Types/mesothelioma/patient/mesothelioma-treatment-pdq

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I-Malignant Mesothelioma Treatment (Adult) (®) -Patient Version

Imininingwane Jikelele Mayelana neMesothelioma Embi

AMAPHUZU ASEMQOKA

  • I-mesothelioma ebulalayo yisifo lapho amangqamuzana amabi (umdlavuza) akha khona ulwelwesi lwesifuba noma esiswini.
  • Ukuvezwa ku-asbestos kungathinta ubungozi be-mesothelioma ebulalayo.
  • Izimpawu nezimpawu ze-mesothelioma enobungozi zifaka ukuphefumula okuncane nobuhlungu ngaphansi kwezimbambo.
  • Izivivinyo ezihlola ingaphakathi lesifuba nesisu zisetshenziselwa ukuxilonga i-mesothelioma ebulalayo.
  • Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

I-mesothelioma ebulalayo yisifo lapho amangqamuzana amabi (umdlavuza) akha khona ulwelwesi lwesifuba noma esiswini.

I-malignant mesothelioma yisifo lapho kutholakala khona amangqamuzana abulalayo (umdlavuza) ku-pleura (ungqimba oluncane lwezicubu olugqobhoza umgodi wesifuba futhi lumboze amaphaphu) noma i-peritoneum (ungqimba oluncane lwezicubu olugcoba isisu futhi lumboze iningi izitho esiswini). I-mesothelioma ebulalayo nayo ingakheka enhliziyweni noma emasendeni, kepha lokhu akuvamile.

Amafomu e-mesothelioma amabi esendweni elincanyana lezicubu ezihlanganisa amaphaphu, udonga lwesifuba, isisu, inhliziyo, noma amasende.

Ukuvezwa ku-asbestos kungathinta ubungozi be-mesothelioma ebulalayo.

Noma yini eyandisa amathuba akho okuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola umdlavuza; ukungabi nezici zobungozi akusho ukuthi ngeke uthole umdlavuza. Khuluma nodokotela wakho uma ucabanga ukuthi ungaba sengozini.

Iningi labantu abane-mesothelioma ebulalayo basebenze noma bahlala ezindaweni lapho bahogela khona noma bagwinya i-asbestos. Ngemuva kokuvezwa ku-asbestos, imvamisa kuthatha isikhathi eside ukuthi kwakhiwe i-mesothelioma enobungozi. Ukuhlala nomuntu osebenza eduze ne-asbestos nakho kuyingozi engozini ye-mesothelioma ebulalayo.

Izimpawu nezimpawu ze-mesothelioma enobungozi zifaka ukuphefumula okuncane nobuhlungu ngaphansi kwezimbambo.

Kwesinye isikhathi umdlavuza ubangela ukuthi uketshezi luqoqane esifubeni noma esiswini. Izimpawu nezimpawu zingabangelwa uketshezi, i-mesothelioma ebulalayo, noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

  • Ukuphefumula kanzima.
  • Khwehlela.
  • Ubuhlungu ngaphansi kwezimbambo.
  • Ubuhlungu noma ukuvuvukala esiswini.
  • Izigaxa esiswini.
  • Ukuqunjelwa.
  • Izinkinga ngamahlule egazi (amahlule enza lapho kungafanele).
  • Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.
  • Ukuzizwa ngikhathele kakhulu.

Izivivinyo ezihlola ingaphakathi lesifuba nesisu zisetshenziselwa ukuxilonga i-mesothelioma ebulalayo.

Kwesinye isikhathi kuba nzima ukutshela umehluko phakathi kwe-mesothelioma ebulalayo esifubeni nasemdlavuza wamaphaphu.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa ukuxilonga i-mesothelioma enesifo esifubeni noma i-peritoneum:

  • Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli, ukuvezwa kwe-asbestos, kanye nokugula nokwelashwa kwangaphambilini.
  • I-x-ray yesifuba: I-x-ray yezitho namathambo ngaphakathi kwesifuba. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.
I-X-ray yesifuba. Ama-X-ray asetshenziselwa ukuthatha izithombe zezitho namathambo esifuba. Ama-X-ray adlula esigulini aye kwifilimu.
  • I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane zesifuba nesisu, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.
  • I-Biopsy: Ukususwa kwamaseli noma izicubu ku-pleura noma i-peritoneum ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuze ahlole izimpawu zomdlavuza.

