Makemake ʻoe e ʻike hou aʻe e pili ana i ka maʻi ʻaʻai iwi? Mai makaʻu, e kamaʻilio kākou!

Ua manaʻo paha ʻoe e hiki i ko kākou mau iwi, ʻo ia hoʻi, nā iwi, ke ulu i ka maʻi kanesa? Malia paha ua ʻike ʻoe a i ʻole kekahi āu i ʻike ai i ka ʻeha o ka iwi a i ʻole kahi puʻupuʻu liʻiliʻi a ua noʻonoʻo e pili ana i ia mea. He aha maoli ka maʻi kanesa o ka iwi, pehea e ulu ai, he aha nā hōʻailona, ​​a aia kekahi lāʻau lapaʻau? E kamaʻilio mākou e pili ana i kēia mau mea a pau i kēia lā, me ka maʻalahi loa.

He aha ke Kanesa Iwi?

I ka ʻōlelo maʻalahi, ʻo "Bone Cancer" kahi huaʻōlelo laulā no kekahi mau ʻano kanesa like ʻole e ulu ana i loko o ko kākou mau iwi. Ke hoʻomaka kēia mau hunaola kanesa e ulu i loko o ka iwi, e like me kahi mea kanu maikaʻi ʻole, hōʻino lākou i ko kākou ʻiʻo iwi maikaʻi. ʻO ia hoʻi, hōʻino lākou i nā iwi olakino. ʻOiai hiki i kēia mau kanesa ke ulu i loko o kekahi iwi, ʻike pinepine ʻia lākou ma ka iwi ʻūhā, ka iwi ʻūhā, a i ʻole ka iwi lima luna.

I kēia manawa, ʻelua ʻano nui o ke kanesa iwi. ʻO kekahi, ʻo ia ka wā e hoʻomaka ai ke kanesa i loko o nā iwi . Kāhea mākou iā lākou he 'nā kanesa iwi mua' a i ʻole 'nā sarcomas iwi'. ʻO kekahi ʻano, ʻo ia ka wā e hoʻomaka ai ke kanesa ma kahi ʻē aʻe o ke kino, e like me ka umauma, ka māmā, a i ʻole ka prostate, a pālahalaha ia i nā iwi . Kāhea mākou i kēia he 'metastases bony'. Ua like ia me ka wā e hoʻomaka ai ke kanesa ma kahi ʻē aʻe a laila pālahalaha i nā iwi. ʻO ke kanesa umauma, ke kanesa prostate, a me ke kanesa māmā nā ʻano e pālahalaha nui ai i nā iwi.

He maʻi koʻikoʻi ka maʻi ʻaʻai iwi, no laila he mea nui e mālama koke iā ia . Akā he nūhou maikaʻi! He ʻano like ʻole nā ​​​​ala a kā mākou mau kauka e mālama ai i kēia mau maʻi ʻaʻai iwi, a i kekahi manawa hiki ke ho'ōla loa ʻia.

He aha nā ʻano maʻi ʻaʻai iwi i loaʻa?

ʻEkolu mau ʻano nui o ke kanesa iwi mua, ʻo ia hoʻi ke kanesa e hoʻomaka ana i loko o ka iwi ponoʻī. Ua hoʻokaʻawale ʻia kēia mau mea ma muli o ke ʻano o ke kelepona a me nā ʻiʻo e hoʻomaka ai ke kanesa:

1. Osteosarcoma : ʻO kēia ke ʻano maʻamau o ka maʻi ʻaʻai iwi. Hoʻomaka ia i loko o nā pūnaewele e hana ana i nā ʻiʻo iwi hou. ʻO ia ka mea maʻamau i nā keiki ʻōpio (ʻoi aku hoʻi ma waena o nā makahiki 10 a me 20) , akā hiki ke loaʻa i nā keiki a me nā ʻōpio.

2. ʻO ka sarcoma Ewing : Hiki i kēia ʻano maʻi kanesa ke ulu i loko o nā iwi a me nā ʻiʻo palupalu a puni. He mea maʻamau hoʻi ia i nā keiki a me nā ʻōpio .

3. Chondrosarcoma : Hoʻomaka kēia maʻi kanesa ma ke cartilage, ka ʻiʻo hoʻopili palupalu e kōkua i ko mākou mau hono a me nā iwi e neʻe. ʻO ia ka mea maʻamau i nā pākeke .

