So mmarima nso betumi anya nufu mu kokoram? (Male Breast Cancer) Momma yɛnka eyi ho asɛm!

Sɛ yɛdwene nufu mu kokoram ho a, yɛdwene mmea ho, ɛnte saa? Nnipa pii susuw sɛ eyi yɛ yare a ɛka mmea nkutoo. Nanso so wunim sɛ mmarima nso betumi anya nufu mu kokoram (Male Breast Cancer). Ampa, ɛho yɛ na kakra. Wɔn a wɔwɔ nufu mu kokoram bɛyɛ 100 biara mu biako pɛ na ɔyɛ ɔbarima. Nanso, yɛrentumi mmu yɛn ani ngu so esiane sɛ ɛntaa nsi nti. Sɛ wuhu sɛ akisikuru anaa akisikuru bi wɔ wo moma so a, nnye no ngu kɛkɛ sɛ "Oh, eyi nnsi mmarima so." Ɛho hia yiye sɛ wode akisikuru biara a ɛyɛ adwenem naayɛ kyerɛ oduruyɛfo na wɔma wɔhwɛ mu.

Dɛn ne Mmarima Nufu mu Kokoram?

Sɛ yɛbɛka no tiawa a, mmarima nufu mu kokoram ne bere a nkwammoaa a ɛwɔ nufu mu ntini a ɛwɔ wo koko mu no fi ase nyin wɔ ɔkwan a ɛnteɛ so na wontumi nni so. Mmarima nso wɔ nufu mu ntini te sɛ mmea ara pɛ, nanso ɛyɛ kakraa bi. Ɛyɛ saa ntini yi mu na kokoram betumi anya.

Ɛho hia yiye sɛ wuhu tebea yi wɔ Sri Lanka nso. Efisɛ, ɛtɔ mmere bi a esiane aniwu anaa adwene a ɛnteɛ a ɛne sɛ "nufu mu kokoram bɛn na ɛyɛ ma mmarima?", nnipa pii twentwɛn wɔn nan ase sɛ wɔbɛkɔ oduruyɛfo nkyɛn bere mpo a wɔwɔ sɛnkyerɛnne ahorow no. Eyi ma hokwan a ɛwɔ hɔ sɛ yare no mu bɛyɛ den no yɛ kɛse.

Dɛn ne mmarima nufu mu kokoram ahorow?

Saa kokoram yi fi ase wɔ nufu mu ntini a ɛwɔ wo moma so no mu. Mmarima nufu, te sɛ mmea de no, wɔ ntini nketenkete a ɛma nufusu (lobules) ne ntini nketenkete (ducts) a ɛde nufusu (sɛ ɛwɔ hɔ a) kɔ nufusu no mu. Nanso, wɔ mmarima mu no, eyinom nyɛ akɛse saa, efisɛ enhia sɛ wɔma wɔn nufu. Enti, mpɛn pii no, kokoram yi fi ase wɔ ntini ahorow no mu. Akwan titiriw abien na ɛwɔ hɔ:

• Ductal Carcinoma: Kokoram a ɛte sɛɛ na ɛma mmarima nufu mu kokoram 10 biara mu bɛyɛ 9 ba. Wɔ saa kokoram yi mu no, kokoram no fi ase wɔ ntini a ɛde nufusu kɔ no mu na afei ɛtrɛw kɔ nufu no afã afoforo. Saa su yi ahorow abien na ɛwɔ hɔ:
• Invasive Ductal Carcinoma: Eyi ne nea abu so sen biara. Kokoram no fi ase wɔ ntini ahorow no mu na ɛtrɛw kɔ nufu mu ntini a atwa ho ahyia no mu.
• Ductal Carcinoma In Situ (DCIS): Eyi ntaa mma kakra. Ɛha yi, kokoram no wɔ ntini no mu na ɛntrɛwee wɔ akyi.

• Lobular Carcinoma: Eyi yɛ kokoram bi a efi ase wɔ ntini a ɛma nufusu (lobules) no mu. Invasive Lobular Carcinoma kyerɛ sɛ atrɛw akɔ ntini a atwa ho ahyia no mu. Nanso, saa ɔkwan yi ho yɛ na koraa wɔ mmarima mu, efisɛ mmarima wɔ lobules kakraa bi pɛ anaasɛ wonni bi koraa.

