Hiki i ka huaʻōlelo "maʻi kanesa" ke hoʻohihi iā kākou āpau i ka makaʻu nui. Akā me ka holomua o ka ʻepekema lapaʻau, aia nā lāʻau lapaʻau ikaika loa e hakakā ai i kēia maʻi. Ua lohe paha ʻoe i ka chemotherapy, ʻo ia hoʻi ka lawelawe ʻana i nā lāʻau lapaʻau e luku pololei i nā hunaola kanesa. Eia kekahi, ʻo kahi lāʻau lapaʻau hou e kamaʻilio nui ʻia nei ʻo ia ka immunotherapy. Pili kēia i ka hoʻoulu ʻana i ka ʻōnaehana pale o ko kākou kino ponoʻī a me ka hoʻoikaika ʻana iā ia e hakakā i ka maʻi kanesa. Akā i kekahi manawa hiki ke paʻakikī ke hoʻokō i nā hopena i makemake ʻia me hoʻokahi lāʻau lapaʻau wale nō. ʻO ia ke kumu e kū mai ai ke kumumanaʻo o "Combination Care" a mākou e kamaʻilio nei i kēia lā.
No ke aha e hoʻohui pū ai i kēia mau lāʻau lapaʻau?
I ka ʻōlelo maʻalahi, ʻoi aku ka lanakila o kahi hui o nā koa me nā mākaukau like ʻole ma mua o hoʻokahi koa e hakakā wale ana. Pēlā nō hoʻi i ka mālama ʻana i ka maʻi kanesa. Ke hoʻohana pū ʻia kekahi a ʻoi aku paha nā lāʻau lapaʻau, hoʻonui ʻia ka manawa e kāohi ai i ka maʻi kanesa, hoʻōla loa iā ia, a hoʻolōʻihi paha i ke ola o ka mea maʻi.
He mea nui loa kēia mau lāʻau lapaʻau i hui pū ʻia no nā maʻi kanesa koʻikoʻi a holomua paha, e like me ke kanesa o ka māmā a me ka melanoma ʻili.
He aha nā manaʻolana nui mai ka hoʻohui ʻana i kēia mau lāʻau lapaʻau?
- Ke hoʻoikaika nei i ka hakakā ʻana o kā mākou ʻōnaehana pale i ke kanesa: Kōkua kekahi mau lāʻau lapaʻau i ka ʻōnaehana pale e ʻike maʻalahi i nā hunaola kanesa.
- Ke hoʻopilikia nei i ka hiki o nā hunaola kanesa ke "peʻe" mai ka ʻōnaehana pale: He mau hunaola maalea loa nā hunaola kanesa. Hoʻohana lākou i nā ʻano hana like ʻole e pale aku ai i kā mākou ʻōnaehana pale. Hiki i nā lāʻau lapaʻau hui pū ke hoʻopilikia i kēia mau ʻano hana.
- Ka hōʻemi ʻana i ka helu o nā hunaola kanesa a i ʻole ka nui o kahi puʻupuʻu: Ke hoʻemi kekahi lāʻau i kahi puʻupuʻu, e maʻalahi ia no kekahi lāʻau ʻē aʻe e luku i nā hunaola i koe.
Nā lāʻau lapaʻau hui i hoʻohana pinepine ʻia
Hoʻohui nā kauka i nā ʻano lapaʻau like ʻole. E nānā kākou i kekahi o lākou.
1. He papa kūikawā o ka immunotherapy i kapa ʻia ʻo Checkpoint Inhibitors
He lāʻau lapaʻau hoihoi loa kēia. E noʻonoʻo i ko kākou ʻōnaehana pale ma ke ʻano he pūʻali koa e pale aku ana i ka ʻāina. Hiki i kēia mau pūnaewele pūʻali koa (nā pūnaewele T) ke ʻike a hoʻouka i nā pūnaewele ʻenemi. Akā i kekahi manawa, hoʻopau nā pūnaewele maʻi kanesa i nā "checkpoints" i loko o kēia mau pūnaewele pūʻali koa a pāʻani i kahi hana hoʻopunipuni, me ka ʻōlelo ʻana, "ʻO wau kekahi o ʻoukou, mai hoʻouka mai iaʻu."
