Omanyi kookolo ono atatera kubaawo akula mu lubuto (peritoneal mesothelioma)?

Oluusi owulira obulumi obutategeerekeka oba okuzimba mu lubuto? Owulira ng’oyagala okulya n’okugejja? Wadde ng’oluusi tubuusa amaaso obubonero buno, buyinza okuba obubonero obw’obulwadde obw’amaanyi obusirikitu. Leero tugenda kwogera ku kika kya kookolo ekitali kya bulijjo katono, naye nga kisaana okufaayo ennyo. Oyo kookolo ayitibwa `Peritoneal Mesothelioma`.

Obulwadde bwa Peritoneal Mesothelioma buno kye ki?

Mu ngeri ennyangu, `Peritoneal Mesothelioma` kookolo akula munda mu lubuto lwaffe, kwe kugamba, mu luwuzi olugonvu olubikka ekituli ky’olubuto, mu by’obujjanjabi, `peritoneum`. Lowooza ku kino, `peritoneum` eno eringa ekibikka ekikuumi ekiweweevu okwetooloola ebitundu ebikulu munda mu lubuto lwaffe, gamba ng'ekibumba, ebyenda, n'olubuto.

Kookolo ono okufaananako n’ebika ebirala ebya mesothelioma, atera okukwatagana n’okusooka okubeera n’ekintu ekiyitibwa asbestos. Oyinza okuba nga wali owulidde nti asibesito kintu ekikozesebwa okukola ebintu ebimu ebizimba. Kiba kya bulabe nnyo kubanga ebiwuzi ebigirimu bisobola okuleeta obuzibu obw’amaanyi singa obissa oba okubirya.

Obulwadde bwa Peritoneal mesothelioma kookolo akola nnyo era asaasaana mangu. Ebiseera ebisinga ne bwe kizuulibwa, kookolo aba yasaasaana dda mu lubuto lwonna. N’olwekyo, kizibu okukizuula nga bukyali.

Njawulo ki eriwo wakati wa Peritoneal Mesothelioma ne Pleural Mesothelioma?

`Peritoneal Mesothelioma` ne `Pleural Mesothelioma` zombi zikula mu membranes eziriko layini z’ebituli ebikulu n’ebitundu by’omubiri eby’omunda.

• Peritoneal mesothelioma ekula mu luwuzi oluli mu layini y’olubuto era nga lwetoolodde ebitundu by’olubuto, kwe kugamba, olubuto lwe twayogeddeko emabegako.
• Pleural mesothelioma ekula mu luwuzi oluli mu layini y’ekifuba naddala amawuggwe. Kiyitibwa ‘pleura’ (pleura).

Obuwuka buno bwombi bukolebwa ekika ky’obutoffaali eky’enjawulo ekiyitibwa `mesothelial cells`. Eno y’ensonga lwaki kookolo ono ayitibwa `mesothelioma`.

Ebika byombi ebya mesothelioma bitera okuba eby’obulabe, ekitegeeza nti biba bya kookolo . Obutoffaali buno obubi obw’omu kisenge ky’omubiri (mesothelial cells) bukula mangu era nga tebufugibwa, ne bwonoona ebitundu ebiramu ebibyetoolodde. Pleural mesothelioma kika kya kookolo ekisinga okubeerawo okusinga peritoneal mesothelioma.

Ani asinga okukwatibwa obulwadde buno? Kitera kitya?

Omuntu yenna asobola okulwala `Peritoneal Mesothelioma`. Kyokka tekitera kubaawo nnyo mu baana abato. Ebiseera ebisinga, obulwadde buno buzuulibwa mu bantu abali mu myaka gyabwe egy’obukulu 50.

Newankubadde nga `Peritoneal Mesothelioma` kye kika kya `Mesothelioma` ekyokubiri mu bungi (ekisooka ye `Pleural Mesothelioma`), era kookolo atatera kulabika nnyo. `Peritoneal Mesothelioma` ekula wakati wa 10% ne 20% ku balwadde bonna aba `Mesothelioma`. Teebereza, mu nsi nga America, abantu bano abapya wakati wa 400 ne 1000 bokka be bakwatibwa buli mwaka. Kale, wadde ng’abalwadde bano bayinza okubaawo ne mu Sri Lanka, omuwendo mutono nnyo.

