Cov kab mob ntsws uas tsis yog mob me

Cov kab mob ntsws uas tsis yog hom me yog hom mob ntsws tshaj plaws. Nws feem ntau loj hlob thiab kis qeeb dua li mob ntsws me me ntawm lub ntsws.

Muaj peb hom mob uas tsis yog mob qog nqaij hlav hauv hlwb tsawg (NSCLC):

• Adenocarcinomas feem ntau pom nyob rau thaj tsam sab hauv ntawm lub ntsws.
• Cov hlav carcinomas (Squamous cell carcinomas) feem ntau pom nyob hauv qhov chaw ntawm lub ntsws ib sab ntawm lub raj cua (bronchus).
• Cov carcinomas loj hauv lub cev tuaj yeem tshwm sim hauv txhua qhov chaw ntawm lub ntsws.
• Muaj ntau ntau yam tsis tshua muaj hom mob ntsws uas tseem hu ua tsis yog me.

Kev haus luam yeeb ua rau feem ntau tus neeg mob (li ntawm 90%) ntawm cov neeg mob uas tsis mob ntsws mob hlwb tsawg. Qhov txaus ntshai yog nyob ntawm cov naj npawb luam yeeb koj haus luam yeeb txhua hnub thiab ntev npaum li cas koj tau haus luam yeeb. Nyob ntawm cov pa luam yeeb los ntawm lwm tus neeg (cov pa luam yeeb) kuj ua rau koj muaj feem mob qog nqaij hlav cancer. Tab sis qee cov neeg uas ib txwm tsis tau haus luam yeeb muaj kev mob qog noj ntshav.

Kev tshawb fawb qhia tau hais tias kev haus luam yeeb yeeb tshuaj yeeb yuav pab cov leeg mob hlwb. Tab sis tsis muaj qhov txuas ncaj qha ntawm kev haus luam yeeb yeeb tshuaj xas thiab kev tsim mob qog noj ntshav.

Kev nphav raug cov pa paug ntau ntau thiab haus cov dej uas muaj theem siab ntawm arsenic tuaj yeem ua rau koj muaj feem mob ntsws. Keeb kwm ntawm txoj kev kho hluav taws xob rau lub ntsws kuj tseem tuaj yeem ua rau muaj kev pheej hmoo.

Ua haujlwm nrog lossis nyob ze cov tshuaj tua kabmob lossis khoom siv hauv lub cev yuav tuaj yeem ua rau muaj kev pheej hmoo mob qog nqaij hlav cancer. Xws li cov tshuaj muaj xws li:

• Asbestos
• Radon
  
• Cov khoom siv tshuaj xws li uranium, beryllium, vinyl chloride, npib tsib xee chromates, cov khoom lag luam thee, roj av, chloromethyl ethers, roj av, thiab roj av ua kom muaj zog.
• Qee yam alloys, xim tsev, xim xim, thiab tshuaj ntsuab
• Cov khoom lag luam siv chloride thiab formaldehyde

Cov tsos mob tuaj yeem suav nrog:

• Kev mob hauv siab
• Hnoos tsis ploj mus
• Kev hnoos ntshav
• Nkees
• Tsis qab los noj mov
• Los poob phaus yam tsis tau sim
• Ua tsis taus pa
• Hawb pob
• Mob thaum kis mus rau lwm thaj chaw ntawm lub cev

Kev mob ntsws thaum ntxov yuav tsis ua mob dabtsi.

Lwm cov tsos mob uas tuaj yeem yog vim NSCLC, feem ntau ua ntu zus:

• Mob leeg los yog rhiab
• Tawv muag muag daj
• Hoarseness lossis hloov lub suab
• Mob tej pob txha
• Ntsia teeb meem
• Nqos nyuaj
• Teb lub ntsej muag
• Neeg tsis muaj zog
• Mob lub xub pwg lossis tsis muaj zog

Cov tsos mob no tuaj yeem yog vim lwm yam, tsis muaj mob hnyav. Nws yog ib qho tseem ceeb nrog koj tus kws kho mob tham yog tias koj muaj cov tsos mob.

Tus kws khomob yuav kuaj ib ce thiab nug txog koj li keeb kwm kev khomob. Luag yuav nug tias koj haus luam yeeb li cas, thiab yog li ntawd, koj haus luam yeeb ntau npaum li cas thiab ntev li cas koj tau haus luam yeeb. Lawv tseem yuav nug koj txog lwm yam uas yuav ua rau koj muaj kev pheej hmoo mob ntsws ntsws, xws li raug qee yam tshuaj lom neeg.

