Ke manaʻo nei ʻoe i kekahi manawa i ka ʻeha o ka ʻōpū, ka pehu ʻana, a i ʻole ka ʻeha o ka ʻōpū? He mea maʻamau kēia mau hōʻailona, a i kekahi manawa hiki ke hana ʻia e kahi mea a mākou e ʻai ai a inu paha, a i ʻole kahi maʻi liʻiliʻi. Eia nō naʻe, i kekahi manawa aia paha kekahi mea koʻikoʻi ma hope o lākou e pono ai ka nānā ʻana. ʻO ia ke ʻano o ka peritoneal carcinomatosis . He mea paʻakikī paha ke kani ʻana o ka inoa, akā e kamaʻilio maʻalahi kākou e pili ana iā ia a e hoʻomaopopo iā ia.
He aha ka Peritoneal Carcinomatosis?
I ka ʻōlelo maʻalahi, ʻo ia hoʻi, ua laha ka maʻi kanesa i hoʻomaka ma kahi ʻē aʻe o ko mākou kino i kahi membrane i kapa ʻia ʻo ka peritoneum . I kēia manawa ke noʻonoʻo nei paha ʻoe i ke ʻano o kēia peritoneum. He membrane lahilahi ia e uhi ana i loko o ko mākou ʻōpū, ʻo ia hoʻi, ka lua ʻōpū a me ka lua pelvic. Ua uhi ʻia kekahi mau ʻōpū o loko, e like me ko mākou naʻau, ke akepaʻa, a me ka ʻōpū, e kēia membrane.
No laila, ke ulu ka maʻi kanesa i loko o kekahi ʻōkana ʻē aʻe, no ka laʻana, he ovary a he colon paha, a hele mai kēlā mau hunaola kanesa i ka peritoneum a hana i nā ʻōpū hou ma laila, kapa mākou ia he peritoneal carcinomatosis . He ʻokoʻa kēia mai ke kanesa peritoneal mua, kahi e hoʻomaka ai i loko o ka peritoneum ponoʻī, no ka mea, i kēia hihia hoʻomaka ke kanesa ma kahi ʻē aʻe.
Ua kapa ʻia kēia mau ʻano maʻi kanesa he maʻi kanesa hope loa a i ʻole ka maʻi kanesa metastatic . ʻOiaʻiʻo, ʻoi aku ka koʻikoʻi o kēia mau mea ma mua o nā maʻi kanesa mua. Akā, mai hopohopo. Me nā lāʻau lapaʻau hou i loaʻa, hiki ke kāohi i ka laha ʻana o kēia maʻi a kōkua i ka mea maʻi e ola lōʻihi.
He aha nā ʻano maʻi ʻaʻai e hoʻoulu pinepine ai i kēia maʻi?
Hiki i kekahi maʻi kanesa ke laha i ka peritoneum, akā ʻo nā ʻano maʻi kanesa e hiki ke hoʻoulu i kēia ʻano:
- ʻO ke kanesa ovarian (ʻo kēia ka mea maʻamau)
- Ka maʻi ʻaʻai kolona
- Ka maʻi ʻōpū
- Ka maʻi ʻaʻai pancreatic
- Ka maʻi ʻaʻai ʻāpiki
- Ka maʻi ʻaʻai rectum
He aha nā hōʻailona o ka Peritoneal Carcinomatosis?
ʻO ka hapa nui o ka manawa, ʻaʻole kēia ʻano e hōʻike i kekahi mau hōʻailona a hiki i ka wā e hoʻopilikia ai i kahi ʻāpana nui o ka peritoneum. ʻO ia hoʻi, hoʻomaka wale nā hōʻailona e ʻike ʻia ma hope o ka laha iki ʻana o ka maʻi. Ke hana ʻia kēia, ʻo ka hōʻailona maʻamau ka hōʻiliʻili ʻana o ka wai i loko o ka ʻōpū (ascites) . ʻO kēia ka manawa e hoʻomaka ai ka ʻōpū e pehu ma ke ʻano ʻē.
Aia paha kekahi mau hōʻailona ʻē aʻe e pili ana i kēia:
- Luhi pinepine
- ʻŌpū pehu ( ma muli o ka paʻa ʻana o ka wai)
- ʻEha ʻōpū
- ʻŌpū nui
- ʻEha haʻahaʻa
- Ka luaʻi a me ka luaʻi
- Ka paʻa ʻana o ka ʻōpū
- ʻO ka pohō kaumaha a i ʻole ka piʻi ʻana o ke kaumaha i wehewehe ʻole ʻia
I kēia manawa, e nānā, ʻo ka hapa nui o kēia mau hōʻailona he mea maʻamau nō hoʻi i nā maʻi maʻamau ʻē aʻe. No ka laʻana, hiki ke loaʻa ka ʻeha o ka ʻōpū i ka gastritis. No laila, no ka mea wale nō iā ʻoe kēia mau hōʻailona, mai hopohopo a manaʻo he maʻi koʻikoʻi kou. Eia nō naʻe, inā hoʻomau ʻoe i kēia mau hōʻailona, he mea naʻauao ke ʻike pono i ke kauka a nānā ʻia. No ka mea, ʻo ke kauka wale nō ke ʻike maopopo inā he maʻi kanesa kēia a ʻaʻole paha.
He aha ke kumu o kēia?
E like me ka mea i ʻōlelo ʻia ma mua, hiki mai ka peritoneal carcinomatosis i ka wā e laha ai ke kanesa mai kekahi ʻāpana o ke kino i ka peritoneum. ʻO ka hapa pinepine, hoʻomaka kēia kanesa i loko o ka ʻōpū, ma kahi ʻāpana kokoke i ka peritoneum. No ka laʻana, nā ovaries a i ʻole ka colon.
Eia nō naʻe, ma kahi o ʻumi pakeneka (10%) o nā hihia, hoʻomaka kēia maʻi kanesa i loko o kahi ʻōkana ma waho o ka lua ʻōpū. I kēlā hihia, hele nā pūnaewele kanesa ma o ke kahe koko a i ʻole ka ʻōnaehana lymphatic e hiki i ka peritoneum. E noʻonoʻo e like me nā ʻāpana liʻiliʻi o ka lepo e neʻe ana ma o kahi ala wai, hele pū kēia mau pūnaewele ma o nā wai o ke kino.
Pehea e ʻike ʻia ai kēia maʻi? (Diagnosis)
Hoʻohana nā kauka i kekahi mau hoʻokolohua e ʻike ai i kēia maʻi. ʻO kekahi o lākou:
- Nā hoʻāʻo kiʻi: ʻO kēia nā scan CT , nā scan MRI , a me nā scan PET . Hiki i kēia ʻano scan ke hāʻawi i kahi kiʻi maopopo o ka mamao o ka laha ʻana o ke kanesa i ka peritoneum a me kona wahi.
- Nā hoʻāʻo koko: Nānā ʻia kou koko no nā protein kūikawā i kapa ʻia he mau māka tumor . Hoʻokuʻu kekahi mau hunaola kanesa i kēia mau mea i loko o ke koko. ʻO ke kiʻekiʻe o kēia mau mea hiki ke lilo i hōʻailona o ka maʻi.
- Paracentesis: Inā he wai i loko o kou ʻōpū (ascites), hiki i kāu kauka ke lawe i kahi hāpana liʻiliʻi o ka wai a hoʻāʻo ʻia i loko o kahi lab. Hiki i kēia ke kōkua i ka hoʻoholo ʻana i ke ʻano o ka maʻi kanesa i laha, a i ʻole ke ʻano o ke kanesa mua.
- Biopsy: Pili kēia i ka lawe ʻana i kahi ʻāpana liʻiliʻi loa o ka puʻupuʻu a nānā iā ia ma lalo o kahi microscope e ʻike inā he mau hunaola kanesa. ʻO kēia wale nō ka hoʻāʻo e hiki ke haʻi maopopo inā he kanesa a ʻaʻole paha.
He aha ka Peritoneal Carcinomatosis Index (PCI)?
He mea hana koʻikoʻi kēia PCI i ke kaʻina hana diagnostics e kōkua i nā kauka e hoʻolālā i ka lāʻau lapaʻau. Ma ka hoʻohana ʻana i kēia helu kuhikuhi, hāʻawi nā kauka iā ʻoe i kahi helu e pili ana i kahi a me ka nui o nā hunaola kanesa i loko o kou ʻōpū a me ka ʻōpū liʻiliʻi.
Hiki i kēia ʻike ke kōkua i ke kauka e hoʻomaopopo a loaʻa kahi manaʻo inā hiki i ke ʻoki kino ke hoʻopau loa i kēia mau ʻōpū.
He aha nā lāʻau lapaʻau no kēia? (Lāʻau lapaʻau)
ʻO ke kumu nui a me ka lāʻau maʻamau no ka peritoneal carcinomatosis kahi lāʻau i kapa ʻia ʻo Hyperthermic Intraperitoneal Chemotherapy (HIPEC) i hui pū ʻia me ke ʻoki cytoreductive (CRS) .
