Ngati mukulimbana ndi khansa, kapena ngati muli ndi wokondedwa amene ali nayo, mwina mukudziwa bwino mawu monga "chemotherapy" ndi "radiation therapy." Mwina mwamvapo za zotsatirapo zoyipa zomwe zimabwera ndi mankhwalawa. Koma lero tikambirana za gulu latsopano la mankhwala omwe amangokhudza maselo a khansa okha ndipo amachepetsa kwambiri kuwonongeka kwa maselo athanzi. Izi zimatchedwa PARP Inhibitors .
Mwachidule, kodi PARP Inhibitor iyi ndi chiyani?
Kuti timvetse izi, choyamba tiyenera kumvetsetsa njira yaying'ono koma yofunika kwambiri yomwe imachitika mkati mwa maselo a thupi lathu. Mkati mwa selo lililonse m'thupi lathu muli chinthu chotchedwa DNA. Taganizirani ngati pulani yayikulu yomwe yalemba momwe chilichonse m'thupi lathu chiyenera kugwirira ntchito. Nthawi zina, masamba a pulani iyi ya DNA amawonongeka pang'ono.
Apa ndi pomwe puloteni yotchedwa PARP imagwira ntchito. "PARP" ndi chidule cha Poly (ADP-ribose) polymerase . PARP ili ngati "makina okonzera" mkati mwa maselo athu. DNA ikawonongeka, puloteni ya PARP imalowa ndikuikonza. Izi ndizofunikira kuti maselo athanzi akhalebe ndi moyo.
Koma vuto ndilakuti, maselo a khansa amagwiritsanso ntchito njira ya PARP iyi kuti apindule. Pamene DNA ya maselo a khansa yawonongeka, amagwiritsanso ntchito PARP iyi kuti ayikonze. Zotsatira zake, maselo a khansa safa, koma amapitiriza kukula ndikufalikira m'thupi lonse.
Pofuna kuthetsa vutoli, madokotala amagwiritsa ntchito mankhwala otchedwa PARP Inhibitor. "Inhibitor" amatanthauza "blocker." Chomwe mankhwalawa amachita ndi "kutseka" njira ya PARP yomwe imathandiza maselo a khansa. Popanda thandizo la PARP, maselo a khansa amafooka pang'onopang'ono, osatha kukonza DNA yowonongeka, ndipo pamapeto pake amafa.
Izi zili ngati kuzimitsa "njira yopulumukira" ya maselo a khansa. Ndicho chifukwa chake njira yochiritsira iyi imatchedwanso chithandizo cholunjika . Izi zikutanthauza kuti, mankhwala awa amalimbana mwachindunji ndi kufooka kwa maselo a khansa.
Mitundu yayikulu ya zoletsa za PARP zomwe zimagwiritsidwa ntchito padziko lonse lapansi
Pali mankhwala angapo oletsa PARP omwe avomerezedwa pano kuti agwiritsidwe ntchito pochiza khansa. Ngati dokotala wanu akulemberani chimodzi mwa izi, chikhoza kukhala pamndandandawu.
| Dzina la Mankhwala | Dzina la Kampani |
|---|---|
| Olaparib | Lynparza® |
| Niraparib | Zejula® |
| Rucaparib | Rubraca® |
| Talazoparib | Talzenna® |
Kodi mankhwalawa amagwiritsidwa ntchito pa mitundu iti ya khansa?
Mankhwala oletsa PARP nthawi zambiri amagwiritsidwa ntchito pa khansa zomwe zakula kwambiri kapena zomwe zafalikira ku ziwalo zina za thupi (metastatic). Pali mitundu ingapo ya khansa yomwe imagwira ntchito kwambiri.
