癌症治疗 - 化学治疗篇
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗癌症<span style="color: black;">通常</span>有三种方式，分别为化学治疗、放射治疗及外科手术。然而，放射治疗和外科手术<span style="color: black;">重点</span>集中针对个别身体部位，例如乳房、肺、前列腺等，属于局部治疗，难以对付<span style="color: black;">已然</span>扩散到其他部位的癌细胞；化学治疗则能填补<span style="color: black;">以上</span>两种<span style="color: black;">办法</span>的不足，在<span style="color: black;">病人</span>全身攻击癌细胞。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">化学治疗，简<span style="color: black;">叫作</span>「化疗」，泛指利用化学物质医治<span style="color: black;">各样</span><span style="color: black;">疾患</span>，后来<span style="color: black;">逐步</span>演变成专指癌症的其中一种治疗方式，把<span style="color: black;">药品</span>溶入<span style="color: black;">病人</span>的血液，在<span style="color: black;">身体</span>运行，<span style="color: black;">同期</span>击杀癌细胞。<span style="color: black;">因为</span>化疗是利用癌细胞分裂较正常细胞为快的特性来歼灭<span style="color: black;">她们</span>，会殃及<span style="color: black;">周边</span>用作<span style="color: black;">弥补</span>身体的正常细胞，<span style="color: black;">包含</span>造血的骨髓细胞、生长毛髮的毛囊细胞和消化道细胞等，产生不同的副<span style="color: black;">功效</span>，<span style="color: black;">选取</span><span style="color: black;">运用</span>化疗及<span style="color: black;">选取</span>採用哪种<span style="color: black;">药品</span>之前，都要先作<span style="color: black;">仔细</span>考量，<span style="color: black;">包含</span>癌症的种类、分佈，以及<span style="color: black;">病人</span>的年龄、体质等。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">疗程前须知</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">部分<span style="color: black;">病人</span>可能<span style="color: black;">必须</span><span style="color: black;">吃下</span>多于一种<span style="color: black;">药品</span>，以<span style="color: black;">增多</span>疗效。然而，如须<span style="color: black;">同期</span><span style="color: black;">吃下</span>多种化疗<span style="color: black;">药品</span>，<span style="color: black;">或</span>须在化疗<span style="color: black;">时期</span><span style="color: black;">吃下</span>其他<span style="color: black;">药品</span>，则<span style="color: black;">没</span>论<span style="color: black;">可否</span><span style="color: black;">必须</span><span style="color: black;">大夫</span>处方，都要<span style="color: black;">保证</span><span style="color: black;">药品</span>之间<span style="color: black;">无</span>相冲，<span style="color: black;">以避免</span>削弱疗效或加剧副<span style="color: black;">功效</span>。<span style="color: black;">病人</span>应事先将<span style="color: black;">平常</span><span style="color: black;">吃下</span>的<span style="color: black;">药品</span><span style="color: black;">通知</span><span style="color: black;">大夫</span>，<span style="color: black;">包含</span>营养<span style="color: black;">弥补</span>剂、风湿药等。<span style="color: black;">另一</span>，<span style="color: black;">病人</span><span style="color: black;">亦</span>要<span style="color: black;">重视</span>某些维他命会与化疗<span style="color: black;">药品</span>相冲，例如维他命A、E及C的抗氧化<span style="color: black;">功效</span>，可避免人体产生破坏细胞DNA的自由基，但部分化疗药可能<span style="color: black;">必须</span>依靠这些自由基来破坏癌细胞的DNA，使其<span style="color: black;">不可</span>分裂。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">化疗可分为全身及局部化疗。前者共有两大类，分别为注射剂及口服药，<span style="color: black;">其中</span>以注射剂最常用。部分<span style="color: black;">药品</span><span style="color: black;">同期</span>适合注射和口服，但<span style="color: black;">亦</span>要<span style="color: black;">思虑</span>癌肿的分佈和<span style="color: black;">病人</span>的体质，<span style="color: black;">病人</span>应该依从<span style="color: black;">大夫</span>指示，<span style="color: black;">选取</span>最适当的用药<span style="color: black;">办法</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">全身化疗</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">注射剂<span style="color: black;">重点</span>有三种：静脉注射、肌肉注射及皮下注射。