Ngaba uyayazi le mhlaza ingaqhelekanga ekhula kwi-membrane yesisu (peritoneal mesothelioma)?

Ngaba ngamanye amaxesha uziva iintlungu ezingacacanga okanye ukudumba esiswini sakho? Ngaba uziva uphelelwa ngumdla wokutya kwaye wehla emzimbeni? Nangona ngamanye amaxesha singazinaki ezi mpawu, zinokuba ziimpawu zesifo esinzulu esisisiseko. Namhlanje siza kuthetha ngohlobo lomhlaza olungaqhelekanga, kodwa olufanele ukuqwalaselwa kakhulu. Lo ngumhlaza obizwa ngokuba yi-'Peritoneal Mesothelioma'.

Yintoni le Peritoneal Mesothelioma?

Ngamafutshane, i-'Peritoneal Mesothelioma' ngumhlaza okhula ngaphakathi esiswini sethu, oko kukuthi, kwi-membrane encinci egubungela umngxuma wesisu, ngokwezonyango, i-'peritoneum'. Cinga ngayo, le 'peritoneum' ifana nesigqubuthelo esithambileyo esikhuselayo esijikeleze amalungu abalulekileyo esiswini sethu, njengesibindi, amathumbu, kunye nesisu.

Lo mhlaza, njengezinye iintlobo ze-mesothelioma, udla ngokunxulunyaniswa nokudibana ngaphambili nento ebizwa ngokuba yi-asbestos. Usenokuba ukhe weva ukuba i-asbestos yinto esetyenziselwa ukwenza ezinye izinto zokwakha. Iyingozi kakhulu kuba imicu ekuyo inokubangela iingxaki ezinkulu ukuba uyaziphefumla okanye uzitya.

I-peritoneal mesothelioma ngumhlaza ohlaselayo nosasazeka ngokukhawuleza. Uninzi lwexesha, nokuba ufunyenwe, umhlaza sele usasazeke kulo lonke ulwelo lwesisu. Ngenxa yoko, kunzima ukuwubona kwangethuba.

Yintoni umahluko phakathi kwe-peritoneal mesothelioma kunye ne-pleural mesothelioma?

Zombini i-'Peritoneal Mesothelioma' kunye ne-'Pleural Mesothelioma' zikhula kwiimembrane ezijikeleze imingxunya ebalulekileyo kunye namalungu angaphakathi omzimba wethu.

• I-peritoneal mesothelioma ikhula kwi-membrane ejikeleze isisu kwaye ijikeleze amalungu esisu, oko kukuthi, i-peritoneum esikhankanyileyo ngaphambili.
• I-Pleural mesothelioma ikhula kwi-membrane ejikeleze umgodi wesifuba, ingakumbi imiphunga. Ibizwa ngokuba yi-pleura.

Zombini ezi membrane zenziwe ngohlobo oluthile lweseli olubizwa ngokuba yi-'mesothelial cells'. Yiyo loo nto lo mhlaza ubizwa ngokuba yi-'mesothelioma'.

Zombini ezi ntlobo ze-mesothelioma zihlala ziyingozi, oko kuthetha ukuba zinomhlaza . Ezi seli ze-mesothelioma ziyingozi zikhula ngokukhawuleza nangokungalawulekiyo, zonakalisa izicubu eziphilileyo ezijikeleze imithambo. I-mesothelioma ye-Pleural luhlobo lomhlaza oluqhelekileyo kune-peritoneal mesothelioma.

Ngubani onokuthi abe nesi sifo? Sixhaphake kangakanani?

Nabani na unokufumana i-'Peritoneal Mesothelioma'. Nangona kunjalo, ayiqhelekanga kakhulu kubantwana abancinci. Ngokuqhelekileyo, esi sifo sifunyanwa kubantu abakwiminyaka yabo yama-50.

