Timamvetsetsa mantha, mantha, ndi mafunso ambiri omwe amabuka mukazindikira kuti muli ndi khansa ya m'mawere. Koma chofunika kwambiri panthawiyi ndikudziwa bwino. Chifukwa, si khansa zonse za m'mawere zomwe zili zofanana. Pali mankhwala omwe cholinga chake ndi mitundu ina ya khansa. Chabwino, chithandizo chimodzi chomwe chagwiritsidwa ntchito bwino kwa anthu ambiri ndi chithandizo cha mahomoni . Tiyeni tikambirane za izi lero.
Kodi chithandizo cha mahomoni n'chiyani? Kodi ndi choyenera kwa aliyense?
Mwachidule, mahomoni ena m'thupi lathu amathandiza maselo ena a khansa ya m'mawere kukula. Makamaka, mahomoni awiri otchedwa estrogen ndi progesterone.
Ganizirani maselo a khansa ngati nyumba zazing'ono. Maselo ena a khansa ali ndi 'zitseko' zapadera (ma receptor) zomwe zimalola mahomoniwa kulowa. Timatcha khansa zomwe zili ndi ma hormone receptor a zitseko izi kuti ndi zabwino . Madokotala, mwina mwalemba izi mu lipoti lanu kuti ndi zabwino kwa ER (zitseko za estrogen) kapena zabwino kwa PR (zitseko za progesterone).
Mankhwala a mahomoni amagwira ntchito pa khansa zomwe zili ndi ma hormone gets awa. Mankhwalawa amatseka ma hormone amenewo kapena amachepetsa kupanga ma hormone amenewo m'thupi. Izi zimalepheretsa maselo a khansa kupeza "zakudya" zomwe amafunikira, zomwe zimapangitsa kuti asiye kukula kapena kufa.
Chofunika ndichakuti, ngati maselo anu a khansa alibe ma hormone receptors awa, kutanthauza kuti, ngati alibe ma hormone receptor , ma hormone treatments awa sagwira ntchito. Madokotala amalimbikitsa ma therapy ena kwa anthu otere.
Kodi mitundu ikuluikulu ya mankhwala a mahomoni ndi iti?
Pali mitundu ingapo yayikulu ya mankhwala a mahomoni omwe amagwiritsidwa ntchito pa khansa ya m'mawere. Dokotala wanu adzakusankhirani mankhwala oyenera kwambiri kutengera zinthu zambiri, kuphatikizapo zaka zanu, mtundu wa khansa, komanso ngati mwakhala mukusiya kusamba. Tiyeni tiwone mitundu iwiri ikuluikulu.
| Mtundu wa chithandizo | Kodi chimaperekedwa kwa ndani makamaka? | Zotsatirapo zoyipa zomwe muyenera kudziwa |
|---|---|---|
| Mankhwala "Tamoxifen". | Kwa akazi a msinkhu uliwonse (asanathe kusamba komanso atatha kusamba). Mankhwala omwe akhala akugwiritsidwa ntchito bwino kwa zaka zambiri. | Kuwonjezeka pang'ono kwa chiopsezo cha khansa ya m'chiberekero, magazi kuundana m'miyendo ndi m'mapapo, sitiroko, maso otupa, ndi kutentha thupi. |
| Aromatase Inhibitors (AIs) Mwachitsanzo: Anastrozole, Letrozole | Makamaka kwa akazi akatha kusamba. | Kufooka kwa mafupa (Osteoporosis) ndi chiopsezo cha kusweka kwa mafupa, kupweteka kwa mafupa ndi minofu, mavuto okumbukira, komanso chiopsezo chowonjezeka pang'ono cha matenda a mtima. |
Zambiri zokhudza Tamoxifen
Imeneyi ndi piritsi yomwe mumamwa tsiku lililonse. Kafukufuku wasonyeza kuti kumwa kwa zaka zingapo, nthawi zambiri pafupifupi zaka 5, kumachepetsa kwambiri chiopsezo cha khansa kubwerera komanso chiopsezo cha khansa zatsopano.
Komabe, muyeneranso kudziwa za zotsatirapo zomwe takambirana patebulopo. Makamaka chiopsezo cha khansa ya m'chiberekero. Ndicho chifukwa chake ndikofunikira kuti muyezetse m'chiuno nthawi zonse mukumwa mankhwalawa. Komanso, ngati mukumva kutuluka magazi m'mimba mwanu modabwitsa, muyenera kuuza dokotala wanu nthawi yomweyo.
Zambiri zokhudza Aromatase Inhibitors (AIs)
Mankhwala amtundu uwu amagwira ntchito poletsa kupanga kwa hormone ya estrogen mwa akazi akasiya kusamba. Izi zimachotsa maselo a khansa mahomoni omwe amafunikira kuti akule.
Chiwopsezo chachikulu cha mankhwalawa ndi osteoporosis , chomwe ndi chiopsezo cha mafupa kufooka ndikusweka mosavuta. Pachifukwa ichi, dokotala wanu mwina adzayesa kuchuluka kwa mafupa musanayambe kumwa mankhwalawa komanso mukamamwa. Angakulimbikitseninso kuti mumwe mankhwala owonjezera a calcium ndi vitamini D.
Mankhwala ena ndi apamwamba
Kuwonjezera pa mitundu ikuluikulu ya mankhwala omwe atchulidwa pamwambapa, palinso mitundu ina ya mankhwala omwe amagwiritsidwa ntchito, makamaka khansa ikafalikira ku ziwalo zina za thupi (yomwe yafalikira kwambiri kapena yofalikira).
Mwachitsanzo, pali mankhwala monga `Fulvestrant (Faslodex)` ndi `Toremifene (Fareston)`. Kuphatikiza apo, pali mankhwala ambiri apamwamba otchedwa `Targeted Therapy` masiku ano. `Palbociclib (Ibrance)`, `Abemaciclib (Verzenio)`, `Alpelisib (Piqray)` ndi zitsanzo za mankhwala otere. Izi zimagwira ntchito poyang'ana mapuloteni enaake omwe amathandiza maselo a khansa kukula. Izi nthawi zambiri zimaperekedwa kwa odwala pamodzi ndi mankhwala a mahomoni omwe atchulidwa pamwambapa.
Zisankho zonsezi za chithandizo zimapangidwa kutengera matenda anu, mtundu wa khansa, zaka zanu, komanso thanzi lanu lonse. Choncho musaope kukambirana ndi dokotala wanu mafunso aliwonse omwe muli nawo.
Chithandizo chapadera kwa iwo omwe sanapite ku nthawi yopuma (Ovarian Ablation)
Ngati simunafike nthawi yosamba, zomwe zikutanthauza kuti mukuchita msambo nthawi zonse , mahomoni akuluakulu a estrogen m'thupi lanu amapangidwa ndi mazira anu. Chifukwa chake, kwa munthu amene ali ndi khansa ya ER-positive, dokotala wanu angasankhe kuletsa mazira awa kupanga estrogen. Izi zimatchedwa ovarian ablation/suppression .
Pali njira zingapo zochitira izi:
- Kuchotsa mazira m'chiberekero mwa opaleshoni: Iyi ndi njira yokhazikika.
- Chithandizo cha radiation ku mazira: Izi zitha kuletsanso kugwira ntchito kwa mazira kwamuyaya.
- Mankhwala oletsa kwakanthawi mazira kuti asagwire ntchito: Mankhwala otchedwa `(LHRH) agonists` (nthawi zambiri jakisoni) amagwiritsidwa ntchito pa izi. Bola mukamwa mankhwalawa, mazira anu sapanga mahomoni.
Kafukufuku wasonyeza kuti pamodzi ndi kuletsa mazira awa, mankhwala a mahomoni monga tamoxifen angathandize kwambiri.
Uthenga Wopita Nawo Kunyumba
- Chithandizo cha mahomoni si mankhwala a khansa yonse ya m'mawere. Chimaperekedwa kokha kwa khansa ya receptor-positive (ER/PR-positive) .
- Chithandizo choyenera kwambiri kwa inu (monga Tamoxifen kapena Aromatase Inhibitor) chidzatsimikiziridwa ndi dokotala wanu, kutengera zaka zanu ndi thanzi lanu.
- Mankhwala onsewa akhoza kukhala ndi zotsatirapo zake. Musawaope, ingodziwani zomwe zili. Ngati mukukumana ndi zizindikiro zachilendo, uzani dokotala wanu nthawi yomweyo.
- Ndikofunikira kwambiri kuti dokotala apereke mayeso pa nthawi yake panthawi ya chithandizo.
- Onetsetsani kuti mwakambirana momasuka za mantha anu, kukayikira kwanu, ndi mafunso anu ndi gulu lanu lachipatala. Izi zidzakhala mphamvu yayikulu paulendo wanu wochira.
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