ʻOiai paha he ʻano paʻakikī kēia o kahi huaʻōlelo ʻelua huaʻōlelo, penei wale nō ia:
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* CRS (ʻoki kino Cytoreductive): ʻO ka pahuhopu o kēia ʻoki kino, ʻo ia ka wehe ʻana i nā puʻupuʻu kanesa a pau i ʻike ʻia ma ka membrane peritoneal.
* HIPEC (Hyperthermic Intraperitoneal Chemotherapy): Hoʻohana ʻia kēia ʻano hana e luku i nā hunaola kanesa i koe i liʻiliʻi loa e ʻike ʻia e ka maka ʻōlohelohe ma hope o ke ʻoki ʻana o CRS. Ma kēia, ua hoʻokomo pololei ʻia nā lāʻau chemotherapy i hoʻomehana ʻia i loko o ka lua ʻōpū, waiho ʻia no kekahi manawa pōkole, a laila wehe ʻia. No ka mea ua hoʻomehana ʻia nā lāʻau a hāʻawi pololei ʻia i ke kanesa, ʻoi aku ka maikaʻi ma mua o ka chemotherapy kuʻuna.
Hāʻawi ʻia kēia lāʻau CRS a me HIPEC ma waho aʻe o ka lāʻau i hāʻawi ʻia i ke kino kahi i hoʻomaka mua ai ke kanesa.
I kekahi manawa, ʻaʻole hiki i nā kānaka a pau ke hana i ke ʻoki CRS. ʻO ia hoʻi, ʻaʻole paha kūpono ke kūlana o ka mea maʻi no ke ʻoki ʻana. ʻOiai no ia poʻe, hiki i ka mālama palliative ke kōkua i ka kaohi ʻana i nā hōʻailona a hōʻemi i ka ʻeha. ʻO ka mālama palliative kahi lāʻau lapaʻau e kōkua ai i ka mea maʻi e ʻoluʻolu e like me ka hiki, me ka nānā ʻole i ke kahua o ke kanesa.
Aia kekahi mau pilikia o ka lāʻau lapaʻau?
Ua hōʻike ʻia ma ka noiʻi hou loa he palekana a he pono nā lāʻau lapaʻau ʻo CRS a me HIPEC ke nānā pono ʻia nā mea maʻi a koho pono ʻia. He maikaʻi loa nā hopena ke hana ʻia ke ʻoki ʻana ma kahi kikowaena akamai e hana mau ana i kēia lāʻau lapaʻau.
Eia nō naʻe, e like me nā ʻoki kino nui a pau, aia kekahi mau pilikia e hiki ke loaʻa. ʻOiai he mea kakaikahi loa, hiki i kēia mau mea ke hoʻoweliweli i ke ola inā ʻaʻole mālama koke ʻia. ʻO kēia mau mea:
- Kahe nui ʻana o ke koko
- Ka puka ʻana o kahi ʻōkana
- Ka leaka anastomotic ma hope o ke ʻoki ʻana
- Maʻi
- ʻŌpū
- Sepsis ( kahi maʻi koʻikoʻi i hoʻokumu ʻia e nā mikrob e komo ana i ke koko)
E wehewehe mua ana kāu kauka i kēia mau mea a pau iā ʻoe. ʻO ka mea nui, ʻo ia kou hoʻomaopopo ʻana i ke ʻano o ka ʻoi aku o nā pono o ka lāʻau lapaʻau ma mua o nā pilikia.
He aha ka wānana no ka peritoneal carcinomatosis?
Ua hoʻomaikaʻi nui ʻia ka wānana maikaʻi ʻole e pili ana me ka peritoneal carcinomatosis me ka hiki ʻana mai o nā lāʻau lapaʻau CRS a me HIPEC. ʻOiai ʻaʻohe lāʻau lapaʻau no ke ʻano, kōkua kēia mau lāʻau lapaʻau i nā mea maʻi e ola lōʻihi .
ʻO ka poʻe i hana ʻia i ke ʻoki kino e wehe loa i nā koena āpau o ke kanesa (CRS), 45% e ola ana ma hope o ʻelima mau makahiki. ʻO ia hoʻi, he kanahākumamālima pakeneka o ka poʻe i loaʻa ka CRS holomua e ola ana no ʻelima mau makahiki. Eia nō naʻe, inā ʻaʻole hiki i ke ʻoki kino ke wehe loa i ke kanesa, ʻo ka helu ola ʻelima makahiki ma lalo o 10%.
Aia kekahi mau kumu ʻē aʻe e hoʻopilikia i kou manaʻo:
- ʻO ke ʻano o ke kanesa mua
- Pehea ke ʻano ʻē o nā hunaola kanesa
- Pehea ka koʻikoʻi o kou mau hōʻailona
- ʻO kāu helu PCI
Hiki i kāu kauka ke wehewehe hou aku e pili ana i kēia mau mea e hoʻopilikia ai i kou kūlana.
Pehea e mālama ai iaʻu iho? (Mālama ponoʻī)
ʻO ka noho ʻana me ka maʻi kanesa metastatic, kahi maʻi e like me ka peritoneal carcinomatosis, hiki ke paʻakikī. Hiki i nā hōʻailona kino ke paʻakikī i ka hele ʻana i ka lā. A ʻo ka maopopo ʻole e pili ana i ke ʻano o ka pane ʻana o kou kino i ka lāʻau lapaʻau hiki ke hoʻokaumaha i ka naʻau.
ʻO kēia ke kumu he mea nui e loaʻa ke kākoʻo a pau hiki iā ʻoe ke loaʻa.
Hiki i kēia ke komo pū me ka loaʻa ʻana o ka mālama palliative e kōkua i ka hoʻokele ʻana i nā hōʻailona. He manaʻo maikaʻi nō hoʻi e ʻimi i ka ʻōlelo aʻoaʻo e kōkua iā ʻoe e hoʻoponopono i nā manaʻo paʻakikī e hele mai me kahi hōʻailona. He mea kōkua nui ke komo ʻana i kahi hui kākoʻo kahi e hiki ai iā ʻoe ke hoʻopili me nā poʻe ʻē aʻe e noho nei me nā maʻi kanesa holomua e like me ʻoe. Hiki i kēia ke kōkua iā ʻoe e manaʻo ʻaʻole mehameha a hiki iā ʻoe ke aʻo mai nā ʻike o haʻi.
E nīnau i kāu kauka e pili ana i nā kumuwaiwai e hiki ai ke maʻalahi iki ka noho ʻana me ka peritoneal carcinomatosis.
Āhea wau e ʻike ai i ke kauka?
Pono ʻoe e ʻike pinepine i kāu kauka e ʻike i ka maikaʻi o kāu lāʻau lapaʻau. I kēia manawa, inā loaʻa iā ʻoe nā hōʻailona hou a i ʻole e ʻoi aku ka ʻino o kāu mau hōʻailona, e haʻi koke i kāu kauka.A laila hiki iā ia ke ʻōlelo i nā lāʻau lapaʻau hou a i ʻole nā loli i kāu hoʻolālā lapaʻau e kōkua paha iā ʻoe.
He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?
Ke hālāwai ʻoe me kāu kauka, he mea maikaʻi ke nīnau i nā nīnau e like me kēia:
- He aha nā hoʻokolohua e pono ai iaʻu e hana?
- He aha ke ʻano o ka lāʻau lapaʻau āu e paipai mai nei iaʻu?
- He aha nā hopena ʻaoʻao e hiki iaʻu ke manaʻo mai nā lāʻau lapaʻau?
- He aha nā hopena e hiki iaʻu ke manaʻo ma hope o ka mālama ʻana?
- He aha nā kumuwaiwai e loaʻa ana e kōkua iaʻu e hoʻomanawanui i nā hōʻailona a me nā hopena ʻaoʻao?
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)
I ka wā ma mua, i ka wā i ʻike ʻia ai ke kanaka me ka Peritoneal Carcinomatosis, ua manaʻo ʻia he pōkole loa ko lākou ola. Eia naʻe, ua ʻokoʻa ke kūlana i kēia manawa. Mahalo i nā lāʻau lapaʻau holomua i loaʻa i kēia lā, ua hoʻolōʻihi nui ʻia ka manawa ola o ka poʻe me kēia maʻi.
Eia nō naʻe, e hilinaʻi kou ʻike i kāu hōʻailona kikoʻī. Hiki i kāu kauka ke wehewehe iā ʻoe inā he moho maikaʻi ʻoe no nā lāʻau lapaʻau e like me CRS a me HIPEC. Hiki iā ia ke hoʻopili iā ʻoe me nā kumuwaiwai e hōʻoia i ka loaʻa ʻana o ke kākoʻo āu e pono ai e kū i kēia kūlana.
Mai hoʻōki i ka manaʻolana. ʻO ka loaʻa ʻana o ka ʻike kūpono, ka loaʻa ʻana o ka lāʻau lapaʻau i ka manawa kūpono, a me ke kākoʻo noʻonoʻo a me ke kino āu e pono ai he mea nui loa ia i kēia hakakā.
ʻO ka maʻi ʻaʻai Peritoneal, Peritoneal Carcinomatosis, Kanesa, Peritoneum, Ascites, CRS, HIPEC, Nā hōʻailona Kanesa, Lapaʻau Kanesa
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