Ese kanseri y'ibere yawe ifite HER2-Positive? Reka tubiganireho birambuye!

Ese wigeze wumva kanseri y'ibere? Birashoboka ko hari inshuti yawe cyangwa umuvandimwe wawe wayirwaye. Mu by'ukuri hari ubwoko butandukanye bwa kanseri y'ibere. Uyu munsi tugiye kuvuga kuri imwe muri zo, idasanzwe kandi ishobora gukwirakwira vuba. Iyo ni kanseri y'ibere ya HER2-Positive (HER2-Positive) . Iyo wumvise iri zina, ushobora gutekereza ko rigoye gato, ariko ntugahangayike. Tuzabivugaho mu buryo bworoshye, mu buryo ushobora kumva.

Kanseri y'ibere ya HER2-Positive (HER2+) ni iki?

Mu magambo make, kanseri y'ibere ya HER2 (HER2+) ni ubwoko bwa kanseri ikura vuba kandi ishobora gukwirakwira byoroshye hanze y'ibere (`invasive`) . Iyo abaganga bavuze ko ufite ubwoko bw'iyi kanseri, bivuze ko uturemangingo twa kanseri yawe dufite poroteyine idasanzwe igenzura imikurire n'igabanyuka ry'uturemangingo mu mubiri wawe - yitwa ``Human Epidermal Growth Factor Receptor 2`` , cyangwa HER2 mu magambo ahinnye. Iyi poroteyine ya HER2 ni nk'``ikimenyetso'' kibwira uturemangingo gukura. Iyo ibaye myinshi cyane, uturemangingo twigabanyamo kabiri vuba kandi mu buryo budasubirwaho, bigatera kanseri.

Ubwoko bw'iyi kanseri y'ibere bushobora gukwirakwira cyane (metastasize) kuva mu ibere kugera mu bindi bice by'umubiri wawe, nko mu duce tw'imitsi, umwijima, ibihaha, cyangwa ndetse n'ubwonko bwawe. Ariko icy'ingenzi ni uko iyi kanseri iramutse igaragaye hakiri kare, mbere yuko ikwirakwira mu bindi bice by'umubiri, abaganga bashobora kuyivura neza bakoresheje uburyo bugezweho bwo kuvura buboneka muri iki gihe. Niyo mpamvu kuyimenya hakiri kare ari ingenzi cyane.

Kanseri y'ibere ya HER2-positive ikunze kugaragara gute?

Nk’uko bivugwa n’Umuryango w’Abanyamerika ushinzwe kurwanya kanseri, abagore barenga 290.000 bazasuzumwa kanseri y’ibere iva mu maraso (invasive ductal carcinoma na lobular breast cancer) mu 2023 gusa. Muri abo , 15% kugeza kuri 20% bafite HER2. Abagabo nabo bashobora kurwara kanseri y’ibere, ariko kanseri y’ibere iva mu maraso ya HER2 ntabwo ikunze kugaragara cyane ku bagabo.

Ni ibihe bimenyetso bya kanseri y'ibere ya HER2?

Kimwe n'ubwoko bwinshi bwa kanseri y'ibere, iyi ndwara ya HER2-positive rimwe na rimwe ntabwo igaragaza ibimenyetso bigaragara mu ntangiriro. Ariko iyo ibimenyetso bigaragaye, bisa n'ibigaragara muri kanseri y'ibere isanzwe. Reka turebere hamwe ibyo ari byo:

• Impinduka mu bunini, imiterere, cyangwa imiterere y'ibere . Ibere ​​rimwe rishobora kumva rinini kurusha irindi, cyangwa imiterere yaryo igahinduka.
• Ikibyimba cyangwa ikibyimba kiri mu ibere cyangwa mu kwaha. Iki kibyimba gishobora kuba gito nk'amashaza. Niba ikibyimba kigikomeje nyuma y'uko imihango yawe irangiye, ugomba kugira impungenge.
• Impinduka mu miterere cyangwa uko uruhu rw'ibere cyangwa ibere rimera . Uruhu rushobora kuba rubi, rukabyimba cyangwa rukabyimba, cyangwa rukamera nk'urufite ibibyimba cyangwa rukabyimba. Hari igihe uruhu rushobora kuba rutukura cyangwa rwirabura kurusha uko bisanzwe.
• Kumva ahantu hakomeye munsi y'uruhu, nk'amabuye y'agaciro .
• Amaraso cyangwa amazi asukuye asohoka mu ibere.

