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Pono ka ʻike ʻana i ka maʻi maʻi ʻaʻai māmā e wikiwiki, piha a piha. A laila ʻae maoli ia i ke koho ʻana a me ka optimization o ka mālama maʻi kanesa. Mahalo i nā lāʻau lapaʻau hou, loaʻa i kekahi mau maʻi ka manawa e hoʻolōʻihi i ko lākou ola ʻaʻole i ka liʻiliʻi, akā i nā mahina he ʻumi. Lilo ka ma'i ma'i ma'i i ma'i mau.
ʻO ka maʻi maʻi maʻi maʻi - hōʻailona
- Pono ka hoʻopaʻa ʻana i ka maʻi maʻi ʻāʻī i ke komo ʻana o nā mea lapaʻau he nui, ʻaʻole like me kekahi mau maʻi maʻi maʻi kino, e like me ka maʻi maʻi umauma a i ʻole ka melanoma, i ʻike ʻia a mālama nui ʻia e nā oncologists. He ʻokoʻa loa ka maʻi kanesa ma ʻaneʻi - wahi a Prof. dr hab. n. med. ʻO Joanna Chorostowska-Wynimko, ke poʻo o ka 'Oihana o Genetics a me Clinical Immunology o ka Institute of Tuberculosis and Lung Diseases ma Warsaw.
He mea koʻikoʻi ka hui pū ʻana o nā loea he nui, ʻo ka manawa i hoʻolaʻa ʻia i nā diagnostics a laila pono ke kūpono no ka mālama ʻana. - ʻO ka wikiwiki o ka ʻike ʻia ʻana o ka maʻi kanesa, ʻoi aku ka wikiwiki o ka hoʻokō ʻana i nā diagnostics imaging a me endoscopic, ʻoi aku ka wikiwiki o ka loiloi pathomorphological a me nā hoʻokolohua molecular pono e hana ʻia, hiki iā mākou ke hāʻawi i ka mea maʻi i ka lāʻau maikaʻi loa. ʻAʻole suboptimal, kūpono wale nō. Ma muli o ka pae o ka maʻi kanesa, hiki iā mākou ke ʻimi i ka lāʻau lapaʻau, e like me ke ʻano o ka pae I-IIIA, a i ʻole ma ka maʻi maʻi maʻi ākea. I ka hihia o ka holomua kūloko, hiki iā mākou ke hoʻohana i ka lāʻau kūloko i hui pū ʻia me ka mālama ʻōnaehana, e like me ka radiochemotherapy, hoʻohui maikaʻi ʻia me ka immunotherapy, a i ʻole ka mālama ʻana i ka ʻōnaehana i hoʻolaʻa ʻia i nā poʻe maʻi me ka maʻi kanesa āpau, eia ka manaʻolana i nā ʻano hana hou o ka mālama ʻana, ʻo ia hoʻi ka molecularly targeted. a i ʻole nā lāʻau immunocompetent. ʻO ka maʻi oncologist, radiotherapist, kaʻi lapaʻau pono e komo pono i kahi hui interdisciplinary o nā loea - i loko o nā ʻōpū o ka ʻōpū he mea lapaʻau thoracic - i nā manawa he nui pū kekahi pulmonologist a me kahi loea i ka diagnostics imaging, ʻo ia hoʻi he radiologist - wehewehe ʻo Prof. dr hab. n. med. ʻO Dariusz M. Kowalski mai ke Keʻena ʻo Lung a me Thoracic Cancer o ka National Institute of Oncology-National Research Institute ma Warsaw, pelekikena o ka Polish Lung Cancer Group.
Hoʻomanaʻo ʻo Prof. Chorostowska-Wynimko he nui nā maʻi maʻi maʻi maʻi maʻi maʻi e noho pū ana me nā maʻi hanu. - ʻAʻole hiki iaʻu ke noʻonoʻo i kahi kūlana i hana ʻia ai ka hoʻoholo e pili ana i ka mālama oncological maikaʻi loa o ia mea maʻi me ka ʻole e noʻonoʻo i nā maʻi ʻeha. No ka mea, e kupono ana makou no ka lapaau ana i ka mea ma'i me na akemāmā ola ma'amau koe wale no ka ma'i 'a'ai, a me ka mea ma'i me ka ma'i hanu mau, e like me ka pulmonary fibrosis a i 'ole ka ma'i obstructive pulmonary ma'i (COPD). E ʻoluʻolu e hoʻomanaʻo he mau kumu pilikia koʻikoʻi nā kūlana ʻelua no ka maʻi kanesa maʻi. I kēia manawa, i ka makahiki o kahi maʻi maʻi, e loaʻa iā mākou nā maʻi he nui me nā pilikia pulmonary COVID-19 - wahi a Prof. Chorostowska-Wynimko.
