Hiki i ke kanesa ke laha i kou mau iwi? (Bone Metastasis) E kamaʻilio kākou e pili ana i kēia!

Ua lohe paha ʻoe i kekahi kanaka me ke kanesa i loaʻa i ka ʻeha iwi a i ʻole nā ​​iwi nāwaliwali. Ua ʻike paha ʻoe i kēia iho. ʻOiaʻiʻo, ua hoʻokumu ʻia kēia e nā hunaola kanesa e laha ana mai kekahi ʻāpana o ke kino a i nā iwi. Kāhea mākou i kēia he metastasis iwi . ʻOiai he maʻi koʻikoʻi kēia, mai hopohopo. ʻO ka mea nui loa, ʻo ia ka makaʻala a me ka mālama pono ʻana iā ia.

He aha ka Bone Metastasis? E hoʻomaopopo maʻalahi kākou.

I ka ʻōlelo maʻalahi, ʻo ka metastasis iwi ka wā e hele ai nā hunaola kanesa i hoʻomaka ma kahi ʻē aʻe o kou kino (e like me ka umauma, ka māmā, a i ʻole ka prostate) ma o kou kahe koko i kou mau iwi a hoʻomaka e ulu ma laila. ʻO kēia kekahi o nā hōʻailona o ka maʻi kanesa metastatic .

ʻO ka mea nui e ʻike ai, ʻaʻole kēia he maʻi ʻaʻai iwi mua. He maʻi ʻaʻai kēia i laha i nā iwi mai kahi ʻē aʻe.

ʻO ka mea pōʻino, ʻaʻohe lāʻau lapaʻau no kēia maʻi. Eia nō naʻe, he nui nā lāʻau lapaʻau i loaʻa e kāohi i nā hōʻailona a hoʻolohi i ka holomua o ke ʻano. ʻO kekahi kumu ʻē aʻe, ʻo ia ka lōʻihi o ke ola ʻana o ka poʻe me ke kanesa ma mua o ka wā ma mua, no laila ke lilo nei ka metastasis iwi i mea maʻamau. Ua hōʻike ʻia kekahi noiʻi ua piʻi ka nui o ka metastasis iwi mai 3% i ka makahiki mua ma hope o ka ʻike ʻia ʻana o ke kanesa a i 8% 10 mau makahiki ma hope.

He aha nā hōʻailona o kēia? E nānā inā loaʻa iā ʻoe kēia mau mea pū kekahi

ʻO ka hōʻailona maʻamau ka ʻeha o ka iwi . Hiki ke manaʻo ʻia e like me ke huki ʻia ʻana o kekahi mea a i ʻole ke kaumaha. Hiki ke ʻoi aku ka ʻeha i ka pō, ʻoi aku hoʻi i ka pō. I kekahi manawa hiki ke ʻoi, hou, a ʻoi paha.

Hiki i ka metastasis iwi ke hana i nā pilikia ʻē aʻe. Aia kekahi mau hōʻailona kikoʻī e pili ana i ia mea:

• Nā Haʻihaʻi Iwi: Hoʻolilo kēia ʻano i kou mau iwi i mea palupalu loa. ʻO ia hoʻi, hiki iā ʻoe ke haki i ka iwi me ka ʻole o ka hāʻule nui. Hiki iā ia ke hoʻopilikia i kekahi iwi i loko o kou kino. Akā ʻo ka mea maʻamau ka hoʻopilikia ʻana i ka iwi kuamoʻo, nā iwi ʻaoʻao, ka pelvis, ka humerus, ka femur, a me ke poʻo. He ʻoi loa a koʻikoʻi ka ʻeha i ka wā e haki ai ka iwi. Inā haki ʻoe i ka lima a i ʻole ka wāwae, ʻaʻole hiki iā ʻoe ke hoʻoneʻe.
• Hypercalcemia: ʻO kēia ka manawa e kiʻekiʻe loa ai nā pae calcium o kou koko. ʻO nā hōʻailona e komo pū me ka dizziness, constipation, nalowale o ka makemake, nausea, a me ka luaʻi.
• ʻO ke kaomi ʻana o ke kaula kuamoʻo: Inā ua pālahalaha kahi puʻupuʻu a ke kaomi nei i kou kaula kuamoʻo, hiki iā ʻoe ke ʻike i ka ʻeha o ke kua, ka nāwaliwali a i ʻole ka mae ʻana o kou mau lima a me kou mau wāwae, a me ka hiki ʻole ke hoʻōki i ka mimi. ʻO kēia ka meaPono e mālama ʻia me he mea lā he pilikia.