Tekereza, inshuti yawe, reka tumwite "Sunita". Umunsi umwe, ubwo yari arimo koga, Sunita yabonye impinduka nto mu ibere rye. Byasaga n'aho ari akabyimba gato. Mbere na mbere, ntiyabyitayeho cyane, yibwira ati "Bizashira gusa." Ariko nyuma y'ibyumweru bike, byari bikiri aho. Nyuma, ubwo yabyerekaga kwa muganga, yabonye ko ari ikimenyetso cya kanseri y'ibere. Kubwibyo, niba ubonye impinduka zidasanzwe mu ibere ryawe, ni ngombwa cyane gushaka inama kwa muganga utirengagije.

Ni iki gitera kanseri y'ibere ya HER2?

Kanseri y'ibere ya HER2 iterwa n'impinduka mu ngirabuzimafatizo yitwa HER2. Iyi ngirabuzimafatizo ya HER2 ikora poroteyine ya HER2 twavuze mbere. Izi poroteyine za HER2 (zitwa kandi 'receptors') zisanzwe ziboneka ku buso bw'uturemangingo twose tw'ibere.

Mu bihe bisanzwe, izi poroteyine za HER2 zigenzura imikurire n'isana ry'uturemangingo tw'ibere, zigatuma uturemangingo dushya twigabanyamo ibice bihagije kugira ngo dusimbuze uturemangingo twangiritse cyangwa dupfa.

Ariko, iyo jeni ya HER2 ihindutse, ikora kopi nyinshi cyane. Iyo jeni ya HER2 ikabije, ikora na poroteyine ya HER2 nyinshi cyane. Iyo poroteyine ya HER2 ibaye nyinshi cyane, uturemangingo tw'ibere twigabanyamo kabiri kandi tugakura mu buryo butunguranye, tukaba ibibyimba bya kanseri.

Ni ibihe bintu bishobora gutera ibi?

Kimwe na kanseri y'ibere, ibintu bishobora gutera kanseri y'ibere ya HER2 ni bimwe n'ibya kanseri y'ibere isanzwe. Ushobora kwandura kanseri y'ibere waba ufite ibi bintu cyangwa udafite. Ariko, ibi bintu bishobora kongera ibyago byawe:

• Kugira ihinduka ry’uturemangingo mu buryo bw’umubiri . Urugero, ihinduka ry’uturemangingo mu turemangingo twa BRCA1 cyangwa BRCA2.
• Kuba nararwaye kanseri y'ibere mbere.
• Kugira izindi ndwara ziterwa n'amabere nka 'atypical ductal hyperplasia'.
• Imihango itangira mbere y'igihe gisanzwe.
• Gucura bibaho nyuma y'imyaka isanzwe.
• Gufata imiti isimbura imisemburo.
• Kunywa ibinyobwa bisindisha birenze kimwe ku munsi.
• Kuba narakorewe ubuvuzi bushingiye ku maraso ku ndwara zimwe na zimwe nka lymphoma (kanseri yo mu maraso).

Ni izihe ngorane ziterwa na kanseri y'ibere ya HER2?

Kanseri y'ibere ya HER2-Positive ishobora gukwirakwira mu bindi bice by'umubiri, cyangwa 'metastasize'. Mu bantu bagera kuri kimwe cya kabiri barwaye iyi kanseri y'ibere, kanseri iba yamaze gukwirakwira mu bindi bice by'umubiri, cyane cyane ubwonko, mu gihe bayirwaye. Kanseri y'ibere imaze gukwirakwira mu bwonko ('metastasis to your brain cancer') ishobora gushyira ubuzima mu kaga. Niyo mpamvu kuyimenya hakiri kare no kuyivura vuba ari ingenzi.

