Kodi ma SERM ndi chiyani? Tiyeni tiphunzire za mankhwala awa a khansa ya m'mawere ndi osteoporosis (Selective Estrogen Receptor Modulators)

Mwina mwamvapo za khansa ya m'mawere, kapena osteoporosis. Lero tikambirana za gulu lapadera la mankhwala omwe amagwiritsidwa ntchito pochiza matenda onsewa. Amatchedwa Selective Estrogen Receptor Modulators, kapena SERM mwachidule. Ngakhale dzinalo lingamveke ngati lasayansi pang'ono, momwe amagwirira ntchito ndi losavuta. Tiyeni tiwone zomwe SERM zili ndi momwe zimakhudzira matupi athu.

Mwachidule, kodi ma SERM awa ndi chiyani?

Ma SERM ndi mtundu wa mankhwala omwe amalamulira kapena kusintha momwe hormone estrogen m'thupi lathu imagwirira ntchito. Ganizirani za estrogen ngati kiyi. Maselo a thupi lathu ali ndi ma receptor omwe amalowa mu kiyi iyi. Pamene estrogen imamangirira ku ma receptor awa, maselo amenewo amalandira mauthenga enaake. Mwachitsanzo, uthenga wowauza kuti "akule."

Ma SERM amachita ntchito yabwino kwambiri. Amaletsa estrogen kulowa m'bowo la kiyi m'zigawo zina za thupi. Ndipo, m'zigawo zina za thupi, mankhwalawa amagwira ntchito ngati estrogen . Izi zikutanthauza kuti mankhwala omwewo amachita zinthu ziwiri, kutengera malo omwe ali. Zili ngati munthu yemweyo amene amagwira ntchito ngati woteteza nthawi ina komanso ngati wothandiza nthawi ina.

Mankhwala awiri omwe amagwiritsidwa ntchito kwambiri m'gululi ndi tamoxifen ndi raloxifene .

Kodi ma SERM awa amagwira ntchito bwanji?

Monga tanenera kale, izi zimagwira ntchito mosiyana m'malo osiyanasiyana. Tiyeni tifotokoze pang'ono zimenezo.

1. Ponena za khansa ya m'mawere: Pali mitundu ina ya khansa ya m'mawere yomwe imathandizidwa kukula ndi hormone estrogen. Timatcha khansa ya m'mawere iyi hormone receptor (HR) positive kapena estrogen receptor (ER). Mitundu iyi ya maselo a khansa ili ndi malo pamwamba pake pomwe estrogen imalumikizana. Pamene estrogen ilumikizana ndi malo awa, maselo a khansa amalandira uthenga wowauza kuti "agawanitse ndikukula kwambiri." Ma SERM amagwira ntchito potseka malo awa estrogen isanakwane. Zili ngati kuyika kiyi yolakwika mu bowo la kiyi. Kenako estrogen yoyenera singathe kufika pa kiyi ndikulumikizana. Izi zimaletsa maselo a khansa kuti asafikitse uthengawo kukula.

2. Thanzi la mafupa: Kumbali ina, estrogen ndi hormone yofunika kwambiri kuti mafupa athu akhale olimba. Makamaka akamaliza kusamba, kuchuluka kwa estrogen m'thupi la akazi kumachepa, zomwe zimawonjezera chiopsezo cha kutayika kwa mafupa, kapena osteoporosis . Pakadali pano, ma SERM amagwira ntchito m'maselo a mafupa mofanana ndi momwe estrogen imachitira . Izi zikutanthauza kuti, amapita ku mafupa ndikuwapatsa uthenga wakuti, "Khalani olimba, musataye calcium."

Kodi ma SERM amagwiritsidwa ntchito pazochitika ziti?

Madokotala amalimbikitsa kwambiri mankhwalawa nthawi zingapo.

Za khansa ya m'mawere

• Kwa amayi omwe ali pachiwopsezo chachikulu cha khansa ya m'mawere yokhala ndi ER: Ngati wina m'banjamo adadwala khansa iyi, kapena ngati mayeso a majini atsimikizira kuti ali ndi kusintha kwa majini komwe kumawonjezera chiopsezo cha khansa, amapatsidwa mankhwalawa kuti apewe khansa isanayambe.
• Kwa iwo omwe adachitidwa opaleshoni ya khansa ya m'mawere: Pambuyo pa opaleshoni, mankhwalawa amaperekedwa kuti aletse khansa kubwereranso (kubwereranso). Amathandizanso kupewa khansa kuti isakule m'mawere ena athanzi.
• Kwa DCIS (Ductal Carcinoma in Situ): Iyi ndi nthawi yoyambirira kwambiri ya khansa ya m'mawere. Ma serum amagwiritsidwa ntchito kuti vutoli lisafalikire kwambiri.
• Khansa ya m'mawere yomwe yafalikira ku ziwalo zina za thupi (Metastatic Breast Cancer): Mankhwalawa amaperekedwa kuti athetse khansa.
• Kwa khansa ya m'mawere ya amuna: Inde, amuna nawonso akhoza kutenga khansa ya m'mawere. Tamoxifen imagwiritsidwanso ntchito pa khansa ya ER-positive.

