Ke ʻike nei ʻoe i kekahi manawa i ka maneʻo mau a puni ka anus, a i ʻole ke koko iki i kou wā e kahe ai? He mea hilahila maoli ke kamaʻilio e pili ana i kēia mau mea me kekahi, ʻeā? Akā, ʻaʻole paha he mau mea maʻalahi a liʻiliʻi kēia. I kēia lā, e kamaʻilio kākou e pili ana i kahi maʻi i kapa ʻia ʻo ka maʻi ʻaʻai anal. He mea kēia e pono ai kākou a pau e makaʻala.
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He aha ke kanesa anal?
I ka ʻōlelo maʻalahi, ʻo ke kanesa anal ka maʻi kanesa e ulu ana i loko o nā ʻiʻo o kou anus, a i ʻole ka uhi o kou kahawai anal. ʻIke ʻoe, ʻo ke kahawai anal ka paipu e hoʻopili ai i kou anus (ka puka kahi e puka mai ai nā ʻōpala) i kou rectum (ka ʻāpana haʻahaʻa loa o kāu ʻōnaehana hoʻoheheʻe). I ka pololei, haʻalele kāu ʻōpala i kou kino ma o kēia paipu. ʻO ka mea maikaʻi loa, inā ʻike ʻia kēia kanesa a mālama ʻia i ka wā mua, hiki ke ho'ōla loa ʻia.
Aia kekahi mau ʻano maʻi ʻaʻai rectal?
ʻAe, ʻelua ʻano nui o ke kanesa rectal.
- ʻO ka Squamous Cell Carcinoma: ʻO kēia ke ʻano maʻamau o ka maʻi ʻaʻai rectal. Eia nō naʻe, he ʻokoʻa ia mai ka maʻi ʻaʻai ʻili, kahi e ulu ana ma ka papa luna o ka ʻili.
- Adenocarcinoma: ʻO kēia kekahi ʻano ʻē aʻe.
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ʻAʻole, ʻaʻole maʻamau ka maʻi ʻaʻai rectal. E noʻonoʻo i kēia: Wahi a ka American Cancer Society, ma kahi o 9,000 mau kānaka ma ʻAmelika Hui Pū ʻIa e ʻike ʻia me ka maʻi i ka makahiki 2023. (Pono kēia me ke kanesa rectal, ke kanesa anorectal, a me ke kanesa anal.) Eia nō naʻe, manaʻo lākou he 153,000 mau kānaka i ʻike ʻia me ke kanesa colon. No laila hiki iā ʻoe ke ʻike he haʻahaʻa kēia.
He aha nā hōʻailona o kēia?
Hiki i nā hōʻailona o ke kanesa rectal ke like me nā kūlana maʻamau i kekahi manawa. Eia kekahi laʻana, ka ʻūlū mau ʻana i loko o ka anus. Hiki i nā hōʻailona ʻē aʻe ke komo pū me:
- Ke kahe ʻana o ke koko mai ka rectum , ʻoiai i ka wā o ka neʻe ʻana o ka ʻōpū.
- Ke manaʻo nei i kahi mea e like me kahi puʻupuʻu a i ʻole kahi puʻupuʻu ʻiʻo. (Hiki ke ʻike ʻia kēia ʻano puʻupuʻu kokoke i ka puka anal.)
- ʻEha.
- Nā loli i nā ʻano hana ʻōpū. ʻO ia hoʻi, nā loli i ke alapine (pinepine) o ka neʻe ʻana o ka ʻōpū, a i ʻole ke kūlike (mānoanoa) o nā ʻōpala.
- Nā neʻe ʻana o ka ʻōpū i kāohi ʻole ʻia.
- He manaʻo mau o ka pono e hoʻokahe i ka ʻōpū (ua kapa ʻia kēia ʻo "Tenesmus" ma ka ʻōlelo lapaʻau).
