Khansa ya m'matumbo yobadwa nayo: Kodi mukudziwa za HNPCC?

Kodi munamvapo kuti m'modzi, mwina awiri kapena atatu, m'banja mwanu ali ndi khansa ya m'matumbo? Kapena mukuopa pang'ono chifukwa chakuti m'banja mwanu muli ndi khansa? Ndipotu, mitundu ina ya khansa imatha kupatsiridwa kuchokera ku mibadwomibadwo. Lero tikambirana za mtundu wapadera wa khansa ya m'matumbo yomwe imapatsiridwa kudzera m'majini athu. Timaitcha HNPCC.

Kodi HNPCC ndi chiyani?

Mwachidule, HNPCC (Heredary Nonpolyposis Colorectal Cancer) ndi mtundu wa khansa ya m'matumbo yomwe imayamba chifukwa cha kusintha kwina (kusintha kwa majini) komwe kumadutsa m'mibadwomibadwo. Iyi ndi khansa yomwe imapezeka m'matumbo athu akuluakulu (colon).

Kodi izi ndi zofanana ndi Lynch Syndrome?

Mwina mwamvapo za Lynch Syndrome kawirikawiri kuposa HNPCC. Awiriwa ndi ofanana kwambiri, koma si ofanana kwenikweni. Taganizirani izi motere. Lynch Syndrome ndi vuto la majini m'thupi lathu. Ndi vuto la majini lomwe limawonjezera chiopsezo cha khansa.

HNPCC ndi dzina lomwe limaperekedwa ku vuto lomwe munthu yemwe ali ndi Lynch Syndrome amakhala ndi khansa ya m'matumbo kapena khansa zina zokhudzana nazo (monga khansa ya m'chiberekero kapena ya m'matumbo ang'onoang'ono), makamaka asanakwanitse zaka 50. Khansa ya HNPCC nthawi zambiri imapezeka mbali yakumanja ya matumbo akulu.

Kodi matenda a HNPCC ndi ofala bwanji? Kodi zizindikiro zake ndi ziti?

Matenda a HNPCC ndi omwe amachititsa pakati pa 2% ndi 4% ya khansa yonse ya m'matumbo yomwe yanenedwa padziko lonse lapansi. Ngakhale kuti matendawa amatha kuchitika pa msinkhu uliwonse, nthawi zambiri amapezeka mwa anthu osakwana zaka 50.

Matenda a HNPCC sangakhale ndi zizindikiro zenizeni kumayambiriro, koma khansa ikapitirira, zizindikirozi zingawonekere.

N’chifukwa chiyani matenda a HNPCC amakula? Kodi amapatsirana?

Chifukwa chachikulu cha izi ndi majini athu. Ganizirani thupi lathu ngati nyumba yomangidwa motsatira dongosolo lalikulu. Buku lomwe lili ndi dongosolo limenelo ndi DNA yathu. Timatchula malangizo omwe ali mu majini a DNA awa.

Anthu omwe ali ndi matenda a Lynch Syndrome ali ndi vuto m'majini angapo (`MLH1`, `MSH2`, `MSH6`, `PMS2` ndi `EPCAM`) omwe amakonza zolakwika mu DNA. Majini amenewa akapanda kugwira ntchito bwino, zolakwika mu DNA (`zolakwika zobwerezabwereza za DNA`) zomwe zimachitika maselo athu akamagawikana sizimakonzedwa. Pakapita nthawi, zolakwikazi zimasonkhana ndipo selo labwinobwino limakhala ndi mwayi waukulu wokhala selo la khansa.

Chofunika kwambiri ndichakuti HNPCC si matenda opatsirana. Izi zikutanthauza kuti sifalikira kuchokera kwa munthu wina kupita kwa wina ngati chimfine. Komabe, jini yolakwika yomwe imayambitsa matendawa imatha kufalikira kuchokera ku mibadwomibadwo. Izi zikutanthauza kuti ngati kholo lililonse lili ndi Lynch Syndrome, mwana ali ndi mwayi wa 50% wolandira jini imeneyo. Ngati alandira jini imeneyo, mwanayo ali ndi chiopsezo chachikulu chotenga HNPCC kapena khansa zina zokhudzana nazo mtsogolo.

Kodi dokotala amazindikira bwanji izi?

Ngati muli ndi zizindikiro zomwe tatchula pamwambapa, makamaka ngati wina m'banja mwanu wakhala ndi khansa ya m'matumbo, muyenera kuonana ndi dokotala.

Dokotala adzakuyesani kaye. Kenako, ngati mukukayikira kuti muli ndi khansa ya m'matumbo, mayeso ofala kwambiri ndi colonoscopy . Izi zimaphatikizapo kulowetsa chubu chopyapyala kudzera mu anus ndikugwiritsa ntchito kamera kuti muyeze mkati mwa matumbo akulu.