Bubonero ki obulaga obulwadde bwa Peritoneal Mesothelioma? Oyinza otya okuzitegeera?

Eno nsonga nkulu nnyo kubanga ebiseera ebisinga, Peritoneal Mesothelioma telaga bubonero bwonna mu ntandikwa. Obubonero butandika okulabika nga kookolo amaze okusaasaana mu bitundu by’olubuto.

Akabonero akasinga okulabika kwe kuzimba amazzi mu lubuto. Kino era kiyitibwa `ascites`. Amazzi bwe gakuŋŋaana, olubuto lutandika okugaziwa n’okuzimba. Akabonero ak’okubiri akasinga okulabika kwe kulumwa olubuto.

Obubonero obulala buyinza okuli:

• Ascites : Awulira ng’olubuto lujjudde ate nga luzitowa.
• Okuzimba olubuto oba okuzimba : Engoye ziyinza okunywezebwa.
• Obulumi mu lubuto : Buno buyinza okuba obulumi obusaasaana mu lubuto lwonna, oba buyinza okuba obulumi obuwulirwa mu kifo kimu kyokka.
• Oyinza okuwulira ekizimba ekiruma mu lubuto olwa wansi .
• Okuziyira oba okuzibikira ekyenda : Kiwulira ng’olubuto lufuukuuse n’ofuna obuzibu okuyisa omusulo.
• Okuziyira n'okusiiyibwa .
• Omusujja ogutategeerekese n'okutuuyana ekiro .
• Okugejja mu ngeri etayinza kulowoozebwako .
• Emmere tewooma .

Ekikulu: Bw’osigala ng’olina obubonero buno obumu oba obusingawo, kikulu nnyo okugenda ew’omusawo akuwe amagezi. Tofaayo, obubonero buno bwonna si nti buva ku kookolo. Era ziyinza okuva ku mbeera endala ezitera okubaawo. Kyokka bulijjo kiba kirungi okwekebejjebwa.

Biki ebivaako n’ebiyinza okuvaako okulwala obulwadde bwa Peritoneal Mesothelioma?

Ekikulu ekiyinza okuvaako okulwala obulwadde bwa mesothelioma kwe kukwatibwa asibesito. Asbestos kintu kya fibrous ekikozesebwa mu kuzimba, okukola amazzi, emirimu gy’amasannyalaze, okuzimba akasolya, amakolero agamu agakola ebintu, n’amakolero g’emmotoka. Abantu bangi abakwatibwa obulwadde bwa mesothelioma balina emirimu egibaleetera asibesito.

Wabula wadde ng’abantu abasinga obungi abakwatibwa obulwadde bwa pleural mesothelioma (ekika ekikwata amawuggwe) balina ebyafaayo by’okukwatibwa asibesito, akakwate akaliwo wakati w’obulwadde bwa peritoneal mesothelioma (ekika ekikosa olubuto) ne asibesito tetegeerekeka bulungi. Abantu abamu abafuna obulwadde bwa peritoneal mesothelioma bayinza okuba nga tebaalina byafaayo bya kukwatibwa asbestos ku mulimu. Kino kikyanoonyezebwa.

Wano waliwo ebintu ebirala ebiyinza okuvaako okulwala `Peritoneal Mesothelioma`:

• Okukwatibwa asibesito : Ebiwuzi bya asibesito bwe biyingira mu butonde bwaffe, bifuuka bya mpewo. Bwe zikola bwe zityo, zisobola okuyingira mu mubiri gwaffe nga ziyita mu kamwa kaffe n’ennyindo, ne zitambula okutuuka mu kisenge ky’olubuto (peritoneum), ne zisula awo. Bwe zimala okusuza, zoonoona obutoffaali bw’omubiri (mesothelial cells) ne buba ne bwawukana mu ngeri etaali ya bulijjo. Kino kye kivaako ebizimba bya kookolo okutondebwawo. Teebereza, mesothelioma ebaawo oluvannyuma lw’emyaka oluvannyuma lw’okukwatibwa asibesito, oluusi okumala emyaka 40.
• Silica ne Erionite Exposure : Bino bye minerali ebya bulijjo ebisangibwa mu nsi. Okukwatibwa bino nakyo kizuuliddwa nti kikwatagana n’obulwadde bwa Pleural ne Peritoneal Mesothelioma.
• Enkyukakyuka mu buzaale : Okunoonyereza okumu kulaga nti singa oba okwatibwa asibesito n’ofuna enkyukakyuka ezimu mu buzaale, obulabe bwo obw’okufuna obulwadde bwa peritoneal mesothelioma buyinza okweyongera. Ekimu ku bikyukakyuka ebisinga okubeerawo kwe kukyuka mu buzaale obuyitibwa BAP1. Ensengekera eno eyitibwa BAP1 y’evunaanyizibwa ku kuziyiza kookolo okukula.
• Okukwatibwa emisinde : Okufuna obujjanjabi bw’amasannyalaze ku kookolo w’olubuto eyasooka nakyo kirowoozebwa nti kyongera obulabe bw’okufuna obulwadde bwa peritoneal mesothelioma. Wabula, okunoonyereza okusingawo kwetaagibwa okutegeera mu bujjuvu enkolagana wakati w’obusannyalazo n’akabi k’obulwadde bwa mesothelioma.

Omanya otya oba olina obulwadde bwa Peritoneal Mesothelioma?

Okuzuula obulwadde bwa Peritoneal Mesothelioma kiyinza okuba ekizibu, nga bwe twayogeddeko emabegako, kubanga emirundi mingi telaga bubonero mu ntandikwa. Obubonero bwe bulabika, buyinza okufaananako n’endwadde endala eza bulijjo ez’omu lubuto oba ebika bya kookolo ebirala. N’olwekyo, embeera zino eza bulijjo zitera okugobwa nga bakola okuzuula obulwadde.

Ebigezo bino wammanga osobola okubikola okuzuula obulwadde buno:

• CT scan : Omusawo ayinza okulagira okukeberebwa CT scan okugaana embeera endala ezireeta obubonero obufaananako n’obulwadde bwa peritoneal mesothelioma, gamba nga kookolo w’enkwaso oba adenocarcinoma. Kino kiyinza okuzingiramu okukuba langi etali ya bulabe (contrast) mu musaayi gwo okusobola okulabika obulungi ebintu ng’ebizimba mu lubuto lwo ku sikaani.
• MRI scan (Magnetic Resonance Imaging (MRI)) : MRI esobola okuwa omutindo gwe gumu ogw’obujjuvu nga CT scan. MRI eyinza okukolebwa singa tosobola kukola CT scan nga eriko contrast.
• Okukebera omusaayi: Omusawo ayinza okukebera obubonero obumu mu musaayi gwo, gamba nga puloteyina ezenjawulo, ekiyinza okuba akabonero k’ekizimba kya kookolo.
• Okwekenenya amazzi g’omu lubuto : Mu nkola eno, omusawo akuyingiza empiso mu lubuto lwo n’akwata sampuli y’amazzi ago okukebera obubonero bw’obulwadde bwa mesothelioma. Kyokka, okugezesebwa kuno kulina we kukoma. Ewa amawulire gokka ku mazzi agali mu lubuto lwo, so si bitundu ebiri mu lubuto lwo. Omutendera gwa kookolo gusinziira ku bungi bwa kookolo bw’asasaanye mu bitundu by’omubiri.
• CT-guided core needle biopsy oba laparoscopic biopsy : Engeri yokka ey’okukakasa okuzuula obulwadde bwa peritoneal mesothelioma kwe kulongoosebwa. Mu kino, omusawo wo akozesa okukuba ebifaananyi (nga sikaani) okuzuula ekifo ekituufu ekizimba kyo we kiri. Oluvannyuma nga bakozesa ebikozesebwa mu kulongoosa, batwala sampuli y’ebitundu by’omubiri ne bagisindika mu laabu okukeberebwa.

Mitendera ki egy’obulwadde bwa Peritoneal Mesothelioma?

