Iyini i-Pheochromocytoma? Izimpawu, Izimbangela, & Ukwelashwa

I-Pheochromocytoma iyisigxobo esingavamile esikhula ezicubuzelweni ze-adrenal, izicubu ezincane ezihlala phezulu kwezinkalweni zakho. Lezi zigxobo zenza ama-hormone amaningi okuthiwa yi-catecholamines, ezihlanganisa i-adrenaline ne-noradrenaline.

Cabanga ngakho njengesistimu yokuxwayisa yomzimba wakho ebanjelwe ekuqhubekeni okukhulu. Nakuba izingxenye eziningi ze-pheochromocytomas zilungile (ezingezona ezomdlavuza), zingabangela izinkinga ezinkulu zempilo ngoba zigcwalisa uhlelo lwakho ngama-hormone wokucindezeleka. Izindaba ezinhle ukuthi ngokuxilongwa okuqondile nokuphathwa, lesi simo singaphathwa kahle.

Ziyini izimpawu ze-pheochromocytoma?

Izimpawu zenzeka ngoba umzimba wakho uhlale ugcwele ama-hormone wokucindezeleka, okwenza uzizwe njengoba uhlale usesimweni sokulwa noma ukubaleka. Lezi zimpawu zingafika zihambe ngokungalindelekile, okuvame ukwenza ukuxilongwa kube nzima.

Izimpawu ezivamile ongazihlangabezana nazo zihlanganisa:

• Uxinzelelo lwegazi oluphezulu oluyinselele ukulawula ngemithi
• Ubuhlungu bokhanda obukhulu obuzwakala buhlukile ebuhlungwini bakho bokhanda oluvamile
• Ukukhipha ukushisa okukhulu, ngisho noma ungashisi noma usebenza
• Intsha yokushaya kwenhliziyo noma engavamile
• Ukukhathazeka noma ukuhlaselwa kokukhathazeka
• Ukuthuthumela noma ukuzamazama
• Isikhumba esimhlophe
• Ukulahlekelwa isisindo okungachazwanga

Abanye abantu bahlangabezana nalokho odokotela abakubiza ngokuthi “ama-episodes” noma “ukuhlukunyezwa” lapho lezi zimpawu zibe zimbi kakhulu ngokuzumayo. Lezi zikhathi zingagcina kusukela emaminithini ambalwa kuya emahoreni amaningana. Phakathi kwama-episodes, ungase uzizwe uqondile, yingakho lesi simo singaba nzima ukusibamba.

Kwezinye izikhathi ezingavamile, ungase uhlangabezane nokuhlanza, ukugabha, izinkinga zobuso, noma ubuhlungu esifubeni. Nakuba lezi zimpawu zingaba yizinto ezesabekayo, khumbula ukuthi ukwelashwa okuphumelelayo kukhona uma isimo sixilongwe kahle.

Yini ebangela i-pheochromocytoma?

Imbangela eqondile ye-pheochromocytoma ayicaci ngaso sonke isikhathi, kodwa siyazi ukuthi ivela lapho amaseli athile ezicubuzelweni zakho ze-adrenal eqala ukukhula ngokungavamile. La maseli, okuthiwa amaseli e-chromaffin, avame ukuba nomthwalo wokuveza ama-hormone amancane wokucindezeleka.

Cishe i-40% ye-pheochromocytomas ihlotshaniswa nezimo zezofu zakwa-genetic eziwusizo. Uma unomlando womndeni wezifo ezithile ze-genetic, ingozi yakho ingase ibe phezulu. Lokhu kuhlanganisa izimo ezifana ne-multiple endocrine neoplasia (MEN) izinhlobo ze-2A ne-2B, isifo se-von Hippel-Lindau, ne-neurofibromatosis uhlobo lwe-1.

Kweminye imicimbi, izigxobo zibonakala zikhula ngokuzimela ngaphandle kokuxhumana okucacile kwe-genetic. Abacwaningi basafunda ukuthi yini ebangela lokhu kukhula okungavamile kwamaseli kubantu abangenayo imfuzo ye-genetic.

