Amaphuzu avelele
Ukubika ngemiphumela yesivivinyo somtholampilo yezidakamizwa ze-cytotoxic chemotherapy kwehlisa ubungozi kanye nobuthi bezidakamizwa ngezincazelo ezinamandla futhi ezivame ukudukisa. Ucwaningo lapho kuthiwa umuthi ubekezeleleke kahle lubike ngaphezu kwesithathu seziguli eziyeka umuthi ngenxa yezehlakalo ezimbi kakhulu. Ukuxhumana ngendlela engafanele nobuthi bezidakamizwa kufanele kugwenywe futhi nemiphumela engemihle yezidakamizwa kufanele ibikwe ngokunembile.
Wake wakubona ukuthengisa ngomuthi omusha ofikile emakethe ogcwele abantu abajabule ngesikhathi sokuhweba bese kuthi ekugcineni, ngoba izinkampani ezidayisa izidakamizwa ziphoqelekile ngokomthetho ukuthi zenze njalo, izwi elisheshayo neliphansi impela lifundwa uhlu olwesabekayo lwemiphumela emibi cishe oluphela njalo ngokufa okungenzeka? Ngokusobala, izinkampani ezidayisa izidakamizwa zizozama ukwehlisa noma imiphi imiphumela emibi engaba khona engadalwa imishanguzo yazo noma ngabe, futhi ezimweni eziningi lokhu kuyiqiniso, imiphumela emibi ingase ibe mibi kunenkinga yokuqala le mithi ezama ukuyilungisa. Ngokufanayo, izivivinyo eziningi zomtholampilo zisebenzisa ulimi olungachazi ngokuphelele ubuthi obungahle bube khona (okuholela ekuxhumaneni ngokungeyikho) nemiphumela emibi yezidakamizwa ezinqunyiwe zamakhemikhali.
Isizathu esenza ukuthi ubungozi bezidakamizwa ezinobuthi budlaliselwe phansi isiguli esingahle sibe ngenxa nje yolimi oludukisayo nolweqa ngokweqile olusetshenziswa izinkampani ze-pharma. Futhi ukuzwakalisa i-alamu kwabanye odokotela kanye nabaphenyi bemitholampilo ngale nkinga, abacwaningi bezokwelapha baseMassachusetts General Hospital eBoston bashicilela udaba ku- New England Journal of Medicine. Kule ndatshana, bathole ukuthi izivivinyo zomtholampilo zizohlala zichaza imiphumela emibi yezidakamizwa ze-chemo njenge 'ephathekayo,' 'ephephile futhi esebenzayo' noma 'evame ukubekezelelwa kahle' lapho kungekho okunye kwalokhu okusondele ekuchazeni ngokuphelele ubukhulu benkinga. Isibonelo, ku- umdlavuza colorectal ucwaningo phakathi kwamaqembu amabili okwakuthathwa ngokuthi 'lubekezelelwe kahle,' ”izehlakalo ezimbi zaholela ekuyekisweni kwe-chemotherapy ezigulini ezingama-39% eqenjini elilodwa lokwelashwa kwathi ku-27% kwelinye. Sebebonke, abantu abangu-13 bafa ngenxa yesigameko esibi ”(UChana A. Sacks et al, N ENGL J MED., 2019). Ukubeka ilebuli emnene kumuthi onobuthi obubangela ukuthi abanye abantu bafe akulungile. Umphumela wekhwalithi yempilo yomuntu usacutshungulwa ngezifundo ezingenakubalwa kepha okusemqoka ukuthi izifundo zomtholampilo zidinga indlela entsha yokuthi bazokwazisa kanjani abasebenzisi nabodokotela abangaba khona ngemiphumela engemihle yomuthi wabo.
Ukudla Okufanele Ukudla Ngemuva Kokuxilongwa Komdlavuza!
Akukho mdlavuza owodwa ofanayo. Dlulela ngale kwemihlahlandlela ejwayelekile yokudla kuwo wonke umuntu futhi wenze izinqumo ezenziwe ngezifiso ngokudla nezithasiselo ngokuzethemba.
