Types/childhood-cancers/late-effects-pdq

Iziphumo zokugqibela zonyango lweCancer yaBantwana (®) -Patient Version

Ulwazi ngokubanzi malunga neZiphumo zeLate

IINGONGOMA EZIPHAMBILI

• Iziphumo zokugqibela ziingxaki zempilo ezenzeka iinyanga okanye iminyaka emva kokuba unyango luphelile.

• Iziphumo zokugqibela kumaxhoba omhlaza wobuntwana zichaphazela umzimba nengqondo.

• Zintathu izinto ezibalulekileyo ezichaphazela umngcipheko weziphumo ezibi.

• Ithuba lokufumana iziphumo kade liyonyuka ngokuhamba kwexesha.

• Unonophelo olulandelayo olulandelayo lubaluleke kakhulu kumaxhoba omhlaza wabantwana.

• Imikhwa elungileyo yezempilo ikwabalulekile kumaxhoba omhlaza wabantwana.

Iziphumo zokugqibela ziingxaki zempilo ezenzeka iinyanga okanye iminyaka emva kokuba unyango luphelile.

Unyango lomhlaza lunokubangela iingxaki zempilo kumaxhoba omhlaza wobuntwana iinyanga okanye iminyaka emva kokuba unyango olunempumelelo luphelile. Unyango lomhlaza lunokwenzakalisa amalungu omzimba, izicwili, okanye amathambo kwaye lubangele iingxaki zempilo kamva ebomini. Ezi ngxaki zempilo zibizwa ngokuba ziziphumo ezifike kade.

Unyango olunokubangela iziphumo kade zibandakanya oku kulandelayo:

• Ugqirha.

• Unyango ngamayeza.

• Unyango ngemitha.

• Ukufakelwa kweseli.

Oogqirha bafunda ngeziphumo ezibi ezibangelwe lunyango lomhlaza. Basebenzela ukuphucula unyango lomhlaza kunye nokuyeka okanye ukunciphisa iziphumo zasemva kwexesha. Ngelixa uninzi lweziphumo ezifike kade zingasongeli ubomi, zinokubangela iingxaki ezinzulu ezichaphazela impilo kunye nomgangatho wobomi.

Iziphumo zokugqibela kumaxhoba omhlaza wobuntwana zichaphazela umzimba nengqondo.

Iziphumo zokugqibela kumaxhoba omhlaza wabantwana anokuchaphazela oku kulandelayo:

• Amalungu, izicubu kunye nokusebenza komzimba.

• Ukukhula kunye nophuhliso.

• Imood, iimvakalelo, kunye nezenzo.

• Ukucinga, ukufunda nokukhumbula.

• Uhlengahlengiso kwezentlalo nangokwengqondo.

• Umngcipheko womhlaza wesibini.

Zintathu izinto ezibalulekileyo ezichaphazela umngcipheko weziphumo ezibi.

Uninzi lwamaxhoba omhlaza wobuntwana luya kuba neziphumo zasemva kwexesha. Umngcipheko wokuvela kade uxhomekeke kwizinto ezinxulumene nethumba, unyango kunye nesigulana. Oku kubandakanya oku kulandelayo:

• Izinto ezinxulumene nethumba

• Uhlobo lomhlaza.

• Apho ithumba likhona emzimbeni.

• Indlela ithumba eliyichaphazela ngayo indlela izicubu kunye namalungu asebenza ngayo.

• Izinto ezinxulumene nonyango

• Uhlobo lotyando.

• Uhlobo lweChemotherapy, idosi, kunye neshedyuli.

• Uhlobo lonyango lwemitha, inxenye yomzimba ophathwe, kunye nedosi.

• Ukufakelwa kweseli.

• Ukusetyenziswa kweentlobo ezimbini okanye nangaphezulu zonyango ngexesha elinye.

• Ukufakwa kwegazi kwimveliso yegazi.

• Isifo esinganyangekiyo sokuchasana nomlo.

• Izinto ezinxulumene nesigulana

• Isini somntwana.

• Iingxaki zempilo umntwana wayenazo ngaphambi kokuba afunyaniswe enomhlaza.

• Ubudala bomntwana kunye nenqanaba lokukhula xa efunyaniswe kwaye ephathwa.

• Ubude bexesha okoko kwafunyaniswa isifo kunye nonyango.

• Utshintsho kumanqanaba ehomoni.

• Ukubanakho kwezicubu ezinempilo ezichaphazeleke kunyango lomhlaza ukuzilungisa.

• Utshintsho oluthile kwimfuza yomntwana.

• Imbali yosapho yomhlaza okanye ezinye iimeko.

• Imikhwa yempilo.

Ithuba lokufumana iziphumo kade liyonyuka ngokuhamba kwexesha.

Unyango olutsha lomhlaza wobuntwana linciphisile inani lokufa komhlaza wokuqala. Ngenxa yokuba abo basindileyo benomhlaza baphila ixesha elide, baneziphumo ezibi emva kwexesha kunyango lomhlaza. Abasindileyo abanakuphila ixesha elide njengabantu ababengenawo umhlaza. Ezona zinto zixhaphakileyo zokufa kwabantu abasindileyo kumhlaza womntwana zezi:

• Umhlaza wokuqala ubuya.

• Iifom zomhlaza zesibini zokuqala (ezahlukileyo).

• Umonakalo wentliziyo nomphunga.

Izifundo zoonobangela beziphumo ezifike mva zikhokelele kutshintsho kunyango. Oku kuphucule umgangatho wobomi kumaxhoba omhlaza kwaye kunceda ukuthintela ukugula kunye nokufa kwiziphumo ezifike kade.

Unonophelo olulandelayo olulandelayo lubaluleke kakhulu kumaxhoba omhlaza wabantwana.

Ukulandelelwa rhoqo ziingcali zempilo eziqeqeshelwe ukufumana nokunyanga iziphumo ezifike emva kubalulekile kwimpilo yexesha elide yamaxhoba omhlaza wabantwana. Unonophelo olulandelayo luya kwahluka kumntu ngamnye onyangwe ngenxa yomhlaza. Uhlobo lokhathalelo luya kuxhomekeka kuhlobo lomhlaza, uhlobo lonyango, izinto zofuzo, kunye nempilo yomntu ngokubanzi kunye nemikhwa yempilo. Ukhathalelo olulandelayo lubandakanya ukukhangela iimpawu kunye neempawu zeziphumo zasemva kwexesha kunye nemfundo yezempilo malunga nendlela yokuthintela okanye ukunciphisa iziphumo ezifika kade.

Kubalulekile ukuba amaxhoba omhlaza wobuntwana enze uviwo okungenani kanye ngonyaka. Iimviwo kufuneka zenziwe yingcali yezempilo owaziyo umngcipheko wexhoba malunga neziphumo ezifike kade kwaye onokubona iimpawu zokuqala zeziphumo zasemva kwexesha. Uvavanyo lwegazi kunye nemifanekiso lunokwenziwa.

Ukulandelwa kwexesha elide kunokuphucula impilo kunye nomgangatho wobomi kumaxhoba omhlaza. Kukwabanceda oogqirha bafunde iziphumo zasemva kwexesha lonyango lomhlaza ukuze kunyangwe iindlela ezikhuselekileyo zonyango lwabantwana abasandula ukufunyanwa.

Imikhwa elungileyo yezempilo ikwabalulekile kumaxhoba omhlaza wabantwana.

Umgangatho wobomi kumaxhoba omhlaza unokuphuculwa ngokuziphatha okukhuthaza impilo kunye nokuba sempilweni. Oku kubandakanya ukutya okusempilweni, ukwenza umthambo, kunye nokuhlolwa rhoqo kwezonyango nakwezamazinyo. Ezi ndlela zokuzinakekela zibaluleke kakhulu kumaxhoba omhlaza ngenxa yomngcipheko weengxaki zempilo ezinxulumene nonyango. Ukuziphatha okunempilo kunokwenza ukuba iziphumo ezifike kade zingabikho mandla kwaye zinciphise umngcipheko wezinye izifo.

Ukuphepha indlela yokuziphatha eyonakalisa impilo kubalulekile. Ukutshaya, ukusebenzisa utywala ngokugqithisileyo, ukusebenzisa iziyobisi ngokungekho mthethweni, ukuvezwa kukukhanya kwelanga, okanye ukungasebenzi emzimbeni kunokudala umonakalo kumzimba onxulumene nonyango kwaye kunokunyusa umngcipheko womhlaza wesibini.

Umhlaza wesibini

IINGONGOMA EZIPHAMBILI

• Abasindileyo bomhlaza wabantwana banomngcipheko okhulayo womhlaza wesibini kamva ebomini.

• Iipateni ezithile zofuzo okanye ii-syndromes zinokunyusa umngcipheko womhlaza wesibini.

• Izigulana ezinyangelwe umhlaza zifuna iimvavanyo zokuvavanywa rhoqo ukujonga umhlaza wesibini.

• Uhlobo lovavanyo olwalusetyenziselwa ukukhusela umhlaza wesibini luxhomekeke kwinxalenye yonyango lomhlaza owawunesigulana ngaphambili.

Abasindileyo bomhlaza wabantwana banomngcipheko okhulayo womhlaza wesibini kamva ebomini.

Umhlaza wokuqala owahlukileyo owenzeka ubuncinci kwiinyanga ezimbini emva kokuphela konyango lomhlaza ubizwa ngokuba ngumhlaza wesibini. Umhlaza wesibini unokwenzeka emva kweenyanga okanye iminyaka emva kokuba ugqityiwe unyango. Uhlobo lomhlaza wesibini olwenzekayo luxhomekeke kwinxalenye yohlobo lokuqala lomhlaza kunye nonyango lomhlaza. Izifo zeBenign (kungekhona umhlaza) nazo zinokwenzeka.

Umhlaza wesibini owenzeka emva konyango lomhlaza ubandakanya oku kulandelayo:

• Amathumba aqinileyo.

• Isifo seMyelodysplastic kunye ne-leukemia ebukhali ye-myeloid.

Izidumba eziqinileyo ezinokubonakala ngaphezulu kweminyaka eli-10 emva kokufunyaniswa kwesifo somhlaza kunye nonyango zibandakanya oku kulandelayo:

• Umhlaza webele. Kukho umngcipheko owandayo womhlaza webele emva konyango lweedosi ephezulu yesifuba kwiHodgkin lymphoma. Izigulana eziphathwe ngemitha engaphezulu kwesithambisi esingabandakanyi ii-lymph node ekhwapheni zinomngcipheko ophantsi womhlaza wamabele.

Unyango lomhlaza osasazeke esifubeni okanye emiphungeni ngemitha yesifuba inokwandisa umngcipheko womhlaza wamabele.

Kukwakho nomngcipheko owandayo womhlaza wamabele kwizigulana ezanyangwa ngeearhente ze-alkylating kunye nee-anthracyclines kodwa hayi ngemitha yesifuba. Umngcipheko uphezulu kwi-sarcoma kunye ne-leukemia abasindileyo.

• Umhlaza wedlala lengqula. Umhlaza wedlala lengqula unokuvela emva konyango lwe-radiation ye-Hodgkin lymphoma, i-acute lymphocytic leukemia, okanye i-tumors yengqondo; emva konyango lwe-iodine ene-radioactive ye-neuroblastoma; okanye emva komzimba opheleleyo we-irradiation (TBI) njengenxalenye yokufakelwa kweseli.

• Amathumba ebongo. Izidumbu zeBongo zinokwenzeka emva konyango lwe-radiation entloko kunye / okanye kwi-chemotherapy ye-intrathecal usebenzisa i-methotrexate yesifo sokuqala sobuchopho okanye umhlaza osasazeke kwingqondo okanye kumqolo womqolo, njenge-lymphocytic leukemia okanye i-non-Hodgkin lymphoma. Xa i-intrathecal chemotherapy isebenzisa i-methotrexate kunye nonyango lwe-radiation zinikezelwa kunye, umngcipheko wesifo sobuchopho uphakama nangakumbi.

• Amathambo kunye nezicwili ezithambileyo. Kukho umngcipheko okhulayo wamathambo kunye nezicubu ezithambileyo zomzimba emva konyango lwemitha ye-retinoblastoma, i-Ewing sarcoma, kunye neminye imihlaza yomhlaza wethambo.

I-Chemotherapy ene-anthracyclines okanye ii-alkylating agents ikwandisa umngcipheko wamathambo kunye nezicwili ezithambileyo.

• Umhlaza wemiphunga. Kukho umngcipheko okhulayo womhlaza wemiphunga emva konyango lwemitha esifubeni seHodgkin lymphoma, ngakumbi kwizigulana ezitshayayo.

• Isisu, isibindi, okanye umhlaza webala. Isisu, isibindi, okanye umhlaza wecolorectal kungenzeka emva konyango lwemitha esiswini okanye kwi-pelvis. Umngcipheko ukwanda ngamanani aphezulu emitha. Kukho umngcipheko okhulayo wee-polyps ezimibala.

Unyango lwe-chemotherapy kuphela okanye i-chemotherapy kunye nonyango lwemitha ngokudibeneyo kukonyusa umngcipheko wesisu, isibindi, okanye umhlaza wecolorectal.

• Umhlaza wesikhumba we-Nonmelanoma (i-basal cell carcinoma okanye i-squamous cell carcinoma). Kukho umngcipheko owandayo womhlaza wesifo se-nonmelanoma emva konyango lwemitha; ihlala ibonakala kwindawo apho kunikezelwa ngemitha. Ukuvezwa kwimitha ye-UV kunokunyusa lo mngcipheko. Izigulana ezenza umhlaza wolusu ongena-malmoma emva konyango lwemitha zinamathuba amaninzi okuba ziphuhlise ezinye iintlobo zomhlaza kwixesha elizayo. Umngcipheko we-basal cell carcinoma nawo uyonyuswa emva konyango ngamayeza e-chemotherapy, abizwa ngokuba yi-vinca alkaloids, anje nge-vincristine kunye ne-vinblastine.

• I-melanoma enobungozi. I-melanoma ebulalayo inokwenzeka emva kwemitha okanye ngokudityaniswa kwekhemotherapy kunye neearhente ze-alkylating kunye neziyobisi ezichasayo (njenge-vincristine kunye ne-vinblastine). Abasindileyo kwiHodgkin lymphoma, i-retinoblastoma yelifa, ithambo le-sarcoma ethambileyo, kunye ne-gonadal tumors kunokwenzeka ukuba zibeke emngciphekweni omkhulu wokuba ne-melanoma ebulalayo. I-melanoma ebulalayo njengomhlaza wesibini ayiqhelekanga kunomdlavuza wesikhumba we-nonmelanoma.

• Umhlaza womlomo womlomo. Umhlaza womlomo womlomo unokwenzeka emva kokufakwa kweseli ye-stem kunye nembali yesifo esinganyangekiyo sokulwa nokuchasana.

Umhlaza wezintso. Kukho umngcipheko owandayo womhlaza wezintso emva konyango lwe-neuroblastoma, unyango lwe-radiation embindini womqolo, okanye i-chemotherapy enje nge-cisplatin okanye i-carboplatin.

• Umhlaza wesinyi. Umhlaza wesinyi unokuvela emva kwekhemotherapy kunye necyclophosphamide.

I-Myelodysplastic syndrome kunye ne-leukemia ye-myeloid ebukhali inokubonakala ingaphantsi kweminyaka eli-10 emva kokufunyaniswa kwesifo somhlaza esisisiseko se-Hodgkin lymphoma, i-acute lymphoblastic leukemia, okanye i-sarcoma kunye nonyango lwe-chemotherapy ebandakanya oku kulandelayo:

• Iarhente yokuthambisa efana necyclophosphamide, ifosfamide, mechlorethamine, melphalan, busulfan, carmustine, lomustine, chlorambucil, okanye dacarbazine.

• Iarhente ye-II inhibitor enjenge-etoposide okanye i-teniposide.

Iipateni ezithile zofuzo okanye ii-syndromes zinokunyusa umngcipheko womhlaza wesibini.

Abanye abasindileyo kumhlaza womntwana banokuba nomngcipheko okhulayo wokuba nomhlaza wesibini kuba banembali yosapho yomhlaza okanye isifo somhlaza esifa njengeLi-Fraumeni syndrome. Iingxaki ngendlela iDNA elungiswa ngayo kwiiseli kunye nendlela iziyobisi ze-anticancer ezisetyenziswa ngayo ngumzimba zinokuchaphazela umngcipheko wesifo somhlaza wesibini.

Izigulana ezinyangelwe umhlaza zifuna iimvavanyo zokuvavanywa rhoqo ukujonga umhlaza wesibini.

Kubalulekile kwizigulana ezinyangelwe umhlaza ukuba zihlolwe umhlaza wesibini ngaphambi kokuba kuvele iimpawu. Oku kubizwa ngokuba kukuvavanywa komhlaza wesibini kwaye kunokunceda ekufumaneni umhlaza wesibini kwinqanaba lokuqala. Xa izicwili okanye umhlaza ongaqhelekanga ufunyanwa kwangethuba, kunokuba lula ukunyanga. Ngexesha lokuvela kweempawu, umhlaza usenokuba sele uqalile ukusasazeka.