Nangona i-'Peritoneal Mesothelioma' iluhlobo lwesibini oluxhaphakileyo lwe-'Mesothelioma' (owokuqala yi-'Pleural Mesothelioma'), ikwangumhlaza ongaqhelekanga. I-'Peritoneal Mesothelioma' ikhula phakathi kwe-10% kunye ne-20% yazo zonke izigulane ze-'Mesothelioma'. Khawuthelekelele, kwilizwe elifana neMelika, kuphela phakathi kwama-400 kunye ne-1000 amatyala amatsha ezi zigulane axelwayo minyaka le. Ngoko ke, nangona ezi zigulane zinokubakho naseSri Lanka, inani liphantsi kakhulu.

Zithini iimpawu ze-Peritoneal Mesothelioma? Ungazibona njani?

Eli linqaku elibaluleke kakhulu kuba uninzi lwexesha, i-Peritoneal Mesothelioma ayibonisi zimpawu kwasekuqaleni. Iimpawu ziqala ukubonakala emva kokuba umhlaza usasazeke kwizitho zesisu.

Uphawu oluqhelekileyo kukuqokelelwa kolwelo esiswini. Oku kukwabizwa ngokuba yi-'ascites'. Xa ulwelo luqokelelwa, isisu siqala ukwanda nokudumba. Uphawu lwesibini oluqhelekileyo ziintlungu zesisu.

Ezinye iimpawu zingabandakanya:

• I-Ascites : Ivakala ngathi isisu sigcwele kwaye sinzima.
• Ukudumba okanye ukudumba kwesisu : Iimpahla zinokuba nzima.
• Intlungu yesisu : Le inokuba yintlungu esasazeka esiswini sonke, okanye inokuba yintlungu eviwa kwindawo enye kuphela.
• Usenokuva iqhuma elibuhlungu esiswini esisezantsi .
• Ukuqhinwa okanye ukuvaleka kwamathumbu : Kuvakala ngathi isisu sakho sidumbile kwaye unobunzima bokuphuma endle.
• Isicaphucaphu nokuhlanza .
• Umkhuhlane ongachazekiyo kunye nokubila ebusuku .
• Ukunciphisa umzimba ngendlela engaqhelekanga .
• Ukutya akunancasa .

Kubalulekile: Ukuba uqhubeka nokuba nenye okanye ngaphezulu kwezi mpawu, kubaluleke kakhulu ukubona ugqirha ukuze akunike ingcebiso. Ungakhathazeki, ayizizo zonke ezi mpawu ezibangelwa ngumhlaza. Zinokubangelwa nazezinye iimeko eziqhelekileyo. Nangona kunjalo, kungcono rhoqo ukuya kuhlolwa.

Ziziphi izizathu kunye nezinto ezibangela umngcipheko wokuphuhlisa i-Peritoneal Mesothelioma?

Eyona nto iphambili ebangela ukuba umntu abe ne-mesothelioma kukufumana i-asbestos. I-Asbestos yimpahla eneefayibha esetyenziswa ekwakheni, kwimibhobho yamanzi, kumsebenzi wombane, ekufuleleni, kumashishini athile okuvelisa izinto, nakwishishini leemoto. Abantu abaninzi abaphuhlisa i-mesothelioma banemisebenzi ebafaka kwi-asbestos.

Nangona kunjalo, nangona uninzi lwabantu abafumana i-pleural mesothelioma (uhlobo oluchaphazela imiphunga) banembali yokuchaphazeleka yi-asbestos, unxibelelwano phakathi kwe-peritoneal mesothelioma (uhlobo oluchaphazela ulwelo lwesisu) kunye ne-asbestos alucaci kangako. Abanye abantu abafumana i-peritoneal mesothelioma basenokuba abazange babe nembali yokuchaphazeleka yi-asbestos emsebenzini. Oku kusaphandwa.