Hoʻoikaika ka poʻe akamai i ka pono o ka diagnostics maikaʻi, piha a piha. - No ka mea he mea nui loa ka manawa, pono e hana ʻia nā diagnostics me ka maikaʻi a me ka maikaʻi, ʻo ia hoʻi ma nā kikowaena maikaʻi e hiki ke hana pono i nā diagnostics liʻiliʻi a me ka invasive, me ka hōʻiliʻili ʻana i ka nui kūpono o nā mea biopsy maikaʻi no nā hoʻokolohua hou aku, me ka nānā ʻole i ka ʻenehana i hoʻohana ʻia. Pono e hoʻopili pono ʻia kēlā kikowaena me kahi kikowaena pathomorphological a me ka molecular diagnostics center. Pono e hoʻopaʻa pono ʻia nā mea noiʻi a hoʻouna koke ʻia, kahi e hiki ai ke loiloi maikaʻi i nā ʻōlelo o ka maʻi pathomorphological, a laila nā ʻano genetic. ʻO ke kūpono, pono e hōʻoia ke kikowaena diagnostic i ka hana like ʻana o nā hoʻoholo biomarker - manaʻoʻiʻo ʻo Prof. Chorostowska-Wynimko.
He aha ke kuleana o ka pathologist
Me ka loaʻa ʻole o kahi hoʻokolohua pathomorphological a cytological, ʻo ia hoʻi ka ʻike ʻana i ka loaʻa ʻana o nā maʻi maʻi maʻi, ʻaʻole hiki i ka mea maʻi ke kūpono no kekahi lapaʻau. - Pono ka pathomorphologist e hoʻokaʻawale inā mākou e pili ana i ka maʻi maʻi maʻi ʻaʻole liʻiliʻi liʻiliʻi (NSCLC) a i ʻole ka maʻi kanesa liʻiliʻi liʻiliʻi (DRP), no ka mea, pili ka mālama ʻana i nā maʻi. Inā ua ʻike mua ʻia ʻo ia ka NSCLC, pono e hoʻoholo ka pathologist i ke ʻano o ka subtype - glandular, cell large, squamous a i ʻole kekahi o nā mea ʻē aʻe, no ka mea, he mea pono loa ke kauoha ʻana i nā hoʻokolohua molecular, ʻoi aku ma ke ʻano o ka non. -squamous cancer, i mea e kūpono ai no ka molecular lapaʻau i hoʻopaʻa ʻia - hoʻomanaʻo iā prof. Kowalski.
I ka manawa like, pono e hāʻawi ʻia ka hāʻawi ʻana i ka mea i kahi pathologist e hoʻopiha i nā diagnostics molecular e uhi ana i nā biomarkers āpau i hōʻike ʻia e ka papahana lāʻau, nā hopena e pono ai e hoʻoholo i ka mālama maikaʻi ʻana o ka mea maʻi. - Ua hoʻouna ʻia ka mea maʻi i kekahi mau hoʻokolohua molekula. He kūpono ʻole kēia ʻano. ʻAʻole hiki ke hoʻoholo i ke ʻano o ka mālama maikaʻi ʻana i ka mea maʻi. Aia kekahi mau kūlana i hoʻopaʻa ʻia nā pae hoʻokahi o nā diagnostics molecular i nā kikowaena like ʻole. ʻO ka hopena, ke holo nei ka ʻiʻo a i ʻole nā mea cytological a puni Polani, a ke holo nei ka manawa. ʻAʻohe manawa o ka poʻe maʻi, ʻaʻole pono lākou e kali - alarms prof. Chorostowska-Wynimko.
- I kēia manawa, he lāʻau lapaʻau hou, koho pono ʻia, hiki i ka mea maʻi me ka maʻi maʻi maʻi e lilo i maʻi maʻi a hoʻolaʻa iā ia ʻaʻole i kekahi mau mahina o ke ola, akā i kekahi mau makahiki - hoʻohui ʻo Prof. Kowalski.
- E nānā i kou pilikia o ka ulu ʻana i ka maʻi kanesa. E hoʻāʻo iā ʻoe iho! E kūʻai i kahi pūʻolo noiʻi no nā wahine a me nā kāne
Pono e ʻike piha ʻia nā maʻi āpau?
ʻAʻole pono kēlā me kēia maʻi e hoʻokō i kahi papa piha o nā hoʻokolohua molecular. Hoʻoholo ʻia e ke ʻano o ka maʻi kanesa. - I loko o ka maʻi maʻi ʻaʻole squamous, ka nui o ka adenocarcinoma, pono nā poʻe maʻi āpau i kūpono no ka mālama ʻana i ka maʻi palliative e loaʻa i kahi maʻi molecular holoʻokoʻa, no ka mea i kēia maʻi maʻi maʻi molecular disorders (EGFR mutations, ROS1 a me ALK gene rearrangements) i ʻoi aku ka nui ma mua o nā ʻano subtypes ʻē aʻe. . Ma kekahiʻaoʻao, pono e hanaʻia ka loiloiʻana o ka ligand no keʻano 1 programmed death receptor,ʻo ia hoʻi PD-L1, i nā hihia a pau o NSCLC - wahi a Prof. Kowalski.
ʻOi aku ka maikaʻi o ka Chemoimmunotherapy ma mua o ka chemotherapy wale nō
I ka hoʻomaka ʻana o 2021, ua hāʻawi ʻia nā mea maʻi me nā subtypes NSCLC āpau i ka manawa e loaʻa ai ka lāʻau immunocompetent, me ka ʻole o ka pae o ka ʻōlelo protein PD-L1. Hiki ke hoʻohana ʻia ʻo Pembrolizumab inā ʻo ka ʻōlelo PD-L1 he <50%. - i loko o ia ʻano, i hui pū ʻia me ka chemotherapy me ka hoʻohana ʻana i nā pūhui platinum a me nā pūhui cytostatic ʻekolu o nā hanauna i koho ʻia e like me ka subtype cancer.
- ʻOi aku ka maikaʻi o ia kaʻina hana ma mua o ka chemotherapy kūʻokoʻa - ʻo nā ʻokoʻa o ka lōʻihi o ke ola ʻana a hiki i 12 mau mahina no ka chemoimmunotherapy - wahi a prof. Kowalski. ʻO ia ke ʻano o ka poʻe maʻi i mālama ʻia me ka hui pū ʻana e ola ma kahi awelika o 22 mahina, a ʻo nā poʻe maʻi e loaʻa i ka chemotherapy wale nō ma mua o 10 mau mahina. Aia kekahi poʻe maʻi, mahalo i ka chemoimmunotherapy, e ola i kekahi mau makahiki mai kona hoʻohana ʻana.
Loaʻa ia lāʻau lapaʻau i ka lālani mua o ka mālama ʻana inā ʻaʻole hiki ke hoʻohana ʻia ke ʻoki a me ka chemoradiotherapy i nā poʻe maʻi me ka maʻi holomua, ʻo ia hoʻi nā metastases mamao. Ua waiho ʻia nā kūlana kikoʻī ma ka Polokalamu Lapaʻau o ke Kuhina Ola no ka mālama ʻana i ka maʻi maʻi maʻi maʻi (program B.6). Wahi a nā kuhi, 25-35 pakeneka he mau moho no ka chemoimmunotherapy. nā maʻi me ka pae IV NSCLC.
Mahalo i ka hoʻohui ʻana o kahi lāʻau immunocompetent i ka chemotherapy, ʻoi aku ka maikaʻi o ka poʻe maʻi i ka mālama anticancer ma mua o ka poʻe e loaʻa ana i ka chemotherapy wale nō. ʻO ka mea nui, ma hope o ka pau ʻana o ka chemotherapy, hoʻohana ʻia ka immunotherapy ma ke ʻano he hoʻomau o ka hui pū ʻana ma kahi maʻi maʻi. ʻO ia hoʻi, ʻaʻole pono ka mea maʻi e hoʻopaʻa ʻia i ka haukapila i kēlā me kēia manawa i loaʻa iā lākou. Hoʻomaikaʻi maoli ia i kona maikaʻi o ke ola.
Ua hana ʻia ka ʻatikala ma ke ʻano o ka hoʻolaha "Longer Life with Cancer", i hoʻokō ʻia e ka portal www.pacjentilekarz.pl.
E hoihoi paha kēia iā ʻoe:
- He mea make e like me ka asbestos. Pehea ka nui o kāu e ʻai ai i ʻole e hōʻeha iā ʻoe iho?
- Ke ulu nei nā hihia maʻi kanesa. Ke ulu nei ka nui o ka poe i make ma Polani
- ʻO ia ʻano hōʻailona he haʻalulu. He aha kaʻu e ʻike ai e pili ana i ka maʻi kanesa?
ʻO ka ʻike o ka pūnaewele medTvoiLokony i manaʻo ʻia e hoʻomaikaʻi, ʻaʻole e hoʻololi i ka pilina ma waena o ka mea hoʻohana pūnaewele a me kā lākou kauka. Hoʻolālā ʻia ka pūnaewele no ka ʻike a me ka hoʻonaʻauao wale nō. Ma mua o ka hahai ʻana i ka ʻike loea, i ka ʻōlelo aʻoaʻo olakino, aia ma kā mākou Pūnaewele, pono ʻoe e nīnau i ke kauka. ʻAʻole lawe ka Luna Hoʻokele i nā hopena ma muli o ka hoʻohana ʻana i ka ʻike i loaʻa ma ka Pūnaewele. Pono ʻoe i kahi kūkākūkā lāʻau a i ʻole kahi leka uila? E hele i ka halodoctor.pl, kahi e loaʻa ai iā ʻoe ke kōkua pūnaewele - wikiwiki, palekana a haʻalele ʻole i kou home.