Isiri-diki kenza yemapapu kenza

Isiri-diki kenza yemapapu kenza ndiyo inonyanya kufarirwa kenza yemapapu. Iyo inowanzo kukura uye inopararira zvishoma nezvishoma kupfuura diki kenza yemapapu yemukenza.

Kune matatu matatu akajairika marudzi easina-madiki maseru kenza yemapapu (NSCLC):

• Adenocarcinomas inowanzo kuwanikwa munzvimbo yekunze yemapapu.
• Squamous cell carcinomas inowanzo kuwanikwa pakati pepapu padivi pechubhu yemhepo (bronchus).
• Makuru maseru carcinomas anogona kuitika mune chero chikamu chemapapu.
• Kune mamwe marudzi asina kujairika ekenza yemapapu ayo anonziwo asiri madiki.

Kusvuta kunokonzeresa zviitiko zvakawanda (kutenderedza 90%) yekenza isiri-diki yemukenza yemapapu. Ngozi iyi inoenderana nenhamba yefodya yaunosvuta zuva rega rega uye kuti wakasvuta kwenguva yakareba sei. Kuva wakakomberedza utsi kubva kune vamwe vanhu (hutsi hwefodya) zvakare kunokwidza njodzi yako yekenza yemapapu. Asi vamwe vanhu vasina kumbobvira vaputa vanoita gomarara remapapu.

Tsvagiridzo inoratidza kuti kuputa mbanje kunogona kubatsira maseru ekenza kukura. Asi hapana hukama chaihwo pakati pokusvuta mbanje nekukura kenza yemapapu.

Kugara uchisangana nemweya wakakwira kusvibiswa uye mvura yekunwa iyo ine yakakwira arsenic inogona kuwedzera njodzi yako yekenza yemapapu. Nhoroondo ye radiation radiation kumapapu inogona zvakare kuwedzera njodzi.

Kushanda pamwe kana kugara padyo nemakemikari anokonzera kenza kana zvigadzirwa zvinogona zvakare kuwedzera njodzi yekuva nekenza yemapapu. Makemikari akadaro anosanganisira:

• Asbestosi
• Radon
  
• Makemikari akadai seuranium, beryllium, vinyl chloride, nickel chromates, zvigadzirwa zvemarasha, gasi yemasitadhi, chloromethyl ethers, peturu, uye dhiziri
• Mamwe maalloys, pendi, pigment, uye zvinochengetedza
• Zvigadzirwa zvinoshandisa chloride uye formaldehyde

Zviratidzo zvinogona kusanganisira:

• Kurwadziwa pachifuva
• Kukosora uko hakuendi
• Kukosora ropa
• Kuneta
• Kupererwa nechido
• Kuderedza uremu pasina kuyedza
• Kufema kwekufema
• Kushungurudza
• Marwadzo kana achipararira kune dzimwe nzvimbo dzomuviri

Kenza yepakutanga yemapapu inogona kusakonzera chero zviratidzo.

Zvimwe zviratidzo zvinogona kunge zvakakonzerwa neNSCLC, kazhinji mumatanho ekupedzisira:

• Kurwadziwa kwepfupa kana hunyoro
• Eyelid ichinyura
• Hoarseness kana kuchinja izwi
• Joint kurwadziwa
• Matambudziko ezvipikiri
• Kumedza kuoma
• Kuzvimba kwechiso
• Kushaya simba
• Kutambudzika kwepfudzi kana kushaya simba

Zviratidzo izvi zvinogona kukonzerwa nezvimwe, zvishoma zvakakomba mamiriro. Zvakakosha kutaura nemupi wako wezvehutano kana iwe uine zviratidzo.

Iye mupi achaita bvunzo dzepanyama uye obvunza nezve nhoroondo yako yekurapa. Iwe uchabvunzwa kana iwe uchisvuta, uye kana zvirizvo, kuti unosvuta zvakadii uye kuti une nguva yakareba sei uchisvuta. Iwe zvakare uchabvunzwa nezve zvimwe zvinhu izvo zvinogona kunge zvichikuisa iwe panjodzi yekenza yemapapu, sekuratidzwa kune mamwe makemikari.