然而，为免化疗<span style="color: black;">药品</span>刺激皮肉，大部分<span style="color: black;">状况</span>下<span style="color: black;">大夫</span>会<span style="color: black;">选取</span>静脉注射方式。静脉注射的原理是将带有胶管的针头插进<span style="color: black;">病人</span>手臂或手腕的小静脉，并连接输液的透明软胶管，<span style="color: black;">而后</span>把<span style="color: black;">药品</span>输入其身体。这种做法能够让<span style="color: black;">药品</span>随著血管流动，<span style="color: black;">快速</span>走遍全身攻击癌细胞。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">另一种静脉注射的<span style="color: black;">办法</span><span style="color: black;">叫作</span>为「中央静脉导管」，于<span style="color: black;">病人</span>胸腔的锁骨下静脉、颈内静脉等插针，好处是能够多次<span style="color: black;">运用</span>，首次疗程之后毋须拔出针头，留待以后<span style="color: black;">每日</span><span style="color: black;">运用</span>，直至疗程完成。<span style="color: black;">另一</span>，<span style="color: black;">大夫</span>和<span style="color: black;">病人</span>可<span style="color: black;">按照</span>疗程长短、输液时间、个人<span style="color: black;">爱好</span>、收费等<span style="color: black;">原因</span>，<span style="color: black;">选取</span>适合的导管和接口。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">通常</span>而言，置入导管或接口进入<span style="color: black;">病人</span><span style="color: black;">身体</span>的程序毋须<span style="color: black;">麻木</span>，惟事前要为<span style="color: black;">病人</span>验血，<span style="color: black;">保证</span>血小板数量正常，置入导管的位置<span style="color: black;">能够</span><span style="color: black;">快速</span>凝血。<span style="color: black;">不外</span>，置入导管仍有可能<span style="color: black;">显现</span><span style="color: black;">各样</span><span style="color: black;">危害</span>，例如刺伤静脉，使四周<span style="color: black;">显现</span>瘀肿、<span style="color: black;">流血</span>，<span style="color: black;">乃至</span>感染。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">至于口服的化疗药，则分为四种：药丸、药片、胶囊及药水，均可<span style="color: black;">自动</span>在家<span style="color: black;">吃下</span>。虽然口服<span style="color: black;">药品</span>费用较注射剂低，但<span style="color: black;">因为</span>胃酸可能冲淡<span style="color: black;">药品</span>，或<span style="color: black;">药品</span><span style="color: black;">不可</span>被肠胃吸收，<span style="color: black;">乃至</span>部分药性较强的<span style="color: black;">药品</span>会伤及胃黏膜，<span style="color: black;">因此呢</span>口服<span style="color: black;">药品</span>不如注射剂般普及。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">局部化疗</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">至于局部化疗，则指将大剂量的化疗<span style="color: black;">药品</span>送到癌肿位处的部位，从而以最集中的<span style="color: black;">办法</span>杀癌，并减少疗程产生的副<span style="color: black;">功效</span>。局部化疗的方式有以下七种：</p>动脉内灌注<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">大夫</span>会找出通往癌肿部位的动脉，并将导管接入，<span style="color: black;">也</span>会在体外以小型泵维持液压。针对不同部位的疗程有不<span style="color: black;">朋友</span>名，治疗肝脏时<span style="color: black;">叫作</span>为「离体肝脏灌注」，而治疗手脚时则<span style="color: black;">叫作</span>为「离体四肢灌注」。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2. 膀胱内化疗</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">常用于较<span style="color: black;">初期</span>的膀胱癌。<span style="color: black;">病人</span>每次用药须将导管透过尿道伸入膀胱，<span style="color: black;">药品</span>会在膀胱内停留大约两小时，<span style="color: black;">而后</span>排出体外。疗程需时由4至12 个星期不等。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3. 胸膜内化疗</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一般</span>用于肺膜间皮瘤、<span style="color: black;">已然</span>扩散到胸膜的肺癌和乳癌。