Uyazi yini ngezimila ze-Gastrointestinal Neuroendocrine Tumors (GI NETs) ezingakhula ohlelweni lwakho lokugaya ukudla?

Ingabe ngezinye izikhathi uthola izinhlungu zesisu, ukuqunjelwa, noma ezinye izimpawu ezibonakala sengathi ziza njalo? Noma ingabe wehlisa isisindo ngaphandle kwesizathu esibonakalayo? Nakuba lezi zingaba izimpawu zezifo ezivamile, kungase kube nesimo esingavamile ngemuva kwazo okufanele usiqaphele. Namuhla sizokhuluma ngesinye salezo zimo. Sibizwa ngokuthi ama-Gastrointestinal Neuroendocrine Tumors , noma ama-GI NET ngamafuphi. Ungakhathazeki, sizokhuluma ngalokhu kalula.

Ziyini lezi zimila ze-neuroendocrine zesistimu yokugaya ukudla (i-GI NETs)?

Kalula nje, ama-GI NET awuhlobo olungavamile lomdlavuza oluvela kumaseli e-neuroendocrine ohlelweni lwakho lokugaya ukudla. Manje ungase uzibuze ukuthi ayini amaseli e-neuroendocrine. Lawa uhlobo olukhethekile lweseli oluxhumanisa uhlelo lwethu lwezinzwa kanye nohlelo lwe-endocrine. Afana nezikhungo ezincane zemiyalezo. Lawa maseli atholakala ezindaweni eziningi emizimbeni yethu, okuhlanganisa nohlelo lokugaya ukudla.

Umgudu wakho wokugaya ukudla uyisimiso eside, esifana nethubhu esigaya ukudla esikudlayo, simunce izakhamzimba, futhi sisuse imfucuza. Lawa mathumba e-'GI NET' (ngaphambili ayebizwa ngokuthi 'amathumba e-carcinoid') avame ukukhula emathunjini akho amancane kanye nase-rectum . Kodwa-ke, angakhula nasesiswini sakho, e-appendix, kanye nase-esophagus. Ngezinye izikhathi, lawa mathumba angasakazeka ngaphandle komgudu wokugaya ukudla, njengasesibindini sakho .

Ubani othinteka kakhulu yilesi simo se-GI NET?

Lesi yisimo esingavamile. Ngokwezibalo, lesi simo sithinta abantu abangaba ngu-4 kwabangu-100,000 . Ngisho nasezweni elifana ne-United States, abantu abadala abangaba ngu-8,000 kuphela abatholakala benalesi sifo minyaka yonke.

Lesi simo sivame ukuthinta abantu abaneminyaka ephakathi kuka-55 no-65. Kodwa-ke, singakhula kubantu abadala banoma yimuphi ubudala. Abamhlophe banamathuba amancane okuthola lesi simo kunabamnyama. Futhi, idatha ikhombisa ukuthi abesifazane banamathuba amancane okuthola lesi 'GI NET' kunabesilisa.

Yiziphi izimpawu ze-GI NET?

Nansi into ebalulekile. Abanye abantu bangaba nalezi zimila emizimbeni yabo ngaphandle kwezimpawu . Ngezinye izikhathi zitholakala ngengozi uma into efana ne-'scan' yenziwa ngesizathu esithile.

Kodwa-ke, uma kuvela izimpawu, zingafana nezezifo ezivamile, ezingatheni kangako. Yingakho ngezinye izikhathi zingatholakala sekwephuzile. Bona ukuthi lezi zimpawu zizwakala zijwayelekile yini kuwe:

• Ubuhlungu besisu: Lokhu kungaba uphawu lokuthi uvale amathumbu, mhlawumbe ngenxa yesimila se-GI NET.
• Uhudo:Ukunyakaza kwamathumbu njalo. Lesi sibonakaliso sivame kakhulu kubantu abanesifo esibizwa ngokuthi "i-Carcinoid Syndrome" (esinye isethi sezimpawu ezihlotshaniswa ne-"NET"), noma kulabo abaye basuswa inyongo noma ingxenye yamathumbu abo ngokuhlinzwa.
• Isicanucanu nokuhlanza: Uma isicanucanu nokuhlanza kuqhubeka, kungaba uphawu lokugula okukhulu.
• Ukwehlisa isisindo ngokungahlosile: Uma wehlisa isisindo ngokushesha ngaphandle kokunciphisa ukudla, ukuzivocavoca, noma ngaphandle kwesizathu esibonakalayo, kuyisibonakaliso esivamile se-GI NETs.
• Igazi elisesihlahleni: Uma indle yakho ibomvu ngokumnyama noma iphuzile, lokhu kungaba izimpawu zokopha emathunjini.
• I-Jaundice: Lokhu kubangela ukuthi isikhumba sakho kanye namehlo akho amhlophe aphenduke aphuzi.
• Ukukhathala: Lokhu akukhona nje ukulala. Kuwukuzizwa ukhathele kakhulu ngaso sonke isikhathi, ungakwazi ukwenza lutho.

Khumbula, ukuba nalezi zimpawu akusho ukuthi une-GI NET. Kodwa-ke, uma lezi zimpawu ziqhubeka, kubalulekile ukubona udokotela ukuze akunike iseluleko.

Yiziphi izimbangela ze-GI NET?

Eqinisweni, abacwaningi bezokwelapha abakakwazi ukuthola imbangela eqondile ye-GI NETs. Kodwa-ke, bathole ukuthi abantu abane-asidi ephansi esiswini (i-hypochlorhydria) bahlobene nalesi simo.

Ngaphezu kwalokho, abantu abanezimo ezithile ezizuzwe njengefa kanye nesifo sofuzo bangase babe sengozini enkulu yokuthola ama-GI NET. Ezinye zalezi zimo zifaka:

• I-Multiple endocrine neoplasia (MEN): Kunezinhlobo ezimbili zalokhu. Uhlobo olulodwa (MEN1) lubangela ukuthi izindlala zakho ze-thyroid, i-parathyroid, noma i-adrenal zisebenze ngokweqile noma zikhule izimila. Olunye uhlobo (MEN2) lubangela ukuthi izindlala zakho ze-pancreas, i-pituitary, noma i-parathyroid zisebenze ngokweqile noma zikhule izimila.
• Isifo sikaVon Hippel-Lindau: Lesi futhi yisimo esingavamile kakhulu. Sibangela ukwakheka kwezimila ezingezona umdlavuza (ezingemnandi) ezingxenyeni ezahlukene zomzimba.
• Uhlobo 1 lwe-Neurofibromatosis: Lesi futhi yisimo esingavamile. Sibangela ukwakheka kwamathumba esikhumbeni nasezinzwa, futhi singathinta namehlo nezinye izingxenye zomzimba.

Odokotela bakuthola kanjani lesi simo se-GI NET?

Uma unezimpawu ezishiwo ngenhla, noma uma kukhona okusolakala nganoma yisiphi esinye isizathu, odokotela bazokwenza izivivinyo ezahlukahlukene.

