ʻO ka pancreas kahi ʻāpana i loko o ko mākou kino i ʻōlelo ʻole ʻia e ka poʻe he nui, a he mea hūnā iki ia. I ka ʻōlelo maʻalahi, aia ia i loko o kou ʻōpū, ma hope o kou ʻōpū a ma mua o kou iwi kuamoʻo. Hana kēia ʻāpana liʻiliʻi i ʻelua mau mea koʻikoʻi no ko mākou kino. ʻO kekahi, ʻo ia ka hana ʻana i nā hormones e kāohi ana i nā pae kō koko. ʻO kekahi, ʻo ia ka hana ʻana i nā enzymes e kōkua i ka hoʻoheheʻe ʻana i ka meaʻai a mākou e ʻai ai. Eia naʻe, i ka wā e loli ʻole ai nā cell i loko o kēia ʻāpana a hoʻomaka e māhele wikiwiki, e hana ʻia kahi puʻupuʻu. ʻO ia ka mea a mākou e kapa nei he kanesa pancreatic.
No ke aha i paʻakikī ai ka ʻike ʻana i kēia maʻi kanesa?
ʻO ka pilikia nui me kēia maʻi, ʻaʻole ia e hōʻike i nā hōʻailona i nā pae mua . ʻOiai nā scan maʻamau, ʻaʻole ʻike ʻia kēia mau puʻupuʻu i nā pae mua. No laila, i ka manawa e ʻike ai ka hapa nui o ka poʻe ua loaʻa iā lākou kēia maʻi, ua laha mua ke kanesa (metastasized) i nā ʻōpū ʻē aʻe ma waho o ka pancreas. Eia kekahi, ua kūpaʻa kēia kanesa i nā lāʻau anti-cancer he nui, no laila hiki ke paʻakikī iki ke mālama. Akā, mai hopohopo, ke holomua nei ka ʻepekema lapaʻau i kēlā me kēia lā, no laila ke noiʻi mau ʻia nei nā ʻano lapaʻau hou.
He aha nā ʻano o ke kanesa pancreatic?
ʻElua mau ʻano nui o ke kanesa pancreatic.
1. Nā puʻupuʻu exocrine: ʻO kēia ke ʻano maʻamau. ʻOi aku ma mua o 90% o nā maʻi kanesa o kēia ʻano. ʻO ke ʻano maʻamau o kēia ʻo Adenocarcinoma . Hoʻomaka kēia i loko o nā pūnaewele e hoʻopili ana i loko o nā ducts pancreatic.
2. Nā puʻupuʻu Neuroendocrine (NETs): He mea laha ʻole kēia, ʻaʻole i hiki i ka 10% o nā hihia.
He aha nā hōʻailona o kēia maʻi?
E like me kā mākou i ʻōlelo ai ma mua, ʻaʻohe hōʻailona maopopo i nā pae mua. Hoʻomaka wale nā hōʻailona e ʻike ʻia ke ulu ka maʻi ʻaʻai a hoʻomaka e hoʻopilikia i nā ʻōpū ʻē aʻe i loko o ka ʻōnaehana hoʻoheheʻe kokoke. No laila, he mea nui loa ka makaʻala i kēia mau hōʻailona.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| Melemele o ka ʻili a me nā maka (Jaundice) | Hana ʻia kēia i ka wā e ālai ai ke kanesa i ke kahawai bile mai ka gallbladder, e hōʻiliʻili ana i kahi kemika melemele i kapa ʻia ʻo bilirubin i loko o ke kino. |
| Mimi ʻeleʻele | Lilo ka mimi i melemele ʻeleʻele a ʻeleʻele paha ma muli o ka piʻi ʻana o nā pae bilirubin i loko o ke kino. |
| Nā noho waihoʻoluʻu māmā | Ma muli o ke ālai ʻana o ke aʻa bile, ʻaʻole i hōʻiliʻili ʻia nā kemika e hāʻawi ana i ka ʻōpala i kona kala ʻeleʻele, e lilo ai ka ʻōpala i kala māmā e like me ka pālolo. |
| ʻEha o ka ʻōpū o luna a me ke kua | Hiki i ka puʻupuʻu ke hoʻonui a kaomi i nā aʻalolo a puni. Hiki ke ʻoi aku ka ʻeha ma hope o ka ʻai ʻana a i ʻole ke moe ʻana. |
| ʻO ka pohō kaumaha me ke kumu ʻole | Hiki ke emi ke kaumaha ma muli o nā loli i ka metabolism o ke kino a me ka nalowale o ka makemake e ʻai ma muli o ke kanesa. |
| ʻAnorexia a me ka nausea | Ka nalowale ʻana o ka makemake e ʻai, me he mea lā e luaʻi ana. |
| ʻIli ʻāʻī | Hiki ke hana ʻia e ka hōʻiliʻili ʻana o ka bilirubin i loko o ka ʻili. |
| Ka maʻi diabetes hou | Inā loaʻa koke i kekahi ka maʻi diabetes me ka ʻole o nā kumu pilikia ʻē aʻe, ʻoiai ma hope o 50 mau makahiki, he hōʻailona paha ia o ka maʻi ʻaʻai pancreatic. |
ʻO ka mea nui, ʻo ka loaʻa ʻana o hoʻokahi a ʻoi aku paha o kēia mau hōʻailona ʻaʻole ia he manaʻo he maʻi ʻaʻai pancreatic kou. Hiki i kēia ke lilo i mau hōʻailona o nā maʻi ʻē aʻe. Eia nō naʻe, inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, he mea naʻauao ke ʻike koke i ke kauka no ka ʻōlelo aʻo.
He aha nā mea e pilikia ai no ka maʻi ʻaʻai pancreatic?
ʻAʻole i ʻike ʻia ke kumu kikoʻī o kēia maʻi kanesa. Eia nō naʻe, ua ʻike nā kauka i kekahi mau mea pilikia e hoʻonui ai i ka pilikia o ka loaʻa ʻana o ka maʻi.
- Puhipaka: ʻO ka hoʻohana ʻana i nā cigarette, nā cigarette, a me nā huahana paka ʻē aʻe he kumu nui ia o ka pilikia.
- Momona: ʻO ke kaumaha o ke kino, ʻoiai ka hōʻiliʻili ʻana o ka momona ma ka ʻōpū, hoʻonui i ka pilikia.
- Maʻi diabetes: He mea pilikia ka loaʻa ʻana o ka maʻi diabetes (ʻoi aku ka type 2) no ka manawa lōʻihi. A e like me kā mākou i ʻōlelo ai ma mua, hiki i ka hoʻomaka koke ʻana o ka maʻi diabetes ke lilo i hōʻailona.
- ʻO ka pancreatitis mau loa: ʻO ka mumū o ka pancreas no ka manawa lōʻihi.
- Mōʻaukala ʻohana a me nā kumu hoʻoilina: ʻOi aku ke kiʻekiʻe o ka pilikia inā loaʻa kekahi o ka ʻohana (nā mākua, nā kaikaina) i ka maʻi kanesa pancreatic a i ʻole he mau hoʻololi genetic i pili i ka maʻi kanesa e like me BRCA1 a me BRCA2 .
- Ka ʻike ʻia ʻana i nā kemika: Ka ʻike lōʻihi ʻia ʻana i nā mea e like me nā pesticides a me nā kemika i hana ʻia me ka petroleum.
- Makahiki: Piʻi ka pilikia me ka makahiki.
Pehea e ʻike ai i ka maʻi? (Diagnosis)
Inā kānalua kāu kauka i ke kanesa pancreatic ma muli o kāu mau hōʻailona, e paipai lākou i kekahi mau hoʻokolohua e hōʻoia i ka maʻi.
1. Nā hoʻāʻo kiʻi
Hoʻohana ʻia kēia mau mea e kiʻi i nā kiʻi o ka pancreas a me nā ʻōkana e hoʻopuni ana i loko o ke kino e ʻike ai inā he puʻupuʻu a me ka mamao o kona laha ʻana.
- ʻO ke kiʻi CT (Computed Tomography)
- ʻO ke kiʻi MRI (Magnetic Resonance Imaging)
- ʻO ke kiʻi PET (Positron Emission Tomography)
- ʻO Endoscopic Ultrasound (EUS): He nānā kokoke ʻana i ka pancreas me ka hoʻohana ʻana i kahi kāmela a me ka scanner i hoʻopili ʻia i kahi ʻōmole lahilahi i hoʻokomo ʻia ma ka waha.
2. Nā hoʻāʻo koko
Nānā ʻia ke koko no kekahi mau protein (nā māka tumor) i hana ʻia e nā hunaola kanesa. I ke kanesa pancreatic, hiki ke kiʻekiʻe ke kiʻekiʻe o kahi māka tumor i kapa ʻia ʻo CA 19-9 .
3. Biopsy
ʻO kēia ke ala maopopo e hōʻoia ai i ka maʻi. Ma kēia kaʻina hana, lawe ʻia kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai ka puʻupuʻu pancreatic a nānā ʻia ma lalo o kahi microscope e ʻike inā he mau hunaola kanesa. Hiki ke lawe ʻia kēia laʻana ʻiʻo i ka wā o ka hoʻokolokolo EUS.
4. Hoʻāʻo ʻana i ka genetics
Inā ua ʻike ʻia ʻoe he maʻi kanesa, hiki i kāu kauka ke ʻōlelo aku i ka hoʻāʻo ʻana i ka genetic. E kōkua kēia i ka hoʻoholo ʻana inā he kumu hoʻoilina no kou maʻi kanesa a kōkua iā ʻoe e koho i ka lāʻau lapaʻau kūpono loa iā ʻoe.
Ke hoʻoholo nei i ke kahua o ka maʻi ʻaʻai (staging)
Ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau, he mea nui loa ia e hoʻoholo i ke kahua o ke kanesa. ʻO ia hoʻi inā ua kaupalena ʻia ka puʻupuʻu i ka pancreas a ua pālahalaha paha i nā kīʻaha koko kokoke a i ʻole nā ʻōpū ʻē aʻe. I ka ʻōlelo maʻalahi, ua māhele ʻia nā puʻupuʻu kanesa i 4 mau māhele nui.
| Kahua o ke kanesa | Manaʻo |
|---|---|
| Hiki ke wehe ʻia (hiki ke wehe ʻia ma ke ʻoki ʻana) | Ua paʻa ka puʻupuʻu i ka pancreas. ʻAʻole ia i pālahalaha i nā kīʻaha koko a puni. Hiki ke wehe loa ʻia me ke ʻoki ʻana. |
| Hiki ke ʻoki ʻia ka palena | Ua pili iki ka puʻupuʻu i nā kīʻaha koko e hoʻopuni ana, akā aia nō naʻe i kahi pae e hiki ai i ke kauka ʻoki akamai ke wehe. |
| Holomua kūloko | Ua pālahalaha maikaʻi ka puʻupuʻu i loko o nā kīʻaha koko nui e hoʻopuni ana. He paʻakikī a he weliweli paha ka wehe ʻana i ke ʻoki kino. |
| Metastatic | Ua pālahalaha ke kanesa i nā ʻōpū mamao aku, e like me ke akepaʻa, nā māmā, a i ʻole ka lua ʻōpū. |
He aha nā koho lapaʻau?
Hoʻoholo ʻia ke ʻano o ka mālama ʻana e ke ʻano o ka maʻi kanesa, ke kahua, kahi o ka puʻupuʻu, a me ke olakino holoʻokoʻa o ka mea maʻi.
ʻoki kino
ʻO ke ala maoli wale nō e ho'ōla loa ai i ka maʻi ʻaʻai pancreatic, ʻo ia ka wehe ʻana i ka puʻupuʻu holoʻokoʻa ma o ke ʻoki ʻana . Akā hiki ke hana ʻia kēia i nā pae mua, i ka wā e kaupalena ʻia ai ke kanesa i ka pancreas.
- Ke kaʻina hana Whipple: ʻO ke ʻoki kino nui i hana ʻia inā aia ka puʻupuʻu ma ke poʻo o ka pancreas. Ma kēia kaʻina hana, ua wehe ʻia ke poʻo o ka pancreas, kahi ʻāpana o ka ʻōpū liʻiliʻi, ka gallbladder, a me nā lymph node a puni.
