He mau puʻupuʻu kupanaha i loko o ka pancreas? E aʻo kākou e pili ana i ka (Intraductal Papillary Mucinous Neoplasm - IPMN) ma ke ala maʻalahi!

He aha kēia maʻi me ka inoa lōʻihi? Ke noʻonoʻo nei paha ʻoe i ke ʻano o ka 'Intraductal Papillary Mucinous Neoplasm' a i ʻole '(IPMN)'. He mea weliweli iki paha ke kani ʻana o ka inoa a paʻakikī ke hoʻomaopopo, akā e mālama kākou i ka maʻalahi. Ua lohe paha ʻoe a i ʻole kekahi āu i ʻike ai i kēia ʻano. No laila, mai hopohopo a ʻike pono i ke ʻano o ia mea.

He aha maoli ka manaʻo o ka `IPMN`?

I ka ʻōlelo maʻalahi, he puʻupuʻu piha wai ka IPMN, a he cyst paha, e hana ʻia ana i loko o nā ducts o kou pancreas. ʻAʻole kēia he maʻi kanesa maoli, akā manaʻo nā kauka he "precancerous." ʻO ke ʻano kēia, ʻaʻole lākou he maʻi kanesa i kēia manawa, akā hiki ke lilo i maʻi kanesa i ka wā e hiki mai ana.

E noʻonoʻo e pili ana i ia mea, i kekahi manawa ua like ia me kahi mea kanu liʻiliʻi. He lāʻau nui paha ia a ʻaʻole paha. Pēlā ke ʻano o kēia puʻupuʻu `(IPMN)`. Manaʻo nā kānaka noiʻi ma waena o 20% a me 30% o ka poʻe i loaʻa i ka maʻi ʻaʻai pancreatic, a i ʻole ʻelua a ʻekolu paha o ka ʻumi poʻe, ua hoʻomaka ke kanesa ma ke ʻano he `(IPMN)`. Hiki i kekahi poʻe ke loaʻa i kēia puʻupuʻu no nā makahiki me ka ʻole o ka hōʻike ʻana i nā hōʻailona. Hoʻōla ʻia ka `(IPMN)` me ke ʻoki ʻana, a i ʻole me ka nānā pono ʻana no ka manawa lōʻihi.

He maʻi kanesa mau anei ka `IPMN`?

ʻAʻole, ʻaʻole lilo nā IPMN āpau i maʻi kanesa . ʻO ia ka mea mua e hoʻomaopopo ai. Eia nō naʻe, hiki i kekahi ke ulu i ka pancreatic ductal adenocarcinoma (PDAC). ʻO PDAC ke ʻano maʻamau o ka maʻi kanesa pancreatic. He ʻano maʻi kanesa kakaʻikahi ka maʻi kanesa pancreatic. He 3% ia o nā maʻi kanesa āpau ma ʻAmelika Hui Pū ʻIa. Eia nō naʻe, he 7% o nā make āpau o ke kanesa ka maʻi kanesa pancreatic. ʻO ka mea pōʻino, ʻaʻole pinepine ʻike ʻia i ka wā mua, i ka wā e hiki ai ke lilo i mea maikaʻi loa ka lāʻau lapaʻau.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia kūlana?

He mea paʻakikī i nā kauka ke ʻōlelo pololei i ka nui o ka poʻe i loaʻa i kēia mau puʻupuʻu, no ka mea, ʻaʻole lākou e hōʻike pinepine i nā hōʻailona a hele ʻole i ka ʻike ʻia. Eia nō naʻe, ua hōʻike ʻia nā noiʻi he mea maʻamau lākou i nā kāne ma waena o 50 a me 70 mau makahiki .

He aha ka mea e hana ʻia i ke kino me kēia `(IPMN)`?

