Iimbalasane
Kukho ukusasazeka kwelebheli yokusetyenziswa kweziyobisi kunyango lomhlaza, amaxesha amaninzi kungekho bungqina bokuba kukho isibonelelo sonyango. Uhlalutyo lweemeta kwizifundo zeklinikhi lubonise ukusetyenziswa kweziyobisi ezingekho kwilebula kwi-13-71% yezigulana ezinomhlaza wabantu abadala. Ukusetyenziswa kwelebula engaphandle kwelebheli kwakuphezulu kwizigulana ezinesifo se-metastatic kunye nokunakekelwa kwepalliative, abagqibe yonke eminye imigangatho yokhetho.
Unyango lweCancer ikakhulu lusekelwe kwizikhokelo zeklinikhi ezivela kwimibutho eyahlukeneyo efana ne-NCCN (National Comprehensive Cancer Network), ASCO (American Society of Clinical Oncology) kunye nabanye. Ezi zikhokelo zichongwa ngobungqina besayensi kunye neziqinisekiso zolawulo kunye nokuvunywa, kwizibonakaliso ezithile zomhlaza, inqanaba kunye nohlobo lomhlaza, nokuba usanda kuxilongwa, ubuyele, unqabile okanye usasazeke (i-metastasized) ukuya kweminye imimandla. Ngaphandle kwezikhokelo zonyango ezisekelwe kubungqina, kukho usetyenziso olubalulekileyo noluxhaphakileyo lweziyobisi kwizifo ezininzi ezibandakanya umhlaza (U-Repucci N, J woThotyelo lwezeMpilo, ngo-2011).
Ukutya okuTyiwa emva kokuChongwa koMhlaza!
Akukho mhlaza mibini ifanayo. Yiya ngaphaya kwezikhokelo zesondlo esiqhelekileyo kuwo wonke umntu kwaye wenze izigqibo ezizezakho malunga nokutya kunye nezongezo ngokuzithemba.
Iziyobisi ezingekho kwilebula yokuNyanga uMhlaza
Ukusetyenziswa kwelebula engekho emthethweni kulapho ichiza limiselwa khona, isigulana okanye imeko engahambelaniyo nokumisela ulwazi oluvunyiweyo ngabasemagunyeni abalawulayo. Olunye uphononongo lubonakalisile ukuba iipesenti ezingama-73 zamachiza amayeza angekhoyo kwilebula akaxhaswanga bubungqina besayensi benzuzo yekliniki esebenzayoURadley DC okqhubekayo, Oovimba abagcina amayeza angaphakathi, 2006). Kule blog, umahluko kunye nezizathu zokusetyenziswa kwelebheli engekho mthethweni kunye nemicimbi ejikeleze okufanayo kuya kuxoxwa ngazo.
Ukusetyenziswa kwelebheli engekho kwilebula kunokuba kukusebenzisa ichiza ukubonisa ukuba alizange livavanywe kwaye livunywe, lisetyenziswe kumnxeba ongavunyelwanga kunyango okanye ukusebenzisa iyeza ngokungafaniyo kwindlela yolawulo okanye idosi kwinto eyayivunyelwe kuqala. Kukho umahluko phakathi kokusetyenziswa kwelebheli engekho kwichiza elinxulumene nokusetyenziswa kwesiyobisi okuvunyiweyo kunye nokusetyenziswa kwemfesane okunika ukufikelela kwiziyobisi zophando kwizigulana ezinezifo ezisongela ubomi ezingenazo ezinye iindlela. Ukusetyenziswa kweziyobisi ezingekho mthethweni akubandakanyi ukusetyenziswa kwemveliso yonyango engekho mthethweni engakhange ihambe kuyo nayiphi na imvume yolawulo. Eminye imiba ephambili ejikeleze ukusetyenziswa kwelebheli ezingekho kwilebheli kukungaqiniseki kwezibonelelo zeklinikhi kunye neetyhefu ezinokubakho kubemi abangavavanywanga, kunye nokunyuka kweendleko zepokotho kwisigulana kuba amayeza angekho kwilebheli ahlala engafakwanga ngababoneleli beinshurensi yezempilo.
Uphononongo olwenziwe liSebe lezeMithi, kwiDyunivesithi yeSizwe yaseSingapore, kuvavanywe ukuba oontanga babo baphonononge izifundo ezipapashiweyo phakathi kowe-1975 ukuya koka-2016 ekusetyenzisweni kwelebheli ngaphandle kweleyibheli kunyango, kwaye basondeza kwizifundo ezingama-23 kweziyi-199 ezikoluhlu olufutshane kuhlalutyo lwabo (Saiyed MM et al., J weKlinikhi yeFarm kunye nonyango., 2017). Ezinye zeziphumo ezinomdla zohlalutyo lwabo zezi:
- Ukusetyenziswa kweziyobisi ezingekho kwilebheli kuqheleke ukwenziwa kuzo zonke iintlobo zomhlaza.
- Ukusetyenziswa kweziyobisi ezingekho kwilebula kwizigulana ezinomhlaza phakathi kwe-18-41%.
- Ukusetyenziswa kweziyobisi ngaphandle kwelebheli kwizigulana ezinomhlaza kubantu abadala phakathi kwe-13-71%.
