Chithandizo cha Khansa ya m'mawere ndi Gawo

Zamkati

• Gawo 0 (DCIS)
• Opaleshoni
• Thandizo la radiation
• Chithandizo cha mahomoni kapena chithandizo chofunikira
• Gawo 1
• Opaleshoni
• Thandizo la radiation
• Chemotherapy ndi chithandizo chofunikira
• Thandizo la mahomoni
• Gawo 2
• Opaleshoni
• Thandizo la radiation
• Chemotherapy
• Chithandizo cha mahomoni
• Gawo 3
• Chithandizo
• Gawo 4
• Chithandizo
• Immunotherapy ngati mankhwala omwe akutuluka
• Kusamalira ululu
• Zinthu zomwe zimakhudza chithandizo cha khansa ya m'mawere
• Zaka
• Mimba
• Kukula kwa chotupa
• Mkhalidwe wa kusintha kwa majini ndi mbiri ya banja
• Chiwonetsero

Chidule

Pali mankhwala osiyanasiyana a khansa ya m'mawere, ndipo mankhwala amapezeka pagawo lililonse la khansa. Anthu ambiri amafunika kuphatikiza mankhwala awiri kapena kupitilira apo.

Mukazindikira, dokotala wanu adzazindikira gawo la khansa yanu. Adzaganiza zakomwe angapeze chithandizo chamankhwala kutengera gawo lanu ndi zina, monga zaka, mbiri yabanja, kusintha kwa majini, komanso mbiri yazachipatala.

Chithandizo cha khansa ya m'mawere koyambirira sichingakhale chothandiza kwa khansa ya m'mawere. Magawo a khansa ya m'mawere amachokera pa 0 mpaka 4. Zinthu zosiyanasiyana zimatsimikizira gawo lanu, kuphatikiza:

• kukula kwa chotupacho
• kuchuluka kwa ma lymph node omwe akhudzidwa
• kaya khansara yafalikira mbali zina za thupi lanu

Madokotala amagwiritsa ntchito mayeso osiyanasiyana kuti apange khansa ya m'mawere. Kuyesa kuyerekezera ndikuphatikizira CT scan, MRI, ultrasound, X-ray, ndi PET scan.

Izi zitha kuthandiza adotolo kuchepetsa khansa, kuwerengetsa kukula kwa chotupa, ndikuwona ngati khansayo yafalikira mbali zina za thupi.

Ngati kuyesa kujambula kumawonetsa kuchuluka m'gawo lina la thupi, dokotala wanu amatha kupanga biopsy kuti awone ngati misa ndiyolakwika kapena yoyipa. Kuyezetsa thupi ndi kuyezetsa magazi kumathandizanso polemba.

Gawo 0 (DCIS)

Ngati maselo a khansa kapena khansa atsekereredwa m'makina amkaka, amatchedwa khansa ya m'mawere yosasunthika kapena ductal carcinoma in situ (DCIS).

Khansa ya m'mawere ya Gawo 0 imatha kukhala yolanda ndikufalikira kupitilira timadontho. Kuchiritsidwa msanga kungakulepheretseni kukhala ndi khansa ya m'mawere.

Opaleshoni

Mu lumpectomy, dokotalayo amachotsa maselo a khansa ndikupulumutsa mawere ena onse. Ndi njira yothandiza pamene DCIS imangokhala gawo limodzi la bere.

Lumpectomy itha kuchitidwa ngati njira yothandizira odwala. Izi zikutanthauza kuti mutha kupita kunyumba mutangochita opareshoni ndipo simudzafunika kuti mukhale m'chipatala usiku wonse.

Matenda opatsirana ndi kuchotsa kwa m'mawere. Ndibwino kuti DCIS ipezeke m'mawere onse. Kuchita opaleshoni yomanganso bere kumatha kuyamba nthawi ya mastectomy kapena pambuyo pake.

Thandizo la radiation

Poizoniyu ndi mtundu wa mankhwala omwe mukufuna. Nthawi zambiri amalimbikitsidwa pambuyo poti lumpectomy ya khansa ya m'mawere ya siteji 0. Mphamvu zazikulu za X-ray zimagwiritsidwa ntchito kuwononga maselo a khansa ndi kuwaletsa kuti asafalikire.

