Yini i-Intraoperative Radiation Therapy (IORT)? Injongo, Inqubo & Nemiphumela

I-Intraoperative radiation therapy (IORT) iyindlela ekhethekile yokwelapha umdlavuza eletha imisebe eqondiswe ngqo ezindaweni zomdlavuza ngesikhathi sokuhlinzwa. Cabanga ngayo njengendlela eqondile, eqondiwe lapho ithimba lakho labahlinzi lingelapha khona amaseli omdlavuza ngqo emthonjeni ngenkathi usahlinzwa.

Le ndlela ivumela odokotela ukuthi balethe imithamo ephezulu yemisebe ngokunemba okumangalisayo, bevikela izicubu ezinempilo ezingaba sendleleni yemisebe. Kufana nokuba nomuntu oqeqeshwe kahle ongashaya umgomo oqondile ngenkathi egcina konke okunye kuphephile.

Yini i-intraoperative radiation therapy?

I-IORT ihlanganisa ukuhlinzwa kanye nemisebe yokwelapha ibe yisikhathi esisodwa sokwelashwa esihleliwe. Ngesikhathi sokuhlinzwa kwakho, ngemuva kokuthi udokotela ohlinzayo esuse umdlavuza obonakalayo, uletha imisebe ngqo embhedeni womdlavuza noma kumaseli omdlavuza asele.

Umshayo wemisebe uqondisa endaweni eqondile lapho amaseli omdlavuza maningi amathuba okuthi abuye khona. Ngenxa yokuthi izitho ezinempilo nezicubu zithuthwa okwesikhashana ngesikhathi sokuhlinzwa, ithimba lakho lezokwelapha lingasebenzisa imithamo ephezulu yemisebe kunokuthi iphephe ngemisebe yangaphandle yokwelapha.

Le ndlela ibaluleke kakhulu emdlavuzeni ovame ukuphindeka endaweni eyodwa, okusho ukuthi babuya endaweni efanayo lapho baqala khona ukukhula. Ithimba lakho labahlinzi lingabhekana nokususwa komdlavuza kanye nokwelashwa ngemisebe ngenkathi ungaphansi kwe-anesthesia, okungenzeka ukuthi kunciphisa isikhathi sakho sokwelashwa.

Kungani kwenziwa i-intraoperative radiation therapy?

I-IORT isiza ukuthuthukisa imiphumela yokwelashwa komdlavuza ngokuqondisa amaseli omdlavuza amancane angase asele ngemuva kokuhlinzwa. Noma ngabe odokotela abahlinzayo besusa zonke izicubu zomdlavuza ezibonakalayo, amaseli omdlavuza amancane ngezinye izikhathi angahlala ngemuva, angabonakali ngeso lenyama.

Udaktela wakho we-oncologist angase ancome i-IORT uma unezinhlobo ezithile zomdlavuza wamabele, umdlavuza we-colorectal, ama-sarcoma, noma ezinye izimila eziqinile lapho ukuphindeka kwendawo kuyinkinga. Kuyasiza ikakhulukazi lapho isimila sitholakala eduze kwezitho ezibalulekile noma izakhiwo okungaba nzima ukuzivikela ngesikhathi sokwelashwa ngemisebe evamile.

Ukwelashwa kungazuza futhi ezigulini ezinokukhetha okulinganiselwe kokwelashwa ngemisebe yangaphandle. Abanye abantu kungenzeka ukuthi sebethole imithamo ephephile ephezulu yemisebe endaweni ethile, okwenza i-IORT ibe enye indlela ebalulekile yokubhekana nomdlavuza omusha noma ophindayo esifundeni esifanayo.

Ngeminye imidlavaza yamabele yesigaba sokuqala, i-IORT ingase ithathe indawo yesidingo samaviki okwelashwa kwemisebe yangaphandle yansuku zonke. Lokhu kunganciphisa kakhulu umthwalo wakho wokwelashwa futhi kukusize ubuyele emisebenzini yakho evamile ngokushesha.

Yini inqubo yokwelashwa ngemisebe ngaphakathi?

