Ukuthi yini i-Ewing Sarcoma? Izimpawu, Izimbangela, kanye Nokwelashwa

I-Ewing sarcoma uhlobo oluyimfihlo lomdlavuza oluthinta ikakhulu amathambo nemitho yomzimba, oluvela kakhulu kubantwana nabantu abadala abasebancane. Lo mdlavuza onamandla uvamise ukuvela emathanbeni amade esandleni nasezinzweni, emathanbeni omzimba, ezinhlangothini, noma emgogodleni, nakuba ngezinye izikhathi ungase ubonakale emithoni yomzimba efana nemisipha noma amanoni.

Nakuba ukuxilongwa kungase kube nzima, ukuthuthuka ekwelapheni kuye kwathuthukisa kakhulu imiphumela eminingi yabagula. Ukuqonda lesi simo kungakusiza ukuthi uqhubeke nohambo oluzayo ngokuzethemba okukhulu nokuqonda.

Ukuthi yini i-Ewing Sarcoma?

I-Ewing sarcoma iyingxenye yomndeni wemidlavuza ebizwa ngokuthi i-Ewing sarcoma family of tumors (ESFT). Le midlavuza iqala lapho amaseli athile eqala ukukhula ngokungenakulawuleka, akha iziphumu ezingase zisakazeke kwezinye izingxenye zomzimba uma zingalashwa.

Lo mdlavuza uvamise ukuthinta abantu abaneminyaka ephakathi kuka-10 no-20, nakuba ungase ubonakale kunoma iyiphi iminyaka. Umelela cishe i-1% yemidlavuza yabantwana, okwenza kube yinto eyingozi kodwa edinga ukunakekelwa okukhethekile uma kwenzeka.

Lo mdlavuza uqanjwe ngegama likaDkt. James Ewing, owawuchaza okokuqala ngo-1921. Okwenza i-Ewing sarcoma ibe yiyona i-genetic makeup yayo ethile nendlela esabela ngayo ezindleleni zokwelapha ezithile.

Ziyini Izimpawu ze-Ewing Sarcoma?

Izimpawu zokuqala ze-Ewing sarcoma ngezinye izikhathi zingase ziphuthelwe njengezinxeba eziqhelekile noma ubuhlungu bokuthola, kungakho kubalulekile ukunaka izimpawu eziqhubeka noma eziyanda ngokuhamba kwesikhathi.

Izimpawu ezivamile zihlanganisa:

• Ubuhlungu obuhlala njalo emathanbeni noma ezinhlangothini obungase bube sibi ebusuku noma ngenkathi usebenza
• Ukukhula noma i-lump ebonakalayo eduze kwendawo ethintekile
• Ukweqileka kwamathani okwenzeka ngokuthinta okuncane
• Ukukhubazeka noma ukukhuluphala kokunyakaza indawo ethintekile
• Ukukhathala nokuzizwa okungekuhle ngokujwayelekile
• Ukuqhuma okufika futhi kuhamba ngaphandle kwesizathu esicacile
• Ukulahlekelwa isisindo ngaphandle kokuzikhandla

Izimpawu ezingavamile kodwa ezinobuhlungu kakhulu zingase zihlanganise ubunzima bokuthola umoya uma i-tumor ithinta indawo yesifuba, noma ukungabi namandla nobuthakathaka uma icinezela izinzwa. Lezi zimpawu zidinga ukunakekelwa kwezokwelapha ngokushesha.

Ziyini Izinhlobo ze-Ewing Sarcoma?

Odokotela bahlukanisa i-Ewing sarcoma ngokuthi ivela kuphi emzimbeni wakho. Izinhlobo eziyinhloko zisiza ukuqondisa izinqumo zokwelapha futhi zikunikeze isithombe esicacile sokuthi yini okulindelekile.

I-Skeletal Ewing sarcoma ivela emathanbeni futhi imelela cishe i-80% yazo zonke izimo. Ivamise ukuthinta i-pelvis, izinhlangothi, umgogodla, namathambo amade esandleni nasezinzweni. Lo mbono uvamise ukubangela ubuhlungu emathanbeni futhi ungase uholele ekweqilekeni kwamathani.

I-Extraosseous Ewing sarcoma ikhula emithoni yomzimba kunamathani, okwenza kube cishe i-20% yezimo. Ingase ikhule ezinzwini, emathaneni, noma kwezinye izitho zomzimba kunoma yikuphi emzimbeni, kufaka phakathi udonga lwesifuba, izandla, izinzwani, noma i-pelvis.

