Maopopo iaʻu ke kaumaha a me ka weliweli paha ke ʻike ʻia ʻoe he maʻi ʻaʻai umauma. Ma kekahi ʻaoʻao, aia ka hopohopo e pili ana i ka maʻi, a ma kekahi ʻaoʻao, ke ʻōlelo nā kauka i nā huaʻōlelo e like me (Chemotherapy) a me ka hormone therapy , e huikau loa kou manaʻo, ʻeā? "E loaʻa pū anei iaʻu ka chemo? E hāʻule anei koʻu lauoho? E paʻakikī anei ia no koʻu kino?" He nui kāu mau nīnau i loko o kou manaʻo. Akā, mai hopohopo. I kēia lā, e kamaʻilio mākou e pili ana i ke ʻano o kou makahiki a inā ua hala ʻoe i ka menopause a i ʻole e lilo i mea nui i ka hoʻoholo ʻana i ka lāʻau e hāʻawi ʻia iā ʻoe.
I ka wā ma mua, ua hāʻawi ʻia ka chemotherapy i ka hapa nui o nā kānaka i ka wā i ʻike ai lākou ua laha ka maʻi ʻaʻai umauma i nā lymph nodes. Ua like ia me ka paʻa ʻana i ka hāmare a hoʻohālike i nā mea āpau me he kui lā. Akā i kēia manawa ua holomua nui ka lāʻau lapaʻau. I kēia manawa ua ʻike mākou ʻaʻole like nā maʻi ʻaʻai umauma āpau, a ʻaʻole e pane like nā maʻi āpau i ka lāʻau like. I kekahi manawa hiki i nā hopena ʻaoʻao o ka chemotherapy ke ʻoi aku ma mua o nā pono. No laila, i kēia manawa, ʻoi aku ka hopohopo o nā kauka ʻaʻole wale i ka nui o ka puʻupuʻu a me ke kahua o ke kanesa, akā, i ke ʻano olaola o ke kanesa.
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No ke aha he mea nui ka menopause i kēia moʻolelo?
Inā paha ua hala ʻoe i ka menopause, ʻo ka manawa e pau mau ai kou mau wā mahina, he mea nui loa ia i ka mālama ʻana i ka maʻi ʻaʻai umauma. Nui nā kumu no kēia.
I ka ʻōlelo maʻalahi, ʻoi aku ka nui o ka huhū o ka maʻi kanesa o ka umauma i nā wahine ʻōpio, premenopausal ma mua o ke kanesa i nā wahine postmenopausal .
Eia kekahi, hoʻoholo pū ia i ke ʻano o ka lāʻau lapaʻau āu e loaʻa ai. No ka laʻana, inā he maʻi kanesa kou e pili ana i ka hormone, ʻokoʻa ke ʻano o ka lāʻau lapaʻau hormone hiki iā ʻoe ke loaʻa ma muli o kou kūlana menopausal.
- Postmenopausal: Hiki ke hāʻawi ʻia iā ʻoe kahi lāʻau lapaʻau e like me Arimidex, kahi e hoʻōki ai i ke kino mai ka hana ʻana i ka hormone estrogen.
- Inā ʻoe ma mua o ka menopause: Ke hana mau nei kāu mau ovaries i ka estrogen, no laila ʻaʻole e maikaʻi loa nā lāʻau lapaʻau e like me Arimidex. No laila e kuhikuhi pinepine kāu kauka i kahi lāʻau i kapa ʻia ʻo Tamoxifen. Hana kēia ma ke ālai ʻana i ka leka a ka estrogen e hoʻouna ai i nā hunaola kanesa.
Maopopo iā ʻoe? Ma muli o ke ʻano o ka loli ʻana o ka hana hormonal o kou kino, pono e loli pū nā lāʻau lapaʻau e hakakā nei i ka maʻi kanesa.
ʻO ke olaola o ke kanesa: Nā mea hoʻokipa hormone a me HER2
ʻAe, e ʻeli hohonu kākou. Ke waiho nei i ka ʻaoʻao inā kūpono ka lāʻau lapaʻau hormone iā ʻoe, ʻo ka nīnau nui aʻe inā pono ʻoe i ka chemotherapy.
