Nā Pae Kanaka ʻili: He aha ka manaʻo?

Anter

• He aha e ʻike ai e pili ana i nā pae maʻi ʻaʻai
• ʻO nā pae o ka maʻi ʻaʻai ʻeleʻele Basal a me squamous
• Nā koho lapaʻau
• Nā pae Melanoma
• Hoʻomaʻo Melanoma
• Ke laina lalo

Hōʻike nā pae maʻi ʻaʻai i ka nui o ka tumo mua a pehea ka laha ʻana o ka maʻi ʻaʻai mai kahi i hoʻomaka ai. Aia nā ʻōkuhi hoʻonohonoho like ʻole no nā ʻano maʻi ʻaʻai.

Hāʻawi ka hoʻonohonoho i kahi nānā o ka mea e manaʻo ai. E hoʻohana kāu kauka i kēia ʻike e noʻonoʻo me kahi hoʻolālā lapaʻau maikaʻi loa nāu.

I kēia ʻatikala, e nānā hohonu mākou i ka hoʻokumu ʻia ʻana o ka cell basal cell, ka cell squamous, a me nā maʻi ʻili melanoma.

He aha e ʻike ai e pili ana i nā pae maʻi ʻaʻai

ʻO ka maʻi ʻaʻai ka maʻi e hoʻomaka i hoʻokahi wahi liʻiliʻi o ke kino, e like me ka ʻili. Inā mālama ʻole ʻia i ka wanaʻao, e pālahalaha paha ia i nā ʻāpana ʻē aʻe o ke kino.

Hoʻohana nā kauka i ka ʻike e hoʻomaopopo:

• ehia nā maʻi ʻaʻai i ke kino o ke kanaka
• kahi o ka maʻi ʻaʻai
• inā ua pālahalaha ka maʻi ʻaʻai ma ʻō aku o kahi i hoʻomaka ai
• pehea e mālama ai i ka maʻi ʻaʻai
• he aha ka kuanaʻike a wānana paha

ʻOiai ʻokoʻa ka maʻi ʻaʻai no nā mea āpau, mālama pinepine ʻia nā kanesa me ka pae like i ke ala like a loaʻa pinepine i nā hiʻohiʻona like.

Hoʻohana nā kauka i kahi mea hana i ʻike ʻia ʻo ka ʻōnaehana hoʻonohonoho TNM e hoʻokumu i nā ʻano maʻi ʻaʻai like ʻole. Pili kēia ʻōnaehana hoʻonohonoho kanesa i nā helu ʻekolu o ka ʻike:

• T:tka nui umor a pehea ka hohonu o kona ulu ʻana i loko o ka ʻili
• N: lymph nkomo ʻaʻano
• M:metastasis a i ʻole inā pālahalaha ka maʻi ʻaʻai

Hoʻonohonoho ʻia nā maʻi ʻili mai ka 0 a i ka 4. Ma ke ʻano he rula maʻamau, ʻo ka hoʻohaʻahaʻa ʻia o ka helu hoʻonohonoho, ʻo ka liʻiliʻi o ka laha ʻana o ka maʻi ʻaʻai.

ʻO kahi laʻana, ke kahua 0, a i ʻole ke kinikona ma situ, ʻo ia hoʻi nā pūnaewele ʻino ʻole, hiki ke lilo i maʻi ʻaʻai. Akā mau kēia mau huna i nā hunaola kahi i hana mua ai. ʻAʻole lākou i ulu i kahi kiko kokoke a hoʻolaha paha i nā wahi ʻē aʻe.

ʻO ke kahua 4, ma ka ʻaoʻao ʻē aʻe, ʻo ia ka mea kiʻekiʻe loa. I kēia wā, ua pālahalaha ka maʻi ʻaʻai i nā mea ʻē aʻe a i ʻole nā ​​ʻāpana o ke kino.

ʻO nā pae o ka maʻi ʻaʻai ʻeleʻele Basal a me squamous

ʻAʻole pono ka hoʻonohonoho ʻana no ka maʻi ʻaʻai ʻeleʻele basal. ʻO ia no ka mea mālama pinepine ʻia kēia mau maʻi ʻōpala ma mua o ka hoʻolaha ʻana i nā wahi ʻē aʻe.

ʻOi aku ka nui o ka hiki o ka palahalaha ʻana o nā maʻi ʻaʻai ʻāpuni squamous, ʻoiai ʻo ka haʻahaʻa ka haʻahaʻa.

