Dɛn ne Wilms Tumor? So wo ba no da asiane mu? Momma yɛnhwɛ yiye!

Sɛ woreguare, woresiesie wo ho, anaasɛ worekura wo ba ketewa no ara kwa na wote nka sɛ biribi te sɛ akisikuru ketewaa bi wɔ wɔn yafunu mu a, wobɛte nka dɛn? Ɛno yɛ hu ankasa, ɛnte saa? Wɔ mmere te sɛ eyinom mu no, ɛsɛ sɛ yesusuw tebea a wɔfrɛ no Wilms akisikuru yi ho. Momma yɛnka ho asɛm nnɛ ara kwa.

Dɛn ankasa ne Wilms Tumor?

Sɛ yɛbɛka no tiawa a, Wilms tumor yɛ asaabo mu kokoram bi a ɛba mmofra nkumaa so. Ɛno na ɛma mmofra asaabo mu kokoram bɛyɛ ɔha biara mu nkyem 90. Ɛtɔ da bi a, Wilms akisikuru tumi ne tebea afoforo a ɛwɔ hɔ wɔ awo mu no bom ba. Yɛfrɛ eyinom ``congenital syndromes'' anaasɛ tebea horow a wɔaboaboa ano a ɛwɔ hɔ wɔ awo mu.

Wɔsan frɛ eyi `(Wilms' tumor)` ne `(nephroblastoma)`. Mpɛn pii no, akisikuru biako pɛ na ɛwɔ asaabo biako mu. Nanso, mmofra binom betumi anya akisikuru wɔ asaabo abien no nyinaa mu `(bilateral),` anaasɛ kokoram betumi ayɛ nea ɛboro biako wɔ asaabo biako mu.

Hena na onya eyi kɛse?

Eyi yɛ tebea a ɛntaa nsi a ɛka mpanyimfo. Wilms tumor yɛ kokoram a ɛka mmofra a wonnii mfe 15 titiriw.Mmofra a wɔwɔ saa yare yi mu 95% na wohu ansa na wɔadi mfe 10.

Mmofra a wɔyɛ abibifo a wofi Afrika no wɔ asiane kɛse mu kakra. Asiafo mmofra wɔ asiane a ɛba fam mu. Afei nso, mmeawa taa nya bi kakra sen mmarimaa.

Wɔ mmusua kakraa bi pɛ mu no, wɔabɔ amanneɛ nso sɛ eyi yɛ biribi a efi awosu mu nneɛma mu.

Saa tebea yi abu so dɛn?

Wɔ ɔman te sɛ Amerika mu no, wɔka sɛ wɔbɔ amanneɛ sɛ nnipa foforo bɛyɛ 500 na wɔanya Wilms akisikuru afe biara. Ɛyɛ den sɛ yebenya akontaabu pɔtee a ɛkyerɛ sɛnea ɛte wɔ Sri Lanka, nanso eyi yɛ kokoram a wotumi hu wɔ mmofra mu.

Dɛn ne awo mu yare a wobetumi ahu wɔ Wilms akisikuru ho?

Ɛntaa mma koraa sɛ mmofra a wɔwɔ Wilms akisikuru no benya tebea afoforo a wonya fi awo mu. Nanso ebetumi aba. Nyarewa atitiriw no bi ni:

• Beckwith-Wiedemann yareɛ: Mmofra a wɔwɔ saa yareɛ yi wɔ asiane 5% kɔsi 10% sɛ wɔbɛnya Wilms akisikuru. Eyi yɛ tebea a nipadua no afã horow nyin kɛse sen sɛnea ɛte daa. Ɛtɔ mmere bi a, nipadua no fã biako betumi ayɛ kɛse asen foforo.
• WAGR syndrome: Mmofra a wɔwɔ saa yare yi wɔ asiane 50% sɛ wobenya Wilms akisikuru (W a ɛwɔ din no mu no gyina hɔ ma Wilms). Eyi betumi ama iris (Aniridia) no fã bi ayera, ne ɔbarima ne ɔbea nna ne adwene mu haw ahorow nso.
• Denys-Drash yare no:Mmofra a wɔwɔ sɛnkyerɛnne ahorow a wɔaka abom yi wɔ asiane kɛse mu sɛ wobenya Wilms akisikuru, na ɛno nso betumi de ɔhaw ahorow aba awo akwaa ne asaabo mu.

Dɛn ne Wilms akisikuru ho sɛnkyerɛnne?

Hwehwɛ nsɛnkyerɛnne yi wɔ wo ba no mu:

• Akuru anaa akuru a ɛyɛ den/akuru a ɛwɔ yafunu mu (yafunu). Ɛtɔ da bi a, saa akuru anaa akuru yi tumi yɛ yaw, nanso mpɛn pii no ɛnyɛ yaw.
• Yafunu mu yaw.
• Mogya a ɛwɔ nsu mu (hematuria).
• Huraeɛ.
• Mogya mmoroso (hypertension). Eyi betumi ama abofra no hwene mu mogya, ne ti ayɛ no yaw, na aniwa a mogya ayɛ no ma.

