So wunim HER2-Negative Nufu mu Kokoram? Momma yɛnkasa!

Ebia woate nufu mu kokoram ho asɛm pii. Nanso so wunim nea wɔfrɛ no kokoram a ɛte sɛɛ ‘HER2-negative’ ankasa? Ɛyɛ soronko kakra wɔ nufu mu kokoram ahorow afoforo bi ho, na ebia ɛsono sɛnea wɔde sa no. Mma ɛnhaw wo, ɛnnɛ yɛbɛka saa `HER2-Negative Breast Cancer` yi ho asɛm wɔ ɔkwan tiawa so a wobɛtumi ate aseɛ, ɛyɛ?

Dɛn ne HER2-Negative Nufu mu Kokoram?

Sɛ yɛbɛka no tiawa a, `HER2-negative breast cancer` kyerɛ sɛ kokoram nkwammoaa a ɛwɔ wo nufu mu no nni protein soronko bi a wɔfrɛ no `human epidermal growth factor 2 (HER2) pii anaasɛ kakraa bi. So wunim sɛ nufu mu kokoram taa ba esiane hormone ahorow (titiriw estrogen ne progesterone) anaasɛ esiane saa `HER2` protein yi nti? Sɛ nhwɛso no, wɔ `HER2-positive` nufu mu kokoram mu no, `HER2` protein no wɔ nkwammoaa no ani, na ɛma kokoram nkwammoaa no mu paapae ntɛmntɛm na ɛyɛ akisikuru.

Nanso wɔ `HER2-negative` nsɛm mu no, kokoram no nnya efisɛ `HER2` protein dɔɔso dodo. Ɛne sɛ, nneɛma afoforo nso ka ho.

Sɛ wo duruyɛfoɔ hu sɛ wowɔ nufu mu kokoram a, akyinnyeɛ biara nni ho sɛ wɔbɛhwehwɛ wo `HER2` tebea (i.e., papa anaa bɔne). Eyinom ne kokoram nkwammoaa su titiriw, a yɛfrɛ no `biomarkers` , na sɛ wɔte ase yiye a, nnuruyɛfo betumi asi ayaresa a ɛfata na etu mpɔn kɛse ma wo ho gyinae. Ate aseɛ?

Dɛn ne nufu mu kokoram ahorow atitiriw a HER2 nnim?

Nufu mu kokoram dodow no ara a wɔahu mprempren no yɛ `HER2-negative` type. Eyi yɛ ahorow atitiriw abien, momma yɛnhwɛ nea ɛyɛ:

1. Nufu mu kokoram a ɛwɔ hormone receptor-positive ne HER2-negative (HR+/HER2-) :

Eyi ne nufu mu kokoram a abu so sen biara, na ɛyɛ nufu mu kokoram nyinaa mu bɛyɛ ɔha biara mu nkyem 70 (70%) . Wɔ eyi mu no, kokoram nkwammoaa no wɔ ntini ahorow a ɛma wotumi te estrogen hormone (ER+), progesterone hormone (PR+), anaa n’abien nyinaa nka. Sɛ yɛbɛka no tiawa a, sɛ saa nkwaadɔm yi kyekyere saa ntini ahorow yi a, kokoram nkwammoaa no fi ase nyin. Nanso, kokoram ahorow yi nni HER2 protein no pii. Ɛno nti na wɔfrɛ wɔn HR+/HER2-.

2. Nufu mu kokoram a ɛnyɛ hormone receptor-negative ne HER2-negative (HR-/HER2-) :

Saa kokoram yi yɛ nufu mu kokoram nyinaa mu bɛyɛ ɔha biara mu nkyem 11 (11%). Saa kokoram nkwammoaa yi nni nneɛma a ɛma wonya estrogen anaa progesterone. Afei nso, sɛnea yɛadi kan aka no, `HER2` protein no nkɔ soro. Eyi kyerɛ sɛ hormone anaa `HER2` protein no biara ntumi mma kokoram yi nnyin . Edin foforo a wɔde frɛ eyi ne `Triple-Negative Breast Cancer` . Eyi te saa efisɛ estrogen agyefo, progesterone agyefo, ne `HER2` protein nyinaa yɛ `negative` wɔ eyi mu.

