Ua loaʻa anei i kekahi o kou ʻohana ka maʻi ʻaʻai kolona? E hele mai, e kamaʻilio kākou e pili ana i kēia maʻi hoʻoilina (Familial Adenomatous Polyposis - FAP)!

Ua loaʻa anei i kekahi o kou ʻohana, malia paha i kona wā ʻōpiopio, ke kanesa kolona? A i ʻole ua haʻi aku kekahi kauka iā ʻoe he mau ulu liʻiliʻi kou (polyps) i loko o kou kolona me nā pilikia ʻōpū? Inā paha ua lohe ʻoe i ia mea a i ʻole, he mea nui loa ia e ʻike i kēia kūlana i kapa ʻia ʻo `FAP` a mākou e kamaʻilio nei i kēia lā. No ka mea, ʻoiai he mea kakaikahi iki ia, inā ʻike mua ʻia, hiki iā ia ke hoʻopakele iā ʻoe i nā pilikia nui he nui.

He aha ka FAP ma nā huaʻōlelo maʻalahi?

I ka ʻōlelo maʻalahi, ʻo Familial Adenomatous Polyposis, a i ʻole FAP no ka pōkole, he ʻano genetic ia e hoʻoulu ai i ka nui o nā ulu liʻiliʻi (polyps) i kapa ʻia ʻo adenomas, hiki ke lilo i maʻi ʻaʻai, e hana i loko o kou kolona a i kekahi manawa i loko o kou rectum.

E noʻonoʻo e pili ana i ia mea, hoʻomohala kekahi poʻe i hoʻokahi a ʻelua paha o kēia mau puʻupuʻu i loko o ko lākou kolona i ko lākou wā ʻelemakule. He mea maʻamau kēlā. Akā no kekahi me ka 'FAP', ʻoi aku ka nui o lākou ma mua o hoʻokahi haneli, i kekahi manawa he mau tausani o kēia mau puʻupuʻu, akā hoʻomaka lākou e ulu i ka wā ʻōpiopio loa, malia paha he ʻumi makahiki. No laila, ʻo ka manawa kūpono e lilo ai kekahi o kēia mau puʻupuʻu i ka maʻi kanesa ('colorectal cancer'), ʻo ia hoʻi, ka pilikia ma luna o ke ola holoʻokoʻa, he kiʻekiʻe loa ia .

No ke kāohi ʻana i kēia pilikia, ʻōlelo pinepine nā kauka i kahi ʻoki kino e wehe i ka colon holoʻokoʻa (colectomy holoʻokoʻa) . I kekahi manawa, wehe ʻia ka rectum (proctocolectomy). ʻO kēia no ka mea ma FAP, ulu wikiwiki kēia mau puʻupuʻu e hiki ʻole ke kāohi ʻia ma ka wehe ʻana iā lākou hoʻokahi. ʻO ka ʻoiaʻiʻo, inā ʻaʻole i hana ʻia kēia ʻoki kino, nui ka poʻe me FAP e loaʻa i ka maʻi kanesa i ka wā waena .

Hiki i nā kānaka me FAP ke hoʻomohala i nā ʻano puʻupuʻu ʻē aʻe, ʻaʻole wale ma ka kolona, ​​akā ma nā wahi ʻē aʻe hoʻi, e like me ka ʻili, nā ʻiʻo palupalu, nā niho, a me nā iwi. ʻOiai ma hope o ka wehe ʻia ʻana o ka kolona, ​​pono paha ʻoe e hoʻomau i nā nānā ʻana e nānā i kēia mau puʻupuʻu ʻē aʻe, a pono paha ʻoe e hana i ke ʻoki kino no lākou.

He aha ka pilikia o ka loaʻa ʻana o ka maʻi kanesa no ka poʻe me FAP?

Inā ʻaʻole mālama ʻia, kokoke i ka 100% o ka loaʻa ʻana o ka maʻi ʻaʻai kolona i kahi kanaka me FAP. Eia kekahi, hiki i ke kanesa ke ulu ma mua a i ka wā ʻōpiopio ma mua o nā poʻe ʻē aʻe. Inā ʻike ʻia kekahi lālā o ka ʻohana he maʻi ia, pono nā keiki o kēlā mau ʻohana e hana i kahi colonoscopy i kēlā me kēia makahiki e hoʻomaka ana i ka makahiki 10 .