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a , ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara.

Dɛn na ɛde Wilms akisikuru ba?

Nokwarem no, yɛda so ara nnim nea ɛde Wilms akisikuru ba ankasa. Ɛwom sɛ ebia nnipa kakraa bi pɛ na wɔwɔ awosu mu su de, nanso ɛnyɛ nea ɛda adi pefee sɛ nea enti a ɛba wɔ nsɛm dodow no ara mu.

Ɔkwan bɛn so na wohu (wohu) Wilms akisikuru?

Sɛ wuhu sɛ akisikuru bi wɔ wo ba no mpaboa no baabi, anaasɛ akuru no na ɛde mpaboa kɛse redi dwuma a, ebia wo duruyɛfo bɛpɛ sɛ ɔsɔ Wilms akisikuru hwɛ anaa. Ɛtɔ mmere bi a, saa akisikuru yi betumi ayɛ akɛse asen asaabo.

Sɛ wo ba no wɔ syndromes a yɛadi kan aka ho asɛm no mu biako anaasɛ awosu mu haw bi a, wubetumi ne wo duruyɛfo akasa na woasi gyinae sɛ wobɛtoa so ayɛ nhwehwɛmu anaa.

Nhwehwɛmu ahorow a wɔde hu Wilms akisikuru ne:

• Nipadua mu nhwehwɛmu: Wɔ eyi mu no, oduruyɛfo no de ahwɛyiye de ne nsa ka abofra no yafunu.
• Mfoninitwa sɔhwɛ ahorow:
• Yafunu mu ultrasound scan a wɔde yɛ nhwehwɛmu.
• CT scan - Wɔtaa yɛ eyi denam nsu titiriw bi a wɔde gu nipadua mu (contrast) so.
• Oduruyɛfo no betumi ayɛ ne koko X-ray anaa CT scan nso ahwɛ sɛ kokoram no akɔ ahurututu no mu anaa.
• Saa mfoninitwa nhwehwɛmu ahorow yi betumi aboa ma woahu sɛ ebia wo ba no wɔ akisikuru anaa. Wobetumi nso aboa ma wɔahu nsonsonoe a ɛda Wilms akisikuru ne asaabo mu kokoram foforo ntam.
• Mogya ne nsu mu nhwehwɛmu: Eyinom bi ne mmerɛbo dwumadi mu nhwehwɛmu ne mogya a ɛtwetwe mu nhwehwɛmu.
• Biopsy: Nea ɛka eyi ho ne sɛ wobeyi ntini ketewaa bi afi akisikuru no mu na wɔde akɔ lab ma wɔayɛ ho nhwehwɛmu.

Dɛn na ɛsɛ sɛ wuhu fa kokoram a wɔde di dwuma wɔ tebea horow mu ho?

Akwan abien na ɛwɔ hɔ a wɔfa so hu Wilms akisikuru no fã, kyerɛ sɛ, baabi a kokoram no atrɛw akodu. Wɔfrɛ eyi ``staging.'' Dodow a dodow no kɔ soro no, dodow no ara na kokoram no atrɛw.

Nnuruyɛfo a wɔwɔ Europa aman mu no de International Society of Pediatric Oncology (SIOP) nhyehyɛe no di dwuma. Nnuruyɛfo a wɔwɔ United States ne Canada de Children’s Oncology Group (COG) nhyehyɛe no di dwuma.

Nsonsonoe biako a ɛda akwan abien yi ntam ne sɛ wɔ COG kwan no so no, wɔhwɛ akisikuru no fã a ɛwɔ oprehyɛn akyi ne ansa na wɔde nnuru a wɔde sa kokoram (nnuru a wɔde ko tia kokoram) ama. Wɔ SIOP kwan no so no, wɔyɛ oprehyɛn no wɔ nnuru a wɔde sa yare akyi na ɛno akyi nkutoo na wɔhwɛ ɔfã no.

Wɔakyekyɛ akwan horow a ɛwɔ COG nhyehyɛe no ase no mu sɛnea edidi so yi:

• Ɔfã I: Akisikuru no wɔ abofra no asaabo mu nkutoo na wobetumi ayi no afi hɔ koraa denam oprehyɛn so.
• Ɔfã II: Akisikuru no anyin afi asaabo no mu, nanso wobetumi ayi no koraa denam oprehyɛn so.
• Ɔfã III: Wontumi nyi akisikuru no mfi hɔ koraa. Kokoram nkwammoaa kɔ so tra abofra no yafunu (yafunu mu).
• Ɔfã IV: Kokoram no atrɛw akɔ akyiri sen abofra no yafunu ne ne hwene akɔ mmeae afoforo, te sɛ ahurututu, mmerɛbo, nnompe, ne amemene.
• Ɔfã V: Akisikuru no wɔ asaabo abien no nyinaa mu (afã abien). Wɔ saa fã yi mu no, nnuruyɛfo hwɛ asaabo abien no nyinaa gyinabea wɔ ɔkwan soronko so.

Ɔkwan bɛn so na wɔsa Wilms akisikuru?

Wɔtaa de oprehyɛn ne nnuru a wɔde sa Wilms akisikuru no sa. Ɛtɔ mmere bi a, wobetumi de mframa a wɔde sa yare nso adi dwuma.

Mmofra a wɔwɔ akisikuru a asiane nnim, baabi a kokoram no ntrɛwee na wotumi yi akisikuru no koraa no betumi ayɛ wɔn oprehyɛn nkutoo. Ɛtɔ mmere bi a, wobetumi de nnuru a wɔde sa yare ama ansa na wɔayɛ oprehyɛn de atew akisikuru no so, na ama oprehyɛn no ayɛ nea ahobammɔ wom.

Wɔtaa de nnuru a wɔde sa yare no fa ntini mu (IV). Wobetumi ayɛ eyi wɔ ayaresabea a wɔde wɔn kɔ ayaresabea anaasɛ wɔ ayaresabea.

Ebia wo ba no benya nsunsuanso bɔne afi nnuru a wɔde sa yare anaa mframa a wɔde sa yare mu. Sɛ eyi ba a, hwɛ hu sɛ wobɛka akyerɛ wo duruyɛfo. Nneɛma bi wɔ hɔ a wubetumi ayɛ de atew nsunsuanso bɔne ne nnuru a wubetumi de ama wo ba no so.

So wobetumi asiw Wilms akisikuru no ano?

Biribiara nni hɔ ankasa a wo anaa wo ba betumi ayɛ de Wilms akisikuru aba anaasɛ asiw ano. Eyi yɛ biribi a yentumi nyɛ ho hwee.

Dɛn ne nkɔmhyɛ a ɛwɔ hɔ ma obi a ɔwɔ Wilms akisikuru?

Mpɛn pii no, Wilms akisikuru ho nkɔmhyɛ no ye wɔ nsɛm dodow no ara mu. Mpɛn pii no, nea efi mu ba no ye paa, titiriw sɛ oduruyɛfo no tumi yi akisikuru no fi hɔ koraa na kokoram no ntrɛwee wɔ nipadua no mu baabi foforo a. Nanso, hokwan ketewaa bi wɔ hɔ sɛ Wilms akisikuru no ``bɛsan aba bio''.

So Wilms akisikuru betumi akum obi?

Ɛwom sɛ wobetumi de oprehyɛn, nnuru a wɔde sa yare, ne/anaasɛ mframa a wɔde sa yare a wɔaka abom asa Wilms akisikuru no yiye de, nanso .Eyi da so ara yɛ kokoram. Enti, ebetumi akum obi. Ɛno nti na ɛho hia sɛ wuhu ntɛm na wufi ase sa yare no.

Dɛn ne Wilms akisikuru no nkwagye dodow?

Nnipa a wɔahu sɛ wɔwɔ Wilms akisikuru no mu bɛyɛ 90% da so te ase wɔ mfe anum akyi. Saa dodow yi betumi ayɛ soronko kakra a egyina nneɛma te sɛ kokoram no gyinabea, akisikuru no kɛse, ne sɛnea kokoram nkwammoaa no hwɛ wɔ afiri a wɔde hwɛ nneɛma nketenkete mu (histology) so. Bere a kan no na wɔka sɛ mmofra a wonnii mfe 2 no nni asiane a ɛwɔ hɔ sɛ wɔbɛsan anya bi no sua no, mprempren mfe a wɔadi nyɛ ade titiriw sɛnea na ɛte kan no.

Bere bɛn na ɛsɛ sɛ mekɔ me duruyɛfo nkyɛn wɔ Wilms akisikuru ho?

Sɛ wɔresa wo ba no yare wɔ Wilms akisikuru ho a, sɛ wowɔ nsɛm bi a ɛhaw wo anaa nsɛmmisa bi a, kɔ wo duruyɛfo nkyɛn. Titiriw sɛ wuhu sɛnkyerɛnne foforo biara anaasɛ ɛte sɛ nea biribi resɛe a, ma wɔnhu ntɛm ara.

Bere a woreyɛ wo ayaresa no, w’aduruyɛfo kuw no bɛkyerɛ wo nea ɛsɛ sɛ wohwɛ yiye wɔ ho, te sɛ sɛnkyerɛnne ahorow a ɛkyerɛ sɛ wowɔ nsu mu yare. Sɛ eyi ba a, ebia ebehia sɛ wokɔ baabi a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu.