Dɛn ne nufu mu kokoram a HER2 nnim ho sɛnkyerɛnne?

Nokwarem no, nufu mu kokoram a HER2 nnim ho sɛnkyerɛnne te sɛ nufu mu kokoram foforo biara de koraa. Ɛsɛ sɛ wuhu nea edidi so yi:

• Sɛ wuhu nsakrae soronko bi wɔ wo nufu biako anaa abien no nyinaa kɛse anaa ne nsusuwii mu a.
• Sɛ wuhu sɛ akisikuru foforo, akuru, anaasɛ ayɛ den wɔ wo nufu anaa wo nsateaa mu, titiriw sɛ akuru no nsakra bere a wo bra ɔsram biara no.
• Changes in the skin of the breast or nipple. Nhwɛsoɔ:
• Dimpling of the skin, te sɛ akutu a wɔayam
• Wora a ɛyɛ nwininwini, ɛyɛ kurukuruwa
• Wora a ɛyɛ mmerɛw
• Ɛyɛ akisikuru a ɛkɔ so daa
• Wora kɔla sesa (kɔkɔɔ, kɔkɔɔ, bruu, anaa tuntum soronko).
• Nufusu mu nsu a ɛba . Eyi betumi ayɛ kɔkɔɔ te sɛ mogya, nsu a emu da hɔ, anaasɛ kɔla fitaa a ɛte sɛ nufusu (sɛ wunnyinsɛn anaasɛ woremma nufu a).
• Nipple inversion (sɛ na enni hɔ kan a).

Ɛho hia sɛ yɛhyɛ no nsow sɛ ɛnyɛ bere nyinaa na nufu mu kokoram ma nsakrae a ɛda adi pefee ba sɛnea wohwɛ wo ho no mu . Afei nso, wobetumi ahu nsakrae yi pii nso wɔ tebea horow a ɛnyɛ hu, a ɛfata (e.g. cysts, fibroadenoma). Ɛno nti na ɛho hia kɛse sɛ wohwɛ wo nufu so daa na woyɛ nufu mu kokoram ho nhwehwɛmu a ɛfata wo mfe a woadi no . Sɛ wowɔ nsakrae bi ho dadwen bi a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn akɔhwɛ sɛ ɛyɛ kokoram anaa tebea foforo ho sɛnkyerɛnne anaa.

Dɛn na ɛde nufu mu kokoram a HER2 nnim ba?

Sɛ yɛbɛka no tiawa a, nufu mu kokoram a HER2 nnim no fi nsakrae a ɛba awosu mu nkwaadɔm anaa DNA a ɛwɔ nufu mu nkwammoaa mu, a wɔfrɛ no mutations , a ɛma saa nkwammoaa no dan kokoram nkwammoaa no mu. Afei kokoram nkwammoaa yi mu paapae na ɛdɔɔso ntɛmntɛm a wontumi nni so, na ɛyɛ akisikuru.

Nneɛma a Ɛde Asiane Ba

Abenfo da so ara nnim nea ɛde awosu mu nsakrae yi ba ankasa wɔ nufu mu kokoram a HER2 nnim mu no yiye. Nanso, wɔahu nneɛma pii a ebetumi ama asiane a ɛwɔ hɔ sɛ obi benya nufu mu kokoram wɔ ɔkwan a ɛkɔ akyiri so no ayɛ kɛse. Eyinom bi ne:

• Awosu mu nkwaadɔm mu nsakrae pɔtee biara nni hɔ a ɛne nufu mu kokoram a ɛfa HER2 ho wɔ abusuabɔ. Nanso, sɛ obi nya awosu mu nkwaadɔm mu nsakrae te sɛ BRCA1 anaa BRCA2 fi awo mu a, asiane kɛse wom sɛ obenya nufu mu kokoram (ne kokoram afoforo bi) wɔ ɔkwan a ɛkɔ akyiri so.
• Wo anaa obi a ɔwɔ w’abusua mu anya nufu mu kokoram pɛn.: Sɛ woanya nufu mu kokoram pɛn a, asiane bi wɔ hɔ sɛ ɛbɛsan aba bio. Afei nso, sɛ wo mogya abusuafo (titiriw wo maame, wo papa, wo nuanom, wo mma) anya nufu mu kokoram a, wo nso wowɔ asiane a ɛkɔ soro kakra.
• Estrogen anaa progesterone hormone a wode wo ho bɛhyɛ mu bere tenten : Sɛ wufii wo bra a edi kan ase wɔ wo mmofraase (e.g., ansa na woadi mfe 12), anaasɛ sɛ wugyae brayɛ akyiri (sɛ nhwɛso no, bere a woadi mfe 55 akyi) a, wo nipadua no anya saa nna mu nkwaadɔm yi bere tenten. Eyi nso betumi ayɛ asiane. Nnuru bi a wɔde si hormone ananmu nso betumi ama asiane a ɛwɔ hɔ no ayɛ kɛse bere a wɔfa bere tenten no.
• Nsã a wɔnom : Nhwehwɛmu ada no adi sɛ sɛ obi nom nsa bɛboro biako a wɔnom da biara a, ɛma asiane a ɛwɔ hɔ sɛ obenya nufu mu kokoram no yɛ kɛse.

Nea ɛka eyi ho no, nneɛma te sɛ mfe a obi adi, kɛseyɛ mmoroso, ne apɔw-mu-teɛteɛ a ɔnyɛ nso betumi ama nufu mu kokoram ho asiane no ayɛ kɛse wɔ ɔkwan a ɛkɔ akyiri so.

Ɔkwan bɛn so na wohu nufu mu kokoram a HER2 nnim?

Nnuruyɛfo taa hu nufu mu kokoram a HER2 nnim denam nufu mu nhwehwɛmu so . Eyi hwehwɛ sɛ wogye ntini ketewaa bi (afã bi) fi akuru anaa beae bi a ɛyɛ adwenem naayɛ mu na wɔde kɔ aduruyɛdan mu. Ɛhɔ no, ɔyare ho ɔbenfo bi de afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ nhwɛsode no mu hwɛ sɛ kokoram nkwammoaa wɔ hɔ anaa.

Sɛ wosi kokoram nkwammoaa so dua a, afei wɔyɛ nhwehwɛmu titiriw bi de hwɛ sɛnea `HER2` protein no dodow te wɔ saa kokoram nkwammoaa no ani, anaasɛ `HER2` awosu mu abɔde no mfonini dodow a ɛwɔ hɔ.

• Sɛ wowɔ `HER2` protein anaa gene dodow a ɛfata (a ɛba fam) a, wowɔ `HER2-negative` nufu mu kokoram.

Nhwehwɛmu titiriw abien a wɔyɛ wɔ aduruyɛdan mu de yɛ eyi ne:

1. Immunohistochemistry (IHC) : Saa sɔhwɛ yi de nnuru pɔtee bi a ɛko tia nyarewa ne nnuru a wɔde yɛ nneɛma di dwuma de hu HER2 protein a ɛwɔ kokoram nkwammoaa ani. Sɛ IHC aba no yɛ 0 anaa 1+ a, wobu kokoram no sɛ HER2-negative. Sɛ nea efi mu ba no yɛ 2+ (ɛtɔ da bi a wɔfrɛ no "equivocal" anaa "borderline") a, wɔyɛ sɔhwɛ a wɔfrɛ no FISH nso de si HER2 tebea no so dua.

2. Fluorescence in situ hybridization (FISH) : Saa sɔhwɛ yi hwɛ HER2 gene a ɛyɛ HER2 protein no mfonini dodow a ɛwɔ kokoram nkwammoaa mu. Eyi de afiri a wɔde hwɛ nneɛma nketenkete ne fluorescent (a ɛma hann) agyiraehyɛde ahorow di dwuma. Wɔ nsɛm a IHC sɔhwɛ no aba no nyɛ nea ɛyɛ nokware, te sɛ 2+ no, FISH sɔhwɛ no betumi asi HER2 tebea no so dua koraa (ɛnyɛ bɔne anaasɛ ɛyɛ papa).

Wɔ saa `HER2` sɔhwɛ ahorow yi akyi no, ɔyare ho ɔbenfo no nso bɛhwehwɛ biopsy nhwɛsode no mu na wahwɛ sɛ estrogen receptors (ETU) ne progesterone receptors (PR) wɔ kokoram no mu.

Ebia ɛho behia nso sɛ woyɛ mfoninitwa akwan te sɛ mammogram, ultrasound, CT scan, anaa MRI scan na ama woahu baabi a wo kokoram no wɔ (kyerɛ sɛ, wobɛhwɛ sɛnea akisikuru no kɛse te ne sɛ ebia atrɛw akɔ ntini a ɛma mogya tu anaa nipadua no afã afoforo a ɛwɔ akyirikyiri).

Wo duruyɛfo no bɛka saa nsɛm yi nyinaa abom (HER2 tebea, HR tebea, kokoram gyinabea, ne kokoram su) de ayɛ ayaresa nhyehyɛe a ɛfata sen biara ama wo.

Dɛn ne ayaresa ahorow a wɔde sa nufu mu kokoram a HER2 nnim?

Ayaresa a eye sen biara a wɔde sa nufu mu kokoram a HER2 nnim no betumi ayɛ soronko wɔ onipa biara ho. Egyina nneɛma pii so, a nea ɛka ho ne wo kokoram no gyinabea, sɛ́ ɛyɛ hormone receptor-positive anaasɛ negative (HR+/HER2- anaa HR-/HER2-), ne w’akwahosan nyinaa.

Mpɛn pii no, ayaresa ahorow no betumi ayɛ:

• Nufu mu kokoram oprehyɛn : Kokoram akisikuru no ne ebia ntini bi a ɛte apɔw a atwa ho ahyia a woyi fi hɔ. Eyi betumi ayɛ lumpectomy, a woyi nufu no fã bi, anaasɛ mastectomy, a woyi nufu no nyinaa.
• Mframa a wɔde sa yare : Wɔde mframa a ahoɔden wom kɛse di dwuma de sɛe kokoram nkwammoaa biara a ebetumi aka wɔ oprehyɛn akyi, anaasɛ wɔde tew akisikuru no so ansa na wɔayɛ oprehyɛn.

Wɔ saa ayaresa atitiriw yi akyi no, ayaresa pɔtee afoforo wɔ hɔ a egyina kokoram ko so:

HR+/HER2- (hormone receptor-positive, HER2-negative) nufu mu kokoram ho ayaresa

Esiane sɛ kokoram a ɛte sɛɛ gyina hormone so nti, saa ayaresa ahorow yi nso ho hia de ka oprehyɛn ne/anaasɛ mframa a wɔde sa yare ho:

• Hormone therapy : Saa ayaresa ahorow yi yɛ adwuma denam hormone estrogen anaa progesterone a ɛboa ma kokoram nyin no dodow a ɛtew so, anaasɛ ɛma saa hormone ahorow no ntumi nkɔ kokoram nkwammoaa mu no so. Nhwɛsoɔ:
• Nnuru a esiw aromatase ano (sɛ nhwɛso no, Anastrozole, Letrozole, Exemestane) .
• Gonadotropin-releasing hormone (GnRH) agonists (egyae nkwaadɔm a efi awotwaa mu ba) .
• `Estrogen agyefo a wɔpaw (SERMs)` (sɛ nhwɛso no, Tamoxifen, Raloxifene) .

Wɔ tebea horow bi mu no, ebia ebehia sɛ wɔyɛ wo oprehyɛn (oophorectomy) de yi wo mmadwoa a ɛma estrogen no fi hɔ. Wobetumi de hormone ayaresa nkutoo ama anaasɛ wɔde aka ayaresa a wɔde asi wɔn ani so ho mfe pii.

• Ayaresa a wɔde wɔn ani asi so : Saa ayaresa ahorow yi de wɔn ani si mmerɛwyɛ pɔtee bi a ɛwɔ kokoram nkwammoaa mu so na ɛtow hyɛ so de siw kokoram nkwammoaa nyin ne ne trɛw ano. Wɔ HR+/HER2- kokoram ho no, wɔde nnuru a wɔfrɛ no CDK4/6 inhibitors (e.g. Palbociclib, Ribociclib, Abemaciclib) ka hormone ayaresa ho. Eyinom siw enzyme bi a ɛhwɛ kokoram nkwammoaa mu mpaapaemu so.
• Nnuru a wɔde sa yare: Wɔ HR+/HER2- nufu mu kokoram binom fam no, titiriw sɛ kokoram no atrɛw anaasɛ ɛyɛ hu a, nnuruyɛfo betumi akamfo nnuru a wɔde sa yare aka hormone ayaresa ne/anaasɛ ayaresa a wɔde asi wɔn ani so ho.