Nea ɛho hia no, ɛtɔ mmere bi a kokoram nkwammoaa wɔ nneɛma soronko a ɛte sɛ ‘antennae’ a ɛma nipadua no nya nkwaadɔm. Sɛ hormone ahorow bi kyekyere saa antenna ahorow yi a, kokoram nkwammoaa no fi ase kyekyɛ na enyin ntɛmntɛm. Fa no sɛ safe bi a ɛrehwehwɛ ɔpon bi. Wɔ mmarima nufu mu kokoram dodow no ara mu no, .Nneɛma bi wɔ hɔ a ɛma nkwaadɔm a wɔfrɛ no estrogen ne progesterone no yɛ wɔn ade. Ntini mu kokoram a ɛtaa ba mmarima mu ne estrogen receptor-positive (ER+).

Dɛn ne mmarima nufu mu kokoram ho sɛnkyerɛnne?

Mpɛn pii no, sɛnkyerɛnne a edi kan ne akisikuru a ɛyɛ den a ɛnyɛ yaw wɔ nufu no mu, a mpɛn pii no ɛwɔ nufu no ase . Nsɛnkyerɛnne afoforo betumi ayɛ:

• Akuru bi a ɛwɔ abasa mu.
• Wora a ɛwɔ moma so no yɛ mmerɛw, ɛte sɛ borɔdɔma a wɔayam, na ɛte sɛ amena.
• Wora a ɛwɔ koko anaa nufu no so no yɛ kɔkɔɔ na ɛyɛ mmerɛw.
• Ɛyaw anaa ntini a ɛyɛ den a wobɛte nka wɔ wo koko anaa wo abasa mu.
• Nsu a emu da hɔ anaa biribi a ɛte sɛ mogya a efi nufu no mu, anaa nufu a wɔadan no.

Sɛ wuhu biribi te sɛ eyi a, nsusuw kɛkɛ sɛ, "Eyi sii ara kwa." Kɔ oduruyɛfo nkyɛn ntɛm ara.

Dɛn na ɛde mmarima nufu mu kokoram ba?

Sɛ yɛbɛka no pɛpɛɛpɛ a, nsakrae a ɛba nufu mu nkwammoaa mu wɔ DNA, anaa nkwaadɔm mu nsakrae mu na ɛde nufu mu kokoram ba. Saa nkwammoaa a wɔasakra no yi fi ase kyekyɛ ntɛmntɛm a wontumi nni so, a enwu. Awiei koraa no, kokoram nkwammoaa yi bom yɛ akisikuru. Ɛtɔ mmere bi a, saa akisikuru yi asinasin betumi abubu na atrɛw akɔ nipadua no afã afoforo denam ntini a ɛma mogya tu anaa mogya no so. Sɛ eyi ba a, wɔfrɛ no kokoram a ɛtrɛw kɔ mmeae afoforo.

Nyansahufo da so ara reyɛ nea enti a nkwammoaa a ɛte apɔw dan kokoram nkwammoaa mu nhwehwɛmu.

Nneɛma a Ɛde Asiane Ba

Nneɛma bi betumi ama asiane a ɛwɔ hɔ sɛ wubenya nufu mu kokoram no ayɛ kɛse. Momma yɛnhwɛ nea wɔyɛ:

• Mfe a woadi: Asiane a ɛwɔ hɔ sɛ wubenya yare yi kɔ soro kakra bere a worenyin no. Wɔtaa hu mmarima nufu mu kokoram wɔ nnipa a wɔadi boro mfe 60. Ɛno nkyerɛ sɛ ɛnyɛ mmerante ne mmabaa so, nanso asiane no kɔ soro bere a obi nyin no.
• Abusua abakɔsɛm a wofi awosu mu: Sɛ wo maame, wo papa, wo nuabarima, wo nuabea, anaa wo ba anya nufu mu kokoram anaa awotwaa mu kokoram a, asiane kɛse wom. Eyi te saa efisɛ kokoram ahorow bi tumi fa awosu mu nkwaadɔm mu.
• Awosu mu nkwaadɔm: Awosu mu nsakrae ahorow bi ma asiane a ɛwɔ hɔ sɛ obi benya nufu mu kokoram no yɛ kɛse. Eyinom mu nea abu so kɛse ne BRCA1 ne titiriw no BRCA2. Afei nso, nsakrae a ɛba PTEN awosu mu abɔde a ɛwɔ Cowden yare mu, TP53 awosu mu abɔde a ɛwɔ Li-Fraumeni yare mu, ne MMR awosu mu abɔde a ɛwɔ Lynch yare mu no nso betumi ama asiane no ayɛ kɛse.
• Estrogen hormone a ɛkɔ soro:Ayaresa mu tebea horow bi te sɛ mmerɛbo mu yare, kɛseyɛ mmoroso, anaa awosu mu tebea bi a wɔfrɛ no Klinefelter syndrome betumi ama estrogen dodow akɔ soro wɔ nipadua no mu. Nsã a wɔnom boro so nso betumi de aba.
• Nsɛm a ɛfa awotwaa ho: Sɛ wɔayɛ wo oprehyɛn ayi wo mmadwoa no biako (orchiectomy), sɛ woanya ahodwiriw bi wɔ wo mmadwoa mu, anaasɛ wowɔ tebea bi te sɛ orchitis, anaasɛ wowɔ awotwaa a ensii fam a, wowɔ asiane kɛse mu.
• Mframa a wɔde sa yare: Sɛ woadi kan de mframa a wɔde sa wo moma so a, asiane a ɛwɔ hɔ sɛ wubenya nufu mu kokoram no betumi ayɛ kɛse.

