Kia ako tātou i ētahi atu kōrero mō te mate pukupuku o te vulvar. Kaua e mataku, me kōrero tātou!

Kua rongo kē koe i tētahi mea e kīia ana ko te "Vulvar Cancer"? Tērā pea ka mataku koe ina rongo koe i tēnei ingoa. Kaua e manukanuka. He momo mate pukupuku tino onge tēnei. Heoi, he mea nui kia mōhio koe ki tēnei. Nā te mea, ki te kitea wawetia, ka māmā ake te rongoā. Me kōrero tātou mō tēnei i tēnei rā, me te tino māmā hoki.

He aha te Matepukupuku Vulvar?

He whakarāpopototanga noa iho, ko te Matepukupuku Vulvar he matepukupuku e tupu ana i roto i ngā kiko o tō vulva. Ko "Vulva" te ingoa whānui mō ngā ira tangata o waho katoa o te wahine. Kei te mahara koe, i a tātou e tamariki ana, i paku whakama tātou ki te kōrero mō ēnei okana, engari he mea tino nui kia mōhio tātou ki ngā wāhanga katoa o tō tātou tinana.

Whakaarohia, kei roto i tō ure ēnei wāhanga:

• Te pūaha o te tara: Ko te ngongo uaua e whakamahia ana mō te moepuku, te whānautanga, me te paheketanga (paheketanga).
• Labia Minora: Ko ngā kopa kiko e karapoti ana i te pūaha o te tenetene, e toro atu ana ki runga ake i te clitoris.
• Labia Majora: Ko te wāhi kikokiko e karapoti ana i ngā ngutu o roto.
• Te Clitoris: Ko te puku iti, e pāngia ana e te moepuku, kei runga ake i te pūaha o te tenetene.
• Mons Pubis: Ko te wāhi porowhita kei mua i ngā wheua hope ka huruhuru i te wā e pakeke haere ana.
• Te Putanga o te Urethra: Ko te putanga o te ngongo e puta ai te mimi i te tinana.
• Perineum: Ko te wāhi kiri i waenganui i te tenetene me te nono.

Ko tēnei momo mate pukupuku vulvar ka puhoi te whanaketanga, mō ngā tau maha. Ka tīmata hei kiko precancerous (ngā whara). Ko te tikanga ka kite tuatahi ngā tākuta i ēnei tipu rerekē i te paparanga o waho o te kiri. Ko ēnei whara precancerous e kiia ana ko te "vulvar intraepithelial neoplasia" (VIN) .

He aha ngā momo mate pukupuku vulvar?

Ka whakarōpūhia e ngā tākuta te mate pukupuku tara i runga i te momo pūtau e tīmata ai te mate pukupuku. Ko ngā momo tino noa ko:

• Te Matepukupuku Pūtau Kōpiko Vulvar: E 90% o ngā matepukupuku vulvar ka puta mai i tēnei momo. Ka puta i roto i ngā pūtau kei te mata o te kiri.
• Te Melanoma Vulvar: E 5% pea o ngā matepukupuku vulvar e pā ana ki tēnei momo melanoma. Ka tere te tipu, ā, he nui te tūponotanga ka horapa ki ētahi atu wāhanga o te tinana.

He tino onge ake ngā momo mate pukupuku vulvar e toe ana. Kei roto i ēnei:

• Matepukupuku Pūtau Tuturu
• Te Adenocarcinoma o te Repe Bartholin
• Te Mate Paget o te Vulva
• Sarcoma
• Matepukupuku Verrucous

He pēhea te noa o te mate pukupuku o te vulvar?

Ina hoki, he tino onge te mate pukupuku o te vulvar. Hei tauira, i te Hononga o Amerika, he iti iho i te 6,500 ngā kēhi hou o te mate pukupuku vulvar e kitea ana i ia tau.