ʻO ka mea nui, ʻoiai inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ʻaʻole ia he manaʻo he maʻi ʻaʻai rectal kou. Nui nā kumu ʻē aʻe no kēia mau hōʻailona. Eia nō naʻe, inā ʻaʻole e emi kēia mau hōʻailona i loko o kekahi mau lā a i ʻole e lilo i mea ʻoi aku ka koʻikoʻi, he mea nui e ʻike i ke kauka no ka ʻōlelo aʻo.
He mea maʻamau ke hilahila iki a hilahila paha e kamaʻilio me kāu kauka e pili ana i kekahi mau hōʻailona, e like me ka ʻānai anal. Akā e hoʻomanaʻo, he nui nā kumu like ʻole o ka maʻi ʻaʻai anal. No laila, ʻaʻohe kumu e hilahila ai no ka loaʻa ʻana o kēia mau hōʻailona. Eia kāu mau kauka e kōkua iā ʻoe me kāu mau pilikia olakino āpau, me kēia mau hōʻailona o ka maʻi ʻaʻai anal.
He aha ke kumu o kēia? He aha nā kumu pilikia?
ʻAʻole ʻike ʻia ke kumu kikoʻī o ka maʻi ʻaʻai anal. Eia nō naʻe, ua ʻike ʻia kekahi mau mea pilikia e pili ana i ka maʻi. No ka laʻana, ʻo ka hapa nui o nā maʻi ʻaʻai anal e pili ana i ka maʻi me kekahi mau ʻano o ka papillomavirus kanaka (HPV) . Eia naʻe, ʻo ka mea nui, ʻaʻole e loaʻa i nā mea āpau i loaʻa i ka HPV ka maʻi ʻaʻai anal.
Ma waho aʻe o ka HPV, aia kekahi mau kumu ʻē aʻe e hiki ke hoʻonui i kou pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai anal:
- Ka hoʻohana ʻana i nā immunosuppressants. ʻO kēia nā lāʻau lapaʻau e pale ai i kāu ʻōnaehana pale mai ka hōʻino ʻana i nā cell olakino.
- Loaʻa i ka maʻi HIV (Human Immunodeficiency Virus). Ma muli o ka hoʻopilikia ʻana o ka HIV i kou ʻōnaehana pale a hiki i ka moekolohe anal pale ʻole ke hoʻoili i ka maʻi HIV, piʻi ka pilikia o ka maʻi ʻaʻai anal.
- ʻO ka lilo ʻana i hoa loaʻa i ka wā o ka moe anal. He mea maʻamau kēia i nā mea āpau, me ka nānā ʻole i ke kāne a me ka wahine. ʻO ka loaʻa ʻana o nā hoa he nui no kēlā me kēia ʻano pilina moekolohe e hoʻonui i ka pilikia o ka HPV, a no laila ka pilikia o ka maʻi ʻaʻai anal.
- ʻAʻole i loaʻa ka lāʻau pale no ka HPV. ʻO kekahi mau ʻano HPV kekahi kumu nui o ka maʻi ʻaʻai anal.
- He 55 makahiki a ʻoi paha. ʻO ka maʻamau, ʻike pinepine nā kauka i ka maʻi ʻaʻai rectal i nā poʻe o kēia hui makahiki.
- Puhipaka. ʻOi aku ka nui o ka poʻe puhipaka i ka loaʻa ʻana o nā ʻano maʻi kanesa āpau.
- Loaʻa i kahi maʻi a i ʻole ka lawe ʻana i nā lāʻau lapaʻau e hoʻonāwaliwali i ka ʻōnaehana pale. No ka laʻana, pono paha ka poʻe i loaʻa i kahi hoʻoili kino e lawe i nā lāʻau lapaʻau e pale aku i ka hōʻole ʻia ʻana o ke kino i hoʻoili ʻia.
- Loaʻa kahi puka kūpono ʻole ('Anal Fistula') e holo ana mai ka rectum a i ka ʻili a puni ka anus.
- Loaʻa nā maʻi ʻaʻai ʻē aʻe. Eia kekahi laʻana, ka maʻi ʻaʻai vulvar, ka maʻi ʻaʻai vaginal, a i ʻole ka maʻi ʻaʻai cervical.
