Ke haʻi aku kāu kauka iā ʻoe a i ʻole kahi mea aloha i loaʻa i ka maʻi kanesa, he mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke lohe ʻoe i nā huaʻōlelo "radiation therapy" i ka wā e kamaʻilio ai e pili ana i ka lāʻau e hiki mai ana. Ke lohe mākou i ka huaʻōlelo "radiation", hiki mai kahi kiʻi weliweli iki i ko mākou noʻonoʻo. Akā i ka ʻoiaʻiʻo, me ka ʻenehana o kēia wā, ua holomua loa kēia mau lāʻau lapaʻau a palekana hoʻi. No laila i kēia lā, e kamaʻilio kākou e pili ana i ke ʻano nui a me ka mea i hoʻohana pinepine ʻia o ka radiation therapy, ʻo ia hoʻi ʻo `External Beam Radiation Therapy` a i ʻole `(EBRT)`. Ke maopopo nei iaʻu i ka manawa e pau ai kāu heluhelu ʻana i kēia ʻatikala, e nalowale ana kou makaʻu no kēia a e loaʻa iā ʻoe kahi ʻike maopopo.
I ka ʻōlelo maʻalahi, he aha ka External Beam Radiation Therapy (EBRT)?
He mea maʻalahi loa ia. ʻO kēia ke ʻano nui o ka radiation therapy i hoʻohana ʻia e hakakā i ka maʻi kanesa. Pili ia iā ʻoe e moe ana ma luna o kahi moena kūikawā a me kahi mīkini nui e hoʻouna ana i kahi kukuna radiation i kāohi pono ʻia i ka maʻi kanesa.
ʻO ka mea nui loa, ʻaʻole kēia mīkini e paʻi i kekahi wahi o kou kino . Hana ia mai kahi mamao aku. I ka pololei, ua hoʻolālā ʻia kēia mīkini e luku wale i nā hunaola kanesa, me ka hoʻēmi ʻana i ka hōʻino ʻana i nā hunaola olakino.
E noʻonoʻo ʻoe he pahuhopu liʻiliʻi nā hunaola kanesa i loko o kou kino. Ua like kēia mīkini EBRT me kahi sniper super hiki ke pana i kēlā pahuhopu me ka pololei loa. Hoʻopau ia i ka pahuhopu me ka ʻole o ka hōʻeha ʻana i nā hunaola hala ʻole (olakino) a puni.
Pehea e hana ai kēia lāʻau lapaʻau i loko o ke kino?
Hoʻohana kēia lāʻau lapaʻau i nā kukuna ikehu kiʻekiʻe. Hiki i kēia mau kukuna ke hana i nā ʻāpana ikaika a hoʻouka nui ʻia e hiki ke pepehi i nā hunaola kanesa. Hiki i kekahi ʻano kukuna ke hele hohonu i loko o kou kino, e hoʻopilikia ana i nā hunaola kanesa a me nā hunaola olakino kokoke. Akā, ʻo ka pahuhopu nui o nā kauka ke kuhikuhi wale i nā hunaola kanesa me ka hoʻēmi ʻana i ka hōʻino ʻana i nā ʻiʻo olakino.
Aia kekahi mau ʻano nui o nā ʻāpana i hoʻohana ʻia no kēia. E nānā kākou i ko lākou ʻano.
| ʻAno ʻāpana i hoʻohana ʻia | He wehewehe maʻalahi |
|---|---|
| Nā Photons - e.g. nā kukuna X, nā kukuna gamma | ʻO kēia nā mea i hoʻohana nui ʻia. Hiki iā lākou ke komo hohonu i loko o ke kino a luku i nā hunaola kanesa. |
| Nā proton | Hoʻōki kēia mau mea ke hiki aku lākou i ka puʻupuʻu kanesa. No laila, he liʻiliʻi loa ka pōʻino i nā ʻiʻo olakino a puni. Eia nō naʻe, loaʻa wale kēia ʻenehana ma nā wahi palena wale nō o ka honua. |
| Nā ʻelektronika | ʻAʻole komo hohonu kēia i loko o ke kino, no laila hoʻohana nui ʻia lākou e mālama i ka maʻi ʻaʻai ʻili a i ʻole nā maʻi ʻaʻai e pili ana i ka ʻili. |
Hoʻohana ka hapa nui o nā lāʻau EBRT i kahi mīkini i kapa ʻia ʻo `linear accelerator` (LINAC).
