yu kin no yehri boht dis nem "chordoma" bifo. Dat nɔ sɔprayz, bikɔs dis na wan kayn kansa we nɔ kin bɔku. Bɔt pan ɔl we i nɔ kin apin so ɔltɛm, i rili impɔtant fɔ no bɔt dis. biכs, dis kayn tכmכro kin apin na wi spayna כ na di bכs pat na di sכkul. So tide, lɛ wi tɔk ditayli ɛn rili simpul bɔt wetin na dis kɔd, aw i kin kam, wetin na di sayn dɛm, ɛn wetin na di tritmɛnt dɛm.
Wetin na Kɔdɔma? Lɛ wi fɛn ɔltin simpul wan!
Fɔ tɔk am simpul wan, kɔdɔma na kansa we kin mek na di bon dɛn . Bɔku tɛm i kin de na yu spayna ɔ na di bays pan yu skel, di bon dɛn we de ɔp yu nɛk ɛn dɔŋ yu bren. Dɔktɔ dɛn kin kɔl am wan kayn kansa we dɛn kɔl sarkoma. Sarkoma na jεnarכl tεm fכ kεnsar dεm we de fכm na di bon dεm εn sכft tisu dεm (kכnektiv tisu dεm).
Di kɔdoma dɛn kin gro sloslo . Bɔt di prɔblɛm na dat, i kin tranga smɔl fɔ trit dɛn bikɔs dɛn de rili nia wi nervɔs sistɛm, dat na di bren ɛn spɛshal kɔd, ɛn dɛn kin invayd di dilik tisu dɛn we de rawnd dɛn.
Wan ɔda tin na dat, ivin afta dɛn dɔn trit dɛn tumbu ya, dɛn kin gɛt bɔku chans fɔ kam bak . Bɔku tɛm, dis kin apin na di sem ples usay di fɔs tumbu bin de. כlso, insay 30% to 40% pan di kes dεm, di kכdכma kεnsar sεl dεm kin spre to כda pat dεm na di bכdi. Dɔktɔ dɛn kin kɔl dis ``mɛtastasayz''.
Usay Chordoma kin spre to ɔda pat dɛn na di bɔdi?
If wan kɔdɔma mɛtastas, dat na, i go spre to ɔda pat dɛn na di bɔdi, di say dɛn we i kin skata pas ɔl na:
- Yu lɔng dɛn
- di limf no dεm we de nia di tכmכro
- Ɔda bon dɛn
- Liva
- Kanda
Usay kɔdɔma kin divɛlɔp?
Kɔdɔma kin apin ɛnisay along yu spayna, bɔt tri say dɛn de we dɛn kin gɛt mɔ:
1. di sakrum: Dis na di triangul bon bitwin yu bכtכm. bכt 35% pan di kכdכm dεm de divεlכp ya.
2. Skul bays: spεshal wan, na di bכs pat pan yu sכkul, na di bon dεm we de sכpכt yu bren. dεn kכl dεn tin ya bak ``Clival chordoma'' biכs dεn kin fכm bכku tεm na di ``Clivus'' bon, we de ya. dis kayn de bak fכ bכt 35% pan כl di kכdכma dεm.
3. insay di vεrbra dεm we de muv na di spayna (`vεrbra`): dat na di vεrbra dεm na yu nεk, chεst, εn bak. di kכdכma de apin insay lεk 30% pan dεn wan ya. dεn kin kכmכn mכst na di sεkכn sεvikal vεrbra. dεn kin apin bak na di vεrbra dεm na di lכw bכk (lכmba spayna) εn chεst (thoracic spine).
Wetin na di men kayn kɔdɔma?
Di Wol Ɛlth Ɔganayzeshɔn (WHO) dɔn sheb kɔdɔma to tri men kayn. dis klasification dεm de bays pan aw di kεnsar sεl dεm de luk כnda maykroskכp (`histology`).
1. Klasik/kכvεshכnal kכdכma: dis na di tכp we kכmכn pas כl (80% to 90% pan כl di kכdכma). di sεl dεm we de insay dis tכp na spεshal tכp sεl we gεt sכm "bכbul" we de sho. Chondroid chordoma na ɔda kayn we fɔ dis kayn. i de bitwin 5% εn 15% pan כl di kכdכma dεm. di chondroid chordoma kin divεlכp bכku tεm na di bכs pat pan di sכkul.
2. Dedifferentiated chordoma: Dis na wan kayn we we nɔ kin bɔku (lɛs dan 5%). di kכntribyushכn we di sεl dεm miks we nכ nכmal. Dis kayn kin gro fast fast, i kin agresiv, ɛn i kin mek i go na ɔda pat dɛn na di bɔdi pas ɔda kayn dɛn.