Izinqubo ezisetshenziselwa ukuqoqa amaseli noma izicubu zifaka okulandelayo:

  • I-Fine-needle (FNA) aspiration biopsy yephaphu: Ukususwa kwezicubu noma uketshezi kusetshenziswa inaliti ezacile. Inqubo yokuthatha izithombe isetshenziselwa ukuthola izicubu noma uketshezi olungajwayelekile emaphashini. Kungenziwa ukusikeka okuncane esikhunjeni lapho inaliti ye-biopsy ifakwa ezicutshini ezingajwayelekile noma uketshezi, bese kususwa isampula.
I-biopsy yenaliti enhle yenaliti. Isiguli silele etafuleni elihamba ngomshini we-computed tomography (CT), othatha izithombe ze-x-ray ezingaphakathi komzimba. Izithombe ze-x-ray zisiza udokotela ukuthi abone lapho izicubu ezingavamile zikhona emaphashini. Inaliti ye-biopsy ifakwa odongeni lwesifuba futhi ingene endaweni yezicubu zamaphaphu ezingavamile. Kususwa ucezu oluncane ngenaliti bese luhlolwa ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • I-Thoracoscopy: Kusikwa (ukusika) phakathi kwezimbambo ezimbili ne-thoracoscope (insimbi encane, efana nethubhu enelambu nelensi yokubuka) ifakwa esifubeni.
  • I-Thoracotomy: Ukusikwa (ukusika) kwenziwa phakathi kwezimbambo ezimbili ukuhlola ngaphakathi kwesifuba ukuthi akukho zimpawu zesifo.
  • I-Peritoneoscopy: Kusikwa (ukusika) odongeni lwesisu kanye ne-peritoneoscope (insimbi encane, efana nethubhu enokukhanya nelensi yokubuka) ifakwa esiswini.
  • I-Open biopsy: Inqubo lapho kusikeka khona (ukusika) ngesikhumba ukudalula nokususa izicubu ukubheka izimpawu zesifo.

Ukuhlolwa okulandelayo kungenziwa kumaseli nakwizicubu zomzimba ezithathiwe:

  • Ukuhlolwa kweCytologic: Ukuhlolwa kwamaseli angaphansi kwesibonakhulu ukubheka noma yini engajwayelekile. Ku-mesothelioma, uketshezi luthathwa esifubeni noma esiswini. Isazi sezifo sihlola uketshezi kwezimpawu zomdlavuza.
  • I-Immunohistochemistry: Isivivinyo selabhorethri esisebenzisa amasosha omzimba ukubheka ama-antigen (amakaki) athile kusampula yezicubu zesiguli. Amasosha omzimba avamise ukuhlanganiswa ne-enzyme noma udayi we-fluorescent. Ngemuva kokuthi ama-antibody abophele kwi-antigen ethile kusampula yezicubu, i-enzyme noma idayi iyasebenza, bese kuthi i-antigen ibonakale ngaphansi kwesibonakhulu. Lolu hlobo lokuhlola lusetshenziselwa ukuxilonga umdlavuza nokusiza ukutshela uhlobo oluthile lomdlavuza kolunye uhlobo lomdlavuza.
  • I-Electron microscopy: Ukuhlolwa kwelabhorethri lapho amaseli esampula yezicubu abukwa khona ngaphansi kwesibonakhulu esinamandla amakhulu ukubheka ushintsho oluthile kumaseli. Isibonakhulu se-electron sikhombisa imininingwane emincane kangcono kunezinye izinhlobo zama-microscopes.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Izinketho zokubikezela nokwelashwa zincike kokulandelayo:

  • Isigaba somdlavuza.
  • Usayizi wesimila.
  • Ukuthi isimila singasuswa ngokuphelele ngokuhlinzwa.
  • Inani loketshezi esifubeni noma esiswini.
  • Iminyaka yesiguli.
  • Izinga lomsebenzi wesiguli.
  • Impilo ejwayelekile yesiguli, kufaka phakathi impilo yamaphaphu nenhliziyo.
  • Uhlobo lwamaseli we-mesothelioma nokuthi abukeka kanjani ngaphansi kwesibonakhulu.
  • Inani lamaseli amhlophe egazi nokuthi i-hemoglobin engakanani esegazini.
  • Ukuthi isiguli kungowesilisa noma owesifazane.
  • Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Izigaba zeMesothelioma enobungozi

AMAPHUZU ASEMQOKA

  • Ngemuva kokuthi kutholakale i-mesothelioma ebulalayo, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakaze kwezinye izingxenye zomzimba.
  • Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
  • Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.
  • Lezi zigaba ezilandelayo zisetshenziselwa i-mesothelioma ebulalayo yamaphaphu:
  • Isiteji I
  • Isigaba II
  • Isigaba III
  • Isigaba IV
  • I-mesothelioma ebulalayo ingaphinde ibuye (ibuye) ngemuva kokuphathwa kwayo.

