Ke lohe mākou e pili ana i ka maʻi ʻaʻai umauma, ua pūʻiwa loa mākou. A i ka lohe ʻana ua hiki i ka pae ʻehā, ʻo ia hoʻi, ua laha ka maʻi ʻaʻai i nā ʻāpana ʻē aʻe o ke kino, ʻoi aku ka weliweli a me ke kaumaha. He kūlana koʻikoʻi maoli kēia. Akā me kēia ʻepekema lapaʻau holomua, nui nā lāʻau lapaʻau e hiki ke hana ʻia i kēia pae, hiki ke kōkua i ka kaohi ʻana i ka maʻi a hoʻolōʻihi i ke ola. No laila e kamaʻilio kākou e pili ana i kēia i kēia lā, e ʻike i nā pane maʻalahi i nā nīnau āu e noʻonoʻo nei.
He aha maoli ke ʻano o ka Pae IV?
I ka ʻōlelo maʻalahi, ʻo ke kahua 4 ke ʻano o nā hunaola kanesa i hoʻomaka i loko o ka umauma ua laha ma o ke koko a i ʻole nā kīʻaha lymph i nā wahi ʻē aʻe o ke kino. Ua kapa ʻia kēia laha ʻana he 'Metastasis'. ʻO nā wahi maʻamau e hiki ai i ke kanesa ke laha ma kēia ʻano, ʻo ia nā iwi, ka lolo, nā māmā, a i ʻole ke akepaʻa .
ʻO ka mea nui e hoʻomaopopo ma ʻaneʻi, ʻo ka pahuhopu nui o ka mālama ʻana i kēia pae, ʻaʻole ia e hoʻōla loa i ka maʻi, akā , e kāohi i ka ulu ʻana o ke kanesa, e hōʻemi i nā hōʻailona, a hāʻawi iā ʻoe i kahi ola maikaʻi no ka lōʻihi e hiki ai. Noho kekahi mau maʻi no nā makahiki he nui me kēia lāʻau. No laila, he mea nui e hopohopo ʻole i ka wā e lohe ai ʻoe e pili ana i kēia hiki, akā, e kamaʻilio pono me kāu kauka e pili ana i nā koho lapaʻau i loaʻa.
He aha nā lāʻau lapaʻau nui i loaʻa?
I ke kahua 4, no ka mea ua laha ka maʻi ʻaʻai i nā wahi he nui, he paʻakikī ke hoʻokō i nā hopena holomua me nā lāʻau lapaʻau e kuhikuhi wale ana i hoʻokahi wahi, e like me ke ʻoki kino a i ʻole ka radiation therapy. No laila, ʻo nā lāʻau lapaʻau systemic e hoʻopilikia i ke kino holoʻokoʻa ka mea maʻamau e hoʻohana ʻia.
Kemoterapia
ʻO ka chemotherapy ka lāʻau lapaʻau nui i kēia pae. Hana ia ma ka pepehi ʻana i nā hunaola kanesa e māhele wikiwiki ana. Hiki i kēia ke hoʻolohi i ka ulu ʻana o ke kanesa. Hāʻawi ʻia ka chemotherapy ma nā ʻano like ʻole. I kekahi manawa hāʻawi ʻia ia ma ke ʻano he mau pila, akā ʻo ka hapa nui pinepine ʻia e hāʻawi ʻia ma ke ʻano intravenous (ma o kahi vein) .
ʻAʻole hāʻawi mau ʻia kēia lāʻau lapaʻau. Hāʻawi pinepine ʻia ia i kekahi mau pōʻaiapuni . Ma hope o ka pau ʻana o hoʻokahi pōʻaiapuni, hāʻawi ʻia ke kino i kahi manawa hoʻomaha pōkole e hoʻōla ai. A laila wale nō e hoʻomaka ai ke pōʻaiapuni aʻe.
Hoʻōla Hormone
ʻAʻole kūpono kēia lāʻau lapaʻau no nā kānaka a pau. ʻOi aku ka maikaʻi o ia i nā wāhine me ke ʻano maʻi kanesa i kapa ʻia ʻo hormone receptor-positive . ʻO ia hoʻi, ʻo nā hormones e like me ka estrogen i loko o ko lākou kino e hoʻoulu i ka ulu ʻana o nā hunaola maʻi kanesa. E noʻonoʻo i kēia ʻano: ua like nā hormones me ke kī, a ʻo ka mea loaʻa ma ke hunaola maʻi kanesa ua like me ka laka. Ke hoʻokomo ʻoe i ke kī, wehe ka laka a ulu ka maʻi kanesa.