No ke aha lā kēia e hana nei? He aha ke kumu?

Hiki mai kēia ʻano ke haki nā pūnaewele mai nā puʻupuʻu kanesa, komo i loko o kou koko, hele ma loko, a laila hele i kou mau iwi. I ka manawa ma laila, hoʻomaka kēlā mau pūnaewele kanesa i kahi hana i kapa ʻia e nā loea ʻo "vicious cycle of bone metastasis."

I mea e hoʻomaopopo ai i kēia pōʻaiapuni, he mea kōkua ke ʻike iki e pili ana i ka hana ʻana o kāu mau hunaola iwi. ʻElua ʻano nui o nā hunaola i loko o ko kākou mau iwi: nā osteoblast a me nā osteoclasts .

• ʻO nā osteoblasts he mau pūnaewele e hana i ka iwi hou.
• ʻO nā Osteoclasts nā pūnaewele e hoʻoheheʻe, wāwahi, a wehe i nā pūnaewele iwi kahiko a hōʻino ʻia.

ʻO ka maʻamau, hana pū kēia mau ʻano ʻelua o nā cell e mālama i ke kaulike ma waena o ka hana ʻana o nā cell iwi hou a me ka hoʻololi ʻana o nā cell iwi kahiko. Akā i ka wā e komo ai ke kanesa i loko o nā iwi, hele hewa kēia kaʻina hana. Eia ka mea e hana ʻia:

• Inā hana nā osteoblasts i nā hunaola iwi hou he nui loa, e nui loa ka hōʻiliʻili ʻana o kou iwi, a e ulu aʻe nā wahi o ka hoʻokumu ʻia ʻana o ka iwi maʻamau ʻole. Hiki i kāu kauka ke kapa i kēia mau wahi he mau ʻeha osteosclerotic a i ʻole nā ​​ʻeha osteoblastic . Hiki ke nānā aku kēia mau wahi he paʻakikī mai waho mai, akā he palupalu loa lākou, e like me kahi papa hau lahilahi ma ke kapa o ka muliwai. Hiki iā lākou ke haki a hiolo maʻalahi.
• Ke wāwahi wikiwiki nā osteoclasts i nā ʻāpana iwi ma mua o ka maʻamau, hiki i nā mea i hoʻokuʻu ʻia e kou mau ʻāpana iwi ke hana i nā lua liʻiliʻi i loko o kou iwi. Inā ʻoe e nānā iā ia ma lalo o kahi microscope, hiki ke like me kekahi i wili i nā lua i loko o kou iwi. Ua kapa kāu kauka i kēia mau lua he mau ʻeha osteolytic . Hoʻolilo kēia mau ʻeha i kou mau iwi i mea palupalu a nāwaliwali. Hoʻonui kēia i kou pilikia o ka haki ʻana o ka iwi.

Ua hōʻike ʻia e ka noiʻi aia kahi pilina ma waena o kekahi mau ʻano o nā cell iwi a me kekahi mau ʻano o ka maʻi kanesa metastatic. No ka laʻana, 70% a 85% o nā metastases iwi mai ka maʻi kanesa prostate he osteogenic, ʻo ia hoʻi ke kumu o lākou e hana nui ai nā osteoblasts i ka iwi. Eia nō naʻe, 75% o nā metastases mai ka maʻi kanesa umauma he osteolytic, ʻo ia hoʻi ke kumu o lākou e haki koke ai nā cell iwi.

