Ua ʻike anei ʻoe i ke Kanesa Thyroid Medullary (MTC), kahi ʻano maʻi kanesa thyroid?

Ua lohe paha ʻoe i ke ʻano o ka ʻōpū thyroid ma ke alo o kou ʻāʻī. I kekahi manawa hiki iā ʻoe ke manaʻo i kahi puʻupuʻu liʻiliʻi ma kēia ʻōpū. A i ʻole e ʻike paha ke kauka iā ia i kou nānā ʻana iā ʻoe. ʻOiai ʻaʻole ia he mea weliweli kēia puʻupuʻu, hiki iā ia, i nā hihia kakaikahi, ke lilo i hōʻailona o ka maʻi kanesa. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano maʻi kanesa kūikawā, akā he kakaikahi iki, e kū mai ana ma ka ʻōpū thyroid.

He aha ke ʻano o ka maʻi ʻaʻai thyroid medullary (MTC)?

I ka ʻōlelo maʻalahi, ʻo ka Medullary Thyroid Cancer (MTC) kahi maʻi kanesa e ulu ana i loko o kou kelepa thyroid. ʻO ka ʻaoʻao o loko o kēia kelepa i kapa ʻia ʻo 'medulla' . Aia kekahi ʻano cell kūikawā i loko o kēia medulla, i kapa ʻia ʻo 'parafollicular C cells' . Hoʻopuka kēia mau cell C i ka hormone 'calcitonin' . No laila, ke hoʻomaka kēia mau cell C e ulu me ka hiki ʻole ke kāohi ʻia, kū mai ka MTC. E noʻonoʻo e like me nā mea kanu makemake ʻole ʻia i loko o kahi māla e pālahalaha ana ma nā wahi āpau me ka ʻole o ke kāohi.

He mea maʻamau ka loaʻa ʻana o nā nīnau a me nā makaʻu he nui ke lohe ʻoe e pili ana i ka maʻi kanesa, ʻoiai inā he ʻano kakaikahi ia. Akā e hoʻomanaʻo, aia kāu hui lapaʻau me ʻoe ma kēia huakaʻi. Nui nā ʻano like ʻole e mālama ai iā MTC.

Pehea ka maʻamau o ka maʻi ʻaʻai thyroid medullary (MTC)?

I kēia manawa, ke noʻonoʻo nei paha ʻoe, "ʻAuē, he maʻi anei kēia i loaʻa i nā kānaka a pau?" Mai hopohopo. He mea maʻamau ka maʻi kanesa thyroid. Eia nō naʻe, ʻo ke ʻano a mākou e kamaʻilio nei , ʻo ia hoʻi ka maʻi kanesa thyroid medullary (MTC) , he mea kakaikahi loa ia. ʻOiai ma kahi ʻāina e like me ʻAmelika Hui Pū ʻIa, ʻo 4% a 10% wale nō o nā maʻi kanesa thyroid āpau i hōʻike ʻia ua ʻike ʻia he MTC. ʻO ia hoʻi, aia wale nō ma kahi o 1,000 poʻe i ʻike ʻia me MTC ma laila i kēlā me kēia makahiki. No laila, ma Sri Lanka, ʻoi aku ka haʻahaʻa o kēia helu.

He aha nā hōʻailona o ka maʻi ʻaʻai thyroid medullary (MTC)?

ʻAe, he aha nā hōʻailona o MTC? ʻAʻole like nā hōʻailona o nā kānaka a pau. Eia nō naʻe, aia kekahi mau mea maʻamau:

• Hiki ke ʻike ʻia kahi puʻupuʻu (nodule) ma luna o kou kelepa thyroid . ʻO kēia ka hōʻailona nui e kū mai ana ma 75% a 95% o ka poʻe i ka wā e ʻike ʻia ai lākou. Hiki ke manaʻo ʻia e like me kahi puʻupuʻu liʻiliʻi, a hiki ke ʻike ʻia i kekahi manawa ke nānā ʻoe i ke alo o kou ʻāʻī.
• Nā ʻōpuʻu lymph pehu i ka ʻāʻī . ʻIke ʻia kēia ma kahi o 70% o ka poʻe i ka wā i hōʻoia ʻia ai. Hiki ke ʻike ʻia kēia mau mea ma ke ʻano he mau puʻupuʻu liʻiliʻi ma nā ʻaoʻao ʻelua o ka ʻāʻī.

Eia nō naʻe, he mea kakaikahi loa, inā nui ka nodule thyroid, hiki ke ʻike ʻia nā hōʻailona penei:

• Nā loli o ka leo, ka palahalaha o ka leo.
• Ka paʻakikī i ka ale ʻana i ka meaʻai.
• Paʻakikī ka hanu ʻana.