Nazi ezinye izinto ezibangela umngcipheko wokuphuhlisa i-'Peritoneal Mesothelioma':

• Ukuvezwa yi-asbestos : Xa iifayibha ze-asbestos zingena kwindawo esikuyo, ziyabhabha emoyeni. Xa zingena, zinokungena emzimbeni wethu ngomlomo nangempumlo, ziye kwi-membrane yesisu (peritoneum), zize zihlale apho. Xa zifakwe, zonakalisa iiseli ze-mesothelial, zibangele ukuba zahlukane ngendlela engaqhelekanga. Yile nto ibangela ukuba kubekho iithumba ezinomhlaza. Khawuthelekelele, i-mesothelioma yenzeka emva kweminyaka emininzi ichaphazeleka yi-asbestos, ngamanye amaxesha ide ibe yiminyaka engama-40.
• Ukuvezwa kweSilica kunye neErionite : Ezi ziiminerali eziqhelekileyo ezifumaneka emhlabeni. Ukuvezwa kwezi zinto kukwafunyenwe kunxulunyaniswa nePleural kunye nePeritoneal Mesothelioma.
• Utshintsho kwizakhi zofuzo : Ezinye izifundo zibonise ukuba ukuba ujongene ne-asbestos kwaye unezinye iinguqulelo kwizakhi zofuzo, umngcipheko wakho wokuba ne-peritoneal mesothelioma unokwanda. Enye yezona nguqu zixhaphakileyo kukutshintsha kwezakhi zofuzo ezibizwa ngokuba yi-BAP1. Le gene, ebizwa ngokuba yi-BAP1, inoxanduva lokuthintela ukukhula komhlaza.
• Ukuvezwa kwimitha : Ukuba ufumene unyango lwemitha yomhlaza wesisu wangaphambili kucingelwa ukuba kwandisa umngcipheko wokuba ne-peritoneal mesothelioma. Nangona kunjalo, kufuneka uphando oluthe kratya ukuze kuqondwe ngokupheleleyo ulwalamano phakathi kwemitha kunye nomngcipheko we-mesothelioma.

Ungazi njani ukuba une-Peritoneal Mesothelioma?

Ukuchonga iMesothelioma yePeritoneal kunokuba nzima, njengoko besitshilo ngaphambili, kuba ayibonisi zimpawu kwizigaba zokuqala. Xa kuvela iimpawu, zinokufana nezinye izifo eziqhelekileyo zendlela yokugaya okanye ezinye iintlobo zomhlaza. Ke ngoko, ezi meko ziqhelekileyo zihlala zingabikho xa kuchongwa isifo.

Ezi mvavanyo zilandelayo zingenziwa ukuze kufunyaniswe isifo:

• I-CT scan : Ugqirha wakho unokuyalela i-CT scan ukuze akhuphe ezinye iimeko ezibangela iimpawu ezifana ne-peritoneal mesothelioma, njengomhlaza wesibeleko okanye i-adenocarcinoma. Oku kunokubandakanya ukufaka idayi ekhuselekileyo (i-contrast) egazini lakho ukuze izinto ezifana namaqhuma esiswini sakho zibonakale ngakumbi kwi-scan.
• I-MRI scan (Magnetic Resonance Imaging (MRI)) : I-MRI inokubonelela ngeenkcukacha ezifanayo ne-CT scan. I-MRI ingenziwa ukuba awukwazi ukwenza i-CT scan ene-contrast.
• Uvavanyo lwegaziUgqirha wakho unokuvavanya iimpawu ezithile egazini lakho, ezifana neeproteni ezithile, ezinokuba luphawu lomhlaza.
• Uhlalutyo lolwelo lwesisu : Kule nkqubo, ugqirha wakho ufaka inaliti esiswini sakho aze athathe isampuli yolwelo ukujonga iimpawu ze-mesothelioma. Nangona kunjalo, olu vavanyo lunomda omnye. Lunika ulwazi kuphela malunga nolwelo olusesiswini sakho, hayi kwizicubu ezikwisisu sakho. Inqanaba lomhlaza lixhomekeke ekubeni umhlaza usasazeke kangakanani kwizicubu.
• I-CT-guided core needle biopsy okanye i-laparoscopic biopsy : Eyona ndlela yokuqinisekisa ukuxilongwa kwe-peritoneal mesothelioma kukuba ne-biopsy. Kule nto, ugqirha wakho usebenzisa i-imaging (efana ne-scan) ukufumana indawo echanekileyo yeqhubu lakho. Emva koko, besebenzisa izixhobo zotyando, bathatha isampuli yethishu baze bayithumele kwilebhu ukuze ivavanywe.