3. Kכrdoma we nכ de difrεnt fayn: Dis n כ kin bכku bak . I nɔ rich 60 pasɛnt dɛn we dɛn dɔn rayt na di mɛdikal rɛkɔd te naw. wan spεshal fכs fכ dis kayn na we wan jin we dεn kכl `(SMARCB1)` כ `(INI1)` de inaktivat (dilit). Dis kayn kɔdɔma kin de pan pikin ɛn yɔŋ pipul dɛm.
Udat kin gɛt kɔrdɔma mɔ?
Kɔdɔma kin apin pan ɛni ej, pan ɛnibɔdi. Bɔt i kin bɔku pan big pipul dɛn we ol bitwin 50 ɛn 80. Pikin dɛn kin gɛt smɔl smɔl sik dɛn nɔmɔ, we na lɛk 5% pan ɔl di kes dɛm.
Dɛn dɔn si bak se man dɛn kin gɛt kɔdɔma lɛk 1.5 tɛm pas uman dɛn.
Aw kɔmɔn tin dis?
Chordoma na kansa we nɔ kin bɔku . I kin afɛkt lɛk wan pan ɛvri milyɔn pipul dɛn ɛvri ia. Dat min se fɔ ɛgzampul, na Amɛrika, na lɛk 300 nyu wan dɛn nɔmɔ dɛn kin no bɔt ɛvri ia.
di kכdכma dεm de bitwin 1% εn 4% pan כl di praymar bon tכmכro dεm.
Wetin na di sayn dɛm wae de sho se yu gɛt kɔrdɔma?
as di kכdכma de gro, i kin put prεshכn pan di spεnal kכd כ di bren we de rawnd am. Dis prɛshɔn kin mek pɔsin gɛt sɔm sayn dɛn . di simptom dεm kin difrεn bak dipכnt pan usay di tכmכro de na di spayna.
Di kɔmɔn sayn dɛm fɔ kɔdɔma na pen, wik, ɛn/ɔ swɛt na yu bak, yu an, ɔ yu leg .
Karakta dεm fכ wan sכkul bays kכrdoma:
If yu gɛt kɔdɔma na di bays pan yu skel, we de ɔnda yu bren, yu kin gɛt sɔm sayn dɛn lɛk:
- Dabl vishɔn (Diplopia) .
- Di vishɔn we nɔ klia
- Ed de at
- Fes we de swɛ ɔ we i de fil pen
di kכntribyushכn dεm fכ wan kכrdoma na di telbon/sakrum:
If yu gɛt kɔdɔma na di pat we de dɔŋ pas ɔl na yu spayna, nia di sakrum, yu kin gɛt sɔm sayn dɛn lɛk:
- Lump ɔ bɔmp we de kɔmɔt na di skin
- I nɔ izi fɔ pis ɔ fɔ pul dɔti (blad ɔ bɔdi nɔ de wok fayn) .
- Pen na di lכw bak כ di bכtכm εria
Yu fɔ mɛmba se, sɔmtɛm dɛn kin kɔnfyus dɛn sik ya wit ɔda kɔmɔn mɛrɛsin. Na dat mek i impɔtant fɔ go to dɔktɔ if yu gɛt ɛni sayn we nɔ de dɔn, we nɔ kin izi fɔ yu.
Wetin mek Chordoma kin divɛlɔp? Wetin na di tin dɛn we kin mek i apin?
Risach pipul dɛn stil nɔ no bɛtɛ bɛtɛ wan wetin kin mek pɔsin gɛt kɔdɔma, bɔt dɛn biliv se di chenj dɛn we kin apin na wan jin we dɛn kɔl TBXT kin apin.
Ripɔt dɔn de bɔt sɔm famili dɛn we gɛt kɔrdɔma. we dεn tεst dεm, dεn fכnshכn se dεn inhεrit wan duplikεshכn fכ di `(TBXT)` jin. כlso, dεn dכn no chenj dεm na di `(TBXT)` jin pan pipul dεm we gεt kכdכma bכt nכ wan pan di famili gεt di sik.
di kכdoma de divεlכp frכm sεl dεm we de insay wan strכkchכ we dεn kכl ``notochord`` dis ``notochord`` na tεmporari strכkchכ we rili imכtant fכ di divεlכpmεnt fכ di spεnal kכd fכ di εmbrayo we i de divεlכp. כltu, dis ``notochord`` de disappear bay lεk et wiks we di bεlε de. כltu, insay sכm nכmba fכ pipul dεm, sכm pan dεn ``notochord`` sεl dεm kin de na di bon dεm na di spayna כ di bכs pat na di sכkul.
so, di we aw pipul dεn de si naw na dat if chenj de na di `(TBXT)` jin we wi bin dכn tכk bכt, dεn rεst `(notochord)` sεl dεm kin bigin fכ gro abnכmal εn fכm kכrdoma.