Aia i loko o nā IPMN kahi wai mānoanoa e like me ka jelly. Ua kapa ʻia ia e nā kauka he mucin. Ke hoʻomaka kēia mau puʻupuʻu maʻamau, ʻaʻole cancerous e lilo i kanesa, hoʻomaka lākou e hana hou aku i kēia wai i kapa ʻia ʻo mucin. E noʻonoʻo e like me kahi pōpō liʻiliʻi e hoʻopiha ana i ka wai. Ke hōʻiliʻili ʻia kēia mucin, hiki iā ia ke ālai i nā ducts pancreatic i loko o kāu pancreas. He mau paipu liʻiliʻi kēia mau ducts e kōkua i ka hoʻoheheʻe ʻana i ka meaʻai. Ke ālai ʻia lākou, hiki iā ia ke hoʻoulu i ka mumū o ka pancreas (pancreatitis) .Hiki i kēia ke lilo i mea ʻeha loa. I kekahi manawa ʻo kēia mumū o ka pancreas ka hōʻailona mua o kahi IPMN.

He aha nā hōʻailona o ka IPMN?

ʻAʻole maʻi ka nui o ka poʻe me kēia maʻi a ʻaʻole loaʻa iā lākou kekahi mau hōʻailona kikoʻī. ʻO ia ka pilikia me kēia. ʻO ka hapa nui o ka manawa, ʻike ʻia kēia ʻano puʻupuʻu ma ka manawa kūpono i ka wā e hoʻāʻo ʻia ai lākou no kekahi maʻi ʻē aʻe. Eia nō naʻe, hiki i kekahi poʻe ke ʻike i nā hōʻailona e like me:

• ʻEha ʻōpū manawa ʻole: Hiki i kekahi poʻe ke ʻeha i ka ʻōpū ma hope o ka ʻai ʻana. Hiki i kēia ke kumu o ka nalowale o ka makemake.
• ʻO ka pohō kaumaha i manaʻo ʻole ʻia: Inā ʻoe e pohō kaumaha me ka hoʻāʻo ʻole, he hōʻailona nō hoʻi kēlā.
• Ka luaʻi a me ka luaʻi.
• ʻEha hope.
• ʻŌpala/noho ʻaila: Inā ʻike ʻia ka ʻōpala he ʻaila.

I kekahi manawa, hiki i kēia mau puʻupuʻu ke hana i nā hōʻailona like me nā maʻi ʻē aʻe. Eia kekahi laʻana:

• Jaundice: Melemele o ka ʻili ma muli o ke ālai ʻana o nā ʻauwai bile.
• ʻO ka maʻi diabetes hou: Ke kiʻekiʻe o ke kō koko ma muli o ka hōʻino ʻia ʻana o ka pancreas ponoʻī.
• Pancreatitis: He maʻi i hana ʻia e ka poloka ʻana o nā ducts pancreatic.

He aha ke kumu o ka IPMN?

Manaʻo nā kānaka noiʻi e ulu ana nā IPMN i ka wā e loaʻa ai nā loli (nā mutations) i loko o nā genes e kāohi ana i ka ulu ʻana o kā mākou mau cell a pale paha i ka hoʻokumu ʻana o nā puʻupuʻu. ʻO ke ʻano kēia e nāwaliwali kekahi o nā ʻōnaehana pale o ko mākou kino. Inā ua loaʻa i kekahi o ka ʻohana ka maʻi ʻaʻai pancreatic (PDAC) , ʻoi aku ka nui o ka pilikia o nā lālā ʻē aʻe o kēlā ʻohana i ka hoʻomohala ʻana i nā IPMN.

Pehea e ʻike ai nā kauka i kēia?

Hoʻohana nui nā kauka i nā ʻano hoʻāʻo `(kiʻi)` like ʻole e ʻike ai i ka `(IPMN)`. ʻO kēia mau mea, he mea nui loa kahi hoʻāʻo kūikawā i kapa ʻia ʻo `Magnetic Resonance Cholangiopancreatography (MRCP)`. He hoʻāʻo kēia e hoʻohana ana i kahi mīkini `(MRI)`. Hiki i kēia ke kiʻi i nā kiʻi maopopo loa o kou ake, nā ʻauwai bile, ka gallbladder, ka pancreas, a me nā ʻauwai pancreatic. Hoʻohana nā kauka i kēia hoʻāʻo e ʻike inā he mau loli i nā ʻauwai pancreatic.

