Ukuqonda Lesi Sareletal Muscle Cancer Rare
I-Rhabdomyosarcoma yisifo somdlavuza ongasavamile samasipha esivela kaningi ebuntwaneni. Ziyini izimpawu zalezi zicubu, zitholakala kanjani, nokuthi yiziphi izinketho zokwelashwa ezitholakalayo?
I-Rhabdomyosarcoma-Incazelo
I-Rhabdomyosarcoma uhlobo lwe- sarcoma . I-Sarcomas yizinhlayiya ezivela emangqamuzaneni okuthiwa i-mesothelial, amangqamuzana emzimbeni avuselela izicubu ezinjenge-bone, cartilage, muscle, ligaments, nezinye izicubu ezithambile.
Cishe amaphesenti angama-85 ekhansela, ngokuphambene, ama-carcinoma, avela kuma-epithelial cells.
Ngokungafani ne-carcinomas lapho amangqamuzana e-epithelial anento eyaziwa ngokuthi "isifenqo sezansi," ama-sarcomas awunayo "isiteji esinqunyiwe" futhi ngakho-ke ukuhlola izivivinyo zezinyathelo ezihamba phambili zesifo akusebenzi. (Funda kabanzi mayelana nezinhlobo ezahlukene zomdlavuza nokuthi ama-sarcomas ahlukile kanjani)
I-Rhabdomyosarcoma ingumdlavuza wamangqamuzana e-muscle, ikakhulukazi imisipha yamathambo (imisipha egxilile) esiza ekuhambeni kwemizimba yethu. Ngokomlando, i-rhabdomyosarcoma iyaziwa ngokuthi "i-tumor encane eluhlaza okwesibhakabhaka sezinsana zobuntwana" esekelwe umbala amangqamuzana aphenduka ngombala othize osetshenziselwa amathishu.
Konke, lo mdlavuza uhlobo lwesithathu oluvame kakhulu lomdlavuza oqinile wobuntwana (hhayi ukufaka umdlavuza wegazi ohlobene negazi njengengculaza). Kuyinto evamile kakhulu kubafana kunamantombazane futhi ibuye ibe yinto evamile kakhulu ezinganeni zase-Asia nase-Afrika kunabantwana abamhlophe.
Izinhlobo zeRhabdomyosarcoma
I-Rhabdomyosarcoma ihlehlisiwe ibe yi-subtypes emithathu:
- I-abryonal rhabdomyosarcoma ibhalela ngamaphesenti angama-60 kuya kwangu-70 alawa makhukhi futhi kwenzeka njalo kaningi ezinganeni eziphakathi kweminyaka yobudala kanye neminyaka engu-4 ubudala. Lolu hlobo luphinde lwaphulwa phansi zibe yi-subtypes. Amathumba angama-embryonal angase afike endaweni ekhanda nasentanyeni, izicubu ze-genitourinary, noma ezinye izifunda zomzimba.
- I-raveolar rhabdomyosarcoma uhlobo lwesibili oluvame kakhulu futhi litholakala ezinganeni eziphakathi kweminyaka yobudala kanye no-19. Uhlobo oluvame kakhulu lwe-rhabdomyosarcoma elibonwa kwentsha kanye nabantu abadala. Lezi zomshukela zivame ukutholakala emikhawulweni (izingalo nemilenze), indawo ye-genitourinary, kanye nesifuba, isisu nesifuba.
- I-anaplastic (pleomorphic) i-rhabdomyosarcoma ayitholakali futhi ibonakala kaningi kubantu abadala kunabantwana.
Amasayithi e-Rhabdomyosarcomas
I-Rhabdomyosarcomas ingenzeka noma kuphi emzimbeni lapho kutholakala khona imisipha yamathambo. Izindawo ezivame kakhulu zihlanganisa isifunda nenhloko yesigqoko, njengezicubu zomzimba (eduze kweso), nezinye izifunda, i-pelvis (izicubu ze-genitourinary), eduze kwezinzwa ezithandekayo ebuchosheni (parameningeal), nasemaphethelweni (izingalo nemilenze ).
