Ua ʻike anei kāu kauka iā ʻoe a i ʻole kahi mea aloha i ka maʻi ʻaʻai umauma? A laila ua lohe paha ʻoe i ka huaʻōlelo 'chemotherapy'. He mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke lohe ʻoe i kēia. Akā inā ua hoʻomaopopo pono ʻia mākou e pili ana i kēia mau lāʻau lapaʻau , hiki ke hoʻemi nui ʻia kēlā makaʻu. No laila, ʻo kekahi o nā papa lāʻau koʻikoʻi i hoʻohana ʻia i nā lāʻau lapaʻau chemo ua kapa ʻia ʻo anthracyclines . I kēia lā, e kamaʻilio mākou e pili ana i kēia me ka maʻalahi a ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
Pehea e hana maoli ai kēia lāʻau lapaʻau i loko o ke kino?
I ka ʻōlelo maʻalahi, ʻo nā anthracyclines kahi ʻano antibiotic e kōkua i ka pepehi ʻana i nā hunaola kanesa. Akā, ʻaʻole like lākou me nā antibiotic a mākou e lawe ai no ke anu maʻamau a i ʻole ka maʻi flu. Hoʻopuka ʻia lākou e kahi ʻano fungus i kapa ʻia ʻo Streptomyces, e noho ana i loko o ka lepo.
E noʻonoʻo i kahi hunaola kanesa e like me ka mīkini kope e hana ana i nā kope me ka ʻole o ka mana. Ke hana mau nei kēia mīkini i nā tausani kope o ia iho. Penei ke ʻano o ka hoʻokumu ʻana a me ka ulu ʻana o nā ʻōpū. ʻO ka hana a nā anthracyclines, ʻo ia ke hoʻopili ʻana i ka 'kope haku' o ka DNA i loko o kēlā mīkini kope. A laila ʻaʻole hiki iā lākou ke hana i nā kope hou. ʻO ia hoʻi, ua pau loa ka hiki o nā hunaola kanesa ke māhele a ulu koke.
ʻO ka maʻamau, hāʻawi ʻia kēia lāʻau lapaʻau iā ʻoe ma ke ʻano he inikini a i ʻole he wai saline i loko o kahi aa (intravenous a i ʻole IV). Na kāu kauka e hoʻoholo i ka nui o ka lāʻau lapaʻau e lawe ai a me ka lōʻihi e hoʻomau ai i ka lāʻau lapaʻau ma muli o ke kahua a me ke kūlana o kou maʻi ʻaʻai.
I ka hapanui o nā hihia, i ka wā e hoʻomaka ana ke kanesa o ka umauma, hana ʻia ke ʻoki kino e wehe i ka puʻupuʻu. A laila, hāʻawi ʻia ka chemotherapy e luku loa i nā hunaola kanesa liʻiliʻi loa a ʻike ʻole ʻia e waiho ʻia ana i loko o ke kino. Kāhea mākou i kēia "Adjuvant Chemotherapy" . Hoʻemi nui kēia i ka manawa e hoʻi hou mai ai ke kanesa. ʻO Anthracyclines kekahi o nā papa nui o nā lāʻau i hoʻohana ʻia ma "Adjuvant Chemotherapy".
Pehea ka maikaʻi o nā anthracyclines?
Ua hōʻike ʻia nā haʻawina he nui he ʻoi aku ka holomua o nā regimen chemotherapy e loaʻa ana nā anthracyclines ma mua o nā regimen i loaʻa ʻole ia mau mea.
Ma kekahi noiʻi nui, ua māhele ʻia ma mua o 4,000 mau wāhine me ka maʻi ʻaʻai umauma mua, ka poʻe i pilikia nui i ka hoʻi hou ʻana, i ʻelua mau pūʻulu a hāʻawi ʻia i ʻelua mau lāʻau lapaʻau.
