Ekika ky’eddagala lya SERM: Obujjanjabi obw’enjawulo eri kookolo w’amabeere n’okuzimba amagumba (Selective Estrogen Receptor Modulators - SERMs)

Singa ggwe oba omuntu gw’omanyi azuuliddwaako kookolo w’amabeere, kya bulijjo okuwulira okutya n’okukankana okw’amaanyi. Mu ngeri y’emu, bwe tukaddiwa, amagumba geeyongera okunafuwa era ne bwe tugwa akatono kiyinza okugamenya. Kyokka olw’okukulaakulana kw’eddagala, waliwo obujjanjabi obulungi eri embeera zino. Leero, tugenda kwogera ku bujjanjabi obumu obw’enjawulo obw’engeri eyo.

Mu ngeri ennyangu, SERM zino ze ziruwa?

SERMs zimpimpi ku Selective Estrogen Receptor Modulators . Kino kika kya bujjanjabi bwa hormone. Kino kizingiramu okuddukanya engeri obusimu obuyitibwa estrogen mu mubiri gwaffe gye bukolamu. Kilowoozeeko nga maneja omugezi. Aziyiza ebikolwa bya estrogen mu bitundu by’omubiri ebimu, ate mu birala kikola nga estrogen okuyamba omubiri.

Eddagala bbiri enkulu mu kiraasi eno ye Tamoxifen ne Raloxifene . Mu kiseera kino bino bikozesebwa ng’obujjanjabi obukola ennyo ku bika ebimu ebya kookolo w’amabeere n’okuzimba amagumba.

Eddagala lino erya SERM likola litya munda mu mubiri?

Kino kiyinza okulabika ng’ekizibu okutegeera, naye mu butuufu kyangu nnyo. Kino katukitegeere nga tulina ekyokulabirako.

• Mu kookolo w’amabeere: Obutoffaali obumu obwa kookolo w’amabeere (obuyitibwa kookolo bwa Hormone Receptor positive oba ER-positive ) bwetaaga obubaka okuva mu kisumuluzo ekiyitibwa estrogen okukula n’okwawukana. Eddagala lya SERM likola nga liziba oluggi (receptor) ku butoffaali buno obwa kookolo. Kiba ng’okuteeka ekintu ekirala mu kinnya ky’ekisumuluzo ky’oluggi. Olwo estrogen omutuufu tasobola kutuuka ku kisumuluzo n’aggulawo oluggi. N’ekyavaamu, obutoffaali bwa kookolo bufiirwa obubaka obw’okukula, era okukula kwabwo kuyimirira oba kukendeera.

• Mu magumba: Mu kiseera kye kimu, eddagala lino erya SERM bwe ligenda mu magumba gaffe, likola nga estrogen eyo. Kwe kugamba, egenda ku nzigi mu magumba n’eggulawo enzigi ezo, n’eyamba okukuuma amagumba nga ganywevu n’okusigaza ekirungo kya ‘calcium’. Kino kiziyiza obulwadde bw’amagumba.

Olabye obusobozi obw’ekitalo obw’eddagala lino? Eddagala lye limu likola mu ngeri bbiri ez’enjawulo ddala mu bifo bibiri. Eno y'ensonga lwaki kiyitibwa "Selective".

Migaso ki emikulu egya SERMs?

Abasawo bateesa ku bujjanjabi buno okusinga mu mbeera bbiri.

1. Ku kookolo w’amabeere

SERMs bujjanjabi bukulu nnyo naddala ku kookolo w’amabeere akwata obusimu (ER-positive).

• Ku abo abali mu bulabe obw’amaanyi obwa kookolo: Singa omuntu mu maka abadde alina kookolo w’amabeere, oba singa okukebera obuzaale kukakasizza nti alina enkyukakyuka mu buzaale eyongera obulabe bwa kookolo, bamuwa eddagala lino okutangira kookolo okukula.
• Oluvannyuma lw’okulongoosebwa kookolo: Oluvannyuma lwa kookolo okulongoosebwa, SERMs zikozesebwa okuziyiza kookolo okudda (`recurrence`) n’okuziyiza kookolo okukula mu mabeere amalala.
• Mu DCIS: Okuziyiza okuddamu okulwala Ductal Carcinoma in Situ (DCIS), kookolo ow’omutendera ogusooka abeera mu mifulejje gy’amabeere.
• Ku kookolo asaasaanidde mu mubiri gwonna: Okufuga kookolo asaasaanidde mu bitundu by’omubiri ebirala (Metastatic Breast Cancer).
• Ku kookolo w’amabeere g’abasajja: Wadde tekitera kubaawo abasajja okufuna kookolo w’amabeere, naye n’obujjanjabi buno bumukozesebwa singa abaawo.

