Ua ʻike anei ʻoe e pili ana i kēia lāʻau kupaianaha e kuhikuhi wale ana i nā hunaola kanesa? (Tyrosine Kinase Inhibitors)

Ke ʻike mākou he maʻi kanesa ko mākou, makaʻu loa mākou a pau. I ka manawa like, noʻonoʻo mākou i nā lāʻau lapaʻau e like me ka chemotherapy. Hoʻopau ka chemotherapy i nā cell e māhele wikiwiki ana. Eia naʻe, hiki iā ia ke luku ʻaʻole wale i nā cell cancer, akā i nā cell olakino hoʻi i loko o ko mākou kino, no ka laʻana, nā cell lauoho, nā cell e hoʻoulu ai i nā ʻōpū waha, a me nā cell i loko o nā ʻōpū. ʻO ia ke kumu e hoʻoulu ai ka chemo i ka nalowale o ka lauoho, nā ʻōpū waha, a me ka ʻeha o ka ʻōpū. Akā, e noʻonoʻo... pehea ka maikaʻi inā he ʻano lāʻau lapaʻau e hiki ke kuhikuhi wale i nā cell cancer, e like me ka pū sniper? ʻO ia ka mea a mākou e kamaʻilio ai i kēia lā. Ua kapa ʻia kēia mau mea he Tyrosine Kinase Inhibitors , a i ʻole TKIs no ka pōkole.

I ka ʻōlelo maʻalahi, he aha kēia mau TKI?

ʻO nā TKI kahi ʻano lāʻau lapaʻau i hoʻohana ʻia i ka mālama ʻana i ka maʻi kanesa. Hana lākou ma ke ālai ʻana i kekahi mau mea i loko o nā hunaola kanesa e kōkua iā lākou e ulu a māhelehele. I nā huaʻōlelo ʻē aʻe, loaʻa i nā hunaola kanesa kahi ʻōnaehana hōʻailona e haʻi iā lākou e "ulu a māhelehele." Hana nā TKI ma ke komo ʻana i kēlā ʻōnaehana hōʻailona a hoʻōki iā ia.

ʻAʻole paha e ho'ōla loa kēia mau lāʻau lapaʻau i ke kanesa, akā hiki iā lākou ke kōkua i nā mea maʻi e mālama i ka kaohi lōʻihi (remission) o ke kanesa, a i ʻole e ola i kahi ola maikaʻi me ke kanesa.

Pehea e hana maoli ai kēia lāʻau lapaʻau? E nānā kākou i nā kikoʻī hou aku.

I mea e hoʻomaopopo ai i kēia, pono mua kākou e ʻike iki e pili ana i ke kaʻina hana maʻamau o ka mahele ʻana o nā cell i loko o ko kākou kino. E noʻonoʻo he hale hana nui ko kākou kino. Ua kapa ʻia nā limahana ma kēia hale hana he mau cell.

1. Nā kumu ulu: ʻO kēia nā ʻelele mai waho o ka hale hana e lawe mai ana i ka leka "E hoʻomaka i ka hana ʻana i kēia manawa."

2. Tyrosine kinases: ʻO kēia nā enzymes i loko o nā pūnaewele e lawe i ka leka a haʻi i nā poʻe ʻē aʻe "OK, e hoʻomaka kākou e hana."

Eia ka mea e hana ʻia ana i loko o kahi cell olakino maʻamau. Hele mai ka ʻelele (growth factor) a hāʻawi i ka leka i ka luna (tyrosine kinase). Lawe ka luna i kēlā leka a haʻi i ke cell e māhele. Ma hope o ka māhele ʻana o nā cell e like me kā lākou e pono ai, hoʻopau ka luna i ke kuapo. He hana i kāohi nui ʻia kēia.

Akā i loko o nā hunaola kanesa, hele hewa kēia ʻōnaehana. I kekahi mau ʻano kanesa, ʻoi aku hoʻi, hele pupule kēia mau luna (Tyrosine kinases). Ke hoʻā mau nei kā lākou kuapo. ʻAʻole pono lākou i kahi leka mai waho, ke haʻi mau nei lākou i nā hunaola e "māhelehele, māhelehele, māhelehele." ʻO kēia māhelehele hunaola i kāohi ʻole ʻia ka mea a mākou e kapa nei he kanesa.

ʻO ka laʻana maikaʻi loa: Chronic Myeloid Leukemia (CML)

He ʻano maʻi ʻaʻai koko kēia. I ka wā ma mua, i ka wā i ulu ai ʻo CML, he maʻi make ia. Akā ma hope o ka ʻike ʻia ʻana o nā TKI, ua lilo ʻo CML i maʻi mau loa e hiki ke kāohi ʻia me nā lāʻau lapaʻau e like me ka maʻi diabetes a me ke koko kiʻekiʻe.

