Ua haʻi aku kāu kauka iā ʻoe e pili ana i kahi ʻano lāʻau i kapa ʻia ʻo SERMs a i ʻole SERDs no ka mālama ʻana i ka maʻi ʻaʻai umauma? Mai hopohopo, he paʻakikī iki paha kēia mau inoa. I kēia lā, e kamaʻilio mākou ma nā ʻōlelo maʻalahi e pili ana i ko lākou ʻano, pehea lākou e hana ai, a me nā mea e pono ai ʻoe e ʻike e pili ana iā lākou. ʻO kēia nā ʻano lāʻau koʻikoʻi ʻelua e hiki ke kōkua iā mākou e hakakā i ka maʻi ʻaʻai umauma .
He aha nā SERM? Pehea lākou e hana ai?
I ka ʻōlelo maʻalahi, ʻo SERMs (Selective Estrogen Receptor Modulators) he ʻano lāʻau lapaʻau e hoʻōki i ka ulu ʻana o nā hunaola maʻi umauma. Eia naʻe, hana wale lākou ma kahi ʻano maʻi kikoʻī. ʻO ia ke ʻano maʻi i ʻike ʻia ʻo Estrogen Receptor-Positive . ʻO 75% wale nō o nā maʻi umauma i ʻike ʻia ma ko mākou ʻāina no kēia ʻano.
E noʻonoʻo, he mau "antenna" liʻiliʻi kēia mau hunaola kanesa ma ko lākou ʻili. I ka lāʻau lapaʻau, kapa mākou i kēia mau mea loaʻa . Ke hoʻopili ka hormone estrogen i loko o ko mākou kino i kēia mau antenna, loaʻa i ka hunaola kanesa kahi hōʻailona e "māhele a ulu hou."
Eia ka hana a nā SERM :
Hele lākou a ālai i kēlā mau antenna, ʻo ia hoʻi, nā mea loaʻa. A laila, ʻaʻohe wahi o ka hormone estrogen e hele mai ai a hoʻopili iā ia iho. No ka mea, ʻaʻole ia e loaʻa i ka hōʻailona, ua pau ka ulu ʻana o nā hunaola kanesa a ua kāohi nui ʻia paha.
ʻO ka mea nui, ua kapa ʻia ʻo 'selective' no kekahi kumu. ʻOiai ke ālai nei kēia mau lāʻau i ka hana o ka estrogen i loko o nā umauma, ʻae lākou i ka hormone e hana maikaʻi ma nā ʻāpana ʻē aʻe o ke kino, e like me nā iwi a me ka uterus. ʻO ia ka mea e hoʻolilo ai iā lākou i mea kūikawā.
Nā ʻano o SERM a me kā lākou hoʻohana
Aia kekahi mau ʻano nui o SERM i ʻāpono ʻia no ka maʻi ʻaʻai umauma .
| Inoa o ka lāʻau lapaʻau | Nā hihia hoʻohana nui |
|---|---|
| ʻO Tamoxifen |
|
| ʻO Toremifene | |
| ʻO Raloxifene |
No laila he aha nā SERD?
ʻO nā SERD (Selective Estrogen Receptor Downregulators) kahi ʻano lāʻau lapaʻau e hana ikaika iki ana ma mua o nā SERM. E like me nā SERM, ke ālai nei lākou i nā mea loaʻa estrogen. Akā eia kekahi, hoʻemi nā SERD i ka helu o nā mea loaʻa (downregulate) a hoʻololi pū i ka hana o nā mea loaʻa i koe, e hoʻemi ana i ko lākou pono.
Aia i kēia manawa ʻelua ʻano o nā SERD i ʻāpono ʻia:
- ʻO Fulvestrant
- ʻElacestant
Hāʻawi nui ʻia kēia mau mea no nā maʻi ʻaʻai umauma holomua, hormone receptor-positive a me HER2-negative . ʻO ke ʻano o ka HER2-negative ʻaʻohe protein i kapa ʻia ʻo HER2 ma luna o nā hunaola kanesa e kōkua iā lākou e ulu.
Pehea e hoʻohana ai i kēia lāʻau lapaʻau?
- Nā SERM: Loaʻa ka hapa nui o kēia mau mea ma ke ʻano pila . E haʻi aku kāu kauka iā ʻoe e lawe i 20mg a 40mg i kēlā me kēia lā. Inā ʻoe e lawe nei i kēia mau lāʻau lapaʻau e pale aku i ka hoʻi hou ʻana mai o ke kanesa, pono ʻoe e hoʻomau i ka lawe ʻana iā lākou no 5 a 10 mau makahiki.
- Nā SERD: No ka laʻana, hele mai ʻo Fulvestrant ma ke ʻano he inikini.ʻElua. Hāʻawi ʻia kēia mau inikini ʻelua i loko o kahi ʻiʻo ma ka puhaka. Hāʻawi ʻia lākou i ʻekolu manawa i ka malama mua o ka lāʻau lapaʻau a laila hoʻokahi manawa i ka mahina ma hope.
I nā kūlana hea e hāʻawi ʻia ai nā SERM a me nā SERD?
