Karsinoma Pūtau Whanau

Ko te karsinoma pūtau tūturu he momo mate pūngāwerewere kiri. Ka tīmata te karsinoma pūtau tūturu i ngā pūtau tūturu—he momo pūtau kei roto i te kiri e hanga ana i ngā pūtau kiri hou i te wā e mate ai ngā pūtau tawhito.

Ka puta mai te karsinoma pūtau tūturu i te nuinga o te wā hei pupuku maramara iti i runga i te kiri, ahakoa ka taea e ia te whakaatu i ētahi atu āhua. Ka puta mai te karsinoma pūtau tūturu i te nuinga o te wā i ngā wāhi o te kiri e whakakitea ana ki te rā, pēnei i tō upoko me tō kaki.

Ko te nuinga o ngā karsinoma pūtau tūturu e whakaarohia ana he hua o te whakakitenga roa ki te pāmahana ultraviolet (UV) mai i te rā. Ko te karo i te rā me te whakamahi i te kirirakau ka āwhina pea ki te tiaki i a koe i te karsinoma pūtau tūturu.

Ko te karcinoma pūtau tūturu e whāiti ana te whanaketanga i ngā wāhanga o tō tinana e pā ana ki te rā, inā koa tō ūtū me tō kaki. Ka iti ake te tūponotanga o te whanaketanga o te karcinoma pūtau tūturu ki ngā wāhanga o tō tinana e tiakina ana i te rā, pēnei i ngā ira tangata.

Ka puta te karcinoma pūtau tūturu hei huringa i te kiri, pēnei i te tipu, te pōka e kore e ora. Ko ēnei huringa o te kiri (ngā whara) e whai ana i tētahi o ēnei āhuatanga:

• He pupū kanapa, tae kiri e mārama ana, ā, e taea ana te kite atu i roto i te mata. Ka taea te titiro mawhero parauri, pēnei i te kiri ma. I runga i te kiri parauri me te kiri pango, ka titiro te pupū he parauri, he pango kanapa rānei. Ka kitea pea ngā uaua toto iti, ahakoa ka uaua pea te kite i runga i te kiri parauri me te kiri pango. Ka taea te toto me te pupuhi o te pupū.
• He whara parauri, pango, pango ranei — he whara ranei me ngā tohu pouri — me te taha o te piki ake, e mārama ana.
• He papatahi, he papatahi, he papatahi me te taha piki ake. I te roanga o te wā, ka taea e ēnei papatahi te tipu nui.
• He whara ma, ngawari, rite ki te tohu kahore he taha e taea te whakatau.

Whakaritea he whakatau me tō kaiwhakarato hauora ki te kite koe i ngā huringa o te ahua o tō kiri, pēnei i te tipu hou, te huringa o te tipu o mua, te pōkainga rānei e puta mai anō.

Ka puta te karsinoma pūtau tūturu ina whanake tētahi o ngā pūtau tūturu o te kiri he rerekētanga i roto i tōna DNA.

Kei raro o te epidermis ngā pūtau tūturu—ko te paparanga o waho o te kiri. Ka whakaputa ngā pūtau tūturu i ngā pūtau kiri hou. I te whakaputanga o ngā pūtau kiri hou, ka pehia ngā pūtau tawhito ki te mata o te kiri, kei reira ngā pūtau tawhito ka mate ka ngaro atu.

Ko ngā take e piki ai tō tūponotanga ki te mate pūkawa basal cell carcinoma:

• Te whakamātautau rā roa. He nui te wā i whakapauhia ki te rā—arā atu rānei i roto i ngā moenga tākuta whakahiato—e piki ai te tūponotanga o te mate pūkawa basal cell carcinoma. Ka nui ake te tūponotanga mena kei te noho koe i tētahi wāhi rā nui, i tētahi wāhi teitei rānei, e rua ngā wāhi e āhua nui atu ai te pānga o te whākōkī ultraviolet (UV). Ka piki ake hoki tō tūponotanga nā ngā tahunga rā nui.
• Te rongoā whakahiato. Ka piki pea te tūponotanga o te mate pūkawa basal cell carcinoma ki ngā wāhi i mua i te rongoā i te kiri, mā te rongoā whakahiato hei whakaora i te mate huango, i ētahi atu āhuatanga kiri rānei.
• Te kiri māwhero. Ka nui ake te tūponotanga o te mate pūkawa basal cell carcinoma i roto i te hunga e ngawha ngāwari ana, e tahuna ngāwari ana rānei, i te hunga he kiri māwhero rawa, he makawe whero, he huruhuru kowhai rānei, he kanohi māwhero rānei.
• Te pikinga o te tau. Nō te mea ka roa te whakawhānautanga o te mate pūkawa basal cell carcinoma, he maha ngā mate pūkawa basal cell carcinoma e puta ana i ngā tāngata pakeke. Engari ka pā hoki ki ngā tāngata kōuri, a kei te noho hei mea noa atu i ngā tāngata kei roto i ō rātou tau rua tekau me ngā tau toru tekau.
• Te hītori whaiaro, te hītori whānau rānei o te mate pūkawa. Mena kua pāngia koe e te mate pūkawa basal cell carcinoma kotahi, neke atu rānei ngā wā, he tūponotanga pai kei a koe kia puta anō. Mena he hītori whānau tōu mō te mate pūkawa, tera pea ka piki ake tō tūponotanga ki te whanake i te mate pūkawa basal cell carcinoma.
• Ngā rongoā whakaiti mate-pūnaha. Ko te inu i ngā rongoā e whakaiti ana i tō pūnaha mate, pēnei i ngā rongoā whakakore-whakangaro e whakamahia ana i muri i te pokanga whakawhiti, ka piki nui ake tō tūponotanga ki te mate pūkawa.
• Te whakamātautau ki te arsenic. Ko te arsenic, he konganuku kino e kitea whānuitia ana i te taiao, e piki ai te tūponotanga o te mate pūkawa basal cell carcinoma me ētahi atu mate pūkawa. He whakamātautau arsenic katoa kei a tātou katoa, nā te mea he mea noa. Engari tera pea ka nui ake te whakamātautau i ētahi atu, ki te inu rātou i te wai puna kī, ki te mahi rānei i tētahi mahi e pā ana ki te whakaputa, ki te whakamahi rānei i te arsenic.
• Ngā mate pūngao i whakawhiwhia e whakaeke ana i te mate pūkawa. Ka taea e ētahi mate pūngao onge te piki ake o te tūponotanga o te mate pūkawa basal cell carcinoma, tae atu ki te mate pūkawa basal cell carcinoma nevoid (mate pūngao Gorlin-Goltz) me te xeroderma pigmentosum.

Ko ngā raruraru o te mate pūngāwerewere papatipu ka uru ki:

• Te tūponotanga o te hokinga mai. He maha ngā hokinga mai o te mate pūngāwerewere papatipu, ahakoa kua ora pai te maimoatanga.
• Te piki o te tūponotanga o ētahi atu momo mate pūngāwerewere kiri. Ka piki pea te tūponotanga o te whanake i ētahi atu momo mate pūngāwerewere kiri, pēnei i te mate pūngāwerewere papatipu whero, ki te pēhi o te mate pūngāwerewere papatipu.
• Te mate pūngāwerewere e horapa atu ana i tua o te kiri. Ko te tino onge, ka horapa (ka horapa) te mate pūngāwerewere papatipu ki ngā whekau lymph tata me ētahi atu wāhi o te tinana, pēnei i ngā wheua me ngā pūkahukahu.

Hei whakaiti i tō tūponotanga ki te mate pūkohu papatipu, ka taea e koe te:

• Kaua e noho ki te rā i te waenganui o te rā. I ngā wāhi maha, he kaha rawa te rā i waenga i te 10 am me te 4 pm. Whakaritea ngā mahi i waho mō ētahi atu wā o te rā, ahakoa i te takurua, i te mea kapua rānei te rangi.
• Kakahu i te kirirakau i te tau katoa. Whakamahia he kirirakau whānui-whanui me te SPF o te 30 noa atu rānei, ahakoa he kapua te rangi. Tāpirihia te kirirakau nui, ā, whakahokia i ngā haora e rua—i te maha atu rānei mena kei te kauhoe koe, kei te wera wera rānei.
• Kakahu kakahu tiaki. Hipokina tō kiri ki ngā kakahu pouri, kōwhatu pūmau e hipoki ana i ō ringa me ō waewae, me te potae whānui-pōtae, e whakarato ana i te tiaki nui atu i te potae poitūkohu, i te pūeru rānei. Kei ētahi kamupene ētahi kakahu tiaki. Ka taea e te taote kiri te tūtohutia tētahi waitohu tika. Kaua e wareware ki ngā karāhe. Rapua ngā mea e aukati ana i ngā momo radiation UV e rua—te ultraviolet A (UVA) me te ultraviolet B (UVB).
• Kaua e whakamahi i ngā moenga tāne. Ka tukuna e ngā moenga tāne ngā hihi UV, ā, ka taea te whakapiki ake i tō tūponotanga ki te mate pūkohu kiri.
• Tirohia tō kiri i ia wā, ā, whakamōhiotia ngā huringa ki tō taote. Tirohia au tō kiri i ia wā mō ngā tipu kiri hou, i ngā huringa rānei i ngā taonga, ngā ira, ngā pūngāwerewere me ngā tohu whānau. Mā te whakamahi i ngā whakaata, tirohia tō mata, tō kaki, tō taringa me tō pane. Tirohia tō uma me tō puku me ngā pito o runga me raro o ō ringa me ō ringa. Tirohia ngā taha o mua me muri o ō waewae me ō waewae, tae atu ki ngā papa me ngā wāhi i waenga i ō maihao. Tirohia hoki tō wāhi ira tangata me waenga i ō turi.

Hei aromatawai i ngā pūngāwerewere, i ngā huringa rānei o tō kiri, ka whakahaerehia e tō tākua, e te tohunga kiri rānei (te dermatologist) he whakamātautau hauora me te whakamātautau tinana.

Ka whakahaerehia e tō tākua he whakamātautau tinana whānui, ka ui atu hoki ki a koe mō tō hītori hauora, ngā huringa o tō kiri, ngā tohu rānei, ngā tohu rānei kē atu i kitea e koe.

Ka uru pea ngā pūrongo ki:

Ka tirotirohia e tō tākua, ehara i te wāhi whakapae anake o tō kiri, engari ko te toenga o tō tinana mō ētahi atu mate kiri.

Ka taea e tō tākua te mahi i te tātaritanga kiri, e whakauru ana i te tango i te tauira iti o te mate kiri hei whakamātautau i roto i te taiwhanga. Ka whakakite mai tēnei mēnā kei a koe te mate pūngāwerewere o te kiri, ā, ki te pēhea, te momo mate pūngāwerewere o te kiri. Ko te momo tātaritanga kiri ka whiwhi koe ka whakawhirinaki ki te momo me te rāhi o te mate kiri.

• I tehea wā i kite tuatahi ai koe i tēnei pūngāwerewere kiri, mate kiri rānei?
• Kua huri mai i te wā i kite tuatahi ai koe?
• He mamae te pūngāwerewere, mate kiri rānei?
• Kei a koe ētahi atu pūngāwerewere, mate kiri rānei e awangawanga ana koe?
• Kua pangia koe e te mate pūngāwerewere o te kiri i mua?
• Kei te whānau o tō whānau tetahi kua pangia e te mate pūngāwerewere o te kiri? He aha te momo?
• Kei te whakamahi koe i ngā whakamarumaru kia ora ai koe i te rā, pēnei i te karo i te rā o te poutū me te whakamahi i te sunscreen?
• Kei te tirotiro koe i tō kiri i ia wā?

Ko te whāinga o te maimoatanga mō te mate pūtau papatipu ko te tango katoa i te mate pukupuku. Ko tehea maimoatanga te pai rawa mōu e whakamahere ana i te momo, te wāhi me te rāhi o tō mate pukupuku, me ō hiahia me tō kaha ki te haere ki ngā whakamātautau. Ka taea hoki te whakawhirinaki o te whiriwhiri maimoatanga ki te mea he mate pūtau papatipu tuatahi tēnei, he mate pūtau papatipu anō rānei.

Ko te nuinga o te wā ka maimoatia te mate pūtau papatipu mā te pokanga hei tango i te mate pukupuku katoa me ētahi o ngā kiko hauora kei te taha.

Ka āhei pea ngā kōwhiringa:

Te whakakotinga pokanga. I roto i tēnei tukanga, ka tapahia e tō tākuta te mate pukupuku me te taha o te kiri hauora kei te taha. Ka tirotirohia te taha i raro i te microscope kia kore ai he pūtau mate pukupuku.

Ka tūtohu pea te whakakotinga mō ngā mate pūtau papatipu ka iti ake te hokinga mai, pēnei i te hunga e hanga ana i te uma, te tuara, ngā ringa me ngā waewae.

Te pokanga Mohs. I te wā o te pokanga Mohs, ka tangohia e tō tākuta te mate pukupuku i te paparanga ki te paparanga, ka tirotirohia ia paparanga i raro i te microscope kia kore ra ano ngā pūtau rerekē. Ka taea ai e te taote te tino mohio kua tangohia te tipu katoa, ā, kia kore ai e tangohia te nui o te kiri hauora kei te taha.

Ka tūtohu pea te pokanga Mohs ki te mea kei tō mate pūtau papatipu te tūponotanga teitei o te hokinga mai, pēnei i te mea nui ake, te horapa atu ki roto i te kiri, kei runga rānei i tō mata.

I ētahi wā, ka tūtohu pea ētahi atu maimoatanga i roto i ētahi āhuatanga, pēnei i te kore e taea e koe te pokanga, te kore rānei e hiahia koe ki te pokanga.

Ko ētahi atu maimoatanga:

Te kukū me te whakawera hiko (C me E). Ko te maimoatanga kukū me te whakawera hiko (C me E) e pā ana ki te tango i te mata o te mate pukupuku kiri mā te taputapu kukū (kukū), katahi ka wera te pūtake o te mate pukupuku mā te ngira hiko.

C me E pea he kōwhiringa mō te maimoatanga i ngā mate pūtau papatipu iti ka iti ake te hokinga mai, pēnei i te hunga e hanga ana i te tuara, te uma, ngā ringa me ngā waewae.

Te rongoā whakahihiko. Ka whakamahi te rongoā whakahihiko i ngā hihi kaha, pēnei i ngā X-rays me ngā protons, hei whakamate i ngā pūtau mate pukupuku.

Ka whakamahia pea te rongoā whakahihiko i muri i te pokanga ina he nui ake te tūponotanga ka hoki mai te mate pukupuku. Ka taea hoki te whakamahi ina kāore he kōwhiringa pokanga.

Te whakakore. Ko tēnei maimoatanga e pā ana ki te whakakore i ngā pūtau mate pukupuku mā te hau konutai wai (cryosurgery). He kōwhiringa pea mō te maimoatanga i ngā whara kiri mata. Ka taea te whakakore i muri i te whakamahinga i te taputapu kukū (kukū) hei tango i te mata o te mate pukupuku kiri.

Ka whakaaro pea te cryosurgery mō te maimoatanga i ngā mate pūtau papatipu iti, angiangi ina kāore he kōwhiringa pokanga.

Te rongoā whakaahua. Ka whakakotahi te rongoā whakaahua i ngā rongoā whakaohooho marama me te mārama hei maimoatanga i ngā mate pukupuku kiri mata. I te wā o te rongoā whakaahua, ka tāpirihia he rongoā wai e whakaohooho ana i ngā pūtau mate pukupuku ki te mārama ki te kiri. I muri mai, ka whakamahia he mārama hei whakangaro i ngā pūtau mate pukupuku kiri ki taua wāhi.

Ka whakaaro pea te rongoā whakaahua ina kāore he kōwhiringa pokanga.

Ko te tino onge, ka horapa pea te mate pūtau papatipu (metastasize) ki ngā ngota lymph tata me ētahi atu wāhi o te tinana. Ko ētahi atu kōwhiringa maimoatanga i tēnei āhuatanga:

Te rongoā tarukino whāinga. Ka arotahi ngā maimoatanga tarukino whāinga ki ngā ngoikoretanga motuhake kei roto i ngā pūtau mate pukupuku. Mā te aukati i ēnei ngoikoretanga, ka taea e ngā maimoatanga tarukino whāinga te whakamate i ngā pūtau mate pukupuku.

Ka aukati ngā rongoā maimoatanga whāinga mō te mate pūtau papatipu i ngā tohu molecular e taea ai te tipu tonu o ngā mate pukupuku. Ka whakaaro pea i muri i ētahi atu maimoatanga, i te kore rānei e taea ētahi atu maimoatanga.

• Te whakakotinga pokanga. I roto i tēnei tukanga, ka tapahia e tō tākuta te mate pukupuku me te taha o te kiri hauora kei te taha. Ka tirotirohia te taha i raro i te microscope kia kore ai he pūtau mate pukupuku.

  Ka tūtohu pea te whakakotinga mō ngā mate pūtau papatipu ka iti ake te hokinga mai, pēnei i te hunga e hanga ana i te uma, te tuara, ngā ringa me ngā waewae.

• Te pokanga Mohs. I te wā o te pokanga Mohs, ka tangohia e tō tākuta te mate pukupuku i te paparanga ki te paparanga, ka tirotirohia ia paparanga i raro i te microscope kia kore ra ano ngā pūtau rerekē. Ka taea ai e te taote te tino mohio kua tangohia te tipu katoa, ā, kia kore ai e tangohia te nui o te kiri hauora kei te taha.

  Ka tūtohu pea te pokanga Mohs ki te mea kei tō mate pūtau papatipu te tūponotanga teitei o te hokinga mai, pēnei i te mea nui ake, te horapa atu ki roto i te kiri, kei runga rānei i tō mata.

• Te kukū me te whakawera hiko (C me E). Ko te maimoatanga kukū me te whakawera hiko (C me E) e pā ana ki te tango i te mata o te mate pukupuku kiri mā te taputapu kukū (kukū), katahi ka wera te pūtake o te mate pukupuku mā te ngira hiko.

  Ka taea pea te C me E hei kōwhiringa mō te maimoatanga i ngā mate pūtau papatipu iti ka iti ake te hokinga mai, pēnei i te hunga e hanga ana i te tuara, te uma, ngā ringa me ngā waewae.

• Te rongoā whakahihiko. Ka whakamahi te rongoā whakahihiko i ngā hihi kaha, pēnei i ngā X-rays me ngā protons, hei whakamate i ngā pūtau mate pukupuku.

  Ka whakamahia pea te rongoā whakahihiko i muri i te pokanga ina he nui ake te tūponotanga ka hoki mai te mate pukupuku. Ka taea hoki te whakamahi ina kāore he kōwhiringa pokanga.

• Te whakakore. Ko tēnei maimoatanga e pā ana ki te whakakore i ngā pūtau mate pukupuku mā te hau konutai wai (cryosurgery). He kōwhiringa pea mō te maimoatanga i ngā whara kiri mata. Ka taea te whakakore i muri i te whakamahinga i te taputapu kukū (kukū) hei tango i te mata o te mate pukupuku kiri.

  Ka whakaaro pea te cryosurgery mō te maimoatanga i ngā mate pūtau papatipu iti, angiangi ina kāore he kōwhiringa pokanga.

• Ngā maimoatanga matū. Ka whakaaro pea ngā kirikiri rongoā rānei ngā hinu mō te maimoatanga i ngā mate pūtau papatipu iti, angiangi ina kāore he kōwhiringa pokanga.

• Te rongoā whakaahua. Ka whakakotahi te rongoā whakaahua i ngā rongoā whakaohooho marama me te mārama hei maimoatanga i ngā mate pukupuku kiri mata. I te wā o te rongoā whakaahua, ka tāpirihia he rongoā wai e whakaohooho ana i ngā pūtau mate pukupuku ki te mārama ki te kiri. I muri mai, ka whakamahia he mārama hei whakangaro i ngā pūtau mate pukupuku kiri ki taua wāhi.

  Ka whakaaro pea te rongoā whakaahua ina kāore he kōwhiringa pokanga.

• Te rongoā tarukino whāinga. Ka arotahi ngā maimoatanga tarukino whāinga ki ngā ngoikoretanga motuhake kei roto i ngā pūtau mate pukupuku. Mā te aukati i ēnei ngoikoretanga, ka taea e ngā maimoatanga tarukino whāinga te whakamate i ngā pūtau mate pukupuku.

  Ka aukati ngā rongoā maimoatanga whāinga mō te mate pūtau papatipu i ngā tohu molecular e taea ai te tipu tonu o ngā mate pukupuku. Ka whakaaro pea i muri i ētahi atu maimoatanga, i te kore rānei e taea ētahi atu maimoatanga.

• Te chemotherapy. Ka whakamahi te chemotherapy i ngā rongoā kaha hei whakamate i ngā pūtau mate pukupuku. He kōwhiringa pea ina kāore i awhina ētahi atu maimoatanga.

Kaore he uauatanga