I-IORT yenzeka ekamelweni lokusebenza elihlome ngendlela ekhethekile eliqukethe zombili izindawo zokuhlinzwa kanye nemishini yemisebe. Inqubo yakho izobandakanya iqembu elihleliwe labahlinzi, odokotela be-oncologists abasebenzisa imisebe, odokotela be-physicists bezokwelapha, kanye nabahlengikazi abangochwepheshe.

Inqubo iqala njengokuhlinzwa okujwayelekile komdlavuza, nawe ngaphansi kwe-anesthesia ejwayelekile. Umhlinzi wakho uzosusa kuqala isimila kanye nama-lymph nodes noma izicubu ezithintekile njengoba kuhlelelwe. Lapho ukususwa kokuhlinzwa sekuqediwe, bazolungisa indawo yokulethwa kwemisebe.

Nakhu okwenzekayo ngesikhathi somsebenzi wemisebe:

Iqembu lakho lezokwelapha lizobeka ngokucophelela isicelo semisebe ngqo ngokuphambene noma ngaphakathi embhedeni wesimila. Le divayisi iletha imisebe ngendlela elawulwa kakhulu, egxilile. Izitho ezinempilo nezicubu eziseduze nendawo yokwelashwa zisuswa ngobumnene eceleni noma zivikelwe ngamashidi akhethekile.

Ukunikezwa kwemisebe yangempela kuvame ukuthatha phakathi kwemizuzu eyi-10 kuya kwengama-45, kuye ngohlelo lwakho oluthile lokwelapha. Ngesikhathi lesi, amalungu amaningi abasebenzi azophuma ekamelweni lokusebenzela ngenkathi imisebe inikezwa, nakuba uzoqhubeka nokugadwa.

Ngemuva kokuthi ukwelashwa ngemisebe kuqediwe, udokotela ohlinzayo uzoqeda ukuhlinzwa ngokuvala indawo yokuhlinzwa. Inqubo yonke ngokuvamile ithatha amahora ama-2 kuya kwangu-6, kuye ngobunzima bokuhlinzwa kwakho kanye nohlobo oluthile lomdlavuza olwelashwayo.

Ungalungiselela kanjani ukwelashwa kwakho ngemisebe ngesikhathi sokuhlinzwa?

Ukulungiselela i-IORT kufana nokulungiselela ukuhlinzwa okukhulu, nokucatshangelwa okwengeziwe. Ithimba lakho lezokwelapha lizohlinzeka ngemiyalelo ethile esekelwe esimweni sakho ngasinye kanye nohlobo lokuhlinzwa okwenzayo.

Ngokuvamile uzodinga ukuyeka ukudla nokuphuza amahora ayi-8 kuya kwangu-12 ngaphambi kwenqubo yakho. Udokotela wakho angase futhi akucele ukuthi uyeke imithi ethile okwesikhashana, ikakhulukazi ama-blood thinners, ukunciphisa ingozi yokopha ngesikhathi sokuhlinzwa.

Ngaphambi kosuku lwakho lokwelashwa, cishe uzoba nokuqokwa okuningana kokulungiselela. Lokhu kungabandakanya ukuhlolwa kwegazi, izifundo zokucabanga, kanye nokubonisana nethimba lakho lokuhlinza kanye nodokotela we-oncologist wemisebe. Lokhu kuvakasha kusiza ukuqinisekisa ukuthi konke kuhlelwe ngokuphelele icala lakho elithile.

Kubalulekile ukuhlela ukuthi othile akuqhubele ekhaya ngemuva kwenqubo yakho futhi ahlale nawe amahora okuqala angama-24. Uzophinda ufune ukulungisa ikhaya lakho ukuze ululame, okuhlanganisa ukuba nezimpahla ezikhululekile, ukudla okulula ukukulungisa, kanye nemithi ebekiwe elungile.

Ithimba lakho lezokwelapha lizoxoxa nganoma yiziphi izinyathelo ezithile zokulungiselela ezisekelwe ohlotsheni lwakho lomdlavuza nempilo yonke. Unganqikazi ukubuza imibuzo mayelana nokuthi yini ongayilindela noma ukuveza noma yikuphi ukukhathazeka ongase ube nakho.

