ʻO ka huaʻōlelo "radiation" paha e hoʻoweliweli iki iā ʻoe. ʻOi loa aku i ka wā e pili ana i ka mālama ʻana i ka maʻi kanesa, hiki i kēlā makaʻu ke ʻoi aku ka nui. Akā ua holomua nui ka ʻenehana i kēia mau lā. ʻAʻole e like me ka wā ma mua, hiki ke hana ʻia kēia mau lāʻau me ka pololei a me ke akahele. No laila i kēia lā ke kamaʻilio nei mākou e pili ana i ka mālama ʻana i ka radiation maʻamau no ka maʻi kanesa, ʻo External Beam Radiation Therapy, a i ʻole EBRT no ka pōkole.
I ka ʻōlelo maʻalahi, he aha ka EBRT?
E noʻonoʻo ʻoe e moe ʻoluʻolu ana ma luna o kahi moe. Me ka hoʻopā ʻole ʻana i kou kino, ke hoʻokuʻu nei kahi mīkini nui ma kahi mamao aku i nā kukuna radiation i hoʻolālā pono ʻia, i kuhikuhi wale ʻia i ka puʻupuʻu i loko o kou kino. ʻO ia ka mea a mākou e kapa wale nei he EBRT.
Pili kēia i ka hoʻohana ʻana i nā kukuna ikehu kiʻekiʻe e luku i nā hunaola kanesa. ʻO ka pahuhopu nui ka hōʻemi ʻana i ka hōʻino ʻana i nā hunaola olakino a puni lākou me ka luku ʻana i nā hunaola kanesa. He lāʻau lapaʻau waho kēia, no laila ʻaʻohe mea i hoʻokomo ʻia i loko o kou kino.
Ma kēia lāʻau lapaʻau, ʻaʻole loa e hoʻopā ka mīkini radiation i kou kino. Akā, hoʻolālā ka hui lapaʻau i ka mīkini e kuhikuhi wale i nā hunaola kanesa mai kahi mamao aku, e luku ana iā lākou.
He aha ka ʻokoʻa ma waena o ka radiation therapy o waho a me loko?
Hiki ke hoʻokaʻawale ʻia ka radiation therapy i ʻelua mau ʻano nui.
1. Ka Lapaʻau ʻana i ke Kukui Kūwaho (EBRT): ʻO kēia ke ʻano hana a mākou e kamaʻilio nei. Pili ia i ka lawe ʻana i ka radiation mai kahi mīkini ma waho o ke kino.
2. Lapaʻau Kukui Kūloko: Pili kēia i ke kau ʻana i kahi mea radioactive liʻiliʻi i loko a i ʻole kokoke i ka puʻupuʻu ma ke ʻoki ʻana.
ʻOiai ʻo kēia mau ʻano ʻelua e hoʻopau i nā hunaola kanesa, ʻokoʻa ke ʻano o kā lāua hana ʻana.
He aha nā ʻano kukuna ikehu i hoʻohana ʻia no kēia lāʻau lapaʻau?
He kukuna ikehu ka radiation i loaʻa nā ʻāpana i hoʻouka nui ʻia. Loaʻa i kēia mau ʻāpana ka mana e luku i nā hunaola kanesa. ʻO ka pilikia nui o kēia lāʻau lapaʻau, ʻo ia ka luku wale ʻana i nā hunaola kanesa me ka ʻole o ka hōʻeha ʻana i nā hunaola olakino. Hoʻohana ʻia nā ʻano ʻāpana like ʻole no kēia.
- Nā Photons (nā kukuna X a me nā kukuna gamma): ʻO kēia nā mea i hoʻohana nui ʻia i ka mālama ʻana iā EBRT. Ua like lākou me nā kukuna X ikehu kiʻekiʻe. Hiki iā lākou ke komo hohonu i loko o kou ʻiʻo a pepehi i nā hunaola kanesa.
