ʻO ka mea e pono ai ʻoe e ʻike e pili ana i nā maʻi carcinoid māmā

Ua loaʻa anei iā ʻoe ka ʻū no kekahi manawa? Malia paha ua hele pū me ka phlegm? A i ʻole ke manaʻo nei ʻoe he pōkole iki ka hanu? Hoʻopoina pinepine mākou i kēia mau mea, me ka manaʻo he anu wale nō lākou. Akā, he mea kākaʻikahi loa, aia paha kekahi mea ʻē aʻe ma hope o ia ʻano hōʻailona liʻiliʻi e pono ai mākou e makaʻala. I kēia lā, e kamaʻilio mākou e pili ana i kahi maʻi kanesa kakaʻikahi akā koʻikoʻi loa o nā māmā. ʻO ia hoʻi nā Lung Carcinoid Tumors.

I ka ʻōlelo maʻalahi, he aha kēia mau ʻōpū carcinoid māmā?

Pono kēia i kahi wehewehe iki. Aia kekahi ʻano cell kūikawā i loko o ko kākou kino e pili ana i ka ʻōnaehana nerve a me ka ʻōnaehana hormonal. Kāhea mākou i kēia mau cell neuroendocrine. E noʻonoʻo i kēia mau cell ma ke ʻano he mau mea hoʻonohonoho i loko o ko kākou kino. Ke hele mai kahi leka mai ka ʻōnaehana nerve, ʻo kā lākou hana ka hana ʻana i nā hormones i ka pane ʻana iā ia a kaohi i nā hana like ʻole i loko o ke kino. No ka laʻana, kōkua kēia mau cell i ka kaohi ʻana i ke ala e komo ai ko kākou hanu i loko o nā māmā a me ke ala e neʻe ai ka meaʻai ma o ke ala digestive.

No laila, no kekahi kumu, i ka wā e hoʻomaka ai kēia mau pūnaewele neuroendocrine e māhele a hoʻonui me ke kāohi ʻole ʻia, hoʻokumu ʻia nā puʻupuʻu ma kēlā mau wahi. Kāhea mākou i nā puʻupuʻu carcinoid māmā nā puʻupuʻu kanesa e hoʻomaka ana i loko o kēia mau pūnaewele neuroendocrine i loko o nā māmā.

Akā, mai makaʻu ʻoe ke lohe ʻoe i ka huaʻōlelo "maʻi kanesa." No ka mea, ʻelua ʻano o kēia mau puʻupuʻu carcinoid. ʻOkoʻa loa ke ʻano o nā mea ʻelua.

ʻO nā ʻano nui ʻelua o nā cysts cassinoid

Ua māhele ʻia lākou i ʻelua ʻano nui e pili ana i ko lākou wikiwiki o ka ulu ʻana a me ka hiki ke hoʻolaha.

He aha nā hōʻailona o kēia maʻi?

ʻO ka hapa nui o ka manawa, ʻoiai hoʻi i nā poʻe me nā cysts maʻamau, ʻaʻohe hōʻailona . ʻIke ʻia lākou ma ka hanana, me he mea lā ma kahi X-ray umauma no kekahi kumu ʻē aʻe. Eia nō naʻe, hiki i kekahi poʻe ke ʻike i kēia mau hōʻailona:

• ʻŪhū mau (i kekahi manawa me ke koko a i ʻole ka mucus)
• ʻEha umauma
• Ka paʻakikī o ka hanu ʻana (dyspnea)
• Ke lohe nei i kahi leo ʻūlū iki i ka wā e hanu ana (wheezing)

He kūlana kūikawā i kapa ʻia ʻo Carcinoid Syndrome

ʻAʻole pinepine loa, hoʻomaka kēia mau puʻupuʻu e hana i ka nui o ka hormone serotonin. Hiki i kēia ke hana i nā hormonal imbalances i loko o ke kino, e alakaʻi ana i nā ʻano hōʻailona like ʻole. Ua kapa ʻia kēia he carcinoid syndrome . ʻO kāna mau hōʻailona:

• Ka maʻi pākī nui
• ʻUlaʻula a manaʻo paha o ka mehana ma ka maka a me ka ʻāʻī (flushing)
• Piʻi ke kaumaha me ke kumu ʻole
• Ka paʻakikī o ka hanu ʻana a i ʻole nā ​​hōʻailona like me ka hānō

Inā loaʻa kēia mau hōʻailona, ​​​​he mea nui e ʻimi koke i ke kōkua lapaʻau.