Ma waho aʻe o kēia mau ʻano nui ʻekolu, aia kekahi mau ʻano maʻi ʻaʻai iwi kakaikahi ʻē aʻe:

• Chordoma : Hoʻomaka kēia maʻi kanesa ma ke kaula kuamoʻo a i ʻole ma ke kumu o ke poʻo.
• ʻO ka Fibrosarcoma (ʻO Fibrosarcoma)Hoʻomaka kēia mau mea ma nā ʻiʻo hoʻopili fibrous ma nā wēlau o nā iwi.
• Nā puʻupuʻu cell nunui : ʻO kēia mau puʻupuʻu ʻaʻole maʻi kanesa (benign), akā hiki ʻole iā lākou ke lilo i maʻi kanesa.
• ʻO ka sarcoma pleomorphic undifferentiated : He ʻano maʻi kanesa ʻoi aku ka ikaika ʻole e hoʻomaka ana i nā ʻiʻo palupalu a me nā iwi.

Pehea ka maʻamau o ke kanesa iwi?

Akā eia ka mea, ʻaʻole maʻamau loa ka maʻi kanesa iwi . ʻO ka ʻoiaʻiʻo, i ka hoʻohālikelike ʻia me nā ʻano maʻi kanesa ʻē aʻe, he mea kakaikahi loa ia. No ka laʻana, ma kahi ʻāina e like me ʻAmelika, ʻo ka maʻi kanesa iwi ka emi ma mua o 1% o nā maʻi kanesa āpau. ʻOiai hiki ke ulu i loko o kekahi o kēlā me kēia makahiki, ʻoi aku ka maʻamau i nā keiki a me nā ʻōpio ma mua o nā pākeke.

ʻO ka mea nui, ʻoiai he puʻupuʻu kou i loko o kou iwi, ʻaʻole ia he manaʻo he maʻi kanesa ia. ʻO ka hapa nui o nā puʻupuʻu iwi he maʻi ʻaʻole ia he maʻi kanesa (benign). ʻAʻole pālahalaha kēia mau puʻupuʻu ʻaʻole he maʻi kanesa i loko o ke kino e like me ke kanesa.

He aha nā hōʻailona o ka maʻi ʻaʻai iwi?

ʻAʻole paha e hōʻike kekahi poʻe me ka maʻi ʻaʻai iwi i kekahi mau hōʻailona, ​​he puʻupuʻu ʻeha ʻole wale nō. Akā, hiki i kekahi ke loaʻa nā ʻano hōʻailona like ʻole. E noʻonoʻo i kāu keiki a i ʻole kekahi āu i ʻike ai e hoʻopiʻi mau ana i ka ʻeha ma kekahi wāwae a lima paha, ʻoi aku ka ʻino i ka pō, a i kekahi manawa he ʻeha ʻoi a hou . Manaʻo paha ʻoe, "Auē, no ka hāʻule ʻana paha kēia i ka wā e pāʻani ana," a i ʻole "He ʻeha ulu wale nō ia." I kekahi manawa hiki ke kuhihewa ʻia kēia mau hōʻailona no nā kūlana ʻē aʻe, e like me ka arthritis. Hiki i kēia ke hoʻopaneʻe i ka hōʻailona.

ʻO kēia nā hōʻailona maʻamau o ka maʻi ʻaʻai iwi:

• ʻEha iwi e piʻi mālie ana a mau loa (ʻoi aku ka ʻino i ka pō. Hiki ke palalulu, ʻeha, a hou paha).
• He puʻu a pehu paha ma kahi i hoʻopilikia ʻia (hiki ke paʻakikī a palupalu paha ke pā aku).
• Ka pehu ʻana a puni ka iwi i hoʻopilikia ʻia me ka ʻike ʻole ʻia .
• Ka paʻakikī o ka neʻe ʻana (ʻoi aku hoʻi inā kokoke ka pehu ʻana i kahi hono).
• Luhi .
• Kuni .

He aha nā kumu o ka maʻi ʻaʻai iwi?

ʻAʻole maopopo loa i nā loea ke kumu o ke kanesa iwi. Akā, e like me nā kanesa ʻē aʻe, ulu nā puʻupuʻu iwi i ka wā e hoʻomaka ai nā pūnaewele e ulu ma waho o ke kaohi ma muli o nā hewa i loko o kā lākou DNA. I ka hala ʻana o ka manawa, hiki i kēia mau pūnaewele ke ulu pū e hana i kahi puʻupuʻu, e hōʻino ana i nā ʻiʻo olakino a puni. Inā ʻaʻole mālama ʻia, hiki i ke kanesa iwi ke laha i nā ʻāpana ʻē aʻe o ke kino.

