Kāohi i ka maʻi maʻi umauma

ʻIke Nui e pili ana i ka maʻi maʻi umauma

'O ka ma'i 'a'ai 'o ia ka ma'i i ho'okumu 'ia ai nā pūnaewele 'ino (cancer) i loko o nā kino o ka umauma.

Hana ʻia ka umauma i nā lobes a me nā ʻauamo.He 15 a 20 mau ʻāpana i kapa ʻia nā lobes i kēlā me kēia umauma, a he nui nā ʻāpana liʻiliʻi i kapa ʻia he lobules.Hoʻopau nā lobules i nā ʻumi o nā puʻupuʻu liʻiliʻi hiki ke hana i ka waiū.Hoʻopili ʻia nā lobes, lobules, a me nā puʻupuʻu e nā paipu lahilahi i kapa ʻia ʻo ducts.

Loaʻa i kēlā me kēia umauma nā kīʻaha koko a me nā kīʻaha lymph.Lawe nā moku lymph i kahi wai ʻaʻohe kala ʻole, wai wai i kapa ʻia ʻo lymph.Lawe nā moku Lymph i ka lymph ma waena o nā pūnana lymph.He ʻano liʻiliʻi nā ʻōpū Lymph e kānana i ka lymph a mālama i nā keʻokeʻo keʻokeʻo e kōkua i ke kaua ʻana i ka maʻi a me ka maʻi.Loaʻa nā pūʻulu lymph ma kahi kokoke i ka umauma ma ke axilla (ma lalo o ka lima), ma luna o ka ʻāʻī, a ma ka umauma.

ʻO ka maʻi kanesa ka lua o ka maʻi kanesa maʻamau i nā wahine ʻAmelika.

Loaʻa i nā wāhine ma ʻAmelika Hui Pū ʻIa ka maʻi kanesa o ka umauma ma mua o nā ʻano maʻi kanesa ʻē aʻe koe wale nō ka maʻi kanesa ʻili.ʻO ka maʻi kanesa o ka umauma ka lua ma mua o ka maʻi kanesa ma ke ʻano he kumu o ka make ʻana o ka maʻi kanesa i nā wahine ʻAmelika.Eia nō naʻe, ua emi iki ka make ʻana o ka maʻi kanesa o ka umauma i kēlā me kēia makahiki ma waena o 2007 a me 2016. ʻO ka maʻi maʻi umauma pū kekahi i nā kāne, akā liʻiliʻi ka nui o nā hihia hou.

Kāohi i ka maʻi maʻi umauma

ʻO ka pale ʻana i nā mea pilikia a me ka hoʻonui ʻana i nā mea pale e kōkua i ka pale ʻana i ka maʻi kanesa.

ʻO ka pale ʻana i nā mea pili i ka maʻi kanesa hiki ke kōkua i ka pale ʻana i kekahi mau maʻi kanesa.ʻO nā kumu pilikia e pili ana i ka puhi paka, ke kaumaha, a ʻaʻole lawa ka hoʻoikaika kino.ʻO ka hoʻonui ʻana i nā mea pale e like me ka haʻalele ʻana i ka puhi paka a me ka hoʻoikaika kino hiki ke kōkua i ka pale ʻana i kekahi mau maʻi kanesa.E kamaʻilio me kāu kauka a i ʻole kekahi mea mālama ola kino e pili ana i ke ʻano o ka hoʻohaʻahaʻa ʻana i kou pilikia o ka maʻi kanesa.

ʻO kēia nā kumu pilikia no ka maʻi kanesa o ka umauma:

1. Ka makahiki kahiko

ʻO ka ʻelemakule ke kumu nui o ka maʻi kanesa.Piʻi ka loaʻa ʻana o ka maʻi kanesa i kou wā ʻelemakule.

2. He moʻolelo pilikino o ka maʻi kanesa o ka umauma a i ʻole ka maʻi umauma maʻi (noncancer).

Ua piʻi aʻe ka pilikia o ka maʻi maʻi umauma i nā wahine me kekahi o kēia mau mea:

• He moʻolelo pilikino o ka maʻi maʻi umauma invasive, ductal carcinoma in situ (DCIS), a i ʻole lobular carcinoma in situ (LCIS).
• He moʻolelo pilikino o ka maʻi umauma benign (noncancer).

