Omwana wo obuulidde ku High-Grade Glioma? Ka twogere ku nsonga eyo.

Kizibu okuteeka mu bigambo bwe kiwulira ng’omuzadde okuwulira nti omwana wo alina kookolo w’obwongo. Ebibuuzo bingi nnyo ebijja mu birowoozo mu kiseera nga kino. Kale, leero tugenda kwogera ku High-Grade Glioma, ekika ky’ekizimba ky’obwongo eky’amaanyi, ekisaasaana amangu. Tusuubira nti amawulire gano gajja kukuwa okutegeera n’amaanyi mu lugendo luno oluzibu.

Glioma ow’eddaala erya waggulu kye ki? Ka tukitegeere mu ngeri ennyangu ennyo.

Mu ngeri ennyangu, glioma ow’omutindo ogwa waggulu kika kya kookolo akula mangu nnyo mu bwongo oba mu mugongo gw’omwana wo. "Glioma" kitegeeza ekizimba. Ebizimba bino bitondebwa ekika ky'obutoffaali obuyitibwa "glial cells" bwe kitandika okwekutula ne kikula amangu nga tekifugibwa. Obutoffaali buno obwa glial kika kya butoffaali obuwanirira n’okuliisa obusimu obuyitibwa neurons oba obusimu mu nkola yaffe ey’obusimu obw’omu makkati.

"High-grade" kitegeeza nti ekika kino ekya glioma kikula mangu nnyo era kya bukambwe . Mu butuufu, gliomas ez’omutindo ogwa waggulu ziyinza obutawona bulijjo. Kino kiri bwe kityo kubanga zisinga kusoomoozebwa kujjanjaba. Kino kiri bwe kityo kubanga obutoffaali buno obwa kookolo busaasaana mangu nnyo mu bwongo oba mu mugongo. Era zikula nga zilumba ne zikwatagana n’obutoffaali obulamu. Teebereza engeri gye kizibu okuggyawo kookolo yekka nga tofunye bulabe ku bitundu biramu ng’obutoffaali obulamu n’obutoffaali bwa kookolo bikwatagana. Y’ensonga lwaki oluusi kiba kizibu okuziggyawo ddala ng’olongooseddwa.

"Eddaala" lya gliomas ery'omutindo ogwa waggulu kye ki?

Ekitongole ky’ebyobulamu mu nsi yonna (WHO) kigabanya gliomas okusinziira ku ngeri gye zikulamu n’obuzibu bwazo. Okusinziira ku kino, waliwo ebika bibiri: "eby'ekigero ekya wansi" (ebitali bya maanyi nnyo, ebibinja 1 ne 2) ne "eby'ekigero ekya waggulu" (ebisingako obuzibu, ebibinja 3 ne 4). Gliomas ez’omutindo ogwa waggulu bizimba ebikula amangu nga biri mu ddaala lya 3 oba 4.

Gliomas ezimu mu bantu abakulu ziyinza okutandika nga za ddaala lya wansi ate oluvannyuma ne zifuuka ez’omutindo ogwa waggulu. Kyokka, ekyewuunyisa, gliomas ez’omutindo ogwa waggulu mu baana zitera okutandika nga za ddaala lya waggulu. Wabula, gliomas ez’omutindo ogwa wansi mu baana okusinga zijjanjabibwa era tezitera kufuuka za mutindo gwa waggulu.

Wa mu bwongo gliomas ez’omutindo ogwa waggulu we zisinga okubeera?

Gliomas ez'omutindo ogwa waggulu zisinga kukula mu "supratentorial compartment" y'obwongo, oba ekikolo ky'obwongo.

• Supratentorial compartment: Kino kye kitundu ky’obwongo ekirimu obwongo, thalamus ne hypothalamus. Ebizimba bino bisobola okuva mu butoffaali bwa glial obusangibwa wano.
• Ekikolo ky’obwongo:Gliomas zino ez’omutindo ogwa waggulu nazo zisobola okukula mu kitundu ky’obwongo ekiyitibwa ``pons``. Kino kiyitibwa ekika eky'enjawulo ekya ``Diffuse Intrinsic Pontine Gliomas'' (DIPG). Ekika kya DIPG kino kya bukambwe nnyo era kizibu okujjanjaba.

