Sidee looga hortagi karaa soo noqoshada kansarka mindhicirka? Sidee loo daaweeyaa soo noqoshada kansarka mindhicirka qalliinka ka dib?
Kansarka malawadka waa mid caan ah oo caan ah, oo ay ku jiraan kansarka malawadka iyo malawadka. Dhacdooyinka kansarka mindhicirka mindhicirka min sare ilaa hoose waa malawadka, mindhicirka weyn ee 'sigmoid colon', xuubka weyn ee kor u kacaya, iyo xiidanka hoose. Sanadihii la soo dhaafay, waxaa jiray isbeddel ku dhowaad (xiidanka midig).
Haddii kansarka malawadka goor hore la ogaado, badanaa waa la daaweyn karaa.
Qiyaasta badbaadada 5-sano ee kansarka malawadka
Sida laga soo xigtay xogta rasmiga ah ee US ASCO, heerka 5 sano ee bukaanka kansarka malawadka waa 65%. Si kastaba ha noqotee, heerka badbaadada kansarka mindhicirka malawadka way kala duwanaan kartaa iyadoo ku xiran dhowr arrimood, gaar ahaan heerka.
Kansarka mindhicirka, guud ahaan 5-ta sano ee heerka badbaadadu waa 64%. Heerka badbaadada 5-sano ee kansarka mindhicirka gudaha waa 90%; Heerka badbaadada 5-sano waa 71% metastasis ee unugyada ku xeeran ama xubnaha iyo / ama qanjidhada gobolka; Heerka badbaadada 5-sano waa 14% kansarka mindhicirka kaas oo dhacay meel fog .
Kansarka malawadka, wadarta guud ee heerka 5 sano waa 67%. Heerka badbaadada 5-sano ee kansarka malawadka maxalliga ah waa 89%; heerka badbaadada 5-sano waa 70% metastases-ka unugyada ku hareeraysan ama xubnaha iyo / ama qanjidhada gobolada. Haddii metastases fog ka dhacaan kansarka malawadka, heerka badbaadada 5-sano waa 15%.
Daawaynta hadda ee kansarka mindhicirka waxa ka mid ah qalliin, kiimoterabi, radiotherapy, daawaynta la bar tilmaameedsado, iyo immunotherapy. Qalliinku waa habka la door bidayo ee lagu daweeyo kansarka mindhicirka. Laakiin Vicki, tafatiraha guriga ee 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 looga hortagaa soo noqoshada kansarka malawadka?
Hagaajinta nolosha
Jooji khamriga, joojiso khamriga, joojiso khamriga, waxyaabaha muhiimka ah ayaa la sheegay saddex jeer, waa inaad joojisaa khamriga. Sidoo kale, ha cabbin sigaar, ha ka badin, oo faraxsanow.
Jimicsi ku habboon, 2-3 bilood qalliinka ka dib, waxaad samayn kartaa jimicsi dabacsan, sida socodka, oo si tartiib tartiib ah u kordhi 15 daqiiqo ilaa 40 daqiiqo; Waxa kale oo aad jimicsan kartaa qigong, Tai Chi, jimicsi raadiyaha iyo jimicsiyo kale oo dabacsan.
Feejignaan gaar ah waa in la siiyaa cuntada, ha cunin cunno caaryo ah, hilib dubis, hilib doofaar, tofu iyo cuntooyinka kale ee ay ku jirto nitrite, hana cunin dawooyinka dhaqameed ee Shiinaha.
Cuntada qalliinka ka dib badanaa waa iftiin, iyo qaadashada borotiin tayo sare leh sida ukunta cad iyo hilibka caatada ah ayaa si habboon loo kordhiyay. Cuntada qalliinka ka dib guud ahaan waxay u gudubtaa biyaha, boorashka, caanaha, ukunta uumiga ah, kalluunka, hilibka caatada ah ee cuntada caadiga ah.
