Uke wezwa ngohlobo lomdlavuza wesisu oluzuzwa njengefa? (Umdlavuza Wesisu Osabalala Ngokwefa - HDGC) Ake sixoxe ngalokhu!

Namuhla sizokhuluma ngesimo esibucayi abantu abaningi abangasazi. Lolu uhlobo lomdlavuza wesisu oludluliselwa ngofuzo. Odokotela bawubiza ngokuthi `(Heroditary Diffuse Gastric Cancer)` noma `(HDGC)` ngamafuphi. Uma othile emndenini wakho eke waba nalesi simo, noma uma ufuna ukwazi okwengeziwe ngaso, lesi sihloko sizoba sibaluleke kakhulu kuwe. Ungakhathazeki, ake sixoxe ngaso kalula.

Kuyini lokhu `(HDGC)`?

Kalula nje, i-HDGC iyisimo esiyingozi somdlavuza esizuzwa njengefa. Lokhu kusho ukuthi ingozi yakho yokuphila konke yokuba nomdlavuza wesisu (umdlavuza wesisu) ikhuphuka cishe ngo-70%. Akukhona lokho kuphela, abesifazane abazuza lesi simo njengefa banamathuba angu-42% okuthuthukisa uhlobo oluthile lomdlavuza webele , i-Lobular Breast Cancer (LBC) .

Abantu abanalesi simo `(HDGC)` bathola i-gene eguquliwe (`(gene eguquliwe)`) komunye wabazali babo. Ngokuvamile, lesi yi-gene ebizwa ngokuthi `(CDH1)` . Kodwa ngezinye izikhathi ezinye izakhi zofuzo zingabandakanyeka. `(CDH1)` iyi-gene evimbela isimila (`(gene evimbela isimila)`). Uma lokhu kuguqulwa, akusebenzi kahle ukulawula umdlavuza. Cabanga ngakho, lesi sakhi sofuzo sifana nephoyisa emzimbeni wethu elivimba amangqamuzana omdlavuza ukuthi angakhuli. Ngakho-ke kwenzekani uma lelo phoyisa liba buthakathaka? Yilokho okwenzekayo nalapha.

Uyini umdlavuza wesisu "osakazeka"?

Manje ake sibone ukuthi iyini le `(umdlavuza wesisu osakazeka kabanzi)`. Lolu uhlobo lomdlavuza wesisu. Kodwa esikhundleni sokukhula endaweni eyodwa njengeminye imidlavuza, lona usakazeka odongeni lwesisu ngamaqoqo amancane amaseli. Kufana nokuvuza kwamanzi okusabalala odongeni. Ngenxa yalokhu, udonga lwesisu luyaqina futhi luqine. Kancane kancane, lusakazeka ezingqimbeni ezijulile zodonga lwesisu.

Lolu hlobo lomdlavuza wesisu kunzima ukuluthola ngoba alubonakali kahle ezivivinyweni ezijwayelekile zezithombe. Futhi, izimpawu zivame ukuvela kuphela ngemva kokuba isifo sesisabalele, ezigabeni zakamuva. Ngaleso sikhathi, umdlavuza kungenzeka ukuthi ususakazeke (wasakazeka) ngodonga lwesisu uye ezicutshini eziseduze, njengesibindi noma amathambo.

Sivame kangakanani lesi simo?

Uma sikhuluma ngesimo `(HDGC)`, kulinganiselwa ukuthi cishe abantu abahlanu kuya kwabayishumi kwabayizinkulungwane eziyishumi bangazuza lesi simo lapho bezalwa. Cishe u-20% wabo bonke umdlavuza wesisu ungowohlobo `(olusakazeka)`. Cishe u-2% walabo mdlavuza osakazeka ungowofuzo `(HDGC). Nakuba umdlavuza wesisu uvame kakhulu emazweni ase-Asia kunasemazweni aseNtshonalanga, lesi simo `(HDGC)` sibikwa kaningi emazweni aseNtshonalanga.

Ziyini izimpawu zesimo `(HDGC)`?

