Mfundo
Odwala ambiri omwe ali ndi khansa omwe akulandira chithandizo chamankhwala amamwa mankhwala owonjezera monga mavitamini ngati palibe njira zina zochiritsira zomwe zilipo, kuti apitirize kukhala ndi moyo wabwino, kapena amapita ndi chithandizo chawo nthawi zonse kuti athe kuthana ndi zotsatira za mankhwala omwe alipo kapena akale. . Komabe, khansa iliyonse ndi yapadera. Zakudya zowonjezera zakudya monga mavitamini ambiri, omega-3 fatty acids (ochokera kunyanja), ndi zina zotero sizingapindule ndi khansa zonse ndipo zimatha kugwirizana molakwika ndi mankhwala enaake, ngati sasankhidwa mwasayansi. M'pofunika kufufuza zakudya/zakudya zomwe munthu amadya zomwe mwasayansi zimagwirizana ndi mawonekedwe a khansa, machiritso omwe akupitilira komanso moyo wa odwala. khansa odwala omwe ali pansi pa chisamaliro chochepa.
Khansara ndi yachiwiri yomwe imayambitsa kufa kwa anthu padziko lonse lapansi. Kupezeka kwa khansa kumakhudza osati wodwala yekha, komanso banja lake. Ndi kupita patsogolo kwaposachedwa pazachipatala komanso kuzindikira koyambirira, ziwopsezo za kufa kwa mitundu yambiri ya khansa monga khansa ya m'mawere, komanso kuchuluka kwa matenda a khansa monga khansa ya m'mapapo kwatsika m'zaka zingapo zapitazi (American Cancer Society, 2020) . Pali mitundu yosiyanasiyana yamankhwala ochizira khansa omwe akupezeka masiku ano kuphatikiza makalasi osiyanasiyana a chemotherapy, immunotherapy, mankhwala omwe akuwongolera, ma hormonal therapy ndi radiation therapy. Katswiri wa oncologist amasankha njira yochiritsira yomwe iyenera kugwiritsidwa ntchito kwa wodwala khansa kutengera zinthu zosiyanasiyana kuphatikiza mtundu ndi gawo la khansayo, komwe kuli khansa, momwe wodwalayo alili, zaka za wodwalayo komanso thanzi lake.
Komabe, ngakhale kupita patsogolo kwachipatala ndi kusintha kwa chiwerengero cha opulumuka khansa m'zaka makumi angapo zapitazi, khansa komanso mankhwala ochizira khansa amatha kuyambitsa zotsatirapo kuphatikizapo zizindikiro za thupi monga kupweteka, kutopa, zilonda zam'kamwa, kusowa chilakolako cha kudya, nseru, kusanza, kupuma movutikira, ndi kusowa tulo. Odwala khansa amathanso kukhala ndi zovuta zamaganizidwe, zachikhalidwe komanso zamalingaliro. Kutengera ndi mtundu ndi kuchuluka kwa mankhwalawo, zimatha kuyambitsa zovuta zoyipa. Zotsatira zoyipa izi zimakhudza kwambiri moyo wa wodwala khansa. Chisamaliro cha Palliative cholinga chake ndi kupereka mpumulo kwa odwala khansa ku zovuta zokhudzana ndi thanzi izi ndikuthandizira kukonza moyo wawo.
Kodi Palliative Care ndi chiyani?
Chisamaliro cha Palliative, chomwe chimadziwikanso kuti Chithandizo Chothandizira, ndicho chisamaliro choperekedwa kwa odwala khansa omwe amayang'ana kwambiri kuwongolera moyo wawo komanso zizindikiro zakuthupi. Chisamaliro chapalliative poyamba chinkaonedwa ngati chisamaliro chachipatala kapena chisamaliro chakumapeto kwa moyo pamene chithandizo chamankhwala sichinalinso njira yothandizira odwala omwe ali ndi matenda oopsa monga khansara, koma patapita nthawi, izi zasintha. Masiku ano, chisamaliro chothandizira chimaperekedwa kwa wodwala khansa nthawi iliyonse yaulendo wake wa khansa- kuyambira pakuzindikira khansa mpaka kumapeto kwa moyo.
- Chisamaliro chapalliative chingaphatikizidwe limodzi ndi njira zochizira khansa monga chemotherapy ndi radiation therapy kuti muchepetse, kuyimitsa kapena kuchiza khansa.
- Chisamaliro chapalliative chingapereke mayankho omwe angapangitse moyo wabwino wa wodwala yemwe wapezeka ndi khansa ndipo wayambitsa chithandizo cha khansa.
- Chisamaliro chapalliative chingaperekedwe kwa wodwala yemwe wamaliza chithandizo cha khansa koma amakhalabe ndi zotsatirapo zake kapena zizindikiro zakuthupi.