<span style="color: black;">大夫</span>将导管置入<span style="color: black;">病人</span>的胸部，注入化疗<span style="color: black;">药品</span>，<span style="color: black;">乃至</span>可<span style="color: black;">同期</span>排出胸膜腔的积水，必要时<span style="color: black;">移植</span>液压泵。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4. 腹膜内化疗</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这是卵巢癌的标准疗法，<span style="color: black;">同期</span>适用于复发的大肠癌、在腹腔扩散的盲肠癌和胃癌。化疗<span style="color: black;">药品</span>进入<span style="color: black;">病人</span>的腹腔后，在流入血管前就会被癌肿吸收，<span style="color: black;">增多</span>疗效。然而，<span style="color: black;">因为</span>局部治疗剂量较多，身体<span style="color: black;">必须</span>较多时间吸收<span style="color: black;">药品</span>，所产生的副<span style="color: black;">功效</span>可能比静脉注射<span style="color: black;">更加多</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">5. 脊椎内化疗</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">原理是将<span style="color: black;">药品</span>直接注入<span style="color: black;">病人</span>脑部和脊椎裡的脑脊液〔注1〕，<span style="color: black;">通常</span>于癌细胞已扩散至中央神经系统时<span style="color: black;">运用</span>，最<span style="color: black;">平常</span>于白血病，而部分淋巴瘤和后期乳癌、肺癌等<span style="color: black;">也</span>适用，惟不适用于直接在脑部或脊椎里原生的癌肿。<span style="color: black;">仔细</span>做法有二，<span style="color: black;">能够</span>每次用药做一次腰椎穿刺，在脊椎近底部的骨节间插针，使<span style="color: black;">药品</span><span style="color: black;">能够</span>透过针头流入脑脊液；<span style="color: black;">亦</span><span style="color: black;">能够</span>将一个形状像小鼓的接口<span style="color: black;">安置</span>于头皮下，再把连接的导管穿透头颅伸入脑室，并用特制的针头穿透头皮、伸入接口，用以输药。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">6. 瘤腔内化疗</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">这是把化疗药直接注入癌肿的一种疗法，但<span style="color: black;">因为</span>针头穿过体表、伸入癌肿时，并<span style="color: black;">不可</span>影响其他器官，<span style="color: black;">因此呢</span>这种治疗方式<span style="color: black;">一般</span>只用于位处皮肤和皮下的癌肿。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">7. 外用药化疗</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">重点</span>是用药膏涂抹皮肤，最<span style="color: black;">平常</span>于治疗基底细胞癌、鳞状细胞癌等皮肤癌。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">副<span style="color: black;">功效</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因为</span>化疗<span style="color: black;">药品</span>利用癌细胞分裂较快的特性，对其发动攻击，间接影响其他正常细胞，<span style="color: black;">因此呢</span><span style="color: black;">病人</span>在接受化疗后，可能会<span style="color: black;">显现</span><span style="color: black;">各样</span>副<span style="color: black;">功效</span>，<span style="color: black;">包含</span>疲倦、脱髮、食慾不振等。<span style="color: black;">通常</span>而言，这些副<span style="color: black;">功效</span>会在疗后<span style="color: black;">起始</span>两至三个星期后<span style="color: black;">显现</span>，<span style="color: black;">也</span>有可能在服药后数小时<span style="color: black;">逐步</span>浮现。</p>疲倦<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">病人</span><span style="color: black;">身体</span>的红血球不足，身体的氧分会减少，容易令人感到<span style="color: black;">没</span>力、迷惘、精神难以集中等。<span style="color: black;">病人</span>应<span style="color: black;">保证</span>充足<span style="color: black;">休憩</span>，多喝水，并<span style="color: black;">按时</span>进行轻量运动。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2. 噁心呕吐</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一般</span>在注药后数小时<span style="color: black;">显现</span>，严重者<span style="color: black;">乃至</span>会脱水。<span style="color: black;">病人</span>在注药前，宜先<span style="color: black;">摄食</span>少量轻食，例如汤或粥等流质；而在注药后，多<span style="color: black;">弥补</span>水分，<span style="color: black;">也</span><span style="color: black;">尽可能</span>少食多餐，并<span style="color: black;">选取</span>易消化的清淡<span style="color: black;">食品</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3. 