Kubalulekile ukuba ukhumbule ukuba ugqirha womntwana wakho akacingi ukuba umntwana wakho unomhlaza ukuba ngaba ucebisa uvavanyo lokuhlola. Uvavanyo lokuhlola lunikezelwa xa umntwana wakho engenazo iimpawu zomhlaza. Ukuba iziphumo zovavanyo lokuhlola aziqhelekanga, umntwana wakho unokufuna ukuba kwenziwe olunye uvavanyo ukuze afumanise ukuba ngaba unomhlaza wesibini. Ezi zibizwa ngokuba ziimvavanyo zokuqonda isifo.

Uhlobo lovavanyo olwalusetyenziselwa ukukhusela umhlaza wesibini luxhomekeke kwinxalenye yonyango lomhlaza owawunesigulana ngaphambili.

Zonke izigulana ezinyangwe umhlaza kufuneka zenziwe uvavanyo lomzimba kunye nembali yonyango olwenziwe kube kanye ngonyaka. Uvavanyo lomzimba lwenziwa ukujonga iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma, utshintsho kulusu, okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yezonyango ithathwa ukuze ifunde malunga nemikhwa yempilo yesigulana kunye nezigulo zangaphambili kunye nonyango.

Ukuba isigulana sifumene unyango ngemitha, olu vavanyo lulandelayo kunye neenkqubo zinokusetyenziselwa ukukhangela ulusu, ibele, okanye umhlaza wombala:

• Uvavanyo lolusu : Ugqirha okanye umongikazi ukhangela ulusu ukuba lunamaqhuma okanye amabala abonakala engaqhelekanga ngombala, ubungakanani, imilo, okanye ubume, ngakumbi kwindawo apho kunikwe imitha. Kucetyiswa ukuba kuvavanywe ulusu kanye ngonyaka ukujonga iimpawu zomhlaza wolusu.

• Ukuzivavanya amabele : Uvavanyo lwesifuba ngumguli. Isigulana siva ngononophelo amabele naphantsi kweengalo zamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Kuyacetyiswa ukuba abasetyhini baphathwe ngedosi ephezulu yonyango lwemitha esifubeni benze uvavanyo lwenyanga lokuzihlola ukuqala ebusheni ukuya kwiminyaka engama-25. Abasetyhini abanyangwe ngedosi esezantsi yemitha esifubeni kusenokungafuneki ukuba baqale ukujonga umhlaza webele xa ufikisa. Thetha nogqirha wakho malunga nokuba kufuneka uqale nini ukuzihlola amabele.

• Uviwo lwebele lwezonyango (i-CBE): Uvavanyo lwebele ngugqirha okanye yingcali yezempilo. Ugqirha uya kuva ngononophelo amabele naphantsi kweengalo zamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Kuyacetyiswa ukuba abasetyhini baphathwe ngedosi ephezulu yonyango ngemitha esifubeni kuvavanyo lwebele lweklinikhi rhoqo ngonyaka ukuqala ngexesha lokufikisa kude kube yiminyaka engama-25. Emva kweminyaka engama-25 okanye iminyaka esi-8 emva kokuba unyango lwe-radiation luphelile (nokuba yeyiphi na eyokuqala), iimviwo zebele zeklinikhi zenziwa rhoqo kwiinyanga ezi-6. Abasetyhini abanyangwe ngedosi esezantsi yemitha esifubeni kusenokungafuneki ukuba baqale ukujonga umhlaza webele xa ufikisa. Thetha nogqirha wakho malunga nokuba kufuneka uqale nini na kwiimviwo zebele zeklinikhi.

• Isisombululo: X-reyi yebele. I-mammogram inokwenziwa kwabasetyhini ababenethamo eliphezulu lemitha esifubeni kwaye abangenazo amabele axineneyo. Kuyacetyiswa ukuba aba bafazi bane-mammogram kube kanye ngonyaka ukuqala kweminyaka esi-8 emva konyango okanye kwiminyaka engama-25, nokuba yeyiphi kamva. Thetha nogqirha wakho malunga nokuba kufuneka uqale nini ukufumana iimammograms ukujonga umhlaza webele.

• I-MRI yebele (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zesifuba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI). I-MRI inokwenziwa kwabasetyhini abanedosi ephezulu yemitha esifubeni kwaye banamabele ashinyeneyo. Kuyacetyiswa ukuba aba bafazi bane-MRI kube kanye ngonyaka ukuqala kweminyaka esi-8 emva konyango okanye kwiminyaka engama-25 ubudala, nokuba yeyiphi na kamva. Ukuba unayo i-radiation esifubeni, thetha nogqirha wakho malunga nokuba ufuna i-MRI yebele ukujonga umhlaza webele.

• IColonoscopy: Inkqubo yokujonga ngaphakathi kwi-rectum kunye ne-colon yee-polyps, iindawo ezingaqhelekanga, okanye umhlaza. I-colonoscope ifakwe kwi-rectum kwi-colon. Ikholonoscope sisixhobo esibhityileyo, esifana netyhubhu esinesibane kunye neelensi zokujonga. Isenokuba nesixhobo sokususa iipolyps okanye iisampulu zethishu, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza. Kucetyiswa ukuba amaxhoba omhlaza wabantwana abanedosi ephezulu yesisu esiswini, isinqe, okanye umqolo une-colonoscopy qho emva kweminyaka emi-5. Oku kuqala kubudala beminyaka engama-35 okanye iminyaka eli-10 emva kokuba unyango luphelile, nokuba yeyiphi na kamva. Ukuba ubunemitha esiswini, isinqe, okanye umqolo, thetha nogqirha wakho malunga nokuba kufuneka uqale nini ukuba neekolonoscopy ukujonga umhlaza wecolorectal.

Inkqubo yeentliziyo

IINGONGOMA EZIPHAMBILI

• Isiphumo sentliziyo kunye negazi emva kwexesha kunokwenzeka kakhulu ukuba zenzeke emva konyango lwee-cancer ezithile zomntwana.

• Imitha esifubeni kunye neentlobo ezithile ze-chemotherapy yonyusa umngcipheko wentliziyo kunye nemithambo yegazi emva kwexesha.

• Iziphumo ezifika emva kwexesha ezichaphazela intliziyo kunye nemithambo yegazi zinokubangela iingxaki ezithile zempilo.

• Iimpawu ezinokubakho kunye neempawu zentliziyo kunye nemithambo yegazi emva kwexesha kubandakanya ukuphefumla kunye nentlungu esifubeni.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo entliziyweni nakwimithambo yegazi.

• Imikhwa yempilo ekhuthaza intliziyo kunye nemithambo yegazi esempilweni ibalulekile kumaxhoba omhlaza wabantwana.

Isiphumo sentliziyo kunye negazi emva kwexesha kunokwenzeka kakhulu ukuba zenzeke emva konyango lwee-cancer ezithile zomntwana. Unyango lwale neminye imihlaza yomhlaza kunokubangela iziphumo zentliziyo kunye nemithambo yegazi emva kwexesha:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Igazi leukemia eliyingozi (AML).

• Ingqondo kunye nethumbu lomqolo.

• Intloko kunye nomhlaza wentamo.

• IHodgkin lymphoma.

• I-non-Hodgkin lymphoma.

• Ithumba leWilms.

• Umhlaza uphathwa ngokufakwa kweseli.

Imitha esifubeni kunye neentlobo ezithile ze-chemotherapy yonyusa umngcipheko wentliziyo kunye nemithambo yegazi emva kwexesha.

Umngcipheko weengxaki zempilo ezibandakanya intliziyo kunye nemithambo yegazi iyanda emva konyango ngezi zinto zilandelayo:

• Ukutshiswa ngemitha esifubeni, emqolo, kwingqondo, entanyeni, kwizintso, okanye kwimithambo yomzimba iyonke (i-TBI) njengenxalenye yokufakwa kweseli. Umngcipheko weengxaki uxhomekeke kwindawo yomzimba ebichanabeke kwimitha, ubungakanani bemitha enikiweyo, nokuba ngaba imitha yanikezelwa ngeedosi ezincinci okanye ezinkulu.

• Iindidi ezithile ze-chemotherapy kunye nedosi iyonke ye-anthracycline enikiweyo. I-Chemotherapy ene-anthracyclines enjenge-doxorubicin, i-daunorubicin, i-idarubicin, kunye ne-epirubicin, kunye ne-anthraquinones enjenge-mitoxantrone inyusa umngcipheko weengxaki zentliziyo kunye negazi. Umngcipheko weengxaki uxhomekeke kwidosi epheleleyo yechemotherapy enikiweyo kunye nohlobo lweziyobisi ezisetyenzisiweyo. Kuxhomekeke ekubeni ngaba unyango nge-anthracyclines lunikwe umntwana ongaphantsi kweminyaka eli-13 kwaye nokuba ichiza ekuthiwa yi-dexrazoxane lanikwa na ngexesha lonyango lwe-anthracyclines. UDexrazoxane unokunciphisa ukonakala kwentliziyo kunye nomthambo wegazi ukuya kwiminyaka emi-5 emva konyango. Ukuba i-ifosfamide, i-methotrexate, kunye ne-chemotherapy ngeplatinam, njenge-carboplatin kunye ne-cisplatin, inokubangela intliziyo kunye negazi emva kwexesha.

• Ukufakelwa kweseli.

• I-Nephrectomy (utyando ukususa konke okanye inxalenye yezintso).

Abasindileyo bomhlaza wabantwana abaye baphathwa nge-radiation entliziyweni okanye kwimithambo yegazi kunye neentlobo ezithile ze-chemotherapy zisengozini enkulu.

Unyango olutsha olwehlisayo inani lemitha enikiweyo kunye nokusebenzisa iidosi ezisezantsi zekhemotherapy okanye amayeza amayeza amayeza anobungozi anokunciphisa umngcipheko wentliziyo kunye nemithambo yegazi emva kwexesha xa kuthelekiswa nonyango oludala.

Oku kulandelayo kungonyusa umngcipheko wentliziyo kunye negazi emva kwexesha:

• Ixesha elide ukususela kunyango.

• Ukuba noxinzelelo lwegazi oluphezulu okanye ezinye izinto ezinobungozi besifo sentliziyo, njengembali yosapho yesifo sentliziyo, ukutyeba kakhulu, ukutshaya, i-cholesterol ephezulu, okanye isifo seswekile. Xa le miba yomngcipheko idityanisiwe, umngcipheko weziphumo ezifike kade uphezulu kakhulu.

• Ukuba namaxabiso asezantsi kunesiqhelo we-thyroid, ukukhula, okanye iihomoni zesini.

Iziphumo ezifika emva kwexesha ezichaphazela intliziyo kunye nemithambo yegazi zinokubangela iingxaki ezithile zempilo.

Abasindileyo bomhlaza wabantwana abafumana i-radiation okanye iintlobo ezithile ze-chemotherapy banomngcipheko okhulayo weziphumo eziya entliziyweni nakwimithambo yegazi kunye neengxaki zempilo ezinxulumene noko. Oku kubandakanya oku kulandelayo:

• Ukubetha kwentliziyo okungaqhelekanga.

• Imisipha yentliziyo ebuthathaka.

• Intliziyo edumbileyo okanye ingxowa ejikeleze intliziyo.

• Ukonakala kwezivalo zentliziyo.

• Isifo semithambo yegazi (ukuqina kwemithambo yentliziyo).

• Ukusilela kwentliziyo.

• Intlungu yesifuba okanye isifo sentliziyo.

• Amahlwili egazi okanye ukubetha okukodwa okanye nangaphezulu.

• Isifo semithambo yeCarotid.

Iimpawu ezinokubakho kunye neempawu zentliziyo kunye nemithambo yegazi emva kwexesha kubandakanya ukuphefumla kunye nentlungu esifubeni.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa yintliziyo kunye negazi emva kwexesha okanye ngezinye iimeko:

• Ingxaki yokuphefumla, ngakumbi xa ulele phantsi.

• Ukubetha kwentliziyo okucothayo, okukhawulezayo, okanye okungafaniyo nesingqisho sentliziyo esiqhelekileyo.

• Intlungu yesifuba okanye iintlungu engalweni okanye emlenzeni.

• Ukudumba kweenyawo, amaqatha, imilenze, okanye isisu.

• Xa ivezwe yingqele okanye ineemvakalelo ezinamandla, iminwe, iinzwane, iindlebe, okanye impumlo iba mhlophe ize ijike ibe luhlaza okwesibhakabhaka. Xa oku kusenzeka

• kwiminwe, kusenokubakho iintlungu kunye nokuncwina.

• Ukuphazamiseka ngesiquphe okanye ubuthathaka bobuso, ingalo, okanye umlenze (ngakumbi kwicala elinye lomzimba).

• Ukudideka ngesiquphe okanye unengxaki yokuthetha okanye ukuqonda intetho.

• Ingxaki engxamisekileyo yokubona ngamehlo omabini okanye omabini.

• Ingxaki ekhawulezileyo yokuhamba okanye yokuziva unesiyezi.

• Ukuphulukana ngesiquphe kwemali eseleyo okanye yokulungelelanisa.

• Intloko ebuhlungu ngesiquphe ngaphandle kwesizathu esaziwayo.

• Ubuhlungu, ukufudumala, okanye ubomvu kwindawo enye yengalo okanye umlenze, ngakumbi umva womlenze ongezantsi.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo entliziyweni nakwimithambo yegazi.

Ezi kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukufumanisa okanye ukufumanisa isifo sentliziyo kunye negazi emva kwexesha:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga intliziyo ukuba akukho zimpawu zezifo, ezinje ngokubetha kwentliziyo okungaqhelekanga, uxinzelelo lwegazi oluphezulu, okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• I-Electrocardiogram (EKG): Ukurekhodwa kwento yombane yentliziyo ukujonga inqanaba kunye nesingqisho sayo. Inani leepads ezincinci (ii-electrode) zibekwe esifubeni sesigulana, iingalo, kunye nemilenze, kwaye zidityaniswe ziintambo kumatshini we-EKG. Umsebenzi wentliziyo emva koko ubhalwa njengegrafu ephepheni. Umsebenzi wombane okhawulezayo okanye ocothayo kunesiqhelo unokuba luphawu lwesifo sentliziyo okanye ukonakala.

• I-Echocardiogram: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) abethelwa entliziyweni nakwizicubu ezikufuphi okanye kwizitho kunye nokwenza i-echoes. Umfanekiso ohambayo wenziwe ngeentliziyo kunye nezivalo zentliziyo njengoko igazi lifakwa emphefumlweni entliziyweni.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kumalungu anjengentliziyo kwaye enza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography. Le nkqubo yenziwa ukujonga amahlwili egazi.

• Izifundo zeprofayili yeLipid: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa ze-triglycerides, i-cholesterol, kunye ne-low- and high-density lipoprotein cholesterol egazini.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zentliziyo kunye negazi emva kwexesha. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Imikhwa yempilo ekhuthaza intliziyo kunye nemithambo yegazi esempilweni ibalulekile kumaxhoba omhlaza wabantwana.

Abasindileyo kumhlaza wabantwana banokunciphisa umngcipheko wentliziyo kunye negazi emva kokuphila ngendlela esempilweni, ebandakanya:

• Ubunzima obuphilileyo.

• Ukutya okusempilweni.

• Ukuzilolonga rhoqo.

• Akatshayi.

Inkqubo eNkulu yeNervous

IINGONGOMA EZIPHAMBILI

• Ubuchopho kunye nentambo yomqolo emva kwexesha kunokubakho emva konyango lwee-cancer ezithile zomntwana.

• Imitha ebuchotsheni yonyusa umngcipheko wobuchopho kunye nentambo yomqolo emva kwexesha.

• Iziphumo ezifika emva kwexesha ezichaphazela ingqondo kunye nomqolo onokubangela iingxaki ezithile zempilo.

• Iimpawu ezinokubakho kunye neempawu zobuchopho kunye nentambo yomqolo emva kwexesha zibandakanya iintloko, ukuphulukana nolungelelwaniso, kunye nokubanjwa.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwingqondo nakumqolo.

• Abasindileyo kumhlaza wobuntwana banokuba noxinzelelo kunye noxinzelelo olunxulumene nomhlaza wabo.

• Abanye abasindileyo abanomhlaza wobuntwana banexinzelelo lwasemva koxinzelelo.

• Abafikisayo abafunyaniswa benomhlaza banokuba neengxaki zentlalo kamva ebomini.

Ubuchopho kunye nentambo yomqolo emva kwexesha kunokubakho emva konyango lwee-cancer ezithile zomntwana.

Unyango lwezi kunye neminye imihlaza yomhlaza enokubangela ubuchopho kunye nentambo yomqolo emva kwexesha.

• I-leukemia ye-lymphoblastic acute (BONKE).

• Ingqondo kunye nethumbu lomqolo.

• Intloko kunye nentamo yomhlaza, kubandakanya i-retinoblastoma.

• I-non-Hodgkin lymphoma.

