I-osteosarcoma

Umdlavuza wethambo i-Osteosarcoma wuhlobo lomdlavuza olungandile kodwa olubucayi oluqala kumaseli akha amathambo. Lolu hlobo lomdlavuza ngokuvamile luhlasela izingane, intsha, kanye nabantu abadala, okubangela ubuhlungu nokuvuvukala endaweni ethintekile. Ukuqonda izimpawu zomdlavuza we-osteosarcoma kanye nezinketho zokwelapha kubalulekile ukuze utholakale kusenesikhathi nokuphatha ngempumelelo. Le ndatshana ihlola izimbangela ze-osteosarcoma, izinhlobo zayo ezahlukahlukene, kanye nezimpawu ezijwayelekile ze-osteosarcoma okufanele uzibheke. 

Iyini i-Osteosarcoma?

Umdlavuza we-Osteosarcoma, noma i-osteogenic sarcoma, umdlavuza wethambo ovame kakhulu, futhi uqala kumaseli anesibopho sokwenza ithambo elisha. Lolu hlobo lomdlavuza olungavamile luvame ukuvela kumaseli e-osteoblast, abalulekile ekwakhekeni kwamathambo. Nokho, ithambo elikhiqizwa yila mangqamuzana anomdlavuza alinamandla njengethambo elivamile.

Umdlavuza wamathambo we-Osteosarcoma uvame ukuphatha amathambo amade, njengalawo asezingalweni nasemilenzeni. Ngokuvamile kwenzeka ngasekugcineni kwalawa mathambo, aziwa ngokuthi ama-metaphyses, ikakhulukazi emadolweni, lapho ukukhula okusheshayo kwenzeka entsheni. Izindawo ezivame kakhulu ze-osteosarcoma zihlanganisa i-femur (ithambo lethanga) eduze kwamadolo, i-tibia (ithambo le-shin) eduze kwedolo, kanye ne-humerus (ithambo lengalo engenhla) eduze kwehlombe.

Nakuba i-osteosarcoma ingakhula kunoma yiliphi ithambo emzimbeni, ayivamile ezindaweni ezifana ne-pelvis, ugebhezi, nomhlathi. Ezimweni ezingavamile, kungase kuthinte ngisho nezicubu ezithambile noma izitho ezisesiswini noma esifubeni.

Lolu hlobo lomdlavuza luvame ukukhula lube yizicubu eziseduze ezinempilo, njengemisipha noma imisipha. Ingase futhi isakaze noma i-metastases ngomjikelezo wegazi iye kwezinye izitho noma amathambo emzimbeni.

Izinhlobo ze-Osteosarcoma

Umdlavuza wamathambo we-Osteosarcoma ungahlukaniswa ngezinhlobo eziningana, ngayinye inezici zayo kanye nezindawo ngaphakathi komzimba. Izigaba ezimbili eziyinhloko yilezi: 

• I-Osteosarcoma Eyisisekelo: Lokhu kwenzeka ngenxa yokungajwayelekile ekukhuleni kwamathambo futhi kuvame kakhulu ezinganeni nasentsheni amathambo abo asakhula. Lezi futhi zihlukaniswe zibe izinhlobo ezintathu eziyinhloko:
  • I-Intramedullary Osteosarcoma: Le osteosarcoma iwuhlobo oluvame kakhulu, olubalelwa ku-80% wazo zonke izifo ze-osteosarcoma. Ikhula emgodini we-medullary wamathambo amade, njenge-femur. Izinhlobo ezincane zifaka i-osteoblastic, i-chondroblastic, i-fibroblastic, i-small-cell, ne-epithelioid.
  • I-Juxtacortical Osteosarcoma: Lolu hlobo lwakha u-10-15% wazo zonke izifo futhi lukhula ngaphandle kwamathambo noma i-periosteum, ungqimba oluminyene lwezicubu ezixhumeneyo ezimboza amathambo.
  • I-Osteosarcoma ye-Extraskeletal: Lolu hlobo olungavamile lubala ngaphansi kuka-5% kukho konke ukuxilonga. Lezi zimila zivela ezicutshini ezithambile futhi azinamathele ethanjeni, ngokuvamile ezenzeka ezindaweni zangaphambilini ukwelashwa kwemisebe.
• I-Osteosarcoma yesibili: Lokhu kuvame ukwenzeka kubantu abadala abanamathambo akheke ngokugcwele futhi ngokuvamile kubhekwa njengezifo eziyingozi zezinga eliphakeme kune-osteosarcoma eyinhloko.
• Ezinye izinhlobo ezingaphansi ezingavamile zihlanganisa i-parosteal, i-periosteal, i-telangiectatic, ne-small-cell osteosarcoma. 

