N'zovuta kufotokoza m'mawu mantha ndi kudabwa komwe mumamva mukazindikira kuti muli ndi khansa ya m'mawere . Muli ndi mafunso ambiri m'maganizo mwanu. Ndizachilendo kukhala ndi mafunso monga, "N'chifukwa chiyani izi zandichitikira ine?", "Ndichite chiyani tsopano?", "Kodi izi zitha kuchiritsidwa?". Mu ulendowu, ndikuyesera kufotokoza zinthu mosavuta komanso m'chinenero chomwe mungamvetse. Kudziwa bwino mtundu wa khansa yomwe muli nayo kuli ngati kumvetsetsa mdani musanayambe nkhondo. Imeneyo ndiye sitepe yoyamba komanso yofunika kwambiri posankha chithandizo choyenera kwa inu.
Khansa ya m'mawere yokhala ndi mahomoni yolandira chithandizo cha khansa
Uwu ndi mtundu wofala kwambiri wa khansa ya m'mawere. Pafupifupi, khansa ya m'mawere pafupifupi 80 mwa khansa 100 zilizonse imagwera m'gululi.
Ndiye kodi "kudalira mahomoni" kumeneku kumatanthauza chiyani?
Tangoganizirani izi. Matupi athu, makamaka matupi a akazi, ali ndi mahomoni awiri achilengedwe otchedwa estrogen ndi progesterone . Izi ndizofunikira kwambiri pazochitika zachibadwa m'matupi athu. Komabe, maselo ena a khansa "amazolowera" kwambiri mahomoni awa. Izi zikutanthauza kuti, pamwamba pa maselo a khansa awa, pali "ma receptor" ang'onoang'ono kapena zitseko zomwe mahomoni awa amatha kubwera ndikumamatira. Pamene mahomoni a estrogen abwera ndikugogoda pachitseko chimenecho, selo la khansa limalandira chakudya kuchokera pamenepo ndipo limayamba kukula ndikugawikana. Monga momwe mumathirira chomera, chimakula.
Ngati lipoti lanu lachipatala likunena kuti `ER-positive` (Estrogen Receptor-Positive), zikutanthauza kuti maselo anu a khansa amakhudzidwa ndi hormone ya estrogen. Ngati likunena kuti `PR-positive` (Progesterone Receptor-Positive), zikutanthauza kuti limakhudzidwa ndi hormone ya progesterone. Ngati likhudzidwa ndi chilichonse mwa izi, khansa imatchedwa khansa ya hormone receptor-positive .
Iyi ndi nkhani yabwino kwambiri. Chifukwa ngati tikudziwa zomwe khansa imagwiritsa ntchito pokulitsa, tikhoza kutseka njirayo ndikulamulira khansa. Ndicho chimene "mankhwala a mahomoni" amagwiritsidwa ntchito.
Mankhwala a mahomoni nthawi zambiri amaperekedwa pambuyo pa opaleshoni, chemotherapy, kapena radiation kuti khansa isabwererenso. Mankhwalawa amagwira ntchito potseka "zitseko" za maselo a khansa, kapena poletsa thupi kupanga estrogen.
| Gulu la chithandizo | Kufotokozera kosavuta ndi zitsanzo |
|---|---|
| Ma SERM (Ma Selective ER Modulators) | Izi zimaletsa cholandirira mahomoni pa selo la khansa, zomwe zimalepheretsa mahomoni kulowa. Zitsanzo: Tamoxifen, Toremifene . |
| SERDs (Zosankha Zochotsera Chilandiro cha Estrogen) | Izi sizimangoletsa cholandirira, komanso zimachiwononga. Zitsanzo: Fulvestrant (Faslodex), Elacestrant (Orserdu) . |
| Zoletsa za Aromatase | Izi zimaletsa thupi kupanga mahomoni otchedwa estrogen (omwe nthawi zambiri amaperekedwa kwa akazi omwe asiya kusamba). Zitsanzo: Anastrozole (Arimidex), Letrozole (Femara) . |
| Agonists a LHRH | Izi zimaletsa kwakanthawi mazira kuti asapange estrogen. Zitsanzo: Goserelin (Zoladex), Leuprolide (Lupron) . |
| Mankhwala Ena Omwe Amagwiritsidwa Ntchito | Mankhwala ena omwe amawonjezera kupambana kwa chithandizo cha mahomoni. Zitsanzo: Palbociclib (Ibrance), Ribociclib (Kisqali), Alpelisib (Piqray) . |
Khansa ya m'mawere ya HER2-Positive
Tsopano tiyeni tikambirane za mtundu wina. Maselo ena a khansa ya m'mawere (pafupifupi 20% ya khansa zonse) amapanga puloteni yapadera kwambiri pamwamba pake yotchedwa HER2 (Human Epidermal growth factor Receptor 2) .
Ganizirani za HER2 ngati antenna kakang'ono komwe kamauza selo la khansa kuti "likule mofulumira, ligawane mofulumira." Selo labwinobwino limakhala ndi ma antenna ochepa okha. Koma selo la khansa la HER2 lomwe lili ndi ma antenna ambiriwa. Ichi ndichifukwa chake mitundu iyi ya khansa imatha kukhala yamphamvu kwambiri .
Koma palinso nkhani yabwino apa. Ndi kupita patsogolo kwa sayansi, tsopano pali " mankhwala ochiritsira " omwe amalimbana ndikuwononga tinyanga ta HER2 tomwe timapezeka. Chifukwa izi zimapeza ndikuukira maselo omwe ali ndi HER2 yambiri, kuwonongeka kwa maselo abwinobwino sikuchepa.
Mankhwala akuluakulu komanso ogwira mtima kwambiri omwe amaperekedwa pa izi ndi Trastuzumab (Herceptin) . Izi zimathandiza kwambiri kupewa khansa kuti isabwererenso. Komabe, pali chiopsezo chochepa cha zotsatira zina pamtima kapena m'mapapo mukalandira chithandizochi. Musadandaule ndi zimenezo , dokotala wanu nthawi zonse amafufuza ngati chilipo.
| Mankhwala ena ogwiritsidwa ntchito pa khansa ya HER2-positive | |
|---|---|
| Pertuzumab (Perjeta) | Ado-trastuzumab emtansine (Kadcyla) |
| Lapatinib (Tykerb) | Neratinib (Nerlynx) |
| Tucatinib (Tukysa) | Enhertu (Fam-trastuzumab deruxtecan-nxki) |
Khansa ya m'mawere "Yoipa Katatu"
Uwu ndi mtundu wachitatu waukulu. Pafupifupi 10%-20% ya khansa ya m'mawere imagwera mu mtundu uwu. Kodi mukudziwa chifukwa chake imatchedwa "triple-negative" kapena "triple negative"?
Chifukwa m'maselo a khansa awa,
1. Palibe estrogen receptor (ETU) .
2. Palibe cholandirira cha progesterone (PR).
3. Palibe mapuloteni ambiri a HER2 .
Popeza maselo a khansa awa alibe zolinga zitatu zazikulu zomwe takambirana kale, chithandizo cha mahomoni kapena njira zochiritsira za HER2 monga Herceptin sizigwira ntchito pa iwo. Choncho kuwachiza kungakhale kovuta pang'ono.
Mtundu uwu wa khansa nthawi zambiri umayamba chifukwa cha BRCA1.Zimagwirizanitsidwa ndi kusintha kwa majini otchedwa . Chifukwa chake ngati muli ndi khansa ya triple-negative, dokotala wanu angakulangizeninso kuti muyesedwe majini.
Mtundu uwu umachiritsidwa makamaka ndi opaleshoni, chemotherapy, ndi radiation . Komabe, tsopano pali njira zatsopano zochiritsira zamtunduwu.
- Mankhwala oletsa PARP: Mankhwala monga Olaparib (Lynparza) ndi Talazoparib (Talzenna) amagwiritsidwa ntchito kwa anthu omwe ali ndi kusintha kwa majini a BRCA. Mankhwalawa amalepheretsa maselo a khansa kudzikonza okha.
- Chithandizo cha Immunotherapy: Mankhwala monga Atezolizumab (Tecentriq) amathandiza kulimbana ndi maselo a khansa pogwiritsa ntchito maselo athu oteteza thupi.
Zonsezi zingawoneke ngati zovuta pang'ono. Zimenezo ndi zachilendo. Chofunika ndikukumbukira kuti mosasamala kanthu za mtundu wa khansa womwe muli nawo, pali mankhwala omwe alipo masiku ano omwe ndi oyenera. Dokotala wanu ndi gulu lachipatala adzagwira nanu ntchito kuti apange dongosolo labwino kwambiri la chithandizo kwa inu.
Uthenga Wopita Nawo Kunyumba
- Khansa ya m'mawere imagawidwa m'magulu atatu akuluakulu: Hormone Receptor-Positive, HER2-Positive, ndi Triple-Negative .
- Kudziwa mtundu wa khansa yomwe muli nayo n'kofunika kwambiri pokonzekera chithandizo.
- Khansa yokhala ndi mahomoni imayankha bwino chithandizo cha mahomoni.
- Ngakhale kuti khansa ya HER2 imakula mofulumira, pali njira zochizira zothandiza kwambiri zomwe zapangidwira makamaka iwo.
- Ngakhale kuti kuchiza khansa ya triple-negative n'kovuta, kumatha kuthetsedwa ndi mankhwala a chemotherapy ndi njira zatsopano zochizira.
- Ngati muli ndi mafunso okhudza chilichonse chomwe chili m'kaundula wanu wa zachipatala, musaope kufunsa . Funsani dokotala wanu kuti akufotokozereni momveka bwino. Simuli nokha, ndipo pali anthu ambiri omwe angakuthandizeni.
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