E noʻonoʻo, ua maʻi loa kekahi no kekahi mau lā, ua palupalu iki ko lākou hoʻomanaʻo, ʻeha kekahi manawa ko lākou mau hono, a hoʻomaka ko lākou ʻili e maneʻo. No laila, ke hele ʻoe i ke kauka no kekahi mea e like me kēia, a hana lākou i nā hoʻokolohua like ʻole, ʻike lākou ʻo ke kumu o kēia mau mea a pau he maʻi kanesa i hūnā ʻia i loko o ke kino. ʻAʻole anei he mea kupaianaha? Aia ke kanesa ma kahi hoʻokahi, akā ma muli o kona hopena, ʻike ʻia nā hōʻailona i like ʻole me ka pili ʻole ma nā ʻāpana like ʻole o ke kino. ʻO ia ka mea a mākou e kapa nei he Paraneoplastic Syndrome i ka lāʻau lapaʻau.
I ka ʻōlelo maʻalahi, he aha ka Paraneoplastic Syndrome?
Me he mea lā he mea paʻakikī iki kēia ke hoʻomaopopo, akā e mālama kākou i ka maʻalahi. Ke ulu kahi puʻupuʻu ʻino i loko o kou kino, aia nā hopena pololei. No ka laʻana, inā loaʻa iā ʻoe ka maʻi ʻaʻai māmā, loaʻa paha iā ʻoe ka ʻūhā. Inā loaʻa iā ʻoe ka maʻi ʻaʻai colon, loaʻa paha ke koko i loko o kou ʻōpala. ʻO kēia nā hōʻailona pololei o ka maʻi ʻaʻai.
Akā, he mea ʻokoʻa ka Paraneoplastic Syndrome . ʻO ka mea e hana ʻia ma ʻaneʻi, ʻo ia ka hana ʻana o kou kino i kahi hōʻiliʻili o nā hōʻailona ʻē aʻe i ka pane ʻana i ke kanesa. ʻO ia hoʻi, ʻaʻole ia he mea a ke kanesa e hana pololei ai, akā no ka mea aia ke kanesa i loko o ke kino, hele hewa nā ʻōnaehana ʻē aʻe i loko o ke kino ma ke ʻano he 'pane' iā ia.
ʻElua ala nui e hiki ai kēia:
1. Pane Autoimmune: E noʻonoʻo i ka ʻōnaehana pale o ko mākou kino e like me kahi pūʻali koa e pale aku ana i kahi ʻāina. ʻO nā hunaola kanesa he ʻenemi i komo i loko o ka ʻāina. No laila, hoʻomaka kā mākou pūʻali koa (ʻōnaehana pale) e kaua aku i kēia ʻenemi (maʻi kanesa). No kēlā, hana lākou i nā mea kaua kūikawā, ʻo ia hoʻi , nā antibodies . Akā i kekahi manawa, i loko o kēia hakakā, hana hewa kā mākou pūʻali koa. Hoʻomaka lākou e hoʻouka ʻaʻole wale i nā hunaola ʻenemi, akā, i nā hunaola maikaʻi a olakino hoʻi i loko o ko mākou kino ponoʻī, me ka manaʻo he ʻenemi lākou. No ka laʻana, hiki iā lākou ke hoʻouka i nā hunaola i loko o ka ʻōnaehana nerve, nā hunaola ʻili, a i ʻole nā hunaola i loko o nā hono. ʻO ia ka manawa e ʻike ʻia ai nā hōʻailona e pili ana i kēlā mau ʻōpū.
2. Ka hana ʻana o nā hormone e nā hunaola kanesa: Hiki i kekahi ʻano kanesa ke hana i nā nui o nā mea, e like me nā hormones, ʻaʻole i hana maʻamau ʻia e ko mākou kino, a i ʻole hana iki wale nō. Hōʻiliʻili kēia mau hormones ʻano ʻē i loko o ke koko a hele a puni ke kino, e hoʻopilikia ana i ka hana o nā ʻōkana like ʻole. No ka laʻana, hiki i kēia mau hormones ke hoʻonui nui i ke koko, a i ʻole ka piʻi ʻana o ka pae calcium i loko o ke koko.
ʻO ka mea nui, i kekahi manawa, ma mua o ka ʻike ʻia ʻana o ka maʻi kanesa, ʻike mua ʻia nā hōʻailona e pili ana i kēia Paraneoplastic Syndrome. No laila, he mea nui loa ka makaʻala i kēia mau hōʻailona.
He aha nā ʻāpana o ke kino i hoʻopilikia ʻia e kēia maʻi?
Hiki i nā maʻi Paraneoplastic ke hoʻopilikia i ka aneane o nā ʻōnaehana āpau i loko o ke kino. Eia nō naʻe, ʻike pinepine ʻia lākou i loko o kēia mau ʻōnaehana. E nānā kākou i ke ʻano o lākou a me nā kūlana e hiki ke hana e pili ana iā lākou.
| Hoʻopilikia ʻia ka ʻōnaehana kino | Nā kūlana olakino hiki (nā laʻana) |
|---|---|
| ʻŌnaehana nerve (lolo, iwi kuamoʻo, nā aʻalolo) | Nā kūlana e like me ka Cerebellar degeneration, Encephalitis, Lambert-Eaton myasthenic syndrome, Myasthenia gravis, Peripheral neuropathy, Stiff person syndrome. |
| ʻŌnaehana endocrine (nā hormones) | ʻO nā kūlana e like me ka Cushing syndrome, Hypercalcemia (hoʻonui ʻia ka calcium i ke koko), a me ka Carcinoid syndrome. |
| ʻO ka ʻiʻo pili (iwi, hono, ʻiʻo) | ʻO Dermatomyositis, Paraneoplastic polyarthritis (mū o nā hono), Hypertrophic osteoarthropathy. |
| Koko | ʻO ka anemia o nā maʻi maʻi mau loa, Paraneoplastic erythrocytosis, Paraneoplastic thrombocytosis. |
| ʻIli | ʻO ka acanthosis nigricans (ka mānoanoa a me ka mānoanoa o ka ʻili ma nā wahi e like me nā armpits a me ka ʻāʻī), Dermatomyositis, Sweet syndrome, Paraneoplastic pemphigus. |
He aha nā hōʻailona maʻamau a kikoʻī?
Aia kekahi mau hōʻailona maʻamau i ʻike mua ʻia i loko o kahi maʻi paraneoplastic. Hiki ke ʻike ʻia kēia mau mea i nā maʻi ʻē aʻe, no laila ʻaʻole ia he manaʻo maikaʻi e hopohopo wale ma ka ʻike ʻana i kēia mau mea.
Nā hōʻailona maʻamau:
- Kuni me ke kumu ʻole
- Makemake nui
- Ka hou nui ʻana i ka pō
- ʻO ka pohō kaumaha maʻamau me ka ʻole o ka hoʻoikaika ʻana
Ma waho aʻe o kēia mau hōʻailona maʻamau, e like me kā mākou i kūkākūkā ai ma mua, kū mai nā hōʻailona kikoʻī ma muli o ka ʻōnaehana kino i hoʻopilikia ʻia.
| ʻŌnaehana i hoʻopilikia ʻia | Nā hōʻailona kikoʻī e ʻike ʻia |
|---|---|
| ʻŌnaehana nerve | Paʻakikī i ka hele wāwae, nalowale ke kaulike, poniuniu, ʻike pālua, nalowale ka hoʻomanaʻo, dementia, nāwaliwali o nā ʻiʻo, paʻakikī i ka ʻōlelo ʻana. |
| ʻŌnaehana endocrine | Ke koko kiʻekiʻe, ke kaumaha i loaʻa me ka wehewehe ʻole ʻia, ke kō koko kiʻekiʻe, ka luhi nui. |
| ʻIʻo hoʻopili | ʻEha nā hono, pehu nā hono, ʻeha nā ʻiʻo a me ka nāwaliwali. |
| Koko | Ka emi ʻana a i ʻole ka piʻi ʻana o kekahi ʻano o ke koko (e like me ka anemia, a i ʻole ka piʻi ʻana o ke ʻano o ke koko e pipili). |
| ʻIli | Nā puʻupuʻu ʻaʻole maʻi kanesa ma ka ʻili, ka ʻulaʻula o ka ʻili, ka maneʻo nui, a me nā loli o ke kala o ka ʻili. |
ʻO wai ka mea i ʻoi aku ka pilikia o ka loaʻa ʻana o kēia maʻi?
Ma ke kumumanaʻo, hiki ke loaʻa nā maʻi paraneoplastic i kekahi kanaka me ke kanesa. Eia nō naʻe, ʻoi aku ka nui o ko lākou hiki ke loaʻa me kekahi mau ʻano kanesa. Wahi a nā helu helu, ma kahi o 8 o 100 mau maʻi kanesa (8%) e loaʻa i kēia maʻi.
ʻO nā ʻano maʻi kanesa e pili pinepine ʻia me kēia ʻano:
- Ka maʻi ʻaʻai māmā (ʻike pinepine ʻia me kēia ʻano)
- Ka maʻi ʻaʻai umauma
- Nā maʻi ʻaʻai e pili ana i ke koko (e like me lymphoma, leukemia)
- Ka maʻi ʻōpū
Pehea e ʻike ai ke kauka i kēia?
Ke hele ʻoe e ʻike i ke kauka me kēia mau hōʻailona, ʻo ka mea mua āna e hana ai, ʻo ia ke lawe i kahi mōʻaukala piha a hana i kahi hoʻokolokolo kino. A laila, e kauoha lākou i kekahi mau hoʻokolohua e hoʻoholo ai inā ua hoʻokumu ʻia nā hōʻailona e ka maʻi kanesa a i ʻole kekahi maʻi ʻē aʻe.
- Nā hoʻāʻo koko: Hiki i nā hoʻāʻo koko maʻamau ke nānā i nā kumu ʻē aʻe o kāu mau hōʻailona (e laʻa, nā maʻi, nā kaulike ʻole o ka hormonal). Eia kekahi, hiki i kekahi mau hoʻāʻo koko kūikawā ke nānā i nā antibodies a i ʻole nā māka tumor e pili ana i kahi paraneoplastic syndrome.
- Kiʻi: Hoʻohana ʻia nā hoʻāʻo e like me CT scan , MRI scan , a i ʻole ultrasound e ʻike ai inā he puʻupuʻu kanesa i loko o ke kino.
- Hoʻokolohua Neurological: Inā manaʻo ʻia kāu mau hōʻailona e pili ana i ka ʻōnaehana nerve, e hana kāu kauka i nā hana like ʻole e hoʻāʻo ai i kou ikaika, hoʻomanaʻo, kaulike, a me ka hoʻonohonoho ʻana.
- ʻO ke kī ʻana o ka iwi kuamoʻo/Lumbar Puncture: Pili kēia i ka lawe ʻana i kahi liʻiliʻi o ka wai cerebrospinal, ka wai e hoʻopuni ana i kou kaula iwi kuamoʻo, a hoʻāʻo iā ia e ʻike inā he mau antibodies kūpono ʻole i loko o kēia wai e hoʻouka nei i nā cell olakino.
Pehea e mālama ʻia ai?
ʻO ka mea nui a koʻikoʻi loa i ka mālama ʻana i ka maʻi paraneoplastic, ʻo ia ka mālama ʻana i ke kanesa nāna i hoʻokumu i nā mea āpau. Ke kāohi ʻia a hoʻōla ʻia paha ke kanesa, e emi pinepine nā hōʻailona e pili ana i ka maʻi paraneoplastic ma o lākou iho.
I ka manawa like, i ka wā o ka mālama ʻana i ka maʻi kanesa, hāʻawi ʻia nā lāʻau lapaʻau e kāohi i nā hōʻailona i kū mai. ʻO ka pahuhopu nui o kēia mau lāʻau lapaʻau ka hoʻomālielie i ka ʻōnaehana pale, ka mea e hoʻouka hewa ana i nā ʻāpana olakino.
- Corticosteroids: Nā lāʻau lapaʻau e like me Prednisolone. Hana kēia ma ka hōʻemi ʻana i ka mumū a me ka pehu ʻana i loko o ke kino.
- Nā lāʻau pale kino:Hoʻemi kēia mau lāʻau i ka hana o ka ʻōnaehana pale kino a hoʻōki iā ia mai ka hoʻouka ʻana i nā hunaola olakino.
- ʻO ka immunoglobulin intravenous (IVIG): ʻO kēia ka hāʻawi ʻana i kahi mea i loaʻa nā antibodies i lawe ʻia mai nā poʻe olakino ma o ka intravenous. Kōkua kēia mau antibodies i ka luku ʻana i nā antibodies maikaʻi ʻole e hōʻino ana i ke kino.
- Plasmapheresis: He hana like kēia me ka hoʻomaʻemaʻe koko. Lawe ʻia kou koko, hoʻokaʻawale ʻia ka ʻāpana wai (plasma), kānana ʻia nā antibodies ʻino, a hoʻokomo hou ʻia ka plasma i hoʻomaʻemaʻe ʻia i loko o kou kino.
- Hoʻōla kino, ʻoihana a me ka ʻōlelo: Inā ua hoʻopilikia ʻia ka ʻōnaehana nerve a he paʻakikī ke hele wāwae, kamaʻilio a hana paha i nā hana o kēlā me kēia lā, hiki i kēia mau lāʻau lapaʻau ke kōkua i ke kūkulu hou ʻana i kēlā mau hiki.
Āhea ʻoe e ʻike ai i ke kauka?
Inā loaʻa iā ʻoe kekahi mau hōʻailona ʻē e like me nā mea i ʻōlelo ʻia ma kēia ʻatikala, ʻoiai inā he koʻikoʻi a mau paha ma mua o ʻelua pule, pono ʻoe e ʻike i ke kauka.
E hoʻomanaʻo, ʻaʻole nā kānaka a pau i loaʻa i kēia mau hōʻailona he maʻi kanesa. Hiki ke hana ʻia kekahi o kēia mau hōʻailona e nā kūlana ʻē aʻe ʻaʻole koʻikoʻi e like me ke kanesa. No laila, mai manaʻo ʻoe ʻo ka mea ʻino loa a hopohopo. Eia nō naʻe, he mea nui e ʻike pono i ke kumu o ia mea. No laila e ʻimi pono i ka ʻōlelo aʻoaʻo lapaʻau.
Inā ua mālama ʻia ʻoe no ka maʻi kanesa i ka wā ma mua, e ʻōlelo i loko o nā makahiki ʻelima i hala iho nei, a ke ʻike nei ʻoe i nā hōʻailona e like me kēia, he mea nui loa ia e hoʻāʻo hou ʻia. Hiki i kēia ke kōkua i ka hoʻoholo ʻana inā ua hoʻi mai ke kanesa.
Ke noho ʻoe me ka maʻi kanesa, he mea maʻamau ka manaʻo kaumaha ke loaʻa iā ʻoe ka hui pū ʻana o nā hōʻailona e like me kēia. Akā he mea nui e hoʻomaopopo ʻo ka lāʻau lapaʻau maikaʻi loa no kēia paraneoplastic syndrome ua like ia me ka lāʻau lapaʻau no ke kanesa. ʻO ka hahai pono ʻana i kāu hoʻolālā lapaʻau kanesa e kōkua nui iā ʻoe e hoʻokele i kēia mau hōʻailona. Nui nā lāʻau lapaʻau e hiki ke hāʻawi iā ʻoe i ka hōʻoluʻolu. E kamaʻilio ākea me kāu kauka e pili ana iā lākou.
Leka Lawe-Home
- ʻAʻole ka hopena pololei o ka maʻi kanesa ka Paraneoplastic syndrome, akā, he hopena pololei ʻole ia i hoʻokumu ʻia e ka ʻōnaehana pale o ke kino a i ʻole nā hormones i ka pane ʻana i ka maʻi kanesa.
- I kekahi mau hihia, ʻike mua ʻia nā hōʻailona e pili ana i kēia maʻi, ma mua o ka ʻike ʻia ʻana o ka maʻi kanesa.
- ʻO ke ala nui e mālama ai i kēia maʻi, ʻo ia ka mālama ʻana i ke kanesa kumu.
- Inā loaʻa iā ʻoe nā hōʻailona ʻē (e like me ka pohō kaumaha, nāwaliwali o nā ʻiʻo, nā loli o ka ʻili) e ʻike ʻia me ke kumu ʻole a mau no nā pule ʻelua, e ʻike koke i ke kauka.
- ʻOiai hiki ke hana ʻia kēia mau hōʻailona e nā maʻi olakino ʻē aʻe he nui, he mea nui e pale aku i ka hopohopo a ʻimi i kahi hoʻokolokolo lapaʻau kūpono .
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