Chii chinonzi Remission, Relapse uye Refractory Lymphoma?
Kuregererwa
Kuregererwa kwakazara ndiko kana ma scans & bvunzo ako asingaratidze chiratidzo che lymphoma mumuviri wako mushure mekurapwa.
Kuregererwa kwechikamu ndiko kana kuchine lymphoma mumuviri wako, asi iri pasi pehafu yezvayaive isati yarapwa.
Kudzokorora
Refractory
Mavhesi ekuregererwa anorapa
Mushonga kana iwe usina zviratidzo zve lymphoma yakasara mumuviri wako uye haigoni kudzoka. Vanachiremba vanowanzosarudza kushandisa izwi rekuregererwa, nokuti tinoziva lymphoma inogona kudzoka.
Iyo nguva yakareba iwe uri mukuregererwa zvishoma zvingaita kuti lymphoma ine hutsinye idzoke, saka chiremba wako angapedzisira ati wapora, asi kazhinji vanozoshandisa izwi rekuregererwa. Izvi ndezvokuti kunyange zvazvo vanhu vakawanda vangasamboita lymphoma yavo kudzoka, hatizivi kuti ndiani achadzoka uye ndiani asingazodzoki zvakare.
Vamwe vanhu vanogona kunge vaine zvimwe zvinhu zvine njodzi zvinoita kuti zvive nyore kudzoka, asi iwe unofanirwa kutaura nachiremba wako nezve njodzi yako uye mikana yekurapwa, kuregererwa kana kudzoka zvakare.
Chii chinoitika kana lymphoma inodzoka zvakare?
Chiremba wako acharamba achikutarisa mushure mekunge wapedza kurapwa, uye chimwe chezvikonzero zvavanoita izvi kutarisa zviratidzo nezviratidzo zve lymphoma yako inodzoka zvakare. Nekuramba vachikuona nguva nenguva, vanozokwanisa kukurumidza kukurumidza, uye kuraira kuongororwa kwakawanda kana kutanga kurapwa zvakare pazvinenge zvichidikanwa.
Kunyange zvazvo zvingave zvichiodza mwoyo kuona kuti lymphoma yako yadzoka zvakare, zvakakosha kuziva kuti kunyange lymphoma yakadzoka inowanzopindura zvakanaka kurapwa, uye inogona kuita kuti iwe uende mukuregererwa zvakare.
Kudzoka kwakajairika kune vanhu vane indolent lymphoma nokuti indolent lymphomas haifaniri kunzi inoporesa. Pane kudaro, iwe uchararama ne indolent lymphoma kwehupenyu hwako hwose. Zvisinei, pakati pekurapwa uye munguva dzekuregererwa, vanhu vazhinji vanorarama hupenyu hwemazuva ose uye vazhinji vanewo nguva yeupenyu yakajairika.
Mune zvimwe zviitiko zvisingawanzoitiki, indolent lymphoma inogona kuchinja kuva yakasiyana, uye yakanyanya hutsinye subtype ye lymphoma. Kushandurwa lymphoma kwakasiyana nekudzoka zvakare. Kuti udzidze zvakawanda nezve yakashandurwa lymphoma tinya iyi link iripazasi.
Sei lymphoma ichidzoka zvakare?
Kudzokorora kunogona kuitika nekuda kwezvikonzero zvakawanda. Zvimwe zvacho zvinosanganisira:
- Iko hakuna mushonga unozivikanwa kune mamwe lymphomas, kunyanya indolent lymphomas. Saka, nepo kurapwa kunoshanda pakugadzirisa chirwere hachigone kuchirapa. Paunenge uine indolent lymphoma, pachagara paine mamwe masero e-lymphoma akasiiwa ane mukana wekumuka uye kukura.
- Kumwe kuchinjwa kwemajini hakugone kurapwa nekurapa kwazvino. Saka, kunyange kana pasina chiratidzo che lymphoma chakasara mumuviri wako, mamwe maitiro ekuchinja anogona kuita kuti lymphoma ikure zvakare.
