Ɛnibɔdi na yu famili dɔn gɛt kansa na yu kɔlon? Kam, lɛ wi tɔk bɔt dis jenɛtik kɔndishɔn (Familial Adenomatous Polyposis - FAP)!

Ɛnibɔdi na yu famili, sɔntɛm we i yɔŋ, dɔn gɛt kansa na yu kɔlon? Ɔ dɔktɔ dɔn tɛl yu se yu gɛt smɔl smɔl tin dɛn we de gro (polyps) na yu kɔlon wit prɔblɛm dɛn na yu bɛlɛ? Ilɛksɛf yu dɔn yɛri bɔt dis kayn tin ɔ yu nɔ yɛri bɔt dis, i kin rili impɔtant fɔ no bɔt dis kɔndishɔn we dɛn kɔl `FAP` we wi go tɔk bɔt tide. Bikɔs pan ɔl we i nɔ kin apin smɔl, if yu no am kwik, i kin sev yu bɔku big prɔblɛm dɛn.

Wetin na FAP insay simpul wɔd dɛn?

Fɔ tɔk am simpul wan, Familial Adenomatous Polyposis, ɔ FAP fɔ shɔt, na wan jɛnɛtik kɔndishɔn we de mek bɔku bɔku smɔl smɔl tin dɛn we de gro (polyps) we dɛn kɔl adenomas, we kin bi kansa, fɔm na yu kɔlon ɛn sɔm tɛm dɛn de insay yu rɛktum.

Tink bɔt am, sɔm pipul dɛn kin gɛt wan ɔ tu pan dɛn tumbu ya na dɛn kɔlon as dɛn de ol. Dat na nɔmal tin. Bɔt fɔ pɔsin we gɛt `FAP`, dɛn kin gɛt pas wan ɔndrɛd, sɔmtɛm tawzin pan dɛn tumbu ya, bɔt dɛn kin bigin fɔ divɛlɔp we dɛn rili yɔŋ, sɔntɛm dɛn kin yɔŋ lɛk tɛn ia. fכ dat, di chans fכ wan pan dεn tכmכro dεm ya go tכn to kεnsar (`kכlorektal kεnsar`), dat na di risk fכ wan layf, rili hכy .

Fɔ kɔntrol dis prɔblɛm, dɔktɔ dɛn kin se dɛn fɔ du ɔpreshɔn fɔ pul di wan ol kɔlon (total colectomy) . sכmtεm, dεn kin pul di rεktum bak (proctocolectomy). dis na biכs insay FAP, dεn tכmכro dεm ya de gro tu kwik fכ kכntro bay we dεn de pul dεm wan bay wan. Infakt, if dɛn nɔ du dis ɔpreshɔn, bɔku pipul dɛn we gɛt FAP go gɛt kansa we dɛn rich midul ej .

Pipul dεm wae gεt FAP kin gεt כda kayn tכmכro, nכto jכs na di kכlon, bכt na כda ples dεm, lεk di skin, sכft tisu, tit, εn bon dεm. Ivin afta dɛn dɔn pul di kɔlon, yu kin nid fɔ kɔntinyu fɔ du skrinin fɔ chɛk fɔ si if dɛn ɔda tɔŋ ya, ɛn yu kin nid fɔ du ɔpreshɔn fɔ dɛn bak.

Wetin na di risk fɔ gɛt kansa fɔ pipul dɛm wae gɛt FAP?

If dɛn nɔ trit pɔsin, pɔsin we gɛt FAP gɛt klos to 100% chans fɔ gɛt kɔlon kansa. Dɔn bak, di kansa kin kam kwik ɛn we i yɔŋ pas ɔda pipul dɛn. If dɛn no se pɔsin na di famili gɛt dis sik, pikin dɛn na dɛn famili dɛn de fɔ gɛt kɔlon skɔpi ɛvri ia we dɛn ol 10 ia .

