Ka maʻi ʻaʻai māmā? E aʻo kākou e pili ana i ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi (NSCLC)!

Ke ʻike nei ʻoe i ka pōkole o ka hanu a i ʻole ka ʻū mau? Malia paha ua lohe kekahi o kou ʻohana i ka maʻi kanesa māmā. I kēia lā e kamaʻilio mākou e pili ana i kekahi o nā ʻano maʻamau o ka maʻi kanesa māmā. ʻOiai he kumuhana paʻakikī kēia, e kamaʻilio maʻalahi mākou e pili ana iā ia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha ka maʻi ʻaʻai māmā ʻaʻole liʻiliʻi (NSCLC)?

I ka ʻōlelo maʻalahi, ʻo ka Non-Small Cell Lung Cancer (NSCLC) ka wā e hoʻomaka ai nā cell i loko o kou mau māmā e māhele a ulu me ke ʻano ʻē a me ke kāohi ʻole ʻia. E like me ka nāhelehele, hoʻāʻo kēia mau cell e pālahalaha i nā wahi āpau me ke kāohi ʻole ʻia. ʻElua ʻano nui o ka maʻi kanesa māmā. ʻO kekahi ua kapa ʻia ʻo NSCLC. ʻO kekahi ua kapa ʻia ʻo Small Cell Lung Cancer (SCLC) . Hoʻokumu ʻia kēia mau inoa ʻelua ma ke ʻano o kēia mau cell kanesa ma lalo o kahi microscope. He liʻiliʻi, poepoe, a ʻano like me ka pōpō nā cell i loko o SCLC. ʻOi aku ka nui o nā cell i loko o NSCLC.

ʻOi aku ka ikaika o ka SCLC ma mua o ka NSCLC, ʻo ia hoʻi ka laha wikiwiki. Eia nō naʻe, ʻoiai ʻoi aku ka nui o nā cell NSCLC, lohi pinepine lākou e ulu. ʻO ka pilikia ma ʻaneʻi, hiki i ka NSCLC ke lilo i asymptomatic i kona mau pae mua . No laila, i ka manawa e ʻike ʻia ai, ua laha mua paha ke kanesa (metastasized) i nā ʻāpana ʻē aʻe o ke kino. ʻO ia ke kumu he mea nui loa ka ʻike ʻana a me ka mālama ʻana iā ia i ka wā mua . ʻO ka ʻoiaʻiʻo, 80% a 85% o nā maʻi kanesa māmā he NSCLC.

Aia kekahi mau ʻano o ka NSCLC?

ʻAe, aia kekahi mau ʻano nui o NSCLC. Hoʻomaopopo nā kauka i kēia mau mea ma ka nānā ʻana i nā hunaola kanesa ma lalo o kahi microscope a ma muli o ko lākou helehelena. Ke kamaʻilio nui nei mākou e pili ana i ʻekolu mau ʻano:

• Adenocarcinoma: ʻO kēia ke ʻano maʻamau o NSCLC. Hoʻomohala pinepine ia ma nā ʻāpana o waho o nā māmā.
• ʻO ka maʻi kanesa nui: ʻIke ʻia kēia ʻano maʻi kanesa ʻoi aku ka nui ma mua o nā ʻano ʻē aʻe ke nānā ʻia ma lalo o ka microscope. Hiki iā ia ke ulu ma nā wahi āpau o nā māmā.
• ʻO ka maʻi kanesa cell squamous: Hoʻomaka kēia ma waenakonu o nā māmā, kokoke i nā ala ea nui a mākou e hanu ai.

Ma waho aʻe o kēia mau ʻano nui ʻekolu, aia kekahi mau ʻano kakaikahi e like me ka sarcomatoid carcinoma a me ka adenosquamous carcinoma , akā ʻaʻole ʻike pinepine ʻia.

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He aha nā hōʻailona o kēia?

ʻAe, i kēia manawa ke noʻonoʻo nei paha ʻoe i nā hōʻailona a NSCLC e hoʻokumu ai. E like me ka mea i ʻōlelo ʻia ma mua, i kekahi manawa ʻaʻohe hōʻailona iki, ʻo ia ka ʻāpana weliweli loa. Akā aia kekahi mau hōʻailona maʻamau. Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau mea, mai hopohopo, akā he manaʻo maikaʻi ke ʻike i ke kauka.

