Umhlaza wemiphunga ongekho mncinci

Umhlaza wamaphaphu ongekho mncinci lolona hlobo luqhelekileyo lomhlaza wemiphunga. Ihlala ikhula kwaye isasazeka kancinci kancinci kunesifo somhlaza esincinci semiphunga.

Zintathu iintlobo eziqhelekileyo zomhlaza wesifo somhlaza wamaphaphu (NSCLC):

• I-Adenocarcinomas zihlala zifumaneka kwindawo engaphandle yemiphunga.
• I-squamous cell carcinomas zihlala zifumaneka embindini wemiphunga ecaleni kwetyhubhu yomoya (bronchus).
• Ii-carcinomas ezinkulu zeseli zinokwenzeka nakweyiphi na indawo yemiphunga.
• Kukho iintlobo ezingaqhelekanga zomhlaza wemiphunga ekwabizwa ngokuba ayincinci.

Ukutshaya kubangela iimeko ezininzi (malunga neepesenti ezingama-90) zesifo somhlaza esingeyiyo esincinci semiphunga. Umngcipheko uxhomekeke kwinani leesigarethi ozitshayayo suku ngalunye nokuba unexesha elingakanani utshaye. Ukuba kufutshane nomsi ovela kwabanye abantu (umsi wecuba) kuphakamisa umngcipheko womhlaza wemiphunga. Kodwa abanye abantu abangazange batshaye baba nomhlaza wemiphunga.

Uphando lubonisa ukuba ukutshaya intsangu kunokunceda iiseli zomhlaza zikhule. Kodwa akukho nxibelelo ngqo phakathi kokutshaya intsangu kunye nokukhula komhlaza wemiphunga.

Ukuvezwa rhoqo kwamanqanaba aphezulu okungcoliseka komoya kunye namanzi okusela anezinga eliphezulu le-arsenic kunokunyusa umngcipheko womhlaza wemiphunga. Imbali yonyango lwemitha kwimiphunga nayo inokwandisa umngcipheko.

Ukusebenza okanye ukuhlala kufutshane neekhemikhali okanye izixhobo ezinokubangela umhlaza kungonyusa umngcipheko wokuba nomhlaza wemiphunga. Ezi khemikhali zibandakanya:

• Iasbestos
• URadon
  
• Iikhemikhali ezinje nge-uranium, i-beryllium, i-vinyl chloride, i-nickel chromates, iimveliso zamalahle, irhasi ye-mustard, i-chloromethyl ethers, ipetroli kunye nedizili
• Iialloys ezithile, iipeyinti, ii-pigment, kunye ne-preservatives
• Iimveliso ezisebenzisa i-chloride kunye ne-formaldehyde

Iimpawu zingabandakanya:

• Iintlungu zesifuba
• Ukukhwehlela okungahambiyo
• Ukukhohlela igazi
• Ukudinwa
• Ukuphelelwa ngumdla wokutya
• Ukunciphisa umzimba ngaphandle kokuzama
• Ukuqhawukelwa ngumphefumlo
• Ukukhawuleza
• Intlungu xa isasazeka kwezinye iindawo zomzimba

Umhlaza wemiphunga kwangoko awunakubangela zimpawu.

Ezinye iimpawu ezinokuthi zibangelwe yi-NSCLC, rhoqo kwizigaba zokugqibela:

• Intlungu yethambo okanye ukuthamba
• Ukujongwa kweenkophe
• Ukugquma okanye ukutshintsha kwelizwi
• Intlungu edibeneyo
• Iingxaki zenzipho
• Ukuginya ubunzima
• Ukudumba kobuso
• Ubuthathaka
• Intlungu yamagxa okanye ubuthathaka

Ezi mpawu zinokubangelwa zezinye, iimeko ezingathandekiyo. Kubalulekile ukuba uthethe nomboneleli wakho wezempilo ukuba uneempawu.

Umboneleli uya kwenza uvavanyo lomzimba kwaye abuze malunga nembali yakho yonyango. Uya kubuzwa ukuba uyatshaya na, ukuba kunjalo, kangakanani utshaya kwaye unexesha elingakanani utshaye. Uya kubuzwa malunga nezinye izinto ezinokuthi zikubeke emngciphekweni womhlaza wemiphunga, njengokuvezwa kweekhemikhali ezithile.