- Nā proton:He mau ʻāpana kēia me ka hoʻouku maikaʻi. ʻO ka lāʻau lapaʻau e hoʻohana ana i kēia ua kapa ʻia ʻo `(Proton Therapy)`. He ʻenehana hou kēia. ʻO ka mea kūikawā ma ʻaneʻi, ma hope o ka paʻi ʻana o ke kukuna proton i ka puʻupuʻu kanesa, e pau ia me ka ʻole o ka hele ʻana ma mua o ia. No laila, ʻo ka hōʻino ʻana i nā ʻiʻo olakino e pili ana i ke kanesa he mea liʻiliʻi loa ia. Eia naʻe, ʻaʻole i maʻamau loa kēia ʻano lāʻau lapaʻau ma ka honua.
- Nā Electron: He mau ʻāpana i hoʻopiʻi maikaʻi ʻole ʻia kēia. ʻAʻole hiki iā lākou ke hele hohonu e like me nā photons a i ʻole nā protons. No laila, hoʻohana nui ʻia lākou e mālama i nā puʻupuʻu ma ka ʻili o ke kino, e like me ke kanesa ʻili.
No ka hapa nui o nā lāʻau lapaʻau EBRT, hoʻohana ʻia kahi mīkini i kapa ʻia ʻo "Linear Accelerator" (LINAC) e hoʻolalelale i kēia mau ʻāpana a lawe iā lākou i nā hunaola kanesa.
Aia kekahi mau ʻano like ʻole o ka mālama ʻana iā EBRT?
ʻAe, me ka holomua o ka ʻenehana, aia i kēia manawa kekahi mau hoʻolālā like ʻole a me nā ʻano lapaʻau EBRT. Ma muli o ke ʻano a me ka wahi o kou maʻi ʻaʻai, e koho kāu kauka i ke ʻano kūpono loa iā ʻoe.
| ʻAno Lapaʻau | I ka ʻōlelo maʻalahi... (Wehewehe Maʻalahi) |
|---|---|
| ʻO ka Lapaʻau Radiation Conformal 3D | Ma ka hoʻohana ʻana i nā mea e like me nā CT scans, hana ʻia kahi kumu hoʻohālike ʻekolu-dimensional (3D) o ke kanesa a kuhikuhi ʻia nā kukuna radiation iā ia mai nā kihi like ʻole e hoʻohālikelike iā ia. |
| ʻO ka Lapaʻau Radiation Modulated Intensity (IMRT) | He ʻano hana 3D holomua kēia. Maanei, ʻaʻole wale ke ʻano o ka puʻupuʻu e hiki ke kuhikuhi ʻia, akā hiki ke kuhikuhi ʻia nā wahi me nā hunaola kanesa he nui me ka mana kiʻekiʻe , a hiki ke kuhikuhi ʻia nā wahi me nā hunaola kanesa liʻiliʻi me ka mana haʻahaʻa . |
| ʻO ka Radiation Therapy i alakaʻi ʻia e ke kiʻi (IGRT) | Ma mua o kēlā me kēia lāʻau lapaʻau, lawe ʻia kahi scan kiʻi (e like me ka scan CT) e hoʻoholo pololei i kahi o ke kanesa a laila hoʻouna ʻia ka radiation. ʻO kēia ka mea e kiʻekiʻe loa ai ka pololei. |
| ʻO ke keʻena radio Stereotactic (e laʻa me ka Gamma Knife) | ʻAʻole kēia he ʻoki kino, ʻoiai ua kapa ʻia ʻo "ʻoki kino." He ʻano ia o ka hāʻawi ʻana i nā dosis kiʻekiʻe loa o ka radiation i nā ʻōpū liʻiliʻi i loko o ka lolo, ma ka pana hoʻokahi a i ʻole ma nā pana he nui, ma ke ʻano pololei loa. |
| ʻO ka Lapaʻau Radiation Kino Stereotactic (SBRT) | ʻO kēia ke ʻano hana like me luna, akā hoʻohana ʻia no nā maʻi ʻaʻai i loaʻa ma waho o ka lolo, ʻoiai ma nā wahi e like me nā māmā, ke akepaʻa, a me ka iwi kuamoʻo. |
| Ka Pāhawewe Intraoperative (IORT) | Hana ʻia kēia i ka wā o ke ʻoki kino e wehe ai i ke kanesa. Hāʻawi ʻia ka radiation i ka manawa like i nā ʻāpana o ke kanesa i hiki ʻole ke wehe loa ʻia e ke ʻoki kino. |
He aha nā ʻano hihia e hoʻohana ʻia ai ka lāʻau EBRT?
