Hoʻoweliweli iki ka huaʻōlelo "maʻi ʻaʻai" iā kākou a pau, ʻeā? Akā me ka holomua o ka ʻepekema lapaʻau, ua puka mai nā ala hou a holomua e hakakā ai i ka maʻi ʻaʻai. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau holomua e kamaʻilio nui ʻia nei, ʻoiai no ka maʻi ʻaʻai umauma. Ua kapa ʻia kēia ʻo Targeted Therapy . E nānā kākou i ke ʻano o ia mea, pehea e hana ai, a me nā mea āu e pono ai e ʻike e pili ana i ia mea.
I ka ʻōlelo maʻalahi, he aha ka Targeted Therapy?
E noʻonoʻo e pili ana i ia mea, ʻo ka chemotherapy, e like me kā mākou e ʻike mau nei, e luku i nā cell e māhele wikiwiki ana. Hiki i kēia ke hōʻino ʻaʻole wale i nā cell kanesa akā i nā cell olakino hoʻi i loko o ko mākou kino. ʻO ia ke kumu e hoʻoulu pinepine ai ka chemotherapy i nā hopena ʻaoʻao e like me ka hāʻule ʻana o ka lauoho a me ka nausea.
Akā, ʻokoʻa loa kēia ʻano lapaʻau i kapa ʻia ʻo Targeted Therapy mai kēlā. I ka pololei, he lāʻau lapaʻau 'akamai' loa kēia. Hoʻopaʻa a hoʻouka wale ia i nā hunaola kanesa . Hoʻohana kēia ʻano lapaʻau i ka ʻōnaehana pale kino o ko mākou kino e luku i nā hunaola kanesa, a i ʻole e ālai i nā hōʻailona e pono ai nā hunaola kanesa e ulu. Hoʻemi kēia i ka hōʻino ʻana i nā hunaola olakino. ʻO ka pōmaikaʻi o kēia, ʻoi aku ka liʻiliʻi o nā hopena ʻaoʻao ma mua o ka chemotherapy.
Hana kēia lāʻau lapaʻau ma nā ʻano nui ʻelua:
1. Ka Hoʻohana ʻana i nā Antibodies: Hoʻopuka ʻia kēia mau antibodies e nā cell kūikawā i loko o ka ʻōnaehana pale o ko mākou kino. Hana ʻia kēia mau antibodies ma ke ʻano hana i loko o ka hale hana a hāʻawi ʻia i ke kino ma ke ʻano he lāʻau lapaʻau. Hoʻopili kēia mau mea i nā cell cancer a kāohi iā lākou mai ka ulu ʻana a i ʻole ka luku ʻana iā lākou.
2. Nā lāʻau lapaʻau molekole liʻiliʻi: ʻO kēia nā lāʻau lapaʻau e hiki ke lawe ʻia ma ke ʻano he mau pila. Hana lākou ma ke ālai ʻana i nā ala hōʻailona i loko o nā hunaola kanesa e kōkua iā lākou e māhele a ulu.
Na kāu kauka e hoʻoholo i ke ʻano o ka lāʻau lapaʻau i kūpono iā ʻoe ma muli o ke ʻano kikoʻī o ka maʻi ʻaʻai umauma āu e loaʻa ai.
ʻO ke Kanesa ʻUma HER2-Positive a me kāna Lapaʻau
Ma kahi o 20% o ka poʻe me ka maʻi ʻaʻai umauma, a i ʻole ma kahi o hoʻokahi i loko o ʻelima, he kīnā ko lākou i loko o kahi gene i kapa ʻia ʻo `HER2`. ʻO kēia hemahema ke kumu o ka hana ʻana o ka gene i nā kope he nui loa. Inā nui loa ka protein `HER2` ma nā hunaola kanesa, kapa mākou i kēlā kanesa he "HER2-positive breast cancer."
Inā he 'HER2-positive' kou maʻi ʻaʻai, aia nā lāʻau lapaʻau kikoʻī a kūpono loa no ia.