Ma waho aʻe o ke kanesa colon, hiki i ka poʻe me FAP ke pilikia no ka hoʻomohala ʻana i nā ʻano maʻi ʻē aʻe:

• ʻO ke kanesa o ka ʻaoʻao o luna o ka ʻōpū liʻiliʻi (ʻO ke kanesa Duodenal) - ma kahi o 8%
• ʻO ke kanesa thyroid papillary - ma kahi o 2%
• Ka maʻi ʻaʻai pancreatic - ma kahi o 2%
• ʻO ke kanesa o ke akepaʻa i kapa ʻia ʻo "Hepatoblastoma" (ʻoi aku hoʻi i nā keiki) - ma kahi o 1.5%
• ʻO ke kanesa ʻōpū - ma kahi o 1%
• Nā ʻōpū o ka lolo a me ke kaula kuamoʻo - emi ma mua o 1%

Aia kekahi mau ʻano FAP like ʻole?

ʻAe, aia kekahi ʻano nui o ka 'FAP' a me kekahi mau ʻano ʻē aʻe ma waho aʻe o kēlā.

• "Classic" FAP: Hōʻike ʻia kēia e ke alo o nā adenomas he 100 a ʻoi ma ke kolona.
• "Attenuated" FAP (AFAP): He ʻano ʻano ʻoi aku ka liʻiliʻi o kēia. Aia ma waena o 20 a me 100 mau cysts i loko o ka colon.
• ʻO ka maʻi Gardner: E like me ka `FAP` maʻamau, aia ma mua o 100 mau puʻupuʻu i loko o ka kolona. Eia kekahi, ulu nā ʻano puʻupuʻu ʻē aʻe ma kahi ʻē aʻe o ke kino.
• ʻO ka maʻi Turcot: Hoʻomaka kahi maʻi kanesa i loko o ka lolo me nā maʻi he nui i loko o ka ʻōpū.

Pehea ka maʻamau o kēia kūlana i kapa ʻia ʻo FAP?

He maʻi laha ʻole ka FAP. Hoʻopilikia ia i hoʻokahi i loko o 8,000 mau kānaka. ʻO ka FAP ma kahi o 0.5% o nā maʻi ʻaʻai colon āpau. ʻOi aku ka laha ʻole o nā ʻano subtypes e like me AFAP, Gardner syndrome, a me Turcotte syndrome.

He aha ka ʻokoʻa ma waena o ka FAP a me ka Lynch Syndrome?

ʻO ka maʻi Lynch kekahi ʻano hoʻoilina e hoʻonui ai i ka pilikia o ka loaʻa ʻana o ke kanesa colon a me nā maʻi kanesa ʻē aʻe. Ua kapa ʻia ʻo Lynch syndrome ʻo HNPCC (hereditary nonpolyposis colorectal cancer syndrome). E like me ka inoa e hōʻike nei, ʻaʻole kēia manaʻo he nui ka nui o nā puʻupuʻu colon e ulu ana .

Hiki i nā kānaka me ka Lynch syndrome ke loaʻa i ka maʻi kanesa me hoʻokahi a ʻoi aku paha nā puʻupuʻu i loko o ka colon. Eia kekahi, ulu iki nā puʻupuʻu a me ke kanesa ma mua o ka FAP, a emi iki ka pilikia. Hoʻokumu ʻia kēia mau kūlana ʻelua e nā mutations gene like ʻole .

He aha nā hōʻailona o ka FAP? Pehea mākou e ʻike ai?

I loko o ka FAP, hoʻomaka nā polyp colon e hana ma mua o ka heluna kanaka maʻamau, pinepine i nā makahiki ʻōpio . ʻAʻole paha e hōʻike kēia mau polyp i kekahi mau hōʻailona a hiki i ko lākou nui loa. Akā inā loaʻa iā ʻoe kahi colonoscopy, hiki i kāu kauka ke loaʻa iā lākou.

Loaʻa paha i ka poʻe me ka `FAP` he mau haneli a he mau tausani paha o nā polyps i loko o ko lākou kolona . Loaʻa i ka poʻe me ka `AFAP` ma ka liʻiliʻi he 20. No ka mea, ʻoi aku ka nui o nā polyps a ulu wikiwiki i ka `FAP`, ʻoi aku ka nui o ko lākou hiki ke hoʻoulu i nā hōʻailona ma mua o nā polyps. Aia nā hōʻailona:

• Ke kahe koko ʻana o ka rectum
• Ka maʻi pākī
• ʻEha ʻōpū mau loa

Hiki i nā poʻe me FAP ke loaʻa i kekahi manawa nā hōʻailona e hiki i nā kauka ke ʻike ma waho:

• Dermatofibromas: He mau puʻupuʻu fibrous, e like me ka ʻeha ma lalo o ka ʻili.
• Nā cysts Epidermal: Nā puʻupuʻu poepoe i piha i ke keratin ma lalo o ka ʻili.
• Osteomas: Nā puʻupuʻu ʻaʻole cancerous e hana ʻia i loko o nā iwi. Loaʻa pinepine lākou i ka iwi ʻauwae a i ʻole ke poʻo.
• Nā niho keu a i ʻole nā ​​niho i pā ʻia:Hiki ke ʻike ʻia kēia mau mea ma ka X-ray o nā niho.
• ʻO ka hypertrophy hānau o ka retinal pigment epithelium (CHRPE): Hiki ke ʻike ʻia kēia mau mea i ka wā o ka hoʻokolokolo maka. Eia naʻe, ʻaʻole lākou e hoʻoulu i nā pilikia ʻike.

I ka makahiki hea e hoʻomaka pinepine ai nā hōʻailona FAP?

I loko o ka FAP, hoʻomaka ka ulu ʻana o ka kolona ma kahi o 16 mau makahiki. I loko o ka AFAP, hiki ke hoʻomaka ma hope iki. Inā ʻike kou mau mākua a me nā kauka ua pilikia ʻoe no ke ʻano, e hoʻomaka paha lākou e hoʻāʻo iā ʻoe ma hope o 10 mau makahiki. Inā ʻaʻole ʻoe, e ʻike ʻia paha ʻoe me ke ʻano ma muli o kāu mau hōʻailona.

He aha ke kumu nui o ka FAP?

ʻO ke kumu nui o ka FAP he hoʻololi ʻana o ka gene . Ua kapa ʻia kēia gene ʻo ka adenomatous polyposis coli (APC) gene . Ua kapa ʻia hoʻi ʻo ia he tumor suppressor gene. ʻO ke ʻano kēia e pale aku ai kēia gene i nā cell mai ka ulu ʻana ma waho o ke kaohi a me ka hoʻokumu ʻana i nā tumors. Ke hana ʻia kahi hoʻololi ʻana o ka gene, ua hoʻopilikia ʻia ka hana o kēia gene.

ʻO ka hoʻololi ʻana o ka gene e hoʻoulu ai i ka FAP he hoʻololi germline. ʻO ke ʻano kēia, ʻaʻole ia he mea e hana ʻia i ka wā o ke ola, akā he mea e hana ʻia i ka wā hāpai . He mea kēia i hoʻoili ʻia mai kēlā hanauna a i kēia hanauna. Inā loaʻa i kekahi o kou mau mākua kēia hoʻololi ʻana, he 50% kou manawa e hoʻoilina ai. Eia nō naʻe, ma kahi o 30% o kēia mau hoʻololi he mea hou (nā hoʻololi mua), ʻo ia hoʻi, ʻaʻole lākou i hoʻoilina ʻia . No laila, ma kahi o 30% o nā maʻi i ʻike ʻia me FAP ʻaʻohe moʻolelo ʻohana o ka maʻi.

He aha nā pilikia e hiki ke loaʻa mai ka FAP?

ʻO ka pilikia koʻikoʻi e mālama ai i ka FAP ʻo ia ka maʻi ʻaʻai kolona . Hiki i ke ʻoki ʻana e wehe i kou kolona (colectomy) ke hōʻemi nui i kēia pilikia. Eia nō naʻe, hiki i ka noho ʻana me ka ʻole o kahi kolona ke loaʻa kekahi mau hopena i kou ola no ka mea ke loli ke ʻano o kou hele ʻana i ka ʻōpala. Pono paha ʻoe e hoʻohana i kahi ʻeke ileostomy a i ʻole ka ʻeke ileal ma kahi o kahi kolona.

