ඇසටවත් නොපෙනෙන සියුම් තැනකින් ආරම්භ වී මුළු ලෝකයම අපෙන් ඉවත් කරන්නට බොහෝ විට ඉඩ ඇති මාරාන්තික රෝගයක් පිළිබඳව අදත් අපි කතා කරමු. කුමන වයසකදි කවරෙකුට මෙය කෙසේ වැළඳේවිදැයි කාටවත් කිව නොහැකිය. අති සියුම් තැනකින් ආරම්භ වී කිසිවක් නොදන්වා හොර රහසේම වර්ධනය වන නිසා බොහෝ විට කල්තියා හඳුනා ගන්නට නොහැකිවීම මෙහි ඇති අවාසනාවයි.
අපේ බාහිර ශරීරයේ පියවි ඇසට දැක ගත හැකි සියුම්ව දෙය ලෙස සඳහන් කළ හැකි වන්නේ කෙස් ගසයි. එහෙත් ඒ කෙස් ගස සැදි ඇති ආකාරය ගැන සොයා බලන්නට නම් ඇසේ දෘෂ්ටිය ප්‍රමාණවත් නොවේ. කෙස් ගසක් නිර්මාණය වී ඇති ආකාරය දැක ගන්නට නම් කුඩා දේ විශාල කර බැලිය හැකි අත් කාචයක හෝ ඊටත් වඩා සියුම් උපකරණයක සහාය ලබා ගන්නට සිදුවේ.
එවැනිම උපකරණයකින් නිරීක්ෂණය කළ විටදි අපේ මුළු ශරීරයම සෑදි ඇත්තේ අති සියුම් ඉතාමත් කුඩා කාමර ගණනාවකින් යන්න දැක බලා ගත හැකිය. අප ෙසෙලයක් ලෙස හඳුන්වන්නේ ඒ අති සියුම් එක් කාමරයකි. මව් කුස තුළදී මේ එකම එක ෙසෙලයකින් ආරම්භ වී මේ තරම් සිරුරකට හිමිකම් කියන්නට ඒ තුළ සිදු වූ පෙරළිය කුමක්ද? මුලදි තනි සෛලයක් වූ අපි ඊළඟට ෙසෙල දෙකක් බවට පත්වූයේ තනි කාමරයක් වූ එම සෛලය මැදින් බිත්තියක් වැටී එය කාමර දෙකක් බවට පත්වීම නිසාය.
එවිට බිහි වූ කුඩා කාමර දෙක පසුව මුල් කාමරය තරමටම විශාල වූ කාමර දෙකක් ලෙසට නිර්මාණය වේ. පසුව එම කාමර දෙක හතරක් බවටත්, හතර අටක් බවටත් අට දහසයක්, තිස් දෙකක් ආකාරයට බෙදෙමින් හා වර්ධනය වෙමින් ගොස් එය ත්‍රිලියන පනහක් පමණ වූ තැනදී වැඩුණු ශරීරයක් නිර්මාණය වේ. එය සාමාන්‍ය ෙසෙල බෙදීමේ වර්ධනයේත් අවසානයයි. ඉන් ඉදිරියට එක් ඇඟිල්ලක් හෝ දික් නොවන බව ඔබ දනී.
මිනිස් සිරුරේ ෙසෙල බෙදීම හා වර්ධනය එලෙසින් නතර වුවද හිසකෙස්, රැවුල, නිය‍පොතු ආදි කොටස් දිගින් දිගටම වර්ධනය වෙමින් පවතී. ඊට අමතරව අප කුණු අතුල්ලන විටදී ඇඹරි ඇඹරී ගැලවී යන සමේ මියගිය සියුම් කොටස් ඔබ දැක ඇති. එයද නැවත නැවත වර්ධනය වෙමින් පවතින්නකි.
සිදු වූ තුවාලයක් නැවත සුව වීමේදී එතන සම ගොඩවීම සිදුවේ. තුවාලයක් එලෙස ගොඩවීම යනු තුවාලයේ මායිම් මැදට මැදට වර්ධනය වෙමින් එකට එකතු වීමයි. තුවාලයක්ද එතනින් එහාට තවත් වර්ධනය වන්නේ නැත.
මේ ස්වාභාවික සංසිද්ධිය ඒ ආකාරයට සිදු නොවී ඒ වර්ධනය නැවතීමේ පණිවුඩය වෙනස් වුවහොත් සිදු වන්නේ කුමක්ද? වර්ධනය නතර වී ඇති ශරීරයේ යම් තැනක මස් ගුළියක් නොනවත්වාම දිගින් දිගටම වර්ධනය වන්නට පටන් ගත් විටදි සිදු වන්නේ කුමක්ද?
