Kanza yemaperembudzi

Chii chinonzi Cancer yemapapu?

Gomarara remapapu imhando yegomarara rinotangira mumapapu. Kenza yemapapu inotanga mumapapu uye inogona kupararira kune lymph nodes kana dzimwe nhengo dziri mumuviri, dzakadai seuropi. Gomarara rinobva kune dzimwe nhengo zvakare rinogona kupararira kumapapu. Kana masero ekenza akapararira kubva kune imwe nhengo kuenda kune imwe, anonzi metastases.

Masero ese ari mumuviri ane magene anonzi deoxyribonucleic acid (DNA). Nguva yega yega sero rakura parinopatsanuka kuita maseru maviri matsva, DNA yaro inoteedzerwa chaizvo. Iwo maseru makopi esero rekutanga, akafanana munzira dzese. Neiyi nzira, miviri yedu inoramba ichizadza yega. Masero ekare anofa uye chizvarwa chinotevera chinotsiva.

Kenza inotanga nekanganiso, kana shanduko, muDNA rechitokisi. Shanduko dzeDNA dzinogona kukonzerwa neyakajairika nzira yekukwegura kana kuburikidza nezvinhu zvakatipoteredza, senge utsi hwefodya, kufema muasbestos fibers, uye kuratidzwa kune radon gasi.

Researchers have found that it takes a series of mutations to create a lung cancer cell. Before becoming fully cancerous, cells can be precancerous, in that they have some mutations but still function normally as lung cells. When a cell with a genetic mutation divides, it passes along its abnormal genes to the two new cells, which then divide into four cells with errors in their DNA and so on. With each new mutation, the lung tissue cell becomes more mutated and may not be as effective in carrying out its function as a lung cell. At a later stage of disease, some cells may travel away from the original tumarara and start growing in other parts of the body. This process is called metastasis and the new distant sites are referred to as metastases.

Chekutanga Kupesana Sekondari Lung Cancer

Primary lung cancer starts in the lungs. The cancer cells are abnormal lung cells. Sometimes, people will have cancer travel from another part of their body or metastasize to their lungs. This is called secondary lung cancer because the lungs are a secondary site compared to the original primary location of the cancer. So, for example, kenza yebonde cells which have traveled to the lung are not lung cancer but rather metastatic breast cancer and will require treatment prescribed for breast cancer rather than lung cancer.

Njodzi zvinhu zvekenza yemapapu

Chinhu chengozi chinhu chero chinowedzera mukana wemunhu wekutora chirwere senge kenza Kenza dzakasiyana dzine njodzi dzakasiyana. Zvimwe zvinhu zvine njodzi, sekusvuta, zvinogona kuchinjwa. Vamwe, sezera remunhu kana nhoroondo yemhuri, haigone kuchinjwa.

Asi kuve nenjodzi, kana kunyangwe akati wandei, hazvireve kuti uchawana chirwere. Uye vamwe vanhu vanowana chirwere vanogona kunge vaine mashoma kana asina kuzivikanwa ngozi zvinhu.

Zvinhu zvinoverengeka zvine njodzi zvinogona kuita kuti iwe uwedzere kuve nekenza yemapapu. Izvi zvinhu zvine hukama nenjodzi yekenza yemapapu kazhinji. Zvinogoneka kuti zvimwe zveizvi zvinogona kusashanda kune diki kenza yemapapu kenza (SCLC).

Zvinhu zvine njodzi iwe zvaunogona kuchinja

Fodya utsi

Kusvuta ndiko kwakanyanya kukonzera njodzi yekenza yemapapu. Inenge makumi masere muzana muzana yemakenza emapapu kufa anofungidzirwa kuti anobva mukusvuta uye iyi nhamba ingangodaro yakatokura kune diki kenza yemapapu kenza (SCLC). Izvo zvisingawanzoitika kune mumwe munhu asina kumbobvira aputa kuti ave neSCLC.

Ngozi yemukenza wemapapu kune vanosvuta yakawandisa zvakapetwa pane vasingaputi. Kana iwe uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uhu huya hwacho, hunowedzerawo njodzi yako.

Cigar kusvuta uye pombi kuputa zvinoita kunge zvingangoita kukonzera kenza yemapapu sekusvuta fodya. Kusvuta fodya yakadzika-tara kana "yakajeka" fodya inowedzera njodzi yekenza yemapapu zvakanyanya senge yakajairwa midzanga. Kusvuta midzanga yefodya kunogona kuwedzera njodzi zvakanyanya nekuti iyo menthol inogona kubvumira vanosvuta kuti vape mweya zvakanyanya.

Utsi hwefodya

Ukasasvuta, kufema muutsi hwevamwe (hunonzi hutsi hwechipiri kana hweutsi hwefodya yezvakatipoteredza) kunogona kuwedzera njodzi yako yekuva nekenza yemapapu. Utsi hwefodya hunofungidzirwa kuti hunokonzera kufa kwevanhu vanopfuura zviuru zvitanhatu pagomarara remapapu gore rega rega.

