He pukupuku repeure anō hoki tōu? Me kōrero taipitopito tātou mō tēnei!

Tērā pea i whai `Scan` koe mō tētahi atu take, pērā i te `CT` (Computed Tomography) te `MRI` rānei (Magnetic Resonance Imaging), ā, i kī mai te tākuta he iti te whē i roto i tō repeure? Ina rongo koe i tētahi mea pēnei, ka ohorere koe ka mataku, ka āwangawanga, tika? He maha ngā pātai pēnei i te "He aha tēnei? He morearea?" ka ara ake i roto i tō hinengaro. Nō reira, kaua e manukanuka. I tēnei rā, me kōrero tātou mō ēnei whē i roto i te repeure me te mārama, me te ngāwari hoki.

He aha te pukupuku repeure?

He māmā noa iho, he pēke iti, he mirumiru rānei te pukupuku repe taiaki e puta mai ana i roto i tō repe taiaki, i ētahi wā rānei i runga i tōna mata. Whakaarohia he rite ki te poihau wai iti. He rerekē ngā momo pukupuku, e whakarōpūtia ana i runga i ngā rauemi pūtau e hangaia ai. Ko ētahi momo e kiia ana he neoplastic. Ko te tikanga o te neoplastic ko ētahi o rātou ka taea te huri hei mate pukupuku i roto i te wā. Ko ētahi atu momo e kiia ana he nonneoplastic. Kāore ēnei pukupuku nonneoplastic e whanake hei mate pukupuku. Nō reira, kāore he mea hei manukanuka.

He aha te tikanga o te mate pukupuku pancreatic?

Inaianei kei te whakaaro pea koe, "Āe, he aha te tikanga o tēnā mēnā kei a au tētahi o ēnei?" Ahakoa te āhua nei he hononga ētahi o ngā whēke repe ki tētahi mate e kiia nei ko te pancreatitis, i te nuinga o te wā ka puta ake kāore he take e kitea ana, me te mea he tūpono noa iho. Ko te mea nui, ko te nuinga o ngā whēke repe kāore e whakararu i a koe. Tērā pea kei reira noa iho.

Heoi, he tino onge te tīmatanga o te mate pukupuku repeure i roto i tētahi momo pukupuku e kiia nei ko te 'neoplastic'. Ina koa mēnā kua pāngia tētahi o tō whānau, arā, tō whaea, tō pāpā, ō tungāne, me ō tuāhine, e te mate pukupuku repeure, he paku teitei ake tēnei mōrearea i ērā atu. Engari kāore i te noa mō te katoa.

Me manukanuka ahau mō te pukupuku repeure?

Koinei te pātai nui rawa atu a te tini tāngata. Mēnā ka kite tō tākuta i tētahi whēwhe repeure i runga i te matawai whakaahua, pērā i te CT, te MRI rānei, ka whakarōpū tonutia e ia hei mōrearea iti, waenga, nui rānei . Ko tēnei whakarōpūtanga e hangai ana ki te āhua o te whēwhe e kitea ana i runga i te matawai (pērā i tōna rahi me tōna āhua) me te mea kei a koe ētahi tohu e pā ana ki taua mea.

Mena kei roto te pukupuku i te kāwai "iti te mōrearea", kāore pea he mea hei manukanuka. I te nuinga o te wā, kāore he mea e taea te mahi.

Mena he "waenga" he "tiketike" rānei te mōrearea, ka whakaratohia e ngā tākuta te maimoatanga e tika ana e ai ki ā rātou aratohu hauora.

I te nuinga o te wā, ka puritia ngā pukupuku repeure ki raro i te 'tirotiro'. Ko te tikanga o te tirotiro ka matawaihia e ngā tākuta i ia wā, i ia wā, me te pātai, "Kei te nui haere tēnei pukupuku? Kei te huri te āhua? He mea hou?" Mena ka huri tētahi pukupuku iti-morearea ki tētahi pukupuku mōrearea-waenga i roto i te wā, ka mahia he 'biopsy' hei rapu atu i ētahi atu mōhiohio mōna. Ka mahia he 'biopsy' mā te whakauru i tētahi mea pēnei i te ngira angiangi, ka tangohia he wahi kiko iti rawa mai i te pukupuku ka tirotirohia i raro i te karu hiko. Pērā ai, ka taea te whakatau i te momo pūtau tika i roto. Mena ka huri tētahi pukupuku mōrearea-waenga ki tētahi pukupuku mōrearea-nui, arā, he ahua nui ake te tūponotanga he mate pukupuku, ka whakamahere ngā tākuta ki te mahi pokanga hei tango atu.