Ngemuva kokuthi kutholakale i-mesothelioma ebulalayo, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakaze kwezinye izingxenye zomzimba.

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza usakaze ngaphandle kwe-pleura noma i-peritoneum ibizwa nge-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi ukuthi umdlavuza ususakazekile yini ukuze uhlele ukwelashwa.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

  • I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane zesifuba nesisu, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.
  • I-PET scan (i-positron emission tomography scan): Inqubo yokuthola amangqamuzana abulalayo omzimba emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.
  • I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).
  • I-endoscopic ultrasound (EUS): Inqubo lapho kufakwa khona i-endoscope emzimbeni. I-endoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Iphenyo ekugcineni kwe-endoscope isetshenziselwa ukuqhuma amaza omsindo wamandla aphezulu (i-ultrasound) ezicutshini zangaphakathi noma ezithweni futhi enze ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Le nqubo ibizwa nangokuthi i-endosonography. I-EUS ingasetshenziselwa ukuqondisa i-fine-needle aspiration (FNA) biopsy yephaphu, i-lymph node, noma ezinye izindawo.
I-endoscopic-eqondiswa i-fine-needle aspiration biopsy. I-endoscope enomphenyi we-ultrasound nenaliti ye-biopsy ifakwa ngomlomo nangaphakathi komphimbo. I-probe igxuma amaza omsindo ezicutshini zomzimba ukuze yenze ama-echoes akha i-sonogram (isithombe sekhompyutha) sama-lymph node aseduze nomphimbo. I-sonogram isiza udokotela ukuthi abone ukuthi angabeka kuphi inaliti ye-biopsy ukususa izicubu kuma-lymph node. Lesi sicubu sihlolwa ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • I-Laparoscopy: Inqubo yokuhlinza ukubheka izitho ezingaphakathi esiswini ukubheka izimpawu zesifo. Ukusikeka okuncane (ukusikeka) kwenziwa odongeni lwesisu bese kufakwa i-laparoscope (ithubhu elincane elikhanyisiwe) kokunye okusikiwe. Ezinye izinsimbi zingafakwa ngokusebenzisa okufanayo noma okunye ukusikeka ukwenza izinqubo ezifana nokuthatha amasampula ezicubu ayohlolwa ngaphansi kwemakhroskophu ukuthola izimpawu zesifo.
  • I-lymph node biopsy: Ukususwa kwakho konke noma ingxenye ye-lymph node. Isazi sezifo sibheka izicubu ze-lymph node ngaphansi kwesibonakhulu ukuhlola amaseli omdlavuza.
  • I-Mediastinoscopy: Inqubo yokuhlinza yokubheka izitho, izicubu, nama-lymph node phakathi kwamaphaphu ezindaweni ezingavamile. Kusikwa (ukusika) ngenhla kwesifuba sesifuba bese kufakwa i-mediastinoscope esifubeni. I-mediastinoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa amasampula wezicubu noma ama-lymph node, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.

Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

Umdlavuza ungasakazeka ngezicubu, uhlelo lwe-lymph, kanye negazi:

  • Izicubu. Umdlavuza usakazeka lapho uqale khona ngokukhulela ezindaweni eziseduze.
  • Uhlelo lweLymph. Umdlavuza usakazeka lapho uqale khona ngokungena ohlelweni lwe-lymph. Umdlavuza udabula imithambo ye-lymph uye kwezinye izingxenye zomzimba.
  • Igazi. Umdlavuza usakazeka lapho uqale khona ngokungena egazini. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.

Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Lapho umdlavuza usakazekela kolunye uhlangothi lomzimba, ubizwa ngokuthi yi-metastasis. Amaseli womdlavuza aqhamuka lapho aqale khona (isimila sokuqala) futhi ahamba ngohlelo lwe-lymph noma igazi.

