Amakhansela aphezulu weBanga eliPhakambili neNcane elincane le-neuroendocrine ye-Colon
Uma wena noma othandekayo uthola ukuthi unesifo esibi noma sezingeni eliphakeme le-neuroendocrine ye- colon noma i-rectum cishe uyesaba futhi udidekile. Izikhumba ze-neuroendocrine ezihlukumezayo azifani kakhulu kunezinye ezinye zegciwane le-colon. Ngaphezu kwalokho, bavame ukungaboni kahle futhi kubalulekile ukuba ngummeli wakho uma unesinye sezicubu.
Yini esikwaziyo ngalezi zomshukela, zithathwa kanjani, futhi yiziphi izibikezelo?
Ziyini Izicubu Ze-Neuroendocrine?
Izicubu ze-Neuroendocrine ziyi-tumors eziqala kuma-neuroendocrine amaseli. Zingase zenzeke endleleni yokugaya, amaphaphu, noma ubuchopho. Esigabeni sokugaya kungase kuhilele isisu, ama-pancreas, amathumbu amancane, i-colon, ne-rectum.
E-colon kanye ne-rectum, izicubu ze-neuroendocrine ziba ngamaphesenti angu-2 noma ngaphansi komdlavuza we- colorectal . Ngeshwa, ngokungafani nezinye izinhlobo zomdlavuza we-colon, ukubikezela akuzange kushintshe kakhulu eminyakeni yamuva nje nokuhlolwa komdlavuza wekoloni.
Izikhumba ze-Neuroendocrine sezilokhu zanda, ngokunyuka kwama-5 okuphawulwe kusukela ngo-1973 kuya ku-2004 nokukhula okuqhubekayo kusukela ngaleso sikhathi. Akuqiniseki ukuthi kungani lokhu kwenzeka okwamanje.
Ukuhlukumeza ngokumelene nezidakamizwa ezingekho emthethweni
Izikhumba ze-Neuroendocrine zihlukaniswa kuqala zibe izigaba ezimbili eziyisisekelo ngokusekelwe kokuhlukumeza kwezicubu.
- Isisindo esiphakeme samangqamuzana amakhulu kanye nezimbungulu ezincane ze-neuroendocrine zihlukumeza. Lezi zicubu zivame ukukhula ngokushesha futhi zihlasele ezinye izicubu
- Izicubu ze-carcinoid ye-colon zibhekwa njengezingcolile. Zivame ukukhula kancane futhi zingenangqondo kakhulu kunezingqamuzana ezinkulu namaselula omzimba we-neuroendocrine.
Kubalulekile ukuhlukanisa izicubu ezinonya nezindlala njengoba izindlela zokwelapha ezifanele futhi ukuhlukunyezwa kwehluka kakhulu.
Amaseli amakhulu nezinsimba ezincane zamaseli
Ibanga eliphakeme, noma izidakamizwa ezinonya, ze-neuroendocrine zihlukaniswe zibe izingqamuzana ezinkulu zamaseli namancane amancane, ahluke ngokususelwa ekubukeni kwamaseli ngaphansi kwe-microscope. Zombili izinhlobo zomdlavuza zibhekwa njengento "engafaneleki" okusho ukuthi amaseli avela esihlotsheni esiphelele kakhulu kumaseli ajwayelekile we-neuroendocrine futhi aziphathe kabi. Esikhathini esidlule kwakucatshangwa ukuthi izicubu ezinkulu zesisindo zazivame kakhulu, nokho isifundo se-2016 sathola ukuthi amaphesenti angu-89 wamathumba ayeyizinambuzane ezincane zesifo se-neuroendocrine.
Ngandlela-thile, izicubu eziphezulu ze-neuroendocrine zifana nomdlavuza omncane wesifo samaphaphu, futhi zivame ukubhekana nemithi efana nayo, kepha zingenakwenzeka ukuba zihlotshaniswe nokubhema kunezincane zamangqamuzana wamaphaphu emangqamuzana futhi zingenakwenzeka ukuba zibe nemithambo emathanjeni nasebuchosheni.
Ucwaningo oluthile luye lwathola ukuthi izicubu zenzeka ngokujwayelekile ngakwesokudla kolononi (okwenyuka koloni) kanti ucwaningo lwamuva luthole ukuthi indawo evame kakhulu yalezi zicubu kwakuyi-colon rectum ne-sigmoid.
Ukukhishwa komdlavuza weColon akuzange kubangele ukwanda okuphawulekayo ekukhulumeni kwalezi zicubu, nakuba kuhlolwa okukodwa, amaphesenti angu-30 e-tumor atholakale ehlotshaniswa ne- adenomas .
Iningi lamathumba (amaphesenti angu-64) isiteji sesi-4 noma i-metastatic ngesikhathi sokuxilongwa.
Izimpawu
Izimpawu ze-neuroendocrine izicubu ze-colon zingase zibandakanye izinguquko emikhondweni yemilenze, njengesifo sohudo, ubuhlungu besisu, futhi kokubili izinga eliphakeme le-glucose yegazi. Njengoba lezi zitholampilo zivame ukutholakala ngezigaba kamuva, izimpawu zomdlavuza ophuthumayo ezifana nokulahlekelwa kwesisindo okungenasisekelo zivame ukutholakala.
Ukuqinisekisa Ukuhlola Okufanele
Ucwaningo lubonisa ukuthi izicubu ezinonya ze-neuroendocrine zivame ukubhekwa njengama-tumorcinoid tumors. Lokho kuyiphutha elibi ngoba i-carcinoid ikhula kancane futhi ingasakazeki.