ʻO ka hana a nā lāʻau i kapa ʻia ʻo 'Checkpoint Inhibitors', ʻo ia ke hoʻohuli i ke kuapo i pio ai nā hunaola kanesa. A laila hiki i kā mākou ʻōnaehana pale ke ʻike i nā hunaola kanesa a hoʻomaka e hoʻouka iā lākou.
ʻOi aku ma mua o 75% o ka noiʻi immunotherapy i kēia lā e hoʻohui i kēia mau mea pale checkpoint me nā lāʻau lapaʻau ʻē aʻe. Kōkua kēia ʻano hana i ka hoʻēmi ʻana i nā ʻano maʻi kanesa he nui, e hāʻawi ana i nā hopena lōʻihi me nā hopena ʻaoʻao liʻiliʻi.
Eia kekahi laʻana, ua hoʻohana pono ʻia ka hui pū ʻana o ʻelua mau lāʻau lapaʻau checkpoint inhibitor, ʻo ipilimumab lāua ʻo nivolumab, no nā makahiki he nui e mālama ai i ka melanoma aggressive i pālahalaha i ka lolo.
Ua ʻae ʻia kēia hui no ka puʻupaʻa, colon, ate, māmā, a me nā ʻano maʻi kanesa ʻē aʻe.
2. Hoʻohui i ka Immunotherapy a me Chemotherapy
He ʻano hana kēia i hōʻike i nā hopena holomua loa. ʻOiai ʻo ka chemotherapy e luku ai i nā hunaola kanesa, kōkua ka immunotherapy i ka ʻōnaehana pale e ʻimi a luku i nā hunaola i koe.
| ʻAno maʻi kanesa | ʻO ka pōmaikaʻi o ka hui pū ʻana |
|---|---|
| Ka maʻi ʻaʻai umauma | He paʻakikī i ka ʻōnaehana pale ke ʻike i kekahi mau ʻano maʻi ʻaʻai umauma, akā ʻo ka hui pū ʻana o ka immunotherapy me ka chemotherapy (e.g., Taxol) ua hōʻike i nā hopena maikaʻi loa. |
| Ka maʻi ʻaʻai pancreatic | ʻO ka hoʻohui ʻana i ka chemotherapy me nā lāʻau immunotherapy e like me nivolumab ua loaʻa nā hopena maikaʻi no ka maʻi ʻaʻai pancreatic i laha a puni ke kino. |
| Nā maʻi ʻaʻai koko | He kūleʻa loa nā lāʻau lapaʻau e like me ka CAR T-cell therapy no nā maʻi ʻaʻai koko e like me ka leukemia. Eia kekahi, ʻo ka hoʻohui ʻana i nā lāʻau lapaʻau checkpoint inhibitor me ka chemotherapy ua aneane pāpālua ka nui o ka kūleʻa o nā maʻi i pane ʻole i ka lāʻau lapaʻau. |
| Ka maʻi ʻaʻai o ka ʻōpū | No nā maʻi ʻaʻai e hoʻi hou mai ana ma hope o ka chemotherapy a me ka radiation, ua hoʻonui nui ka hoʻohui ʻana o ka immunotherapy i ke ola o nā maʻi. |
3. Hoʻohui i ka Immunotherapy a me ka Targeted Therapy
He ʻano ʻokoʻa ka `Targeted Therapy` ma mua o ka chemotherapy. Hiki i ka Chemotherapy ke hoʻopilikia i nā ʻāpana āpau e māhele wikiwiki ana (nā ʻāpana maʻi kanesa a me nā ʻāpana olakino). Eia nō naʻe, kuhikuhi a hoʻouka ka `Targeted Therapy` i kahi kīnā genetic a protein paha e hoʻoulu ai i nā ʻāpana kanesa.
