CHHUL HMAWR CANCER
-Dr. Eric Zomawia
Chhul hmawr hi Saptawng chuan ‘Cervix’ an ti a, chhul (uterus) hnuai dawmtu, chhul kawngka ti pawhin a sawi theih ang. Nu in nau a pai hian chhul chhungah naute a thang lian a, a tlak mai loh nan chhul hmawr chip chuan a lo dang tlat a, naute a pian dawnin chhulhmawr chu a lo inhawng zau ta vak thin a ni. Hmeichhe thlatin thi pawh hi chhul chhungah insiamin cervix atang hian a rawn baw chhuak thin a ni.
Chhul hmawr Cancer pawimawhna em em te chu – kumtin hmeichhe nunna tam tak suattu a nih vangte; inven
theih a nihna te; cancer tak taka a chan hma, zaa za tihdam theih a nih laia awlsamte a
hmuhchhuah theih a nihna te; hmuhchhuah hma theihna test awlsam tak, na bawk si lo a awm vangte hi a ni.
A hluar dan :
Chhulhmawr cancer hi
khawvela hmeichhe cancer zinga hluar ber 4-na niin kumkhat chhungin vei thar mi
528, 000 leh thihpui mi
266,000 an awm a (2012). Ram changkang lo apiangin an vei nasa in an thihpui tam a, vei
thar zawng zawng zinga 85% leh thihpui zinga 87% zet chu ram changkang lo zawk a mi
te an ni. Ram changkang zawkah chhulhmawr cancer thihpui an tlemna chhan chu
hmuhchhuah hma-na
programme (cervical cancer screening programme) tha tak
an nei a, cancer tak tak a chan hmain an hmuchhuakin an
enkawl dam zel vang a ni. National Cancer Registry Programme in a tarlan danin India rama population chhuta
chhulhmawr cancer hluarna ber chu Mizoram (Aizawl district) a ni. Mizoramah kum 5 chhung (2006-2010) khan
chhulhmawr cancer vei
hmuhchhuah 364 an awm a ni.
A awm chhan :
Chhul hmawr cancer zinga 90% aia tam mah hi natna hrik chikhat ‘Human Papilloma
Virus’ (HPV) an tih avanga awm a ni a. HPV chu sex hman atanga inkai niin, mipa leh hmeichhiain an kai thei ve ve a. HPV hi kai a awl hle a, hmeichhia kum 50 tling tawh zinga a zatve (50%) zet hian HPV an kai tawh an ti a ni. Sex
hman hma lutukte, kawppui ngahte, a mipa zawkin kawppui a ngahte hian HPV kai a awl bik a, mahse kawppui pakhat chauh neih pawhin a kai theih tho. Mahse HPV tam zawk chu amahin a reh/bo/dam ve leh mai a, a bo mai loh chuan a rei hnuin chhulhmawr cancer a siam thei a ni. HPV hi chi 200 vel a awm a, cancer an thlen vek lova, a then chuan vun leh serh leh mawngkaw bulah te, hrawkah te singsihlip leh vun chawr (wart) an siam thei a; type 16 leh type 18 te hi chhulhmawr cancer thlentu tam ber an ni.
Hengte hian chhulhmawr cancer a ti tam bawk-
1) Mei zuk.
2) HIV/AIDS vei zingah.
3) Birth control pill rei tak (kum 5 chuang) ei tawh zingah.
4) Fa 3 emaw a aia tam nei zingah.
5) Serh bawr vel invawng thianghlim lo zingah.
A lan chhuah dan :
Chhulhmawr cancer veite chu rei tak in sawisel lovin an awm thei a, a rei hnu chuan a
hunbi ni lova thi chhuakte, sex hman zawha thi chhuakte, a
pangngai aia rei thi neihte, thi hul tawh hnua thi neih leh te, bawlhhlawh leh tui chhuak te, tai na leh sex hman laia n ate an nei thei. Heng insawiselna
te hi chhul hmawr cancer ah kher lo pawh a awm thei na in, hengte hi a awm a nih chuan ngaihthah miah lova doctor in entir vat tur a ni.
A hmuhchhuah dan :
1) Pap Smear : Miin HPV hrik a pai chuan kum tam tak hnuah zawi zawiin chhul hmawra timur (cells) te chu cancer-a an chan tak tak hma-in cancer ni chiah si lovin an lo thang danglam phawt thin a;
hetianga timur thang danglam hi ‘dysplasia’ (dis-plei-sia tia lam tur ) an ti a, ‘CIN’
(Cervical Intraepthelial Neoplasia) te pawh an ti bawk. He timur thang danglam hi a nasat dan azir in ‘milddysplasia’ (CIN 1), ‘moderate dysplasia’ (CIN 2), ‘severe dysplasia’ (CIN 3) an ti thin.
He dysplasia/ CIN hi
awlsamte in Microscope (enlenna) hmangin a hmuh theih a, chhulhmawr kha zawite
in doctor emaw nurse in emaw hmawlhte (spatula) emaw brush emaw hmangin an hru a, chu chu ‘slide’ (malaria en dawna thisen lakna darthlalang hi) ah tat kaiin chemical hrang
hrangah an chiah a, chu chu pathologist (doctor specialist chikhat) ten microscope ah an lo enfiah leh thin a ni. Pap
Smear hi Grik doctor
Papanicolaou chuan 1926 vel daih a a hmuhchhuah tawh kha
niin, he test hmang hian chhulhmawr cancer a hriat theih mai bakah cancer hmahruai
(dysplasia/CIN) a hriat theih avangin a tha em em a, a awlsam bawk si a. Chuvangin khawvel hmun tinah Pap Smear hi chhul hmawr cancer
hriat chhuah hma nan an hmang nasa hle. Ram changkangah phei chuan hmeichhia sex
hmang tawh emaw pasal nei tawh emaw chu kum 25 an nih
atangin kum 3/4 danah Pap Smear an tih tir ziah thin a, a tan tirte cancer a la nih hmainah an hmuchhuak a, an enkawl dam vat a, chhulhmawr cancer vei leh thih pui an tlem phah ta em em a ni.
