Ikusasa lokwelashwa okuhlosiwe (TTT)

Cabanga ukuthi unikezwe iphromoshini oyithole kanzima emsebenzini, izingane zakho zenza kahle esikoleni futhi ikhefu lasentwasahlobo seliseduze. Wenze izinhlelo ezikhethekile zokuya e-Disneyland futhi ohlezi endlini usendleleni. Umqondo wakho udidekile, kodwa awukaze ujabule. Ufuna ukujabulela lesi sikhathi futhi ucabange ukuthi usuhambe kangakanani.

Bese uthola ucingo oluvela kudokotela wakho mayelana ne-x-ray akuthathe izolo. Akasithandi isithombe esikhulu asibonayo. Ubhukha i-CT scan kanye ne-aphoyintimenti ephuthumayo nodokotela ohlinzayo we-thoracic osanda kubhekwa-bese, ezinsukwini ezimbalwa kamuva, sekuyisikhathi sokuthola imiphumela yakho.

Izindaba zinjengoba ubusaba: lesi yisiqalo sokukhula komdlavuza. Umhlaba wakho ophelele uphahlazeka ngokuzumayo.

Ungase udideke futhi ukhungathekiswe izindlela eziningi zokwelapha ezikhona. Ngaphandle kokuhlinzwa—uma isimila sisebenza—ungathola ukuthi izindlela zokwelapha zendabuko ezifana nokwelashwa ngamakhemikhali nemisebe zingasebenza. Mhlawumbe ukhetha okunye ongakhetha kukho njengomuthi ophelele, ukuzivocavoca nokudla, umthandazo noma ukwelulekwa. Noma mhlawumbe ufaneleka ukuthola indlela eyaziwa ngokuthi i-target therapy treatment (TTT).

Uma ufaneleka ukuthola inketho yokwelashwa ye-TTTꟷa ethatha izinhlobo eziningana ezihlukene kuye ngomdlavuza, amathuba akho angaba ngcono. Lokhu kwelashwa kunezinga eliphezulu lokusinda kwesiguli kunezinye izindlela eziningi zokwelapha futhi kunganikeza izinga eliphezulu lempilo, kuye ngokuxilonga isiguli. Bangu-10-15% kuphela abantu baseNyakatho Melika abafanelekela lolu hlobo oluthile lokwelashwa.

Akuyona yonke i-TTT ezohlinzeka ngekhambi eliphelele, kodwa inhloso yayo ukwehlisa nokulawula ukukhula komdlavuza. Ngokungafani ne-chemotherapy, i-TTT iyahlukanisa futhi (okufanelekile) ibulala amaseli omdlavuza kuyilapho inomthelela omncane kumaseli akho emvelo. I-TTT ingabizwa ngokufanelekile ngokuthi “imithi eqondile,” njengoba “isebenzisa ukwaziswa okuphathelene nezakhi zofuzo namaprotheni omuntu ukuze ivimbele, ixilonge, futhi yelaphe izifo.”

Ukuvela kokwelashwa okuhlosiwe

I-chemotherapy ejwayelekile yatholwa ekuqaleni kweMpi Yezwe I yamakhemikhali. Ukuziphendukela kwemvelo kwayo kwaqala ngokuhlolwa kwezidumbu zezisulu ezazichayeke ku-nitrogen mustard. Kulokhu kuhlolwa kwezidumbu, ukucindezelwa nokuhlukaniswa kwamaseli athile e-somatic kwatholwa futhi kwahunyushwa njengempumelelo yomdlavuza.

Kusukela ekuqaleni kwawo-1900, ukwelashwa ngamakhemikhali kuye kwaba ngcono kakhulu, futhi sekuvule iminyango yokuhlinzwa komdlavuza, ama-antibiotics kanye nolunye ucwaningo lomdlavuza olubandakanya izidakamizwa ozikhethela zona njengalezo ezisetshenziswa ku-TTT. Izinsiza eziningi ze-TTT zidaliwe futhi zahlolwa ngaphakathi immunotherapy izilingo eminyakeni engu-80 edlule.

Kulezi zivivinyoꟷEminye imithi yakamuva kakhulu ye-TTT eyahlukene ivunyelwe njengempumelelo yi-FDA. Ezinye izindlela zaqala ukutholakala emakethe ngo-2004. Lezi zindlela zihlanganisa i-Gefitnib ne-Erlotnib, “ama-signal transduction inhibitors” okuhloswe ngawo ukwelapha. umdlavuza wamaphaphu weselula ongewona omncane.

