o ka Naauao
ʻO ka maʻi kanesa o ka umauma metastatic, ʻike ʻia hoʻi ʻo ka maʻi maʻi umauma pae IV, kahi ʻano holomua o ka maʻi i laha ai ka maʻi kanesa i nā wahi ʻē aʻe o ke kino, e like me nā iwi, nā māmā, nā ate, a i ʻole ka lolo. He hapa liʻiliʻi wale nō (6%) o nā wahine i ʻike mua ʻia me ka umauma metastatic Ka maʻi 'aʻai, me ka nui o nā hihia i loaʻa ma muli o ka hoʻihoʻi ʻana ma hope o ka mālama mua ʻana a me kahi manawa kala.
He ʻokoʻa nui ma waena o nā maʻi maʻi umauma a me nā maʻi maʻi metastatic; ʻO ka maʻi ʻaʻai umauma kahi huaʻōlelo umbrella no nā ʻano āpau a me nā pae o ka carcinoma i puka mai ma ka ʻiʻo umauma. Ma ka ʻaoʻao ʻē aʻe, hāʻawi pū ka National Cancer Institute (NCI) i ka ʻike e pili ana i nā maʻi maʻi maʻi metastatic a me nā pae maʻi maʻi umauma ʻokoʻa, me ka wehewehe ʻana o ka maʻi maʻi maʻi metastatic ma ke ʻano he pae IV o ka maʻi, kahi i laha ai nā pūnaʻi kanesa i nā wahi ʻē aʻe o ke kino. .
ʻOiai ʻike pinepine ʻia ka maʻi kanesa o ka umauma metastatic i nā wahine, pili pū kekahi i kahi helu liʻiliʻi o nā kāne. Wahi a ka American Cancer Society's Cancer Facts and Figures hōʻike mai 2019, ʻoi aku ka liʻiliʻi o 5 mau makahiki ola no nā maʻi maʻi umauma metastatic ma mua o 30%.
Segar, Jennifer M et al. "ʻO kahi haʻawina Phase II o Irinotecan a me Etoposide e like me ka mālama ʻana no ka Refractory Metastatic Breast Cancer." ʻO ka maʻi oncologist vol. 24,12 (2019): 1512-e1267. doi:10.1634/theoncologist.2019-0516
ʻO ka ho'āʻo hoʻokolohua (NCT00693719): Irinotecan a me Etoposide i ka Metastatic Breast Cancer
- Aia he 31 mau wahine i kākau inoa ʻia i kēia lima hoʻokahi, ka hoʻokolohua hoʻokolohua pae II, ma waena o nā makahiki o 36-84 mau makahiki.
- 64% o kēia mau wahine i loaʻa ka hormone maikaʻi a me HER2 ʻano maikaʻi ʻole o ka maʻi ʻaʻai umauma.
- Ua mālama ʻia nā wahine me ka median o 5 ma mua o nā hoʻoponopono a ua kūpaʻa i ka antracycline, taxane a me capecitabine therapy.
Nā Mea ʻai e ʻAi ai Ma hope o ka ʻike maʻi ʻaʻai!
ʻAʻohe ʻelua maʻi ʻaʻai. E hele i waho o nā kulekele meaʻai maʻamau no kēlā me kēia kanaka a hoʻoholo i nā koho pilikino e pili ana i ka meaʻai a me nā mea hoʻopihapiha me ka hilinaʻi.
ʻO ke kumu ʻepekema no ke aʻo ʻana
- ʻO ke kumu ma hope o ka hoʻokolokolo ʻana e hoʻāʻo i kahi hou o nā lāʻau chemotherapy i hōʻike ʻelua i ka hana i hoʻopaʻa ʻia i nā maʻi maʻi ʻaʻai umauma a ua hōʻoia ʻia ka hui ʻana preclinically.
- ʻO Irinotecan lāua ʻo Etoposide he kūlohelohe, nā mea kanu i loaʻa i nā mea kanu i modulator o topofomerase (TOP) isoforms enzyme. Koi ʻia nā enzyme TOP no ka hoʻopili ʻana o DNA a me ka transcription, nā kaʻina hana koʻikoʻi ʻelua no kahi cell cancer cancer e ulu wikiwiki nei. ʻO ka hoʻopilikia ʻana me ka hana TOP ke kumu o ka haki ʻana o ka strand DNA, ka hōʻino ʻana o DNA a me ka make ʻana o ka cell.
