Cancer, Syndromes Paraneoplasiques

Indwara ziterwa n'ibyago bya kanseri ku mutwe, ni ubwumwe bw'ibibazo bitoroshye bibaho ku bamwe mu barwaye kanseri. Uretse ubwonko, izi ndwara zishobora no kwibasira ibindi bice by'umubiri, birimo imisemburo, uruhu, amaraso n'ingingo.

Indwara ziterwa n'ibyago bya kanseri ku mutwe zibaho iyo ibintu byo mu mubiri birwanya kanseri bigatuma n'ibice by'ubwonko, umugongo, imitsi yo ku ruhu cyangwa imikaya bigabanyuka.

Bitewe n'aho mu mutwe habaye ikibazo, izi ndwara zishobora kugira ingaruka ku mikorere y'imikaya, guhuza ibikorwa by'umubiri, gutahura ibintu, kwibuka, ubwenge cyangwa no gusinzira.

Rimwe na rimwe, ikibazo cyangiza ubwonko gishobora gukira hakoreshejwe ubuvuzi bugamije kanseri n'ubwirinzi bw'umubiri. Ariko rimwe na rimwe, izi ndwara zishobora gutera iyangirika ry'ubwonko ridakira.

Kuvura kanseri n'ubundi buvuzi bishobora gukumira iyangirika ry'ubwonko no kunoza ubuzima bw'umurwayi.

