He aha ka maʻi Leptomeningeal? E kamaʻilio kākou e pili ana i ia mea!

He mea paʻakikī ke hoʻākāka i ka makaʻu a me ka hopohopo āu e ʻike ai ke ʻike ʻoe he maʻi kanesa kou. Ke hakakā nei ʻoe i ka maʻi kanesa, ua lohe mākou a pau e hiki ke laha i nā ʻāpana ʻē aʻe o ke kino. I kēia lā, e kamaʻilio mākou e pili ana i hoʻokahi ala e hiki ai i ka maʻi kanesa ke hoʻopilikia i ko mākou lolo, nā membrane e hoʻopuni ana i ko mākou iwi kuamoʻo, a me ko mākou wai cerebrospinal. Ua kapa ʻia kēia e nā kauka he maʻi Leptomeningeal , i kekahi manawa i kapa ʻia ʻo LMD a i ʻole LM .

I ka ʻōlelo maʻalahi, he aha ka maʻi Leptomeningeal?

ʻAe, e wehewehe iki kākou i kēia. ʻEkolu mau membrane lahilahi e pale ana i ko kākou lolo a me ke kaula iwi kuamoʻo. Kāhea mākou i kēia mau meninges. ʻO nā membrane lahilahi ʻelua i loko o kēia mau meninges ua kapa ʻia ʻo leptomeninges . E like me nā uhi o kahi puke, pale kēia mau membrane i kēia mau ʻāpana koʻikoʻi ʻelua o kā mākou ʻōnaehana nerve.

ʻO ka mea aʻe, aia kahi wai kūikawā e kahe ana i loko o ko kākou lolo a puni ko kākou kaula iwi kuamoʻo. Ua kapa ʻia kēia ʻo ka wai cerebrospinal (CSF) . Hoʻoulu kēia wai i ka lolo a me ke kaula iwi kuamoʻo, pale iā ia, a hoʻoneʻe i nā huahana ʻōpala.

I kēia manawa, ʻo ka maʻi leptomeningeal (LMD) ka wā e laha ai kahi maʻi kanesa ma kahi ʻē aʻe o ke kino, e like me ke kanesa umauma a i ʻole ke kanesa māmā, a komo i loko o kēlā mau membrane leptomeningeal a mākou i kamaʻilio ai a me ka wai cerebrospinal (CSF). ʻO ia hoʻi, hoʻomaka nā hunaola kanesa e lana i loko o kēia wai, e like me nā ʻōpala e lana ana i ka wai. Ua manaʻo ʻia kēia he ʻano maʻi kanesa koʻikoʻi.

Pehea ka maʻamau o ka maʻi leptomeningeal (LMD)?

ʻAʻole maʻamau ka maʻi Leptomeningeal (LMD). Eia nō naʻe, me ka holomua o nā lāʻau lapaʻau e hiki ai i nā kānaka ke ola lōʻihi me ka maʻi kanesa, ke lilo nei ia i mea maʻamau. Ma ka awelika, loaʻa ka LMD ma kahi o 5% o nā maʻi kanesa.

ʻIke pinepine ʻia kēia ʻano LMD i nā poʻe me nā ʻano maʻi kanesa penei:

• Ka maʻi ʻaʻai umauma: ʻO ka maʻi ʻaʻai umauma ke ʻano maʻamau o ka maʻi ʻaʻai umauma e pili ana me LMD. Hoʻopilikia ia i 3% a 5% o nā wahine me ka maʻi ʻaʻai umauma. Ua hōʻike ʻia nā noiʻi he ʻoi aku ka nui o ka pilikia o nā wahine me ke ʻano i kapa ʻia ʻo "Triple negative breast cancer" a me ke ʻano "Lobular breast cancer" i ka hoʻomohala ʻana i ka LMD.
• Ka maʻi ʻaʻai māmā: Hiki i nā maʻi ʻaʻai māmā ʻaʻole liʻiliʻi (NSCLC) a me ke kanesa māmā liʻiliʻi (SCLC) ke laha i nā leptomeninges a me ka wai cerebrospinal. Manaʻo nā kauka ma waena o 4% a me 7% o ka poʻe me NSCLC e loaʻa i ka LMD. Piʻi kēia helu i kahi 11% o ka poʻe me SCLC.
• Melanoma: He ʻano maʻi ʻili koʻikoʻi kēia. Ma kahi o 5% o ka poʻe me ka melanomaHiki ke hoʻomohala ʻia ka LMD.
• ʻO ka leukemia lymphocytic acute (ALL): He maʻi ʻaʻai koko kēia. Ma waena o 1% a me 10% o ka poʻe me ALL e loaʻa paha iā LMD.
• ʻO ka lymphoma Non-Hodgkin (NHL): He maʻi ʻaʻai kēia o ka ʻōnaehana lymphatic. Ma waena o 5% a me 10% o ka poʻe me NHL e loaʻa paha iā NHL.

He aha ka ʻokoʻa ma waena o nā metastases o ka lolo a me ka maʻi leptomeningeal (LMD)?

Hana ʻia kēia mau mea ʻelua i ka wā e laha ai ke kanesa, akā aia kahi ʻokoʻa iki.

ʻO nā metastases o ka lolo ke hele pololei nā hunaola kanesa i loko o ka ʻiʻo o ka lolo a hana i nā tumors ma laila.

Eia nō naʻe, ʻo ka maʻi leptomeningeal (LMD) ka wā e hele ai nā hunaola kanesa i loko o ka wai cerebrospinal (CSF) a me nā membrane leptomeningeal e hoʻopuni ana i ka lolo a me ke kaula spinal . Maanei, e lana ana paha nā hunaola kanesa i loko o ka wai a i ʻole e pālahalaha ana ma luna o ka ʻili o nā membrane.

I kekahi manawa hiki ke hui pū ʻia kēia mau kūlana ʻelua, a i ʻole hiki ke hana like ʻia.

He aha nā hōʻailona o kēia maʻi?

Nui nā hōʻailona o ka maʻi leptomeningeal (LMD), no ka mea, hoʻopilikia ia i ka lolo a me ke kaula spinal, ʻo ia hoʻi ko kākou ʻōnaehana nerve holoʻokoʻa. Eia nō naʻe, eia kekahi o nā hōʻailona maʻamau:

• ʻEha poʻo: ʻO kēia ka hōʻailona nui i ʻike ʻia e ka hapa nui o ka poʻe. ʻAʻole ia e like me ka ʻeha poʻo maʻamau, hiki ke koʻikoʻi iki, a i kekahi manawa ʻoi aku ka ʻino i ke kakahiaka.
• Ka luaʻi a me ka luaʻi: ​​Hiki ke loaʻa ka luaʻi a me ka luaʻi, ʻoiai i ke kakahiaka.
• Nā loli i ke ʻano o ka hele ʻana: Manaʻo paha ʻoe e nalowale ana kou mana a e hina ana ʻoe i ka wā e hele ana.
• Poho lohe: Hiki ke hiki koke mai ka pohō lohe, a hoʻomaka paha ʻoe e lohe i nā leo like ʻole i loko o kou mau pepeiao.
• Nā pilikia ʻike: Hiki ke ʻike pālua a me ka ʻike pōwehiwehi.
• Nā ʻūlū : Hiki ke nalowale koke ka ʻike a me nā ʻūlū.
• Ka huikau a me nā loli i ka ʻike, ke ʻano, a i ʻole ke ʻano: Hiki ke paʻakikī i ka noʻonoʻo ʻana, ka nalowale o ka hoʻomanaʻo, ka huhū, a me ka hoʻonāukiuki.
• ʻEha kua a me ka wāwae: Hiki ke ʻeha ma ke kua a ma nā wāwae.
• Ka mae a nāwaliwali paha i nā wāwae a i ʻole nā ​​puʻupuʻu: Hiki i kou mau wāwae ke manaʻo he mae a make.
• Nā pilikia mimi a i ʻole ka ʻōpala: He mea paʻakikī paha ke kaohi i ka mimi a me ka ʻōpala.
• Nā pilikia neurological hou ʻē aʻe: Ma waho aʻe o kēia, hiki ke ʻike ʻia nā hōʻailona neurological hou, e like me ka paʻakikī i ka ʻōlelo ʻana a me ka maneʻo ʻana ma kahi ʻāpana o ka maka.

