Khansa ya m'mapapo yosakhala yaying'ono

Khansa ya m'mapapo yaing'ono kwambiri ndiyo khansa yamapapu yamtundu uliwonse. Nthawi zambiri imakula ndikufalikira pang'onopang'ono kuposa khansa yaying'ono yamapapo yam'mapapo.

Pali mitundu itatu yodziwika bwino ya khansa ya m'mapapo yaing'ono kwambiri (NSCLC):

• Adenocarcinomas amapezeka nthawi zambiri kunja kwa mapapo.
• Squamous cell carcinomas nthawi zambiri amapezeka pakatikati pa mapapo pafupi ndi chubu cha mpweya (bronchus).
• Ma cell carcinomas akulu amatha kupezeka paliponse m'mapapu.
• Pali mitundu yambiri yachilendo ya khansa yamapapu yomwe imatchedwanso kuti yaying'ono.

Kusuta kumayambitsa milandu yambiri (pafupifupi 90%) ya khansa yaying'ono yamapapo yam'mapapo. Kuopsa kwake kumatengera kuchuluka kwa ndudu zomwe mumasuta tsiku lililonse komanso kuti mwakhala mukusuta fodya kwa nthawi yayitali bwanji. Kukhala pafupi ndi utsi wochokera kwa anthu ena (utsi wa fodya) kumakwezanso chiopsezo cha khansa yamapapo. Koma anthu ena omwe sanasutepo amakhala ndi khansa yamapapo.

Kafukufuku akuwonetsa kuti kusuta chamba kumatha kuthandiza ma cell a khansa kukula. Koma palibe kulumikizana kwachindunji pakati pa kusuta chamba ndi kukhala ndi khansa yam'mapapo.

Kukhazikika pafupipafupi pakuwonongeka kwa mpweya ndi madzi akumwa omwe ali ndi arsenic wambiri kumatha kukulitsa chiopsezo cha khansa yamapapo. Mbiri yothandizira ma radiation kumapapu imathanso kuwonjezera ngozi.

Kugwira ntchito kapena kukhala pafupi ndi mankhwala kapena zinthu zomwe zimayambitsa khansa kumawonjezeranso chiopsezo chokhala ndi khansa yamapapo. Mankhwalawa ndi monga:

• Asibesitosi
• Radon
  
• Mankhwala monga uranium, beryllium, vinyl chloride, ma nickel chromates, zopangira malasha, mpweya wa mpiru, chloromethyl ethers, mafuta, ndi utsi wa dizilo
• Ma alloys ena, utoto, inki, ndi zotetezera
• Zamgululi ntchito mankhwala enaake ndi formaldehyde

Zizindikiro zimaphatikizapo:

• Kupweteka pachifuwa
• Chifuwa chomwe sichichoka
• Kutsokomola magazi
• Kutopa
• Kutaya njala
• Kuchepetsa thupi osayesa
• Kupuma pang'ono
• Kutentha
• Zowawa zikafalikira kumadera ena a thupi

Khansa yam'mapapo yoyambirira siyingayambitse zizindikiro zilizonse.

Zizindikiro zina zomwe zingakhale chifukwa cha NSCLC, nthawi zambiri kumapeto:

• Kupweteka kwa mafupa kapena kukoma
• Eyelid akugwera
• Kuwopsya kapena kusintha mawu
• Ululu wophatikizana
• Mavuto amisomali
• Kumeza vuto
• Kutupa kwa nkhope
• Kufooka
• Kupweteka pamapewa kapena kufooka

Zizindikirozi zimatha kukhala chifukwa cha zinthu zina zochepa. Ndikofunika kuti mulankhule ndi omwe akukuthandizani ngati muli ndi zizindikiro.

Wothandizira adzayesa thupi ndikufunsa za mbiri yanu yachipatala. Mudzafunsidwa ngati mumasuta, ndipo ngati ndi choncho, mumasuta fodya komanso kuti mwakhala mukusuta nthawi yayitali bwanji. Mudzafunsidwanso za zinthu zina zomwe mwina zikukuyikani pachiwopsezo cha khansa yam'mapapo, monga kupezeka kwa mankhwala ena.