Pehea ʻoe e ʻike ai i kēia?

E hana ana kāu kauka i kekahi mau hoʻokolohua kiʻi like ʻole e ʻike ai i kēia maʻi. Hiki iā lākou ke hana i nā hoʻokolohua koko a i ʻole nā ​​hoʻokolohua mimi e nānā i nā mea e hōʻike ana i ka hōʻino ʻia o ka iwi. Hiki i nā hoʻokolohua kiʻi ke komo pū me:

• Nānā iwi
• CT scan (Computered tomography - CT scan)
• MRI scan (kiʻi resonance magnetic - MRI scan)
• Nānā PET (Positron emission tomography - nānā PET)
• X-ray

Hiki i kēia mau hoʻokolohua ke haʻi pololei iā ʻoe i ka mea e hana nei me kou mau iwi, inā ua pālahalaha nā hunaola kanesa, a me ka mamao o ko lākou pālahalaha ʻana.

He aha nā lāʻau lapaʻau?

ʻO ka mea pōʻino, ʻaʻohe lāʻau lapaʻau no ka metastasis iwi. Eia nō naʻe, aia nā lāʻau lapaʻau a me nā lāʻau lapaʻau e hiki ke kōkua i ka hōʻemi ʻana i ka ʻeha a kaohi i ka holomua o ke ʻano . Hiki i kēia mau lāʻau lapaʻau ke hele lōʻihi i ka hoʻomaikaʻi ʻana i kou ʻano ola.

Eia kekahi o nā ʻano lapaʻau nui:

• ʻO Bisphosphonates: Hoʻoikaika kēia mau lāʻau (e.g., Pamidronate, Zoledronic acid (Zometa®)) i kou mau iwi, hoʻemi i ka nui o ka calcium i loko o kou koko, a hoʻemi i ka pilikia o ka hoʻomohala ʻana i ka hypercalcemia.
• ʻO ka Chemotherapy a i ʻole ka lāʻau lapaʻau hormone: Hiki i kāu kauka ke kuhikuhi i kēia lāʻau lapaʻau inā he ʻoi aku ma mua o hoʻokahi wahi o nā hunaola kanesa e pālahalaha ana (metastases) i kou mau iwi.
• ʻO ka lāʻau lapaʻau antibody monoclonal: Hāʻawi ʻia nā lāʻau lapaʻau e like me Denosumab (Prolia® a i ʻole Xgeva®) e hōʻemi i ka pilikia o ka haki ʻana o ka iwi.
• Lapaʻau radiation: Inā loaʻa iā ʻoe ka ʻeha mai kahi puʻupuʻu i loko o kekahi o kou mau iwi, hiki ke hāʻawi ʻia ka radiation therapy e mālama i kēlā ʻeha. Hiki iā ia ke kōkua i ka ʻeha i hoʻokumu ʻia e ke kaomi ʻana o ke kaula spinal. Hiki i kāu kauka ke hāʻawi iā ʻoe i nā corticosteroids me ka radiation therapy.
• Kyphoplasty: He lāʻau lapaʻau kēia no nā haki ʻokiʻoki o ka iwi kuamoʻo.
• ʻoki kino: Hiki i kāu kauka ke ʻōlelo i ke ʻoki kino e hoʻoikaika i nā iwi palupalu a wehe paha i kahi puʻupuʻu maʻi kanesa.

E hoʻomanaʻo, na kāu kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa nāu, no laila e kamaʻilio pono me ia e pili ana i kēia.

He aha ka mea e hana ʻia inā ʻaʻole mālama ʻia?