I loko o nā pūnaewele i loko o ka iwi iwi o nā maʻi CML, ua hoʻokumu ʻia ka enzyme Tyrosine kinase a mākou i ʻōlelo ai ma ke ʻano ʻē, a ua 'on' mau loa kona kuapo. No laila, hana ka iwi iwi i nā hunaola koko keʻokeʻo me ka ʻole o ke kaohi. Pale kēia i ka hana ʻana o nā hunaola koko ʻulaʻula olakino, nā hunaola koko keʻokeʻo, a me nā platelets. ʻO nā TKI, e like me Imatinib (Gleevec®) , e kuhikuhi i kēlā enzyme ʻē aʻe a hoʻohuli i kāna kuapo 'on' 'off'. He kipi nui kēia i ka mōʻaukala o ka mālama ʻana i ka maʻi kanesa.

He aha nā ʻano maʻi kanesa e hoʻohana ʻia ai nā TKI?

Ke hoʻohana ʻia nei kēia lāʻau lapaʻau i kuhikuhi ʻia no nā ʻano maʻi kanesa he nui. ʻAʻole ia e hana no nā maʻi kanesa āpau. ʻO kēia no ka mea ʻaʻole i loaʻa i nā maʻi kanesa āpau ka Tyrosine kinase 'i hoʻohuli ʻia'. Lawe nā kauka i kahi biopsy o nā hunaola kanesa a ʻike inā loaʻa iā lākou kēia molekala hiki ke kuhikuhi ʻia. Inā loaʻa, e hāʻawi lākou i kēia lāʻau.

Aia ma lalo iho kekahi o nā ʻano maʻi kanesa nui i mālama ʻia me nā TKI.

I kēia manawa, ua ʻāpono ka US FDA ma mua o 50 mau TKI e mālama i nā ʻano maʻi kanesa like ʻole. ʻO ka lāʻau lapaʻau mua i ʻāpono ʻia, ʻo Imatinib (Gleevec®), hoʻohana ʻia e mālama i 7 mau ʻano maʻi kanesa.

Pehea e loaʻa ai iaʻu kēia lāʻau lapaʻau? Pehea ka lōʻihi o ka manawa e lawe ai?

ʻO kēia kekahi mea pono nui o kēia lāʻau lapaʻau. Loaʻa ka hapa nui o nā TKI i ke ʻano pila a wai paha . No laila, ʻaʻole pono ʻoe e noho i ka haukapila a hoʻokomo ʻia ka lāʻau lapaʻau ma o kahi wai saline. Pono ʻoe e lawe i hoʻokahi a ʻelua paha mau pila i ka manawa like i kēlā me kēia lā mai ka home.

ʻO ka lōʻihi o kou pono e lawe i ka lāʻau lapaʻau e pili ana i ke ʻano o ka maʻi kanesa āu e loaʻa ai, ke kahua o ka maʻi, a pehea e pane ai kou kino i ka lāʻau lapaʻau. No ka laʻana, inā loaʻa iā ʻoe ʻo CML, pono paha ʻoe e lawe i ka lāʻau lapaʻau no ke koena o kou ola. No nā ʻano maʻi kanesa ʻē aʻe, hiki i kāu kauka ke hoʻoholo e hoʻōki i ka lāʻau lapaʻau ke kaohi ʻia ke kanesa.

E makaʻala hoʻi kākou i nā hopena ʻaoʻao.

No ka mea, he mau lāʻau lapaʻau i kuhikuhi ʻia nā TKI, ʻoi aku ka liʻiliʻi o nā hopena ʻaoʻao ma mua o ka chemotherapy. ʻO kēia no ka mea he liʻiliʻi ka pōʻino o nā cell olakino. Akā, ʻaʻole hiki ke ʻōlelo ʻia he "ʻaʻohe hopena ʻaoʻao." ʻO kēia no ka mea ʻo ka molekala a lākou e kuhikuhi ai, i kapa ʻia ʻo Tyrosine kinase, ʻaʻole wale ia i loko o nā cell kanesa, akā i loko o nā ʻāpana liʻiliʻi hoʻi i kekahi mau cell olakino. No laila, hiki ke hoʻopilikia ʻia kēlā mau cell.

ʻOkoʻa nā hopena ʻaoʻao mai kēlā kanaka a kēia kanaka a hilinaʻi hoʻi i ka lāʻau TKI i hoʻohana ʻia.

Nā hopena ʻaoʻao maʻamau:

• Luhi: He kūlana maʻamau kēia i ʻike ʻia e ka poʻe he nui.
• Ka maʻi kahe: Hiki ke hana ʻia e ka hōʻino ʻia ʻana o nā pūnaewele i loko o nā ʻōpū.
• Ka luaʻi a me ka luaʻi: ​​Hiki i kekahi poʻe ke loaʻa i kēia maʻi.
• Nā ʻōhū ʻili: He mea maʻamau nā ʻōhū ʻili, ka maloʻo, a me ka maneʻo.
• Nā loli o ka makemake a me ke kaumaha: E emi ana ke kaumaha o kekahi poʻe, aʻo kekahi poʻe e piʻi aʻe ke kaumaha ma muli o ka pehu ʻana.
• kuni

Nā hopena ʻaoʻao koʻikoʻi hiki ke loaʻa:

Hiki i kekahi mau TKI ke hana i nā hopena ʻaoʻao ma ka puʻuwai, ke akepaʻa, a i ʻole nā ​​māmā. Hiki iā lākou ke hana i nā maʻi ʻili koʻikoʻi, a hiki ke hoʻoweliweli i ke ola, e like me ka Stevens-Johnson syndrome , ka mea e hoʻopilikia ai i ka ʻili. Akā he mea kakaikahi loa kēia. ʻO ke koko kiʻekiʻe (hypertension) kekahi hopohopo ʻē aʻe.