Womabili lawo mabala ahlanganyela izici ezifanayo ze-genetic futhi aphendule ngezindlela ezifanayo zokwelapha, nakuba indawo ingase ithinte izinketho zokuthunga nohlelo lokwelapha oluphelele.

Yini ebangela i-Ewing Sarcoma?

I-Ewing sarcoma ivela ngenxa yokushintsha kwe-genetic okuqondile okwenzeka ngokungahleliwe kumaseli, hhayi ngenxa yanoma yini owenzile wena noma umndeni wakho. Lezi zinguquko azithathwa kubazali ezimweni eziningi.

Umdlavuza uqala lapho amajini amabili ehlangana ngokungajwayelekile, edala lokho odokotela abakubiza ngokuthi i-fusion gene. Ukuxuba okuvamile kuhilela i-EWSR1 gene ne-FLI1 gene, okwenzeka cishe ku-85% yezimo. Leli phutha le-genetic liyenza amaseli akhule ngokungenakulawuleka.

Ngokungafani nezinye izinhlobo zomdlavuza, i-Ewing sarcoma ayixhunyaniswanga nezici zokuphila njengokubhema, ukudla, noma ukukhishwa kwemvelo. Kubonakala sengathi kuyisenzakalo se-genetic esingahleliwe esingase senzeke kunoma ubani, nakuba kuvame kakhulu kubantu baseYurophu.

Abacwaningi baqhubeka becwaninga ukuthi kungani lezi zinguquko ze-genetic zenzeka, kodwa njengamanje, ayikho indlela eyaziwayo yokuvimbela ukwenzeka kwazo.

Nini Okufanele Ubone Udokotela Nge-Ewing Sarcoma?

Kufanele uxhumane nodokotela wakho uma uhlushwa ubuhlungu obuhlala njalo emathanbeni noma ezinhlangothini obungaphuli ngokuphumula noma obube sibi ngokuhamba kwesikhathi. Nakuba ubuhlungu obuningi abubibi, kubalulekile ukuba izimpawu eziqhubekayo ziqondiswe.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uqaphela ukukhula noma ama-lump angachazeki, ikakhulu uma ekhula noma ebangela ukungakhululeki. Ukweqileka kwamathani okwenzeka ngenxa yezinxeba ezincane noma imisebenzi evamile futhi kudinga ukuhlolwa ngokushesha.

Ungalindi uma uhlushwa ukuqhuma kanye nobuhlungu emathanbeni, ukulahlekelwa isisindo okungachazeki, noma ukukhathala okukhulu okuhlupha imisebenzi yansuku zonke. Lezi zinhlobo zezimpawu zidinga ukuhlolwa ngumuntu ochwepheshe.

Thembani izinzwa zakho uma kukhona okungalungile. Ukuhlolwa kwasekuqaleni kungenza umehluko omkhulu emiphumeleni yokwelapha, futhi iqembu lakho lezokunakekelwa kwezempilo lilapho ukuze likusize ukuthola ukuthi yini ebangela izimpawu zakho.

Ziyini Izingozi Ze-Ewing Sarcoma?

Ukuqonda izingozi kungakusiza ukuthi uqonde ukuthi kungani lo mdlavuza uqalile, nakuba kubalulekile ukwazi ukuthi ukuba nezingozi akusho ukuthi umuntu uzothola umdlavuza ngokuqinisekile.

Iminyaka idlala indima enkulu, ngezimo eziningi ezenzeka phakathi kweminyaka engu-10 no-20. Noma kunjalo, i-Ewing sarcoma ingase ithinte abantu abadala, ikakhulu labo abaneminyaka engu-20 no-30, nakuba lokhu kuya kuba yinto engavamile ngokuhamba kweminyaka.

Ubuzwe kubonakala buthinta ingozi kakhulu. Abantu baseYurophu noma baseCaucasian banesilinganiso esikhulu sokuthola i-Ewing sarcoma uma kuqhathaniswa nalabo base-Afrika, Asia, noma base-Hispanic, nakuba izizathu zalokhu zingaqondakali ngokuphelele.

Ubulili lubonisa iphethini encane, ngamadoda anethuba elikhulu lokuthola lo mdlavuza kunabesifazane. Ukwelashwa kwangaphambili ngomgogodla ngenxa yezinye izinhlobo zomdlavuza kungase kukhulise ingozi kancane, kodwa lokhu kuyinto engavamile kakhulu.

Abantu abaningi abane-Ewing sarcoma abanazo izingozi eziqondakali, okuqinisekisa ukuthi lo mdlavuza uvamise ukuvela ngokungahleliwe kunokuba ube ngenxa yezizathu ezingavikeleka.

Ziyini Izinselele Ezingase Zenzeke Nge-Ewing Sarcoma?

Nakuba ukuxoxa ngezingozi kungase kube nzima, ukuqonda izinselele ezingase zenzeke kukusiza ukulungiselela nokusebenza neqembu lakho lezokwelapha ukuze uzivimbele noma uzilawule ngokuphumelelayo.

Ukukhathazeka okukhulu kakhulu ukusabalala, lapho amaseli omdlavuza esakazeka kwezinye izingxenye zomzimba. I-Ewing sarcoma ivame ukusabalala emaphaphwini, kwezinye amathambo, noma emathaneni. Cishe i-20-25% yabagula inezibonakaliso zokusabalala ngesikhathi sokuxilongwa.

Izinselele ezihlobene nokwelapha zingase zihlanganise imiphumela emibi yekhemitherapi njengokwanda kwengozi yokutheleleka, isicanucanu, ukulahlekelwa izinwele, nemiphumela emibi yesikhathi eside emisebenzi yentliziyo noma yizinkalweni. Ukwelashwa ngomgogodla kungase kubangele ukushintsha kwesikhumba futhi, ngezinye izikhathi, imidlavuza yesibili eminyakeni eminingi kamuva.

Izinselele zokuthunga ziyahlukahluka kuye ngendawo ye-tumor kodwa zingase zihlanganise ukushintsha kwemisebenzi yelungu, isidingo se-prosthetics, noma izinselele zokwakha kabusha. Izinkinga zokukhula zingase zenzeke kubantwana uma ukwelapha kuthinta ama-growth plates emathaneni.

Imiphumela yesikhathi eside ingase ivele eminyakeni eminingi ngemuva kokwelapha, kufaka phakathi ukukhathazeka ngokuzala, izinkinga zentliziyo, noma imidlavuza yesibili. Noma kunjalo, abantu abaningi baqhubeka bephila impilo ezele, enempilo ngemuva kokwelapha, futhi iqembu lakho lezokwelapha liqapha lezi zinto ukuze lizixazulule ngokushesha uma zenzeka.

Ukuthi yini i-Ewing Sarcoma?

Ukuxilongwa kwe-Ewing sarcoma kuhilela izinyathelo eziningana ukuze kuqinisekiswe umdlavuza futhi kunqunywe ubukhulu bawo. Udokotela wakho uzoqala ngokuhlola okuphelele nokubuyekezwa kwezimpawu zakho nomlando wakho wezokwelapha.

Izivivinyo zokuthola izithombe zisiza ukubona i-tumor nokuhlola ukusabalala. Ama-X-rays avame ukuza kuqala, alandelelwe yi-MRI scans ukuze ubone izithombe ezinemininingwane yendawo ethintekile. Ama-CT scans esifuba futhi ngezinye izikhathi ama-PET scans asisiza ukuthola ukuthi umdlavuza usakazeke kwenye indawo.

I-biopsy inikeza ukuxilongwa okuqinisekile ngokususa ingxenye encane yethishu ye-tumor ukuze ihlolwe elabhoratri. Abaphathi be-pathologists bafuna ukushintsha kwe-genetic okuqondile okuqinisekisa i-Ewing sarcoma, ikakhulu ukuxuba kwamajeni okukhulunywe ngakho ngaphambili.

Izivivinyo ezengeziwe zingase zihlanganise ama-bone marrow biopsies ukuze ahlole amaseli omdlavuza emathaneni, nezivivinyo zegazi ukuze ahlole impilo yonke ngaphambi kokuba ukwelapha kuqale. Lokhu kuhlolwa okuphelele kuvame ukuthatha amasonto ambalwa kodwa kuqinisekisa ukuthi uhlelo lwakho lokwelapha luqondene nesimo sakho.

Ukuthi yini Ukwelashwa kwe-Ewing Sarcoma?

Ukuphathwa kwe-Ewing sarcoma ngokuvamile kuhilela indlela ehlangene yokusebenzisa i-chemotherapy, ukuthunga, futhi ngezinye izikhathi ukwelashwa ngomgogodla. Le nqubo enezinyathelo eziningi iye yathuthukisa imiphumela ngeminyaka engaphelileyo.

I-Chemotherapy ngokuvamile iqala kuqala ukuze inciphise i-tumor futhi iwelaphe noma yimaphi amaseli omdlavuza angase asakazeke kodwa angabonakali. Imithi evamile ihlanganisa i-vincristine, i-doxorubicin, i-cyclophosphamide, i-ifosfamide, ne-etoposide, ngokuvamile inikezwa ngokuhlanganyela izinyanga eziningi.

