Isifo seCarcinoid

I-Carcinoid syndrome yiqembu lezimpawu ezihambisana nezicubu ze-carcinoid. Lezi yizicubu zamathumbu amancane, i-colon, isithasiselo kanye namashubhu we-bronchial emaphashini.

I-Carcinoid syndrome iyisibonelo sezimpawu kwesinye isikhathi esibonakala kubantu abanezicubu ze-carcinoid. Lezi zicubu azivamile, futhi zivame ukukhula kancane. Izicubu eziningi ze-carcinoid zitholakala emgodleni wamathumbu nasemaphashini.

I-Carcinoid syndrome ivela kubantu abambalwa kakhulu abanezicubu ze-carcinoid, ngemuva kokuthi isimila sesisakaze esibindini noma emaphashini.

Lezi zicubu zikhipha i-hormone serotonin eningi kakhulu, kanye namanye amakhemikhali amaningana. Amahomoni enza ukuthi imithambo yegazi ivuleke (ivuleke). Lokhu kubangela i-carcinoid syndrome.

I-carcinoid syndrome yakhiwa izimpawu ezine eziyinhloko ezibandakanya:

• Ukuqhuma (ubuso, intamo, noma isifuba esingenhla), njengemithambo yegazi evulekile ebonakala esikhumbeni (telangiectasias)
• Kunzima ukuphefumula, njengokuphefumula
• Uhudo
• Izinkinga zenhliziyo, njengama-valve wenhliziyo avuzayo, ukushaya kwenhliziyo okuhamba kancane, umfutho wegazi ophansi noma ophakeme

Izimpawu kwesinye isikhathi zilethwa ukuzikhandla ngokomzimba, noma ukudla noma ukuphuza izinto ezifana noshizi oluhlaza okwesibhakabhaka, ushokoledi noma iwayini elibomvu.

Iningi lalezi zicubu zitholakala lapho kwenziwa izivivinyo noma izinqubo ngezinye izizathu, njengesikhathi sokuhlinzwa kwesisu.

Uma kwenziwa ukuhlolwa komzimba, umhlinzeki wezokunakekelwa kwempilo angathola izimpawu ze:

• Izinkinga ze-valve yenhliziyo, njengokukhononda
• Isifo sokushoda kwe-Niacin (pellagra)

Ukuhlolwa okungenziwa kufaka phakathi:

• Amazinga we-5-HIAA emchameni
• Ukuhlolwa kwegazi (kufaka phakathi i-serotonin ne-chromogranin test yegazi)
• I-CT ne-MRI scan esifubeni noma esiswini
• I-Echocardiogram
• Ukuskena okune-radiolabeled kwe-Octreotide

Ukuhlinzwa ukukhipha isimila kuvame ukuba ukwelashwa kokuqala. Ingaselapha unomphela lesi simo uma isimila sisuswe ngokuphelele.

Uma isimila sesisabalele esibindini, ukwelashwa kubandakanya okulandelayo:

• Ukususa izindawo zesibindi ezinamaseli wesimila
• Ukuthumela (ukufaka) umuthi ngqo esibindini ukuqeda izicubu

Lapho sonke isimila singeke sisuswe, ukususa izingxenye ezinkulu zesimila ("debulking") kungasiza ekunciphiseni izimpawu.

Imijovo ye-Octreotide (Sandostatin) noma i-lanreotide (Somatuline) inikezwa abantu abanezicubu ezisezingeni eliphezulu ze-carcinoid ezingasuswa ngokuhlinzwa.

Abantu abane-carcinoid syndrome kufanele bagweme utshwala, ukudla okukhulu, nokudla okuphezulu ku-tyramine (ushizi osekhulile, ukwatapheya, ukudla okuningi okusetshenzisiwe), ngoba kungadala izimpawu.

Eminye imithi ejwayelekile, njenge-serotonin reuptake inhibitors ekhethiwe (i-SSRIs), efana ne-paroxetine (Paxil) ne-fluoxetine (i-Prozac), ingenza izimpawu zibe zimbi ngokwanda kwamazinga e-serotonin. Kodwa-ke, UNGAYIYI ukuthatha le mithi ngaphandle kokuthi umhlinzeki wakho akutshele ukuthi wenze njalo.

Funda kabanzi mayelana ne-carcinoid syndrome futhi uthole ukwesekwa kusuka:

• ICarcinoid Cancer Foundation - www.carcinoid.org/resource/support-groups/directory/
• I-Neuroendocrine Tumor Research Foundation - netrf.org/for-patients/

Umbono wabantu abane-carcinoid syndrome kwesinye isikhathi wehlukile kumbono wabantu abanezicubu ze-carcinoid ngaphandle kwesifo.

Isibikezelo sincike nasendaweni yesimila. Kubantu abane-syndrome, isimila sivame ukusabalala siye esibindini. Lokhu kwehlisa izinga lokusinda. Abantu abane-carcinoid syndrome nabo banamathuba amaningi okuba nomdlavuza ohlukile (isimila sesibili sokuqala) ngasikhathi sinye. Sekukonke, isibikezelo ngokuvamile sihle kakhulu.

Izinkinga ze-carcinoid syndrome zingafaka:

• Ingozi eyengeziwe yokuwa nokulimala (kusuka kumfutho wegazi ophansi)
• Ukuvinjelwa kwamathumbu (kusuka ku-tumor)
• Ukopha emathunjini
• Ukuhluleka kwe-valve yenhliziyo

Ifomu elibulalayo le-carcinoid syndrome, inkinga ye-carcinoid, ingavela njengomphumela oseceleni wokuhlinzwa, i-anesthesia noma i-chemotherapy.

Xhumana nomhlinzeki wakho ukuze uthole i-aphoyintimenti uma unezimpawu zesifo se-carcinoid.

Ukwelapha isimila kunciphisa ubungozi be-carcinoid syndrome.

I-Flush syndrome; I-Argentaffinoma syndrome

• Ukuthathwa kweSerotonin

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa kwezicubu zomzimba emathunjini (Adult) (PDQ) - inguqulo yezempilo. www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq. Kubuyekezwe ngo-Septhemba 16, 2020. Kufinyelelwe ngo-Okthoba 14, 2020.

Öberg K. Neuroendocrine izimila kanye nokuphazamiseka okuhlobene. Ku: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 14. IPhiladelphia, PA: Elsevier; 2020: isahluko 45.

I-Wolin EM, iJensen RT. Izimila ze-Neuroendocrine. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 219.