He mau nīnau kāu e pili ana i ke kanesa esophageal? E kamaʻilio kākou!

Ua lohe paha ʻoe e pili ana i ke Kanesa ʻEsophageal. He maʻi koʻikoʻi kēia, akā he mea nui loa ia e makaʻala i ia mea. No ka mea, i kekahi manawa ua holomua loa ke kanesa i ka wā e ʻike ʻia ai nā hōʻailona. Akā, mai hopohopo, e kamaʻilio kākou e pili ana i nā mea āpau ma nā ʻōlelo maʻalahi.

He aha ke kanesa esophageal? Pehea e ulu ai?

I ka ʻōlelo maʻalahi, ʻo ka esophagus kahi paipu lōʻihi i hana ʻia me nā ʻiʻo e lawe ana i ka meaʻai mai ka puʻu a i ka ʻōpū ke ale mākou. No laila, loaʻa ka maʻi ʻaʻai ke hoʻomaka nā pūnaewele i loko o kēia esophagus e māhele like ʻole a me ke kāohi ʻole ʻia. Hōʻuluʻulu nā pūnaewele i hana ʻia ma kēia ʻano a hana i kahi puʻupuʻu.

ʻO ke kanesa ʻōpū ka ʻumi o nā maʻi kanesa maʻamau ma ka honua. Hiki ke lilo i mea koʻikoʻi iki, no ka mea, e like me kaʻu i ʻōlelo ai ma mua, hiki i kēia kanesa ke ulu no kekahi manawa me ka ʻole o ka hōʻike ʻana i nā hōʻailona . ʻO ke kumu o kēia, hiki i ko kākou ʻōpū ke kīkoʻo iki, e like me ka wā e ale ai kākou i kahi waha nui o ka meaʻai. No laila, a hiki i ka wā e nui iki ai ke kanesa, ʻaʻole paha kākou e ʻike i kekahi ʻoluʻolu ʻole. Akā, i ka wā e nui ai ka puʻupuʻu a hoʻomaka e ālai i ka wehe ʻana o ka esophagus, lilo ia i mea paʻakikī ke ale i ka meaʻai, a ʻeha ia i ka wā e ale ai kākou.

ʻElua ʻano nui o ke kanesa esophageal, ʻeā?

ʻAe, ʻelua mau ʻano nui:

1. Adenocarcinoma: ʻO kēia ke ʻano maʻamau, ʻoi aku hoʻi ma nā ʻāina Komohana. Hoʻomohala ia i loko o nā pūnaewele o nā kelepaʻi ma ka esophagus e hana ana i ka mucus e kōkua ai i ka ale ʻana. Hoʻomohala pinepine ʻia kēia ʻano ma ka ʻaoʻao haʻahaʻa o ka esophagus.

2. ʻO ka maʻi kanesa cell squamous: Hoʻomaka kēia ʻano i loko o nā cell squamous e hoʻopili ana i loko o ka esophagus. Hoʻomohala pinepine ia ma nā ʻāpana o luna a me waena o ka esophagus.

Hiki ke ho'ōla loa ʻia kēia maʻi kanesa?

Aia maoli kēia i ke ʻano o ka ʻike mua ʻia ʻana o ke kanesa. Inā ʻike mua ʻia, ʻo ia hoʻi, i ka wā liʻiliʻi o ke kanesa, hiki ke wehe ʻia ma ke ʻoki ʻana a i kekahi manawa e ho'ōla loa ʻia. Akā, ʻo ka mea pōʻino, he 25% wale nō o ka poʻe me kēia kanesa i ʻike ʻia ma mua o ka laha ʻana o ke kanesa. ʻO ia ke kumu a mākou e ʻōlelo nei, inā loaʻa iā ʻoe kahi hōʻailona liʻiliʻi loa, e hopohopo no ia mea.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o kēia maʻi kanesa?

Ma keʻano laulā, hōʻike nā helu helu he maʻamau kēia maʻi i nā kāne ma luna o 60 mau makahiki. Eia kekahi, aia kekahi mau ʻokoʻa ma waena o kekahi mau lāhui. No ka laʻana, ʻoi aku ka maʻamau o ka squamous cell carcinoma i nā poʻe ʻeleʻele a me ʻAsia, ʻoiai ʻoi aku ka maʻamau o ka adenocarcinoma i nā poʻe keʻokeʻo. Eia nō naʻe, he mau nānā maʻamau wale nō kēia, a hiki i kekahi ke loaʻa i kēia maʻi.

