He uaua ki te whakapuaki i te wehi me te ohorere e pā ana ki a koe ina kitea he mate pukupuku ū tōu . He maha ngā pātai kei roto i tō hinengaro. He mea noa te pātai pēnei i te, "He aha i pā ai tēnei ki ahau?", "Me aha ahau ināianei?", "Ka taea te whakaora i tēnei?". I tēnei haerenga, kei te ngana ahau ki te whakamārama i ngā mea kia māmā noa iho, kia mārama hoki. Ko te mōhio ki te momo mate pukupuku kei a koe he rite ki te mārama ki te hoariri i mua i te tīmatanga o te pakanga. Koinei te taahiraa tuatahi me te taahiraa nui rawa atu i roto i te whiriwhiri i te maimoatanga e tika ana māu.
Te Matepukupuku o te Uma e Whai Hua ana ki te Kaiwhakawhiwhi Hōmona
Koinei te momo mate pukupuku ū e tino kitea ana. E 80 i roto i te 100 o ngā mate pukupuku ū ka taka ki tēnei wāhanga.
Nā, he aha te tikanga o tēnei "e whakawhirinaki ana ki te homoni"?
Whakaarohia noa iho. E rua ngā homoni o roto i ō tātou tinana, inā koa ko ngā tinana o ngā wāhine, e kiia nei ko te estrogen me te progesterone . He mea nui ēnei mō ngā tukanga noa i roto i ō tātou tinana. Heoi, he tino "whakapā" ētahi pūtau matepukupuku ki ēnei homoni. Arā, i runga i te mata o ēnei pūtau matepukupuku, he iti noa ngā "kaiwhakawhiwhi" me ngā tatau ka taea e ēnei homoni te piri atu. Ina tae mai te homoni estrogen ka patuki i taua tatau, ka whiwhi te pūtau matepukupuku i te kai mai i a ia, ka tīmata te tipu me te wehewehe. Pērā i te wā e whakamakuku ana koe i tētahi tipu, ka nui ake tōna tipu.
Mena kei te kī tō pūrongo hauora he 'ER-positive' (Estrogen Receptor-Positive), ko te tikanga he tairongo ō pūtau matepukupuku ki te homoni estrogen. Mena kei te kī 'PR-positive' (Progesterone Receptor-Positive), ko te tikanga he tairongo ki te homoni progesterone. Mena he tairongo ki tētahi o ēnei, ka kiia te matepukupuku he matepukupuku receptor-positive .
He rongo pai tēnei i tētahi ara. Nā te mea, ki te mōhio tātou ki te whakamahinga a te mate pukupuku hei tipu, ka taea e tātou te aukati i taua ara me te whakahaere i te mate pukupuku. Koinei te whakamahinga o te "whakaora homoni" .
I te nuinga o te wā ka tukuna te rongoā homoni i muri i te pokanga, te chemotherapy, te radiation rānei hei ārai i te hokinga mai o te mate pukupuku. Ka mahi ēnei rongoā mā te kati i ngā "tatau" o ngā pūtau mate pukupuku, mā te aukati rānei i te tinana ki te hanga estrogen.
| Kāwai maimoatanga | He whakamārama māmā me ngā tauira |
|---|---|
| Ngā SERM (Ngā Kaiwhakahaere ER Whiriwhiri) | Ka ārai ēnei i te kaiwhakawhiwhi homoni i runga i te pūtau matepukupuku, ka ārai i te urunga o te homoni. Hei tauira: Tamoxifen, Toremifene . |
| Ngā SERD (Ngā Kaiwhakaiti i te Kaiwhiwhi Estrogen Kōwhiringa) | Ehara i te mea ka ārai noa i te kaiwhakawhiwhi, engari ka whakangaro hoki i a ia. Hei tauira: Fulvestrant (Faslodex), Elacestrant (Orserdu) . |
| Ngā Ārai Aromatase | Ka aukati ēnei i te tinana ki te whakaputa i te homoni estrogen (he maha ngā wā ka hoatu ki ngā wāhine kua mutu te pāheketanga). Hei tauira: Anastrozole (Arimidex), Letrozole (Femara) . |
| Ngā Kaiwhakaora LHRH | Ka aukati ēnei i te whakaputanga o te estrogen e ngā ovaries mō tētahi wā poto. Hei tauira: Goserelin (Zoladex), Leuprolide (Lupron) . |
| Ētahi atu Whakaora Whaiaro | Ētahi atu rongoā hei whakanui ake i te angitu o te rongoā homoni. Tauira: Palbociclib (Ibrance), Ribociclib (Kisqali), Alpelisib (Piqray) . |
Matepukupuku ū HER2-Pai
Nā, me kōrero tātou mō tētahi atu momo. Ko ētahi pūtau matepukupuku ū (tata ki te 20% o ngā matepukupuku katoa) ka whakaputa i te nui rawa o te pūmua motuhake i runga i ō rātou mata e kiia nei ko te HER2 (Human Epidermal growth factor Receptor 2) .
