Maʻi Carcinoid

Hōʻike mai ka maʻi carcinoid ke hoʻokuʻu mai kahi ʻano maʻi kanesa liʻiliʻi i kapa ʻia ʻo ka maʻi carcinoid i kekahi mau kemika i loko o kou kahe koko, e hoʻoulu ai i nā ʻano hōʻailona a me nā hōʻailona like ʻole. ʻO ka maʻi carcinoid, ʻo ia kekahi ʻano o ka maʻi neuroendocrine, e loaʻa pinepine ana ma ka ʻōnaehana digestive a i ʻole nā ​​māmā.

ʻO ka maʻi carcinoid maʻamau e loaʻa i nā kānaka i loaʻa i nā maʻi carcinoid i holomua. ʻO ka mālama ʻana i ka maʻi carcinoid e pili pinepine ana i ka mālama ʻana i ka maʻi kanesa. Eia naʻe, ma muli o ka nui o nā maʻi carcinoid ʻaʻole e hoʻoulu i ka maʻi carcinoid a hiki i ka holomua ʻana, ʻaʻole paha e hiki ke ho'ōla. Hiki ke kuhikuhi ʻia nā lāʻau lapaʻau e hoʻomaha i kāu mau hōʻailona maʻi carcinoid a hoʻoluʻolu iā ʻoe.

ʻO nā hōʻailona a me nā hōʻailona o ka maʻi carcinoid e hilinaʻi ana i nā kemika a ka pōʻino carcinoid e hoʻokuʻu ai i loko o kou kahe koko.

ʻO nā hōʻailona a me nā hōʻailona maʻamau loa:

• ʻĀʻīʻili o ka ʻili. E ʻoluʻolu a loli ke kala o ka ʻili ma kou maka a me kou umauma luna — mai ka poni a i ka ʻulaʻula. Hiki i nā manawa ʻāʻīʻili ke lōʻihi mai kekahi mau minuke a i kekahi mau hola a ʻoi aku paha.

Hiki paha ke ʻāʻīʻili me ke kumu ʻike ʻole ʻia, ʻoiai i kekahi manawa hiki ke hoʻonāukiuki ʻia e ke kaumaha, ka hoʻoikaika kino a i ʻole ka inu ʻawaʻawa.

• Nā ʻeha o ka ʻili o ka maka. Hiki ke ʻike ʻia nā wahi ʻulaʻula o nā veins spiderlike ma kou ihu a me kou lehelehe luna.
• ʻO ka luaʻi. Hiki ke loaʻa i nā kānaka i loaʻa ka maʻi carcinoid ka luaʻi pinepine, nā wai wai, i kekahi manawa me nā ʻeha ʻōpū.
• Paʻakikī o ka hanu. Hiki ke loaʻa nā hōʻailona a me nā hōʻailona like me ka maʻi hanu, e like me ka wheezing a me ka pōkole o ka hanu, i ka manawa like āu e ʻike ai i ka ʻāʻīʻili o ka ʻili.
• ʻO ka wikiwiki o ka naʻau. Hiki i nā manawa o ka wikiwiki o ka naʻau ke hōʻailona o ka maʻi carcinoid.

E hoʻokaʻaʻike i kāu kauka inā loaʻa iā ʻoe nā hōʻailona a me nā ʻōuli e hopohopo nei iā ʻoe.

Hoʻokumu ʻia ka maʻi carcinoid e kahi ʻōpū carcinoid e hoʻopuka ana i ka serotonin a i ʻole nā kemika ʻē aʻe i loko o kou kahe koko. Hoʻomaka pinepine nā ʻōpū carcinoid ma ka ʻōnaehana digestive, me kou ʻōpū, nā ʻōpū liʻiliʻi, ka appendix, ka colon a me ka rectum.

He hapa liʻiliʻi wale nō o nā ʻōpū carcinoid e hoʻopuka ana i nā kemika e hoʻokumu ai i ka maʻi carcinoid. I ka wā e hoʻopuka ai kēia mau ʻōpū i nā kemika, hoʻoneʻe maʻamau ka ate i nā kemika ma mua o ka hiki ʻana iā lākou ke hele ma kou kino a hoʻokumu i nā hōʻailona.

Eia naʻe, i ka wā e pālahalaha ai kahi ʻōpū holomua (metastasizes) i ka ate ponoʻī, hiki iā ia ke hoʻopuka i nā kemika i hoʻoneʻe ʻole ʻia ma mua o ka hiki ʻana i ke kahe koko. ʻO ka hapanui o nā kānaka e ʻike i ka maʻi carcinoid he kanesa holomua i pālahalaha i ka ate.

ʻAʻole pono nā ʻōpū carcinoid ke holomua e hoʻokumu i ka maʻi carcinoid. No ka laʻana, nā ʻōpū carcinoid o ka māmā e hoʻopuka ana i nā kemika i loko o ke koko e hana pēlā ma kahi mamao aku mai ka ate, ʻaʻole hiki i ka ate ke hoʻomaʻemaʻe a kāpae i nā kemika.

