ʻAʻole paha ʻoe i lohe i kēia inoa "chordoma" ma mua. ʻAʻole ia he mea kupanaha, no ka mea, he ʻano maʻi kanesa kakaʻikahi kēia. Eia naʻe, ʻoiai he mea kakaʻikahi, he mea nui loa ia e makaʻala i kēia. No ka mea, hiki i kēia ʻano puʻupuʻu ke kū i loko o ko kākou iwi kuamoʻo a i ʻole ma ke kumu o ke poʻo. No laila i kēia lā, e kamaʻilio kikoʻī a maʻalahi hoʻi e pili ana i ke ʻano o kēia chordoma, pehea e ulu ai, he aha nā hōʻailona, a he aha nā lāʻau lapaʻau.
He aha ʻo Chordoma? E ʻike kākou maʻalahi!
I ka ʻōlelo maʻalahi, he puʻupuʻu kanesa ka chordoma e hana ʻia ana i loko o nā iwi . Hoʻomohala pinepine ia i loko o kou iwi kuamoʻo a i ʻole ke kumu o kou iwi poʻo, nā iwi ma luna o kou ʻāʻī a ma lalo o kou lolo. Hoʻokaʻawale nā kauka iā ia ma ke ʻano he ʻano kanesa i kapa ʻia ʻo sarcoma. ʻO Sarcoma kahi huaʻōlelo maʻamau no nā kanesa e hana ʻia ana i loko o nā iwi a me nā ʻiʻo palupalu (nā ʻiʻo pili).
ʻO ka maʻamau, ulu mālie nā chordomas. Eia nō naʻe, ʻo ka pilikia, hiki ke paʻakikī iki ka mālama ʻana no ka mea aia lākou ma kahi kokoke loa i kā mākou ʻōnaehana nerve, ʻo ia hoʻi, ka lolo a me ke kaula spinal, a hoʻouka i nā ʻiʻo palupalu a puni lākou.
ʻO kekahi mea ʻē aʻe, ʻoiai ma hope o ka mālama ʻana, loaʻa i kēia mau puʻupuʻu kahi manawa kiʻekiʻe e hoʻi hou mai . ʻO ka hapa pinepine, hana ʻia kēia ma kahi like me ka puʻupuʻu mua. Eia kekahi, ma 30% a 40% o nā hihia, hiki i nā hunaola kanesa chordoma ke laha i nā ʻāpana ʻē aʻe o ke kino. Kāhea nā kauka i kēia he "metastasizing".
Ma hea e laha ai ʻo Chordoma i nā ʻāpana ʻē aʻe o ke kino?
Inā hoʻolaha ka chordoma i nā ʻāpana ʻē aʻe o ke kino, ʻo nā wahi maʻamau e hiki ai ke hoʻolaha:
- Kou mau māmā
- Nā kikowaena lymph kokoke i ka puʻupuʻu
- Nā iwi ʻē aʻe
- Ake
- ʻIli
Ma hea e hiki ai i ka chordoma ke ulu?
Hiki ke loaʻa ka Chordoma ma nā wahi āpau ma kou kuamoʻo, akā aia ʻekolu mau wahi maʻamau:
1. ʻO ka sacrum: ʻO kēia ka iwi huinakolu ma waena o kou mau puʻupuʻu. Ma kahi o 35% o nā chordomas e ulu ana ma ʻaneʻi.
2. Kumu iwi poʻo: Ma ke kumu o kou iwi poʻo, ma nā iwi e kākoʻo ana i kou lolo. Ua kapa ʻia kēia mau mea he "Clival chordomas" no ka mea, hana pinepine lākou i loko o ka iwi "Clivus", aia ma ʻaneʻi. ʻO kēia ʻano kekahi no kahi 35% o nā chordomas āpau.
3. I loko o nā iwi kuamoʻo e neʻe ana o ka iwi kuamoʻo (`vertebrae`): ʻO ia hoʻi, nā iwi kuamoʻo ma kou ʻāʻī, umauma, a me ke kua. Loaʻa nā chordomas ma kahi o 30% o kēia mau mea. ʻOi aku ka maʻamau o lākou ma ka lua o ka iwi kuamoʻo. Hiki nō hoʻi iā lākou ke loaʻa ma nā iwi kuamoʻo ma ke kua haʻahaʻa (lumbar spine) a me ka umauma (thoracic spine).