Ibimenyetso bya syndrome ya paraneoplastique y'imiterere y'ubwonko bishobora kuza vuba cyane, akenshi mu minsi cyangwa mu byumweru. Akenshi bitangira mbere y'uko kanseri imenyekana.\n\nIbimenyetso bihinduka bitewe n'igice cy'umubiri cyangiritse, kandi bishobora kuba birimo:\n\n- Kugorana kogenda.\n- Kugorana guhagarara.\n- Gutakaza ubushobozi bwo guhuza imitsi.\n- Gutakaza imbaraga z'imitsi cyangwa intege nke.\n- Gutakaza ubuhanga bwo gukora ibintu bito, nko gufata ibintu.\n- Kugorana kwishima.\n- Kuvuga nabi cyangwa guhindagurika.\n- Gutakaza kwibuka n'izindi mpamvu zo gutekereza nabi.\n- Impinduka z'ububone.\n- Kugorana gusinzira.\n- Kugwa mu marangamutima.\n- Kubona ibintu bitariho.\n- Imitwaro idashobora kugenzurwa.\n\nIngero za syndrome ya paraneoplastique y'imiterere y'ubwonko harimo:\n\n- Degeneration ya Cerebellar, izwi kandi nka ataxia ya cerebellar. Muri iyi syndrome, gutakaza uturemangingo tw'imitsi bibaho mu gice cy'ubwonko cyitwa cerebellum gicunga imikorere y'imitsi n'uburinganire. Ibimenyetso bishobora kuba birimo kugorana kogenda, kutagira ubushobozi bwo guhuza amaboko n'amaguru, kugorana guhagarara, no guhindagurika. Bishobora kandi kuba birimo isereri, imitwaro y'amaso idashobora kugenzurwa, kubona ibintu bibiri, kugorana kuvuga cyangwa kugorana kwishima.\n- Encephalitis ya Limbic. Iyi syndrome ijyanye no kubyimba, bizwi nko kwangirika, mu gice cy'ubwonko cyitwa limbic system. Limbic system igenzura amarangamutima, imyitwarire n'imikorere imwe y'urwibutso. Abantu bafite iyi ndwara bashobora kugira impinduka mu mico cyangwa mu marangamutima, gutakaza kwibuka, kugwa mu marangamutima, kubona ibintu bitariho, cyangwa ubunebwe.\n- Encephalomyelitis. Iyi syndrome ivuga ku kwangirika kw'ubwonko n'umugongo. Bishobora kuba hari ibimenyetso bitandukanye bitewe n'igice cyangiritse.\n- Opsoclonus-myoclonus. Iyi syndrome ibaho iyo cerebellum cyangwa ibyo ikorana na byo bitakora neza. Bishobora gutera imitwaro y'amaso yihuta, idahwitse n'imitsi y'amaboko, amaguru n'igituza. \n- Stiff person syndrome. Mbere yari izwi nka stiff man syndrome, iyi syndrome itera ubukana bukomeye bw'imitsi, bizwi nko gukomera, bikagenda biba bibi uko igihe gihita. Ubukana bugira ingaruka ahanini ku mugongo n'amaguru. Bishobora kandi gutera imitego y'imitsi ibabaza.\n- Myelopathy. Iyi mvugo ivuga kuri syndrome ijyanye no kwangirika kw'umugongo. Ibimenyetso biterwa n'igipimo cyo kwangirika kw'umugongo. Ibimenyetso bishobora kuba birimo impinduka mu mikorere y'amara n'umutwe, n'intege nke n'ubupfapfa kugeza ku rwego runaka mu mubiri. Niba urwego rw'ibyangiritse ruhariye mu ijosi, bishobora gutera ubumuga bukomeye bugira ingaruka ku maboko n'amaguru.\n- Lambert-Eaton myasthenic syndrome. Iyi syndrome iterwa no guhagarika itumanaho hagati y'imitsi n'imitsi. Ibimenyetso birimo intege nke z'imitsi mu kibuno n'amaguru, n'umunaniro. Bishobora kandi gutera kugorana kwishima no kuvuga, imitwaro y'amaso idahwitse, no kubona ibintu bibiri. Ibindi bimenyetso bishobora kuba birimo umunwa wumye n'ikibazo cyo kubura ubushobozi bwo gutera akabariro.\n\nIyo bibaye nk'indwara ya paraneoplastique, Lambert-Eaton myasthenic syndrome isanzwe ifitanye isano na kanseri y'ibihaha.\n- Myasthenia gravis. Myasthenia gravis ifitanye isano no guhagarika itumanaho hagati y'imitsi n'imitsi. Abantu bafite myasthenia gravis bagira intege nke n'umunaniro wihuta w'imitsi yose iri munsi y'igenzura ry'ubushake. Ibi birimo imitsi yo mu maso, amaso, amaboko n'amaguru. Imitsi ikoreshwa mu kuruma, kwishima, kuvuga no guhumeka ishobora kugira ingaruka.\n\nIyo myasthenia gravis iba nk'indwara ya paraneoplastique, isanzwe ifitanye isano na kanseri y'umusemburo wa thymus, izwi nka thymoma.\n- Neuromyotonia, izwi kandi nka Isaacs' syndrome. Neuromyotonia ibaho iyo hari umubare munini w'impulso z'imitsi zigengura imitsi. Ibi bizwi nko kwihuta kw'imitsi y'ibice by'umubiri. Izi impulso zishobora gutera guhindagurika, imitsi ihindagurika isa nka "umufuka w'udusimba" n'ubukana bukomeza kuba bubi uko igihe gihita. Bishobora kandi gutera imitego y'imitsi, kugenda buhoro n'ibindi bibazo by'imitsi.\n- Peripheral neuropathy. Muri iyi ndwara, imitsi ituma ubutumwa buva mu bwonko cyangwa umugongo bugera ku bindi bice by'umubiri yangiritse. Iyi mitsi izwi nka peripheral nerves. Iyo iyangirika ririmo imitsi y'ubwenge gusa, itera ububabare n'impinduka z'ubwenge aho ari ho hose mu mubiri.\n\nLambert-Eaton myasthenic syndrome. Iyi syndrome iterwa no guhagarika itumanaho hagati y'imitsi n'imitsi. Ibimenyetso birimo intege nke z'imitsi mu kibuno n'amaguru, n'umunaniro. Bishobora kandi gutera kugorana kwishima no kuvuga, imitwaro y'amaso idahwitse, no kubona ibintu bibiri. Ibindi bimenyetso bishobora kuba birimo umunwa wumye n'ikibazo cyo kubura ubushobozi bwo gutera akabariro.\n\nIyo bibaye nk'indwara ya paraneoplastique, Lambert-Eaton myasthenic syndrome isanzwe ifitanye isano na kanseri y'ibihaha.\n\nMyasthenia gravis. Myasthenia gravis ifitanye isano no guhagarika itumanaho hagati y'imitsi n'imitsi. Abantu bafite myasthenia gravis bagira intege nke n'umunaniro wihuta w'imitsi yose iri munsi y'igenzura ry'ubushake. Ibi birimo imitsi yo mu maso, amaso, amaboko n'amaguru. Imitsi ikoreshwa mu kuruma, kwishima, kuvuga no guhumeka ishobora kugira ingaruka.\n\nIyo myasthenia gravis iba nk'indwara ya paraneoplastique, isanzwe ifitanye isano na kanseri y'umusemburo wa thymus, izwi nka thymoma.

