He aha ʻo Carmustine: Nā Hoʻohana, Ka Leka, Nā hopena ʻaoʻao a me nā mea hou aku

ʻO Carmustine he lāʻau chemotherapy ikaika e pili ana i kahi pūʻulu o nā lāʻau lapaʻau e hakakā ana i ka maʻi maʻi i kapa ʻia ʻo nā mea alkylating. Hana ia ma ka hoʻopilikia ʻana i ka hiki o nā pūnaewele maʻi maʻi e ulu a hoʻonui, e hoʻōki ana iā lākou i kā lākou mau ala. Hiki i kāu kauka ke ʻōlelo aku iā carmustine ke kū nei ʻoe i kekahi mau ʻano maʻi maʻi lolo, lymphomas, a i ʻole multiple myeloma i pane ʻole maikaʻi i nā lāʻau lapaʻau ʻē aʻe.

He aha ʻo Carmustine?

ʻO Carmustine he lāʻau chemotherapy i hāʻawi pololei ʻia i loko o kou kahe koko ma o ka laina IV (intravenous). Ua ʻike ʻia hoʻi ma kona inoa inoa ʻo BiCNU, a ʻo ia ka mea a nā kauka e kāhea ai i ka nitrosourea alkylating agent. Ke kōkua nei kēia lāʻau lapaʻau i ka poʻe e hakakā i ka maʻi maʻi no nā makahiki he nui, a he mea waiwai nui ia no ka mea hiki ke hele i ka pale koko-lolo, e hana ana i mea kūpono i nā maʻi maʻi lolo.

Hele mai ka lāʻau lapaʻau ma ke ʻano he pauka e hui pū ai kāu hui mālama ola me kahi hoʻonā kūikawā ma mua o ka hāʻawi ʻana iā ʻoe. Ke komo i loko o kou kino, hele ʻo carmustine ma kou kahe koko e hiki i nā pūnaewele maʻi maʻi ma kahi e hūnā ai. Manaʻo ʻia he lāʻau ikaika e pono ai ka nānā pono ʻana a me ka loea mai kāu hui lapaʻau.

No ke aha e hoʻohana ʻia ai ʻo Carmustine?

Hoʻomaʻamaʻa ʻo Carmustine i kekahi mau ʻano maʻi maʻi, me nā kauka e kauoha pinepine ana iā ia no nā maʻi maʻi lolo a me nā maʻi koko. Hiki i kāu oncologist ke ʻōlelo aku i kēia lāʻau lapaʻau ke hana ʻole nā lāʻau lapaʻau ʻē aʻe e like me ka mea i manaʻo ʻia, a i ʻole ma ke ʻano he ʻāpana o kahi hoʻolālā therapy hui.

Eia nā kūlana nui e hiki ai iā carmustine ke kōkua:

• Nā maʻi maʻi lolo (me ka glioblastoma a me ka anaplastic astrocytoma)
• Hodgkin's lymphoma
• Non-Hodgkin's lymphoma
• Multiple myeloma
• Nā ʻano leukemia

I kekahi manawa, hoʻohana nā kauka i ka carmustine i nā regimens chemotherapy kiʻekiʻe ma mua o nā transplants stem cell. E hoʻoholo kāu hui lapaʻau inā kūpono kēia lapaʻau no kāu kūlana kikoʻī e pili ana i kāu ʻano maʻi maʻi, ke olakino holoʻokoʻa, a me ke ʻano o kāu pane ʻana i nā lāʻau lapaʻau mua.

Pehea e hana ai ʻo Carmustine?

Hana ʻo Carmustine ma ka hōʻino ʻana i ka DNA i loko o nā cell maʻi maʻi, kahi e pale ai iā lākou mai ka mahele a me ka ulu ʻana. E noʻonoʻo e like me ka waiho ʻana i kahi wili i loko o ka mīkini o ka cell maʻi maʻi e hoʻohana ai e hana i nā kope o ia iho. He lāʻau lapaʻau ikaika kēia ʻaʻole e kuhikuhi wale i nā cell maʻi maʻi, no laila e nānā pono kāu hui lapaʻau iā ʻoe i ka wā o ka lapaʻau.

ʻO ka mea e waiwai ai ʻo carmustine ʻo kona hiki ke hele i ka pale koko-lolo, ʻo ia ka pale pale kūlohelohe o kou kino a puni kou lolo. ʻAʻole hiki i nā lāʻau lapaʻau he nui ke hele i kēia pale, akā hiki i ka carmustine, e lilo ia i mea pono no ka mālama ʻana i nā maʻi lolo i hiki ʻole i nā lāʻau ʻē aʻe ke hiki pono.