He aha nā ʻano nui o ka chordoma?
Ua hoʻokaʻawale ka World Health Organization (WHO) i ka chordoma i ʻekolu mau ʻano nui. Hoʻokumu ʻia kēia mau hoʻokaʻawale ʻana ma ke ʻano o ke ʻano o nā hunaola kanesa ma lalo o kahi microscope ('histology').
1. Chordoma maʻamau/kuʻuna: ʻO kēia ke ʻano maʻamau (80% a 90% o nā chordomas āpau). ʻO nā cell i loko o kēia ʻano he ʻano cell kūikawā nona ke ʻano "pehu". ʻO Chondroid chordoma kekahi ʻano o kēia ʻano. Aia ia ma waena o 5% a me 15% o nā chordomas āpau. Hoʻomohala pinepine ʻia ka chondroid chordoma ma ke kumu o ka iwi poʻo.
2. Chordoma Dedifferentiated: He ʻano laha loa kēia (ʻaʻole i ʻoi aku ma mua o 5%). Hōʻike ʻia ia e kahi hui ʻano ʻē o nā cell. ʻOi aku ka wikiwiki o ka ulu ʻana o kēia ʻano, ʻoi aku ka huhū, a ʻoi aku ka nui o ka metastasize i nā ʻāpana ʻē aʻe o ke kino ma mua o nā ʻano ʻē aʻe.
3. Chordoma i hoʻokaʻawale maikaʻi ʻole ʻia: He mea kākaʻikahi loa kēia. ʻAʻole i hoʻopaʻa ʻia ma mua o 60 mau maʻi i loko o nā moʻolelo lapaʻau a hiki i kēia manawa. ʻO kahi hiʻohiʻona kūikawā o kēia ʻano, ʻo ia ka hoʻopau ʻia ʻana o kahi gene i kapa ʻia ʻo `(SMARCB1)` a i ʻole `(INI1)` (holoi ʻia). ʻIke pinepine ʻia kēia ʻano chordoma i nā keiki a me nā ʻōpio.
ʻO wai ka mea e loaʻa pinepine ai ka chordoma?
Hiki ke loaʻa ka Chordoma i kēlā me kēia makahiki, i loko o kekahi. Eia nō naʻe, ʻoi aku ka maʻamau i nā pākeke ma waena o 50 a me 80 mau makahiki. Hoʻopilikia ʻia nā keiki e kahi helu liʻiliʻi wale nō o nā hihia, ma kahi o 5% o nā hihia āpau.
Ua ʻike ʻia hoʻi he 1.5 mau manawa ka nui o ka loaʻa ʻana o ka chordoma i nā kāne ma mua o nā wahine.
Pehea ka maʻamau o kēia?
He maʻi ʻaʻai laha ʻole ʻo Chordoma. Hoʻopilikia ia i hoʻokahi i loko o hoʻokahi miliona mau kānaka i kēlā me kēia makahiki. ʻO ia hoʻi, no ka laʻana, ma ʻAmelika Hui Pū ʻIa, he 300 wale nō hihia hou i ʻike ʻia i kēlā me kēia makahiki.
ʻO Chordomas ka helu ma waena o 1% a me 4% o nā ʻōpū iwi mua a pau.
He aha nā hōʻailona o ka chordoma?
I ka ulu ʻana o ka chordoma, hiki iā ia ke kau i ke kaomi ma luna o ke kaula kuamoʻo a i ʻole ka lolo e hoʻopuni ana. Hoʻokumu kēia kaomi i nā hōʻailona . Hiki ke ʻokoʻa nā hōʻailona ma muli o kahi o ka puʻupuʻu ma ka iwi kuamoʻo.
ʻO nā hōʻailona maʻamau o ka chordoma e komo pū ana me ka ʻeha, ka nāwaliwali, a me/a i ʻole ka maneʻo ma ke kua, nā lima, a i ʻole nā wāwae .
