Types/skin/patient/merkel-cell-treatment-pdq

Mālama ʻo Merkel Cell Carcinoma

ʻO ka ʻike pili e pili ana iā Merkel Cell Carcinoma

NA MANA KUNI

• ʻO ka Mercin cell carcinoma kahi maʻi liʻiliʻi loa kahi e loaʻa ai nā cell malignant (cancer) i ka ʻili.

• Hiki i ka lā a me ka loaʻa ʻana o kahi ʻōnaehana pale nawaliwali ke hoʻopili i ka makaʻu o ka cell cancer cancer.

• ʻIke pinepine ʻia ka cell cell cancer ʻo Merkel ma ke ʻano he puʻuwai ʻeha ʻole ma ka ʻili i hōʻike ʻia i ka lā.

• Hoʻohana ʻia nā hoʻokolohua a me nā kaʻina hana e nānā i ka ʻili e ʻike (loaʻa) a ʻike ʻia ka maʻi kanakea Merkel cell.

• Kū kekahi mau kumu i ka wānana (kahi o ke ola ʻana) a me nā koho lapaʻau.

ʻO ka Mercin cell carcinoma kahi maʻi liʻiliʻi loa kahi e loaʻa ai nā cell malignant (cancer) i ka ʻili.

Loaʻa nā pūnaewele Merkel i ka papa luna o ka ʻili. Pili loa kēia mau pūnaewele i nā hopena aʻa e loaʻa ai ke ʻano o ka hoʻopā. ʻO ka cell cancer cancer, i kapa ʻia he neuroendocrine carcinoma o ka ʻili a i ʻole ka maʻi ʻaʻai trabecular, kahi ʻano lahilahi loa o ka maʻi ʻaʻai ʻili i hana ke ulu aʻe nā cell Merkel mai kahi kāohi. Hoʻomaka pinepine ka maʻi make cell Merkel i nā wahi o ka ʻili i hōʻike ʻia i ka lā, keu hoʻi ke poʻo a me ka ʻāʻī, a me nā lima, nā wāwae, a me ke kumu.

ʻO Anatomy o ka ʻili e hōʻike ana i ka epidermis, dermis, a me nāʻiʻo subcutaneus. Aia nā pūnaewele Merkel i ka papa o nā hunaola basal ma ka hohonu o ka epidermis a pili i nā ʻalolo.

ʻO ka make koke ʻana o ka cell cell cancer ʻo Merkel a metastasize (pālahalaha ʻia) i ka wā mua. Hoʻolahalaha pinepine ia i nā lymph node kokoke a laila e pāhola paha i nā lymph node a i ʻole ka ʻili i nā wahi mamao o ke kino, nā mumū, ka lolo, nā iwi, a me nā meaola ʻē aʻe.

ʻO ka cell cancer cancer ʻo Merkel ka lua o ke kumu o ka make ʻana o ka maʻi ʻaʻai ʻili ma hope o melanoma.

Hiki i ka lā a me ka loaʻa ʻana o kahi ʻōnaehana pale nawaliwali ke hoʻopili i ka makaʻu o ka cell cancer cancer.

ʻO nā mea āpau e hoʻonui i kou makaʻu i ka loaʻa ʻana i kahi maʻi i kapa ʻia he kumu weliweli. ʻO ka loaʻa ʻana o kahi mea pilikia ʻaʻole ia he kumu e loaʻa ʻoe i ka maʻi ʻaʻai. ʻaʻohe o nā kumu pilikia ʻaʻole ia he kumu ʻaʻole ʻoe e loaʻa i ka maʻi ʻaʻai. E kamaʻilio me kāu kauka inā manaʻo ʻoe ua makaʻu paha ʻoe. Nā kumuhana kūpilikiʻi no ka make cell cell cancer ʻo Merkel:

• Hōʻike ʻia i ka nui o ka lā kūlohelohe.

• Ke hōʻike ʻia nei i ka lā o ka lā i hana ʻia, e like me ka moe tanning a psoralen a me ultraviolet A (PUVA) therapy no psoriasis.

• Ua nāwaliwali ka ʻōnaehana pale e ka maʻi, e like me ka leukemia lymphocytic mau a i ʻole ka maʻi HIV.

• Lawe i nā lāʻau e hōʻemi iki i ka ʻōnaehana pale, e like me ma hope o kahi hoʻoliʻiliʻi o nā meaola.

• Loaʻa ka moʻaukala o nā ʻano maʻi ʻaʻai ʻē aʻe.

• ʻOi aku ma mua o 50 mau makahiki, kāne, a keʻokeʻo.

ʻIke pinepine ʻia ka cell cell cancer ʻo Merkel ma ke ʻano he puʻuwai ʻeha ʻole ma ka ʻili i hōʻike ʻia i ka lā.

ʻO kēia a me nā hoʻololi ʻē aʻe i ka ʻili e hoʻokumu ʻia e Merkel cell carcinoma a i ʻole nā ​​ʻano ʻē aʻe. E hōʻoia me kāu kauka inā ʻike ʻoe i nā loli i kou ʻili.

ʻIke pinepine ʻia ka cell cancer ʻo Merkel ma ka ʻili i hōʻike ʻia e ka lā me he puʻupuʻu hoʻokahi lā:

• Ulu-ulu.

• Painless.

• Paʻa a kūlike hoʻi i luna.

• ʻUlaʻula a ʻulaʻula paha i ke kala.

Hoʻohana ʻia nā hoʻokolohua a me nā kaʻina hana e nānā i ka ʻili e ʻike (loaʻa) a ʻike ʻia ka maʻi kanakea Merkel cell.

