Izinketho Zokwelapha Umdlavuza Webele ngeSiteji

-Delile

• Isigaba 0 (DCIS)
• Ukuhlinzwa
• Ukwelashwa ngemisebe
• Ukwelashwa kweHormone noma ukwelashwa okuhlosiwe
• Isigaba 1
• Ukuhlinzwa
• Ukwelashwa ngemisebe
• I-Chemotherapy kanye nokwelashwa okuhlosiwe
• Ukwelashwa kweHormone
• Isigaba 2
• Ukuhlinzwa
• Ukwelashwa ngemisebe
• Ukwelashwa ngamakhemikhali
• Ukwelashwa kweHormone
• Isigaba 3
• Ukwelashwa
• Isigaba 4
• Ukwelashwa
• I-Immunotherapy njengokwelashwa okuvelayo
• Ukuphathwa kobuhlungu
• Izici ezithinta ukwelashwa komdlavuza webele
• Ubudala
• Ukukhulelwa
• Ukukhula kwesimila
• Isimo sokuguquka kwezakhi zofuzo nomlando womndeni
• Umbono

Ukubuka konke

Kunezinhlobo ezahlukahlukene zokwelashwa komdlavuza webele, kanti ukwelashwa kuyatholakala kuzo zonke izigaba zomdlavuza. Iningi labantu lidinga inhlanganisela yokwelashwa okubili noma ngaphezulu.

Ngemuva kokuxilongwa, udokotela wakho uzonquma isigaba somdlavuza wakho. Bazobe sebenquma ngezindlela ezingcono zokwelashwa ezincike esigabeni sakho nakwezinye izinto, ezinjengobudala, umlando womndeni, isimo sokuguquka kwezakhi zofuzo, nomlando wakho wezokwelapha.

Ukwelashwa komdlavuza webele webanga lokuqala kungahle kungasebenzi kumdlavuza webele wesigaba esithuthukile. Izigaba zomdlavuza webele zisuka ku-0 ziye ku-4. Izici ezahlukahlukene zinquma isigaba sakho, kufaka phakathi:

• ubukhulu besimila
• inani lama-lymph node athintekile
• ngabe umdlavuza ususabalalise yini ezinye izingxenye zomzimba wakho

Odokotela basebenzisa izivivinyo ezehlukene ukwenza umdlavuza webele. Ukuhlolwa kokufanekisa kufaka phakathi i-CT scan, i-MRI, i-ultrasound, i-X-ray, ne-PET scan.

Lokhu kungasiza udokotela ukuba anciphise indawo okukhona kuyo umdlavuza, abale usayizi wesimila, futhi anqume ukuthi umdlavuza ususabalele yini kwezinye izingxenye zomzimba.

Uma ukuhlolwa kwe-imaging kubonisa ubukhulu kwenye ingxenye yomzimba, udokotela wakho angenza i-biopsy ukuze abone ukuthi ngabe isisindo sibi noma asibi yini. Ukuhlolwa komzimba nokuhlolwa kwegazi nakho kungasiza ngokubeka esiteji.

Isigaba 0 (DCIS)

Uma amangqamuzana angaphambi kwesikhumba noma omdlavuza egcinwe emapayipini obisi, abizwa ngokuthi umdlavuza webele ongahlaseli noma i-ductal carcinoma in situ (DCIS).

Umdlavuza webele wesigaba 0 ungangena futhi usabalale ngale kwamapayipi. Ukwelashwa kusenesikhathi kungakuvimba ekuthuthukiseni umdlavuza webele.

Ukuhlinzwa

Ku-lumpectomy, udokotela ohlinzayo ususa amangqamuzana anomdlavuza futhi asindise lonke ibele. Kuyindlela esebenzayo lapho i-DCIS ivalelwe endaweni eyodwa yesifuba.

I-lumpectomy ingenziwa njengenqubo yokwelashwa kweziguli. Lokhu kusho ukuthi ungaya ekhaya ngemuva nje kokuhlinzwa futhi ngeke udinge ukuhlala esibhedlela ubusuku bonke.

I-mastectomy ukususwa kokuhlinzwa kwesifuba. Kunconywa lapho iDCIS itholakala kulo lonke ibele. Ukuhlinzwa okwakha kabusha isifuba kungaqala ngesikhathi se-mastectomy noma ngolunye usuku.