כlso, pipul dεm we gεt jεnεtik kכndyushכn we dεn kכl ``Tuberous sclerosis`` de pan risk fכ gεt kכrdoma. dis ``Tuberous sclerosis`` kכndyushכn kin mek yu gεt εpilepsy, divεlכpmεnt delay, εn tכmכro dεm na difrεn pat dεm na di bכdi. dis de kכz fכ mכtεshכn insay tu jin dεm we dεn kכl ``TSC1`` εn ``TSC2``.
Aw fɔ no wan kɔdɔma?
If yu gɛt sayn dɛm fɔ kɔda, dɔktɔ go aks yu fɔs bɔt yu sik ɛn mɛdikal histri. Dɔn dɛn go du ɛgzam fɔ dɛn bɔdi ɛn ɛgzam fɔ di nyurolɔjik.
If di dɔktɔ tink se tumbu de, i go ɔda fɔ mek dɛn du imej tɛst lɛk ɛkstrem rayt, kɔmpyuta tomografi (CT) skan, ɔ MRI skan. Bɔku tɛm dis MRI skan kin ɛp fɔ no if pɔsin gɛt kɔdɔma.
Dɔn, i go mɔs bi se yu dɔktɔ go sɛn yu to spɛshal pɔsin we sabi bɔt bon kansa fɔ kɔnfirm di sik ɛn gɛt sɛkɔn opinion. Dɛn kin du ɔda tɛst dɛn bak fɔ no usay di kɔdoma de, si if i dɔn skata to ɔda pat dɛn na di bɔdi, ɛn du ɔda tɛst dɛn.
Bɔt di wangren we fɔ no if pɔsin gɛt kɔdɔma na fɔ mek dɛn tek bayɔpsi . Dis min se dɛn kin tek smɔl sampul pan di lump, bɔku tɛm dɛn kin yuz nidul bayɔpsi, ɛn chɛk am ɔnda maykroskɔp. Na da tɛm de nɔmɔ spɛshal pɔsin go no fɔ tru if na kɔdɔma.
Wetin na di tritmɛnt dɛm fɔ Chordoma?
Di men ɛn bɛst tritmɛnt fɔ kɔdɔma na fɔ pul di wan ol tumbu tru ɔpreshɔn . dכkta dεn kכl dis ``En bloc resection.`` If dεn pul di tכmכro kכmplit wan dis we, di sikman gεt di bεst chans fכ liv fכ lכng tεm.
Bɔt i kin dipen usay di tumbu dɛn de, dis kin rili at fɔ du. spεshal wan, bכku tεm i nכ kin izi fכ pul di kכrdoma dεm we de na di bכs pat pan di sכkul kכmplit wan.
Bikɔs wan kɔdɔma na di spayna kin pwɛl yu spɛshal kɔd ɛn di impɔtant nɛv ɛn blɔd vesel dɛn we de rawnd am. If dis pwɛl we dɛn de du ɔpreshɔn, i kin mek i nɔ ebul fɔ waka fɔ lɔng tɛm ɔ i kin ivin day. כlso, i at fכ pul wan kכdכma we de na di bכs pat na di sכkul kכmplit biכs i de so nia di bren stem, di kraynia nεv dεm, εn di spεnal kכd. Nyurosɔjɔn dɛn kin tray fɔ pul bɔku pan di tumbu as dɛn ebul, pan ɔl we dɛn kin sef as dɛn ebul.
Bɔrku tɛm, kɔrdɔm nɔ kin ansa fayn to redyushɔn tɛrapi ɔ kemotɛrapi as praymar tritmɛnt. Bɔt afta dɛn dɔn du di ɔpreshɔn, yu mɛdikal tim kin tɛl yu fɔ yuz redyushɔn tɛrapi fɔ mek di tumbu nɔ kam bak.
Naw, di wan dɛn we de stɔdi bɔt dis de fɛn nyu tritmɛnt fɔ kɔda, lɛk di tritmɛnt we dɛn de tɔk to pɔsin ɛn di tritmɛnt we dɛn de yuz fɔ fɛt di sik we dɛn kɔl immunotherapy. I kin ivin gɛt klinik trial dɛn we yu kin tek pat pan.
Yu tink se dɛn kin mek pɔsin nɔ gɛt kɔda?
Fɔ tɔk tru, nɔrtin nɔr de we yu kin du fɔ mek kɔrdɔm nɔr de divɛlɔp. Bɔrku tɛm, dɛn kin divɛlɔp randomly.
Bɔt if pɔsin na yu famili dɔn gɛt Chordoma, ɔ if yu gɛt wan sik we dɛn kɔl ``Tuberous sclerosis,'' i impɔtant fɔ mek yu go to dɔktɔ ɔltɛm fɔ chɛk-ap. Dɔn dɛn kin wach yu fɔ si sayn dɛn fɔ Chordoma. Di kwik we dɛn no dis, na di mɔ i go bi se di tritmɛnt go wok fayn.
