ʻO ka mea e pono ai ʻoe e ʻike e pili ana i ke Kanesa Ampullary

Ua ʻike anei ʻoe i kēia mau lā aku nei ua melemele iki kou mau maka a me kou ʻili? A i ʻole, ua emi koke kou kaumaha me ke kumu ʻole? ʻOiai he mau mea maʻamau kēia a mākou e manaʻo ai i kekahi manawa ʻaʻole mākou e nānā nui, ʻo ia paha nā hōʻailona mua o kahi maʻi laha ʻole akā koʻikoʻi i kapa ʻia ʻo Ampullary Cancer. Mai makaʻu ke lohe ʻoe i kēia inoa. ʻO ka mea nui loa, ʻo ia ka ʻike piha ʻana i kekahi maʻi. No laila, i kēia lā e kamaʻilio mākou e pili ana i ke ʻano o ka Ampullary Cancer, pehea e ulu ai, he aha nā hōʻailona, ​​a me nā ʻano lapaʻau ma ke ʻano maʻalahi hiki iā ʻoe ke hoʻomaopopo.

He aha ke Kanesa Ampullary?

I mea e hoʻomaopopo ai i kēia, pono mua kākou e ʻike e pili ana i kahi ʻāpana liʻiliʻi o ko kākou kino. Loaʻa iā kākou ʻelua mau ʻōkana i loko o ko kākou kino i kapa ʻia ʻo ka pancreas a me ke akepaʻa. Hoʻopuka kēia mau mea ʻelua i nā wai kūikawā e kōkua iā kākou e hoʻoheheʻe i kā kākou meaʻai. E noʻonoʻo e hui pū ana kēia mau wai ʻelua a hiki i kahi hoʻokahi, e like me ke kihi kahi e hui ai nā alanui ʻelua. A laila mai laila mai, hui pū kēia mau wai a pau a komo i loko o ko kākou ʻōpū liʻiliʻi (duodenum).

I ka lāʻau lapaʻau, kapa mākou i ka puka liʻiliʻi kahi e hōʻiliʻili ai kēlā wai i ka ampulla o Vater .

No laila, i ka wā e hoʻomaka ai nā hunaola kanesa e ulu ma kēia wahi i kapa ʻia ʻo ka ampulla o Vater , kapa mākou iā ia he ampullary carcinoma . He ʻano kanesa ʻino loa kēia. Eia kekahi, no ka mea, kokoke loa ka wahi e ulu ai i nā kino koʻikoʻi e like me ke akepaʻa a me ka pancreas, he kiʻekiʻe ka manawa e laha ai ke kanesa i kēlā mau kino. No laila, ʻo ke ala maikaʻi loa e loaʻa ai nā hopena maikaʻi loa, ʻo ia ka wehe ʻana i kēia kanesa ma o ke ʻoki ʻana ma mua o ka laha ʻana.

Pehea ka maʻamau o kēia maʻi?

He maʻi kanesa laha ʻole kēia. ʻAʻole i hiki i ka 1% o nā maʻi kanesa āpau i loko o kā mākou ʻōnaehana hoʻoheheʻe (gastrointestinal tract) i hōʻike ʻia he maʻi kanesa ampullary. No laila, ʻaʻole kēia he maʻi e hoʻopilikia i nā mea āpau.

He aha nā hōʻailona? Pehea mākou e ʻike ai i kēia?

ʻO ka mea ʻokoʻa loa e pili ana i kēia maʻi kanesa, ʻo ia ka hōʻike ʻana i nā hōʻailona i nā pae mua. I waena o lākou, ʻo ka hōʻailona nui a maʻamau ka jaundice . ʻO ia hoʻi, e melemele nā ​​​​keʻokeʻo o nā maka a me ka ʻili.

Ma waho aʻe o kēia hōʻailona nui, aia kekahi mau hōʻailona ʻē aʻe e ʻike ʻia. E nānā kākou iā lākou ma ke ʻano maʻalahi e hoʻomaopopo.

No ke aha e ulu ai kēia ʻano maʻi kanesa?