Miedzo inogona kuitwa kuti uongorore kenza yemapapu kana kuona kana yapararira inosanganisira:

• Bone scan
• Chest x-ray
• Yakazara kuverenga ropa (CBC)
• CT scan yechifuva
• MRI yechipfuva
• Positron emission tomography (PET) scan
• Sputum bvunzo kutarisa maseru ekenza
• Thoracentesis (sampling yemvura inovaka yakatenderedza mapapu)

Muzviitiko zvakawanda, chidimbu chetishu chinobviswa mumapapu ako kuti uongororwe pasi pe microscope. Izvi zvinonzi biopsy. Pane nzira dzinoverengeka dzekuita izvi:

• Bronchoscopy inosanganiswa ne biopsy
• CT-scan-inotungamirwa tsono biopsy
• Endoscopic esophageal ultrasound (EUS) ine biopsy
• Mediastinoscopy ine biopsy
• Vhura mapapu biopsy
• Pleural biopsy

Kana iyo biopsy inoratidza gomarara, mimwe miedzo yekufungidzira inoitwa kuti uwane danho rekenza. Stage zvinoreva kukura kwaro bundu uye nekupararira kwarakaita. NSCLC yakakamurwa muzvikamu zvishanu:

• Stage 0 - Iyo kenza haina kutambanuka kupfuura iyo yemukati mutsetse wemapapu.
• Chikamu I - Iyo kenza idiki uye haina kupararira kune iyo lymph node.
• Chikamu chechipiri - Kenza yapararira kune mamwe ma "lymph node" padhuze nebundu repakutanga.
• Chikamu chechitatu - Kenza yakapararira kumatishu ari padyo kana kune ma lymph node ari kure.
• Chikamu IV - Kenza yakapararira kune dzimwe nhengo dzemuviri, senge rimwe bundu, huropi, kana chiropa.

Kune akawanda marudzi akasiyana ekurapa kweNSCLC. Kurapa kunoenderana padanho rekenza.

Kuvhiya ndiko kwakajairika kurapwa kweNSCLC iyo isina kupararira kupfuura node dzepedyo. Chiremba anovhiya anogona kubvisa:

• Imwe yemaruva emapapu (lobectomy)
• Chikamu chidiki chete chemapapu (wedge kana chidimbu kubviswa)
• Iyo yose mapapu (pneumonectomy)

Vamwe vanhu vanoda chemotherapy. Chemotherapy inoshandisa mishonga kuuraya cancer maseru uye kumisa maseru matsva kubva mukukura. Kurapa kunogona kuitwa nenzira dzinotevera:

• Chemotherapy chete inowanzo shandiswa kana gomarara rapararira kunze kwepapu (danho IV).
• Inogona zvakare kupihwa pamberi pekuvhiyiwa kana radiation kuti zviite marapirwo aya anyatsobudirira. Izvi zvinonzi neoadjuvant therapy.
• Inogona kupihwa mushure mekuvhiyiwa kuuraya chero gomarara rasara. Izvi zvinonzi kurapwa kweAdjuvant.
• Chemotherapy inowanzo kupihwa kuburikidza netsinga (ne IV). Kana, inogona kupihwa nemapiritsi.

Kudzora zviratidzo uye kudzivirira kusagadzikana panguva uye mushure memakemikari chikamu chakakosha chekutarisira.

Immunotherapy ndiyo nyowani mhando yekurapa iyo inogona kupihwa yega kana nekemotherapy.

Kurapa kwakanangwa kunogona kushandiswa kurapa NSCLC. Targeted therapy inoshandisa zvinodhaka zero mune zvakanangwa (mamorekuru) mukati kana pane maseru ekenza. Izvi zvinangwa zvinoita sekuti maseru ekenza anokura nekurarama. Uchishandisa izvi zvinangwa, mushonga unoremadza maseru ekenza kuitira kuti atadze kupararira.