• Osteosarcoma.

Imitha ebuchotsheni yonyusa umngcipheko wobuchopho kunye nentambo yomqolo emva kwexesha.

Umngcipheko weengxaki zempilo ezichaphazela ingqondo okanye intambo yomqolo iyanda emva konyango ngezi zinto zilandelayo:

• Imitha yengqondo okanye intambo yomqolo, ngakumbi iidosi eziphezulu zemitha. Oku kubandakanya i-irradiation yomzimba iyonke enikezwe njengenxalenye yokufakwa kweseli.

• I-intrathecal okanye i-intraventricular chemotherapy.

• I-Chemotherapy ngethamo eliphezulu le-methotrexate okanye i-cytarabine enokuwela isithintelo segazi-ngengqondo (ulwelo olukhuselayo olujikeleze ingqondo).

Oku kubandakanya i-chemotherapy yedosi ephezulu enikezwe njengenxalenye yokufakelwa kweseli.

• Ugqirha lokususa ithumba ebuchotsheni okanye kwintambo yomqolo.

Xa i-radiation ebuchotsheni kunye ne-intrathecal chemotherapy inikezelwa ngaxeshanye, umngcipheko weziphumo ezifike kade uphezulu.

Oku kulandelayo kungonyusa umngcipheko wobuchopho kunye nentambo yomqolo emva kwexesha kwiziphumo zobuntwana abasindayo.

• Ukuba malunga neminyaka emi-5 ubudala okanye umncinci ngexesha lonyango.

• Ukuba ngumfazi.

• Ukuba nehydrocephalus kunye ne-shunt ebekiweyo yokususa ulwelo olongezelelekileyo kwii-ventricles.

• Ukuphulukana nokuva.

• Ukuba ne-cerebellar mutism emva kotyando lokususa ithumba lobuchopho. I-Cerebellar mutism ibandakanya ukungakwazi ukuthetha, ilahleko

• ukulungelelanisa kunye nokulinganisela, ukuguquka kwemizwelo, ukucaphuka, kunye nokukhala okuphezulu.

• Ukuba nembali yobuqu yesifo.

• Ukuxhuzula.

Inkqubo ye-neva esembindini yeziphumo ezichaphazelekayo zikwachaphazeleka apho ithumba lenzeke khona kwingqondo nakumqolo.

Iziphumo ezifika emva kwexesha ezichaphazela ingqondo kunye nomqolo onokubangela iingxaki ezithile zempilo.

Abasindileyo bomhlaza wabantwana abafumana i-radiation, iintlobo ezithile ze-chemotherapy, okanye utyando kwingqondo okanye intambo yomqolo banomngcipheko okhulayo weziphumo zobuchwephesha kunye nentambo yomqolo kunye neengxaki zempilo ezinxulumene noko. Oku kubandakanya oku kulandelayo:

• Intloko ebuhlungu.

• Ukuphulukana nolungelelwaniso kunye nokulingana.

• Ukuba nesiyezi.

• Ukuxhuzula.

• Ukuphulukana nesithambiso se-myelin esigubungela imisonto yengqondo kwingqondo.

• Ukuphazamiseka kwentshukumo okuchaphazela imilenze namehlo okanye ukukwazi ukuthetha nokuginya.

• Umonakalo wemithambo ezandleni okanye ezinyaweni.

• Ukubetha. Isibetho sesibini sinokubakho ngakumbi kumaxhoba afumana imitha kwingqondo, abe nembali yoxinzelelo lwegazi oluphezulu,

• okanye babeneminyaka engaphezu kwama-40 ubudala xa babenesifo sokuqala.

• Ukulala emini.

• IHydrocephalus.

• Ukuphulukana nesinyi kunye / okanye ukulawula amathumbu.

• ICavernomas (izihloko zemithambo yegazi engaqhelekanga).

• Umqolo obuhlungu.

Abasindileyo banokuba neziphumo ezifika kade ezichaphazela ukucinga, ukufunda, inkumbulo, iimvakalelo kunye nokuziphatha.

Iindlela ezintsha zokusebenzisa ngakumbi iithagethi ezisezantsi kunye nezisezantsi zemitha kwingqondo kunokunciphisa umngcipheko wobuchopho kunye nentambo yomqolo emva kwexesha.

Iimpawu ezinokubakho kunye neempawu zobuchopho kunye nentambo yomqolo emva kwexesha zibandakanya iintloko, ukuphulukana nolungelelwaniso, kunye nokubanjwa.

Ezi mpawu kunye neempawu zinokubangelwa yingqondo kunye nentambo yomqolo emva kwexesha okanye ngezinye iimeko:

• Intloko enokuthi ihambe emva kokugabha.

• Ukuxhuzula.

• Ukuphulukana nokulingana, ukunqongophala kokulungelelanisa, okanye ingxaki yokuhamba.

• Ingxaki yokuthetha okanye ukuginya.

• Ingxaki yokuba namehlo asebenza kunye.

• Ubudenge, ukubetha, okanye ubuthathaka ezandleni okanye ezinyaweni.

• Ukungakwazi ukugoba iqatha ukuze uphakamise unyawo phezulu.

• Ukuphazamiseka ngesiquphe okanye ubuthathaka bobuso, ingalo, okanye umlenze (ngakumbi kwicala elinye lomzimba).

• Ukulala ngokungaqhelekanga okanye utshintsho kwinqanaba lomsebenzi.

• Utshintsho olungaqhelekanga kubuntu okanye ekuziphatheni.

• Utshintsho kwimikhwa yamathumbu okanye ingxaki yokuchama.

• Ukwandisa ubungakanani beentloko (kwiintsana).

• Ukudideka ngesiquphe okanye unengxaki yokuthetha okanye ukuqonda intetho.

• Ingxaki engxamisekileyo yokubona ngamehlo omabini okanye omabini.

• Intloko ebuhlungu ngesiquphe ngaphandle kwesizathu esaziwayo.

Ezinye iimpawu kunye neempawu zibandakanya oku kulandelayo:

• Iingxaki ngememori.

• Iingxaki ngokuhoya.

• Ingxaki ngokusombulula iingxaki.

• Ingxaki ngokulungiselela iingcinga kunye nemisebenzi.

• Ukukhawuleza ukufunda nokusebenzisa ulwazi olutsha.

• Unengxaki yokufunda, ukubhala, okanye ukwenza izibalo.

• Ingxaki yokulungelelanisa intshukumo phakathi kwamehlo, izandla kunye nezinye izihlunu.

• Ukulibaziseka kuphuhliso oluqhelekileyo.

• Ukurhoxa ekuhlaleni okanye ingxaki yokuvana nabanye.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwingqondo nakumqolo.

Olu kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukukhangela okanye ukufumanisa ubuchwephesha kunye nentambo yomqolo emva kwexesha:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lwe-Neurological: Uthotho lwemibuzo kunye novavanyo lokujonga ubuchopho, intambo yomqolo kunye nokusebenza kwentliziyo. Uvavanyo lujonga imeko yomntu ngokwengqondo, ulungelelwaniso, kunye namandla okuhamba ngesiqhelo, kunye nendlela esebenza ngayo izihlunu, imizwa kunye nengqondo. Oku kunokubizwa ngokuba luvavanyo lwe-neuro okanye uvavanyo lwe-neurologic. Kwezinye iimeko, uvavanyo olupheleleyo ngakumbi lungenziwa ngugqirha we-neurologist okanye i-neurosurgeon.

• Uvavanyo lwe-Neuropsychological: Uthotho lweemvavanyo zokuvavanya iinkqubo zengqondo kunye nokuziphatha kwesigulana. Iindawo ezijongwa rhoqo zibandakanya:

• Ukwazi ukuba ungubani kwaye uphi kwaye ungowuphi umhla.

• Amandla okufunda nokukhumbula ulwazi olutsha.

• Ubukrelekrele.

• Amandla okusombulula iingxaki.

• Ukusetyenziswa kolwimi oluthethwayo nolubhaliweyo.

• Ukulungelelaniswa kwesandla ngamehlo.

• Amandla okulungiselela ulwazi kunye nemisebenzi.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zengqondo kunye nentambo yomqolo emva kwexesha. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Abasindileyo kumhlaza wobuntwana banokuba noxinzelelo kunye noxinzelelo olunxulumene nomhlaza wabo.

Abasindileyo kumhlaza wobuntwana banokuba noxinzelelo kunye noxinzelelo olunxulumene notshintsho lomzimba, ukuba neentlungu, indlela abajongeka ngayo, okanye uloyiko lomhlaza ukubuya. Ezi kunye nezinye izinto zinokubangela iingxaki kubudlelwane bomntu, imfundo, ingqesho kunye nempilo, kwaye zibangele iingcinga zokuzibulala. Abasindileyo kwezi ngxaki basenokungakwazi ukuhlala bodwa xa sele bebadala.

Iimviwo zokulandelela abo basinde kumhlaza wabantwana kufuneka zibandakanye ukuhlolwa kunye nonyango lwexinzelelo lwengqondo, ezinje ngoxinzelelo, uxinzelelo kunye neengcinga zokuzibulala.

Abanye abasindileyo abanomhlaza wobuntwana banexinzelelo lwasemva koxinzelelo.

Ukufunyanwa nokunyangwa kwesifo esisongela ubomi kunokuba yingozi. Olu xinzelelo lunokubangela uxinzelelo lwasemva koxinzelelo (PTSD). I-PTSD ichazwa njengokuziphatha okuthile kulandela isiganeko soxinzelelo esabandakanya ukufa okanye isoyikiso sokufa, ukonzakala okunzima, okanye isoyikiso kuwe nakwabanye.

I-PTSD inokuchaphazela abasindileyo bomhlaza ngezi ndlela zilandelayo:

• Ukubuyisa ixesha lokuchongwa nokunyangwa komhlaza, kumaphupha amabi okanye ukubuyela umva, kwaye ucinga ngalo lonke ixesha.

• Ukuphepha iindawo, iminyhadala, kunye nabantu ezibakhumbuza ngamava omhlaza.

Ngokubanzi, abasindileyo bomhlaza wabantwana babonisa amanqanaba asezantsi e-PTSD, ngokuxhomekeke kwinxalenye yesitayile sokukhawulelana nezigulana nabazali babo. Abasindileyo abafumana unyango lwe-radiation entloko xa bebancinci kuneminyaka emi-4 okanye abasindileyo abafumana unyango olunzulu banokuba semngciphekweni omkhulu we-PTSD. Iingxaki zosapho, ukuxhaswa okuncinci okanye ukungabikho kwenkxaso kwezentlalo kusapho okanye kubahlobo, kunye noxinzelelo olungahambelani nomhlaza kunokunyusa amathuba okuba ne-PTSD.

Ngenxa yokuba ukuphepha indawo kunye nabantu abadibene nomhlaza bangaba yinxalenye ye-PTSD, abasindileyo abane-PTSD abanako ukufumana unyango abalufunayo.

Abafikisayo abafunyaniswa benomhlaza banokuba neengxaki zentlalo kamva ebomini.

Abafikisayo abafunyaniswa benomhlaza banokufikelela kumanqanaba okuncipha ekuhlaleni okanye bafikelele kubo kamva ebomini kunakwishumi elivisayo angafumanekanga enomhlaza. Amanqanaba entlalontle abandakanya ukuba nesoka lokuqala okanye intombi, ukutshata, nokuba nomntwana. Banokuba nengxaki yokuhlangana nabanye abantu okanye bazive ngathi abathandi abanye abalingana nabo.

Abasindileyo bomhlaza kweli qela leminyaka baxele ukungoneliseki kangako yimpilo yabo kunye nobomi babo ngokubanzi xa kuthelekiswa nabanye abakwiminyaka efanayo ababengenawo umhlaza. Ulutsha kunye nabantu abadala abancinci abasindileyo kumhlaza bafuna iinkqubo ezizodwa ezibonelela ngenkxaso yengqondo, yemfundo kunye nomsebenzi.

Inkqubo yokwetyisa

IINGONGOMA EZIPHAMBILI

• Amazinyo nemihlathi

• Iingxaki ngamazinyo nasemhlathini ziziphumo ezifike kade ezinokuthi zenzeke emva konyango lwee-cancer ezithile zobuntwana.

• Imitha entloko nasentanyeni kunye neentlobo ezithile zonyango lwe-chemotherapy zonyusa umngcipheko weziphumo zamva nasemazantsi emihlathi.

• Iziphumo ezifika emva kwexesha ezichaphazela amazinyo nemihlathi zingadala iingxaki ezithile zempilo.

• Iimpawu ezinokubakho kunye neempawu zeziphumo zamazinyo kunye nemihlathi zibandakanya ukubola kwamazinyo (imingxunya) kunye nentlungu yomhlathi.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo emlonyeni nasemhlathini.

• Ukunyamekelwa rhoqo kwamazinyo kubaluleke kakhulu kumaxhoba omhlaza wabantwana.

• Kwindlela yokugaya ukutya

• Iziphumo zokugaya emva kwexesha zinokwenzeka emva konyango lwee-cancer ezithile zomntwana.

• Ukutshiswa ngemitha kwisinyi, iprostate, okanye amasende kunye nezinye iintlobo zonyango lwe-chemotherapy kunyusa umngcipheko wokugaya ukutya emva kwexesha.

• Iziphumo ezifika emva kwexesha ezichaphazela ukwetyisa zinokubangela iingxaki ezithile zempilo.

• Iimpawu ezinokubakho kunye neempawu zokugaya ukutya emva kwexesha kubandakanya iintlungu zesisu kunye norhudo.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwindawo yokwetyisa.

• Isibindi kunye nemibhobho yenyongo

• Iziphumo zesibindi kunye nenyongo emva kwexesha kunokwenzeka ukuba zenzeke emva konyango lwee-cancer ezithile zomntwana.

• Iindidi ezithile ze-chemotherapy kunye ne-radiation kwisibindi okanye i-bile ducts zonyusa umngcipheko weziphumo ezibi.

• Iziphumo ezinokuchaphazela isibindi kunye ne-bile ducts zinokubangela iingxaki ezithile zempilo.

• Iimpawu ezinokubakho kunye neempawu zesibindi kunye ne-bile duct yeziphumo ezibi zibandakanya iintlungu zesisu kunye nejundice.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwisibindi nakwindlela ye-bile.

• Imikhwa yempilo ekhuthaza isibindi esempilweni ibalulekile kumaxhoba omhlaza wabantwana.

• Iipancreas

• Unyango ngemitha lonyusa umngcipheko wepancreatic iziphumo ezibi.

• Iziphumo ezifika emva kwexesha ezichaphazela i-pancreas zinokubangela iingxaki ezithile zempilo.

• Iimpawu ezinokubakho kunye neempawu zepancreatic emva kwexesha zibandakanya ukuchama rhoqo kunye nokunxanwa.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwi-pancreas.

Amazinyo nemihlathi

Iingxaki ngamazinyo nasemhlathini ziziphumo ezifike kade ezinokuthi zenzeke emva konyango lwee-cancer ezithile zobuntwana.

Unyango lwale neminye imihlaza yomhlaza inokubangela umphumo weengxaki zamazinyo nemihlathi.

• Intloko kunye nentamo yomhlaza.

• IHodgkin lymphoma.

• Neuroblastoma.

• Ileukemia esasazeka kwingqondo nakumqolo.

• Umhlaza weNasopharyngeal.

• Amathumba ebongo.

• Umhlaza uphathwa ngokufakwa kweseli.

Imitha entloko nasentanyeni kunye neentlobo ezithile zonyango lwe-chemotherapy zonyusa umngcipheko weziphumo zamva nasemazantsi emihlathi.

Umngcipheko weengxaki zempilo ezichaphazela amazinyo nemihlathi ziyanda emva konyango ngezi zinto zilandelayo:

• Unyango ngemitha entloko nasentanyeni.

• Umzimba wonke we-irradiation (TBI) njengenxalenye yokufakelwa kweseli.

• I-Chemotherapy, ngakumbi ngeedosi eziphezulu zeealkylating agents ezinje ngecyclophosphamide.

• Ugqirha kwindawo yentloko nentamo.

Umngcipheko uyonyuswa nakwabasindileyo ababebancinci kuneminyaka emi-5 ngexesha lonyango kuba amazinyo abo asisigxina ayengekakheki ngokupheleleyo.

Iziphumo ezifika emva kwexesha ezichaphazela amazinyo nemihlathi zingadala iingxaki ezithile zempilo.

Iziphumo zamazinyo kunye nomhlathi emva kwexesha kunye neengxaki zempilo ezinxulumene nazo zibandakanya oku kulandelayo:

• Amazinyo angaqhelekanga.

• Ukubola kwamazinyo (kubandakanya imingxunya) kunye nesifo seentsini.

• Amadlala amathe awenzi ngokwaneleyo amathe.

• Ukufa kweeseli zamathambo emhlathini.

• Utshintsho kwindlela yobuso, umhlathi, okanye ukakayi.