Hoʻokumu pinepine ʻia kēia hoʻoholo ma nā ʻano o nā mea loaʻa ma ka ʻili o kāu mau hunaola kanesa . E noʻonoʻo i kēia mau mea loaʻa e like me nā 'antennas' ma nā hunaola kanesa. ʻOhi kēia mau antennas i nā 'hōʻailona' e pono ai ke kanesa e ulu. ʻElua ʻano nui o nā mea loaʻa a mākou e nānā nei.
1. Nā Mea Loaʻa Hormone (HR): Nā mea loaʻa i pili i nā hormones estrogen a me progesterone.
2. Mea hoʻokipa HER2: ʻO kēia kekahi protein e kōkua i ka ulu ʻana o nā hunaola kanesa.
E nānā i ka papa ma lalo no ke ʻano o ka hoʻokaʻawale ʻana i nā maʻi kanesa a me ka hoʻoholo ʻana o ka lāʻau lapaʻau ma muli o ka hui pū ʻana o kēia mau mea.
| ʻAno maʻi kanesa (ma muli o ka pane) | ʻO ke ʻano a me ka hoʻolālā lapaʻau maʻamau |
|---|---|
| HR-maikaʻi, HER2-maikaʻi ʻole | ʻIke ʻole i ka hormone, akā ʻaʻole ʻike i ka HER2. Hana maikaʻi ka lāʻau lapaʻau hormonal. He paʻakikī ka hoʻoholo ʻana inā pono ka chemotherapy a ʻaʻole paha. He mea nui loa ke kūlana menopause ma aneʻi. |
| HR-maikaʻi, HER2-maikaʻi | Pilikia i nā hormones a me HER2. ʻO ka hui pū ʻana o ka lāʻau hormonal a me ka lāʻau i kuhikuhi ʻia i ka HER2 hiki ke hāʻawi i nā hopena maikaʻi. Hiki ke pale pinepine ʻia ka chemotherapy ʻino. |
| HR-maikaʻi ʻole, HER2-maikaʻi | ʻAʻole i maʻalahi i nā hormones, akā i maʻalahi i ka HER2. Pono ka chemotherapy me ka lāʻau lapaʻau i hoʻopaʻa ʻia no ka HER2. |
| ʻEkolu-ʻAʻole | ʻAʻole i loaʻa nā mea loaʻa hormone a me ka mea loaʻa HER2, ʻo ia mau mea ʻekolu. No laila, ʻaʻole pono ka lāʻau hormone a me ka lāʻau i hoʻolālā ʻia no HER2. Pono pinepine ka chemotherapy. |
He aha ka hoʻāʻo Oncotype Dx?
Inā he HR-positive kou maʻi ʻaʻai, HER2-negative, ʻo ia hoʻi, ke ʻano mua ma ka papa ma luna, ʻo ka nīnau "Pono anei au i ka chemo?" ka mea paʻakikī loa e pane. I nā hihia e like me kēia e hoʻohana ai nā kauka i kahi hoʻāʻo genomic e like me Oncotype Dx .
Hoʻopili kēia hoʻāʻo i 21 mau genes i loko o kahi hāpana liʻiliʻi o kou maʻi kanesa. Ma muli o kēia, hāʻawi ia iā ʻoe i kahi helu e hōʻike ana inā he haʻahaʻa, waena, a kiʻekiʻe paha ka pilikia o ka hoʻi hou ʻana o kāu maʻi kanesa i ka wā e hiki mai ana.
- Ka helu haʻahaʻa: Hiki iā ʻoe ke hoʻomaikaʻi pinepine me ka ʻole o ka chemotherapy .
- Inā kiʻekiʻe ka helu: ʻO ka chemotherapy ka mea kūpono loa.
Akā loaʻa i ka nui o ka poʻe kahi helu waena . ʻO ia kahi e kū hou ai ka pilikia.
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ʻO ka mea pōmaikaʻi, ua hāʻawi mai ʻelua mau noiʻi nui i hala koke aku nei, ʻo TAILORx lāua ʻo RxPONDER, i nā pane maikaʻi loa i ka nīnau no ka mea e hana ai me kēia mau wahine me ke kūlana kaulike. Ua hōʻoia hou kēia mau noiʻi i ke koʻikoʻi o ka menopause.