Kev ntsuam xyuas uas yuav ua los ntsuas mob ntsws los yog pom tias nws kis tau:

• Cov pob txha scan
• Kev ntsuas hluav taws xob xoo
• Ua kom tiav cov ntshav suav (CBC)
• CT scan ntawm lub hauv siab
• MRI ntawm lub hauv siab
• Positron emission tomography (PET) scan
• Cov hnoos qeev txhawm rau kuaj cov qog nqaij hlav cancer
• Thoracentesis (piv txwv ntawm cov kua buildup ncig lub ntsws)

Feem ntau, ib daim ntawv voos raug tshem tawm ntawm koj lub ntsws mus kuaj hauv lub tshuab tsom. Qhov no yog hu ua biopsy. Muaj ob peb txoj hauv kev los ua qhov no:

• Bronchoscopy ua ke nrog biopsy
• Siv rab koob CT-scan-qhia koob
• Txoj hlab pas txoj hlab (Endoscopic esophageal ultrasound (EUS)) nrog kev kuaj me
• Mediastinoscopy nrog kev kuaj me
• Siv lub tshuab kuaj kab mob tawm
• Tso me me

Yog tias kuaj me me qhia qog noj ntshav, yuav sim ntau qhov kev sim ntsuas qhov ntsuas qog mob qog nqaij hlav. Theem txhais tau hais tias lub pob loj npaum li cas thiab nws kis tau deb npaum li cas. NSCLC tau muab faib ua 5 theem:

• Theem 0 - Tus kabmob tsis kis mus rau sab hauv lub ntsws.
• Theem I - Cov qog nqaij hlav me me thiab tsis kis rau cov qog ntshav.
• Theem II - Mob cancer tau kis rau qee cov qog ntshav nyob ze ntawm thawj cov qog ntshav.
• Theem III - Kab mob cancer tau kis rau cov nqaij mos nyob ze lossis ze rau cov qog ntshav.
• Theem IV - Tus kabmob tau kis mus rau lwm yam hauv lub nruab nrog cev, xws li lwm lub ntsws, hlwb lossis daim siab.

Muaj ntau hom kev kho mob rau NSCLC. Kev kho yog nyob ntawm theem mob cancer.

Kev hlais tawm yog cov kev kho mob nquag rau NSCLC uas tsis kis mus dhau cov qog ntshav nyob ze. Tus kws phais mob tshem tau:

• Ib qho ntawm cov lobes ntawm lub ntsws (lobectomy)
• Tsuas yog ib feem me me ntawm kev mob ntsws (wedge lossis ntu tshem tawm)
• Tag nrho lub ntsws (ntsws)

Qee cov neeg xav tau cov tshuaj tua hluav taws. Kev siv tshuaj kho mob siv cov tshuaj tua cov mob qog noj ntshav thiab txwv tsis pub cov hlav tshiab tuaj. Kev kho mob tuaj yeem ua raws li hauv qab no:

• Kev siv tshuaj kho ib leeg feem ntau siv thaum mob qog tawm sab nraum lub ntsws (theem IV).
• Nws kuj tseem raug muab ua ntej kev phais mob lossis hluav taws xob txhawm rau kom ua rau cov kev kho mob zoo dua. Qhov no hu ua kev kho mob neoadjuvant.
• Nws yuav tau muab tom qab kev phais txhawm rau tua txhua yam mob cancer uas tseem tshuav. Qhov no hu ua kev kho nrog rau.
• Kev siv tshuaj khomob feem ntau yog muab los ntawm txoj hlab ntshav (los ntawm IV). Lossis, nws tuaj yeem raug muab tshuaj noj.

Kev tswj cov tsos mob thiab tiv thaiv cov kev mob tshwm sim thaum thiab tom qab siv tshuaj khomob yog ib qho tseem ceeb ntawm kev saib xyuas.

Immunotherapy yog kev kho mob tshiab dua uas tuaj yeem muab los ntawm nws tus kheej lossis nrog kev siv tshuaj kho mob.

Kev siv hom phiaj tej zaum yuav siv los kho NSCLC. Hom phiaj kho siv cov tshuaj xoom rau ntawm cov hom phiaj tshwj xeeb (molecules) hauv lossis ntawm cov qog nqaij hlav cancer. Cov hom phiaj no tau ua ib txoj haujlwm ntawm cov qog nqaij hlav cancer loj hlob thiab ciaj sia li cas. Siv cov hom phiaj no, cov tshuaj cuam tshuam rau cov qog nqaij hlav cancer thiaj li tsis tuaj yeem kis mus tau.

Kev siv hluav taws xob tuaj yeem siv nrog kev siv tshuaj khomob yog tias phais tsis tau. Kev siv hluav taws xob los siv duab xoo hluav taws xob zoo lossis lwm yam hluav taws xob txhawm rau tua cov qog nqaij hlav cancer. Yuav siv hluav taws xob mus rau:

• Kho cov qog ntshav, nrog rau kev siv tshuaj kho mob, yog tias tsis tuaj yeem phais
• Pab daws cov tsos mob tshwm sim los ntawm mob cancer, xws li ua pa nyuaj thiab o
• Pab pab txo mob qog nqaij hlav thaum mob cancer tau kis rau cov pob txha

Kev tswj cov tsos mob thaum thiab tom qab hluav taws xob mus rau lub hauv siab yog qhov tseem ceeb ntawm kev saib xyuas.

