Ama-Sarcoma

Ama-Sarcomas athinta izinkulungwane zabantu minyaka yonke, akhula ezicutshini ezixhumene zomzimba ezifana nemisipha, amathambo, amafutha kanye nemithambo yegazi. Nakuba imele i-1% kuphela yawo wonke umdlavuza wabantu abadala, lezi zimila ezingavamile zingenzeka kunoma iyiphi iminyaka nakunoma iyiphi ingxenye yomzimba. Lo mhlahlandlela ophelele uhlola umdlavuza wama-sarcomas, kusukela ezinhlotsheni zawo ezihlukahlukene nezimpawu kuya ezinketho zokwelapha kanye namasu okuvimbela. 

Yini amaSarcoma?

I-sarcoma wuhlobo lomdlavuza oluyivelakancane olukhula ezicutshini ezixhumeneyo zomzimba. Ngokungafani nomdlavuza ovamile, ama-sarcomas ahlukile ngoba akha ezicutshini ezixhuma noma ezisekela ezinye izitho zomzimba. Lezi zimila eziyingozi zingakhula ezindaweni ezihlukahlukene, zizenze zibe nzima kakhulu ukuzibona nokwelapha.

Lezi zomdlavuza zingathinta izinhlobo eziningana zezicubu, kuhlanganise:

• Imisipha nemisipha
• Amathambo namalunga
• Izicubu ezinamafutha
• Imithambo yegazi
• Imizwa
• Izicubu zesikhumba ezijulile
• Izicubu ze-Fibrous

Izinhlobo zamaSarcoma

Lezi zimila ezingavamile zihlukaniswa ngobubanzi zibe izigaba ezimbili eziyinhloko:

1. Ama-Sarcoma Ezicubu Ezithambile: I-soft tissue sarcoma ingakhula ezindaweni eziningi emzimbeni wonke, okuhlanganisa:

• Imithambo yegazi (Angiosarcoma)
• I-Digestive tract (isimila se-stromal yamathumbu)
• Amaseli amafutha (Liposarcoma)
• Imisipha ebushelelezi (Leiomyosarcoma)
• Imisipha yamathambo (Rhabdomyosarcoma)
• Ama-nerve sheaths (Amathumba e-peripheral nerve sheath tumors)
• Izicubu ezixhumeneyo (Fibrosarcoma)

Cishe ingxenye eyodwa kwezintathu kuya kwengxenye yawo wonke ama-sarcomas ezicubu ezithambile zenzeka emaphethelweni aphansi. Ama-sarcoma e-retroperitoneal ahlanganisa u-15% kuya ku-20% wawo wonke ama-sarcomas ezicubu ezithambile, ama-visceral sarcoma ahlanganisa u-24% futhi ama-sarcoma ekhanda nentamo cishe afinyelela ku-4%.

2. I-Bone Sarcomas: Ama-sarcoma amathambo, nakuba engavamile, ahlanganisa izinhlobo eziningana ezihlukene, njenge-osteosarcoma, ethinta kakhulu amathambo amakhulu engalo noma umlenze & ne-chondrosarcoma, eyakha uqwanga. Lezi zimila zinikeza izinselelo eziyingqayizivele zokuxilonga ngenxa yokungatholakali kwazo kanye nokuhlukahluka kwe-morphological.

Izimpawu zeSarcoma

Lokhu okulandelayo yizimpawu ezivamile ze-sarcomas:

• Isigaxa esisha esingase sibe buhlungu noma singabi buhlungu
• Ubuhlungu ezingalweni, emilenzeni, noma esiswini
• Ibanga elilinganiselwe lokunyakaza emalungeni
• Ukulahlekelwa kwesisindo esingachaziwe
• Ukuhlungu obusemhlane noma ubunzima bokuhamba
• Izinkinga zokuphefumula lapho izimila zithinta indawo yesifuba

Izimbangela zeSarcomas

Ukuthuthukiswa kwama-sarcomas kuqala ezingeni lamangqamuzana, lapho izinguquko ku-DNA zenza amathambo angavuthiwe noma amangqamuzana ezicubu ezithambile akhule ngokungalawuleki. 