Kubalulekile ukwazi ukuthi akukho lutho olukwenzile noma olungakwenzanga oluyimbangela yalesi simo. Lezi zigxobo zingakhula kunoma ubani, kungakhathaliseki ukukhetha kwesitayela sempilo noma imikhuba yempilo.

Nini okufanele ubona udokotela nge-pheochromocytoma?

Kufanele uxhumane nodokotela wakho uma uhlangabezana nokuhlanganiswa kokuhlungu kwekhanda okukhulu, ukukhipha ukushisa okukhulu, nokushaya kwenhliziyo okusheshayo, ikakhulukazi uma lezi zimpawu zifika ngama-episodes. Leli qembu lezimpawu, ikakhulukazi uma zivele ndawonye ngokuphindaphindiwe, lidinga ukunakekelwa kwezokwelapha.

Funani ukunakekelwa kwezokwelapha ngokushesha uma unexinzelelo lwegazi eliphezulu kakhulu (ngaphezulu kwe-180/120) kanye nezimpawu ezifana nobuhlungu bokhanda obukhulu, ubuhlungu esifubeni, ubunzima bokuqeda umoya, noma ukushintsha kobuso. Lokhu kungase kubonise ingozi ye-hypertensive, edinga ukwelashwa okusheshayo.

Futhi xhumana nodokotela wakho uma unexinzelelo lwegazi eliye laba nzima ukulawula ngemithi yakho evamile, noma uma uhlangabezana nokukhathazeka okusha, okungachazwanga noma ukuhlaselwa kokukhathazeka kanye nezimpawu zomzimba.

Uma unomlando womndeni we-pheochromocytoma noma izimo ze-genetic ezihlobene, kuwukuhlakanipha ukuxoxa ngezinketho zokuhlola nodokotela wakho, ngisho noma awunazo izimpawu.

Ziyini izinto ezingozi ze-pheochromocytoma?

Ukuqonda izinto zakho ezingozi kungakusiza wena nodokotela wakho ukuthi nihlale nixwayile ngezibonakaliso ezingaba khona zalesi simo. Into enkulu engaba yingozi ukuba nezimo ezithile ze-genetic eziwusizo ezidlulela emindenini.

Ingozi yakho ingase ibe phezulu uma una:

• I-multiple endocrine neoplasia (MEN) uhlobo lwe-2A noma lwe-2B
• Isifo se-Von Hippel-Lindau
• I-Neurofibromatosis uhlobo lwe-1
• I-Hereditary paraganglioma syndrome
• Umlando womndeni we-pheochromocytoma

Ubudala buphinde bube nomthelela, ngezinengi ze-pheochromocytomas ezixilongwe kubantu abaneminyaka engama-40 kuya kwengu-60. Kodwa-ke, zingase zenzeke kunoma yimuphi ubudala, kuhlanganise nezingane nabantu abadala abasebasha, ikakhulukazi uma zihlotshaniswa nezimo ze-genetic.

Ngokungafani nezinye izimo eziningi, izinto ezithinta isitayela sempilo ezifana nokudla, ukuzivocavoca, noma amazinga wokucindezeleka azithinti kakhulu ingozi yakho yokuthuthukisa i-pheochromocytoma. Lokhu kusho ukuthi akufanele uzisole uma uxilongwe ngalesi simo.

Ziyini izinhlanganisela ezingaba khona ze-pheochromocytoma?

Ngaphandle kokwelashwa, i-pheochromocytoma ingabangela izinhlanganisela ezinkulu ngoba ama-hormone amaningi abeka umthwalo omkhulu ohlelweni lwakho lokugaya inhliziyo. Inhlanganisela ephambili eyinkathazo yingozi ye-hypertensive, lapho uxinzelelo lwegazi lukhuphuka kakhulu.

Izinhlanganisela ezingaba khona zihlanganisa:

• Izinkinga zenhliziyo, kuhlanganise nezindlela ezingavamile, ukuhlaselwa kwenhliziyo, noma ukwehluleka kwenhliziyo
• Ukushaya ngenxa yokuphakama kakhulu kwegazi
• Ukonakala kwesibindi ngenxa yokuphakama kwegazi isikhathi eside
• Izinkinga zamehlo, kuhlanganise nokulahlekelwa umbono ngenxa yomonakalo wezitho zegazi
• I-Diabetes ngenxa yemiphumela ye-hormonal egazini
• Umanzi emaphaphwini (i-pulmonary edema)

Kwezinye izikhathi ezingavamile, uma isigxobo simbi (umdlavuza), singasakazeka kwenye ingxenye yomzimba wakho. Kodwa-ke, iningi le-pheochromocytomas lilungile.