He aha ka mea e hana ʻia inā ʻaʻole hāʻawi ʻia ka lāʻau lapaʻau? (Nā pilikia)
Inā ʻaʻole i mālama pono ʻia, hiki i ke kanesa rectal ke laha i nā ʻiʻo kokoke (ua kapa ʻia kēia he "metastasize"). I kekahi manawa, hiki nō hoʻi ke laha i kou mau māmā a i ʻole ke akepaʻa.
Pehea ʻoe e ʻike ai i kēia?
E nīnau aku ke kauka iā ʻoe e pili ana i kāu mau hōʻailona, pehea ka lōʻihi o ko lākou ʻike ʻana, kou mōʻaukala olakino, me nā kūlana e hoʻopilikia ai i kāu ʻōnaehana pale, a hiki paha ke nīnau e pili ana i kāu hana moekolohe.
He aha nā hoʻokolohua e hana ʻia e ʻike ai i kēia maʻi?
E hana kāu kauka i kahi hoʻokolokolo rectal digital . A laila, e lawe lākou i nā cell a hoʻouna iā lākou i kahi pathologist e nānā iā lākou ma lalo o kahi microscope. E hana lākou i kahi hoʻāʻo Pap anal a i ʻole biopsy . (No nā wahine, hiki iā lākou ke hana i kahi hoʻokolokolo pelvic.) Eia kekahi, e hana kāu kauka i nā hoʻokolohua endoscopic a me nā hoʻokolohua kiʻi .
Nā hoʻāʻo Endoscopy
Hoʻohana nā kauka i ka endoscopy e nānā i loko o kou rectum a me kou anus. Hana ʻia kēia mau hoʻokolohua me ka hoʻohana ʻana i nā mea hana kūikawā. He mau ʻōmole lahilahi a palupalu kēia me ke kukui, ka lens, a me ke kāmela wikiō. I loko o kēia manawa, hiki ke lawe ʻia nā hāpana ʻiʻo (i kapa ʻia ʻo 'biopsies') a nānā ʻia e kahi pathologist. ʻO nā hoʻokolohua Endoscopy:
- ʻAnoscopy: Hoʻohana nā kauka i kahi ʻōmole pōkole a hoʻomālamalama ʻia i kapa ʻia he anoscope e nānā i kou anus a me ka rectum haʻahaʻa.
- Sigmoidoscopy Flexible: Nānā i kou rectum a me kou anus no nā ulu ʻana o ke kanesa a me nā polyps.
- Colonoscopy: Nānā ʻia kou kolona holoʻokoʻa no nā ulu ʻana o ka maʻi ʻaʻai a me nā polyp.
Nā Hoʻāʻo Kiʻi
Hiki i nā hoʻokolohua kiʻi ke kōkua i nā kauka e aʻo hou aʻe e pili ana i nā puʻupuʻu kanesa, e like me ko lākou nui a me kahi kikoʻī. Hiki i kēia mau hoʻokolohua ke komo pū me:
- Ke nānā ʻana i ke kiʻi Magnetic Resonance Imaging (MRI).
- ʻO ke kani ultrasound transrectal.
- ʻO ke kiʻikuhi Computed Tomography (CT).
- Ke nānā ʻana o ka Positron Emission Tomography (PET).
Ka Hoʻonohonoho ʻana o ke Kanesa Anal
Hoʻohana nā kauka i nā ʻōnaehana hoʻonohonoho ʻana i ke kanesa e hoʻolālā i ka lāʻau lapaʻau a hāʻawi i kahi wānana, ʻo ia hoʻi, ka mea hiki iā ʻoe ke manaʻo ma hope o ka lāʻau lapaʻau. Noʻonoʻo lākou i nā mea e like me ka nui o ka puʻupuʻu, inā paha aia ke kanesa i loko o nā lymph nodes, a inā ua laha ka puʻupuʻu (metastasized). ʻElima mau pae o ke kanesa rectal:
- Pae 0:
Aia nā pūnaewele ʻē i loko o ka membrane mucous (mucosal lining) o kou rectum. ʻAʻole kēia mau pūnaewele ʻē he maʻi kanesa, akā hiki iā lākou ke lilo i maʻi kanesa. Ua kapa ʻia hoʻi ka maʻi kanesa rectal Stage 0 he high-grade squamous intraepithelial lesion (HSIL) .