Inā waiho ʻole ʻia ka metastasis iwi i ka mālama ʻole ʻia, hiki ke loaʻa nā pilikia e like me ka hypercalcemia. Inā waiho ʻole ʻia, hiki i kēia ke alakaʻi i ka coma. Eia kekahi, ʻaʻole paha ʻoe e hiki ke hele a hana paha i kāu hana ma muli o ka haki ʻana o ka iwi. Hiki i ka ʻeha nui o ka iwi ke hōʻemi i kou hiki ke hauʻoli i ke ola. ʻO ka mea nui loa, hiki i ke kaomi ʻana o ke kaula spinal ke alakaʻi i ka maʻi lolo inā waiho ʻole ʻia. No laila, mai hoʻowahāwahā i nā hōʻailona.

He aha kāu e manaʻo ai inā he metastasis kou i ka iwi?

Inā loaʻa iā ʻoe ka metastasis iwi, ʻo ia hoʻi ua laha ka maʻi kanesa mai kahi ʻāpana ʻē aʻe o kou kino i kou mau iwi. He hōʻailona kēia o ka maʻi kanesa holomua . I kēia hihia, pono ʻoe i ka lāʻau lapaʻau a me ke kākoʻo no ke kanesa mua a me ka metastasis iwi.

He mea nui loa ia ʻaʻole e hopohopo, e hahai i nā ʻōlelo aʻoaʻo a ke kauka, a e noho maikaʻi.

ʻEhia ka lōʻihi e hiki ai iā ʻoe ke ola me kēia maʻi?

He mea paʻakikī ke hāʻawi i hoʻokahi pane i kēia nīnau. No ka mea, pili ia i nā kumu he nui. Hiki ke ʻokoʻa kēia wā, maʻamau mai ʻeono mahina a ʻoi aku ma mua o ʻehā makahiki. ʻO nā kumu nui e hoʻopilikia nei iā ia:

• ʻAno maʻi ʻaʻai: Wahi a kekahi noiʻi, ʻo ka manawa ola no ka maʻi ʻaʻai māmā i pālahalaha i nā iwi ma kahi o ʻeono a ʻehiku mahina, ʻoiai no ka maʻi ʻaʻai prostate i pālahalaha i nā iwi, hiki i ka manawa ola ma kahi o 53 mahina.
• Kahua o ke kanesa: ʻO ka poʻe me ke kanesa i ʻike ʻia ma ke kahua I (Kahua I) ʻaʻole lākou e loaʻa i nā metastases iwi ma mua o ka poʻe i ʻike ʻia ma ke kahua IV (Kahua IV). No ka laʻana, ua ʻike nā kānaka noiʻi nāna i nānā i ka helu o nā metastases iwi 10 mau makahiki ma hope o ka ʻike ʻia ʻana o ke kanesa he 3% o ka poʻe me ke kahua I i loaʻa i ke kūlana, ʻoiai he 28% o ka poʻe me ke kahua IV i loaʻa iā ia.

Ua loaʻa iaʻu ke kanesa pae 1, a ua hoʻomaha ʻia. No ke aha i laha ai koʻu kanesa?

ʻO ka mea pōʻino, i kekahi manawa ma hope o ka mālama ʻia ʻana o ke kanesa a ke kala ʻia nei , hiki ke ulu ka kanesa metastatic, i ʻike ʻia hoʻi he metastasis iwi. ʻO ke ʻano o ka "Remission" ʻaʻohe ou hōʻailona a ʻaʻohe hōʻailona o ke kanesa e loaʻa ma nā hoʻokolohua. Inā loaʻa iā ʻoe nā metastases iwi, hiki i kāu kauka ke kapa i kēia ʻano he kanesa recurrent mamao . ʻO ke kanesa recurrent ka wā e hoʻi mai ai ke kanesa ma hope o ka mālama ʻana.

Pehea wau e mālama ai iaʻu iho?

