Unoziva here nezvegomarara iri risingawanzoitiki rinokura mudumbu (peritoneal mesothelioma)?

Dzimwe nguva unonzwa kurwadziwa kusinganzwisisike kana kuzvimba mudumbu mako here? Unonzwa kurasikirwa nechido chekudya uye kudzikira kwehuremu here? Kunyangwe dzimwe nguva tichiregeredza zviratidzo izvi, zvinogona kuva zviratidzo zvechirwere chakakomba. Nhasi tichataura nezverudzi rwekenza rusingawanzoitiki, asi runofanira kutariswa zvakanyanya. Iyoyo ikenza inonzi `Peritoneal Mesothelioma`.

Chii chinonzi Peritoneal Mesothelioma iyi?

Zvichitaurwa zviri nyore, `Peritoneal Mesothelioma` igomarara rinokura mudumbu medu, kureva kuti, muganda rakatetepa rinofukidza dumbu, kana tichitarisa zvokurapa, `peritoneum`. Funga nezvazvo, `peritoneum` iyi yakaita sechifukidziro chakasimba chekudzivirira nhengo dzinokosha dziri mudumbu medu, dzakadai sechiropa, ura, nedumbu.

Gomarara iri, semamwe marudzi e mesothelioma, rinowanzo batanidzwa nekusangana nechinhu chinonzi asbestos kare. Ungave wakambonzwa kuti asbestos chinhu chinoshandiswa kugadzira zvimwe zvinhu zvekuvaka. Zvine njodzi huru nekuti fiber dziri mairi dzinogona kukonzera matambudziko akakomba kana ukazvifema kana kuzvidya.

Mesothelioma yemudumbu igomarara rinokurumidza kupararira. Kazhinji, kunyangwe kana rikaonekwa, gomarara racho rinenge ratopararira mudumbu rose. Saka, zvakaoma kuriona nekukurumidza.

Ndeupi musiyano uripo pakati pePeritoneal Mesothelioma nePleural Mesothelioma?

Zvose `Peritoneal Mesothelioma` ne`Pleural Mesothelioma` zvinokura muma membranes ari pamipata yakakosha uye nhengo dzemukati memuviri wedu.

• Peritoneal mesothelioma inokura mu membrane inofukidza dumbu uye inokomberedza nhengo dzedumbu, kureva peritoneum yatakambotaura.
• Pleural mesothelioma inokura mumembrane iri pachipfuva, kunyanya mapapu. Inonzi pleura.

Mamembrane ese ari maviri akaumbwa nerudzi rwesero rwakakosha runonzi `mesothelial cells`. Ndosaka gomarara iri richinzi `mesothelioma`.

Mhando dzese dzemesothelioma dzinowanzova nekenza, zvichireva kuti dzine kenza . Masero aya emesothelioma anokuvadza anokura nekukurumidza uye asingadzoreki, achikuvadza nyama dzakakomberedza dzine hutano. Pleural mesothelioma rudzi rwekenza rwakajairika kupfuura peritoneal mesothelioma.

Ndiani ane mukana mukuru wekuwana chirwere ichi? Chinowanikwa kakawanda sei?

Munhu wese anogona kuwana `Peritoneal Mesothelioma`. Zvisinei, hazviwanzoitiki pakati pevana vadiki. Kazhinji, chirwere ichi chinowanikwa muvanhu vane makore ari pakati pe50.

Kunyangwe `Peritoneal Mesothelioma` iriyo mhando yechipiri inonyanya kuwanikwa ye`Mesothelioma` (yekutanga i`Pleural Mesothelioma`), igomarara risingawanzoitiki. `Peritoneal Mesothelioma` inokura pakati pe10% ne20% yevarwere vese ve`Mesothelioma`. Fungidzira, munyika yakaita seAmerica, vanhu vari pakati pe400 ne1000 chete ndivo vanoonekwa gore rega rega. Saka, kunyangwe varwere ava vangangove varipowo muSri Lanka, nhamba yacho yakaderera zvikuru.

Ndezvipi zviratidzo zvePeritoneal Mesothelioma? Ungazviziva sei?

Iyi inyaya yakakosha nekuti kazhinji, Peritoneal Mesothelioma hairatidzi zviratidzo pakutanga. Zviratidzo zvinotanga kuonekwa chete kana kenza yapararira mudumbu.

