Kusho Ukuthini Uma Umdlavuza Wamangqamuzana Amancane Isigaba Esikhulu

-Delile

• Ukubuka konke
• Isiteji esikhulu se-SCLC
• Ukwelashwa kwe-SCLC ebanzi
• Ukwelashwa ngamakhemikhali
• I-Immunotherapy
• Imisebe
• Ukuhlolwa kwemitholampilo
• Izindlela zokwelapha ezisekelayo
• I-Outlook yesigaba esibanzi se-SCLC
• Ukukhetha ukwelashwa
• Ukuphila nge-SCLC ebanzi
• Ukunakekelwa kwe-Palliative
• Ukuthatha

Ukubuka konke

Imidlavuza eminingi inezigaba ezine, kepha umdlavuza omncane wamaphaphu wamangqamuzana (SCLC) ujwayele ukuhlukaniswa ngezigaba ezimbili - isigaba esilinganiselwe nesigaba eseluliwe.

Ukwazi isiteji kukunikeza umbono othile ngombono ojwayelekile nokuthi yini ongayilindela ekwelashweni. Lapho uthatha isinqumo ngezinyathelo ezilandelayo, isigaba akusona ukuphela kokucatshangelwa. Udokotela wakho uzobuye abhekane nobudala bakho, impilo yonke, nezinto ozithandayo maqondana nekhwalithi yakho yokuphila.

Funda ukuze ufunde kabanzi mayelana nokuthi kusho ukuthini ukuba nesigaba esibanzi se-SCLC.

Isiteji esikhulu se-SCLC

Isiteji esikhulu se-SCLC sisabalale kude nesimila sokuqala. Udokotela wakho uzohlonza i-SCLC ebanzi lapho umdlavuza:

• isakazeke kulo lonke iphaphu elilodwa
• selisabalele nakwelinye iphaphu
• ihlasele indawo ephakathi kwamaphaphu
• ifinyelele kuma-lymph node ngakolunye uhlangothi lwesifuba
• ifinyelele emnkantsheni noma ezindaweni ezikude njengobuchopho, izindlala ze-adrenal, noma isibindi

Ngoba kaningi azikho izimpawu zakuqala, cishe abantu ababili kwabathathu abane-SCLC banezifo zesigaba esikhulu ngesikhathi sokuxilongwa.

I-SCLC evamile ngumdlavuza obuyile ngemuva kokuba ukwelashwa sekuqediwe.

Ukwelashwa kwe-SCLC ebanzi

Ukwelashwa ngamakhemikhali

Ngoba umdlavuza ususabalele, ukwelashwa okuyinhloko kwesigaba esibanzi se-SCLC ngamakhemikhali. I-Chemotherapy wuhlobo lokwelashwa okuhlelekile. Akukhombe isimila esithile noma indawo yomzimba. Ifuna futhi ihlasele amangqamuzana omdlavuza noma ngabe akuphi. Inganciphisa izicubu nokuqhubeka kancane.

Ezinye zezidakamizwa ze-chemo ezijwayeleke kakhulu ezisetshenziselwa i-SCLC yilezi:

• I-carboplatin
• umabhebhana
• etoposide
• inyathi

Imvamisa, kusetshenziswa izidakamizwa ezimbili zihlangene.

I-Immunotherapy

Imithi ye-Immunotherapy efana ne-atezolizumab ingasetshenziswa ngokuhlangana ne-chemotherapy, njengokwelashwa kwesondlo, noma lapho i-chemotherapy ingasasebenzi.

Imisebe

Esigabeni esibanzi se-SCLC, imisebe esifubeni ivame ukwenziwa kuphela uma unempendulo enhle ekhemotherapy.

Ukwelashwa ngemisebe kungasetshenziswa ukukhomba izindawo ezithile zomzimba lapho umdlavuza usabalale khona. Lokhu kungasiza ekunciphiseni izicubu ukuze kuthuthukiswe izimpawu futhi kungahle kwandise impilo yakho.

Ngisho noma umdlavuza ungakasakazeki ebuchosheni bakho, udokotela wakho angancoma imisebe ebuchosheni (i-prophylactic cranial irradiation). Lokhu kungavimbela umdlavuza ukuthi usabalale lapho.

Umdlavuza emaphashini ungaholela ekopheni nasekunenkingeni yokuphefumula. Uma lokho kwenzeka, ukwelashwa ngemisebe noma ukuhlinzwa nge-laser kungasetshenziswa. Inhloso akuyona ukuyelapha, kepha ukuthuthukisa izimpawu zakho kanye nekhwalithi yempilo yonke.