Isku day inaad cuntid cunnooyinka si fudud loo shiidi karo, ka fogow dufanka, basbaaska, cuncunka, adag, dhegta leh iyo cuntooyinka kale, cun cunno isku dheellitiran, cun cunno yar, mana aha inay dhergaan.
Isticmaalka joogtada ah ee looska sida cashews, hazelnuts, walnuts, almonds, iyo walnuts waxay yarayn kartaa heerka soo noqnoqda ee kansarka mindhicirka.
Talooyinka daryeelka qalliinka kadib ee kansarka malawadka
Tolmada ayaa la dhammaystiray 7-10 maalmood ka dib kansarka mindhicirka weyn. Bukaannada waayeelka ah ama bukaanada leh dhibaatooyinka qaarkood waxay si ku habboon u dheereyn karaan waqtiga goynta tolidda. Ka-qaadista tolida ka dib, waa inay fiiro gaar ah u yeeshaan nadaafadda dhaawaca si looga fogaado infekshin.
Ka dib marka tolmada laga saaro, faashadda iyo silsiladaha caloosha waa inay sii wadaan in la adkeeyo inta nabarku bogsanayo illaa inta qalliinka qalliinka laga wada bogsanayo, kaasoo qaadanaya qiyaastii nus bil.
Jirka maqaarka waa in laga qaadaa ugu yaraan 10 maalmood qalitaanka ka dib. Nabarku waa inuu ahaadaa mid nadiif ah oo qallalan intii suurtogal ah si dhididku u yaraado. Waad qubeysan kartaa, laakiin ma xoqin kartid dhaawaca.
Waa caadi in kabuubyo lagu yeesho agagaarka nabarka qalliinka ka dib, kaasoo baaba'aya waxoogaa kadib
Waa wax caadi ah in booguhu soo baxaan. In yar ayaa loo isticmaali karaa jeermiska maxalliga ah. Ku beddel faashadda dusha sare. Si kastaba ha noqotee, haddii qadarka dheecaanka uu weyn yahay oo casaan daran yahay, barar iyo xanuun dhaco, waa inaad la xiriirtaa dhakhtarkaaga si loo daweeyo dhaawaca.
Marka qalliinka qalliinka uu korayo, wuxuu dareemi doonaa cuncun, oo badanaa loo yaqaan "hilib dheer". Waqtigaan, iska ilaali xoqida, biyo ha helin, iskana ilaali infekshanka.
Nabarku wuu dhaafsan yahay mudadii bogsashada, laakiin wali si fiican ugama uu korin. Waxaad u baahan tahay inaad hesho dhakhtar qalliin oo takhasus leh oo wax ka qabta, daawada ku beddela waqtigeeda, nadiifiya boogta, isla markaana daweeya caabuqa. Isla mar ahaantaana, fiiro gaar ah u yeelo xakamaynta sonkorta dhiigga iyo xoojinta nafaqada.
Nabarada dabada badanaa waxay qaataan bil si ay u bogsadaan. Bogsashada ka dib, waxaad si tartiib tartiib ah ugu tababbaran kartaa fadhiisashada, 3-5 daqiiqo markasta, hal mar subaxdii iyo galabtii.
Haddii nabarku si fiican u bogsado, waad qubeysan kartaa 7-14 maalmood ka dib markaad tolmada ka bixiso. Waad isticmaali kartaa jirkaaga ama saabuun, laakiin iska ilaali dhaawaca.
Dib u eegis xilliyeed
Sida laga soo xigtay tirakoobyada, soo noqoshada iyo heerka metastasis ee kansarka mindhicirka dambe ee hawlgalka ka dib waa ilaa 50%, in ka badan 90% soo noqoshada iyo metastasis waxay dhacdaa 2-3 sano hawlgalka ka dib, iyo soo noqoshada ayaa ka hooseysa 5 sano ka dib . Sidaa darteed, qalliin ma aha hawl hal mar ah, waana inaad ku adkeysato dib u eegis joogto ah qalliinka kadib.