Whakaarohia te HER2 hei pūihi iti e kī ana ki te pūtau matepukupuku kia "tere ake te tipu, kia tere ake te wehewehe." He torutoru noa iho ēnei pūihi o te pūtau noa. Engari he maha ngā pūihi o te pūtau matepukupuku HER2-pai. Koia te take ka kaha ake te kaha o ēnei momo matepukupuku.
Engari he rongo pai anō hoki tēnei. Nā te whanaketanga o te pūtaiao, kua puta ngā " rongoā arotahi" e arotahi ana, e whakangaro ana hoki i ēnei pūihi HER2. Nā te mea ka kitea, ka whakaekea hoki e ēnei ngā pūtau he nui rawa te HER2, ka iti ake te kino ki ngā pūtau noa.
Ko te rongoā matua me te rongoā tino whai hua e hoatu ana mō tēnei ko Trastuzumab (Herceptin) . He tino āwhina tēnei ki te ārai i te hokinga mai o te mate pukupuku. Heoi, he iti noa te tūponotanga o ētahi pānga ki te ngākau, ki ngā pukahukahu rānei ina tangohia tēnei maimoatanga. Kaua e manukanuka ki tēnā , ka tirotirohia tonutia e tō tākuta.
| Ētahi atu rongoā kua arotahihia e whakamahia ana mō ngā mate pukupuku HER2-pai | |
|---|---|
| Pertuzumab (Perjeta) | Ado-trastuzumab emtansine (Kadcyla) |
| Lapatinib (Tykerb) | Neratinib (Nerlynx) |
| Tucatinib (Tukysa) | Enhertu (Fam-trastuzumab deruxtecan-nxki) |
Te Matepukupuku o te Uma "Toru-Kino"
Koinei te tuatoru o ngā momo matua. Tata ki te 10%-20% o ngā mate pukupuku ū ka taka ki roto i tēnei momo. E mōhio ana koe he aha i kiia ai ko "toru-kino" "toru-kino" rānei?
Nā te mea i roto i ēnei pūtau matepukupuku ,
1. No estrogen receptor (ETU) .
2. Kāore he kaiwhakawhiwhi progesterone (PR).
3. Kāore i te nui te pūmua HER2 .
Nā te mea kāore i roto i ēnei pūtau matepukupuku ngā whāinga matua e toru i kōrerotia i mua ake nei, kāore te rongoā homoni me ngā rongoā e arotahi ana ki te HER2 pērā i a Herceptin e mahi ki a rātou. Nō reira, he uaua pea te rongoā i a rātou.
Ko te BRCA1 te pūtake o tēnei momo mate pukupuku.E pā ana tēnei ki tētahi whakarerekētanga ira i roto i tētahi ira e kiia nei ko . Nō reira, ki te mea he mate pukupuku triple-negative tōu, ka tūtohu pea tō tākuta kia whakamātauria he ira.
Ko te nuinga o te wā ka rongoatia tēnei momo mā te pokanga, te rongoā chemotherapy, me te radiation . Heoi anō, kei reira ngā maimoatanga hou e hāngai ana ki tēnei momo.
- Ngā Ārai PARP: Ko ngā rongoā pēnei i a Olaparib (Lynparza) me Talazoparib (Talzenna) e whakamahia ana mō te hunga whai whakarerekētanga ira BRCA. Ka ārai ēnei i te kaha o ngā pūtau matepukupuku ki te whakatika i a rātou anō.
- Ārai Mate: Ka āwhina ngā rongoā pēnei i a Atezolizumab (Tecentriq) ki te whawhai ki ngā pūtau matepukupuku mā te whakamahi i ō tātou ake pūtau ārai mate.
Tērā pea he ahua uaua tēnei katoa. He mea noa tēnā. Ko te mea nui kia maumahara ahakoa te momo mate pukupuku kei a koe, kei reira ngā maimoatanga e wātea ana i ēnei rā e tika ana mōna. Ka mahi tahi tō tākuta me tō rōpū hauora ki a koe ki te waihanga i te mahere maimoatanga pai rawa atu māu.
Karere Tangohia ki te Kāinga
- E toru ngā momo matua o te mate pukupuku o te ū: He pai te kaiwhakawhiwhi homoni, he pai te HER2, me te kino-toru .
- He mea nui te mōhio ki te momo mate pukupuku kei a koe hei whakamahere i te maimoatanga.
- He pai te urupare a ngā mate pukupuku e whai homoni ana ki te rongoā homoni.
- Ahakoa te tere o te tipu o ngā mate pukupuku HER2-positive , he tino whai hua ngā maimoatanga kua whakawhanakehia mō rātou.
- Ahakoa he uaua te rongoā i ngā mate pukupuku toru-kino , ka taea te whawhai ki ēnei mā te chemotherapy me ngā maimoatanga hou kua arotahihia.
- Mena he pātai āu mō tētahi mea kei roto i tō pūkete hauora, kaua e wehi ki te pātai . Pātai atu ki tō tākuta mō tētahi whakamārama mārama. Kāore koe i te mokemoke, ā, he tokomaha ngā tāngata ka taea te āwhina i a koe.
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