Noho ka lāʻau lapaʻau i loko o kou kino no kekahi mau hola ma hope o kēlā me kēia infusion, e hoʻomau ana i ka hana ʻana i nā cell maʻi maʻi i kēlā manawa. Eia naʻe, no ka mea e pili ana i nā cell e mahele wikiwiki ana, hiki iā ia ke hoʻopilikia i kekahi o kāu mau cell olakino, ʻo ia ke kumu e loaʻa ai nā hopena ʻaoʻao.

Pehea wau e lawe ai iā Carmustine?

Hāʻawi mau ʻia ʻo Carmustine ma ke ʻano he intravenous (IV) infusion i loko o kahi haukapila a i ʻole ke kikowaena lapaʻau maʻi maʻi e nā poʻe loea mālama ola i hoʻomaʻamaʻa ʻia. ʻAʻole ʻoe e lawe i kēia lāʻau lapaʻau ma ka home a i ʻole ma ka waha. E hoʻokomo kāu hui lapaʻau i kahi paipu liʻiliʻi i loko o kekahi o kou mau veins, maʻamau i kou lima, a e kahe mālie ka lāʻau lapaʻau i loko o kou kahe koko ma kahi o 1-2 mau hola.

Ma mua o kāu lapaʻau ʻana, loaʻa paha iā ʻoe nā lāʻau lapaʻau e kōkua i ka pale ʻana i ka nausea a me ka luaʻi. E nānā pū kāu hui mālama ola i kāu helu koko a me ka hana o nā puʻupaʻa e hōʻoia i ka mākaukau o kou kino no ka lapaʻau. ʻAʻole pono ʻoe e pale i ka ʻai ʻana ma mua o ka carmustine, akā ʻo ka ʻai ʻana i ka meaʻai māmā ma mua e kōkua paha iā ʻoe e ʻoluʻolu.

I ka wā o ka hoʻokomo ʻana, e nānā pono ʻia ʻoe no nā hopena koke. Hiki paha i ka pūnaewele IV ke ʻoluʻolu iki a i ʻole ke ʻano tingling, he mea maʻamau kēia. Inā ʻoe e ʻike i kekahi ʻoluʻolu ʻole, ke kuni, a i ʻole ka ʻeha ma ka pūnaewele IV, e haʻi koke i kāu kahu hānai.

Pehea ka lōʻihi e lawe ai au i ka Carmustine?

ʻO ka lōʻihi o ka lapaʻau carmustine e ʻokoʻa loa ma muli o kāu ʻano maʻi maʻi kikoʻī a me ka maikaʻi o kou pane ʻana i ka lāʻau. Loaʻa ka hapa nui o nā kānaka i nā lapaʻau i nā pōʻaiapuni, me kēlā me kēia pōʻaiapuni i hoʻokaʻawale ʻia i 6-8 mau pule e ʻae i kou kino i ka manawa e ola ai ma waena o nā meaʻai.

Hiki iā ʻoe ke loaʻa ma kahi o 2-6 mau pōʻaiapuni o ka lapaʻau, ʻoiai pono kekahi poʻe i ka nui a i ʻole ka liʻiliʻi ma muli o ko lākou kūlana. E nānā mau kāu oncologist i kāu helu koko, ka hana o nā puʻupaʻa, a me ka hana o ka māmā i ka wā o ka lapaʻau e hōʻoia i ka mālama pono ʻana o kou kino i ka lāʻau.

ʻO ka lono maikaʻi, e nānā ana kāu hui lapaʻau i ka pane ʻana o kāu maʻi maʻi i ka lapaʻau ma o nā scans a me nā hoʻokolohua koko. Inā hana maikaʻi ka carmustine a ke ʻae nei ʻoe iā ia, hiki iā lākou ke hoʻomau i ka lapaʻau. Inā lilo nā hopena ʻaoʻao i mea paʻakikī loa e mālama a i ʻole inā ʻaʻole e pane ka maʻi maʻi, e kūkākūkā lākou i nā koho ʻē aʻe me ʻoe.

He aha nā hopena ʻaoʻao o Carmustine?

E like me nā lāʻau lapaʻau maʻi maʻi ikaika a pau, hiki i ka carmustine ke hana i nā hopena ʻaoʻao no ka mea e pili ana i nā cell maʻi a me kekahi mau cell olakino i kou kino. ʻIke ka hapa nui o nā kānaka i kekahi mau hopena ʻaoʻao, akā hiki ke mālama ʻia me ka mālama kūpono a me ke kākoʻo mai kāu hui lapaʻau.

