Rāhui Lynch

Ko te mate o Lynch tetahi āhuatanga e whakapiki ake ana i te tūponotanga o ngā momo pūngāwerewere maha. Ka tukuna mai tēnei āhuatanga e ngā mātua ki ā rātou tamariki.

Ko ngā whānau he mate o Lynch kei a rātou he maha atu ngā mate pūngāwerewere i te mea i whakaarohia. I roto i ēnei pea ko te mate pūngāwerewere o te kōroke, te mate pūngāwerewere o te endometrium me ētahi atu momo pūngāwerewere. Ka whakaeke hoki te mate o Lynch i ngā mate pūngāwerewere kia puta i te wā anō te iti.

Me āta whakamātautau pea ngā tāngata he mate o Lynch kia kimihia te pūngāwerewere i te wā iti. He nui ake te tūponotanga o te angitu o te rongoā ina mau te pūngāwerewere i te wā wātea. Ko ētahi o ngā tāngata he mate o Lynch pea ka whakaaro ki ngā rongoā hei ārai i te pūngāwerewere.

I karangatia mua te mate o Lynch ko te mate pūngāwerewere colorectal tuku iho kore polyposis (HNPCC). Ko te HNPCC te kupu e whakamahia ana hei whakaahua i ngā whānau he hītori kaha o te mate pūngāwerewere o te kōroke. Ko te mate o Lynch te kupu e whakamahia ana ina kitea e ngā tākua he ira e rere ana i roto i te whānau ā ka puta te pūngāwerewere.

Ko ngā tāngata e pā ana ki te mate o Lynch pea ka pā ki a rātou: Te mate pukupuku rōpū i mua i te 50 tau Te mate pukupuku o te paparinga o roto o te kopu (mate pukupuku endometrial) i mua i te 50 tau He hītori whaiaro mo tetahi atu momo mate pukupuku He hītori whānau mo te mate pukupuku i mua i te 50 tau He hītori whānau mo ētahi atu mate pukupuku i puta mai i te mate o Lynch, tae atu ki te mate pukupuku puku, te mate pukupuku ovaries, te mate pukupuku pancreas, te mate pukupuku whatukuhu, te mate pukupuku pūkahukahu, te mate pukupuku ureteral, te mate pukupuku roro, te mate pukupuku puku iti, te mate pukupuku repe, te mate pukupuku ngongo o te ate me te mate pukupuku kiri Ki te pēhea te mema o tō whānau e pā ana ki te mate o Lynch, korero atu ki tō kaiwhakarato hauora. Pātai atu ki tō kaiwhakarato kia āwhina i te whakarite i tetahi whakatau me tetahi tohunga kua whakangungua ki roto i te ira, pēnei i tetahi kaitohutohu ira. Ka taea e tēnei tangata te āwhina i a koe ki te mārama ki te mate o Lynch, he aha ngā take, me te mea he tika te whakamātautau ira mōu.

Mēnā he mema o te whānau kei a rātou te mate o Lynch, kī atu ki tō kaiwhakarato hauora. Pātai atu ki tō kaiwhakarato kia āwhina i te whakarite i te whakatau me tetahi tohunga kua whakangungua ki ngā kaupapa ira, pēnei i te kaitohutohu ira. Ka taea e tēnei tangata te āwhina i a koe ki te mārama ki te mate o Lynch, ngā take o te mate, me te tika rānei o te whakamātautau ira mōu.

Ko te mate o Lynch te take o ngā ira e tukuna ana e ngā mātua ki ō rātou tamariki.

Ko ngā ira ngā wāhanga o te DNA. Ko te DNA he rite ki te huinga o ngā tohutohu mō ia tukanga matū e puta ana i roto i te tinana.

I te tipu o ngā pūtau me te hanga i ngā pūtau hou hei wāhanga o tō rātou oranga, ka hanga e rātou ngā kape o tō rātou DNA. I ētahi wā, he hapa ngā kape. Kei te tinana tētahi huinga o ngā ira e pupuri ana i ngā tohutohu mō te kimi i ngā hapa me te whakatika i aua hapa. Ka karanga ngā tākua i ēnei ira ko ngā ira whakatikatika hapa.

Ko ngā tāngata e pangia ana e te mate o Lynch he ira whakatikatika hapa kāore e mahi i te ara e tumanakohia ana. Ki te puta he hapa i roto i te DNA, pea kāore e whakatikatikahia. Ka taea e tēnei te whakaeke i ngā pūtau e tipu ana i waho o te mana me te riro hei pūtau mate pukupuku.

