Mankhwala a khansa ndi amodzi mwa mankhwala ofala kwambiri komanso ofala kwambiri ochizira khansa. Izi zimaphatikizapo kutumiza mankhwala kudzera m'magazi mwathu kuti aphe maselo a khansa ndikuletsa kukula kwawo. Koma kodi mukudziwa kuti pali mitundu yosiyanasiyana ya mankhwala a khansa omwe amagwira ntchito mosiyana? Mankhwala oletsa metabolites ndi amodzi mwa mankhwala apadera. Ngakhale dzinalo lingamveke lovuta, momwe amagwirira ntchito ndi odabwitsa. Lero tikambirana za mankhwala oletsa metabolites awa.
Kodi ma antimetabolites amenewa amapha bwanji maselo a khansa?
Mwachidule, zomwe mankhwalawa amachita ndikunyenga maselo a khansa, monga kuwapatsa kiyi yabodza yomwe imawoneka ngati yeniyeni.
Kuti timvetse izi, choyamba tiyeni tiwone momwe selo la khansa limapangira (kugawa) maselo ambiri. Monga selo lililonse m'thupi lathu, maselo a khansa ali ndi chinthu chotchedwa DNA. Taganizirani izi ngati "buku la malangizo" la selo kapena "pulani." Dongosolo ili ndi lomwe selo limachita, komanso momwe limapangira makope ambiri a lokha.
Kuti apange bwino DNA plan iyi, selo limafunikira zosakaniza zofunika kwambiri. Monga momwe kumanga nyumba kumafunira njerwa ndi simenti. Zosakaniza izi timazitcha metabolites. Izi makamaka ndi izi:
- Ma Purines: Awa ndi ma steam ofunikira kwambiri pakupanga DNA ndi RNA.
- Ma Pyrimidines: Awa ndi ma steam ofunikira kwambiri a DNA ndi RNA.
- Folic acid: Iyi ndi mtundu wa vitamini womwe umapereka mphamvu pakugawa maselo.
Tsopano, nayi zomwe mankhwala oletsa metabolite amachita. Molekyu ya mankhwala iyi imapangidwa mofanana kwambiri ndi zosakaniza zenizeni (ma metabolites) zomwe zatchulidwa pamwambapa. Chifukwa chake, pamene selo la khansa likuyesera kupanga DNA yake, limagwiritsa ntchito chosakaniza chabodza ichi, mankhwalawo, poganiza kuti ndi chosakaniza chenicheni.
Tangoganizani mukuphika mpunga. Mukuganiza kuti ndi mchere ndipo mukuwonjezera shuga womwe mukuwona. Ndiye chimachitika ndi chiyani? Kukoma ndi kapangidwe ka mpunga wonse kumasokonekera, sichoncho? Mofananamo, selo la khansa likagwiritsa ntchito chosakaniza chabodza ichi, DNA yake imakhala yolakwika kwambiri. Ndi pulani yolakwika, selo silingathe kupanga makope ambiri. Pamapeto pake, selo la khansa silingathe kugawikananso ndikumwalira.
Kodi mitundu ikuluikulu ya antimetabolites ndi iti?
Mukukumbukira zinthu zitatu zofunika zomwe tidakambirana kale? Mankhwalawa amagawidwa m'magulu atatu akuluakulu, kutengera ndi gawo liti mwa magawo atatuwo lomwe akufuna.
- Ma purine antagonists: Izi zimaletsa maselo a khansa kupanga ma purine.
- Mankhwala oletsa khansa: Izi zimaletsa maselo a khansa kupanga ma pyrimidines.
- Otsutsa a folic acid (antifolates):Izi zimaletsa maselo a khansa kugwiritsa ntchito folic acid popanga DNA.
Kodi mankhwalawa amagwiritsidwa ntchito pa mitundu iti ya khansa?
Mankhwala oletsa metabolite amagwiritsidwa ntchito pochiza mitundu yambiri ya khansa. Dokotala wanu adzasankha mankhwala omwe ali abwino kwa inu kutengera mtundu wa khansa yomwe muli nayo, gawo lake, komanso momwe mudayankhira chithandizo cham'mbuyomu. Mankhwala ena amagwiritsidwanso ntchito pochiza matenda ena (monga matenda odziteteza ku matenda) kuwonjezera pa khansa.
Gome ili m'munsimu likuwonetsa zina mwa mankhwala oletsa khansa omwe amagwiritsidwa ntchito kwambiri komanso mitundu ya khansa yomwe amachizira.
| Dzina la Mankhwala | Mitundu ya Khansa Yochiritsidwa |
|---|---|
| Fluorouracil (5-FU) | Khansa ya m'mawere, m'matumbo, m'mimba, kapamba, ndi pakhungu |
| Capecitabine (Xeloda®) | Khansa ya m'mawere, m'matumbo, m'mimba, m'mero, ndi m'mapapo |
| Gemcitabine (Gemzar®) | Khansa ya m'mawere, ya m'mapapo (yosakhala yaing'ono), ya mazira ndi ya kapamba |
| Methotrexate | Khansa ya m'magazi, khansa ya m'magazi, khansa ya m'mawere, ya m'mapapo, ya mutu ndi khosi, khansa ya m'mafupa (Osteosarcoma) |
| Cytarabine | Mitundu yosiyanasiyana ya khansa ya m'magazi (Acute myeloid, ALL, CML) |
| Hydroxyurea | Khansa ya m'magazi (CML), khansa ya mutu ndi khosi |
Kodi mankhwalawa amaperekedwa bwanji m'thupi?
