Cancer Cachexia: Kino tunaayogerako?

Bw’oba ​​ggwe oba omuntu gw’omanyi alina kookolo, oyinza okuba ng’okirabye nti ekiseera bwe kigenda kiyitawo, omubiri gwe gugenda gugonvuwa ne gutuuka n’okulabika ng’ogw’enjawulo. Abantu bangi balowooza nti kino kitundu kyokka ku kookolo oba ekizibu ekiva mu bujjanjabi. Ekyo kiyinza okuba nga kituufu okutuuka ku ddaala eritali limu. Kyokka, embeera eno oluusi eyinza okuba ekintu ekisingawo obuziba, embeera eyitibwa cancer cachexia . Kino ka twogere mu bujjuvu leero, kubanga kikosa omutindo gw’obulamu bw’abalwadde ba kookolo n’engeri gye bakwatamu obujjanjabi.

Obulwadde bwa Cancer Cachexia kye ki?

Mu ngeri ennyangu, kookolo cachexia bulwadde bwa kwonoona bwa maanyi obuva ku kookolo. Kino w'ofiirwa ebinywa by'amagumba n'amasavu mu mubiri . Si kugejja kwokka, wabula n’ebinywa ebiwa amaanyi. Okugejja kuno kuyinza okukyusa endabika yo, okukuleetera obuzibu mu nneewulira, n’okukaluubiriza okugumira obujjanjabi bwa kookolo. Era kiyinza okukosa omutindo gw’obulamu bwo n’oluusi okutaataaganya obusobozi bwo okugumira kookolo.

Abakugu bagamba nti embeera eno ekosa abalwadde ba kookolo nga 50% . Era, kiyinza okulabibwa mu bantu nga 75% kookolo waabwe asaasaanidde, kwe kugamba, mu kookolo ow’omutendera ogw’okuna . Eky’ennaku, embeera eno y’evunaanyizibwa ku bantu 25% abafa kookolo.

Wadde embeera eno esobola okubaawo mu kika kya kookolo kyonna, naddala etera okubeera mu bantu abalina ebika bya kookolo bino:

• Kookolo w’olubuto n’omumwa gwa nnabaana
• Kookolo w’amawuggwe
• Melanoma, ekika kya kookolo w’olususu
• Kookolo w’olubuto

Wadde ng’abasawo tebasobola kuwonya ddala bulwadde bwa kookolo obuyitibwa cachexia, obujjanjabi bugezaako okwongera ku bungi bw’emmere gy’olya naddala ng’essira liteekebwa ku mmere erimu ebirungo ebizimba omubiri ebingi, erimu kalori nnyingi .

Bubonero ki obwa kookolo cachexia?

Akabonero akakulu era akasinga okweyoleka mu mbeera eno kwe kukendeeza ku buzito bw’omubiri gwo bwonna ebitundu ebisukka mu 10% mu myezi 6 okutuuka ku 12 egiyise . Kuno kw’ogatta ebinywa n’amasavu. Ng’oggyeeko ekyo, wayinza okubaawo obubonero obulala obuwerako:

• Obukoowu n’obunafu obuyitiridde: Oyinza okuwulira nga tolina maanyi gamala kukola mirimu gyo egya bulijjo, okulabirira amaka go, oba n’okukola emirimu gyo egy’obuntu. Kiringa nga tolina bulamu.
• Okukendeera kw’ebinywa: Abasawo era kino bakiyita kwonoona binywa oba okukendeera kw’ebinywa . Kino kwe kufiirwa ebinywa n’okubula kw’ebinywa.
• Obulwadde bw’okwetamwa okulya: Kino w’obulwa obwagazi bwonna obw’okulya, towulira njala. Oluusi toyagala na kulowooza ku mmere. Naye kino kyawukana ku buzibu bw’okulya obuyitibwa anorexia nervosa bwe tuwuliddeko.
• Okukendeera kw’omusaayi: Oyinza okufuna okukendeeza ku musaayi kubanga omubiri gwo, mu kuddamu okuzimba, gufulumya ekirungo ekiyitibwa protein ekikosa okukola obutoffaali obumyufu.
• Obulwadde obutera okukwatibwa: Obulwadde bwa kookolo obuyitibwa cachexia busobola okunafuya abaserikale b’omubiri, ekigifuula obutasobola kulwanyisa ndwadde. Kino kiyinza okukuleetera okufuna yinfekisoni.

Lwaki cachexia eno eya kookolo ebaawo?

Waliwo ensonga eziwerako eziviirako kino. Kookolo ayanguyiza omubiri gwo . Kino kitegeeza nti omubiri gwo gwetaaga amaanyi mangi okuva mu mmere. Mu kiseera kye kimu, obujjanjabi bwa kookolo ne kookolo nabwo busobola okukendeeza ku njagala y’okulya. Ekivaamu kwe kulya kitono ng’omubiri gwo gwetaaga ebiriisa bingi.

