原创 癌症晚期，倾家荡产吃靶向药延长生命值得吗？答案暗地里都是心酸
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">刘姨今年58岁，家庭和谐子女<span style="color: black;">亦</span>成家了，本应顺利的度过晚年，却<span style="color: black;">由于</span>一纸体检报告单，面临生死抉择<span style="color: black;">困难</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">原来她年初单位体检的时候<strong style="color: blue;">查出了肺癌，<span style="color: black;">况且</span>是晚期。</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">大夫</span>解释她的<span style="color: black;">状况</span>普通治疗<span style="color: black;">已然</span>没什么用了，只能试试<strong style="color: blue;">靶向药治疗</strong>，但这种药价格很贵，<span style="color: black;">一月</span>可能就要花十几万。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">她<span style="color: black;">晓得</span>，就算花了所有的积蓄加上子女的支持，<span style="color: black;">亦</span>就能治个大半年，后续就没办法了，但<span style="color: black;">这般</span>砸钱进<span style="color: black;">没</span>底洞真的值得吗？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q2.itc.cn/images01/20240405/d76818be3d184f6ab2be69f1b7e23612.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">1、</span>癌症晚期，砸钱吃靶向药延长生命值不值得？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">广州中医药大学<span style="color: black;">第1</span><span style="color: black;">附庸</span>医院肿瘤科<span style="color: black;">专家</span>林丽珠</strong><span style="color: black;">暗示</span>，<span style="color: black;">非常多</span>晚期癌症临床<span style="color: black;">病人</span>都面临着该<span style="color: black;">不应</span>“全力一搏”的问题，<span style="color: black;">由于</span><strong style="color: blue;">药效并不是百分百能<span style="color: black;">掌控</span>住病情的</strong>，有的人可能钱花了，病治了但人还是没了，但<span style="color: black;">亦</span>有人<span style="color: black;">因此呢</span><span style="color: black;">得到</span>新生。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">林丽珠<span style="color: black;">大夫</span>曾分享过<span style="color: black;">这般</span>两个案例：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">①父亲高龄患癌，儿子<strong style="color: blue;">花了十几万治疗后又再次复发</strong>，而后续治疗<span style="color: black;">必须</span>用到昂贵的靶向药，让本就不富裕的家庭雪上加霜，加上儿子一家还背着房贷，家属纠结了很久。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">最后还是<span style="color: black;">选取</span>奋身一搏，<strong style="color: blue;">把<span style="color: black;">整家</span>的积蓄都用上了，还借了十几万的外债</strong>，<strong style="color: blue;"><span style="color: black;">结果父亲治疗100天后还是不治身亡</span></strong>。</p><img src="//q1.itc.cn/images01/20240405/cd03c3e173fb425594fa0eb10cad7985.jpeg" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">②53岁的老马<span style="color: black;">由于</span><strong style="color: blue;">肝癌晚期，再复发</strong>后<span style="color: black;">没</span>法再<span style="color: black;">经过</span>常规手段治疗，<span style="color: black;">大夫</span>提出<span style="color: black;">能够</span>用靶向<span style="color: black;">药品</span>“搏一搏”了。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">老马觉得之前花了这么多钱<span style="color: black;">亦</span>没<span style="color: black;">掌控</span>住，想说<span style="color: black;">不必</span>再“尝试”，<strong style="color: blue;">怕家里人经济压力太大</strong>，<span style="color: black;">乃至</span>想就<span style="color: black;">这般</span>死了算了。但家属却不同意，坚决继续治疗：<strong style="color: blue;">“钱没了<span style="color: black;">能够</span>再挣，人走了就什么都<span style="color: black;">无</span>了。”</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">然而幸运的是，他仅仅<span style="color: black;">保持</span>了<strong style="color: blue;">3个月的靶向<span style="color: black;">药品</span>治疗</strong><strong style="color: blue;">，病情竟然真的</strong><strong style="color: blue;">得到<span style="color: black;">掌控</span></strong>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">如今3年存活期已过，他的病情仍然较稳定。<strong style="color: blue;"><span style="color: black;">他很<span style="color: black;">幸运</span>当时</span></strong><strong style="color: blue;"><span style="color: black;">家里人“放手一搏”，为自己“捡回了一条命”。