Mankhwalawa amachepetsa chiopsezo chobwereza. Thandizo la radiation limaperekedwa masiku asanu pasabata kwa milungu isanu kapena isanu ndi iwiri.

Chithandizo cha mahomoni kapena chithandizo chofunikira

Dokotala wanu angakulimbikitseni chithandizo cha mahomoni ngati mwakhala ndi lumpectomy kapena mastectomy imodzi ya estrogen receptor-positive kapena progesterone receptor-positive khansa ya m'mawere.

Mankhwala amtundu wamlomo, monga tamoxifen, nthawi zambiri amaperekedwa kuti muchepetse chiopsezo chanu chokhala ndi khansa ya m'mawere. Chithandizo cha mahomoni sichingaperekedwe kwa azimayi omwe adachitapo khansa ya m'mawere kawiri.

Dokotala wanu angakulimbikitseni trastuzumab (Herceptin), mankhwala omwe angakuthandizeni, ngati khansa yanu ya m'mawere ikuyesa mapuloteni ambiri a HER2.

Gawo 1

Gawo 1A khansa ya m'mawere imatanthauza kuti chotupa choyambirira ndi 2 masentimita kapena ochepera ndipo ma lymph node samakhudzidwa. Pa siteji 1B, khansa imapezeka m'mitsempha yam'mimba ndipo mulibe chotupa m'chifuwa kapena chotupacho ndi chaching'ono kuposa masentimita awiri.

Zonse 1A ndi 1B zimawerengedwa kuti khansa yoyamwa ya m'mawere. Kuchita opaleshoni ndi njira imodzi kapena zingapo zithandizire.

Opaleshoni

Lumpectomy ndi mastectomy ndizosankha zonse pagawo 1 khansa ya m'mawere. Lingaliro lakhazikitsidwa:

• kukula ndi malo a chotupacho
• zokonda zanu
• zina monga chibadwa

Zilonda zam'mimba zimatha kuchitidwa nthawi yomweyo.

Kwa mastectomy, kumangidwanso kwa bere kumatha kuyamba nthawi yomweyo ngati mukufuna, kapena mukamaliza mankhwala ena.

Thandizo la radiation

Mankhwala a radiation amalimbikitsidwa pambuyo poti achite opaleshoni ya khansa yoyamba ya m'mawere. Zingakhale zosafunikira kwa amayi azaka zopitilira 70, makamaka ngati chithandizo cha mahomoni ndichotheka.

Chemotherapy ndi chithandizo chofunikira

Khansa ya m'mawere yomwe ilibe vuto la estrogen, progesterone, ndi HER2 amatchedwa khansa ya m'mawere yopanda katatu (TNBC). Chemotherapy nthawi zambiri imakhala yofunikira pamilandu iyi chifukwa palibe chithandizo chofunikira cha TNBC.

Chemotherapy iperekedwenso khansa ya m'mawere yomwe imayambitsa mahomoni. Herceptin, mankhwala othandizira, amaperekedwa limodzi ndi chemotherapy ya khansa ya m'mawere ya HER2. Dokotala wanu angalimbikitsenso njira zina zochiritsira za HER2, monga Perjeta kapena Nerlynx.

Komabe, chemotherapy sikuti nthawi zonse imafunikira khansa ya m'mawere koyambirira, makamaka ngati ingathe kuthandizidwa ndi mankhwala a mahomoni.

Thandizo la mahomoni

Madokotala amalimbikitsa mankhwala a mahomoni amtundu wa khansa ya m'mawere yolandila, mosasamala kanthu za kukula kwa chotupa.

Gawo 2

Pa gawo 2A, chotupacho ndi chaching'ono kuposa masentimita awiri ndipo chafalikira mpaka pakati pa ma lymph node amodzi kapena atatu apafupi. Kapena, ili pakati pa 2 ndi 5 masentimita ndipo siinafalikire ku ma lymph node.