Nā kumu pilikia

Ua loaʻa i nā kānaka noiʻi kahi pilina ma waena o ke kanesa o ka iwi a me kekahi mau kumu pilikia. Eia kēia mau mea:

• Ma hope o ka loaʻa ʻana o ka lāʻau lapaʻau ma mua : Inā ua loaʻa iā ʻoe ka radiation therapy a i ʻole kekahi mau lāʻau chemotherapy e like me ka lāʻau lapaʻau no nā maʻi ʻē aʻe, e hoʻonui iki ʻia paha kou pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai iwi i ka wā e hiki mai ana.
• Nā kumu hoʻoilina : ʻO kekahi mau kūlana hoʻoilina kakaikahi, i hoʻoilina ʻia, e like me ka maʻi Li-Fraumeni, hiki ke hoʻonui i ka pilikia o ka maʻi ʻaʻai iwi. Eia kekahi, ʻo ka hoʻoilina ʻana i kahi mutation genetic e hoʻoulu ai i kahi kūlana i kapa ʻia ʻo retinoblastoma e hoʻonui pū i ka pilikia.
• Nā maʻi iwi ʻaʻole he maʻi ʻaʻai : He mea kākaʻikahi loa, hiki i nā kūlana iwi ʻaʻole he maʻi ʻaʻai ke lilo i maʻi ʻaʻai. No ka laʻana, inā loaʻa iā ʻoe nā kūlana i kapa ʻia ʻo 'Paget disease of the bone' a i ʻole 'multiple enchondromas', hiki ke hoʻonui iki ʻia ka pilikia.

Eia nō naʻe, ʻaʻohe o kēia mau mea pilikia i ka nui o ka poʻe i loaʻa i ka maʻi ʻaʻai iwi . I ka manawa pinepine, hiki mai ia me ke kumu ʻole.

He aha nā pilikia o kēia maʻi?

Hoʻonāwaliwali ka maʻi ʻaʻai iwi i nā iwi e ulu ana i loko. I kekahi manawa, hiki i kēia maʻi ʻaʻai ke kumu i nā haki iwi. Kāhea mākou i kēia mau 'haʻi pathologic'. I kekahi manawa ʻike nā kauka i ka maʻi ʻaʻai iwi ke nānā lākou i kahi haki iwi e like me kēia.

Pehea e ʻike ʻia ai ka maʻi ʻaʻai iwi? (Diagnosis)

No ka ʻike ʻana i ke kanesa o ka iwi, e lawe mua kāu kauka i nā kukuna X e nānā i kou mau iwi. A laila, e hana pinepine lākou i nā scan Magnetic Resonance Imaging (MRI) a me Computed Tomography (CT) e kiʻi i nā kiʻi maopopo o nā wahi a puni nā iwi. He mea nui kēia ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau.

No ka hōʻoia ʻana i ka maʻi kanesa, e hana kāu kauka i kahi biopsy . ʻO ia hoʻi ke lawe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai kou iwi a nānā ʻia ma lalo o kahi microscope e kahi loea (pathologist). Hāʻawi ka biopsy i ka ʻike kikoʻī e pili ana i ke ʻano o ka maʻi kanesa. Me kēia ʻike, hiki i kāu kauka ke hoʻoholo pololei i ka lāʻau lapaʻau kūpono loa iā ʻoe.

Ka Hoʻonohonoho ʻana o ke Kanesa Iwi

Ma ka hoʻoholo ʻana i ke kahua o ke kanesa ('Cancer staging'), hiki i nā kauka ke hoʻoholo inā ua kūloko ke kanesa a ua laha paha i loko o ke kino (metastasized). Nānā pū lākou i ka likelika o kona laha ʻana, inā ʻaʻole i laha. ʻO ke ʻano ʻē o nā hunaola kanesa ('tumor grade') e hāʻawi i kahi hōʻailona o ka likelika o ka laha ʻana o ke kanesa. Aia ʻelua mau ʻano hana a nā kauka e hoʻohana ai e hoʻoholo ai i ke kahua o ke kanesa iwi:

1.ʻAhahui Tumor Musculoskeletal (ʻAhahui Tumor Musculoskeletal` a i ʻole `ʻŌnaehana Enneking`):

• Pae 1 : He haʻahaʻa ke ʻano o ke kanesa a ʻaʻole i laha.
• Pae 2 : Ua kiʻekiʻe ke ʻano o ke kanesa, akā ʻaʻole i laha.
• Pae 3 : Ua pālahalaha ke kanesa.

