Yadda za a hana sake kamuwa da cutar kansa ta bayan-gida, yaya za a magance sake kamuwa da cutar kansa bayan tiyata?
Colorectal cancer is a common malignant tumor, including colon cancer and rectal cancer. The incidence of colorectal cancer from high to low is rectum, sigmoid colon, ascending colon, descending colon and transverse colon. In recent years, there is a trend toward the proximal end (right colon). If maganin ciwon daji is detected early, it can usually be cured.
Adadin rayuwa na shekaru 5 na ciwon sankarau
Dangane da bayanan gidan yanar gizo na ASCO na Amurka, adadin rayuwar shekaru 5 na masu fama da cutar sankarau ya kai 65%. Koyaya, ƙimar rayuwar kansar kai tsaye na iya bambanta dangane da dalilai da yawa, musamman ma matakin.
Ma ciwon daji, the overall 5-year survival rate is 64%. The 5-year survival rate for limited-stage colon cancer is 90%; the 5-year survival rate is 71% for metastasis to surrounding tissues or organs and / or regional lymph nodes; the 5-year survival rate is 14% if colon cancer has metastasized distant .
Don ciwon daji na dubura, yawan rayuwar shekaru 5 shine 67%. Adadin rayuwa na shekaru 5 na iyakantaccen matakin kansar dubura shine 89%; ƙimar rayuwa ta shekaru 5 na metastasis zuwa ƙwayoyin da ke kewaye ko gabobi da / ko ƙugiyoyin lymph na yanki shine 70%. Idan akwai wata cuta mai nisa ta kansar dubura, adadin rai na shekaru 5 shine 15%.
Currently, treatments for colorectal cancer include surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy. Yin aikin tiyata ita ce hanyar da aka fi so don kawar da cutar kansa. Amma Vicki, editan gidan da ba shi da cutar kansa, ya koyi cewa kimanin kashi 60% zuwa 80% na marasa lafiya da ke fama da ciwon sankarar dubura za su sake dawowa cikin shekaru 2 bayan tiyatar.
Ta yaya za a iya hana sake faruwar cutar kansa?
Inganta rayuwa
Don barin shan giya, barin shan giya, daina shan giya, faɗi mahimman abubuwa sau uku, dole ne ka daina sha. Bugu da kari, kar a sha taba, kar a yi aiki da yawa, kuma a kiyaye yanayin farin ciki.
Ayyukan da ya dace, watanni 2-3 bayan tiyata, za ku iya yin motsa jiki mai laushi, irin su tafiya, karuwa a hankali daga minti 15 zuwa minti 40; Hakanan zaka iya yin qigong, Tai Chi, gymnastics na rediyo da sauran motsa jiki masu laushi.
Kula da abinci sosai, kada ku ci abinci mai laushi, barbecue, naman alade, tofu, abinci mai sinadarin nitrite, kuma kada ku ci magungunan kasar Sin da kayayyakin kiwon lafiya.
Abincin bayan an gama aiki yafi haske, kuma yawan cin protein mai inganci, kamar su farin kwai da nama maras nauyi, ana haɓaka yadda ya kamata. Abincin bayan gida gabaɗaya sauyawa ne daga ruwa, alawa, madara, ƙwai da aka dafa, kifi, nama mai laushi zuwa abincin yau da kullun.
Ku ci abinci mai narkewa gwargwadon iko, ku guji maƙarƙashiya, mai yaji, mai tayar da hankali, mai tsananin wuya, makalewa da sauran abinci, ku ci abinci mai kyau, ku rage cin abinci kadan kuma kada ku ci da yawa a kowane abinci.
Yin amfani da goro a kai a kai kamar cashews, hazelnuts, gyada, almonds, da gyada na iya rage yawan kamuwa da cutar kansar hanji.
Nasihun kula da jinya na bayan gida don ciwan kansa
An kammala cire dinki 7-10 kwanaki bayan tiyatar kansa. Tsoffin marasa lafiya ko marasa lafiya da wasu rikitarwa na iya tsawaita lokaci don cire zaren. Bayan cire zaren, kula da tsabtar raunin don gujewa kamuwa da cuta.
Bayan an cire dinkunan, ya zama dole a ci gaba da rufe sutura da kuma matse duwawun ciki yayin warkar da rauni har sai da aikin tiyatar ya warke gaba daya, wanda ke daukar rabin wata.
