Chithandizo cha Khansa ya Ovarian

Zamkati

• Opaleshoni ya khansa yamchiberekero
• Chemotherapy ya khansa yamchiberekero
• Kwa khansa yaminyewa yaminyewa
• Khansara yamchiberekero yomwe imayamba m'maselo a majeremusi
• Khansara yamchiberekero yomwe imayamba m'maselo a stromal
• Mankhwala ena a chemotherapy
• Poizoniyu wa khansa yamchiberekero
• Chithandizo cha mahormone cha khansa yamchiberekero
• Chithandizo chamankhwala cha khansa yamchiberekero
• Mayeso azachipatala a khansa yamchiberekero
• Njira zochiritsira za khansa yamchiberekero
• Chiwonetsero

Kupanga dongosolo lamankhwala

Pali njira zambiri zopezera chithandizo cha khansa yamchiberekero. Kwa amayi ambiri, zimatanthauza kuchitidwa opaleshoni. Izi nthawi zambiri zimaphatikizidwa ndi chemotherapy, hormone therapy, kapena chithandizo chofunikira.

Zina mwazomwe zimathandizira kutsogolera chithandizo ndi:

• mtundu wanu wa khansa yamchiberekero
• gawo lanu pofufuza
• kaya ndinu pre- kapena postmenopausal
• kaya mukufuna kukhala ndi ana

Werengani kuti mumve zambiri zamankhwala amchiberekero ndi zomwe zimaphatikizapo.

Opaleshoni ya khansa yamchiberekero

Zosankha zopangira opaleshoni zimadalira momwe khansara yafalikira.

Kwa khansa yamchiberekero choyambirira, ndizotheka kusunga chonde. Ndikofunika kukaonana ndi dokotala musanachite opaleshoni.

Ngati khansa imapezeka mchiberekero chimodzi chokha, dokotala wanu amatha kuchotsanso komanso kuchotsa chubu chomwe chimalumikizidwa. Mudzapitirizabe kusamba ndi kusamba chifukwa cha ovary yanu yotsalira, ndikukhalabe ndi mwayi wokhala ndi pakati.

Khansa ikapezeka m'mazira onse awiri, mazira anu onse ndi machubu onse amtundu wa fallopian amatha kuchotsedwa. Izi zimayambitsa kusamba. Zizindikiro zimatha kuphatikizira kutentha, thukuta usiku, komanso kuuma kwa nyini. Dokotala wanu angakulimbikitseninso kuti muchotse chiberekero chanu.

Mu khansa yoyambirira yamchiberekero, opaleshoni yochepetsetsa ya laparoscopic ikhoza kukhala njira. Izi zimachitika ndi kamera ya kanema ndi zida zazitali, zopyapyala zomwe zimayikidwa pang'onopang'ono.

Kwa khansara yotsogola kwambiri, opaleshoni yotseguka yam'mimba ndiyofunikira.

Njira yotchedwa debulking cytoreductive oparesheni imagwiritsidwa ntchito pochiza khansa yachigawo ya 4 yamchiberekero. Zimaphatikizapo kuchotsa mazira anu ndi mazira, komanso ziwalo zina zomwe zakhudzidwa. Izi zitha kuphatikiza:

• chiberekero ndi khomo pachibelekeropo
• mafupa am'chiuno
• minofu yomwe imaphimba matumbo anu ndi ziwalo zam'munsi zam'mimba
• gawo lina lakulemba kwanu
• matumbo
• ndulu
• chiwindi

Ngati muli ndi madzimadzi m'mimba mwanu kapena m'chiuno, amathanso kuchotsedwa ndikuyesedwa ngati ali ndi khansa.

Chemotherapy ya khansa yamchiberekero

Chemotherapy ndi mtundu wamankhwala amachitidwe. Mankhwala amphamvu awa amayenda mthupi lanu lonse kufunafuna ndikuwononga ma cell a khansa. Amagwiritsidwa ntchito asanachite opareshoni kuti achepetse zotupa kapena atachita opareshoni kupha maselo amtundu uliwonse a khansa.

Mankhwalawa amatha kuperekedwa kudzera m'mitsempha (IV) kapena pakamwa. Amathanso kubayidwa m'mimba mwanu.

Kwa khansa yaminyewa yaminyewa

Khansara ya epithelial ovarian imayamba m'maselo akunja kwa mazira anu. Chithandizochi chimaphatikizapo mankhwala osachepera awiri a IV. Amapatsidwa katatu kapena kasanu ndi kamodzi, nthawi zambiri amasiyanitsa milungu itatu kapena inayi. Mankhwala osakanikirana ndi cisplatin kapena carboplatin kuphatikiza paclitaxel (Taxol) kapena docetaxel (Taxotere).

Khansara yamchiberekero yomwe imayamba m'maselo a majeremusi

Nthawi zina khansa yamchiberekero imayamba m'maselo anu anyongolosi. Awa ndi maselo omwe pamapeto pake amapanga mazira. Kuphatikiza kwa mankhwala omwe amagwiritsidwa ntchito pazotupa zamagulu anyongolosi ndi cisplatin (Platinol), etoposide, ndi bleomycin.

Khansara yamchiberekero yomwe imayamba m'maselo a stromal

Khansara yamchiberekero amathanso kuyamba m'maselo a stromal. Awa ndi maselo omwe amatulutsa mahomoni ndikulumikiza minofu yamchiberekero. Kuphatikizana kwa mankhwalawa mwina kungakhale kofananako kugwiritsira ntchito zotupa zamagulu anyongolosi.

Mankhwala ena a chemotherapy

Ma chemotherapies ena a khansa yamchiberekero ndi awa:

• albino womangidwa paclitaxel (Abraxane)
• altretamine (Hexalen)
• capecitabine (Xeloda)
• cyclophosphamide (Cytoxan)
• miyala yamtengo wapatali (Gemzar)
• ifosfamide (Ifex)
• irinotecan (Camptosar)
• liposomal doxorubicin (Doxil)
• nyimbo (Alkeran)
• pemetrexed (Alimta)
• topotecan (Hycamtin)
• vinblastine (Velban)
• vinorelbine (Mchombo)

Zotsatira zoyipa zimasiyanasiyana kutengera kuchuluka kwa mankhwala ndi kuphatikiza mankhwala. Zitha kuphatikiza:

• nseru ndi kusanza
• kusowa chilakolako
• kutopa
• kutayika tsitsi
• zilonda mkamwa kapena chingamu chotuluka magazi
• chiopsezo chachikulu chotenga matenda
• kutuluka magazi kapena kuphwanya

Zambiri mwa zotsatirazi ndizosakhalitsa. Dokotala wanu akhoza kuthandiza kuchepetsa iwo. Zotsatira zina zoyipa, monga kuwonongeka kwa impso, zitha kukhala zowopsa komanso zokhalitsa. Ngakhale mutakhala ndi amodzi m'mimba mwanu, chemotherapy imatha kubweretsa kusamba koyambirira.

Poizoniyu wa khansa yamchiberekero

Poizoniyu ndi mankhwala omwe amalimbana ndi zotupa. Itha kuperekedwa kunja kapena mkati.

Radiation si mankhwala oyambira khansa ya m'mimba. Koma nthawi zina amatha kugwiritsidwa ntchito:

• kuthandiza kuthandizira kuyambiranso kwakanthawi
• Kuchepetsa kupweteka kwa zotupa zazikulu zomwe zimagonjetsedwa ndi chemotherapy
• ngati njira ina ngati simungathe kulekerera chemotherapy

Musanalandire chithandizo choyamba, mufunika gawo lokonzekera kuti mudziwe malo anu enieni. Cholinga ndikumenya chotupacho ndikuchepetsa kuwonongeka kwa minofu yabwinobwino. Zojambulajambula nthawi zina zimagwiritsidwa ntchito pozindikiritsa khungu lanu.

Chisamaliro chapadera chimaperekedwa pakuyika nthawi iliyonse. Ngakhale zimatenga kanthawi, chithandizo chenicheni chimangokhala kwa mphindi zochepa. Kutentha sikumapweteka, koma kumafuna kuti mukhale chete. Mankhwala amalandira masiku asanu pasabata kwa milungu itatu kapena isanu.

Zotsatira zoyipa zimatha kutha pomwe mankhwala amatha koma atha kuphatikizanso:

• ofiira, khungu loyipa
• kutopa
• kutsegula m'mimba
• kukodza pafupipafupi

Chithandizo cha mahormone cha khansa yamchiberekero

Khansara ya Epithelial ovarian imachiritsidwa kawirikawiri ndi mankhwala a mahomoni. Amagwiritsidwa ntchito nthawi zambiri ku khansa ya stromal.

Luteinizing-hormone-yotulutsa ma agonists amagwiritsidwa ntchito pochepetsa kuchepa kwa estrogen mwa azimayi a premenopausal. Awiri mwa awa ndi goserelin (Zoladex) ndi leuprolide (Lupron). Amapatsidwa jakisoni miyezi itatu kapena itatu iliyonse. Mankhwalawa amatha kuyambitsa kusamba. Ngati atatengedwa kwa zaka, amatha kufooketsa mafupa anu ndikupangitsa kufooka kwa mafupa.

Estrogen imatha kulimbikitsa kukula kwa chotupa. Mankhwala otchedwa tamoxifen amasunga estrogen kuti isapangitse kukula. Mankhwalawa amathanso kuyambitsa kusamba.

Amayi omwe ali ndi postmenopausal amatha kutenga aromatase inhibitors, monga anastrozole (Arimidex), exemestane (Aromasin), ndi letrozole (Femara). Amaletsa enzyme yomwe imasintha mahomoni ena kukhala estrogen. Mankhwalawa amatengedwa kamodzi patsiku. Zotsatira zoyipa zimaphatikizapo:

• kutentha
• kulumikizana ndi minofu
• kuwonda kwa mafupa anu

Chithandizo chamankhwala cha khansa yamchiberekero

Mankhwala oyang'aniridwa amapeza ndikusintha machitidwe ena am'magazi a khansa omwe sapezeka m'maselo athanzi. Siziwononga pang'ono minofu yathanzi kuposa chemotherapy kapena mankhwala akunja a radiation.

Zotupa zimafunikira mitsempha yamagazi kuti ikule ndikufalikira. Mankhwala a IV otchedwa bevacizumab (Avastin) adapangidwa kuti aletse zotupa kuti zisapangitse mitsempha yatsopano. Amapatsidwa milungu iwiri kapena itatu iliyonse.

Kafukufuku akuwonetsa kuti bevacizumab imatha kuchepa zotupa kapena kuchepa kwa khansa ya epithelial ovarian. Zotsatira zoyipa ndizo:

• kuthamanga kwa magazi
• maselo oyera oyera amawerengeredwa
• kutsegula m'mimba

Poly (ADP-ribose) polymerase (PARP) inhibitors ndi mankhwala akumwa. Amagwiritsidwa ntchito ngati khansa ya m'mimba imagwirizanitsidwa ndi Zamgululi kusintha kwa majini.

Awiri mwa awa, olaparib (Lynparza) ndi rucaparib (Rubraca), atha kugwiritsidwa ntchito kwa khansa yamchiberekero pambuyo pake atayesa chemotherapy. Olaparib imagwiritsidwanso ntchito pochiza khansa yapamimba yamchiberekero mwa amayi omwe alibe kapena opanda Zamgululi masinthidwe.

PARP inhibitor ina, niraparib (Zejula), imatha kuperekedwa kwa azimayi omwe ali ndi khansa yamchiberekero yabwinobwino, kapena wopanda Zamgululi masinthidwe, atayesa chemotherapy.

Zotsatira zoyipa za mankhwalawa zitha kuphatikiza:

• nseru
• kuchepa kwa magazi m'thupi
• kupweteka kwa minofu ndi molumikizana

Mayeso azachipatala a khansa yamchiberekero

Mayesero azachipatala amafanizira chithandizo chamankhwala ndi mankhwala atsopano omwe sanalandiridwe kuti agwiritsidwe ntchito. Mayesero azachipatala atha kuphatikizira anthu omwe ali ndi khansa iliyonse.

Funsani oncologist wanu ngati kuyesa kwachipatala ndi njira yabwino kwa inu. Mutha kuchezanso patsamba losakira ku ClinicalTrials.gov kuti mumve zambiri.

Njira zochiritsira za khansa yamchiberekero

Mutha kuwona kuti ndizothandiza kuwonjezera chisamaliro chanu cha khansa ndi mankhwala othandizira. Anthu ena amawona kuti akuwonjezera moyo wabwino. Zina zomwe mungaganizire ndi izi:

• Chithandizo. Mafuta ofunikira amatha kusintha malingaliro anu ndikuchepetsa kupsinjika.
• Kusinkhasinkha. Njira zopumulira zitha kuthandiza kuchepetsa kupweteka komanso kukonza kugona.
• Kuchulukitsa mankhwala. Mankhwalawa amathandiza kuchepetsa nkhawa komanso kuchepetsa nkhawa komanso kupweteka.
• Tai chi ndi yoga. Zizolowezi zamaganizidwe a Nonaerobic omwe amagwiritsa ntchito kuyenda, kusinkhasinkha, ndi kupuma kumatha kukulitsa moyo wanu wonse.
• Thandizo lazaluso ndi nyimbo. Malo ogulitsa akhoza kukuthandizani kuthana ndi zovuta za khansa ndi chithandizo.
• Kutema mphini. Mtundu uwu wamankhwala achi China momwe masingano adayikiratu amatha kuthana ndi ululu komanso zizindikilo zina.

Funsani dokotala musanayesere njira zatsopano, makamaka zakudya kapena zowonjezera mankhwala. Izi zitha kulumikizana ndi mankhwala anu kapena kuyambitsa mavuto ena.

Mwinanso mungafune kufunsa ndi dokotala wothandizira. Akatswiriwa amagwira ntchito ndi gulu lanu la oncology kuti athetse vuto lanu ndikukhala ndi moyo wabwino.

Chiwonetsero

Zaka zisanu zonse zapakati pa khansa ya ovari ndi 45%.

Ziwerengero za opulumuka zimasiyana malinga ndi mtundu wa khansa, gawo lomwe amapezeka, komanso zaka. Mwachitsanzo, khansa ikagwidwa isanafalikire kunja kwa thumba losunga mazira, kupulumuka kwake ndi 92 peresenti.

Komanso, ziwerengero za kupulumuka siziphatikizapo milandu yaposachedwa kwambiri, pomwe mankhwala atsopano angagwiritsidwe ntchito.

Dokotala wanu adzakupatsani lingaliro la zomwe muyenera kuyembekezera kutengera zomwe mukudziwa ndi momwe mungapangire chithandizo.