1. Papa Anthracycline (TaxAC):Ua hāʻawi ʻia i kēia poʻe nā lāʻau chemotherapy ʻē aʻe ma waho aʻe o nā anthracyclines.
2. Pūʻulu ʻaʻohe Anthracycline (TC): Ua hāʻawi ʻia kēia poʻe i kahi hui lāʻau chemotherapy ʻokoʻa ʻaʻole i loaʻa ka anthracycline.
Ma hope o ka nānā ʻana i nā hui ʻelua no kahi o 3 mau makahiki, ua nānā nā mea noiʻi i ka lōʻihi o ko lākou ola olakino me ka hoʻi ʻole mai o ke kanesa. Penei nā hopena:
- I loko o ka hui anthracycline (TaxAC), ʻaʻole i hoʻi hou mai ka 92.4% o ke kanesa.
- I loko o ka hui non-anthracycline (TC), ʻaʻole i hoʻi hou mai ka 91.7% o ke kanesa.
Hōʻike kēia mau hopena, ʻoiai ʻaʻole nui ka ʻokoʻa, hiki i ka lāʻau lapaʻau e loaʻa ana ka anthracycline ke hōʻemi iki i ka pilikia o ka hoʻi hou ʻana o ka maʻi kanesa.
Aia kekahi mau hopena ʻaoʻao o kēia lāʻau lapaʻau?
ʻAe, e like me nā lāʻau lapaʻau chemotherapy āpau, hiki i nā anthracyclines ke hana i nā hopena ʻaoʻao. Akā, ʻaʻole loaʻa i nā kānaka a pau, a hiki ke hoʻomalu ʻia ka nui o lākou. E hiki i kāu kauka ke aʻo aku iā ʻoe ma kēia mau mea.
| ʻAno o ka hopena ʻaoʻao | Nā hōʻailona hiki ke loaʻa |
|---|---|
| Nā hopena ʻaoʻao ʻoluʻolu a kaulike | |
| Nā hiʻohiʻona maʻamau | Ka luaʻi a me ka nausea, ke anu a me ke kuni, ka maʻi pākī, ka ʻeha o ka ʻōpū, ke kino ʻeha, ka luhi. |
| ʻIli a me nā kui | ʻŌhūhū ʻili, maneʻo, hoʻololi ʻili i ke ʻano o nā kui, hoʻololi ʻili. |
| Nā hopena ʻē aʻe | ʻUlaʻula ka waihoʻoluʻu o ka mimi (ʻulaʻula), anorexia, ʻike i ka mālamalama, pau ka menstruation, a me ka emi ʻana o ka helu sperm i nā kāne. |
| Pili i ke koko | Ke kahe ʻana o ke koko, ka emi ʻana o nā keʻokeʻo koko (kahi e hoʻonui ai i ka pilikia o ka maʻi), a me ka hoʻopau ʻana i ka momona o ka iwi. |
E makaʻala i nā hopena ʻaoʻao koʻikoʻi
ʻO ka hopena nui a koʻikoʻi loa o kēia mau lāʻau lapaʻau, ʻo ia ka pilikia o ka hōʻino ʻana o ka puʻuwai. Ke hoʻohana ʻia kēia mau lāʻau lapaʻau no ka manawa lōʻihi, aia kahi pilikia o nā kūlana e like me ka hāʻule ʻana o ka puʻuwai, hiki ke hoʻonāwaliwali i ka ʻiʻo o ka puʻuwai. Eia kekahi, loaʻa i kekahi mau anthracyclines kahi pilikia liʻiliʻi loa o ka hoʻomohala ʻana i kahi ʻano maʻi ʻē aʻe, e like me ka leukemia, i nā hihia kakaikahi loa.
Ma muli o kēia mau pilikia, e hana pū kāu kauka maʻi ʻōpū a me ke kauka puʻuwai e nānā i ka hana o kou puʻuwai ma o kāu mālama ʻana e hōʻemi i kekahi pōʻino hiki. No laila, mai makaʻu i kēia.