• Izakhi zofuzo: Izimo eziningana ezizuzwe njengefa zingandisa ingozi ye-sarcoma. Lawa ma-syndromes we-genetic predisposition afaka:
  • I-Li-Fraumeni syndrome, ethinta isakhi sofuzo se-TP53
  • I-Neurofibromatosis (isifo se-von Recklinghausen)
  • I-Retinoblastoma, exhunywe kufuzo lwe-RB1
  • I-Werner syndrome
  • I-Gardner syndrome
• Izici Zemvelo Nezokwelapha: Izici zangaphandle nazo zingaba nomthelela ekuthuthukisweni kwe-sarcoma. 
  • Ukuchayeka kumakhemikhali athile, ikakhulukazi i-vinyl chloride ne-arsenic
• Ezinye Izinto Zobungozi: 
  • Ubudala nobulili: Isibonelo, i-osteosarcoma ivame ukwenzeka ezinganeni nakubantu abadala ngesikhathi sokukhula okusheshayo. 
  • Indawo: I-lymphedema engapheli, noma ukuvuvukala okuhlala isikhathi eside ezingalweni noma emilenzeni, 
  • I-Radiation Therapy: Iziguli ezinomdlavuza ezithola ukwelashwa ngemisebe yalesi sifo zisengozini enkulu yokuthuthukisa ama- sarcoma esikhathini esizayo.
  • I-Lymphedema: Ukuvuvukala okungapheli kwe-lymphatic system kungase kwenyuse ingozi yohlobo lwe-sarcoma olubizwa ngokuthi i-angiosarcoma.

Izinkinga zeSarcomas

Ama-sarcomas angalashwa angaholela ezinkingeni ezinkulu ezithinta izinhlelo eziningi zomzimba. Lokhu kubandakanya:

• I-Metastasis: Okukhathaza kakhulu i-metastasis, lapho amangqamuzana omdlavuza ethuthela kwezinye izitho ngegazi noma uhlelo lwe-lymphatic. 
• Izinkinga Zemizwa: Lezi zinkinga zingabonakala ngezindlela ezihlukahlukene:
  • Ukubandakanyeka ohlelweni lwezinzwa oluphakathi
  • Ukulimala kwe-peripheral nerve system
  • Umgogodla eminyanisiwe
  • Ingcindezi ye-intracranial ephakeme
  • Ukuphazamiseka kokusebenza kobuchopho nezinzwa
• Izinkinga Zokusebenza: Iziguli zingase zibe nobunzima bokuphefumula lapho izimila zicindezela izakhiwo zokuphefumula kanye nokulinganiselwa kokunyakaza lapho izimila zithinta amalunga noma imisipha. Lokhu kucindezela kungabangela nobuhlungu obukhulu futhi kuphazamise ukusebenza kwesitho esivamile ezindaweni ezithintekile.

Sifo

• Ukuhlola Umzimba: Odokotela baqala ngokuhlola umzimba okuphelele kanye nokuhlola umlando wezokwelapha okuningiliziwe lapho iziguli zinezimpawu ezisolisayo. Odokotela bangase bahlole izigaxa, ukuvuvukala, noma ubuhlungu endaweni ethintekile.
• Ukuhlola Okuthuthukisiwe Kwezithombe: Amaqembu ezokwelapha ngokuvamile asebenzisa izindlela ezimbalwa zokuthatha izithombe:
  • Ama-X-ray ukuze athwebule izithombe zamathambo nezicubu ezithambile
  • I-Computed tomography (CT) ihlola ukubukwa okunemininingwane ehlukene
  • I-Magnetic resonance imaging (MRI) yokuhlolwa kwezicubu ezithambile eziphakeme
  • Izikena zethambo ukuze kutholakale ukuphazamiseka kwamathambo
  • I-PET scans ukuze ibone izindawo ezinoshukela ophezulu
  • I-Ultrasound yokuhlolwa kokuqala kwezigaxa ezingaphezulu
• Isidumbu: Ukuxilongwa okuqinisekile kuza ngenqubo ye-biopsy, lapho ochwepheshe bekhipha amasampula ezicubu ukuze ahlaziywe elabhorethri. Lesi sinyathelo esibucayi sisiza ukunquma uhlobo oluqondile lwe-sarcoma futhi siqondise izinqumo zokwelashwa. Inqubo ye-biopsy ibalulekile, njengoba izinqubo ezingafanele zingase zibe nzima izinketho zokwelapha zesikhathi esizayo.