Zithini izigaba ze-Peritoneal Mesothelioma?

Amanqanaba omhlaza abonisa ukuba esi sifo sihambe kangakanani kwaye sisasazeke kangakanani. Inkqubo yokulinganisa esetyenziswa kakhulu kwi-peritoneal mesothelioma yi-PCI (Peritoneal Cancer Index).

Kwindlela ye-`PCI`, isisu sakho sahlulwe saba ngamacandelo ali-13, kwaye icandelo ngalinye linikwa amanqaku ukusuka ku-0 ukuya ku-3.

• U-0 uthetha ukuba akukho mhlaza kuloo ndawo.
• 3 ithetha ukuba inxalenye igutyungelwe ngumhlaza ngokupheleleyo.

Ugqirha emva koko udibanisa amanqaku kwicandelo ngalinye aze amisele inqanaba lomhlaza. Inqanaba loku-1 lelona liphezulu kakhulu. Inqanaba lesi-4 lelona liphezulu kakhulu.

• Inqanaba loku-1: Amanqaku e-PCI ukusuka ku-1 ukuya kwi-10.
• Inqanaba lesi-2: Amanqaku e-PCI ukusuka kwi-11 ukuya kwi-20.
• Inqanaba lesi-3: Amanqaku e-PCI ukusuka kuma-21 ukuya kuma-30.
• Inqanaba lesi-4: Amanqaku e-PCI angama-31 ukuya kuma-39.

Ziziphi iindlela zonyango lwe-peritoneal mesothelioma?

Iindlela zonyango zixhomekeke kwinqanaba lomhlaza wakho, impilo yakho iyonke, kunye nezinye izinto ezininzi.

Utyando lokunciphisa i-cytore kunye nonyango lwe-HIPEC (ukunciphisa i-cytore nge-HIPEC)

Unyango olusetyenziswa kakhulu kwi-peritoneal mesothelioma ludibaniso lotyando lwe-cytoreduction kunye ne-hyperthermic intraperitoneal chemotherapy (HIPEC) .

• Ukunciphisa umhlaza : Olu lutyando olususa iiseli zomhlaza ngaphakathi esiswini sakho. Oogqirha baza kususa naziphi na iziqwenga ezibonakalayo. Basenokususa neendawo ze-peritoneum kunye nezitho zesisu apho umhlaza usasazeke khona.
• I-hyperthermic intraperitoneal chemotherapy (`HIPEC`): Olu luhlobo olukhethekileyo lwe-chemotherapy olunikwa emva kotyando lwe-cytoreduction. Amayeza e-chemotherapy afudunyezwa kubushushu obukhuselekileyo aze anikwe ngqo kwisisu. Olu bushushu lwenza la mayeza abe namandla kakhulu kune-chemotherapy eqhelekileyo. I-HIPEC ibulala naziphi na iiseli zomhlaza ezincinci ezinokuba zishiywe ngasemva ezingasuswanga ngexesha lotyando. I-HIPEC ikwanazo neziphumo ebezingalindelekanga ezimbalwa kune-chemotherapy eqhelekileyo.

Utyando lokunciphisa iiseli zesisu kunye ne-HIPEC ziinkqubo ezinkulu nezintsonkothileyo ezinokuthatha iiyure ezingaphezu kwe-10. Nangona kunjalo, uphando lubonise ukuba le ndlela yonyango inceda abantu abane-Peritoneal Mesothelioma baphile ixesha elide.

Unyango ngamakhemikhali

Ukuba awukwazi ukwenza utyando lokunciphisa imithambo yegazi kunye ne-HIPEC, unganikwa i-systemic chemotherapy. Amayeza e-systemic chemotherapy ahamba egazini lakho aze abulale iiseli zomhlaza emzimbeni wakho wonke. Iindidi ezahlukeneyo zamayeza e-chemotherapy zinokunikwa kunye.