Kuti atsimikizire ngati muli ndi HNPCC, dokotala wanu adzafufuzanso zotsatirazi:

• Mbiri ya khansa ya m'banja:Mudzafunsidwa ngati wina aliyense m'banja mwanu, monga amayi anu, abambo anu, kapena abale anu, adakhalapo ndi khansa ya m'matumbo kapena khansa ina yokhudzana ndi Lynch Syndrome asanakwanitse zaka 50.
• Kuyezetsa Majini: Kuyezetsa magazi kwapadera kumalimbikitsidwa kuti mudziwe ngati muli ndi kusintha kwa majini komwe kumayambitsa HNPCC.
• Kupewa matenda ena: Monga HNPCC, palinso matenda ena obadwa nawo a khansa ya m'matumbo otchedwa FAP (Familial Adenomatous Polyposis) . Chifukwa pali kusiyana pakati pa awiriwa, mayeso adzachitikanso kuti atsimikizire kuti muli ndi HNPCC osati FAP.

Kodi kusiyana pakati pa HNPCC ndi FAP ndi kotani?

Ngakhale kuti zonsezi ndi matenda obadwa nawo a khansa ya m'matumbo, majini omwe amachititsa matendawa ndi osiyana. Kusiyana kwakukulu ndi kuchuluka kwa ma polyps omwe amakula m'matumbo.

Kodi mankhwala a HNPCC ndi ati?

Chithandizo chachikulu cha HNPCC ndi opaleshoni (colectomy) . Izi zimaphatikizapo kuchotsa mbali kapena m'matumbo onse kumene khansa ili. Izi zitha kuchitika m'njira zosiyanasiyana.

• Kuchotsa gawo la m'mimba momwe khansa ilili: Kuchotsa gawo la m'mimba momwe muli khansa.
• Kuchotsa matumbo onse akuluakulu: Kuchotsa matumbo onse akuluakulu.
• Kuchotsa matumbo akuluakulu ndi a rectum: Kuchotsa matumbo akuluakulu ndi a rectum.

Ngati khansa yafalikira (yafalikira) ku ziwalo zina za thupi, dokotala wanu angakulangizeni njira zina zochiritsira kuwonjezera pa opaleshoni.

• Chemotherapy: Mankhwala omwe amawononga maselo a khansa.
• Chithandizo cha Immunotherapy: Kulimbikitsa chitetezo cha mthupi lathu kuti chilimbane ndi maselo a khansa.

Nthawi zambiri, chithandizo cha immunotherapy chingakhale chothandiza kwambiri pa khansa ya HNPCC.

Kodi tsogolo la munthu amene ali ndi HNPCC ndi lotani?

Matenda a Lynch ndi matenda a majini omwe sangachiritsidwe. Ndi matenda omwe amakhalapo kwa moyo wonse. Komabe, opaleshoni imatha kuchiritsa khansa ya HNPCC ndikuletsa khansa ya m'matumbo mtsogolo.

Munthu amene ali ndi HNPCC ali pachiwopsezo chotenga mitundu ina ya khansa kuwonjezera pa khansa ya m'matumbo. Ichi ndichifukwa chake dokotala wanu adzakuuzani kuti muyezedwe nthawi zonse.

• Khansa ya endometrial
• Khansa ya m'chiberekero
• Khansa ya m'mimba
• Khansa ya impso, ubongo, chiwindi ndi khungu

Pa avareji, pafupifupi 60% ya anthu omwe apezeka ndi HNPCC amakhala ndi moyo kwa zaka 5. Ndipo pakati pa 70% ndi 88% ya anthu omwe ali ndi khansa ya m'matumbo chifukwa cha Lynch Syndrome amakhala ndi moyo kwa zaka zoposa 10. Ziwerengerozi zikusonyeza kufunika kozindikira msanga ndi kulandira chithandizo.

Kodi chingachitike n’chiyani kuti tipewe ndikuwongolera chiopsezochi?

Palibe njira yopewera kusintha kwa majini komwe kumayambitsa izi. Ndi chinthu chomwe timatengera. Komabe, pali zinthu zambiri zomwe mungachite kuti mupewe khansa kapena kuizindikira msanga.

• Dziwani mbiri ya banja lanu: Ngati wina m'banja mwanu ali ndi Lynch Syndrome kapena HNPCC, lankhulani ndi dokotala wanu za izi ndipo mufunseni ngati mukufunikiranso kuyezetsa majini.
• Yambani kuyezetsa msanga: Ngati mwapezeka ndi matenda a Lynch Syndrome, dokotala wanu akulangizani kuti muyambe kuyezetsa khansa ya m'matumbo (colonoscopy) muli ndi zaka 20.
• Moyo Wathanzi: Zinthu izi zimathandiza kwambiri kuchepetsa chiopsezo cha khansa:
• Pewani kusuta fodya kotheratu.
• Chepetsani kumwa mowa.
• Idyani zakudya zabwino zokhala ndi ndiwo zamasamba ndi zipatso zambiri.
• Kuchita masewera olimbitsa thupi nthawi zonse.
• Khalani ndi thupi labwino.
• Dziwani zizindikiro: Ngati mukupeza zizindikiro zatsopano, musazinyalanyaze ndipo pitani kwa dokotala nthawi yomweyo.