Khansara ya m'mapapo imakhala matenda aakulu

Kuzindikira khansa ya m'mapapo kuyenera kukhala kwachangu, kokwanira komanso kokwanira. Ndiye kwenikweni amalola munthu kusankha ndi kukhathamiritsa kwa khansa mankhwala. Chifukwa cha njira zochiritsira zatsopano, odwala ena ali ndi mwayi wowonjezera moyo wawo osati pang'ono, koma ndi miyezi khumi ndi iwiri. Khansara ya m'mapapo imakhala matenda aakulu.

Khansara ya m'mapapo - kuzindikira

- Kuzindikira khansa ya m'mapapo kumafuna kuti akatswiri ambiri azitengapo mbali, mosiyana ndi khansa ya m'thupi, monga khansa ya m'mawere kapena khansa ya melanoma, yomwe imapezeka ndikuthandizidwa makamaka ndi oncologists. Khansara ya m'mapapo imasiyana kwambiri pano - akutero Prof. Dr hab. n. med. Joanna Chorostowska-Wynimko, wamkulu wa dipatimenti ya Genetics ndi Clinical Immunology ya Institute of Tuberculosis and Lung Diseases ku Warsaw.

Mgwirizano wa akatswiri ambiri ndi wofunika kwambiri, nthawi yoperekedwa ku diagnostics ndiyeno chiyeneretso cha chithandizo ndi ofunika kwambiri. - Mwamsanga pamene khansa yapezeka, mwamsanga kujambula ndi endoscopic diagnostics ikuchitika, mwamsanga kufufuza kwa pathomorphological ndi kuyezetsa koyenera kwa maselo kumachitika, mwamsanga tingathe kupereka chithandizo choyenera kwa wodwalayo. Osati suboptimal, basi mulingo woyenera. Kutengera siteji ya khansara, titha kupeza chithandizo, monga momwe zilili ndi gawo la I-IIIA, kapena khansa ya m'mapapo yodziwika bwino. Pankhani ya kupita patsogolo kwanuko, titha kugwiritsa ntchito chithandizo cham'deralo chophatikizidwa ndi chithandizo chamankhwala, monga radiochemotherapy, chowonjezera bwino ndi immunotherapy, kapena pomaliza chithandizo chamankhwala choperekedwa kwa odwala omwe ali ndi khansa ya m'mapapo yodziwika bwino, apa chiyembekezo ndi njira zatsopano zochizira, mwachitsanzo, zomwe zimayang'aniridwa ndi maselo. kapena immunocompetent mankhwala. Katswiri wa zachipatala, radiotherapist, dokotala wa opaleshoni ayenera kutenga nawo mbali mu gulu la akatswiri amitundu yosiyanasiyana - mu zotupa za thoracic ndi opaleshoni ya thoracic - nthawi zambiri komanso pulmonologist ndi katswiri wa zojambulajambula, mwachitsanzo radiologist - akufotokoza Prof. Dr hab. n. med. Dariusz M. Kowalski wochokera ku Dipatimenti ya Lung ndi Khansa ya Thoracic ya National Institute of Oncology-National Research Institute ku Warsaw, pulezidenti wa Polish Lung Cancer Group.

Prof. Chorostowska-Wynimko akukumbutsa kuti odwala khansa ya m'mapapo ambiri amakhala ndi matenda opuma. -Sindingathe kulingalira momwe chisankho chothandizira chithandizo chabwino cha oncological cha wodwala woterecho chimapangidwa popanda kuganizira za matenda a m'mapapo. Izi ndichifukwa choti tidzayenerera kulandira chithandizo cha opaleshoni wodwala yemwe ali ndi mapapu athanzi kupatula khansa, komanso wodwala matenda opumira, monga pulmonary fibrosis kapena matenda osachiritsika a pulmonary (COPD). Chonde kumbukirani kuti zonsezi ndizomwe zimayambitsa khansa ya m'mapapo. Tsopano, m'zaka za mliri, tidzakhala ndi odwala ambiri omwe ali ndi vuto la m'mapapo la COVID-19 - akutero Prof. Chorostowska-Wynimko.

Akatswiri akugogomezera kufunika kwa diagnostics zabwino, mabuku ndi wathunthu. - Popeza nthawi ndi yofunika kwambiri, matenda ayenera kuchitidwa moyenera komanso mogwira mtima, mwachitsanzo, m'malo abwino omwe angathe kuchita bwino pofufuza matenda ang'onoang'ono komanso ovuta, kuphatikizapo kusonkhanitsa kuchuluka kwa zinthu zabwino za biopsy kuti ayesedwenso, mosasamala kanthu za njira yomwe imagwiritsidwa ntchito. Malo oterowo ayenera kulumikizidwa bwino ndi malo abwino owunikira matenda a pathomorphological ndi ma cell. Zinthu zofufuzira ziyenera kutetezedwa bwino ndikutumizidwa nthawi yomweyo, zomwe zimalola kuwunika bwino kwa matenda a pathomorphological, ndiyeno mawonekedwe amtundu. Moyenera, malo opangira matenda akuyenera kuwonetsetsa kuti zidziwitso za biomarker zimagwira ntchito munthawi yomweyo - akukhulupirira Prof. Chorostowska-Wynimko.

Kodi ntchito ya pathologist ndi yotani

Popanda kufufuza kwa pathomorphological kapena cytological, mwachitsanzo, kuzindikira kukhalapo kwa maselo a khansa, wodwalayo sangathe kulandira chithandizo chilichonse. - Katswiri wa zachipatala ayenera kusiyanitsa ngati tikulimbana ndi khansa ya m'mapapo yopanda maselo (NSCLC) kapena khansa yaing'ono (DRP), chifukwa kasamalidwe ka odwala amadalira. Ngati zikudziwika kale kuti iyi ndi NSCLC, dokotalayo ayenera kudziwa kuti subtype ndi chiyani - glandular, cell yayikulu, squamous kapena ina iliyonse, chifukwa ndikofunikira kwambiri kuyitanitsa mayeso angapo a ma cell, makamaka mu mtundu wa non. -khansa ya squamous, kuti ayenerere kulandira chithandizo cha maselo - amakumbutsa Prof. Kowalski.

