Isigaxa sobuchopho seMetastatic

Isimila sobuchopho obungu-metastatic ngumdlavuza oqale kwenye ingxenye yomzimba futhi ususakazekele ebuchosheni.

Izinhlobo eziningi zesimila noma umdlavuza zingasakazeka ziye ebuchosheni. Okuvame kakhulu yilezi:

• Umdlavuza wamaphaphu
• Umdlavuza webele
• I-Melanoma
• Umdlavuza wezinso
• Umdlavuza wamakholoni
• Umdlavuza wegazi

Ezinye izinhlobo zomdlavuza azivamile ukusabalala ziye ebuchosheni, njengomdlavuza wesinye. Kwezinye izimo, isimila singasakazeka siye ebuchosheni sisendaweni engaziwa. Lokhu kubizwa ngomdlavuza wamabanga aphansi angaziwa (CUP).

Izicubu zobuchopho ezikhulayo zingabeka ingcindezi ezingxenyeni eziseduze zobuchopho. Ukuvuvukala kobuchopho ngenxa yalezi zicubu nakho kudala ingcindezi eyandayo ngaphakathi kogebhezi.

Izicubu zobuchopho ezisakazeka zihlukaniswa ngokususelwa endaweni yesimila ebuchosheni, uhlobo lwezicubu ezihilelekile, kanye nendawo yokuqala yesimila.

Izicubu zobuchopho ze-Metastatic zenzeka cishe kokukodwa (i-25%) yawo wonke umdlavuza osakazeka emzimbeni. Zivame kakhulu kunezicubu eziyinhloko zobuchopho (izicubu eziqala ebuchosheni).

Izimpawu zingafaka noma yikuphi okulandelayo:

• Ukwehla kokudidiyela, ubudlabha, ukuwa
• Ukugula okujwayelekile noma ukukhathala
• Ukuphathwa ikhanda, okusha noma okunzima kakhulu kunokujwayelekile
• Ukulahleka kwememori, ukwahlulela kabi, ukuxazulula ubunzima
• Ubundikindiki, ukudikiza, ubuhlungu, nezinye izinguquko ekuzizweni
• Ubuntu buyashintsha
• Izinguquko zemizwa ezisheshayo noma isimilo esingajwayelekile
• Ukuquleka okusha
• Izinkinga ngenkulumo
• Izinguquko zombono, ukubona kabili, ukwehla kombono
• Ukuhlanza, isicanucanu noma ngaphandle kwaso
• Ubuthakathaka bendawo yomzimba

Izimpawu ezithile ziyahlukahluka. Izimpawu ezijwayelekile zezinhlobo eziningi zamathumba obuchopho be-metastatic zibangelwa ingcindezi eyengeziwe ebuchosheni.

Ukuhlolwa kungabonisa izinguquko zobuchopho nezesistimu ngokuya ngokuthi isimila sikuphi ebuchosheni. Izimpawu zokunyuka kwengcindezi kugebhezi nazo zivamile. Ezinye izicubu kungenzeka zingakhombisi zimpawu zize zibe nkulu kakhulu. Ngemuva kwalokho, zingadala ukwehla okusheshayo kokusebenza kwesistimu yezinzwa.

Isimila sokuqala (sokuqala) singatholakala ngokuhlola izicubu zesimila ebuchosheni.

Ukuhlolwa kungafaka:

• I-Mammogram, i-CT iskena sesifuba, isisu, nesikhumba ukuthola indawo yokuqala yesimila
• I-CT scan noma i-MRI yobuchopho ukuqinisekisa ukuxilongwa nokuthola indawo yesimila (i-MRI ivame ukuzwela kakhulu ukuthola izicubu ebuchosheni)
• Ukuhlolwa kwezicubu ezisuswe ku-tumor ngesikhathi sokuhlinzwa noma i-CT scan- noma i-biopsy eqondiswa yi-MRI ukuqinisekisa uhlobo lwesimila
• Ukubhoboza i-Lumbar (umpompi womgogodla)

Ukwelashwa kuncike ku:

• Usayizi nohlobo lwesimila
• Indawo emzimbeni kusuka lapho isakazeka khona
• Impilo ejwayelekile yomuntu

Izinhloso zokwelashwa kungaba ukukhulula izimpawu, ukuthuthukisa ukusebenza, noma ukunikeza induduzo.

Ukwelashwa ngemisebe yobuchopho okuphelele (i-WBRT) kuvame ukusetshenziselwa ukwelapha izicubu ezisabalalele ebuchosheni, ikakhulukazi uma kunezimila eziningi, futhi ukuhlinzwa akuyona inketho enhle.

Ukuhlinzwa kungasetshenziswa uma kunesimila esisodwa kanti umdlavuza awusabalalanga kwezinye izingxenye zomzimba. Ezinye izicubu zingasuswa ngokuphelele. Izicubu ezijule noma ezinwebeka kwizicubu zobuchopho zingancishiswa ngosayizi (debulked).

Ukuhlinzwa kunganciphisa ingcindezi futhi kunciphise izimpawu ezimweni lapho isimila singeke sisuswe.