Ɔkwan bɛn so na wobetumi atew asiane no so?

Sɛ wususuw sɛ ebia wowɔ awosu mu nsakrae bi a ɛma asiane a ɛwɔ hɔ sɛ wubenya kokoram no yɛ kɛse a, ɛyɛ papa sɛ wobɛyɛ awosu mu nhwehwɛmu. Sɛ obi a ɔwɔ w’abusua mu anya nufu anaa awotwaa mu kokoram a, ɛno yɛ sɛnkyerɛnne a ɛkyerɛ sɛ ebia wowɔ BRCA2 awosu mu nkwaadɔm mu nsakrae no. Ɛnyɛ nufu mu kokoram nko na saa awosu mu nsakrae yi betumi de aba, na mmom honam ani kokoram (melanoma), dwensɔtwaa mu kokoram, ne prostate kokoram nso.

Oduruyɛfo betumi aboa wo ma woasi gyinae sɛ ebia awosu mu nhwehwɛmu fata wo anaa.

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Sɛ wokɔ oduruyɛfo nkyɛn a, obebisa wo wo yare no ho sɛnkyerɛnne ne nneɛma a ɛde asiane ba. Afei wɔbɛyɛ nhwehwɛmu pii de ahu sɛ wowɔ mmarima nufu mu kokoram anaa:

• Nufu mu nhwehwɛmu: Oduruyɛfo no bɛte wo nufu mu ntini nka na wahwɛ sɛ honam ani nsakrae, akuru, anaa nneɛma afoforo a ɛnteɛ biara wɔ hɔ anaa.
• Mfonini a wɔde yɛ nhwehwɛmu: Mammogram tumi hu nufu mu kokoram dodow no ara wɔ mmarima mu. Eyi gye X-ray a wɔde yɛ nufu no. Ɛtɔ mmere bi a wobetumi ayɛ ultrasound ansa na wɔayɛ mammogram no anaasɛ wɔayɛ no akyi de asua pii afa akisikuru no ho.
• Biopsy: Eyi ne ɔkwan a eye sen biara a wobɛfa so anya awerɛhyem . Oduruyɛfo no yi ntini ketewaa bi fi akuru anaa baabi a ɛyɛ adwenem naayɛ no mu na ɔde kɔ aduruyɛdan mu ma wɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ kokoram nkwammoaa mu.

Wɔ lab no, nyarewa ho animdefo hwehwɛ ntini a wɔde yɛɛ nhwɛso no mu hwɛ sɛ ebia kokoram nkwammoaa wɔ mu, ne sɛ ebia ɛwɔ hormone receptors a yɛadi kan aka ho asɛm no, ne sɛ ebia ɛwɔ HER2 receptor (protein a ɛboa ma kokoram nyin). Saa nsɛm yi bɛboa wo duruyɛfo kɛse wɔ w’ayaresa ho nhyehyɛe mu.

Mmarima nufu mu kokoram fã ahorow

Sɛ wohu kokoram wie a, nnuruyɛfo bɛkyerɛ ne `stage`. Eyi kyerɛ sɛ wobɛhwɛ akisikuru no kɛse ne beae a ɛwɔ ahwɛ baabi a atrɛw akodu ne sɛnea ɛyɛ aniberesɛm. Saa berɛ yi, wobɛtumi nso anya `imaging` sɔhwɛ foforɔ, ne `sentinel node biopsy` nso. Nea ɛka eyi ho ne sɛ wobeyi ntini biako anaa nea ɛboro saa a ɛbɛn akisikuru no afi hɔ de ahwɛ sɛ kokoram nkwammoaa wɔ hɔ anaa.