Akalla kwanaki 10 bayan aikin, ana iya cire mai daga fata, kuma ya kamata a kiyaye rauni a bushe kamar yadda ya kamata don rage gumi. Kuna iya yin wanka, amma ba shafa rauni ba.
Yana da kyau a ji rauni a jikin raunin bayan aikin, kuma zai ɓace bayan ɗan lokaci.
Yana da kyau idan rauni ya yi taho, kuma za a iya kashe kwayoyin kadan daga wani abu, kuma za a iya canza ado a saman. Koyaya, idan adadin fitarwa yana da girma kuma mai tsananin ja da kumburi suna faruwa, ya kamata a tuntuɓi likita a kan lokaci don maganin rauni.
Lokacin da tiyatar tiyatar ke gab da girma, zai ji ƙaiƙayi, wanda aka fi sani da “dogon nama”. A wannan lokacin, guji yin ƙwanƙwasa, ruwa, da kamuwa da cuta.
Raunin bai warke ba bayan lokacin warkarwa. Kuna buƙatar neman ƙwararren likita don magance shi, canza sutura a cikin lokaci, tsabtace rauni, da kula da kamuwa da cuta, kuma ku mai da hankali ga sarrafa sukarin jini da ƙarfafa abinci mai gina jiki.
Raunin farji yawanci yakan ɗauki wata ɗaya don ya warke. Bayan warkarwa, zaku iya motsa jiki a hankali motsa jiki, mintuna 3-5 kowane lokaci, sau ɗaya safe da rana.
Idan raunin ya warke da kyau, zaka iya yin wanka kwanaki 7-14 bayan an cire dinkunan. Zaka iya amfani da gel ko sabulu, amma ka guji rauni.
Yin bita akai-akai
Dangane da kididdiga, yawan sake dawowa da kuma saurin kamuwa da cutar sankarau a kasar Sin ya kai 50%, kuma sama da kashi 90% na sake dawowa da yaduwar cutar na faruwa ne a cikin shekaru 2-3 bayan aikin tiyata, kuma yawan sake dawowa ya ragu bayan shekaru 5. Sabili da haka, aikin ba sau ɗaya ba ne, kuma dole ne mu dage kan yin nazari na yau da kullun bayan aikin.
Mai yiwuwa masu cutar kansar hanji su sake dawowa cikin shekaru 3 bayan tiyata. A wannan lokacin, yawan sake duba marasa lafiya ya zama yana da yawa; bayan shekaru 3, za a iya sake tsawan lokacin sake jarrabawa yadda ya kamata.
Gabaɗaya, sake duba kowane watanni 3 tsakanin shekara 1 bayan aiki; sake duba kowace rabin shekara a cikin shekaru 2-3 na biyu; duba shi sau ɗaya a shekara a cikin shekaru 4-5. Hakanan takamaiman lokacin bita yana buƙatar nemo likitanka don tantancewa Yayin nazarin, abubuwan da za'a bincika sun haɗa da,
Blood gwaje-gwaje: blood routine, liver and kidney function, tumo markers (CEA, etc.);
Gwajin hoto: ciki duban duban dan tayi, kirji radiograph
Binciken ciki: 3 watanni bayan tiyata don ƙayyade warkar da anastomosis kuma kiyaye polyps a wasu sassa
Yaya za'a magance sake kamuwa da cutar kansa bayan aiki?
Tiyata ta biyu
Hanya mafi dacewa ga marasa lafiya da ke fama da cutar sankarar launi don sake dawowa shine cire raunin da ke faruwa don cimma burin warkarwa. Da farko dai, ya danganta ne da ko za a iya yin aikin tiyata na biyu. Idan ya cika ka'idojin tiyata, za a iya cire ciwon cikin tiyata.
Idan akwai raunuka da yawa, yankin mamayewa yana da girma babba, ko kuma metastasis yana da nisa, idan sake aiki yana da haɗari, ana iya zaɓar wasu hanyoyin magani yayin da ba a tabbatar da fa'idar tiyata ba.
magani
Ciwon kansar kansar hanji
Magungunan chemotherapeutic na yau da kullun sune 5-fluorouracil, irinotecan, oxaliplatin, calcium folinate, capecitabine, tigeol (S-1), TAS-102 (trifluridine / tipiracil).