Mayeso omwe angachitike kuti mupeze khansa yamapapu kapena kuwona ngati yafalikira ndi awa:

• Kujambula mafupa
• X-ray pachifuwa
• Kuwerengera kwathunthu kwa magazi (CBC)
• Kujambula kwa CT pachifuwa
• MRI ya chifuwa
• Kusanthula kwa Positron emission tomography (PET)
• Kuyesa kwa sputum kuyang'ana maselo a khansa
• Thoracentesis (zitsanzo zamadzimadzi ozungulira mapapo)

Nthawi zambiri, chidutswa cha minofu chimachotsedwa m'mapapu anu kuti mupimidwe ndi maikulosikopu. Izi zimatchedwa biopsy. Pali njira zingapo zochitira izi:

• Bronchoscopy yophatikizidwa ndi biopsy
• CT-scan-yolunjika biopsy singano
• Endoscopic esophageal ultrasound (EUS) yokhala ndi biopsy
• Mediastinoscopy yokhala ndi biopsy
• Tsegulani mapapu
• Zosangalatsa kwambiri

Ngati biopsy iwonetsa khansara, kumayesedwa kwambiri kuti azindikire gawo la khansa. Gawo limatanthauza kukula kwa chotupacho komanso momwe chinafalikira. NSCLC imagawidwa m'magawo 5:

• Gawo 0 - Khansara siinafalikire kupyola mkatikati mwa mapapo.
• Gawo I - Khansara ndi yaying'ono ndipo siyinafalikire kumatenda am'mimba.
• Gawo lachiwiri - Khansara yafalikira kumatenda ena am'mimba pafupi ndi chotupa choyambirira.
• Gawo lachitatu - Khansara yafalikira kumatenda oyandikira kapena ma lymph node akutali.
• Gawo lachinayi - Khansara yafalikira ku ziwalo zina za thupi, monga mapapo ena, ubongo, kapena chiwindi.

Pali mitundu yambiri yamankhwala a NSCLC. Chithandizo chimadalira gawo la khansa.

Opaleshoni ndi mankhwala wamba a NSCLC omwe sanafalikire kupitilira ma lymph node apafupi. Dokotalayo akhoza kuchotsa:

• Chimodzi mwa ma lobes am'mapapo (lobectomy)
• Gawo laling'ono lokhalo lamapapu (kuchotsa mphero kapena gawo)
• Mapapu onse (pneumonectomy)

Anthu ena amafunikira chemotherapy. Chemotherapy imagwiritsa ntchito mankhwala kupha ma cell a khansa ndikuletsa maselo atsopano kuti asakule. Chithandizo chitha kuchitidwa motere:

• Chemotherapy yokha imagwiritsidwa ntchito khansa ikafalikira kunja kwa mapapo (gawo IV).
• Zitha kuperekedwanso asanachite opaleshoni kapena radiation kuti mankhwalawa azigwira ntchito bwino. Izi zimatchedwa neoadjuvant therapy.
• Ikhoza kuperekedwa pambuyo pa opaleshoni kupha khansa iliyonse yotsala. Izi zimatchedwa mankhwala othandizira.
• Chemotherapy nthawi zambiri imaperekedwa kudzera mumitsempha (ya IV). Kapena, akhoza kuperekedwa ndi mapiritsi.

Kulamulira zizindikiro ndikupewa zovuta panthawi yamankhwala am'thupi komanso pambuyo pake ndi gawo lofunikira pakusamalira.

Immunotherapy ndi mtundu watsopano wamankhwala omwe angaperekedwe mwaokha kapena ndi chemotherapy.

Chithandizo chomwe mukufuna chingagwiritsidwe ntchito pochiza NSCLC. Chithandizo chomwe akuyembekezerachi chimagwiritsa ntchito mankhwala osokoneza bongo mosagwirizana ndi ma molekyulu kapena ma cell a khansa. Zolingazi zimathandizira momwe ma cell a khansa amakulira ndikupulumuka. Pogwiritsa ntchito zolingazi, mankhwalawa amalepheretsa maselo a khansa kuti asafalikire.

Thandizo la radiation lingagwiritsidwe ntchito ndi chemotherapy ngati opaleshoni singatheke. Thandizo la radiation limagwiritsa ntchito ma x-ray amphamvu kapena mitundu ina ya radiation kuti iphe ma cell a khansa. Magetsi angagwiritsidwe ntchito:

• Chitani khansa, komanso chemotherapy, ngati opaleshoni siyotheka
• Thandizani kuthetsa zizindikiro zomwe zimayambitsidwa ndi khansa, monga kupuma komanso kutupa
• Thandizani kuthetsa ululu wa khansa khansa ikafalikira m'mafupa

Kuwongolera zizindikiritso pakatikati ndi pambuyo pa radiation pachifuwa ndi gawo lofunikira pakusamalira.