Apat frɔm di kɔlon kansa, pipul dɛm wae gɛt FAP kin gɛt ɔda kayn kansa:

• kansa na di כp pat pan di sכmכl intestכn (`Duodenal cancer`) - bכt 8%
• Papilari tayroyd kansa - lɛk 2% .
• Pankrias kansa - lɛk 2% .
• Liva kansa we dεn kכl ``Hepatoblastoma`` (especially fכ pikin dεm) - lεk 1.5%
• Bɛlɛ kansa - lɛk 1% .
• di tכmכro dεm na di bren εn spεnal kכd - less dan 1% .

Difrɛn kayn FAP dɛn de?

Yes, wan men kayn `FAP` de ɛn sɔm ɔda sabtayp dɛn apat frɔm dat.

• "Klasik" FAP: dis de sho se i pas 100 adenoma dεm na di kכlon.
• "Attenuated" FAP (AFAP): Dis na sכbtayp we nכ sכmtεm sכmtεm. bitwin 20 ɛn 100 sist dɛn de na di kɔlon.
• Gardner syndrome: lεk klashik `FAP`, i pas 100 tכmכro dεm na di kכlon. Apat frɔm dat, ɔda kayn tumbu dɛn kin kam ɔdasay na di bɔdi.
• Turcot syndrome: Wan kansa tכmכro de divεlכp na di bren wit plεnti tכmכro dεm na di intestinal.

Aw kכmכn dεn kכl dis kכndyushכn FAP?

FAP na wan kɔndishɔn we nɔ kin apin so ɔltɛm . I kin afɛkt lɛk wan pan ɛvri 8,000 pipul dɛn. FAP de mek lɛk 0.5% pan ɔl di kɔlon kansa dɛn. Sɔbtayp dɛm lɛk AFAP, Gardner syndrome, ɛn Turcotte syndrome kin ivin shɔt.

Wetin na di difrɛns bitwin FAP ɛn Lynch syndrome?

Lynch syndrome na ɔda sik we pɔsin kin gɛt frɔm in mama ɛn papa we kin mek pɔsin gɛt kansa na in kɔlon ɛn ɔda kansa dɛn. dεn kכl di Lynch sεndrכm bak HNPCC (hεreditary nonpolyposis colorectal cancer syndrome). As di nem sho, dis nɔ min se bɔku bɔku tɔŋ dɛn we de na di kɔlon kin kam .

Pipul wae gɛt Lynch syndrome kin gɛt kansa ivin wit wan ɔr mɔr tumor na dɛn kɔlon. Dɔn bak, di tumbu ɛn kansa kin kam smɔl leta pas FAP, ɛn di risk kin smɔl. Dɛn tu tin ya kin apin bikɔs ɔf difrɛn jin dɛn we kin chenj .

Wetin na di sayn dɛm fɔ FAP? Aw wi kin no am?

insay FAP, di kכlon polip dεm kin bigin fכ fכm bכku bכku wan pas di jεnarכl pipul dεm, bכku tεm na di tεn ia dεm . Dɛn polip ya nɔ kin mek yu gɛt ɛni sayn te dɛn big we denja. Bɔt if yu gɛt kɔlon skɔpi, yu dɔktɔ kin fɛn dɛn.

Pipul wae gɛt `FAP` kin gɛt ɔndrɛd ɔ tawzin polip na dɛn kɔlon . Pipul dεm we gεt `AFAP` gεt at le 20. Bikɔs di polip dεm kin bכku εn de gro fast fast na `FAP`, dεn kin kכz di sik pas di polip dεm. Di sayn dɛm na:

• Blɔd we de kɔmɔt na di rɛktɔ
• Rɔnbɛlɛ
• Pɔsin we de fil pen na di bɛlɛ we nɔ de dɔn

Sɔmtɛm pipul dɛm wae gɛt FAP kin gɛt sɔm kayn sik wae dɔktɔ kin no na do:

• Dεrmatofibromas: Faybrous, lεk ska lכm dεm כnda di skin.
• Epidamal sist: na kεratin fulכp, sfεri lכm dεm we de כnda di skin.
• Osteomas: Na tכmכro dεm we nכ de fכm na di bon dεm. Dɛn kin si dɛn mɔ na di jawbon ɔ di skel.
• Ekstra tit ɔ tit dɛn we gɛt impak:Yu kin si dɛn tin ya pan ɛkstrem rayt fɔ di tit dɛn.
• di kכnεjital haypatrכfi fכ di rεtina pigmεnt εpitεlium (CHRPE): dεn kin si dεn tin ya we dεn de egzam di yay. Bɔt bɔku tɛm, dɛn nɔ kin mek pɔsin nɔ ebul fɔ si fayn.

Na us ej FAP simptom dɛn kin bigin?

insay FAP, di gכt fכ di kכlon kin bigin arawnd di ej 16. Insay AFAP, i kin stat sכmtεm leta. If yu mama ɛn papa ɛn dɔktɔ no se yu de pan denja fɔ gɛt dis sik, dɛn kin bigin fɔ tɛst yu afta yu dɔn ol 10. If yu nɔr du dat, dɛn kin no se yu gɛt dis sik bikɔs ɔf yu sayn dɛm.

Wetin na di men tin we kin mek pɔsin gɛt FAP?

Di men tin we kin mek FAP na di jin we kin chenj . Dɛn kɔl dis jin di adenomatous polyposis coli (APC) jin . Dɛn kin kɔl am bak wan jin we de stɔp di bɔdi we de mek i gɛt tumbu. dis min se dis jin de mek di sεl dεm nכ de gro we dεn nכ de kכntrכl εn fכ mek tכmכro. We jin muteshon apin, di wok we dis jin de du kin ambɔg.

di jin mכtεshכn we de mek FAP na jεmlayn mכtεshכn. Dis min se nɔto sɔntin we kin apin we pɔsin de liv, bɔt na sɔntin we kin apin we pɔsin gɛt bɛlɛ . Dis na sɔntin we dɛn kin pas frɔm wan jɛnɛreshɔn to ɔda jɛnɛreshɔn. If wan pan yu mama ɛn papa gɛt dis muteshon, yu gɛt 50% chans fɔ gɛt am. כltu, lεk 30% pan dεn mכtεshכn dεm ya na nyu (original mutations), dat min se dεn nכ de inhεrit . So, lɛk 30% pan di sik pipul dɛm we dɛn no se gɛt FAP kin nɔ gɛt ɛni famili histri bɔt di sik.

Wetin na di prɔblɛm dɛn we kin apin to FAP?

di mכst imכtant komplikεshכn fכ mεnεj insay FAP na kכlon kεnsar . Ɔpreshɔn fɔ pul yu kɔlon (colectomy) kin ridyus dis risk bad bad wan. Bɔt fɔ liv we yu nɔ gɛt kɔlon kin gɛt sɔm ifɛkt pan yu layf bikɔs di we aw yu de pas stɔl kin chenj. Yu kin nid fɔ yuz ileostomy paus ɔ ileal paus instead ɔf kɔlon.

Bikɔs di jin we de mek FAP de insay ɛvri sɛl na yu bɔdi, tumbu kin kam ɛnisay na yu bɔdi . Ɔda tumbu dɛn kin kam bak na do na di kɔlon, ɛn sɔntɛnde dɛn kin gɛt kansa. Yu dɔktɔ kin tɛl yu fɔ mek yu chɛk fɔ si dɛn kayn tɔŋ ya:

• di polip dεm we de na di duodenal/periampullary:dis dεm de divεlכp na di כp pat pan yu sכmכl intestכn (duodenum), כ usay di bayl dakt כ pankrεas dakt de jכyn di sכmכl intestin. Klose to ɔlman wae gɛt FAP kin divɛlɔp dɛn tin ya. Smɔl nɔmba pan pipul dɛn kin gɛt duodenal kansa, ampullary kansa, pankrias kansa na di dakt, ɔ bayl dakt kansa.
• Bεlε polip: Na lεk 90% pan di pipul dεm we gεt FAP kin gεt bεlε polip, bכt na 1% pan dεm de divεlכp to kεnsar.
• Desmoid tumors: Dis na tכmכro dεm we nכ de kεnsar we de fכm insay kכnektiv tisu. Dɛn kin apin pan lɛk 15% pan pipul dɛm wae gɛt FAP. Pan ɔl we dɛn nɔ gɛt kansa, sɔntɛnde (lɛk 5%) kin mek dɛn gɛt siriɔs wɛlbɔdi prɔblɛm ɛn ivin day. Dɛn kin rili agresiv, spre to strɔkchɔ dɛn we de nia, ɛn prɛs ɔ blok blɔd vesel, ɔgan, ɛn nɛv. I nɔ kin izi fɔ pul dɛn ɛn dɛn kin kam bak.
• Papillary thyroid cancer: Dis kayn tayroyd kansa kin apin pan lɛk 2% pan pipul dɛm wae gɛt FAP. I nɔ kin rili denja ɛn bɔku tɛm dɛn kin mɛn am.
• Liva kansa: Pikin dɛn we gɛt FAP, mɔ kin gɛt smɔl risk fɔ gɛt wan liva kansa we nɔ kin apin so ɔltɛm we dɛn kɔl ɛpatoblastoma.
• Medulloblastoma: Dis na kansa na yu bren. I kin apin wit Turcot syndrome, we gɛt fɔ du wit FAP. Ivin wit FAP, i rili rare.
• Rɛktal polip: If yu nɔ pul yu rɛktum wit yu kɔlon, yu de pan risk fɔ gɛt rɛktal polip, so yu go nid fɔ du prɔktoskɔpi ɛgzam ɔlsay na yu layf.

Aw yu go no fɔ tru if yu gɛt FAP?

If yu want fɔ no if yu dɔn gɛt di APC jin muteshon, yu kin no bay we yu du jenɛtik tɛst . Wan jenɛtik tɛst de tek wan sɛmpul pan yu DNA (lɛk blɔd ɔ saliva) ɛn luk fɔ sɔm patikyula jin muteshɔn dɛn. if yu gεt di mכtεshכn, di nεks step na fכ du kכlonoskopi fכ chεk fכ adenomas.

FAP dεn kin no we atכs 100 polip dεm de (20 if AFAP) εn di prεsεns fכ di APC jin mכtεshכn . FAP nכto di כnli hεridishכn kכndyushכn we de mek adenomatous polyps. MUTYH-associated polyposis na di sem kayn kכndyushכn, bכt i de kכz fכ wan mכtεshכn insay wan difrεn jin we dεn kכl MUTYH.

Wetin na di tritmɛnt plan fɔ pɔsin we gɛt FAP?

Di tritmɛnt plan fɔ FAP inklud layflɔng sɔvɛlayshɔn ɛn mandatory ɔpreshɔn.Insay di fɔs tɛm, if yu gɛt smɔl nɔmba pan di polip (ɔ AFAP), yu dɔktɔ kin pul dɛn wan bay wan we dɛn de du kɔlonɔskɔpi (polypectomy). We di polip dɛn kin rili big ɔ dɛn kin gɛt kansa, i kin nid fɔ du ɔpreshɔn.

