He aha ka Rhabdomyosarcoma? Nā Hōʻailona, Nā Kumu, a me ka Lapaʻau

He aha ka Rhabdomyosarcoma?

ʻO ka rhabdomyosarcoma kahi ʻano kanesa e ulu ana i nā ʻiʻo palupalu o kou kino, ʻoi aku hoʻi i nā ʻiʻo ʻiʻo. ʻO ia ka kanesa ʻiʻo palupalu maʻamau loa i nā keiki a me nā ʻōpio, ʻoiai hiki ke pā i nā mākua kekahi manawa.

E hana ana kēia kanesa i ka wā e hoʻomaka ai nā cell e ulu i ka ʻiʻo iwi e ulu ana ma waho o ke kaohi. E noʻonoʻo iā ia e like me nā cell kūkulu ʻiʻo o kou kino e loaʻa ana i kā lākou mau hōʻailona i hui ʻia a hoʻonui ʻia i ka wā ʻaʻole pono.

ʻOiai ʻo ka huaʻōlelo “sarcoma” paha he mea weliweli, ʻo ia wale nō ka manaʻo o kahi kanesa e hoʻomaka ana i nā ʻiʻo pili e like me ka ʻiʻo, ka iwi, a i ʻole ka momona. Hoʻopili kūikawā ka rhabdomyosarcoma i ke ʻano o ka ʻiʻo āu e hoʻohana ai e hoʻoneʻe i kou mau lima, nā wāwae, a me nā ʻāpana ʻē aʻe o ke kino.

ʻO ka ʻoiaʻiʻo maikaʻi, ua holomua nui nā koho lapaʻau i nā makahiki i hala. He nui nā kānaka me kēia kūlana e ola ana i nā ola olakino piha ma hope o ka lapaʻau.

He aha nā hōʻailona o ka Rhabdomyosarcoma?

ʻO nā hōʻailona āu e ʻike ai e hilinaʻi nui ana i kahi e ulu ai ka tumor i kou kino. ʻOiai hiki i kēia kanesa ke hana ma aneʻane i nā wahi a pau, hiki ke ʻokoʻa loa nā hōʻailona mai ke kanaka a i ke kanaka.

ʻO ka hōʻailona mua maʻamau kahi ʻāpana a i ʻole ka pehu e hiki ke ʻike ʻia ma lalo o ka ʻili. Hiki ke paʻa kēia puʻupuʻu a hiki paha ʻaʻole ʻeha ke pā aku ʻoe.

Eia nā hōʻailona āu e ʻike ai ma muli o kahi e ulu ai ka kanesa:

• Kahi ʻāpana i ʻike ʻia a i ʻike ʻia paha e ulu ana i ka manawa
• Pehu i nā lima, nā wāwae, a i ʻole nā ʻāpana ʻē aʻe o ke kino
• ʻEha a i ʻole ka palupalu i ka wahi i pā ʻia
• Paʻakikī e hoʻoneʻe i ka ʻāpana kino i pā ʻia ma ke ʻano maʻamau
• Nā ihu kahe a i ʻole ka congestion nasal (inā aia ma ka wahi poʻo)
• Nā pilikia maka e like me ka puʻupuʻu a i ʻole nā loli ʻike
• Paʻakikī e ʻai a i ʻole ka hanu (no nā tumors kokoke i ka ʻāʻī)
• Nā pilikia mimi a i ʻole nā ʻōpū (no nā tumors pelvic)
• Luhi weliweli ʻole a i ʻole ka pohō kaumaha

He mea nui e hoʻomanaʻo he nui o kēia mau hōʻailona hiki ke loaʻa nā kumu ʻē aʻe, ʻoi aku ka liʻiliʻi. Eia naʻe, pono ke kamaʻilio me kāu kauka i kēlā me kēia ʻāpana e ulu a mau no kahi mau pule.

He aha nā ʻano o ka Rhabdomyosarcoma?

Hoʻokaʻawale nā kauka i ka rhabdomyosarcoma i nā ʻano he nui ma muli o ke ʻano o nā cell kanesa ma lalo o ka microscope. Ke hoʻomaopopo ʻoe i kou ʻano kūikawā e kōkua i kāu hui lapaʻau e hoʻolālā i ke ala lapaʻau maikaʻi loa.

ʻO nā ʻano nui ʻelua āu e lohe ai ʻo ia ka embryonal a me ka alveolar rhabdomyosarcoma. ʻO kēlā me kēia e pili ana i nā hui makahiki a me nā wahi kino like ʻole.

Embryonal rhabdomyosarcoma ka ʻano maʻamau loa, e hana ana i kahi 60% o nā hihia a pau. Hoʻopili pinepine ia i nā keiki ʻōpio a ulu pinepine ma ke poʻo, ka ʻāʻī, a i ʻole ka wahi pelvic. Hoʻomaʻamaʻa maikaʻi kēia ʻano i ka lapaʻau.

Alveolar rhabdomyosarcoma e ulu pinepine ana i nā ʻōpio a me nā mākua ʻōpio. Hoʻopili pinepine ia i nā lima, nā wāwae, a i ʻole ka wahi kumu a hiki ke ʻoi aku ka ikaika ma mua o ke ʻano embryonal.

Aia kekahi mau ʻano ʻē aʻe, me ka pleomorphic rhabdomyosarcoma, ka mea e pili ana i nā mākua, a me ka spindle cell rhabdomyosarcoma, ka mea he mau hiʻohiʻona kūikawā ma lalo o ka microscope.

He aha ka mea e hoʻokumu ai i ka Rhabdomyosarcoma?

ʻO ka pane pololei, ʻaʻole maopopo i nā kauka i ka mea e hoʻokumu ai i ka rhabdomyosarcoma i ka hapa nui o nā hihia. E like me nā kanesa he nui, ʻo ia paha ka hopena o ka hui ʻana o nā mea e hoʻolilo ai i nā cell maʻamau i nā cell kanesa.

ʻO ka mea a mākou e ʻike ai, ʻo kēia kanesa e ulu ana i ka wā e hana ai nā loli genetic i nā cell e manaʻo ʻia e lilo i ʻiʻo ʻiʻo. Hoʻokumu kēia mau loli i nā cell e ulu a hoʻokaʻawale i ka manaʻo ʻole ma mua o ka hahai ʻana i kā lākou ʻano hoʻomohala maʻamau.

Ua hānau ʻia kekahi poʻe me nā kūlana genetic e hoʻonui i ko lākou pilikia, ʻoiai kēia e pili ana i kahi hapa liʻiliʻi wale nō o nā hihia. I ka hapa nui o ka manawa, nā loli genetic e alakaʻi ai i kēia kanesa e hana kūpono ʻole i ke ola o ke kanaka.

Ua pili nā mea pili i ke kaiapuni e like me ka hōʻike radiation i kekahi mau hihia, akā, hou, hōʻike kēia i kahi hapa liʻiliʻi loa o nā diagnoses rhabdomyosarcoma a pau. No ka hapa nui o nā ʻohana, ʻaʻohe mea a lākou i hana ai a i ʻole i hana ʻole ai i hoʻokumu ai i kēia kanesa.

I ka wā e ʻike ai i ke kauka no ka Rhabdomyosarcoma?

Pono ʻoe e hoʻokaʻaʻike i kāu kauka inā ʻike ʻoe i kekahi ʻāpana a i ʻole ka pehu ʻaʻole e hele i loko o ʻelua a ʻekolu pule. ʻOiai ʻo ka hapa nui o nā ʻāpana he mea ʻino ʻole, ʻoi aku ka maikaʻi o ka nānā ʻana iā lākou ma mua o ka hope.

E hoʻonohonoho i kahi hālāwai koke inā ʻike ʻoe i kahi ʻāpana e ulu ana, manaʻo ʻia paʻa a i ʻole paʻa i kahi, a i ʻole e hoʻokumu i ka ʻeha. ʻAʻole kēia mau hiʻohiʻona e manaʻo ai i ka kanesa, akā pono lākou i ka nānā ʻana i ka lāʻau lapaʻau.

ʻO nā hōʻailona ʻē aʻe e pono ai ke kāhea aku i kāu kauka e komo pū me nā hōʻailona mau e like me nā ihu kahe weliweli ʻole, nā loli ʻike, ka paʻakikī e ʻai, a i ʻole nā pilikia me ka mimi a i ʻole nā neʻe ʻōpū e mau ana ma mua o kekahi mau lā.

