Ngaba wakha weva ukuba ilungu elinye, mhlawumbi amabini okanye amathathu, losapho lwakho linomhlaza wamathumbu amakhulu? Okanye uloyiko kancinci kuba unembali yomhlaza kusapho lwakho? Enyanisweni, ezinye iintlobo zomhlaza zinokudluliselwa kwizizukulwana ngezizukulwana. Namhlanje siza kuthetha ngohlobo olukhethekileyo lomhlaza wamathumbu amakhulu oludluliselwa ngeejini zethu. Lo mhlaza siwubiza ngokuba yi-HNPCC.
Yintoni i-HNPCC?
Ngamafutshane, i-HNPCC (iHereditary Nonpolyposis Colorectal Cancer) luhlobo lomhlaza wamathumbu amakhulu olubangelwa lutshintsho oluthile (utshintsho) kwiijini ezidluliselwa kwizizukulwana ngezizukulwana. Lo ngumhlaza owenzeka emathunjini ethu amakhulu (ikholoni).
Ngaba oku kuyafana neLynch Syndrome?
Mhlawumbi ukhe wayiva iLynch Syndrome rhoqo kuneHNPCC. Ezi zimbini zihlobene kakhulu, kodwa azifani ncam. Cinga ngale ndlela. ILynch Syndrome sisiphene semfuza emizimbeni yethu. Yimeko yemfuza eyonyusa umngcipheko womhlaza.
I-HNPCC ligama elinikwa imeko apho umntu one-Lynch Syndrome eba nomhlaza wamathumbu amakhulu okanye eminye imidlaza enxulumene nayo (njengomhlaza wesibeleko okanye wamathumbu amancinci), ingakumbi ngaphambi kokuba abe neminyaka engama-50 ubudala. Imidlaza ye-HNPCC idla ngokukhula kwicala lasekunene lamathumbu amakhulu.
Ngamafutshane, iLynch Syndrome yimbangela yemfuza yesi sifo. I-HNPCC yimeko yomhlaza ebangelwa yiloo nto.
Ixhaphake kangakanani i-HNPCC? Zithini iimpawu?
I-HNPCC ibandakanya phakathi kwe-2% kunye ne-4% yazo zonke iintlobo zomhlaza we-colorectal ezixeliweyo kwihlabathi liphela. Nangona le meko inokwenzeka nakweyiphi na iminyaka, idla ngokuchongwa kubantu abangaphantsi kweminyaka engama-50.
I-HNPCC isenokungabi nazimpawu zithile kwizigaba zokuqala, kodwa njengoko umhlaza uqhubeka, ezi mpawu zinokuvela.
| Uphawu | Icacisiwe ngokulula |
|---|---|
| Intlungu yesisu okanye ukudumba | Ukungakhululeki kwesisu rhoqo, iintlungu, okanye ukuziva uqunjelwe. |
| Umnqweno wokutya | Ukuncipha komnqweno wokutya. |
| Igazi esitulweni | Igazi elikwisitulo okanye isitulo esimnyama xa usiya kwindlu yangasese. |
| Ndiziva ndidiniwe ngaphandle kwesizathu | Ukuziva udiniwe kangangokuba awukwazi nokwenza imisebenzi eqhelekileyo. |
| Ukunciphisa umzimba ngaphandle kwesizathu | Ukwehla kobunzima ngequbuliso ngaphandle kokunciphisa ukutya okanye ukwenza umthambo. |
Kutheni i-HNPCC ikhula? Ingaba iyasulela?
Eyona sizathu siphambili sale nto ziijini zethu. Cinga ngemizimba yethu njengesakhiwo esakhiwe ngokwesicwangciso esikhulu. Incwadi equlathe eso sicwangciso yiDNA yethu. Siyibiza imiyalelo kwezi jini zeDNA.
Abantu abaneLynch Syndrome baneziphene kwiijini ezithile (`MLH1`, `MSH2`, `MSH6`, `PMS2` kunye ne`EPCAM`) ezilungisa iimpazamo kwiDNA. Xa ezi jini zingasebenzi kakuhle, iimpazamo kwiDNA (`iimpazamo zokuphindaphinda kweDNA`) ezenzeka xa iiseli zethu zahlukana azilungiswa. Ekuhambeni kwexesha, ezi mpazamo ziyaqokelelana kwaye iseli eqhelekileyo iba sengozini yokuba yiseli yomhlaza.
