Momma yensua Lynch Syndrome a ɛma asiane a ɛwɔ hɔ sɛ wubenya kokoram no yɛ kɛse no ho ade.

So woate asɛmfua ``Lynch Syndrome'' ho asɛm pɛn? Ebia eyi bɛyɛ asɛmfua foforo ama wo. Nanso ɛho hia sɛ yɛn nyinaa hu. Sɛ yɛbɛka no tiawa a, Lynch Syndrome yɛ tebea a ɛma asiane a ɛwɔ hɔ sɛ yebenya kokoram no yɛ kɛse esiane nsakrae bi a ɛba yɛn awosu mu nkwaadɔm mu nti. Ne titiriw no, ɛma asiane a ɛwɔ hɔ sɛ obi benya kokoram ansa na wadi mfe 50. Enti, momma yɛnka eyi ho asɛm nkɔ akyiri kakra, ɛnte saa?

Dɛn ankasa ne Lynch Syndrome? Hena na onya?

Lynch syndrome yɛ awosu mu tebea a wonya fi awo mu . Ɛne sɛ, awosu mu nsakrae a ɛba awosu mu nkwaadɔm a yenya fi yɛn maame anaa yɛn papa hɔ no na ɛde ba. Fa no sɛ, sɛ yɛn nkwammoaa mu paapae a, ɛtɔ mmere bi a mfomso nketenkete betumi aba. Yɛn nipadua wɔ awosu mu nkwaadɔm soronko bi a ɛma wohu mfomso ahorow yi na wosiesie. Wɔfrɛ eyinom ‘Mismatch Repair genes’ (MMR awosu mu nkwaadɔm). Obi a ɔwɔ Lynch syndrome no wɔ sintɔ bi wɔ saa ‘MMR’ awosu mu nkwaadɔm yi biako anaa nea ɛboro saa mu. Afei, wɔrentumi nsiesie mfomso afoforo no bere a saa nkwammoaa no mu apaapae no. Saa nkwammoaa a asɛe yi boaboa ano na ɛbɛyɛ kokoram .

Eyi betumi ato obiara. Efisɛ ɛyɛ awosu mu nneɛma. Ɛtɔ mmere bi a, sɛ obiara nni abusua no mu a wanya saa tebea yi da mpo a, obi betumi anya bi esiane awosu mu nsakrae a ɛbae kwa nti. Eyi kyerɛ sɛ esiane sɛ abusua abakɔsɛm nni hɔ nti, ɛnkyerɛ sɛ ɛrensi.

Sɛnea akontaabu a ɛwɔ United States kyerɛ no, nnipa 279 biara mu bɛyɛ biako betumi anya Lynch yare no. Wɔkyerɛ sɛ Lynch syndrome na ɛde kokoram a ɛwɔ akyi berɛmo mu bɛyɛ 4,000 ne awotwaa mu kokoram bɛyɛ 1,800 ba. Ɛho hia yiye sɛ wuhu tebea yi wɔ Sri Lanka nso.

Dɛn ne Lynch yare no ho sɛnkyerɛnne?

Nsɛnkyerɛnne no betumi ayɛ soronko a egyina sɛnea tebea no mu yɛ den ne kokoram ko a ɛde reba no so. Nsɛnkyerɛnne a ɛtaa ba wɔ kokoram a ɛwɔ akyi berɛmo mu ho ne:

• Mogya a ɛwɔ wo nsu mu.
• Ayamtim .
• Yafunu mu yaw anaasɛ akisikuru.
• Atiridiinini anaa nsu a ɛyɛ ketewaa sen sɛnea ɛte daa.
• Ɔbrɛ a ɛtaa ba (`Ɔbrɛ`).
• Sɛ wote nka sɛ woayɛ ma anaasɛ wo ho ayɛ wo hyew.
• Akisikuru anaa ɔfe.

Nea ɛho hia ne sɛ ebia nnipa binom renkyerɛ yare no ho sɛnkyerɛnne biara kosi sɛ kokoram no bɛkɔ anim kɛse. Enti, sɛ wowɔ saa sɛnkyerɛnne ahorow yi bi a, ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara .

Kokoram ahorow bɛn na Lynch yare no betumi de aba?

Eyi betumi aka akwaa pii ankasa. Kokoram ahorow bi a Lynch syndrome betumi de aba ni:

• Amemene mu kokoram
• Colon ne rectal cancer - Eyi ne nea ɛyɛ titiriw.
• Kokoram a ɛwɔ akisikuru mu
• mmerɛbo mu kokoram
• Kokoram a ɛwɔ awotwaa mu
• Kokoram a ɛwɔ dwensɔtwaa mu
• Prostate kokoram
• Honam ani kokoram
• Kokoram a ɛba dwensɔtwaa nketenkete mu
• Yafunu mu kokoram
• Kokoram a ɛwɔ ntini a ɛwɔ soro
• Uterine (endometrial) cancer - Kokoram foforo a ɛtaa ka mmea.

Nsakrae a ɛwɔ mu a gene (`gene`) wɔ mu no na ɛkyerɛ akwaa a ɛwɔ asiane kɛse mu sɛ wobenya kokoram. Awosu mu nkwaadɔm atitiriw anum na ɛne Lynch yare no wɔ abusuabɔ. Wɔn ne: `MLH1`, `MSH2`, `MSH6`, `PMS2` ne `EPCAM`.

Kokoram a ɛwɔ akyi berɛmo mu a Lynch syndrome de ba no betumi anya ntɛm (wɔ mfe 1-2 mu) sen nnipa dodow no ara. Mpɛn pii no, egye bɛyɛ mfe 10 ansa na kokoram a ɛwɔ akyi berɛmo mu aba. Afei nso, obi a wanya kokoram wɔ ne menewa mu no wɔ asiane kɛse sɛ obenya kokoram no bio . Asiane bɛyɛ 15% wɔ mfeɛ 10 akyi wɔ oprehyɛn no mu ama kokoram a ɛdi kan no, asiane bɛyɛ 40% wɔ mfeɛ 20 mu, ne bɛyɛ 60% wɔ mfeɛ aduasa akyi.

Dɛn na ɛde Lynch yare no ba?

Sɛnea yɛadi kan aka no, nea ɛde eyi ba titiriw ne awosu mu nsakrae a ɛba awosu mu nkwaadɔm anum a ɛsiesie mfomso ahorow a ɛwɔ yɛn DNA mu (``mismatch repair gene`` anaa ``MMR gene``) no mu biako anaa nea ɛboro saa mu. Saa awosu mu nkwaadɔm anum no ne:

• `MLH1`
• `MSH2`
• `MSH6`
• `PMS2`
• `EPCAM`

Sɛ wowɔ Lynch syndrome a, wo `MMR` awosu mu nkwaadɔm no nnya akwankyerɛ a wohia na ama wɔayi nkwammoaa a asɛe no afi hɔ. Afei saa nkwammoaa a asɛe no boaboa ano wɔ ntini mu na ɛde kokoram ba.

Ɔkwan bɛn so na eyi fi awo ntoatoaso so kɔ awo ntoatoaso so?

Lynch syndrome yɛ ``autosomal dominant`` tebea. Sɛ yɛbɛka no tiawa a, sɛ ɔwofo biako pɛ na ɔwɔ awosu mu nkwaadɔm a wɔayɛ no foforo no mpo a, abofra no betumi anya bi . Wei kyerɛ sɛ 50% wɔ hɔ sɛ abofra no nso benya tebea no.

Sɛ wɔahu sɛ wowɔ Lynch syndrome a, ɛho hia sɛ wobɔ w’abusua mufo amanneɛ na wohyɛ wɔn nkuran sɛ wɔnhwehwɛ awosu mu afotu . Awosu mu afotu betumi aboa wo ne w’abusua ma moate tebea no ne asiane a ɛwɔ hɔ sɛ wo ba benya bi afi awo mu no ase. Wobetumi ayɛ awosu mu nhwehwɛmu nso de ahu sɛ ebia wowɔ Lynch syndrome awosu mu nkwaadɔm mu nsakrae no anaa.

Ɔkwan bɛn so na wohu sɛ obi anya Lynch yare no?

Wo duruyɛfo betumi afa nhwehwɛmu a wɔyɛ ansa na wɔawo ne awosu mu nhwehwɛmu so ahu Lynch yare no. Wobetumi ayɛ awosu mu nhwehwɛmu nso bere a wɔawo wo ba no akyi.

Awosu mu nhwehwɛmu hwehwɛ sɛ wɔfa mogya anaa buccal swab de hwɛ sɛ nsakrae bi aba awosu mu nkwaadɔm a yɛadi kan aka ho asɛm `MLH1`, `MSH2`, `MSH6`, `PMS2` anaa `EPCAM` mu. Sɛ awosu mu nhwehwɛmu kyerɛ sɛ nkwaadɔm mu nsakrae a ɛte saa wɔ hɔ a, oduruyɛfo no behu sɛ ɔwɔ Lynch yare no.

Nhwehwɛmu bɛn na wɔde hu kokoram ahorow a ɛbata Lynch syndrome ho?

Sɛ wohu sɛ wowɔ Lynch syndrome a, wo duruyɛfo bɛtaa kamfo akyerɛ wo sɛ wɔnyɛ nhwehwɛmu pii mfa nhwɛ sɛ ebia wowɔ kokoram anaa. Sɔhwɛ ahorow a wɔtaa yɛ ne:

• Colonoscopy: Eyi hwehwɛ sɛ wɔde afiri (scope) a mfoninitwa afiri a wɔde abata akyi berɛmo no mu bɛhyɛ mu de ahwɛ dwensɔtwaa kɛse ne akyi berɛmo no mu. Wɔtaa yɛ eyi pɛnkoro afe biara anaa mfe abien biara.
• Transvaginal ultrasound: Wɔde adwinnade ketewaa bi (probe) fa ɔbea no awotwaa no mu de hwehwɛ awotwaa ne awotwaa mu. Wɔkamfo eyi nso kyerɛ pɛnkoro anaa mprenu afe biara.
• Nsuo mu nhwehwɛmu: Wɔfa wo nsuo bi de hwɛ sɛ nneɛma te sɛ asaabo mu akisikuru anaa. Wɔtaa yɛ eyi pɛnkoro afe biara.
• Tumor biopsy: Sɛ wo duruyɛfo susuw sɛ wowɔ akisikuru wɔ wo nipadua mu baabi a, wɔbɛfa ne fã ketewaa bi na wɔasɔ ahwɛ wɔ aduruyɛdan mu ahwɛ sɛ kokoram nkwammoaa wɔ mu anaa.
• Upper endoscopy anaa capsule endoscopy: Adeyɛ a wɔde afiri ketewaa bi a ɛyɛ tratraa (scope) anaa microscopic camera (afiri ketewa a ɛyɛ tratraa a wɔmene te sɛ aduru) di dwuma de hwehwɛ kokoram wɔ yafunu ne dwensɔtwaa ketewaa mu. Ebia wɔbɛka akyerɛ wo sɛ yɛ eyi mfe abiɛsa kosi anum biara.

Ɔkwan bɛn so na wɔsa Lynch yare no?

Ade titiriw a wɔde sa Lynch yare no ne sɛ wobehu akisikuru ntɛm na wɔayɛ oprehyɛn ayi afi hɔ . Eyi kyerɛ sɛ wɔbɛyɛ nhwehwɛmu daa na woanya kokoram ntɛm, sɛ ɛwɔ hɔ a.

Hena na ɔsa eyi?

Ɛyɛ papa sɛ wobɛhwehwɛ ayaresa afi nnuruyɛfo atitiriw kuw bi hɔ ama tebea a ɛte sɛɛ.Esiane sɛ Lynch yare no betumi aka akwaa ahorow pii nti, ebia animdefo ahorow bɛka ayaresa kuw no ho, a nea ɛka ho ne yafunu mu yare ho animdefo, oprehyɛn ho animdefo, mmea kokoram ho animdefo, ntini mu yare ho animdefo, honam ani yare ho animdefo, mmea ho animdefo, nnuruyɛfo a wɔhwɛ wɔn titiriw, awosu ho animdefo, awosu ho afotufo, ne kokoram ho animdefo.

So kokoram betumi asan aba bere a wɔasa no yare awie no?

Yiw, sɛ wɔyɛ oprehyɛn yi kokoram no mpo a, hokwan wɔ hɔ sɛ kokoram no bɛsan aba . Ɛno nti na ɛho hia sɛ wotoa so sɔ hwɛ no.

Nnipa binom a wɔwɔ Lynch syndrome, esiane sɛ asiane kɛse wom sɛ wobenya kokoram nti, wosi gyinae sɛ wɔbɛyɛ oprehyɛn de ayi awotwaa (hysterectomy), awotwaa (oophorectomy), anaa dwensɔtwaa no fã bi (colectomy anaa bowel resection oprehyɛn) ntɛm. Eyi yɛ ankorankoro gyinaesi titiriw, na ɛsɛ sɛ wogyina oduruyɛfo afotu so.

So wobetumi asiw Lynch yare no ano?

Nea ɛyɛ awerɛhow no, Lynch yare no yɛ awosu mu yare, enti wontumi nsiw ano koraa . Nanso, wobetumi ayɛ nnipa a wɔwɔ Lynch syndrome no mu nhwehwɛmu sɛ ebia wɔwɔ kokoram wɔ wɔn nkwa nna nyinaa mu, fi wɔn mpanyin afe so, sɛnea ɛbɛyɛ a sɛ ɛba a, wobetumi ahu kokoram ntɛm .

Sɛ wowɔ Lynch syndrome a, dɛn na ɛba? Dɛn na wubetumi ahwɛ kwan?

