E aʻo kākou e pili ana i ka neoadjuvant therapy, kahi lāʻau e hoʻēmi ai i ke kanesa ma mua o ke ʻoki ʻana.

Ke haʻi aku ke kauka iā ʻoe a i ʻole kekahi āu i ʻike ai he maʻi kanesa, ʻo ka mea aʻe e hiki mai ana i ka noʻonoʻo, ʻo ia paha ke ʻoki ʻana e wehe i ka puʻupuʻu. He mea maʻamau kēlā. Akā, ua ʻike anei ʻoe i kekahi manawa, ma mua o kēia ʻoki ʻana, aia kahi lāʻau lapaʻau kūikawā e hiki ke hāʻawi ʻia e hoʻēmi i ka puʻupuʻu, kaohi iā ia, a e maʻalahi a holomua hoʻi ke ʻoki ʻana? ʻO ia ka mea a mākou e kapa nei he Neoadjuvant Therapy ma ka lāʻau lapaʻau. I kēia lā, e kamaʻilio mākou e pili ana i kēia, ma ke ʻano maʻalahi loa, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

I ka ʻōlelo maʻalahi, he aha ka Neoadjuvant Therapy?

E noʻonoʻo e holo ana ʻoe i kahi marathon nui. Pehea ka maʻalahi inā e hoʻomehana iki ʻoe a hana i kekahi mau hoʻomaʻamaʻa liʻiliʻi (hoʻomehana) ma mua o kou hoʻomaka ʻana e holo, ma mua o ka holo koke ʻana? Pēlā nō ia me kēia.

ʻO ka lāʻau lapaʻau Neoadjuvant kahi ʻano lāʻau i hāʻawi ʻia e hoʻēmi i kahi puʻupuʻu ma mua o ke ʻoki ʻana e wehe iā ia. Hiki i kāu kauka maʻi ke kapa iā ia he "lāʻau perioperative" a i ʻole "lāʻau hoʻokomo." ʻO ka pahuhopu nui o kēia lāʻau lapaʻau, ʻo ia ka hoʻēmi ʻana i kahi puʻupuʻu nui i hiki ke wehe maʻalahi ʻia e ke ʻoki ʻana. ʻO ka mea kupanaha, i kekahi manawa hiki i kēia lāʻau lapaʻau ke hoʻopau loa i ka puʻupuʻu, e hana ana i ke ʻoki ʻana he mea pono ʻole.

He aha nā ʻano o kēia lāʻau lapaʻau?

Aia kekahi mau ʻano lapaʻau nui i hoʻohana ʻia ma ke ʻano he neoadjuvant therapy. Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa nāu ma muli o nā mea e like me ke ʻano a me ke kahua o kou maʻi ʻaʻai.

I kekahi manawa, hiki i kāu hui lapaʻau ke hāʻawi iā ʻoe ma mua o hoʻokahi o kēia mau lāʻau lapaʻau. No ka laʻana, ʻo ka hāʻawi pū ʻana i ka chemotherapy a me ka radiation therapy ua kapa ʻia ʻo "neoadjuvant chemoradiation."

Hiki i kēia wā lapaʻau ke mau mai kekahi mau pule, kekahi mau mahina, a i ʻole hoʻokahi makahiki. I ka hapanui o nā hihia, hana ʻia ke ʻoki ʻana i loko o hoʻokahi mahina ma hope o ka pau ʻana o kēia lapaʻau.

He aha nā ʻano maʻi kanesa e hoʻohana ʻia ai kēia lāʻau lapaʻau?

Ke hoʻohana pono ʻia nei kēia ʻano lapaʻau no nā ʻano maʻi kanesa he ʻumi a ʻoi aku. ʻO kēia kekahi o nā maʻi kanesa maʻamau.

Ka maʻi ʻaʻai umauma

He mea nui loa kēia ʻano hana i ka maʻi ʻaʻai umauma, ʻoiai hoʻi:

• Inā nui iki ka puʻupuʻu.
• I nā ʻano e laha wikiwiki ana e like me ke 'kani ʻaʻai umauma mumū'.
• No kekahi mau ʻano maʻi ʻaʻai umauma kikoʻī, e like me ka `HER2-positive` a me ka `triple-negative`.

Hiki i kēia lāʻau lapaʻau ke ʻae i kahi hana ʻoki liʻiliʻi (lumpectomy) e wehe wale i ka puʻupuʻu, ma mua o kahi hana nui (mastectomy) e wehe ai i ka umauma holoʻokoʻa.