Ma muli o ka hoʻololi ʻana o ka gene e hoʻoulu ai i ka FAP aia i loko o kēlā me kēia cell i loko o kou kino, hiki i nā tumors ke ulu i nā wahi āpau o kou kino . Hiki i nā tumors ʻē aʻe ke ulu ma waho o ka colon, a hiki iā lākou ke lilo i maʻi kanesa i kekahi manawa. Hiki i kāu kauka ke paipai i kahi papa hana nānā e nānā ai i kēia mau ʻano tumors:

• Nā polyps Duodenal/periampullary:Hoʻomohala kēia mau mea ma ka ʻaoʻao o luna o kou ʻōpū liʻiliʻi (duodenum), a i ʻole kahi e hui ai ke ala bile a i ʻole ke ala pancreatic i ka ʻōpū liʻiliʻi. Loaʻa i ka hapa nui o nā kānaka me FAP kēia mau mea. Hiki i kahi poʻe liʻiliʻi ke loaʻa i ke kanesa duodenal, ke kanesa ampullary, ke kanesa pancreatic i loko o ke ala, a i ʻole ke kanesa ala bile.
• Nā polyps o ka ʻōpū: Ma kahi o 90% o ka poʻe me FAP e loaʻa i nā polyps o ka ʻōpū, akā 1% wale nō o kēia mau mea e lilo i maʻi kanesa.
• Nā puʻupuʻu Desmoid: ʻO kēia nā puʻupuʻu ʻaʻole cancerous e hana ʻia i loko o nā ʻiʻo pili. Loaʻa lākou ma kahi o 15% o ka poʻe me FAP. ʻOiai ʻaʻole lākou he cancerous, hiki iā lākou i kekahi manawa (ma kahi o 5%) ke hana i nā pilikia olakino koʻikoʻi a me ka make. Hiki iā lākou ke huhū loa, pālahalaha i nā hale kokoke, a kaomi a ālai paha i nā kīʻaha koko, nā ʻōpū, a me nā aʻalolo. He paʻakikī lākou e wehe a hiki ke hana hou.
• ʻO ke kanesa thyroid papillary: Loaʻa kēia ʻano kanesa thyroid ma kahi o 2% o ka poʻe me FAP. ʻAʻole ia he mea weliweli loa a hiki ke ho'ōla pinepine ʻia.
• ʻO ke kanesa o ke akepaʻa: ʻO nā keiki me FAP, ma ke ʻano nui, he liʻiliʻi ko lākou pilikia o ka hoʻomohala ʻana i kahi maʻi kanesa o ke akepaʻa i kapa ʻia ʻo hepatoblastoma.
• Medulloblastoma: He maʻi ʻaʻai lolo kēia. Hiki ke hana me ka maʻi Turcot, kahi e pili ana me FAP. ʻOiai me FAP, he mea kakaikahi loa ia.
• Nā polyps Rectal: Inā ʻaʻole ʻoe e wehe i kou rectum me kou colon, aia ʻoe i ka pilikia no ka hoʻomohala ʻana i nā polyps rectal, no laila pono ʻoe e hana i nā hoʻokolohua proctoscopy i kou ola a pau.

Pehea ʻoe e ʻike pono ai inā loaʻa iā ʻoe ka FAP?

Inā makemake ʻoe e ʻike inā ua hoʻoilina ʻoe i ka mutation gene APC, hiki iā ʻoe ke ʻike ma ka hana ʻana i ka hoʻāʻo genetic . Lawe kahi hoʻāʻo genetic i kahi hāpana o kāu DNA (e like me ke koko a i ʻole ka lawai) a nānā i nā mutation gene kikoʻī. Inā loaʻa iā ʻoe ka mutation, ʻo ka hana aʻe ka loaʻa ʻana o kahi colonoscopy e nānā i nā adenomas.

Hoʻomaopopo ʻia ka FAP ke loaʻa ma ka liʻiliʻi he 100 mau polyp (20 inā AFAP) a me ke alo o ka mutation gene APC . ʻAʻole ʻo FAP wale nō ke ʻano hoʻoilina e hoʻoulu ai i nā polyp adenomatous. He ʻano like ka polyposis e pili ana iā MUTYH, akā ua hoʻokumu ʻia e kahi mutation i loko o kahi gene ʻokoʻa i kapa ʻia ʻo MUTYH.

He aha ka hoʻolālā lapaʻau no kekahi me FAP?

ʻO ka hoʻolālā lapaʻau no FAP e komo pū me ka nānā ʻana i ke ola holoʻokoʻa a me ke ʻoki kino i koi ʻia.I nā pae mua, inā he liʻiliʻi kāu mau polyps (a i ʻole AFAP), hiki i kāu kauka ke wehe iā lākou pākahi i ka wā o ka colonoscopy (polypectomy). Ke nui loa nā polyps a lilo paha i maʻi kanesa, pono paha ke ʻoki kino.