Inā ʻoe e ʻike ana i ka ʻeha nui, ka pehu wikiwiki, a i ʻole kekahi mau hōʻailona e hoʻopilikia ana i nā hana o kēlā me kēia lā, mai kali. E hilinaʻi i kou mau manaʻo - ʻoe ke ʻike maikaʻi loa i kou kino, a pono ke loiloi ʻia nā loli mau.

He aha nā mea pilikia no ka Rhabdomyosarcoma?

Hiki i ka hoʻomaopopo ʻana i nā mea pilikia ke kōkua i ka hoʻokomo ʻana i kēia kūlana i ka manaʻo, ʻoiai he mea nui e ʻike ʻaʻole ʻo ka loaʻa ʻana o nā mea pilikia e manaʻo ai e loaʻa nō ʻoe i ka kanesa. He nui nā kānaka me nā mea pilikia ʻaʻole loa e loaʻa i ka rhabdomyosarcoma, ʻoiai kekahi poʻe ʻaʻohe mea pilikia i ʻike ʻia.

ʻO ka makahiki ka mea pilikia nui loa āu e ʻike ai. Hana pinepine ʻia kēia kanesa i nā keiki, me kahi hapa o nā hihia a pau i ʻike ʻia ma mua o 10 mau makahiki. Aia kekahi piko liʻiliʻi i nā ʻōpio a me nā mākua ʻōpio.

Eia nā mea pilikia nui i ʻike ʻia e nā kauka:

• Makahiki (maʻamau loa i nā keiki ma lalo o 10 a me nā ʻōpio)
• Nā kūlana genetic e like me ka Li-Fraumeni syndrome
• Neurofibromatosis type 1
• Ka lapaʻau radiation mua
• Mōʻaukala ʻohana o kekahi mau kanesa
• Kekahi mau mutations genetic i hoʻoilina ʻia

He mea kūpono e hoʻomaopopo ʻaʻole ka hapa nui o nā keiki a me nā ʻōpio e loaʻa ana i ka rhabdomyosarcoma i nā mea pilikia i ʻike ʻia. Hōʻike pinepine ʻia kēia kanesa e ulu kūpono ʻole, ka mea hiki ke manaʻo ʻia he mea hoʻonāukiuki akā ʻo ia hoʻi ʻaʻohe mea i hiki ke hana ʻia e pale aku ai.

He aha nā pilikia hiki ke loaʻa i ka Rhabdomyosarcoma?

ʻOiai he mea maʻamau ke hopohopo e pili ana i nā pilikia, he mea kōkua ke hoʻomaopopo i ka mea hiki ke hana i hiki iā ʻoe ke hana pū me kāu hui lapaʻau e hoʻoponopono i nā pilikia e kū mai ana. Hiki ke hoʻokele ʻia ka hapa nui o nā pilikia me ka mālama lapaʻau kūpono.

ʻO nā pilikia āu e hālāwai ai e hilinaʻi nui ana i kahi o kāu kanesa a pehea ka pane ʻana i ka lapaʻau. Hoʻopili kekahi mau hopena pololei i ka tumor, ʻoiai kekahi mau mea hiki ke hopena mai ka lapaʻau ponoʻī.

Eia nā pilikia nui e makaʻala ai:

• Ka hoʻolaha kūloko i nā ʻiʻo a me nā kino kokoke
• Metastasis (hoʻolaha i nā ʻāpana mamao o ke kino)
• Nā pilikia hana i ka wahi i pā ʻia
• Nā hopena mai ka chemotherapy a i ʻole ka radiation
• Nā hopena lōʻihi ma ka ulu a me ka hoʻomohala (i nā keiki)
• Nā kanesa lua (ʻano maʻamau ʻole, akā hiki ke loaʻa ma hope o nā makahiki)
• Nā pilikia momona mai kekahi mau lapaʻau
• Nā pilikia naʻau a i ʻole nā māmā mai nā lāʻau kūikawā

ʻO ka lono hoʻoikaika, ʻo nā ala lapaʻau hou e hoʻoikaika e hoʻemi i kēia mau pilikia ʻoiai e mālama pono ana i ka kanesa. E nānā pono kāu hui lapaʻau iā ʻoe a hoʻoponopono i ka lapaʻau e like me ka pono e hoʻemi i nā pilikia.

Pehea ka hōʻoia ʻana o ka Rhabdomyosarcoma?

