Hnute cancer i vei tih hmuhchhuah a nih chuan a rit leh hlauhawm zia chu ka hrethiam. Khawthlang lamah chuan natna chungchanga lungkhamna a awm a, khawthlang lamah chuan doctor-te'n (Chemotherapy) leh hormone therapy tih ang chi thu an sawi hian i rilru a buai zual sauh sauh a ni lawm ni? "Kei pawh chemo ka la ve dawn em ni? Ka sam a tla chhuak dawn em ni? Ka taksa tan a harsa dawn em ni?" I rilruah zawhna tam tak i nei ngei ang. Mahse, lungngai suh. Vawiin hian i kum leh menopause i paltlang tawh leh paltlang loh chungchang kan sawi dawn a, i enkawlna tur i hriat chian nan.
Tun hma chuan mi zawng zawng deuhthaw chu hnute cancer chu lymph node-ah a darh tih an hriat veleh chemotherapy pek an ni. Hammer vawn a, engkim chu nail ang maia siam ang mai a ni. Mahse tunah chuan damdawi lam hian hma a sawn nasa hle. Tunah chuan hnute cancer zawng zawng hi a inang vek lo tih kan hria a, damlo zawng zawng hian enkawlna inang an dawng vek dawn lo tih kan hria. A châng chuan chemotherapy hian a ṭhatna a tluk phah thei bawk. Chuvangin tunah chuan doctor-te chuan tumor lian tham leh cancer stage chauh ni lovin, cancer biological nature pawh an ngaihtuah nasa zawk a ni.
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Engvangin nge he thawnthu atan hian menopause hi a pawimawh?
Menopause i paltlang tawh emaw, i paltlang tawh lo emaw, thla tin i period a tawp reng hun chhung hi hnute cancer enkawlna atan a pawimawh hle. Hei hi chhan hrang hrang a awm a.
A awlsam zawngin, hmeichhe naupang zawk, premenopausal-te hnute cancer hi postmenopausal hmeichhia cancer aiin a nasat zawk deuh a ni .
Chu bâkah, i enkawlna chi hrang hrang a tichiang bawk. Entirnan, hormone-dependent cancer i neih chuan i menopausal status a zirin hormone treatment i dawn theih chi chu a inang lo ang.
- Postmenopausal: Arimidex ang damdawi pek i ni thei a, chu chuan taksain hormone estrogen a siam chhuah a titawp thei a ni.
- Premenopausal i nih chuan: I ovaries hian estrogen a la siam chhuak a, chuvangin Arimidex ang damdawi hian a hlawk vak dawn lo. Chuvangin i doctor chuan Tamoxifen tih damdawi a pe fo ang. Hei hian estrogen-in cancer cell-te hnena thuchah a thawn chu a block-in hna a thawk a ni.
I hrethiam em? I taksa hormone activity a inthlak dan azirin cancer dotu damdawi te pawh a inthlak a ngai bawk.
Cancer Biology: Hormone Receptor leh HER2 te hi a ni
Awle, tunah chuan tlem han laih thui deuh ila. Hormone therapy hi i tan a tha em tih chu dah bo ila, zawhna lian tak lo awm tur chu chemotherapy i mamawh leh mamawh loh hi a ni.
He thutlukna hi i cancer cells chunglama receptor chi hrang hrang atanga siam a ni fo thin . Heng receptor te hi cancer cell-a ‘antenna’ awm angin ngaihtuah rawh. Heng antenna te hian cancer thanlenna atana a mamawh ‘signal’ te chu an la chhuak thin. Receptor chi hnih kan en thin hi chi hnih a awm a.
1. Hormone Receptors (HR): Hormone estrogen leh progesterone te laka sensitive Receptor.
2. HER2 receptor: Hei hi cancer cells thanna tura puitu protein dang a ni.
Cancer chi hrang hrang thliar hran dan leh hengte inzawmkhawm atanga enkawl dan tur chu a hnuaia table hi en la.
| Cancer chi hrang hrang (a chhanna a zirin) . | A awmzia leh enkawl dan tlangpui |
|---|---|
| HR-positive, HER2-negative te an ni | Hormone-sensitive, mahse HER2-insensitive. Hormonal therapy hian hna a thawk tha hle. Chemotherapy mamawh leh mamawh loh chungchanga thutlukna siam hi thil buaithlak tak a ni. Hetah hian menopausal status hi a pawimawh hle. |
| HR-positive, HER2-positive te an ni | Hormone leh HER2 pahnih a sensitive. Hormonal therapy leh HER2-targeted therapy te hman dun hian result tha tak a pe thei a ni. Chemotherapy khauh tak hi pumpelh theih a ni fo. |
| HR-negative, HER2-positive a ni | Hormone sensitive lo, mahse HER2 sensitive. HER2-targeted therapy nen hian chemotherapy a ngai bawk. |
| Triple-Negative a ni | Hormone receptor leh HER2 receptor pahnih hi a bo vek a, pathumte hi a bo vek a ni. Chuvangin hormone therapy emaw HER2-targeted therapy emaw hian hna a thawk lo. Chemotherapy hi a tul tak zet fo thin. |
Oncotype Dx test hi eng nge ni?
