Kia ako tātou i ētahi atu kōrero mō te matepukupuku repeure. He mea nui hoki ēnei mea māu!

I tēnei rā ka kōrero tātou mō tētahi mate kino rawa atu, engari me mōhio tātou katoa ki tēnei mate. Ko te mate pukupuku repeure, arā, ko te '(Mate Pukupuku Repeure)'. I roto i tēnei mate, ka tīmata ngā pūtau o te okana e kiia nei ko te repeure i roto i tō tātou tinana ki te whanonga rerekē. Nā te mea he mate huna tēnei, ko te mea nui ko te mōhio wawe ki tēnei mate.

He aha te mate pukupuku o te pancreas?

I roto i ngā kupu māmā noa iho, ko te mate pukupuku repe taiaki te wā e tere wehewehe ai ngā pūtau o tō repe taiaki, ka tipu hei pukupuku, hei puku rānei. Tērā pea kei te whakaaro koe he aha te repe taiaki, ā, kei hea ia, tika? He repe kei roto i tō tātou puku, i waenganui i te tuaiwi me te puku. Ka hangaia e ia ngā homoni e whakahaere ana i ngā taumata huka toto, me ngā whākōkī e āwhina ana i a tātou ki te nakunaku kai.

Ko te nuinga o ēnei mate pukupuku repe taiaki ka tīmata i roto i ngā awaawa o te repe taiaki. Mā te awaawa matua o te repe taiaki ka hono te repe taiaki ki tō tātou awaawa au.

Engari, kāore e kitea ngāwaritia ana tēnei mate pukupuku mā roto i ngā whakamātautau whakaahua i ōna wāhanga tōmua. Nō reira, i te wā e mōhio ana te nuinga o te tangata kei a rātou, kua horapa kē te mate pukupuku, kua horapa rānei. Ko tētahi atu take he ātete tēnei mate pukupuku ki te maha o ngā rongoā ārai-mate pukupuku. Nō reira he uaua ki te rongoā.

Kei te haere tonu ngā rangahau mō tēnei mea, inā koa mā roto i ngā whakamātautau ira me ngā tikanga whakaahua hou, engari he nui tonu ngā mea hei ako mā tātou.

He aha ngā momo mate pukupuku o te pancreas?

E rua ngā momo matua o te mate pukupuku repeure :

• Ngā pukupuku o waho o te tinana: Neke atu i te 90% o ngā mate pukupuku repeure he momo pēnei. Ko te momo tino noa ko te adenocarcinoma. Ka tīmata tēnei momo i roto i ngā pūtau e whakarārangi ana i roto i ō tātou whekau.
• Ngā pukupuku neuroendocrine (NET): He iti iho i te 10% o ngā pukupuku katoa e kitea ana i tēnei momo pukupuku. E kiia ana hoki ko te mate pukupuku pūtau islet.

He pēhea te noa o tēnei mate pukupuku?

I tētahi whenua pēnei i a Amerika, e 3 o ia 100 momo mate pukupuku e kiia ana he mate pukupuku repeure. Ko te 10 o ngā mate pukupuku e tino kitea ana i waenga i ngā tāne, ko te 8 o ngā mate pukupuku e tino kitea ana i waenga i ngā wāhine. Heoi anō, kei te piki haere te tokomaha o ngā tāngata e pāngia ana e tēnei mate pukupuku i ia rā, i ia rā. E ai ki ētahi pūrongo, tera pea ka noho ko ia te tuarua o ngā tino take o ngā mate pukupuku i Amerika i te tau 2030. He wā tēnei hei āwangawanga mō tēnei mea i Sri Lanka anō hoki.

He aha ngā tohu o te mate pukupuku o te pancreas?

Engari, kāore i te tino kitea ngā tohu tōmua o tēnei mate pukupuku. Ka tīmata noa te puta o ngā tohu ina nui haere te pukupuku , ā, ka pā ki ētahi atu okana o roto i te pūnaha nakunaku.