• I-X-ray: Lokhu kungathatha izithombe zalokho okungaphakathi emzimbeni. Kodwa-ke, ngezinye izikhathi isimila se-GI NET sikhulu kakhulu noma sincane kakhulu ukuba singabonwa ku-X-ray. Uma kunjalo, udokotela wakho angase ancome ezinye izinhlobo zokuskena.
• I-computed tomography (CT) scan:Lokhu kusebenzisa ikhompyutha kanye nochungechunge lwe-X-rays ukudala umbono onezinhlangothi ezintathu (3D) wezitho zakho namathambo. I-CT scan ingabonisa izinto ezifana nosayizi wesimila nokuthi ngabe sisakazekele esibindini noma kwezinye izindawo.
• Ukuthwebula izithombe ze-magnetic resonance (MRI): Lokhu kuhlola kusebenzisa i-magnet, amaza omsakazo, kanye nekhompyutha ukukhiqiza izithombe ezicacile zezitho zakho namathambo.
• I-Endoscopy: Kule nqubo, odokotela basebenzisa i-endoscope, ithuluzi elincane, elifana nethubhu elinokukhanya kanye nekhamera ngaphambili, ukuze babheke ngaphakathi kwendlela yakho yokugaya ukudla engenhla. Le thhubhu ingafakwa ngomlomo wakho noma nge-rectum. I-colonoscope isetshenziselwa ukubheka ingxenye engezansi yomgudu wakho wokugaya ukudla.
• I-Endoscopic ultrasound (EUS): Lokhu kusebenzisa i-endoscope namaza omsindo anamandla aphezulu ukuthatha izithombe zesistimu yokugaya ukudla. I-endoscope ifakwa ngomlomo noma nge-rectum, bese i-probe ekugcineni ithumela amaza omsindo endleleni yokugaya ukudla. Ama-echo aphuma ezicutshini ngaphakathi akha izithombe ezibizwa ngokuthi ama-sonogram.
• Iskeni se-Positron emission tomography (PET): Lokhu kuhlola kuthola izimila ze-neuroendocrine kusetshenziswa udayi okhethekile (oklanyelwe ngqo ukuthola amaseli esimila se-neuroendocrine).
• I-Biopsy: Lolu uhlobo lokuhlola oluvame kakhulu olusetshenziswa ukuqinisekisa ukuxilongwa. Kulokhu, kuthathwa ingxenye encane yezicubu endaweni esolisayo bese ihlolwa ngaphansi kwesibonakhulu ukuze kubonakale ukuthi kukhona yini amangqamuzana omdlavuza.

Ingabe kunezinhlobo ezahlukene zezimila ze-neuroendocrine?

Yebo, odokotela basebenzisa uhlelo lokuhlukanisa ukuze bahlukanise la mathumba. Lubasiza ukuhlela ukwelashwa kwabo. Isigaba sesimila sinqunywa ngokuhlola amangqamuzana omdlavuza ngaphansi kwe-microscope. Babheka ukuthi mangaki amangqamuzana ahlukanayo, ukuthi ahlukana ngokushesha kangakanani, nokuthi amangqamuzana afana kangakanani namangqamuzana omdlavuza kunamaseli anempilo. Nazi izigaba ze-'GI NET':

• Ibanga 1 (isimila esisezingeni eliphansi): Lawa maseli ahlukana kancane kakhulu. Lokhu kusho ukuthi isimila sikhula kancane kakhulu.
• Ibanga lesi-2 (isimila esiphakathi nendawo): Izinga lala maseli ahlukana ngalo lilinganiselwe.
• Ibanga lesi-3 (isimila sezinga eliphezulu): Lawa maseli ahlukana ngokushesha kakhulu, ngakho isimila sikhula ngokushesha kakhulu.

Yiziphi izindlela zokwelapha ama-Gastrointestinal Endocrine Tumors (ama-GI NET)?

Kunezindlela eziningana zokwelapha ama-GI NET. Odokotela bakhetha ukwelashwa okungcono kakhulu kuwe ngokusekelwe ezicini eziningi, okuhlanganisa izinga lomdlavuza wakho, imiphumela emibi engaba khona ngenxa yokwelashwa, impilo yakho iyonke, kanye nezintandokazi zakho. Kunezindlela eziningana zokwelapha eziyinhloko: ukuqapha okusebenzayo, ukuhlinzwa, kanye nokwelashwa kwezokwelapha.

Kuyini Ukuqapha Okusebenzayo?

Uma isimila sikhula kancane kakhulu futhi singenangozi yokusabalala kwezinye izingxenye zomzimba, odokotela bangase basikisele ukwelashwa okubizwa ngokuthi "ukuqapha okusebenzayo." Lokhu kuhilela ukukuhlola ngezikhathi ezithile , kunokuthi uqale ukwelashwa okukhulu ngokushesha.