2. ʻŌnaehana Hui Pū ʻIa o ke Komite ʻAmelika no ke Kanesa (`ʻAmelika Hui Pū ʻIa no ke Kanesa - AJCC`):

• Pae 1 : Haʻahaʻa ke ʻano o ka puʻupuʻu a ʻaʻole i laha ka maʻi ʻaʻai.
• Pae 2 : ʻAʻole i pālahalaha ke kanesa, akā ua kiʻekiʻe ke ʻano o ka puʻupuʻu.
• Pae 3 : Kiʻekiʻe ke ʻano o ka puʻupuʻu, a ua pālahalaha ke kanesa i nā wahi ʻē aʻe i loko o ka iwi hoʻokahi.
• Pae 4 : Ua pālahalaha ke kanesa mai ka iwi a i nā ʻāpana ʻē aʻe o ke kino, no ka laʻana, nā māmā a i ʻole ke akepaʻa.

Pehea e mālama ʻia ai ka maʻi ʻaʻai iwi?

ʻO ke ʻano lapaʻau nui no ka maʻi ʻaʻai iwi, ʻo ia ke ʻoki ʻana e wehe i ke kanesa . ʻO ke ʻano ʻoki maʻamau ka "Limb-sparing surgery." Ma kēia ʻoki ʻana, wehe wale ke kauka ʻoki i ke kanesa a me kahi liʻiliʻi o nā ʻiʻo olakino a puni, akā waiho wale i kou lima a wāwae paha. Hiki ke kūkulu hou ʻia ka iwi i hōʻino ʻia me nā "real bone grafts" a i ʻole nā ​​"artificial bone grafts."

I kekahi manawa, pono paha ke kauka lapaʻau e wehe i kahi lima a i ʻole ka wāwae holoʻokoʻa ('amputation') e mālama i ka maʻi kanesa. Inā hana ʻia kēlā, e hoʻokomo ʻia ʻoe me kahi lima a i ʻole ka wāwae prosthetic ma hope o ke ʻoki ʻana. Ua holomua loa kēia mau mea hana i kēia manawa, a hiki iā lākou ke kōkua iā ʻoe e hoʻokō i kāu mau hana o kēlā me kēia lā e like me kā lākou i hana ai ma mua o ke ʻoki ʻana.

ʻO nā lāʻau lapaʻau ʻē aʻe:

• Lapaʻau radiation : Hoʻohana ʻia kēia e hoʻēmi i nā puʻupuʻu ma mua o ke ʻoki ʻana a i ʻole e luku i nā hunaola kanesa i koe ma hope o ke ʻoki ʻana. Hiki ke hoʻohana ʻia ka lāʻau radiation ma kahi o ke ʻoki ʻana no kekahi mau maʻi kanesa iwi.
• ʻO Chemotherapy : Hāʻawi ʻia kēia e mālama i ke kanesa mua, ke kanesa i laha (metastases), a me nā hunaola kanesa e lana ana i loko o ke kino. Hāʻawi pinepine ʻia ka Chemotherapy ma mua o ke ʻoki ʻana e kāohi i ka laha ʻana o ke kanesa a hiki ke hoʻēmi i ka puʻupuʻu. Kōkua ka Chemotherapy (chemo) i hāʻawi ʻia ma hope o ke ʻoki ʻana i ka "hoʻomaʻemaʻe" i nā hunaola kanesa i koe i loko o ke kino a pale i ka hoʻi hou ʻana mai o ke kanesa iwi.

Pehea ka wikiwiki o koʻu ʻoluʻolu ma hope o ka lāʻau lapaʻau?

ʻO ka maʻamau, hoʻomaka ka ʻeha i hoʻokumu ʻia e ka maʻi ʻaʻai iwi e emi koke i ka hoʻomaka ʻana o ka lāʻau lapaʻau. Eia nō naʻe, hiki i ka lāʻau lapaʻau ke hana i kekahi mau hopena ʻaoʻao, a he manawa ka hoʻōla ʻana.

Hiki ke hala a hiki i ʻeono mahina o ka hoʻōla hou ʻana a me ka hoʻōla kino e hoʻomaʻamaʻa ai i kahi prosthesis. Inā ua hana ʻia ʻoe i ke ʻoki ʻana i nā lālā, hiki ke hala a hiki i hoʻokahi makahiki e ʻoluʻolu loa ai me nā loli i kou mau iwi.

ʻO ka mea hope loa, pili kou manawa hoʻōla i ke ʻano o ke kanesa, kona pae, a me ka hui pū ʻana o nā lāʻau lapaʻau āu e pono ai. E haʻi aku kāu kauka iā ʻoe i ka mea e manaʻo ai, i hiki iā ʻoe ke hoʻoholo i nā lāʻau lapaʻau kūpono loa iā ʻoe.

Hiki ke pale ʻia ke kanesa o ka iwi?

ʻOiai ʻaʻole maopopo loa i nā loea ke kumu o ka maʻi ʻaʻai iwi, ʻaʻohe ala e pale aku ai . Ma ka ʻaoʻao ʻē aʻe, ʻo ka radiation therapy, kahi kumu ʻē aʻe i ʻike ʻia o ka maʻi ʻaʻai iwi, he mea nui ia no ka mālama ʻana i kekahi mau maʻi ʻaʻai ʻē aʻe, no laila ʻaʻole hiki ke pale ʻia loa.

Eia nō naʻe, pono ʻoe e ʻike i ke kauka inā ʻike ʻoe i kekahi mau loli ʻē i kou mau iwi, e like me kahi puʻupuʻu a i ʻole ka hoʻonui ʻana o ka ʻeha o ka iwi. ʻAʻole kēia mau hōʻailona e hōʻike mau i ka maʻi kanesa. Eia nō naʻe, hiki i ke kauka ke ʻike i ke kumu pololei o ka pilikia.

He aha kaʻu e manaʻo ai inā loaʻa iaʻu ka maʻi ʻaʻai iwi?

Hoʻomaʻamaʻa pinepine ʻia ka mālama ʻana no ka maʻi ʻaʻai iwi. I ka hapanui o nā hihia, ʻaʻole e hoʻi hou mai ke kanesa. Pono paha ma mua o hoʻokahi ʻoki kino e hoʻokō ai i kēia hopena.

Pono paha ka poʻe me nā ʻano maʻi ʻaʻai iwi holomua e hoʻomau i nā lāʻau lapaʻau, e like me ka radiation therapy a me ka chemotherapy, i mea e pale ai i ka laha ʻana o ke kanesa. Hiki ke hāʻawi ʻia kēia mau lāʻau lapaʻau no ka manawa lōʻihi e kāohi i ke kanesa.

ʻO ka mea hope loa, ʻokoʻa ke kūlana o kēlā me kēia kanaka, no laila ʻaʻole like ka hopena o kēlā me kēia kanaka me ka maʻi ʻaʻai iwi. E wehewehe kāu kauka i kāu wānana ma muli o ke ʻano, ke kahua, kahi o kou maʻi ʻaʻai, a me kāu pane ʻana i ka lāʻau lapaʻau.

He aha ka nui o ka ho'ōla ʻana no ka maʻi ʻaʻai iwi?

ʻOiai hiki ke make ka maʻi ʻaʻai iwi, nui ka poʻe e hoʻōla piha . ʻO ka helu ola ʻelima makahiki no ka maʻi ʻaʻai iwi he 68.2%. ʻO ke ʻano kēia he 68.2% o ka poʻe me ka maʻi ʻaʻai iwi e ola mau ana i ʻelima mau makahiki ma hope o ka ʻike ʻia ʻana. ʻOi aku ka maikaʻi o ka poʻe me ka maʻi ʻaʻai iwi i ka wā mua e hoʻōla piha ai. ʻO ka poʻe me ka maʻi ʻaʻai iwi i ka wā holomua, ʻo ia hoʻi ua laha mua ke kanesa, aia lākou i ka pilikia nui o ka hoʻi hou ʻana mai o ke kanesa.