ʻO ka mea nui, hiki i kekahi poʻe ke loaʻa iā MTC akā ʻaʻole hōʻike i kekahi mau hōʻailona no ka manawa lōʻihi. ʻO kēia no ka mea he maʻi kanesa ka puʻupuʻu.He liʻiliʻi loa ia. No laila, inā ʻike ʻoe i kekahi mea ʻē ma kou ʻāʻī, he mea nui loa ia e makaʻala iā ia.

No ke aha e ulu ai ka maʻi kanesa thyroid medullary (MTC)?

I kēia manawa, e nānā kākou i ke kumu o kēia MTC. Aia kekahi mau kumu no kēia. ʻO ka mea nui, aia ʻelua mau ala e hana ai ʻo MTC.

MTC Sporadic

Ma kahi o 75% (ma kahi o ʻekolu mai ka ʻehā) o nā maʻi MTC e loaʻa i ke ʻano i kēlā me kēia manawa . ʻO ke ʻano kēia, ʻaʻohe mea o ko lākou ʻohana i loaʻa i ka MTC ma mua. Hana ʻia ia me ka ʻole o ka mōʻaukala ʻohana. ʻAʻole i loaʻa i nā kānaka ʻepekema ke kumu pololei o kēia MTC sporadic. Eia nō naʻe, ma waena o 40% a me 50% o ka poʻe e hoʻomohala i ka MTC ma kēia ʻano he mau mutations i loko o kahi gene i kapa ʻia ʻo ``(RET)`` . ʻAʻole kēia he mea i hānau ʻia me lākou, akā he ʻano genetic ʻē aʻe e ulu ana ma hope o ke ola.

MTC mai kēlā hanauna a i kēia hanauna

Ma ka ʻaoʻao ʻē aʻe, ma kahi o 25% o nā maʻi MTC (ma kahi o hoʻokahi i loko o ʻehā) hiki ke loaʻa i kahi maʻi hoʻoilina i kapa ʻia ʻo 'Multiple Endocrine Neoplasia type 2' (MEN2) . Aia kekahi mau ʻano like ʻole o 'MEN2':

• `(MEN2A)`: He kiʻekiʻe loa ka pilikia o ka poʻe me kēia maʻi i ka loaʻa ʻana o ka MTC (ma kahi o 90%) .
• `(MEN2B)`: He mau maʻi hoʻoilina kekahi mau hihia o `(MEN2B)`. Eia naʻe, i ka hapanui o nā hihia, ʻaʻole kēia ka hihia. Loaʻa i ka poʻe me `(MEN2B)` he 100% ka manawa kūpono e loaʻa ai ka MTC i ka wā ʻōpiopio loa .

Aia kekahi ʻano ʻē aʻe o kēia `(MEN2B)`, i kapa ʻia ʻo `Familial Medullary Thyroid Cancer (FMTC) . Loaʻa i ka poʻe me `(FMTC)` kahi mutation gene `(RET)`, akā loaʻa iā lākou wale nō ka MTC (ʻaʻole nā ​​ʻano maʻi ʻē aʻe).

E noʻonoʻo, inā loaʻa kekahi o kou ʻohana i kēia hoʻololi ʻana o ka gene "(RET)", hiki paha iā ʻoe ke pale aku i kahi pilikia nui ma ka wehe ʻana i ke kelepa thyroid ma o ke ʻoki pale ʻana ma mua o ka ulu ʻana o ka maʻi kanesa.

Pehea e ʻike ʻia ai ka maʻi ʻaʻai thyroid medullary (MTC)?

ʻIke pinepine ʻia ka MTC ma ke ʻano he puʻupuʻu i loko o ke kelepa thyroid. Hiki iā ʻoe ke ʻike iā ia iho, a i ʻole e ʻike paha kāu kauka iā ia ke ʻike ʻoe i kou ʻāʻī i ka wā o ka hoʻokolokolo maʻamau. I kekahi manawa, loaʻa ka puʻupuʻu ma ke ʻano ulia i ka wā o kahi hoʻāʻo kiʻi i hana ʻia no kekahi kumu ʻē aʻe.

