Kuyini Ukuxolelwa, Ukuphindaphinda kanye ne-Refractory Lymphoma?
Ukuthethelelwa
Ukuxolelwa okuphelele kulapho izikena nokuhlolwa kwakho kungabonisi zimpawu ze-lymphoma emzimbeni wakho ngemva kokwelashwa.
Ukukhululwa okuyingxenye yilapho kusekhona i-lymphoma emzimbeni wakho, kodwa ingaphansi kwengxenye yalokho ebiyikho ngaphambi kokwelashwa.
Ukushiyeka
I-Refractory
Ukwelashwa kuhlanganisa ukwelashwa
Ukwelapha yilapho ungenazo izimpawu ze-lymphoma esele emzimbeni wakho futhi cishe ngeke ibuye. Odokotela bavame ukukhetha ukusebenzisa igama elithi ukuxolelwa, ngoba siyazi ukuthi i-lymphoma ingabuya.
Uma usuxolelwe isikhathi eside mancane amathuba okuthi i-lymphoma enolaka ibuye, ngakho udokotela wakho angase agcine ethi welashiwe, kodwa ngokuvamile bazosebenzisa igama elithi ukuxolelwa. Lokhu kungenxa yokuthi nakuba abantu abaningi bengase bangabe besaba ne-lymphoma yabo, asazi ukuthi ubani ozokwenza futhi ngubani ongeke aphinde abuyele.
Abanye abantu bangase babe nezici ezithile zobungozi ezenza kube lula ukubuya, kodwa udinga ukukhuluma nodokotela wakho mayelana nezici zakho eziyingozi kanye namathuba okwelashwa, ukukhululwa noma ukuphinda ugule.
Kwenzekani lapho i-lymphoma ibuya?
Udokotela wakho uzoqhubeka nokukuqapha ngemva kokuqeda ukwelashwa, futhi esinye sezizathu esenza lokhu ukubuka izimpawu nezimpawu ze-lymphoma yakho ebuyela emuva. Ngokuqhubeka nokukubona njalo, bazokwazi ukusheshe baqale noma yikuphi ukuphinda baqale, futhi ba-ode ukuhlolwa okwengeziwe noma baqale ukwelashwa futhi lapho kudingeka.
Nakuba kungase kudumaze ukuthola ukuthi i-lymphoma yakho ibuyele emuva, kubalulekile ukwazi ukuthi ngisho ne-lymphoma ephindaphindiwe ngokuvamile isabela kahle ekwelapheni, futhi ingase ibangele ukuthi uphinde ungene ekuxolelweni futhi.
Ukubuyela emuva kuvame kakhulu kubantu abane-lymphoma engenzi lutho ngoba i-lymphomas indolent ayibhekwa njengokwelashwa. Esikhundleni salokho, uzophila ne-lymphoma engenalutho impilo yakho yonke. Kodwa-ke, phakathi kokwelashwa nangezikhathi zokuxolelwa, abantu abaningi baphila impilo evamile futhi abaningi banesikhathi sokuphila esivamile.
Kwezinye izimo ezingavamile, i-lymphoma engenalutho ingase iguquke ibe yi-subtype ehlukile, futhi enonya kakhulu ye-lymphoma. I-lymphoma eguquliwe ihlukile ekubuyiseleni. Ukuze ufunde kabanzi mayelana ne-lymphoma eguquliwe chofoza isixhumanisi esingezansi.
Kungani i-lymphoma ibuyela emuva?
Ukuphinda kwenzeke ngenxa yezizathu eziningana. Ezinye zazo zihlanganisa:
- Alikho ikhambi elaziwayo lamanye ama-lymphomas, ikakhulukazi ama-lymphoma angasebenzi. Ngakho-ke, nakuba ukwelashwa kusebenza ngempumelelo ekulawuleni isifo akukwazi ukuselapha. Uma une-indolent lymphoma, kuzohlala kukhona amaseli e-lymphoma asele anamandla okuvuka futhi akhule.
- Okunye ukuguqulwa kofuzo akukwazi ukwelapheka ngokwelashwa kwamanje. Ngakho-ke, ngisho noma lungekho uphawu lwe-lymphoma esele emzimbeni wakho, ezinye izinguquko zofuzo zingabangela ukuthi i-lymphoma ikhule futhi.