</span></strong></p><img src="//q4.itc.cn/images01/20240405/71b38bac4ab146839c9d4b92ec5d994e.jpeg" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">类似的案例<span style="color: black;">能够</span>说<span style="color: black;">每日</span>都在上演，<strong style="color: blue;">昂贵的靶向药<span style="color: black;">作为</span><span style="color: black;">非常多</span>癌症<span style="color: black;">病人</span>最后一根“救命稻草”</strong>，治还是不治？值不值得“搏”？<span style="color: black;">针对</span>病人和家属<span style="color: black;">来讲</span>其实都是一个巨大的<span style="color: black;">困难</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">况且</span><strong style="color: blue;">不是<span style="color: black;">每一个</span>家庭都能承担“搏”输了人财两空的后果</strong>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q1.itc.cn/images01/20240405/0a8894588d7f494d94dc2c5441e43b27.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">对此林丽珠教授<span style="color: black;">暗示</span>，<strong style="color: blue;"><span style="color: black;">靶向药不是所有癌症类型都适合</span></strong>，它只针对某些合适群体的肿瘤<span style="color: black;">病人</span>有疗效，<strong style="color: blue;"><span style="color: black;">选取</span>用药前<span style="color: black;">必定</span>要先算账</strong>，怎么<span style="color: black;">才可</span>把钱花在刀刃上，这是<span style="color: black;">每一个</span><span style="color: black;">病人</span><span style="color: black;">必须</span><span style="color: black;">思虑</span>的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">意见</span>遵循<span style="color: black;">药品</span>经济学原则</strong>，综合<span style="color: black;">将来</span><span style="color: black;">存活</span>期、<span style="color: black;">存活</span>质量以及<span style="color: black;">病人</span>安全以及<span style="color: black;">最后</span>成本-效果比等<span style="color: black;">原因</span>，<strong style="color: blue;">全面<span style="color: black;">评定</span>治疗<span style="color: black;">办法</span>的优劣后再做<span style="color: black;">选取</span></strong>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">临床上<span style="color: black;">非常多</span>肿瘤晚期<span style="color: black;">病人</span>都有一种“治愈”执着，林丽珠认为，<strong style="color: blue;"><span style="color: black;">针对</span>晚期<span style="color: black;">病人</span><span style="color: black;">来讲</span>，治愈<span style="color: black;">不该</span>该<span style="color: black;">作为</span><span style="color: black;">目的</span></strong>，<span style="color: black;">知道</span>肿瘤<span style="color: black;">状况</span>以及最优预后<span style="color: black;">选取</span>，<span style="color: black;">按照</span>身体承受能力以及家庭经济实力，<strong style="color: blue;"><span style="color: black;">在<span style="color: black;">保准</span><span style="color: black;">存活</span>质量的<span style="color: black;">同期</span>减少家庭<span style="color: black;">包袱</span>更<span style="color: black;">要紧</span></span></strong><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q7.itc.cn/images01/20240405/86e7c6f1bf9a43de90c621ab912e7b20.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">2、</span>击垮<span style="color: black;">没</span>数家庭的靶向药，<span style="color: black;">为何</span><span style="color: black;">不可</span>降价？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">非常多</span>人可能不<span style="color: black;">认识</span>靶向药是什么，<strong style="color: blue;">南方医科大学珠江医院肿瘤科<span style="color: black;">专家</span>张健</strong>解释：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>把癌症和靶向治疗放在对立面作战，<strong style="color: blue;">癌症的军事基地<span style="color: black;">便是</span>致癌位点</strong>，是癌细胞有生力量的源头，<strong style="color: blue;">而靶向药就像“生物导弹”</strong>，<span style="color: black;">能够</span><span style="color: black;">精细</span>找到致癌位点，在不<span style="color: black;">损伤</span><span style="color: black;">周边</span>正常组织的<span style="color: black;">同期</span>，<strong style="color: blue;">实施</strong><strong style="color: blue;">个性化打击</strong>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q7.itc.cn/images01/20240405/52c149fb41714f198eb74ccf92b286b9.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">相比于传统治疗手段，靶向药<strong style="color: blue;">在<span style="color: black;">保准</span>良好疗效的<span style="color: black;">同期</span>，又能够减少副<span style="color: black;">功效</span></strong>，<span style="color: black;">加强</span>肿瘤病人的生活质量。