Yiziphi Izinketho Zokwelapha Ezikhona Zomdlavuza Webele Othuthukile?

-Delile

• Ukwelashwa kweHormone
• Izidakamizwa ezihlosiwe
• Ukwelashwa ngamakhemikhali
• Imisebe
• Ukuhlinzwa
• Imithi yezinhlungu
• Izindlela zokwelapha ezihambisanayo
• Okubalulekile

Ukuba nohlobo lomdlavuza oluthuthukile kungazizwa sengathi unokhetho oluncane noma awunazo nhlobo zokwelashwa. Kodwa akunjalo. Thola ukuthi yiziphi izinketho ongazithola, bese uqala ukuthola uhlobo olufanele lwezokwelapha.

Ukwelashwa kweHormone

Kunezinhlobo zokwelashwa kwamahomoni ukwelapha umdlavuza webele we-hormone receptor-positive (i-estrogen receptor-positive noma i-progesterone receptor-positive):

I-Tamoxifen iyindlela yokwelapha yomlomo yansuku zonke yabesifazane be-premenopausal.

I-Aromatase inhibitors yimithi yomlomo yabesifazane be-postmenopausal. Lokhu kungahlanganiswa nezidakamizwa ezihlosiwe ezifana ne-palbociclib (Ibrance) noma i-everolimus (i-Afinitor). Ama-aromatase inhibitors afaka:

• i-anastrozole (i-Arimidex)
• i-exemestane (i-Aromasin)
• i-letrozole (Femara)

Imiphumela emibi yokwelashwa kwe-hormonal ingafaka:

• ukushisa okushisayo nokujuluka ebusuku
• ukoma kwesitho sangasese sowesifazane
• kwehlise ukushayela ucansi
• ukushintsha kwemizwelo
• ukuphazamiseka kumjikelezo wokuya esikhathini kwabesifazane be-premenopausal
• ngamehlo
• ingozi eyengeziwe yamahlule egazi, isifo sohlangothi nokuhlaselwa yinhliziyo
• ukulahleka kwamathambo

Izindlela zokwelapha ze-Hormonal azisebenzi ekwelapheni umdlavuza webele we-hormone receptor-negative.

Izidakamizwa ezihlosiwe

Izidakamizwa eziningana zikhomba umdlavuza webele we-HER2-positive. Qaphela ukuthi lezi zindlela zokwelapha akuzona ukwelashwa okusebenzayo komdlavuza webele we-HER2-negative.

I-Trastuzumab (i-Herceptin) ilawulwa ngemithambo futhi ivame ukunikezwa ngokuhlanganiswa ne-chemotherapy. Umthamo wokuqala uvame ukuthatha imizuzu engama-90. Ngemuva kwalokho, amanani amancane futhi athatha cishe isigamu sehora. Phakathi kwemiphumela emibi engaba khona yilena:

• ukumnika ukusabela
• imfiva
• isicanucanu nokuhlanza
• isifo sohudo
• izifo
• ikhanda
• ukukhathala
• ukuqubuka

IPertuzumab (iPerjeta) nayo ilawulwa ngemithambo yegazi. Umthamo wokuqala uthatha cishe ihora. Kungaphindwa njalo emavikini amathathu ngemithamo emincane. Kuvame ukusetshenziswa ngokubambisana ne-chemotherapy. Imiphumela emibi evela ku-pertuzumab ne-chemotherapy ingafaka:

• isicanucanu
• isifo sohudo
• ukulahleka kwezinwele
• ukukhathala
• ukuqubuka
• ukuba ndikindiki nokushoshozela (i-peripheral neuropathy)

Omunye umuthi ophuzwe ngomjovo, i-ado-trastuzumab emtansine (iKadcyla) unikezwa njalo ezinsukwini ezingama-21. Phakathi kwemiphumela emibi engaba khona yilena:

• ukumnika ukumnika
• ukukhathala
• isicanucanu
• ikhanda nobuhlungu bemisipha
• ukuqunjelwa
• ukuphuma kwamakhala nokopha