Iimpawu ezinokubakho kunye neempawu zeziphumo zamazinyo kunye nemihlathi zibandakanya ukubola kwamazinyo (imingxunya) kunye nentlungu yomhlathi.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa ziziphumo zamazinyo kunye nemihlathi okanye ngezinye iimeko:

• Amazinyo amancinci okanye akanayo imilo eqhelekileyo.

• Amazinyo asisigxina.

• Amazinyo asisigxina angena emva kwexesha eliqhelekileyo.

• Amazinyo ane-enamel encinci kunesiqhelo.

• Maninzi ukubola kwamazinyo (imingxunya) kunye nesifo seentsini kunesiqhelo.

• Umlomo owomileyo.

• Ingxaki yokuhlafuna, ukugwinya kunye nokuthetha.

• Intlungu yomhlathi.

• Imihlathi ayivuli kwaye ivale indlela ebekufanele.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo emlonyeni nasemhlathini.

Olu kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukufumanisa okanye ukufumanisa iziphumo zamazinyo emihlathi:

• Uvavanyo lwamazinyo kunye nembali: Uvavanyo lwamazinyo, umlomo kunye nemihlathi ukujonga imiqondiso yempilo yamazinyo, kubandakanya nokujonga iimpawu zesifo, ezinje ngembambo okanye nantoni na ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa. Oku kunokubizwa ngokuba kukujonga amazinyo.

• IPanorex x-ray: IX -reyi yawo onke amazinyo neengcambu zawo. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• IX-reyi yemihlathi: IX-reyi yemihlathi. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjengentloko nentamo, ezithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinjengentloko nentamo. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• I-Biopsy: Ukususwa kweeseli zamathambo emhlathini ukuze zibonwe phantsi kwemicroscope ukujonga iimpawu zokufa kwamathambo emva konyango lwemitha.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zamazinyo kunye nomhlathi emva kwexesha. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Ukunyamekelwa rhoqo kwamazinyo kubaluleke kakhulu kumaxhoba omhlaza wabantwana.

Oogqirha bacebisa ukuba amaxhoba omhlaza wobuntwana aya kuhlolwa amazinyo kunye nonyango lokucoca kunye ne-fluoride rhoqo kwiinyanga ezi-6. Abantwana abanonyango lwe-radiation kwisisu somlomo banokubona i-orthodontist okanye i-otolaryngologist. Ukuba izilonda zikhona emlonyeni, i-biopsy inokufuneka.

Kwindlela yokugaya ukutya

Iziphumo zokugaya emva kwexesha zinokwenzeka emva konyango lwee-cancer ezithile zomntwana.

Unyango lwale neminye imihlaza yomhlaza kunokubangela iziphumo zendlela yokugaya kade (isisu, isisu, amathumbu amancinci kunye namakhulu, i-rectum kunye ne-anus):

• IRhabdomyosarcoma yesinyi okanye eyeprostate, okanye kufutshane namasende.

• I-non-Hodgkin lymphoma.

• Izidumba zeseli zentsholongwane.

• Neuroblastoma.

• Ithumba leWilms.

Ukutshiswa ngemitha kwisinyi, iprostate, okanye amasende kunye nezinye iintlobo zonyango lwe-chemotherapy kunyusa umngcipheko wokugaya ukutya emva kwexesha.

Umngcipheko weengxaki zempilo ezichaphazela indawo yokugaya ukwanda emva konyango ngezi zinto zilandelayo:

• Ukunyanga ngemitha esiswini okanye kwiindawo ezikufutshane nesisu, ezinje ngomqala, isinyi, iprostate, okanye amasende, kunokubangela iingxaki zokugaya ukutya eziqala ngokukhawuleza kwaye zihlale ixesha elincinci. Kwezinye izigulana, nangona kunjalo, iingxaki zendlela yokwetyisa ziyalibaziseka kwaye zihlala ixesha elide. Ezi ziphumo zasemva kwexesha zibangelwa lonyango lwemitha olonakalisa imithambo yegazi. Ukufumana iidosi eziphezulu zonyango lwe-radiation okanye ukufumana i-chemotherapy enje nge-dactinomycin okanye i-anthracyclines kunye nonyango lwe-radiation kunokunyusa lo mngcipheko.

• Utyando lwesisu okanye utyando lwe-pelvic ukususa isinyi.

• I-Chemotherapy ene-alkylating agents ezinjenge-cyclophosphamide, i-procarbazine, kunye ne-ifosfamide, okanye ii-arhente zeplatinam ezifana ne-cisplatin okanye i-carboplatin, okanye ii-anthracyclines ezinjenge-doxorubicin, i-daunorubicin, idarubicin kunye ne-epirubicin.

• Ukufakelwa kweseli.

Oku kulandelayo kungonyusa umngcipheko wokugaya ukutya emva kwexesha:

• Ukuguga ekufumanekeni okanye xa unyango luqala.

• Unyango lwazo zombini unyango lwe-radiation kunye ne-chemotherapy.

• Imbali yesifo esinganyangekiyo sokuchasana nokusingathwa.

Iziphumo ezifika emva kwexesha ezichaphazela ukwetyisa zinokubangela iingxaki ezithile zempilo.

Ukucola ukutya emva kwexesha kunye neengxaki zempilo kubandakanya oku kulandelayo:

• Ukunciphisa umqala okanye amathumbu.

• Izihlunu zomqala azisebenzi kakuhle.

• Reflux

• Urhudo, ukuqhina, ukungakwazi ukubamba ukungcola, okanye ukuvala amathumbu.

• Ukuhlanjwa kwamathumbu (umngxunya emathunjini).

• Ukudumba kwamathumbu.

• Ukufa kwenxalenye yamathumbu.

• Amathumbu akakwazi ukufunxa izondlo ekutyeni.

Iimpawu ezinokubakho kunye neempawu zokugaya ukutya emva kwexesha kubandakanya iintlungu zesisu kunye norhudo.

Ezi kunye neminye imiqondiso kunye neempawu zinokubangelwa kukugaya ukutya emva kwexesha okanye ngezinye iimeko:

• Ingxaki yokuginya okanye ukuziva ngathi ukutya kubambekile emqaleni.

• Isitshisa.

• Umkhuhlane oneentlungu eziqatha esiswini kunye nesicaphucaphu.

• Intlungu esiswini.

• Utshintsho kwimikhwa yamathumbu (ukuqhina okanye urhudo).

• Isicaphucaphu nokugabha.

• Iintlungu zarhoqo zerhasi, ukudumba, ukugcwala okanye isijwili.

• Iimpawu.

• Reflux.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwindawo yokwetyisa.

Olu kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukukhangela okanye ukufumanisa imeko yokugaya ukutya emva kwexesha:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngesisu esiswini okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lwe-rectal yovavanyo lwangaphakathi Ugqirha okanye umongikazi ufaka i-lubricated, iiglavu ngomnwe kwi-rectum ukuze uve amaqhuma okanye nayiphi na into ebonakala ingaqhelekanga.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• IX-reyi: IX-reyi luhlobo lombane wamandla onokuthi uhambe emzimbeni nakwifilimu, wenze umfanekiso weendawo ezingaphakathi komzimba. I-x-ray ingathathwa esiswini, kwizintso, kwi-ureter, okanye kwisinyi ukujonga iimpawu zesifo.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zendlela yokugaya emva kwexesha. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Isibindi kunye nemibhobho yenyongo

Iziphumo zesibindi kunye nenyongo emva kwexesha kunokwenzeka ukuba zenzeke emva konyango lwee-cancer ezithile zomntwana.

Unyango lwale neminye imihlaza yomhlaza kunokubangela iziphumo zesibindi okanye inyongo emva kwexesha:

• Umhlaza wesibindi.

• Ithumba leWilms.

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umhlaza uphathwa ngokufakwa kweseli.

Iindidi ezithile ze-chemotherapy kunye ne-radiation kwisibindi okanye i-bile ducts zonyusa umngcipheko weziphumo ezibi.

Umngcipheko wesibindi okanye i-bile duct yeempembelelo ezinokufika emva kwexesha unokunyuswa kumaxhoba omhlaza wabantwana anyangwe ngenye yezi zinto zilandelayo:

• Ugqirha lokususa inxenye yesibindi okanye ukufakelwa kwesibindi.

• I-Chemotherapy ebandakanya idosi ephezulu ye-cyclophosphamide njengenxalenye yokufakelwa kweseli.

• I-Chemotherapy efana ne-6-mercaptopurine, 6-thioguanine, kunye ne-methotrexate.

• Ukunyanga ngemitha esibindini nakwimibhobho yenyongo. Umngcipheko uxhomekeke koku kulandelayo:

• Umthamo wemitha kunye nokuba uninzi kangakanani isibindi sonyango.

• Ubudala xa unyangwa (ubuncinci ubudala, umngcipheko ophakamileyo).

• Nokuba kukho utyando lokususa inxenye yesibindi.

• Nokuba ngaba ichemotherapy, enje nge-doxorubicin okanye i-dactinomycin, yanikwa kunye nonyango lwemitha.

Ukufakelwa kweseli kwestem (kunye nembali yesifo esinganyangekiyo sokulwa nokuchasana).

Iziphumo ezinokuchaphazela isibindi kunye ne-bile ducts zinokubangela iingxaki ezithile zempilo.

Iziphumo zesibindi kunye ne-bile emva kwexesha kunye neengxaki zempilo ezinxulumene noko zibandakanya oku kulandelayo:

• Isibindi asisebenzi ngendlela ekufanele ukuba siyeke okanye siyeke ukusebenza.

• Amatye egall.

• Izilonda zesibindi seBenign.

• Usulelo lweHepatitis B okanye uC.

• Umonakalo wesibindi obangelwa sisifo se-veno-occlusive isifo / isifo se-sinusoidal (VOD / SOS).

• Isibindi se-fibrosis (ukugqithisa kwezicubu ezinesibindi) okanye i-cirrhosis.

• Isibindi esinamafutha esinokunganyangeki kwi-insulin (imeko apho umzimba wenza i-insulin kodwa ungakwazi ukuyisebenzisa kakuhle).

• Izicubu kunye nomonakalo kumzimba ukusuka ekwakhiweni kwentsimbi eyongezelelweyo emva kotofelo-gazi oluninzi.

Iimpawu ezinokubakho kunye neempawu zesibindi kunye ne-bile duct yeziphumo ezibi zibandakanya iintlungu zesisu kunye nejundice.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa sisibindi kunye ne-bile duct yeziphumo ezibi okanye ezinye iimeko:

• Ukutyeba okanye ukunciphisa umzimba.

• Ukudumba kwesisu.

• Isicaphucaphu nokugabha.

• Intlungu esiswini. Ubuhlungu bunokubakho kufutshane neembambo, rhoqo kwicala lasekunene, okanye emva kokutya ukutya okunamafutha.

• IJaundice (ukuba tyheli kolusu kunye namhlophe ngamehlo).

• Ukuhamba kwemibala ekhanyayo.

• Umchamo omnyama-mnyama.

• Irhasi eninzi.

• Ukungabikho komdla.

• Ndiziva ndidiniwe okanye ndibuthathaka.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Ngamanye amaxesha akukho miqondiso okanye iimpawu zesibindi okanye i-bile duct yeziphumo ezibi kwaye unyango lunokungafuneki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwisibindi nakwindlela ye-bile.

Ezi kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukufumanisa okanye ukufumanisa isifo sesibindi okanye inyongo emva kwexesha:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (elingaphezulu okanye elisezantsi kunesiqhelo) lesinto linokuba luphawu lwesifo Umzekelo, kunokuba nenqanaba eliphezulu le-bilirubin, i-alanine aminotransferase (ALT), kunye ne-aspartate aminotransferase (AST) emzimbeni ukuba isibindi sinaso zonakalisiwe.

• Inqanaba leFerritin: Inkqubo apho kuhlolwe khona isampulu yegazi ukulinganisa isixa se-ferritin. IFerritin yiprotein ebopha isinyithi kwaye iyigcine ukuze isetyenziswe ngumzimba. Emva kokufakelwa kweseli ye-stem, inqanaba eliphezulu le-ferritin inokuba luphawu lwesifo sesibindi.

• Izifundo zegazi ukujonga ukuba igazi livale kangakanani: Inkqubo apho isampulu yegazi ihlolwe khona ukulinganisa inani leeplatelet emzimbeni okanye ukuba lithatha ixesha elingakanani ukuze igazi lijiye.

• Uvavanyo lwe- Hepatitis: Inkqubo apho kuvavanywa isampulu yegazi ngamaqhekeza e-hepatitis virus. Isampulu yegazi inokusetyenziselwa ukulinganisa ukuba ingakanani intsholongwane ye-hepatitis esegazini. Zonke izigulana ezatofelwa igazi ngaphambi kowe-1972 kufanele ukuba zivavanyelwe i-hepatitis B. Izigulana ezazitofelwe igazi ngaphambi kuka-1993 kufuneka zivavanyelwe i-hepatitis C.

Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kwizitho, ezinjenge-gall bladder, kunye nokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva.

• I-Biopsy: Ukususwa kweeseli okanye izicwili esibindini ukuze zibonwe phantsi kwemicroscope ukujonga iimpawu zesibindi esinamanqatha.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga imiqondiso yesibindi okanye ye-bile duct yeziphumo. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Imikhwa yempilo ekhuthaza isibindi esempilweni ibalulekile kumaxhoba omhlaza wabantwana.

Abasindileyo kumhlaza wabantwana abanesibindi emva kwexesha kufuneka bakhathalele ukukhusela impilo yabo, kubandakanya:

• Ukuba nobunzima obunempilo.

• Ukungaseli tywala.

• Ukufumana izitofu zentsholongwane ye-hepatitis A kunye ne-hepatitis B.

Iipancreas

Unyango ngemitha lonyusa umngcipheko wepancreatic iziphumo ezibi.

Umngcipheko weempembelelo zepancreatic emva kwexesha unokunyuswa kumaxhoba omhlaza wabantwana emva konyango ngenye yezi zinto zilandelayo:

• Unyango ngemitha esiswini.

• Umzimba wonke we-irradiation (TBI) njengenxalenye yokufakelwa kweseli.

Iziphumo ezifika emva kwexesha ezichaphazela i-pancreas zinokubangela iingxaki ezithile zempilo.

Iziphumo zepancreatic emva kwexesha kunye neengxaki zempilo ezinxulumene noko zibandakanya oku kulandelayo:

• Ukuxhathisa kwe-insulin: Imeko apho umzimba ungasebenzisi i-insulin ngendlela ekufuneka uyenzile. I-insulin iyafuneka ukunceda ukulawula inani leswekile (uhlobo lweswekile) emzimbeni. Ngenxa yokuba i-insulin ayisebenzi ngendlela ekufanele ukuba isebenze ngayo, iswekile kunye nenqanaba lamafutha liyenyuka.

• Isifo seswekile: Sisifo apho umzimba ungayenzi ngokwaneleyo i-insulin okanye ungayisebenzisi ngendlela efanelekileyo. Xa insulin ingonelanga, inani leswekile egazini liyonyuka kwaye izintso zenza umchamo omkhulu.

Iimpawu ezinokubakho kunye neempawu zepancreatic emva kwexesha zibandakanya ukuchama rhoqo kunye nokunxanwa.

Ezi kunye neminye imiqondiso kunye neempawu zinokubangelwa ziziphumo zepancreatic okanye ezinye iimeko:

• Ukuchama rhoqo.

• Ndiziva ndinxaniwe.

• Ndiziva ndilambile kakhulu.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ndiziva ndidiniwe.

• Ukuhlaselwa rhoqo, ngakumbi ulusu, iintsini, okanye isinyi.

• Umbono omfiliba.

• Amanxeba okanye imivumbo ecothayo ukunyanga.

• Ukuba ndindisholo okanye ukubetha ezandleni okanye ezinyaweni.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwi-pancreas.

Olu kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukufumanisa okanye ukufumanisa iziphumo zekamva zepancreatic:

• Uvavanyo lwe-Glycated hemoglobin (A1C): Inkqubo apho kuthathwa khona isampulu yegazi kunye nenani leswekile encanyathiselwe kwiiseli ezibomvu zegazi. Inani elingaphezulu kwesiqhelo le-glucose efakwe kwiiseli ezibomvu zegazi linokuba luphawu lwesifo seswekile.

• Ukuzila ukutya kweswekile yovavanyo: Uvavanyo apho isampulu yegazi ihlolwe khona ukulinganisa ubungakanani beswekile egazini. Olu vavanyo lwenziwa emva kokuba isigulana singenanto siyityayo ubusuku bonke. Inani elingaphezulu kwesiqhelo kwiglucose egazini kunokuba ngumqondiso wesifo seswekile.

Inkqubo ye-Endocrine

IINGONGOMA EZIPHAMBILI

• Idlala lengqula

• Iziphumo zokugqibela ze-thyroid kunokwenzeka ukuba zenzeke emva kokunyanga komhlaza othile wobuntwana.

• Ukunyanga ngamayeza entloko nasentanyeni kwandisa umngcipheko wefuthe le-thyroid.

• Iziphumo ezinokubakho emva kwexesha ezichaphazela idlala lengqula zinokubangela iingxaki ezithile zempilo.