- Ukusetyenziswa kwelebheli okusetyenzisiweyo kuphezulu ngokuthelekisa izigulana zemastatic (33-65%) kunye Unonophelo lwendalo abaguli (34-76%), abagqibe yonke eminye imigangatho yokhetho.
- Ukusetyenziswa kwelebheli yomhlaza ngaphandle kwelebheli kwakuphezulu kakhulu kwizigulana ezinomhlaza wamabele ezinamarejimeni angekho kwilebhile kwizigaba 1, 2, 3 kunye ne-4 yezigulana ezinomhlaza wamabele ezingama-70, 76, 74 kunye nama-82% ngokwahlukeneyo ngokokuqikelelwa kwedatha yamayeza e-SEER (U-Eaton okqhubekayo, J Natl Compr Canc Network, 2016).
- Ezona ziyobisi zisetyenziswa ngokuxhaphakileyo kwelebheli yomhlaza zazingamachiza e-chemotherapy angachazwanga aneziphumo ebezingalindelekanga ezibi, kubandakanya i-carboplatin, doxorubicin, fluorouracil, paclitaxel, docetaxel, vinorelbine, gemcitabine kunye ne-oxaliplatin.
- Uninzi lwezonyango olujolise kwelebheli ekujoliswe kuzo lwalunjalo bevacizumab, cetuximab, rituximab, gefitinib kunye neerlotinib.
Isizathu sokuba la manani angasentla okusetyenziswa kwelebheli engabalulekanga abalulekile kwaye abalulekile kuba abaxhasi ibango eliqhelekileyo lonyango lomhlaza ekusekweni kobungqina kuphela kunye nezikhokelo eziqhutywa. Nje ukuba ichiza livunyiwe kwanokubonakaliswa kwenkedama, ichiza elamkelweyo linokusetyenziswa ngaphandle kwelebheli kwaye liyonyuselwa ngokubanzi kwizibonelelo zalo zonyango. Umzekelo, ukusetyenziswa kwelebheli ye-anti-angiogenesis bevacizumab kunyango lwe-adjuvant lwenziwa ngaphandle kwedatha enganiki phuculo kwinkqubela phambili yokuphila ngokukhululekileyo (PFS) xa kuthelekiswa ne-chemotherapy esemgangathweni (UCameron D okqhubekayo, uLancet Oncol, 2013). Ukongeza ngokulandela umkhondo ngokukhawuleza kunye nokutyunjwa kwendlela yokulawula ukwamkelwa kweziyobisi, iimvavanyo zeklinikhi ezibonisa iinkedama okanye iintlobo zomhlaza ezingaqhelekanga zihlala zixhotyiswa ngokungafanelekanga ukongeza ekusebenziseni iindawo zokugqibela ezingalinganiseli mpembelelo kubomi besigulana ngokubanzi okanye kumgangatho wokuphuculwa kobomi. Isishwankathelo, kukho ukusasazeka kwelebheli yokusetyenziswa kwamachiza kunyango lomhlaza, amaxesha amaninzi kungabikho bungqina bokuba uncedo lweklinikhi.
Kukuphi ukutya okutyayo kwaye okuncedisayo kukuthatha sisigqibo osithathayo. Isigqibo sakho kufuneka sibandakanye ukuthathelwa ingqalelo kotshintsho lomhlaza kuhlobo lomhlaza, unyango oluqhubekayo kunye nezongezelelo, nakuphi na ukwaliwa, ulwazi ngobomi bakho, ubunzima, ukuphakama kunye nemikhwa.
Isicwangciso sesondlo somhlaza esivela kwi-addon asisekelwanga kukhangelo lwe-Intanethi. Isebenza ngokuzenzekelayo ukwenza izigqibo zakho kusekwe kwisayensi yemolekyuli ephunyezwe ngoososayensi kunye neenjineli zesoftware. Nokuba ukhathalele na ukuqonda iindlela ezisisiseko seemolekyuli okanye hayi - zokucwangciswa kwesondlo somhlaza ukuqonda kuyafuneka.
Qalisa NGOKU ngokucwangciswa kwesondlo ngokuphendula imibuzo ngegama lomhlaza, uguquko kwimfuza, unyango oluqhubekayo kunye nezincedisi, nakuphi na ukwaliwa, imikhwa, indlela yokuphila, iqela lobudala kunye nesini.
ISondlo esiSiqu soMhlaza!
Umhlaza uyatshintsha ngokuhamba kwexesha. Yenza ngokwezifiso kwaye uguqule isondlo sakho ngokusekwe kwisalathiso somhlaza, unyango, indlela yokuphila, ukhetho lokutya, i-allergies kunye nezinye izinto.
Izigulana ezinomhlaza zihlala zisebenza ngeendlela ezahlukeneyo iziphumo ebezingalindelekanga ezichaphazela umgangatho wobomi babo kwaye bajonge ezinye iindlela zonyango lomhlaza. Ukuthatha isondlo esifanelekileyo kunye nezongezelelo ezisekwe kuqwalaselo lwenzululwazi (ukunqanda ukuqikelela kunye nokukhetha okungahleliwe) sesona sixhobo sendalo somhlaza kunye neziphumo ebezingalindelekanga zonyango.