Ukuhlolwa kwemitholampilo

I-SCLC kunzima ukuyelapha. Ungahle uthande ukucabangela izivivinyo zomtholampilo zama-chemotherapy agents amasha, ama-immunotherapies, noma ezinye izindlela zokwelapha ezingatholakali ngenye indlela. Uma unentshisekelo yokufunda kabanzi, udokotela wakho angathola ukuthi iziphi izivivinyo ezingaba ngumdlalo omuhle kuwe.

Izindlela zokwelapha ezisekelayo

Ngaphezu kwalokho, ungadinga ukunakekelwa okusekelayo (okunciphisayo) ukubhekana nezimpawu ezithile. Ngokwesibonelo:

• ama-bronchodilator ukunweba imigwaqo yomoya yamaphaphu akho
• ukwelashwa komoya-mpilo
• ukudambisa izinhlungu
• ama-corticosteroids
• imithi yamathumbu

Ungasebenza futhi nodokotela wezokudla ukuze uthole ukusekelwa kokudla okunempilo.

I-Outlook yesigaba esibanzi se-SCLC

I-Chemotherapy ingasebenza ekunciphiseni i-SCLC. Abantu abaningi bazothola ukukhululeka kwezimpawu ezithile.

Noma umdlavuza uncipha uze ufike lapho ukuhlolwa kwe-imaging kungasakwazi ukuwuthola, udokotela wakho kungenzeka aphakamise ukwelashwa kwesondlo. Lokho kungenxa yokuthi i-SCLC yisifo esinolaka esicishe sibuye njalo.

Yize lungekho ikhambi le-SCLC ebanzi, ukwelashwa kungasiza ekuqhubekeni kancane futhi kuthuthukise ikhwalithi yempilo yakho.

Ukukhetha ukwelashwa

Kunezindlela eziningi zokwelapha ezijwayelekile ze-SCLC ebanzi, nezinto eziningi okufanele uzicabangele. Ngaphezu kwesigaba, udokotela wakho uzoncoma ukwelashwa okususelwa ku:

• lapho umdlavuza usabalale (metastasized) nokuthi yiziphi izitho ezithintekayo
• ubunzima bezimpawu
• iminyaka yakho
• okuthandwa nguwe

I-Chemotherapy kanye nemisebe kungaholela emiphumeleni emibi, ngisho nakubantu abanempilo kakhulu. Impilo yakho iyonke izokuhola izinqumo mayelana namakhemikhali we-chemotherapy kanye nokufakwa kwemithamo.

Beka eceleni isikhathi sokuba nengxoxo ejulile ne-oncologist yakho. Kungasiza ukufaka amalungu omndeni noma abanye abantu obathandayo. Thola umqondo omuhle ngohlobo ngalunye lwezokwelapha, ukuthi yini okufanele uyilindele ngokufanele, kanye nemiphumela emibi engaba khona.

Buza mayelana nokwelashwa kokwelashwa nokuthi kuzokuthinta kanjani impilo yakho usuku nosuku. Izinga lakho lempilo libalulekile. Okudingayo kubalulekile. Khuthaza udokotela wakho ukuthi akhulume ngokusobala ukuze ukwazi ukuthatha izinqumo ezinhle.

Uma ukwelashwa ngamakhemikhali noma izivivinyo zomtholampilo kungakulungele kahle, usengaqhubeka nokuthola ukunakekelwa okusekelayo. Esikhundleni sokuzama ukwelapha umdlavuza noma ukuqhubeka kancane, ukunakekelwa okusekelayo kugxile ekuphathweni kwezimpawu nasekugcineni ikhwalithi engcono kakhulu yokuphila isikhathi eside ngangokunokwenzeka.

Ukuphila nge-SCLC ebanzi

Ukuphila nge-SCLC ebanzi kungakhungathekisa. Kepha kunezindlela zokubhekana nalesi sifo futhi uphile impilo yakho ngokugcwele.

Abanye abantu bakuthola kuwusizo ukubona umelaphi ozosiza ekuxazululeni imizwa yabo. Lokhu kungasiza nabathandekayo ababhekene nobunzima.