• Iimpawu kunye neempawu zethyroidism emva kwexesha zixhomekeke ekubeni kuncinci okanye kuninzi kakhulu kwihomoni yedlala emzimbeni.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwi-thyroid.

• Indawo yolwimi lamathe

• Iziphumo ze-Neuroendocrine emva kwexesha zinokubangelwa emva konyango lwee-cancer ezithile zomntwana.

• Unyango oluchaphazela i-hypothalamus okanye i-pituitary gland yonyusa umngcipheko we-neuroendocrine system emva kwexesha.

• Iziphumo ezifika emva kwexesha ezichaphazela i-hypothalamus zinokubangela iingxaki ezithile zempilo.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwinkqubo ye-neuroendocrine.

• Amasende kunye namaqanda

• Isifo seMetabolic syndrome

• Isifo seMetabolic syndrome kunokwenzeka ukuba senzeke emva konyango lwee-cancer ezithile zabantwana.

• Unyango ngemitha lonyusa umngcipheko wesifo se-metabolic.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa isifo se-metabolic syndrome.

• I-Metabolic syndrome inokubangela isifo sentliziyo kunye negazi kunye neswekile.

• Ubunzima

• Ukutyeba, ukutyeba kakhulu, okanye ukutyeba kakhulu sisiphumo esifike kade esinokwenzeka emva konyango lwee-cancer ezithile zomntwana.

• Unyango ngemitha lonyusa umngcipheko wokutyeba, ukutyeba kakhulu, okanye ukutyeba kakhulu.

• Iimvavanyo ezithile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa utshintsho kubunzima.

Idlala lengqula

Iziphumo zokugqibela ze-thyroid kunokwenzeka ukuba zenzeke emva kokunyanga komhlaza othile wobuntwana.

Unyango lwezi kunye neminye imihlaza yomhlaza kunokubangela iziphumo ze-thyroid emva kwexesha:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Amathumba ebongo.

• Intloko kunye nentamo yomhlaza.

• IHodgkin lymphoma.

• Neuroblastoma.

• Umhlaza uphathwa ngokufakwa kweseli.

Ukunyanga ngamayeza entloko nasentanyeni kwandisa umngcipheko wefuthe le-thyroid.

Umngcipheko we-thyroid emva kwexesha unokunyuka kumaxhoba omhlaza wabantwana emva kokunyanga nantoni na elandelayo:

• Unyango lwe-radiation kwi-thyroid njengenxalenye yonyango lwe-radiation entloko nasentanyeni okanye kwidlala lengqondo kwingqondo.

• Umzimba wonke we-irradiation (TBI) njengenxalenye yokufakelwa kweseli.

• I-MIBG (i-radioactive iodine) yonyango lwe-neuroblastoma.

Umngcipheko ukwandiswa nakwabasetyhini, kubantu abasindileyo ababebancinci ngexesha lonyango, kwabasindileyo ababenedosi ephezulu yemitha, kwaye nanjengoko ixesha lokufumanisa isifo kunye nonyango liba lide.

Iziphumo ezinokubakho emva kwexesha ezichaphazela idlala lengqula zinokubangela iingxaki ezithile zempilo.

Iziphumo ze-thyroid emva kwexesha kunye neengxaki zempilo ezibandakanya oku kulandelayo:

• IHypothyroidism (ayonelanga yihomoni yedlala lengqula) . Ihlala ivela kwiminyaka emi-2 ukuya kwemi-5 emva kokuba unyango luphelile kodwa inokwenzeka kamva. Ixhaphake kakhulu kumantombazana kunamakhwenkwe.

• I-Hyperthyroidism (i-hormone ye-thyroid eninzi): Ihlala ivela kwiminyaka emi-3 ukuya kwemi-5 emva kokuba unyango luphelile.

I-Goiter (i-thyroid eyandisiweyo).

• Izigaqa kwidlala lengqula: Zidla ngokwenzeka kwiminyaka eli- 10 okanye nangaphezulu emva kokuba unyango luphelile. Ixhaphake kakhulu kumantombazana kunamakhwenkwe. Oku kukhula kunokuba yinto enobungozi (hayi umhlaza) okanye isifo esibi (umhlaza).

Iimpawu kunye neempawu zethyroidism emva kwexesha zixhomekeke ekubeni kuncinci okanye kuninzi kakhulu kwihomoni yedlala emzimbeni.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa yimiphumo ye-thyroid okanye ezinye iimeko:

I-Hypothyroidism (incinci kakhulu i-hormone ye-thyroid)

• Ndiziva ndidiniwe okanye ndibuthathaka.

• Ukuba novakalelo ngakumbi kubanda.

• Isikhumba esomileyo nesomileyo.

• Iinwele ezirhabaxa nezibhityileyo.

• Iinzipho ezikrwada.

• Ilizwi elingxolayo.

• Ubuso obukhukhumeleyo.

• Imisipha kunye nokudibana kwamalungu kunye nokuqina.

• Ukuqunjelwa.

• Ixesha lokuya exesheni elinzima kunesiqhelo.

• Ukutyeba ngenxa yesizathu esingaziwayo.

• Uxinzelelo okanye ingxaki ngememori okanye ukukwazi ukugxila.

Rhoqo, i-hypothyroidism ayibangeli zimpawu.

Hyperthyroidism (ihroneid eninzi kakhulu)

• Uziva unovalo, unxunguphalo okanye unemoody.

• Ingxaki yokulala.

• Ndiziva ndidiniwe okanye ndibuthathaka.

• Ukuba nezandla ezingcangcazelayo.

• Ukubetha kwentliziyo ngokukhawuleza.

• Ukuba nobomvu, ulusu olufudumeleyo olunokubakho.

• Ukuba neenwele ezintle, ezithambileyo eziwayo.

• Ukuba nokuhamba rhoqo okanye ngokukhululekileyo kwamathumbu.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwi-thyroid.

Ezi kunye nezinye iimvavanyo kunye neenkqubo zingasetyenziselwa ukufumana okanye ukufumanisa i-thyroid emva kwexesha.

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Izifundo zehomoni yegazi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zehomoni ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lexabiso linokuba luphawu lwesifo kwilungu okanye kwithishu eyenzayo. Igazi linokujongwa kumanqanaba angaqhelekanga e-thyroid-stimulating hormone (TSH) okanye i-thyroxine yasimahla (T4).

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kwizitho zokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva. Le nkqubo inokubonisa ubungakanani be-thyroid kunye nokuba kukho amaqhuqhuva (amaqhuma) kwi-thyroid.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zempembelelo ye-thyroid. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Indawo yolwimi lamathe

Iziphumo ze-Neuroendocrine emva kwexesha zinokubangelwa emva konyango lwee-cancer ezithile zomntwana.

Inkqubo ye-neuroendocrine yinkqubo yemithambo-luvo kunye nenkqubo ye-endocrine esebenza kunye.

Unyango lwezi kunye neminye imihlaza yomhlaza kunokubangela iziphumo ze-neuroendocrine emva kwexesha:

• Ingqondo kunye nethumbu lomqolo.

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umhlaza weNasopharyngeal.

• Umhlaza uphathwa nge-irradiation yomzimba iyonke (i-TBI) ngaphambi kokufakwa kweseli ye-stem.

Unyango oluchaphazela i-hypothalamus okanye i-pituitary gland yonyusa umngcipheko we-neuroendocrine system emva kwexesha.

Abasindileyo bomhlaza wabantwana banomngcipheko okhulayo weziphumo ze-neuroendocrine emva kwexesha. Ezi ziphumo zibangelwa lonyango lwemitha kwingqondo kwindawo yehypothalamus. Ihypothalamus ilawula indlela ekwenziwa ngayo iihormoni kwaye ikhutshelwe kwigazi ngendlala yebhinqa. Unyango lwe-radiation lunokunikwa ukunyanga umhlaza kufutshane ne-hypothalamus okanye njenge-body-irradiation yomzimba (TBI) ngaphambi kokufakwa kweseli. Ezi ziphumo zibangelwa luqhaqho kwindawo ye-hypothalamus, i-pituitary gland, okanye i-optic pathways.

Abasindileyo bomhlaza wabantwana abaneziphumo ze-neuroendocrine emva kwexesha banokuba namanqanaba asezantsi alo naliphi na kula mahomoni alandelayo enziwe kwincindi yebhinqa kwaye ikhutshelwe egazini:

• I-hormone yokukhula (GH; inceda ukukhuthaza ukukhula nokulawula imetabolism).

• Ihomoni yeAdrenocorticotropic (ACTH; ilawula ukwenziwa kweglucocorticoids).

• Prolactin (ilawula ukwenziwa kobisi lwebele).

• Ihomoni ekhuthaza i-thyroid (TSH; ukulawula ukwenziwa kwehomoni yedlala lengqula).

• Ukunciphisa i-hormone (LH; ukulawula ukuveliswa kwakhona).

• Ifollicle-evuselela i-hormone (FSH; ilawula ukuveliswa kwakhona).

Iziphumo ezifika emva kwexesha ezichaphazela i-hypothalamus zinokubangela iingxaki ezithile zempilo.

Iziphumo zasemva kwexesha zeNeuroendocrine kunye neengxaki zempilo ezinxulumene noko zibandakanya oku kulandelayo:

• Ukunqongophala kwehomoni yokukhula: Inqanaba eliphantsi lokukhula kwehomoni sisiphumo esiqhelekileyo sasemva kwemitha kwingqondo kumaxhoba omhlaza wabantwana. Ukunyuka kwedosi yemitha kunye nexesha elide ukususela kunyango, umngcipheko omkhulu wokusebenza kade. Inqanaba eliphantsi lokukhula kwehommoni linokubakho ebuntwaneni BONKE kunye nokusinda kwabasindileyo abasindileyo abafumene unyango ngemitha kwingqondo kunye nomqolo kunye / okanye ikhemotherapy.

Inqanaba eliphantsi lokukhula kwehomoni ekukhuleni komntwana kubangela ukuphakama kwabantu abadala okufutshane kunokoqhelekileyo. Ukuba amathambo omntwana akakakhuli ngokupheleleyo, amanqanaba okukhula asezantsi anokunyangwa ngokunyanga okuya endaweni yonyango emva kokuphela konyango.

Ukusilela kwe-Adrenocorticotropin: Inqanaba eliphantsi le-adrenocorticotropic hormone sisiphumo esingaqhelekanga emva kwexesha. Inokwenzeka ukuba usinde kubantwana abasindayo, abasindileyo abanamanqanaba okukhula asezantsi okanye i-hypothyroidism esembindini, okanye emva konyango lwemitha kwingqondo.

Iimpawu zokusilela zisenokungabi nzima kwaye zinokungaqatshelwa. Iimpawu zokusilela kwe-adrenocorticotropin zibandakanya oku kulandelayo:

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Andiziva ndilambile.

• Isicaphucaphu.

• Ukuhlanza.

• Uxinzelelo lwegazi oluphantsi.

• Ndiziva ndidiniwe.

Amanqanaba asezantsi e-adrenocorticotropin anokunyangwa ngonyango lwe-hydrocortisone.

• I-Hyperprolactinemia: Inqanaba eliphezulu le-hormone prolactin inokwenzeka emva kwedosi ephezulu yemitha ebuchotsheni okanye kuqhaqho oluchaphazela inxenye yedlala lengqula. Inqanaba eliphezulu leprolactin linokubangela oku kulandelayo:

• Ukufikisa kubudala obudala kunesiqhelo.

• Ukuhamba kobisi lwebele kumfazi ongakhulelwanga okanye oncelisayo.

• Ukuhamba rhoqo okanye ukungayi exesheni okanye ukuya exesheni ngokuhamba kancinci.

• Ukutshisa okutshisayo (kwabasetyhini).

• Ukungakwazi ukukhulelwa.

• Ukungakwazi ukufumana ulwakhiwo olufunekayo xa usabelana ngesondo.

• Ukuqhuba ngesondo okungaphantsi (emadodeni nakwabafazi).

• I-Osteopenia (ubuncinci bamaminerali amathambo).

Ngamanye amaxesha akukho zimpawu. Unyango kunqabile ukuba lufuneke.

• Ukunqongophala kwehomoni ekhuthaza idlala lengqula

Ngamanye amaxesha iimpawu zokunqongophala kwehomoni ekhuthaza idlala lengqula azibonwa. Amanqanaba ehomoni ye-thyroid asezantsi anokubangela ukukhula kancinci kunye nokulibaziseka ukufikisa, kunye nezinye iimpawu. Inqanaba eliphantsi lehomoni ye-thyroid inokunyangwa nge-thyroid esikhundleni sonyango.

• I-hormone ye-Luteinizing okanye i-follicle-evuselela ukusilela kwehomoni: Amanqanaba asezantsi ala mahomoni angabangela iingxaki zempilo ezahlukeneyo. Uhlobo lwengxaki luxhomekeke kwidosi yemitha.

Abasindileyo bomhlaza wabantwana abaye baphathwa ngeedosi ezisezantsi kwimitha yobuchopho banokukhula kwinqanaba lokufikisa eliphambili (imeko ebangela ukufikisa ukuba iqale ngaphambi kweminyaka eyi-8 kumantombazana kunye neminyaka eli-9 kubafana). Le meko inokunyangwa nge-gonadotropin-ekhulula i-hormone (GnRH) unyango lwe-agonist ukulibazisa ukufikisa kunye nokunceda ukukhula komntwana. IHydrocephalus inokunyusa umngcipheko wokusebenza kade.

Abasindileyo bomhlaza wabantwana abaye baphathwa ngeedosi eziphezulu zemitha kwingqondo banokuba namanqanaba asezantsi e-luteinizing hormone okanye i-follicle-evuselela ihomoni. Le meko inokunyangwa ngokunyanga i-hormone yonyango. Idosi iya kuxhomekeka kubudala bomntwana nokuba umntwana sele efikisa.

• Isifo seswekile esiphakathi: I-insipidus yesifo seswekile inokubangelwa kukungabikho okanye isixa esisezantsi sazo zonke iihomoni ezenziwe ngaphambili kwincindi yebhinqa kwaye zikhutshelwe egazini. Inokwenzeka kumaxhoba omhlaza wobuntwana anyangwa ngotyando kwindawo yehypothalamus okanye yebhinqa. Iimpawu kunye neempawu zesifo seswekile esiphakathi zinokubandakanya oku kulandelayo:

• Ukuba nomthamo omkhulu womchamo okanye amanabukeni amanzi ngokungaqhelekanga.

• Ndiziva ndinxaniwe.

• Intloko ebuhlungu.

• Ingxaki ngombono.

• Ukukhula okucothayo kunye nophuhliso.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

Unyango lunokubandakanya unyango lwe-hormone yonyango kunye ne-vasopressin, i-hormone elawula inani lomchamo owenziwe emzimbeni.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwinkqubo ye-neuroendocrine.

Ezi kunye nezinye iimvavanyo kunye neenkqubo zingasetyenziselwa ukufumana okanye ukufumanisa i-thyroid emva kwexesha.

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Isifundo se-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinje ngeglucose, ekhutshelwa egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Izifundo zehomoni yegazi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zehomoni ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lexabiso linokuba luphawu lwesifo kwilungu okanye kwithishu eyenzayo. Igazi linokujongwa kumanqanaba angaqhelekanga e-follicle-evuselela i-hormone, i-luteinizing hormone, i-estradiol, i-testosterone, i-cortisol, okanye i-thyroxine yasimahla (T4).

• Izifundo zeprofayili yeLipid: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa ze-triglycerides, i-cholesterol, kunye ne-low- and high-density lipoprotein cholesterol egazini.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zempembelelo ye-neuroendocrine. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Amasende kunye namaqanda

Jonga icandelo leNkqubo yokuzala kwesi sishwankathelo solwazi malunga neziphumo zamva nje kumasende kunye namaqanda.

Isifo seMetabolic syndrome

Isifo seMetabolic syndrome kunokwenzeka ukuba senzeke emva konyango lwee-cancer ezithile zabantwana.

I-Metabolic syndrome liqela leemeko zonyango ezibandakanya ukuba namafutha amaninzi kwisisu kwaye ubuncinci koku kulandelayo:

• Igazi elonyukayo.

• Amanqanaba aphezulu e-triglycerides kunye namanqanaba asezantsi e-lipoprotein (HDL) ye-cholesterol esegazini.

• Amanqanaba aphezulu eswekile (iswekile) egazini.

Unyango lwezi kunye neminye imihlaza yomhlaza kunokubangela ukuba isifo se-metabolic syndrome senzeke kamva ebomini:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umhlaza uphathwa ngokufakwa kweseli.

• Umhlaza uphathwe ngemitha esiswini, njenge-Wilms tumor okanye i-neuroblastoma.

Unyango ngemitha lonyusa umngcipheko wesifo se-metabolic.

Umngcipheko wesifo se-metabolic syndrome unokwandiswa kubasaphilayo bomhlaza wabantwana emva konyango ngayo nayiphi na kwezi zinto zilandelayo:

• Unyango ngemitha kwingqondo okanye esiswini.