He kūpono anei kēia no kekahi mau ʻano maʻi ʻaʻai umauma?
ʻAe. ʻAʻole like nā maʻi ʻaʻai umauma a pau. No laila, e koho kāu kauka i ka lāʻau lapaʻau kūpono loa iā ʻoe. E hilinaʻi kēia i kekahi mau kumu:
- Kahua o ke kanesa
- Inā paha he maʻalahi ke kanesa i nā hormones (Hormone-receptor status)
- Ke kūlana HER2 o ka maʻi kanesa
- Inā ua pālahalaha ke kanesa i nā lymph nodes
- Kou makahiki a me kou olakino holoʻokoʻa
Eia kekahi laʻana, inā ʻoi aku kekahi ma mua o 60, he koko kiʻekiʻe kona, a he mōʻaukala maʻi puʻuwai kona, ʻoi aku ka nui o ke kauka e ʻōlelo aku i kahi papa hana lapaʻau ʻaʻole i komo pū me nā anthracyclines.
Ua hōʻike ʻia e ka noiʻi ʻana ʻo ka poʻe me nā ʻano maʻi kanesa ʻino, e like me ka triple-negative, a me ka poʻe nona ka maʻi kanesa i nā lymph nodes e pōmaikaʻi nui ana mai nā lāʻau lapaʻau i loaʻa ka anthracycline.
He aha ka mea e hana ai inā kūpaʻa ke kanesa i nā anthracyclines?
I kekahi manawa, i ka hala ʻana o ka manawa, hiki i nā hunaola kanesa ke kū'ē i kēia mau lāʻau lapaʻau, ʻo ia hoʻi, ʻaʻole hana nā lāʻau lapaʻau. Mai hopohopo inā hana kēia. Inā hana ia, aia kekahi mau lāʻau lapaʻau ʻē aʻe a me nā lāʻau lapaʻau e hiki i kāu kauka ke hoʻohana.
Eia kekahi mau laʻana:
- ʻO Capecitabine (Xeloda)
- ʻEribulin (Halaven)
- ʻO Gemcitabine (Gemzar)
- ʻO Vinorelbine (Navelbine)
- Nā lāʻau lapaʻau hou e like me nā hui lāʻau antibody
Aia kekahi mau lāʻau lapaʻau holomua i loaʻa, e like me ka lāʻau lapaʻau i kuhikuhi ʻia a me ka immunotherapy. ʻO ka mea nui loa, ʻo ia ka mālama mau ʻana i ka launa pū ʻana me kāu hui lapaʻau.
Leka Lawe-Home
- He papa ikaika loa nā Anthracyclines o nā lāʻau chemotherapy i hoʻohana ʻia no ka maʻi ʻaʻai umauma.
- ʻO kā lākou hana nui ka hoʻopilikia ʻana i ka DNA o nā hunaola kanesa, e kāohi ana iā lākou mai ka māhele ʻana a me ka ulu ʻana.
- E like me nā lāʻau lapaʻau a pau, aia nā hopena ʻaoʻao. Ma muli o nā hopena hiki ke loaʻa ma ka puʻuwai, he mea nui e loaʻa ka lāʻau lapaʻau ma lalo o ka nānā pono ʻana o ke kauka.
- ʻO ka hoʻoholo ʻana inā e hāʻawi ʻia ʻoe i nā anthracyclines a i ʻole e hana ʻia ma hope o ka noʻonoʻo ʻana i nā kumu he nui, e like me ke ʻano o kou maʻi ʻaʻai a me kou kūlana olakino.
- Mai makaʻu e kamaʻilio ākea me kāu kauka e pili ana i kāu lāʻau lapaʻau, nā hopena ʻaoʻao, a i ʻole nā nīnau, nā makaʻu, a i ʻole nā hopohopo āu e loaʻa ai. ʻO ka ʻike kūpono ka mea kaua maikaʻi loa e lanakila ai i kēia kaua.
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