Singakhuluma nge-lymphoma ethinta uhlelo lwakho lwezinzwa oluphakathi (i-CNS Lymphoma)?

Ngezinye izikhathi singabhekana nezinkinga zomzimba ngokuzumayo, akunjalo? Ikhanda elibuhlungu, ubunzima bokukhuluma, noma umuzwa wokungalawuleki. Ngezinye izikhathi asizinaki kakhulu lezi zinto, kodwa zingaba futhi izimpawu zesifo esithile esibi. Namuhla, sizokhuluma ngohlobo lomdlavuza olungavamile kodwa oluyingozi oluthinta isimiso sethu sezinzwa esiyinhloko.

Kuyini i-CNS lymphoma?

Kulungile, ake siqale sibone ukuthi iyini le lymphoma yesistimu yezinzwa ephakathi, noma `(CNS Lymphoma)` . `CNS` imele `iSistimu Yezinzwa Ephakathi`. Kalula nje, lolu uhlobo lomdlavuza olubi kakhulu oluvela ohlelweni lwethu lwezinzwa oluphakathi , okungukuthi, ubuchopho, intambo yomgogodla (intambo yezinzwa ngaphakathi kwekholomu yomgogodla), uketshezi lwe-cerebrospinal (uketshezi oluzungeze lesi simiso sezinzwa), kanye namehlo (ngoba amehlo aseduze kakhulu nobuchopho). Lokhu kungohlobo lwe-lymphoma olubizwa ngokuthi `(Non-Hodgkin lymphoma)` .

Le lymphoma ethi 'CNS' iqala emangqamuzaneni egazi amhlophe emzimbeni wethu abizwa ngokuthi ama-lymphocyte . Lawa ma-lymphocyte ayingxenye yesimiso sethu se-lymphatic. Ubuwazi, lesi simiso se-lymphatic siyingxenye ebaluleke kakhulu yesimiso sethu sokuzivikela komzimba . Sisiza imizimba yethu ukulwa nezifo kanye nokutheleleka. Ngakho-ke, uma le lymphoma ikhula kuphela ohlelweni lwethu lwezinzwa oluphakathi futhi ingatholakali kwenye indawo emzimbeni, siyibiza ngokuthi 'i-primary CNS lymphoma' . Kodwa-ke, uma i-lymphoma itholakala nakwezinye izingxenye zomzimba, okuhlanganisa nesimiso sezinzwa esiphakathi, ibizwa ngokuthi 'i-secondary CNS lymphoma' .

Nakuba lo mdlavuza ungakhula kunoma ubani, kungenzeka kakhulu ukuthi ukhulele kubantu abanezivikeli mzimba ezibuthakathaka , njengalabo abane -HIV ne -AIDS , ikakhulukazi amadoda. Abantu abangaphezu kweminyaka engu-65 nabo basengozini. Kodwa-ke, umdlavuza ongavamile kakhulu. Ngisho nasezweni elifana ne-United States, kubikwa amacala amasha angaba ngu-1,500 kuphela minyaka yonke. Ngakho-ke, kungakhathaliseki ukuthi isimo sakho siyini, ithimba lakho lezokwelapha lizokusiza ukuthola ukwelashwa okungcono kakhulu kokulwa ne-CNS lymphoma.

Ziyini izimpawu ze-CNS lymphoma?

Manje ake sibone ukuthi yiziphi izimpawu zale lymphoma ethi 'CNS'. Empeleni, izimpawu ziyahlukahluka kuye ngokuthi i-tumor ikuphi . Isibonelo, uma le tumor isezingxeni ezimboze ubuchopho kanye nomgogodla ( ama-'meninges' ), ingase ingakhombisi zimpawu. Kodwa-ke, uma kukhona isimila eduze kwamehlo, kungase kube nezinguquko embonweni. Noma, uma kukhona isimila engxenyeni yobuchopho elawula ukunyakaza, kungase kube nomuzwa wokuba ndikindiki, izinguquko ekulinganiseni njengalapho uhamba.