Ka rere te mate o Lynch i roto i ngā whānau i roto i tētahi tauira tuku mana motuhake. Ko te tikanga, ki te mea he ira kei tētahi mātua e whakaeke ana i te mate o Lynch, he 50% te tūponotanga ka whiwhi ia tamaiti i ngā ira e whakaeke ana i te mate o Lynch. Kāore te mātua e mau ana i te ira e pā ana ki te tūponotanga.

Kaore he uauatanga

Ko te mohiotanga kei a koe te mate Lynch syndrome ka ara ake ngā whakaaro mō tō hauora. Ka ara ake pea hoki ētahi whakaaro mō ētahi atu wāhanga o tō oranga. Ā, ko ēnei pea:

• Tō tūpato. Ka pāngia koe pea e ngā pātai mō te aha ka puta mai mehemea ka kite atu ētahi atu kei a koe te mate Lynch syndrome. Hei tauira, āta whakaaro pea koe kei te kitea e tō mahi, e ngā kamupene inihua rānei. Ka taea e te tohunga ira te whakamārama i ngā ture hei tiaki i a koe.
• Au tamariki. Ki te mea kei a koe te mate Lynch syndrome, kei te tūpono ngā tamariki ki te whiwhi i taua mate i a koe. Ka taea e te tohunga ira te āwhina i a koe ki te whakatakoto mahere mō te kōrero ki ō tamariki. Ka uru pea te mahere ki te pēhea me te wā hei kōrero atu ki a rātou, me te wā e tika ai te whakaaro ki te whakamātautau.
• Tō whānau whānui. Kei te whai pānga te mate Lynch syndrome ki tō whānau katoa. Kei te tūpono pea ētahi atu whānau toto ki te whiwhi i te mate Lynch syndrome. Ka taea e te tohunga ira te āwhina i a koe ki te kimi i te huarahi pai hei kōrero atu ki ngā mema o te whānau.

Kaore he uauatanga

Ka timata pea te whakatau i te mate o Lynch syndrome me te arotake i te hītori o tō whānau e pā ana ki te mate pukupuku. Ka hiahia tō kaiwhakarato hauora ki te mohio mēnā kua pangia koe, kē koe tetahi o tō whānau e te mate pukupuku rōpū, te mate pukupuku endometrial me ētahi atu mate pukupuku. Ka āhei pea tenei ki ētahi atu whakamātautau me ngā tukanga hei whakatau i te mate o Lynch syndrome.

Ka hiahia pea tō kaiwhakarato kia whakaaro koe ki te whakamātautau ira mo te mate o Lynch syndrome ki te mea he kotahi, neke atu rānei o ngā mea e whai ake nei i roto i te hītori o tō whānau:

• He maha ngā whānau e pangia ana e tetahi o ngā mate pukupuku e hono ana ki a Lynch, tae atu ki te mate pukupuku rōpū me te mate pukupuku endometrial. Ko ētahi atu mate pukupuku i puta mai i te mate o Lynch ko ngā mate e puta ana i te puku, ngā ovaries, te pancreas, ngā whatukuhu, te putea mimi, ngā ureters, te roro, te gallbladder, ngā kaukau bile, te puku iti me te kiri.
• Kotahi, neke atu rānei ngā mema o te whānau i pangia e te mate pukupuku i mua i te 50 tau.
• Kotahi, neke atu rānei ngā mema o te whānau kua pangia e neke atu i te kotahi momo mate pukupuku.
• Neke atu i te kotahi whakatupuranga o te whānau me te momo mate pukupuku kotahi.

Ki te mea kua pangia koe, kē tetahi o tō whānau e te mate pukupuku, ka taea pea te whakamātautau i te tauira o ngā pūtau mate pukupuku.

Ko ngā whakamātautau i runga i ngā pūtau mate pukupuku ko:

• Te whakamātautau Immunohistochemistry (IHC). Ka whakamahi te whakamātautau IHC i ngā tae motuhake hei whakairo i ngā tauira kiko. Ka whakaatu te tūnga, kē te kore o te whakairo mēnā kei te kiko te kiko i ētahi pūmua. Ka āhei pea te ngaro o ngā pūmua ki te whakatau mēnā ko ngā ira e pā ana ki te mate o Lynch i puta ai te mate pukupuku.
• Te whakamātautau koretake microsatellite (MSI). Ko ngā microsatellites he ngā pū ā-DNA. I roto i te hunga e pangia ana e te mate o Lynch, ka puta pea ngā hapa, kē te koretake i ēnei pū.

Ka taea e ngā hua whakamātautau IHC, kē MSI pai te whakaatu kei ngā pūtau mate pukupuku ngā huringa ira e hono ana ki te mate o Lynch. Engari kāore e taea e ngā hua te kī tino mēnā kei a koe te mate o Lynch. Kei ētahi tangata ēnei huringa ira i roto i ō rātou pūtau mate pukupuku anake. Ko te tikanga kāore i tukuna mai ngā huringa ira.

Kei ngā tangata e pangia ana e te mate o Lynch ngā ira e puta ai te mate o Lynch i roto i ngā pū katoa o o rātou tinana. Me whakamātautau ira hei tirotiro mēnā kei ēnei ira ngā pū katoa.

Ka rapu te whakamātautau ira i ngā huringa i roto i ngā ira e puta ai te mate o Lynch. Ka taea e koe te hoatu i te tauira o tō toto mō tēnei whakamātautau.

Ki te mea he mema o te whānau kei a ia te mate o Lynch, ka titiro pea tō whakamātautau ki te ira anake e rere ana i roto i tō whānau. Ki te mea ko koe te tangata tuatahi i roto i tō whānau hei whakamātautau mō te mate o Lynch, ka tirotiro pea tō whakamātautau i ngā ira maha ka taea te rere i roto i ngā whānau. Ka taea e tetahi tohunga ira te awhina ki te whakatau i te whakamātautau pai mōu.

Ka taea e te whakamātautau ira te whakaatu:

• He hua whakamātautau ira pai. Ko te tikanga o te hua pai ko te huringa ira i puta ai te mate o Lynch i kitea i roto i ō pūtau. Kāore te tikanga ka pangia koe e te mate pukupuku. Engari ko te tikanga ko tō tūponotanga ki ētahi mate pukupuku he teitei atu i te hunga kāore he mate o Lynch.

  Ko tō tūponotanga whaiaro ki te mate pukupuku e whakawhirinaki ana ki ngā ira e rere ana i roto i tō whānau. Ka taea e koe te whakaiti i tō tūponotanga me ngā whakamātautau hei rapu i ngā tohu o te mate pukupuku. Ka taea e ētahi maimoatanga te awhina i te whakaiti i tō tūponotanga ki ētahi mate pukupuku. Ka taea e tetahi tohunga ira te whakamārama i tō tūponotanga takitahi ki a koe i runga i ō hua.

• He hua whakamātautau ira kino. Ko te tikanga o te hua kino ko ngā huringa ira i puta ai te mate o Lynch kāore i kitea i roto i ō pūtau. Ko te tikanga kāore pea koe e pangia e te mate o Lynch. Engari ka taea tonu te piki o tō tūponotanga ki te mate pukupuku. Ko te take ko te hunga he hītori whānau kaha o te mate pukupuku ka piki pea te tūponotanga o te mate.

• He rerekētanga ira o te tikanga kore e mohiotia. Kāore ngā whakamātautau ira i te wa katoa e homai ana he whakautu ae, kē kāo. I etahi wā, ka kitea e te whakamātautau ira he ira kāore ngā tākuta e tino mōhio ana. Ka taea e tetahi tohunga ira te kī ki a koe he aha te tikanga mō tō hauora.

He hua whakamātautau ira pai. Ko te tikanga o te hua pai ko te huringa ira i puta ai te mate o Lynch i kitea i roto i ō pūtau. Kāore te tikanga ka pangia koe e te mate pukupuku. Engari ko te tikanga ko tō tūponotanga ki ētahi mate pukupuku he teitei atu i te hunga kāore he mate o Lynch.

Ko tō tūponotanga whaiaro ki te mate pukupuku e whakawhirinaki ana ki ngā ira e rere ana i roto i tō whānau. Ka taea e koe te whakaiti i tō tūponotanga me ngā whakamātautau hei rapu i ngā tohu o te mate pukupuku. Ka taea e ētahi maimoatanga te awhina i te whakaiti i tō tūponotanga ki ētahi mate pukupuku. Ka taea e tetahi tohunga ira te whakamārama i tō tūponotanga takitahi ki a koe i runga i ō hua.

I te wā o te colonoscopy, ka whakauruhia e te kaimahi hauora he colonoscope ki roto i te tūturu hei tirotiro i te kōtore katoa. Kāo te rongoā mō te mate Lynch. Ka whakamātautau ngā tāngata e pangia ana e te mate Lynch i te nuinga o te wā hei kimi i ngā tohu o te mate pukupuku i te wā e tīmata ana. Mēnā ka kitea te mate pukupuku i te wā iti, ka nui ake te angitu o te rongoā. I etahi wā ka taea te aukati i te mate pukupuku mā ngā mahi tāpāpaku hei tango i ētahi whekau i mua i te whakawhānui o te mate pukupuku. Kōrero atu ki tō kaiwhakarato hauora mō ō koutou whiringa. Ko ngā whakamātautau tātaritanga mate pukupuku he whakamātautau hei kimi i ngā tohu o te mate pukupuku i ngā tāngata kāore he tohu mate pukupuku. Ko te whakamātautau mate pukupuku e hiahiatia ana e koe e whakahaeretia ana e tō āhuatanga. Ka whakaarohia e tō kaiwhakarato hauora te kiripuaki mate Lynch e mau ana koe. Ka whakaarohia hoki e tō kaiwhakarato ngā mate pukupuku kei roto i tō whānau. Ka taea e koe te whakamātautau hei kimi i:

• Te mate pukupuku kōtore. He tukanga te colonoscopy e whakamahi ana i te pūpoi roa ngawari hei titiro ki roto i tō kōtore. Ka taea e tēnei whakamātautau te kimi i ngā tipu i mua i te mate pukupuku me ngā wāhi o te mate pukupuku. Ka tīmata pea ngā tāngata e pangia ana e te mate Lynch i te whakamātautau colonoscopy ia tau, ia rua tau rānei, i te tīmatanga o ō rātou tau rua tekau, tau toru tekau rānei.
• Te mate pukupuku endometrial. Ko te mate pukupuku endometrial te mate pukupuku e tīmata ana i te papanga o roto o te kopu. Ko te papanga te ingoa ko te endometrium. Hei kimi i tēnei mate pukupuku, ka taea e koe te whakamahi i te whakaahua ultrasound o te kopu. Ka tangohia pea he tauira o te endometrium. Ka whakamātautauhia te tauira mō ngā tohu o te mate pukupuku. Ko te ingoa o tēnei tukanga ko te biopsy endometrial.
• Te mate pukupuku ovarian. Ka taea e tō kaiwhakarato te kōrero mō te ultrasound me te whakamātautau toto hei kimi i ngā tohu o te mate pukupuku i roto i ngā ovaries.
• Te mate pukupuku puku me te mate pukupuku puku iti. Ka taea e tō kaiwhakarato te kōrero mō te tukanga hei titiro ki roto i te esophagus, te puku me te puku iti. Ko te ingoa o tēnei tukanga ko te endoscopy. Ka uru atu ki te whakawhiti i te pūpoi roa, angiangi me te kamera kei te pito ki raro i tō korokoro. Ka taea hoki e koe te whakamātautau hei kimi i te huaketo e whakapiki ana i te tūponotanga o te mate pukupuku puku.
• Te mate pukupuku pūnaha mimi. Ka taea e tō kaiwhakarato te kōrero mō te whakamātautau i te tauira o tō mimi hei kimi i ngā tohu o ngā mate pukupuku pūnaha mimi. Ka uru atu tenei ki te mate pukupuku i roto i ngā whatukuhu, te putea me ngā ureters. Ko ngā ureters ngā pūpoi e hono ana i ngā whatukuhu ki te putea.
• Te mate pukupuku pancreatic. Ka taea e tō kaiwhakarato te kōrero mō te whakamātautau whakaahua hei kimi i te mate pukupuku i roto i te pancreas. Ko te tikanga tenei mā te MRI.
• Te mate pukupuku kiri. Ka taea e tō kaiwhakarato te kōrero mō te whakamātautau kiri. Ka uru atu tenei ki te titiro ki tō tinana katoa mō ngā tohu o te mate pukupuku kiri. Ka hiahia pea koe ki ētahi atu whakamātautau mēnā he hītori whānau tōu mō ētahi atu momo mate pukupuku. Pātai atu ki tō kaiwhakarato mō ngā whakamātautau pai mōu. Ka whakaatu mai ētahi rangahau ko te kai i te aspirin ia rā ka whakaiti pea i te tūponotanga o te mate pukupuku i ngā tāngata e pangia ana e te mate Lynch. He nui ake te rangahau e hiahiatia ana hei mārama ki te nui o te aspirin e hiahiatia ana hei whiwhi i te painga nui rawa atu. Tākupuhia ngā painga me ngā tūponotanga o te rongoā aspirin ki tō kaiwhakarato. Ka taea e kōrua te whakatau mēnā he tika tēnei mōu. I ētahi āhuatanga, ka taea e koe te whakaaro ki te pokanga, ki ngā rongoā rānei hei aukati i te mate pukupuku. Tākupuhia ngā painga me ngā tūponotanga ki tō kaiwhakarato hauora. Ka taea pea te wātea ngā rongoā mō:
• Te aukati i te mate pukupuku endometrial. Ko te pokanga hei tango i te kopu te ingoa ko te hysterectomy. Ka aukati i te mate pukupuku endometrial. He whiringa atu pea he tukanga hei whakanoho i te taputapu whakahaere whānau ki roto i te kopu. Ko te taputapu, te ingoa ko te taputapu intrauterine (IUD), ka tukuna he hormone e whakaiti ana i te tūponotanga o te mate pukupuku endometrial. Ka aukati hoki i a koe kei hāpai.
• Te aukati i te mate pukupuku ovarian. Ko te pokanga hei tango i ngā ovaries te ingoa ko te oophorectomy. Ka whakaiti nui i te tūponotanga o te mate pukupuku ovarian. He whiringa atu pea ko ngā pire whakahaere whānau waha, e kiia ana hoki ko ngā pire whakahaere whānau. Ka whakaatu mai te rangahau ko te kai i ngā pire whakahaere whānau waha mō te 5 tau neke atu ka whakaiti i te tūponotanga o te mate pukupuku ovarian.
• Te aukati i te mate pukupuku kōtore. Ko te pokanga hei tango i te nuinga, i te katoa rānei o tō kōtore te ingoa ko te colectomy. Ka whakaiti i tō tūponotanga o te mate pukupuku kōtore. Ka taea pea tēnei mahi hei whiringa i ētahi āhuatanga. Hei tauira, ka taea pea hei whiringa mēnā kua pangia koe e te mate pukupuku kōtore. Ka aukati te tango i tō kōtore i a koe kei pangia e te mate pukupuku kōtore anō. Ohauru kore utu ka whiwhi i te aratohu hohonu ki te whakahaere i te mate pukupuku, me ngā korero whai hua mo te whiwhi i te whakaaro tuarua. Ka taea e koe te whakakore i te ohaurunga i te hononga whakakore i roto i te īmēra. Ka tae mai tō aratohu hohonu ki te whakahaere i te mate pukupuku ki tō pouakaroto i te wa poto. Ka tae mai hoki… Ka taea te whakawhiti i te mate Lynch. Ko te mohio kei te piki ake tō tūponotanga o te mate pukupuku ka taea te whakawehi i a koe mō tō heke mai. I te wā, ka kite koe i ngā huarahi hei whakahaere i te ahotea me te manukanuka. Kia tae ra ano ki reira, ka kite pea koe he whai hua ki te:
• Kimi i ngā mea katoa e taea ana e koe mō te mate Lynch. Hangaia he rārangi o ngā pātai mō te mate Lynch ka ui atu ki a rātou i tō hui e whai ake nei. Pātai atu ki tō rōpū hauora mō ētahi atu puna korero. Ko te ako mō te mate Lynch ka taea te awhina i a koe kia whakapono ake i te wā e whakatau ana koe mō tō hauora.
• Titiro ki a koe. Ko te mohio kei te piki ake tō tūponotanga o te mate pukupuku ka taea te whakaaro ki a koe kāore e taea te whakahaere i tō hauora. Hangaia ngā whiringa hauora mō ngā wāhanga o tō hauora e taea ana e koe te whakahaere. Hei tauira, whiriwhiria he kai hauora. Whakapakarihia te nuinga o ngā rā o te wiki. Whakahaerehia te taumaha hauora. Whiwhi i te moe nui kia oho koe i te wā e okioki ana. Haere ki ō hui whakarite hauora katoa, tae atu ki ō whakamātautau tātaritanga mate pukupuku.

Kaore he uauatanga