Kāohi ʻana i ka maʻi ʻaʻai umauma

ʻIke Laulā e pili ana i ke Kanesa Umauma

He maʻi ka maʻi ʻaʻai umauma kahi e hoʻokumu ʻia ai nā hunaola ʻino (maʻi ʻaʻai) i loko o nā ʻiʻo o ka umauma.

Hana ʻia ka umauma i nā lobes a me nā ducts. Loaʻa i kēlā me kēia umauma he 15 a 20 mau ʻāpana i kapa ʻia he lobes, nona nā ʻāpana liʻiliʻi he nui i kapa ʻia he lobules. Hoʻopau nā lobules i nā ʻumi o nā ʻōpuʻu liʻiliʻi e hiki ke hana i ka waiū. Hoʻopili ʻia nā lobes, lobules, a me nā ʻōpuʻu e nā ʻōmole lahilahi i kapa ʻia he ducts.

Loaʻa i kēlā me kēia umauma nā kīʻaha koko a me nā kīʻaha lymph. Lawe nā kīʻaha lymph i kahi wai wai ʻaneʻane ʻole i kapa ʻia ʻo lymph. Lawe nā kīʻaha lymph i ka lymph ma waena o nā lymph nodes. He mau ʻano liʻiliʻi nā lymph nodes, e like me ka pīni, e kānana ana i ka lymph a mālama i nā hunaola koko keʻokeʻo e kōkua ana i ke kaua ʻana i ka maʻi a me nā maʻi. Loaʻa nā hui o nā lymph nodes kokoke i ka umauma ma ka axilla (ma lalo o ka lima), ma luna o ka iwi ʻāʻī, a ma ka umauma.

ʻO ke kanesa o ka umauma ka lua o ke ʻano maʻamau o ke kanesa i nā wahine ʻAmelika.

ʻOi aku ka nui o ka loaʻa ʻana o ka maʻi ʻaʻai umauma i nā wāhine ma ʻAmelika Hui Pū ʻIa ma mua o nā ʻano maʻi ʻē aʻe koe wale nō ka maʻi ʻaʻai ʻili. ʻO ka lua o ka maʻi ʻaʻai umauma ma hope o ke kanesa māmā ma ke ʻano he kumu make no nā wāhine ʻAmelika. Eia nō naʻe, ua emi iki ka make ʻana mai ke kanesa umauma i kēlā me kēia makahiki ma waena o 2007 a me 2016. Loaʻa pū kekahi ka maʻi ʻaʻai umauma i nā kāne, akā he kakaikahi ka nui o nā hihia hou.

Kāohi ʻana i ka maʻi ʻaʻai umauma

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

ʻO ka pale ʻana i nā mea pilikia o ka maʻi kanesa e kōkua paha i ka pale ʻana i kekahi mau maʻi kanesa. ʻO nā mea pilikia e pili ana i ka puhipaka, ka momona, a me ka lawa ʻole o ka hoʻoikaika kino. ʻO ka hoʻonui ʻana i nā mea pale e like me ka haʻalele ʻana i ka puhipaka a me ka hoʻoikaika kino e kōkua pū i ka pale ʻana i kekahi mau maʻi kanesa. E kamaʻilio me kāu kauka a i ʻole kekahi loea mālama ola e pili ana i ke ʻano e hoʻemi ai i kou pilikia o ka maʻi kanesa.

Eia nā kumu pilikia no ka maʻi ʻaʻai umauma:

1. Ka ʻelemakule

ʻO ka ʻelemakule ke kumu nui o ka pilikia no ka hapa nui o nā maʻi kanesa. Piʻi ka manawa e loaʻa ai ka maʻi kanesa i kou wā ʻelemakule.

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

ʻO nā wāhine me kekahi o kēia mau mea, ua piʻi aʻe ka pilikia o ka maʻi ʻaʻai umauma:

• He moʻolelo pilikino o ke kanesa 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. Ka pilikia hoʻoilina o ka maʻi ʻaʻai umauma

ʻO nā wāhine me ka moʻolelo ʻohana o ka maʻi ʻaʻai umauma ma kahi hoahānau mua (makuahine, kaikuahine, a kaikamahine paha) he piʻi aʻe ka pilikia o ka maʻi ʻaʻai umauma.