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">但张健<span style="color: black;">大夫</span><span style="color: black;">亦</span>提醒，<strong style="color: blue;">靶向药不是所有的<span style="color: black;">病人</span>都适用，靶向药</strong><strong style="color: blue;">只对特定致癌位点有效</strong>，就像钥匙和锁头，匹配上<span style="color: black;">才可</span>解锁。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此</span>，<span style="color: black;">病人</span><span style="color: black;">运用</span>靶向<span style="color: black;">药品</span>前，要<span style="color: black;">经过</span>基因检测<span style="color: black;">知道</span>癌细胞的突变类型，<span style="color: black;">是不是</span>存在对应的靶点。</p><img src="//q1.itc.cn/images01/20240405/ef1007e324c044bea58b15ac04c726b7.jpeg" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">非常多</span>人疑惑<span style="color: black;">为何</span>靶向药这么贵？<span style="color: black;">这儿</span><span style="color: black;">重点</span><span style="color: black;">能够</span>从以下三方面解释：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">1、<span style="color: black;">开发</span>成本高</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">任何药在面世前，都经过了很长的<span style="color: black;">科研</span><span style="color: black;">发掘</span>、筛选、优化合成、临床实验等<span style="color: black;">过程</span>，<span style="color: black;">这儿</span><span style="color: black;">每一个</span><span style="color: black;">过程</span>都是成本，<span style="color: black;">况且</span><strong style="color: blue;">有的药可能要耗费10-15年时间<span style="color: black;">才可</span>落地</strong>，耗费数10亿美金以上，一旦任何一个环节没跟上，都可能血本<span style="color: black;">没</span>归。</p><img src="//q5.itc.cn/images01/20240405/37ea3485388d4552addf1a315b84d0af.jpeg" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">2、<span style="color: black;">营销</span>和流通成本贵</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">非常多</span>靶向药是进口<span style="color: black;">药品</span>，<span style="color: black;">营销</span>价格中<span style="color: black;">包括</span>了引进国内要缴纳的进口关税、增值税，以及<span style="color: black;">药品</span>的推广、运输以及层层分销加价。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">3、审批成本</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">不是所有的药一面世就能临床应用，<span style="color: black;">常常</span><span style="color: black;">必须</span>经过临床<span style="color: black;">实验</span>后<span style="color: black;">才可</span>审批<span style="color: black;">经过</span>，而这个过程产生的成本<span style="color: black;">亦</span>会加到药费里。</p><img src="//q7.itc.cn/images01/20240405/67e39866280249048bc226d4b5ea4d00.jpeg" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">3、</span>靶向用药的四大误区，千万别踩“坑”</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">虽然靶向药在某些肿瘤中疗效更快更好，副<span style="color: black;">功效</span><span style="color: black;">亦</span>更小，但并不<span style="color: black;">表率</span><span style="color: black;">能够</span>乱用。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">抗肿瘤专科临床药师董俊丽</strong><span style="color: black;">暗示</span>，口服靶向药<span style="color: black;">亦</span>有不少“禁忌”，以下<span style="color: black;">重视</span>事项<span style="color: black;">必定</span>要<span style="color: black;">认识</span>：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">1、用药不规范</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">靶向治疗用药过程中，<span style="color: black;">必须</span><span style="color: black;">按时</span>定量<span style="color: black;">运用</span>，<span style="color: black;">倘若</span><strong style="color: blue;"><span style="color: black;">显现</span></strong><strong style="color: blue;">少服<span style="color: black;">或</span>漏服，<span style="color: black;">必定</span>要在12小时内补上</strong>，<span style="color: black;">倘若</span>超过12小时<span style="color: black;">亦</span><span style="color: black;">不消</span>补了，否则<span style="color: black;">便是</span>过量用药，<span style="color: black;">亦</span>会<span style="color: black;">导致</span>不良反应的<span style="color: black;">出现</span>率。