Sida looga hortago soo noqoshada kansarka mindhicirka, sidee loo daaweeyaa soo noqoshada kansarka mindhicirka qalliinka ka dib?
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 kansarka mindhicirka is detected early, it can usually be cured.
Heerka badbaadada 5-sano ee kansarka mindhicirka
Marka loo eego xogta rasmiga ah ee US ASCO, heerka badbaadada 5-sano ee bukaanka kansarka mindhicirka waa 65%. Si kastaba ha ahaatee, heerka badbaadada kansarka mindhicirka way kala duwanaan kartaa iyadoo ku xidhan arrimo badan, gaar ahaan heerka.
Waayo, kansarka mindhicirka, 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 .
Kansarka malawadka, guud ahaan 5-ta sano ee heerka badbaadadu waa 67%. Heerka badbaadada 5-sano ee heerka xaddidan ee kansarka malawadka waa 89%; heerka badbaadada 5-sano ee metastasis ee unugyada ku xeeran ama xubnaha iyo / ama qanjidhada gobolka waa 70%. Haddii uu jiro metastasis fog oo kansarka malawadka ah, heerka badbaadada 5-sano waa 15%.
Currently, treatments for colorectal cancer include surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy. Qalliinku waa habka la door bidayo ee ciribtirka kansarka mindhicirka. Laakiin Vicki, oo ah tifaftiraha guriga aan kansarka lahayn, ayaa ogaatay in qiyaastii 60% ilaa 80% bukaannada qaba kansarka malawadka ay dib u soo noqon doonaan 2 sano gudahood qalitaanka ka dib.
Sidee si wax ku ool ah looga hortagi karaa soo noqoshada kansarka mindhicirka?
Hagaajinta nolosha
Si aad u joojiso cabbitaanka, joojiso cabbitaanka, joojiso cabbitaanka, aad u sheegto waxyaalaha muhiimka ah saddex jeer, waa in aad joojiso cabbitaanka. Intaa waxaa dheer, ha cabbin sigaar, ha ka badin, oo ilaali niyadda farxadda.
Jimicsi ku habboon, 2-3 bilood qalliinka ka dib, waxaad samayn kartaa jimicsi jilicsan, sida socodka, si tartiib tartiib ah u kordhi 15 daqiiqo ilaa 40 daqiiqo; Waxa kale oo aad ku tababaran kartaa qigong, Tai Chi, jimicsi raadiyaha iyo jimicsiyo kale oo dabacsan.
Fiiro gaar ah u yeelo cuntada, ha cunin cuntooyinka caaryada leh, barbecue, hilib doofaar, tofu, cunto ay ku jirto nitrit, hana cunin dawooyinka Shiinaha iyo agabka caafimaadka.
Cunnada qalliinka ka dib inta badan waa iftiin, iyo qaadashada borotiinka tayada sare leh, sida ukunta cad iyo hilibka caatada ah, ayaa si habboon loo kordhiyaa. Cuntada qalliinka ka dib waxay guud ahaan ka gudubtaa biyaha, boorash, caano, ukun la camiray, kalluunka, hilibka aan baruurta lahayn oo loo beddelo cuntada caadiga ah.
Cun cuntooyinka dheefshiidka leh intii suurtogal ah, ka fogow dufanka, basbaaska, xanaaqa, aad u adag, dhegdhegyada iyo cuntooyinka kale, cun cunto dheellitiran, cun cuntooyin yar oo ha cunin cuntooyin badan.
Isticmaalka joogtada ah ee lawska sida cashews, hazelnuts, walnuts, almonds, iyo walnuts waxay yarayn kartaa heerka soo noqnoqda ee kansarka mindhicirka.
Talada kalkaalinta qaliinka ka dib ee kansarka mindhicirka
Ka saarista tolmada ayaa la dhameeyay 7-10 maalmood ka dib qalliinka kansarka mindhicirka. Bukaannada da'da weyn ama bukaannada qaba dhibaatooyinka qaarkood waxay si habboon u kordhin karaan wakhtiga ay ka saarayaan dunta. Ka dib markaad ka saarto dunta, fiiro gaar ah u yeelo nadaafadda boogta si aad uga fogaato caabuqa.
Ka dib marka tolida la saaro, waxaa lagama maarmaan ah in la sii wado daboolida dhaymada iyo adkeynta xajinta caloosha inta lagu jiro bogsashada nabarka ilaa jeexitaanka qaliinka si buuxda loo bogsado, kaas oo qaadanaya qiyaastii nus bil.
Ugu yaraan 10 maalmood ka dib qaliinka, wiishka maqaarka ayaa laga saari karaa, waana in nabarka lagu hayaa nadiif oo engegan intii suurtagal ah si loo yareeyo dhididka. Waad qubaysan kartaa, laakiin ma xoqin boogta.
