ʻOihana 4 Renal Cell Carcinoma: Metastasis, nā helu ola, a me ka mālama ʻana

Anter

• He aha ke kinikini kinikini?
• Pehea ia e palahalaha ai?
• ʻO ka hoʻonohonoho ʻana o TNM a me nā pae o ka maʻi ʻaʻai kidney
• He aha ke kuanaʻike?
• He aha nā koho lapaʻau?
• ʻO ka lawe lawe ʻana

He aha ke kinikini kinikini?

ʻO ka maʻi kanesa puʻupaʻa (RCC), i kapa ʻia hoʻi ʻo ke kanulau ʻōpala puʻuwai a i ʻole adenocarcinoma pūnana renal, he ʻano maʻamau ia o ka maʻi ʻaʻai pūpū. ʻO ka helu ʻana o nā carcinomas pūnana ʻoi loa ma kahi o 90 pākēneka o nā maʻi ʻōhua āpau.

Hoʻomaka ka RCC ma ke ʻano he tumo e ulu ana i hoʻokahi o kou puʻupaʻa. Hiki iā ia ke hoʻomohala i nā puʻupaʻa ʻelua.ʻOi aku ka maʻi ma nā kāne ma mua o ka wahine.

Pehea ia e palahalaha ai?

Inā loaʻa kahi tumo maʻi ʻaʻai i loko o kekahi o kou mau puʻupaʻa, ʻo ka hana maʻamau ka wehe ʻana i kahi ʻoki a i ʻole nā ​​kuhi āpau āpau.

Inā ʻaʻole lawe ʻia ka tumo, ʻoi aku paha ka palahalaha ʻana o ka maʻi ʻaʻai i kāu mau lymph node a i ʻole nā ​​mea ʻē aʻe. Kāhea ʻia ka hoʻolaha ʻana o ka maʻi ʻaʻai.

I ka hihia o RCC, hiki i ka tumo ke hoʻouka i kahi aa nui e alakaʻi ana i waho o ka puʻupaʻa. Hiki iā ia ke pālahalaha i ka ʻōnaehana lymph a me nā meaola ʻē aʻe. ʻAno maʻalahi ka hū.

ʻO ka hoʻonohonoho ʻana o TNM a me nā pae o ka maʻi ʻaʻai kidney

Hōʻike ʻia ka maʻi ʻaʻai kidney ma nā pae i hoʻomohala ʻia e ke Kōmike Hui Hui ʻAmelika no ka maʻi ʻaʻai. ʻOi aku ka ʻike o ka ʻōnaehana ʻo ia ka ʻōnaehana TNM.

• “T” pili i ka tumo. Hāʻawi nā kauka i kahi "T" me kahi helu e pili ana i ka nui a me ka ulu ʻana o ka tumo.
• “N” wehewehe inā ua pālahalaha ka maʻi ʻaʻai i nā aka i ka ʻōnaehana lymph.
• “M” ʻo ia hoʻi, ua metastasized ka maʻi ʻaʻai.

Ma muli o nā ʻano ma luna, hāʻawi nā kauka iā RCC i kahi pae. Hoʻokumu ʻia ke kahua ma ka nui o ka tumo a me ka hoʻolaha ʻana o ka maʻi ʻaʻai.

ʻEhā hanana:

• Nā pae 1 a me 2 ho'ākāka i nā maʻi 'aʻai kahi o ka tumo i loko o ka puʻupaʻa. ʻO ka pae 2 ʻoi aku ka nui o ka tumo ma mua o ʻehiku mau kenimika ma ʻō.
• Nā Papa 3 a me 4 ʻo ia hoʻi ua pāhola ʻia ka maʻi ʻaʻai i loko o kahi aa nui a i ʻole nā ​​mea kokoke a i ʻole nā ​​lymph node.
• Kahua 4 ʻo ia ke ʻano ʻoi loa o ka maʻi. ʻO ka pae 4 ʻo ia ka hoʻolaha ʻana o ka maʻi ʻaʻai i ka momona adrenal a i ʻole hoʻolaha ʻia i nā lymph node mamao a i ʻole nā ​​mea ʻē aʻe. Ma muli o ka hoʻopili ʻana o ka ʻaihue adrenal i ka puʻupaʻa, hoʻolaha pinepine ka maʻi ʻaʻai ma mua.

He aha ke kuanaʻike?

Hoʻokumu ʻia nā helu ola he ʻelima mau makahiki no ka maʻi ʻaʻai kidney ma ka pākēneka o ka poʻe e noho ma kahi o 5 mau makahiki me ka maʻi ma hope o ka ʻike ʻia.