Ukuphathwa kwendawo kulandela, kuhilela ukuthunga ukususa i-tumor noma ukwelashwa ngomgogodla uma ukuthunga kungenakwenzeka. Ukukhetha kuncike ezintweni ezifana nendawo ye-tumor, ubukhulu, nendlela esabela ngayo e-chemotherapy yokuqala.

Ukuthunga kugqamele ukususa yonke i-tumor ngenkathi kulondolozwa imisebenzi evamile ngangokunokwenzeka. Ngezinye izikhathi lokhu kudinga izinqubo zokulondoloza amalungu, ngenkathi kwezinye izikhathi, ukususa ingxenye yomzimba kungase kudingeke ukuze kube khona umphumela omuhle.

Ukuphathwa ngomgogodla kusebenzisa imisebe yamandla aphezulu ukubhubhisa amaseli omdlavuza futhi kungase kusetshenziswe esikhundleni sokuthunga noma ngaphezu kwakho. Uhlelo lokwelapha ngokuvamile luhlala izinyanga eziningi futhi ludinga ukubambisana eduze phakathi kwezinhloli ezahlukene.

I-Chemotherapy eyengeziwe ngokuvamile ilandela ukwelashwa kwendawo ukuze isuse noma yimaphi amaseli omdlavuza asaleyo. Kuyo yonke inqubo yokwelapha, iqembu lakho liqapha impendulo yakho futhi lilungise uhlelo njengoba kudingeka.

Ukuthi Ungayiphatha Kanjani Ukukhathalela Ekhaya Ngesikhathi Sokwelashwa Kwe-Ewing Sarcoma?

Ukuphatha impilo yansuku zonke ngesikhathi sokwelapha kudinga ukulungiswa okuthile, kodwa imisebenzi eminingi ingaqhubeka ngenhlelo efanele nokusekelwa yiqembu lakho lezokwelapha.

Ukuvimbela ukutheleleka kuba yinto ebalulekile ngesikhathi se-chemotherapy lapho i-immune system yakho ingase ibe buthakathaka. Lokhu kusho ukugeza izandla njalo, ukugwema izixuku lapho inani legazi liphansi, nokuthintana nodokotela wakho ngokushesha uma uthola ukuqhuma noma uzizwa ungekuhle.

Ukusekelwa kokudla kusiza ukugcina amandla ngesikhathi sokwelapha. Gxila ekudleni lapho uzizwa kahle, hlala uthambile, futhi usebenze nodokotela wezondlo uma isicanucanu noma ukushintsha kokudla kuya kuba nzima. Ukudla okuncane, okuvamile ngokuvamile kusebenza kangcono kunokudla okukhulu.

Ukuphathwa kwamandla kuhilela ukulinganisa ukuphumula nomsebenzi olula njengoba kubekezeleleka. Ukuzivocavoca okulula njengokuhamba kungasiza ukugcina amandla nengqondo, kodwa lalela umzimba wakho uphumule uma kudingeka.

Ukusekelwa ngokomzwelo kubaluleke kakhulu. Cabanga ngokuxhumana namaqembu okusekela, abacebisi, noma ezinye imindeni eyaqonda ukuthi uhamba ngani. Izipitali eziningi zinikeza lezi zinsiza njengengxenye yokunakekelwa okuphelele.

Ukuthi Kufanele Uzilungiselele Kanjani Imihlangano Yakho Nodokotela?

Ukulungiselela imihlangano kukusiza ukuba wenze kakhulu isikhathi sakho neqembu lezokwelapha futhi kuqinisekisa ukuthi konke ukukhathazeka kwakho kuqondiswe ngokuphelele.

Bhala phansi imibuzo yakho ngaphambi kwesikhathi ngasinye sokuvakasha, uqale ngezibaluleke kakhulu. Faka ukukhathazeka ngezimpawu, imiphumela emibi yokwelapha, ukumisa imisebenzi, noma noma yini ekukhathazayo phakathi kwemihlangano.

Gcina idayari yezimpawu uqaphele amazinga obuhlungu, ukushintsha kwamandla, ukudla, noma noma yiziphi izimpawu ezintsha. Lolu lwazi lusisiza udokotela wakho ukuba alandelele indlela obuyela ngayo ekwelapheni futhi alungise ukunakekelwa njengoba kudingeka.