Njengoba sishilo ngaphambili, izimpawu zalolu hlobo lomdlavuza wesisu osabalele zingase zingaveli kuze kube yilapho lesi sifo sesisakazekile (sisabalale). Yingakho kubalulekile ukuqaphela ingozi yokuthi lesi simo singangena emindenini. Ku-HDGC, umdlavuza uqala usemncane kancane kunakweminye imidlavuza. Iningi labantu litholakala ngaphambi kweminyaka engama-40.

Izimpawu eziyinhloko zingaba:

• Ubuhlungu besisu (ikakhulukazi engxenyeni engenhla kwesobunxele yesisu)
• Ukuqunjelwa kwesisu, ukuqunjelwa
• Isicanucanu nokuhlanza
• Isifiso sokudla
• Ukwehlisa isisindo
• Ukukhathala okukhulu, ukukhathala
• Ubunzima bokugwinya ukudla
• Igazi elisendle (`(Igazi elisendle)`)
• Ukuhlanza igazi (`(Ukuhlanza igazi)`)
• I-jaundice (ukuphuzi kwamehlo nesikhumba)

Ngezinye izikhathi, isici sokuzalwa esibizwa ngokuthi i-cleft lip noma i-cleft palate singaba uphawu lokuqala lwalesi sifo. Lokhu kungenxa yokuthi lokhu kuguquka kwezakhi zofuzo kungabangela lesi sici sokuzalwa. Kodwa-ke, isikhathi esiningi, i-cleft lip ayihlobene ne-HDGC. Kodwa-ke, uma wazalwa unesici sokuzalwa esinjalo futhi othile emndenini wakho enalezi zinhlobo zomdlavuza, ungase ube nokungabaza okuncane.

Iyini imbangela yokwakheka kwalokhu `(HDGC)`?

I-HDGC iyisifo sofuzo . Kwenzeka lapho ukuguquka kwesinye sezakhi zofuzo ezicindezela isimila esikhulume ngaso ngaphambilini kushintsha uhlelo lwe-DNA yakho. Izakhi zofuzo ezicindezela isimila zitshela amangqamuzana ukuthi alawule ukuhlukana nokukhula kwamaseli. Ngakho-ke uma lawa mazakhi zofuzo engasebenzi kahle, umdlavuza ungavela.

Uzuza lesi sakhi sofuzo esiguquliwe kumama wakho noma kubaba wakho. Ukuguqulwa kwezakhi zofuzo okuzuzwe ngale ndlela kubizwa ngokuthi ukuguqulwa kwezakhi zofuzo . Kuthinta ikhodi yezakhi zofuzo yamaseli akho okuzala.

Lokhu `(HDGC)` kuzuzwe kanjani njengefa?

I-HDGC yisimo esilawula i-autosomal . Lokhu kusho ukuthi udinga ikhophi eyodwa kuphela yesakhi sofuzo esiguquliwe ukuze uzuze lesi sifo. Singazuzwa kumama wakho noma kuyihlo. Uma omunye wabazali bakho enesakhi sofuzo, wena noma izingane zakini ninethuba elingu-50% lokusizuza njengefa. Cabanga ngakho njengethuba lokuthi uhlamvu lwemali luvele emakhanda noma emisileni.

Ingabe wonke umuntu ozuza ifa lokuguqulwa kwezakhi zofuzo uba nomdlavuza?

Cha. Ukuguquka kwezakhi zofuzo okuzuza kubazali bakho kuthinta ikhophi eyodwa kuphela yezakhi zofuzo ezicindezela umdlavuza kuseli ngalinye. Kodwa iseli ngalinye linamakhophi amabili alesi sakhi sofuzo, elilodwa elivela kumama wakho nelinye elivela kubaba wakho. Ngakho-ke noma ungalizuzi ifa elifanayo kubazali bobabili, usenayo ikhophi yezakhi zofuzo ezisebenza kahle.

Ukuze umdlavuza ukhule, kuza uguquko lwesibili (`(uguquko lwe-somatic)`)Kumele kwenzeke ezicutshini lapho umdlavuza wakheka khona (okungukuthi, ulwelwesi lwesisu noma ama-lobules ebele) ngesikhathi sokuphila kwakho. Lokhu kuguquka kwesibili nakho kuyayiqeda enye ikhophi yesakhi sofuzo. Yilapho umdlavuza uqala ukukhula khona.

Iyini imbangela yalolu guquko lwesibili?

