Kodi khansa yanu ya m'mawere ili ndi HER2-Positive? Tiyeni tikambirane izi mwatsatanetsatane!

Kodi mudamvapo za khansa ya m'mawere? Mwina mnzanu kapena wachibale wanu adadwala nayo. Pali mitundu yosiyanasiyana ya khansa ya m'mawere. Lero tikambirana za imodzi mwa izo, yomwe ndi yapadera ndipo imatha kufalikira mwachangu. Imeneyi ndi khansa ya m'mawere ya HER2-Positive (HER2-positive) . Mukamva dzinali, mungaganize kuti ndi lovuta pang'ono, koma musadandaule. Tikambirana mwachidule, m'njira yomwe mungamvetse.

Kodi khansa ya m'mawere ya HER2-Positive (HER2+) ndi chiyani?

Mwachidule, khansa ya m'mawere ya HER2 (HER2+) ndi mtundu wa khansa yomwe imakula mofulumira ndipo imatha kufalikira mosavuta kunja kwa bere ('invasive') . Madokotala akamanena kuti muli ndi khansa yamtunduwu, zikutanthauza kuti maselo anu a khansa ali ndi puloteni yapadera yomwe imayang'anira kukula ndi kugawikana kwa maselo m'thupi lanu - yotchedwa ``Human Epidermal Growth Factor Receptor 2`` , kapena mwachidule HER2 . Puloteni iyi ya HER2 ili ngati ``chizindikiro'' chomwe chimauza maselo kuti akule. Ikakhala yochuluka kwambiri, maselo amagawikana mofulumira komanso mosalamulirika, zomwe zimapangitsa khansa.

Mtundu uwu wa khansa ya m'mawere umafalikira kwambiri (metastasize) kuchokera ku bere kupita ku ziwalo zina za thupi lanu, monga ma lymph nodes, chiwindi, mapapo, kapena ubongo wanu. Koma chofunika ndichakuti ngati khansa iyi yapezeka msanga, isanafalikire ku ziwalo zina za thupi, madokotala amatha kuchiza bwino ndi mankhwala apamwamba omwe alipo masiku ano. Ndicho chifukwa chake kuzindikira msanga ndikofunikira kwambiri.

Kodi khansa ya m'mawere ya HER2-positive ndi yofala bwanji?

Malinga ndi bungwe la American Cancer Society, akazi opitilira 290,000 adzapezeka ndi khansa ya m'mawere yolowa m'malo mwa khansa (invasive ductal carcinoma ndi lobular breast cancer) mu 2023 yokha. Mwa awa , 15% mpaka 20% ali ndi HER2-positive. Amuna amathanso kutenga khansa ya m'mawere, koma khansa ya m'mawere ya HER2-positive si yofala kwambiri mwa amuna.

Kodi zizindikiro za khansa ya m'mawere ya HER2-positive ndi ziti?

Monga mitundu yambiri ya khansa ya m'mawere, mtundu uwu wa HER2-positive nthawi zina suwonetsa zizindikiro zoonekeratu poyamba. Koma zizindikiro zikaonekera, zimakhala zofanana ndi zomwe zimawonedwa mu khansa ya m'mawere yachizolowezi. Tiyeni tiwone zomwe zili:

• Kusintha kwa kukula, mawonekedwe, kapena mawonekedwe a bere . Bere limodzi lingamveke lalikulu kuposa linzake, kapena mawonekedwe ake angasinthe.
• Chotupa kapena chotupa m'mabere kapena m'khwapa. Ichi chingakhale chaching'ono ngati nandolo. Ngati chotupacho chikupitirira pambuyo poti nthawi yanu ya msambo yatha, muyenera kuda nkhawa.
• Kusintha kwa mawonekedwe kapena momwe khungu la bere kapena bere limaonekera . Khungu likhoza kukhala louma, losawoneka bwino kapena lotupa, kapena likhoza kumva ngati lili ndi ziphuphu kapena kutupa. Nthawi zina khungu likhoza kukhala lofiira kapena lakuda kuposa masiku onse.
• Kumva malo olimba pansi pa khungu, ngati marble .
• Madzi otuluka m'chifuwa kapena m'mimba.

