ʻO ka loaʻa ʻana o ka mālama ʻana i ka lymphoma he hoʻoholo hoʻopakele ola. Eia nō naʻe, ke kau nei ia iā ʻoe i ka pilikia nui o ka hoʻomohala ʻana i ka lua ma hope o ke ola. I ka nui o nā hihia, hiki ke loa'a ka ma'i 'elua ma mua o 10 mau makahiki ma hope o kou ho'omaka 'ana i kāu lapa'au lymphoma. I nā hihia kakaʻikahi hiki ke hana ma mua.
Hiki ke hoʻonui i kou pilikia o ka maʻi maʻi ʻelua i ʻokoʻa i kāu lymphoma mua ma kahi ʻōnaehana pale nāwaliwali, ka chemotherapy a me ka radiation therapy. Hiki i nā lāʻau lapaʻau ʻē aʻe ke hoʻonui i kou pilikia.
'A'ole e loa'a ka ma'i 'a'ai lua o ka po'e a pau i mālama 'ia, akā, he mea nui e maka'ala i ka pilikia i hiki ai iā 'oe ke mālama i kou olakino a loa'a koke i ka 'ōlelo a'o kino. ʻO ka nānā mau ʻana me kāu kauka lapaʻau maʻamau (GP), hematologist, oncologist a i ʻole radiation oncologist he ʻāpana koʻikoʻi ia o ka hōʻoia ʻana e kiʻi koke ʻia nā maʻi maʻi ʻelua a mālama ʻia inā pono.
E hāʻawi ana kēia ʻaoʻao i ka ʻike e pili ana i ka mea e nānā ai, he aha kāu nānā pono ʻana, a me ka manawa e ʻike ai i ke kauka e pili ana i nā hōʻailona hou.
He aha ka lua o ka maʻi kanesa
ʻO ka lua o ka maʻi kanesa ka ulu ʻana o kahi maʻi maʻi hou pili ʻole i kāu lymphoma mua a i ʻole CLL maʻi. ʻo ia ʻaʻole he hoʻi hou a i ʻole ka hoʻololi ʻana o kou lymphoma/CLL.
No ka 'ike hou aku e pili ana i ka lymphoma ho'i hou a i ho'ololi 'ia, e kaomi i nā loulou ma lalo nei.
No ke aha e hiki mai ai nā maʻi maʻi ʻelua?
Ke hana nei kekahi mau lāʻau lapaʻau ma ka hoʻololi ʻana i ke ʻano o ka hana ʻana o kāu ʻōnaehana pale, aʻo nā mea ʻē aʻe e hōʻino pololei i ka DNA o kāu mau cell. He mea nui kēia no ka mea kōkua ia i ka luku ʻana i nā pūnaewele lymphoma. Eia nō naʻe, hiki iā ia ke hoʻonui i kou pilikia o nā maʻi maʻi ʻelua e like me ka nāwaliwali o kou ʻōnaehana pale, a i ʻole ka hopena o ka hōʻino DNA i ka hopena o nā pūnaewele rogue (pōʻino) e pakele i kāu ʻōnaehana pale a hoʻonui a hiki i ka lilo ʻana i ka maʻi kanesa.
ʻAʻole loaʻa ka maʻi maʻi lua i ka hapa nui o nā kānaka. Eia nō naʻe, he mea nui e ʻike i kou pilikia i hiki iā ʻoe ke hoʻomaʻamaʻa maʻamau a loaʻa koke i ka ʻōlelo aʻoaʻo olakino.
Pehea ka ulu maʻamau?
ʻO ka maʻamau ka ulu ʻana a hoʻonui ʻia nā cell ma kahi ala paʻa a hoʻonohonoho pono ʻia. Hoʻolālā ʻia lākou e ulu a hana i kekahi ʻano, a hoʻonui a make paha i kekahi mau manawa.