Izindaba ezikhuthazayo ukuthi ngokwelashwa okuqondile, lezi zinhlanganisela ngokuvamile zingavikeleka. Ukuxilongwa kwasekuqaleni nokuphathwa okuqondile kunciphisa kakhulu ingozi yakho yokubhekana nalezi ziphumo ezinkulu.

I-pheochromocytoma ixilongwa kanjani?

Ukuxilongwa kwe-pheochromocytoma ngokuvamile kuqala ngezivivinyo zegazi nezinye ze-urine ezinga-measure amazinga e-catecholamines nemikhiqizo yazo yokwahlukaniswa ohlelweni lwakho. Udokotela wakho cishe uzokucela ukuthi uqoqe i-urine phakathi namahora angu-24 noma unikeze amasampula egazi.

Uma lezi zihloko zikhomba i-pheochromocytoma, udokotela wakho uzokubeka izifundo zokubonisa ukuthola isigxobo. I-CT scans noma i-MRI scans ngokuvamile zingabonisa ukuthi isigxobo sikuphi ezicubuzelweni zakho ze-adrenal noma, kwezinye izikhathi ezingavamile, kwenye indawo emzimbeni wakho.

Ngezinye izikhathi odokotela basebenzisa uhlobo oluhlukile lokucubungula okuthiwa yi-MIBG scintigraphy, esebenzisa into enesakhiwo esibonakalayo esidonsa amaseli e-pheochromocytoma. Lolu vivinyo lungaba usizo kakhulu ekutholeni izigxobo ezingase zibe fihliwe ezindaweni ezingavamile.

Udokotela wakho angase futhi akukhuthaze ukuhlolwa kwe-genetic, ikakhulukazi uma uxilongwe usemncane noma unomlando womndeni wezimo ezihlobene. Lolu lwazi lungaba usizo ohlelweni lwakho lokwelashwa nakubalandeli bomndeni abangase bazuze ekucubunguleni.

Ukuphathwa kwe-pheochromocytoma kuyini?

Ukuhlinzwa kokususa isigxobo kuyindlela eyinhloko yokwelapha i-pheochromocytoma, futhi ngokuvamile kuyaphilisa. Kodwa-ke, iqembu lakho lezokwelapha lizodinga ukukulungiselela ngokucophelela ukuhlinzwa ngoba ukususa isigxobo kuqala kungabangela amazinga e-hormone ukuba ashintshe kakhulu.

Ngaphambi kokuhlinzwa, ngokuvamile uzoba nemithi okuthiwa yi-alpha-blockers amasonto ambalwa. Le mithi ikusiza ukulawula uxinzelelo lwakho lwegazi nesivinini senhliziyo ngokuvimba ezinye iziphumo zama-hormone amaningi. Imithi evamile ihlanganisa i-phenoxybenzamine noma i-doxazosin.

Udokotela wakho angase futhi afake i-beta-blockers, kodwa kuphela ngemuva kokusebenzisa i-alpha-blockers kuqala. Kuzodingeka futhi ukhulisa ukudla kwakho usawoti namanzi phakathi nalesi sikhathi sokulungiselela ukuze ukhulisa umthamo wagadi.

Ukuhlinzwa ngokwalo ngokuvamile kwenziwa nge-laparoscopically (okungenayo ukungena okukhulu) uma kungenzeka, okusho ukuthi ukunqunywa okuncane nokuphulukiswa okusheshayo. Kwezinye izikhathi, ikakhulukazi ngezigxobo ezinkulu, ukuhlinzwa okuvulekile kungase kudingeke.

Kweminye imicimbi engavamile lapho i-pheochromocytoma imbi futhi isakazeke, ukwelashwa kungase kuhlanganise i-chemotherapy, i-radiation therapy, noma imithi ehloselwe. Iqembu lakho le-oncology lizosisebenza nawe ukuze likhethe indlela engcono kakhulu yesimo sakho esithile.

