Kua tūtohutia koe kia whakamahia te maimoatanga PRRT? Me kōrero tātou mō tēnei tikanga maimoatanga mate pukupuku (Peptide Receptor Radionuclide Therapy - PRRT) i roto i ngā kupu māmā noa iho.

He uaua ki te whakapuaki i ō kare ā-roto ina kitea e koe he mate pukupuku tōu, tō hoa aroha rānei. He mea noa te mataku me te hiahia ki te mōhio ina kōrero mai tō tākuta mō tētahi maimoatanga hou, pērā i te PRRT, he kupu tauhou tēnei. Kaua e manukanuka. Ahakoa he kaupapa uaua tēnei, i tēnei rā ka kōrero tātou mō te PRRT, āna mahi, me ōna painga me ōna ngoikoretanga, i roto i tētahi huarahi tino māmā ka taea e koe te mārama.

He aha te tikanga o te PRRT?

He māmā noa iho, he maimoatanga tino matatau te PRRT e aro ana, e rapu ana, e whakangaro ana hoki i ngā pūtau matepukupuku, he rite tonu ki te 'miseli ārahi' . He mea whakamahi motuhake hei rongoā i tētahi momo matepukupuku e kiia nei ko 'Neuroendocrine Tumors (NETs).'

Ko te āhuatanga motuhake o tēnei maimoatanga ko te urunga tika o te rauemi irahiko (te mahi irahiko) e tukuna ana e ia ki roto i ngā pūtau matepukupuku ka whakangaro i a rātou. Nō reira, he iti ake te kino ki ngā pūtau hauora i tērā o te rongoā irahiko noa.

He pēhea te mahi a tēnei maimoatanga i roto i te tinana?

Hei mārama ki tēnei, me whakamahi tātou i tētahi tauira māmā. Whakaarohia ko ō pūtau matepukupuku he tatau me ngā 'pū kōhao' motuhake ('kaiwhakawhiwhi'). He kī motuhake anake te āhua e uru ana ki ia tatau.

Ko tēnei rongoā, e kiia nei ko te PRRT, ka hangaia mā te whakakotahi i ngā wāhanga e rua:

1. Te Kī: He pūmua tēnei. Ka uru noa tēnei kī ki roto i te 'kōhao kī' o ngā pūtau matepukupuku. Kāore e uru ki roto i ngā pūtau hauora.

2. Te Pāhihi Irahiko: He huānga iti rawa te irahiko (`radionuclide`) kei tēnei kī.

Nō reira, ina hoatu e koe tēnei rongoā ki tō tinana, ka haere tēnei 'kī' puta noa i te tinana, ka kimi i ngā 'kōhao kī' i roto i ngā pūtau matepukupuku, ka piri ki a rātou. Kātahi ka uru te 'pāhihi irahiko' i runga i te kī ki roto i te pūtau matepukupuku, ka pakaru te DNA o taua pūtau, ā, ka whakangaro i te pūtau mai i roto.

Ko te rongoā PRRT e whakamahia whānuitia ana i ēnei rā ko te `lutetium Lu 177 dotatate (LUTATHERA®)`.

Mā wai e tūtohutia te maimoatanga PRRT?

Kāore tēnei maimoatanga e pai mō ngā tūroro matepukupuku katoa. I tēnei wā, ko te nuinga o te wā e taunakitia ana mō ngā matepukupuku e kiia nei ko ngā 'gastroenteropancreatic NETs', arā, ko ngā matepukupuku o te ara nakunaku (ngā whekau, te puku, te rectum) me te pancreas. He maha ngā āhuatanga ka pai ai tēnei maimoatanga mōu.

He aha ngā mahi i mua atu, ā, i te wā e rongoatia ana?

I mua i te maimoatanga

Mena kei te tango koe i ētahi atu rongoā mō ngā NET (ina koa ko ngā momo somatostatin), tera pea ka tohutohu tō tākuta kia mutu te tango i aua rongoā i ētahi wiki i mua i te PRRT. Tērā pea ka whakamātauhia e tō tākuta ngā whakamātautau toto i te wiki i mua i tō maimoatanga hei tirotiro i te mahi a ō whatukuhu me te maha o ngā pūtau toto hei whakarite kei te pai tō tinana ki te whiwhi i te maimoatanga.

I te rā o te maimoatanga

I te nuinga o te wā ka tukuna tēnei maimoatanga i ia rua marama, mō ngā wāhanga e whā, mō te wā e waru marama. He tikanga tēnei mō te wā o waho, kāore e hiahiatia kia noho ki te hōhipera. E 5-6 hāora te roa o te tikanga katoa.

• Tuatahi, ka whakauruhia he ngongo iti (cannula) ki roto i te uaua i roto i tō ringa, ā, ka hangaia he raina tote.
• Tata ki te haora i mua i te tīmatanga o te maimoatanga, ka hoatu he rongoā hei ārai i te whakapairuaki me te ruaki.
• Kātahi ka hoatu he wai tote kei roto ngā waikawa amino hei tiaki i ō whatukuhu mō te 4 hāora pea. He mea tino nui tēnei.
• Tata ki te 30 meneti i muri i te tīmatanga o te hoatutanga o ngā waikawa amino, ka tukuna te rongoā PRRT ki te tinana mā te tote mō te 30-45 meneti.
• Kia tukuna katoatia te tote, ka tangohia te ngongo i te ringa.

Hei te rā i muri i te maimoatanga, ka tirotirohia anō koe hei tirotiro i te wāhi kua riro te rongoā irahiko ki roto i tō tinana, inā koa ko ngā pūtau matepukupuku.

He aha ngā pānga taha me ngā mōrearea?

Pērā i ngā maimoatanga katoa, tera pea ētahi pānga taha.

Ngā pānga taha tino noa:

Ko ngā pānga taha e tino kitea ana ko te whakapairuaki me te ruaki , engari ka taea te whakahaere i ēnei mā te maimoatanga wawe.

Ētahi atu raruraru pea:

• Te pānga ki te mahi a te whatukuhu, te ate rānei.
• Te hekenga o te maha o ngā pūtau toto (ngā pūtau toto mā, ngā pūtau toto whero, ngā pereti toto). Ka uaua pea te manawa, ka pāngia e ngā mate, ka nui ake te mōrearea o te toto, te marō rānei.
• He tino onge, he iti rawa te mōrearea o te whakawhanake i ētahi atu mate pukupuku toto pērā i te myelodysplastic syndrome, te leukemia rānei.

Ka aroturukihia e tō tākuta ō taumata toto i ia wā puta noa i tō maimoatanga. Mēnā ka puta he raruraru, ka whakatau pea rātou ki te whakarerekē i te horopeta, ki te whakamutu rānei i tō maimoatanga.

He āhuatanga tino kino e hiahia ana kia arohia tonutia!

Te oranga o ia rā i muri i te maimoatanga

He pai te aro o te nuinga ki tēnei maimoatanga, ā, ka tere te ora.

Te irahiko me te haumaru:

He iti noa te nui o te irahiko e whakamahia ana mō te maimoatanga. Ka tukuna atu tēnei i roto i tō tinana i roto i tō mimi me tō tūtae i ngā rā torutoru e whai ake nei. I tēnei wā, ka hoatu e tō tākuta he tohutohu ki a koe kia kore ai ētahi atu e pāngia e te irahiko.

• He mea tino nui kia noho tawhiti atu i ngā wāhine hāpu me ngā tamariki nohinohi mō ētahi rā.
• Horoia pai ō ringaringa ki te hopi i muri i te whakamahinga o te wharepaku.

Te haereere:

Tērā pea he iti noa te nui o te irahiko i roto i tō tinana tae atu ki te 3 marama i muri i tō maimoatanga. Tērā pea ka pupuhi ngā taputapu kite irahiko i ngā taunga rererangi, i ngā rohe rānei. Nō reira, me pupuri tonu te kāri motuhake i riro mai i te hōhipera me ngā taipitopito mō tō maimoatanga. He mea tino nui tēnei hei karo i ngā raruraru i a koe e haere ana.