- ʻO Trastuzumab :ʻO kēia ka lāʻau lapaʻau nui i kuhikuhi ʻia no ka maʻi kanesa `HER2-positive`. Loaʻa kēia lāʻau lapaʻau ma lalo o nā inoa inoa like ʻole e like me `Herceptin`, `Kanjinti`, `Ogivri`. He inikini ia i hāʻawi ʻia i loko o kahi aʻa. Ua manaʻoʻiʻo ʻia e kāohi i ke kanesa ma ʻekolu mau ala nui:
- Hoʻopili nā hunaola kanesa i ka ʻili a kāohi i ko lākou ulu ʻana.
- Kōkua ia i ka luku ʻana i nā hunaola kanesa ma o ka hōʻailona ʻana i kā mākou ʻōnaehana pale ponoʻī.
- Ke hāʻawi ʻia me ka chemotherapy, hoʻonui ia i ka holomua o kēlā mau lāʻau lapaʻau.
- ʻO Pertuzumab: ʻO kēia lāʻau lapaʻau, nona ka inoa inoa ʻo 'Perjeta', he antibody ʻē aʻe i hāʻawi ʻia i ka maʻi kanesa 'HER2-positive'. Hāʻawi pinepine ʻia me ka hui pū ʻana me 'Trastuzumab' a me ka lāʻau chemotherapy 'docetaxel'. Eia naʻe, ʻaʻole kūpono ia no nā wahine hāpai, no ka mea hiki ke hōʻeha i ka pēpē i hānau ʻole ʻia.
- Nā lāʻau lapaʻau ʻē aʻe: ʻO ʻAdo-trastuzumab emtansine (Kadcyla), ʻMargetuximab (Margenza), a me ʻFam-trastuzumab deruxtecan-nxki (Enhertu)` he mau lāʻau lapaʻau hou nō hoʻi i hāʻawi ʻia no kēia ʻano maʻi kanesa, ʻoiai i nā hihia kahi i laha ai ke kanesa (holomua) a i ʻole i ka wā i hāʻule ʻole ai nā lāʻau ʻē aʻe.
- Nā Pila: ʻO Lapatinib (Tykerb) a me Neratinib (Nerlynx) he mau lāʻau lapaʻau i kuhikuhi ʻia no nā maʻi ʻaʻai HER2-positive hiki ke lawe ʻia ma ke ʻano he pila. Hāʻawi pinepine ʻia kēia mau mea ma hope o nā lāʻau lapaʻau ʻē aʻe.
Lapaʻau no ka maʻi ʻaʻai umauma HER2-Negative
Inā ʻaʻohe kīnā gene `HER2` i ʻōlelo ʻia ma luna, ʻo ia hoʻi, ʻaʻole nui ka protein `HER2`, a laila ua kapa ʻia kēlā maʻi kanesa ʻo "HER2-negative breast cancer." A laila e hāʻawi ʻia ʻoe i kahi ʻano lāʻau ʻokoʻa.
Aia kekahi mau lāʻau lapaʻau i kuhikuhi kūikawā ʻia no kēia ʻano maʻi kanesa.
- Hāʻawi ʻia nā lāʻau lapaʻau e like me ʻEverolimus (Afinitor), ʻPalbociclib (Ibrance), a me ʻRibociclib (Kisqali) me ka lāʻau lapaʻau hormone. He mau lāʻau lapaʻau kēia i hāʻawi ʻia i nā wahine, ʻoi aku hoʻi ma hope o ka menopause, nona ka maʻi kanesa i laha.
- Nā Mea Hoʻopale PARP: Inā he HER2-negative kou maʻi kanesa a he hoʻololi ʻana o ka gene BRCA kou, hiki ke hāʻawi ʻia iā ʻoe kahi papa kūikawā o nā lāʻau lapaʻau i kapa ʻia ʻo nā mea hoʻopale PARP, e like me Olaparib (Lynparza) a me Talazoparib (Talzenna). He mau lāʻau lapaʻau i kuhikuhi ʻia kēia e kuhikuhi pono ana i nā hunaola kanesa.
ʻO ka mea nui, ua hoʻoholo ʻia kēia mau lāʻau āpau e ka pae genetic a me ke kelepona o kou maʻi kanesa. No laila, he mea nui e kūkākūkā pono i kēia me kāu kauka a koho i ka lāʻau lapaʻau kūpono loa iā ʻoe.
He aha nā hopena ʻaoʻao maʻamau?