Koyaya, kansar sankara ta hanji yawanci haɗuwa ce da magungunan ƙwayoyi masu yawa. Haɗuwa gama gari sune:
1.FOLFOX (fluorouracil, folinate calcium, oxaliplatin)
2. FOLFIRI (fluorouracil, calcium folinate, irinotecan)
3.CAPEOX (Capecitabine, Oxaliplatin)
4. FOLFOXIRI (fluorouracil, calcium folinate, irinotecan, oxaliplatin)
Magungunan da aka yi niyya akan kansar hanji da magungunan rigakafi
1. KRAS / NRAS / BRAF nau'ikan ƙwayoyi masu niyya: cetuximab ko panitumumab (yawanci ana amfani da shi don cutar kansa ta hagu)
2. Masu hana anti-angiogenesis: bevacizumab ko ramucirumab ko ziv abercept
3. BRAF V600E magungunan da aka yi niyya: dabrafenib + trametinib; connetinib + bimetinib
4. Fusion na NTRK da aka yi niyya: Larotinib; Entratinib
5.MSI-H (dMMR) PD-1: pembrolizumab; nivolumab ± ipilimumab
6. HER2-tabbatacce magani niyya: trastuzumab + (pertuzumab ko lapatinib)
Bugu da ƙari ga tiyata da kuma maganin rediyo, babban ciwon sankara babban fage ne na ba da magani. Lissafin layi na farko yana nufin matakin farko na magani tare da maganin ƙwayar cuta
magungunan ciwon daji, wanda kuma ake kira maganin farko. Akwai zaɓuɓɓuka da yawa don maganin layin farko na ci-gaba da ciwon hanji, yawanci bisa chemotherapy.
Koyaya, ya zama dole a rarrabe yanayin mai haƙuri da yanayin jikinsa. Bayan jerin gwaje-gwaje, ana iya raba marasa lafiya zuwa nau'i biyu na marasa lafiya waɗanda suka dace da magani mai ƙarfi kuma basu dace da magani mai ƙarfi ba.
Zaɓin magani wanda ya dace da marasa lafiya tare da magani mai ƙarfi
Ya kasu kashi uku:
Maganin farko-layi tare da oxaliplatin
Maganin farko-layi tare da irinotecan
(1) Maganin farko-wanda yake dauke da sinadarin oxaliplatin
FOLFOX ± bevacizumab
CAPOX ± bevacizumab
FOLFOX + (cetuximab ko panitumumab) (kawai don KRAS / NRAS / BRAF irin-daji na hagu na hagu)
(2) Tsarin layi na farko tare da irinotecan
FOLFIRI ± bevacizumab ko
FOLFIRI + (cetuximab ko panitumumab) (kawai don KRAS / NRAS / BRAF irin-daji na hagu na hagu)
(3) Magani na farko wanda ya ƙunshi oxaliplatin + irinotecan
FOLFOXIRI ± bevacizumab
Zaɓin magunguna ba dace da magani mai ƙarfi ba
Zaɓuɓɓukan shan magani na farko
1. Jiko na 5-fluorouracil + calcium folinate ± bevacizumab ko
2. Capecitabine + Bevacizumab
3. Cetuximab ko panitumumab (Shaida ta 2B, ana iya amfani da ita ga KRAS / NRAS / BRAF daji mai nau'in hagu na hagu)
4. Nivolumab ko pembrolizumab (kawai don dMMR / MSI-H)
5. Nivolumab + Ipilimumab (Shaida ta 2B, wanda ya dace da dMMR / MSI-H)
6. Trastuzumab + (Pertuzumab ko Lapatinib) (Ya dace da haɓakar HER2 da ƙwayar RAS na daji)
1) Bayan maganin da ke sama, babu ci gaba a yanayin aiki, zaɓi mafi kyawun maganin tallafi (kulawar kwantar da hankali);
2) Bayan jiyya na sama, yanayin aiki ya inganta, kuma ana iya yin la'akari da shirin farko mai ƙarfi.
Zaɓin magani na ƙarshe
Regfini
Trifluorothymidine + tipiracil
Mafi kyawun tallafi (kulawar kwantar da hankali)