Panthawi imodzimodziyo, kutumizidwa kwa zinthuzo kwa katswiri wa zachipatala kuyenera kutumizidwa ku matenda athunthu a maselo omwe amaphimba zizindikiro zonse zomwe zasonyezedwa ndi pulogalamu ya mankhwala, zomwe zotsatira zake zimafunika kusankha chithandizo choyenera cha wodwalayo. - Zimachitika kuti wodwalayo amangotumizidwa ku mayeso ena a maselo. Khalidweli siliyenera. Diagnostics anachita motere nthawi zambiri zimapangitsa kuti athe kusankha momwe angachitire bwino wodwalayo. Pali nthawi zina pomwe magawo a maselo amthupi amapangidwa m'malo osiyanasiyana. Zotsatira zake, minofu kapena zinthu za cytological zikuzungulira ku Poland, ndipo nthawi ikupita. Odwala alibe nthawi, sayenera kudikirira - ma alarm prof. Chorostowska-Wynimko.

- Pakalipano, chithandizo chamakono, chosankhidwa bwino, chimalola wodwala khansa ya m'mapapo kukhala matenda aakulu ndi kumupereka osati miyezi ingapo ya moyo, koma ngakhale zaka zingapo - akuwonjezera Prof. Kowalski.

1. Yang'anani chiopsezo chanu chokhala ndi khansa. Dziyeseni nokha! Gulani kafukufuku wa amayi ndi abambo

Kodi odwala onse ayenera kuwazindikira?

Sikuti wodwala aliyense ayenera kuyezetsa thupi lonse. Zimatsimikiziridwa ndi mtundu wa khansara. - Mu carcinoma yosakhala ya squamous, makamaka adenocarcinoma, odwala onse oyenerera kulandira chithandizo chamankhwala ayenera kuyesedwa kwathunthu, chifukwa mumkhalidwe woterewu (EGFR mutations, ROS1 ndi ALK gene rearrangements) imapezeka nthawi zambiri kusiyana ndi mitundu ina ya khansa ya m'mapapo. . Kumbali inayi, kuyesa kwa ligand kwa mtundu wa 1 wovomerezeka wa imfa, PD-L1, ayenera kuchitidwa pazochitika zonse za NSCLC - akutero Prof. Kowalski.

Chemoimmunotherapy ndi yabwino kuposa chemotherapy yokha

Kumayambiriro kwa 2021, odwala omwe ali ndi ma subtypes onse a NSCLC adapatsidwa mwayi wolandila chithandizo chamankhwala osakwanira, mosasamala kanthu za kuchuluka kwa mapuloteni a PD-L1. Pembrolizumab itha kugwiritsidwa ntchito ngakhale mawu a PD-L1 ali <50%. - Zikatero, kuphatikiza mankhwala amphamvu ndi ntchito platinamu mankhwala ndi m`badwo wachitatu cytostatic mankhwala osankhidwa malinga ndi subtype khansa.

- Njira yotereyi ndiyabwino kuposa chithandizo chamankhwala chodziyimira pawokha - kusiyana kwa kutalika kwa moyo kumafika ngakhale miyezi 12 mokomera chemoimmunotherapy - akutero prof. Kowalski. Izi zikutanthauza kuti odwala omwe amathandizidwa ndi mankhwala ophatikiza amakhala pafupifupi miyezi 22, ndipo odwala omwe amalandira chithandizo chamankhwala okha kwa miyezi 10 yokha. Pali odwala omwe, chifukwa cha chemoimmunotherapy, amakhala zaka zingapo atagwiritsidwa ntchito.

Chithandizo choterocho chimapezeka pamzere woyamba wa chithandizo pamene opaleshoni ndi chemoradiotherapy sizingagwiritsidwe ntchito kwa odwala omwe ali ndi matenda apamwamba, mwachitsanzo, metastases yakutali. Mikhalidwe yatsatanetsatane yaikidwa mu Drug Programme ya Unduna wa Zaumoyo pochiza khansa ya m'mapapo (pulogalamu B.6). Malinga ndi kuyerekezera, 25-35 peresenti ndi ofuna chemotherapy. odwala omwe ali ndi siteji IV NSCLC.

Chifukwa cha kuwonjezera kwa mankhwala osokoneza bongo ku chemotherapy, odwala amayankha bwino kwambiri pochiza khansa kusiyana ndi anthu omwe amangolandira mankhwala a chemotherapy. Chofunika kwambiri, pambuyo pa kutha kwa chemotherapy, immunotherapy monga kupitiriza kwa mankhwala osakaniza amagwiritsidwa ntchito pachipatala. Izi zikutanthauza kuti wodwalayo safunikira kugonekedwa m’chipatala nthawi iliyonse akalandira. Izo ndithudi zimasintha khalidwe lake la moyo.

Nkhaniyi idapangidwa ngati gawo la kampeni ya "Longer Life with Cancer", yomwe idakhazikitsidwa ndi portal www.pacjentilekarz.pl.

Izi zingakusangalatseni:

1. Poizoni ngati asibesitosi. Kodi mungadye bwanji kuti musadzivulaze?
2. Matenda a khansa akukula. Chiwerengero cha omwalirawo chikukulanso ku Poland
3. Matenda otere ndi odabwitsa. Kodi ndiyenera kudziwa chiyani za khansa ya m'mapapo?

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