Ɔpreshɔn

Mɔs pipul dɛn we gɛt klas FAP go nid fɔ gɛt tɔtal kɔlektɔmi we dɛn dɔn let twɛnti ɔ ali tati ia . Yu dɔktɔ go disayd ustɛm fɔ du yu ɔpreshɔn bay di patikyula tin dɛn we de mek yu gɛt prɔblɛm. I go tɔk to yu bak bɔt di difrɛn kayn kɔlektɔmi we yu kin gɛt.

we dεn pul yu kכlon, wan gap de kכmכt bitwin yu sכmכl intestin εn yu rεktum (כ anus). Sɔntɛnde, dɔktɔ we de du ɔpreshɔn kin kɔnɛkt dɛn tu ɛnd dɛn ya bak. Dɔn yu kin gɛt bɔdi muvmɛnt tru yu rɛktum lɛk aw yu kin du. if dat nכ posεbul, dεn go mek wan 'ostomy', we na nyu opin na yu bכdi fכ yu stכl kכmכt.

Skrin we dɛn de du

Yu mɛdikal tim go advays yu bɔt aw ɔltɛm yu fɔ gɛt skrinin tɛst fɔ difrɛn kayn tɔŋ dɛm, bay yu yon risk factor dɛm. fכ klas FAP, dεn kin rεkomεnd fכ du kכlonoskopi εvri ia frכm 10 ia te dεn kכlεktomi . Fɔ AFAP, di skrinin fɔ bigin ɛvri ia, bigin we dɛn ol 20 ia.

Afta yu kolεktomi, yu fכ kכntinyu fכ du sigmoidoscopy egzam, we de egzamin di lכw pat pan yu GI trakt. If yu gɛt wan pat pan yu rɛktum we lɛf, yu fɔ mek dɛn chɛk am ɛvri 6 to 12 mɔnt. If dεn pul yu rεktum εn riples am wit ileal paus, yu fכ mek dεn chεk am εvri 1 to 4 ia.

Ɔda tɛst dɛn we dɛn dɔn plan fɔ du kin bi:

• di כp εndoskopi: Dis lεk di kכlon sכkכpi, bכt dεn kin du am na di כp pat pan yu dijestiv sistεm. dεn kin pas εndoskop dכn yu trot εn insay yu bεlε εn di כp pat pan yu sכmכl intestin (duodenum) fכ chεk fכ polyp. If ɛni wan de, yu dɔktɔ kin pul dɛn di sem tɛm we dɛn de du am.
• Ultrasound test fɔ tayroyd ɔ liva kansa.
• CT skan (kɔmpyuta tomografi skan) ɔ MRI (magnɛtik rɛsɔnans imej) tɛst fɔ dɛsmɔyd tɔmɔs.

Yu tink se dɛn kin ebul fɔ stɔp FAP?

Jɛnɛtik kɔyl fɔ ɔndastand di risk fɔ pas di FAP kɔndishɔn to yu pikin dɛmI kin ɛp. We yu tɔk bɔt dɛn bad tin ya, dat kin ɛp yu fɔ plan yu famili. Bɔku tɛm, i nɔ pɔsibul fɔ mek di jenɛtik muteshɔn nɔ apin we yu gɛt bɛlɛ, bɔt difrɛn we dɛn de fɔ plan famili we yu kin tink bɔt.

Wetin na di layf we pɔsin we gɛt FAP de liv?

If dɛn nɔ trit am, di avɛrej layf we pɔsin kin liv na lɛk 42 ia . Bɔt if yu gɛt di rayt mɛrɛsin ɛn tritmɛnt, yu go ebul fɔ liv nɔmal layf . afta dεn dכn pul yu kכlon, yu big risk de kכmכt frכm כda dijestiv sistεm kεnsar dεm εn di mכr prכblεm ‘desmoid’ tכmכro dεm. Dɛn tin ya nɔ kin bɔku pas di kɔlon kansa.

If a gɛt dis sik, wetin a fɔ ɛkspɛkt?

