Yintoni isifo seLeptomeningeal? Makhe sithethe ngaso!

Kunzima ukuchaza uloyiko kunye nexhala olivayo xa ufumanisa ukuba unomhlaza. Xa ulwa nomhlaza, sonke sivile ukuba unokusasaza kwezinye iindawo zomzimba. Namhlanje, siza kuthetha ngendlela enye umhlaza onokuchaphazela ngayo ingqondo yethu, ii-membranes ezijikeleze umqolo wethu, kunye nolwelo lwethu lwe-cerebrospinal. Oogqirha babiza esi sifo ngokuthi yi-Leptomeningeal Disease , ngamanye amaxesha esibizwa ngokuba yi-LMD okanye i-LM .

Ngamafutshane, yintoni isifo seLeptomeningeal?

Kulungile, masiyihlalutye kancinci le nto. Kukho ii-membrane ezintathu ezibhityileyo ezikhusela ingqondo yethu kunye nomqolo. Ezi sizibiza ngokuba zii-meninges. Ii-membrane ezimbini ezibhityileyo ezingaphakathi kwezi meninges zibizwa ngokuba zii-leptomeninges . Njengeengubo zencwadi, ezi membrane zikhusela ezi ndawo zimbini zibalulekileyo kwinkqubo yethu yemithambo-luvo.

Okulandelayo, kukho ulwelo olukhethekileyo oluhamba ngaphakathi kwengqondo yethu kwaye lujikeleze umqolo wethu. Oku kubizwa ngokuba lulwelo lwe-cerebrospinal (CSF) . Olu lwelo londla ingqondo kunye nomqolo, luyikhusele, kwaye lususa inkunkuma.

Ngoku, isifo se-leptomeningeal (LMD) kuxa umhlaza okwindawo ethile emzimbeni, njengomhlaza webele okanye umhlaza wemiphunga, usasazeka kwaye ungene kwi-leptomeningeal membranes esithethe ngayo kunye nolwelo lwe-cerebrospinal (CSF). Oko kuthetha ukuba iiseli zomhlaza ziqala ukudada kolu lwelo, njengenkunkuma edada emanzini. Oku kuthathwa njengohlobo olubi lomhlaza.

Ixhaphake kangakanani isifo se-leptomeningeal (LMD)?

Isifo seLeptomeningeal (LMD) asiqhelekanga kangako. Nangona kunjalo, ngenxa yokuqhubela phambili kunyango oluvumela abantu ukuba baphile ixesha elide benomhlaza, siya sixhaphaka ngakumbi. Ngokomyinge, i-LMD yenzeka kwi-5% yezigulana ezinomhlaza.

Le meko ye-LMD idla ngokubonakala kubantu abaneentlobo ezilandelayo zomhlaza:

• Umhlaza webele: Umhlaza webele lolona hlobo luqhelekileyo lomhlaza webele olunxulunyaniswa ne-LMD. Uchaphazela i-3% ukuya kwi-5% yabasetyhini abanomhlaza webele. Izifundo zibonise ukuba abafazi abanohlobo olubizwa ngokuba yi-"Triple negative breast cancer" kunye ne-"Lobular breast cancer" basengozini enkulu yokuhlaselwa yi-LMD.
• Umhlaza wemiphunga: Zombini umhlaza wemiphunga ongengoweeseli ezincinci (i-NSCLC) kunye nomhlaza wemiphunga weeseli ezincinci (i-SCLC) zinokusasazeka ziye kwi-leptomeninges kunye nolwelo lwe-cerebrospinal. Oogqirha baqikelela ukuba phakathi kwe-4% kunye ne-7% yabantu abane-NSCLC bahlakulela i-LMD. Eli zinga linyuka liye kuthi ga kwi-11% yabantu abane-SCLC.
• I-Melanoma: Olu luhlobo olubi kakhulu lomhlaza wolusu. Malunga ne-5% yabantu abane-melanomaI-LMD ingaphuhla.
• I-Acute lymphocytic leukemia (ALL): Lo ngumhlaza wegazi. Phakathi kwe-1% kunye ne-10% yabantu abane-ALL banokuba ne-LMD.
• I-Non-Hodgkin's lymphoma (NHL): Le ikwangumhlaza wenkqubo ye-lymphatic. Phakathi kwe-5% kunye ne-10% yabantu abane-NHL banokuba ne-NHL.

