He mea noa te mataku me te ohorere ina kitea he mate pukupuku koroni tōu. Engari he mea nui kia mōhio koe i ngā wā pēnei. He āwhina nui te mārama ki ngā maimoatanga ka whiwhi koe me ngā mea hei tumanako atu. Ko te maimoatanga mō te mate pukupuku koroni e whakawhirinaki ana ki tōna "wāhanga". Ki te kī noa, ko te mahere maimoatanga ka whakatauhia e te horapa o te mate pukupuku.
Wāhanga 0: Te tīmatanga tonu o te mate pukupuku
Ko te tikanga o tēnei kei roto tonu te mate pukupuku i ōna wāhanga tino tīmatanga. Ko te tikanga kei roto noa iho ngā pūtau mate pukupuku i te arai angiangi o tō koroni, o tō tōku rānei. Nō reira, he maha ngā wā ka taea te whakaora katoa i tēnei wāhanga mā te pokanga.
Ko te momo pokanga ka mahia ki a koe ka whakawhirinaki ki te rahi o te pukupuku.
- Mō ngā pukupuku iti: Tērā pea ka tangohia e te tākuta te pukupuku matepukupuku me tētahi wahi kiko iti noa iho i tōna taha. Ka kiia hoki tēnei ko te "Polypectomy." Ka taea te mahi i tēnei i te wā o te colonoscopy, he tikanga e whakamahi ana i te kāmera hei tirotiro i roto i te koroni.
- Mō ngā pukupuku nui: Mena he tino nui te pukupuku, me tapahi pea e te tākuta te wāhanga matepukupuku o te koroni, ka hono anō i ngā wāhanga hauora e rua. Ka kiia tēnei he anastomosis. Whai muri i tēnei, ka mahi anō ō whekau i te āhua noa.
I ētahi wā ka whakaarohia pea e te tākuta te rongoā irahiko.
Wāhanga I: Taumata e taea tonu ana te whakahaere
I tēnei wā, kua horapa te mate pukupuku ki tua atu i te arai o te koroni, ki roto i te paparanga tuarua me te tuatoru. Engari ko te mea nui, kāore anō te mate pukupuku kia horapa ki tua atu i te pakitara uaua o te koroni, ki waho rānei o te koroni.
I tēnei wā, ko te maimoatanga matua ko te pokanga tonu hei tango i te mate pukupuku me te iti o ngā kiko e karapoti ana. I te nuinga o te wā, kāore e hiahiatia he maimoatanga tāpiri (pēnei i te chemotherapy).
Heoi, ki te mea kua koroheke rawa te tūroro, he mate kino rānei tōna, ka whakatau pea te tākuta ki te whakarato noa i te rongoā irahiko hei utu mō te pokanga.
Wāhanga II: Ka horapa mā roto i te pakitara o te puku
I te wāhanga tuarua, kua nui ake ngā pūtau matepukupuku, ā, kua tipu mā roto i te pakitara uaua o te koroni. Tērā pea kua horapa ki ngā whekau tata pērā i te pūkahukahu, te kōpū (i roto i ngā wāhine), te repeure rānei (i roto i ngā tāne).
Engari ko te rongo pai hoki i konei , kāore anō te mate pukupuku kia horapa ki ngā pona lymph, ki ngā whekau tawhiti rānei o te tinana.
I tenei wa, ko te maimoatanga ko:
- Ka tangohia te mate pukupuku me te kiko e karapoti ana i horapa ai ki reira mā te pokanga.
- Ka taea te hoatu i te rongoā irahiko me te rongoā matū i mua atu, i muri rānei i te pokanga. Ka hoatu ēnei maimoatanga i mua i te pokanga hei whakaiti i te pukupuku, hei ngāwari ake hoki te tango. Ka hoatu i muri i te pokanga hei whakangaro i ngā pūtau matepukupuku e toe ana, hei ārai hoki i te hokinga mai o te mate.
Wāhanga III: Ka horapa ki ngā repe hinu
Ko te wāhanga 3 ko te wā kua horapa te mate pukupuku ki tētahi, ki ētahi atu rānei o ngā kōpū waikura. He hanganga iti ngā kōpū waikura e hanga ana i ngā pūtau hei whawhai i te mate i roto i tō tātou tinana, ā, he rite ki ngā tātari.
E toru ngā wāhanga o tēnei wāhanga: A, B, me C. He māmā noa iho:
- Wāhanga IIIA: Kei roto i te pakitara o te koroni te mate pukupuku, ā, kua horapa ki ngā kōpū lymph.
- Wāhanga IIIB: Kua tipu te mate pukupuku mā roto i te pakitara o te koroni, ā, kua horapa ki te 1-4 o ngā kōpū waikura.
- Wāhanga IIIC: Kua horapa te mate pukupuku ki neke atu i te 4 ngā kōpū lymph, ā, kua horapa pea ki ngā whekau tata.
Ko te mahere maimoatanga i tēnei wā ka rite ki tēnei:
- Pokanga: Ki te taea, ka tangohia te pukupuku matepukupuku me ngā kōpū lymph katoa e pā ana.
- Te rongoā matū: Ka tukuna te rongoā matū i muri i te pokanga.
- Whakaora irahiko: Mena he nui te mate pukupuku, ā, kua horapa ki ngā kiko e karapoti ana, ka taea hoki te hoatu i te rongoā irahiko.
Wāhanga IV: Matepukupuku Metastatic
Ko te wāhanga 4 ko te horapa o te mate pukupuku ki ngā whekau tawhiti o te tinana, inā koa te ate, ngā pukahukahu rānei . Ka karangahia hoki tēnei wāhanga e ngā tākuta he mate pukupuku "metastatic". I tēnei wā, ko te whāinga matua o te maimoatanga he whakahaere i te mate, he whakaiti i ngā tohu, he whakaroa i te oranga o te tūroro i ngā wā katoa e taea ana, me te pupuri i te kounga teitei o te oranga.
Me titiro tātou ki ngā tikanga maimoatanga matua e whakamahia ana i tēnei wā i te ripanga i raro nei.
| Tikanga maimoatanga | Whakaahuatanga me ngā tauira |
|---|---|
| Te rongoā matū | Koinei te maimoatanga matua i tēnei wā. Ko ngā rongoā e whakamahia whānuitia ana ko te `5-fluorouracil`, `Capecitabine (Xeloda)`, `Irinotecan (Camptosar)`, `Oxaliplatin (Eloxatin)`, me te `trifluridine me te tipiracil (Lonsurf)`. Mena kua horapa te mate pukupuku ki te ate, ka taea te hoatu tika i te chemotherapy ki te ate. |
| Te Whakaora Whaiaro | He rongoā ēnei e aro ana ki ngā ngota motuhake e āwhina ana i ngā pūtau matepukupuku kia tipu me te horapa, me te whakaiti i te kino ki ngā pūtau noa. Kei roto i ēnei ko ngā rongoā pēnei i te `Bevacizumab (Avastin), `Cetuximab (Erbitux),` me te `Panitumumab (Vectibix).` Ka kiia hoki ēnei he `(Monoclonal antibodies)`. |
| Pokanga | Ko te whāinga o te pokanga he whakahaere i ngā tohu. Hei tauira, ka mahia te pokanga hei whakaora i te aukati o te puku, hei whakamutu rānei i te toto kāore e taea te whakahaere. I ētahi wā, ka taea te tango i tētahi, i ētahi rānei pukupuku matepukupuku i roto i te ate. Ko ētahi atu tikanga ko te whakatio i ngā pukupuku (cryosurgery) te whakamahi rānei i te wera (radiofrequency ablation). |
| Te rongoā irahiko | Ka whakamahia te rongoā irahiko hei whakamamae i ngā tohu pēnei i te mamae. |
A, ki te hoki mai te matepukupuku? (Te Matepukupuku Whakahoki)
I ētahi wā, ka hoki mai anō te mate pukupuku i muri i te maimoatanga. Ka kiia tēnei e ngā tākuta he "mate pukupuku anō". Ka noho pea tēnei i te wāhi kotahi i mua i te mate pukupuku, i tētahi atu wāhanga rānei o te tinana. He paku teitei ake tēnei mōrearea i roto i te hunga kua pāngia e te mate pukupuku i te wāhanga kua roa (hei tauira, te Wāhanga III).
Te maimoatanga mēnā ka hoki mai te mate pukupuku:
- Pokanga: Kua whakaatuhia e ngā rangahau mēnā ka taea te tango katoa i te mate pukupuku kua hoki mai anō mā te pokanga, ka taea e ia te āwhina i te roa ake o te ora o te tūroro.
- Te rongoā matū me te rongoā irahiko: Ka whakamahia ēnei maimoatanga mēnā kāore e taea e te pokanga te tango katoa i te mate pukupuku. I ētahi wā ka taea e ēnei maimoatanga te whakaiti i te pukupuku kia taea ai te tango mā te pokanga i muri mai.
- Ngā Whakamātautau Hauora:He rangahau ēnei mō ngā rongoā hou, ngā maimoatanga rānei. I ētahi wā, ka whai wāhi pea koe ki te whakamātau i tētahi maimoatanga hou kāore i te whakamahia whānuitia i tēnei wā. Kōrero ki tō tākuta mō tēnei.
Karere Tangohia ki te Kāinga
- Ko te mahere maimoatanga mō te matepukupuku koroni e whakawhirinaki ana ki te wāhanga o te mate.
- I ngā wā tōmua (Wāhanga 0, I), ko te pokanga te maimoatanga matua.
- I ngā āhuatanga kua horapa te mate pukupuku (Wāhanga II, III, IV), ka whakamahia ngātahitia tētahi, ētahi rānei tikanga pēnei i te pokanga, te chemotherapy, te radiation therapy, me te therapy arotahi.
- Mā te tīma hauora, e arahina ana e te tākuta e tirotiro ana i tō āhua, e whakatau te mahere maimoatanga tino tika māu, mā tō whanaunga rānei.
- Nō reira, kia tino tuwhera, kia pono hoki ki a rātou mō ngā pātai, ngā feaa, ngā wehi rānei kei a koe. Mā te mōhiotanga tika me te maimoatanga tika, ka taea e koe te whawhai angitu ki tēnei mate.
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