ʻO nā wāhine i hoʻoilina i nā loli i loko o nā genes a me a i ʻole kekahi mau genes ʻē aʻe, ʻoi aku ka nui o ka pilikia o ka maʻi ʻaʻai umauma. ʻO ka pilikia o ka maʻi ʻaʻai umauma i hoʻokumu ʻia e nā loli gene hoʻoilina e pili ana i ke ʻano o ka hoʻololi ʻana o ka gene, ka mōʻaukala ʻohana o ka maʻi ʻaʻai, a me nā kumu ʻē aʻe.

4. Nā umauma mānoanoa

ʻO ka loaʻa ʻana o nā ʻiʻo umauma paʻa ma ka mammogram kekahi kumu i ka pilikia o ka maʻi kanesa umauma. Aia ka pae o ka pilikia i ka paʻa o nā ʻiʻo umauma. ʻOi aku ka nui o ka pilikia o nā wāhine me nā umauma paʻa loa i ka maʻi kanesa umauma ma mua o nā wāhine me ka paʻa haʻahaʻa o ka umauma.

ʻO ka hoʻonui ʻia ʻana o ka nui o ka umauma he ʻano hoʻoilina ia, akā hiki ke hana ʻia i nā wahine i loaʻa ʻole nā ​​​​keiki, loaʻa ka hāpai mua ʻana i ka wā ma hope o ke ola, lawe i nā hormones postmenopausal, a inu waiʻona paha.

5. Ka hōʻike ʻana o ka ʻiʻo umauma i ka estrogen i hana ʻia i loko o ke kino

He hormone i hana ʻia e ke kino ka Estrogen. Kōkua ia i ke kino e hoʻomohala a mālama i nā ʻano wahine. ʻO ka hōʻike ʻia ʻana i ka estrogen no ka manawa lōʻihi e hoʻonui paha i ka pilikia o ka maʻi ʻaʻai umauma. ʻOi aku ka kiʻekiʻe o nā pae estrogen i nā makahiki e menstruating ai ka wahine.

Ua hoʻonui ʻia ka pilikia o ka estrogen i loko o ka wahine ma nā ʻano penei:

• ʻO ka hoʻomaka ʻana o ka menstruation: ʻO ka hoʻomaka ʻana o ka menstruation i ka makahiki 11 a i ʻole ka ʻōpiopio e hoʻonui i ka nui o nā makahiki e hōʻike ʻia ai ka estrogen i nā ʻiʻo umauma.
• Hoʻomaka i ka wā ma hope: ʻO ka nui o nā makahiki o ka wahine e menstruation ai, ʻo ka lōʻihi o ka hōʻike ʻana o kona ʻiʻo umauma i ka estrogen.
• ʻElemakule i ka hānau mua ʻana a i ʻole ka hānau ʻole ʻana: Ma muli o ka haʻahaʻa o nā pae estrogen i ka wā hāpai, ua hōʻike ʻia nā ʻiʻo umauma i ka estrogen hou aʻe i nā wahine i hāpai no ka manawa mua ma hope o 35 mau makahiki a i ʻole ʻaʻole i hāpai.

6. Ke lawe nei i ka lāʻau lapaʻau hormone no nā hōʻailona o ka menopause

Hiki ke hana ʻia nā hormones, e like me ka estrogen a me ka progesterone, i loko o ke ʻano pila i loko o kahi keʻena hoʻokolohua. 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 he hormone replacement therapy (HRT) a i ʻole hormone therapy (HT). ʻO ka hui pū ʻana o HRT/HT he estrogen i hui pū ʻia me progestin. Hoʻonui kēia ʻano HRT/HT i ka pilikia o ka maʻi ʻaʻai 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, emi ka pilikia o ka maʻi ʻaʻai umauma.