Kanseri y'ibere ya HER2 ipimwa ite?

Abaganga bakoresha cyane cyane isuzuma ry’ibere kugira ngo bapime kanseri zose z’ibere. Ibi bikubiyemo gufata agace gato k’urugingo mu gace gakekwaho kanseri y’ibere bakagasuzuma bakoresheje mikorosikopi.

Iyo isuzuma ry’ibere ryemejwe ko hari kanseri, umuganga w’indwara (umuganga w’inzobere mu gupima indwara) azakora ibizamini byihariye kugira ngo arebe niba uturemangingo tw’ibere turimo poroteyine ya HER2. Hari ubwoko bubiri bw’ingenzi bw’ibizamini kuri ibi:

1. Ubuvuzi bw'indwara z'umubiri (IHC): Iki kizamini cyemerera abahanga mu by'indwara gushakisha poroteyine ya HER2 mu tunyangingo twa kanseri y'ibere. Iki kizamini gikoresha irangi ryihariye (immunostaining) kugira ngo barebe urwego rwa poroteyine ya HER2 mu tunyangingo twa kanseri.

2. Guhuza imiterere y'amafi mu buryo bwa fluorescence (FISH): Iki kizamini cy'amafi rimwe na rimwe gikoreshwa mu kwemeza ibyavuye mu kizamini cya IHC. Iki kizamini gishobora kugaragaza niba hari kopi z'inyongera za jeni ya HER2.

Nyuma y'ibi bizamini, abaganga bakomeza gushyira kanseri mu byiciro. Bakoresha 'uburyo bwo gupima'. Ibi bireba urwego rwa poroteyine ya HER2 ruri hejuru mu gipimo cy'uturemangingo tw'ibere, ndetse n'umubare w'uturemangingo twa kanseri turimo. Tekereza kuri ubu buryo:

• Niba ikizamini cyerekanye ko urwego rwa poroteyine ya HER2 ruri hasi, kizaba ari 0 cyangwa 1+ . Umuganga w’indwara azavuga ko ari HER2 negative .
• Iyo hari uturemangingo twa kanseri kandi urwego rwa poroteyine ruri hagati, ushobora kubona amanota 2+ . Hanyuma umuganga w’indwara azemeza ikizamini cya `FISH` cyavuzwe haruguru.
• Iyo hari uturemangingo twinshi twa kanseri kandi urwego rwa poroteyine ruri hejuru cyane, ubona amanota 3+ . Icyo gihe umuganga w’indwara avuga ko afite HER2 positive .

Ubu buryo bwo gutanga amanota bugena neza niba ufite HER2-positive cyangwa HER2-negative.

Ni ubuhe buryo bwo kuvura kanseri y'ibere ya HER2?

Kubera ko iyi ari kanseri y'ibere "ikwirakwira", uburyo bwo kuyivura bugenwa n'ibintu byinshi, nko ku rwego rwa kanseri n'imiterere ya HER2. Ubu buryo bukurikira bushobora gukoreshwa:

• Ubuvuzi bwibasiwe:Ubu ni bwo buryo bwihariye bwo kuvura kanseri ya HER2. Bukubiyemo gutanga imiti yibasira poroteyine ya HER2 no kwica uturemangingo twa kanseri. Hari ubwoko bwinshi bw'ingenzi bwo kuvura muri ubu buryo:
• Uburyo bwo kuvura indwara zo mu bwoko bwa monoclonal antibody: Izi zigira uruhare mu mikorere ya poroteyine ya HER2 kandi zigahagarika uturemangingo twa kanseri gukura.
• Uburyo bwo kuvura indwara ya Tyrosine kinase: Iyi miti yinjira mu tunyangingo twa kanseri kandi igafunga inzira zituma utwo tunyangingo dukura.
• Udukoko two kurwanya kanseri (ADCs): Ubu buryo ni ubugezweho cyane. Muri ubu buryo, umuti urwanya kanseri ushyirwa ku gice cy’umubiri gishakisha uturemangingo twa kanseri. Hanyuma iki gice kijya mu turemangingo twa kanseri kikarekura umuti, bigatuma uturemangingo tuzima twangirika gake.
• Chimiotherapie: Chimiotherapie itangwa mbere yo kubagwa kugira ngo igabanye ikibyimba (neoadjuvant therapy) cyangwa ngo yica uturemangingo twa kanseri dusigaye nyuma yo kubagwa (adjuvant therapy). Hari igihe chimiotherapie itangwa hamwe n'ubuvuzi bwihariye.