Iimvavanyo ezinokuthi zenziwe ukuxilonga umhlaza wemiphunga okanye ubone ukuba sele zisasazekile zibandakanya:

• Ukuskena amathambo
• I-x-ray yesifuba
• Gcwalisa ubalo lwegazi (CBC)
• Ukuxilongwa kwe-CT kwesifuba
• I-MRI yesifuba
• Ukuskena i-Positron emission tomography (PET)
• Uvavanyo lwesikhohlela ukujonga iiseli zomhlaza
• I-Thoracentesis (isampulu yolwakhiwo lolwelo olujikeleze umphunga)

Kwiimeko ezininzi, iqhekeza leethishu liyasuswa kwimiphunga yakho ukuze lihlolwe ngemicroscope. Oku kubizwa ngokuba yi-biopsy. Zininzi iindlela zokwenza oku:

• I-Bronchoscopy idityaniswe ne-biopsy
• I-CT-scan-ngqo kwi-biopsy yenaliti
• I-endoscopic esophageal ultrasound (EUS) ene-biopsy
• I-Mediastinoscopy kunye ne-biopsy
• Vula i-lung biopsy
• I-biopsy yePleural

Ukuba i-biopsy ibonisa umhlaza, kwenziwa iimvavanyo zokucinga ngakumbi ukufumana inqanaba lomhlaza. Inqanaba lithetha ukuba likhulu kangakanani ithumba kwaye lide lasasazeka kangakanani. I-NSCLC yahlulwe yangamanqanaba ama-5:

• Isigaba 0 - Umhlaza awusasazekanga ngaphaya komgca wangaphakathi wemiphunga.
• Isigaba I - Umhlaza umncinci kwaye awusasazekanga kwii-lymph node.
• Isigaba II - Umhlaza usasazeke kwii-lymph node ezithile kufutshane nethumba lokuqala.
• Isigaba III - Umhlaza usasazeke kwizicubu ezikufutshane okanye kwiindawo ezikude ze-lymph node.
• Isigaba IV - Umhlaza usasazeke kwamanye amalungu omzimba, njengamanye amaphaphu, ingqondo, okanye isibindi.

Zininzi iintlobo ezahlukeneyo zonyango lwe-NSCLC. Unyango luxhomekeke kwinqanaba lomhlaza.

Utyando lonyango oluqhelekileyo lwe-NSCLC olungasasazekanga ngaphaya kwee-lymph node ezikufutshane. Ugqirha ususa:

• Enye yeelobes zemiphunga (lobectomy)
• Inxalenye encinci yomphunga (ukususwa okanye ukususwa kwecandelo)
• Umphunga wonke (pneumonectomy)

Abanye abantu bafuna ichemotherapy. I-Chemotherapy isebenzisa iziyobisi ukubulala iiseli zomhlaza kunye nokuyeka iiseli ezintsha ekukhuleni. Unyango lunokwenziwa ngezi ndlela zilandelayo:

• I-Chemotherapy yodwa ihlala isetyenziswa xa umhlaza usasazekile ngaphandle kwemiphunga (inqanaba IV).
• Inokunikwa kwakhona ngaphambi kotyando okanye kwimitha ukwenza olo nyango lusebenze ngakumbi. Oku kubizwa ngokuba lonyango lwe-neoadjuvant.
• Inokunikwa emva kotyando ukubulala nawuphi na umhlaza oshiyekileyo. Oku kubizwa ngokuba lunyango oluncedisayo.
• I-Chemotherapy ihlala inikwa ngomthambo (nge-IV). Okanye, inokunikwa ziipilisi.

Ukulawula iimpawu kunye nokukhusela iingxaki ngexesha nasemva kwe-chemotherapy yinxalenye ebalulekileyo yokhathalelo.

I-Immunotherapy luhlobo olutsha lonyango olunokunikwa lulodwa okanye nge-chemotherapy.

Unyango ekujoliswe kulo lungasetyenziselwa ukunyanga i-NSCLC. Unyango ekujoliswe kulo lusebenzisa iziyobisi zero kwiithagethi ezithile (iimolekyuli) ngaphakathi okanye kwiiseli zomhlaza. Ezi njongo zidlala indima kwindlela iiseli zomhlaza ezikhula kwaye zisinde ngayo. Sebenzisa oku kujoliswe kuko, iyeza likhubaza iiseli zomhlaza ukuze zingabinako ukusasazeka.

