He aha kou manaʻo inā ʻike ʻoe i kahi ʻulaʻula liʻiliʻi a i ʻole ka ʻili e ʻili ana ma kou nipple? I ka hapa nui o ka manawa, manaʻo ʻoe he maʻi ʻili maʻamau wale nō ia, malia paha he mea e like me ka eczema. ʻOiaʻiʻo, hiki ke like ia ma ka hapa nui o nā hihia. Eia naʻe, he mea kakaikahi loa, ʻo kahi māka liʻiliʻi e like me kēia ke hōʻailona mua o ka maʻi ʻaʻai umauma. ʻO ia kekahi o kēlā mau ʻano maʻi ʻaʻai kakaikahi, akā koʻikoʻi a mākou e kamaʻilio ai i kēia lā.
I ka ʻōlelo maʻalahi, he aha ka maʻi o Paget o ka umauma?
ʻO ka maʻi ʻo Paget o ka umauma he ʻano maʻi ʻaʻai laha ʻole ia e kū mai ana ma ka ʻili o kou nipple, a i kekahi manawa ma ka ʻili ʻeleʻele a puni ka nipple (areola). I kekahi manawa hiki ke kaupalena ʻia i ka nipple. Ua kapa ʻia kēia he maʻi ʻaʻai umauma pae 0, a i ʻole ductal carcinoma in situ . Akā i kekahi manawa, me kēia loli ʻili, hiki nō hoʻi ke loaʻa ka maʻi ʻaʻai umauma invasive i pālahalaha i nā ducts waiū i loko o ka umauma.
Ma muli o ke ʻano like o nā hōʻailona me ka eczema, nui ka poʻe i kuhihewa mua he maʻi ʻili maʻamau. ʻO nā hōʻailona e komo pū me ka maneʻo, ka ʻili ʻana, ka ʻulaʻula, a i kekahi manawa he kahe mai ka nipple. E hoʻomanaʻo, ʻaʻole nā kānaka a pau i loaʻa i kēia mau hōʻailona he maʻi Paget. Eia nō naʻe, inā loaʻa iā ʻoe kēia maʻi, ʻo ia paha ka hōʻailona mua o ka maʻi kanesa e ulu ana i loko o ka umauma.
ʻO wai ka mea i loaʻa pinepine i kēia maʻi?
ʻO ka maʻi ʻo Paget o ka umauma ka mea maʻamau i nā wahine. Eia nō naʻe, ua hōʻike ʻia i nā kāne pū kekahi. ʻO ka awelika o ka makahiki o ka ʻike ʻia ʻana ma kahi o 57 mau makahiki. Eia nō naʻe, hiki ke loaʻa i nā poʻe ʻōpio a ʻoi aku ka nui ma mua o kēlā. He mea kākaʻikahi loa ia a emi iho ma mua o 4% o nā maʻi ʻaʻai umauma āpau i hōʻike ʻia. No laila, ʻoiai he maʻi kākaʻikahi loa ia, he mea nui e makaʻala iā ia.
Pehea ka wikiwiki o ka laha ʻana o kēia maʻi? Pehea ka nui o kona koʻikoʻi?
Aia nō ia i ka loaʻa ʻana o kekahi maʻi kanesa ʻē aʻe i loko o kou umauma, a inā pēlā, i ke kahua hea ia.
- Inā ua kaupalena ʻia ke kanesa i nā ʻauwai waiū: Inā ua kaupalena ʻia kou kanesa i nā ʻauwai waiū a ʻaʻole i laha i nā ʻiʻo umauma a puni, kapa mākou ia he "ductal carcinoma in situ" (DCIS) . Ua manaʻo ʻia kēia he kanesa pae 0. Hoʻōla ʻia kēia ʻano kanesa ma ka wehe ʻana i nā hunaola kanesa a me ka nipple me ke ʻoki ʻana, a ukali ʻia e ka radiation therapy. Inā ʻike ʻia ka maʻi i kēia pae, kiʻekiʻe loa ka manawa e ho'ōla piha ʻia ai.
- Inā ua pālahalaha ke kanesa ma waho o nā ʻauwai waiū: Ke hoʻomaka ke kanesa i loko o nā ʻauwai waiū e pālahalaha i loko o nā ʻiʻo umauma a puni, ua kapa ʻia ʻo "invasive ductal carcinoma." Hoʻomohala kēia kanesa i kekahi mau pae. I nā pae mua, hiki ke mālama ʻia ma ka wehe ʻana i nā ʻiʻo umauma i hoʻopilikia ʻia a me nā axillary lymph nodes. Eia nō naʻe, i ka wā e hoʻomaka ai ke kanesa e pālahalaha ma waho o ka umauma, ʻo ia hoʻi, i nā pae hope, lilo ka maʻi i ʻoi aku ka koʻikoʻi a paʻakikī hoʻi e mālama.
He aha nā hōʻailona o ka maʻi o Paget?
ʻIke pinepine ʻia kēia mau hōʻailona ma kou nipple a/a i ʻole ka ʻili ʻeleʻele a puni ia (areola). ʻO ka hapa nui, ʻike ʻia kēia mau hōʻailona ma hoʻokahi umauma wale nō, akā he mea kākaʻikahi loa, hiki ke loaʻa i nā umauma ʻelua. ʻOiai ke ʻano o kēia mau hōʻailona e hele mai a hele aku i ka wā mua, e lilo lākou i mea ʻino i ka hala ʻana o ka manawa.
| Hōʻailona | Wehewehena |
|---|---|
| Ka ʻūhū a me ka mumū | Hiki ke ulu aʻe kahi nipple maneʻo, a ma hope aku e lilo ia i mumū. |
| Ka maloʻo ʻana a me ka ʻili ʻana o ka ʻili | E ʻike paha ʻoe i ka maloʻo a me ka ʻili ʻana o ka ʻili ma luna a puni paha o ka nipple. |
| ʻŌhū ʻili | Hiki ke ʻulaʻula ka ʻili, pehu, ʻiliʻili, ʻeha, a kahe paha ke koko. |
| Ka mumū a me ka ʻeha | E pehu a ʻeha paha ka ʻili. |
| ʻO kahi kūlana e like me ka eczema | Ua like ia me ka eczema e uē ana, me nā ʻili e hana ana a me kahi wai e kahe ana i waho. |
| Hoʻokuʻu ʻia ʻana o ka nipple | Hiki ke puka mai kahi kahe koko a i ʻole he pus mai loko mai o ka nipple. |
| Nā loli o ka nipple | Hiki ke pālahalaha a hoʻohuli ʻia paha ka nipple (inverted nipple). |
| He puʻu ma ka umauma | Hiki paha iā ʻoe ke manaʻo i kahi puʻupuʻu a i ʻole ka ʻōpū ma lalo o ka ʻili. |
He aha ke kumu maoli o kēia?
He mea pohihihi nō i nā kānaka ʻepekema ke kumu maoli o ke kanesa. Akā, ke hana mau ʻia nei nā noiʻi hou e wehe i nā ʻoiaʻiʻo hou. ʻO ka mea a mākou e ʻike ai, ʻo ia ka loaʻa ʻana o ke kanesa i ka wā e lilo ai kekahi o nā ʻāpana o ko mākou kino i mea ʻē, e māhelehele ana a e ulu ana me ke kāohi ʻole ʻia. I kēia manawa, ua manaʻoʻiʻo ʻia e hoʻomaka paha kēia mau loli o ke kelepona me nā loli i loko o kā mākou code genetic, a i ʻole DNA . Akā, ʻaʻohe pane maopopo i ke kumu o kēia mau loli.
Ua ʻike nā kānaka ʻepekema aia kekahi mau "kumu pilikia" e hoʻonui ai i ka pilikia o ka loaʻa ʻana o ka maʻi kanesa. No ka laʻana, ʻo ka ʻike ʻana i kekahi mau mea ʻawahia o ke kaiapuni, ka puhipaka, a me ka inu ʻona nui e hoʻonui ai i ka pilikia o ka maʻi kanesa. Akā, he mea kupanaha, 85% o nā maʻi kanesa o ka umauma e loaʻa ana i nā poʻe ʻaʻohe o lākou mau kumu pilikia nui.