ʻO nā kelepona iā lākou iho he microscopic - ʻo ia hoʻi he liʻiliʻi loa lākou ʻaʻole hiki iā mākou ke ʻike iā lākou. Akā, ke hui pū lākou a pau, hoʻokumu lākou i kēlā me kēia ʻāpana o ko mākou kino e like me ko mākou ʻili, nā kui, nā iwi, ka lauoho, nā puʻupuʻu lymph, ke koko a me nā ʻāpana kino.
Nui nā mākaʻikaʻi a me nā kaulike e hōʻoia i ka hoʻomohala ʻana o nā cell i ke ala kūpono. Aia kēia mau mea i nā "immune checkpoints". ʻO nā wahi hoʻopaʻa palekana he mau kiko i ka wā o ka ulu ʻana o ke kelepona kahi e "hōʻoia ai" kā mākou ʻōnaehana pale ʻana he cell maʻamau a olakino.
Inā nānā ʻia ke kelepona a ʻike ʻia he olakino, hoʻomau ka ulu ʻana. Inā he maʻi, a he poino paha ma kekahi ʻano, hoʻoponopono ʻia a luku ʻia paha (make), a hoʻoneʻe ʻia mai ko mākou kino ma o kā mākou lymphatic system.
- Ke hoʻonui ʻia nā pūnaewele, ua kapa ʻia mahele pūnaewele.
- Ke make nā pūnaewele ua kapa ʻia apoptosis.
Hoʻoponopono ʻia kēia kaʻina o ka mahele cell a me ka apoptosis e nā genes i kā mākou DNA, a ke hana nei i loko o ko mākou kino i nā manawa a pau. Hana mākou i ʻekolu mau cell i kēlā me kēia lā e hoʻololi i nā mea kahiko i hoʻopau i kā lākou hana a i ʻole i pōʻino.
Genes a me DNA
Aia i loko o kēlā me kēia pūnaewele (koe naʻe ke koko ʻulaʻula) he nucleus me 23 mau chromosomes.
Hoʻokumu ʻia nā Chromosomes i kā mākou DNA, a ʻo kā mākou DNA i hana ʻia i nā ʻano genes like ʻole e hāʻawi i ka "mea ʻai" no ke ʻano e ulu ai, hoʻonui, hana a make.
Hiki mai ka ma'i 'a'ai ke loa'a nā pō'ino a i 'ole nā hewa i loko o ko kākou mau genes. Hiki i kekahi mau lāʻau lapaʻau no ka lymphoma ke hoʻopōʻino mau i nā genes.
E aʻo hou aʻe e pili ana i ka hopena o kā mākou mau genes a me DNA i ka wikiō ma lalo nei. Mai hopohopo nui e pili ana i nā inoa o nā protein a me nā kaʻina hana, ʻaʻole koʻikoʻi nā inoa e like me kā lākou hana.
He aha ka mea maʻi?
ʻO ka maʻi maʻi he a ka genema'i tic. Hana ʻia ia i ka wā i loaʻa ai ka pōʻino a i ʻole nā hewa i loko o kā mākou ka genes, ka hopena o ka ulu ʻole ʻana o nā cell.
Hiki mai ka ma'i 'a'ai ke ho'omau 'ia ka ulu 'ole a me ke 'ano 'ole o ke kino a lilo i pu'upu'u, a i 'ole ka pi'i 'ana o ka ma'i 'a'ai ma kou koko a i 'ole ka lymphatic system.
ʻO kēia mau hoʻololi i kā mākou DNA i kekahi manawa i kapa ʻia ʻo genetic mutations a i ʻole genetic variations.
Loaʻa nā maʻi maʻi maʻi lua ma muli o ka mālama ʻana i kāu maʻi maʻi mua - lymphoma a i ʻole CLL ke kumu i kāu DNA, genes a i ʻole ʻōnaehana pale.
He aha ke 'ano o ka ma'i 'a'ai lua e hiki mai ana?
ʻO ka loaʻa ʻana o ka lāʻau lapaʻau no ka lymphoma hiki ke hoʻonui iki iā ʻoe i kekahi ʻano maʻi kanesa. Eia nō naʻe, ʻoi aku ka nui o ka pilikia o kekahi mau maʻi maʻi maʻi lua ma muli o ke ʻano o ka mālama ʻana iā ʻoe, a me kahi o ka lymphoma e mālama ʻia.
Hiki ke hoʻonui ʻia ka pilikia o ka lāʻau lapaʻau me ka chemotherapy maʻi ʻaʻai koko e like me ka myeloma a i ʻole leukemia a i ʻole, inā ua loaʻa iā ʻoe ka Hodgkin Lymphoma, hiki iā ʻoe ke hoʻomohala i kahi ʻano subtype o Non-Hodgkin Lymphoma. Hiki ke hoʻonui ʻia ka maʻi T-cell kaʻa i kou pilikia o ka hoʻomohala ʻana i ka lymphoma T-cell, leukemia a i ʻole ka maʻi maʻi ʻili, ʻoiai ua manaʻo ʻia he liʻiliʻi ka pilikia.
ʻO ka pilikia o ka lua o ka maʻi kanesa ma hope o ka mālama ʻana i ka radiation e pili ana i kahi o kou kino kahi i hoʻopaʻa ʻia ai ka lāʻau lapaʻau.
Kaomi ma nā poʻomanaʻo ma lalo nei e aʻo hou e pili ana i ka pilikia o nā ʻano maʻi maʻamau o ka lua.
Hiki i nā maʻi maʻi ʻili ke:
- ʻO nā kinikini basal cell
- ʻO ka memicoma pūmaʻi maʻamau
- Melanoma
- Merkel cell carcinomas.
ʻOi aku ka maʻi kanesa o ka umauma i nā wahine ma mua o nā kāne, akā hiki i nā kāne ke loaʻa i ka maʻi maʻi umauma. Inā ua loaʻa iā ʻoe ka radiation i kou umauma, hiki paha iā ʻoe ke ulu i ka maʻi kanesa ma hope o kou ola.
Pono ʻoe e hoʻomaka i ka nānā ʻana i kēlā me kēia makahiki e like me ka mammogram a me ka ultrasound mai ka makahiki 30, a i ʻole 8 mau makahiki ma hope o kou hoʻomaka ʻana i ka mālama ʻana no ka lymphoma/CLL - ʻo ia ka mea e hele mua mai.
ʻOi aku ka kiʻekiʻe o kou pilikia o ka hoʻomohala ʻana i ka maʻi maʻi umauma ma muli o ka hopena lōʻihi o kāu mālama lymphoma inā loaʻa ʻoe i ka radiation i kou umauma i ka wā i emi iho ai ʻoe ma mua o 30 mau makahiki.
E noi i kāu GP (kauka kūloko) e hōʻike iā ʻoe pehea e nānā ai i kou umauma no nā ʻōpū. E nānā i nā lumps i kēlā me kēia mahina a hōʻike i nā loli i kāu GP.
Hiki iā ʻoe ke hoʻomohala i kahi lymphoma lua a pili ʻole. ʻo kēia ʻokoʻa i ka hoʻi hou ʻana a i ʻole lymphoma i hoʻololi ʻia.
No ka laʻana, inā ua mālama mua ʻoe iā Hodgkin Lymphoma, hiki iā ʻoe ke hoʻomohala i kahi lymphoma lua ʻo ia ka subtype o Non-Hodgkin Lymphoma (NHL). Inā loaʻa iā ʻoe ka NHL ma mua, hiki iā ʻoe ke hoʻomohala i kahi ʻano NHL a i ʻole Hodgkin Lymphoma.
Ua hoʻomohala kekahi poʻe i kahi lymphoma T-cell ma hope o ka CAR T-cell therapy no kahi lymphoma B-cell.
Bus maanei mai ka ike hou aku i nā hōʻailona o ka lymphoma a me ka wā e ʻike ai i kāu kauka.
Ma muli o ke ʻano o ka lapaʻau ʻana i loaʻa iā ʻoe, hiki paha iā ʻoe ke hoʻomohala i kahi ʻano leukemia i kapa ʻia ʻo Acute Myeloid Leukemia (AML). ʻO nā hōʻailona o AML e komo pū ana:
- ʻO ke koko a i ʻole ka ʻeha ʻana ma mua o ka maʻamau, a i ʻole ka poni a ʻulaʻula paha.
- Ka luhi a me ka nāwaliwali maʻamau
- Hoʻemi kaumaha me ka pau ʻole o ka ʻai
- ʻO nā ʻeha e ola ʻole e like me ka mea i manaʻo ʻia
- ʻO ke kuni a/a i ʻole ke anu
- ʻO nā maʻi e hoʻi mau ana a hele ʻole paha
- ʻO ka hanu paʻakikī, pōkole o ka hanu a i ʻole ka ʻeha o ka umauma
- Nā hoʻololi i kāu hoʻāʻo koko.
E nīnau i kāu kauka inā ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka AML a me ka mea e pono ai ʻoe.
Hiki paha iā ʻoe ke piʻi iki i ka ulu ʻana i ka maʻi kanesa ma hope o ke ola inā loaʻa iā ʻoe ka radiation i kou umauma. Hoʻonui ʻia kēia pilikia inā ua puhi ʻoe, akā naʻe, hiki i ka poʻe ʻaʻole paka ke loaʻa ia mea.
ʻO nā ʻano hana hou o ka mālama ʻana i ka radiation e palekana a hoʻemi i ka pilikia, akā pono ʻoe e hōʻike i nā hōʻailona hanu i kāu kauka inā lōʻihi lākou ma mua o ʻelua pule. Aia kēia mau mea:
- ʻO ka manaʻo pōkole no ke kumu ʻole
- Ka luhi a i ʻole ka hanu ʻana ma mua o ka mea i manaʻo ʻia ke hoʻoikaika ʻoe
- ʻEha ma kou umauma
- ʻO ka pilikia ke hanu ʻoe
- ʻAke me ka ʻaʻa ʻole a i ʻole
- ʻAke koko.
Hiki paha iā ʻoe ke loaʻa i ka maʻi maʻi thyroid inā loaʻa iā ʻoe ka radiation ma kou ʻāʻī a i ʻole ka puʻu.
ʻO nā hōʻailona o ka maʻi maʻi thyroid:
- ʻEha ʻeha a ʻeha paha ma mua o kou ʻāʻī e piʻi ana i kou mau pepeiao
- He puʻu i mua o kou puʻu
- Pehu ma kou ʻāʻī
- Pilikia i ka ale ʻana a me ka hanu ʻana
- Hoʻololi i kou leo
- ʻO ka maʻi ʻaʻole e pau.
E ʻike i kāu kauka kūloko (GP) inā he koʻikoʻi kekahi o kēia mau hōʻailona, a inā lōʻihi lākou ma mua o 2 pule.
Hiki ke hoʻonui i ka hoʻomohala ʻana i ka maʻi maʻi ʻōpū ma hope o kou ola ʻana. E hōʻike i nā hoʻololi a pau i kāu kauka no ka loiloi. ʻO nā hoʻololi e loaʻa iā ʻoe e komo pū me:
- Ka weheweheʻana a iʻole ka paʻa
- ʻO ka ʻeha a i ʻole ka ʻeha ma kou ʻōpū a me kou ʻōpū
- ʻO ke koko ke hele ʻoe i ka lua wai - ua like paha kēia me ke koko ʻulaʻula ʻulaʻula a i ʻole kahi poʻo ʻeleʻele ʻeleʻele
- Paʻakikī i ka ʻai ʻana ma muli o ka manaʻo piha
- ʻO ka naʻi a me ka luaʻi
- Ka hoʻemi kaumaha me ka hoʻāʻo ʻole.
