E aʻo kākou e pili ana i ka lāʻau i hāʻawi ʻia ma mua o ke ʻoki ʻana i ka maʻi kanesa? (Neoadjuvant Therapy)

Ua haʻi aku anei kāu kauka iā ʻoe a i ʻole kekahi āu i ʻike ai e pono ke ʻoki kino no ka maʻi kanesa? Ke ʻōlelo lākou i kēlā, haʻi pū paha lākou iā ʻoe e pili ana i ka 'lāʻau lapaʻau ma mua o ke ʻoki kino'. Ua kapa ʻia kēia ma ke ʻano lapaʻau ʻo Neoadjuvant Therapy . Ke lohe lākou i kēia inoa, nui ka poʻe e hopohopo iki, me ka noʻonoʻo ʻana, "E hana ʻia ana au i ke ʻoki kino, no laila pono anei au e loaʻa ka lāʻau lapaʻau ma mua o kēlā?" Akā, he mea kēia e hiki ke kōkua nui iā ʻoe a lawe mai i ka manaʻolana iā ʻoe. E kamaʻilio maʻalahi kākou e pili ana i kēia, e wehe ana i nā makaʻu a me nā kānalua āu e pili ana i ia mea.

He aha ka lāʻau lapaʻau neoadjuvant?

I ka ʻōlelo maʻalahi, ʻo ka Neoadjuvant Therapy kahi ʻano lapaʻau e hiki ai i kahi puʻupuʻu ke emi, ʻo ia hoʻi, e liʻiliʻi, ma mua o ke ʻoki ʻana e wehe ai. E noʻonoʻo e pili ana, aia kekahi mea paʻakikī ke wehe, e like me ka pōhaku nui. He maʻalahi ke kuʻi, kuʻi, a wehe, ʻeā? Pēlā nō kēia. Inā nui ka puʻupuʻu, he mea paʻakikī paha i ke kauka ʻoki ke wehe loa. Akā i ka wā e hoʻemi ʻia ai ka puʻupuʻu me kēia mau lāʻau lapaʻau, e maʻalahi a holomua ka ʻoki ʻana.

I kekahi manawa, ua holomua loa kēia mau lāʻau lapaʻau a nalowale loa ka puʻupuʻu a ʻaʻole pono ke ʻoki kino. Hiki i kāu kauka ke kapa i kēia he "perioperative therapy" a i ʻole "induction therapy." He like kēia mau mea a pau.

He aha kēia mau lāʻau lapaʻau?

Hoʻohana kēia ʻano lapaʻau `neoadjuvant` i nā mea like ʻole. Na kāu kauka e hoʻoholo i ka mea maikaʻi loa iā ʻoe ma muli o ke ʻano a me ke ʻano o kou maʻi ʻaʻai. E nānā kākou i nā ʻano hana nui.

I kekahi manawa, hiki i kāu hui ke hoʻohui i kēia mau lāʻau ʻelua. No ka laʻana, hāʻawi pū ʻia ka chemotherapy a me ka radiation therapy (neoadjuvant chemoradiation). Hiki i kēia lāʻau ke mau mai kekahi mau pule a i kekahi mau mahina, a i ʻole hoʻokahi makahiki. Hana pinepine ʻia ke ʻoki ʻana i loko o hoʻokahi mahina o ka hoʻopau ʻana i ka lāʻau.

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

Hoʻohana nā Oncologists i kēia lāʻau lapaʻau no nā ʻano maʻi kanesa he ʻumikūmālua, me:

• Ka Maʻi ʻUma: No kekahi ʻano maʻi ʻuma, hāʻawi ʻia ka chemotherapy, hormone, a i ʻole immunotherapy ma mua o ke ʻoki ʻana.
• Ka Maʻi ʻAʻai Kolon: Inā ua hoʻopili ʻia ke kanesa i ke akepaʻa, hiki ke hāʻawi ʻia ka chemotherapy ma mua o ke ʻoki ʻana.
• Ka Maʻi ʻAʻai Mama: Hāʻawi pinepine ʻia ka chemotherapy no kekahi ʻano maʻi ʻaʻai mama i pālahalaha.
• Ka Maʻi ʻAʻai Prostate: Hoʻoulu ʻia kēia maʻi ʻaʻai e ka hormone kāne testosterone. Hoʻomalu ʻia me ka lāʻau lapaʻau hormone.
• Kanesa ʻAʻai Rectal: He mea maʻamau nō hoʻi ka hāʻawi pū ʻia ʻana o kēia mau mea me ka radiation therapy a me ka chemotherapy.