Ungawaqonda kanjani imiphumela yakho yokwelashwa ngemisebe ngesikhathi sokuhlinzwa?

Imiphumela ye-IORT ayikwazi ukulinganiswa ngokushesha njengokuhlolwa kwegazi noma ukuhlolwa kwesithombe. Kunalokho, impumelelo yokwelashwa kwakho ihlolwa ngokuhamba kwesikhathi ngokuqokwa okulandelayo njalo nokugadwa.

Udokotela wakho we-oncologist wemisebe uzoqaphela impumelelo yokwelashwa ngokulandela ukuthi umdlavuza ubuyela yini endaweni ewelashwe. Lokhu kuvame ukuhlolwa ngokuhlolwa komzimba njalo, izifundo zokuthwebula izithombe njenge-CT scans noma i-MRIs, futhi ngezinye izikhathi ukuhlolwa kwegazi lokuthola izimpawu zomdlavuza.

Isikhathi esiqondile ngemuva kokwelashwa sigxila ekupholiseni kokuhlinzwa kunemiphumela yemisebe. Ithimba lakho lokuhlinzwa lizogada ukuphola kwakho kokusika, amazinga obuhlungu, nokululama okuphelele. Abantu abaningi bahlangabezana nezimpawu zokululama okujwayelekile kokuhlinzwa kunemiphumela emibi yemisebe yendabuko.

Impumelelo yesikhathi eside ilinganiswa ngamanani okulawula endawo, okusho ukuthi ukwelashwa kuvimbela kahle kangakanani umdlavuza ukuthi ungabuyi endaweni efanayo. Izifundo zikhombisa ukuthi i-IORT ingathuthukisa kakhulu amanani okulawula endawo ezinhlotsheni eziningi zomdlavuza, ngokuvamile ihambisana noma idlula ukusebenza kahle kokwelashwa kwemisebe yangaphandle yendabuko.

Uhlelo lwakho lokulandela luzolungiswa esimweni sakho esithile, kodwa ngokuvamile luhlanganisa ukuqokwa njalo emavikini ama-3 kuya kwangu-6 iminyaka embalwa yokuqala, bese kuthi minyaka yonke. Ithimba lakho lezokwelapha lizochaza ukuthi yini okufanele uyibheke nokuthi ungaxhumana nabo nini ngezinkinga.

Ziyini izinzuzo zokwelashwa ngemisebe ngaphakathi?

I-IORT inikeza izinzuzo eziningi ezibalulekile ngaphezu kokwelashwa kwemisebe yangaphandle yendabuko. Inzuzo ebaluleke kakhulu yikhono lokuletha imithamo ephezulu yemisebe ngqo emangqamuzaneni omdlavuza ngenkathi kuvikelwa izicubu ezinempilo ezizungezile.

Kungenzeka ukuthi uzohlangabezana nemiphumela emibi embalwa uma uqhathaniswa nokwelashwa kwemisebe yangaphandle. Njengoba imisebe ilethwa ngaphakathi futhi izicubu ezinempilo zivikelwe ngesikhathi sokwelashwa, mancane amathuba okuthi uzohlangabezana nokucasuka kwesikhumba, ukukhathala, noma ukulimala kwezitho eziseduze.

Into okwenza kube lula kubantu abaningi kubalulekile. Esikhundleni sokwelashwa ngemisebe nsuku zonke amasonto amaningi, uthola ukwelashwa kwakho ngemisebe ngesikhathi esifanayo nokuhlinzwa kwakho. Lokhu kunganciphisa kakhulu umthwalo wakho wokwelashwa futhi kukusize ubuyele emisebenzini ejwayelekile ngokushesha.

Ngeminye iminyango yomdlavuza, i-IORT ingathuthukisa imiphumela yokwelashwa. Izifundo zikhombise amazinga amahle okulawula endaweni, okusho ukuthi umdlavuza mancane amathuba okuthi ubuye endaweni elashwayo. Lokhu kuyiqiniso ikakhulukazi kumdlavuza webele wesigaba sokuqala kanye nezinhlobo ezithile zomdlavuza we-colorectal.

