Mate Kōmate

Ako atu mō te mate pukupuku tairoirī i te tohunga taero a Mabel Ryder, M.D.

He mea ke atu e taea te whakapiki ake i ō tūmanako kia puta mai te mate pukupuku tairoirī. E toru te whakawhānui o ngā wāhine ki te whanake i te mate pukupuku tairoirī. Ā, ko te whakaū ki ngā taumata teitei o te radiation, hei tauira, te rongoā radiation ki te ūtū, ki te kaki rānei mō ētahi atu mate pukupuku, ka taea te whakapiki ake i tō tūponotanga. Ka taea hoki e ētahi momo mate pukupuku whatukuhu te whai wāhi. He maha ngā momo mate pukupuku tairoirī e tino pā ana ki ngā rōpū tau rerekē. Ko te mate pukupuku tairoirī papillary te momo tino noa o te mate pukupuku tairoirī. Ā, ahakoa ka puta mai i tetahi tau, ka pā tonu ki ngā tāngata kei te 30 ki te 50 tau te pakeke. Ko te mate pukupuku tairoirī follicular te nuinga o ngā tāngata e pā ana ki te pakeke atu i te 50 tau. Ko te mate pukupuku tairoirī anaplastic he momo mate pukupuku onge rawa atu e puta ana i ngā pakeke 60 tau me te pakeke ake. Ā, ko te mate pukupuku tairoirī medullary. Ahakoa he mea onge, tae atu ki te 30 ōrau o ngā turoro e mate ana i te mate pukupuku tairoirī medullary e hono ana ki ngā mate pukupuku whatukuhu e taea te whakapiki ake i tō tūponotanga mō ētahi atu mate pukupuku.

Te nuinga, kaore te mate pukupuku tairoirī e whakaoho i ētahi tohu, i ētahi tohu rānei i ona wā tīmatanga. I te tipu, ka kite pea koe i te pupū e taea te kite i roto i te kiri o tō kaki. Ka kite pea koe i ngā huringa ki tō reo, tae atu ki te ngākau o tō reo, ki te raruraru rānei ki te horomi. Ka puta pea te mamae i te kaki, i te korokoro rānei i ētahi. Rānei ka puta pea ngā whekau lymph pupū i tō kaki. Ki te pā ana koe ki ētahi o ēnei take, ā, kei te manukanuka koe, whakaritea he whakatau ki tō tākuta.

Ko te nuinga, ko te whakatau i te mate pukupuku tairoirī ka tīmata ki te whakamātautau tinana. Ka ngākau nui tō tākuta ki ngā huringa tinana i tō kaki me te tairoirī. Ko te tikanga ka whai ake ngā whakamātautau toto me te whakaahua ultrasound. I te wā e mau ana i tēnei mōhiohio, ka whakatau pea ngā tākuta ki te mahi i te biopsy hei tango i te tauira iti o te kiko mai i tō tairoirī. I ētahi wā, ka taea te mahi i te whakamātautau whatukuhu hei awhina i te whakatau i ngā take whatukuhu e hono ana. Ki te whakatauhia te mate pukupuku tairoirī, ka taea te mahi i ētahi atu whakamātautau hei awhina i tō tākuta ki te whakatau mena kua horapa atu tō mate pukupuku i tua atu o te tairoirī, i waho atu rānei o te kaki. Ka uru pea ēnei whakamātautau ki ngā whakamātautau toto hei tirotiro i ngā tohu mate pukupuku me ngā whakamātautau whakaahua, pēnei i ngā CT scans, MRI, i ngā whakamātautau whakaahua ngākau, pēnei i te karapa tinana katoa o te radioiodine.

Waihoki, ko te nuinga o ngā mate pukupuku tairoirī ka taea te patu me ngā rongoā. Ko ngā mate pukupuku iti rawa - i raro i te 1 henimita - he iti te tūponotanga o te tipu, o te horapa rānei, ā, no reira, pea kaore e hiahiatia te rongoā i te wa tonu. Engari, ka tūtohu pea tō tākuta i te tirotiro me ngā whakamātautau toto, te ultrasound, me te whakamātautau tinana kotahi, rua rānei i te tau. I te nuinga o ngā tāngata, ko tēnei mate pukupuku iti - i raro i te 1 henimita - pea kaore e tipu, ā, pea kaore e hiahiatia te pokanga. I ngā take e hiahiatia ana te rongoā atu, he mea noa te pokanga. I runga i tō mate pukupuku, ka tango pea tō tākuta i te wāhanga o te tairoirī - he tukanga e mohiotia ana ko te thyroidectomy. Rānei ka tango pea tō tākuta i te tairoirī katoa. Ka uru pea ētahi atu rongoā ki te rongoā hormone tairoirī, te whakakorenga waipiro, te iodine radioactive, te rongoā rongoā whai pūtaiao, te rongoā radiation o waho, me te chemotherapy, i ētahi. I te mutunga, ko te āhua o tō rongoā ka whakawhirinaki ki te wā o tō mate pukupuku me te momo mate pukupuku tairoirī kei a koe.

Ka puta te mate pukupuku tairoirī i roto i ngā pūtau o te tairoirī.

Pea kaore te mate pukupuku tairoirī e puta mai he tohu. Engari i te tipu, ka taea te puta mai ngā tohu me ngā tohu, pēnei i te pupū i tō kaki, ngā huringa reo me te raruraru ki te horomi.

He maha ngā momo mate pukupuku tairoirī. Ko te nuinga o ngā momo e tipu haere ana, ahakoa ko ētahi momo ka tino kaha. Ko te nuinga o ngā mate pukupuku tairoirī ka taea te whakaora me te rongoā.

Kei te piki haere te maha o ngā mate pukupuku tairoirī. Ka puta pea te pikinga i te whakapai ake o te hangarau whakaahua e taea ai e ngā kaiwhakarato hauora te kimi i ngā mate pukupuku tairoirī iti i runga i ngā CT me ngā MRI scans i mahia mō ētahi atu āhuatanga (ngā mate pukupuku tairoirī tūpono). Ko ngā mate pukupuku tairoirī i kitea i tēnei ara he mate pukupuku iti te nuinga e whakautu pai ana ki ngā rongoā.

Ko te nuinga o ngā mate pukupuku tairoirī e kore e puta he tohu, he āhuatanga rānei i te tīmatanga o te mate. I te tipu haere o te mate pukupuku tairoirī, ka pā pea: He pūngāwerewere (nodule) e taea te kite mā te kiri o tō kaki He āhua kua pīrahi rawa ngā kākahu kaki e mau tata ana He huringa ki tō reo, tae atu ki te piki haere o te reo whakararuraru He uaua ki te horomia Ngā whekau lymph pupū i tō kaki Te mamae i tō kaki me tō korokoro Ki te pāngia koe e tetahi tohu, āhuatanga rānei e manukanuka ana koe, whakaritea he whakatau ki tō kaiwhakarato hauora.

Mēnā ka pāngia koe e tetahi tohu rānei tohu rānei e awangawanga ana koe, whakaritea he whakatau ki tō kaiwhakarato hauora. Ohauru kore utu ka whiwhi koe i tetahi aratohu hohonu ki te whakahaere i te mate pukupuku, me ngā korero whai hua e pā ana ki te whiwhi i tētahi atu whakaaro. Ka taea e koe te whakakore i tō ohaurunga i tetahi wā. Ka tae mai tō aratohu hohonu mō te whakahaere i te mate pukupuku ki tō pouakaroto i roto i ngā wā poto. Ka

Ka puta te mate pukupuku tairoiti ina whanakehia e ngā pūtau i roto i te tairoiti ngā huringa i roto i ō rātou DNA. Kei roto i te DNA o te pūtau ngā tohutohu e kōrero ana ki te pūtau me aha. Ko ngā huringa, e kiia ana e ngā tākuta he mutations, e kī ana ki ngā pūtau kia tipu haere me te tōtika tere. Ka haere tonu te oranga o ngā pūtau ina mate pūtau hauora i te tikanga. Ko ngā pūtau e kohikohi ana ka hanga he kohinga e kiia nei he mate pukupuku.

Ka taea e te mate pukupuku te tipu ki te whakaeke i ngā kiko e tata ana, ā, ka horapa (metastasize) ki ngā ngota lymph i te kaki. I etahi wā, ka taea e ngā pūtau mate pukupuku te horapa atu i te kaki ki ngā pūkahukahu, ngā wheua me ētahi atu wāhanga o te tinana.

Mō te nuinga o ngā mate pukupuku tairoiti, kāo te mārama he aha ngā take o ngā huringa DNA e puea ai te mate pukupuku.

Ka wehewehea te mate pukupuku tairoiti ki ngā momo e whakaū ana i ngā momo pūtau e kitea ana i roto i te mate pukupuku. Ka whakatauhia tō momo ina tirohia he tauira o te kiko mai i tō mate pukupuku i raro i te microscope. Ka whakaarohia te momo mate pukupuku tairoiti i te whakatau i tō maimoatanga me tō whakatau.

Ko ngā momo mate pukupuku tairoiti e whai ake nei:

• Te mate pukupuku tairoiti papillary. Koinei te momo mate pukupuku tairoiti tino noa. Ka taea te puta i tetahi tau, engari ka tino pā ki ngā tāngata kei te 30 ki te 50 tau te pakeke. Ko te nuinga o ngā mate pukupuku tairoiti papillary he iti, ā, ka pai te whakautu ki te maimoatanga, ahakoa ka horapa ngā pūtau mate pukupuku ki ngā ngota lymph i te kaki. He wāhanga iti o ngā mate pukupuku tairoiti papillary he kaha, ā, ka taea te tipu ki te whakauru i ngā hanganga i te kaki, te horapa rānei ki ētahi atu wāhi o te tinana.
• Te mate pukupuku tairoiti follicular. Koinei te momo mate pukupuku tairoiti onge e pā ana ki ngā tāngata neke atu i te 50 tau te pakeke. Kāore ngā pūtau mate pukupuku tairoiti follicular e tino horapa ki ngā ngota lymph i te kaki. Engari ko ētahi mate pukupuku nui me te kaha ka taea te horapa ki ētahi atu wāhi o te tinana. Ko te mate pukupuku tairoiti follicular e tino horapa ana ki ngā pūkahukahu me ngā wheua.
• Te mate pukupuku tairoiti pūtau Hurthle. I whakaarohia tēnei momo mate pukupuku tairoiti onge hei momo mate pukupuku tairoiti follicular. Inaianei kua whakaarohia he momo ake nā te rerekē o te whāinga o ngā pūtau mate pukupuku, ā, ka whakautu ki ngā maimoatanga rerekē. He kaha ngā mate pukupuku tairoiti pūtau Hurthle, ā, ka taea te tipu ki te whakauru i ngā hanganga i te kaki, te horapa rānei ki ētahi atu wāhi o te tinana.
• Te mate pukupuku tairoiti kaore i tino rerekē. Koinei te momo mate pukupuku tairoiti onge e kaha ake ana i ētahi atu mate pukupuku tairoiti rerekē, ā, kāore e tino whakautu ki ngā maimoatanga noa.
• Te mate pukupuku tairoiti anaplastic. Koinei te momo mate pukupuku tairoiti onge e tipu tere ana, ā, ka uaua ki te whakaora. Heoi, ka taea e ngā maimoatanga te whakaheke i te whāinga o te mate. Ko te mate pukupuku tairoiti anaplastic e puta ana ki ngā tāngata neke atu i te 60 tau te pakeke. Ka taea te whakaeke i ngā tohu me ngā tohu kino, pēnei i te pupuhi o te kaki e kino haere ana tere, ā, ka āhei te arahi ki te uaua o te manawa me te horomi.
• Te mate pukupuku tairoiti medullary. Koinei te momo mate pukupuku tairoiti onge e tīmata ana i ngā pūtau tairoiti e kiia nei ko ngā pūtau C, e whakaputa ana i te homoni calcitonin. Ko ngā taumata teitei o te calcitonin i roto i te toto ka taea te tohu i te mate pukupuku tairoiti medullary i te tīmatanga rawa. Ko ētahi mate pukupuku tairoiti medullary i puta mai i te gene e kiia nei ko te RET e tukuna ana e ngā mātua ki ngā tamariki. Ka taea e ngā huringa i roto i te gene RET te whakaeke i te mate pukupuku tairoiti whānau me te multiple endocrine neoplasia, momo 2. Ka piki ake te tūponotanga o te mate pukupuku tairoiti i te mate pukupuku tairoiti whānau. Ka piki ake te tūponotanga o te mate pukupuku tairoiti, te mate pukupuku o te whekau adrenal me ētahi atu momo mate pukupuku i te multiple endocrine neoplasia, momo 2.
• Ētahi atu momo onge. Ka taea e ētahi atu momo mate pukupuku onge te tīmata i te tairoiti. Kei roto i ēnei ko te lymphoma tairoiti, e tīmata ana i ngā pūtau pūnaha ārai mate o te tairoiti, me te sarcoma tairoiti, e tīmata ana i ngā pūtau kiko hono o te tairoiti.

