Uyalwazi yini lolu hlobo lomdlavuza olungavamile oluvela olwelwesini lwesisu (i-peritoneal mesothelioma)?

Ingabe ngezinye izikhathi uzizwa ubuhlungu obungacacile noma ukuqunjelwa esiswini sakho? Ingabe uzizwa ulahlekelwa yisifiso sokudla kanye nokwehla kwesisindo? Nakuba ngezinye izikhathi singazinaki lezi zimpawu, zingaba izimpawu zesifo esibucayi esiyisisekelo. Namuhla sizokhuluma ngohlobo lomdlavuza olungavamile kancane, kodwa oludinga ukunakwa kakhulu. Lowo umdlavuza obizwa ngokuthi 'i-Peritoneal Mesothelioma'.

Iyini le Mesothelioma ye-Peritoneal?

Kalula nje, i-'Peritoneal Mesothelioma' ingumdlavuza okhula ngaphakathi esiswini sethu, okungukuthi, olwelwesini oluncane olumboza umgodi wesisu, ngokwezokwelapha, i-'peritoneum'. Cabanga ngakho, le 'peritoneum' ifana nesivikelo esibucayi esizungeze izitho ezibalulekile ngaphakathi esiswini sethu, njengesibindi, amathumbu, kanye nesisu.

Lo mdlavuza, njengezinye izinhlobo ze-mesothelioma, uvame ukuhlotshaniswa nokuchayeka ngaphambilini entweni ebizwa ngokuthi i-asbestos. Kungenzeka ukuthi uke wezwa ukuthi i-asbestos iyinto esetshenziselwa ukwenza ezinye izinto zokwakha. Iyingozi kakhulu ngoba imicu ekuyo ingabangela izinkinga ezinkulu uma uyiphefumula noma uyidla.

I-mesothelioma yesisu ingumdlavuza onolaka kakhulu futhi osakazeka ngokushesha. Esikhathini esiningi, ngisho noma utholakala, umdlavuza usuvele usakazeke kulo lonke ulwelwesi lwesisu. Ngakho-ke, kunzima ukuwuthola kusenesikhathi.

Uyini umehluko phakathi kwe-peritoneal mesothelioma ne-pleural mesothelioma?

Kokubili i-'Peritoneal Mesothelioma' kanye ne-'Pleural Mesothelioma' kukhula ezingxeni ezimboze imigodi ebalulekile kanye nezitho zangaphakathi zomzimba wethu.

• I-mesothelioma ye-peritoneal ikhula olwelwesini olumboze umgodi wesisu futhi luzungeze izitho zesisu, okungukuthi, i-peritoneum esikhulume ngayo ekuqaleni.
• I-mesothelioma ye-Pleural ikhula olwelwesini olumboze umgodi wesifuba, ikakhulukazi amaphaphu. Ibizwa ngokuthi i-pleura.

Zombili lezi zindwangu zakhiwe uhlobo olukhethekile lweseli olubizwa ngokuthi `amaseli e-mesothelial`. Yingakho lo mdlavuza ubizwa ngokuthi `i-mesothelioma`.

Zombili izinhlobo ze-mesothelioma zivame ukuba yingozi, okusho ukuthi zinomdlavuza . Lawa maseli e-mesothelial ayingozi akhula ngokushesha nangokungalawuleki, elimaza izicubu ezinempilo ezizungezile. I-mesothelioma ye-Pleural uhlobo lomdlavuza oluvame kakhulu kune-peritoneal mesothelioma.

Ubani onamathuba amaningi okuthola lesi sifo? Sivame kangakanani?

Noma ubani angaba ne-'Peritoneal Mesothelioma'. Kodwa-ke, ayivamile kakhulu ezinganeni ezincane. Ngokuvamile, lesi sifo sitholakala kubantu abaneminyaka engu-50.

Nakuba i-'Peritoneal Mesothelioma' iwuhlobo lwesibili oluvame kakhulu lwe-'Mesothelioma' (owokuqala yi-'Pleural Mesothelioma'), futhi ingumdlavuza ongavamile kakhulu. I-'Peritoneal Mesothelioma' ikhula phakathi kuka-10% no-20% wabo bonke abaguli be-'Mesothelioma'. Cabanga nje, ezweni elifana neMelika, kubikwa amacala amasha aphakathi kuka-400 no-1000 kuphela alaba ziguli minyaka yonke. Ngakho-ke, nakuba lezi ziguli zingase zibe khona naseSri Lanka, inani liphansi kakhulu.

Ziyini izimpawu ze-Peritoneal Mesothelioma? Ungazibona kanjani?

Leli iphuzu elibaluleke kakhulu ngoba isikhathi esiningi, i-Peritoneal Mesothelioma ayibonisi zimpawu ezigabeni zokuqala. Izimpawu ziqala ukuvela kuphela ngemva kokuba umdlavuza ususakazekele ezithweni zesisu.

Uphawu oluvame kakhulu ukunqwabelana koketshezi esiswini. Lokhu kubizwa nangokuthi 'ama-ascites'. Lapho uketshezi lunqwabelana, isisu siqala ukukhula nokuvuvukala. Uphawu lwesibili oluvame kakhulu ubuhlungu besisu.

Ezinye izimpawu zingase zihlanganise:

• Ama-Ascites : Kuzwakala sengathi isisu sigcwele futhi sinzima.
• Ukuvuvukala noma ukuqunjelwa kwesisu : Izingubo zingaqina.
• Ubuhlungu besisu : Lokhu kungaba ubuhlungu obusakazeka esiswini sonke, noma kungaba ubuhlungu obuzwakala endaweni eyodwa kuphela.
• Ungase uzwe iqhubu elibuhlungu esiswini esingezansi .
• Ukuqunjelwa noma ukuvaleka kwamathumbu : Kuzwakala sengathi isisu sakho sivuvukele futhi unenkinga yokuphuma kwendle.
• Isicanucanu nokuhlanza .
• Umkhuhlane ongachazeki kanye nokujuluka ebusuku .
• Ukwehlisa isisindo okungenakucatshangwa .
• Ukudla akunambitheki .

Okubalulekile: Uma uqhubeka nokuba nesinye noma ngaphezulu salezi zimpawu, kubaluleke kakhulu ukubona udokotela ukuze akunike iseluleko. Ungakhathazeki, akuzona zonke lezi zimpawu ezibangelwa umdlavuza. Zingabangelwa nezinye izimo ezivamile. Kodwa-ke, kungcono njalo ukuhlolwa.

Yiziphi izimbangela kanye nezici eziyingozi zokuthuthukisa i-peritoneal mesothelioma?

Isici esiyinhloko sengozi yokuthuthukisa i-mesothelioma ukuchayeka ku-asbestos. I-Asbestos iyinto enemicu esetshenziswa ekwakheni, ekufakeni amapayipi, emsebenzini kagesi, ekufuleleni, kwezinye izimboni zokukhiqiza kanye nasembonini yezimoto. Abantu abaningi abathuthukisa i-mesothelioma banemisebenzi ebachaya ku-asbestos.

Kodwa-ke, yize abantu abaningi abathola i-pleural mesothelioma (uhlobo oluthinta amaphaphu) benomlando wokuchayeka ku-asbestos, ukuxhumana phakathi kwe-peritoneal mesothelioma (uhlobo oluthinta ulwelwesi lwesisu) ne-asbestos akucaci kahle. Abanye abantu abathola i-peritoneal mesothelioma kungenzeka ukuthi abazange babe nomlando wokuchayeka ku-asbestos emsebenzini. Lokhu kusacwaningwa.

Nazi ezinye izinto ezingabangela ingozi yokuthola i-'Peritoneal Mesothelioma':

• Ukuchayeka ku-asbestos : Uma imicu ye-asbestos ingena endaweni esikuyo, iba nomoya. Uma ingena, ingangena emzimbeni wethu ngemilomo namakhala ethu, iye odongeni lwesisu (i-peritoneum), bese ihlala lapho. Uma ingaphakathi, yonakalisa amangqamuzana e-mesothelial, okubangela ukuba ahlukane ngendlela engavamile. Yilokhu okubangela ukwakheka kwezimila ezinomdlavuza. Cabanga nje, i-mesothelioma yenzeka eminyakeni eminingi ngemva kokuchayeka ku-asbestos, ngezinye izikhathi ifinyelela eminyakeni engama-40.
• Ukuvezwa kwe-Silica kanye ne-Erionite : Lawa ngamaminerali avamile atholakala emhlabeni. Ukuvezwa kuwo kutholakale nokuthi kuhlobene ne-Pleural kanye ne-Peritoneal Mesothelioma.
• Ukuguqulwa kwezakhi zofuzo : Ezinye izifundo zikhombisile ukuthi uma ubhekene ne-asbestos futhi unezinguquko ezithile zezakhi zofuzo, ingozi yakho yokuthola i-peritoneal mesothelioma inganda. Enye yezinguquko ezivame kakhulu ukushintsha kwezakhi zofuzo ezibizwa nge-BAP1. Le zakhi zofuzo, ezibizwa nge-BAP1, zinomthwalo wokuvimbela ukukhula komdlavuza.
• Ukuchayeka emisebeni : Ukuthola ukwelashwa ngemisebe yomdlavuza wesisu wangaphambilini kucatshangwa ukuthi kwandisa ingozi yokuthola i-peritoneal mesothelioma. Kodwa-ke, kudingeka ucwaningo olwengeziwe ukuze kuqondwe ngokugcwele ubudlelwano phakathi kwemisebe nengozi ye-mesothelioma.

Uthola kanjani ukuthi une-Peritoneal Mesothelioma?

Ukuxilonga i-Peritoneal Mesothelioma kungaba yinselele, njengoba sishilo ngaphambili, ngoba ngokuvamile ayibonisi izimpawu ezigabeni zokuqala. Uma izimpawu zivela, zingafana nezinye izifo ezivamile zomgudu wokugaya ukudla noma ezinye izinhlobo zomdlavuza. Ngakho-ke, lezi zimo ezivamile zivame ukungatholakali lapho kwenziwa ukuxilongwa.

Ukuhlolwa okulandelayo kungenziwa ukuze kutholakale lesi sifo:

• I-CT scan : Udokotela wakho angase akucele ukuthi kwenziwe i-CT scan ukuze akhiphe ezinye izimo ezibangela izimpawu ezifana ne-peritoneal mesothelioma, njengomdlavuza wesibeletho noma i-adenocarcinoma. Lokhu kungase kuhilele ukufaka idayi ephephile (i-contrast) egazini lakho ukuze wenze izinto ezifana namaqhubu esiswini sakho zibonakale kakhulu ku-scan.
• Ukuskena kwe-MRI (I-Magnetic Resonance Imaging (MRI)) : I-MRI inganikeza izinga elifanayo lemininingwane njenge-CT scan. I-MRI ingenziwa uma ungakwazi ukwenza i-CT scan ene-contrast.
• Ukuhlolwa kwegaziUdokotela wakho angase ahlole izimpawu ezithile egazini lakho, njengeprotheni ethile, okungaba uphawu lwesimila somdlavuza.
• Ukuhlaziywa koketshezi lwesisu : Kule nqubo, udokotela wakho ufaka inaliti emgodini wakho wesisu bese ethatha isampula yoketshezi ukuze ahlole izimpawu ze-mesothelioma. Kodwa-ke, lokhu kuhlolwa kunomkhawulo owodwa. Kuhlinzeka ngolwazi kuphela mayelana noketshezi olusesiswini sakho, hhayi izicubu ezisesiswini sakho. Isigaba somdlavuza sincike ekutheni umdlavuza ususakazeke kangakanani ezicutshini.
• I-CT-guided core needle biopsy noma i-laparoscopic biopsy : Okuwukuphela kwendlela yokuqinisekisa ukuxilongwa kwe-peritoneal mesothelioma ukwenza i-biopsy. Kulokhu, udokotela wakho usebenzisa i-imaging (njengokuskena) ukuthola indawo eqondile yeqhubu lakho. Bese, besebenzisa amathuluzi okuhlinza, bathatha isampula yezicubu bese beyithumela elebhu ukuze ihlolwe.

Yiziphi izigaba ze-peritoneal mesothelioma?

Izigaba zomdlavuza zibonisa ukuthi lesi sifo sesiqhubekele phambili futhi sisakazeke kangakanani. Uhlelo lokulinganisa olusetshenziswa kakhulu lwe-peritoneal mesothelioma yi-PCI (Peritoneal Cancer Index).

Ngendlela ethi `PCI`, isisu sakho sihlukaniswe izingxenye ezingu-13, futhi ingxenye ngayinye inikezwa amaphuzu kusukela ku-0 kuya ku-3.

• U-0 usho ukuthi akukho mdlavuza kuleyo ndawo.
• 3 kusho ukuthi ingxenye imbozwe ngokuphelele umdlavuza.

Udokotela ube esehlanganisa amaphuzu esigaba ngasinye bese enquma isigaba somdlavuza. Isigaba 1 yisigaba esingathuthuki kakhulu. Isigaba 4 yisigaba esithuthuke kakhulu.

• Isigaba 1: Isilinganiso se-PCI sisuka ku-1 kuya ku-10.
• Isigaba 2: Isilinganiso se-PCI sisuka ku-11 kuya ku-20.
• Isigaba 3: Isilinganiso se-PCI sisuka ku-21 kuya ku-30.
• Isigaba 4: Amaphuzu e-PCI angu-31 kuya ku-39.

Yiziphi izindlela zokwelapha i-peritoneal mesothelioma?

Izinketho zokwelapha zincike esigabeni somdlavuza wakho, impilo yakho iyonke, kanye nezinye izici eziningana.

Ukuhlinzwa kokunciphisa i-Cytore kanye nokwelashwa kwe-HIPEC (ukunciphisa i-Cytore nge-HIPEC)

Ukwelashwa okuvame ukusetshenziswa kakhulu kwe-peritoneal mesothelioma yinhlanganisela yokuhlinzwa kwe-cytoreduction kanye ne-hyperthermic intraperitoneal chemotherapy (HIPEC) .

• Ukunciphisa Umdlavuza : Lokhu kuyindlela yokuhlinzwa esusa amangqamuzana omdlavuza ngaphakathi esiswini sakho. Odokotela bazosusa noma yiziphi izigaxa ezibonakalayo. Bangase futhi basuse izingxenye ze-peritoneum nezitho zesisu lapho umdlavuza ususakazeke khona.
• I-hyperthermic intraperitoneal chemotherapy (`HIPEC`): Lolu uhlobo olukhethekile lwe-chemotherapy olunikezwa ngemva kokuhlinzwa kwe-cytoreduction. Imithi ye-chemotherapy ishiswa ibe yizinga lokushisa eliphephile futhi inikezwe ngqo emgodini wesisu. Lokhu kushisa kwenza imithi ibe namandla kakhulu kune-chemotherapy ejwayelekile. I-HIPEC ibulala noma yimaphi amangqamuzana amancane omdlavuza okungenzeka ukuthi ashiywe ngemuva angasuswanga ngesikhathi sokuhlinzwa. I-HIPEC futhi inemiphumela emibi embalwa kune-chemotherapy ejwayelekile.

Ukuhlinzwa kwe-Cytoreduction kanye ne-HIPEC kuyizinqubo ezinkulu neziyinkimbinkimbi ezingathatha amahora angaphezu kwe-10. Kodwa-ke, ucwaningo lukhombisile ukuthi le ndlela yokwelapha isiza abantu abane-Peritoneal Mesothelioma ukuba baphile isikhathi eside.

Ukwelashwa ngamakhemikhali

Uma ungakwazi ukwenza ukuhlinzwa kwe-cytoreduction kanye ne-HIPEC, ungase unikezwe i-systemic chemotherapy. Imithi ye-systemic chemotherapy ihamba egazini lakho futhi ibulale amangqamuzana omdlavuza emzimbeni wakho wonke. Izinhlobo ezahlukene zemithi ye-chemotherapy zinganikezwa ndawonye.

Ukwelashwa nge-immunotherapy

Imithi yokwelapha nge-immunotherapy ebizwa ngokuthi "i-immune checkpoint inhibitors" isiza isimiso sakho somzimba sokuzivikela ukuthola nokubhubhisa amangqamuzana omdlavuza. Le mithi ivame ukusetshenziswa ukwelapha "i-pleural mesothelioma." Udokotela wakho angase ayinike nemithi yokwelapha "i-peritoneal mesothelioma."

Ukwelashwa okuqondiwe

Abanye abantu abane-peritoneal mesothelioma bangase babe nezinguquko zofuzo emaseli abo omdlavuza. Lokhu kungelashwa ngezindlela zokwelapha eziqondiwe. Izindlela zokwelapha eziqondiwe zisebenza ngokubhekisa ngqo izinguquko zofuzo ezibangela ukuba amaseli aphilile abe amaseli omdlavuza. Lezi zindlela zokwelapha zingatholakala ngodokotela wakho we-oncologist olaphayo, noma ngezifundo ezibizwa ngokuthi izivivinyo zemitholampilo ezihlola ukuphepha nokusebenza kahle kwezindlela zokwelapha ezintsha. Kubalulekile ukuba kwenziwe ukuhlolwa kofuzo (ukuhlolwa kofuzo) ezicutshini zomdlavuza ezithathwe ku-biopsy yakho ukuze kubonwe ukuthi umdlavuza wakho unalezi zinguquko zofuzo eziqondiwe.

Ukunakekelwa kobuhlungu

Ukuze akusize uphathe izimpawu zomdlavuza kanye nemiphumela emibi yokwelashwa, udokotela wakho angase akuncome ukunakekelwa kokunciphisa ubuhlungu. Uma ungaphilile ngokwanele ukuba uhlinzwe, noma uma umdlavuza wakho usesigabeni esithuthukile, ukunakekelwa kokunciphisa ubuhlungu kungaba yindlela engcono kakhulu kuwe. Ukunakekelwa kokunciphisa ubuhlungu kungase kuhlanganise nezinqubo ezifana ne-paracentesis, esusa uketshezi esiswini. Lokhu kungasiza ekunciphiseni ukungakhululeki nobuhlungu obubangelwa ukunqwabelana koketshezi.

Ungayinciphisa kanjani ingozi yokuthola lesi sifo?

Ukuphela kwendlela yokunciphisa ingozi yokuthola i-Peritoneal Mesothelioma ukuUkugwema ukuchayeka ku-asbestos. Ngawo-1970, izinhlangano ezifana ne-Environmental Protection Agency (EPA) e-United States zamisa imithethonqubo mayelana nokusetshenziswa kwe-asbestos. Kodwa-ke, izakhiwo ezakhiwe ngaphambi kokuba leyo mithethonqubo iqale ukusebenza zingase zibe ne-asbestos. Uma imicu ye-asbestos iphazamiseka, ingaba nomoya futhi ibe yingozi kakhulu.

Ukuze unciphise ingozi yakho, gwema ukulungisa noma ukwenza izinguquko ezingakubangela ukuthi uhlaselwe yi-asbestos. Kunalokho, qasha uchwepheshe, njengochwepheshe wokususa i-asbestos, ukuze aphathe lowo msebenzi.

Uhlobo luni lwethemba ongaba nalo uma uphila ne-Peritoneal Mesothelioma?

I-peritoneal mesothelioma akuyona isifo esingelapheki ngokuphelele. Kodwa-ke, ukwelashwa kungandisa impilo yakho futhi kubangele ngisho nezikhathi zokululama. Ukusebenza nethimba lodokotela be-oncologists abangochwepheshe ekwelapheni i-mesothelioma kungathuthukisa imiphumela yakho yokwelashwa. Ukusebenza nochwepheshe bokunakekelwa kwe-palliative nakho kungathuthukisa ikhwalithi yokuphila kwakho njengoba uphila nalokhu kutholakala komdlavuza.

Yiziphi izici ezithinta ukubikezela kwakho?

Ukubikezela kwesifo sakho kuncike ezintweni eziningana:

• Uhlobo lweseli : Kunezinhlobo ezintathu zamaseli ezingakhula zibe izimila. Uhlobo oluvame kakhulu, olubizwa ngamaseli e-epithelioid, lunesimo esingcono kunezinye izinhlobo ezimbili zamaseli, amaseli e-sarcomatoid namaseli e-biphasic.
• Isigaba se-mesothelioma yakho : Uma lesi sifo sitholakala futhi selashwa kusenesikhathi, cishe uzothola imiphumela engcono.
• Ubulili bakho : Uma kukhulunywa nge-Peritoneal Mesothelioma, abesifazane baboniswe ukuthi banesimo esingcono kunabesilisa.
• Ukususwa ngokuphelele kwezigaxa : Uma udokotela wakho ekwazi ukususa zonke izigaxa ngokuphelele, isibikezelo sakho singase sibe ngcono.
• I-Thrombocytosis : Uma une-thrombocytosis, isibikezelo sakho singase sibe sibi. I-Thrombocytosis yisimo lapho unama-platelet amaningi egazini lakho. Ama-platelet amaseli asiza ukujiya kwegazi lakho.

Ungaphila isikhathi esingakanani ne-Peritoneal Mesothelioma?

Abantu abatholakale benesifo i-Peritoneal Mesothelioma ngokuvamile bangaphila cishe izinyanga eziyi-6 kuya kweziyi-12 ngaphandle kokwelashwa. Kodwa-ke, ngokwelashwa, izinga lokusinda lingcono kakhulu. Iziguli ze-Peritoneal Mesothelioma ezihlinzwa ngokuhlinzwa kanye ne-HIPEC ziphila iminyaka emibili kuya kweyisithupha ngemva kokuxilongwa. Abanye abantu baphila isikhathi eside nakakhulu.

Kodwa-ke, ukubikezela kwakho kuncike ezintweni eziningana. Udokotela wakho ungumuntu ongcono kakhulu ukuqonda ukuthi yiziphi izici ezizothinta ukubikezela kwakho, ngokusekelwe ezindleleni zakho zokwelapha.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela wakho?

Uma utholakale une-peritoneal mesothelioma, khuluma nodokotela wakho ngalezi zinto:

• "Obani odokotela abangochwepheshe abazongelapha?"
• "Kungcono yini kimi ukuthola usizo eqenjini lokunakekelwa kweziguli ezidambisa ubuhlungu?"
• "Luhlobo luni lwe-mesothelioma enginalo?"
• "Umdlavuza wami ususakazeke kangakanani? (Okungukuthi, isigaba sini?)"
• "Ngiziphi izindlela zokwelapha enginazo?"
• "Ingabe kukhona 'izivivinyo zemitholampilo' (izifundo ezihlola ukwelashwa okusha) engingahlanganyela kuzo?"
• "Yimiphi imiphumela engingayilindela ekwelashweni okutholakalayo?"
• "Yimiphi imiphumela emibi yokwelashwa? Ingalawulwa kanjani?"

Okokugcina, izinto okufanele uzikhumbule...

I-Peritoneal Mesothelioma ingumdlavuza ongavamile kodwa onzima. Ukuchayeka ku-asbestos kungaba yimbangela enkulu. Uma unezinye zezimpawu esixoxe ngazo, kubalulekile ukufuna usizo lwezokwelapha ngokushesha.

Kuvamile ukuzizwa wesaba futhi ukhathazekile uma ufunda ngesifo esinjengalesi. Kodwa khumbula, awuwedwa. Unodokotela, umndeni, nabangani abazokusiza. Into ebaluleke kakhulu ukuthola ulwazi olufanele, ukhulume ngokukhululekile nodokotela bakho, futhi uthole ukwelashwa okungcono kakhulu kuwe. Ukwelashwa kungasiza ngempela ekwandiseni impilo yakho futhi kuthuthukise ikhwalithi yokuphila kwakho.

I- Mesothelioma yesisu, umdlavuza, umdlavuza wesisu, i-asbestos, i-peritoneum, i-mesothelioma, i-HIPEC, izimpawu, ukwelashwa