Ingabe ingane yakho encane ineqhubu esiswini noma entanyeni elizwakala sengathi liqhubu? Noma ingabe kukhona imivimbo noma amabala aluhlaza okwesibhakabhaka azungeze amehlo ayo abonakala sengathi ishayiwe? Wonke umama noma ubaba uyesaba kakhulu futhi ukhathazekile lapho ebona into efana nale. Kuvamile kakhulu. Kodwa ngezinye izikhathi lokhu kungaba izimpawu zohlobo lomdlavuza olubizwa ngokuthi 'i-Neuroblastoma', oluvela ikakhulukazi ezinganeni ezincane. Ngakho-ke namuhla, ake sixoxe ngalokhu ngaphandle kokwesaba futhi sichaze ngokucacile konke okudingeka ukwazi.
Iyini ngempela i-Neuroblastoma?
Kalula nje, i-Neuroblastoma uhlobo lomdlavuza oluvela ohlelweni lwezinzwa lwezingane ezincane nezinsana. Izinzwa zomzimba wethu zakhiwa ngamaseli ezinzwa angakavuthwa abizwa ngokuthi 'ama-neuroblast'. Umdlavuza we-Neuroblastoma uvela kula maseli ezinzwa angakavuthwa.
Ngokuvamile, lo mdlavuza uqala emangqamuzaneni ezinzwa angakavuthwa ezindlaleni ze-adrenal, izindlala ezimbili ezincane ezitholakala ngaphezu kwezinso. Lezi zindlala zikhiqiza ama-hormone alawula izinto eziningi emzimbeni wethu esingaziboni ukuthi zenzeka, njengokushaya kwenhliziyo, umfutho wegazi, ukuphefumula, kanye nokugaya ukudla. Ngaphezu kwalokhu, lo mdlavuza ungaqala nasezicutshini zezinzwa emgogodleni, esiswini, esifubeni, noma entanyeni. Ngokuhamba kwesikhathi, lawa mangqamuzana omdlavuza angasakazekela kwezinye izingxenye zomzimba.
Ukubikezela kwengane enalesi sifo kuncike ezintweni eziningana, okuhlanganisa indawo yomdlavuza, iminyaka yengane, kanye nesigaba (ukuthi umdlavuza ususakazeke kangakanani).
Ingabe lesi yisifo esivame kakhulu?
Cha, i-Neuroblastoma ingumdlavuza ongavamile. Kodwa into ebaluleke kakhulu ukuthi uhlobo lomdlavuza oluvame kakhulu olubonakala ezinsaneni. Lesi sifo sivame ukwenzeka ezinganeni ezingaphansi kweminyaka emi-5. Ngezinye izikhathi lo mdlavuza ungavela ngisho noma ingane isesesibelethweni. Akuvamile kakhulu ukubona lo mdlavuza ezinganeni ezingaphezu kweminyaka eyi-10.
Izigaba ze-Neuroblastoma zihlukaniswa kanjani?
Uma ingane yakho iqinisekisiwe ukuthi inalesi sifo, odokotela bazobheka ukuthi umdlavuza ususakazeke kangakanani nokuthi ukhula ngokushesha kangakanani. Lokhu kuzonquma 'izinga lengozi' yalesi sifo. Kulapho-ke kuphela lapho kuzokhethwa khona indlela yokwelapha efanele kakhulu yengane.
Esikhathini esidlule, lesi sigaba sasinqunywa ngokubheka ukuthi umdlavuza ungakanani osele emzimbeni ngemva kokuhlinzwa. Kodwa manje, odokotela basebenzisa indlela eyamukelwa emhlabeni wonke. Kuso, isigaba sinqunywa ngokubheka ukuthi umdlavuza ususakazeke kangakanani, ngokusekelwe kuma-scan (njenge-'CT scan' noma i-'MRI`). Ake siqonde lezi zigaba ngamagama alula.