Indlela yokuphatha izimpawu ekhaya ngesikhathi sokwelashwa?

Ngesikhathi ulungiselela ukwelashwa noma uphulukisa ngemuva kokuhlinzwa, kunezinto eziningana ongenza ekhaya ukuze usize ukuphatha izimpawu zakho nokusekela impilo yakho yonke. Ikhona ukugwema izinto ezingase zibangele ama-episodes ezimpawu.

Zama ukugwema izinto ezibangela izimpawu zakho zibe zimbi:

• Ukudla okuthile njenge-cheese elikhulile, i-chocolate, noma ukudla okune-tyramine eningi
• Uchweba ne-caffeine
• Imithi ethile, ikakhulukazi i-decongestants
• Ukuzinyathela okukhulu noma ukushintsha kwesikhundla ngokuzumayo
• Ucindezeleko olukhulu uma kungenzeka

Gxilisa emisebenzini ebushelelezi, evamile ekhuthaza ukuphumula. Ukuhamba okukhanyayo, ukuzivocavoca kokuphefumula okujulile, noma ukuzindla kungasiza ukuphatha ukukhathazeka namazinga ocindezeleko. Qiniseka ukuthi uthola ukuphumula okwanele, njengoba ukhathele kungenza izimpawu zibe zimbi.

Gcina idayari yezimpawu ukuze uqaphele ukuthi ama-episodes enzeka nini nokuthi yini engase iwayibangele. Lolu lwazi lungaba usizo kakhulu eqenjini lakho lezokwelapha ekuphatheni isimo sakho.

Thatha imithi yakho ebekiwe ngokuqondile njengoba iyalwe, ikakhulukazi imithi yoxinzelelo lwegazi. Ungayeki noma ungashintshi izilinganiso ngaphandle kokukhuluma nodokotela wakho kuqala, njengoba lokhu kungabangela ukuguquguquka okubi koxinzelelo lwegazi.

Kufanele ulungiselele kanjani i-appointment yakho yodokotela?

Ukulungiselela kahle i-appointment yakho kuzosiza ukuqinisekisa ukuthi udokotela wakho uneyonke imininingwane edingekayo ukukunikeza ukunakekelwa okuhle kakhulu. Qala ngokubhala zonke izimpawu zakho, kuhlanganise nokuthi zaqala nini nokuthi zivele kangaki.

Letha uhlu oluphelele lwazo zonke imithi oyithathayo, kuhlanganise nemithi yokuthengwa ngaphandle komthetho kanye nezinye izinto. Imithi ethile ingase ihlanganise nemiphumela yokuhlola noma ibe zimbi izimpawu, ngakho udokotela wakho udinga lesi sithombe esiphelele.

Lungiselela ulwazi ngomlando womndeni wakho wezokwelapha, ikakhulukazi noma yimiphi izihlobo eziye zaba ne-pheochromocytoma, izigxobo ezingavamile, noma izimo ze-genetic ezihlobene. Lolu lwazi lungaba yinto ebalulekile ekuxilongweni nasekulungiseleleni ukwelashwa kwakho.

Bhala imibuzo ofuna ukuyibuza udokotela wakho. Ungakhathazeki ngokuba nemibuzo eminingi kakhulu. Lena impilo yakho, futhi ukuqonda isimo sakho kubalulekile ukuthula kwakho kwengqondo nokuphumelela kokwelashwa.

Cabanga ngokuletha umngani othembekile noma ilungu lomndeni e-appointment yakho. Bangakusiza ukuba ukhumbule imininingwane ebalulekile futhi banikeze ukusekela ngokomzwelo ngesikhathi esingase sizizwe sinzima.

Yini eyinhloko ebalulekile nge-pheochromocytoma?

I-Pheochromocytoma iyisimo esingavamile kodwa esingaphatheka esithinta izicubuzelweni zakho ze-adrenal ezakha ama-hormone. Nakuba izimpawu zingase zibe yizinto ezesabekayo futhi zidide, iningi lalezi zigxobo lilungile futhi lingaphathwa ngempumelelo ngokuhlinzwa.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukuxilongwa kwasekuqaleni nokuphathwa okuqondile kuholela eziphumeni ezinhle kubantu abaningi. Ngokunakekelwa kwezokwelapha okufanele, ungalindela ukubuyela ekuphileni okuqondile ngemuva kokwelashwa.