Chiratidzo chinonyanya kuzivikanwa ndechekuungana kwemvura mudumbu. Izvi zvinonziwo 'ascites'. Kana mvura yaungana, dumbu rinotanga kukura nekuzvimba. Chiratidzo chechipiri chinowanzoonekwa kurwadziwa mudumbu.

Zvimwe zviratidzo zvinogona kusanganisira:

• Ascites : Inonzwa sekuti dumbu razara uye rinorema.
• Kuzvimba kana kuzvimba mudumbu : Zvipfeko zvinogona kuoma.
• Kurwadziwa kwemudumbu : Uku kunogona kuva kurwadziwa kunopararira mudumbu rese, kana kuti kunogona kuva kurwadziwa kunonzwikwa panzvimbo imwe chete.
• Unganzwa bundu rinorwadza mudumbu repazasi .
• Kuzvimba kana kuvharika kwedumbu : Zvinoita sekunge dumbu rako rakazvimba uye unonetseka kubuda tsvina.
• Kusvotwa nekurutsa .
• Fivha isinganzwisisike uye kudikitira husiku .
• Kudzikira uremu kusingafungidzike .
• Chikafu hachina kunaka .

Zvakakosha: Kana ukaramba uine chimwe chezviratidzo izvi kana kupfuura, zvakakosha kuti uone chiremba kuti akupe mazano. Usazvidya mwoyo, hazvisi zvese zviratidzo izvi zvinokonzerwa nekenza. Zvinogonawo kukonzerwa nezvimwe zvirwere zvakajairika. Zvisinei, nguva dzose zvakanaka kuenda kunoongororwa.

Ndezvipi zvikonzero uye zvinhu zvinokonzera njodzi yekukura kwePeritoneal Mesothelioma?

Chinhu chikuru chinokonzera mesothelioma kusangana neasbestos. Asbestos chinhu chinoshandiswa mukuvaka, mukugadzira mapaipi, mumabasa emagetsi, mudenga, mune mamwe maindasitiri ekugadzira, uye muindasitiri yemotokari. Vanhu vazhinji vanogadzira mesothelioma vane mabasa anovabatanidza neasbestos.

Zvisinei, kunyange hazvo vanhu vazhinji vanowana pleural mesothelioma (rudzi runokanganisa mapapu) vaine nhoroondo yekusangana neasbestos, hukama huripo pakati peperitoneal mesothelioma (rudzi runokanganisa mukati medumbu) neasbestos hahuna kujeka. Vamwe vanhu vanowana peritoneal mesothelioma vanogona kunge vasina kumbobvira vasangana neasbestos pabasa. Izvi zvichiri kuongororwa.

Heano mamwe matambudziko anokonzera `Peritoneal Mesothelioma`:

• Kusangana neAsbestos : Kana machira easbestos apinda munzvimbo yatinogara, anobhururuka nemhepo. Kana akapinda, anogona kupinda mumuviri wedu nemuromo nemhino, oenda kudumbu (peritoneum), ogara imomo. Kana apinda, anokuvadza masero emesothelial, zvichiita kuti apatsanuke zvisina kujairika. Izvi ndizvo zvinokonzera kuti bundu rekenza riumbwe. Fungidzira, mesothelioma inoitika makore mushure mekusangana neasbestos, dzimwe nguva inosvika makore makumi mana.
• Kuwanikwa kweSilica neErionite : Izvi zvicherwa zvinowanikwa muvhu. Kuwanikwa kweizvi kwakawanikwawo kuti kwakabatana nePleural nePeritoneal Mesothelioma.
• Kuchinja kwemajini : Dzimwe ongororo dzakaratidza kuti kana ukasangana neasbestos uye uine mamwe majini akachinja, njodzi yako yekuve ne peritoneal mesothelioma inogona kuwedzera. Imwe yekuchinja kwakajairika kuchinja kwemajini anonzi BAP1. Jini iri, rinonzi BAP1, ndiro rinodzivirira kukura kwegomarara.
• Kusangana nemwaranzi : Kurapwa nemwaranzi yekenza yemudumbu kwakamboitwa kunofungidzirwawo kuti kunowedzera njodzi yekubatwa ne peritoneal mesothelioma. Zvisinei, kutsvagurudza kwakawanda kunodiwa kuti tinzwisise hukama huripo pakati pemwaranzi nengozi ye mesothelioma.

Ungaziva sei kana une Peritoneal Mesothelioma?