• Umzimba wonke we-irradiation (TBI) njengenxalenye yokufakelwa kweseli.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa isifo se-metabolic syndrome.

Ezi kunye nezinye iimvavanyo kunye neenkqubo zingasetyenziselwa ukufumana okanye ukufumanisa isifo se-metabolic syndrome:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinje ngeglucose, ekhutshelwa egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Izifundo zeprofayili yeLipid: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa ze-triglycerides, i-cholesterol, kunye ne-low- and high-density lipoprotein cholesterol egazini.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zesifo se-metabolic syndrome. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

I-Metabolic syndrome inokubangela isifo sentliziyo kunye negazi kunye neswekile.

Isifo seMetabolic syndrome sinxulunyaniswa nomngcipheko owandayo wesifo sentliziyo kunye nesifo seswekile. Imikhwa yempilo eyehlisa le mngcipheko ibandakanya:

• Ukuba nobunzima obunempilo.

• Ukutya ukutya okunesifo sentliziyo.

• Ukuzilolonga rhoqo.

• Akatshayi.

Ubunzima

Ukutyeba, ukutyeba kakhulu, okanye ukutyeba kakhulu sisiphumo esifike kade esinokwenzeka emva konyango lwee-cancer ezithile zomntwana. Unyango lwale neminye imihlaza yomhlaza kunokubangela utshintsho kubunzima:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Izidumbu zobuchopho, ngakumbi i-craniopharyngiomas.

• Umhlaza uphathwa ngemitha ebuchotsheni, kubandakanywa i-irradiation yomzimba iyonke (i-TBI) njengenxalenye yokufakwa kweseli ye-stem.

Unyango ngemitha lonyusa umngcipheko wokutyeba, ukutyeba kakhulu, okanye ukutyeba kakhulu.

Umngcipheko wokutyeba kancinci ukonyuka emva konyango kwezi zinto zilandelayo:

• Umzimba wonke we-irradiation (TBI) yabasetyhini.

• Unyango ngemitha esiswini kumadoda.

• Iindidi ezithile zekhemotherapy (iiarhente ze-alkylating agents kunye ne-anthracyclines).

Umngcipheko wokutyeba kakhulu uyanda emva konyango kwezi zinto zilandelayo:

• Unyango ngemitha kwingqondo.

• Utyando olonakalisa i-hypothalamus okanye i-pituitary gland, enje ngotyando lokususa ithumba lobuchopho be-craniopharyngioma.

Oku kulandelayo kungonyusa umngcipheko wokutyeba kakhulu:

• Ukufunyaniswa ndinomhlaza xa uneminyaka emi-5 ukuya kweli-9.

• Ukuba ngumfazi.

• Ukuba nokukhula kwehommone yokukhula okanye amanqanaba asezantsi e-leptin yehomoni.

• Ukungayenzi imisebenzi eyaneleyo yomzimba ukuhlala kubunzima bomzimba obusempilweni.

• Ukuthatha i-antidepressant ebizwa ngokuba yi-paroxetine.

Abasindileyo bomhlaza wabantwana abafumana umthambo ngokwaneleyo kwaye banesiqhelo esiqhelekileyo soxinzelelo banomngcipheko omncinci wokutyeba kakhulu.

Iimvavanyo ezithile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa utshintsho kubunzima.

Ezi kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukukhangela okanye ukufumanisa utshintsho kubunzima:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya ubunzima okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinje ngeglucose, ekhutshelwa egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Izifundo zeprofayili yeLipid: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa ze-triglycerides, i-cholesterol, kunye ne-low- and high-density lipoprotein cholesterol egazini.

Ukutyeba, ukutyeba kakhulu, okanye ukutyeba kakhulu kunokulinganiswa ngokobunzima, isalathiso sobunzima bomzimba, ipesenti yamafutha omzimba, okanye ubungakanani besisu (amafutha esiswini).

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zotshintsho kubunzima. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Inkqubo yomzimba

IINGONGOMA EZIPHAMBILI

• Utyando lokususa udakada luyonyusa umngcipheko wamajoni omzimba emva kwexesha.

• Iziphumo ezifika emva kwexesha ezichaphazela amajoni omzimba kunokubangela usulelo.

• Abantwana abasuswe ipeni yabo banokufuna i-antibiotics ukunciphisa umngcipheko wosulelo.

Utyando lokususa udakada luyonyusa umngcipheko wamajoni omzimba emva kwexesha.

Umngcipheko weengxaki zempilo ezichaphazela amajoni omzimba anyuka emva konyango kwezi zinto zilandelayo:

• Utyando lokususa udakada.

• Unyango lwe-radiation ephezulu kwi-spleen ebangela ukuba udakada uyeke ukusebenza.

• Ukufakelwa kweseli kwestem kulandelwa sisifo esixhonyiweyo nesichaseneyo nesibangela ukuba udakada uyeke ukusebenza.

Iziphumo ezifika emva kwexesha ezichaphazela amajoni omzimba kunokubangela usulelo.

Iziphumo ezifika emva kwexesha ezichaphazela amajoni omzimba zinokunyusa umngcipheko wosulelo olukhulu kakhulu lwebhaktiriya. Lo mngcipheko uphezulu kubantwana abancinci kunakubantwana abadala kwaye unokuba mkhulu kwiminyaka yokuqala emva kokuba udakada uyeke ukusebenza okanye ususwe ngotyando. Ezi mpawu neempawu zisenokubangelwa lusulelo:

• Ubomvu, ukudumba, okanye ukufudumala kwelungu lomzimba.

• Ubuhlungu obukwelinye ilungu lomzimba, njengeliso, indlebe, okanye umqala.

• Ifiva.

Usulelo lunokubangela ezinye iimpawu ezixhomekeke kwinxalenye yomzimba ochaphazelekayo. Umzekelo, usulelo lwemiphunga lunokubangela ukukhohlela kunye nengxaki yokuphefumla.

Abantwana abasuswe ipeni yabo banokufuna i-antibiotics ukunciphisa umngcipheko wosulelo.

Iintsholongwane zemihla ngemihla zinokumiselwa abantwana abangaphantsi kweminyaka emi-5 ubudala apho ipeni yabo ingasasebenziyo okanye ubuncinci unyaka omnye emva kotyando lokususa udakada. Kwizigulana ezithile ezisengozini enkulu, ii-antibiotics zemihla ngemihla zinokumiselwa ebuntwaneni nasebudaleni.

Ukongeza, abantwana abanomngcipheko owandayo wosulelo kufuneka bagonywe kwishedyuli ngokufikisa ngokuchasene noku kulandelayo:

• Isifo sepneumococcal.

• Isifo se-Meningococcal.

• Uhlobo lwe-Haemophilus influenzae uhlobo b (Hib).

• IDiphtheria-tetanus-pertussis (DTaP).

• IHepatitis B.

Thetha nogqirha womntwana wakho malunga nokuba lolunye ugonyo lwabantwana olunikwe ngaphambi kokuba unyango lomhlaza ludinga ukuphindwa.

Inkqubo yeMusculoskeletal

IINGONGOMA EZIPHAMBILI

• Amathambo kunye nokudibana kwexesha emva kwexesha kunokwenzeka ukuba kwenzeke emva konyango lwee-cancer ezithile zomntwana.

• Ugqirha, ichemotherapy, unyango ngemitha, kunye nezinye iindlela zonyango zonyusa umngcipheko wethambo kunye nokudibana kade.

• Unyango ngemitha

• Ugqirha

• I-Chemotherapy kunye nolunye unyango lweziyobisi

• Ukufakelwa kweseli

• Iimpawu ezinokubakho kunye neempawu zethambo kunye nokudibana emva kwexesha kubandakanya ukudumba ngaphezulu kwethambo okanye ithambo kunye nentlungu edibeneyo.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwithambo nakwilungu.

Amathambo kunye nokudibana kwexesha emva kwexesha kunokwenzeka ukuba kwenzeke emva konyango lwee-cancer ezithile zomntwana.

Unyango lwezi kunye neminye imihlaza yomhlaza kunokubangela iziphumo zethambo kunye nokudibana kade:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umhlaza wethambo.

• Ingqondo kunye nethumbu lomqolo.

• Ukufumana isarcoma.

• Intloko kunye nentamo yomhlaza.

• Neuroblastoma.

• I-non-Hodgkin lymphoma.

• Osteosarcoma.

• I-Retinoblastoma.

• I-sarcoma yethishu ethambileyo.

• Ithumba leWilms.

• Umhlaza uphathwa ngokufakwa kweseli.

Ukutya okungalunganga kunye nokungonelisi komzimba ngokwaneleyo kunokubangela iziphumo zethambo kade.

Ugqirha, ichemotherapy, unyango ngemitha, kunye nezinye iindlela zonyango zonyusa umngcipheko wethambo kunye nokudibana kade.

Unyango ngemitha

Unyango lwe-radiation lungayeka okanye lucothise ukukhula kwethambo. Uhlobo lwethambo kunye nokudibana emva kwexesha kuxhomekeke kwinxalenye yomzimba ofumene unyango ngemitha. Ukunyanga ngemitha kunokubangela nayiphi na kwezi zinto zilandelayo:

• Utshintsho kwindlela yobuso okanye yokhakhayi, ngakumbi xa i-radiation yedosi ephezulu kunye okanye ngaphandle kwe-chemotherapy inikwa abantwana ngaphambi kweminyaka eyi-5.

• Isiqu esifutshane (ukuba mfutshane kunesiqhelo)

• I-Scoliosis (ukugoba komqolo) okanye i-kyphosis (ukujikeleza umqolo).

• Enye ingalo okanye umlenze umfutshane kunenye ingalo okanye umlenze.

• I-Osteoporosis (ithambo elibuthathaka okanye elibhityileyo elinokwaphuka ngokulula).

• I-Osteoradionecrosis (iinxalenye zethambo lomhlathi ziyafa ngenxa yokungabikho kwegazi).

• I-Osteochondroma (isisu esibuhlungu sesithambo).

Ugqirha

Ukunqunyulwa kwamalungu okanye utyando lokuthintela amalungu ukuba ususe umhlaza kunye nokuwuthintela ukuba ungabuyi kunokubangela iziphumo emva kwexesha ngokuxhomekeke ekubeni laliphi na ithumba, ubudala besigulana, kunye nohlobo lotyando. Iingxaki zempilo emva kokunqunyulwa okanye utyando lokulondolozwa kwamalungu kunokubandakanya:

• Ukuba neengxaki kwimisebenzi yobomi bemihla ngemihla

• Ukungabinakho ukusebenza njengesiqhelo.

• Ubuhlungu obungapheliyo okanye usulelo.

• Iingxaki ngendlela ye-prosthetics efanelekileyo okanye esebenza ngayo.

• Ithambo elaphukileyo.

• Ithambo alinakuphola kakuhle emva kotyando.

• Enye ingalo okanye umlenze umfutshane kunomnye.

Izifundo azibonisi mahluko kumgangatho wobomi kumaxhoba omhlaza wabantwana abaye banqunyulwa xa kuthelekiswa nabo babenotyando lokugcina amalungu.

I-Chemotherapy kunye nolunye unyango lweziyobisi

Umngcipheko unokunyuswa kumaxhoba omhlaza wabantwana abafumana unyango lwe-anticancer olubandakanya i-methotrexate okanye i-corticosteroids okanye i-glucocorticoids enjenge-dexamethasone. Unyango lweziyobisi lunokubangela nayiphi na kwezi zinto zilandelayo:

• I-Osteoporosis (ithambo elibuthathaka okanye elibhityileyo elinokwaphuka ngokulula).

• I-Osteonecrosis (enye okanye ngaphezulu kwamathambo asweleka ngenxa yokunqongophala kwegazi), ngakumbi esinqeni okanye emadolweni.

Ukufakelwa kweseli

Ukufakelwa kweseli ye-stem kunokuchaphazela ithambo kunye namalungu ngeendlela ezahlukeneyo:

• Umzimba wonke we-irradiation (i-TBI) enikezwe njengenxalenye yokufakelwa kweseli ye-stem inokuchaphazela amandla omzimba okwenza i-hormone yokukhula kwaye ibangele ubude obufutshane (bufutshane kunesiqhelo). Inokubangela ne-osteoporosis (ithambo elibuthathaka okanye elibhityileyo elinokwaphuka ngokulula).

• I-Osteochondroma (i-tumor enobungozi emathanjeni amade, njengengalo okanye amathambo omlenze) angenza.

• Isifo esinganyangekiyo sokuchasana nokusingathwa komntu sinokubakho emva kokufakelwa kweseli kwintsholongwane kwaye kubangele ikhontrakthi ngokudibeneyo (ukuqiniswa kwezihlunu ezibangela ukuba indibaniselwano icuthe kwaye iqine kakhulu). Inokubangela ne-osteonecrosis (inye okanye ngaphezulu kwamathambo aswelekileyo ngokungabikho kokuhamba kwegazi).

Iimpawu ezinokubakho kunye neempawu zethambo kunye nokudibana emva kwexesha kubandakanya ukudumba ngaphezulu kwethambo okanye ithambo kunye nentlungu edibeneyo.

Ezi kunye neminye imiqondiso kunye neempawu zinokubangelwa yimiphumo yethambo kunye nokudibana kade okanye ngezinye iimeko:

• Ukudumba ngaphezulu kwethambo okanye ithambo lomzimba.

• Intlungu kwithambo okanye ngokudibeneyo.

• Ubomvu okanye ukufudumala phezu kwethambo okanye ukudibanisa.

• Ukuqina ngokudibeneyo okanye ingxaki yokuhamba ngesiqhelo.

• Ithambo eliphuka ngaphandle kwesizathu esaziwayo okanye laphuka ngokulula.

• Isiqu esifutshane (ukuba mfutshane kunesiqhelo)

• Elinye icala lomzimba lijongeka liphezulu kunelinye icala okanye umzimba utsala kwelinye icala.

• Ukuhlala uhleli rhoqo okanye umi kwindawo e-slouching okanye ukubonakala ngathi ubuyile umva.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwithambo nakwilungu.

Ezi kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukufumanisa okanye ukufumanisa iziphumo zethambo kunye nokudibana kade:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana, izigulo zangaphambili kunye nonyango nazo ziya kuthathwa. Uvavanyo lwamathambo kunye nezihlunu yingcali nayo inokwenziwa.

• Ukuvavanywa kokuxinana kwamaminerali amathambo: Uvavanyo lokucinga olulinganisa uxinano lwethambo (isixa samaminerali ethambo kwinani elithile lamathambo) ngokudlulisa i-x-ray ngamanqanaba amabini ohlukeneyo kwithambo. Isetyenziselwa ukuxilonga i-osteoporosis (ithambo elibuthathaka okanye elibhityileyo elinokwaphuka ngokulula). Ikwabizwa ngokuba yi-BMD scan, DEXA, DEXA scan, i-x-ray ye-absorptiometric scan, i-x-ray absorptiometry kunye ne-DXA.

• IX-reyi: IX-reyi luhlobo lombane wamandla onokuthi uhambe emzimbeni nakwifilimu, wenze umfanekiso weendawo ezingaphakathi emzimbeni, ezinjengamathambo.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zethambo kunye neziphumo ezidibeneyo zasemva kwexesha. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Inkqubo yokuzala

IINGONGOMA EZIPHAMBILI

• Amatyhalarha

• Iziphumo ezivavanyiweyo emva kwexesha kunokwenzeka ukuba zenzeke emva konyango lwee-cancer ezithile zomntwana.

• Utyando, unyango ngemitha, kunye neentlobo ezithile ze-chemotherapy zonyusa umngcipheko weziphumo ezifika kade ezichaphazela amasende.

• Iziphumo ezifika emva kwexesha ezichaphazela amasende zinokubangela iingxaki ezithile zempilo.

• Amaqanda

• Iziphumo ze-Ovarian emva kwexesha kunokwenzeka ukuba zenzeke emva konyango lwee-cancer ezithile zobuntwana.

• Unyango ngemitha esiswini kunye neendidi ezithile zekhemotherapy zonyusa umngcipheko weempembelelo ze-ovarian emva kwexesha.

• Iziphumo ezifika emva kwexesha ezichaphazela ii-ovari kunokubangela iingxaki zempilo ezithile.

• Iimpawu ezinokubakho kunye neempawu zokuchaphazeleka kade kwe-ovari kubandakanya ukungahambi ngendlela okanye ukungabikho exesheni kunye nokukhanya okutshisayo.

• Ukuchuma kunye nokuzala

• Unyango lomhlaza kunokubangela ukungabikho kwenzala kumaxhoba omhlaza wobuntwana.

• Abasindileyo bomhlaza wabantwana banokuba neziphumo ezifika kade ezichaphazela ukukhulelwa.

• Kukho iindlela ezinokuthi zisetyenziswe ukunceda amaxhoba omhlaza wabantwana ukuba babe nabantwana.

• I-hildren yamaxhoba omhlaza wobuntwana awachaphazeleka kunyango lwabazali langaphambili lomhlaza.