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.
Zakudya / Zakudya kwa Odwala mu Palliative Care
Chithandizo cha khansa monga chemotherapy chimagwiritsidwa ntchito kupha maselo a khansa omwe amagawikana mwachangu. Komabe, panthawiyi, ziwalo zosiyanasiyana za thupi lathu zomwe maselo abwinobwino amagawanika pafupipafupi zimakhudzidwa zomwe zimapangitsa kuwonongeka kwachuma. Nthawi zambiri, zimakhala zovuta kuti wodwalayo apitirize kumwa mankhwala omwe dokotala wamulembera kapena chithandizo chanthawi zonse. Kudya zakudya / zakudya zopatsa thanzi kuphatikiza zakudya zoyenera mwasayansi ndi zakudya zowonjezera ndi imodzi mwazinthu zomwe mungachite pazovuta za khansa yapalliative.
Kwa zaka zambiri, cholinga chachikulu cha zakudya zopatsa thanzi komanso chisamaliro chachipatala chakhala chongokulitsa moyo wa odwala khansa. Komabe, tsopano chithandizo chamankhwala chothandizira chikuphatikizidwa pamagawo osiyanasiyana aulendo wa khansa, zakudya / zakudya (kuphatikiza zakudya ndi zakudya zowonjezera) za odwala khansa ziyenera kupangidwa kuti zipindule mbali imodzi kapena zingapo za kupulumuka kwa khansa zomwe zimakhudza khalidwe. za moyo, thanzi lonse ndi kuthandiza kulamulira khansa kubwereza ndi kupitirira kwa matenda ndi kutsitsa ma cell zinthu zomwe zimalimbikitsa matendawa.
Umboni pa Ubwino wa Zakudya Zowonjezera Zakudya / Kulowetsedwa mu Palliative Care
Tiyeni tsopano tiwone ena mwa maphunziro omwe adasindikizidwa okhudza momwe amakhudzira kapena phindu lotenga zakudya zinazake zowonjezera kapena zakudya kapena kulowetsedwa ndi odwala khansa yapalliative pazizindikiro zakuthupi kapena moyo wawo.
Kuonjezera kwa Vitamini D mu Odwala Khansa Yolimba Pansi pa Palliative Care
Mavitamini abwinobwino a vitamini D ndi ofunikira kuti mafupa ndi minofu zisungidwe bwino, komanso magwiridwe antchito a machitidwe osiyanasiyana a thupi lathu. Zakudya zokhala ndi Vitamini D zambiri zimaphatikizapo nsomba zamafuta monga salimoni, tuna ndi mackerel, nyama, mazira, mkaka ndi bowa. Thupi la munthu limapanganso Vitamini D pamene khungu limayang'aniridwa ndi dzuwa.
Pakafukufuku wofalitsidwa mu 2015, ofufuza a ku Spain adawona kugwirizana kwa kusowa kwa Vitamini D ndi zovuta zokhudzana ndi thanzi, kutopa, komanso kugwira ntchito mwakuthupi kwa odwala omwe ali ndi khansa yapakatikati kapena yosagwira ntchito. . (Montserrat Martínez-Alonso et al, Palliat Med., 2016) Mwa odwala 30 omwe anali ndi khansa yapamwamba yolimba pansi pa chisamaliro chothandizira, 90% anali. vitamini D akusowa. Kuwunika kwa zotsatira za kafukufukuyu kunapeza kuti kuwonjezeka kwa vitamini D kumachepetsa kutopa komanso kumapangitsa kuti thupi likhale labwino komanso labwino.
Mu kafukufuku wina wofalitsidwa mu 2017, ofufuza ochokera ku Karolinska Institutet, Stockholm, Sweden adafufuza ngati kuwonjezera kwa vitamini D kungathandize kuchepetsa ululu, moyo wabwino (QoL) ndi kuchepetsa matenda m'thupi. khansa odwala omwe ali pansi pa chisamaliro chothandizira (Maria Helde-Frankling et al, PLoS One., 2017). Kafukufukuyu adaphatikizapo odwala 39 a khansa omwe anali pansi pa chisamaliro chochepa cha Vitamini D (omwe ali ndi 25-hydroxyvitamin D <75 nmol / L). Odwalawa adawonjezeredwa ndi vitamini D 4000 IE / tsiku, ndipo adafanizidwa ndi odwala 39 omwe sanalandire chithandizo. Zotsatira za Vitamini D supplementation pa mlingo wa Opioid (omwe amagwiritsidwa ntchito poyang'anira ululu), kumwa maantibayotiki ndi ubwino wa moyo unkayang'aniridwa. Ofufuzawo adawona kuti pambuyo pa mwezi wa 1, gulu lowonjezera ndi vitamini D linali ndi mlingo wochepa kwambiri wa opioid poyerekeza ndi gulu losagwiritsidwa ntchito ndi kusiyana pakati pa mlingo wogwiritsidwa ntchito m'magulu a 2 pafupifupi kawiri pambuyo pa miyezi ya 3. Kafukufukuyu adapezanso kuti moyo wabwino udayenda bwino m'gulu la Vitamini D mwezi woyamba komanso kuti gululi lidachepetsa kwambiri kumwa maantibayotiki pambuyo pa miyezi 3 poyerekeza ndi gulu lomwe silinalandire chithandizo.