便秘及腹泻</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">部分化疗<span style="color: black;">药品</span>会影响消化系统的内壁，<span style="color: black;">引起</span>便秘或腹泻，前者可透过<span style="color: black;">摄食</span>蔬果、全穀麵包等高纤维食品缓和，而后者则<span style="color: black;">能够</span>戒除食辣的习惯，多<span style="color: black;">摄食</span>清淡或温热的流质<span style="color: black;">食品</span>，以<span style="color: black;">弥补</span>腹泻时流失的水分。如<span style="color: black;">状况</span>属轻微，<span style="color: black;">病人</span>可<span style="color: black;">自动</span><span style="color: black;">吃下</span>非处方<span style="color: black;">药品</span>，惟倘若<span style="color: black;">状况</span>严重，有可能<span style="color: black;">引起</span>脱水，应尽早<span style="color: black;">通告</span><span style="color: black;">大夫</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4. 口腔溃烂</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">部分化疗<span style="color: black;">药品</span>会引致口腔黏膜炎，<span style="color: black;">引起</span>黏膜红肿、白斑溃疡、吞嚥困难等<span style="color: black;">状况</span>。<span style="color: black;">病人</span>可<span style="color: black;">自动</span>清洁口腔，例如用暖盐水漱口，以防感染，<span style="color: black;">或</span>用药止痛，并多<span style="color: black;">摄食</span>流质<span style="color: black;">食品</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">5. 脱髮</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">传统的化疗<span style="color: black;">药品</span>会攻击分裂快的癌细胞，而毛囊细胞<span style="color: black;">因为</span>更新快，<span style="color: black;">一样</span>会被<span style="color: black;">药品</span>攻击，使毛髮脱落。<span style="color: black;">病人</span><span style="color: black;">通常</span>在接受<span style="color: black;">第1</span>次化疗的两个星期内<span style="color: black;">起始</span>脱髮，程度因人而异，但<span style="color: black;">广泛</span>在停药后1至2个月，头髮便会重生。在脱髮<span style="color: black;">时期</span>，<span style="color: black;">病人</span>可改用婴儿洗头水，<span style="color: black;">守护</span>头皮，并<span style="color: black;">运用</span>棉质、化学纤维或丝质枕头。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">6. 皮肤痕痒及剥落</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">化疗可能令皮肤乾燥、痕痒、剥落，或对阳光<span style="color: black;">敏锐</span>。<span style="color: black;">病人</span><span style="color: black;">能够</span>用粟米粉涂抹在痕痒处，或在乾燥的位置涂抹润肤膏。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">7. 神经和肌肉麻痺</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">部分<span style="color: black;">药品</span>会影响<span style="color: black;">病人</span>的神经线，令其手指或脚趾感到刺痛麻痹、腿部肌肉<span style="color: black;">没</span>力、眼球震颤、面部麻痹、声音沙哑、视力模糊、耳鸣等等。如有以上<span style="color: black;">状况</span>，<span style="color: black;">必要</span><span style="color: black;">通告</span><span style="color: black;">大夫</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">8. 生育问题</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">化疗可能会令女性的<span style="color: black;">大姨妈</span><span style="color: black;">错乱</span>，部分女性于疗程过后，<span style="color: black;">大姨妈</span>会恢复正常，但<span style="color: black;">也</span>有人从此收经。停经后，女性<span style="color: black;">病人</span>可能<span style="color: black;">显现</span>热潮红、夜盗汗、皮肤乾燥等问题，<span style="color: black;">大夫</span>可处方<span style="color: black;">药品</span>纾援。至于男性，化疗后精子可能减少、活力不足，<span style="color: black;">引起</span>勃起困难，但<span style="color: black;">一般</span><span style="color: black;">状况</span>只属暂时性。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">资料<span style="color: black;">源自</span>：希愈肿瘤中心</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">照片</span><span style="color: black;">源自</span>：网上</p>
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