Ua ʻike anei ʻoe i ke kanesa laha ʻole i kapa ʻia ʻo Sarcomatoid Carcinoma? E kamaʻilio kākou me nā kikoʻī!

Hoʻoweliweli iki ka maʻi kanesa iā kākou a pau, ʻeā? Akā, ʻaʻole like nā maʻi kanesa a pau. I kēia lā, e kamaʻilio kākou e pili ana i kahi ʻano maʻi kanesa kakaʻikahi a paʻakikī hoʻi. Ua kapa ʻia ʻo Sarcomatoid Carcinoma. He mea ʻē paha ka inoa iā ʻoe, akā e hoʻāʻo kākou e wehewehe maʻalahi. Ua kapa ʻia kēia e nā kauka he ʻano maʻi kanesa ulu wikiwiki loa a ikaika hoʻi .

He aha ka Sarcomatoid Carcinoma?

I ka ʻōlelo maʻalahi, ʻo Sarcomatoid Carcinoma ka hui pū ʻana o ʻelua ʻano maʻi kanesa. ʻO ia hoʻi, he mau ʻano like me ka carcinoma a me ka sarcoma. I kēia manawa, e nānā kākou i ke ʻano o ka carcinoma a me ka sarcoma.

• Carcinoma: ʻO kēia ke ʻano maʻamau o ka maʻi kanesa. Hoʻomaka ia i loko o nā ʻiʻo e uhi ana i ka ʻili o ko mākou mau kino a i ʻole ka ʻili. Kāhea mākou i kēia mau ʻiʻo he ʻiʻo epithelial no ka mea ua hana ʻia lākou me nā cell epithelial.
• ʻO Sarcoma: ʻAʻole kēia i maʻamau ma mua o ka carcinoma. Hoʻomaka nā Sarcomas ma nā wahi e like me ka iwi, nā ʻiʻo hoʻohui (e.g., cartilage, tendons), a me nā ʻiʻo palupalu (e.g., muscle, fat, nerves). Hana ʻia lākou me kahi ʻano cell i kapa ʻia nā cell mesenchymal.

No laila, i ke ʻano o ka sarcomatoid carcinoma, hoʻokumu ʻia kahi puʻupuʻu e loaʻa ana nā pūnaewele a me nā ʻiʻo e pili ana i ka carcinoma a me ka sarcoma. Ulu koke kēia mau puʻupuʻu a hiki ke laha (metastasize) i nā ʻāpana like ʻole o ke kino. Ke laha kēia, ua hōʻino ʻia nā ʻiʻo olakino i loko o ke kino.

Ma hea ma ke kino e hana pinepine ʻia ai kēia?

Ke lohe ʻoe i ka inoa sarcomatoid carcinoma, pili paha ʻoe iā ia me kou mau māmā . Eia nō naʻe, hiki i kēia ʻano maʻi kanesa, nona nā ʻano o ka carcinoma a me ka sarcoma, ke hana pū ma nā wahi ʻē aʻe o ke kino. Eia kekahi laʻana:

• ʻIli
• Iwi
• Waha
• ʻO ke kele thyroid
• Nā umauma
• ʻōpū
• ʻōpū liʻiliʻi
• Ake
• ʻO ka pancreas
• ʻōpū
• ʻO ka prostate
• ʻŌpū mimi
• nā puʻupaʻa
• ʻO ka hakahaka ma waenakonu o ka umauma (ua kapa ʻia kēia ʻo "Mediastinum". Aia nā mea e like me ka puʻuwai, trachea, a me ka thymus gland ma ʻaneʻi)

ʻO ka sarcomatoid carcinoma, ka mea e hoʻomaka ana i loko o nā māmā, ua ʻōlelo ʻia e pālahalaha koke loa. Ma kēia ʻano, hiki iā ia ke pālahalaha i kekahi mau wahi i ka manawa hoʻokahi, e like me nā kelepa adrenal, ka lolo, nā iwi, ke akepaʻa, nā puʻupaʻa, ka peritoneum, ka pancreas, ka ʻili, a me ka puʻuwai.

Aia kekahi mau ʻano like ʻole o kēia?

ʻAe, ua hoʻokaʻawale ka World Health Organization (WHO) i ka sarcomatoid carcinoma i ʻelima mau ʻano nui i ka makahiki 2015. Ua kapa ʻia kēlā me kēia ʻano he "poorly differentiated non-small cell lung carcinoma." ʻO ke ʻano o "Poorly differentiated" ua ʻokoʻa loa ka hoʻokaʻawale ʻana o nā cell i mea paʻakikī ke ʻōlelo pololei i ko lākou ʻano. ʻO ka maʻi kanesa māmā non-small cell kahi ʻano maʻamau o ka maʻi kanesa māmā e ulu a laha koke.

