Kanesa maʻi ʻaʻai liʻiliʻi liʻiliʻi

ʻO ka maʻi ʻaʻai liʻiliʻi liʻiliʻi liʻiliʻi ka ʻano maʻamau o ka maʻi ʻaʻai. Māhuahua mau a pālahalaha aʻe ma mua o ka maʻi ʻaʻai liʻiliʻi liʻiliʻi.

ʻEkolu ʻano maʻamau o ka maʻi ʻaʻai liʻiliʻi liʻiliʻi liʻiliʻi (NSCLC):

• Loaʻa pinepine ʻo Adenocarcinomas i kahi ma waho o ka akemāmā.
• ʻIke mau ʻia nā carcinomas ʻāpana squamous i waenakonu o ka māmā ma hope o kahi pahu ea (bronchus).
• Hiki ke loaʻa nā carcinomas nui pūnaewele i nā ʻāpana o ka akemāmā.
• Aia kekahi ʻano maʻamau o ka maʻi ʻaʻai pūpū i kapa ʻia he poʻe liʻiliʻi.

ʻO ke puhipaka ka hapanui o nā hihia (ma kahi o 90%) o ka maʻi ʻaʻai liʻiliʻi liʻiliʻi ʻole. Pili ka makaʻu i ka helu o nā paka i puhi ʻoe i kēlā me kēia lā a no ka lōʻihi o kou puhipaka. Ke hoʻopuni nei i ka uahi mai nā poʻe ʻē aʻe (ka uahi lua) e hāpai pū i kou makaʻu o ka maʻi ʻaʻai māmā. Akā ʻo kekahi poʻe ʻaʻole puhipaka loa e hoʻomōhala i ka maʻi ʻaʻai māhū.

Hōʻike ka noiʻi e hiki i ka puhi ʻana i ka pakalōlō ke kōkua i nā hunaola maʻi ʻaʻai e ulu. Akā ʻaʻohe loulou pololei ma waena o ka puhi ʻana i ka pakalōlō a me ka ulu ʻana i ka maʻi ʻaʻai māmā.

ʻO ka ʻike mau ʻana i nā kiʻekiʻe o ka haumia ea a me ka wai inu i loaʻa i kahi kiʻekiʻe o ka arsenic hiki ke hoʻonui i kāu makaʻu o ka maʻi ʻaʻa maʻi. Hiki i ka moʻaukala o ka radiation radiation i nā māmā ke hoʻonui i ka makaʻu.

ʻO ka hana pū ʻana a i ʻole ke noho ʻana ma kahi kokoke i nā maʻi ʻaʻai a me nā mea hiki ke hoʻonui i ka makaʻu o ka maʻi ʻaʻai māmā. ʻO nā kemika e like me:

• ʻAsbestos
• Radon
  
• Nā kemika e like me ka uranium, beryllium, vinyl chloride, nā nickel chromates, nā huahana lānahu, ke kinoea mākeke, nā ether kloromethyl, ʻaila, a me ka pau ʻana o ka diesel
• Kekahi oka a, pena, pigment, a me nā preservatives
• Nā huahana e hoʻohana ana i ka chloride a me formaldehyde

Pākuʻi ʻia paha nā ʻōuli:

• ʻEha ʻeha
• Mele hele ʻole
• ʻApu ʻana i ke koko
• Ka luhi
• Loaʻa ka ʻai ʻole
• Ke kaupaona ʻana me ka hoʻāʻo ʻole
• Pokole o ka hanu
• ʻUhihi
• ʻEha ke pālahalaha ʻia i nā wahi ʻē aʻe o ke kino

ʻAʻole kumu o ka maʻi ʻaʻai mua i nā ʻōuli.

Nā hōʻailona ʻē aʻe e pili ana iā NSCLC, pinepine i nā hopena hope.

• ʻEha iwi a palupalu paha
• E hāʻule ana ka ʻōmaka
• Hoarseness a hoʻololi paha i ka leo
• ʻEha hui
• Nā pilikia kui
• Pahu i ka paʻakikī
• ʻO ka pehu o ka maka
• Nawaliwali
• ʻEha ʻeha a nāwaliwali paha

Hiki i kēia mau hōʻailona ma muli o nā kūlana ʻē aʻe, ʻoi aku ka liʻiliʻi. He mea nui e kamaʻilio me kāu kauka mālama inā loaʻa nā ʻōuli.

E hana ka mea hāʻawi i kahi hoʻokolohua kino a nīnau e pili ana i kāu mōʻaukala olakino. Nīnau ʻia ʻoe inā puhipaka ʻoe, a inā pēlā, pehea ka nui o kou puhipaka a me ka lōʻihi o kou puhipaka. E nīnau ʻia ʻoe e pili ana i nā mea ʻē aʻe e hoʻokau iā ʻoe i ka maʻi ʻaʻai pūpū, e like me ka hōʻike ʻana i kekahi mau kemika.

Nā hoʻokolohua i hiki ke hana ʻia e ʻike pono i ka maʻi ʻaʻai a i ʻole ʻike inā ua pālahalaha ʻia.

• ʻImi iwi
• Pākuʻi x-ray
• Helu piha koko (CBC)
• CT scan o ka umauma
• MRI o ka umauma
• Positron emission tomography (PET) scan NineManga.com
• Hōʻike Sputum e nānā no nā hunaola maʻi ʻaʻai
• Thoracentesis (ka laʻana o ka hoʻoulu wai a puni ka akemāmā)

I ka hapanui o nā hihia, hemo kahi ʻāpana o kou kino no ka hoʻokolokolo ʻana ma lalo o kahi microscope. Kapa ʻia kēia he biopsy. Nui a hewahewa nā ala e hana ai i kēia:

• Hoʻohui ʻia ʻo Bronchoscopy me ka biopsy
• ʻO ka biopsy Needle-kuhikuhi ʻia e ka CT-scan
• Endoscopic esophageal ultrasound (EUS) me ka biopsy
• Mediastinoscopy me ka biopsy
• Wehe biopsy māmā
• ʻO Biopsy Pleural

Inā hōʻike ka biopsy i ke kanesa, hana ʻia nā hoʻokolohua kiʻi hou aku e ʻike i ke kahua o ka maʻi ʻaʻai. ʻO ke kumu ke ʻano o ka nui o ka tumo a pehea ka nui i hoʻolaha ai. Māhele ʻia ʻo NSCLC i nā pae he 5:

• Kahua 0 - ʻAʻole i pālahalaha ka maʻi ʻaʻai ma ʻō aku o ka pale o loko o ka māmā.
• ʻOihana I - He liʻiliʻi ka maʻi ʻaʻai a ʻaʻole pāhola i nā lymph node.
• ʻOihana II - Ua pālahalaha ka maʻi ʻaʻai i kekahi mau pūnana lymph kokoke i ka tumo kumu.
• Kahua III - Ua pālahalaha ka maʻi ʻaʻai i nā kiko kokoke a i ʻole nā ​​wahi lymph mamao loa.
• ʻOihana IV - Ua pālahalaha ka maʻi ʻaʻai i nā mea ʻē aʻe o ke kino, e like me nā māmā, nā lolo, a me ke akepaʻa ʻē aʻe.

Nui a hewahewa nā ʻano lapaʻau like ʻole no NSCLC. Pili ka mālama ʻana i ke kahua o ka maʻi ʻaʻai.

ʻO ka ʻoki lāʻau ka lāʻau maʻamau no NSCLC ʻaʻole i pālahalaha ma ʻō aku o nā nū lymph kokoke. Hiki i ke kaukōkō ke hemo:

• ʻO kekahi o nā ʻaoʻao o ka māmā (lobectomy)
• ʻO kahi ʻāpana wale nō o ka hū
• ʻO ka lung āpau (pneumonectomy)

Pono kekahi poʻe i ka chemotherapy. Hoʻohana ʻo Chemotherapy i nā lāʻau e hoʻomake i nā hunaola maʻi ʻaʻai a hoʻokū i nā hunaola hou mai ka ulu ʻana. Hiki ke hana i ka mālama ʻana i nā ala aʻe:

• Hoʻohana pinepine ʻia ʻo Chemotherapy ke pāhola ʻia ka maʻi ʻaʻai ma waho o ka māmā (pae IV).
• Hāʻawi ʻia ia paha ma mua o ke kaha ʻana a i ʻole ka radiation e hana ai i kēlā mau lapaʻau me ka maikaʻi. Kapa ʻia kēia ʻo neoadjuvant therapy.
• Hāʻawi ʻia paha ia ma hope o ke kaha ʻana e luku i nā maʻi ʻaʻai i koe. Kapa ʻia kēia ʻo adjuvant therapy.
• Hāʻawi pinepine ʻia ʻo Chemotherapy ma o kahi aa (e IV). A i ʻole, hāʻawi ʻia ia e nā pila.

ʻO ke kaohi ʻana i nā ʻōuli a me ka pale ʻana i nā pilikia i ka wā a ma hope o ka chemotherapy he ʻāpana nui ia o ka mālama.

ʻO ka Immunotherapy kahi ʻano lapaʻau hou e hiki ke hāʻawi ʻia e ia iho a i ʻole me chemotherapy.

Hiki ke hoʻohana ʻia i ka lāʻau hoʻomāka ʻia e mālama iā NSCLC. Hoʻohana ka mea i hoʻomākaukau ʻia i nā lāʻau lapaʻau ʻole i loko o nā pahuhopu kikoʻī (nā mole) i a i ʻole nā ​​hunaola maʻi ʻaʻai. He mea nui kēia mau pahuhopu pehea e ulu a ola ai nā hunaola maʻi ʻaʻai. Ke hoʻohana nei i kēia mau pahuhopu, hoʻopau ka lāʻau i nā hunaola maʻi ʻaʻai no laila ʻaʻole hiki iā lākou ke pālahalaha.

Hiki ke hoʻohana ʻia ka radiation radiation me chemotherapy inā ʻaʻole hiki ke ʻoki. Hoʻohana ka radiation radiation i nā kukuna x ikaika a i ʻole nā ​​ʻano radiation e hoʻomake i nā hunaola maʻi ʻaʻai. Hoʻohana ʻia ka kukuna i:

• E mālama i ka maʻi ʻaʻai, me chemotherapy, inā ʻaʻole hiki ke ʻoki
• Kōkua e hōʻoluʻolu i nā ʻōuli i hopena ʻia e ka maʻi ʻaʻai, e like me nā pilikia hanu a me ka pehu
• Kōkua e hōʻoluʻolu i ka maʻi ʻaʻai ke pālahalaha ka maʻi ʻaʻai i nā iwi

ʻO ke kaohi ʻana i nā ʻōuli i ka wā a ma hope o ka pāhawewe ʻana i ka umauma he mea nui ia o ka mālama.

Hoʻohana ʻia nā ʻano lawelawe aʻe e hōʻoluʻolu i nā ʻōuli i hoʻokumu ʻia e NSCLC.

• Hoʻomaʻamaʻa laser - Hoʻonā kahi kukui liʻiliʻi o ka mālamalama a make i nā hunaola maʻi ʻaʻai.
• Photodynamic therapy - hoʻohana i kahi kukui e hoʻoulu ai i kahi lāʻau i loko o ke kino, ka mea e luku ai i nā hunaola maʻi ʻaʻai.

Hiki iā ʻoe ke hoʻomāmā i ke koʻikoʻi o ka maʻi ma ke komo ʻana i kahi hui kākoʻo. ʻO ke kaʻana ʻana me nā poʻe ʻē aʻe i loaʻa nā ʻike a me nā pilikia maʻamau e hiki ke kōkua iā ʻoe e noʻonoʻo ʻole.

Kūleʻa ka nānā. ʻO ka pinepine, ulu mālie ʻo NSCLC. I kekahi mau hihia, hiki ke ulu a laha koke a hiki i ka make wikiwiki. E pāhola paha ka maʻi ʻaʻai i nā ʻāpana ʻē aʻe o ke kino, e like me ka iwi, ka ate, ka ʻōpū liʻiliʻi, a me ka lolo.

Ua hōʻike ʻia ʻo Chemotherapy e hoʻolōʻihi i ke ola a hoʻomaikaʻi i ka maikaʻi o ke ola i kekahi poʻe me ka pae IV NSCLC.

Pili nā helu hoola i ke kahua o ka maʻi a inā hiki iā ʻoe ke hana i kahi ʻoki.

• ʻO ke kanesa ʻo I a me II nā maʻi ʻoi loa ke ola a me nā helu hōʻola.
• Hiki ke hoola i ka maʻi ʻaʻai pae III i kekahi mau hihia.
• ʻO ke kanesa IV i hoʻi mai ua aneane pau ʻole i ka hoʻōla ʻia. ʻO nā pahuhopu o ka therapy e hoʻolōʻihi a hoʻomaikaʻi i ka maikaʻi o ke ola.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o ka maʻi ʻaʻai pūpū, keu hoʻi inā ʻoe e puhi.

Inā puhi ʻoe, ʻo kēia ka manawa e haʻalele ai. Inā pilikia ʻoe i ka haʻalele ʻana, e kamaʻilio me kāu mea hāʻawi. Nui a hewahewa nā ala e kōkua ai iā ʻoe e haʻalele, mai nā hui kākoʻo i nā lāʻau lapaʻau. Eia kekahi, e hoʻāʻo e hōʻalo i ka uahi lua.

Inā ʻoi aku ʻoe i ka makahiki 55 a puhi a hoʻohana paha i ka puhi i loko o nā makahiki he ʻumi i hala, e kamaʻilio me kāu mea hoʻolako e pili ana i ka loiloi ʻana no ka maʻi ʻaʻai māmā. No ka pale ʻana, pono ʻoe i kahi CT scan o ka pahu.

Ka maʻi ʻaʻai - lung - non-liʻiliʻi cell; Maʻi ʻaʻai liʻiliʻi liʻiliʻi liʻiliʻi ʻole; NSCLC; Adenocarcinoma - māmā; Carcinoma pūnaewele ʻōpala - lung; Ka maʻi kanesa nui - lung

• Pāhawewe umauma - hoʻokuʻu
• ʻOki kino - hoʻokuʻu

• Lungs
• ʻO ka uahi lua a me ke kanesa maʻi ʻaʻai

Araujo LH, Horn L, Merritt RE, Shilo K, Xu-Welliver M, Carbone DP. Ka maʻi ʻaʻai o ka akahā: maʻi ʻaʻai liʻiliʻi liʻiliʻi liʻiliʻi a me ka maʻi ʻaʻa liʻiliʻi o ka pūpū liʻiliʻi. I: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. ʻO Oncology Clinical ʻo Abboff. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2020: chap 69.

Ettinger DS, Wood DE, Aggarwal C, et al. Nā ʻike o nā alakaʻi NCCN: ka maʻi ʻaʻai liʻiliʻi liʻiliʻi liʻiliʻi, mana 1.2020. ʻO J Natl Compr Canc Netw. 2019; 17 (12): 1464-1472. PMID: 31805526. pubmed.ncbi.nlm.nih.gov/31805526/.

Pūnaewele ʻo National Cancer Institute. ʻO ka mālama ʻana i ka maʻi ʻaʻai liʻiliʻi liʻiliʻi liʻiliʻi (PDQ) - mana ʻoihana olakino. www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq. Hoʻohou ʻia Mei 7, 2020. Loaʻa iā Iulai 13, 2020.

Silvestri GA, Pastis NJ, Tanner NT, Jett JR. ʻO nā ʻano maʻi o ka maʻi ʻaʻai. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 53.