Ingxoxo noDkt Edward M. Wolin, MD
Ukufa kukaSteve Imisebenzi kusuka emthonjeni ongavamile wesifo somdlavuza we-pancreatic okuthiwa i-pancreatic neuroendocrine umdlavuza uvusa isithakazelo emdlalweni we-pancreatic. Kulolu daba, uDkt. Edward Wolin, isazi somdlavuza we-neuroendocrine esihambisana neCedars Sinai Medical Center, uxoxisana nomdlavuza we-pancreatic neuroendocrine nokuthi iziguli zilwa kanjani nesifo. UDkt. Wolin ungumqondisi weCarcinoid ne-Neuroendocrine Tumor Program at Cedars-Sinai Medical Center futhi unomkhuba omkhulu kunazo zonke wezizwe onguchwepheshe womdlavuza we-neuroendocrine we-pancreatic.
Akazange aphathe uSteve Imisebenzi.
Ungachaza ukuthi yini umdlavuza we-pancreatic neuroendocrine?
Amagciwane we-Pancreatic neuroendocrine ayama-tumor ezikhulayo ezikhula kancane kancane eziqala amangqamuzana e-endocrine (amangqamuzana ekhiqiza ama-hormone) ama-pancreas, awaziwa njengeziqhwa ze-islet. Nakuba lezi zicubu zingaveza amahomoni amaningi e-pancreatic, eziningi azikhiqizi ama-hormone. Zivame ukusabalalisa endaweni yesisu nangesibindi ngesikhathi sokuxilongwa. Kodwa-ke, izinga lokusinda livame kakhulu kunalohlobo oluvamile lomdlavuza we-pancreatic (adenocarcinoma) , ngisho nalapho kutholakala izidakamizwa.
Kutholakala kanjani? Zikhona yini izimpawu?
Lapho lezi zomshukela zikhiqiza ama-hormone, izimpawu zokuqala zingaba nzima futhi ziholele ekutholeni ukuxilongwa. Isibonelo, i-tumor eveza i-insulin iveza izimpawu zeshukela egazini kakhulu, noma i-gastrin-producer tumor, idala izilonda ezinzima zesisu ne-duodenal, okuholela ekuxilongweni nge-CT scan, i-MRI scan, noma i-endoscopic ultrasound ye-pancreas.
Uma ukukhiqizwa kwe-hormone kungabangeli izimpawu zomtholampilo, izikhumba zizovame ukukhula zibe usayizi omkhulu futhi zisakaze esibindi nakwezinye izingosi ngesikhathi sokutholakala ku-CT noma i-MRI. Kulezi zimo, izimpawu zokuqala zingase zibe ubuhlungu besisu, i-jaundice, ukulahlekelwa isisindo, i-malaise, ukubhubhisa kwesisu, ukuhlanza, ukunqanda isikhumba, ubuthakathaka, nokuhuda.
Ngubani osengozini? Ingabe isilinganiso, umuntu onempilo kufanele akhathazeke ngomdlavuza we-necendocrine we-pancreatic?
Lezi yizinkinga ezingavamile kakhulu, ezinama-3 amacala abantu abayizigidi baseMelika, abalelwa ku-3% we-pancreatic kancreatic. Ngakho-ke, isilinganiso, umuntu onempilo akufanele akhathazeke kakhulu ngokuthuthukisa umdlavuza we-pancreatic neuroendocrine. Okuhlukile kuneminye imindeni lapho umdlavuza we-pancreatic neuroendocrine uvame ukuvame ukuvame ukuhlala nomzimba we-parathyroid ne- pituitary . Lokhu kufakazelwa komndeni kwaziwa ngokuthi i-endocrine neoplasia uhlobo 1 (MEN-1).
Ingabe siyazi ukuthi kubangelwa yini?
Siyazi ukuthi ukuguquguquka - isakhi sofuzo esisuka kumuntu singenza i-MEN-1, futhi siyazi ukuthi ezinye izakhi zofuzo ezingavamile zithandwa kakhulu emdlalweni we-pancreatic neuroendocrine, kodwa ngokuvamile imbangela ayifakazi.
Zikhona yini izindlela zokunciphisa ingozi noma ukuvimbela umdlavuza we-pancreatic neuroendocrine?
Ayikho indlela eyaziwayo yokunciphisa ingozi noma ukuvimbela umdlavuza we-neuroendocrine we-pancreatic.
Yiziphi zokwelapha ezitholakalayo?
Ngenxa yokungabi nalutho kwalezi zinambuzane emphakathini jikelele, futhi uhlobo olukhethekile lokunakekelwa oludingekayo, iziguli zikhuthazwa kakhulu ukuba zifune ukubonisana nezikhungo ezikhethekile ze-neuroendocrine tumor centre. Kulezi zikhungo, kubambisene eduze ne- oncology yezokwelapha , i-endocrinology, i-gastroenterology, i-pathology, ukuhlinzwa kwe-hepatobiliary, i-oncology yokuhlinza, i-radiology yokungenelela, i-radiology yokuxilonga, kanye nemithi yenukliya yokwandisa ukunakekelwa komuntu ngamunye ngesiguli.
Ukwelapha kufaka ukuthengiswa okuhlinzekwa kwezicubu ezisemqoka kanye nezidakamizwa, ukuxoshwa kwe-metastases nama-microwave, ukuphatha izicubu nge-radiation intrahepatic (i-radioembolization) ne-intrahepatic chemotherapy (i-chemoembolization), ukuvimbela ukukhula kwe-tumor nama-biologic ahloselwe (ama-somatostatin analogs, i-m-TOR inhibitors, i-tyrosine kinase inhibitors , ukwelashwa kwe-radionuclide okuhloswe okubizwa ngokuthi i-PRRT, ukwelashwa kwamagciwane, kanye nezidakamizwa ezilwa ne-anti-angiogenic), nokusetshenziswa kwe- chemotherapy ngomlomo ophansi.
Ukuze ufunde kabanzi mayelana noDkt. Edward Wolin kanye nomkhuba wakhe eKedars Sinai Medical Centre, sicela uvakashele iwebhusayithi yeCedars Sinai.