He aha nā hōʻailona o ke kanesa esophageal? Pehea e ʻike ai?

ʻO ka hōʻailona mua a ka poʻe he nui e ʻike ai, ʻo ia ka paʻakikī i ka ale ʻana (dysphagia) . Hiki ke manaʻo ʻia ua paʻa kekahi mea i loko o ka puʻu. Eia kekahi, aia paha nā hōʻailona e like me:

• ʻEha ma ka ʻāʻī a i ʻole ke kua o ka umauma, ʻo ia hoʻi ma hope o ka iwi umauma a i ʻole ma waena o nā ʻūhā poʻohiwi.
• Ka luaʻi ʻana, malia paha ka luaʻi ʻana i ke koko.
• Ke ʻū ʻana i ke koko.
• ʻO ka puʻuwai pinepine.
• He leo ʻūhū, a i ʻole he ʻūhā mau.
• Ka pohō kaumaha i manaʻo ʻole ʻia .

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​ʻaʻole ia he manaʻo he maʻi ʻaʻai esophageal kou. Eia nō naʻe, inā hoʻomau kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ke ʻike ʻana i ke kauka no ka nānā ʻana.

Pehea ka wikiwiki o ka laha ʻana o kēia maʻi ʻaʻai?

ʻO ke kanesa ʻōpū he ʻano kanesa ia e ulu koke loa . E like me kaʻu i ʻōlelo ai ma mua, no ka mea he palupalu loa ko kākou ʻōpū, i ka ulu ʻana o ke kanesa, e hoʻopuni pinepine ia a puni. ʻO ia ke kumu e ʻike pinepine ʻia ai nā hōʻailona ma hope o ka laha iki ʻana o ke kanesa.

He aha nā kumu nui o kēia maʻi kanesa? He aha nā mea pilikia?

He mea paʻakikī ke ʻōlelo maopopo i ke kumu pololei. Eia nō naʻe, ua ʻike nā kauka i kekahi mau kumu e hoʻonui ai i ka pilikia o ka loaʻa ʻana o kēia maʻi kanesa. E nānā kākou i ke ʻano o lākou:

• Ka hoʻohana ʻana i ka paka: Hoʻokomo pū kēia i ka puhi paka a me ka paka uahi ʻole (e.g. ka nau ʻana i ka paka me ka gum nau, ka nau ʻana i ka gum me ka gum nau). Hiki i kēia mau mea ke hōʻino i nā hunaola o ka esophagus a hoʻonui nui i ka pilikia o ka maʻi ʻaʻai.
• Ka hoʻohana ʻana i ka waiʻona: ʻO ka inu ʻana i ka waiʻona no ka manawa lōʻihi a i ʻole ka inu nui ʻana he kumu nui nō hoʻi ia o ka pilikia.
• Momona: ʻO ka momona nui a momona paha ke kumu o ka mumū i loko o ka esophagus. Hiki i kēia mumū ke alakaʻi i ka maʻi kanesa.
• ʻO ka esophagus a Barrett a me ka reflux waikawa mau loa: ʻO ka reflux waikawa lōʻihi, ʻo ia ke kahe hope o ka waikawa ʻōpū i loko o ka esophagus, hiki ke hana i nā loli i loko o nā cell ma ka ʻaoʻao haʻahaʻa o ka esophagus inā ʻaʻole mālama pono ʻia. Ua kapa ʻia kēia maʻi ʻo ka esophagus a Barrett. ʻAʻole ia he maʻi ʻaʻai, akā he maʻi ia e piʻi aʻe ana ka pilikia o ka ulu ʻana i ka maʻi ʻaʻai. ʻO ka poʻe ʻaʻohe o ka esophagus a Barrett akā he heartburn lōʻihi ko lākou pilikia hoʻi i ka ulu ʻana o ka maʻi ʻaʻai esophageal.
• ʻO ka Human Papillomavirus (HPV): He maʻi maʻamau loa ka HPV. Hiki iā ia ke hoʻololi i nā ʻiʻo o nā kaula leo, ka waha, nā lima, nā wāwae, a me nā ʻōpū. Hoʻonui kekahi mau ʻano HPV i ka pilikia o ka maʻi ʻaʻai esophageal.
• Inā ua loaʻa iā ʻoe ka maʻi kanesa ma mua: ʻO ka poʻe i loaʻa i ka maʻi kanesa o ke poʻo a i ʻole ka ʻāʻī e ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o ka maʻi kanesa o ka esophageal.
• Nā kūlana olakino ʻē aʻe:Ua pili pū kēia maʻi ʻaʻai me kekahi mau maʻi laha ʻole a hoʻoilina. No ka laʻana, ʻo ka achalasia , kahi maʻi laha ʻole e paʻakikī ai ke ale ʻana , a me ka tylosis , kahi maʻi laha ʻole, hoʻoilina e hoʻoulu ai i ka mānoanoa o ka ʻili ma nā poho lima a me nā kapuwaʻi o nā wāwae.
• Ka ʻike ʻia ʻana i kekahi mau kemika: ʻO ka poʻe i ʻike ʻia i nā kemika e like me nā mea hoʻoheheʻe hoʻomaʻemaʻe maloʻo no ka manawa lōʻihi, ʻoi aku ka nui o ka pilikia o kēia maʻi kanesa.