ʻO kēia mau ʻano ʻelima:

• Nā carcinoma Pleomorphic: Loaʻa i kēia mau mea nā hiʻohiʻona carcinoma. Eia nō naʻe, ma ka liʻiliʻi he 10% o lākou i loaʻa nā hiʻohiʻona sarcoma. ʻO kēia ke ʻano maʻamau o ka carcinoma sarcomatoid.
• ʻO ka maʻi kanesa Spindle-cell: Loaʻa i kēia ʻano maʻi kanesa kona inoa mai ke ʻano o kona mau cell ma lalo o kahi microscope. He lōʻihi lākou, lahilahi, a ua like me nā wili o kahi huila wili.
• ʻO ka carcinoma cell nui: Loaʻa i kēia nā cell nui i hoʻonohonoho ʻia ma ke ʻano like me nā sarcomas. Hoʻokumu pinepine ʻia kēia mau mea ma ka ʻaoʻao o luna o nā māmā.
• Carcinosarcoma: Hoʻokomo pū kēia i nā ʻiʻo mai kekahi mau ʻano carcinoma, e like me ka adenocarcinoma a me ka squamous cell carcinoma. Hoʻokomo pū ia i nā ʻiʻo sarcoma maʻamau ʻole, i ulu maikaʻi ʻole ʻia.
• ʻO ka blastoma pulmonary: He ʻano adenocarcinoma kēia e like me ka ʻiʻo māmā o kahi fetus. Hiki ke ʻike ʻia nā pūnaewele mesenchymal (e like me nā sarcomas).

ʻO wai ka mea i ʻoi aku ka paʻakikī ke hoʻomohala i kēia?

ʻO ka Sarcomatoid Carcinoma ka mea maʻamau i nā kāne . He mea maʻamau loa ia i nā poʻe e hoʻohana nei i nā huahana paka a i ʻole ua hoʻohana mua iā lākou . ʻO ka awelika o ka makahiki o ka maʻi ma kahi o 65 mau makahiki.

Pehea ka maʻamau o kēia?

He ʻano maʻi kanesa laha ʻole kēia. ʻO ka Sarcomatoid Carcinoma kahi pakeneka liʻiliʻi loa o nā maʻi kanesa māmā āpau, ma waena o 0.1% a me 0.4%.

He aha nā hōʻailona o kēia?

ʻO nā hōʻailona āu e ʻike ai ma muli o kahi i laha ai ke kanesa i loko o kou kino. Inā loaʻa iā ʻoe ka sarcomatoid carcinoma o nā māmā, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Kuke (mau)
• Ka paʻakikī o ka hanu ʻana (dyspnea)
• ʻEha umauma
• Ke kahe koko me ka mucus
• ʻO ka pohō kaumaha me ke kumu ʻole

No ke aha lā e hana ʻia ai kekahi mea e like me kēia?

Manaʻo nā kauka he kumu nui o ka sarcomatoid carcinoma kahi hana i kapa ʻia ʻo "Epithelial-Mesenchymal Transition (EMT)." I ka ʻōlelo maʻalahi, ʻo ia ka manawa e loli ai nā cell epithelial cancerous i loko o ka non-small cell lung carcinoma, a hoʻololi kekahi o lākou i nā cell mesenchymal. ʻO nā cell cancerous i loli ma kēia ʻano e pālahalaha koke loa i loko o ke kino.

Hoʻopili pinepine ʻia kēia mau loli o nā cell a me ka ulu wikiwiki ʻana me nā mutations genetic i loko o nā cell . ʻIke ʻoe, ʻo kā mākou mau genes nā kuhikuhi e haʻi i nā cell pehea e hana ai. ʻO ka mutation genetic kahi loli a hewa paha i kēlā mau kuhikuhi. Ua ʻike nā kānaka ʻepekema i kekahi mau mutations genetic e pili ana me ka sarcomatoid carcinoma.

He aha nā kumu pilikia e hoʻopilikia ai i kēia?

ʻO kahi mea pilikia kahi mea e hoʻonui ai i ka manawa kūpono o ka loaʻa ʻana o kahi maʻi. I ke ʻano o ka sarcomatoid carcinoma, ʻo ka puhipaka ka mea nui a ʻike nui ʻia. He mea kūpono ke hoʻomaopopo ʻia ma waena o 80% a me 90% o ka poʻe e loaʻa ana i kēia maʻi kanesa māmā he poʻe puhipaka o kēia manawa a i ʻole ma mua.

Mai poina e hiki i ka haʻalele ʻana i ka puhipaka ke pale iā ʻoe mai nā maʻi māmā he nui, me ke kanesa e like me kēia.

Pehea e ʻike ai ke kauka i kēia?

E nānā mua kāu kauka iā ʻoe a, inā pono, e hana i kekahi mau kaʻina hana kiʻi. Eia nō naʻe, i mea e hōʻoia ai he sarcomatoid carcinoma kēia, pono kahi biopsy e nānā i nā hunaola kanesa.