He aha nā kūlana e hoʻohana ʻia ai ka mālama ʻana o EBRT?
Hoʻohana nā kauka i kēia ʻano lapaʻau no kekahi mau kumu nui.
- E luku i nā hunaola kanesa a i ʻole e pale aku iā lākou mai ka laha ʻana i nā ʻāpana ʻē aʻe o ke kino.
- Ma ke ʻano he mea hoʻohui i nā lāʻau lapaʻau ʻē aʻe. No ka laʻana, e hoʻēmi i kahi puʻupuʻu ma mua o ke ʻoki ʻana, a i ʻole e hoʻopau loa i nā hunaola kanesa i koe ma hope o ke ʻoki ʻana a i ʻole chemotherapy.
- Hoʻomaha i nā hōʻailona. I kekahi manawa, hoʻohana ʻia kēia lāʻau lapaʻau e hoʻēmi i nā puʻupuʻu e hoʻoulu ai i ka ʻeha a i ʻole nā mea ʻoluʻolu ʻole a hāʻawi i ka hōʻoluʻolu i ka mea maʻi. Kāhea pū mākou i kēia 'mālama palliative'.
Hoʻohana nui ʻia kēia lāʻau lapaʻau no nā maʻi ʻaʻai i hoʻopaʻa ʻia i kahi kikoʻī a i ʻole nā wahi he nui. Eia kekahi laʻana:
- Nā maʻi ʻaʻai o ka umauma, kolona, māmā, prostate, ʻōpū, a me ke poʻo a me ka ʻāʻī
- Nā maʻi ʻaʻai e like me ka leukemia a me ka 'Non-Hodgkin lymphoma'
Aia kekahi mau ʻano lapaʻau EBRT like ʻole?
ʻAe. Ua māhele ʻia ʻo EBRT i kekahi mau ʻano lapaʻau e pili ana i ke ʻano o ke ʻano o ka kukuna radiation, ke kuhikuhi ʻana, a me ke kuhikuhi ʻana. He ʻano loea iki kēia, akā inā ʻoe e hoʻomaopopo maʻalahi iā lākou, e kōkua nui lākou iā ʻoe.
| Inoa o ke ʻano lapaʻau | He aha ka mea e hana ʻia me kēia? |
|---|---|
| ʻO ka lāʻau lapaʻau radiation conformal 3D | Ma ka hoʻohana ʻana i kahi mea e like me ka CT scan, hana ʻia kahi kumu hoʻohālike ʻekolu-dimensional (3D) o ka puʻupuʻu. A laila, hoʻoponopono ʻia kekahi mau kukuna e hele mai ana mai nā kihi like ʻole e kūlike i ke ʻano o ka puʻupuʻu a hoʻouka ʻia. |
| ʻO ka lāʻau lapaʻau radiation i hoʻololi ʻia e ka ikaika (IMRT) | He ʻano hana holomua loa kēia. Hoʻohana ia i nā kukuna i kōkua ʻia e ke kamepiula o nā ikaika like ʻole e hāʻawi i kahi mahele kiʻekiʻe o ka radiation i ka puʻupuʻu kanesa me ka mālama ʻana i nā ʻiʻo olakino. |
| ʻO ka lāʻau lapaʻau i alakaʻi ʻia e ke kiʻi (IGRT) | I ka wā o ka mālama ʻana, hoʻohana ʻia nā ʻano hana kiʻi e like me nā scan e hoʻoholo pono i kahi o ka puʻupuʻu. Inā loli iki ke kūlana o ka puʻupuʻu, hoʻoponopono ʻia ke kukuna e like me ia e hōʻoia i ka kuhikuhi ʻia ʻana i ka pahuhopu kūpono. |
| ʻO ka lāʻau lapaʻau Tomotherapy | He ʻano hana e kuhikuhi ʻia ai nā kukuna radiation i ka puʻupuʻu ma ke ʻano ʻōwili i kou neʻe ʻana ma loko o kahi mīkini ʻano donut. |