Ibimenyetso bya syndrome ya paraneoplastique y'imiterere y'ubwonko bisa n'ibimenyetso bya byinshi mu ndwara, harimo kanseri, ingaruka za kanseri ndetse na bimwe mu buvuzi bwa kanseri.

Ariko rero, niba ufite ibimenyetso bigaragaza syndrome ya paraneoplastique, reba umuganga wawe vuba bishoboka. Kugirango hamenyekane hakiri kare kandi hahabwe ubuvuzi bukwiye ni ingenzi mu kuvura kanseri no gukumira ibindi byangiza ubwonko.

Indwara ziterwa n'uburwayi bwa kanseri zifata urubuga rw'imiterere y'imyakura ntizigizwe n'uturemangingo twa kanseri ubwabyo cyangwa kanseri ikwirakwira, bizwi nko gukwirakwira kwa kanseri. Ntizigizwe kandi n'ibindi bibazo, nko kwandura cyangwa ingaruka z'ubuvuzi. Ahubwo, izi ndwara zigaragara hamwe na kanseri kubera ko ubudahangarwa bw'umubiri bwakozwe. Abashakashatsi bemeza ko indwara ziterwa n'uburwayi bwa kanseri zifata urubuga rw'imiterere y'imyakura ziterwa n'ubushobozi bw'ubudahangarwa bw'umubiri bwo kurwanya kanseri. By'umwihariko, imiti igwanya indwara n'uturemangingo bimwe by'amaraso yera, bizwi nka T cells, birizwa kuba birimo. Aho kugaba igitero ku turemangingo twa kanseri gusa, ibi bintu by'ubudahangarwa bw'umubiri bigaba igitero no ku turemangingo twiza tw'imiterere y'imyakura.

Kanseri iyo ari yo yose ishobora guherekezwa na syndrome ya paraneoplastique y'imiterere y'ubwonko. Ariko, ikunda kugaragara cyane mu bantu barwaye kanseri y'ibihaha, iy'ovari, iy'amabere, iy'intanga ngabo cyangwa iy'impyiko.

Kugira ngo hamenyekane indwara y'imitsi iterwa n'uburwayi bwa kanseri, bishobora kuba ngombwa gukora isuzuma rusange n'ibipimo by'amaraso. Bishobora kandi kuba ngombwa gukora ibizamini byo kubona amashusho cyangwa igikorwa cyo kubaga umutima, kizwi kandi nka lumbar puncture.

Kubera ko indwara z'imitsi ziterwa na kanseri zifitanye isano na kanseri, bishobora kuba ngombwa gukora ibizamini byo kwipima kanseri hashingiwe ku myaka yawe.