Gawo 2B limatanthauza kuti chotupacho chili pakati pa 2 ndi 5 sentimita ndipo chafalikira mpaka pakati pa ma lymph node amodzi kapena atatu apafupi. Kapena ndi wokulirapo kuposa masentimita 5 ndipo sunafalikire kumatenda amtundu uliwonse.

Mwinanso mungafunike kuchitidwa opaleshoni, chemotherapy, ndi chimodzi kapena zingapo zotsatirazi: chithandizo chothandizira, ma radiation, ndi chithandizo cha mahomoni.

Opaleshoni

Lumpectomy ndi mastectomy zitha kukhala zosankha kutengera kukula ndi malo a chotupacho.

Kusintha kwakukulu kwa mastectomy ndikuchotsa bere, kuphatikiza minofu ya chifuwa. Ngati musankha kumanganso, ntchitoyi imatha kuyamba nthawi yomweyo kapena mukamaliza kulandira chithandizo cha khansa.

Thandizo la radiation

Mankhwala a radiation amalimbana ndi maselo amtundu uliwonse a khansa pachifuwa ndi ma lymph node. Nthawi zambiri amalimbikitsidwa pambuyo pa opaleshoni.

Chemotherapy

Chemotherapy ndi njira yothandizira kupha ma cell a khansa mthupi lonse. Mankhwala amphamvuwa amaperekedwa kudzera m'mitsempha (m'mitsempha) pakadutsa milungu kapena miyezi yambiri.

Pali mankhwala osiyanasiyana a chemotherapy omwe amagwiritsidwa ntchito pochiza khansa ya m'mawere, kuphatikizapo:

• docetaxel (Taxotere)
• doxorubicin (Adriamycin)
• cyclophosphamide (Cytoxan)

Mutha kulandila mankhwala osakaniza angapo a chemotherapy. Chemotherapy ndiyofunika kwambiri ku TNBC. Herceptin imaperekedwa limodzi ndi chemotherapy ya khansa ya m'mawere ya HER2.

Dokotala wanu angalimbikitsenso njira zina zochiritsira za HER2, monga Perjeta kapena Nerlynx.

Chithandizo cha mahomoni

Pambuyo poti mankhwala ena onse atha, mutha kupindula ndi chithandizo chamankhwala cha khansa ya m'mawere.

Mankhwala apakamwa monga tamoxifen kapena aromatase inhibitors amatha kupatsidwa zaka zisanu kapena kupitilira apo.

Gawo 3

Gawo 3A khansa ya m'mawere imatanthawuza kuti khansara yafalikira mpaka zinayi mpaka zisanu ndi zinayi za axillary (armpit) lymph node kapena yakulitsa ma lymph node amkati. Chotupa choyambirira chikhoza kukhala kukula kulikonse.

Zitha kutanthauzanso kuti chotupacho ndi chachikulu kuposa masentimita 5 ndipo timagulu tating'onoting'ono ta khansa timapezeka m'matenda am'mimba. Pomaliza, gawo 3A liphatikizanso zotupa zopitilira masentimita asanu ndikuphatikizira gawo limodzi kapena atatu am'mimba am'mimba kapena mfundo zam'mimba.

Gawo 3B limatanthauza kuti chotupa cha m'mawere chalowa pachifuwa kapena pakhungu ndipo mwina sichitha kulowa m'ma lymph node.

Gawo 3C limatanthauza kuti khansa imapezeka mu 10 kapena kuposa ma axillary lymph node, ma lymph node pafupi ndi kolala, kapena ma mammary node.

Zizindikiro za khansa yotupa ya m'mawere (IBC) ndi yosiyana ndi mitundu ina ya khansa ya m'mawere. Kuzindikira kumatha kuchedwa chifukwa nthawi zambiri sipakhala chotupa cha m'mawere. Mwakutanthauzira, IBC imapezeka pa siteji 3B kapena pamwambapa.

Chithandizo

Chithandizo cha khansa ya m'mawere yachitatu ndi yofanana ndi ya 2.

Gawo 4

Gawo 4 likuwonetsa kuti khansa ya m'mawere yasintha (kufalikira mbali yakutali ya thupi).

