Nukae nye Wilms Tumor? Ðe viwòa ɖo afɔku mea? Mina míanɔ ŋudzɔ!

Aleke nàse le ɖokuiwò me ne èle tsi ƒum, le awu dom, alo nèle viwò suea lém ko eye nèse ƒuƒu sue aɖe le woƒe dɔme? Ema dzi ŋɔ ŋutɔŋutɔ, alo? Le ɣeyiɣi siawo tɔgbe me la, ele be míabu nɔnɔme sia si woyɔna be Wilms ƒe dɔdzẽ ŋu. Mina míaƒo nu tso eŋu egbea ko.

Nuka tututue nye Wilms Tumor?

Kpuie ko la, Wilms tumor nye ayiku me dɔdzẽ ƒomevi aɖe si dzɔna ɖe ɖevi suewo dzi. Ehea ayiku me kansa siwo ade 90 le alafa me vɛ le ɖeviwo me. Ɣeaɖewoɣi la, Wilms ƒe dɔdzẽ ate ŋu adzɔ ɖekae kple nɔnɔme bubu siwo nɔa anyi le vidzidzi me. Míeyɔa esiawo be ``dzidzime ƒe dɔlélewo'' alo nɔnɔme siwo nɔa anyi le vidzidzi me ƒe ƒuƒoƒo.

Wogayɔa esia be `(Wilms ƒe dɔdzẽ)` kple `(nephroblastoma)`. Zi geɖe la, dɔdzẽ ɖeka koe nɔa ayiku ɖeka me. Ke hã, ɖevi aɖewo ate ŋu akpɔ dɔdzẽ le ayiku eveawo siaa me `(bilateral),` alo kansa ƒe teƒe siwo wu ɖeka ate ŋu anɔ ayiku ɖeka me.

Amekae xɔa esia wu?

Esia nye nɔnɔme si mebɔ o si dzea ame tsitsiwo dzi. Wilms tumor nye kansa si dzea ɖevi siwo mexɔ ƒe 15 haɖe o koŋ dzi.Wokpɔa ɖevi siwo ŋu dɔléle sia le ƒe 95% hafi woxɔa ƒe 10.

Ameyibɔvi siwo tso Afrika la le afɔku me vie. Asia-viwo le afɔku me boo o. Azɔ hã, nyɔnuviwo ate ŋu axɔe vie wu ŋutsuviwo.

Le ƒome ʋɛ aɖewo ŋutɔ me la, woka nya ta hã be esia nye nane si tso domenyiŋusẽfianu me.

Aleke gbegbee nɔnɔme sia bɔe?

Le dukɔ abe Amerika ene me la, wogblɔna be Wilms dɔdzẽ ƒe dɔlékui yeye siwo ade 500 ye ƒe sia ƒe. Esesẽ be woakpɔ akɔntabubu siwo sɔ pɛpɛpɛ le alesi wòle le Sri Lanka ŋu, gake esia nye kansa si woate ŋu akpɔ le ɖeviwo dome.

Nukae nye vidzidzi ƒe dɔléle siwo woate ŋu akpɔ le Wilms dɔdzẽ ŋu?

Ƒã ŋutɔ be ɖevi siwo ŋu Wilms ƒe dɔdzẽ le naxɔ dɔléle bubu siwo wodzina. Gake ate ŋu adzɔ. Dɔléle vevi aɖewoe nye esi:

• Beckwith-Wiedemann ƒe dɔléle: Ðevi siwo ŋu dɔléle sia le ate ŋu axɔ Wilms dɔdzẽ tso 5% va ɖo 10%. Esia nye nɔnɔme si me ŋutilã ƒe akpa aɖewo tsina lolona wu alesi wòle dzɔdzɔmee. Ɣeaɖewoɣi la, ŋutilãa ƒe akpa ɖeka ate ŋu alolo wu evelia.
• WAGR ƒe dɔléle: Ðevi siwo ŋu dɔléle sia le ate ŋu axɔ Wilms ƒe dɔdzẽ 50% (W si le ŋkɔa me tsi tre ɖi na Wilms). Esia ate ŋu ana ŋkume ƒe akpa aɖe nabu (Aniridia), eye wòana vidzinuwo kple ayiku me kuxiwo hã nado mo ɖa.
• Denys-Drash ƒe dɔlélea:Ðevi siwo ŋu dzesi siawo ƒo ƒu le la ate ŋu axɔ Wilms dɔdzẽ, si ate ŋu ahe kuxiwo vɛ le vidzidziŋutetewo kple ayikuwo hã ŋu.