ʻO kaʻoiaʻiʻo, ʻaʻole hiki i nā loea ke ʻōlelo pololei i ke kumu e ulu ai kēia maʻi kanesa ampullary. Akā ua ʻike mākou e ulu ana nā maʻi kanesa āpau i ka wā e loaʻa ai kahi loli (mutation) i loko o ka DNA e kāohi ana i ka ʻike genetic i loko o nā cell o ko mākou kino. Ma kēia ʻano, hoʻomaka nā cell maʻamau ʻole me nā loli DNA e māhele wikiwiki a me ka hoʻomalu ʻole ʻia. Hoʻokumu ʻia kahi puʻupuʻu kanesa i ka wā e ulu pū ai nā cell he nui me ka ʻole o ke kāohi.

Ke noiʻi nei nā loea i nā loli DNA e pili ana i kēia maʻi kanesa. Ma muli o kēlā ʻike, hiki ke loaʻa nā lāʻau lapaʻau ʻoi aku ka maikaʻi i ka wā e hiki mai ana.

Nā Kumu Pilikia

Aia kekahi mau kumu e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i kēia maʻi kanesa:

• Ma luna o 70 mau makahiki: Piʻi ka pilikia me ka makahiki.
• ʻO ke kāne: ʻOi aku ka maʻamau o kēia maʻi kanesa i nā kāne ma mua o nā wahine.
• Kekahi mau kūlana hoʻoilina: Hiki i kekahi mau kūlana hoʻoilina ke hoʻonui i ka pilikia o ka maʻi kanesa. No ka laʻana, nā kūlana e like me Familial Adenomatous Polyposis (FAP) a me Lynch syndrome.

Pehea e ʻike pololei ai ke kauka i kēia maʻi? (Diagnosis)

ʻO ka maʻamau, ke hele ke kanaka i ke kauka me nā maka melemele a me ka ʻili (jaundice), kū mai nā kānalua a hoʻomaka nā hoʻokolohua. Hana ʻia kekahi mau hoʻokolohua e hōʻoia i ka maʻi.

• Nā hoʻāʻo koko a me ka mimi: Nānā kēia i nā pae o nā kemika i loko o ke kino e pili ana me nā hunaola kanesa, i kapa ʻia he mau māka tumor.
• Nā Hoʻāʻo Kiʻi: Hoʻohana ʻia kēia mau mea e kiʻi i nā kiʻi o nā ʻōpū i loko o ke kino e nānā ai no ka maʻi ʻaʻai. Hoʻohana ʻia nā hoʻāʻo e like me ka `CT scan`, `Ultrasound scan` a me `MRCP` no kēia.
• Nā Hoʻāʻo Endoscopic: Pili kēia i ke komo ʻana i kahi ʻōmole lōʻihi a lahilahi (endoscope) me kahi kāmela i hoʻopili ʻia ma kou waha e nānā i ke kanesa. ʻO ka endoscopy kiʻekiʻe a me ka ERCP (Endoscopic Retrograde Cholangiopancreatography) ʻelua mau hoʻāʻo like. E hāʻawi ʻia ʻoe i ka anesthesia i ka wā o kēia mau hoʻāʻo, no laila ʻaʻole ʻoe e ʻeha.
• Biopsy:ʻO kēia wale nō ka hoʻāʻo e hiki ke hōʻoia 100% inā he maʻi kanesa ia. I ka wā o ka endoscopy, lawe ʻia kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai ka wahi kānalua a hoʻāʻo ʻia i loko o ka hale hana e hōʻoia inā he mau hunaola kanesa.

He aha ke kahua o ka maʻi kanesa?

Ke ʻike ʻia ka maʻi, e hoʻoholo ke kauka i ka mamao o ka laha ʻana o ke kanesa. Ua kapa ʻia kēia he staging. Hoʻoholo ʻia ka lāʻau lapaʻau ma muli o kēia pae. ʻOi aku ka maʻalahi o ka hoʻōla ʻia ʻana o ke kanesa i loaʻa i nā pae mua.

He mea nui loa e hoʻomaopopo pono i ke kahua o kou maʻi ʻaʻai a pehea e pili ai i kāu lāʻau lapaʻau ma ke nīnau ʻana i kāu kauka.

He aha nā lāʻau lapaʻau?

Aia kekahi mau koho lapaʻau no ka maʻi ʻaʻai ampullary.