- Khansa ya m'mawere
- Khansa ya m'chiberekero
- Khansa ya m'chubu cha fallopian
- Khansa ya prostate
- Khansa yoyamba ya m'mimba
- Khansa ya kapamba
Kugwirizana kwapadera ndi kusintha kwa majini a BRCA
Nayi mfundo ina yofunika kudziwa yokhudza jini ya BRCA . BRCA ndi jini ina yofunika kwambiri yomwe imathandiza kukonza DNA m'maselo athu ndikuletsa khansa. Koma anthu ena akhoza kukhala ndi kusintha kwa majini a BRCA. Izi zikutanthauza kuti imodzi mwa njira zawo zazikulu zokonzera DNA sigwira ntchito bwino. Chifukwa cha izi, ali pachiwopsezo chachikulu chotenga khansa.
Galimoto ikakhala ndi mabuleki awiri. BRCA ndi imodzi, ndipo PARP ndi inayo. Mu selo la khansa lomwe lili ndi kusintha kwa majini a BRCA, dongosolo limodzi la mabuleki (BRCA) limakhala litasweka kale. Kotero selo la khansa limadalira kwambiri dongosolo lina la mabuleki (PARP) kuti likhale ndi moyo.
Tsopano tikamapereka mankhwala a PARP Inhibitor, timazimitsanso mabuleki achiwiri. Kenako selo la khansa silingathe kukonza DNA yake, ndipo limafa. Ichi ndichifukwa chake PARP Inhibitors ndi othandiza kwambiri pa khansa yokhala ndi kusintha kwa majini a BRCA.
Kodi ndingapeze bwanji chithandizochi ndipo chimatenga nthawi yayitali bwanji?
Chimodzi mwa zinthu zabwino zomwe zimapezeka mu mankhwalawa ndichakuti amapezeka mu mawonekedwe a mapiritsi (makapisozi kapena mapiritsi). Chifukwa chake muyenera kumwa mankhwalawa kamodzi kapena kawiri patsiku. Nthawi zina mankhwalawa okha ndi okwanira. Nthawi zina, mungafunike kumwa limodzi ndi mankhwala ena a khansa.
Mwachitsanzo, mutalandira chithandizo chomwe chimawononga DNA ya maselo a khansa, monga chemotherapy kapena radiation therapy, mutha kupereka mankhwala oletsa PARP. Kenako, popeza PARP sithandiza maselo a khansa owonongekawo kudzikonza okha, maselo amenewo amatsimikizika kuti adzafa.
Nthawi ya chithandizo
Izi zimasiyana malinga ndi munthu.
- Anthu ena amapatsidwa mankhwalawa kwa nthawi inayake, monga zaka ziwiri kapena zitatu, pambuyo poti chithandizo cha chemotherapy chatha.
- Anthu ena amapitiriza kumwa mankhwalawa bola ngati akugwira ntchito m'thupi lawo.
- Nthawi zina, ngati zotsatirapo zake zikuposa ubwino wa mankhwala, mutha kulankhula ndi dokotala wanu ndikusiya chithandizocho.
Choncho, ndikofunikira kwambiri kukambirana ndi dokotala wanu nthawi yomwe muyenera kumwa mankhwalawo ndikupeza chisankho.
Kodi ubwino ndi kuipa kwa chithandizochi ndi kotani?
Mankhwala oletsa PARP sangachiritse khansa kwathunthu. Komabe, angathandize odwala omwe ali ndi mitundu ina ya khansa kukhala ndi moyo wautali . Mankhwalawa amawongolera kukula kwa khansa. Madokotala amati izi zimawonjezera "chiwerengero cha kupulumuka kosapitirira muyeso." Mwachidule, amawonjezera nthawi yomwe khansa imakhalabe yolamulidwa bwino popanda kuipiraipira. Nthawi zina, amatha kukhala othandiza kwambiri kuposa chemotherapy.
Komabe, pakapita nthawi, maselo ena a khansa amayamba "kukana" mankhwala awa. Izi zikutanthauza kuti mankhwalawa sagwiranso ntchito. Izi zitha kuchitika kwa odwala pakati pa 40% ndi 70%. Asayansi akuyesera kumvetsetsa chifukwa chake izi zimachitika ndipo akufufuza njira zatsopano zopangira mankhwalawa kukhala ogwira mtima kwambiri.
Tiyeni tidziwenso za zotsatira zake.
Monga mankhwala ena aliwonse a khansa, zoletsa za PARP zingayambitse zotsatira zina zoyipa. Koma si aliyense amene amalandira. Ndipo zambiri mwa izi zitha kulamuliridwa.
| Zotsatira zoyipa zofala | Chifukwa cha zimenezo kapena zambiri |
|---|---|
| Kutopa ndi kutopa | Kawirikawiri zimatha kuchitika chifukwa cha kuchepa kwa magazi m'thupi, komwe ndi kuchepa kwa maselo ofiira m'magazi. |
| Kutuluka magazi (monga kuvulala, kutuluka magazi m'mphuno) | Zingakhale chifukwa cha kuchepa kwa chiwerengero cha ma platelet m'magazi. |
| Matenda opatsirana pafupipafupi | Kuchepa kwa chiwerengero cha maselo oyera m'magazi kungafooketse chitetezo cha mthupi. |
| Kusanza ndi kusanza | Mankhwala ena angatengedwe kuti athetse vutoli. |
| Kupweteka m'mimba, kudzimbidwa, kapena kudzimbidwa | Ikhoza kuthetsedwa ndi kusintha zakudya, komanso ngati pakufunika, mankhwala. |
| Kusintha kwa kukoma mkamwa (dysgeusia) | Chakudya chimatha kukhala ndi kukoma kosiyana. |
| Kuchepetsa thupi, chizungulire, mutu | Izi ndi zochitika zomwe zingachitikire anthu ena. |
Kawirikawiri, zoletsa zina za PARP zingawonjezere chiopsezo chotenga khansa ya m'magazi yotchedwa acute myeloid leukemia . Komabe, iyi ndi vuto losowa kwambiri.
Nthawi yoti mudziwitse dokotala wanu nthawi yomweyo
Ngati mukumwa mankhwala oletsa PARP, ndikofunikira kuuza dokotala wanu ngati mukukumana ndi zotsatirapo zina zatsopano kapena zoipitsitsa . Iye angasinthe mlingo kapena kukupatsani mankhwala ena kuti akuthandizeni ndi zinthu monga nseru.
Makamaka ngati mukukumana ndi zizindikiro zotsatirazi:Uzani dokotala wanu kapena chipatala chomwe chikukuthandizani nthawi yomweyo:
- Zizindikiro za matenda: malungo, kuzizira, ndi kugwedezeka.
- Zizindikiro za chibayo: Kuvuta kupuma, kupuma movutikira, kulimba pachifuwa, ndi zina zotero. (Iyi ndi matenda otupa m'mapapo).
- Zizindikiro za magazi kuundana: kutupa kwa miyendo, kupweteka, kufiira kapena kupweteka pachifuwa, kuvutika kupuma.
Uthenga Wopita Nawo Kunyumba
- Ma PARP Inhibitors ndi mtundu wa "mankhwala olunjika" omwe amalunjika ku dongosolo lokonzanso DNA ya maselo a khansa ndikuwononga.
- Izi zimathandiza kwambiri makamaka pa khansa monga khansa ya m'mawere, yam'chiberekero, ndi ya prostate yomwe ili ndi kusintha kwa majini a BRCA.
- Mankhwalawa saperekedwa ndi jakisoni, koma ngati mapiritsi/makapisozi omwe amatengedwa tsiku lililonse.
- Ngakhale izi sizimachiritsa khansa yonse, zimathandiza odwala kukhala ndi moyo wautali poletsa kukula kwa khansa.
- Monga mankhwala ena a khansa, izi zimakhala ndi zotsatirapo zake. Kutopa, nseru, komanso kuchepa kwa maselo m'magazi kumatha kuchitika.
- Ndikofunikira kwambiri kukhala pafupi ndi dokotala wanu nthawi yonse ya chithandizo chanu ndikufotokozera zotsatirapo zake nthawi yomweyo.
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