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Unyango lweCancer Lung Cancer (®) –Patient Version

Ulwazi ngokubanzi malunga noMhlaza weSifo seMiphunga

IINGONGOMA EZIPHAMBILI

• Umhlaza omncinci wesifo somhlaza sisifo apho umhlaza (umhlaza) weeseli zenzeka kwizicubu zemiphunga.

• Kukho iintlobo ezimbini eziphambili zesifo somhlaza wamaphaphu omncinci.

• Ukutshaya yeyona nto iphambili emngciphekweni wesifo somhlaza esincinci semiphunga.

• Iimpawu kunye neempawu zesifo somhlaza esincinci semiphunga kubandakanya ukukhwehlela, ukuphefumla kancinci, kunye nentlungu esifubeni.

• Uvavanyo kunye neenkqubo ezivavanya imiphunga zisetyenziselwa ukufumanisa (ukufumana), ukufumanisa isifo, kunye nenqanaba lomhlaza omncinci wesifo semiphunga.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

• Kwizigulana ezininzi ezinomhlaza omncinci wamaphaphu, unyango lwangoku alunyangi umhlaza.

Umhlaza omncinci wesifo somhlaza sisifo apho umhlaza (umhlaza) weeseli zenzeka kwizicubu zemiphunga.

Imiphunga zizinto zokuphefumla ezimile okwee-cone ezifumaneka esifubeni. Imiphunga izisa ioksijini emzimbeni xa uphefumlela ngaphakathi kwaye ikhuphe ikharbon diokside xa uphefumlela ngaphandle. Umphunga ngamnye unamacandelo abizwa ngokuba ziilobes. Umphunga wasekhohlo unee-lobes ezimbini. Umphunga wasekunene, omkhulu kancinci, unemithathu. Inwebu ebhityileyo ebizwa ngokuba yiplaura ijikeleze imiphunga. Iityhubhu ezimbini ezibizwa ngokuba yi-bronchi zikhokelela kwi-trachea (umbhobho womoya) ukuya kwimiphunga yasekunene nasekhohlo. Ngamanye amaxesha i-bronchi ichaphazeleka ngumhlaza wemiphunga. Iityhubhu ezincinci ezibizwa ngokuba zii-bronchioles kunye neesakana zomoya ezincinci ezibizwa ngokuba zii-alveoli zenza ngaphakathi kwimiphunga.

I-Anatomy yenkqubo yokuphefumla, ebonisa i-trachea kunye nemiphunga yomibini kunye ne-lobes yazo kunye neendlela zomoya. Iimpawu ze-lymph kunye ne-diaphragm nazo zibonisiwe. Ioksijini iphefumlelwe ngaphakathi emiphungeni kwaye idlula kwiimbumba ezincinci zealveoli nasegazini (jonga ngaphakathi).

Zimbini iintlobo zomhlaza wemiphunga: umhlaza wamangqamuzana amancinci kunye nomhlaza wamaphaphu ongaqhelekanga.

Esi sishwankathelo malunga nomhlaza omncinci wesifo somhlaza kunye nonyango. Jonga ezi zishwankathelo zilandelayo ze- ngolwazi oluthe kratya malunga nomhlaza wemiphunga:

• Unyango lweCancer Lung Cancer

• Umhlaza ongaqhelekanga woNyango lwaBantwana

• Uthintelo lomhlaza wemiphunga

• Uvavanyo lomhlaza wemiphunga

Kukho iintlobo ezimbini eziphambili zesifo somhlaza wamaphaphu omncinci.

Ezi ntlobo zimbini zibandakanya iintlobo ezahlukeneyo zeeseli. Iiseli zomhlaza zohlobo ngalunye zikhula kwaye zisasaze ngeendlela ezahlukeneyo. Iindidi zesifo somhlaza wamaphaphu esincinci zibizwa ngokuba ziintlobo zeeseli ezifumaneka kumhlaza kunye nendlela iiseli ezijongeka ngayo xa zijongwa phantsi kwemicroscope:

• Iseli encinci ye-carcinoma (umhlaza weseli ye-oat).

• Iseli encinci edibeneyo yeseli.

Ukutshaya yeyona nto iphambili emngciphekweni wesifo somhlaza esincinci semiphunga.