Kuratidzira kune radon

Radoni inowanzoitika giradioactive gasi inoguma nekuparara kweuranium muvhu nematombo. Iwe haugone kuona, kuravira, kana kunhuwidza. Sekureva kweUS Environmental Protection Agency (EPA), radon ndiyo yechipiri inokonzeresa kenza yemapapu munyika ino, uye ndiyo inonyanya kukonzera vanhu vasingasvuti.

Kunze, kune radon shoma zvekuti haigone kuve nenjodzi. Asi mukati, radon inogona kuve yakanyanya kusimbiswa. Kuifuridzira kunoisa pachena mapapu ako kune mashoma emwaranzi. Izvi zvinogona kuwedzera njodzi yemunhu yekenza yemapapu.

Dzimba nezvimwe zvivakwa munenge chero chikamu cheUnited States chinogona kuve nemazinga epamusoro emadhoni emumba (kunyanya mudzimba dzepasi).

Kuratidzwa kune asbestosi

Vanhu vanoshanda neasbestosi (senge mumigodhi, zvigayo, micheka yemachira, nzvimbo dzinoshandiswa kuputira, uye nzvimbo dzekutakura ngarava) vane mikana yakawanda yekufa nekenza yemapapu. Njodzi yekenza yemaperembudzi yakanyanya kukura kune vashandi vanoratidzwa kune asbestos vanosvutawo. Hazvizivikanwe kuti yakadzika sei-yakadzika kana pfupi-pfupi kuratidzwa kune asbestos kunogona kukwidza njodzi yemukenza yemapapu.

People exposed to large amounts of asbestos also have a greater risk of developing mesothelioma, a type of cancer that starts in the pleura (the lining surrounding the lungs). For more on this type of cancer, see Malignant Mesothelioma.

Mumakore achangopfuura, zvirevo zvehurumende zvakadzora zvakanyanya kushandiswa kweasbestos muzvigadzirwa nekutengesa. Ichiripo mudzimba zhinji uye zvimwe zvivakwa zvekare, asi hazviwanzo kunzi zvinokuvadza chero bedzi zvisina kuburitswa mumhepo nekukanganisa, kupaza, kana kugadzirisa. Kuti uwane rumwe ruzivo, ona Asbestos uye Njodzi yeCancer.

Kuratidzirwa kune vamwe vanokonzera kenza munzvimbo yebasa

Zvimwe zvinokonzeresa (zvinokonzeresa zvegomarara) zvinowanikwa mune dzimwe nzvimbo dzebasa dzinogona kuwedzera njodzi yekenza yemapapu dzinosanganisira:

• Radioactive ores senge uranium
• Inhaled makemikari akadai arsenic, beryllium, cadmium, silica, vinyl chloride, nickel makomponi, chromium makomputa, marasha zvigadzirwa, masardard gasi, uye chloromethyl ethers
• Diesel pedza

Hurumende nemaindasitiri vatora matanho mumakore achangopfuura ekubatsira kuchengetedza vashandi kubva kuzhinji kwekufumurwa uku. Asi njodzi dzichiripo, saka kana iwe ukashanda uchitenderedza vamiririri ava, chenjera kudzikisira kuratidzwa kwako pazvinogoneka.

Kutora zvimwe zvekudya zvinowedzera

Zvidzidzo zvichitarisa chinokwanisika chikamu chevhitamini chinowedzera mukuderedza kenza yemapapu njodzi yakave nemhedzisiro inoodza mwoyo. Muchokwadi, zvidzidzo zviviri zvakakura zvakawana kuti vaputi vakatora beta carotene zvinowedzera chaizvo vaive nenjodzi yakawedzera yekenza yemapapu. Mhedzisiro yezvidzidzo izvi inoratidza kuti vaputi havafanirwe kutora beta carotene zvinowedzera.

Arsenic mumvura yekunwa

Zvidzidzo zvevanhu muzvikamu zveSoutheast Asia neSouth America vane yakakwira arsenic mumvura yavo yekunwa vakawana njodzi yakanyanya yekenza yemapapu. Mune mazhinji ezvidzidzo izvi, iwo mazinga earsenic mumvura aive akawandisa zvakapetwa pane izvo zvinowanzoonekwa muUnited States, kunyangwe nzvimbo dzine arsenic dzakakwirira kupfuura zvakajairwa. Kune vazhinji maAmerican ari paruzhinji masystem emvura, yekumwa mvura haisi iyo hombe sosi ye arsenic.

Njodzi zvinhu zvausingakwanise kuchinja

Yapfuura radiation kurapwa kumapapu

Vanhu vakamborapwa neradiation pachipfuva kune mamwe cancer vari panjodzi huru yekenza yemapapu, kunyanya kana vakaputa. Mienzaniso inosanganisira vanhu vakarapwa chirwere cheHodgkin kana vakadzi vanowana mwaranzi yemuchipfuva mushure mekuvhiyiwa gomarara rezamu. Vakadzi vane radiation kurapwa kuzamu mushure me lumpectomy havaratidzike kunge vane njodzi yakakwira kupfuura inotarisirwa yekenza yemapapu.