| ʻO ke ʻoki kino radiotactic | ʻOiai ke ʻōlelo nei ka inoa he "ʻoki kino," ʻaʻole kēia he ʻoki kino maoli. He ʻano ia o ka hāʻawi ʻana i nā dosis kiʻekiʻe o ka radiation i nā puʻupuʻu liʻiliʻi i loko o ka lolo, me ka ʻole o ke ʻoki kino. |
| ʻO ka lāʻau lapaʻau radiation kino Stereotactic (SBRT) | Ua like kēia me ke ʻano hana i ʻōlelo ʻia ma luna, akā hoʻohana ʻia ia no nā puʻupuʻu i loaʻa ma waho o ka lolo, ma nā wahi ʻē aʻe o ke kino (e.g., nā māmā, ke akepaʻa, ka iwi kuamoʻo). He mea pono loa kēia i nā hihia kahi hiki ʻole ai ke ʻoki kino. |
| Ka radiation intraoperative (IORT) | Hāʻawi ʻia kēia lāʻau lapaʻau i ka wā o ke ʻoki kino. Hāʻawi pololei ia i ka radiation i nā wahi o ke kanesa i hiki ʻole ke wehe loa ʻia, me ka mālama ʻana i nā ʻiʻo olakino a puni. |
He aha ka mea e hana ʻia ma mua o ka mālama ʻana? Hoʻomākaukau (Hoʻohālike)
Ma mua o ka hoʻomaka ʻana o kāu lāʻau lapaʻau, aia kahi pae hoʻolālā i kapa ʻia ʻo 'simulation'. ʻO kēia ke hōʻoia i ka hoʻonohonoho pono ʻana o nā mea āpau no ka hālāwai lapaʻau mua a e hāʻawi iā ʻoe i kahi ʻike maopopo o ka mea e hana ʻia.
Ma kēia `simulation`, e hana ʻia nā mea aʻe:
- Ke kūlana e hoʻomoe ʻia ai ʻoe: ʻO ke kūlana e hoʻomoe ʻia ai ʻoe i ka wā o ka mālama ʻana, ʻo ia ke kūlana like e hoʻomoe ʻia ai ʻoe i kēia manawa.
- Nā Scans: Hana ʻia kahi CT, MRI, a i ʻole PET scan e ʻike i kahi kikoʻī o kāu puʻupuʻu a hoʻoholo i ke kihi e kuhikuhi ʻia ai nā kukuna radiation.
- Kaha ʻili: No ka hoʻoholo pono ʻana i kahi e kuhikuhi ʻia ai ke kukuna radiation, ua kau ʻia kahi māka liʻiliʻi e like me ke kiko ma kou ʻili, e like me ka peʻa. E noho mau kēia mau māka a hiki i ka hopena o ka wā lapaʻau.
- Nā mea kōkua hoʻonohonoho: Hiki ke hana ʻia nā mea e like me ka pale maka a i ʻole ka ʻaila e kūpono iā ʻoe e kōkua iā ʻoe e noho mālie i ka wā o ka mālama ʻana.
Hiki i kēia 'hoʻohālikelike' ke lōʻihi ma mua o kahi kau lapaʻau maʻamau, mai 30 mau minuke a ʻelua hola. A laila, i loko o kekahi mau lā a i ʻole mau pule, hoʻohana kāu hui lapaʻau i kēia ʻike e hana i kahi hoʻolālā lapaʻau e pili pono ana iā ʻoe.
He aha ka mea e hana maoli ana i ka wā o ka mālama ʻana?
ʻAʻole ʻo EBRT kahi hana outpatient, ʻo ia hoʻi hiki iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi i loaʻa ai iā ʻoe ka lāʻau lapaʻau.
Eia ka mea e manaʻo ai i kēlā me kēia kau lapaʻau:
1. E hoʻonoho ʻia ʻoe ma ke kūlana like me ʻoe i ka hoʻohālike. E kākoʻo ʻia ʻoe e like me ka mea e pono ai e noho mālie a ʻoluʻolu hoʻi.