Mankhwalawa amagwiritsidwa ntchito kuthana ndi zovuta zoyambitsidwa ndi NSCLC:

• Mankhwala a Laser - Mtengo wawung'ono wowala umayaka ndikupha ma cell a khansa.
• Photodynamic therapy - Amagwiritsa ntchito nyali kuti atsegule mankhwala m'thupi, omwe amapha ma cell a khansa.

Mutha kuchepetsa nkhawa zamankhwala ndikulowa nawo gulu lothandizira. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha.

Kaonedwe kake kamasiyana. Nthawi zambiri, NSCLC imakula pang'onopang'ono. Nthawi zina, imatha kukula ndikufalikira mwachangu ndikupha msanga. Khansara imatha kufalikira mbali zina za thupi, kuphatikizapo fupa, chiwindi, matumbo ang'onoang'ono, ndi ubongo.

Chemotherapy yasonyezedwa kuti yatalikitsa moyo ndikusintha moyo wa anthu ena omwe ali ndi gawo IV NSCLC.

Mitengo yamankhwala imakhudzana ndi gawo la matenda komanso ngati mungathe kuchitidwa opaleshoni.

• Khansa ya Gawo I ndi II imakhala ndi moyo wabwino kwambiri komanso wamachiritso.
• Khansa ya Gawo lachitatu imatha kuchiritsidwa nthawi zina.
• Khansa ya Gawo IV yomwe yabwerera sichichiritsidwa. Zolinga zamankhwala ndikukulitsa ndikukhala ndi moyo wabwino.

Itanani omwe akukuthandizani ngati muli ndi zizindikilo za khansa yamapapo, makamaka mukasuta.

Ngati mumasuta, ino ndiyo nthawi yoti musiye. Ngati mukuvutika kusiya, lankhulani ndi omwe akukuthandizani. Pali njira zambiri zokuthandizirani kusiya, kuyambira magulu othandizira mpaka mankhwala akuchipatala. Komanso, yesetsani kupewa kusuta fodya.

Ngati muli ndi zaka zopitilira 55 ndikusuta kapena kusuta zaka khumi zapitazi, lankhulani ndi omwe amakupatsani mwayi wokhudza kuyesedwa kwa khansa yamapapo. Kuti muwunikidwe, muyenera kukhala ndi CT pachifuwa.

Khansa - mapapo - khungu laling'ono; Khansa ya m'mapapo yosakhala yaying'ono; NSCLC; Adenocarcinoma - mapapo; Squamous cell carcinoma - m'mapapo; Cellcinoma yayikulu - mapapo

• Chest radiation - kumaliseche
• Opaleshoni m'mapapo - kumaliseche

• Mapapo
• Utsi wosuta ndi khansa ya m'mapapo

Araujo LH, Horn L, Merritt RE, Shilo K, Xu-Welliver M, Carbone DP. Khansa yam'mapapo: khansa ya m'mapapo yosakhala yaying'ono komanso khansa yaying'ono yamapapu. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 69.

(Adasankhidwa) Ettinger DS, Wood DE, Aggarwal C, et al. Malangizo a NCCN kuzindikira: khansa ya m'mapapo yosakhala yaying'ono, mtundu wa 1.2020. J Natl Compr Khansa Netw. 2019; 17 (12): 1464-1472 (Adasankhidwa) [Adasankhidwa] PMID: 31805526. pubmed.ncbi.nlm.nih.gov/31805526/.

Tsamba la National Cancer Institute. Chithandizo cha khansa ya m'mapapo osakhala yaying'ono (PDQ) - mtundu wa akatswiri azaumoyo. www.cancer.gov/types/lung/hp/non-small-cell-lung-kuchiza-pdq. Idasinthidwa pa Meyi 7, 2020. Idapezeka pa Julayi 13, 2020.

Silvestri GA, Pastis NJ, Tanner NT, Jett JR. Matenda a khansa yamapapu. Mu: Broaddus VC, Mason RJ, Ernst JD, et al, olemba. Murray ndi Nadel's Bookbook of Respiratory Medicine. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2016: chap 53.