ILapatinib (iTykerb) ngumuthi wokwelapha ngomlomo. Ingasetshenziswa yodwa noma ihlanganiswe namakhemikhali noma ezinye izidakamizwa ezihlosiwe. Ngokuya ngokuthi iyiphi imithi ehlanganiswe nayo, i-lapatinib ingadala:

• isifo sohudo
• isicanucanu nokuhlanza
• ukuqubuka
• ukukhathala

Izindlela zokwelapha ezihlosiwe ezilandelayo zisetshenziselwa ukwelapha umdlavuza webele we-hormone receptor-positive / HER2-negative:

I-Palbociclib (Ibrance) yimithi ye-anoral esetshenziswa nge-aromatase inhibitor. Imiphumela emibi ingafaka:

• isicanucanu
• izilonda zomlomo
• ukulahleka kwezinwele
• ukukhathala
• isifo sohudo
• ingozi eyengeziwe yokutheleleka

Isidakamizwa somlomo i-everolimus (Afinitor) sithathwa ngomlomo futhi sisetshenziswe ngokuhlangana ne-exemestane (Aromasin). Imvamisa ayisetshenziswa kuze kube yilapho sekuzanywe i-letrozole noma i-anastrozole. Imiphumela emibi engaba khona ibandakanya:

• ukuphelelwa umoya
• ukukhwehlela
• ubuthakathaka
• ingozi eyengeziwe yokutheleleka, i-lipids ephezulu yegazi, noshukela ophakeme wegazi

Ukwelashwa ngamakhemikhali

I-Chemotherapy ingasetshenziselwa noma yiluphi uhlobo lomdlavuza webele. Esikhathini esiningi, lokhu kuzobandakanya inhlanganisela yezidakamizwa eziningana zamakhemikhali.

Azikho izindlela zokwelashwa zamahomoni noma ezihlosiwe zomdlavuza webele okungukuthi zombili i-hormone receptor-negative ne-HER2-negative (eyaziwa nangokuthi umdlavuza webele ophindwe kathathu, noma i-TNBC). I-Chemotherapy iyindlela yokwelashwa komugqa wokuqala kulezi zimo.

I-Chemotherapy yindlela yokwelashwa okuhlelekile. Ingafinyelela futhi ibhubhise amangqamuzana omdlavuza noma yikuphi emzimbeni wakho. Ngaphansi kwezimo ezithile, imithi yamakhemikhali ingahanjiswa ngqo endaweni ethile ye-metastasis, efana nesibindi sakho noma uketshezi oluzungeze ubuchopho bakho.

Izidakamizwa zenziwa ngemithambo yegazi. Isikhathi ngasinye sokwelapha singahlala amahora amaningi. Inikezwa ngezikhathi ezivamile kuze kube amasonto amaningana. Lokhu ukuvumela umzimba wakho ukuthi ululame phakathi kwezindlela zokwelashwa.

Imithi yokwelashwa ngamakhemikhali iyasebenza ngoba ibulala amangqamuzana omdlavuza akhula ngokushesha. Ngeshwa, angabulala namaseli aphilayo akhula ngokushesha. Lokho kungadala imiphumela eminingi emibi engaba khona, kufaka phakathi:

• isicanucanu nokuhlanza
• ukulahleka kwezinwele
• ukulahlekelwa isifiso sokudla
• ukuqunjelwa noma uhudo
• ukukhathala
• izinguquko esikhunjeni nasezipikili
• izilonda zomlomo nezinsini ezophayo
• ukuguquka kwemizwelo
• ukuncipha komzimba
• ukulahleka kocansi
• izinkinga zokuzala

Imisebe

Kwezinye izimo, ukwelashwa ngemisebe kungasiza ekwelapheni umdlavuza webele osezingeni eliphakeme. Ezinye izibonelo yilezi:

• ukukhomba imastastasis endaweni ethile, njengobuchopho bakho noma umgogodla
• ukusiza ukuvimbela ukuphuka kwamathambo abuthakathaka
• ukukhomba isimila esidala isilonda esivulekile
• ukwelapha ukuvinjelwa kwemithambo yegazi esibindini sakho
• ukuhlinzeka ukukhululeka kobuhlungu

Ukwelashwa ngemisebe akunabuhlungu. Kepha kungadala ukucasuka kwesikhumba okwesikhashana nokukhathala kwesikhathi eside. Imvamisa iphathwa nsuku zonke kuze kube amasonto ayisikhombisa, ngakho-ke kunesibopho sesikhathi sansuku zonke.

