Esesẽ be nàgblɔ vɔvɔ̃ kple dzidziƒoame si nèsena le ɖokuiwò me ne èva nya be no me dɔdzẽ le ye ŋu. Nyabiase geɖe ŋutɔ le susu me na wò. Enye nusi sɔ be nyabiasewo abe, "Nukatae nusia dzɔ ɖe dzinye?", "Nukae mawɔ fifia?", "Ðe woateŋu ada esia?". Le mɔzɔzɔ sia me la, mele agbagba dzem be maɖe nuwo me bɔbɔe eye maɖe gbe si gɔme nàte ŋu ase me. Kansa ƒomevi si tututu le ŋuwò nyanya le abe futɔa gɔmesese hafi adze aʋa gɔme ene. Emae nye afɔɖeɖe gbãtɔ kple vevitɔ kekeake si nàwɔ le atikewɔwɔ si sɔ na wò tiatia me.
Hormone Receptor-Positive No me Dɔdzẽ
Esiae nye no me dɔdzẽ ƒomevi si bɔ wu. Ne míagblɔe teti la, no me dɔdzẽ 100 ɖesiaɖe dometɔ siwo ade 80 dzena le hatsotso sia me.
Eyata nukae "nusi nɔa te ɖe lãmetsiŋusẽ dzi" sia fia?
Bu eŋu kpɔ ko. Lãmetsiŋusẽ eve siwo le dzɔdzɔme nu siwo woyɔna be estrogen kple progesterone , le míaƒe ŋutilã me, vevietɔ nyɔnuwo ƒe ŋutilã. Esiawo le vevie na dɔwɔwɔ siwo sɔ le míaƒe ŋutilã me. Gake kansa lãmenugbagbevi aɖewo "zu numame na" lãmetsi siawo ŋutɔ. Eyae nye be le kansa lãmenugbagbevi siawo ƒe anyime la, "nuxɔla" alo ʋɔtru sue aɖewo koe li siwo dzi lãmetsi siawo ate ŋu ava lé ɖe wo ŋu. Ne estrogen hormone la va ƒo ʋɔ ma la, kansa lãmenugbagbevi la xɔa nunyiame tso eme eye wòdzea tsitsi kple mama gɔme. Abe alesi ko ne ède tsi numiemie aɖe ene la, etsina ɖe edzi.
Ne wò atikewɔwɔ ŋuti nyatakaka gblɔ be `ER-positive` (Estrogen Receptor-Positive) la, efia be wò kansa lãmenugbagbeviwo sea veve ɖe lãmetsi si nye estrogen nu. Ne egblɔ be `PR-positive` (Progesterone Receptor-Positive) la, efia be esea veve ɖe lãmetsi si nye progesterone nu. Ne esea veve ɖe nusiawo dometɔ ɖesiaɖe nu la, woyɔa kansa la be kansa si me lãmetsiŋusẽ ƒe dɔlékuiwo xɔna .
Le nyateƒe me la, nya nyui aɖee esia nye le mɔ aɖe nu. Elabena ne míenya nusi kansa zãna tsɔ tsina la, míate ŋu axe mɔ ma eye míaɖu kansa la dzi. Emae nye nusi wozãna "hormone therapy" na.
Zi geɖe la, wowɔa lãmetsiŋusẽdɔdamɔnu le amekoko, atikewɔmɔnu, alo keklẽŋusẽ zazã vɔ megbe be kansa nagatrɔ ava o. Atike siawo wɔa dɔ to "ʋɔtruwo" tutu me le kansa lãmenugbagbeviwo ŋu, alo to mɔxexe ɖe ŋutilãa nu be wòagawɔ estrogen o.