- Kunyangwe kana ma scan uye bvunzo zvichiratidza kuti hapana lymphoma yasara mumuviri wako, pane dzimwe nguva panogona kuve nemicroscopic lymphoma masero ari mashoma kana madiki kuti aonekwe neazvino bvunzo uye scans. Kana izvi zviripo, zvinogona kukura uye kuwanda mushure mekunge kurapwa kwapera.
Kudzokorora kunoitika nokukurumidza sei?
Kana uine lymphoma ine hukasha yakadai seHodgkin Lymphoma kana kuti ine hukasha (inokurumidza kukura) Non-Hodgkin Lymphoma, mushonga unobvira. Zvisinei kana ukadzokera shure, zvinowanzoitika mukati memakore mashoma ekupedza kurapwa.
Kana uine indolent (inokura zvishoma nezvishoma) Non-Hodgkin Lymphoma, kudzoka zvakare kunowanzo. Nepo kudzokazve kunogona kuitika mukati memwedzi yekupedza kurapwa, kazhinji kuregererwa kunotora makore mazhinji kusati kwatangazve.
Dzidza nezvekurapa lymphoma yakadzoka zvakare naDr Michael Dickinson
Hematologist
Unoziva sei kana lymphoma yakadzoka zvakare?
Lymphoma inogona kudzoka muchikamu chimwechete chemuviri wako kana inogona kukanganisa chikamu chakasiyana chemuviri wako kubva pawakanga uine lymphoma kare. Unogona kana kusave nezviratidzo uye kana ukadaro, zvinogona kusanganisira:
- Zvitsva kana lymph nodes kana mapundu asina hukama nehutachiona kana chirwere
- Kunyorova usiku dikita
- Unexplained kuora kurasikirwa
- Kuneta kwakaipisisa kupfuura kwakajairika
- Itching
- Kushanda kweganda
- Diarrhea
- Kurwadziwa kusingatsananguriki kana kusagadzikana
- B-zviratidzo.
Chii chinoitika kana lymphoma ikadzoka zvakare
- Biopsy yemalymph nodes matsva kana mapundu
- Kuyera ropa
- Positron emission tomography (PET) scan
- Computed tomography (CT) scan
- Lumbar puncture kana lymphoma ichifungidzirwa mukati menheyo system.
Chii chinoitika kana lymphoma yangu ichiramba kurapwa?
Zvinogona kushungurudza kuziva kuti kurapwa kwako ikozvino hakusi kushanda kurapa, kumisa kana kuderedza lymphoma yako. Kunzwa kutya, kutsamwa kana kuzvidya mwoyo zvinowanzoitika. Zvakakosha kunzwisisa zvakadaro, kuti nekuda kwekuti kurapwa uku hakuna kushanda sezvakarongwa, hazvireve kuti tariro yarasika. Ma<em>lymphoma mazhinji asingapindure zvakanaka pakurapa mutsara wekutanga, anogona kuramba aine mhinduro yakanaka kune yechipiri kana yechitatu-mutsara kurapwa.
Refractory lymphoma inogona kuitika apo masero e-lymphoma anokura zvipingamupinyi zvekuchengetedza kana nzvimbo dzekutarisa dzinoita kuti dzidzivirire kumishonga yakajairika. Kumwe kuchinjwa kwemajini kunogonawo kuita kuti zvisaite kuti mamwe marapirwo anorwisa gomarara ashande nemazvo.
Kana izvi zvikaitika chiremba wako achada kuedza rudzi rwakasiyana rwekurapa runoshanda nenzira yakasiyana kune marapirwo ako azvino.
Ndinoziva sei kana lymphoma yangu iri refractory?