Nantoni na eyandisa amathuba akho okufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha wakho ukuba ucinga ukuba unokuba semngciphekweni womhlaza wemiphunga.

Imiba yomngcipheko womhlaza wemiphunga ibandakanya oku kulandelayo:

• Ukutshaya iisigarethi, imibhobho, okanye iicigars, ngoku okanye ngaphambili. Le yeyona nto ibaluleke kakhulu kumngcipheko wemiphunga. Ukuqala ebomini umntu uqala ukutshaya, kokukhona umntu etshaya, kwaye okukhona umntu etshaya, kokukhona umngcipheko womhlaza wemiphunga umkhulu.

• Ukuvezwa kukutshaya.

• Ukuvezwa kwi-asbestos, arsenic, chromium, beryllium, nickel, soot, okanye tar kwindawo yokusebenza.

• Ukuvezwa kwimitha kuyo nayiphi na kwezi zinto zilandelayo:

• Unyango ngemitha esifubeni okanye esifubeni.

• Radon ekhaya okanye kwindawo yokusebenza.

• Ukujonga iimvavanyo ezinje nge-CT scan.

• Imitha yeebhombu zeatom.

• Ukuhlala apho kukho ungcoliseko lomoya.

• Ukuba nembali yosapho yomhlaza wemiphunga.

• Ukosulelwa yintsholongwane kaGawulayo (i-HIV).

• Ukuthatha izongezo ze-beta carotene kunye nokutshaya kakhulu.

Ukwaluphala yeyona nto iphambili kumngcipheko womhlaza. Ithuba lokufumana umhlaza liyonyuka njengokuba usiya ukhula.

Xa ukutshaya kudityaniswa nezinye izinto ezinobungozi, umngcipheko womhlaza wemiphunga uyanda.

Iimpawu kunye neempawu zesifo somhlaza esincinci semiphunga kubandakanya ukukhwehlela, ukuphefumla kancinci, kunye nentlungu esifubeni.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa ngumhlaza omncinci wesifo somhlaza okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Ukungonwabi kwesifuba okanye iintlungu.

• Isikhohlela esingahambiyo okanye esiba mandundu ngokuhamba kwexesha.

• Ingxaki yokuphefumla.

• Ukukhawuleza.

• Igazi kwisikhohlela (amafinyila akhohlela emiphungeni).

• Ukurhabaxa.

• Ingxaki yokuginya.

• Ukuphelelwa ngumdla wokutya.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ndiziva ndidiniwe.

• Ukudumba ebusweni kunye / okanye imithambo entanyeni.

Uvavanyo kunye neenkqubo ezivavanya imiphunga zisetyenziselwa ukufumanisa (ukufumana), ukufumanisa isifo, kunye nenqanaba lomhlaza omncinci wesifo semiphunga.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana, kubandakanya ukutshaya, kunye nemisebenzi eyadlulayo, izifo kunye nonyango nazo ziya kuthathwa.

• Uvavanyo lwelabhoratri: Iinkqubo zonyango ezivavanya iisampulu zethishu, igazi, umchamo, okanye ezinye izinto emzimbeni. Ezi mvavanyo zinceda ukufumanisa isifo, ukucwangcisa kunye nokujonga unyango, okanye ukubeka esweni isifo ekuhambeni kwexesha.

• I-x-ray yesifuba: IX-reyi yamalungu namathambo ngaphakathi kwesifuba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

X-ray esifubeni. IX-reyi isetyenziselwa ukuthatha imifanekiso yamalungu namathambo esifuba. IX-ray idlula kwisigulana kwifilimu.

• Ukuskena i-CT (ukuskena i-CAT) kwengqondo, isifuba, kunye nesisu: Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha yeendawo ezingaphakathi emzimbeni, ezithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• Isikhohlela cytology: Imicroscope isetyenziselwa ukujonga iiseli zomhlaza kwisikhohlela (inkohlela ekhohlela ukuphuma emiphungeni).