Cov kev kho mob hauv qab no feem ntau yog siv los daws cov tsos mob tshwm sim los ntawm NSCLC:

• Kev kho laser - Qhov nqaj me me ntawm lub teeb hlawv thiab tua cov mob qog nqaij hlav.
• Txoj kev kho kom ci ntsa iab - Siv lub teeb ci los ua kom cov tshuaj hauv lub cev, uas tua cov qog nqaij hlav cancer.

Koj tuaj yeem daws kev ntxhov siab kev mob los ntawm koom nrog pab pawg txhawb nqa. Faib qhia rau lwm tus uas muaj kev paub thiab teeb meem ntau yam tuaj yeem pab koj tsis txhob xav tias yog ib leeg.

Lub zeem muag txawv. Feem ntau, NSCLC qeeb qeeb. Muaj qee kis, nws tuaj yeem loj hlob thiab kis ceev ceev thiab ua rau tuag sai. Kab mob kheesxaws yuav kis mus rau lwm qhov ntawm lub cev, suav nrog pob txha, nplooj siab, plab hnyuv, thiab lub hlwb.

Kev siv tshuaj tua kab mob tau pom tias yuav ua kom ntev lub neej thiab txhim kho lub neej zoo hauv qee cov neeg nrog rau theem IV NSCLC.

Kev kho tus nqi yog cuam tshuam nrog theem ntawm tus kab mob thiab seb koj puas tuaj yeem tau phais.

• Kauj theem I thiab II mob qog nqaij hlav muaj qhov siab tshaj plaws thiab kev kho mob.
• Mob Theem III yuav kho tau qee qhov mob.
• Theem IV mob cancer uas tau rov qab los yog yuav luag tsis muaj tshuaj kho tau. Lub hom phiaj ntawm txoj kev kho yog kom txuas ntxiv thiab txhim kho lub neej kom zoo.

Hu rau koj tus kws kho mob yog tias koj muaj tsos mob ntsws mob ntsws, tshwj xeeb yog koj haus luam yeeb.

Yog tias koj haus luam yeeb, tam sim no yog lub sijhawm txiav luam yeeb. Yog tias koj muaj teeb meem txiav luam yeeb, tham nrog koj tus kws kho mob. Nws muaj ntau txoj hauv kev los pab koj txiav luam yeeb, los ntawm pab pawg txhawb nqa tshuaj mus rau cov tshuaj noj. Tsis tas li, yuav tsum sim ua kom tsis txhob muaj cov pa luam yeeb.

Yog koj muaj hnub nyoog tshaj 55 xyoos thiab haus luam yeeb lossis siv haus luam yeeb nyob hauv kaum xyoo dhau los, tham nrog koj tus kws kho mob txog kev kuaj mob qog nqaij hlav cancer. Txhawm rau kuaj mob, koj yuav tsum muaj CT scan ntawm lub hauv siab.

Cancer - mob ntsws - tsis yog-tes me; Cov kab mob ntsws uas tsis mob me me; NSCLC; Adenocarcinoma - mob ntsws; Squamous cell carcinoma - mob ntsws; Loj cell carcinoma - mob ntsws

• Hauv siab tawg - tso tawm
• Mob ntsws phais - kev tshem tawm

• Lub ntsws
• Kev nqus tau pa luam yeeb thiab mob ntsws

Araujo LH, Horn L, Merritt RE, Shilo K, Xu-Welliver M, Carbone DP. Mob kheesxaws ntawm lub ntsws: tsis yog cell cell mob ntsws me me thiab mob ntsws me me. Hauv: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6 tus ed. Philadelphia, PA: Elsevier; 2020: chap 69.

Ettinger DS, Ntoo DE, Aggarwal C, li al. NCCN cov lus qhia pom ntxiv: tsis mob me me rau cov ntsws mob ntsws, version 1.2020. J Natl Compr Canc Netw. 2019; 17 (12): 1464-1472. PMID: 31805526. pubmed.ncbi.nlm.nih.gov/31805526/.

Lub koom haum Cancer National website. Kev kho mob ntsws cancer uas tsis yog mob me me (PDQ) - cov kws muaj txuj ci kho mob. www.cancer.gov/types/lung/hp/non-small-cell-lung-nyuj-pdq. Hloov kho thaum Lub Tsib Hlis 7, 2020. Nkag mus Lub Xya Hli 13, 2020.

Silvestri GA, Pastis NJ, Tanner NT, Jett JR. Cov chaw soj ntsuam kab mob ntsws. Hauv: Broaddus VC, Mason RJ, Ernst JD, li al, eds. Murray thiab Nadel Cov Ntawv Phau Ntawv Qhia Txog Cov Pa. 6 tus ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 53.