Stage 4 Renal Cell Carcinoma: Kurapa uye Kufungidzira

Zvemukati

• Kurapa sarudzo dzeRCC
• Kuvhiya
• Immunotherapy
• Checkpoint inhibitors
• Interleukin-2
• Interferon alpha
• Targeted kurapwa
• mTOR inhibitors
• Radiation kurapa
• Chemotherapy
• Kliniki miedzo
• Renal cell carcinoma staging
• Outlook

Renal cell carcinoma (RCC) imhando yekenza inobata maseru eitsvo. RCC ndiyo yakajairika mhando yekenza yeitsvo. Kune akawanda njodzi njodzi dzekuvandudza RCC, kusanganisira:

• nhoroondo yemhuri yechirwere
• kusvuta
• kufutisa
• BP
• chirwere chetsvo che polycystic

Iyo yekutanga yaonekwa, inowedzera mukana wako wekurapa kwakanaka.

Kurapa sarudzo dzeRCC

Kunyangwe danho rechina RCC rakaiswa sedanho repamberi rekenza, kuchine dzimwe nzira dzekurapa dziripo.

Kuvhiya

Mune zvimwe zviitiko, apo bundu guru rinobviswa uye gomarara risati rapararira zvakanyanya, nephrectomy yakakura inogona kuitwa. Izvi zvinosanganisira kubvisa kuvhiya kwakawanda kana kwese itsvo dzakabatwa.

Kuvhiya kubvisa mamwe mamota kunogona kudikanwa kune vanhu vane metastatic cancer. Chikwata chehunyanzvi chinofunga kana mamastasized tumors anogona kubviswa pasina njodzi yakawandisa.

Kana kuvhiya kusingaiti, embolization embolization inogona kushandiswa. Maitiro aya anocheka kuwanda kweropa kune bundu, iro rinobatsira kudzikisa zviratidzo.

Kamwe kuvhiyiwa kwave kuitwa kubvisa bundu remuno, vanhu vazhinji vangangoda systemic kurapwa. Rudzi urwu rwekurapa rwunobata gomarara mumuviri wese. Inogona kubatsira kudzikamisa kenza inodzokororazve.

Systemic kurapa kwechikamu 4 RCC inosanganisira immunotherapy, yakanangwa kurapa, radiation, uye chemotherapy.

Immunotherapy

Immunotherapy inzira yekurapa inovavarira kukurudzira immune system kurwisa gomarara maseru. Haasi munhu wese ane RCC anopindura zvakanaka kune immunotherapy, uye mhedzisiro inogona kuve yakakomba.

Immunotherapy, kana biologic therapy, kurapwa kunobatsira immune immune yako kurwisa cancer. Iyo inowanzo kuunzwa apo iyo RCC isingakwanise kubviswa nekuvhiya.

Immunotherapy inoshandisa mashoma mashoma marudzi emishonga:

Checkpoint inhibitors

Immune system yako inoshandisa system ye "checkpoints" kusiyanisa pakati pesero rine hutano uye rine cancer. Checkpoint inhibitors inovavarira kubatsira immune system yako kuwana maseru ekenza akavanda kubva kuzvirwere zvako.

Nivolumab (Opdivo) inonzi checkpoint inhibitor inoshandiswa kuburikidza neIV yakave iri mukurapa kweRCC mumakore achangopfuura.

Zvimwe zvinokanganisa zvinosanganisira:

• mapundu
• kuneta
• manyoka
• kusvotwa
• musoro
• kuputika kweganda
• kurwadza kwemajoini
• marwadzo emudumbu
• kunetseka kufema

Interleukin-2

Interleukin-2 (IL-2, Proleukin) ikopi yekugadzira yemapuroteni anonzi cytokines anovavarira kumisikidza immune system yako kurwisa mamota maseru.

Zvinoratidzwa kuva nekwaniso yekuita. Inogona kuve nemhedzisiro mhedzisiro saka inongoshandiswa muvanhu vane hutano avo vanokwanisa kushivirira mhedzisiro.

Imwe yekubudirira pane vanowanzo vachena varume vane hasha fomu yeRCC vakaona yakakwira yekupona mwero nekushandiswa kwepamusoro-dhizaini interleukin-2.

Zvimwe zvinokanganisa zvinosanganisira:

• kuneta
• kubuda ropa
• chills
• kupindwa nechando
• yakaderera BP
• Urume mumapapu
• kukuvara kweitsvo

Interferon alpha

Interferon ane antiviral, antiproliferative (inhibits cancer cancer kukura), uye immunomodulatory (inokanganisa immune immune system) zvivakwa. Interferon alpha inovavarira kumisa bundu maseru kubva pakupatsanuka nekukura.

Interferon dzimwe nguva inopihwa nemamwe madhiragi, senge bevacizumab (Avastin).

Zvikanganiso zve interferon zvinosanganisira:

• kusvotwa
• furu-kunge zviratidzo
• kuneta

Interferon akanyanya kutsiviwa ne-single-agent yakanangwa kurapwa. Imwe-mumiririri interferon kurapa hakuwanzo kushandiswa.

Targeted kurapwa

Targeted therapy yeRCC zvinoreva kushandisa zvinodhaka zvinonyatso tarisa cancer maseru. Mishonga yakanangwa inodikanwa nekuti haikuvadze kana kuuraya maseru ane hutano mumuviri.

Kune akatiwandei mishonga yakanangwa padanho rechina RCC inoshanda kudzivirira hutachiona kukura. Vanotarisa puroteni inonzi vascular endothelial growth factor (VEGF) iyo inosimudzira kukura kwemasero ekenza.

Kuvandudzwa kwemishonga iyi yakanangwa kwakabatsira kuwedzera hupenyu hwevamwe vatambi vechikamu chechina. Iyo yekurapa yakaratidza kuvimbisa zvakakwana zvekuti vatsvagiri vanoramba vachigadzira mishonga mitsva yakanangwa.

Iyo mishonga bevacizumab (Avastin) inovhara VEGF uye inoitiswa kuburikidza netsinga.

Zvimwe zvinokanganisa zvinosanganisira:

• manyoka
• kuonda
• kufenda
• kuda kudya
• chirungurira
• maronda emuromo

Iyo tyrosine kinase inhibitor (TKI) inomisa mitsva yeropa kukura mumamota uye inouya iri fomu yepiritsi. Mienzaniso yerudzi urwu rwechinodhaka inosanganisira:

• sorafenib (Nexavar)
• cabozantinib (Cabometyx)
• pazopanib (Votrient)
• sunitinib (Sutent)

Zvimwe zvinokanganisa zveTKIs zvinosanganisira:

• BP
• kusvotwa
• manyoka
• kurwadziwa mumaoko ako netsoka

mTOR inhibitors

Mechanistic target ye rapamycin (mTOR) inhibitors inotarisa iyo mTOR protein, iyo inokurudzira renal cell cancer kukura.

Izvi zvinosanganisira:

• temsirolimus (Torisel), inotungamirwa kuburikidza ne IV
• everolimus (Afinitor), inotorwa nemuromo mupiritsi fomu

Zvimwe zvinokanganisa zvinosanganisira:

• mapundu
• kushaya simba
• kuda kudya
• maronda emuromo
• mvura inovaka kumeso kana makumbo
• shuga yeropa uye cholesterol

Radiation kurapa

Radiation inoshandisa yakakwira-simba X-ray matanda kuuraya cancer maseru. Radiation inogona zvakare kushandiswa mushure mekuvhiyiwa kuuraya chero gomarara maseru akasiiwa mushure mekurapwa.

Mune advanced RCC, inowanzo shandiswa kugadzirisa zviratidzo sekurwadziwa kana kuzvimba. Rudzi urwu rwekurapa runodaidzwa kunzi kurapa.

Zvikanganiso zve radiation zvinosanganisira:

• mudumbu kugumbuka
• kutsvuka kweganda
• kuneta
• manyoka

Chemotherapy

Chemotherapy inzira yekurapa yechinyakare mhando dzekenza. Zvinosanganisira kushandisa mushonga kana mubatanidzwa wemishonga kuuraya cancer maseru.

Chemotherapy mishonga haina kunangwa, zvakadaro, saka inouraya maseru ane hutano zvakare uye inogadzira yakawanda mhedzisiro.

Chemotherapy kazhinji haishande zvakanaka pane vanhu vane RCC. Nekudaro, chiremba wako aigona kuikurudzira kana immunotherapy uye zvakanangwa kurapwa zvisina kushanda.

Iyi kurapwa inogona kutorwa intravenously kana mupiritsi fomu. Iyo inopihwa mumatunhu ane nguva dzekunze dzekuzorora. Iwe unowanzoda kugamuchira chemotherapy mwedzi wega wega kana mwedzi mishoma yega yega.

Zvimwe zvinokanganisa zvinosanganisira:

• kuneta
• maronda emuromo
• kusvotwa uye kurutsa
• manyoka kana kupatira
• kurasikirwa nevhudzi
• kuda kudya
• kuwedzera njodzi yezvirwere

Kliniki miedzo

Imwe sarudzo yevanhu vane nhanho 4 RCC ndeye kubatanidzwa mumakiriniki ekuedzwa. Zvemakiriniki miedzo ndeyekutsvagisa miedzo yekuyedza mishonga mitsva nemishonga.

Iwe unogona kukurukura zviripo zvemakiriniki miedzo - pamwe nenjodzi dzadzo dzinogona kuitika uye mabhenefiti - nachiremba wako kana mupi wehutano

Renal cell carcinoma staging

Vanachiremba vanoongorora nekurapa RCC uye mamwe marudzi ekenza vanoshandisa sisitimu. Munhu wega wega ane RCC anopihwa nhamba inotumidzwa kubva pa1 kusvika pa4. Chikamu 1 ndiyo yekutanga nhanho yechirwere uye nhanho yechina ndiyo yazvino uye yepamusoro.

Kugadzira RCC kunoenderana ne:

• kukura kwethumba rekutanga muitsvo
• kupararira kwemasero ane gomarara kubva pabundu rekutanga kusvika kumatumbu ari pedyo
• degree remastastasis
• kupararira kwekenza kune dzimwe nhengo mumuviri

Stage 4 RCC inogona kusanganisira musanganiswa wakasiyana weiyo mamiriro ekuratidzira:

• Kana bundu rekutanga rakakura uye rapararira muitsvo yese uye mumatumbu ari pedyo. Muchiitiko ichi, maseru ekenza anogona kana kunge asina kunge akapararira kune dzimwe nhengo mumuviri.
• Kana gomarara rave metastasized uye riripo munhengo dziri kure. Muchiitiko ichi, bundu rekutanga rinogona kunge riine saizi, uye panogona kunge paine kenza mumatumbu nekukomberedza itsvo.

Outlook

Iyo yegore-mashanu yehukama hwekupona huwandu hwevanhu vane nhanho 4 RCC i12 muzana. Zvisinei, zviitiko zvakasiyana zvinogona kukonzera kukwira kwehuwandu hwekupona.

Vanhu vanogona kuvhiyiwa kuti vabvise mamastastatic tumors vane zvirinani kurarama, uye vazhinji vanorapwa nemishonga yakanangwa vanorarama kwenguva yakareba kupfuura avo vasina.