Amatyhalarha

Iziphumo ezivavanyiweyo emva kwexesha kunokwenzeka ukuba zenzeke emva konyango lwee-cancer ezithile zomntwana.

Unyango lwezi kunye neminye imihlaza yomhlaza kunokubangela iimpembelelo zamva nje:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Izidumba zeseli zentsholongwane.

• IHodgkin lymphoma.

• I-non-Hodgkin lymphoma.

• ISarcoma.

• Umhlaza wamatyhalarha.

• Umhlaza uphathwa nge-irradiation yomzimba iyonke (i-TBI) ngaphambi kokufakwa kweseli ye-stem.

Utyando, unyango ngemitha, kunye neentlobo ezithile ze-chemotherapy zonyusa umngcipheko weziphumo ezifika kade ezichaphazela amasende.

Umngcipheko weengxaki zempilo ezichaphazela amasende ukwanda emva konyango ngenye yezi zinto zilandelayo:

• Utyando, njengokususwa kwetyhalarha, inxenye yeprostate, okanye ii-lymph nodes esiswini.

• I-Chemotherapy ene-alkylating agents, njenge-cyclophosphamide, i-dacarbazine, i-procarbazine kunye ne-ifosfamide.

• Unyango lwe-radiation kwisisu, i-pelvis, okanye kwindawo ye-hypothalamus kwingqondo.

• Umzimba wonke we-irradiation (TBI) ngaphambi kokufakelwa kweseli.

Iziphumo ezifika emva kwexesha ezichaphazela amasende zinokubangela iingxaki ezithile zempilo.

Iziphumo zokugqibela zamatyhalarha kunye neengxaki zempilo ezinxulumene noko zibandakanya oku kulandelayo:

• Inani eliphantsi lobudoda: Inani elingu-zero lobudoda okanye ubudoda obuphantsi kunokuba yinto yethutyana okanye esisigxina Oku kuxhomekeke kwidosi yemitha kunye neshedyuli, indawo yomzimba onyangiweyo, kunye nobudala bokunyangwa.

• Ukungachumi: Ukungakwazi ukuba ngutata womntwana.

• Ukubuyisela kwakhona i-ejaculation: Incinci kakhulu okanye akukho semen iphuma kwilungu lobudoda ngexesha le-orgasm.

Emva konyango lwe-chemotherapy okanye i-radiation, amandla omzimba okwenza isidoda angabuya emva kwexesha.

Amaqanda

Iziphumo ze-Ovarian emva kwexesha kunokwenzeka ukuba zenzeke emva konyango lwee-cancer ezithile zobuntwana.

Unyango lwezi kunye neminye imihlaza yomhlaza kunokubangela iziphumo ze-ovarian emva kwexesha:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Izidumba zeseli zentsholongwane.

• IHodgkin lymphoma.

• Umhlaza we-Ovarian.

• Ithumba leWilms.

• Umhlaza uphathwa nge-irradiation yomzimba iyonke (i-TBI) ngaphambi kokufakwa kweseli ye-stem.

Unyango ngemitha esiswini kunye neendidi ezithile zekhemotherapy zonyusa umngcipheko weempembelelo ze-ovarian emva kwexesha.

Umngcipheko weempembelelo ze-ovarian emva kwexesha unokunyuswa emva konyango ngayo nayiphi na kwezi zinto zilandelayo:

• Ugqirha lokususa i-ovari enye okanye zombini.

• I-Chemotherapy ene-alkylating agents, njenge-cyclophosphamide, mechlorethamine, cisplatin, ifosfamide, lomustine, busulfan, ngakumbi i-procarbazine.

• Unyango ngemitha esiswini, isinqe, okanye umva osezantsi. Kubantu abasindileyo ababenemitha esiswini, umonakalo kwizibeleko uxhomekeke kwidosi yemitha, ubudala ngexesha lonyango, nokuba ingaba sonke okanye inxenye yesisu ifumene imitha.

• Ukunyanga ngemitha esiswini okanye kwi-pelvis kunye neearhente zealkylating.

• Unyango lwe-radiation kwindawo ekufutshane ne-hypothalamus kwingqondo.

• Umzimba wonke we-irradiation (TBI) ngaphambi kokufakelwa kweseli.

Iziphumo ezifika emva kwexesha ezichaphazela ii-ovari kunokubangela iingxaki zempilo ezithile.

Iziphumo zokugqibela ze-Ovarian kunye nezinye iingxaki ezinxulumene nempilo zibandakanya oku kulandelayo:

• Ukuyeka ukuya exesheni kwangoko, ngakumbi kwabasetyhini abasuswe amaqanda okanye baphathwa ngearhente yokunyanga kunye nokunyanga ngemitha esiswini.

• Utshintsho exesheni.

• Ukungachumi (ukungakwazi ukukhulelwa umntwana).

• Ukufikisa akuqali.

Emva konyango lwe-chemotherapy, ii-ovari ziqala ukusebenza ngokuhamba kwexesha.

Iimpawu ezinokubakho kunye neempawu zokuchaphazeleka kade kwe-ovari kubandakanya ukungahambi ngendlela okanye ukungabikho exesheni kunye nokukhanya okutshisayo.

Ezi kunye neminye imiqondiso kunye neempawu zinokubangelwa ziziphumo ze-ovarian emva kwexesha okanye ngezinye iimeko:

• Ukungahambi kakuhle okanye ukungayi exesheni.

• Kushushu.

• Ukubila ebusuku.

• Ingxaki yokulala.

• Imood iyatshintsha.

• Ukuhla ngesondo.

• Ukoma kwelungu lobufazi.

• Ukungakwazi ukukhulelwa umntwana.

• Iimpawu zesondo, njengokukhulisa ingalo, indawo yokushicilela, kunye neenwele zomlenze okanye ukwandisa amabele, azenzeki xa ufikisa.

• I-Osteoporosis (ithambo elibuthathaka okanye elibhityileyo elinokwaphuka ngokulula).

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Ukuchuma kunye nokuzala

Unyango lomhlaza kunokubangela ukungabikho kwenzala kumaxhoba omhlaza wobuntwana.

Umngcipheko wokungachumi uyanda emva konyango kwezi zinto zilandelayo:

• Kumakhwenkwe, unyango lwonyango ngemitha kumasende.

• Kumantombazana, unyango ngonyango lwemitha esinqeni, kubandakanya ii-ovari kunye nesibeleko.

• Unyango lwe-radiation kwindawo ekufutshane ne-hypothalamus kwingqondo okanye kumqolo osezantsi.

• Umzimba wonke we-irradiation (TBI) ngaphambi kokufakelwa kweseli.

• I-Chemotherapy ene-alkylating agents, njenge-cisplatin, i-cyclophosphamide, i-busulfan, i-lomustine kunye ne-procarbazine.

• Utyando, njengokususwa kwetyhalarha okanye i-ovary okanye ii-lymph node esiswini.

Abasindileyo bomhlaza wabantwana banokuba neziphumo ezifika kade ezichaphazela ukukhulelwa.

Iziphumo emva kwexesha lokukhulelwa zibandakanya ukwanda komngcipheko woku kulandelayo:

• Igazi elonyukayo.

• Seswekile ngexesha lokukhulelwa.

• Ukunqongophala kwegazi.

• Ukuphuma kwesisu okanye ukuzala umntwana oswelekileyo.

• Iintsana ezinobunzima bokuzalwa obuncinci.

• Umsebenzi kwangoko kunye / okanye ukuhanjiswa.

• Ukuhanjiswa kwecandelo leCesarean.

• Umbungu ongekho kwimeko efanelekileyo yokuzalwa (umzekelo, unyawo okanye iimpundu zikulungele ukuphuma phambi kwentloko).

Olunye uphononongo alubonisanga mngcipheko owandileyo wokukhulelwa.

Kukho iindlela ezinokuthi zisetyenziswe ukunceda amaxhoba omhlaza wabantwana ukuba babe nabantwana.

Kungasetyenziswa ezi ndlela zilandelayo ukuze amaxhoba omhlaza wabantwana abe nabantwana:

• Ukuqanda iqanda okanye isidoda ngaphambi konyango lomhlaza kwizigulana esele zifikile ebusheni.

• Ukukhutshwa kwesidoda sokuvavanya (ukususwa kwesixa esincinci sezicubu ezinesidoda esivela kwitestamente).

• Intracytoplasmic sperm injection (iqanda lichumiswa ngesidoda esinye esichonyelwe kwiqanda elingaphandle komzimba).

• In vitro fertilization (IVF) (amaqanda nesidoda zibekwa ngokudibeneyo, zinika isidoda ithuba lokungena kwiqanda).

Abantwana abasindileyo abanomhlaza kubantwana abachaphazeleka kunyango lwabazali langaphambili lomhlaza.

Abantwana abasindileyo bomhlaza wabantwana ababonakali benomngcipheko okhulayo wokukhubazeka kokuzalwa, isifo semfuza, okanye umhlaza.

Inkqubo yokuphefumla

IINGONGOMA EZIPHAMBILI

• Imiphunga emva kwexesha kunokwenzeka ukuba yenzeke emva konyango lwee-cancer ezithile zomntwana.

• Iindidi ezithile zekhemotherapy kunye nemitha kwimiphunga zonyusa umngcipheko wemiphunga emva kwexesha.

• Iziphumo ezifika emva kwexesha ezichaphazela imiphunga zinokubangela iingxaki ezithile zempilo.

• Iimpawu ezinokubakho kunye neempawu zemiphunga emva kwexesha zibandakanya ukuphefumla nzima kunye nokukhohlela.

• Iimvavanyo ezithile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa iingxaki zempilo emiphungeni.

• Imikhwa yezempilo ekhuthaza imiphunga esempilweni ibalulekile kumaxhoba omhlaza wabantwana.

Imiphunga emva kwexesha kunokwenzeka ukuba yenzeke emva konyango lwee-cancer ezithile zomntwana.

Unyango lwale neminye imihlaza yomhlaza kunokubangela iziphumo zasemva kwemiphunga:

• IHodgkin lymphoma.

• Ithumba leWilms.

• Umhlaza uphathwa ngokufakwa kweseli.

Iindidi ezithile zekhemotherapy kunye nemitha kwimiphunga zonyusa umngcipheko wemiphunga emva kwexesha.

Umngcipheko weengxaki zempilo ezichaphazela umphunga ukwanda emva konyango ngezi zinto zilandelayo:

• Ugqirha lokususa yonke okanye inxenye yomphunga okanye udonga lwesifuba.

• Unyango ngamayeza. Kwabo basindileyo baphathwa nge-chemotherapy, njenge-bleomycin, i-busulfan, i-carmustine, okanye i-lomustine, kunye nonyango lwe-radiation esifubeni, kukho umngcipheko omkhulu wokonakaliswa kwemiphunga.

• Ukunyanga ngemitha esifubeni. Kubantu abasindileyo ababenemitha esesifubeni, ukonakala kwemiphunga kunye nodonga lwesifuba kuxhomekeke kwidosi yemitha, nokuba yonke okanye inxenye yemiphunga kunye nodonga lwesifuba ifumene imitha, nokuba ngaba imitha yanikezelwa kancinci, yahlulahlulwe idosi yemihla ngemihla, kunye ubudala bomntwana kunyango.

• Umzimba wonke we-irradiation (TBI) okanye iintlobo ezithile ze-chemotherapy ngaphambi kokufakelwa kweseli.

Umngcipheko wemiphumela yamaphaphu mva mkhulu kubasindileyo bomhlaza wabantwana abaphathwa ngokudityaniswa kotyando, ichemotherapy, kunye / okanye unyango lwemitha. Umngcipheko uyonyuswa nakwabasindileyo abanembali yoku kulandelayo:

• Usulelo okanye isifo se-graft-versus-host emva kokufakelwa kweseli.

• Imiphunga okanye isifo somoya, esifana nesifuba, ngaphambi konyango lomhlaza.

• Udonga lwesifuba esingaqhelekanga.

• Ukutshaya imidiza okanye ezinye izinto.

Iziphumo ezifika emva kwexesha ezichaphazela imiphunga zinokubangela iingxaki ezithile zempilo.

Iziphumo zamaphaphu emva kwexesha kunye neengxaki zempilo ezinxulumene noku zibandakanya oku kulandelayo:

• Radiation pneumonitis (ukudumba kwemiphunga okubangelwa lunyango ngemitha).

• I-pulmonary fibrosis (ukwakhiwa kwezicubu ezibomvu emiphungeni).

• Ezinye iingxaki zemiphunga kunye neendlela zomoya ezinje ngesifo esinganyangekiyo semiphunga (i-COPD), inyumoniya, ukukhohlela okungapheliyo, kunye nesifuba.

Iimpawu ezinokubakho kunye neempawu zemiphunga emva kwexesha zibandakanya ukuphefumla nzima kunye nokukhohlela.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa yimiphunga emva kwexesha okanye ezinye iimeko:

• I-Dyspnea (ukuphefumla okufutshane), ngakumbi xa usebenza.

• Ukukhawuleza.

• Ifiva.

• Isikhohlela esinganyangekiyo.

• Ukuxinana (imvakalelo yokugcwala emiphungeni evela kwiminyeko eyongezelelweyo).

• Izifo ezingapheliyo zemiphunga.

• Ndiziva ndidiniwe.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Iziphumo zokugqibela kwemiphunga kumaxhoba omhlaza wobuntwana zinokuthi zenzeke kancinci ngokuhamba kwexesha okanye kungabikho zimpawu. Ngamanye amaxesha umonakalo wemiphunga unokufunyanwa kuphela ngokucinga okanye ukuvavanywa kokusebenza kwemiphunga. Iziphumo zemiphunga mva zinokuphucula ngokuhamba kwexesha.

Iimvavanyo ezithile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa iingxaki zempilo emiphungeni.

Olu kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukufumanisa okanye ukufumanisa iziphumo zangasemva kwemiphunga:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• I-x-ray yesifuba: IX-reyi yamalungu namathambo ngaphakathi kwesifuba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• Uvavanyo lomsebenzi wePulmonary (PFT): Uvavanyo lokujonga ukuba imiphunga isebenza njani. Ilinganisa ukuba ingakanani imiphunga onokuyibamba kwaye ukhawulezisa kangakanani ukungena nokuphuma kwemiphunga emiphungeni. Ikwalinganisa ukuba isetyenziswa kangakanani ioksijini kwaye ingakanani ikharbon diokside oyinikwayo xa uphefumla. Oku kukwabizwa ngokuba luvavanyo lomsebenzi wemiphunga.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zemiphunga emva kwexesha. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Imikhwa yezempilo ekhuthaza imiphunga esempilweni ibalulekile kumaxhoba omhlaza wabantwana.

Abasindileyo kumhlaza wabantwana abanemiphunga emva kwexesha kufuneka bakhathalele ukukhusela impilo yabo, kubandakanya:

• Akatshayi.

• Ukufumana izitofu zomkhuhlane kunye ne-pneumococcus.

Iimpawu

IINGONGOMA EZIPHAMBILI

• Ukuva

• Iingxaki zokuva ziziphumo ezifike kade ezinokubakho emva konyango lwee-cancer ezithile zomntwana.

• Unyango lwe-radiation ebuchotsheni kunye neentlobo ezithile ze-chemotherapy zonyusa umngcipheko wokulahleka kwendlebe.

• Ukuphulukana nokuva luphawu oluqhelekileyo lokuva iziphumo ezifike kade.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwindlebe nakwiingxaki zokuva.

• Ukubona

• Iingxaki zamehlo nezombono ziziphumo ezifike kade ezinokubakho emva konyango lwee-cancer ezithile zomntwana.

• Unyango ngemitha kwingqondo okanye entloko lonyusa umngcipheko weengxaki zamehlo okanye ukulahleka kombono.

• Iziphumo ezinokuchaphazela iso ezinokubangela iingxaki zempilo ezithile.

• Iimpawu ezinokubakho kunye neempawu zamehlo kunye nezokufika emva kwexesha kubandakanya utshintsho kumbono kunye namehlo owomileyo.

• Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwamehlo nakwingxaki zombono.

Ukuva

Iingxaki zokuva ziziphumo ezifike kade ezinokubakho emva konyango lwee-cancer ezithile zomntwana.

Unyango lwale neminye imihlaza yomhlaza kunokubangela ukuva iziphumo zasemva kwexesha:

• Amathumba ebongo.

• Intloko kunye nentamo yomhlaza.

• Neuroblastoma.

• I-Retinoblastoma.

• Umhlaza wesibindi.

• Izidumba zeseli zentsholongwane.

• Umhlaza wethambo.

• I-sarcoma yethishu ethambileyo.

Unyango lwe-radiation ebuchotsheni kunye neentlobo ezithile ze-chemotherapy zonyusa umngcipheko wokulahleka kwendlebe.

Umngcipheko wokulahleka kwendlebe uyonyuka kumaxhoba omhlaza wabantwana emva konyango ngoku kulandelayo:

• Iindidi ezithile ze-chemotherapy, ezinje nge-cisplatin okanye i-carboplatin yedosi ephezulu.

• Unyango ngemitha kwingqondo.