Uma sikhuluma iqiniso, asazi isizathu esiqondile salokhu. Kodwa izici ezahlukene zingase zidlale indima. Ukuchayeka endaweni ezungezile kuvame ukuba nendima "ekubangeleni" izifo zofuzo. Ezinye izakhi zofuzo nazo zingase zihileleke. Eminye imindeni ephethe isakhi sofuzo se-HDGC inezinga eliphezulu lomdlavuza kuneminye.

Ezinye izinto ezibangela ingozi yemvelo ezibangela ukuthuthukiswa komdlavuza wesisu yilezi:

• Ukubhema
• Ukusetshenziswa kotshwala ngokweqile
• Ukudla inyama ebomvu kakhulu (njengenyama yenkomo, iwundlu)
• (H. pylori) ukutheleleka (lokhu kubangelwa yibhaktheriya ebangela izilonda zesisu)

Injani inqubo yokuhlola `(HDGC)`?

Ngisho noma ungenazo izimpawu okwamanje, uma kunesizathu sokucabanga ukuthi usengozini (isibonelo, uma othile emndenini wakho eke waba nalezi zinhlobo zomdlavuza, noma uma uke waba nokuhlolwa kofuzo okutholakele ukuguquka ku-gene `(CDH1)`), udokotela angakuthumela ukuze uyohlolwa i-`(HDGC)`.

Udokotela wakho uzobala ingozi yakho ngokusekelwe emlandweni womndeni wakho kanye/noma imiphumela yokuhlolwa kwezakhi zofuzo. Bangase futhi babheke izinto ezibangela umdlavuza ezicutshini zakho. Isibonelo, bangase babheke isimo esibizwa ngokuthi i-Lobular Carcinoma In Situ (LCIS) emaseli ebele noma uhlobo lwendandatho yesandla olwelwesini lwesisu. Lezi izinguquko zakuqala ezingaba umdlavuza.

I-HDGC ihlolwa kanjani?

Uma unezimpawu zomdlavuza wesisu osabalele, udokotela wakho uzobheka ubufakazi bomdlavuza odongeni lwesisu sakho. Uzothatha amasampula ezicubu bese ewahlola ngaphansi kwe-microscope. Uma kutholakala umdlavuza wesisu osabalele, futhi uma othile emndenini wakho eke waba nalolu hlobo lomdlavuza, udokotela wakho angase asikisele ukuthi wenze ukuhlolwa kofuzo .

Njengamanje, cishe ama-40% eziguli ezine-HDGC atholakale enalolu guquko lwe-CDH1. Ezinye izinguquko zingase zihileleke, kodwa i-CDH1 yiyona eyinhloko esiyaziyo futhi esingayibona. Uma unayo, iyindlela eqinisekile yokuthola i-HDGC. Kodwa-ke, uma unomlando womndeni walolu hlobo lomdlavuza wesisu osabalele, ungase utholakale une-HDGC noma ungenayo i-CDH1 mutation.

Yiziphi izivivinyo ezisetshenziswa ukuxilonga `(HDGC)`?

Lezi zivivinyo zingenziwa ukuze kutholakale lesi sifo:

• Ukuhlolwa kofuzo:Lokhu ukuhlolwa kwegazi. Kuthathwa isampula yegazi lakho bese kuhlaziywa ukuze kubonakale ukuthi kukhona yini ukuguquka kwezakhi zofuzo okuhlobene nezifo zofuzo. Abanye abantu bathola lokhu kuhlolwa ngoba banomlando womndeni wezifo zofuzo. Abanye bathola lolu hlobo lokuhlolwa kwezakhi zofuzo ngoba abazi umlando wempilo yomndeni wabo, ukuze bazibonele bona, noma ngoba bahlela ukuba nezingane.
• I-endoscopy ephezulu (ukuhlolwa kwe-EGD): Lolu uhlobo lokuhlola olubheka ingaphakathi lomgudu wakho ongaphezulu wokugaya ukudla (okungukuthi, umphimbo, isisu) bese uthatha amasampula ezicubu. Lokhu kubalulekile ekuxilongweni komdlavuza wesisu, ikakhulukazi lolu hlobo lomdlavuza olusakazeke. Udokotela wezifo zamathumbu (udokotela ochwepheshe bezifo zamathumbu) wenza lokhu. Ufaka ithubhu elide (i-endoscope) elinekhamera encane emlonyeni wakho bese lehla ngomphimbo wakho liye esiswini sakho. Amasampula ezicubu nawo angathathwa ngethubhu. Kodwa-ke, ngisho nangalezi zindlela, kungaba nzima ukuthola umdlavuza wesisu osabalele. Ngenxa yokuthi usakazeke kakhulu, udokotela angase angakwazi ukuwubona noma ukuwuthola kumasampula ezicubu. Ngakho-ke, udokotela ofuna lolu hlobo lomdlavuza kumele abe nokuqeqeshwa okukhethekile kanye nolwazi.
• I-MRI Yebele: Ngenxa yokuthi umdlavuza webele we-lobular awutholakali nge-mammogram ejwayelekile, odokotela batusa i-MRI. Uma i-MRI ikhombisa noma yini engavamile, iyaphawulwa bese omunye udokotela ethatha isampula yezicubu.
• I-Biopsy: Udokotela uthatha isampula yezicubu bese ezithumela elabhorethri ukuze zihlolwe ngaphansi kwe-microscope. Le biopsy ingaqinisekisa ukuthi isampula yezicubu inamangqamuzana omdlavuza.

Kwenzekani ngemva kokuba itholakale ine-`(HDGC)`?

Uma usuvele unomdlavuza, udokotela wakho uzokhuluma nawe ngezinketho zokwelapha. Ngisho noma ungakabi nomdlavuza okwamanje, uma unalesi sifo, udokotela wakho cishe uzoncoma ukuhlolwa njalo kokuhlolwa komdlavuza, njengoba kushiwo ngenhla. Ukuhlinzwa kokuvimbela kungenye indlela ongakhuluma ngayo nodokotela wakho.

Umdlavuza wesisu osabalele uphathwa kanjani?

Ukuhlinzwa ngokuvamile kuyindlela yokuqala yokwelapha umdlavuza engasuswa ngokuhlinzwa. Uma une-HDGC, udokotela wakho uvame ukuncoma ukuthi kukhishwe isisu ngokuphelele . Lokhu kungenxa yokuthi i-HDGC inengozi enkulu yokusabalala kude ngaphambi kokuba itholakale.

Ekuhlinzweni kwesisu okuphelele, udokotela ohlinzayo ususa isisu sakho sonke bese exhumanisa ingxenye yomphimbo wakho ngqo namathumbu akho amancane. Kungenzeka ukuthi uphile ngaphandle kwesisu, kodwa kunemiphumela emibi ethile. Ngemva kokuhlinzwa, ungase uthole ukwelashwa okwengeziwe (ukwelashwa okusizayo) njengokwelashwa ngemisebe noma ngamakhemikhali.

Ngenxa yokuthi abesifazane abane-`(HDGC)` nabo basengozini yokuthola umdlavuza webele we-lobular (`(LBC)`), kudingeka bahlale beqaphela izimpawu ze-`(LBC)` ngesikhathi sokwelashwa. Uma une-`(LBC)`, ukwelashwa kuvame ukuqala ngokuhlinzwa komdlavuza webele. Kube sekunikezwa ukwelashwa okwengeziwe.

Iyini isikhathi sokuphila esilindelekile ngesimo se-`(HDGC)`?

Isikhathi sokuphila sincike ekutholeni nasekuphatheni umdlavuza kusenesikhathi. Ngisho nokuhlolwa njalo, lokhu kungaba nzima. Uma umdlavuza wesisu osabalele utholakala futhi welashwa kusenesikhathi, izinga lokusinda kweminyaka emihlanu lingaphezu kuka-90%. Kodwa-ke, uma utholakala sekwephuzile, ngemva kokuba usungene odongeni lwesisu, izinga lehla liye ngaphansi kuka-30%.

Yingakho sithi kubaluleke kakhulu ukuqaphela umlando womndeni nokufuna iseluleko sezokwelapha uma usengozini.

Ingabe ikhona indlela yokuvimbela `(HDGC)`?

Uma une-gene mutation `(CDH1)` (ehlotshaniswa nengozi eyengeziwe yokuba nomdlavuza), kunezindlela eziningana zokuvimbela ongazithatha. Kubantu abangenalo lolu shintsho oluthile lwe-gene, izingozi nezinyathelo azichazwanga ngokucacile. Ungakhuluma nodokotela wakho ngezingozi zakho siqu kanye nezinketho.

