He aha nā SERM? E aʻo kākou e pili ana i kēia lāʻau no ka maʻi ʻaʻai umauma a me ka osteoporosis (Selective Estrogen Receptor Modulators)

Ua lohe paha ʻoe i ke kanesa o ka umauma, a i ʻole ka osteoporosis. I kēia lā e kamaʻilio mākou e pili ana i kahi papa kūikawā o nā lāʻau lapaʻau i hoʻohana ʻia e mālama i kēia mau kūlana ʻelua. Ua kapa ʻia lākou ʻo Selective Estrogen Receptor Modulators, a i ʻole SERM no ka pōkole. ʻOiai ke kani iki nei ka inoa i ka ʻepekema, he maʻalahi loa ke ʻano o kā lākou hana. E nānā kākou i ke ʻano o nā SERM a pehea lākou e hoʻopilikia ai i ko mākou kino.

I ka ʻōlelo maʻalahi, he aha kēia mau SERM?

ʻO nā SERM kahi ʻano lāʻau lapaʻau e kāohi a hoʻololi paha i ke ʻano o ka hana ʻana o ka hormone estrogen i loko o ko mākou kino. E noʻonoʻo i ka estrogen ma ke ʻano he kī. Loaʻa i nā cell o ko mākou kino nā receptors e kūpono i kēia kī. Ke hoʻopaʻa ka estrogen i kēia mau receptors, loaʻa i kēlā mau cell kekahi mau leka. No ka laʻana, he leka e haʻi ana iā lākou e "ulu."

Hana maikaʻi loa nā SERM. Pale lākou i ka estrogen mai ke komo ʻana i loko o ka lua kī ma kekahi mau wahi o ke kino. A, ma nā wahi ʻē aʻe o ke kino, hana kēia mau lāʻau lapaʻau e like me ka estrogen . ʻO ia hoʻi, hana ka lāʻau lapaʻau hoʻokahi i ʻelua mau mea, ma muli o ka wahi. Ua like ia me ke kanaka hoʻokahi e hana ana ma ke ʻano he mea pale i kekahi manawa a ma ke ʻano he mea kōkua i kekahi.

ʻO ʻelua o nā lāʻau lapaʻau i hoʻohana nui ʻia ma kēia hui ʻo tamoxifen lāua ʻo raloxifene .

Pehea e hana ai kēia mau SERM?

E like me kā mākou i ʻōlelo ai ma mua, hana like ʻole kēia ma nā wahi like ʻole. E wehewehe iki kākou i kēlā.

1. E pili ana i ka maʻi ʻaʻai umauma: Aia kekahi mau ʻano maʻi ʻaʻai umauma i kōkua ʻia e ulu e ka hormone estrogen. Kāhea mākou i kēia mau mea he hormone receptor (HR) maikaʻi a i ʻole estrogen receptor (ER) maikaʻi ka maʻi ʻaʻai umauma. Loaʻa i kēia ʻano o nā cell maʻi ʻaʻai nā wahi ma ko lākou ʻili kahi e hoʻopaʻa ai ka estrogen. Ke hoʻopaʻa ka estrogen i kēia mau wahi, loaʻa i nā cell maʻi ʻaʻai kahi leka e haʻi ana iā lākou e "māhele a ulu hou." Hana nā SERM ma ke ālai ʻana i kēia mau wahi ma mua o ka hana ʻana o ka estrogen. Ua like ia me ke kau ʻana i ke kī hewa i loko o kahi puka kī. A laila ʻaʻole hiki i ka estrogen kūpono ke hiki i ke kī a hoʻopaʻa. Hoʻōki kēia i nā cell maʻi ʻaʻai mai ka loaʻa ʻana o ka leka e ulu.

2. Ola kino o ka iwi: Ma ka ʻaoʻao ʻē aʻe, he hormone koʻikoʻi ka estrogen no ka mālama ʻana i ko kākou mau iwi i ikaika. ʻOi loa ma hope o ka menopause, emi iho ka pae estrogen o nā wahine, kahi e hoʻonui ai i ka pilikia o ka nalowale o ka iwi, a i ʻole ka osteoporosis . I kēia manawa, hana nā SERM ma nā ʻāpana iwi e like me ka estrogen . ʻO ia hoʻi, hele lākou i nā iwi a hāʻawi iā lākou i ka leka, "E noho ikaika, mai lilo ka calcium."

I nā hihia hea e hoʻohana ʻia ai nā SERM?

Paipai nui nā kauka i kēia lāʻau lapaʻau ma nā kūlana he nui.

No ka maʻi ʻaʻai umauma

• No nā wahine i ka piʻi ʻana o ka pilikia o ka maʻi ʻaʻai umauma ER-positive: Inā ua loaʻa i kekahi o ka ʻohana kēia maʻi ʻaʻai, a inā ua hōʻoia ka hoʻāʻo genetic he mau hoʻololi genetic ko lākou e hoʻonui ai i ka pilikia o ka maʻi ʻaʻai, hāʻawi ʻia kēia lāʻau lapaʻau iā lākou e pale aku i ka maʻi ʻaʻai ma mua o ka ulu ʻana.
• No ka poʻe i hana ʻia i ke ʻoki kino no ke kanesa o ka umauma: Ma hope o ke ʻoki kino, hāʻawi ʻia kēia mau lāʻau lapaʻau e pale i ka hoʻi hou ʻana mai o ke kanesa (recurrence). Kōkua pū lākou i ka pale ʻana i ka ulu ʻana o ke kanesa ma ka umauma olakino ʻē aʻe.
• No DCIS (Ductal Carcinoma in Situ): He kahua mua loa kēia o ka maʻi ʻaʻai umauma. Hoʻohana ʻia nā SERM e pale i kēia maʻi mai ka laha hou aku.
• No ke kanesa o ka umauma i laha i nā ʻāpana ʻē aʻe o ke kino (Metastatic Breast Cancer): Hāʻawi ʻia kēia lāʻau lapaʻau e kāohi i ke kanesa.
• No ke kanesa umauma kāne: ʻAe, hiki i nā kāne ke loaʻa i ke kanesa umauma. Hoʻohana ʻia ʻo Tamoxifen no nā maʻi kanesa ER-positive.

