Ukuqonda le Ngqungquthela ye-Skeletal Muscle Cancer
I-Rhabdomyosarcoma isifo somdlavuza osisidlangalazi esingaqhelekanga esenzeka rhoqo kwixesha lokubantwana. Ziziphi iimpawu zala mathambo, njani ufunyaniswa, kwaye ziziphi iindlela zokonyango ezikhoyo?
Rhabdomyosarcoma-Inkcazo
I-Rhabdomyosarcoma luhlobo lwe- sarcoma . I-Sarcomas iimvumi ezivela kwiiseli ze-mesothelial, iiseli zomzimba ezivelisa izicubu ezixhamlayo ezifana ne-bone, cartilage, muscle, ligaments, nezinye izicubu ezinotsholongwane.
Phantse ama-85 ekhulwini lamagciwane, ngokuchaseneyo, i-carcinomas, ephuma kwiiseli ze-epithelial.
Ngokungafani ne-carcinomas apho iiseli ze-epithelial zinento eyaziwa ngokuba "yimbumba engaphantsi," ama-sarcomas ayinaso "isigaba esinqununu" kwaye ngoko iimvavanyo zokuhlola izigulane ezingenakwenzekayo zesifo azisebenzi. (Funda kabanzi malunga neentlobo ezahlukeneyo zomhlaza kunye nendlela ama-sarcomas ahluke ngayo.)
I-Rhabdomyosarcoma ngumhlaza weeseli ezinamahlunu, ngokuthe ngqo imisipha yamathambo (imisipha eqhutywayo) enceda ekuhambeni kwemizimba yethu. Ngokomlando, i-rhabdomyosarcoma iyaziwa ngokuba yi "encinci ye-cell tumor tumor of childhood" esekelwe kumbala iiseli zijika ngedayi ethile esetyenziselwa iifom.
Konke, lo mhlaza ngowona wesithathu uhlobo oluqhelekileyo lwesifo somhlaza esisemgangathweni (kungabandakanywa neengcingo ezinxulumene negazi ezifana ne-leukemia). Kuqheleke ngakumbi kubafana abafana namantombazana kwaye ngokuqhelekileyo kuqhelekileyo kubantwana baseAsia nabaseAfrika kunabantwana abamhlophe.
Iintlobo zeRhabdomyosarcoma
I-Rhabdomyosarcoma idilizwe ibe ngamathathu:
- I-embryonal rhabdomyosarcoma i-akhawunti yee-60 ukuya kuma-70 ekhulwini zala ma-cancer kwaye iyenzeka kaninzi kubantwana phakathi kweminyaka yokuzalwa kunye neminyaka emine ubudala. Olu hlobo luphinde lwaphulwa phantsi zibe ngamacandelwana. Izicubu ezinobomi zingenzeka kwindawo yentloko nentamo, izicubu ze-genitourinary, okanye ezinye iindawo zomzimba.
- I-alveolar rhabdomyosarcoma ngowona wesibini uhlobo oluqhelekileyo kwaye lufumaneka kubantwana phakathi kweminyaka yokuzalwa kunye no-19. Luhlobo oluqhelekileyo lwe-rhabdomyosarcoma ebonwa kulutsha kunye nabantu abadala. Ezi kancinci zifumaneka rhoqo kwimida (iingalo kunye nemilenze), indawo ye-genitourinary, kunye nesifuba, isisu, neengxowa.
- I-Anaplastic (i-pleomorphic) i-rhabdomyosarcoma ayiqhelekanga kwaye ibonakala ngokuqhelekileyo kubantu abadala kunabantwana.
Iindawo zeRhabdomyosarcomas
I-Rhabdomyosarcomas iyakwenzeka naphi na apho emzimbeni apho i-muscular muscle ikhona khona. Iindawo eziqhelekileyo ziquka indawo yentloko nentamo, njengemithwalo ye-orbital (ecaleni kweso), nakweminye imimandla, i-pelvis (izicubu ze-genitourinary), kufuphi neentsholongwane ezithandekayo kwingqondo (parameningeal), kunye nasemacaleni (iingalo nemilenze ).