Kuongororwa kwePeritoneal Mesothelioma kunogona kuoma, sezvatakambotaura, nekuti kazhinji hairatidzi zviratidzo pakutanga. Kana zviratidzo zvikaonekwa, zvinogona kufanana nezvimwe zvirwere zvakajairika zvemudumbu kana mamwe marudzi ekenza. Nokudaro, zvirwere izvi zvakajairika zvinowanzobviswa pakuongorora chirwere.

Miedzo inotevera inogona kuitwa kuti uongorore chirwere ichi:

• CT scan : Chiremba wako anogona kurayira kuti uitwe CT scan kuti aone zvimwe zvirwere zvinokonzera zviratidzo zvakafanana ne peritoneal mesothelioma, zvakaita sekenza ye ovarian kana adenocarcinoma. Izvi zvinogona kusanganisira kubaya dhayi yakachengeteka (contrast) muropa rako kuti zvinhu zvakaita semapundu mudumbu rako zvionekwe zviri nani pa scan.
• Kuongororwa kweMRI (Magnetic Resonance Imaging (MRI)) : MRI inogona kupa ruzivo rwakafanana nerweCT scan. MRI inogona kuitwa kana usingakwanise kuongororwa neCT scan ine contrast.
• Kuongororwa kweropa: Chiremba wako anogona kukuyedza zvimwe zviratidzo muropa rako, zvakaita semapuroteni chaiwo, izvo zvinogona kuva chiratidzo chegomarara.
• Kuongorora mvura yemudumbu : Mukuita uku, chiremba wako anoisa tsono mudumbu mako otora sampuli yemvura kuti aone kana paine zviratidzo zve mesothelioma. Zvisinei, bvunzo iyi ine muganho mumwe chete. Inongopa ruzivo nezvemvura iri mudumbu mako, kwete nyama iri mudumbu mako. Danho rekenza rinoenderana nekuti kenza yapararira zvakadii munyama.
• Kuongororwa kwetsinga dzeropa neCT kana laparoscopic biopsy : Nzira chete yekusimbisa kuongororwa kwe peritoneal mesothelioma ndeyekuita biopsy. Mukuita izvi, chiremba wako anoshandisa imaging (senge scan) kuti awane nzvimbo chaiyo yebundu rako. Zvadaro, vachishandisa michina yekuvhiya, vanotora tissue sample voitumira ku lab kuti iongororwe.

Matanho ePeritoneal Mesothelioma ndeapi?

Matanho egomarara anoratidza kuti chirwere ichi chafambira mberi uye chapararira kusvika papi. Nzira inonyanya kushandiswa yekutarisa peritoneal mesothelioma iPCI (Peritoneal Cancer Index).

Munzira ye `PCI`, dumbu rako rakakamurwa kuita zvikamu gumi nezvitatu, uye chikamu chimwe nechimwe chinopihwa mamakisi kubva pa 0 kusvika pa 3.

• 0 zvinoreva kuti hapana kenza munzvimbo iyoyo.
• 3 zvinoreva kuti chikamu chakafukidzwa nekenza zvachose.

Chiremba anobva asanganisa mamakisi echikamu chimwe nechimwe cheizvi obva aona danho regomarara. Danho rekutanga ndiro danho risina kunyanya kukura. Danho rechina ndiro danho rakanyanya kukura.

• Danho 1: PCI score kubva pa1 kusvika pa10.
• Danho rechipiri: PCI score kubva pa11 kusvika pa20.
• Danho rechitatu: PCI score kubva pa21 kusvika pa30.
• Danho rechina: PCI score 31 kusvika 39.

Ndeipi mishonga yekurapa Peritoneal Mesothelioma?

Nzira dzekurapa dzinoenderana nedanho regomarara rako, hutano hwako hwese, nezvimwe zvinhu zvakawanda.

Kuvhiyiwa kweCytoreduction uye kurapwa kweHIPEC (Cytoreduction neHIPEC)

Kurapa kunonyanya kushandiswa kwe peritoneal mesothelioma kunosanganisira kuvhiyiwa kwe cytoreduction uye hyperthermic intraperitoneal chemotherapy (HIPEC) .

• Kubviswa kwemasero ekenza : Uku kuvhiyiwa kunobvisa masero ekenza mudumbu mako. Vanachiremba vanobvisa mapundu anoonekwa. Vanogonawo kubvisa zvikamu zveperitoneum nenhengo dzedumbu uko kenza yakapararira.
• Mishonga yekurapa inotonhora zvakanyanya ('HIPEC'): Iyi imhando yechemotherapy inopiwa mushure mekuvhiyiwa kwe cytoreduction. Mishonga ye chemotherapy inodziiswa kusvika patembiricha yakachengeteka uye inopihwa zvakananga mudumbu. Kupisa uku kunoita kuti mishonga iyi ive nesimba kupfuura chemotherapy yenguva dzose. HIPEC inouraya chero masero madiki ekenza angave akasiyiwa asina kubviswa panguva yekuvhiyiwa. HIPEC hainawo migumisiro yakawanda pane chemotherapy yenguva dzose.

