Siyini isifo se-Leptomeningeal? Ake sixoxe ngaso!

Kunzima ukusho ngamazwi ukwesaba nokukhathazeka ozizwayo uma uthola ukuthi unomdlavuza. Uma ulwa nomdlavuza, sonke sizwile ukuthi ungasakazeka kwezinye izingxenye zomzimba. Namuhla, sizokhuluma ngendlela eyodwa umdlavuza ongathinta ngayo ubuchopho bethu, ulwelwesi oluzungeze umgogodla wethu, kanye noketshezi lwethu lomgogodla. Odokotela babiza lokhu ngokuthi i-Leptomeningeal Disease , ngezinye izikhathi ebizwa ngokuthi i-LMD noma i-LM .

Kalula nje, siyini isifo se-leptomeningeal?

Kulungile, ake sichaze lokhu kancane. Kunezinhlayiya ezintathu ezincane ezivikela ubuchopho bethu kanye nomgogodla. Lezi sizibiza ngokuthi ama-meninges. Izinhlayiya ezimbili ezincane ezingaphakathi kwalezi zinhlayiya zibizwa ngokuthi ama-leptomeninges . Njengezembozo zencwadi, lezi zinhlayiya zivikela lezi zingxenye ezimbili ezibaluleke kakhulu zesimiso sethu sezinzwa.

Okulandelayo, kukhona uketshezi olukhethekile olugeleza ngaphakathi kobuchopho bethu kanye naseduze komgogodla wethu. Lokhu kubizwa ngokuthi uketshezi lwe-cerebrospinal (CSF) . Lolu ketshezi londla ubuchopho kanye nomgogodla, luwuvikele, futhi lususe imfucuza.

Manje, isifo se-leptomeningeal (LMD) yilapho umdlavuza osendaweni ethile emzimbeni, njengomdlavuza webele noma umdlavuza wamaphaphu, usakazeka futhi ungene kulezo zingxenyana ze-leptomeningeal esikhulume ngazo kanye noketshezi lwe-cerebrospinal (CSF). Lokho kusho ukuthi amangqamuzana omdlavuza aqala ukuntanta kulolu ketshezi, njengodoti ontanta emanzini. Lokhu kubhekwa njengohlobo olubi lomdlavuza.

Sivame kangakanani isifo se-leptomeningeal (LMD)?

Isifo se-Leptomeningeal (LMD) empeleni asivamile kangako. Kodwa-ke, ngentuthuko kwezokwelapha evumela abantu ukuba baphile isikhathi eside benomdlavuza, siya siba sivame kakhulu. Ngokwesilinganiso, i-LMD yenzeka cishe ku-5% weziguli zomdlavuza.

Lesi simo se-LMD sivame ukubonakala kubantu abanezinhlobo ezilandelayo zomdlavuza:

• Umdlavuza webele: Umdlavuza webele uhlobo oluvame kakhulu lomdlavuza webele oluhlotshaniswa ne-LMD. Uthinta u -3% kuya ku-5% wabesifazane abanomdlavuza webele. Ucwaningo lubonise ukuthi abesifazane abanohlobo olubizwa ngokuthi "umdlavuza webele ongaphili kahle" kanye nohlobo oluthi "umdlavuza webele we-lobular" basengozini enkulu yokuthola i-LMD.
• Umdlavuza wamaphaphu: Kokubili umdlavuza wamaphaphu ongewona amangqamuzana amancane (i-NSCLC) kanye nomdlavuza wamaphaphu wamangqamuzana amancane (i-SCLC) ungasakazeka uye kuma-leptomeninges kanye noketshezi lomgogodla. Odokotela balinganisela ukuthi phakathi kuka-4% no-7% wabantu abane-NSCLC bahlakulela i-LMD. Leli zinga lenyuka laya cishe ku-11% wabantu abane-SCLC.
• I-Melanoma: Lolu uhlobo olubi kakhulu lomdlavuza wesikhumba. Cishe abantu abangu-5% abane-melanomaI-LMD ingakhula.
• I-acute lymphocytic leukemia (ALL): Lona umdlavuza wegazi. Phakathi kuka-1% no-10% wabantu abanayo yonke i-ALL bangase babe ne-LMD.
• I-Non-Hodgkin's lymphoma (NHL): Lokhu futhi kuwumdlavuza wesistimu ye-lymphatic. Phakathi kuka-5% no-10% wabantu abane-NHL bangase babe ne-NHL.