ʻO ka mea nui loa, inā loaʻa iā ʻoe ka maʻi kanesa, e haʻi koke aku i kāu kauka inā loaʻa iā ʻoe kekahi mau hōʻailona hou e like me kēia.

No ke aha e kū mai ai ka maʻi leptomeningeal (LMD)?

I ka ʻōlelo maʻalahi, hana ʻia ka LMD i ka wā e hemo ai nā hunaola kanesa mai kahi mua o ke kanesa i loko o ke kino (e.g., umauma, māmā), hele ma ke kahe koko a i ʻole ka ʻōnaehana lymphatic, a komo i loko o ka wai cerebrospinal (CSF) a me nā leptomeninges a mākou i kamaʻilio ai ma mua. Hōʻike kēia i ka mamao o ka laha ʻana o ke kanesa.

ʻO ka maʻamau, hana ʻia ka wai cerebrospinal (CSF) i loko o ko kākou lolo, a laila hele a puni ka lolo a me ke kaula spinal, a hoʻihoʻi ʻia i loko o ke kahe koko. Hana ʻia kēia ma ke ʻano he pōʻaiapuni. Eia naʻe, ke komo nā hunaola kanesa i loko o kēia CSF, hiki iā lākou ke hoʻopilikia i ke kahe maʻamau o kēia wai. A laila hiki i ka CSF ke hōʻiliʻili, e hoʻonui ana i ke kaomi i loko o ka lolo. ʻO ia ke kumu e ʻike ʻia ai nā hōʻailona he nui. Eia kekahi, ke laha nā hunaola kanesa i nā membrane leptomeningeal, hiki iā lākou ke hōʻino i kēlā mau membrane a me nā aʻalolo e pili ana iā lākou.

Pehea e ʻike ai nā kauka i kēia?

Inā manaʻo ʻoe he LMD kou, e hana nā kauka i ʻelua mau hoʻokolohua nui:

1. MRI scan (Magnetic Resonance Imaging - MRI): Hana ʻia kahi MRI scan o kou lolo a/a i ʻole ke kaula kuamoʻo e nānā i nā hunaola kanesa e laha ana i nā leptomeninges a no ke ālai ʻana i ke kahe o ka CSF.

2. Lumbar puncture / Spinal Tap: Ma kēia hoʻāʻo , hoʻokomo ʻia kahi nila lahilahi i loko o kou kua haʻahaʻa, e mālama pono ʻaʻole e hōʻino i kou kaula spinal, e wehe i kahi hāpana liʻiliʻi o ka wai cerebrospinal (CSF). A laila hoʻāʻo ʻia ka hāpana ma kahi keʻena hoʻokolohua e ʻike inā he mau hunaola kanesa.

I kekahi manawa, inā he maalea loa ka laha ʻana o nā hunaola kanesa (microscopic), ʻaʻole paha e ʻike ʻia ma kahi scan MRI. I ia mau hihia, hiki ke paʻakikī iki ka ʻike ʻana i ka maʻi. No laila he mea nui e haʻi pololei i kāu kauka e pili ana i kāu mau hōʻailona.

Aia kekahi lāʻau lapaʻau piha no kēia?