Ekifo ekizimba we kiri kikulu nnyo, kubanga kye kijja okusalawo obujjanjabi omwana wo bw’ayinza okukozesa. Ng’ekyokulabirako, ebizimba mu kikolo ky’obwongo ebiseera ebisinga tebisobola kuggyibwawo mu ngeri ya kulongoosa.

Ani asinga okukosebwa embeera eno?

Glioma ow’omutindo ogwa waggulu asobola okubaawo mu baana abawere, abaana abakulu, abato abakulu, n’abantu abakulu. Wabula, glioma ey’omutindo ogwa waggulu mu baana abawere n’abaana abato ya njawulo ku glioma ey’omutindo ogwa waggulu mu bavubuka n’abantu abakulu. Olw’enjawulo zino, enzijanjaba y’abaana abawere n’abaana abato eyinza okuba ey’enjawulo.

Glioma ey’omutindo ogwa waggulu etera etya?

Gliomas ez’omutindo ogwa waggulu kye kika eky’okubiri ekisinga okubeera mu kizimba ekibi ku bwongo mu baana. Zikola wakati wa 10% ne 20% ku bizimba byonna ebikosa obusimu obw’omu makkati mu baana.

Bubonero ki obw’obulwadde bwa glioma obw’omutindo ogwa waggulu?

Obubonero buyinza okwawukana okusinziira ku mwana. Bisinziira ku kitundu ki eky’obwongo (oba omugongo) ekizimba kye kikosezza, emyaka gy’omwana, n’amangu ekizimba kye kikula. Obubonero buno businga kuva ku kizimba okussa puleesa ku bwongo ne kivaako okuzimba.

Akabonero akasinga okulabika kwe kulumwa omutwe. Kino kituufu naddala singa omutwe guwerekerwako okuziyira oba okusiiyibwa. Okulumwa omutwe kuno kusinga kukwata ku makya. Oluusi, kiyinza okuba eky’amaanyi ennyo ne kikuzuukusa ekiro. Teebereza omwana omuto ng’alina obuzibu bwe butyo.

Obubonero obulala obuyinza okulabibwa mulimu:

• Okukaluubirirwa okulaba, okuwulira oba okwogera (okulaba okuzibu, okubulwa okuwulira, okwogera obubi).
• Okubulwa bbalansi oba okunafuwa kw’ebinywa (ataxia), gamba ng’okukaluubirirwa okutambula oba okukwata ebintu.
• Okutabulwa oba okubulwa okujjukira.
• Otulo buli kiseera, okuwulira ng’okooye.
• Okukonziba (nga okugwa) .

Abalongo abato ennyo (abaana abawere) bayinza okulaba okukaaba okutali kwa bulijjo, okunyiiga, enkyukakyuka mu ngeri gye balya (nga obutanywa mata). Era oluusi bayinza okwetegereza emitwe gyabwe nga gikula katono, era ebifo ebigonvu (fontanelles) oba "entobazzi" waggulu ku mitwe gyabwe biyinza okweyoleka.

Lwaki gliomas zino ez’omutindo ogwa waggulu zikula? Biki ebivaako?

Mu butuufu, abanoonyereza n’okutuusa kati tebamanyi nsonga ntuufu lwaki kino kivuddeko.Mu bantu abakulu, obujjanjabi obw’amasannyalaze obusookerwako buzuuliddwa nti buyinza okuleeta ebizimba bino. Kisoboka okuba nti abaana nabo bayinza okukosebwa ensonga ezifaananako ez’obulabe ez’ebweru oba ez’obutonde, naye okunoonyereza okulala kwetaagibwa.

Kyokka, obulwadde obumu obw’obuzaale obusikira obutatera kulabika nnyo busobola okwongera ku bulabe bw’okufuna glioma ey’omutindo ogwa waggulu mu baana. Embeera y'obuzaale bwe bulema oba obutali bwa bulijjo mu buzaale, nga buno bwe "code" ebuulira obutoffaali engeri gye bukola.

