Ese ni ibintu byo mu bwonko? Ibimenyetso, Intandaro, n'Ubuvuzi

Ese ni udukoko dukura mu tugingo twihariye mu mubiri wawe, dukora imisemburo kandi dufasha mu guhuza imikorere y'ingenzi y'umubiri. Izi cellules, twita neuroendocrine cells, zikora nk'ikidomo hagati y'ubwonko bwawe n'ibice by'umubiri bikora imisemburo.

Nubwo izina rishobora kuba rigoranye, tekereza kuri iyi misemburo nk'udukoko dushobora kugira ingaruka ku buryo umubiri wawe ukora kandi ukabya imisemburo. Ese ni udukoko twinshi dukura buhoro kandi abantu benshi babaho ubuzima buzuye, bukorwa neza, bafite ubuvuzi bukwiye no gukurikiranwa.

Ese ni ibintu byo mu bwonko?

Ese ni udukoko dukora iyo neuroendocrine cells zitangiye gukura nabi. Izi cellules zihariye zikwirakwira mu mubiri wawe wose, ariko zikunze kuboneka mu gice cy'igogorwa, mu bihaha, no mu kibuno.

Udukoko dushobora kuba dufite ubuzima bwiza (utari kanseri) cyangwa ububi (kanseri). Ese ni udukoko twinshi dukorera, bisobanura ko bikora imisemburo myinshi ishobora gutera ibimenyetso byumvikana. Ibindi ntabwo bikora kandi bishobora kutagera ibimenyetso kugeza igihe byakuriye bihagije kugira ngo bikure ku zindi nzego.

Aya maduka ni make cyane, agera kuri 6-7 ku bantu 100.000 buri mwaka. Ariko kandi, abaganga barabimenya cyane ubu kubera uburyo bwiza bwo kubona amashusho no kongera ubumenyi.

Ese ni ibihe bimenyetso by'ibintu byo mu bwonko?

Ibimenyetso bihinduka cyane bitewe n'aho udukoko duherereye niba dukora imisemburo. Abantu benshi bagira ibimenyetso rusange bishobora kwitiranywa n'izindi ndwara.

Dore ibimenyetso bisanzwe ushobora kubona:

• Kubabara mu nda cyangwa guhindagurika bidashira
• Guhinduka mu mirire, harimo no guhitwa bikomeza ibyumweru
• Gutakaza ibiro bidateganijwe utabikoze
• Guhindagurika kw'uruhu aho mu maso na mu ijosi byahita biba umutuku kandi bikaba byuzuye ubushyuhe
• Guhumeka nabi cyangwa kugira ikibazo cyo guhumeka bigaragara nk'aho biturutse ahantu
• Guhumeka cyane cyangwa guhindagurika kw'umutima
• Uburwayi budakira nubwo wari uburuhukira

Bamwe bagira icyo abaganga bita "carcinoid syndrome," bibaho iyo udukoko dukora imisemburo dufungura ibintu mu maraso yawe. Ibi bishobora gutera guhindagurika kw'uruhu, guhitwa, no kugira ibibazo byo guhumeka.

Ibimenyetso bidafite akamaro bishobora kuba harimo ibibyimba ku ruhu, guhinduka kw'isukari mu maraso, cyangwa ibyo mu gifu. Ikintu cy'ingenzi cyo kwibuka ni uko ibimenyetso bikunze kuza buhoro buhoro kandi bishobora kuba bito mu ntangiriro.

Ese ni ubwoko ki bw'ibintu byo mu bwonko?

Abaganga basobanura ibintu byo mu bwonko bitewe n'aho bikura n'uburyo byakura. Ahantu h'ibintu bikunze kugaragara ibimenyetso ushobora kugira n'uburyo bwo kuvura bukora neza.

Ubwoko busanzwe harimo:

• Udukoko twa gastroenteropancreatic (GEP) dukura mu gifu, mu mara, cyangwa mu kibuno
• Udukoko tw'ibintu byo mu bwonko tw'ibihaha dukora mu gihumeka
• Udukoko tw'ibintu byo mu bwonko tw'ikibuno, harimo insulinomas na gastrinomas
• Udukoko twa carcinoid, bikunze kuba mu mara mato cyangwa mu mugongo

Abaganga kandi bagabanya aya maduka kuva kuri G1 kugeza kuri G3 bitewe n'uburyo cellules zigabana vuba. Udukoko twa G1 dukura buhoro, udukoko twa G2 dukura mu muvuduko uciriritse, kandi udukoko twa G3 dukura vuba kandi bisaba ubuvuzi bukomeye.

Itsinda ryawe ry'ubuvuzi rizamenya ubwoko n'ikiciro byihariye binyuze mu bipimo bitandukanye, ibi bifasha mu gutegura gahunda y'ubuvuzi ikwiranye n'umwanya wawe.

Ese ni iki gitera ibintu byo mu bwonko?

Intandaro nyayo y'ibintu byinshi byo mu bwonko ntirazwi, ariko abashakashatsi bemeza ko bikura iyo neuroendocrine cells zihinduka mu buryo bwa gene, bituma zikura nabi. Ibi bihinduka bikunze kubaho mu buryo butunguranye igihe kinini.

Ibintu bimwe bishobora gutera iterambere ryabyo:

• Guhinduka kw'uturemangingo dufite imyaka, kuko aya maduka akunda kubaho mu bantu barengeje imyaka 50
• Indwara z'imyororokere nk'indwara za Multiple Endocrine Neoplasia (MEN)
• Amateka y'umuryango w'ibintu byo mu bwonko cyangwa ibindi bibazo bifitanye isano
• Indwara zimwe na zimwe z'ubuvuzi zigira ingaruka ku gukora kwa acide mu gifu

Mu bihe bidafite akamaro, abantu baragira impinduka za gene zongera cyane ibyago byabo. Aya masosiyete y'imyororokere agera kuri 5-10% gusa y'ibintu byose byo mu bwonko.

Ikintu cy'ingenzi ni uko aya maduka ataterwa n'imikorere y'ubuzima nk'imirire, kunywa itabi, cyangwa umunaniro. Nta kintu wakoze gituma uba uri muri iki kibazo, kandi nta mpamvu yo kwibasira niba ufite ikibazo cy'ibintu byo mu bwonko.

Ni ryari ukwiye kubona umuganga kubera ibintu byo mu bwonko?

Ukwiye kuvugana n'umuganga wawe niba ufite ibimenyetso bikomeza ibyumweru birenga bike, cyane cyane niba bigira ingaruka ku buzima bwawe bwa buri munsi. Nubwo aya mamenyetso ashobora kuba aturuka ku bintu byinshi, bihora ari byiza kuyasuzuma.

Shaka ubufasha bw'abaganga vuba niba ubona:

• Kubabara mu nda bikomeye bidakira n'imiti yo mu rugo
• Guhitwa bikomeza ibyumweru birenga bibiri
• Gutakaza ibiro bidateganijwe birenga ibiro 10
• Guhindagurika kw'uruhu kenshi hamwe n'ibindi bimenyetso
• Gukora nabi cyangwa guhumeka nabi bigenda biba bibi

Ntugatege amatwi niba ufite ibimenyetso bikomeye cyangwa niba ibimenyetso byinshi biri hamwe. Umuganga wawe ashobora kugufasha kumenya niba hari ibindi bipimo bikenewe.

Wibuke ko ibibazo byinshi bishobora gutera ibimenyetso nk'ibyo, rero gerageza kudahangayika cyane mbere yo kuvugana n'umuganga. Gusuzuma hakiri kare bikunze gutera ibyiza iyo ubuvuzi bukenewe.

Ese ni ibihe bintu byongera ibyago by'ibintu byo mu bwonko?

Ibintu bimwe bishobora kongera amahirwe yawe yo kugira ikibazo cy'ibintu byo mu bwonko, nubwo ufite ibyago ntibisobanura ko uzabibona. Gusobanukirwa ibi bintu bishobora kugufasha wowe n'umuganga wawe guhora mu maso y'ibimenyetso bishoboka.

Ibyago by'ingenzi harimo:

• Immyaka irengeje 50, iyo guhinduka kw'uturemangingo biba byinshi
• Amateka y'umuryango w'ibintu byo mu bwonko cyangwa indwara z'imyororokere
• Indwara z'imyororokere nk'indwara za Multiple Endocrine Neoplasia
• Ibibazo bimwe na bimwe by'igifu bigabanya acide
• Kuba umwirabura, bikongera gato ibyago by'ubwoko bumwe

Indwara zimwe na zimwe z'imyororokere zongera cyane ibyago, harimo von Hippel-Lindau disease na neurofibromatosis type 1. Izi ndwara zikwirakwira mu muryango kandi zikunze kuba zirimo ubwoko bwinshi bw'udukoko.

Kugira kimwe cyangwa ibyago byinshi ntibisobanura ko uzagira ikibazo cy'ibintu byo mu bwonko. Abantu benshi bafite ibyago ntibabona aya maduka, mu gihe abandi badafite ibyago bizwi babona.

Ese ni ibihe bibazo bishoboka by'ibintu byo mu bwonko?

Ese ni udukoko twinshi tw'ibintu byo mu bwonko dukura buhoro kandi bikaba bifite ibibazo byoroshye, cyane cyane iyo byafashwe hakiri kare. Ariko kandi, ibibazo bimwe bishobora kuza niba udukoko tudavuwe cyangwa niba dukora imisemburo myinshi.

Ibibazo bisanzwe ushobora kugira harimo:

• Carcinoid syndrome ituruka ku dukoko dukora imisemburo itera guhindagurika kw'uruhu no guhitwa
• Kubabara mu mara niba udukoko mu mara byakuriye bihagije
• Ibibazo by'umutima bituruka kuri carcinoid syndrome igihe kirekire
• Kugira ibibazo by'isukari mu maraso bituruka ku dukoko tw'ikibuno
• Ibyo mu gifu bituruka ku dukoko dukora gastrin

Ibibazo bidafite akamaro ariko bikomeye bishobora kuba harimo carcinoid crisis, irimo guhindagurika kw'uruhu bikomeye, guhinduka kw'umuvuduko w'amaraso, no kugira ibibazo byo guhumeka. Ibi bikunze kubaho gusa mu dukoko dukora imisemburo dukura.

Inkuru nziza ni uko ubuvuzi bugezweho bushobora gukumira cyangwa gucunga ibibazo byinshi neza. Itsinda ryawe ry'ubuvuzi rizakukurikirana hafi kandi rihindure ubuvuzi uko bikenewe kugira ngo bigabanye ibibazo byose.

Ese ibintu byo mu bwonko bishobora gukumirwa gute?

Ikibabaje ni uko nta buryo bwemewe bwo gukumira ibintu byinshi byo mu bwonko kuko bikunze kuza kubera impinduka za gene zibaho mu buryo butunguranye. Ariko kandi, ushobora gufata ingamba zo gushyigikira ubuzima bwawe muri rusange no gufata ibibazo hakiri kare.

Dore ibyo ushobora gukora:

• Kugira isuzuma rya buri gihe n'umuganga wawe
• Kumenyesha ibimenyetso byose bikomeza cyangwa bidasanzwe vuba
• Kugendera ku nama zo gusuzuma niba ufite amateka y'umuryango
• Gutekereza ku bijyanye n'imyororokere niba ufite ibyago by'imyororokere
• Kugira ubuzima bwiza muri rusange bufite imirire myiza n'imyitozo ngororamubiri ya buri gihe

Niba ufite indwara y'imyororokere izwi izongera ibyago byawe, umuganga wawe ashobora kugutegeka ibizamini byihariye cyangwa gukurikirana kenshi. Ubu buryo bwo kwitegura bishobora gufasha mu gufata udukoko hakiri kare iyo bivurwa.

Nubwo utazi gukumira aya maduka burundu, kumenya umubiri wawe no kugirana ikiganiro cyiza n'itsinda ryawe ry'ubuvuzi biguha amahirwe meza yo kubona hakiri kare no kuvurwa neza.

Ese ibintu byo mu bwonko bipimwa bite?

Gupima ibintu byo mu bwonko bikunze gusaba ibizamini bitandukanye kuko ibimenyetso bishobora kuba nk'ibindi bibazo byinshi. Umuganga wawe azatangira amateka y'ubuzima n'isuzuma ry'umubiri kugira ngo asobanukirwe ibimenyetso byawe.

Uburyo bwo gupima bukunze kuba:

• Ibizamini by'amaraso kugira ngo urebe urwego rw'imisemburo n'ibimenyetso by'udukoko
• Ibizamini by'inkari kugira ngo upime ibintu byangiritse by'imisemburo
• Ibizamini bya CT cyangwa MRI kugira ngo ubone kandi upime udukoko
• Ibizamini byihariye nk'ibizamini bya octreotide bigenda ku neuroendocrine cells
• Uburyo bwo kubona amashusho kugira ngo urebe igogorwa ryawe
• Biopsy kugira ngo yemeze ibyavuye mu isuzuma kandi amenye ikiciro cy'udukoko

Umuganga wawe ashobora gutegeka ibizamini byihariye by'imisemburo bitewe n'ibimenyetso byawe. Urugero, niba ufite ibibazo by'isukari mu maraso, azareba urwego rw'insuline. Niba ufite guhindagurika kw'uruhu no guhitwa, azapima ibintu bifitanye isano na carcinoid syndrome.

Uburyo bwose bwo gupima bushobora gufata ibyumweru cyangwa amezi, ibyo bishobora kuba bigoye. Ariko kandi, kubona ibyavuye mu isuzuma neza ni ingenzi mu gutegura gahunda y'ubuvuzi ikwiranye n'umwanya wawe.

Ese ni ubuhe buvuzi bw'ibintu byo mu bwonko?

Ubuvuzi bw'ibintu byo mu bwonko biterwa n'ibintu byinshi birimo aho udukoko duherereye, ubunini, ikiciro, niba dukora imisemburo. Abantu benshi bakora neza bafite ubuvuzi, kandi udukoko tumwe na tumwe dushobora gukira burundu.

Gahunda yawe y'ubuvuzi ishobora kuba irimo:

• Kubaga kugira ngo ukureho udukoko, ibi bikunze kuba ubuvuzi bwiza bw'udukoko duherereye ahantu hamwe
• Imiterere ya somatostatin kugira ngo igenzure gukora kw'imisemburo no kugabanya gukura kw'udukoko
• Imiti igenda ku dukoko igana ku dukoko
• Chemotherapy ku dukoko dukomeye cyangwa dukura
• Radiotherapy kugira ngo igabanye udukoko cyangwa ikureho ibimenyetso
• Ubuvuzi bw'umwijima niba udukoko byakwirakwira mu mwijima

Ku dukoko dukora imisemburo, umuganga wawe azibanda ku gucunga ibimenyetso mu gihe avura udukoko ubwayo. Ibi bishobora kuba birimo imiti yo gucunga guhitwa, guhindagurika kw'uruhu, cyangwa ibibazo by'isukari mu maraso.

Abantu benshi bafite udukoko dukura buhoro bashobora gukurikiranwa n'ibizamini bya buri gihe n'ibizamini by'amaraso batavuwe. Ubu buryo, twita active surveillance, bugufasha kwirinda ingaruka mbi z'ubuvuzi mu gihe ubwira umuganga ko udukoko tudahindutse.

Uburyo bwo gucunga ibintu byo mu bwonko mu rugo?

Gucunga ubuzima ufite ikibazo cy'ibintu byo mu bwonko birimo ubuvuzi n'ingamba za buri munsi. Abantu benshi basanga bashobora kubungabunga ubuzima bwabo bafite impinduka n'uburyo bwo kwita ku buzima.

Dore ingamba zifasha mu gucunga buri munsi:

• Kwandika ibimenyetso kugira ngo ubone imiterere n'ibintu bibitera
• Kurya ibiryo bike, byinshi kugira ngo bifashe mu bibazo by'igogorwa
• Kunywa amazi ahagije, cyane cyane niba uri guhitwa
• Kwirinda ibiryo n'ibinyobwa biterwa no guhindagurika kw'uruhu
• Gukora imyitozo yo kugabanya umunaniro nk'ubuhumeka bwimbitse cyangwa gutekereza
• Kuryama bihagije no kugira gahunda yo gusinzira ya buri gihe

Niba ufite carcinoid syndrome, ushobora kuba ukeneye kwirinda ibiryo bimwe na bimwe nk'amagi ashaje, inzoga, cyangwa ibiryo birimo ibinyomoro bishobora gutera guhindagurika kw'uruhu. Itsinda ryawe ry'ubuvuzi rishobora gutanga amabwiriza yihariye y'imirire.

Komeza guhuza n'amatsinda y'ubufasha cyangwa serivisi z'ubujyanama niba wumva uhangayitse. Abantu benshi basanga ari byiza kuvugana n'abandi basobanukirwa ibyo banyuramo.

Ese ukwiye gutegura gute inama yawe n'umuganga?

Gutegura inama yawe bishobora kugufasha gukoresha neza igihe cyawe n'umuganga wawe kandi bikwizeza ko ubonye amakuru yose ukeneye. Gutegura neza kandi bifasha umuganga wawe gusobanukirwa neza umwanya wawe.

Mbere y'inama yawe:

• Andika ibimenyetso byawe byose, harimo igihe byatangiye n'uburyo bikunze kubaho
• Zana imiti yawe yose, harimo ibintu byongera imirire n'imiti yo mu rugo
• Tegura ibibazo ku bijyanye n'ibyavuye mu isuzuma, uburyo bwo kuvura, n'ibyo utegereje
• Kora dosiye y'amakuru y'ubuvuzi yavuye ku bandi baganga
• Tegereza kuzana umuntu wo mu muryango cyangwa inshuti kugira ngo aguhe inkunga kandi aguhe ubufasha mu kwibuka amakuru

Andika ibibazo byihariye ushaka kubabaza, nko kumenya ubwoko bw'udukoko ufite, uburyo bwo kuvura buhari, n'ibyo utegereje mu gihe kizaza. Ntugatinye gusaba ibisobanuro niba hari ikintu kidakumenyerewe.

Wibuke ko ibi ari ubuzima bwawe, kandi ufite uburenganzira bwo gusobanukirwa neza uko uhagaze. Umuganga mwiza azatwara igihe cyo gusubiza ibibazo byawe no kugufasha kumva neza gahunda yawe y'ubuvuzi.

Ese ni iki kintu cy'ingenzi cyo kwibuka ku bijyanye n'ibintu byo mu bwonko?

Ese ni ibibazo byoroshye bigira ingaruka ku turemangingo dukora imisemburo mu mubiri wawe wose. Nubwo kubona aya makuru bishobora kuba bigoye, abantu benshi bafite aya maduka babaho ubuzima buzuye, bukorwa neza, bafite ubuvuzi bukwiye no gukurikiranwa.

Ibintu by'ingenzi cyane byo kwibuka ni uko aya maduka akunda gukura buhoro, uburyo bwinshi bwo kuvura buhari, kandi kubona hakiri kare bikunze gutera ibyiza. Itsinda ryawe ry'ubuvuzi rizakorana nawe kugira ngo ritegure gahunda y'ubuvuzi ikwiranye n'umwanya wawe.

Ntugatinye kubabaza ibibazo, gushaka ibindi byifuzo niba bikenewe, no kwiringira abaguha inkunga muri uru rugendo. Hamwe n'ubuvuzi bugezweho n'uburyo bwo gukurikirana, ibyiringiro by'abantu bafite ibintu byo mu bwonko bikomeza kuzamuka.

Ibibazo bikunze kubazwa ku bijyanye n'ibintu byo mu bwonko

Ese ibintu byo mu bwonko bihora ari kanseri?

Oya, ibintu byo mu bwonko bishobora kuba byiza (utari kanseri) cyangwa bibi (kanseri). Ese ni udukoko twinshi dukura buhoro cyane kandi bishobora kutakwirakwira mu bindi bice by'umubiri wawe. Umuganga wawe azamenya niba udukoko twawe ari byiza cyangwa bibi binyuze mu bipimo bitandukanye birimo biopsy n'ibizamini by'amashusho.

Ese ibintu byo mu bwonko bishobora gukira burundu?

Yego, ibintu byinshi byo mu bwonko bishobora gukira burundu, cyane cyane iyo byafashwe hakiri kare kandi bitarakwirakwira mu gice cyacyo. Kubaga bishobora gukuraho udukoko twose, bigatuma ukira burundu. Nubwo gukira bitashoboka, abantu benshi babaho imyaka myinshi bafite ubuvuzi bukwiye n'ubuvuzi.

Ese nzakenera ubuvuzi ako kanya niba narabimenye?

Si ngombwa. Ese ni udukoko twinshi tw'ibintu byo mu bwonko dukura buhoro bishobora gukurikiranwa n'isuzuma rya buri gihe n'ibizamini by'amaraso batavuwe. Ubu buryo, twita active surveillance cyangwa gutegereza, bugufasha kwirinda ingaruka mbi z'ubuvuzi mu gihe ubwira umuganga ko udukoko tudahindutse. Umuganga wawe azagutegeka ubuvuzi ako kanya gusa niba udukoko dukomeje gukura, gutera ibimenyetso, cyangwa gukora imisemburo myinshi.

Ese umunaniro cyangwa imirire bishobora gutera ibintu byo mu bwonko?

Oya, ibintu byo mu bwonko ntibiterwa n'umunaniro, imirire, cyangwa imikorere y'ubuzima. Aya maduka akura kubera impinduka za gene mu turemangingo bikunze kubaho mu buryo butunguranye igihe kinini. Nubwo ibiryo bimwe bishobora gutera ibimenyetso mu bantu basanzwe bafite udukoko dukora imisemburo, ntibitera aya maduka ubwayo gukura.

Ese nzakenera inama zikurikiranye n'ibizamini kenshi gute?

Gahunda yo gukurikirana ihinduka bitewe n'ubwoko bw'udukoko, ubuvuzi, n'ubuzima muri rusange. Abantu benshi bakenera isuzuma buri mezi 3-6 mu ntangiriro, ibyo bishobora kuzamuka rimwe cyangwa kabiri mu mwaka uko igihe gihita. Umuganga wawe azakenera ibizamini by'amaraso n'ibizamini by'amashusho kugira ngo akurikirane uko uhagaze. Ubwinshi nyakuri buzaba buhuye n'umwanya wawe n'uburyo ubayeho neza mu buvuzi.