He aha te whakamātautau ira BRCA? Te Whāinga, Ngā Taumata/Tikanga me te Hua

Ko te whakamātautau ira BRCA he whakamātautau toto e tirotiro ana i ngā huringa i roto i ō ira BRCA1 me BRCA2. Ko ēnei ira te tikanga ka āwhina i a koe ki te tiaki i a koe i ngā mate pukupuku o te u me te ovarian mā te whakatika i te DNA kua pakaru i roto i ō pūtau.

Inā he huringa kino (e kiia ana ko ngā huringa) i ēnei ira, kāore e taea e rātou te mahi tiaki tika. Ko te tikanga ka nui ake tō tūponotanga ki te whakawhanake i ētahi momo mate pukupuku i te toharite. Ka āwhina te whakamātautau i a koe me tō tākuta ki te mārama ki tō tūponotanga mate pukupuku whaiaro kia taea ai e koe te whakatau i ngā whakatau mō tō hauora.

He aha te whakamātautau ira BRCA?

Ko te whakamātautau ira BRCA e rapu ana i ngā huringa motuhake i roto i ngā ira nui e rua e kiia ana ko BRCA1 me BRCA2. Whakaarohia ēnei ira hei kaimahi whakatika tūturu o tō tinana mō te DNA kua pakaru.

Kei ia tangata ēnei ira, ā, e mahi ana rātou i te wā katoa ki te whakatika i ngā raru DNA iti e puta noa ana i roto i ō pūtau. Inā he pai te mahi, ka tino whakaiti rātou i tō tūponotanga mate pukupuku. Heoi, inā he huringa kino i ēnei ira, kāore e taea e rātou te mahi i ā rātou mahi tiaki.

Kei roto i te whakamātautau te tango i tētahi tauira toto iti mai i tō ringa. I ētahi wā, ka kohikohi pea tō tākuta i te huware hei utu. Ka haere te tauira ki tētahi taiwhanga motuhake e tirotiro ana ngā kaipūtaiao i tō raupapa DNA ki te rapu i ngā huringa kino e mōhiotia ana.

He aha te take e mahia ai te whakamātautau ira BRCA?

Ka āwhina te whakamātautau BRCA ki te tautuhi i ngā tāngata kua riro i a rātou te tūponotanga nui ake ki te whakawhanake i te u, te ovarian, me ētahi atu momo mate pukupuku. Ka tūtohu pea tō tākuta i tēnei whakamātautau inā he mate pukupuku i tō whānau, inā rānei he tāngata whai take tūponotanga koe.

Ka taea e ngā mōhiohio mai i tēnei whakamātautau te ārahi i ngā whakatau hauora nui. Inā he pai tō whakamātautau mō tētahi huringa kino, ka taea e koe me tō rōpū hauora te hanga i tētahi mahere whaiaro mō te ārai mate pukupuku me te kite wawe. Ka uru pea tēnei ki te tirotiro auau ake, ngā rongoā ārai, tae atu ki ngā pokanga ārai.

Ka taea hoki e te whakamātautau te whakarato i ngā mōhiohio whai hua mō ō whānau. I te mea ka riro mai ēnei huringa, tērā pea ka akiaki ō hua i ō whanaunga ki te whakaaro ki te whakamātautau. Ka taea e tēnei huarahi whānau te āwhina i te tiaki i ngā whakatupuranga maha.

He aha te tikanga mō te whakamātautau ira BRCA?

He tika tonu te tikanga whakamātautau ira BRCA, ā, he meneti noa iho te roa. Ka tango tō tākuta hauora i te iti o te toto mai i te uaua i tō ringa, pērā i te mahi toto noa.

I mua i te whakamātautau, ka tūtaki koe ki tētahi kaiwhakatakoto tohutohu ira e arotake ana i te hītori o tō whānau, ā, ka whakamārama i te tikanga o ngā hua. He mea nui tēnei wāhanga tohutohu nā te mea ka āwhina i a koe ki te mārama ki ngā pānga o te whakamātautau, ā, ka whakarite i a koe mō ngā putanga rerekē.

Anei te mea ka taea e koe te tūmanako i te wā o te tukanga whakamātautau:

1. He wāhanga tohutohu ira i mua i te whakamātautau hei kōrero mō te hītori o tō whānau me ngā āhuatanga tūpono
2. Te tango toto, te kohikohi huware rānei i tētahi whare hauora
3. Te tātari taiwhanga o tō DNA, e rua ki te whā wiki te roa
4. Te kōrero hua me tō kaiwhakatakoto tohutohu ira me tō tākuta hauora
5. Te tohutohu i muri i te whakamātautau hei whakamārama i ngā hua me te kōrero mō ngā mahi e whai ake nei

E whakanui ana te tukanga katoa i te tautoko me te mātauranga. E hiahia ana tō rōpū hauora kia mōhio koe, kia pai hoki i te wā o tō haerenga whakamātautau.

Me pēhea te whakarite mō tō whakamātautau ira BRCA?

Ko te whakarite mō te whakamātautau ira BRCA ko te kohikohi mōhiohio mō te hītori hauora o tō whānau, kaua ki te whakarite tinana. Kāore koe e hiahia ki te nohopuku, ki te karo rānei i ngā kai, i ngā rongoā rānei i mua i te whakamātautau.

Ko te whakarite tino nui ko te kohikohi mōhiohio taipitopito mō ngā tātaritanga mate pukupuku i tō whānau. Kei roto i tēnei ngā taha e rua o tō rākau whānau, me hoki atu ki te toru whakatupuranga ki te taea. Ka whakamahi tō kaiwhakatakoto tohutohu ira i ēnei mōhiohio hei aromatawai mēnā e tika ana te whakamātautau mōu.

Anei ngā pārongo me kohikohi koe i mua i tō pōwhiri:

• Ngā momo mate pukupuku i tātai i roto i ngā mema o te whānau
• Ngā tau i tātai ai ngā mema o te whānau i te mate pukupuku
• Mēnā i whai whakamātautau ira ngā whanaunga
• Ngā pārongo mō ngā whanaunga mai i ngā taha o tō whaea me tō pāpā
• Ngā huringa ira e mōhiotia ana i tō whānau

Whakaarohia te kawe mai i tētahi mema o te whānau, i tētahi hoa rānei e mōhiotia ana ki ō pōwhiri tohutohu. Mā te whai tautoko aronganui e āwhina i a koe ki te tukatuka i ngā pārongo me te whakatau i ngā whakatau e tika ana mōu.

Me pēhea te pānui i ngā hua o tō whakamātautau ira BRCA?

E toru ngā kāwai matua o ngā hua o te whakamātautau ira BRCA: pai, kino, he rerekētanga rānei o te hiranga kāore i te tino mōhiotia. Mā tō kaitohutohu ira e whakamārama te tikanga o ō hua motuhake mō tō hauora.

Ko te hua pai te tikanga he huringa kino tōu i roto i te BRCA1, i te BRCA2 rānei. Ka nui ake tō tūponotanga ki te whakawhanake i te mate pukupuku o te u, te pūkahukahu, me ētahi atu momo mate pukupuku i tō oranga. Heoi, ko te whai huringa kāore e taurangi ka whakawhanake koe i te mate pukupuku.

Ko te hua kino te tikanga kāore i kitea he huringa BRCA kino. Mēnā he hītori kaha tō whānau mō te mate pukupuku, tērā pea ko te tūponotanga o te mate pukupuku o tō whānau nā ētahi atu āhuatanga ira, i ngā take taiao rānei kāore i te hono ki ngā ira BRCA.

Ko te rerekētanga o te hiranga kāore i te tino mōhiotia te tikanga i kitea e te whakamātautau he huringa ira, engari kāore te hunga pūtaiao i te tino mōhio mēnā ka piki ake te tūponotanga o te mate pukupuku. E hiahia ana tēnei hua ki te aroturuki tupato i te wā e wātea ana ētahi atu rangahau hei whakamārama i te hiranga o te rerekētanga.

He aha te hua whakamātautau ira BRCA pai rawa atu?

Ko te hua whakamātautau ira BRCA pai rawa atu he kino pono, te tikanga kāore i kitea he huringa kino, ā, kāore he hītori o te mate pukupuku e pā ana ki te BRCA i tō whānau. E whakaatu ana tēnei hua he rite te tūponotanga o te mate pukupuku ki te taupori whānui.

Heoi anō, he mōhiohio whai hua kei ia hua e ārahi ana i āu whakatau hauora. Ahakoa he hua pai, ahakoa he āwangawanga, ka whai mana koe i te mōhiohio ki te whai i ngā mahi whai hua mō tō hauora. He tokomaha ngā tāngata e whai huringa BRCA kāore rawa i whanake te mate pukupuku, ina koa ka whai rātou i ngā rautaki tātari me te ārai e taunakitia ana.

Ko te mea nui ko te whakamahi i āu hua ki te whakatau i ngā whakatau mō tō hauora. Ahakoa he pai, he kino rānei, ka noho āu hua hei taputapu mō te hanga i tētahi mahere hauora whaiaro e hāngai ana ki tō āhuatanga me ō hiahia.