7. Ka lāʻau lapaʻau radiation i ka umauma a i ʻole ka umauma

Hoʻonui ka lāʻau lapaʻau radiation i ka umauma no ka mālama ʻana i ke kanesa i ka pilikia o ka maʻi kanesa o ka umauma, e hoʻomaka ana he 10 mau makahiki ma hope o ka mālama ʻana. Aia ka pilikia o ka maʻi kanesa o ka umauma i ka nui o ka radiation a me ka makahiki i hāʻawi ʻia ai. ʻOi aku ka nui o ka pilikia inā ua hoʻohana ʻia ka lāʻau radiation i ka wā ʻōpio, i ka wā e hoʻokumu ʻia ai nā umauma.

ʻAʻole ʻike ʻia ka hoʻōla ʻana o ka radiation e mālama i ka maʻi kanesa ma kekahi umauma e hoʻonui i ka pilikia o ka maʻi kanesa ma kekahi umauma.

No nā wāhine i hoʻoilina i nā loli i loko o nā genes BRCA1 a me BRCA2, ʻo ka ʻike ʻia ʻana i ka radiation, e like me ka mea mai nā x-ray umauma, hiki ke hoʻonui hou aku i ka pilikia o ka maʻi ʻaʻai umauma, ʻoiai hoʻi i nā wāhine i x-ray ʻia ma mua o 20 mau makahiki.

8. Ka momona nui

Hoʻonui ka momona i ka pilikia o ka maʻi ʻaʻai umauma, ʻoi aku hoʻi i nā wahine postmenopausal ka mea i hoʻohana ʻole i ka lāʻau hoʻololi hormone.

9. Ka inu ʻana i ka waiʻona

Hoʻonui ka inu ʻana i ka waiʻona i ka pilikia o ka maʻi ʻaʻai umauma. Piʻi ka pae o ka pilikia i ka piʻi ʻana o ka nui o ka waiʻona i inu ʻia.

Eia nā mea palekana no ka maʻi ʻaʻai umauma:

1. Ka emi ʻana o ka ʻike ʻana o ka ʻiʻo umauma i ka estrogen i hana ʻia e ke kino

ʻO ka hōʻemi ʻana i ka lōʻihi o ka manawa e hōʻike ʻia ai ka estrogen i loko o ka umauma o ka wahine e kōkua paha i ka pale ʻana i ka maʻi ʻaʻai umauma. Hoʻemi ʻia ka hōʻike ʻana i ka estrogen ma nā ʻano penei:

• Hāpai mua: ʻOi aku ka haʻahaʻa o nā pae estrogen i ka wā hāpai. ʻO nā wahine i hāpai piha ma mua o 20 mau makahiki he haʻahaʻa ko lākou pilikia o ka maʻi ʻaʻai umauma ma mua o nā wahine i loaʻa ʻole nā ​​​​keiki a i ʻole ka poʻe i hānau i kā lākou keiki mua ma hope o 35 mau makahiki.
• Ka hānai waiū: Hiki ke noho haʻahaʻa nā pae estrogen i ka wā e hānai waiū ana ka wahine. ʻOi aku ka haʻahaʻa o ka pilikia o nā wahine i hānai waiū i ka maʻi ʻaʻai umauma ma mua o nā wahine i hānau keiki akā ʻaʻole i hānai waiū.

2. Ke lawe nei i ka lāʻau lapaʻau hormone estrogen-wale nō ma hope o ka hysterectomy, nā modulators receptor estrogen koho, a i ʻole nā ​​​​​​mea hoʻopaʻa aromatase a me nā mea hoʻopau

ʻO ka lāʻau lapaʻau hormone Estrogen wale nō ma hope o ka hysterectomy

Hiki ke hāʻawi ʻia ka lāʻau lapaʻau hormone me ka estrogen wale nō i nā wahine i loaʻa i ka hysterectomy. I loko o kēia mau wahine, hiki i ka lāʻau lapaʻau estrogen wale nō ma hope o ka menopause ke hōʻemi i ka pilikia o ka maʻi ʻaʻai umauma. Aia kahi piʻi aʻe o ka pilikia o ka hahau ʻana a me ka maʻi puʻuwai a me nā kīʻaha koko i nā wahine postmenopausal e lawe ana i ka estrogen ma hope o ka hysterectomy.

Nā modulators receptor estrogen koho

No ka ʻohana o nā lāʻau lapaʻau i kapa ʻia ʻo Tamoxifen lāua ʻo raloxifene i kapa ʻia ʻo selective estrogen receptor modulators (SERMs). Hana nā SERM e like me ka estrogen ma kekahi mau ʻiʻo o ke kino, akā pale i ka hopena o ka estrogen ma nā ʻiʻo ʻē aʻe.

Hoʻemi ka mālama ʻana me ka tamoxifen i ka pilikia o ka maʻi ʻaʻai umauma estrogen receptor-positive (ER-positive) a me ka ductal carcinoma in situ i nā wahine premenopausal a me postmenopausal me ka pilikia kiʻekiʻe. Hoʻemi pū ka mālama ʻana me ka raloxifene i ka pilikia o ka maʻi ʻaʻai umauma i nā wahine postmenopausal. Me kekahi o nā lāʻau lapaʻau, mau ka pilikia i hoʻemi ʻia no kekahi mau makahiki a ʻoi aku paha ma hope o ka hoʻōki ʻana o ka mālama ʻana. Ua ʻike ʻia nā helu haʻahaʻa o nā iwi haʻihaʻi i nā poʻe maʻi e lawe ana i ka raloxifene.

ʻO ka lawe ʻana i ka tamoxifen e hoʻonui i ka pilikia o nā ʻā wela, ka maʻi ʻaʻai endometrial, ka hahau ʻana, nā cataracts, a me nā ʻūpā koko (ʻoi aku hoʻi i nā māmā a me nā wāwae). Hoʻonui nui ʻia ka pilikia o ka loaʻa ʻana o kēia mau pilikia i nā wahine ma mua o 50 mau makahiki i hoʻohālikelike ʻia me nā wahine ʻōpio. ʻO nā wahine ma lalo o 50 mau makahiki i loaʻa ka pilikia nui o ka maʻi ʻaʻai umauma e pōmaikaʻi nui mai ka lawe ʻana i ka tamoxifen. Hoʻemi ʻia ka pilikia o ka loaʻa ʻana o kēia mau pilikia ma hope o ka hoʻōki 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 nā ʻūpā koko i loko o nā māmā a me nā wāwae, akā ʻaʻole ia e hoʻonui i ka pilikia o ka maʻi ʻaʻai endometrial. I nā wahine postmenopausal me ka osteoporosis (ka emi ʻana o ka nui o ka iwi), hoʻohaʻahaʻa ka raloxifene i ka pilikia o ka maʻi ʻaʻai umauma no nā wahine i loaʻa ka pilikia kiʻekiʻe a haʻahaʻa paha o ka maʻi ʻaʻai umauma. ʻAʻole maopopo inā e loaʻa ka hopena like o ka raloxifene i nā wahine ʻaʻohe 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.

Nā mea hoʻopaʻa aromatase a me nā mea hoʻopau

Hoʻemi nā mea hoʻopaʻa aromatase (anastrozole, letrozole) a me nā mea hoʻopau (exemestane) i ka pilikia o ka hoʻi hou ʻana a me nā maʻi ʻaʻai umauma hou i nā wahine i loaʻa ka mōʻaukala o ka maʻi ʻaʻai umauma. Hoʻemi pū nā mea hoʻopaʻa aromatase i ka pilikia o ka maʻi ʻaʻai umauma i nā wahine me nā kūlana penei:

• Nā wahine postmenopausal me ka moʻolelo pilikino o ka maʻi ʻaʻai umauma.
• ʻO nā wahine me ka ʻole o ka moʻolelo pilikino o ka maʻi ʻaʻai umauma a he 60 mau makahiki a ʻoi, he moʻolelo o ka ductal carcinoma in situ me ka mastectomy, a i ʻole he kiʻekiʻe ka pilikia o ka maʻi ʻaʻai umauma e pili ana i ka mea hana hoʻohālike Gail (kahi mea hana i hoʻohana ʻia e kuhi i ka pilikia o ka maʻi ʻaʻai umauma).

