cikin hanyoyi guda uku. Ɗaya yana kusa da kututtukan. Wani yana ta hanyar lymphatics. Kuma na uku shine ta hanyar jini. Lokacin da kwayoyin cutar ciwon daji ke shiga cikin jini suna tafiya cikin jiki. (Wasu masu bincike sun yi imanin cewa ciwon huhu na iya ci gaba da yaduwa, ko ta hanyar hanyoyi.)
A cikin binciken daya da yayi nazarin tasirin adrenalectomy akan rayuwa, an gano cewa tare da "cutar tsarrai" - wato, yaduwar cutar ciwon daji zuwa glandon jiki a gefe ɗaya na jiki kamar cutar ciwon huhu - tsawon shekaru 5 na rayuwa ya kasance kashi 83. Ya bambanta, tsawon rayuwar shekaru 5 na mutanen da suke da "ƙananan ƙaddarar" -nar da ƙananan ƙwayoyin jiki a gefe guda na jiki daga ciwon huhu na huhu, tsawon shekaru 5 da aikin tiyata ba kome ba ne.
Ana tsammanin cewa lokacin da ciwon huhu ya yadu zuwa gland din da ke gefe ɗaya na jiki, sai ya kai glandar ta hanyar hanyar lymphatic. Ya bambanta, a lokacin da gwanin da ke jikinsa ya shafa, zai iya tafiya ta hanyar jini (zubar da jini) don isa gawar da ke ciki kuma sakamakon ba shi da kyau.
Kalma Daga
Sakamakon ganewa tare da kwayar cutar (mataki na 4) ciwon huhu ba shine abin da muke so ba. Wannan ya ce, daga dukkan shafuka na metastases, adadar ganyayyaki sun kasance suna da mafi alhẽri a cikin kwayoyin halitta (kuma kamar yadda aka gani, zangon mahimmanci ya fi kyau idan glandar jikin ta kasance a gefe ɗaya na jiki kamar cutar ciwon huhu). Bugu da ƙari, zaɓuɓɓukan maganin da zafin rayuwa don ciwon ciwon huhu na ciwon huhu a gaba ɗaya suna inganta sosai, musamman idan an yi amfani da hanyoyin kwantar da hankula don maye gurbin kwayoyin halitta ko kwayoyin immunotherapy don magance tumɓir.
Idan an gano ku tare da ciwon daji na 4 da ciwon daji da ƙwayar cuta, ku ɗauki lokaci ku koyi game da ciwon daji. Kasancewa a cikin ciwon kankara a cikin layi yana da matukar taimako. Sabbin magunguna suna inganta lafiyar rayuwa, amma maganin ciwon huhu na huhu yana canzawa da sauri wanda yana da wahala ga kowa ya zauna a kan sabon binciken. Idan kuna tunanin yadda za ku sami mutanen da suke kan "cututtuka" na bincike kan cutar kanjamau, ta amfani da hashtag #lcsm don ciwon kwakwalwa ta hanyar ciwon kwakwalwa ta jiki ba komai ba ne.
Kuna iya yin la'akari da ra'ayi na biyu a daya daga cikin Cibiyar Cancer ta Cibiyar Cancer ta Tsakiya-wadda aka tsara cibiyoyin ciwon ciwon daji, inda masu ilimin likitocin da suka kware a kan ciwon huhu a cikin mahaifa sun sami damar yin bincike da kuma gwaje-gwaje na asibiti. Abu mafi mahimmanci, yi aiki mai kyau a kulaka kuma zama mai bada shawara . Muna koyon cewa kai tsaye (ko samun aboki ko ƙaunataccen wanda zai iya nazarin lafiyar ku da kuma mai ba da shawara ga ku), ba kawai rage damuwa ba kuma yana taimaka muku ji daɗin cutar ku, amma zai iya inganta sakamakon ku.
> Sources:
> Bastian, S. et al. Nazarin Harkokin Miki na Ƙananan Ƙananan Ƙararren Ƙararruwar Marasa lafiya da marasa lafiya da ƙwayar cutar ƙwayar cutar ƙwayar cutar ta jiki: Ƙwarewar Kwarewa da Ƙwarewar Litattafai. Onkologie . 2011. 34 (12): 665-70.
> Bazhenova, L. et al. Maganin ƙwayar cuta a cikin Ciwon Kwayar Kwayar Kwayar cuta: Abubuwan Tafiyar Halitta na Halin Lissafi. Jaridar Thoracic Oncology . 2014. 9 (4): 442-6.
> Frenk, N., Daye, D., Tuncali, K. et al. Gudanar da Yanki da Rayuwa Bayan Bayanan Hotuna-Yadda Za a Yi Magana da Abun Cutar Abun Cizon Ƙasa. Journal of Vascular and Interventional Radiology . 2018. 29 (2): 276-284.
> Hwang, E. et al. Dalilai na Dama don Saukewa da Saurin Halitta Bayan Adrenalectomy for Carcinoma Metastatic. BMC Urology . 2014. 14:41.
> Nakazawa, K. et al. Ƙididdigar Dabbobi na Musamman da Rayuwa a Ƙananan Ciwon Cutar Kwayar Kwayoyin Kwayoyin cuta. Takardun Oncology . 2012. 4 (4): 617-620.
> Raz, D. et al. Ayyukan marasa lafiya tare da ƙananan ƙananan ƙwayoyin cuta daga ƙananan ƙwayar cutar kankara. Annals na Thoracic Tiyata . 2011. 92 (5): 1788-92.
> Riiimaki, M. et al. Tasirin Metastatic da Rayuwa a Ciwon Kankara. Lung Cancer . 2014 Aug 2. Epub gaban bugu.