Kwa osteoporosis

Mankhwala otchedwa raloxifene amagwiritsidwa ntchito poletsa kutayika kwa mafupa pambuyo pa kusamba komanso kuchepetsa chiopsezo cha kusweka kwa mafupa.

Kodi chithandizochi chikuyenda bwino bwanji?

Inde, awa ndi mankhwala othandiza kwambiri. Tiyeni tiwone zina mwa zomwe zapezeka kuchokera ku kafukufuku:

• Kupereka tamoxifen kwa amayi omwe ali pachiwopsezo chachikulu omwe ali ndi nthawi yopuma (osadutsa nthawi yopuma) kungachepetse chiopsezo cha khansa ya m'mawere ndi pafupifupi 40% .
• Ngati munthu amene wachitidwa opaleshoni ya khansa m'bere limodzi wamwa tamoxifen, chiopsezo chotenga khansa m'bere lina chimachepa ndi 50% .
• Tamoxifen imathandiza kuchepetsa chiopsezo chobwereranso ndi 30% mpaka 50% kwa munthu amene ali ndi khansa ya m'mawere yoyambirira.
• Kafukufuku wasonyeza kuti mankhwala a raloxifene amachepetsa chiopsezo cha kusweka kwa msana kwa amayi omwe atsala pang'ono kusamba omwe ali ndi matenda a osteoporosis.

Kodi zotsatirapo zake zingakhale zotani chifukwa chomwa mankhwalawa?

Monga mankhwala ena aliwonse, ma SERM angayambitse zotsatirapo zoyipa. Komabe, si aliyense amene amalandira zotsatirapo zoyipa zonsezi.Ndikofunikira kukumbukira zimenezo. Komanso, ubwino wa mankhwala amenewa nthawi zambiri umaposa zotsatira zake. Dokotala amene akukuthandizani adzakufotokozerani zonsezi.

Mu tebulo ili m'munsimu, tasiyanitsa zotsatira zoyipa zomwe zimachitika kawirikawiri komanso zomwe sizichitika kawirikawiri za mankhwalawa.

Kodi kusasangalala komwe kumachitika chifukwa cha zotsatirapo zake kungachepe?

Inde, mungathedi. Pali zinthu zingapo zomwe mungachite kuti muchepetse kusasangalala, makamaka zizindikiro zofanana ndi kusamba (kutentha thupi, kusowa tulo, kuuma kwa nyini).

• Chepetsani kutentha: Chepetsani caffeine (khofi, tiyi) ndi zakudya zokometsera. Anthu ena amapeza mpumulo podya zakudya zomwe zili ndi phytoestrogens, monga soya, nsawawa, ndi mphodza.
• Pa mavuto ogona: Kuchita masewera olimbitsa thupi tsiku ndi tsiku kumakuthandizani kugona bwino.
• Pa kuuma kwa nyini: Pali zodzoladzola zapadera za nyini zomwe zingagwiritsidwe ntchito pa izi. Mutha kufunsa dokotala wanu za izi.

Kodi muyenera kufunafuna upangiri wa dokotala nthawi yomweyo liti?

Ngati mukuona kuti zotsatirapo zoyipa zikuipiraipira, dziwitsani dokotala wanu. Komabe, pali matenda ena akuluakulu omwe samachitika kawirikawiri ndi ma SERM. Ngati mukukumana ndi zizindikiro zotsatirazi, musazengereze. Pitani ku chipinda chapafupi chadzidzidzi (ETU) nthawi yomweyo.

• Kusanza kapena kufooka mbali imodzi ya thupi kapena nkhope.
• Kuvuta kulankhula, kusalankhula bwino mawu.
• Mutu wopweteka kwambiri komanso wodzidzimutsa mwadzidzidzi.
• Kuvuta kupuma mwadzidzidzi.
• Kupweteka kwambiri pachifuwa, mkono, phewa, kapena nsagwada komwe kumachitika popanda chifukwa chomveka.

Izi zitha kukhala zizindikiro za sitiroko kapena pulmonary embolism, kotero muyenera kusamala kwambiri ndi izi.