Ukwelashwa kweSarcomas

Ukwelashwa kuncike ezintweni ezihlukahlukene, okuhlanganisa uhlobo lwe-sarcoma, indawo ekuyo, nokuthi umdlavuza ususabalele yini kwezinye izitho zomzimba. Ukwelashwa kwe-sarcoma yesimanje ngokuvamile kuhilela inhlanganisela yezindlela zokwelapha:

• Ukungenelela Ngokuhlinzwa: Ukuhlinzwa kuseyindlela yokuqala yokwelapha ezimweni eziningi ze-sarcoma. Odokotela abahlinzayo bahlose ukususa sonke isimila kanye nomugqa wezicubu ezinempilo, ngokuvamile u-1 kuya ku-2 cm, eduze komdlavuza. Kuma-sarcomas esitho, odokotela manje bakhetha ukuhlinzwa okusindisa izitho esikhundleni sokunqunywa, okugcina ngempumelelo ukusebenza ezimweni eziningi. Odokotela bangasebenzisa ezinye izindlela ezifana nokwelashwa okuqondisiwe noma i-immunotherapy ezimeni lapho ukuhlinzwa kungenzeki khona. 
• Ukwelashwa Kwemisebe: Isebenzisa imishayo enamandla amakhulu ukuqeda amangqamuzana omdlavuza
• Ukwelashwa ngamakhemikhali: Ukwelashwa kwezidakamizwa okuqondise kumaseli omdlavuza
• Ukwelapha Okuhlosiwe: Ihlasela ubuthakathaka obuthile kumaseli omdlavuza
• I-Immunotherapy: Ithuthukisa ukusabela komzimba komzimba
• Ukwelashwa kwe-Ablation: Ibhubhisa amangqamuzana omdlavuza ngokusebenzisa ukushisa noma amakhaza

Ngaphambi kokuhlinzwa, ezinye iziguli zithola ukwelashwa kwe-neoadjuvant (ukwelashwa kwangaphambi kokuhlinzwa) ukuze kuncishiswe isimila futhi kube lula ukusikhipha. Ngemva kokuhlinzwa, odokotela bangase batuse ukwelashwa kwe-adjuvant ukuze kuqedwe noma yimaphi amangqamuzana omdlavuza asele futhi kuncishiswe ingozi yokuphinda futhi.

Uzoyibona Nini Udokotela

Umuntu ngamunye kufanele ayothola usizo lwezempilo lapho ebona:

• Noma yisiphi isigaxa esikhulu kuno-5 amasentimitha (cishe usayizi webhola legalofu)
• Isisindo esikhulayo noma esivela ekujuleni kwezicubu
• Ubuhlungu obungapheli obungathuthuki ngokuphumula noma ngemithi etholakala ngaphandle kwekhawunta
• Noma yisiphi isigaxa esiphindayo ngemva kokususwa kwangaphambilini

Prevention

Nakuba ukuvimbela okuphelele kungenakwenzeka, abantu ngabanye bangathatha izinyathelo zokunciphisa ukuchayeka kwabo ezicini eziyingozi ezaziwayo. Izinto ezilawulekayo zobungozi zihlanganisa:

• Ukunciphisa ukuchayeka kumakhemikhali ezimboni, ikakhulukazi i-vinyl chloride ne-arsenic
• Ukunciphisa ukuchayeka emisebeni okungadingekile
• Ukulandela imihlahlandlela yokuphepha ezimbonini ezisengozini enkulu
• Ukusebenzisa izinto zokuzivikela ezifanele ezindaweni zomsebenzi

Ukubonisana njalo nodokotela kubaluleka kubantu abane-genetic predisposition syndromes njenge-Li-Fraumeni syndrome, i-retinoblastoma, noma i-neurofibromatosis. 

Ukutholwa kusenesikhathi kuseyingxenye ebalulekile yesu lokuvimbela. Nakuba kungekho ukuhlolwa okungakwazi ukubona amangqamuzana e-sarcoma ezigabeni zawo zokuqala, ukunaka ngokushesha izimpawu ezingavamile kungaholela ekuxilongweni kwangaphambili. Odokotela bagcizelela ukubaluleka kokuhlola izigaxa ezintsha noma ezikhulayo, ikakhulukazi uma zibangela ubuhlungu noma zanda ngosayizi.

