Iyo umuntu asanzwe arwaye kanseri y'ibere, yumva ababaye cyane kandi afite ubwoba. Ibyo ni ibisanzwe. Ariko bitewe n'ubumenyi bw'ubuvuzi bwateye imbere muri iki gihe, ubwoko bwinshi bwa kanseri y'ibere bushobora kugenzurwa no gukira. Ariko, hari ubwoko bumwe na bumwe bwa kanseri bugoye kuvura kurusha ubundi. Izi zitwa "kanseri z'ibere zigoye kuvura." Abashakashatsi mu by'ubuvuzi bafite icyizere kinini kuri ibi, kuko uburyo bushya bwo kuvura buri munsi burimo gutegurwa. Reka tubiganireho uyu munsi.
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Kuki kanseri zimwe na zimwe z'ibere zigoye kuvura?
Mu magambo make, uburyo bwiza bwo kuvura kanseri y'ibere bugamije kugenzura uko uturemangingo twa kanseri dukura. Tekereza kuri ubu buryo: niba uturemangingo twa kanseri tumeze nk'urugi, imisemburo na poroteyine bimwe na bimwe ni nk'imfunguzo zifungura urwo rugi. Ubuvuzi bukora bufunga inzugi (receptors) kugira ngo izi mfunguzo zidakora. Kanseri y'ibere igabanyijemo ubwoko butatu bw'ingenzi hashingiwe ku bwoko bw' 'inzugi'.
Noneho reka turebe ubwo bwoko butatu.
| Ubwoko bwa kanseri | Ibisobanuro byoroshye |
|---|---|
| Kanseri ya receptor y'imisemburo (HR-positive) | Izi selile za kanseri zifite receptors za estrogen (ER) na/cyangwa receptors za progesterone (PR), ibyo bigatuma zikira neza imiti ikoreshwa mu misemburo. |
| Kanseri ya HER2 (HER2-positive) | Utu turemangingo dufite urwego rwo hejuru rwa poroteyine yitwa HER2. Bityo, dushobora kugenzurwa hakoreshejwe uburyo bwo kuvura bwibanda kuri HER2 receptor. |
| Kanseri y'ibere ifite ingaruka eshatu (TNBC) | Ubu ni bwo bwoko bugoye cyane. Utu tunyangingo twa kanseri nta receptor ya estrogen, nta receptor ya progesterone, kandi nta receptor ya HER2. Ibyo bivuze ko utwo tunyangingo tudafite utwo 'rugi' dutatu navuze mbere. |
Hagati ya 10% na 20% by'abarwayi bose ba kanseri y'ibere bafite ibiNi ubwoko bwa kanseri y'ibere yitwa kanseri y'ibere itera kanseri eshatu (TNBC). Uburyo bwo kuvura imisemburo ikoreshwa neza ku zindi kanseri ntabwo bukora kuri ubwo bwoko bwa kanseri, kuko idafite uburyo bwo kwakira imisemburo. Nanone, imiti yibasira HER2 ntabwo ifasha.
Byongeye kandi, kanseri ya TNBC irakomeye kurusha izindi. Ibi bivuze ko kanseri ishobora kuba yarakwirakwiriye mu bindi bice by'umubiri mu gihe isanzwe ifatwa. Imyitwarire yayo iratandukanye kuri buri muntu, kandi ishobora guhinduka uko igihe kigenda gihita ikananirwa imiti imwe n'imwe.
Ni gute impinduka mu miterere y'uturemangingo zigira ingaruka kuri ibi?
Bumwe mu buryo bwiza bwo kumenya kanseri nka TNBC hakiri kare ni ukumenya abantu bafite ibyago byinshi byo kwandura. Kugira ngo babigereho, abashakashatsi barimo kwiga impinduka mu miterere y’uturemangingo (mutations) zihererekanywa mu bisekuruza kandi zifitanye isano na kanseri y’ibere.
- BRCA1 (gene ya kanseri y'ibere ya 1)
- BRCA2 (Gene ya 2 ya Kanseri y'ibere)
Iyo uvukanye ihinduka ry’uturemangingo muri imwe muri izi ngirabuzimafatizo ebyiri, uba ufite ibyago byinshi byo kurwara kanseri y’ibere n’intanga ngore. Iyo ufite iyi hinduka ry’uturemangingo, uba ufite amahirwe menshi yo kurwara kanseri ukiri muto.
Kanseri nyinshi z'ibere zifite BRCA1 mutation ziba zifite triple-negative . Kubwibyo, gusobanukirwa iyi gene byafasha kubona uburyo bwiza bwo kuvura TNBC.
Abaganga bamwe basaba ko buri wese urwaye TNBC yakwipimisha uturemangingo dufitanye isano na kanseri, harimo BRCA1 na BRCA2. Niba warapimwe TNBC mbere y'imyaka 60, cyangwa niba hari umuntu wo mu muryango wawe wigeze kurwara TNBC, muganga wawe ashobora kukugira inama yo gupima uturemangingo. Ibi bishobora kugufasha wowe na muganga wawe guhitamo uburyo bwiza bwo kuvura.
