He aha te DCIS? Tohutohu, Take, me te Maimoatanga

Ko te DCIS, ko te ductal carcinoma in situ rānei, he momo mate pukupuku u he kore-whakauru, kei reira ngā pūtau kē i kitea i roto i ngā ngongo waiū, engari kāore i horapa ki ngā kōpū u tata atu. Whakaarohia he pūtau mate pukupuku kua ‘pupuri’ ki roto i ngā ngongo, penei i te wai i roto i te paipa kāore ano kia rere mai.

Ahakoa ka rongo te kupu ‘carcinoma’ he wehi, e kiia ana te DCIS he mate pukupuku u Wāhanga 0, no te mea kāore ano i werohia ngā kōpū a tawhio noa. He maha ngā tākuta e kī ana he āhuatanga ‘mua-mate pukupuku’ tēnei, ā, mā te maimoatanga tika, he pai te tirohanga mō te nuinga o te iwi.

He aha ngā tohu o te DCIS?

Ko te nuinga o te iwi e pangia ana e te DCIS kāore e kitea he tohu. E kitea ana tēnei āhuatanga i te whakamātautau mammography noa, ehara i te mea i kitea e tetahi tetahi mea kē.

Ki te puta mai ngā tohu, he ngāwari ki te tirotiro. Ko ēnei ngā tohu ka puta mai pea:

• He pūngāwerewere iti, kore-mamae ka taea te kite i te whakamātautau whaiaro
• Te rere o te ngongo, ka ma, kōwhai, kākahu rānei
• Ngā huringa i te ahua o te ngongo, penei i te toia ki roto, te āhua kē rānei
• Te mamae o te u, te ngawari rānei i tētahi wāhi motuhake
• Ngā huringa kiri i runga i te u, penei i te pūngāwerewere, te kōkī rānei

He mea nui kia mahara ka taea hoki e ēnei tohu te tohu i ngā āhuatanga u pai. Ko te mea nui ehara i te mea kia wehi, engari kia tirohia e tō kaiwhakarato hauora ngā huringa katoa i te wa tika.

He aha ngā take o te DCIS?

Ka whanake te DCIS ina tīmata ngā pūtau i roto i ngā ngongo waiū ki te tipu kē, ki te wehewehe kore-manaaki hoki. Ahakoa kāore tatou e tino mōhio he aha te take o tēnei mahi, kua kitea e ngā kairangahau ngā take maha ka āwhina pea.

Ko te take matua te āwangawanga ki te DNA i roto i ngā pūtau ngongo u. Ka taea te puta mai tēnei āwangawanga i te wā roa na te koroheketanga noa, ngā awe o te homoni, ngā take taiao rānei. Ko te tikanga ka whakatika tō tinana i tēnei momo āwangawanga, engari i etahi wā kāore te mahi whakatikatika e mahi pai.

He maha ngā take ka piki ake te tūponotanga o te whanaketanga o te DCIS:

• Tau - ko te nuinga o ngā keehi kei ngā wāhine neke atu i te 50
• Te hītori whānau o te mate pukupuku u, mate pukupuku ovaries rānei
• Ngā biopsy u o mua e whakaatu ana i ngā pūtau kē
• Te rongoā whakakapi homoni roa
• Te tīmatanga o te menestrual i te wa iti, te mutu o te menestrual i te wa roa rānei
• Kāore i whānau tamariki, te whānau i tō tamaiti tuatahi i muri i te 30 tau rānei
• Ngā rerekētanga ira, ina koa ko te BRCA1 me te BRCA2

Ko te whai i ēnei take tūponotanga kāore e kī ka whanake koe i te DCIS. He maha ngā tāngata e whai ana i ngā take tūponotanga maha kāore e whanake i te āhuatanga, ka whanake ētahi atu kāore he take tūponotanga e mohiotia ana.

He aha ngā momo DCIS?

Ka wehewehea te DCIS ki ngā momo rerekē i runga i te ahua o ngā pūtau kē i raro i te microscope me te tere o te tipu. Ko te mārama ki tō momo motuhake ka āwhina i tō tākuta ki te whakarite i te huarahi maimoatanga pai.

