Ciwon daji na ciki shine daya daga cikin ƙananan ƙwayoyin cuta, wanda shine mafi yawan mutuwar mace tsakanin mata. Duk da haka, ba kamar sauran ciwon sukari ba, irin su ciwon huhu ko cizon sauro, wanda sau da sauri ya kai ga mutuwar yawancin marasa lafiya, a cikin ciwon nono, magani yana yiwuwa kashi biyu cikin uku na marasa lafiya. A cikin labarin "Ciwon ƙwayar Ciwon daji a Matasan Mata" za ku sami bayani mai amfani sosai don kanku.
Rukunin hadarin
Sabanin yarda da imani, ciwon nono yana tasowa ne a cikin tsofaffin mata, mafi yawan lokuta bayan mazaune. Abinda yiwuwar faruwar cutar zuwa shekaru 35 shine kusan 1: 2500. Bayan shekaru 50, wannan hadarin ya kai zuwa 1:50, kuma bayan shekaru 80 ya kai mita 1:10. Ko da yake a mafi yawancin lokuta ba shi yiwuwa a gano ainihin dalilin ciwon nono, yawancin abubuwan haɗari ga ci gaba da cutar sun dogara ne akan abin da aka sani:
• shekaru;
• Hanisis na cutar a cikin iyali ko mai haƙuri;
• baya ciwon ciwon ƙwayar nono;
• Sakamakon ƙananan ciwon hawan zabin jima'i na jima'i na mace-mace (tsohuwar al'ada da kuma daga farkon farawa), da kuma amfani da tsarin maye gurbin hormone (HRT);
• fasali na abinci mai gina jiki da barasa.
Wata mace, wanda mahalarta 'yan uwanta, musamman ma dangi na farko (iyaye mata da' ya'ya mata), suna fama da ciwon daji, yana da mummunan haɗari na bunkasa cutar. Wannan shi ne saboda gadon mamar nono. Masana kimiyya sun gano nau'i biyu da ke da alhakin ciwon daji, BRCA1 da BRCA2. Rashin haɓaka ƙwayar ƙwayar ƙwayar ƙwayar cuta a cikin masu dauke da waɗannan kwayoyin halitta shine 87%. Saboda wannan dalili, yana da mahimmanci don gano irin waɗannan iyalai da kuma bada shawara na kwayoyin halitta. Kwayar cutar ciwon nono daga mace mai rashin lafiya an kai shi ga zuriya da yiwuwar kashi 50%. Iyalan gidan da suka gada wannan jinsin suna da mummunar haɗari na tasowa.
Wasu dalilai
Kodayake kasancewar kwayar cututtuka ta nono ita ce babbar mahimmancin ci gaba da cutar, dole ne a fahimci cewa a cikin dukkan lokuta na ciwon daji, yawancin marasa lafiya a cikin iyalinsu wadannan kwayoyin halitta an gano su ne kasa da 10%. Akwai hanyoyin da yawa na hana ƙwayar nono. Amfani da su shine mafi mahimmanci ga mata masu hadari, kuma musamman ma wadanda suke ɗaukar daya daga cikin kwayoyin cutar ciwon nono.
Tamoxifen
A baya, don rigakafin ciwon nono, an yi amfani da maganin tamoxifen anti-tungsten. Nazarin da aka gudanar a {asar Amirka ya nuna cewa, matan da suka yi maganin har tsawon shekaru 5, sun yi rashin lafiya, tare da ciwon nono, sau da yawa, fiye da wa] anda ba su kar ~ a shi ba. A gefe guda, yin amfani da tamoxifen ya kara yawan haɗarin ciwon ciwon ciwon endometrial (membrane mucous na mahaifa) da kuma thromboembolism (samfurin thrombi a cikin jijiyoyin ƙananan ƙafa da ƙaura zuwa tasoshin huhu). Bugu da ƙari, ya bayyana cewa amfani da miyagun ƙwayoyi ba ya rage yawan mutuwar daga ciwon nono ba. Sakamakon farko na nazarin zamani a cikin rukuni na mata tare da tarihin iyali na ciwon ƙwayar nono ba su tabbatar da ƙwarewar tamoxifen ba. Sakamakon rikitarwa ya haifar da rashin tsarin kulawa ɗaya. Mata suna la'akari da yiwuwar chemoprophylaxis na ciwon daji zai karbi cikakken bayani daga likitan da ya dace.
Yin aikin tiyata
- Mastectomy. Hanyar mafi mahimmanci na rigakafi tare da sakamako mai kyau shine haɓaka na biyu (ko mastectomy a cikin marasa lafiya da suka rigaya ya rigaya ya shawo kan ciwon nono). Cire kullun mammary mai kyau shine yanke shawara mai zurfi wanda ke buƙatar yin la'akari da hankali da kuma yin la'akari da hanyoyin da za a bi. Raguwa a cikin hadarin ciwon nono ya danganta da ƙarar kayan glandular cire. Saboda wannan dalili, yawanci ba a bada shawarar ba, mai riƙe da nono ba tare da shawarar ba, tun lokacin da ya bar kashi 10 cikin 100 na nono, idan aka kwatanta da 1% bayan aiki na al'ada.