| Atikewɔwɔ ƒe hatsotso | Numeɖeɖe bɔbɔe kple kpɔɖeŋuwo |
|---|---|
| SERMs (ER Modulators Tiatia) . | Esiawo xea mɔ na lãmetsiŋusẽ si xɔa kansa lãmenugbagbevi la, si wɔnɛ be lãmetsiŋusẽa mete ŋu gena ɖe eme o. Kpɔɖeŋuwo: Tamoxifen, Toremifene . |
| SERDs (Estrogen Xɔla ƒe Nugblẽnu Tiatia) . | Menye ɖeko esiawo xea mɔ na xɔla la ko o, ke wogblẽnɛ hã. Kpɔɖeŋuwo: Fulvestrant (Faslodex), Elacestrant (Orserdu) . |
| Aromatase Mɔxenuwo | Esiawo xea mɔ na ŋutilãa be wòagawɔ lãmetsi si nye estrogen (si wonana nyɔnu siwo tsi dzinu megbe zi geɖe). Kpɔɖeŋuwo: Anastrozole (Arimidex), Letrozole (Femara) . |
| LHRH Agonisttɔwo | Esiawo xea mɔ na azigoloawo be womegawɔa estrogen o hena ɣeyiɣi aɖe. Kpɔɖeŋuwo: Goserelin (Zoladex), Leuprolide (Lupron) . |
| Atikewɔmɔnu Bubu Siwo Woɖo Ðe Edzi | Atike bubu siwo nana lãmetsiŋusẽ zazã ƒe dzidzedzekpɔkpɔ dzina ɖe edzi. Kpɔɖeŋuwo: Palbociclib (Ibrance), Ribociclib (Kisqali), Alpelisib (Piqray) . |
HER2-Positive No me Dɔdzẽ
Azɔ mina míaƒo nu tso ƒomevi bubu aɖe ŋu. No me dɔdzẽ ƒe lãmenugbagbevi aɖewo (anɔ abe kansa katã ƒe 20%) wɔa protein tɔxɛ aɖe si woyɔna be HER2 (Human Epidermal growth factor Receptor 2) fũ akpa le woƒe gowo dzi .
Bu HER2 be enye antenna sue aɖe si gblɔna na kansa lãmenugbagbevi be "wòatsi kabakaba, ama kabakaba." Antenna siawo dometɔ ʋɛ aɖewo koe le lãmenugbagbevi si sɔ me. Gake antenna siawo dometɔ geɖe le kansa lãmenugbagbevi si me HER2 le me. Esia tae kansa siawo ƒomevi ate ŋu awɔ nuvevi ame wu ɖo .
Gake nya nyui aɖe le afisia hã. Esi dzɔdzɔmeŋutinunya le ŋgɔ yim ta la, " dɔdamɔnu siwo woɖo taɖodzinu na " li fifia siwo tɔa ŋku HER2 antenna siawo tututu hetsrɔ̃a wo. Esi wònye be lãmenugbagbevi siwo me HER2 sɔ gbɔ ɖo koe amesiawo dia eye wodzea wo dzi ta la, nu megblẽna le lãmenugbagbevi siwo sɔ ŋu boo o.
Atike vevitɔ si wɔa dɔ wu si wonana na esiae nye Trastuzumab (Herceptin) . Esia kpena ɖe ame ŋu ŋutɔ le mɔxexe ɖe kansa la ƒe tɔtrɔgbɔ nu me. Gake afɔku sue aɖe li be wòakpɔ ŋusẽ aɖewo ɖe dzi alo lãkusi dzi ne wole atike sia zãm. Mègatsi dzi ɖe ema ŋu o , wò ɖɔkta akpɔe ɖa ɣesiaɣi.
| Atikewɔmɔnu bubu siwo woɖo taɖodzinu na siwo wozãna na kansa siwo me HER2 le | |
|---|---|
| Atike si woyɔna be Pertuzumab (Perjeta) . | Atike si nye ado-trastuzumab si nye emtansine (Kadcyla) . |
| Lapatinib (Tykerb) ƒe atike . | Neratinib (Nerlynx) ƒe atike . |
| Tucatinib (Tukysa) ƒe atike . | Enhertu (Fam-trastuzumab deruxtecan-nxki) ƒe dɔlékuiwo ƒe dɔwɔwɔ. |
"Etɔ̃-Negative" No me Dɔdzẽ
Esiae nye ƒomevi vevitɔ etɔ̃lia. No me dɔdzẽ siwo ade 10%-20% dzena ɖe ƒomevi sia me. Ènya nusita woyɔnɛ be "triple-negative" alo "triple negative"a?
Elabena le kansadɔlékui siawo me la , .
1. Estrogen-xɔla (ETU) aɖeke meli o .
2. Progesterone xɔla (PR) aɖeke meli o .
3. HER2 protein geɖe mele eme o .
Esi wònye be kansa lãmenugbagbevi siawo mekpɔa taɖodzinu vevi etɔ̃ siwo ŋu míeƒo nu tsoe va yi o ta la, lãmetsiŋusẽ ƒe atikewɔwɔ alo HER2-dɔdamɔnu siwo woɖo taɖodzinu na abe Herceptin ene mewɔa dɔ ɖe wo dzi o. Eyata wo dada ate ŋu asesẽ vie.
Zi geɖe la, BRCA1 gbɔe kansa sia ƒomevi tsona.Edo ƒome kple domenyiŋusẽfianu aɖe si woyɔna be . Eyata ne kansa si me dɔléle etɔ̃ le le ŋuwò la, wò ɖɔkta ate ŋu aɖo aɖaŋu hã be nàdo domenyiŋusẽfianu kpɔ.
Amekoko, atikewɔmɔnu, kple keklẽŋusẽ koŋue wotsɔ daa dɔ sia ƒomevi . Gake fifia la, atikewɔmɔnu yeye siwo ku ɖe dɔ sia ƒomevi koŋ ŋu la li fifia.
- PARP Mɔxenuwo: Wozãa atikewo abe Olaparib (Lynparza) kple Talazoparib (Talzenna) na amesiwo ŋu BRCA domenyiŋusẽfianu ƒe tɔtrɔ le. Esiawo xea mɔ na kansa lãmenugbagbeviwo ƒe ŋutete be woaɖɔ wo ɖokui ɖo.
- Dɔlélenutsiŋutete ƒe dɔdamɔnu: Atikewo abe Atezolizumab (Tecentriq) kpena ɖe ame ŋu be míawɔ avu kple kansa lãmenugbagbeviwo to mía ŋutɔwo ƒe dɔlélenutsiŋutete ƒe lãmenugbagbeviwo zazã me.
Esiawo katã ate ŋu adze nu sesẽ vie. Ema sɔ. Nu vevitɔe nye be nàɖo ŋku edzi be kansa ka ƒomevie ɖale ŋuwò o, atikewɔmɔnu aɖewo li egbea siwo sɔ nɛ. Wò ɖɔkta kple atikewɔlawo ƒe ƒuƒoƒo awɔ dɔ kpli wò be woawɔ atikewɔwɔ ƒe ɖoɖo nyuitɔ kekeake na wò.
Gbedasi si Wotsɔ Yi Aƒeme
- Woma no me dɔdzẽ ɖe hatsotso vevi 3 me: Lãmetsiŋusẽ ƒe Xɔla-Dzɔdzɔe, HER2-Nɔnɔme, kple Triple-Negative .
- Kansa ƒomevi si le ŋuwò nyanya le vevie ŋutɔ be nàwɔ ɖoɖo ɖe edada ŋu.
- Kansa siwo me lãmetsiŋusẽ le wɔa nu nyuie ne wotsɔ lãmetsiŋusẽ ƒe atikewɔwɔ.
- Togbɔ be kansa siwo me HER2 le tsina kabakaba hã la, atikewɔmɔnu siwo ŋu wotrɔ asi le siwo wɔa dɔ nyuie ŋutɔ li siwo woto vɛ na wo koŋ.
- Togbɔ be kansa siwo me dɔléle etɔ̃ le dada sesẽ hã la, woate ŋu atsɔ atikewɔmɔnu kple atikewɔmɔnu yeye siwo ŋu woɖo taɖodzinu ɖo awɔ avu kplii.
- Ne nya aɖe le asiwò ku ɖe nane ŋu le wò atikewɔwɔ ŋuti nuŋlɔɖi me la, mègavɔ̃ be yeabiae o . Bia wò ɖɔkta be wòana numeɖeɖe si me kɔ. Menye wò ɖeka koe o, eye ame geɖewo li siwo ate ŋu akpe ɖe ŋuwò.
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