Inā manaʻo kāu kauka he MTC kou, e kauoha paha lākou i kēia mau hoʻokolohua:

• Nā hoʻāʻo kiʻi: Hiki i kēia ke kōkua i ka ʻike maopopo ʻana i ka puʻupuʻu thyroid. No ka laʻana , he ultrasound thyroid , CT scan , a/a i ʻole MRI.Hiki iā ʻoe ke hana i nā hoʻokolohua e like me kēia. E like me ke kiʻi ʻana i kahi kiʻi me kahi kāmela, hiki i kēia mau mīkini ke ʻike maopopo i nā mea o loko o ke kino.
• ʻO ka ʻume ʻana i ka nila maikaʻi (biopsy nila): E paipai paha kāu kauka e lawe i kahi laʻana liʻiliʻi o ka ʻiʻo (biopsy) mai kou nodule thyroid. Pili kēia i ka hoʻohana ʻana i kahi nila maikaʻi loa. Manaʻo ia e like me kahi nila liʻiliʻi. A laila e nānā ʻia kēia laʻana ʻiʻo ma lalo o kahi microscope e ʻike inā he mau hunaola kanesa.
• Nā hoʻāʻo koko: Hiki i kēia ke komo pū me nā hoʻokolohua e ana i nā pae o nā mea i loko o kou koko i kapa ʻia ʻo calcitonin a me carcinoembryonic antigen (CEA) . Hoʻokiʻekiʻe pinepine ʻia kēia mau pae i ka poʻe me MTC.

Hiki i kāu kauka ke paipai i ka hoʻāʻo ʻana i ka genetic e ʻike inā he maʻi genetic kou i kapa ʻia ʻo "MEN2". Inā pēlā, hiki iā lākou ke paipai i ka hoʻāʻo genetic no nā hoahānau koko ʻē aʻe, no ka mea hiki i kēia ke kōkua i ka hoʻoholo ʻana inā pilikia lākou.

He aha nā lāʻau lapaʻau no ka maʻi kanesa thyroid medullary (MTC)?

ʻAe, e nānā kākou i nā lāʻau lapaʻau i loaʻa no MTC.

ʻO ke ʻano lapaʻau nui no ka MTC, ʻo ia ke ʻoki ʻana e wehe i kou kelepa thyroid holoʻokoʻa (thyroidectomy holoʻokoʻa) . ʻOiai paha e like kēia me kahi ʻoki nui, ʻo ia ke ala maikaʻi loa e ho'ōla ai i kēia maʻi kanesa.

• Ka wehe ʻana i nā kīpē lymph: Inā ua pālahalaha ke kanesa thyroid (metastasized) i nā kīpē lymph i kou ʻāʻī, e wehe paha ke kauka lapaʻau iā lākou.
• Hoʻōla hormone: Ma hope o ke ʻoki ʻana, pono ʻoe e lawe i nā lāʻau lapaʻau pani hormone thyroid no ke koena o kou ola. No ka mea he mea nui nā hormones i hana ʻia e ke kelepa thyroid no ke kino, pono e hāʻawi ʻia i waho ma ke ʻano o nā pila.

Ma waho aʻe o ke ʻoki ʻana, hiki i kāu kauka ke ʻōlelo i nā lāʻau lapaʻau ʻē aʻe, e like me:

• Lapaʻau radiation: He ʻano hana e luku ai i nā hunaola kanesa me ka hoʻohana ʻana i nā kukuna ikehu kiʻekiʻe.
• Chemotherapy: He ʻano hana e hoʻohana ai i nā lāʻau lapaʻau e pepehi i nā hunaola kanesa.
• Nā lāʻau lapaʻau i kuhikuhi ʻia: I kekahi mau hihia o MTC, hoʻohana ʻia nā lāʻau lapaʻau kikoʻī e kuhikuhi wale ana i nā loli i ka DNA . ʻO nā hiʻohiʻona e komo pū me vandetanib a me cabozantinib .

Ma hope o ka mālama ʻana no MTC, e nānā mau kāu kauka i kāu mau pae CEA a me Calcitonin ma o nā hoʻāʻo koko. E kōkua kēia iā lākou e ʻike i ka maikaʻi o ka mālama ʻana a inā ua hoʻi hou mai ke kanesa.

He maʻi kanesa ʻo MTC i ʻoi aku ka ikaika ma mua o nā ʻano maʻi kanesa thyroid ʻē aʻe. Eia nō naʻe, inā loaʻa ma mua o ka laha ʻana i nā lymph node ma ka ʻāʻī a i ʻole nā ​​​​​​ʻāpana ʻē aʻe o ke kino, ʻoi aku ka maʻalahi o ka mālama ʻana, ho'ōla ʻana, a me ke kāohi ʻana.

He aha ka wānana no kekahi me ka maʻi ʻaʻai thyroid medullary (MTC)?

ʻO ka wānana, a i ʻole ka nānā ʻana, no kekahi me MTC e pili ana i nā kumu he nui.

• Ke kahua o ke kanesa (ʻo ia hoʻi, pehea ka mamao o ka laha ʻana o ke kanesa).
• Inā ua pālahalaha ke kanesa (metastasized) i nā ʻāpana ʻē aʻe o ke kino.
• ʻEhia ka nui o ka puʻu kanesa i wehe ʻia i ka wā o ke ʻoki ʻana.
• Kou makahiki a me kou olakino holoʻokoʻa.