Nukae nye Wilms ƒe dɔdzẽ ƒe dzesiwo?

Di dzesi siawo le viwòa ŋu:

• Ƒuƒoƒo alo sesẽ/ƒuƒoƒo le ƒodo me (ƒodo). Kpe alo ƒuƒu sia ate ŋu ase veve ɣeaɖewoɣi, gake zi geɖe la, mevea ame o.
• Dɔgbo ƒe vevesese.
• Ʋu si le aɖuɖɔ me (hematuria).
• Asrã.
• Ʋusɔgbɔdɔ (ʋusɔgbɔdɔ). Esia ate ŋu ana ɖevia nado ʋu le ŋɔti me, ta navee, eye ŋku siwo me ʋu le dodom le.

Ne dzesi siawo dometɔ ɖeka alo esi wu nenema le ŋuwò la , ele be nàyi ɖɔkta gbɔ enumake.

Nukae hea Wilms ƒe dɔdzẽ vɛ?

Le nyateƒe me la, míenya nusi tututu hea Wilms ƒe dɔdzẽ vɛ haɖe o. Togbɔ be domenyiŋusẽfianu ate ŋu anɔ ame ʋɛ aɖewo ko me hã la, womenya nusita wòdzɔna le go geɖe me o.

Aleke wowɔa wokpɔa Wilms ƒe dɔdzẽ (wokpɔnɛ dzea sii)?

Ne ède dzesii be ƒu aɖe le viwòa ƒe aklala ƒe akpa si wòdona, alo ne ƒunukpeƒeae na nèle aklala si lolo wu zãm la, wò ɖɔkta adi be yeado Wilms ƒe dɔdzẽ kpɔ hã. Ɣeaɖewoɣi la, dɔdzẽ siawo ate ŋu alolo wu ayiku.

Ne dɔléle siwo ŋu míeƒo nu tsoe va yi dometɔ ɖeka le viwòa ŋu alo domenyiŋusẽfianu ƒe kuxi aɖe le eŋu la, àte ŋu aƒo nu kple wò ɖɔkta ahatso nya me nenye be yeayi dodokpɔa dzi.

Dodokpɔ siwo wozãna tsɔ dea dzesi Wilms ƒe dɔdzẽe nye:

• Lãmedodokpɔ: Le esia me la, ɖɔktaa léa asi ɖe ɖevia ƒe ƒodo ŋu nyuie.
• Nɔnɔmetatawo ɖeɖe ƒe dodokpɔwo:
• Ƒodo ƒe ultrasound scan.
• CT scan - Zi geɖe la, wowɔa esia to tsi tɔxɛ aɖe dodo me (vovototodedeameme).
• Ðɔktaa ate ŋu awɔ akɔta ƒe X-ray alo CT scan hã atsɔ akpɔe ɖa be kansa la kaka ɖe lãkusi me hã.
• Nɔnɔmetatawo dodokpɔ siawo ate ŋu akpe ɖe ŋuwò nànya nenye be dɔdzẽ le viwòa ŋu. Woate ŋu akpe ɖe ame ŋu hã be woade vovototo Wilms dɔdzẽ kple ayiku me dɔdzẽ ƒomevi bubu dome.
• Ʋu kple aɖuɖɔ dodokpɔ: Esiawo dometɔ aɖewoe nye aklã ƒe dɔwɔwɔ dodokpɔ kple ʋu ƒe sisi dodokpɔ.
• Biopsy: Esia bia be woaɖe lãkusi sue aɖe tso dɔdzẽa me atsɔe ayi dodokpɔxɔ me be woadoe kpɔ.