Emitendera gya kookolo giraga obulwadde buno gye bugenda mu maaso n’okusaasaana. Enkola esinga okukozesebwa mu kusengeka obulwadde bwa peritoneal mesothelioma ye PCI (Peritoneal Cancer Index).

Mu nkola ya `PCI`, olubuto lwo lwawulwamu ebitundu 13, era buli kitundu kiweebwa obubonero okuva ku 0 okutuuka ku 3.

• 0 kitegeeza nti mu kitundu ekyo tewali kookolo.
• 3 kitegeeza nti ekitundu ekyo kibikkiddwa ddala kookolo.

Oluvannyuma omusawo agatta obubonero bwa buli kimu ku bitundu bino n’asalawo omutendera gwa kookolo. Omutendera 1 gwe mutendera ogusinga obutagenda mu maaso. Omutendera ogw’okuna gwe mutendera ogusinga okubeera ogw’omulembe.

• Omutendera 1: PCI obubonero okuva ku 1 okutuuka ku 10.
• Omutendera 2: PCI obubonero okuva ku 11 okutuuka ku 20.
• Omutendera 3: PCI obubonero okuva ku 21 okutuuka ku 30.
• Omutendera 4: PCI obubonero 31 okutuuka ku 39.

Bujjanjabi ki obw’obulwadde bwa Peritoneal Mesothelioma?

Enkola z’obujjanjabi zisinziira ku mutendera gwa kookolo wo, obulamu bwo okutwalira awamu, n’ensonga endala eziwerako.

Okulongoosa okukendeeza obuwuka n’obujjanjabi bwa HIPEC (Cytoreduction with HIPEC) .

Obujjanjabi obusinga okukozesebwa ku bulwadde bwa peritoneal mesothelioma bwe kugatta okulongoosa okukendeeza ku busimu obuyitibwa cytoreduction surgery ne hyperthermic intraperitoneal chemotherapy (HIPEC) .

• Cytoreduction : Kuno kulongoosa okuggya obutoffaali bwa kookolo munda mu lubuto lwo. Abasawo bajja kuggyawo ebizimba byonna ebirabika. Era ziyinza okuggyawo ebitundu by’olubuto n’ebitundu by’olubuto kookolo w’asasaanye.
• Eddagala eriweweeza ku bbugumu erisukkiridde mu lubuto (`HIPEC`) .: Kino kika kya ddagala lya njawulo eriweebwa oluvannyuma lw’okulongoosebwa okukendeeza ku busimu obuyitibwa cytoreduction. Eddagala lino erijjanjaba eddagala lino libuguma okutuuka ku bbugumu eritali lya bulabe ne liweebwa butereevu mu lubuto. Ebbugumu lino lifuula eddagala lino okuba ery’amaanyi ennyo okusinga eddagala erya bulijjo. HIPEC etta obutoffaali bwonna obutono obwa kookolo obuyinza okuba nga bwalekebwawo obutaggyibwamu nga balongooseddwa. HIPEC nayo erina ebizibu ebitono okusinga ku ddagala erya bulijjo.

Okulongoosa okukendeeza obutoffaali (cytoreduction surgery) ne HIPEC nkola nnene era nzibu era eziyinza okutwala essaawa ezisukka mu 10. Wabula okunoonyereza kulaga nti enkola eno ey’obujjanjabi eyamba abantu abalina obulwadde bwa Peritoneal Mesothelioma okuwangaala.

Obujjanjabi bw’eddagala

Bw’oba ​​tosobola kulongoosebwa cytoreduction ne HIPEC, oyinza okuweebwa systemic chemotherapy. Eddagala erijjanjaba eddagala eriyitibwa systemic chemotherapy litambula mu musaayi gwo ne litta obutoffaali bwa kookolo mu mubiri gwo gwonna. Ebika by’eddagala ery’enjawulo liyinza okuweebwa awamu.