Kusvibiswa kwemhepo

Mumaguta, kusvibiswa kwemhepo (kunyanya padhuze nemigwagwa inotengeswa zvakanyanya) zvinoita kunge kunosimudza njodzi yekenza yemapapu zvishoma. Iyi njodzi ishoma kwazvo kupfuura njodzi inokonzerwa nekusvuta, asi vamwe vaongorori vanofungidzira kuti pasirese zvikamu zvishanu kubva muzana zverufu rwegomarara remapapu zvinogona kunge zvichikonzerwa nekushatiswa kwemweya kwekunze.

Yega kana yemhuri nhoroondo yekenza yemapapu

Kana iwe uine kenza yemapapu, iwe une mukana wakakura wekuvandudza imwe kenza yemapapu.

Vakoma, hanzvadzi, uye vana vevanhu vane kenza yemapapu vanogona kuve nenjodzi yakati pfuurei yekenza yemapapu pachavo, kunyanya kana hama iyi yakaonekwa ichiri diki. Hazvizivikanwe kuti yakawanda sei njodzi iyi inogona kunge iri nekuda kwemajene akagovaniswa pakati penhengo dzemhuri uye kuti ingani kubva kune yakagovaniswa mhuri kufumurwa (senge utsi hwefodya kana radon).

Vatsvakurudzi vakaona kuti genetics inoita kunge inotamba chinzvimbo mune dzimwe mhuri dzine nhoroondo yakasimba yekenza yemapapu.

Zviitiko zvine isina chokwadi kana zvisina kuvharwa mhedzisiro panjodzi yekenza yemapapu

Kusvuta mbanje

Pane zvikonzero zvekufunga kuputa mbanje zvinogona kuwedzera njodzi yemukenza yemapapu.

• Utsi hwembanje hune tara uye zvakawanda zvakafanana zvinhu zvinokonzeresa zvegomarara zviri muutsi hwefodya. (Tar ndiyo inonamira, yakasimba zvinhu zvinosara mushure mekutsva, izvo zvinofungidzirwa kuti zvine zvakawanda zvezvinhu zvinokuvadza muutsi.)
• Midzanga yefodya (majoini) anowanzo puta nzira yese kusvika kumagumo, uko tara yezvakanyanya kukwirisa.
• Mbanje inofemerwa zvakanyanya uye hutsi hunobatwa mumapapu kwenguva yakareba, izvo zvinopa chero chinhu chinokonzera gomarara mukana wekuisa mumapapu.
• Nekuti mbanje ichiri kusiri pamutemo munzvimbo zhinji, zvinogona kutadza kudzora zvimwe zvinhu zvayingave iine.

Vaya vanoshandisa mbanje vanowanzo puta fodya mbanje shoma pazuva kana muvhiki kupfuura huwandu hwefodya inopedzwa nevanhu vanosvuta midzanga. Iyo shoma shoma inopfungaira yaizoita kuti zvive zvakaoma kuona kukanganisa kwecancer yemapapu ngozi.

Zvave zvakaoma kudzidza kana paine hukama pakati pembanje uye gomarara remapapu nekuti mbanje yanga isiri pamutemo munzvimbo zhinji kwenguva yakareba, uye hazvisi nyore kuunganidza ruzivo nezve kushandiswa kwemishonga isiri pamutemo. Zvakare, muzvidzidzo zvakatarisa zvakapfuura kushandiswa kwembanje muvanhu vaive nekenza yemapapu, vazhinji vevaputi vembanje vakaputawo midzanga. Izvi zvinogona kuita kuti zviome kuti uzive kuti yakawanda sei njodzi yakawedzera kubva mufodya uye kuti ingangodaro sei kubva kumbanje. Dzimwe tsvagurudzo dzinodiwa kuti uzive njodzi dzekenza kubva kuputa mbanje.

E-midzanga

E-midzanga rudzi rwemagetsi nicotine kuendesa system. Izvo hazvina chero fodya asi iyo Chikafu neDrug Administration (FDA) inozvisarudzira se "fodya" zvigadzirwa. E-midzanga iri nyowani nyowani uye kumwe kutsvagurudza kunodiwa kuti uzive kuti ndeipi mhedzisiro-yenguva mhedzisiro inogona kunge iri, kusanganisira njodzi yekuva nekenza yemapapu.

Talc uye talcum upfu

Talc ndeyemamineral ayo mune ayo echisimba fomu anogona kunge aine asbestos. Zvimwe zvidzidzo zvakaratidza kuti vashandi vetalc uye vanhu vanoshandisa zvigayo zvetalc vanogona kuve nenjodzi yakakwira yekenza yemapapu uye zvimwe zvirwere zvekufema nekuda kwekuratidzwa kwavo kumabhizimusi egiredhi talc. Asi zvimwe zvidzidzo hazvina kuwana kuwedzera kwecancer cancer.

Talcum poda inogadzirwa kubva kune talc. Iko kushandiswa kweye cosmetic talcum poda haina kuwanikwa kuti iwedzere njodzi yemukenza yemapapu.

Mhando dzekenza yemapapu

Kune maviri makuru marudzi ekenza yemapapu uye anorapwa zvakasiyana zvakasiyana.