• ʻEha umauma: Me he mea lā e ʻūmi ana kekahi i kou umauma, a i ʻole he ʻeha e ʻoi aku ka ʻino ke hanu ʻoe, ʻakaʻaka, a ʻūlū paha.
• ʻŪhū mau: He ʻūhū e mau ana no nā pule, i kekahi manawa e ʻoi aku ka ʻino, me ka ʻole o ke anu.
• ʻUha koko: He hōʻailona weliweli kēia. Inā ʻuha ʻoe i ke koko a i ʻole ka huʻa poni, pono ʻoe e ʻike i ke kauka.
• Loli/waliwali o ka leo: Inā loli koke kou leo ​​​​​​i kawaliwali a i ʻole kawaliwali, pono e nānā ʻia kēlā.
• Ka nalowale o ka makemake e ʻai a me ka pohō kaumaha: Ka nalowale o ka makemake e ʻai, me ka pohō kaumaha no ke kumu ʻole.
• Pōkole o ka hanu: Manaʻo i ka pōkole o ka hanu ʻoiai me ka hoʻoikaika iki ʻana, a i ʻole ka luhi ma mua o ka maʻamau i ka hana ʻana i nā mea e like me ke piʻi ʻana i nā alapiʻi.
• Luhi / Māluhiluhi: Manaʻo mau i ka luhi , ʻoiai ma hope o ka hiamoe maikaʻi.
• ʻŌhūhū (he leo hūhū) i ka wā e hanu ana.
• Nā maʻi pinepine o ka māmā e like me ka bronchitis a i ʻole ka pneumonia.

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​mai makaʻu e manaʻo he NSCLC ia. Hiki i nā kūlana olakino ʻē aʻe ke hana i kēia mau hōʻailona. Akā inā hoʻomau kēia mau hōʻailona, ​​​​he manaʻo maikaʻi mau ke ʻike i ke kauka no ka nānā ʻana.

No ke aha e ulu ai kēia maʻi kanesa? He aha nā kumu pilikia?

ʻĀ, no ke aha e ulu ai kēia maʻi ʻaʻai NSCLC? ʻO ka ʻoiaʻiʻo, ʻaʻole hiki i nā kauka ke ʻōlelo maopopo i ke kumu e loaʻa ai i kekahi poʻe a ʻaʻole i loaʻa i kekahi. Akā ua ʻike lākou i kekahi mau mea pilikia e hiki ke hoʻopilikia iā ia. ʻO kahi mea pilikia kahi mea e hoʻonui ai i kou manawa e loaʻa ai ka maʻi.

ʻO ke kumu nui a maʻamau no ka maʻi ʻaʻai māmā, ʻo ia ka puhipaka. ʻOi aku ke kiʻekiʻe o kēia pilikia ʻaʻole wale no ka poʻe puhipaka, akā no ka poʻe hoʻohana i nā mea e like me ka bidis, cigars, a me nā hookahs. Eia kekahi, ʻo ka poʻe ʻaʻole puhipaka akā ua pili i ka uahi lua (pahu paka passive / uahi lua) ua pilikia pū kekahi.

E noʻonoʻo wale, ke puhipaka ʻoe, komo nā tausani o nā kemika ʻino i loko o kou mau māmā. Hoʻopōʻino kēia i nā hunaola māmā a hiki ke lilo i mau hunaola kanesa.

ʻO kekahi mau kumu pilikia ʻē aʻe:

• Moʻolelo ʻohana o ka maʻi kanesa māmā: Inā ua loaʻa i kou mau mākua, nā kaikaina, a i ʻole nā ​​​​lālā ʻē aʻe o ka ʻohana ka maʻi, aia paha he mana hoʻoilina.
• Ka ʻike ʻia ʻana o ka asbestos: Hiki iā ʻoe ke ʻike ʻia i kēia mai nā mea e like me nā pepa asbestos i hoʻohana ʻia e kūkulu i kekahi mau hale i ka wā ma mua, a i ʻole ke hana nei i nā ʻoihana e pili ana i ka asbestos.
• Ka ʻike ʻia ʻana i ka lepo metala a me ka mineral: ʻO ka poʻe e hana ana ma kekahi mau hale hana e pilikia paha i ka ʻike ʻia ʻana i nā mea e like me ka arsenic, chromium, a me ka nickel.
• Ka ʻike ʻia ʻana i ka radon, kahi kinoea radioactive kūlohelohe:He kinoea kēia e puka mai ana mai ka lepo mai. Ma kekahi mau wahi, hiki ke piʻi aʻe kona pae i loko o nā hale.
• Loaʻa i nā maʻi hanu mau loa e like me COPD (Maʻi Pulmonary Obstructive Chronic) a i ʻole Pulmonary Fibrosis.
• Inā ua loaʻa iā ʻoe ka radiation therapy i kou umauma a i ʻole ka umauma no kekahi maʻi ʻē aʻe, e like me ke kanesa o ka umauma.
• Hiki i ka noho ʻana i kahi ʻano me nā pae kiʻekiʻe o ka haumia o ka ea ke loaʻa kekahi hopena.

ʻAʻole nā ​​kānaka a pau i loaʻa i kēia mau mea e loaʻa i ka maʻi kanesa. Akā, he mea nui e ʻike e hoʻonui kēia mau mea i kou pilikia. ʻO ka pale ʻana i ka puhipaka ke ala maikaʻi loa e hōʻemi ai i kou pilikia o ka maʻi kanesa māmā.

He aha nā pilikia e hiki ke loaʻa mai ka NSCLC?

ʻO kekahi o nā mea weliweli loa e pili ana i kahi maʻi kanesa e like me NSCLC, ʻo ia ka hiki ke laha (metastasize) i nā ʻāpana ʻē aʻe o ke kino. Ke laha, lilo ke kūlana i mea paʻakikī loa. Eia kekahi o nā wahi maʻamau e hiki ai i ka NSCLC ke laha:

• ʻO nā kelepa adrenal (he mau kelepa liʻiliʻi kēia e kū ana ma luna o nā puʻupaʻa)
• Nā iwi
• lolo
• Ake
• Nā puka lymph (e like me nā puʻupuʻu)
• ʻIli

Ke laha ia ma kēia ʻano, hiki ke ʻike ʻia nā hōʻailona ma nā ʻōkana like ʻole. No ka laʻana, inā laha ia i nā iwi, hiki iā ia ke hōʻeha nui i ka iwi, a inā laha ia i ka lolo, hiki iā ia ke hōʻeha i ke poʻo a me nā hopu ʻana.

Pehea e ʻike ai nā kauka i kēia?

ʻAe, i kēia manawa ua loaʻa iā ʻoe nā hōʻailona. Pehea ʻoe e ʻike pono ai inā he NSCLC ia ke hele ʻoe i ke kauka?

ʻO ka mea mua, e nīnau ke kauka iā ʻoe e pili ana i kou mau hōʻailona, ​​​​ka mōʻaukala ʻohana, a me kāu mau hana (e like me ka puhipaka). A laila e hana ʻo ia i kahi hoʻokolokolo kino a hoʻolohe i kou mau māmā.

A laila, inā he kānalua no NSCLC, e kauoha lākou i kekahi mau hoʻokolohua e hōʻoia iā ia a ʻike i ke kahua o ke kanesa.

ʻO nā hoʻokolohua maʻamau:

• ʻO ka biopsy māmā: Pili kēia i ka lawe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai kahi wahi kānalua o ka māmā a nānā iā ia ma lalo o kahi microscope. Hiki i kēia ke haʻi pololei inā he mau hunaola kanesa a me ke ʻano o lākou. Aia nā ʻano like ʻole e lawe ai i kahi biopsy. Hiki ke hana ʻia i ka wā o ka bronchoscopy, a i ʻole ma ke kau ʻana i kahi nila lahilahi ma o ka umauma (biopsy nila).
• Bronchoscopy: Ma kēia, ua hoʻokomo ʻia kahi ʻōmole liʻiliʻi me ke kāmela ma ka waha a i ʻole ka ihu, i lalo o ka ʻōpū hanu, a i loko o nā māmā. ʻAe kēia i ke kauka e ʻike i loko o nā māmā a, inā pono, e lawe i kahi hāpana (biopsy).
• Nā hoʻāʻo kiʻi:Lawe kēia i nā kiʻi o loko o ke kino a nānā i nā mea e like me kahi o ke kanesa, kona nui, a inā ua pālahalaha.
• X-ray o ka umauma: He hoʻāʻo maʻamau kēia.
• CT scan: Hiki i kēia ke lawe i nā kiʻi ʻoi aku ka maopopo, ʻoi aku ka ʻoki ʻana ma mua o kahi X-ray.
• PET scan: Kōkua kēia i ka ʻike ʻana i nā wahi e hana nei nā hunaola kanesa.
• ʻO ke kiʻi MRI o ka lolo: Hoʻohana ʻia kēia e ʻike inā ua pālahalaha ke kanesa i ka lolo.
• ʻO ke ʻoki kino umauma me ke kōkua wikiō (VATS): He ʻoki kino liʻiliʻi nō hoʻi kēia e nānā ai i loko o ka umauma. Hoʻokomo ʻia kahi kāmela a me nā mea hana ma o kekahi mau ʻoki liʻiliʻi e nānā ai a, inā pono, e lawe i kahi biopsy.