Eia nā hopena ʻaoʻao maʻamau e ʻike ai ʻoe:

• Ka luaʻi a me ka luaʻi ʻana (maʻa mau e hoʻomaka ana ma 2-6 hola ma hope o ka lapaʻau)
• Luhi a me ka nāwaliwali
• Nalo o ka ʻai
• Ka helu haʻahaʻa o nā keena koko (hiki ke hoʻonui i ka pilikia o ka maʻi)
• Ka hāʻule ʻana o ka lauoho a i ʻole ka lahilahi
• Nā ʻeha o ka waha
• Pāpaʻa

Hōʻike maʻa mau kēia mau hopena i loko o nā lā a i ʻole nā pule o ka lapaʻau a pinepine e hoʻomaikaʻi i waena o nā pōʻaiapuni. E hāʻawi kāu hui mālama ola i nā lāʻau a me nā hoʻolālā e kōkua i ka mālama ʻana i kēia mau hōʻailona.

Hiki ke loaʻa kekahi mau hopena ʻaoʻao liʻiliʻi akā ʻoi aku ka koʻikoʻi, a ʻoiai he mea maʻamau lākou, he mea nui e ʻike iā lākou:

• Nā pilikia o ka māmā (pulmonary fibrosis) - hiki ke ulu i nā mahina a i ʻole nā makahiki ma hope o ka lapaʻau
• Nā pilikia o ka puʻupaʻa
• Nā loli o ka hana o ke ake
• Nā maʻi ʻaʻai lua (maʻa mau, akā hiki i nā makahiki ma hope)
• Nā hopena maʻi maʻi koʻikoʻi i ka wā o ka hoʻokomo ʻana

E nānā pono kāu hui lapaʻau iā ʻoe no kēia mau hopena koʻikoʻi ma o nā hoʻokolohua koko maʻamau a me nā nānā ʻana. Inā loaʻa iā ʻoe ka ʻūlū mau, ka hanu pōkole, a i ʻole ka luhi maʻamau ma waena o nā lapaʻau, e hoʻokaʻaʻike koke i kāu hui mālama ola.

ʻO wai ka mea pono ʻole e lawe iā Carmustine?

ʻAʻole kūpono ʻo Carmustine no nā mea a pau, a e loiloi pono kāu oncologist inā palekana ia iā ʻoe e pili ana i kou olakino holoʻokoʻa a me ka mōʻaukala olakino. Pono kēia lāʻau i ka hana puʻupaʻa a me ka māmā e hoʻohana palekana ʻia, no laila ʻaʻole paha nā kānaka me nā pilikia nui i kēia mau wahi.

ʻAʻole pono ʻoe e loaʻa iā carmustine inā loaʻa iā ʻoe:

• Maʻi puʻupaʻa koʻikoʻi
• Maʻi māmā nui a i ʻole nā pilikia hanu
• Nā pilikia ake koʻikoʻi
• Ka helu haʻahaʻa loa o nā keena koko
• Nā maʻi koʻikoʻi ikaika
• ʻIke ʻia ka maʻi maʻi i ka carmustine a i ʻole nā lāʻau like

He mea nui e noʻonoʻo ai inā hāpai ʻoe, hānai waiū, a i ʻole e hoʻolālā ana e hāpai, no ka mea, hiki i ka carmustine ke hōʻino i nā pēpē e ulu ana. E kūkākūkā kāu hui lapaʻau i nā koho mālama momona ma mua o ka mālama ʻana inā he hopohopo kēia iā ʻoe.

Inā ʻoe i ʻelemakule a i ʻole he mau maʻi olakino ʻē aʻe e like me ka maʻi puʻuwai a i ʻole ka maʻi diabetes, e loiloi kāu kauka i nā pōmaikaʻi a me nā pilikia me ka akahele. ʻAʻole kēia manaʻo ʻaʻole hiki iā ʻoe ke loaʻa ka carmustine, akā pono paha ʻoe i ka nānā ʻana a i ʻole nā hoʻoponopono ʻana i ka lāʻau.

Nā inoa inoa o Carmustine

Loaʻa pinepine ʻia ka Carmustine ma lalo o ka inoa inoa ʻo BiCNU ma ʻAmelika Hui Pū ʻIa. ʻO kēia ke ʻano intravenous i hui hou ʻia ma mua o kēlā me kēia mālama ʻana. Hiki nō hoʻi iā ʻoe ke lohe i nā mea mālama ola e kuhikuhi ana iā ia ma kona inoa generic, carmustine, a i ʻole ma kāna pōkole kemika BCNU.