Obujjanjabi bw’abaserikale b’omubiri

Eddagala erijjanjaba abaserikale b’omubiri eriyitibwa ``immune checkpoint inhibitors`` liyamba abaserikale bwo bennyini okuzuula n’okusaanyaawo obutoffaali bwa kookolo. Eddagala lino litera okukozesebwa okujjanjaba ``pleural mesothelioma.`` Omusawo wo ayinza n'okulikuwa okujjanjaba ``peritoneal mesothelioma.``

Obujjanjabi obugendereddwamu

Abantu abamu abalina obulwadde bwa peritoneal mesothelioma bayinza okuba n’enkyukakyuka mu buzaale mu butoffaali bwa kookolo waabwe. Kino kiyinza okujjanjabibwa n’obujjanjabi obugendereddwamu. Enzijanjaba ezigendereddwamu zikola nga zitunuulira butereevu enkyukakyuka mu buzaale ezireetera obutoffaali obulamu okufuuka obutoffaali bwa kookolo. Obujjanjabi buno buyinza okufunibwa ng’oyita mu musawo wo ajjanjaba kkansa, oba okuyita mu kunoonyereza okuyitibwa clinical trials okugezesa obukuumi n’obulungi bw’obujjanjabi obupya. Kikulu okukola okukebera obuzaale (gene testing) ku bitundu bya kookolo ebiggiddwa mu biopsy yo okulaba oba kookolo wo alina enkyukakyuka zino ez’obuzaale ezigendereddwamu.

Obulabirizi obukkakkanya obulumi

Okusobola okukuyamba okuddukanya obubonero bwa kookolo n’ebizibu ebiva mu bujjanjabi, omusawo ayinza okukuwa amagezi ku bujjanjabi obw’okukkakkanya obulumi. Bw’oba ​​tolina bulamu bulungi kimala kulongoosebwa, oba kookolo wo bw’aba ali ku mutendera ogw’amaanyi, obujjanjabi obukkakkanya obulumi buyinza okuba nga bwe businga obulungi gy’oli. Obujjanjabi obukkakkanya obulumi era buyinza okuzingiramu enkola nga paracentesis, eggyamu amazzi mu lubuto. Kino kiyinza okuyamba okukendeeza ku butabeera bulungi n’obulumi obuva ku mazzi agakuŋŋaanyiziddwa.

Oyinza otya okukendeeza ku bulabe bw’okukwatibwa obulwadde buno?

Engeri yokka ey’okukendeeza ku bulabe bw’okufuna obulwadde bwa Peritoneal Mesothelioma kwe...Okwewala okubeera mu mbeera ya asibesito. Mu myaka gya 1970, ebitongole nga Environmental Protection Agency (EPA) mu Amerika byassaawo amateeka ku nkozesa ya asibesito. Kyokka ebizimbe ebyazimbibwa nga amateeka ago tegannatandika kukola biyinza okuba nga bikyalimu asibesito. Singa ebiwuzi bya asibesito bitaataaganyizibwa, bisobola okufuuka eby’empewo ne bifuuka eby’obulabe ennyo.

Okukendeeza ku bulabe bwo, weewale okuddaabiriza oba okukyusaamu ebiyinza okukuleetera okukwatibwa asibesito. Mu kifo ky’ekyo, funa omukugu, gamba ng’omukugu mu kuggyawo asibesito, okukola emirimu egyo.

Essuubi lya ngeri ki ly’oyinza okuba nalyo ng’obeera n’obulwadde bwa Peritoneal Mesothelioma?

Obulwadde bwa Peritoneal mesothelioma si bulwadde buwonyezebwa ddala. Kyokka, obujjanjabi busobola okwongera ku bulamu bwo n’okutuuka n’okukuleetera okusonyiyibwa okumala ebiseera. Okukolagana ne ttiimu y’abakugu mu kujjanjaba kookolo abakugu mu kujjanjaba obulwadde bwa mesothelioma kiyinza okulongoosa ebiva mu bujjanjabi bwo. Okukolagana n’abakugu mu kujjanjaba obulwadde bw’okukkakkanya obulumi nakyo kisobola okutumbula omutindo gw’obulamu bwo nga bw’obeera n’obulwadde buno obwa kookolo.

Bintu ki ebikosa enteekateeka yo ey’okuteebereza?