  • Uhlelo lweLymph. Umdlavuza ungena ohlelweni lwe-lymph, udabule emithanjeni ye-lymph, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.
  • Igazi. Umdlavuza ungena egazini, udabule emithanjeni yegazi, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

Isigaxa se-metastatic luhlobo olufanayo lomdlavuza njengesimila sokuqala. Isibonelo, uma i-mesothelioma ebulalayo isakazekela ebuchosheni, amangqamuzana omdlavuza ebuchosheni empeleni angamaseli amabi we-mesothelioma. Lesi sifo yi-mesasthelioma ebulalayo, hhayi umdlavuza wobuchopho.

Lezi zigaba ezilandelayo zisetshenziselwa i-mesothelioma ebulalayo yamaphaphu:

Isiteji I

Isigaba I sihlukaniswe ngezigaba IA ne-IB:

  • Esigabeni IA, umdlavuza utholakala ngaphakathi kolayini odongeni lwesifuba kolunye uhlangothi lwesifuba. Ngasohlangothini olufanayo lwesifuba, umdlavuza ungatholakala nakokukodwa noma okuningi kokulandelayo:
  • Ingqimba emincane yezicubu emboza iphaphu.
  • Ingqimba emincane yezicubu emboza izitho eziphakathi kwamaphaphu.
  • Ungqimba oluncane lwezicubu olumboza ngaphezulu kwesivalo.
  • Esigabeni IB, umdlavuza utholakala ulwelwesi lwangaphakathi lwodonga lwesifuba, nakuzo zonke izingqimba zomzimba ezimboze iphaphu, izitho eziphakathi kwamaphaphu, kanye naphezulu kwesifuba kolunye uhlangothi lwesifuba. Ngasohlangothini olufanayo lwesifuba, umdlavuza ubuye wasabalala waba kokukodwa noma ngaphezulu kokulandelayo:
  • I-diaphragm.
  • Izicubu zomzimba.
  • Izicubu eziphakathi kwezimbambo nolwelwesi lwangaphakathi lwodonga lwesifuba.
  • Amafutha asendaweni ephakathi kwamaphaphu.
  • Izicubu ezithambile zodonga lwesifuba.
  • Sac nxazonke zenhliziyo.

Isigaba II

Esigabeni II, umdlavuza utholakala ngaphakathi kolwelwesi lwesifuba kolunye uhlangothi lwesifuba. Ngasohlangothini olufanayo lwesifuba, umdlavuza ungatholakala nakokukodwa noma okuningi kokulandelayo:

  • Ingqimba emincane yezicubu emboza iphaphu.
  • Ingqimba emincane yezicubu emboza izitho eziphakathi kwamaphaphu.
  • Ungqimba oluncane lwezicubu olumboza ngaphezulu kwesivalo.

Umdlavuza usabalalele kuma-lymph node enkabeni yesifuba ngasohlangothini olufanayo lwesifuba njengesimila.

noma

Umdlavuza utholakala ngaphakathi kolwelwesi lwesifuba, nakuzo zonke izingqimba zomzimba ezimboze iphaphu, izitho eziphakathi kwamaphaphu, kanye naphezulu kwesifuba kolunye uhlangothi lwesifuba. Ngasohlangothini olufanayo lwesifuba, umdlavuza ubuye wasabalala waba kokukodwa noma kokubili kokulandelayo:

  • I-diaphragm.
  • Izicubu zomzimba.

Umdlavuza usabalalele kuma-lymph node enkabeni yesifuba ngasohlangothini olufanayo lwesifuba njengesimila.

Isigaba III

Isigaba III sehlukaniswe ngezigaba IIIA ne-IIIB.

  • Esigabeni IIIA, umdlavuza utholakala ulwelwesi lwangaphakathi lwodonga lwesifuba, nakuzo zonke izingqimba ezincanyana zezicubu ezimboza iphaphu, izitho eziphakathi kwamaphaphu, kanye naphezulu kwesifuba kolunye uhlangothi lwesifuba. Ngasohlangothini olufanayo lwesifuba, umdlavuza ubuye wasabalala waba kokukodwa noma ngaphezulu kokulandelayo:
  • Izicubu eziphakathi kwezimbambo nolwelwesi lwangaphakathi lwodonga lwesifuba.
  • Amafutha asendaweni ephakathi kwamaphaphu.
  • Izicubu ezithambile zodonga lwesifuba.
  • Sac nxazonke zenhliziyo.

