Tutegeera okutya, okuwuniikirira, n’ebibuuzo bingi ebibaawo ng’okizudde nti olina kookolo w’amabeere. Naye ekisinga obukulu mu kiseera kino kwe kutegeezebwa obulungi. Kubanga, kookolo w’amabeere yenna si y’emu. Waliwo obujjanjabi obugendereddwamu ennyo ebika bya kookolo ebimu. Wamma, obujjanjabi obumu obubadde bukozesebwa obulungi eri abantu bangi kwe kujjanjaba obusimu . Ka twogere ku nsonga eno mu ngeri ennyangu leero.
Obujjanjabi bw’obusimu kye ki? Kituufu eri buli muntu?
Mu ngeri ennyangu, obusimu obumu mu mibiri gyaffe buyamba obutoffaali obumu obwa kookolo w’amabeere okukula. Okusingira ddala, obusimu bubiri obuyitibwa estrogen ne progesterone.
Lowooza ku butoffaali bwa kookolo ng’amayumba amatonotono. Obutoffaali bwa kookolo obumu bulina ‘enzigi’ (receptors) ez’enjawulo ezisobozesa obusimu buno okuyingira. Kookolo alina enzigi zino tugiyita hormone receptor-positive . Abasawo, kino oyinza okuba nga mwakiraba mu lipoota yammwe nga ER-positive (estrogen-doors) oba PR-positive (progesterone-doors).
Obujjanjabi bwa hormone bukola ku kookolo alina emiryango gino egy’obusimu. Obujjanjabi buno buggalawo emiryango egyo oba okukendeeza ku kukola obusimu obwo mu mubiri. Kino kimalako obutoffaali bwa kookolo "emmere" gye bwetaaga, ekibuleetera okulekera awo okukula oba okufa.
Ekikulu kiri nti, singa obutoffaali bwo obwa kookolo tebulina bikwata busimu buno, kwe kugamba, bwe buba nga tebulina busimu buno , obujjanjabi buno obw’obusimu tebujja kukola. Abasawo bateesa ku bujjanjabi obulala eri abantu ng’abo.
Bika ki ebikulu eby’obujjanjabi bw’obusimu?
Waliwo ebika by’obujjanjabi bw’obusimu ebikulu ebiwerako ebikozesebwa ku kookolo w’amabeere. Omusawo ajja kulonda eddagala erisinga okukusaanira okusinziira ku bintu bingi omuli emyaka gyo, ekika kya kookolo, n’okumanya oba oyise mu nsonga. Ka tulabe ebika bibiri ebikulu.
| Ekika ky’obujjanjabi | Kisinga kuweebwa ani? | Ebizibu ebivaamu okumanya |
|---|---|---|
| Eddagala lya Tamoxifen | Ku bakyala ab’emyaka gyonna (pre ne post menopause). Eddagala eribadde likozesebwa obulungi okumala emyaka mingi. | Obulabe obweyongera katono obwa kookolo wa nnabaana, omusaayi okuzimba mu magulu n’amawuggwe, okusannyalala, okuzimba amaaso n’ebbugumu. |
| Ebiziyiza Aromatase (AIs) . Okugeza: Eddagala lya Anastrozole, Eddagala lya Letrozole | Okusinga ku bakyala oluvannyuma lw’okuggwaamu amaanyi mu nsonga. | Okunafuwa kw’amagumba (Osteoporosis) n’obulabe bw’okumenya, okulumwa ennyondo n’ebinywa, obuzibu mu kujjukira, n’obulabe bw’okulwala omutima okweyongera katono. |
Ebisingawo katono ku Tamoxifen
Eno ddagala ly’omira buli lunaku. Okunoonyereza kulaga nti okugimira okumala emyaka egiwerako, ebiseera ebisinga emyaka nga 5, kikendeeza nnyo ku bulabe bwa kookolo okuddamu n’obulabe bw’okufuna kookolo omupya.
Kyokka era olina okumanya ebizibu ebivaamu bye twayogeddeko mu kipande ekyo. Naddala obulabe bwa kookolo wa nnabaana. Eno y’ensonga lwaki kikakatako okwekebeza ekisambi buli kiseera ng’omira eddagala lino. Ekirala bw’ofuna omusaayi gwonna ogutali gwa bulijjo mu bukyala, olina okutegeeza omusawo mu bwangu.