Khansa ya m'mawere nthawi zambiri imafalikira m'mapapu, ubongo, chiwindi, kapena mafupa. Khansa ya m'mawere yamatenda sangachiritsidwe, koma imatha kuchiritsidwa ndi mankhwala amwano mwamphamvu.

Chifukwa khansara imakhudza ziwalo zosiyanasiyana za thupi, mungafunike mankhwala angapo kuti muchepetse kukula kwa chotupa ndikuchepetsa zizindikilo.

Chithandizo

Kutengera ndi khansa ya m'mawere yomwe yapita patsogolo, mwina mudzalandira chemotherapy, radiation radiation, ndi mankhwala a mahomoni (ngati muli ndi khansa yolandila mahomoni).

Njira ina ndiyo chithandizo chamankhwala, chomwe chimayang'ana mapuloteni omwe amalola kuti maselo a khansa akule. Kwa khansa ya HER2, njira zochiritsira za HER2 zitha kuphatikizira Herceptin, Perjeta, Nerlynx, Tykerb, kapena Kadcyla.

Ngati khansara imafalikira kumatenda am'mimba, mutha kuwona kutupa kapena kukulitsa mfundo zanu. Opaleshoni, chemotherapy, ndi radiation zitha kugwiritsidwa ntchito pochiza khansa yomwe imafalikira kumatenda am'mimba.

Chiwerengero ndi malo am'mimba zimatsimikizira zomwe mungasankhe.

Opaleshoni si njira yoyamba yodzitetezera ndi khansa ya m'mawere, koma dokotala wanu angakulimbikitseni kuchitidwa opaleshoni kuti muzitha kupsinjika kwa msana, mafupa osweka, ndi misala imodzi yoyambitsidwa ndi metastasis. Izi zimathandiza kuthetsa ululu ndi zizindikilo zina.

Mankhwala ena omwe amagwiritsidwa ntchito pochiza khansa ya m'mawere ndi awa:

• mankhwala opatsirana pogonana
• anticonvulsants
• mankhwala
• mankhwala oletsa ululu m'deralo

Immunotherapy ngati mankhwala omwe akutuluka

Immunotherapy ndi njira yatsopano yothandizira, ndipo ngakhale kuti FDA sinavomerezedwe chifukwa cha khansa ya m'mawere, ndi malo odalirika.

Pali maphunziro angapo azachipatala omwe akuwonetsa kuti zitha kusintha zotsatira zamankhwala kwa anthu omwe ali ndi khansa ya m'mawere.

Immunotherapy imakhala ndi zovuta zochepa kuposa chemotherapy ndipo imayambitsa kukana. Immunotherapy imagwira ntchito pokweza chitetezo chachilengedwe chamthupi kuti chiteteze khansa.

Pembrolizumab ndi choletsa chitetezo cha mthupi. Ndi mtundu wa immunotherapy womwe wasonyeza lonjezo linalake pochiza khansa ya m'mawere.

Zimagwira ntchito poletsa ma antibodies omwe amalepheretsa chitetezo cha mthupi kulimbana ndi khansa, kulola kuti thupi lizilimbana bwino. Kafukufuku wina adapeza kuti 37.5% ya odwala omwe ali ndi khansa ya m'mawere yopanda katatu adawona phindu kuchokera kuchipatala.

Chifukwa immunotherapy sivomerezedwa ndi FDA pano, chithandizo chimapezeka kwambiri kudzera m'mayesero azachipatala pano.

Kusamalira ululu

Khansa ya m'mawere yomwe imafalikira mbali zina za thupi imatha kupweteketsa mtima, monga kupweteka kwa mafupa, kupweteka kwa minofu, kupweteka mutu, komanso kusokonezeka pachiwindi. Lankhulani ndi dokotala wanu za kusamalira ululu.

Zosankha zowawa pang'ono mpaka pang'ono zimaphatikizapo acetaminophen ndi NSAIDs, monga ibuprofen.

Kuti mupweteke kwambiri mtsogolo, adokotala angakulimbikitseni opioid monga morphine, oxycodone, hydromorphone, kapena fentanyl.

Zinthu zomwe zimakhudza chithandizo cha khansa ya m'mawere

Ngakhale gawo la khansa ya m'mawere limakhudzana kwambiri ndi njira zamankhwala, zinthu zina zimakhudzanso zosankha zanu.