ශරීරයේ සෑම තැනකටම ලබා දී ඇති ඉඩකඩ සීමා සහිතය. මෙවැනි අසාමාන්‍ය වර්ධනයක් ආරම්භ වූ විටදී එම ස්ථානය වටා පිහිටා තිබූ සාමාන්‍ය ශරීර කොටස් තද වීමකට ලක්වීම නොවැළැක්විය හැකියි. එසේ තද වීමකට ලක් වූ කොටස් වල කාර්යය නවතාලිය හැකි ආකාරයට ශරීරයේ මතෛක් යහතින් ජීවත් වූ ඉතා වැදගත් කොටසක් අකර්මණ්‍ය වුවහොත් එය රෝග ලක්ෂණයක් ආකාරයට පෙන්විය හැකිය.
එසේ තද වීමකට ලක්වීමේ ප්‍රතිඵලය තීරණය වන්නේ තදවීමකට ලක් වී ඇති කොටසට මතෛක් කල් පැවරී තිබුණ රාජකාරියේ ස්වභාවය මතයි. එම ස්ථානය සමහර විට රාජකාරියක් නොමැති ශරීර කොටසක් විය හැකි අතර සමහර විට ජීවිතය ඉදිරියට රැගෙන යාමට නැතිවම බැරි හුස්ම වැටීම, සිහිකල්පනාව වැනි බරපතළ රාජකාරියක්ද විය හැකිය. රෝගියාට එය දැනෙන්නට පටන් ගන්නේ සුපුරුදු රාජකාරිය අඩපණ වූ විට දී හෝ වෙනස් වූ විටදීය. එලෙස පෙන්වන සමහර ලක්ෂණ රෝගියාට දැනුණද ඔවුන් ඒ පිළිබඳව අවධානය යොමු කරනුයේ හෝ නොකරනුයේ තම තමන්ගේ දැනුවත්භාවයට අනුවය.
සමහර ලක්ෂණ ඒ ආකාරයට රෝගියා නොතකා සිටියද රෝගී සිරුර නිරීක්ෂණය කරන වෛද්‍යවරයා වහා හඳුනා ගනී. තවත් ලක්ෂණ එක්ස් කිරණ, ස්කෑන් පරීක්ෂණ ආදියේදී හෙළිදරව්වන අවස්ථා තිබේ.
තමන්ගේ ශරීරය තුළ මෙවැනි බරපතළ රෝගයක් ඇතැයි බොහෝ අය නොසිතන්නේ තමන්ට දැනෙන තරමේ වේදනාවක් නැතිකමටයි. එහෙත් අවධාරණය කළ යුතු කරුණ වන්නේ ශරීර අභ්‍යන්තරයේ හටගෙන ඇති මෙවැනි වර්ධනයක් හේතුවෙන් රෝගියාට වේදනාවක් නොදැනෙන බවයි.
එලෙස අපේ ශරීරයේ සංවේදී නොවන තැනක හට ගන්නා මෙවැනි වර්ධනයක් කිසිදු ලක්ෂණයක් නොපෙන්වාම මාරාන්තික තත්ත්වයක් වනතුරු වර්ධනය විය හැකියි. කිසිදු හෝඩුවාවක් නොමැතිව මෙවැනි වර්ධනයක් සිදුවීම අතිශය කනගාටුදායක වන්නේ එය කිසිවෙකුට මුල් අවස්ථාවේදී හඳුනා ගන්නට මාර්ගයක් නැතිවන නිසයි.
එවැනි තත්ත්වයකදි ඉන් පසුව සිදුවන්නේ අපි බලා‍පොරොත්තු නොවන දෙයකි. වර්ධනය වූ එවැනි මස් ගුලියක් තුළින් ලේ නහර වල ලේ ගලා යද්දි එම මස් ගුලියේ ෙසෙල කොටස් ලේ ගමනාගමනයට එකතුවන අවස්ථා තිබේ. එලෙස ලේ දහරාවට එකතු වී ශරීරය පුරා ගමන් ගන්නා අසාමාන්‍ය සෛල මුළු ශරීරය පුරාම තැන තැන අසාමාන්‍ය මස් ගුළි පැලපදියම් කරවන්නට පටන් ගනී. එසේ ඉස්මතු වන්නේද තමන්ගේම ශරීරයේම කොටස්ම වන නිසා ශරීරය ඊට කිසිදු විරුද්ධත්වයක් එල්ල කරන්නේද නැත.