Yintoni umahluko phakathi kwe-brain metastases kunye nesifo se-leptomeningeal (LMD)?

Zombini ezi zinto zenzeka xa umhlaza usasazeka, kodwa kukho umahluko omncinci.

Ukwanda kwe-metastases yobuchopho kwenzeka xa iiseli zomhlaza zihamba ngqo kwizicubu zobuchopho zize zenze ii-tumor apho.

Nangona kunjalo, isifo se-leptomeningeal (LMD) siyenzeka xa iiseli zomhlaza zingena kwi -cerebrospinal fluid (CSF) nakwi-leptomeningeal membranes ezijikeleze ingqondo kunye nomqolo . Apha, iiseli zomhlaza zisenokuba zintanta kulwelo okanye zisasazeke kumphezulu wee-membranes.

Ngamanye amaxesha zombini ezi meko zinokwenzeka kunye, okanye zinokwenzeka ngokwahlukeneyo.

Zithini iimpawu zesi sifo?

Kunokubakho iimpawu ezininzi zesifo se-leptomeningeal (LMD), njengoko sichaphazela ingqondo kunye nomgogodla, okuyiyo yonke inkqubo yethu yemithambo-luvo. Nangona kunjalo, nazi ezinye zeempawu eziqhelekileyo:

• Intloko ebuhlungu: Olu luphawu oluphambili olufunyanwa ngabantu abaninzi. Alufani nentloko eqhelekileyo, lunokuba buhlungu kancinci, kwaye ngamanye amaxesha luba mandundu kusasa.
• Isicaphucaphu nokuhlanza: Isicaphucaphu nokuhlanza kunokwenzeka, ingakumbi kusasa.
• Utshintsho kwindlela ohamba ngayo: Usenokuziva ngathi ulahlekelwa kukulawula kwaye uyakhubeka xa uhamba.
• Ukulahlekelwa kukuva: Ukulahlekelwa kukuva kunokubakho ngequbuliso, kwaye usenokuqala ukuva izandi ezahlukeneyo ezindlebeni zakho.
• Iingxaki zokubona: Ukubona kabini kunye nokubona okufipheleyo kunokwenzeka.
• Ukuxhuzula : Ukulahlekelwa yingqondo ngequbuliso kunye nokuxhuzula kunokwenzeka.
• Ukudideka kunye notshintsho kwingqondo, kwimo yengqondo, okanye kwindlela yokuziphatha: Ubunzima bokugxila, ukulahlekelwa yinkumbulo, ukucaphuka, kunye nokuxhalaba kunokwenzeka.
• Intlungu yomqolo nemilenze: Intlungu inokubakho emqolo nakwimilenze.
• Ukuba ndindisholo okanye ubuthathaka emilenzeni okanye ezimpundu: Imilenze yakho isenokuvakala ngathi andindisholo kwaye ayinabomi.
• Iingxaki zokuchama okanye zokukhupha indle: Kunokuba nzima ukulawula umchamo kunye nendle.
• Ezinye iingxaki ezintsha ze-neurological: Ukongeza koku, iimpawu ezintsha ze-neurological zinokuvela, ezinje ngobunzima bokuthetha kunye nokungaziva mnandi kwinxalenye yobuso.

Eyona nto ibalulekileyo kukuba ukuba unomhlaza, xelela ugqirha wakho ngoko nangoko ukuba ufumanisa naziphi na iimpawu ezintsha ezifana nezi.

Kutheni kukho isifo se-leptomeningeal (LMD)?

Ngamafutshane, i-LMD yenzeka xa iiseli zomhlaza ziphuma kwindawo yokuqala yomhlaza emzimbeni (umz., ibele, imiphunga), zihamba ngegazi okanye inkqubo ye-lymphatic, zize zingene kwi-cerebrospinal fluid (CSF) kunye ne-leptomeninges esithethe ngazo ngaphambili. Oku kubonisa ukuba umhlaza usasazeke kangakanani.