Uyini umehluko phakathi kwe-metastases yobuchopho nesifo se-leptomeningeal (LMD)?

Kokubili lokhu kwenzeka lapho umdlavuza usakazeka, kodwa kunomehluko omncane.

Ukwanda kobuchopho kwenzeka lapho amangqamuzana omdlavuza ehamba ngqo ezicutshini zobuchopho bese enza amathumba lapho.

Kodwa-ke, isifo se-leptomeningeal (LMD) yilapho amangqamuzana omdlavuza engena ku -cerebrospinal fluid (CSF) kanye ne-leptomeningeal membranes ezungeze ubuchopho kanye nomgogodla . Lapha, amangqamuzana omdlavuza angase antante oketshezini noma asakazeke ebusweni be-membranes.

Ngezinye izikhathi zombili lezi zimo zingenzeka ndawonye, ​​​​noma zingenzeka ngokwehlukana.

Ziyini izimpawu zalesi sifo?

Kungaba nezimpawu eziningi zesifo se-leptomeningeal (LMD), njengoba sithinta ubuchopho kanye nomgogodla, okuyisimiso sethu sezinzwa sonke. Kodwa-ke, nansi ezinye zezimpawu ezivame kakhulu:

• Ikhanda elibuhlungu: Lesi yisibonakaliso esiyinhloko abantu abaningi ababhekana naso. Akufani nekhanda elibuhlungu elivamile, lingaba likhulu kancane, futhi ngezinye izikhathi liba libi kakhulu ekuseni.
• Isicanucanu nokuhlanza: Isicanucanu nokuhlanza kungase kwenzeke, ikakhulukazi ekuseni.
• Izinguquko endleleni ohamba ngayo: Ungase uzizwe sengathi ulahlekelwa ukuzibamba futhi uyakhubeka lapho uhamba.
• Ukulahlekelwa ukuzwa: Ukulahlekelwa ukuzwa kungenzeka ngokuzumayo, futhi ungase uqale ukuzwa imisindo ehlukene ezindlebeni zakho.
• Izinkinga zokubona: Ukubona kabili kanye nokubona okufiphele kungase kwenzeke.
• Ukuquleka : Ukulahlekelwa yingqondo ngokuzumayo kanye nokuquleka kungase kwenzeke.
• Ukudideka kanye nezinguquko ekuqondeni, emizweni, noma ekuziphatheni: Ubunzima bokugxilisa ingqondo, ukulahlekelwa yinkumbulo, ukucasuka, kanye nokukhathazeka kungase kwenzeke.
• Ubuhlungu emhlane nasemilenzeni: Ubuhlungu bungase buvele emhlane nasemilenzeni.
• Ukuba ndikindiki noma ubuthakathaka emilenzeni noma ezinqeni: Imilenze yakho ingase izwakale indikindiki futhi ingenampilo.
• Izinkinga zokuchama noma zokukhipha indle: Kungaba nzima ukulawula umchamo nendle.
• Ezinye izinkinga ezintsha zemizwa: Ngaphezu kwalokhu, kungase kuvele izimpawu ezintsha zemizwa, njengobunzima bokukhuluma kanye nokungazweli engxenyeni yobuso.

Into ebaluleke kakhulu ukuthi uma unomdlavuza, tshela udokotela wakho ngokushesha uma uthola izimpawu ezintsha ezifana nalezi.

Kungani kwenzeka isifo se-leptomeningeal (LMD)?

Kalula nje, i-LMD yenzeka lapho amangqamuzana omdlavuza ehlukana nendawo yokuqala yomdlavuza emzimbeni (isib., ibele, amaphaphu), ehamba ngegazi noma ohlelweni lwe-lymphatic, bese engena ku-cerebrospinal fluid (CSF) kanye ne-leptomeninges esikhulume ngayo ngaphambili. Lokhu kukhombisa ukuthi umdlavuza ususakazeke kangakanani.

