I fa hian hetiang hian thluaka tumor a nei em? (Diffuse Intrinsic Pontine Glioma - DIPG) Hemi chungchang hi kan sawi dawn em ni?

I fate hriselna ngaihtuah hian stress nasa tak i neih hi thil pangngai a ni. A châng chuan, naupangte nghawng thei natna kan hriat hian kan buai tak zet a ni. Vawiin hian thluaka natna hrik (brain tumor) chungchang kan sawi dawn a, chu chu a na zawk deuh a, mahse a fimkhur a pawimawh hle. Diffuse intrinsic pontine glioma an ti a, a tawi zawngin ``DIPG'' an ti bawk.

DIPG chu eng nge ni? He hming hian eng nge a awmzia?

He hming hi sei deuhin lang mah se, a awmzia hriat hian he natna chungchangah hian ngaihtuahna engemaw zat a pe thei che a ni. A peng hrang hrangte awmzia i han en teh ang.

• Diffuse: Hei hi hmun khata lump ang a ni lo. Cancer cell te hi a darh zau a, cell hrisel nen an inhmeh hle. Tui glass khata dye drop khat i dah chuan glass chhung zawngah a darh vek ang mai a ni. Chuvang chuan surgery hmanga lakchhuah a harsat em em a ni. A chhan chu heng cell darh zau tak takte hi a hrisel lam tichhe lovin paih chhuah theih a nih loh vang a ni.
• Intrinsic: Hei hi naupang thluak bul chhungah a awm a. Chu chu a inzawm tlat a, a chhungril thuk takah a lut tihna a ni.
• Pontine: Pontine tih hian thluak bul chhunga pons an tih chu a kawk a ni. He pons hi hmun pawimawh tak a ni. Kan taksaa nunna atana thil pawimawh ber ber, thisen sang, thinlung na leh thawk dan te a thunun a ni. Chu mai ni lovin, mit hmuhna, hriatna, thusawi, leh balance ang chi thilte pawh a thunun bawk. Chuvangin hei hi heng `(DIPG)` tumor te hi a hlauhawm em em chhan pakhat a ni.
• Glioma: Glioma chu glial cells cancer a nih chuan tumor a lo awm thin a ni. Heng glial cells te hi kan central nervous system (CNS) a nerve cells, a nih loh leh neurons te humhimtu cell chi khat an ni.

A awlsam zawngin DIPG hi naupang thluak bul atanga lo chhuak, pons-a glial cells atanga lo chhuak, malignant tumor a ni. A lo thang chak hle a, glioma grade sang tak anga ngaih a ni.

DIPG leh DMG (Diffuse Midline Glioma) hi eng nge an danglamna?

`(Diffuse Midline Glioma - DMG)` tih pawh i hre tawh mai thei. Tun hma chuan `(DIPG)` leh `(DMG)` tih hi inthlengin an hmang thin a. `(DIPG)` pawh hi `(DMG)` category-ah a tel ve bawk. `(DMG)` type hi thluak lai takah a lo thang lian thin. Chu chu `(Pons)`, `(Thalamus)` leh `(Spinal Cord)` ang hmunah te a ni. Mahse, `(DIPG)` hi `(Pons)` area-ah a bik takin a lo thang lian a ni.

An pahnih hian gliomas grade sang tak an ni. Mahse, an pahnih inkarah hian danglamna engemaw zat a awm. I fa i enkawl dawnin i doctor chuan heng inthlauhna te hi a ngaihtuah ang a, eng enkawlna nge i tan a tha ber tih a rel ang.

Tuin nge DIPG dawng? Engtiang chiahin nge a hluar?

Heng tumor te hi naupang kum eng pawhah, mipa leh hmeichhiaah pawh a lo awm thei a ni. Mahse, naupang kum 5 leh 9 inkar zingah an awm tam ber.

Puitling pawhin DIPG an nei thei a, mahse a tlem hle.

Hei hi a takah chuan thil awm lo tak a ni. America ang ramah pawh kum tin naupang 150 atanga 300 vel chauh he tumor chi hi an vei tih hmuhchhuah a ni. Naupangte zinga gliomas lo awm tam zawk hi ``low-grade'' an ni a, chu chu enkawl leh tihdam theih a ni tihna a ni. Mahse, naupang thluaka tumor zinga 10% vel chauh hi he chi hlauhawm tak ``DIPG'' an tih hi a ni.

DIPG natna lan chhuah dante chu engte nge ni?

He tumor, ``DIPG'' tia koh hi a lo thang chak em em a, symptoms a lo lang nghal vat thin. I fate zingah heng chhinchhiahnate hi lo thlir reng ang che:

• Mit lama harsatna: mit hmuhna fiah lo, mit hmuhna pahnih, mit chet dan thunun loh, mitmeng tlak hniam.
• Lu na: Lu na, a bik takin zing lamah. A châng chuan, he natna hi luak chhuah hnuah a reh ṭhin.
• Kea kal harsatna: Kea kal harsatna, balance hloh (ataxia), leh taksa ruh inzawmna tlahniam. Leiah i ke dah theih loh ang maiin.
• Hmai sir khatah sagging emaw chak lohna emaw .
• Chaw ei leh ei harsa.
• Ke ruh leh ke ruh chak lohna hriatna . Kut chakna hloh thut emaw, ke chet harsa emaw ang maiin a lang.
• Nausea leh luak chhuak.
• I thusawi chu a slurred ang maia inhriatna , i thusawi chu a inzawm tha thei lo (slurred speech).