Kafukufukuyu akuwonetsa kuti kudya zakudya zowonjezera za Vitamini D kwa odwala omwe ali ndi khansa yolimba omwe ali pansi pa chisamaliro chochepa kungakhale kotetezeka ndipo kungathandize wodwalayo powongolera kasamalidwe ka ululu komanso kuchepetsa matenda.
Kuonjezera kwa Omega-3 fatty acid mu Advanced Esophago-Gastric Cancer odwala omwe amathandizidwa ndi Palliative Platinum based Chemotherapy
Omega-3 Fatty Acids ndi gulu lamafuta acids ofunikira omwe samapangidwa ndi thupi ndipo amachokera ku zakudya zathu zatsiku ndi tsiku. Mitundu yosiyanasiyana ya omega-3 fatty acids ndi eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) ndi alpha-linolenic acid (ALA).
Magwero a Omega 3 fatty acids: nsomba ndi mafuta a nsomba ndi magwero abwino kwambiri a Omega-3 fatty acids monga EPA ndi DHA. Komabe, magwero a mbewu monga mtedza, mafuta a masamba ndi njere monga mbewu za Chia ndi mbewu za fulakesi ndizomwe zimachokera ku Omega-3 fatty acid monga ALA.
Ofufuza ochokera ku yunivesite ya Leicester, UK posachedwapa adafalitsa kafukufuku wachipatala yemwe adasanthula zotsatira za mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogonana - EOX pamodzi ndi kulowetsedwa kwa Omega-3 fatty acid sources (Omegaven®) mlungu uliwonse kwa odwala 20 omwe ali ndi matenda a esophago-gastric adenocarcinoma. (Amar M Eltweri et al, Anticancer Res., 2019) Zotsatirazo zinafaniziridwa ndi odwala 37 olamulira omwe adalandira EOX chemotherapy okha. Kafukufukuyu adapeza kuti kuphatikizika kwa Omega-3 mafuta acid kumawongolera mayankho a radiological, ndikuyankha pang'ono kuchokera ku 39% (EOX yokha) mpaka 73% (EOX kuphatikiza omega-3). Ofufuzawo adapezanso kuti poizoni wa grade 3 kapena 4 monga poizoni wa m'mimba ndi thrombo-embolism adachepetsedwanso mwa omwe adalandira omega-3 pamodzi ndi EOX.
Kuphatikizapo magwero a chakudya ndi zakudya zowonjezera za omega-3 fatty acids muzokwanira monga gawo la zakudya zathanzi za odwala khansa omwe akulandira chithandizo chamankhwala EOX chemotherapy angakhale opindulitsa.
Palliative Vitamin C Supplementation mwa Odwala Omwe Ali ndi Radiotherapy-Resistant Bone Metastases
Vitamini C, kapena ascorbic acid, ndi antioxidant wamphamvu komanso imodzi mwazinthu zomwe zimagwiritsidwa ntchito kwambiri ndi chitetezo chamthupi. Magwero apamwamba a Vitamini C ndi zipatso za citrus monga malalanje, mandimu, sipinachi, kabichi wofiira, mphesa, pomelos, ndi mandimu, guava, tsabola wa belu, sitiroberi, zipatso za kiwi, papaya, chinanazi, phwetekere, mbatata, broccoli ndi cantaloupes.