Bukaannada qaba kansarka mindhicirka waxay u badan tahay inay ku soo laabtaan 3 sano gudahood qalitaanka ka dib. Inta lagu jiro muddadan, tirada dib-u-eegiddu waa inay ahaataa mid soo noqnoqota; 3 sano ka dib, mudada dib-u-baadhitaanka ayaa si habboon loo dheereyn karaa.
Guud ahaan, waxaa dib loo eegaa 3dii biloodba mar 1 sano kadib qalitaanka; waxaa dib loo eegaa nus-sanadle ah 2-3-da sano ee hore; iyo 4-5-tii sanaba mar. Waqtiga dib-u-eegista gaarka ah wuxuu kaloo u baahan yahay inuu raadsado dhakhtarkooda si ay u go'aamiyaan.
Inta lagu jiro dib u eegista, waxyaabaha la baarayo waxaa ka mid ah:
Baadhitaanada dhiigga: Jadwalka dhiiga, shaqada beerka iyo kilyaha, calaamadaha burooyinka (CEA, iwm);
Imtixaanka sawirka: B-ultrasound, shucaaca xabadka
Colonoscopy: wuxuu sameeyay 3 bilood qalliinka ka dib si loo go'aamiyo bogsashada qalliinka anastomosis iyo in lagu ilaaliyo burooyinka qaybaha kale.
Sidee loo daaweeyaa soo noqoshada kansarka mindhicirka qalliinka kadib?
Qalliinka labaad
Habka ugu fiican ee loogu talagalay soo noqoshada bukaanka kansarka malawadka qalliinka kadib waa in laga saaro dhaawacyada soo noqnoqda si loo gaaro hadafka daaweynta xagjirka ah. Waxa ugu horreeya ee la sameeyo waa in la arko haddii qalliin labaad oo qalliin lagu samayn karo. Haddii shuruudaha qalliinka la buuxiyo, burooyinka ayaa qalliin looga saari karaa.
Haddii ay jiraan nabaro badan, aagga duulaanka ayaa ah mid aad u ballaaran, ama metastases-ka fog, haddii dib-u-hawlgalku u nugul yahay khatar, iyo haddii aan la hubin faa'iidada qalliinka, hababka kale ee daaweynta ayaa la dooran karaa.
Daawada loo isticmaalo daaweynta kansarka mindhicirka weyn
Dawooyinka kimoteraabiga kansarka mindhicirka weyn
Kiimikada caadiga ah waa 5-fluorouracil, irinotecan, oxaliplatin, calcium folinate, capecitabine, tigio (S-1), iyo TAS-102 (trifluridine / tipiracil).
Si kastaba ha noqotee, daaweynta kiimikada ee kansarka mindhicirka badanaa waa isku dhaf dhowr daaweyn oo kimikal ah, hababka isku dhafan ee caadiga ahna waa:
1.FOLFOX (fluorouracil, kaalshiyam folinate, oxaliplatin)
FOLFIRI (fluorouracil, calcium folinate, irinotecan)
3.CAPEOX (Capecitabine, Oxaliplatin)
4.FOLFOXIRI (fluorouracil, folinate calcium, irinotecan, oxaliplatin)
Kansarka mindhicirka ee lagu bartilmaameedsado daroogada iyo dawooyinka difaaca jirka
1. KRAS / NRAS / BRAF nooca duurjoogta ah ee lala beegsaday dawooyinka: cetuximab ama panitumumab (sida badan loo isticmaalo kansarka mindhicirka bidix)
2. Kahortagayaasha anti-angiogenesis: bevacizumab ama ramonizumab ama ziv aflibercept
3. BRAF V600E daroogada la bartilmaameedsaday: dalafenib + trimetinib; connetinib + bimetinib
4. Fiyuuska NTRK ee bartilmaameedsanaya daawooyinka: Larotinib; Emtricinib
5.MSI-H (dMMR) PD-1: Paimumab; Navumab ± Ipilimumab
6.HER2-daroogada bartilmaameedka wanaagsan: Trastuzumab + (Pertuzumab ama Lapatinib)
Marka lagu daro qalliinka iyo shucaaca ku daweynta kansarka mindhicirka ee horumarsan, daaweynta nidaamsan ayaa ah marxalad daaweyn lagama maarmaan ah. Fir
Daaweynta st-line waxaa loola jeedaa marxaladda daaweynta ugu horreysa ee dawooyinka lidka ku ah kansarka, oo sidoo kale loo yaqaan daaweynta bilowga ah. Waxaa jira xulashooyin badan oo loogu talagalay daaweynta-safka-koowaad ee kansarka mindhicirka ee horumarsan, oo badanaa ku saleysan kiimoteraabiga.
