Ndinonzwisisa kuti zvinorema uye zvinotyisa sei kana ukaonekwa uine kenza yemazamu. Kune rumwe rutivi, pane kunetseka nezvechirwere ichi, uye kune rumwe rutivi, kana vanachiremba vakataura mazwi akadai sekuti ``(Chemotherapy)`` uye hormone therapy , pfungwa dzako dzinowedzera kuvhiringidzika, handiti? "Ndichawanawo chemotherapy here? Vhudzi rangu richadonha here? Zvichaomera muviri wangu here?" Unofanira kunge uine mibvunzo yakawanda mupfungwa dzako. Asi usazvidya mwoyo. Nhasi, tichataura nezvekuti zera rako uye kana wakambosvika panguva yekuguma kwemwedzi kana kuti kwete zvichave zvakakosha sei pakusarudza kurapwa kwaunopiwa.
Kare, vanhu vakawanda vaipiwa chemotherapy pavakangoziva kuti kenza yemazamu yakanga yapararira kusvika kuma lymph nodes. Zvainge zvakaita sekubata nyundo woita kuti zvese zviite sembambo. Asi ikozvino mushonga wafambira mberi zvakanyanya. Iye zvino tava kuziva kuti havasi vese kenza yemazamu yakafanana, uye havasi vese varwere vanozopindura kurapwa kwakafanana. Dzimwe nguva migumisiro ye chemotherapy inogona kupfuura mabhenefiti. Saka ikozvino vanachiremba vava kunyanya kunetseka kwete nehukuru hwebundu uye danho rekenza, asiwo nehunhu hwekenza .
Sei kuenda kumwedzi kuchikosha munyaya iyi?
Ungave wakaenda kumwedzi kana kuti kwete, nguva iyo kuenda kwako kumwedzi kunomira zvachose, inokosha zvikuru pakurapa kenza yemazamu. Pane zvikonzero zvakawanda zveizvi.
Zvichitaurwa zviri nyore, kenza yemazamu kuvakadzi vadiki vasati vasvika nguva yekuenda kumwedzi ine mukana wekuva nekenza yakanyanya kuipa kupfuura kuvakadzi vadarika nguva yekuenda kumwedzi .
Pamusoro pezvo, zvinosarudzawo rudzi rwekurapwa kwauchawana. Semuenzaniso, kana uine kenza inokonzerwa nemahormone, rudzi rwekurapwa kwemahormone kwaunogona kuwana ruchasiyana zvichienderana nemamiriro ako ekusvika panguva yekuenda kumwedzi.
- Mushure mekusvika kumwedzi: Unogona kupihwa mushonga wakaita seArimidex, unomisa muviri kugadzira hormone inonzi estrogen.
- Kana wasvika nguva yekusvika kumwedzi: Mazai ako achiri kugadzira estrogen, saka mishonga yakaita seArimidex haizonyatsoshanda. Saka chiremba wako anowanzo kunyora mushonga unonzi Tamoxifen. Izvi zvinoshanda nekuvhara meseji inotumirwa neestrogen kumasero ekenza.
Unonzwisisa here? Zvichienderana nekuchinja kunoita mahormone emuviri wako, mishonga inorwisa kenza inofanirawo kuchinja.
Biology yeKenza: Mahormone Receptors uye HER2
Zvakanaka, ngationgororei zvakadzama. Tichisiya parutivi kana kurapwa nemahormone kwakakunakirai kana kwete, mubvunzo mukuru unotevera ndewekuti munoda chemotherapy here kana kuti kwete.
Sarudzo iyi inowanzo enderana nemhando dzemareceptor ari pamusoro pemasero ako ekenza. Funga nezvemareceptor aya se'antenna' ari pamasero ekenza. Maantenna aya anobata 'zviratidzo' zvekuti kenza inoda kukura. Kune mhando mbiri huru dzemareceptor atinotarisa.