He aha nā pōmaikaʻi o kēia ʻano lapaʻau?

Nui nā pono o kēia. ʻO ka ʻike ʻana i kēia mau mea e kōkua iā ʻoe e lanakila ma luna o kou makaʻu i kēia lāʻau lapaʻau.

• Nā puʻupuʻu liʻiliʻi: E like me kā mākou i kūkākūkā ai ma mua, lilo nā puʻupuʻu nui i liʻiliʻi , e maʻalahi ai ke ʻoki ʻana. No ka laʻana, inā liʻiliʻi kahi puʻupuʻu i kahi hihia maʻi ʻaʻai umauma, ma kahi o ka mastectomy, kahi e wehe ai i ka umauma holoʻokoʻa, hiki ke hana ʻia kahi ʻoki liʻiliʻi i kapa ʻia he lumpectomy, kahi e wehe ai i ka puʻupuʻu wale nō.
• Nalowale loa kekahi mau puʻupuʻu: I kekahi manawa e nalowale loa paha nā puʻupuʻu liʻiliʻi a ʻaʻole pono paha ke ʻoki ʻana.
• Hoʻemi ʻia ka manawa ho'ōla:Ke liʻiliʻi ke ʻoki ʻana, ʻoi aku ka liʻiliʻi o nā ʻoki ma kou kino. No laila hiki iā ʻoe ke hoʻōla koke a hoʻi i kou ola maʻamau.
• Hiki ke ana ʻia ka holomua o ka lāʻau lapaʻau: I ka wā e mālama ai ma mua o ke ʻoki kino, hiki i nā kauka ke ʻike pehea e pane ai ke kanesa i ka lāʻau lapaʻau a me ka wikiwiki o ka emi ʻana o ka puʻupuʻu. ʻAe kēia iā lākou e hana i nā hoʻoholo maikaʻi aʻe e pili ana i ka lāʻau lapaʻau e hiki mai ana.
• Ke pepehi ʻana i nā hunaola kanesa: I kekahi manawa, ʻike ʻole ʻia nā hunaola kanesa liʻiliʻi e hemo ana mai ka puʻupuʻu nui, a ʻaʻole hiki ke ʻike ʻia e nā scans, a hiki ke hele i nā ʻāpana ʻē aʻe o ke kino (micrometastases). Ua pepehi ʻia kēia mau hunaola e nā lāʻau lapaʻau e like me ka chemotherapy, ka mea e hoʻopilikia ai i ke kino holoʻokoʻa.
• Hoʻemi ʻia ka pilikia o ka hoʻi hou ʻana o ke kanesa: Ua ʻike kekahi mau noiʻi e hōʻemi ana ka mālama ʻana i ka neoadjuvant i ka pilikia o ka hoʻi hou ʻana o ke kanesa ma hope o kona hoʻōla ʻia ʻana.

ʻAʻohe hopena ʻaoʻao?

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

• Makemake nui
• Ka maʻi pākī
• Luhi
• Ka nalowale o ka ʻono ma ke alelo (ageusia)
• Ka luaʻi a me ka luaʻi

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

Ua lohe paha ʻoe i ka 'Adjuvant Therapy'. He mau lāʻau lapaʻau ʻelua i hāʻawi ʻia ma ke ʻano he kākoʻo no ke ʻoki ʻana i ka maʻi kanesa. ʻO ka ʻokoʻa ma ka manawa o ka lāʻau lapaʻau.

Inā ʻoe e noʻonoʻo i kēia e like me ka marathon, ʻo ka `Neoadjuvant therapy` ua like ia me ka `hoʻomehana` ma mua o ka heihei. Hoʻomākaukau maikaʻi ia iā ʻoe no ka heihei. ʻO ka `Adjuvant therapy` ua like ia me ka `hoʻoluʻolu` ma hope o ka heihei, hoʻopau ia i nā pilikia i koe a hoʻōla piha iā ʻoe.