Iwe unogona kunge uine ma scans mushure mekunge wapedza kanenge maviri kana matatu maitiro ekurapwa kwako. Kana iwe uine ma scans aya zvinoenderana nemamiriro ako ega, subtype uye rudzi rwekurapa. Bvunza chiremba wako kana iwe uchange uine mamwe ma scan uye bvunzo.
Kazhinji mushure mekutanga kurapwa unoona kuti malymph nodes ako akazvimba kana zvimwe zviratidzo zvinovandudza mushure memazuva mashoma ekurapwa. Zvisinei mune dzimwe nguva unogona kuona, kana kuongorora kunogona kuratidza kuti lymphoma haina kuvandudza uye iwe unogona kuva nenzvimbo itsva dze lymphoma.
Chiremba wako anogona kuenderera mberi nekurapa kwako uye kuita mamwe mascans mushure memamwe maitiro ekurapa, kana vangasarudza kuchinja kurapwa kwako pakarepo. Ivo vanozotaura newe nezvezvakanakisa sarudzo kune yako wega mamiriro.
Nzira dzekurapa dzekudzokazve kana refractory lymphoma
Nzira dzekurapa dzaunopiwa kana iwe uine kudzoka zvakare kana refractory lymphoma zvinoenderana nezvinhu zvakawanda, kusanganisira:
- iyo subtype, nhanho uye nzvimbo / s ye lymphoma yako
- genetic mutations inobatanidzwa mu lymphoma yako
- kana wanga uine nguva yekuregererwa uye kana zvakadaro, wakagara kwenguva yakareba sei uri mukuregererwa
- zera rako uye kugara zvakanaka kwese
- kuti wakararama sei nemishonga yapfuura
- kukodzera kwako kumiedzo yekiriniki
- zvaunoda iwe pachako.
Mhando dzekurapa kwekudzokazve kana refractory lymphoma
Nekuedzwa kwekiriniki uye marapirwo matsva ari kubvumidzwa kurapwa kana kutungamira lymphoma muAustralia, isu tine sarudzo dzakawanda dzechipiri uye yechitatu-mutsara marapirwo kupfuura kare. Sezvo zvakadaro, nekuda kwezvikonzero zviri pamusoro apa, hapana nzira imwe chete yekurapa. Nekudaro, mamwe ekurapa anowanikwa mune yechipiri uye yechitatu-mutsara kurapwa anosanganisira:
- Clinical kuedza kubatanidzwa
- Combination chemotherapy
- Salvage chemotherapy (yakanyanya dose chemotherapy)
- Stem cell transplant (autologous & allogeneic)
- Targeted therapy
- immunotherapy
- Biological mishonga
- Radiotherapy
- Chimeric antigen receptor (CAR) T-cell therapy
- Off label kuwana mishonga.
Off label kuwana mushonga
Dzimwe nguva, unogona kukwanisa kuwana mishonga isingapihwe mari pachena, asi inonzi yakachengeteka uye iri pamutemo kuti ishandiswe muAustralia neTherapeutic Goods Administration (TGA).
Zvinhu zvinokosha zvekuziva:
- Izvi zvinogona kunge zvisiri sarudzo yemunhu wese sezvo nyika yega yega ine mitemo nemirau yakasiyana.
- Ungangoda kufamba kune kumwe kana kurapwa kwese.
- Inogona kudhura zvakanyanya sezvaunoda kuzvipa wega, kana kuzvibhadharira wega. Saka, chimwe chinhu chinoda kunyatsotariswa uye kukurukurwa nehematologist yako kuti unzwisise zvizere.
- Mune zvimwe zviitiko, unogona kukwanisa kuwana mushonga pane "zvikonzero zvetsitsi" apo kambani yemishonga inobhadhara imwe kana mari yose yemishonga ye-off-label. Bvunza chiremba wako kana iyi iri sarudzo kwauri.