- Pae I:
Ua hōʻuluʻulu ʻia nā hunaola kanesa e hana i kahi puʻu he 2 kenimika a emi mai paha, e like me ka nui o ka pīnati.
- Pae II:
Ua māhele ʻia ke kanesa rectal Stage II i ʻelua ʻāpana:
- ʻO ke kahua IIA ʻo ia hoʻi he puʻupuʻu i ʻoi aku ka nui ma mua o 2 kenimika akā ʻoi aku ka liʻiliʻi ma mua o 5 kenimika.
- ʻO ke kahua IIB ʻo ia hoʻi he 5 kenimika ka nui o ka puʻupuʻu - ua like ia me ka nui o ka lemona - akā ʻaʻole i pālahalaha ma waho o kou anus.
- Pae III:
Ua māhele ʻia ka Māhele III i ʻekolu ʻāpana:
- Pae IIIA: He 5 kenimika a liʻiliʻi paha ka puʻupuʻu, a ua pālahalaha aku i nā lymph nodes i loko o kou anus a i ʻole ka ʻūhā.
- Pae IIIB: Ua pālahalaha ke kanesa rectal i nā ʻōpū kokoke, e like me kou vagina, urethra, a i ʻole ka ʻōpū mimi.
- Pae IIIC: Aia ke kanesa ma nā ʻōpū kokoke, a ua pālahalaha i nā lymph node kokoke i kou anus a i ʻole ka ʻūhā.
- Pae IV:
Aia ke kanesa i loko o nā lymph nodes mamao loa mai kou anus a ma nā ʻōpū mamao e like me kou māmā a i ʻole ke akepaʻa.
Pehea e mālama ʻia ai ke kanesa rectal?
ʻO ke ʻano o ka mālama ʻana no ke kanesa rectal e pili ana i ke ʻano a me ke kahua o ke kanesa, akā hiki ke komo pū me:
Hoʻōla Pāhawewe
Hoʻōla nā kauka i ke kanesa rectal me ka radiation therapy beam external (EBRT). Aia kekahi mau ʻano EBRT:
- Intensity-Modulated Radiation Therapy (IMRT): Hoʻohana kēia i nā kukuna he nui o nā ikaika like ʻole e kuhikuhi i ka puʻupuʻu.
- ʻO ka Lapaʻau Radiation Kino Stereotactic (SBRT): Hoʻopili kēia i nā ʻōpū liʻiliʻi me ka ʻole o ka hōʻino ʻana i nā ʻiʻo olakino kokoke.
- ʻO ka Lapaʻau Radiation Conformal ʻEkolu-Dimensional (3D-CRT): Hoʻokumu kēia i kahi kiʻi ʻekolu-dimensional o ka puʻupuʻu.
- Brachytherapy: He radiation therapy kūloko kēia.
Kemoterapia
Hoʻohana pinepine nā kauka i ka chemotherapy a me ka radiation therapy ma ke ʻano he lāʻau lapaʻau mua no ka maʻi ʻaʻai rectal. Hiki i kēia lāʻau lapaʻau i hui pū ʻia ke hoʻopau pinepine i ka maʻi ʻaʻai rectal, no laila ʻaʻole pono ʻoe i ke ʻoki ʻana.
Eia nō naʻe, inā pono ʻoe i ke ʻoki ʻana, hiki ke hāʻawi ʻia iā ʻoe ka chemotherapy ma mua o ke ʻoki ʻana e hoʻēmi i ka puʻupuʻu (Neoadjuvant Chemotherapy), a i ʻole ma hope o ke ʻoki ʻana e luku i nā hunaola kanesa i koe (Adjuvant Chemotherapy).
ʻoki kino
E mālama i ke kanesa rectal i hoʻi hou mai a i ʻole ʻaʻole i pane i ka radiation therapy a/a i ʻole chemotherapy.Hoʻohana ʻia kahi ʻoki kino minimally invasive i kapa ʻia ʻo laparoscopic abdominoperineal resection. Pili kēia i ka wehe ʻana i kou anus, rectum, a me kahi ʻāpana o kou colon.
