I-neuroblastoma

I-Neuroblastoma wuhlobo lomdlavuza oluvela kumaseli ezinzwa angavuthiwe agcwele wonke umzimba.

Izindlala ze-adrenal, ezinesiqalo esiqhathanisekayo namangqamuzana ezinzwa futhi ahlala phezu kwezinso, yilapho ngokuvamile i-neuroblastoma iqala khona. I-Neuroblastoma ingakhula nakwezinye izingxenye zesisu, njengesifuba, intamo, naseduze nomgogodla, lapho kukhona khona amaqoqo ezinzwa.

I-Neuroblastoma ivame kakhulu ezinganeni ezineminyaka engu-5 nangaphansi, kuyilapho ingase futhi iphathe izingane ezindala. Ezinye izinhlobo ze-neuroblastoma zizozihambela zodwa, kanti ezinye zizodinga ukwelashwa okuningi. Izinketho zokwelapha ze-neuroblastoma zengane yakho zizonqunywa izinto ezimbalwa.

Izimpawu nezimpawu ze-neuroblastoma

Izimpawu nezimpawu ze-neuroblastoma ziyahlukahluka kuye ngokuthi iyiphi ingxenye yomzimba ethintekile.

I-Neuroblastoma esiswini - ifomu elivame kakhulu - lingabangela izimpawu nezimpawu ezifana nalezi:

• Ubuhlungu besisu
• Isisindo esingaphansi kwesikhumba esingathambile uma sithintwa
• Ukushintsha kwemikhuba yamathumbu, njengokuhuda noma ukuqunjelwa

I-Neuroblastoma esifubeni kungabangela izimpawu nezimpawu ezifana nalezi:

• Ukushisa
• ubuhlungu besifuba
• Izinguquko zamehlo, okuhlanganisa amajwabu amehlo ashona phansi kanye nosayizi womfundi ongalingani

Ezinye izimpawu nezimpawu ezingase zibonise i-neuroblastoma zihlanganisa:

• Izigaxa zezicubu ngaphansi kwesikhumba
• Amabhola wamehlo abonakala ephuma ezisekelweni (proptosis)
• Imibuthano emnyama, efana nemihuzuko, ezungeze amehlo
• Ukuhlungu obusemhlane
• Fever
• Ukulahlekelwa kwesisindo esingachaziwe
• Ubuhlungu be-Bone

Izinkinga ze-neuroblastoma

Ngokuvamile, umdlavuza uqala ngokuguqulwa kofuzo okuvumela amangqamuzana avamile, anempilo ukuthi aqhubeke ekhula naphezu kokuthi amangqamuzana avamile aphendula izimpawu zokuma. Amangqamuzana omdlavuza ayanda futhi azalana ngokungalawuleki. Amaseli ahlukene aqoqayo akha inqwaba (isisu).

I-Neuroblastoma iqala ngama-neuroblasts, okungamaseli ezinzwa angavuthiwe akhiqizwa umbungu njengengxenye yokukhula kwayo.

Ama-neuroblasts avuthwa abe amaseli ezinzwa kanye nemicu, kanye namaseli akha izindlala ze-adrenal, njengoba umbungu ukhula. Nakuba inani elincane lama-neuroblasts angavuthiwe lingatholwa ezinganeni, ama-neuroblasts amaningi akhula ngokuzalwa. Lawa ma-neuroblasts ayavuthwa noma ayafa ezikhathini eziningi. Abanye, ngakolunye uhlangothi, baba nesimila esibizwa ngokuthi i-neuroblastoma. 

Imbangela yokuguqulwa kofuzo kokuqala okuholela ku-neuroblastoma ayaziwa.

Izimbangela

Izingane ezinomlando womndeni we-neuroblastoma zingase zibe maningi amathuba okuba zithole lesi sifo. Nokho, i-neuroblastoma yomndeni kucatshangwa ukuthi ihlanganisa inani elincane kakhulu lamacala e-neuroblastoma. Ezimweni eziningi ze-neuroblastoma, imbangela ayibonakali.

Izinkinga

Izinkinga ze-neuroblastoma zingabandakanya:

• Ukusabalala komdlavuza (i-metastasis). I-Neuroblastoma ingase isabalale (i-metastasize) kwezinye izingxenye zomzimba, njengama-lymph nodes, umnkantsha, isibindi, isikhumba namathambo.
• Ukucindezelwa komgogodla. Amathumba angase akhule futhi acindezele intambo yomgogodla, okubangela ukucindezelwa komgogodla. Ukucindezelwa komgogodla kungase kubangele ubuhlungu nokukhubazeka.
• Izimpawu nezimpawu ezibangelwa ukukhishwa kwesimila. Amaseli e-Neuroblastoma angase akhiphe amakhemikhali athile acasula ezinye izicubu ezivamile, abangele izimpawu nezimpawu ezibizwa ngokuthi i-paraneoplastic syndromes. I-paraneoplastic syndrome eyodwa eyenzeka ngokungavamile kubantu abane-neuroblastoma ibangela ukunyakaza kwamehlo okusheshayo kanye nobunzima bokusebenzisana. Enye i-syndrome engavamile ibangela ukuvuvukala kwesisu kanye nesifo sohudo.

Ukuxilongwa kwe-neuroblastoma

Ukuhlolwa nezinqubo ezisetshenziselwa ukuxilonga i-neuroblastoma zihlanganisa:

• Ukuhlolwa ngokomzimba. Udokotela wengane yakho uhlola umzimba ukuze ahlole noma yiziphi izimpawu nezimpawu. Udokotela uzokubuza imibuzo mayelana nemikhuba nokuziphatha kwengane yakho.
• Ukuhlolwa komchamo negazi. Lokhu kungase kubonise imbangela yanoma yiziphi izimpawu nezimpawu ingane yakho enazo. Ukuhlolwa komchamo kungase kusetshenziselwe ukuhlola amazinga aphezulu amakhemikhali athile avela kumaseli e-neuroblastoma akhiqiza ama-catecholamine amaningi.
• Ukuhlola ukuhlolwa. Ukuhlolwa kwesithombe kungase kwembule inqwaba engabonisa isimila. Ukuhlolwa kwesithombe kungase kuhlanganise i-X-ray, i-ultrasound, i-computerized tomography (CT) scan, i-metaiodobenzylguanidine (MIBG) scan kanye imaging resonance magnetic (MRI), phakathi kwabanye.
• Ukukhipha isampula lethishu ukuze lihlolwe. Uma kutholakala inqwaba, udokotela wengane yakho angase afune ukukhipha isampula yethishu ukuze ihlolwe elabhorethri (i-biopsy). Ukuhlolwa okukhethekile kusampula yethishu kungaveza ukuthi yiziphi izinhlobo zamangqamuzana ezibandakanyeka esimila kanye nezici ezithile zofuzo zamangqamuzana omdlavuza. Lolu lwazi lusiza udokotela wengane yakho ukuthi enze uhlelo lokwelapha lomuntu ngamunye.
• Ukukhipha isampula yomnkantsha ukuze kuhlolwe. Ingane yakho ingase futhi ihlolwe i-bone marrow biopsy kanye nezinqubo ze-bone marrow aspiration ukuze ibone ukuthi i-neuroblastoma isisabalele yini emnkantsheni - into eyisiponji ngaphakathi kwamathambo amakhulu lapho amaseli egazi akheka khona. Ukuze kukhishwe umnkantsha ukuze kuhlolwe, kufakwa inaliti ku-hipbone yengane yakho noma emhlane ongezansi ukuze kukhishwe umnkantsha.

Ukwelashwa kwe-neuroblastoma

Ngemva kokuxilongwa kwe-neuroblastoma, udokotela wengane yakho angase acele ukuhlolwa okwengeziwe ukuze ahlole izinga lomdlavuza futhi uma ususabalele kwezinye izitho, inqubo eyaziwa ngokuthi isiteji. Ukwazi isigaba somdlavuza kusiza udokotela ekunqumeni indlela yokwelapha engcono kakhulu.

Ama-X-ray, ama-bone scans, i-CT, i-MRI, ne-MIBG aphakathi kwezinqubo zokuthwebula ezisetshenziswa esiteji somdlavuza.

Izigaba ze-neuroblastoma zimelelwa izinombolo zesiRoman ezisukela ku-0 kuye ku-IV, ezinezigaba eziphansi kakhulu ezibonisa umdlavuza otholakala endaweni. Ngesigaba IV, umdlavuza ususabalele kwezinye izingxenye zomzimba futhi ubizwa ngokuthi ukuqhubeka.

Ukwelashwa kwe-neuroblastoma

Udokotela wengane yakho unquma ngohlelo lokwelapha kuye ngezici eziningana ezithonya ukubikezela kwayo. Iminyaka yengane yakho, isigaba sesifo, uhlobo lwamangqamuzana athintekayo emdlavuzeni, nokuthi ingabe kukhona noma cha noma iyiphi i-chromosome noma izakhi zofuzo ezingavamile zonke izici okufanele zicatshangelwe.

Lolu lwazi lusetshenziswa udokotela wengane yakho ukuze ahlukanise umdlavuza njengengcuphe ephansi, emaphakathi, noma ephezulu. Uhlobo lokwelashwa kwe-neuroblastoma noma inhlanganisela yokwelashwa ingane yakho eyitholayo kunqunywa iqembu lengozi.

Ukuhlinzwa

Odokotela abahlinzayo basebenzisa ama-scalpel namanye amathuluzi okuhlinza ukuze basuse amangqamuzana omdlavuza. Ezinganeni ezine-neuroblastoma enobungozi obuphansi, ukuhlinzwa ukuze kukhishwe isimila kungase kube ukuphela kokwelashwa okudingekayo.

Ukuthi isimila singasuswa ngokuphelele kuncike endaweni yaso kanye nobukhulu baso. Izimila ezinamathele ezithweni ezibalulekile eziseduze - njengamaphaphu noma umgogodla - zingase zibe yingozi kakhulu ukuthi zingasuswa.

Ku-neuroblastoma enobungozi obuphakathi nendawo, odokotela abahlinzayo bangase bazame ukususa isimila esiningi ngangokunokwenzeka. Okunye ukwelashwa, okufana nokwelashwa ngamakhemikhali kanye nemisebe, kungase kusetshenziselwe ukubulala amangqamuzana omdlavuza asele.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha esebenzisa amakhemikhali ukubulala amangqamuzana omdlavuza. I-Chemotherapy uhlobo lokwelapha oluqondise kumaseli akhula ngokushesha emzimbeni, njengamaseli omdlavuza. I-Chemotherapy, nokho, ingadala imiphumela emibi ngokulimaza amangqamuzana anempilo akhula ngokushesha, njengalawo asemiphondweni yezinwele kanye nomgudu wamathumbu.

Ngaphambi kokuhlinzwa, izingane ezine-neuroblastoma eyingozi emaphakathi zivame ukuthola inhlanganisela yemithi yokwelapha ngamakhemikhali ukuze kwandiswe amathuba okukhipha sonke isimila.

Imithi yokwelapha ngamakhemikhali esezingeni eliphezulu inikezwa izingane ezine-neuroblastoma eyingozi kakhulu ukunciphisa isimila futhi zibulale noma yimaphi amangqamuzana omdlavuza asabalele kwenye indawo emzimbeni. I-Chemotherapy ivame ukunikezwa ngaphambi kokuhlinzwa kanye nokufakelwa komnkantsha.

Ukufakelwa komnkantsha wethambo

Izingane ezine-neuroblastoma esengozini enkulu zingase zifanelekele ukufakelwa i-bone marrow stem cell (ukufakelwa kwe-stem cell okuzenzakalelayo).

Ingane yakho izoba nokwelashwa okuhluza futhi kuqoqe ama-stem cells egazini lakhe ngaphambi kokufakelwa komnkantsha wethambo, okwaziwa ngokujwayelekile ngokuthi ukufakelwa kwe-stem cell. Ama-stem cell agcinwa efrijini kuze kube yilapho edingeka. Amaseli omdlavuza asele emzimbeni wengane yakho abe esebulawa ngemithamo emikhulu yokwelapha ngamakhemikhali. Ama-stem cells wengane yakho azobe esefakwa emzimbeni wakhe, lapho ezokwazi khona ukukhiqiza amaseli egazi amasha, anempilo.

I-Immunotherapy isebenzisa izidakamizwa ezisebenza ngokubonisa amasosha omzimba wakho ukusiza ukulwa namaseli omdlavuza. Izingane ezine-neuroblastoma engcuphe kakhulu zingathola immunotherapy izidakamizwa ezishukumisa amasosha omzimba ukubulala amaseli e-neuroblastoma.

Ukwelashwa okusha

Odokotela bafunda uhlobo olusha lokwelapha ngemisebe olungasiza ukulawula i-neuroblastoma enobungozi kakhulu. Ukwelashwa kusebenzisa uhlobo olukhipha imisebe lwekhemikhali i-metaiodobenzylguanidine (MIBG). Uma ijova egazini, i-MIBG iya kumaseli e-neuroblastoma futhi ikhiphe imisebe.

Ukwelashwa kwe-MIBG ngezinye izikhathi kuhlanganiswe ne-chemotherapy noma ukufakelwa komnkantsha. Ngemva kokuthola umjovo we-MIBG enemisebe, ingane yakho kuzodingeka ihlale ekamelweni elikhethekile lasesibhedlela kuze kube yilapho imisebe ishiya umzimba wayo emchamweni. Ukwelashwa kwe-MIBG ngokuvamile kuthatha izinsuku ezimbalwa.