Pali njira zingapo zoperekera mankhwala awa, kutengera mtundu wa mankhwala omwe akuperekedwa.
- Mu njira ya mtsempha (IV): Iyi ndi njira yodziwika kwambiri. Mankhwalawa amaperekedwa m'thupi ngati madzi amchere kudzera mu cannula kapena chemo port yomwe imayikidwa m'dzanja kapena pachifuwa. Mankhwalawa amatha kwa mphindi zingapo, maola angapo, kapena masiku angapo.
- Monga jakisoni: Mankhwala ena amaperekedwanso ngati jakisoni mu gawo lamafuta lomwe lili pansi pa khungu.
- Mapiritsi: Mapiritsi ena oletsa metabolites amapezekanso ngati mapiritsi omwe angathe kumezedwa.
- Monga kirimu wa pakhungu: Mankhwala a 5-FU, omwe amagwiritsidwa ntchito pochiza khansa ya pakhungu (basal cell carcinoma), amapezekanso ngati kirimu wa pakhungu.
Kodi zotsatirapo zake zingakhale zotani chifukwa cha chithandizochi?
Chinthu chofala kwambiri pa mankhwala a chemotherapy ndichakuti amalimbana ndi maselo omwe amagawikana mofulumira. Maselo a khansa ndi mtundu wa selo lomwe limagawikana mwachangu kwambiri. Koma vuto ndilakuti, maselo ena athanzi m'thupi lathu amagawikananso mofulumira. Mwachitsanzo:
- Maselo a tsitsi
- Maselo mkamwa ndi m'mimba
- Maselo a khungu
- Maselo opanga magazi
Mankhwala oletsa metabolites sangasiyanitse maselo a khansa ndi maselo athanzi. Chifukwa chake, maselo athanzi awa amathanso kuwonongeka. Ichi ndichifukwa chake zotsatirapo zoyipa zimachitika.
Zotsatira zoyipa kwambiri ndi izi:
- Kutopa ndi kutopa
- Kutaya tsitsi
- Kusintha kwa khungu (monga ziphuphu )
- Kusanza ndi kusanza
- Kutsegula m'mimba (kupweteka m'mimba)
- Chilakolako cha chakudya
Koma zotsatirapo zake sizimachitikira aliyense mofanana. Zimatengera mankhwala omwe mwapatsidwa, mlingo wake, ndi zina zotero. Chifukwa chake ndikofunikira kwambiri kukambirana ndi dokotala wanu za izi musanayambe kulandira chithandizo. Pali mankhwala ambiri oletsa zotsatirapo zake.
Kodi ubwino ndi zoopsa za chithandizochi ndi ziti?
Ubwino:
Phindu lalikulu la mankhwala oletsa khansa ndilakuti amapha maselo a khansa ndikuletsa kukula kwa chotupa. Izi zitha kutalikitsa moyo wa munthu amene ali ndi khansa ndikupangitsa moyo kukhala wosavuta poletsa zizindikiro.
Zoopsa:
Choopsa chachikulu ndi zotsatirapo zomwe takambirana kale. Komanso, si mankhwala onse a khansa omwe amagwira ntchito mofanana kwa aliyense. Mankhwala enaake sangagwire ntchito pa khansa yanu. Pakapita nthawi, maselo a khansa amatha kukhala osagwira ntchito ndi mankhwalawa, ndipo mankhwalawa sangagwire ntchito bwino. Ngati izi zitachitika, dokotala wanu angakulangizeni mankhwala ena a chemotherapy kapena mankhwala ena (monga radiation, immunotherapy).
Ngati muli ndi pakati, mukuyamwitsa, kapena muli ndi vuto lina lililonse la matenda, onetsetsani kuti mwadziwitsa dokotala wanu musanayambe chithandizochi.
Uthenga Wopita Nawo Kunyumba
- Mankhwala oletsa kugawikana kwa maselo a khansa ndi mtundu wapadera wa mankhwala a chemotherapy omwe "amanyenga" maselo a khansa kuti asagawanike.
- Mankhwalawa amagwira ntchito poletsa maselo a khansa kupeza zinthu zofunika kuti apange DNA yawo (majini).
- Izi zimagwiritsidwa ntchito pochiza mitundu yosiyanasiyana ya khansa, monga khansa ya m'mawere, ya m'mapapo, ndi ya m'magazi.
- Zotsatirapo zoyipa monga kutaya tsitsi ndi nseru zimatha kuchitika chifukwa mankhwalawa amakhudzanso maselo athanzi omwe amagawikana mwachangu.
- Kuphunzira za chithandizo kungakhale koopsa pang'ono. Koma musaope kufunsa dokotala wanu za mankhwala omwe mukupatsidwa, zabwino zake, kuipa kwake, ndi zotsatira zake zoyipa. Kukhala wodziwa bwino ndi gawo lofunika kwambiri la chithandizo.
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