I-Brain tumor - eyinhloko - yabantu abadala

Isimila esiyinhloko sobuchopho yiqembu (isisindo) samaseli angajwayelekile aqala ebuchosheni.

Izicubu zobuchopho eziyinhloko zifaka noma yisiphi isimila esiqala ebuchosheni. Izicubu zobuchopho eziyinhloko zingaqala kusuka kumaseli obuchopho, ulwelwesi oluzungeze ubuchopho (ama-meninges), izinzwa noma izindlala.

Izimila zingabhubhisa ngqo amaseli obuchopho. Futhi zingalimaza amaseli ngokukhiqiza ukuvuvukala, ngokufaka ingcindezi kwezinye izingxenye zobuchopho, nokukhuphula ingcindezi ngaphakathi kogebhezi.

Imbangela yamathumba ayisisekelo obuchopho ayaziwa. Kunezici eziningi zobungozi ezingadlala indima:

• Ukwelashwa ngemisebe okusetshenziselwa ukwelapha umdlavuza wobuchopho kwandisa ingozi yamathumba obuchopho kuze kube yiminyaka engama-20 noma engama-30 kamuva.
• Ezinye izimo ezizuzwe njengefa zandisa ubungozi bamathumba obuchopho, kufaka phakathi i-neurofibromatosis, i-Von Hippel-Lindau syndrome, i-Li-Fraumeni syndrome, ne-Turcot syndrome.
• AmaLymphomas aqala ebuchosheni kubantu abanamasosha omzimba abuthakathaka kwesinye isikhathi axhunyaniswa nokutheleleka ngegciwane le-Epstein-Barr.

Lokhu akubonisanga ukuthi kuyizinto ezinobungozi:

• Ukuvezwa ngemisebe emsebenzini, noma ezintanjeni zikagesi, omakhalekhukhwini, izingcingo ezingenazintambo, noma amadivayisi angenazintambo
• Ukulimala ekhanda
• Ukubhema
• Ukwelashwa kweHormone

IZINHLOBO ZESILIMA ESIKHETHEKILE

Izicubu zobuchopho zihlukaniswa kuye ngokuthi:

• Indawo yesimila
• Uhlobo lwezicubu ezihilelekile
• Noma ngabe azinomdlavuza (zinobungozi) noma zinomdlavuza (ziyingozi)
• Ezinye izinto

Kwesinye isikhathi, izicubu eziqala ukungabi nolaka kakhulu zingashintsha ukusebenza kwazo kwe-biologic futhi zibe nolaka ngokwengeziwe.

Izicubu zingenzeka nganoma yisiphi isikhathi, kepha izinhlobo eziningi zivame kakhulu eqenjini elithile leminyaka. Kubantu abadala, ama-gliomas nama-meningiomas yikhona okuvame kakhulu.

Ama-gliomas avela kumaseli we-glial anjenge-astrocyte, ama-oligodendrocyte namaseli we-ependymal. AmaGliomas ahlukaniswe izinhlobo ezintathu:

• Izicubu ze-Astrocytic zifaka phakathi i-astrocytomas (ingabi umdlavuza), i-anaplastic astrocytomas, ne-glioblastomas.
• Izimila ze-Oligodendroglial. Ezinye izicubu zobuchopho eziyinhloko zakhiwa zombili izicubu ze-astrocytic kanye ne-oligodendrocytic. Lawa abizwa ngama-gliomas axubekile.
• I-Glioblastomas yilona uhlobo olunolaka kakhulu lwe-tumor eyinhloko yobuchopho.

I-Meningiomas ne-schwannomas ezinye izinhlobo ezimbili zezicubu zobuchopho. Lezi zicubu:

• Kuvela kaningi phakathi kweminyaka engama-40 nengama-70.
• Imvamisa ayinankinga, kepha isengadala izinkinga ezinkulu nokufa kusuka ngosayizi noma indawo. Abanye banomdlavuza futhi banolaka.

Ezinye izicubu zobuchopho eziyinhloko kubantu abadala azivamile. Lokhu kufaka phakathi:

• Ependymomas
• I-Craniopharyngiomas
• Izilonda zesikhumba
• Isisekelo (isimiso sezinzwa esiyinhloko - CNS) lymphoma
• Izimila zezindlala zikaphayini
• Izicubu eziyinhloko zamagciwane egciwane ebuchosheni

Ezinye izicubu azibangeli zimpawu zize zibe nkulu kakhulu. Ezinye izicubu zinezimpawu ezikhula kancane.

Izimpawu zincike kubukhulu besimila, indawo, ukuthi sisabalale kangakanani, nokuthi kukhona yini ukuvuvukala kobuchopho. Izimpawu ezivame kakhulu yilezi:

• Izinguquko ekusebenzeni kwengqondo yomuntu
• Ukuphathwa ikhanda
• Ukuquleka (ikakhulukazi kubantu abadala asebekhulile)
• Ubuthakathaka engxenyeni eyodwa yomzimba

Ukuphathwa yikhanda okubangelwa izicubu zobuchopho kungahle:

• Kuba kubi kakhulu lapho umuntu evuka ekuseni, bese evuka emahoreni ambalwa
• Yenzeka ngesikhathi sokulala
• Kuvela ngokuhlanza, ukudideka, ukubona kabili, ubuthakathaka, noma ukuba ndikindiki
• Kubi kakhulu ngokukhwehlela noma ukuzivocavoca umzimba, noma ngokushintsha kwesimo somzimba

Ezinye izimpawu zingabandakanya:

• Shintsha ekuxwayeni (kufaka phakathi ukulala, ukungazi lutho, ne-coma)
• Izinguquko kokuzwa, ukunambitha, noma ukuhogela
• Izinguquko ezithinta ukuthinta nokukwazi ukuzwa ubuhlungu, ingcindezi, amazinga okushisa ahlukile, noma esinye isikhuthazi
• Ukudideka noma ukulahleka kwememori
• Kunzima ukugwinya
• Kunzima ukubhala noma ukufunda
• Isiyezi noma ukuzwa okungavamile kokunyakaza (i-vertigo)
• Izinkinga zamehlo njengokujula kwejwabu leso, abafundi abanobukhulu obuhlukahlukene, ukunyakaza kwamehlo okungalawuleki, ubunzima bokubona (kufaka phakathi ukwehla kombono, ukubona kabili, noma ukulahleka ngokuphelele kombono)
• Ukuthuthumela kwesandla
• Ukuntuleka kokulawula isinye noma amathumbu
• Ukulahlekelwa ibhalansi noma ukuxhumanisa, ubuhlanya, ukuhamba ngezinkinga
• Ubuthakathaka bemisipha ebusweni, engalweni, noma emlenzeni (imvamisa ohlangothini olulodwa)
• Ukuba ndikindiki noma ukuncinza kolunye uhlangothi lomzimba
• Ubuntu, imizwa, indlela yokuziphatha, noma izinguquko ezingokomzwelo
• Inkinga yokukhuluma noma ukuqonda abanye abakhulumayo

Ezinye izimpawu ezingase zivele ngesimila se-pituitary:

• Ukukhishwa kwengono okungavamile
• Ukungayi esikhathini (izikhathi)
• Ukukhula kwamabele emadodeni
• Izandla ezikhulisiwe, izinyawo
• Izinwele zomzimba ezeqile
• Izinguquko ebusweni
• Umfutho wegazi ophansi
• Ukukhuluphala ngokweqile
• Ukuzwela ukushisa noma ukubanda

Ukuhlolwa okulandelayo kungaqinisekisa ubukhona besimila sobuchopho futhi kutholakale ukuthi sikuphi:

• I-CT scan yekhanda
• I-EEG (ukukala umsebenzi kagesi wobuchopho)
• Ukuhlolwa kwezicubu ezisuswe ku-tumor ngesikhathi sokuhlinzwa noma i-biopsy eqondiswa yi-CT (kungaqinisekisa uhlobo lwesimila)
• Ukuhlolwa kwe-cerebral spinal fluid (CSF) (kungakhombisa amaseli anomdlavuza)
• I-MRI yekhanda

Ukwelashwa kungabandakanya ukuhlinzwa, ukwelashwa ngemisebe nokwelashwa ngamakhemikhali. Izicubu zobuchopho ziphathwa kahle yithimba elibandakanya:

• Neuro-oncologist
• I-Neurosurgeon
• I-oncologist yezokwelapha
• I-radiation oncologist
• Abanye abahlinzeki bezempilo, njengodokotela bezinzwa nabasebenzi bezenhlalakahle

Ukwelashwa kusenesikhathi kuvame ukuthuthukisa amathuba emphumela omuhle. Ukwelashwa kuya ngosayizi nohlobo lwesimila nempilo yakho jikelele. Izinhloso zokwelashwa kungaba ukwelapha isimila, ukuqeda izimpawu, nokwenza ngcono ukusebenza kobuchopho noma ukunethezeka.

Ukuhlinzwa kuvame ukudingeka kwizicubu eziningi zobuchopho eziyinhloko. Ezinye izicubu zingasuswa ngokuphelele. Lokho okujule ngaphakathi ebuchosheni noma okufaka izicubu zobuchopho kungakhishwa esikhundleni sokususwa. I-Debulking inqubo yokunciphisa usayizi wesimila.

Kungaba nzima ukususa izicubu ngokuphelele ngokuhlinzwa wedwa. Lokhu kungenxa yokuthi isimila sihlasela izicubu zobuchopho ezizungeze kakhulu njengezimpande ezivela esitshalweni esisakazeka enhlabathini. Lapho isimila singeke sisuswe, ukuhlinzwa kungasiza ekunciphiseni ingcindezi nasekunciphiseni izimpawu.

Ukwelashwa ngemisebe kusetshenziselwa izicubu ezithile.

I-Chemotherapy ingasetshenziswa ngokuhlinzwa noma ukwelashwa ngemisebe.

Eminye imithi esetshenziselwa ukwelapha izicubu eziyinhloko zobuchopho ezinganeni ingafaka:

• Imithi yokwehlisa ukuvuvukala kobuchopho nengcindezi
• Ama-Anticonvulsants ukunciphisa ukuquleka
• Imithi yezinhlungu

Izinyathelo zokududuza, izinyathelo zokuphepha, ukwelashwa ngokomzimba, kanye nokwelashwa emsebenzini kungadingeka ukuze kuthuthukiswe ikhwalithi yempilo. Ukwelulekwa, amaqembu okusekela, nezinyathelo ezifanayo kungasiza abantu ukubhekana nalesi sifo.

Ungacabanga ukubhalisa esivivinyweni somtholampilo ngemuva kokukhuluma nethimba lakho lezokwelapha.

Izinkinga ezingabangelwa izicubu zobuchopho zifaka:

• I-Brain herniation (evame ukubulala)
• Ukulahlekelwa kwamandla okusebenzisana noma okusebenza
• Ukuhlala unomphela, ukuwohloka, nokulahleka okukhulu kobuchopho
• Ukubuyiselwa kokukhula kwesimila
• Imiphumela emibi yemithi, kufaka phakathi i-chemotherapy
• Imiphumela emibi yokwelashwa ngemisebe

Shayela umhlinzeki wakho uma uthuthuka noma yiliphi ikhanda elisha, eliphikelelayo noma ezinye izimpawu zesimila ebuchosheni.

Shayela umhlinzeki wakho noma uye egumbini labezimo eziphuthumayo uma uqala ukuquleka, noma ngokuzumayo uthuthuke (ukunciphisa ukuqapha), izinguquko zombono, noma izinguquko zenkulumo.

I-Glioblastoma multiforme - abantu abadala; I-Ependymoma - abantu abadala; I-glioma - abadala; I-Astrocytoma - abantu abadala; IMedulloblastoma - abantu abadala; Neuroglioma - abadala; Oligodendroglioma - abantu abadala; I-Lymphoma - abantu abadala; I-vestibular schwannoma (i-acoustic neuroma) - abantu abadala; Meningioma - abadala; Umdlavuza - isimila sobuchopho (abantu abadala)

• Imisebe yobuchopho - ukukhishwa
• Ukuhlinzwa kobuchopho - ukukhishwa
• I-Chemotherapy - yini ongayibuza udokotela wakho
• Ukwelashwa ngemisebe - imibuzo ongayibuza udokotela wakho
• Ama-radiosurgery we-stereotactic - ukukhishwa

• Isigaxa sobuchopho

UDorsey JF, uSalinas RD, uDang M, et al. Umdlavuza wesistimu yezinzwa emaphakathi. Ku: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 63.

UMichaud DS. I-Epidemiology yezicubu zobuchopho. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 71.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa kwezimila zesistimu yabantu abadala (PDQ) - inguqulo yezobuchwepheshe yezempilo. www.cancer.gov/types/brain/hp/ultult-brain-treatment-pdq. Kubuyekezwe uJanuwari 22, 2020. Kufinyelelwe ngoMeyi 12, 2020.

Iwebhusayithi ye-National Comprehensive Cancer Network. Izinkombandlela ze-NCCN Clinical Practice Guidelines ku-Oncology (Izinkombandlela ze-NCCN): umdlavuza wesistimu yezinzwa. Inguqulo 2.2020. www.nccn.org/professionals/physician_gls/pdf/cns.pdf. Kubuyekezwe u-Ephreli 30, 2020. Kufinyelelwe ngoMeyi 12, 2020.