No laila, ʻo ka hana a kēia mau lāʻau lapaʻau hormone, ʻo ia ke hoʻōki i ka hana ʻana o kēlā kī (hormone), a i ʻole ke ālai ʻana iā ia mai ke komo ʻana i loko o ka laka. ʻO nā ʻano lāʻau lapaʻau nui i hāʻawi ʻia no kēia:
- ``Tamoxifen''
- Nā mea hoʻopaʻa Aromatase (no nā wahine postmenopausal) - Nā laʻana: Anastrozole (Arimidex), Exemestane (Aromasin)
- Nā lāʻau lapaʻau e like me 'Fulvestrant (Faslodex)' e ālai ana i nā mea loaʻa hormone.
I kekahi manawa, ua ʻōlelo ʻia ka wehe ʻana o nā ovaries i ke ʻoki kino no nā wahine i hiki ʻole i ka menopause, no ka mea he ala maikaʻi ia e hoʻōki ai i ka hana ʻana o nā hormones e kōkua i ka ulu ʻana o ka maʻi kanesa.
Hoʻōla i kuhikuhi ʻia
He lāʻau lapaʻau hou kēia a he kūpono loa. Ma kahi o ka hōʻino ʻana i nā hunaola olakino e like me ka chemotherapy, kuhikuhi ia a hoʻouka i nā protein a i ʻole nā genes kikoʻī i loaʻa wale i nā hunaola kanesa . ʻO ka hopena, he kakaikahi nā hopena ʻaoʻao.
Ma kahi o 20% o nā wāhine me ka maʻi ʻaʻai umauma he nui loa ka protein i kapa ʻia ʻo `HER2`. ʻO kēia ke kumu o ka laha koke ʻana o ke kanesa. No kēia mau maʻi ʻaʻai `HER2-positive`, hāʻawi ʻia nā lāʻau lapaʻau e like me `Trastuzumab (Herceptin)`. Hoʻōki ia i ka protein `HER2` mai ka hana ʻana a kāohi i ka ulu ʻana o nā hunaola kanesa.
E hoʻomanaʻo, ʻaʻole manaʻo ka pae ʻehā ka pau ʻana o ka lāʻau lapaʻau. He manawa kēia e kālele ai i nā lāʻau lapaʻau e kōkua ai i ka kaohi ʻana i ka maʻi a mālama i kahi ola maikaʻi.
E nānā kākou i kekahi mau ʻano ʻē aʻe o nā lāʻau lapaʻau i hoʻolālā ʻia ma ka papa ma lalo nei.
| ʻAno lapaʻau i kuhikuhi ʻia | Pahuhopu a me ka hana | Nā hihia hoʻohana |
|---|---|---|
| Nā mea pale CDK4/6 | Hoʻopaʻa i nā protein i kapa ʻia ʻo CDK a kāohi i ka mahele ʻana o nā cell cancer. No ka laʻana: Palbociclib (Ibrance), Ribociclib (Kisqali) | No nā maʻi ʻaʻai hormone receptor-positive a me HER2-negative. |
| Nā mea pale PARP | Hoʻopili i ka protein PARP, ka mea e kōkua ai i ka ulu ʻana o nā hunaola kanesa. Eia kekahi laʻana: Olaparib (Lynparza) | No nā maʻi ʻaʻai i HER2-maikaʻi ʻole a he loli ko ka gene BRCA. |
| Nā mea pale mTOR | Hoʻopaʻa i ka protein mTOR a hoʻōki i ka ulu ʻana a me ka laha ʻana o nā cell cancer. No ka laʻana: Everolimus (Afinitor) | Me ka lāʻau lapaʻau hormone no nā ʻano maʻi kanesa kikoʻī. |
| Nā hui pū ʻana o ka antibody-lāʻau lapaʻau | Hoʻopili ʻia kahi lāʻau chemo i kahi antibody, ka mea e hāʻawi pololei i ka lāʻau i ke keena kanesa a luku iā ia. Laʻana: Sacituzumab govitecan (Trodelvy) | No ka maʻi ʻaʻai umauma holomua. |
Hoʻōla lāʻau pale
He lāʻau lapaʻau holomua loa kēia. Ma kahi o ka hāʻawi ʻana i nā lāʻau lapaʻau mai waho e pepehi i ke kanesa, hoʻoulu ia i kāu ʻōnaehana pale ponoʻī e ʻimi a luku i nā hunaola kanesa. ʻIke kekahi mau hunaola kanesa pehea e peʻe ai mai ka ʻōnaehana pale. No laila, hoʻopau kēia mau lāʻau i kēlā mau ʻano peʻe a ʻae i nā hunaola pale e ʻike i ke kanesa.