Pehea e ʻike ai i kēia maʻi? (Diagnosis)
Ke hele ʻoe e ʻike i ke kauka me nā hōʻailona e like me kēia, manaʻo paha ʻo ia i ka wā mua he eczema wale nō ia. No laila e mālama ʻo ia ia mea. Akā inā ʻaʻole kōkua kēlā mau lāʻau lapaʻau, a i ʻole ke kānalua ʻia ka maʻi o Paget, pono ʻo ia e hana i kekahi mau hoʻokolohua e ʻike pololei i ka maʻi.
ʻO ka hana mua a koʻikoʻi loa, ʻo ia ke lawe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka ʻili o ka nipple a nānā iā ia ma lalo o kahi microscope (biopsy). ʻO ke ʻano maʻamau i hoʻohana ʻia no kēia he "punch biopsy." ʻO ke ʻano kēia, ua lawe ʻia kahi ʻāpana ʻili poepoe liʻiliʻi a nānā ʻia me kahi mea hana liʻiliʻi, e like me ka punch pepa. ʻO kēia ke ala maʻalahi loa e ʻike ai i nā hunaola kanesa e pili ana i ka maʻi o Paget.
Ke hōʻoia ʻia ka maʻi ʻo Paget, ʻo ka hana aʻe e ʻike ai inā he maʻi ʻē aʻe i loko o ka umauma a, inā pēlā, pehea ka mamao o kona laha ʻana. Na kāu kauka e hana i kēia.Hiki ke kuhikuhi ʻia ʻoe no nā hoʻokolohua kiʻi, e like me ka mammogram a i ʻole ka ultrasound umauma. Inā loaʻa i kēia mau hoʻokolohua kahi wahi kānalua no ka maʻi kanesa, hiki ke ʻōlelo ʻia kahi "biopsy nila" , kahi e wehe ʻia ai kahi ʻāpana liʻiliʻi o ka ʻiʻo me kahi nila a nānā ʻia.
He aha nā lāʻau lapaʻau?
ʻO ka lāʻau lapaʻau e komo pū ana me ke ʻoki kino a me kekahi manawa nā lāʻau lapaʻau maʻi kanesa hou aʻe (nā lāʻau lapaʻau adjuvant).
1. ʻO ke ʻoki ʻana i ka maʻi ʻaʻai umauma
Pono e wehe ʻia kekahi maʻi kanesa i loko o kou umauma ma ke ʻoki ʻana, akā ʻo ka nui o ka ʻiʻo i wehe ʻia e pili ana i kou kūlana.
- ʻO ke ʻoki ʻana i ka umauma: Inā loaʻa iā ʻoe ka maʻi Paget o ka nipple wale nō a ʻaʻohe puʻupuʻu ʻē aʻe, e hoʻāʻo kāu kauka ʻoki e wehe wale i ka ʻiʻo i hoʻopilikia ʻia. Pili kēia i ka wehe ʻana i kou nipple, ka ʻili a puni ia (areola), a me kahi liʻiliʻi o nā ʻiʻo olakino a puni ia.
- Mastectomy: Inā ua pālahalaha ke kanesa i kahi ʻāpana nui, hiki i kāu kauka lapaʻau ke ʻōlelo aku e wehe i ka umauma holoʻokoʻa (mastectomy). Ma hope o ke ʻoki ʻana, hiki iā ʻoe ke hana i ke ʻoki hana hou ʻana o ka umauma inā makemake ʻoe.
2. Lapaʻau kōkua
Ma hope o ke ʻoki ʻana, hāʻawi ʻia nā lāʻau lapaʻau hou aʻe e pale aku i ka hoʻi hou ʻana mai o ke kanesa. Ua kapa ʻia kēia he adjuvant therapy.
- Lapaʻau radiation: ʻO ka hoʻohana ʻana i nā kukuna ikehu kiʻekiʻe e luku i nā hunaola kanesa i koe.
- Chemotherapy: Ke hoʻohana ʻana i nā lāʻau lapaʻau e pepehi i nā hunaola kanesa a hoʻōki paha i ko lākou ulu ʻana.
- Hoʻōla hormone: He kuleana ko nā hormones i ka ulu ʻana o kekahi mau maʻi ʻaʻai umauma. No ia mau maʻi ʻaʻai, hāʻawi ʻia nā lāʻau lapaʻau e ālai ana i ka hana o nā hormones.
- Immunotherapy: He lāʻau lapaʻau e hoʻoulu ai i ka ʻōnaehana pale o kou kino ponoʻī e hakakā i nā hunaola kanesa.