I nā wahine me ka piʻi ʻana o ka pilikia o ka maʻi ʻaʻai umauma, ʻo ka lawe ʻana i nā mea hoʻopaʻa aromatase e hōʻemi 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 ʻiʻo momona, a me ka ʻili. Ma hope o ka menopause, oki nā ovaries i ka hana ʻana i ka estrogen, akā ʻaʻole nā ​​ʻiʻo ʻē aʻe. Hoʻopaʻa nā mea hoʻopaʻa aromatase i ka hana a kahi enzyme i kapa ʻia ʻo aromatase, kahi i hoʻohana ʻia e hana i nā estrogen āpau o ke kino. Hoʻōki nā mea hoʻopau aromatase i ka hana ʻana o ka enzyme.

ʻO nā pōʻino e hiki mai ana mai ka lawe ʻana i nā mea hoʻopaʻa aromatase e komo pū me ka ʻeha o nā ʻiʻo a me nā hono, ka osteoporosis, nā ʻā ʻana o ka wela, a me ka luhi loa.

3. Ka hoʻemi ʻana i ka pilikia o ka mastectomy

Hiki i kekahi mau wahine i loaʻa ka pilikia kiʻekiʻe o ka maʻi ʻaʻai umauma ke koho e hana i kahi mastectomy e hōʻemi ana i ka pilikia (ka wehe ʻana i nā umauma ʻelua ke ʻole nā ​​​​hōʻailona o ka maʻi ʻaʻai). ʻOi aku ka haʻahaʻa o ka pilikia o ka maʻi ʻaʻai umauma i kēia mau wahine a ʻoi aku ka nui o ka poʻe e hopohopo nei e pili ana i ko lākou pilikia o ka maʻi ʻaʻai umauma. Eia nō naʻe, he mea nui loa ka loaʻa ʻana o kahi loiloi pilikia o ka maʻi ʻaʻai a me ke aʻo ʻana e pili ana i nā ʻano like ʻole e pale aku ai i ka maʻi ʻaʻai umauma ma mua o ka hana ʻana i kēia hoʻoholo.

4. Hoʻopau ʻana o ka ʻōpū

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 e komo pū me ke ʻoki ʻana e wehe i nā ovaries, ka radiation therapy, a i ʻole ka lawe ʻana i kekahi mau lāʻau. Ua kapa ʻia kēia he ovarian ablation.

ʻO nā wahine premenopausal i loaʻa ka pilikia kiʻekiʻe o ka maʻi ʻaʻai umauma ma muli o kekahi mau loli i nā genes BRCA1 a me BRCA2 e koho paha e loaʻa i ka oophorectomy hoʻēmi pilikia (ka wehe ʻana o nā ovaries ʻelua ke ʻole nā ​​​​hōʻailona o ka maʻi ʻaʻai). Hoʻemi kēia i ka nui o ka estrogen i hana ʻia e ke kino a hoʻohaʻahaʻa i ka pilikia o ka maʻi ʻaʻai umauma. Hoʻohaʻahaʻa pū ka oophorectomy hoʻēmi pilikia i ka pilikia o ka maʻi ʻaʻai umauma i nā wahine premenopausal maʻamau a i nā wahine me ka piʻi ʻana o ka pilikia o ka maʻi ʻaʻai umauma ma muli o ka radiation i ka umauma. Eia nō naʻe, he mea nui loa ka loaʻa ʻana o kahi loiloi pilikia o ka maʻi ʻaʻai a me ke aʻo ʻana ma mua o ka hana ʻana i kēia hoʻoholo. ʻO ka hāʻule koke ʻana o nā pae estrogen e hoʻomaka ai nā hōʻailona o ka menopause. ʻO kēia mau mea e komo pū me nā ʻā wela, ka pilikia hiamoe, ka hopohopo, a me ke kaumaha. ʻO nā hopena lōʻihi e komo pū me ka emi ʻana o ka makemake moe kolohe, ka maloʻo o ka vagina, a me ka emi ʻana o ka nui o ka iwi.

5. Ka lawa ʻana o ka hoʻoikaika kino

ʻO nā wāhine e hoʻoikaika kino ana i ʻehā a ʻoi aku paha mau hola i ka pule, he haʻahaʻa ko lākou pilikia i ka maʻi ʻaʻai umauma. ʻO ka hopena o ka hoʻoikaika kino ma ka pilikia o ka maʻi ʻaʻai umauma paha ka mea nui loa i nā wāhine premenopausal nona ke kaumaha kino maʻamau a haʻahaʻa paha.

ʻAʻole maopopo inā pili kēia i ka pilikia o ka maʻi ʻaʻai umauma:

1. Nā mea pale hormonal

Loaʻa i nā mea pale hānau hormonal ka estrogen a i ʻole ka estrogen a me ka progestin. Ua hōʻike kekahi mau noiʻi e loaʻa i nā wahine e hoʻohana nei a i ʻole nā ​​mea hoʻohana hou nei i nā mea pale hānau hormonal kahi piʻi iki o ka pilikia o ka maʻi ʻaʻai umauma. ʻAʻole i hōʻike ʻia e nā noiʻi ʻē aʻe kahi piʻi nui o ka pilikia o ka maʻi ʻaʻai umauma i nā wahine e hoʻohana ana i nā mea pale hānau hormonal.

Ma kekahi noiʻi, ua piʻi iki ka pilikia o ka maʻi ʻaʻai umauma i ka lōʻihi o ka hoʻohana ʻana o ka wahine i nā mea pale hānau hormonal. Ua hōʻike kekahi noiʻi ua emi iki ka piʻi ʻana o ka pilikia o ka maʻi ʻaʻai umauma i ka hala ʻana o ka manawa i ka wā i hoʻōki ai nā wahine i ka hoʻohana ʻana i nā mea pale hānau hormonal.

Pono nā haʻawina hou aku e ʻike ai inā pili nā hana pale ʻana i ka hormonal i ka pilikia o ka wahine i ka maʻi ʻaʻai umauma.

2. Kaiapuni

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

Ua hōʻike ʻia nā noiʻi he liʻiliʻi a ʻaʻohe hopena paha kekahi mau kumu i ka pilikia o ka maʻi ʻaʻai umauma.

ʻAʻohe hopena a liʻiliʻi paha kēia i ka pilikia o ka maʻi ʻaʻai umauma:

• Ka hoʻopau ʻana i ka hāpai keiki.
• Ke hoʻololi nei i ka ʻai ʻana e like me ka ʻai ʻana i ka momona a i ʻole ka ʻai ʻana i nā huaʻai a me nā mea kanu hou aʻe.
• ʻO ka lawe ʻana i nā huaora, me ka fenretinide (kahi ʻano huaora A).
• ʻO ka puhipaka cigarette, ʻo ia hoʻi ka hana a me ka hana ʻole (ka hanu ʻana i ka uahi lua).
• Ka hoʻohana ʻana i ka deodorant a i ʻole ka antiperspirant ma lalo o ka lima.
• Ke lawe nei i nā statins (nā lāʻau hoʻohaʻahaʻa cholesterol).
• ʻO ka lawe ʻana i nā bisphosphonates (nā lāʻau lapaʻau i hoʻohana ʻia e mālama ai i ka osteoporosis a me ka hypercalcemia) ma ka waha a i ʻole ma ka hoʻokomo ʻana i loko o ka intravenous.
• Nā loli i kou circadian rhythm (nā loli kino, noʻonoʻo, a me ke ʻano i hoʻopilikia nui ʻia e ka pouli a me ka mālamalama i nā pōʻaiapuni 24 hola), hiki ke hoʻopilikia ʻia e ka hana ʻana i nā hoʻololi pō a i ʻole ka nui o ke kukui i loko o kou lumi moe i ka pō.

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