Letha umuntu okusekelayo emihlanganweni ebalulekile uma kunokwenzeka. Bangakusiza ukuba ukhumbule ulwazi oluxoxwe futhi banikeze ukusekelwa ngokomzwelo ngesikhathi sezingxoxo ezinzima.

Hlela ulwazi lwakho lwezokwelapha, kufaka phakathi imithi yamanje, amakhadi yomshuwalense, nanoma yiziphi iziphumo zezivivinyo ezivela kwabanye odokotela. Ukuba nakho konke kulula ukwenza ukunakekelwa kwakho kube lula.

Ungangabazi ukucela incazelo uma ungaqondi lutho. Iqembu lakho lezokwelapha lifuna uzizwe ulwazi futhi ukhululekile ngohlelo lwakho lokwelapha.

Yini Eyinhloko Ngokuphathelene Ne-Ewing Sarcoma?

I-Ewing sarcoma yimdlavuza onzima kodwa ophatheka kalula odinga ukunakekelwa okukhethekile nendlela yokwelapha ephelele. Nakuba ukwamukela lo mxilongo kungase kube nzima, ukuthuthuka okukhulu ekwelapheni kuye kwathuthukisa imiphumela kakhulu eminyakeni yamuva.

Impumelelo ixhomeke kakhulu ekutholeni kwasekuqaleni nasekufuneni ukunakekelwa kwamaqembu anekhono azi lo mdlavuza ongaqhelekile. Ukuhlanganiswa kwe-chemotherapy, ukuthunga noma ukwelashwa ngomgogodla, nokuqapha okuqhubekayo kunikeza abantu abaningi amathuba amahle okuphulukisa nokubuyela emisebenzini evamile.

Khumbula ukuthi awuwedwa kulolu hambo. Iqembu lakho lezokwelapha, umndeni, abangane, nezinhlangano zokusekela iziguli zonke yizinsiza ezitholakalayo ukuze zikusize ukuhamba ngokwelashwa nokubuyiselwa impilo ngokuphumelelayo.

Imibuzo Evamile Ngokuphathelene Ne-Ewing Sarcoma

Ingabe i-Ewing sarcoma iyefa?

Cha, i-Ewing sarcoma ngokuvamile ayithathwa kubazali. Ukushintsha kwe-genetic okubangela lo mdlavuza kwenzeka ngokungahleliwe kumaseli ngamanye, hhayi emajini adluliselwa emindenini. Ngaphansi kuka-5% yezimo zine-family history yesifo.

Iyini izinga lokuphila nge-Ewing sarcoma?

Izinga lokuphila lixhomeke ezintweni eziningi kufaka phakathi isigaba ngesikhathi sokuxilongwa nendlela esabela ngayo ekwelapheni. Ngomdlavuza oqondile, izinga lokuphila eminyakeni emihlanu cishe yi-70-80%. Uma umdlavuza usakazeke ngesikhathi sokuxilongwa, izinga liphansi kodwa abantu abaningi basaphila isikhathi eside ngokwelashwa kwamanje.

Ingabe i-Ewing sarcoma ingavikeleka?

Njengamanje, ayikho indlela eyaziwayo yokuvimbela i-Ewing sarcoma njengoba ivela ekushintsheni kwe-genetic okungahleliwe okwenzeka ngokungahleliwe. Ngokungafani nezinye izinhlobo zomdlavuza, ayixhunyaniswanga nezici zokuphila, ukukhishwa kwemvelo, noma izimo ze-genetic ezithathwa ezindodeni ezingase ziguqulwe.

Ukwelashwa kuvame ukuphela isikhathi esingakanani?

Ukuphathwa ngokuvamile kuhlala izinyanga eziyi-9-12 futhi kuhlanganisa izigaba eziningi ze-chemotherapy kanye nokuthunga noma ukwelashwa ngomgogodla. Isikhathi esiqondile sihlukahluka kuye ngokuthi umuntu uyaphendula kanjani ekwelapheni nezinqubo ezithile ezisetshenziswa yiqembu lakho lezokwelapha.

Ngizokwazi yini ukubuyela emisebenzini evamile ngemuva kokwelapha?

Abantu abaningi babuyela emisebenzini yabo yangaphambili ngemuva kokuphela kokwelapha, nakuba lokhu kuncike ezintweni ezifana nendawo ye-tumor nohlobo lokuthunga olufunwa. Iqembu lakho lezokwelapha lizo sebenza nawe kuyo yonke inqubo yokwelapha ukuze lithuthukise umphumela wakho wokusebenza futhi likusize ufinyelele imigomo yakho yemisebenzi.