Lezi yizimpawu ezivamile ze-CNS lymphoma:

• Isicanucanu nokuhlanza
• Ubuthakathaka ezingalweni, emilenzeni, noma ebusweni
• Ubuthakathaka ohlangothini olulodwa lomzimba (hemiparesis)
• Ukukhubazeka kokuzwa, ukungezwa
• Ubunzima bokugwinya (i-dysphagia)
• Izimpawu zokucindezeleka okukhulu ebuchosheni (ikhanda elibuhlungu, ukudideka, ukudideka)
• Izinkinga zokubona (ukubona okufiphele, ukubona okuphindwe kabili, izinto ezintantayo )
• Izinguquko esimweni sengqondo (ubunzima bokukhuluma, ukulahlekelwa inkumbulo, ukuzizwa uvilapha)
• Ukuquleka (lokhu kunganda kancane kancane ezinsukwini noma emavikini ambalwa)
• Ukungakwazi ukulawula umchamo kanye nendle (ukungakwazi ukuzibamba ngenxa yokuchama kanye nendle)

Yini ebangela i-CNS lymphoma?

Okulandelayo, ake sibheke ukuthi yini ebangela i-CNS lymphoma. Njengezinye izinhlobo ze-lymphoma, i-CNS lymphoma ikhula lapho amangqamuzana kuma-lymph node eqala ukuziphatha ngendlela engajwayelekile. Lawa maseli anda ngokungalawuleki , ecindezela amangqamuzana anempilo. Ku-CNS lymphoma, amangqamuzana aqala ukukhula ngendlela engajwayelekile yi-lymphocytes, uhlobo lweseli elimhlophe legazi elibizwa ngokuthi amaseli e-B .

Abacwaningi abakakazi kahle ukuthi kungani i-lymphocyte iba yiseli lomdlavuza, kodwa bathole ezinye izici ezandisa ingozi yokuthola i-CNS lymphoma.

Izici zengozi ze-CNS lymphoma

Izimo ezithile ezenza buthaka amasosha omzimba zingandisa ingozi yokuthola i-CNS lymphoma. Lezi zici eziyingozi zifaka:

• I-HIV/AIDS (ikakhulukazi uma unegciwane le -Epstein-Barr elisebenzayo)
• I-Wiskott-Aldrich syndrome (i-WIS)
• Isimo sokuntuleka kwamasosha omzimba esivamile (i-CVID)
• I-Ataxia - i-telangiectasia
• Ukusetshenziswa kwemithi yokucindezela amasosha omzimba ngemva kokufakelwa isitho

I-CNS lymphoma ihlolwa kanjani?

Udokotela wakho angase ancome ukuhlolwa nezinqubo ezahlukahlukene ukuze anqume ukuthi une-CNS lymphoma. Lokhu kutholakala kubizwa nangokuthi umdlavuza . Lesi sigaba somdlavuza sisiza odokotela baqonde ukuthi umdlavuza ususakazeke kangakanani nokuthi yiziphi izindlela zokwelapha ezingaba yimpumelelo.

Kuzodingeka wenze lezi zivivinyo:

• Ukuhlolwa ngokomzimba : Udokotela wakho uzohlola impilo yobuchopho bakho, umgogodla, kanye namehlo. Uzokwenza ukuhlolwa kwezinzwa ukuhlola uhlelo lwakho lwezinzwa oluphakathi (i-CNS). Bangase futhi benze ukuhlolwa kwesibani esiqhekekile ukuhlola isimila ngemuva kweso.
• Ukuhlolwa kwezithombe : Ukubona ukuthi umdlavuza ukuphi ngaphakathi emzimbeni, njenge -`(MRI)`, `(CT scan)` nomaUdokotela wakho angase akucele ukuthi kwenziwe i-PET scan. I-CNS lymphoma ayivamile ukusabalala ngale kwesistimu yezinzwa ephakathi. Kodwa-ke, ingasabalala ngokushesha ngaphakathi kwaleyo sistimu.
• Ukuhlolwa kwegazi : Ukuhlolwa kwegazi kungahlola amangqamuzana akho ukuthi awanazo yini izimpawu zomdlavuza. Lokhu kufaka phakathi ukubalwa kwegazi okuphelele , ucwaningo lwe-chemistry yegazi, kanye nokuhlolwa kwe-HIV .
• Ukuhlolwa kwezicubu noketshezi : Kungase kuthathwe isampula yoketshezi lomgogodla wakho, umongo wamathambo , noma isimila ngokwaso ukuze kuhlolwe amangqamuzana omdlavuza.

Yiziphi izindlela zokwelapha i-CNS lymphoma?