Ebisingawo katono ku Aromatase Inhibitors (AIs)
Eddagala ery’ekika kino likola nga liyimiriza okukola obusimu obuyitibwa estrogen mu bakyala oluvannyuma lw’okuva mu nsonga. Kino kimalako obutoffaali bwa kookolo obusimu bwe bwetaaga okukula.
Obulabe obusinga obuli mu ddagala lino bwe bulwadde bw’amagumba , nga buno bwe bulabe bw’amagumba okunafuwa ne gamenya mangu. Olw’ensonga eno, omusawo wo kirabika ajja kukeberebwa amagumba nga tonnatandika kumira ddagala lino era ng’olimira. Era ayinza okukuwa amagezi okumira eddagala lya calcium ne vitamin D.
Obujjanjabi obulala n’obw’omulembe
Ng’oggyeeko ebika by’eddagala ebikulu ebyogeddwako waggulu, waliwo n’ebika by’eddagala ebirala ebikozesebwa naddala nga kookolo asaasaanidde mu bitundu by’omubiri ebirala (advanced oba metastatic).
Okugeza waliwo eddagala nga `Fulvestrant (Faslodex)` ne `Toremifene (Fareston)`. Okugatta ku ekyo, waliwo eddagala lingi ery'omulembe eriyitibwa `Targeted Therapy` leero. `Palbociclib (Ibrance)`, `Abemaciclib (Verzenio)`, `Alpelisib (Piqray)` bye byokulabirako by'eddagala eryo. Bino bikola nga bitunuulira obutoffaali obw’enjawulo obuyamba obutoffaali bwa kookolo okukula. Bino bitera okuweebwa abalwadde nga bigattiddwa wamu n’obujjanjabi obw’obusimu obwogeddwako waggulu.
Okusalawo kuno kwonna ku bujjanjabi kukolebwa okusinziira ku mbeera yo, ekika kya kookolo, emyaka gyo, n’obulamu bwo okutwalira awamu. Kale totya kuteesa ku bibuuzo byonna by'olina n'omusawo wo .
Obujjanjabi obw’enjawulo eri abo abatayise mu nsonga (Ovarian Ablation) .
Bw’oba tonnagenda mu nsonga, ekitegeeza nti ogenda mu nsonga buli kiseera, obusimu obukulu obuyitibwa estrogen mu mubiri gwo bukolebwa enkwaso zo. Kale, ku muntu alina kookolo alina ER-positive, omusawo wo ayinza okusalawo okukomya enkwaso zino okukola estrogen. Kino kiyitibwa okuggyamu enkwaso/okunyigiriza .
Waliwo engeri eziwerako ez’okukola kino:
- Okulongoosa okuggyamu enkwaso : Eno nkola ya lubeerera.
- Obujjanjabi bw’amasannyalaze eri enkwaso: Kino nakyo kisobola okuyimiriza enkola y’enkwaso enkalakkalira.
- Eddagala okuyimiriza enkwaso okukola okumala akaseera: Eddagala eriyitibwa `(LHRH) agonists` (emirundi mingi empiso) lye likozesebwa ku kino. Kasita omira eddagala lino, enkwaso zo tezijja kukola busimu.
Okunoonyereza kulaga nti ng’oggyeeko okunyigiriza enkwaso zino, obujjanjabi bw’obusimu nga tamoxifen busobola okuvaamu ebirungi ennyo.
Obubaka Obutwala Awaka
- Obujjanjabi bw’obusimu si bujjanjabi bwa kookolo w’amabeere yenna. Kiweebwa kookolo w’obusimu obuyitibwa hormone receptor-positive (ER/PR-positive) zokka.
- Obujjanjabi obusinga okukusaanira (e.g. Tamoxifen oba Aromatase Inhibitor) bujja kusalibwawo omusawo wo, okusinziira ku myaka gyo n’embeera y’obulamu bwo.
- Eddagala lino lyonna liyinza okuvaako ebizibu. Tobatya, just be aware of what they are. Bw’ofuna obubonero bwonna obutali bwa bulijjo, tegeeza omusawo mu bwangu.
- Kikulu nnyo okubeera n’okukebera omusawo kw’akulagidde mu budde ng’ojjanjabibwa.
- Kakasa nti oteesa mu lwatu ku bintu by’otya, by’obuusabuusa, n’ebibuuzo byo ne ttiimu yo ey’abasawo. Kijja kuba maanyi mangi mu lugendo lwo olw’okudda engulu.
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