Nneɛma atitiriw a ɛma mmarima nufu mu kokoram nya ne:

• Ɔfã 0: Kokoram nkwammoaa no wɔ nufu mu ntini no mu nkutoo. Wɔsan frɛ eyi Ductal Carcinoma In Situ.
• Ɔfã I: Akisikuru no sua na ɛntrɛw nkɔ ntini a ɛma mogya tu no mu.
• Ɔfã II: Akisikuru no sõ kakra sen ɔfã I. Ebia atrɛw akɔ axillary lymph nodes pii mu.
• Ɔfã III: Kokoram no atrɛw akɔ ntini ahorow pii mu, ebia akisikuru no yɛ kɛse, na ebia kokoram nkwammoaa atrɛw akɔ koko no fasu anaa honam ani.
• Ɔfã IV: Kokoram nkwammoaa atrɛw akɔ nipadua no afã horow a ɛwɔ akyirikyiri. Wɔ mmarima nufu mu kokoram mu no, mmeae a ɛtaa trɛw ne nnompe, ahurututu, ne mmerɛbo .

Ɔkwan bɛn so na wɔsa mmarima nufu mu kokoram?

Ayaresa a wobɛnya no begyina nneɛma pii so, a kokoram ko ne baabi a atrɛw akodu (ɔfã) ka ho. Ebia ebehia sɛ woma wɔyɛ ayaresa ahorow pii nnidiso nnidiso. Wo duruyɛfo bɛkyerɛkyerɛ eyi mu akyerɛ wo kɔ akyiri.

Sɛɛgyiri

Ayaresa a wɔtaa de sa mmarima nufu mu kokoram a edi kan ne oprehyɛn. Mpɛn pii no, woyi nufu no nyinaa fi hɔ. Wɔfrɛ eyi mastectomy . Ɛtɔ mmere bi a, wɔyɛ lumpectomy, a eyi akisikuru no nkutoo, nso, nanso wɔ mmarima fam no, nufu a wotwa ne nea abu so sen biara.

Ɛtɔ da bi a wɔyɛ ``radical mastectomy``. Wɔ eyi mu no, woyi nufu mu ntini nyinaa, ntini a ɛwɔ abasa no mu, ne koko mu ntini no fã bi fi hɔ. Nanso seesei nea ɛtaa ba ne ``modified radical mastectomy.`` Wɔ eyi mu no, wonyi ntini mu ntini no mfi hɔ, na woyi ntini kakraa bi nso fi hɔ.

Mframa a wɔde sa yare

Mframa a wɔde sa nufu mu kokoram no de X-ray anaa mframa ahorow afoforo a ahoɔden wom di dwuma de sɛe kokoram nkwammoaa. Wɔtaa de saa ayaresa yi ma bere a wɔatwa lumpectomy akyi de akum kokoram nkwammoaa biara a aka no. Ɛtɔ mmere bi a, mframa a wɔde sa yare no tumi kum kokoram nkwammoaa nketenkete a oprehyɛn ntumi nyi mfi hɔ na ɛbɛn koko fasu anaa honam ani. Eyi betumi aboa ma akisikuru no annyin bio.

Nnuru a wɔde sa yare

Nnuru a wɔde sa yare yɛ nnuru titiriw a wɔde kum kokoram nkwammoaa a ɛwɔ nipadua no mu nyinaa. Wɔ akisikuru a ɛwɔ baabi (a ɛnyɛ hu) ho no, wobetumi de nnuru a wɔde sa yare ama ansa na wɔayɛ oprehyɛn de atew akisikuru no so. Anaasɛ, wobetumi de nnuru a wɔde sa yare ama wɔ oprehyɛn akyi denam mframa a wɔde sa yare so na ama asiane a ɛwɔ hɔ sɛ akisikuru bɛsan aba anaasɛ kokoram no atrɛw akɔ nipadua no afã afoforo no so atew. Wɔmfa saa ayaresa ahorow yi mma bere koro mu, na mmom mmiako mmiako.

Hormone ayaresa

Sɛ kokoram nkwammoaa de nkwaadɔm te sɛ estrogen di dwuma ma enyin a, nnuruyɛfo de hormone ayaresa di dwuma de brɛ estrogen dodow ase anaasɛ esiw ne nkɛntɛnso ano. Tamoxifen yɛ aduru a wɔtaa de sa mmarima nufu mu kokoram. Afei nso, nnuru a wɔfrɛ no aromatase inhibitors, sɛ wɔde ka gonadotropin-releasing hormone (GnRH) agonists ho a, ebetumi asiw kokoram nkwammoaa a hormone ahorow de ba no nyin ano.