Inā loaʻa iā ʻoe kēia ʻoki kino, e hana pū kāu kauka ʻoki i kahi colostomy mau loa. ʻO ke ʻano kēia e hele ana kāu ʻōpala ma o kahi ʻeke a ʻeke paha i hoʻopili ʻia i kou kino. ʻOiai he mea paʻakikī iki kēia, ʻaʻole ʻoe hoʻokahi. E kōkua kāu hui lapaʻau iā ʻoe e maʻa iā ia.
Hoʻōla lāʻau pale
Inā loaʻa iā ʻoe ka maʻi ʻaʻai rectal holomua, hiki i kāu kauka ke ʻōlelo aku i ka immunotherapy e kōkua i ka mālama ʻana i kāu mau hōʻailona. Kōkua kēia lāʻau i kou kino e hakakā i ke kanesa.
He aha nā hopena ʻaoʻao o ka lāʻau lapaʻau?
Hiki i nā lāʻau lapaʻau he nui ke hana i nā hopena ʻaoʻao. No ka laʻana, hiki i nā hopena ʻaoʻao o ka chemotherapy a me ka radiation therapy ke komo pū me nā ʻulaʻula ʻili, ka ʻeha ma ka ʻāpana anal, ka luhi, ka noe lolo i hoʻokumu ʻia e ka chemotherapy, ka nausea, a me ka luaʻi.
He aha nā pilikia o ka mālama ʻana?
Hiki i nā kauka ke mālama i ka maʻi ʻaʻai rectal me ke ʻoki ʻana. Hiki i nā pilikia o ke ʻoki ʻana ke komo pū me:
- He hopena i ka anesthesia.
- Ke kahe koko nui ʻana.
- He maʻi.
He aha nā helu ola no ka maʻi ʻaʻai rectal?
ʻO ka helu ola no ka maʻi ʻaʻai rectal he kuhi ia o ka pakeneka o ka poʻe e ola ana i ʻelima mau makahiki ma hope o ka ʻike ʻia ʻana. ʻOkoʻa kēia helu ma muli o ka ʻike ʻia ʻana o ka maʻi a me ka mālama ʻia ʻana ma mua o kona laha ʻana. Ma ke ʻano holoʻokoʻa, e like me ka National Cancer Institute, 70% o ka poʻe me ka maʻi ʻaʻai rectal e ola ana i ʻelima mau makahiki ma hope o ka ʻike ʻia ʻana.
Eia nō naʻe, he mea nui e hoʻomanaʻo e pili ana kēia mau ʻano hoʻōla hou ʻana i nā ʻike o kahi hui nui o ka poʻe me nā pilikia olakino like ʻole. ʻO ka mea ʻoiaʻiʻo no lākou ʻaʻole paha ia he ʻoiaʻiʻo nou. Inā he mau nīnau kāu, e noi i kāu kauka e wehewehe i ka mea hiki iā ʻoe ke manaʻo.
Pehea ʻoe e pale aku ai i kēia? (Kāohi ʻana)
ʻAʻohe ala i hōʻoia ʻia e pale aku ai i ka maʻi ʻaʻai rectal. Eia nō naʻe, hiki iā ʻoe ke hōʻemi i kou pilikia o ka loaʻa ʻana ma o ka hahai ʻana i kēia mau ʻanuʻu:
- Mai puhi paka. Inā ʻoe e puhi paka, e ʻimi i nā ala e kōkua iā ʻoe e haʻalele. Hiki i kāu kauka ke kōkua iā ʻoe.
- E hoʻomaʻamaʻa i ka moekolohe palekana. Inā moe kolohe ʻoe, e hōʻoia e hoʻohana ʻoe i ka condom.
- Inā kūpono ʻoe, e kiʻi i ka lāʻau pale Human Papillomavirus (HPV). Hiki i kēia lāʻau pale ke pale aku ʻaʻole wale i ke kanesa anal, akā, i ke kanesa waha a me ka ʻāʻī, ke kanesa cervical, a me ke kanesa penile.
