Kodi matenda a Leptomeningeal ndi chiyani? Tiyeni tikambirane za izi!

N'zovuta kufotokoza m'mawu mantha ndi nkhawa zomwe mumamva mukazindikira kuti muli ndi khansa. Mukalimbana ndi khansa, tonse tamva kuti imatha kufalikira ku ziwalo zina za thupi. Lero, tikambirana za njira imodzi yomwe khansa ingakhudzire ubongo wathu, nembanemba yozungulira msana wathu, ndi madzi a m'mitsempha yathu. Madokotala amatcha matenda a Leptomeningeal , nthawi zina amatchedwa LMD kapena LM .

Mwachidule, kodi matenda a Leptomeningeal ndi chiyani?

Chabwino, tiyeni tikambirane pang'ono. Pali ma nembanemba atatu owonda omwe amateteza ubongo wathu ndi msana wathu. Timatcha ma meninge. Ma nembanemba awiri owonda omwe ali mkati mwa ma meningewa amatchedwa ma leptomeninge . Monga zivundikiro za buku, ma nembanemba awa amateteza magawo awiri ofunikira kwambiri a dongosolo lathu la mitsempha.

Kenako, pali madzi apadera omwe amayenda mkati mwa ubongo wathu komanso mozungulira msana wathu. Madzi amenewa amatchedwa cerebrospinal fluid (CSF) . Madzi amenewa amadyetsa ubongo ndi msana, amauteteza, komanso amachotsa zinyalala.

Tsopano, matenda a leptomeningeal (LMD) ndi pamene khansa yomwe ili kwinakwake m'thupi, monga khansa ya m'mawere kapena khansa ya m'mapapo, imafalikira ndikulowa mu nembanemba ya leptomeningeal yomwe tidakambirana komanso madzi a m'mitsempha (CSF). Izi zikutanthauza kuti maselo a khansa amayamba kuyandama m'madzi awa, ngati zinyalala zomwe zimayandama m'madzi. Imeneyi imaonedwa ngati khansa yoopsa.

Kodi matenda a leptomeningeal (LMD) ndi ofala bwanji?

Matenda a Leptomeningeal (LMD) kwenikweni si ofala kwambiri. Komabe, chifukwa cha kupita patsogolo kwa chithandizo chamankhwala chomwe chimalola anthu kukhala ndi moyo wautali ndi khansa, chikuchulukirachulukira. Pa avareji, LMD imapezeka mwa pafupifupi 5% ya odwala khansa.

Matenda a LMD nthawi zambiri amapezeka mwa anthu omwe ali ndi mitundu iyi ya khansa:

• Khansa ya m'mawere: Khansa ya m'mawere ndi mtundu wofala kwambiri wa khansa ya m'mawere wokhudzana ndi LMD. Umakhudza akazi 3% mpaka 5% omwe ali ndi khansa ya m'mawere. Kafukufuku wasonyeza kuti akazi omwe ali ndi mtundu wotchedwa ``Triple negative breast cancer'' ndi mtundu wa ``Lobular breast cancer'' ali pachiwopsezo chachikulu chotenga LMD.
• Khansa ya m'mapapo: Khansa ya m'mapapo yosakhala ya maselo ang'onoang'ono (NSCLC) ndi khansa ya m'mapapo ya maselo ang'onoang'ono (SCLC) imatha kufalikira ku leptomeninges ndi cerebrospinal fluid. Madokotala akuyerekeza kuti pakati pa 4% ndi 7% ya anthu omwe ali ndi NSCLC amadwala LMD. Chiwerengerochi chikuwonjezeka kufika pa 11% ya anthu omwe ali ndi SCLC.
• Khansa ya pakhungu: Iyi ndi khansa yoopsa kwambiri ya pakhungu. Pafupifupi 5% ya anthu omwe ali ndi khansa ya pakhunguLMD ikhoza kupangidwa.
• Acute lymphocytic leukemia (ALL): Iyi ndi khansa ya m'magazi. Pakati pa 1% ndi 10% ya anthu omwe ali ndi ALL akhoza kudwala LMD.
• Non-Hodgkin's lymphoma (NHL): Iyi ndi khansa ya dongosolo la lymphatic. Pakati pa 5% ndi 10% ya anthu omwe ali ndi NHL akhoza kudwala NHL.