Kuvhiyiwa kweCytoreduction uye HIPEC inzira dzakakura uye dzakaoma dzinogona kutora maawa anopfuura gumi. Zvisinei, tsvakurudzo yakaratidza kuti nzira iyi yekurapa inobatsira vanhu vane Peritoneal Mesothelioma kurarama kwenguva yakareba.

Kurapwa nemakemikari

Kana usingakwanise kuvhiyiwa kwe cytoreduction uye HIPEC, unogona kupihwa systemic chemotherapy. Mishonga yesystemic chemotherapy inofamba nemuropa rako uye inouraya masero ekenza mumuviri wako wese. Mhando dzakasiyana dzemishonga yechemotherapy dzinogona kupihwa pamwe chete.

Kurapa nekudzivirira muviri

Mishonga yekudzivirira muviri inonzi ``immune checkpoint inhibitors`` inobatsira masoja emuviri wako kuwana nekuparadza masero ekenza. Mishonga iyi inowanzoshandiswa kurapa ``pleural mesothelioma``. Chiremba wako anogonawo kuirayira kurapa ``peritoneal mesothelioma``.

Kurapa kwakanangana

Vamwe vanhu vane peritoneal mesothelioma vanogona kunge vaine shanduko dzemajini mumasero avo egomarara. Izvi zvinogona kurapwa nekurapa kwakanangwa. Kurapa kwakanangwa kunoshanda nekutarisa zvakananga shanduko dzemajini dzinoita kuti masero ane hutano ave masero egomarara. Kurapa uku kunogona kuwanikwa kuburikidza nechiremba wegomarara anorapa, kana kuburikidza nezvidzidzo zvinonzi kliniki zvinoedza kuchengetedzeka uye kushanda kwemishonga mitsva. Zvakakosha kuti kuongororwa kwemajini (gene testing) kuitwe pamatishu egomarara kubva ku biopsy yako kuti uone kana gomarara rako riine shanduko idzi dzemajini dzinonangwa.

Kutarisirwa kwevarwere vane marwadzo emusana

Kuti zvikubatsire kudzora zviratidzo zvegomarara uye migumisiro yekurapwa, chiremba wako anogona kukurudzira kurapwa kwekuderedza kushushikana. Kana usina hutano hwakakwana hwekuvhiyiwa, kana kuti gomarara rako rava padanho repamusoro, kurapwa kwekuderedza kushushikana kunogona kuva sarudzo yakanakisa kwauri. Kurapa kwekunyaradza kunogona kusanganisirawo nzira dzakadai separacentesis, iyo inobvisa mvura mudumbu. Izvi zvinogona kubatsira kuderedza kusagadzikana nekurwadziwa kunokonzerwa nekuunganidzwa kwemvura.

Ungaderedza sei njodzi yekubatwa nechirwere ichi?

Nzira chete yekuderedza njodzi yekuve nePeritoneal Mesothelioma ndeyekudzikisa njodzi iyi.Kudzivirira kubatwa neasbestos. Mumakore ekuma1970, masangano akaita seEnvironmental Protection Agency (EPA) muUnited States akaisa mitemo pakushandiswa kweasbestos. Zvisinei, zvivakwa zvakavakwa mitemo iyoyo isati yatanga kushanda zvinogona kunge zvichiri neasbestos. Kana machira easbestos akakanganiswa, anogona kubhururuka nemhepo uye kuva nengozi huru.

Kuti uderedze njodzi yako, dzivisa kugadzirisa kana kugadzirisa zvinhu zvinogona kukuisa panjodzi yeasbestos. Pane kudaro, tora nyanzvi, yakaita senyanzvi yekubvisa asbestos, kuti iite basa rakadaro.

Iwe unogona kuva netariro yerudzii kana uchirarama nePeritoneal Mesothelioma?