Radiation therapy inogona kushandiswa ne chemotherapy kana kuvhiya kusingaiti. Radiation therapy inoshandisa masimba x-ray kana mamwe mafomu e radiation kuuraya cancer maseru. Radiation inogona kushandiswa ku:

• Rapa kenza, pamwe nekemotherapy, kana kuvhiya kusingaiti
• Batsira kubvisa zviratidzo zvinokonzerwa nekenza, senge matambudziko ekufema uye kuzvimba
• Batsira kubvisa marwadzo ekenza kana gomarara rapararira kumapfupa

Kudzora zviratidzo panguva uye mushure me radiation kuchipfuva chikamu chakakosha chekutarisira.

Aya marapirwo anotevera anonyanya kushandiswa kubvisa zviratidzo zvinokonzerwa neNSCLC:

• Laser kurapa - Chidiki diki chechiedza chinopisa uye chinouraya cancer maseru.
• Photodynamic therapy - Inoshandisa mwenje kumisikidza mushonga mumuviri, unouraya cancer maseru.

Unogona kudzikisira kushushikana kwehurwere nekujoinha boka rekutsigira. Kugovana nevamwe vane zvakajairika zviitiko uye matambudziko zvinogona kukubatsira kuti usazonzwa kusurukirwa.

Maonero anosiyana. Kazhinji kazhinji, NSCLC inokura zvishoma nezvishoma. Mune zvimwe zviitiko, inogona kukura nekupararira nekukurumidza uye kukonzera kufa nekukurumidza. Gomarara rinogona kupararira kune dzimwe nhengo dzemuviri, kusanganisira bhonzo, chiropa, ura hudiki, uye huropi.

Chemotherapy yakaratidzwa kuwedzera hupenyu uye kuvandudza hupenyu hwevamwe vanhu vane nhanho IV NSCLC.

Mishonga yekurapa yakabatana padanho rechirwere uye kana uchikwanisa kuvhiyiwa.

• Girafu I ne II kanzura vane kupona kwepamusoro uye kurapa mitengo.
• Gomarara reStage III rinogona kurapwa mune dzimwe nguva.
• Mukenza weGwara IV wakadzoka unenge usati wamboporeswa. Zvinangwa zvekurapa ndezvekuwedzera nekuvandudza hupenyu hwehupenyu.

Fonera mupiki wako kana iwe uine zviratidzo zvegomarara remapapu, kunyanya kana uchisvuta.

Kana iwe uchisvuta, ino ndiyo nguva yekurega. Kana iwe uchinetseka kurega, taura nemupi wako. Kune nzira dzakawanda dzekukubatsira kurega, kubva kumapoka ekutsigira kusvika kumishonga yekunyorera. Uyezve, edza kudzivisa utsi hwefodya.

Kana iwe uchipfuura makore makumi mashanu nemashanu uye uchisvuta kana waimboputa mukati memakore gumi apfuura, taura nemupi wako nezve kuongororwa gomarara remapapu. Kuti uongororwe, unofanirwa kuve neCT scan chipfuva.

Kenza - mapapu - isiri-diki sero; Isiri-diki kenza yemapapu kenza; NSCLC; Adenocarcinoma - mapapu; Squamous cell carcinoma - mapapu; Makuru maseru carcinoma - mapapu

• Chest radiation - kubuda
• Kuvhiyiwa kwemapapu - kubuda

• Mapapu
• Chechipiri utsi uye kenza yemapapu

Araujo LH, Nyanga L, Merritt RE, Shilo K, Xu-Welliver M, Carbone DP. Kenza yemapapu: isiri- diki kenza yemapapu kenza uye diki maseru gomarara gomarara. Mune: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 69.

Ettinger DS, Wood DE, Aggarwal C, uye al. NCCN nhungamiro inonzwisisa: isiri-diki kenza yemapapu kenza, vhezheni 1.2020. J Natl Compr Cancer Netw. 2019; 17 (12): 1464-1472. PMID: 31805526. pubmed.ncbi.nlm.nih.gov/31805526/.

National Cancer Institute webhusaiti. Asiri-madiki maseru emapapu kurapwa kenza (PDQ) - hutano nyanzvi vhezheni. www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq. Yakagadziridzwa May 7, 2020. Yakasvika muna Chikunguru 13, 2020.

Silvestri GA, Pastis NJ, Tanner NT, Jett JR. Clinical zvinhu zvekenza yemapapu. Mune: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray naNadel Chinyorwa cheRefiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits.