Izinhlobo Zezifo Ze-Neuroendocrine? Izimpawu, Izimbangela, Nokwelashwa

Izifo ze-neuroendocrine ziyizikhulu ezithuthukela ezicellulweni ezikhethekile emzimbeni wakho ezakha ama-hormone futhi zisize ekuqondiseni imisebenzi ebalulekile yomzimba. Lezi zicell, ebizwa ngokuthi yi-neuroendocrine cells, zisebenza njengobhuloho phakathi kwesistimu yakho yezinzwa nama-glands akha ama-hormone.

Nakuba igama lingase lizwakale liyinkimbinkimbi, cabanga ngalezi zifo njengezikhulu ezingathinta indlela umzimba wakho okhiqiza futhi usebenzisa ngayo ama-hormone. Izifo eziningi ze-neuroendocrine zikhula kancane futhi abantu abaningi baphila impilo egcwele, esebenzayo ngokwelashwa okulungile nokulandelela.

Ziyini izifo ze-neuroendocrine?

Izifo ze-neuroendocrine zibunjwa lapho i-neuroendocrine cells iqala ukukhula ngokungavamile. Lezi zicell ezikhethekile zisasazwe kulo lonke umzimba wakho, kodwa zitholakala kakhulu ohlelweni lwakho lokugaya ukudla, emaphashini, nase-pancreas.

Izifo zingaba yi-benign (ezingezona ezomdlavuza) noma i-malignant (ezomdlavuza). Izifo eziningi zalezi zisebenza, okusho ukuthi zikhiqiza ama-hormone amaningi angabangela izimpawu ezibonakalayo. Ezinye azisebenzi futhi zingase zingabangeli izimpawu kuze zikhule zibe khulu ngokwanele ukucindezela izitho eziseduze.

Lezi zifo azivamile, zithinta abantu abacishe babe ngu-6-7 ngabantu abangu-100,000 unyaka ngamunye. Noma kunjalo, odokotela bayazithola ngokwanda manje ngenxa yezindlela ezinhle zokuthola izithombe nokukhula kokwaziswa.

Ziyini izimpawu zezifo ze-neuroendocrine?

Izimpawu zihluka kakhulu kuye ngokuthi isifo sikhona kuphi nokuthi sikhiqiza ama-hormone yini. Abantu abaningi baye baba nezimpawu ezijwayelekile ezingase ziphambaniswe kalula nezinye izimo.

Nazi izimpawu ezivamile ongaziqaphela:

• Ubuhlungu obuqhubekayo besisu noma ukubamba esiswini okungapheli
• Ukushintsha kwemisindo yomathumbu, kufaka phakathi ukweluka okuphela amasonto
• Ukulahlekelwa isisindo okungachazeki ngaphandle kokuzimisela ukulahlekelwa isisindo
• Iziqephu zokufudumala lapho ubuso nekhala lakho kuphenduka luhlaza ngokuzumayo futhi kuzizwa lufudumele
• Ukufiphaza noma ubunzima bokuqeda umoya okubonakala kuvela endaweni engaziwa
• Ukushona kwenhliziyo noma ukushaya kwenhliziyo okungavamile
• Ukukhathala okungaphuli ngokuphumula

Abanye abantu baye baba nalokho odokotela abakubiza ngokuthi “i-carcinoid syndrome,” eyenzeka lapho izifo ezikhiqiza ama-hormone zikhulula izinto egazini lakho. Lokhu kungabangela iziqephu zokufudumala, ukweluka, nobunzima bokuqeda umoya.

Izimpawu ezingavamile zingafaka izikhumba, ukushintsha kweswekile yegazi, noma ama-ulcers esiswini. Into ebalulekile okumele uyikhumbule ukuthi izimpawu zivame ukuthuthuka kancane futhi zingase zibe zingebonakali ekuqaleni.

Ziyini izinhlobo zezifo ze-neuroendocrine?

Odokotela bahlukanisa izifo ze-neuroendocrine ngokusekelwe lapho zithuthukela khona nokuthi zikhula ngokushesha kangakanani. Indawo ivame ukunquma ukuthi yiziphi izimpawu ongaziqaphela nokuthi yiziphi izinketho zokwelapha ezisebenza kangcono.

Izinhlobo ezivamile zifaka:

• Izifo ze-Gastroenteropancreatic (GEP) ezithuthukela esiswini sakho, emithunzini, noma e-pancreas
• Izifo ze-neuroendocrine zephunga ezakha ohlelweni lwakho lokuphefumula
• Izifo ze-neuroendocrine ze-pancreas, kufaka phakathi ama-insulinomas nama-gastrinomas
• Izifo ze-Carcinoid, ezivame kakhulu ukuba khona emithunzini yakho emincane noma e-appendix

Odokotela futhi baqapha lezi zifo kusuka ku-G1 kuya ku-G3 ngokusekelwe ekutheni izicell ziyahlukaniswa ngokushesha kangakanani. Izifo ze-G1 zikhula kancane, izifo ze-G2 zikhula ngesivinini esiphakathi, futhi izifo ze-G3 zikhula ngokushesha futhi zidinga ukwelashwa okunamandla.

Iqembu lakho lokunakekelwa kwezempilo lizoqonda uhlobo oluthile nokuqapha ngezindlela ezahlukene zokuhlola, okuwasiza ukuba bakhe uhlelo lokwelapha oluphumelela kakhulu esimweni sakho.

Ziyini izimbangela zezifo ze-neuroendocrine?

Imbangela eqondile yezifo eziningi ze-neuroendocrine ayaziwa, kodwa abacwaningi bakholelwa ukuthi zithuthukela lapho i-neuroendocrine cells ihlangabezana nezinguquko ze-genetic ezibangela ukuba zikhule ngokungavamile. Lezi zinguquko zivame ukwenzeka ngokungahleliwe ngokuhamba kwesikhathi.

Izici eziningi zingase zinikezele ekuthuthukiseni kwazo:

• Ukushintsha kwezicell ezihlobene nobudala, njengoba lezi zifo zivame kakhulu kubantu abadala kuno-50
• Izifo ze-genetic eziwusizo njenge-Multiple Endocrine Neoplasia (MEN) syndromes
• Umbukiso womndeni wezifo ze-neuroendocrine noma izimo ezihlobene
• Izimo ezithile zezokwelapha ezithinta ukukhiqizwa kwe-acid yesisu

Kwezinye izimo ezingavamile, abantu bafa bafa i-mutations ye-genetic ezikhuphula kakhulu ingozi yabo. Lezi syndromes eziwusizo zibala kuphela cishe u-5-10% wazo zonke izifo ze-neuroendocrine.

Okubaluleke kakhulu, lezi zifo azibangelwa izinqumo zokuphila njengokudla, ukubhema, noma ukucindezeleka. Awukwenzanga lutho ukubangela le simo, futhi akukho sizathu sokuzisola uma ubhekene nesifo se-neuroendocrine.

Nini okumele ubona udokotela ngezifo ze-neuroendocrine?

Kufanele uxhumane nodokotela wakho uma uhlangabezana nezimpawu eziqhubekayo ezithatha amasonto amaningi, ikakhulu uma zithinta impilo yakho yansuku zonke. Nakuba lezi zimpawu zingaba nezimbangela eziningi, kuhlale kungcono ukuzihlola.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uqaphela:

• Ubuhlungu obukhulu besisu obungaphuli ngemithi yokwelapha engaphezu kwe-counter
• Ukweluka okuqhubekayo okuphela amasonto amabili
• Ukulahlekelwa isisindo okungachazeki okungaphezu kwamapounds angu-10
• Iziqephu ezivamile zokufudumala ezihlangene nezinye izimpawu
• Ubunzima bokuqeda umoya noma ukufiphaza okuya kubi

Ungalindi uma uhlangabezana nezimpawu ezinzima noma uma izimpawu eziningi zenzeka ndawonye. Udokotela wakho angakusiza aqonde ukuthi ingabe kukhona ukuhlolwa okwengeziwe okudingekayo.

Khumbula, izimo eziningi zingabangela izimpawu ezifanayo, ngakho-ke zama ukungakhathazeki kakhulu ngaphambi kokukhuluma nochwepheshe wezokwelapha. Ukubheka kwasekuqaleni kuvame ukubangela imiphumela emihle lapho ukwelashwa kudingeka.

Ziyini izici zengozi zezifo ze-neuroendocrine?

Izici eziningi zingase zikhulise amathuba akho okuthuthukisa isifo se-neuroendocrine, nakuba ukuba nezici zengozi akusho ukuthi uzokuthuthukisa ngokuqinisekile. Ukuqonda lezi zici kungakusiza wena nodokotela wakho ukuba niqaphele izimpawu ezingase zibe khona.

Izici eziyinhloko zengozi zifaka:

• Ubudala obuphezulu kuno-50, lapho ukushintsha kwezicell kuya kuba khona
• Umbukiso womndeni wezifo ze-neuroendocrine noma izifo ze-genetic ezihlobene
• Izimo eziwusizo njenge-Multiple Endocrine Neoplasia syndromes
• Izimo ezithile zesisu ezunciphisa ukukhiqizwa kwe-acid
• Ukuba yi-African American, okuthinta kancane ingozi yezinye izinhlobo

Ezinye izifo ze-genetic ezingavamile zikhuphula kakhulu ingozi, kufaka phakathi isifo se-von Hippel-Lindau nesifo se-neurofibromatosis type 1. Lezi zimo zihamba emindenini futhi zivame ukufaka izinhlobo eziningi zezifo.

Ukuba nenye noma ngaphezulu kwezici zengozi akusho ukuthi uzokuthuthukisa isifo se-neuroendocrine. Abantu abaningi abanezici zengozi abazithuthukisi lezi zifo, kanti abanye abangenazo izici zengozi ezaziwayo bayazithuthukisa.

Ziyini izinhlanganisela ezingase zenzeke zezifo ze-neuroendocrine?

Izifo eziningi ze-neuroendocrine zikhula kancane futhi zibangela izinhlanganisela ezilawuleka, ikakhulu uma zitholakala kwasekuqaleni. Noma kunjalo, ezinye izinhlanganisela zingase zithuthuke uma izifo zingelaphiwa noma uma zikhiqiza ama-hormone amaningi.

Izinhlanganisela ezivamile ongazihlangabezana nazo zifaka:

• I-carcinoid syndrome evela ezifweni ezikhiqiza ama-hormone ebangela ukufudumala nokweluka
• Ukuphahlazeka kwamathumbu uma izifo emithunzini yakho zikhula zibe khulu ngokwanele
• Izinkinga ze-valve yenhliziyo evela ku-carcinoid syndrome yesikhathi eside
• Ukungahlangani kweswekile yegazi evela ezifweni ze-pancreas
• Ama-ulcers esiswini evela ezifweni ezikhiqiza i-gastrin

Izinhlanganisela ezingavamile kodwa ezinzima zingafaka i-carcinoid crisis, ebandakanya ukufudumala okukhulu, ukushintsha kwezinga lokucindezela kwegazi, nobunzima bokuqeda umoya. Lokhu kuvame ukwenzeka kuphela ngezifo ezikhiqiza ama-hormone ezithuthukile.

Izindaba ezinhle ukuthi ukwelashwa kwamanje kungavimbela noma kulawule izinhlanganisela eziningi ngokuphumelelayo. Iqembu lakho lokunakekelwa kwezempilo lizokulandela eduze futhi lilungise ukwelashwa njengoba kudingeka ukuze kuncishiswe noma yiziphi izinhlanganisela.

Ungazivimbela kanjani izifo ze-neuroendocrine?

Ngeshwa, ayikho indlela eyiqiniso yokuvimbela izifo eziningi ze-neuroendocrine njengoba zivame ukuthuthukela ngenxa yezinguquko ze-genetic ezingahleliwe. Noma kunjalo, ungathatha izinyathelo zokusekela impilo yakho yonke nokuthola noma yiziphi izinkinga kwasekuqaleni.

Nansi ongayenza:

• Gcina ukuhlolwa okujwayelekile nodokotela wakho
• Bika noma yiziphi izimpawu eziqhubekayo noma ezingavamile ngokushesha
• Landela izincomo zokuhlola uma unembukiso womndeni
• Cabanga ngokwelulekwa kwe-genetic uma unezici zengozi eziwusizo
• Phila impilo enempilo ngokudla okuhle nokuzivocavoca okujwayelekile

Uma unesisifo se-genetic esaziwayo esikhuphula ingozi yakho, udokotela wakho angase akukhuthaze ukuhlolwa okuthile noma ukulandelela okuvamile. Le ndlela yokwenza izinto ngaphambi kwesikhathi ingasiza ekutholeni izifo kwasekuqaleni lapho zilawuleka kakhulu.

Nakuba ungazivimbeli ngokuphelele lezi zifo, ukuqaphela umzimba wakho nokugcina ukuxhumana okuvulekile neqembu lakho lokunakekelwa kwezempilo kukunika ithuba elihle kakhulu lokuthola kwasekuqaleni nokwelashwa okuphumelelayo.

Izifo ze-neuroendocrine ziqondwa kanjani?

Ukuqonda izifo ze-neuroendocrine kuvame ukudinga ukuhlolwa okuhlukene njengoba izimpawu zingafana nezinye izimo eziningi. Udokotela wakho uzoqala ngomlando wezokwelapha ophelele nokuhlolwa komzimba ukuqonda izimpawu zakho.

Inqubo yokuxilonga ivame ukufaka:

• Ukuhlolwa kwegazi ukuhlola amazinga ama-hormone nama-markers esifo
• Ukuhlolwa komchamo ukuqapha imikhiqizo yokwahlukaniswa kwama-hormone
• I-CT noma i-MRI scans ukuthola nokulinganisa izifo
• I-scans ezikhethekile njenge-octreotide scans ezibheka i-neuroendocrine cells
• Izindlela ze-Endoscopy ukuhlola umthambo wakho wokugaya ukudla
• I-Biopsy ukuqinisekisa ukuxilongwa nokuqonda izinga lesifo

Udokotela wakho angase a-ode ukuhlolwa kwama-hormone okuthile ngokusekelwe ezimpawu zakho. Isibonelo, uma unezinkinga zeswekile yegazi, bazohlola amazinga e-insulin. Uma uhlangabezana nokufudumala nokweluka, bazohlola izinto ezihlobene ne-carcinoid syndrome.

Inqubo yonke yokuxilonga ingathatha amasonto amaningana noma ngisho nezinyanga, okungase kuzwakale kuyadumaza. Noma kunjalo, ukuthola ukuxilongwa okuchane kusemqoka ekwakheni uhlelo lokwelapha oluphumelela kakhulu esimweni sakho esithile.

Kuyini ukwelashwa kwezifo ze-neuroendocrine?

Ukwelashwa kwezifo ze-neuroendocrine kuncike ezintweni eziningi kufaka phakathi indawo yesifo, usayizi, izinga, nokuthi likhiqiza ama-hormone yini. Abantu abaningi benza kahle kakhulu ngokwelashwa, futhi ezinye izifo zingaphiliswa ngokuphelele.

Uhlelo lwakho lokwelapha lungafaka:

• Ukuhlinzwa ukususa isifo, okuvame ukuba yindlela yokwelapha ekhethwayo yezifo eziku-localized
• Ama-somatostatin analogs ukulawula ukukhiqizwa kwama-hormone nokunciphisa ukukhula kwesifo
• Imithi yokwelapha ehloselwe ukuhlasela izicell zesifo ngokuqondile
• I-Chemotherapy yezifo ezinamandla noma ezisasazwe kakhulu
• I-Radiation therapy ukunciphisa izifo noma ukunciphisa izimpawu
• Ukwelashwa okuqondiswe e-Liver uma izifo zisasazwe e-liver

Ngezifo ezikhiqiza ama-hormone, udokotela wakho uzogxila ekulawuleni izimpawu ngenkathi elapha isifo ngokwalo. Lokhu kungafaka imithi yokulawula ukweluka, ukufudumala, noma izinkinga zeswekile yegazi.

Abantu abaningi abanezifo ezikhula kancane bangalandelelwa nge-scans eziqondile nokuhlolwa kwegazi ngaphandle kokwelashwa kwangoko. Le ndlela, ebizwa ngokuthi yi-active surveillance, ikuvumela ukuba ugweme imiphumela emibi yokwelashwa ngenkathi uqinisekisa ukuthi isifo asikhuli noma asishintshi.

Indlela yokuphatha izifo ze-neuroendocrine ekhaya?

Ukuphatha impilo ngesifo se-neuroendocrine kubandakanya kokubili ukwelashwa kwezokwelapha neqhinga le-daily strategies. Abantu abaningi bathola ukuthi bangagcina ikhwalithi yempilo yabo ngezinguquko ezithile nezindlela zokunakekela.

Nazi izindlela eziwusizo zokuphatha kwansuku zonke:

• Gcina idayari yesimpawu ukuqapha izindlela nezici
• Dla ukudla okuncane, okuvamile ukusiza ngezimpawu zokugaya ukudla
• Hlala uthambile, ikakhulu uma uhlangabezana nokweluka
• Gwema ukudla neziphuzo ezibangela iziqephu zokufudumala
• Zama izindlela zokulawula ukucindezeleka njengokuphefumula okujulile noma ukucamngca
• Thola ukuphumula okwanele futhi ugcine isimiso sokulala esiqondile

Uma ubhekene ne-carcinoid syndrome, kungase kudingeke ugweme ukudla okuthile njenge-aged cheeses, utshwala, noma ukudla okunoshushu okungabangela iziqephu zokufudumala. Iqembu lakho lokunakekelwa kwezempilo lingakunikeza isiqondiso esithile sokudla.

Hlala uxhumene namaqembu asekelayo noma izinsizakalo zokwelulekwa uma uzizwa ukhulu. Abantu abaningi bathola ukuthi kuwusizo ukukhuluma nabanye abaqonda lokho abakubhekana nakho.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukulungiselela i-appointment yakho kungakusiza ukuba wenze okuningi ngesikhathi sakho nodokotela wakho futhi kuqinisekise ukuthi uthola lonke ulwazi oludingayo. Ukulungiselela okuhle futhi kusiza udokotela wakho ukuthi aqonde kangcono isimo sakho.

Ngaphambi kwe-appointment yakho:

• Bala zonke izimpawu zakho, kufaka phakathi ukuthi zaqala nini nokuthi zivame kangakanani
• Letha yonke imithi yakho yamanje, kufaka phakathi izongezo nemithi yokwelapha engaphezu kwe-counter
• Lungisa imibuzo mayelana nokuxilongwa kwakho, izinketho zokwelapha, kanye ne-prognosis
• Butha amarekhodi ezokwelapha afanele evela kwabanye odokotela
• Cabanga ngokuletha ilungu lomndeni noma umngani ukusekela nokusiza ukukhumbula ulwazi

Bhala imibuzo ethile ofuna ukuyibuza, njengohlobo lwesifo olukhona, izinketho zokwelapha ezitholakalayo, nokuthi yini okulindelekile kuqhubeke. Unganqikazi ukucela incazelo uma kukhona okungachazeki.

Khumbula ukuthi lokhu kuyinakekelwa yakho, futhi unamalungelo okuqonda isimo sakho ngokuphelele. Udokotela omuhle uzotatha isikhathi sokuphendula imibuzo yakho nokukusiza uzizwe ukhululekile ngohlelo lwakho lokwelapha.

Iyini into ebalulekile mayelana nezifo ze-neuroendocrine?

Izifo ze-neuroendocrine ziyizimo ezilawuleka ezithinta izicell ezikhiqiza ama-hormone kulo lonke umzimba wakho. Nakuba ukuthola le nxilongo kungase kuzwakale kuyadumaza, abantu abaningi abanezi zifo baphila impilo egcwele, esebenzayo ngokwelashwa okulungile nokulandelela.

Izinto ezibaluleke kakhulu okumele uzikhumbule ukuthi lezi zifo zivame ukukhula kancane, izinketho eziningi zokwelapha ziyatholakala, futhi ukuthola kwasekuqaleni kuvame ukubangela imiphumela emihle. Iqembu lakho lokunakekelwa kwezempilo lizosisebenza nawe ukwakha uhlelo lokwelapha oluqondene nesimo sakho esithile.

Unganqikazi ukubuza imibuzo, funani imibono yesibili uma kudingeka, futhi xhasa uhlelo lwakho lokusekela phakathi nalo lohambo. Ngokwelashwa kwamanje okuthuthukile nezindlela zokulandelela, umbono wabantu abanezifo ze-neuroendocrine uqhubeka uthuthuka.

Imibuzo evamile ebuzwayo mayelana nezifo ze-neuroendocrine

Ingabe izifo ze-neuroendocrine zihlale zingezomdlavuza?

Cha, izifo ze-neuroendocrine zingaba yi-benign (ezingezona ezomdlavuza) noma i-malignant (ezomdlavuza). Izifo eziningi zalezi zikhula kancane kakhulu futhi zingase zingasabalali kwezinye izingxenye zomzimba wakho. Udokotela wakho uzoqonda ukuthi isifo sakho esithile siyi-benign noma i-malignant ngezindlela ezahlukene zokuhlola kufaka phakathi i-biopsy nezifundo zokuthola izithombe.

Ingabe izifo ze-neuroendocrine zingaphiliswa ngokuphelele?

Yebo, izifo eziningi ze-neuroendocrine zingaphiliswa ngokuphelele, ikakhulu uma zitholakala kwasekuqaleni futhi azisabalalanga ngaphandle kwendawoni yazo yokuqala. Ukuhlinzwa kuvame ukususa isifo sonke, okuholela ekwelapheni okuphelele. Ngisho noma ukwelapha akunakwenzeka, abantu abaningi baphila iminyaka eminingi ngokulawulwa kwezimpawu okuphumelelayo nokwelashwa.

Ingabe ngizodinga ukwelashwa ngokushesha uma ngixilongwe?

Akudingeki. Izifo eziningi ze-neuroendocrine ezikhula kancane zingalandelelwa ngokuhlolwa okujwayelekile ne-scans ngaphandle kokwelashwa kwangoko. Le ndlela, ebizwa ngokuthi yi-active surveillance noma ukulinda, ikuvumela ukuba ugweme imiphumela emibi yokwelashwa ngenkathi uqinisekisa ukuthi isifo asiguquki. Udokotela wakho uzokukhuthaza ukwelashwa kwangoko kuphela uma isifo sikhula, sibangela izimpawu, noma sikhiqiza ama-hormone amaningi.

Ingabe ukucindezeleka noma ukudla kungabangela izifo ze-neuroendocrine?

Cha, izifo ze-neuroendocrine azibangelwa ukucindezeleka, ukudla, noma izinqumo zokuphila. Lezi zifo zithuthukela ngenxa yezinguquko ze-genetic ezicell ezivame ukwenzeka ngokungahleliwe ngokuhamba kwesikhathi. Nakuba ukudla okuthile kungase kubangele izimpawu kubantu abasenesifo ezikhiqiza ama-hormone, akuzibangeli izifo ngokwazo ukuthi zithuthuke.

Ngaziqondisa kanjani i-appointment zokulandelela nokuhlolwa?

Izinhlelo zokulandelela zihluka kuye ngohlobo lwesifo sakho esithile, ukwelashwa, nempilo yakho yonke. Abantu abaningi badinga ukuhlolwa njalo ngenyanga ezingu-3-6 ekuqaleni, okungase kusabalale kanye noma kabili ngonyaka njengoba isikhathi siqhubeka. Udokotela wakho uzokubeka ukuhlolwa kwegazi okujwayelekile ne-imaging scans ukuqapha isimo sakho. Ukuvamile okuqondile kuzolungiswa ngesimo sakho somuntu siqu nokuthi uphendula kanjani ekwelapheni.