• Ukuhlolwa kwezithombe njenge-CT scan.
• Ukuhlolwa kwegazi okufana nokubalwa kwegazi okuphelele (i-CBC).
• Ukuhlolwa komzimba.

Yikuphi ukuhlinzwa okwenziwayo kwe-GI NET?

Uhlobo lokuhlinzwa okwenziwa nge-GI NET luncike ezicini ezifana nendawo lapho isimila sikhona nokuthi ngabe sisakazekele kwezinye izingxenye zomzimba.

Kubaluleke kakhulu ukuthi ngaphambi kokuba uhlinzwe, ithimba lakho lokuhlinzwa lazi ukuthi unesifo '(Carcinoid Syndrome)' (isimo esibonisa izimpawu 'zezimila ze-neuroendocrine'). Ngoba, uma unesifo '(Carcinoid Syndrome)', ukuhlinzwa kungabangela izinkinga ezingaba yingozi empilweni. Uma udokotela ohlinzayo azi ngalokhu, uzozama ukuvimbela lezi zinkinga ngokukunikeza imithi ekhethekile ngaphambi, ngesikhathi, nangemva kokuhlinzwa.

Ezinye zezindlela zokuhlinzwa ezivame kakhulu ezenziwa i-GI NET yilezi:

• Ukususwa kwesisu okuyingxenye: Lokhu kuhilela ukususa ingxenye yesisu sakho.
• Ukususwa kwamathumbu amancane: Lokhu kuhilela ukususa ingxenye yamathumbu amancane equkethe isimila. Udokotela ohlinzayo angase futhi enze i-anastomosis (ukuxhumanisa kabusha iziphetho ezimbili zamathumbu aqoshiwe ndawonye). Ama-lymph node aseduze kwamathumbu amancane avame ukususwa futhi ahlolwe ngaphansi kwe-microscope ukuze kubonakale ukuthi akhona yini amangqamuzana omdlavuza.
• Ukususwa kwe-Appendectomy: Odokotela abahlinzayo bangasusa i-appendix yakho ngokusebenzisa ukusika okukhulu noma ngokuhlinzwa kwe-laparoscopic (ukusika okuncane ngekhamera efakiwe).
• Ukususwa kwe-Hemicolectomy: Kulokhu, kususwa uhlangothi lwesokudla noma lwesobunxele lwekholoni, kanye nemithambo yegazi eseduze kanye nama-lymph node.
• Ukususwa kwesisu okungaphansi: Odokotela abahlinzayo basusa ingxenye ye-rectum yakho, kodwa bashiye i-anus yakho ingathintekile. Lokhu kukuvumela ukuthi ube nokuhamba kwamathumbu okuvamile.
• Ukususwa kwesisu (APR): Lokhu kuhlinzwa kususa indunu yakho, i-rectum, kanye nengxenye ye-colon yakho . Lokhu kuhlinzwa kuvame ukuhambisana ne-colostomy. Lokhu kusho ukuthi kwenziwa imbobo kusukela ku-colon yakho iye ebusweni besisu sakho ukuze indle (imfucuza yokugaya ukudla) idlule.
• Ukususwa kwesibindi: Lokhu kuhlinzwa kususa ama-GI NET asakazekele esibindini.

Yiziphi izinkinga noma imiphumela emibi yalokhu kuhlinzwa?

Konke lokhu kuhlinzwa kungaba nemiphumela emibi kakhulu . Ngezinye izikhathi ungadinga usizo olwengeziwe ekhaya ngenkathi ululama. Buza udokotela wakho ukuthi yini ongayilindela ngemva kokuhlinzwa okuthile okwenzayo.

Ingabe ukuhlinzwa kwe-GI NET kuzothinta indlela yami yokuphila?

Yebo, kungaba nemiphumela emibi . Njengoba lokhu kuhlinzwa kuvame ukususa ingxenye yesimiso sakho sokugaya ukudla, kungase kube nezinguquko endleleni odla futhi uphuze ngayo, ngisho nendlela oya ngayo endlini yokugezela. Udokotela wakho ohlinzayo uzochaza ngqo ukuthi ukuhlinzwa kuzokuthinta kanjani, nokuthi uzokwenzani ukuze aphathe noma yiziphi izinkinga zokugaya ukudla.