Nukae wòle be nànya tso kansa ƒe afɔɖeɖe ƒe ɖoɖo ŋu?

Mɔ eve li siwo dzi woato anya afisi Wilms ƒe dɔdzẽa le, si nye afisi kansa la kaka ɖo. Woyɔa esia be ``staging.'' Zi alesi xexlẽmea loloe la, zi nenemae kansa la kakae.

Ðɔkta siwo le Europa-dukɔwo me zãa Dukɔwo Dome Ðeviwo ƒe Dɔdzẽ Ŋuti Nusrɔ̃ƒe (SIOP) ƒe ɖoɖoa. Ðɔkta siwo le United States kple Canada zãa Ðeviwo ƒe Dɔdzẽŋutinunyalawo ƒe Ƒuƒoƒo (COG) ƒe ɖoɖoa.

Vovototo ɖeka si le mɔnu eve siawo domee nye be le COG mɔnu me la, wokpɔa afisi dɔdzẽa le le amekoko vɔ megbe kple hafi wonaa atikewɔmɔnu (atike siwo tsia kansa nu) nana. Le SIOP mɔnu me la, wowɔa amekokoa le atikewɔmɔnu vɔ megbe eye le ema megbe ko hafi wodaa afɔɖeɖea kpɔna.

Woma afɔɖeɖe siwo le COG ɖoɖoa te ale:

• Afɔɖeɖe I: Ðevia ƒe ayiku me koe dɔdzẽa le eye woate ŋu aɖee ɖa keŋkeŋ ne wowɔ dɔ nɛ.
• Afɔɖeɖe II: Dɔdzẽa tsi tso ayiku me, gake woate ŋu aɖee ɖa keŋkeŋ ne wowɔ dɔ nɛ.
• Afɔɖeɖe III: Womate ŋu aɖe dɔdzẽa ɖa keŋkeŋ o. Kansa lãmenugbagbeviwo nɔa ɖevia ƒe dɔgbo (ƒodo me) me.
• Akpa IV: Kansa la kaka wu ɖevia ƒe ƒodo kple akɔta yi teƒe bubuwo, abe lãkusi, aklã, ƒuwo, kple ahɔhɔ̃ ene.
• Afɔɖeɖe V: Dɔdzẽa le ayiku eveawo siaa me (afã eve). Le afɔɖeɖe sia me la, ɖɔktawo léa ŋku ɖe ayiku eveawo ƒe afɔɖeɖe ŋu ɖe vovo.

Aleke wodaa Wilms ƒe dɔdzẽe?

Zi geɖe la, wozãa amekoko kple atikewɔmɔnu vovovowo tsɔ daa Wilms ƒe dɔdzẽa. Ɣeaɖewoɣi la, woate ŋu azã keklẽŋusẽdɔdamɔnu hã.

Ðevi siwo ŋu dɔdzẽ siwo me afɔku mele boo o le, afisi kansa la mekaka o eye woate ŋu aɖe dɔdzẽa ɖa keŋkeŋ le la, woate ŋu awɔ dɔ na wo ɖeɖe. Ɣeaɖewoɣi la, woate ŋu awɔ atike na ame hafi awɔ dɔ nɛ be wòaɖe dɔdzẽa dzi akpɔtɔ, si ana amekokoa nanɔ dedie wu.

Zi geɖe la, wodoa atike na ame to ʋuka me (IV). Woate ŋu awɔ esia le kɔdzi alo le kɔdzi.

Atikewɔmɔnu alo keklẽŋusẽdɔdamɔnu ate ŋu agblẽ nu le viwòa ŋu. Ne edzɔ alea la, kpɔ egbɔ be yegblɔe na wò ɖɔkta. Nu aɖewo li nàte ŋu awɔ atsɔ aɖe eƒe nugbegblẽ le ame ŋu kple atike siwo nàte ŋu ana viwòa dzi akpɔtɔ.

