Omuntu bw’azuulibwa ng’alina kookolo w’amabeere, awulira ennaku nnyo era ng’atidde. Ekyo kya bulijjo. Naye olw’okuba ssaayansi w’obusawo ow’omulembe aliwo ennaku zino, ebika bya kookolo w’amabeere ebisinga obungi bisobola okufugibwa n’okuwona. Wabula waliwo ebika bya kookolo ebimu ebizibu katono okujjanjaba okusinga ebirala. Bino biyitibwa "kookolo w'amabeere omuzibu okujjanjaba." Abanoonyereza ku by’obujjanjabi kino balina essuubi ddene, kubanga obujjanjabi obupya buli lunaku bukolebwa. Katukwogere ku nsonga eno leero.
Lwaki kookolo w’amabeere omu asoomoozebwa okujjanjaba?
Mu ngeri ennyangu, obujjanjabi bwa kookolo w’amabeere obusinga okukola obulungi bugenderera okufuga engeri obutoffaali bwa kookolo gye bukulamu. Lowooza ku kino: obutoffaali bwa kookolo bwe buba ng’oluggi, obusimu n’obutoffaali obumu biba ng’ebisumuluzo ebiggulawo oluggi olwo. Obujjanjabi bukola nga buziba enzigi (receptors) ebisumuluzo bino bireme kukola. Kookolo w’amabeere ayawulwamu ebika bisatu ebikulu okusinziira ku kika kya ‘enzigi’.
Kati ka tulabe ebika bino ebisatu kye biruwa.
| Ekika kya kookolo | Ennyinyonnyola ennyangu |
|---|---|
| Kookolo alina obusimu obukwata obusimu (HR-positive) . | Obutoffaali buno obwa kookolo bulina estrogen receptors (ER) ne/oba progesterone receptors (PR), ekibufuula okuddamu obujjanjabi bw’obusimu. |
| Kookolo alina HER2 (HER2-positive) . | Obutoffaali buno bulina ekirungo ekiyitibwa HER2 ekinene. Kale, zisobola okufugibwa n’obujjanjabi obugenderera HER2 receptor. |
| Kookolo w’amabeere ow’emirundi esatu (TNBC) . | Kino kye kika ekisinga okusoomoozebwa. Obutoffaali buno bwa kookolo tebulina kifo kya estrogen, tebulina kikwata kya progesterone, era tebulina kikwata kya HER2. Ekyo kitegeeza nti obutoffaali buno tebulina ‘nzigi’ ezo essatu ze nnayogeddeko emabegako. |
Wakati wa 10% ne 20% ku balwadde bonna aba kookolo w’amabeere balina kinoKika kya kookolo w’amabeere ayitibwa triple-negative breast cancer (TNBC). Obujjanjabi bw’obusimu obukozesebwa obulungi ku bika bya kookolo ebirala tebukola ku kookolo wa kika kino, kubanga tebulina bikwata busimu. Ate era, eddagala erigenderera HER2 teriyamba.
Okugatta ku ekyo, kookolo wa TNBC akola nnyo okusinga ebika ebirala. Kino kitegeeza nti kookolo w’azuulibwa atera okuba ng’asaasaana mu bitundu by’omubiri ebirala. Era kyeyisa mu ngeri ya njawulo mu buli muntu, era kisobola okukyuka okumala ekiseera ne kigumira eddagala erimu.
Enkyukakyuka mu buzaale ekosa etya kino?
Emu ku ngeri ezisinga obulungi ez’okuzuula kookolo nga TNBC nga bukyali kwe kuzuula abo abali mu bulabe obw’amaanyi. Kino okukikola, abanoonyereza banoonyereza ku nkyukakyuka mu buzaale (mutations) eziyisibwa mu milembe era nga zikwatagana ne kookolo w’amabeere.
- BRCA1 ( obuzaale bwa kookolo w’amabeere 1) .
- BRCA2 (Ekikula kya kookolo w’amabeere 2) .
Singa osikira enkyukakyuka mu emu ku buzaale buno obubiri, oba mu bulabe bwa maanyi okukwatibwa kookolo w’amabeere n’enkwaso. Bw’oba olina enkyukakyuka eno, era otera okukwatibwa kookolo ng’okyali muto.
Kookolo z’amabeere ezisinga obungi ezirina enkyukakyuka mu buzaale bwa BRCA1 zibeera za mirundi esatu . N’olwekyo, okutegeera obuzaale buno kiyinza okuyamba okuzuula engeri ennungi ez’okujjanjaba TNBC.
Abasawo abamu bagamba nti buli muntu alina TNBC akebere obuzaale obukwatagana ne kookolo omuli BRCA1 ne BRCA2. Singa wazuulibwa nti olina TNBC nga tonnaweza myaka 60, oba singa omuntu mu maka go abadde n’obulwadde bwa TNBC, omusawo ayinza okukuwa amagezi okukeberebwa kuno okw’obuzaale. Kino kiyinza okukuyamba ggwe n’omusawo wo okulonda obujjanjabi obusinga okukuyamba.
Kiki ky’olina okumanya ku kookolo w’amabeere agenda mu bitundu ebirala?