Ngokwesiqhelo, ulwelo lwe-cerebrospinal (CSF) lwenziwa engqondweni yethu, emva koko luhambahamba ubuchopho kunye nomqolo, luze luphinde lufunxwe lungene egazini. Oku kwenzeka kumjikelo. Nangona kunjalo, xa iiseli zomhlaza zingena kule CSF, zinokuphazamisa ukuhamba okuqhelekileyo kolu lwelo. Emva koko i-CSF inokuqokelelwa, yonyuse uxinzelelo ngaphakathi kwengqondo. Yiyo loo nto kuvela iimpawu ezininzi. Kwakhona, xa iiseli zomhlaza zisasazeka kwiimembrane ze-leptomeninges, zingonakalisa ezo membrane kunye nemithambo-luvo edibene nazo.

Oogqirha bayibona njani le nto?

Ukuba ukrokrela ukuba une-LMD, oogqirha baza kwenza uvavanyo oluphambili olubini:

1. I-MRI scan (Magnetic Resonance Imaging - MRI): I-MRI scan yengqondo yakho kunye/okanye umqolo wakho iyenziwa ukujonga ukuba iiseli zomhlaza zisasazeka kwi-leptomeninges kwaye azithinteli ukuhamba kwe-CSF.

2. Ukubhobozwa kweLumbar / iSpinal Tap: Kolu vavanyo , kufakwa inaliti encinci emqolo wakho ongezantsi, kunyanyekelwa ukuba ingonakalisi i-spinal cord yakho, kususwe isampuli encinci ye-cerebrospinal fluid (CSF). Emva koko isampuli iyavavanywa kwilebhu ukuze kubonwe ukuba kukho iiseli zomhlaza na.

Ngamanye amaxesha, ukuba ukusasazeka kweeseli zomhlaza kungabonakali kakhulu (nge-microscopic), kusenokungabonwa kwi-MRI scan. Kwiimeko ezinjalo, ukufumanisa isifo kunokuba nzima kancinci. Yiyo loo nto kubalulekile ukuxelela ugqirha wakho ngqo ngeempawu zakho.

Ngaba ikho indlela epheleleyo yokunyanga oku?

Ngelishwa, okwangoku akukho nyango lwesifo se-leptomeningeal (LMD). Ngenxa yokuba luhlobo lomhlaza olubi nolusasazekileyo, iinjongo eziphambili zonyango kukulawula ukusasazeka komhlaza, ukunciphisa iimpawu nokukunceda uphile kamnandi kangangoko, kunye nokugcina umgangatho wobomi.

Iindlela zonyango zixhomekeke kwizinto ezifana nohlobo lomhlaza owawunawo ekuqaleni, ukuba umhlaza usasazeke kangakanani, kunye nempilo yakho iyonke. Ezinye zeendlela zonyango ezisetyenziswa kakhulu ziquka:

• Unyango ngemitha: Unyango ngemitha lunikezelwa kwiindawo ezichaphazelekayo zengqondo okanye kwi-spinal cord. Oku kunokunciphisa ezinye iimpawu (umz. iintlungu, ubuthathaka bemithambo-luvo) kwaye kuphucule ukusebenza kwemithambo-luvo.
• Unyango ngamakhemikhali:Amayeza anikwa ukubulala iiseli zomhlaza. La mayeza anokuthathwa njengeepilisi, anikwe njengeenaliti emthanjeni, okanye ngamanye amaxesha afakwe ngqo kwi-cerebrospinal fluid (CSF). Oku kubizwa ngokuba yi-"Intrathecal chemotherapy." Oku kwenziwa ngetyhubhu encinci efakwa engqondweni ebizwa ngokuba yi-"ventricular access device."

Ngaba zikho iindlela zokunciphisa ukwenzeka koku?

Enyanisweni, okwangoku akukho ndlela ithile yokuthintela uphuhliso lwe-LMD, njengoko kwenzeka ngenxa yokusasazeka komhlaza osele ukho emzimbeni.

Ungaphila ixesha elingakanani nale sifo?

Ndiyazi ukuba lo ngumbuzo onzima ukuwubuza. I-LMD linqanaba eliphambili lomhlaza. Oku kuthetha ukuba xa le meko isenzeka, isigulana sikwinqanaba elibi kakhulu lomhlaza.

