Wake wezwa ngegama elithi 'Chordoma'? Mhlawumbe akunjalo. Ngoba kuyisimo esingavamile kakhulu, okungukuthi, isimo esibi esingatholakali njalo. Lesi simila esinomdlavuza sikhula ezindaweni ezimbili ezibaluleke kakhulu emzimbeni wethu. Esinye siwumgogodla wethu, kanti esinye siyisisekelo sekhanda lethu. Kunengqondo ukuzizwa wesaba kancane lapho igama elithi umdlavuza lishiwo endaweni enjalo. Kodwa ungakhathazeki. Sizoxoxa ngakho konke ngendlela elula, ecacile, neqondakalayo kuwe.
Kalula nje, iyini i-Chordoma?
I-Chordoma umdlavuza okhula emathanjeni ethu. Uma sikhuluma iqiniso, ungoweqembu lomdlavuza obizwa ngokuthi ama-sarcomas. Umdlavuza okhula kancane kakhulu. Lokhu kusho ukuthi ungahlala ungenazimpawu isikhathi eside.
Lo mdlavuza ungakhula noma kuphi emgogodleni, kodwa kunezindawo ezintathu ezivame kakhulu:
- Iphuzu eliphansi kakhulu lomgogodla (i-Sacrum): Cishe ama-35% azo zonke izitho zomgogodla akhula kule ndawo.
- Isisekelo sekhanda: Amanye amacala angu-35% akhula lapha. Ithambo kuleli qophelo libizwa ngokuthi 'i-clivus'. Lolu hlobo lubizwa nangokuthi 'ama-clival chordomas'.
- Amanye amathambo omgogodla: Ama-30% asele avela kwezinye izingxenye zomgogodla. Avame kakhulu emhlane wesibili womlomo wesibeletho, alandelwe yithambo lomgogodla kanye nethambo lomgogodla.
Inselele enkulu ngalo mdlavuza ukuthi, nakuba ukhula kancane, uhlasela izingxenye ezibalulekile zesimiso sezinzwa esizungezile. Lokhu kusho ukuthi ungalimaza izindawo ezibucayi kakhulu njengobuchopho nomgogodla.
Enye into ukuthi inomkhuba omkhulu wokuphinda ubuye, ngisho nangemva kokwelashwa. Ngokuvamile ibuya endaweni efanayo eyayiyiyo ngaphambili. Futhi, cishe ku-30% - 40% wamacala, lo mdlavuza ungasakazeka (usakazeke) kwezinye izingxenye zomzimba. Uma kwenzeka, uvame ukusabalala ku:
- Emaphashini
- Kuma-lymph node azungezile
- Kwamanye amathambo
- Esibindini
- Esikhumbeni
Ingabe zikhona izinhlobo ze-Chordoma?
Yebo, i-World Health Organization (WHO) ithole izinhlobo ezintathu eziyinhloko zalo mdlavuza. Lokhu kuhlukaniswa kusekelwe endleleni amangqamuzana omdlavuza abukeka ngayo ngaphansi kwe-microscope (histology). Ake sibone ukuthi ayini.
| Uhlobo lwe-Chordoma | Incazelo elula |
|---|---|
| I-Chordoma Yakudala/Ejwayelekile | Lolu uhlobo oluvame kakhulu. Luthinta iziguli ezingama-80%-90%. Amaseli alo abukeka “njengamabhamuza” ngaphansi kwe-microscope. I-chondroid chordoma, eyakheka phansi kwekhanda, iwuhlobo lwalolu hlobo. |
| I-Chordoma Engahlukanisiwe | Lokhu akuvamile kakhulu (ngaphansi kuka-5%). Kubonakala ngokuqoqwa okungajwayelekile kwamaseli. Kukhula ngokushesha kunohlobo olujwayelekile, kunolaka kakhulu, futhi kunengozi enkulu yokusabalala (ukusabalala kwe-metastasizing) kwezinye izingxenye zomzimba. |
| I-Chordoma Engahlukaniswa Kahle | Lokhu kuyinto engavamile ngisho nakakhulu. Kubikwe amacala angaphansi kuka-60 kumarekhodi ezokwelapha. Lolu hlobo lubonakala ngokulahlekelwa yi-gene ebizwa ngokuthi i-SMARCB1 noma i-INI1 emaseli. Lolu hlobo luvame kakhulu ezinganeni nakubantu abadala abasebasha . |
Ubani onamathuba amaningi okuthola lesi sifo? Sivame kangakanani?
Nakuba i-chondroma ingakhula kunoma yimuphi ubudala, ivame kakhulu kubantu abadala abaneminyaka ephakathi kuka-50 no-80. Iphesenti elincane, cishe u-5%, liyakhula ezinganeni. Futhi, amadoda anamathuba aphindwe ka-1.5 okuthola lesi sifo kunabesifazane.