Lapho i-TTT ikhona manje

NgokweNational Cancer Institute, nalu uhlu lwezindlela zokwelapha ezihlosiwe ezivame ukusetshenziswa namuhla:

• Ukwelashwa kwama-hormone (okusetshenziselwa isifuba ne-prostate)
• Ama-Signal transduction inhibitors (asetshenziselwa amaphaphu)
• Ama-apoptosis inducers (angaphoqa ukufa kwamaseli omdlavuza)
• I-Angiogenesis inhibitors (esetshenziselwa izinso)
• Amasosha omzimba e-monoclonal (asetshenziselwa ukuletha ubuthi kumaseli omdlavuza)
• Ulwazi olwengeziwe mayelana nendlela ngayinye yalezi zindlela zokwelapha ezisebenza ngayo ingatholakala lapha.

Ngokuya ngomdlavuza wakho kanye nezici ezihlukahlukene zempilo, i-TTT ingasetshenziswa iyodwa noma ihlanganiswe nezinye izindlela zokwelapha, zombili zendabuko nezintsha. Inhlanganisela ekulungele into udokotela wakho we-oncologist anganquma kangcono.

Nakuba ingenabuthi obuncane kune-chemotherapy, kubalulekile ukuqaphela ukuthi i-TTT inayo imiphumela emibi. Lokhu kubandakanya:

• Izinkinga zesikhumba
• Umfutho wegazi ophezulu
• I-Nosebleeds
• Ukubhobozwa kwamathumbu
• Uhudo

Le miphumela kufanele iqashwe, kodwa ngokuvamile iyalawuleka.

Lapho i-TTT ibheke khona esikhathini esizayo

I-TTT ingasetshenziswa ngezindlela ezihlukahlukene ezimangalisayo zokulwa nomdlavuza. Lolu hlobo lokwelapha alukwazi nje ukumisa ukwakheka kwemithambo yegazi ezimila, kodwa futhi lubangele ukufa kwamangqamuzana omdlavuza, luhambise izinto ezibulala amangqamuzana kumangqamuzana omdlavuza futhi lusize ngisho namasosha omzimba abhubhise amangqamuzana omdlavuza. Isisekelo salokhu okutholakele kuyinqubo ebizwa ngokuthi “iphrofayili ye-genomic,” njengoba kuchazwe uDkt. Kenneth C. Anderson we-Dana Farber Cancer Institute, oqhubeka echaza ukuthi le ndlela izosiza kanjani i-TTT iqhubekele phambili yocwaningo.

"Okokuqala, iphrofayili ye-genomic izoqhubeka nokukhomba izindlela eziguquliwe ezivumela ukukhula nokusinda kwamaseli e-tumor," kusho u-Anderson. “Lolu lwazi lungasiza abacwaningi ukuthi bathuthukise izindlela zokwelapha ezihlosiwe. Okwesibili, imishanguzo yokuzivikela komzimba ehlanganisa amasosha omzimba e-monoclonal, izidakamizwa ze-immunomodulatory, imithi yokugoma, i-checkpoint inhibitors, kanye nokwelashwa kwamaselula, ikakhulukazi ngokuhlanganiswa, kuzosiza umzimba ukuthi ufunde ukulwa ne-myeloma ngokwakho futhi unikeze ukusinda isikhathi eside ngaphandle kwezifo. Okokugcina, ukusetshenziswa kwenhlanganisela yokwelapha ehlosiwe kanye neyokuzivikela komzimba ekuqaleni kwenkambo yesifo, ngaphambi kokuvela kwezimpawu ezinzima kakhulu, ekugcineni kuzovimbela ukukhula kwesifo esisebenzayo futhi kutholakale ukwelashwa. "

Ukuthuthukiswa kwezindlela zokwelapha ezintsha ezihlosiwe kunesithembiso esikhulu. Imithi yokugoma, amasosha omzimba kanye nemithi eminingi yokwelapha yamaselula izosiza ukulwa nomdlavuza, ikakhulukazi uma isetshenziswa ihlangene. Imithi yokwelapha yamasosha omzimba ehlanganiswe nemithi ehlosiwe ithandeka kakhulu, ikakhulukazi ezigabeni zokuqala zomdlavuza. Zonke lezi zindlela zizofinyeleleka futhi zithuthukiswe phakathi neminyaka eyi-10.