E aʻo kākou e pili ana i ke Kanesa Parathyroid. Mai makaʻu, e kamaʻilio kākou!

Loaʻa iā kākou āpau nā loli liʻiliʻi a me nā ʻoluʻolu ʻole i loko o ko kākou kino i kēlā me kēia manawa, ʻeā? Malia paha he puʻupuʻu liʻiliʻi ia ma ka ʻāʻī, a i ʻole he mea e like me ka luhi me ke kumu ʻole, a i ʻole ka make wai i nā manawa a pau. ʻOiai ʻo ka hapa nui o kēia mau mea ʻaʻole ia he mea e hopohopo ai, i nā hihia kakaikahi, hiki iā lākou ke lilo i mau hōʻailona nui o kahi maʻi. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano maʻi kanesa i kakaikahi iki, akā he mea nui loa ia no kākou a pau e makaʻala. ʻO ia ka maʻi kanesa e ulu ana i loko o nā kelepa parathyroid, i kapa ʻia ma ke ʻano lapaʻau he maʻi kanesa parathyroid , a i ʻole `(Parathyroid Carcinoma)`.

He aha ke Kanesa Parathyroid?

I ka ʻōlelo maʻalahi, he ʻano maʻi ʻaʻai kakaikahi loa ka maʻi ʻaʻai parathyroid e ulu ana i loko o nā ʻiʻo o kou mau kelepa parathyroid. Aia kāu mau kelepa parathyroid ma hope o ke kelepa thyroid ʻano pepeke ma ke alo o kou ʻāʻī.

ʻAʻole i hoʻokaʻawale ʻia ke kanesa parathyroid i ʻehā mau pae (ka "ʻōnaehana inoa ʻehā pae") e like me nā ʻano kanesa ʻē aʻe. Akā, ua hoʻokaʻawale nā ​​kauka i ke kanesa i ʻekolu mau ʻano nui:

• Kūloko: ʻO ke ʻano kēia, aia wale nō ke kanesa i loko o kou kelepa parathyroid. I kekahi manawa ua pālahalaha iki paha i nā ʻiʻo a puni. ʻO ke ʻano kēia, ua kaupalena ʻia ke kanesa i hoʻokahi wahi.
• Metastatic: ʻO kēia ka wā i pālahalaha ai ke kanesa i nā ʻāpana ʻē aʻe o kou kino, e like me nā lymph nodes, ke akepaʻa, nā māmā, nā iwi, a i ʻole ka pancreas. Ma waena o 10% a me 30% o ka poʻe me ke kanesa parathyroid ua pālahalaha ke kanesa (metastatic) i ka manawa o ka hōʻoia ʻana. ʻO nā wahi maʻamau ka māmā, nā iwi, a i ʻole ke akepaʻa.
• Hoʻi hou: ʻO kēia ka manawa e hoʻi mai ai ke kanesa ma hope o ka mālama mua ʻana - ma hope o ka wehe ʻia ʻana o ke kelepa kanesa. ʻOi aku ma mua o ka hapalua o ka poʻe me ke kanesa parathyroid e loaʻa i kēia ʻano kanesa. Hoʻi pinepine mai ke kanesa i loko o ʻelua a ʻelima mau makahiki o ke ʻoki mua ʻana. Eia nō naʻe, hiki i kekahi manawa ke hoʻi mai a hiki i 20 mau makahiki.

He aha kēia mau kelepa parathyroid?

ʻEhā mau kelepa parathyroid o ka hapa nui o kākou e like me ka nui o ka pī. E like me ka mea i ʻōlelo ʻia ma mua, aia kēia mau mea ma hope o ke kelepa thyroid. E like me ke kelepa thyroid, ʻo nā kelepa parathyroid kekahi ʻāpana o kāu ʻōnaehana endocrine. I kekahi manawa, hiki ke loaʻa kēia mau kelepa parathyroid ma kou esophagus a i ʻole ma kou umauma. Ua kapa ʻia kēia he ectopic.Ua kapa ʻia nā kelepa parathyroid he mau kelepa parathyroid, ʻo ia hoʻi, ʻaʻole lākou i kahi e kū pono ai.

ʻO ka hana nui o kāu mau kelepa parathyroid ka hoʻomalu ʻana i ka nui o ka calcium i loko o kou koko ma ka hana ʻana i ka hormone parathyroid (PTH) . I kekahi manawa, hoʻomaka kekahi a ʻoi aku paha o kāu mau kelepa parathyroid e hana i ka nui o kēia hormone parathyroid (PTH). Ua kapa ʻia kēia ʻano ʻo Primary Hyperparathyroidism (pHPT) . Ke hana ʻia ka nui o ka PTH, piʻi ka pae calcium i loko o kou koko. Ua kapa ʻia kēia ʻano ʻo hypercalcemia .

He aha ka ʻokoʻa ma waena o ka maʻi kanesa parathyroid a me ka parathyroid adenoma?

He ulu maikaʻi ʻole ka adenoma parathyroid, ʻaʻole ia he maʻi kanesa i loko o ka ʻōpū parathyroid. Eia nō naʻe, ʻo ka maʻi kanesa parathyroid ka ulu ʻana o nā hunaola ʻino, ʻaʻole he maʻi kanesa i loko o kou ʻiʻo parathyroid. ʻO nā maʻi e pili ana me nā ʻōpū parathyroid, ʻoi aku ka maʻamau o ka adenoma parathyroid ma mua o ke kanesa parathyroid.

Akā eia ka mea nui: Ma kēia mau kūlana ʻelua, ka maʻi ʻaʻai parathyroid a me ka adenoma parathyroid, hiki i kou kelepa parathyroid ke lilo i overactive a hana i ka nui o ka hormone parathyroid (PTH). A laila, e like me ka mea i ʻōlelo ʻia ma mua, loaʻa ka hypercalcemia. Hiki i kēia hypercalcemia ke hoʻopilikia i kou kino a me ke olakino. No laila, ʻo ka lāʻau maʻamau no ka maʻi ʻaʻai parathyroid, a me nā adenomas parathyroid, ʻo ia ke wehe ʻoki ʻana i ka kelepa parathyroid overactive.

ʻOiai no nā kauka, hiki ke paʻakikī ke ʻike koke inā he adenoma parathyroid a he carcinoma parathyroid paha. No ka mea hiki ke like ke ʻano o nā pūnaewele o nā mea ʻelua, ma hope o ka wehe ʻia ʻana o ka ʻoki kino o ka parathyroid, pono nā hoʻokolohua hou aʻe e hōʻoia inā he adenoma a he carcinoma paha.

He aha ka hypercalcemia? Pehea e pili ai i ka maʻi ʻaʻai parathyroid?

ʻO ka Hypercalcemia ka wā e kiʻekiʻe ai kou pae calcium koko ma mua o ka maʻamau. Hoʻomohala pinepine ka poʻe me ka maʻi ʻaʻai parathyroid i ka hypercalcemia. ʻO kēia no ka mea ke kumu o ka maʻi ʻaʻai i kou kelepa parathyroid e hana nui a hana i ka hormone parathyroid (PTH) nui loa. Hoʻoponopono ka hormone Parathyroid (PTH) i ka nui o ka calcium i loko o kou koko. No laila, inā nui kāu hormone parathyroid (PTH), e piʻi aʻe kou pae calcium koko.

Hiki i ka Hypercalcemia ke hoʻopilikia i kou olakino a me kou kino. No laila, he mea nui loa ka mālama ʻana i ka hypercalcemia i hoʻokumu ʻia e ka maʻi ʻaʻai parathyroid a me ke kanesa ponoʻī.

Aia kekahi mau ʻano like ʻole o ke kanesa parathyroid?

ʻAe, ʻelua ʻano nui o ka maʻi ʻaʻai parathyroid.

1. ʻO ke ʻano maʻamau: I kēia hihia, hoʻoulu nā hunaola kanesa i kāu kelepa parathyroid e hana i ka nui o ka hormone parathyroid (PTH) a hoʻokuʻu iā ia i loko o ke koko. Hoʻonui kēia i ka pae calcium i loko o kou koko.

2. ʻO ka maʻi parathyroid hana ʻole: Ua kapa ʻia hoʻi kēia he "non-secreting parathyroid carcinoma". He ʻokoʻa kēia mai nā ʻano ʻē aʻe. No ka mea, ʻaʻole i kiʻekiʻe ka nui o ka hormone parathyroid (PTH) a i ʻole ka calcium i loko o ko lākou koko i ka poʻe me kēia ʻano maʻi kanesa. He mea kākaʻikahi loa kēia ʻano, ʻaʻole i loaʻa ma mua o 10% o nā maʻi maʻi parathyroid.

Ke ʻike ʻia ka maʻi ʻaʻai parathyroid, hana ʻia nā hoʻokolohua hou aʻe e hoʻoholo ai inā he kūloko , metastatic , a recurrent paha . E like me ka mea i ʻōlelo ʻia ma mua, ʻaʻole hoʻohana ʻia ka hoʻokaʻawale ʻana ʻehā pae i hoʻohana ʻia no nā maʻi ʻaʻai ʻē aʻe no kēia.

ʻO wai ka mea i ʻoi aku ka nui o ka loaʻa ʻana o ka maʻi ʻaʻai parathyroid?

Hoʻopilikia like kēia maʻi ʻaʻai i nā wahine a me nā kāne. ʻIke pinepine ʻia ia i nā poʻe ma luna o 30 mau makahiki .

Pehea ka maʻamau o kēia maʻi?

He maʻi laha ʻole ka maʻi ʻaʻai parathyroid. E noʻonoʻo wale, he 0.005% wale nō ia o nā maʻi ʻaʻai āpau. Eia kekahi, ʻo ka maʻi ʻaʻai parathyroid ma waena o 0.5% a me 1% o nā maʻi āpau e pili ana i ka ʻōpū parathyroid. No laila, he mea laha ʻole kēia.

He aha nā kumu o ke Kanesa Parathyroid?

ʻO kaʻoiaʻiʻo, ʻaʻohe kumu kikoʻī o ka maʻi ʻaʻai parathyroid i loaʻa.

Eia nō naʻe, ʻo nā kūlana genetic laha ʻole (ʻo ia hoʻi, i hoʻoilina ʻia mai ka ʻohana) ua manaʻo ʻia he mau mea pilikia no kēia maʻi kanesa:

• ʻO ka neoplasia endocrine lehulehu ʻano I (MEN1)
• ʻO ka hyperparathyroidism hoʻokaʻawale ʻohana (FIHP)
• ʻO ka maʻi puʻupuʻu ʻāwae Hyperparathyroidism-ʻauwae

Eia kekahi, inā ua loaʻa iā ʻoe ka radiation therapy i kou poʻo a i ʻole ka ʻāʻī ma mua, hiki iā ia ke hoʻonui i kou pilikia o ka hoʻomohala ʻana i ka maʻi ʻaʻai parathyroid.

He aha nā hōʻailona o ke Kanesa Parathyroid?

ʻO ka hapa pinepine, ʻo nā hōʻailona o ka maʻi ʻaʻai parathyroid nā hōʻailona o ka hypercalcemia e hopena. Hiki i nā hōʻailona a me nā hōʻailona o ka hypercalcemia ke komo pū me:

• Pono e mimi pinepine ma mua o ka maʻamau (mimi pinepine)
• Manaʻo makewai ma mua o ka maʻamau
• Ka luaʻi a me ka luaʻi
• ʻo ka maʻamauʻAʻole pōloli
• Ka paʻa ʻana o ka ʻōpū
• Manaʻo luhi loa
• Manaʻo e like me ʻoe e kaumaha ana
• Ka poina ʻana a i ʻole ka nalowale o ka hoʻomanaʻo
• ʻEha ʻiʻo, nāwaliwali, a/a i ʻole ka ʻōʻō ʻana