Hiki ke hoʻohana ʻia nā hoʻāʻo a me nā kaʻina hana aʻe:

• ʻO ka hoʻāʻo kino a me ka mōʻaukala: kahi hōʻike o ke kino e nānā i nā hōʻailona laulā o ke olakino, e like me ka nānā ʻana i nā hōʻailona o ka maʻi, e like me nā puʻupuʻu a i ʻole nā ​​mea ʻē aʻe e ʻano ʻē. E lawe ʻia kahi moʻolelo o nā ʻano olakino o ka mea maʻi a me nā maʻi i hala a me nā mālama ʻana.

• ʻO ka hoʻāʻo ʻili o ke kino holoʻokoʻa: Nānā ke kauka a kahu hānai paha i ka ʻili no nā puʻupuʻu a i ʻole nā ​​kiko e nānā keu i ke kala, ka nui, ke ʻano, a me ke ʻano. ʻO ka nui, ke kinona, a me ke ʻano o nā lymph node e nānā pū ʻia.

• ʻO ka biopsy o ka ʻili : ka hemo ʻana o nā hunaola a i ʻole nā ​​ʻili i hiki iā lākou ke ʻike ma lalo o kahi microscope e kahi pathologist e nānā i nā hōʻailona o ka maʻi ʻaʻai.

Kū kekahi mau kumu i ka wānana (kahi o ke ola ʻana) a me nā koho lapaʻau.

ʻO ka wānana (loaʻa o ke ola) a me nā koho lapaʻau e pili i kēia:

• ʻO ke kahua o ka maʻi ʻaʻai (ka nui o ka tumo a inā ua pālahalaha ʻia i nā lymph node a i ʻole nā ​​ʻāpana ʻē aʻe o ke kino).

• Ma hea ka maʻi ʻaʻai i ke kino.

• Inā ua hōʻoia wale ʻia ka maʻi ʻaʻai a i ʻole ua hoʻi hou (hoʻi.

• ʻO ka makahiki o ka mea hoʻomanawanui a me ke olakino laulā.

Pili pū ka Prognosis i ka ulu ʻana o ka tumo i loko o ka ʻili.

Nā pae o Merkel Cell Carcinoma

NA MANA KUNI

• Ma hope o ka ʻike ʻia ʻana o ka cancer cancer Merkel, hana ʻia nā hoʻokolohua e ʻike inā ua pāhola nā hunaola maʻi maʻi i nā ʻāpana ʻē aʻe o ke kino.

• ʻEkolu ala e hoʻolaha ai ka maʻi ʻaʻai i loko o ke kino.

• E laha paha ka maʻi ʻaʻai mai kahi i hoʻomaka ai i nā ʻāpana ʻē aʻe o ke kino.

• Hoʻohana ʻia nā pae aʻe no ka Merkel cell carcinoma:

• Kahua 0 (carcinoma ma kahi)

• Ke kahua I

• Kahua II

• Kahua III

• Kahua IV

Ma hope o ka ʻike ʻia ʻana o ka cancer cancer Merkel, hana ʻia nā hoʻokolohua e ʻike inā ua pāhola nā hunaola maʻi maʻi i nā ʻāpana ʻē aʻe o ke kino.

ʻO ke kaʻina hana e ʻike inā ua pālahalaha ka maʻi ʻaʻai i nā ʻāpana ʻē aʻe o ke kino i kapa ʻia he staging. ʻO ka ʻikepili i hōʻiliʻili ʻia mai ke kaʻina hana e hoʻoholo ai i ka pae o ka maʻi. He mea nui ia e ʻike i ke kahua i mea e hoʻolālā ai i ka lāʻau.

Hiki ke hoʻohana ʻia nā hoʻokolohua aʻe a me nā kaʻina hana i ke kaʻina hoʻonohonoho:

• CT scan (CAT scan): Kahi hana e hana ai i ka moʻo o nā kiʻi kikoʻī o nā wahi i loko o ke kino, i lawe ʻia mai nā ʻaoʻao ʻokoʻa. Hana ʻia nā kiʻi e kahi kamepiula i hoʻopili ʻia i kahi mīkini x-ray. Hoʻokomo ʻia paha ke kala i loko o ke aa a i ʻole ale ʻia e kōkua i nā ʻōpū a i ʻole nā ​​kino i hōʻike hou aku me ka maopopo. Hiki ke hoʻohana ʻia kahi CT scan o ka umauma a me ka ʻōpū e nānā no ka maʻi ʻaʻai liʻiliʻi liʻiliʻi o ka pūpū liʻiliʻi, a i ʻole e ʻike i ka carcinoma o Merkel cell i pāhola ʻia. Hiki ke hoʻohana ʻia kahi CT scan o ke poʻo a me ka ʻāʻī e ʻike i ka carcinoma o Merkel cell i pālahalaha ʻia i nā lymph node. Kāhea ʻia kēia kaʻina hana he tomography i helu ʻia, kamepiula tomography, a i ʻole he tomography axial computerized.

• PET scan (positron emission tomography scan): kahi hana e loaʻa ai nā puʻupuʻu tumo malignant i loko o ke kino. Hoʻokomo ʻia kahi liʻiliʻi o ka glucose radioactive (kō) i loko o kahi aa koko. Hoʻopili ka scanner PET a puni ke kino a hana i kahi kiʻi o kahi e hoʻohana ʻia ai ka glucose i ke kino. ʻOi aku ka mālamalama o nā hunaola tumo ma ke kiʻi no ka mea ʻoi aku ka hana a lawe i ka glucose ma mua o ka hana ʻana o nā hunaola maʻamau.

• ʻO ka biopsy Lymph node: Nui a hewahewa nā ʻano o ka biopsy lymph node i hoʻohana ʻia e hoʻokū ai i ka carcinoma cell Merkel

• ʻO ka biopsy lymph node Sentinel: ʻO ka lawe ʻana i ka lymph node sentinel i ke kau ʻana. ʻO ka lymph node sentinel ka lua o nā lymph node i kahi hui o nā lymph node e loaʻa ai ka hoʻokahe ʻana i ka lymphatic mai ka tumo mua. ʻO ia ka pūnana lymph mua e laha aku ai ka maʻi ʻaʻai mai a ka tumo mua. Hoʻokomo ʻia kahi mea lekiō a me / a i ʻole ke kala polū ma kahi kokoke i ka tumo. Kahe ka mea a kala paha ma o nā kahena lymph i nā lymph node. Lawe ʻia ka pona lymph mua e loaʻa ai ka waiwai a kala paha. ʻIke kahi pathologist i ke kiko ma lalo o kahi microscope e nānā no nā hunaola maʻi ʻaʻai. Inā ʻaʻole i loaʻa nā hunaola maʻi ʻaʻai, ʻaʻole pono paha e hemo i nā pūnana lymph. I kekahi manawa, loaʻa kahi lymph node sentinel i kahi ʻoi aku o hoʻokahi hui o nā aka.

ʻO ka biopsy lymph node Sentinel o ka ʻili. Hoʻokomo ʻia kahi mea lekiō a me / a i ʻole ke kala polū ma kahi kokoke i ka tumo (panela mua). ʻIke ʻia nā mea i injected i ka ʻike a / a i ʻole me kahi ʻimi e ʻike ai i ka lekiō (panina waena). Lawe ʻia nā nū sentinel (nā lymph node mua e lawe i nā mea) a nānā ʻia no nā hunaola maʻi ʻaʻai (panela hope).

• ʻO ka Lymph node dissection: kahi kaʻina hana e wehe ʻia ai nā puka lymph a nānā ʻia kahi laʻana o nā kiko ma lalo o kahi microscope no nā ʻōuli o ke kanesa. No ka hoʻokaʻawale lymph node dissection, lawe ʻia kekahi o nā lymph node i ka wahi tumo. No kahi dissection lymph node radical, lawe ʻia ka hapa nui a i ʻole nā ​​lymph node āpau i ka wahi tumo. Kapa ʻia kēia kaʻina hana he lymphadenectomy.

• ʻO ka biopsy o ka nila nui: kahi hana e wehe ai i kahi laʻana o nā kiko me ka hoʻohana ʻana i kahi nila ākea. ʻIke kahi pathologist i ke kiko ma lalo o kahi microscope e nānā no nā hunaola maʻi ʻaʻai.

• ʻO ka biopsy aspiration maikaʻi-nila: kahi kaʻina hana e wehe i kahi laʻana o nā kiko me ka hoʻohana ʻana i kahi nila kuina. ʻIke kahi pathologist i ke kiko ma lalo o kahi microscope e nānā no nā hunaola maʻi ʻaʻai.

• Immunohistochemistry: ʻO kahi hoʻokolohua hoʻokolohua e hoʻohana ai i nā anti-antibodies e nānā ai no kekahi antigens (markers) i kahi laʻana o kaʻiʻo o ka mea maʻi. Hoʻopili pinepine ʻia nā mea ʻino i kekahi enzyme a i ʻole ka waihoʻoluʻu fluorescent. Ma hope o ka hoʻopili ʻana o nā mea ʻume i kekahi antigen kikoʻī i ka laʻana kiko, hoʻōloli ʻia ka enzyme a i ʻole ke kala, a laila ʻike ʻia ka antigen ma lalo o kahi microscope. Hoʻohana ʻia kēia ʻano hoʻāʻo e kōkua i ke kuhi ʻana i ka maʻi ʻaʻai a kōkua e haʻi i kekahi ʻano maʻi ʻaʻai mai kekahi ʻano maʻi ʻaʻai.

ʻEkolu ala e hoʻolaha ai ka maʻi ʻaʻai i loko o ke kino.

Hiki ke pālahalaha ʻia ka maʻi ʻaʻai ma o nā meaola, ka ʻōnaehana lymph, a me ke koko.

• Kāpena. Hoʻolahalaha ka maʻi ʻaʻai mai kahi i hoʻomaka ai i ka ulu ʻana i nā wahi kokoke.

• ʻŌnaehana Lymph. Hoʻolahalaha ka maʻi ʻaʻai mai kahi i hoʻomaka ai i ke komo ʻana i ka ʻōnaehana lymph. Hele ka maʻi ʻaʻai ma o nā kīʻaha lymph i nā ʻāpana ʻē aʻe o ke kino.

• Koko. Hoʻolahalaha ka maʻi ʻaʻai mai kahi i hoʻomaka ai i ke komo ʻana i ke koko. Hele ka maʻi ʻaʻai ma o nā kīʻaha koko i nā ʻāpana ʻē aʻe o ke kino.

E laha paha ka maʻi ʻaʻai mai kahi i hoʻomaka ai i nā ʻāpana ʻē aʻe o ke kino.

Ke pālahalaha ʻia ka maʻi ʻaʻai i kekahi ʻāpana o ke kino, ua kapa ʻia ia ʻo metastasis. E haki nā hunaola maʻi 'aʻai mai kahi a lākou i hoʻomaka ai (ka tumo mua) a hele i loko o ka ʻōnaehana lymph a i ʻole ke koko.

• ʻŌnaehana Lymph. Komo ka maʻi ʻaʻai i loko o ka ʻōnaehana lymph, hele ma waena o nā kīʻaha lymph, a hana i kahi tumo (tumo metastatic) i kekahi ʻāpana o ke kino.

• Koko. Komo ke kanesa i loko o ke koko, hele ma waena o nā kīʻaha koko, a hana i kahi tumo (tumo metastatic) i kekahi ʻāpana o ke kino.

ʻO ka tumo metastatic ka ʻano like o ke kanesa me ka tumo mua. ʻO kahi laʻana, inā pālahalaha ʻia ka cell carcinoma Merkel i ke ake, ʻo nā hunaola maʻi ʻaʻai i loko o ke akepaʻa he mau cell Merkel maʻi ʻaʻai. ʻO ka maʻi he metastatic Merkel cell carcinoma, ʻaʻole ka maʻi ʻaʻai ate.

Hoʻohana ʻia nā pae aʻe no ka Merkel cell carcinoma:

Ana ʻia ka nui o nā tumor i nā kenimika (cm) a i ʻole nā ​​ʻīniha. ʻO nā mea ʻai maʻamau i hiki ke hoʻohana ʻia e hōʻike i ka nui o ka tumo i ka cm me: kahi pea (1 cm), kahi peanut (2 cm), kahi hua waina (3 cm), kahi wōnati (4 cm), he lime (5 cm a i ʻole 2 'īniha), he hua manu (6 cm), kahi peach (7 cm), a me kahi huaʻulu (10 cm a 4' īniha).

Kahua 0 (carcinoma ma kahi)

I ke kahua 0, loaʻa nā hunaola Merkel maʻamau i ka papa luna o ka ʻili. Hiki i kēia mau ʻino ʻino ke lilo i maʻi ʻaʻai a hohola ʻia i loko o nā kiko maʻamau.

Ke kahua I

I ke kahua I, ʻo ka tumo he 2 kenimika a ʻoi iki paha.

Kahua II

Māhele ʻia ke kinona kinikini ʻo Merkel pae II i nā pae IIA a me IIB.

• I ke kahua IIA, ʻoi aku ka nui o ka tumo ma mua o 2 kenimika.

• I ke kahua IIB, ua palahalaha aku ka ʻōpuʻu i nā mea hoʻopili pili kokoke, nā mākala, nā iwi a me nā iwi.

Kahua III

Māhele ʻia ka paukū ʻo Merkel cell carcinoma i nā pae IIIA a me IIIB.

I ke kahua IIIA, loaʻa kekahi o kēia mau mea:

• he nui paha ka tumo a ua pālahalaha paha i nā mea pili kokoke, nā mākala, nā iwi, a me nā iwi. ʻAʻole hiki ke ʻike ʻia kahi lymph node i ka wā o ka hoʻokolohua kino akā ʻike ʻia ka maʻi ʻaʻai i loko o ka lymph node e ka biopsy lymph node sentinel a ma hope paha o ka hemo ʻana o ka lymph node a nānā ʻia ma lalo o kahi microscope no nā ʻōuli o ke kanesa. a i ʻole

• ʻike ʻia kahi node lymph pehu i ka wā o kahi hoʻokolohua kino a / a i ʻole ʻike ʻia ma kahi hōʻike kiʻi. Ke hoʻoneʻe ʻia ka lymph node a nānā ʻia ma lalo o kahi microscope no nā ʻōuli o ke kanesa, loaʻa ka maʻi ʻaʻai i loko o ka lymph node. ʻAʻole ʻike ʻia kahi i hoʻomaka ai ka maʻi ʻaʻai.

I ke kahua IIIB, he nui paha ka tumo a:

• ua pālahalaha paha i nā mea hoʻopili pili kokoke, nā mākala, nā iwi a me nā iwi. ʻIke ʻia kahi kōpena lymph pehu i ka wā o kahi hoʻokolohua kino a / a i ʻike ʻia paha ma kahi hōʻike kiʻi. Ke hoʻoneʻe ʻia ka lymph node a nānā ʻia ma lalo o kahi microscope no nā ʻōuli o ke kanesa, loaʻa ka maʻi ʻaʻai i loko o ka lymph node; a i ʻole

• ʻo ka maʻi ʻaʻai aia i loko o kahi kīʻaha lymph ma waena o ka tumo mua a me nā pūnana lymph e kokoke a mamao aku paha. Ua pālahalaha paha ka maʻi ʻaʻai i nā pūnana lymph.

Kahua IV

I ke anu IV, ua palahalaha aku ka ʻōpuʻu i ka ʻili i kokoke ʻole i ka tumo mua a i ʻole nā ​​ʻāpana ʻē aʻe o ke kino, e like me ke akepaʻa, akemāmā, iwi, a me ka lolo.

ʻO Merci Cell Carcinoma hou

ʻO ka maʻi kanesa Merkel hou he kanesa ia i hoʻi hou (hoʻi hou) ma hope o ka mālama ʻia ʻana. Hiki ke hoʻi mai ka maʻi ʻaʻai i loko o ka ʻili, nā lymph node, a i ʻole nā ​​ʻāpana ʻē aʻe o ke kino. He mea maʻamau ia no ka Merkel cell carcinoma e hoʻi hou.

Laulā Manaʻo Option Oponopono

NA MANA KUNI

• Aia nā ʻano lapaʻau like ʻole no nā mea maʻi me ka cell cancer cancer.

• Hoʻohana ʻia nā ʻano ʻehā o ka hoʻoponopono maʻamau:

• ʻOki kino

• Lapaʻau hoʻomākala

• ʻO Chemotherapy

• Immunotherapy

• Ke hoʻāʻo ʻia nei nā ʻano lapaʻau hou i nā hoʻokolohua hoʻokolohua.

• ʻO ka mālama ʻana no ka make ʻana o ka cell cell cancer ʻo Merkel.