Ma muli o ka ʻike i loaʻa mai kēia mau hoʻokolohua, hoʻoholo ke kauka inā he NSCLC kou, inā pēlā, pehea ka mamao o kona laha ʻana (staging), a me ke ʻano o ka lāʻau kūpono.

He aha nā lāʻau lapaʻau?

Makaʻu ka poʻe he nui ke lohe lākou i ka huaʻōlelo kanesa, a he mea maʻamau kēlā. Akā i kēia manawa aia nā lāʻau lapaʻau holomua loa no NSCLC. ʻO ke ʻano o ka lāʻau lapaʻau āu e loaʻa ai ma muli o nā kumu he nui, me ke ʻano o ke kanesa, kona pae, inā he mau loli genetic i loko o nā hunaola kanesa, a me kou olakino holoʻokoʻa.

• ʻO ke ʻoki kino: Inā ua kaupalena ʻia ke kanesa i nā māmā, ʻo ia hoʻi, ʻaʻole i laha i nā wahi ʻē aʻe (i nā pae mua), ʻo ke ʻoki kino ke koho mua. Pili kēia i ka wehe ʻana i ke kanesa a me kahi liʻiliʻi o nā ʻiʻo olakino a puni. I kekahi manawa, ma muli o ka mamao o ka laha ʻana o ke kanesa, pono paha kahi ʻāpana o ka māmā (lobectomy) a i ʻole ka māmā holoʻokoʻa (lung resection / pneumonectomy) .

E noʻonoʻo, aia kahi nāhelehele i loko o kahi māla. Ua like kēia ʻoki kino me ka huki mua ʻana iā ia. Akā, ʻaʻole hiki i nā kānaka a pau ke hana i ke ʻoki kino, pono ʻoe e mākaukau no ia.

• Kemoterapia: Ua lohe paha ʻoe i kēia. Pili kēia i ka hāʻawi ʻana i ke kino i nā lāʻau lapaʻau e pepehi ai i nā hunaola kanesa. Hiki ke hāʻawi ʻia kēia mau lāʻau lapaʻau ma ke ʻano he inikini a i ʻole he mau pila. ʻO kēia ka lāʻau lapaʻau maʻamau no NSCLC. Hiki ke hāʻawi wale ʻia ke kemoterapia, e hoʻēmi i ka puʻupuʻu ma mua o ke ʻoki ʻana, e pepehi i nā hunaola i koe ma hope o ke ʻoki ʻana, a i ʻole me ka hui pū ʻana me ka radiation therapy.

• Immunotherapy: He lāʻau lapaʻau hou kēia, akā he lāʻau lapaʻau kūpono loa. Pili ia i ka hoʻoulu ʻana i ka ʻōnaehana pale ponoʻī o kou kino e ʻike a luku i nā hunaola kanesa. Ua like ia me ke aʻo ʻana i kāu mau koa ponoʻī e hakakā i ka maʻi kanesa. ʻAʻole ia e hana no nā ʻano NSCLC āpau, a ke hana ʻia nei nā hoʻokolohua kūikawā no kēlā.