Nā ʻano o ka chordoma kumu poʻo:
Inā he chordoma kou ma ke kumu o kou poʻo, aia ma lalo o kou lolo, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:
- ʻIke pālua (Diplopia)
- ʻIke pōwehiwehi
- ʻEha poʻo
- ʻO ka mae ʻana o ka maka a i ʻole ka ʻeha
Nā ʻano o ka chordoma ma ka iwi huelo/sacrum:
Inā loaʻa iā ʻoe kahi chordoma ma ka ʻaoʻao haʻahaʻa loa o kou kuamoʻo, kokoke i ka sacrum, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:
- He puʻupuʻu a puʻupuʻu paha e puka mai ana ma o ka ʻili
- Ka paʻakikī i ka mimi ʻana a i ʻole ka defecating (ka hana ʻana o ka ʻōpū a i ʻole ka ʻōpū)
- ʻEha ma ke kua haʻahaʻa a i ʻole ka ʻāpana puʻupuʻu
E hoʻomanaʻo, i kekahi manawa hiki ke huikau ʻia kēia mau hōʻailona me nā maʻi lapaʻau maʻamau ʻē aʻe. No laila he mea nui e ʻimi i ke aʻo lapaʻau inā loaʻa iā ʻoe kekahi mau hōʻailona mau a ʻano ʻē.
No ke aha e ulu ai ʻo Chordoma? He aha nā kumu?
ʻAʻole maopopo i nā kānaka noiʻi ke kumu o ka chordoma, akā manaʻoʻiʻo lākou he pili nā mutations i loko o kahi gene i kapa ʻia ʻo TBXT.
Ua loaʻa nā hōʻike no kekahi mau ʻohana me ka chordoma. I ka wā i hoʻāʻo ʻia ai lākou, ua ʻike ʻia ua hoʻoilina lākou i kahi pālua o ka gene `(TBXT)`. Eia kekahi, ua ʻike ʻia nā loli i loko o ka gene `(TBXT)` i nā poʻe i loaʻa ka chordoma akā ʻaʻohe mea o ka ʻohana i loaʻa i ka maʻi.
Hoʻomohala ʻia ʻo Chordoma mai nā pūnaewele i loko o kahi ʻano i kapa ʻia ʻo "notochord." ʻO kēia "notochord" he ʻano manawa pōkole ia he mea nui loa no ka ulu ʻana o ke kaula spinal o kahi embryo i kona wā e ulu ana. ʻO ka maʻamau, nalowale kēia "notochord" ma kahi o ʻewalu pule o ka hāpai ʻana. Eia nō naʻe, i loko o kahi helu liʻiliʻi loa o ka poʻe, hiki i kekahi o kēia mau pūnaewele "notochord" ke noho i loko o nā iwi o ke kuamoʻo a i ʻole ke kumu o ke poʻo.
No laila, ʻo ka manaʻo o kēia manawa inā he loli i ka gene `(TBXT)` i ʻōlelo mua ʻia, hiki i kēia mau cell `(notochord)` i koe ke hoʻomaka e ulu ma ke ʻano ʻē a hana i kahi chordoma.
Eia kekahi, ʻo ka poʻe me kahi maʻi genetic i kapa ʻia ʻo "Tuberous sclerosis" e piʻi aʻe ka pilikia o ka loaʻa ʻana o ka chordoma. Hiki i kēia maʻi "Tuberous sclerosis" ke hoʻoulu i ka maʻi epilepsy, ka lohi o ka ulu ʻana, a me nā puʻupuʻu ma nā ʻāpana like ʻole o ke kino. Hoʻokumu ʻia kēia e nā mutations i ʻelua mau genes i kapa ʻia ʻo "TSC1" a me "TSC2".
Pehea e ʻike ai i kahi chordoma?
Inā loaʻa iā ʻoe nā hōʻailona o chordoma, e nīnau mua ke kauka e pili ana i kāu mau hōʻailona a me ka mōʻaukala olakino. A laila e hana lākou i kahi hoʻokolohua kino a me kahi hoʻokolohua neurological.
Inā kānalua ke kauka i kahi puʻupuʻu, e kauoha ʻo ia i kahi hoʻāʻo kiʻi e like me ka X-ray, kahi computed tomography (CT) scan, a i ʻole kahi MRI scan. He kōkua pinepine kēia MRI scan i ka ʻike ʻana i kahi chordoma.
A laila, e kuhikuhi paha kāu kauka iā ʻoe i kahi loea maʻi ʻaʻai iwi e hōʻoia i ka hōʻailona a loaʻa i kahi manaʻo ʻelua. Hiki iā lākou ke hana i nā hoʻokolohua kiʻi hou aʻe e hoʻoholo ai i kahi kikoʻī o ka chordoma, e ʻike inā ua pālahalaha i nā ʻāpana ʻē aʻe o ke kino, a hana i nā hoʻokolohua ʻē aʻe.