Ukunemba kwe-IORT kuvumela nokwelashwa komdlavuza ezindaweni eziyinselele. Lapho izinso ziseduze nezakhi ezibucayi njengomgogodla, imithambo emikhulu yegazi, noma izitho ezibalulekile, i-IORT inganikeza ukwelashwa okuphumelelayo ngenkathi inciphisa ubungozi kulezi zindawo ezibalulekile.

Yiziphi izinkinga ezingaba khona zokwelashwa ngemisebe ngesikhathi sokuhlinzwa?

Njenganoma iyiphi inqubo yezokwelapha, i-IORT inezinye izingozi, nakuba izinkinga ezinzima zingavamile. Abantu abaningi bahlangabezana nemiphumela emibi engalawuleka enyamalalayo ngokuhamba kwesikhathi nokunakekelwa okufanele.

Imiphumela evamile yesikhathi esifushane ihlobene kakhulu nokuhlinzwa ngokwako kunemisebe. Lokhu kungabandakanya izingozi ezijwayelekile zokuhlinzwa njengokopha, ukutheleleka, noma ukusabela ku-anesthesia. Ithimba lakho lokuhlinzwa lizokuqapha eduze ngezinkinga ezijwayelekile zangemva kokuhlinzwa.

Nawa amanye amiphumela ejwayelekile ehlobene nemisebe ongase uyithole:

Ushintsho lwezicubu endaweni elashwayo lungenzeka ngokuhamba kwesikhathi. Abanye abantu bathuthukisa ukuqina, ukujiya, noma izinguquko ekuthunjweni kwesikhumba lapho imisebe yanikezwa khona. Lezi zinguquko zivame ukuthuthuka kancane kancane ezinyangeni eziningi futhi zivame ukuba mnene.

Ukuphola kwamanxeba kungase kube kancane kancane kwezinye izimo. Imisebe ingathinta ukuthi izicubu zizilungisa ngokushesha kangakanani, nakuba lokhu ngokuvamile akubangeli izinkinga ezinkulu uma ulandela imiyalelo yakho yokunakekelwa ngemva kokuhlinzwa ngokucophelela.

Izinkinga ezingavamile kodwa ezingathi sína zingabandakanya ukulimala kwezitho noma izakhiwo eziseduze. Kodwa-ke, ukuhlela ngokucophelela nokubona ngesikhathi sangempela ngesikhathi se-IORT kunciphisa kakhulu le ngozi uma iqhathaniswa nokwelashwa ngemisebe yangaphandle.

Abanye abantu bahlangabezana nobuhlungu obungapheli noma ukuba ndikindiki endaweni ewelashwe. Lokhu kuvamile ngezinhlobo ezithile zezinqubo nezindawo, futhi ithimba lakho lezokwelapha lizoxoxa ngale ngozi ethile ngokusekelwe ecaleni lakho ngalinye.

Imiphumela yesikhathi eside, nakuba ingavamile, ingabandakanya ukuthuthukiswa komdlavuza wesibili endaweni ewelashwe. Le ngozi ngokuvamile iphansi nge-IORT uma iqhathaniswa nokwelashwa ngemisebe yendabuko ngenxa yokugxila okunembile kanye nendlela yokulinganisa eyodwa.

Kufanele ngibone nini udokotela mayelana nokwelashwa ngemisebe ngesikhathi sokuhlinzwa?

Kufanele uthinte ithimba lakho lezokwelapha ngokushesha uma uhlangabezana nezimpawu zezinkinga ezingathi sína ngemva kwenqubo yakho ye-IORT. Lokhu kungabandakanya ubuhlungu obukhulu obungathuthuki ngemithi enikeziwe, izimpawu zokutheleleka njengomkhuhlane noma ukukhishwa okungavamile, noma izinguquko ezingazelelwe endaweni yakho yokuhlinzwa.

