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TATKALA Pakar Bedah Kanser Kepala dan Leher dari Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Prof Madya Mohd. Razif Mohamad Yunus menunjukkan gambar-gambar pesakit dibedah akibat menghidap kanser jenis itu, terbit satu perasaan yang sukar diungkapkan di dada penulis.

Rasa gerun, takut dan seriau menyelubungi diri. Tidak dapat diungkapkan bagaimana keadaan pesakit yang menjalani pembedahan bagi membuang ketumbuhan di bahagian tersebut.

Penulis percaya, bila disebut tentang kanser, bagi kebanyakan daripada kita hanya memikirkan soal mati. Apatah lagi bila ia membabitkan bahagian kepala.

“Sebenarnya ramai yang tidak tahu bahawa pesakit kanser di bahagian kepala dan leher mampu diselamatkan andainya mereka bertindak dari peringkat awal. Walaupun bukan 100 peratus pulih seperti asal, namun sekurang-kurangnya kita mampu menyelamatkan atau memanjangkan hayat mereka dengan hidup yang lebih berkualiti,” kata beliau.

Menurut Prof Mohd. Razif, kanser kepala dan leher dirujuk sebagai satu kumpulan kanser di bahagian bawah otak hingga ke bahagian esofagus. Ia merangkumi bibir, rongga mulut (termasuk lidah), rongga hidung, sinus, tekak, peti suara dan salur pemakanan. Kadangkala, ia melibatkan kes kombinasi dengan otak yang turut memerlukan perhatian pakar neurologi.

Katanya, sebanyak 90 peratus daripada kanser jenis itu merupakan sel squamous carcinoma yang berasal daripada lapisan mukosal (epitelium) di kawasan tersebut. Biasanya ia akan merebak ke kawasan nodus limfa pada leher dan ini merupakan tanda-tanda yang biasa dapat dilihat ketika diagnosis.

Menurut beliau, punca yang dikaitkan dengan kanser kepala dan leher adalah merokok, pengambilan minuman beralkohol, amalan mengunyah pinang, sirih dan juga gambir serta beberapa jenis virus seperti virus papiloma manusia (HPV).

Kata Prof. Mohd. Razif, kanser kepala dan leher lebih biasa menyerang golongan lelaki usia pertengahan namun kes melibatkan wanita muda berusia sekitar 20-an turut ditemui sejak akhir-akhir ini.

Ditanya sejauh mana seriusnya penyakit ini kata beliau, ia bergantung kepada peringkat mana ia dikesan dan dirawat. Jika masih diperingkat awal, pesakit mampu diselamatkan.

Walaupun umum jarang membicarakan mengenai kanser kepala dan leher, hakikatnya secara global penyakit itu merupakan antara tiga jenis kanser yang paling banyak dihidapi oleh kaum lelaki. Dan angkanya juga menunjukkan peningkatan dari tahun ke tahun. Pada tahun 2009, sebanyak 35,720 kes kanser kepala dan leher dikesan di Amerika Syarikat.

Simptom dan tanda-tanda:

Kanser di bahagian tekak biasanya bermula dengan simptom biasa seperti pembesaran nodus limfa di luar bahagian leher, sakit tekak atau perubahan suara. Namun jika ia berkaitan dengan kanser, keadaan ini kelihatan lebih kronik. Ia mungkin dapat dilihat dengan jelas melalui benjolan atau kesakitan di bahagian tekak, leher yang tidak sembuh untuk tempoh yang lama. Pertuturan turut terjejas dan pesakit mungkin mengalami sakit di bahagian telinga.

Menurut Prof. Mohd. Razif, biasanya kanser di bahagian kepala dan leher mudah dikesan.

“Sebagai contoh, kanser di dalam hidung. Pesakit akan menyedari kelainan dan rasa terdapat ketumbuhan, bengkak dan keluar darah di bahagian yang terbabit. Adakalanya ketumbuhan tersebut akan keluar daripada hidung, begitu juga di bahagian-bahagian lain.

“Bagi kanser lidah dan mulut pula, ia biasanya ditunjukkan melalui ulser pada mulut yang luar biasa,” katanya.

Jelas beliau, ulser adalah masalah biasa setiap individu dan ia akan pulih dengan sendirinya selepas beberapa hari. Namun dalam kes ini, ulser terlalu lama melebihi dua minggu dan ia semakin membesar sehingga berdarah memberi petanda bahawa ia bukan sesuatu yang biasa.

Seandainya kanser itu terdapat di bahagian tekak pula, pesakit biasanya mengalami kesukaran menelan dan kadangkala ia membengkak di bahagian leher.

Begitu juga dengan kanser peti suara, dimana pesakit mengalami kelainan pada suara melebihi dua minggu sehingga kadangkala boleh menyebabkan suara hilang. Pesakit juga akan bernafas lebih kuat dan seandainya di peringkat serius, ia boleh menyebabkan pendarahan.

Sebenarnya kanser di bahagian itu kata Prof. Mohd Razif saling berkait antara satu sama lain. Ada pesakit yang mengalami kanser pada hidung dan kemudian ia merebak ke bahagian leher dan ada yang bermula dari leher ke hidung. Selepas itu ia merebak pula ke paru-paru, hati dan seterusnya ke tulang.

Pesakit yang bertemu doktor akan menjalani ujian endoskop terlebih dahulu pada bahagian yang dijangkiti. Jika terdapat tisu yang tidak normal, mereka akan disarankan menjalani Selepas ujian saringan resonan magnetik (MRI) dan CT scan . Seandainya disahkan menghidap kanser, mereka akan diberi cadangan rawatan mengikut peringkat yang bersesuaian.

Prof. Mohd Razif berkata, terdapat beberapa jenis rawatan yang perlu dijalani pesakit bergantung kepada peringkat yang mereka alami.

Menurut beliau, ada pesakit yang hanya memerlukan pembedahan sahaja. Ada pula yang memerlukan radioterapi sahaja dan ada pula yang perlukan pembedahan diikuti dengan radioterapi. Terdapat juga pesakit yang memerlukan pakej rawatan lengkap iaitu pembedahan diikuti kemoterapi dan radioterapi.

Menurutnya, bagi pesakit kronik yang sudah berada pada tahap empat di mana sel kanser sudah merebak ke seluruh tubuh badan, maka mereka diberi rawatan paliatif yang menyokong pesakit.

Namun bagi pesakit yang dipercayai mempunyai harapan untuk sembuh, mereka akan dibedah bagi membuang kawasan yang dijangkiti.

Kata beliau, biasanya kes-kes melibatkan kanser kepala dan leher memerlukan pemerhatian daripada pakar bedah kanser kepala dan leher, pakar bedah plastik rekonstruktif, pakar telinga, hidung dan tekak, pakar onkologi, pakar bedah mulut dan juga pakar terapi pertuturan. Menurutnya, tidak semua hospital menawarkan kepakaran pembedahan untuk kanser jenis itu kerana ia melibatkan risiko yang tinggi. Hanya hospital tertentu termasuk PPUKM yang setakat ini melakukannya dan peratusan kejayaan boleh dibanggakan.

Biasanya pesakit yang berada di tahap awal iaitu satu dan dua mempunyai harapan yang tinggi untuk sembuh. Pembedahan panjang perlu mereka lalui hingga kadangkala memakan masa selama 12 hingga 24 jam. Jika tiada sebarang komplikasi dan pesakit tidak mempunyai penyakit kronik yang lain, proses sembuh tidak mengambil tempoh yang lama.

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