• Biopsy: Ukususwa kweeseli okanye izicwili ukuze zijongwe ngemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Iindlela ezahlukeneyo ezinokwenziwa nge-biopsy zibandakanya oku kulandelayo:

• Fine-inaliti aspiration (FNA) biopsy of the lung: Ukususwa kwethishu okanye ulwelo olusuka emphungeni, kusetyenziswa inaliti encinci. I-CT scan, i-ultrasound, okanye enye inkqubo yokucinga isetyenziselwa ukufumana izicwili ezingaqhelekanga okanye ulwelo emiphungeni. Kunokwenziwa isikhumba esincinci kulusu apho inaliti ye-biopsy ifakwe kwithishu engaqhelekanga okanye kulwelo. Isampuli iyasuswa ngenaliti ize ithunyelwe elebhu. Ugqirha wezifo emva koko ujonge isampulu phantsi kwemicroscope ukujonga iiseli zomhlaza. IX-reyi yesifuba yenziwa emva kwenkqubo yokuqinisekisa ukuba akukho moya uvuzayo ukusuka emiphungeni uye esifubeni.

Isilingo esine-aspiration biopsy semiphunga. Isigulana silele etafileni esisilayida ngomatshini wecomputer tomography (CT), esithatha imifanekiso ye-x-ray engaphakathi komzimba. Imifanekiso ye-x-ray inceda ugqirha ukuba abone apho izihlunu ezingaqhelekanga zikhona emiphungeni. Inaliti ye-biopsy ifakwe kudonga lwesifuba nakwindawo yeethishu zemiphunga engaqhelekanga. Isiqwenga esincinci senyama siyasuswa ngenaliti kwaye sijongwe phantsi kwemicroscope kwimpawu zomhlaza.

• I-Bronchoscopy: Inkqubo yokujonga ngaphakathi kwetrachea kunye neendlela ezinkulu zomoya kwimiphunga yeendawo ezingaqhelekanga. I-bronchoscope ifakwe ngempumlo okanye emlonyeni kwi-trachea kunye nemiphunga. I-bronchoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Inokuba nesixhobo sokususa iisampulu zethishu, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza.

Bronchoscopy. I-bronchoscope ifakwe ngomlomo, i-trachea, kunye ne-bronchi enkulu emiphungeni, ukukhangela iindawo ezingaqhelekanga. I-bronchoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Inokuba nesixhobo sokusika. Iisampulu zethishu zingathathwa zijongwe ngemicroscope kwimpawu zesifo.

• I-Thoracoscopy: Inkqubo yotyando yokujonga amalungu ngaphakathi kwesifuba ukukhangela iindawo ezingaqhelekanga. Ukusikwa (ukusika) kwenziwa phakathi kweembambo ezimbini, kwaye i-thoracoscope ifakwe esifubeni. I-thoracoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Isenokuba nesixhobo sokususa iisampulu zethishu okanye i-lymph node, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza. Ngamanye amaxesha, le nkqubo isetyenziselwa ukususa inxenye yomqala okanye imiphunga. Ukuba izicwili ezithile, amalungu, okanye ii-lymph node azinakufikelelwa, i-thoracotomy inokwenziwa. Kule nkqubo, ukusikwa okukhulu kwenziwa phakathi kweembambo kunye nesifuba kuvulwa.

• I-Thoracentesis: Ukususwa kolwelo kwisithuba esiphakathi kwempahla yesifuba kunye nemiphunga, kusetyenziswa inaliti. Ugqirha wezifo ujonga ulwelo phantsi kwemicroscope ukukhangela iiseli zomhlaza.

• Mediastinoscopy: Inkqubo yotyando yokujonga amalungu, izicwili kunye ne-lymph node phakathi kwemiphunga yeendawo ezingaqhelekanga. Ukuqhekeka (ukusika) kwenziwa ngaphezulu kwesifuba kunye ne-mediastinoscope ifakwe esifubeni. I-mediastinoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Isenokuba nesixhobo sokususa iisampulu zethishu okanye i-lymph node, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza.

• Ukukhanya kunye ne-electron microscopy: Uvavanyo lwelabhoratri apho iiseli kwisampulu yethishu zijongwa phantsi kwemicroscopes eqhelekileyo kunye nephakamileyo ukujonga utshintsho oluthile kwiiseli.