Me kēia ʻano maʻi ʻili ʻili, hiki i kekahi mau hiʻohiʻona ke hoʻonui a hoʻi paha i nā hunaola maʻi ʻino ke hoʻoneʻe ʻia. ʻO kēia mau hiʻohiʻona hiʻohiʻona kiʻekiʻe:

• he carcinoma (nā maʻi ʻaʻai maʻi) ʻoi aku ka mānoanoa ma mua o 2 mm (millimeter)
• komo i loko o nā aʻalolo i ka ʻili
• hoʻouka i nā papa o lalo o ka ʻili
• kahi ma ka lehelehe a pepeiao paha

Hoʻonohonoho ʻia nā kinikini ʻili squamous a me nā ʻili basal e like me kēia:

• Kahua 0: Aia nā hunaola maʻi maʻi i ka papa luna o ka ʻili (epidermis) a ʻaʻole i hohola hohonu i ka ʻili.
• Kahua 1: ʻO ka tumo he 2 cm (kenimika) a ʻoi iki paha, ʻaʻole pālahalaha i nā lymph node kokoke, a he hoʻokahi a ʻoi aku paha nā hiʻohiʻona kiʻekiʻe o ka makaʻu.
• Kahua 2: ʻO ka tumo he 2 a 4 cm, ʻaʻole pālahalaha i nā lymph node kokoke, a i ʻole he nui ka tumo a ʻelua a ʻoi paha mau hiʻohiʻona kiʻekiʻe.
• Kahua 3: ʻOi aku ka tumo ma mua o 4 cm, a i ʻole ua pālahalaha ʻia i kekahi o kēia mau mea:
  • subcutaneousʻaʻaʻa, ʻo ia ka hohonu, ka hohonu o ka ʻili i hoʻopili ʻia me nā kīʻaha koko, nā hopena nerve, a me nā follicle o ka lauoho.
  • iwi, kahi i hoʻopilikia iki ai
  • he wahi lymph kokoke
• Kahua 4: Hiki ke like ka nui o ka tumo a ua pālahalaha ʻia i:
  • hoʻokahi aʻoi aku paha nā lymph node, ʻoi aku ka nui ma mua o 3 cm
  • iwi a iwi ʻōiwi
  • nā lālā ʻē aʻe i ke kino

Nā koho lapaʻau

Inā hopu koke ʻia ka cell squamous a i ʻole ka maʻi ʻaʻa basal, hiki ke mālama ʻia. Hoʻohana pinepine ʻia nā ʻoki lāʻau ʻokoʻa e wehe i nā hunaola maʻi ʻino.

Hana pinepine ʻia kēia mau kaʻina hana i ke keʻena o ke kauka a i ʻole ke keʻena maʻi ma waho o ka anesthesia kūloko. ʻO kēia ke ala ʻana ʻoe, a ʻo ka wahi e puni ana i ka maʻi ʻaʻai o ka ʻili e pau i ka ihu. ʻO ke ʻano o nā kaʻina hana ʻokiʻoki e pili ana i:

• ke ʻano o ka maʻi ʻaʻai ʻili
• ka nui o ka maʻi ʻaʻai
• kahi o ka maʻi ʻaʻai

Inā ua pālahalaha nui ka maʻi ʻaʻai i loko o ka ʻili a i ʻoi aku paha ka nui o ka makaʻi o ka hoʻolaha ʻana, pono paha nā lāʻau ʻē aʻe ma hope o ke kaha ʻana, e like me radiation a chemotherapy.

ʻO kekahi o nā koho lapaʻau maʻamau no ka cell basal a i ʻole nā ​​maʻi ʻili squamous cell e komo pū me kēia:

• Excision: Me ka excision, e hoʻohana kāu kauka i kahi pahi kahi ʻoi loa a i ʻole ka scalpel e wehe i nā kiko maʻi ʻaʻai a me kekahi o nā mea olakino e hoʻopuni iā ​​ia. E hoʻouna ʻia ke kele i lawe ʻia i kahi keʻena hoʻokolohua no ka loiloi.
• Uila: ʻIke ʻia hoʻi me ka curettage a me ka electrodesiccation, kūpono kēia hana i ka maʻi ʻaʻai ʻili ma ka piko o ka ʻili. E hoʻohana kāu kauka i kahi mea hana kūikawā i kapa ʻia ʻo curette e lawe i ka maʻi ʻaʻai. Puhi ʻia ka ʻili me ka uila i mea e luku ai i nā maʻi ʻaʻai i koe. Hoʻomaʻamaʻa pinepine ʻia kēia hana i nā manawa ʻelua i ka manawa o ke kipa keʻena like e hōʻoia i ka hemo ʻana o ka maʻi ʻaʻai.
• ʻOki kino Mohs: Me kēia kaʻina hana, hoʻohana kāu kauka i kahi scalpel e wehe pono i ka ʻili kūpono ʻole i nā papa ākea a me kekahi o nā mea a puni. Nānā ʻia ka ʻili ma lalo o kahi microscope ke lawe ʻia. Inā loaʻa nā hunaola maʻi ʻaʻai, wehe koke ʻia kahi ʻili o ka ʻili a hiki i ka ʻike hou ʻole ʻia ʻana o nā hunaola maʻi ʻino.
• Kahikina: Me ka cryosurgery, hoʻohana ʻia ka nitrogen wai e hoʻokuʻu a hoʻopau i nā mea maʻi maʻi. Hoʻomaʻa hou ʻia kēia hana i nā manawa he nui i ka wā o ke kipa ʻo ke keʻena like e hōʻoia i ka luku ʻia ʻana o nā maʻi maʻi maʻi āpau.

Nā pae Melanoma

ʻOiai ʻoi aku ka liʻiliʻi o ka melanoma ma mua o ka cell basal a i ʻole nā ​​maʻi ʻili squamous cell, ʻoi aku ka ikaika. ʻO ka manaʻo o ia mea he ʻoi aku paha ia e palahalaha aku i nā aʻa kokoke, nā lymph node, a me nā ʻāpana ʻē aʻe o ke kino, ke hoʻohālikelike ʻia me nā maʻi ʻili nonmelanoma.

Hana ʻia ʻo Melanoma penei:

• Kahua 0: Aia wale nā ​​hunaola maʻi ʻaʻai i ka papa o waho loa o ka ʻili a ʻaʻole i hoʻouka i kahi kiko kokoke. I kēia pae noninvasive, hiki ke wehe ʻia ka maʻi ʻaʻai e ka ʻoki wale nō.
• Kahua 1A: ʻAʻoleʻoi aku ka mānoanoa o ka tumo ma mua o 1 mm o ka mānoanoa. ʻAʻole hiki iā ia ke ulcerated a i ʻole (kahi haki i ka ʻili e ʻae ai i nā kiko i lalo e hōʻike ma o).
• Kahua 1B: ʻO 1 ka 2 mm o ka mānoanoa o ka tumor, a ʻaʻohe ulceration.
• Kahua 2A: ʻO ka Tumor he 1 a 2 mm ka mānoanoa a ulcerated, a i ʻole 2 a 4 mm a ʻaʻole ulcerated.
• Kahua 2B: ʻO ka tumor he 2 a 4 mm ka mānoanoa a ulcerated, a i ʻole ʻoi aku ma mua o 4 mm a ʻaʻole ulcerated.
• Kahua 2C: ʻOi aku ka nui o ka tumor ma mua o 4 mm o ka mānoanoa a me ka ulcerated.
• Kahua 3A: ʻAʻoleʻoi aku ka mānoanoa o ka tumor ma mua o 1 mm a aia ka ulceration, a i ʻole 1 a 2 mm a ʻaʻole ulcerated. ʻIke ʻia ka maʻi ʻaʻai ma 1 a 3 sentinel lymph node.
• Kahua 3B: Aia ka tumo i 2 mm o ka mānoanoa me ka ulceration, a i ʻole 2 a 4mm me ka ʻole o ka ulceration, a ʻo ka maʻi ʻaʻai aia i kekahi o kēia:
  • hoʻokahi a ʻekolu paha lymph node
  • i nā hui liʻiliʻi o nā hunaola tumola, i kapa ʻia he tumors microsatelit, ma ka ʻaoʻao pono o ka tumo mua
  • i nā hui liʻiliʻi o nā hunaola tumo ma waena o 2 knm o ka tumo mua, i kapa ʻia he mau ukali ukali
  • i nā pūnaewele i pālahalaha ʻia i nā moku lymph kokoke, i ʻike ʻia ma ke ʻano he metastases in-transit
• Kahua 3C: Aia ka tumo i 4 mm o ka mānoanoa me ka ulceration, a i ʻole 4 mm a ʻoi aku ka nui me ka ʻole o ka ulceration, a ʻo ka maʻi ʻaʻai aia i kekahi o kēia:
  • ʻelua a ʻekolu paha lymph node
  • hoʻokahi a ʻoi mau kikoʻī, a eia kekahi aia nā microsatelit tumors, satellite tumors, a i ʻole transastures metastases
  • ʻehā a ʻoi mau kikoʻī a i ʻole kekahi helu o nā helu i hoʻopili ʻia
• Kahua 3D: ʻOi aku ka mānoanoa o ka tumor ma mua o 4 mm a ua ulcerated. Loaʻa nā hunaola maʻi ʻaʻai i kekahi o kēia mau wahi.
  • ʻehā a ʻoi paha mau lymph node a i ʻole kekahi mau helu i hoʻopili ʻia
  • ʻelua a ʻoi mau kikoʻī a i ʻole kekahi mau helu i hoʻopili ʻia, a ʻoi pū me nā tumo microsatelit, nā tumele ukali, a i ʻole nā ​​metastases i lawe ʻia
• Kahua 4: Ua pālahalaha ka maʻi ʻaʻai i nā ʻāpana mamao o ke kino. Pākuʻi paha kēia i nā lymph node a i ʻole nā ​​ʻokena e like me ke ake, nā akemāmā, ka iwi, ka lolo, a me nā wahi digestive