2. Ma hope o kou kau ʻana i ke kūlana kūpono, e haʻalele ke loea (therapist) i ka lumi a hoʻā i ka mīkini.
3. Mai hopohopo! Ke nānā mai nei ʻo ia iā ʻoe ma kahi monitor. Hiki nō hoʻi iā ʻoe ke kamaʻilio me ia ma o kahi `intercom`.
4. Neʻe mālie ka mīkini a puni ʻoe, e kuhikuhi pololei ana i nā kukuna radiation i ka puʻupuʻu kanesa.
5. He mea nui loa e noho mālie ʻoe i kēia manawa. Akā hiki iā ʻoe ke hanu maʻamau.
6. ʻAʻole hāʻawi mau ʻia ka radiation, akā i nā manawa pōkole.
He ʻeha anei kēia?
ʻAʻole. ʻAʻole ʻoe e ʻike i ka radiation. Akā lohe paha ʻoe i kahi leo "kāomi" a i ʻole kani hū mai ka mīkini. ʻIke paha ʻoe i nā kukui uila (ʻoi aku hoʻi i ka wā e mālama ai i ka lolo). Hiki paha iā ʻoe ke honi i kahi ʻala ʻē. He mea maʻamau kēia a ʻaʻole ia he mea ʻino.
ʻEhia ka lōʻihi o ka mālama ʻana?
E hilinaʻi ana kāu papa hana lapaʻau i ke ʻano, ka nui, a me ka wahi o kou maʻi ʻaʻai. Hāʻawi pinepine ʻia ka lāʻau lapaʻau i kēlā me kēia lā (ʻelima mau lā o ka pule) no kekahi mau pule. E wehewehe pono ana kāu kauka radiation oncologist i kāu hoʻolālā lapaʻau a me ka lōʻihi.
He aha nā pōmaikaʻi a me nā hopena ʻaoʻao e hiki ke loaʻa mai kēia lāʻau lapaʻau?
Ua hoʻohana ʻia ka radiation therapy no nā makahiki he 100 a ʻoi. Me ka ʻenehana i loaʻa i kēia lā, ua lilo ia i mea palekana a pololei hoʻi. ʻO nā pono nui o ka mālama ʻana iā EBRT:
- Ke luku nei i nā hunaola kanesa.
- Ke kāohi ʻana a i ʻole ke kāohi ʻana i ka ulu ʻana o nā maʻi ʻaʻai.
- Ke pale nei i ka hoʻi hou ʻana mai o ke kanesa.
- Hoʻopau i nā hōʻailona a hoʻomaikaʻi i ke ʻano o ke ola.
Akā e like me kekahi ʻaoʻao o ke kālā, hiki ke hoʻopilikia ʻia nā ʻāpana olakino kokoke i ka wahi e mālama ʻia ana me ka radiation. ʻO ia ke kumu e loaʻa ai nā hopena ʻaoʻao.
ʻO ka hopena ʻaoʻao maʻamau ka luhi . Aia nā hopena ʻaoʻao ʻē aʻe i ka wahi o kou kino e mālama ʻia nei. ʻO kekahi o lākou:
- Ka luaʻi a i ʻole ka luaʻi
- Makemake nui
- ʻEha poʻo
- Ka nalowale o ka lauoho (ma kahi i mālama ʻia wale nō)
- Paʻakikī ke ale ʻana
- Paʻakikī ka hanu ʻana
- ʻUlaʻula, ʻeha, a ʻeha paha ma ka ʻili (e like me ka lā wela)
- Ka mumū a i ʻole ka pehu ʻana ma kahi i mālama ʻia
ʻO ka mea nui loa: ʻAʻole loaʻa i nā kānaka a pau kēia mau hopena ʻaoʻao. Hiki i nā kānaka ʻelua me ka maʻi kanesa like ke ʻike i nā hopena ʻaoʻao ʻokoʻa. E kōkua kāu hui lapaʻau iā ʻoe e hoʻokele i kēia mau mea.
Pehea ka lōʻihi o koʻu ola ʻana?
ʻOkoʻa nō hoʻi kēia mai kēlā kanaka a kēia kanaka. Hiki i kekahi poʻe ke hoʻomau i kā lākou mau hana maʻamau i ka wā e loaʻa ana ka lāʻau lapaʻau. Pono paha kekahi i nā lā hoʻomaha, ʻoiai inā ua luhi loa lākou.
