Ua lohe paha ʻoe ua loaʻa i hoʻokahi, ʻelua a ʻekolu paha mau lālā o kou ʻohana ka maʻi kanesa colon? A i ʻole ua hopohopo iki ʻoe no ka mea he moʻolelo ʻohana kou no ka maʻi kanesa? ʻO ka ʻoiaʻiʻo, hiki ke hoʻoili ʻia kekahi mau ʻano maʻi kanesa mai kēlā hanauna a i kēia hanauna. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano kūikawā o ka maʻi kanesa colon i hoʻoili ʻia ma o kā mākou mau genes. Kāhea mākou i kēia HNPCC.
He aha ka HNPCC?
I ka ʻōlelo maʻalahi, ʻo ka HNPCC (Hereditary Nonpolyposis Colorectal Cancer) he ʻano maʻi ʻaʻai kolona i hoʻokumu ʻia e kekahi mau loli (mutations) i loko o nā genes i hoʻoili ʻia ma o nā hanauna. He maʻi ʻaʻai kēia e kū mai ana i loko o ko kākou ʻōpū nui (colon).
No laila, like kēia me ka Lynch Syndrome?
Ua lohe pinepine paha ʻoe i ka Lynch Syndrome ma mua o ka HNPCC. Pili loa nā mea ʻelua, akā ʻaʻole like loa. E noʻonoʻo i kēia ʻano. ʻO ka Lynch Syndrome kahi kīnā genetic i loko o ko mākou kino. He kūlana genetic ia e hoʻonui ai i ka pilikia o ka maʻi kanesa.
ʻO HNPCC ka inoa i hāʻawi ʻia i kahi kūlana kahi e loaʻa ai i kahi kanaka me Lynch Syndrome ka maʻi kanesa colon a i ʻole nā maʻi kanesa pili ʻē aʻe (e like me ke kanesa uterine a i ʻole ka maʻi kanesa ʻōpū liʻiliʻi), ʻoi aku hoʻi ma mua o 50 mau makahiki . Hoʻomohala pinepine nā maʻi kanesa HNPCC ma ka ʻaoʻao ʻākau o ka ʻōpū nui.
I ka hōʻuluʻulu manaʻo, ʻo Lynch Syndrome ke kumu hoʻoilina o ka maʻi. ʻO HNPCC ke kūlana kanesa i loaʻa mai ia kumu.
Pehea ka maʻamau o ka HNPCC? He aha nā hōʻailona?
ʻO HNPCC ka helu ma waena o 2% a me 4% o nā maʻi kanesa colorectal āpau i hōʻike ʻia ma ka honua holoʻokoʻa. ʻOiai hiki ke loaʻa ke ʻano i kēlā me kēia makahiki, ʻike pinepine ʻia ia i nā poʻe ma lalo o 50 mau makahiki.
ʻAʻole paha he mau hōʻailona kikoʻī o ka HNPCC i nā pae mua, akā i ka holomua ʻana o ke kanesa, e ʻike ʻia paha kēia mau hōʻailona.
| Hōʻailona | Ua wehewehe maʻalahi ʻia |
|---|---|
| ʻEha ʻōpū a pehu paha | ʻO ka ʻeha mau o ka ʻōpū, ka ʻeha, a i ʻole ka manaʻo o ka pehu ʻana. |
| Makemake nui | Ua emi ka makemake. |
| Koko i loko o ka ʻōpala | Koko i loko o ka ʻōpala a i ʻole ka ʻōpala ʻeleʻele i ka wā e hele ai i ka lua. |
| Manaʻo luhi me ke kumu ʻole | Luhi loa ka manaʻo a hiki ʻole iā ʻoe ke hana i nā hana maʻamau. |
| ʻO ka pohō kaumaha me ke kumu ʻole | Ka pohō kaumaha koke me ka ʻole o ka ʻai ʻana a i ʻole ka hoʻoikaika kino ʻana. |
No ke aha e ulu ai ka HNPCC? He mea laha paha ia?
ʻO ke kumu nui o kēia, ʻo ia ko kākou mau genes. E noʻonoʻo i ko kākou kino me he hale i kūkulu ʻia e like me kahi hoʻolālā nui. ʻO ka puke e loaʻa ana kēlā hoʻolālā, ʻo ia ko kākou DNA. Kāhea mākou i nā kuhikuhi i loko o kēia mau genes DNA.
Loaʻa i ka poʻe me ka Lynch Syndrome kahi kīnā i loko o kekahi mau genes kikoʻī (`MLH1`, `MSH2`, `MSH6`, `PMS2` a me `EPCAM`) e hoʻoponopono ana i nā hewa i loko o ka DNA. Ke hana pono ʻole kēia mau genes, ʻaʻole e hoʻoponopono ʻia nā hewa i loko o ka DNA (`DNA replication errors`) e kū mai ana i ka wā e māhelehele ai kā mākou mau cell. I ka hala ʻana o ka manawa, hōʻiliʻili kēia mau hewa a lilo kahi cell maʻamau i cell kanesa.