Heng symptoms pakhat emaw a aia tam emaw a lo lang thut a, a pung chak hle a nih chuan doctor pan vat a pawimawh hle.

DIPG hi eng thilin nge a thlen?

A awlsam zawngin DIPG-a thil thleng chu glial cell-a lo thanglian tur cell-te chu cancer cell-ah an chang ta a ni. Chumi hnuah chuan heng cancer cell te hi rang tak leh thunun theih lohvin an thang lian ta a ni.

Cancer tam zawk ang lo takin he ``DIPG'' an tih hi environment risk factors, cigarette meikhu emaw radiation emaw nen a inzawm lo niin a lang. Chu chu nu leh pate thil tih vang nge, kan chhehvela thil awm vang nge tih erawh hriat chian a la ni lo tihna a ni.

Mahse, i fa hian Li-Fraumeni syndrome ang chi natna hlauhawm tak a neih chuan a hlauhawmna chu a sang deuh thei a ni. Tin, cell-a genetic change thenkhat, mutations an tih hian DIPG a thlen thei bawk. Tunah chuan protein pakhat H3K27M-a mutation awm chuan heng glial cells te hi cancer a siam thei tih hmuhchhuah a ni ta.

Engtin nge DIPG hi hmuhchhuah a nih?

A tlangpuiin biopsy, cancer test nana tissue sample lak a ngai thin. Mahse, DIPG chungchangah chuan hei hi a theih reng reng lo. Hei hi a chhan chu tumor awmna hmun hi a sensitive hle a ni. Chuvangin, doctor-te chuan DIPG hi naupang natna lan chhuah dan leh special imaging study te enin an hmuchhuak fo thin.

• MRI (Magnetic Resonance Imaging) hmanga enfiah a nih chuan:MRI hian naupang tumor thlalak chiang tak tak a siam thei a ni. Tin, tumor chu pons pawn lamah a darh tawh em tih pawh a hriat theih bawk. DIPG tumor hi MRI-ah chuan a danglam deuh deuh. Radiologist tawnhriat ngah tak chuan brainstem tumor dang aiin a thliar hrang thei a ni.
• Stereotactic Biopsy: A châng chuan, chutianga tih chu a him a nih chuan, doctor chuan tube ang maia hmanraw te tak te, te tak te hmangin tumor chu test nan a la thei (biopsy). Mahse, a tam zawkah chuan thluak bul a pons atanga tissue pakhat lak hi a hlauhawm hle a, a chhan chu thluak hnah a tichhe thei a ni. DIPG biopsy i neih chuan hetiang chi hi tih fo thin leh chutiang lama thiamna nei damdawi inah chauh tih tur a ni.

DIPG hi engtin nge enkawl a nih?

Hei hi hriat a lungchhiatthlak deuh a, mahse tuna enkawl dan hian `(DIPG)` hi a tidam kim thei lo. Mahse, heng enkawlnate hian naupang dam chhung hun eng emaw chen a ti sei thei a, natna lan chhuah dan a tiziaawm thei a, naupang tan hahdamna a pe thei bawk. Brain stem hi kan taksaa hnathawh pawimawh tak tak control tu nerve tissue atanga siam hmun a ni. Chuvangin operation hmanga tumor lakchhuah i tum chuan heng nerve structure pawimawh tak takte hi a chhe thei a ni.

Chuvangin doctor-te chuan surgery ni lo enkawlna dang an rawt a:

• Radiation therapy: Hei hi (DIPG) enkawlna ber a ni. Hemiah hian machine pakhat chuan radiation beam hmangin cancer cell te chu a tichhia a ni. Tin, a chhehvela tissue hrisel tihchhiatna tihtlem a tum bawk. Radiation therapy hian tumor chu a ti tlem a, cancer cells a that a, symptoms a ti tlem bawk. I fa hian kar ruk vel chhung chu nitin radiation therapy a dawng mai thei.
• Corticosteroids: I fate radiation hmanga enkawl hma emaw, a enkawl hnuah emaw damdawi chi khat, corticosteroid an tih chu i doctor chuan a pe thei che a ni. Heng damdawi te hian thluaka swelling a tihziaawm bakah symptoms control nan a pui thei bawk. Radiation hmanga enkawl hnua a hring (swelling) tihziaawmna atan pawh an pui thei bawk. Mahse, corticosteroid hian side effect a nei thei a ni. Chung zingah chuan ei duhna tihpun, taksa rihna sang, leh mood swing te pawh a tel . Heng damdawi te hi a thatna leh a hlauhawmna hrethiam turin i doctor nen inbia ang che.
• Chemotherapy: Cancer natna tlangpui chemotherapy ang chi enkawlna hi DIPG tan chuan a hlawk vak lo. Mahse, a châng chuan i doctor chuan i fa chu chemotherapy leh radiation therapy hmanga clinical trial- a tel tûrin a rawt thei a ni.
• Palliative care-a enkawlna: 1.1.Palliative care professional-te chuan nang leh i doctor te nen thawk hovin i fate nunphung tisang thei tur care plan an siam thei a ni. DIPG ang chi diagnosis i hmachhawn hunah nang leh i fa leh i chhungte mamawh damdawi lam, rilru lam leh thlarau lam tanpuina an pe thei a ni.

