Hoʻomaopopo mākou i ka makaʻu, ka haʻalulu, a me nā nīnau he nui e kū mai ana ke ʻike ʻoe he maʻi ʻaʻai umauma kou. Akā ʻo ka mea nui loa i kēia manawa, ʻo ia ka hoʻomaopopo pono ʻia. No ka mea, ʻaʻole like nā maʻi ʻaʻai umauma āpau. Aia nā lāʻau lapaʻau i kuhikuhi pono ʻia no kekahi mau ʻano maʻi ʻaʻai. ʻĀ, hoʻokahi lāʻau lapaʻau i hoʻohana pono ʻia no nā poʻe he nui, ʻo ia ka lāʻau lapaʻau hormone . E kamaʻilio kākou e pili ana i kēia lā.
He aha ka lāʻau lapaʻau hormone? He kūpono anei ia no nā mea āpau?
I ka ʻōlelo maʻalahi, kōkua kekahi mau hormones i loko o ko kākou kino i ka ulu ʻana o kekahi mau hunaola maʻi umauma. ʻO ke kikoʻī, ʻelua mau hormones i kapa ʻia ʻo estrogen a me progesterone.
E noʻonoʻo i nā hunaola kanesa e like me nā hale liʻiliʻi. Loaʻa i kekahi mau hunaola kanesa nā 'puka' kūikawā (nā mea loaʻa) e ʻae ai i kēia mau hormones e komo. Kāhea mākou i nā kanesa i loaʻa kēia mau puka he hormone receptor-positive . E nā kauka, ua ʻike paha ʻoe i kēia ma kāu hōʻike he ER-positive (nā puka estrogen) a i ʻole PR-positive (nā puka progesterone).
Hana ka lāʻau lapaʻau hormone no nā maʻi kanesa i loaʻa kēia mau puka hormone. Pani kēia mau lāʻau lapaʻau i kēlā mau puka a hōʻemi paha i ka hana ʻana o kēlā mau hormones i loko o ke kino. Hoʻonele kēia i nā hunaola kanesa i ka "meaʻai" e pono ai lākou, e hoʻōki ai i ka ulu ʻana a make paha.
ʻO ka mea nui, inā ʻaʻohe o kāu mau hunaola kanesa i kēia mau mea loaʻa hormone, ʻo ia hoʻi, inā he hormone receptor-negative lākou, ʻaʻole e holo pono kēia mau lāʻau lapaʻau hormone. Paipai nā kauka i nā lāʻau lapaʻau ʻē aʻe no ia poʻe.
He aha nā ʻano nui o ka lāʻau lapaʻau hormone?
Aia kekahi mau ʻano nui o ka lāʻau lapaʻau hormone i hoʻohana ʻia no ka maʻi ʻaʻai umauma. E koho kāu kauka i ka lāʻau lapaʻau kūpono loa nāu ma muli o nā kumu he nui, me kou makahiki, ke ʻano o ke kanesa, a inā ua hala ʻoe i ka menopause. E nānā kākou i ʻelua ʻano nui.
| ʻAno lapaʻau | Iā wai ka mea nui i hāʻawi ʻia aku ai? | Nā hopena ʻaoʻao e ʻike ai |
|---|---|---|
| ʻO Tamoxifen | No nā wāhine o kēlā me kēia makahiki (ma mua a ma hope o ka menopause). He lāʻau lapaʻau i hoʻohana pono ʻia no nā makahiki he ʻumi. | ʻO ka piʻi iki ʻana o ka pilikia o ke kanesa ʻōpū, nā ʻūpā koko i nā wāwae a me nā māmā, ka hahau ʻana, nā cataracts, a me nā ʻālohilohi wela. |
| Nā mea pale ʻala Aromatase (AI) Laʻana: Anastrozole, Letrozole | ʻOi loa no nā wahine ma hope o ka menopause. | Ka nāwaliwali o nā iwi (Osteoporosis) a me ka pilikia o ka haki ʻana o nā iwi, ka ʻeha o nā hono a me nā ʻiʻo, nā pilikia hoʻomanaʻo, a me ka piʻi iki ʻana o ka maʻi puʻuwai. |
Nā mea hou aʻe e pili ana iā Tamoxifen
He pila kēia āu e lawe ai i kēlā me kēia lā. Ua hōʻike ʻia e ka noiʻi ʻana i ka lawe ʻana no kekahi mau makahiki, ma kahi o 5 mau makahiki, e hōʻemi nui ana i ka pilikia o ka hoʻi hou ʻana mai o ke kanesa a me ka pilikia o ka loaʻa ʻana o nā kanesa hou.
Eia nō naʻe, pono ʻoe e makaʻala i nā hopena ʻaoʻao a mākou i kūkākūkā ai ma kēlā papa. ʻOi aku ka pilikia o ka maʻi ʻaʻai uterine. ʻO ia ke kumu he mea koi ʻia e hana i nā hoʻokolohua pelvic maʻamau i ka wā e lawe ana i kēia lāʻau lapaʻau. Eia kekahi, inā loaʻa iā ʻoe kekahi kahe koko ʻano ʻē, pono ʻoe e haʻi koke i kāu kauka.