Ekika kya kookolo ekirala ekizibu okujjanjaba ye kookolo w’amabeere asaasaanidde mu bitundu by’omubiri eby’ewala. Kino kiyitibwa kookolo w'amabeere agenda mu bitundu ebirala . Buyinza okusaasaana mu bitundu by’omubiri ebirala, gamba ng’amagumba, obwongo, ekibumba oba amawuggwe. Oluusi kookolo azuulibwa ng’asasaanye bw’ati. Naye emirundi mingi, kookolo akomawo n’asaasaana oluvannyuma lw’okusooka okujjanjabwa, oluusi oluvannyuma lw’emyaka.
Kookolo wo ow’amabeereSinga kookolo asaasaanidde mu bifo eby’ewala, ekigendererwa ekikulu eky’obujjanjabi kwe kufuga kookolo. Enzijanjaba ey’enkola y’emirimu (systemic therapy) y’obujjanjabi obusinga okukozesebwa ku kino. Omusawo ajja kusalawo ku bujjanjabi bwo ng’asinziira ku bubonero bwo, obujjanjabi obw’emabega, kookolo gy’asasaanye, n’ekika ky’obutoffaali bwa kookolo.
Bujjanjabi ki obusembyeyo ku kino?
Obujjanjabi bwa kookolo w’amabeere TNBC, metastatic ne recurrent kookolo, buteredde nnyo mu myaka egiyise. Obujjanjabi bwa Chemotherapy bwe bujjanjabi obusinga ku kino. Kati abasawo bagiwa nga bagigatta wamu n’eddagala eddala.
Wano waliwo obujjanjabi obulala obupya:
Ebiziyiza PARP
Zino kika kya ddagala erisaanyaawo DNA y’obutoffaali bwa kookolo mu bantu abalina enkyukakyuka mu buzaale bwa BRCA ne kookolo wa HER2-negative ne metastatic. Eby’okulabirako mulimu `olaparib (Lynparza)` ne `talazoparib (Talzenna).` Bino nabyo biraga ebirungi ku TNBC ey’omutendera ogusooka.
Obujjanjabi bw’abaserikale b’omubiri
Enzijanjaba zino zisitula abaserikale b’omubiri gwennyini okusaanyaawo obutoffaali bwa kookolo. Pembrolizumab (Keytruda) lye limu ku ddagala eryo. Zitera okuweebwa nga zigatta wamu n’obujjanjabi bw’eddagala.
Ebirungo ebiziyiza endwadde n’eddagala (ADCs) .
Ono tekinologiya anyuma nnyo. Kilowoozeeko ng’enkola ya GPS elungamya eddagala okutuuka ku kifo we liri. Obuziyiza obuli mu ddagala lino buzuula obutoffaali bwa kookolo, ne bubukwatako, ne busaanyaawo obutoffaali bwa kookolo n’eddagala erikwatagana, awatali bulabe ku butoffaali bulamu. `Sacituzumab govitecan (Trodelvy)` ddagala lya ADC erikkirizibwa okukola TNBC ey'omulembe.
Enzijanjaba ez’okwongerako
Waliwo eddagala eppya eriwerako eriweebwa nga ligattibwa wamu n’obujjanjabi bw’obusimu ku kookolo alina obusimu obuyitibwa hormone receptor (HR). Abemaciclib (Verzenio) lye limu ku ddagala eryo.
Biki ebisuubirwa mu biseera eby’omu maaso mu nsonga eno?
Abanoonyereza buli kiseera bakola okugaziya obujjanjabi bwa kookolo ono, omuli okuzuula ebirungo ebipya eby’obujjanjabi bw’abaserikale b’omubiri n’okuzuula obubonero obuyinza okulagula ebinaava mu bujjanjabi.
Bano era banoonyereza oba eddagala erikkirizibwa okulwala endwadde endala linaabanga lya mugaso eri TNBC. Bano era banoonyereza ku ngeri y’okukozesaamu eddagala nga PARP inhibitors mu bugazi. Okunoonyereza okumu era kugezaako okukozesa obutundutundu obuyitibwa nanoparticles obw’omugaso eri omubiri okutta obutoffaali bwa kookolo obuziyiza eddagala.
Kale, wadde ng’okubeera ne kookolo ow’ekika kino kiyinza okuba ekizibu, waliwo essuubi ly’obujjanjabi obupya. Ekisinga obukulu kwe kwogera n’omusawo wo buli kiseera n’osalawo ku nteekateeka y’obujjanjabi ekusinga obulungi.
Obubaka Obutwala Awaka
- Kookolo z’amabeere ezimu naddala Triple-Negative Breast Cancer (TNBC) , zisoomoozebwa okuzijjanjaba kubanga tezirina bikozesebwa mu busimu oba puloteyina ya HER2.
- Enkyukakyuka mu buzaale, nga BRCA1 ne BRCA2 , kikulu mu kuzuula obulabe bwo obw’okulwala TNBC n’obujjanjabi bwo. Bw’oba olina TNBC, yogerako n’omusawo wo ku kukebera obuzaale.
- Ekigendererwa ky’okujjanjaba kookolo agenda mu bitundu ebirala kwe kufuga obulwadde buno.
- Enzijanjaba ez’omulembe nga PARP inhibitors, immunotherapy, ne antibody-drug conjugates (ADCs) kati ziwa essuubi ddene ne ku kookolo omuzibu okujjanjaba.
- Ka kibeere nti oli mu mbeera ki, kikulu nnyo bulijjo okukolagana obulungi n’omusawo wo okulonda obujjanjabi obusinga obulungi.
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