Ko ngā tohu o te mate pukupuku pancreatic ka uru pea ki:

• Te kōwhai o te kiri (te kōwhai): He kōwhai tēnei o ngā mā o ngā kanohi me te kiri. E kīia ana hoki e ētahi ko te 'kirikā kōwhai'.
• Mimi pouri: Ka huri te mimi ki te kōwhai pouri, i ētahi wā ka rite ki te tae o te wai tī.
• Ngā tūtae mārama: Ka kite pea koe he tae uku, he hina rānei ō tūtae.
• Mamae o te puku o runga: Tērā pea ka mamae te puku o runga, inā koa kei runga ake i te pito.
• Mamae o waenganui o te tuara: He mea anō tēnei e kōrerotia ana e te tini tāngata. Haunga te mamae o te puku, he mamae anō hoki kei waenganui o te tuaiwi.
• Ngenge: Ehara i te ngenge noa iho, engari he kare ā-roto o te ngenge ahakoa te roa o te moe.
• Kiri mākūkū: Ka pā tēnei ki te kiri mākūkū, inā koa me te jaundice.
• Whakapairuaki me te ruaki: Whakapairuaki me te ruaki me te kore hiahia kai.
• Pupuhi, pupuhi rānei: Te mākū tonu ahakoa he iti noa te kai i muri i te kai, te mākū tonu o te puku.
• Anorexia: Te ngaro o te hiahia ki te kai.
• Ngā toto totoka: I ētahi wā ka puta he toto totoka i roto i ngā waewae.
• Te whakaiti taumaha: Ka ngaro tō taumaha, kāore he take, me te kore e whakahaere i tāu kai.
• Te mate huka hou: He tohu anō hoki tēnei o te mate huka ka puta ohorere mai i roto i te tangata kāore anō kia pāngia e te mate huka i mua.

Mena kua kitea tō mate huka i ēnei wā tata nei, kei a koe rānei tētahi mate pēnei i te pancreatitis (he mumura mamae o te repe taiaki), tera pea ka whakapae tō tākuta kei te mate pukupuku repe taiaki koe.

Heoi, he rerekē pea ngā tohu o te mate pukupuku neuroendocrine pancreatic. Hei tauira, ka puta pea ngā tohu pēnei i te korere me te anemia, hei utu mō te jaundice me te ngaronga taumaha.

Kia pēhea te roa ka mōhio ai koe mēnā he mate pukupuku repeure tōu?

E ai ki te kōrero i mua ake nei, kāore he tohu wawe e kitea ana. Mō ētahi tāngata, ka tīmata pea te puta haere o ngā tohu, ā, ka roa pea te wā tae atu ki te tau i mua i te tautuhi i te mate.

He tokomaha te hunga e kī ana i pāngia tuatahitia rātou e te mamae o te tuara, o te mamae o te puku rānei. Tērā pea ka haere mai, ka memeha atu tēnei mamae i te tīmatanga, engari ka kino haere pea i muri i te kai, i te takoto rānei.

He aha te take o te mate pukupuku o te pancreas?

Kāore anō kia kitea he whakautu mārama mō tēnei. Kāore anō kia tino mōhiotia he aha te take. Heoi, kua tautuhia e ngā tohunga ētahi āhuatanga mōrearea ka whai wāhi pea ki tēnei.

Ngā āhuatanga mōrearea mō te mate pukupuku repeure

Ko te take mōrearea he mea e whakanui ake ai i te tūponotanga o te whakawhanaketanga o tētahi mate. Ko ngā take mōrearea noa mō te mate pukupuku repeure ko:

• Te kai hikareti: Ko te mōrearea nui ko te whakamahi i ngā hikareti, ngā hikā, me ētahi atu momo tupeka.
• Momona: Ko te hunga he nui rawa te ngako, inā koa kei te taha o te puku, ka nui ake te mōrearea.
• Mate huka: Mō te hunga mate huka momo 2, kua kiia ko te tīmatanga ohorere o te mate huka he tohu anō hoki o te mate pukupuku repeure.
• Te pānga ki ētahi matū: Ngā mea pēnei i ngā patu pepeke me ngā matū hinu.
• Te mate pāwera mau tonu: Te mumura roa o te repe taiaki.
• Te mate pāwera mau tonu: He mate i tukuna iho mai i ngā mātua ki ngā tamariki nā ngā whakarerekētanga ira.
• Ētahi mate tuku iho: Ngā āhuatanga i puta mai i ngā huringa o ngā ira pēnei i te BRCA1, te BRCA2 rānei. Ka taea hoki ēnei te tuku iho mai i ngā mātua ki ngā tamariki.

He aha ngā raruraru o te mate pukupuku repeure?

Ka horapa te mate pukupuku repeure ki ngā oko toto me ngā kōpū lymph e tata ana. Kātahi ka horapa ki te ate, ki te arai o te puku (peritoneum), me ngā pukahukahu.

He mea nui: I te nuinga o te wā, i te wā e kitea ai te mate pukupuku repe taiaki, kua horapa kē ki waho o te repe taiaki. Koia te take he tino morearea.

Me pēhea te tautuhi i te mate pukupuku o te pancreas?

He tino uaua te kite i te mate pukupuku repeure i ngā wāhanga tōmua nā te mea kāore e taea e ngā tākuta te rongo i te repeure i te wā e tirotirohia ana. Kāore hoki e taea te kite i ēnei pukupuku i ngā whakamātautau whakaahua paerewa.

Mena kei te whakapae te tākuta he mate pukupuku repe taiaki, ka tonoa e rātou ētahi whakamātautau hei tirotiro i te mahi a te repe taiaki. Kei roto pea i ēnei:

Ngā whakamātautau whakaahua

Tērā pea ka kī atu tō tākuta kia mahia e koe tētahi, ētahi rānei o ēnei e whai ake nei:

• Matawai CT (CT - matawai tomography rorohiko)
• Matawai MRI (MRI - whakaahua aukume)
• Matawai PET `(PET - tomografi tukunga positron)`
• Ultrasound Endoscopic (EUS): Ko te whakauru i tētahi kāmera iti mā te waha hei tirotiro tata atu ki te repe taiaki.

Ngā whakamātautau toto

Ka taea e ngā whakamātautau toto repeure te kite i ngā tohu pukupuku. He matū te tohu pukupuku e tohu ana i te aroaro o te mate pukupuku.

Mō te matepukupuku repe taiaki, ka taea te whakapae he pukupuku mēnā he nui te taumata o te pūmua e kiia nei ko te "Carbohydrate antigen (CA) 19-9" (he mea tēnei e tukuna ana e ngā pūtau matepukupuku repe taiaki) i roto i te toto.

Te whakarite i te laparoscopy

I ētahi wā, ka whakamahia e ngā tākuta tētahi tikanga e kīia nei ko te laparoscopy hei tirotiro i te whānui o te horapa o te mate pukupuku repeure, me te kite mēnā ka taea te tango.

I roto i tēnei tikanga, ka tapahia e te taote pokanga ētahi tapahi iti ki te puku, ā, ka whakauruhia he ngongo roa me te kāmera e piri ana. Mā tēnei ka taea e te taote pokanga te titiro ki roto i te puku kia kite ai mēnā he hapa kei roto. He maha ngā wā ka tangohia he tauira iti i tēnei wā hei whakamātautau (biopsy).

Whakamātautau ira

Mena kua tāpaetia koe he mate pukupuku repeure, me whakaaro pea koe ki te whakamātautau ira. Nā te mea kua riro pea i a koe te mate pukupuku i roto i tō tinana. Ka āwhina hoki i tō tākuta ki te whakatau ko tēhea te maimoatanga pai rawa atu māu.