Umuganga wawe cyangwa umuganga w'indwara z'imitsi azakora isuzuma rusange n'isuzuma ry'imitsi. Uzabazwa ibibazo kandi umuganga wawe azakora ibizamini byoroshye mu biro kugira ngo amenye:

• Imikorere y'imitsi.
• Imbara y'imitsi.
• Uburyo imitsi ikora.
• Uburyo bw'uruhu.
• Ububonye n'ukumva.
• Ubushobozi bwo guhuza ibikorwa.
• Ubushobozi bwo kubungabunga umubiri.
• Imimerere y'umutima.
• Ubwenge.

Ibizamini bya laboratwari bishobora kuba birimo:

• Ibizamini by'amaraso. Ushobora guhabwa igipimo cy'amaraso kugira ngo hakorwe ibizamini byinshi, birimo ibizamini bigamije kumenya antikorps zihora zifitanye isano n'indwara z'imitsi ziterwa na kanseri. Ibindi bipimo bishobora gufasha kumenya indwara, ibibazo by'imisemburo cyangwa ibibazo mu gukoresha intungamubiri, bizwi nka metabolic condition.
• Kubaga umutima, bizwi kandi nka lumbar puncture. Mu gihe cyo kubaga umutima, hafatwa igipimo cy'amazi yo mu bwonko (CSF). CSF irinda ubwonko na spinal cord. Umuganga w'indwara z'imitsi cyangwa umuforomo watojwe neza ashyira umugozi mu mugongo wawe kugira ngo akureho igipimo gito cya CSF kugira ngo gisuzuzwe.

Rimwe na rimwe antikorps ziterwa na kanseri zishobora kuboneka muri CSF ariko ntizishobora kuboneka mu maraso yawe. Niba izi antikorps ziboneka muri CSF na maraso yawe, bitanga ibimenyetso bikomeye byerekana ko indwara y'imitsi iterwa na kanseri ari yo itera ibimenyetso.

Kubaga umutima, bizwi kandi nka lumbar puncture. Mu gihe cyo kubaga umutima, hafatwa igipimo cy'amazi yo mu bwonko (CSF). CSF irinda ubwonko na spinal cord. Umuganga w'indwara z'imitsi cyangwa umuforomo watojwe neza ashyira umugozi mu mugongo wawe kugira ngo akureho igipimo gito cya CSF kugira ngo gisuzuzwe.

Rimwe na rimwe antikorps ziterwa na kanseri zishobora kuboneka muri CSF ariko ntizishobora kuboneka mu maraso yawe. Niba izi antikorps ziboneka muri CSF na maraso yawe, bitanga ibimenyetso bikomeye byerekana ko indwara y'imitsi iterwa na kanseri ari yo itera ibimenyetso.

Ibizamini byo kubona amashusho bikoresha kugira ngo hamenyekane uburwayi bwa kanseri cyangwa ibindi bintu biterwa n'ibimenyetso byawe. Kimwe cyangwa ibindi bizamini bikurikira bishobora gukoreshwa:

• Computerized tomography (CT) ni ikoranabuhanga rya X-ray ridasanzwe riha amashusho mato mato y'ingingo.
• Magnetic resonance imaging (MRI) ikoresha ikirere cya magnetique n'amajwi ya radio kugira ngo ikore amashusho mato mato cyangwa amashusho atatu y'ingingo z'umubiri wawe.
• Positron emission tomography (PET) ikoresha ibintu bya radioactive byinjijwe mu maraso yawe kugira ngo ikore amashusho mato mato cyangwa amashusho atatu y'umubiri. PET scan ishobora gukoreshwa mu kumenya uburwayi bwa kanseri, gupima metabolism mu ngingo, kwerekana imiterere y'amaraso no kubona impinduka mu bwonko zifitanye isano n'indwara z'ubwonko.
• PET plus CT, ihuriro rya PET na CT, ishobora gufasha mu kubona kanseri nto. Kanseri nto ni zo zisanzwe ziboneka mu bantu bafite indwara z'imitsi ziterwa na kanseri.