• Hoʻōla i kuhikuhi ʻia:He lāʻau lapaʻau kūikawā nō hoʻi kēia. Hoʻohana ia i nā lāʻau lapaʻau e pili ana i nā hoʻololi genetic kikoʻī a i ʻole nā ​​​​protein e kōkua i nā cell cancer e ulu a laha. ʻO ka pōmaikaʻi o kēia, ʻo ia ka mea e hōʻino iki ai i nā cell olakino ma mua o ka chemotherapy. Eia hou, pono ʻoe e hoʻāʻo i kāu mau cell cancer no kēlā mau hoʻololi kikoʻī.

• Lapaʻau radiation: Hoʻohana kēia i nā kukuna X-ikehu kiʻekiʻe e pepehi i nā hunaola kanesa. Kuhikuhi ʻia kēia mau kukuna i kahi kikoʻī o ke kanesa. Hiki ke hāʻawi ʻia kēia me ka chemotherapy, hoʻokahi wale nō, a i ʻole ma mua a ma hope paha o ke ʻoki ʻana. I kekahi manawa, hoʻohana ʻia kēia lāʻau lapaʻau e hōʻemi i ka ʻeha.

I ka manawa pinepine, no ka mea, ʻaʻole hiki ke ʻike mua ʻia ka NSCLC, e hoʻohana pū nā kauka i hoʻokahi a ʻoi aku paha o kēia mau lāʻau lapaʻau (hui pū ʻia). Na kāu kauka maʻi ʻōpū e hoʻomohala i ka hoʻolālā lapaʻau kūpono loa iā ʻoe.

ʻEhia ka lōʻihi e ho'ōla ai?

ʻOkoʻa ka manawa hoʻōla ma hope o ka mālama ʻana i ka NSCLC mai kēlā kanaka a i kēia kanaka. Aia ia i nā kumu he nui, me ka nui o ke kanesa, kahi i loaʻa ai, ke ʻano o ka mālama ʻana āu i loaʻa ai (e like me ke ʻoki kino, chemotherapy, radiation), a me ka hiki o kou kino ke ho'ōla. Hiki i kekahi poʻe ke ho'ōla i loko o kekahi mau mahina. Hiki i kekahi ke hala i nā makahiki, a pono paha e loaʻa nā hahai ʻana. No laila, ʻoi aku ka maikaʻi o ka nīnau ʻana i kāu kauka i ka lōʻihi o ka manawa a me ka mea e manaʻo ai ma muli o kou kūlana.

Āhea ʻoe e ʻike ai i ke kauka?

Inā ʻoe e mālama ʻia nei no ka NSCLC, a i ʻole ua pau wale ka mālama ʻana, aia kekahi mau manawa e pono ai ʻoe e ʻike koke i ke kauka. E makaʻala i kēia mau mea:

• ʻAʻole pilikia inā loaʻa iā ʻoe ka hanu pōkole hou a inā paha e ʻoi aku ka ʻino o kou hanu pōkole o kēia manawa.
• Inā loaʻa iā ʻoe ke kuni ma luna o 100.4 degere Fahrenheit (38 degere Celsius), ʻoiai ʻoiai e loaʻa ana ka chemotherapy.
• Inā loaʻa iā ʻoe ka ʻeha nui (e.g., ma ka umauma, nā iwi) ʻaʻole ia e emi iho ʻoiai ke lawe nei i ka lāʻau lapaʻau.
• Inā ʻike ʻia nā hōʻailona hou (e laʻa me ka paʻakikī o ka ʻōlelo ʻana, ka nalowale o ka ʻike, ka ʻeha poʻo nui), a inā paha e koʻikoʻi nā hōʻailona e kū nei,
• Inā loaʻa iā ʻoe ka luaʻi mau a i ʻole ka diarrhea.

I loko o ia kūlana, e hoʻomaopopo koke i kāu kauka maʻi kanesa a i ʻole kāna hui. Inā ʻaʻole, e hele i ka ʻoihana pilikia o ka haukapila kokoke loa.

Pehea lā ke ʻano o ke ola me kēia kūlana?

Ke noʻonoʻo nei paha ʻoe, "Pehea ke ʻano o ke ola me kēia maʻi?" ʻO ka ʻoiaʻiʻo, ʻo ka lōʻihi o ka manawa e hiki ai iā ʻoe ke ola me ka NSCLC (ka manaʻolana ola) e pili ana i nā kumu he nui, me ke kahua o ke kanesa i ka wā i ʻike ʻia ai, ke ʻano o ka NSCLC, a me kou olakino holoʻokoʻa.

