Kodi mukudziwa za mankhwala odabwitsa awa omwe amangolimbana ndi maselo a khansa? (Tyrosine Kinase Inhibitors)

Tikadziwa kuti tili ndi khansa, tonse timachita mantha kwambiri. Nthawi yomweyo, timaganiza za mankhwala monga chemotherapy. Chemotherapy imawononga maselo ogawa mofulumira. Komabe, imathanso kuwononga osati maselo a khansa okha, komanso maselo athanzi m'thupi lathu, mwachitsanzo, maselo a tsitsi, maselo omwe amayambitsa zilonda pakamwa, ndi maselo m'matumbo. Ndicho chifukwa chake chemotherapy imayambitsa kutaya tsitsi, zilonda pakamwa, komanso kusokonezeka m'mimba. Koma, taganizirani ... zikanakhala bwino bwanji ngati pakanakhala mtundu wa mankhwala omwe angangokhudza maselo a khansa okha, monga mfuti ya sniper? Ndicho chimene tikambirana lero. Izi zimatchedwa Tyrosine Kinase Inhibitors , kapena TKIs mwachidule.

Mwachidule, kodi ma TKI awa ndi chiyani?

Ma TKI ndi mtundu wa mankhwala ogwiritsidwa ntchito pochiza khansa. Amagwira ntchito potseka zinthu zina mkati mwa maselo a khansa zomwe zimawathandiza kukula ndikugawa. Mwa kuyankhula kwina, maselo a khansa ali ndi njira yolumikizira zizindikiro yomwe imawauza kuti "akule ndikugawanitsa." Ma TKI amagwira ntchito posokoneza njira yolumikizira zizindikiroyo ndikuyimitsa.

Mankhwalawa sangachiritse khansa kwathunthu, koma angathandize odwala kuti asamadwale khansa kwa nthawi yayitali, kapena kukhala ndi moyo wabwino ndi khansa.

Kodi mankhwalawa amagwira ntchito bwanji kwenikweni? Tiyeni tiwone mwatsatanetsatane.

Kuti timvetse izi, choyamba tiyenera kudziwa pang'ono za njira yachibadwa yogawikana kwa maselo m'thupi lathu. Tangoganizani kuti thupi lathu ndi fakitale yayikulu. Ogwira ntchito mufakitale iyi amatchedwa maselo.

1. Zinthu Zokhudza Kukula: Awa ndi amithenga ochokera kunja kwa fakitale omwe amabweretsa uthenga wakuti "Yambani kupanga tsopano."

2. Tyrosine kinases: Awa ndi ma enzyme omwe ali mkati mwa maselo omwe amatenga uthengawo ndikuuza ena kuti "Chabwino, tiyeni tiyambe kugwira ntchito."

Izi ndi zomwe zimachitika mu selo yathanzi labwinobwino. Mtumiki (chinthu chokulitsa) amabwera ndikupereka uthenga kwa manejala (tyrosine kinase). Manejala amatenga uthengawo ndikuuza selo kuti ligawane. Maselo akagawanitsa momwe akufunira, manejala amatseka switch. Iyi ndi njira yolamulidwa kwambiri .

Koma m'maselo a khansa, dongosololi limasokonekera. Mu mitundu ina ya khansa, makamaka, oyang'anira awa (Tyrosine kinases) amasokonezeka. Kusintha kwawo kumakhala kokhazikika. Safunikira uthenga wochokera kunja, amangouza maselo kuti "agawanitse, agawanitse, agawanitse." Kugawikana kwa maselo kosalamulirika kumeneku ndi komwe timatcha khansa.

Chitsanzo chabwino kwambiri: Chronic Myeloid Leukemia (CML)

Uwu ndi mtundu wa khansa ya m'magazi. Kale, pamene CML inayamba, inali matenda oopsa. Koma pambuyo poti matenda a TKI apezeka, CML tsopano yakhala matenda osatha omwe angathe kuthetsedwa ndi mankhwala monga matenda a shuga ndi kuthamanga kwa magazi.

Mu maselo omwe ali mu mafupa a odwala a CML, enzyme ya Tyrosine kinase yomwe tatchulayi imapangidwa molakwika, ndipo kusintha kwake kumakhala 'kwanthawi zonse'. Chifukwa chake mafuta a m'mafupa amapanga maselo oyera amagazi popanda kulamulira. Izi zimalepheretsa kupanga maselo ofiira amagazi athanzi, maselo oyera amagazi, ndi ma platelet. Ma TKI, monga Imatinib (Gleevec®) , amalunjika ku enzyme yosazolowerekayo ndikuyimitsa 'kutsegula' kwake. Uku ndi kusintha kwakukulu m'mbiri ya chithandizo cha khansa.

Kodi ma TKI amagwiritsidwa ntchito pa mitundu iti ya khansa?

Mankhwala ochizira khansa amenewa akugwiritsidwa ntchito pa mitundu yambiri ya khansa. Sizigwira ntchito pa khansa zonse. Izi zili choncho chifukwa si khansa zonse zomwe zili ndi Tyrosine kinase yomwe yayamba kugwiritsidwa ntchito. Madokotala amatenga biopsy ya maselo a khansa ndikuwona ngati ali ndi molekyulu iyi yomwe ingagwire ntchito. Ngati ikugwira ntchito, ndi pomwe angapereke mankhwalawa.

Pansipa pali mitundu ikuluikulu ya khansa yomwe imachiritsidwa ndi ma TKI.

Pakadali pano, bungwe la US FDA lavomereza ma TKI oposa 50 kuti athetse mitundu yosiyanasiyana ya khansa. Mankhwala oyamba ovomerezeka, Imatinib (Gleevec®), amagwiritsidwa ntchito pochiza mitundu 7 ya khansa.

Kodi ndingapeze bwanji chithandizochi? Zimatenga nthawi yayitali bwanji?

Ichi ndi chinthu china chabwino kwambiri chothandiza pa chithandizochi. Ma TKI ambiri amapezeka mu mapiritsi kapena madzi . Chifukwa chake simuyenera kukhala m'chipatala ndikubayidwa mankhwala kudzera mu saline solution. Muyenera kumwa piritsi limodzi kapena awiri nthawi imodzi tsiku lililonse kunyumba.

Kutalika kwa nthawi yomwe muyenera kumwa mankhwala kumadalira mtundu wa khansa yomwe muli nayo, gawo la matendawa, komanso momwe thupi lanu limayankhira mankhwalawo. Mwachitsanzo, ngati muli ndi CML, mungafunike kumwa mankhwalawo moyo wanu wonse. Pa mitundu ina ya khansa, dokotala wanu angasankhe kusiya kumwa mankhwalawo khansa ikatha.

Tiyeni tidziwenso za zotsatirapo zake.

Popeza ma TKI ndi mankhwala ochizira omwe cholinga chake ndi kuchiza matenda, nthawi zambiri amakhala ndi zotsatirapo zochepa kuposa mankhwala a chemotherapy. Izi zili choncho chifukwa sawononga maselo athanzi kwambiri. Koma sizingatheke kunena kuti "alibe zotsatirapo zoyipa konse." Izi zili choncho chifukwa molekyulu yomwe amachizira, yotchedwa Tyrosine kinase, siimapezeka m'maselo a khansa okha, komanso m'maselo ena athanzi. Chifukwa chake maselo amenewo angakhudzidwenso.

Zotsatirapo zake zimasiyana malinga ndi munthu ndipo zimadaliranso mankhwala a TKI omwe agwiritsidwa ntchito.

Zotsatira zoyipa zofala:

• Kutopa: Ichi ndi vuto lofala lomwe anthu ambiri amakumana nalo.
• Kutsegula m'mimba: Kungayambike chifukwa cha kuwonongeka kwa maselo m'matumbo.
• Kusanza ndi Kusanza: Anthu ena angakumane ndi vutoli.
• Ziphuphu pakhungu: Ziphuphu pakhungu, kuuma, ndi kuyabwa ndizofala.
• Kudya ndi kusintha kwa thupi: Anthu ena amataya thupi, pomwe ena amatha kunenepa chifukwa cha kudzimbidwa.
• Malungo

Zotsatirapo zoyipa zomwe zingakhalepo:

Matenda ena a TKI angayambitse mavuto pamtima, chiwindi, kapena mapapo. Angayambitsenso matenda aakulu a pakhungu omwe amaika moyo pachiswe, monga matenda a Stevens-Johnson , omwe amakhudza khungu. Koma izi sizichitika kawirikawiri. Kuthamanga kwa magazi (kuthamanga kwa magazi) ndi vuto lina.

Kodi ndingachite chiyani kuti chithandizochi chikhale chosavuta kwa ine?

Kulandira chithandizo cha khansa kungakhale nthawi yovuta, mwakuthupi komanso m'maganizo. Pali zinthu zingapo zomwe mungachite kuti nthawi ino ikhale yosavuta.

1. Kupuma: Kutopa ndi vuto lalikulu. Choncho gonani mokwanira momwe mungathere, pumulani pang'ono masana, ndipo mvetserani thupi lanu.

2. Zakudya: Kudya kungakhale kovuta chifukwa cha zinthu monga kusowa chilakolako cha chakudya komanso nseru. Yesetsani kudya pang'ono kangapo patsiku. Imwani madzi ambiri monga madzi, madzi a zipatso, phala, ndi supu. Ngati mukuchepetsa thupi kapena kunenepa mosayenera, ndikofunikira kwambiri kufunsa upangiri kwa katswiri wa zakudya.

3. Kuthana ndi mavuto: Ngati muli ndi kutsegula m'mimba, idyani zinthu monga mafuta, zokometsera zochepa, chutney yophikidwa ndi nthunzi, mpunga, ndi nthochi. Kumwa zakumwa monga Jeevani ndi kwabwino kwambiri. Ngati mukumva kutupa pakhungu, gwiritsani ntchito mafuta odzola opanda sopo komanso osanunkhira. Lankhulani ndi dokotala wanu za izi ndipo pezani mankhwala oyenera.

4. Konzani zinthu: Lembani tsiku lobadwa la zizindikiro zanu ndi zotsatira zake. Muzionetse kwa dokotala wanu mukamamuona. Kumbukirani kumwa mankhwala anu nthawi yomweyo yomwe mukufunikira.

5. Thanzi la maganizo: Ndikofunikira kwambiri kukhala olimba m'maganizo panthawiyi. Lankhulani ndi abale ndi abwenzi. Gawani mavuto anu. Ngati kuli kofunikira, funani uphungu.

6. Chisamaliro Chochepetsa Kupweteka: Izi sizikutanthauza kuti matendawa ndi osachiritsika. Ili ndi gulu la akatswiri omwe amakuthandizani kukhala bwino mwa kuchepetsa zizindikiro monga kupweteka, nseru, ndi kutopa komwe kumabwera chifukwa cha chithandizo cha khansa. Muthanso kulankhula ndi dokotala wanu za chithandizochi.

Kodi zoopsa za chithandizochi ndi ziti?

Ngakhale kuti ma TKI amagwira ntchito bwino pa khansa zambiri, nthawi zina mavuto amatha kuchitika pakapita nthawi. Chofunika kwambiri ndi kukula kwa kukana mankhwala .

Mwachidule, maselo a khansa ndi maselo ochenjera kwambiri. Akapatsidwa mankhwala omwewo pakapita nthawi, amatha kusintha n’kukhala osagonjetsedwa ndi mankhwalawo. Monga momwe mabakiteriya amakhalira osagonjetsedwa ndi maantibayotiki. Zimenezi zikachitika, mankhwala a TKI omwe poyamba ankagwira ntchito bwino sangagwirenso ntchito.

Koma si mapeto a dziko. Chifukwa asayansi amadziwa izi, tsopano pali ma TKI a "m'badwo wachiwiri" ndi "m'badwo wachitatu" omwe angaperekedwe pamene kukana kukukula. Choncho ngati mankhwala amodzi sakugwira ntchito, dokotala wanu angakusinthireni ku TKI ina.