Eqinisweni, ayikho indlela eyodwa efanela bonke yokwelapha i-CNS lymphoma. Esikhundleni salokho, ithimba lakho lezokunakekelwa kwempilo lizoncoma uhlelo lokwelapha olusebenza kahle kuwe ngokusekelwe ezicini ezifana neminyaka yakho, ukuthi une-HIV/AIDS, nokuthi umdlavuza usanda kutholakala noma ubuyile ngemuva kokwelashwa (okuphindayo) . Ngokuvamile, kuzosetshenziswa inhlanganisela yezindlela zokwelapha.

Izindlela zokwelapha i-CNS lymphoma yilezi:

• Ukwelashwa ngamakhemikhali : Lokhu kuhilela ukusebenzisa imithi ukubulala amangqamuzana omdlavuza. Imithamo ephezulu yomuthi we-chemotherapy i-methotrexate (HD-MTX) ivame ukusetshenziselwa ukwelapha i-CNS lymphoma esanda kutholakala.
• Ukwelashwa ngemisebe : Lokhu kusebenzisa imisebe yamandla ukubulala amangqamuzana omdlavuza. Uhlobo olulodwa lokwelashwa ngemisebe olungasiza ekunciphiseni izimpawu imisebe yobuchopho bonke . Ibulala amangqamuzana omdlavuza ebuchosheni bonke.
• Ukwelashwa okuqondiwe : Lokhu kusebenzisa izinto ezifana namaprotheni nama-antibodies ukuhlasela amangqamuzana omdlavuza. I-Rituximab kanye ne -ibutinib yizindlela zokwelapha eziqondiwe udokotela wakho angase azincome.
• Ukufakelwa kwe-stem cell : Ekufakweni kwe-stem cell, unikezwa amangqamuzana egazi anempilo ukuze athathe indawo yamangqamuzana egazi alimele ngenxa yokwelashwa komdlavuza njengokwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe.
• Izivivinyo zemitholampilo : Udokotela wakho angase asikisele ukuthi uhlanganyele esivivinyweni semitholampilo esihlola izindlela ezintsha zokwelapha. Izivivinyo zamanje zihlola ukuthi imithi emisha yokwelapha eqondiwe kanye nenhlanganisela emisha yemithi ye-chemotherapy isebenza kahle kangakanani ekwelapheni i-CNS lymphoma.

Uma une-HIV noma une-AIDS, kufanele uqhubeke nokwelashwa kwakho ngama-antiretroviral (ART) ngenkathi welashwa i-CNS lymphoma.

Yiziphi izinkinga nemiphumela emibi yokwelashwa?

Ukwelashwa kwe-CNS lymphoma kungabangela imiphumela emibi . Udokotela wakho uzokuchazela lokhu kusenesikhathi. Isibonelo, imisebe yobuchopho obuphelele ibulala amangqamuzana omdlavuza ebuchosheni. Kodwa-ke, ingabangela nemiphumela emibi kakhulu engathinta indlela ubuchopho bakho obusebenza ngayo. Zonke izinketho zokwelapha zinezingozi.

Khuluma nodokotela wakho ngezinzuzo nezingozi zohlelo lwakho lokwelashwa. Buza ukuthi bayakuncoma yini ukunakekelwa kokunciphisa ubuhlungu, okungakusiza ukuphatha imiphumela emibi kanye nomthelela womdlavuza empilweni yakho.

Yini engingayilindela ngalesi simo?

I-CNS lymphoma ingumdlavuza okhula ngokushesha , futhi inethuba elikhulu lokubuya ngemva kokwelashwa. Kodwa-ke, ithuba lakho lokululama, noma ukubikezela , lincike ezintweni eziningana ezithile. Lezi zici zifaka:

• iminyaka yakho
• Isimo sakho sempilo iyonke
• Isimo sakho se-HIV
• Lapho kutholakala khona isimila
• Imiphumela yokuhlolwa kwe-chemistry yegazi lakho (lokhu kungabonisa ukuthi umdlavuza uzithinte kanjani izitho zakho zangaphakathi)

Ithimba lakho lezokwelapha lizosebenza nawe ukuthola uhlelo lokwelashwa olukunikeza ithuba elihle kakhulu lokusinda ngaphandle kokunciphisa izinga lempilo yakho.

Lingakanani izinga lokululama kwe-CNS lymphoma?