• I-Immunohistochemistry: Uvavanyo lwaselebhu olusebenzisa ii-antibodies ukukhangela ii-antigen ezithile (iimpawu) kwisampulu yesicwili somguli. Amachiza omzimba ahlala enxulunyaniswa ne-enzyme okanye idayi ye-fluorescent. Emva kokuba ii-antibodies zibophelela kwi-antigen ethile kwisampulu yethishu, i-enzyme okanye idayi iyasebenza, kwaye i-antigen iya kuthi emva koko ibonwe phantsi kwemicroscope. Olu hlobo lovavanyo lusetyenziselwa ukufumanisa isifo somhlaza kunye nokunceda uxelele olunye uhlobo lomhlaza kolunye uhlobo lomhlaza.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Inqanaba lomhlaza (nokuba kukwisifuba kuphela okanye sele usasazekile kwezinye iindawo emzimbeni).

• Iminyaka yesigulana, isini, kunye nempilo ngokubanzi.

Kwizigulana ezithile, ukuxela kwangaphambili kuxhomekeke ekubeni isigulana siphathwa ngayo zombini ichemotherapy kunye nemitha.

Kwizigulana ezininzi ezinomhlaza omncinci wamaphaphu, unyango lwangoku alunyangi umhlaza.

Ukuba kufunyenwe umhlaza wemiphunga, abaguli kufuneka bacinge ngokuthatha inxaxheba kolunye lwezilingo ezininzi ezenziwa ukuphucula unyango. Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe kwizigulana ezinawo onke amanqanaba esifo somhlaza esincinci semiphunga. Ulwazi malunga novavanyo oluqhubekayo lwezonyango luyafumaneka kwiwebhusayithi ye-NCI.

Amanqanaba omhlaza wesifo semiphunga emincinci

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe isifo somhlaza wamaphaphu omncinci, kwenziwa uvavanyo ukuze kufunyaniswe ukuba ngaba iiseli zomhlaza zisasazekile esifubeni okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• Amanqanaba alandelayo asetyenziselwa umhlaza wamaphaphu omncinci weseli:

• Inqanaba elincinci loMhlaza weSifo semiphunga

• Amanqanaba amancinci emhlaza wemiphunga yamaphaphu

Emva kokuba kufunyaniswe isifo somhlaza wamaphaphu omncinci, kwenziwa uvavanyo ukuze kufunyaniswe ukuba ngaba iiseli zomhlaza zisasazekile esifubeni okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza usasazekile esifubeni okanye kwamanye amalungu omzimba kuthiwa yistage. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Ezinye zeemvavanyo ezisetyenziselwa ukufumanisa isifo somhlaza wamaphaphu esincinci zikwasetyenziselwa ukubeka isifo. (Jonga icandelo loLwazi ngokubanzi.)

Olunye uvavanyo kunye neenkqubo ezinokuthi zisetyenziswe kwinkqubo yokuqokelela zibandakanya oku kulandelayo:

• I-MRI (imaging resonance imaging) yobuchopho: Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha yeendawo ezingaphakathi emzimbeni. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngengqondo, isifuba okanye isisu esingaphezulu, esithathwe kwiimbombo ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• Ukuskena i-PET (positron emission tomography scan) Inkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo. Ukuskena i-PET kunye ne-CT scan kunokwenziwa ngaxeshanye. Oku kubizwa ngokuba yi-PET-CT.

• Ukuskena amathambo: Inkqubo yokujonga ukuba ngaba kukho iiseli ezahlula ngokukhawuleza, ezinje ngeeseli zomhlaza, emathanjeni. Inani elincinci kakhulu lezinto ezisasazeka ngemitha lifakwa emthanjeni kwaye lihamba ngokuhamba kwegazi. Izinto ezinemitha eqhumayo ziqokelela emathanjeni anomhlaza kwaye zifunyenwe siskena.

Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

Umhlaza unokusasazeka ngezicubu, inkqubo ye-lymph, kunye negazi:

• Izicubu. Umhlaza usasazeka ukusuka apho waqala ngokukhula waya kwiindawo ezikufuphi.

• Inkqubo yeLymph. Umhlaza usasazeka ukusuka apho waqala ngokungena kwinkqubo ye-lymph. Umhlaza uhamba ngemithambo ye-lymph ukuya kwamanye amalungu omzimba.

• Igazi. Umhlaza usasazeka ukusuka apho waqala ngokungena egazini. Umhlaza uhamba ngemithambo yegazi uye kwamanye amalungu omzimba.

Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

Xa umhlaza usasazeka kwelinye ilungu lomzimba, ubizwa ngokuba yi-metastasis. Iiseli zomhlaza ziyaphuma apho ziqale khona (ithumba lokuqala) kwaye zihamba ngenkqubo ye-lymph okanye igazi.