Tangoganizirani, mnzanu, tiyeni timutche "Sunita". Tsiku lina, akusamba, Sunita anaona kusintha pang'ono m'bere lake. Linkamveka ngati chotupa chaching'ono. Poyamba, sanachilabadire kwambiri, akuganiza kuti, "Chidzangotha." Koma patatha milungu ingapo, chinali chidakalipo. Pambuyo pake, atachiwonetsa kwa dokotala, anazindikira kuti chinali chizindikiro cha khansa ya m'mawere. Chifukwa chake, ngati muwona kusintha kulikonse kwachilendo m'mawere anu, ndikofunikira kwambiri kufunafuna upangiri wa dokotala popanda kunyalanyaza.

Kodi n’chiyani chimayambitsa khansa ya m’mawere ya HER2-positive?

Khansa ya m'mawere ya HER2 imayamba chifukwa cha kusintha kwa majini otchedwa HER2. Jini ya HER2 iyi imapanga puloteni ya HER2 yomwe tidakambirana kale. Mapuloteni a HER2 awa (omwe amatchedwanso `receptors`) nthawi zambiri amapezeka pamwamba pa maselo onse a m'mawere.

Muzochitika zachibadwa, mapuloteni a HER2 awa amalamulira kukula ndi kukonzanso kwa maselo a m'mawere, kuonetsetsa kuti maselo atsopano agawikana mokwanira kuti alowe m'malo mwa maselo owonongeka kapena akufa.

Komabe, jini ya HER2 ikasintha, imapanga makope ambiri. Jini ya HER2 ikachuluka kwambiri, imapanganso puloteni ya HER2 yambiri. Puloteni ya HER2 ikachuluka kwambiri, maselo a m'mawere amagawikana mofulumira ndikukula mosalamulirika, zomwe zimapangitsa kuti zikhale zotupa za khansa.

Kodi ndi zinthu ziti zomwe zimayambitsa izi?

Monga khansa ya m'mawere, zinthu zomwe zimayambitsa khansa ya m'mawere ya HER2 ndi zofanana ndi zomwe zimayambitsa khansa ya m'mawere yachizolowezi. Mutha kutenga khansa ya m'mawere kaya muli ndi zinthuzi kapena ayi. Komabe, zinthuzi zitha kuwonjezera chiopsezo chanu:

• Kukhala ndi kusintha kwa majini komwe kunabadwa nako . Mwachitsanzo, kusintha kwa majini a BRCA1 kapena BRCA2.
• Popeza ndinali ndi khansa ya m'mawere kale.
• Kukhala ndi matenda ena okhudzana ndi mabere monga `atypical ductal hyperplasia`.
• Kusamba kumayamba msanga kuposa masiku onse.
• Kusamba kumachitika mochedwa kuposa msinkhu wabwinobwino.
• Kutenga mankhwala obwezeretsa mahomoni.
• Kumwa zakumwa zoledzeretsa zoposa kamodzi patsiku.
• Atalandira chithandizo cha radiation cha matenda ena monga lymphoma (khansa ya dongosolo la lymphatic).

Kodi mavuto a khansa ya m'mawere ya HER2-positive ndi ati?

Khansa ya m'mawere ya HER2-Positive imatha kufalikira ku ziwalo zina za thupi, kapena 'kufalikira'. Pafupifupi theka la anthu omwe ali ndi khansa ya m'mawere yamtunduwu, khansayo imakhala itafalikira kale ku ziwalo zina za thupi, makamaka ubongo, pofika nthawi yomwe apezeka ndi matendawa. Khansa ya m'mawere yomwe yafalikira ku ubongo ("khansa ya m'mawere yomwe yafalikira ku ubongo wanu") ikhoza kukhala yoopsa. Ichi ndichifukwa chake kuzindikira msanga ndi chithandizo mwachangu ndikofunikira.