Hiki paha iā ʻoe ke loaʻa i ka maʻi maʻi prostate inā loaʻa ʻoe i ka radiation i kou ʻōpū a i ʻole ʻāpana pelvic, a i ʻole nā ʻano lāʻau anti-cancer ʻē aʻe e like me ka chemo, targeted a immunotherapies.
E nānā mau i ka prostate me kāu GP a hōʻike i nā loli e like me:
- pilikia me ke kahe ʻana o ka mimi (uwee) a i ʻole pono e hele ʻoi aku ma mua o ka maʻamau
- nā hoʻololi i ka loaʻa ʻana o ke kūkulu ʻana a i ʻole ke koko i loko o kāu puna
- ʻeha, ʻōpū a ʻeha paha i loko o kou ʻōpū.
He aha nā maʻi maʻi maʻi ʻelua āu e pilikia ai, a he aha nā hoʻokolohua a me nā scan e pono ai ʻoe. Hiki i kāu GP ke kōkua i ka hoʻonohonoho ʻana i kēia mau hoʻokolohua.
He mea kūpono paha ka loaʻa ʻana o ka lāʻau lapaʻau?
He hoʻoholo pilikino loa kēia. ʻO ka pilikia o ka hoʻomohala ʻana i ka maʻi maʻi ʻelua, ʻoiai ʻoi aku ka kiʻekiʻe ma mua o ka poʻe i mālama ʻole ʻia no ka lymphoma, ʻoi aku ka haʻahaʻa.
Ma ka loaʻa ʻana o ka lāʻau lapaʻau i kēia manawa, hiki iā ʻoe ke hoʻokō i ke kala ʻana a i ʻole ka hoʻōla ʻana mai kāu lymphoma o kēia manawa. Hiki i kēia ke hāʻawi iā ʻoe i nā makahiki he nui o ke ola maikaʻi.
ʻO ka ʻike ʻana aia ka pilikia o ka lua o ka maʻi maʻi maʻi hiki ke hoʻoulu i ka hopohopo, akā ʻo ia hoʻi ke ʻike ʻoe i nā hōʻailona e nānā ai a me ka wā e ʻike ai i ke kauka. ʻO ia hoʻi, e hahai pono ʻia ʻoe a e hana ʻia nā scans a i ʻole nā hoʻāʻo e kiʻi koke i kekahi maʻi maʻi lua. ʻO kēia ka manaʻolana e hāʻawi iā ʻoe i ka manawa maikaʻi loa e mālama maikaʻi ʻia.
Eia naʻe, hiki iā ʻoe ke hoʻoholo i nā pilikia āu e makemake ai e lawe me kou olakino. E nīnau i kāu kauka haematologist e pili ana i ka pilikia o ka loaʻa ʻole o ka lāʻau lapaʻau a lākou e ʻōlelo ai. E nīnau iā lākou e pili ana i kou pilikia o ka maʻi maʻi ʻelua a me nā hoʻokolohua e pono ai ʻoe.
A laila, e kamaʻilio me kāu poʻe aloha a i ʻole kahi psychologist inā pono ʻoe. E hoʻoholo i kāu hoʻoholo ma muli o ka ʻike i hāʻawi ʻia iā ʻoe, a me ka mea kūpono iā ʻoe. Inā manaʻo ʻoe ʻaʻole lawa ka ʻike, hiki iā ʻoe ke noi no ka manaʻo ʻelua no kāu mālama ʻana. Hiki i kāu kauka haematologist a i ʻole GP ke kōkua iā ʻoe e hoʻonohonoho i kahi manaʻo ʻelua.
He aha nā hoʻokolohua e pono ai iaʻu?
ʻAʻohe protocol kikoʻī e hana i ka hoʻāʻo ʻana no nā maʻi maʻi ʻelua ma hope o ka mālama ʻana. ʻO kēia no ka mea e pili ana kāu mea e pono ai i ke ʻano o ka lymphoma i loaʻa iā ʻoe, nā lāʻau i loaʻa iā ʻoe, a me nā wahi o kou kino i hoʻopilikia ʻia.
E kamaʻilio me kāu kauka haematologist a i ʻole ka maʻi oncologist e pili ana i ke ʻano o nā hoʻokolohua hahai e pono ai ʻoe. Eia naʻe, aia ma lalo ke alakaʻi i nā mea e pono ai ʻoe e noʻonoʻo.
- Nā hoʻāʻo koko maʻamau e like me ka ʻōlelo a kāu kauka oncologist a i ʻole haematologist.
- ʻO ka nānā ʻana i ka umauma ponoʻī o kēlā me kēia mahina (e hōʻike i nā loli i kāu GP i ka wā hiki loa), a me ka mammogram a/a i ʻole ultrasound e like me ka ʻōlelo a kāu kauka.
- ʻO ka mammogram a me ka ultrasound makahiki mai ka makahiki 30 a i ʻole 8 mau makahiki ma hope o ka radiation i kou umauma inā mālama ʻia ma mua o ka makahiki 30.
- Pap smears e like me ka ʻōlelo a kāu kauka.
- Nānā ʻili makahiki - ʻoi aku ka pinepine inā ʻōlelo ʻia e kāu kauka.
- Ka nānā ʻana i ka ʻōpū i kēlā me kēia makahiki ʻelua mai ka makahiki 50, a ma mua inā ʻōlelo ʻia e kāu kauka.
- E nānā i ka prostate i kēlā me kēia makahiki mai ka makahiki 50, a ma mua inā ʻōlelo ʻia e kāu kauka.
- Nā lāʻau lapaʻau e like me ka ʻōlelo a kāu kauka.
hōʻuluʻulu manaʻo
- Hiki i nā lāʻau lapaʻau Lymphoma ke hoʻopakele ola, akā ʻo nā ʻano lapaʻau āpau e kau ai i kahi ʻoi aku ka nui o ka loaʻa ʻana o ka lua ma hope o ke ola.
- ʻO nā maʻi maʻi maʻi ʻelua ʻaʻole ia he hoʻihoʻi a hoʻololi paha i kāu lymphoma mua. He ʻano maʻi maʻi ʻokoʻa pili ʻole i kāu lymphoma.
- Hiki i ka lapaʻau ʻana me ka radiotherapy ke hoʻonui iā ʻoe i ka lua o ka maʻi kanesa ma kahi i kuhikuhi ʻia ai ka radiation.
- Hiki i ka chemotherapy ke hoʻonui i kou pilikia o ka lua o ka maʻi maʻi koko, a i ʻole nā ʻano maʻi ʻaʻai paʻa.
- ʻO ka maʻi kanesa ʻili ka lua maʻamau. He mea nui ka nānā ʻana i ka ʻili i kēlā me kēia makahiki.
- Hiki i nā kāne a me nā wahine ke loaʻa i ka maʻi maʻi maʻi umauma ʻoiai ʻoi aku ka maʻamau o nā wahine. Inā ua loaʻa iā ʻoe ka radiation ma kou umauma, e hoʻomaka i ka nānā ʻana iā ʻoe iho i kēlā me kēia mahina, a hōʻike i nā hoʻololi āpau i kāu kauka.
- E hoʻomau i ka ʻike me kāu mau hoʻāʻo hoʻomaʻamaʻa hōʻoia, scans, a me ka hoʻopaʻa ʻana.
- E nīnau i kāu kauka haematologist, oncologist a i ʻole radiation oncologist e pili ana i kou pilikia o nā maʻi maʻi ʻelua a hana i kahi hoʻolālā me lākou no ka mālama ʻana.
- Inā ʻaʻohe GP āu e hilinaʻi nei, e ʻimi i hoʻokahi a hōʻike iā lākou i kāu mau lapaʻau a me nā pilikia e mau nei. E noi iā lākou e launa pū me kāu kauka haematologist, oncologist a i ʻole radiation oncologists no ke alakaʻi ʻana i ka mālama mau ʻana.