Ukwelashwa ngemisebe

Imisebe wuhlobo lwezokwelapha ezihlosiwe. Ngokuvamile kunconywa ngemuva kwe-lumpectomy yomdlavuza webele wesigaba 0. Kusetshenziswa ama-X-ray anamandla amakhulu ukubhubhisa amangqamuzana omdlavuza nokuwavimba ekusakazekeni.

Lokhu kwelashwa kunganciphisa ingozi yokuphindeka. Ukwelashwa ngemisebe kuvame ukuphathwa izinsuku ezinhlanu ngesonto phakathi kwamasonto amahlanu kuya kwayisikhombisa.

Ukwelashwa kweHormone noma ukwelashwa okuhlosiwe

Udokotela wakho angancoma ukwelashwa kwe-hormone uma ngabe une-lumpectomy noma i-mastectomy eyodwa yomdlavuza webele we-estrogen receptor-positive noma we-progesterone receptor-positive.

Ukwelashwa kwama-hormone ngomlomo, njenge-tamoxifen, ngokuvamile kunqunyelwe ukwehlisa ingozi yokuba nomdlavuza webele. Ukwelashwa kweHormone kungahle kungabekelwa abesifazane abake baba ne-mastectomy ephindwe kabili yomdlavuza webele wesigaba 0.

Udokotela wakho futhi angancoma i-trastuzumab (Herceptin), ukwelashwa okuhlosiwe, uma umdlavuza wakho webele uvivinywa unamaprotheni we-HER2 ngokweqile.

Isigaba 1

Isigaba 1A Umdlavuza webele usho ukuthi isimila sokuqala singamasentimitha ama-2 noma ngaphansi kanti ama-lymph node e-axillary awathinteki. Esigabeni 1B, umdlavuza utholakala kuma-lymph node futhi asikho isimila esifubeni noma isimila sincane kunamasentimitha ama-2.

Kokubili i-1A ne-1B kubhekwa njengomdlavuza webele wesigaba sokuqala. Kunganconywa ukuhlinzwa kanye nokwelashwa okukodwa noma ngaphezulu.

Ukuhlinzwa

I-Lumpectomy ne-mastectomy zombili izinketho zesigaba 1 somdlavuza webele. Isinqumo sisuselwa ku:

• usayizi nendawo yesimila sokuqala
• okuthandwa nguwe
• ezinye izinto njengokuthambekela kofuzo

I-biopsy yama-lymph node cishe izokwenziwa ngasikhathi sinye.

Nge-mastectomy, ukwakhiwa kabusha kwesifuba kungaqala ngasikhathi sinye uma kufunwa, noma ngemuva kokuba ukwelashwa okwengeziwe sekuqediwe.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe kuvame ukunconywa ngemuva kokuhlinzwa komdlavuza webele wesigaba 1. Kungahle kungadingeki kwabesifazane abadala kuneminyaka engama-70, ikakhulukazi uma ukwelashwa kwamahomoni kungenzeka.

I-Chemotherapy kanye nokwelashwa okuhlosiwe

Umdlavuza webele ongemuhle nge-estrogen, i-progesterone, ne-HER2 ibizwa ngomdlavuza webele ongemuhle kathathu (TNBC). I-Chemotherapy cishe njalo iyadingeka kulawa macala ngoba akukho ukwelashwa okuhlosiwe kwe-TNBC.

I-Chemotherapy nayo inganikezwa umdlavuza webele one-hormone-positive. I-Herceptin, ukwelashwa okuhlosiwe, inikezwa kanye ne-chemotherapy yomdlavuza webele we-HER2-positive. Udokotela wakho futhi angancoma ezinye izindlela zokwelashwa eziqondiswe ku-HER2, njengePerjeta noma iNerlynx.

Kodwa-ke, i-chemotherapy ayidingeki ngaso sonke isikhathi kumdlavuza webele wesigaba sokuqala, ikakhulukazi uma ingalashwa ngokwelashwa kwamahomoni.

Ukwelashwa kweHormone

Odokotela bangancoma ukwelashwa kwama-hormone komdlavuza webele owamukela i-hormone receptor, kungakhathalekile ukuthi ungakanani usayizi wesimila.

Isigaba 2

Esigabeni 2A, isimila sincane kunamasentimitha ama-2 futhi sesisabalalele phakathi kwelungu elilodwa kuya kwamathathu ama-lymph node. Noma, kuphakathi kwamasentimitha amabili kuya kwangu-5 futhi akukasakazeki kuma-lymph node.