Entegeera y’obulwadde bwo esinziira ku bintu ebiwerako:

• Ekika ky’obutoffaali : Waliwo ebika by’obutoffaali bisatu ebiyinza okukula ne bifuuka ebizimba. Ekika ekisinga okumanyibwa, ekiyitibwa epithelioid cells, kirina okuteebereza okulungi okusinga ebika by’obutoffaali ebirala ebibiri, sarcomatoid cells ne biphasic cells.
• Omutendera gwa mesothelioma yo : Singa obulwadde buzuulibwa ne bujjanjabwa nga bukyali, osanga ojja kuvaamu ebirungi.
• Ekikula kyo : Bwe kituuka ku Peritoneal Mesothelioma, abakyala balaze nti balina prognosis ennungi okusinga abasajja.
• Okuggyawo ebizimba mu bujjuvu : Singa omusawo asobola okuggyawo ebizimba byonna, enteekateeka yo eyinza okuba ennungi.
• Thrombocytosis : Bw’oba ​​olina obulwadde bwa thrombocytosis, prognosis yo eyinza okuba embi. Obulwadde bwa Thrombocytosis mbeera gy’obeera n’obutoffaali obuyitibwa platelets bungi mu musaayi gwo. Platelets butoffaali obuyamba omusaayi gwo okuzimba.

Osobola okumala bbanga ki ng’olina obulwadde bwa Peritoneal Mesothelioma?

Abantu abazuuliddwa nga balina obulwadde bwa Peritoneal Mesothelioma batera okuwangaala emyezi nga 6 ku 12 nga tebafunye bujjanjabi. Kyokka, n’obujjanjabi, omuwendo gw’abawona gubeera mulungi nnyo. Abalwadde ba Peritoneal Mesothelioma abalongoosebwa cytoreductive surgery ne HIPEC bawangaala emyaka ebiri ku mukaaga oluvannyuma lw’okuzuulibwa. Abantu abamu bawangaala nnyo.

Kyokka, enteekateeka yo ey’okuteebereza esinziira ku bintu ebiwerako. Omusawo wo y’asinga okutegeera ensonga ezigenda okukosa okuteebereza kwo, okusinziira ku bujjanjabi bwo.

Bibuuzo ki ebikulu by’olina okubuuza omusawo wo?

Bw’oba ​​ozuuliddwa ng’olina obulwadde bwa Peritoneal Mesothelioma, yogerako n’omusawo wo ku bintu bino:

• "Abasawo abakugu abagenda okunjjanjaba be baani?"
• "Kyasinga nze okufuna obuyambi okuva mu ttiimu y'abajjanjabi abakkakkanya obulumi?"
• "Nnina kika ki ekya mesothelioma?"
• "Kkookolo wange asaasaanidde wa? (Kwe kugamba, mutendera ki?)"
• "Bujjanjabi ki bwe nnina?"
• "Waliwo `clinical trials` (okunoonyereza okugezesa obujjanjabi obupya) kwe nsobola okwetabamu?"
• "Biki bye nsuubira okuva mu bujjanjabi obuliwo?"
• "Biki ebiva mu bujjanjabi? Biyinza bitya okufugibwa?"

N’ekisembayo, ebintu by’olina okujjukira...

Peritoneal Mesothelioma kookolo atatera kulabika naye nga wa maanyi. Okukwatibwa asibesito kiyinza okuba ekizibu ekinene okuvaako. Bw’oba ​​olina obubonero bwonna bwe twogeddeko, kikulu okugenda ew’omusawo mu bwangu.

Kya bulijjo okuwulira ng’otya n’okweraliikirira ng’otegedde ku bulwadde nga buno. Naye jjukira nti toli wekka. Olina abasawo, ab’omu maka gaabwe, n’emikwano egijja okukuyamba. Ekisinga obukulu kwe kufuna amawulire amatuufu, okwogera mu lwatu n’abasawo bo, n’okufunira obujjanjabi obusinga obulungi. Obujjanjabi busobola ddala okuyamba okwongera ku bulamu bwo n’okutumbula omutindo gw’obulamu bwo.

` Peritoneal Mesothelioma, kookolo, kookolo w’olubuto, asbestos, peritoneum, mesothelioma, HIPEC, obubonero, obujjanjabi