Ma kekahi ʻaoʻao, nā ʻōpū carcinoid ma ka ʻōpū, e hoʻopuka ana i nā kemika i loko o ke koko e pono e hele mua ma ka ate ma mua o ka hiki ʻana i ke koena o ke kino. Hoʻoneʻe maʻamau ka ate i nā kemika ma mua o ka hiki ʻana iā lākou ke hoʻopili i ke koena o ke kino.

ʻAʻole maopopo ka mea e hoʻokumu ai i nā ʻōpū carcinoid.

Hiki i ka maʻi carcinoid ke kumu i kēia mau pilikia:

• Ka maʻi naʻau carcinoid. Loaʻa i kekahi poʻe me ka maʻi carcinoid ka maʻi naʻau carcinoid. Hoʻopilikia ka maʻi carcinoid i nā valve naʻau, e paʻakikī ai kā lākou hana pono ʻana. No laila, hiki ke leaka nā valve naʻau.

ʻO nā hōʻailona a me nā hōʻailona o ka maʻi naʻau carcinoid, ʻo ia ka luhi a me ka hanu ʻole. Hiki i ka maʻi naʻau carcinoid ke alakaʻi i ka hāʻule ʻana o ka naʻau. Hiki ke lilo ka hoʻoponopono ʻana i nā valve naʻau i hōʻino ʻia i kahi koho.

• Ka pilikia carcinoid. Hoʻokumu ka pilikia carcinoid i kahi manawa nui o ka ʻulaʻula, ka haʻahaʻa o ke koko, ka huikau a me ka pilikia o ka hanu. Hiki ke loaʻa ka pilikia carcinoid i nā poʻe me nā ʻōpū carcinoid i ka wā e hōʻike ʻia ai lākou i kekahi mau mea hoʻonāukiuki, me ka anesthetic i hoʻohana ʻia i ka wā o ka ʻoki kino. Hiki i ka pilikia carcinoid ke make. Hiki i kāu kauka ke hāʻawi iā ʻoe i nā lāʻau ma mua o ka ʻoki kino e hoʻemi i ka pilikia o ka pilikia carcinoid.

E loiloi kāu kauka i kāu mau hōʻailona a me nā hōʻailona e kāpae i nā kumu ʻē aʻe o ka ʻulaʻula ʻili a me ka luaʻi. Inā ʻaʻohe kumu ʻē aʻe i loaʻa, hiki i kāu kauka ke kānalua i ka maʻi carcinoid.

No ka hōʻoia ʻana i kahi ʻike, hiki i kāu kauka ke ʻōlelo aku i nā hoʻokolohua hou aku, e komo pū ana:

Kahi scope a i ʻole kamera e ʻike i loko o kou kino. Hiki i kāu kauka ke hoʻohana i kahi paipu lōʻihi, lahilahi i hoʻolako ʻia me kahi lense a i ʻole kamera e nānā i nā wahi i loko o kou kino.

Hiki i kahi endoscopy, kahi e komo pū ai ka hoʻohana ʻana i kahi scope i lalo i kou puʻu, ke kōkua i kāu kauka e ʻike i loko o kou gastrointestinal tract. Hiki i kahi bronchoscopy, kahi e hoʻohana ai i kahi scope i hoʻohana ʻia i lalo i kou puʻu a komo i loko o kou mau māmā, ke kōkua i ka loaʻa ʻana o nā tumors carcinoid māmā. Hiki i ka hoʻohana ʻana i kahi scope ma o kou rectum (colonoscopy) ke kōkua i ka ʻike ʻana i nā tumors carcinoid rectal.

• Hoʻokolohua mimi. Hiki i kāu mimi ke loaʻa i kahi mea i hana ʻia i ka wā e wāwahi ai kou kino i ka serotonin. Hiki i ka nui o kēia mea ke hōʻike i ka hana ʻana o kou kino i ka serotonin hou aku, ʻo ia ka kemika i hoʻopuka pinepine ʻia e nā tumors carcinoid.

• Hoʻokolohua koko. Hiki i kou koko ke loaʻa i nā kiʻekiʻe o kekahi mau mea i hoʻokuʻu ʻia e kekahi mau tumors carcinoid.

• Nā hoʻokolohua kiʻi. Hiki ke hoʻohana ʻia nā hoʻokolohua kiʻi e ʻimi i ka tumor carcinoid mua a hoʻoholo inā ua pālahalaha. Hiki i kāu kauka ke hoʻomaka me kahi computed tomography (CT) scan o kou ʻōpū, no ka mea, ʻike pinepine ʻia nā tumors carcinoid ma ka gastrointestinal tract. Hiki i nā scans ʻē aʻe, e like me ka Magnetic resonance imaging (MRI) a i ʻole nā ​​scan lāʻau nuklea, ke kōkua i kekahi mau kūlana.

