Ua manaʻo paha ʻoe i ke kaumaha, kahi puʻupuʻu liʻiliʻi, a i ʻole ka manaʻo o ka piha ma lalo o kou mau iwi ʻaoʻao ma ka ʻaoʻao ʻākau? I kekahi manawa he mau ʻeha kinoea maʻamau kēia. Eia nō naʻe, i kekahi manawa he mau hōʻailona ia o kahi maʻi koʻikoʻi o ke akepaʻa, kekahi o nā ʻōkana koʻikoʻi loa i loko o ko kākou kino. I kēia lā ke kamaʻilio nei mākou e pili ana i ka Hepatocellular Carcinoma (HCC), ke ʻano maʻamau o ke kanesa e kū mai ana i loko o ke akepaʻa. ʻOiai paha he mea weliweli a paʻakikī kēia inoa ke lohe ʻoe, mai hopohopo. E kamaʻilio kākou e pili ana i kēia ma ke ʻano maʻalahi e hiki ai i nā mea a pau ke hoʻomaopopo.
He aha kēia Hepatocellular Carcinoma (HCC)?
I ka ʻōlelo maʻalahi, ʻo HCC ke ʻano maʻamau o ka maʻi kanesa e hoʻomaka ana i loko o nā hunaola o ke ake. He ʻano maʻi kanesa ikaika loa ia. ʻIke pinepine ʻia i nā poʻe i loaʻa mua i kahi maʻi akepaʻa mau loa, ʻoiai ʻo ka cirrhosis , kahi kūlana e lilo ai ke akepaʻa i ʻoʻoleʻa a ʻeha, a ua hoʻopilikia ʻia kāna hana. I kēia mau lā iho nei, ua ʻike pinepine ʻia ʻo HCC i nā poʻe me ka metabolic dysfunction-associated steatotic ate disease (MASLD), kahi kūlana i hoʻokumu ʻia e ka hōʻiliʻili ʻana o ka momona i loko o ke ake.
ʻO kekahi o nā mea kaumaha e pili ana i kēia maʻi kanesa, ʻo ia ka ulu lohi loa i nā pae mua. No laila, ʻaʻohe paha he mau hōʻailona i nā pae mua. Hiki ke ho'ōla ʻia i nā pae mua ma ka wehe ʻana i ka puʻupuʻu ma ke ʻoki kino a i ʻole ma ke kāpili ʻana i ke akepaʻa. Eia nō naʻe, i ka manawa e ʻike ʻia ai ka hapa nui o ka poʻe me kēia maʻi, ua pālahalaha mua ke kanesa a aia i kahi pae e hiki ai ke pālahalaha koke. I ka hopena, hiki i kēia ke alakaʻi i ka hāʻule ʻana o ke akepaʻa. I ia hihia, lilo ka mālama ʻana i nā kauka i mea paʻakikī loa.
He mea koʻikoʻi loa kēia kūlana a inā loaʻa iā ʻoe kahi maʻi akepaʻa e like me ka cirrhosis a i ʻole MASLD, e nānā mau kāu kauka iā ʻoe e ʻike inā he mau hōʻailona kāu o ke kanesa HCC.
Pehea ka maʻamau o kēia maʻi kanesa?
E noʻonoʻo i kēia: 85 a 90 o 100 mau maʻi kanesa mua i loko o ke akepaʻa he HCC. (Ke pālahalaha ke kanesa i ke akepaʻa mai kahi ʻē aʻe, kapa mākou ia he kanesa metastatic.) ʻO ia ke ono o ke kanesa i ʻike pinepine ʻia ma ka honua a ʻo ke kolu o ke kumu nui o ka make ʻana i ke kanesa.
Eia kekahi, ʻelua a ʻekolu paha manawa ka nui o ka loaʻa ʻana o ka maʻi i nā kāne ma mua o nā wahine. ʻO ka hapa pinepine, ʻo ka poʻe i ʻike ʻia me ka maʻi he 60 mau makahiki a ʻoi paha.
He aha nā hōʻailona o ka HCC?