- Ngisho noma izikena nokuhlolwa kubonisa ukuthi ayikho i-lymphoma esele emzimbeni wakho, ngezinye izikhathi kungase kube namaseli e-lymphoma amancane kakhulu noma amancane kakhulu ukuthi angatholwa ngokuhlolwa kwamanje namaskeni. Uma lezi zikhona, zingakhula futhi zande ngemva kokuphela kokwelashwa.
Kwenzeka ngokushesha kangakanani ukuphindeka?
Uma une-lymphoma enamandla njenge-Hodgkin Lymphoma noma i-Non-Hodgkin Lymphoma enamandla kakhulu (ekhula ngokushesha), ukwelashwa kungenzeka. Kodwa-ke uma uphinda uphinda, ngokuvamile kuzokwenzeka phakathi neminyaka embalwa yokuqedwa kokwelashwa.
Uma une-indolent (ekhula kancane) i-Non-Hodgkin Lymphoma, ukubuyela emuva kuvame kakhulu. Nakuba ukuphindeka kungase kwenzeke phakathi nezinyanga zokuqeda ukwelashwa, ngokuvamile ukuphumula kuthatha iminyaka eminingi ngaphambi kokuba kuphinde kuqale.
Funda ngoDkt Michael Dickinson mayelana nokwelapha i-lymphoma ebuyelile
I-Hematologist
Wazi kanjani ukuthi i-lymphoma ibuyele emuva?
I-Lymphoma ingase ibuyele engxenyeni efanayo yomzimba wakho noma ingase ithinte ingxenye ehlukile yomzimba wakho kusukela lapho une-lymphoma ngaphambili. Ungase ube nezimpawu noma ungabi nazo futhi uma unazo, zingabandakanya:
- Ama-lymph nodes amasha noma ama-lymph nodes angahlobene nokutheleleka noma ukugula
- Ukujuluka ebusuku
- Ukulahlekelwa kwesisindo esingachaziwe
- Ukukhathala okubi kakhulu kunokujwayelekile
- Itching
- Ukukhwabanisa isikhumba
- Uhudo
- Ubuhlungu obungachazeki noma ukungakhululeki
- B-izimpawu.
Kwenzekani uma i-lymphoma iphindela
- I-Biopsy yama-lymph nodes amasha akhulisiwe noma izigaxa
- Ukuhlolwa kwegazi
- Ukuskena kwe-Positron emission tomography (PET)
- Icwecwe le-computer tomography (CT)
- I-Lumbar puncture uma i-lymphoma isolwa ohlelweni lwezinzwa oluphakathi.
Kwenzekani uma i-lymphoma yami iphikisana nokwelashwa?
Kungase kucindezele ukuthola ukuthi ukwelashwa kwakho kwamanje akusebenzi ukwelapha, ukumisa noma ukwehlisa i-lymphoma yakho. Ukuzizwa wethukile, uthukuthele noma ukhathazekile kuyinto evamile. Kubalulekile ukuqonda nokho, ukuthi ngenxa yokuthi lokhu kwelashwa akuzange kusebenze njengoba bekuhleliwe, akusho ukuthi ithemba seliphelile. Ama-lymphoma amaningi angaphenduli kahle ekwelashweni komugqa wokuqala, asengaba nokusabela okuhle ekwelashweni komugqa wesibili noma wesithathu.
I-Refractory lymphoma ingenzeka lapho amangqamuzana e-lymphoma ehlakulela izithiyo zokuphepha noma izindawo zokuhlola ezibenza bangakwazi ukwelapha okujwayelekile. Ukuguqulwa okuthile kofuzo nakho kungenza kube mancane amathuba okuthi ezinye izindlela zokwelapha ezilwa nomdlavuza zisebenze ngempumelelo.
Uma lokhu kwenzeka udokotela wakho uzofuna ukuzama uhlobo oluhlukile lokwelashwa olusebenza ngendlela ehlukile kwezokwelapha zakho zamanje.
Ngazi kanjani ukuthi i-lymphoma yami i-refractory?
Cishe uzoba nezikena ngemuva kokuqeda okungenani imijikelezo emibili noma emithathu yokwelashwa kwakho. Impela uma unalezi zikena kuzoncika esimweni sakho ngasinye, uhlobo oluncane kanye nohlobo lokwelashwa. Buza udokotela wakho ukuthi uzowathola nini amanye amaskena kanye nokuhlolwa.