I cancer chu HR-positive, HER2-negative a nih chuan, chu chu a chunga table-a type hmasa ber, zawhna "Chemo ka mamawh em?" tih hi chhan harsa ber a ni. Hetiang case-ah hian doctor-te chuan Oncotype Dx ang chi genomic test an hmang thin.
He test hian i cancer sample tlemte atanga gene 21 a zirchiang a. Chumi atanga chhut chuan i cancer hian nakin lawka a lo lang leh theihna chance a nei tlem, a hniam emaw, a sang emaw tih hriattirna score a pe che a ni.
- Score hniam: Chemotherapy tel lo chuan i dam thei fo .
- Score a san chuan: Chemotherapy hi a remchang ber.
Mahse mi tam tak chuan intermediate score an hmu thin . Chutah chuan buaina a lo chhuak leh ta a ni.
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Vanneihthlak takin tun hnaia zirchianna lian tak pahnih TAILORx leh RxPONDER te hian heng hmeichhe moderate-score te hi engtin nge an tih ang tih zawhna hi chhanna tha tak a pe a ni. Heng zirchiannate hian menopause pawimawhzia a nemnghet lehzual a ni.
- TAILORx trial (cancer chu lymph node-ah a darh lo tan):
- He zirchianna hian chiang takin a tarlang a, postmenopausal hmeichhia Oncotype Dx score hniam tak nei te chuan chemotherapy atang hian hlawkna dang an hmu lo tih a tarlang. Hormone therapy ringawt pawh an tan a tawk.
- RxPONDER study (cancer vei, lymph node-a darh tawhte tan):
- Hei pawh hian chutiang bawk chu a lantir a ni. Hmeichhe postmenopausal tam zawk chuan an cancer chu lymph node-ah a darh tawh a nih pawhin chemotherapy hi an hlawkpui vak lo.
- Mahse, premenopausal hmeichhia tan chuan thawnthu hi a danglam vek a, a bik takin kum 50 hnuai lam tan chuan a danglam hle a , an tan hormone therapy-ah chemotherapy an dah belh chuan cancer lo kir leh tawh lo tura ven theihna chu nasa takin a pung a ni
A awlsam zawngin, hmeichhe naupang premenopausal i nih chuan chemotherapy hi i nunna chhanhim thei tur ralthuam chak tak a ni thei. Mahse postmenopausal i nih chuan hormone therapy hmangin a side effects i tawk lo thei a, result tha zawk i hmu thei mai thei.
Thutlukna hnuhnung ber leh ngaihtuah tur thilte
Heng zawng zawng nen hian heng thutlukna siamte hi mahni chauha siam a harsat zia chu i hrethiam mai thei. Chuvang chuan heng zawng zawng hi doctor nen zalen taka sawipui a pawimawh em em a ni.
Premenopausal i nih chuan, a bik takin kum 40 hnuai lam i nih chuan thil dang ngaihtuah tur a awm. Chemotherapy hian i period chu a titawp vek thei a, menopause hma a thlen thei bawk. Naupang zawk tan chuan i period hi hun eng emaw chen a tawp a, a tan leh thei bawk. Mahse nakin lawka fa neih i beisei a nih chuan enkawlna i tan hmain i doctor nen fertility preservation chungchang hi sawipui hmasa phawt ang che.
A tawpah chuan nang leh i doctor chuan i tan eng enkawlna nge tha ber tih chu in rel ang. Chu sawihonaah chuan i cancer chi, stage, Oncotype Dx score, leh postmenopausal i nih leh nih loh te chu sawiho tur thupui pawimawh tak a ni.
Take-Home Thuchah a ni
- Hnute cancer zawng zawng hi a inang vek lo va, chuvangin enkawlna inang hi mi zawng zawng tan a tha lo.
- Menopause i paltlang tawh emaw, paltlang lo emaw pawh nise, i enkawlnaah nasa takin nghawng a nei ang a, a bik takin chemotherapy leh hormone therapy te hi a nghawng nasa hle ang.
- Oncotype Dx ang chi genetic test hian hmeichhia HR-positive, HER2-negative cancer nei te chu chemotherapy a tul leh tul loh hriat theih nan a pui thei a ni.
- Tun hnaia zirchianna hrang hrangah chuan postmenopausal hmeichhiate hian chemotherapy hmangin hlawkna dang an hmu lo fo a, mahse premenopausal hmeichhia tan chuan a hlawkpui hle thei a ni.
- I enkawl dan tur chungchangah i doctor hnenah inhawng tak leh rinawm takin sawi rawh. I kum, menopausal status, leh hmalam hun atana ruahmanna (fa neih ang chi) te chu chiang takin sawi rawh.
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