Kizibu okuteeka mu bigambo okutya n’okukankana kw’owulira ng’okizudde nti olina kookolo w’amabeere . Olina ebibuuzo bingi nnyo mu birowoozo byo. Kya bulijjo okuba n'ebibuuzo nga, "Lwaki kino kyantuukako?", "Nkole ntya kati?", "Kino kisobola okuwona?". Mu lugendo luno, nfuba okunnyonnyola ebintu mu ngeri ennyangu era mu lulimi lw’osobola okutegeera. Okumanya obulungi ekika kya kookolo ky’olina kiringa okutegeera omulabe nga tonnatandika lutalo. Ogwo gwe mutendera ogusooka era ogusinga obukulu mu kulonda obujjanjabi obukusaanira.
Kookolo w’amabeere ayitibwa Hormone Receptor-Positive
Kino kye kika kya kookolo w’amabeere ekisinga okubeerawo. Mu kugeraageranya, kookolo w’amabeere nga 80 ku buli 100 agwa mu kiti kino.
Kale kino "ekisinziira ku busimu" kitegeeza ki?
Lowooza ku nsonga eyo. Emibiri gyaffe naddala egy’abakyala girina obusimu bubiri obubeera mu butonde obuyitibwa estrogen ne progesterone . Bino byetaagisa nnyo mu nkola eza bulijjo mu mibiri gyaffe. Wabula obutoffaali bwa kookolo obumu "bulina omuze" nnyo ku busimu buno. Kwe kugamba, ku ngulu w'obutoffaali buno obwa kookolo, waliwo "ebikwata" oba enzigi entono obusimu buno bwe busobola okujja ne bunywerera ku. Obusimu bwa estrogen bwe bujja ne bukonkona ku mulyango ogwo, akatoffaali ka kookolo kafuna emmere okuva mu yo ne katandika okukula n’okwawukana. Nga bw’ofukirira ekimera, kikula kinene.
Singa lipoota yo ey’abasawo egamba nti `ER-positive` (Estrogen Receptor-Positive), kitegeeza nti obutoffaali bwo obwa kookolo bukwata ku busimu bwa estrogen. Bwe kiba kigamba nti `PR-positive` (Progesterone Receptor-Positive), kitegeeza nti kikwata ku busimu bwa progesterone. Singa eba ewulikika ku kimu ku bino, kookolo ayitibwa kookolo ayitibwa hormone receptor-positive cancer.
Mu butuufu gano mawulire malungi mu ngeri emu. Kubanga singa tumanyi kookolo ky’akozesa okukula, tusobola okuziba ekkubo eryo ne tufuga kookolo. Ekyo "obujjanjabi bw'obusimu" kye bukozesebwa.
Obujjanjabi bw’obusimu butera okuweebwa oluvannyuma lw’okulongoosebwa, eddagala eriweweeza ku bulwadde oba okukuba amasannyalaze okutangira kookolo okuddamu. Eddagala lino likola nga liggalawo "enzigi" ku butoffaali bwa kookolo, oba nga liyimiriza omubiri okukola estrogen.
| Ekika ky’obujjanjabi | Ennyinyonnyola ennyangu n’ebyokulabirako |
|---|---|
| SERMs (Ebikyusakyusa ER ebisunsuddwa) . | Bino biziyiza ekirungo ekikwata obusimu ku katoffaali ka kookolo, ne kiremesa obusimu okuyingira. Eby’okulabirako: Tamoxifen, Toremifene . |
| SERDs (Ebirungo ebironda estrogen Receptor Degraders) . | Bino tebikoma ku kuziyiza kikwata, wabula era bikisaanyaawo. Eby’okulabirako: Ekirungo kya Fulvestrant (Faslodex), Ekirungo kya Elacestrant (Orserdu) . |
| Ebiziyiza Aromatase | Bino bikomya omubiri okukola obusimu obuyitibwa estrogen (obutera okuweebwa abakyala abava mu nsonga). Eby’okulabirako: Anastrozole (Arimidex), Letrozole (Femara) . |
| LHRH Abavuzi ba Agonists | Bino biyimiriza enkwaso okukola estrogen okumala akaseera. Eby’okulabirako: Goserelin (Zoladex), Leuprolide (Lupron) . |
| Enzijanjaba endala ezigendereddwamu | Eddagala eddala lyongera ku buwanguzi bw’obujjanjabi bw’obusimu. Eby’okulabirako: Palbociclib (Ibrance), Ribociclib (Kisqali), Alpelisib (Piqray) . |
HER2-Positive Kookolo w’amabeere
Kati ka twogere ku kika ekirala. Obutoffaali obumu obwa kookolo w’amabeere (nga 20% ku kookolo yenna) bukola ekisusse ku puloteyina ey’enjawulo ku ngulu yaabwe eyitibwa HER2 (Human Epidermal growth factor Receptor 2) .
Lowooza ku HER2 nga antenna entono egamba akatoffaali ka kookolo "okukula amangu, okwawukana amangu." Akatoffaali aka bulijjo kalina antenna zino ntono zokka. Naye akatoffaali ka kookolo akalina HER2 kalina antenna zino nnyingi. Eno y’ensonga lwaki ebika bya kookolo bino bisobola okuba eby’amaanyi ennyo .