Ua māhele ʻia kēia mau puʻupuʻu "(IPMN)" i ʻekolu ʻano nui:

• ʻAno duct nui (MD-IPMN): ʻO kēia nā puʻupuʻu e ālai ana i ka duct nui o kou pancreas. Hiki i kēia ke hoʻonui a hoʻomāhuahua paha i ka duct nui. ʻO ke anawaena o kahi duct nui ma kahi o 3.5 millimeters. Inā ʻoi aku ka nui ma mua o 5 millimeters, he hōʻailona paha ia e ʻoi aku ka nui o ka maʻi kanesa.
• ʻAno ʻauwai lālā (BD-IPMN): ʻO kēia nā puʻupuʻu e hana ʻia ana i loko o nā ʻauwai liʻiliʻi e like me ka lālā e lālā ana mai ka ʻauwai nui. ʻO ka maʻamau, he maikaʻi ʻole kēia mau puʻupuʻu.
• ʻAno hui ʻia (MT-IPMN): He mau puʻupuʻu kēia e ulu ana ma nā ʻauwai nui a me nā ʻauwai lālā o ka pancreas.

Aia kekahi mau hoʻokolohua ʻē aʻe e ʻike ai i ka 'IPMN'?

ʻAe, aia kekahi mau hoʻokolohua ʻē aʻe. Hiki i nā kauka ke hana i kahi hoʻokolohua i kapa ʻia ʻo Endoscopic Ultrasound (EUS). Hiki i kēia ke kiʻi i nā kiʻi maopopo loa o ka pancreas a me ka puʻupuʻu. I loko o kēia hoʻokolohua, hiki ke lawe ʻia kahi laʻana liʻiliʻi o ka puʻupuʻu, i kapa ʻia ʻo Fine-Needle Aspiration (FNA), (biopsy). A laila e nānā ʻia ka laʻana ma lalo o kahi microscope e hoʻoholo ai i ke ʻano o nā cell (dysplasia) (inā he ʻano ʻē nā cell) a me ka hoʻāʻo genetic e hoʻoholo ai i ka pilikia o ka lilo ʻana i maʻi kanesa.

He aha ka 'Dysplasia'? No ke aha he mea nui?

ʻO ke ʻano o ka "Dysplasia" he ʻano ʻē ke nānā ʻia kāu mau cell ke nānā ʻia ma lalo o kahi microscope.

• ʻO ke ʻano o ka "dysplasia kiʻekiʻe" ʻo ia hoʻi, ʻoi aku ka like o kāu mau cell me nā cell kanesa ma mua o nā cell olakino. ʻO ia hoʻi, ʻoi aku ke kiʻekiʻe o ka pilikia.
• ʻO ka dysplasia haʻahaʻa ke ʻano o kekahi mau cell e like me nā cell kanesa, akā ua manaʻo ʻia he haʻahaʻa ka pilikia o ka ulu ʻana i ka maʻi kanesa.

Hoʻohana nā kauka i ka ʻike e pili ana i ke kūlana (dysplasia) a me ka ʻike genetic o ka puʻupuʻu e hoʻokaʻawale i nā IPMN i ʻehā mau ʻano nui. He kumuhana hohonu kēia, akā e mālama maʻalahi wau:

1. Nā IPMN ʻAno ʻŌpū: Hoʻomohala pinepine kēia mau mea i loko o nā ʻauwai lālā o ka pancreas. Loaʻa iā lākou ka dysplasia haʻahaʻa. ʻOi aku ma mua o 90% o ka poʻe me kēia ʻano puʻupuʻu e ola ana he 10 mau makahiki ma hope o ka hōʻoia ʻana.

2. Nā IPMN ʻAno ʻŌpū: Hiki ke loaʻa kēia mau mea ma nā ʻāpana nui a me nā lālā o ka pancreas. Loaʻa paha iā lākou ka dysplasia kiʻekiʻe a hiki ke lilo i ka maʻi ʻaʻai pancreatic. Ma kahi o 70% o ka poʻe me kēia ʻano puʻupuʻu e ola ana i 5 mau makahiki ma hope o ka hōʻoia ʻana. Hāʻule kēia pakeneka i 50% ma 10 mau makahiki.

3. Nā IPMN ʻano Pancreatobiliary: Hiki ke loaʻa kēia mau mea ma nā ducts nui a me nā lālā, a loaʻa iā lākou ka dysplasia kiʻekiʻe. Hiki i ka 80% o ka poʻe me kēia ʻano puʻupuʻu ke hoʻomohala i ka maʻi kanesa pancreatic invasive.

4. Nā IPMN ʻano oncocytic: He ʻano puʻupuʻu kakaikahi kēia. Hoʻomohala lākou i loko o ke kahawai pancreatic nui a loaʻa iā lākou ka dysplasia kiʻekiʻe. Ma kahi o ka hapalua o ka poʻe me kēia ʻano puʻupuʻu e loaʻa i ka maʻi ʻaʻai pancreatic invasive.

Mea nui: Mai hopohopo i kēia mau hoʻokaʻawale ʻana a me nā helu helu. He ʻike laulā wale nō kēia. ʻO kāu kauka wale nō ke haʻi pololei iā ʻoe i kou kūlana.

Pehea e mālama ʻia ai nā IPMN?

Inā manaʻo ʻia he haʻahaʻa ka pilikia o ka IPMN, ʻōlelo pinepine nā kauka i ka hoʻomau ʻana o ka nānā pono ʻana i ka puʻupuʻu.ʻO kēia no ka mea ʻaʻole lilo ka hapa nui o nā puʻupuʻu benign (IPMN) i maʻi kanesa. Eia nō naʻe, inā he puʻupuʻu kou ma ke kahawai nui o kou pancreas, ʻo ia hoʻi, aia ʻoe i kahi pilikia kiʻekiʻe iki, hiki i kāu kauka ke ʻōlelo aku i ke ʻoki ʻana e wehe i ka puʻupuʻu. Eia kekahi mau laʻana:

• ʻO ka pancreatectomy distal: Pili kēia i ka wehe ʻana i ka huelo a/a i ʻole ke kino o ka pancreas. Hana ʻia kēia ʻoki kino inā he mau puʻupuʻu i loko o nā ducts nui ma ia wahi.
• ʻO ka pancreatectomy holoʻokoʻa: Pili kēia i ka wehe ʻana i ka pancreas holoʻokoʻa, ka gallbladder, ke kahawai bile maʻamau, nā ʻāpana o ka ʻōpū a me ka ʻōpū liʻiliʻi, a pinepine ka spleen. He hana nui kēia.
• Ke kaʻina hana Whipple (pancreatoduodenectomy): Hiki ke ʻōlelo ʻia kēia ʻoki kino no nā puʻupuʻu ma nā ducts nui o ke poʻo o ka pancreas (ka ʻāpana ākea loa kahi e pili ai ka pancreas i ka ʻōpū liʻiliʻi). Pili ia i ka wehe ʻana i ke poʻo o ka pancreas, ka ʻāpana mua o ka ʻōpū liʻiliʻi (duodenum), ka gallbladder, kahi ʻāpana o ke duct bile, a me nā lymph nodes kokoke.

He aha nā pilikia e hiki mai ana o kēia ʻoki kino?

E like me nā ʻoki kino nui a pau, aia nā pilikia e hiki mai ana. ʻAʻole like ke kūlana o kēlā me kēia kanaka. No laila, ʻoi aku ka maikaʻi o ka nīnau ʻana i kāu kauka e pili ana i nā pilikia kikoʻī āu e ʻike ai.

ʻEhia ka lōʻihi e hoʻōla ai ma hope o ke ʻoki kino e like me kēia?

ʻOkoʻa kēia mai kēlā kanaka a kēia kanaka. Eia nō naʻe, pono ka hapa nui o ka poʻe e noho i ka haukapila no kekahi mau lā ma hope o ke ʻoki ʻana o ka pancreas. Hiki ke hala i nā pule a i ʻole nā ​​mahina e hoʻōla piha ai.

Pono anei iaʻu e hana i ka chemotherapy a i ʻole ka radiation therapy ma hope o ke ʻoki ʻana?

Ua hōʻike kekahi mau noiʻi he mea kōkua paha ka chemotherapy a me/a i ʻole ka radiation therapy ma hope o ke ʻoki ʻana. Eia nō naʻe, pono ʻoe e noʻonoʻo i nā hopena ʻaoʻao o nā lāʻau lapaʻau. I kekahi manawa ʻoi aku ka nui o nā hopena ʻaoʻao ma mua o nā pono o nā lāʻau lapaʻau. E nīnau i kāu kauka no ka ʻike hou aku e pili ana i kēia.

Ua ʻōlelo mai koʻu kauka e nānā i ka `IPMN`. He aha ke ʻano o ia mea?

ʻO ke ʻano kēia, ua hōʻike kāu mau hoʻokolohua he maʻi ʻole kāu IPMN a ʻaʻole paha e lilo i maʻi kanesa. E hoʻomau nā kauka i ka nānā ʻana i kēia mau puʻupuʻu maikaʻi ʻole me nā hoʻokolohua kiʻi (e like me MRCP). ʻO ke ʻano kēia, "E nānā pono kākou i kēia a ʻike inā he loli kekahi mea."

He aha kaʻu e hana ai e hōʻemi i koʻu pilikia o ka loaʻa ʻana o ka IPMN?

Manaʻo nā kānaka noiʻi ua hoʻokumu ʻia kēia mau puʻupuʻu e nā loli o nā genes. No laila, ʻaʻohe mea hiki iā ʻoe ke hana kūikawā e pale aku i ka ulu ʻana o kahi IPMN. Eia nō naʻe, hiki i kēia mau mea ke kōkua i ka hōʻemi ʻana i kou pilikia holoʻokoʻa o ka maʻi ʻaʻai pancreatic a kōkua iā ʻoe e loiloi i kou pilikia o ka IPMN:

• E aʻo e pili ana i ka mōʻaukala lapaʻau o kou ʻohana.Inā ua loaʻa kekahi o kou ʻohana i ka maʻi ʻaʻai pancreatic (PDAC), ʻoi aku kou pilikia o ka loaʻa ʻana o ka IPMN.
• Ua pili ka maʻi ʻaʻai pancreatic i ka puhipaka. Inā ʻoe e hoʻohana i ka paka (nā cigarette, beedis, cigars), e hoʻāʻo e hoʻōki.
• E hōʻemi i kāu inu ʻana i ka waiʻona, a i ʻole e hoʻōki loa.
• E ho'āʻo e mālama i ke kaumaha olakino.
• E ho'āʻo e pale i ka maʻi diabetes type 2 me ka ʻai olakino a me ka hoʻoikaika kino. Inā loaʻa iā ʻoe ka maʻi diabetes, e hana pū me kāu kauka e kaohi i kou pae kō koko.

ʻEhia ka lōʻihi e hiki ai iā ʻoe ke ola me kahi IPMN?

E like me nā maʻi kanesa āpau, ʻo ka ʻike mua ʻana a me ka mālama ʻana nā mea nui loa i ka hoʻoholo ʻana i ke ola. Ma keʻano holoʻokoʻa, ma kahi o 95% o ka poʻe i ʻike ʻia a mālama ʻia ma mua o ka ulu ʻana o ka IPMN i ka maʻi kanesa pancreatic e ola mau ana i ʻelima mau makahiki ma hope o ka ʻike ʻana. Inā he mau nīnau kāu e pili ana i kou kūlana, ʻo kāu kauka ke kumu ʻike maikaʻi loa.

He IPMN maikaʻi koʻu. Pehea wau e mālama ai iaʻu iho?

ʻO ka hapa nui o ka manawa, ʻaʻole lilo kēia mau puʻupuʻu i maʻi kanesa. Eia nō naʻe, he mea maʻamau ke kaumaha a me ka hopohopo ma muli o ka manaʻo, "Malia paha." Inā manaʻo ʻoe i kēia ʻano, e kamaʻilio me kāu kauka e pili ana i ia mea. E wehewehe ʻo ia i ke kumu e emi ai kou pilikia o ka loaʻa ʻana o ke kanesa pancreatic. E aʻo pū ʻo ia iā ʻoe i nā mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia holoʻokoʻa o ka loaʻa ʻana o ke kanesa pancreatic.