Ɛho behia nso sɛ abofra no kɔsra wɔn akyi bere ne bere mu na ama wɔahwɛ ahu sɛ wɔn ho retɔ no yiye. Oduruyɛfo no nso betumi de abofra no akɔma asaabo ho ɔbenfo (nephrologist) anaa urinary system ho ɔbenfo (urologist).

Mɛyɛ dɛn aboa me ba no ma wanya apɔwmuden bere a wɔasa Wilms akisikuru no awie no?

Ɛho hia sɛ wo ba yɛ saa nneɛma yi:

• Nom nsu a ɛdɔɔso a ɛbɛboa w’asaabo ma ayɛ adwuma yiye.
• To nnuru te sɛ aspirin, ibuprofen, ne naproxen a wode bedi dwuma no ano hye. Wo ne wo ba no duruyɛfo nkasa mfa nnuru a ɛnyɛ den koraa sɛ ebepira wo ba no asaabo ho.
• Hwɛ wo mogya mmoroso bere ne bere mu.

So Wilms tumor yɛ yaw?

Ɛtɔ mmere bi a Wilms akisikuru betumi ayɛ yaw, nanso ɛnyɛ bere nyinaa na ɛyɛ yaw.

Nsonsonoe bɛn na ɛda Wilms akisikuru (nephroblastoma) ne neuroblastoma ntam?

Ɛwom sɛ nsɛmfua abien yi te sɛ nea ɛte saa de, nanso ɛyɛ kokoram ahorow abien a efi ase wɔ nkwammoaa ahorow abien mu. Nephroblastoma yɛ kokoram a ɛba asaabo mu. Neuroblastoma yɛ kokoram a efi ase wɔ ntini mu nkwammoaa mu. Ɛtaa fi ase wɔ adrenal glands no mu, nanso ebetumi akɔhyɛn asaabo no nso so. Kokoram ahorow abien no nyinaa ba mmofra so, na abien no nyinaa betumi ada adi sɛ akuru wɔ yafunu mu. Enti, ɛho hia sɛ wonya yare no ho nhwehwɛmu a edi mu.

Sɛ wohu sɛ wo ba no anya Wilms akisikuru a, ɛda adi sɛ wo duruyɛfo bɛkamfo akyerɛ sɛ wo ne aduruyɛbea bi a wɔn ho akokwaw wɔ mmofra kokoram a wɔsa mu nkɔ. Ɛwom sɛ Wilms akisikuru ho yɛ na de, nanso ɛyɛ yare a wotumi sa. Ebia wo ba no nso fata sɛ ɔde ne ho hyɛ ayaresabea sɔhwɛ bi mu. Wɔde mmofra pii a wɔwɔ Wilms tumor din ahyɛ nhyehyɛe yi mu. Nkɔso pii a aba wɔ Wilms akisikuru ayaresa mu no fi saa nnuruyɛ mu sɔhwɛ ahorow yi mu.

Ade a ɛho hia sen biara (Take-Home Message) .

Okay, enti yɛaka Wilms tumor no ho asɛm pii, ɛnte saa? Ade titiriw a ɛsɛ sɛ wokae ne sɛ , sɛ wuhu sɛ wo ba no yafunu mu akisikuru anaa ɛho ahonhon a ɛyɛ soronko a, mma wo ho nnpopo na kɔ oduruyɛfo nkyɛn ntɛm ara.

• Wilms akisikuru yɛ kokoram a ɛba mmofra nkumaa asaabo mu.
• Ɛwom sɛ wonnim nea ɛde eyi ba ankasa de, nanso ebia awosu mu nkɛntɛnso bi wɔ hɔ.
• Sɛ wohu ntɛm na wɔsa wɔn yare yiye a, hokwan a ɛwɔ hɔ sɛ wɔn ho bɛtɔ no no yɛ kɛse koraa.
• Oprehyɛn, nnuru a wɔde sa yare, ne ɛtɔ mmere bi a mframa a wɔde sa yare ne ayaresa titiriw.
• Sɛ wɔsa yare wie mpo a, ɛho hia paa sɛ wodi oduruyɛfo no akwankyerɛ akyi yiye na wokɔhwɛ wɔn wɔ mmere a wɔahyɛ no mu.

Nsuro. Aduruyɛ ho nyansahu akɔ anim yiye nnɛ. Ade a ɛho hia sen biara ne w’adwene a wode besi biribi so na woayɛ ho biribi ntɛm. Mepɛ sɛ wo ba no ho tɔ no ntɛm!

` Wilms tumor, nephroblastoma, mmofraberem kokoram, asaabo mu kokoram, mmofra akwahosan, kokoram ho sɛnkyerɛnne, kokoram ayaresa