වර්ධනය වන ඒ සියලු මස් ගුලිද තමන් අවට වපසරිය තව තවත් පීඩනයට ලක් කරමින් තමන්ගේ අසීමිත වර්ධනය එලෙසම පවත්වාගෙන යන්නට කටයුතු කරයි. එවැනි තත්ත්වයන් සුලබව හට ගන්නා අවයවයන් අතර මොළය, සුෂුම්නාව, අක්මාව, පෙනහළු ප්‍රධානය.
මේ වන විට සිදුවිය යුතු සියල්ල සිදු වී හමාරය. පැතිර ඇති තරමේ කොණක් මායිමක් හසුකර ගන්නට කොතරම් දක්ෂ වෛද්‍යවරයෙකුටවත් නොහැකිය. මුලින්ම හටගත් මස් ගුලිය එතනදීම හඳුනා ගත්තා නම් ශල්‍යකර්මයක් මගින් එය ඉවත් කර දමන්නට හැකියාව තිබිණ. එවිට සියල්ල එතනින් හමාරය.
මේ වන විට මුළු ශරීරයම ඩැහැගත් මස් ගුලි කොහෙන් පටන්ගෙන කොහෙන් ඉවර කර දමන්නද කරන්ට් ඇල්ලීම, ඉන්ජෙක්ෂන් ආදිය මගින් යම් පාලනයකට නතු කර ගත හැකි වුවද දිවි ගමන කොයි මොහොතේ නතර කර දමන්නට සිදුවේදැයි කිසිවෙකුට පැවැසිය නොහැකිය. සියලු බලා‍පොරොත්තු තම දෑස් ඉදිරියේදීම එකින් එක බිඳ වැටෙන අයුරු බලා සිටිනවා හැර මෙවන් රෝගියෙකුට වෙන කළ හැකි යමක් නැත. සිදුවන සියල්ල නවතා දිගටම ජීවත් වන්නට හැකියැයි ස්ථිරවම ප්‍රකාශ කරන්නට තරම් අපි තවම දියුණු නැත.
මෙවැනි අවාසනාවන්ත
තත්ත්වයකින් හැකි පමණ ගැලවෙන්නට නම්
* ශරීරයේ සියුම් වෙනස්කම් පිළිබඳව අවධානයෙන් පසුවන්න.
* වෛද්‍ය උපදෙස් වලට යොමු වන්න
* නිර්දේශ කරන වෛද්‍ය පරීක්ෂණ වලට ඉක්මනින් මුහුණ දෙන්න. FNAනමින් හැඳින්වෙන බයොප්සි පරීක්ෂණයේදී කාමරයක් වැනි ෙසෙලයක අකීකරු හැසිරීමක් මුලදීම හඳුනා ගන්නට දක්ෂ වෛද්‍යවරයෙකුට අපහසු නැත.
සමට ආසන්නයේ හටගෙන ඇති මෙවැනි මස් ගුලියක් හඳුනා ගන්නට සිදු කරන FNA පරීක්ෂණයේදී සම තුළින් ඇතුළු කරන අති සියුම් නූලක් අසාමාන්‍ය මස් ගුලිය පතුලටම කිඳා බස්සවනු ලබයි. අපි මුලින් සඳහන් කළ අති සියුම් කාමර කාමර ආකාර ගත් කුඩා ෙසෙල කිහිපයක් ඇතුළු කරන ලද එම සියුම් නූලට හසුකරගනු ලබයි.
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මතෛක් ඔබට ගැටලුවක් නොවන්නට ඇත. ගේ දොර ඉඩකඩම්, රැකියාව ආදායම් හැරුණු විට ඔබට පෙනෙන්නට වෙනත් ගැටලුවක් නොතිබෙන්නට ඇත. බොහෝ දුක් ගැහැට විඳ දෙපයින් නැගී සිටි ඔබව වට්ටවන්නට හැකි ජගතෙකු නැතැයි ඔබ උදම් අනනවාද ඇත. කිසිදු අනතුරු ඇඟවීමක් නැති ශරීරය පිළිබඳව උදේ සවස ඉර නැග බැස යන ආකාරයේ විශ්වාසයක්ද ඔබ තුළ පවතිනවා ඇත. ඒ සියලු විශ්වාස බලා‍පොරොත්තු අතරේ මේ වන විටත් ඔබේ ශරීරයේ කෙළවරක පෙර කී ආකාරයේ අසාමාන්‍ය සෛල වර්ධනයක් සිදු නොවෙමින් පවතිනවා යැයි කාට නම් කිව හැකිද?
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