Ko te pūnaha wehewehenga matua e titiro ana ki te tohu o ngā pūtau:

• DCIS iti-tohu - ko ngā pūtau e rite ana ki ngā pūtau u noa, ka tipu haere hoki

• DCIS tohu-waenganui - he pūtau kē teitei te āhua, he tere te tipu waenganui
• DCIS tohu-teitei - ko ngā pūtau he rerekē rawa atu i ngā pūtau noa, ka tipu tere ake hoki

Ka tirotirohia hoki e tō pathologist ngā kaiwhiwhi homoni (estrogen me te progesterone) me te pūmua e kiia nei ko te HER2. Ka āwhina ēnei taipitopito ki te whakatau mena ka āwhina pea ētahi maimoatanga, penei i te rongoā homoni, mōu.

He huarahi anō ngā tākuta e whakaahua ana i te DCIS, ko te āhua tipu i roto i ngā ngongo. Ko ētahi momo e tipu ana i te āhua pumau, ko ētahi atu he āhua marara atu, he cribriform (rite ki te mīti Huipī) te ahua. Ka āwhina tēnei mōhiohio ki te kī he aha te āhua o te āhuatanga.

Nōhea te haere ki te tākuta mō te DCIS?

Me whakapiri atu koe ki tō kaiwhakarato hauora ki te kite koe i ngā huringa kē i roto i ō u, ahakoa he iti rawa. Ko te kite wawe me te aromatawai he pai tonu i te tatari me te manukanuka.

Whakaritea he hui i roto i ngā rā torutoru mena ka pāngia koe e:

• Tetahi pūngāwerewere hou, te mātotorotanga rānei i roto i tō u, i raro i tō ringa rānei
• Te rere o te ngongo ka puta mai kaore i te pehi
• Ngā huringa i te rahi, te ahua rānei o te u
• Ngā huringa kiri penei i te pūngāwerewere, te kōkī, te whero rānei
• Ngā huringa ngongo, tae atu ki te tahuri, te āhua kē rānei

Ki te neke atu i te 40 ō tau, te hītori whānau rānei o te mate pukupuku u, kaua e ngaro ō whakamātautau mammography noa. E kitea ana te nuinga o ngā keehi o te DCIS i te whakamātautau noa i mua i te puta mai o ngā tohu.

Kia mahara ko te nuinga o ngā huringa u ehara i te mate pukupuku, engari he mea pai tonu te whai i te aromatawai ngaio mō te rangimarie o te ngākau me te tiaki tika.

He aha ngā take tūponotanga mō te DCIS?

He maha ngā take ka piki ake ō tūponotanga ki te whanake i te DCIS, ahakoa ko te whai i ngā take tūponotanga kāore e kī ka whanake koe i te āhuatanga. Ko te mārama ki ēnei take ka āwhina i a koe ki te whakatau i ngā whakatau mō te whakamātautau me ngā kōwhiringa oranga.

Ko ēnei ngā take tūponotanga nui rawa:

• Tau - ka piki haere te tūponotanga i muri i te menopause, ko te nuinga o ngā keehi kei ngā wāhine neke atu i te 50
• Te hītori whānau - ko te whai whānau tata e pangia ana e te mate pukupuku u, mate pukupuku ovaries rānei ka rua te tūponotanga
• Ngā raruraru u o mua - te hītori o te hyperplasia kē, te lobular carcinoma in situ rānei
• Ngā rerekētanga ira - BRCA1, BRCA2, me ētahi atu huringa ira kua oti te whakawhiwhi
• Te kōpū u matotoru - ka uaua ake te kite me te piki ake te tūponotanga
• Te whakamahinga homoni - ngā wā roa o te whakamahinga estrogen na te tīmatanga o ngā wā iti, te mutu o te menopause i te wa roa, te rongoā homoni rānei

Ko ētahi atu take tūponotanga iti ake kua kitea e ngā kairangahau ko te kore e whakūmāmā, te momona i muri i te menopause, me te whakahaere tinana iti. Engari, he iti rawa te pā o ēnei take ki tō tūponotanga whānui.

He mea tika te kī ko te 75% o ngā wāhine e pangia ana e te DCIS kāore he take tūponotanga e mohiotia ana atu i te tau me te wahine. Koinei te take he mea nui te whakamātautau noa mō te kite wawe.

He aha ngā raruraru pea o te DCIS?

Ko te āwangawanga nui mō te DCIS ko te ka taea te whanake hei mate pukupuku u whakauru ki te kore e maimoatia. Engari, ehara tēnei whakawhitinga i te mea tino, ā, he maha ngā keehi o te DCIS kāore e puta hei mate pukupuku whakauru.

E kī ana ngā rangahau, ki te kore e maimoatia, ka taea e te 30-50% o ngā keehi DCIS te puta hei mate pukupuku whakauru i roto i ngā tau maha. Ko te tūponotanga e whakawhirinaki ana ki ngā take penei i te tohu o tō DCIS me ō āhuatanga motuhake.

Ko ēnei ngā raruraru pea:

• Te whakawhitinga ki te mate pukupuku whakauru - ko te āwangawanga nui e arahi ana i ngā whakatau maimoatanga
• Te hokinga mai - ka taea te hokinga mai o te DCIS ki te wāhi kotahi, te whanake rānei i ētahi atu wāhi o te u
• Ngā pānga e pā ana ki te maimoatanga - ngā pānga o te pokanga, te rongoā radiation, te rongoā rānei
• Te pānga hinengaro - te manukanuka mō te whakatau mate pukupuku me ngā whakatau maimoatanga

Ko te rongo pai, mā te maimoatanga tika, ko te nuinga o te iwi e pangia ana e te DCIS ka ora tonu, ka ora hauora. Ko te reiti ora rima-tau mō te DCIS tata ki te 100% ina maimoatia tika.

Ka mahi tahi tō rōpū hauora ki a koe ki te taurite i ngā painga o te maimoatanga ki ngā tūponotanga me ngā pānga, mā te whakaaro ki tō āhuatanga motuhake me ō hiahia.

Me pēhea te whakatau i te DCIS i te kāinga?

Ahakoa he mea nui te maimoatanga hauora mō te DCIS, he maha ngā mea ka taea e koe te mahi i te kāinga hei tautoko i tō hauora whānui me tō oranga pai i te wā me muri i te maimoatanga.

Arotake ki te pupuri i te oranga hauora e tautoko ana i ngā mahi whakatikatika taiao o tō tinana. Kei roto i ēnei te kai kai tōtika e whai hua ana i ngā hua, ngā huawhenua, me ngā witi katoa, me te whakaiti i ngā kai tukatuka me te inu waipiro nui.

Ka taea e te whakahaere tinana noa te whakapakari i tō pūnaha mate, te whakapai ake hoki i tō oranga pai whānui. Tīmata ki ngā mahi ngāwari penei i te hikoi, te kauhoe rānei, ka piki haere te kaha i te wa e pai ana koe me te whakaae a tō tākuta.

He mea nui te whakahaere i te ahotea mō tō whakaora me tō hauora haere tonu. Whakaarohia ngā tikanga penei i te ngākau marie, ngā whakamahi manawa hohonu, te yoga rānei. He maha ngā tāngata e kite ana ko te uru atu ki ngā rōpū tautoko, te kōrero rānei ki ētahi atu kua whai wheako rite ka tino whai hua.

Pupuri i ngā huringa i roto i ō u, me haere ki ngā hui whakarite katoa me tō rōpū hauora. Kaua e whakaroa ki te whakapiri atu ki tō tākuta ki te kite koe i tetahi mea kē, te manukanuka rānei mō tō whakaora.

Me pēhea te whakarite mō tō hui tākuta?

Ko te whakarite mō tō hui ka āwhina i a koe ki te whiwhi i te nuinga o tō wā me tō kaiwhakarato hauora, me te whakautu tika i ō pātai katoa.

Tīmata mā te tuhi i ō tohu katoa, tae atu ki te wā i tīmata ai rātou me te āhua o te huringa i te wā. Tākina ngā take e āwhina ana ki te whakapai ake i ngā tohu, te whakaiti rānei, ahakoa he kore hononga ki ō raruraru u.

Kohikohia he rārangi katoa o ō rongoā, tae atu ki ngā rongoā rongoā, ngā rongoā kore-rongoā, ngā huaora, me ngā taapiri. Tāpiritia hoki ngā mōhiohio mō tō hītori hauora whānau, ina koa te hītori o te mate pukupuku u, mate pukupuku ovaries, mate pukupuku rānei.

Whakaritea he rārangi o ngā pātai e hiahia ana koe ki te ui ki tō tākuta. Ko ētahi pātai nui pea ko:

• He aha te momo me te tohu o taku DCIS?
• He aha ngā kōwhiringa maimoatanga, me te aha tāu e tūtohutia ana?
• He aha ngā pānga pea o ia maimoatanga?
• Me pēhea te pānga o te maimoatanga ki aku mahi o ia rā?
• He aha te tiaki whakarite ka hiahia ahau?
• He huringa oranga kāore e hiahia ana ahau ki te whakaaro?

Whakaarohia te kawe mai i tētahi hoa whakawhirinaki, mema whānau rānei ki tō hui. Ka taea e rātou te āwhina i a koe ki te mahara ki ngā mōhiohio nui me te whakarato tautoko hinengaro i te wā ka rongo pea he nui te kōrero.

He aha te mea nui mō te DCIS?

He āhuatanga tino maimoatia te DCIS me te tirohanga pai ina kitea wawe ka whakahaeretia tika. Ahakoa ka rongo te whiwhi i te whakatau mate pukupuku he nui, kia mahara ko te DCIS e kiia ana he mate pukupuku Wāhanga 0 no te mea kāore ano i horapa atu i ngā ngongo waiū.

Ko te mea nui rawa atu kia mārama koe kei a koe te wā ki te whakatau i ngā whakatau maimoatanga. Ko te tikanga ka tipu haere te DCIS, na reira kaua e hohoro ki ngā whakatau maimoatanga. Tangohia te wā ki te mārama ki ō kōwhiringa, ki te tiki i tētahi atu whakaaro mena e hiahiatia ana, me te whiriwhiri i te huarahi e tika ana mōu.

Mā te maimoatanga tika, ko te nuinga o te iwi e pangia ana e te DCIS ka ora tonu, ka ora hauora, kaore te āhuatanga e puta hei mate pukupuku whakauru. Ko te tiaki whakarite tonu me te pupuri i te oranga hauora ka āwhina atu ki tō oranga pai roa.

Kia mahara kei reira tō rōpū hauora hei tautoko i a koe i ia kaupae o tēnei haerenga. Kaua e whakaroa ki te ui pātai, ki te whakaatu i ō manukanuka, ki te rapu tautoko atu rānei ina hiahia koe.

Ngā pātai e ui pinepinetia ana mō te DCIS

He mate pukupuku pono te DCIS?

E whakarōpūhia ana te DCIS hei mate pukupuku u Wāhanga 0, engari he maha ngā tākuta e pai ana ki te karanga ‘mua-mate pukupuku’ no te mea kāore ngā pūtau kē i horapa atu i ngā ngongo waiū. Ahakoa he tūponotanga hei mate pukupuku whakauru ki te kore e maimoatia, ehara i te mea mate-kino i tōna āhua o nāianei, ā, he pai te tirohanga mā te maimoatanga.

Me hiahia ahau ki te chemotherapy mō te DCIS?

Ko te tikanga kāore te chemotherapy e tūtohutia mō te DCIS no te mea kāore ngā pūtau kē i horapa atu i ngā ngongo. Ko te maimoatanga ko te pokanga me te rongoā radiation rānei, te rongoā homoni rānei. Ka whakawhirinaki tō mahere maimoatanga motuhake ki ngā āhuatanga o tō DCIS me ō āhuatanga motuhake.

Ka taea te hokinga mai o te DCIS i muri i te maimoatanga?

He iti te tūponotanga ka taea te hokinga mai o te DCIS, hei DCIS anō rānei, hei mate pukupuku u whakauru rānei. Ko te tikanga he iti te tūponotanga, ina koa mā te maimoatanga katoa tae atu ki te pokanga me te rongoā radiation ina tūtohutia. Ko te tiaki whakarite tonu mā ngā whakamātautau mammography me ngā whakamātautau hauora ka āwhina ki te kite wawe i ngā huringa.

E hia te roa o te maimoatanga DCIS?

Ka rerekē te wa i runga i tō mahere maimoatanga. Ko te pokanga ko te tikanga he torutoru wiki te whakaora, ko te rongoā radiation rānei, ina tūtohutia, ko te tikanga he maimoatanga o ia rā mō te 3-6 wiki. Ko te rongoā homoni, ina tuhia, ko te tikanga ka tangohia mō te 5 tau. Ka hoatu e tō tākuta he wa motuhake i runga i tō mahere maimoatanga.

Me whai whakamātautau ira ahau mō te DCIS?

Ka tūtohutia pea te whakamātautau ira ki te whai koe i te hītori whānau kaha o te mate pukupuku u, mate pukupuku ovaries rānei, i whakatauhia koe i te wa iti, he take tūponotanga anō rānei e tohu ana i ngā mate pukupuku ira. Ka taea e tō tākuta, te kaiāwhina ira rānei te āwhina i a koe ki te whakatau mena ka whai hua te whakamātautau i tō āhuatanga.