He pēhea te noa o ngā pukupuku repeure?

E whakaatu ana ngā rangahau ka kitea noatia ngā whēwhe repeure i roto i te 10% o te hunga e tirotirohia ana e te CT (Computed Tomography scans) me te MRI (Magnetic Resonance Imaging). He maha ngā wā ka kitea noatia i roto i ngā whakamātautau whakaahua mō tētahi atu take, pērā i ngā raruraru puku. Nā te mea he maha ngā tāngata e pāngia ana e ēnei whēwhe, ā, kāore e whakaatu i tētahi tohu, kāore mātou i te tino mōhio e hia ngā tāngata o te ao kāore e mōhio kei a rātou tētahi.

E hia ōrau o ngā pukupuku repe taiaki ka huri hei matepukupuku?

He mea nui anō hoki tēnei. He iti iho i te 1% o ngā whēkau repe ka huri hei matepukupuku. He iti noa iho tēnei ōrau. Heoi, tata ki te 30% o ngā whēkau repe ka taea te huri hei matepukupuku. Ka kiia ēnei he whēkau precancerous. Koia te take e rapu tonu ai ngā tākuta i a rātou. Engari he rongo pai tēnei. He maha ngā wā ka tino nui te tipu o ēnei whēkau precancerous, ā, ka rerekē haere mōrearea. Nō reira, mā te tirotiro tonu, arā, mā te matawai i ia wā, ka taea te tautuhi i ngā huringa matepukupuku i te wā wawe tonu. Kātahi ka taea te tīmata wawe i te maimoatanga.

He aha ngā momo rerekē o ngā pukupuku pancreatic?

He kōrero taipitopito tēnei, he maha ngā ingoa hauora. Engari kia māmā noa iho. E kīia ana e rua ngā momo matua.

Ngā Pūngāwerewere Neoplastic, Precancerous rānei

Ka kiia hoki ēnei ko ngā 'pancreatic cystic neoplasms (PCN).' Koinei ngā momo me āta tirohia e tātou. Ko ētahi o ēnei:

• Ngā Pūngāwerewere Mucinous Papillary Intraductal (IPMN): Koinei te momo pukupuku neoplastic tino noa. Ka puta i roto i te awa pancreatic. He ngongo iti te awa pancreatic e kawe ana i ngā wai nakunaku i hangaia e te pancreas ki ngā whekau. Ko te wai i roto i ēnei pukupuku he ranunga o ngā wai pancreatic me te matū matotoru e kiia nei ko te mucin. He wāhanga o te hūpē te mucin. Ka taea e tēnei mucin te pupuhi me te whakanui ake i te awa pancreatic.
• ``Ngā Pūngāwerewere Pūkahukahu (MCN)'':Kāore ēnei i te tino kitea pērā i ngā 'IPMN'. Ko te nuinga o te wā ka puta i roto i ngā wāhine neke atu i te 50 tau te pakeke. Ka puta i te wāhanga waenga o te repeure (te 'tinana o te repeure').
• 'Ngā Pūngāwerewere Pseudopapillary Totoka (SPN):' He tino onge ēnei. He wāhanga totoka, he wāhanga wai hoki. I te nuinga o te wā ka puta i roto i ngā wāhine taitamariki i roto i ō rātou tau 20 me te 30.
• Ngā Pūkahu Neuroendocrine o te Pancreas Cystic (PNET): He momo pūkahu onge ngā pūkahu neuroendocrine o te pancreas (e kiia ana ko ngā pūkahu pūtau islet). He pūkahu totoka te nuinga, engari i ētahi wā ka puta hei pūkahu.