Ngesikhathi sokululama kwakho, qaphela izimpawu ezingase zibonise izinkinga. Ukuvuvukala ngokweqile, ukopha okuqhubekayo, noma ukukhipha endaweni yakho yokusika kufanele kunakekelwe ngokushesha kwezokwelapha. Ithimba lakho lokuhlinzwa lizohlinzeka ngemihlahlandlela ethile mayelana nokuthi yini ejwayelekile nokuthi yini edinga ukunakekelwa ngokushesha.

Ukuze uqhubeke nokuqapha, gcina zonke izikhathi zakho zokulandela ezihleliwe ngisho noma uzizwa ulungile. Ukuhlolwa okuvamile kuvumela ithimba lakho lezokwelapha ukuthi lithole noma yiziphi izinkinga kusenesikhathi futhi liqinisekise ukuthi ukwelashwa kwakho kuyasebenza njengoba kulindelekile.

Xhumana nodokotela wakho uma uqaphela noma yimaphi amajuba amasha, ama-bumps, noma izinguquko endaweni ewelashwe ngesikhathi sokululama kwakho nangaphezulu. Nakuba izinguquko eziningi ziyizimpendulo ezijwayelekile zokuphulukisa, ithimba lakho lezokwelapha linganquma ukuthi ngabe ukuhlolwa okuqhubekayo kuyadingeka yini.

Unganqikazi ukuxhumana ngemibuzo noma izinkathazo mayelana nokululama kwakho. Ithimba lakho lezokwelapha lilindele futhi liyakwamukela imibuzo yakho, futhi ukubhekana nezinkathazo ekuqaleni kuvame ukuvimbela izinkinga ezincane ukuthi zingabi izinkinga ezinkulu.

Imibuzo evame ukubuzwa mayelana nokwelashwa ngemisebe ngesikhathi sokuhlinzwa

Q.1 Ingabe ukwelashwa ngemisebe ngesikhathi sokuhlinzwa kulungile ngomdlavuza webele?

Yebo, i-IORT ingaba yinhle kakhulu ezinhlotsheni ezithile zomdlavuza webele, ikakhulukazi izimila zesigaba sokuqala. Ucwaningo lubonisa ukuthi ezigulini ezikhethwe ngokucophelela ezinomdlavuza omncane, onengozi ephansi webele, i-IORT ingasebenza kahle njengokwelashwa ngemisebe yangaphandle yendabuko.

Ukwelashwa kunenzuzo ikakhulukazi ezigulini ezindala noma lezo ezinomdlavuza webele wesigaba sokuqala, omuhle ngama-hormone-receptor. Abesifazane abaningi bayakujabulela ukukwazi ukuqeda ukwelashwa kwabo ngemisebe ngesikhathi esifanayo nenqubo yabo ye-lumpectomy, ukugwema amasonto okuqokwa ngemisebe yansuku zonke.

Nokho, i-IORT ayifaneleki kuyo yonke imidlavuza yomdlavuza webele. Udokotela wakho we-oncologist uzocabangela izinto ezifana nosayizi wesimila, indawo, izinga, kanye nokubandakanyeka kwe-lymph node lapho enquma ukuthi ungumuntu ofanelekayo yini kule ndlela.

Q.2 Ingabe ukwelashwa ngemisebe ngesikhathi sokuhlinzwa kubangela imiphumela eminingi emibi kune-radiation ejwayelekile?

Eqinisweni, i-IORT ngokuvamile ibangela imiphumela emibi embalwa kune-radiation yangaphandle yendabuko. Ngenxa yokuthi imisebe ihanjiswa ngokuqondile endaweni okuyiwa kuyo ngenkathi izicubu ezinempilo zivikelekile, mancane amathuba okuthi uzothola imiphumela emibi ejwayelekile yemisebe efana nokucasuka kwesikhumba nokukhathala.

Indlela yokuthatha umthamo owodwa ye-IORT futhi isho ukuthi ngeke uthole imiphumela eqongelelwe engakhula ngokwelashwa kwemisebe yangaphandle yansuku zonke. Imiphumela eminingi emibi oyitholayo izohlobana nokuhlinzwa ngokwako kunokuthi kube yingxenye yemisebe.