Waa caadi in la dareemo kabuubyo agagaarka nabarka ka dib qalliinka, wuuna baaba'aa muddo ka dib.
Waa wax iska caadi ah in nabarku soo baxo, wax yarna qayb ahaan waa laga jeermi karaa, dhaymada dushana waa la beddeli karaa. Si kastaba ha ahaatee, haddii qadarka dheecaanku uu weyn yahay oo casaan iyo barar daran ay dhacaan, dhakhtarka waa in lala xiriiriyaa wakhtiga daaweynta dhaawaca.
Marka jeexitaanka qalliinka uu ku dhow yahay inuu koro, waxay dareemi doontaa cuncun, oo loo yaqaan "hilib dheer". Waqtigaan, iska ilaali xagashada, biyaha, iyo caabuqa.
Nabarku ma bogsan wax ka badan xilliga bogsashada. Waxaad u baahan tahay inaad hesho dhakhtar qalliin oo xirfad leh si uu wax uga qabto, u beddelo dhaymada wakhtiga, nadiifi dhaawaca, oo daaweeya caabuqa, oo fiiro gaar ah u leh xakamaynta sonkorta dhiigga iyo xoojinta nafaqada.
Nabarka dabada waxay caadi ahaan qaataan hal bil si ay u bogsadaan. Ka dib bogsashada, waxaad si tartiib ah u baran kartaa dhaqdhaqaaqa squat, 3-5 daqiiqo mar kasta, hal mar subaxdii iyo galabtii.
Haddii nabarku si fiican u bogsado, waxaad qubaysan kartaa 7-14 maalmood ka dib marka tolmada la gooyo. Waxaad isticmaali kartaa jeelka qubeyska ama saabuunta, laakiin iska ilaali nabarka.
Dib u eegista joogtada ah
Marka loo eego tirakoobyada, heerka soo noqoshada iyo metastasis ee kansarka mindhicirka ee Shiinaha ayaa ah mid aad u sarreeya ilaa 50%, in ka badan 90% soo noqoshada iyo metastasisku waxay dhacaan 2-3 sano ka dib qalliinka, heerka soo noqoshada ayaa ka hooseeya 5 sano ka dib. Sidaa darteed, qalliinku maaha hal mar iyo dhammaan, waana inaan ku adkaysannaa dib-u-eegis joogto ah ka dib qalliinka.
Bukaanjiifka kansarka mindhicirka waxay u badan tahay inay soo noqdaan 3 sano gudahood qalliinka ka dib. Inta lagu jiro muddadan, tirada bukaan-socodka dib-u-eegista waa inay ahaadaan kuwo soo noqnoqda; 3 sano ka dib, inta u dhaxaysa dib-u-imtixaanka ayaa loo kordhin karaa si habboon.
Guud ahaan, dib u hubi 3dii biloodba mar 1 sano gudaheed kadib qalliinka; dib u hubi nuskii sano ee labaad 2-3 sano; hubi sannadkii hal mar 4-5 sano. Waqtiga gaarka ah ee dib u eegista sidoo kale wuxuu u baahan yahay inuu helo dhakhtarkaaga si uu u go'aamiyo. Inta lagu jiro dib u eegista, walxaha la hubinayo waxaa ka mid ah,
Tijaabada dhiiga: blood routine, liver and kidney function, buro markers (CEA, etc.);
Baaritaanka sawirka: ultrasound miskaha caloosha, shucaaca xabadka
Colonoscopy: 3 bilood ka dib qaliinka si loo go'aamiyo bogsashada anastomosis iyo in la eego burooyinka qaybaha kale
Sidee loo daaweeyaa soo noqoshada kansarka mindhicirka qaliinka ka dib?
Qalliinka labaad
Habka ugu habboon ee bukaanada qaba kansarka mindhicirka ay dib ugu soo noqon karaan waa in meesha laga saaro nabarrada soo noqnoqda si loo gaaro yoolka daawaynta xagjirka ah. Ugu horreyntii, waxay kuxirantahay in dib-u-soo-celinta labaad ee qalliinka la samayn karo. Haddii ay buuxiso shuruudaha qalliinka, burada waxaa laga saari karaa qaliin.
Haddii ay jiraan dhaawacyo badan, aagga duullaanku waa mid aad u weyn, ama metastasisku waa fog yahay, haddii dib-u-shaqeyntu ay khatar u tahay, hababka kale ee daaweynta ayaa la dooran karaa marka faa'iidada qaliinka aan dammaanad qaadin.
Dawo
Dawaynta kansarka mindhicirka
Dawooyinka kiimikaad ee caadiga ah waa 5-fluorouracil, irinotecan, oxaliplatin, calcium folinate, capecitabine, tigeol (S-1), TAS-102 (trifluridine / tipiracil).