• Inkqubo yeLymph. Umhlaza ungena kwinkqubo ye-lymph, uhamba kwiinqanawa ze-lymph, kwaye wenze i-tumor (i-metastatic tumor) kwenye indawo yomzimba.

• Igazi. Umhlaza ungena egazini, uhambe kwimithambo yegazi, kwaye wenze ithumba (metastatic tumor) kwelinye ilungu lomzimba.

I-tumor ye-metastatic yinto efanayo yomhlaza njenge-tumor yokuqala. Umzekelo, ukuba umhlaza omncinci wesifo somhlaza usasazeka kwingqondo, iiseli zomhlaza kwingqondo ziyiseli zomhlaza wemiphunga. Esi sifo sisifo somhlaza wamangqamuzana amancinci, hayi umhlaza wobuchopho.

Amanqanaba alandelayo asetyenziselwa umhlaza wamaphaphu omncinci weseli:

Inqanaba elincinci loMhlaza weSifo semiphunga

Kwinqanaba elilinganiselweyo, umhlaza usemiphungeni apho uqale khona kwaye unokuthi usasazeke kwindawo ephakathi kwemiphunga okanye kwii-lymph node ezingaphezulu kwekhola.

Amanqanaba amancinci emhlaza wemiphunga yamaphaphu

Kwinqanaba elibanzi, umhlaza usasazeke ngaphesheya kwemiphunga okanye indawo phakathi kwemiphunga okanye ii-lymph node ngaphezulu kwentloko yomqolo kwezinye iindawo emzimbeni.

Umhlaza wesifo semiphunga esiphindaphindayo

Umhlaza wamaphaphu omncinci ophindaphindiweyo ngumhlaza ophindaphindiweyo (ubuye) emva kokuba unyangiwe. Umhlaza ungabuya ubuye esifubeni, kwinkqubo ye-nervous system, okanye kwamanye amalungu omzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinesifo somhlaza esincinci semiphunga.

• Iindidi ezintandathu zonyango zisetyenziswa:

• Ugqirha

• Unyango ngamayeza

• Unyango ngemitha

• Unyango lwe-Immunotherapy

• Unyango lweLaser

• Ukubekwa kwesentoscopic stent

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwesifo somhlaza wamaphaphu esincinci kunokubangela iziphumo ebezingalindelekanga.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinesifo somhlaza esincinci semiphunga.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinesifo somhlaza esincinci semiphunga. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kuvavanyo lweklinikhi. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha kwizigulana ezinomhlaza. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Iindidi ezintandathu zonyango zisetyenziswa:

Ugqirha

Utyando lunokusetyenziswa ukuba umhlaza ufumaneka kwimiphunga enye nakwii-lymph node ezikufutshane kuphela. Ngenxa yokuba olu hlobo lomhlaza wemiphunga luhlala lufumaneka kwimiphunga yomibini, utyando kuphela alusetyenziswa rhoqo. Ngexesha lotyando, ugqirha uya kususa ii-lymph node ukuze afumanise ukuba banomhlaza na. Ngamanye amaxesha, utyando lunokusetyenziselwa ukususa isampulu yemisipha yemiphunga ukufumana olona hlobo lomhlaza wemiphunga.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, ezinye izigulana zinokunikwa ichemotherapy okanye unyango lweradiation emva kotyando lokubulala naziphi na iiseli zomhlaza ezisele. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy). Xa i-chemotherapy ibekwa ngqo kwi-cerebrospinal fluid, ilungu, okanye indawo yomzimba efana nesisu, iziyobisi zichaphazela kakhulu iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi). Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo.

Jonga iziyobisi ezivunyiweyo zomhlaza wesifo semiphunga esincinci ngolwazi oluthe kratya.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Zimbini iintlobo zonyango lwe-radiation:

• Unyango lwangaphandle lwemitha lusebenzisa umatshini ngaphandle komzimba ukuthumela imitha kumhlaza.

• Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo okanye kufutshane nomhlaza.

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga umhlaza wamaphaphu omncinci, kwaye lunokusetyenziswa njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi. Unyango ngemitha kwingqondo ukunciphisa umngcipheko wokuba umhlaza usasazeke kwingqondo nawo unokunikwa.