Ko ngā take ka piki ake pea te tūponotanga o te mate pukupuku tairoirī e whai ake nei:

• Wahine te ira tangata. Ka tō te mate pukupuku tairoirī i ngā wāhine atu i ngā tāne. E whakaaro ana ngā tohunga he hononga pea ki te homoni ōihana. Ko te nuinga o te hunga i whānau mai hei wahine kei teitei ake te taumata o te ōihana i roto i o rātou tinana.
• Te whakaū ki ngā taumata teitei o te radiation. Ka piki ake te tūponotanga o te mate pukupuku tairoirī mā te whakamahinga o te rongoā radiation ki te ūtū me te kaki.
• Ngā tūāhua ira tuku iho motuhake. Ko ngā tūāhua ira tuku iho e piki ake ai te tūponotanga o te mate pukupuku tairoirī e whai ake nei: te mate pukupuku tairoirī medullary whānau, te mate pukupuku maha o ngā whatūnga endocrine, te mate pukupuku Cowden, me te mate pukupuku adenomatous whānau. Ko ngā momo mate pukupuku tairoirī e puta ana i roto i ngā whānau ko te mate pukupuku tairoirī medullary me te mate pukupuku tairoirī papillary.

Ka taea te hoki mai te mate pukupuku tairoirō ahakoa te whakaora angitu, ā, ka taea tonu te hoki mai ahakoa kua tangohia tō tairoirō. Ka taea pea te tupu o tēnei mena ka horapa ngā pūtau mate pukupuku ki tua atu o te tairoirō i mua i te tango.

E kore te nuinga o ngā mate pukupuku tairoirō e tino hokinga mai, tae atu ki ngā momo mate pukupuku tairoirō tino noa—te mate pukupuku tairoirō papillary me te mate pukupuku tairoirō follicular. Ka taea e tō kaiwhakarato hauora te kōrero ki a koe mena kei te piki ake te tūponotanga o te hokinga mai o tō mate pukupuku i runga i ngā mōhiohio motuhake o tō mate pukupuku.

He nui ake te tūponotanga o te hokinga mai mena he kaha tō mate pukupuku, mena rānei ka tupu atu i tō tairoirō. I te hokinga mai o te mate pukupuku tairoirō, ka kitea i roto i ngā tau rima tuatahi i muri i tō tātaritanga tuatahi.

He pai tonu te whakatau a te mate pukupuku tairoirō e hoki mai ana. He maha tonu te whakaora, ā, ka whai whakaora angitu te nuinga o te iwi.

Ka taea te hokinga mai o te mate pukupuku tairoirō ki:

• Ngā whekau lymphatic i te kaki
• Ngā kōwae iti o te kiko tairoirō i mahue i muri i te pokanga
• Ētahi atu wāhi o te tinana, pēnei i ngā pūkahukahu me ngā wheua

Ka tūtohu pea tō kaiwhakarato hauora i ngā whakamātau toto auau, i ngā tirotiro tairoirō rānei hei tirotiro i ngā tohu kua hoki mai tō mate pukupuku. I ēnei whakatau, ka ui pea tō kaiwhakarato mena kua pāngia koe e ētahi tohu me ngā tohu o te hokinga mai o te mate pukupuku tairoirō, pēnei i:

• Te mamae o te kaki
• Te pupū i te kaki
• Te raruraru ki te horomi
• Ngā huringa reo, pēnei i te reo ngāngā

Ka horapa pea te mate pukupuku tairoirō ki ngā whekau lymphatic tata atu, ki ētahi atu wāhi rānei o te tinana. Ka kitea pea ngā pūtau mate pukupuku e horapa ana i te wā e tātaritingia ana koe, i muri rānei i te whakaora. Ko te nuinga nui o ngā mate pukupuku tairoirō e kore e horapa rawa.

I te horapa o te mate pukupuku tairoirō, ka haere atu ki:

• Ngā whekau lymphatic i te kaki
• Ngā pūkahukahu
• Ngā wheua
• Te roro
• Te ate
• Te kiri

Ka kitea pea te mate pukupuku tairoirō e horapa ana i runga i ngā whakamātau whakaahua, pēnei i te CT me te MRI, i te wā e tātaritingia ana koe ki te mate pukupuku tairoirō. I muri i te whakaora angitu, ka tūtohu pea tō kaiwhakarato hauora i ngā whakatau whakarunga hei rapu i ngā tohu kua horapa tō mate pukupuku tairoirō. Ka uru pea ēnei whakatau ki ngā tirotiro whakaahua pūkaha e whakamahi ana i te ahua pūkaha o te iodine me te kamera motuhake hei kite i ngā pūtau mate pukupuku tairoirō.

Kāore ngā tākua e tino mōhio ki te take o ngā huringa o ngā ira e āhei ai te nuinga o ngā mate pukupuku tairoirī, na reira, kāore he huarahi hei ārai i te mate pukupuku tairoirī ki ngā tāngata he tino tūponotanga noa te mate. Āhei ngā tāngata pakeke rāua ko ngā tamariki e whai ana i te ira kua oti te whakawhiwhi e whakapiki ake ana i te tūponotanga o te mate pukupuku tairoirī medullary te whakaaro ki te pokanga tairoirī hei ārai i te mate pukupuku (prophylactic thyroidectomy). Tākupuhia ō kōwhiringa ki te kaiāwhina ira e āhei ana te whakamārama i tō tūponotanga o te mate pukupuku tairoirī me ō kōwhiringa maimoatanga. He rongoā e aukati ana i ngā pānga o te pāmahana ki te tairoirī ka whakawhiwhia ki ētahi o ngā tāngata e noho ana i te taha o ngā whare hiko pūkaha i te United States. Ka taea te whakamahi i te rongoā (potassium iodide) i te mea kaore e tōkia he aituā i te whare hiko pūkaha. Ki te noho koe i roto i te 10 maero mai i tetahi whare hiko pūkaha, ā, kei te manukanuka koe ki ngā whakaritenga haumaru, whakapiri atu ki tō tari whakahaere āwhina ā-rohe mō ētahi atu mōhiohio.

Ko te tohunga Endocrine a Mabel Ryder, M.D., te kaiwhakautu i ngā pātai tino maha e ui ana mo te mate pukupuku tairoki.

Ko te mahi e whai ake nei i te whakatau o te mate pukupuku tairoki ko te tiki i tetahi whakaahua oro-whakaata whānui, teitei-whakatau. He mea nui tēnei, nā te mea ko te mate pukupuku tairoki papillary me ētahi atu momo mate pukupuku tairoki e horapa ana ki ngā pūngāwerewere i te kaki. Ki te pai ēnei mō te mate pukupuku tairoki, me te mea pai, ka mahi te taote i tetahi pokanga whānui hei tango i te tairoki me ngā pūngāwerewere.

Me te mea pai, he tino pai te tohu mō te nuinga o ngā turoro e mate ana i te mate pukupuku tairoki. Ko te tikanga, ehara te mate pukupuku tairoki i te mea mate-kino, ā, he tino āta whakaora. I roto i tetahi rōpū iti o ngā turoro, ka taea te whanake o te mate. Mā te pūtaiao nui ake, mā ngā raraunga mai i te taiwhanga me ngā whakamātautau hauora, me te hangarau, ka taea e tātou te whakapai ake i ngā maimoatanga mō ō tātou turoro. Ā, kua pai ake ngā hua o ēnei turoro, ā, he pai ake te tohu.

Me te mea pai, mō ngā mate pukupuku tairoki iti, kāore e pā ki te mahi o te whekau. Ka ine tātou i te mahi o te whekau mā te ine i ngā homoni e kiia nei ko TSH me T4. Ā, ki te noa ēnei, ko te tikanga kua tiakina te mahi tairoki.

Ki te whakatauhia koe ki te mate pukupuku tairoki papillary, ka taea pea e koe te whakaora i tētahi wāhanga o tō tairoki. E mohio ana tātou ko te nuinga o ngā mate pukupuku tairoki papillary – i raro iho i te 3 ki te 4 henimita – e noho ana ki te tairoki he iti te tūponotanga. Ko te tikanga ka taea e ngā turoro te mahi lobectomy hei tango i te haurua o te whekau, kaua ko te whekau katoa. Ko te painga o tēnei ko te taea pea e koe te tiaki i tō mahi tairoki ake i muri i te pokanga.

He maha ngā turoro e awangawanga ana mō ō rātou kounga ora me te mahi i muri i te tango i te whekau tairoki. Me te mea pai, he homoni tā tātou e kiia nei ko levothyroxine, ko Synthroid rānei. He rite tēnei homoni ki te homoni i whakaputahia e tō tairoki. He haumaru. He whai hua. Kāore hoki he pānga kino ina kei runga koe i te horopeta tika.

Ko te huarahi pai ki te hono atu ki tō rōpū ko te whakatuwhera ki tō rōpū mō ō pātai, ō wehi me ō manukanuka mō tō mate, me te pono ki ō whāinga tiaki. I te nuinga o te wā, ko te tuhituhi i ō pātai me te whakarārangi i ō kaupapa matua ka tino whai hua ki a koe me tō rōpū ki te whakatau he aha te mahi e whai ake nei mōu. Kaua rawa e whakaroa ki te ui ki tō rōpū hauora i ētahi pātai, i ētahi awangawanga rānei kei a koe. Ko te whakamārama ka hanga i te rerekētanga katoa. Mauruuru mō tō wā, ā, e mihi ana mātou ki a koe.

I te wā o te biopsy ngira, ka whakauruhia he ngira roa, angiangi i roto i te kiri, ki te wāhi whakapae. Ka tangohia ngā pūtau, ka whakamātautauhia hei titiro ki ngā tohu o te mate pukupuku.

Ngā whakamātautau me ngā tukanga e whakamahia ana hei whakatau i te mate pukupuku tairoki:

• Te tirotiro tinana. Ka tirotirohia e tō kaiwhakarato hauora tō kaki hei whakamātautau i ngā huringa i tō tairoki, pēnei i te pūngāwerewere (nodule) i te tairoki. Ka ui pea te kaiwhakarato ki ō kaupapa morearea, pēnei i te whakaū i mua ki te radiation me te hītori whānau o ngā mate pukupuku tairoki.

• Ngā whakamātautau toto mahi tairoki. Ngā whakamātautau e ine ana i ngā taumata toto o te homoni whakaohooho tairoki (TSH) me ngā homoni e whakaputahia ana e tō whekau tairoki ka hoatu pea ki tō rōpū hauora ngā tohu mō te hauora o tō tairoki.

• Te tango i te tauira o te kōpū tairoki. I te wā o te biopsy whakawhāiti-ngira pai, ka whakauruhia e tō kaiwhakarato he ngira roa, angiangi i roto i tō kiri, ki te nodule tairoki. Ka whakamahia te whakaahua oro-whakaata hei arahi tika i te ngira. Ka whakamahia e tō kaiwhakarato te ngira hei tango i ētahi pūtau mai i te tairoki. Ka tukuna te tauira ki te taiwhanga hei tātaritanga.

  I te taiwhanga, ka tirotirohia e tetahi taote e tohunga ana ki te tātaritanga i te toto me te kōpū tinana (pathologist) te tauira kōpū i raro i te microscope, ā, ka whakatau mena kei te noho te mate pukupuku. Kāore ngā hua i te mea mārama tonu. Ko ētahi momo mate pukupuku tairoki, inā te mate pukupuku tairoki follicular me te mate pukupuku tairoki Hurthle, he tino tūpono ake te whiwhi i ngā hua kore-mārama (ngā nodule tairoki kore-mārama). Ka tūtohu pea tō kaiwhakarato i tētahi tukanga biopsy anō, i tētahi mahi rānei hei tango i te nodule tairoki mō te whakamātautau. Ka taea hoki te whai hua ngā whakamātautau motuhake o ngā pūtau hei titiro ki ngā huringa ira (te whakamātautau tohu molecular).

• Tetahi whakamātautau whakaahua e whakamahi ana i te tracer radioactive. Ka whakamahi te scan iodine radioactive i tētahi momo iodine radioactive me te kamera motuhake hei kite i ngā pūtau mate pukupuku tairoki i roto i tō tinana. Ko te nuinga o te wā ka whakamahia i muri i te pokanga hei kimi i ētahi pūtau mate pukupuku pea e toe ana. He tino whai hua tēnei whakamātautau mō ngā mate pukupuku tairoki papillary me follicular.

  Ka tango me te whakamahi ngā pūtau tairoki hauora i te iodine mai i te toto. Ka mahi ētahi momo pūtau mate pukupuku tairoki i tēnei, hoki. Ina whakauruhia te iodine radioactive ki te uaua, ki te horomia rānei, ka tangohia e ngā pūtau mate pukupuku tairoki katoa i roto i te tinana te iodine. Ka whakaaturia ngā pūtau katoa e tango ana i te iodine i runga i ngā whakaahua scan iodine radioactive.

• Ētahi atu whakamātautau whakaahua. Ka taea e koe te whai i tētahi, i ngā whakamātautau whakaahua rānei hei āwhina i tō kaiwhakarato ki te whakatau mena kua horapa tō mate pukupuku i tua atu i te tairoki. Ka uru pea ngā whakamātautau whakaahua ki te oro-whakaata, CT me MRI.

• Te whakamātautau ira. Ko tētahi wāhanga o ngā mate pukupuku tairoki medullary ka puta mai i ngā ira kua oti te whakawhiwhi e tukuna ana mai i ngā mātua ki ngā tamariki. Ki te whakatauhia koe ki te mate pukupuku tairoki medullary, ka tūtohu pea tō kaiwhakarato ki te tūtaki ki tētahi kaiāwhina ira hei whakaaro ki te whakamātautau ira. Ko te mohio kei a koe he ira kua oti te whakawhiwhi ka taea te āwhina i a koe ki te mārama ki tō tūponotanga o ētahi atu momo mate pukupuku me te tikanga o tō ira kua oti te whakawhiwhi mō ō tamariki.

Te whakaahua oro-whakaata. Ka whakamahi te oro-whakaata i ngā ngaru oro teitei-auau hei hanga i ngā pikitia o ngā hanganga tinana. Hei hanga i tetahi whakaahua o te tairoki, ka whakanohoia te transducer oro-whakaata ki tō kaki raro.

Ko te āhua o te nodule tairoki i runga i te whakaahua oro-whakaata ka āwhina i tō kaiwhakarato ki te whakatau mena he tino mate pukupuku. Ko ngā tohu he tino mate pukupuku pea te nodule tairoki ko ngā tāpiringa kōhatu (microcalcifications) i roto i te nodule me te rohe kore-tūturu i te taha o te nodule. Ki te tino tūpono pea he mate pukupuku te nodule, me ngā whakamātautau atu hei whakau i te whakatau me te whakatau i te momo mate pukupuku tairoki kei te noho.

Ka taea hoki e tō kaiwhakarato te whakamahi i te oro-whakaata hei hanga i ngā whakaahua o ngā pūngāwerewere i te kaki (te mahere pūngāwerewere) hei titiro ki ngā tohu o te mate pukupuku.

Te tango i te tauira o te kōpū tairoki. I te wā o te biopsy whakawhāiti-ngira pai, ka whakauruhia e tō kaiwhakarato he ngira roa, angiangi i roto i tō kiri, ki te nodule tairoki. Ka whakamahia te whakaahua oro-whakaata hei arahi tika i te ngira. Ka whakamahia e tō kaiwhakarato te ngira hei tango i ētahi pūtau mai i te tairoki. Ka tukuna te tauira ki te taiwhanga hei tātaritanga.

I te taiwhanga, ka tirotirohia e tetahi taote e tohunga ana ki te tātaritanga i te toto me te kōpū tinana (pathologist) te tauira kōpū i raro i te microscope, ā, ka whakatau mena kei te noho te mate pukupuku. Kāore ngā hua i te mea mārama tonu. Ko ētahi momo mate pukupuku tairoki, inā te mate pukupuku tairoki follicular me te mate pukupuku tairoki Hurthle, he tino tūpono ake te whiwhi i ngā hua kore-mārama (ngā nodule tairoki kore-mārama). Ka tūtohu pea tō kaiwhakarato i tētahi tukanga biopsy anō, i tētahi mahi rānei hei tango i te nodule tairoki mō te whakamātautau. Ka taea hoki te whai hua ngā whakamātautau motuhake o ngā pūtau hei titiro ki ngā huringa ira (te whakamātautau tohu molecular).

Tetahi whakamātautau whakaahua e whakamahi ana i te tracer radioactive. Ka whakamahi te scan iodine radioactive i tētahi momo iodine radioactive me te kamera motuhake hei kite i ngā pūtau mate pukupuku tairoki i roto i tō tinana. Ko te nuinga o te wā ka whakamahia i muri i te pokanga hei kimi i ētahi pūtau mate pukupuku pea e toe ana. He tino whai hua tēnei whakamātautau mō ngā mate pukupuku tairoki papillary me follicular.

Ka tango me te whakamahi ngā pūtau tairoki hauora i te iodine mai i te toto. Ka mahi ētahi momo pūtau mate pukupuku tairoki i tēnei, hoki. Ina whakauruhia te iodine radioactive ki te uaua, ki te horomia rānei, ka tangohia e ngā pūtau mate pukupuku tairoki katoa i roto i te tinana te iodine. Ka whakaaturia ngā pūtau katoa e tango ana i te iodine i runga i ngā whakaahua scan iodine radioactive.

Ka whakamahi tō rōpū hauora i ngā mōhiohio mai i ō whakamātautau me ō tukanga hei whakatau i te whānui o te mate pukupuku, ā, hei tuku i tētahi wāhi ki a ia. Ka kōrerotia e te wāhi o tō mate pukupuku ki tō rōpū tiaki mō tō tohu, ā, ka āwhina i a rātou ki te tīpako i te maimoatanga e tino āhei ana ki te āwhina i a koe.

Ka tohuhia te wāhi mate pukupuku me te tau i waenga i te 1 me te 4. Ko te tau iti ake te tikanga he tino āhei te mate pukupuku ki te whakautu ki te maimoatanga, ā, ko te tikanga he mate pukupuku anake te tairoki. Ko te tau teitei ake te tikanga he tino kino te whakatau, ā, pea kua horapa te mate pukupuku i tua atu i te tairoki ki ētahi atu wāhanga o te tinana.

He rerekē ngā momo mate pukupuku tairoki he rerekē ngā wāhi. Hei tauira, he rerekē ngā wāhi o ngā mate pukupuku tairoki medullary me anaplastic. Ko ngā momo mate pukupuku tairoki rerekē, tae atu ki te papillary, follicular, Hurthle cell me te kore-rerekē, e whakaū ana i te wāhi. Mō ngā mate pukupuku tairoki rerekē, ka rerekē pea tō wāhi i runga i tō tau.

Ko ngā whiringa rongoā mō te mate pukupuku tairoirō i a koe e whakawhirinaki ana ki te momo me te wāhanga o tō mate pukupuku tairoirō, tō hauora whānui, me ō hiahia. Ko te nuinga o te hunga i whakatauhia te mate pukupuku tairoirō he tino pai te tohu, i te mea ka taea te whakaora i te nuinga o ngā mate pukupuku tairoirō me te rongoā. Pea kaore e hiahiatia te rongoā i te wa tonu mō ngā mate pukupuku tairoirō papillary iti rawa (papillary microcarcinomas) nā te iti o te tūponotanga o enei mate pukupuku ki te tipu, ki te horapa rānei. Hei whakakapi mō te pokanga, te rongoā rānei, pea ka whakaaro koe ki te tirotiro mahi me te tirotiro tūturu o te mate pukupuku. Pea ka tūtohutia e tō kaiwhakarato hauora ngā whakamātautau toto me te whakamātautau ultrasound o te kaki kotahi, rua rānei i te tau. I ētahi tāngata, pea kaore rawa te mate pukupuku e tipu, kaore hoki e hiahiatia te rongoā. I ētahi atu, pea ka kitea te tipu i te mutunga, ka taea te tīmata i te rongoā. Ko ngā whatukuhu parathyroid iti e whā, kei te taha o te tairoirō, e hanga ana i te homoni parathyroid. Kei te whai wāhi te homoni ki te whakahaere i ngā taumata o ngā kohuke kārati me te phosphorus i roto i te tinana. Ko te nuinga o te hunga he mate pukupuku tairoirō e hiahia ana ki te rongoā ka tukuna ki te pokanga hei tango i tetahi wāhanga, te katoa rānei o te tairoirō. Ko te mahi pokanga pea ka tūtohutia e tō rōpū hauora e whakawhirinaki ana ki tō momo mate pukupuku tairoirō, te rahi o te mate pukupuku, me te horapa atu rānei o te mate pukupuku ki tua atu o te tairoirō ki ngā ngota lymph. Ka whakaarohia hoki e tō rōpū tiaki ō hiahia i te hanga i te mahere rongoā. Ko ngā mahi pokanga e whakamahia ana hei whakaora i te mate pukupuku tairoirō:

• Tango i te katoa, te nuinga rānei o te tairoirō (thyroidectomy). He mahi pokanga hei tango i te whatukuhu tairoirō pea ka uru ki te tango i te katoa o te kiko tairoirō (total thyroidectomy) te nuinga rānei o te kiko tairoirō (near-total thyroidectomy). Ka waiho pinepine e te taote ngā taha iti o te kiko tairoirō i te taha o ngā whatukuhu parathyroid hei whakaiti i te tūponotanga o te kino ki ngā whatukuhu parathyroid, e āwhina ana ki te whakahaere i ngā taumata kārati i roto i tō toto.
• Tango i tetahi wāhanga o te tairoirō (thyroid lobectomy). I te wā o te thyroid lobectomy, ka tangohia e te taote te haurua o te tairoirō. Pea ka tūtohutia te lobectomy ki te mea he mate pukupuku tairoirō ngāwari te tipu i roto i tetahi wāhanga o te tairoirō, kaore he ngota whakapae i ētahi atu wāhanga o te tairoirō, kaore hoki he tohu o te mate pukupuku i roto i ngā ngota lymph.
• Tango i ngā ngota lymph i te kaki (lymph node dissection). Ka horapa pinepine te mate pukupuku tairoirō ki ngā ngota lymph tata i te kaki. Pea ka whakaatuhia e te whakamātautau ultrasound o te kaki i mua i te pokanga ngā tohu kua horapa ngā pūtau mate pukupuku ki ngā ngota lymph. Ki te pēnei, pea ka tangohia e te taote ētahi o ngā ngota lymph i te kaki hei whakamātautau. Hei uru atu ki te tairoirō, ka taea e ngā taote te tapahi (incision) i te wāhanga raro o te kaki. Ko te rahi o te tapahi e whakawhirinaki ana ki tō āhuatanga, pēnei i te momo mahi me te rahi o tō whatukuhu tairoirō. Ka ngana pinepine ngā taote ki te whakanoho i te tapahi ki roto i te kopiko kiri ka uaua ki te kite i te wā e ora ana, ka waiho hei toka. Ko te pokanga tairoirō he tūponotanga o te toto me te mate. Ka taea hoki te pakaru o ō whatukuhu parathyroid i te wā o te pokanga, ka āhei ai te iti o ngā taumata kārati i roto i tō tinana. He tūponotanga anō pea kaore ngā uaua e hono atu ana ki ō aho reo e mahi ana i muri i te pokanga, ka āhei ai te reo whakararuraru me ngā huringa reo. Ka taea e te rongoā te whakapai ake, te whakahōu rānei i ngā raruraru uaua. Muri i te pokanga, ka tumanako koe ki ētahi mamae i te wā e ora ana tō tinana. Ko te roa o te ora e whakawhirinaki ana ki tō āhuatanga me te momo pokanga i whiwhi koe. Ko te nuinga o te hunga ka tīmata te ora i roto i ngā rā 10 ki te 14. Pea ka haere tonu ētahi ārahitanga ki tō mahi. Hei tauira, pea ka tūtohutia e tō taote te whakarere i te mahi kaha mō ētahi wiki atu. Muri i te pokanga hei tango i te katoa, te nuinga rānei o te tairoirō, pea ka whai koe i ngā whakamātautau toto hei tirotiro mena kua tangohia katoatia te mate pukupuku tairoirō. Pea ka inehia e ngā whakamātautau:
• Thyroglobulin — he pūmua i hangaia e ngā pūtau tairoirō hauora me ngā pūtau mate pukupuku tairoirō rerekē
• Calcitonin — he homoni i hangaia e ngā pūtau mate pukupuku tairoirō medullary
• Carcinoembryonic antigen — he matū i whakaputaina e ngā pūtau mate pukupuku tairoirō medullary Ka whakamahia hoki ēnei whakamātautau toto hei rapu i ngā tohu o te hokinga mai o te mate pukupuku. Ko te rongoā homoni tairoirō he rongoā hei whakakapi, hei tāpiri rānei i ngā homoni i whakaputaina i roto i te tairoirō. Ko te rongoā homoni tairoirō e inuhia ana i te nuinga o te wā i roto i te ahua o te pire. Ka taea te whakamahi hei:
• Whakakapi i ngā homoni tairoirō i muri i te pokanga. Ki te tangohia katoatia tō tairoirō, ka hiahia koe ki te tango i ngā homoni tairoirō mō te toenga o tō oranga hei whakakapi i ngā homoni i hangaia e tō tairoirō i mua i tō mahi pokanga. Ka whakakapi tenei rongoā i ō homoni taiao, no reira kāore he pānga taha i te wā ka kitea e tō rōpū hauora te horoinga e tika ana mōu. Pea ka hiahia koe ki te whakakapi homoni tairoirō i muri i te pokanga hei tango i tetahi wāhanga o te tairoirō, engari ehara i te katoa. Ki te iti rawa ō homoni tairoirō i muri i te pokanga (hypothyroidism), pea ka tūtohutia e tō rōpū hauora ngā homoni tairoirō. Whakakapi i ngā homoni tairoirō i muri i te pokanga. Ki te tangohia katoatia tō tairoirō, ka hiahia koe ki te tango i ngā homoni tairoirō mō te toenga o tō oranga hei whakakapi i ngā homoni i hangaia e tō tairoirō i mua i tō mahi pokanga. Ka whakakapi tenei rongoā i ō homoni taiao, no reira kāore he pānga taha i te wā ka kitea e tō rōpū hauora te horoinga e tika ana mōu. Pea ka hiahia koe ki te whakakapi homoni tairoirō i muri i te pokanga hei tango i tetahi wāhanga o te tairoirō, engari ehara i te katoa. Ki te iti rawa ō homoni tairoirō i muri i te pokanga (hypothyroidism), pea ka tūtohutia e tō rōpū hauora ngā homoni tairoirō. Ko te rongoā iodine pāwera e whakamahi ana i tetahi momo iodine he pāwera hei whakamate i ngā pūtau tairoirō me ngā pūtau mate pukupuku tairoirō pea ka toe i muri i te pokanga. Ko te nuinga o te wā ka whakamahia hei whakaora i ngā mate pukupuku tairoirō rerekē he tūponotanga ki te horapa ki ētahi atu wāhanga o te tinana. Pea ka whai koe i te whakamātautau hei tirotiro mena ka āwhinahia tō mate pukupuku e te iodine pāwera, i te mea ehara i te katoa o ngā momo mate pukupuku tairoirō e whakautu ana ki tēnei rongoā. Ko ngā momo mate pukupuku tairoirō rerekē, tae atu ki te papillary, follicular me te Hurthle cell, he tino āhei ki te whakautu. Ko ngā mate pukupuku anaplastic me te medullary kaore i te nuinga o te wā e rongoātia ana me te iodine pāwera. Ko te rongoā iodine pāwera he kapuhu, he wai rānei e horomia ana e koe. Ko te iodine pāwera e tangohia ana e ngā pūtau tairoirō me ngā pūtau mate pukupuku tairoirō, no reira he iti te tūponotanga o te kino ki ētahi atu pūtau i roto i tō tinana. Ko ngā pānga taha e pā ana ki a koe e whakawhirinaki ana ki te horoinga o te iodine pāwera i whiwhi koe. Ko ngā horoinga teitei pea ka puta:
• Te waha maroke
• Te mamae o te waha
• Te mumura o te kanohi
• Te huringa o te reka, o te hongi rānei Ko te nuinga o te iodine pāwera ka puta atu i tō tinana i roto i tō mimi i ngā rā tuatahi i muri i te rongoā. Ka hoatu ki a koe ngā tohutohu mō ngā tūpato e hiahia ana koe ki te tango i taua wā hei tiaki i ētahi atu tāngata i te pāwera. Hei tauira, pea ka tonohia koe ki te karo i te hononga tata ki ētahi atu tāngata, ina koa ngā tamariki me ngā wāhine hapu. Ko te whakakorenga waipiro, e kiia ana hoki ko te whakakorenga ethanol, e uru ana ki te whakamahi i te ngira hei whakauru i te waipiro ki ngā wāhanga iti o te mate pukupuku tairoirō. Kei te whakamahia te whakaahua ultrasound hei arahi tika i te ngira. Ko te waipiro e whakaiti ana i ngā pūtau mate pukupuku tairoirō. Pea ka taea te whakakorenga waipiro hei whiringa hei whakaora i ngā wāhanga iti o te mate pukupuku tairoirō, pēnei i te mate pukupuku i kitea i roto i tetahi ngota lymph i muri i te pokanga. I etahi wa he whiringa mena kaore koe i te hauora mo te pokanga. Ko ngā mate pukupuku tairoirō kaha e tipu ana i te tere pea ka hiahia ki ētahi atu whiringa rongoā hei whakahaere i te mate. Ko ngā whiringa pea ka uru ki:
• Rongoā rongoā whai pūtaiao. Ko ngā rongoā rongoā whai pūtaiao e arotahi ana ki ngā matū motuhake kei roto i ngā pūtau mate pukupuku. Ma te aukati i ēnei matū, ka taea e ngā rongoā rongoā whai pūtaiao te whakamate i ngā pūtau mate pukupuku. Ko ētahi o ēnei rongoā kei roto i te ahua o te pire, ā, ko ētahi kei te hoatuhia mā te uaua. He maha ngā rongoā rongoā whai pūtaiao rerekē mō te mate pukupuku tairoirō. Ko ētahi e āta whai ana i ngā oko toto e hangaia ana e ngā pūtau mate pukupuku hei kawe mai i ngā kai e āwhina ana i ngā pūtau ki te ora. Ko ētahi atu rongoā e āta whai ana i ngā huringa ira motuhake. Pea ka tūtohutia e tō kaiwhakarato ngā whakamātautau motuhake o ō pūtau mate pukupuku hei tirotiro i ngā rongoā pea ka āwhina. Ko ngā pānga taha e whakawhirinaki ana ki te rongoā motuhake e tangohia ana e koe.
• Rongoā pāwera. Ko te pāwera o waho e whakamahi ana i te mīhini e āta whakatakoto ana i ngā kaupapa kaha, pēnei i ngā X-rays me ngā protons, ki ngā tohu tika i tō tinana hei whakamate i ngā pūtau mate pukupuku. Pea ka tūtohutia te rongoā pāwera ki te kore tō mate pukupuku e whakautu ki ētahi atu rongoā, ki te hokinga mai rānei. Ka taea e te rongoā pāwera te āwhina i te whakahaere i te mamae e puta mai ana i te mate pukupuku e horapa ana ki ngā wheua. Ko ngā pānga taha o te rongoā pāwera e whakawhirinaki ana ki te wāhi e āta whakatakoto ana te pāwera. Ki te āta whakatakotohia ki te kaki, pea ka uru ngā pānga taha ki te āhuatanga rite ki te tahuna i te kiri, te mare, me te horomia mamae.
• Rongoā chemotherapy. Ko te chemotherapy he rongoā rongoā e whakamahi ana i ngā matū hei whakamate i ngā pūtau mate pukupuku. He maha ngā rongoā chemotherapy rerekē ka taea te whakamahi kotahi, te whakakotahi rānei. Ko ētahi kei roto i te ahua o te pire, engari ko te nuinga kei te hoatuhia mā te uaua. Pea ka āwhina te chemotherapy ki te whakahaere i ngā mate pukupuku tairoirō tere te tipu, pēnei i te mate pukupuku tairoirō anaplastic. I ētahi wā, pea ka whakamahia te chemotherapy mō ētahi atu momo mate pukupuku tairoirō. I etahi wā ka whakakotahihia te chemotherapy me te rongoā pāwera. Ko ngā pānga taha o te chemotherapy e whakawhirinaki ana ki ngā rongoā motuhake e whiwhi ana koe.
• Whakangaro i ngā pūtau mate pukupuku me te wera me te makariri. Ko ngā pūtau mate pukupuku tairoirō e horapa ana ki ngā pūkahukahu, ate me ngā wheua ka taea te rongoā me te wera me te makariri hei whakamate i ngā pūtau mate pukupuku. Ko te whakakorenga radiofrequency e whakamahi ana i te kaha hiko hei whakawera i ngā pūtau mate pukupuku, ka āhei ai te whakamate. Ko te cryoablation e whakamahi ana i te hau hei tio me te whakamate i ngā pūtau mate pukupuku. Ka taea e ēnei rongoā te āwhina i te whakahaere i ngā wāhanga iti o ngā pūtau mate pukupuku. Rongoā rongoā whai pūtaiao. Ko ngā rongoā rongoā whai pūtaiao e arotahi ana ki ngā matū motuhake kei roto i ngā pūtau mate pukupuku. Ma te aukati i ēnei matū, ka taea e ngā rongoā rongoā whai pūtaiao te whakamate i ngā pūtau mate pukupuku. Ko ētahi o ēnei rongoā kei roto i te ahua o te pire, ā, ko ētahi kei te hoatuhia mā te uaua. He maha ngā rongoā rongoā whai pūtaiao rerekē mō te mate pukupuku tairoirō. Ko ētahi e āta whai ana i ngā oko toto e hangaia ana e ngā pūtau mate pukupuku hei kawe mai i ngā kai e āwhina ana i ngā pūtau ki te ora. Ko ētahi atu rongoā e āta whai ana i ngā huringa ira motuhake. Pea ka tūtohutia e tō kaiwhakarato ngā whakamātautau motuhake o ō pūtau mate pukupuku hei tirotiro i ngā rongoā pea ka āwhina. Ko ngā pānga taha e whakawhirinaki ana ki te rongoā motuhake e tangohia ana e koe. Ko te tiaki whakaora he tiaki hauora motuhake e arotahi ana ki te whakarato i te whakaora mai i te mamae me ētahi atu tohu o te mate kino. Ka mahi tahi ngā tohunga tiaki whakaora me koe, tō whānau me tō rōpū hauora hei whakarato i tetahi atu paparanga tautoko e whakakī ana i tō tiaki haere tonu. Ka taea te whakamahi i te tiaki whakaora i te wā e haere tonu ana ngā rongoā kaha, pēnei i te pokanga, te chemotherapy, te rongoā pāwera rānei. Kei te tino whakawhanakehia te tiaki whakaora i te tīmatanga o te maimoatanga mate pukupuku. I te wā e whakamahia ana te tiaki whakaora me ngā rongoā tika katoa, pea ka pai ake te ahua o te hunga he mate pukupuku, he kounga ora pai ake, he roa ake te ora. Ko te tiaki whakaora e whakaratohia ana e tetahi rōpū o ngā taote, ngā nēhi me ētahi atu tohunga whakangungu motuhake. Ko te whāinga o ngā rōpū tiaki whakaora ko te whakapai ake i te kounga ora mō te hunga he mate pukupuku me ō rātou whānau. Muri i te mutunga o tō maimoatanga mate pukupuku tairoirō, pea ka tūtohutia e tō kaiwhakarato ngā whakamātautau me ngā tukanga whai muri hei rapu i ngā tohu kua hoki mai tō mate pukupuku. Pea ka whai koe i ngā hui whai muri kotahi, rua rānei i te tau mō ētahi tau i muri i te mutunga o te maimoatanga. Ko ngā whakamātautau e hiahia ana koe e whakawhirinaki ana ki tō āhuatanga. Ko ngā whakamātautau whai muri pea ka uru ki:
• Te whakamātautau tinana o tō kaki
• Ngā whakamātautau toto
• Te whakamātautau ultrasound o tō kaki
• Ngā whakamātautau whakaahua atu, pēnei i te CT me te MRI Ohauru kore utu ka whiwhi i te aratohu hohonu ki te whakahaere me te mate pukupuku, me ngā korero whai hua mo te whiwhi i tetahi atu whakaaro. Ka taea e koe te whakakore i te ohaurunga i te ka hono whakakore i te īmēra. Ka tae mai tō aratohu hohonu ki te whakahaere i te mate pukupuku ki tō pouakaroto i te wa poto. Ka taea hoki e koe Ka roa pea te whakaae me te ako ki te whakahaere i te whakatau mate pukupuku tairoirō. Ka kite katoa te tangata i tōna ake huarahi whakahaere. Kia tae ra ano koe ki te mea e mahi ana mōu, whakaarohia te ngana ki te:
• Kite i te nui o ngā korero mō te mate pukupuku tairoirō hei whakatau i ngā whakatau mō tō tiaki. Tuhia ngā kōrero o tō mate pukupuku tairoirō, pēnei i te momo, te wāhanga me ngā whiringa rongoā. Pātai atu ki tō kaiwhakarato hauora kei hea koe e haere ai mō ētahi atu korero. Ko ngā puna korero pai hei tīmata i a koe ko te National Cancer Institute, te American Cancer Society me te American Thyroid Association.

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