Hiki i ka metastasis iwi ke hoʻopilikia i kou ʻano ola. ʻAʻole maʻalahi ka noho ʻana me nā hōʻailona e like me ka ʻeha a me ka manaʻo e pālahalaha ana ke kanesa. Akā eia kekahi mau manaʻo e kōkua paha iā ʻoe:

• ʻAi maikaʻi: Hiki i nā pilikia mai nā metastases iwi ke hoʻopilikia i kou makemake. E kamaʻilio me kahi meaʻai meaʻai e hoʻomohala i kahi hoʻolālā ʻai olakino e pono ai nāu.
• E noʻonoʻo e pili ana i nā papahana ola maʻi kanesa: He mea ola ʻoe i ke kanesa mai ka lā i ʻike ʻia ai ʻoe. I kēia manawa ke hana nei ʻoe me nā metastases iwi, ua like ʻoe. Aia paha he mau papahana a me nā hui kākoʻo e kōkua i nā poʻe i ke kūlana like me ʻoe.
• E nīnau e pili ana i ka mālama palliative:ʻO ka pinepine, ʻo ka hōʻailona mua o ka metastases iwi ka ʻeha iwi. Hiki i kēia ʻeha ke koʻikoʻi a hoʻopilikia i kou ʻano ola. Hoʻokomo pū ka mālama palliative i nā lāʻau ʻeha a me nā kākoʻo hoʻokele ʻeha ʻē aʻe. Hoʻokomo pū ka mālama palliative i ka ʻōlelo aʻoaʻo noʻonoʻo e kōkua iā ʻoe e hoʻokele i nā pilikia naʻau e hele mai me ka loaʻa ʻana o ka maʻi ʻaʻai hope loa.
• E nānā i nā hoʻokolohua lapaʻau: Ke nānā nei nā kānaka noiʻi i nā ala hou e mālama ai i nā metastases iwi mai nā ʻano maʻi kanesa like ʻole. E nīnau i kāu kauka e pili ana i nā hoʻokolohua lapaʻau e kūpono paha iā ʻoe.

Pono anei au e noʻonoʻo i ka mālama hospice?

Aia nō ia i kou kūlana. Inā manaʻo kāu kauka ʻaʻole paha e ho'ōla ʻia kou maʻi ʻaʻai me ka hoʻomau ʻana i ka mālama ʻana, a he ʻeono mahina a emi mai paha kou ola inā e hoʻōki ʻia ka mālama ʻana, hiki iā ia ke paipai i ka mālama hospice . Ke nānā nei ka mālama hospice i kou ʻoluʻolu kino, ke kūʻokoʻa mai ka ʻeha, a me ka mālama ʻana i nā hōʻailona ʻē aʻe.

Āhea wau e ʻike ai i kaʻu kauka?

Inā e ʻoi aku ka ʻino o kāu mau hōʻailona o ka metastases iwi, no ka laʻana, inā loaʻa iā ʻoe ka ʻeha hiki ʻole iā ʻoe ke kāohi me ka lāʻau lapaʻau i kuhikuhi ʻia, e ʻike koke i kāu kauka. E hoʻomanaʻo, ʻaʻole pono ʻoe e noho me ka ʻeha nui o ka metastases iwi. E kuhikuhi kāu kauka i nā lāʻau lapaʻau hōʻoluʻolu ʻeha a me nā lāʻau lapaʻau ʻē aʻe ʻaʻole e hoʻopilikia i kou ʻano ola, me kou hiki ke noho pū me kāu poʻe aloha.

Āhea wau e hele ai i ka lumi pilikia?

Inā loaʻa iā ʻoe nā hōʻailona o ke koʻikoʻi o ke kaula spinal, pono ʻoe e kāhea i ka 911 a i ʻole e hele koke i ka lumi pilikia. ʻO kēia mau hōʻailona:

• Inā he ʻeha a he ʻāʻī paha kou mau wāwae, nā kapuwaʻi o kou mau wāwae, a i ʻole ka ʻōpū lalo.
• Inā pilikia ʻoe i ka hoʻoneʻe ʻana i kou mau wāwae.
• Inā ʻaʻole hiki iā ʻoe ke kāohi i kou mimi ʻana a i ʻole ka defecation.
• Inā ʻaʻole hiki iā ʻoe ke mimi iki.

