Mfundo
Pali kugwiritsidwa ntchito kosagwiritsidwa ntchito kwa mankhwala kwa khansa, nthawi zambiri popanda umboni wopanda umboni woti kupindula ndi mankhwala. Kusanthula kwa meta kwamaphunziro azachipatala kukuwonetsa kugwiritsa ntchito mankhwala osokoneza bongo mu 13-71% ya odwala khansa akulu. Kugwiritsa ntchito mankhwala osokoneza bongo kunali kwakukulu kwa odwala omwe ali ndi matenda a metastatic komanso chisamaliro chodekha, omwe atopa njira zina zonse zosamalira.
Chithandizo cha khansa nthawi zambiri chimachokera ku malangizo azachipatala ochokera ku mabungwe osiyanasiyana monga NCCN (National Comprehensive Cancer Network), ASCO (American Society of Clinical Oncology) ndi ena. Maupangiri awa amatsimikiziridwa kudzera muumboni wasayansi ndi ziyeneretso zowongolera ndi kuvomereza, pazowonetsa za khansa, siteji ndi mtundu wa khansayo, kaya yangopezeka kumene, yobwereranso, yokana kapena kufalikira (metastasized) kumadera ena. Ngakhale kuti pali malangizo ochiritsira ozikidwa pa umboni, pali kugwiritsiridwa ntchito kwakukulu kwa mankhwala osalembedwa m'matenda ambiri kuphatikizapo khansa (Repucci N, J waku Health Care Compliance, 2011).
Zakudya Zoti Mudye Mukatha Kuzindikira Khansa!
Palibe khansa ziwiri zomwezi. Pitani kupitilira malangizo omwe anthu onse amapereka kwa onse ndikupanga zisankho zomwe mungakonde pazakudya ndi zowonjezera ndi chidaliro.
Mankhwala Osokoneza Bongo a Chithandizo cha Khansa
Kugwiritsa ntchito mankhwala osokoneza bongo ndi komwe mankhwalawo amalembedwa, anthu odwala kapena zochitika zomwe sizikugwirizana ndi chidziwitso chovomerezedwa ndi oyang'anira. Kafukufuku wina wasonyeza kuti 73% ya mankhwala omwe amalembedwa pamankhwalawa sanathandizidwe ndiumboni wa sayansi wothandiza kuchipatala (Radley DC et al, Zolemba Zakale za Mankhwala, 2006). Mu blog iyi, kusiyanasiyana ndi zifukwa zakusagwiritsa ntchito mankhwala osokoneza bongo ndizovuta zomwezo zikambirana.
Kugwiritsa ntchito mankhwala osokoneza bongo kungakhale kugwiritsa ntchito mankhwalawa posonyeza kuti sanayesedwe ndikuvomerezedwa, kugwiritsa ntchito mankhwala osavomerezeka kapena kugwiritsa ntchito mankhwalawa mosiyana ndi njira yoyendetsera kapena kuchuluka kwa zomwe zidavomerezedwa koyamba. Pali kusiyana pakati pa kugwiritsira ntchito mankhwala osokoneza bongo komwe kumakhudzana ndi kugwiritsa ntchito mankhwala ovomerezeka motsutsana ndi kugwiritsa ntchito mwachifundo komwe kumapereka mwayi wopeza mankhwala ofufuza kwa odwala omwe ali ndi matenda owopsa omwe alibe njira zina. Kugwiritsa ntchito mankhwala osokoneza bongo sikuphatikizanso kugwiritsa ntchito mankhwala osavomerezeka omwe sanayende movomerezeka. Zina mwazikuluzikulu zokhudzana ndi kugwiritsa ntchito mankhwala osokoneza bongo ndikosatsimikizika kwa maubwino azachipatala komanso zoopsa zomwe zingachitike mwa anthu osayesedwa, ndikuwonjezeka pamitengo ya wodwala popeza mankhwala omwe amalembedwa nthawi zambiri samakhala ndi inshuwaransi yazaumoyo.
Kafukufuku wochitidwa ndi department of Pharmacy, ku National University of Singapore, adawunika anzawo kuti awunikenso maphunziro omwe adasindikizidwa pakati pa 1975 mpaka 2016 pankhani yogwiritsa ntchito mankhwala osokoneza bongo pochiza khansa, ndipo adakwaniritsa maphunziro 23 mwa 199 omwe adasankhidwa kuti awunike (Saiyed MM et al., J wa Clin Pharm & Ther., 2017). Zina mwazinthu zosangalatsa zomwe apeza ndi izi:
- Kugwiritsa ntchito mankhwala osokoneza bongo sikupezeka pamitundu yonse ya khansa.
- Kugwiritsa ntchito mankhwala osokoneza bongo kwa odwala omwe ali ndi khansa kuchipatala kunali pakati pa 18-41%.
- Kugwiritsa ntchito mankhwala osokoneza bongo mwa odwala khansa akuluakulu amakhala pakati pa 13-71%.
- Kugwiritsa ntchito mankhwala osokoneza bongo sikokwanira odwala metastatic (33-65%) ndi chisamaliro chapamwamba odwala (34-76%), omwe atopa njira zina zonse zamankhwala.
- Kugwiritsa ntchito mankhwala osokoneza bongo a khansa kunali kwakukulu kwambiri kwa odwala khansa ya m'mawere omwe ali ndi ma regiment omwe sanatchulidwepo m'magawo 1, 2, 3 ndi 4 odwala khansa ya m'mawere ali 70, 76, 74 ndi 82% motsatana malinga ndi kuyerekezera kwa data ya SEER yamankhwala (Eaton et al, J Natl Compr Canc Network, 2016).
- Mankhwala omwe amagwiritsidwa ntchito kwambiri omwe amapezeka ndi khansa anali mankhwala osagwirizana ndi chemotherapy omwe ali ndi zovuta zoyipa, kuphatikiza carboplatin, doxorubicin, fluorouracil, paclitaxel, docetaxel, vinorelbine, gemcitabine ndi oxaliplatin.
- Njira zochiritsira zomwe sizinagwiritsidwe ntchito nthawi zambiri zinali bevacizumab, cetuximab, rituximab, gefitinib ndi erlotinib.
Zomwe ziwerengero zomwe tazitchula pamwambapa zimakhala zofunikira komanso zofunikira ndikuti sizimagwirizana ndi zonena zamankhwala zamankhwala zokhazokha zokhazikitsidwa ndi umboni. Mankhwalawa atavomerezedwa ngakhale kwa mwana wamasiye, mankhwalawo akhoza kugwiritsidwa ntchito ngati chizindikiro ndipo amalimbikitsidwa chifukwa chazithandizo zake. Mwachitsanzo, kugwiritsa ntchito mankhwala osokoneza bongo a anti-angiogenesis bevacizumab mu chithandizo cha adjuvant kumachitika ngakhale kuti sizikupangitsa kuti pakhale kupitilirabe kwaulere (PFS) poyerekeza ndi chemotherapy wamba (Cameron D et al, Lancet Oncol, 2013). Kuphatikiza pa mayendedwe achangu komanso njira zololeza kuvomerezeka kwa mankhwala osokoneza bongo, mayesero azachipatala omwe amawonetsa ana amasiye kapena mitundu yachilendo ya khansa nthawi zambiri amakhala osagwiritsidwa ntchito mopitilira muyeso wogwiritsa ntchito malekezero ena omwe sagwirizana ndi kupulumuka kwa wodwalayo kapena kusintha kwa moyo. Mwachidule, anthu ambiri amagwiritsa ntchito mankhwala osokoneza bongo pochiza khansa, nthawi zambiri popanda umboni uliwonse wothandizidwa.
Chakudya chomwe mumadya komanso chomwe chimakupatsani thanzi ndi chisankho chomwe mumapanga. Lingaliro lanu liyenera kuphatikizapo kulingalira za kusintha kwa majini a khansa, khansa, chithandizo chamankhwala chopitilira muyeso, zovuta zilizonse, zidziwitso za moyo, kulemera, kutalika ndi zizolowezi.
Kukonzekera kwa khansa kuchokera ku addon sikudalira pakusaka kwa intaneti. Zimakusankhirani zomwe mungasankhe malinga ndi sayansi yamayendedwe omwe asayansi athu ndi akatswiri a mapulogalamu. Mosasamala kanthu kuti mumasamala kumvetsetsa zomwe zimayambira zamagulu am'thupi kapena ayi - pakukonzekera zakudya za khansa kumvetsetsa kumafunikira.
Yambirani TSOPANO ndikukonzekera zakudya zanu poyankha mafunso okhudzana ndi khansa, kusintha kwa majini, mankhwala opitilira muyeso ndi zowonjezera, chifuwa chilichonse, zizolowezi, moyo, gulu la zaka komanso jenda.
Zakudya Zawekha za Khansa!
Khansara imasintha ndi nthawi. Sinthani ndikusintha zakudya zanu kutengera zomwe zikuwonetsa khansa, machiritso, moyo, zomwe mumakonda, zomwe zingakusangalatseni ndi zina.
Odwala khansa nthawi zambiri amakhala ndi zovuta zosiyanasiyana chemotherapy mavuto zomwe zimakhudza moyo wawo ndikuyang'ana njira zina zochiritsira khansa. Kutenga chakudya choyenera ndi zowonjezera zowonjezera kutengera zomwe asayansi amalingalira (kupewa kuyerekezera ndi kusankha mwachisawawa) ndiye njira yabwino kwambiri yachilengedwe ya khansa ndi zovuta zina zokhudzana ndi chithandizo.