He aha ngā āhuatanga tūpono mō ngā huringa ira BRCA?

Ko ngā huringa ira BRCA he āhuatanga tūturu, nō reira ko tō āhuatanga tūpono tuatahi ko te whai hītori whānau o ēnei huringa. Ka riro i a koe tētahi kape o ia ira BRCA mai i ia mātua, ā, ka taea e te huringa i tētahi kape te whakanui i tō tūponotanga ki te mate pukupuku.

He nui ake te reiti o ngā huringa BRCA i ētahi iwi. Ko ngā tāngata o te uri o Ashkenazi Jewish he 1 i roto i te 40 te tūponotanga ki te mau i tētahi huringa BRCA, ka whakatauritea ki te 1 i roto i te 500 i roto i te taupori whānui. Ko tēnei pikinga o te auau nā te pānga o te kaiwhakaū i ēnei taupori.

He maha ngā tauira hītori whānau e whakaatu ana i te pikinga o te tūponotanga o ngā huringa BRCA:

• He maha ngā mema o te whānau e mate ana i te mate pukupuku uma, i te mate pukupuku ovarian rānei
• I tātaihia te mate pukupuku uma i mua i te 50 tau
• Te mate pukupuku ovarian i ngā tau katoa
• Te mate pukupuku uma tane
• Te mate pukupuku uma triple-negative
• Te mate pukupuku uma i ngā u e rua
• Te mate pukupuku uma me te mate pukupuku ovarian i te tangata kotahi

Ko te whai i ēnei āhuatanga tūpono kāore i te kī he tino huringa BRCA tōu. He tokomaha ngā tāngata e whai hītori whānau kaha ana ka kino te whakamātautau, i te wā e pai ana ētahi atu e iti ana te hītori whānau.

He aha ngā raruraru ka puta mai i ngā huringa ira BRCA?

Ka nui ake te tūponotanga o te whakawhanake i ētahi momo mate pukupuku e te huringa ira BRCA, ko te mate pukupuku u me te ovarian te mea tino noa. He rerekē te tūponotanga tika i runga i te ira e pā ana me ētahi atu āhuatanga whaiaro.

Ko ngā wāhine e whai huringa BRCA1 he 55-72% te tūponotanga o te mate pukupuku u i roto i te oranga, me te 39-44% te tūponotanga o te mate pukupuku ovarian. Ko te hunga e whai huringa BRCA2 e tūpono ana ki te 45-69% te tūponotanga o te mate pukupuku u me te 11-17% te tūponotanga o te mate pukupuku ovarian. He nui ake ēnei tau i ngā tūponotanga o te taupori whānui.

I tua atu i te mate pukupuku u me te ovarian, ka taea e ngā huringa BRCA te whakanui ake i te tūponotanga mō ētahi atu mate pukupuku:

• Te mate pukupuku pancreatic (nō te huringa BRCA2)
• Te mate pukupuku prostate i ngā tāne
• Te mate pukupuku u tāne
• Melanoma
• Te mate pukupuku ngongo fallopian
• Te mate pukupuku peritoneal tuatahi

Ko ēnei mate pukupuku e pā ana ki ngā huringa BRCA ka puta i ngā tau taitamariki ake i te tikanga. Ka kaha ake pea, he rerekē rānei ngā āhuatanga i ngā mate pukupuku e puta ana i roto i ngā tāngata kāore he huringa ira.

Āhea ahau e kite ai i te tākuta mō te whakamātautau ira BRCA?

Me whakaaro koe ki te kōrero mō te whakamātautau ira BRCA ki tō tākuta mēnā he hītori whaiaro, he hītori whānau rānei tōna e whakaatu ana i te tūponotanga nui ake o te mate pukupuku. He whakatau whaiaro te whakatau ki te whakamātau, ā, e whakawhirinaki ana ki ngā āhuatanga rerekē tae atu ki tō hītori whānau, te pakeke, me ngā hiahia whaiaro.

Ka tūtohu pea tō tākuta i te tohutohu ira mēnā he āhuatanga tūpono tōna. Kāore tēnei e kī ana me whakamātau koe, engari ka āwhina i a koe ki te mārama mēnā he pai te whakamātau mōu me tō whānau.

Whakaarohia te whakarite i tētahi kōrero mēnā kei a koe ēnei āhuatanga:

• He maha ngā whanaunga he mate pukupuku u, he mate pukupuku ovarian rānei
• I kitea te mate pukupuku i ngā tau taitamariki i roto i tō whānau
• He mōrearea BRCA e mōhiotia ana i roto i tō whānau
• Ngā whanaunga tāne he mate pukupuku u
• Ngā whanaunga he mate pukupuku u me te mate pukupuku ovarian
• Ngā uri o Ashkenazi Jewish me te hītori whānau o te mate pukupuku u, ovarian rānei

Ahakoa kāore koe e tutuki i ngā paearu paerewa mō te whakamātautau, mā te kōrero ki tō tākuta e āwhina i a koe ki te mārama ki tō tūponotanga whaiaro me ngā kōwhiringa tātari.