I-Regorafenib njengesibonelo somuthi onobuthi obubalulekile
I-Regorafenib ihlosiwe umdlavuza umuthi ogunyazwe yi-FDA ukuthi welaphe umdlavuza we-metastatic colorectal kuphela uma iziguli zehlulekile ezinye izinhlobo zokwelashwa ngamakhemikhali ezifana ne-OXA, i-fluoropyridine, i-IRN based chemotherapies kanye nokwelashwa kwe-anti-VEGF. Umuthi ofana ne-Regorafenib wawuhlotshaniswa nobuthi obubalulekile kumithamo egunyaziwe, eyagunyaza ukubuyekezwa kweshejuli yomthamo wayo kanye nokugunyazwa kwephrofayela yobuthi. Ngakho-ke yize lo muthi ufakazelwe ukuthi uyasebenza ngokwamandla awo okuqeda izimila, odokotela kufanele baqaphe ngokwedlulele kukho kokubili ukuletha imithamo nokwazisa iziguli ngobuthi obungaba khona obuza nokuthatha umuthi onjalo. Ocwaningweni olwenziwa abacwaningi bezokwelapha abavela eNyuvesi yase-Columbia eNew York mayelana nokusebenza ngempumelelo kanye nemiphumela engaba khona ye-Regorafenib, uhlolo lwe-GRID lwenziwa kubhaliswa abantu abangu-199 abathatha i-160mg ye-Regorafenib ngomlomo amaviki angu-3 kwangu-4 umjikelezo ngamunye kanye nemiphumela emibi yabikwa I-98% yeziguli kanye "nokusabela okubi okuvame kakhulu okubikiwe ukusabela kwesikhumba sonyawo (56%), umfutho wegazi ophezulu (48.5%), isifo sohudo (40%) nokukhathala (38.6%)"UDemetri GD et al, Lancet, 2013; UKrishnamoorthy SK et al, Therap Adv Gastroenterol., 2015). Ngaphezu kwalokhu, kube nokulimala okukhulu kwesikhumba ezandleni zomuntu nakho okwabikwa yiziguli.
Okusemqoka ukuthi iziguli zidinga ukwazi ukuthi zingena kuphi futhi lokhu ngeke kwenzeke uma zikhohliswa ngamagama abanzi ngamabomu noma ngokungenhloso (ukuxhumana okungafanele) okuhluleka ukuchaza ngokunembile izinkinga ezingaba khona ezifana nobuthi, ukuthi leyo mithi ingaholela .
Ukudla okudlayo nokuthi yikuphi okunezelayo okwenzayo yisinqumo osithathayo. Isinqumo sakho kufanele sifake ukucutshungulwa kwezakhi zofuzo zomdlavuza, okuwumdlavuza, ukwelashwa okuqhubekayo kanye nezithasiselo, noma yikuphi ukungezwani komzimba, imininingwane yokuphila, isisindo, ubude nemikhuba.
Ukuhlelela okunomsoco komdlavuza kusuka ku-addon akususelwa ekusesheni kwe-inthanethi. Kwenzela wena ukuthathela izinqumo ngokuya ngesayensi yamangqamuzana eyenziwe ososayensi bethu nonjiniyela be-software. Kungakhathalekile ukuthi ngabe uyakukhathalela ukuqonda okuyisisekelo kwamakhemikhali amakhemikhali noma cha - wokuhlelela umsoco ukuhlela lokho kudinga ukuqonda.
Qalisa MANJE ngokuhlela kwakho okunomsoco ngokuphendula imibuzo egameni lomdlavuza, ukuguquka kwezakhi zofuzo, ukwelashwa okuqhubekayo kanye nezithasiselo, noma yikuphi ukungezwani komzimba, imikhuba, indlela yokuphila, iqembu lobudala nobulili.
Ukudla Okungokwakho Komdlavuza!
Umdlavuza uyashintsha ngokuhamba kwesikhathi. Enza ngendlela oyifisayo futhi uguqule umsoco wakho ngokusekelwe kunkomba yomdlavuza, ukwelashwa, indlela yokuphila, okuncamelayo kokudla, izinto ezingakuphathi kahle nezinye izici.
Iziguli ezinomdlavuza ngokuvamile kufanele zibhekane nokuhlukile imiphumela emibi ye-chemotherapy okuthinta ikhwalithi yempilo yabo futhi babheke ezinye izindlela zokwelapha umdlavuza. Ukuthatha ukudla okunomsoco nezithasiselo ezisuselwa ekucabangeni kwesayensi (ukugwema ukuqagela nokukhetha okungahleliwe) ikhambi lemvelo elingcono kakhulu umdlavuza kanye nemiphumela engemihle ehlobene nokwelashwa.