Kodi pali kusiyana kotani pakati pa matenda a ubongo otchedwa metastases ndi matenda a leptomeningeal (LMD)?

Zonsezi zimachitika khansa ikafalikira, koma pali kusiyana pang'ono.

Kuchuluka kwa maselo a khansa m'maselo a ubongo kumachitika pamene maselo a khansa amalowa mwachindunji mu minofu ya ubongo ndikupanga zotupa pamenepo.

Komabe, matenda a leptomeningeal (LMD) ndi pamene maselo a khansa amalowa mu cerebrospinal fluid (CSF) ndi nembanemba ya leptomeningeal yomwe imazungulira ubongo ndi msana . Apa, maselo a khansa akhoza kukhala akuyandama m'madzi kapena kufalikira pamwamba pa nembanemba.

Nthawi zina zonsezi zimatha kuchitika pamodzi, kapena zitha kuchitika padera.

Kodi zizindikiro za matendawa ndi ziti?

Pakhoza kukhala zizindikiro zambiri za matenda a leptomeningeal (LMD), chifukwa zimakhudza ubongo ndi msana, womwe ndi dongosolo lathu lonse la mitsempha. Komabe, nazi zina mwa zizindikiro zodziwika bwino:

• Mutu: Ichi ndi chizindikiro chachikulu chomwe anthu ambiri amakumana nacho. Sichifanana ndi mutu wamba, ukhoza kukhala woopsa pang'ono, ndipo nthawi zina umakula kwambiri m'mawa.
• Kusanza ndi kusanza: Kusanza ndi kusanza kungachitike, makamaka m'mawa.
• Kusintha kwa kayendedwe: Mungamve ngati mukutaya mphamvu ndi kupunthwa mukuyenda.
• Kutaya kumva: Kutaya kumva kungachitike mwadzidzidzi, ndipo mungayambe kumva mawu osiyanasiyana m'makutu mwanu.
• Mavuto a maso: Kuona kawiri komanso kusawona bwino kungachitike.
• Kukomoka : Kutaya mwadzidzidzi chidziwitso ndi kukomoka kungachitike.
• Kusokonezeka ndi kusintha kwa chikumbumtima, malingaliro, kapena khalidwe: Kuvuta kuganizira, kuiwala, kukwiya, ndi kusokonezeka maganizo kungachitike.
• Kupweteka kwa msana ndi mwendo: Kupweteka kumatha kuchitika kumbuyo ndi m'miyendo.
• Kusanza kapena kufooka kwa miyendo kapena matako: Miyendo yanu ingamve ngati yachita dzanzi komanso yopanda moyo.
• Mavuto pokodza kapena kuchita chimbudzi: Zingakhale zovuta kulamulira mkodzo ndi ndowe.
• Mavuto ena atsopano a mitsempha: Kuwonjezera pa izi, zizindikiro zatsopano za mitsempha zingawonekere, monga kuvutika kulankhula ndi dzanzi mbali ina ya nkhope.

Chofunika kwambiri ndichakuti ngati muli ndi khansa, uzani dokotala wanu nthawi yomweyo ngati muyamba zizindikiro zatsopano ngati izi.

Chifukwa chiyani matenda a leptomeningeal (LMD) amapezeka?

Mwachidule, LMD imachitika pamene maselo a khansa amachoka pamalo oyamba a khansa m'thupi (monga bere, mapapo), amayenda m'magazi kapena m'thupi, ndikulowa m'madzi a m'mitsempha (CSF) ndi ma leptomeninges omwe tidakambirana kale. Izi zikusonyeza momwe khansa yafalikira.