Unyango lwe-Immunotherapy

I-Immunotherapy lunyango olusebenzisa amajoni omzimba omzimba ukulwa nomhlaza. Izinto ezenziwe ngumzimba okanye ezenziwe elebhu zisetyenziselwa ukonyusa, ukuqondisa, okanye ukubuyisela ukhuseleko lwendalo lomzimba kumhlaza. Olu hlobo lonyango lomhlaza lukwabizwa ngokuba yi-biotherapy okanye unyango lwe-biologic.

Unyango lwe-immune checkpoint inhibitor luhlobo lwe-immunotherapy:

• Unyango lwe-immune checkpoint inhibitor: Ezinye iintlobo zeeseli zomzimba, ezinje ngeeseli ze-T, kunye nezinye iiseli zomhlaza zineeproteni ezithile, ezibizwa ngokuba ziiprotein zokujonga, kumphezulu wazo ezigcina iimpendulo zomzimba zijongiwe. Xa iiseli zomhlaza zinezixa ezikhulu zezi proteni, aziyi kuhlaselwa zibulawe ziiseli T. Amajoni okuvavanywa kwamajoni omzimba athintela ezi proteni kwaye amandla eeseli T okubulala iiseli zomhlaza ayonyuswa. Zisetyenziselwa ukunyanga ezinye izigulana ezinomhlaza wamaphaphu weseli encinci.

Zimbini iintlobo zonyango lwe-immune checkpoint inhibitor.

• I-CTLA-4 inhibitor: I-CTLA-4 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-CTLA-4 incamathele kwenye iprotein ebizwa ngokuba yi-B7 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. I-CTLA-4 inhibitors inamathela kwi-CTLA-4 kwaye ivumela iiseli ze-T ukuba zibulale iiseli zomhlaza. I-Ipilimumab luhlobo lwe-CTLA-4 inhibitor.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-B7-1 / B7-2 kwiiseli ezibonisa i-antigen (APC) kunye ne-CTLA-4 kwiiseli ze-T, zinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-T-cell receptor (TCR) ibophelela kwi-antigen kunye ne-histocompatibility complex (MHC) protein kwi-APC kunye ne-CD28 ebopha kwi-B7-1 / B7-2 kwi-APC, iseli ye-T inokusebenza. Nangona kunjalo, ukubopha kwe-B7-1 / B7-2 ukuya kwi-CTLA-4 kugcina iiseli ze-T zikwimeko yokungasebenzi ukuze bangakwazi ukubulala iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-B7-1 / B7-2 ukuya kwi-CTLA-4 nge-immune checkpoint inhibitor (anti-CTLA-4 antibody) ivumela iiseli ze-T ukuba zisebenze kwaye zibulale iiseli zesisu (iphaneli esekunene).

• I-PD-1 inhibitor: I-PD-1 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-PD-1 incamathele kwenye iprotein ebizwa ngokuba yi-PDL-1 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. PD-1 inhibitors zinamathele kwi-PDL-1 kwaye zivumele iiseli ze-T ukuba zibulale iiseli zomhlaza. IPembrolizumab kunye ne-nivolumab ziindidi ze-PD-1 inhibitors.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-PD-L1 kwiiseli zethumba kunye ne-PD-1 kwiiseli ze-T, zinceda ukugcina iimpendulo ze-immune zitshekishwe. Ukubopha kwe-PD-L1 ukuya kwi-PD-1 kugcina iiseli ze-T ekubulaleni iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-PD-L1 ukuya kwi-PD-1 nge-immune checkpoint inhibitor (anti-PD-L1 okanye anti-PD-1) ivumela iiseli ze-T ukuba zibulale iiseli zesisu (iphaneli esekunene).

Jonga iziyobisi ezivunyiweyo zomhlaza wesifo semiphunga esincinci ngolwazi oluthe kratya.

Unyango lweLaser

Unyango lwe-Laser lunyango lomhlaza olusebenzisa umqadi we-laser (umqadi omxinwa wokukhanya okungxamisekileyo) ukubulala iiseli zomhlaza.