• Kahi scope a i ʻole kamera e ʻike i loko o kou kino. Hiki i kāu kauka ke hoʻohana i kahi paipu lōʻihi, lahilahi i hoʻolako ʻia me kahi lense a i ʻole kamera e nānā i nā wahi i loko o kou kino.

  Hiki i kahi endoscopy, kahi e komo pū ai ka hoʻohana ʻana i kahi scope i lalo i kou puʻu, ke kōkua i kāu kauka e ʻike i loko o kou gastrointestinal tract. Hiki i kahi bronchoscopy, kahi e hoʻohana ai i kahi scope i hoʻohana ʻia i lalo i kou puʻu a komo i loko o kou mau māmā, ke kōkua i ka loaʻa ʻana o nā tumors carcinoid māmā. Hiki i ka hoʻohana ʻana i kahi scope ma o kou rectum (colonoscopy) ke kōkua i ka ʻike ʻana i nā tumors carcinoid rectal.

• Ke wehe ʻana i ka ʻiʻo no ka hoʻokolohua labo. Hiki ke hōʻiliʻili ʻia kahi laʻana o ka ʻiʻo mai ka tumor (biopsy) e hōʻoia i kāu ʻike. ʻO ke ʻano o ka biopsy āu e hele ai e hilinaʻi ana i kahi o kāu tumor.

Ke mālama ʻana i ka maʻi carcinoid syndrome, e komo pū ana ka mālama ʻana i kāu maʻi kanesa, a hiki nō hoʻi ke hoʻohana i nā lāʻau lapaʻau e kaohi ai i kāu mau hōʻailona a me nā ʻōuli kūikawā.

Hiki i nā ʻano mālama ke komo pū me:

• ʻO ka ʻoki kino. Hiki paha ke koho ʻia ka ʻoki kino e wehe ai i kāu maʻi kanesa a i ʻole ka hapa nui o kāu maʻi kanesa.
• Nā lāʻau lapaʻau e pale ai i nā sela kanesa mai ka hoʻopuka ʻana i nā kemika. Hiki i ka hoʻopili ʻana i nā lāʻau lapaʻau ʻo octreotide (Sandostatin) a me lanreotide (Somatuline Depot) ke hoʻemi i nā hōʻailona a me nā ʻōuli o ka maʻi carcinoid syndrome, me ka ʻulaʻula ʻana o ka ʻili a me ka luaʻi. Hiki ke hoʻohui ʻia ka lāʻau i kapa ʻia ʻo telotristat (Xermelo) me kēia mau lāʻau e kaohi ai i ka luaʻi i hoʻokumu ʻia e ka maʻi carcinoid syndrome.
• Nā lāʻau lapaʻau e hoʻouna pololei ana i ka radiation i nā sela kanesa. Hoʻohui ka peptide receptor radionuclide therapy (PRRT) i kahi lāʻau lapaʻau e ʻimi ana i nā sela kanesa me kahi mea radioactive e pepehi ai iā lākou. I loko o ka peptide receptor radionuclide therapy (PRRT) no nā tumors carcinoid, e hoʻopili ʻia ka lāʻau lapaʻau i loko o kou kino, kahi e hele ai i nā sela kanesa, e hoʻopili i nā sela a hoʻouna pololei i ka radiation iā lākou. Hoʻohana ʻia kēia ʻano mālama i nā poʻe i loaʻa i ka maʻi kanesa holomua i pane ʻole i nā ʻano mālama ʻē aʻe.
• Ke kāohi ʻana i ka lako koko i nā tumors o ke akepaʻa. I loko o kahi kaʻina hana i kapa ʻia ʻo hepatic artery embolization, e hoʻokomo ka kauka i kahi catheter ma o kahi nila kokoke i kou ʻūhā a e kaula iā ia i ka artery nui e lawe ana i ke koko i kou akepaʻa (hepatic artery). E hoʻopili ka kauka i nā ʻāpana i hoʻolālā ʻia e pani i ka hepatic artery, e ʻoki ana i ka lako koko i nā sela kanesa i pālahalaha i ke akepaʻa. E ola nā sela akepaʻa olakino ma ka hilinaʻi ʻana i ke koko mai nā moku koko ʻē aʻe.
• Ke pepehi ʻana i nā sela kanesa i loko o ke akepaʻa me ka wela a i ʻole ke anu. Hoʻouna ka radiofrequency ablation i ka wela ma o kahi nila i nā sela kanesa i loko o ke akepaʻa, e hoʻokumu ana i ka make ʻana o nā sela. Hoʻohālikelike ʻia ka cryotherapy, akā hana ia ma ka hoʻoilo ʻana i ka tumor.
• Chemotherapy. Hoʻohana ka chemotherapy i nā lāʻau lapaʻau ikaika e pepehi ai i nā sela kanesa. Hiki ke hāʻawi ʻia nā lāʻau lapaʻau chemotherapy ma o kahi vein (intravenously) a i ʻole ma ke ʻano o nā papa, a i ʻole hiki ke hoʻohana ʻia nā ʻano ʻelua.