Uretse ibi, bitewe n'urwego rwa kanseri, ibintu nka 'kubagwa', 'gukoresha imirasire', cyangwa 'gukoresha imisemburo' nabyo bishobora gukorwa.

Ingaruka mbi z'ubuvuzi ni izihe?

Ingaruka mbi zishobora gutandukana bitewe n'uburyo ubuvuzi bukoreshwa. Niba urimo kuvurwa, ganira na muganga wawe ku buryo ubuvuzi buzagira ingaruka kuri wewe n'uko buzagira ingaruka ku buzima bwawe bwa buri munsi. Baza kandi muganga wawe ku bijyanye n'ubuvuzi bugabanya ububabare . Ubuvuzi bugabanya ububabare ni serivisi igufasha gucunga ibimenyetso bya kanseri n'ingaruka mbi zo kuvurwa no gutuma wumva umerewe neza uko bishoboka kose mu gihe cyo kuvurwa. Ntabwo ari ubuvuzi bw'abantu badashobora gukira kanseri gusa, ahubwo bushobora gufasha umuntu wese uri kuvurwa.

Ese ubu buryo bwo kuvura bushobora gukiza burundu kanseri y'ibere ya HER2?

Iyo abaganga bavuze ko "bakijije" kanseri, bashobora kuba bashaka kuvuga ko kanseri yagabanutse imyaka myinshi nyuma yo kuvurwa. Gusubiramo bivuze ko nta bimenyetso bya kanseri ugaragaza kandi nta kanseri ishobora kuboneka mu bipimo. Umuntu usanzwe arwaye kanseri y'ibere ya HER2, akavurwa, akamara imyaka itanu afatwa nk' "uwakize."

Nk’uko Ikigo cy’Igihugu gishinzwe Kurwanya Kanseri muri Amerika (NCI) kibitangaza, abantu barenga 90% banduye kanseri y’ibere ya HER2 baracyariho nyuma y’imyaka itanu. Bashobora gufatwa nk’abakize kanseri yabo. Ariko, kanseri ya HER2 ishobora kongera kugaruka no gukwirakwira mu bindi bice by’umubiri. Kubwibyo, ni ngombwa gukomeza kujya kwisuzumisha kwa muganga.

Ni ikihe gipimo cyo kubaho kwa kanseri y'ibere ya HER2?

Amahirwe yo kurokoka kanseri y'ibere ya HER2-positive aratandukanye bitewe n'uko kanseri ari receptor-positive (HR+) cyangwa receptor-negative (HR-) . (Izi receptor z'imisemburo ni receptor ziri ku buso bw'uturemangingo zishobora gufatana n'imisemburo. Hafi kimwe cya kabiri cya kanseri zose za HER2-positive zifite izi receptor. Ikigo gishinzwe kurwanya kanseri (NCI) gishyira aya mahirwe mu byiciro bya kanseri: aho iherereye (igarukira ku ibere), aho iherereye (ikwirakwira ku tunyangingo tw'umubiri turi hafi), n'aho iherereye (ikwirakwira mu bice bya kure by'umubiri). Ushobora kuvugana na muganga wawe kuri ibi kugira ngo umenye byinshi.

Ese kanseri y'ibere ya HER2 ishobora kwirindwa?

Birashoboka cyane ko atari byo. Nubwo hari ibintu ushobora gukora kugira ngo ugabanye ibyago byo kurwara kanseri y'ibere, kanseri y'ibere ya HER2 iterwa n'impinduka mu ngirabuzimafatizo ya HER2 ituma uturemangingo twa kanseri dukora. Abashakashatsi baracyari kwiga impamvu ibi bibaho, bityo ntibarabasha kuvuga neza icyakorwa kugira ngo hirindwe kanseri ya HER2.

Ariko, ushobora gukora ibi kugira ngo ugabanye ibyago byo kurwara kanseri y'ibere muri rusange:

• Wite ku buzima bw'ibere ryawe. Kora isuzuma ry'ibere ryawe buri gihe, kandi ufate imiti ya mammogram ku myaka n'igihe byatanzwe na muganga wawe. Menya neza impinduka zose ziba mu ibere ryawe. Muri ubu buryo, kanseri ishobora kumenyekana hakiri kare kandi ikavurwa byoroshye.
• Komeza kugira ibiro bizima. Ibi bigomba kuba ibiro bikubereye. Baza muganga wawe inama z'uburyo wakomeza kugira ibiro bizima.
• Kurya indyo yuzuye. Ubushakashatsi bumwe bwagaragaje ko indyo ikungahaye ku mboga, imbuto, ibikomoka ku mata bikungahaye kuri kalisiyumu, na poroteyine zitarimo ibinure bishobora kugabanya ibyago byo kurwara kanseri y'ibere. Ni byiza kandi kugabanya inyama zitukura n'izitunganyijwe.
• Gira imyitozo ngororamubiri. Ubushakashatsi bwagaragaje ko gukora imyitozo ngororamubiri buri gihe bigabanya ibyago byo kurwara kanseri y'ibere. Ndetse no kugenda n'amaguru iminota 30 ku munsi ni byiza.
• Irinde ibinyobwa bisindisha. Ubushakashatsi bwerekana isano iri hagati ya kanseri y'ibere n'inzoga. Ishyirahamwe ry'abaganga b'Abanyamerika risaba abagore kugabanya inzoga banywa ku kinyobwa kimwe ku munsi.

Nitwara nte?

Kubaho urwaye kanseri y'ibere bivuze kubaho ufite ibimenyetso bya kanseri, uburyo bwo kuyivura, n'ingaruka zayo. Hari igihe ushobora kubaho ufite ikibazo cyo kutizera ahazaza. Hari igihe ushobora kumva uremerewe cyane kandi ubabaye. Niba ubyumva utyo, tekereza ku nama zikurikira zo kwita ku buzima bwawe:

• Humura bihagije.Kanseri y'ibere n'uburyo bwo kuyivura birananiza cyane. Wibuke kuruhuka igihe cyose ubyifuza, atari igihe ufite umwanya gusa.
• Rya neza. Ubuvuzi bushobora kugabanya ubushake bwo kurya, ariko kurya indyo ikungahaye ku mbuto, imboga, poroteyine zitarimo ibinure n'ibinyampeke byiza bizagufasha gukomeza kugira imbaraga mu gihe cyo kuvurwa.
• Gucunga imihangayiko yawe. Kanseri ni ikintu gitera imihangayiko ikomeye. Imyitozo ngororamubiri ishobora kugufasha muri ibi. Kugenda n'amaguru buri gihe no kwitabira gahunda z'imyitozo ngororamubiri nka yoga ni byiza.
• Shaka ubufasha. Uri uwarokotse kanseri y'ibere, kandi ibyo bitangira umunsi umenyereweho. Baza muganga wawe gahunda zo kurengera abarokotse kanseri . Izi gahunda zishobora kugufasha gutsinda imbogamizi zo kubana na kanseri y'ibere. Kuganira n'umuryango wawe n'inshuti nabyo ni uburyo bwiza bwo kwibeshaho.

Ni ryari ngomba kujya kwa muganga?