Isiri-diki kenza yemapapu kenza (NSCLC)

About 80% to 85% of lung cancers are NSCLC. The main subtypes of NSCLC are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. These subtypes, which start from different types of lung cells are grouped together as NSCLC because their treatment and prognoses (outlook) are often similar.

Adenocarcinoma: Adenocarcinomas inotanga mumasero ayo anowanzo buritsa zvinhu zvakaita semamus.

Rudzi rwekenza yemapapu inoitika kunyanya mune vezvino kana vekare vanoputa, asi iri zvakare rudzi rwevazhinji rwegomarara remapapu rinoonekwa mune vasingaputi. Izvo zvinowanzoitika kune vakadzi kupfuura varume, uye zvinowanzoitika kune vechidiki kupfuura mamwe marudzi ekenza yemapapu.

Adenocarcinoma inowanzo kuwanikwa munzvimbo dzekunze dzemapapu uye inowanzo kuwanikwa isati yapararira.

People with a type of adenocarcinoma called adenocarcinoma in situ (previously called bronchioloalveolar carcinoma) tend to have a better outlook than those with other types of lung cancer.

Squamous cell carcinoma: Squamous cell carcinomas inotanga mumaseru ane squamous, ayo ari maseru akatsetseka anoteedzera mukati memafambiro emhepo mumapapu. Ivo vanowanzo kuve vanobatanidzwa kune nhoroondo yekusvuta uye vanowanzo kuwanikwa mukati epakati chikamu chemapapu, padhuze neiyo huru nzira yemhepo (bronchus).

Makuru masero (asina kukamurwa) carcinoma: Makuru maseru carcinoma anogona kuoneka mune chero chikamu chemapapu. Iyo inowanzo kukura uye kupararira nekukurumidza, izvo zvinogona kuita kuti zvive zvakaoma kurapa. Chidimbu cheesero hombe carcinoma, inozivikanwa seyakakura sero neuroendocrine carcinoma, kenza inokura nekukurumidza iyo yakafanana zvikuru nekenza diki yemukenza yemapapu.

Mamwe madiki madiki: Mamwe mashoma madiki eNSCLC, akadai seadenosquamous carcinoma uye sarcomatoid carcinoma, haana kujairika.

Diki kenza yemapapu kenza (SCLC)

Inenge gumi kubva muzana kusvika gumi muzana muzana yekenza dzese dzemapapu iSCLC uye dzimwe nguva inonzi oat cell cancer.

Rudzi urwu rwegomarara remapapu rinowanzokura nekupararira nekukurumidza kupfuura NSCLC. Inenge 70% yevanhu vane SCLC vachave negomarara rakatopararira panguva yavanenge vaonekwa. Sezvo gomarara iri richikura nekukurumidza, rinowanzopindura zvakanaka kuchemotherapy uye neradiation therapy. Zvinosuruvarisa, kune vanhu vazhinji, kenza ichadzoka pane imwe nguva.

Mamwe marudzi emapundu emapapu

Pamwe pamwe nemhando huru dzekenza yemapapu, mamwe mamota anogona kuitika mumapapu.

Lung carcinoid mamota: Carcinoid tumors of the lung account for fewer than 5% of lung tumors. Most of these grow slowly. For more information about these tumors, see Lung Carcinoid Tumor.

Other lung tumors: Other types of lung cancer such as adenoid cystic carcinomas, lymphomas, and sarcomas, as well as benign lung tumors such as hamartomas are rare. These are treated differently from the more common lung cancers and are not discussed here.

Cancers inopararira kumapapu: Cancers inotanga mune dzimwe nhengo (senge zamu, rwatata, itsvo, kana ganda) dzimwe nguva dzinogona kupararira (metastasize) kumapapu, asi aya haasi kanzuru yemapapu. Semuenzaniso, gomarara rinotanga muzamu uye richipararira kumapapu richiri gomarara repazamu, kwete gomarara remapapu. Kurapa kwekenza yemasasta kumapapu kunoenderana nekwakatangira (iyo yekutanga gomarara saiti).

Zviratidzo zvegomarara remapapu

Kenza yemaperembudzi haikonzeri zviratidzo nezviratidzo mumatanho ayo ekutanga. Zviratidzo nezviratidzo zvegomarara remapapu zvinowanzoitika chete kana chirwere ichi chaenderera.

Zviratidzo nezviratidzo zvegomarara remapapu zvinogona kusanganisira:

• Kukosora kutsva kusingaendi
• Kukosora ropa, kunyangwe shomashoma
• Kupfupika kwemhepo
• Chipfuva chepfu
• Hoarseness
• Kuderedza uremu pasina kuyedza
• Pfupa kurwadziwa
• kurwadziwa nemusoro

Kana iyo yepakutanga kenza yemapapu yakapararira, munhu anogona kunzwa zviratidzo mune dzimwe nzvimbo mumuviri. Nzvimbo dzinozivikanwa dzegomarara remapapu kupararira dzinosanganisira zvimwe zvikamu zvemapapu, lymph node, mapfupa, huropi, chiropa, uye adrenal gland.