Ngokomndilili, izigulana ezifumana unyango zinokulindela ukuphila iinyanga ezintathu ukuya kwezintandathu emva kokuba zixilongiwe . Kwabo bangafumani unyango, eli xesha linokuba malunga nenyanga.

Nangona kunjalo, oku kunokwahluka kumntu nomntu. Kuxhomekeke kwizinto ezininzi, njengohlobo lomhlaza onawo kunye nendlela umzimba wakho osabela ngayo kunyango. Ugqirha wakho ngumntu ofanelekileyo ukukunika ulwazi malunga noku.

Ndingazinyamekela njani? Ngaba ndifanele ndicinge ngokhathalelo lwe-hospice?

Ukuba une-LMD, kubalulekile ukuba uyiqonde kakuhle imeko yakho. I-LMD yingxaki engapheliyo yomhlaza. Buza ugqirha wakho ukuba ulindele ntoni ngokusekelwe kwimeko yakho. Ngale ndlela, unokulawula iimpawu zakho, uhlale ukhululekile kangangoko unako, kwaye ubeke phambili izinto ezibalulekileyo kuwe.

Ezi zinto azilula ukuthetha ngazo, nokuba nguwe okanye ugqirha wakho. Kodwa zibaluleke kakhulu. Ugqirha wakho angakunceda uqonde okwenzekayo emzimbeni wakho kunye noko kunokwenzeka kwixesha elizayo. Angakunceda ucinge ngeendlela onokukhetha kuzo, kwaye ukuba kuyimfuneko, akuthumele kwiinkonzo zenkxaso.

Ukhathalelo lwe-Hospice yinkonzo enceda abantu abanezifo ezithintela ubomi babo, ezingapheliyo, baphile imihla yabo yokugqibela ngokukhululeka, benesidima, belawulwa ngabo, kwaye benomgangatho ophezulu wobomi. Xa silwa nesifo esinzima, uninzi lwexesha lethu kunye namandla ethu agxile kunyango. Xa sicinga ngokhathalelo lwe-hospice, ingqwalasela ikwindlela yokuchitha ixesha eliseleyo, endaweni yokugula ngokwako. Ngokuthetha nogqirha wakho malunga nendlela i-LMD eya kuyichaphazela ngayo ubomi bakho, ukuba loluphi unyango olufumanekayo kuhlobo lwakho lomhlaza, kunye noko unokukulindela kuloo nyango, ungenza isigqibo esifanelekileyo kuwe.

Ukuba une-LMD, mhlawumbi uphila nomhlaza onzima osasazeke emzimbeni wakho wonke nangona unyangwa. Xa ufumanisa ukuba unengxaki enganyangekiyo nenzima, usenokuziva wothukile, unomsindo, kwaye usoyika. Usenokuzibuza, "Kutheni oku kusenzeka kum?" Awuwedwa kule meko. Cela uncedo kugqirha wakho. Bayaqonda ukuba ujamelene nantoni na, kwaye baya kukunceda nangayiphi na indlela abanokukunceda ngayo.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

• Isifo seLeptomeningeal (LMD) kukusasazwa komhlaza kwiinwebu ezigubungela ingqondo kunye nomqolo kunye nolwelo lwe-cerebrospinal.
• Le yimeko enzima kakhulu engenakunyangwa.
• Iimpawu ze-neurological ezifana nentloko ebuhlungu, isicaphucaphu, ubunzima bokuhamba, iingxaki zokubona/ukuva, kunye nokudideka kunokwenzeka.
• Esi sifo sichongwa nge-MRI scan kunye nokubhobozwa kwe-lumbar.
• Injongo yonyango kukulawula iimpawu nokugcina umgangatho wobomi.
• Musa ukoyika ukuthetha ngokukhululekileyo nogqirha wakho malunga nemeko yakho, ikamva lakho, kunye nezinye iindlela ezifana nokhathalelo lwe-hospice. Fumana inkxaso oyifunayo wena nosapho lwakho ukuze nikwazi ukudlula kweli xesha linzima.

Isifo seLeptomeningeal , Umhlaza, Ubuchopho, Umqolo, Ulwelo lweCerebrospinal, Iimpawu, Ukusasazeka komhlaza