Kumvetsetsa Kachira Kameneka Kameneka Kameneka
Rhabdomyosarcoma ndi khansa yosabadwa yomwe imapezeka nthawi zambiri ali mwana. Kodi zizindikiro za zotupazi, zimapezeka bwanji, ndipo ndi njira ziti zamankhwala zomwe zingapezeke?
Rhabdomyosarcoma-Tanthauzo
Rhabdomyosarcoma ndi mtundu wa sarcoma . Sarcomas ndi zotupa zomwe zimachokera ku maselo a mesothelial, maselo m'thupi omwe amachititsa minofu yolumikizana monga fupa, karotila, minofu, mitsempha, ziwalo zina zofewa.
Pafupifupi 85 peresenti ya khansa, mosiyana, ndi ma carcinoma, omwe amachokera ku maselo a epithelial.
Mosiyana ndi ma carcinomas omwe maselo a epithelial ali ndi chinachake chomwe chimadziwika kuti ndi "chingwe chapansi," mitsempha sichikhala ndi "sitepe yodziwika bwino" ndipo chotero kuyesa kuyesera kwa magawo osatetezeka a matendawa sikugwira ntchito. (Phunzirani zambiri za mitundu yosiyanasiyana ya khansa komanso momwe mzere wamakono ulili wapadera.)
Rhabdomyosarcoma ndi khansara ya maselo a minofu, makamaka mitsempha ya mitsempha (minofu yovuta) yomwe imathandiza kuyenda kwa matupi athu. Kalekale, rhabdomyosarcoma imadziwika ngati "khungu labuluu labuluu la ubwana" motengera mtundu wa maselo akutembenuka ndi dothi lapadera lomwe limagwiritsidwa ntchito pa matenda.
Zonsezi, kansara iyi ndi mtundu wachitatu wa khansa yeniyeni yeniyeni (osati kuphatikizapo khansa yokhudzana ndi magazi monga khansa ya m'magazi). Ndizofala kwambiri kwa anyamata kusiyana ndi atsikana ndipo amakhalanso ochepa kwambiri ku Asia ndi Africa American ana kuposa ana oyera.
Mitundu ya Rhabdomyosarcoma
Rhabdomyosarcoma yaphwasulidwa kukhala atatu subtypes:
- Ma embryonararcoma amatha 60 mpaka 70 peresenti ya khansa imeneyi ndipo amapezeka kawirikawiri pakati pa zaka za kubadwa ndi zaka 4. Mtundu uwu umasinthidwanso kukhala subtypes. Matumbo a embryonal amapezeka pamutu ndi m'khosi, ziwalo za thupi, kapena zigawo zina za thupi.
- Mankhwalawa amadziwika kwambiri ndipo amapezeka mwa ana pakati pa zaka za kubadwa ndi 19. Ndi mtundu wochuluka wa rhabdomyosarcoma womwe umapezeka achinyamata ndi achinyamata. Mankhwalawa amapezeka pamapeto (mikono ndi miyendo), malo odyetserako ziweto, komanso chifuwa, mimba, ndi pakhosi.
- Anaplastic (pleomorphic) rhabdomyosarcoma ndi yosazolowereka ndipo imawoneka nthawi zambiri mwa akuluakulu kuposa ana.
Masamba a Rhabdomyosarcomas
Rhabdomyosarcomas ikhoza kupezeka paliponse m'thupi pamene minofu imakhalapo. Malo omwe amapezeka kwambiri amapezeka pamutu ndi m'khosi, monga zilonda zam'mimba (pafupi ndi diso), ndi madera ena, pelvis (zotupa za genitourinary), pafupi ndi mitsempha yosangalatsa ya ubongo (parameningeal), komanso pamapeto (mikono ndi miyendo ).
Zizindikiro ndi zizindikiro za Rhabdomyosarcoma
Zizindikiro za rhabdomyosarcoma zimasiyana kwambiri malingana ndi malo a chotupacho. Zizindikiro ndi dera la thupi zingakhalepo:
- Zofupa za m'mimba: Kutupa m'mimba mwa mimba kumayambitsa magazi mumtambo kapena m'mimba, kumatenda kapena kumaliseche, kukhumudwa, ndi vuto la m'mimba kapena chikhodzodzo.