I-Chemotherapy yamathumba obuchopho be-metastatic imvamisa ayisizi njengokuhlinzwa noma imisebe. Ezinye izinhlobo zamathumba, noma kunjalo, ziyasabela ekwelashweni ngamakhemikhali.

I-stereosactic radiosurgery (i-SRS) nayo ingasetshenziswa. Le ndlela yokwelashwa ngemisebe igxila emandleni amakhulu ama-x-ray endaweni encane yobuchopho. Isetshenziswa lapho kunezimila ezimbalwa ze-metastatic kuphela.

Imithi yezimpawu zesimila sobuchopho ifaka phakathi:

• Ama-Anticonvulsants afana ne-phenytoin noma i-levetiracetam ukunciphisa noma ukuvimbela ukuquleka
• Ama-Corticosteroids afana ne-dexamethasone ukunciphisa ukuvuvukala kobuchopho
• Ama-diuretics e-Osmotic afana ne-hypertonic saline noma i-mannitol ukunciphisa ukuvuvukala kobuchopho
• Imithi yezinhlungu

Lapho umdlavuza ususabalele, ukwelashwa kungagxila ekudambiseni izinhlungu nezinye izimpawu. Lokhu kubizwa ngokuthi ukunakekelwa okunciphisayo noma okusekelayo.

Izinyathelo zokududuza, izinyathelo zokuphepha, ukwelashwa ngokomzimba, ukwelashwa emsebenzini, nokunye ukwelashwa kungathuthukisa ikhwalithi yempilo yesiguli. Abanye abantu bangafuna ukufuna iseluleko sezomthetho sokubasiza ukuthi benze inkomba kusengaphambili namandla wommeli wezokunakekelwa kwezempilo.

Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokusekela umdlavuza. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa.

Kubantu abaningi abanezimila zobuchopho ze-metastatic, umdlavuza awulapheki. Ekugcineni izosakazeka nakwezinye izindawo zomzimba. Isibikezelo sincike ohlotsheni lwesimila nokuthi siphendula kanjani ekwelashweni.

Izinkinga zempilo ezingaba nomphumela zifaka:

• Ukuqothulwa kobuchopho (okubulalayo)
• Ukulahleka kwekhono lokusebenza noma lokuzinakekela
• Ukulahlekelwa kwamandla okuxhumana
• Ukulahlekelwa unomphela, okunzima kwesistimu yezinzwa okuba kubi ngokuhamba kwesikhathi

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma uba nekhanda eliqhubekayo elisha noma elihlukile kuwe.

Shayela umhlinzeki wakho noma uye egumbini labezimo eziphuthumayo uma wena noma umuntu omaziyo ngokuzumayo uba novila noma kube nokushintsha kombono, noma ukukhubazeka ekukhulumeni, noma ukubanjwa okusha noma okuhlukile.

Isigaxa sobuchopho - i-metastatic (yesibili); Umdlavuza - isimila sobuchopho (i-metastatic)

• Imisebe yobuchopho - ukukhishwa
• Ukuhlinzwa kobuchopho - ukukhishwa
• Ukwelashwa ngemisebe - imibuzo ongayibuza udokotela wakho

• Ubuchopho
• I-MRI yobuchopho

UClifton W, Reimer R. Metastatic brain tumors. Ku: Chaichana K, Quiñones-Hinojosa A, ama-eds. Ukubuka Okuphelele Kwezindlela Zanamuhla Zokuhlinzekwa Kwamathumbu Wangaphakathi Wobuchopho. IPhiladelphia, PA: Elsevier; 2019: isahluko 8.

UDorsey JF, uSalinas RD, uDang M, et al. Umdlavuza wesistimu yezinzwa emaphakathi. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 63.

Umdala JB, uNahed BV, uLinskey ME, u-Olson JJ. Ukubuyekezwa okuhlelekile kweCongress of Neurological Surgeons kanye nemihlahlandlela esekwe ebufakazini ngendima yezindlela zokwelashwa ezivelayo neziphenyayo zokwelashwa kwabantu abadala abanezicubu zobuchopho ze-metastatic. I-Neurosurgery. 2019; 84 (3): E201-E203. I-PMID 30629215 pubmed.ncbi.nlm.nih.gov/30629215/.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa kwezimila zesistimu yabantu abadala (PDQ) - inguqulo yezobuchwepheshe yezempilo. www.cancer.gov/types/brain/hp/ultult-brain-treatment-pdq. Kubuyekezwe uJanuwari 22, 2020. Kufinyelelwe ngoFebhuwari 12, 2020.

U-Olson JJ, uKalkanis SN, uRyken TC. ICongress of Neurological Surgeons Ukubuyekezwa okuhlelekile kanye nezinkombandlela ezisuselwa ebufakazini zokwelashwa kwabantu abadala abane-metastatic brain tumors: isifinyezo esiphezulu. I-Neurosurgery. 2019; 84 (3): 550-552. I-PMID 30629218 pubmed.ncbi.nlm.nih.gov/30629218/.

Patel AJ, Lang FF, Suki D, Wildrick DM, Sawaya R. Metastatic brain tumors. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans neWinn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 146.