Hoʻohana ʻia kēia lāʻau lapaʻau no kekahi mau kumu nui.
- No ka luku ʻana i nā hunaola kanesa: Hoʻohana ʻia ʻo EBRT ma ke ʻano he lāʻau lapaʻau mua no nā ʻano maʻi kanesa he nui.
- No ke kākoʻo ʻana i nā lāʻau lapaʻau ʻē aʻe: Hoʻohana ʻia ia e hoʻēmi i ka puʻupuʻu ma mua o ke ʻoki ʻana (neo-adjuvant therapy) a i ʻole e luku i nā hunaola kanesa i manaʻo ʻia e waiho ʻia ma hope o ke ʻoki ʻana a pale i ka hoʻi hou ʻana mai o ke kanesa (adjuvant therapy).
- No ka hōʻoluʻolu ʻana i nā hōʻailona: ʻOiai i kekahi mau hihia ʻaʻole hiki ke ho'ōla loa ʻia ke kanesa, kōkua kēia lāʻau lapaʻau i ka kaohi ʻana i nā hōʻailona e like me ka ʻeha i hoʻokumu ʻia e nā ʻōpū kanesa a mālama i ke ʻano o ke ola o ka mea maʻi.
Nā ʻano maʻi kanesa i mālama ʻia me EBRT
He lāʻau lapaʻau nui ʻo EBRT no nā ʻano maʻi kanesa kūloko he nui, e like me:
- Ka maʻi ʻaʻai umauma
- Ka maʻi ʻaʻai kolona
- Ka maʻi ʻaʻai māmā
- Ka maʻi ʻaʻai prostate
- Ka maʻi ʻōpū
- Ka maʻi ʻaʻai poʻo a me ka ʻāʻī
- Nā maʻi ʻaʻai koko e like me ka leukemia a me ka lymphoma
He aha ka mea e hana ʻia ma mua o ka mālama ʻana? (Ka pae hoʻolālā)
ʻO kēia pae hoʻolālā, i ʻike ʻia hoʻi ʻo "simulation", he ʻāpana koʻikoʻi ia o ka holomua o ka mālama ʻana iā EBRT. Pili ia i ka hoʻomākaukau ʻana i nā mea āpau no kāu mālama mua.
1. Ke kūlana:E hoʻonoho ʻia ʻoe ma luna o kahi moe i kēia lā hoʻolālā, e like me ʻoe i ka wā o ka mālama ʻana.
2. Nā scan: A laila, hana ʻia kahi CT, MRI, a i ʻole PET scan e kiʻi i nā kiʻi pololei o kou maʻi ʻaʻai a me nā ʻōpū olakino e pili ana. ʻO kēia ka mea e kōkua ai i ka hoʻoholo ʻana i ka nui, ke ʻano, a me kahi kikoʻī o ke kanesa.
3. Kaha ʻana: Ma hope aʻe, e hana ʻia kekahi mau kaha liʻiliʻi e like me ke kiko ma kou ʻili me ka peni e ʻike ai i ka wahi e mālama ʻia ai. Pono e mālama ʻia kēia mau mea a hiki i ka pau ʻana o ka manawa mālama.
4. Ke hana ʻana i nā ʻōmole/nā pale maka: I mea e kōkua ai iā ʻoe e noho mālie i ka wā o ka mālama ʻana, hiki ke hana ʻia kahi ʻōmole kūikawā a pale maka paha e kūpono i kou ʻāpana kino.
Ma ka hoʻohana ʻana i kēia ʻike, e hoʻolilo kāu hui lapaʻau i kekahi mau lā e hana ana i kahi hoʻolālā lapaʻau e pili pono ana iā ʻoe.
He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?
ʻAʻole ʻoe e ʻike i kekahi ʻeha i ka wā o ka mālama ʻana.