Into ebalulekileyo kukuba i-HNPCC ayisosifo esosulelayo. Oko kuthetha ukuba ayisasazeki ukusuka komnye umntu ukuya komnye njengomkhuhlane. Nangona kunjalo, i-gene engalunganga eyibangelayo inokudluliselwa kwizizukulwana ngezizukulwana. Oko kuthetha ukuba ukuba umzali ngamnye une-Lynch Syndrome, umntwana unethuba elingama-50% lokufumana eso jini. Ukuba bazuza eso jini, loo mntwana usemngciphekweni omkhulu wokufumana i-HNPCC okanye eminye imingcipheko enxulumene nayo kwixesha elizayo.
Ugqirha uyibona njani le nto?
Ukuba uneempawu ezichazwe apha ngasentla, ingakumbi ukuba umntu kusapho lwakho ukhe waba nomhlaza wamathumbu amakhulu, ngokuqinisekileyo kuya kufuneka ubone ugqirha.
Ugqirha uza kuqala akuhlole. Emva koko, ukuba kukho umhlaza wamathumbu amakhulu, uvavanyo oluqhelekileyo yi -colonoscopy . Oku kubandakanya ukufaka umbhobho omncinci nge-anus nokusebenzisa ikhamera ukujonga ingaphakathi lamathumbu amakhulu.
Ukuqinisekisa ukuxilongwa kwe-HNPCC, ugqirha uya kujonga oku kulandelayo:
- Imbali yomhlaza wosapho:Ngokuqinisekileyo uza kubuzwa ukuba ngaba kukho nabani na kusapho lwakho olusondeleyo, njengomama wakho, utata, okanye abantakwenu, owakha waba nomhlaza wamathumbu amakhulu okanye omnye umhlaza onxulumene neLynch Syndrome ngaphambi kokuba abe neminyaka engama-50.
- Uvavanyo lweMfuzo: Kucetyiswa uvavanyo lwegazi olukhethekileyo ukuze kuqinisekiswe ukuba unayo na i-genetic changes ebangela i-HNPCC.
- Ukuthintela ezinye iimeko: Njenge-HNPCC, kukho enye imeko yomhlaza wamathumbu amakhulu ezuzwe njengelifa ebizwa ngokuba yi-FAP (Familial Adenomatous Polyposis) . Ngenxa yokuba kukho umahluko phakathi kwezi zimbini, kuya kwenziwa uvavanyo ukuqinisekisa ukuba une-HNPCC hayi i-FAP.
Yintoni umahluko phakathi kwe-HNPCC kunye ne-FAP?
Nangona zombini zizifo ezizuzwa njengelifa zomhlaza wamathumbu amakhulu, ii-genes ezibangela oku zahlukile. Umahluko ophambili linani lee-polyps ezikhula kumathumbu amakhulu.
| Uphawu | I-HNPCC (iLynch Syndrome) | I-FAP |
|---|---|---|
| Ubungakanani beepolyps | Zimbalwa kakhulu okanye aziveli kwaphela iziqhamo (ngesiqhelo zingaphantsi kwe-10). | Kuvela amakhulu, mhlawumbi amawakawaka amantongomane. |
| Ukuba ngumhlaza | Izityalo ezimbalwa zinokuba ngumhlaza ngokukhawuleza. | Ukuba ayinyangwa, kukho ithuba eliyi-100% lokuba enye yezi thumba ibe ngumhlaza. |
Ziziphi iindlela zonyango ze-HNPCC?
Unyango oluphambili lwe-HNPCC lutyando (colectomy) . Oku kuquka ukususa ngotyando inxalenye okanye yonke ikholoni apho umhlaza ukhoyo khona. Oku kungenziwa ngeendlela ezahlukeneyo.
- Ukususwa kwenxalenye yekholoni kuphela apho umhlaza ukhoyo.
- I-colectomy iyonke: Ukususwa kwamathumbu amakhulu onke.
- I-Proctectomy: Ukususwa kwamathumbu amakhulu kunye ne-rectum.
Ukuba umhlaza usasazeke (usuqhelile) kwezinye iindawo zomzimba, ugqirha wakho unokucebisa ezinye iindlela zonyango ukongeza kutyando.