ʻO ka loaʻa ʻana o kahi hōʻoia pololei e komo pū me nā ʻanuʻu he nui, a e hoʻomaka paha kāu kauka me nā hoʻokolohua maʻalahi ma mua o ka neʻe ʻana i nā mea kūikawā. Hoʻolālā ʻia ke kaʻina hana e hōʻiliʻili i ka ʻike nui e pili ana i kou kūlana kūikawā.

E hoʻomaka kāu kauka me kahi nānā kino, e ʻike ana i nā ʻāpana a e nīnau ana e pili ana i kāu mau hōʻailona a me ka mōʻaukala lapaʻau. E kōkua kēia loiloi mua i ka alakaʻi ʻana i nā hoʻokolohua e pono ai ma hope.

ʻO ke kaʻina hana hōʻoia e komo pinepine pū me nā hoʻokolohua kiʻi e like me nā CT scans, MRI scans, a i ʻole nā ultrasounds e kiʻi i kahi kiʻi maopopo o ka nui a me ka wahi o ka tumor. He mea ʻoluʻolu kēia mau hoʻokolohua a kōkua i kāu hui lapaʻau e hoʻolālā i nā ʻanuʻu aʻe.

ʻAneʻane pono ka biopsy e hōʻoia i ka hōʻoia. I kēia kaʻina hana, e wehe ʻia kahi laʻana liʻiliʻi o ka ʻiʻo a e nānā ʻia ma lalo o ka microscope e kahi loea i kapa ʻia ʻo ka pathologist.

Hiki i nā hoʻokolohua hou ke komo pū me ka hana koko, nā hoʻokolohua iwi iwi, a i ʻole nā haʻawina kiʻi kūikawā e hoʻoholo ai inā ua pālahalaha ka kanesa i nā ʻāpana ʻē aʻe o kou kino. E kōkua kēia ʻike i kāu hui lapaʻau e hoʻomohala i ka papahana lapaʻau kūpono loa no kou kūlana kūikawā.

He aha ka lapaʻau no ka Rhabdomyosarcoma?

ʻO ka lapaʻau no ka rhabdomyosarcoma e komo pinepine ana i kahi ala hoʻohui, ʻo ia hoʻi e hoʻohana paha kāu hui lapaʻau i nā ʻano like ʻole i ka hui. Ua hōʻoia ʻia kēia hoʻolālā hoʻonui i ka mea maikaʻi loa no ka loaʻa ʻana o nā hopena maikaʻi loa.

ʻO ka hapa nui o nā papahana lapaʻau e komo pū me ka chemotherapy ma ke ʻano he pōhaku kumu. E hele kēia mau lāʻau ma kou kino holoʻokoʻa e hoʻopili i nā cell kanesa ma nā wahi a pau, ʻoiai inā he liʻiliʻi loa lākou e ʻike ʻia me nā scans.

He kuleana nui ka ʻoki kino i ka wā hiki ke wehe ʻia ka tumor me ka palekana me ka ʻole o ka hoʻokumu ʻana i nā pilikia nui. I kekahi manawa, hana ʻia ka ʻoki kino i ka hoʻomaka o ka lapaʻau, ʻoiai i kekahi manawa ua hoʻolālā ʻia ma hope o ka hoʻemi ʻana o ka chemotherapy i ka tumor.

Hiki ke manaʻo ʻia ka radiation therapy e hoʻopili i nā cell kanesa i koe i ka wahi kūikawā kahi i loaʻa ai kāu tumor. Hoʻohana kēia lapaʻau i nā kukuna kiʻekiʻe e luku i nā cell kanesa ʻoiai e hoʻemi ana i ka pōʻino i nā ʻiʻo olakino.

E hoʻopilikino ʻia kāu papahana lapaʻau ma muli o nā mea he nui, me ke ʻano o ka rhabdomyosarcoma āu e loaʻa ai, kahi e loaʻa ai, kona nui, a inā ua pālahalaha. E wehewehe kāu hui lapaʻau i kēlā me kēia ʻanuʻu a e kōkua iā ʻoe e hoʻomaopopo i ka mea e manaʻo ai.

Pehea e hoʻokele ai i nā hōʻailona i ka wā o ka lapaʻau Rhabdomyosarcoma?

ʻO ka hoʻokele ʻana i nā hōʻailona a me nā hopena i ka wā o ka lapaʻau he ʻāpana nui ia o kāu mālama holoʻokoʻa. Makemake kāu hui lapaʻau iā ʻoe e ʻoluʻolu e like me ka hiki i kēia kaʻina hana, no laila mai kānalua e kamaʻilio e pili ana i nā hopohopo.

ʻO ka hoʻokele ʻeha pinepine ka mea nui, a nui nā koho maikaʻi loa e loaʻa ana. Hiki i kāu kauka ke manaʻo aku i nā mea hoʻoemi ʻeha ma luna o ka counter, nā lāʻau lapaʻau, a i ʻole nā ​​​​mea ʻoluʻolu ʻē aʻe ma muli o kāu mau pono.

He mea maʻamau ka luhi i ka wā o ka lapaʻau, no laila he mea nui ke hoʻolohe i kou kino a hoʻomaha i ka wā e pono ai. Hiki i nā hana mālie e like me nā hele pōkole ke kōkua i ka hoʻonui ʻana i kou mau pae ikehu i ka wā e manaʻo ai ʻoe.

Hiki ke paʻakikī ka ʻai maikaʻi i ka wā o ka lapaʻau, akā ke kākoʻo nei ka meaʻai maikaʻi i ke kaʻina ho'ōla o kou kino. E hana pū me kahi meaʻai inā pilikia ʻoe i ka mālama ʻana i kou makemake a i ʻole ka mālama ʻana i ka meaʻai.

E noho pili me nā hoaaloha a me nā ʻohana no ke kākoʻo manaʻo. He nui nā kānaka e ʻike he mea kōkua ke kamaʻilio me kahi kākā'ōlelo a hui pū me kahi hui kākoʻo e pili ana i nā poʻe ʻē aʻe e hele nei i nā ʻike like.

Pehea ʻoe e hoʻomākaukau ai no kāu hālāwai kauka?

Hiki i ka hoʻomākaukau ʻana no kāu hālāwai ke kōkua iā ʻoe e hana i ka hapa nui o kou manawa me kāu hui lapaʻau. ʻO ka loaʻa ʻana o kāu mau nīnau a me ka ʻike i hoʻonohonoho ʻia ma mua e hoʻemi i ke kaumaha a e hōʻoia ʻaʻole ʻoe e poina i nā kumuhana nui.

E kākau i kāu mau hōʻailona a pau, me ka wā i hoʻomaka ai lākou a inā ua loli lākou i ka manawa. E komo pū me nā kikoʻī e pili ana i nā pae ʻeha, pehea e hoʻopilikia ai nā hōʻailona i kāu mau hana o kēlā me kēia lā, a me nā mea e hoʻomaikaʻi ai a ʻoi aku ka maikaʻi.

E lawe mai i kahi papa inoa piha o nā lāʻau āu e lawe nei, me nā lāʻau lapaʻau, nā lāʻau lapaʻau ma luna o ka counter, nā huaora, a me nā mea hoʻohui. E komo pū me nā allergies a i ʻole nā ​​​​mea pane mua i nā lāʻau lapaʻau.

E hoʻomākaukau i kahi papa inoa o nā nīnau āu e makemake ai e nīnau. Mai hopohopo e pili ana i ka nui o nā nīnau - ke manaʻo nei kāu hui lapaʻau i kēia a makemake e pane i kāu mau hopohopo a pau.

E noʻonoʻo e lawe mai i kahi hoaaloha a i ʻole kahi ʻohana hilinaʻi pū me ʻoe. Hiki iā lākou ke kōkua iā ʻoe e hoʻomanaʻo i ka ʻike i kūkākūkā ʻia i ka wā o ka hālāwai a hāʻawi i ke kākoʻo manaʻo.

He aha ka mea nui e pili ana i ka Rhabdomyosarcoma?

ʻO ka mea nui loa e hoʻomaopopo e pili ana i ka rhabdomyosarcoma, ʻoiai he hōʻailona koʻikoʻi ia, ua holomua nui nā hopena lapaʻau i nā makahiki he nui i hala. He nui nā kānaka me kēia kūlana e ola ana i nā ola olakino piha.

ʻO ka ʻike mua a me ka lapaʻau wikiwiki e hana i kahi ʻokoʻa nui i nā hopena. Inā ʻike ʻoe i kekahi mau ʻāpana mau, pehu, a i ʻole nā ​​​​hōʻailona hopohopo ʻē aʻe, mai kali e ʻimi i ka nānā ʻana i ka lāʻau lapaʻau.

E hoʻomanaʻo he kūikawā ka ʻike o kēlā me kēia kanaka me ka rhabdomyosarcoma. E hana pū kāu hui lapaʻau me ʻoe e hoʻomohala i kahi papahana lapaʻau i hoʻopilikino ʻia i kou kūlana, e noʻonoʻo ana i kou olakino holoʻokoʻa, nā hiʻohiʻona o kāu kanesa, a me kāu mau makemake pilikino.

ʻO ka loaʻa ʻana o kahi ʻōnaehana kākoʻo ikaika e hana i kahi ʻokoʻa maoli i ka wā o ka lapaʻau. Mai kānalua e hilinaʻi i nā ʻohana, nā hoaaloha, nā mea lawelawe olakino, a me nā hui kākoʻo i kou huakaʻi.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka Rhabdomyosarcoma

Q1. He mea make mau anei ka rhabdomyosarcoma?

ʻAʻole, ʻaʻole make mau ka rhabdomyosarcoma. Ua holomua nui nā helu ola me nā ala lapaʻau hou. ʻO ka manaʻo e hilinaʻi ana i nā mea he nui me ke ʻano o ka rhabdomyosarcoma, kahi e loaʻa ai, pehea ka lōʻihi o ka pālahalaha ʻana, a pehea ka pane maikaʻi ʻana i ka lapaʻau. Hiki ke ho'ōla ʻia nā kānaka he nui, ʻoi aku hoʻi nā keiki, me ka lapaʻau kūpono.

Q2. Hiki i ka rhabdomyosarcoma ke hoʻi mai ma hope o ka lapaʻau?

ʻAe, hiki i ka rhabdomyosarcoma ke hoʻi hou ma hope o ka lapaʻau, ʻo ia ke kumu o nā hālāwai nānā ma hope o ka mea nui. Eia naʻe, he nui nā kānaka i hoʻopau i ka lapaʻau ʻaʻole loa e ʻike i ka hoʻi hou ʻana. E nānā pono kāu hui lapaʻau iā ʻoe me nā nānā maʻamau a me nā scans e hopu i kekahi hoʻi hou ʻana i ka wā e mālama maikaʻi ʻia ai.

Q3. Pehea ka lōʻihi o ka lapaʻau no ka rhabdomyosarcoma?

ʻO ka lōʻihi o ka lapaʻau e ʻokoʻa ma muli o kou kūlana kūikawā, akā ʻo ka hapa nui o nā papahana lapaʻau e mau ana ma waena o 6 mau mahina a i hoʻokahi makahiki. ʻO kēia e komo pinepine ana i nā mahina he nui o ka chemotherapy, hiki ke hui pū ʻia me ka ʻoki kino a me ka radiation therapy. E hāʻawi kāu hui lapaʻau iā ʻoe i kahi papa manawa kūikawā ma muli o kāu papahana lapaʻau pilikino.

Q4. Hiki i nā mākua ke loaʻa i ka rhabdomyosarcoma, a i ʻole e pili wale ana i nā keiki?

ʻOiai ʻoi aku ka maʻamau o ka rhabdomyosarcoma i nā keiki a me nā ʻōpio, hiki i nā mākua ke loaʻa kēia kanesa. ʻOi aku ka liʻiliʻi o nā hihia mākua a i kekahi manawa e hana like ʻole me nā hihia kamaliʻi. Hiki ke ʻokoʻa iki nā ala lapaʻau no nā mākua i hoʻohālikelike ʻia i nā keiki.

Q5. Aia kekahi mau hopena lōʻihi mai ka lapaʻau Rhabdomyosarcoma?

Hiki i kekahi poʻe ke ʻike i nā hopena lōʻihi mai ka lapaʻau, ʻoiai he nui e ola ana me ka ʻole o nā pilikia mau nui. Hiki i nā hopena lōʻihi ke komo pū me nā pilikia momona, nā pilikia naʻau mai kekahi mau lāʻau chemotherapy, a i ʻole nā ​​​​kanesa lua ma hope o nā makahiki. E kūkākūkā kāu hui lapaʻau i nā pilikia hiki ke loaʻa iā ʻoe a e nānā no kēia mau pilikia i ka wā o ka mālama nānā ma hope.