Unyango lwe-immunotherapy

Amayeza e-immunotherapy abizwa ngokuba yi-"immune checkpoint inhibitors" anceda inkqubo yakho yomzimba ifumane kwaye itshabalalise iiseli zomhlaza. La mayeza asetyenziswa rhoqo ukunyanga i-"pleural mesothelioma." Ugqirha wakho angawayalela ukuba anyange i-"peritoneal mesothelioma."

Unyango olujoliswe kulo

Abanye abantu abane-peritoneal mesothelioma banokuba notshintsho kwimfuza kwiiseli zabo zomhlaza. Oku kunokunyangeka ngonyango olujoliswe kuko. Unyango olujoliswe kuko lusebenza ngokujolisa ngokuthe ngqo kutshintsho lwemfuza olubangela ukuba iiseli eziphilileyo zibe ziiseli zomhlaza. Olu nyango lunokufumaneka ngogqirha wakho we-oncologist, okanye ngezifundo ezibizwa ngokuba zizilingo zeklinikhi ezivavanya ukhuseleko kunye nokusebenza kakuhle konyango olutsha. Kubalulekile ukuba kwenziwe uvavanyo lwemfuza (uvavanyo lwemfuza) kwizicubu zomhlaza ezithathwe kwi-biopsy yakho ukuze kubonwe ukuba umhlaza wakho unalo na olu tshintsho lwemfuza olujoliswe kuko.

Ukhathalelo lwentlungu

Ukuze akuncede ulawule iimpawu zomhlaza kunye nemiphumo emibi yonyango, ugqirha wakho unokucebisa unyango oluthomalalisa iintlungu. Ukuba awuphilile ngokwaneleyo ukuba ungatyandwa, okanye ukuba umhlaza wakho ukwinqanaba eliphezulu, unyango oluthomalalisa iintlungu lunokuba lolona khetho lufanelekileyo kuwe. Unyango oluthomalalisa iintlungu lungabandakanya neenkqubo ezifana ne-paracentesis, esusa ulwelo esiswini. Oku kunokunceda ukunciphisa ukungakhululeki kunye nentlungu ebangelwa kukuqokelelana kolwelo.

Ungayinciphisa njani ingozi yokuhlaselwa sesi sifo?

Eyona ndlela yokunciphisa umngcipheko wokufumana i-Peritoneal Mesothelioma kukuUkuphepha ukuvezwa kwi-asbestos. Kwiminyaka yoo-1970, ii-arhente ezifana ne-Environmental Protection Agency (EPA) e-United States zabeka imithetho yokusetyenziswa kwe-asbestos. Nangona kunjalo, izakhiwo ezakhiwe ngaphambi kokuba loo mithetho iqale ukusebenza zisenokuba zisenayo i-asbestos. Ukuba imicu ye-asbestos iyaphazamiseka, inokuba nomoya kwaye ibe yingozi kakhulu.

Ukuze unciphise umngcipheko wakho, kuphephe ukwenza ukulungiswa okanye utshintsho olunokukubeka kwi-asbestos. Endaweni yoko, qesha ingcali, efana nengcali yokususa i-asbestos, ukuba iphathe loo msebenzi.

Luhlobo luni lwethemba onokuba nalo xa uphila ne-Peritoneal Mesothelioma?

I-peritoneal mesothelioma ayisosifo esinokunyangeka ngokupheleleyo. Nangona kunjalo, unyango lunokwandisa ubomi bakho kwaye lude lubangele amaxesha okuxolelwa. Ukusebenza neqela leengcali zomhlaza ezigxile ekunyangeni i-mesothelioma kunokuphucula iziphumo zonyango lwakho. Ukusebenza neengcali zokhathalelo lwentlungu kunokuphucula umgangatho wobomi bakho njengoko uphila nolu xilongo lomhlaza.

Zeziphi izinto ezichaphazela ukuqikelela kwakho isifo?