Kuwana maonero echipiri
Zvakajairika kuti varwere vabvunze maonero echipiri. Iyi isarudzo yakanaka yekunzwa pfungwa dzechipiri chiremba wehematologist uyo angangokwanisa kusimbisa ruzivo rwawakapihwa nachiremba wako wekutanga wehematologist, kana kukupa nzira dzakasiyana. Hapana chikonzero chekunzwa zvakaipa pamusoro pekukumbira maonero echipiri. Vazhinji vehematologists vakagadzikana newe uchitsvaga yechipiri maonero - Ndihwo hutano hwako shure kwezvose.
Kana iwe uchida kuwana maonero echipiri taura nehematologist wako. Kazhinji, vanogona kukurongera chimwe chinhu, kana kuti unogona kutaura naChiremba wezvirwere zvese. Iri idanho rakakosha pakuita chokwadi chekuti unowana ruzivo rwaunoda kuti uwane kurapwa kwakakodzera kwemamiriro ako ega.
Dzidza zvakawanda nezve 'off label access' muvhidhiyo iri pazasi
Kuronga kurapwa
Kutarisana nemanzwiro uye emuviri kudzvinyirirwa kwekuva nelymphoma, uye kurapwa kunogona kunetesa. Zvakakosha kuti usvike uye uwane rubatsiro paunoda. Kazhinji tine vanhu muhupenyu hwedu vanoda kubatsira, asi vasingazive kuti sei. Vamwe vanhu vanonetsekawo nekutaura nezvekuti uri kufamba sei nekuti vane hanya kuti vachataura zvisirizvo, kukudarika kana kukugumbura. Izvi hazvirevi kuti havana basa nazvo.
Inogona kubatsira kuita kuti vanhu vazive zvaunoda. Nokuva akajeka pamusoro pezvaunoda, unogona kuwana betsero netsigiro zvaunoda, uye vadiwa vako vanogona kuva nomufaro wokukwanisa kukubatsira nenzira ine revo. Kune mamwe masangano akaisa pamwe zvirongwa zvaunogona kushandisa kuronga kumwe kwekuchengeta. Ungada kuedza:
Kuronga mberi kwekutarisira
Kufanoronga kwekutarisira inzira huru yekuita shuwa kuti timu yako yekurapa nemhuri vanoziva marapirwo aunoita, uye vasingade kuve nawo mune ramangwana.
Wese munhu anofanirwa kuve nefanochengeta hurongwa. Mafomu anodiwa uye maitiro ekugadzira chirongwa chekutarisira chepamberi anogona kusiyana kubva mudunhu nenyika. Kuti uwane rumwe ruzivo nezve kuronga kwekutarisira kwepamberi, uye kuwana mafomu akakodzera edunhu rako, tinya chinongedzo chiri pazasi.
Kuchengetedza kwepakati
Vanhu vazhinji vanofunga kuti palliative care ndeyekutarisira kwekupedzisira kwehupenyu. Kunyange zvazvo iri rimwe remabasa, ivo vane rimwe basa guru. Vanobatsirawo kugadzirisa zviratidzo uye mhedzisiro yakaoma kurapa yaungasangana nayo chero nguva panguva yako lymphoma. Chinangwa chikuru ndechekubatsira kuve nechokwadi chekuti une hupenyu hwepamusoro panguva yekurapwa kwako uye pakupera kwehupenyu.
Symptom/side-effect management
Lymphoma uye marapirwo ayo anogona kukonzera zvakasiyana-siyana zviratidzo uye mhedzisiro. Nepo wako wehematologist kana oncologist achigona kubatsira nezvakawanda zveizvi, dzimwe nguva zviratidzo kana mhedzisiro inoda humwe hunyanzvi hwekutarisira. The palliative care team inyanzvi pakugadzirisa izvi. Ivo zvakare vanokwanisa kuwana mishonga iyo wako haematologist kana oncologist vasina mvumo yekuraira. The palliative care timu chinhu chikuru chekuvandudza hupenyu hwako.