ʻO ka mea pōʻino, ʻaʻohe lāʻau lapaʻau no ka maʻi leptomeningeal (LMD) i kēia manawa. No ka mea he ʻano maʻi kanesa koʻikoʻi a laha nui, ʻo nā pahuhopu nui o ka mālama ʻana, ʻo ia ke kāohi i ka laha ʻana o ke kanesa, hōʻemi i nā hōʻailona a kōkua iā ʻoe e noho ʻoluʻolu e like me ka hiki, a mālama i ke ʻano o ke ola.

Aia nā koho lapaʻau i nā mea e like me ke ʻano o ka maʻi kanesa i loaʻa iā ʻoe i ka wā mua, pehea ka mamao o ka laha ʻana o ke kanesa, a me kou olakino holoʻokoʻa. ʻO kekahi o nā lāʻau lapaʻau i hoʻohana pinepine ʻia:

• Lapaʻau radiation: Hāʻawi ʻia ka lāʻau radiation i nā ʻāpana i hoʻopilikia ʻia o ka lolo a i ʻole ke kaula kuamoʻo. Hiki i kēia ke hōʻemi i kekahi mau hōʻailona (e.g., ʻeha, nāwaliwali o ke aʻalolo) a hoʻomaikaʻi i kekahi hana aʻalolo.
• Kemokalama:Hāʻawi ʻia nā lāʻau lapaʻau e pepehi i nā hunaola kanesa. Hiki ke lawe ʻia kēia mau lāʻau lapaʻau ma ke ʻano he pila, hāʻawi ʻia ma ke ʻano he inikini i loko o kahi aʻa, a i kekahi manawa e inikini pololei ʻia i loko o ka wai cerebrospinal (CSF). Ua kapa ʻia kēia he "Intrathecal chemotherapy." Hana ʻia kēia ma o kahi ʻōmole liʻiliʻi i kau ʻia i loko o ka lolo i kapa ʻia ʻo "ventricular access device."

Aia kekahi mau ala e hōʻemi ai i ka hanana o kēia?

ʻO kaʻoiaʻiʻo, ʻaʻohe ala kikoʻī e pale aku ai i ka ulu ʻana o LMD i kēia manawa, no ka mea, hana ia ma muli o ka laha ʻana o ka maʻi kanesa i loaʻa mua i ke kino.

Pehea ka lōʻihi e hiki ai iā ʻoe ke ola me kēia maʻi?

Ua ʻike au he nīnau paʻakikī kēia e nīnau. He pae holomua ka LMD o ke kanesa. ʻO ke ʻano kēia, i ka wā e kū mai ai kēia maʻi, aia ka mea maʻi i ke pae koʻikoʻi loa o ke kanesa.

Ma ka awelika, hiki i nā mea maʻi e loaʻa ana ka lāʻau lapaʻau ke manaʻo e ola no ʻekolu a ʻeono mahina ma hope o ka hōʻoia ʻana . No ka poʻe i loaʻa ʻole ka lāʻau lapaʻau, hiki i kēia manawa ke like me hoʻokahi mahina.

Eia nō naʻe, hiki ke ʻokoʻa kēia mai kēlā kanaka a kēia kanaka. Aia ia i nā mea he nui, e like me ke ʻano o ka maʻi kanesa āu e loaʻa ai a pehea e pane ai kou kino i ka lāʻau lapaʻau. ʻO kāu kauka ke kanaka maikaʻi loa e hāʻawi iā ʻoe i ka ʻike e pili ana i kēia.

Pehea wau e mālama ai iaʻu iho? Pono anei au e noʻonoʻo i ka mālama hospice?

Inā loaʻa iā ʻoe ka LMD, he mea nui e loaʻa kahi ʻike maopopo i kou kūlana. ʻO ka LMD kahi hopena hope loa o ka maʻi kanesa, hiki ʻole ke hoʻōla ʻia. E nīnau i kāu kauka i ka mea e manaʻo ai ma muli o kou kūlana. Ma kēlā ala, hiki iā ʻoe ke hoʻokele i kāu mau hōʻailona, ​​​​noho ʻoluʻolu e like me ka hiki, a hoʻonohonoho i nā mea nui iā ʻoe.