Ngā pātai auau mō te whakamātautau ira BRCA

Q.1 He pai te whakamātautau ira BRCA mō te ārai i te mate pukupuku?

Kāore te whakamātautau ira BRCA e ārai i te mate pukupuku, engari e whakarato ana i ngā kōrero nui e ārahi ana i ngā rautaki ārai mate pukupuku. E tautuhi ana te whakamātautau i te mea kei a koe ngā huringa ira e whakanui ana i tō tūponotanga ki te mate pukupuku.

Ki ēnei kōrero, ka taea e koe me tō rōpū hauora te whakawhanake i tētahi mahere ārai whaiaro. Ka uru pea tēnei ki te tātari whakarei ki te MRI me te mammography, ngā rongoā ārai, ngā pokanga whakaheke tūponotanga rānei. E whakaatu ana ngā rangahau ka taea e ēnei rautaki te whakaiti i te tūponotanga ki te mate pukupuku i roto i ngā tāngata he mōrearea BRCA.

Q.2 Ko te whai mōrearea BRCA te tikanga ka mate pukupuku au?

Kāore, ko te whai mōrearea BRCA kāore e taurangi ka whanake koe i te mate pukupuku. Ahakoa e whakanui ana ēnei huringa i tō tūponotanga ki te mate pukupuku, he maha ngā tāngata he mōrearea BRCA kāore rawa e whanake i te mate pukupuku i roto i ō rātou oranga.

Ko ngā ōrau e rongo ana koe mō te tūponotanga ki te mate pukupuku e pā ana ki te BRCA e tohu ana i ngā toharite puta noa i ngā taupori nui. E whakawhirinaki ana tō tūponotanga whaiaro ki ngā mea maha tae atu ki tō mōrearea motuhake, te hītori whānau, ngā whiringa oranga, me ētahi atu mea ira. Koinei te take he mea nui te tohutohu whaiaro.

Q.3 Ka whai hua ngā tāne i te whakamātautau ira BRCA?

Āe, ka whai hua ngā tāne mai i te whakamātautau ira BRCA. Ahakoa he iti ake te pūhui o te mate pukupuku uma i ngā wāhine, ka piki tonu te tūponotanga o ngā tāne ki te mate pukupuku uma, te pūkahukahu, me te puku.

Ka tukuna hoki e ngā tāne whai huringa BRCA ēnei ira ki ā rātou tamariki. He 50% te tūponotanga o te tāne whai huringa BRCA ki te tuku atu ki ia tamaiti, ahakoa te ira tangata o te tamaiti. Ka taea e te whakamātautau te whakarato i ngā mōhiohio whai hua mō te whakamahere whānau me ngā whakatau tirotiro.

Q.4 E hia te tika o ngā whakamātautau ira BRCA?

He tino tika ngā whakamātautau ira BRCA ina mahia e ngā taiwhanga whaimana. Ka tika te tautuhi i ngā huringa kino neke atu i te 99% o te wā ina rapu ana i ngā huringa e mōhiotia ana.

Heoi, ka titiro noa te whakamātautau ki ngā huringa kua tautuhia e ngā kaipūtaiao he kino. Tera pea he huringa onge, he huringa kāore i te mōhiotia e kore e kitea e ngā whakamātautau o nāianei. Koinei te take kāore te hua kino e whakakore katoa i te pikinga o te tūponotanga o te mate pukupuku, ina koa he kaha te hītori o te whānau.

Q.5 Ka utua e taku inihua te whakamātautau ira BRCA?

He maha ngā mahere inihua e utu ana i te whakamātautau ira BRCA ina tutuki i a koe ngā paearu rongoā motuhake. Ko ēnei paearu ko te nuinga he hītori whaiaro, he hītori whānau rānei e whakaatu ana i te pikinga o te tūponotanga ki te mau i te huringa BRCA.

Ka taea e tō kaiāwhina ira te āwhina ki te whakatau mēnā ka tutuki i a koe ngā paearu kapinga, me te āwhina i te whakaaetanga i mua i te hiahia. Ka tukuna hoki e ētahi kamupene whakamātautau ngā hōtaka āwhina pūtea mō ngā tāngata kāore he kapinga inihua, mō te hunga rānei e raru ana i te pūtea.