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Indi kanseri igoranye kuvura ni kanseri y'ibere yakwirakwiriye mu bice bya kure by'umubiri. Iyi yitwa kanseri y'ibere ya metastatic . Ishobora gukwirakwira mu bindi bice by'umubiri, nko mu magufwa, mu bwonko, mu mwijima, cyangwa mu bihaha. Hari igihe kanseri imenyekana iyo yakwirakwiriye muri ubu buryo. Ariko akenshi, kanseri igaruka igakwirakwira nyuma y'icyiciro cya mbere cy'ubuvuzi, rimwe na rimwe nyuma y'imyaka myinshi.
Kanseri y'ibere yaweIyo kanseri yakwirakwiriye ahantu hatandukanye, intego nyamukuru yo kuvura ni ukurwanya kanseri. Ubuvuzi bushingiye ku buryo bw'umubiri ni bwo busanzwe bukoreshwa kuri ibi. Muganga wawe azagufatira icyemezo cy'uburyo uvura hashingiwe ku bimenyetso byawe, uburyo wavuwe mbere, aho kanseri yakwirakwiriye, n'ubwoko bw'uturemangingo twa kanseri.
Ni ubuhe buryo bushya bwo kuvura ibi?
Uburyo bwo kuvura kanseri y'ibere ya TNBC, kanseri ya metastatic na kanseri y'ibere isubiramo bwateye imbere cyane mu myaka ya vuba aha. Ubu ubuvuzi bushingiye ku misemburo ya chimiotherapie ni bwo buryo bw'ingenzi bwo kuvura ibi. Ubu abaganga bayitanga hamwe n'indi miti.
Dore ubundi buryo bushya bwo kuvura:
Ibinini bya PARP
Iyi ni ubwoko bw'umuti usenya ADN y'uturemangingo twa kanseri mu bantu bafite BRCA gene mutations na HER2-negative na metastasis. Ingero zirimo olaparib (Lynparza) na talazoparib (Talzenna). Iyi miti kandi yagaragaje umusaruro mwiza kuri TNBC yo mu cyiciro cya mbere.
Ubudahangarwa bw'umubiri
Ubu buryo bwo kuvura butuma ubudahangarwa bw'umubiri bushobora gusenya uturemangingo twa kanseri. Pembrolizumab (Keytruda) ni umwe mu miti nk'iyo. Ubusanzwe itangwa hamwe na chemotherapy.
Udukoko two mu bwoko bwa ADC (Antibody-drug conjugates)
Iri ni ikoranabuhanga rishimishije cyane. Tekereza kuri ryo nk'uburyo bwa GPS buyobora umuti kugera ku ntego yawo. Utunyangingo tw'umubiri turi muri iyi miti bibona uturemangingo twa kanseri, tukadufata, hanyuma tugasenya uturemangingo twa kanseri hamwe n'umuti ufatanye, nta kwangiza uturemangingo tuzima. Sacituzumab govitecan (Trodelvy) ni umuti wa ADC wemewe na TNBC igezweho.
Uburyo bwo kuvura bw'inyongera
Hari imiti mishya myinshi itangwa hamwe n'imiti ivura kanseri ifata imisemburo (HR). Abemaciclib (Verzenio) ni imwe muri iyo miti.
Ni ibihe byiringiro by'ejo hazaza muri uru rwego?
Abashakashatsi bakomeje gukora ibishoboka byose kugira ngo bagure uburyo bwo kuvura izi kanseri, harimo gushaka imiti mishya ivura ubudahangarwa bw'umubiri no kumenya ibimenyetso bishobora guhanura umusaruro w'ubuvuzi.
Barimo kandi gukora iperereza ku bijyanye n'imiti yemewe ku zindi ndwara izaba ingirakamaro kuri TNBC. Barimo kandi gukora ubushakashatsi ku buryo bwo gukoresha imiti nka PARP inhibitors mu buryo bwagutse. Hari n'ubushakashatsi burimo kugerageza gukoresha uduce duto tw'umubiri dufasha mu kwica uturemangingo twa kanseri tudashobora imiti.
Nubwo kubaho na kanseri nk'iyi bishobora kugorana, hari icyizere cy'uburyo bushya bwo kuvura. Ikintu cy'ingenzi ni ukuganira na muganga wawe buri gihe no gufata icyemezo ku buryo bwo kuvura bukubereye.
Ubutumwa bwo kujyana mu rugo
- Zimwe muri kanseri z'ibere, cyane cyane kanseri y'ibere ifite inenge eshatu (TNBC) , ziragoye kuvura kuko zitagira imisemburo cyangwa poroteyine ya HER2.
- Impinduka mu ngirabuzimafatizo, nka BRCA1 na BRCA2 , ni ingenzi mu kumenya ibyago byo kwandura TNBC n'ubuvuzi bwawe. Niba ufite TNBC, vugana na muganga wawe ku bijyanye no gupima ngirabuzimafatizo.
- Intego yo kuvura kanseri yanduye ni ukurwanya iyo ndwara.
- Uburyo bwo kuvura bugezweho nka PARP inhibitors, immunotherapy, na antibody-drug conjugates (ADCs) ubu butanga icyizere gikomeye ndetse no ku kanseri zigoye kuvura.
- Uko ikibazo cyawe cyaba kiri kose, ni ngombwa cyane gukorana bya hafi na muganga wawe kugira ngo uhitemo uburyo bwiza bwo kuvura.
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