2. Ku bulwadde bw’amagumba

SERM eyitibwa Raloxifene ekozesebwa okufuga okugwa kw’amagumba, okunyweza amagumba n’okukendeeza ku bulabe bw’okumenya naddala mu bakyala abava mu nsonga.

Obujjanjabi buno buba buwanguzi butya?

Yee, buno bujjanjabi bukola nnyo. Okunoonyereza kulaga nti eddagala lya Tamoxifen naddala liyinza okukendeeza ku bulabe bwa kookolo w’amabeere ebitundu nga 40% .

• Singa omuntu eyalongoosebwa kookolo mu bbeere erimu amira eddagala lya Tamoxifen, emikisa gy’okufuna kookolo mu mabeere amalala gikendeera ebitundu 50% .
• Ku muntu eyafuna kookolo nga tannava mu nsonga, obulabe bwa kookolo okuddamu okugwa busobola okukendeera wakati wa 30% ne 50% .
• Raloxifene era kizuuliddwa nti akendeeza nnyo ku bulabe bw’okumenya omugongo olw’obulwadde bw’amagumba oluvannyuma lw’okuggwaamu amaanyi.

Kiki ekibaawo mu kiseera ky’obujjanjabi?

Obujjanjabi buno butera kuweebwa ng’empeke oba amazzi agamira buli lunaku. Ebbanga ly’obujjanjabi liyinza okwawukana okusinziira ku mbeera gy’olimu n’omusawo by’akugamba.

• Tamoxifen: Abantu abamumira okuziyiza oba okujjanjaba kookolo w’amabeere batera okumira eddagala lino okumala emyaka 5 egy’omuddiring’anwa. Omusawo wo ayinza okwongera ku kiseera kino okutuuka ku myaka 10. Oyinza n’okukyusibwa n’odda ku ddagala eddala (nga aromatase inhibitor) oluvannyuma lw’emyaka mitono.
• Raloxifene: Abamumira okukendeeza ku bulabe bw’okufuna kookolo w’amabeere oba obulwadde bw’amagumba balina okumumira ng’empeke ya buli lunaku okumala ebbanga omusawo lye bamugamba.

Biki ebiyinza okuva mu bujjanjabi buno?

Nga bwe kiri ku bujjanjabi bwonna obwa kookolo, SERMs zisobola okuleeta ebizibu ebimu. Kyokka, si buli muntu nti byonna ajja kubifuna. Ebisinga ku bino bisobola okuddukanyizibwa.

Raloxifene asobola okuba n’ebizibu ebifaanagana (e.g. ebbugumu, okulumwa amagulu), naye obulabe bwa kookolo wa nnabaana butono okusinga ku Tamoxifen. Kino omusawo ajja kukunnyonnyola mu bujjuvu.

Kiki kye nnyinza okukola okusobola okuddukanya ebizibu ebivaamu?

Waliwo ebintu ebitonotono by’osobola okwekolera okusobola okwanguyiza okubeera n’ebizibu bino.

• Ku bbugumu: Kendeeza ku byokunywa ebirimu caffeine nga kaawa ne caayi. Abantu abamu bayinza okufuna obuweerero nga balya emmere erimu ebirungo ebiyitibwa phytoestrogens nga soya, entangawuuzi n’entungo.
• Ku buteebaka: Dduyiro buli kiseera asobola okulongoosa omutindo gw’otulo.
• Obukalu bw’obukyala: Waliwo eddagala ery’enjawulo erifukirira obukyala eriyinza okukozesebwa ku kino. Buuza omusawo wo ku bino.

Ddi lw’osaanidde okunoonya amagezi mu bwangu omusawo?

Singa ebizibu ebitera okuvaamu biba bya maanyi, tegeeza omusawo wo. Wabula bw’ofuna obubonero bwonna ku buno wammanga, genda mu kitongole ky’eddwaaliro eky’amangu (ETU) mu bwangu oba kuba 1990. Buno buyinza okuba obubonero bw’embeera ey’amaanyi ng’okusannyalala oba okuzimba omusaayi mu mawuggwe (pulmonary embolism).

• Okuziyira oba okunafuwa ku ludda olumu olw’omubiri oba mu maaso.
• Okukaluubirirwa okwogera, okukuba ebigambo ebisongovu.
• Omutwe ogw’amaanyi ogw’amangu.
• Okukaluubirirwa okussa mu bwangu.
• Obulumi obw’amaanyi mu kifuba, omukono, ekibegabega oba akawanga nga tewali kimanyiddwa.

Obubonero buno tobubuusa maaso. Okukola eky’amangu kiyinza okutaasa obulamu bw’abantu.