- Ziphuphu zogonana: Ziphuphu pafupi ndi diso zingayambitse kutupa m'maso ndi diso lopweteka ( proptosis ).
- Ziphuphu za parameningeal: Manjenje pafupi ndi msana wamtsempha angakhale ndi mavuto okhudzana ndi mitsempha yambiri yomwe ili pafupi ndi ululu wa nkhope, zizindikiro za sinus, mphuno yamagazi, ndi mutu.
- Zoopsa: Pamene mahabwenzi amapezeka m'mikono kapena miyendo, chizindikiro chofala kwambiri ndi chifuwa kapena kutupa zomwe sizimachoka koma kumawonjezeka kukula.
Chikoka
Rhabdomyosarcoma ndi wamba ndipo amawerengera pafupifupi 3.5 peresenti ya khansa ana. Pafupifupi ana 250 ali ndi khansa iyi ku United States chaka chilichonse.
Zifukwa ndi Zoopsa
Sitikudziŵa chomwe chimayambitsa rhabdomyosarcoma, koma zifukwa zochepa zoopsya zadziwika.
Izi zikuphatikizapo:
- Ana omwe ali ndi nthenda yotenga nthenda yotchedwa neurofibromatosis type 1 (NF1), Li-Fraumeni syndrome, Costello syndrome , pleuropulmonary blastoma, cardio-facial cutaneous syndrome, matenda a Noonan, ndi matenda a Beckwith-Wiedermann
- Makolo amagwiritsira ntchito chamba kapena cocaine
- Kulemera kwakukulu
Kudziwa
Kafukufuku wa rhabdomyosarcoma amayamba ndi mbiri yosamalitsa komanso kuunika kwa thupi. Malinga ndi malo a chotupacho, maphunziro ojambula monga x-ray, CT scan, MRI, bone scan, kapena PET scan akhoza kuchitidwa.
Kuti atsimikizire kuti akudziwika kuti akudwala matenda, chidziwitso chimafunika kuti chichitike. Zosankha zingaphatikizepo singano yabwino ya singano (kugwiritsira ntchito singano yaing'ono kuti ifune aspirate ya minofu), chingwe chachikulu cha singano, kapena chidziwitso chotseguka chikhoza kuchitidwa. Mayiyu akamakhala ndi mnofu wa minofu, chotupacho chimayang'anitsitsa pansi pa microscope ndipo maphunziro ena nthawi zambiri amapangidwa kuti azindikire momwe maselo amachitira phokoso (kuyang'ana zamoyo zomwe zimayambitsa matendawa).
Kuti muyang'ane matenda odwala matendawa , chiwerengero cha nthendayi chikhoza kuchitika. Kuyezetsa uku kumaphatikizapo kupiritsa utoto wabuluu ndi kusokoneza mavitamini mumatumbo ndiyeno kutenga chitsanzo cha ma lymph nodes pafupi kwambiri ndi chotupa chomwe chimakhala chowala kapena chodetsedwa. Kuthamanga kwathunthu kwa maselo ammimba kumatithandizanso ngati mayeso a testinel ali abwino chifukwa cha khansa. Maphunziro ena oti apeze masiteti angaphatikizepo fupa la fupa , fupa la mafupa , ndi / kapena CT ya chifuwa.
Kulemba ndi Kugawana
"Kulimba" kwa rhabdomyosarcoma kumatanthauzanso kupyolera mu siteji kapena gulu la khansa.
Pali magawo 4 a rhabdomyosarcoma:
- Gawo Woyamba: Gawo Lomwe ndimapewa amapezeka mu "malo abwino" monga orbital (pafupi ndi diso), mutu ndi khosi, m'mimba zoberekera (monga ma testes kapena mazira), ma tubes akugwirizanitsa impso ndi chikhodzodzo. ), chubu imagwirizanitsa chikhodzodzo kunja (urethra) kapena kuzungulira ndulu. Ziphuphuzi zikhoza kapena sizifalikira ku maselo am'mimba.
