Ithumba lobuchopho - eziziiprayimari - zabantu abadala

Ithumba eliphambili lobuchopho liqela (ubunzima) beeseli ezingaqhelekanga eziqala kwingqondo.

Izidumbu zengqondo zokuqala zibandakanya nasiphi na isimila esiqala kwingqondo. Izidumba zobuchopho zaseprayimari zinokuqala kwiiseli zobuchopho, inwebu ejikeleze ingqondo (i-meninges), imithambo-luvo okanye amadlala.

Izidumbu zinokutshabalalisa ngqo iiseli zobuchopho. Banokonakalisa iiseli ngokuvelisa ukudumba, ukubeka uxinzelelo kwamanye amalungu engqondo, kunye nokonyusa uxinzelelo ngaphakathi kokakayi.

Unobangela wezidumbu zokuqala zobuchopho awaziwa. Zininzi izinto ezinobungozi ezinokudlala indima:

• Unyango lwemitha olusetyenziselwa ukunyanga umhlaza wobuchopho lwonyusa umngcipheko wamathumba obuchopho ukuya kuthi ga kwiminyaka engama-20 okanye engama-30 kamva.
• Ezinye zeemeko ezizuzwe njengelifa zonyusa umngcipheko wamathumba obuchopho, kubandakanya i-neurofibromatosis, iVon Hippel-Lindau syndrome, iLi-Fraumeni syndrome kunye neTurcot syndrome.
• IiLymphomas eziqala ebuchotsheni kubantu abanamajoni omzimba abuthathaka ngamanye amaxesha zinxulunyaniswa nosulelo lwe-Epstein-Barr virus.

Ezi aziboniswanga njengezinto ezinobungozi:

• Ukubonakaliswa kwimitha emsebenzini, okanye kwiintambo zombane, iiselfowuni, iifowuni ezingenazintambo, okanye izixhobo ezingenazingcingo
• Ukwenzakala entloko
• Ukutshaya
• Unyango lweHormone

IINTLOBO ZESIPHUMO ESIKHETHEKILEYO

Izidumbu zobuchopho zihlelwa ngokwe:

• Indawo yethumba
• Uhlobo lwethishu ebandakanyekayo
• Enoba ayinomdlavuza (unobungozi) okanye umhlaza (unobungozi)
• Ezinye izinto

Ngamanye amaxesha, amathumba aqala ukuba ndlongondlongo anokutshintsha indlela aziphethe ngayo kwaye abe ndlongondlongo.

Izidumbu zinokubakho nakweyiphi na iminyaka, kodwa iintlobo ezininzi zixhaphakile kwiqela elithile leminyaka. Kubantu abadala, i-gliomas kunye ne-meningiomas zezona zixhaphakileyo.

I-Gliomas zivela kwiiseli ezinjenge-astrocytes, i-oligodendrocyte, kunye neeseli ze-ependymal. I-Gliomas yahlulwe yaziintlobo ezintathu:

• Amathumba e-Astrocytic abandakanya i-astrocytomas (ayinakuba ngumhlaza), i-anaplastic astrocytomas, kunye ne-glioblastomas.
• Amathumba e-Oligodendroglial. Ezinye izilonda zengqondo eziphambili zenziwe ngamathumba e-astrocytic kunye ne-oligodendrocytic. Ezi zibizwa ngokuba ziigliomas ezidityanisiweyo.
• I-Glioblastomas lolona hlobo luhlaselayo lwesisu sobuchopho.

I-Meningiomas kunye ne-schwannomas zezinye iintlobo ezimbini zamathumba obuchopho. Ezi zivumba:

• Yenzeka rhoqo phakathi kweminyaka engama-40 ukuya kuma-70.
• Zihlala zingenamhlaza, kodwa zisenokubangela iingxaki ezinzulu kunye nokufa kubungakanani bazo okanye indawo ekuyo. Abanye banomhlaza kwaye banoburharha.

Ezinye izilonda zengqondo ephambili kubantu abadala zinqabile. Oku kubandakanya:

• Ependymomas
• Craniopharyngiomas
• Amathumba ebhinqa
• Iiprayimari (inkqubo ye-nervous central - CNS) i-lymphoma
• Amathumba endlala yepineal
• Izidumba zokuqala zentsholongwane ebuchotsheni

Ezinye izicubu azibangeli zimpawu zide zibe nkulu kakhulu. Amanye amathumba aneempawu ezikhula kancinci.

Iimpawu zixhomekeke kubungakanani beethumba, indawo ekuyo, ukuba sele isasazeke kangakanani, nokuba kukho ukudumba kwengqondo. Ezona mpawu zixhaphakileyo zezi:

• Utshintsho ekusebenzeni kwengqondo yomntu
• Intloko ebuhlungu
• Ukuxhuzula (ngakumbi kubantu abadala abadala)
• Ubuthathaka kwilungu elinye lomzimba

Intloko ebangelwa ngamathumba ebuchwephesha inokuthi:

• Yiba mbi ngakumbi xa umntu evuka kusasa, kwaye aphume kwiiyure ezimbalwa
• Yenzeka ngexesha lokulala
• Yenzeka ngokugabha, ukudideka, ukubona kabini, ukuba buthathaka, okanye ukuba ndindisholo
• Iya iba mbi ngokukhohlela okanye ukwenza umthambo, okanye ngokutshintsha komzimba

Ezinye iimpawu zingabandakanya:

• Guqula ukulumka (kubandakanya ukulala, ukungabikho zingqondweni, kunye nokudinwa)
• Utshintsho kwindlebe, incasa, okanye ivumba
• Utshintsho oluchaphazela ukubamba kunye nokukwazi ukuziva iintlungu, uxinzelelo, amaqondo obushushu ahlukeneyo, okanye esinye isishukumisi
• Ukudideka okanye ukulahleka kwememori
• Kunzima ukugwinya
• Kunzima ukubhala okanye ukufunda
• Isiyezi okanye uvakalelo olungaqhelekanga lokuhamba (i-vertigo)
• Iingxaki zamehlo ezinje nge-eyelid drooping, abafundi bobukhulu obahlukeneyo, ukungalawuleki kwamehlo, ubunzima bokubona (kubandakanya ukunciphisa umbono, umbono ophindwe kabini, okanye ukulahleka ngokupheleleyo kombono)
• Ukungcangcazela kwesandla
• Ukunqongophala kolawulo kwisinyi okanye emathunjini
• Ukuphulukana nokulingana okanye ukulungelelanisa, ukungakwazi ukuhamba, ukuhamba nzima
• Ubuthathaka bemisipha ebusweni, engalweni, okanye emlenzeni (ngesiqhelo kwicala elinye)
• Ubudenge okanye ukurhawuzelela kwelinye icala lomzimba
• Ubuntu, imo, isimilo, okanye utshintsho lweemvakalelo
• Ingxaki yokuthetha okanye ukuqonda abanye abathethayo

Ezinye iimpawu ezinokuthi zenzeke nge-pituitary tumor:

• Ukukhutshwa kwengono engaqhelekanga
• Ukungayi exesheni (amaxesha)
• Ukukhula kwebele emadodeni
• Izandla ezandisiweyo, iinyawo
• Izinwele zomzimba ezigqithileyo
• Utshintsho ebusweni
• Uxinzelelo lwegazi oluphantsi
• Ukutyeba kakhulu
• Ukuziva ubushushu okanye ukubanda

Ezi mvavanyo zilandelayo zinokuqinisekisa ubukho be-tumor ebuchotsheni kwaye zifumane indawo ekuyo:

• Ukuvavanywa kwentloko kwe-CT
• I-EEG (ukulinganisa umsebenzi wombane wobuchopho)
• Ukuhlolwa kwezicubu ezisuswe kwi-tumor ngexesha lotyando okanye kwi-biopsy ekhokelwa yi-CT (inokuqinisekisa uhlobo lwethumba)
• Uvavanyo lwe-cerebral spinal fluid (CSF) (inokubonisa iiseli ezinomhlaza)
• I-MRI yentloko

Unyango lunokubandakanya utyando, unyango ngemitha, kunye nekhemotherapy. Amathumba ebongo anyangwa kakuhle liqela elibandakanya:

• Neuro-oncologist
• Neurosurgeon
• Ugqirha wezonyango
• Imitha ye-oncologist
• Abanye ababoneleli ngononophelo lwempilo, njengeeurologists kunye noonontlalontle

Unyango lwakwangoko luhlala luphucula ithuba lesiphumo esihle. Unyango luxhomekeke kubungakanani nohlobo lwethumba kunye nempilo yakho ngokubanzi. Unyango lunokuba kukunyanga ithumba, ukunciphisa iimpawu kunye nokuphucula ukusebenza kwengqondo okanye intuthuzelo.

Utyando kufuneka rhoqo kwizifo zengqondo zokuqala. Amanye amathumba asuswe ngokupheleleyo. Ezo zingene nzulu ngaphakathi kwengqondo okanye ezingena kwizicubu zobuchopho zinokukhutshelwa endaweni yokususwa. Ukuchithwa kwenkqubo yinkqubo yokunciphisa ubungakanani besisu.

Izidumbu kunokuba nzima ukuzisusa ngokupheleleyo ngotyando kuphela. Kungenxa yokuba ithumba lingena ngaphakathi kwingqondo yakho njengengcambu yesityalo esisasazekayo emhlabeni. Xa ithumba lingenakususwa, utyando lusenokunceda ukunciphisa uxinzelelo kunye nokunciphisa iimpawu.

Unyango lwemitha lusetyenziselwa amathumba athile.

I-Chemotherapy inokusetyenziswa ngotyando okanye unyango ngemitha.

Amanye amayeza asetyenziselwa ukunyanga amathumba engqondo aphambili ebantwaneni anokubandakanya:

• Amayeza okunciphisa ukudumba kwengqondo kunye noxinzelelo
• Anticonvulsants ukunciphisa ukuxhuzula
• Amayeza entlungu

Amanyathelo okuthuthuzela, amanyathelo okhuseleko, unyango lomzimba, kunye nonyango olusebenzayo lunokufuneka ukuphucula umgangatho wobomi. Ingcebiso, amaqela enkxaso, kunye namanyathelo afanayo anokunceda abantu ukumelana nesi sifo.

Unokucinga ngokubhalisa kuvavanyo lweklinikhi emva kokuthetha neqela lakho lonyango.

Iingxaki ezinokubangelwa ngamathumba obuchopho zibandakanya:

• I-Brain herniation (ihlala ibulala)
• Ukuphulukana nokukwazi ukusebenzisana okanye ukusebenza
• Unaphakade, ukuwohloka, kunye nelahleko enkulu yokusebenza kwengqondo
• Ukubuya kokukhula kwethumba
• Iziphumo ebezingalindelekanga zamayeza, kubandakanya ichemotherapy
• Imiphumo emibi yonyango lwe-radiation

Tsalela umnikezeli wakho ukuba uphuhlisa nayiphi na intloko, intloko eqhubekayo okanye ezinye iimpawu zethumba lobuchopho.

Fowunela umniki-nkonzo wakho okanye uye kwigumbi likaxakeka ukuba uqala ukuxhuzula, okanye ngesiquphe uvelise ubuthongo (ukunciphisa ukuqonda), utshintsho lombono, okanye utshintsho lwentetho.

Glioblastoma multiforme - abadala; Ependymoma - abantu abadala; IGlioma - abantu abadala; Astrocytoma - abadala; IMedulloblastoma - abantu abadala; Neuroglioma - abadala; Oligodendroglioma - abadala; Lymphoma - abadala; Vestibular schwannoma (acoustic neuroma) - abantu abadala; Meningioma - abadala; Umhlaza-ithumba lobuchopho (abantu abadala)

• Imitha yobuchopho-ukukhutshwa
• Utyando lobuchopho-ukukhutshwa
• I-Chemotherapy -yintoni oza kuyibuza ugqirha wakho
• Unyango ngemitha- imibuzo oza kuyibuza ugqirha wakho
• I-radiosurgery yestereotactic-ukukhutshwa

• Ithumba lobuchopho

UDorsey JF, uSalinas RD, uDang M, et al. Umhlaza we-nervous system. Ku: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, ii-eds. I-Oncology yeklinikhi yase-Abeloff. Umhla wesi-6. IPhiladelphia, PA: Elsevier; 2020: isahl. 63.

UMichaud DS. I-Epidemiology yamathumba obuchopho. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2016: isahluko 71.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lwabadala kunyango lwamathumba (PDQ) -uhlobo lobungcali kwezempilo. www.cancer.gov/types/brain/hp/ult-brain-kunyanga-pdq. Ukuhlaziywa ngoJanuwari 22, 2020. Ifikeleleke ngoMeyi 12, 2020.

Iwebhusayithi yeNethiwekhi yeCancer epheleleyo yoMhlaza. Izikhokelo zokuziqhelanisa neKliniki ye-NCCN kwi-Oncology (Izikhokelo ze-NCCN): inkqubo yeeseli zomhlaza. Inguqulelo 2.2020. www.nccn.org/professionals/physician_gls/pdf/cns.pdf. Ukuhlaziywa ngo-Epreli 30, 2020. Kufikeleleke ngoMeyi 12, 2020.