He raruraru ō whatukuhu? Me ako tātou mō te Renal Cell Carcinoma (RCC)!

Kua whakaaroaro hōhonu koe mō ō whatukuhu? He okana iti engari he mea nui ngā whatukuhu i roto i tō tātou tinana. He rite rātou ki ngā tātari i roto i tō tātou tinana. Heoi, i ētahi wā ka pāngia hoki ēnei whatukuhu e ngā raruraru. I tēnei rā ka kōrero tātou mō tētahi o ngā momo mate pukupuku tino noa ka puta i roto i ngā whatukuhu, ko te "Renal Cell Carcinoma" te RCC rānei. Kaua e manukanuka, ka kōrerohia e tātou tēnei mea mā te ngāwari, i roto i tētahi huarahi e mārama ai koe.

He aha te mate pukupuku pūtau whatukuhu (RCC)?

Ki te whakarapopoto, ko te mate pukupuku pūtau whatukuhu (RCC) te momo mate pukupuku whatukuhu tino noa. He whatunga ngongo tino angiangi kei roto i ō tātou whatukuhu e kiia nei ko ngā ngongo . Ko ēnei ngongo te mea e kawe ana i te wai me ngā matūkai o te tinana ki roto i te toto, ā, e tango ana i ngā para i roto i te mimi. I roto i ēnei ngongo ka tīmata te hanga o te RCC. Tata ki te 85% o ngā mate pukupuku whatukuhu he momo pēnei.

I te nuinga o te wā, ka tīmata te RCC hei puranga iti o ngā pūtau matepukupuku i roto i te whatukuhu kotahi. Ka kiia hoki tēnei he pukupuku . Heoi, i ētahi wā ka puta he puranga maha i roto i te whatukuhu kotahi, i roto rānei i ngā whatukuhu e rua.

He aha ngā momo matua o te RCC?

He rerekē ngā momo RCC. Whakaarohia he rite ki te whai tāngata rerekē i roto i te whānau kotahi. Ko tēnei whakarōpūtanga e hangai ana ki te āhua o ngā pūtau matepukupuku i raro i te karuārai, ō rātou DNA , ngā rauemi ira rānei. He torutoru ngā momo matua:

• Mārama te mate pukupuku whatukuhu pūtau (ccRCC): Tata ki te 85% o te RCC e pā ana ki tēnei momo. Nā te mea he mārama te āhua o ngā pūtau mate pukupuku i raro i te karuārai.
• Matepukupuku pūtau whatukuhu papillary: Kei waenganui i te 10% me te 15% o ngā matepukupuku pūtau whatukuhu katoa tēnei momo. I tapaina tēnei momo nā ngā pūwero rite ki te matihao ( papillae ) e kitea ana i runga i ēnei pukupuku.
• Matepukupuku pūtau whatukuhu chromophobe: Kei waenga i te 5% me te 10% te nui o tēnei momo. He mārama hoki te tae o ēnei pūtau, he rite ki ngā pūtau mārama, engari he paku nui ake.
• RCC Kāore i Whakarōpūtia: Tata ki te 6% o te RCC kāore e taea te whakarōpū ki tētahi momo nui. Heoi, kei te ngana tonu ngā kaipūtaiao ki te whakarōpū i tēnei rōpū kāore i whakarōpūtia i roto i ngā huarahi hou, i runga i ngā mea pēnei i ngā āhuatanga moroiti o ngā pūtau me ō rātou DNA .

Tērā pea kua rongo koe i ngā tākuta e whakamahi ana i ngā kupu "localized" "advanced" "metastatic" rānei ina kōrero ana mō te RCC. Ko te tikanga o te localized RCC kei roto noa i te whatukuhu te mate pukupuku, ā, kua horapa pea ki ngā kiko tata.Ko tōna tikanga kua horapa te mate pukupuku ki ētahi atu wāhanga o te tinana. Ko te momo mate kei a koe e whakatau ana i ō whiringa maimoatanga me te tūponotanga o te ora.

He pēhea te noa o te RCC?

E 400,000 ngā kēhi hou o te RCC e pūrongohia ana i ia tau puta noa i te ao. I te Hononga o Amerika, e 80,000 pea te maha. Ahakoa ka taea e te tangata katoa te pāngia e te RCC, he mea noa tēnei i waenga i ngā tāne i waenga i te 60 me te 80 tau te pakeke .

He aha ngā tohu o te mate pukupuku pūtau whatukuhu?

He tokomaha te hunga kāore e pāngia e ngā tohu i ngā wāhanga tōmua. Ka tīmata ngā tohu te puta mai ina tipu te mate pukupuku, ā, ka tīmata te pā ki ngā kiko, ki ngā whekau rānei e karapoti ana.

Ko ngā tohu o te RCC ko:

• Te toto i roto i te mimi (hematuria). Koinei te tohu tino kitea.
• Mamae o te hope: E pā ana tēnei ki te mamae e pā ana ki ia taha o te tinana, i runga ake i te hope me raro iho i ngā rara.
• Te ahua o te puku e pupuhi ana, te tuara o raro, te hope rānei.
• Te kirika e puta mai ana, kāore he take.
• Te werawera o te pō.
• Te whakahekenga taumaha kāore i te whakamāramatia.

Hei tāpiritanga, ka puta pea ngā tohu o te anemia , pērā i te poto o te manawa me te ngenge. Tērā pea ka puta anō hoki ngā tohu o tētahi āhuatanga e kiia nei ko ngā mate paraneoplastic . I tēnei wā, ka tukuna ngā matū pērā i ngā homoni mai i ngā pukupuku matepukupuku, ka puta ai ngā huringa maha i roto i te tinana.

He aha ngā take o te RCC?

Ka puta te RCC ina tīmata te tipu haere o ngā pūtau rerekē i roto i ngā ngongo whatukuhu me te kore e taea te whakahaere. Kāore anō kia mōhiotia te tino take. Heoi, kua tautuhia e ngā kaipūtaiao ētahi āhuatanga mōrearea e whakanui ake ana i te mōrearea o te whakawhanake i te RCC.

He aha ngā āhuatanga mōrearea?

Ka nui ake te mōrearea o te whakawhanake i te RCC mēnā kei a koe ēnei āhuatanga:

• Te kai hikareti: Ka nui ake tō kai hikareti, ka nui ake te mōrearea.
• Momona: Ka teitei ake tō taupū papatipu tinana (BMI), ka nui ake tō mōrearea.
• Te toto toto tiketike (hypertension).
• Te mate tākihi mau tonu: Kei roto i tēnei ko te hunga e whiwhi ana i te maimoatanga dialysis mō te wā roa.
• Te mate Hepatitis C mau tonu.
• Te whakamahinga roa o ētahi rongoā whakamamae mamae (hei tauira, ngā NSAID, acetaminophen).
• I mua i te whiwhinga i te rongoā irahiko ki te puku.
• Te pānga ki ngā matū carcinogens, pērā i te cadmium me te asbestos .
• Mate pūtau hāripiri: E pā ana tēnei ki tētahi momo RCC onge.
• Hītori whānau mō te mate pukupuku whatukuhu.
• Ngā whakarerekētanga ira: Ko ngā huringa ēnei o te DNA o ngā pūtau.
• Te matatini o te sclerosis ngongo.
• Te mate a Von Hippel-Lindau (VHL).

Mena kei a koe tētahi o ēnei āhuatanga mōrearea, ka tūtohu pea tō tākuta kia tirotirohia koe e tō whatukuhu i ia wā, hei āwhina i te kite i te mate pukupuku i te wā tōmua.

Me pēhea te tautuhi i te RCC?

Tata ki te 25% o te hunga whai RCC ka kitea kua pāngia rātou e te mate i muri i te horapa paku o te mate pukupuku, arā, i te wā ka tīmata te puta o ngā tohu.

Heoi, ko te rongo pai ko ngā whakamātautau whakaahua e mahia ana mō ētahi atu take kei te piki haere te kite i ngā pukupuku RCC i mua i te putanga mai o ngā tohu. Nā reira, he maha ake ngā tāngata e whiwhi maimoatanga ana mō te mate pukupuku i tōna wā tino taea te rongoā.

Ngā whakamātautau hei tautuhi i te RCC

Ka whakamahia e ngā tākuta ngā whakamātautau whakaahua hei tātaritanga i te mate pukupuku me te whakamahere maimoatanga. Ko ngā whakamātautau tino noa ko:

• Matawai Ultrasound: Kei roto i tēnei ko te tuku i ngā ngaru oro auau teitei mā roto i ngā kiko o te tinana, me te hanga whakaahua ka taea te tiro i runga i te mata tirotiro. Ka taea e te ultrasound te āwhina ki te whakatau mēnā kei te kī tonu te puku i te wai (he maha ngā wā he cyst ) he totoka rānei (he mea noa ake i roto i ngā puku matepukupuku).
• Matawai Tomography Rorohiko (CT): Ka hangaia he raupapa pikitia e homai ana he pikitia taipitopito o roto o te tinana. Me werowero pea koe i tētahi tae e kiia nei ko te contrast ki roto i tētahi uaua, ā, me matawai i mua atu, i muri mai hoki. Ka haere tēnei tae ki te matepukupuku, ā, ka kitea mārama.
• Matawai Whakaahua Aukume (MRI): Ka whakamahia he aukume nui, he ngaru reo irirangi, me te rorohiko hei hanga whakaahua taipitopito o roto o te tinana. Tērā pea ka tūtohu tō tākuta i tētahi MRI mēnā kāore e taea te whai i tētahi matawai CT (hei tauira, mēnā he mate pāwera koe ki te tae i whakahuatia i mua ake nei), mēnā rānei kāore i te tino mārama ngā hua o te ultrasound me te matawai CT.

Ahakoa he tikanga te mahi i te koiora hei tātaritanga i te mate pukupuku, he onge noa iho tēnei mahi i roto i te RCC. Ko te koiora he tango i tētahi tauira iti o te kiko mai i te puku, ka tirotirohia i raro i te karuārai hei tirotiro mēnā he pūtau mate pukupuku kei roto.

Engari he maha ngā wā he mōrearea te tango i te koiora o te RCC nā te mea ka kino pea te whatukuhu. Nō reira, he maha ngā wā ka whakamātauhia e ngā tākuta ngā pūtau matepukupuku i muri i te tango i te pukupuku katoa hei rongoā. Mena ka whakaatuhia e te whakaahua kua horapa te matepukupuku, ka taea e rātou te tango i ngā pūtau matepukupuku mai i tētahi atu wāhi ehara i te whatukuhu ka whakamātau i a rātou.

Mā te whakamātautau i ēnei pūtau anake te huarahi hei mōhio mārika ki te momo RCC kei a koe (mēnā kāore i te mārama mai i te whakaahua). Ka āwhina hoki ki te tautuhi ko ēhea maimoatanga e tino whai hua ana mō taua momo matepukupuku.

Te whakatau i te āhua o te mate pukupuku pūtau whatukuhu

Mā te mōhio ki te wāhanga o tō matepukupuku ka āwhina i tō tākuta kia mārama ki te horapa o tō matepukupuku. Ka mōhio hoki koe mēnā kua horapa te matepukupuku ki te rohe , kua horapa rānei. Mā ēnei mōhiohio ka āwhina koe ki te whakamahere i tō maimoatanga, ā, ka hoatu he whakaaro ki a koe mō te āhua o te matepukupuku.

Ka whakamahia e ngā tākuta tētahi pūnaha e kīia nei ko te TNM (pukupuku, kōpuku lymph, metastasis) hei whakatau i te wāhanga o te RCC. Ka whakarōpūhia e rātou te mate pukupuku ki ngā wāhanga I ki te IV. Ka whakarōpūhia ngā mate pukupuku wāhanga I, II, me te III hei mate pukupuku ā-rohe, ko te wāhanga IV ia he RCC metastatic.

• Wāhanga I RCC: He iti iho i te 7 henimita te rahi o te mate pukupuku, ā, kāore anō kia horapa ki waho o te whatukuhu.
• Wāhanga II RCC: He nui ake te mate pukupuku i te 7 henimita, engari kāore anō kia horapa ki waho o te whatukuhu.
• Wāhanga III RCC: Ka taea e te pukupuku te hanga i tētahi rahi, ā, kua horapa ki ngā kiko tata huri noa i te whatukuhu.
• Wāhanga IV RCC: Kua horapa te mate pukupuku ki tua atu i te whatukuhu ki ngā kōpū lymph me ētahi atu okana.

He mea nui: He mea nui te mōhio ki te wāhanga o te mate pukupuku hei whakatau i te maimoatanga, nō reira me kōrero marie ki tō tākuta.

Kei hea te tīmatanga o te horapa o te RCC?

Ka horapa te RCC metastatic ki ō pona lymph, ki ō pukahukahu, ki ō wheua, ki tō ate, me tō roro. I ētahi wā ka horapa ki ō ovaries, ki ō testicles rānei.

He aha ngā maimoatanga mō te mate pukupuku pūtau whatukuhu?

He maha ngā āhuatanga e whakawhirinaki ana ki te maimoatanga, tae atu ki te taumata o te mate pukupuku me tō hauora whānui. He rerekē te maimoatanga mō te RCC ā-rohe i te maimoatanga mō te RCC kua horapa .