- Gawo Lachiwiri: Zovunda za Stage II sizinafalikire ku maselo, sizoposa masentimita awiri, koma zimapezeka "malo osasangalatsa" monga malo ena omwe sanatchulidwe pansi pa sitepe I.
- Gawo Lachitatu: Chotupacho chinalipo pamalo osavomerezeka ndipo mwina sichikufalikira ku minofu kapena kukhala wamkulu kuposa masentimita asanu.
- Gawo lachisanu ndi chimodzi: Khansara ya malo alionse kapena kupatsirana kwa mitsempha yomwe yafalikira kumalo akutali.
Palinso magulu 4 a rhabdomyosarcomas:
- Gulu I: Gulu 1 limaphatikizapo zotupa zomwe zingathetsedwe ndi opaleshoni ndipo sizinafalikire ku ma lymph nodes.
- Gulu lachiwiri: Matenda a gulu lachiwiri akhoza kuchotsedwa ndi opaleshoni koma palinso maselo a khansa omwe ali pamphepete mwa m'mphepete mwake (kumapeto kwa chifuwa chochotsedwa), kapena khansara yayamba kufalikira ku maselo.
- Gulu 3: Matenda a magulu atatu ndi omwe sanafalikire, koma sangathe kuchotsedwa ndi opaleshoni chifukwa china (nthawi zambiri chifukwa cha malo otupa).
- Gulu 4: Matenda a gulu la 4 ndi awa omwe afalikira kumadera akutali a thupi.
Pogwiritsa ntchito magawowa ndi magulu, magulu a rhabdomyosarcomas amaikidwa pangozi kukhala:
- Childhood rhabdomyosarcoma
- Chiwerengero cha ana omwe ali ndi kachilombo ka HIV
- Ana ambiri omwe ali pachiopsezo cha ubongo
Metastases
Pamene khansa imafalikira, malo ambiri omwe amapezeka ndi metastases ndi mapapo, mafupa, ndi mafupa.
Mankhwala a Rhabdomyosarcoma
Njira zabwino zothandizira pa matenda a rhabdomyarcoma zimadalira pa siteji ya matenda, malo a matenda, ndi zina zambiri. Zosankha zikuphatikizapo:
- Kuchita opaleshoni: Opaleshoni ndizofunika kwambiri pa chithandizo cha mankhwala ndipo zimapereka chithandizo chabwino kwambiri chothetsera vutoli kwa nthawi yaitali. Mtundu wa opaleshoni udzadalira malo a chotupacho.
- Thandizo la ma ARV: Mankhwalawa akhoza kugwiritsidwa ntchito pofuna kuchepetsa chotupa chimene sichigwira ntchito kapena kuchiza m'mphepete mwa chotupacho pambuyo pa opaleshoni kuchotsa maselo ena onse a khansa .
- Chemotherapy: Rhabdomyosarcomas zimayankha bwino chemotherapy , ndipo 80 peresenti ya zotupazi zimachepetsa kukula ndi mankhwala.
- Zilonda zamankhwala: Njira zina zothandizira monga mankhwala osokoneza bongo amayamba kuphunzira m'mayesero.
Kulimbana
Popeza ambiri mwa khansa amachitika ali mwana, makolo ndi mwanayo ayenera kuthana ndi vutoli losayembekezereka komanso loopsya.
Kwa ana achikulire ndi achinyamata omwe ali ndi khansa, palinso chithandizo chambiri kuposa kale. Kuchokera kumidzi yothandizira pa intaneti kupita kumalo obisala matenda a khansa omwe amapangidwa makamaka kwa ana ndi achinyamata, kumanga msasa kwa mwana kapena banja, pali zinthu zambiri zomwe mungapeze. Mosiyana ndi sukulu yomwe mwana angadzimve kuti ndi wapadera, osati mwa njira yabwino, maguluwa akuphatikizapo ana ena ndi achinyamata kapena achinyamata omwe akukumana ndi chinthu chomwe palibe mwana aliyense amene ayenera kuchitapo kanthu.