Abacwaningi babika amazinga okusinda komdlavuza ngokubheka ukuthi bangaki abantu abanomdlavuza othile abasaphila ngemva kwesikhathi esithile, ngokuvamile iminyaka emihlanu. Izinga lokusinda kweminyaka emihlanu kubantu abane-CNS lymphoma licishe libe ngu-30% . Lokho kusho ukuthi abantu abathathu kwabayishumi abane-CNS lymphoma bayaphila ngemva kweminyaka emihlanu.

Kodwa-ke, lezi zibalo zijwayelekile kakhulu . Azinaki ezinye izici ezithile ezithinta amathuba okusinda kwesiguli. Isibonelo, uma amasosha omzimba wakho engabuthakathaka, noma uma i-lymphoma ingasakazekanga ngale kobuchopho, umphumela uvame ukuba ngcono. Futhi, la mazinga okusinda awabonisi ukuthi ukwelashwa okusha kuthinta kanjani isikhathi sakho sokuphila.

Udokotela wakho ungumuntu ongcono kakhulu ukuchaza ukuthi ikusasa lakho liphetheni ngokusekelwe esimweni sakho sempilo kanye nokuxilongwa kwakho komdlavuza.

Ngizinakekela kanjani?

Ukuphila ne-lymphoma kungaba nzima kakhulu . Ungase uzizwe ukhathazekile ngokuthi yiziphi izivivinyo kanye nokwelashwa okuzodingeka ukwenze. Ungase ungazi ukuthi ungabelana kanjani ngemizwa yakho nabanye.

Kusesikhathini esinjengalesi,Kufanele uzame ukuthola lonke usizo ongaluthola . Lokho kungasho ukukhuluma nabathandekayo bakho, noma ngabe kunzima. Noma, kungasho ukubuza udokotela wakho ngokunakekelwa kweziguli ezidambisa ubuhlungu noma amaqembu okusekela . Uhambo lomuntu wonke lomdlavuza luhlukile. Kodwa kubalulekile ukuxhumana nabanye kuzo zonke izinyathelo zohambo.

Kufanele ngimbone nini udokotela?

Ngisho noma i-CNS lymphoma yakho isiphelile (okungukuthi, awusenazo izimpawu noma izimpawu zomdlavuza), kuzodingeka ukuthi uhlolwe njalo ukuze uhlole ukuthi ngabe umdlavuza uphinde ubuye yini. Kuzodingeka ubone udokotela wakho kaningi phakathi neminyaka emihlanu yokuqala ngemva kokwelashwa. Lokhu kungenxa yokuthi amacala amaningi e-CNS lymphoma abuyayo ayenzeka phakathi neminyaka emihlanu yokuqala.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Nazi ezinye imibuzo ongayibuza udokotela wakho:

• Yiziphi izivivinyo engizodinga ukuze ngithole uhlelo lwami lokwelashwa?
• Yiziphi izingozi nezinzuzo zezindlela ezahlukene zokwelapha?
• Kukangaki lapho kuzodingeka ngize ngiyohlolwa ukuze ngibone ukuthi umdlavuza usabela kanjani ekwelashweni?
• Ingabe ngiyafaneleka ukubamba iqhaza esivivinyweni somtholampilo ? Ingabe uyangincoma ukuthi ngenze kanjalo?
• Ungangincoma yini ukunakekelwa kwe-palliative ?

Umyalezo obaluleke kakhulu okufanele uwuthathe uye nawo ekhaya

I-CNS lymphoma yisimo esibucayi esidinga ukubhekwa eduze kanye nohlelo lokwelashwa oluqondiswe ngqo kuwe. Kubalulekile ukusebenzisana eduze nethimba lezokwelapha elinolwazi lokwelapha i-lymphoma noma umdlavuza othinta uhlelo lwezinzwa oluphakathi (i-CNS).

Ithimba lakho lezokwelapha lingachaza izinketho zakho zokwelapha, likusize uhlole izinzuzo zazo kanye nezingozi ezingaba khona noma imiphumela emibi, futhi likuxhumanise nochwepheshe bokunakekelwa kobuhlungu abangakunikeza induduzo njengoba unquma ngezinyathelo zakho ezilandelayo.

I - CNS lymphoma, isimiso sezinzwa esiyinhloko, umdlavuza, umdlavuza wobuchopho, i-lymphoma, isimiso somzimba sokuzivikela, ukwelashwa