THISEN CANCER
Dr. Dorris Lallawmzuali
Cancer zingah chuan thisen cancer hi tihbaiawm ber pawl a ni awm e. Kum 2000 chhung khan khawvel pumah mi 2,56,000 in an vei a, chung zing a mi, 2,09,000 te chuan an thihpui a ni1. Kum 2002 khan India ramah thisen cancer hi mi 1,20,603 velin an vei a. Mizoramah chuan thisen Cancerah pawh a rang chi kan tih (Acute Leukemia) bik hi mi 135 in 2005-2008 chhungin an vei a*, Mizo cancer vei zawng zawng zingah2.8% a ni.
Engvanga hlauhawm viau nge ni?
Thisen cancer (leukemia) hi thling a thisen var (WBC, White Blood Cell) insiam diklo (Blast) vang a awm a ni. Heng ‘blast’ te hi an nih tur ang a an than puitlin theih loh avangin thlingah nasa takin a pung a, taksa mamawh thisen timur dang insiam thei lo leh hnathawk thei lovin an siam a, an rawn luahlan thin a ni.
Thisen cancer hlauhawm zual bikna chhan tlangpui han tarlang ila.
• Cancer, a intanna organ (taksa peng) zai thlak hlawk theih chi hi chu a zung nen a paih fai vek theih a nih loh pawhin, nasa takin a tai darh tur a veng a. Thisen cancer insiamna hi thling (bone marrow) a nih avangin cancer dang te, eg. hnute, pumpui, etc. te ang in a zai thlak hlawk ve theih loh a. Chemotherapy emaw bone marrow transplant emaw chauhvin enkawl theih a ni.
• Thling a chak tak a insiam a nih avangin, thling a insiam ve tho, RBC (Red Blood Cell- thisen ‘sen’), WBC (White Blood Cell- thisen var) leh Platelets (pem neih a thisen tikhaltu) te hi insiam thei lovin a nek chep a. Hengte hi taksa in a mamawh avangin damlo chu rang takin a chau nghal thin a ni.
• Cancer dang aiin inven a harsa. Cancer tam tak hi chu chin tha lo vangte in a awm duh bik a. Entirnan, zu leh meizial te hian pumpui, chawkawng, hrawk, chuap leh cancer dangte a thlen a. Hepatitis B leh C vei te’n thin (liver) cancer an nei duh bik a. Sex hman hma/uar lutuk avangte in chhul hmawr cancer te a insiam a. Thisen cancer hi x-ray leh radiation dang hmuh nasat lutuk avang te, chemical thenkhat eg. Benzene, cancer damdawi vang te a awm thin ni a rinhlelh nimahsela, a tam zawk hi chu kan timur insiam fuh lo (genetic defect) avanga lo awm a ni.
Thisen cancer chi hrang hrang te
Thisen cancer hi chi hrang hrang a awm a. Mizoten a ‘a rang chi’ kan tih hi Acute Leukemia a ni. A muang chi leh rei tak dampui ve theih ho hi Chronic Leukemia, eg. Chronic Myelocytic leukemia (CML), Chronic Lymphocytic Leukemia (CLL), Chronic Myelomo-nocytic leukemia (CMML) leh a dangte a ni. A rang chi ho chanchin chauh hi kan thlir dawn a ni.
Acute Leukemia pawh hi chi hnih lian pui puiah then leh a ni a. Acute Lymphoblastic Leukemia (ALL) leh Acute Myeloblastic Leukemia (AML) te a ni. ALL hi chi 3 – (L1-L3) ah then leh a ni. AML hi chi 8, (M0-M7) ah then a ni. Thisen Cancerah hian eng chi chiah nge a nih hriatchian a tul em em chhan chu a enkawlna damdawi leh a natna kalhmang inan loh vang a ni.
Thisen cancer lanchhuah dan te:
Kan sawi tawh ang khan, thling hian thisen a timur (cell) chi hrang hrang a siam a. RBC kan tih hian thisenzamah oxygen leh taksa mamawh dangte tisa hmun hrang hrangah a keng kual a. WBC kan tih hian natna hri a do ve thung a ni. Platelets kan tih te hian pem leh thisen chhuahnaah te pungkhawmin, thi chhuak pur pur tur a tikhal vat thin a ni. Thisen cancer cell te hi thlingah, heng taksa mamawh cell te aia chak hian an pung a, cell pangai hnathawh pawimawh tak tak hi an tibuai ta thin a ni. Chuvangin thisen cancer natna rawn lanchhuah chhan chu taksa in a mamawh cell te a tlakchham vang a ni ber.