Kwa makolo, pali zinthu zovuta monga momwe zimayendera khansara kwa mwana wanu. Makolo ambiri sakonda kanthu kusiyana ndi kusintha malo ndi mwana wawo. Komabe kudzisamalira nokha sikofunikira kwambiri.
Pali anthu ambiri komanso amtundu wa intaneti (masewera a pa Intaneti komanso magulu a Facebook) omwe apangidwa makamaka kwa makolo a ana omwe ali ndi kansa ya ubwana komanso ngakhale rhabdomyosarcoma makamaka. Magulu othandizira awa angakhale mzere wa moyo pamene muzindikira kuti abwenzi anu apamtima sangathe kumvetsa zomwe mukukumana nazo. Kusonkhana ndi makolo ena mwanjira iyi kukhoza kukuthandizani pamene ndikukupatsani malo omwe makolo angathe kugawana nawo posachedwapa. Nthawi zina zimadabwitsa kuti makolo nthawi zambiri amadziwa njira zamakono zothandizira ngakhale anthu ambiri m'midzi.
Musachepetse udindo wanu monga woimira. Munda wa oncology ndi waukulu ndikukula tsiku ndi tsiku. Ndipo palibe amene ali ndi chidwi ngati kholo la mwana yemwe ali ndi khansa. Phunzirani zina mwa njira zopenda khansa pa Intaneti ndipo tengani kamphindi kuti mudziwe za kukhala nokha (kapena mwana wanu) woyang'anira khansa yanu .
Kuthamangitsani
Chizindikiro cha rhabdomyosarcoma chimasiyana kwambiri malinga ndi zinthu monga mtundu wa chotupa, msinkhu wa munthu yemwe amapezeka, malo a chotupa, ndi mankhwala omwe amalandira. Chiwerengero cha zaka zisanu ndi zisanu ndi zisanu ndi zisanu ndi ziwiri (70%), ndi zotupa zochepa zomwe zimakhala ndi moyo wa 90 peresenti. Zonsezi, kupulumuka kwawoneka bwino kwa zaka makumi angapo zapitazo.
Mawu Ochokera
Rhabdomyosarcoma ndi khansara ya ubwana yomwe imachitika m'matumbo a chigoba kulikonse kumene minofu ili mu thupi. Zizindikiro zimasiyanasiyana malinga ndi malo enieni a chotupacho komanso njira zabwino zodziwira chotupacho. Kuchita opaleshoni ndi njira yoyamba yothandizira, ndipo ngati chotupacho chikhoza kuchotsedwa ndi opaleshoni pali njira yabwino yothetsera matendawa kwa nthawi yaitali. Njira zina zothandizira mankhwalawa ndi mankhwala othandizira mazira, chemotherapy, ndi immunotherapy.
Ngakhale kupulumuka kwa khansara ya ana kumakula, tikudziwa kuti ana ambiri amavutika ndi zotsatira za mankhwala. Kukhalitsa kwa nthawi yaitali ndi dokotala wodziwa zotsatira zoyenera za chithandizo ndizofunikira kuti kuchepetsa zotsatira za izi.
Makolo ndi ana omwe amapezeka, athandizidwa kumalo ena othandizira ana ena komanso makolo omwe akulimbana ndi rhabdomyosarcoma ndi ofunika kwambiri, ndipo m'zaka zapitazi pali zambiri zomwe mungapeze.
> Zotsatira:
> Dasgupta, R., Fuchs, J., ndi D. Rodeberg. Rhabdomyosarcoma. Masemina pa Opaleshoni ya Ana . 2016. 25 (5): 276-283.
> National Cancer Institute. Chithandizo cha Child Rhabdomyosarcoma Treatment (PDQ) -Health Professional Version. Kusinthidwa 12/01/17. https://www.cancer.gov/types/soft-tissue-sarcoma/hp/rhabdomyosarcoma-treatment-pdq