Inā ʻaʻole mālama ʻia, hiki i ke kaomi ʻana o ke kaula spinal ke alakaʻi i ka maʻi lolo, no laila e makaʻala pono i kēia mau hōʻailona.

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

ʻO ka ʻike ʻana he metastasis iwi kou, ʻoiai ʻoe e hana nei me ka maʻi kanesa, hiki ke hoʻopilikia hou aku i kou ʻano ola. Eia kekahi mau nīnau hiki iā ʻoe ke nīnau i kāu kauka:

• ʻO wai o koʻu mau iwi i piha i nā hunaola kanesa?
• Pehea ka hopena o ka maʻi ʻaʻai iwi i koʻu prognosis holoʻokoʻa?
• He aha nā lāʻau lapaʻau a i ʻole nā ​​​​hui pū ʻana o nā lāʻau lapaʻau e hiki ke kōkua iaʻu?
• Hiki i nā lāʻau lapaʻau ke pale aku i ka laha ʻana o nā metastases o ka iwi i nā iwi ʻē aʻe?
• He aha nā koho no ka mālama ʻana i koʻu ʻeha iwi?
• Pehea e hiki ai iaʻu ke hōʻemi i koʻu pilikia o ka haki ʻana o nā iwi?

He aha ka ʻokoʻa ma waena o ke Kanesa o ka Iwi a me ka Metastasis o ka Iwi?

He mea kēia e huikau ai nā kānaka he nui.

• ʻO ke kanesa iwi kahi ʻano kanesa e hoʻomaka ana i loko o kou mau iwi, e like me ka osteosarcoma a i ʻole Ewing sarcoma .
• ʻO ka metastasis iwi ka wā e laha ai ke kanesa i hoʻomaka ma kahi ʻē aʻe o kou kino i kou mau iwi.

ʻO ka metastasis iwi kahi hōʻailona o ke kanesa metastatic. Hiki ke haʻi ʻia iā ʻoe he metastasis iwi kou, ʻo ia ka manawa mua āu i ʻike ai ua laha kou kanesa mai kahi i hoʻomaka ai. Hiki i ka nūhou ke kaumaha a hoʻoluhi. Eia kekahi, ʻo ka ʻike ʻana he kumu ka metastasis iwi i ka ʻeha mau a hoʻopilikia i kou ʻano ola hiki ke ʻoi aku ka hoʻoluhi. Hiki iā ʻoe ke hopohopo a makaʻu i ka mea e manaʻo ai ma hope. Akā e hoʻomanaʻo, aia kāu mau kauka ma laila e hoʻolohe iā ʻoe a hoʻomaopopo i kou mau hopohopo. Hiki iā lākou ke kōkua iā ʻoe me nā mea āpau mai ka hoʻokele ʻana i kou ʻeha a hiki i ka wehewehe ʻana i ka mea e manaʻo ai inā laha kou kanesa.

ʻO ka mea hope loa, leka lawe i ka home:

ʻOiai he maʻi koʻikoʻi ka metastasis iwi, aia nā ala e mālama ai.

• ʻO ka mea nui loa, ʻaʻole e hopohopo a hahai pono i nā ʻōlelo a ke kauka.
• Aia nā lāʻau lapaʻau e kāohi i ka ʻeha a mālama i kahi ola maikaʻi.
• ʻAʻole ʻoe hoʻokahi. Loaʻa iā ʻoe ka ʻohana, nā hoaaloha, nā kauka, a me nā loea mālama ola e kōkua iā ʻoe.
• He mea nui loa ka noho maikaʻi a me ka ikaika o ka noʻonoʻo ma kēia huakaʻi.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai makaʻu e nīnau i kāu kauka. E wehewehe ʻo ia i nā mea āpau iā ʻoe.

ʻO ke kanesa, ka metastasis iwi, ka ʻeha iwi, ka laha ʻana o ke kanesa, ka mālama ʻana i ke kanesa, ka hoʻonui ʻana o ka calcium, ke kaomi ʻana o ka iwi kuamoʻo