Si kastaba ha noqotee, xaaladda bukaanka iyo xaaladda jireed waa in la kala saaraa. Kadib baaritaano taxane ah, bukaanada waxaa loo qaybin karaa laba qaybood: bukaanada ku haboon daaweynta xoojinta sare iyo kuwa aan u qalmin.
Xulashada daroogada ee daaweynta xoogga leh ee bukaanka kansarka mindhicirka
Waxaa loo qaybiyaa saddex qaybood:
Xalka ugu horeeya ee loo yaqaan 'oxaliplatin'
Xallinta-safka hore ee leh irinotecan
(1) Qorshaha safka hore oo ay kujiraan oxaliplatin
FOLFOX ± bevacizumab
CPEOX ± Bevacizumab
FOLFOX + (cetuximab ama panitumumab) (kaliya loogu talagalay KRAS / NRAS / BRAF nooca duurjoogta ee kansarka mindhicirka bidix)
(B) qorshaha safka-koowaad oo ay kujiraan irinotecan
FOLFIRI ± bevacizumab ama
FOLFIRI + (cetuximab ama panitumumab) (kaliya loogu talagalay KRAS / NRAS / BRAF nooca duurjoogta ee kansarka mindhicirka bidix)
(III) Qorshaha safka-koowaad oo ay kujiraan oxaliplatin + irinotecan
FOLFOXIRI ± Bevacizumab
Xulashada daroogada ee aan ku habboonayn daaweynta xoogga leh ee kansarka malawadka
Fursadaha daawada-koowaad
1. Faleebo 5-fluorouracil + calcium folinate ± bevacizumab ama
2.Capecitabine ± Bevacizumab
3. Cetuximab ama panitumumab) (Caddaynta heerka 2B, kaliya loogu talagalay KRAS / NRAS / BRAF nooca duurka ee kansarka mindhicirka bidix)
4. Navumab ama Paimumab (kaliya loogu talagalay dMMR / MSI-H)
5. Nivolumab + Ipilimumab (nooca caddeynta 2B, oo keliya khuseeya dMMR / MSI-H)
6. Trastuzumab + (Pertuzumab ama Lapatinib) (burooyinka leh HER2 kordhinta iyo nooca duurjoogta ee RAS)
1) Daawooyinka kor ku xusan ka dib, xaaladda waxqabadka ma hagaageyso, oo daaweynta ugu fiican ee taageerada ah (daaweynta palliative) ayaa la xushay;
2) Daawooyinka kor ku xusan ka dib, xaaladda shaqeysa ayaa soo hagaageysa, iyo qorshe bilow ah oo xoog badan ayaa la tixgelin karaa.
Xulashada daawada ee ugu dambeysa kansarka mindhicirka
Rigfini
Trifluorothymidine + tipiracil
Daryeelka taageerada ugu fiican (daryeelka xanuunka)
Tixraacyo:
https://www.cancer.net/cancer-types/colorectal-cancer/statistics
https://zhuanlan.zhihu.com/p/42575420
https://www.nccn.org/professionals/physician_gls/default.aspx
