Ua ʻike anei ʻoe i ka Cholangiocarcinoma? E kamaʻilio maʻalahi kākou e pili ana.

Ua loaʻa anei iā ʻoe kahi ʻeha ʻē ma ka ʻaoʻao ʻākau o kou ʻōpū, ma lalo o kou mau iwi ʻaoʻao, he melemele o kou ʻili a me kou mau maka (e like me ka jaundice), a i ʻole he manaʻo nāwaliwali wale nō? ʻOiai ke ʻano o kēia mau mea he mau mea maʻamau, i kekahi manawa aia kekahi kumu koʻikoʻi ma hope o lākou. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano maʻi kanesa kakaikahi akā he mea weliweli loa. ʻO ia ka maʻi kanesa bile duct, i ʻike ʻia ma ke ʻano lapaʻau ʻo Cholangiocarcinoma .

I ka ʻōlelo maʻalahi, he aha ka cholangiocarcinoma?

ʻAe, e nānā mua kākou i ke ʻano o kēia mau ʻauwai bile. E noʻonoʻo, hana ko kākou ake i kahi wai i kapa ʻia ʻo "bile". Kōkua nui kēia i ka ʻeli ʻana i nā meaʻai momona. No laila, ʻo ka ʻōnaehana o nā ʻōmole liʻiliʻi e lawe ana i kēia bile mai ke ake a i ko kākou ʻōpū liʻiliʻi ua kapa ʻia ʻo nā ʻauwai bile .

ʻO ka Cholangiocarcinoma kahi maʻi ʻaʻai e hoʻomaka ana i loko o nā pūnaewele o ka ʻōnaehana bile duct.

He ʻano maʻi kanesa ʻino kēia. ʻO ka mea kaumaha, ʻo ka hapa nui o ka manawa, i ka manawa e ʻike ʻia ai kēia maʻi kanesa, ua pālahalaha mua ia ma ʻō aku o nā ʻauwai bile. I ia hihia, he paʻakikī loa ka mālama ʻana, a maikaʻi ʻole ka wānana. Akā, mai hopohopo, ke ʻimi mau nei nā kauka a me nā ʻepekema i nā lāʻau lapaʻau hou e hiki ke kāohi i ka laha ʻana o kēia maʻi kanesa a hāʻawi i nā mea maʻi i kahi ola maikaʻi aʻe.

He aha nā ʻano nui o kēia maʻi kanesa?

Ua māhele ʻia ke kanesa ʻaʻai bile i ʻekolu mau ʻano nui e pili ana i kona wahi:

1. Intrahepatic cholangiocarcinoma: Hoʻokumu ʻia kēia i loko o nā ʻauwai bile liʻiliʻi i loko o ke akepaʻa .

2. Perihilar/hilar cholangiocarcinoma: ʻO kēia ke ʻano maʻamau. Hoʻomohala ia ma kahi kokoke i ka hilum, kahi e puka ai nā ʻauwai bile mai ke akepaʻa. Ua kapa ʻia hoʻi ia he puʻupuʻu Klatskin .

3. Distal cholangiocarcinoma: Hoʻomohala kēia ʻano i loko o nā ʻauwai bile i loaʻa ma waho o ke akepaʻa, kokoke i ka ʻōpū liʻiliʻi.

Ua kapa ʻia nā ʻano ʻelua 2 a me 3 he mau maʻi ʻaʻai bile duct extrahepatic . ʻO ia hoʻi, nā maʻi ʻaʻai e ulu ana "ma waho o ke ake."

He aha nā hōʻailona o kēia maʻi?

ʻO ka hapa nui o ka manawa, ʻaʻohe hōʻailona a hiki i ka nui ʻana o ke kanesa a ālai i kahi ʻauwai bile. Ke ʻike ʻia nā hōʻailona, ​​​​hiki iā ʻoe ke ʻike i nā mea e like me kēia.

I nā pae mua, ʻaʻole kēia maʻi ʻaʻai e hoʻoulu i ka ʻeha. Eia nō naʻe, i ka ulu ʻana o ka puʻupuʻu, hiki ke loaʻa ka ʻeha ma ka ʻaoʻao ʻākau o ka ʻōpū. I kekahi poʻe, hiki ke laha kēia ʻeha i nā ʻāpana ʻē aʻe o ka ʻōpū a i ʻole ke kua.

He aha nā kumu a me nā kumu pilikia no ka hoʻomohala ʻana i kēia maʻi kanesa?

