He aha ʻo Avelumab: Nā Hoʻohana, Nā Kumu, Nā ʻaoʻao ʻaoʻao a me nā mea hou aku

He lāʻau lapaʻau i manaʻo ʻia ʻo Avelumab e kōkua ana i kāu ʻōnaehana pale e hakakā i kekahi mau ʻano maʻi maʻi maikaʻi aʻe. He ʻano lāʻau lapaʻau immunotherapy i kapa ʻia he monoclonal antibody e ālai ana i nā protein e pale ai i kāu ʻōnaehana pale mai ka hoʻouka ʻana i nā pūnaewele maʻi maʻi.

Hāʻawi ʻia kēia lāʻau lapaʻau ma o ka IV infusion ma kahi kikowaena lapaʻau maʻi maʻi a i ʻole ka haukapila. E nānā pono kāu hui mālama ola iā ʻoe i ka wā a ma hope o kēlā me kēia lapaʻau e hōʻoia i kou palekana a me kou hōʻoluʻolu.

He aha ʻo Avelumab?

He lāʻau lapaʻau immunotherapy i kauoha ʻia ʻo Avelumab e hana ana ma ka wehe ʻana i nā kaʻa ma kāu ʻōnaehana pale. No kahi papa o nā lāʻau lapaʻau i kapa ʻia ʻo PD-L1 inhibitors, ʻo ia hoʻi, e ālai ana i kahi protein e hoʻohana ai nā pūnaewele maʻi maʻi e hūnā mai nā pale kūlohelohe o kou kino.

ʻAʻole like me ka chemotherapy kuʻuna e hoʻouka pololei i nā pūnaewele maʻi maʻi, kōkua ʻo avelumab i kāu ʻōnaehana pale ponoʻī e ʻike a luku i nā pūnaewele maʻi maʻi. E noʻonoʻo e like me ka hāʻawi ʻana i kāu ʻōnaehana pale i nā mea hana maikaʻi e hana i kāna hana o ka pale ʻana i kou kino mai nā pūnaewele ʻino.

Hana ʻia ka lāʻau lapaʻau ma ke ʻano he wai wai e pono e hoʻoheheʻe ʻia ma mua o ka hāʻawi ʻia ʻana ma o ka laina intravenous. Mālama nā poʻe loea mālama ola i nā hoʻomākaukau a me ka lawelawe ʻana e hōʻoia i ka hoʻohana pono ʻana a me ka palekana.

No ke aha e hoʻohana ʻia ai ʻo Avelumab?

Ua ʻae ʻia ʻo Avelumab e mālama i kekahi mau ʻano maʻi maʻi kikoʻī kahi i hana ʻole ai nā lāʻau lapaʻau ʻē aʻe a ʻaʻole kūpono paha. E hoʻoholo kāu oncologist inā kūpono kēia lāʻau lapaʻau no kāu kūlana kikoʻī e pili ana i kāu ʻano maʻi maʻi a me ka mōʻaukala olakino.

ʻO nā hoʻohana maʻamau e pili ana i ka mālama ʻana i ka maʻi maʻi ʻōpū holomua i laha i nā ʻāpana ʻē aʻe o ke kino. Hoʻohana ʻia ia i ka wā i hoʻomau ai ka ulu ʻana o ka maʻi maʻi ma hope o ka chemotherapy a i ʻole ke kūpono ʻole ka chemotherapy iā ʻoe.

Hoʻohana ʻia ʻo Avelumab no kahi maʻi ʻili laha ʻole i kapa ʻia ʻo Merkel cell carcinoma. Pane maikaʻi kēia maʻi ʻaʻai ʻino i nā lāʻau immunotherapy e like me avelumab, ʻoiai ke laha aku ma mua o ke kahua tumora kumu.

Eia kekahi, hiki ke hoʻohana ʻia me nā lāʻau ʻē aʻe e mālama i kekahi mau ʻano maʻi ʻaʻai kīkī. E wehewehe pono kāu hui mālama maʻi ʻaʻai i ke kumu e ʻōlelo ʻia nei kēia lāʻau lapaʻau no kāu maʻi kikoʻī.

Pehea e hana ai ʻo Avelumab?

Hana ʻo Avelumab ma ka hoʻopaʻa ʻana i kahi protein kikoʻī i kapa ʻia ʻo PD-L1 e noho ana ma luna o nā pūnaewele maʻi ʻaʻai. Hana kēia protein e like me ka hoʻopunipuni e hoʻopunipuni i kāu ʻōnaehana pale e haʻalele i nā pūnaewele maʻi ʻaʻai.