Zviratidzo zvekenza yemapapu inogona kuitika kumwe kunhu mumuviri:

• Kurasikirwa kwechido kana kusanzwisisika kuonda
• Tsvina inoparadza (inozivikanwawo se cachexia)
• Kuneta
• Kutemwa nemusoro, bhonzo kana kurwadziwa pamwe chete
• Bone kutsemuka zvisina hukama nekukuvara netsaona
• Neurological zviratidzo, senge isina kugadzikana gait kana kurasika kurasikirwa
• Neck kana kumeso kuzvimba
• Kazhinji kushaya simba
• Bleeding
• Ropa rinovhara

Kenza yemapapu kuongororwa

Kana kenza yemapapu ichifungidzirwa semhedzisiro yekuongorora (CT, MRI kana PET scan), chidimbu chidiki chechipfuva kubva mumapapu chinofanira kuongororwa pasi pe microscope kutsvaga masero ekenza. Inodaidzwa kuti biopsy, maitiro aya anogona kuitwa nenzira dzakasiyana. Mune zvimwe zviitiko, chiremba anopfuudza tsono nepakati peganda mumapapu kuti abvise chidimbu chidiki chemucheka; maitiro aya anowanzozonzi tsono biopsy.

Mune zvimwe zviitiko, biopsy inogona kuitwa panguva yebronchoscopy. Nemurwere ari pasi pekunyaradza, chiremba anoisa chubhu diki kuburikidza nemuromo kana mhino uye mumapapu. Iyo chubhu, iyo ine mwenje, diki kamera uye mudziyo wekuvhiya kumagumo, inobvumira chiremba kuti aone mukati memapapu uye kubvisa diki tiki sampuro.

Munguva pfupi yapfuura, iyo FDA yakabvumidza yekutanga yemvura biopsy yekenza yemapapu iyo inoshandisa mahara DNA inoyerera muropa muropa kuti iongororwe. Bundu rinodurura iyi DNA zvinhu muropa sezvo masero ari mukati mawo anofa. Iyo DNA inounganidzwa uye inoongororwa ichibvumira vanachiremba kuti vatore "mufananidzo" wekuchinja kwemajini uye zvimwe zvisina kufanira zvinotyaira bundu kukura. Liquid biopsies inopa zvimwe zvakakosha, mukuti izvo hazvisi zvinokuvadza, zvisingadhuri, zvinopa mhedzisiro panguva uye zvinodzokororwa zviri nyore.

Kana masero emukenza akawanikwa mune yemhando tenzi, geneti bvunzo inogona kuitwa. Genetic test, iyo inogona zvakare kunzi "mamorekuru ekunyora kana kushandura shanduko," inobvumidza vanachiremba kutarisa mukati memasero emota nekuda kwekuchinja kwemajini kana shanduko dzinogona kunge dzakakonzera kuva nekenza. Uku kuyedzwa kunobatsira chiremba kugadzira chirongwa chekurapa kumurwere.

Varapi vepathologist (vanachiremba vanoona zvirwere nekuongorora maseru uye zvinyama pasi pe microscope) uye magene (masayendisiti ane hunyanzvi hwekudzidzira mumajini) anogona kupa chiremba wako ruzivo rwaanoda kuti agadzirise kurapwa kunenge kuchinyatso shanda. Aya mazvikokota anogona kuona hunhu hwakasarudzika hwekenza yemapapu yega yega: iyo mhando yemarara (NSCLC kana SCLC, semuenzaniso); yakasvika kure zvakadii (danho rayo); uye shanduko (geni inochinja) iyo inokonzeresa kana "kufambisa" gomarara.

Sezvo kukosha kwekunzwisisa hunhu hwemapapu bundu sero kwawedzera, varapi vepathologist uye pulmonologists vari kukurudzira kuti kuongororwa kwekufungisisa kuitwe. Reflex kuyedza kunosanganisira kuita kuyedza kweazvino anozivikanwa kenza yemapapu shanduko kana madhiraivha panguva imwe chete iyo yekuongororwa kuyedzwa kunoitwa, zvisinei nedenda remurwere.

Matanho ekenza yemapapu

Stage I: Gomarara rinowanikwa mumapapu chete uye harina kupararira kune mamwe ma "lymph node".

Stage II: Kenza iri mumapapu uye ma lymph node ari padyo.

Stage III: Gomarara rinowanikwa mumapapu uye munhengo dzemukati mukati mechipfuva, zvinotsanangurwawo sehosha yemuno. Chikamu chechitatu chine madiki maviri:

• Kana gomarara rapararira chete kune ma "lymph node" kudivi rimwe chete rechipfuva pakatangira kenza, inonzi danho IIIA.
• Kana gomarara rapararira kune ma "lymph node" kune rimwe divi repachipfuva, kana pamusoro pekora pfupa, inonzi danho IIIB.