Ngokuvamile, uketshezi lwe-cerebrospinal (CSF) lukhiqizwa ebuchosheni bethu, bese luhamba luzungeze ubuchopho kanye nomgogodla, bese luphinde lungene egazini. Lokhu kwenzeka ngomjikelezo. Kodwa-ke, lapho amangqamuzana omdlavuza engena kule CSF, angaphazamisa ukugeleza okuvamile kwalolu ketshezi. Ngemuva kwalokho i-CSF ingaqoqana, yandise ingcindezi ngaphakathi kobuchopho. Yingakho kuvela izimpawu eziningi. Futhi, lapho amangqamuzana omdlavuza esakazekela ezingxeni ze-leptomeninges, angalimaza lawo ma-membrane kanye nemizwa exhunywe kuwo.

Odokotela bakubona kanjani lokhu?

Uma usola ukuthi une-LMD, odokotela bazokwenza izivivinyo ezimbili eziyinhloko:

1. Ukuskena kwe-MRI (I-Magnetic Resonance Imaging - i-MRI): Ukuskena kwe-MRI kobuchopho bakho kanye/noma umgogodla kwenziwa ukuhlola amangqamuzana omdlavuza asakazekela kuma-leptomeninges kanye nokuvinjelwa kokugeleza kwe-CSF.

2. Ukubhoboza i-Lumbar / Umpompi Womgogodla: Kulesi sivivinyo , kufakwa inaliti encane emhlane wakho ongezansi, kuqikelelwe ukuthi ingalimazi umgogodla wakho, ukuze kususwe isampula encane yoketshezi lwe-cerebrospinal (CSF). Isampula bese ihlolwa elabhorethri ukuze kubonakale ukuthi kukhona yini amangqamuzana omdlavuza.

Ngezinye izikhathi, uma ukusabalala kwamangqamuzana omdlavuza kungabonakali kakhulu (microscopic), kungase kungatholakali ku-MRI scan. Ezimweni ezinjalo, ukuthola lesi sifo kungaba nzima kancane. Yingakho kubalulekile ukutshela udokotela wakho ngqo ngezimpawu zakho.

Ingabe ikhona ikhambi eliphelele lalokhu?

Ngeshwa, okwamanje akukho ukwelashwa kwesifo se-leptomeningeal (LMD). Ngenxa yokuthi uhlobo lomdlavuza olubi kakhulu nolusakazekile, imigomo eyinhloko yokwelashwa ukulawula ukusabalala komdlavuza, ukunciphisa izimpawu nokukusiza uphile ngokunethezeka ngangokunokwenzeka, nokugcina ikhwalithi yokuphila.

Izindlela zokwelapha zincike ezicini ezifana nohlobo lomdlavuza owawunawo ekuqaleni, ukuthi umdlavuza ususakazeke kangakanani, kanye nempilo yakho iyonke. Ezinye zezindlela zokwelapha ezisetshenziswa kakhulu zifaka:

• Ukwelashwa ngemisebe: Ukwelashwa ngemisebe kunikezwa izingxenye ezithintekile zobuchopho noma umgogodla. Lokhu kunganciphisa ezinye izimpawu (isib. ubuhlungu, ubuthakathaka bemizwa) futhi kuthuthukise ukusebenza kwemizwa.
• Ukwelashwa ngamakhemikhali:Imithi inikezwa ukubulala amangqamuzana omdlavuza. Le mithi ingathathwa njengamaphilisi, inikezwe njengomjovo emthanjeni, noma ngezinye izikhathi ijovwe ngqo ku-cerebrospinal fluid (CSF). Lokhu kubizwa ngokuthi "i-Intrathecal chemotherapy." Lokhu kwenziwa ngethubhu elincane elifakwa ebuchosheni elibizwa ngokuthi "idivayisi yokufinyelela ye-ventricular."

Ingabe zikhona izindlela zokunciphisa ukwenzeka kwalokhu?

Eqinisweni, okwamanje ayikho indlela eqondile yokuvimbela ukuthuthukiswa kwe-LMD, njengoba kwenzeka ngenxa yokusabalala komdlavuza osevele ukhona emzimbeni.

Ungaphila isikhathi esingakanani nalesi sifo?

Ngiyazi ukuthi lo mbuzo unzima ukuwubuza. I-LMD iyisigaba esithuthukile somdlavuza. Lokhu kusho ukuthi uma lesi simo senzeka, isiguli sisesigabeni esibucayi kakhulu somdlavuza.

Ngokwesilinganiso, iziguli ezithola ukwelashwa zingalindela ukuphila izinyanga ezintathu kuya kweziyisithupha ngemva kokuxilongwa . Kulabo abangatholi ukwelashwa, lesi sikhathi singaba cishe inyanga.

Kodwa-ke, lokhu kungahluka kumuntu nomuntu. Kuncike ezintweni eziningi, njengohlobo lomdlavuza onawo kanye nendlela umzimba wakho osabela ngayo ekwelashweni. Udokotela wakho ungumuntu ongcono kakhulu ukukunikeza ulwazi ngalokhu.

Ngingazinakekela kanjani? Ingabe kufanele ngicabangele ukunakekelwa kwe-hospice?

Uma une-LMD, kubalulekile ukuqonda kahle isimo sakho. I-LMD iyinkinga engapheli nengelapheki yomdlavuza. Buza udokotela wakho ukuthi yini ongayilindela ngokusekelwe esimweni sakho. Ngaleyo ndlela, ungakwazi ukuphatha izimpawu zakho, uhlale ukhululekile ngangokunokwenzeka, futhi ubeke phambili izinto ezibalulekile kuwe.

Lezi akuzona izinto ezilula ukukhuluma ngazo, kungaba nawe noma nodokotela wakho. Kodwa zibaluleke kakhulu. Udokotela wakho angakusiza uqonde ukuthi kwenzekani emzimbeni wakho nokuthi yini engase yenzeke esikhathini esizayo. Angakusiza futhi ukuthi ucabange ngezinketho zakho, futhi uma kudingeka, akuthumele ezinkonzweni zokusekela.

Ukunakekelwa kwe-Hospice kuyisevisi esiza abantu abanezifo ezivimbela impilo yabo futhi ezibulalayo ukuba baphile izinsuku zabo zokugcina ngokunethezeka, ngesithunzi, ngaphansi kolawulo lwabo, kanye nekhwalithi ephezulu yokuphila. Lapho silwa nesifo esingathi sína, isikhathi sethu esiningi namandla ethu kugxile ekwelashweni. Uma sicabanga ngokunakekelwa kwe-hospice, kugxilwa endleleni yokusebenzisa isikhathi esisele, kunokuba sigxile ekuguleni ngokwako. Ngokukhuluma nodokotela wakho ngokuthi i-LMD izokuthinta kanjani impilo yakho, ukuthi yiziphi izindlela zokwelapha ezitholakalayo zohlobo lwakho lomdlavuza, nokuthi yini ongayilindela kulezo zindlela zokwelapha, ungenza isinqumo esikulungele kangcono.

Uma une-LMD, cishe uphila nomdlavuza omkhulu osakazeke emzimbeni wakho wonke naphezu kokwelashwa. Uma uthola ukuthi unenkinga engelapheki futhi engathi sína, ungase uzizwe ushaqekile, uthukuthele, futhi wesaba. Ungase uzibuze, "Kungani lokhu kwenzeka kimi?" Awuwedwa kulesi simo. Cela usizo kudokotela wakho. Bayaqonda ukuthi ubhekene nani, futhi bazokusiza nganoma iyiphi indlela abangakusiza ngayo.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

• Isifo se-Leptomeningeal (LMD) ukusabalala komdlavuza ezithweni ezimboze ubuchopho nomgogodla kanye noketshezi lwe-cerebrospinal.
• Lesi yisimo esibucayi esingelapheki.
• Izimpawu ze-neurological ezifana nekhanda elibuhlungu, isicanucanu, ubunzima bokuhamba, izinkinga zokubona/ukuzwa, kanye nokudideka kungase kube khona.
• Lesi sifo sitholakala nge-MRI scan kanye nokubhobozwa kwe-lumbar.
• Umgomo wokwelashwa ukulawula izimpawu nokugcina ikhwalithi yokuphila.
• Ungesabi ukukhuluma ngokukhululekile nodokotela wakho ngesimo sakho, ikusasa lakho, kanye nezinketho ezifana nokunakekelwa kwe-hospice. Thola ukwesekwa okudingayo wena nomndeni wakho ukuze nibhekane nalesi sikhathi esinzima.

Isifo se - Leptomeningeal, Umdlavuza, Ubuchopho, Umgogodla, Uketshezi Lomgogodla, Izimpawu, Ukusabalala Komdlavuza