Kawirikawiri, madzi a m'mitsempha ya ubongo (CSF) amapangidwa mu ubongo wathu, kenako amayendayenda mu ubongo ndi msana, ndipo amalowanso m'magazi. Izi zimachitika munthawi yochepa. Komabe, maselo a khansa akalowa mu CSF iyi, amatha kusokoneza kayendedwe kabwino ka madzi awa. Kenako CSF ​​imatha kusonkhana, ndikuwonjezera kuthamanga kwa magazi mkati mwa ubongo. Ichi ndichifukwa chake zizindikiro zambiri zimawonekera. Komanso, maselo a khansa akafalikira ku nembanemba za leptomeninges, amatha kuwononga nembanembazo ndi mitsempha yomwe imalumikizidwa nazo.

Kodi madokotala amazindikira bwanji izi?

Ngati mukuganiza kuti muli ndi matenda a LMD, madokotala adzachita mayeso awiri akuluakulu:

1. Kujambula kwa MRI (Magnetic Resonance Imaging - MRI): Kujambula kwa MRI kwa ubongo wanu ndi/kapena msana wanu kumachitika kuti muwone ngati maselo a khansa akufalikira ku leptomeninges komanso ngati CSF yatsekedwa.

2. Kuboola msana/Kuboola msana: Mu mayesowa , singano yopyapyala imayikidwa m'munsi mwa msana wanu, kusamala kuti isawononge msana wanu, kuchotsa chitsanzo chaching'ono cha madzi a m'mitsempha (CSF). Kenako chitsanzocho chimayesedwa mu labu kuti chione ngati pali maselo a khansa.

Nthawi zina, ngati kufalikira kwa maselo a khansa kuli kochepa kwambiri (microscopic), sikungadziwike pa MRI scan. Pazochitika zotere, kuzindikira matendawa kungakhale kovuta pang'ono. Ndicho chifukwa chake ndikofunikira kuuza dokotala wanu za zizindikiro zanu.

Kodi pali mankhwala athunthu a izi?

Mwatsoka, pakadali pano palibe mankhwala a matenda a leptomeningeal (LMD). Popeza ndi khansa yoopsa komanso yofala kwambiri, zolinga zazikulu za chithandizo ndikuwongolera kufalikira kwa khansa, kuchepetsa zizindikiro ndikukuthandizani kukhala bwino momwe mungathere, komanso kukhala ndi moyo wabwino.

Njira zochiritsira zimadalira zinthu monga mtundu wa khansa yomwe munali nayo poyamba, momwe khansayo yafalikira, komanso thanzi lanu lonse. Zina mwa njira zochiritsira zomwe zimagwiritsidwa ntchito kwambiri ndi izi:

• Chithandizo cha radiation: Chithandizo cha radiation chimaperekedwa ku ziwalo za ubongo kapena msana zomwe zakhudzidwa. Izi zitha kuchepetsa zizindikiro zina (monga kupweteka, kufooka kwa mitsempha) ndikuwonjezera ntchito ya mitsempha.
• Mankhwala a Chemotherapy:Mankhwala amaperekedwa kuti aphe maselo a khansa. Mankhwalawa amatha kumwedwa ngati mapiritsi, kuperekedwa ngati jakisoni mumtsempha, kapena nthawi zina kulowetsedwa mwachindunji mu cerebrospinal fluid (CSF). Izi zimatchedwa ``Intrathecal chemotherapy.`` Izi zimachitika kudzera mu chubu chaching'ono chomwe chimayikidwa muubongo chotchedwa ``ventricular access device.''

Kodi pali njira zochepetsera kuchitika kwa izi?

Ndipotu, pakadali pano palibe njira yeniyeni yopewera kukula kwa LMD, chifukwa kumachitika chifukwa cha kufalikira kwa khansa yomwe ilipo kale m'thupi.

Kodi mungakhale ndi matendawa kwa nthawi yayitali bwanji?

Ndikudziwa kuti funso ili ndi lovuta kufunsa. LMD ndi gawo lapamwamba la khansa. Izi zikutanthauza kuti vutoli likachitika, wodwalayo amakhala pa gawo lalikulu kwambiri la khansa.

Pa avareji, odwala omwe amalandira chithandizo amatha kukhala ndi moyo kwa miyezi itatu mpaka isanu ndi umodzi atapezeka ndi matendawa . Kwa iwo omwe sanalandire chithandizo, nthawi imeneyi imatha kukhala pafupifupi mwezi umodzi.