If dɛn no se yu gɛt FAP, yu kin tink se dɛn go du dɔktɔ tɛst fɔ yu layf ɔl ɛn sɔntɛm dɛn go du bɔku ɔpreshɔn fɔ pul di tumbu dɛn . di tכmכro dεm we de divεlכp ausayd yu kכlon nכ kin bi kansa pas di polip dεm na yu kכlon. Pan ɔl we desmoid tumor nɔto kansa, sɔntɛnde i kin bi smɔl prɔblɛm ɔ big prɔblɛm.

Yu kin ɛkspɛkt fɔ gɛt tɔtal kɔlektɔmi ali na layf . Afta dat, yu intestin dεm kin kכnεkt bak, כ yu kin gεt ileal pouch כ ostomy. Ɛni wan pan dɛn opshɔn ya kin gɛt risk fɔ gɛt sɔm patikyula prɔblɛm dɛn. Bɔt yu kin stil liv lɔng, wɛlbɔdi layf afta yu dɔn pul kɔlektɔmi.

Na nɔmal tin fɔ fil bad ɛn wɔri we yu kam fɔ no se yu gɛt wan sik we yu de gɛt we go mek yu nid fɔ gɛt mɛrɛsin fɔ yu layf ɔl. Bɔt we yu dɔn no, yu kin du tin dɛn fɔ kɔntrol di prɔblɛm we yu gɛt fɔ gɛt kansa . Pan ɔl we ɔpreshɔn go mɔs bi na yu tumara bambay, dɔktɔ dɛn go tray fɔ mek i nɔ gɛt wan prɔblɛm.

Bɔku pipul dɛn kin gɛt laparoscopic prosidur fɔ pul di kɔlon, we dɛn kin du tru smɔl smɔl say dɛn we dɛn kɔt ɛn i kin wɛl kwik kwik wan . Pipul dɛn we gɛt ileal pouch kin gɛt fɔ du bɔku ɔpreshɔn, bɔt leta dɛn go ebul fɔ yuz di tɔylɛt lɛk aw dɛn bin de yuz am trade.

Di tin dɛn we impɔtant pas ɔl fɔ mɛmba frɔm wetin wi dɔn tɔk bɔt (Take-Home Message) .

Okay, so, frɔm wetin wi dɔn tɔk bɔt `FAP`, na di impɔtant tin dɛn we yu nid fɔ mɛmba:

• FAP na jεnεtik kכndishכn we kin pas dכn tru jεnereshכn.
• Dis kin mek ɔndrɛd ɔ tawzin polip dɛn fɔm na di kɔlon, we kin bi kansa.
• If dɛn nɔ trit am, di risk fɔ gɛt kansa na di bɔdi kin rili bɔku .
• I rili impɔtant fɔ bigin fɔ du kɔlonoskɔpi tɛst frɔm we yu yɔŋ (10-12 ia) .
• Di men tritmɛnt na ɔpreshɔn fɔ pul di kɔlon (colectomy) .
• Ivin afta dεn dכn pul di kכlon, dεn nid fכ sכk di bכdi f כ sכm pipul dεm fכ sכm tכmכro dεm we de divεlכp כdasay na di bכdi.
• Pan ɔl we dis na sik we pɔsin kin gɛt fɔ ɔl in layf ɛn we pɔsin fɔ kɔntrol, if pɔsin gɛt di rayt tritmɛnt ɛn tɛst am, i pɔsibul fɔ liv nɔmal layf we gɛt wɛlbɔdi .

If yu ɔ sɔmbɔdi na yu famili gɛt ɛni wan pan dɛn sik ya, ɔ if yu want fɔ no mɔ bɔt dis, go mɔs go to dɔktɔ . Fɔ no kwik kwik wan ɛn fɔ du sɔntin kwik kwik wan na di tin dɛn we impɔtant pas ɔl.

` FAP, Familial Adenomatous Polyposis, Jɛnɛtik Diziz, Kɔlɔn Polips, Kɔlɔn Kansa, APC Jin, Kolonoskopi, Kɔlektɔmi, Ɔpreshɔn