- I-Chemotherapy: Unyango lweziyobisi olutshabalalisa iiseli zomhlaza.
- Unyango lwe-Immunotherapy: Ukuvuselela amasosha omzimba wethu ukuze alwe neeseli zomhlaza.
Kwiimeko ezininzi, unyango lwe-immunotherapy lunokuba nempumelelo ngakumbi kumhlaza we-HNPCC.
Liyintoni ikamva lomntu one-HNPCC?
I-Lynch Syndrome yimeko yemfuza engenakunyangeka. Yimeko ehlala ubomi bonke. Nangona kunjalo, utyando lunokunyanga umhlaza we-HNPCC kwaye luthintele umhlaza wamathumbu kwixesha elizayo.
Umntu one-HNPCC usemngciphekweni wokufumana ezinye iintlobo zomhlaza ukongeza kumhlaza wamathumbu amakhulu. Yiyo loo nto ugqirha wakho eya kukuxelela ukuba uhlolwe rhoqo.
- Umhlaza we-endometrial
- Umhlaza wesibeleko
- Umhlaza wesisu
- Umhlaza wezintso, ubuchopho, isibindi kunye nolusu
Eyona nto ibalulekileyo kukufumanisa isifo kwangethuba . Ukuba uvavanywa ngexesha, naluphi na umhlaza ungafunyanwa kwangethuba kwaye unyangwe ngempumelelo.
Ngokomyinge, malunga nama-60% abantu abafunyaniswe bene-HNPCC baphila iminyaka emi-5. Kwaye phakathi kwama-70% nama-88% abantu abanomhlaza wamathumbu ngenxa yeLynch Syndrome baphila iminyaka engaphezu kwe-10. Ezi zibalo zibonisa indlela ekubaluleke ngayo ukufunyanwa kwangethuba kunye nonyango.
Yintoni enokwenziwa ukuze kuphetshwe kwaye kulawulwe le ngozi?
Akukho ndlela yokuthintela utshintsho lwemfuza olubangela oku. Yinto esiyizuzisa njengelifa. Nangona kunjalo, zininzi izinto onokuzenza ukuthintela umhlaza okanye ukuwubona kwangethuba.
- Qaphela imbali yosapho lwakho: Ukuba kukho umntu kusapho lwakho oneLynch Syndrome okanye i-HNPCC, thetha nogqirha wakho ngayo kwaye ubuze ukuba ngaba nawe ufuna uvavanyo lwemfuza.
- Qala uhlolo kwangethuba: Ukuba ufunyaniswe uneLynch Syndrome, ugqirha wakho uya kukucebisa ukuba uqale uhlolo lomhlaza wamathumbu amakhulu (colonoscopy) xa uneminyaka engama-20 ubudala.
- Indlela yokuphila enempilo: Ezi zinto zinceda kakhulu ekunciphiseni umngcipheko womhlaza:
- Kuphephe ukutshaya ngokupheleleyo.
- Nciphisa ukusetyenziswa kotywala.
- Yitya ukutya okunempilo okutyebileyo kwimifuno neziqhamo.
- Zilolonge rhoqo.
- Gcina ubunzima bomzimba busempilweni.
- Lumka ngeempawu: Ukuba ufumana naziphi na iimpawu ezintsha, musa ukuzityeshela kwaye ubone ugqirha ngoko nangoko.
Umyalezo Wokuya Ekhaya
- I-HNPCC yimeko yomhlaza wamathumbu amakhulu ezuzwe njengelifa ebangelwa sisiphene semfuza esibizwa ngokuba yiLynch Syndrome.
- Ukuba elinye okanye amalungu osapho lwakho afumene umhlaza wamathumbu amakhulu ngaphambi kokuba afikelele kwiminyaka engama-50, thetha nogqirha ukuze ubone ukuba nawe usemngciphekweni.
- Le meko ayisuleli, kodwa kukho amathuba angama-50% okuba abantwana baza kufumana ilifa le gene ebangela umngcipheko.
- Ngokuhlolwa ngexesha elifanelekileyo, umhlaza unokubonwa kwasekuqaleni kwaye ubomi bunokusindiswa.
- I-HNPCC inokunyangeka ngempumelelo ngotyando kunye nezinye iindlela zonyango.
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