Ukubekwa kwesentoscopic stent

I-endoscope sisixhobo esibhityileyo esifana netyhubhu esisetyenziselwa ukujonga izicwili ngaphakathi emzimbeni. I-endoscope inokukhanya kunye neelensi yokujonga kwaye inokusetyenziselwa ukubeka i-stent kulwakhiwo lomzimba ukugcina ulwakhiwo luvulekile. I-endoscopic stent ingasetyenziselwa ukuvula indlela yomoya evalwe ziithishu ezingaqhelekanga.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lwesifo somhlaza wamaphaphu esincinci kunokubangela iziphumo ebezingalindelekanga. Ngolwazi malunga neziphumo ebezingalindelekanga ezibangelwa lunyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando ngomhlaza. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba unyango lomhlaza olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lomhlaza lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ukuphucula indlela umhlaza oza kunyangwa ngayo kwixa elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinomhlaza ongakhange ubengcono. Kukwakho nezilingo zeklinikhi ezivavanya iindlela ezintsha zokumisa umhlaza ekubuyeleni (ekubuyeni) okanye ukunciphisa iziphumo ebezingalindelekanga zonyango lomhlaza.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo ukufumanisa umhlaza okanye ukufumanisa inqanaba lomhlaza zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yakho itshintshile okanye ukuba umhlaza ubuyile (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Ukhetho lonyango ngeSigaba

Kweli Candelo

• Inqanaba elincinci loMhlaza weSifo semiphunga

• Amanqanaba amancinci emhlaza wemiphunga yamaphaphu

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Inqanaba elincinci loMhlaza weSifo semiphunga

Unyango lwecandelo elincinci lomhlaza wamaphaphu umhlaza unokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy kunye nokunyanga ngemitha esifubeni. Unyango ngemitha kwingqondo lunokunikwa kamva kwizigulana ezineempendulo ezipheleleyo.

• Ukudibanisa i-chemotherapy yodwa kwizigulana ezingenakunikwa unyango ngemitha.

• Utyando olulandelwa yichemotherapy.

• Utyando olulandelwa yichemotherapy kunye nonyango lwemitha.

• Unyango ngemitha kwingqondo lunokunikwa abaguli abanempendulo epheleleyo, ukunqanda ukusasazeka komhlaza kwingqondo.

• Uvavanyo lwezonyango lwe-chemotherapy entsha, utyando, kunye nonyango lwemitha.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Amanqanaba amancinci emhlaza wemiphunga yamaphaphu

Unyango lwe-cell-cancer encinci yemiphunga inokubandakanya oku kulandelayo:

• Ukudibanisa i-chemotherapy.

• Unyango ngemitha kwingqondo, umqolo, ithambo, okanye amanye amalungu omzimba apho umhlaza usasazeke khona, njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Ukunyanga ngemitha esifubeni kunokunikwa abaguli abasabelayo kunyango lwe-chemotherapy.

• Unyango ngemitha kwingqondo lunokunikwa abaguli abanempendulo epheleleyo, ukunqanda ukusasazeka komhlaza kwingqondo.
• Uvavanyo lweklinikhi yonyango olutsha nge-chemotherapy okanye i-immunotherapy ene-immune checkpoint inhibitors.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukhetho kunyango oluPhindaphindeneyo lweCell Lung Cancer

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwesifo somhlaza wamaphaphu esincinci esingaqhelekanga sinokubandakanya oku kulandelayo:

• Unyango ngamayeza.

• I-Immunotherapy kunye ne-immune checkpoint inhibitors.

• Unyango lwe-radiation njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Unyango lwe-Laser, ukubekwa kwesitent ukugcina i-airways ivulekile, kunye / okanye unyango lwangaphakathi lwemitha njengonyango lokuthomalalisa iimpawu kunye nokuphucula umgangatho wobomi.

• Uvavanyo lwezonyango zonyango olutsha lwe-chemotherapy.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukufunda ngakumbi malunga noMhlaza weSifo seMiphunga

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nomhlaza omncinci wesifo somhlaza, bona oku kulandelayo:

• Ikhasi lasekhaya lomhlaza wemiphunga

• Uthintelo lomhlaza wemiphunga

• Uvavanyo lomhlaza wemiphunga

• Iziyobisi ezivunyiweyo kuMhlaza weSifo seMiphunga

• Icuba (kubandakanya uncedo ngokuyeka)

• Ukutshaya icuba: Ubungozi bezeMpilo kunye nendlela yokuyeka

• Umsi wesibini kunye nomhlaza

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli