Ua ʻike anei ʻoe i ke koko i loko o kou mimi? A i ʻole he ʻeha kua kou a luhi mau paha? ʻOiai ʻaʻole paha he mea nui kēia e hopohopo ai, hiki i kekahi manawa ke lilo i mau hōʻailona o kahi maʻi kanesa e ulu ana i loko o ke ala mimi. ʻO kekahi ʻano maʻi kanesa ʻo
Urothelial Carcinoma , i kapa ʻia i kekahi manawa ʻo
Transitional Carcinoma . I kēia lā, e kamaʻilio mākou e pili ana i kēia me
nā kikoʻī hou aku , me he mea lā e kamaʻilio ana mākou me kahi hoaaloha.
He aha ka Urothelial Carcinoma? I ka ʻōlelo maʻalahi...
I ka ʻōlelo maʻalahi, ʻo
Urothelial Carcinoma kahi maʻi kanesa e hoʻomaka ana i loko o ka ʻiʻo i kapa ʻia
ʻo urothelium, kahi e uhi ai i kekahi mau ʻāpana o kāu ʻōnaehana mimi. E noʻonoʻo e like me ka uhi o loko o kekahi mau ʻōkana i loko o ko kākou kino. ʻO ka urothelium kekahi o ia mau ʻiʻo. Loaʻa nui ia i loko o ka ʻōpū mimi, nā puʻupaʻa (ʻoi aku ka pelvis renal), a me nā ureters. Ua ʻike anei ʻoe he
90% o nā maʻi kanesa o ka ʻōpū mimi a me
7% o nā maʻi kanesa o nā puʻupaʻa he mau maʻi kanesa urothelial? Ua like loa nā hōʻailona o nā mea ʻelua. ʻO ka mea maikaʻi loa,
ʻoi aku ka maʻalahi o ka mālama ʻana a me ka ho'ōla ʻana i kēia mau maʻi kanesa inā ʻike mua ʻia . Eia naʻe, hiki iā lākou ke hoʻi hou i kekahi manawa. ʻO ia ke kumu he mea nui e makaʻala i kēia.
Pehea ka hopena o kēia maʻi ʻaʻai i ko mākou kino?
ʻOkoʻa iki ke ʻano o ka hopena o ka maʻi ʻaʻai urothelial i kou ʻōpū mimi a me nā puʻupaʻa.
ʻO ke kanesa urothelial o ka ʻōpū mimi
He ʻano ʻeke liʻiliʻi kou ʻōpū mimi. Aia ia ma waena o kou mau iwi ʻūhā, ma luna o kou urethra, a ma lalo o kou mau puʻupaʻa. Hōʻiliʻili ka mimi mai kou mau puʻupaʻa i loko o kēia ʻōpū mimi. Ua uhi ʻia ka ʻaoʻao o loko o ka ʻōpū mimi me ka ʻiʻo a mākou i ʻōlelo ai ma mua i kapa ʻia
ʻo urothelium . Hiki i nā ʻāpana o kēia ʻiʻo ke kīkoʻo i ka wā e piha ai kou ʻōpū mimi me ka mimi a ʻūlū i ka wā e ninini ai. (Hiki i kou ʻōpū mimi ke paʻa ma kahi o ʻelua kīʻaha o ka mimi.) Ke loaʻa iā ʻoe ka maʻi ʻaʻai ʻōpū mimi, māhele ʻē nā ʻāpana o kēia urothelium a laha mai ka papa o loko o kou ʻōpū mimi a i nā papa ʻē aʻe. I kekahi manawa, hiki i kēia mau ʻāpana ʻē ke uhaʻi i nā paia o kou ʻōpū mimi a i loko o ka ʻiʻo momona a puni.
Inā ʻaʻole mālama ʻia, hiki i kēia maʻi ʻaʻai ke laha ma o ka paia o ka ʻōpū mimi i nā lymph node kokoke a mai laila aku i nā wahi ʻē aʻe e like me nā iwi, nā māmā, a me ke akepaʻa. ʻElua ʻano nui o ka maʻi ʻaʻai ʻōpū mimi:
- ʻO ke kanesa urothelial kiʻekiʻe: He ʻoi aku ka weliweli o kēia. ʻOi aku ka nui o ka hiki ke hoʻi hou mai me ka mālama ʻia. Hiki iā ia ke pālahalaha i ka papa ʻiʻo o ka ʻōpū mimi, nā ʻāpana ʻē aʻe o ke kino, aHiki iā ia ke laha i nā lymph nodes .
- ʻO ke kanesa urothelial haʻahaʻa: Hiki ke hoʻi mai kēia, akā he mea paʻakikī loa ke pālahalaha aku i ka papa ʻiʻo o ka ʻōpū mimi a i nā ʻāpana ʻē aʻe o ke kino.
ʻO ke kanesa urothelial o nā puʻupaʻa
ʻElua mau puʻupaʻa ko kākou maʻamau. Ua like lākou me ʻelua mau ʻano kino ʻano pīni, aia ma lalo pono o ka iwi ʻaoʻao a ma hope o ka ʻōpū. Kānana nā puʻupaʻa i nā huahana ʻōpala a me nā mea ʻawahia mai ke koko a hana i ka mimi. Hōʻiliʻili kēia mimi ma waenakonu o ka puʻupaʻa i kapa ʻia
ʻo ka pelvis renal . Mai laila mai, hele ka mimi i lalo i kahi ʻōmole lōʻihi e hoʻopili ai i ka puʻupaʻa i ka ʻōpū mimi. Ua kapa ʻia kēia ʻōmole
ʻo ka ureter . E like me nā puʻupaʻa, ua uhi ʻia ka pelvis renal a me ka ureter me nā ʻiʻo urothelial. Hiki mai ka maʻi ʻaʻai puʻupaʻa i ka wā e ulu ai nā cell urothelial maʻamau a hana i nā tumors i loko o nā puʻupaʻa, pelvis renal, a i ʻole ureter. Hiki i ka maʻi ʻaʻai puʻupaʻa ke laha i nā ʻano kino a i ʻole nā ʻiʻo ʻē aʻe.
ʻO wai ka mea i loaʻa i kēia maʻi kanesa?
ʻO ke kanesa ʻōpū ka ono o nā maʻi kanesa maʻamau ma ʻAmelika Hui Pū ʻIa. A
he 90% o nā maʻi kanesa ʻōpū he mau maʻi kanesa urothelial.
ʻOi aku ka nui o nā kāne i ka loaʻa ʻana o ka maʻi kanesa ʻōpū ma mua o nā wahine . ʻO ke kanesa puʻupaʻa ka walu o nā maʻi kanesa maʻamau. Ma kahi o
7% o nā maʻi kanesa puʻupaʻa he mau maʻi kanesa urothelial. Loaʻa pinepine ia
i nā poʻe ma waena o 65 a me 74 mau makahiki. ʻOi aku ka nui o nā kāne i ka loaʻa ʻana o ka maʻi. He aha ka hōʻailona nui o ka maʻi ʻaʻai urothelial?
ʻAʻole paha e loaʻa nā hōʻailona o ke kanesa urothelial i kona mau wā mua. Eia nō naʻe, ʻo
ke koko i loko o ka mimi (hematuria) ka hōʻailona mua. Inā ʻike ʻoe i ke koko i loko o ka mimi a i ʻole he mau hōʻailona ʻē aʻe kēia,
pono ʻoe e ʻike i ke kauka :
He aha ke kumu o kēia maʻi kanesa?
ʻAʻole maopopo loa i nā kānaka noiʻi lapaʻau ke kumu o ka maʻi ʻaʻai urothelial o ka ʻōpū mimi a me nā puʻupaʻa. Eia nō naʻe, ua ʻike lākou i kekahi mau kumu pilikia maʻamau:
- Puhi paka : ʻOi aku ka nui o ka pilikia o ka poʻe puhi paka i ka loaʻa ʻana o ka maʻi ʻaʻai urothelial i loko o ka ʻōnaehana mimi.Kiʻekiʻe loa ka pilikia o ka loaʻa ʻana o ka maʻi kanesa . ʻO kēia ke kumu nui o ka pilikia.
- Ka ʻike ʻia ʻana i kekahi mau kemika: Ua hōʻike ʻia nā noiʻi he nui ka pilikia o ka poʻe e hana ana ma nā wahi e hana ana i kekahi mau kala, ka laholio, nā mea ʻili, nā pena, kekahi mau lole, a me nā huahana kaila lauoho i ka hoʻomohala ʻana i kēia maʻi kanesa.
Pehea e ʻike ai nā kauka i kēia maʻi kanesa?
Hoʻohana nā kauka i kēia mau hoʻokolohua e ʻike i nā maʻi ʻōpū a me nā maʻi puʻupaʻa, me ke kanesa urothelial:
- Urinalysis: He hoʻāʻo e nānā i kāu mimi no ke kala, ke kō, ka protein, ke koko, a me ka bacteria.
- ʻO ka cytology mimi: Lawe ʻia kahi laʻana o kāu mimi a nānā ʻia ma lalo o kahi microscope e nānā i nā cell ʻano ʻē. Inā loaʻa iā ʻoe ka maʻi kanesa i loko o nā puʻupaʻa, ka ʻōpū mimi, a i ʻole ka urethra, hiki ke loaʻa nā cell kanesa i loko o kāu mimi.
- ʻO ka pyelogram intravenous (IVP): He ʻano hoʻāʻo X-ray kēia. Hana ʻia ia e nānā i ka maʻi ʻaʻai i loko o nā puʻupaʻa, nā ureters, a me ka ʻōpū mimi. Hoʻokomo nā kauka i kahi wai kūikawā (contrast dye) i loko o kou aʻa. A laila, lawe ʻia nā kukuna X i ka wā e hele ai ka wai ma o kou mau puʻupaʻa, nā ureters, a me ka ʻōpū mimi e ʻike inā he mea paʻa.
- Ureteroscopy: Hoʻokomo ʻia kahi mea hana e like me ka paipu lahilahi (me kahi kāmela a me ke kukui) ma o ka urethra e nānā i loko o ka ureter a me ka pelvis renal. Hoʻohana ʻia nō hoʻi ia e lawe i nā laʻana ʻiʻo.
- CT scan (Computed tomography - CT scan): Lawe kahi kamepiula i hoʻopili ʻia i kahi mīkini X-ray i nā kiʻi kikoʻī o nā ʻāpana like ʻole o ke kino.
- Ultrasound: Hoʻouna ʻia nā nalu kani ikehu kiʻekiʻe (ultrasound) i loko o nā ʻiʻo i loko o ke kino a hoʻohana ʻia nā leo e hoʻi mai ana e hana i kahi kiʻi (sonogram). Hiki ke hana ʻia kahi ultrasound ʻōpū e ʻike i nā maʻi ʻaʻai o ka pelvis renal a me ka ureter.
- MRI (Magnetic resonance imaging - MRI): Hoʻohana i kahi magnet, nā nalu lekiō, a me ke kamepiula e kiʻi i nā kiʻi kikoʻī o nā wahi i loko o ke kino, e like me ka lua pelvic.
He aha ke kahua o ka maʻi kanesa?
Hoʻohana nā kauka
i kahi ʻōnaehana hoʻonohonoho maʻi kanesa e hoʻolālā i ka lāʻau lapaʻau a hoʻoholo i ka wānana. Hōʻike kēia i ke ʻano o ka ulu ʻana a me ka laha ʻana o ke kanesa.
He hana paʻakikī ka hoʻonohonoho ʻana i ke ʻano o ka maʻi kanesa. Inā manaʻo ʻia ua hoʻokomo ʻia kou kūlana i loko o kahi ʻano me kekahi mau leka a me nā helu, hiki ke hopohopo a huikau. He mea maopopo ia. Inā ʻaʻole ʻoe maopopo e pili ana i kēia a i ʻole ke manaʻo nei ʻoe e hopohopo, e noi i kāu kauka e wehewehe pehea e pili ai kēia ʻōnaehana i kou kūlana.
Nā pae o ka maʻi ʻaʻai mimi
Hiki i ke kanesa ʻōpū ke pae mua (i kaupalena ʻia i ka uhi o ka ʻōpū) a i ʻole ua holomua (ua komo i loko o ka paia o ka ʻōpū a laha i nā ʻōpū kokoke a i ʻole nā kikowaena lymph). Penei nā pae o ke kanesa ʻōpū:
- Pae I: Ua kaupalena ʻia ke kanesa i ka uhi o ka ʻōpū mimi a i ʻole nā ʻiʻo pili ma lalo ona. ʻAʻole ia i pālahalaha i ka paia ʻiʻo nui o ka ʻōpū mimi.
- Pae II: Ua pālahalaha ke kanesa i ka paia ʻiʻo o ka ʻōpū mimi.
- Pae III: Ua pālahalaha ke kanesa mai ka ʻiʻo o ka ʻōpū mimi a i ka ʻiʻo momona ma waho.
- Pae IV: Ua pālahalaha ke kanesa mai ka ʻōpū mimi a i nā lymph node, nā ʻōpū ʻē aʻe, a i ʻole nā iwi.
Hoʻokaʻawale pū nā kauka i ke kanesa ʻōpū ma ke ʻano he
noninvasive ,
non-muscle-invasive , a i ʻole
muscle-invasive .
- ʻAʻohe invasive: I kēia hihia, hiki ke loaʻa ke kanesa ma kahi liʻiliʻi o ka ʻiʻo, a i ʻole e kaupalena ʻia i ka ʻili o ka ʻōpū.
- ʻAʻole komo i nā ʻiʻo: I kēia hihia, ua komo hohonu ke kanesa i loko o ka ʻōpū mimi, akā ʻaʻole i laha i nā ʻiʻo.
- Hoʻokomo i nā ʻiʻo: I kēia hihia, ua pālahalaha ke kanesa i nā ʻiʻo o ka paia o ka ʻōpū mimi a ua pālahalaha paha i nā papa momona ma waho o ka ʻōpū mimi a i ʻole nā ʻiʻo o nā ʻōpū.
Nā pae o ka maʻi ʻaʻai puʻupaʻa
ʻAʻole i hoʻonohonoho ʻia ke kaʻina hana o ke kanesa puʻupaʻa ma muli o ke ʻano o ke kelekema kanesa. ʻO ke kanesa urothelial ma kahi o 7% o nā kanesa puʻupaʻa. He ʻokoʻa ke hoʻonohonoho ʻana o ke kaʻina hana o ke kanesa puʻupaʻa a me ke kanesa pelvis/ureter renal.
- Pae I: ʻAʻole i pālahalaha ke kanesa ma ʻō aku o ka puʻupaʻa.
- Pae II: Ua ulu ka maʻi kanesa, akā ʻaʻole i pālahalaha ma waho o ka puʻupaʻa.
- Pae III: Ua pālahalaha ke kanesa mai ka puʻupaʻa a i nā kīʻaha koko nui - ka aʻa renal a me ka vena cava haʻahaʻa - a i ʻole i nā ʻiʻo a puni ka puʻupaʻa, a i ʻole i nā lymph node kokoke.
- Pae IV: Ua pālahalaha ke kanesa mai ka ʻōpū adrenal (kahi ʻōpū liʻiliʻi ma luna o ka puʻupaʻa), i nā lymph node mamao, a i ʻole nā ʻōpū ʻē aʻe.
Nā pae o ke kanesa o ka pelvis renal a me ka ureter
- Pae 0: Aia nā pūnaewele ʻano ʻē i loko o ka uhi o ka pelvis renal a i ʻole ureter. Ua kapa ʻia kēia he papillary carcinoma a i ʻole carcinoma in situ .
- Pae I (Pae 1): Ua pālahalaha ke kanesa ma o ka papa o loko o ka pelvis renal a/a i ʻole ka ureter a i loko o ka papa pili.
- Pae II:Ua laha ke kanesa ma o nā ʻiʻo pili i ka papa ʻiʻo o ka pelvis renal a/a i ʻole ka ureter.
- Pae IV: (ʻAʻole i ʻōlelo ʻia ke Pae III ma ʻaneʻi, akā aia ma waena o II a me IV, e hōʻike ana i ka laha ʻana i nā hale kokoke) Ua laha ke kanesa i nā ʻōpū kokoke, hoʻokahi a ʻoi aku paha nā lymph node, ka papa momona a puni ka puʻupaʻa, a i ʻole nā ʻōpū mamao e like me nā māmā, ke akepaʻa, a i ʻole nā iwi.
Pehea e mālama ai nā kauka i ka maʻi ʻaʻai urothelial?
ʻOkoʻa nā ʻano lapaʻau ma muli o kahi o ke kanesa urothelial i loko o ka ʻōpū mimi, nā puʻupaʻa, ka pelvis renal, a me ka ureter.
Ka mālama ʻana i ka maʻi ʻōpū
Hiki i nā koho lapaʻau ke komo pū me:
- ʻO ke ʻoki kino: Hoʻopau nā kauka i ka puʻupuʻu kanesa a puhi paha iā ia me ka hoʻohana ʻana i kahi au uila ikehu kiʻekiʻe. Ua kapa ʻia kēia he electrocautery (fulguration) .
- Chemotherapy: Hāʻawi ʻia nā lāʻau lapaʻau e luku i nā hunaola kanesa.
- Immunotherapy: Hoʻoulu i ka ʻōnaehana pale ponoʻī o kou kino e hakakā i ka maʻi kanesa.
- Lapaʻau radiation: Hoʻohana i nā kukuna ikehu kiʻekiʻe e luku i nā hunaola kanesa.
- Lapaʻau i hoʻolālā ʻia: Nā lāʻau lapaʻau e hoʻolālā ana i nā molekala kikoʻī e kōkua ana i ka ulu ʻana o nā pūpū kanesa.
Ka lāʻau lapaʻau no ka maʻi ʻaʻai puʻupaʻa
Hoʻohana ʻia kekahi o nā lāʻau lapaʻau like no ke kanesa puʻupaʻa e like me ke kanesa ʻōpū. Eia kekahi, hiki ke hoʻohana ʻia kēia mau lāʻau lapaʻau:
- ʻOki kino: ʻO ka ʻāpana o ka puʻupaʻa me ke kanesa wale nō e hiki ke wehe ʻia, a i ʻole hiki ke wehe ʻia ka puʻupaʻa holoʻokoʻa.
- Cryoablation: Hoʻohana i ke anu nui e luku ai i nā hunaola kanesa.
- ʻO ka hoʻopau ʻana o ke alapine radio: Hoʻohana ʻia nā nalu radio e hoʻomehana a luku i nā hunaola kanesa.
Ka mālama ʻana i ke kanesa o ka pelvis renal a/a i ʻole ureter
- ʻOki kino: Ua wehe ʻia ka ʻāpana o ka pelvis kidney a i ʻole ka ureter kahi i loaʻa ai ke kanesa.
He aha ka nui o ke ola inā loaʻa iā ʻoe ka maʻi ʻaʻai urothelial?
ʻOiai ʻo ke kanesa urothelial kahi kanesa e hoʻomaka ana mai ke ʻano like o nā cell, hiki ke ʻokoʻa ke ala o ka maʻi ma muli o kahi e ulu ai (ʻōpū mimi, puʻupaʻa, pelvis renal, ureter).
Nānā no ka maʻi ʻaʻai mimi
E like me ka hapa nui o nā maʻi ʻaʻai,
ʻoi aku ka nui o ka hiki ke ola o ka maʻi ʻaʻai ʻōpū inā ʻike ʻia a mālama ʻia i ka wā mua. Wahi a ka ʻikepili 2018 mai ka National Cancer Institute (NCI), 96% o ka poʻe i mālama ʻia no ka maʻi ʻaʻai mua e ola ana i ʻelima mau makahiki ma hope o ka hōʻoia ʻana. Ma keʻano holoʻokoʻa, 77% o ka poʻe me ka maʻi ʻaʻai ʻōpū e ola ana i ʻelima mau makahiki ma hope o ka hōʻoia ʻana.