- Hoʻokolohua TAILORx (no ka poʻe i laha ʻole ko lākou kanesa i nā lymph nodes):
- Hōʻike maopopo kēia haʻawina ʻaʻole loaʻa i nā wahine postmenopausal me nā helu Oncotype Dx kaulike kekahi pono hou aʻe mai ka chemotherapy. Ua lawa ka lāʻau lapaʻau hormone wale nō no lākou.
- Haʻawina RxPONDER (no ka poʻe me ka maʻi kanesa i pālahalaha i nā lymph nodes):
- Hōʻike pū kēia i ka mea like. ʻO ka hapa nui o nā wahine postmenopausal , ʻoiai inā ua pālahalaha ke kanesa i nā lymph nodes, ʻaʻole lākou e pōmaikaʻi nui mai ka chemotherapy.
- Eia nō naʻe, ʻokoʻa loa ka moʻolelo no nā wahine premenopausal, ʻoi aku hoʻi ka poʻe ma lalo o 50 mau makahiki. Ke hoʻohui ʻia ka chemotherapy i ka hormone therapy no lākou, ua hoʻonui nui ʻia ka hiki ke pale i ka maʻi kanesa mai ka hoʻi hou ʻana mai.
I ka ʻōlelo maʻalahi, inā he wahine ʻōpio ʻoe i premenopausal, hiki i ka chemotherapy ke lilo i mea kaua ikaika e hiki ai ke hoʻopakele i kou ola. Akā inā ʻoe ma hope o ka menopause, hiki paha iā ʻoe ke loaʻa nā hopena maikaʻi me ka lāʻau lapaʻau hormone me ka ʻike ʻole i kona mau hopena ʻaoʻao.
ʻO ka hoʻoholo hope loa a me nā mea e noʻonoʻo ai
Me kēia mau mea a pau, maopopo paha iā ʻoe ke paʻakikī o ka hana ʻana i kēia mau hoʻoholo hoʻokahi. ʻO ia ke kumu he mea nui e kamaʻilio ākea e pili ana i kēia mau mea a pau me kāu kauka.
Inā ʻoe ma mua o ka menopause, ʻoiai i kou mau makahiki 40 mua, aia kekahi mea e hoʻomanaʻo ai. Hiki i ka chemotherapy ke hoʻōki mau i kou mau wā a hoʻopau i ka menopause mua. No ka poʻe ʻōpiopio, hiki i kou mau wā ke hoʻōki no kekahi manawa a laila hoʻomaka hou. Akā inā ʻoe e manaʻolana e loaʻa nā keiki i ka wā e hiki mai ana, e kamaʻilio me kāu kauka e pili ana i ka mālama ʻana i ka momona ma mua o ka hoʻomaka ʻana i ka lāʻau.
I ka hopena, na ʻoe a me kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe. I loko o kēlā kūkākūkā ʻana, ʻo kou ʻano maʻi kanesa, ke kahua, ka helu Oncotype Dx, a inā paha he postmenopausal ʻoe he mau kumuhana nui ia e kūkākūkā ʻia.
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- ʻAʻole like nā maʻi ʻaʻai umauma a pau, no laila ʻaʻole kūpono ka lāʻau like no nā kānaka a pau.
- Inā paha ua hala ʻoe i ka menopause a i ʻole ʻaʻole paha, e hoʻololi nui ia i ka lāʻau āu e loaʻa ai, ʻoiai ka chemotherapy a me ka hormone therapy.
- Hiki i nā hoʻokolohua genetic e like me Oncotype Dx ke kōkua i nā wahine me nā maʻi ʻaʻai HR-positive, HER2-negative e hoʻoholo inā pono ka chemotherapy.
- Hōʻike nā noiʻi hou nei ʻaʻole loaʻa pinepine i nā wahine postmenopausal kekahi pōmaikaʻi hou aʻe mai ka chemotherapy, akā hiki ke lilo i mea maikaʻi loa no nā wahine premenopausal.
- E wehe a ʻoiaʻiʻo me kāu kauka e pili ana i kāu hoʻolālā lapaʻau. E akaka e pili ana i kou mau makahiki, ke kūlana menopausal, a me nā hoʻolālā e hiki mai ana (e like me ka loaʻa ʻana o nā keiki).
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