Pehea e ʻike ai nā kauka i kēia maʻi kanesa? (Diagnosis)

Inā loaʻa iā ʻoe nā hōʻailona i ʻōlelo ʻia ma luna, e nīnau mua kāu kauka iā ʻoe e pili ana i kāu mau hōʻailona a me kou mōʻaukala olakino. A laila, hana paha lākou i kekahi mau hoʻokolohua, e like me:

• Hoʻāʻo ale ʻia ka Barium: ʻO kēia ka hoʻāʻo ʻana iā ʻoe e inu i kahi wai i loaʻa kahi mea i kapa ʻia ʻo barium a lawe i kahi moʻo o nā kukuna X. Hoʻomaopopo maopopo ka barium i ka esophagus ma nā kiʻi X-ray. A laila hiki ke hoʻohana ʻia kēia e ʻike inā he mau mea ʻē i loko o ka esophagus.
• ʻO ke scan CT (Computed Tomography scan): Hiki i kēia hoʻāʻo i nā kauka ke ʻike inā ua pālahalaha ke kanesa i nā ʻāpana ʻē aʻe o ka umauma a me ka ʻōpū (ʻōpū).
• ʻEsophagogastroduodenoscopy (EGD): Ma kēia, ua hoʻokomo ʻia kahi ʻōmole lahilahi a palupalu i kapa ʻia ʻo endoscope (i lako me kahi kāmela) ma o ka waha a nānā pololei i loko o ka esophagus. Hiki i kēia ke ʻike maopopo i nā loli a i ʻole nā ​​​​pūpū i loko o ka paia o ka esophagus.
• ʻO ka ultrasound endoscopic esophageal: Hiki ke hana ʻia kēia i ka manawa like me ka EGD. Hoʻohana ia i nā nalu kani e kiʻi i nā kiʻi o loko o ka esophagus. Hiki i kēia ke kōkua i ka hoʻoholo ʻana i ka hohonu o ka ulu ʻana o ke kanesa i loko o ka paia esophagus a inā ua pālahalaha aku i nā lymph node kokoke.
• Biopsy: Inā ʻike ke kauka i kahi wahi kānalua i ka wā o ka EGD, e lawe lākou i kahi ʻāpana liʻiliʻi o ka ʻiʻo a nānā iā ia ma lalo o kahi microscope. Penei lākou e hiki ai ke hōʻoia inā loaʻa nā hunaola kanesa.

Hoʻohana nā kauka i ka ʻike mai kēia mau hoʻokolohua e hoʻoholo ai i ke kahua a me ke ʻano o ke kanesa. ʻO ke kahua o ke kanesa pehea ka mamao o ka laha ʻana o ke kanesa (e.g., ka nui o ka puʻupuʻu, inā ua pālahalaha i nā lymph node, a i ʻole i nā ʻōpū mamao). ʻO ke ʻano o ka puʻupuʻu pehea ka like o nā hunaola kanesa me nā hunaola olakino a pehea ka wikiwiki o ko lākou māhele ʻana. Hoʻolālā ʻia ka lāʻau lapaʻau ma muli o kēia kahua a me ke ʻano.

He aha nā lāʻau lapaʻau no kēia?