Peritoneal mesothelioma haisi chirwere chinorapika zvachose. Zvisinei, kurapwa kunogona kuwedzera hupenyu hwako uye kutoita kuti unzwe kurerukirwa. Kushanda nechikwata chevanachiremba vekenza vane hunyanzvi mukurapa mesothelioma kunogona kuvandudza mhedzisiro yekurapwa kwako. Kushanda nenyanzvi dzekurapa vanhu vanorwara negomarara kunogonawo kuvandudza hupenyu hwako sezvaunorarama nechirwere ichi chegomarara.

Ndezvipi zvinhu zvinokanganisa fungidziro yako yechirwere?

Kufanotaura kwechirwere chako kunoenderana nezvinhu zvakati wandei:

• Rudzi rweSero : Kune mhando nhatu dzemasero dzinogona kukura kuita bundu. Rudzi rwakajairika, runonzi epithelioid cells, rune fungidziro iri nani kupfuura mamwe marudzi maviri emasero, sarcomatoid cells nebiphasic cells.
• Danho reMesothelioma yako : Kana chirwere ichi chikaonekwa uye chikarapwa pakutanga, ungangove nemigumisiro iri nani.
• Murume/Mukadzi Wako : Kana zvasvika paPeritoneal Mesothelioma, vakadzi vanoratidzwa kuti vane fungidziro iri nani kupfuura varume.
• Kubviswa kwezvipundu zvachose : Kana chiremba wako akakwanisa kubvisa zvipundu zvese zvachose, fungidziro yako inogona kunge iri nani.
• Thrombocytosis : Kana uine thrombocytosis, fungidziro yako inogona kunge isina kunaka. Thrombocytosis chirwere chekuti une maplatelet akawanda muropa rako. Maplatelet masero anobatsira kuumba ropa rako.

Unogona kurarama kwenguva yakareba sei nePeritoneal Mesothelioma?

Vanhu vanoonekwa vaine Peritoneal Mesothelioma vanogona kurarama kwemwedzi inosvika 6 kusvika 12 vasina kurapwa. Zvisinei, kana vakarapwa, mwero wekurarama kwavo uri nani zvikuru. Varwere vePeritoneal Mesothelioma vanovhiyiwa necytoreductive uye HIPEC vanorarama kwemakore maviri kusvika matanhatu mushure mekuongororwa. Vamwe vanhu vanorarama kwenguva yakareba.

Zvisinei, kufambira mberi kwechirwere chako kunoenderana nezvinhu zvakati wandei. Chiremba wako ndiye munhu akakodzera kunzwisisa kuti ndezvipi zvinhu zvichakanganisa kufambira mberi kwechirwere chako, zvichienderana nesarudzo dzako dzekurapa.

Ndeipi mibvunzo inokosha yekubvunza chiremba wako?

Kana ukaonekwa uine Peritoneal Mesothelioma, taura nachiremba wako nezvezvinhu zvinotevera:

• "Ndivanaani vanachiremba vane hunyanzvi vachandirapa?"
• "Zviri nani here kuti ndiwane rubatsiro kubva kuchikwata chevanorapa varwere vanorwara nepfungwa dzakadzikama?"
• "Ndine rudzii rwemesothelioma?"
• "Kenza yangu yapararira kusvika papi? (Ndizvo kuti, danho rayo nderei?)"
• "Ndedzipi nzira dzekurapa dzandinadzo?"
• "Pane here `miedzo yekiriniki` (zvidzidzo zvinoedza mishonga mitsva) yandinogona kutora chikamu mazviri?"
• "Ndezvipi zvandingatarisira kubva mukurapa kuripo?"
• "Ndezvipi migumisiro yekurapwa? Inogona kudzorwa sei?"

Pakupedzisira, zvinhu zvekurangarira...

Peritoneal Mesothelioma igomarara risingawanzoitiki asi rakakomba. Kusangana neasbestos kunogona kuva chikonzero chikuru. Kana uine chimwe chezviratidzo zvatakurukura, zvakakosha kutsvaga rubatsiro rwechiremba nekukasika.

Zvakajairika kuti unzwe kutya uye kunetseka paunonzwa nezvechirwere chakadai. Asi yeuka, hausi wega. Une vanachiremba, mhuri, neshamwari kuti vakubatsire. Chinhu chakakosha ndechekuwana ruzivo rwakakodzera, kutaura pachena navanachiremba vako, uye kuwana kurapwa kwakanakira iwe. Kurapwa kunogona kubatsira kuwedzera hupenyu hwako uye kuvandudza hupenyu hwako.

` Peritoneal Mesothelioma, kenza, kenza yemudumbu, asbestos, peritoneum, mesothelioma, HIPEC, zviratidzo, kurapwa