Wetin na di chans fɔ mek yu wɛl frɔm wan kɔdɔma? (Prɔgnosis) .
di prכgnosis, כ aw dεn kin si, fכ wan kכrdoma de dipכnt pan sεvεra tin dεm:
- Di say we di tumbu de ɛn aw bɔku dɛn kin pul am bay ɔpreshɔn: If dɛn kin pul di tumbu ɔlsay, di chans fɔ mek i wɛl kin bɔku. If na ɔda tritmɛnt dɛn nɔmɔ dɛn yuz we dɛn nɔ du ɔpreshɔn, di chans nɔ go bɔku.
- If di kansa dɔn spre to ɔda pat dɛn na di bɔdi (metastasized): If i dɔn spre to say dɛn we de fa, di rit we pɔsin kin liv kin ridyus.
- Yu ej wae dɛn no se yu gɛt dis sik: Jɛnɛral wan, di nɔmba fɔ pipul dɛm wae dɔn pas 60 ia kin shɔt smɔl.
- if di tכmכro de difrεns כ nכ de difrεns: tכp dεm lεk ``Poorly differentiated chordoma`` gεt wכs prכgnosis pas ``kכnvεnshכnal kכrdoma``.
Yu mɛdikal tim kin gi yu di kɔrɛkt infɔmeshɔn bɔt wetin fɔ ɛkspɛkt bay aw yu sik, so nɔr fred fɔ aks dɛn kwɛstyɔn.
Yu tink se dis kin mek pɔsin day?
Yɛs, kɔdɔma kin kil pɔsin. Bɔku tɛm, day kin apin afta di tumbu dɔn kam bak, ɛn dis kin pwɛl di tisu dɛn na yu spɛshal kɔd, yu bren, ɔ yu bren stem.
Wan stכdi pan 357 kכrdoma pasεnshכn dεm sho se di rεt we dεn sכvayv na dεn wan ya:
- Afta tri ia: 80.5%
- Afta fayv ia: 68.4%
- Tɛn ia afta dat: 39.2%
Bɔt mɛmba se dɛn tin ya na jɔs avrej. Yu mɛdikal tim kin gi yu mɔr ditayl infɔmeshɔn bɔt aw pɔrsin de liv bay aw yu de si yu patikyula sityueshɔn.
Na Kɔdɔma Kansa ɔ na Nɔmal Tumɔ?
Chordoma na definitely malignant (kansa). Nɔn pan in sɔbtayp dɛn nɔ kin tek am se nɔto kansa.
Ustɛm a fɔ go to dɔktɔ?
Kɔdɔma kin kam bak ivin afta dɛn dɔn trit am, ivin afta sɔm ia. So, fɔ fala yu mɛdikal tim fɔ lɔng tɛm rili impɔtant.
If yu gɛt ɛni nyu sik, ɔ if di sik we yu gɛt naw de wɔs , mek shɔ se yu tɔk to yu dɔktɔ.
Fɔ dɔn, sɔm tin dɛn fɔ mɛmba (Take-Home Message) .
Na nɔmal tin fɔ mek yu fil fred ɛn strɛs we yu kam fɔ no se yu gɛt wan kansa we nɔ kin bɔku na yu bon. Chordoma na kansa wae nɔr kin izi fɔ trit bikɔs ɔf di say we i de.
Bɔt, trɔst se yu mɛdikal tim go mek wan ditayla tritmɛnt plan we go fayn fɔ yu ɛn go ɛp yu fɔ trit yu kɔdɔma ɛn fɔ mek yu layf bɛtɛ .
- E fayn fɔ no di sayn dɛm kwik kwik wan: go to dɔktɔ if yu gɛt pen ɔltɛm, yu nɔr de fil fayn, ɔr yu de chenj yu yay.
- Go to dɔktɔ we sabi bɔt mɛrɛsin: Bikɔs kɔdɔma na sik we nɔ kin apin so ɔltɛm, i rili impɔtant fɔ go to tritmɛnt frɔm dɔktɔ we gɛt ɛkspiriɛns.
- I nid fɔ de chɛk-ap ɔltɛm ivin afta dɛn dɔn trit yu: Bikɔs di sik kin kam bak, atɛnd di chɛk-ap dɛn lɛk aw di dɔktɔ dɛn tɛl yu.
A op se yu go si se dis infɔmeshɔn go ɛp yu. If yu gɛt ɛni kwɛstyɔn, nɔ shek fɔ aks yu dɔktɔ.
` Chordoma, kansa, bon kansa, spayna, skel, sakrum, klivus
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