Ngā pūkahukahu kore-matepukupuku ('Nonneoplastic' 'Ngā pūkahukahu pai' rānei)

Kāore ēnei e pāngia e te mate pukupuku. Nō reira, kāore he take e mataku rawa ai koe i a rātou.

• Ngā Pūwero Māmā (ngā Pūwero Pupuri rānei): He pūwero kino ēnei e tupu ana i roto i te repe taiaki, kua wehea mai i te awa repe taiaki. He paparanga kotahi o ngā pūtau epithelial kei roto. Ko te nuinga o te wā ka puta i roto i ngā tamariki nohinohi.
• Cystadenoma Serous: He pukupuku noa iho ēnei, ā, he kore kino. Heoi, ki te nui haere, ka raru pea i ētahi wā pērā i te pēhi i ngā whekau tata. I taua wā, me tango ma te pokanga i ētahi wā.
• Ngā Pūwero Kore-Nui: He pūwero kino ēnei, he pūwero whakaputa pūwero. Heoi, me āta tirotiro e ngā tākuta kia wehewehea ai rātou mai i ngā momo pūwero, ka taea te mate pukupuku.
• Ngā Pūmua Lymphoepithelial: He tino onge ēnei pukupuku, kāore he kino. Ka kitea pinepine i roto i ngā tāne.

He kōrero nui: Tērā tētahi atu mea e kiia nei ko ngā 'Pūkore-pūkahukahu Pankreas'. I ētahi wā ka pōhēhē te tangata i ēnei he pūkahukahu tūturu. Heoi, ehara te 'pūkore-pūkahukahu' i te tipu hou pērā i te 'pūkahukahu'. He pēke kī tonu i te wai e puta mai ana i te wa e turuturu ana ngā wai o te pūkahukahu mai i te pūkahukahu nā te whara o te pūkahukahu (pērā i te 'pancreatitis'). He mate pai ngā 'Pūkore-pūkahukahu'.

He aha ngā tohu o te pukupuku pancreatic?

Anei tētahi mea ka miharo pea te tini tāngata: Ko te nuinga o ngā pukupuku repe taiaki kāore e puta he tohu. Ae, he pono. Tērā pea kāore koe e kite i tētahi pukupuku. Ka tīmata noa ngā tohu ina nui te pukupuku hei aukati, hei pēhi rānei i te awa repe taiaki, i te ara biliary, i te puku, i ngā whekau rānei (ara gastrointestinal (GI)). Ina tupu tēnā, ka puta pea ēnei āhuatanga:

• Mamae puku: He maha ngā wā ka pā te mamae ki te puku o runga.
• Mamae tuara: I ētahi wā ka horapa te mamae o te puku ki te tuara.
• Te ngaronga o te hiahia kai:Ka ngaro katoa taku hiahia ki te kai.
• Te whakahekenga taumaha kāore i te mārama: Ka heke ohorere tō taumaha ahakoa kāore koe e kai ana i te kai iti, e whakakorikori tinana rānei.
• Pupuhi: Ka kī tonu ahakoa he iti te kai.
• Te koretake o te nakunaku: Te āhua nei kāore te kai e nakunakuhia ana.
• Whakapairuaki: Te āhua nei ka ruaki koe.
• Te kiri māwhero: Ka huri te mā o ngā kanohi me te kiri hei kōwhai. Ka puta tēnei ina kore e rere tika te au o te ate.
• Paru hinuhinu, mārama te tae (te steatorrhea rānei): Ka huri te tae o te paru, ka hinuhinu.
• Te ahua o te puku i roto i tō puku: Mena he nui rawa te puku, tera pea ka rangona.

He aha ngā take o ngā pukupuku repeure?

He tipu pūtau rerekē ngā whēkau repeure. He kupu ngāwari, he iti noa te huringa o ngā ira o ngā pūtau (he 'whakarerekētanga ira') ā, ka tīmata te wehewehe rerekē. Engari kāore anō kia tino mōhiotia e ngā kairangahau te take i puta ai ēnei huringa ira. E whakaaro ana rātou he huinga pea o te āheinga ira, te mumura o te repeure, me ētahi atu āhuatanga o waho, pērā i te koroheketanga. He iti noa te ōrau o ngā whēkau e hono tika ana ki ētahi āhuatanga tuku iho.

Ko ētahi o ngā āhuatanga tuku iho e pā ana ki ngā pukupuku pancreatic ko:

• Te mate a Von Hippel-Lindau
• Te mate tākihi polycystic (he nui ngā cysts i roto i ngā tākihi)
• 'Te mate pukupuku kiriuhi'

He maha ngā āhuatanga ka whai wāhi ki te whanaketanga o ngā pukupuku pancreatic:

• Te pakeke haere: Ka piki ake te mōrearea o te whakawhanake i ngā whēkau repeure i a koe e pakeke haere ana. E ai ki ngā rangahau, e kiia ana he hauwhā (25%) o te hunga kei roto i ō rātou tau 70 e pāngia ana e tēnei mate.
• Te mate pāwera: Ko ētahi momo pukupuku e pā ana ki te mate pāwera. Waihoki, ka taea e ētahi momo pukupuku te whakaputa i te mate pāwera.
• Hītori whānau: Mena kua pāngia tetahi o tō whānau e te mate pukupuku repeure, he mate tuku iho rānei tōu e pā ana ki ngā pukupuku repeure, ka nui ake te tūponotanga ka pāngia koe e ngā pukupuku repeure.

He aha ngā raruraru ka puta mai i ngā pukupuku pancreatic?

He tino onge ngā raruraru, engari ki te puta, ka uru atu ki ēnei:

• Te aukati i te awaawa repeure:Ka taea e ētahi momo pukupuku e kiia nei ko ngā 'mucinous neoplasms' te whakaputa i tētahi matū matotoru e kiia nei ko te 'mucin' ki roto i te awaawa pancreatic. Kātahi ka pupuhi te awaawa, ka kī, ā, ka mutu ka āraia. Mā tēnei ka ārai i ngā whākōkī nakunaku i hangaia e te pancreas kia kore e haere mā roto i te awaawa ki roto i tō whekau iti. Kātahi ka hoki ngā whākōkī ki roto i te pancreas, ka pakaru, ka mumura te pancreas (pancreatitis). I taua wā, kāore tō pūnaha nakunaku e whiwhi i ngā whākōkī e hiahiatia ana hei nakunaku i te kai.
• Te aukati i te awaawa au: Ki te pēhia e te pukupuku nui te awaawa au, ka āraia te rere o te au. Ka kiia tēnei ko te cholestasis. Ka puta te au i tēnei, ka kino pea te awaawa au me ētahi atu okana e hono ana ki reira (pērā i te ate). Ka taea hoki e te au te whakaranu ki te toto, ka puta ngā tohu pēnei i te jaundice.
• Te aukati i te puku: Ki te pēhia e te pukupuku nui tō puku, tō whekau rānei, ka pāngia pea koe e ngā tohumate puku maha, tae atu ki te mamae o te puku, te kore whakamarie, te pupuhi, te mate kōroke, me te kore hiahia kai. I ngā wā tino kino, ka mutu pea te neke o te kai i roto i tō pūnaha nakunaku.
• Matepukupuku repeure: E ai ki te kōrero i mua ake nei, he iti noa te ōrau o ngā pukupuku ka taea te whanake hei matepukupuku. I te nuinga o te wā, he momo e kiia nei ko te adenocarcinoma. Ko te matepukupuku repeure he momo matepukupuku ka horapa tere. Nō reira, he mea tino nui kia kitea wawetia.

Me pēhea te tautuhi i te mate pukupuku pancreatic?

Ka whakamahia e ngā tākuta ngā whakamātautau e whai ake nei hei whakatau mēnā kei reira he whēwhe repeure, ā, mēnā kei reira, he aha tōna āhua:

• Irahiko: Mā ngā tikanga whakaahua kounga teitei, pērā i ngā karapa CT, ngā karapa MRI rānei, ka taea te whakaatu mārama i ngā pukupuku repeure. Ka taea te tautuhi i ētahi momo pukupuku i runga i te karapa. Engari ko ētahi me whakamātautau anō kia mōhiotia ai te momo, kia kite rānei mēnā kei roto ngā pūtau matepukupuku. I ēnei wā, me tango pea e ngā tākuta he tauira (he koiora) o te pukupuku.
• Te Rongoā-Uri Endoscopic / Te Momihanga Ngira Pai (EUS-FNA): Mā te tikanga e kīia nei ko te Rongoā-Uri Endoscopic (EUS) ka taea e te tākuta te whakauru i tētahi endoscope iti, ngāwari (he ngongo me te kāmera me te taputapu ultrasound) mā te waha, ki roto hoki i te puku kia tae atu ai ki tētahi pukupuku repeure. Mā te ultrasound e whakaatu tika te wāhi kei reira te pukupuku, ā, ka tukuna he ngira angiangi (he ngira pai) mā te endoscope hei tango i tētahi tauira iti o te kiko me te wai mai i te pukupuku. Ka kiia tēnei ko te Momihanga Ngira Pai (FNA). Kātahi ka tātarihia te tauira i roto i tētahi taiwhanga.
• Te tātaritanga wai:Ka tātarihia te wai cystic mai i te FNA i roto i te taiwhanga hei whakatau i te momo. Ka kiia hoki tēnei ko te cytology. Ka rapua e rātou ngā mea pēnei i te mucin. Ka āwhina te mucin ki te tautuhi i ngā neoplasm mucinous. Ka rapua hoki e rātou ngā tohu pukupuku pēnei i te carcinoembryonic antigen (CEA). He pūmua te CEA e kitea ana i roto i te toto, ā, ka taea e ōna taumata te homai i ētahi tohu mō te aroaro o te mate pukupuku.

He aha ngā rongoā mō ngā pukupuku pancreatic?

Ko te maimoatanga o te pukupuku repe taiaki e whakawhirinaki ana ki ngā āhuatanga maha, tae atu ki te momo pukupuku, tōna rahi, mēnā he tohumate, me tōna tūponotanga kia noho hei matepukupuku. Anei ngā kōwhiringa maimoatanga matua:

• Te Tirotiro: Ko te tikanga o tēnei ko te kore mahi i tetahi mea, engari me matawai tonu me te mātakitaki mēnā ka rerekē te pukupuku.
• 'Biopsy': Te tango tauira kiko, ka tirotiro hei whakatau i te āhua tuturu o te pukupuku.
• Te tango mā te pokanga: Mena he mea morearea te pukupuku, he mea raru rānei, ka tangohia mā te pokanga.

Ko te nuinga o ngā whēwhe ka rongoatia mā te tirotiro. Ko te tikanga ka tirotirohia te whēwhe i ia wā, i ia wā (ia 6 marama, ia tau, neke atu rānei) hei tirotiro i te whēwhe. Mena he huringa whakapae, ka mahia he EUS-FNA, ā, ka tātarihia te wai. Mena e tohu ana ngā hua he mate pukupuku, ka tūtohu pea tō tākuta kia tangohia, i runga i te pai o tō āhua hei pokanga.

Ka memeha haere ngā pukupuku repeure i a rātou anō?

Ka taea e ētahi pukupuku pai, inā koa ko ngā mea iti, te whakaiti i a rātou anō, te ngaro rānei i ētahi wā. Engari ko ngā momo e kiia nei ko te neoplastic, ka taea te huri hei matepukupuku, kāore e ngaro i a rātou anō. I te nuinga o te wā, ka tipu tonu rātou, engari he tino puhoi. Ka aroturukihia e ngā tākuta tō rātou tipu. I te mea ka noho iti tonu, ki te kore e nui rawa, e rerekē rānei i tētahi ara whakapae, kāore ngā tākuta e mahi i tetahi mea mō rātou, ka mātakitaki noa rātou.

Kia pehea te tere o te tipu o ngā pukupuku pancreatic?

He rerekē te tere o te tipu o ngā momo pukupuku repe taiaki, engari i te nuinga o te wā, he tino puhoi te tipu. Mena ka neke atu i te 3 mirimita (3 mm) te tipu o te pukupuku i ia tau, ka paku whakapae ngā tākuta, ā, ka nui ake te aro. Mena kei te tirotirohia te pukupuku mō ngā huringa, ka tirohia i ia tau, i ia rua tau, i ētahi wā i ia rima tau, i runga i te tere o tōna tipu.

Āhea me tango ngā pukupuku repeure?

Me tango pea ētahi pukupuku repeure mena ka puta he raruraru, ka whakapaetia rānei he matepukupuku. Engari he tikanga nui te pokanga repeure, me ōna ake mōrearea me ngā pānga taha. Koia te take ka āta whakaarohia e ngā tākuta ia pukupuku. Ka whai rātou i ngā aratohu hauora taipitopito hei whakatau i te wā e pokanga ai, e tango ai hoki i te pukupuku.

Anei ētahi o ngā mea e whakaarohia ana e rātou:

• Rahi: Ko ngā puku nui atu i te 3 henimita (3 henimita), ko ērā rānei e ahua tere ake ana te tipu i te tikanga, me tirotiro pea mēnā kei te tūpono te mate pukupuku. I ētahi wā, ahakoa kāore he kino o ngā puku nunui, me tango pea nā te mea ka whakararuraru, ka pāngia rānei ētahi atu okana.
• Momo: He nui ake te tūponotanga o ētahi momo pukupuku (hei tauira, ngā MCN, ētahi IPMN) kia noho hei matepukupuku. Tērā pea ka tūtohu te tākuta kia tangohia wawetia. Ka aromatawaihia e ngā tākuta te tūponotanga o te matepukupuku, ka whakatauritea ki ngā tūponotanga o te pokanga, me te whai whakaaro ki te hauora whānui o te tangata.
• Ngā tohu tirohanga: I ētahi wā, ka kite ngā tākuta i ngā tohu i runga i ngā matawai e tohu ana he pukupuku matepukupuku, he pukupuku rānei kei mua i te matepukupuku. Hei tauira, ka kite pea koe kua nui haere te awaawa o tō repe taiaki, ko te tikanga pea he pukupuku mucinous tōu e whakaputa ana i te mucin ki roto i te awaawa. Ka kite rānei koe he wāhanga totoka kei roto i te pukupuku, ko te tikanga pea ehara i te mea he puku wai anake, engari he pukupuku totoka.
• Tō āhua: He mate hauora anō ō ētahi tāngata (pēnei i te mate manawa, te mate huka) he āhuatanga nui rānei, pērā i te pakeketanga, e nui ake ai te mōrearea o te pokanga repeure mō rātou. Ka paunatia e ngā tākuta ēnei āhuatanga mōrearea ki tō mōrearea matepukupuku kia pai ai te whakatau.

Me pēhea te mahi pokanga hei tango i te pukupuku repeure?

Ki te tūtohu tō tākuta kia tangohia he pukupuku, ko te tikanga ka pokanga koe. He uaua ake ēnei pokanga. I ētahi wā ka taea e te taote pokanga te tapahi marie i te pukupuku anake mai i tō repe taiaki. Engari i te nuinga o te wā, me tango hoki tetahi wahi o tō repe taiaki. I runga i te wāhi kei reira te pukupuku, me tango pea ētahi wāhanga o ētahi atu okana tata (pērā i te whēkau, i te wāhanga rānei o te whekau iti).

He maha ngā momo pokanga ka taea te mahi:

• Enucleation: Koinei te tango āta i tētahi pukupuku kotahi mai i te repe taiaki me te kore e kino te kiko repe taiaki hauora e karapoti ana. Mena he pukupuku kotahi, he iti, he pai tōu, kei te wāhi e kitea ana, ā, kāore e rite ki te mate pukupuku, tera pea ka tika koe mō tēnei pokanga iti noa iho.
• Te tango wāhanga o te pancreas:Ko te tikanga o tēnei ko te tango i te wāhanga o te repe taiaki kei roto te pukupuku, ngā pukupuku rānei. Whakaarohia tō repe taiaki he āhua rite ki te ika. He "upoko", he "tinana", me te "hiku". Mā te tango i te repe taiaki pokapū ka tangohia te wāhanga waenga o te repe taiaki. Mā te tango i te repe taiaki tawhiti ka tangohia te hiku. Nā te mea he tino hononga te hiku o te repe taiaki me te whēkau, he maha ngā wā ka tangohia te whēkau (splenectomy) i te tango i te repe taiaki tawhiti.
• Te tikanga Whipple (e mōhiotia ana ko te pancreaticoduodenectomy): He mahi nui ake tēnei. Ka tangohia e te tikanga Whipple te upoko o te pancreas me ngā awa pancreatic. He maha ngā wā ka kitea ngā pukupuku matepukupuku, pērā i ngā neoplasm mucinous, i roto i tēnei upoko. He hononga pukumahi hoki te wāhi e tūtaki ai te wāhanga o runga o tō whekau iti (duodenum), te awa pancreatic, me te awa bile noa. Mena kei hea te matepukupuku i tēnei hononga, ka horapa pea ki ētahi atu peka, nō reira ka tangohia e te tikanga Whipple te upoko o te pancreas, tae atu ki tō duodenum, te awa bile noa, me te gallbladder, e piri ana ki tētahi atu pito o te awa bile noa.
• Te tango katoa i te pancreas: Ko te tango i tō pancreas katoa tēnei . Tērā pea he mea tika tēnei mēnā he maha ngā pukupuku hei tango, mēnā rānei kua horapa te mate pukupuku puta noa i tō pancreas. Tērā pea ka tangohia e te tango katoa i ngā oko toto me ngā whekau tata pērā i te whēkau, te pūkahukahu, te duodenum, me te wāhanga o raro o te puku.

He aha ngā mōrearea me ngā pānga taha o te pokanga mō te pukupuku repeure?

Ka pāngia pea te mahi noa o tō repe taiaki e te pokanga. Me whakaputa e tō repe taiaki ētahi whākōkī me ngā homoni nui hei whakahaere i te huka toto, tae atu ki te insulin. He homoni te insulin e whakahaere ana i ngā taumata huka toto. Mena ka tangohia e tō repe taiaki he nui rawa ngā pūtau e hanga ana i ngā whākōkī, i te insulin rānei, me tango e koe ngā rongoā mō te wā katoa hei whakakapi i aua mea. Hei tauira, me werohanga insulin, me ngā pire whākōkī rānei hei whakakapi i a rātou.

Ka tangohia, ka whakarerekētia rānei ētahi okana e ētahi pokanga tango i te puku. Ka pā pea ēnei ki tō pūnaha nakunaku, tō pūnaha biliary, me tō pūnaha ārai mate. Tērā pea ka uaua ki a koe te nakunaku i ētahi kai me te mimiti i ētahi matūkai (ina koa te ngako) i muri mai. Mēnā ka tangohia tō puku, tērā pea ka ngoikore haere tō pūnaha ārai mate, ā, ka maha ake pea ō mate pāwera.

Ko ngā pānga taha motuhake ka puta ko:

• Mate huka: Mēnā ka whakangaromia ngā pūtau e whakaputa ana i te insulin.
• Te ngoikore o te repe taiaki:Kāore i te rawaka ngā whākōkī nakunaku e whakaputaina ana e te repe taiaki. Ka taea e tēnei te puta o te kai mā roto i te puku, engari kāore e nakunaku.
• Te ngoikore o te mimiti ngako: He uaua ki te nakunaku ngā kai ngako.
• Te ngoikore o te pūnaha ārai mate: Mēnā ka tangohia te ate.

Ko ētahi atu mōrearea noa o te pokanga ko:

• Te toto
• Ngā mate urutā
• Ngā toto totoka
• Te turuturu o te puku (te turuturu mai i te wāhi e honoa anō ai ngā mea pēnei i ngā whekau i te wā pokanga)

He pēhea te kino o te pukupuku repeure?

E ai ki ngā tatauranga, he iti ake te tūponotanga o ngā pukupuku repe taiaki ki te whakaputa raruraru nui. Ka tino tupato ngā tākuta ki ngā pukupuku repe taiaki, nā te mea e hiahia ana rātou ki te karo i tētahi mōrearea. Ka aromatawaihia e rātou tō pukupuku, ā, ka whakatau i ngā mahi ārai hei mahi. Ahakoa he mea nui te pokanga repe taiaki, kāore te nuinga o ngā pukupuku repe taiaki e hiahiatia he pokanga. Nō reira, kaua e mataku ina kitea he pukupuku tōu.