Izimpawu Nezibonakaliso Ze-Rhabdomyosarcoma
Izimpawu ze-rhabdomyosarcoma ziyahlukahluka ngokuya ngesayithi se-tumor. Izimpawu ngesifunda somzimba zingafaka:
- Izicubu ze-Genitourinary: Izicubu ezisekhanda zingabangela igazi emcimbini noma emzimbeni, ubunzima obuqhamukayo noma besifazane, ukuvimbela, kanye nobunzima besisu noma isisu.
- Izicubu zomzimba: Izicubu eduze kweso zingabangela ukuvuvukala ezungeze iso kanye nesibindi (i- proptosis ).
- Izicubu ze-parameningeal: Izicubu eduze komthambo womgogodla zingabonisa ngezinkinga ezihlobene nesisindo somgogodla ziseduze nobuhlungu obusweni, izimpawu zesinasi, impumulo enegazi kanye nekhanda.
- Ukweqisa: Uma i-rhabdomyosarcomas ivela ezingalweni noma emilenzeni, uphawu oluvame kakhulu luyisigubhu noma ukuvuvukala okungahambi kodwa kwanda ngobukhulu.
Isigameko
I-Rhabdomyosarcoma ayinjwayele futhi ilandise cishe amaphesenti angu-3.5 kancane ezinganeni. Abantwana abangaba ngu-250 batholakala ukuthi banomdlavuza e-United States unyaka ngamunye.
Izimbangela Nezici Zengozi
Asazi kahle ukuthi kubangelwa yini i-rhabdomyosarcoma, kodwa kunezici ezimbalwa eziyingozi.
Lokhu kufaka:
- Izingane ezinama-syndromes azalwa njenge- neurofibromatosis type 1 (NF1), i-Li-Fraumeni syndrome, i- Costello syndrome , i-pleellopulmonary blastoma, i-cardio-facial cutaneous syndrome, i-Noonan syndrome, ne-Beckwith-Wiedermann syndrome
- Ukusetshenziswa komzali ngensangu noma i-cocaine
- Isisindo sokuzalwa esiphakeme
Ukuxilongwa
Ukuxilongwa kwe-rhabdomyosarcoma ngokuvamile kuqala ngomlando oqaphele nokuhlolwa komzimba. Kuncike ekutheni indawo ye-tumor, izifundo ze-imaging ezifana ne-x-ray, CT scan, i-MRI, i-bone scan, noma i-PET scan ingenziwa.
Ukuze uqinisekise ukuxilongwa okusolakala ukuthi kutholakala, i-biopsy ngokuvamile idinga ukwenziwa. Izinketho zingabandakanya inaliti ye-needle enhle (ukusebenzisa inaliti encane ukuze ifune isampula yezincubu), insipho ye-needle eyinhloko, noma i-biopsy evulekile ingenziwa. Uma i-pathologist isine isampula lezicubu, i-tumor ibhekwa ngaphansi kwe-microscope kanye nezinye izifundo zivame ukwenziwa ukucacisa iphrofayili ye-molecular of the tumor (efuna izakhi zofuzo ezithintekayo ekukhuleni kwesisu).
Ukuhlola isifo se-metastatic , i-sentinel node biopsy ingenziwa. Lokhu kuhlolwa kuhilela ukujola idayi eluhlaza okwesibhakabhaka kanye ne-traceable radioactive ngaphakathi kwesisu bese uthatha isampula yama-lymph nodes esiseduze ne-tumor ekhanya noma ekhonjiswe okwesibhakabhaka. I-lseph node dissection egcwele ingadingeka futhi uma ukuhlolwa kwe-nodeel e-positive kunomdlavuza. Ucwaningo oluqhubekayo lokubheka imitha yesimiso kungabandakanya ukukhipha amathambo , umthambo we-bone marophi , kanye / noma i-CT yesifuba.
Ukuthungatha nokuhlanganisa
"Ubunzima" be-rhabdomyosarcoma kuhlongozwa kabanzi ngokuhlola isiteji noma iqembu lomdlavuza.
Kunezinyathelo ezine ze-rhabdomyosarcoma:
- Isigaba I: Izitebhisi I-Stage I iyatholakala "kumasayithi afanelekayo" njenge-orbital (eduze kweso), ikhanda nentamo, ezithombeni zokubeletha (njengezivivinyo noma ama-ovari), amashubhu ahlangene nezinso kuya kwesinye (ama-ureters ), i-tube exhuma isambiso ngaphandle (urethra) noma eduze ne-gallbladder. Lezi zicubu kungenzeka noma zingakaze zisakaze kuma-lymph nodes.