• Makemake paha nā mea maʻi e noʻonoʻo e pili ana i ka hoʻokolokolo ʻana.

• Hiki i nā mea maʻi ke komo i nā hoʻokolohua hoʻokolohua ma mua, i ka wā, a ma hope paha o ka hoʻomaka ʻana i kā lākou mālama maʻi ʻaʻai.

• Pono paha nā hoʻokolohua ukali.

Aia nā ʻano lapaʻau like ʻole no nā mea maʻi me ka cell cancer cancer.

Loaʻa nā ʻano lapaʻau like ʻole no nā mea maʻi me ka cell carcinoma Merkel. Kūlana maʻamau kekahi mau hōʻailona (ʻo ka lāʻau i hoʻohana ʻia i kēia manawa), a ʻo kekahi e hoʻāʻo ʻia nei i nā hoʻokolohua hoʻokolohua. ʻO kahi hoʻokolohua hoʻokolohua lapaʻau kahi noiʻi noiʻi i manaʻo ʻia e kōkua i ka hoʻomaikaʻi ʻana i nā mālama ʻana i kēia manawa a i ʻole loaʻa ka ʻike e pili ana i nā mālama hou no nā maʻi me ka maʻi ʻaʻai. Ke hōʻike nā hoʻokolohua hoʻokolohua ʻoi aku ka maikaʻi o kahi lapaʻau hou ma mua o ka maʻamau maʻamau, lilo paha ka lāʻau hou i ka lapaʻau maʻamau. Makemake paha nā mea maʻi e noʻonoʻo e pili ana i ka hoʻokolokolo ʻana. ʻO kekahi mau hoʻokolohua hoʻokolohua e hāmama wale i nā mea maʻi i hoʻomaka ʻole i ka lāʻau.

Hoʻohana ʻia nā ʻano ʻehā o ka hoʻoponopono maʻamau:

ʻOki kino

Hiki ke hoʻohana ʻia i hoʻokahi a ʻoi paha o nā kaʻina hana e mālama ai iā Merkel cell carcinoma.

• ʻO ka laulā kūloko: ʻoki ʻia ka maʻi ʻaʻai mai ka ʻili a me kekahi o nā mea a puni iā. Hiki ke hana ʻia kahi biopsy lymph node sentinel i ka manawa o ke kaʻina hana excision ākea. Inā loaʻa ka maʻi ʻaʻai i nā lymph node, hana pū ʻia kahi dissection node lymph.

• ʻO ka Lymph node dissection: kahi kaʻina hana e lawe ʻia nā lymph node a nānā ʻia kahi laʻana o nā kiko ma lalo o kahi microscope no nā ʻōuli o ke kanesa. No ka hoʻokaʻawale lymph node dissection, lawe ʻia kekahi o nā lymph node i ka wahi tumo; no kahi dissection lymph node radical, lawe ʻia ka hapa nui a i ʻole nā ​​lymph node āpau i ka wahi tumo. Kapa ʻia kēia kaʻina hana he lymphadenectomy.

Ma hope o ka hemo ʻana o ke kauka i nā maʻi ʻaʻai āpau i hiki ke ʻike ʻia i ka manawa o ke ʻoki ʻana, hiki i kekahi mau mea maʻi ke hāʻawi ʻia i ka chemotherapy a i ʻole ka radiation therapy ma hope o ke kaha ʻana e luku i nā hunaola maʻi ʻea i koe. ʻO ka lāʻau i hāʻawi ʻia ma hope o ke kaha ʻana, e hoʻohaʻahaʻa i ka makaʻu e hoʻi mai ka maʻi ʻaʻai, i kapa ʻia ʻo adjuvant therapy.

Lapaʻau hoʻomākala

ʻO ka radiation radiation kahi lāʻau maʻi maʻi maʻi e hoʻohana i nā kukuna x nui ikaika a i ʻole nā ​​ʻano radiation e hoʻomake i nā hunaola maʻi ʻaʻai a mālama ʻole paha i ka ulu ʻana. ʻElua ʻano o radiation radiation:

• Hoʻohana ka radiation radiation kūwaho i kahi mīkini ma waho o ke kino e hoʻouna i ka radiation i ka maʻi ʻaʻai.

• Hoʻohana ka radiation radiation i loko i kahi lāʻau radioactive i hoʻopaʻa ʻia i nā nila, nā hua, nā uea, a i ʻole nā ​​catheters i kau pololei ʻia i loko a kokoke paha i ka maʻi ʻaʻai.

Hāʻawi ʻia ke ala o ka radiation radiation i ke ʻano a me ke kahua o ka maʻi ʻaʻai e mālama ʻia. Hoʻohana ʻia ka radiation radiation kūwaho e mālama iā Merkel cell carcinoma, a hoʻohana ʻia paha ma ke ʻano he palliative therapy e hōʻoluʻolu i nā ʻōuli a hoʻomaikaʻi i ka maikaʻi o ke ola.

ʻO Chemotherapy

ʻO Chemotherapy kahi lāʻau lapaʻau maʻi maʻi e hoʻohana i nā lāʻau e hōʻoki i ka ulu ʻana o nā hunaola maʻi ʻaʻai, ma ka luku ʻana paha i nā hunaola a i ʻole ke kū ʻana i nā hunaola mai ka hoʻokaʻawale Ke lawe ʻia ka chemotherapy e ka waha a i ʻole injected i loko o kahi aa koko a i ʻole nā ​​mākala, komo nā lāʻau i ke kahe o ke koko a hiki ke kiʻi i nā hunaola maʻi ʻōpio i loko o ke kino (chemotherapy ʻōnaehana). Ke waiho pololei ʻia ka chemotherapy i loko o ka wai cerebrospinal, kahi hui, a i ʻole ke kino o ke kino e like me ka ʻōpū, ʻo nā lāʻau lapaʻau ka mea nui e hoʻopili i nā hunaola maʻi ʻaʻai i kēlā mau wahi (chemotherapy āpau). Hāʻawi ʻia ke ala o ka chemotherapy i ka ʻano a me ke kahua o ka maʻi ʻaʻai e mālama ʻia.

Immunotherapy

ʻO ka Immunotherapy kahi lapaʻau e hoʻohana i ka ʻōnaehana pale maʻi o ka mea maʻi e hakakā i ka maʻi ʻaʻai. Hoʻohana ʻia nā mea i hana ʻia e ke kino a i hana ʻia paha i kahi keʻena hoʻokolohua e hoʻonui, kuhikuhi, a hoʻihoʻi hou i nā pale kūlohelohe o ke kino i ka maʻi ʻaʻai. Kāhea ʻia kēia ʻano lapaʻau maʻi ʻaʻai a biotherapy a i ʻole biologic therapy.

ʻO kekahi ʻano o nā hunaola pale, e like me nā hunaola T, a me kekahi mau pūnaʻi maʻi ʻaʻai i loaʻa kekahi mau protein, i kapa ʻia nā protein checkpoint, ma ko lākou ʻaoʻao e mālama i nā pane pale ʻole i ka nānā. Ke loaʻa ka nui o kēia mau protein i nā hunaola maʻi ʻaʻai, ʻaʻole lākou e hoʻouka ʻia a make ʻia e nā hunaola T. Pale aku nā mea hoʻopale nānā Immune i kēia mau protein a hoʻonui ʻia ka hiki o nā hunaola T e pepehi i nā hunaola maʻi ʻaʻai.

ʻElua ʻano o ka checkpoint inhibitor therapy:

• Mea kāohi PD-1: ʻO PD-1 kahi protein i ka ʻili o nā hunaola T e kōkua ai i ka mālama ʻana i nā pane pale o ke kino. Ke hoʻopili aku ʻo PD-1 i kahi protein ʻē aʻe i kapa ʻia ʻo PDL-1 ma kahi hunaola maʻi ʻoki, paʻa ia i ke kele T mai ka luku ʻana i ka pūnaeho maʻi maʻi. Hoʻopili nā mea pale PD-1 i PDL-1 a ʻae i nā hunaola T e pepehi i nā hunaola maʻi ʻaʻai. Hoʻohana ʻia ʻo Avelumab a me pembrolizumab e mālama i ka carcinoma Merkel cell holomua. Ke aʻo ʻia nei ʻo Nivolumab e mālama i ka make ʻo Merkel cell carcinoma.

Mea hoʻopukapuka hōʻoiaʻiʻo pale pale. ʻO nā protein checkpoint, e like me PD-L1 ma nā hunaola tumo a me PD-1 ma nā hunaola T, e kōkua i ka mālama ʻana i nā pane pale ʻole. Mālama ka paʻa ʻana o PD-L1 iā PD-1 mālama i nā hunaola T mai ka pepehi ʻana i nā hunaola tumora i loko o ke kino (panel hema). Ke kāpae nei i ka hoʻopaʻa ʻana o PD-L1 iā PD-1 me kahi mea pale pale pale pale pale (anti-PD-L1 a i ʻole anti-PD-1) ʻae i nā hunaola T e pepehi i nā hunaola tumera (ʻaoʻao ʻākau)

• Mea kāohi CTLA-4: ʻO ka CTLA-4 kahi protein i ka ʻili o nā pūnaewele T e kōkua ai e mālama i nā pane pale o ke kino. Ke hoʻopili aku ʻo CTLA-4 i kahi protein ʻē aʻe i kapa ʻia ʻo B7 ma ke kolamu maʻi ʻaʻai, kū ia i ka hunaola T mai ka luku ʻana i ka pūnaeho maʻi maʻi. Hoʻopili ka mea pāpālina CTLA-4 i CTLA-4 a ʻae i nā hunaola T e pepehi i nā hunaola maʻi ʻaʻai. ʻO Ipilimumab kahi ʻano o ka mea pāpālina CTLA-4 ke hoʻopaʻa ʻia e mālama ai i ka make ʻo Merkel cell carcinoma.

Mea hoʻopukapuka hōʻoiaʻiʻo pale pale. ʻO nā protein checkpoint, e like me B7-1 / B7-2 ma nā hunaola e hōʻike nei i nā antigen (APC) a me CTLA-4 ma nā pūnaewele T, e kōkua i ka mālama ʻana i nā pane pale o ke kino i ka nānā ʻana. Ke nakinaki ka mea loaʻa ʻo T-cell (TCR) i ka antigen a me nā protein histocompatibility complex (MHC) nui ma ka APC a me CD28 e hoʻopili iā B7-1 / B7-2 ma ka APC, hiki ke hoʻoulu ʻia ka pūnaewele T. Eia nō naʻe, ʻo ka hoʻopaʻa ʻana o B7-1 / B7-2 i CTLA-4 mālama i nā hunaola T i ke ʻano hana ʻole no laila ʻaʻole hiki iā lākou ke pepehi i nā hunaola tumora i loko o ke kino (panel hema). Ke kāpae nei i ka hoʻopaʻa ʻana o B7-1 / B7-2 i CTLA-4 me kahi mea hōʻoki pale pale pale (anti-CTLA-4 antibody) e ʻae i nā pūnaewele T e hana a make a make i nā pūhaka tumora (ʻaoʻao ʻākau).

E ʻike i nā lāʻau i ʻae ʻia no ka maʻi ʻaʻai ʻili no ka ʻike hou aku.

Ke hoʻāʻo ʻia nei nā ʻano lapaʻau hou i nā hoʻokolohua hoʻokolohua.

Loaʻa nā ʻike e pili ana i nā hoʻokolohua hoʻokolohua mai ka pūnaewele NCI.

ʻO ka mālama ʻana no ka make ʻana o ka cell cell cancer ʻo Merkel.

No ka ʻike e pili ana i nā hopena i hopena ʻia e ka lapaʻau ʻana no ka maʻi ʻaʻai, e ʻike i kā mākou ʻaoʻao ʻaoʻao ʻaoʻao.

Makemake paha nā mea maʻi e noʻonoʻo e pili ana i ka hoʻokolokolo ʻana.

No kekahi mau mea maʻi, ke komo nei i ka hoʻokolohua hoʻokolohua ke koho lapaʻau maikaʻi loa paha. ʻO nā hoʻokolohua hoʻokolohua kahi ʻāpana o ka noiʻi ʻana o ka maʻi ʻaʻai. Hana ʻia nā hoʻokolohua hoʻokolohua e ʻike inā palekana a maikaʻi a maikaʻi paha nā hoʻomaʻamaʻa maʻi ʻaʻai ma mua o ka maʻamau maʻamau.

ʻO ka hapa nui o nā hana maʻamau no ka maʻi ʻaʻai i kau ʻia ma nā hoʻokolohua hoʻokolohua mua. ʻO nā mea maʻi i komo i ka hoʻokolokolo hoʻokolohua hiki ke loaʻa i ka lāʻau maʻamau a i ʻole i waena o nā mea mua i loaʻa kahi lāʻau hou.

ʻO nā mea maʻi i komo i nā hoʻokolohua hoʻokolohua kōkua pū kekahi i ka hoʻomaikaʻi ʻana i ke ʻano o ka mālama ʻana i ka maʻi ʻaʻai i ka wā e hiki mai ana. ʻOiai ʻaʻole nā ​​alakaʻi hoʻokolohua e alakaʻi i nā hoʻoponopono hou maikaʻi, pane pinepine lākou i nā nīnau nui a kōkua i ka neʻe i mua o ka noiʻi.

Hiki i nā mea maʻi ke komo i nā hoʻokolohua hoʻokolohua ma mua, i ka wā, a ma hope paha o ka hoʻomaka ʻana i kā lākou mālama maʻi ʻaʻai.

Hoʻopili wale kekahi mau hoʻokolohua hoʻokolohua i nā mea maʻi i loaʻa ʻole ka lapaʻau. ʻO nā hoʻokolohua ʻē aʻe e hōʻoia i nā mālama ʻana no ka poʻe maʻi i loaʻa ʻole ka maikaʻi o ka maʻi ʻaʻai. Aia kekahi mau hoʻokolohua hoʻokolohua e hoʻāʻo i nā ala hou e hōʻoki i ka maʻi ʻaʻai mai ka hoʻi hou ʻana (hoʻi ʻana) a hōʻemi paha i nā hopena o ka mālama ʻana i ka maʻi ʻaʻai.

Ke mālama ʻia nei nā hoʻokolohua hoʻokolohua ma nā wahi he nui o ka ʻāina. Hiki ke ʻike ʻia ka ʻike e pili ana i nā hoʻokolohua hoʻokolohua e kākoʻo ʻia e NCI ma ka pūnaewele ʻimi noiʻi hoʻokolohua a NCI. Hiki ke loaʻa nā hoʻokolohua hoʻokolohua i kākoʻo ʻia e nā hui ʻē aʻe ma ka pūnaewele ClinicalTrials.gov.

Pono paha nā hoʻokolohua ukali.

ʻO kekahi o nā hoʻokolohua i hana ʻia e hōʻoia i ka maʻi ʻaʻai a i ʻole e ʻike i ke kahua o ka maʻi ʻaʻaʻa e hana hou ʻia paha. E hana hou ʻia kekahi mau hōʻike i mea e ʻike ai i ka maikaʻi o ka mālama ʻana. Hoʻoholo ʻia nā hoʻoholo e pili ana inā e hoʻomau, hoʻololi, a kū paha i ka lāʻau ʻana ma nā hopena o kēia mau hoʻāʻo.

E hoʻomau ʻia kekahi o nā hoʻokolohua mai kēlā me kēia manawa ma hope o ka pau ʻana o ka lāʻau. Hiki i nā hopena o kēia mau hoʻāʻo ke hōʻike inā ua loli kou ʻano a i ʻole inā ua hoʻi hou ke kanesa. Kapa ʻia kēia mau hoʻāʻo i kekahi manawa nā hoʻokolohua ukali a i ʻole nā ​​loiloi.

Nā koho lapaʻau e ke kahua

Ma keia Pauku

• ʻOihana I a me ke kahua II Merkel Cell Carcinoma

• ʻOihana III Merkel Cell Carcinoma

• ʻOihana IV Merkel Cell Carcinoma

No ka ʻike e pili ana i nā lāʻau i helu ʻia ma lalo, e ʻike i ka ʻaoʻao Overtion Option Overview.

ʻOihana I a me ke kahua II Merkel Cell Carcinoma

ʻO ka mālama ʻana i ke kahua I a me ka pae II Merkel cell carcinoma e komo pū paha me kēia:

• Hoʻopau ke ʻoki e wehe i ka tumo, e like me ka excision local a me ka ʻole o ka dissection lymph node.

• ʻO ka radiation radiation ma hope o ke kahakaha ʻana.

E hoʻohana i kā mākou ʻimi hoʻokolohua hoʻokolohua e ʻike i nā hoʻokolohua hoʻokolohua maʻi maʻi i kākoʻo ʻia e NCI e ʻae nei i nā mea maʻi. Hiki iā ʻoe ke ʻimi i nā hoʻāʻo e pili ana i ke ʻano o ka maʻi ʻaʻai, ka makahiki o ka mea hoʻomanawanui, a kahi e hana ʻia ai nā hoʻokolokolo. Loaʻa nā ʻike laulā e pili ana i nā hoʻokolohua hoʻokolohua.

ʻOihana III Merkel Cell Carcinoma

ʻO ka mālama ʻana i ke kahua ʻoihana Mer Merci cell pae ke komo pū i kēia:

• ʻO ka excision kūloko a me ka ʻole o ka dissection lymph node.

• Lapaʻau hoʻomākala.

• Immunotherapy (immune checkpoint inhibitor therapy e hoʻohana nei i ka pembrolizumab), no nā tumors i hiki ʻole ke hemo e ke ʻoki.

• ʻO kahi hoʻokolohua hoʻokolohua o ka chemotherapy.

• ʻO kahi hoʻokolohua hoʻokolohua o immunotherapy (nivolumab).

E hoʻohana i kā mākou ʻimi hoʻokolohua hoʻokolohua e ʻike i nā hoʻokolohua hoʻokolohua maʻi maʻi i kākoʻo ʻia e NCI e ʻae nei i nā mea maʻi. Hiki iā ʻoe ke ʻimi i nā hoʻāʻo e pili ana i ke ʻano o ka maʻi ʻaʻai, ka makahiki o ka mea hoʻomanawanui, a kahi e hana ʻia ai nā hoʻokolokolo. Loaʻa nā ʻike laulā e pili ana i nā hoʻokolohua hoʻokolohua.

ʻO ke kahua IV Merkel Cell Carcinoma lapaʻau o ke kahua IV Merkel cell carcinoma e komo pū paha me kēia:

Immunotherapy (immune checkpoint inhibitor therapy e hoʻohana ana i ka avelumab a i ʻole pembrolizumab). Chemotherapy, ʻoki kino a i ʻole radiation radiation ma ke ʻano he palliative lapaʻau e hōʻoluʻolu i nā ʻōuli a hoʻomaikaʻi i ka maikaʻi o ke ola. ʻO kahi hoʻokolohua hoʻokolohua o ka immunotherapy (nivolumab a me ipilimumab). E hoʻohana i kā mākou ʻimi hoʻokolohua hoʻokolohua e ʻike i nā hoʻokolohua hoʻokolohua maʻi maʻi i kākoʻo ʻia e NCI e ʻae nei i nā mea maʻi. Hiki iā ʻoe ke ʻimi i nā hoʻāʻo e pili ana i ke ʻano o ka maʻi ʻaʻai, ka makahiki o ka mea hoʻomanawanui, a kahi e hana ʻia ai nā hoʻokolokolo. Loaʻa nā ʻike laulā e pili ana i nā hoʻokolohua hoʻokolohua.

Nā koho lapaʻau no ka Merkel Cell Carcinoma hou

No ka ʻike e pili ana i nā lāʻau i helu ʻia ma lalo, e ʻike i ka ʻaoʻao Overtion Option Overview.

Hiki i ka mālama ʻana i ka cancer cancer Merkel hou ke hoʻopili i kēia mau mea:

• ʻO ka excision kūloko e wehe i kahi nui o nā kiko ma mua o ka lawe ʻia i ke ʻoki mua. A lymph node dissection hiki nō ke hana.

• ʻO ka radiation radiation ma hope o ke kahakaha ʻana.

• ʻO Chemotherapy.

• ʻO ka radiation radiation a me / a i ʻole ke ʻoki kino e like me ka hoʻomaʻamaʻa palliative e hōʻoluʻolu i nā hōʻailona a hoʻomaikaʻi i ka maikaʻi o ke ola.

E hoʻohana i kā mākou ʻimi hoʻokolohua hoʻokolohua e ʻike i nā hoʻokolohua hoʻokolohua maʻi maʻi i kākoʻo ʻia e NCI e ʻae nei i nā mea maʻi. Hiki iā ʻoe ke ʻimi i nā hoʻāʻo e pili ana i ke ʻano o ka maʻi ʻaʻai, ka makahiki o ka mea hoʻomanawanui, a kahi e hana ʻia ai nā hoʻokolokolo. Loaʻa nā ʻike laulā e pili ana i nā hoʻokolohua hoʻokolohua.

E aʻo hou aʻe e pili ana iā Merkel Cell Carcinoma

No ka ʻike hou aku mai ka National Cancer Institute e pili ana iā Merkel cell carcinoma, e ʻike i ka mea aʻe:

• ʻAoʻao Kanaka ʻili (Me Melanoma) ʻaoʻao home

• Kāohi ʻana i ka maʻi ʻaʻai ʻili

• ʻImi ʻana i ka maʻi ʻaʻai ʻili

• ʻO Sentinel Lymph Node Biopsy

No ka ʻike ākea maʻi ʻaʻai a me nā kumuwaiwai ʻē aʻe mai ka National Cancer Institute, e ʻike i ka mea aʻe:

• E pili ana i ka maʻi ʻaʻai

• Ke hoʻokū nei

• ʻO Chemotherapy a ʻo ʻoe: Kākoʻo no ka poʻe me ka maʻi ʻaʻai

• Radiation Therapy a ʻo ʻoe: Kākoʻo no ka poʻe me ka maʻi ʻaʻai

• Ke kāohi nei i ka maʻi ʻaʻai

• Nā nīnau e nīnau ai i kāu kauka e pili ana i ka maʻi ʻaʻai

• No nā mea ola a me nā mea mālama