Ka maʻi ʻaʻai kolona

Inā ua pālahalaha ke kanesa kolona (metastasized) i nā wahi ʻē aʻe, e like me ke ake, hiki ke hāʻawi ʻia ka chemotherapy ma mua o ke ʻoki ʻana.

Ka maʻi ʻaʻai māmā

ʻO ka Chemotherapy a i ʻole chemoradiation ka mea maʻamau i hoʻohana ʻia no ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi.

Ka maʻi ʻaʻai prostate

Hoʻokele ʻia kekahi ʻano o kēia maʻi kanesa i nā kāne e ka hormone testosterone. No laila, hōʻemi ka lāʻau lapaʻau hormone i ka hana o kēlā hormone a kāohi i ka puʻupuʻu.

Ka maʻi ʻaʻai rectal

He mea maʻamau ka hāʻawi pū ʻana i ka radiation therapy a me ka chemotherapy no ka maʻi ʻaʻai rectal i pālahalaha. I kekahi manawa, hāʻawi mua ʻia ka chemotherapy, a ukali ʻia e ka chemoradiation, ma ke ʻano i kapa ʻia ʻo "total neoadjuvant therapy".

He aha nā pōmaikaʻi o ka Neoadjuvant Therapy?

Aia kekahi mau pono i loaʻa i ka mea maʻi mai kēia ʻano lapaʻau.

E makaʻala hoʻi kākou i nā hopena ʻaoʻao.

E like me nā lāʻau lapaʻau maʻi kanesa, hiki i kēia mau lāʻau lapaʻau ke hana i nā hopena ʻaoʻao. Akā, pili lākou i ke ʻano o ka lāʻau lapaʻau āu e loaʻa nei. ʻO kekahi o nā hopena ʻaoʻao maʻamau:

• Luhi
• Ka luaʻi a me ka luaʻi
• Makemake nui
• Ka maʻi pākī
• Ka nalowale o ka ʻono i loko o ka waha

Akā, mai hopohopo. E aʻo aku kāu kauka iā ʻoe e pili ana i nā hopena ʻaoʻao a me nā lāʻau lapaʻau hiki iā ʻoe ke lawe e mālama iā lākou ma mua o kou hoʻomaka ʻana i ka mālama ʻana. E kōkua pū kāu hui lapaʻau iā ʻoe e mālama i kēia mau hōʻailona i kahi nui ma o ka mālama palliative.

Āhea ʻoe e pono ai e ʻike i ke kauka?

ʻOiai ʻoe e loaʻa ana i kēia lāʻau lapaʻau, e nānā pono ana kāu hui lapaʻau iā ʻoe. Eia nō naʻe, inā loaʻa iā ʻoe kekahi mau pilikia, mai hoʻokaʻulua i ka hōʻike ʻana iā lākou.

• Inā ʻoi aku ka ʻino o nā hopena ʻaoʻao ma mua o ka mea i manaʻo ʻia: Eia kekahi laʻana, inā ʻaʻole hiki iā ʻoe ke kaohi i ka nausea ma hope o ka lawe ʻana i ka lāʻau lapaʻau, a ʻoluʻolu ʻole ʻoe i ka lā a pau.
• Inā ʻike ʻoe i nā loli hou i kou kino: Inā loaʻa iā ʻoe kekahi mau hōʻailona hou e hōʻike ana e ʻoi aku ka ʻino o ke kanesa.

He aha ka ʻokoʻa ma waena o ka Neoadjuvant a me ka Adjuvant Therapy?

Hiki i kēia mau huaʻōlelo ʻelua ke huikau iki, akā maʻalahi loa ka ʻokoʻa.

• Lapaʻau Neoadjuvant: Hāʻawi ʻia ka lāʻau lapaʻau ma mua o ke ʻoki ʻana (e like me ka hoʻomehana ʻana ma mua o ka marathon).
• Lapaʻau Hoʻohui: Hāʻawi ʻia ka lāʻau lapaʻau ma hope o ke ʻoki ʻana. Hana ʻia kēia e pepehi i nā hunaola kanesa e waiho ʻia ana i loko o ke kino ma hope o ke ʻoki ʻana a pale i ka hoʻi hou ʻana mai o ke kanesa. (E like me ka hoʻomaha ʻana ma hope o ka marathon).

ʻAʻole ʻo ka lāʻau Neoadjuvant kahi koho lapaʻau no kēlā me kēia maʻi kanesa. Eia nō naʻe, ma muli o kou kūlana, he koho maikaʻi paha ia nou. No laila, e kamaʻilio ākea e pili ana i kēia me kāu kauka. E nīnau i kāu mau nīnau a pau a e loaʻa kahi hoʻomaopopo maikaʻi i kāu huakaʻi lapaʻau.