ʻO ke ʻoki kino a me ka radiation
E like me kā mākou i ʻōlelo ai ma mua, ʻaʻole hoʻohana ʻia kēia mau mea ma ke ʻano he lāʻau lapaʻau nui i kēia pae. Eia nō naʻe, inā he ʻeha nui ma kahi i laha ai ke kanesa, no ka laʻana ma ka iwi, hāʻawi ʻia ka radiation therapy e kāohi i ka ʻeha a me nā hōʻailona ʻē aʻe . Eia kekahi, hiki ke hana ʻia ke ʻoki kino inā pono e kāohi i kekahi mau pilikia.
Nā mea nui ʻē aʻe
- Ka mālama ʻana i nā hopena ʻaoʻao: Hiki i kēia mau lāʻau āpau ke loaʻa nā hopena ʻaoʻao, e like me ka nausea, ka luaʻi ʻana, a me ka luhi. Akā aia nā lāʻau lapaʻau e loaʻa ana e mālama iā lākou. No laila e haʻi i kāu kauka e pili ana i kekahi ʻoluʻolu ʻole āu e manaʻo ai.
- Nā Hoʻokolohua Lapaʻau: I kekahi manawa, hiki paha iā ʻoe ke komo i nā 'Hoʻokolohua Lapaʻau', kahi e hoʻāʻo ai i nā lāʻau lapaʻau hou i hoʻohana nui ʻole ʻia. Hiki i kēia ke hāʻawi iā ʻoe i ka manawa kūpono e loaʻa ai nā lāʻau lapaʻau hou loa. E nīnau pū i kāu kauka e pili ana i kēia.
ʻAʻole kēia huakaʻi āu e hele hoʻokahi ai. Aia kou ʻohana, nā hoaaloha, nā kauka, nā kahu maʻi, a me ka hui lapaʻau holoʻokoʻa me ʻoe. E kiʻi i kā lākou kākoʻo. E haʻi mai i kou mau manaʻo. He ikaika nui ia e lanakila ai i kēia manawa paʻakikī.
Leka Lawe-Home
- ʻO ke kahua IV o ka maʻi ʻaʻai umauma ʻo ia hoʻi ua laha ke kanesa i nā ʻāpana ʻē aʻe o ke kino.
- ʻO ka pahuhopu nui o ka mālama ʻana i kēia pae, ʻaʻole ia e hoʻōla loa i ka maʻi, akā, e kāohi i ke kanesa, e hōʻemi i nā hōʻailona, a e hoʻolōʻihi i ke ola me kahi ola maikaʻi.
- ʻO ka Chemotherapy, ka hormonal therapy, ka therapeutic i hoʻopaʻa ʻia, a me ka immunotherapy nā ʻano lapaʻau nui.
- Na kāu kauka e hoʻoholo i ka lāʻau kūpono loa nāu ma muli o ke ʻano o kou maʻi kanesa (e like me, HER2-positive a hormone receptor-positive paha).
- Aia kekahi mau lāʻau lapaʻau e hoʻokele i nā hopena ʻaoʻao mai ka lāʻau lapaʻau, no laila e kamaʻilio me kāu kauka e pili ana i kekahi ʻehaʻeha āu e ʻike nei.
- He mea nui loa ia e noho ikaika i ka noʻonoʻo a e ʻimi i ke kākoʻo mai ka ʻohana a me ka hui lapaʻau.
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