ʻAʻole i ʻike ʻia ke kumu kikoʻī o kēia maʻi kanesa. Eia nō naʻe, ua manaʻoʻiʻo ʻia ʻo ka mumū mau loa , ʻo ia hoʻi, nā kūlana mumū, i loko o nā ʻauwai bile ke kumu nui.

I ka ʻōlelo maʻalahi, hiki i ka hōʻino mau ke hōʻino i ka DNA o nā cell bile duct. Ua like ka DNA me ka "papahana nui" e haʻi ana i kā mākou mau cell pehea e hana ai. Ke hōʻino ʻia kēia DNA, hiki i nā cell ke hoʻomaka e māhelehele me ka ʻole o ke kāohi ʻia, e alakaʻi ana i ka hoʻokumu ʻia ʻana o nā puʻupuʻu kanesa.

Aia kekahi mau kumu e hoʻonui ai i ka pilikia o kēia:

• Nā maʻi e pili ana i nā ʻauwai bile: Nā kūlana e like me nā pōhaku gallstones, nā pōhaku ʻauwai bile, a me ka `Primary sclerosing cholangitis` (kahi maʻi e haiki ai a paʻa ai nā ʻauwai bile).
• Nā maʻi o ke akepaʻa: Cirrhosis (ka ʻeha o ke akepaʻa), nā maʻi Hepatitis B a i ʻole Hepatitis C.
• Nā kūlana olakino ʻē aʻe: Chronic ulcerative colitis, Inflammatory bowel disease (IBD), Diabetes.
• Nā kumu o ke ola: ka inu nui ʻana i ka waiʻona, ka momona, ka puhipaka.
• Nā maʻi parasitic: ʻO kahi maʻi parasitic i kapa ʻia ʻo 'Clonorchiasis' he mea maʻamau ia ma nā ʻāina ʻo Asia Hikina Hema.
• Ka ʻike ʻia ʻana i nā kemika ʻawahia: Kekahi mau kemika, ʻoi aku hoʻi nā mea i hoʻohana ʻia i nā hale hana laholio a i ʻole nā ​​​​hale hana kaʻa.

Pehea e ʻike ai ke kauka i kēia maʻi?

Ke ʻike ʻoe i ke kauka, e hoʻolohe pono mua ʻo ia i kāu mau hōʻailona, ​​e lawe i kāu mōʻaukala olakino, a hana i kahi hoʻokolokolo kino. A laila, inā kānalua ʻia ka maʻi ʻaʻai, hiki iā lākou ke paipai i kekahi mau hoʻokolohua, e like me:

Nā hoʻāʻo koko

• Nā hoʻāʻo hana ate: Hiki i kēia ke hāʻawi i kahi manaʻo o ka hana maikaʻi o ke akepaʻa. Inā paʻa nā ala bile, e piʻi aʻe nā pae o kekahi mau enzymes ('nā enzymes ate') i loko o ke koko.
• Nā hoʻāʻo māka puʻupuʻu: Nā hoʻāʻo e ana i kekahi mau mea (nā māka puʻupuʻu) e hoʻonui ana i ke koko ke loaʻa ka maʻi kanesa. ʻO `CA 19-9` a me `CEA` ʻelua mau hōʻailona e hiki ke hoʻonui i kēia ʻano maʻi kanesa.

Nā Hoʻāʻo Kiʻi

• ʻO ka maʻamau, hana mua ʻia ka ultrasound o ka ʻōpū.
• Eia kekahi, hiki ke hana ʻia kahi CT scan a i ʻole MRI scan . ʻO ka magnetic resonance cholangiopancreatography (MRCP) kahi ʻano kūikawā o MRI e hiki ke ʻike maopopo i ka ʻōnaehana bile duct.

Nā hoʻāʻo Endoscopy

ʻO kēia ke komo ʻana i kahi ʻōmole lahilahi a palupalu (endoscope) me kahi kāmela i hoʻopili ʻia ma kou waha, e hoʻokomo ana ma kou ʻōpū a i loko o kou ʻōpū liʻiliʻi, kahi e wehe ai nā ʻauwai bile, a e nānā pono i ka wahi. E hoʻomaha ʻia ʻoe i ka wā o kēia kaʻina hana, no laila ʻaʻole ʻoe e ʻike i kekahi ʻeha. He hoʻāʻo maʻamau ka Endoscopic retrograde cholangiopancreatography (ERCP).