- ʻO ka pancreatectomy distal: Inā aia ka puʻupuʻu ma ka huelo o ka pancreas, e wehe ʻia kēlā ʻāpana a me ka spleen.
- ʻO ka pancreatectomy holoʻokoʻa: Inā ua pālahalaha ke kanesa i ka pancreas holoʻokoʻa, e wehe ʻia ka pancreas holoʻokoʻa. ʻO ke ʻano kēia, pono ʻoe e lawe i nā inikini insulin a me nā pila enzyme digestive no ke koena o kou ola.
Kemoterapia
ʻO kēia ka hāʻawi ʻana i ke kino i nā lāʻau lapaʻau e pepehi ai i nā hunaola kanesa. Hāʻawi ʻia kēia mau mea ma ke ʻano he mau pila a i ʻole ma o ka inikini ʻana i loko o kahi aa. Hoʻohana ʻia lākou e hoʻēmi i kahi puʻupuʻu ma mua o ke ʻoki ʻana, e pepehi i nā hunaola i koe ma hope o ke ʻoki ʻana, a i ʻole ma ke ʻano he lāʻau lapaʻau nui no ka maʻi kanesa i laha.
Hoʻōla radiation
ʻO ka hoʻohana ʻana i nā kukuna X-ikehu kiʻekiʻe e luku i nā hunaola kanesa. Hāʻawi pinepine ʻia kēia me ka chemotherapy (chemoradiation).
Hoʻōla i kuhikuhi ʻia
He ʻano lāʻau lapaʻau hou kēia e hana ana ma ke kālele ʻana i nā protein kikoʻī e kōkua ana i nā hunaola kanesa e ulu a hoʻolaha.
Ka hoʻokele ʻeha
Ma muli o ka hoʻopilikia ʻana o ke kanesa pancreatic i nā aʻalolo a puni ka pancreas, hiki iā ia ke hōʻeha nui i kekahi manawa. No laila, ʻo ka kaohi ʻana i ka ʻeha he ʻāpana koʻikoʻi loa ia o ka mālama ʻana. E ʻōlelo aku kāu kauka i nā lāʻau ʻeha kūpono a i ʻole nā ʻano hana ʻē aʻe nāu. Mai hoʻomanawanui i ka ʻeha, e kamaʻilio me kāu kauka e pili ana i ia mea.
Hiki iā kākou ke pale aku i kēia maʻi?
ʻAʻohe ala e pale loa ai i ka maʻi kanesa pancreatic, akā aia kekahi mau mea hiki iā mākou ke hana e hōʻemi i ko mākou pilikia.
- E pale loa i ka puhipaka. ʻO kēia ka mea nui loa.
- E kaupalena i ka inu ʻana i ka waiʻona.
- E mālama i ke kaumaha olakino.
- E ʻai i ka meaʻai momona i nā huaʻai hou, nā mea kanu, a me nā palaoa holoʻokoʻa.
- E hōʻemi i kāu ʻai ʻana i ka ʻiʻo ʻulaʻula, nā mea inu kō, a me nā meaʻai i hana ʻia.
Leka Lawe-Home
- He maʻi leo ʻole ka maʻi kanesa pancreatic e hōʻike ʻole ana i nā hōʻailona i nā pae mua.
- E makaʻala i nā hōʻailona e like me ka melemele o ka ʻili a me nā maka (jaundice), ka ʻeha mau ma ka ʻōpū a i ʻole ke kua, ka pohō kaumaha i wehewehe ʻole ʻia, a me ka hoʻomaka hou ʻana o ka maʻi diabetes.
- He kumu nui ka puhipaka no kēia maʻi kanesa, no laila he mea nui loa e pale aku.
- Hiki ke ho'ōla loa ʻia kēia maʻi inā ʻike ʻia i ka wā mua a wehe loa ʻia ka puʻupuʻu ma o ke ʻoki ʻana.
- Inā loaʻa iā ʻoe a i ʻole kekahi o kou ʻohana nā hōʻailona i luna a i ʻole nā kumu pilikia, mai makaʻu a hoʻokaʻulua paha i ka ʻike ʻana i ke kauka no ka ʻōlelo aʻo.
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