Wano waliwo ensonga ezikosa embeera eno mu ngeri ey’enjawulo:

• Ebika ebimu ebya cytokines: Cytokines ddagala erifuga engeri n’ddi abaserikale baffe gye baddamu ebirumba nga akawuka. Mu kookolo cachexia, abaserikale b’omubiri bo bafulumya ebika ebimu ebya cytokines. Bino bireeta okuzimba, ekyongera ku sipiidi omubiri gwo kwe gumenya amasavu n’ebinywa. Kookolo naye aleeta okuzimba, era ebirungo bino ebiyitibwa cytokines bisobola okusajjula okuzimba okwo.
• Obubonero bwa kookolo n’ebizibu ebivaamu: Obulumi, okuziyira n’okusiiyibwa ebiva ku kookolo bisobola okukuleetera okulya obutono. Ate era bw’oba ​​olina kookolo kiyinza okukuleetera okuwulira ng’olina ekiwuubaalo n’okubulwa okulya.
• Ebizibu ebiva mu kujjanjaba kookolo: Ebintu nga okulongoosa, obujjanjabi obw’amasannyalaze , eddagala eriweweeza ku bulumi , n’eddagala erimu eriweweeza ku bulumi erya opioid bisobola okuleeta obuzibu mu kumira oba okutaataaganya obusobozi bw’omubiri okunyiga ebiriisa.
• Okuziyiza insulini: Kino kitegeeza nti ebinywa byo n’obutoffaali bw’amasavu tebiddamu bulungi insulini. Okuziyiza kuno kwa insulini, okubaawo mu cachexia, kuyinza okuvaako ebinywa okweyongera okwonooneka.
• Okwongera ku nkyukakyuka ya puloteyina: Okukyusa obutoffaali y’enkola puloteyina enkadde mu butoffaali bwo gye zikyusibwamu obutoffaali obupya. Kino kibaawo nga kiyita mu kuvunda kwa puloteyina . Mu cachexia ya kookolo, puloteyina mu butoffaali zimenya mangu nnyo puloteyina empya ne zitasobola kuzidda mu kifo kyazo. Kino nakyo kireeta ebinywa okuggwaawo.

Bizibu ki ebiva mu kookolo cachexia?

Embeera eno eyinza n’okuteeka obulamu bw’omuntu mu matigga. Okugeza lowooza ku cachexia, nga kino kye kisinga okufa mu balwadde 20% ku 25% abalina ebizimba ebigumu ebisaasaana, gamba nga kookolo w’amawuggwe oba enseke, kookolo bw’asaasaana mu bitundu by’omubiri ebirala .

Ebizibu ebirala ebiyinza okuvaamu biyinza okuli:

• Enkosa ku bujjanjabi bwa kookolo: Omubiri gwo gwetaaga ebinywa n’amasavu okusobola okuwona obujjanjabi bwa kookolo. Okufiirwa bino kiyinza okukosa obusobozi bwo okufuna obujjanjabi bwa kookolo. Oyinza n’okubulwa amaanyi ag’okugumira obujjanjabi obwo.
• Ensonga z’obulamu bw’obwongo: Okuzuulibwa nti olina obulwadde bwa kookolo cachexia kiyinza okutegeeza nti olina emyezi gyokka okuwangaala. Okumanya kuno kuyinza okukuleetera okweraliikirira ennyo n’okwennyamira.
• Ebikosa ab’omu maka n’emikwano: Embeera eno era esobola okukuteeka akazito ku nkolagana yo n’ab’omu maka go n’emikwano. Temukoma ku kuwulira nnaku ng’olaba enkyukakyuka mu mubiri gwo, naye n’abakulabirira bayinza n’okufaayo ennyo ku bulamu bwo. Okunoonyereza kulaga nti ab’omu maka bwe balaba obubonero buno, bayinza okuwaliriza omulwadde okulya, ne bwe kiba nga kiva ku kwagala, ekiyinza okuvaako obutakkaanya obuteetaagisa n’okwongera ku mbeera eyali emaze okunyigirizibwa.

Teebereza, omuntu w'omu maka bw'aba mugonvu olw'obulwadde bwa kookolo n'atasobola kulya, kya bulijjo okukkaatiriza nti, "Nsaba olyeko katono, nsaba naawe olye kino." Naye ekyo kiyinza n’okusingawo okunyigirizibwa omulwadde.

Abasawo bazuula batya obulwadde bwa kookolo obuyitibwa cachexia?