Wano waliwo embeera ng’ezo:

• Obulwadde bw’obusimu ekika-1 (`Obulwadde bw’obusimu ekika-1 - NF1`)
• Obulwadde bwa Turcot syndrome
• Obulwadde bwa Li-Fraumeni

Wabula kikulu okujjukira nti abaana bangi abalina glioma ey’omutindo ogwa waggulu tebalina byafaayo bya famire ya mbeera eno.

Glioma ow’omutindo ogwa waggulu azuulibwa atya?

Omusawo w’omwana wo ajja kusooka kwetegereza n’obwegendereza obubonero bw’omwana wo n’ebyafaayo by’obujjanjabi. Olwo, okukebera obwongo, oba `okukuba ebifaananyi`, kuyinza okukolebwa okulaba oba ekizimba kiriwo era oba kye kireeta obubonero. Singa ekizimba kibaawo, `biopsy` ejja kukolebwa okuzuula obukakafu oba kookolo (malignant) oba benign (benign).

• Okukuba ebifaananyi: Sikaani ya MRI (Magnetic Resonance Imaging) ne CT scan (Computed Tomography scan) bisobola okuyamba abasawo okulaba ebizimba mu bwongo oba mu mugongo gw’omwana wo. MRI naddala MRI ey’enjawulo esobola okufulumya ebifaananyi ebitegeerekeka obulungi era ebikwata ku nsonga eno okusinga CT scan. MRI ekozesa magineeti n’amayengo ga leediyo okukola ebifaananyi by’ebintu ebiri munda mu mubiri ku ssirini ya kompyuta. Okwawukanako n’ekyo MRI, langi etaliimu bulabe efukibwa mu mukono gw’omwana wo. Kino kifuula ebitundu ebirimu ebizimba okulabika obulungi ku ssirini.

• Biopsy: Enkola ey'enjawulo eyitibwa "stereotactic biopsy" esobola okuzuula ekifo ekituufu ekizimba we kiri n'aggyayo akatundu akatono ak'ekitundu n'akasindika mu laabu. Olwo, omukugu ayitibwa "pathologist" akebera obutoffaali okulaba oba butoffaali bwa glioma obw'omutindo ogwa waggulu. Ebigezo bino era bisobola okuzuula engeri ezimu ez’obutoffaali bwa kookolo. Engeri zino oluusi zikozesebwa okuzuula obujjanjabi. Ng’ekyokulabirako, obujjanjabi obumu obupya obwa kookolo bukoleddwa okukola ku bika by’obutoffaali bwa kookolo ebimu byokka. Kale, ebigezo bino era bisobola okuyamba okuzuula oba omwana wo mulungi okuweebwa obujjanjabi obwo.

Oluusi bwe kiba kisoboka, abasawo baggyawo ekizimba kyonna mu kifo ky’okutwala akatundu akatono ne bakikebera.Olwo, awamu n’okuzuula, obujjanjabi (okulongoosa) nabwo bubaawo.

Kyokka, okukebera omubiri (biopsy) kuyinza obutasoboka bulijjo mu gliomas ez’omutindo ogwa waggulu. Okusinziira ku kifo ekizimba we kiri (okugeza mu kikolo ky’obwongo), okutwala ekitundu ky’omubiri kiyinza okwonoona ebitundu ebikulu eby’obwongo. Mu mbeera ng’ezo, abasawo beesigama ku kukebera ebifaananyi okusobola okuzuula obulwadde buno.

Glioma ow’omutindo ogwa waggulu asobola okuwona ddala?

Kino kye kibuuzo ekisinga obunene mu birowoozo bya buli muntu. Kizibu okuwa eky’okuddamu ekitereevu. Waliwo ebintu bingi ebikosa kino, gamba ng’emyaka gy’omwana, enkyukakyuka ki ez’obuzaale eziri mu butoffaali bwa kookolo, n’obungi bw’ekizimba obwaggyibwawo nga bamulongoosa.

Bujjanjabi ki obuweebwa obulwadde bwa glioma obw’omutindo ogwa waggulu?