• Ke Kaʻina Hana Whipple:ʻO kēia ke ʻoki kino maʻamau a maʻamau loa no kēia ʻano maʻi kanesa. He ʻoki kino nui a paʻakikī hoʻi ia. Ma kēia, ʻaʻole wale ke kanesa ponoʻī e wehe ʻia, akā, ʻo nā wahi a puni kahi i laha ai paha nā hunaola kanesa (ka ʻōpū palahēhē, kekahi hapa o ke auwai bile, kekahi hapa o ka ʻōpū liʻiliʻi, a me ke poʻo o ka pancreas).
• ʻO ke ʻoki kino Endoscopic: Inā aia ke kanesa i kahi pae mua loa, hiki i kekahi manawa ke wehe i ke kanesa me ka hoʻohana ʻana i kahi endoscope.
• Kemoterapi: ʻO kēia ka hāʻawi ʻana i ke kino i nā lāʻau ikaika e pepehi ai i nā hunaola kanesa. Hāʻawi ʻia kēia lāʻau lapaʻau e pepehi i nā hunaola kanesa i koe ma hope o ke ʻoki ʻana a i ʻole e kāohi i ka ulu ʻana o ke kanesa ke hiki ʻole ke ʻoki ʻia.
• Lapaʻau Radiation: ʻO kēia kahi e hoʻohana ʻia ai nā kukuna ikehu ikaika e luku i nā hunaola kanesa. I kekahi manawa hāʻawi ʻia kēia lāʻau lapaʻau me ka chemotherapy e hoʻēmi i ka puʻupuʻu ma mua o ke ʻoki ʻana a i ʻole e luku i nā hunaola i koe ma hope o ke ʻoki ʻana.
• Mālama Palliative: He lāʻau lapaʻau kēia e kālele ana i ka hōʻoluʻolu ʻana i nā hōʻailona ma mua o ka hoʻōla ʻana i ka maʻi. No ka laʻana, hiki ke kau ʻia kahi stent i loko o kahi ala bile i paʻa e wehe ai. Hiki i kēia ke kōkua i ka hōʻemi ʻana i nā hōʻailona e like me ka jaundice a me ka maneʻo, hiki ke hāʻawi i ka hōʻoluʻolu nui.

Hiki ke ho'ōla loa ʻia kēia maʻi kanesa?

ʻO ke ala wale nō e ho'ōla loa ai i kēia maʻi kanesa, ʻo ia ka wehe loa ʻana i ke kanesa ma o ke ʻoki kino. ʻOi aku ka maikaʻi o kēia ke loaʻa ka maʻi kanesa i kona wā mua.

I kekahi manawa, nalowale loa ke kanesa ma hope o ke ʻoki ʻana. Eia nō naʻe, hiki ke hoʻi hou ma hope o kekahi manawa (ka maʻi kanesa hou). No laila, ʻoiai ma hope o ke ʻoki ʻana, he mea nui loa ia e hoʻomau i ka hele ʻana i ke kauka no nā hoʻokolohua a me nā keʻena lapaʻau e like me ka mea i ʻōlelo ʻia. Kiʻekiʻe loa ka pilikia o ka hoʻi hou ʻana o ke kanesa i loko o nā makahiki ʻelima mua.

Aia kekahi ala e pale aku ai i kēia?

ʻO ka mea pōʻino, ʻo nā kumu pilikia (makahiki, genetics) e hoʻoulu ai i kēia maʻi kanesa ʻaʻole ia he mea hiki iā mākou ke kaohi. No laila, ʻaʻohe ala kikoʻī e pale aku ai. Eia nō naʻe, inā loaʻa iā ʻoe kahi maʻi genetic e like me FAP a i ʻole Lynch syndrome, hiki i kāu kauka ke ʻōlelo aku e hana ʻoe i nā hoʻokolohua maʻamau. Hiki i kēia ke kōkua i ka ʻike ʻana i ka maʻi kanesa i ka wā mua.

He mea maʻamau ka manaʻo kaumaha a me ka haʻalulu ke aʻo ʻoe e pili ana i ka maʻi kanesa. E kamaʻilio ākea me kāu kauka a me kou ʻohana e pili ana i kāu mau nīnau, makaʻu, a me nā kānalua. ʻO ka loaʻa ʻana o ka ʻike kūpono, ka lāʻau lapaʻau kūpono, a me ke kākoʻo naʻau e lilo ia i ikaika nui ma kēia huakaʻi.