Stage IV: Iyi ndiyo nhanho yepamusoro yekenza yemapapu, uye inotsanangurwawo sehosha yepamusoro. Apa ndipo apo gomarara rapararira kumapapu ese, kusvika ku fluid munzvimbo yakatenderedza mapapu, kana kune chimwe chikamu chemuviri, chakadai sechiropa kana dzimwe nhengo.

Kurapa kwekenza yemapapu

Kuvhiya, radiation, chemotherapy, kurapwa kwakanangwa uye immunotherapy - yega kana musanganiswa - anoshandiswa kurapa kenza yemapapu. Imwe yemhando idzi dzekurapa dzinogona kukonzera akasiyana mhedzisiro.

Surgery

Most stage I and stage II non-small cell lung cancers are treated with surgery to remove the tumor. For this procedure, a surgeon removes the lobe, or section, of the lung containing the tumor.

Vamwe vanovhiya vanoshandisa vhidhiyo-inobatsira thoracoscopic kuvhiya (VATS). Yemaitiro aya, chiremba anovhiya anoita kucheka, kana kucheka, mubhokisi uye anoisa chubhu inonzi thoracoscope. Iyo thoracoscope ine mwenje uye kamera diki yakabatana nevhidhiyo yekutarisa kuitira kuti chiremba anovhiya aone mukati mechipfuva. Lobe yemapapu inogona kubviswa kuburikidza nekuyera, pasina kugadzira kukanda kukuru mubhokisi.

Chemotherapy uye Radiation

Kune vanhu vane isina-diki maseru mapundu mapundu anogona kuvhiyiwa achibviswa, humbowo hunoratidza kuti chemotherapy mushure mekuvhiyiwa, inozivikanwa se "adjuvant chemotherapy," inogona kubatsira kudzivirira cancer kuti isadzoke. Izvi zvinonyanya kuitika kuvarwere vane danho II uye IIIA chirwere. Mibvunzo inosara pamusoro pekuti adjuvant chemotherapy inoshanda kune vamwe varwere uye kuti vanobatsirwa zvakadii.

Kune vanhu vane danho rechitatu kenza yemapapu isingakwanise kubviswa kuvhiya, vanachiremba vanowanzo kurudzira chemotherapy mukubatana neyakajeka (yakakwira-dosi) kurapwa kwemwaranzi. Muchikamu IV kenza yemapapu, chemotherapy ndiyo inonyanya kurapwa. Muchikamu chevarwere IV, radiation inoshandiswa chete kudzikisira zviratidzo.

Iyo chemotherapy kurapwa chirongwa chekenza yemapapu kazhinji inosanganisira musanganiswa wemishonga. Pakati pemishonga inowanzo shandiswa cisplatin (Platinol) kana carboplatin (Paraplatin) plus docetaxel (Taxotere), gemcitabine (Gemzar), paclitaxel (Taxol nevamwe), vinorelbine (Navelbine nevamwe), kana pemetrexed (Alimta).

Pane dzimwe nguva apo kurapwa uku kungasashande. Kana, mushure mekunge madhiragi aya achishanda kwechinguva, kenza yemapapu inogona kudzoka. Mumamiriro ezvinhu akadaro, vanachiremba vanowanzopa kosi yechipiri yekurapa kwezvinodhaka inonzi sechipiri-mutsara chemotherapy.

Munguva pfupi yapfuura, pfungwa yekuchengetedza chemotherapy yakaedzwa mumakiriniki ekuedzwa, kungaita sekuchinjira kune mumwe mushonga kenza isati yaenderera; kana kuenderera imwe yemishonga inoshandiswa pakutanga kwenguva yakareba. Idzi nzira mbiri dzakaratidza zvakanakira varwere vakasarudzwa.

Chemotherapy Asati Mamwe Mishonga (Neoadjuvant Treatment)

Kugamuchira chemotherapy pamberi pe radiation kana kuvhiyiwa kunogona kubatsira vanhu vane gomarara remapapu nekudzora bundu rakaringana kuti zviite nyore kubvisa nekuvhiya, kuwedzera kushanda kwemwaranzi uye nekuparadza maseru emukenza akavanzika panguva yekutanga.

Kana bundu risingapere nekemotherapy, mishonga inogona kumiswa ipapo ipapo, ichibvumira chiremba kuti aedze imwe nzira yekurapa. Uye zvakare, kutsvagurudza kunoratidza kuti vanhu vane gomarara remapapu vanokwanisa zvakanyanya kukunda mhedzisiro yemakemikari paanopihwa vasati vavhiyiwa.

Dzimwe nguva, nguva pfupi yekuyedzwa yekurapa nemushonga inoderedza bundu usati wavhiyiwa. Kana zvirizvo, saka kuenderera mberi nekurapwa nemushonga mumwe chete mushure mekuvhiyiwa kunogona kubatsira murwere. Nekuti vazhinji vanegomarara remapapu kupota pasirese vari kupa chemotherapy kuvarwere vavo vasati vavhiyiwa, varwere vanofanirwa kuikurukura nachiremba wavo.

