He puʻupuʻu kou ma kou ʻāʻī? E kamaʻilio kākou e pili ana i ka Papillary Thyroid Cancer (PTC)!

Ua ʻike anei ʻoe i kahi puʻupuʻu liʻiliʻi ma kou ʻāʻī? A i ʻole ua haʻi aku kekahi kauka iā ʻoe i ka wā o ka hoʻokolokolo ʻana? I kekahi manawa, ʻo kahi puʻupuʻu liʻiliʻi e like me kēia ke hōʻailona mua o kahi maʻi i kapa ʻia ʻo Papillary Thyroid Cancer (PTC). Mai hopohopo, e kamaʻilio mākou e pili ana i ia mea me nā kikoʻī a me ka maʻalahi.

He aha ka papillary thyroid carcinoma (PTC)? He aha ke kelepa thyroid?

I ka ʻōlelo maʻalahi, ʻo ka maʻi kanesa thyroid papillary (PTC) kahi ʻano maʻi kanesa e ulu ana i loko o ko kākou kelepa thyroid. Hoʻomaka ia i loko o nā pūnaewele follicular o ka kelepa thyroid. Hoʻopuka kēia mau pūnaewele i kahi protein i kapa ʻia ʻo thyroglobulin . ʻO ka mea nui e ʻike ai, ʻo ka PTC ke ʻano maʻamau o ka maʻi kanesa thyroid.

I kēia manawa, e nānā kākou i ke ʻano o ka ʻōpū thyroid . E noʻonoʻo, ma ke alo o kou ʻāʻī, ma lalo o ka ʻili, he ʻōkana liʻiliʻi e like me ka pepeke. ʻO ia ka ʻōpū thyroid. He ʻāpana kēia o kā mākou ʻōnaehana endocrine . ʻO kāna hana nui ka hana ʻana a me ka hoʻokuʻu ʻana i nā hormones e kāohi ana i nā hana koʻikoʻi he nui i loko o ko mākou kino.

I ka wā e pili ana i ka PTC, he maʻamau ia he kanesa ulu lohi loa . Eia kekahi, ulu pinepine ia ma kekahi ʻaoʻao (lobe) o ka thyroid gland.

Aia kekahi mau ʻano like ʻole o ka `PTC`?

ʻAe, aia kekahi mau ʻano like ʻole o ka `PTC`. ʻO kēia mau mea, ʻo ka ʻano like ʻole o ka follicular ka mea maʻamau. I kekahi manawa ua kapa ʻia ʻo ia he `mixed papillary-follicular variant`. ʻAʻole like ka maʻamau o nā ʻano like ʻole ʻē aʻe. Eia naʻe, hiki iā lākou ke ulu a pālahalaha wikiwiki iki . ʻO ia mau ʻano like ʻole:

• `Kola`
• `Keena kiʻekiʻe`
• `Insular`
• ʻO ka sclerosis hoʻolaha

I kekahi manawa ua kapa ʻia ʻo 'PTC' ʻo 'papillary thyroid carcinoma' .

ʻO wai ka mea e loaʻa ana i ka maʻi papillary thyroid?

ʻOiaʻiʻo, hiki i ka PTC ke ulu i loko o kekahi. Eia nō naʻe, ʻoi aku ka maʻamau o ia i nā pākeke waena . Eia kekahi, ʻoi aku ka nui o ka loaʻa ʻana o kēia maʻi i nā wahine ma mua o nā kāne.

He maʻi laha ʻole ka PTC i nā keiki. Eia nō naʻe, ʻo ia ke ʻano maʻamau o ka maʻi kanesa thyroid i nā keiki.

Pehea ka maʻamau o kēia `PTC`?

He maʻi maʻamau ka maʻi kanesa thyroid. Eia nō naʻe, e like me kā mākou i ʻōlelo ai ma mua, 80% a 85% o nā hihia he ʻano PTC. ʻO ia hoʻi, ma kahi o ʻewalu o ka ʻumi o ka poʻe e loaʻa ana i ka maʻi kanesa thyroid he ʻano kēia.

He maʻi koʻikoʻi anei ka `PTC`?

He koʻikoʻi ke kanesa o kēlā me kēia ʻano. Pono ia i ka mālama lapaʻau a hiki ke laha (metastasize) i nā ʻāpana ʻē aʻe o ke kino. Eia nō naʻe, maikaʻi loa ka wānana no ka PTC i hoʻohālikelike ʻia me nā ʻano kanesa thyroid ʻē aʻe.

I ka hapa nui o ka manawa, hiki ke mālama pono ʻia ka PTC. He mea kākaʻikahi loa hoʻi ke kumu o ka make. No laila, he mea nui e pale i ka hopohopo a hahai i nā ʻōlelo aʻoaʻo lapaʻau kūpono.

Ma hea kahi e laha mua ai ka `PTC`?

Inā pālahalaha ka PTC, ʻoi aku ka nui o ka laha ʻana i nā lymph node ma ka ʻāʻī . He mau ʻano liʻiliʻi kēia mau node e like me ka pīni he ʻāpana o ka ʻōnaehana lymphatic a me ka ʻōnaehana pale o ko mākou kino.

Pehea ka mamao o ka laha ʻana o ka `PTC`?

ʻOiai ke ulu mālie nei ka PTC, hiki ke pālahalaha pinepine i nā lymph node ma ka ʻāʻī. Ma ke ʻano maʻamau, ma kahi o 30% o ka poʻe me PTC e pālahalaha i nā wahi ʻē aʻe (metastatic papillary thyroid cancer) i ka manawa o ka hōʻoia ʻana .

He aha nā hōʻailona o ka 'PTC'?

ʻO ka pinepine, ʻo ka hōʻailona nui o PTC ka ʻike ʻia ʻana o kahi nodule ʻeha ʻole i loko o ka ʻōpū thyroid . Hiki ke ʻike ʻole ʻia nā hōʻailona ʻē aʻe.

Eia nō naʻe, he mea kākaʻikahi loa, hiki i kekahi poʻe ke ʻeha ma ka ʻāʻī, ka ʻāwae, a i ʻole ka pepeiao . Inā nui ka puʻupuʻu e kaomi i ko kākou ʻōpū hanu a i ʻole ka esophagus, hiki iā ia ke pilikia i ka hanu ʻana a i ʻole ke ale ʻana .

He mea nui: Inā ʻike ʻoe i kahi puʻupuʻu hou ma kou ʻāʻī, ʻoiai inā ʻaʻole ia he ʻeha, pono ʻoe e ʻike i ke kauka. ʻO ka mua o kou ʻike ʻana, ʻo ka ʻoi aku ka holomua o ka lāʻau.

He aha nā kumu o ka 'PTC'?

ʻAʻole maopopo i nā kānaka ʻepekema ke kumu pololei o PTC, akā ua ʻike lākou i kekahi mau mea pilikia e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i ke kūlana, me ka ʻike ʻana i ka radiation a me kekahi mau kūlana genetic .

Ka hōʻike ʻana i ka radiation a me ka `PTC`

ʻO ka poʻe i hōʻike ʻia i nā nui o ka radiation ionizing i ko lākou mōʻaukala, ʻoi aku ka nui o ka loaʻa ʻana o ka PTC. ʻO nā ala e hiki ai ke hōʻike ʻia kēia radiation:

• Hāʻawi ʻia nā lāʻau lapaʻau radiation waho kiʻekiʻe i ka ʻāʻī e mālama i ka maʻi kanesa a i ʻole nā ​​​​​​kūlana ʻē aʻe ʻaʻole maʻi kanesa, ʻoi aku hoʻi i ka wā kamaliʻi.
• Ka hōʻike ʻia ʻana o ka radiation mai nā ulia pōpilikia o ka hale hana mana nukelea. No ka laʻana, ma hope o ka ulia pōpilikia nukelea ʻo Chernobyl i ka makahiki 1986, ua piʻi ka nui o nā maʻi PTC ma nā wahi a puni mai 3-fold a i 75-fold.

Nā kūlana genetic a me ka `PTC`

Aia kekahi mau kūlana genetic (hoʻoilina) e pili ana me PTC:

• ʻO ka Familial Adenomatous Polyposis (FAP / Gardner syndrome): He ʻano laha ʻole kēia, he ʻano hoʻoilina. Hoʻoulu ia i ke kanaka e ulu i nā polyps he nui i loko o ko lākou kolona a me ka rectum, hiki ke lilo i maʻi kanesa. Loaʻa i ka poʻe me FAP ka nui o ka pilikia o ka ulu ʻana o nā puʻupuʻu ma nā wahi ʻē aʻe o ke kino, me ka thyroid gland. Hoʻokumu ʻia ke ʻano e kahi mutation hoʻoilina i loko o ka gene APC.
• ʻO ka maʻi Werner : He ʻano laha ʻole kēia. Hōʻike ia i nā hōʻailona o ka ʻelemakule wikiwiki loa (progeria). ʻOi aku ka nui o ka pilikia o ka poʻe me ka maʻi Werner i ka loaʻa ʻana o ka maʻi kanesa. ʻO ke ʻano maʻamau ka maʻi kanesa thyroid. Ua ʻike ʻia ma mua o 80 mau mutations like ʻole i loko o ka gene WRN i nā poʻe me kēia ʻano.
• ʻAno paʻakikī Carney 1 : Hoʻonui pū kēia kūlana i ka pilikia o ka hoʻomohala ʻana i nā ʻano puʻupuʻu like ʻole, me nā puʻupuʻu thyroid. Hoʻokumu pinepine ʻia e nā mutations i loko o ka gene PRKAR1A.

Eia nō naʻe, pono e hoʻomanaʻo ʻia he 5% wale nō o nā maʻi PTC āpau e pili ana me ia mau kūlana hoʻoilina.

Pehea e ʻike ai i ka `PTC`?

ʻO ka hapa pinepine, hōʻike ʻia kahi PTC ma ke ʻano he puʻupuʻu i loko o ke kelepa thyroid. Ua ʻike paha ʻoe iā ʻoe iho, a i ʻole e loaʻa paha i ke kauka i ka wā o ka hoʻokolokolo ʻana i ka ʻāʻī maʻamau. I kekahi manawa, loaʻa ka puʻupuʻu ma ke ʻano ulia i ka wā o ka scan no kekahi maʻi ʻē aʻe.

Hiki i kāu kauka ke kauoha i nā hoʻokolohua aʻe e hōʻoia i ka PTC:

• Nā hoʻāʻo kiʻi : Hiki i kēia mau hoʻāʻo ke kōkua i ka ʻike ʻana i kahi puʻupuʻu thyroid. No ka laʻana, hiki ke hana ʻia kahi ultrasound thyroid , CT scan , a/a i ʻole MRI scan .
• ʻO ka ʻume ʻana i ka nila maikaʻi (biopsy nila ): E lawe pinepine ke kauka i kahi laʻana liʻiliʻi o ka ʻiʻo (biopsy) mai kou nodule thyroid me ka hoʻohana ʻana i kahi nila lahilahi loa. E nānā ke kauka maʻi i ka ʻiʻo ma lalo o kahi microscope e ʻike inā he mau hunaola kanesa a, inā pēlā, he aha ke ʻano o ka maʻi kanesa thyroid.

I kekahi manawa, hiki i kāu kauka ke kuhikuhi iā ʻoe no ke aʻo ʻana i nā genetics e ʻike inā he ʻano genetic kou e hoʻoulu ai i ka PTC, a me nā ʻano ʻē aʻe o nā tumors.

Pehea e mālama ʻia ai ka PTC?

ʻO ke ʻano o ka mālama ʻana no ka PTC e pili ana i ka nui o ka puʻupuʻu a inā ua pālahalaha ke kanesa.

ʻO ke ʻoki ʻana ke ʻano nui a maʻamau no ka PTC.Ma muli o ka nui a me kahi o ka puʻupuʻu, hiki i kāu kauka lapaʻau ke wehe i kahi hapa o ka ʻōpū thyroid (lobectomy) a i ʻole ka ʻōpū holoʻokoʻa (thyroidectomy). Inā aia ke kanesa i loko o nā ʻōpū thyroid, hiki i ke kauka lapaʻau ke wehe i nā ʻōpū i hoʻopilikia ʻia i ka manawa like me ke ʻoki ʻana o ka thyroid a i ʻole ma kahi ʻoki ʻelua.

He mea nui: Inā wehe ʻia kou kelepa thyroid holoʻokoʻa (thyroidectomy holoʻokoʻa), pono ʻoe e lawe i nā pila hormone thyroid no ke koena o kou ola .

ʻO nā lāʻau lapaʻau ʻē aʻe no PTC:

• Lapaʻau Radioiodine : Hoʻopili nā pūnaewele thyroid a me nā pūnaewele PTC i ka iodine mineral (i loaʻa i kekahi mau meaʻai). No kēia kumu, hoʻohana pinepine nā kauka i kahi ʻano radioactive o ka iodine e luku i kekahi ʻiʻo thyroid maʻamau i koe ma hope o ka wehe ʻia ʻana o ke kelepa thyroid, a me kekahi ʻiʻo thyroid maʻi kanesa e koe paha.
• Lapaʻau radiation : Pepehi ka radiation i nā hunaola kanesa a hoʻōki iā lākou mai ka ulu ʻana. I ka radiation therapy waho, kuhikuhi kahi mīkini i nā kukuna ikehu ikaika pololei i ka puʻupuʻu. I ka radiation therapy kūloko, kau ʻia nā hua radioactive i loko a i ʻole a puni ka puʻupuʻu.
• Kemoterapi : ʻO nā lāʻau lapaʻau Kemoterapi i hāʻawi ʻia ma ke ʻano intravenous (IV) a i ʻole ma ka waha (waha) e pepehi i nā hunaola kanesa a hoʻōki i ka ulu ʻana o ke kanesa. Eia nō naʻe, he hapa liʻiliʻi wale nō o ka poʻe me ke kanesa thyroid e pono ai ka chemotherapy.

He aha nā hopena ʻaoʻao a me nā pilikia o ka mālama ʻana i ka 'PTC'?

ʻO kahi hopena ʻaoʻao paha o ka thyroidectomy a me ka radioiodine therapy ʻo ia ka hypothyroidism mau loa. No laila, inā loaʻa iā ʻoe kekahi a i ʻole nā ​​​​​​lāʻau ʻelua, pono ʻoe e lawe i nā pila hormone thyroid no ke koena o kou ola.

Aia kekahi mau pilikia e hiki ke kū mai i ka wā o ke ʻoki ʻana i ka thyroid:

• Ka maʻi ʻana.
• Ka wehe ʻana a i ʻole ka hōʻino ʻia ʻana o nā kelepa parathyroid , ka mea e kaohi ai i ka pae o ka calcium i loko o kou koko.
• Ka hōʻino ʻana i ke aʻalolo laryngeal recurrent, ka mea e holo ana ma hope o ke kelepa thyroid. Hiki i kēia ke hoʻolilo i ka leo i leo haʻalulu a nāwaliwali.

Nā hopena ʻaoʻao e pili ana i ka mālama ʻana me ka iodine radioactive:

• Ka luaʻi a me ka luaʻi.
• Sialadenitis - ka pehu ʻana o nā kelepa salivary.
• ʻO ka thyrotoxicosis manawa pōkole.
• ʻO ka fibrosis pulmonary kahi maʻi e hoʻoulu ai i ka ʻeha o ka ʻiʻo o ka māmā.
• Ka hānau ʻole ʻana no ka manawa pōkole a mau loa paha.
• LeukemiaHe wahi liʻiliʻi o ka pilikia o ka loaʻa ʻana o ka maʻi leukemia, ka maʻi ʻaʻai umauma, a i ʻole ke kanesa ʻōpū.

Hiki ke pale ʻia ka `PTC`?

ʻAʻohe kumu pilikia kūikawā o ka nui o ka poʻe i loaʻa i ka maʻi kanesa thyroid. No laila, ʻaʻole hiki ke pale ʻia ka hapa nui o nā hihia o PTC.

ʻO ka ʻike ʻia ʻana i ka radiation, ʻoiai i ka wā kamaliʻi, he mea ia e pilikia ai ka PTC. Ma muli o kēia, ʻaʻole hoʻohana hou nā kauka i ka radiation no nā kūlana koʻikoʻi ʻole. Hoʻopili ʻia nā keiki i ka radiation mai nā hoʻokolohua kiʻi e like me nā X-ray a me nā scan CT, akā ma nā dosis haʻahaʻa loa. ʻAʻole maopopo i ka nui o ka hoʻonui ʻana i ka pilikia o ka PTC.

Inā ua loaʻa i kekahi o kou ʻohana ke kanesa thyroid, makemake paha ʻoe e kiʻi i ke aʻoaʻo genetic. E kōkua kēia i ka hoʻoholo ʻana inā loaʻa iā ʻoe kahi maʻi genetic e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i ka PTC. Inā hana ʻoe, hiki i kāu kauka ke ʻōlelo aku i kahi ʻoki prophylactic e wehe i kou kelepa thyroid ma mua o ka ulu ʻana o ke kanesa.

He aha ka wānana o ka PTC?

Ma keʻano laulā, maikaʻi loa ka wānana no ka PTC , ʻoiai inā ʻoe ma lalo o 40 mau makahiki a he liʻiliʻi ka puʻupuʻu. Hiki ke mālama pono ʻia ka PTC. ʻOiai inā ua pālahalaha aʻe i nā lymph nodes ma ka ʻāʻī, ʻaʻole pinepine ia e make.

ʻO nā kumu e hiki ke hōʻemi i ka wikiwiki o ka hoʻōla ʻana:

• ʻOi aku ma mua o 55 mau makahiki i ka wā i ʻike ʻia ai ka maʻi.
• Ke ulu nui nei ka puʻupuʻu .
• Ua pālahalaha ke kanesa i nā ʻāpana mamao o ke kino .
• Loaʻa iā ia kahi ʻano ʻano kakaikahi a ikaika hoʻi o ka `PTC` (e.g. `tall cell variant`, `diffuse sclerosis variant`, `solid variant`).

Hiki iā ʻoe ke ola i ka `PTC`?

He kiʻekiʻe loa ka nui o ke ola no ka PTC. ʻOi aku ma mua o 90% o nā pākeke me PTC e ola ana no ka liʻiliʻi he 10 a 20 mau makahiki ma hope o ka mālama ʻana.

Āhea wau e ʻike ai i ke kauka e pili ana i ka `PTC`?

Inā ua ʻike ʻia ʻoe me PTC, pono ʻoe e hālāwai me kāu hui lapaʻau i kēlā me kēia manawa e nānā i ka holomua o kāu lāʻau lapaʻau. Pono nō hoʻi ʻoe e loaʻa i nā kipa hoʻomau lōʻihi i kēlā me kēia 6 a 12 mau mahina no ka liʻiliʻi he ʻelima mau makahiki e nānā ai no ka hoʻi hou ʻana.

Inā ua wehe ʻia kou kelepa thyroid a/a i ʻole ua hāʻawi ʻia ka lāʻau iodine radioactive ma ke ʻano he ʻāpana o kāu lāʻau lapaʻau, pono ʻoe e lawe i nā pila hormone thyroid no ke koena o kou ola . E nānā ke kauka i kāu mau pae hormone thyroid i kou ola a pau e hōʻoia i ka kūpono o kāu nui o ka lāʻau lapaʻau iā ʻoe.

ʻO ka ʻike ʻia ʻana he maʻi kanesa, ʻoiai ke ʻano, hiki ke lilo i mea hoʻohoka. Eia nō naʻe, ʻo ka nūhou maikaʻi, ʻo ka wānana no ka PTC he maikaʻi loa ia. E hana pū kāu hui lapaʻau me ʻoe e hoʻoholo i ka hoʻolālā lapaʻau maikaʻi loa nāu.

## Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

ʻAe, no laila, mai nā mea a mākou i kamaʻilio ai, eia nā mea nui loa e pono ai ʻoe e hoʻomanaʻo:

• ʻO ke kanesa thyroid papillary (PTC) ke ʻano maʻamau o ka maʻi thyroid a ʻo ia ka prognosis maikaʻi loa.
• ʻO ka hōʻailona nui he puʻupuʻu ʻeha ʻole ma ka ʻāʻī. Inā ʻike ʻoe i kekahi mea e like me ia, e ʻike pono i ke kauka.
• ʻO ke ʻoki kino ke ʻano nui o ka lāʻau lapaʻau. Pono paha ka lāʻau lapaʻau iodine radioactive .
• Inā wehe loa ʻia ke kelepa thyroid, pono ʻoe e lawe i nā hormones thyroid no ke koena o kou ola .
• ʻO ka ʻike mua ʻia ʻana o kēia maʻi, ʻo ka ʻoi aku ka holomua o ka lāʻau lapaʻau. No laila, he mea nui loa nā nānā lapaʻau mau a me ka hahai ʻana i nā ʻōlelo aʻoaʻo.
• Mai makaʻu. ʻAʻole ʻoe hoʻokahi. Aia nā kauka, ka ʻohana, a me nā hoaaloha e kōkua iā ʻoe.

Manaʻolana wau he kōkua kēia ʻike iā ʻoe. Inā he mau nīnau kāu, mai kānalua e nīnau i kāu kauka. E noho olakino!

ʻO ke kanesa thyroid, ke kanesa thyroid papillary, PTC, nā nodules ʻāʻī, ke ʻoki thyroid, ka radiation therapy, ka hormone therapy