Umdlavuza usabalalele kuma-lymph node enkabeni yesifuba ngasohlangothini olufanayo lwesifuba njengesimila.

  • Esigabeni IIIB, umdlavuza utholakala ngaphakathi kolwelwesi lwesifuba, futhi ungatholwa nasezingxenyeni ezincanyana zezicubu ezimboza iphaphu, izitho eziphakathi kwamaphaphu, kanye / noma ngaphezulu kovalo ngakolunye uhlangothi isifuba. Ohlangothini olufanayo lwesifuba, umdlavuza kungenzeka ukuthi usabalalele kokukodwa noma ngaphezulu kokulandelayo:
  • I-diaphragm.
  • Izicubu zomzimba.
  • Izicubu eziphakathi kwezimbambo nolwelwesi lwangaphakathi lwodonga lwesifuba.
  • Amafutha asendaweni ephakathi kwamaphaphu.
  • Izicubu ezithambile zodonga lwesifuba.
  • Sac nxazonke zenhliziyo.

Umdlavuza usabalalele kuma-lymph node ngenhla kokhololo ohlangothini ngalunye lwesifuba noma umdlavuza usabalalele kuma-lymph node enkabeni yesifuba kolunye uhlangothi lwesifuba njengesimila.

noma

Umdlavuza utholakala ngaphakathi kolwelwesi lwesifuba, nakuzo zonke izingqimba zomzimba ezimboze iphaphu, izitho eziphakathi kwamaphaphu, kanye naphezulu kwesifuba kolunye uhlangothi lwesifuba. Umdlavuza ubuye wasabalalela kokukodwa noma ngaphezulu kokulandelayo:

  • Udonga lwesifuba futhi lungatholakala embambo.
  • Ngokusebenzisa i-diaphragm ku-peritoneum.
  • Izicubu ezifaka isifuba ngakolunye uhlangothi lomzimba njengesimila.
  • Izitho ezisendaweni ephakathi kwamaphaphu (isopha, trachea, thymus, imithambo yegazi).
  • Umgogodla.
  • Ngesikhwama esizungeze inhliziyo noma imisipha yenhliziyo.

Umdlavuza kungenzeka usabalalele kuma-lymph node.

Isigaba IV

Esigabeni IV, umdlavuza usabalalele ezicutshini ezihlanganisa iphaphu noma iphaphu kolunye uhlangothi lwesifuba, i-peritoneum, amathambo, isibindi, ama-lymph node ngaphandle kwesifuba, noma kwezinye izingxenye zomzimba.

I-mesothelioma ebulalayo ingaphinde ibuye (ibuye) ngemuva kokuphathwa kwayo.

Umdlavuza ungabuya esifubeni noma esiswini noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

  • Kunezinhlobo ezahlukene zokwelashwa kweziguli ezine-mesothelioma ebulalayo.
  • Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:
  • Ukuhlinzwa
  • Ukwelashwa ngemisebe
  • Ukwelashwa ngamakhemikhali
  • Ukwelashwa okuhlosiwe
  • Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
  • I-Immunotherapy
  • Ukwelashwa kwe-mesothelioma ebulalayo kungadala imiphumela emibi.
  • Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.
  • Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.
  • Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukene zokwelashwa kweziguli ezine-mesothelioma ebulalayo.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezine-mesothelioma ebulalayo. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

Ukuhlinzwa

Izindlela zokwelashwa ezilandelayo zingasetshenziselwa i-mesothelioma ebulalayo esifubeni:

  • Ukusikwa kwendawo yonke: Kuhlinzwa ukukhipha umdlavuza kanye nezinye izicubu ezinempilo ezizungezile.
  • I-Pleurectomy ne-decortication: Ukuhlinzwa ukususa ingxenye yesembozo samaphaphu kanye nolwelwesi lwesifuba nengxenye yendawo engaphandle yamaphaphu.
  • I-Extrapleural pneumonectomy: Ukuhlinzwa kususwe iphaphu elilodwa nengxenye yolwelwesi lwesifuba, idayaphragm, nolwelwesi lwesaka oluzungeze inhliziyo.
  • I-Pleurodesis: Inqubo yokuhlinza esebenzisa amakhemikhali noma izidakamizwa ukwenza isibazi esikhaleni phakathi kwezingqimba ze-pleura. Uketshezi luqala ukukhishwa esikhaleni kusetshenziswa ipayipi noma ishubhu lesifuba bese kufakwa ikhemikhali noma isidakamizwa esikhaleni. Isibazi simisa ukwakheka koketshezi emgodini wokuncenga.