Hoʻonui pinepine ʻia nā hopena ʻaoʻao i ka hala ʻana o ka manawa. ʻO kēia no ka mea ʻaʻole make koke nā hunaola kanesa ma hope o ka radiation. He mau lā a he mau pule paha e hoʻomaka ai lākou e make. No laila, ʻaʻole paha ʻoe e ʻike i kekahi ʻeha i ka wā mua, akā hiki iā ʻoe ke ʻike mālie i ka luhi i ka hoʻomau ʻana o ka lāʻau.
ʻOiai ma hope o ka lāʻau lapaʻau, ʻokoʻa nā manawa hoʻōla. Hoʻōla kekahi poʻe i loko o kekahi mau pule. No kekahi poʻe, hiki ke hala i kekahi mau mahina.
He aha kaʻu e hana ai e maʻalahi ai ka lāʻau lapaʻau?
E noi i kāu hui lapaʻau no nā ʻōlelo aʻoaʻo kikoʻī e pili ana i kāu hoʻolālā lapaʻau. Ma keʻano laulā, e kōkua kēia mau mea iā ʻoe:
- E hoʻomaha nui. ʻO ka luhi kahi hopena nui o kēia lāʻau lapaʻau. No laila e hiamoe a hoʻomaha i ka nui e like me ka hiki.
- E ʻai i ka meaʻai momona.He mea nui ka meaʻai no ke kino e ho'ōla.
- E inu i ka wai he nui. He mea nui e pale aku i ka maloʻo ʻana o ka wai.
- E hoʻolohe i kou kino. Inā luhi ʻoe, e hana iki. E hana wale i ka mea hiki iā ʻoe.
E haʻi i kāu hui lapaʻau e pili ana i nā hōʻailona āu e ʻike nei. Aia lākou ma laila e kōkua iā ʻoe e hoʻokele i nā hopena ʻaoʻao a hoʻoluʻolu iā ʻoe e like me ka hiki.
Āhea wau e kāhea aku ai i kaʻu kauka?
Ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau, e kamaʻilio me kāu kauka e pili ana i nā hopena ʻaoʻao āu e manaʻo ai, a me nā hōʻailona e hiki ke lilo i pilikia. Ma keʻano laulā, e haʻi koke i kāu kauka inā loaʻa iā ʻoe kekahi o kēia mau mea:
- Inā loaʻa nā hōʻailona i manaʻo ʻole ʻia a koʻikoʻi paha .
- Inā e ʻoi aku ka ʻino o nā hopena ʻaoʻao.
- Inā ʻoe e hōʻike i nā hōʻailona o ka maʻi, e like me ke kuni, ka ʻūlū, a me ka haʻalulu .
- Inā pilikia ʻoe i ka hanu ʻana a i ʻole ka ʻeha o ka umauma .
ʻO kāu hui lapaʻau kāu kākoʻo maikaʻi loa. Mai kānalua e kamaʻilio me lākou e pili ana i nā nīnau a hopohopo paha āu e loaʻa ai, i ka wā a ma hope paha o kāu mālama ʻana.
Leka Lawe-Home
- He ʻano lapaʻau pololei loa a maikaʻi hoʻi ka External Beam Radiation Therapy (EBRT) i hoʻohana nui ʻia no ka maʻi kanesa.
- ʻAʻohe ʻeha i ka wā o ka mālama ʻana, akā hiki ke loaʻa nā hopena ʻaoʻao e like me ka luhi a me nā loli ʻili.
- He mea nui loa e kamaʻilio ākea me kāu kauka a i ʻole ka hui lapaʻau e pili ana i kekahi ʻeha a i ʻole nā hopena ʻaoʻao āu e ʻike nei.
- He mea nui e hoʻomaha pono, e ʻai i nā meaʻai momona, a inu i ka wai lawa i kēia manawa.
- He mea maʻamau ka makaʻu i ka mālama ʻana i ka maʻi kanesa. Akā e hoʻomanaʻo, mahalo i ka ʻenehana holomua o kēia wā, ʻoi aku ka palekana o kēia mau lāʻau lapaʻau ma mua o ka wā ma mua. Ua mākaukau mau kāu hui lapaʻau e kōkua iā ʻoe.
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