He aha kaʻu e hana ai e maʻalahi ai kēia lāʻau lapaʻau noʻu?

Hiki i ka mālama ʻana i ka maʻi kanesa ke lilo i manawa paʻakikī, ma ke kino a me ka noʻonoʻo. Aia kekahi mau mea hiki iā ʻoe ke hana e maʻalahi iki ai kēia manawa.

1. Hoʻomaha: ʻO ka luhi kahi hopena ʻaoʻao nui. No laila e hiamoe i ka nui e like me ka hiki, e hoʻomaha iki i ke ao, a e hoʻolohe i kou kino.

2. ʻIke Meaʻai: Hiki ke paʻakikī ka ʻai ʻana ma muli o nā mea e like me ka nalowale o ka makemake a me ka nausea. E ho'āʻo e ʻai liʻiliʻi i nā manawa he nui i ka lā. E inu i nā wai he nui e like me ka wai, ka wai huaʻai, ka porridge, a me ka sopa. Inā ʻoe e emi ana ke kaumaha a i ʻole e piʻi ana ke kaumaha me ke kumu ʻole, he mea nui loa ia e ʻimi i ka ʻōlelo aʻo mai kahi meaʻai meaʻai.

3. Ka mālama ʻana i nā hopena ʻaoʻao: Inā loaʻa iā ʻoe ka maʻi diarrhea, e ʻai i nā mea e like me ka ʻaila, nā mea ʻala ʻole, nā mea kanu mahu, ka laiki, a me ka maiʻa. He mea maikaʻi loa ka inu ʻana i nā mea inu e like me Jeevani. Inā loaʻa iā ʻoe kahi ʻulaʻula ʻili, e hoʻohana i kahi moisturizer ʻala ʻole me ke kopa ʻole. E kamaʻilio me kāu kauka e pili ana i kēia a loaʻa i ka lāʻau lapaʻau kūpono.

4. E hoʻonohonoho: E mālama i kahi puke moʻolelo o kāu mau hōʻailona a me nā hopena ʻaoʻao. E hōʻike iā ia i kāu kauka ke ʻike ʻoe iā ia. E hoʻomanaʻo e lawe i kāu mau lāʻau lapaʻau i ka manawa kūpono āu e pono ai.

5. Ola kino: He mea nui loa ia e noho ikaika i ka noʻonoʻo i kēia manawa. E kamaʻilio me ka ʻohana a me nā hoaaloha. E haʻi i kou mau pilikia. Inā pono, e ʻimi i ke aʻo ʻana.

6. Mālama Palliative: ʻAʻole kēia manaʻo he maʻi hiki ʻole ke ho'ōla ʻia. He hui kēia o nā loea e kōkua iā ʻoe e ola ʻoluʻolu ma o ka kaohi ʻana i nā hōʻailona e like me ka ʻeha, ka nausea, a me ka luhi e hele mai me ka mālama ʻana i ka maʻi kanesa. Hiki iā ʻoe ke kamaʻilio me kāu kauka e pili ana i kēia lawelawe.

He aha nā pilikia o kēia lāʻau lapaʻau?

ʻOiai hana maikaʻi nā TKI no nā maʻi kanesa he nui, i kekahi manawa hiki ke kū mai nā pilikia i ka hala ʻana o ka manawa. ʻO ka mea nui ka ulu ʻana o ke kū'ē .

I ka ʻōlelo maʻalahi, he mau pūnaewele maalea loa nā hunaola kanesa. Ke hāʻawi ʻia i ka lāʻau like i ka hala ʻana o ka manawa, hiki iā lākou ke loli e lilo i kūʻē i kēlā lāʻau. E like me ka bacteria e kūʻē i nā antibiotics. Ke hana ʻia kēlā, ʻaʻole paha e hana hou kahi lāʻau TKI i hana maikaʻi i ka wā mua.

Akā, ʻaʻole ia ka hopena o ke ao nei. No ka mea, ua ʻike nā kānaka ʻepekema i kēia, aia i kēia manawa nā TKI "hanauna ʻelua" a me "hanauna ʻekolu" hiki ke hāʻawi ʻia i ka wā e kū ai ke kūʻē. No laila, inā ʻaʻole holo pono kekahi lāʻau, hiki i kāu kauka ke hoʻololi iā ʻoe i kahi TKI ʻē aʻe.