Ayaresa a wɔde wɔn ani asi so

Ayaresa ahorow a wɔde wɔn ani asi so no yɛ adwuma denam nneɛma pɔtee bi a ɛboa ma kokoram nkwammoaa nyin a ɛde ne ho hyɛ mu no so. Saa ayaresa ahorow yi yɛ adwuma wɔ kokoram nkwammoaa ahorow pɔtee bi nkutoo so. Sɛ nhwɛso no, ayaresa ahorow bi yɛ adwuma wɔ nufu mu kokoram a ɛwɔ hormone receptors nkutoo so. Ayaresa ahorow nso wɔ hɔ, te sɛ nnuru a esiw PARP ano, ma kokoram nkwammoaa a wɔwɔ BRCA awosu mu nkwaadɔm mu nsakrae.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ akisikuru bi a wontumi nkyerɛkyerɛ mu wɔ wo nufu mu a ɛnkɔ wɔ adapɛn abien akyi a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn. Afei nso, di wo duruyɛfo akwankyerɛ a ɛfa mpɛn dodow a ɛsɛ sɛ woyɛ kokoram ho nhwehwɛmu ho akyi.

Sɛ mewɔ mmarima nufu mu kokoram a, dɛn na ɛba? (Nkɔmhyɛ) .

Kokoram ko ne gyinabea a ɛwɔ mu no ka sɛnea wo yare no kɔ so kɛse, kyerɛ sɛ, nea ɛbɛba daakye. Sɛ wohu no ntɛm a, dodow a wɔde sa yare no dɔɔso koraa.

Nnansa yi nhwehwɛmu bi daa no adi sɛ mmarima a wɔwɔ nufu mu kokoram (hormone-responsive - `HR+` type) a wowuwu wɔ kokoram gyinabea mu no yɛ: Wɔ mfe 20 akyi bere a wohuu no:

• Ɔfã I: 12.4% wuwui wɔ nufu mu kokoram mu.
• Ɔfã II: 26.2% wuwui wɔ nufu mu kokoram mu.
• Ɔfã III: Na 46% awuwu wɔ nufu mu kokoram mu.

Nea ɛyɛ awerɛhow no, mmarima pii twentwɛn wɔn nan ase sɛ wɔbɛkɔ oduruyɛfo nkyɛn. Ne saa nti, bere a wobehu sɛ wɔwɔ kokoram no, na kokoram no akɔ anim koraa dedaw, na ɛma ɛyɛ den sɛ wɔbɛsa.

Ɛno nti na yɛka sɛ, sɛ wuhu akuru bi a ɛyɛ soronko wɔ wo nufu mu a, kɔ oduruyɛfo nkyɛn ntɛm ara. Mmarima pii nsusuw sɛ wɔwɔ nufu mu kokoram. Enti ebia wɔrenhu sɛnkyerɛnne ahorow no. Nanso mmarima nya nufu mu kokoram ampa.Sɛ wuhu wo ntɛm na wosa wo yare a, ebetumi agye wo nkwa. Sɛ obi a ɔwɔ w’abusua mu anya nufu mu kokoram a, wo ne wo duruyɛfo nkasa mfa sɛnea wubehu kokoram ntɛm.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Okay, enti momma yɛnbɔ nneɛma bi a ɛsɛ sɛ wokae fi nea yɛaka ho asɛm no mu no mua:

• Mmarima nso betumi anya nufu mu kokoram. Ɛwom sɛ ɛntaa nsi de, nanso mmu w’ani ngu so.
• Nufu no mu akisikuru a ɛnyɛ yaw , titiriw wɔ nufu no ase no betumi ayɛ sɛnkyerɛnne titiriw. Hwɛ nso sɛ akisikuru wɔ abasa mu, honam ani nsakrae, ne nufusu mu nsu a ɛtɔ.
• Asiane no yɛ kɛse sɛ obi a ɔwɔ w’abusua mu anya nufu mu kokoram, sɛ woadi boro mfe 60, anaasɛ wowɔ awosu mu tebea horow bi (BRCA).
• Sɛ w’adwene mu yɛ wo naa a, nfɛre na kɔ oduruyɛfo nkyɛn ntɛm. Nhwehwɛmu te sɛ mammogram ne biopsy betumi asi yare no so dua.
• Sɛ wɔkyere no ntɛm a, hokwan a ɛwɔ hɔ sɛ wobenya ayaresa no yɛ kɛse koraa! Ayaresa ahorow wɔ hɔ a wobetumi apaw, te sɛ oprehyɛn, mframa a wɔde sa yare, nnuru a wɔde sa yare, ne hormone ayaresa.

Sɛ wuhu eyi a, ebetumi ama nsakrae kɛse aba w’asetra ne mmarima afoforo a wunim wɔn asetra mu. Kɔ so nya apɔwmuden!

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