Targeted Kurapwa

Chimwe chezviitiko zvinonyanya kufadza mumushonga wekenza yemapapu ndiko kuunzwa kwekurapwa kwakanangwa. Kusiyana nemakemikari madhiragi, asingakwanise kuudza musiyano uripo pakati pemasero akajairika uye maseru ekenza, marapirwo akagadzirirwa akagadzirirwa kurwisa maseru ekenza nekubatanidza kana kuvhara zvinangwa zvinoonekwa pamusoro pemasero aya Vanhu vane kenza yemapapu yakakwira nemamwe mamorekuru biomarkers vanogona kupihwa kurapwa nechinongedzo chinodhaka chete kana musanganiswa nekemotherapy. Iyi mishonga yekenza yemapapu inosanganisira:

Erlotinib (Tarceva nevamwe). Mushonga wakanangwa unonzi erlotinib wakaratidzirwa kubatsira vamwe vanhu vane isina-diki kenza yemapapu kenza. Mushonga uyu unovharira yakatarwa mhando yekugamuchira pasero pevhu-iyo epidermal yekukura factor receptor (EGFR). Vanogamuchira vakadai seEGFR vanoita semasuo nekubvumira zvinhu mune izvo zvavanogona kukurudzira gomarara sero kukura nekupararira. Lung cancer maseru ane shanduko paEGFR anogona kupindura pakurapwa neerlotinib pane chemotherapy. Kune varwere vakagamuchira chemotherapy, uye vari kuda kurapwa kwekuwedzera, erlotinib inogona kushandiswa kunyangwe pasina kuvapo kwekuchinja.

Afatinib (Gilotrif). Muna 2013, iyo FDA yakabvumidza afatinib yekurapa kwekutanga kwemasastatic NSCLC mune varwere vane yakafanana EGRF geni shanduko kana kubviswa sevaya vanogona kurapwa zvinobudirira neerlotinib.

Gefitinib (Iressa). Muna 2015, iyo FDA yakabvumidza gefitinib yemutsara wekutanga kurapwa kwevarwere vane NSCLC vane mamota ane mhando dzakasiyana dzeEGFR geni shanduko, sezvinoonekwa nemuedzo unobvumidzwa neDFA.

Bevacizumab (Avastin). Kungofanana nematuru akajairwa, mamota anoda kupihwa ropa kuti ararame. Tsinga dzeropa dzinokura munzira dzinoverengeka. Imwe nzira iri kuburikidza nekuvapo kwechinhu chinonzi vascular endothelial growth factor (VEGF). Chinhu ichi chinosimudzira tsinga dzeropa kuti dzipinde mumamota uye nekupa oxygen, zvicherwa, uye zvimwe zvinovaka muviri kufudza bundu. Kana mamota akapararira mumuviri wese, anosunungura VEGF kuti vagadzire matsva eropa.

Bevacizumab inoshanda nekumisa VEGF kubva mukusimudzira kukura kwemidziyo yeropa. (Nekuti zvinyama zvakajairika zvine ropa rakasimbiswa, izvo hazvikanganisike nemushonga.) Kana ichibatanidzwa nekemotherapy, bevacizumab yakaratidzirwa kusimudzira kupona muvanhu vane mamwe marudzi ekenza isiri yemapapu yemapapu, senge adenocarcinoma uye hombe cell carcinoma. .

Crizotinib (Xalkori). Mushonga wakaratidza mabhenefiti kune vanhu vane yepamusoro- isiri diki kenza yemapapu kenza vane ALK jeni mutende. Crizotinib inoshanda nekuvharira ALK uye nekumisa kukura kwethumba.

Ceritinib (Zykadia). Izvi zvakagamuchirwa muna2014 kune vanhu vane metastatic ALK-positive kenza yemapapu vasingakwanise kutsungirira crizotinib kana kenza yavo yakaramba ichikura ichirapwa ne crizotinib.

Nekuti magene emakenza maseru anogona kushanduka, mamwe mamota anogona kupokana nemushonga wakanangwa. Mishonga yekusangana nematambudziko aya iri kuongororwa izvozvi mumakiriniki ekuedzwa, ayo anowanzo kupa sarudzo dzakakosha dzevanhu vane kenza yemapapu.

immunotherapy

Immunotherapy ichangobva kubuda senzira nyowani yekurapa kune mamwe kanzura yemapapu. Kunyangwe chero kurapwa kwekenza kuchikonzera mhedzisiro, immunotherapy inowanzo shingirira; izvi zviri muchikamu nekuda kwemaitiro ekuita.

Ma immune system edu anogara achishanda kuti tigare takagwinya. Inoziva uye inorwisa njodzi, senge kutapukirwa, hutachiona, uye kukura masero ekenza. Kazhinji, immunotherapy inoshandisa immune system yedu sekurapa kenza.

Muna Kurume 2015, iyo FDA yakabvumidza iyo immunotherapy nivolumab (Opdivo) yekurapa metastatic squamous NSCLC iyo isina kubudirira kurapwa nekemotherapy. Nivolumab inoshanda nekukanganisa mamorekuru "brake" inozivikanwa sePD-1 iyo inodzivirira immune system kurwisa mamota.