2) VIA/VILI : VIA (Visual Inspection with Acetic acid) emaw VILI (Visual Inspection with Lugol’s Iodine) hi tunhnua an uar tak em em, awlsam taka na si lova chhul hmawr thalo
hriatchhuahna a ni a. Doctor kher ngailovin nurse emaw health worker pawhin awlsamte a a tih ve theih mai a nih avangin leh a damdawi hman hi a tlawm em avangin
India ram hmun hrang hrangah pawh an hmang nasa tawh hle.
Acetic acid pawlh dal
(Vinegar kan hman thin ang hi) emaw Iodine emaw kha chhulhmawrah an hnawih a a rawng inthlak dan en khan diklo lai a awm chuan a hmuh theih mai a. Chu rawng dik lo chu a awm
a nih chuan cancer emaw dysplasia emaw a nih theih avangin Gynaecologist (Hmeichhe Specialist) hnenah refer in Biopsy lak tur a ni.
3) Colposcopy : Hei hi chu Gynaecologist in khawl pakhat ‘Colposcope’ hmanga chhulhmawr a endik kha a ni a. Colposcope khawl chuan a hmawrah en lenna a neih avangin chiang zawkin chhulhmawr kha a hmuh theih a. VIA leh VILI te nen an hmang kawp fo va, chhulhmawr dik lo lai tak kha
colposcope a en chungin Biopsy an la thin a ni.
4) Biopsy : Hei hi chu chhulhmawr kha a them an help thla a, Pathologist nen uluk taka anlo en thin kha a ni. A chunga test hrang hrang kan sawi – Pap Smear , VIA/VILI ,
Colposcopy a dik lohna awm kha cancer emaw dysplasia emaw a ni chiah em tih finfiahtu ber chu biopsy hi a ni.
5) HPV Test : Chhul hmawr cancer zawng zawng deuhthaw hi HPV kai benvawn atanga lo
awm a nih avangin chhulhmawrah HPV a awm leh awm loh test hi ram changkang zawkah chuan an uar tawh hle a. HPV negative an nih chuan engmah tih a ngai lova, HPV Positive an nih chuan chhul cancer an vei theih avangin uluk taka khing test kan sawi
hmang khian en thin tur a ni.
A enkawlna :
Dysplasia a la nih a cancer a la nih loh chuan tih dam awlsam lai tak a ni a, chuvangin hmuhchhua hma hi a tha hle a ni. Mild dysplasia/CIN 1 chu
enkawlna hran a ngai lova, thla 6 danah emaw zel Pap Smear leh test danga enzui mai kha a
tawk a ni. CIN2/CIN3 a nih chuan heng hrang hrang hian a enkawl dam theih – Cryotherapy (Thil vawt taka deh) emaw LEEP (Loop Electrosurgical Excision
Procedure) emaw conization (zai tenau chikhat) in enkawl a ni tlangpui. Hetiang hmanrua hi a awm chuan chhul paih kher
loh pawhin a enkawl theih a ni. Chhul hmawr cancer chu a stage a zirin – Surgery (Zai),
Radiotherapy (Hem), Chemo therapy (Damdawia enkawl) te hman a ni thin a, a mal
chauh emaw pahnih emaw a vaiin emaw hman a tul mai thei.
A inven dan :
1) Pap Smear – kum 25 chung lam, kawppui nei tawh tan chuan kum 3 atanga kum 5 danah Pap Smear hi tih ziah tur a ni. Hei hi kan ti theilo a nih pawhin kum 25 leh kum 40 inkarah vawi 2/3 tal tih kan tum tur a ni. Pap Smear aiah VIA emaw VILI pawh a hman theih.
2) Sex atanga HPV hrik kailo tura hma lak –
I. Kawppui a tlem thei ang ber neih tur a ni.
II. Sex hi kum tlem deuh
(tleirawl) laia hman loh tur a ni.
III. Condom hman thin hian engemaw chen a veng thei.
3) Vaccine : Tunhnaia chhulhmawr cancer venna atana thil
pawimawh em em mai chu HPV danna Vaccine tha tak a awm tawh hi a ni. HPV hi chhulhmawr cancer zawng zawng
deuhthaw thlentu a nih avangin he vaccine hian chhulhmawr cancer tam tak a veng ngei tura ngaih a ni. Tunah chuan
khawvelah company 2 chiahin anla siamchhuak a, chu chu
‘Cervirax’ leh ‘Gardasil’ an ni. Heng vaccine te hi WHO pawhin him tawk hleah a ngai a, ram 100 chuang feah an hmang tawh a ni. Tun dinhmunah chuan vaccine la tu tur chu hmeichhe tleirawl, sex
la hmang ngai lo te niin an ngai. Vaccine hi thla 6 chhunga vawi 3 chiu tur a ni a, tunah chuan a
la to rih hle.
Tlangkawmna :
Chhulhmawr cancer hi
ram changkang zawkah a tlem tawh hle laiin ram changkanglo zawk Mizoram te angah te
vei leh thih pui kan la tam hle a. Inven theih leh cancer tak taka a chan hmaa hmuh-
chhuaha tihdam hmiah theih a nihna te hre thar leh ila, vaccine te pawh hi ngaihven ila, tiin kan inchah a ni.