Biopsy

Maanei, lawe ʻia kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai kahi kānalua a nānā ʻia ma lalo o kahi microscope. Hiki ke loaʻa kēia ʻāpana ʻiʻo i ka wā o ke kaʻina hana ERCP. Hiki ke hoʻāʻo ʻia kēia laʻana ʻiʻo no nā loli genetic (biomarkers) i loko o nā hunaola kanesa. Hiki i kēia ke kōkua i ka hoʻoholo ʻana inā hiki ke hāʻawi ʻia i kekahi poʻe i kahi "lāʻau lapaʻau i kuhikuhi ʻia."

He aha nā pae a me nā lāʻau lapaʻau o ka maʻi kanesa?

Ke ʻike ʻia ka maʻi, hoʻoholo mākou i ke kahua o ke kanesa e ʻike ai i ka mamao o kona laha ʻana i loko o ke kino. He mea nui loa kēia no ka hoʻolālā ʻana i ka mālama ʻana. Hoʻokaʻawale pinepine ʻia ia i nā kahua 0 a 4. ʻO ke kahua 4 ke ʻano o ka laha ʻana o ke kanesa ma ʻō aku o nā ʻauwai bile i nā wahi mamao o ke kino (metastatic).

Hoʻoholo ʻia ke ʻano o ka mālama ʻana e ka wahi o ke kanesa, kona pae, a me ke olakino holoʻokoʻa o ka mea maʻi.

• ʻOki kino: Inā ʻaʻole i laha ka maʻi kanesa, ʻo ke ʻoki kino ka lāʻau lapaʻau maikaʻi loa e wehe loa i ke kanesa a me nā ʻiʻo a puni. I kekahi manawa hoʻohana ʻia ke ʻoki kino e kau i kahi stent e mālama i ka ʻauwai bile i paʻa.
• Hoʻoili ʻana i ke akepaʻa: ʻO ke hoʻoili ʻana i ke akepaʻa kahi manawa kūpono e ho'ōla ai no kekahi mau maʻi ʻaʻai perihilar mua.
• Lapaʻau radiation: Hoʻohana i nā kukuna ikehu kiʻekiʻe e luku i nā hunaola kanesa a hoʻēmi paha i nā ʻōpū.
• Chemotherapy: Hāʻawi ʻana i ke kino i nā lāʻau lapaʻau e pepehi ai i nā hunaola kanesa.
• ʻO ka lāʻau lapaʻau i hoʻolālā ʻia: Pili kēia i ka lawelawe ʻana i nā lāʻau lapaʻau e pili ana i nā protein kikoʻī e kōkua i nā ʻōpū kanesa e ulu a hoʻōki i kā lākou hana.
• Immunotherapy: Ke hāʻawi ʻana i nā lāʻau lapaʻau e hoʻoulu ai i ka ʻōnaehana pale ponoʻī o ko mākou kino a kōkua iā ia e hakakā i nā hunaola kanesa.

Aia kekahi mau ala e pale aku ai iā ʻoe iho mai kēia maʻi?

ʻAʻohe ala e pale aku ai i ka ulu ʻana o kēia maʻi kanesa 100%. Eia nō naʻe, hiki iā mākou ke hōʻemi i ka pilikia ma ka mālama ʻana i ko mākou akepaʻa a me nā ʻauwai bile i ke olakino.

• E pale iā ʻoe iho mai nā maʻi e like me ka Hepatitis B, Hepatitis C, a me ka HIV (e.g., e kiʻi i ka lāʻau pale Hepatitis B, e hahai i nā hana palekana)
• E pale i ka inu nui ʻana i ka waiʻona.
• E mālama i ke kaumaha o ke kino olakino.
• E pale loa i ka puhipaka.

He ʻoiaʻiʻo he maʻi koʻikoʻi loa ka cholangiocarcinoma. Eia nō naʻe, ʻo ka ʻike ʻana iā ia, ka ʻike ʻana i nā kumu pilikia inā he mau mea, a me ka ʻike ʻana i ke kauka i ka wā e ʻike ʻia ai kekahi mau hōʻailona ʻē, hāʻawi iā mākou i ka ikaika nui e hakakā ai i kēia maʻi. ʻO kāu kauka ke kanaka hiki ke hāʻawi iā ʻoe i ka ʻōlelo aʻoaʻo a me ka lāʻau maikaʻi loa.