Kodi khansa ya m'mawere ya HER2-positive imapezeka bwanji?

Madokotala amagwiritsa ntchito njira yoyezera khansa ya m'mawere kuti adziwe khansa yonse ya m'mawere. Izi zimaphatikizapo kutenga minofu yaying'ono kuchokera pamalo okayikitsa a bere ndikuiyang'ana pansi pa maikulosikopu.

Ngati biopsy ya m'mawere ikutsimikizira kuti pali khansa, katswiri wa matenda (dokotala yemwe ndi katswiri wodziwa matenda) adzachita mayeso apadera kuti aone ngati maselo a minofu ya m'mawere ali ndi mapuloteni a HER2. Pali mitundu iwiri ikuluikulu ya mayeso a izi:

1. Immunohistochemistry (IHC): Kuyesa kumeneku kumalola akatswiri a matenda kufufuza mapuloteni a HER2 m'maselo a khansa ya m'mawere. Kuyesa kumeneku kumagwiritsa ntchito utoto wapadera (immunostaining) kuti awone kuchuluka kwa mapuloteni a HER2 m'maselo a khansa.

2. Kusakaniza kwa Fluorescence in situ (NSOMBA): Kuyesa kwa NSOMBA kumeneku nthawi zina kumagwiritsidwa ntchito kutsimikizira zotsatira za mayeso a IHC. Kuyesa kumeneku kumatha kuzindikira ngati pali makope ena a jini la HER2.

Pambuyo pa mayeso awa, madokotala amaika khansa m'magulu ena. Amagwiritsa ntchito njira yowerengera. Izi zimayang'ana kuchuluka kwa mapuloteni a HER2 m'chitsanzo cha minofu ya m'mawere, komanso kuchuluka kwa maselo a khansa omwe alipo. Taganizirani izi motere:

• Ngati mayeso akuwonetsa kuti kuchuluka kwa mapuloteni a HER2 kuli kotsika, adzawerengedwa ngati 0 kapena 1+ . Kenako katswiri wa matenda adzanena kuti ndi HER2 negative .
• Ngati pali maselo a khansa ndipo kuchuluka kwa mapuloteni kuli pang'ono, mutha kupeza zigoli 2+ . Kenako katswiri wa matenda adzatsimikiziranso mayeso a `FISH` omwe atchulidwa kale.
• Ngati pali maselo ambiri a khansa ndipo kuchuluka kwa mapuloteni kuli kwakukulu kwambiri, mumapeza zigoli 3+ . Pamenepo ndi pomwe katswiri wa matenda amanena kuti ali ndi HER2 positive .

Dongosolo la mayeso limeneli limatsimikiza ngati muli ndi HER2-positive kapena HER2-negative.

Kodi mankhwala a khansa ya m'mawere ya HER2-positive ndi ati?

Popeza iyi ndi mtundu wa khansa ya m'mawere yomwe imayambitsa matenda ambiri, njira zochiritsira zimatsimikiziridwa ndi zinthu zambiri, monga gawo la khansa ndi momwe HER2 ilili. Mankhwala otsatirawa angagwiritsidwe ntchito:

• Chithandizo cholunjika:Uwu ndiye mankhwala enieni kwambiri a khansa ya HER2. Umaphatikizapo kupereka mankhwala omwe amakhudza mapuloteni a HER2 ndikupha maselo a khansa. Pali mitundu ingapo yayikulu ya chithandizo pansi pa izi:
• Mankhwala a monoclonal antibody: Izi zimamangirira ku puloteni ya HER2 ndikuletsa maselo a khansa kukula.
• Mankhwala oletsa Tyrosine kinase: Mankhwalawa amalowa m'maselo a khansa ndikutseka njira zolumikizirana zomwe zimathandiza maselo kukula.
• Mankhwala oletsa khansa (ADCs): Iyi ndi njira yapamwamba kwambiri. Mu njira iyi, mankhwala oletsa khansa amamangiriridwa ku antibody yomwe imafufuza maselo a khansa. Kenako mankhwalawa amapita mwachindunji ku maselo a khansa ndikutulutsa mankhwalawo, zomwe zimapangitsa kuti maselo athanzi asawonongeke kwambiri.
• Chemotherapy: Chemotherapy imaperekedwa opaleshoni isanayambe kuti ichepetse chotupa (neoadjuvant therapy) kapena kupha maselo ena onse a khansa pambuyo pa opaleshoni (adjuvant therapy). Nthawi zina chemotherapy imaperekedwa pamodzi ndi chithandizo cholunjika.

Kupatula izi, kutengera ndi gawo la khansa, zinthu monga 'opaleshoni', 'mankhwala a radiation', kapena 'mankhwala a mahomoni' zitha kuchitidwanso.

Kodi zotsatirapo zake ndi ziti?

Zotsatirapo zake zimatha kusiyana malinga ndi chithandizo. Ngati mukulandira chithandizo, lankhulani ndi dokotala wanu za momwe chithandizocho chidzakukhudzireni komanso momwe chidzakhudzire moyo wanu watsiku ndi tsiku. Komanso, funsani dokotala wanu za chisamaliro chochepetsa ululu . Chisamaliro chochepetsa ululu ndi ntchito yomwe imakuthandizani kuthana ndi zizindikiro za khansa komanso zotsatirapo zake ndikukupangitsani kukhala omasuka momwe mungathere panthawi ya chithandizo. Si cha anthu okha omwe sangathe kuchiza khansa, koma chingathandize aliyense amene akulandira chithandizo.

Kodi mankhwala awa angachiritse khansa ya m'mawere ya HER2-positive kwathunthu?

Madokotala akamanena kuti "adachiritsa" khansa, mwina amatanthauza kuti khansayo idachotsedwa kwa zaka zambiri ndi chithandizo. Kuchotsedwa kumatanthauza kuti mulibe zizindikiro za khansa ndipo palibe khansa yomwe ingapezeke poyesedwa. Munthu amene wapezeka ndi khansa ya m'mawere ya HER2, wachiritsidwa, ndipo amakhala ndi moyo kwa zaka zisanu amaonedwa kuti "wachiritsidwa."

Malinga ndi bungwe la US National Cancer Institute (NCI), anthu opitilira 90% omwe adapezeka ndi khansa ya m'mawere ya HER2 amakhalabe ndi moyo patatha zaka zisanu. Amatha kuonedwa kuti achiritsidwa ku khansa yawo. Komabe, khansa ya HER2 ikhoza kubwereranso ndikufalikira ku ziwalo zina za thupi. Chifukwa chake, ndikofunikira kupitiliza kupita kukayezetsa kuchipatala.

Kodi chiŵerengero cha kupulumuka khansa ya m'mawere ya HER2-positive ndi chiyani?

Mwayi wopulumuka khansa ya m'mawere ya HER2 umasiyananso kutengera ngati khansayo ndi ya hormone receptor-positive (HR+) kapena ya hormone receptor-negative (HR-) . (Ma hormone receptors awa ndi ma receptor pamwamba pa maselo omwe amatha kumangirira ku mahomoni. Pafupifupi theka la khansa zonse za HER2-positive zili ndi ma receptor awa. NCI imagawa mwayi uwu potengera gawo la khansa: yakomweko (yomwe imafikira bere lokha), yachigawo (yofalikira ku ma lymph nodes apafupi), ndi yakutali (yofalikira kumadera akutali a thupi). Mutha kulankhula ndi dokotala wanu za izi kuti mudziwe zambiri.

Kodi khansa ya m'mawere ya HER2-positive ingapewedwe?

Mwina ayi. Ngakhale pali zinthu zomwe mungachite kuti muchepetse chiopsezo chanu cha khansa ya m'mawere, khansa ya m'mawere ya HER2 imayamba chifukwa cha kusintha kwa majini a HER2 komwe kumayambitsa maselo a khansa. Ofufuza akuphunzirabe chifukwa chake izi zimachitika, kotero sanganenebe zomwe zingachite kuti apewe khansa ya HER2.