Ke ālai ʻo avelumab iā PD-L1, wehe ia i kēia hoʻopunipuni a hiki i nā T-cells o kāu ʻōnaehana pale ke ʻike i ka maʻi ʻaʻai ma ke ʻano he malihini. Ke hiki i kāu ʻōnaehana pale ke ʻike maopopo i ka maʻi ʻaʻai, hiki iā ia ke hoʻouka a luku i kēia mau pūnaewele ʻino me ka maikaʻi.

Manaʻo ʻia he lāʻau lapaʻau maʻi ʻaʻai ikaika e hiki ke hana i nā pane nui i kekahi poʻe maʻi. Eia naʻe, hana ʻokoʻa ia ma mua o ka chemotherapy kuʻuna a hiki ke lawe i kekahi mau pule a i ʻole mau mahina e hōʻike i kāna hopena piha.

Ke hoʻomau nei ka lāʻau lapaʻau i ka hana ʻana i kāu ʻōnaehana ʻoiai ma waena o nā lāʻau lapaʻau. ʻO kēia hana immune e hoʻomau nei ke kumu e ʻike ai kekahi poʻe i nā pane lohi a i ʻole e hoʻomau i ka hoʻomaikaʻi ʻana i nā pule ma hope o ka hoʻomaka ʻana i ka lāʻau lapaʻau.

Pehea wau e lawe ai iā Avelumab?

Hāʻawi mau ʻia ʻo Avelumab e nā poʻe loea mālama ola ma o ka intravenous infusion i loko o kahi hale lapaʻau. ʻAʻole hiki iā ʻoe ke lawe i kēia lāʻau lapaʻau ma ka home, a pono ia i ka hoʻomākaukau pono a me ka nānā ʻana e nā limahana i hoʻomaʻamaʻa ʻia.

Lawe maʻamau ka infusion ma kahi o 60 mau minuke e hoʻopau. E hoʻokomo kāu hui mālama ola i kahi laina IV i loko o kou lima a i ʻole laina waena inā loaʻa iā ʻoe, a laila e hāʻawi mālie i ka lāʻau lapaʻau i hoʻoheheʻe ʻia.

E loaʻa ana iā ʻoe ka lapaʻau i kēlā me kēia pule ʻelua, akā hiki i kāu kauka ke hoʻololi i kēia papa manawa ma muli o kou pane ʻana a me nā hopena ʻaoʻao āu e ʻike ai. He mea nui e mālama i nā manawa i hoʻonohonoho ʻia, ʻoiai inā maikaʻi kou manaʻo.

Ma mua o kēlā me kēia hoʻokomo ʻana, e loaʻa ana iā ʻoe nā lāʻau lapaʻau e kōkua i ka pale ʻana i nā hopena maʻi. ʻO kēia mau lāʻau lapaʻau ma mua, e komo pinepine ana i nā antihistamines a i kekahi manawa nā steroids, e kōkua i ka hōʻemi ʻana i ka pilikia o nā hopena ʻaoʻao e pili ana i ka hoʻokomo ʻana.

ʻAʻole pono ʻoe e ʻai i nā meaʻai kūikawā ma mua o ka lapaʻau ʻana, akā he mea kōkua ka noho ʻana i ka wai. Manaʻo kekahi poʻe he maʻalahi ka ʻai ʻana i ka meaʻai māmā i kekahi mau hola ma mua o kā lākou manawa ma mua o ka hele ʻana me ka ʻōpū ʻole.

Pehea ka lōʻihi e lawe ai au i ka Avelumab?

He ʻokoʻa nui ka lōʻihi o ka lapaʻau ʻana me ka avelumab mai kēlā kanaka i kēia kanaka a pili i ka maikaʻi o ka pane ʻana o kāu maʻi kanesa i ka lāʻau lapaʻau. Hoʻomau kekahi poʻe i ka lapaʻau ʻana no nā mahina he nui a i ʻole nā makahiki inā e hana maikaʻi ana a hiki ke mālama ʻia nā hopena ʻaoʻao.

E nānā mau kāu oncologist i kou holomua ʻana ma o nā kiʻi kiʻi, nā hoʻokolohua koko, a me nā hoʻokolohua kino. Kōkua kēia mau loiloi i ka hoʻoholo ʻana inā e emi ana ka lapaʻau i kāu maʻi kanesa a i ʻole e pale ana i ka ulu ʻana.

Hoʻomau ka lapaʻau ʻana i ka wā e pane ana kāu maʻi kanesa a ʻaʻole ʻoe e ʻike i nā hopena ʻaoʻao koʻikoʻi. Inā hoʻomaka hou kāu maʻi kanesa e ulu a i ʻole inā paʻakikī loa nā hopena ʻaoʻao e mālama ai, e kūkākūkā kāu kauka i nā koho lapaʻau ʻē aʻe.

Pono paha kekahi poʻe e hoʻomaha mai ka lapaʻau ʻana inā loaʻa iā lākou kekahi mau hopena ʻaoʻao. Hāʻawi kēia mau lā hoʻomaha lapaʻau i kou kino e ola ana i ka wā e mālama pinepine ana i nā hopena maikaʻi o ka immunotherapy.

He aha nā hopena ʻaoʻao o Avelumab?

E like me nā ʻano lapaʻau maʻi ʻaʻai a pau, hiki i ka avelumab ke hana i nā hopena ʻaoʻao, ʻoiai ʻaʻole nā mea a pau e ʻike iā lākou. Hana ʻia nā hopena ʻaoʻao no ka mea e hoʻāla ai ka lāʻau i kāu ʻōnaehana pale, i kekahi manawa hiki ke hoʻopilikia i nā ʻāpana olakino o kou kino.

ʻO ka hapa nui o nā kānaka e ʻike i kekahi mau hopena ʻaoʻao, akā hiki ke mālama ʻia ka nui me ka mālama olakino kūpono a me ke kākoʻo. E nānā pono kāu hui mālama ola iā ʻoe a hāʻawi i nā lapaʻau e kōkua i ka hōʻemi ʻana i ka pilikia ke loaʻa nā hopena ʻaoʻao.

Eia nā hopena ʻaoʻao maʻamau e ʻike ai ʻoe:

• Luhi a i ʻole ka manaʻo e luhi pinepine ana ma mua o ka maʻamau
• ʻEha ʻiʻo a i ʻole hui
• ʻO ka maʻi a i ʻole ka emi ʻana o ka ʻai
• Pāpaʻi ʻili a i ʻole ka ʻū
• Pāpaʻi a i ʻole ka paʻa
• Nā hopena hoʻokomo e like me ke kuni a i ʻole nā anu i ka wā o ka lapaʻau

He maʻalahi a maʻalahi paha kēia mau hopena ʻaoʻao maʻamau a pinepine e hoʻomaikaʻi i ka wā e hoʻoponopono ai kou kino i ka lapaʻau. Hiki i kāu hui lapaʻau ke hāʻawi i nā lāʻau lapaʻau a me nā hoʻolālā e kōkua i ka mālama ʻana i kēia mau hōʻailona me ka maikaʻi.

Hiki i nā hopena ʻaoʻao koʻikoʻi akā ʻaʻole maʻamau ke hoʻopilikia i nā ʻōkana like ʻole ke lilo kāu ʻōnaehana pale i mea hana nui. ʻOiai he mea hopohopo kēia, hiki ke hoʻohuli ʻia me ka nānā ʻana i ka lāʻau lapaʻau:

• Hoʻāhu māmā e hana ana i ka pōkole o ka hanu a i ʻole ka ʻū mau
• Nā pilikia ate e hiki ke hana i ka melemele o ka ʻili a i ʻole nā maka
• Nā loli o ka ʻōpū thyroid e pili ana i nā pae ikehu a me ka metabolism
• Nā hopena ʻili koʻikoʻi a i ʻole nā pāpaʻi ākea
• Nā pilikia kīkī e hiki ke hana i nā loli i ka mimi
• Hoʻāhu ʻōpū e hana ana i ka maʻi nui a i ʻole ka ʻeha o ka ʻōpū

Pono kēia mau hopena ʻaoʻao e pili ana i ka pale i ka nānā ʻana i ka lāʻau lapaʻau a pono pinepine i ka lapaʻau me nā steroids a i ʻole nā lāʻau ʻē aʻe e hoʻomaha i kāu ʻōnaehana pale. Hoʻōla piha ka hapa nui o nā kānaka ke hopu ʻia a mālama ʻia kēia mau hopena ʻaoʻao i ka wā mua.

ʻO wai ka mea ʻaʻole pono e lawe iā Avelumab?