Isigaba 2B sisho ukuthi isimila siphakathi kwamasentimitha amabili kuya kwayisi-5 futhi sesisabalalele saba phakathi kwelungu elilodwa kuya kwamathathu ama-lymph node. Noma likhulu kunamasentimitha ama-5 futhi alisakazekanga kunoma yimaphi ama-lymph node.

Cishe uzodinga inhlanganisela yokuhlinzwa, i-chemotherapy, kanye nokukodwa noma okuningi kokulandelayo: ukwelashwa okuqondisiwe, imisebe, kanye nokwelashwa kwamahomoni.

Ukuhlinzwa

I-Lumpectomy ne-mastectomy zombili zingaba izinketho ngokuya ngosayizi nendawo yesimila.

I-radical mastectomy eguquliwe ukususwa kwesifuba, kufaka phakathi imisipha yesifuba. Uma ukhetha ukwakha kabusha, inqubo ingaqala ngasikhathi sinye noma ngemuva kokuphela kokwelashwa komdlavuza.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe kuhlose noma yimaphi amangqamuzana omdlavuza asele esifubeni nakuma-lymph node. Kuvame ukunconywa ngemuva kokuhlinzwa.

Ukwelashwa ngamakhemikhali

I-Chemotherapy iyindlela yokwelapha ebulala amaseli womdlavuza emzimbeni wonke. Le mithi enamandla ihanjiswa ngemithambo (emthanjeni) phakathi namasonto noma izinyanga eziningi.

Kunezinhlobonhlobo zemithi yokwelapha ngamakhemikhali esetshenziselwa ukwelapha umdlavuza webele, kufaka phakathi:

• i-docetaxel (Taxotere)
• doxorubicin (Adriamycin)
• i-cyclophosphamide (iCytoxan)

Ungathola inhlanganisela yemithi eminingana yamakhemikhali. I-Chemotherapy ibaluleke kakhulu kwi-TNBC. I-Herceptin inikezwa kanye ne-chemotherapy yomdlavuza webele we-HER2-positive.

Udokotela wakho futhi angancoma ezinye izindlela zokwelashwa eziqondiswe ku-HER2, njengePerjeta noma iNerlynx.

Ukwelashwa kweHormone

Ngemuva kokuthi lonke olunye ukwelashwa seluphelile, ungazuza ekwelashweni okuqhubekayo komdlavuza webele one-hormone.

Imithi yomlomo efana ne-tamoxifen noma i-aromatase inhibitors ingahle inqunyelwe iminyaka emihlanu noma ngaphezulu.

Isigaba 3

Isigaba 3A Umdlavuza webele usho ukuthi umdlavuza ususabalale waya kuma-lymph node angama-axillary (armpit) amane kuya kwayisishiyagalolunye noma usukhulise ama-lymph node angaphakathi. I-tumor eyinhloko ingaba yinoma yisiphi isayizi.

Kungasho futhi ukuthi isimila sikhulu kunamasentimitha ama-5 kanti amaqembu amancane amangqamuzana omdlavuza atholakala kuma-lymph node. Ekugcineni, isigaba 3A singafaka nezicubu ezingaphezulu kwamasentimitha ama-5 ngokubandakanyeka kwama-lymph node ama-axillary okukodwa kuya kwamathathu noma yimaphi amabele wesifuba.

Isigaba 3B sisho ukuthi isimila sesifuba sihlasele udonga lwesifuba noma isikhumba futhi kungenzeka noma singahlasela ama-lymph node afinyelela kwayisishiyagalolunye.

Isigaba 3C sisho ukuthi umdlavuza utholakala kuma-lymph node ayi-10 noma ngaphezulu, ama-lymph node eduze ne-collarbone, noma ama-mammary node wangaphakathi.

Izimpawu zomdlavuza webele wokuvuvukala (IBC) zihlukile kwezinye izinhlobo zomdlavuza webele. Ukuxilongwa kungahle kubambezeleke ngoba imvamisa asikho isigaxa sebele. Ngokwencazelo, i-IBC itholakala esigabeni 3B noma ngaphezulu.

Ukwelashwa

Ukwelashwa komdlavuza webele wesigaba 3 kuyafana nokwesigaba 2.

Isigaba 4

Isigaba 4 sibonisa ukuthi umdlavuza webele une-metastasized (usakazeka engxenyeni ekude yomzimba).