Unyango ngemitha lunokusetyenziswa ngechemotherapy ukuba utyando alunakwenzeka. Unyango lwe-radiation lusebenzisa i-x-reyi enamandla okanye ezinye iindlela zemitha yokubulala iiseli zomhlaza. Imitha ingasetyenziselwa:

• Nyanga umhlaza, kunye ne-chemotherapy, ukuba utyando alunakwenzeka
• Nceda unciphise iimpawu ezibangelwa ngumhlaza, ezinje ngokuphefumla kunye nokudumba
• Nceda ukhulule iintlungu zomhlaza xa umhlaza usasazekile waya emathanjeni

Ukulawula iimpawu ngexesha nasemva kokutshiswa kwemitha esifubeni yinxalenye ebalulekileyo yokhathalelo.

Olu nyango lulandelayo lusetyenziselwa ukunciphisa iimpawu ezibangelwa yi-NSCLC:

• Unyango lweLaser-Umqadi omncinci wokutsha kokutsha kwaye ubulala iiseli zomhlaza.
• Unyango lwe-Photodynamic -Usebenzisa ukukhanya ukwenza iziyobisi emzimbeni, ezibulala iiseli zomhlaza.

Ungaluphelisa uxinzelelo lokugula ngokujoyina iqela lenkxaso. Ukwabelana nabanye abanamava afanayo kunye neengxaki kunokukunceda ungaziva ulilolo.

Imbonakalo iyahluka. Rhoqo, i-NSCLC ikhula kancinci. Ngamanye amaxesha, inokukhula kwaye isasaze ngokukhawuleza kwaye ibangele ukufa ngokukhawuleza. Umhlaza unokusasazeka kwamanye amalungu omzimba, kubandakanya ithambo, isibindi, amathumbu amancinci kunye nengqondo.

I-Chemotherapy ibonakalisiwe ukwandisa ubomi kunye nokuphucula umgangatho wobomi kwabanye abantu abanesigaba IV NSCLC.

Amanqanaba onyango ahambelana nenqanaba lesifo nokuba uyakwazi na ukwenza utyando.

• Umdlavuza weSigaba I kunye no-II banamaqondo aphezulu okusinda kunye nonyango.
• Umhlaza weSigaba III unokunyangeka kwezinye iimeko.
• Umhlaza weSigaba IV obuyileyo phantse awunyangeki. Iinjongo zonyango kukunyusa nokuphucula umgangatho wobomi.

Biza umnikezeli wakho ukuba unempawu zomhlaza wemiphunga, ngakumbi ukuba uyatshaya.

Ukuba uyatshaya, ngoku lixesha lokuba uyeke. Ukuba unengxaki yokuyeka, thetha nomboneleli wakho. Zininzi iindlela zokukunceda uyeke, ukusuka kumaqela enkxaso ukuya kumayeza amiselweyo. Kwakhona, zama ukukuphepha ukutshaya.

Ukuba ungaphezulu kweminyaka engama-55 kwaye utshaye okanye usebenzise ukutshaya kule minyaka ilishumi idlulileyo, thetha nomboneleli wakho malunga nokuvavanywa komhlaza wemiphunga. Ukuze uhlolwe, kufuneka uhlolwe i-CT yesifuba.

Umhlaza - umphunga - iseli engeyiyo encinci; Umhlaza wemiphunga ongekho mncinci; NSCLC; Adenocarcinoma - imiphunga; Squamous cell carcinoma - imiphunga; Iseli enkulu carcinoma - imiphunga

• Imitha yesifuba - ukukhutshwa
• Utyando lwemiphunga - ukukhupha

• Amaphaphu
• Umsi otshaywayo nomhlaza wemiphunga

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I-Ettinger DS, iWood DE, iAggarwal C, et al. Izikhokelo ze-NCCN ukuqonda: umhlaza wamaphaphu ongekho mncinci, inguqulelo 1.2020. J Natl Compr Umhlaza weNetw. Ngo-2019; 17 (12): 1464-1472. IINKCUKACHA: I-PMID: 31805526. pubmed.ncbi.nlm.nih.gov/31805526/.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lwesifo somhlaza esincinci esincinci (PDQ) -uhlobo lobungcali kwezempilo. www.cancer.gov/types/lung/hp/non-small-cell-lung-nyango-pdq. Ukuhlaziywa ngoMeyi 7, 2020. Ifikeleleke ngoJulayi 13, 2020.

USilvestri GA, uPastis NJ, uTanner NT, uJett JR. Imiba yezonyango yomhlaza wemiphunga. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray kunye neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 53.