Eia kekahi laʻana, NSCLC pae mua (localized)I ke ʻano o ka maʻi ʻaʻai māmā, ʻo ka nui o ke ola ʻana no ʻelima mau makahiki ma kahi o 65% . ʻO ke ʻano kēia he 65 o 100 mau kānaka i ʻike ʻia me kēia maʻi e ola mau ana ma hope o ʻelima mau makahiki.

Inā ua pālahalaha ke kanesa i nā ʻiʻo kokoke a i ʻole nā ​​​​kikowaena lymph (NSCLC kūloko) , ma kahi o 37% kēia helu. Inā ua pālahalaha ke kanesa i nā wahi mamao o ke kino (e.g., akepaʻa, lolo, iwi) (metastatic / distant NSCLC) , ʻo ka helu ola ʻelima makahiki ma kahi o 9% .

Akā e hoʻomanaʻo: He awelika wale nō kēia mau helu ola e pili ana i ka ʻikepili mai kahi hui nui o ka poʻe. ʻAʻole lākou e haʻi pololei iā ʻoe i ka lōʻihi o kou ola ʻana a pehea e pane ai kou kino i ka lāʻau lapaʻau. He ʻokoʻa ka huakaʻi a kēlā me kēia kanaka. No laila he mea nui e kamaʻilio me kāu kauka e pili ana i ka hopena o kēia mau helu iā ʻoe.

I kēia mau lā iho nei, ua hoʻomaikaʻi ʻia kēia mau helu ola ma muli o nā lāʻau lapaʻau hou (ʻoi aku ka lāʻau lapaʻau i kuhikuhi ʻia a me ka immunotherapy).

He maʻi hiki ke ho'ōla ʻia ka NSCLC, ʻoiai inā ʻike ʻia a mālama ʻia i ka wā mua. Eia nō naʻe, ʻo nā mea e like me ke ʻano o ka maʻi kanesa, kona pae, a me kou olakino holoʻokoʻa e hoʻoholo ai i ka hopena (prognosis).

ʻOiai ʻaʻole hiki ke ho'ōla ʻia ka NSCLC, i ka hapanui o nā hihia hiki ke kāohi ʻia a hiki ke hoʻēmi ʻia nā hōʻailona (hiki ke mālama ʻia). He nui ka poʻe me NSCLC e hoʻokele pono i kā lākou mau hōʻailona a ola i kahi ola maikaʻi.

ʻO ka mea nui a kākou e hoʻomanaʻo ai, ʻo ia ka

ʻO ka ʻike ʻana ua loaʻa iā ʻoe ka maʻi kanesa kekahi o nā ʻike paʻakikī loa āu e kū ai. He mea maʻamau ka makaʻu, ka hopohopo, a me ka hoʻonāukiuki. ʻOiai ke ʻano o ka Non-Small Cell Lung Cancer (NSCLC) āu e loaʻa ai, hiki i ka lāʻau lapaʻau ke kōkua i ka hōʻemi ʻana i kāu mau hōʻailona a hoʻomaikaʻi i kou ʻano ola.

E kamaʻilio me kāu kauka e pili ana i kāu mau koho, ka hoʻolālā lapaʻau, a me nā hopena ʻaoʻao. Mai makaʻu e nīnau i nā nīnau. I loko o kēia manawa kānalua, hiki ke kōkua i ke kamaʻilio ʻana me kou ʻohana, nā hoaaloha, a, inā pono, he kākāʻōlelo a mea hana kaiaulu paha.

Eia kekahi, ʻo ke komo ʻana i kahi hui kākoʻo, inā ma ka pūnaewele a i ʻole ma kou wahi, hiki ke kōkua iā ʻoe e emi iho ka noho mehameha, e aʻo mai nā ʻike o haʻi, a loaʻa ka ikaika. E hoʻomanaʻo, ʻaʻole ʻoe wale nō i loko o kēia hakakā.

ʻO ke kanesa māmā, NSCLC, ʻO ke kanesa māmā ʻaʻole liʻiliʻi, nā hōʻailona o ke kanesa, ka mālama ʻana i ke kanesa, ka puhi paka, nā maʻi hanu