E like me ka mea i ʻōlelo ʻia ma mua, ʻoiai he emi nā hopena ʻaoʻao ma mua o ka chemotherapy, hiki i ka lāʻau lapaʻau i kuhikuhi ʻia ke hana i kekahi mau hopena ʻaoʻao. ʻOkoʻa kēia mau mea mai ka lāʻau a i ka lāʻau. Inā loaʻa iā ʻoe kekahi mau hopena ʻaoʻao , e haʻi koke i kāu kauka . ʻO ka hapa nui o ka manawa, hiki ke hoʻomalu ʻia.
| Nā hopena ʻaoʻao maʻamau |
|---|
| Nā hopena maʻi āpau - ka ʻili ʻili, ka ʻūlū. |
| Ka luaʻi a me ka maʻi pākī. |
| Kuni a me ke anu. |
| ʻEha kino, luhi, a me ka nāwaliwali. |
| Ka pilikia hanu a me ka pehu. |
| Pōʻaiʻī . |
Pehea e ʻike ai i kahi pilikia?
Inā ʻike ʻoe i kekahi a ʻoi aku paha o nā hōʻailona ma lalo nei, he pilikia paha ia. Mai hoʻowahāwahā iā lākou. E kāhea koke aku i kāu kauka. Inā ʻaʻole hiki iā ʻoe ke hoʻokaʻaʻike aku iā ia, e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.
| E nānā pono i kēia mau hōʻailona! | |
|---|---|
| Kuni: He kuni ma luna o 100.4 Fahrenheit (38 Celsius). Inā loaʻa iā ʻoe ke kuni ma hope o ke anu ʻana, e haʻi koke i kāu kauka . | Nā pilikia waha: Nā ʻeha hou ma ka waha, nā kiko keʻokeʻo, ke alelo pehu, a i ʻole nā ʻāʻī koko. |
| ʻEha ka ʻāʻī: Manaʻo maloʻo, ʻeha, ʻūlū, a i ʻole "pehu" i loko o ka ʻāʻī. | Kuke: Kuke hou a mau paha. |
| Nā pilikia mimi: Ke mimi pinepine ʻana, ka maʻi ʻaʻai mimi, a i ʻole ke koko i loko o ka mimi. | Nā pilikia o ka ʻōpū: ʻO ka puʻuwai koʻikoʻi, ka nausea, ka luaʻi ʻana, ka paʻa ʻana o ka ʻōpū, a i ʻole ka maʻi palahēhē e mau ana ma mua o 2-3 mau lā. |
| Paʻakikī ka hanu ʻana: Pōkole ka hanu ʻoiai me ka hoʻoikaika iki ʻana. | Ke kahe koko ʻano ʻē: Koko i loko o ka ʻōpala. |
| Pehu: Pehu ma nā wāwae a i ʻole ka kuʻekuʻe wāwae. | Luhi nui: Manaʻo nui i ka luhi a ʻaʻole hiki iā ʻoe ke hana i kekahi mea. |
Leka Lawe-Home
- ʻO ka Targeted Therapy kahi ʻano lapaʻau hou e kuhikuhi pono ana a hoʻouka i nā hunaola kanesa o ka umauma, ʻokoʻa mai ka chemotherapy maʻamau.
- ʻO ke ʻano o ka lāʻau lapaʻau āu e loaʻa ai e pili ana i ke ʻano o ka maʻi kanesa āu e loaʻa ai (e.g., inā he `HER2-positive` a i ʻole `HER2-negative`). Hana ʻia nā hoʻokolohua kūikawā e hoʻoholo ai i kēia.
- Hiki i kēia mau lāʻau lapaʻau ke loaʻa nā hopena ʻaoʻao, no laila e kamaʻilio me kāu kauka e pili ana i nā loli a i ʻole ka ʻoluʻolu ʻole āu e manaʻo ai.
- E makaʻala mau i nā hōʻailona ulia pōpilikia e like me ke kuni nui, ka paʻakikī o ka hanu ʻana, a me ka pehu ʻana. Inā ʻike ʻoe i kekahi o kēia mau mea, e ʻimi koke i ke kōkua lapaʻau.
- He huakaʻi ka mālama ʻana i ka maʻi kanesa. ʻO kāu kauka a me ka hui mālama ola kino kou mau hoa pili maikaʻi loa ma kēia huakaʻi. No laila e hilinaʻi iā lākou a e hana pū me lākou.
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