Aia kekahi mau kūlana e kuhikuhi ai kāu kauka i kēia mau lāʻau lapaʻau.
| Manawa kūpono | Wehewehena |
|---|---|
| Ma mua o ke ʻoki kino (Neoadjuvant Therapy) | Inā nui kou puʻupuʻu, hiki ke hāʻawi ʻia kēia lāʻau lapaʻau ma mua o ke ʻoki ʻana e hoʻēmi iā ia a maʻalahi hoʻi ka wehe ʻana. |
| Ma hope o ke ʻoki kino (Adjuvant Therapy) | Hāʻawi ʻia kēia lāʻau lapaʻau e luku i nā hunaola kanesa liʻiliʻi e koe paha ma hope o ke ʻoki ʻana a e pale aku i ke kanesa mai ka hoʻi hou ʻana mai. |
| No ke Kanesa Hope Loa | Inā ua pālahalaha ke kanesa i nā ʻāpana ʻē aʻe o ke kino ma waho o ka umauma, hiki i kēia mau lāʻau lapaʻau ke kōkua i ka kaohi a hoʻolohi paha i kona ulu ʻana. |
| No ka pale ʻana | ʻOiai inā ʻaʻole ʻoe i loaʻa i ka maʻi ʻaʻai umauma, inā ʻoi aku kou pilikia o ka ulu ʻana ma mua o ka awelika ma muli o nā kumu e like me ka genetics, hiki ke kuhikuhi ʻia nā SERM e hōʻemi i kēlā pilikia. |
He aha nā hopena ʻaoʻao a me nā pilikia o kēia mau lāʻau lapaʻau?
E like me nā lāʻau lapaʻau āpau, hiki i kēia ke loaʻa nā hopena ʻaoʻao. Akā, ʻaʻole i loaʻa i nā kānaka a pau. He mea nui e makaʻala i nā hopena ʻaoʻao hiki ke loaʻa.
Nā hopena ʻaoʻao o nā SERM
ʻO nā hopena ʻaoʻao i ʻike pinepine ʻia e like me nā mea i ʻike ʻia i ka wā menopause.
- Nā ʻā wela
- Ka maloʻo o ka ʻōpū, ka hoʻokuʻu ʻana, a i ʻole ke kahe koko māmā
- Nā hou o ka pō
- Ka luaʻi
- Nā loli o ke ʻano
Nā hopena ʻaoʻao kakaikahi akā koʻikoʻi:
- Piʻi iki loa ka pilikia o ka maʻi ʻaʻai uterine
- ʻO nā ʻōpū koko i nā wāwae (Deep Vein Thrombosis, a i ʻole DVT) a i ʻole nā ʻōpū koko i loko o nā māmā (Pulmonary Embolism)
- Nā Cataracts
- ʻO ka lahilahi o nā iwi i nā wahine ma mua o ka menopause
Nā hopena ʻaoʻao o nā SERD
- ʻEha manawa pōkole ma kahi i inikini ʻia
- Ka luaʻi
- ʻEha iwi, ʻiʻo, a i ʻole nā hono
- ʻEha poʻo
- Ka hana nui
- Nā ʻā wela
He mea nui loa: Hiki i nā SERD ke hōʻemi i ka helu o nā platelets, kahi e kōkua ai i ke kāpili ʻana o ke koko. Hiki i kēia ke hoʻonui iki i ka pilikia o ke kahe ʻana o ke koko. Eia kekahi, ʻaʻole ʻōlelo ʻia kēia mau lāʻau lapaʻau ʻelua i ka wā hāpai a inā ʻoe e hoʻāʻo nei e hāpai . He mea nui e hoʻohana i kahi ʻano kaohi hānau ʻole-hormonal i ka wā e lawe ana i kēia mau lāʻau lapaʻau a no ka liʻiliʻi o hoʻokahi makahiki ma hope o ka hoʻōki ʻana i ka lāʻau.
Inā ʻōlelo kāu kauka i kēia lāʻau lapaʻau, e kamaʻilio me ia e pili ana i ia mea. Mai makaʻu e nīnau i nā nīnau e like me, "He aha nā pono e hāʻawi mai ai kēia lāʻau lapaʻau iaʻu?", "He aha nā hopena ʻaoʻao e hiki iaʻu ke manaʻo?", a "Pehea ka lōʻihi e pono ai iaʻu e lawe i kēia lāʻau lapaʻau?"
Leka Lawe-Home
- He mau lāʻau lapaʻau kūpono loa nā SERM a me nā SERD no ka maʻi ʻaʻai umauma estrogen receptor-positive. Ke ālai nei lākou i ka hana o ka hormone estrogen, he mea nui ia no ka ulu ʻana o nā hunaola kanesa.
- ʻAʻole kūpono kēia mau lāʻau lapaʻau a pau no nā kānaka a pau. ʻO kāu kauka wale nō ke hoʻoholo i ka lāʻau lapaʻau maikaʻi loa nou ma muli o ke ʻano o ka maʻi kanesa, kou makahiki, a me kou olakino.
- Hiki ke loaʻa nā hopena ʻaoʻao, akā hiki ke hoʻokele ʻia ka hapa nui o lākou. E kamaʻilio me kāu kauka e pili ana i kekahi ʻeha āu e ʻike ai, ʻaʻohe mea liʻiliʻi.
- He mea nui loa ia e pale i ka hāpai ʻana i ka wā e lawe ana i kēia lāʻau lapaʻau. E hōʻoia e kūkākūkā me kāu kauka e pili ana i nā ʻano hana hoʻomalu hānau kūpono.
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