Ðe woate ŋu axe mɔ ɖe Wilms ƒe dɔdzẽ nua?

Le nyateƒe me la, naneke meli si wò alo viwòa ate ŋu awɔ atsɔ ahe Wilms ƒe dɔdzẽ vɛ alo axe mɔ ɖe enu o. Esia nye nusi dzi míate ŋu aɖu o.

Nukae nye nyagblɔɖi na amesi ŋu Wilms dɔdzẽ le?

Zi geɖe la, Wilms ƒe dɔdzẽ ƒe nyagblɔɖi nyona le go akpa gãtɔ me. Zi geɖe la, emetsonua nyona ŋutɔ, vevietɔ ne ɖɔktaa te ŋu ɖe dɔdzẽa ɖa keŋkeŋ eye kansa la mekaka ɖe ŋutilãa ƒe akpa bubu o. Ke hã, mɔnukpɔkpɔ sue aɖe li be Wilms ƒe dɔdzẽ ``agadzɔ ake''.

Ðe Wilms ƒe dɔdzẽ ate ŋu awu amea?

Togbɔ be woate ŋu ada Wilms ƒe dɔdzẽ dzidzedzetɔe to amekoko, atikewɔmɔnu, kple/alo keklẽŋusẽ zazã ƒokpli me hã la, .Esia gakpɔtɔ nye kansa. Eyata ate ŋu awu ame. Esia tae wòle vevie be nàde dzesii kaba eye nàdze atikewɔwɔ gɔme.

Nukae nye agbetsitsi ƒe agbɔsɔsɔme le Wilms dɔdzẽ me?

Ame siwo ŋu wokpɔ Wilms dɔdzẽ le la dometɔ siwo ade 90% gakpɔtɔ le agbe le ƒe atɔ̃ megbe. Agbɔsɔsɔ sia ate ŋu ato vovo vie le nusiwo nye afisi kansa la le, dɔdzẽa ƒe lolome, kple alesi kansa ƒe lãmenugbagbeviwo le le nusuekpɔmɔ̃ (histology) me nu. Togbɔ be wogblɔna tsã be ɖevi siwo mexɔ ƒe 2 haɖe o ƒe afɔku be woagadze dɔa ake dzi boo o hã la, fifia ya ƒexɔxɔ meganye nusi gbɔ wòtso tsã o.

Ɣekaɣie wòle be makpɔ nye ɖɔkta le Wilms ƒe dɔdzẽ ŋu?

Ne wole Wilms ƒe dɔdzẽ dam na viwòa la, ke yi ɖɔkta gbɔ ne ètsi dzi alo nya aɖe le ŋuwò. Vevietɔ ne ède dzesi dzesi yeye aɖewo alo ne edze abe nane le sesẽm ɖe edzi ene la, na woanya enumake.

Le wò atikewɔwɔ me la, wò atikewɔlawo ƒe ƒuƒoƒoa agblɔ nusiwo ŋu nàlé ŋku ɖo, abe aɖuɖɔtoedɔléle ƒe dzesiwo ene na wò. Ne edzɔ alea la, ahiã be nàyi xɔ si me wowɔa dɔ kpata le.

Ahiã hã be ɖevia nayi ɖasrãe kpɔ le ɣeyiɣi aɖewo me be yeakpɔ egbɔ be yeƒe lãme sẽ. Ðɔktaa ate ŋu aɖo ɖevia ɖe ayikuŋutinunyala (aɖuɖɔtoeŋutinunyala) alo aɖuɖɔtoeŋutinunyala (aɖuɖɔtoeŋutinunyala) hã gbɔ.

Aleke mate ŋu akpe ɖe vinyea ŋu be wòanɔ lãmesẽ me le Wilms dɔdzẽ ƒe atikewɔwɔ vɔ megbe?