ʻoki kino

Pono ka hapa nui o ka poʻe me ka FAP maʻamau e hana i kahi colectomy piha i ko lākou mau makahiki he iwakālua a i ʻole kanakolu . Na kāu kauka e hoʻoholo i ka wā e hana ai i kāu ʻoki kino ma muli o kāu mau kumu pilikia kikoʻī. E kamaʻilio pū ʻo ia me ʻoe e pili ana i nā ʻano colectomy like ʻole hiki iā ʻoe ke hana.

Ke wehe ʻia kou kolona, ​​hana ʻia kahi hakahaka ma waena o kou ʻōpū liʻiliʻi a me ka rectum (a i ʻole anus). I kekahi manawa, hiki i ke kauka lapaʻau ke hoʻopili hou i kēia mau wēlau ʻelua. A laila hiki iā ʻoe ke neʻe i ka ʻōpū ma o kou rectum e like me ka mea maʻamau. Inā ʻaʻole hiki kēlā, e hana lākou i kahi 'ostomy', ʻo ia hoʻi kahi puka hou i loko o kou ʻōpū no kou ʻōpala e puka mai ai.

Nānā ʻana

E aʻo aku kāu hui lapaʻau iā ʻoe i ka pinepine o kāu hana ʻana i nā hoʻokolohua nānā no nā ʻano ʻōpū like ʻole, ma muli o kāu mau kumu pilikia pilikino. No ka FAP maʻamau, ua ʻōlelo ʻia nā colonoscopies makahiki mai ka makahiki 10 a hiki i ka colectomy . No ka AFAP, pono e hoʻomaka ka nānā ʻana i kēlā me kēia makahiki, e hoʻomaka ana i ka makahiki 20.

Ma hope o kāu colectomy, pono ʻoe e hoʻomau i nā hoʻokolohua sigmoidoscopy, kahi e nānā ai i ka ʻaoʻao haʻahaʻa o kou ala GI. Inā he ʻāpana o kou rectum i koe, pono ʻoe e nānā ʻia i kēlā me kēia 6 a 12 mau mahina. Inā ua wehe ʻia kou rectum a pani ʻia me kahi ʻeke ileal, pono ʻoe e nānā ʻia i kēlā me kēia 1 a 4 mau makahiki.

Hiki i nā hoʻokolohua i hoʻonohonoho ʻia ke komo pū me:

• ʻO ka endoscopy kiʻekiʻe: Ua like kēia me ka colonoscopy, akā hana ʻia ma ka ʻaoʻao o luna o kāu ʻōnaehana hoʻoheheʻe. Hoʻokomo ʻia kahi endoscope i lalo o kou puʻu a i loko o kou ʻōpū a me ka ʻaoʻao o luna o kou ʻōpū liʻiliʻi (duodenum) e nānā i nā polyps. Inā he mau polyps, hiki i kāu kauka ke wehe iā lākou i ka manawa like me ke kaʻina hana.
• Nā hoʻāʻo ultrasound no ka maʻi kanesa thyroid a i ʻole ke akepaʻa.
• ʻO nā hoʻokolohua CT scan (computed tomography scan) a i ʻole MRI (magnetic resonance imaging) no nā ʻōpū desmoid.

Hiki ke pale ʻia ka FAP?

ʻO ke aʻo ʻana i nā ʻano genetics e hoʻomaopopo i ka pilikia o ka hoʻoili ʻana i ke kūlana FAP i kāu mau keikiHiki ke kōkua. ʻO ke kamaʻilio ʻana e pili ana i kēia mau pilikia e kōkua iā ʻoe e hoʻolālā i kou ʻohana. ʻO ka maʻamau, ʻaʻole hiki ke pale aku i kahi loli genetic mai ka wā o ka hāpai ʻana, akā aia nā koho hoʻolālā ʻohana like ʻole hiki iā ʻoe ke noʻonoʻo.

He aha ke kūlana o ke ola o kekahi me FAP?

Inā ʻaʻole mālama ʻia, ʻo ka awelika o ke ola ma kahi o 42 mau makahiki . Eia nō naʻe, me ka mālama pono ʻana i ke olakino a me ka mālama ʻana, hiki iā ʻoe ke ola i kahi ola maʻamau . Ma hope o ka wehe ʻia ʻana o kou kolona, ​​ʻo kou pilikia nui loa e hele mai ana mai nā maʻi ʻaʻai ʻē aʻe o ka ʻōnaehana hoʻoheheʻe a me nā puʻupuʻu 'desmoid' pilikia. ʻOi aku ka liʻiliʻi o kēia mau mea ma mua o ke kanesa kolona.