- Isigaba II: Izicubu ze-Stage II azizange zisakaze kuma-lymph nodes, azikho ezinamaphesenti angu-5 kuya kwangu-2, kepha zitholakala "kumasayithi angalungile" njenganoma yimaphi amasayithi angakhulunywa ngaphansi kwesigaba I.
- Isigaba III: I-tumor yayisendaweni engavumeleki futhi ingahle isakaze noma isakaze kuma-lymph nodes noma ibe ngaphezulu kuka-5 cm.
- Isigaba IV: Umdlavuza kunoma yisiphi isigaba noma ukubandakanyeka kwe-lymph node esakaze kumasayithi akude.
Kukhona namaqembu amane ama-rhabdomyosarcomas:
- IQembu I: Iqembu 1 lihlanganisa izicubu ezingasuswa ngokuphelele ngokuhlinzwa futhi azange zisakaze kuma-lymph nodes.
- Iqembu 2: Izicubu zeqembu 2 zingasuswa ngokuhlinzwa kodwa kusekhona namaseli omdlavuza akhona emaphethelweni (ekugcineni komzimba osuswe), noma umdlavuza usakaze kuma-lymph nodes.
- Iqembu lama-3: Ama-tumor yeqembu lama-3 yiwo angakaze asakaze, kodwa akakwazi ukususwa ngokuhlinzeka ngesizathu esithile (ngokuvamile ngenxa yendawo yesisu).
- Iqembu 4: Izicubu zeqembu lama-4 zihlanganisa lezo ezisakaze ezindaweni ezikude zomzimba.
Ngokusekelwe emazingeni angenhla namaqembu, ama-rhabdomyosarcomas ahlukaniswa ngengozi abe:
- I-rhabdomyosarcoma yobuntwana obuncane
- I-rhabdomyosarcoma yobuntwana obuncane
- I-rhabdomyosarcoma yobuntwana obukhulu kakhulu
Ama-Metastases
Lapho lezi zomshukela zisabalalisa, amasayithi avamile kakhulu we-metastase amaphaphu, umnkantsha wamathambo namathambo.
Ukwelashwa kweRhabdomyosarcoma
Izinketho ezinhle zokwelapha ze-rhabdomyosarcoma kuxhomeke esigabeni sesifo, indawo yesifo, nezinye izici eziningi. Izinketho zihlanganisa:
- Ukuhlinzwa: Ukwelashwa yiyona ndlela yokwelashwa okuyisisekelo futhi unikeza ithuba elihle lokulawula isikhathi eside kwesikhumba. Uhlobo lokuhlinzeka luzoxhomekeka endaweni yesikhumba.
- Ukwelashwa kwezidakamizwa: Ukwelashwa kwezidakamizwa kungasetshenziselwa ukunciphisa isisu esingasebenzi noma ukuphatha imiphetho yesisu emva kokuhlinzwa ukususa noma yiliphi amangqamuzana omdlavuza .
- I-Chemotherapy: I- Rhabdomyosarcomas ijwayele ukuphendula kahle nge- chemotherapy , kanti amaphesenti angu-80 alawa mathambo ayancipha ngobukhulu ngemithi.
- Ukuhlolwa kwemitholampilo: Ezinye izindlela zokwelashwa ezifana nezidakamizwa ze- immunotherapy njengamanje zifundiswa ekuvivinyweni kwemitholampilo.
Ukubhekana
Njengoba eziningi zalezi zomshukela zenzeka ebuntwaneni, bobabili abazali kanye nengane kumele babhekane nalesi sifo esingazilindele futhi esesabekayo.
Kuzingane ezindala kanye nentsha ephila nomdlavuza, kukhona ukwesekwa okungaphezulu kakhulu kunesikhathi esedlule. Ukusuka emiphakathini yokusekela e-intanethi kuya emiphakathini yomdlavuza eyenzelwe ngqo izingane kanye nentsha, ukumisa amakamu ngane noma umndeni, kunezinketho eziningi ezitholakalayo. Ngokungafani nokuhlelwa kwesikole lapho ingane ingazizwa ingavamile khona, futhi hhayi ngendlela enhle, la maqembu afaka ezinye izingane kanye nentsha noma abantu abasha abafana nokubhekana nokuthile okungekho ingane okufanele kudingeke ibhekane nayo.