Kia pēhea te roa o te oranga i muri i te maimoatanga mō te pukupuku repeure?

Kei te momo pukupuku me te whānui o tōna horapa tēnei. Mēnā ka tangohia te pukupuku i mua i tōna noho hei matepukupuku (precancerous) i te wā rānei kāore anō kia horapa te matepukupuku (kore-invasive), ko te reiti oranga mō ngā tau e rima i muri i te pokanga matepukupuku repe taiaki e tata ana ki te 100%. Ko te tikanga he tino pai ngā hua. Mō te hunga whai matepukupuku invasive, ko te reiti oranga mō ngā tau e rima i muri i te maimoatanga he tata ki te 65%-75%. Ka rerekē anō hoki tēnei i runga i te momo pukupuku me te wāhanga o te matepukupuku. Ko te reiti mate (te mōrearea o te mate mai i te pokanga) mō tētahi pokanga repe taiaki nui he tata ki te 4%.

He aha ngā pātai me pātai atu e au ki taku tākuta mō aku pukupuku repeure?

Ina kitea he pukupuku repe taikaha tōu, he mea noa te maha o ngā pātai kei roto i tō hinengaro. Kei a koe te tika ki te pātai i ngā pātai pēnei i tō tākuta:

• "He aha te momo pukupuku kei a au?"
• "He iti, he waenga, he teitei rānei te mōrearea o te mate pukupuku o te ū ki ahau?"
• "Kia pēhea te auau o taku tirotiro whakaahua hei tirotiro i aku pukupuku?"
• "Ka nui ake ōku ū? Ki te pērā, kia pēhea te tere?"
• "Ahakoa kāore he tohu o te mate, me tango atu tēnei pukupuku?"
• "Mēnā me pokanga ahau, he aha ngā mōrearea? He aha ngā pānga taha ka pā mai ki ahau?"

Ahakoa he iti noa te mōrearea, ina whakaarohia te mate pukupuku repeure me te pokanga, ka nui te manukanuka ka pā mai. Engari kia maumahara, ko te nuinga o ngā pukupuku repeure kāore he mea e wehi ai. Ko ngā aratohu hauora mō te aroturuki, te whakamātautau, me te rongoā i ngā pukupuku repeure kua hangaia hei whakamama i taua wehi koretake, hei tiaki hoki i a koe.

He mea noa ngā tipu rerekē (pērā i ngā pūmua) i roto i ngā whekau maha, inā koa ka pakeke haere koe. Ko ngā pūmua repeure tētahi atu whekau hei tāpiri atu ki taua rārangi. He iti noa te mōrearea o ēnei tipu ka huri hei matepukupuku. Ki te tangohia tonutia e koe tētahi pūmua i mua i te matepukupuku, kāore e whai wāhi ki te huri hei matepukupuku.

Ngā mea tino nui me maumahara koe

Kaua e mataku, kaua hoki e mataku ina kīia atu he whēwhe repeure tōu. Whakamānawahia tō manawa, ka kōrero mārire ki tō tākuta.

I te nuinga o te wā, kāore ēnei e kino, kāore e whakaatu i ngā tohu, ā, ka kitea noatia.

Ki te kī mai te tākuta i tēnā, pātai atu mō ētahi atu kōrero. Whakamāramahia te momo pukupuku kei a koe, me pēhea tōna pānga ki a koe, me te aha me mahi e koe i muri mai.

Ahakoa kei reira ngā momo mate pukupuku ka taea te whanake, kei reira ngā tikanga matatau hei kimi i a rātou, ā, ki te tika, hei rongoā i te wā tika. Ko te mea nui ko te whai i ngā tohutohu a te tākuta me te whai i ngā karapa whai muri i te wā tika. Kātahi ka kore koe e manukanuka ki tēnei mea. Kia ora!

` Panihi, Ngā Pūngāwerewere Panihi, Matepukupuku Panihi, Ngā Tohu o te Panihi, Te Maimoatanga o te Panihi, Te Pokanga Panihi