Komabe, izi zitha kusiyana malinga ndi munthu. Zimatengera zinthu zambiri, monga mtundu wa khansa yomwe muli nayo komanso momwe thupi lanu limayankhira chithandizo. Dokotala wanu ndiye munthu wabwino kwambiri woti akupatseni chidziwitso chokhudza izi.

Kodi ndiyenera kuganizira za chisamaliro cha odwala omwe ali ndi hospice?

Ngati muli ndi matenda a LMD, ndikofunikira kumvetsetsa bwino za matenda anu. LMD ndi vuto losachiritsika la khansa. Funsani dokotala wanu zomwe mungayembekezere kutengera matenda anu. Mwanjira imeneyi, mutha kuthana ndi zizindikiro zanu, kukhala omasuka momwe mungathere, ndikuyika patsogolo zinthu zofunika kwa inu.

Izi si zinthu zosavuta kukambirana, kaya ndi inu kapena dokotala wanu. Koma ndizofunikira kwambiri. Dokotala wanu angakuthandizeni kumvetsetsa zomwe zikuchitika m'thupi lanu komanso zomwe zingachitike mtsogolo. Angakuthandizeninso kuganizira zomwe mungasankhe, ndipo ngati pakufunika, akutumizireni ku mautumiki othandizira.

Chisamaliro cha odwala omwe ali ndi matenda oletsa moyo ndi chithandizo chomwe chimathandiza anthu omwe ali ndi matenda oletsa moyo kukhala ndi moyo wabwino, ndi ulemu, pansi pa ulamuliro wawo, komanso ndi moyo wabwino kwambiri. Tikamalimbana ndi matenda aakulu, nthawi yathu yambiri ndi mphamvu zathu zimayang'ana kwambiri pa chithandizo. Tikamaganizira za chisamaliro cha odwala omwe ali ndi matenda oletsa moyo, cholinga chathu chimakhala pa momwe tingagwiritsire ntchito nthawi yotsalayo, osati pa matenda okhawo. Mwa kulankhula ndi dokotala wanu za momwe LMD ingakhudzire moyo wanu, mankhwala omwe alipo a khansa yanu, komanso zomwe mungayembekezere kuchokera ku chithandizocho, mutha kupanga chisankho chomwe chili chabwino kwa inu.

Ngati muli ndi matenda a LMD, mwina mukukhala ndi khansa yoopsa yomwe yafalikira m'thupi lanu lonse ngakhale mutalandira chithandizo. Mukazindikira kuti muli ndi vuto losachiritsika komanso lalikulu, mungadabwe, mukwiya, komanso mumachita mantha. Mungadabwe kuti, "N'chifukwa chiyani izi zikundichitikira?" Simuli nokha mumkhalidwe uwu. Funsani dokotala wanu kuti akuthandizeni. Amamvetsetsa zomwe mukukumana nazo, ndipo adzakuthandizani m'njira iliyonse yomwe angathe.

Zinthu zofunika kwambiri kukumbukira (Uthenga Wopita Nawo Kunyumba)

• Matenda a Leptomeningeal (LMD) ndi kufalikira kwa khansa ku nembanemba zomwe zimaphimba ubongo ndi msana komanso kulowa mu cerebrospinal fluid.
• Uwu ndi matenda aakulu omwe sangachiritsidwe.
• Zizindikiro za mitsempha monga mutu, nseru, kuvutika kuyenda, mavuto a kuwona/kumva, komanso kusokonezeka maganizo kungachitike.
• Matendawa amapezeka kudzera mu MRI scan ndi lumbar puncture.
• Cholinga cha chithandizo ndikuwongolera zizindikiro ndikusunga moyo wabwino.
• Musaope kulankhula momasuka ndi dokotala wanu za matenda anu, tsogolo lanu, ndi zosankha monga chisamaliro cha odwala omwe ali ndi hospice. Pezani thandizo lomwe inu ndi banja lanu mukufunikira kuti mupirire nthawi yovutayi.

Matenda a Leptomeningeal, Khansa, Ubongo, Msana, Madzi a m'mitsempha, Zizindikiro, Kufalikira kwa Khansa