He mea nui, e 80% o te hunga kua tāpaetia ki te mate he neke atu i te 50 tau te pakeke. Waihoki, neke atu i te haurua o ngā tāpaetanga ka puta i te hunga neke atu i te 70 tau te pakeke. Ko te tau toharite mō te tāpaetanga he tata ki te 68 tau te pakeke.

Arā, te āhua nei ka piki ake tēnei mōrearea i te kaumātuatanga, tika?

He aha ngā tohu o te mate pukupuku vulvar?

Nā, me titiro tātou ki ngā tohu o tēnei mate. Ko ngā tohu tuatahi ka kitea i te nuinga o te wā ko ngā panonitanga kiri i runga i tō labia majora o waho, i tō labia minora o roto rānei. Heoi, ka puta te mate pukupuku i ngā wāhi katoa o te vulva.

Ko ngā tohu o te mate pukupuku tara ko:

• Te rerekētanga o te kiri: Ka pouri ake, ka mārama ake rānei ētahi wāhi i te tikanga, ka puta ake rānei he wāhi mā.
• Te mātotoru, te taratara rānei o te kiri: Tērā pea ka matotoru, ka taratara ētahi wāhi ina pāngia.
• Ngā puku, ngā tupu rānei: Tērā pea ka puta he puku, he kiritona, he mariao kāore e ora, he whēkau rānei.
• Te mākūkū, te wera rānei: Tērā pea ka rongo koe i te mākūkū, i te wera rānei e mau tonu ana, kāore e heke.
• Te toto kāore e pā ana ki tō paheketanga: Mena he toto tara tōu kāore e pā ana ki tō paheketanga, me whai whakaaro anō hoki ki tēnā.
• Mamae me te ngaungau ina pā: Tērā pea ka mamae koe i te wā e moe tāne ana, e mimi ana rānei.

Mena kei a koe tētahi, ētahi rānei o ēnei tohu, me toro atu ki te tākuta. Tērā pea kāore e kitea ngā tohu o te matepukupuku tara i ngā wāhanga tōmua. Nō reira, he pai ake kia whakamātauria wawe tonu.

Heoi, he maha ngā wā ka kitea ēnei tohu i roto i ētahi atu āhuatanga ehara i te matepukupuku. Nō reira, he mea nui kia kaua e mataku, engari me toro atu ki te tākuta kia mōhio ai mēnā he tohu matepukupuku ēnei huringa, he tohu rānei nō tētahi atu mea.

He aha ngā pūtake o te mate pukupuku vulvar?

I roto i te mate pukupuku tara, ka tīmata te whakanui haere i ngā pūtau me te kore e taea te whakahaere. Ki te kore e rongoatia, ka horapa ēnei pūtau mate pukupuku ki ētahi atu wāhanga o te tinana.

Ko te Vulvar Squamous Cell Carcinoma, te momo tino noa, e puta mai ana i ngā āhuatanga matua e rua:

• Te mate pāwera Human Papillomavirus (HPV): He mate pāwera noa tēnei e horapa ana mā te pā o te kiri ki te kiri. Ka whakanui ake ētahi momo HPV i te mōrearea o ētahi momo mate pukupuku, tae atu ki te mate pukupuku o te kaki, te mate pukupuku o te ihu, me te mate pukupuku o te vulvar.
• Te Rimuriki Sclerosus: He mate kiri mau tonu tēnei (mo te wa katoa). Ka taea e te Rimuriki Sclerosus te whakaputa i ngā tohu pēnei i te mumura o te vulva, te hurihanga o te kiri, me te mākūkū.

He aha ngā āhuatanga mōrearea?

He maha ngā āhuatanga e whakanui ake ai i te mōrearea o te mate pukupuku vulvar:

• Tau: Ka piki ake te mōrearea o te mate pukupuku vulvar i te pakeketanga.
• Te pānga ki te HPV: Ehara i te mea ko ngā momo HPV katoa ka puta ai te mate pukupuku, engari ko ētahi momo ka puta ai ngā huringa pūtau ka arahi atu ai ki te mate pukupuku vulvar.
• Ngā mate kiri o te vulva: Ko ngā whanaketanga e pā ana ki ngā āhuatanga pēnei i te 'Lichen Sclerosus' ka taea te whanake hei mate pukupuku o te vulva.
• Te neoplasia intraepithelial Vulvar (VIN): He mate pukupuku mua te VIN, ki te kore e rongoatia, ka taea te whanake hei mate pukupuku vulvar.
• Mate urutā HIV: Ina ngoikore te pūnaha ārai mate i tētahi mate pēnei i te HIV, ka uaua ki te tinana te whawhai ki te mate pukupuku.
• Momi hikareti: Ka piki ake te mōrearea o te maha o ngā momo mate pukupuku e te momi hikareti, tae atu ki te mate pukupuku o te vulvar.

Me pēhea te tātaritanga o te mate pukupuku Vulvar?

Ina kite koe i tētahi tākuta, ka pātai ia mō tō hītori hauora, ngā āhuatanga mōrearea, me ngā tohumate. He maha ngā whakamātautau ka mahia hei whakatau i te mate.

Ngā whakamātautau hei kite i te mate pukupuku tara

Kei roto pea i ēnei whakamātautau:

• Whakamātautau Pelvic: Ka tirohia e te tākuta tō tenetene, ka rapu i ngā huringa kiri rerekē. Ka whakaurua e ia tētahi, e rua rānei ngā maihao kua pania ki te karapu, kua pania ki te hinu, ka tirohia ā-ringa mō ngā puku, ngā tohu rānei o te mate pukupuku. Ka taea hoki te tirotiro i te nono i taua ara anō. Ka whakamahia pea e ia he taputapu e kiia nei ko te speculum hei whakawhānui i te tenetene, hei rapu hoki i ngā āhuatanga rerekē.
• Pap Smear: I te wā o te whakamātautau pelvis, ka tangohia pea e tō tākuta he tauira o ngā pūtau ka tirohia mēnā he huringa matepukupuku. Ka whakamatautauria pea te tauira mō te HPV hei tirotiro mēnā he mate HPV tōu.
• Colposcopy: Ka taea e te tākuta te whakamahi i tētahi taputapu whakanui rama e kiia nei ko te "colposcope" hei tirotiro i tō vulva, te tara, me te cervix (te okana i waenganui i te tara me te kōpū) kia tino taipitopito ake. Tērā pea ka pania e ia tētahi otinga motuhake hei whakamārama i ngā pūtau rerekē, kia māmā ake ai te kite.
• Kohikohi: Ka tangohia pea e te tākuta he tauira o te kiko rerekē ka whakamātautau mō ngā pūtau matepukupuku. Ko te kohikohi anake te huarahi hei mōhio māu mēnā he matepukupuku tara tōu.

Ngā whakamātautau hei tirotiro mēnā kua horapa te mate pukupuku

Mena he mate pukupuku tōu, ka whakahaerehia e tō tākuta ētahi atu whakamātautau hei tirotiro mēnā kua horapa ki tua atu i te ure. Ki te kore e rongoatia, ka horapa te mate pukupuku ure ki te tenetene, ki ētahi atu okana tata rānei, ki ngā kōpū lymph i roto i te pelvis, ā, i te mutunga ki te toto. He tino uaua te rongoā i te mate pukupuku metastatic.

Kei roto i ēnei whakamātautau:

• Ngā Whakamātautau Whānui: Tērā pea ka whai cystoscopy koe hei tirotiro mēnā kua horapa te mate pukupuku ki te urethra, ki te pūkahukahu rānei. Mā te proctoscopy ka rapua ngā pūtau mate pukupuku i roto i te rectum, i te nono rānei.
• Ngā whakamātautau whakaahua: Ka taea e ngā hihi-X, ngā karapa CT, ngā MRI, me ngā karapa PET te whakaatu mēnā kua horapa te matepukupuku mai i te ure ki ētahi atu kiko.
• Kohikohi Pūnaha Tiaki: Ka tangohia pea e tō tākuta tētahi pūnaha lymph (pūnaha sentinel) e tata ana ki tō puku matepukupuku hei tirotiro mō ngā pūtau matepukupuku. I roto i te matepukupuku vulvar, ka horapa te matepukupuku ki ngā pūnaha lymph kaitiaki i te rohe o te hope.