Kubazali, kunezinto ezimbalwa ezinzima njengoba zibhekene nomdlavuza enganeni yakho. Abazali abaningi bangathandi lutho ngaphandle kokushintsha izindawo nengane yabo. Kodwa ukuzikhathalela akubaluleke nakakhulu.
Kunezinamba zomuntu kanye nemiphakathi ye-intanethi (amaforamu e-inthanethi kanye namaqembu e-Facebook) oklanyelwe ngokukhethekile abazali bezingane ababhekene nomdlavuza wezingane kanye ne-rhabdomyosarcoma ikakhulukazi. Lawa maqembu okusekela angaba yindlela yokuphila uma uqaphela ukuthi abangani bomndeni abanakho indlela yokuqonda ukuthi uyaphi. Ukuhlangana nabanye abazali ngale ndlela kungakhokhisa ngenkathi kuninika indawo abazali abangabelana ngazo ngentuthuko yamuva yophando. Ngezinye izikhathi kuyamangaza ukuthi abazali bavame kanjani ukuthola izindlela zokwelapha zakamuva ngisho nangaphambi kwabaningi be-oncologists yomphakathi.
Unganciphisi indima yakho njengommeli. Insimu ye-oncology inkulu futhi ikhula nsuku zonke. Futhi akekho okhuthazwa njengomzali wengane ephila nomdlavuza. Funda ezinye zezindlela zokucwaninga umdlavuza e-intanethi bese uthatha isikhashana ufunde mayelana nokuba ngummeli wakho (noma ingane yakho) ukunakekelwa komdlavuza wakho .
Isibikezelo
Ukuchazwa kwe-rhabdomyosarcoma kuyahluka kakhulu kuye ngezici ezifana nohlobo lwesifo, isifo somuntu esitholakale, indawo yesikhumba, kanye nokwelashwa okutholiwe. Isilinganiso seminyaka engu-5 sokusinda singamaphesenti angama-70, enezifo ezincane ezingenabungozi ezinesilinganiso sokusinda samaphesenti angu-90. Ngokubanzi, izinga lokusinda liye lathuthuka kakhulu emashumini eminyaka edlule.
Izwi elivela
I-Rhabdomyosarcoma ingumdlavuza wezingane owenzeka emisipha yamathambo noma yikuphi le misipha ikhona emzimbeni. Izimpawu ziyahlukahluka kuye ngokuthi isayithi elithile le-tumor kanye nezindlela ezingcono kakhulu zokuxilonga isisu. Ukwelashwa yiyona ndlela yokwelashwa okuyisisekelo, futhi uma isisu singasuswa ngokuhlinzwa kukhona umbono omuhle wokulawula isikhathi eside lesi sifo. Ezinye izindlela zokwelapha zibandakanya ukwelashwa kwama-radiation, chemotherapy, kanye ne-immunotherapy.
Nakuba ukusinda kusukela umdlavuza wezingane kuyathuthuka, siyazi ukuthi izingane eziningi zihlushwa imiphumela yamuva yokwelapha. Ukulandelwa isikhathi eside nodokotela ojwayele imiphumela emibi yesikhathi eside yokwelashwa kubalulekile ukunciphisa umthelela wale mibandela.
Abazali nezingane ezitholwa ukuthi zibandakanyeka emphakathini wokusekela wezinye izingane kanye nabazali ababhekana ne-rhabdomyosarcoma kuyigugu, futhi eminyakeni yobudala kunamathuba amaningi atholakalayo.
> Imithombo:
> Dasgupta, R., Fuchs, J., noD. D. Rodeberg. I-Rhabdomyosarcoma. Ama-Seminar at Surgery Surgery . 2016. 25 (5): 276-283.
> National Cancer Institute. Ukwelashwa kwabantwana be-Rhabdomyosarcoma (PDQ) -Health Professional Version. Kubuyekezwe 12/01/17. https://www.cancer.gov/types/soft-tissue-sarcoma/hp/rhabdomyosarcoma-treatment-pdq