ʻO ka Intraductal Papillary Mucinous Neoplasm (IPMN) kahi inoa lōʻihi a huikau i kekahi manawa no kahi puʻupuʻu e hana ʻia ana i loko o nā ducts pancreatic a loaʻa ka hiki ke lilo i ka maʻi kanesa pancreatic. ʻAʻole hōʻike pinepine kēia puʻupuʻu i nā hōʻailona a ʻike pinepine ʻia i ka wā o nā hoʻokolohua i hana ʻia no nā kumu ʻē aʻe.

Ke haʻi aku kāu kauka iā ʻoe he IPMN kou, e pūʻiwa paha ʻoe. Akā e hoʻomanaʻo, ʻo ka loaʻa ʻana o kēia maʻi ʻaʻole ia he manaʻo e loaʻa maoli iā ʻoe ka maʻi kanesa. I ka hapa nui o nā hihia, e hōʻike nā hoʻokolohua hou aʻe ʻaʻole he maʻi kanesa ka puʻupuʻu (benign). Inā ʻaʻole he maʻi kanesa kou puʻupuʻu, e hoʻomau kāu kauka i ka nānā ʻana iā ia e ʻike inā he kiʻekiʻe ka pilikia a inā he maʻi kanesa. A, ʻo ka mea nui, ʻoiai inā ʻike ʻia kou puʻupuʻu he kiʻekiʻe ka pilikia, ma kahi o 95% o ka poʻe i loaʻa ka IPMN i ʻike ʻia a mālama ʻia ma mua o ka lilo ʻana i maʻi kanesa e ola mau ana i ʻelima mau makahiki ma hope o ka ʻike ʻana.

ʻOiai kou kūlana, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia o ka loaʻa ʻana o ke kanesa pancreatic. E kamaʻilio me kāu kauka e pili ana i kēia. E hauʻoli ʻo ia e kōkua iā ʻoe.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

ʻAe, ke lana nei koʻu manaʻo ua ʻoi aku kou maopopo i ka mea a mākou i kamaʻilio ai, ʻo ``(IPMN)``. ʻOiai he kumuhana paʻakikī kēia, e hoʻāʻo kākou e hoʻomaopopo maʻalahi.

• He puʻupuʻu ka IPMN e ulu ana i loko o nā ducts o ka pancreas a hiki ke lilo i maʻi kanesa. ʻAʻole lilo lākou a pau i maʻi kanesa.
• ʻO ka hapa nui o ka manawa, ʻaʻole ia e hōʻike i kekahi mau hōʻailona a ʻike ʻia ia ma kahi ulia i ka wā o kahi hoʻokolohua ʻē aʻe.
• Hoʻomaopopo ʻia ka maʻi ma o nā hoʻokolohua e like me `(MRCP)` a me `(EUS)`.
• Hiki i ka lāʻau lapaʻau ke komo pū me ka nānā ʻana a i ʻole ke ʻoki ʻana , ma muli o ke ʻano a me ka pilikia o ka puʻupuʻu.
• ʻO ka ʻike mua ʻana a me ka mālama ʻana ka mea nui loa.
• Mai hopohopo inā haʻi ʻia iā ʻoe he IPMN kou. E kamaʻilio me kāu kauka a hoʻoholo i ka hoʻolālā lapaʻau maikaʻi loa no kou kūlana.
• E noʻonoʻo pū i nā loli o ke ʻano o ka nohona (ka haʻalele ʻana i ka puhipaka, ka mālama ʻana i ke kaumaha olakino, a me nā mea ʻē aʻe) e hiki ai ke hōʻemi i ka pilikia o ka maʻi ʻaʻai pancreatic.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai kānalua e nīnau i kāu kauka. E noho olakino!

ʻAkeka , IPMN, Kanesa, Kanesa ʻAkeka, Puʻupuʻu, Nā Hōʻailona, ​​Lapaʻau