Uma uhlangabezana nokuhlanganiswa okuvamile kokuhlungu kwekhanda okukhulu, ukukhipha ukushisa okukhulu, nokushaya kwenhliziyo okusheshayo, ikakhulukazi ngama-episodes, ungangabazi ukufuna ukucubungula kwezokwelapha. Nakuba i-pheochromocytoma ingavamile, ukuyibamba kwasekuqaleni kwenza ukwelashwa kube lula kakhulu.

Hlala uxhumene neqembu lakho lezokwelapha kulo lonke uhambo lwakho lokwelashwa. Yiwona umthombo wakho omuhle kakhulu wokuphatha lesi simo nokuqinisekisa iziphumo ezinhle kakhulu zempilo yakho nekhwalithi yempilo.

Imibuzo evamile ebuzwa nge-pheochromocytoma

Ingavikeleka yini i-pheochromocytoma?

Izingxenye eziningi ze-pheochromocytomas azikwazi ukuvinjelwa ngoba ngokuvamile zikhula ngenxa yezizathu ze-genetic noma ezingaziwa. Kodwa-ke, uma unesisimo esaziwayo se-genetic esandisa ingozi yakho, ukucubungula okuvamile kungasiza ekutholeni izigxobo kwasekuqaleni lapho zilawuleka kakhulu. Ukugcina impilo enhle yonke futhi ugweme izinto ezibangela izimpawu kungasiza ekuphatheni isimo uma sixilongwe.

Ngingadinga yini ukwelashwa okuphila konke ngemuva kokuhlinzwa?

Abantu abaningi abadingi ukwelashwa okuqhubekayo ngemuva kokususa i-pheochromocytoma elungile ngempumelelo. Udokotela wakho uzokulandela ngezivivinyo zegazi eziphindaphindiwe nokubheka ukuqinisekisa ukuthi isigxobo asibuyanga. Abanye abantu bangase badinge imithi yoxinzelelo lwegazi oluqhubekayo, kodwa lokhu ngokuvamile kuyasheshisa njengoba umzimba wakho uqondanisa ngemuva kokuhlinzwa.

Ingabuya yini i-pheochromocytoma ngemuva kokwelashwa?

Ukubuyela emuva akuvamile ngemuva kokususa ngokuhlinzwa okuphelele, kwenzeka ngaphansi kwe-10% yezimo. Ingozi iphezulu kancane uma unesisimo se-genetic noma uma isigxobo sokuqala sasingabi luhle. Yingakho udokotela wakho azokukhuthaza ukuthi ube ne-appointment yokulandelela eziphindaphindiwe nokuhlolwa okuphindaphindiwe ukuze uqaphele noma yiziphi izibonakaliso zokubuyela emuva.

I-Pheochromocytoma iyimdlavuza ngaso sonke isikhathi?

Cha, cishe i-90% ye-pheochromocytomas iluhle, okusho ukuthi ayisakazeki kwenye ingxenye yomzimba. Ngisho nezigxobo ezilungile zidinga ukwelashwa ngoba zenza ama-hormone amaningi angabangela izinkinga ezinkulu zempilo. Cishe i-10% kuphela ezingabi luhle (umdlavuza), futhi ngisho nalokhu ngokuvamile kungaphathwa ngempumelelo ngokwelashwa okufanele.

Ucindezeleko lungabangela ama-episodes e-pheochromocytoma?

Nakuba ucindezeleko lungabangeli i-pheochromocytoma ngokwayo, lungabangela ama-episodes ezimpawu kubantu abasenesimo. Isigxobo sivelisa ama-hormone ocwecwe ngokuqhubekayo, futhi ucindezeleko olwengeziwe lungakhuphula la mazinga, okubangela izimpawu ezimbi kakhulu. Ukuphatha ucindezeleko ngezindlela zokuphumula kungasiza ekuthuthukiseni ubukhulu nokuvamile kwama-episodes.