Udliwano-ndlebe noDkt Edward M. Wolin, MD
Ukufa kukaSteve Jobs kwimizimba engaqhelekanga yomdlavuza we-pancreatic ebizwa ngokuba ngumdlavuza we-pancreatic neuroendocrine wakhulisa umdla kumdlavuza we-pancreatic. Ngolu dliwano-ndlebe, uDkt. Edward Wolin, ingcali yomhlaza we-neuroendocrine ehambisana neCedars Sinai Centre Centre, uxoxa ngomdlavuza we-pancreatic neuroendocrine kunye nendlela izigulane zilwa ngayo nesifo. UDkt. Wolin ungumqondisi-ntsebenziswano weCarcinoid ne-Neuroendocrine Programme ye-Tumor Programme kwiCedars-iSinayi Medical Center kwaye enye yeyona ndlela iphakamileyo yesizwe ekhethekileyo kwi-pancreatic neuroendocrine yomhlaza.
Akazange amphathe uSteve Jobs.
Ngaba unokuchaza ukuba yintoni umdlavuza we-pancreatic neuroendocrine?
I-Cancer i-Pancreatic neuroendocrine ikhula ngokukhawuleza ihlamba eqalayo eqala kwiiseli ze-endocrine (ii-hormone-producing cells) ze-pancreas, ezaziwa ngokuba njengezisele ze-islet. Nangona ezi zicubu zinokuvelisa i-hormone ezahlukahlukeneyo, ezininzi azivelisi amahomoni. Bahlala besasazeka kwindawo yesisu kunye nesibindi ngexesha lokuxilongwa. Nangona kunjalo, izinga lokusinda lihlala liphezulu kakhulu kunelo hlobo oluqhelekileyo lomhlaza we- pancreatic (adenocarcinoma) , nangona i-metastases ikhona.
Kufunyanwa njani? Ngaba zikhona na iimpawu?
Xa ezi khansa zivelisa ama-hormone, iimpawu zakuqala zinokuba nzima kwaye zikhokelela ekufumaneni i-diagnostic. Ngokomzekelo, i-tumor-producing-tumor ibangela iimpawu zentshukela ephantsi kakhulu yegazi , okanye i-gastrin-producing-tumor idala izilonda ezinzulu zesisu kunye ne-duodenal, ezikhokelela ekuxilongwa yi-CT scan, i-MRI scan, okanye i-endoscopic ultrasound ye-pancreas.
Ukuba ukuveliswa kwehomoni kungabangeli iimpawu zeklinikhi, izibilini ziza kukhula zize zibe zikhulu kwaye zisasaze esibindi nasinye isayithi ngexesha lokufumana kwi-CT okanye i-MRI. Kule meko, iimpawu zokuqala zinokuba ziintlungu zesisu, i-jaundice, ukulahleka kwesisindo, i-malaise, ukubetha kwesisu, ukuhlanza, ukugqithisa kwesikhumba, ubuthathaka kunye nohudo.
Ngubani osemngciphekweni? Ngaba umlinganiselo, umntu ophilileyo unokukhathazeka nge-pancreatic neuroendocrine umdlavuza?
Ezi ziyizidalwa ezinqabileyo kakhulu, kunye nesiganeko seemeko ezi-3 kwizigidi zabantu baseMerika, kubalwe i-3% ye-cancer ye-pancreatic. Ngoko ke, umyinge, umntu onempilo akafanelekanga kakhulu malunga nokuphucula umdlavuza we-pancreatic neuroendocrine. Iminye iminye imindeni apho umdlavuza we-pancreatic neuroendocrine uqhelekileyo, ngokuqhelekileyo uhlala kunye neengxaki zokuzilahla. Olu khetho lwentsapho luyaziwa ngokuba yi-endocrine neoplasia uhlobo 1 (MEN-1).
Ngaba siyazi ukuba kubangelwa ntoni?
Siyazi ukuba ukuguqulwa komzimba - i-gene menin idala i-MEN-1, kwaye siyazi ukuba ezinye iinguqu ezingaqhelekanga zinguqu zengqondo ziqheleke kakhulu kumdlavuza we-pancreatic neuroendocrine, kodwa ngokuqhelekileyo isizathu asiyazi.
Ngaba zikhona iindlela zokunciphisa umngcipheko okanye ukukhusela umdlavuza we-neuroendocrine?
Akukho ndlela eyaziwayo yokunciphisa umngcipheko okanye ukukhusela umdlavuza we-neuroendocrine.
Ziziphi iindlela zokwelapha ezikhoyo?
Ngenxa yokungabi nalutho kwezi zihlamba kubantu bonke, kwaye uhlobo oluthile olujongene nolondolozo olufunekayo, izigulane zikhuthazwa kakhulu ukuba zifune ukubonisana kwiziko elithile le-neuroendocrine. Kwimiziko enjalo, kubambisana ngokusondeleyo kunye ne- oncology yezokwelapha , i-endocrinology, i-gastroenterology, i-pathology, i-hepatobiliary chirurgical, i-oncology yokuphazamiseka, i-radiology yangenelelo, i-radiology yokuxilonga, kunye neyeza zenyukliya ukwenzela ukwandiswa komntu ngamnye.
Unyango lubandakanya ukuthengiswa kokugqithisa kwezicathulo eziphambili kunye ne-metastase, ukuxhoma kweemetastases kunye nama-microwave, ukuphatha iimvumi nge-radiation intrahepatic (i-radioembolization) kunye ne-intrahepatic chemotherapy (i-chemoembolization), ukuvimba ukukhula kwe-tumor kunye ne-biologicalic agents (i-somatostatin analogs, i-m-TOR inhibitors, i-tyrosine kinase inhibitors , i-radionuclide ithagethi eyaziwa njenge-PRRT, unyango lwe-immune, kunye neziyobisi ezinxamnye ne-angiogenic), kunye nokusetyenziswa kwe- chemotherapy yomlomo onobungozi obuphantsi.
Ukuze ufunde kabanzi malunga noDkt Edward Wolin kunye nokusebenza kwakhe kwiCedars Sinai Centre Centre, nceda uvakashele iwebhusayithi yeCedars yeSinayi.