Ebigendererwa ebikulu mu bujjanjabi kwe kuggyawo ekizimba, okuyimiriza oba okufuga okukula kw’ekizimba, n’okuwa omwana obuweerero nga bakendeeza ku bubonero.

Okusinziira ku kika ky’ekizimba, ekifo we kiri, n’ensonga endala, abakugu abawerako bayinza okwenyigira mu kulabirira omwana wo. Ttiimu eno eyinza okubaamu omusawo alongoosa obusimu, omukugu mu by’obusimu, omukugu mu by’obusimu, omukugu mu by’endwadde z’omubiri (radiation oncologist), omusawo w’endwadde z’omu lubuto, omusawo akola ku by’omubiri (nurse practitioner), n’omukozi w’ensonga z’abantu.

Ekimu oba ebisingawo ku bino wammanga biyinza okukozesebwa ng’obujjanjabi:

• Okulongoosa: Okulongoosa bwe bujjanjabi obukulu eri gliomas ez’omutindo ogwa waggulu ezisobola okuggyibwawo awatali bulabe. Wano, omusawo agezaako okuggyawo ekizimba ekinene nga bwe kisoboka nga tayonoona bitundu biramu ebikyetoolodde.
• Obujjanjabi bw’amasannyalaze: Obujjanjabi bwa ‘focal radiation therapy’ bujjanjabi bwa mutindo eri abaana abasukka mu myaka 3. Abaana abato ennyo batera obutaweebwa bujjanjabi bwa masanyalaze kubanga buyinza okukosa enkula y’obwongo bwabwe. Obujjanjabi buno buzingiramu ekyuma ekikozesa ebyuma ebikuba ebifaananyi eby’amaanyi (X-rays) okutuuka ku kizimba, nga kifaayo obutakwonoona bitundu biramu ebibyetoolodde. Obujjanjabi bw’amasannyalaze bukendeeza ku bizimba, butta obutoffaali bwa kookolo, era bukendeeza ku bubonero.
• Chemotherapy: Olw’okuba abaana abato ennyo tebasobola kufuna bujjanjabi bwa radiation, chemotherapy ekozesebwa okufuga okukula kw’ebizimba. Chemotherapy ekozesa eddagala okutta obutoffaali bwa kookolo. Kyokka, wakyaliwo okukubaganya ebirowoozo ku ngeri eddagala ly’eddagala gye likola obulungi ku gliomas ez’omutindo ogwa waggulu. Wadde ng’eddagala erimu erya Chemotherapy, nga temozolomide, likola bulungi ku bika ebimu ebya gliomas mu bantu abakulu, eddagala lye limu terikola nnyo mu baana.
• Obulabirizi obukkakkanya obulumi:Abakugu mu kujjanjaba omwana wo basobola okukuyamba okusalawo ebijja okuyamba okukuuma omutindo gw’obulamu bw’omwana wo ng’ajjanjabibwa. Era basobola okukuwa amagezi ku ngeri gy’oyinza okuyambamu omwana wo okugumira obulwadde buno n’okufuna obuweerero okuva ku bubonero.

Glioma ow’omutindo ogwa waggulu atera okuddamu oluvannyuma lw’okujjanjabwa. Singa kino kibaawo, omusawo wo ayinza okukuwa amagezi ku "bujjanjabi obugendereddwamu." Zino bujjanjabi obutunuulira molekyu zokka ezitali za bulijjo (ezireetebwa enkyukakyuka mu buzaale) mu kizimba ky’omwana wo. "Enzijanjaba zino ezigendereddwamu molekyu" ziyinza okufunibwa okuyita mu "kugezesebwa okw'obujjanjabi." Okugezesebwa mu malwaliro kwe kunoonyereza okugezesa obukuumi n’obulungi bw’obujjanjabi obupya.

Oluusi, singa eddagala lino ery’obujjanjabi erigendereddwamu liba ku katale, oba singa okunoonyereza okwakolebwa emabegako kulaga nti likola bulungi ku kika kya glioma ky’omwana wo, omusawo wo ayinza okusobola okulikuwa ebweru w’okugezesebwa mu malwaliro.