Ko ētahi tāngata he mate pukupuku repeure kei roto i ngā ira e kiia nei ko te BRCA1 me te BRCA2. Kua rongo pea koe i ēnei ira ko ngā "ira mate pukupuku ū". Engari ko ngā whakarerekētanga ira o te BRCA1 me te BRCA2 ka pāngia e te mate pukupuku ū, tae atu ki te mate pukupuku repeure, te mate pukupuku whēkau, me te mate pukupuku repeure.

Mena kua pāngia tētahi o tō whānau (matua, tamaiti, teina/tuākana/teina) e te mate pukupuku repeure, whakaarohia te whakamātautau ira. Mā tēnei ka taea e koe te mōhio mena kei a koe he whakarerekētanga ira 'BRCA1', 'BRCA2' rānei. Engari kia maumahara, ehara i te mea ka pāngia koe e te mate pukupuku mena he whakarerekētanga ira. Engari he mea nui kia mōhio koe ki tō mōrearea.

He aha te rerekētanga i waenga i te mate pukupuku repeure ka taea te tango me te kore e taea te tango?

E wehewehe ana ngā tākuta i te mate pukupuku repeure kia whā ngā wāhanga matua:

• Ka taea te tango: Kei roto i te repeure anake te pukupuku. Kāore anō kia horapa ki ngā oko toto tata, ki ētahi atu okana rānei. Ka taea te tango katoa mā te pokanga.
• Ka taea te tango i te rohe: Kei roto i te repe taiaki te pukupuku, ā, he pānga ki ngā oko toto tata, engari ka taea tonu e te taote pokanga te tango.
• Kua horapa te pukupuku ki te rohe: Kei roto i te repeure te pukupuku, ā, kua horapa nui ki ngā uaua toto tata. I ēnei wā, ka uaua pea te tango pokanga, ka mōrearea rānei.
• Metastatic:Kua horapa te mate pukupuku ki ngā wāhanga tawhiti o te tinana, pērā i te ate, ngā pukahukahu, te puku rānei. Tērā pea kua horapa atu ki ngā whekau, ki ngā kiko, ki ngā kōpū waikura rānei e tata ana ki te repeure.

Mena he pātai motuhake āu mō te whakatau i te taumata o te mate pukupuku repeure, kōrero ki tō tākuta. Mā te mārama ki tō mate ka āwhina i a koe ki te whakatau whai whakaaro mō te maimoatanga.

Ka taea te rongoa i te mate pukupuku repeure?

Ahakoa he iti te tere ora mō te mate pukupuku repe taiaki, ka taea te murunga katoa mēnā ka kitea, ka rongoatia wawe. Ko te huarahi pono anake hei whakaora i te mate pukupuku repe taiaki ko te tango katoa i te mate pukupuku mā te pokanga.

Me pēhea te rongoā i te mate pukupuku repeure?

Ko te maimoatanga tika e whakawhirinaki ana ki etahi mea, tae atu ki:

• Te wāhi tika o te pukupuku.
• Te wāhanga o te mate pukupuku.
• Tō hauora whānui .
• Mena kua horapa te mate pukupuku ki waho o te repe taiaki.

Ko ngā maimoatanga mate pukupuku repeure ko:

Pokanga

Ko te pokanga anake te huarahi tūturu hei whakaora i te mate pukupuku repeure. Engari ka tūtohu noa ngā taote pokanga mēnā e whakaaro ana rātou ka taea te tango katoa i te mate pukupuku. Ki te kore, kāore e nui te painga.

Kia angitu ai te pokanga, me herea katoatia te mate pukupuku ki te repe taiaki. Ahakoa tērā, kāore pea e taea te tango katoa i te mate pukupuku.