Ngemuva kokuthi udokotela awususe wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, ezinye iziguli zinganikezwa i-chemotherapy noma i-radiation therapy ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwe ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke endaweni yomzimba enomdlavuza. Ingasetshenziswa futhi njengokwelapha okwehlisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesifuba noma i-peritoneum, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda). Inhlanganisela yokwelashwa ngamakhemikhali ukusetshenziswa kwezidakamizwa ezingaphezu kweyodwa ze-anticancer.

I-Hyperthermic intraperitoneal chemotherapy isetshenziswa ekwelapheni i-mesothelioma esabalele kwi-peritoneum (izicubu ezigcwala isisu futhi zimboze izitho eziningi esiswini). Ngemuva kokuthi udokotela ohlinzayo awususe wonke umdlavuza ongabonakala, isixazululo esiqukethe imishanguzo yokulwa nomdlavuza siyashiswa bese sifakwa ngaphakathi nangaphandle kwesisu ukubulala amangqamuzana omdlavuza asele. Ukushisa imishanguzo yokulwa nomdlavuza kungabulala amangqamuzana omdlavuza amaningi.

Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Bheka Izidakamizwa Kuvunyelwe i-Malignant Mesothelioma ukuthola eminye imininingwane.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lwezokwelapha olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amaseli womdlavuza athile. Izindlela zokwelashwa ezihlosiwe zivame ukudala ukulimala okuncane kumaseli ajwayelekile kunokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe.

Ukwelashwa kwe-monoclonal antibody uhlobo lwezokwelapha ezihlosiwe. Ama-antibody e-monoclonal angamaprotheni ama-immune system enziwe elebhu ukwelapha izifo eziningi, kufaka phakathi umdlavuza. Njengokwelashwa komdlavuza, la ma-antibodies anganamathela kokuhlosiwe okuthile kumaseli womdlavuza noma amanye amaseli angasiza amangqamuzana omdlavuza ukuthi akhule. Amasosha omzimba akwazi ukubulala amangqamuzana omdlavuza, avimbe ukukhula kwawo, noma awagcine ekusakazekeni. Ama-antibody e-monoclonal anikezwa ngokumnika. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi noma okokusebenza okukhipha imisebe ngqo kumaseli womdlavuza.

I-Bevacizumab iyi-anti-monoclonal antibody esetshenziselwa ukwelapha i-mesothelioma ebulalayo ethuthukile. Ibopha iprotheni ebizwa nge-vascular endothelial growth factor (VEGF). Lokhu kungavimbela ukukhula kwemithambo yegazi emisha okudingeka ukuthi izimila zikhule. Amanye ama-antibody monoclonal acwaningwa nge-mesothelioma ebulalayo.

I-Kinase inhibitors uhlobo lwezokwelapha ezihlosiwe ezifundwayo ekwelapheni i-mesothelioma ebulalayo. Ama-Kinase inhibitors yimithi yokwelapha ehlosiwe evimba amasiginali adingekayo ukuze izimila zikhule.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Lesi sigaba esifingqiwe sichaza izindlela zokwelashwa ezicwaningwa ekuhlolweni kwemitholampilo. Kungenzeka kungasho yonke imishanguzo emisha efundwayo. Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

I-Immunotherapy

I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Izinto ezenziwe ngumzimba noma ezenziwe elabhoratri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba kumdlavuza. Lokhu kwelashwa komdlavuza uhlobo lwezokwelapha ze-biologic.

Ukwelashwa kwe-mesothelioma ebulalayo kungadala imiphumela emibi.

Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Ukwelashwa Kwesigaba I I-Mesothelioma Eyingozi

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Uma isigaba I-mesothelioma ebulalayo isengxenyeni eyodwa yesikhumba sesifuba, ukwelashwa kungaba okulandelayo:

  • Ukuhlinzwa ukususa ingxenye yesifuba esifakwe umdlavuza nezicubu ezizungezile.