ʻIke hou aku e pili ana i nā Aromatase Inhibitors (AIs)
Hana kēia ʻano lāʻau lapaʻau ma ka hoʻōki ʻana i ka hana ʻana o ka hormone estrogen i nā wahine ma hope o ka menopause. Hoʻonele kēia i nā hunaola kanesa o ka hormone e pono ai lākou e ulu.
ʻO ka pilikia nui o kēia lāʻau lapaʻau, ʻo ia ka osteoporosis , ʻo ia ka pilikia o ka nāwaliwali o nā iwi a haki maʻalahi. No kēia kumu, e hana paha kāu kauka i kahi hoʻāʻo paʻa o ka iwi ma mua o kou hoʻomaka ʻana e lawe i kēia lāʻau lapaʻau a ʻoiai ʻoe e lawe ana. Hiki iā ia ke paipai iā ʻoe e lawe i nā mea hoʻohui calcium a me ka wikamina D.
Nā lāʻau lapaʻau ʻē aʻe a me nā holomua
Ma waho aʻe o nā ʻano lāʻau lapaʻau nui i ʻōlelo ʻia ma luna, aia kekahi mau ʻano lāʻau lapaʻau ʻē aʻe i hoʻohana ʻia, ʻoiai ke pālahalaha aku ka maʻi kanesa i nā ʻāpana ʻē aʻe o ke kino (holomua a metastatic paha).
Eia kekahi laʻana, aia nā lāʻau lapaʻau e like me `Fulvestrant (Faslodex)` a me `Toremifene (Fareston)`. Eia kekahi, he nui nā lāʻau lapaʻau holomua i kapa ʻia ʻo `Targeted Therapy` i kēia lā. ʻO `Palbociclib (Ibrance)`, `Abemaciclib (Verzenio)`, `Alpelisib (Piqray)` nā laʻana o ia mau lāʻau lapaʻau. Hana kēia mau mea ma ka hoʻopaʻa ʻana i nā protein kikoʻī e kōkua i ka ulu ʻana o nā hunaola kanesa. Hāʻawi pinepine ʻia kēia mau mea i nā maʻi me ka hui pū ʻana me ka lāʻau lapaʻau hormone i ʻōlelo ʻia ma luna.
Hana ʻia kēia mau hoʻoholo lapaʻau āpau ma muli o kou kūlana, ke ʻano o ke kanesa, kou mau makahiki, a me kou olakino holoʻokoʻa. No laila, mai makaʻu e kūkākūkā i kāu mau nīnau me kāu kauka .
Lapaʻau kūikawā no ka poʻe i hala ʻole i ka menopause (Ovarian Ablation)
Inā ʻaʻole ʻoe i menopause, ʻo ia hoʻi ke loaʻa nei iā ʻoe nā wā maʻamau , hana ʻia ka hormone estrogen nui o kou kino e kāu mau ovaries. No laila, no kekahi me ka maʻi kanesa ER-positive, hiki i kāu kauka ke hoʻoholo e hoʻōki i kēia mau ovaries mai ka hana ʻana i ka estrogen. Ua kapa ʻia kēia he ovarian ablation/suppression .
Aia kekahi mau ala e hana ai i kēia:
- Ka wehe ʻana i nā ovaries me ke ʻoki kino: He ʻano hana mau loa kēia.
- ʻO ka radiation therapy i nā ovaries: Hiki i kēia ke hoʻōki mau i ka hana o nā ovaries.
- Lāʻau lapaʻau e hoʻōki i ka hana ʻana o nā ovaries no kekahi manawa: Hoʻohana ʻia nā lāʻau lapaʻau i kapa ʻia ʻo `(LHRH) agonists` (pinepine i nā inikini) no kēia. Inā ʻoe e lawe i kēia mau lāʻau lapaʻau, ʻaʻole e hana kāu mau ovaries i nā hormones.
Ua hōʻike ʻia e ka noiʻi me ka hoʻopau ʻana i kēia mau ovaries, hiki i ka lāʻau lapaʻau hormone e like me tamoxifen ke hoʻokō i nā hopena maikaʻi loa.
Leka Lawe-Home
- ʻAʻole ka lāʻau lapaʻau hormone he lāʻau lapaʻau no nā maʻi ʻaʻai umauma āpau. Hāʻawi wale ʻia ia i nā maʻi ʻaʻai hormone receptor-positive (ER/PR-positive) .
- ʻO ka lāʻau lapaʻau e kūpono loa iā ʻoe (e like me Tamoxifen a i ʻole Aromatase Inhibitor) e hoʻoholo ʻia e kāu kauka, ma muli o kou makahiki a me ke kūlana olakino.
- Hiki i kēia mau lāʻau lapaʻau āpau ke loaʻa nā hopena ʻaoʻao. Mai makaʻu iā lākou, e makaʻala wale i ko lākou ʻano. Inā ʻike ʻoe i kekahi mau hōʻailona ʻē, e haʻi koke i kāu kauka.
- He mea nui loa ka loaʻa ʻana o nā hoʻokolohua i kauoha ʻia e ke kauka i ka manawa kūpono i ka wā o ka mālama ʻana.
- E hōʻoia e kūkākūkā ākea i kou mau makaʻu, kānalua, a me nā nīnau me kāu hui lapaʻau. He ikaika nui ia i kāu huakaʻi hoʻōla.
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