ʻO ka lāʻau lapaʻau no ke kanesa esophageal e pili ana i ke kahua a me ke ʻano o ke kanesa, e like me ka mea i ʻōlelo ʻia ma luna, a me ke olakino holoʻokoʻa o ka mea maʻi. Aia kekahi mau koho lapaʻau nui:

• ʻO ke ʻoki kino: ʻO ka lāʻau lapaʻau maʻamau no ka maʻi ʻaʻai esophageal mua loaHe hana i kapa ʻia he esophagectomy. Pili kēia i ka wehe ʻana i kahi hapa a i ʻole ka esophagus holoʻokoʻa, me nā ʻiʻo a puni. A laila, huki ʻia kahi ʻāpana o ka ʻōpū i luna a hoʻopili ʻia i ka umauma a me ka ʻāʻī, e hana ana i kahi esophagus hou.
• Lapaʻau radiation: Pili kēia i ke kuhikuhi ʻana i nā kukuna ikehu kiʻekiʻe (nā kukuna radiation) i ka puʻupuʻu e pepehi i nā hunaola kanesa. Hoʻohana ʻia hoʻi ia ma ke ʻano he lāʻau lapaʻau adjuvant ma mua a ma hope paha o ke ʻoki ʻana.
• ʻO Chemotherapy: ʻO kēia ka hāʻawi ʻana i nā lāʻau lapaʻau e pepehi i nā hunaola kanesa a i ʻole e hoʻōki iā lākou mai ka ulu ʻana. Hiki ke hāʻawi ʻia kēia ma mua, ma hope o ke ʻoki ʻana, a i ʻole me ka hui pū ʻana me ka radiation therapy.
• ʻO ka Endoscopic Submucosal Dissection (ESD): Hoʻohana ʻia kēia kaʻina hana e wehe i nā maʻi ʻaʻai mua loa i hoʻopaʻa ʻia i nā papa superficial o ka paia esophageal.
• ʻO ka Endoscopic Mucosal Resection (EMR): He kaʻina hana kēia e like me ka ESD, i hoʻohana ʻia e wehe i nā ʻōpū kanesa i loko o ka uhi mucous o ka esophagus.
• ʻO ka lāʻau laser Endoscopic: Ke ālai kahi puʻupuʻu maʻi kanesa i ka esophagus a paʻakikī ke ale, hoʻohana ʻia kahi kukuna laser e wehe i kahi ʻāpana o ka puʻupuʻu e hōʻemi i ka ʻoluʻolu ʻole.
• ʻO ka lāʻau lapaʻau Photodynamic (PDT): Ma kēia, hāʻawi ʻia nā lāʻau lapaʻau kūikawā i kapa ʻia ʻo photosensitizers i ke kino, a laila kuhikuhi ʻia kahi kukui kūikawā i kahi maʻi kanesa. Ke pā kēia kukui, hoʻāla ʻia ka lāʻau lapaʻau a hoʻoulu i kahi hopena kemika e luku ai i nā hunaola kanesa.
• Lapaʻau i kuhikuhi ʻia: Loaʻa i kekahi mau hunaola kanesa esophageal kahi nui kūpono ʻole o kahi protein i kapa ʻia ʻo ka protein HER2 . Kōkua kēia protein i ka ulu ʻana o nā hunaola kanesa. ʻO ka lāʻau lapaʻau i kuhikuhi ʻia e pili ana i ka hāʻawi ʻana i nā lāʻau lapaʻau e kuhikuhi ana i kēia protein HER2.
• Immunotherapy: Pili kēia i ka hoʻoulu ʻana i ka ʻōnaehana pale ponoʻī o ko mākou kino e hakakā i nā hunaola kanesa. Hoʻohana ʻia nā lāʻau i kapa ʻia ʻo immune checkpoint inhibitors no kēia kumu.

E hoʻomanaʻo, ʻaʻole kūpono kēia mau lāʻau lapaʻau a pau no kēlā me kēia maʻi. Na kāu hui lapaʻau e hoʻoholo i nā lāʻau lapaʻau i kūpono loa i kou kūlana.

He aha ka mea e hiki ai i kekahi me ke kanesa esophageal ke manaʻo?

Aia maoli kēia ma luna o nā kumu he nui, e like me kou olakino holoʻokoʻa a me ka mamao o ka laha ʻana o ke kanesa i ka wā i ʻike ʻia ai. Inā ʻike koke ʻia, hiki i nā kauka ke mālama pono iā ia. Ma kahi o 46% o ka poʻe i mālama mua ʻia e ola mau ana i ʻelima mau makahiki ma hope o ka ʻike ʻia ʻana.

