Ukuthi yini i-Gastrointestinal Stromal Tumor? Izimpawu, Izimbangela, kanye Nokwelashwa

I-gastrointestinal stromal tumor (GIST) uhlobo oluyimfihlo lomdlavuza olukhula endleleni yokugaya ukudla, ikakhulukazi esiswini noma esibindini esincane. Lezi zinhlayiya zikhula ezicellini ezikhethekile ebizwa nge-interstitial cells of Cajal, ezisiza ekulawuleni ukuhamba kokudla ngendlela yokugaya ukudla.

Nakuba igama elithi "inhlayiya" lingase libe yinto ebangela ukwesaba, kubalulekile ukwazi ukuthi izinhlayiya eziningi ze-GIST zikhula kancane futhi zingaphathwa ngempumelelo uma zitholakala ekuqaleni. Ukuqonda ukuthi ukubhekana nani kungakusiza uzizwe ulungile futhi uqiniseke ngokunakekelwa kwakho.

Ziyini izimpawu ze-gastrointestinal stromal tumors?

Abantu abaningi abane-GIST encane abanawo noma yimiphi impawu ekuqaleni, kungakho lezi zinhlayiya ngezinye izikhathi zitholakala ngesikhathi sokuhlolwa kokwelapha okuvamile noma izinqubo zezinye izimo. Uma izimpawu zivele, zivame ukuvela kancane njengoba inhlayiya ikhula ibe khulu.

Izimpawu ezivamile ongaziqaphela zihlanganisa ubuhlungu obuqhubekayo besisu noma ukungakhululeki okungabonakali ukuthi kubangelwa yini. Lobu buhlungu bungase buzizwe njengokuhlungu okuthambile noma ukucindezela endaweni yesisu lakho.

Nazi izimpawu abantu abane-GIST abazibonayo njalo:

• Ubuhlungu besisu noma ukugabha okuza nokuhamba
• Ukuzizwa ugcwele ngokushesha uma udle, ngisho noma ungadli okuningi
• Ukuphefumula noma ukugabha, ikakhulukazi ngemva kokudla
• Igazi ematinyeni akho, elingase libukeke limnyama noma liyisiliva
• Ukugabha igazi noma into ebukeka njengezinkomba zekhofi
• Ukulahlekelwa isisindo okungachazeki emasontweni noma izinyanga eziningi
• Ukukhathala noma ubuthakathaka obungaphuli ngokuphumula
• Isibopho ongasithola esiswini lakho

Abanye abantu nabo baye baba nezimpawu ezingavamile njengobunzima bokuginya uma inhlayiya itholakala endleleni yokugaya ukudla phezulu, noma ukushintsha ekuhambeni kwesisu. Into ebalulekile okumele uyikhumbule ukuthi lezi zimpawu zingaba nezizathu eziningi ezahlukene, futhi ukuziba akukho okusho ukuthi une-GIST.

Ziyini izinhlobo ze-gastrointestinal stromal tumors?

I-GIST ihlelwa ngokusekelwe lapho ikhula khona endleleni yokugaya ukudla nokuthi iziphatha kanjani. Ukuqonda uhlobo kusiza iqembu lakho lokwelapha ukwakha uhlelo lokwelapha oluphumelelayo sesimo sakho esithile.

Indawo evamile ye-GIST yisiswini sakho, lapho cishe u-60% walezi zinhlayiya zikhula khona. I-GIST yesisu ivame ukukhula kancane futhi ingase ibe nombono omuhle uma iqhathaniswa nalezo ezisezinye izindawo.

I-GIST yesibindini esincane iqukethe cishe u-30% yezimangalo futhi ivame ukutholakala lapho ikhulu ngoba le ndawo yendlela yakho yokugaya ukudla inendawo enkulu yezinhlayiya zokukhula ngaphambi kokubangela izimpawu.

Ngokungavamile, i-GIST ingakhula esibindini sakho, esiswini, noma esifubeni. Lezi zindawo ziyizimbangela ezisele futhi ngayinye ingase idinge izindlela zokwelapha ezihlukile.

Udokotela wakho uzobuye ahlukanise i-GIST yakho ngokusekelwe ezingeni lobungozi, elithinta izinto ezifana nobukhulu, indawo, nokuthi amaseli ahlukaniswa ngokushesha kangakanani. Lokhu kuhlukaniswa kusiza ukubikezela ukuthi inhlayiya ingaziphatha kanjani futhi kuqondisa izinqumo zokwelapha.

Yini ebangela i-gastrointestinal stromal tumors?

Izinhlayiya eziningi ze-GIST zikhula lapho ama-gene athile ezicellini zendlela yakho yokugaya ukudla ehlala eguquka noma eguqulwa. Ushintsho oluvamile luthinta i-gene ebizwa nge-KIT, evame ukusisiza ekulawuleni ukuthi amaseli akhula futhi ahlukaniswa kanjani.

Cishe u-85% we-GIST ine-mutations ku-KIT gene, kanti enye i-5-10% inezinguquko ku-gene ehlobene ebizwa nge-PDGFRA. Lezi zinguquko ze-genetic zibangela amaseli ukukhula nokukhula ngokungalawuleki, kwakha inhlayiya.

Into ebalulekile okumele uyiqonde ukuthi lezi zinguquko ze-genetic ngokuvamile zenzeka ngokungahleliwe phakathi nokuphila kwakho kunokuba zidluliselwe kubazali bakho. Abantu abaningi abane-GIST abanalo umlando womndeni wesimo.

Kodwa-ke, kunezimo ezithile ezidluliselwa ngezizukulwane ezingandisa ingozi yakho:

• I-Neurofibromatosis type 1 (NF1), ethinta cishe umuntu o-1 ku-3,000
• I-Carney-Stratakis syndrome, isimo se-genetic esingavamile kakhulu
• I-Carney triad, enye i-syndrome engavamile kakhulu engase ihlanganise i-GIST eminingi

Uma unomlando womndeni we-GIST noma izimo ezihlobene, udokotela wakho angase akukhuthaze ukubonisana nge-genetic ukukusiza uqonde izingozi zakho nezinketho zokubeka iliso.

Nini okumele ubheke udokotela nge-gastrointestinal stromal tumors?

Kufanele uxhumane nodokotela wakho uma uhlangabezana nezimpawu zokugaya ukudla eziqhubekayo ezingaphuli ngemva kweviki noma ezimbili zokunakekelwa ekhaya. Nakuba lezi zimpawu ngokuvamile zibangelwa izimo ezivamile, kuhlale kungcono ukuzihlola.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uqaphela igazi ematinyeni akho noma ukugabha, ikakhulukazi uma igazi libukeka limnyama noma elimnyama. Lokhu kungase kubonise ukuphuza igazi kwenye indawo endleleni yakho yokugaya ukudla okudinga ukuhlolwa ngokushesha.

Ezinye izimpawu zezexwayiso ezidinga ukunakekelwa kwezokwelapha ngokushesha zihlanganisa ubuhlungu obukhulu besisu obuqala ngokuzumayo, ukugabha okuqhubekayo okukuvimbela ekuqondeni ukudla noma amanzi, noma ukulahlekelwa isisindo okungachazeki okungaphezu kwamapounds angu-10 ezinyangeni ezimbalwa.

Uma ungazizwa isibopho noma inhlayiya esiswini sakho engayikho ngaphambili, lokhu futhi kufanele kuhlolwe ngokushesha udokotela. Ngisho noma kuvela ukuthi kuyinto engalutho, kubalulekile ukuyihlola ochwepheshe bezempilo.

Ziyini izimbangela zengozi ze-gastrointestinal stromal tumors?

Izinto eziningi zingakhuphula kancane amathuba akho okukhula kwe-GIST, nakuba kubalulekile ukukhumbula ukuthi ukuba nezinto ezingozi akusho ukuthi uzokhula ngokuqinisekile lesi simo. Abantu abaningi abanezinto ezingozi abakhulumi i-GIST, kanti abanye abangenazo izinto ezingozi ezaziwayo bayenza.

Ubudala yinto ebaluleke kakhulu eyingozi, i-GIST ivame kakhulu kubantu abadala kuno-50. Ubudala obuvamile besikhathi sokutholakala cishe u-60, nakuba lezi zinhlayiya ngezinye izikhathi zingase zenzeke kubantu abadala abasebasha ngisho nabantwana.

Nazi izinto eziyinhloko ezingase zikhulise ingozi yakho:

• Ukuba neminyaka engaphezu kuka-50, ingozi iqhubeka ikhula ngokwanda kobudala
• Ukuba ne-neurofibromatosis type 1 (NF1), isimo se-genetic
• Umlando womndeni we-GIST noma izimo ze-genetic ezihlobene
• Ukuvezwa kwangaphambili kwemisebe esiswini, nakuba lokhu kuyinto engavamile

Ngokungafani nezinye izinhlobo eziningi zomdlavuza, izinto zokuphila ezifana nokudla, ukubhema, noma ukusetshenziswa kotshwala kubonakala sengathi azithinti kakhulu ingozi ye-GIST. Lokhu kusho ukuthi azikho izinguquko ezithile zokuphila ezingavimbela lezi zinhlayiya ekuqaleni.

Ziyini izinhlanganisela ezingase zenzeke ze-gastrointestinal stromal tumors?

Nakuba izinhlayiya eziningi ze-GIST ziphathwa ngempumelelo, ezinye zingabangela izinhlanganisela uma zikhula zibe khulu noma zisakazeke kwezinye izingxenye zomzimba wakho. Ukuqonda lezi zinto ezingase zenzeke kungakusiza uqaphele izimpawu ekuqaleni futhi usebenze neqembu lakho lokwelapha ukuze uzixazulule.

Ukuphuza igazi kungenye yezinhlanganisela ezivamile, ikakhulukazi ngezinhlayiya ezinkulu. Lokhu kwenzeka lapho inhlayiya yonakalisa imithambo yegazi endleleni yakho yokugaya ukudla, futhi ukuphuza igazi kungase kube kancane futhi kuqhubeke noma kube ngokushesha futhi kube nzima.

Izinhlayiya ezinkulu zingase futhi zibangele ukuphahlazeka endleleni yakho yokugaya ukudla, okwenza kube nzima ukudla ukuhamba ngokujwayelekile. Lokhu kungase kube ukuphefumula okuqhubekayo, ukugabha, noma isiphithiphithi esinzima esingaphenduli ekuphulukiseni okujwayelekile.

Ezinye izinhlanganisela ezingase zenzeke zihlanganisa:

• Ukuqhekeka kwenhlayiya, okungabangela ubuhlungu obukhulu besisu nokuphuza igazi yangaphakathi
• Ukuqhekeka odongeni lwesibindini, okwenza umgodi ovumela okuqukethwe kokugaya ukudla ukuvuza
• I-Metastasis (ukusakazeka) kwezinye izitho, ikakhulukazi isibindi
• I-Anemia evela ekopha igazi okuqhubekayo, okubangela ukukhathala nobuthakathaka
• Ukuphahlazeka kwesisu okudinga ukwelashwa kwezokwelapha okusheshayo

Izindaba ezinhle ukuthi ngokwelashwa kwamanje, izinhlanganisela eziningi zingaqalekelwa noma ziphathwe kahle uma zitholakala ekuqaleni. Ukulandelela njalo neqembu lakho lokwelapha kubalulekile ekuqapheleni noma yiziphi izinguquko.

I-gastrointestinal stromal tumor ihlonishwa kanjani?

Ukuhlola i-GIST ngokuvamile kuhilela izinyathelo eziningi, kuqala ngodokotela wakho oxoxa ngezimpawu zakho nomlando wezokwelapha. Uzothanda ukuqonda ukuthi izimpawu zakho zaqala nini, zishintshe kanjani ngokuhamba kwesikhathi, nokuthi yini eyenza zibe ngcono noma zibe zimbi.

Udokotela wakho uzoqhuba ukuhlolwa komzimba, aqaphele kakhulu isisu sakho ukuhlola noma yiziphi izibopho, ubuhlungu, noma ukukhula. Angase futhi alalele imisindo yesisu lakho futhi ahlole izimpawu ze-anemia.

Isinyathelo esilandelayo ngokuvamile sihilela ukuhlolwa kwezithombe ukuze uthole umbono ophelele wendlela yakho yokugaya ukudla. I-CT scan yesisu lakho ne-pelvis ngokuvamile iyona vivinyo lokuqala eliyalwe ngoba lingabonisa ubukhulu, indawo, nezici zanoma iyiphi inhlayiya.

Izivivinyo ezengeziwe udokotela wakho angase azikhuthaze zihlanganisa:

• I-MRI scan yezithombe ezinemininingwane, ikakhulukazi yethishu ebushelelezi
• I-Upper endoscopy ukuze ubone ngqo izinhlayiya esiswini noma esibindini esincane esiphezulu
• I-Colonoscopy uma inhlayiya ingase ibe esibindini noma esiswini
• I-PET scan ukuze uhlole ukuthi inhlayiya isakazeke kwezinye izindawo
• Izivivinyo zegazi ukuze uhlole i-anemia kanye nezimpawu zempilo jikelele

Uma izithombe zikhomba i-GIST, udokotela wakho angase akukhuthaze i-biopsy ukuze aqinisekise ukuxilongwa. Lokhu kuhilela ukuthatha isampula encane yethishu ukuze ihlolwe ngaphansi kwesikrini, ngokuvamile iqondiswe yi-CT noma i-ultrasound imaging.

Izivivinyo ezikhethekile ku-biopsy sample zingakwazi ukubona i-genetic mutations ethile enhlayiyeni yakho, okusisiza ukunquma indlela yokwelapha engcono kakhulu yesimo sakho esithile.

Yini ukwelashwa kwe-gastrointestinal stromal tumors?

Ukwelashwa kwe-GIST kuye kwathuthuka kakhulu phakathi neminyaka engamashumi amabili edlule, kunikeza abantu abaningi imiphumela emihle. Uhlelo lwakho lokwelapha luzoxhomeka ezintweni ezifana nobukhulu benhlayiya, indawo, ukwakheka kwe-genetic, nokuthi isakazeke yini.

Ukuhlinzwa ngokuvamile kuyindlela yokuqala yokwelapha i-GIST engasuswa ngokuphelele. Umgomo ukususa inhlayiya yonke kanye nezingxenye ezincane zethishu enempilo ukuqinisekisa ukuthi azikho amaseli omdlavuza ashiyekile.

Ngezinhlayiya ezinkulu noma ezisezinzindeni ezinzima, udokotela wakho angase akukhuthaze ukwelashwa okuqondiswe ngaphambi kokuhlinzwa ukuze unciphise inhlayiya futhi kulula ukuyisusa ngokuphepha. Le ndlela ingasiza ekuvikeleni ingxenye enkulu yendlela yakho yokugaya ukudla.

Izinketho zokwelapha eziyinhloko zihlanganisa:

• Ukususwa okuhlinzwayo (ukusika) kwenhlayiya nethishu ezungezile
• Ukwelashwa okuqondiswe ngemithi efana ne-imatinib (Gleevec)
• I-Sunitinib (Sutent) yezinhlayiya ezingaphenduli ku-imatinib
• I-Regorafenib (Stivarga) yezimo eziqhutshwe kakhulu
• Imithi emisha eqondiswe njenge-ripretinib yezinhlayiya ezinokumelana

Imithi yokwelapha eqondiswe isebenza ngokuvimba amaprotheni angajwayelekile abangela amaseli e-GIST ukukhula ngokungalawuleki. Le mithi ithathwa njengezithasiselo futhi ingasebenza kakhulu ekulawuleni ukukhula kwenhlayiya.

Oncologist yakho izolandelela impendulo yakho ekwelapheni ngokuqapha okuvamile nezivivinyo zegazi, ilungise uhlelo lwakho lokwelapha njengoba kudingeka ukuqinisekisa ukuthi uthola imiphumela engcono kakhulu.

Indlela yokuphatha izimpawu ekhaya ngesikhathi sokwelashwa?

Ukuphatha izimpawu zakho nemiphumela emibi ekhaya kuyiyingxenye ebalulekile yokunakekelwa kwakho okuphelele. Ukusebenzisana eduze neqembu lakho lokwelapha kuzokusiza ukwakha amasu asebenza kangcono sesimo sakho esithile.

Uma uhlangabezana nokuphefumula ekuphulukiseni, ukudla ukudla okuncane, okuvamile usuku lonke kungasiza. Khetha ukudla okumnandi, okulula ukukugaya njenge-crackers, i-toast, noma irayisi lapho isisu sakho sizizwa singakhululekile.

Ukukhathala kuyinto evamile ngesikhathi sokwelashwa, ngakho-ke lalela umzimba wakho uphumule uma udinga. Imisebenzi ethambile njengokuhamba okufushane ingasiza ekuqinisiseni amazinga wakho kwamandla uma uzizwa ukhona.

Nazi ezinye izindlela ezisebenzayo abantu abaningi abazithola ziwusizo:

• Gcina idayari yempawu ukuze uqaphele izindlela nezici
• Hlala uthambile ngokuphuza amanzi amancane usuku lonke
• Dla ukudla okumnandi, okunomsoco uma unezinkinga zokugwinya
• Sebenzisa i-heating pad ngenxa yokungakhululeki kwesisu (hlola nodokotela wakho kuqala)
• Zama amasu okuphumula njengokuphefumula okujulile noma ukuzindla
• Joyina iqembu lokusekela labantu abane-GISTs

Xhumana njalo neqembu lakho lokwelapha uma izimpawu zakho zibe zimbi noma uma uthola izimpawu ezintsha ezibangel' ukukhathazeka njengobushushu, ubuhlungu obukhulu, noma ukugabha okuqhubekayo. Bangalungisa ukwelashwa kwakho noma banikeze ukunakekelwa okwengeziwe kokusekela njengoba kudingeka.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ukulungiselela i-aphoyintimenti yakho yokwelapha kungakusiza ukwenza okuningi ngesikhathi sakho neqembu lakho lokwelapha futhi kuqinisekise ukuthi uthola lonke ulwazi oludingayo. Qala ngokubhala phansi imibuzo yakho ngaphambi kokuya kwakho ukuze ungakhohlwa lutho olubalulekile.

Letha uhlu oluphelele lwazo zonke imithi oyithathayo, kuhlanganise imithi yokwelapha, imithi yokwelapha engaphezu kokukhokhelwa, amavithamini, kanye nezinye izinto ezengeziwe. Faka imithamo nokuthi uyiphuza kangaki ngayinye.

Gcina idayari yempawu okungenani isonto ngaphambi kwe-aphoyintimenti yakho, uqaphele ukuthi izimpawu zenzeka nini, yini ezibangela, nokuthi yini esiza ekuzikhululeni. Lolu lwazi lunganikeza izinkomba ezibalulekile zodokotela wakho.

Cabanga ukuletha ilungu lomndeni omethembayo noma umngani e-aphoyintimenti yakho, ikakhulukazi ngezivakashi ezibalulekile lapho uzobe uxoxa ngezinketho zokwelapha. Bangakusiza ukukhumbula ulwazi futhi banikeze ukusekela ngokomzwelo.

Lungiselela lezi zinto ngesikhathi sokuya kwakho:

• Uhlu lwempawu zamanje nokuthi zaqala nini
• Uhlu oluphelele lwemithi kanye nezinye izinto ezengeziwe
• Amakhadi yomshuwalense kanye nokuhlonza
• Imiphumela yokuvivinya yangaphambili noma amarekhodi ezokwelapha
• Uhlu olubhaliwe lwemibuzo yodokotela wakho
• Ulwazi lokuxhumana lodokotela abanye abahilelekile ekunakekelweni kwakho

Ungangabazi ukubuza udokotela wakho ukuthi achaze noma yini ongayiqondi. Kubalulekile ukuthi uzizwe ukhululekile ngohlelo lwakho lokwelapha futhi wazi ukuthi yini okulindeleke ukuthi iyenzeke phambili.

Yini into ebalulekile nge-gastrointestinal stromal tumors?

Into ebaluleke kakhulu okumele uyiqonde nge-GIST ukuthi iyakwazi ukwelashwa, ikakhulukazi uma itholakala ekuqaleni. Nakuba ukwamukela ukuxilongwa komdlavuza kungase kube yinto ebangela ukukhathazeka, ukuthuthuka ekwelapheni okuqondiswe kuye kwaguqula umbono wabantu abanezi zinhlayiya.

Abantu abaningi abane-GIST baqhubeka bephila impilo egcwele, esebenzayo ngokwelashwa okufanele nokuqapha. Umgomo ukusebenzisana eduze neqembu lakho lokwelapha, uhlale unolwazi ngesimo sakho, futhi ungangabazi ukufuna usizo uma unezinkathazo.

Khumbula ukuthi isimo sabo bonke abantu sihlukile, futhi udokotela wakho ungumthombo omuhle wolwazi ngesimo sakho esithile. Hlala uhileleke ekunakekelweni kwakho, buza imibuzo, futhi ungesabi ukufuna umbono wesibili uma uzizwa sengathi kuzoba usizo.

Ngezinketho zokwelapha zanamuhla nokucwaninga okuqhubekayo ngezindlela zokwelapha ezintsha, kunesizathu esiqinile sokwethemba nokukhuthazela ngokuphatha i-GIST ngempumelelo.

Imibuzo evamile ebuzwayo mayelana ne-gastrointestinal stromal tumors

Q1: Ingabe i-gastrointestinal stromal tumors iyadluliselwa ezizukulwaneni?

Izinhlayiya eziningi ze-GIST zenzeka ngokungahleliwe futhi azidluliselwa kubazali bakho. Cishe u-5% kuphela yezimangalo ezihlobene nezimo ze-genetic ezidluliselwa ezizukulwaneni njenge-neurofibromatosis type 1. Uma unomlando womndeni we-GIST noma izimo ezihlobene, ukubonisana nge-genetic kungasiza ekuqondeni ingozi yakho siqu nokuxoxa ngezinketho zokubeka iliso.

Q2: Ingabe i-gastrointestinal stromal tumors ingavikeleka?

Ngeshwa, ayikho indlela eyaziwayo yokuvimbela i-GIST njengoba ngokuvamile ivela ekuqaleni kwezinguquko ze-genetic ezenzeka phakathi nokuphila kwakho. Ngokungafani nezinye izinhlobo eziningi zomdlavuza, izinto zokuphila ezifana nokudla, ukuzivocavoca, noma ukugwema utshaba kubonakala sengathi azithinti ingozi ye-GIST. Indlela engcono kakhulu ukuba uqaphele izimpawu futhi ufunane ukunakekelwa kwezokwelapha ngokushesha uma izimpawu ezibangel' ukukhathazeka zivele.

Q3: Abantu baphila isikhathi esingakanani nge-gastrointestinal stromal tumors?

Umbono wabantu abane-GIST uthuthukile kakhulu ngokwelashwa kwamanje. Abantu abaningi abanezinhlayiya ezincane, ezitholakala endaweni ethile bangaphuliwa ngokuhlinzwa. Ngisho nasezimweni eziqhutshwe kakhulu, imithi yokwelapha eqondiswe ingalawula isifo iminyaka eminingi. Ukubikezelwa kwakho siqu kuya kuxhomeka ezintweni ezifana nobukhulu benhlayiya, indawo, ukwakheka kwe-genetic, nokuthi iphendula kangcono kanjani ekwelapheni.

Q4: Ingabe i-gastrointestinal stromal tumors ihlale idinga ukuhlinzwa?

Akuzona zonke i-GIST ezidinga ukuhlinzwa ngokushesha. Izinhlayiya ezincane kakhulu (ngaphansi kwe-2 cm) ezingabangeli izimpawu zingase ziqaphelwe ngokuqapha okuvamile. Ezinye izinhlayiya ezinkulu ziphathwa ngokwelashwa okuqondiswe kuqala ukuze zinciphisiwe ngaphambi kokuhlinzwa. Udokotela wakho uzosikisela indlela engcono kakhulu ngokusekelwe ezicini zenhlayiya yakho nempilo yakho jikelele.

Q5: Kufanele ngilindele ini ngesikhathi sokuphulukiswa kokuhlinzwa kwe-GIST?

Isikhathi sokuphulukiswa sihluka kuye ngobukhulu nendawo yenhlayiya yakho nohlobo lokuhlinzwa okuenziwe. Abantu abaningi bahlala esibhedlela izinsuku ezingu-3-7 ngemva kokuhlinzwa. Uzobuyela kancane emisebenzini evamile phakathi kwezinyanga ezingu-4-6, ukubuyela ngokuphelele ngokuvamile kuthatha izinyanga ezingu-2-3. Iqembu lakho lokuhlinzwa lizonikeza imiyalo ethile yokudla, umsebenzi, nokunakekelwa kwezinyo ngesikhathi sakho sokuphulukiswa.