Omusawo wo akola ku bulwadde bwa kkansa ne/oba ttiimu yo ey’okujjanjaba obulwadde bw’okukkakkanya obulumi ejja kukukebera mu mubiri. Bayinza okukusaba okujjuzaamu ekibuuzo ekikwata ku ngeri gy’olya, era bayinza n’okukola ebigezo okupima obulamu bwo okutwalira awamu n’amaanyi g’ebinywa.

Okugatta ku ekyo, kiyinza okusemba okukeberebwa CT scan oba DXA scan . Sikaani eno eya DXA epima obungi bw’ebitundu ebigonvu mu mikono n’amagulu go. Kiyinza okuwa omusawo wa kkansa endowooza ku binywa byo. Ebinaava mu kukeberebwa kuno bijja kuyamba omusawo okumanya omutendera gw’obulwadde buno.

Mitendera ki egya kookolo cachexia?

Waliwo emitendera esatu emikulu egya kookolo cachexia:

• Pre-cachexia: Mu mutendera guno, oba okendeeza ku mugejjo wadde ng’olya bulungi. Wabula mu myezi 6-12 egiyise tokendeddeko bitundu bisukka mu 5% ku buzito bw’omubiri gwo bwonna. Bw’oba ​​omugejjo, okugejja kuno kuyinza obutalabika, naye okukeberebwa kulaga nti enkyukakyuka mu nkyukakyuka y’emmere ebaddewo era okendeeza ku binywa wamu n’amasavu.
• Obulwadde bwa Cachexia:We tutuukidde wano, okendedde ebitundu ebisukka mu 5% ku buzito bw’omubiri gwo mu myezi 6-12 egiyise, oba ng’okendedde ebitundu ebisukka mu 2% ku buzito bw’omubiri gwo, ate nga body mass index (BMI) yo eri wansi wa 20kg/m2. Okukebera kuyinza okulaga obubonero bw’okubula kw’ebinywa n’okuzimba.
• Refractory cachexia: Ku mutendera guno, obadde okendedde ebitundu ebisukka mu 20% ku buzito bwo obwa bulijjo era BMI yo eri wansi wa 27 kg/m2 (kino kiyinza okulabika ng’ekinene, naye kiba kya maanyi bwe kigatta n’okugejja ennyo). Okugejja kwo kuyinza okukuleetera obutalabika bulungi nnyo n’okukuleetera obutasobola kugumira bujjanjabi bwa kookolo. Mu mbeera ezimu, obujjanjabi bwa kookolo buyinza n’okulekera awo okukola.

Bujjanjabi ki obujjanjaba kookolo cachexia?

Obujjanjabi bwo okusinga bujja kussa essira ku ngeri y'okulongoosaamu endya . Okugeza, ttiimu yo eya kookolo ne ttiimu yo ey’okujjanjaba abalwadde ba kookolo bayinza okukuwa amagezi ku bintu nga:

• Lya bulungi: Essira lisse ku kulya emmere entonotono n’emmere ey’akawoowo erimu kalori nnyingi, amasavu, ne puloteyina . Okulya emmere entonotono kijja kukuyamba okufuna kalori nnyingi. Yogerako n’omukugu mu by’endya ku mmere ki egenda okukuyamba okufuna ekisingawo mu buli lw’olya. Bayinza okukuwa amagezi okugattako ebintu nga kkeeki, butto, entangawuuzi n’amata agataliimu mazzi mu mmere yo.
• Gezaako eddagala eriweweeza ku bulwadde: Buuza omusawo wo omukugu mu by’obulwadde bwa kkansa oba omukugu mu by’endya ku bikozesebwa mu kunywa oba okulya wakati w’emmere. Bino bisobola okuwa ebiriisa eby’enjawulo.
• Funa dduyiro: Dduyiro omutono asobola okuyamba okukendeeza ku kufiirwa ebinywa, naye kino kisaana okukikola ng’abasawo bakiwa amagezi.
• Weesigamye ku ttiimu yo ey’abasawo: Ttiimu yo ey’okujjanjaba abalwadde b’okukkakkanya obulumi esobola okukuyamba mu bintu ng’obulamu bw’obwongo n’obuyambi mu by’omwoyo. Obuwagizi obwo bwa muwendo nnyo mu kiseera kino.

Waliwo eddagala erijjanjaba obulwadde bwa cachexia?

Si mu kiseera kino. Wadde ng’okunoonyereza kulaga nti eddagala eriyitibwa megestrol acetate liyinza okwongera okwagala okulya n’okukuyamba okugejja, ekitongole kya U.S. Food and Drug Administration (FDA) tekinnakkiriza kujjanjaba kookolo cachexia. Mu mbeera ezimu, omusawo ayinza okukuwa eddagala eriweweeza ku bulwadde bwa corticosteroids ery’ekiseera ekitono .