Eia nō naʻe, ʻo ke ala wale nō e ʻike pono ai i ka chordoma, ʻo ia ka loaʻa ʻana o kahi biopsy . Pili kēia i ka lawe ʻana i kahi hāpana liʻiliʻi o ka puʻupuʻu, me ka hoʻohana pinepine ʻana i ka biopsy nila, a me ka nānā ʻana ma lalo o kahi microscope. A laila wale nō e hiki ai i kahi loea ke ʻike maopopo inā he chordoma ia.
He aha nā lāʻau lapaʻau no Chordoma?
ʻO ka lāʻau lapaʻau nui a maikaʻi loa no ka chordoma, ʻo ia ka wehe ʻana i ka puʻupuʻu holoʻokoʻa ma o ke ʻoki ʻana . Ua kapa ʻia kēia e nā kauka he "En bloc resection." Inā wehe loa ʻia ka puʻupuʻu ma kēia ʻano, loaʻa i ka mea maʻi ka manawa kūpono loa e ola ai no ka manawa lōʻihi.
Eia nō naʻe, ma muli o kahi o nā puʻupuʻu, hiki ke paʻakikī loa kēia e hana. ʻOi aku ka nui, ʻaʻole hiki ke wehe loa i nā chordomas i loaʻa ma ke kumu o ke poʻo.
No ka mea, hiki i kahi chordoma ma ka iwi kuamoʻo ke hōʻino i kou kaula iwi kuamoʻo a me nā aʻalolo koʻikoʻi a me nā kīʻaha koko a puni. Inā hōʻino ʻia kēia i ka wā o ke ʻoki ʻana, hiki iā ia ke hana i ke kīnā lōʻihi a i ʻole ka make. Eia kekahi, he paʻakikī ke wehe loa i kahi chordoma ma ke kumu o ke poʻo iwi no ka mea kokoke loa ia i ka lolo, nā aʻalolo cranial, a me ke kaula iwi kuamoʻo. Hoʻāʻo nā neurosurgeons e wehe i ka nui o ka puʻupuʻu e like me ka hiki, me ka palekana e like me ka hiki.
ʻAʻole pane maikaʻi nā Chordomas i ka radiation therapy a i ʻole chemotherapy ma ke ʻano he lāʻau lapaʻau mua. Eia nō naʻe, ma hope o ke ʻoki ʻana, hiki i kāu hui lapaʻau ke paipai i ka radiation therapy e pale i ka hoʻi hou ʻana mai o ka puʻupuʻu.
Ke noiʻi nei nā kānaka noiʻi i nā lāʻau lapaʻau hou no ka chordoma, e like me ka lāʻau lapaʻau i hoʻolālā ʻia a me ka immunotherapy. Aia paha he mau hoʻokolohua lapaʻau hiki iā ʻoe ke komo.
Hiki ke pale ʻia ka chordoma?
ʻOiaʻiʻo, ʻaʻohe mea hiki iā ʻoe ke hana e pale aku i ka ulu ʻana o nā chordomas. ʻO ka hapa nui o ka manawa, ulu lākou ma ke ʻano hūpō.
Eia nō naʻe, inā ua loaʻa i kekahi o kou ʻohana ʻo Chordoma, a inā he maʻi kou i kapa ʻia ʻo "Tuberous sclerosis," he mea nui e ʻike pinepine ʻoe i ke kauka no nā nānā ʻana. A laila hiki iā lākou ke nānā iā ʻoe no nā hōʻailona o Chordoma. ʻO ka wikiwiki o ka ʻike ʻia ʻana o kēia, ʻo ka nui o ka kūleʻa o ka lāʻau lapaʻau.
He aha nā manawa kūpono e ho'ōla ai mai kahi chordoma? (Prognosis)
ʻO ka wānana, a i ʻole ka nānā ʻana, no kahi chordoma e pili ana i nā kumu he nui:
- ʻO kahi o ka puʻupuʻu a me ka nui e hiki ke wehe ʻia ma ke ʻoki ʻana: Inā hiki ke wehe loa ʻia ka puʻupuʻu, kiʻekiʻe ka manawa e hoʻōla ai. Inā hoʻohana wale ʻia nā lāʻau ʻē aʻe me ke ʻoki ʻole ʻana, haʻahaʻa ka manawa.