- Ovariectomy. Masu ɗaukan kwayoyin BRCA suna da hatsari mafi girma kuma cutar ciwon daji ta ovarian, sabili da haka, ya kamata a yi la'akari da su sosai a matsayin hanyar da za a hana yarinyar (kawar da ovaries).
Ovariectomy yana rage hadarin bunkasa ƙwayar nono ta hanyar rage girman isrogen, ciki har da matan da ke dauke da kwayoyin BRCA. Tsammani da ciwon nono zai iya faruwa a cikin wadannan lokuta:
• ganewar samfurin nazarin ilmin lissafi a tsarin mammography;
• gano ƙwayar da mai haƙuri.
Mafi yawan alamun ciwon nono ya hada da ilimin ilimi, canji a cikin siffar gland, da ƙwayar fata da kuma nono, da fitarwa daga kan nono. Sakamakon ganewar ƙwayar yana dogara ne akan jarrabawar asibiti, mammography da kuma ƙarshen kwayar halitta. A wasu mata, musamman ma mata masu mata, mammography ne mai illa maras kyau saboda nauyin nau'in glandular, a cikin irin waɗannan lokuta, daya daga cikin wuraren da za a gwada jarrabawa ko hotunan jima'i. A mafi yawan marasa lafiya tare da mummunan ciwon daji, mai rashin ciwon nono ba a tabbatar ba. Tare da taƙaitaccen tabbaci, mace tana shan magani. Yana buƙatar sha'anin kulawa da tsararraki wanda ya shafi likitan likita, likitan ilimin likita, likita da kuma likitoci. Mataimakin ma'aikatan likita, masu horarwa sosai, suna taka muhimmiyar rawa don kula da marasa lafiya da ke fama da ciwon nono, don taimaka musu su shawo kan wasu lokuta mai tsanani. Sabbin hanyoyi na jiyya na ciwon daji na iya rage yawan mutuwa ga wannan cutar ta kashi 30%. Shirin maganin zai iya haɗa da tiyata, rediyo, hormonal ko chemotherapy.
A mafi yawan marasa lafiya, hanyar farko na magance ciwon nono shine tiyata - kawar da ƙananan ƙwayar cuta.
Ayyuka
A cikin marasa lafiya da mummunan ƙwayar cuta, yana da kyau a yi aikin mastectomy (kawar da dukan nono), bayan haka za'a iya gyara gyaran filastik. Tare da ƙananan ƙwayar ƙwayar jiki, ana gudanar da aikin gyare-gyare mai sauƙi, wanda aka kawar da glanden. Irin wannan saƙo ya fi dacewa daga ra'ayi na kwaskwarima. A lokacin aiki, a matsayin mai mulkin, sashe ko duk ɓangaren lymph na yankin axillary an cire. Bayan haka, ana nazarin shiri a karkashin wani microscope, bayan haka masanin ilimin likita ya bada iyakacin cewa cikakkun ƙwayar magungunan farko, da tarihin tarihinsa, lambar lambobin lymph da aka kamu da kuma haɗin mai karɓar estrogen. Gwajin gwaji na mai haƙuri yakan hada da rayukan X-ray don ƙayyadad da ƙwayar cutar, gwajin jini, kuma, idan an yi la'akari da gudana, ƙwayar kashi ko duban dan tayi na hanta. Bisa ga cikakkiyar waɗannan bayanan, an tsara shirin don ƙarin magani.
Radiotherapy
Postoperative radiotherapy an dauke wani m bangaren magani a marasa lafiya wanda underwent sectoral resection; Rashin iska daga yankin axillary na iya zama madadin kawar da ƙwayar lymph. An sani cewa rediyon rediyo na yanki, ƙwayar da ke ciki da kuma yankin axillary yana rage hadarin komawa, wanda, a gefe guda, ya rage mace-mace. An umurce lafiyar cututtukan kwayoyin cuta da cututtukan hormone a cikin hanzari ko kuma bayan da aka tilasta su. Wannan wajibi ne don halakar micrometastases - ƙananan gutsurewa na nama mai ciwo da suka rabu da ƙirar farko da kuma yada ta jiki. Irin wannan mummunan zane-zane yana wakiltar barazanar komawa cutar.