Biki ebiva mu bujjanjabi buno?

Yogerako n’omusawo wo ku biyinza okuva mu bujjanjabi obw’enjawulo. Wadde ng’abasawo bafuba nga bwe basobola okwewala okwonoona ebitundu ebiramu mu kiseera ky’obujjanjabi obw’amasannyalaze, ebitundu ebimu ebiramu bikyayinza okukosebwa. Okusinziira ku bitundu by’obwongo ebikoseddwa, obujjanjabi obw’amasannyalaze busobola okukosa enkola y’obwongo, okukula kw’omwana, n’okutaataaganya okukola obusimu.

Kikulu nnyo okukubaganya ebirowoozo n‟obwegendereza n‟okupima emigaso n‟obulabe obuyinza okuva mu bujjanjabi ne ttiimu y‟abasawo ejjanjaba omwana.

Kiki kye nsuubira singa omwana wange alina obulwadde bwa glioma obw’omutindo ogwa waggulu?

Entegeera y’omwana wo esinziira ku bintu bingi, omusawo wo by’ayinza okukubaganyaako ebirowoozo naawe. Ekika ky’obutoffaali obukoseddwa, engeri obutoffaali obwo, n’obungi bw’ekizimba bwe bwaggyibwawo nga balongoosebwa byonna bye bisalawo ekivaamu.

Buuza omusawo wo ky’osuubira okusinziira ku mbeera y’omwana wo entongole.

Omuwendo gw’okuwangaala ku glioma ey’omutindo ogwa waggulu guli gutya?

Ekizimba eky’ekika kino kitera okudda oluvannyuma lw’okujjanjabwa. Omuwendo gw’emyaka etaano egy’okuwangaala ku gliomas ez’omutindo ogwa waggulu mu baana guli wansi wa 20%. Wabula kikulu okumanya nti ebizimba bino bya njawulo nnyo ku birala. Zikula mu bifo eby’enjawulo, era engeri obutoffaali obuzirimu za njawulo. Enjawulo zino ziyinza okukosa ebiseera by’omwana wo eby’omu maaso.

Bibuuzo ki bye nnina okubuuza omusawo?

Waliwo ebibuuzo ebitabalika ebijja mu birowoozo mu kiseera nga kino. Naye tewerabira okubuuza omusawo wo ebibuuzo bino:

• Bujjanjabi ki obuliwo eri omwana wange?
• Ekifo ekizimba we kiri kikwata kitya ku ngeri y’obujjanjabi?
• Obulabe ki obuli mu bujjanjabi?
• Biki bye tusaanidde okusuubira okuva mu bujjanjabi?
• Nsaanidde kulabirira ntya omwana wange mu kiseera ky’obujjanjabi?
• Omwana wange ajja kwetaaga okujja emirundi emeka okujjanjabibwa n’okugoberera?

N’ekisembayo, ebintu by’olina okujjukira

Okufuna okuzuulibwa nti olina glioma ey’omutindo ogwa waggulu kiyinza okuba ekintu ekizibu ennyo. Kookolo ono asaasaana mangu, era ebizimba bisobola okudda ne bwe biba bimaze okujjanjabibwa. Emirundi mingi ojja kuba olina okupima emigaso gy’obujjanjabi n’ebizibu ebivaamu by’otayagala omwana wo.

Kozesa ebintu byonna ebiriwo okuyamba ggwe, omwana wo, n’ab’omu maka go abalala mu kiseera kino. Yogerako n’omusawo wo ku ngeri y’obujjanjabi n’okugezesebwa mu malwaliro. Bwe wabaawo empeereza y‟okujjanjaba obulwadde bw‟okukkakkanya obulumi, batuukirire. Kakasa omwana wo nti bulijjo mujja kumuwagira nga bwe muyolekagana n’okuzuula kuno nga muli wamu. Kino kijja kuba kya maanyi nnyo gye bali.

` Glioma, Kookolo w’obwongo, Kookolo w’abaana, Glioma ow’eddaala erya waggulu, Okulongoosa obusimu, Okujjanjaba amasannyalaze, Chemotherapy