Noma kunjalo, imiphumela oyitholayo ingase igxile endaweni ephathwayo. Abanye abantu bathuthukisa izinguquko zezicubu noma ukuqina lapho kwakhishwa khona imisebe, kodwa lokhu kuvamile ukulawuleka futhi kuthuthuka kancane kancane ngokuhamba kwesikhathi.

Q.3 Kuthatha isikhathi esingakanani ukululama ngemva kokwelashwa ngemisebe ngesikhathi sokuhlinzwa?

Isikhathi sokululama sincike ikakhulukazi ohlotsheni lokuhlinzwa obukwenzile kunokuthi yini imisebe. Abantu abaningi balulama ezinhlelweni ze-IORT ngesikhathi esifanayo abangathola ngaso ukuhlinzwa kuphela.

Nge-IORT yamabele, iziguli eziningi zibuyela emisebenzini ejwayelekile phakathi kwamasonto angu-1 kuya kwangu-2, okufana nokululama ku-lumpectomy ejwayelekile. Ukuhlinzwa okuningi ngokwemvelo kudinga izikhathi ezinde zokululama, ngokuvamile amasonto angu-4 kuya kwangu-6 ezinqubweni zesisu.

Ingxenye yemisebe ingase yehlise kancane ukuphulukiswa kwezicubu kwezinye izimo, kodwa lokhu akuvamile ukwelula isikhathi sakho sokululama esiphelele. Ithimba lakho lezokwelapha lizohlinzeka ngamalungiselelo athile ngokusekelwe kunqubo yakho ngayinye nempilo yonke.

Q.4 Ingabe ukwelashwa ngemisebe ngesikhathi sokuhlinzwa kungaphindwa uma umdlavuza ubuyela?

Ukuphinda i-IORT endaweni efanayo kungaba yinselele ngoba izicubu sezivele zithole umthamo omkhulu wemisebe. Noma kunjalo, ngezinye izikhathi kungenzeka kuye ngendawo, isikhathi esidlule kusukela ekwelashweni kokuqala, nesimo sakho sempilo esiphelele.

Udokotela wakho we-oncologist wemisebe uzohlola ngokucophelela izici ezinjengomthamo ophelele wemisebe izicubu zakho ezizitholile, isikhathi esidlule kusukela ekwelashweni kwakho kokuqala, nendawo yanoma yimuphi umdlavuza obuyayo. Ngezinye izikhathi ukwelashwa okuhlukile kungase kufaneleke kakhulu ezifweni eziphindayo.

Uma umdlavuza ubuyela endaweni ehlukile yomzimba wakho, i-IORT ingase isaba yindlela yokwelapha indawo entsha. Isimo ngasinye siyingqayizivele, futhi ithimba lakho lezokwelapha lizothuthukisa uhlelo olungcono kakhulu lokwelashwa olwenzelwe izimo zakho ezithile.

Q.5 Ingabe ukwelashwa ngemisebe ngesikhathi sokuhlinzwa kukhokhelwa ngumshuwalense?

Izinhlelo eziningi zomshuwalense, okuhlanganisa i-Medicare, zihlanganisa i-IORT uma kufaneleka ngokwezokwelapha futhi yenziwa ngezinkomba ezivunyelwe. Ukwelashwa kuthathwa njengenketho ejwayelekile yezinhlobo ezithile zomdlavuza, ikakhulu umdlavuza webele kanye neminye imidlavaza ye-colorectal.

Kodwa-ke, ukumbozwa kungahluka ngokuya ngohlelo lwakho lomshuwalense oluthile kanye nohlobo lomdlavuza olwelashwayo. Kubalulekile ukusebenza nabeluleki bezimali beqembu lakho lezokwelapha ukuqinisekisa ukumbozwa nokuqonda noma yiziphi izindleko ezingase ziphume ekhokheni ngaphambi kwenqubo yakho.

Uma uhlangabezana nezinkinga zokumbozwa, ithimba lakho lezokwelapha livame ukuhlinzeka ngemibhalo esekela isidingo sezokwelapha se-IORT esimweni sakho esithile. Izinkampani eziningi zomshuwalense ziyaqaphela ukusebenza kahle kwezindleko ze-IORT uma kuqhathaniswa namasonto e-external radiation therapy.