Naye waliwo amawulire amalungi ne wano. Olw'enkulaakulana mu sayansi, kati waliwo " obujjanjabi obugendereddwamu " obutunuulira n'okusaanyaawo antenna zino ennyo eza HER2. Olw’okuba bino bisanga era ne bilumba obutoffaali bwokka obulina HER2 omungi, wabaawo okwonooneka okutono eri obutoffaali obwa bulijjo.
Eddagala erisinga era erisinga okukola obulungi eriweebwa ku kino ye Trastuzumab (Herceptin) . Kino kiyamba nnyo mu kutangira kookolo okudda. Wabula waliwo akabi akatono ak’ebikosa ebimu ku mutima oba amawuggwe ng’omira obujjanjabi buno. Ekyo tokyeraliikirira , omusawo wo bulijjo ajja kukikebera.
| Enzijanjaba endala ezigendereddwamu ezikozesebwa ku kookolo alina HER2 | |
|---|---|
| Eddagala eriweweeza ku bulwadde bwa Pertuzumab (Perjeta) . | Eddagala eriweweeza ku bulwadde bwa ado-trastuzumab emtansine (Kadcyla) . |
| Eddagala lya Lapatinib (Tykerb) . | Eddagala lya Neratinib (Nerlynx) . |
| Obulwadde bwa Tucatinib (Tukysa) . | Enhertu (Eddagala eriweweeza ku bulwadde bwa Fam-trastuzumab deruxtecan-nxki) . |
"Triple-Negative" Kookolo w'amabeere
Kino kye kika ekikulu eky’okusatu. Ebitundu nga 10%-20% ku kookolo w’amabeere agwa mu kika kino. Omanyi lwaki kiyitibwa "triple-negative" oba "triple negative"?
Kubanga mu butoffaali buno obwa kookolo , .
1. Tewali kirungo kya estrogen (ETU) .
2. Tewali kirungo kya progesterone (PR).
3. Tewali puloteyina ya HER2 nnyingi.
Olw’okuba obutoffaali buno bwa kookolo tebulina bigendererwa bisatu ebikulu bye twayogeddeko emabegako, wadde obujjanjabi bwa hormone oba obujjanjabi obugendereddwamu HER2 nga Herceptin tebukola ku buziba. Kale okuzijjanjaba kiyinza okukusoomooza katono.
Kookolo ow’ekika kino atera okuva ku BRCA1.Kikwatagana n'enkyukakyuka mu buzaale obuyitibwa . N’olwekyo bw’oba olina kookolo ow’emirundi esatu, omusawo ayinza n’okukuwa amagezi okukebera obuzaale.
Ekika kino kisinga kujjanjabwa n’okulongoosebwa, okukozesa eddagala eriweweeza ku bulwadde, n’okukozesa amasannyalaze . Wabula kati waliwo obujjanjabi obupya obukwata ku kika kino.
- Ebiziyiza PARP: Eddagala nga Olaparib (Lynparza) ne Talazoparib (Talzenna) likozesebwa ku bantu abalina enkyukakyuka mu buzaale bwa BRCA. Bino biziyiza obutoffaali bwa kookolo okweddaabiriza.
- Obujjanjabi bw’abaserikale b’omubiri: Eddagala nga Atezolizumab (Tecentriq) liyamba okulwanyisa obutoffaali bwa kookolo nga tukozesa obutoffaali bwaffe obw’abaserikale b’omubiri.
Kino kyonna kiyinza okulabika ng’ekizibu katono. Ekyo kya bulijjo. Ekikulu kwe kujjukira nti ne bw’oba olina kookolo wa kika ki, waliwo obujjanjabi obuliwo leero obumusaanira. Omusawo wo ne ttiimu y’abasawo bajja kukolagana naawe okukukolera enteekateeka y’obujjanjabi esinga obulungi.
Obubaka Obutwala Awaka
- Kookolo w’amabeere ayawulwamu ebika 3 ebikulu: Hormone Receptor-Positive, HER2-Positive, ne Triple-Negative .
- Okumanya ekika kya kookolo ky’olina kyetaagisa nnyo mu kutegeka obujjanjabi.
- Kookolo alina obusimu akola bulungi ku bujjanjabi bw’obusimu.
- Wadde nga kookolo alina HER2 akula mangu, waliwo obujjanjabi obugendereddwamu obulungi ennyo obukoleddwa mu ngeri ey’enjawulo ku bo.
- Wadde ng’okujjanjaba kookolo ow’emirundi esatu kizibu , asobola okulwanyisibwa n’obujjanjabi obw’eddagala n’obujjanjabi obupya obugendereddwamu.
- Bw’oba olina ekibuuzo kyonna ku kintu kyonna mu biwandiiko byo eby’obujjanjabi, totya kubuuza . Saba omusawo akunnyonnyola mu ngeri entegeerekeka. Si ggwe wekka, era waliwo abantu bangi abasobola okukuyamba.
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