Mu kafukufuku wofalitsidwa mu 2015, ofufuza ochokera ku yunivesite ya Bezmialem Vakif, Istanbul, Turkey adafufuza zotsatira za vitamini C (ascorbic acid) pa ululu, ntchito, komanso nthawi yopulumuka kwa odwala khansa. (Ayse Günes-Bayi et al, Nutr Cancer., 2015) Kafukufukuyu adaphatikizapo odwala 39 omwe ali ndi ma metastases osagwirizana ndi radiotherapy. Mwa awa, odwala 15 adalandira mankhwala a chemotherapy, odwala 15 adalandira kulowetsedwa kwa Vitamini C / ascorbic acid ndipo odwala 9 omwe amawongolera sanalandire chithandizo chamankhwala kapena vitamini C. Kafukufukuyu adapeza kuti ntchitoyo idawonjezeka mwa odwala 4 a gulu la vitamini C ndi Wodwala 1 wa gulu la chemotherapy, komabe, magwiridwe antchito mu gulu lowongolera anali atachepa. Kafukufukuyu adapezanso 50% kuchepetsa kupweteka kwa gulu la vitamini C pamodzi ndi kuwonjezeka kwa nthawi yapakati yopulumuka ndi miyezi 8. (Ayse Günes-Bayir et al, Nutr Cancer., 2015)
Mwachidule, zakudya zowonjezera za Vitamini C kapena kulowetsedwa pamlingo woyenera zingathandize odwala khansa omwe ali ndi fupa la radiotherapy-resistant metastases pochepetsa ululu ndi kuonjezera momwe amachitira komanso kupulumuka kwawo poyerekeza ndi odwala ena omwe sanalandire Vitamini C.
Kuonjezera kwa Curcumin kwa kukhazikika kwa nthawi yaitali kwa Myeloma
Nthawi zina, zotsatira zoyipa za chithandizo cha khansa zimatha kupangitsa kuti zikhale zovuta kuti wodwalayo apitirize kulandira chithandizo. Kapena siteji imabwera pamene pali kusowa kwa njira zina zothandizira odwala. Zikatero, zakudya zopatsa thanzi kuphatikiza zakudya zoyenera mwasayansi ndi zakudya zomwe zimagwirizana ndi mawonekedwe a khansa zitha kupindulitsa wodwalayo.
Curcumin ndiye gawo lofunikira la zokometsera za curry Turmeric. Curcumin amadziwika kuti ali ndi antioxidant, anti-inflammatory, antiseptic, anti-proliferative ndi analgesic properties.
Kafukufuku wina adasindikizidwa mu 2015 ponena za wodwala myeloma wobwereranso, wazaka 57, yemwe adalowanso kachiwiri kwachitatu komanso chifukwa chosowa njira zina zothandizira anti-myeloma, adayambitsa kudya kwa curcumin tsiku ndi tsiku. Kafukufukuyu adawonetsa kuti wodwalayo adatenga 8 g ya oral curcumin pamodzi ndi bioperine (kuti azitha kuyamwa bwino) ndipo wakhalabe wolimba kwa zaka zoposa 5. (Zaidi A, et al., BMJ Case Rep., 2017)
Kafukufukuyu akuwonetsa kuti curcumin supplementation ingathandize odwala myeloma mu chisamaliro chothandizira pakukhazikika kwa nthawi yayitali kwa matendawa. Komabe, mayesero odziwika bwino azachipatala amafunikira kuti akhazikitse zomwezo.
Kutsiliza
Mwachidule, deta yochokera m'mayesero ang'onoang'ono a zachipatala ndi kafukufuku wa zochitika zimasonyeza kuti kugwiritsa ntchito zakudya zoyenera ndi zowonjezera kungathandize odwala omwe ali ndi chithandizo chothandizira kupweteka, kuchepetsa matenda komanso kusintha zizindikiro za thupi ndi thanzi labwino. Chiyembekezo tsopano ndi kukhala ndi mayesero akuluakulu azachipatala kuti akhazikitse zomwezo.
Odwala ambiri omwe ali ndi khansa omwe ali pansi pa chisamaliro chamankhwala amangodya zakudya zopatsa thanzi monga mavitamini pamodzi ndi chithandizo chanthawi zonse kapena pakakhala kusowa kwa njira zina zochiritsira zomwe zilipo, kuti athe kuthana ndi zotsatira za mankhwala omwe alipo kapena am'mbuyomu, kusamalira zizindikiro ndi kuonjezera umoyo wabwino. Khansara iliyonse ndi yapadera ndipo mawonekedwe a matenda kapena matenda omwe amalimbikitsa njira zimasiyana kuchokera ku khansa kupita ku khansa. Thandizo la khansa lingakhalenso ndi kugwirizana koyipa ndi zakudya zowonjezera zakudya ngati sizinasankhidwe mwasayansi. Chifukwa chake, kugwiritsa ntchito mankhwala osokoneza bongo kumatha kukulitsa thanzi lanu khansa ndi kusokoneza chithandizo cha khansa. Chifukwa chake, pakufunika kufufuza kadyedwe / kadyedwe kake kazakudya ndi zakudya zowonjezera zomwe mwasayansi zimagwirizana ndi mawonekedwe a khansa, machiritso omwe akupitilira komanso moyo wa wodwala khansa yemwe akusamalidwa bwino kuti apindule.
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.