Umdlavuza webele uvame ukusabalala uye emaphashini, ebuchosheni, esibindini noma emathanjeni. Umdlavuza webele we-Metastatic awulapheki, kepha ungaphathwa ngokwelashwa okune-systemic ngolaka.

Ngoba umdlavuza uhilela izingxenye ezihlukene zomzimba, ungadinga izindlela zokwelashwa eziningi ukumisa ukukhula kwesimila nokunciphisa izimpawu.

Ukwelashwa

Ngokuya ngokuthi umdlavuza wakho webele uthuthuke kangakanani, cishe uzoba ne-chemotherapy, i-radiation therapy, ne-hormone therapy (uma unomdlavuza we-hormone receptor-positive).

Enye indlela yokwelashwa okubhekiswe kukho, okubhekiswe kwiprotheni evumela ukuthi amangqamuzana omdlavuza akhule. Kuma-cancer we-HER2-positive, izindlela zokwelashwa eziqondiswe ku-HER2 zingabandakanya i-Herceptin, Perjeta, Nerlynx, Tykerb, noma iKadcyla.

Uma umdlavuza usakazekela kuma-lymph node, ungaqaphela ukuvuvukala noma ukukhuliswa kwezindawo zakho. Ukuhlinzwa, ukwelashwa ngamakhemikhali kanye nemisebe kungasetshenziswa ukwelapha umdlavuza osakazekela kuma-lymph node.

Inombolo nendawo yamathumba inquma izinketho zakho zokuhlinzwa.

Ukuhlinzwa akuyona indlela yokuqala yokuzivikela ngomdlavuza webele osuthuthukile, kepha udokotela wakho angancoma ukuhlinzwa ukwelapha ukucindezelwa kwentambo yomgogodla, amathambo aphukile, kanye nenqwaba yabantu ababangelwa imastastasis. Lokhu kusiza ukuqeda izinhlungu nezinye izimpawu.

Eminye imithi esetshenziselwa ukwelapha umdlavuza webele osezingeni eliphakeme ihlanganisa:

• imishanguzo
• ama-anticonvulsants
• ama-steroids
• izinzwa zendawo

I-Immunotherapy njengokwelashwa okuvelayo

I-Immunotherapy iyindlela yokwelashwa entsha, futhi ngenkathi ingakavunyelwa i-FDA yomdlavuza webele okwamanje, yindawo ethembisayo.

Kunezifundo ezimbalwa ezandulela ukwelashwa nezomtholampilo eziphakamisa ukuthi ingathuthukisa imiphumela yomtholampilo kubantu abanomdlavuza webele.

I-Immunotherapy inemiphumela emibi embalwa kune-chemotherapy futhi mancane amathuba okuthi imelane nayo. I-Immunotherapy isebenza ngokukhulisa izivikelo zemvelo zomzimba ukulwa nomdlavuza.

I-Pembrolizumab iyi-immune checkpoint inhibitor. Luhlobo lwe-immunotherapy olukhombise isithembiso esithile ekwelapheni umdlavuza webele we-metastatic.

Isebenza ngokuvimba izivikeli mzimba ezithile ezenza kube nzima ukuthi amasosha omzimba alwe nomdlavuza, avumele umzimba ukuthi uphinde ulwe ngempumelelo. Olunye ucwaningo luthole ukuthi amaphesenti angama-37.5 eziguli ezinomdlavuza webele onezinhlungu eziphindwe kathathu zithole inzuzo kulokho kwelashwa.

Ngoba i-immunotherapy ayikavunyelwa i-FDA okwamanje, ukwelashwa kutholakala kakhulu ngokuhlolwa komtholampilo ngalesi sikhathi.

Ukuphathwa kobuhlungu

Umdlavuza webele osakazekela kwezinye izingxenye zomzimba ungadala ubuhlungu, njengobuhlungu bamathambo, ubuhlungu bemisipha, ikhanda elibuhlungu nokungahambi kahle kwesibindi. Khuluma nodokotela wakho mayelana nokuphathwa kobuhlungu.

Izinketho zobuhlungu obumaphakathi kuya obulinganiselayo zihlanganisa i-acetaminophen nama-NSAID, njenge-ibuprofen.

Ukuze uthole ubuhlungu obukhulu esikhathini esizayo, udokotela wakho angancoma i-opioid efana ne-morphine, i-oxycodone, i-hydromorphone, noma i-fentanyl.