Yiziphi ezinye izindlela zokwelapha ezitholakalayo ze-GI NET?

Odokotela ngezinye izikhathi bangase bahlanganise lokhu kwelashwa nokuhlinzwa:

• Ukwelashwa ngamakhemikhali: Lokhu kusebenzisa izinhlobo ezahlukene zemithi eyenzelwe ukubulala amangqamuzana omdlavuza.
• Ukwelashwa okuqondiwe: Lokhu kusebenzisa izidakamizwa noma ezinye izinto ezihlasela amangqamuzana omdlavuza kuphela, ngaphandle kokulimaza amangqamuzana aphilile avamile.
• Ukwelashwa nge-immunotherapy: Lokhu kusebenzisa amasosha omzimba wakho ukubulala amangqamuzana omdlavuza noma ukuwavimba ekukhuleni kwawo.
• Ukwelashwa ngemisebe: Lokhu kusebenzisa imisebe enamandla ukubulala amangqamuzana omdlavuza noma ukuwavimba ekukhuleni kwawo.
• Ama-analog e-Somatostatin: Lezi yizinhlobo zokwenziwa ze-hormone i-somatostatin. I-somatostatin yakho isebenza ngokuvimbela umzimba wakho ekwenzeni i-hormone eningi kakhulu.

Yimiphi imiphumela emibi noma izinkinga zalokhu kwelashwa?

Ngayinye yalezi zindlela zokwelapha ithinta umuntu ngamunye ngendlela ehlukile. Ngakho-ke, kubalulekile ukuxoxa ngokucacile ngezinzuzo nemiphumela emibi yokwelashwa ngakunye nodokotela wakho. Lokhu kuzokusiza uqonde ukuthi ukwelashwa ngakunye kuzokuthinta kanjani. Udokotela wakho uzoncoma ukwelashwa okusekelwe empilweni yakho iyonke kanye nezintandokazi zakho.

Ingabe ama-tumor e-Endocrine amathumbu angavinjelwa?

Ngeshwa, okwamanje ayikho indlela yokuvimbela ama-GI NET. Kodwa-ke, abacwaningi bezokwelapha bathole ukuxhumana phakathi kwezifo ezithile zofuzo kanye/noma izimo zezokwelapha kanye nengozi yokuthola izimila ze-neuroendocrine. Khuluma nodokotela wakho ngomlando wakho wezokwelapha kanye nomlando wezokwelapha womndeni wakho. Angase ancome ukuhlolwa okukhethekile ukuthola izimpawu zokuqala zama-GI NET, ​​ukuze izimila zibanjwe futhi zelashwe kusenesikhathi.

Uma nginalesi simo, yini okufanele ngiyilindele?

Ukubikezela kwakho kuncike ekutheni umdlavuza utholakale nini nokuthi ukwelashwa kuqalwe nini. Cishe abantu abangu-97% abathola ukwelashwa ngaphambi kokuba umdlavuza usakazekele kwezinye izingxenye zomzimba bazosinda.Eminyakeni emihlanu ngemva kokuxilongwa. Uma isimila sesisakazekele ezicutshini eziseduze noma kuma-lymph node, leso silinganiso sokusinda seminyaka emihlanu sehla saya ku-95%. Cishe abantu abangu-67% abane-GI NETs abasakazeke ngaphandle kwendlela yokugaya ukudla baphila iminyaka emihlanu ngemva kokuxilongwa.

I-GI NET ingabuya. Kuye ngobukhulu, ibanga, kanye nendawo yesimila, kungadingeka ukuthi ube nokuhlolwa kokulandelela njalo. Isibonelo, udokotela wakho angancoma ukuthi uhlolwe nge-CT kanye ngonyaka eminyakeni emithathu yokuqala ngemva kokwelashwa kanye nokuhlolwa ngokomzimba njalo ngonyaka. Buza udokotela wakho mayelana nokuqokwa kokulandelela kanye nokuhlolwa okuqondene nesimo sakho.