Omuntu alina obulwadde bwa kookolo cachexia ayinza kusuubira ki?

Ddala kisinziira ku mbeera gy’olimu. Kwe kugamba, mutendera ki ogwa cachexia gw’oli, mutendera ki ogwa kookolo gw’oli mu.Okugeza, bw’oba ​​olina pre-cachexia, okukola enkyukakyuka mu by’olya kiyinza okukendeeza ku sipiidi gy’okendeeza ku masavu n’ebinywa. Naye, ebyembi, ne bw’oyongera ku bungi bw’olya, tosobola kuyimiriza ddala kufiirwa oba okuddamu okufuna ebinywa n’amasavu ebyabula.

Bw’oba ​​olina kookolo ow’omulembe n’obulwadde bwa cachexia, oba cachexia obutaddamu bujjanjabi (refractory cachexia), omusawo wo ow’obulwadde bwa kookolo ayinza okugamba nti anaatera okuggwaako. Bw’oba ​​ojjanjabwa obulwadde bwa cachexia, ttiimu yo ey’abasawo esobola okukuwa amawulire agasinga obulungi ku by’osuubira.

Omuntu alina obulwadde bwa kookolo cachexia awangaala ki?

Obulamu obusuubirwa bwawukana okusinziira ku muntu. Wadde nga kookolo cachexia etera okukwata abantu abalina kookolo ow’amaanyi, osobola okufuna obubonero nga tonnaba kukwatibwa kookolo ku mutendera gwonna ogwa kookolo wo. Ekyo bwe kibaawo, osobola okubeera n’ebizibu nga kookolo ne cachexia okumala emyaka. Wabula okunoonyereza kulaga nti okubeera n’obulwadde bwa kookolo obutawona (refractory cancer cachexia), nga kino kika kya kookolo ataddamu bujjanjabi, kikendeeza ku mikisa gyo egy’okuwona kookolo ebitundu nga 30%.

Cancer cachexia ebaawo kubanga obulwadde buno buleetera omubiri gwo okukozesa amaanyi agava mu mmere mu bwangu okusinga ku bulijjo. Ng’oggyeeko ekyo, obujjanjabi bwa kookolo ne kookolo busobola okukulemesa okulya obulungi. N’ekyavaamu, obuzito bwo n’ebinywa byo bisobola okukendeera ennyo, ne bikosa endabika yo (n’okwessaamu ekitiibwa), amaanyi go, n’omutindo gw’obulamu bwo.

Wadde nga tewali bujjanjabi bwa njawulo ku bulwadde bwa kookolo obuyitibwa cachexia, waliwo ebintu by’oyinza okukola okuyamba okuddukanya obubonero bwayo. Bw’oba ​​ofuna kino, saba ttiimu yo ekola ku kookolo akuyambe. Bategeera okusoomoozebwa okuli mu kubeera n’obulwadde bwa kookolo obuyitibwa cancer cachexia era bajja kukola kyonna ekisoboka okukuyamba okubuddukanya.

Obubaka Obutwala Awaka

• Cancer cachexia si kitundu kya kookolo yennyini, wabula embeera ya njawulo eyeetaaga okuddukanyizibwa. Bw’oba ​​ggwe oba omuntu wo mugejja, tayagala mmere oba ng’okooye nnyo, yogerako n’omusawo wo.
• Endya kikulu nnyo. Okulya emmere entonotono, enfunda eziwera nga mulimu kalori nnyingi ne puloteyina, n’okunoonya amagezi g’abasawo ku mmere erimu ebiriisa kiyinza okuyamba okuddukanya embeera eno.
• Toli wekka. Waliwo abakugu mu by’obulwadde bwa kookolo, ba nurse, abakugu mu by’endya, ne ttiimu z’abajjanjabi abakendeeza ku bulwadde okukuyamba mu lugendo luno. Funa obuwagizi bwabwe.
• Obulamu bw’obwongo nakyo kikulu nnyo. Ng’oggyeeko enkyukakyuka mu mubiri, n’okwennyamira kuyinza okubaawo. Yogerako ne ttiimu yo ey’abasawo ku nsonga eno ofune obuyambi obwetaagisa.

Okulwanyisa kookolo si kyangu. Kizibu okugumira okusoomoozebwa okulala nga kuno. Naye, singa omuntu amanyi n’obuwagizi obutuufu, okusoomoozebwa kuno kuyinza okuvvuunukibwa.

` Kookolo cachexia, kookolo, okwonoona, okwonoona ebinywa, endya, anorexia, obujjanjabi bwa kookolo