Muna 2016, iyo FDA yakatendera immunotherapy nyowani inonzi pembrolizumab (Keytruda) yekurapa yepamusoro NSCLC seyakatanga kurapwa. Basa rayo rekurapa rakafanana neye nivolumab. Varwere vanoongororwa puroteni inozivikanwa sePDL-1 uye kana huwandu hwakakwana hukaonekwa, vanogona kukodzera kurapwa uku.

Kuwedzera nzira dzekuzvidzivirira kwechirwere chegomarara remapapu dzakaratidza kuvimbisa mukutanga kiriniki miedzo uye iye zvino vava mukupedzisira-chikamu chikamu. Mishonga yeNSCLC yakafambira mberi zvakanyanya; zvisinei, akati wandei matsva ekurapa immune-akavakirwa SCLC ari zvakare mukukura kwekiriniki. Aya marapirwo anowira mukati zvikamu zvina zvikuru:

• Monoclonal antibodies ari mamorekuru-anogadzirwa nemarabhoritari anotarisa chaiwo mamota maantigen (chinhu chinoonekwa nemasoja emuviri sekune dzimwe nyika kana chine njodzi)
• Checkpoint inhibitors tarisa mamorekuru ayo anoshanda secheki uye zviyero mukugadzirisa kweyekudzivirira mhinduro.
• Mishonga yekurapa tarisiro yakagovaniswa kana bundu-yakatarisana nemaantigen.
• Inogamuchira T-cell kuendesa inzira iyo T-maseru (rudzi rwechena ropa maseru) anobviswa kubva kumurwere, akagadziridzwa nemageneti kana kurapwa nemakemikari kusimudzira basa ravo, uye kuunzwa zvakare mumurwere nechinangwa chekuvandudza immune system's anticancer mhinduro .

CAR T-Cell kurapa uye Natural Killer (NK) Maseru ekurapa ndiwo mamwe marapirwo matsva ekurapa kenza yemapapu.

Kenza yemapapu ingadzivirirwa sei?

Iko hakuna nzira yechokwadi yekudzivirira kenza yemapapu, asi iwe unogona kudzikisa njodzi yako kana iwe:

• Usapute. Kana usati wamboputa, usatange. Taura nevana vako nezvekusasvuta kuitira kuti vanzwisise nzira yekudzivirira iyi yakakosha njodzi kenza yemapapu. Tanga kukurukura nezvengozi dzekusvuta nevana vako pachine nguva kuitira kuti vazive maitiro ekuita kufurirwa nevezera rako.
• Rega kusvuta. Chirega kuputa manje. Kurega kunoderedza njodzi yako yekenza yemapapu, kunyange iwe wakasvuta kwemakore. Taura nachiremba wako nezvemazano uye kumisa-kuputa zvibatsiro zvinogona kukubatsira kurega. Sarudzo dzinosanganisira nicotine zvinotsiva zvigadzirwa, mishonga, uye mapoka ekutsigira.
• Dzivisa kuputa fodya. Kana uchigara kana kuti uchishanda nemunhu anosvuta, mukurudzire kurega. Pazvishoma, mukumbire kuti asvute panze. Dzivisa nzvimbo dzinoputa vanhu, dzakaita semabhawa nemaresitorendi, uye tsvaga sarudzo dzisina utsi.
• Edza imba yako radon. Ita kuti mazinga eradon mumba mako aongororwe, kunyanya kana iwe uchigara munzvimbo inozivikanwa kuti radon idambudziko. Mahara radon mazinga anogona kugadziriswa kuti imba yako igare yakachengeteka. Kuti uwane ruzivo nezve kuyedzwa kweradon, taura nedhipatimendi rako remunharaunda rehutano hweveruzhinji kana chitsauko chemuno cheAmerican Lung Association.
• Dzivisa ma carcinogen ari kushanda. Tora matanho kuti uzvidzivirire kubva pakusangana nemishonga ine chepfu kubasa. Tevedzera matanho ewaunoshandira. Semuenzaniso, kana iwe ukapihwa kumeso kumeso kwekudzivirira, gara uchipfeka. Kumbira chiremba wako zvimwe zvaunogona kuita kuti uzvidzivirire uri pabasa. Ngozi yako yekukuvara kwemapapu kubva kunzvimbo dzinoshanda ma carcinogen inowedzera kana iwe uchisvuta.
• Idya chikafu chizere nemichero nemiriwo. Sarudza chikafu chine hutano nemhando dzakasiyana dzemichero nemiriwo. Zvekudya zvinyorwa zvevhithamini uye zvinovaka muviri zviri nani. Dzivisa kutora muhombe madhithamini mumafomu epiritsi, nekuti anogona kukuvadza. Semuenzaniso, vaongorori vachitarisira kudzikisa njodzi yekenza yemapapu mune vanoputa zvakanyanya vakavapa beta carotene zvinowedzera. Mhedzisiro yakaratidza izvo zvekuwedzera zvinowedzera njodzi yekenza mune vanoputa.
• Exercise mazuva mazhinji evhiki. Kana iwe usingaite muviri nguva dzose, tanga zvishoma nezvishoma. Edza kurovedza muviri mazuva mazhinji evhiki.