Ukubikezela kwangaphambili kwesifo sakho kuxhomekeke kwizinto ezininzi:

• Uhlobo lweseli : Kukho iintlobo ezintathu zeeseli ezinokukhula zibe ziithumba. Uhlobo oluqhelekileyo, olubizwa ngokuba ziiseli ze-epithelioid, lunesimo sengqondo esingcono kunezinye iintlobo ezimbini zeeseli, iiseli ze-sarcomatoid kunye neeseli ze-biphasic.
• Inqanaba le-mesothelioma yakho : Ukuba isifo sifunyenwe kwaye sinyangwa kwasekuqaleni, kusenokwenzeka ukuba ube neziphumo ezingcono.
• Isini sakho : Xa kufikwa kwi-Peritoneal Mesothelioma, abafazi babonakalisiwe ukuba banoqikelelo olungcono kunamadoda.
• Ukususwa ngokupheleleyo kwamaqhuqhuva : Ukuba ugqirha wakho unokuwasusa ngokupheleleyo onke amaqhuqhuva, ingqikelelo yakho inokuba ngcono.
• I-Thrombocytosis : Ukuba une-thrombocytosis, i-prognosis yakho isenokuba ayilunganga. I-Thrombocytosis yimeko apho unee-platelet ezininzi egazini lakho. Ii-platelet ziiseli ezinceda ukujiya kwegazi lakho.

Ungaphila ixesha elingakanani ne-Peritoneal Mesothelioma?

Abantu abafunyenwe bene-Peritoneal Mesothelioma badla ngokuphila malunga neenyanga ezi-6 ukuya kwezi-12 ngaphandle konyango. Nangona kunjalo, ngonyango, izinga lokusinda lingcono kakhulu. Izigulane ze-Peritoneal Mesothelioma ezenza utyando lwe-cytoreductive kunye ne-HIPEC ziphila iminyaka emibini ukuya kwemithandathu emva kokufunyaniswa kwazo. Abanye abantu baphila ixesha elide nangakumbi.

Nangona kunjalo, uqikelelo lwakho luxhomekeke kwizinto ezininzi. Ugqirha wakho ngumntu ofanelekileyo ukuqonda ukuba zeziphi izinto eziya kuchaphazela uqikelelo lwakho, ngokusekelwe kwiindlela zonyango lwakho.

Yeyiphi imibuzo ebalulekileyo omele uyibuze ugqirha wakho?

Ukuba ufunyaniswe une-Peritoneal Mesothelioma, thetha nogqirha wakho ngale nto ilandelayo:

• "Ngoobani oogqirha abaziingcali abaza kundinyanga?"
• "Ingaba kungcono ukuba ndifumane uncedo kwiqela lezonyango ezithomalalisayo?"
• "Luhlobo luni lwe-mesothelioma endinalo?"
• "Umhlaza wam usasazeke kangakanani? (Oko kukuthi, lithini inqanaba?)"
• "Zeziphi iindlela zonyango endinazo?"
• "Ngaba kukho naziphi na 'izilingo zeklinikhi' (uphando oluvavanya unyango olutsha) endinokuthatha inxaxheba kuzo?"
• "Zithini iziphumo endinokuzilindela kunyango olufumanekayo?"
• "Zithini iziphumo ebezingalindelekanga zonyango? Zingalawulwa njani?"

Okokugqibela, izinto ekufuneka uzikhumbule...

I-Peritoneal Mesothelioma ngumhlaza ongaqhelekanga kodwa onzima. Ukuvezwa kwi-asbestos kunokuba yimbangela enkulu. Ukuba unayo nayiphi na kwezi mpawu sizikhankanyileyo, kubalulekile ukufuna unyango ngokukhawuleza.

Kuqhelekile ukuba noloyiko kwaye uxhalabe xa ufunda ngesifo esifana nesi. Kodwa khumbula, awuwedwa. Unoogqirha, usapho, kunye nabahlobo abanokukunceda. Eyona nto ibalulekileyo kukufumana ulwazi olufanelekileyo, uthethe ngokukhululekileyo noogqirha bakho, kwaye ufumane unyango olungcono kuwe. Unyango lunokukunceda ngokuqinisekileyo ukwandisa ubomi bakho kwaye luphucule umgangatho wobomi bakho.

I- Mesothelioma yesisu, umhlaza, umhlaza wesisu, i-asbestos, i-peritoneum, i-mesothelioma, i-HIPEC, iimpawu, unyango