Āhea ʻoe e ʻike ai i ke kauka?
Inā ʻoe e mālama ʻia no ka maʻi ʻaʻai rectal, pono ʻoe e hele i nā manawa a kāu kauka i nā lā i hoʻonohonoho ʻia a hoʻokaʻaʻike aku iā lākou e like me ke kuhikuhi ʻana. No ka laʻana, hiki i kāu kauka ke haʻi aku iā ʻoe e kelepona inā loaʻa iā ʻoe kekahi ʻeha a kuni paha.
I kekahi manawa, ʻo ka mālama ʻana no ka maʻi ʻaʻai rectal e pili ana i ka wehe ʻana i nā ʻāpana o kāu ʻōnaehana hoʻoheheʻe a me ka hana ʻana i kahi colostomy mau loa (kahi ʻano hana ʻoki) e ʻae i ka ʻōpala e hele. Hiki ke paʻakikī ke noho me kahi colostomy mau loa. Akā, ʻaʻole ʻoe hoʻokahi. Hiki i kāu hui lapaʻau ke kōkua iā ʻoe e hoʻokele i kāu neʻe ʻana o ka ʻōpū a hoʻomaʻamaʻa i ke ola ʻana i kahi ola piha a maʻamau ma hope o ke ʻoki ʻana i ka maʻi ʻaʻai rectal.
He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?
Inā loaʻa iā ʻoe ka maʻi ʻaʻai rectal, makemake paha ʻoe e nīnau i kāu kauka i kēia mau nīnau:
- He aha ke ʻano o ka maʻi ʻaʻai rectal i loaʻa iaʻu?
- He aha ke kahua o koʻu maʻi kanesa?
- He aha nā koho lapaʻau e loaʻa iaʻu?
- Inā pono iaʻu ke ʻoki kino, he aha ke ʻano o ke ʻoki kino āu e ʻōlelo aku ai?
He aha ka ʻokoʻa ma waena o ka maʻi kanesa anal a me ka dysplasia anal?
ʻO ka ʻokoʻa, ʻaʻole ka anal dysplasia he maʻi kanesa, akā hiki iā ia ke alakaʻi i ka maʻi kanesa anal. I ka anal dysplasia, lilo nā pūnaewele i mea ʻē. I ka hala ʻana o ka manawa, hiki i kēia mau pūnaewele ʻē ke hoʻomaka e hoʻonui a hana i nā puʻupuʻu kanesa.
Pehea ka ʻokoʻa o ke kanesa rectal mai ke kanesa rectal a me ke kanesa colon?
ʻO kou anus, rectum, a me ka colon nā ʻāpana a pau o kāu ʻōnaehana hoʻoheheʻe. Akā, ʻokoʻa loa nā pūnaewele e hana ana i nā ʻiʻo ma kēlā me kēia ʻāpana. ʻO ia hoʻi, mālama nā kauka i kēia mau maʻi kanesa ma nā ʻano like ʻole.
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)
ʻO ke kanesa anal kahi maʻi kanesa e ulu ana i loko o kou anus - ka ʻāpana o kou kino āu e holoi ai ma hope o ka neʻe ʻana o ka ʻōpū. ʻO nā hōʻailona maʻamau ka kahe koko mai ka anus a i ʻole ka maneʻo. Hiki i kēia mau mea ke hoʻokaʻulua iā ʻoe e kamaʻilio me kāu kauka e pili ana i kēia mau mea. Eia nō naʻe, ʻoi aku ka maʻalahi o ka mālama ʻana i ke kanesa anal inā ʻike ʻia a mālama ʻia i ka wā mua, ma mua o ka laha ʻana. Inā loaʻa iā ʻoe kahi hōʻailona e like me ka maneʻo anal e hoʻomau nei a ʻaʻole e nalo, e kamaʻilio me kāu kauka. Eia lākou e kōkua iā ʻoe. ʻAʻohe pono e makaʻu a hilahila paha. ʻO kou olakino ka mea nui loa.
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