No ka osteoporosis

Hoʻohana ʻia kahi lāʻau i kapa ʻia ʻo raloxifene e kāohi i ka nalowale o ka iwi ma hope o ka menopause a hōʻemi i ka pilikia o nā haki.

Pehea ka holomua o kēia lāʻau lapaʻau?

ʻAe, he mau lāʻau lapaʻau maikaʻi loa kēia. E nānā kākou i kekahi o nā mea i loaʻa mai nā haʻawina:

• ʻO ka hāʻawi ʻana i ka tamoxifen i nā wahine kiʻekiʻe ka pilikia i hala ʻole i ka menopause hiki ke hōʻemi i ka pilikia o ka maʻi ʻaʻai umauma ma kahi o 40% .
• Inā lawe ka mea i hana ʻia i ke ʻoki no ka maʻi ʻaʻai ma kekahi umauma i ka tamoxifen, ua hoʻemi ʻia ka pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai ma kekahi umauma e 50% .
• Kōkua ʻo Tamoxifen i ka hōʻemi ʻana i ka pilikia o ka hoʻi hou ʻana ma 30% a 50% no kekahi kanaka me ka maʻi ʻaʻai umauma i ke kahua mua.
• Ua hōʻike ʻia nā noiʻi e hōʻemi ana ka lāʻau raloxifene i ka pilikia o ka haki ʻana o ke kuamoʻo i nā wahine postmenopausal me ka osteoporosis.

He aha nā hopena ʻaoʻao e hiki ke loaʻa mai ka lawe ʻana i kēia lāʻau lapaʻau?

E like me nā lāʻau lapaʻau āpau, hiki i nā SERM ke hana i nā hopena ʻaoʻao. Eia naʻe, ʻaʻole loaʻa i nā kānaka āpau kēia mau hopena ʻaoʻao āpau.He mea nui e hoʻomanaʻo i kēlā. Eia kekahi, ʻoi aku ka nui o nā pono o kēia mau lāʻau lapaʻau ma mua o nā hopena ʻaoʻao. Na ke kauka nāna ʻoe e mālama e wehewehe i kēia mau mea āpau iā ʻoe.

Ma ka papa ma lalo nei, ua hoʻokaʻawale mākou i nā hopena ʻaoʻao maʻamau a me nā hopena ʻaoʻao kakaʻikahi o kēia lāʻau lapaʻau.

Hiki ke hoʻēmi ʻia ka ʻehaʻeha i hoʻokumu ʻia e nā hopena ʻaoʻao?

ʻAe, hiki nō iā ʻoe. Aia kekahi mau mea hiki iā ʻoe ke hana e kōkua i ka hōʻemi ʻana i ka ʻoluʻolu ʻole, ʻoiai nā hōʻailona e like me ka menopause (nā ʻōlinolino wela, ka hiamoe ʻole, ka maloʻo o ka ʻōpū).

• E hōʻemi i nā ʻā wela: E hōʻemi i ka caffeine (kofe, kī) a me nā mea ʻala. Loaʻa i kekahi poʻe ka hōʻoluʻolu ma ka ʻai ʻana i nā meaʻai i loaʻa nā phytoestrogens, e like me ka soybeans, chickpeas, a me nā lentils.
• No nā pilikia hiamoe: Kōkua ka hoʻoikaika kino i kēlā me kēia lā iā ʻoe e hiamoe maikaʻi.
• No ka maloʻo o ka ʻōpū: Aia nā mea hoʻomaʻū ʻōpū kūikawā e hiki ke hoʻohana ʻia no kēia. Hiki iā ʻoe ke nīnau i kāu kauka e pili ana i kēia mau mea.

Āhea ʻoe e ʻimi koke ai i ke aʻo lapaʻau?

Inā manaʻo ʻoe e ʻoi aku ka ʻino o nā hopena ʻaoʻao maʻamau, e hoʻomaopopo i kāu kauka. Eia nō naʻe, aia kekahi mau kūlana koʻikoʻi e hiki ʻole ke loaʻa me nā SERM. Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​​​mai hoʻokaʻulua. E hele koke i ka lumi pilikia haukapila kokoke loa (ETU).

• Ka maneʻo a nāwaliwali paha ma kekahi ʻaoʻao o ke kino a i ʻole ka maka.
• Ka paʻakikī o ka ʻōlelo ʻana, ka slurring o nā huaʻōlelo.
• He ʻeha poʻo nui a koke.
• Ka paʻakikī koke o ka hanu ʻana.
• ʻEha nui ma ka umauma, lima, poʻohiwi, a i ʻole ka ʻauwae e kū mai ana me ke kumu ʻole.

He mau hōʻailona paha kēia o ka hahau ʻana a i ʻole ka pulmonary embolism, no laila pono ʻoe e makaʻala loa e pili ana i kēia mau mea.