Te maimoatanga o te mate pukupuku pūtau whatukuhu ā-rohe

Ko te maimoatanga mō tēnei he tango i te matepukupuku, he whakangaro rānei i te matepukupuku mā te whakamahi i ngā tikanga tango (te patu i ngā pūtau ki te wera nui, ki te makariri nui rānei).

Ko te pokanga te maimoatanga tino noa mō te RCC ā-rohe.

• Te tango i te whatukuhu me te mate pukupuku: Ko te tango i te whatukuhu me te mate pukupuku me ētahi o ngā kiko e karapoti ana (pērā i ngā kōpū lymph me ngā repe adrenal, kei reira pea ngā pūtau mate pukupuku). Mō te nuinga o te tangata, kotahi te whatukuhu hauora e ranea ana.
• Te tango hapa i te nephropathy:Ko te tikanga o tēnei ko te tango i te wāhanga anake o te whatukuhu kei roto te matepukupuku. Ka taea tēnei pokanga mēnā he iti tō matepukupuku. Ka taea e tēnei te whakaora i ētahi o ngā mahi a tō whatukuhu. He mea tino nui tēnei mēnā kāore i a koe ngā whatukuhu hauora e rua.

Mena ehara koe i te kaitono pai mō te pokanga, ka tūtohu pea tō tākuta i ngā tikanga tango i te wheua . Kei roto i ēnei:

• Whakaora-mate: Ka patua ngā pūtau matepukupuku mā te whakatio.
• Te tango i ngā pūtau matepukupuku mā te wera nui: Ka tahuna ngā pūtau matepukupuku mā te whakaatu i a rātou ki te wera nui.

Te maimoatanga o te mate pukupuku pūtau whatukuhu metastatic

Ko te maimoatanga mō te RCC kua horapa ko te whawhai ki ngā pūtau matepukupuku puta noa i te tinana. Ka taea te mahi pokanga hei tango i te pukupuku, engari kāore e ranea hei whakakore katoa i te matepukupuku kua horapa. Heoi, mā te tango i te pukupuku ka āwhina i te whakaiti i ngā tohu me te whakaroa i te tīmatanga o ētahi atu maimoatanga.

Ko ngā maimoatanga tino noa ko te immunotherapy me te therapy arotahi . I runga i ngā āhuatanga rerekē, ka hoatu takitahitia ēnei rongoā, ka hoatu ngātahitia rānei.

Ngā maimoatanga ārai mate

Ko te mahi a te immunotherapy mā te whakapakari i tō pūnaha ārai mate, mā te āwhina i a ia ki te kimi me te whawhai ki ngā pūtau matepukupuku. Ko ētahi o ēnei rongoā ko:

• Avelumab (Avelumab - Bavencio®)
• Ipilimumab (Ipilimumab - Yervoy®)
• Nivolumab (Nivolumab - Opdivo®)
• Pembrolizumab (Pembrolizumab - Keytruda®)

Ngā maimoatanga rongoā kua arotahihia

Ko te mahi a ngā rongoā arotahi mā te whakararuraru i te tukanga whakatipu pūtau matepukupuku. Ka whakawhāitihia e tēnei maimoatanga te rere o te toto ki ngā pūtau matepukupuku, ka whakaroa i tō rātou tipu. Ko ētahi o ēnei rongoā ko:

• Axitinib (Axitinib - Inlyta®)
• Bevacizumab (Bevacizumab - Avastin®)
• Cabozantinib (Cabozantinib - Cabometyx®)
• Everolimus (Everolimus - Afinitor®)
• Lenvatinib (Lenvatinib - Lenvima®)
• Pazopanib (Pazopanib - Votrient®)
• Sorafenib (Sorafenib - Nexavar®)
• Sunitinib (Sunitinib - Sutent®)
• Temsirolimus (Temsirolimus - Torisel®)
• Tivozanib (Tivozanib - Fotivda®)

I runga i te wāhanga o te mate pukupuku, te wāhi kua horapa, tōna kaha, me tō urupare ki ētahi atu maimoatanga, ka tūtohu pea tō tākuta i ētahi atu maimoatanga mate pukupuku, pērā i te rongoā irahiko .

Ka taea te whakaora katoa i te RCC?

Kei runga i tō mate tākutatanga. RCC ā-roheKo te hunga he RCC ā-rohe mōrearea nui, ā, ka tangohia te mate pukupuku mā te pokanga, he pai te hua mō te wā roa. Tērā pea ka hoatu he rongoā ārai mate ki te hunga he RCC ā-rohe mōrearea nui i muri i te tangohanga o te mate pukupuku hei whakapai ake i ngā hua mō te wā roa.

Kāore anō kia kitea he rongoā mō te RCC kua horapa ki tua atu i te whatukuhu i tēnei wā. Heoi, i te mea kua kitea e ngā kaipūtaiao he maimoatanga pai ake e aro ana ki ngā pūtau matepukupuku motuhake, kua roa ake te ora o te hunga whai RCC kua horapa.

He aha ngā tirohanga mō ngā RCC?

Kua pai ake te āheinga o ngā tākuta ki te kite i te RCC i ōna wāhanga tōmua, i te wā e taea ai te rongoā i te mate pukupuku. Nā te kitenga wawe me te whakapai ake i ngā maimoatanga kua pai ake te ora. E 90% o te hunga whai RCC wāhanga tuatahi ka ora mō ngā tau e rima. Waihoki, ahakoa i mua ko te roanga o te oranga mō te hunga whai RCC wāhanga tuawhā he marama noa iho, he tokomaha inaianei e ora ana mō ngā tau maha.

Ka taea te ārai i te RCC?

Kāore e taea te ārai i te RCC i ngā wā katoa. Engari ka taea e koe te whakaiti i tō mōrearea. Hei tauira, ko te kore e momi hikareti (te kore rānei e mutu te momi hikareti mēnā ka pēhia e koe) tētahi o ngā mea pai rawa atu ka taea e koe te mahi hei whakaiti i tō mōrearea ki te mate pukupuku. He mea nui anō hoki kia mau tonu te taumaha hauora, kia kai i te kai taurite, kia whakahaere hoki i te toto toto tiketike.

Me pēhea taku tiaki i ahau anō?

Kōrero ki tō tākuta mō tētahi mahere tiaki hei āwhina i a koe ki te whakahaere i ngā tohu o tō mate pukupuku me ngā pānga taha o tō maimoatanga. Hei tauira, me tīmata pea ētahi tāngata ki te dialysis i muri i te pokanga mēnā kāore tetahi, e rua rānei o ngā whatukuhu e mahi tika ana. He mea nui kia mōhio koe ki te pānga o ēnei maimoatanga ki a koe.

Tērā pea ka hiahia āwhina koe ki te whakahaere i ngā pānga taha o te rongoā arotahi , te rongoā ārai mate rānei. Pātai atu ki tō tākuta he aha ngā mea hei tumanakohia i mua i te tīmatanga o te maimoatanga.

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

• He aha te momo RCC kei a au?
• Kia pēhea te horapa o taku mate pukupuku (he aha te wāhanga)?
• He aha ngā painga me ngā ngoikoretanga o ngā maimoatanga e wātea ana?
• He aha ngā pānga taha, ngā raruraru rānei me mōhio ahau i mua i te tīmatanga o te maimoatanga?
• Kia pēhea te auau o taku haerenga mai ki te tākuta mō ngā tirotiro hauora i muri i te maimoatanga?
• He aha ngā huringa e tika ana kia tumanakohia e au i roto i tōku āhua noho i te wā e rongoatia ana?
• He aha te matapae mō tōku āhua?

Ka whakawhirinaki tō wheako maimoatanga mate pukupuku whatukuhu (RCC) ki ngā āhuatanga maha, tae atu ki tō hauora whānui, te momo me te taumata o te RCC, me tō urupare ki te maimoatanga. Engari ko te hunga kua kitea he mate pukupuku whatukuhu ka whai hua mai i te hanga hononga tata ki tā rātou tīma hauora. Kaua e mangere ki te pātai mō tō tautuhi mate, ngā painga me ngā huakore o ngā kōwhiringa maimoatanga, me ngā putanga e tumanakohia ana. Ko tō tākuta te tangata pai rawa atu hei whakamārama i te tikanga ki a koe o te whai RCC.

Hei whakamutunga, ngā mea hei maumahara

Ahakoa he mate kino te mate pukupuku whatukuhu (RCC), kua tino pai ake te tere o te whakaora i te kitenga wawe me te maimoatanga tika. Mena kei a koe ētahi tohu, inā koa he toto i roto i tō mimi, he mamae i tō hope, he puku i tō ringa, he hītori whānau rānei o te mate pukupuku whatukuhu, rapua tonutia he tohutohu hauora. Ka taea e koe te whakaiti i tō tupono ki te pangia e tēnei mate mā te karo i te momi hikareti me te whai i tētahi momo noho hauora. Kaua e wehi ki te kōrero ki tō tākuta mena he āwangawanga āu. Kāore koe i te mokemoke.

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