Nufu mu kokoram a wɔfrɛ no HR-/HER2- (a ɛnyɛ papa mprɛnsa) a wɔsa

Esiane sɛ nufu mu kokoram abiɛsa a enye no nnyina hormone so nti, hormone ayaresa ntumi nyɛ adwuma yiye. Wɔ oprehyɛn ne/anaasɛ mframa a wɔde sa yare akyi no, wɔde ayaresa a edidi so yi di dwuma titiriw:

• Nnuru a wɔde sa yare : Nnuru a wɔde sa yare yɛ aduru a ɛho hia yiye a wɔde sa kokoram abiɛsa a ɛnyɛ papa. Nnuruyɛfo de nnuru ahorow a wɔde sa yare di dwuma. Ebia wɔbɛma aduru biako anaa nnuru pii a wɔaka abom.
• Immunotherapy : Eyi yɛ ayaresa foforo koraa. Ɛyɛ adwuma denam wo nipadua no ankasa nipadua mu ahoɔden a ɛko tia nyarewa a ɛkanyan no ma ehu kokoram nkwammoaa na ɛsɛe no so. Pembrolizumab (Keytruda®) yɛ aduru a wɔde sa yare a ɛko tia nyarewa a Aduan ne Nnuru Dwumadibea (FDA) apene so na wɔde ka nnuru a wɔde sa nufu mu kokoram ahorow bi a ɛnyɛ papa ho.
• Ayaresa a wɔde asi wɔn ani so : Wɔ kokoram a ɛnyɛ papa abiɛsa a ɛwɔ BRCA awosu mu nkwaadɔm mu nsakrae ho no, wɔde nnuru a wɔde asi wɔn ani so a wɔfrɛ no PARP inhibitors (e.g., Olaparib, Talazoparib) di dwuma. Afei nso, wɔ yare a ɛkɔ mmeae afoforo ho no, mprempren wɔanya ayaresa ahorow foforo a wɔde wɔn ani asi so (e.g., antibody-drug conjugates).

Dɛn ne ayaresa ahorow no mu nsunsuanso bɔne?

Ɛwom sɛ kokoram ayaresa betumi ako atia kokoram yiye de, nanso ayaresa nyinaa, a nnuru a wɔde sa yare, mframa a wɔde sa yare, hormone ayaresa, ayaresa a wɔde wɔn ani asi so, ne nipadua mu ahoɔden a ɛko tia nyarewa ka ho no betumi de ɔhaw ahorow bi aba. Eyinom betumi ayɛ bere tiaa mu de anaa bere tenten. Sɛ nhwɛso no, ɔbrɛ, akisikuru, ɔfe, ti nhwi a ɛtɔ, aduan ho akɔnnɔ a ɛyera, ano a ɛyɛ kuru, honam ani nsakrae, akisikuru anaa akisikuru, ne mogya mu nkwammoaa dodow a ɛba fam.

Hwɛ hu sɛ wo ne wo duruyɛfo bɛkasa afa nea saa nsunsuanso bɔne yi yɛ, bere tenten a ɛbɛtra hɔ, ne sɛnea wobedi ho dwuma ho. Ebia wɔde wo nso bɛkɔ akɔma nnuruyɛfo a wɔyɛ aduruyɛ a ɛma obi ho dwo no . Ɛnyɛ kokoram no fã a etwa to nko na wɔde hwɛ a ɛma wo ho dwo no, na mmom ɛboa wo ma wokura w’asetra mu yiye denam sɛnkyerɛnne ne nea efi mu ba a wubedi ho dwuma wɔ ayaresa no nyinaa mu no so.

Dɛn ne nufu mu kokoram a HER2 nnim no ayaresa dodow?

Wɔ nufu mu kokoram a HER2 nnim nyinaa mu no, nkwa a wonya no dɔɔso kɛse bere a kokoram no wɔ nufu no mu nkutoo na entrɛwee (mpɔtam hɔ fã) sen bere a kokoram no atrɛw akɔ nipadua no akwaa ahorow a ɛwɔ akyirikyiri (e.g., mmerɛbo, ahurututu, amemene, nnompe) (kokoram a ɛtrɛw anaa akyirikyiri fã).Nkwa dodow a kokoram a atrɛw akɔ ntini a ɛbɛn hɔ nkutoo mu nanso ɛntrɛw nkɔ akwaa a ɛwɔ akyirikyiri (ɔmantam fã) mu no wɔ ntam.

Nanso, ɛho hia sɛ wokae sɛ hokwan a wowɔ sɛ wo ho bɛtɔ wo, anaasɛ wo nkɔmhyɛ no gyina nneɛma pɔtee bi a ɛfa wo yare no ho so. Eyinom bi ne baabi a kokoram no atrɛw akodu (afã), sɛ ebia kokoram no wɔ hormone receptor tebea (HR+/HER2- anaa HR-/HER2-), sɛnea kokoram nkwammoaa no yɛ basabasa (grade), mfe a woadi, w’akwahosan nyinaa, ne sɛnea woyɛ w’ade wɔ ayaresa ho. Eyinom yɛ nneɛma a wo duruyɛfo betumi ne wo aka ho asɛm na wakyerɛkyerɛ nea ɛsɛ sɛ wohwɛ kwan mu akyerɛ wo. Akontaabu yɛ nkyɛmu ara kwa, na ɛrenyɛ pɛ mma obiara.

Mɛyɛ dɛn ahwɛ me ho? (Ne ho a wɔhwɛ) .

Sɛ́ ebia woyɛ obi a wowɔ nufu mu kokoram a HER2 nnim ntɛm anaasɛ obi a ɔwɔ kokoram a akɔ anim no, ɛho hia sɛ wugye bere de hwɛ wo ho. Eyi bɛboa wo wɔ nipadua ne adwene nyinaa mu. Nneɛma bi a wubetumi ayɛ ni:

• Gye w’ahome bere a ɛho hia : Ɛyɛ ade a ɛfata sɛ wobɛte ɔbrɛ ne ɔbrɛ nka, esiane kokoram ne kokoram ayaresa nyinaa nti. Sɛ wote nka sɛ woabrɛ a, gye w’ahome na gye w’ahome. Tie wo nipadua.
• Di aduan a ahoɔden wom na ahoɔden wom : Kokoram ayaresa ahorow bi betumi aka w’akɔnnɔ ne sɛnea wopɛ. Nanso bɔ mmɔden sɛ wubedi aduan a ɛkari pɛ na ama woanya aduannuru a wo nipadua hia no. Fa nnuaba, nhabannuru, fiber, ne nnuan a protein pii wom ka ho. Sɛ wunnim nnuan a ɛsɛ sɛ wudi ne nea ɛnsɛ a, wo ne aduan ho ɔbenfo nkasa na ama woanya afotu.
• Apɔw-mu-teɛteɛ (nanso mma ɛntra so) : Ɛho hia sɛ woteɛteɛ w’apɔw mu daa wɔ baabi a ɛfata wo, sɛnea wo duruyɛfo kamfo kyerɛ no. Nantew a emu nyɛ duru anaa yoga mpo betumi ayɛ papa. Ebetumi ama w’ahoɔden ayɛ kɛse, ama wo nkate atu mpɔn, na aboa ma nneɛma bɔne a efi mu ba no so atew. Nanso, bisa wo duruyɛfo apɔw-mu-teɛteɛ ko a ɛfata wo ne dodow a ɛsɛ sɛ woyɛ, a egyina nea woahu ne ayaresa a woanya so.
• Di adwennwen ho dwuma : Ɛyɛ ade a ɛfata sɛ wobɛte adwennwen, dadwen, ne ehu nka wɔ yare a ɛte sɛɛ ho. Hwehwɛ akwan a wobɛfa so adi ho dwuma a ɛyɛ adwuma ma wo. Bere a adwennwen ne ahomegye yɛ adwuma ma ebinom no, ebia afoforo bɛpɛ sɛ wɔde wɔn ho hyɛ adebɔ dwumadi ahorow te sɛ nhoma akenkan, nnwom a wotie, mfoniniyɛ, anaa turoyɛ mu. Fa bere bi si hɔ da biara ma dwumadi biara a ɛbɛboa wo ma wo ho adwo wo na wo ho adwo wo.
• Nya adwene mu mmoa: Ɛho hia sɛ wo ne w’abusuafo ne wo nnamfo paa bɛka wo nkate ho asɛm. Ebetumi nso ama tumi kɛse sɛ wo ne afoforo a wɔredi kokoram a wɔahu ho dwuma no adi nkitaho na woaka wɔn suahu ahorow. Bisa wo duruyɛfo no akuw a wɔboa anaa nhyehyɛe ahorow a wɔyɛ de nya kokoram ho asɛm.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Ɛho hia yiye sɛ wo ne wo duruyɛfo bedi nkitaho bere nyinaa, bere a wɔreyɛ ayaresa no ne bere a wɔasa yare no akyi nyinaa.

• Sɛ wunya sɛnkyerɛnne foforo (sɛ nhwɛso no, ɛyaw a ɛkɔ so tra hɔ, akisikuru foforo, ɛyɛ den sɛ wobɛhome, wo mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu), anaasɛ ɛte sɛ nea wo mprempren sɛnkyerɛnne no reyɛ kɛse a , kɔ wo duruyɛfo nkyɛn anaa bɔ amanneɛ ntɛm ara .
• Sɛ wosa wo yare wie a, wo duruyɛfo bɛyɛ nhyehyɛe bere a wɔde bɛhwɛ wo akyi bere ne bere mu . Hwɛ hu sɛ wubedi saa nhyehyɛe ahorow yi so. Eyinom ne sɛ wobɛhwɛ sɛ ebia asan aba bio, adi ayaresa no mu nsunsuanso bɔne a ɛtra hɔ kyɛ ho dwuma, na woahwɛ wo yiyedi nyinaa. Saa bere a wɔde di akyi yi ho hia titiriw wɔ mfe anum a edi kan wɔ ayaresa akyi . Eyi ne bere a kokoram taa san ba bio.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wo ne wo duruyɛfo rekasa a, nsuro sɛ wubebisa nsɛm biara a wowɔ, ɛmfa ho sɛnea ɛyɛ ketewaa biara. Nsɛmmisa bi a wubetumi abisa de aboa wo ni:

• So me kokoram hormone receptor-positive anaasɛ ɛnyɛ papa?
• Dɛn ne me kokoram no fã ketewaa pɔtee ne ne fã?
• Ayaresa bɛn na wokamfo kyerɛ me? Adɛn?
• Dɛn ne bere tiaa ne bere tenten mu nsunsuanso bɔne a ɛsɛ sɛ yɛhwɛ kwan fi saa ayaresa ahorow yi mu? Dɛn na wobetumi ayɛ de atew wɔn so?
• Bere tenten ahe na ayaresa gye?
• Dɛn na wubetumi aka afa me nkɔmhyɛ ho akyerɛ me?
• So metumi akɔ so ayɛ me da biara da dwumadi ahorow (adwuma, ofie nnwuma) wɔ ayaresa bere mu?
• So nneɛma titiriw bi wɔ hɔ a ɛsɛ sɛ mehwɛ so yiye wɔ m’aduan ne m’apɔw-mu-teɛteɛ ho?
• Dɛn na metumi ayɛ de atew asiane a ɛwɔ hɔ sɛ kokoram bɛsan aba no so?
• Sɛ mehia mmoa dwumadie anaa afotuo a, so metumi anya referral ama no?

Ɛyɛ papa sɛ wobɛkyerɛw nsɛmmisa yi na woabisa, sɛnea ɛbɛyɛ a wo werɛ remfi biribiara.

So eye sɛ wobɛyɛ obi a ɔwɔ HER2 anaasɛ wobɛyɛ nea enye?

Eyi yɛ asɛm a nnipa pii bisa. Nanso ɛyɛ den sɛ yɛbɛma eyi ho mmuae tiawa, efisɛ nokwasɛm ne sɛ ‘egyina’ .

Sɛ nhwɛso no, nufu mu kokoram a ɛwɔ HER2 no taa nyin ntɛmntɛm na ɛyɛ den sen kokoram a HER2 nnim. Nanso, mfaso bi wɔ eyi so. Ayaresa pɔtee bi wɔ hɔ a ebetumi de wɔn ani asi HER2 protein ahorow so, s.e., Herceptin, Perjeta, na etu mpɔn kɛse ma kokoram ahorow a ɛwɔ HER2. Saa ayaresa ahorow yi nyɛ adwuma mma kokoram ahorow a HER2 nnim, efisɛ saa kokoram ahorow no nni HER2 protein pii a wɔde bɛto wɔn ani so.

Ɔkwan foforo so no, sɛ kokoram a `HER2-negative` yɛ `HR+` (hormone receptor-positive), kyerɛ sɛ, `HR+/HER2-` type a, ɛnde hormone ayaresa a etu mpɔn yiye ne ayaresa a wɔde wɔn ani asi so te sɛ `CDK4/6 inhibitors` wɔ hɔ. Nokwarem no, wobu `HR+/HER2-` nufu mu kokoram sɛ ɛwɔ nkɔmhyɛ a eye sen biara wɔ nufu mu kokoram nketewa a ɛwɔ hɔ dedaw no mu.

Nanso sɛ kokoram no yɛ `HER2-negative` (HR-) (hormone receptor-negative), kyerɛ sɛ, ɛyɛ triple-negative a, mpɛn pii no ebetumi ayɛ basabasa sen ahorow afoforo, na ayaresa betumi ayɛ den kakra. Nanso mprempren nnuru a wɔde sa yare, nipadua mu ahoɔden a ɛko tia nyarewa, ne ayaresa foforo a wɔde wɔn ani asi so wɔ hɔ ma ɛno nso.

Enti, ɛrentumi nyɛ yiye sɛ yɛbɛka sɛ biako "ye" anaasɛ "bɔne" sen ɔfoforo no. Ade a ɛho hia sen biara ne sɛ wubehu wo kokoram no fã ketewaa pɔtee no pɛpɛɛpɛ na woanya ayaresa a etu mpɔn sen biara a ɛfata no.

Awiei koraa no, ɛsɛ sɛ meka kyerɛ wo... (Take-Home Message)

Sɛ wohu sɛ wowɔ `HER2-negative` nufu mu kokoram a, ɛyɛ ade a ɛfata sɛ wobɛte ehu ne dadwen nka. Nanso kae sɛ, eyi nyɛ wiase awiei. Nyansahu ne aduruyɛ mu mfiridwuma anya nkɔso kɛse nnɛ, na nnuru a etu mpɔn pii wɔ hɔ a wɔde sa kokoram a ɛte sɛɛ.

Ade a ɛho hia sen biara ne sɛ:

• Tebea yi ho amanneɛbɔ a ɛfata.
• Hu nsakrae a ɛba wo nipadua mu bere nyinaa, titiriw wo nufu mu.
• Sɛ w’adwene mu yɛ wo naa a, kɔ oduruyɛfo nkyɛn bere ano na kɔhwɛ wo ho.
• Wo ne wo duruyɛfo nkasa pefee na fi nokwaredi mu, bisa wo nsɛm nyinaa, na nya ayaresa a wubetumi apaw no ho ntease pa.

Kae sɛ ɛnyɛ wo nkutoo na woretu kwan yi. Nnuruyɛfo, ayarehwɛfo a wɔn ho akokwaw, w’abusua, ne wo nnamfo paa wɔ hɔ a wɔbɛboa wo na wɔaboa wo. Nya adwempa, di wo nnuruyɛfo akwankyerɛ akyi pɛpɛɛpɛ, na nya mmoa a wuhia, na akyinnye biara nni ho sɛ wubetumi agyina tebea yi ano yiye na wo ho atɔ wo. Ɛmmra sɛ wo ho nyɛ den!

` Nufu mu kokoram, HER2-negative, kokoram ho sɛnkyerɛnne, kokoram ayaresa, mmea akwahosan, hormone ayaresa, abiɛsa-negative