Inā loaʻa iaʻu kēia maʻi, he aha kaʻu e manaʻo ai?

Inā ua ʻike ʻia ʻoe me FAP, hiki iā ʻoe ke manaʻo e loaʻa i nā hoʻokolohua lapaʻau no ke ola holoʻokoʻa a me kekahi mau ʻoki kino e wehe i nā puʻupuʻu . ʻO nā puʻupuʻu e ulu ana ma waho o kou kolona, ​​ʻaʻole lākou e lilo i maʻi kanesa ma mua o nā polyp i loko o kou kolona. ʻOiai ʻaʻole maʻi kanesa nā puʻupuʻu desmoid, i kekahi manawa hiki iā lākou ke lilo i mea hoʻonāukiuki liʻiliʻi a i ʻole he mea hoʻonāukiuki nui.

Hiki iā ʻoe ke manaʻo e loaʻa kahi colectomy piha i ka wā ʻōpiopio o ke ola . Ma hope o kēlā, hiki ke hoʻopili hou ʻia kou mau ʻōpū, a i ʻole he ʻeke ileal a i ʻole ostomy paha. Loaʻa i kēlā me kēia o kēia mau koho kahi pilikia o nā pilikia kikoʻī. Eia nō naʻe, hiki nō iā ʻoe ke ola i kahi ola lōʻihi a olakino ma hope o kahi colectomy.

He mea maʻamau ke kaumaha a me ka hopohopo ke ʻike ʻoe he maʻi genetic kou e pono ai ka mālama olakino no ke ola holoʻokoʻa. Eia nō naʻe, ke ʻike ʻoe, hiki iā ʻoe ke hana i nā hana e hoʻokele ai i kou pilikia maʻi kanesa . ʻOiai ʻo ke ʻoki ʻana he mea ia no kou wā e hiki mai ana, e hoʻāʻo nā kauka e hana ia mea me ka maʻalahi e like me ka hiki.

Hiki i nā poʻe he nui ke hana i ke kaʻina hana laparoscopic e wehe i ka colon, kahi i hana ʻia ma o nā ʻoki liʻiliʻi a ho'ōla koke . Pono paha ka poʻe me kahi ʻeke ileal e hana i kekahi mau ʻoki kino, akā i ka hopena e hiki iā lākou ke hoʻohana i ka lua e like me ma mua.

Nā mea nui e hoʻomanaʻo mai nā mea a mākou i kūkākūkā ai (Leka Lawe-Home)

ʻAe, no laila, mai kā mākou i kamaʻilio ai e pili ana i ka `FAP`, eia nā mea nui loa e pono ai ʻoe e hoʻomanaʻo:

• He ʻano hoʻoilina ka FAP i hiki ke hoʻoili ʻia ma o nā hanauna.
• ʻO kēia ke kumu o nā haneli a i ʻole nā ​​​​kaukani o nā polyps e hana i loko o ka kolona, ​​hiki ke lilo i maʻi kanesa.
• Inā ʻaʻole mālama ʻia, kiʻekiʻe loa ka pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai colon .
• He mea nui loa e hoʻomaka i nā hoʻāʻo colonoscopy mai ka wā ʻōpiopio (10-12 mau makahiki) .
• ʻO ke ʻano nui o ka mālama ʻana, ʻo ia ke ʻoki ʻana e wehe i ka kolona (colectomy) .
• ʻOiai ma hope o ka wehe ʻia ʻana o ka kolona, ​​pono nā hoʻāʻo no ke ola holoʻokoʻa e nānā i nā ʻōpū e ulu ana ma nā wahi ʻē aʻe o ke kino.
• ʻOiai he kūlana kēia no ke ola holoʻokoʻa e pono e mālama ʻia, me ka mālama pono ʻana a me nā hoʻāʻo ʻana, hiki ke ola i kahi ola maʻamau a olakino .

Inā loaʻa iā ʻoe a i ʻole kekahi o kou ʻohana kekahi o kēia mau hōʻailona, ​​a inā makemake ʻoe e ʻike hou aku e pili ana i kēia, e ʻimi pono i ke kōkua lapaʻau . ʻO ka ʻike mua a me ka hana mua nā mea nui loa.

` FAP, ʻOhana Adenomatous Polyposis, Nā Maʻi Genetic, Colon Polyps, Colon Cancer, APC Gene, Colonoscopy, Colectomy, ʻoki kino