Komabe, mungathe kuchita zinthu izi kuti muchepetse chiopsezo chanu cha khansa ya m'mawere:

• Samalani thanzi la bere lanu. Chitani mayeso a bere lanu nthawi zonse, ndipo pitani ku mammograms malinga ndi msinkhu ndi nthawi zomwe dokotala wanu wakupatsani. Dziwani kusintha kulikonse m'mabere anu. Mwanjira imeneyi, khansa imatha kuzindikirika msanga ndikuchiritsidwa mosavuta.
• Sungani kulemera kwabwino. Uwu uyenera kukhala kulemera komwe kungakusangalatseni. Funsani dokotala wanu kuti akupatseni upangiri wa momwe mungasungire kulemera kwabwino.
• Idyani zakudya zopatsa thanzi. Kafukufuku wina wasonyeza kuti kudya zakudya zokhala ndi ndiwo zamasamba, zipatso, mkaka wokhala ndi calcium yambiri, ndi mapuloteni opanda mafuta ambiri kungachepetse chiopsezo cha khansa ya m'mawere. Ndibwinonso kuchepetsa nyama zofiira ndi zokonzedwa.
• Khalani ochita masewera olimbitsa thupi. Kafukufuku wasonyeza kuti kuchita masewera olimbitsa thupi nthawi zonse kumachepetsa chiopsezo cha khansa ya m'mawere. Ngakhale kungoyenda kwa mphindi 30 patsiku ndikwabwino.
• Pewani zakumwa zoledzeretsa. Kafukufuku akusonyeza kuti pali kugwirizana pakati pa khansa ya m'mawere ndi mowa. Bungwe la American Medical Association limalimbikitsa akazi kuti achepetse kumwa mowa kamodzi patsiku.

Kodi ndimadzisamalira bwanji?

Kukhala ndi khansa ya m'mawere kumatanthauza kukhala ndi zizindikiro za khansa, mankhwala, ndi zotsatirapo zake. Ndipo, nthawi zina, mungafunike kukhala ndi moyo wosadziwa bwino za tsogolo. Nthawi zina mungamve kuti mwatopa komanso kukhumudwa. Ngati mukumva choncho, ganizirani malangizo awa odzisamalira:

• Pumulani mokwanira.Khansa ya m'mawere ndi chithandizo chake zimatopetsa kwambiri. Kumbukirani kupuma nthawi iliyonse yomwe mukufuna, osati nthawi yokha.
• Idyani bwino. Chithandizo chingachepetse chilakolako chanu cha chakudya, koma kudya zakudya zokhala ndi zipatso, ndiwo zamasamba, mapuloteni opanda mafuta ambiri, ndi tirigu wathanzi kudzakuthandizani kukhalabe olimba panthawi ya chithandizo.
• Sinthani kupsinjika kwanu. Khansa ndi vuto lalikulu. Kuchita masewera olimbitsa thupi kungathandize pa izi. Kuyenda nthawi zonse komanso kutenga nawo mbali m'mapulogalamu olimbitsa thupi monga yoga ndikwabwino.
• Pezani chithandizo. Ndinu opulumuka khansa ya m'mawere, ndipo zimenezo zimayamba tsiku lomwe mwapezeka ndi matendawa. Funsani dokotala wanu za mapulogalamu opulumutsa khansa . Izi zingakuthandizeni kuthana ndi mavuto okhala ndi khansa ya m'mawere. Kulankhula ndi achibale anu ndi anzanu ndi njira yabwino yodzithandizira.

Kodi ndiyenera kupita kwa dokotala liti?

Muyenera kuonana ndi dokotala nthawi zonse mukalandira chithandizo. Komabe, ngati muwona kusintha kulikonse kwatsopano m'mabere kapena m'thupi lanu komwe kungakhale chizindikiro chakuti khansa yanu ya HER2 yafalikira, uzani dokotala nthawi yomweyo. Mwachitsanzo, ngati khansa ya m'mawere yafalikira mpaka m'mapapo, mutha kukhala ndi zizindikiro monga kupweteka pachifuwa, matenda pachifuwa pafupipafupi, kuvutika kupuma, kapena kutsokomola magazi.

Kodi ndiyenera kupita ku chipinda chadzidzidzi liti?

Ngati thupi lanu likuchita bwino kwambiri polandira chithandizo cha khansa kuposa momwe mumayembekezera, muyenera kupita kuchipatala. Mwachitsanzo, ngati mwataya madzi ambiri chifukwa cha kusanza kosalekeza, pitani kuchipatala nthawi yomweyo.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Ngati mayeso anu akusonyeza kuti muli ndi khansa ya m'mawere ya HER2, mungafune kufunsa dokotala wanu mafunso monga:

• Kodi mkhalidwe wanga wa HER2 ndi wotani kwenikweni? (monga momwe chiwerengero changa cha IHC/FISH chilili?)
• Kodi mkhalidwe wanga wa hormone receptor ndi wotani? (HR+ kapena HR-?)
• Kodi ma HER2 ndi ma hormone receptor awa amakhudza bwanji nthawi yanga yobereka (monga nthawi yobereka komanso nthawi yomwe matendawa adzachitike mtsogolo)?
• Ndi mankhwala ati omwe mukundilimbikitsa? Chifukwa chiyani?
• Kodi ndiyenera kuganizira zotenga nawo mbali mu mayeso azachipatala kuti ndichiritse khansa ya m'mawere ya HER2?

Kupita patsogolo kwa chithandizo cha khansa n'kosowa kwambiri. Ichi ndichifukwa chake ofufuza khansa anali okondwa kwambiri pamene kafukufuku adawonetsa kuti kusintha kwa majini a HER2 kumapangitsa kuti maselo agawikane mwachangu kuposa masiku onse. Anapeza mwachangu kulumikizana pakati pa kusintha kwa majini a HER2 ndi mitundu ina ya khansa ya m'mawere yomwe ikukula mwachangu. Kuchokera pamenepo, adapanga mankhwala omwe angathandize kuchiza khansa ya m'mawere ya HER2 yomwe ili pachiwopsezo choyambirira. Tsopano ofufuza akuyang'ana kwambiri kupeza mankhwala othandiza kwambiri omwe angachepetse kapena kuletsa kufalikira kwa khansa. Mayeso azachipatala ndi komwe zinthu zatsopanozi zimachitikira. Ngati muli ndi khansa ya m'mawere ya HER2 yomwe ili ndi kachilombo ('metastatic'), lankhulani ndi dokotala wanu za kutenga nawo mbali mu mayeso azachipatala. Angakuthandizeni.

Pomaliza, uthenga wopita nawo kunyumba

Khansa ya m'mawere ya HER2 ndi khansa yoopsa komanso yofala mofulumira. Komabe, ndi kuzindikira kolondola komanso koyambirira komanso njira zamakono zochiritsira, tsopano n'zotheka kuwongolera ndikuchiritsa vutoli bwino.

• Nthawi zonse muzisamala thupi lanu, makamaka mabere anu. Ngati muwona kusintha kulikonse kwachilendo, musanyalanyaze ndipo funsani upangiri wa dokotala nthawi yomweyo.
• Tsatirani mayeso ndi mankhwala omwe dokotala wanu akulangizani bwino lomwe. Musaope kulankhula ndi dokotala wanu za mafunso kapena nkhawa zilizonse zomwe mungakhale nazo.
• Ndikofunikira kwambiri kukhala ndi chiyembekezo. Simuli nokha. Pali banja, abwenzi, madokotala, ndi maupangiri okuthandizani.

Tikukhulupirira kuti izi zikuthandizani. Khalani ndi thanzi labwino!

Khansa ya m'mawere , HER2-Positive, zizindikiro za khansa, chithandizo cha khansa, thanzi la akazi, kusintha kwa majini, mammogram