No ke aha e like ai kēia ʻano me nā puʻupuʻu? Aia kekahi mau mea pilikia?

ʻO ka mea ʻoiaʻiʻo, ʻaʻole i ʻike ʻia ke kumu kikoʻī i hoʻomaka koke ai kēia mau pūnaewele neuroendocrine e māhelehele me ka ʻole o ke kāohi .

Eia nō naʻe, ua ʻike ʻia kekahi poʻe he ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o kēia maʻi. ʻO kēia mau mea:

• Loaʻa iā ʻoe kahi maʻi hoʻoilina laha ʻole i kapa ʻia ʻo Multiple Endocrine Neoplasia type 1 (MEN1) .
• ʻO ka puhipaka (ʻoi aku hoʻi no ke ʻano atypical)
• ʻOiai he wahine (ʻoi aku ka nui o ka loaʻa ʻana o kēia ʻano i nā wahine)
• Ma waena o 45 a me 55 mau makahiki. ʻOiai ʻo ka maʻi ka mea i ʻike pinepine ʻia i kēia hui makahiki, hiki ke loaʻa i kēlā me kēia makahiki, ʻoiai i nā keiki ʻuʻuku loa.

Pehea e ʻike ai i kēia maʻi?

Inā loaʻa iā ʻoe kekahi o nā hōʻailona i ʻōlelo ʻia ma luna, pono ʻoe e ʻike mua i kāu kauka. E nīnau ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona, ​​e hoʻolohe i kou umauma me kahi stethoscope, a, inā kānalua, e paipai i kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona.

1. Kiʻi: ʻO ka hana mua, ʻo ia ke kiʻi ʻana i kahi X-ray umauma . Inā loaʻa kekahi mau mea ʻē, hiki ke kauoha ʻia kahi CT scan (Computed Tomography scan) . Hiki i kahi CT scan ke hana i nā kiʻi ʻokiʻoki maopopo loa o nā māmā, e ʻae ana i ka nui a me kahi o ka puʻupuʻu e hoʻoholo ʻia.

2. Nā hoʻāʻo koko a me ka mimi: Hana ʻia kēia mau hoʻāʻo e ʻike inā aia kekahi mau hormones i hana ʻia e kēia mau puʻupuʻu i loko o ke koko a i ʻole ka mimi.

3. Biopsy: ʻO kēia ka hoʻāʻo koʻikoʻi loa e hōʻoia i ka maʻi 100%. Maanei, lawe ʻia kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai ka puʻupuʻu a nānā ʻia ma lalo o kahi microscope. Hiki i kēia ke hoʻoholo pololei inā he puʻupuʻu carcinoid ka puʻupuʻu, maʻamau a atypical paha. ʻO ke ʻano maʻamau i hoʻohana ʻia e kiʻi i kēia laʻana ʻiʻo ʻo ia ka bronchoscopy . Maanei, hoʻokomo ʻia kahi ʻōmole lahilahi me kahi kāmela liʻiliʻi ma o nā ala ea e nānā ai i ka puʻupuʻu a lawe ʻia kahi ʻāpana liʻiliʻi.

He aha nā koho lapaʻau?

ʻO ke ʻano lapaʻau maikaʻi loa nou e pili ana i ke ʻano, ka nui, kahi o ka puʻupuʻu, a me kou olakino holoʻokoʻa. ʻO ka nūhou maikaʻi , hiki ke ho'ōla loa ʻia ka hapa nui o nā puʻupuʻu carcinoid māmā me ke ʻoki kino wale nō.

Aia kekahi mau koho lapaʻau nui:

• ʻO ke ʻoki kino:
• Lobectomy: Wehe piha ʻana i ka lobe o ka māmā kahi i loaʻa ai ka puʻupuʻu.
• ʻO ka Wedge Resection: Wehe ʻana i ka puʻupuʻu wale nō a me kahi ʻiʻo liʻiliʻi a puni ia.
• Pneumonectomy: He mea kākaʻikahi loa, pono paha e wehe ʻia ka māmā holoʻokoʻa.
• Ka wehe ʻana i nā kīpē lymph: Hiki i ke kauka lapaʻau ke hoʻoholo e wehe i nā kīpē lymph kokoke e ʻike inā ua pālahalaha ke kanesa a pale i ka laha hou ʻana.

• Lapaʻau Radiation: Hāʻawi ʻia kēia lāʻau lapaʻau inā ʻaʻole hiki i ke ʻoki kino ke wehe loa i ka puʻupuʻu a i ʻole inā aia ka mea maʻi i loko o kahi kūlana olakino e hiki ʻole ai ke ʻoki kino. Pili ia i ka radiation kukuna waho a i ʻole ke kau ʻana o nā mea radioactive liʻiliʻi kokoke i ka puʻupuʻu (brachytherapy).

• Kemokalama:Ma muli o ka ulu lohi ʻana o kēia mau puʻupuʻu, ʻaʻole maikaʻi loa ka chemotherapy maʻamau, ka mea e kuhikuhi ana i nā cell e ulu wikiwiki ana. No laila, ʻaʻole hāʻawi pinepine ʻia kēia lāʻau i nā ʻano maʻamau. Eia nō naʻe, pono paha kēia lāʻau no nā ʻano atypical e ulu wikiwiki ana a i ʻole i ka wā i pālahalaha ai lākou i nā ʻōpū ʻē aʻe.

• Nā lāʻau lapaʻau ʻē aʻe:
• Octreotide: Hāʻawi ʻia kēia lāʻau hormonal e kāohi i nā hōʻailona i hoʻokumu ʻia e ka maʻi carcinoid.
• Nā mea hoʻopaʻa MTOR (e like me Everolimus): He ʻano lāʻau lapaʻau e kāohi ai i ka ulu ʻana o ka puʻupuʻu.

He aha ka nui o ka ho'ōla a me ka nānā ʻana?

He pilikia kēia no nā kānaka he nui.

ʻOi aku ka paʻakikī o ka mālama ʻana i nā ʻōpū carcinoid atypical. ʻOi aku ka kiʻekiʻe o ka pilikia o ka hoʻi hou ʻana. Eia nō naʻe, hiki ke hoʻomalu pono ʻia kēia ʻano ma ka hoʻohana ʻana i ka hui pū ʻana o nā ʻano lāʻau like ʻole.

Ma keʻano holoʻokoʻa, ʻo ka nui o ke ola ʻana o ʻelima makahiki no nā ʻano puʻupuʻu carcinoid māmā āpau he 89% . ʻO ke ʻano kēia, mai loko mai o 100 poʻe i ʻike ʻia me kēia maʻi, 89 e olakino mau ana ma hope o 5 mau makahiki.

Āhea ʻoe e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe nā hōʻailona hou a i ʻole e ʻoi aku ka ʻino, ʻoiai ka pōkole o ka hanu, ka maʻi pākī, a i ʻole ka pohō kaumaha i wehewehe ʻole ʻia, e haʻi i kāu kauka. Mai kānalua e kamaʻilio e pili ana i kekahi mau nīnau a hopohopo paha.

I ka manawa hea e hele koke ai i ka ETU (Emergency Treatment Unit)

Inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi ma lalo nei, e hele koke i ka Emergency Department (ETU) o ka haukapila kokoke loa:

• Manaʻo nui i ka hanu ʻole (ʻoiai i ka wā e hoʻomaha ai).
• Ke ʻū ʻana i ke koko.
• ʻEha hou a ʻeha paha ka ʻeha o ka umauma.
• Ka huikau a i ʻole ka ʻike i loli.
• ʻO ke kala polū o ka ʻili, nā lehelehe, a i ʻole nā ​​​​kui lima (cyanosis).

Nā nīnau e nīnau aku ai i kāu kauka

He mea maʻamau ka loaʻa ʻana o nā nīnau ke loaʻa iā ʻoe kahi hōʻailona e like me kēia. He mea kōkua paha ka nīnau ʻana i kāu kauka i nā nīnau e like me kēia:

• He mea maʻamau kēia a i ʻole he mea ʻē aʻe?
• Ua laha anei kēia i nā wahi ʻē aʻe?
• He aha ka lāʻau lapaʻau āu e paipai nei?
• He aha ke ʻano o ka nānā ʻana no kēia ʻano puʻupuʻu?
• Pehea e mālama ai i nā hōʻailona ma ka home?

He ʻike paʻakikī ka loaʻa ʻana o kahi hōʻailona o kekahi maʻi kanesa. Akā e hoʻomanaʻo, ʻo ka hapa nui o nā carcinoids māmā he hiki ke mālama ʻia a he haʻahaʻa ka pilikia o ka hoʻi hou ʻana. E kamaʻilio ākea me kāu hui lapaʻau e pili ana i ka mea e manaʻo ai no kou kūlana. E wehewehe lākou i nā koho lapaʻau maikaʻi loa iā ʻoe a pane i nā nīnau āu e loaʻa ai.