Uma isigaba I-mesothelioma ebulalayo itholakala ezindaweni ezingaphezu kwesisodwa esifubeni, ukwelashwa kungaba okunye kwalokhu okulandelayo:

  • I-pneumonectomy engaphandle.
  • I-Pleurectomy ne-decortication, noma ngaphandle kwemithi yokwelapha ngemisebe, njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.
  • Ukwelashwa ngemisebe njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.
  • Isivivinyo somtholampilo semithi elwa nomdlavuza efakwe ngqo esifubeni ngemuva kokuhlinzwa ukukhipha isimila.
  • Isivivinyo somtholampilo sokuhlanganiswa kokuhlinzwa, ukwelashwa ngemisebe, kanye nokwelashwa ngamakhemikhali.
  • Isivivinyo somtholampilo sokwelapha okusha.

Uma isigaba I-mesothelioma ebulalayo isemgqeni we-peritoneal, ukwelashwa kungaba okulandelayo:

  • Ukuhlinzwa ukususa ingxenye yolwelwesi lwe-peritoneal nomdlavuza nezicubu ezizungezile.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ukwelashwa kweSigaba II, iSigaba III, noma iSigaba IV Esibucayi seMesothelioma

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Uma isigaba II, isigaba III, noma isigaba IV mesothelioma esibi sitholakala esifubeni, ukwelashwa kungaba okunye kwalokhu okulandelayo:

  • Inhlanganisela yamakhemikhali nokwelashwa okuhlosiwe ne-bevacizumab.
  • Ukwelashwa ngamakhemikhali kufakwa ngqo esifubeni ukuze kuncishiswe izicubu nokugcina uketshezi lungakhi.
  • Ukuhlinzwa ukukhipha uketshezi oluqoqwe esifubeni, ukukhulula ukungakhululeki kwesifuba nokwenza ngcono impilo. I-Pleurodesis ingenziwa ukumisa uketshezi oluningi ekuqoqeni esifubeni.
  • I-Pleurectomy ne-decortication, njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.
  • Ukwelashwa ngemisebe njengokwelashwa okunciphisayo ukudambisa izinhlungu.
  • Isivivinyo somtholampilo sokuhlanganiswa kokuhlinzwa, ukwelashwa ngemisebe, kanye nokwelashwa ngamakhemikhali.

Uma isigaba II, isigaba III, noma isigaba IV mesothelioma esibi sitholakala ku-peritoneum, ukwelashwa kungaba okunye kwalokhu okulandelayo:

  • Ukuhlinzwa ukukhipha isimila okulandelwa yi-hyperthermic intraperitoneal chemotherapy.
  • I-Chemotherapy ibekwe ngqo kwi-peritoneum ukunciphisa isimila nokugcina uketshezi lungakhi.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ukwelashwa Kwe-Mesothelioma Ephindaphindiwe Eyingozi

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Ukwelashwa kwe-mesothelioma ebulalayo ephindaphindekayo kungaba kokulandelayo:

  • Ukuhlinzwa ukususa ingxenye yodonga lwesifuba.
  • I-Chemotherapy, uma inganikezwanga njengokwelashwa kokuqala.
  • Isivivinyo somtholampilo se-immunotherapy.
  • Isivivinyo somtholampilo sokwelapha okubhekiswe kukho.
  • Isivivinyo somtholampilo se-chemotherapy.
  • Isivivinyo somtholampilo sokuhlinzwa.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ukufunda Okwengeziwe Nge-Mesothelioma Embi

Ngeminye imininingwane evela ku-National Cancer Institute mayelana ne-mesothelioma ebulalayo, bheka okulandelayo

  • Ikhasi Lasekhaya Le-Malignant Mesothelioma
  • Izidakamizwa zivunyelwe i-Malignant Mesothelioma
  • I-Immunotherapy Yokwelapha Umdlavuza
  • Izindlela Zokwelapha Zomdlavuza
  • Ukuvezwa Kwe-Asbestos kanye Nengozi Yomdlavuza

Ngemininingwane ejwayelekile yomdlavuza nezinye izinsiza ezivela ku-National Cancer Institute, bheka okulandelayo:

  • Mayelana Nomdlavuza
  • Isiteji
  • I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza
  • Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza
  • Ukubhekana Nomdlavuza
  • Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza
  • Kwabasindile Nabanakekeli


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