Ngokuvamile ngemva kokuqala ukwelashwa ungabona ukuthi ama-lymph nodes akho avuvukele noma ezinye izimpawu ziba ngcono ngemva kwemijikelezo embalwa yokwelashwa. Kodwa-ke kwezinye izimo ungase uqaphele, noma ukuskena kungase kubonise ukuthi i-lymphoma ayizange ibe ngcono futhi ungase ube nezindawo ezintsha ze-lymphoma.
Udokotela wakho angase aqhubeke nokwelashwa kwakho kwamanje futhi enze izikena ezengeziwe ngemva kwemijikelezo yokwelashwa eyengeziwe, noma angase anqume ukushintsha imithi yakho ngokushesha. Bazokhuluma nawe mayelana nezinketho ezingcono kakhulu zesimo sakho somuntu ngamunye.
Izinketho zokwelapha ze-lymphoma ephindaphindiwe noma e-refractory
Izinketho zokwelapha ozinikezwayo uma une-lymphoma ephindaphindiwe noma e-refractory izoncika ezintweni eziningi, kuhlanganise:
- uhlobo oluncane, isiteji kanye nendawo/izindawo ze-lymphoma yakho
- izinguquko zofuzo ezihilelekile ku-lymphoma yakho
- uma uke waba nesikhathi sokuxolelwa, futhi uma kunjalo, wawunesikhathi esingakanani ekuthetheleleni
- iminyaka yakho kanye nenhlalakahle jikelele
- uye wabhekana kanjani nokwelashwa kwangaphambilini
- ukufaneleka kwakho ezivivinyweni zomtholampilo
- izintandokazi zakho siqu.
Izinhlobo zokwelapha ze-lymphoma ebuyele emuva noma e-refractory
Njengoba izivivinyo zemitholampilo kanye nokwelashwa okusha kugunyazwa ukwelashwa noma ukuphathwa kwe-lymphoma e-Australia, sinezinketho eziningi zokwelashwa komugqa wesibili nowesithathu kunangaphambili. Kanjalo, ngenxa yalezi zici ezingenhla, ayikho indlela yokwelapha elingana noyedwa. Nokho, ezinye zezindlela zokwelapha ezitholakala ekwelashweni komugqa wesibili nowesithathu zihlanganisa:
- Ukubamba iqhaza kokuhlolwa komtholampilo
- I-chemotherapy ehlanganisiwe
- I-Salvage chemotherapy (i-chemotherapy enethamo eliphezulu)
- Ukufakelwa kwe-stem cell (autologous & allogeneic)
- Ukwelapha okuhlosiwe
- immunotherapy
- Imithi yebhayoloji
- Radiotherapy
- I-Chimeric antigen receptor (CAR) T-cell therapy
- Ukufinyelela ngaphandle kwelebula emithini.
Ukufinyelela ngaphandle kwelebula emithini
Kwesinye isikhathi, ungase ukwazi ukufinyelela emithini engaxhaswanga esidlangalaleni, kodwa okuthiwa iphephile futhi isemthethweni ukuthi isetshenziswe e-Australia yi-Therapeutic Goods Administration (TGA).
Izinto ezibalulekile okufanele uziqaphele:
- Lokhu kungase kungabi inketho yawo wonke umuntu njengoba izwe ngalinye linemithetho nemithethonqubo ehlukile.
- Ungase udinge ukuhamba ukuze uthole okunye noma konke ukwelashwa.
- Kungabiza kakhulu njengoba udinga ukuzixhasa, noma uzikhokhele wena. Ngakho-ke, kuyinto edinga ukucatshangelwa ngokucophelela futhi kuxoxwe ngayo nodokotela wakho wegazi ukuze uyiqonde ngokugcwele.
- Kwezinye izimo, ungase ukwazi ukuthola imithi “ngezizathu zozwelo” lapho inkampani eyenza imithi ikhokhela ezinye noma zonke izindleko zomuthi ongekho ilebula. Buza udokotela wakho uma lokhu kuyinketho yakho.
Ukuthola umbono wesibili
Kuvamile ukuthi iziguli zicele umbono wesibili. Lokhu kuyindlela enhle yokuzwa imicabango kadokotela wegazi wesibili ongase akwazi ukuqinisekisa ulwazi olunikezwe udokotela wakho wokuqala we-hematologist, noma akunikeze izinketho ezahlukene. Asikho isizathu sokuzizwa kabi ngokucela umbono wesibili. Izazi eziningi ze-hematologists zikhululekile uma ufuna umbono wesibili - impilo yakho phela.
Uma ungathanda ukuthola umbono wesibili khuluma nodokotela wakho wegazi. Ngokuvamile, bangakuhlelela okuthile, noma ungakhuluma nodokotela wakho. Lesi yisinyathelo esibalulekile sokuqinisekisa ukuthi uthola ulwazi oludingayo ukuze uthole ukwelashwa okufanele kwezimo zakho ngazinye.
Funda kabanzi mayelana 'nokufinyelela ngaphandle kwelebula' kuvidiyo engezansi
Ukuhlela ukwelashwa
Ukubhekana nezingcindezi ezingokomzwelo nezomzimba zokuba ne-lymphoma, futhi ukwelashwa kungakhandla. Kubalulekile ukufinyelela futhi uthole ukwesekwa lapho ukudinga. Ngokuvamile sinabantu ezimpilweni zethu abafuna ukusiza, kodwa abazi kahle ukuthi kanjani. Abanye abantu baphinde bakhathazeke ngokukhuluma ngokuthi uhamba kanjani ngoba bekhathazekile bazokhuluma okungeyikho, bakweqe noma bakucasule. Lokhu akusho ukuthi abanandaba.
Kungasiza ukwazisa abantu ukuthi yini oyidingayo. Ngokucacisa lokho okudingayo, ungathola usizo nokusekelwa okudingayo, futhi obathandayo bangaba nenjabulo yokukwazi ukukusiza ngendlela ezuzisayo. Kukhona ezinye izinhlangano ezihlanganise izinhlelo ongazisebenzisa ukuxhumanisa okunye ukunakekelwa. Ungase uthande ukuzama:
Ukuhlela ukunakekelwa kusengaphambili
Ukuhlela ukunakekelwa kusenesikhathi kuyindlela enhle yokuqinisekisa ukuthi ithimba lakho lezokwelapha kanye nomndeni bayazi ukuthi iyiphi indlela yokwelapha oyenzayo, futhi abafuni ukuba nayo esikhathini esizayo.
Wonke umuntu kufanele abe nohlelo lokunakekela kusenesikhathi. Amafomu adingekayo kanye nenqubo yokuthuthukisa uhlelo lokunakekela kusenesikhathi kungase kwehluke ngokwezifundazwe. Ukuze uthole ulwazi olwengeziwe mayelana nokuhlelwa kokunakekelwa okuthuthukisiwe, kanye nokufinyelela amafomu afanele wesifunda sakho, chofoza isixhumanisi esingezansi.
Ukunakekelwa kwe-palliative
Abantu abaningi bacabanga ukuthi ukunakekelwa kwe-palliative kumayelana nokunakekelwa kokuphela kwempilo. Nakuba lena kungenye yezindima, nazo zinenye indima enkulu. Zibuye zisize ukuphatha izimpawu kanye nemiphumela emibi okunzima ukuyiphatha ongase ube nayo nganoma isiphi isikhathi ngesikhathi sakho se-lymphoma. Inhloso enkulu ukusiza ukuqinisekisa ukuthi unekhwalithi yokuphila engcono kakhulu phakathi nokwelashwa kwakho kanye nasekupheleni kokuphila kwakho.
Ukuphathwa kwezimpawu/umphumela omubi
I-Lymphoma kanye nokwelashwa kwayo kungabangela izimpawu ezihlukahlukene kanye nemiphumela emibi. Nakuba i-hematologist yakho noma i-oncologist ingasiza kulokhu okuningi, ngezinye izikhathi izimpawu noma imiphumela emibi idinga ukuphathwa okukhethekile. Ithimba lokunakekelwa kwe-palliative lingochwepheshe ekulawuleni lezi. Futhi banokufinyelela emithini i-hematologist yakho noma i-oncologist engagunyaziwe ukuyinikeza. Ithimba lokunakekelwa kwe-palliative liyisisetshenziswa esihle sokuthuthukisa izinga lakho lempilo.
Ezinye izimpawu noma imiphumela engemihle abangakusiza ukuyilawula ihlanganisa:
- ubuhlungu - kuhlanganise ne-peripheral neuropathy
- isicanucanu noma ngaphandle kokuhlanza
- ukukhathazeka
- ukuphelelwa umoya
Ukuphela kokunakekelwa kwempilo
Izivivinyo zomtholampilo eziyimpumelelo, kusho ukuthi kunezinhlobo eziningi zokwelapha ezintsha ezithuthukise kakhulu imiphumela yabantu abane-lymphoma - ngisho ne-lymphoma ebuyele emuva kanye ne-refractory. Abantu abaningi baphila impilo ende futhi enempilo ngisho nangemva kokuxilongwa kwe-lymphoma. Nokho, ngeshwa, ngezinye izikhathi abantu bafa nge-lymphoma.
Iqhaza eliqondwa kakhulu lokunakekelwa kwe-palliative ukusiza abantu abasondele ekupheleni kwempilo yabo ukuthi babe nokulawula ukuthi baphila kanjani impilo yabo yonke. Zinhle kakhulu ngokukunika amandla ocabanga ngazo, futhi uhlele izidingo zakho nalapho ungathanda ukuchitha isikhathi sakho khona, ube uqinisekisa ukuthi uphephile, unempilo enhle ngalesi sikhathi.
Sekela lapho ususondele ekupheleni kwempilo yakho
Ukunakekelwa kwe-Palliative nakho kungasiza umndeni wakho kanye nabathandekayo bakho baqonde ukuthi kwenzekani, futhi baqinisekise ukuthi banokusekelwa abakudingayo ngalesi sikhathi futhi. Ezinye izinto abangasiza ngazo zihlanganisa:
- ukuhlela izinto ozozisebenzisa ekhaya uma ukhetha ukuhlala ekhaya
- ukukhuluma nabantu obathandayo ngezinto ezibucayi njengokuphela kwempilo yakho nezinhlelo zomngcwabo
- ukukuxhumanisa nezinkonzo ezahlukene emphakathini
- qinisekisa ukuthi izinkolelo zakho zamasiko nezomoya ziyasekelwa ekufeni kwakho
- ukwelulekwa nokusekelwa ngokomzwelo.
Isifinyezo
- Ukwelapha yilapho ingekho i-lymphoma esele emzimbeni wakho futhi ingabuyi.
- Ukuxolelwa kungaba okuphelele noma okuyingxenye kungabi nazimpawu ze-lymphoma emzimbeni wakho (kuphelele), noma lapho amangqamuzana e-lymphoma enciphe ngaphezu kwengxenye (ingxenye).
- I-Lymphoma ingaphindela emuva (ibuye) ngemva kwesikhathi sokuxolelwa. Ukuxolelwa kungathatha amasonto, izinyanga noma iminyaka eminingi.
- Lapho i-lymphomas enolaka iphindeka, ngokuvamile iba eminyakeni embalwa yokuqala ngemva kokuqeda ukwelashwa. Uma uxolelwe isikhathi eside, maningi amathuba okwelashwa.
- I-Indolent lymphomas ivame ukubuya, kodwa futhi ngokuvamile isabela kahle ekwelashweni. Uzophila ne-indolent lymphoma impilo yakho yonke, kodwa ungaphila kahle ngezikhathi zokuxolelwa.
- Kwezinye izimo, i-lymphoma ayibi ngcono ngokwelashwa komugqa wokuqala - lokhu kubizwa ngokuthi i-refractory.
- I-Refractory lymphoma isengasabela kahle ekwelashweni komugqa wesibili nowesithathu.
- Ukuhlela ukunakekelwa kusenesikhathi kubalulekile ukuze uqinisekise ukuthi umndeni wakho nodokotela bayazazi izifiso zakho mayelana nokunakekelwa kwezempilo.
- Ukunakekelwa kwe-Palliative kungasiza ngezimpawu kanye nokulawula umphumela ongase ube nawo.
- Abanye abantu bazodinga ukunakekelwa kokuphela kwempilo uma i-lymphoma yabo ingaphenduli ekwelashweni. Ukunakekelwa kwe-Palliative kungaba ukwesekwa okukhulu, futhi uqinisekise ukuthi unekhwalithi yokuphila engcono kakhulu phakathi nesikhathi sokuphela kwempilo, futhi unikeze ukusekelwa okudingekayo kwabathandekayo bakho.