Hoʻomaʻo Melanoma

No ka melanoma, kaukaʻi e kaukaʻi ʻia i ka pae a me kahi o ka ulu maʻi ʻaʻai. Eia nō naʻe, hoʻoholo pū kekahi i nā kumu ʻē aʻe i ke ʻano o ka lāʻau e hoʻohana ai.

• Kahua 0 a me 1: Inā ʻike wawe ʻia ka melanoma, ʻo ka wehe ʻana o ka tumo a me nā mea a puni e like me ka mea maʻamau. Paipai ʻia ka nānā ʻana i ka ʻili maʻamau e hōʻoia ʻole i ka ulu ʻana o ka maʻi ʻaʻai hou.
• Kahua 2: Lawe ʻia ka melanoma a me nā a puni e ʻoki ai.Hiki paha i kāu kauka ke koi aku i kahi biopsy lymph node sentinel e hōʻoia i ka palahalaha ʻole o ka maʻi ʻaʻai i nā lymph node kokoke. Inā ʻike ka biopsy lymph node biopsy cancer cells, hiki i kāu kauka ke koi aku i ka wehe ʻana o nā lymph node ma kēlā wahi. ʻIke ʻia kēia ma ke ʻano he lymph node dissection.
• Kahua 3: E hoʻoneʻe ʻia ka melanoma me kahi nui o nā mea a puni. Ma muli o ka palahalaha ʻana o ka maʻi ʻaʻai i nā lymph node e kēia pae, e hoʻopili pū ʻia ka lapaʻau me ka dissection lymph node. Ma hope o ke kaha ʻana, e paipai ʻia nā lāʻau hou. Pākuʻi ʻia lākou:
  • nā lāʻau immunotherapy e kōkua i ka hoʻonui ʻana i ka pane o kāu ʻōnaehana immune i ke kanesa
  • nā lāʻau lapaʻau e hoʻomoe ʻia e pale i kekahi mau protein, nā ʻenemika, a me nā mea ʻē aʻe e kōkua i ka ulu ʻana o ka maʻi ʻaʻai
  • ka radiation radiation e kia ana ma nā wahi kahi i lawe ʻia ai nā lymph node
  • ka chemotherapy kaʻawale, kahi e hoʻopili ai i kahi o kahi i loaʻa ai ka maʻi ʻaʻai
• Kahua 4: Hoʻomaopopo pinepine ʻia ka wehe ʻana o ka tumo a me nā lymph node. Ma muli o ka palahalaha ʻana o ka maʻi ʻaʻai i nā lālā mamao, e hoʻopili ʻia ka lapaʻau ʻana i hoʻokahi a ʻoi paha o kēia mau mea.
  • nā lāʻau immunotherapy i kapa ʻia he checkpoint inhibitors
  • lāʻau lapaʻau hoʻomālama ʻia
  • chemotherapy

Ke laina lalo

Hiki i nā pae o ka maʻi ʻaʻai ʻili ke haʻi nui iā ʻoe e pili ana i ka holo ʻana o ka maʻi. E noʻonoʻo kāu kauka i ke ʻano kikoʻī o ka maʻi ʻaʻai ʻili a me ke kahua e hoʻoholo ai i ka lāʻau kūpono no ʻoe.

Hoʻomaopopo ka ʻike mua ʻana a me ka mālama ʻana i ka nānā maikaʻi loa. Inā pilikia nui ʻoe no ka maʻi ʻaʻai ʻili a i ʻole ʻike i kahi mea maʻamau ʻole i kou ʻili, e hoʻonohonoho i kahi kānana maʻi ʻili i ka wā hiki loa.