Zaka

Chizindikiro cha khansa ya m'mawere nthawi zambiri chimakhala choyipa kwambiri kwa azimayi ochepera zaka 40 chifukwa khansa ya m'mawere imakonda kukhala yovuta kwa atsikana.

Kuyanjanitsa chithunzithunzi cha thupi ndikuchepetsa chiopsezo kumatha kutenga nawo gawo pakusankha pakati pa lumpectomy ndi mastectomy.

Kuphatikiza pa opaleshoni, chemotherapy, ndi radiation, zaka zingapo zamankhwala othandizira ma khansa omwe ali ndi khansa m'mawere nthawi zambiri amalimbikitsidwa kwa atsikana. Izi zitha kuthandiza kupewa kubwereza kapena kufalikira kwa khansa ya m'mawere.

Kwa amayi omwe ali ndi premenopausal, kuponderezedwa kwa ovari kungalimbikitsidwe kuwonjezera pa mankhwala a mahomoni.

Mimba

Kukhala ndi pakati kumakhudzanso chithandizo cha khansa ya m'mawere. Kuchita opaleshoni ya khansa ya m'mawere nthawi zambiri kumakhala kotetezeka kwa amayi apakati, koma madokotala amatha kukhumudwitsa chemotherapy mpaka trimester yachiwiri kapena yachitatu.

Thandizo la mahomoni ndi mankhwala a radiation zitha kuvulaza mwana wosabadwa ndipo sizoyenera kulandira pakati.

Kukula kwa chotupa

Chithandizo chimadaliranso momwe khansa imakulira ndikufalikira.

Ngati muli ndi khansa ya m'mawere, dokotala angakulimbikitseni njira yowopsya, monga opaleshoni ndi mankhwala ena.

Mkhalidwe wa kusintha kwa majini ndi mbiri ya banja

Chithandizo cha khansa ya m'mawere chimadalira kukhala ndi wachibale wapafupi ndi mbiri ya khansa ya m'mawere kapena kuyesa kukhala ndi jini yomwe imawonjezera chiopsezo chokhala ndi khansa ya m'mawere.

Amayi omwe ali ndi izi atha kusankha njira yodzitetezera, monga ma mastectomy amitundu iwiri.

Chiwonetsero

Kufotokozera kwa khansa ya m'mawere kumadalira, makamaka, pa siteji panthawi yodziwitsa. Mukamapezeka koyambirira, zotsatira zake zimakhala zabwino.

Ichi ndichifukwa chake ndikofunikira kuti azidziyesa mwezi ndi mwezi ndikukhazikitsa mammograms wamba. Lankhulani ndi dokotala wanu za nthawi yoyenera yowunika ndi yoyenera kwa inu. Phunzirani za ndandanda zowunikira ndi zina zambiri pamalangizo onsewa a khansa ya m'mawere.

Pali mankhwala ochiritsira amitundu yosiyanasiyana komanso magawo a khansa ya m'mawere, koma chithandizo chanu chidzagwirizana ndi zosowa zanu.

Kuphatikiza pa siteji yodziwitsa, madokotala anu adzawona mtundu wa khansa ya m'mawere yomwe muli nayo komanso zina zathanzi. Ndondomeko yanu yothandizira imasinthidwa kutengera momwe mumayankhira.

Mayesero azachipatala ndi kafukufuku yemwe amagwiritsa ntchito anthu kuyesa chithandizo chatsopano. Ngati muli ndi chidwi, funsani dokotala wanu wa oncologist kuti mudziwe zamayesero omwe alipo.

Muthanso kuyang'ana njira zochiritsira zothandizira panthawi iliyonse ya khansa ya m'mawere. Awa ndi mankhwala omwe amagwiritsidwa ntchito limodzi ndi mankhwala wamba. Amayi ambiri amapindula ndimankhwala monga kutikita minofu, kutema mphini, ndi yoga.

Pezani chithandizo kuchokera kwa ena omwe ali ndi khansa ya m'mawere. Tsitsani pulogalamu yaulere ya Healthline Pano.