Lokhu akuvamile kangangokuthi umuntu oyedwa kuphela kwabayisigidi (100,000) emphakathini uthola lesi sifo minyaka yonke . Lokhu kusho ukuthi ngisho nasezweni elifana nelethu, zimbalwa kakhulu izigameko ezintsha ezibikwayo minyaka yonke.
Into ebaluleke kakhulu ukuthi i-Chordoma ihlala iyisimo esibi. Ayikho uhlobo olungeyona umdlavuza.
Ziyini izimpawu zalokhu?
Njengoba i-chordoma ikhula, ibeka ingcindezi ebuchosheni obuzungezile noma emgogodleni. Lokhu kucindezela kubangela izimpawu. Futhi, izimpawu zingahluka kuye ngokuthi isimila sikuphi.
Ake sibone etafuleni elingezansi ukuthi izimpawu ziyahlukahluka kanjani kuye ngokuthi iqhubu likuphi.
| Indawo Yesimila | Izimpawu Ezingenzeka |
|---|---|
| Izimpawu ezivamile ezingase zenzeke | Ubuhlungu, ubuthakathaka, kanye/noma ukungazweli emhlane, ezingalweni, noma emilenzeni. |
| Amagama Ayisisekelo Ekhanda | - Ukubona kabili (i-diplopia) - Umbono ofiphele - Ikhanda elibuhlungu - Ubuhlungu noma ukungakhululeki kobuso |
| Engxenyeni ephansi yomgogodla (i-Tailbone/Sacrum) | - Iqhubu elingazwakala esikhumbeni - Ubunzima bokuchama noma ukukhipha indle (ukulahlekelwa ukulawula) - Ubuhlungu embotsheni noma emhlane ongezansi |
Kungani lolu hlobo lomdlavuza luvela? Iyini imbangela?
Abacwaningi abakakwazi ukuthola imbangela eqondile, kodwa bakholelwa ukuthi izinguquko ezakhiweni zofuzo ezibizwa ngokuthi i-TBXT ziyabandakanyeka.
Cabanga ngakho, lapho umntwana eqala ukukhula esibelethweni sikanina, ngaphambi kokuba umgogodla wakheke, kwakheka uhlaka oluncane olubizwa ngokuthi i-notochord . Yilokhu okuzokhula kamuva lube umgogodla. Ngokuvamile, lolu hlaka lunyamalala ngokuphelele lapho umntwana esenamasonto ayisishiyagalombili ubudala.
Kodwa akuvamile kakhulu, amanye ala maseli angahlala esisekelweni sekhanda noma emathanjeni omgogodla. Kukholelwa ukuthi kamuva, uma kukhona ushintsho ku-TBXT gene esikhulume ngayo, la maseli asele angaqala ukukhula ngokungalawuleki futhi abe umdlavuza we-chondroma.
Ngaphezu kwalokho, abantu abanesifo sofuzo i-tuberous sclerosis basengozini enkulu kancane yokuthola i-chordoma.
Ungasithola kanjani lesi sifo? (Ukuxilongwa)
Uma unezimpawu ezibalwe ngenhla, kufanele uqale ubonane nodokotela wakho. Udokotela uzokubuza ngezimpawu zakho kanye nomlando wakho wezokwelapha. Ngemuva kwalokho, bazokwenza ukuhlolwa ngokomzimba kanye nokuhlolwa kwezinzwa.
Uma kusolwa ukuthi kukhona iqhubu elinomdlavuza, udokotela uzokuthumela ukuze uyohlolwa ngezithombe.
- I-X-ray
- Ukuskena kwe-Computed Tomography (CT)
- Ukuskena kwe-Magnetic Resonance Imaging (MRI)
Ngemva kwalezi zivivinyo, cishe uzothunyelwa kudokotela ochwepheshe bomdlavuza wamathambo. Kungase kudingeke ukuhlolwa okwengeziwe ukuqinisekisa lesi sifo nokubona ukuthi sesisakazekele kwezinye izingxenye zomzimba.
Ukuphela kwendlela yokuqiniseka nge-100% ngalesi sifo ukwenza i-biopsy , okuhilela ukuthatha isampula encane kakhulu yezicubu ezivela eqhubu usebenzisa inalithi encane bese uyihlola ngaphansi kwe-microscope.
Iphathwa kanjani?
Ukwelashwa okuyinhloko nokungcono kakhulu kwe-chordoma ukuhlinzwa. Imiphumela emihle kakhulu yesiguli itholakala ngokususwa kwenqwaba yomdlavuza ngangokunokwenzeka (ukususwa kwe-en bloc).
Kodwa-ke, lokhu akulula njengoba kubonakala ngoba, njengoba sixoxile ngaphambili, la mathumba akheka eduze kwezitho ezibalulekile nezibucayi kakhulu.
- Izimila ezingaphansi kogebhezi: Kunzima kakhulu ukuzisusa ngokuphelele ngoba zitholakala eduze kwesiqu sobuchopho, imizwa ebalulekile, kanye nemithambo yegazi.