ʻAʻole maikaʻi ka wānana no ka MTC e like me ka maʻi kanesa thyroid papillary a me ka maʻi kanesa thyroid follicular . Eia nō naʻe, inā loaʻa iā ʻoe a me kāu kauka ka MTC i ka wā mua, hiki ke ho'ōla loa ʻia me ke ʻoki kino . ʻOiai inā lohi ka ʻike ʻana, hoʻolaha pinepine ka MTC (e ʻoi aku ka ʻino) me ka lohi .

ʻOi aku ka haʻahaʻa o ka hiki ke ho'ōla hou no nā poʻe e like me kēia:

• ʻO nā kānaka ma luna o 65 mau makahiki.
• ʻO nā kānaka i nā pae holomua o ka maʻi kanesa.
• ʻO ka poʻe i hiki ʻole ke wehe loa ʻia ko lākou maʻi kanesa i ka wā o ke ʻoki ʻana.

He aha ka manaʻolana e ola ai no ka maʻi kanesa thyroid medullary (MTC)?

I ka wā e pili ana i ka nui o ke ola o kekahi me MTC, hōʻike ka noiʻi o kēia manawa ʻo ka nui o ke ola ʻelima makahiki no nā pae ʻekahi, ʻelua, a me ʻekolu o MTC ma kahi o 93%. Eia naʻe, no ke pae ʻehā, hāʻule kēia helu i 28%.

Eia nō naʻe, ʻo ka mea nui ma ʻaneʻi, no ka mea, he kakaikahi nā hihia hou o MTC i hōʻike ʻia i kēlā me kēia makahiki, ʻaʻole paha pololei loa kēia mau helu ola. E hāʻawi kāu hui lapaʻau iā ʻoe i kahi manaʻo maikaʻi aʻe o ka mea e manaʻo ai.

He aha ka ʻokoʻa ma waena o ka maʻi papillary thyroid a me ka medullary thyroid cancer?

I kēia manawa ke noʻonoʻo nei paha ʻoe, 'He aha ka ʻokoʻa ma waena o kēia MTC a me kēlā mau maʻi kanesa thyroid ʻē aʻe?'

ʻO ke kanesa thyroid papillary ke ʻano maʻamau o ke kanesa thyroid . He 80% ia o nā maʻi kanesa thyroid. Eia nō naʻe, he mea kakaikahi ka maʻi kanesa thyroid medullary (MTC) .

ʻO ka ʻokoʻa nui aia i nā pūnaewele mai kahi e hoʻomaka ai kēia mau ʻano maʻi ʻaʻai ʻelua.

• Hoʻomaka ka maʻi kanesa thyroid papillary i loko o nā pūnaewele follicular i loko o kou kelepa thyroid e hana ana i ka thyroglobulin, kahi protein.
• Hoʻomohala ʻia ʻo MTC mai nā pūnaewele C i loko o ka thyroid gland e hana ana i ka calcitonin, kahi hormone.

ʻO kekahi mea ʻē aʻe, ʻo ka maʻi kanesa thyroid papillary e pili pinepine ʻia me ka hōʻike ʻana o ka radiation, akā ʻaʻohe pilina maopopo me MTC.

ʻO ka mea hope loa, e hoʻomanaʻo i kēia.

He mea weliweli loa ka lohe ʻana ua loaʻa iā ʻoe ka maʻi kanesa, ʻoiai ke ʻano. Ua ʻike mākou a pau i kēlā. Akā i ka wā e pili ana i ka maʻi kanesa thyroid medullary (MTC) , e hoʻomanaʻo he pane maikaʻi ia i ka lāʻau lapaʻau inā ʻike mua ʻia .

ʻOiai ʻaʻole ʻike ʻia ke kumu kikoʻī o ka hapa nui o nā hihia o MTC, aia kahi pilina ikaika i kekahi mau maʻi hoʻoilina. No laila, inā ua ʻike ʻia ʻoe a i ʻole kahi lālā o ka ʻohana pili (ʻohana mua - nā mākua, nā kaikaina, nā keiki) me MTC, he mea nui loa ia e loaʻa ka hoʻāʻo genetic. Hiki i kēia ke kōkua nui iā ʻoe a me kou ʻohana.

Inā he mau nīnau kāu e pili ana i kou pilikia o ka loaʻa ʻana o ka MTC, mai makaʻu e kamaʻilio me kāu kauka. Aia mau lākou ma laila e kōkua iā ʻoe a pane i kāu mau nīnau. ʻO ka mea nui loa, ʻo ia ka noho ʻike, e noho ʻike, a e hana i nā hana e pono ai.

ʻO ke kanesa thyroid medullary, MTC, ke kelepa thyroid, nā hōʻailona o ke kanesa, ka hoʻāʻo ʻana i ka genetic, MEN2, ke ʻoki kino thyroid