ʻAʻole kūpono ʻo Avelumab no nā mea a pau, a e nānā pono kāu kauka oncologist i kāu moʻolelo olakino ma mua o ka ʻōlelo ʻana i kēia lapaʻau. Hiki i kekahi mau maʻi olakino a i ʻole nā lāʻau lapaʻau ke hoʻolilo i ka avelumab i mea palekana ʻole a i ʻole ka liʻiliʻi.

ʻAʻole pono ʻoe e loaʻa i ka avelumab inā ua loaʻa iā ʻoe kahi hopena maʻi koʻikoʻi i kēia lāʻau lapaʻau a i ʻole kekahi o kāna mau mea i hala. ʻO nā hōʻailona o nā hopena maʻi koʻikoʻi e komo pū ana me ka pilikia o ka hanu ʻana, ka pehu nui ʻana, a i ʻole nā hopena ʻili ākea.

ʻAʻole kūpono paha nā kānaka me nā maʻi autoimmune ikaika e like me ka lupus, rheumatoid arthritis, a i ʻole ka maʻi ʻāʻī ʻāʻī no ka avelumab. No ka mea e hoʻoulu ai kēia lāʻau lapaʻau i kāu ʻōnaehana pale, hiki iā ia ke hoʻonui i kēia mau maʻi.

Inā ʻoe e lawe ana i nā kiʻekiʻe kiʻekiʻe o nā steroids a i ʻole nā lāʻau lapaʻau ʻē aʻe e kāohi ana i kāu ʻōnaehana pale, ʻaʻole paha e hana pono ka avelumab. Pono kāu kauka e kaulike pono i kēia mau lāʻau lapaʻau inā ʻo ka immunotherapy ke koho maikaʻi loa iā ʻoe.

He mea nui nō hoʻi ka hāpai ʻana a me ka hānai ʻana i ka waiū. Hiki i ka Avelumab ke hōʻeha i kahi pēpē i hānau ʻole ʻia, no laila he mea nui ka mana hānau hilinaʻi i ka wā o ka lapaʻau a no kekahi mau mahina ma hope inā hiki iā ʻoe ke hāpai.

Nā inoa inoa ʻo Avelumab

Kūʻai ʻia ʻo Avelumab ma lalo o ka inoa inoa ʻo Bavencio ma ʻAmelika Hui Pū ʻIa a me nā ʻāina ʻē aʻe. ʻO kēia wale nō ka inoa inoa i loaʻa i kēia manawa no kēia lāʻau lapaʻau.

Hana ʻia ʻo Bavencio e Pfizer a me Merck KGaA, a ʻo ia ka mea like ma ka honua holoʻokoʻa. Hiki iā ʻoe ke ʻike i nā ʻōpala a i ʻole nā lepili like ʻole ma nā ʻāina like ʻole, akā paʻa ka mea hana a me ka ikaika.

ʻAʻole like me kekahi mau lāʻau lapaʻau i loaʻa nā inoa inoa he nui a i ʻole nā mana generic, loaʻa wale ka avelumab ma ke ʻano he Bavencio. Kōkua kēia i ka hōʻoia ʻana i ke kūlike i ka dosing a me ka maikaʻi ma nā kikowaena lapaʻau like ʻole.

Nā koho ʻē aʻe o Avelumab

He nui nā lāʻau lapaʻau immunotherapy ʻē aʻe e hana like me avelumab ma ka manaʻo ʻana i ke ala PD-1 a i ʻole PD-L1. Hiki i kāu oncologist ke noʻonoʻo i kēia mau koho ʻē aʻe inā ʻaʻole kūpono ʻo avelumab iā ʻoe a i ʻole inā ʻaʻole pane maikaʻi kāu maʻi maʻi.

ʻO Pembrolizumab (Keytruda) a me nivolumab (Opdivo) ʻelua mau koho ʻē aʻe i hoʻohana pinepine ʻia e ālai i ka protein PD-1 ma kahi o PD-L1. Hana pinepine kēia mau lāʻau lapaʻau i nā ʻano maʻi maʻi like a he mau koho paha inā ʻaʻole i loaʻa a i ʻole kūpono ʻo avelumab.

ʻO Atezolizumab (Tecentriq) a me durvalumab (Imfinzi) nā mea pale PD-L1 ʻē aʻe e like me avelumab. Hana kēia mau lāʻau lapaʻau ma o ke ʻano like akā hiki ke ʻae ʻia no nā ʻano maʻi maʻi like ʻole a i ʻole hoʻohana ʻia i nā hui like ʻole.

ʻO ke koho ʻana ma waena o kēia mau lāʻau lapaʻau e hilinaʻi ana i nā mea e like me kāu ʻano maʻi maʻi, nā lāʻau lapaʻau mua, a me nā mea olakino pilikino. E wehewehe kāu oncologist i ke kumu e ʻōlelo ʻia ai kekahi immunotherapy ma luna o nā mea ʻē aʻe no kāu kūlana.

Ua ʻoi aku ka maikaʻi o Avelumab ma mua o Pembrolizumab?

He mau lāʻau lapaʻau immunotherapy maikaʻi ʻo Avelumab a me pembrolizumab, akā ʻaʻole hiki ke hoʻohālikelike pololei ʻia no ka mea e hoʻohana pinepine ʻia lākou no nā ʻano maʻi maʻi like ʻole. Ua aʻo ʻia a ʻae ʻia kēlā me kēia lāʻau lapaʻau no nā ʻano maʻi maʻi kikoʻī kahi e hōʻike ai i nā hopena maikaʻi loa.

Hoʻopaʻa ʻo Avelumab i ka PD-L1 ma nā cell cancer, ʻoiai ʻo pembrolizumab e hoʻopaʻa i ka PD-1 ma nā cell immune. Loaʻa nā hopena like ʻole i nā ala ʻelua ma ka ʻae ʻana i kāu ʻōnaehana immune e hoʻouka i ka maʻi maʻi maikaʻi, akā ʻokoʻa iki ke ʻano kikoʻī.

ʻO ke koho ʻana ma waena o kēia mau lāʻau lapaʻau e hilinaʻi nui ana i kāu ʻano maʻi maʻi a me ke kahua ma mua o ka mea e ʻoi aku ka maikaʻi ma mua o kekahi. E ʻōlelo kāu oncologist i ka immunotherapy i loaʻa ka hōʻike maikaʻi loa no ka mālama ʻana i kāu maʻi kikoʻī.

I kekahi mau hihia, hiki i kāu kauka ke hoʻololi mai kekahi i kekahi inā pau ka hana ʻana o ka lāʻau mua a i ʻole e hana ana i nā hopena ʻaoʻao he nui. Hāʻawi kēia maʻalahi i kāu hui lapaʻau e hoʻomaikaʻi i kāu mālama ʻana ma muli o kāu pane pilikino.

Nā Nīnau i Nīnau Pinepine ʻia e pili ana iā Avelumab

He Palekana ʻo Avelumab no ka poʻe me ka maʻi puʻuwai?

Hiki ke hoʻohana palekana ʻia ʻo Avelumab i ka poʻe me ka maʻi puʻuwai, akā pono ka nānā pono ʻana. E hana pū kāu oncologist me kāu cardiologist e hōʻoia i ka paʻa o kou maʻi puʻuwai ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau.

Hiki i ka lāʻau lapaʻau ke hana i nā hopena ʻaoʻao e pili ana i ka puʻuwai e like me ka mumū o ka ʻiʻo puʻuwai, ʻoiai he mea maʻamau kēia. E nānā kāu hui mālama ola iā ʻoe no nā hōʻailona o nā pilikia o ka puʻuwai i ka wā o ka lāʻau lapaʻau.

Inā he moʻolelo kou o nā pilikia o ka puʻuwai, e hōʻoia e haʻi i kāu oncologist e pili ana i kāu mau lāʻau puʻuwai a me nā hōʻailona āu e ʻike ai. Hiki ke ʻōlelo ʻia ka nānā ʻana i ka puʻuwai maʻamau i ka wā o kāu lāʻau lapaʻau.

He aha kaʻu e hana ai inā ua hala au i kahi mahele o Avelumab?

No ka mea, hāʻawi ʻia ʻo avelumab e nā poʻe loea mālama ola i loko o kahi keʻena lapaʻau, ʻo ka hala ʻana i kahi mahele, ʻo ia hoʻi ka hala ʻana i kahi manawa i hoʻonohonoho ʻia. E hoʻokaʻaʻike i kāu kikowaena maʻi maʻi i ka hiki wawe e hoʻonohonoho hou i kāu lāʻau lapaʻau.

E hoʻoholo kāu hui mālama ola i ke ala maikaʻi loa e hoʻi ai i ke ala me kāu papa hana lapaʻau. I kekahi manawa hiki iā lākou ke hoʻokō iā ʻoe i loko o kekahi mau lā o kāu manawa i hala.