He rerekē ngā tikanga pokanga i runga i te wāhi me te rahi o te pukupuku:

• Te tikanga Whipple `(Te tikanga Whipple - pancreaticoduodenectomy)`:

Mena kei te pane o te repe taiaki te pukupuku (te wāhanga whānui rawa atu o te repe taiaki, e tata ana ki te whekau iti), ka tūtohu pea tō tākuta i tētahi tikanga Whipple. Ko tēnei ko te tango i te pane o te repe taiaki, tō duodenum (te wāhanga tuatahi o te whekau iti), tō pūhā, te wāhanga o te awaawa wai, me ngā kōpū lymph e tata ana. Kātahi ka hono te taote pokanga i te awaawa wai me te repe taiaki e toe ana ki tō whekau iti. Mā tēnei ka whakarite anō i tō pūnaha nakunaku.

• Te tango i te pancreas tawhiti:

Mena kei te hiku o te repe taiaki te pukupuku, ka taea e te taote pokanga te mahi i tēnei pokanga. Kei roto i tēnei ko te tango i te hiku o te repe taiaki me tētahi wāhanga o te tinana o te repe taiaki. He maha ngā wā ka tangohia hoki te ate taiaki. Nā te mea ka āwhina te ate taiaki i a tātou ki te whawhai ki te mate, ka tūtohu pea tō tākuta kia whiwhi koe i ētahi werohanga i mua i tēnei pokanga.

• Te tango katoa i te pancreas:

Mena kua horapa te mate pukupuku ki te repe katoa engari ka taea tonu te tango (tango), ka whakaarohia pea e tō tākuta he tango katoa i te repe. Ka tangohia e tēnei pokanga tō repe katoa, tō pūkahukahu, tō whēkau, me tētahi wāhanga o tō puku me tō whekau iti.

E taea ana te ora me te kore he repe taiaki. Engari ka pā mai he pānga kino kino. Ka hangaia e tō repe taiaki ngā homoni pērā i te insulin hei āwhina i te pupuri i ō taumata huka toto. Ina ngaro tō repe taiaki, ka pāngia koe e te mate huka, ā, me werohanga insulin kia ora ai. Me tango hoki e koe ngā pire whākōkī repe taiaki hei āwhina i a koe ki te nakunaku kai.

Te rongoā matū

Ko te chemotherapy he whakamahinga o ngā rongoā hei patu i ngā pūtau matepukupuku. Ka hoatu ēnei rongoā hei pire, hei werohanga rānei mā te IV (i roto i ngā uaua) ki roto i te uaua i tō ringaringa.

Ka hoatu hoki e ngā tākuta te chemotherapy hei maimoatanga kotahi - inā koa mō te hunga kua horapa te mate pukupuku. Tērā pea ka tūtohu rātou i te chemotherapy i mua i te pokanga hei whakaiti i te pukupuku, hei patu rānei i ngā pūtau mate pukupuku e toe ana i muri i te pokanga.

Te rongoā irahiko

Ko te rongoā irahiko he whakamahinga o ngā hihi-X kaha-nui hei whakangaro i ngā pūtau matepukupuku. He tikanga tēnei e whakamahia whānuitia ana mō te matepukupuku repeure.

He maha ngā wā ka honoa e ngā tākuta te rongoā irahiko me te rongoā matū (chemoradiation). Ka taea te hoatu i mua i te pokanga, i muri i te pokanga, hei wāhanga rānei o te maimoatanga matua o te mate pukupuku. Ka taea hoki e te rongoā irahiko te āwhina i te whakaiti i ngā tohu o te mate pukupuku repeure i roto i te hunga kāore e taea te pokanga (ina horapa te mate pukupuku).

Te rongoā arotahi

Ka whakamahia e tēnei maimoatanga ngā rongoā e 'aro ana' ki ētahi pūmua. Ka whakahaere ēnei pūmua i te tipu me te horapa o ngā pūtau matepukupuku. Ka whakakotahi pea ngā tākuta i te rongoā arotau me ētahi atu maimoatanga, pērā i te rongoā irahiko.