Abantu abaningi bathola induduzo emaqenjini okusekela, noma ngabe bahlangana ku-inthanethi noma emihlanganweni. Udokotela wakho angakudlulisela emaqenjini asendaweni yangakini, noma ungathola eminye imininingwane kulezi zinhlangano:

• I-American Cancer Society
• I-American Lung Association
• ICancerCare

Ukuthola ukwelashwa kubalulekile, kodwa akuyona into kuphela okufanele uyicabangele. Ziphathe ngemisebenzi ebalulekile kuwe. Ukufanele futhi kuzosiza kwikhwalithi yakho yempilo.

Ukunakekelwa kwe-Palliative

Kungakhathaliseki ukuthi ukhetha i-chemotherapy noma cha, mhlawumbe uzodinga ukunakekelwa okusekelayo, okwaziwa nangokuthi ukunakekelwa kwe-palliative.

Ukunakekelwa kwe-palliative akuwulaphi umdlavuza uqobo kepha kulwela ukukusiza ugcine ikhwalithi engcono kakhulu yokuphila. Lokhu kungafaka ukukhululeka kobuhlungu, usizo lokuphefumula, kanye nokukhululeka kwengcindezi. Ithimba lakho lokunakekelwa kwe-palliative lingafaka:

• odokotela
• abahlengikazi
• abasebenzi bezenhlalakahle
• abelaphi

Uma izindiza zakho zivinjelwe, ungaba nalokhu:

• Ukwelashwa kwe-Photodynamic. Lokhu kwelashwa kusebenzisa umuthi obizwa nge-photosensitizer nokuchayeka ekukhanyeni kuma-wavelength athile. Uzolaliswa njengoba insimbi ebizwa nge-bronchoscope idluliswa ngomphimbo wakho nakumaphaphu akho. Inqubo ingasiza ukuvula i-airway yakho.
• Ukwelashwa nge-Laser. Esebenzisa i-laser ekugcineni kwe-bronchoscope, udokotela angashisa izingxenye zesimila kude. Uzodinga ukuba ngaphansi kwe-anesthesia ejwayelekile.
• Stent. Udokotela angabeka ithubhu ebizwa ngokuthi i-stent ku-airway yakho ukuze ikusize uphefumule.

I-Pleural effusion yilapho une-fluid eyakhelene namaphaphu akho. Ingaphathwa ngenqubo ebizwa nge-thoracentesis. Kule nqubo, inaliti engenalutho ibekwa esikhaleni esiphakathi kwezimbambo ukukhipha uketshezi.

Kukhona nezinqubo eziningana zokugcina uketshezi lungakhi futhi:

• I-chemical pleurodesis. Udokotela ufaka ishubhu elingenalutho odongeni lwesifuba ukukhipha uketshezi. Ngemuva kwalokho kwethulwa ikhemikhali yokwenza ukuthi ulwelwesi lwamaphaphu nodonga lwesifuba lunamathele ndawonye futhi kuvimbele uketshezi oluzayo esikhathini esizayo.
• I-pleurodesis yokuhlinzwa. Ngesikhathi sokuhlinzwa, kushaywa umuthi onjengengxube ye-talc endaweni ezungeze amaphaphu. Lo muthi ubangela ukwakheka kwezicubu ezibomvu, okwenza iphaphu linamathele esifubeni. Lokhu kusiza ukuvala isikhala lapho uketshezi lungaqoqa khona.
• Ipayipi. Udokotela ubeka ipayipi lomuthi esifubeni bese elishiya ngaphandle komzimba. Uketshezi lugelezelwa njalo ebhodleleni.

Uma uketshezi kwakha nxazonke zenhliziyo yakho, lezi zinqubo zingasiza:

• UPericardiocentesis. Eqondiswa i-echocardiogram, udokotela ubeka inaliti esikhaleni esizungeze inhliziyo ukukhipha uketshezi.
• Iwindi le-Pericardial. Ngesikhathi senqubo, udokotela ohlinzayo ususa ingxenye yesaka ezungeze inhliziyo. Lokhu kuvumela uketshezi ukuthi lungene esifubeni noma esiswini.

Kwezimila ezikhula ngaphandle kwamaphaphu, ukwelashwa ngemisebe kungasiza ekunciphiseni ukukhulula izimpawu.

Ukuthatha

Isiteji esikhulu se-SCLC sisho ukuthi umdlavuza wakho usabalele kude nesimila. Alikho ikhambi lalolu hlobo lomdlavuza, kepha ukwelashwa kuyatholakala ukusiza ukuphatha izimpawu nokwelula impilo yakho. Udokotela wakho uzoncoma uhlelo lokwelashwa ngokuya ngokuxilongwa kwakho nempilo yakho yonke.