• Kiʻi: Hiki i ke kauka ke hana i kahi CT scan e ʻike ai i kahi o ke kanesa. No ka loaʻa ʻana o kahi ʻike maopopo o loko o ke kino, hiki ke hana ʻia kahi CT/PET scan a i ʻole kahi F-fluorodeoxyglucose (FDG)-PET scan. Hoʻohui ka CT/PET scan i ʻelua mau hoʻokolohua (CT a me PET) i ka manawa like. ʻO ka Fluorodeoxyglucose kahi kemika i hoʻokomo ʻia i loko o ke kino i ka wā o ka PET scan. Hōʻiliʻili ia a puni nā hunaola kanesa, e ʻike nui ʻia ai lākou ma ke scan.

• Histopathology: ʻO ka Histopathology ka nānā ʻana i kahi laʻana o ka ʻiʻo kanesa i lawe ʻia mai kahi biopsy. Hiki i ke ʻano o nā cell ke kōkua i ke kauka e hoʻoholo inā he sarcomatoid carcinoma a, inā pēlā, he aha ke ʻano o ia (e.g., pleomorphic carcinoma, spindle cell carcinoma).

• Ke kemika pale ʻana i ka maʻi:Ke nānā nei kēia hoʻāʻo i nā mea i kapa ʻia he antigens e pili ana i kekahi mau ʻano cell. Hiki i kekahi mau antigens ke ʻike i kahi cell he mea ʻē aʻe a ʻino paha.

Pehea e mālama ʻia ai?

ʻO ka lāʻau lapaʻau kūpono loa no kēia maʻi kanesa, ʻo ia ke ʻoki ʻana e wehe i ka puʻupuʻu holoʻokoʻa. Hiki i ka chemotherapy ke kōkua i ka pepehi ʻana i nā hunaola kanesa i koe ma hope o ke ʻoki ʻana. Eia nō naʻe, i ka hapa nui o ka manawa, ua laha ka maʻi kanesa i ka manawa e ʻike ʻia ai, no laila ʻaʻole hiki ke ʻoki ʻia. Inā he mau pilikia e like me ka ʻeha, ke kahe ʻana o ke koko, a i ʻole ka paʻakikī o ka hanu ʻana, hiki ke hāʻawi ʻia ka radiation therapy.

I ke ʻano o ka sarcomatoid carcinoma, ʻo ka hoʻāʻo lapaʻau paha ke koho lapaʻau maikaʻi loa. ʻO ka hoʻāʻo lapaʻau kahi haʻawina e hoʻāʻo ai i ka palekana a me ka pono o nā lāʻau lapaʻau hou. Ke noiʻi nei nā kānaka ʻepekema i nā lāʻau lapaʻau e hiki ke kōkua i ka hoʻolōʻihi i ka manawa hiki iā ʻoe ke ola me kēia maʻi kanesa. ʻElua o lākou:

• Lapaʻau i hoʻolālā ʻia: Pili kēia i ka hoʻolālā ʻana i nā ʻano kikoʻī e hoʻoulu ai i nā hunaola kanesa e hoʻonui me ka ʻole o ka kaohi.
• Immunotherapy: Hoʻoulu kēia i kāu ʻōnaehana pale, e kōkua ana iā ia e ʻimi a luku i nā hunaola kanesa.

He aha kā mākou e hana ai e hōʻemi i ka pilikia?

Ma ke koho ʻana e hoʻohana ʻole i nā huahana paka, hiki iā ʻoe ke hōʻemi i kou pilikia o ka loaʻa ʻana o ka sarcomatoid carcinoma, a me nā maʻi kanesa māmā ʻē aʻe. ʻO kēia ka hana koʻikoʻi loa hiki iā ʻoe ke hana.

Hiki ke ho'ōla loa ʻia kēia?

ʻO ka ʻoiaʻiʻo, ʻo ka sarcomatoid carcinoma kahi ʻano maʻi kanesa i paʻakikī ke hoʻōla piha. Eia nō naʻe, i ka wā e aʻo hou ai nā kānaka ʻepekema e pili ana i nā ʻano cellular o kēia mau tumors, e like me nā mutations genetic, hiki iā lākou ke hoʻomohala i nā lāʻau lapaʻau hou e kuhikuhi ana iā lākou. Inā ua ʻike ʻia ʻoe me kēia maʻi, hiki paha iā ʻoe ke komo i kahi hoʻokolohua lapaʻau e hoʻāʻo ana i nā lāʻau lapaʻau hou. E nīnau i kāu kauka e pili ana i kēia.

ʻEhia ka lōʻihi o kou ola ʻana me kēia maʻi?