Uzakenera kujya kwa muganga wawe buri gihe mu gihe cyo kuvurwa. Ariko, niba ubonye impinduka nshya mu mabere yawe cyangwa ku mubiri wawe zishobora kuba ikimenyetso cy'uko kanseri yawe ya HER2 yakwirakwiriye, bwira muganga wawe ako kanya. Urugero, niba kanseri y'ibere yarakwirakwiriye mu bihaha, ushobora kugira ibimenyetso nko kubabara mu gatuza, kwandura indwara mu gatuza kenshi, kugorwa no guhumeka, cyangwa gukorora amaraso.

Ni ryari nkwiye kujya mu cyumba cy’ubutabazi bw’ibanze?

Niba umubiri wawe witabira imiti ya kanseri nabi kurusha uko wari ubyiteze, ugomba kujya mu cyumba cy’ubutabazi bw’ibanze. Urugero, niba warabuze amazi menshi bitewe no kuruka kenshi, jya kwa muganga vuba.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

Niba ibizamini byawe bigaragaza ko ufite kanseri y'ibere ya HER2, ushobora kubaza muganga wawe ibibazo nk'ibi bikurikira:

• Ese koko HER2 yanjye ihagaze ite? (ni ukuvuga amanota yanjye ya IHC/FISH ni angahe?)
• Imiterere yanjye ya receptor y'imisemburo imeze ite? (HR+ cyangwa HR-?)
• Ni gute iyi miterere ya HER2 na hormone receptor igira ingaruka ku mibereho yanjye (ni ukuvuga ku mibereho y'indwara n'uko izagenda mu gihe kizaza)?
• Ni ubuhe buryo bwo kuvura wangiriye inama? Kuki?
• Ese nkwiye gutekereza kwitabira igerageza ryo kuvura kanseri y'ibere ya HER2?

Impinduka mu kuvura kanseri ntizikunze kubaho. Niyo mpamvu abashakashatsi ba kanseri bishimye cyane ubwo ubushakashatsi bwagaragazaga ko impinduka mu ngirabuzimafatizo ya HER2 zituma uturemangingo twigabanyamo kabiri vuba kurusha uko bisanzwe. Bahise bavumbura isano iri hagati y’impinduka mu ngirabuzimafatizo ya HER2 n’ubwoko bumwe na bumwe bwa kanseri y’ibere ikura vuba. Bahereye aho, bateguye uburyo bwo kuvura kanseri y’ibere ya HER2 ikiri mu cyiciro cya mbere. Ubu abashakashatsi barimo kwibanda ku gushaka uburyo bwiza bwo kuvura bushobora kugabanya cyangwa guhagarika ikwirakwira rya kanseri. Igeragezwa ry’ubuvuzi niho ubu buvumbuzi bushya bubera. Niba ufite kanseri y’ibere ya HER2 ikiri mu maraso ('imetastatic'), vugana na muganga wawe ku bijyanye no kwitabira igerageza ry’ubuvuzi. Bashobora kugufasha.

Amaherezo, ubutumwa bwo kujyana mu rugo

Kanseri y'ibere ya HER2 ni ubwoko bwa kanseri ikomeye kandi ikwirakwira vuba. Ariko, hamwe no kuyimenya neza kandi hakiri kare ndetse no kuvura neza, ubu birashoboka kuyirwanya no kuyikiza neza.

• Buri gihe menya neza umubiri wawe, cyane cyane amabere yawe. Nubona impinduka zidasanzwe, ntuzirengagize kandi ushake inama kwa muganga ako kanya.
• Kurikiza ibizamini n'imiti muganga agusaba neza. Ntutinye kuvugana na muganga wawe ku bibazo cyangwa impungenge ushobora kuba ufite.
• Ni ingenzi cyane kugumana icyizere. Ntabwo uri wenyine. Hariho umuryango, inshuti, abaganga, n'abajyanama bagufasha.

Twizeye ko aya makuru azaba ingirakamaro kuri wewe. Komeza ugire ubuzima bwiza!

Kanseri y'ibere , HER2-Positive, ibimenyetso bya kanseri, uburyo bwo kuvura kanseri, ubuzima bw'abagore, impinduka mu ngirabuzimafatizo, mammogram