Kukambirana ndi Dr. Edward M. Wolin, MD
Imfa ya Steve Jobs kuchokera ku khansa yosawerengeka ya pancreatic yotchedwa kancreatic neuroendocrine khansa inakondweretsa chidwi cha khansa ya pancreatic. Phunziroli, Dr. Edward Wolin, katswiri wa khansa ya neuroendocrine yokhala ndi Cedars Sinai Medical Center, akukambirana za khansa ya pancreatic neuroendocrine ndi momwe odwala akulimbana ndi matendawa. Dr. Wolin ndi wotsogolera mgwirizano wa Carcinoid ndi Neuroendocrine Tumor Programme ku Cedars-Sinai Medical Center ndipo ali ndi imodzi mwa njira zazikuru zomwe zikudziwika ndi khansa ya pancreatic neuroendocrine.
Iye samamuchitira Steve Jobs.
Kodi mungathe kufotokozera khansa ya pancreatic neuroendocrine?
Khansa ya khansa yotchedwa neuroendocrine khansa imakula mofulumira kwambiri yomwe imayambira m'maselo otchedwa endocrine (maselo opanga mahomoni) a mphukira, omwe amadziwikanso ngati maselo a islet. Ngakhale kuti zotupazi zingathe kupanga mahomoni osiyanasiyana, ambiri samapanga mahomoni. Kawirikawiri amafalikira kumimba ndi chiwindi nthawi yomwe amadziwa. Komabe, kupulumuka kumakhala kotsika kwambiri kusiyana ndi mtundu wamba wa khansa ya pancreatic (adenocarcinoma) , ngakhale pamene metastases alipo.
Kodi zimapezeka bwanji? Kodi pali zizindikiro zirizonse?
Pamene khansa imabala mahomoni, zizindikiro zoyambirira zikhoza kukhala zoopsa ndipo zimayambitsa matenda oyamba. Mwachitsanzo, chotupa chotulutsa insulini chimayambitsa zizindikiro za shuga wotsika kwambiri, kapena chotupa cha gastrin, chimayambitsa zilonda zam'mimba komanso zam'mimba, zomwe zimayambitsa matenda a CT scan, MRI scan, kapena endoscopic ultrasound ya pancreas.
Ngati kutulutsa kwa ma hormone sikumayambitsa zizindikiro za kuchipatala, zotupa zimayamba kukula mpaka kukula komanso kufalikira ku chiwindi ndi malo ena panthawi yomwe imapezeka pa CT kapena MRI. Pazochitikazi, zizindikiro zoyamba zikhoza kukhala zowawa m'mimba, jaundice, kulemera kwa thupi, malaise, kupweteka m'mimba, kusanza, kutupa khungu, kufooka, ndi kutsegula m'mimba.
Ndani ali pangozi? Kodi munthu wathanzi ayenera kukhala wokhudzidwa ndi khansa ya pancreatic neuroendocrine?
Izi ndizosavuta kwambiri, zomwe zimakhala ndi anthu atatu ku America, zomwe zimawerengetsa 3% za khansa ya pancreatic. Choncho, wamba, munthu wathanzi sayenera kudera nkhaŵa kwambiri za kansalu ya pancreatic neuroendocrine. Chokhachokha chiri m'mabanja ena kumene khansara ya pancreatic neuroendocrine imakhala yowamba, kawirikawiri imagwirizanitsa ndi zotupa za parathyroid ndi zotupa . Chodziwikiratu cha banjachi chimadziwika kuti multiple endocrine neoplasia mtundu 1 (MEN-1).
Kodi tikudziwa chomwe chimayambitsa?
Tikudziwa kuti kusintha kwa thupi - geni imayambitsa AMEN-1, ndipo tikudziwa kuti zina zosabadwa za majini zimakhala zofala makamaka mu kansa ya pancreatic neuroendocrine, koma nthawi zambiri chifukwa chake sichidziwika.
Kodi pali njira zothetsera chiopsezo kapena kupewa khansa ya pancreatic neuroendocrine?
Palibe njira yodziŵira ngozi kapena kupewa khansa ya pancreatic neuroendocrine.
Ndi mankhwala ati omwe alipo?
Chifukwa cha ziphuphu izi mwa anthu ambiri, ndipo chithandizo chofunikira kwambiri chofunikira, odwala amalimbikitsidwa kuti afunse mafunso kuchokera ku khungu lapadera la neuroendocrine tumor center. M'malo amenewa, palinso mgwirizano wapadera ndi zachipatala, zachipatala , zachipatala, zachipatala, opaleshoni yachipatala, opaleshoni ya opaleshoni, ma radio radiological, ma radio radiology, ndi mankhwala a nyukiliya kuti akwaniritse chisamaliro cha munthu aliyense.
Mankhwalawa akuphatikizapo opaleshoni yothandizira odwala matumbo oyambirira ndi metastases, kuperewera kwa metastases ndi microwaves, kuteteza zotupa ndi intrahepatic rayation (radioembolization) ndi intrahepatic chemotherapy (chemoembolization), kuletsa kukula kwa chotupa ndi zida zogwirizana ndi biologic (somatostatin analogs, m-TOR inhibitors, tyrosine kinase inhibitors , chithandizo chamatenda a radionuclide omwe amatchedwa PRRT, chitetezo cha mthupi, ndi mankhwala osagwirizana ndi angiogeni), komanso kugwiritsa ntchito mankhwala otsika poizoni.
Kuti mudziwe zambiri za Dr. Edward Wolin ndi zomwe amachita ku Cedars Sinai Medical Center, chonde pitani ku tsamba la Cedars Sinai.