ʻO nā hōʻailona ʻē aʻe o ke kanesa parathyroid:

• Loaʻa kahi puʻupuʻu ma ka ʻāʻī
• Nā loli leo a i ʻole ka palahalaha ʻana
• Ka paʻakikī i ka ale ʻana i ka meaʻai

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​mai makaʻu e manaʻo he maʻi ʻaʻai parathyroid maoli nō ia. Hiki ke ʻike ʻia kēia mau hōʻailona ma nā ʻano maʻi ʻē aʻe he nui. Eia nō naʻe, inā hoʻomau kekahi mea e like me kēia, ʻoi aku ka maikaʻi o ke ʻike ʻana i ke kauka no ka ʻōlelo aʻo.

Pehea e ʻike ʻia ai ke Kanesa Parathyroid?

Hiki i kekahi manawa ke paʻakikī iki ka ʻike ʻana i ke kanesa parathyroid. ʻO kekahi kumu, ʻo ia ke ʻano like o nā pūnaewele o kahi adenoma parathyroid noncancerous a me nā pūnaewele o kahi kanesa parathyroid.

Hoʻomaopopo pinepine ʻia ke kanesa parathyroid ma hope o ka wehe ʻia ʻana o kou kelepa parathyroid maʻamau ʻole a overactive (kahi `parathyroidectomy`), a nānā hou ʻia ke kino. I kekahi manawa, hiki i ke kauka lapaʻau ke ʻike i ke kanesa parathyroid i ka wā o ke ʻoki ʻana.

He aha nā hoʻokolohua e hana ʻia no ka hōʻoia ʻana?

E like me ka mea i ʻōlelo ʻia ma mua, ʻike pinepine ʻia ka maʻi ʻaʻai parathyroid ma hope o kou ʻike ʻia ʻana me ka hyperparathyroidism mua , a ua wehe ʻia ke kelepa parathyroid maʻamau a overactive hoʻi ma ke ʻoki ʻana. I kekahi manawa, hiki i ke kauka lapaʻau ke ʻike i ka maʻi ʻaʻai parathyroid i ka wā o ke ʻoki ʻana.

Ma mua o kāu hana ʻoki e wehe i kāu kelepa parathyroid hyperactive, hiki iā ʻoe ke loaʻa nā hoʻokolohua e like me kēia:

• Hoʻāʻo ka calcium koko
• Hoʻāʻo koko PTH
• ʻO ka nānā ʻana o ka parathyroid - He ʻano maʻamau kēia o ka scan sestamibi radioactive a/a i ʻole kahi scan CT.

Inā ua ʻike ʻia ʻoe me ke kanesa parathyroid, hiki i kāu kauka ke kauoha i nā hoʻokolohua kiʻi e like me kēia e ʻike ai inā ua pālahalaha ke kanesa (metastasized) i nā ʻāpana ʻē aʻe o kou kino:

• CT scan (kamepiula tomography scan): Hoʻohana ka CT scan i nā kukuna X a me kahi kamepiula e hana i nā kiʻi ʻekolu-dimensional (3D) o kou kino.
• MRI scan (MRI - kiʻi hoʻohuihui magnetic):Hoʻohana kahi scan MRI i kahi magnet nui, nā nalu lekiō, a me ke kamepiula e hana i nā kiʻi kikoʻī o kou kino. ʻAʻole ia e hoʻohana i nā kukuna X (radiation).

He aha nā lāʻau lapaʻau no ka maʻi ʻaʻai parathyroid?

ʻO ke koho lapaʻau nui no ka maʻi ʻaʻai parathyroid, ʻo ia ka wehe ʻana i ke kelepa parathyroid cancerous (`en bloc resection`). Inā ua pālahalaha (metastasized) ke kanesa parathyroid, pono paha i kāu kauka lapaʻau ke wehe i nā ʻiʻo a puni kou kelepa parathyroid a i ʻole nā ​​ʻiʻo cancerous mai nā ʻāpana ʻē aʻe o kou kino.

Hiki ke hoʻohana ʻia nā ʻano hana ʻokiʻoki no ka maʻi ʻaʻai parathyroid:

• ʻO ka resection en bloc: Ma kēia kaʻina hana, wehe ke kauka lapaʻau i kāu kelepa parathyroid holoʻokoʻa a me ke capsule a puni. I kekahi manawa, hiki iā lākou ke wehe i ka hapalua o ka kelepa thyroid ma ka ʻaoʻao like me ka kelepa parathyroid cancerous, me nā ʻiʻo a puni, nā ʻiʻo, a me nā aʻalolo.
• Ka wehe ʻana i ka puʻupuʻu: Ma kēia kaʻina hana, wehe ke kauka ʻoki i ka nui o ka puʻupuʻu e like me ka hiki. ʻAʻole paha e wehe loa ʻia kekahi mau puʻupuʻu.
• Metastasectomy: Ma kēia, wehe ke kauka lapaʻau i kekahi maʻi kanesa i laha (metastasized) i nā ʻiʻo ʻē aʻe a/a i ʻole nā ​​​​​​ʻōpū i loko o kou kino, no ka laʻana, nā māmā.

E loaʻa iaʻu ka chemotherapy a i ʻole ka radiation therapy?

ʻAʻole hoʻohana pinepine ʻia ka chemotherapy a me ka radiation therapy e mālama i ka maʻi ʻaʻai parathyroid. Na kāu kauka e hoʻoholo inā he koho kūpono ka chemotherapy a me/a i ʻole ka radiation therapy nāu.

Aia kekahi lāʻau lapaʻau no ke kanesa parathyroid?

I kēia manawa, ʻaʻohe lāʻau lapaʻau kūikawā no ke kanesa parathyroid. Nui ka poʻe me ke kanesa parathyroid e hoʻomohala i nā hōʻailona o ka hypercalcemia. No ka mea hiki i ka hypercalcemia ke hoʻopilikia, hiki i kāu kauka ke kuhikuhi i hoʻokahi a ʻoi aku paha o nā lāʻau lapaʻau hypercalcemia:

• Cinacalcet (Cinacalcet - Sensipar®)
• Nā Bisphosphonates
• ʻO Denosumab (Denosumab - XGEVA®)

Inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi o ka hypercalcemia, hiki i kāu kauka ke ʻōlelo aku e hoʻokomo koke ʻia ʻoe i ka haukapila a hoʻomaka i nā wai intravenous (IV) a me nā lāʻau ʻē aʻe.

Hiki i koʻu maʻi ʻaʻai parathyroid ke hoʻi hou mai?

ʻAe, ʻoi aku ma mua o ka hapalua o ka poʻe i ʻike ʻia me ka maʻi ʻaʻai parathyroid hiki ke loaʻa hou ka maʻi kanesa.ʻO ka maʻamau, hoʻi hou mai ke kanesa i loko o kekahi mau makahiki - ma waena o ʻelua a me ʻelima mau makahiki. Akā i kekahi mau hihia, hiki ke hana i nā makahiki he ʻumi (20 mau makahiki a ʻoi aku paha) ma hope o kāu ʻike mua ʻana a me ka mālama ʻana.

Hiki i kēia maʻi kanesa ke laha (metastasize) i nā ʻāpana ʻē aʻe o ke kino?

ʻAe, hiki i ke kanesa parathyroid ke laha (metastasize) i nā ʻāpana ʻē aʻe o kou kino. Ma waena o 10% a me 30% o ka poʻe me ke kanesa parathyroid ua laha mua ke kanesa (metastatic) i ka manawa o ka hōʻoia ʻana. I kēia mau hihia, laha pinepine ke kanesa i kou mau māmā, iwi, a i ʻole ke akepaʻa. Eia nō naʻe, hiki iā ia ke laha i kou mau lymph nodes a i ʻole pancreas.

He aha ka prognosis no ka maʻi ʻaʻai parathyroid?

ʻO ka wānana no ka maʻi ʻaʻai parathyroid e pili ana i ka piha ʻana o ke ʻoki ʻana e wehe i ka parathyroid gland i ka wā e ʻike mua ʻia ai ʻoe, ʻoiai ua kaupalena ʻia nā koho lapaʻau lua e like me ka radiation therapy a me ka chemotherapy.

No ka poʻe me ka maʻi ʻaʻai parathyroid i hana ʻia i kahi resection en bloc a he mau palena maikaʻi ʻole, ʻo ka nui o ke ola ʻana he 90% ʻelima mau makahiki ma hope o ke ʻoki kino mua. ʻO ka nui o ke ola ʻana he 67% hoʻi he ʻumi mau makahiki ma hope o ke ʻoki kino mua.

ʻOi aku ma mua o ka hapalua o ka poʻe i ʻike ʻia me ka maʻi ʻaʻai parathyroid a loaʻa i ke ʻoki ʻana e wehe i ke gland e ʻike hou ʻia ke kanesa. I kēia mau hihia, hoʻi hou mai ke kanesa i loko o ʻelua a ʻelima mau makahiki o ke ʻoki mua ʻana. Eia nō naʻe, hiki ke hoʻi hou mai i nā makahiki he ʻumi ma hope.

Hiki ke pale ʻia ke kanesa parathyroid?

ʻO ka mea pōʻino, ʻaʻohe ala i ʻike ʻia e pale aku ai i ka maʻi ʻaʻai parathyroid. Eia kekahi, ʻaʻohe ala e hōʻemi ai i ka pilikia o ka loaʻa ʻana o kēia maʻi. Inā loaʻa kekahi o kou ʻohana i nā maʻi kelepa parathyroid, he manaʻo maikaʻi e kamaʻilio me kāu kauka.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Inā loaʻa iā ʻoe ka maʻi ʻaʻai parathyroid, makemake paha ʻoe e nīnau i kāu kauka i nā nīnau e like me kēia:

• Ua pālahalaha anei ke kanesa ma ʻō aku o koʻu kelepa parathyroid?
• He aha ka lāʻau lapaʻau maikaʻi loa no ka maʻi ʻaʻai parathyroid?
• He aha nā pilikia a me nā hopena ʻaoʻao o ka lāʻau lapaʻau?
• Aia anei koʻu ʻohana i ka pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai parathyroid?
• Hiki iaʻu ke loaʻa hou i ka maʻi ʻaʻai parathyroid?
• Aia anei au i ka pilikia o ka loaʻa ʻana o nā ʻano maʻi ʻē aʻe?
• He aha ka mālama e pono ai iaʻu ma hope o ka lāʻau lapaʻau?
• Pono anei au e makaʻala i nā hōʻailona o nā pilikia?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

Hiki i ka ʻike ʻia ʻana he maʻi kanesa ke lilo i mea weliweli. Akā e hoʻomanaʻo,Eia kāu hui lapaʻau e kōkua iā ʻoe a hōʻike iā ʻoe i ke ʻano lapaʻau maikaʻi loa. ʻOiai ʻo ke ʻoki kino wale nō ka lāʻau lapaʻau no ka maʻi ʻaʻai parathyroid i kēia manawa, ke hoʻomaikaʻi mau nei ka noiʻi a me nā lāʻau lapaʻau no ka maʻi ʻaʻai. Aia paha he hoʻokolohua lapaʻau hiki iā ʻoe ke komo. No laila, mai makaʻu e nīnau i kāu kauka e pili ana i kāu maʻi ʻaʻai parathyroid. E hōʻoia i ka wehewehe ʻia ʻana o nā mea āpau ma ke ʻano āu e maopopo ai.

ʻO ke Kanesa Parathyroid, nā ʻĀpana Parathyroid, Hypercalcemia, Parathyroid Hormone, PTH, nā Hōʻailona Kanesa, ka Lāʻau ʻana i ke Kanesa, ke ʻoki kino