Ukuhlinzwa kokuvimbela

Uma usutholakale une-HDGC okungenani iminyaka engama-20 futhi ungenazo ezinye izinkinga ezinkulu zempilo, udokotela wakho angase akuncome ukuthi uhlinzwe ngokuphelele nge-prophylactic gastrectomy . Nakuba ukulahlekelwa yisisu kungaba nemiphumela ethile ohlelweni lwakho lokugaya ukudla, le miphumela emibi kulula ukuyilawula kunokubhekana nomdlavuza wesisu othuthukile.

Kulabo abangakakulungeli ukuthatha lezi zinyathelo, indlela "yokulinda nokubuka" ingasetshenziswa, ehilela i-endoscopy yamathumbu aphezulu njalo kanye namasampula e-biopsy angahleliwe. Kodwa-ke, ngisho nangokuqapha okunjalo okuseduze, i-HDGC ingase ingatholakali ngaso sonke isikhathi kusenesikhathi (lapho ukwelashwa kusebenza kahle kakhulu).

Imiphumela emibi yokususwa kwesisu ngokuphelele:

• I-Dumping syndrome: Uma ukudla kudlula ngqo kusuka emhubheni kuya emathunjini amancane, kudlula emathunjini amancane ngokushesha kunokujwayelekile. Lokhu kungabangela izinguquko ezinkulu kuma-hormone ohlelweni lokugaya ukudla, okuholela ezimpawini ezifana nesicanucanu, isifo sohudo, kanye noshukela wegazi ophansi. Lezi zimpawu zingalawulwa ngokushintsha imikhuba yakho yokudla. Lezi zimpawu zizophela ngokuhamba kwesikhathi.
• Ukungamuncwa kahle kanye nokungondleki kahle: Uma isisu sisuswa, ingxenye yesisu equkethe ama-acid nama-enzyme asiza ekugayeni ukudla iyalahleka. Lokhu kungavimbela ukudla ukuthi kuqhekeke kahle futhi kuvimbele umzimba ekumunceni izakhamzimba. Lokhu kungaholela ekungondlekini kahle. Lokhu kungasizwa ngokushintsha ukudla kwakho kanye nokuthatha izithasiselo zokudla okunempilo.

Ukwelulekwa ngofuzo kanye nokuhlela umndeni

Kubantu abane-CDH1 gene mutation, ukwelulekwa ngofuzo kungaba usizo kakhulu ekuxoxeni ngokuhlela umndeni. Lokhu kungakusiza uqonde ingozi yokuthi ingane yakho ithole ifa le-HDGC. Uma uhlela ukuba nezingane, enye indlela yokulawula leyo ngozi ukukhetha i-In Vitro Fertilization (IVF) .

Ku-IVF, amaqanda nesidoda kuthathwa kumama nobaba bese kufakwa umanyolo elebhu. Ngemva kokuba ama-embryo ekhule, iseli elilodwa ku-embryo ngayinye lingathathwa futhi lihlolwe ukuguquka kwe-CDH1. Abazali bangakhetha ama-embryo angenayo ukuguqulwa bese bewafaka esibelethweni sikamama.

Okokugcina, okufanele ukukhumbule

Ukuthola ukuthi une-Hereditary Diffuse Gastric Cancer Syndrome (HDGC) kungaba yinto ethinta imizwa kakhulu, futhi kungadingeka wenze izinqumo ezinkulu. Lokhu kungakuthinta wena nomndeni wakho. Zinike isikhathi sokucabanga ngezinto ngaphandle kokwethuka. Buza imibuzo eminingi ngangokunokwenzeka. Ithimba lakho lezokwelapha lilapha ukukusiza ukuthola indlela engcono kakhulu yokuhamba kulolu hambo. Khumbula, ukuqwashisa kuyisinyathelo sokuqala. Awuwedwa.

I- HDGC, umdlavuza wofuzo, umdlavuza wesisu, i-CDH1 gene, umdlavuza wesisu, umdlavuza webele, ukuhlolwa kwezakhi zofuzo, i-endoscopy, i-gastrectomy, ukuvimbela umdlavuza