Kua rongo koe kua pāngia tētahi, e rua, e toru rānei, o tō whānau e te mate pukupuku koroni? He mataku rānei koe nā te mea he hītori whānau tōu mō te mate pukupuku? Inaa, ka taea te tuku iho i ētahi momo mate pukupuku mai i tētahi whakatipuranga ki tētahi whakatipuranga. I tēnei rā ka kōrero tātou mō tētahi momo mate pukupuku koroni motuhake e tukuna iho ana mā roto i ō tātou ira. Ka kiia tēnei he HNPCC.
He aha te HNPCC?
Ki te whakarapopoto, ko te HNPCC (Hereditary Nonpolyposis Colorectal Cancer) he momo matepukupuku koroni e puta mai ana i ētahi huringa (whakarerekētanga) o ngā ira e tukuna iho ana i roto i ngā whakatipuranga. He matepukupuku tēnei e puta ana i roto i tō tātou whekau nui (koroni).
Nō reira, he rite tonu tēnei ki te Lynch Syndrome?
Kua rongo pea koe i te Lynch Syndrome i ngā wā maha atu i te HNPCC. He whanaunga tata ngā mea e rua, engari kāore i te tino ōrite. Whakaarohia pēnei. Ko te Lynch Syndrome he hapa ira i roto i ō tātou tinana. He āhuatanga ira e whakanui ake ana i te mōrearea o te mate pukupuku.
Ko te HNPCC te ingoa i hoatu ki tētahi āhuatanga e pāngia ai te tangata e te Lynch Syndrome e te mate pukupuku koroni, e ētahi atu mate pukupuku rānei e pā ana (pērā i te mate pukupuku o te kōpū, o te puku iti rānei), inā koa i mua i te 50 tau te pakeke . Ko te nuinga o ngā mate pukupuku HNPCC ka puta i te taha matau o te whekau nui.
Hei whakarāpopototanga, ko te Lynch Syndrome te pūtake ira o te mate. Ko te HNPCC te mate pukupuku e puta mai ana i taua pūtake.
He pēhea te noa o te HNPCC? He aha ngā tohu?
E 2% ki te 4% o ngā mate pukupuku koroni katoa puta noa i te ao e pāngia ana e te HNPCC. Ahakoa ka taea te pāngia e te mate i ngā tau katoa, ko te nuinga o te wā ka kitea i roto i te hunga kei raro iho i te 50 tau te pakeke.
Kāore pea he tohu motuhake o te HNPCC i ngā wāhanga tōmua, engari i te whanaketanga haere o te mate pukupuku, ka puta pea ēnei tohu.
| Tohu | He whakamārama ngāwari noa iho |
|---|---|
| Te mamae o te puku, te pupuhi rānei | Te mamae tonu o te puku, te mamae, te pupuhi rānei. |
| Hiahia kai | Te hekenga o te hiahia kai. |
| Te toto i roto i te tūtae | He toto kei roto i te tūtae, he tūtae mangu rānei ina haere ki te wharepaku. |
| Te ngenge mō te kore take | Tino ngenge koe, kāore e taea e koe te mahi i ngā mahi noa. |
| Te ngaronga taumaha me te kore take | Te hekenga taumaha ohorere me te kore e kai tika, e whakakori tinana rānei. |
He aha te take e puta ai te HNPCC? He mate hopuhopu rānei?
Ko te take matua mō tēnei ko ō tātou ira. Whakaarohia tō tātou tinana he whare i hangaia kia rite ki tētahi mahere nui. Ko te pukapuka kei roto taua mahere ko tō tātou DNA. Ka karangahia e tātou ngā tohutohu i roto i tēnei DNA he ira.
He hapa kei roto i ētahi ira motuhake o te hunga whai Lynch Syndrome (`MLH1`, `MSH2`, `MSH6`, `PMS2` me `EPCAM`) e whakatika ana i ngā hapa o te DNA. Ina kore e mahi tika ēnei ira, kāore e whakatikahia ngā hapa o te DNA (`ngā hapa tāruarua DNA`) e puta ana i te wā e wehea ana ō tātou pūtau. I roto i te wā, ka kohikohi ēnei hapa, ā, ka nui ake te tūponotanga o te pūtau noa kia noho hei pūtau matepukupuku.
Ko te mea nui, ehara te HNPCC i te mate hopuhopu. Arā, kāore e horapa mai i tētahi tangata ki tētahi atu pērā i te makariri. Heoi, ka taea te tuku iho i te ira hapa e hua ai tēnei mate i tētahi whakatipuranga ki tētahi whakatipuranga. Arā, mēnā he Lynch Syndrome tō tētahi o ngā mātua, e 50% te tūponotanga ka riro i te tamaiti taua ira. Mēnā ka riro i a rātou taua ira, he nui ake te tūponotanga ka pāngia taua tamaiti e te HNPCC, e ētahi atu mate pukupuku rānei e pā ana ki a rātou ā muri ake nei.
Me pēhea te kite a te tākuta i tēnei?
Mena kei a koe ngā tohu kua whakahuatia ake nei, inā koa kua pāngia tētahi o tō whānau e te mate pukupuku koroni, me toro atu koe ki te tākuta.
Ka tirohia koe e te tākuta i te tuatahi. Kātahi, ki te whakapaetia he mate pukupuku koroni, ko te whakamātautau tino noa ko te colonoscopy . Ko te whakauru i tētahi ngongo angiangi mā roto i te nono me te whakamahi i tētahi kāmera hei tirotiro i te roto o te whekau nui.
Hei whakaū mēnā kei a koe te HNPCC, ka tirohia hoki e tō tākuta ngā mea e whai ake nei:
- Hītori matepukupuku whānau:Ka pātaihia koe mēnā kua pāngia tētahi o tō whānau tata, pēnei i tō whaea, tō pāpā, ō tuākana/teina rānei, e te mate pukupuku koroni, e tētahi atu mate pukupuku rānei e pā ana ki te Lynch Syndrome, i mua i te 50 tau te pakeke.
- Whakamātautau Ira: E taunakihia ana he whakamātautau toto motuhake hei whakatau mēnā kei a koe ngā whakarerekētanga ira e hua ai te HNPCC.
- Te whakakore i ētahi atu āhuatanga: Pērā i te HNPCC, kei reira tētahi atu āhuatanga matepukupuku koroni tuku iho e kiia nei ko te FAP (Familial Adenomatous Polyposis) . Nā te mea he rerekētanga i waenga i ngā mea e rua, ka mahia hoki ngā whakamātautau hei whakaū kei a koe te HNPCC, ehara i te FAP.
He aha te rerekētanga i waenga i te HNPCC me te FAP?
Ahakoa he āhuatanga tuku iho ēnei e rua o te mate pukupuku koroni, he rerekē ngā ira e hua ai ēnei. Ko te rerekētanga matua ko te maha o ngā polyp e tupu ana i roto i te koroni.
| Āhuatanga | HNPCC (Te Mate Lynch) | FAP |
|---|---|---|
| Te rahi o ngā polyp | He iti noa iho ngā hua e puta ana, kāore rānei e puta (he iti iho i te 10 te nuinga o te wā). | Ka hangaia he rau, he mano pea, o ngā nati. |
| Te riro hei mate pukupuku | Ka tere te huri o ētahi tipu hei mate pukupuku. | Ki te kore e rongoatia, he 100% te tūponotanga ka huri tētahi o ēnei pukupuku hei mate pukupuku. |
He aha ngā maimoatanga mō te HNPCC?
Ko te maimoatanga matua mō te HNPCC ko te pokanga (colectomy) . Ko te tango i te wāhanga, i te katoa rānei o te koroni kei reira te mate pukupuku mā te pokanga. He maha ngā huarahi e taea ai tēnei.
- Colectomy wāhanga: Te tango i te wāhanga anake o te koroni kei reira te mate pukupuku.
- Te tango i te whekau nui katoa: Te tango i te puku nui katoa.
- Proctectomy: Te tango i te whekau nui me te rectum.
Mena kua horapa te mate pukupuku (kua horapa ki ētahi atu wāhanga o te tinana), ka tūtohu pea tō tākuta i ētahi atu maimoatanga hei tāpiri atu ki te pokanga.
- Te rongoā matū: He rongoā hei whakangaro i ngā pūtau matepukupuku.
- Ārai Mate: Te whakaoho i te pūnaha ārai mate o te tinana kia whawhai ki ngā pūtau matepukupuku.
I roto i te nuinga o ngā wā, ka angitu ake te rongoā ārai mate mō te mate pukupuku HNPCC.
He aha te heke mai mō te tangata whai HNPCC?
He mate ira te Lynch Syndrome e kore e taea te whakaora. He mate mō te wā katoa. Heoi, mā te pokanga ka taea te whakaora i te mate pukupuku HNPCC me te ārai i te mate pukupuku koroni ā muri ake nei.
Haunga te mate pukupuku koroni, kei te tūpono te tangata whai HNPCC ki te pāngia e ētahi atu momo mate pukupuku. Koia te take ka kī atu tō tākuta kia tirotirohia koe i ia wā.
- Matepukupuku endometrial
- Matepukupuku ovarian
- Matepukupuku puku
- Matepukupuku whatukuhu, roro, ate me te kiri
Ko te mea nui ko te kitea wawe . Ki te whakamātauhia koe i te wā tika, ka taea te kite wawe i tētahi o ēnei mate pukupuku, ā, ka taea te rongoā angitu.
I te toharite, tata ki te 60% o te hunga kua tāpaetia he HNPCC ka ora mō ngā tau e 5. Ā, i waenga i te 70% me te 88% o te hunga e pāngia ana e te mate pukupuku puku nā te Lynch Syndrome ka ora mō ngā tau neke atu i te 10. E whakaatu ana ēnei tatauranga i te hiranga o te kitenga wawe me te maimoatanga.
He aha ngā mea ka taea te mahi hei karo me te whakahaere i tēnei mōrearea?
Kāore he huarahi hei ārai i te whakarerekētanga ira e hua ai tēnei. He mea tuku iho tēnei ki a tātou. Heoi, he maha ngā mea ka taea e koe te mahi hei ārai i te mate pukupuku, hei kite wawe rānei i te mate.
- Kia mōhio ki tō hītori whānau: Mena kei te pāngia tētahi o tō whānau e te Lynch Syndrome, te HNPCC rānei, kōrero ki tō tākuta mōna, ka pātai atu mēnā me whai whakamātautau ira anō hoki koe.
- Tīmata wawe te tirotiro: Mena kua tāpaetia koe kei te mate Lynch Syndrome koe, ka tūtohu tō tākuta kia tīmata koe ki te tirotiro i te mate pukupuku koroni (colonoscopy) i roto i ō tau 20.
- He momo noho hauora: He nui te āwhina o ēnei mea ki te whakaiti i te mōrearea o te mate pukupuku:
- Āta karohia te momi hikareti.
- Whakawhāitihia te inu waipiro.
- Kai i tētahi kai hauora e nui ana ngā huawhenua me ngā hua.
- Whakakorikori tinana i ia wā, i ia wā.
- Kia mau tonu te taumaha tinana hauora.
- Kia tūpato ki ngā tohu: Ki te puta he tohu hou, kaua e warewarehia, engari me toro atu ki te tākuta tonu.
Karere Tangohia ki te Kāinga
- Ko te HNPCC he mate pukupuku koroni tuku iho i puta mai i tētahi hapa ira e kiia nei ko te Lynch Syndrome.
- Mena kua pāngia tētahi, ētahi rānei o tō whānau e te mate pukupuku koroni i mua i te 50 tau te pakeke, kōrero ki te tākuta kia kite ai mēnā kei roto koe i te mōrearea.
- Ehara tēnei mate i te mate hopuhopu, engari e 50% te tūponotanga ka riro i ngā tamariki te ira e hua ai te mōrearea.
- Mā te tirotiro i te wā tika, ka taea te kite i te mate pukupuku i te wā tōmua, ā, ka taea hoki te whakaora i ngā oranga.
- Ka taea te rongoā angitu i te HNPCC mā te pokanga me ētahi atu maimoatanga.
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