E like me ka mea i ʻōlelo ʻia ma mua, ʻaʻole paha e hōʻike nā puʻupuʻu kanesa i kekahi mau hōʻailona i nā pae mua. Eia nō naʻe, i ka holomua ʻana o ke kanesa, e hoʻomaka paha ʻoe e ʻike i nā mea e like me:
| Hōʻailona | I ka ʻōlelo maʻalahi... |
|---|---|
| Piha ma lalo o ka pā iwi ʻākau | He manaʻo kaumaha a i ʻole he puʻu ma lalo o nā iwi ʻaoʻao ma ka ʻaoʻao ʻākau (hiki i kēia ke hōʻailona o kahi akepaʻa i hoʻonui ʻia ). |
| Piha ma lalo o ka pā iwi ʻaoʻao hema | He manaʻo kaumaha ma lalo o nā iwi ʻaoʻao ma ka ʻaoʻao hema (he hōʻailona paha kēia o ka spleen i hoʻonui ʻia ). |
| Melemele o ka ʻili a me nā maka | Kāhea pinepine mākou i kēia he jaundice . |
| Pehu ʻōpū | He manaʻo pehu me he mea lā ua piha ka ʻōpū i ka wai. |
| Makemake nui | ʻAʻole makemake e ʻai, ua māʻona hoʻi ma hope o ka ʻai iki ʻana. |
| Ka emi ʻana o ke kaumaha | Ka emi ʻana o ke kaumaha me ke kumu ʻole. |
| Ka luaʻi a me ka luaʻi | Ka luaʻi mau ʻana a me ka luaʻi ʻana. |
| ʻIli ʻāʻī | Ka maneʻo mau ʻana ma ke kino holoʻokoʻa a i ʻole ma kekahi mau wahi. |
Akā e hoʻomanaʻo i kēia. Hiki ke ʻike pinepine ʻia kēia mau hōʻailona i nā maʻi maʻamau ʻē aʻe. No laila, mai hopohopo no ka mea he hoʻokahi a ʻelua paha o kēia mau mea iā ʻoe. Eia nō naʻe, inā hoʻomau kēia mau hōʻailona no nā pule ʻelua a ʻoi aku, ʻoi aku ka maikaʻi o ke ʻike ʻana i ke kauka a nānā.
No ke aha e ulu ai ke kanesa HCC? He aha nā kumu pilikia?
ʻO ka hapa nui o ka poʻe i ʻike ʻia me HCC (ma kahi o 80%) he cirrhosis. Hiki i kekahi poʻe ke loaʻa i kēia maʻi kanesa ma mua o ka cirrhosis. I loko o kēia mau kūlana, inā ʻaʻole mālama ʻia, hiki i ka mumū mau loa i loko o ke akepaʻa ke alakaʻi i ka ʻeha nui o ke akepaʻa, a hiki ke alakaʻi i ka HCC.
Aia kekahi mau kumu koʻikoʻi e hoʻonui ai i kou pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai HCC.
| Kumu pilikia | Pehea ka hopena o kēia? |
|---|---|
| Maʻi Hepatitis B | Hoʻolaha kahi maʻi viral ma o nā wai o ke kino. ʻO ka mea kūikawā o kēia, hiki iā ia ke hoʻoulu i ka maʻi kanesa HCC ma mua o ka hiki ʻana mai o ka cirrhosis. |
| Ka maʻi Hepatitis C | He maʻi viral e laha ana ma ke koko. Hoʻopōʻino kēia i ke akepaʻa a hoʻonui i ka pilikia o ka maʻi kanesa. |
| Maʻi akepaʻa momona (MASLD) | Ka hōʻiliʻili ʻana o ka momona i makemake ʻole ʻia i loko o ke ake. ʻOi aku ke kiʻekiʻe o kēia pilikia inā loaʻa iā ʻoe ka momona, ka metabolic syndrome, a i ʻole ka maʻi diabetes type 2. |
| Ka inu nui ʻana i ka waiʻona | He lāʻau paʻakikī ka waiʻona no ko kākou akepaʻa e ale. Hiki i ka inu nui ʻana i ka waiʻona no ka manawa lōʻihi ke hōʻino i ke akepaʻa, e alakaʻi ana i ka cirrhosis a me ke kanesa o ke akepaʻa. |
Inā ʻoe i loko o kēia hui pilikia, e nānā mau kāu kauka iā ʻoe no nā hōʻailona o kēia maʻi kanesa. Hiki i kēia ke kōkua i ka ʻike mua ʻana i ka maʻi a mālama iā ia. E kōkua pū kāu kauka iā ʻoe e hoʻōki i ka puhipaka a i ʻole ka inu ʻona, a mālama i nā maʻi maʻi e like me nā maʻi hepatitis a me ka maʻi diabetes.
Pehea e ʻike pono ʻia ai kēia maʻi?
Ke ʻike ʻoe i ke kauka, e nānā mua ʻo ia iā ʻoe ma ke kino a nīnau e pili ana i kāu mau hōʻailona, mōʻaukala olakino, a me ke ʻano o kou nohona. A laila, hana paha lākou i kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona, e like me:
- Nā hoʻāʻo koko: E nānā ʻia kou koko no nā hōʻailona o ka maʻi kanesa. ʻO ke kikoʻī, e nānā ʻia ka pae o kahi protein i kapa ʻia ʻo alpha-fetoprotein (AFP) . Inā kiʻekiʻe kēia pae, he hōʻailona paha ia o ka HCC a i ʻole kahi maʻi e hiki ai ke alakaʻi iā ia, e like me ka hepatitis a i ʻole ka cirrhosis.
- Nā scan kiʻi: Hiki i nā scan e like me ka ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI) , a i ʻole angiography ke hōʻike maopopo i nā ʻano o kahi puʻupuʻu a i ʻole nā puʻupuʻu i loko o ke akepaʻa.
- ʻO ka biopsy akepaʻa: I kekahi mau hihia, inā ʻaʻole lawa ka ʻike o nā hopena scan, e lawe ke kauka i kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai ka puʻupuʻu akepaʻa a nānā iā ia ma lalo o kahi microscope e ʻike inā he mau hunaola kanesa. Eia nō naʻe, ʻo kekahi o nā hiʻohiʻona kūikawā o HCC ʻo ia inā ʻike maopopo ʻia ka puʻupuʻu ma kahi MRI a i ʻole CT scan o ke kanaka me ka cirrhosis, hiki ke hana ʻia ka ʻike me ka ʻole o ka biopsy .
He aha nā lāʻau lapaʻau no ka HCC?
ʻO ke ʻano o ka mālama ʻana no ka HCC e pili ana i ke kahua o ke kanesa, ke olakino holoʻokoʻa o ke akepaʻa, a me kou olakino holoʻokoʻa. Aia kekahi mau koho lapaʻau nui.
| ʻAno lapaʻau | He wehewehe maʻalahi |
|---|---|
| ʻoki kino | Hiki ke hana ʻia ka hepatectomy (ka wehe ʻana i ka ʻāpana o ke akepaʻa kahi i loaʻa ai ke kanesa) a i ʻole ka hoʻoili ʻana i ke akepaʻa (ka hoʻoili ʻana i ke akepaʻa) . Hiki ke hana ʻia kēia i nā pae mua o ka maʻi. |
| Lapaʻau ablation | Ua luku ʻia nā hunaola kanesa ma ke puhi ʻana iā lākou me ka wela nui (nā microwave a i ʻole nā hawewe radiofrequency) a i ʻole ke anu nui me ka hoʻohana ʻana i kahi nila kūikawā. |
| Hoʻopili ʻana | Ua ālai ʻia nā kīʻaha koko e hoʻolako ana i ke koko i ka puʻupuʻu. I kekahi manawa, hoʻouna ʻia nā lāʻau anti-cancer (chemoembolization) a i ʻole nā hua radioactive liʻiliʻi (radioembolization) ma o kēia mau mea. |
| Hoʻōla radiation | Hoʻopau ʻia nā puʻupuʻu liʻiliʻi i hiki ʻole ke wehe ʻia e ke ʻoki ʻana e ka radiation ikehu kiʻekiʻe. ʻO SBRT (Stereotactic body radiation therapy) kahi ʻano hana kūikawā i hoʻohana ʻia no kēia. |
| Hoʻōla lāʻau pale | Hāʻawi mākou i nā lāʻau lapaʻau e hoʻoulu ai i ka ʻōnaehana pale ponoʻī o ko mākou kino, e ʻae ana iā ia e ʻike a hoʻouka i nā hunaola kanesa. |
| Hoʻōla i kuhikuhi ʻia | Hāʻawi ʻia nā lāʻau lapaʻau kūikawā e ālai i nā ala hōʻailona e ʻae ai i nā hunaola kanesa e ulu a māhelehele. |
Hiki paha i kāu kauka ke kuhikuhi iā ʻoe e komo i nā hoʻokolohua lapaʻau e hoʻāʻo ana i nā lāʻau lapaʻau hou. Hiki iā lākou ke hāʻawi i ka mālama palliative e kōkua i ka kaohi ʻana i nā hōʻailona, e hōʻemi i kou ʻehaʻeha, a e maʻalahi ai kou ola.
Hiki ke ho'ōla loa ʻia kēia maʻi?
ʻO ka wehe ʻana i ka puʻupuʻu a i ʻole ka hoʻoili ʻana i ke akepaʻa nā koho maikaʻi loa no ka ho'ōla piha ʻana. ʻOiai inā ʻaʻole hiki ke ʻoki ʻia, aia kekahi mau lāʻau ʻē aʻe e hiki ke hōʻoluʻolu i nā hōʻailona, hoʻolohi i ka ulu ʻana o ke kanesa, a kōkua iā ʻoe e ola lōʻihi.