E hoʻonoho ʻia ʻoe ma ke kūlana like me ʻoe i ka wā o ka simulation. Inā pono, e hāʻawi ʻia ʻoe i kahi mask kūikawā a i ʻole splint. A laila e haʻalele ka mea hoʻōla radiation i ka lumi a hoʻā i ka mīkini. Eia nō naʻe , e nānā paha lākou iā ʻoe ma kahi monitor a kamaʻilio pū me ʻoe ma o kahi intercom .
Hoʻohuli ka mīkini a puni ʻoe, hana i nā leo like ʻole, a hoʻopili i ka radiation ma nā wahi kikoʻī. ʻO kāu wale nō e hana ai, ʻo ia ke noho mālie, kū mālie, a hanu maʻamau. Hiki i ka mālama holoʻokoʻa ke hala ma kahi o 15-30 mau minuke. Eia nō naʻe, ua hoʻopili wale ʻia ka radiation no kekahi mau minuke.
He aha nā hopena ʻaoʻao maʻamau?
ʻOiai inā mākou e hoʻāʻo e hōʻemi i ka hōʻino ʻana i nā ʻāpana olakino e like me ka hiki, he paʻakikī ke pale aku i kekahi mau hōʻino. ʻO ka hōʻino ʻana i kēia mau ʻāpana olakino ke kumu o nā hopena ʻaoʻao.
ʻO ka mea nui, ʻaʻole like kēia mau hopena ʻaoʻao no kēlā me kēia kanaka . Aia nō hoʻi lākou i ka ʻāpana o ke kino e mālama ʻia ana me ka radiation. No ka laʻana, hiki i kekahi e loaʻa ana ka lāʻau lapaʻau ma ke poʻo ke loaʻa ka nalowale o ka lauoho, akā ʻo kekahi e loaʻa ana ka lāʻau lapaʻau ma ka ʻōpū ʻaʻole paha.
ʻO kekahi o nā hopena ʻaoʻao maʻamau e hiki ke ʻike ʻia:
- Manaʻo luhi loa (Fatigue): ʻO kēia ka hopena ʻaoʻao maʻamau.
- Ka luaʻi a me ka luaʻi
- Makemake nui
- ʻUlaʻula, maloʻo, a ʻānai paha o ka ʻili ma kahi i mālama ʻia
- Ka nalowale o ka lauoho ma ka wahi i mālama ʻia
- Paʻakikī ke ale ʻana inā mālama ʻia ka waha a me ka puʻu
- ʻEha poʻo
Hoʻemi mālie ka hapa nui o kēia mau hopena ʻaoʻao i loko o kekahi mau pule ma hope o ka pau ʻana o ka lāʻau lapaʻau. E kamaʻilio ākea me kāu kauka e pili ana i nā hopena ʻaoʻao kikoʻī āu e ʻike ai a pehea e hoʻokele ai iā lākou.Inā koʻikoʻi kekahi mau hopena ʻaoʻao a i ʻole ʻoe e manaʻo i kekahi mea ʻē, e hoʻomaopopo koke i kāu kauka a i ʻole ke kikowaena mālama. I nā hihia koʻikoʻi, he mea nui e hele i ka Emergency Treatment Unit (ETU) o ka haukapila.
Leka Lawe-Home
- He ʻano lapaʻau maʻamau loa ka EBRT, ʻeha ʻole, a kikoʻī loa i hoʻohana ʻia no ka maʻi kanesa i kēia lā.
- Hana ʻia kēia e kahi hui o nā kauka loea. ʻO kāna pahuhopu nui ka luku ʻana i nā hunaola kanesa wale nō me ka pale ʻana i nā hunaola olakino.
- He mea maʻamau nā hopena ʻaoʻao, akā he manawa pōkole wale nō. ʻO ke ʻano o nā hopena ʻaoʻao e kū mai ana ma muli o ka wahi o ke kino e mālama ʻia ana.
- He mea nui loa e kamaʻilio ākea a me ka ʻoiaʻiʻo me kāu kauka e pili ana i ka lāʻau lapaʻau, nā hopena ʻaoʻao, a i ʻole nā makaʻu a hopohopo paha āu e loaʻa ai.
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