Hiki ke ho'ōla loa ʻia kēia?
ʻAe, ʻoiaʻiʻo nō. Inā hiki ke ho'ōla ʻia ka maʻi ʻaʻai umauma, hilinaʻi nui ia i ke kahua o ka maʻi i ka wā i ʻike ʻia ai.
Inā loaʻa iā ʻoe ka maʻi ʻo Paget o ka nipple wale nō, a i ʻole DCIS (kahua 0) ʻaʻole i pālahalaha ma waho o nā ala waiū, kiʻekiʻe loa kou manawa e hoʻōla ai. He nui ka poʻe i ʻike ʻia a mālama ʻia i ka wā mua i kēia mau kūlana e hoʻōla piha. ʻO ka wā wale nō e hoʻomaka ai ka laha ʻana o ka maʻi ʻaʻai umauma e lilo ia i mea paʻakikī ke lanakila. No laila, he mea nui e ʻike i nā hōʻailona a ʻike koke i ke kauka.
I ka manawa hea e pono ai iaʻu ke ʻike i ke kauka?
Inā ʻike ʻoe i kekahi mau loli i ka ʻili a i ʻole ma lalo o ka ʻili o kou mau umauma, e hōʻoia e hoʻomaopopo i kāu kauka. ʻO ka hapa nui o ka manawa, ʻaʻole paha he maʻi kanesa, akā ʻoi aku ka maikaʻi o ka nānā ʻana.
ʻOi aku hoʻi, inā loaʻa iā ʻoe nā hōʻailona o ka eczema ma kou mau nipples a puni paha, a ʻaʻole lākou e nalo ma hope o kou mālama ʻana iā lākou, e ʻike pono i ke kauka no ka hoʻāʻo hou aku. Mai hoʻowahāwahā i kahi mea liʻiliʻi.
Pehea e hiki ai iaʻu ke mālama iaʻu iho inā loaʻa iaʻu kēia maʻi?
ʻO ke ala maikaʻi loa e mālama ai iā ʻoe iho, ʻo ia ka hoʻomaka ʻana i ka lāʻau lapaʻau i ka wā hikiwawe loa. Akā, pono nō hoʻi ʻoe i ke kākoʻo noʻonoʻo he nui.
- E loaʻa i kekahi e kākoʻo iā ʻoe: e kamaʻilio me ʻoe, e kaʻana like i kou mau manaʻo, e hele pū me ʻoe i ke kauka, a e kōkua i nā hana o ka home me kekahi āu e hilinaʻi ai (kāne, ʻohana, hoaaloha).
- E kākau i kāu mau nīnau: Ma mua o kou hele ʻana e ʻike i ke kauka, e kākau i nā nīnau a pau āu e makemake ai e ʻike ma kahi ʻāpana pepa.
- E kākau i nā memo: E kākau i nā memo o ka ʻōlelo a ke kauka. Inā ʻoe e noi i kāu hoa e hana like, hiki iā ʻoe ke hāʻawi i ke kauka i kou manaʻo piha. Hiki iā ʻolua ke nānā hou i ka ʻike ma hope.
Leka Lawe-Home
- ʻO ka maneʻo, ʻulaʻula, a i ʻole ka ʻili ʻana o ka ʻili ma luna a puni paha o kou nipple e like me ka eczema a ʻaʻole e ho'ōla ʻia, he hōʻailona paha ia o ka maʻi Paget o ka umauma.
- He ʻano kakaikahi loa kēia o ka maʻi ʻaʻai umauma, a hiki ke kaupalena ʻia i ka nipple a i ʻole e pili pū me ka maʻi ʻaʻai i loko o ka umauma.
- Mai hoʻowahāwahā i nā loli o ka ʻili ma kou mau nipples, ʻoiai inā ʻaʻole lākou e hoʻomaikaʻi me ka mālama ʻia. E ʻike koke i kāu kauka.
- Ua hōʻoia ʻia ka maʻi ma ka nānā ʻana i kahi ʻāpana liʻiliʻi o ka ʻili (biopsy).
- Inā ʻike ʻia kēia maʻi i kona wā mua, kiʻekiʻe loa ka hiki ke ho'ōla piha ʻia ma o ke ʻoki ʻana a me nā lāʻau lapaʻau ʻē aʻe.
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