Ele vevie be viwòa nawɔ nusiawo:

• No tsi si sɔ be wòakpe ɖe wò ayiku ŋu wòawɔ dɔ nyuie.
• Ðe atikewo abe aspirin, ibuprofen, kple naproxen zazã dzi kpɔtɔ. Ƒo nu kple viwò ƒe ɖɔkta tso atike siwo mate ŋu agblẽ nu le viwò ƒe ayiku ŋu boo o ŋu.
• Kpɔ wò ʋu ƒe sisi ɖa edziedzi.

Ðe Wilms tumor nye vevesesea?

Ɣeaɖewoɣi la, Wilms ƒe dɔdzẽ ate ŋu ave ame, gake menye ɣesiaɣie wòvea ame o.

Vovototo kae le Wilms ƒe dɔdzẽ (nephroblastoma) kple ahɔhɔ̃mekawo dome?

Togbɔ be nya eve siawo ɖi wo nɔewo hã la, wonye kansa ƒomevi eve siwo dzea egɔme tso lãmenugbagbevi ƒomevi vovovo eve me. Nephroblastoma nye ayiku me kansa. Neuroblastoma nye kansa si dzea egɔme tso lãmekawo me. Zi geɖe la, edzea egɔme tso adrenal glands me, gake ate ŋu adze ayikuwo hã dzi. Kansa ƒomevi evea siaa dzɔna ɖe ɖeviwo dzi, eye wo ame evea siaa ate ŋu adze abe ƒunukpeƒetetedɔ ene le ƒodo me. Eyata ele vevie be woakpɔ dɔlélea nyuie.

Ne wokpɔ Wilms dɔdzẽ le viwò ŋu la, anɔ eme be wò ɖɔkta aɖo aɖaŋu na wò be nàte ɖe atikewɔƒe aɖe si bi ɖe ɖeviwo ƒe kansa dada me. Togbɔ be Wilms ƒe dɔdzẽ mebɔ o hã la, enye dɔléle si woate ŋu ada. Viwò ate ŋu adze hã akpɔ gome le dɔdamɔnu dodokpɔ aɖe me. Woŋlɔ ɖevi geɖe siwo ŋu Wilms dɔdzẽ le la ŋkɔ ɖe ɖoɖo sia me. Ŋgɔyiyi geɖe siwo wowɔ le Wilms ƒe dɔdzẽ dada me tso dɔdamɔnu dodokpɔ siawo me.

Nu vevitɔ kekeake (Take-Home Message) .

Enyo, eyata míeƒo nu geɖe tso Wilms ƒe dɔdzẽa ŋu, alo? Nu vevitɔ si dzi wòle be nàɖo ŋkui enye be ne èkpɔ ƒunukpeƒetetedɔ alo vuvu aɖe si mebɔ o le viwò ƒe dɔme la, mègatsi dzodzodzoe eye nàyi ɖɔkta gbɔ enumake o.

• Wilms ƒe dɔdzẽ nye kansa si dona le ɖevi suewo ƒe ayiku me.
• Togbɔ be womenya nusi tututu gbɔ esia tso o hã la, domenyiŋusẽfianu ƒe ŋusẽkpɔɖeamedzi aɖe ate ŋu anɔ anyi.
• Ne wokpɔ dɔlélea dze sii kaba eye wodae nyuie la, mɔnukpɔkpɔ si li be wòahaya la lolo wu sã.
• Amekoko, atikewɔmɔnu, kple ɣeaɖewoɣi keklẽŋusẽdɔdamɔnue nye atike vevitɔwo.
• Le atikewɔwɔ vɔ megbe gɔ̃ hã la, ele vevie ŋutɔ be woawɔ ɖe ɖɔkta ƒe mɔfiamewo dzi nyuie eye woayi aɖado wo kpɔ le ɣeyiɣi siwo woɖo ɖi dzi.

Mègavɔ̃ o. Atikeŋutinunya de ŋgɔ ŋutɔ egbea. Nu vevitɔ kekeakee nye wò susu kple afɔɖeɖe kabakaba. Medi be viwòa nahaya kaba!

` Wilms tumor, nephroblastoma, ɖevime kansa, ayiku me kansa, ɖeviwo ƒe lãmesẽ, kansa ƒe dzesiwo, kansa dada