Ke hoʻopilikia nei nā lāʻau lapaʻau maʻi kanesa i kou puʻuwai? E kamaʻilio kākou e pili ana i ka cardiotoxicity!

ʻIke mākou i ka paʻakikī o ke kaua ʻana i ka maʻi kanesa. ʻO nā lāʻau lapaʻau āu e loaʻa ai, e like me ka chemotherapy a me ka radiation, hiki ke hana i nā pilikia olakino ʻē aʻe. Ua manaʻo paha ʻoe e hiki i nā lāʻau lapaʻau maʻi kanesa ke loaʻa ka hopena i kou puʻuwai? ʻO ia ka mea a mākou e kapa nei he Cardiotoxicity . Mai makaʻu ke lohe ʻoe i kēia inoa. ʻAʻole kēia he mea e hana ʻia i nā mea āpau. Akā he mea nui loa ia e ʻike i kēia. No laila i kēia lā e kamaʻilio mākou e pili ana i kēia me ka maʻalahi, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

I ka ʻōlelo maʻalahi, he aha ka Cardiotoxicity?

ʻO ka cardiotoxicity ka hōʻino i hana ʻia i ko kākou puʻuwai e kekahi mau lāʻau lapaʻau a lāʻau lapaʻau paha. E noʻonoʻo i ka lāʻau lapaʻau e pepehi ana i nā hunaola kanesa e like me ke koa ikaika loa. Ke hakakā kēia koa i nā hunaola kanesa, i kekahi manawa hiki ke hōʻino iki ʻia nā hunaola olakino i loko o ko kākou puʻuwai e kokoke ana. ʻO ia ke ʻano o ka cardiotoxicity.

ʻO ka mea nui e hiki ke hana ʻia, ʻo ia ka paʻakikī o ka puʻuwai e pamu i ke koko ma ke kino holoʻokoʻa. Hiki i ka ʻiʻo puʻuwai ke lilo i nāwaliwali. I kekahi mau hihia koʻikoʻi, hiki i kēia ke alakaʻi i kahi maʻi i kapa ʻia ʻo Cardiomyopathy . ʻO ke ʻano kēia, ua emi nui ka hiki o ka ʻiʻo puʻuwai ke pamu i ke koko.

ʻO kahi mea kūikawā e pili ana i kēia maʻi, hiki ke hana ʻia i kekahi manawa he mau makahiki ma hope o ka pau ʻana o ka mālama ʻana i ka maʻi kanesa. He kiʻekiʻe loa kēia pilikia i nā pākeke i loaʻa ka mālama ʻana i ka maʻi kanesa i ko lākou wā kamaliʻi.

ʻO wai ka mea i pilikia nui?

ʻOiai ʻo kekahi poʻe i mālama ʻia i ka maʻi kanesa he manawa kūpono e loaʻa ai kēia maʻi, ʻaʻole nā ​​​​kānaka a pau e loaʻa iā ia. Eia nō naʻe, aia kekahi poʻe i kahi pilikia kiʻekiʻe iki.

• ʻO ka poʻe e lawe ana i kekahi mau lāʻau lapaʻau: Hiki i kekahi mau lāʻau chemotherapy a me nā lāʻau lapaʻau ʻē aʻe ke hoʻopilikia i ka puʻuwai. E kamaʻilio mākou e pili ana i kēlā ma hope iki.
• ʻO ka poʻe i loaʻa i ka radiation therapy ma ka umauma: Ke hāʻawi ʻia ka radiation therapy no ka maʻi ʻaʻai umauma, no ka laʻana, ka maʻi ʻaʻai umauma, hiki i ka radiation ke hoʻopilikia i ka puʻuwai i kekahi ʻano.
• ʻO ka poʻe i loaʻa ka lāʻau lapaʻau maʻi kanesa i ka wā ʻōpiopio: ʻOi aku ke kiʻekiʻe o kēia pilikia no nā pākeke i loaʻa ka lāʻau lapaʻau i ka wā ʻōpiopio.

Manaʻo kekahi mau noiʻi a hiki i ka 20% o nā pākeke e mālama ʻia ana i ka maʻi kanesa e loaʻa paha i kekahi ʻano maʻi puʻuwai, a ma waena o 7% a me 10% o kēia mau mea e loaʻa ai ka cardiomyopathy a i ʻole ka hāʻule ʻana o ka puʻuwai.

He aha nā hopena o ka cardiotoxicity i ka puʻuwai?

Hiki i kēia kūlana ke hana i nā ʻano pilikia puʻuwai like ʻole. ʻAʻole hiki kēia mau mea āpau i nā kānaka a pau, akā he mea nui e makaʻala i nā kumu hiki. E nānā i ka papa ma lalo.

He aha nā hōʻailona āu e ʻike ai?

Hiki ke ʻike koke ʻia nā hōʻailona o ka puʻuwai e pili ana i ka cardiotoxicity a i ʻole e ulu mālie. Inā ʻoe e mālama ʻia ana a i ʻole ua pau wale ka mālama ʻana i ka maʻi kanesa, he mea nui e makaʻala i kēia mau hōʻailona.

He aha nā kumu nui o ka cardiotoxicity?

ʻOiai he mau tausani o nā ʻano lāʻau lapaʻau no ka maʻi kanesa, aia kekahi mau ʻano nui e hāʻawi nui ana i kēia maʻi.

1. Kekahi mau lāʻau chemotherapy

ʻO nā Anthracyclines kahi papa o nā lāʻau chemotherapy i ʻike nui ʻia no kēia. ʻO kahi laʻana ʻo Doxorubicin (Adriamycin®) . Hoʻohana pinepine ʻia kēia mau mea e mālama i nā maʻi kanesa e like me ka leukemia, lymphoma, ka maʻi kanesa o ka umauma, a me ka myeloma maha.

2. Nā Lāʻau Lapaʻau i Hoʻolālā ʻia

ʻO Trastuzumab (Herceptin®) kahi laʻana o ia ʻano lāʻau. Hoʻohana ʻia ia e mālama i ka maʻi ʻaʻai umauma a me ka maʻi ʻaʻai ʻōpū. Aia kahi piʻi aʻe o ka pilikia o ka cardiomyopathy, ʻoiai ke hāʻawi ʻia kēia lāʻau me ka anthracycline.

3. Ka lāʻau lapaʻau radiation i ka ʻāpana umauma

Ke hāʻawi ʻia ka radiation i ka umauma no kahi maʻi kanesa, e like me ke kanesa o ka umauma a i ʻole ka Hodgkin's Lymphoma, hiki i ka radiation ke hele ma o ka puʻuwai. I ka hala ʻana o ka manawa, hiki i kēia ke hōʻino i nā kīʻaha koko a me nā ʻiʻo o ka puʻuwai.

Pehea e ʻike ai nā kauka i kēia maʻi?

Inā loaʻa iā ʻoe nā hōʻailona i ʻōlelo ʻia ma luna, a inā paha ʻoe i loko o kahi hui pilikia kiʻekiʻe, e kauoha paha kāu kauka i kahi hoʻāʻo hana puʻuwai. ʻO ka hoʻāʻo nui ka nānā ʻana i ka hiki ke pumping o ka puʻuwai. Hana ʻia kēia me ka hoʻohana ʻana i kahi ana i kapa ʻia ʻo ka Left Ventricular Ejection Fraction (LVEF) . I ka ʻōlelo maʻalahi, ʻo kēia ka pakeneka o ke koko a ka puʻuwai e pumping ai i loko o ke kino i kēlā me kēia manawa e kuʻi ai.

Aia ma lalo iho kekahi mau hoʻāʻo i hoʻohana ʻia e ana i kēia mau mea.

Pehea e mālama ʻia ai kēia maʻi?

ʻO ke ʻano o ka mālama ʻana e pili ana i ka nui o ka pōʻino i kou puʻuwai a me kona kumu.

• Ke hoʻololi nei i nā lāʻau lapaʻau: Inā ua hōʻoia ʻia ua hoʻopilikia ka lāʻau lapaʻau āu e lawe nei i kou puʻuwai, hiki i kāu kauka ke hoʻoholo e hoʻōki i ka lāʻau lapaʻau, hoʻemi i ka nui, a hoʻololi paha iā ʻoe i kahi lāʻau lapaʻau ʻē aʻe.
• Nā lāʻau lapaʻau puʻuwai: Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau hou e kōkua i ka hoʻomaikaʻi ʻana i ka hana puʻuwai a me ka kaohi ʻana i nā hōʻailona. Eia kekahi laʻana:
• Nā mea kāohi ACE: Hoʻonui kēia i nā kīʻaha koko a hoʻomaikaʻi i ke kahe koko.
• Nā mea pale Beta: Hoʻomalu kēia i ka helu o ka puʻuwai a hoʻemi i ke kaomi ma ka puʻuwai.
• Diuretics: Kōkua lākou i ka hoʻopau ʻana i ka wai keu mai ke kino ma o ka mimi, kahi e hōʻemi ai i ka pehu.
• Digoxin: Hoʻoponopono ia i ka helu o ka puʻuwai a hoʻoikaika i ka puʻuwai e pamu i ke koko me ka ʻoi aku ka maikaʻi.

Hiki ke ho'ōla loa ʻia kēia maʻi?

He nīnau kēia a ka poʻe he nui. ʻO ka pane, "I kekahi manawa hiki iā ʻoe, i kekahi manawa ʻaʻole hiki iā ʻoe."

• ʻO ka cardiotoxicity i hoʻokumu ʻia e nā lāʻau lapaʻau e like me Trastuzumab (Herceptin®) he mea hoʻihoʻi pinepine ia . ʻO ke ʻano kēia, hiki i ka hana o ka puʻuwai ke hoʻi i ka maʻamau ke hoʻōki ʻia ka lāʻau lapaʻau a hoʻomaka ʻia paha kekahi lāʻau lapaʻau ʻē aʻe.
• ʻO Anthracyclines a i ʻole ka Radiation TherapyʻO ka pōʻino i hana ʻia he mea hiki ʻole ke hoʻihoʻi ʻia . I ia mau hihia, pono paha ʻoe e lawe i nā lāʻau lapaʻau e kākoʻo ana i ka puʻuwai a hana i nā hoʻololi i ke ʻano o ka nohona no ke koena o kou ola.

He aha ka mea hiki ke hana ʻia e hōʻemi ai i ka pilikia?

ʻO kaʻoiaʻiʻo, ʻaʻohe ala e pale aku ai i ka cardiotoxicity 100%. No ka mea, he mea nui kēlā lāʻau lapaʻau no ka ho'ōla ʻana i ka maʻi kanesa. Akā, ʻo ka mea nui loa hiki iā ʻoe ke hana, ʻo ia ke ʻike koke i kēia maʻi.

• E kamaʻilio me kāu kauka: Ma mua o ka hoʻomaka ʻana i ka mālama ʻana i ka maʻi kanesa, e kamaʻilio ākea me kāu kauka e pili ana i nā pono o ka lāʻau lapaʻau, a me nā hopena ʻaoʻao, e like me nā hopena ma ka puʻuwai.
• Nā nānā mau ʻana: I ka wā a ma hope o ka mālama ʻana i ka maʻi kanesa, e nānā mau i kou puʻuwai (e laʻa, kahi scan echo) e like me ke kuhikuhi a kāu kauka. E kōkua kēia i ka ʻike mua ʻana i nā pilikia a hoʻomaka i ka mālama ʻana.

I ka manawa hea e ʻimi koke ai i ke kōkua lapaʻau!

Inā ʻoe e loaʻa ana a i ʻole ua loaʻa iā ʻoe ka lāʻau lapaʻau no ka maʻi kanesa, a loaʻa iā ʻoe kekahi o nā hōʻailona koʻikoʻi ma lalo nei, e hele koke i ka Emergency Department (ETU) o ka haukapila kokoke loa.

• ʻO ka puʻuwai mau a piʻi aʻe paha.
• Pōniuniu, ʻike maka pohihihi, a i ʻole ka nawaliwali.
• Ka ʻoi koke ʻana o ka pōkole o ka hanu a i ʻole ka ʻeha o ka umauma.
• Ka pehu ʻana o nā lehelehe a i ʻole ka puʻu.
• Ka pehu ʻana o nā wāwae a i ʻole nā ​​​​wāwae ma ke ʻano ʻē.
• Piʻi kaumaha ma mua o 1.5 kg (3 paona) i loko o hoʻokahi pule.

Hiki i kēia mau hōʻailona ke lilo i hōʻailona o kahi hōʻeha puʻuwai koʻikoʻi, no laila mai hoʻokaʻulua.