Kubvunzurudza naDr. Edward M. Wolin, MD
Kufa kwaSteve Jobs kubva kune imwe nzira isingawaniki yekenza yepancreatic inonzi kancreatic neuroendocrine kenza yakaita kufarira mupancreatic cancer. Mune hurukuro iyi, Dr. Edward Wolin, nyanzvi yekenza yeuropeendocrine yakabatana neCedars Sinai Medical Center, inokurukura kenza yepancreatic neuroendocrine uye kuti varwere vari kurwisa sei chirwere chacho. Dr. Wolin ndiye mutungamiri weCarcinoid uye Neuroendocrine Tumor Program paCedars-Sinai Medical Center uye ine imwe yenzira dzakakura dzenyika dzinozivikanwa nekenza yepancreatic neuroendocrine.
Haana kubata Steve Jobs.
Ungatsanangura here kuti kancreatic neuroendocrine kanzira chii?
Pancreatic neuroendocrine yekenza inowedzera-inokura zvipembenene zvinotyisa zvinotanga mumasero endocrine (hormone-producing cells) yepancreas, inozivikanwa se islet masero. Kunyangwe izvi zvipembenene zvinogona kubudisa mahomoni akawanda epancreatic, vazhinji havaiti mahomoni. Vanowanzopararira kumucheto uye chiropa panguva yekuongorora. Kunyange zvakadaro, kuponeswa kunowanzove kwakakwirira kudarika nechinowanikwa chepancreatic kenza (adenocarcinoma) , kunyange kana metastases aripo.
Izvo zvinoonekwa sei? Pane zviratidzo here?
Apo aya kanzura anogadzira mahomoni, zviratidzo zvokutanga zvinogona kuva zvakanyanya uye zvinotungamirira pakuita kuti utange kuongororwa. Semuenzaniso, chirwere chinokonzera insulini chinokonzera zviratidzo zvehutano hwepasi shoma , kana chirwere chegastrin-chinokonzera kusuruvara kwemudumbu uye zveodenal, zvichiita kuti uongororwe neT CT scan, MRI scan, kana kuti endoscopic ultrasound yepascreas.
Kana kubudiswa kwehomoni kusakonzera zviratidzo zvekuchiremba, zviputi zvinowanzokura kusvika pakukura kukuru uye zvakapararira kuchiropa uye kune dzimwe nzvimbo panguva yekuonekwa paCCT kana MRI. Muzviitiko izvi, zviratidzo zvekutanga zvinogona kuva kurwadziwa kwepamuviri, jaundice, kurasikirwa kwemaviri, malaise, kubvisa pamuviri, kurutsira, kuputika kweganda, kushaya simba, uye kurwara.
Ndiani ari pangozi? Inofanirwa here, munhu ane utano ane hanya nekenza yepancreatic neuroendocrine?
Idzi idzi dzinonyanya kushandiswa, uye ine zviitiko zvitatu zvitatu pamamiriyoni eAmerica, inotarisa 3% yepancreatic kankere. Nokudaro, muvhareji, munhu ane hutano haafaniri kunge ane hanya zvikuru nekuita kenza yepancreatic neuroendocrine. Izvi zvakasiyana mune dzimwe mhuri umo kenza yepancreatic neuroendocrine inowanzoshamwaridzana, kazhinji inogara pamwe chete nemaronda ane chirwere chepathy and pituitary . Izvi zvinozivikanwa semhuri zvinowanzozivikanwa sa multiple endocrine neoplasia type 1 (MEN-1).
Tinoziva here chinokonzera iyo?
Tinoziva kuti kushanduka-gadziriro yegene inokonzera MEN-1, uye tinoziva kuti zvimwe zvisingawanzogadziriswa kwemajini zvinowanzojairika mumukana wepancreatic neuroendocrine, asi kazhinji chinokonzera hachizivikanwi.
Pane nzira dzekudzikisa dambudziko kana kudzivirira kancreatic neuroendocrine kansa here?
Hapana nzira inozivikanwa yekuderedza ngozi kana kudzivirira kancreatic neuroendocrine kansa.
Ndeapi marapirwo aripo?
Nemhaka yekushayikwa kwezviremera izvi muhuwandu hwevanhu, uye chirongwa chakanyanya chekuchengetedza chinodiwa, varwere vanokurudzirwa zvikuru kutsvaga kubvunzurudzwa kubva kune imwe nyanzvi yeurouroendocrine tumor centre. Munzvimbo dzakadaro, pane kubatana kwakasimba pamwe nehutano hwehutano , endocrinology, gastroenterology, pathology, chirwere chehepatobiliary, chirwere chinoputira, radiology inopindira, ruzivo rwehuroodology, uye mishonga ye nyukireya kugadzirisa kuchengetedzwa kwevanhu pachavo kune mumwe murwere.
Mishonga inosanganisira kuparadzanisa kushandiswa kwemakumbo ekutanga uye mastasine, kubvisa kwemasastase nema microwaves, kurapa matumire ne intrahepatic rayation (radioembolization) uye intrahepatic chemotherapy (chemoembolization), kupedza tumarara kukura nevanoronga biologic agents (somatostatin analogs, m-TOR inhibitors, tyrosine kinase inhibitors , inonzi radhionuclide therapy inonzi PRRT, immune therapy, uye anti-angiogenic zvinodhaka), uye kushandiswa kwekanyanya-toxicity oral chemotherapy .
Kuti udzidze zvakawanda pamusoro paDr. Edward Wolin uye chiitiko chake paCedars Sinai Medical Centre, tapota shanyira maCedars Sinai website.