ʻO ka mea nui, ʻaʻole he maʻi lele ka HNPCC. ʻO ia hoʻi, ʻaʻole ia e laha mai kekahi kanaka a i kekahi kanaka e like me ke anu. Eia nō naʻe, hiki ke hoʻoili ʻia ka gene hewa e hoʻoulu ai mai kēlā hanauna a i kēia hanauna. ʻO ia hoʻi, inā loaʻa i kekahi o nā mākua ka Lynch Syndrome, he 50% ka manawa e loaʻa ai i ke keiki kēlā gene. Inā loaʻa iā lākou kēlā gene, ʻoi aku ka nui o ka pilikia o kēlā keiki i ka loaʻa ʻana o ka HNPCC a i ʻole nā maʻi ʻē aʻe e pili ana i ka wā e hiki mai ana.
Pehea e ʻike ai ke kauka i kēia?
Inā loaʻa iā ʻoe nā hōʻailona i ʻōlelo ʻia ma luna nei, ʻoiai inā ua loaʻa kekahi o kou ʻohana i ka maʻi ʻaʻai colon, pono ʻoe e ʻike i ke kauka.
E nānā mua ke kauka iā ʻoe. A laila, inā kānalua ʻia ka maʻi ʻaʻai kolona, ʻo ka hoʻāʻo maʻamau ka colonoscopy . Pili kēia i ke komo ʻana i kahi ʻōmole lahilahi ma o ka anus a me ka hoʻohana ʻana i kahi kāmela e nānā i loko o ka ʻōpū nui.
No ka hōʻoia inā he HNPCC kāu, e nānā pū kāu kauka i kēia mau mea:
- Ka moʻolelo o ka maʻi ʻaʻai ʻohana:E nīnau ʻia aku ana ʻoe inā paha ua loaʻa i kekahi o kou ʻohana pili, e like me kou makuahine, makuakāne, a i ʻole nā kaikaina, ka maʻi ʻaʻai colon a i ʻole kekahi maʻi ʻaʻai ʻē aʻe e pili ana i ka Lynch Syndrome ma mua o 50 o kona mau makahiki.
- Ka Hoʻāʻo ʻana i ka Genetic: Manaʻo ʻia kahi hoʻāʻo koko kūikawā e hoʻoholo ai inā loaʻa iā ʻoe nā hoʻololi genetic e hoʻoulu ai i ka HNPCC.
- Ke kāpae nei i nā kūlana ʻē aʻe: E like me HNPCC, aia kekahi maʻi kanesa colon hoʻoilina i kapa ʻia ʻo FAP (Familial Adenomatous Polyposis) . Ma muli o nā ʻokoʻa ma waena o nā mea ʻelua, e hana ʻia nā hoʻokolohua e hōʻoia i loaʻa iā ʻoe ʻo HNPCC a ʻaʻole ʻo FAP.
He aha ka ʻokoʻa ma waena o HNPCC a me FAP?
ʻOiai ʻo nā mea ʻelua he mau maʻi hoʻoilina o ka maʻi ʻaʻai kolona, he ʻokoʻa nā genes e hoʻokumu ai iā lākou. ʻO ka ʻokoʻa nui ka helu o nā polyps e ulu ana i loko o ka kolona.
| ʻAno | HNPCC (Lynch Syndrome) | FAP |
|---|---|---|
| Ka nui o nā polyp | He kakaikahi a ʻaʻohe hua i hua ʻia (ʻoi aku ka liʻiliʻi ma mua o 10). | Hoʻokumu ʻia nā haneli, a i ʻole nā tausani, o nā nati. |
| Ke lilo nei i maʻi kanesa | Hiki i kekahi mau ulu ke lilo koke i maʻi ʻaʻai. | Inā ʻaʻole mālama ʻia, aia kahi manawa kūpono he 100% e lilo kekahi o kēia mau puʻupuʻu i maʻi kanesa. |
He aha nā lāʻau lapaʻau no ka HNPCC?
ʻO ke ʻoki kino (colectomy) ka lāʻau lapaʻau nui no ka HNPCC. Pili kēia i ka wehe ʻana i ka ʻāpana a i ʻole ka ʻāpana āpau o ka kolona kahi i loaʻa ai ke kanesa. Hiki ke hana ʻia kēia ma nā ʻano like ʻole.
- ʻO ka colectomy hapa: Wehe wale ʻana i ka ʻāpana o ke kolona kahi i loaʻa ai ke kanesa.
- ʻO ka colectomy holoʻokoʻa: Wehe ʻana i ka ʻōpū nui holoʻokoʻa.
- Proctectomy: Wehe ʻana i ka ʻōpū nui a me ka rectum.
Inā ua pālahalaha ke kanesa (metastasized) i nā ʻāpana ʻē aʻe o ke kino, hiki i kāu kauka ke ʻōlelo i nā lāʻau ʻē aʻe ma waho aʻe o ke ʻoki ʻana.
- Chemotherapy: He lāʻau lapaʻau e hoʻopau ai i nā hunaola kanesa.
- Immunotherapy: Hoʻoulu i ka ʻōnaehana pale ponoʻī o ko mākou kino e hakakā i nā hunaola kanesa.
I nā hihia he nui, hiki i ka immunotherapy ke ʻoi aku ka holomua no ka maʻi kanesa HNPCC.
He aha ka wā e hiki mai ana o kekahi me HNPCC?
He maʻi hoʻoilina ʻole ka Lynch Syndrome. He maʻi ia no ke ola holoʻokoʻa. Eia nō naʻe, hiki i ke ʻoki kino ke hoʻōla i ke kanesa HNPCC a pale i ke kanesa colon i ka wā e hiki mai ana.
ʻO ke kanaka me HNPCC aia i ka pilikia o ka loaʻa ʻana o nā ʻano maʻi ʻē aʻe ma waho aʻe o ke kanesa colon. ʻO ia ke kumu e haʻi aku ai kāu kauka iā ʻoe e hana i nā hoʻokolohua maʻamau.
- Ka maʻi ʻaʻai endometrial
- Ka maʻi ʻōpū
- Ka maʻi ʻōpū
- Ka maʻi ʻaʻai puʻupaʻa, lolo, akepaʻa a me ka ʻili
ʻO ka mea nui loa, ʻo ia ka ʻike mua ʻana . Inā hoʻāʻo ʻia ʻoe i ka manawa kūpono, hiki ke ʻike mua ʻia kekahi o kēia mau maʻi kanesa a mālama pono ʻia.
Ma ka awelika, ma kahi o 60% o ka poʻe i ʻike ʻia me HNPCC e ola no 5 mau makahiki. A ma waena o 70% a me 88% o ka poʻe me ka maʻi ʻōpū ma muli o Lynch Syndrome e ola ana no nā makahiki he 10 a ʻoi. Hōʻike kēia mau helu i ke koʻikoʻi o ka ʻike mua ʻana a me ka mālama ʻana.
He aha ka mea e hiki ke hana ʻia e pale aku a hoʻokele i kēia pilikia?
ʻAʻohe ala e pale aku ai i ka hoʻololi ʻana o ka genetic e kumu ai kēia. He mea ia a kākou e hoʻoilina ai. Eia nō naʻe, nui nā mea hiki iā ʻoe ke hana e pale aku i ka maʻi kanesa a i ʻole e ʻike koke iā ia.
- E makaʻala i kou mōʻaukala ʻohana: Inā loaʻa kekahi o kou ʻohana iā Lynch Syndrome a i ʻole HNPCC, e kamaʻilio me kāu kauka e pili ana i ia mea a nīnau inā pono ʻoe e loaʻa ka hoʻāʻo genetic.
- E hoʻomaka i ka nānā ʻana i ka wā mua: Inā ua ʻike ʻia ʻoe me Lynch Syndrome, e ʻōlelo aku kāu kauka e hoʻomaka ʻoe e loaʻa i ka nānā ʻana i ka maʻi ʻaʻai colon (colonoscopy) i kou mau makahiki 20.
- He nohona olakino: Kōkua nui kēia mau mea i ka hōʻemi ʻana i ka pilikia o ka maʻi kanesa:
- E pale loa i ka puhipaka.
- E kaupalena i ka inu ʻana i ka waiʻona.
- E ʻai i ka meaʻai olakino e waiwai ana i nā mea kanu a me nā huaʻai.
- E hoʻoikaika kino i nā manawa a pau.
- E mālama i ke kaumaha o ke kino olakino.
- E makaʻala i nā hōʻailona: Inā loaʻa iā ʻoe kekahi mau hōʻailona hou, mai hoʻowahāwahā iā lākou a e ʻike koke i ke kauka.
Leka Lawe-Home
- ʻO ka HNPCC kahi maʻi kanesa colon hoʻoilina i hoʻokumu ʻia e kahi kīnā genetic i kapa ʻia ʻo Lynch Syndrome.
- Inā ua loaʻa i kekahi a ʻoi aku paha mau lālā o kou ʻohana ka maʻi ʻaʻai kolona ma mua o 50 mau makahiki, e kamaʻilio me ke kauka e ʻike inā aia ʻoe i ka pilikia.
- ʻAʻole laha kēia maʻi, akā he 50% ka manawa e hoʻoilina ai nā keiki i ka gene e hoʻoulu ai i ka pilikia.
- Ma ka loaʻa ʻana o nā hoʻokolohua maʻamau, hiki ke ʻike ʻia ka maʻi kanesa i ka wā mua a hiki ke hoʻopakele ʻia nā ola.
- Hiki ke mālama pono ʻia ka HNPCC me ke ʻoki ʻana a me nā lāʻau ʻē aʻe.
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