Si kastaba ha ahaatee, daaweynta kemotherabi ee kansarka mindhicirka badanaa waa isku darka dhowr daawooyin kiimiko ah. Isku darka guud waa:
1.FOLFOX (fluorouracil, kaalshiyam folinate, oxaliplatin)
2. FOLFIRI (fluorouracil, calcium folinate, irinotecan)
3.CAPEOX (Capecitabine, Oxaliplatin)
4. FOLFOXIRI (fluorouracil, folinate calcium, irinotecan, oxaliplatin)
Kansarka mindhicirku wuxuu bartilmaameedsaday daawooyinka iyo daawooyinka difaaca
1. KRAS / NRAS / BRAF nooca duurjoogta ah daawooyinka lala beegsaday: cetuximab ama panitumumab (sida badan loo isticmaalo kansarka mindhicirka bidix)
2. Kahortagayaasha angiogenesis-ka: bevacizumab ama ramucirumab ama ziv abercept
3. BRAF V600E daroogooyinka la beegsaday: dabrafenib + trametinib; connetinib + bimetinib
4. Fiyuuska NTRK daroogada lala beegsaday: Larotinib; Entratinib
5.MSI-H (dMMR) PD-1: pembrolizumab; nivolumab ± ipilimumab
6. Daawooyinka la beegsaday HER2 togan: trastuzumab + (pertuzumab ama lapatinib)
Qalitaanka iyo daawaynta shucaaca ka sokow, kansarka mindhicirka ee sare u kacay waa marxalad daawaynta lagama maarmaanka ah. Daawaynta safka kowaad waxa loola jeedaa heerka kowaad ee daawaynta anti-antisk
daawooyinka kansarka, oo sidoo kale loo yaqaan daawaynta bilowga ah. Waxaa jira xulashooyin badan oo loogu talagalay daawaynta safka koowaad ee kansarka mindhicirka sare, oo badanaa ku salaysan kiimoterabi.
Si kastaba ha ahaatee, waa lagama maarmaan in la kala saaro xaaladda bukaanka iyo xaaladda jireed. Baaritaano isdaba joog ah ka dib, bukaanada waxaa loo qaybin karaa laba nooc oo bukaanno ah oo ku habboon daaweynta adag oo aan ku habboonayn daaweynta sare.
Doorashada daawada ku habboon bukaanada leh daawaynta xoogga badan
Waxaa loo qaybiyaa saddex qaybood:
Xalka ugu horreeya ee leh oxaliplatin
Xalka safka hore ee irinotecan
(1) Xalka safka koowaad oo ka kooban oxaliplatin
FOLFOX ± bevacizumab
CPEOX ± bevacizumab
FOLFOX + (cetuximab ama panitumumab) (kaliya loogu talagalay KRAS / NRAS / BRAF nooca duurjoogta ee kansarka mindhicirka bidix)
(2) Qorshaha safka koowaad ee irinotecan
FOLFIRI ± bevacizumab ama
FOLFIRI + (cetuximab ama panitumumab) (kaliya loogu talagalay KRAS / NRAS / BRAF nooca duurjoogta ee kansarka mindhicirka bidix)
(3) Xalka safka kowaad oo ka kooban oxaliplatin + irinotecan
FOLFOXIRI ± bevacizumab
Doorashada daawooyinka aan ku habboonayn daaweynta xoogga badan
Fursadaha daawada-koowaad
1. Faleebo 5-fluorouracil + calcium folinate ± bevacizumab ama
2. Capecitabine + Bevacizumab
3. Cetuximab ama panitumumab (Caddaynta fasalka 2B, kaliya ayaa lagu dabaqi karaa KRAS / NRAS / BRAF nooca duurjoogta ah ee kansarka mindhicirka bidix)
4. Nivolumab ama pembrolizumab (kaliya dMMR / MSI-H)
5. Nivolumab + Ipilimumab (Caddaynta fasalka 2B, oo kaliya lagu dabaqi karo dMMR / MSI-H)
6. Trastuzumab + (Pertuzumab ama Lapatinib) (Waxa lagu dabaqi karaa HER2 la xoojiyay iyo RAS burooyinka nooca duurjoogta ah)
1) Ka dib daaweynta kor ku xusan, ma jiraan wax horumar ah oo ku saabsan xaaladda shaqeynta, dooro daaweynta taageerada ugu fiican (daryeelka palliative);
2) Ka dib daawaynta kor ku xusan, heerka shaqadu wuu fiicnaanayaa, waxaana la tixgelin karaa qorshe hore oo xoog leh.
Doorashada daawaynta kama dambaysta ah
Regfini
Trifluorothymidine + tipiracil
Daawaynta taageerada ugu fiican (daryeel palliative)