Iimpawu kunye neempawu zeRhabdomyosarcoma
Iimpawu ze-rhabdomyosarcoma ziyahluka ngokuxhomekeka kwisayithi se-tumor. Iimpawu zommandla womzimba zingaquka:
- Izibilini ze-Genitourinary: Ukuxhwala kwi-pelvis kungabangela igazi kumchamo okanye ngesiswini, ubunzima obuqhekezayo okanye ubufazi, ukukhuseleka, kunye neengxaki zesisu.
- Izicubu zomlomo: Iindumbu ezisondele kwiso zingabangela ukuvuvukala ecaleni kweso kunye nokugqithisa kweso ( proptosis ).
- Izidumbu zeParameningeal: Izidumbu ezikufutshane nomtya womgudu zingabonisa iingxaki ezinxulumene neentsimbi ze-cranial zisondele ezinjengeentlungu zomzimba, iimpawu zesono, impumlo yegazi kunye neentloko.
- Ukugqithisa: Xa i-rhabdomyosarcomas ivela kwiingalo okanye emilenzeni, uphawu oluqhelekileyo luyinto okanye ukuvuvukala okungahambiyo kodwa kwandisa ubungakanani.
Isiganeko
I-Rhabdomyosarcoma ayiqhelekanga kwaye i-akhawunti engama-3.5 ekhulwini lamanomdla e-cancer. Abantwana abangaba ngu-250 bafumana ukuba nomhlaza wesi-United States ngamnye ngonyaka.
Izizathu kunye neengozi
Asizi kakuhle oko kubangela i-rhabdomyosarcoma, kodwa izinto ezinobungozi ezimbalwa ziye zachongwa.
Ezi ziquka:
- Abantwana abane-syndromes ezizaliswayo njenge- neurofibromatosis type 1 (NF1), i-Li-Fraumeni syndrome, i- Costello syndrome , i-pleuropulmonary blastoma, i-cardio-facial cutaneous syndrome, i-Noonan syndrome kunye ne-Beckwith-Wiedermann syndrome
- Ukusetyenziswa kwabazali nge-marijuana okanye i-cocaine
- Ukuzala okuphezulu
Ukuxilongwa
Ukuxilongwa kwe-rhabdomyosarcoma ngokuqhelekileyo kuqala ngembali ecwangcisekileyo kunye nokuhlolwa komzimba. Ngokuxhomekeka kwindawo yokuxhamla, izifundo zokucinga ezifana ne-x-ray, CT scan, i-MRI, i-scan scan, okanye i-PET scan ingenziwa.
Ukuze kuqinisekiswe ukuxilongwa okusolayo, i-biopsy idinga ukuba yenziwe. Izinketho zingabandakanya inaliti ye-needle biopsy (isebenzisa inaliti encinci ukufuna isampuli yeethambo), i-biopsy yenaliti eyintloko okanye i-biopsy evulekile inokwenziwa. Emva kokuba i-pathologist inesampuli yeethambo, i-tumor ibhekiswa phantsi kwe-microscope kunye nezinye iifundo zenziwa rhoqo ukucacisa i-molecular profile of the tumor (efuna ukuguquka kwezinto ezithintekayo ekukhuleni kwesisu).
Ukujonga isifo se-metastatic , i-nodeinel node biopy inokwenziwa. Olu vavanyo lubandakanya ukufaka idayi eluhlaza okwesibhakabhaka kunye ne-traceeractive actor in the tumor bese uthabatha isampuli yee-lymph nodes eziseduze kwi-tumor ekhanyayo okanye epholileyo. I-lymph node dissection epheleleyo ikwafuneka kwakhona ukuba i-nodeph node test is positive for cancer. Izifundo ezongezelelweyo ukujonga iimetastases zingaquka ukukhangela amathambo , i- bone marrow biopsy , kunye / okanye i-CT yesifuba.
UkuShishini kunye nokuQela
"Ubunzima" be-rhabdomyosarcoma buchazwe ngakumbi ngokuqaphela isigaba okanye iqela lomhlaza.
Kukho izigaba ezine ze-rhabdomyosarcoma:
- Isigaba I: I-stage I i-tumors ifunyenwe "kwiindawo ezihle" ezinjenge-orbital (ecaleni kweso), intloko nentamo, kwizitho zokuzala (njengama-testes okanye ama-ovari), ii-tubes ezidibanisa iintso kwi-bladder (ureters ), ityhubhu edibanisa i-bladder ngaphandle (urethra) okanye nge-gallbladder. Ezi zicubu zinakho okanye zingenako ukusasazeka kwii-lymph nodes.
- Isigaba II: Izigulane zeSigaba II azange zisasaze kwi-lymph nodes, azikho ngaphezulu kwe-5 cm (2½ cm intshi), kodwa zifumaneka "kwiindawo ezingenakulungeleka" ezifana naso nasiphi na isayithi ezingakhankanyiweyo phantsi kwesigaba I.
- Isigaba III: I-tumor yayikho kwindawo engafaneleki kwaye ingaba isasazeka kwii-lymph nodes okanye ingaba mkhulu kune-5 cm.
- Isigaba IV: Umhlaza weliphi na isigaba okanye ukubandakanyeka kwe-lymph node eye yasasazeka kwiindawo ezikude.
Kukho amaqela amane e-rhabdomyosarcomas:
- Iqela I: Iqela le-1 liquka izibilini ezingasuswa ngokupheleleyo kunye nokuhlinzwa kwaye azange zisasaze kwi-lymph nodes.
- Iqela lesi-2: Iimvumba zeqela 2 zingasuswa kunye nokuhlinzwa kodwa kusekho iiseli zomhlaza ezikhoyo kwiimida eziselunxwemeni (kumgca wesisu esisuswe), okanye umhlaza usasazeke kwi-lymph nodes.
- Iqela le-3: Iimvumba zeqela le-3 yizo ezingasasazekayo, kodwa azikwazi ukususwa kunye nokuhlinzwa ngenxa yesizathu esithile (ngokuqhelekileyo ngenxa yendawo yokuhlamba).
- Iqela le-4: Iimvumi zeqela le-4 zibandakanya abo basasaze kwiindawo ezikude zomzimba.
Ngokusekelwe kumanqanaba angentla kunye namaqela, i-rhabdomyosarcomas ihlelwe yengozi:
- Ubuncipheko obuncipheko kubantwana bentrakhyosarcoma
- Ubunzima be-childhood rhabdomyosarcoma
- Ubuncipheko obuncipheko kubantwana be-rhabdomyosarcoma
Metastases
Xa ezi ntsholongwane zisasazeka, iindawo eziqhelekileyo zeemastastases ziyimiphunga, umongo wethambo kunye namathambo.
Unyango lweRhabdomyosarcoma
Izinyathelo ezintle zokonyango kwi-rhabdomyosarcoma kuxhomekeke kwisigaba sesifo, indawo yesifo, kunye nezinye izinto ezininzi. Khetha ziquka:
- Ugqirha: Ugqirha luyintloko yonyango kwaye unikezela ithuba elihle lokulawula ixesha elide le-tumor. Uhlobo lotyando luya kuxhomekeka kwindawo yesikhumba.
- Uphulo lwe-radiation: Unyango lwamayeza lungasetyenziselwa ukunciphisa i-tumor engasebenziyo okanye ukuphatha imida ye-tumor emva kokuhlinzwa ukuba isuse nayiphi na iseli yomhlaza .
- I-Chemotherapy: I- Rhabdomyosarcomas ithambekele ekuphenduleni kakuhle kwi- chemotherapy , kunye ne-80 ekhulwini yalezi zicubu ziyancipha ngobuninzi ngonyango.
- Uvavanyo lwezonyango: Ezinye iindlela zonyango ezifana ne- immunotherapy izidakamizwa ngoku zihlolwe kwizilingo zonyango.
Ukujamelana
Ekubeni amaninzi ala ma-cancer ayenzeka ebuntwaneni, bobabini abazali kunye nomntwana kufuneka babhekane nale ngxaki engalindelekanga neyoyikisayo.
Kubantwana abadala kunye nentsha ephila nomdlavuza, kukho inkxaso engaphezulu kunexesha elidlulileyo. Ukususela kwimimandla yoxhasi lwe-intanethi ukuya kwiindawo zokuhlaselwa ngumhlaza ezenzelwe ngokukhethekileyo abantwana kunye nentsha, ukufaka inkampu kumntwana okanye kwintsapho, kukho iindlela ezininzi ezikhoyo. Ngokungafani nesikolo esikolweni apho umntwana angaziva ekhethekileyo, kwaye kungekhona ngendlela efanelekileyo, la maqela afaka abanye abantwana kunye nentsha okanye abantu abadala abaselula ngokufanayo nento engayi kubakho mntwana.
Kubazali, zizinto ezimbalwa ezinzima njengokuba zijongene nomhlaza kumntwana wakho. Abazali abaninzi abayithandi nto ngaphandle kokutshintsha indawo kunye nomntwana wabo. Ukunyamekela kwakho akubalulekanga.
Kukho inani lomntu kunye noluntu oluku-intanethi (iifom e-intanethi kunye namaqela e-Facebook) ngokukodwa eyenzelwe abazali bezingane ezijongene nomhlaza wengane kunye ne-rhabdomyosarcoma ngokukodwa. La maqela enkxaso angaba ngumgca wokuphila xa uqaphela ukuba abahlobo bentsapho abanakho indlela yokuqonda oko uhambayo. Ukudibana nabanye abazali ngale ndlela kunokuboleka inkxaso ngenkathi kunika indawo abazali abangabelana ngayo ngokutsha zophando zophando. Ngamanye amaxesha umangaliswa ukuba ngaba abazali bahlala bazi njani iindlela zonyango zakutshanje nangaphambi kokuba abaninzi be-oncologists.
Musa ukunciphisa indima yakho njengommeli. Intsimi ye-oncology inkulu kwaye ikhula imihla ngemihla. Kwaye akukho mntu ukhuthazwa njengomzali womntwana ophila nomhlaza. Funda ezinye iindlela zokuphanda umdlavuza kwi-intanethi uze uthathe isikhashana ukuba ufunde malunga nokwakho (okanye umntwana wakho) ukukhuthaza ukunakekelwa ngumhlaza wakho .
Prognosis
Ukugxekwa kwe-rhabdomyosarcoma kuyahluka kakhulu kuxhomekeke kwizinto ezinjengehlobo le-tumor, ubudala bomntu ofunyenweyo, indawo yecala, kunye nonyango olutholileyo. Isilinganiso seminyaka emi-5 yokusinda singama-70 ekhulwini, kunye neengcambu ezinobungozi obuncinane obunomlinganiselo wokusinda kwama-90 ekhulwini. Ngokubanzi, izinga lokusinda liye laphucuka kakhulu kwiminyaka emininzi edlulileyo.
ILizwi
I-Rhabdomyosarcoma ngumhlaza wengane owenzeka kwiimisipha ze-squelette nokuba ziphi izihlunu ezisemzimbeni. Iimpawu ziyahlukahluka kuxhomekeke kwisayithi esithile se-tumor kunye neendlela ezifanelekileyo zokufumanisa i-tumor. Ugqirha luyintloko yokunyanga, kwaye ukuba i-tumor ingasuswa kunye nokuhlinzwa kukho umbono omuhle wokulawula ixesha elide lesi sifo. Ezinye iindlela zokwelapha ziquka unyango lwe-radiation, i-chemotherapy, kunye ne-immunotherapy.
Nangona ukususelwa kwintsholongwane yomntwana isanda kuphucuka, siyazi ukuba abaninzi abantwana banenkxalabo yeziphumo zonyango. Ukulandelelana kwexesha elide kunye nodokotela oqhelekileyo kwimiphumo emibi yonyango kufuneka kubalulekile ukunciphisa impembelelo yale miqathango.
Kubazali kunye nabantwana abafunyaniswayo, ukubandakanyeka kwimeko yoluntu yabantwana kunye nabazali abajongene ne-rhabdomyosarcoma ayilona xabiso, kwaye kwixesha lexesha kukho iindawo ezininzi ezikhoyo.
> Imithombo:
> Dasgupta, R., Fuchs, J., noD. D. Rodeberg. Rhabdomyosarcoma. Iinkomfa kwiiNtsholongwane zonyango . 2016. 25 (5): 276-283.
> INational Cancer Institute. Ukwelashwa kwe-Childhood Rhabdomyosarcoma Treatment (PDQ) -Ingcali yeNgcali yezobugcisa. Ukuhlaziywa 12/01/17. https://www.cancer.gov/types/soft-tissue-sarcoma/hp/rhabdomyosarcoma-treatment-pdq