1. Chauh ngawih ngawih leh dawldanna: RBC an tlem avangin damlo chu a dang bel a. A hma a harhvang thin tak kha tha tho lo leh chau ngawih ngawih in a lo awm ta thin a ni. Thawhah te pawh a nei thei a ni.
2. Khawsik: Taksa a natna dotu WBC an tlem avangin hrileng an vei hma a. Blast tam lutuk hrim hrim pawhin khawsik a siam thei bawk. Damlo chu a chhan ber hriat lovin khawsik a nei deuh reng thei a ni.
3. Taksa a duk ringawt leh thi chhuak: Taksa peng hrang hrangah, intihnat lai hriat si lovin duk rei rui a awm thin. Hei hi platelets tlakchham vang a ni. A chang chuan, ha hni, hnar leh ek thi te an nei thei bawk. Chi thenkhat (AML M5) chuan hahni vung a siam thei a ni.
4. Ruhna: Thling hi ruh chhunga awm a ni a. Cancer Cell-te an lo pun tak vakah chuanruhna a siam thei a. Awm ruh (sternum) hi a na duh tlangpui bik.
5.Thal bawk: Cancer cell an tam viau chuan thal bawk a siam thei a. Thal bawk chhung a cancer cell an tam chuan damlo tan a tha lo hle a, a natna hi a chak zual tihna a ni duh hle.
6.Thin lian, la tla (splenomegaly) leh awm chhung (mediastinum) ah te pawh cancer hlawm hian bawk a siam thei a. Hetiang a awm chuan cancer chu a chak zual duh bik hle a ni.
7. Thluak lam buaina: Cancer cell te’n thluak lamah bu an khuar chuan dam lo chuan lu na, kaih leh chian loh ruaina te a nei thei. Hei pawh hi cancer chu a nasa hle tih hriatna pakhat a ni.
8.Kum: A tlangpuiin ALL hi kum 2 atanga kum 8 inkarah a tam ber.Kum 1 hnuailam leh kum 10 aia upateah hian a natna hi a chak lehzual bik a ni. Kum 30 leh 40 inkarah a tam leh bawk. AML hi chu puitlingah a awm deuh ber thung a, ALL ai pawh hian a rang zawk deuh thin.
Thisen cancer hriath theih dan te:
A chung a kan ziahte ang a i awm chuan doctor pan vat ang che. Doctor chuan uluk tak a a en hnuah che test chi hrang hrang tih tur a hrilh ang che.
Mizoram a test kan tih theih te tarlang phawt ila.
1. Hemogram: Hei hi thisen enna zing a kan hman uar ber leh tangkai ber pawl a ni. He test-ah hian thil chi hrang hrang en a ni.
-Hemoglobin(Hb): Hei hian taksa a RBC tam zawng a en a. Mipa hrisel pangai tak chuan Hb 13-18 gm% a nei thin. Hmeichhia erawh chuan 11-16 gm % a nei tlangpui. Thisen cancer vei Hb chu a hniam tlangpui a, a chang chuan 2 gm % chauh te pawh a ni thei.
-TLC(Total Leukocyte Count): Hei hi thisen var tam zawng sawina a ni ve thung a.Mi hrisel pangngai chuan 4000-11000 /cumm vel a nei a. Thisen cancer ah chuan TLC hi a sang em em a, 20,000-200,000/cumm te a ni thin.
TLC hi natna dang tam tak ah pawh a sang thei a - pun (infection) ah te, naupai te, exercise lak nasat te hian a tisang thei. Amaherawh chu, thisen cancer ang em em hian a sang ve ngai lo a ni.
Thisen cancer nei reng si hian TLC hi a normal emaw, 4000/cumm ai pawhin a tlem ve thei a. ‘Subleukemic’ leh ‘Aleukemic leukemia’ ti a vuah an ni. TLC normal emaw tlem emaw pawh nise, thlingah ‘blast’ kan tih te hi hmuh tur an awm a, thisen pawnlangah an rawn chhuak tlem mai zawk a ni. Hengah hi chuan peripheral smear kha Pathologist in uluk takin a en a ngai a, thling test pawh tih a ngai thin.
-Platelet count: Mihring pangaiah chuan 150,000-400,000/cumm a ni thin.
50,000/cumm aia a tam chuan intihnat loh/pem loh chuan amahin thi a chhuak lova. 10,000-50,000/cumm inkar vel a a hniam chuan intihnat kher loh pawhin thi a chhuak ngawt emaw taksa duk emaw a awm ngawt thei.
