He aha te rongoā iraruke i roto i te mahi (IORT)? Te Whāinga, te Hātepe me ngā Hua

Ko te rongoā iraruke i roto i te mahi (IORT) he rongoā mate pukupuku motuhake e tuku ana i te iraruke i te wāhi tika ki ngā wāhi puku i te wā o te pokanga. Whakaarohia he huarahi tika, whāinga hoki e taea ai e tō rōpū pokanga te rongoā i ngā pūtau mate pukupuku i te puna tonu i a koe e noho ana i roto i te rūma whakahaere.

Ko tēnei tikanga ka taea e ngā tākuta te tuku i ngā horopeta iraruke teitei ake me te tika nui, e tiaki ana i ngā kiko hauora e noho ana i te ara iraruke. He rite ki te whai i tētahi tangata whai pūkenga e taea ana te patu i te whāinga tika i te wā e noho haumaru ana ētahi atu mea i te taha.

He aha te rongoā iraruke i roto i te mahi?

Ka whakakotahi a IORT i te pokanga me te rongoā iraruke ki tētahi wāhanga rongoā kotahi, ruruku. I te wā o tō pokanga, i muri i te tango a te tākuta pokanga i te puku e kitea ana, ka tukuna e rātou te iraruke ki te moenga puku, ki ngā pūtau mate pukupuku e toe ana rānei.

Ko te kurupae iraruke e whāinga ana ki te wāhi tika e tino tūpono ai te hokinga mai o ngā pūtau mate pukupuku. Nā te mea ka nekehia ngā okana me ngā kiko hauora i te wā o te pokanga, ka taea e tō rōpū hauora te whakamahi i ngā horopeta iraruke teitei ake i te mea e haumaru ana ki te rongoā iraruke o waho.

He mea tino nui tēnei huarahi mō ngā mate pukupuku e hiahia ana ki te hoki mai i te rohe, arā, ka hoki mai i te wāhi kotahi i tupu ai. Ka taea e tō rōpū pokanga te whakatika i te tango puku me te rongoā iraruke i a koe e noho ana i raro i te rongoā, e whakaiti ana i tō wā rongoā katoa.

He aha i mahia ai te rongoā iraruke i roto i te mahi?

Ka āwhina a IORT i te whakapai ake i ngā hua rongoā mate pukupuku mā te whāinga i ngā pūtau mate pukupuku microscopic e noho ana i muri i te pokanga. Ahakoa ka tangohia e ngā tākuta pokanga ngā kiko puku e kitea ana, ka noho tonu ngā pūtau mate pukupuku iti, e kore e kitea e te kanohi.

Ka tohutohu pea tō tākuta mate pukupuku i te IORT mēnā he momo mate pukupuku ū, mate pukupuku kōpū, sarcomas, ētahi atu puku mārō rānei kei reira te mōrearea o te hokinga mai. He tino whai hua ina tata te puku ki ngā okana nui, ki ngā hanganga rānei e uaua ana te tiaki i te wā o te rongoā iraruke tikanga.

Ka whai hua hoki te rongoā ki ngā tūroro he iti noa ngā kōwhiringa mō te rongoā iraruke waho. Kua whiwhi pea ētahi tāngata i ngā horopeta iraruke haumaru mōrahi ki tētahi wāhi, ā, he whai hua te IORT hei huarahi kē hei whakatika i te mate pukupuku hou, i te mate pukupuku hoki i te rohe kotahi.

Mō ētahi momo mate pukupuku ū i te wā tuatahi, ka taea e te IORT te whakakapi i te hiahia mō ngā wiki o ngā rongoā iraruke waho ia rā. Ka taea e tēnei te whakaiti i tō kawenga rongoā me te āwhina i a koe kia hoki wawe ki ō mahi noa.

He aha te tikanga mō te rongoā iraruke i roto i te mahi?

Ka tū te IORT i roto i tētahi rūma whakahaere i whakatakotoria motuhake, kei roto ngā taputapu pokanga me ngā taputapu iraruke. Ka uru tō tikanga ki tētahi rōpū tākuta pokanga, tākuta mate pukupuku iraruke, tākuta ahupūngao rongoā, me ngā nēhi motuhake.

Ka tīmata te tukanga pēnei i te pokanga mate pukupuku paerewa, me koe i raro i te rongoā whānui. Ka tangohia e tō tākuta pokanga te puku me ngā kōpuku rāpoi rāpoi kua pā rānei, me ngā kiko i whakaritea. Kia oti te tango pokanga, ka whakarite rātou i te wāhi mō te tuku iraruke.

Koinei te mea ka tū i te wā o te wāhanga iraruke o tō tikanga:

Ka whakatakotoria e tō rōpū rongoā tētahi taputapu tuku iraruke ki te taha tonu, ki roto rānei i te moenga puku. Ka tukuna e tēnei taputapu te iraruke i tētahi ara tino whakahaere, tino arotahi. Ka neke mārire ngā okana me ngā kiko hauora e tata ana ki te wāhi rongoā, ka tiakina rānei ki ngā whakangungu motuhake.

Ko te tukunga iraruke ka roa i waenga i te 10 ki te 45 meneti, i runga i tō mahere maimoatanga. I tēnei wā, ka puta te nuinga o ngā kaimahi i te rūma whakahaere i te wā e tukuna ana te iraruke, engari ka aroturukihia tonu koe.

I muri i te otinga o te maimoatanga iraruke, ka whakaoti tō tākuta i te mahi mā te kati i te wāhi pokanga. Ko te katoa o te tikanga ka roa i te 2 ki te 6 haora, i runga i te uaua o tō pokanga me te momo mate pukupuku e rongoatia ana.

Me pēhea te whakarite mō tō rongoā iraruke i roto i te mahi?

Ko te whakarite mō te IORT he rite ki te whakarite mō te pokanga nui, me ētahi atu whakaaro. Ka hoatu e tō rōpū hauora ngā tohutohu motuhake i runga i tō āhuatanga takitahi me te momo pokanga e mahia ana e koe.

Me mutu te kai me te inu mō te 8 ki te 12 haora i mua i tō tikanga. Ka tono pea tō tākuta ki a koe kia whakamutu i ētahi rongoā, ina koa ngā rongoā whakaheke toto, hei whakaiti i te tūponotanga o te toto i te wā o te pokanga.

I mua i tō rā maimoatanga, ka whai koe i ētahi tūponotanga whakarite. Ka uru pea ēnei ki ngā whakamātautau toto, ngā rangahau whakaahua, me ngā kōrero ki tō rōpū pokanga me te tākuta iraruke. Ka āwhina ēnei haerenga ki te whakarite kia tino pai te whakamahere mō tō keehi motuhake.

He mea nui kia whakarite i tētahi tangata hei taraiwa i a koe ki te kāinga i muri i tō tikanga, me te noho tahi me koe mō te 24 haora tuatahi. Me whakarite hoki tō kāinga mō te whakaora, tae atu ki te whai i ngā kākahu pai, ngā kai ngawari ki te whakarite, me ngā rongoā kua tohua.

Ka kōrero tō rōpū hauora i ngā hikoi whakarite motuhake i runga i tō momo mate pukupuku me te hauora whānui. Kaua e whakaroa ki te pātai pātai mō te aha e tūmanakohia ana, ki te whakaputa rānei i ō āwangawanga.

Me pēhea te mārama ki ō hua rongoā iraruke i roto i te mahi?

E kore e taea te ine tonu ngā hua o te IORT pērā i te whakamātautau toto, i te rangahau whakaahua rānei. Engari, ka arotakehia te angitu o tō maimoatanga i roto i te wā mā ngā tūpono whai-muri me te aroturuki.

Ka ine te tākuta onkorangi iraruke i te angitu o te maimoatanga mā te aroturuki i te hokinga mai o te mate pukupuku i te wāhi i rongoatia. Ko te tikanga ka arotakehia tēnei mā ngā whakamātautau tinana i ngā wā katoa, ngā rangahau whakaahua pērā i te CT scans, i te MRIs rānei, i ētahi wā ka whakamātautau toto mō ngā tohu puku.

Ko te wā i muri tonu i te maimoatanga ka arotahi ki te whakaora i te pokanga, kaua ki ngā pānga o te iraruke. Ka aroturukihia e tō rōpū pokanga te whakaora o tō tapahi, ngā taumata mamae, me te whakaora whānui. Ko te nuinga o te tangata ka pā ki ngā tohumate whakaora pokanga noa, kaua ki ngā pānga taha iraruke tuku iho.