ʻAʻole kēia mau mea he mea maʻalahi ke kamaʻilio e pili ana, me ʻoe a i ʻole kāu kauka. Akā he mea nui loa ia. Hiki i kāu kauka ke kōkua iā ʻoe e hoʻomaopopo i ka mea e hana nei i kou kino a me nā mea e hiki mai ana i ka wā e hiki mai ana. Hiki iā ia ke kōkua iā ʻoe e noʻonoʻo e pili ana i kāu mau koho a, inā pono, e kuhikuhi iā ʻoe i nā lawelawe kākoʻo.

ʻO ka mālama hospice kahi lawelawe e kōkua ai i nā poʻe me nā maʻi palena ola a make e ola i ko lākou mau lā hope loa me ka ʻoluʻolu, me ka hanohano, ma lalo o ko lākou mana, a me ke ʻano kiʻekiʻe o ke ola. I ka wā e hakakā ai i kahi maʻi koʻikoʻi, ʻo ka hapa nui o ko mākou manawa a me ka ikaika e kau ana ma ka mālama ʻana. I ka noʻonoʻo ʻana e pili ana i ka mālama hospice, ʻo ke kumu nui ka pehea e hoʻolilo ai i ke koena o ka manawa, ma mua o ka maʻi ponoʻī. Ma ke kamaʻilio ʻana me kāu kauka e pili ana i ka hopena o ka LMD i kou ola, he aha nā lāʻau lapaʻau i loaʻa no kou ʻano maʻi kanesa, a me nā mea e manaʻo ʻia mai kēlā mau lāʻau lapaʻau, hiki iā ʻoe ke hana i ka hoʻoholo maikaʻi loa iā ʻoe.

Inā loaʻa iā ʻoe ka LMD, ke ola nei paha ʻoe me kahi maʻi ʻaʻai koʻikoʻi i laha ma kou kino me ka nānā ʻole i ka lāʻau lapaʻau. Ke ʻike ʻoe he pilikia koʻikoʻi a hiki ʻole ke hoʻōla ʻia, e hopohopo paha ʻoe, e huhū, a e makaʻu. E noʻonoʻo paha ʻoe, "No ke aha kēia e hana nei iaʻu?" ʻAʻole ʻoe hoʻokahi i kēia kūlana. E noi i kāu kauka no ke kōkua. Hoʻomaopopo lākou i kāu mea e hele nei, a e kōkua lākou iā ʻoe ma nā ʻano āpau e hiki ai iā lākou.

Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

• ʻO ka maʻi Leptomeningeal (LMD) ka laha ʻana o ke kanesa i nā membrane e uhi ana i ka lolo a me ke kaula spinal a i loko o ka wai cerebrospinal.
• He kūlana koʻikoʻi kēia hiki ʻole ke ho'ōla ʻia.
• Hiki ke loaʻa nā hōʻailona neurological e like me ke poʻo ʻeha, ka nausea, ka paʻakikī i ka hele wāwae, nā pilikia ʻike/lohe, a me ka huikau.
• Hoʻomaopopo ʻia ka maʻi ma o ka MRI scan a me ka lumbar puncture.
• ʻO ka pahuhopu o ka mālama ʻana, ʻo ia ke kaohi i nā hōʻailona a mālama i ka maikaʻi o ke ola.
• Mai makaʻu e kamaʻilio ākea me kāu kauka e pili ana i kou kūlana, kou wā e hiki mai ana, a me nā koho e like me ka mālama hospice. E kiʻi i ke kākoʻo e pono ai ʻoe a me kou ʻohana e hele ai i kēia manawa paʻakikī.

ʻO ka maʻi Leptomeningeal, Kanesa, Lolo, Spinal Cord, Cerebrospinal Water, Nā hōʻailona, ​​Ka laha ʻana o ke kanesa