Rawatan Kanser Buah Pinggang

Kanser buah pinggang peringkat serius atau sel renal karsinoma (RCC) berlaku apabila sel-sel buah pinggang menjadi bertambah parah dan tumbuh di luar kawalan.

Dalam kebanyakan kanser buah pinggang, tumor akan mula kelihatan pada lapisan saluran halus dalam buah pinggang.

Tanda-tanda yang biasa kelihatan dalam RCC termasuklah darah dalam air kencing (haematuria), kelesuan, hilang berat badan, anemia, dan sakit atau ada kelompok pada sisi atau pada bahagian bawah belakang. Bagaimanapun, dalam kebanyakan kes kanser ini, ia tidak mudah dikesan semasa pemeriksaan fizikal sehingga ia sudah berada pada peringkat lewat penyakit itu.

Faktor ini menyebabkan pesakit tidak menyedari mereka menghidap kanser ini pada peringkat awal.

Ini menyebabkan kebanyakan kes sampai ke peringkat serius (peringkat ketiga dan keempat) apabila penyakit dikesan. Malah, ia dikesan selepas pesakit mengalami pelbagai gejala kesihatan.

Walaupun kanser ini tidak popular seperti kanser payu dara atau prostat, jumlah pesakit semakin meningkat di kalangan warga emas lelaki berumur 60 hingga 69 tahun.

Ia dikategorikan sebagai 10 kanser utama yang menyebabkan kematian.

Pada 2002, kira-kira 208,000 orang di seluruh dunia menghidap penyakit ini (dan 37,000 daripadanya rakyat Amerika) serta 102,000 meninggal dunia.

Jumlah pesakit kanser buah pinggang di Amerika Syarikat tahun lalu dianggarkan 36,000 orang dan 40 peratus daripadanya berakhir dengan kematian.

Sehingga hari ini, lebih 57,000 kes kanser buah pinggang dikesan di Amerika dan dianggarkan 13,000 pesakit akan meninggal dunia walaupun mendapat rawatan.

Secara global, kanser buah pinggang adalah kanser keenam paling lazim (terutama pada peringkat III dan IV) di dunia selepas kanser paru-paru, payu dara, kolorektal, prostat dan hati.

Di Malaysia, kanser ini di tangga ke-17 bagi lelaki dan ke-20 bagi wanita dan kemungkinan menghidap kanser buah pinggang meningkat dengan cepat selepas berumur 40 tahun.

Terdapat lebih kurang 383 kes-kes barah buah pinggang dan organ pembuangan air kecil sejak 2006 . Di kalangan orang dewasa, RCC adalah penyebab utama bagi 85 peratus kanser buah pinggang dan hampir 30 peratus daripada pesakit-pesakit dengan RCC mempunyai barah metastatik pada peringkat diagnosis.

Tumor barah sel ginjal lanjut

Perunding Onkologi Klinikal, Datuk Dr. Mohd Ibrahim A Wahid, berkata, RCC adalah jenis barah ginjal yang serius tetapi jarang dijumpai.

Ia adalah antara tumor yang paling kalis rawatan, dengan kadar kelangsungan hidup lima tahun sekitar 68.9 peratus sahaja.

Kebiasaannya mereka yang mengamalkan gaya hidup tidak sihat, suka merokok, tekanan darah tinggi serta menghidap penyakit buah pinggang adalah golongan paling berisiko mendapat RCC.

“Sehingga tahun 2005, pilihan rawatan yang boleh didapati adalah terhad. Rawatan utama untuk peringkat awal RCC adalah pembedahan untuk membuang barah daripada tubuh. Walaubagaimanapun, daripada pesakit yang telah didiagnos dengan RCC, kira-kira 25 peratus hingga 30 peratus akan kembali menghidap barah selepas pembedahan dan memerlukan rawatan lanjut melewati pembedahan,” ujarnya.

Bagaimanapun, beberapa tahun lepas, terapi RCC telah mensasarkan laluan-laluan molekular yang khusus dan proses-proses yang mempengaruhi pertumbuhan sel seperti mTOR. Ia merupakan satu protein yang dijumpai dalam sel tubuh untuk pertumbuhan dan pembahagian sel.

Menurut Penasihat Perubatan untuk Unit Oncology & Specialty Care Business dari Pfizer Malaysia, Dr Mohd Nawi Wahid, rawatan baru seperti Torisel disasarkan khusus kepada mereka yang menghidap RCC lanjut. Dalam erti kata lain, RCC tergolong dalam kes yang ‘terlepas pandang’.

“Kajian telah menunjukkan bahawa temsirolimus mampu untuk mencapai hasil yang baik. Pfizer Malaysia amat berbangga dapat membawa harapan baru kepada penghidap RCC lanjut melalui rawatan ini,” ujarnya.

Rawatan RCC

Kehadiran Torisel (temsirolimus), satu ubat intravena (IV) diluluskan sebagai rawatan bersasar baru untuk barah ginjal peringkat lanjut (juga dikenali sebagai tumor barah sel ginjal lanjut) membawa harapan kepada penghidap RCC yang mempunyai kadar kelangsungan hidup yang rendah.

Sama seperti ubat barah yang lain, pesakit yang bakal dirawat dengan Torisel akan melalui penilaian cermat berkenaan kesesuaian mereka terhadap ubat dan faktor-faktor risiko prognosis mereka akan dinilai melalui kesihatan terkini mereka khasnya keadaan organ hati mereka.

Ia merupakan rawatan sekali seminggu yang diberikan secara intravena supaya ubat tersebut boleh memasuki saliran darah secara terus. Tiga puluh minit sebelum pesakit menerima rawatan ini, doktor mungkin akan memberi mereka antihistamin secara intravena untuk membantu mengurangkan peluang kemungkinan reaksi alahan. Rawatan penuh ini dijangka mengambil masa antara 30 hingga 60 minit. Jika antihistamin diberi terlebih dahulu, rawatan penuh akan mengambil masa 60 hingga 90 minit.

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