Ua lohe mākou a pau e pili ana i ke kanesa o ka umauma. Akā, ua ʻike anei ʻoe he ʻano like ʻole o ke kanesa o ka umauma? ʻOi aku ka maʻalahi o ka mālama ʻana i kekahi mau ʻano, akā ʻoi aku ka koʻikoʻi a me ka ʻino o kekahi mau ʻano. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano kanesa o ka umauma i ʻoi aku ka koʻikoʻi, akā hiki ke kāohi ʻia inā hoʻomaopopo pono ʻia a mālama ʻia. ʻO kēia ka mea a nā kauka e kapa nei ʻo "Triple-Negative Breast Cancer" a i ʻole `(Triple-Negative Breast Cancer - TNBC)`.
He aha kēia Triple-Negative?
I ka ʻōlelo maʻalahi, ʻekolu mau mea nui e kōkua ai i ka ulu ʻana o nā hunaola maʻi ʻaʻai umauma. ʻO ia nā hormones estrogen a me progesterone, a me kahi protein i kapa ʻia ʻo HER2. E noʻonoʻo i kēia mau mea he "puka" ma nā hunaola maʻi ʻaʻai. Hāʻawi nā kauka i nā "kī" (ʻo ia hoʻi, nā lāʻau lapaʻau e like me ka hormone therapy) e kūpono i kēia mau "puka" a hoʻōki i ka ulu ʻana o ke kanesa.
Eia nō naʻe, i loko o ke kanesa triple-negative, ʻaʻole i loaʻa i nā hunaola kanesa kēia mau puka ʻekolu (estrogen, progesterone, HER2). ʻO ke ʻano kēia he 'maikaʻi ʻole' lākou. No ka mea, ua nalowale kēlā mau puka, ʻaʻole hana nā mea e like me nā lāʻau lapaʻau hormone i hāʻawi pinepine ʻia no kēia ʻano kanesa. No kēia kumu, ua manaʻo ʻia kēia ʻano kanesa he ʻoi aku ka ikaika, e pālahalaha wikiwiki ana ma mua o nā ʻano ʻē aʻe.
Akā, ʻaʻole kēia manaʻo ʻaʻole hiki ke mālama ʻia. ʻAʻole loa! Aia kekahi mau lāʻau lapaʻau ikaika ʻē aʻe e hiki ke kōkua. Na kāu kauka e koho i ka hoʻolālā lapaʻau kūpono iā ʻoe.
He aha nā hōʻailona o kēia maʻi kanesa?
ʻO nā hōʻailona o ka maʻi ʻaʻai umauma triple-negative e like pinepine me nā ʻano maʻi ʻaʻai umauma ʻē aʻe. Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, mai hoʻowahāwahā iā lākou a e ʻike koke i ke kauka.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| He puʻupuʻu a mānoanoa paha i loko o ka umauma | He puʻu hou i loaʻa ʻole ma mua, hiki iā ʻoe ke hoʻopā ma kou lima. |
| ʻEha/ʻulaʻula o ka umauma a i ʻole ka nipple | ʻEha mau a ʻulaʻula maopopo paha. |
| Ka hoʻohuli ʻana a i ʻole ka hoʻokuʻu ʻana o ka nipple | Ua hoʻohuli ʻia kahi nipple maʻamau ma mua a i ʻole e puka mai ana kahi wai (ʻaʻole he waiū). |
| Pehu ʻana o ka umauma | ʻAʻole paha e ʻike ʻia kahi puʻupuʻu, akā hiki ke pehu kekahi hapa a i ʻole ka umauma holoʻokoʻa. |
| ʻIli e like me ka ʻili ʻalani | Hoʻonui ʻia nā pores i loko o ka ʻili o ka umauma, e like me ka ʻili o ka ʻili ʻalani. |
| Nā pimples ma ka ʻāʻī a puni paha ka lima | Nā ʻōpū lymph pehu (nodules) ma ka ʻāpana armpit a kokoke paha i ka iwi collarbone. |
| Ka loli ʻana o ke ʻano a i ʻole ka nui o ka umauma | He ʻokoʻa loa ke ʻano o kekahi umauma mai kekahi. |
ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o kēia maʻi kanesa?
ʻAʻole ʻike nā kauka i ke kumu kikoʻī o kēia ʻano maʻi kanesa. He mea kākaʻikahi nō hoʻi ia, e pili ana i ka 10%-20% wale nō o nā wahine e loaʻa ana i ka maʻi kanesa o ka umauma. Eia nō naʻe, ʻoi aku ka nui o ka pilikia o kekahi poʻe.
- Nā wahine ma lalo o 40 mau makahiki .
- ʻO nā kānaka me ka hoʻololi ʻana o ka gene BRCA , ʻo ia hoʻi ka gene BRCA1. He loli genetic kēia i hoʻoili ʻia mai nā hanauna.
- ʻO nā wahine momona a ʻaʻole hoʻi e hoʻoikaika kino ma hope o ka menopause (ka pau ʻana o ka menstruation) .
Pehea ʻoe e ʻike pono ai inā loaʻa iā ʻoe ka maʻi kanesa?
ʻO ke kauka wale nō ke haʻi pololei iā ʻoe i ke ʻano o ka maʻi kanesa āu. Pili kēia i kekahi mau hoʻokolohua.
1. Mammogram a me ke scan ultrasound: Hiki i kēia ke ʻike i nā puʻupuʻu a i ʻole nā mea ʻē i loko o ka umauma.
2. Hoʻāʻo Biopsy `(Biopsy)`: ʻO kēia ka meaʻO ka hoʻāʻo koʻikoʻi loa . ʻO ka mea i hana ʻia ma ʻaneʻi, ʻo ia ke lawe ʻana i kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai ka puʻupuʻu kānalua ma lalo o ka anesthesia a hoʻouna aku i ke kauka loea nāna e nānā i ka ʻiʻo.
3. Hoʻāʻo ʻiʻo: Nānā ʻia ka hāpana ʻiʻo ma lalo o kahi microscope e hoʻoholo ai inā he maʻi kanesa a ʻaʻole paha. Inā he maʻi kanesa, nānā ʻia no nā "puka" a mākou i kamaʻilio ai ma mua i kapa ʻia ʻo estrogen, progesterone, a me `HER2`. Inā maikaʻi ʻole nā mea ʻekolu, ua ʻike ʻia he maʻi kanesa triple-negative.
Ke hoʻoholo nei i ke kahua o ka maʻi kanesa
Ma hope o ka ʻike ʻia ʻana o ke kanesa, e hoʻoholo ke kauka i kona "kahua." ʻO ia hoʻi ke ʻano o ka nui o ke kanesa a me ka mamao o kona laha ʻana. Hiki ke pili i kēia i nā hoʻokolohua e like me MRI, CT scan, a me PET scan.
He ʻano hana i ʻae ʻia ma ka honua holoʻokoʻa ka ʻōnaehana `TNM`.
- T (Pumo): Pehea ka nui o ka pumo? (He helu mai 0-4)
- N (Nā Pūnaehana): Ua pālahalaha anei ke kanesa i nā pūnaehana lymph kokoke? (He helu o 0-3)
- M (Metastasis): Ua pālahalaha anei ke kanesa i nā ʻōpū mamao e like me nā māmā, ke akepaʻa, a i ʻole nā iwi? (0 a i ʻole 1)
Ma muli o kēia kahua e hoʻoholo ai ke kauka i ka lāʻau lapaʻau kūpono loa iā ʻoe.
He aha nā lāʻau lapaʻau?
Hoʻohana pinepine ʻia ka hui pū ʻana o nā lāʻau lapaʻau no ka maʻi kanesa triple-negative.
1. Kemoterapi
ʻO kēia ka lāʻau lapaʻau nui a koʻikoʻi loa no kēia ʻano maʻi kanesa. Pili ia i ka hāʻawi ʻana i ke kino i nā lāʻau ikaika e pepehi ai i nā hunaola kanesa. Inā ʻike mua ʻia, pane maikaʻi loa kēia maʻi kanesa i ka chemotherapy.
- Neoadjuvant Chemotherapy: Hāʻawi ʻia ka chemotherapy ma mua o ke ʻoki ʻana e hoʻēmi i ka puʻupuʻu a maʻalahi ke ʻoki ʻana.
- Adjuvant Chemotherapy: Hāʻawi ʻia ka chemotherapy ma hope o ke ʻoki ʻana e luku i nā hunaola kanesa i koe.
2. ʻOki kino
ʻElua ʻano hana ʻoki kino.
- Lumpectomy: Wehe ʻana i ka puʻupuʻu kanesa a me kahi liʻiliʻi o nā ʻiʻo a puni ia.
- Mastectomy: Wehe ʻana i ka umauma holoʻokoʻa. Ma muli o ka ikaika o kēia maʻi kanesa, ʻōlelo pinepine nā kauka e wehe i ka umauma holoʻokoʻa (mastectomy).
3. Hoʻōla Lapaʻau
Ma hope o ke ʻoki kino, hāʻawi ʻia kēia lāʻau lapaʻau e luku i nā hunaola kanesa e waiho ana ma ia wahi a pale i ka hoʻi hou ʻana mai o ke kanesa.
4. Hoʻōla lāʻau pale
He ʻano lapaʻau hou kēia. ʻO kā mākou hana ma ʻaneʻi , ʻo ia ka hoʻoulu ʻana i ka ʻōnaehana pale ponoʻī o ko mākou kino , e kōkua ana iā ia e ʻike a hoʻouka i nā hunaola kanesa. He lāʻau lapaʻau kūleʻa loa kēia no ke kanesa triple-negative.
5. Hoʻōla i kuhikuhi ʻia
He ʻano lapaʻau hou nō hoʻi kēia. Ua like ia me ka "pōkā akamai." ʻO ka hana a kēia mau lāʻau lapaʻau, ʻo ia ke ʻimi pololei i nā hunaola kanesa, hoʻopili iā lākou, a hāʻawi pololei i ka chemo i nā hunaola kanesa. Ua kapa ʻia hoʻi kēia he `Antibody-drug conjugate (ADC).' ʻAʻole nui ka pōʻino o kēia i nā hunaola olakino.
Nā manawa kūpono o ka ho'ōla a me ka hoʻi hou ʻana
He nīnau nui kēia no nā kānaka he nui. He paʻakikī ke hāʻawi i hoʻokahi pane no ka mea he ʻokoʻa ia mai kēlā kanaka a kēia kanaka. Aia ka manawa e ola ai i ka wā mua o ka ʻike ʻia ʻana o ke kanesa a pehea e pane ai ke kino i ka lāʻau lapaʻau.
- No ka maʻi ʻaʻai umauma kūloko, ʻo ka manawa kūpono e ola ai no 5 mau makahiki he 91%.
- Inā pālahalaha ia i nā ʻiʻo kokoke (ʻāpana), ʻo ia helu ma kahi o 65%.
- Inā pālahalaha ia i nā ʻōpū mamao, hāʻule kēlā helu i 12%.
Mai hopohopo i kēia mau helu. He awelika wale nō kēia mai nā tausani o ka poʻe. Hiki ke ʻoi aku ka maikaʻi o kou kūlana. ʻO ka mea nui loa, ʻo ia ka ʻike ʻana i nā hōʻailona a ʻike koke i ke kauka.
Loaʻa i ka maʻi kanesa triple-negative ka pilikia o ka hoʻi hou ʻana i loko o nā makahiki 3 mua ma hope o ka mālama ʻana. Eia nō naʻe, emi koke kēlā pilikia ma hope o 5 mau makahiki. No laila, he mea nui e hoʻomau i nā hoʻokolohua hahai e like me ke kuhikuhi a kāu kauka ma hope o ka mālama ʻana.
Leka Lawe-Home
- ʻO ke kanesa umauma triple-negative (TNBC) kahi ʻano kanesa i ʻoi aku ka ikaika a laha wikiwiki aʻe ma mua o nā ʻano ʻē aʻe.
- ʻO kēia no ka mea ʻaʻohe o kēia mau hunaola kanesa i nā hormones a me nā mea loaʻa protein e kōkua ai i ka ulu ʻana o ka maʻi kanesa.
- ʻOiai ʻaʻole holo pono nā lāʻau lapaʻau hormone maʻamau no kēia, aia nā lāʻau lapaʻau kūpono loa e like me ka chemotherapy, ke ʻoki kino, ka radiation therapy, a me ka immunotherapy.
- He mea nui loa ka ʻike ʻana i nā hōʻailona i ka wā hikiwawe loa no ka hoʻopakele ʻana i nā ola. Mai hoʻowahāwahā i nā loli i kou mau umauma.
- Mai makaʻu e nīnau i kāu kauka e pili ana i kāu lāʻau lapaʻau a me ke kahua o kou maʻi ʻaʻai. ʻO ka ʻike maopopo ʻana i nā mea āpau e hāʻawi iā ʻoe i ka ikaika noʻonoʻo nui.
- ʻAʻole ʻoe hoʻokahi ma kēia huakaʻi. E kiʻi i ke kākoʻo o kou ʻohana a me kou mau hoaaloha. He ikaika nui ia nou.
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