Nānā no ke kanesa puʻupaʻa
E like me ka hapa nui o nā maʻi kanesa,
ʻoi aku ka maʻalahi o ka mālama ʻana i ka maʻi kanesa puʻupaʻa (me ke kanesa pelvis renal) inā ʻike mua ʻia.Wahi a ka ʻikepili NCI (2018), 93% o ka poʻe i mālama ʻia no ka maʻi ʻaʻai puʻupaʻa mua e ola mau ana i ʻelima mau makahiki ma hope o ka ʻike ʻia ʻana. ʻO ka nui o ka ola ʻana o ʻelima mau makahiki he 76.5%.
Pehea e hiki ai iaʻu ke hōʻemi i koʻu pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai urothelial i loko o kaʻu ʻōnaehana mimi?
ʻElua mau mea nui hiki iā ʻoe ke hana e hōʻemi i kou pilikia o ka loaʻa ʻana o kēia maʻi kanesa:
- ʻAʻole puhi paka.
- Ke pale ʻana i ka pili ʻana i kekahi mau kemika ʻino.
Pehea e hiki ai iaʻu ke mālama iaʻu iho?
Inā ʻike koke ʻia ke kanesa, hiki i nā kauka ke ho'ōla pinepine i ke kanesa urothelial, ka mea e ulu ana i loko o ke ala mimi. Akā
, ʻo ka mea pōʻino, ʻoi aku ka nui o ka hiki ke hoʻi hou mai kēia mau ʻano kanesa. Inā ua mālama ʻia ʻoe no kēia ʻano kanesa,
he mea nui e hoʻomau i ka mālama ʻana e like me ke kuhikuhi a kāu kauka. He mea nui loa kēia.
Āhea wau e ʻike ai i ke kauka?
Inā ʻike ʻoe i kekahi mau loli i kou kino, ʻoiai nā hōʻailona e hōʻike ana i ka hoʻi hou ʻana o ke kanesa urothelial i loko o ka ʻōnaehana mimi,
e ʻike koke i ke kauka. ʻO ke ʻano kēia inā ʻike ʻoe i kekahi mau hōʻailona hou, e like me ke koko i loko o kou mimi, ka ʻeha hope, a i ʻole ka luhi hou, pono ʻoe e ʻike i ke kauka.
Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)
ʻAe, eia nā mea nui e pono ai ʻoe e hoʻomanaʻo mai kā mākou i kamaʻilio ai i kēia lā:
- ʻO ka carcinoma urothelial kahi maʻi kanesa e ulu ana i loko o ka papa o loko o kāu ʻōnaehana urinary (bladder, puʻupaʻa, a me nā ureters).
- ʻO ke koko i loko o ka mimi ka hōʻailona nui. ʻO nā hōʻailona ʻē aʻe e pili ana i ka ʻeha o ke kua, ka luhi, a me ka pohō kaumaha.
- ʻO ka puhipaka a me ka ʻike ʻana i kekahi mau kemika nā kumu nui o ka pilikia.
- Inā ʻike ʻia i ka wā mua, ʻoi aku ka nui o ka mālama ʻia a me ka hoʻōla ʻia.
- No ka mea hiki i kēia maʻi ʻaʻai ke hoʻi hou mai, he mea nui e hoʻomau i nā hoʻokolohua lapaʻau ma hope o ka lāʻau lapaʻau.
- Inā he kānalua a he mau hōʻailona paha kāu, mai makaʻu e kamaʻilio me ke kauka. E kōkua lākou iā ʻoe.
Manaʻolana wau he mea pono kēia ʻike iā ʻoe. E noho olakino!
Ka maʻi ʻaʻai Urothelial, Urothelial Carcinoma, Ka maʻi ʻaʻai Urinary, Ka maʻi ʻaʻai Bladder, Ka maʻi ʻaʻai puʻupaʻa, Koko i loko o ka mimi, Nā hōʻailona o ka maʻi ʻaʻai
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