I doctor chuan i fa chu clinical trial ah enroll turin a rawt thei bawk . Clinical trial chu enkawlna tharte hi engtiang chiahin nge a him leh hlawk loh tih zirchianna a ni. Researcher te chuan (DIPG) cancer cells te ziarang thenkhat an hmuchhuak a. Chutiang mizia target-tu enkawlna thar – entirnan , molecular targeted therapy leh immunotherapy – chu clinical trial hmangin a awm thei ang.

Entirnan, zirchiangtute chuan cancer cell tam takah hian gene ``DIPG''-ah (H3K27M) an tih mutation an nei tih an hria a. He mutation nei cancer cell (leh a dangte) target thei therapies thar, experimental therapies siam chhuah a ni tawh a, clinical trial-ah test a ni tawh bawk.

DIPG hi tihdam theih a ni em?

Ni lo, Diffuse Intrinsic Pontine Glioma (DIPG) hi tihdam theih a ni lo. Tuna enkawlna tha ber chu radiation therapy a ni. DIPG atana radiation therapy hian naupang dam chhung a ti rei thei a, hun eng emaw chen atan symptoms leh quality of life a titha thei bawk. He cancer na tak hi a hmalam hun tur tihchangtlun nan hian enkawlna thar zawk, hlawk zawk a ngai a ni.

DIPG vei naupang chu eng chen nge a dam theih ang?

Hei hi hriat a har tih ka hria. Enkawlna tel lo chuan naupang tam zawk hi an natna an hmuhchhuah hnuah thla ruk vel an dam thin. Radiation therapy hian he hun hi thla 9 atanga thla sawm leh pakhat thleng a tizau thei tlangpui. Naupang 10% aia tlem chu kum hnih aia rei an dam. Heng statistics i hriat hian lungngaih hi thil pangngai tak a ni a, mahse naupang tin hi an danglam vek tih hriat reng a pawimawh.

Doctor hnenah eng zawhna nge ka zawh ang?

I fa enkawl dan tur leh an hmalam hun tichhe thei tur thilte hrethiam turin i doctor nen thawhhona tha tak nei rawh. Zawhna i neih apiang zawh hlau suh. Zawhna i zawh theih ṭhenkhat chu hetiang hi a ni:

• Eng enkawlna nge i rawt? An lakah eng nge kan beisei theih ang?
• Ka fa hian eng chen nge enkawlna a mamawh ang?
• Ka fa hian cancer kal zel dan enfiah turin follow-up appointment-ah eng chen nge a lo kal a ngai ang?
• Cancer enkawlna avanga side effect awm thei te hi engtin nge kan enkawl ang?
• Palliative care service leh support group te nen min inzawm tir thei ang em?
• Ka fain a tel theih tur research thar emaw clinical trial thar emaw a awm em?

A tawp berah chuan thil hriat reng tur (Take-Home Message) .

I fain Diffuse Intrinsic Pontine Glioma (DIPG) a vei tih hriat chu nu leh pa anga i hriat harsa ber pakhat a ni thei. I rilru natna te, hlauhna te, leh lungkhamna te chu a hneh thei hle. Mahse he hun chhung hian nangmah chauh i ni lo tih hre reng ang che.

Thla lo awm turtea enkawlna chungchanga thutlukna i siam lai hian, i tanpuina leh hmanraw awm zawng zawng chu hmang tangkai rawh. He natna laka i beisei tur chungchang hi i fa doctor-te nen zalen takin sawipui rawh. I theih chuan palliative care pe thin professional-te hnenah thlen rawh. Thiante leh chhungte hnenah tanpuina dil rawh. A chung berah chuan i fa nen inzawmna nei reng rawh. Amah biak la, inkhelhpui la, hmangaihna pe rawh. A kalna apiangah a bulah i awm tih hria ang che.

Hetiang hun harsaah hian mahni inngaihtuah a pawimawh a, i rilru hriselna i enkawl a pawimawh. I chak reng chuan i fa pawh a chak ve tho ang. Nangmah chauh i ni lo, i bulah kan awm vek a ni.

` Diffuse intrinsic pontine glioma, DIPG, thluak cancer, naupang cancer, pons, radiation therapy, palliative care te a ni