Aia kekahi ʻano carmustine ʻē aʻe i kapa ʻia ʻo Gliadel, e hele mai ana ma ke ʻano he mau wafers liʻiliʻi i waiho pololei ʻia i loko o ka lolo i ka wā o ke ʻoki ʻana no kekahi mau maʻi lolo. He ala ʻokoʻa loa kēia o ka loaʻa ʻana o ka lāʻau a ʻaʻole i hāʻawi ʻia ma o ka IV e like me ke ʻano BiCNU.

Nā koho ʻē aʻe o Carmustine

Inā ʻaʻole kūpono ka carmustine iā ʻoe a i ʻole e pau ka hana ʻana, he nui nā koho lapaʻau ʻē aʻe e noʻonoʻo ai kāu oncologist. ʻO ke koho maikaʻi loa e pili ana i kāu ʻano maʻi maʻi, nā mālama mua, a me ke kūlana olakino holoʻokoʻa.

No nā maʻi lolo, hiki i nā koho ʻē aʻe ke komo:

• Temozolomide (Temodar) - he lāʻau chemotherapy waha
• Lomustine (CeeNU) - he lāʻau nitrosourea ʻē aʻe i lawe ʻia e ka waha
• Bevacizumab (Avastin) - he lāʻau lapaʻau i manaʻo ʻia
• Lapaʻau radiation
• Nā lāʻau lapaʻau hoʻokolohua lapaʻau

No nā lymphomas a me ka myeloma lehulehu, hiki i kāu kauka ke noʻonoʻo i nā hui chemotherapy ʻē aʻe, nā lāʻau immunotherapy, a i ʻole nā lāʻau i manaʻo ʻia. Ke hoʻomau nei ka hoʻololi ʻana o ke kahua o ka mālama ʻana i ka maʻi maʻi, no laila e loaʻa paha nā koho hou i kāu huakaʻi lapaʻau.

E hana pū kāu kauka oncologist me ʻoe e ʻimi i ka hoʻolālā lapaʻau kūpono loa no kāu kūlana kikoʻī, me ka noʻonoʻo ʻana i nā pōmaikaʻi a me nā hopena ʻaoʻao o kēlā me kēia koho.

Ua ʻoi aku ka maikaʻi o Carmustine ma mua o Temozolomide?

ʻAʻole maʻalahi ka hoʻohālikelike ʻana i ka carmustine a me ka temozolomide no ka mea hoʻohana pinepine ʻia lākou i nā kūlana like ʻole a no nā ʻano maʻi lolo like ʻole. Loaʻa i nā lāʻau lapaʻau ʻelua ko lākou mau pono kūikawā, a e koho kāu kauka oncologist ma muli o kāu ʻano maʻi maʻi kikoʻī a me nā kūlana.

Hoʻohana pinepine ʻia ʻo Temozolomide (Temodar) no ka glioblastoma i hōʻike ʻia i ka wā hou no ka mea hiki ke lawe ʻia ma ke ʻano he pila ma ka home a ʻoi aku ka liʻiliʻi o nā hopena ʻaoʻao koʻikoʻi. He maʻalahi hoʻi ke hui pū me ka radiation therapy. Eia naʻe, ʻoi aku ka maikaʻi o ka carmustine no kekahi mau ʻano maʻi lolo i lilo i mea kūʻē i nā lāʻau lapaʻau ʻē aʻe.

ʻO ka hiki o Carmustine ke hele i ka pale koko-lolo e waiwai ai no nā maʻi lolo, akā pono ia i ka hoʻokele IV a me ka nānā ʻana. E noʻonoʻo kāu hui lapaʻau i nā mea e like me kāu ʻano maʻi maʻi, nā lāʻau lapaʻau i hala, ka hana o ka puʻupaʻa a me ka māmā, a me nā makemake pilikino i ka wā e hoʻoholo ai ma waena o kēia mau koho.

I kekahi manawa hoʻohana nā kauka i kēia mau lāʻau lapaʻau ma ke kaʻina, e hoʻomaka ana me kekahi a hoʻololi i kekahi inā pono. ʻO ke koho

Inā he pilikia iki kou mau puʻupaʻa, hiki nō paha iā ʻoe ke loaʻa ka carmustine, akā e hoʻoponopono paha kāu kauka i ka mahele a i ʻole e nānā pono iā ʻoe. Akā naʻe, inā he maʻi puʻupaʻa koʻikoʻi kou, ʻaʻole paha he palekana ka carmustine iā ʻoe, a e ʻimi kāu hui lapaʻau i nā koho lapaʻau ʻē aʻe.