Ukuhlinzwa

Ukuhlinzwa kungaba yingxenye yokwelashwa komdlavuza webele okuthuthukile ngezizathu ezimbalwa. Isibonelo esisodwa ukuhlinzwa ukuze kususwe isimila esicindezela ebuchosheni bakho noma entanjeni yomgogodla.

Ukuhlinzwa kungasetshenziswa kuhlanganiswe nokwelashwa ngemisebe.

Imithi yezinhlungu

Izidakamizwa ezahlukahlukene zingasetshenziswa ukwelapha ubuhlungu obuhambisana nomdlavuza webele osezingeni eliphezulu.

Ungaqala ngokudambisa izinhlungu okuthengwa ekhawunteni. Phakathi kwazo kukhona:

• i-acetaminophen (iTylenol)
• ibuprofen (Advil, Motrin)
• I-naproxen (Aleve, Naprosyn)

Khuluma nodokotela wakho ngaphambi kokusebenzisa imishanguzo yokuthenga. Abanye bangaphazamisa ezinye izindlela zokwelashwa.

Ngobuhlungu obukhulu, udokotela wakho angakunikeza i-opioid yomlomo efana nale:

• i-morphine (MS Contin)
• i-oxycodone (Roxicodone)
• i-hydromorphone (Dilaudid)
• i-fentanyl (i-Duragesic)
• i-methadone (i-Dolophine)
• i-oxymorphone (Opana)
• i-buprenorphine (Buprenex)

Imiphumela engemihle ingafaka ukozela, ukuqunjelwa, kanye nenkanuko. Le mithi enamandla kufanele ithathwe njengoba iqondisiwe.

Lezi zivame ukusetshenziselwa ubuhlungu ngenxa ye-bone metastasis:

• ama-bisphosphonates: i-zoledronic acid (iZometa) noma i-pamidronate (i-Aredia), enikezwe ngemithambo yegazi
• I-RANK ligand inhibitor: i-denosumab (i-Xgeva noma i-Prolia), enikezwe ngomjovo

Le mithi ingasiza futhi ekunciphiseni ubungozi bokuqhekeka kwamathambo. Ubuhlungu bemisipha namathambo yimiphumela emibi engaba khona.

Ezinye izinhlobo zemithi yezinhlungu zomdlavuza webele osezingeni eliphakeme yilezi:

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

Abanye abantu banenkinga yokugwinya amaphilisi. Uma kunjalo, imishanguzo ethile yezinhlungu iyatholakala ifomu eliketshezi noma lesikhumba. Ezinye zingahlinzekwa ngemithambo yegazi noma nge-chemotherapy port noma nge-catheter.

Izindlela zokwelapha ezihambisanayo

Ezinye izindlela zokwelapha ezihambisanayo ezingasiza ekulawuleni ubuhlungu yilezi:

• ukutshopa
• ukushisa nokwelashwa okubandayo
• ukwelashwa kokubhucungwa
• ukuzivocavoca umzimba noma ukwelashwa ngokomzimba
• amasu okuphumula njengokuzindla nezithombe eziqondisiwe

Okubalulekile

Ukwelashwa komdlavuza webele osezingeni eliphakeme kuzohambisana nezidingo zakho kanye nesimo sesifo sakho. Kungabandakanya ukwelashwa okuningi ngasikhathi sinye. Kufanele iguquguquke, iguquke njengoba izidingo zakho zishintsha.

Udokotela wakho uzoqapha impilo yakho kanye nezimpawu zakho. Awudingi ukuqhubeka nokwelashwa okungasebenzi.

Ukuxhumana okuhle nodokotela wakho kubalulekile ukuze uzuze ikhwalithi yokuphila engcono kakhulu.