He mea paʻakikī ke ʻōlelo i ka lōʻihi o kou ola ʻana ma kēia kūlana, akā he mea nui e makaʻala. Ma ka awelika, ʻo ka awelika o ke ola ʻana ma kahi o 10 mau mahina. ʻO ka ʻelima mau makahiki o ke ola ʻana ma kahi o 15%. Eia naʻe, ʻaʻole pili like kēia mau helu i nā kānaka a pau. Nui nā kumu e hiki ke hoʻopilikia i kou kūlana:

• ʻO ke ʻano kikoʻī o ke kele i loko o ka maʻi ʻaʻai.
• He aha nā hoʻololi gene i hana ʻia?
• Pehea ka lōʻihi mai ka hoʻomaka ʻana o nā hōʻailona a hiki i ka ʻike ʻia ʻana o ka maʻi.
• Pehea ka nui o ka ulu ʻana o ke kanesa a me ka luku ʻana i nā ʻiʻo olakino.
• Pehea ka mamao i laha ai ke kanesa.
• Inā hiki i ke kauka ke wehe loa i ka puʻupuʻu kanesa.

No laila, he mea nui loa e kamaʻilio ākea e pili ana i kēia mau mea a pau me kāu kauka i mea e loaʻa ai kahi ʻike pololei o kou kūlana.

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

Ke ʻike ʻoe he sarcomatoid carcinoma kou, e hopohopo nui paha ʻoe a huikau hoʻi no ka mea he ʻano like ʻole a paʻakikī kēia mau maʻi kanesa. He mea nui e kamaʻilio ākea me kāu kauka e pili ana i kāu mau koho lapaʻau a me ke ʻano o ka maʻi i ka wā e hiki mai ana. Hiki i kāu kauka ke wehewehe iā ʻoe i ka mea e manaʻo ai ma muli o nā ʻano o kāu mau hunaola kanesa a me kahi o ke kanesa i loko o kou kino.

Eia kekahi mau nīnau hiki iā ʻoe ke nīnau i kāu kauka:

• Ua laha anei koʻu maʻi ʻaʻai?
• Pehea ke koʻikoʻi o koʻu maʻi kanesa?
• He aha ke ʻano o ka lāʻau lapaʻau āu e paipai nei?
• He aha nā hopena ʻaoʻao e pono ke manaʻo ʻia mai ka lāʻau lapaʻau?
• Manaʻo ʻoe he manaʻo maikaʻi iaʻu e kiʻi i kahi manaʻo lapaʻau ʻelua?
• Pono anei au e hana pū me nā loea mālama palliative?
• Ua kūpono anei au e komo i kahi hoʻokolohua lapaʻau?

Hiki i kāu kauka ke hāʻawi iā ʻoe i ka ʻike āu e pono ai, e kuhikuhi iā ʻoe i nā hoʻokolohua lapaʻau inā kūpono ʻoe, a kōkua iā ʻoe e loaʻa ka mālama palliative.

Nā mea e pono ai mākou e hoʻomanaʻo

ʻAe, no laila, mai nā mea a mākou i kamaʻilio ai e pili ana i ka Sarcomatoid Carcinoma, eia nā mea nui e hoʻomanaʻo ai:

• He ʻano maʻi ʻaʻai laha ʻole loa kēia a he ʻano ikaika hoʻi e laha koke ana.
• Hōʻike kēia i nā hōʻailona o ka carcinoma a me ka sarcoma.
• ʻO ka puhi paka ke kumu nui o kēia.
• Aia nā hōʻailona ma kahi o ke kanesa. I loko o nā māmā, hiki i nā hōʻailona ke komo pū me ka ʻū ʻana a me ka paʻakikī o ka hanu ʻana.
• Pono nā hoʻokolohua kūikawā (biopsy, imaging) e hōʻoia i ka maʻi.
• He paʻakikī nā koho lapaʻau. Ma waho aʻe o ke ʻoki kino, ka chemotherapy, a me ka radiation therapy, ke noʻonoʻo ʻia nei nā lāʻau lapaʻau hou (nā lāʻau lapaʻau i hoʻopaʻa ʻia, immunotherapy).
• ʻOiai he haʻahaʻa nā manawa kūpono o ka ho'ōla piha ʻana, hāʻawi nā noiʻi hou i ka manaʻolana.
• He mea nui loa e kamaʻilio ākea me kāu kauka e pili ana i kou kūlana a ʻike maopopo i nā mea āpau.

Manaʻolana wau he mea kōkua kēia ʻike iā ʻoe. Inā he mau nīnau hou aku kāu e pili ana i kēia, e ʻoluʻolu e nīnau aku i ke kauka.

ʻO ka maʻi kanesa Sarcomatoid, ka maʻi kanesa, ka maʻi kanesa māmā, ka puhipaka, nā hōʻailona o ka maʻi kanesa, ka mālama ʻana i ka maʻi kanesa, ka maʻi kanesa