3. Ua hoʻoili ʻia ka maʻi kanesa o ka umauma

ʻO nā wāhine me ka mōʻaukala ʻohana o ka maʻi kanesa o ka umauma i loko o kahi pili degere mua (makuahine, kaikuahine, a kaikamahine paha) ua piʻi aʻe ka pilikia o ka maʻi maʻi umauma.

ʻO nā wāhine i hoʻoili i nā loli i nā genes a i ʻole kekahi mau genes ʻē aʻe, ʻoi aku ka nui o ka pilikia o ka maʻi maʻi umauma.ʻO ka pilikia o ka maʻi kanesa o ka umauma i hoʻololi ʻia ma muli o ke ʻano o ka mutation gene, ka mōʻaukala ʻohana o ka maʻi kanesa, a me nā mea ʻē aʻe.

4. ʻO nā umauma nui

ʻO ka loaʻa ʻana o ka ʻiʻo o ka umauma paʻa i ka mammogram he kumu ia o ka maʻi kanesa o ka umauma.ʻO ke kiʻekiʻe o ka pilikia e pili ana i ka paʻa o ka ʻiʻo o ka umauma.ʻOi aku ka nui o ka loaʻa ʻana o ka maʻi maʻi umauma ma mua o nā wahine me ka umauma haʻahaʻa.

ʻO ka hoʻonui ʻana i ka nui o ka umauma he ʻano hoʻoilina, akā hiki nō paha ia i nā wahine i hānau keiki ʻole, loaʻa ka hānau mua ma hope o ke ola, lawe i nā hormones postmenopausal, a inu wai ʻona paha.

5. ʻO ka wehe ʻana o ka ʻiʻo o ka umauma i ka estrogen i hana ʻia i loko o ke kino

ʻO Estrogen kahi hormone i hana ʻia e ke kino.Kōkua ia i ke kino e hoʻomohala a mālama i nā hiʻohiʻona wahine.ʻO ka loaʻa ʻana o ka estrogen i ka manawa lōʻihi e hoʻonui i ka pilikia o ka maʻi maʻi umauma.ʻOi aku ka kiʻekiʻe o ka estrogen i nā makahiki o ka wahine.

Hoʻonui ʻia ka ʻike ʻana o ka wahine i ka estrogen ma kēia mau ʻano:

• ʻO ka hoʻomaka ʻana o ka menstrual i ka makahiki 11 a ʻoi aʻe paha e hoʻonui i ka helu o nā makahiki i ʻike ʻia ka ʻiʻo o ka umauma i ka estrogen.
• E hoʻomaka ana ma hope o ka makahiki: ʻO ka nui o nā makahiki o ka wahine menstruates, ʻoi aku ka lōʻihi o ka ʻike ʻana o kona umauma i ka estrogen.
• ʻO ka ʻelemakule ma ka hānau mua ʻana a ʻaʻole i hānau ʻia: No ka emi ʻana o ka pae o ka estrogen i ka wā hāpai, ʻike ʻia ka ʻiʻo o ka umauma i ka estrogen i loko o nā wahine i hāpai ʻia no ka manawa mua ma hope o ka makahiki 35 a ʻaʻole i hāpai.

6. Lawe i ka hormone therapy no nā hōʻailona o ka menopause

Hiki ke hana ʻia nā hormones, e like me ka estrogen a me ka progesterone, i ʻano pila i loko o ke keʻena hana.Hiki ke hāʻawi ʻia ka estrogen, progestin, a i ʻole nā ​​​​mea ʻelua e pani i ka estrogen i hana ʻole ʻia e nā ovaries i nā wahine postmenopausal a i ʻole nā ​​​​wahine i wehe ʻia kā lākou ovaries.Ua kapa ʻia kēia ʻano lāʻau hoʻololi homoni (HRT) a i ʻole hormone therapy (HT).ʻO ka hui HRT/HT he estrogen i hui pū ʻia me ka progestin.Hoʻonui kēia ʻano HRT/HT i ka maʻi kanesa o ka umauma.Hōʻike nā haʻawina i ka wā e hoʻōki ai nā wahine i ka lawe ʻana i ka estrogen i hui pū ʻia me ka progestin, e emi ana ka pilikia o ka maʻi kanesa o ka umauma.

7. ʻO ka lāʻau lapaʻau i ka umauma a i ʻole ka umauma

ʻO ka lāʻau lapaʻau i ka umauma no ka mālama ʻana i ka maʻi kanesa e hoʻonui i ka pilikia o ka maʻi maʻi umauma, e hoʻomaka ana i 10 mau makahiki ma hope o ka mālama ʻana.ʻO ka pilikia o ka maʻi kanesa o ka umauma e pili ana i ka nui o ka radiation a me ka makahiki i hāʻawi ʻia.ʻOi aku ka kiʻekiʻe o ka pilikia inā hoʻohana ʻia ka lāʻau lapaʻau i ka wā ʻōpio, i ka wā e ulu ana nā umauma.

ʻAʻole ʻike ʻia ka lāʻau lapaʻau no ka mālama ʻana i ka maʻi kanesa ma ka umauma hoʻokahi.

No nā wāhine i hoʻoili i nā loli i nā genes BRCA1 a me BRCA2, ʻo ka ʻike ʻana i ka radiation, e like me kēlā mai nā pahu x-ray, hiki ke hoʻonui i ka pilikia o ka maʻi maʻi umauma, ʻoi aku hoʻi i nā wahine i hoʻoheheʻe ʻia ma mua o 20 mau makahiki.

8. Obesity

Hoʻonui ka momona i ka maʻi kanesa o ka umauma, ʻoi aku ka nui o nā wahine postmenopausal ʻaʻole i hoʻohana i ka lāʻau lapaʻau pani pani.

9. Ka inu rama

ʻO ka inu ʻana i ka waiʻona e hoʻonui ai i ka maʻi kanesa o ka umauma.Piʻi ka pae o ka pilikia i ka piʻi ʻana o ka nui o ka waiʻona.

ʻO kēia nā mea palekana no ka maʻi kanesa o ka umauma:

1. Hoʻemi iki ʻia ka ʻiʻo o ka umauma i ka estrogen i hana ʻia e ke kino

ʻO ka hoʻemi ʻana i ka lōʻihi o ka loaʻa ʻana o ka ʻiʻo umauma o ka wahine i ka estrogen hiki ke kōkua i ka pale ʻana i ka maʻi maʻi umauma.Hoʻemi ʻia ka ʻike ʻana i ka estrogen ma kēia mau ʻano:

• Ka hāpai mua ʻana: He haʻahaʻa ka pae o ka estrogen i ka wā hāpai.He haʻahaʻa ka pilikia o ka maʻi ʻaʻai umauma o nā wahine ma mua o ka piha ʻana o ka makahiki ma mua o nā wahine i hānau keiki ʻole a hānau paha i kā lākou keiki mua ma hope o 35 makahiki.
• Ka hānai umauma: Hiki ke emi ka pae o ka estrogen i ka wā e hānai ana ka wahine.ʻOi aku ka liʻiliʻi o ka maʻi kanesa o ka umauma ma mua o nā wahine i hānau keiki akā ʻaʻole i hānai i ka umauma.

2. Ka lawe ʻana i ka hormone therapy estrogen-wale nō ma hope o ka hysterectomy, nā modulators receptor receptor estrogen koho, a i ʻole nā ​​mea hoʻopaneʻe aromatase a me nā mea hana ʻole.

Estrogen-wale ka hormone therapy ma hope o ka hysterectomy

Hiki ke hāʻawi ʻia ka hormone therapy me ka estrogen wale nō i nā wahine i loaʻa i ka hysterectomy.I loko o kēia mau wahine, hiki i ka lāʻau estrogen-wale nō ma hope o ka menopause ke hoʻemi i ka pilikia o ka maʻi maʻi umauma.Aia ka nui o ka pilikia o ka hahau a me ka puʻuwai a me ka maʻi kīʻaha koko i nā wāhine postmenopausal e lawe ana i ka estrogen ma hope o ka hysterectomy.

ʻO nā modulators receptor estrogen koho

ʻO Tamoxifen a me raloxifene ka ʻohana o nā lāʻau i kapa ʻia ʻo selective estrogen receptor modulators (SERMs).Hana nā SERM e like me ka estrogen ma kekahi mau ʻiʻo i loko o ke kino, akā pale i ka hopena o ka estrogen ma nā ʻiʻo ʻē aʻe.

ʻO ka lapaʻau ʻana me ka tamoxifen e hoʻohaʻahaʻa i ka hopena o ka maʻi maʻi umauma o ka estrogen receptor-positive (ER-positive) a me ka carcinoma ductal in situ i nā wahine premenopausal a me nā wahine postmenopausal i ka pilikia kiʻekiʻe.ʻO ka mālama ʻana me ka raloxifene e hoʻohaʻahaʻa i ka pilikia o ka maʻi maʻi umauma i nā wahine postmenopausal.Me kēlā me kēia lāʻau lapaʻau, hoʻemi ʻia ka pilikia no kekahi mau makahiki a ʻoi aku paha ma hope o ka pau ʻana o ka mālama ʻana.Ua ʻike ʻia nā haʻahaʻa haʻahaʻa o nā iwi haʻi i nā maʻi e lawe ana i ka raloxifene.

ʻO ka lawe ʻana i ka tamoxifen e hoʻonui i ka hopena o ka wela wela, ka maʻi maʻi endometrial, ka hahau ʻana, ka maʻi ʻāʻī, a me ke koko koko (ʻoi loa ma ka māmā a me nā wāwae).Piʻi nui ka pilikia o ka loaʻa ʻana o kēia mau pilikia i nā wahine ma mua o 50 mau makahiki ke hoʻohālikelike ʻia me nā wahine ʻōpio.ʻO nā wahine ʻoi aku ma mua o 50 mau makahiki i loaʻa i ka nui o ka maʻi kanesa o ka umauma e pōmaikaʻi nui i ka lawe ʻana i ka tamoxifen.Ke emi nei ka pilikia o ka loaʻa ʻana o kēia mau pilikia ma hope o ka pau ʻana o ka tamoxifen.E kamaʻilio me kāu kauka e pili ana i nā pilikia a me nā pono o ka lawe ʻana i kēia lāʻau.

ʻO ka lawe ʻana i ka raloxifene e hoʻonui i ka pilikia o ke koko koko i loko o ka māmā a me nā wāwae, akā ʻaʻole ʻike ʻia e hoʻonui i ka hopena o ka maʻi maʻi endometrial.I nā wāhine postmenopausal me ka osteoporosis (hōʻemi ka iwi iwi), hoʻohaʻahaʻa ka raloxifene i ka maʻi kanesa o ka umauma no nā wahine i loaʻa i ka maʻi kanesa umauma.ʻAʻole ʻike ʻia inā like ka hopena o ka raloxifene i nā wahine i loaʻa ʻole i ka osteoporosis.E kamaʻilio me kāu kauka e pili ana i nā pilikia a me nā pono o ka lawe ʻana i kēia lāʻau.

Ke aʻo ʻia nei nā SERM ʻē aʻe i nā hoʻokolohua lapaʻau.

Aromatase inhibitors a me inactivators

ʻO nā mea hoʻopaneʻe aromatase (anastrozole, letrozole) a me nā inactivators (exemestane) e hoʻohaʻahaʻa i ka pilikia o ka hoʻi hou ʻana a me nā maʻi maʻi umauma hou i nā wahine i loaʻa ka moʻolelo o ka maʻi maʻi umauma.Hoʻemi pū nā mea hoʻopiʻi aromatase i ka maʻi kanesa o ka umauma i nā wahine me kēia mau kūlana:

• ʻO nā wāhine postmenopausal me kahi moʻolelo pilikino o ka maʻi maʻi umauma.
• ʻO nā wāhine me ka mōʻaukala pilikino o ka maʻi kanesa o ka umauma he 60 mau makahiki a ʻoi aku, he mōʻaukala ko ka ductal carcinoma in situ me ka mastectomy, a i ʻole ka nui o ka pilikia o ka maʻi maʻi umauma ma muli o ka mea hoʻohālike Gail maʻi kanesa).

I nā wahine me ka nui o ka pilikia o ka maʻi kanesa o ka umauma, ʻo ka lawe ʻana i nā mea hoʻopaneʻe aromatase e hoʻemi i ka nui o ka estrogen i hana ʻia e ke kino.Ma mua o ka menopause, hana ʻia ka estrogen e nā ovaries a me nā ʻiʻo ʻē aʻe i loko o ke kino o ka wahine, me ka lolo, ka momona a me ka ʻili.Ma hope o ka menopause, pau nā ovaries i ka hana ʻana i ka estrogen, akā ʻaʻole nā ​​​​mea ʻē aʻe.Hoʻopaʻa ʻia ka hana ʻana o kahi enzyme i kapa ʻia ʻo aromatase, kahi i hoʻohana ʻia e hana ai i ka estrogen o ke kino.Hoʻopau nā mea hoʻolale Aromatase i ka hana ʻana o ka enzyme.

ʻO nā pōʻino mai ka lawe ʻana i nā mea hoʻopaneʻe aromatase ʻo ia ka ʻeha a me ka ʻeha hui, osteoporosis, nā wela wela, a me ka luhi loa.

3. Mastectomy hōʻemi i ka pilikia

Hiki i kekahi mau wahine ke loaʻa i ka maʻi kanesa o ka umauma ke koho e loaʻa i ka mastectomy hoʻemi pilikia (ka wehe ʻana i nā umauma ʻelua inā ʻaʻohe hōʻailona o ka maʻi kanesa).ʻOi aku ka haʻahaʻa o ka maʻi kanesa o ka umauma i kēia mau wahine a ʻaʻole hopohopo ka hapa nui i ko lākou pilikia i ka maʻi maʻi umauma.Eia nō naʻe, he mea nui ka loaʻa ʻana o ka loiloi pilikia a me ka ʻōlelo aʻo e pili ana i nā ʻano like ʻole e pale ai i ka maʻi kanesa ma mua o ka hoʻoholo ʻana.

4. ʻOvarian ablation

Hana nā ovaries i ka hapa nui o ka estrogen i hana ʻia e ke kino.ʻO nā lāʻau lapaʻau e hoʻōki a hoʻohaʻahaʻa paha i ka nui o ka estrogen i hana ʻia e nā ovaries, ʻo ia ka ʻokiʻoki e wehe i nā ovaries, radiation therapy, a i ʻole ka lawe ʻana i kekahi mau lāʻau lapaʻau.Kapa ʻia kēia ablation ovarian.

Hiki i nā wāhine premenopausal ke loaʻa i ka maʻi kanesa o ka umauma ma muli o kekahi mau hoʻololi i nā genes BRCA1 a me BRCA2 ke koho e loaʻa i kahi oophorectomy hoʻemi pilikia (ka wehe ʻana i nā ovaries ʻelua inā ʻaʻohe hōʻailona o ka maʻi kanesa).Hoʻemi kēia i ka nui o ka estrogen i hana ʻia e ke kino a hoʻohaʻahaʻa i ka pilikia o ka maʻi maʻi umauma.ʻO ka oophorectomy e hōʻemi ana i ka pilikia e hoʻohaʻahaʻa i ka pilikia o ka maʻi kanesa o ka umauma i nā wahine premenopausal maʻamau a me nā wahine me ka piʻi nui o ka maʻi kanesa ma muli o ka radiation i ka umauma.Eia nō naʻe, he mea nui ka loaʻa ʻana o ka loiloi a me ka ʻōlelo aʻo ma mua o ka hoʻoholo ʻana.ʻO ka hāʻule koke ʻana o nā pae estrogen hiki ke hoʻomaka i nā hōʻailona o ka menopause.ʻO kēia mau mea he wela wela, pilikia ka hiamoe, hopohopo, a me ke kaumaha.ʻO nā hopena lōʻihi e pili ana i ka hoʻohaʻahaʻa ʻana i ka moe kolohe, ka maloʻo o ka waha, a me ka emi ʻana o ka iwi iwi.

5. Loaʻa i ka hoʻoikaika kino

ʻO nā wāhine hoʻoikaika kino ʻehā a ʻoi aʻe paha hola o ka pule, ʻoi aku ka liʻiliʻi o ka maʻi kanesa o ka umauma.ʻOi aku paha ka hopena o ka hoʻoikaika kino i ka maʻi kanesa o ka umauma i nā wahine premenopausal i loaʻa ke kaumaha maʻamau a haʻahaʻa paha.

ʻAʻole maopopo inā pili kēia mau mea i ka pilikia o ka maʻi kanesa o ka umauma:

1. Hoʻopaʻa hoʻopaneʻe Hormonal

Loaʻa i nā mea hoʻopalekana Hormonal ka estrogen a i ʻole ka estrogen a me ka progestin.Ua hōʻike ʻia kekahi mau haʻawina e piʻi iki ana nā wahine e hoʻohana nei i kēia manawa a i ʻole nā ​​​​mea hoʻohana hou i nā lāʻau lapaʻau hormonal.ʻAʻole i hōʻike ʻia nā haʻawina ʻē aʻe i ka piʻi ʻana o ka maʻi kanesa o ka umauma i nā wahine e hoʻohana ana i nā contraceptive hormonal.

Ma hoʻokahi noiʻi, ua piʻi iki ka pilikia o ka maʻi kanesa o ka umauma i ka lōʻihi o ka hoʻohana ʻana o ka wahine i nā contraceptive hormonal.Ua hōʻike ʻia kekahi haʻawina ʻo ka piʻi iki ʻana o ka maʻi kanesa o ka umauma i ka wā i hoʻōki ai nā wahine i ka hoʻohana ʻana i nā contraceptive hormonal.

Pono nā noiʻi hou aʻe e ʻike ai inā pili nā contraceptive hormonal i ka pilikia o ka wahine i ka maʻi maʻi umauma.

2. Kaiapuni

ʻAʻole i hōʻike ʻia nā haʻawina ʻo ka ʻike ʻana i kekahi mau mea i loko o ke kaiapuni, e like me nā kemika, hoʻonui i ka pilikia o ka maʻi maʻi umauma.

Ua hōʻike nā haʻawina he liʻiliʻi a ʻaʻohe hopena o kekahi mau mea i ka hopena o ka maʻi kanesa o ka umauma.

He liʻiliʻi a ʻaʻohe hopena o kēia mau mea i ka pilikia o ka maʻi kanesa o ka umauma:

• ʻO ka hoʻopaʻa ʻana.
• Hoʻololi i ka meaʻai e like me ka ʻai ʻana i ka momona liʻiliʻi a i ʻole nā ​​​​huaʻai a me nā mea kanu.
• ʻO ka lawe ʻana i nā huaora, me ka fenretinide (kahi ʻano o ka huaora A).
• ʻO ka puhi paka, ʻoi aku ka ikaika a me ka paʻa ʻole (hoʻi ʻana i ka uahi lua).
• Ke hoʻohana nei i ka deodorant underarm a i ʻole antiperspirant.
• Ka lawe ʻana i nā statins (nā lāʻau hoʻohaʻahaʻa i ka cholesterol).
• ʻO ka lawe ʻana i nā bisphosphonates (nā lāʻau lapaʻau i hoʻohana ʻia no ka mālama ʻana i ka osteoporosis a me ka hypercalcemia) ma ka waha a i ʻole ka infusion intravenous.
• ʻO nā hoʻololi i kāu puʻupuʻu circadian (nā hoʻololi kino, noʻonoʻo, a me nā ʻano hana i hoʻopilikia nui ʻia e ka pōʻeleʻele a me ka mālamalama i nā hola 24), hiki ke hoʻopilikia ʻia e ka hana ʻana i ka pō a i ʻole ka nui o ka mālamalama i loko o kou lumi moe i ka pō.

Puna:http://www.chinancpcn.org.cn/cancerMedicineClassic/guideDetail?sId=CDR257994&type=1