He aha ngā wāhanga o te mate pukupuku vulvar?

Mā te whakatau i te taumata o te mate pukupuku tara ka taea e ngā tākuta te whakatau mēnā kua horapa tō mate pukupuku ki tua atu i te tara. Mā ēnei mōhiohio ka taea te ārahi i ngā whakatau maimoatanga. E whā ngā taumata matua:

• Wāhanga I: Ko te mate pukupuku vulvar i te wāhanga tuatahi ka noho ki te vulva, ki te perineum rānei (te rohe i waenganui i te nono me te tara). Ka wehea kia IA, kia IB rānei, i runga i te rahi o te pukupuku me te tawhiti kua horapa ki ngā kiko tata.
• Wāhanga II: Kua horapa te pukupuku (ahakoa te rahi) ki te urethra o raro, te tara o raro, te nono rānei.
• Wāhanga III: Kua horapa te mate pukupuku ki tētahi, ki ētahi atu rānei o ngā kōpū waikura tata. Ka wehea tēnei ki IIIA, IIIB, me IIIC, i runga i te maha me te rahi o ngā kōpū waikura e pā ana.
• Wāhanga IV: Kua horapa te mate pukupuku ki te pito o runga o te urethra, te tara, ētahi atu wāhanga rānei o te tinana. Kua wehea tēnei ki te IVA me te IVB, i runga i te horapa tata, tawhiti rānei i te tara.

He mea tino nui kia pātai atu koe ki tō tākuta mō te pānga o te taumata o tō matepukupuku ki tō maimoatanga.

Me pēhea te rongoā i te Matepukupuku Vulvar?

Ko te maimoatanga ka whiwhi koe ka whakawhirinaki ki ngā āhuatanga pēnei i tō hauora whānui, te taumata o te mate pukupuku, me te mea i kitea tata nei te mate pukupuku, kua hoki mai rānei. Mā tō tākuta koe e whakamārama te mahere maimoatanga pai rawa atu mō tō tātaritanga.

Pokanga

Ko te pokanga te maimoatanga tino noa mō te matepukupuku tara.Ko te whāinga kia tangohia katoatia te mate pukupuku, me te pupuri tonu i tō mahi moepuku. He maha ngā momo pokanga:

• Pokanga Taiaho: Ko te whakamahi i te hihi taiaho hei tapahi i te kiko me te kore toto, hei tango rānei i ngā whara matepukupuku o waho.
• Te Tango Ā-Rohe: Ka tangohia te mate pukupuku me te iti, te nui rānei o ngā kiko noa e karapoti ana i tēnei pokanga. I ētahi wā, ka tangohia ngā kōpū waikura tata hei tirotiro mō ngā pūtau mate pukupuku, mēnā rānei he tohu o te mate pukupuku, ka tangohia aua kōpū waikura.
• Vulvectomy: Ka tangohia e tēnei tikanga tētahi wāhanga, te katoa rānei o tō vulva, me ngā kōpū lymph tata pea. Ka taea hoki te whakamahi i ngā hononga kiri hei whakakapi i te kiri kua tangohia.
• Te Whakaputa i te Pelvic: Ka tangohia e tēnei pokanga tō koroni o raro, te rectum, te pūkahukahu, te cervix, te tenetene, ngā ovaries, me ngā kōpū lymph e tata ana. Ka tapahia e te tākuta kia rere ai te mimi me te paru ki roto i tētahi putea hei kohi i aua mea mai i tō tinana.

Te Whakaora Irahiko

Ka whakamahia e te rongoā irahiko ngā hihi-X, ētahi atu hihi kaha-teitei rānei, hei whakangaro i ngā pūtau matepukupuku. Ko te rongoā tino noa mō te matepukupuku tara ko te rongoā irahiko hihi-waho (EBRT). Ka whakamahia e te EBRT he mīhini hei tuku i te irahiko mā roto i tō kiri ki te wāhi matepukupuku e pā ana.

He maha ngā wā ka tukuna ngātahitia te rongoā irahiko me te rongoā matū ki ngā tūroro (e kiia ana tēnei ko te chemoradiation). Tērā pea ka whiwhi koe i te rongoā irahiko i mua i te pokanga hei whakaiti i te pukupuku, i muri rānei i te pokanga hei patu i ngā pūtau matepukupuku e toe ana.

Te rongoā matū

Ka whakamahia e te chemotherapy ngā rongoā hei whakaeke i ngā pūtau matepukupuku puta noa i te tinana. Tērā pea ka werohia te rongoā e tō tākuta ki roto i te uaua, i te uaua rānei, ka hoatu rānei he pire hei inu māu. Tērā pea ka hoatu hoki he kirīmi ka taea e koe te pani tika ki tō tara. Ka whakaekea e tēnei momo chemotherapy te matepukupuku i te rohe – arā, i te wāhi e pā ana ki tēnei matepukupuku.

Ko te Cisplatin (Cisplatin - Platinol®, Platinol-AQ®) me te fluorouracil (Fluorouracil - Carac®) ngā rongoā chemotherapy e tino tohua ana mō te mate pukupuku vulvar.

Te rongoā ārai mate

Ko te mahi a te immunotherapy mā te āwhina i te pūnaha ārai mate o tō tinana kia kite i ngā pūtau matepukupuku me te whawhai pai ake ki a rātou. Ko te Imiquimod Cream (Aldara®, Zyclara®) he rongoā immunotherapy noa e whakamahia ana hei rongoā i te matepukupuku vulvar.

He aha te momo tirotiro ā muri ake me tumanako ahau i muri i te maimoatanga mate pukupuku vulvar?

I muri i te maimoatanga, ka whakahaerehia pea e tō tākuta he whakamātautau i ngā wā rerekē hei aroturuki i tō āhua me te whakarite kāore anō te matepukupuku kia hoki mai anō.

He maha ngā wā ka whakaurua ki ēnei whakamātautau ngā whakamātautau kotahi e whakamahia ana hei tautuhi me te whakatau i te mate pukupuku tara.

He kino te mate pukupuku tara?

Ae, ka taea. He morearea te mate o te mate pukupuku vulvar kāore i rongoatia. He uaua ake te rongoā i te mate pukupuku kua horapa ki ngā kōpū lymph, ki ētahi atu wāhanga rānei o te tinana, i te rongoā i te mate pukupuku kua kitea wawetia.

Ahakoa he tūponotanga tonu ka hoki mai te mate pukupuku i muri i te maimoatanga, he tokomaha te hunga e whiwhi maimoatanga ana i ngā wāhanga tōmua o te mate ka ora kore mate pukupuku.

He aha te ōrau ora mō te mate pukupuku tara?

Ko te ōrau oranga mō te hunga e pāngia ana e te matepukupuku tara i roto i ngā tau e rima he tata ki te 70%. Heoi, he teitei ake ngā ōrau oranga ina kitea te mate, ā, ka rongoatia i ngā wāhanga tōmua. Hei tauira, ko te ōrau oranga mō te matepukupuku ā-rohe (i roto i te tara tonu) he tata ki te 86%. Ina horapa te matepukupuku, ka heke tēnei ōrau ki te tata ki te 30%.

Heoi, ko tō matapae ka whakawhirinaki ki ngā āhuatanga motuhake e pā ana ki tō tātaritanga, pērā i tō āhua hauora me tō urupare ki te maimoatanga. Pātai atu ki tō tākuta mō ngā putanga pea i runga i tō tātaritanga.

Kia pēhea te tere o te horapa o te mate pukupuku tara?

He puhoi te tipu o te nuinga o ngā momo mate pukupuku vulvar, i roto i ngā tau maha. Ko ngā momo kāore i te tino kitea, pērā i te melanoma, ka tere te tipu me te horapa.

Ka taea te ārai i te mate pukupuku o te vulvar?

Ko te huarahi pai hei whakaiti i tō tupono ko te whiwhi i te kano ārai mate HPV hei ārai i te mate HPV. I te Hononga o Amerika, ka taea e ngā pakeke tae atu ki te 45 tau te whiwhi i te kano ārai mate Gardasil 9®, i runga i te mōrearea o te pānga ki te HPV. Ko Cervarix® me Gardasil® ngā kano ārai mate HPV e wātea ana i ētahi atu whenua.

Mena kei a koe ētahi tohu o te mate pukupuku tara, me toro atu ki te tākuta tonu. Whakaritea he tirotiro hauora auau, tae atu ki te whakamātautau tinana i te iti rawa kotahi i te tau, mō tō hauora wahine.

Me pēhea taku tiaki i ahau anō?

He tokomaha pea ka whakama, ka whakamā rānei mō ngā panonitanga o roto i ō rātou tara. Engari, ahakoa he mate pukupuku tara, ehara i te mea me whakarērea e koe te whanaungatanga ā-tinana. Kaua e whakamā ki te pātai ki tō tākuta me pēhea te pānga o tō tātaritanga ki tō oranga moepuku. Ka taea e ia te hono atu i a koe ki ngā rauemi hei tautoko i ō hiahia ā-tinana me ō hiahia kare ā-roto i a koe e whakahaere ana i tēnei tātaritanga me te maimoatanga.

Kei hea te nuinga o te wā ka tīmata te mate pukupuku tara?

Ko te mate pukupuku tara ka tīmata i te mata o te kiri e karapoti ana i tō tara, arā, te labia majora o waho, te labia minora o roto rānei. Kāore i te tino kitea, ka taea hoki te whanake i ētahi atu wāhanga o te tara, pērā i te repe Bartholin me te clitoris.

He aha te wāhanga tuatahi o te mate pukupuku tara?

Ko te Wāhanga I te wāhanga tuatahi o te mate pukupuku vulvar. I tēnei wāhanga, kāore anō te mate pukupuku kia horapa ki tua atu i te vulva, i te perineum rānei. Wāhanga IA E rua henimita te rahi o te mate pukupuku vulvar (he rite ki te pīnati) he iti iho rānei. Kāore anō kia horapa ki ngā kiko tata atu i te neke atu i te kotahi mirimita (he rite ki te pito o te pene). Wāhanga IB He nui ake ngā mate pukupuku, ā, kua horapa hohonu pea ki roto i ngā kiko tata atu.

Hei whakamutunga, ko te mea nui rawa atu tēnei hei kōrero atu ki a koe! (Karere hei tango ki te kāinga)

He mahi nui tāu ki tō hauora. Kia tūpato ki ngā wāhanga katoa o tō tinana, tae atu ki tō tara. Mā te mōhio ki tō āhua ināianei ka āwhina i a koe ki te kite i ngā huringa i muri mai. Ki te kite koe i ētahi huringa, whakaritea he wā ki te toro atu ki te tākuta tonu. I tēnei wā, kaua rawa e mahue te toro atu ki tō tākuta wahine. Ka taea e rātou te kite i ngā huringa i mua i te matepukupuku i mua i te kino rawa atu.

Kia maumahara, kaua e wehi. Ko te mōhio te kaha nui rawa atu. Kāore koe i te mokemoke.

` Te mate pāwera o te tara, te mate pukupuku o te wahine, te HPV, ngā tohu o te vulvar, te maimoatanga o te mate pukupuku, te hauora o te tara, te ārai i te mate pukupuku