Ua lohe anei ʻoe ua loaʻa i kekahi mau lālā o kou ʻohana ka maʻi kanesa colorectal, ʻoiai ma mua o ka piha ʻana o 50 mau makahiki? A i ʻole he nui ka maʻi kanesa uterine i waena o nā wahine o kou ʻohana? He mea maʻamau ka manaʻo iki i ka makaʻu a me ka hopohopo ke lohe mākou i nā mea e like me kēia. Akā, ʻoi aku ka nui o ka makaʻu ma mua o ka makaʻu e ʻike i kēia. I kēia lā, e kamaʻilio mākou e pili ana i kahi kūlana pilikia kūikawā o ka maʻi kanesa hiki ke hoʻoili ʻia mai kēlā hanauna a i kēia hanauna. Kāhea mākou i kēia he HNPCC.
He aha maoli ka HNPCC?
I ka ʻōlelo maʻalahi, ʻo HNPCC kahi acronym no Hereditary Nonpolyposis Colorectal Cancer . Ma ka ʻōlelo Sinhala, ʻo ia hoʻi kekahi mea e like me "Hereditary Nonpolyposis Colorectal Cancer." Akā, he paʻakikī loa kēlā mau huaʻōlelo, ʻeā? No laila, e hoʻomanaʻo kākou iā ia he HNPCC.
He pilikia kēia no ka maʻi kanesa e hiki ke hoʻoilina ʻia mai kēlā hanauna a kēia hanauna ma muli o kekahi mau loli (mutation) i loko o kā kākou mau genes. Hoʻopilikia nui kēia i ka ʻōpū nui, ʻo ia ka ʻāpana hope loa o kou ʻōpū. Akā, ʻo ka inoa "Nonpolyposis" ʻo ia hoʻi "non-polyposis". ʻO ke kumu o kēia, ʻo ia hoʻi, ʻo ka maʻamau, nā ulu liʻiliʻi i kapa ʻia ʻo "polyps" e hana ʻia i loko o ka ʻōpū ma mua o ka ulu ʻana o ka maʻi kanesa colon. Eia nō naʻe, ʻaʻole i loaʻa i kahi kanaka me HNPCC ka nui o ia mau polyps, akā ʻoi aku ka nui o ka pilikia o ka maʻi kanesa.
No laila, ʻo Lynch syndrome kekahi HNPCC?
ʻAe, hoʻohana pinepine ʻia kēia mau inoa ʻelua no ke ʻano like. Akā aia kahi ʻokoʻa loea iki. ʻO Lynch syndrome ke ʻano genetic e hoʻokumu ai. ʻO ia hoʻi, inā loaʻa i kekahi kahi mutation gene e pili ana i ka Lynch syndrome, ʻoi aku ka nui o ko lākou pilikia o ka hoʻomohala ʻana i kahi maʻi kanesa i kapa ʻia ʻo HNPCC.
ʻO ka mea maʻamau, inā loaʻa i kahi kanaka ma lalo o 50 mau makahiki kahi maʻi kanesa e pili ana me ka Lynch syndrome, e like me ke kanesa colon, ke kanesa endometrial, ke kanesa ʻōpū liʻiliʻi, a i ʻole ke kanesa ureteral, ua ʻōlelo ʻia he maʻi ko ka ʻohana i kapa ʻia ʻo HNPCC. ʻO ka hapa nui o kēia mau maʻi kanesa e ulu ana ma ka ʻaoʻao ʻākau o ka ʻōpū nui.
Pehea ka maʻamau o kēia ʻano? He aha nā hōʻailona?
ʻO HNPCC ka helu no 2% a 4% o nā maʻi kanesa colorectal āpau ma ka honua holoʻokoʻa. ʻO ke ʻano kēia, ma kahi o 2 a 4 o kēlā me kēia 100 mau maʻi kanesa colorectal i hoʻokumu ʻia e kēia kumu hoʻoilina. ʻOiai hiki iā ia ke hoʻopilikia i kekahi, ʻike pinepine ʻia ia i nā poʻe ma lalo o 50 mau makahiki.
ʻO ka hapa nui o ka manawa, ʻaʻole hōʻike ka HNPCC i kekahi mau hōʻailona i nā pae mua. ʻO ia ka ʻāpana weliweli loa. Akā i ka wā e nui ai ke kanesa, e hoʻomaka paha ʻoe e ʻike i nā hōʻailona e like me kēia.
| Hōʻailona | Wehewehena |
|---|---|
| ʻEha ʻōpū a pehu paha | ʻEha mau o ka ʻōpū me ka wehewehe ʻole ʻia a i ʻole ka manaʻo mau o ka piha. |
| Makemake nui | Ka nalowale o ka makemake. |
| Koko i loko o ka ʻōpala | Ke ʻike nei i nā ʻōpala koko ʻeleʻele a hou paha i loko o kou ʻōpala. Mai hoʻowahāwahā i kēia ma ka manaʻo he hemorrhoids ia. |
| Luhi pinepine | Manaʻo nui i ka luhi ma hope o ka hiamoe maikaʻi a i ʻole ka hoʻomaha ʻana. |
| ʻO ka pohō kaumaha me ke kumu ʻole | Inā e emi koke kou kaumaha me ka ʻole o ka ʻai ʻana a i ʻole ka hoʻoikaika kino ʻana, pono ʻoe e hopohopo. |
ʻO ka mea nui, ʻaʻole i loaʻa i nā kānaka a pau me kēia mau hōʻailona ke kanesa. Akā inā hoʻomau ʻoe i kekahi a ʻoi aku paha o kēia mau hōʻailona, pono ʻoe e ʻike i kāu kauka no ka ʻōlelo aʻo.
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 ua like ko kākou kino me kahi puke nui, a ʻo nā genes nā kuhikuhi i kākau ʻia ma ia puke. Hana kēlā me kēia cell i loko o ko kākou kino e like me kēia mau kuhikuhi. I kekahi manawa, aia nā hewa pela (nā mutations) i loko o kēia mau kuhikuhi.
Loaʻa i ko mākou kino nā ʻano genes kūikawā e hiki ke ʻike a hoʻoponopono i kēia mau hewa. E like me kekahi e hoʻoponopono ana i kahi puke. I loko o ka maʻi Lynch, ʻo ia hoʻi ʻo MLH1, MSH2, MSH6, PMS2, a me EPCAM.Ke lilo kēia mau genes i mea kīnā ʻole, ʻaʻole hiki iā lākou ke hoʻoponopono i nā hewa ʻē aʻe ke māhele ʻia nā cell. I ka hala ʻana o ka manawa, ʻoi aku ka nui o ka hōʻiliʻili ʻana o kēia mau cell hemahema a lilo i mau cell cancer.
ʻAʻole kēia he maʻi lele. ʻAʻole hiki iā ʻoe ke loaʻa ma ka ʻai ʻana i ka meaʻai a i ʻole ka noho ʻana me kekahi mea i loaʻa iā HNPCC. Eia nō naʻe, hiki ke hoʻoili ʻia ka hoʻololi ʻana o ka gene e hoʻoulu ai i kēia mai kēlā hanauna a i kēia hanauna. E noʻonoʻo inā loaʻa i ka makuahine a i ʻole ka makuakāne kēia hoʻololi ʻana o ka gene. A laila aia he 50% ka manawa e hoʻoilina ai kekahi o kā lāua mau keiki i kēlā gene. ʻO ia hoʻi, inā he ʻelua keiki, hiki i kekahi o lākou ke hoʻoilina i kēia gene pilikia. ʻO ia ke kumu e loaʻa ai i kekahi poʻe i loko o ia mau ʻohana ka maʻi kanesa.
Pehea e ʻike ai ke kauka i ka HNPCC?
Ke hele ʻoe e ʻike i ke kauka me nā hōʻailona āu i ʻōlelo ai ma luna, ʻo ka mea mua āna e hana ai, ʻo ia ka hoʻolohe pono ʻana i kāu mau hōʻailona a hana i kahi hoʻokolokolo kino. A laila, e nīnau lākou i nā nīnau he nui e pili ana i ka mōʻaukala olakino o kou ʻohana .
- "Ua loaʻa anei i kou makuahine, kou makuakāne, a me kou mau kaikaina ke kanesa?"
- "Inā pēlā, he aha ke ʻano o ke kanesa? I ka makahiki hea i ulu ai?"
- "ʻEhia ka poʻe o kou ʻohana i loaʻa i ka maʻi kanesa?"
He mea nui loa kēia mau nīnau no ka mea inā ua loaʻa i kekahi mau lālā o ka ʻohana ke kanesa colon a uterine paha, ʻoiai i ka wā ʻōpiopio, hiki i ke kauka ke kānalua i ka HNPCC.
ʻO ka mea aʻe, ʻo ka hoʻāʻo nui e hōʻoia inā loaʻa iā ʻoe ka maʻi ʻaʻai kolona he colonoscopy . Pili kēia i ka nānā ʻana i kāu kolona holoʻokoʻa me ka hoʻohana ʻana i kahi ʻōmole me kahi kāmela liʻiliʻi i hoʻopili ʻia. Inā loaʻa kekahi mea kānalua, lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo a hoʻouna ʻia i kahi lab no ka hoʻāʻo ʻana (he biopsy).
No ka hōʻoia ʻana i ke kūlana HNPCC, pono kekahi mau hoʻokolohua kūikawā:
1. Hoʻāʻo ʻana i ka Genetic: Lawe ʻia kahi hāpana o kou koko a hoʻāʻo ʻia no nā hoʻololi genetic e pili ana me ka Lynch syndrome.
2. Hoʻāʻo ʻana i nā ʻiʻo puʻupuʻu: Inā he maʻi kanesa, hoʻāʻo ʻia nā hunaola kanesa no nā māka kikoʻī e pili ana i ka HNPCC.
3. Ke kāpae nei i nā kūlana ʻē aʻe: Aia kekahi kūlana hoʻoilina ʻē aʻe i kapa ʻia ʻo Familial Adenomatous Polyposis (FAP) . I ka FAP, ulu nā haneli a i ʻole nā kaukani o nā polyp i loko o ka colon. ʻAʻole kēia e hana ma HNPCC. No laila, e nānā kāu kauka e ʻike i kahi o kēia mau kūlana ʻelua āu.
He aha nā lāʻau lapaʻau no ka HNPCC?
Inā ulu ka maʻi ʻaʻai kolona ma muli o HNPCC, ʻo ke ʻano lapaʻau nui ka ʻoki ʻana e wehe i ke kanesa a me nā ʻiʻo a puni. Ua kapa ʻia kēia ʻoki he colectomy . Hiki ke hana ʻia ma nā ʻano like ʻole.
- ʻO ka Colectomy hapa: ʻO ka ʻāpana o ke kolona kahi i loaʻa ai ke kanesa e wehe ʻia.
- Colectomy holoʻokoʻa:Hoʻopau ʻia ke kolona holoʻokoʻa. Paipai pinepine ʻia kēia ʻoki kino no kekahi me HNPCC e hōʻemi i ka pilikia o ka loaʻa ʻana o kahi maʻi ʻaʻai ʻē aʻe i ka wā e hiki mai ana.
- Proctectomy: Ua wehe ʻia ka rectum me ka ʻōpū nui.
Nā lāʻau lapaʻau ʻē aʻe
Inā ua pālahalaha ke kanesa (metastasized) i nā ʻāpana ʻē aʻe o ke kino, pono paha nā lāʻau ʻē aʻe ma waho aʻe o ke ʻoki ʻana.
- Chemotherapy: Ke hāʻawi ʻana i nā lāʻau ikaika e hoʻopau i nā hunaola kanesa.
- Immunotherapy: Ke hoʻoulu nei i ka ʻōnaehana pale ponoʻī o ko mākou kino e hakakā i nā hunaola kanesa. Hoʻomaikaʻi pinepine kēia lāʻau lapaʻau no nā maʻi kanesa i hoʻokumu ʻia e HNPCC.
Inā loaʻa iā ʻoe a i ʻole kekahi o kou ʻohana kēia maʻi, e hoʻoholo kāu kauka i ke koho lapaʻau maikaʻi loa. E aʻo pono ʻo ia i kou maʻi a hāʻawi iā ʻoe i ka hoʻolālā lapaʻau kūpono loa.
Nā mea a kekahi e noho nei me HNPCC e pono ai ke ʻike
Inā ua ʻike ʻia ʻoe me ka HNPCC, ʻo ia hoʻi, ʻoi aku kou pilikia ma mua o ke kanaka maʻamau o ka loaʻa ʻana o ka maʻi ʻōpū, akā, ʻo kekahi mau ʻano maʻi ʻē aʻe. No laila, pono e lilo nā nānā lapaʻau maʻamau i ʻāpana o kou ola.
Hiki i kāu kauka ke aʻo iā ʻoe e hoʻokolokolo pinepine ʻia no kēia mau maʻi kanesa:
- ʻōpū
- ʻOvarian
- ʻōpū
- ʻŌnaehana puʻupaʻa a me ka mimi
- lolo
- ʻIli
He mea weliweli paha kēia. Akā ʻo ka mea maikaʻi loa ma ʻaneʻi, ʻo ia ka ʻike mua ʻana . Me ka nānā mau ʻana, ʻoiai inā hoʻomaka ka ulu ʻana o ke kanesa, hiki ke ʻike ʻia i kahi pae mua loa. A laila ʻoi aku ka kiʻekiʻe o ka manawa e mālama ʻia a hoʻōla loa ʻia.
ʻAʻole hiki ke ho'ōla ʻia ka maʻi Lynch, no ka mea, he mea ia i loko o kā mākou mau genes. Eia nō naʻe, hiki ke ho'ōla ʻia nā maʻi kanesa i hoʻokumu ʻia e HNPCC. Hiki i ke ʻoki kino e like me ka colectomy holoʻokoʻa ke pale aku i ka maʻi kanesa colon.
Pehea e hoʻokele ai i kaʻu pilikia?
Inā he moʻolelo ʻohana kou no ka HNPCC a i ʻole Lynch syndrome, ʻo ka mea mua āu e hana ai, ʻo ia ke kamaʻilio me kāu kauka e pili ana i ia mea. Na ia e hoʻoholo inā pono ʻoe e hana i ka hoʻāʻo genetic.
Inā ua hōʻoia ʻia ua loaʻa iā ʻoe ka hoʻololi ʻana o ka gene Lynch syndrome, e aʻo paha kāu kauka iā ʻoe e hoʻomaka i ka nānā ʻana no ka maʻi ʻaʻai colon, e like me colonoscopies, i kou mau makahiki 20.
Eia kekahi, hiki iā ʻoe ke hōʻemi hou i kou pilikia o ka maʻi kanesa ma ka mālama ʻana i kahi nohona olakino:
- E pale loa i ka puhipaka.
- E ʻai i ka ʻai kaulike a me ka momona (e hoʻokomo i nā mea kanu hou aʻe, nā huaʻai, a me nā meaʻai waiwai i ka fiber).
- E hoʻoikaika kino i nā manawa a pau.
- E kaupalena i ka inu ʻana i ka waiʻona.
- E mālama i ke kaumaha o ke kino olakino.
- E hana i nā hoʻokolohua a pau i ʻōlelo ʻia e ke kauka i ka manawa kūpono.
Leka Lawe-Home
- ʻO ka HNPCC kahi mea pilikia no ka maʻi ʻaʻai colon i hoʻokumu ʻia e kahi hoʻololi genetic (Lynch syndrome) i hoʻoili ʻia ma o nā hanauna.
- ʻAʻole kēia he maʻi lele. Eia nō naʻe, aia he 50% ka manawa e hoʻoilina ai nā keiki i ka gene e hoʻoulu ai mai ko lākou mau mākua mai.
- Inā ua loaʻa i kekahi mau lālā o kou ʻohana ke kanesa colon a i ʻole ke kanesa uterine, ʻoiai ma mua o 50 mau makahiki, e kamaʻilio me kāu kauka e pili ana i ia mea.
- Mai hoʻowahāwahā i nā hōʻailona e like me ka ʻeha pinepine o ka ʻōpū, ke koko i loko o ka ʻeke, a me ka pohō kaumaha i wehewehe ʻole ʻia.
- ʻOi aku ka nui o ka pilikia o ka poʻe me HNPCC i ka loaʻa ʻana o nā ʻano maʻi ʻē aʻe ma waho aʻe o ke kanesa colon. No laila, ʻo ka loaʻa ʻana o nā nānā lapaʻau maʻamau e hiki ke kōkua i ka hoʻopakele ʻana i nā ola.
- Hiki ke hoʻēmi ʻia ka pilikia o ka maʻi ʻaʻai ma ka hahai ʻana i kahi nohona olakino a me ka pale ʻana i ka puhipaka.
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