</p><img src="//q0.itc.cn/images01/20240405/cc08b95f56a646ae867452d2b2b7bc78.jpeg" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">2、<span style="color: black;">茫然</span>跟风</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">非常多</span>癌症<span style="color: black;">病人</span>听说靶向治疗治疗效果好，就习惯性跟风，但<span style="color: black;">实质</span>上<strong style="color: blue;">靶向药不是人人适合</strong>，<span style="color: black;">倘若</span>不适应症状<span style="color: black;">茫然</span><span style="color: black;">弥补</span>，不止效果<span style="color: black;">无</span>还可能<span style="color: black;">显现</span>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;"><strong style="color: blue;">3、吃药不忌口</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">靶向药<span style="color: black;">吃下</span>过程中需<strong style="color: blue;">要远离西柚、石榴、杨桃这些<span style="color: black;">果蔬</span></strong>，<span style="color: black;">由于</span>这类<span style="color: black;">果蔬</span>中含有的物质会<span style="color: black;">控制</span>肝脏中CYP3A4酶活性，<span style="color: black;">有害</span>于靶向药发挥疗效。</p><img src="//q4.itc.cn/images01/20240405/b53ab0896fd645fd851f979f37d5397e.jpeg" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">4、不按时监测用药</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">靶向治疗过程中，<strong style="color: blue;"><span style="color: black;">必须</span><span style="color: black;">定时</span>监测用药反应，以防<span style="color: black;">病人</span><span style="color: black;">显现</span><span style="color: black;">药品</span>副<span style="color: black;">功效</span></strong>。<span style="color: black;">例如</span><span style="color: black;">平常</span>的皮疹、高血压、蛋白尿、<span style="color: black;">流血</span>、乏力等，严重<span style="color: black;">乃至</span>可能<span style="color: black;">诱发</span>肝<span style="color: black;">损害</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">定时</span>监测身体反馈，可以<span style="color: black;">即时</span><span style="color: black;">发掘</span><span style="color: black;">反常</span>，并<span style="color: black;">调节</span>治疗手段，避免<span style="color: black;">导致</span>新的<span style="color: black;">危害</span>。</p><img src="//q7.itc.cn/images01/20240405/09571c60505948a6a140d8814b168c10.jpeg" style="width: 50%; margin-bottom: 20px;">
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">尽管靶向治疗<span style="color: black;">已然</span>在临床上表现优异，但仍有不少问题<span style="color: black;">必须</span>继续<span style="color: black;">科研</span><span style="color: black;">处理</span>，随着<span style="color: black;">药品</span><span style="color: black;">科研</span><span style="color: black;">持续</span>更新迭代，<strong style="color: blue;">相信<span style="color: black;">将来</span><span style="color: black;">亦</span>会<span style="color: black;">显现</span><span style="color: black;">更加多</span>好的治疗手段，让<span style="color: black;">病人</span>预后<span style="color: black;">存活</span>质量更有<span style="color: black;">保证</span>。</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">参考资料：</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《每月自费从5万到3000元……已入<span style="color: black;">医疗保险</span>的癌症靶向药<span style="color: black;">名单</span>！》.深圳<span style="color: black;">医疗保险</span>.2022-02-18.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《关于靶向治疗，你想<span style="color: black;">晓得</span>的都在<span style="color: black;">这儿</span>→》.广东<span style="color: black;">颁布</span>.2022-04-16.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">《肿瘤<span style="color: black;">病人</span><span style="color: black;">那些</span><span style="color: black;">食品</span><span style="color: black;">不可</span>吃？<span style="color: black;">大夫</span>告诉你真相！》.健康时报.2023-04-18.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">未经作者<span style="color: black;">准许</span>授权，禁止转载<a style="color: black;"><span style="color: black;">返回<span style="color: black;">外链论坛：http://www.fok120.com/</span>，查看<span style="color: black;">更加多</span></span></a></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">责任编辑：网友投稿</span></p>
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