Ko ngā rongoā tino rongonui mō te mate pukupuku pancreatic ko:

• `Erlotinib`
• `Olaparib`
• `Larotrectinib`
• `Entrectinib`

Te whakahaere mamae

Ka tino mamae te mate pukupuku repeure nā te mea ka pā ki ngā io tata. Tērā pea ka taea e tō tākuta te āwhina i a koe ki te whakahaere i tō mamae mā te whakamahi i ngā rongoā ā-waha, te rongoā whakamoe, te werohanga steroid rānei.

Mena kei a koe te mate pukupuku repe taiaki, ā, ka tīmata koe ki te pāngia e te mamae nui, pumau, me kōrero koe ki tō tākuta . Māna e kimi he rongoā hei whakaiti i ō tohu.

Ka taea e au te ārai i te mate pukupuku pancreatic?

Kāore e taea te ārai katoa i te mate pukupuku repeure, engari he mea ka taea e koe te mahi hei whakaiti i tō tupono:

• Kaua e momi hikareti.
• Whakawhāitihia te inu waipiro.
• Kai i te nui o ngā hua hou, ngā huawhenua, me ngā witi katoa.
• Whakaitihia te kai mīti whero, ngā inu huka, me ngā kai tukatuka.
• Whakawhāitihia te pānga ki ngā matū kino pērā i te asbestos, ngā patu pepeke, me ngā matū hinu.
• Kia mau tonu tō taumaha hauora.

Ngā tirotiro matepukupuku repeure

Kāore ngā tākuta e whakahaere i ngā tirotiro auau mō te matepukupuku repeure. Heoi, e taunaki ana ngā tākuta kia aroturukitia auau mā te whakamahi i ngā whakamātautau whakaahua me ngā ultrasound endoscopic mō te hunga e nui ake ana te mōrearea ki te whakawhanake i te matepukupuku repeure nā te mea he mate ira kei a rātou.

Mena kua pāngia tētahi o ngā whanaunga tuatahi o tō whānau (ngā mātua, ngā tuākana, teina rānei) e te mate pukupuku repe taiaki, me kōrero koe ki tētahi tākuta mō tō tūponotanga ki te pāngia e te mate pukupuku repe taiaki, me te tirotiro tika me te whakamātautau ira.

He aha taku e tumanako atu ai mēnā he mate pukupuku repeure tōku?

He mea taumaha te kitenga kei a koe te mate pukupuku repeure. He rerekē te katoa, ā, he rerekē te āhua o ia tangata. Ka whakatūria e tō tākuta he rōpū tohunga hei whakatau i te mahere maimoatanga pai rawa atu mōu. Kei roto pea i tō rōpū hauora:

• Tohunga kai
• Tohunga mate
• Ngā tohunga mate pukupuku (hauora, pokanga me te irahiko)
• kaimahi hapori

Te rārangi wā o te horapa o te mate pukupuku repeure

I te nuinga o te wā, e 10 ki te 20 tau te roa ka whanake ai tētahi pūtau matepukupuku kotahi i roto i tō repe taiaki hei pukupuku. Ko te whāinga o ngā rangahau o nāianei ko te kimi me pēhea te kite i te matepukupuku repe taiaki i te wā tōmua, i te wā e taea ai te rongoā.

Te auau oranga mō te mate pukupuku repeure

I tētahi whenua pēnei i a Amerika, ko te ōrau oranga mō te hunga e pāngia ana e te mate pukupuku repeure he 11%. Ko te tikanga, 11 i roto i te 100 tāngata e ora tonu ana i te rima tau i muri i te tātaritanga.

He whakatau tata noa iho ngā reiti oranga. Kāore e whakaatu ana i te roa o tō oranga, i te pai rānei o tō urupare ki te maimoatanga. Mena he pātai motuhake āu mō ēnei reiti, me pēhea rānei te pānga ki a koe, kōrero ki tō tākuta.

Āhea ahau me toro atu ki te tākuta?