Uma utshelwe ukuthi une-tumorcinoid tumor, qiniseka ukuthi udokotela wezifo owaziwayo uvumelana nokuxilongwa kwakho. Ukwenza kanjalo kuzodinga ukuthi ucele udokotela wakho imibuzo ethile ebalulekile:
- Ingabe isazi sezinziza sabamba iqhaza ekufundeni kokugcina kwesiboniso sami se-tumor?
- Ingabe isifo sofuba sabhekana nokuhlukanisa phakathi kwezicubu ezihlukumezayo nezingenayo i-neuroendocrine?
- Ingabe lo mhlengikazi waveza noma yikuphi ukungabaza ngokuxilongwa kwami?
Uma izimpendulo zingekho yebo, yebo, futhi cha (noma impela eduze kwaleyo), ithimba lakho lezokwelapha linomsebenzi owengeziwe ongakwenza ngaphambi kokukunikeza ukuxilongwa okucacile.
Ukwelapha
Awekho okwamanje okwelapha okujwayelekile kwezinto ezimbi ezinomsoco ze-colon kanye ne-rectum. Kodwa ukwelashwa kuzokwenziwe ngesiteji se-tumor. Uma enye yalezi zinambuzane itholakala ekuqaleni, inhlanganisela yokuhlinzwa, ukwelapha imisebe, kanye ne-chemotherapy ingacatshangwa.
Ukuze izicubu ze-neuroendocrine eziphakeme ezisezingeni eliphakeme, i- chemotherapy iyindlela yokwelashwa futhi ingabangela ukusinda okude. Amakhemikhali e-Chemotherapy afana nalawo asetshenziselwa ukwelapha umdlavuza omncane we-cell lung , ngokuvamile ehlanganisa izidakamizwa zeplatinum njengePlatinol (cisplatin) noma iParaplatin (carboplatin.)
Ukucwaninga okubandakanya ukufometha komzimba ngalezi zinhlamba kunikeza ithemba lokuthi, esikhathini esizayo, izindlela zokwelashwa ezihlosiwe zingase zitholakale ukuphatha lesi sifo.
Isibikezelo
Izifo ezivuthayo ze-neuroendocrine zivame ukutholakala ngezigaba ezithuthukisiwe, isimo esivame ukuholela ekuhlatheni okubi. Ukuphela kokwelashwa okuye kwaboniswa kuze kube manje ukuthuthukisa ukusinda yi-chemotherapy.
Ngesikhathi samanje, ukusinda okuphakathi (ubude besikhathi emva kwesigamu sabantu abaye bafa kanye nesigamu basaphila) izinyanga ezingu-13 kuya kwezi-15, ngenani leminyaka engu-2 lokusinda lamaphesenti angu-23 kanye nokuphila kweminyaka engu-8 kuphela amaphesenti.
Ukubhekana
Ukuthola ukuthi unesifo esiphakeme se-neuroendocrine asikwesabisi nje kuphela, kodwa kungaba nokudideka kakhulu njengoba isimo singavamile kakhulu. Isibikezelo se-tumor siye, ngeshwa asishintshi kakhulu eminyakeni yamuva, kodwa ukuthuthuka kokwelashwa, njengokufika kwezokwelapha ezihlosiwe kanye ne- immunotherapy , kunikeza ithemba lokuthi izindlela ezintsha zokwelashwa zizotholakala esikhathini esizayo esisha.
Xoxa nodokotela wakho mayelana nokukhethwa kokuhlolwa kwemitholampilo okuhlola lezi zindlela ezintsha zokwelapha. Yiba ngummeli wakho siqu ekunakekeleni umdlavuza wakho bese ubuza imibuzo. Cela usizo kubathandekayo bakho futhi uvumele ukuthi bakusize. Ngaphezu kwalokho, abantu abaningi bakuthola kuwusizo ukufinyelela emiphakathini yokusekela inthanethi. Nakuba izicubu ze-neuroendocrine ezinonya zingavamile futhi akunakwenzeka ukuthi unamaqembu okusekela kulokhu emphakathini wakho, i-intanethi ikuvumela ukuthi ungene ekuthintaneni nabanye obhekene nezinto ezifanayo emhlabeni wonke.
Imithombo:
Conte, B., George, B., Overman, M. et al. I-High-Grade Neuroendocrine Colorectal Carcinomas: Isifundo Esibucayi Seziguli Ezi-100. I-Cancer Colorectal Cancer . 2016. 15 (2): e1-7.
UHammond, W., Crozier, J., Nakhleh, R., noK. Mody. I-Genomic Profiling ye-High-Grade Large-Cell Neuroendocrine Carcinoma ye-Colon. I-Journal ye-Oncology yamathumbu . 2016. 7 (2): E22-4.
UShafgat, J., Ali, S., uShabhab, M., no-A. Oszewski. Ukusinda kweziguli ezine-neuroendocrine carcinoma ye-Colon ne-Rectum: Ukuhlaziywa kwabantu okusekelwe kubantu. Izifo ze-Colon ne-Rectum . 2015. 58 (3): 294-303.
USmith, J., Reidy, D., Goodman, K., Shia, J., noG. Nash. Ukubukezwa okubukeziwe kwe-126 High-Grade Neuroendocrine Carcinomas ye-Colon ne-Rectum. Ama-Annal of Oncology Yokuhlinza . 2014. 21 (9): 2956-62.