Umngcipheko wokulahleka kokuva mkhulu kubasali bomhlaza wabantwana abaselula ngexesha lonyango (umntwana omncinci, umngcipheko omkhulu), baphathwa ngethumba lobuchopho, okanye bafumana unyango ngemitha kwingqondo nakwichemotherapy ngokufanayo ixesha.

Ukuphulukana nokuva luphawu oluqhelekileyo lokuva iziphumo ezifike kade.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa kukuva iziphumo ezifike kade okanye ngezinye iimeko:

• Ukuphulukana nokuva.

• Iyakhala ezindlebeni.

• Ndiziva ndinesiyezi.

• I-wax enzima kakhulu endlebeni.

Ukuphulukana nokuva kunokwenzeka ngexesha lonyango, kungekudala emva kokuba unyango luphelile, okanye iinyanga ezininzi okanye iminyaka emva kokuba unyango luphelile kwaye luba mandundu ngokuhamba kwexesha. Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwindlebe nakwiingxaki zokuva.

Olu kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukukhangela okanye ukufumanisa iziphumo zokuva emva kwexesha:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lwe-Otoscopic: Uvavanyo lwendlebe. I-otoscope isetyenziselwa ukujonga umjelo wendlebe kunye ne-eardrum ukukhangela iimpawu zosulelo okanye ukulahleka kwendlebe. Ngamanye amaxesha i-otoscope ine-bulb yeplastiki efakwe ukuze ikhuphe umoya omncinci wokungena kwindlebe yendlebe. Kwindlebe esempilweni, indlebe iya kuhamba. Ukuba kukho ulwelo emva kwendlebe, alunakushukuma.

• Uvavanyo lokuva : Uvavanyo lokuva lunokwenziwa ngeendlela ezahlukeneyo kuxhomekeke kubudala bomntwana. Uvavanyo lwenziwe ukujonga ukuba umntwana uyakwazi ukuva izandi ezithambileyo nezingxolayo kunye nezandi ezisezantsi neziphezulu. Indlebe nganye ihlolwe ngokwahlukeneyo. Umntwana usenokubuzwa ukuba angasiva na isandi esiphakamileyo semfoloko yokususa xa ibekwe emva kwendlebe okanye ebunzi.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zokuva kade. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Ukubona

Iingxaki zamehlo nezombono ziziphumo ezifike kade ezinokubakho emva konyango lwee-cancer ezithile zomntwana.

Unyango lwale neminye imihlaza yomhlaza kunokubangela iziphumo zamehlo kunye nezokufika emva kwexesha:

• I-Retinoblastoma, i-rhabdomyosarcoma, kunye nezinye izicubu zamehlo.

• Amathumba ebongo.

• Intloko kunye nentamo yomhlaza.

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umhlaza uphathwa nge-irradiation yomzimba iyonke (i-TBI) ngaphambi kokufakwa kweseli ye-stem.

Unyango ngemitha kwingqondo okanye entloko lonyusa umngcipheko weengxaki zamehlo okanye ukulahleka kombono.

Umngcipheko weengxaki zamehlo okanye ukulahleka kombono kunokunyuswa kumaxhoba omhlaza wabantwana emva konyango ngayo nayiphi na kwezi zinto zilandelayo:

• Unyango ngemitha kwingqondo, iliso, okanye isokethi yamehlo.

• Utyando lokususa iliso okanye ithumba kufutshane ne-optic nerve.

• Iindidi ezithile ze-chemotherapy, ezinje nge-cytarabine kunye ne-doxorubicin okanye i-busulfan kunye ne-corticosteroids njengenxalenye yokufakwa kweseli.

• Umzimba wonke we-irradiation (TBI) njengenxalenye yokufakelwa kweseli.

• Ukufakelwa kweseli kwestem (kunye nembali yesifo esinganyangekiyo sokulwa nokuchasana).

Iziphumo ezinokuchaphazela iso ezinokubangela iingxaki zempilo ezithile.

Iziphumo zamehlo emva kwexesha kunye neengxaki zempilo ezinxulumene noku zibandakanya oku kulandelayo:

• Ukuba nesokisi encinci yamehlo echaphazela ukumila kobuso bomntwana njengoko ikhula.

• Ukuphulukana nombono.

• Iingxaki zombono, ezinje ngamehlo okanye i-glaucoma.

• Ukungakwazi ukwenza iinyembezi.

• Umonakalo kwi-optic nerve kunye ne-retina.

• Amathumba enkophe.

Iimpawu ezinokubakho kunye neempawu zamehlo kunye nezokufika emva kwexesha kubandakanya utshintsho kumbono kunye namehlo owomileyo.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa liso kunye nombono wempembelelo okanye emva kwezinye iimeko:

• Utshintsho kumbono, njenge:

• Ukungakwazi ukubona izinto ezikufutshane.

• Ukungakwazi ukubona izinto ezikude.

• Umbono kabini.

• Kunamafu okanye ukungaboni kakuhle.

• Imibala ibonakala ngathi iphelile.

• Ukuthathela ingqalelo ukukhanya okanye ingxaki yokubona ebusuku.

• Ukubona ilitha okanye i-halo ejikeleze izibane ebusuku.

• Amehlo awomileyo anokuziva ngathi arhawuzelele, ayatsha, okanye adumbile, okanye ngathi kukho into esweni.

• Intlungu yamehlo.

• Ukubomvu kwamehlo.

• Ukuba nokukhula kwinkophe.

• Ukutshatyalaliswa kwejwabu leso eliphezulu.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Uvavanyo oluthile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokuchonga iingxaki zempilo kwamehlo nakwingxaki zombono.

Ezi kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukukhangela okanye ukufumanisa iziphumo zamehlo kunye nezokufika emva kwexesha:

• Uvavanyo lwamehlo kunye nomfundi ohlaziyiweyo: Uvavanyo lweliso apho umfundi anyanisiweyo (wandiswa) ngamayeza amayeza afakwe kunyango ukuvumela ugqirha ukuba ajonge iilensi kunye nomfundi kwi-retina. Ingaphakathi leliso, kubandakanya i-retina kunye ne-optic nerve, zijongwa kusetyenziswa isixhobo esenza ukukhanya okumxinwa. Ngamanye amaxesha kuthiwa luvavanyo lwesibane. Ukuba kukho ithumba, ugqirha unokuthatha iifoto ekuhambeni kwexesha ukugcina umkhondo wotshintsho kubungakanani bethumba kunye nokukhula kwayo ngokukhawuleza.

• I-ophthalmoscopy engathanga ngqo: Uvavanyo lwangaphakathi ngasemva kweliso usebenzisa ilensi encinci yokukhulisa kunye nokukhanya.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zamehlo kunye neziphumo zasemva kwexesha. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Inkqubo yoMchamo

IINGONGOMA EZIPHAMBILI

• Izintso

• Ezinye iintlobo zonyango lwe-chemotherapy zonyusa umngcipheko wezintso emva kwexesha.

• Iziphumo ezinokuchaphazela izintso zinokubangela iingxaki zempilo.

• Iimpawu ezinokubakho kunye neempawu zezintso emva kwexesha zibandakanya iingxaki zokuchama kunye nokudumba kweenyawo okanye kwezandla.

• Iimvavanyo ezithile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa iingxaki zempilo kwizintso.

• Imikhwa yempilo ekhuthaza izintso ezisempilweni ibalulekile kumaxhoba omhlaza wabantwana.

• Isinyi

• Utyando kwindawo ye-pelvic kunye neentlobo ezithile ze-chemotherapy zonyusa umngcipheko wesiphumo sokugqibela sesinyi.

• Iziphumo ezifika emva kwexesha ezichaphazela isinyi zinokubangela iingxaki ezithile zempilo.

• Iimpawu ezinokubakho kunye neempawu zesinyi emva kwexesha zibandakanya utshintsho kumchamo kunye nokudumba kweenyawo okanye kwezandla.

• Iimvavanyo ezithile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa iingxaki zempilo kwisinyi.

Izintso

Ezinye iintlobo zonyango lwe-chemotherapy zonyusa umngcipheko wezintso emva kwexesha.

Umngcipheko weengxaki zempilo ezichaphazela ukunyuka kwezintso emva konyango ngezi zinto zilandelayo:

• I-Chemotherapy kubandakanya i-cisplatin, carboplatin, ifosfamide, kunye ne-methotrexate.

• Unyango ngemitha esiswini okanye embindini womqolo.

• Utyando lokususa inxenye okanye lonke izintso.

• Ukufakelwa kweseli.

Umngcipheko weziphumo zezintso emva kwexesha ukhulu kakhulu kumaxhoba omhlaza wabantwana abaphathwa ngokudityaniswa kotyando, ichemotherapy, kunye / okanye unyango lwemitha.

Oku kulandelayo kungonyusa umngcipheko wezintso emva kwexesha:

• Ukuba nomhlaza kwizintso zombini.

• Ukuba nesifo semfuza esonyusa umngcipheko weengxaki zezintso, ezinje ngeDenys-Drash syndrome okanye isifo se-WAGR.

• Ukunyangwa ngeendlela ezingaphezulu kwesinye zonyango.

Iziphumo ezinokuchaphazela izintso zinokubangela iingxaki zempilo.

Iziphumo zezintso okanye iingxaki ezinxulumene nempilo zibandakanya oku kulandelayo:

• Umonakalo kwiindawo zezintso ezihluza kunye nokucoca igazi.

• Umonakalo kwiindawo zezintso ezisusa amanzi ongezelelweyo egazini.

• Ukuphulukana nee-electrolyte, ezinjenge-magnesium, calcium, okanye i-potassium, emzimbeni.

• Uxinzelelo lwegazi (uxinzelelo lwegazi oluphezulu).

Iimpawu ezinokubakho kunye neempawu zezintso emva kwexesha zibandakanya iingxaki zokuchama kunye nokudumba kweenyawo okanye kwezandla.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa ziziphumo zezintso okanye ezinye iimeko:

• Ukuziva isidingo sokuchama ngaphandle kokukwazi ukwenza njalo.

• Ukuchama rhoqo (ngakumbi ebusuku).

• Ingxaki yokuchama.

• Ndiziva ndidiniwe.

• Ukudumba kwemilenze, amaqatha, iinyawo, ubuso, okanye izandla.

• Ulusu olurhawuzayo.

• Isihlunu okanye ukugabha.

• Incasa efana nesinyithi emlonyeni okanye umphefumlo ombi.

• Intloko ebuhlungu.

Ngamanye amaxesha akukho zimpawu okanye zimpawu kumanqanaba okuqala. Iimpawu okanye iimpawu zinokubonakala ngathi umonakalo kwizintso uyaqhubeka ngokuhamba kwexesha. Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Iimvavanyo ezithile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa iingxaki zempilo kwizintso.

Olu kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukukhangela okanye ukufumanisa iziphumo zezintso:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Isifundo se-chemistry yegazi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinje ngemagniziyam, ikhalsiyam, kunye ne potassium, ekhutshelwa egazini ngamalungu kunye nezicubu zomzimba. Isixa esingaqhelekanga (esiphakamileyo okanye esisezantsi kunesiqhelo) sesixa sinokuba luphawu lwesifo sezintso.

• Urinalysis: Uvavanyo lokujonga umbala womchamo kunye neziqulatho zawo, ezinje ngeswekile, iproteni, iiseli ezibomvu zegazi kunye neeseli ezimhlophe zegazi.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphakamileyo amandla (i-ultrasound) ehlaselwa kwizicubu zangaphakathi okanye kwizitho, ezinjengezintso, kwaye zenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zeziphumo zezintso. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Imikhwa yempilo ekhuthaza izintso ezisempilweni ibalulekile kumaxhoba omhlaza wabantwana.

Abasindileyo bomhlaza wabantwana ababenako konke okanye inxalenye yezintso zabo zisuswe kufuneka bathethe nodokotela malunga noku kulandelayo:

• Nokuba kukhuselekile ukudlala imidlalo enomngcipheko omkhulu wokunxibelelana okunzima okanye ifuthe elinjengebhola ekhatywayo okanye ihoki.

• Ukhuseleko lwebhayisikile kunye nokuphepha ukwenzakala kwebarbar.

• Ukunxiba ibhanti esihlalweni, hayi esinqeni.

Isinyi

Utyando kwindawo ye-pelvic kunye neentlobo ezithile ze-chemotherapy zonyusa umngcipheko wesiphumo sokugqibela sesinyi.

Umngcipheko weengxaki zempilo ezichaphazela ukunyuka kwesinyi emva konyango kunye noku kulandelayo:

• Ugqirha lokususa yonke into okanye inxenye yesinyi.

• Ugqirha kwi-pelvis, umqolo, okanye ingqondo.

• Iindidi ezithile zekhemotherapy, ezinje ngecyclophosphamide okanye ifosfamide.

• Unyango lwe-radiation kwiindawo ezikufutshane nebladder, pelvis, okanye urinary tract.

• Ukufakelwa kweseli.

Iziphumo ezifika emva kwexesha ezichaphazela isinyi zinokubangela iingxaki ezithile zempilo.

Iziphumo zesinye sokugqibela kunye neengxaki zempilo zibandakanya oku kulandelayo:

• I-hemorrhagic cystitis (ukudumba okungaphakathi kudonga lwesinyi, olukhokelela ekopha).

• Ukuqina kodonga lwesinyi.

• Ingxaki yokukhupha isinyi.

• Ukungakwazi ukuzibamba.

• Ukuvaleka kwizintso, ureter, bladder, okanye urethra.

• Usulelo lwe-Urinary tract (engapheliyo).

Iimpawu ezinokubakho kunye neempawu zesinyi emva kwexesha zibandakanya utshintsho kumchamo kunye nokudumba kweenyawo okanye kwezandla.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa sisiphumo sokugqibela kwesinyi okanye ngezinye iimeko:

• Ukuziva isidingo sokuchama ngaphandle kokukwazi ukwenza njalo.

• Ukuchama rhoqo (ngakumbi ebusuku).

• Ingxaki yokuchama.

• Ukuziva ngathi isinyi asikhupheli ngokupheleleyo emva kokuchama.

• Ukudumba kwemilenze, amaqatha, iinyawo, ubuso, okanye izandla.

• Kancinci okanye akukho lawulo lwesinyi.

• Igazi kumchamo.

Thetha nogqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi ngxaki.

Iimvavanyo ezithile kunye neenkqubo zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa iingxaki zempilo kwisinyi.

Ezi kunye nolunye uvavanyo kunye neenkqubo zinokusetyenziselwa ukufumanisa okanye ukufumanisa isiphumo sokugqibela sesinyi:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Isifundo se-chemistry yegazi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinje ngemagniziyam, ikhalsiyam, kunye ne potassium, ekhutshelwa egazini ngamalungu kunye nezicubu zomzimba. Isixa esingaqhelekanga (esiphakamileyo okanye esisezantsi kunesiqhelo) sesixa sinokuba luphawu lweengxaki zesinyi.

• Urinalysis: Uvavanyo lokujonga umbala womchamo kunye neziqulatho zawo, ezinje ngeswekile, iproteni, iiseli ezibomvu zegazi kunye neeseli ezimhlophe zegazi.

• Inkcubeko yomchamo: Uvavanyo lokujonga intsholongwane, igwele, okanye ezinye iintsholongwane kumchamo xa kukho iimpawu zosulelo. Iinkcubeko ze-Urine zinokunceda ekuchongeni uhlobo lwe-microorganism ebangela usulelo. Unyango losulelo luxhomekeke kuhlobo lwe-microorganism ebangela usulelo.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kwizitho, ezinjenge-bladder, kunye nokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva.

Thetha nogqirha womntwana wakho malunga nokuba umntwana wakho kufuneka enze iimvavanyo kunye neenkqubo zokujonga iimpawu zesiphumo sokugqibela sesinyi. Ukuba kufuneka iimvavanyo, fumana ukuba kufuneka zenziwe kangaphi.

Ukufunda ngakumbi malunga neziphumo zamva kwexesha zoNyango loMhlaza woMntwana

Ngolwazi oluthe kratya malunga neziphumo zasemva kwexesha lonyango lomhlaza wabantwana, bona oku kulandelayo:

• Izikhokelo zexesha elide zokulandelela abo basindayo ebuntwaneni, ukuFikisa, kunye noMhlaza waBadala aBantu.

• Iziphumo zeLate Directory yeeNkonzoPhuma kwi-Disclaimer

• Ikhompyuter yeTomography (CT) kunye noMhlaza

Ngolwazi oluthe kratya lomhlaza wabantwana kunye nezinye izixhobo zomhlaza ngokubanzi kwiZiko leSizwe loMhlaza, jonga oku kulandelayo:

• Umhlaza wabantwana

• Unyango lokuKhangela uMhlaza waBantwanaPhuma kwiNgcazelo yokuzihlangula

• Abafikisayo kunye naBantu abaDala abaDala abanomhlaza

• Abantwana abanomhlaza: Isikhokelo sabazali

• Umhlaza kuBantwana nakwishumi elivisayo

• Ukuqokelela

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga nomhlaza

• Abasindileyo kunye nabaNonopheli