Eia nō naʻe, inā ua pālahalaha mua ke kanesa, ʻaʻole paha e hiki ke hoʻopau loa iā ia. I kēlā mau hihia, kālele nā ​​​​kauka i ka hāʻawi ʻana i nā lāʻau lapaʻau e kōkua i ka mea maʻi e ola i ka lōʻihi e like me ka hiki, mālama i ke ʻano o ke ola, a hōʻoluʻolu i nā hōʻailona. Ua kapa ʻia kēia he mālama palliative . Kōkua ia i ka mea maʻi e noho ʻoluʻolu a me ka ʻeha ʻole.

Pehea e hiki ai iaʻu ke hōʻemi i koʻu pilikia o ka loaʻa ʻana o kēia maʻi kanesa?

ʻOiai ʻaʻole hiki ke pale loa ʻia, aia kekahi mau mea hiki iā mākou ke hana e hōʻemi i ka pilikia:

• E hahai i kahi papaʻai maikaʻi: E ʻai i ka papaʻai kaulike, e ʻai i nā huaʻai a me nā mea kanu hou aʻe, a mālama i kahi kaumaha olakino e kūpono iā ʻoe.
• Ka noho mamao ʻana mai ka paka a me ka waiʻona: ʻO kēia nā mea ʻelua o nā kumu nui o ka pilikia.
• E pale i ka pili ʻana i kekahi mau kemika (ma muli o ka hana).
• He mea pilikia ka maʻi HPV no ke kanesa ʻesophageal. E nīnau i kāu kauka e pili ana i ka lāʻau pale HPV.
• Inā loaʻa iā ʻoe kahi maʻi e like me ka esophagus a Barrett , e paipai kāu kauka i nā hoʻokolohua nānā mau. E hahai i kēlā mau kuhikuhi.

ʻAʻohe hoʻāʻo nānā i ʻōlelo ʻia no ka maʻi ʻaʻai esophageal no ka heluna kanaka maʻamau i kēia manawa, akā hiki i nā kauka ke ʻōlelo i nā hoʻokolohua e like me ka EGD no ka poʻe me nā kumu pilikia kiʻekiʻe.

Pehea e mālama ai iaʻu iho ma hope o ka lāʻau lapaʻau?

Hiki ke loaʻa kekahi mau hopena ʻaoʻao ma hope o ke ʻoki ʻana no ke kanesa esophageal. Eia kekahi laʻana, ka nausea, ka luaʻi ʻana, a me ka ʻāʻī ʻana o ka puʻuwai. Pono paha ʻoe i ke kōkua i ka mālama ʻana i kēia mau mea. Hiki i nā poʻe he nui ke loaʻa i nā pilikia e like me:

• Paʻakikī i ka ʻai ʻana: Hiki i ke kanesa a me kāna mau lāʻau lapaʻau ke hoʻolilo i ka paʻakikī a me ka ʻeha o ke ale ʻana i ka meaʻai. Hiki i kēia ke hōʻemi i ke kaumaha. Inā pēlā, e ʻimi i ka ʻōlelo aʻo mai kāu kauka. Hiki iā lākou ke paipai i nā mea e like me ka ʻai ʻana i nā meaʻai liʻiliʻi a pinepine a me ka lawe ʻana i nā mea hoʻohui meaʻai.
• ʻO ka maʻi Dumping: Hana ʻia kēia i ka wā e pani ai ka ʻōpū i ka esophagus ma hope o ke ʻoki ʻana. ʻAʻole hiki i ka ʻōpū ke paʻa a hoʻoheheʻe i ka meaʻai, a hele koke ka meaʻai i loko o ka ʻōpū liʻiliʻi. Hiki i kēia ke hana i nā hōʻailona e like me ka nausea, ka luaʻi ʻana, ka ʻeha o ka ʻōpū, ka hou ʻana, a me ka ʻulaʻula.

E kamaʻilio me kāu hui lapaʻau e pili ana i kēia mau mea a e kiʻi i ka ʻōlelo aʻoaʻo no ka pehea e hana ai me lākou.

Hiki i kēia maʻi kanesa ke hoʻi hou mai?