Isiphetho

Ama-Sarcoma ahlala ewumdlavuza oyinkimbinkimbi odinga ukunakwa nokunakekelwa okukhethekile kwezokwelapha. Isayensi yezokwelapha yenze intuthuko enkulu ekuqondeni lezi zimila ezingavamile, ngokwelashwa kwesimanje okunikeza ithemba ezinkulungwaneni zeziguli unyaka ngamunye.

Ulwazi ngama-sarcomas lusiza abantu ukuthi babone izimpawu eziyisixwayiso futhi bafune usizo lwezokwelapha ngokushesha. Inhlanganisela yokuhlinzwa, ukwelashwa ngemisebe, kanye nezinketho ezintsha zokwelapha kunikeza iziguli amathuba angcono okululama kunangaphambili. Ukuhlolwa okuvamile nokunaka ngokushesha izimpawu ezingavamile kudlala indima ebalulekile emiphumeleni yokwelapha ephumelelayo.

Imibuzo Evame Ukubuzwa

1. Ingabe i-sarcoma ingelapheka?

Ukwelapheka kwe-sarcomas kuncike kakhulu ekutholakaleni kusenesikhathi kanye nokwelashwa okufanele. Izinga lokusinda leminyaka emi-5 lilinganiselwa ku-65% kwi-soft tissue sarcoma. Kodwa-ke, leli zinga liyahluka kakhulu ngokuya ngesiteji nendawo yomdlavuza.

2. Ingabe ama-sarcoma abuhlungu?

Amazinga obuhlungu ayahluka phakathi kweziguli ezine-sarcoma. Ucwaningo lubonisa ukuthi mayelana ne-19.7% yezingane ezine-sarcoma esanda kutholakala zizwa ubuhlungu, kanti i-46% ibika ubuhlungu obuphakathi kanye ne-37.8% ibika ubuhlungu obunzima. Ubuhlungu buvame ukwanda lapho isimila sikhula, kubeka ingcindezi ezicutshini ezizungezile.

3. Iyini imbangela ye-sarcoma?

Ama-Sarcomas akhula ngenxa yokuguqulwa kwe-DNA okuthinta ukukhula nokuhlukana kwamaseli. Lezi zinguquko zingaphazamisa ama-oncogene kanye nezicindezeli zesimila, kubangele ukukhula kwamangqamuzana okungalawuleki nokwakheka kwesimila.

4. Ubani osengozini enkulu ye-sarcoma?

Kunezici eziningana ezandisa ingozi ye-sarcoma:

• Izingane kanye nabantu abadala abancane ngesikhathi sokukhula okusheshayo
• Abantu abanokuchayeka ekwelapheni ngemisebe okwedlule
• Abantu abane-lymphedema engapheli
• Labo abachayeke kumakhemikhali athile afana ne-vinyl chloride ne-arsenic

5. Ingabe i-sarcoma iwufuzo?

Ngenkathi ama-sarcomas amaningi eyenzeka ngezikhathi ezithile, ezinye izimo zinezakhi zofuzo. Ama-syndromes amaningana azuzwe njengefa angakhuphula ingozi ye-sarcoma, okuhlanganisa i-Li-Fraumeni syndrome, i-retinoblastoma, ne-neurofibromatosis.

6. Uyithola kanjani i-sarcoma?

Ukutholwa ngokuvamile kuhilela izinyathelo eziningi, okuhlanganisa ukuhlolwa ngokomzimba, ukuhlolwa kwesithombe (i-X-ray, i-MRI, izikena ze-CT), futhi ekugcineni i-biopsy yokuxilongwa okuqinisekile. Ukutholwa kusenesikhathi kungaholela emiphumeleni engcono yokwelashwa.

7. Ingaqala kuphi i-sarcoma?

Ama-Sarcoma angakhula noma yikuphi ezicutshini ezixhumeneyo zomzimba, okuhlanganisa izicubu, amathambo, amafutha, imithambo yegazi, imizwa, nezicubu zesikhumba ezijulile. Zivame ukuvela ezingalweni, emilenzeni, esifubeni, noma esiswini.

CARE Medical Team

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