Zvimwe zviratidzo kana mhedzisiro dzavanogona kukubatsira kubata zvinosanganisira:
- kurwadziwa - kusanganisira peripheral neuropathy
- kuda kurutsa kana kurutsa
- kufunganya
- kukurumidza kufema
Kupera kwekuchengetedza hupenyu
Kubudirira miedzo yekiriniki, zvinoreva kuti kune akawanda emishonga mitsva yakavandudza zvakanyanya mhedzisiro kune vanhu vane lymphoma - kunyangwe kudzoka uye refractory lymphoma. Vanhu vazhinji vanorarama hupenyu hurefu uye hune hutano kunyange mushure mekuongorora lymphoma. Zvinosuruvarisa, dzimwe nguva vanhu vanofa ne lymphoma.
Basa rinonyanya kunzwisiswa rekurapwa kwepalliative nderekubatsira vanhu vava kusvika kumagumo ehupenyu hwavo kuti vave nekutonga pamusoro pemararamiro avanoita hupenyu hwavo hwese. Ivo vakanaka pakukupa simba rekufunga nezvazvo, uye kuronga zvaunoda uye kwaungade kushandisa nguva yako, uchiona kuti wakachengeteka, nehupenyu hwakanaka panguva ino.
Tsigiro kana wava pedyo nekuguma kwehupenyu hwako
Kuchengeta palliative kunogonawo kubatsira mhuri yako nevadikanwi kuti vanzwisise zviri kuitika, uye kuve nechokwadi kuti vane rutsigiro rwavanoda panguva ino zvakare. Zvimwe zvavanogona kubatsira nazvo zvinosanganisira:
- kuronga midziyo yekuti iwe ushandise kumba kana ukasarudza kugara pamba
- kutaura nevadikanwi nezvenyaya dzinonetsa dzakadai sekupera kwehupenyu hwako uye hurongwa hwemariro
- kukubatanidza kumabasa akasiyana munharaunda
- iva nechokwadi chekuti zvaunotenda zvetsika nezvemweya zvinotsigirwa pakufa kwako
- kuraira uye kutsigirwa mupfungwa.
pfupiso
- Mushonga kana pasina lymphoma yasara mumuviri wako uye haidzoki.
- Kuregererwa kunogona kunge kwakazara kana kusara pasina zviratidzo zve lymphoma mumuviri wako (zvakakwana), kana kana masero e-lymphoma aderedzwa neanopfuura hafu (chikamu).
- Lymphoma inogona kudzoka zvakare (kudzoka) mushure menguva yekuregererwa. Kuregererwa kunogona kupedza mavhiki, mwedzi kana makore akawanda.
- Kana aggressive lymphomas adzoka, kazhinji mumakore mashoma ekutanga mushure mekupedza kurapwa. Kana 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 uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchi .
- Indolent lymphomas inowanzodzoka zvakare, asi zvakare inowanzopindura zvakanaka kurapwa. Iwe uchararama ne indolent lymphoma kwehupenyu hwako hwose, asi unogona kurarama zvakanaka munguva dzekuregererwa.
- Mune zvimwe zviitiko, lymphoma haina kuita nani nekutanga kurapwa - iyi inonzi refractory.
- Refractory lymphoma inogona kuramba ichipindura zvakanaka kune yechipiri uye yechitatu mutsara kurapwa.
- Kufanoronga kwekutarisira kwakakosha kuve nechokwadi chekuti mhuri yako uye vanachiremba vanoziva zvishuwo maererano nehutano hwako.
- Palliative care inogona kubatsira nezviratidzo uye side-effect management.
- Vamwe vanhu vachada kuchengetwa kwekuguma kwehupenyu kana lymphoma yavo isingapinduri kurapwa. Palliative care inogona kuva tsigiro huru, uye ive nechokwadi chekuti une hupenyu hwakanakisa munguva yekupedzisira-yehupenyu nguva, uye kupa rubatsiro runodiwa kune vaunoda.