ʻAe, i kekahi manawa hiki i ke kanesa ke hoʻi hou mai (recurrence). Hiki iā ʻoe ke hana i kēia mau mea e hōʻemi ai i kēlā pilikia:

• E kaupalena i ka waiʻona: ʻO ka inu nui ʻana i ka waiʻona e hoʻonui i ka pilikia o ka hoʻi hou ʻana mai o ka maʻi kanesa.
• E hōʻalo i ka hoʻohana ʻana i ka paka: Inā ʻoe e puhipaka, e hoʻāʻo e haʻalele. E ʻimi i ke kōkua lapaʻau inā pono.

Āhea wau e ʻike ai i ke kauka?

E loli kēia ma muli o kou kūlana. ʻOkoʻa ka papa hana hahai no kekahi mea i wehe ʻia ke kanesa ma ke kahua mua ma ke ʻoki ʻana mai ka papa hana no kekahi mea i laha kona kanesa.

Inā holomua kāu lāʻau lapaʻau, e noi pinepine kāu kauka iā ʻoe e hele mai no nā nānā ʻana i kēlā me kēia ʻekolu a ʻeono mahina no nā makahiki ʻelua mua, a i kēlā me kēia ʻeono a ʻumikūmālua mahina no nā makahiki ʻekolu e hiki mai ana. Hiki i kēia mau nānā ʻana ke komo pū me kahi hoʻokolohua kino, nā hoʻāʻo koko, nā hoʻāʻo kiʻi, a me ka endoscopy.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

He maʻi hoʻoweliweli paha ke kanesa ʻōpū. Inā loaʻa iā ʻoe kēia maʻi, makemake paha ʻoe e nīnau i kāu kauka e like me kēia:

• He aha ke ʻano o ka maʻi ʻaʻai esophageal i loaʻa iaʻu?
• I ke kahua hea koʻu maʻi ʻaʻai?
• He aha nā lāʻau lapaʻau āu e paipai nei?
• Hiki ke ho'ōla loa ʻia kēia?
• Inā ʻaʻole hiki iaʻu ke ho'ōla loa ʻia, he aha kāu e hana ai e kōkua mai iaʻu?
• Pehea ka lōʻihi e hiki ai iaʻu ke ola me kēia maʻi kanesa?
• Pono anei iaʻu e hana i ka hoʻāʻo genetic a i ʻole ka hoʻāʻo biomarker?

Mai makaʻu e nīnau i kēia mau nīnau. He mea nui loa e loaʻa iā ʻoe kahi ʻike maopopo o kou kūlana.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

ʻO ke kanesa ʻōpū ka ʻumi o nā kanesa maʻamau i ka honua, a he kanesa paʻakikī hoʻi e mālama. ʻO kēia no ka mea e ʻike pinepine ʻia nā hōʻailona ma hope o ka laha ʻana o ke kanesa. He mea paʻakikī pinepine ka loaʻa ʻana o kahi lāʻau lapaʻau piha. I ia mau hihia, kālele nā ​​​​kauka i ka hāʻawi ʻana i nā maʻi me nā lāʻau lapaʻau e kōkua iā lākou e ola i ka lōʻihi e like me ka hiki a me ke ʻano maikaʻi loa o ke ola.

ʻAʻohe mea paʻakikī loa ma ke ola ma mua o ka haʻi ʻia ʻana, "He maʻi hiki ʻole ke hoʻōla ʻia kāu." I ka manawa e like me ia, pono paha ʻoe i ka manawa a me ke kōkua e hoʻoponopono ai i ke kūlana. Hoʻomaopopo nā kauka i kēia a e hana i nā mea āpau e hiki ai iā lākou ke kōkua iā ʻoe. Inā pono, e kuhikuhi pū lākou iā ʻoe i kahi loea olakino noʻonoʻo.

ʻO ka mea nui loa, ʻo ia ka makaʻala i nā loli i loko o kou kino a e ʻimi koke i ke kōkua lapaʻau inā he mau hopohopo kāu. ʻO ka wā mua āu e ʻike ai, ʻo ka nui o ka kūleʻa o ka lāʻau lapaʻau.

ʻO ke Kanesa ʻEsophageal, Kanesa ʻEsophageal, Nā Hōʻailona Kanesa, ʻEsophagus, Paʻakikī i ke ale ʻana, Lapaʻau Kanesa, Chemotherapy