- Inā ua pālahalaha ke kanesa i nā wahi ʻē aʻe o ke kino (metastasized): Inā ua pālahalaha ia i nā wahi mamao, hiki ke hoʻemi ʻia nā helu ola.
- Kou makahiki i ka wā i ʻike ʻia ai: Ma keʻano laulā, ʻoi aku ka haʻahaʻa o nā helu ola no ka poʻe ma luna o 60 mau makahiki.
- Inā ua dedifferentiated ka puʻupuʻu a i ʻole: ʻO nā ʻano e like me ka "Poorly differentiated chordoma" he ʻoi aku ka maikaʻi o ka prognosis ma mua o ka "conventional chordoma".
Hiki i kāu hui lapaʻau ke hāʻawi iā ʻoe i ka ʻike pololei loa e pili ana i ka mea e manaʻo ai ma muli o kou kūlana, no laila mai makaʻu e nīnau iā lākou.
Hiki paha i kēia ke make?
ʻAe, hiki i ka chordoma ke make. ʻO ka hapa pinepine, hiki mai ka make ma hope o ka hoʻi hou ʻana o ka puʻupuʻu, e luku ana i nā ʻiʻo i loko o kou iwi kuamoʻo, ka lolo, a i ʻole ka lolo.
Ua hōʻike ʻia kahi noiʻi o 357 mau maʻi chordoma e like me kēia nā helu ola:
- Ma hope o ʻekolu makahiki: 80.5%
- Ma hope o ʻelima mau makahiki: 68.4%
- He ʻumi makahiki ma hope mai: 39.2%
Akā e hoʻomanaʻo, he awelika wale nō kēia. Hiki i kāu hui lapaʻau ke hāʻawi i ka ʻike kikoʻī e pili ana i nā helu ola e pili ana i kou kūlana kikoʻī.
He Kanesa Chordoma a he Tumor Maʻamau paha?
He ʻoiaʻiʻo nō he maʻi ʻino (cancerous) ka Chordoma. ʻAʻohe o kona mau ʻano i manaʻo ʻia he ʻaʻole cancerous.
Āhea wau e ʻike ai i ke kauka?
Hiki i ke Chordoma ke hoʻi hou mai ma hope o ka mālama ʻia ʻana, ʻoiai he mau makahiki ma hope. No laila, he mea nui loa ka hahai ʻana i ka wā lōʻihi me kāu hui lapaʻau.
Inā loaʻa iā ʻoe kekahi mau hōʻailona hou, a inā e ʻoi aku ka ʻino o kāu mau hōʻailona i kēia manawa , e kamaʻilio me kāu kauka.
ʻO ka mea hope loa, kekahi mau mea e hoʻomanaʻo ai (Leka Lawe-Home)
He mea maʻamau ke makaʻu a me ke kaumaha ke lohe ʻoe he maʻi ʻaʻai iwi laha ʻole kou. He maʻi ʻaʻai paʻakikī ke mālama ʻia ʻo Chordoma ma muli o kona wahi.
Eia nō naʻe, e hilinaʻi i kāu hui lapaʻau e hana i kahi hoʻolālā lapaʻau kikoʻī i hana kūikawā ʻia nou a e kōkua iā ʻoe e mālama i kāu chordoma a hoʻomaikaʻi i kou ʻano ola .
- He mea nui e ʻike mua i nā hōʻailona: e ʻimi i ke aʻo lapaʻau inā loaʻa iā ʻoe ka ʻeha mau, ka mae ʻana, a i ʻole nā loli i ka ʻike.
- E ʻimi i ka ʻōlelo aʻoaʻo lapaʻau loea: ʻOiai he maʻi laha ʻole ka chordoma, he mea nui loa ia e ʻimi i ka lāʻau lapaʻau mai kahi hui lapaʻau akamai.
- He mea pono nā nānā kino maʻamau ma hope o ka mālama ʻana: No ka mea, aia ka pilikia o ka hoʻi hou ʻana o ka maʻi, e hele i nā nānā kino e like me ke kuhikuhi a nā kauka.
Manaʻolana wau he kōkua kēia ʻike iā ʻoe. Inā he mau nīnau kāu, mai kānalua e nīnau i kāu kauka.
` Chordoma, ma'i 'a'ai, iwi ma'i 'a'ai, iwi kuamo'o, iwi po'o, sacrum, clivus
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo