Ua ʻike anei ʻoe i ke Kanesa ʻUma HER2-Negative? E kamaʻilio kākou!

Ua lohe nui paha ʻoe e pili ana i ka maʻi ʻaʻai umauma. Akā, ua ʻike maoli anei ʻoe i ke ʻano o kēia ʻano maʻi ʻaʻai i kapa ʻia ʻo 'HER2-negative'? He ʻokoʻa iki kona ʻano ma mua o kekahi mau ʻano maʻi ʻaʻai umauma ʻē aʻe, a he ʻokoʻa paha ke ʻano o ka mālama ʻana. Mai hopohopo, i kēia lā e kamaʻilio mākou e pili ana i kēia 'HER2-Negative Breast Cancer' ma ke ʻano maʻalahi e hiki ai iā ʻoe ke hoʻomaopopo, ʻae?

He aha ka maʻi ʻaʻai umauma HER2-Negative?

I ka ʻōlelo maʻalahi, ʻo ke ʻano o ka maʻi ʻaʻai umauma HER2-negative ʻaʻole nui a liʻiliʻi paha o kahi protein kūikawā i kapa ʻia ʻo `human epidermal growth factor 2 (HER2) i loko o nā hunaola maʻi ʻaʻai i loko o kou umauma. Ua ʻike anei ʻoe e ulu pinepine ana ka maʻi ʻaʻai umauma ma muli o nā hormones (ʻoi aku ka estrogen a me ka progesterone) a i ʻole ma muli o kēia protein `HER2`? No ka laʻana, i loko o ka maʻi ʻaʻai umauma `HER2-positive`, aia ka protein `HER2` ma luna o ka ʻili o nā hunaola, ka mea e hoʻokaʻawale koke ai nā hunaola maʻi ʻaʻai a hana i nā puʻupuʻu.

Akā i nā hihia 'HER2-negative', ʻaʻole e ulu ka maʻi kanesa no ka mea he nui loa ka protein 'HER2'. ʻO ia hoʻi, pili nā kumu ʻē aʻe.

Ke hōʻoia kāu kauka iā ʻoe me ka maʻi ʻaʻai umauma, e ʻimi pono lākou i kou kūlana `HER2` (ʻo ia hoʻi, maikaʻi a maikaʻi ʻole paha). ʻO kēia nā ʻano kūikawā o nā hunaola kanesa, a mākou e kapa nei he `biomarkers` , a i ka wā e maopopo pono ai, hiki i nā kauka ke hoʻoholo i ka lāʻau lapaʻau kūpono loa a maikaʻi hoʻi iā ʻoe. Ua maopopo iā ʻoe?

He aha nā ʻano nui o ka maʻi ʻaʻai umauma HER2-negative?

ʻO ka hapa nui o nā maʻi ʻaʻai umauma i ʻike ʻia i kēia manawa he ʻano `HER2-negative`. ʻElua ʻano nui o kēia, e nānā kākou i ko lākou ʻano:

1. Ka maʻi ʻaʻai umauma hormone-positive a me HER2-negative (HR+/HER2-) :

ʻO kēia ke ʻano maʻamau o ka maʻi ʻaʻai umauma, e helu ana ma kahi o 70 pakeneka (70%) o nā maʻi ʻaʻai umauma āpau. I kēia hihia, loaʻa i nā hunaola maʻi kanesa nā mea loaʻa i ka hormone estrogen (ER+), ka hormone progesterone (PR+), a i ʻole nā ​​mea ʻelua. I ka ʻōlelo maʻalahi, ke hoʻopaʻa kēia mau hormones i kēia mau mea loaʻa, hoʻomaka nā hunaola maʻi kanesa e ulu. Eia naʻe, ʻaʻole i loaʻa i kēia mau ʻano maʻi kanesa nā pae kiʻekiʻe o ka protein HER2. ʻO ia ke kumu i kapa ʻia ai lākou ʻo HR+/HER2-.

2. Ka maʻi ʻaʻai umauma HER2-negative a me ka hormone receptor-negative (HR-/HER2-) :

ʻO kēia ʻano he 11 pakeneka (11%) o nā maʻi ʻaʻai umauma āpau. ʻAʻohe o kēia mau hunaola kanesa i nā mea loaʻa no ka estrogen a i ʻole ka progesterone. Eia kekahi, e like me ka mea i ʻōlelo ʻia ma mua, ʻaʻole kiʻekiʻe ka protein `HER2`. ʻO ke ʻano kēia, ʻaʻole nā ​​hormones a me ka protein `HER2` e kōkua i ka ulu ʻana o kēia maʻi ʻaʻai . ʻO kekahi inoa no kēia ʻo `Triple-Negative Breast Cancer` . ʻO kēia no ka mea ʻo ka mea loaʻa estrogen, ka mea loaʻa progesterone, a me ka protein `HER2` he `maikaʻi ʻole` i kēia hihia.

He aha nā hōʻailona o ka maʻi ʻaʻai umauma HER2-negative?

ʻO ka ʻoiaʻiʻo, ua like loa nā hōʻailona o ka maʻi ʻaʻai umauma HER2-negative me nā maʻi ʻaʻai umauma ʻē aʻe. Pono ʻoe e makaʻala i kēia mau mea:

• Inā ʻike ʻoe i kahi loli kūikawā i ka nui a i ʻole ke ʻano o kekahi a i ʻole nā ​​​​uma ʻelua.
• Inā ʻike ʻoe i kahi puʻupuʻu hou, puʻupuʻu, a paʻakikī paha i kou umauma a i ʻole kou ʻāʻī, ʻoiai inā ʻaʻole e loli ka puʻupuʻu me kou pōʻaiapuni menstrual mahina.
• Nā loli i ka ʻili o ka umauma a i ʻole ka nipple. Eia kekahi laʻana:
• Ka ʻili ʻana o ka ʻili, e like me ka ʻili ʻalani
• ʻŌwili ʻili, ʻūlū
• ʻIli unahi
• He ʻū mau
• Nā loli o ke kala o ka ʻili (ʻulaʻula, poni, ʻeleʻele, a ʻeleʻele paha).
• Ka hoʻokahe ʻana o ka nipple . He ʻulaʻula paha kēia e like me ke koko, he wai moakaka, a he keʻokeʻo waiū paha (inā ʻaʻole ʻoe e hāpai a hānai waiū paha).
• Ka hoʻohuli ʻana o ka nipple (inā ʻaʻole ia ma laila ma mua).

He mea nui e hoʻomaopopo ʻaʻole i hoʻololi mau ka maʻi ʻaʻai umauma i kou ʻano . Eia kekahi, hiki ke ʻike ʻia kekahi o kēia mau loli i nā kūlana maʻamau a maikaʻi ʻole (e like me nā cysts, fibroadenoma). ʻO ia ke kumu he mea nui e nānā mau i kou mau umauma a loaʻa i nā nānā ʻana i ka maʻi ʻaʻai umauma kūpono i ka makahiki . Inā he mau hopohopo kāu e pili ana i kahi loli, e ʻike pono i ke kauka e ʻike inā he hōʻailona ia o ka maʻi ʻaʻai a i ʻole kekahi kūlana ʻē aʻe.

He aha ke kumu o ka maʻi ʻaʻai umauma HER2-negative?

I ka ʻōlelo maʻalahi, ua hoʻokumu ʻia ka maʻi ʻaʻai umauma HER2-negative e nā loli i nā genes, a i ʻole DNA, i loko o nā hunaola umauma, i kapa ʻia he mutations , e hoʻolilo ana i kēlā mau hunaola e lilo i mau hunaola kanesa. A laila māhelehele a hoʻonui koke kēia mau hunaola kanesa me ka ʻole o ke kaohi, e hana ana i nā puʻupuʻu.

Nā Kumu Pilikia

ʻAʻole maopopo i nā loea ke kumu pololei o kēia mau hoʻololi genetic i loko o nā maʻi ʻaʻai umauma HER2-negative. Eia nō naʻe, ua ʻike lākou i kekahi mau mea e hiki ai ke hoʻonui i ka pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai umauma ma ke ʻano laulā. ʻO kēia mau mea:

• Nā hoʻololi hoʻoilina i hoʻoilina ʻia : ʻAʻohe hoʻololi hoʻoilina kikoʻī e pili ana i ka maʻi ʻaʻai umauma e pili ana iā HER2. Eia nō naʻe, inā hoʻoilina kekahi i kahi hoʻololi i nā genes e like me BRCA1 a i ʻole BRCA2, ʻoi aku ka nui o ko lākou pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai umauma (a me kekahi mau maʻi ʻaʻai ʻē aʻe) ma ke ʻano laulā.
• Ua loaʻa iā ʻoe a i ʻole kekahi o kou ʻohana ka maʻi ʻaʻai umauma ma mua.Inā ua loaʻa iā ʻoe ka maʻi ʻaʻai umauma ma mua, aia kekahi pilikia o ka hoʻi hou ʻana mai. Eia kekahi, inā ua loaʻa i kou mau hoahānau koko (ʻoi aku hoʻi kou makuahine, makuakāne, mau kaikaina, nā keiki) ka maʻi ʻaʻai umauma, he kiʻekiʻe iki aʻe kou pilikia.
• Ka lōʻihi o ka ʻike ʻana i nā hormones estrogen a progesterone paha : Inā ua hoʻomaka ʻoe i kāu wā mua i ka wā ʻōpiopio (e.g., ma mua o 12 mau makahiki), a inā ua lohi kou menopause (e.g., ma hope o 55 mau makahiki), ua lōʻihi ka ʻike ʻia ʻana o kou kino i kēia mau hormones wahine. Hiki i kēia ke lilo i mea pilikia. Hiki i kekahi mau lāʻau lapaʻau hoʻololi hormone ke hoʻonui i kou pilikia ke lawe ʻia i ka wā lōʻihi.
• Ka hoʻohana ʻana i ka waiʻona : Ua ʻike ʻia e ka noiʻi ʻana ʻo ka inu ʻana ma mua o hoʻokahi mea inu maʻamau i kēlā me kēia lā e hoʻonui ai i ka pilikia o ka maʻi ʻaʻai umauma.

Ma waho aʻe o kēia, hiki i nā mea e like me ka hoʻonui ʻana o ka makahiki, ka momona, a me ka nele o ka hoʻoikaika kino ke hoʻonui i ka pilikia o ka maʻi ʻaʻai umauma ma ka laulā.

Pehea e ʻike ʻia ai ka maʻi ʻaʻai umauma HER2-negative?

ʻO ka maʻamau, ʻike nā kauka i ka maʻi ʻaʻai umauma HER2-negative ma o ka biopsy umauma . Pili kēia i ka lawe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai kahi puʻupuʻu a i ʻole kahi mea kānalua a hoʻouna iā ia i kahi lab. Ma laila, nānā kahi pathologist i ka hāpana ma lalo o kahi microscope e ʻike inā he mau hunaola kanesa.

Inā hōʻoia ʻia nā hunaola kanesa, hana ʻia nā hoʻokolohua kūikawā e ʻike i ka nui o ka protein `HER2` ma luna o ka ʻili o kēlā mau hunaola kanesa, a i ʻole ka nui o nā kope o ka gene `HER2` i loaʻa.

• Inā he nui maʻamau (haʻahaʻa) kou o ka protein a i ʻole ka gene `HER2`, ua loaʻa iā ʻoe ka maʻi ʻaʻai umauma `HER2-negative`.

ʻO nā hoʻokolohua hoʻokolohua nui ʻelua i hana ʻia no kēia kumu:

1. Immunohistochemistry (IHC) : Hoʻohana kēia hoʻāʻo i nā antibodies a me nā dyes kikoʻī e ʻike i ka protein HER2 ma luna o nā cell cancer. Inā ʻo ka hopena IHC he 0 a i ʻole 1+, ua manaʻo ʻia ka maʻi kanesa he HER2-negative. Inā ʻo ka hopena he 2+ (i kekahi manawa i kapa ʻia ʻo "equivocal" a i ʻole "borderline"), hana ʻia kahi hoʻāʻo i kapa ʻia ʻo FISH e hōʻoia i ke kūlana HER2.

2. Fluorescence in situ hybridization (FISH) : Nānā kēia hoʻāʻo i ka nui o nā kope o ka gene HER2, ka mea e hana ai i ka protein HER2, i loko o nā cell cancer. Hoʻohana kēia i kahi microscope kūikawā a me nā māka fluorescent (light-emitting). I nā hihia kahi i hōʻole ʻole ai ka hopena o ka hoʻāʻo IHC, e like me 2+, hiki i ka hoʻāʻo FISH ke hōʻoia paʻa i ke kūlana HER2 (maikaʻi ʻole a maikaʻi paha).

Ma waho aʻe o kēia mau hoʻokolohua 'HER2', e nānā pū ke kauka pathologist i ka hāpana biopsy a nānā i ke alo o nā mea loaʻa estrogen (ETU) a me nā mea loaʻa progesterone (PR) i loko o ke kanesa.

Pono paha ʻoe e hana i nā kaʻina hana kiʻi e like me ka mammogram, ultrasound, CT scan, a i ʻole MRI scan e ʻike ai i ke kahua o kou maʻi ʻaʻai (ʻo ia hoʻi, e ʻike i ka nui o ka puʻupuʻu a inā ua pālahalaha aku i nā lymph nodes a i ʻole nā ​​​​​​ʻāpana mamao ʻē aʻe o ke kino).

E hoʻohui pū kāu kauka i kēia mau ʻike āpau (ke kūlana HER2, ke kūlana HR, ke kahua o ke kanesa, a me nā ʻano o ke kanesa) e hana i ka hoʻolālā lapaʻau kūpono loa nāu.

He aha nā lāʻau lapaʻau no ka maʻi ʻaʻai umauma HER2-negative?

ʻOkoʻa paha ke ʻano o ka lāʻau lapaʻau maikaʻi loa no ka maʻi ʻaʻai umauma HER2-negative mai kēlā kanaka a kēia kanaka. Aia ia i nā kumu he nui, me ke kahua o kou maʻi ʻaʻai, inā he hormone receptor-positive a maikaʻi ʻole paha (HR+/HER2- a i ʻole HR-/HER2-), a me kou olakino holoʻokoʻa.

Ma keʻano laulā, hiki i nā lāʻau lapaʻau ke komo pū me:

• ʻO ke ʻoki ʻana i ke kanesa o ka umauma : ʻO ka wehe ʻana i ka puʻupuʻu kanesa a me kekahi mau ʻiʻo olakino a puni. Hiki i kēia ke lilo i lumpectomy, kahi e wehe ai i kahi ʻāpana o ka umauma, a i ʻole mastectomy, kahi e wehe ai i ka umauma holoʻokoʻa.
• Lapaʻau radiation : Hoʻohana ʻia nā kukuna ikehu kiʻekiʻe e luku i nā hunaola kanesa e waiho ʻia ma hope o ke ʻoki ʻana, a i ʻole e hoʻēmi i ka puʻupuʻu ma mua o ke ʻoki ʻana.

Ma waho aʻe o kēia mau lāʻau lapaʻau maʻamau, aia kekahi mau lāʻau lapaʻau kūikawā ʻē aʻe ma muli o ke ʻano o ka maʻi kanesa:

Lapaʻau no ka maʻi ʻaʻai umauma HR+/HER2- (hormone receptor-positive, HER2-negative)

Ma muli o ke ʻano o kēia ʻano maʻi kanesa e pili ana i ka hormone, he mea nui hoʻi kēia mau lāʻau lapaʻau ma waho aʻe o ke ʻoki kino a me/a i ʻole ka radiation therapy:

• Hoʻōla hormone : Hana kēia mau lāʻau lapaʻau ma ka hoʻemi ʻana i nā pae o nā hormones estrogen a progesterone paha e kōkua i ka ulu ʻana o ka maʻi kanesa, a i ʻole ma ke kāohi ʻana i kēlā mau hormones mai ka hoʻopaʻa ʻana i nā hunaola kanesa. Eia kekahi laʻana:
• Nā mea hoʻopaʻa aromatase (e like me Anastrozole, Letrozole, Exemestane)
• ʻO nā agonists hormone hoʻokuʻu-gonadotropin (GnRH) (e hoʻōki i ka hana ʻana o nā hormones mai nā ovaries)
• ʻO nā mea hoʻololi i ka mea loaʻa estrogen koho (SERMs) (e.g. Tamoxifen, Raloxifene)

I kekahi mau hihia, pono paha ʻoe e hana i ke ʻoki kino (oophorectomy) e wehe i kāu mau ovaries, ka mea e hana ai i ka estrogen. Hiki ke hāʻawi wale ʻia ka lāʻau lapaʻau hormone a i ʻole me ka hui pū ʻana me ka lāʻau lapaʻau i kuhikuhi ʻia no kekahi mau makahiki.

• Lapaʻau i kuhikuhi ʻia : Kuhi kēia mau lāʻau i nā nāwaliwali kikoʻī i loko o nā hunaola kanesa a hoʻouka iā lākou e hoʻōki i ka ulu ʻana a me ka laha ʻana o nā hunaola kanesa. No nā kanesa HR+/HER2-, hoʻohana ʻia nā lāʻau i kapa ʻia ʻo CDK4/6 inhibitors (e.g. Palbociclib, Ribociclib, Abemaciclib) me ka lāʻau lapaʻau hormone. Ke ālai nei kēia mau mea i kahi enzyme e kaohi ana i ka mahele ʻana o nā hunaola kanesa.
• Kemoterapi: No kekahi mau maʻi ʻaʻai umauma HR+/HER2-, ʻoiai inā ua pālahalaha ke kanesa a i ʻole he ʻino, hiki i nā kauka ke ʻōlelo aku i ka chemotherapy me ka lāʻau lapaʻau hormone a/a i ʻole ka lāʻau lapaʻau i hoʻolālā ʻia.

Ka mālama ʻana i ka maʻi ʻaʻai umauma HR-/HER2- (triple-negative)

No ka mea, ʻaʻole hilinaʻi ka maʻi ʻaʻai umauma triple-negative i ka hormone, ʻaʻole pono ka lāʻau lapaʻau hormone. Ma waho aʻe o ke ʻoki kino a me/a i ʻole ka radiation therapy, hoʻohana nui ʻia nā lāʻau lapaʻau penei:

• Kemoterapia : He lāʻau koʻikoʻi loa ka kemoterapia no ke kanesa triple-negative. Hoʻohana nā kauka i nā ʻano lāʻau kemoterapia like ʻole. Hiki iā lākou ke hāʻawi i hoʻokahi lāʻau a i ʻole ka hui pū ʻana o kekahi mau lāʻau.
• Immunotherapy : He lāʻau lapaʻau hou kēia. Hana ia ma ka hoʻoulu ʻana i ka ʻōnaehana pale ponoʻī o kou kino e ʻike a luku i nā hunaola kanesa. ʻO Pembrolizumab (Keytruda®) kahi lāʻau immunotherapy i ʻāpono ʻia e ka Food and Drug Administration (FDA) a hāʻawi ʻia me ka chemotherapy no kekahi mau ʻano maʻi ʻaʻai umauma triple-negative.
• Lapaʻau i kuhikuhi ʻia : No nā maʻi kanesa triple-negative me kahi mutation gene BRCA, hoʻohana ʻia nā lāʻau lapaʻau i kuhikuhi ʻia i kapa ʻia ʻo PARP inhibitors (e.g., Olaparib, Talazoparib). Eia kekahi, no ka maʻi metastatic, loaʻa nā ʻano lapaʻau hou i kuhikuhi ʻia (e.g., antibody-drug conjugates).

He aha nā hopena ʻaoʻao o nā lāʻau lapaʻau?

ʻOiai hiki i nā lāʻau lapaʻau maʻi kanesa ke hakakā pono i ke kanesa, ʻo nā lāʻau lapaʻau āpau, me ka chemotherapy, radiation therapy, hormone therapy, targeted therapy, a me ka immunotherapy, hiki ke hana i kekahi mau hopena ʻaoʻao. Hiki i kēia mau mea ke lilo i manawa pōkole a lōʻihi paha. No ka laʻana, luhi, nausea, luaʻi, nalowale o ka lauoho, nalowale o ka makemake, nā ʻeha waha, nā loli o ka ʻili, ka maʻi diarrhea a i ʻole ka constipation, a me ka helu haʻahaʻa o nā cell koko.

E kamaʻilio pono me kāu kauka e pili ana i kēia mau hopena ʻaoʻao, pehea ka lōʻihi o ko lākou mau manawa, a pehea e hoʻokele ai iā lākou. Hiki iā lākou ke kuhikuhi iā ʻoe i nā loea mālama palliative . ʻAʻole wale ka mālama palliative no nā pae hope o ke kanesa, akā kōkua pū kekahi iā ʻoe e mālama i kou ola maikaʻi ma ka hoʻokele ʻana i nā hōʻailona a me nā hopena ʻaoʻao i ka wā o ka mālama ʻana.

He aha ka helu ho'ōla no ka maʻi ʻaʻai umauma HER2-negative?

I nā maʻi ʻaʻai umauma HER2-negative a pau, ʻoi aku ke kiʻekiʻe o ka nui o ke ola ʻana i ka wā i hoʻopaʻa ʻia ai ke kanesa i ka umauma a ʻaʻole i laha (kahua kūloko) ma mua o ka wā i laha ai ke kanesa i nā ʻōpū mamao o ke kino (e.g., akepaʻa, māmā, lolo, iwi) (maʻi ʻaʻai metastatic a i ʻole kahua mamao).ʻO ka nui o ke ola no nā maʻi ʻaʻai i laha wale i nā lymph node kokoke akā ʻaʻole i laha i nā ʻōpū mamao (kahua kūloko) aia ma waena.

Eia nō naʻe, he mea nui e hoʻomanaʻo i kou manawa e hoʻōla ai, a i ʻole ka prognosis, e pili ana i nā mea kikoʻī i kāu hōʻailona. ʻO kēia mau mea ka mamao o ka laha ʻana o ke kanesa (kahua), inā he kūlana receptor hormone ko ke kanesa (HR+/HER2- a i ʻole HR-/HER2-), pehea ka ikaika o nā hunaola kanesa (grade), kou makahiki, ke olakino holoʻokoʻa, a pehea ʻoe e pane ai i ka lāʻau lapaʻau. ʻO kēia nā mea hiki i kāu kauka ke kamaʻilio me ʻoe a wehewehe iā ʻoe i ka mea e manaʻo ai. He awelika wale nō nā helu helu, a ʻaʻole like lākou no kēlā me kēia kanaka.

Pehea e mālama ai iaʻu iho? (Mālama ponoʻī)

Inā he kanaka ʻoe me ka maʻi ʻaʻai umauma HER2-negative mua a i ʻole kekahi e noho nei me ka maʻi ʻaʻai holomua, he mea nui e hoʻokaʻawale i ka manawa no ka mālama ponoʻī. E kōkua kēia iā ʻoe ma ke kino a me ka noʻonoʻo. Eia kekahi mau mea hiki iā ʻoe ke hana:

• E hoʻomaha i ka wā e pono ai : He mea maʻamau ka luhi a me ka luhi, mai nā lāʻau lapaʻau no ke kanesa a me ke kanesa. Ke luhi ʻoe, e hoʻomaha a hoʻomaha. E hoʻolohe i kou kino.
• ʻAi i kahi meaʻai olakino a momona hoʻi : Hiki i kekahi mau lāʻau lapaʻau no ka maʻi kanesa ke hoʻopilikia i kou makemake a me kou ʻono. Akā e hoʻāʻo e ʻai i kahi meaʻai kaulike e loaʻa ai nā meaola e pono ai kou kino. E hoʻokomo i nā huaʻai, nā mea kanu, nā fiber, a me nā meaʻai waiwai i ka protein. Inā kānalua ʻoe i nā meaʻai e ʻai ai a me nā mea ʻole, e kamaʻilio me kahi meaʻai meaʻai no ka ʻōlelo aʻo.
• Hoʻoikaika kino (akā, mai hana nui) : He mea nui e hana i ka hoʻoikaika kino mau i kahi pae kūpono iā ʻoe, e like me ka ʻōlelo a kāu kauka. ʻOiai ka hele wāwae māmā a i ʻole ka yoga hiki ke maikaʻi. Hiki iā ia ke hoʻonui i kou ikehu, hoʻomaikaʻi i kou ʻano, a kōkua i ka hōʻemi ʻana i nā hopena ʻaoʻao. Eia nō naʻe, e nīnau i kāu kauka i ke ʻano o ka hoʻoikaika kino kūpono iā ʻoe a me ka nui o kāu e hana ai, ma muli o kāu hōʻailona a me ka mālama ʻana.
• E hoʻokele i ke kaumaha : He mea maʻamau ka manaʻo kaumaha, hopohopo, a me ka makaʻu me kahi maʻi e like me kēia. E ʻimi i nā ala e hoʻokele ai iā ia e pono ai iā ʻoe. ʻOiai e pono ai ka noʻonoʻo ʻana a me nā hoʻomaʻamaʻa hanu no kekahi, makemake paha kekahi e komo i nā hana hana e like me ka heluhelu ʻana i kahi puke, ka hoʻolohe ʻana i ke mele, ke kaha kiʻi ʻana, a i ʻole ka māla. E hoʻokaʻawale i kahi manawa i kēlā me kēia lā no kekahi hana e kōkua iā ʻoe e mālie a hoʻomaha.
• E kiʻi i ke kākoʻo noʻonoʻoHe mea nui e kamaʻilio e pili ana i kou mau manaʻo me ka ʻohana a me nā hoaaloha pili. Hiki iā ia ke hoʻoikaika nui i ka hoʻopili ʻana me nā poʻe ʻē aʻe e hana nei me kahi maʻi kanesa a kaʻana like i kā lākou mau ʻike. E nīnau i kāu kauka e pili ana i nā hui kākoʻo a i ʻole nā ​​​​papahana ola maʻi kanesa.