10,000/cumm aia a hniam phei chuan pum leh rilah te, zunkawngah te thi nasa takin a chhuak a, thihpui hial a hlauhawm em em a ni.
-Peripheral smear: He test-ah hi chuan thisen far khat kha glass phekah nawr pherh a ni a. Chumi chu chemical hman tur bik a sawngbawl a nih hnuah enlenna (microscope) hnuaiah zirchian a ni. A chunga kan sawi tak te khi chu khawl leh hmanraw danga en theih a ni a. He test hi chu uluk tak a mit ngei a en a ngai. He test-ah hian kan sawi tak zawng zawng khi mit ngei a finfiah a nih bakah, ‘blast’ awm zat kha chhiar a ni a. An zia atangin ALL nge, AML nge natna dang tih pawh zirchian thin a ni. TLC hniamah pawh ‘blast’ a awm theih tho avangin he test hi a pawimawh em em. TLC sangah pawh cancer nge infection satliah vanga sang ti chiang bertu a ni.
2.Bone marrow examination: Thling test hi thisen cancer zawng zawngah tihnghal a tul kher lo va, a chi (type) chian nan lehdamlovin treatment a lak hnuah a damdawi ngeih leh ngeih loh en nan te tih thin a ni. Hriauvin khelruh hnung lamah emaw, awmruhah emaw, naupangah chuan khup hnuaiah emaw thling hip chhuah thin a ni. A hlauhawm hmel aiin he test hi ‘a na lutuk lo..’ an ti tlangpui.
Mizoram a la tih ve theih rih loh te.
3. Cytochemistry: Hei hi chemical thenkhat hmanga thisen sawngbawlna a ni a, ALL leh AML hriatchian nan a tha hle. Aizawl Civil Hospital-ah pawh hetiang test hi tih ve theihna turin hmalak mek a ni.
4. Immunophenotyping: Hei hi thisen/thling khawl a enna a ni. He khawl hian eng thisen cancer ber nge tih a chian thei. Mizoramah he test hi kan la ti thei ve loh avangin, a tul dan a zirin phaiah thawn thin a ni.
A enkawl dan tlangpui:
1. Chemotherapy: Phase hrang hrang in enkawl thin a ni. ‘Induction phase’ an tih ah hian blast awm zawng zawng kha thah tum a ni a, cancer damdawi chi 3 vel hman a ni tlangpui. Thlinga blast an thah rem duak hnu hi chuan cell pangngai te a rawn insiam leh ta thin. Intensive phase ah hian damdawi chi 2 emaw chi 3 emaw in enkawl leh an ni a, cancer cell lo let leh tur kha lo venna a ni. ‘Maintenance phase’ ah hi chuan nitin emaw kar tin emaw damdawi pek an ni a. Kum 2-3 te hetiang hian enkawl zui an ni. Kum 3 aia rei cancer a rawn let loh chuan dam ang a ngaih an ni. Chemotherapy hian blast bakah cell pangngai a thah ve tho avangin dam lo chuan ‘side effect’ tam tak a nei thin a; khawsik, chauh ngawih ngawih, luak chhuak leh chaw ei tui lo, sam tlakawlh, etc. te hi a hnathawh lanna tlangpui a ni.
2. Radiotherapy: Hei hi khawl hmanga damlo hemna a ni. Mizoramah chuan Zemabawk, Aizawlah a khawl hi bun a ni. Thisen cancer bikah hi chuan hman a nih tho rual in chemotherapy aiin a tangkai lo zawk. Cancer thluak leh tilmu lam a tai darh vennan leh enkawl nan te, ‘bone marrow transplant’ tih hmaa blast tam thei ang ber thah nan te hman a ni tlangpui. Hei pawh hian side effect tam tak neiin, chauhna te, hemna lai vun na te, sam tla te a siam ve thei.
3. Bone marrow transplant:Damlo chu chemotherapy emaw radiothe rapy a enkawl a nih hnu in, a taksa a blast a tlem ber laiin midang (allogenic) emaw a ma (autologous) thling emaw chu amahah dah a ni a. Chu thling, blast nei lo chuan thisen a cell chi hrang hrang te rawn siam tur a beisei a ni. Bone marrow transplant hi thil awlai lo tak a ni a, khawl tha mai bakah hmun thianghlim lutuk te a ngaih avangin Mizoramah tihtheih a la ni ve lo.