Hormonotherapy
Cyclic canzawa a cikin ƙirjin nama suna karkashin kula da estrogens. A cikin 60% na lokuta, ana samun masu karɓar isrogen a cikin ƙwayar nono, saboda haka tamoxifen, wanda ke rarraba wadannan masu karɓa akan kwayoyin cutar Kanada, za'a iya amfani dashi don magani. Wannan yana rage hadarin yadawa da sake dawowa da ciwon sukari. Binciken da aka yi kwanan nan, ya nuna cewa mata masu ciwon ƙirjin ƙirjin mai ciwon estrogen wadanda suke daukar tamoxifen na tsawon shekaru biyar bayan tilastawa suna da cikakkiyar sanarwa.
Chemotherapy tsarin
A cikin marasa lafiya a karkashin shekaru 50 da ciwon nono, an nuna sakamako mai kyau na adjuvant (karin) chemotherapy. Yin amfani da wannan hanya ta hanyar maganin marasa lafiya wanda ya fi dacewa da komawa. An kafa wasu tsarin shamotherapy iri-iri da aka tabbatar don rage haɗarin ciwon sukari. An yi amfani da wani tsari mai suna CMF kuma yana hade da cyclophosphamide, methotrexate da 5-furouracil. Ƙara irin wadannan kwayoyi kamar yadda doxorubicin da paclitaxel, na taimakawa wajen inganta sakamakon chemotherapy.
A cikin marasa lafiya da ciwon daji na ƙwayar cuta - da yaduwar cutar a jikin jiki - magani ba zai yiwu ba. Duk da haka, akwai hanyoyin maganin warkewa da nufin kawar da bayyanar cututtuka, da kuma abubuwan da suka faru na zamani sun ba da damar samun tsira. Abin takaici, duk da ci gaban da aka samu a maganin ciwon nono a cikin 'yan shekarun nan, ba duk masu haƙuri sun sami damar dawowa ba. Marasa lafiya tare da kasancewar metastases a lokacin ganewar asibiti na ciwon daji ko waɗanda wadanda ke da ciwon cibiyoyin ya bayyana bayan jiyya na farko sun sami matsala mara kyau. Mafi yawan wuraren da ake amfani da su don sadaukar da ƙananan ƙwayoyin halitta shine ƙasũsuwa, hanta, huhu, fatar jiki da sutura, ciki har da kwakwalwa.
Manufofin farfadowa
Yin maganin irin wannan magunguna yana nufin kara yawan tsawon lokaci da kuma kawar da bayyanar cututtuka (farfadowa). Ko da yake wasu marasa lafiya da ciwon ciwon ciwon daji na iya tsira kuma shekaru da yawa, maganganun maganin magani a irin wadannan lokuta ba lallai ba ne. Yin aikin tiyata da radiotherapy a gaban masanan ganyayyaki ba su da mahimmanci fiye da chemo da hormone farka, tun da kwayoyi zasu iya rushe kwayoyin tumo cikin jiki. Abinda ya keɓance shi ne ƙananan ƙwararrun kasusuwa, wanda yafi kula da rediyo. Don rage haɗarin kasusuwa da matsalolin da suka shafi dangantaka, ciki har da fractures, yi amfani da rukuni na kwayoyi da ake kira bisphosphonates. Hanya na hanyar magani yana dogara ne da wurin da ƙananan ƙwayoyin cuta, magani na baya, halaye na ciwon sukari da kuma jihohi na lafiyar mai haƙuri.
Darajar rayuwa
A lokacin da aka tsara wani shiri na maganin, za su dauki kowane mutum ga kowane mai haƙuri, tare da girmamawa kan inganta yanayin rayuwa. Domin ya fi dacewa ta magance cututtuka na cutar, yana da kyau ya kunshi likitoci da ma'aikatan jinya waɗanda aka horar da su don ba da kulawa. Gudanar da ciwon ciwo da wasu matakan tallafi a wannan mataki ya zama muhimmiyar mahimmanci. Masana kimiyya da likitoci a duk faɗin duniya suna tayar da hanyoyi sababbin hanyoyin magance ciwon daji, kuma ana kiran gajiyayyu don shiga binciken bincike na asibiti. Mafi sau da yawa a irin waɗannan lokuta, nazarin kwatanta yadda tasirin miyagun kwayoyi da aka gwada. Sauran karatu, ba kwatanta da wanda aka riga ya yi amfani da shi ba, gwada sabon kayan aiki, tantance aikinsa da kuma guba.
Gwajin gwaji
Nazarin na asibiti ya ƙayyade magani mai mahimmanci kuma ya samar da bayanan da ake buƙatar zuba jari a cikin fasaha masu tsada. Abubuwan da aka nuna sun nuna mafi kyau sakamakon magani a cikin marasa lafiya da suka shiga cikin gwaje-gwajen. Yanayin kwanan nan ana nunawa da tashi daga likitoci na gargajiya don amfani da magungunan ƙwayoyi masu guba wanda ke biyan bukatun wani mai haƙuri.