Wahi a nā helu helu, ʻo ka nui o ke ola ʻelima makahiki no ka poʻe me kēia maʻi he 21% wale nō. Akā, mai hopohopo i kēia. ʻAʻole like kēia no nā kānaka a pau. Hiki ke ʻokoʻa loa ia ma muli o kou kūlana, ke kahua o ke kanesa, ke olakino o kou akepaʻa, a me kāu pane ʻana i ka lāʻau lapaʻau. He ʻokoʻa kēlā me kēia maʻi. No laila, ʻo kāu kauka wale nō ke hāʻawi iā ʻoe i ka manaʻo maikaʻi loa o ka mea e manaʻo ai ma muli o kou kūlana.
He aha kā mākou e hana ai e pale aku i ka maʻi ʻaʻai HCC?
Aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia o ka loaʻa ʻana o kēia maʻi kanesa:
- E loaʻa i ka lāʻau pale no ka Hepatitis B. Inā ua loaʻa mua iā ʻoe ka maʻi, e hana i nā hoʻokolohua maʻamau me ke kauka.
- Inā kānalua ʻoe ua loaʻa iā ʻoe ka maʻi Hepatitis C, e ʻike koke i ke kauka. He maʻi kēia i hiki ke ho'ōla loa ʻia me ka lāʻau lapaʻau.
- Kaohi i nā kūlana e pili ana i ka maʻi akepaʻa momona (MASLD). He mea nui loa ia e kaohi i ke kaumaha o ke kino ma o ka ʻai olakino a me ka hoʻoikaika kino.
- E hōʻalo loa i ka inu nui ʻana i ka waiʻona.
- Inā ʻoe e puhipaka ana, e hoʻōki koke.
Āhea wau e ʻike ai i ke kauka? He aha nā nīnau e pono ai iaʻu e nīnau?
Inā loaʻa iā ʻoe nā hōʻailona i ʻōlelo ʻia ma luna no nā pule ʻelua a ʻoi aku paha, a inā e ʻoi aku ka ʻino o kāu mau hōʻailona, e ʻike koke i ke kauka. Inā ʻoe i loko o kahi hui pilikia, mai hōʻalo i nā hoʻokolohua a kāu kauka e kuhikuhi ai. E hoʻomanaʻo, ʻo ka mua o ka ʻike ʻia ʻana o kēia maʻi, ʻo ka nui o ka kūleʻa o ka lāʻau lapaʻau.
Eia kekahi mau nīnau koʻikoʻi e nīnau aku i kāu kauka:
* Pehea ka maikaʻi o ka hana ʻana o koʻu ake?
* I ke kahua hea koʻu maʻi ʻaʻai?
* Hiki ke ho'ōla loa ʻia kēia?
* He aha nā koho lapaʻau e loaʻa iaʻu?
* He aha nā hopena ʻaoʻao o kēlā me kēia lāʻau lapaʻau?
* Pehea e pili ai ka lāʻau lapaʻau i koʻu ola o kēlā me kēia lā?
* Pehea mākou e ʻike ai inā ua holomua ka lāʻau lapaʻau?
He mea maʻamau ka makaʻu, ka hopohopo, a me ka huikau ke aʻo ʻoe e pili ana i kahi maʻi koʻikoʻi e like me HCC. Akā, ʻaʻole ʻoe hoʻokahi i kēia huakaʻi. E hoʻomaopopo i kāu mau lāʻau lapaʻau a me ko lākou mau hopena ʻaoʻao. E kamaʻilio ākea me kou ʻohana, nā hoaaloha, a me ke kauka. He huakaʻi paʻakikī paha kēia, akā me ka ʻike kūpono, ke kākoʻo, a me ka lāʻau lapaʻau, hiki iā ʻoe ke hoʻomanawanui.
Leka Lawe-Home
- ʻO ka hepatocellular carcinoma (HCC) ke ʻano maʻamau o ka maʻi kanesa o ke akepaʻa a ulu wikiwiki loa.
- Hoʻomaʻamaʻa pinepine ʻia kēia ʻano i nā poʻe i loaʻa mua i ka maʻi ate, ʻoiai ka cirrhosis.
- E makaʻala i nā hōʻailona e like me ke kaumaha ma lalo o ka iwi ʻaoʻao ʻākau, ka jaundice, ka pehu ʻana o ka ʻōpū, a me ka pohō kaumaha. Inā hoʻomau kēia mau mea no nā pule ʻelua a ʻoi, e ʻike i ke kauka.
- ʻO ka Hepatitis B/C, ka inu nui ʻana i ka waiʻona, a me ka maʻi akepaʻa momona (MASLD) nā kumu nui o ka pilikia.
- Inā ʻike mua ʻia ka maʻi, hiki ke hoʻōla piha ʻia ma o ke ʻoki ʻana a i ʻole ke kāpili ʻana i ke akepaʻa.
- Inā he kānalua a nīnau paha kāu e pili ana i kēia, mai hoʻowahāwahā iā lākou. He mea nui loa e kamaʻilio ākea me kāu kauka.
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