ʻO ka hoʻohui ʻana i kēia ʻano hana me ka immunotherapy ke hōʻike nei i nā hopena hoʻohiki. No ka laʻana, ua ʻae ʻia kēia mau lāʻau lapaʻau hui no ka maʻi ʻaʻai puʻupaʻa a me ka maʻi ʻaʻai endometrial.
4. ʻO ke ʻoki kino me ka Immunotherapy
He ʻano hana koʻikoʻi loa nō hoʻi kēia.
- Ma mua o ke ʻoki ʻana: Hiki i ka Immunotherapy ke hoʻemi i ka nui o ke kanesa, e maʻalahi ai ke ʻoki ʻana a me ka hoʻemi ʻana i ka nui o nā ʻiʻo e wehe ʻia.
- Ma hope o ke ʻoki kino: Hiki i ka Immunotherapy ke kōkua i ka ʻōnaehana pale e luku i nā hunaola maʻi kanesa liʻiliʻi loa (micrometastases) e waiho mau ana i ka maka ʻike ʻole ʻia ma hope o ke ʻoki kino. Hoʻemi kēia i ka pilikia o ka hoʻi hou ʻana mai o ke kanesa.
Ua hōʻike kēia ʻano hana i nā hopena maikaʻi loa no ka maʻi ʻaʻai o ka lolo, ka māmā, ka umauma, ka ʻōpū, a me ka waha.
5. Immunotherapy me ka Radiation Therapy
Hoʻemi ka lāʻau lapaʻau radiation i nā ʻōpū. Manaʻo pū kekahi nā kānaka noiʻi e maʻalahi ka ʻōnaehana pale e ʻike i ke kanesa ma muli o nā hōʻailona i hoʻopuka ʻia e nā hunaola kanesa i hoʻomālamalama ʻia. No laila, ke hoʻomau nei ka noiʻi e ʻike inā hiki i ka hui pū ʻana o ka immunotherapy me ka radiation therapy ke hoʻonui hou i ka pono o ka lāʻau.
ʻO ka mea nui loa: Inā loaʻa iā ʻoe a i ʻole kekahi mea kokoke iā ʻoe ka maʻi kanesa, he mea nui e kūkākūkā ākea a piha me kāu kauka e pili ana i ka lāʻau lapaʻau maikaʻi loa iā ʻoe, inā pono ka hui pū ʻana o ka lāʻau lapaʻau, a me nā pono a me nā pōʻino. ʻO ka ʻike ma ka Pūnaewele no nā kumu ʻike wale nō ia a ʻaʻole pono e manaʻo ʻia he pani no ka ʻōlelo aʻoaʻo lapaʻau.
Leka Lawe-Home
- Hāʻawi pinepine ka mālama hui pū ʻana i nā hopena ʻoi aku ka maikaʻi ma mua o hoʻokahi lāʻau lapaʻau no ka maʻi kanesa.
- Hoʻolālā ʻia nā hoʻolālā lapaʻau ma ka hoʻohui ʻana i nā ʻano hana e like me ka immunotherapy, chemotherapy, targeted therapy, ʻoki kino, a me ka radiation therapy ma nā ʻano like ʻole.
- Hiki i kēia mau lāʻau lapaʻau i hui pū ʻia ke hoʻokō i nā pahuhopu e like me ka luku ʻana i nā hunaola kanesa, ka hoʻoikaika ʻana i ka ʻōnaehana pale, a me ka pale ʻana i ka hoʻi hou ʻana o ke kanesa.
- He kahua e ulu wikiwiki nei kēia, me nā hui lapaʻau hou a ʻoi aku ka maikaʻi e hoʻolauna mau ʻia nei.
- Hiki i kāu oncologist ke hoʻoholo i ka hoʻolālā lapaʻau maikaʻi loa nāu, no laila e kūkākūkā i nā hoʻoholo āpau me kāu kauka.
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