Akā e hoʻomanaʻo, he mau kuhi wale nō kēia mau helu ola e pili ana i ka poʻe i loaʻa i ka maʻi ʻaʻai iwi ma mua. ʻAʻole lākou e haʻi pololei iā ʻoe i ka lōʻihi o kou ola ʻana a i ʻole ka mea e manaʻo ai i kou kūlana kikoʻī. E kamaʻilio me kāu kauka no ka ʻike hou aku e pili ana i nā helu ola o ka maʻi ʻaʻai iwi.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe ka ʻeha iwi a i ʻole ka pehu ʻana i wehewehe ʻole ʻiaE hoʻonohonoho i kahi manawa e ʻike koke ai i ke kauka. Inā loaʻa i kāu keiki kahi puʻupuʻu a pehu paha i nalowale ʻole, e ʻike i ke kauka o kāu keiki. Inā ke mālama ʻia nei ʻoe no ka maʻi ʻaʻai iwi, e hoʻomaopopo i kāu kauka inā loaʻa iā ʻoe kekahi mau hōʻailona hou.

Ma hope o ka lāʻau lapaʻau, e hōʻoia e hele i nā manawa hoʻopaʻa āpau . I loko o nā makahiki ʻelua mua, pono paha ʻoe e ʻike i kāu kauka i kēlā me kēia ʻekolu a ʻeono mahina, a laila e emi pinepine nā nānā ʻana. Ma ka loaʻa ʻana o nā nānā mau e like me kēia, hiki iā ʻoe ke loaʻa koke i ke kanesa inā hoʻi mai, a e ʻoi aku ka maikaʻi o kāu lāʻau lapaʻau.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

ʻO ka hoʻomaopopo piha ʻana i kāu hōʻailona e kōkua iā ʻoe e hana i nā hoʻoholo maikaʻi loa e pili ana i kou olakino. Eia kekahi mau nīnau hiki iā ʻoe ke nīnau i kāu kauka:

• He aha ke ʻano o ka maʻi ʻaʻai iwi i loaʻa iaʻu?
• Ua laha anei?
• He aha nā hoʻokolohua e pono ai iaʻu e hana?
• He aha kaʻu mau koho lapaʻau?
• He aha kaʻu wānana?

Ke ʻike ʻoe he maʻi ʻaʻai iwi kou, e makaʻu paha ʻoe, hoʻonāukiuki, a kānalua. ʻOiaʻiʻo, he nui nā mea i ʻike ʻole ʻia e pili ana i ka maʻi ʻaʻai. E hilinaʻi kou ʻike i nā kumu he nui, me ke ʻano o ka maʻi ʻaʻai iwi āu a me ka wā i ʻike ʻia ai ʻoe. Akā, ʻaʻole make mau a hiki ʻole ke hoʻōla ʻia ka maʻi ʻaʻai iwi. He nui ka poʻe i ʻike ʻia me kēia maʻi e loaʻa ana i ka lāʻau lapaʻau e hoʻopau ai i ke kanesa .

E kamaʻilio me kāu kauka e pili ana i kāu mau koho lapaʻau. Eia kekahi, e noʻonoʻo e hui pū me kahi hui kākoʻo. ʻO ke kamaʻilio ʻana me nā poʻe e hele nei i nā mea like me ʻoe he mea maikaʻi ia no kou olakino noʻonoʻo, naʻau, a me ka ʻuhane.

Leka Lawe-Home

He mea e makaʻu maoli ai i ka maʻi ʻaʻai iwi, akā ʻo ka mea nui loa, ʻo ia ka ʻike pono e pili ana i ia mea a e ʻimi i ke aʻo lapaʻau i ka manawa kūpono .

E hoʻomanaʻo, ʻaʻole nā ​​ʻeha iwi a i ʻole nā ​​puʻupuʻu āpau he maʻi kanesa. Eia nō naʻe, inā he mau hopohopo kāu, he mea naʻauao ke kamaʻilio me ke kauka e pili ana i ia mea.

Me ka holomua o ka lāʻau lapaʻau hou, nui nā lāʻau lapaʻau kūpono no ka maʻi ʻaʻai iwi. I kekahi mau hihia, hiki ke ho'ōla loa ʻia. No laila, he mea nui loa ia e noho ikaika a hahai i nā ʻōlelo aʻo a kāu mau kauka. ʻAʻole ʻoe hoʻokahi, a he ʻohana kou, nā hoaaloha, a me nā kauka e kōkua iā ʻoe ma kēia huakaʻi.

ʻO ke Kanesa Iwi, Kanesa Iwi, Nā Hōʻailona Kanesa, ʻEha Iwi, Lāʻau no ke Kanesa, Nā ʻAno Kanesa, Kanesa Kamaliʻi