- ʻO Irinotecan kahi TOP1 a ʻo Etoposide kahi modulator TOP2. ʻO ke kumu o ka hoʻohui ʻana i nā mea kāwili TOP1 a me TOP2 ka mea e kamaʻilio ai i ka hoʻoliʻiliʻi compensatory o kahi isoform ʻē aʻe ke kaomi ʻia kekahi o nā isoforms.
Nā Hopena Hoʻokolohua Lapaʻau
- Aia he 24 mau mea maʻi i hiki ke loiloi ʻia no ka pono o kēia regimen hoʻohui o Irinotecan a me Etoposide. 17% he hapa pane a 38% i loaʻa i ka maʻi paʻa.
- Loiloi ʻia nā mea maʻi āpau he 31 no ka hoʻowahāwahā a me 22 o 31 (71%) i ʻike i ka mālama e pili ana i ka hanana 3 a me 4 i nā hanana maikaʻi ʻole. ʻO ka neutropenia ka nui o nā mea ʻino maʻamau, ʻo ia ke kū ʻana o nā neutrophil haʻahaʻa haʻahaʻa ma ke koko e hiki ai ke hoʻonui i ka maʻalahi i nā maʻi.
- Ua hoʻopau mua ʻia ke aʻo ʻana ma muli o ke kaumaha o ka ʻona a ua ʻoi aku ka maikaʻi o ka hui ʻana.
Nā hōʻailona maʻi maʻi maʻi umauma metastatic
- ʻEha iwi a ʻoluʻolu paha: Hiki iā ia ke laha i nā iwi, e hōʻeha a ʻeha paha i nā wahi i hoʻopilikia ʻia.
- ʻO ka luhi: ʻO ka mālama ʻana i ka maʻi kanesa a me ka maʻi kanesa hiki ke hoʻoulu i ka luhi, hiki ke paʻakikī a hoʻomau.
- Pōkole o ka hanu: Hiki ke hoʻopōkole ka hanu i ka maʻi kanesa e laha ana i ka māmā.
- Nā hōʻailona neurological: ʻO ka maʻi maʻi i laha i ka lolo hiki ke hoʻoulu i nā hōʻailona neurological e like me ke poʻo, ka hopu ʻana, a i ʻole nā loli i ka hana noʻonoʻo.
- Pau ka ʻai a me ke kaumaha: ʻO ka mālama ʻana i ka maʻi maʻi a me ka maʻi kanesa hiki ke hoʻopau i ka ʻai a me ke kaumaha.
- ʻO ka jaundice a i ʻole ka pehu ʻana o ka ʻōpū i ka wā i laha ai ka maʻi kanesa i ke ake.
Hiki ke ʻokoʻa ka manaʻolana o ke ola o kekahi kanaka me ka maʻi maʻi umauma metastatic ma muli o nā kumu like ʻole e like me ka wahi a me ka laha ʻana o ka ʻōpū.
Wahi a kahi noiʻi, ʻo ka helu ola 5-makahiki no ke ana o ka nui o ka poʻe me kēia ʻano Ka maʻi 'aʻai ke ola nei i nā makahiki 5 i hala ma hope o ka loaʻa ʻana o ke kanesa. Hōʻike ʻia ia ma ke ʻano he pākēneka, ʻo ia hoʻi ka helu o nā poʻe mai 100 e ola ana ma hope o 5 mau makahiki. Wahi a ka American Cancer Society, he 5% ka helu ola 29 makahiki no nā wahine me ka maʻi maʻi umauma metastatic, aʻo ka helu ola 5 makahiki no nā kāne me ka 22%. He mea nui e hoʻomaopopo he mau helu helu maʻamau kēia a ʻokoʻa paha nā hihia pākahi.
Lapaʻau ʻana i ka maʻi maʻi maʻi metastatic
He paʻakikī ka mālama ʻana akā ʻo ka hui pū ʻana o ka chemotherapy me nā lāʻau chemo kikoʻī he mau pōmaikaʻi i ka mālama ʻana i ka maʻi kanesa. ʻAʻole hiki ke hoʻohana lōʻihi a lōʻihi ma muli o kona ʻano ʻawaʻawa koʻikoʻi a me ka hopena o ke ola o ka mea maʻi. ʻO ka mālama ʻana i ka Immunotherapy kahi koho ʻē aʻe i hiki ke noʻonoʻo ʻia no nā poʻe maʻi me nā maʻi maʻi maʻi metastatic; Hiki i kēia ala lapaʻau ke kōkua i ke kino o ke kino e ʻike a hoʻouka i nā maʻi maʻi maʻi.
ʻO ka loiloi ʻana i ka moʻolelo mutation o ka metastatic tumor hiki ke kōkua i ka ʻike ʻana i nā hui pū ʻana o nā ala lapaʻau i manaʻo ʻia me nā hopena ʻaoʻao haʻahaʻa. ʻO ka pilikia o ka hoʻohana ʻana i ka hui pū ʻana o nā topoisomerase inhibitors Irinotecan a me Etoposide i ʻoi aku ka nui o nā pono a ʻaʻole hiki ke hoʻohana ʻia i ka mālama ʻana i ka umauma metastatic. maʻi pū.
No ka mea ʻokoʻa kēlā me kēia maʻi maʻi umauma metastatic me kāna mau ʻano genomic ʻano like ʻole, hoʻopili ʻia nā koho lapaʻau e like me ka oncologists. Aia nō nā hana e hana ʻia i ka ʻimi ʻana i nā koho lapaʻau maikaʻi a palekana no ia. I kēlā me kēia makahiki, ma ka lā 13 o ʻOkakopa, hoʻolauleʻa ʻia ka lā ʻike maʻi maʻi maʻi metastatic e hāʻawi i ke kākoʻo no ka poʻe i loaʻa i ka maʻi a e ʻohi kālā no ka noiʻi e hoʻomohala i nā koho lapaʻau maikaʻi.
He aha nā meaʻai āu e ʻai ai a me nā mea hoʻopihapiha āu e lawe ai i hoʻoholo. Pono e hoʻoholo i kāu hoʻoholo ʻana e pili ana i ka hoʻololi ʻana i nā ʻāpana o ka maʻi ʻaʻai, ka maʻi ʻaʻai, nā lāʻau e hoʻomau nei a me nā mea hoʻopihapiha, nā maʻi āpau, nā ʻike nohona, ke kaupaona, ke kiʻekiʻe a me nā ʻano.
ʻAʻole hoʻokumu ʻia ka hoʻolālā meaʻai no ka maʻi ʻaʻai mai addon ma ka ʻimi pūnaewele. Hoʻokele ia i ka hoʻoholo ʻana iā ʻoe ma muli o ka ʻepekema molekole i hoʻokō ʻia e ko mākou ʻepekema a me nā ʻenekini polokalamu. Nānā ʻole inā ʻoe e noʻonoʻo e hoʻomaopopo i ke ʻano o nā ʻolaola biōmika kumu a i ʻole ʻole - no ka hoʻolālā meaʻai no ka maʻi ʻaʻai e pono ai ka ʻike.
E hoʻomaka I K NOWIA manawa me kāu hoʻolālā meaʻai e ka pane ʻana i nā nīnau e pili ana i ka inoa o ka maʻi ʻaʻai, ka hoʻololi ʻana o nā kūpuna, nā mālama ʻana a me nā mea hoʻopihapiha mau, nā maʻi āpau, nā ʻano, ka nohona, nā makahiki a me nā kāne.
ʻO nā mea maʻi maʻi maʻi e hana pinepine me nā mea ʻokoʻa nā hopena ʻaoʻao chemotherapy kahi e hoʻopili ai i ko lākou ola o ke ola a nānā i nā hoʻoponopono ʻokoʻa no ka maʻi ʻaʻai. Lawe ana i ka ka meaʻai kūpono a me nā mea hoʻopihapiha e pili ana i nā noʻonoʻo ʻepekema (ka hōʻalo ʻana i ka wānana a me ke koho wale ʻana) ʻo ia ka lāʻau kūlohelohe maikaʻi loa no ka maʻi ʻaʻai a me nā lāʻau e pili ana i nā hopena ʻaoʻao.
E hoʻomaopopo ':
- Cancer.net (2022). Ka maʻi maʻi umauma – Metastatic: Heluhelu.
- National Cancer Institute. (nd). Ka maʻi maʻi umauma.
- ʻAhahui maʻi maʻi ʻAmelika. (2021). ʻO ka maʻi maʻi maʻi maʻi metastatic.
- National Cancer Institute. (2021). ʻO ka maʻi maʻi maʻi maʻi metastatic.
- Cancer.net. (2022). Ka maʻi maʻi umauma – Metastatic: Heluhelu.
Mea 'ai pilikino no ka ma'i 'a'ai!
Hoʻololi ka maʻi kanesa me ka manawa. Hoʻopilikino a hoʻololi i kāu meaʻai e pili ana i ka hōʻailona maʻi maʻi, ka mālama ʻana, ke ʻano o ka nohona, nā makemake meaʻai, nā allergies a me nā mea ʻē aʻe.