Hōʻike ka American Cancer Society (ACS) i ka pākēneka o ka poʻe e noho ana he 5 mau makahiki a ʻoi paha ma hope o ka hōʻoia ʻana e like me ʻekolu mau pae e pili ana i ka ʻike mai ka National Cancer Institute.

ʻO kēia mau pae:

• kūloko (ʻaʻole pālahalaha ka maʻi ʻaʻai ma ʻō aku o ke kōhune)
• āpana (ua pālahalaha ka maʻi ʻaʻai ma kahi kokoke)
• mamao (ua pālahalaha ka maʻi ʻaʻai i nā ʻāpana mamao o ke kino)

Wahi a ka ACS, nā helu ola RCC ma muli o kēia mau pae ʻekolu.

• kūloko 93 pakeneka
• āpana: 70 pakeneka
• mamao: 12 pakeneka

He aha nā koho lapaʻau?

ʻO ke ʻano o ka lapaʻau e loaʻa iā ʻoe ma ka pae o kou maʻi ʻaʻai. Mālama ʻia ka pae 1 RCC me ke kahakaha.

Eia nō naʻe, i ka manawa i neʻe ai ka maʻi ʻaʻai i ka pae 4, ʻaʻole paha he koho ke ʻoki.

Inā hiki ke kaʻawale ka tumo a me ka metastasis, he hiki ke lawe ʻia i ka lāʻau ʻoki kino a me / a i ʻole ka mālama ʻana i ka tumo metastatic ma o ka hemo ʻana a i ʻole nā ​​kaʻina hana ʻē aʻe e like me ka stereotactic body radiation therapy a i ʻole hoʻopau abatic.

Inā loaʻa iā ʻoe ka pae 4 RCC, e noʻonoʻo kāu kauka i ka wahi a me ka hoʻolaha ʻana o kāu maʻi ʻaʻai a me kou olakino holoʻokoʻa e hoʻoholo ai i kāu kuleana no ke ʻoki.

Inā ʻaʻole kahi ʻoki kūpono kahi koho kūpono e mālama ai i ka pae 4 RCC, hiki i kāu kauka ke koi aku i nā ʻōnaehana ʻōnaehana me ka hoʻohana ʻana i kahi hui o nā lāʻau.

ʻO kahi laʻana o kou tumelo, i kapa ʻia he biopsy, i kiʻi ʻia e kōkua i ka hoʻoholo ʻana i ka lāʻau ʻoi loa no kāu ʻano maʻi ʻaʻai. Pili paha ka hoʻomaʻamaʻa inā loaʻa iā ʻoe kahi hunaola a kiko ʻole o ka RCC pūnaewele.

Hiki ke hoʻohana ʻia i ka lāʻau i hoʻomākaukau ʻia a me ka immunotherapy, e like me nā kaohi tyrosine kinase a me nā anti-PD-1 monoclonal antibodies, e mālama ai i ka pae 4 RCC. Hāʻawi ʻia kahi lāʻau kūikawā a i ʻole i ka hui pū ʻana me kekahi lāʻau ʻē aʻe.

Hiki i nā mālama ke hoʻopili:

• axitinib + pembrolizumab
• pazopanib
• sunitinib
• ipilimumab + nivolumab
• cabozantinib

Loaʻa nā lapaʻau hou ma o nā hoʻokolohua hoʻokolohua. Hiki iā ʻoe ke kūkākūkā i ke koho o ke kākau inoa ʻana i loko me kahi kauka.

Hiki paha i kāu kauka ke koi aku i nā hana kākoʻo e kōkua me nā hopena a i ʻole nā ​​hōʻailona.

ʻO ka lawe lawe ʻana

Inā ua loiloi ʻia ʻoe me ka pae 4 RCC, e hoʻomanaʻo e pili ana nā helu ola i paʻi ʻia.

Aia i kāu wānana ponoʻī ma kāu ʻano kikoʻī o ka maʻi ʻaʻai a pehea ka lōʻihi i mua, pane i nā mālama ʻana, a me kou olakino holoʻokoʻa.

ʻO ke kī i:

• hāhai i ka ʻōlelo aʻoaʻo a kāu kauka
• e hele i kāu mau manawa i koho ai
• lawe i kāu mau lāʻau

Eia kekahi, e mālama pono me nā ʻōlelo aʻoaʻo a i ʻole nā ​​loli nohona e hoʻoponopono ai i nā hopena a me nā ʻōuli. Hiki i kēia ke kōkua i ke olakino olakino holoʻokoʻa ke hele nei ʻoe i loko o ka lāʻau.