Mprempren wonni aduru biara a wɔde sa Lynch yare no. Nanso, sɛ wohu kokoram no na woyi fi hɔ ntɛm, ansa na atrɛw akɔ nipadua no afã afoforo a, wonya nea eye sen biara . Enti, ɛho hia yiye sɛ nnipa a wɔwɔ Lynch syndrome no yɛ afe afe nhwehwɛmu a wɔde hwehwɛ mu, te sɛ colonoscopy.

So Lynch syndrome bɛma akisikuru ayɛ me dwonku?

Nnipa a wɔwɔ Lynch syndrome betumi anya ‘adenomas’ pii, onyin a ɛnyɛ kokoram wɔ wɔn akyi berɛmo anaa wɔn akyi berɛmo mu. Sɛ wɔanhu saa ‘polyps’ yi na wɔayi afi hɔ a, ebetumi abɛyɛ kokoram. Ɛno nti na ɛho hia sɛ wɔyɛ colonoscopies daa de hwɛ sɛ eyinom wɔ hɔ na sɛ ɛwɔ hɔ a, woyi fi hɔ.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ Lynch syndrome a, ɛho hia sɛ woyɛ afe afe nhwehwɛmu ne nhwehwɛmu a wɔde hwehwɛ mu wɔ nhyehyɛe a wɔyɛ no daa mu .

Sɛ wuhu sɛ akuru, nneɛma foforo a enyin, anaa honam ani nsakrae bi wɔ wo nipadua no baabiara a, kɔ oduruyɛfo nkyɛn ntɛm ara , efisɛ eyinom betumi ayɛ kokoram ho sɛnkyerɛnne.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

• Mpɛn ahe na ɛsɛ sɛ meyɛ kokoram ho nhwehwɛmu?
• So akuru yi wɔ me honam ani kokoram so?
• Awosu mu nkwaadɔm mu nsakrae bɛn na mewɔ?
• So metumi ayɛ awosu mu nhwehwɛmu ansa na mayɛ nhyehyɛe sɛ mɛnyinsɛn?

So Lynch Syndrome ne HNPCC yɛ ade koro?

Ɛtɔ da bi a wɔde Lynch syndrome ne ``Hereditary Non-Polyposis Colorectal Cancer`` (``HNPCC``) di dwuma de sesa wɔn ho wɔn ho de kyerɛ tebea koro no ara. Nanso, nsonsonoe kakra da abien no ntam wɔ ɔkwan a wɔfa so de wɔn kɔ awo ntoatoaso ahorow mu no mu.

Lynch syndrome no fi nkwaadɔm mu nsakrae a ɛba `MMR` awosu mu abɔde mu. Awosu mu nkwaadɔm mu nsakrae koro no ara nso ka nnipa a wɔwɔ `HNPCC`. Nanso, wɔde edin `HNPCC` ma bere a saa tebea yi ba a abusua abakɔsɛm ka ho . Ɛno kyerɛ sɛ `HNPCC` yɛ agyapadeɛ firi awoɔ ntoatoasoɔ kɔ awoɔ ntoatoasoɔ so berɛ biara. Ɛtɔ da bi a Lynch syndrome tumi ba a abusua no mu biara nni bi, na ebetumi nso aba esiane awosu mu nkwaadɔm mu nsakrae a ɛba kwa nti. Ɛno nti na mprempren wɔde edin Lynch syndrome no di dwuma kɛse no.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Obiara mpɛ sɛ ɔbɛte nsɛm a ɛne sɛ, "Wowɔ kokoram." Sɛ wuhu sɛ wowɔ Lynch syndrome a, ebia ɛsɛ sɛ wote saa nsɛm no fi wo duruyɛfo hɔ. Nanso ɛnsɛ sɛ ɛyɛ ade bɔne.

Sɛ wohu sɛ wowɔ Lynch syndrome wie a, wo duruyɛfo ne wo bɛyɛ adwuma ayɛ nhyehyɛe ayɛ nhwehwɛmu a wɔbɛyɛ daa de aboa ma woahu kokoram ntɛm. Sɛ wuhu ntɛm na wosa wo yare a , ɛno ne akwan a eye sen biara a wobɛfa so ama hokwan a wowɔ sɛ wubenya nkwa no atu mpɔn . Afei wubetumi abɔ bra a anigye ne apɔwmuden wom.

Enti, sɛ́ anka nsɛm yi bɛma ehu aka wo no, hwɛ yiye, hwehwɛ aduruyɛ mu afotu sɛ ɛho hia a, na bɔ mmɔden sɛ wobɛtra ase a ahoɔden wom . Sɛ obi wɔ w’abusua mu a ɔwɔ saa tebea yi a, ɛho hia paa sɛ wobɔ wɔn amanneɛ wɔ eyi nso ho.

` Lynch syndrome, HNPCC, kokoram, awosu mu nsakrae, awosu mu nyarewa, akyi berɛmo mu kokoram, awotwaa mu kokoram