- Izimila zomgogodla: Lezi zingangena emgogodleni, ezinzwa, nasezinhlotsheni ezinkulu zegazi. Uma lezi zilimele ngesikhathi sokuhlinzwa, ukukhubazeka okungapheli noma ngisho nokufa kungenzeka.
Ngakho-ke, odokotela abahlinza izinzwa bazama ukususa isimila ngangokunokwenzeka ngaphandle kokulimaza isiguli.
Umdlavuza we-Chordoma ngokuvamile awusabeli kahle ekwelashweni ngemisebe kanye namakhemikhali, ngakho-ke lokhu akuvamile ukusetshenziswa njengokwelashwa okuyinhloko. Kodwa-ke, ukwelashwa ngemisebe kunikezwa ngemva kokuhlinzwa ukuze kubhujiswe noma yimaphi amangqamuzana omdlavuza asele futhi kuncishiswe ingozi yokuthi umdlavuza uphinde ubuye.
Abacwaningi okwamanje baphenya izindlela zokwelapha zesimanje ezifana nokwelashwa okuqondiwe kanye nokwelashwa nge-immunotherapy.
Iyini inkomba yokubikezela lesi sifo?
"Isibikezelo" siwukubikezela amathuba okululama nokusinda esifweni. Endabeni ye-chondroma, lokhu kuncike ezintweni eziningana:
- Indawo yesimila kanye nokuthi singakanani esisusiwe ngesikhathi sokuhlinzwa: Uma isimila sisusiwe ngokuphelele, imiphumela iba ngcono.
- Ukuthi umdlavuza usakazeke yini (usuhlukaniswe):Uma sesisabalale ezithweni ezikude emzimbeni, izinga lokusinda liyancipha.
- Ubudala bokuxilongwa: Imiphumela ingase ibe ngaphansi kancane kubantu abangaphezu kweminyaka engama-60 ubudala.
- Uhlobo lomdlavuza: Izinhlobo ezivamile zinemiphumela engcono kunezinhlobo ezinolaka kakhulu ezifana ne-"Dedifferentiated" esixoxe ngazo.
Ngokusho kocwaningo olulodwa, amazinga okusinda kweziguli ezine-chordoma ami kanje:
- Ngemva kweminyaka emi-3: 80.5%
- Ngemva kweminyaka emi-5: 68.4%
- Ngemva kweminyaka eyi-10: 39.2%
Kodwa ungakhathazeki ngalezi zibalo. Lezi zimane ziyizilinganiso ezivela eqenjini elikhulu leziguli. Imiphumela yakho ingahluka kakhulu kuye ngesimo sakho, uhlelo lokwelashwa, kanye nendlela umzimba wakho osabela ngayo. Ithimba lakho lezokwelapha kuphela elingakunikeza ulwazi olungcono kakhulu ngalokhu. Ngakho ungesabi ukubabuza imibuzo.
Ingabe lesi sifo singavinjelwa? Kufanele ngibone udokotela nini?
Akukho esingakwenza ukuvimbela ukuthuthukiswa kwe-chondroma. Amacala amaningi avele ngokungahleliwe. Uma othile emndenini wakho ene-chondroma noma i-tuberous sclerosis, kubalulekile ukuthi uhlolwe njalo ngudokotela.
Into ebaluleke kakhulu ukulandela isikhathi eside ngemva kokwelashwa. I-Chondroma ingumdlavuza ongaphinde ubuye ngisho nangemva kweminyaka eminingi yokwelashwa. Ngakho-ke, kubalulekile ukuya kohlolwa njalo njengoba kuceliwe yithimba lakho lezokwelapha.
Uma uthola izimpawu ezintsha noma uma izimpawu zakho ziba zimbi kakhulu, bona udokotela wakho ngokushesha.
Kuvamile ukuzizwa wesaba futhi ukhungathekile uma ufunda ngomdlavuza ongavamile kangaka. Kodwa khumbula, ithimba lakho lezokwelapha lizosebenza nawe ukuthuthukisa uhlelo lokwelashwa olungcono kakhulu kuwe futhi lenze konke okusemandleni alo ukuthuthukisa ikhwalithi yempilo yakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Chordoma uhlobo lomdlavuza olungavamile kakhulu oluvela emathanjeni omgogodla noma phansi kwekhanda.
- Izimpawu zincike endaweni umdlavuza otholakala kuyo futhi zingase zihlanganise ikhanda elibuhlungu, ukubona kabili, ubuhlungu emhlane, kanye nokungazweli kahle ezithweni.
- Ukwelashwa okuyinhloko ukususwa kwesimila ngokuhlinzwa, kodwa lokhu kungaba nzima kakhulu kuye ngokuthi sikuphi.
- Ngisho nangemva kokwelashwa, kunengozi yokuphinda umdlavuza, ngakho-ke ukulandelwa isikhathi eside nodokotela wakho kubalulekile.
- Ungesabi izibalo. Isiguli ngasinye sihlukile. Khuluma nethimba lakho lezokwelapha ukuze uthole ulwazi olunembile ngesimo sakho.
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