Izici ezithinta ukwelashwa komdlavuza webele

Ngenkathi isigaba somdlavuza webele sihlobene kakhulu nezinketho zokwelashwa, ezinye izinto zingathinta nezindlela zakho zokwelashwa.

Ubudala

Isibikezelo somdlavuza webele sivame ukuba sibi kakhulu kwabesifazane abangaphansi kweminyaka engama-40 ngoba umdlavuza webele uvame ukuba nolaka kakhulu kwabesifazane abasebasha.

Ukulinganisa isithombe somzimba nokunciphisa ubungozi obucayiwe kungadlala indima esinqumweni phakathi kwe-lumpectomy ne-mastectomy.

Ngaphezu kokuhlinzwa, ukwelashwa ngamakhemikhali nokwelashwa ngemisebe, iminyaka eminingana yokwelashwa kwama-hormone komdlavuza webele one-hormone ngokuvamile kunconywa abesifazane abasha. Lokhu kungasiza ukuvimbela ukuphindeka noma ukusabalala komdlavuza webele.

Kwabesifazane be-premenopausal, ukucindezelwa kwe-ovari kunganconywa ngaphezu kokwelapha i-hormone.

Ukukhulelwa

Ukukhulelwa nakho kunomthelela ekwelashweni komdlavuza webele. Ukuhlinzwa komdlavuza webele kuvame ukuphepha kwabesifazane abakhulelwe, kepha odokotela bangakudikibalisa ukwelashwa ngamakhemikhali kuze kube i-trimester yesibili noma yesithathu.

Ukwelashwa kweHormone kanye nokwelashwa ngemisebe kungalimaza ingane engakazalwa futhi akunconywa ngesikhathi sokukhulelwa.

Ukukhula kwesimila

Ukwelashwa futhi kuya ngokuthi umdlavuza ukhula futhi usakazeke ngokushesha kangakanani.

Uma unesimo somdlavuza webele onolaka, udokotela wakho angancoma indlela enolaka, njengokuhlinzwa kanye nenhlanganisela yezinye izindlela zokwelapha.

Isimo sokuguquka kwezakhi zofuzo nomlando womndeni

Ukwelashwa komdlavuza webele kungancika ngokwengxenye ekubeni nesihlobo esiseduze esinomlando womdlavuza webele noma ukuhlolwa kutholakale kutholakala ngofuzo olwandisa ubungozi bokuba nomdlavuza webele.

Abesifazane abanezi zinto bangakhetha inketho yokuhlinza yokuvimbela, efana ne-bilateral mastectomy.

Umbono

Isibikezelo somdlavuza webele sincike, ikakhulukazi, esiteji ngesikhathi sokuxilongwa. Lapho uthola ukuthi usheshe watholakala, umphumela uba ngcono.

Yingakho kubalulekile ukuzivivinya amabele nyangazonke nokuhlela ama-mammograms ejwayelekile. Khuluma nodokotela wakho mayelana nokuthi yisiphi isikhathi sokuhlola esifanele wena. Funda ngamashejuli wokuhlola nokuningi kulo mhlahlandlela ophelele womdlavuza webele.

Kunezindlela zokwelashwa ezijwayelekile zezinhlobo ezahlukahlukene kanye nezigaba zomdlavuza webele, kepha ukwelashwa kwakho kuzohambisana nezidingo zakho.

Ngaphezu kwesigaba sokuxilongwa, odokotela bakho bazocubungula uhlobo lomdlavuza webele onawo nezinye izici zezempilo. Uhlelo lwakho lokwelashwa lushintshwa kuye ngokuthi uluphendula kanjani.

Ukuhlolwa kwemitholampilo kuyizifundo zocwaningo ezisebenzisa abantu ukuhlola ukwelashwa okusha. Uma unentshisekelo, cela i-oncologist yakho ngolwazi mayelana nezilingo ezitholakalayo.

Ungabheka nokwelashwa okuhambisanayo kunoma yisiphi isigaba somdlavuza webele. Lezi yizindlela zokwelapha ezisetshenziswa kanye nezindlela zokwelapha ezijwayelekile. Abesifazane abaningi bayasizakala ngezindlela zokwelapha ezinjenge-massage, i-acupuncture ne-yoga.

Thola ukwesekwa kwabanye abaphila nomdlavuza webele. Landa uhlelo lokusebenza lwamahhala lweHealthline lapha.