Cancer, Melanoma Y'Ijisho

Umuhumeka w'amaso akenshi uba mu gice cy'amaso cyo hagati (uvea). Ibice bya uvea by'amaso bishobora kwibasirwa n'umuhumeka harimo igice cy'amaso gifite ibara (iris), imikaya izingiye lenti y'ijisho (ciliary body), n'urwego rw'imitsi y'amaraso rukingira inyuma y'ijisho (choroid).

Umuhumeka ni ubwoko bwa kanseri itera mu mitsi ikora melanin - ikintu gitera uruhu ibara. Amaso yawe na yo afite imisemburo ikora melanin kandi ishobora kwibasirwa n'umuhumeka. Umuhumeka w'amaso witwa kandi ocular melanoma.

Umuhumeka w'amaso uba mu gice cy'ijisho utabona iyo witegereje mu ndorerwamo. Ibi bituma umuhumeka w'amaso ugora kubona. Byongeye kandi, umuhumeka w'amaso ntabwo ugaragaza ibimenyetso bya mbere cyangwa ibimenyetso.

Hari ubuvuzi bw'umuhumeka w'amaso. Ubuvuzi bw'umuhumeka muto w'amaso bushobora kutazagira ingaruka ku kubona kwawe. Ariko, ubuvuzi bw'umuhumeka munini w'amaso bushobora gutera igihombo cy'ububone.

Umuhumeka w'amaso ushobora kutababaza ibimenyetso n'ibibonwa. Iyo bibayeho, ibimenyetso n'ibibonwa by'umuhogo w'amaso bishobora kuba birimo:

• Kumva nk'aho hari ibintu bimeze nk'umuriro cyangwa utubuto tw'umukungugu mu maso yawe (floaters)
• Agacupa kari ku kariso kari kwiyongera
• Impinduka mu ishusho y'umunyura (umunyeshuri) uri hagati y'ijisho ryawe
• Kubura cyangwa guhumana kw'ubwenge mu jisho rimwe
• Kubura ubwenge bwo kubona ibintu biri ku mpande

Egera muganga wawe niba ufite ikimenyetso cyangwa ibimenyetso bikubangamiye. Impinduka zidasanzwe mu kubona kwawe ni ikimenyetso cy'ubukene bwihuse bwo kuvurwa, nuko rero shaka ubufasha bw'abaganga mu buryo bwihuse muri ibyo bihe.

Ntabwo birasobanutse icyateza melanoma y'amaso.

Abaganga bazi ko melanoma y'amaso ibaho iyo habaye amakosa mu miterere ya ADN y'uturemangingo tw'amaso dukozwe neza. Amakosa ya ADN abwira utwo turemangingo gukura no kwiyongera mu buryo butaboneka, bityo utwo turemangingo twahindutse tukomeza kubaho mu gihe bisanzwe byapfa. Uturemangingo twahindutse twibasira mu jisho maze tugakora melanoma y'amaso.

Melanoma y'amaso ikunze kugaragara mu turemangingo two mu rwego rwo hagati rw'ijisho ryawe (uvea). Uvea ifite ibice bitatu kandi buri kimwe gishobora kwibasirwa na melanoma y'amaso:

• Iris, ari yo gice gifite ibara kiri imbere y'ijisho
• Urwego rwa choroid, ari rwo rwego rw'imitsi y'amaraso n'umubiri uhuza hagati ya sclera na retina inyuma ya uvea
• Umubiri wa ciliary, uri imbere ya uvea kandi usohora umusemburo usobanutse (aqueous humor) mu jisho.

Melanoma y'amaso ishobora kandi kuba ku rwego rwo hanze imbere y'ijisho (conjunctiva), mu cyuho gikikije ijisho no ku gipfukisho cy'ijisho, nubwo ubwo bwoko bwa melanoma y'amaso ari bworoshye cyane.

Ibintu byongera ibyago byo kurwara melanoma y'amaso harimo:

• Ibara ry'amaso ryiza. Abantu bafite amaso y'ubururu cyangwa ay'icyatsi bafite ibyago byinshi byo kurwara melanoma y'amaso.
• Kuba umuzungu. Abazungu bafite ibyago byinshi byo kurwara melanoma y'amaso kurusha abandi bantu b'amoko andi.
• Imyaka. Ibyago byo kurwara melanoma y'amaso byiyongera uko umuntu akura.
• Indwara zimwe na zimwe z'uruhu zirakomoka. Indwara yitwa dysplastic nevus syndrome, itera ibibara bidafatika, ishobora kongera ibyago byo kurwara melanoma ku ruhu no mu maso.

Byongeye kandi, abantu bafite ibara ry'uruhu ritari ryo ririmo ijisho n'udusembwa turi hafi, ndetse n'ibara ryinshi ku mboni y'ijisho—bizwi nka ocular melanocytosis— nabo bafite ibyago byinshi byo kurwara melanoma y'amaso.

• Kwihanganira urumuri rwa ultraviolet (UV). Uruhare rw'urumuri rwa ultraviolet mu kurwara melanoma y'amaso ntirurasobanutse. Hari ibimenyetso bimwe na bimwe bigaragaza ko kwihanganira urumuri rwa UV, nko kurumuri rw'izuba cyangwa ibyuma byo kwishima, bishobora kongera ibyago byo kurwara melanoma y'amaso.
• Impinduka zimwe na zimwe za gene. Gene zimwe na zimwe zikomoka ku babyeyi zishobora kongera ibyago byo kurwara melanoma y'amaso.

Indwara zimwe na zimwe z'uruhu zirakomoka. Indwara yitwa dysplastic nevus syndrome, itera ibibara bidafatika, ishobora kongera ibyago byo kurwara melanoma ku ruhu no mu maso.

Byongeye kandi, abantu bafite ibara ry'uruhu ritari ryo ririmo ijisho n'udusembwa turi hafi, ndetse n'ibara ryinshi ku mboni y'ijisho—bizwi nka ocular melanocytosis— nabo bafite ibyago byinshi byo kurwara melanoma y'amaso.

Ingaruka z'imirire ya melanoma y'amaso zishobora kuba:

• Kubura ubushobozi bwo kubona. Imirere minini y'amaso ikunze gutera kubura ubushobozi bwo kubona mu jisho ryagizweho ingaruka kandi ishobora gutera ingaruka, nko gutandukana kwa retina, na byo bikaba bitera kubura ubushobozi bwo kubona.

  Imirere mito y'amaso ishobora gutera kubura ubushobozi bwo kubona mu gihe iba iri mu bice by'ingenzi by'ijisho. Ushobora kugira ikibazo cyo kubona hagati cyangwa ku ruhande. Imirere ikomeye cyane y'amaso ishobora gutera kubura ubushobozi bwo kubona burundu.

• Imirere y'amaso ikwirakwira hanze y'ijisho. Imirere y'amaso ishobora gukwirakwira hanze y'ijisho no mu bice bya kure by'umubiri, harimo umwijima, imyanya y'ubuhumekero n'amagufwa.

Kubura ubushobozi bwo kubona. Imirere minini y'amaso ikunze gutera kubura ubushobozi bwo kubona mu jisho ryagizweho ingaruka kandi ishobora gutera ingaruka, nko gutandukana kwa retina, na byo bikaba bitera kubura ubushobozi bwo kubona.

Imirere mito y'amaso ishobora gutera kubura ubushobozi bwo kubona mu gihe iba iri mu bice by'ingenzi by'ijisho. Ushobora kugira ikibazo cyo kubona hagati cyangwa ku ruhande. Imirere ikomeye cyane y'amaso ishobora gutera kubura ubushobozi bwo kubona burundu.

Mu kugira ngo hamenyekane melanoma y'amaso, muganga wawe ashobora kugutegurira ibi bikurikira:

• Ubuvuzi bw'amaso hifashishijwe ingufu z'amajwi. Ubuvuzi bw'amaso hifashishijwe ingufu z'amajwi bukoresha ingufu z'amajwi zikomeye zikomoka ku gikoreshwa gifite ishusho nk'iy'umuhoro, kitwa transducer, kugira ngo hamenyekane ishusho y'ijisho ryawe. Transducer ishyirwa ku gipfukisho cy'ijisho ryawe cyangwa ku ruhu rwo hejuru rw'ijisho ryawe.
• Kureba imiterere y'ubushyuhe bw'amaraso mu kibyimba no mu gice cyacyo (angiogram). Mu gihe cyo gukora angiogram y'ijisho ryawe, hari ibara ryinjizwa mu mubiri wawe mu gice cy'umutsi wo mu kuboko kwawe. Iryo bara rigera ku mitsi y'amaraso yo mu jisho ryawe.

Camera ifite ibyuma byihariye byo kubona iryo bara ifata amafoto buri segonda bike mu gihe cy'iminota myinshi.

• Optical coherence tomography. Iki kizamini cyo kubona ishusho gikora amafoto y'ibice by'umuvuduko w'amaraso n'umwijima.
• Gukuramo igice cy'umubiri ukekwaho kuba ufite ikibazo kugira ngo gupimwe. Mu bihe bimwe na bimwe, muganga wawe ashobora kugutegurira uburyo bwo gukuramo igice cy'umubiri (biopsy) mu jisho ryawe.

Kugira ngo hakurweho icyo gice, umugozi muto winjizwa mu jisho ryawe ukoreshwa mu gukuraho igice cy'umubiri ukekwaho kuba ufite ikibazo. Icyo gice cy'umubiri gipimwa muri laboratwari kugira ngo hamenyekane niba kirimo uturemangingo twa melanoma y'amaso.

Biopsy y'ijisho ntigomba gukorwa kugira ngo hamenyekane melanoma y'amaso.

Isuzuma ry'amaso. Muganga wawe azasuzumira hanze y'ijisho ryawe, ashake imitsi y'amaraso yagutse ishobora kugaragaza ikibyimba kiri mu jisho ryawe. Hanyuma, afashijwe n'ibikoresho, muganga wawe azareba imbere mu jisho ryawe.

Uburyo bumwe, bwitwa binocular indirect ophthalmoscopy, bukoresha lenses n'umucyo ukomeye ushyirwa ku gahanga ka muganga wawe — nk'itara ry'abacukuzi. Ubundi buryo, bwitwa slit-lamp biomicroscopy, bukoresha lenses na microscope itanga umucyo ukomeye wo kumurikira imbere mu jisho ryawe.

Kureba imiterere y'ubushyuhe bw'amaraso mu kibyimba no mu gice cyacyo (angiogram). Mu gihe cyo gukora angiogram y'ijisho ryawe, hari ibara ryinjizwa mu mubiri wawe mu gice cy'umutsi wo mu kuboko kwawe. Iryo bara rigera ku mitsi y'amaraso yo mu jisho ryawe.

Camera ifite ibyuma byihariye byo kubona iryo bara ifata amafoto buri segonda bike mu gihe cy'iminota myinshi.

Gukuramo igice cy'umubiri ukekwaho kuba ufite ikibazo kugira ngo gupimwe. Mu bihe bimwe na bimwe, muganga wawe ashobora kugutegurira uburyo bwo gukuramo igice cy'umubiri (biopsy) mu jisho ryawe.

Kugira ngo hakurweho icyo gice, umugozi muto winjizwa mu jisho ryawe ukoreshwa mu gukuraho igice cy'umubiri ukekwaho kuba ufite ikibazo. Icyo gice cy'umubiri gipimwa muri laboratwari kugira ngo hamenyekane niba kirimo uturemangingo twa melanoma y'amaso.

Biopsy y'ijisho ntigomba gukorwa kugira ngo hamenyekane melanoma y'amaso.

Muganga wawe ashobora kugutegurira ibizamini n'uburyo bundi bwo kumenya niba melanoma yamanutse (metastasized) mu bindi bice by'umubiri wawe. Ibizamini bishobora kuba ibi bikurikira:

• Ibizamini by'amaraso kugira ngo hamenyekane uko umwijima ukora
• X-ray y'ibituza
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
• Ubuvuzi bw'amaso hifashishijwe ingufu z'amajwi
• Positron emission tomography (PET) scan

Amahitamo yo kuvura melanoma y'amaso azaterwa n'aho melanoma y'amaso iherereye n'ubunini bwayo, ndetse n'ubuzima bwawe rusange n'ibyo ukunda.

Melanoma nto y'amaso ishobora kutakeneye kuvurwa vuba. Niba melanoma ari nto kandi idakura, wowe na muganga wawe mushobora guhitamo gutegereza no kureba ibimenyetso by'uko ikura.

Niba melanoma ikura cyangwa igatera ibibazo, ushobora guhitamo kuvurwa icyo gihe.

Umuti wa radiotherapy ukoresha ingufu nyinshi, nka protoni cyangwa gamma rays, kwica cellule za kanseri. Radiotherapy ikoreshwa cyane kuri melanoma nto cyangwa nini y'amaso.

Umuti wa radiotherapy ubusanzwe ugezwa kuri tumo kuri uburyo bwo gushyira plaque ya radioactive ku jisho ryawe, hafi ya tumo mu buryo bwitwa brachytherapy. Plaque ifatwa ahantu hamwe n'udushumi duhoraho. Plaque isa nka cap ya bidosiye kandi irimo imbuto nyinshi za radioactive. Plaque igumana ahantu mu gihe cy'iminsi ine kugeza kuri itanu mbere yo gukurwaho.

Umuti wa radiotherapy ushobora kandi kuza mu mashini ayobora radiotherapy, nka proton beams, ku jisho ryawe (external beam radiation, cyangwa teletherapy). Ubwo bwoko bwa radiotherapy bukunze gutangwa mu minsi mike.

Umuti ukoresha laser kwica cellule za melanoma ushobora kuba amahitamo mu bihe bimwe na bimwe. Ubwoko bumwe bwo kuvura laser, bwitwa thermotherapy, bukoresha laser ya infrared kandi rimwe na rimwe ikoreshwa hamwe na radiotherapy.

Photodynamic therapy ifatanya imiti hamwe n'ubwoko bwihariye bwa light. Imiti ituma cellule za kanseri zibasirwa na light. Umuti wangiza imiyoboro y'amaraso na cellule zigize melanoma y'amaso. Photodynamic therapy ikoreshwa kuri tumo nto, kuko idakora ku kanseri nini.

Iguhuha rikabije (cryotherapy) rishobora gukoreshwa kuri kwangiza cellule za melanoma muri melanoma nto y'amaso, ariko uwo muti ntabwo ukoreshwa cyane.

Imihanda ikoreshwa mu kuvura melanoma y'amaso irimo imirimo yo gukuraho igice cy'ijisho cyangwa imirimo yo gukuraho ijisho ryose. Imirimo uzakorerwa izaterwa n'ubunini n'aho melanoma y'amaso iherereye. Amahitamo ashobora kuba ari:

• Ubuvuzi bwo gukuraho melanoma n'agace gato k'umubiri muzima. Ubuvuzi bwo gukuraho melanoma n'umutwe w'umubiri muzima uyikikije bushobora kuba amahitamo yo kuvura melanoma nto.
• Ubuvuzi bwo gukuraho ijisho ryose (enucleation). Enucleation ikoreshwa cyane kuri tumo nini z'amaso. Ishobora kanka gukoreshwa niba tumo itera ububabare bw'amaso.

Nyuma y'uko ijisho rifite melanoma rikuweho, igice gishyirwa mu mwanya umwe, kandi imikaya igenzura imiterere y'ijisho ifatwa kuri icyo gice, bituma icyo gice gikora.

Nyuma y'uko umaze kugira umwanya wo gukira, ijisho ry'ikinyoma (prosthesis) rikorwa. Igice cy'imbere cy'ijisho ryawe rishya kizapamirwa kugira ngo rihuze n'ijisho ryawe risanzwe.

Ubuvuzi bwo gukuraho ijisho ryose (enucleation). Enucleation ikoreshwa cyane kuri tumo nini z'amaso. Ishobora kanka gukoreshwa niba tumo itera ububabare bw'amaso.

Nyuma y'uko ijisho rifite melanoma rikuweho, igice gishyirwa mu mwanya umwe, kandi imikaya igenzura imiterere y'ijisho ifatwa kuri icyo gice, bituma icyo gice gikora.

Nyuma y'uko umaze kugira umwanya wo gukira, ijisho ry'ikinyoma (prosthesis) rikorwa. Igice cy'imbere cy'ijisho ryawe rishya kizapamirwa kugira ngo rihuze n'ijisho ryawe risanzwe.

Niba kuvura kanseri yawe bituma ubona ubumuga bw'ijisho rimwe, nko mu gihe ijisho rikuweho, biracyashoboka gukora ibintu byinshi wabashaga gukora ufite amaso abiri akora. Ariko bishobora gufata amezi make kugira ngo umenyere uburyo bushya bw'ubuzima bwawe.

Kugira ijisho rimwe bigira ingaruka ku bushobozi bwawe bwo kubona intera. Kandi bishobora kugorana kurushaho kumenya ibintu biri hafi yawe, cyane cyane ibintu bibaho ku ruhande udafite ubwenge.

Baza muganga wawe kugira ngo aguhe umuntu uza kugufasha cyangwa umukozi w'ubuvuzi, ushobora kugufasha gukora ingamba zo guhangana no kumenyera uburyo bushya bw'ubuzima bwawe.