| Isigaba salesi sifo | Kuchazwe kalula |
|---|---|
| Isigaba L1 | Leli izinga eliphansi kakhulu lengozi. Umdlavuza utholakala engxenyeni eyodwa yomzimba. Futhi, azikho izitho ezinkulu ezithintekile. |
| Isigaba L2 | Nalapha futhi, umdlavuza utholakala endaweni eyodwa kuphela. Kodwa-ke, kungenzeka ukuthi usakazekele kuma-lymph node aseduze. Futhi, ngenxa yokuthi umdlavuza uzungezwe imithambo yegazi emikhulu, kuba nomthelela othile ezithweni ezibalulekile. |
| Isigaba M | Leli izinga eliphezulu kakhulu lengozi. Lapha, amangqamuzana omdlavuza asakazekele ezindaweni ezingaphezu kweyodwa zomzimba, okungukuthi, ezindaweni ezikude (isifo esiqhelelene kakhulu). |
| Isigaba se-MS | Lesi yisimo esikhethekile. Sibonakala kuphela ezinganeni ezingaphansi kwezinyanga ezingu-18 ubudala. Lapha, umdlavuza usakazekele esikhumbeni, esibindini, noma emnkantsheni wamathambo kuphela. Izingane ezikulesi sigaba zinethuba elikhulu lokwelashwa. Lokhu kuvame ukubhekwa njengesimo esingengozi kakhulu. |
Kungani lolu hlobo lomdlavuza lukhula?
Isizathu esiyinhloko salokhu ukuthi amangqamuzana ezinzwa angavuthiwe (`ama-neuroblast') esikhulume ngawo ngaphambilini akhula ngokungalawuleki. Lapho kwenzeka ukuguquka kwezakhi zofuzo kulawo maseli, lawo maseli aqala ukuhlukana futhi akhule ngendlela engavamile. Amangqamuzana aqoqana ngale ndlela akha isimila. Odokotela abasazi imbangela eqondile yalokhu kuguquka kwezakhi zofuzo.
Into ebaluleke kakhulu ukuthi lokhu akubangelwa yinoma yiliphi iphutha labazali. Futhi, ezimweni ezingama-98% - 99%, lesi sifo asizuzwa njengefa.
Kodwa-ke, uma othile emndenini eke waba ne-Neuroblastoma ngaphambili, kunethuba elincane lokuthi ingane izoyithola. Kodwa ayivamile kakhulu. Futhi, izingane ezizalwa nezinye izinkinga zokuzalwa nazo zisengozini enkulu yokuthuthukisa lesi sifo.
Ziyini izimpawu zalesi sifo?
Izimpawu ze-neuroblastoma ziyahlukahluka kakhulu. Ezinye zingase ziqale kancane kakhulu. Lezi zimpawu zincike endaweni yesimila kanye nesigaba sesifo. Ngokuvamile, ngesikhathi izimpawu zivela, umdlavuza usuvele usakazekele kwezinye izingxenye zomzimba.
Nazi ezinye izimpawu ezivamile:
- Amaqhubu: Iqhubu elizwakala kalula entanyeni, esifubeni, esiswini, noma ethangeni. Ezinganeni ezincane, amaqhubu amaningana aluhlaza okwesibhakabhaka noma onsomi angabonakala ngaphansi kwesikhumba.
- Amehlo: Amehlo abonakala sengathi avele, anombala omnyama/oluhlaza okwesibhakabhaka azungeze amehlo, njengokungathi aphukile.
- Ukungakhululeki esiswini: Uhudo, ukuqunjelwa, ubuhlungu besisu, ukulahlekelwa yisifiso sokudla.
- Ukukhathala kanye nokwephuka: Ukukhathala okuqhubekayo, ukukhwehlela, umkhuhlane. Isikhumba esiphaphathekile. Lokhu kungenxa ye-anemia, okuwukwehla kwamaseli abomvu egazi.
- Ukuqunjelwa: Isisu siyavuvukala futhi sibuhlungu.
- Ubunzima bokuphefumula: Ikakhulukazi ezinganeni ezincane.
- Ubuthakathaka: Ubuthakathaka emilenzeni nasezinyaweni, ubunzima bokuhamba, noma ukukhubazeka.
Njengoba lesi sifo siqhubeka, izimpawu ezifana nalezi zingase zivele:
- Umfutho wegazi ophakeme kanye nokushaya kwenhliziyo okusheshayo.
- Ubuhlungu emathanjeni, emhlane, noma emilenzeni.
- Izinkinga ngokulinganisela komzimba kanye nokunyakaza.
- Ukunyakaza kwamehlo okusheshayo nokungalawuleki.
- Isimo esibizwa ngokuthi i-Horner's syndrome, esibonakala ngokugoba kwamehlo ohlangothini olulodwa lobuso, izikhala ezincane, kanye nokuncipha kokujuluka.
Odokotela basithola kanjani lesi sifo?
Lesi simo sivame ukutholakala ezinganeni ezingaphansi kweminyaka emi-5. Ngezinye izikhathi, lesi sigaxa singabonakala ngisho nangesikhathi sokuhlolwa kwe-ultrasound ngesikhathi umntwana esesesibelethweni.
Udokotela wakho uzokwenza izivivinyo eziningana ukuqinisekisa ukuthi unesifo.
Ukuhlolwa Komzimba
Okokuqala, udokotela uzohlola ingane ngokucophelela. Uzohlola amaqhubu nezinye izinkinga. Uzophinde enze ukuhlolwa kwezinzwa ukuze ahlole ukusebenza kwesimiso sezinzwa, ukusabela komzimba, kanye nokuxhumana kwaso.
Ukuhlolwa Kwegazi Nomchamo
Lezi zivivinyo zifaka phakathi ukubalwa kwegazi okuphelele (i-CBC) ukuhlola i-anemia kanye nokunye ukukhubazeka kwegazi, kanye nokuhlola amazinga amakhemikhali athile aqongelela egazini nasemchameni lapho kukhona umdlavuza.
Ukuhlolwa kwebhayoloji
Okwenziwa lapha ukuthatha ingxenye encane kakhulu yezicubu esiqwini bese uyihlola ngaphansi kwe-microscope. Yilokhu okwenza kuqinisekiswe ngokuphelele ukuthi yi-Neuroblastoma. Kuphinde kuhlole ukuthi amangqamuzana omdlavuza kulesi sigaba sezicubu anezinguquko ezikhethekile yini kuma-chromosome awo. Lolo lwazi lubaluleke kakhulu ekunqumeni izinga lobungozi bengane kanye nohlelo lokwelashwa.
Ukuhlolwa Kwe-Bone Marrow
Umnkantsha wamathambo yingxenye ethambile emathanjeni ethu amakhulu. Yilapho kwakheka khona amangqamuzana egazi ethu. Lokhu kuhlolwa kwenziwa ukuze kubonakale ukuthi umdlavuza ususakazekele yini emnkantsha wamathambo.
Ukuskena Kwezithombe
Kunezinhlobo eziningana zokuskena ukuze kubonakale ukuthi umdlavuza ukuphi, ukuthi mkhulu kangakanani, nokuthi ususakazekele kwezinye izindawo.
- I-CT scan: Uchungechunge lwezithombe ze-X-ray luthathwa ngemva kokufaka udayi okhethekile emzimbeni.
- I-MRI scan: Isebenzisa omaginethi namagagasi omsakazo ukuthatha izithombe ezinemininingwane zengaphakathi lomzimba.
- I-MIBG scan: Lesi yi-scan eqondene ne-Neuroblastoma. Kulesi si-scan, kufakwa ikhemikhali enomsebe ephephile emzimbeni. Le khemikhali iya ezindaweni lapho amangqamuzana e-Neuroblastoma atholakala khona. Ngemuva kwalokho, uma ibukwa ngekhamera ekhethekile, kungenzeka ukubona ngokucacile ukuthi umdlavuza usakazeke kuphi emzimbeni. Kodwa-ke, cishe u-10% wamangqamuzana omdlavuza wezingane awamunci le-MIBG. Ezimweni ezinjalo, kusetshenziswa olunye uhlobo lwe-scan olubizwa ngokuthi i-`PET scan`.
- Ukuskena nge-ultrasound kanye ne-X-ray: Lokhu kusetshenziselwa kakhulu ukuthola umbono oqondile wendawo lapho kukhona khona isimila kanye nomphumela waso ezithweni ezizungezile.
Yiziphi izindlela zokwelapha i-Neuroblastoma?
Ukwelashwa kunqunywa iminyaka yengane, isigaba sesifo, izinga lengozi, kanye nendawo yesimila. Ithimba lodokotela lizosebenza nawe ukuthuthukisa uhlelo lokwelapha olungcono kakhulu lwengane yakho.
Ukwelashwa ngokwezinga lengozi
- I-Neuroblastoma Enengozi Ephansi: Ezinye izingane ezikulesi sigaba, ikakhulukazi lezo ezingaphansi kwezinyanga eziyisithupha ubudala, zingase zigcinwe ziqashwe udokotela wazo ngaphandle kokwelashwa. Lokhu kungenxa yokuthi ezinye izimila ziyanyamalala zodwa ngaphandle kokwelashwa. Ezinye izingane zingadinga ukuhlinzwa, ukwelashwa ngamakhemikhali, noma kokubili ukuze kususwe isimila.
- I-Neuroblastoma Enobungozi Obuphakathi: Lezi zingane zivame ukuhlinzwa ukuze kususwe isimila. Uma sesisakazekele kuma-lymph node, nazo ziyasuswa. Ukwelashwa ngamakhemikhali kunikezwa ngemva kokuhlinzwa. Ngezinye izikhathi, ukwelashwa ngamakhemikhali kunganikezwa ngaphambi kokuhlinzwa ukuze kuncishiswe isimila.
- I-Neuroblastoma Eyingozi Kakhulu: Laba bantwana banikezwa inhlanganisela yokwelashwa. Lokhu kungafaka phakathi ukwelashwa ngamakhemikhali, ukuhlinzwa, ukwelashwa ngamakhemikhali ngomthamo ophezulu ngokufakelwa iseli le-stem, imisebe, kanye nokwelashwa nge-immunotherapy.
Ikakhulukazi, izingane ezinezikhophi ezengeziwe ze-MYCN gene emaseli azo omdlavuza ziphathwa njengezisengozini enkulu, kungakhathaliseki ukuthi lesi sifo sikusiphi isigaba, ngoba lesi gene singabangela ukuba umdlavuza ukhule futhi usabalale ngokushesha.
Ake sifunde okwengeziwe ngezindlela zokwelapha.
Kubaluleke kakhulu ukuthi uqonde ngokucacile ukuthi yiziphi izindlela zokwelapha ezinikezwa ingane yakho nokuthi zizohilelani.
| Indlela Yokwelapha | Kalula nje, kwenzekani? |
|---|---|
| Ukwelashwa ngamakhemikhali | Lokhu kuhilela ukunikeza umzimba imithi evimba amangqamuzana omdlavuza ukuthi angahlukani futhi akhule. Le mithi inikezwa ngomthambo. Lokhu kwelashwa kungathatha amasonto noma izinyanga. |
| Ukuhlinzwa | Odokotela abahlinzayo benza ukuhlinzwa ukuze kususwe isimila somdlavuza. Kodwa-ke, ngezinye izikhathi kungase kungenzeki ukusisusa ngokuphelele. Ezimweni ezinjalo, kusetshenziswa i-chemotherapy noma ukwelashwa ngemisebe ukubhubhisa noma yimaphi amaseli asele. |
| Ukwelashwa Ngemisebe | Imisebe enamandla aphezulu isetshenziselwa ukubhubhisa amangqamuzana omdlavuza noma ukuvimba ukukhula kwawo. Lokhu kwelashwa kuvame ukunikezwa izingane ezisengozini enkulu ukuvimbela umdlavuza ukuthi ungabuyi ngemva kokwelashwa. |
| Ukwelashwa nge-immunotherapy | Lokhu kusebenza ngokuqeqesha amasosha omzimba engane ukuthi ahlasele amangqamuzana omdlavuza asele ngemva kokunye ukwelashwa. Imithi ekhethekile (ama-antibodies) inikezwa ngemithambo yegazi. Le mithi ithola futhi inamathele kuphrotheni ebizwa ngokuthi i-GD2 ebusweni bamaseli e-Neuroblastoma. Lokhu-ke kunikeza isimiso somzimba sokuzivikela ukuthi sibhubhise lawo maseli. |
| Ukufakelwa Kweseli Lesiqu | Lokhu kuyindlela yokwelapha eyinkimbinkimbi. Okokuqala, amaseli okuqala engane aphilile athathwa egazini layo agcinwe efrijini. Bese kunikezwa i-chemotherapy enamandla kakhulu, enomthamo ophezulu ukuze kubulawe wonke amaseli omdlavuza emzimbeni. Bese kufakwa lawo maseli aphilile agciniwe emzimbeni wengane. Lawo maseli aya emnkantsheni wamathambo futhi akhe amaseli egazi amasha anempilo kanye nesistimu yomzimba yokuzivikela. |
Iyini ithuba lokwelapha lesi sifo? (Isibikezelo)
Lona ngumbuzo omkhulu kunayo yonke engqondweni yabazali. Izinga lokululama kwezingane ezine-neuroblastoma liyahlukahluka.
- Izinga lokululama liphezulu kakhulu ezinganeni ezisesigabeni esisengozini ephansi noma ephakathi , ikakhulukazi izingane ezincane. Cishe u-90% - 95% wezingane uyalulama ngokuphelele.
- Izinga lokululama kwezingane ezindala eqenjini elisengozini enkulu licishe libe ngu -60% .
Kodwa ungalilahli ithemba. Odokotela nabacwaningi bahlala bezama ukuthola izindlela zokwelapha eziphumelela kakhulu kuleli qembu lezingane ezisengozini enkulu. Kunezindlela zokwelapha eziningi ezintsha esezivele zibonise imiphumela ephumelelayo.
Ingabe lesi sifo singavinjelwa?
Ngeshwa, ayikho indlela yokuvimbela i-Neuroblastoma. Uma wena noma umlingani wakho nalesi sifo niseyingane, noma uma othile emndenini wakho enomlando waso, khuluma nodokotela wakho ngaso. Kodwa khumbula, i-Neuroblastoma yefa ayivamile kakhulu (1% - 2%).
Kufanele ngimbone nini udokotela?
Uma usola ukuthi ingane yakho inanoma yiziphi izimpawu esixoxe ngazo, ungalibali bese ubona udokotela ngokushesha okukhulu. Ezimweni ezinjalo, ukuxilongwa kusenesikhathi kanye nokwelashwa kungathinta kakhulu ukululama kwengane.
Uma ingane itholakala inomdlavuza, kungaba nzima ngomndeni wonke ukubhekana nakho. Kuyashaqisa kakhulu. Kodwa awuwedwa. Odokotela, abahlengikazi, kanye nabasebenzi abaphatha lezi zingane bazinikele kakhulu. Futhi, buza udokotela wakho ngamaqembu okusekelana lapho ungakhuluma khona nabanye abazali abaye baba nokuhlangenwe nakho okufanayo. Ukwabelana okuhlangenwe nakho nokuzwa izindaba zabanye kungaba umthombo omkhulu wamandla kuwe.
Umlayezo Wokuya Nawe Ekhaya
- I-Neuroblastoma uhlobo lomdlavuza oluvela ezinganeni ezincane, ikakhulukazi izinsana.
- Uma ingane yakho inezimpawu ezifana neqhubu esiswini noma entanyeni, ukubukeka okubuhlungu eduze kwamehlo ayo, umkhuhlane oqhubekayo, noma ukuphelelwa yisifiso sokudla, xhumana nodokotela ngokushesha.
- Lesi sifo asibangelwa yiphutha labazali. Sibangelwa ushintsho olungavamile lwezakhi zofuzo. Akuvamile kakhulu ukuthi sidluliselwe ezizukulwaneni ngezizukulwane.
- Izindlela zokwelapha zithuthukisiwe. Ukwelashwa kunqunywa ngokusekelwe ezingeni lengozi yesifo sengane.
- Izingane eziseqenjini elisengozini encane zinethuba elikhulu lokululama. Izindlela zokwelapha ezintsha nezisebenzayo zihlala zitholakala ezinganeni ezisengozini enkulu. Themba njalo ithimba lakho lezokwelapha.
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