Āhea wau e ʻike ai i ke kauka?

He mea nui loa ia e mālama mau i ka launa pū ʻana me kāu kauka, i ka wā a ma hope o ka lāʻau lapaʻau.

• Inā loaʻa iā ʻoe nā hōʻailona hou (e laʻa me ka ʻeha mau, kahi puʻupuʻu hou, ka paʻakikī o ka hanu ʻana, ka pohō kaumaha i wehewehe ʻole ʻia), a inā paha e ʻoi aku ka ʻino o kāu mau hōʻailona i kēia manawa , e ʻike koke a hoʻomaopopo paha i kāu kauka .
• Ma hope o ka lāʻau lapaʻau, e hoʻonohonoho kāu kauka i nā manawa hoʻopaʻa maʻamau . E hōʻoia e mālama ʻoe i kēia mau manawa. ʻO kēia mau mea e nānā no ka hoʻi hou ʻana, e hoʻokele i nā hopena ʻaoʻao lōʻihi o ka lāʻau lapaʻau, a e nānā i kou olakino holoʻokoʻa. He mea nui loa kēia mau manawa hoʻopaʻa i nā makahiki ʻelima mua ma hope o ka lāʻau lapaʻau . ʻO kēia ka manawa e hoʻi hou pinepine ai ke kanesa.

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

I ke kamaʻilio ʻana me kāu kauka, mai makaʻu e nīnau i kāu mau nīnau, ʻaʻohe mea liʻiliʻi. Eia kekahi mau nīnau hiki iā ʻoe ke nīnau e kōkua iā ʻoe:

• He maikaʻi a maikaʻi ʻole paha ka mea loaʻa o ka hormone kanesa i koʻu lolo?
• He aha ke ʻano kikoʻī a me ke kahua o koʻu maʻi kanesa?
• He aha ka lāʻau lapaʻau āu e ʻōlelo mai ai noʻu? No ke aha mai?
• He aha nā hopena ʻaoʻao pōkole a me ka wā lōʻihi e manaʻo ʻia mai kēia mau lāʻau lapaʻau? He aha ka mea e hiki ke hana ʻia e hōʻemi ai iā lākou?
• Pehea ka lōʻihi o ka mālama ʻana?
• He aha kāu e haʻi mai ai iaʻu e pili ana i kaʻu wānana?
• Hiki iaʻu ke hoʻomau i kaʻu mau hana o kēlā me kēia lā (hana, nā hana o ka home) i ka wā o ka mālama ʻana?
• Aia kekahi mau mea kūikawā e pono iaʻu e hoʻolohe e pili ana i kaʻu ʻai a me ka hoʻoikaika kino?
• He aha kaʻu e hana ai e hōʻemi i ka pilikia o ka hoʻi hou ʻana mai o ke kanesa?
• Inā makemake au i nā lawelawe kākoʻo a i ʻole ke aʻo ʻana, hiki iaʻu ke kiʻi i kahi kuhikuhi no ia?

He manaʻo maikaʻi ke kākau i lalo i kēia mau nīnau a nīnau iā lākou, i ʻole ʻoe e poina i kekahi mea.

He maikaʻi anei ke HER2-maikaʻi a maikaʻi ʻole paha?

He nīnau kēia a nā poʻe he nui e nīnau ai. Akā, he paʻakikī ke hāʻawi i kahi pane maʻalahi i kēia, no ka mea, ʻo ka ʻoiaʻiʻo , 'e pili ana' ia.

Eia kekahi laʻana, ʻoi aku ka wikiwiki o ka ulu ʻana o nā maʻi ʻaʻai umauma HER2-positive a ʻoi aku ka ikaika ma mua o nā maʻi ʻaʻai HER2-negative. Eia nō naʻe, aia kahi pōmaikaʻi i kēia. Aia nā lāʻau lapaʻau kikoʻī e hiki ke kuhikuhi i nā protein HER2, e.g., Herceptin, Perjeta, a he kūpono loa lākou no nā maʻi ʻaʻai HER2-positive. ʻAʻole hana kēia mau lāʻau lapaʻau no nā maʻi ʻaʻai HER2-negative, no ka mea, ʻaʻole nui ka protein HER2 o kēlā mau maʻi ʻaʻai e kuhikuhi ai.

Ma ka ʻaoʻao ʻē aʻe, inā he ʻano ...

Akā inā he `HER2-negative` (HR-) (hormone receptor-negative) ke kanesa, ʻo ia hoʻi, triple-negative, hiki ke ʻoi aku ka ikaika ma mua o nā ʻano ʻē aʻe, a hiki ke paʻakikī iki ka mālama ʻana. Akā i kēia manawa aia nā chemotherapy, immunotherapy, a me nā lāʻau lapaʻau hou i kuhikuhi ʻia no kēlā.

No laila, ʻaʻole hiki ke ʻōlelo ʻia he "ʻoi aku ka maikaʻi" a "ʻoi aku ka ʻino" paha kekahi ma mua o kekahi. ʻO ka mea nui loa, ʻo ia ka ʻike pololei ʻana i ke ʻano kikoʻī o kou maʻi ʻaʻai a loaʻa i ka lāʻau lapaʻau kūpono loa e kūpono iā ia.

ʻO ka mea hope loa, pono wau e haʻi aku iā ʻoe... (Leka Lawe-Home)

Ke ʻike ʻia ʻoe me ka maʻi ʻaʻai umauma `HER2-negative`, he mea maʻamau ke makaʻu a me ka hopohopo. Akā e hoʻomanaʻo, ʻaʻole kēia ka hopena o ke ao. Ua holomua loa ka ʻepekema a me ka ʻenehana lapaʻau i kēia lā, a he nui nā lāʻau lapaʻau kūpono no kēia ʻano maʻi ʻaʻai.

ʻO ka mea nui loa:

• Ke hoʻomaopopo pono ʻia nei e pili ana i kēia kūlana.
• E makaʻala mau i nā loli i kou kino, ʻoiai kou mau umauma.
• Inā he kānalua kāu, e ʻike i ke kauka i ka manawa kūpono a e nānā ʻia ʻoe.
• E kamaʻilio ākea a me ka ʻoiaʻiʻo me kāu kauka, e nīnau i kāu mau nīnau a pau, a e loaʻa kahi ʻike maikaʻi o nā koho lapaʻau.

E hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi i kēia huakaʻi. Aia nā kauka akamai, nā kahu maʻi, kou ʻohana, a me kou mau hoaaloha pili loa e kōkua a kākoʻo iā ʻoe. E mālama i kahi ʻano maikaʻi, e hahai pololei i nā ʻōlelo a kāu mau kauka, a e loaʻa ke kākoʻo āu e pono ai, a e hiki nō iā ʻoe ke hoʻoponopono i kēia kūlana me ka holomua a hoʻōla. E ikaika ʻoe!

ʻO ke kanesa o ka umauma, HER2-negative, nā hōʻailona kanesa, ka mālama ʻana i ke kanesa, ke olakino wahine, ka lāʻau lapaʻau hormone, triple-negative