Izimbangela Nezingozi Ze-Osteosarcoma

Imbangela eqondile yomdlavuza wamathambo we-osteosarcoma ayaziwa. Kodwa-ke, abacwaningi bakholelwa ukuthi kubangelwa ukusebenzisana okuyinkimbinkimbi kwezici zofuzo nezemvelo. Nakuba izindlela zokuthuthukisa ezinembile zingaqondwa ngokugcwele, izici ezimbalwa zobungozi ziye zaqashelwa ezingase zandise amathuba okuba nalolu hlobo lomdlavuza olungavamile. Lezi izi:

• Ubudala: Lesi simo sithinta kakhulu izingane, intsha, kanye nabantu abadala abasebasha, ngengozi enkulu kakhulu eyenzeka phakathi kuka-10 no-30. Lokhu kuphakamisa ukuxhumana okungaba khona phakathi kokukhula okusheshayo kwamathambo phakathi nokuthomba kanye nokuthuthukiswa kwe-osteosarcoma. 
• Ubulili: Kuyathakazelisa ukuthi abesifazane bavame ukuthuthukisa lesi simo ngaphambi kwesikhathi kunabesilisa, mhlawumbe ngenxa yokukhula kwangaphambi kwesikhathi.
• Izakhi zofuzo: Amanye ama-syndromes omdlavuza ozuzwe njengefa, njenge-Li-Fraumeni syndrome, i-hereditary retinoblastoma, ne-Rothmund-Thomson syndrome, ahlotshaniswa nethuba elikhulayo lokuthuthukisa i-osteosarcoma. Lawa ma-syndromes abangelwa izinguquko ezithile zofuzo, okuhlanganisa i-TP53, RB1, ne-REQL4, ngokulandelana.
• Ukuchayeka Kwangaphambilini Ekwelapheni Ngemisebe: I-RT, ikakhulukazi esemncane noma enemithamo ephezulu, ingandisa ingozi ye-osteosarcoma. 
• Izifo Zamathambo: Isifo sikaPaget kanye ne-fibrous dysplasia kuye kwaxhunyaniswa nengcuphe ephezulu ye-osteosarcoma.

Izimpawu ze-Osteosarcoma

Umdlavuza wamathambo we-Osteosarcoma uvame ukuletha uhla lwezimpawu ezingahluka ngokuqina nokuqhubeka, okuhlanganisa:

• Ubuhlungu Bethambo: Uphawu oluvame kakhulu ubuhlungu bethambo obuqhubekayo oba bubhebhetheka ngokuhamba kwesikhathi, ikakhulukazi ebusuku. 
• Ukuvuvukala nokubomvu: Ubuhlungu bungase buhambisane nokuvuvukala nokubomvu endaweni yesimila. 
• Isigaxa: Njengoba isimo siqhubeka, abantu bangase babone isigaxa noma inqwaba phezu kwethambo, elingase lizizwe lifudumele.
• Ukuphuka: Ngezinye izikhathi, ithambo elibuthakathaka lingase liphuke kalula kunokuvamile, ngisho nokunyakaza okulula. 
• Ezinye izimpawu zingafaka:
  • Umkhuhlane ongachazeki
  • Ukukhathala
  • I-anemia
  • Ukulahlekelwa kwesisindo esingachaziwe
  • Ukunyakaza okulinganiselwe, ikakhulukazi uma ilunga lithintekile

Izinkinga

Umdlavuza wamathambo we-Osteosarcoma ungaholela ezinkingeni ezihlukahlukene, kokubili kusukela kulesi sifo ngokwaso kanye nokwelashwa kwe-osteosarcoma. Lokhu kubandakanya:

• I-Metastasis: Ukusabalala komdlavuza kwezinye izingxenye zomzimba. I-Osteosarcoma ivame ukusakazeka emaphashini, okufanayo noma elinye ithambo. 
• Inkinga ehlobene nokwelashwa: 
  • I-Chemotherapy ingase iholele isicanucanu, ukukhathala, ukuqothuka kwezinwele, i-anemia, kanye ukulahlekelwa ukudla esikhathini esifushane. Imiphumela emibi yesikhathi eside ingase ihlanganise ukulimala kwenhliziyo namaphaphu, ukulahlekelwa ukuzwa kancane kancane, kanye nengozi eyengeziwe yezinye izinhlobo zomdlavuza. 
  • Ukwelashwa ngemisebe kungabangela imiphumela efanayo yesikhathi eside, kanye nezindaba zokuzala uma kuqondiswe endaweni ye-pelvic. 
  • Ukwengeza, ukutheleleka kwesilonda nokuphulukiswa kancane kungase kwenzeke ngemva kokuhlinzwa. 
  • Izinkinga zokuxhunyelelwa kwamathambo noma izitho zokufakelwa, njengokutheleleka noma ukwehluleka kokufakelwa, zingase ziphakame.

Sifo

• Ukuhlolwa Komzimba: Odokotela bazohlola indawo ethintekile ukuvuvukala, izigaxa, noma ubunzima bokunyakaza. 
• Ukuhlolwa Kwezithombe:
  • Ama-X-ray: I-X-ray yokuxilonga iyindlela yokuqala yokuthatha izithombe futhi ingakwazi ukubona kahle ukungahambi kahle kwamathambo okubangelwa umdlavuza. 
  • I-MRI Scans: Banikeza izithombe ezinemininingwane yamathambo nezicubu ezithambile
  • I-CT Scans: Zinenzuzo ekuhloleni ukuthi umdlavuza ususabalele yini emaphashini.
  • I-Bone Scan: Zingase futhi zenzelwe ukuqoqa ulwazi oluthe xaxa mayelana nengaphakathi lamathambo. 
  • Isidumbu: Kuyindlela ecacile kakhulu yokuxilonga i-osteosarcoma futhi kuhilela ukuthatha isampula yezicubu zamathambo ezithintekile ukuze kuhlaziywe elabhorethri. 

Ukwelashwa

Ukwelashwa komdlavuza wamathambo we-osteosarcoma ngokuvamile kuhilela inhlanganisela yokuhlinzwa kanye ne-chemotherapy. Indlela incike esiteji kanye nendawo ye-bone sarcoma, kanye nempilo yonke yesiguli.

• Ukuhlinzwa: Umgomo oyinhloko ukukhipha wonke amangqamuzana omdlavuza ngenkathi ulondoloza umsebenzi nokubukeka okuningi ngangokunokwenzeka. 
• Ukuhlinzwa Kokonga Izitho: Lapha, isimila kanye nezicubu ezinempilo ezizungezile ziyasuswa. 
• Ukunqunywa: Kungase kudingeke uma umdlavuza ususakazeke kakhulu noma uma ukuhlinzwa kokulondoloza izitho kungenzeki.
• I-Chemotherapy: Ngokuvamile inikezwa ngaphambi kokuhlinzwa (i-neoadjuvant chemotherapy) ukuze kuncishiswe isisindo sesimila futhi kube lula ukusikhipha. Ngemva kokuhlinzwa, i-chemotherapy eyengeziwe (i-adjuvant chemotherapy) inikezwa ukubulala noma yimaphi amangqamuzana omdlavuza asele kanye nokunciphisa ingozi yokuphindeka. 
• Ukwelashwa Kwemisebe: Kungaba inketho uma ukuhlinzwa kungenzeki noma uma wonke umdlavuza ungakwazi ukususwa ngesikhathi sokuhlinzwa. 

Uzoyibona Nini Udokotela

Uma wena noma ingane yakho izwa ubuhlungu bethambo obungapheli obuthatha amasonto ambalwa, kubalulekile ukuhlela isikhathi sokubonana nodokotela ngokushesha. Nakuba lezi zimpawu zingabangelwa izinto eziningi ngaphandle komdlavuza wamathambo we-osteosarcoma, njengokulimala kwezemidlalo, noma yikuphi ukuphazamiseka kwamathambo okuqhubekayo kufanele kuhlolwe udokotela.

Isiphetho

Umdlavuza wamathambo we-Osteosarcoma yisimo esibucayi esidinga isinyathelo esisheshayo nokunakekelwa okuhle. Yize kungesona isimo esijwayelekile, singaba nomthelela omkhulu kulabo abasitholayo, ikakhulukazi abantu abasha. Ukuthola usizo kusenesikhathi kuyisihluthulelo sokubhekana ne-osteosarcoma. Uma wena noma othile omaziyo enobuhlungu obuqhubekayo bamathambo noma ukuvuvukala, ngokushesha thintana nodokotela. Ngokunakekelwa okufanele nokusekelwa, abantu abaningi abane-osteosarcoma bangaba ngcono futhi baphile izimpilo ezigcwele. 

Imibuzo Evame Ukubuzwa

1. Ubani osengozini yokuthola i-osteosarcoma?

Umdlavuza wamathambo we-Osteosarcoma ngokuyinhloko uhlasela izingane, intsha, kanye nabantu abadala abasebasha abasengozini ephakeme kancane kubantu abanezimo ezithile zofuzo, njenge-Li-Fraumeni syndrome noma i-hereditary retinoblastoma noma labo abaye belashwa ngemisebe noma abanezifo ezithile zamathambo njenge-Paget's disease.

2. Yiziphi izimpawu nezimpawu zokuqala?

Izimpawu zakuqala ze-osteosarcoma zihlanganisa ubuhlungu bethambo obuqhubekayo obungase bube bubi nakakhulu ebusuku, ukuvuvukala noma ukuzwela eduze kwendawo ethintekile, kanye neqhubu noma isisindo esizwakala sifudumele lapho sithintwa. 

3. Ingabe i-osteosarcoma ingelapheka?

Indlela yamanje ye-multi-modal (ehlanganisa ukwelashwa ngamakhemikhali nokuhlinzwa) ithuthukise amazinga okusinda esikhathi eside, ngaphandle kwezifo afinyelela ku-60-70% ezigulini eziningi.

4. Ingabe i-osteosarcoma ibuhlungu?

Yebo, i-osteosarcoma ingaba buhlungu. Kodwa-ke, ezinye izimo ze-osteosarcoma zingaba buhlungu, ikakhulukazi ezigabeni zokuqala.

5. Ingabe i-osteosarcoma ingabuya ngemva kokwelashwa?

I-Osteosarcoma ingabuya ngemva kokwelashwa, ngokuvamile phakathi neminyaka emibili kuya kwemithathu yokuqeda ukwelashwa kokuqala. 

6. I-osteosarcoma iba ingakanani iminyaka?

I-Osteosarcoma ivamise ukuphatha abantu abaphakathi kweminyaka eyi-10 nengama-30, kanti izehlakalo eziphakeme kakhulu phakathi neminyaka yobusha. 

7. Ingabe i-osteosarcoma iyahamba?

I-Osteosarcoma ngokuvamile ayizihambi yodwa. Kudinga ukwelashwa okunamandla, ngokuvamile okuhlanganisa inhlanganisela yokwelapha ngamakhemikhali nokuhlinzwa. 

8. Ungayithola kanjani i-osteosarcoma?

I-Osteosarcoma ivamise ukutholwa ngenhlanganisela yokuhlolwa komzimba, ukuhlolwa kwezithombe (i-X-ray, i-CT scan & MRI), kanye ne-biopsy. 

9. Ingakanani i-chemo ye-osteosarcoma?

I-Chemotherapy ye-osteosarcoma ngokuvamile ihlala phakathi kwezinyanga eziyisi-6 kuya kweziyi-12. Ukwelashwa kwe-osteosarcoma ngokuvamile kuhilela imijikelezo ye-chemotherapy ngaphambi nangemuva kokuhlinzwa. Ubude obuqondile bungahluka futhi buncike esimweni ngasinye kanye nephrothokholi yokwelashwa.

10. Ingabe i-osteosarcoma ingabuya ngemva kokuhlinzwa?

Yebo, i-osteosarcoma ingabuya ngemva kokuhlinzwa. Yingakho i-chemotherapy ivame ukunikezwa kokubili ngaphambi nangemva kokuhlinzwa ukusiza ukunciphisa ingozi yokuphinda. 

UDkt. Sohael Mohammed Khan

I-MBBS, i-MS (i-Orthopaedics), iDiploma (Ukuvuselelwa komgogodla)
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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