Niba ibizamini bitabona uburwayi bwa kanseri cyangwa ikindi kintu gitera ibimenyetso byawe, ushobora kuba ufite uburwayi bwa kanseri bukiri buto cyane ngo buboneke. Uburwayi bwa kanseri bushobora kuba butera igikorwa gikomeye cy'ubudahangarwa bw'umubiri bukubungabunga buto cyane. Umuganga wawe ashobora kugusaba gukora ibizamini byo gukurikirana buri mezi 3 kugeza kuri 6 kugeza igihe impamvu izaboneka.

Ururimi ku burwayi bwa kanseri, nka chimiothérapie, umuganga wawe ashobora kwandika imiti imwe cyangwa irenga. Iyi miti ishobora gufasha guhagarika ubudahangarwa bwawe gutera akaga ku mikorere y'ubwonko bwawe:

Bitewe n'ubwoko bwa syndrome ya paraneoplastique n'ibimenyetso, imiti indi ishobora kuba irimo:

• Imiti yo kurwanya ibitero by'ubwonko, bishobora gufasha kugenzura ibitero by'ubwonko bifitanye isano na syndromes ziterwa no kudakora neza kw'amashanyarazi mu bwonko.
• Imiti igamije kunoza itumanaho hagati y'imikaya n'imitsi. Iyi miti ishobora kunoza ibimenyetso bya syndromes zigira ingaruka ku mikorere y'imitsi. Imiti imwe inonosora isohorwa ry'intumwa ikorana n'ubutumwa butuma umubiri ukorana n'imitsi. Imiti indi, nka pyridostigmine (Mestinon, Regonol), ihagarika kwangirika kw'izi ntumwa.

Ubundi buryo bwo kuvura bushobora kunoza ibimenyetso birimo:

• Plasmapheresis. Ubu buryo butandukanya igice cya fluide cy'amaraso, cyitwa plasma, mu uturemangingabo tw'amaraso hakoreshejwe igikoresho kizwi nka blood cell separator. Plasma, irimo antibodies itera ibimenyetso, irasimburwa n'izindi fluide. Utugize amaraso utukura n'utw'umweru, hamwe n'ibipapuro by'amaraso, bisubizwa mu mubiri wawe.
• Intravenous immunoglobulin (IVIg). Immunoglobulin irimo antibodies nzima zivuye mu badahangayikishijwe. Ibiyiko byinshi bya immunoglobulin byongera umuvuduko wo kwangiza antibodies yangiza mu maraso yawe.

Niba ufite syndrome ya paraneoplastic neurologique, birabujijwe gukoresha imiti imwe yo kuvura kanseri yitwa immune checkpoint inhibitors. Ubu buryo bukoresha ubudahangarwa mu kurwanya kanseri. Nubwo ibi bishobora gufasha kwangiza kanseri, bishobora kandi gutera ububi bw'igitero cy'ubudahangarwa ku mikorere y'ubwonko.

Ubundi buryo bwo kuvura bushobora gufasha niba syndrome ya paraneoplastique yateje ubumuga:

• Umuti ngororamubiri. Imikino yihariye ishobora kugufasha gusubirana imikorere y'imitsi yabuze.
• Umuti w'amagambo. Umuti w'amagambo ashobora kugufasha kongera kwiga uburyo bwo gukoresha imitsi niba ugira ikibazo cyo kuvuga cyangwa kwishima.

Abantu benshi barwaye kanseri bagira inyungu mu kumenya no kubona ibikoresho bigenewe kunoza ubushobozi bwo guhangana n'ibibazo. Niba ufite ibibazo cyangwa ushaka ubuyobozi, hagira umuntu wo mu itsinda ry'abaganga bawe. Uko umenya byinshi ku burwayi bwawe, ni ko ubasha kugira uruhare mu myanzuro yerekeye ubuvuzi bwawe.

Amatsinda y'ubufasha ashobora kukuzanira abandi bahuye n'ibibazo nk'ibyo uhura na byo. Niba udashobora kubona itsinda ry'ubufasha rikwiye aho uba, ushobora kubona rimwe kuri internet.