He aha kaʻu e hana ai inā loaʻa iaʻu ka nui o ka Carmustine?

No ka mea, hāʻawi mau ʻia ka carmustine e nā poʻe loea mālama ola i aʻo ʻia i kahi hoʻonohonoho lapaʻau, he mea maʻamau loa nā overdoses ulia pōpilikia. Ana ʻia a nānā pono ʻia ka lāʻau i kēlā me kēia infusion, a e hahai ana kāu hui lapaʻau i nā protocols paʻa e pale ai i nā hewa dosing.

Inā hopohopo ʻoe e pili ana i kāu mahele a i ʻole e ʻike i nā hōʻailona maʻamau i ka wā a i ʻole ma hope o ka lapaʻau ʻana, e ʻōlelo koke. Aia kāu hui mālama ola e pane i nā hopohopo a e nānā pono iā ʻoe no nā hōʻailona o nā pilikia. Loaʻa iā lākou nā protocols e hoʻokele i nā pilikia dosing e kū mai ana.

He aha kaʻu e hana ai inā e hala wau i kahi lapaʻau Carmustine i hoʻonohonoho ʻia?

Inā pono ʻoe e hala i kahi lapaʻau carmustine i hoʻonohonoho ʻia ma muli o ka maʻi, nā helu koko haʻahaʻa, a i ʻole nā kumu lapaʻau ʻē aʻe, e hoʻokaʻaʻike i kāu hui oncology i ka wā hiki loa. E hoʻonohonoho hou lākou i kāu lapaʻau no ka wā e palekana ai ke hoʻomau, ʻo ia paha kekahi mau lā a i ʻole mau pule ma hope ma muli o ke kumu o ka lohi.

ʻAʻole pono ka hala ʻana i kahi lapaʻau, a i kekahi manawa ʻo ia ka mea palekana e hana ai inā pono kou kino i ka manawa hou e ola ai. E nānā kāu hui lapaʻau i kāu mau helu koko a me ke olakino holoʻokoʻa ma mua o ka hoʻonohonoho hou ʻana e hōʻoia ua mākaukau ʻoe no ka lapaʻau e hiki mai ana.

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

ʻO ka hoʻoholo e hooki i ka carmustine e hilinaʻi ana i nā mea he nui, me ka maikaʻi o ka pane ʻana o kāu maʻi maʻi i ka lapaʻau a me ke ʻano o kou ʻae ʻana i nā hopena ʻaoʻao. E loiloi mau kāu oncologist i kou kūlana ma o nā scans, nā hoʻokolohua koko, a me nā hoʻokolohua kino e hoʻoholo ai i ka wā e kūpono ai ke hooki.

Hiki paha iā ʻoe ke hooki i ka carmustine no ka mea ua pane maikaʻi kāu maʻi maʻi i ka lāʻau lapaʻau, no ka mea ua paʻakikī loa nā hopena ʻaoʻao e mālama ai, a i ʻole no ka mea makemake kāu hui lapaʻau e hoʻāʻo i kahi ala lapaʻau ʻē aʻe. Mai hooki i ka lapaʻau ma kāu iho - e kūkākūkā mau i nā hopohopo me kāu hui mālama ola mua.

Hiki iaʻu ke hana i ka wā e loaʻa ana iaʻu ka lapaʻau carmustine?

Hiki i ka nui o nā kānaka ke hoʻomau i ka hana ʻoiai e loaʻa ana ka carmustine, akā pono paha ʻoe e hana i kekahi mau hoʻoponopono i kāu papa hana. No ka mea, ua hoʻokaʻawale ʻia nā lāʻau lapaʻau i 6-8 pule, e loaʻa iā ʻoe ka manawa ma waena o nā pōʻai e ola ai a e like me ʻoe iho.

Hiki paha iā ʻoe ke luhi a maʻi paha no kekahi mau lā ma hope o kēlā me kēia lapaʻau, no laila e noʻonoʻo e hoʻolālā i nā papa hana māmā i kēlā mau manawa. Manaʻo kekahi poʻe he mea kōkua ke hoʻonohonoho i nā lāʻau lapaʻau i nā Pōʻalima i loaʻa iā lākou ka hopena pule e hoʻomaha ai. E kamaʻilio me kāu mea hana e pili ana i nā hoʻonohonoho maʻalahi inā pono, a e hoʻomanaʻo i kou olakino ka mea mua.