Ka inea te angitu wā-roa mā ngā reiti whakahaere ā-rohe, ko te tikanga te pai o te maimoatanga ki te aukati i te hokinga mai o te mate pukupuku i te wāhi kotahi. E whakaatu ana ngā rangahau ka taea e te IORT te whakapai ake i ngā reiti whakahaere ā-rohe mō te maha o ngā momo mate pukupuku, he maha ngā wā ka rite, ka nui ake rānei te whai huatanga i te rongoā iraruke o waho tuku iho.

Ka whakatikatikaina tō hōtaka whai-muri ki tō āhuatanga motuhake, engari ko te tikanga ka uru ngā tūpono ia 3 ki te 6 marama mō ngā tau tuatahi, ā, ia tau. Ka whakamāramahia e tō rōpū hauora te aha hei mātakitaki, me te wā hei whakapā atu ki a rātou mō ngā āwangawanga.

He aha ngā painga o te rongoā iraruke i roto i te pokanga?

He maha ngā painga nui o te IORT i te rongoā iraruke o waho tuku iho. Ko te painga nui rawa atu ko te kaha ki te tuku i ngā horopeta iraruke teitei ake ki ngā pūtau mate pukupuku i te wā e tiaki ana i ngā kiko hauora e tata ana.

Tērā pea ka iti ake ngā pānga taha ka pā ki a koe i te rongoā iraruke o waho. I te mea ka tukuna te iraruke i roto, ā, ka tiakina ngā kiko hauora i te wā o te maimoatanga, he iti ake te tūponotanga ka pā ki a koe te riri kiri, te ngenge, te kino rānei ki ngā okana tata.

He mea nui te watea mō te hunga tūroro. Kāore he rāpoi rāpoi i ia rā mō ētahi wiki, engari ka whiwhi koe i tō rongoā rāpoi i te wā o tō pokanga. Mā tēnei ka whakaiti i tō pōkai rongoā, ā, ka āwhina i a koe kia hoki wawe ki ngā mahi o ia rā.

Mō ētahi momo mate pukupuku, ka taea e te IORT te whakapai ake i ngā hua o te rongoā. Kua whakaatu ngā rangahau i ngā reiti whakahaere rohe pai, arā, he iti ake te tūpono ka hoki mai te mate pukupuku i te wāhi i rongoāhia. He pono tēnei mō te mate pukupuku u i te wāhanga tuatahi me ētahi momo mate pukupuku kōiwi.

Ko te tika o te IORT ka taea hoki te rongoā i ngā mate pukupuku i ngā wāhi uaua. Ki te tata ngā puku ki ngā hanganga nui pēnei i te taurakira, ngā oko toto nui, rānei ngā okana nui, ka taea e te IORT te tuku rongoā whai hua me te whakaiti i te tūpono ki ēnei wāhi nui.

He aha ngā raruraru ka puta mai i te rongoā rāpoi i te wā o te pokanga?

Pērā i ngā mahi rongoā katoa, he tūpono kei te IORT, ahakoa he iti noa ngā raruraru nui. Ko te nuinga o te tangata ka pā ki ngā pānga taha e taea ana te whakahaere, ka ngaro i te wā me te manaaki tika.

Ko ngā pānga wā poto noa e pā ana ki te pokanga tonu, kaua ki te rāpoi. Ka uru pea ēnei ki ngā tūpono pokanga pērā i te toto, te mate, rānei ngā urupare ki te rongoā whakamoe. Ka mātakitaki tata tō rōpū pokanga i a koe mō ēnei āwangawanga i muri i te pokanga.

Anei ngā pānga e pā ana ki te rāpoi ka pā ki a koe:

Ka puta ngā huringa kiko i te wāhi i rongoāhia i te roanga o te wā. Ka puta te pū, te matotoru, rānei ngā huringa i te āhua o te kiri i te wāhi i tukuna ai te rāpoi. Ko ēnei huringa ka puta haere i ngā marama, ā, he ngawari tonu.

Ka puhoi ake te whakaora i ngā patunga i ētahi wā. Ka pā te rāpoi ki te tere o te whakatikatika o ngā kiko i a rātou anō, ahakoa kāore tēnei e pā ana ki ngā raruraru nui ki te whai koe i ngā tohutohu manaaki i muri i te pokanga.

He onge engari he nui ake ngā raruraru ka uru ki te kino ki ngā okana tata, ki ngā hanganga rānei. Heoi, ko te whakamahere tupato me te tirohanga i te wā tūturu i te wā o te IORT ka tino whakaiti i tēnei tūponotanga ki te whakataurite ki te rongoā iraruke o waho.

Ka pā te mamae mau tonu, te ngū rānei ki ētahi tāngata i te wāhi i rongoatia. He mea noa tēnei ki ētahi momo tikanga me ngā wāhi, ā, ka kōrero tō rōpū hauora i tēnei tūponotanga motuhake i runga i tō keehi takitahi.

Ngā pānga wā-roa, ahakoa he mea noa, ka uru ki te whanaketanga o ngā mate pukupuku tuarua i te wāhi i rongoatia. Ko tēnei tūponotanga he iti ake te nuinga ki te IORT ki te whakataurite ki te rongoā iraruke tuku iho nā te whāinga tika me te huarahi horopeta kotahi.

Āhea au e kite ai i te tākuta mō te rongoā iraruke i roto i te mahi?

Me whakapā atu koe ki tō rōpū hauora i te wā tonu ki te pā mai ngā tohu o ngā raruraru nui i muri i tō tikanga IORT. Ka uru pea ēnei ki te mamae nui kāore e pai ake ana ki ngā rongoā kua whakaritea, ngā tohu o te mate pēnei i te kirika, te rere ke rānei, ngā huringa ohorere rānei i tō wāhi pokanga.

I te wā o tō whakaoranga, mātakitaki mō ngā tohu ka tohu i ngā raruraru. Ko te pūhi nui rawa, te toto tonu, te rerenga rānei mai i tō wāhi tapahi ka tika kia āta tirohia e te rōpū hauora. Ka hoatu e tō rōpū pokanga ngā aratohu motuhake mō te mea noa me te mea e hiahia ana kia āta tiakina tonu.

Mō te aroturuki tonu, pupuri i ō pōhiri whai-muri katoa kua whakaritea ahakoa e pai ana koe. Ka taea e ngā arotake auau te rōpū hauora ki te kite i ngā take i te wā tuatahi me te whakarite kei te mahi tō rongoā i te mea e tika ana.

Whakapā atu ki tō tākuta ki te kite koe i ngā puku hou, ngā pūpū rānei, ngā huringa rānei i te wāhi i rongoatia i te wā o tō whakaoranga me tua atu. Ahakoa ko te nuinga o ngā huringa he whakautu whakaora noa, ka taea e tō rōpū hauora te whakatau mēnā e hiahiatia ana he arotake atu.

Kaua e whakaroa ki te whakapā mai mō ngā pātai, ā, mō ngā āwangawanga mō tō whakaoranga. E tatari ana tō rōpū hauora, ā, e manaaki ana i āu pātai, ā, ko te aro ki ngā āwangawanga i te wā wawe ka ārai i ngā raruraru iti kia kaua e nui ake.

Ngā pātai e pātaititia ana mō te rongoā iraruke i te wā o te pokanga

Q.1 He pai te rongoā iraruke i te wā o te pokanga mō te mate pukupuku u?

Āe, he pai rawa te IORT mō ētahi momo mate pukupuku u, otirā mō ngā puku i te wā wawe. E whakaatu ana te rangahau mō ngā tūroro i whiriwhiria mā te āta, me ngā mate pukupuku u iti, iti-mōrearea, ka whai hua te IORT pērā i te rongoā iraruke o waho.

He tino whai hua te rongoā mō ngā tūroro pakeke, mō te hunga rānei he mate pukupuku u i te wā wawe, he pai ki te homoni. He maha ngā wāhine e maioha ana ki te whakaoti i tā rātou rongoā iraruke i te wā o te pokanga lumpectomy, e karo ana i ngā wiki o ngā whakaritenga iraruke ia rā.

Heoi anō, kāore te IORT e tika ana mō ngā mate pukupuku u katoa. Ka whakaaro tō tākuta mate pukupuku ki ngā āhuatanga pēnei i te rahi o te puku, te wāhi, te tohu, me te whai wāhi o te kōpuku lymph i te whakatau mēnā he pai koe mō tēnei huarahi.

Q.2 He nui ake ngā pānga taha o te rongoā iraruke i te wā o te pokanga i te iraruke noa?

Inā, ko te IORT te tikanga he iti ake ngā pānga taha i te rongoā iraruke o waho. Nā te mea ka tukuna te iraruke ki te wāhi e whāia ana i te wā e tiakina ana ngā kiko hauora, he iti ake te tūpono ka pā ki a koe ngā pānga taha iraruke noa pēnei i te riri kiri me te ngenge.

Ko te huarahi horopeta kotahi o te IORT te tikanga e kore koe e pā ki ngā pānga tahi ka puta me ngā rongoā iraruke o waho ia rā. Ko te nuinga o ngā pānga taha ka pā ki a koe ka pā ki te pokanga tonu, kaua ki te wāhanga iraruke.

Heoi anō, ko ngā pānga ka pā ki a koe, tērā pea ka kaha ake te aro ki te wāhi i rongoa. Ka pūremu, ka mārō rānei ētahi tāngata i te wāhi i tukuna ai te iraruke, engari he mea whakahaere ēnei, ā, ka pōturi te whanaketanga i te roanga o te wā.

Q.3 Kia pēhea te roa o te whakaora i muri i te rongoā iraruke i te wā o te mahi pokanga?

Ko te wā whakaora e whakawhirinaki ana ki te momo pokanga i mahia e koe, kaua ki te wāhanga iraruke. Ko te nuinga o te tāngata ka ora mai i ngā tikanga IORT i roto i te wā kotahi i te mea ka ora mai rātou i te pokanga anake.

Mō te IORT u, he maha ngā tūroro ka hoki ki ngā mahi noa i roto i te 1 ki te 2 wiki, he rite ki te whakaora mai i te lumpectomy paerewa. Ko ngā pokanga nui ake ka roa ake te wā whakaora, te tikanga 4 ki te 6 wiki mō ngā tikanga puku.

Ka pōturi pea te wāhanga iraruke i te whakaora i ngā kiko i ētahi wā, engari he uaua tēnei ki te whakaroa i tō wā whakaora katoa. Ka whakarato tō rōpū hauora i ngā tūmanako motuhake i runga i tō tikanga takitahi me tō hauora whānui.

Q.4 Ka taea te whakahoki anō i te rongoā iraruke i te wā o te mahi pokanga mēnā ka hoki mai te mate pukupuku?

He uaua pea te whakahoki anō i te IORT i te wāhi kotahi nā te mea kua whiwhi kē ngā kiko i te horopeta iraruke nui. Heoi anō, i ētahi wā ka taea i runga i te wāhi, te wā i pāhi mai i te rongoā tuatahi, me tō tūnga hauora whānui.

Ka āta arotake tō tākuta iraruke i ngā āhuatanga pēnei i te horopeta iraruke katoa i whiwhi ai ō kiko, te wā mai i tō rongoā tuatahi, me te wāhi o te mate pukupuku hoki mai. I ētahi wā he pai ake pea ngā rongoā kē mō te mate hoki mai.

Mēnā ka hoki mai te mate pukupuku i tētahi wāhi rerekē o tō tinana, tērā pea ka waiho tonu te IORT hei kōwhiringa mō te rongoā i te wāhi hou. He mea motuhake ia tūāhua, ā, ka whakawhanake tō rōpū hauora i te mahere rongoā pai rawa atu mō ō āhuatanga motuhake.

Q.5 Ka hipokina te rongoā iraruke i te wā o te mahi pokanga e te inihua?

Ko te nuinga o ngā mahere inihua, tae atu ki a Medicare, e hipoki ana i te IORT ina tika ana te rongoā, ā, ka mahia mō ngā tohu kua whakaaetia. E kiia ana he kōwhiringa paerewa te rongoā mō ētahi momo mate pukupuku, ina koa te mate pukupuku u me ētahi mate pukupuku puku.

Heoi, ka rerekē pea te hipoki i runga i tō mahere inihua me te momo mate pukupuku e rongoāhia ana. He mea nui kia mahi tahi koe me ngā kaitohutohu pūtea o tō rōpū rongoā ki te whakaū i te hipoki me te mārama ki ngā utu ka puta i mua i tō tikanga.

Mēnā ka pātai koe ki ngā take hipoki, ka taea e tō rōpū rongoā te whakarato i ngā tuhinga e tautoko ana i te hiahia rongoā o te IORT mō tō āhuatanga motuhake. He maha ngā kamupene inihua e mōhio ana ki te whai hua o te IORT ki te whakataurite ki ngā wiki o te rongoā iraruke o waho.