Kāore he tohu e kitea ana i te tīmatanga o te mate pukupuku repeure. Heoi, me toro atu ki te tākuta tonu mēnā ka pāngia koe e tētahi o ēnei e whai ake nei:

• Te kiriuhi
• Mamae puku, mamae tuara rānei
• Te ngaronga taumaha mō te kore take
• Te tīmatanga ohorere o te mate huka

He aha ngā pātai me pātai atu e au ki taku tākuta?

Waihangahia he whanaungatanga tuwhera, mahi tahi me tō tākuta. Mena kua kitea koe, tō hoa aroha rānei kua pāngia e te mate pukupuku repeure, ka taea e koe te pātai i ēnei pātai:

• Kei tehea wāhanga te mate pukupuku? He aha te tikanga mōku?
• He aha ngā kōwhiringa maimoatanga kei a au? He aha tāu e taunaki ana, ā, he aha ai?
• He aha ngā pānga taha ka pā mai pea ki ahau i te maimoatanga?
• He tika te whakamātautau ira mōku?
• He whakamātautau haumanu kei reira?
• Ka taea tonu e au te mahi me te mahi i aku mahi o ia rā?
• Ka taea e koe te kī mai ki ahau kei hea ahau e kimi ai i te āwhina pūtea?
• Ka taea e koe te kōrero mai ki ahau mō ngā wāhi ka taea e au te tiki i te whakamarie hinengaro?
• Me aha ahau kia noho hauora tonu ai?

He aha ngā tohu kua horapa te mate pukupuku repeure?

I te whanaketanga haere o te mate pukupuku repe taiaki, tera pea ka puta he tohu hou. Ko ngā tohu o te mate pukupuku repe taiaki kua horapa haere ko:

• Mamae puku
• Ngenge rawa
• Te ngaronga taumaha mō te kore take
• Te kiriuhi
• Te pupuhi o te puku (ascites)

He wheako tino kino, he wheako whakarerekē hoki te mōhio kei te pāngia koe e te mate pukupuku repe taiaki. Kei reira tō tākuta hei āwhina i a koe i tēnei wā uaua. Ki te taea e koe, uru atu ki tētahi rōpū tautoko ā-rohe, ā-ipurangi rānei mō te hunga e pāngia ana e te mate pukupuku repe taiaki. He tino pai te noho tahi me ētahi atu e pāngia ana e te taua āhuatanga mō tō hauora hinengaro. Ka taea hoki e koe te kōrero mō ō kare ā-roto ki tētahi kaiwhakatakoto whakaaro, kaiwhakaora hinengaro, kaimahi hapori rānei. He mana te mātauranga. He maha ngā rauemi e wātea ana hei āwhina i a koe me tō whānau.

Hei whakarāpopototanga, ngā mea hei maumahara mā tātou (Karere hei tango ki te kāinga)

He mate uaua, he mate huna hoki te mate pukupuku repeure, engari he mea nui kia mōhio koe ki tēnei. Nā te mea he iti noa ngā tohu i ngā wāhanga tōmua, ko te mea pai ko te mōhio ki ō āhuatanga mōrearea, me te toro atu ki te tākuta i te wā e taea ai mēnā ka kite koe i tētahi mea rerekē. Kia maumahara, kaua e warewarehia te jaundice, te mamae tonu o te puku/tuara, te hekenga taumaha ohorere, te tīmatanga hou rānei o te mate huka. Mēnā he mōrearea ira tōu, kōrero ki tō tākuta mō tēnei mea, ā, me whakamātau koe. He maimoatanga kei te wātea, ā, kei te haere tonu ngā rangahau hou. Ko te mea nui ko te kaua e mataku, rapu tohutohu hauora mēnā he ruarua ōu, me te noho pai.

`Matepukupuku Pūkahukahu, Matepukupuku Pūkahukahu, Pūkahukahu, Ngā Tohumate Matepukupuku, Te Maimoatanga Matepukupuku, Te Waikura, Te Mate Huka