Ngizinakekela kanjani?

Uma unesimila se-neuroendocrine esiswini, cishe uzodinga ukuhlinzwa. Odokotela abahlinzayo bavame ukusebenzisa izimbobo ezivulekile, ezinkulu kunokuhlinzwa kwe-laparoscopic. Lokhu kusho ukuthi kuzodingeka uhlale esibhedlela izinsuku ezimbalwa bese ululama ekhaya amasonto ambalwa.

Kufanele ngiye nini eGumbini Lezimo Eziphuthumayo?

Ungase ube nesimiso sokulandelela njalo ukuze ubone ukuthi umdlavuza wakho ubuyile yini. Buza udokotela wakho ohlinzayo ukuthi yiziphi izimpawu ngemva kokuhlinzwa ezingaba yizimpawu zesimo esibucayi. Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, kufanele ufune usizo lwezokwelapha ngokushesha:

• Ubunzima obukhulu obungazelelwe bokuphefumula.
• Uma umkhuhlane ungaphezu kwama-degrees Celsius angu-100.4 (38.3 degrees Celsius).
• Uma ubuhlungu bukhulu, noma uma bungenakulawuleka ngemithi yakho yobuhlungu.
• Uma kukhona ubomvu obuluhlaza, obunuka kabi obuphuma enxebeni lokuhlinzwa, ikakhulukazi uma indawo ezungeze inxeba ishisa uma uyithinta, noma uma ibomvu kakhulu.
• Uma uhlanza njalo noma uhudo.

Isimila se-neuroendocrine esiswini (GI NET) singaba yisifo esishintsha impilo. Lokho kungenxa yokuthi abantu abaningi abanalesi simo kufanele bahlinzwe ukuze kususwe ingxenye noma yonke isimiso sabo sokugaya ukudla. Ukuhlinzwa kwakho kungashintsha indlela odla ngayo, ophuza ngayo, noya ngayo endlini yangasese. Ithimba lakho lezokwelapha liyazi ukuthi ukuzivumelanisa nalezi zinguquko akulula ngaso sonke isikhathi. Uma unemibuzo noma ukukhathazeka, yabelana ngakho nodokotela wakho. Bazoqonda isimo sakho futhi bakusize uthole izixazululo.

Yiziphi izinto ezibaluleke kakhulu esifuna ukuzithatha ekhaya kule ndaba?

• I-'GI NET' uhlobo olungavamile kakhulu lwesimila somdlavuza , kodwa kubalulekile ukuqaphela.
• Abanye abantu bangase babe nalezi zimpawu ngaphandle kwanoma yiziphi izimpawu , kodwa qaphela izimpawu ezifana nobuhlungu besisu, isifo sohudo, kanye nokwehlisa isisindo ngokungahlosiwe.
• Vumela lokhu kukhule.Imbangela eqondile ayikatholakali okwamanje, kodwa ezinye izici zofuzo zingase zibe nendima.
• Kunezinhlobo ezahlukene zokuhlolwa kokuxilonga izifo, njenge-'CT scan', 'MRI', 'Endoscopy', kanye ne-'Biopsy'.
• Izinketho zokwelapha zifaka phakathi ukuhlinzwa, i-chemotherapy, kanye nokwelashwa ngemisebe . Udokotela wakho uzonquma ukuthi yikuphi ukwelashwa okukulungele.
• Ukuxilongwa kusenesikhathi kanye nokuqala ukwelashwa kwandisa kakhulu amathuba okululama.
• Uma unokungabaza noma imibuzo ngalokhu, ungesabi ukukhuluma nodokotela wakho . Bakhona ukuzokusiza.

` I-GI NET, Izimila ze-Neuroendocrine zesisu, Umdlavuza, Umdlavuza wamathumbu, Izimila ze-Neuroendocrine, Uhlelo Lokugaya, Izimpawu