Mai ho'āʻo e hana i kahi mahele i hala ma ka hoʻololi ʻana i kāu papa hana iā ʻoe iho. Pono kāu oncologist e ʻae i nā hoʻololi e hōʻoia i ka palekana a me ka maikaʻi o kāu lāʻau lapaʻau.

I ka manawa hea e hiki ai iaʻu ke hooki i ka lawe ʻana iā Avelumab?

Pono e hana mau ʻia ka hoʻoholo e hooki i ka avelumab me kāu oncologist ma muli o ka maikaʻi o ka hana ʻana o ka lāʻau lapaʻau a me ke ʻano o kou ʻae ʻana iā ia. Hiki i kekahi poʻe ke hooki inā ʻaʻole e pane hou ana kā lākou maʻi maʻi, aʻo nā mea ʻē aʻe e hoʻomau no nā makahiki inā e hana maikaʻi ana.

E hoʻohana ana kāu kauka i nā scans maʻamau a me nā hoʻokolohua koko e nānā i kou holomua a e hoʻoholo i ka manawa e kūpono ai ke hooki i ka lapaʻau. Hiki i kekahi poʻe ke hooki i ka wā ʻaʻole i ʻike ʻia ko lākou maʻi maʻi, aʻo nā mea ʻē aʻe e hoʻomau i ka lapaʻau e pale ai i ka hoʻi hou ʻana.

Mai hooki loa i ka avelumab ma kāu iho, ʻoiai inā maikaʻi kou manaʻo. Pono kāu oncologist e loiloi i kou kūlana holoʻokoʻa a hiki ke ʻōlelo aku i ka nānā hou ʻana a i ʻole nā lapaʻau ʻē aʻe ke hooki ʻoe i ka immunotherapy.

Hiki iaʻu ke inu i ka waiʻona i ka wā e lawe ana i ka Avelumab?

ʻAe ʻia ka inu ʻana i ka waiʻona maʻalahi i ka wā e loaʻa ana ka avelumab, akā he mea nui e kūkākūkā i kēia me kāu hui mālama ola. Hiki i ka waiʻona ke launa pū me kekahi o nā lāʻau lapaʻau i hoʻohana ʻia e mālama i nā hopena ʻaoʻao.

Inā ʻoe e ʻike nei i ka luhi a i ʻole nā hopena ʻaoʻao e pili ana i ke ake mai ka avelumab, hiki i kāu kauka ke ʻōlelo aku e pale i ka waiʻona no ka manawa. Hiki ke hoʻonui ʻia kēia mau hopena ʻaoʻao e ka inu ʻana i ka waiʻona.

E ʻoiaʻiʻo me kāu oncologist e pili ana i kāu hoʻohana ʻana i ka waiʻona i hiki iā lākou ke hāʻawi i ke alakaʻi pilikino e pili ana i kou olakino holoʻokoʻa a me ka pane ʻana i ka lapaʻau. Makemake lākou e hōʻoia e hiki iā ʻoe ke mālama i kou maikaʻi o ke ola i ka wā e noho palekana ana i ka wā o ka lapaʻau.

E pili anei ka Avelumab i koʻu hiki ke hakakā i nā maʻi ʻē aʻe?

Hana ʻo Avelumab ma ka hoʻāla ʻana i kāu ʻōnaehana pale ma mua o ka hoʻopaʻa ʻana, no laila ʻaʻole ia e hoʻonui i kou pilikia o nā maʻi e like me ka chemotherapy kuʻuna. Eia naʻe, hiki i kekahi o nā hopena ʻaoʻao ke hoʻopilikia i ke kaulike o kāu ʻōnaehana pale no ka manawa.

Inā ʻoe e hoʻomohala i nā hopena ʻaoʻao e pili ana i ka pale e koi ai i ka lapaʻau steroid, hiki i kēlā mau steroids ke hoʻolilo iā ʻoe i mea maʻalahi i nā maʻi no ka manawa. E nānā pono kāu hui mālama ola iā ʻoe i ka wā o ka lapaʻau steroid.

E hoʻomau i ka hana ʻana i ka maʻemaʻe maikaʻi a pale i ka pili kokoke ʻana me nā poʻe i loaʻa nā maʻi lele. E hōʻike koke i kāu hui mālama ola inā loaʻa iā ʻoe nā hōʻailona o ka maʻi e like me ke kuni, ka luhi ʻole, a i ʻole ka ʻū ʻana mau.