1. MaReceptor eHormone (HR): MaReceptor anonzwa mahormone eestrogen neprogesterone.
2. HER2 receptor: Iyi imwe puroteni inobatsira masero ekenza kukura.
Ona tafura iri pazasi kuti uone kuti kenza inorongwa sei uye kurapwa kunotsanangurwa zvichienderana nekusanganiswa kweizvi.
| Rudzi rwekenza (zvichienderana nemhinduro) | Zvinoreva uye hurongwa hwekurapa kwakajairika |
|---|---|
| HR-positive, HER2-negative | Inonzwa mahormone, asi hainzwi HER2. Kurapa nemahormone kunoshanda zvakanaka. Kusarudza kana chemotherapy ichidiwa kana kwete kwakaoma. Mamiriro ekuenda kumwedzi akakosha zvikuru pano. |
| HR-positive, HER2-positive | Inonzwira tsitsi mahormone neHER2. Kusanganiswa kwemishonga inorapwa nemahormone neHER2-targeted therapy kunogona kupa mhedzisiro yakanaka. Mishonga inorapwa nemakemikari inogona kudzivirirwa. |
| HR-negative, HER2-positive | Haina kubatwa nemahormone, asi inonzwawo maHER2. Chemotherapy inodiwa pamwe chete neHER2-targeted therapy. |
| Katatu-Negative | Mahormone receptors ese ari maviri neHER2 receptor haapo, ese ari matatu. Saka, hapana hormone therapy kana HER2-target therapy inoshanda. Chemotherapy inowanzo shandiswa zvakanyanya. |
Chii chinonzi Oncotype Dx test?
Kana kenza yako iri HR-positive, HER2-negative, ndiko kuti, rudzi rwekutanga patafura iri pamusoro, mubvunzo wekuti "Ndinoda chemo here?" ndiwo wakaoma kupindura. Muzviitiko zvakaita seizvi ndipo apo vanachiremba vanoshandisa genomic test yakaita se`Oncotype Dx` .
Kuongororwa uku kunoongorora majini makumi maviri nerimwe muchikamu chidiki chegomarara rako. Zvichibva pane izvi, zvinokupa mamakisi anoratidza kana gomarara rako riine mukana wakaderera, uri pakati nepakati, kana kuti wakakwira wekudzokazve mune ramangwana.
- Mapoinzi mashoma: Kazhinji unogona kuva nani usina chemotherapy .
- Kana mamakisi ari pamusoro: Chemotherapy ndiyo yakakodzera zvakanyanya.
Asi vanhu vazhinji vanowana mamakisi ari pakati nepakati . Ndipo panomuka dambudziko zvakare.
Mhinduro kubva mukutsvagurudza kutsva
Nerombo rakanaka, zvidzidzo zviviri zvikuru zvechangobva kuitwa, TAILORx naRxPONDER, zvakapa mhinduro dzakanaka kwazvo kumubvunzo wekuti chii chinofanira kuitwa nevakadzi ava vane mamakisi ari pakati nepakati. Zvidzidzo izvi zvakasimbisa kukosha kwekuenda kumwedzi.
- Kuedzwa kweTAILORx (kune vanhu vane kenza isina kupararira kuma lymph nodes):
- Chidzidzo ichi chinoratidza pachena kuti vakadzi vasvika panguva yekupedza kuenda kumwedzi vane Oncotype Dx scores dziri pakati nepakati havawani chero rubatsiro rwekuwedzera kubva kuchemotherapy. Kurapwa nemahormone chete kwakakwanira kwavari.
- Chidzidzo cheRxPONDER (kune vanhu vane kenza yakapararira kusvika kuma lymph nodes):
- Izvi zvinoratidzawo zvimwe chetezvo. Vazhinji vevakadzi vasvika panguva yekupedza kuenda kumwedzi , kunyangwe kenza yavo yakapararira kumasero eropa, havabatsirwi zvakanyanya nechemotherapy.
- Zvisinei, nyaya yacho yakasiyana zvachose nevakadzi vasati vasvika panguva yekuenda kumwedzi, kunyanya avo vari pasi pemakore makumi mashanu. Kana chemotherapy ikawedzerwa pakurapa nemahormone kwavari, kugona kwavo kudzivirira kenza kuti isadzoke kunowedzera zvakanyanya .
Zvichitaurwa zviri nyore, kana uri musikana wechidiki asati asvika panguva yekuenda kumwedzi, chemotherapy inogona kuva chombo chine simba chinogona kuponesa hupenyu hwako. Asi kana wasvika panguva yekuenda kumwedzi, unogona kuwana mhedzisiro iri nani nekurapwa nemahormone pasina kusangana nemigumisiro yayo.
Sarudzo yekupedzisira uye zvinhu zvekufunga nezvazvo
Nezvose izvi, pamwe unonzwisisa kuti zvakaoma sei kuita sarudzo idzi uri wega. Ndosaka zvichikosha kutaura pachena nezvese izvi nachiremba wako.
Kana uri pamberi pekusvika panguva yekuenda kumwedzi, kunyanya mumakore ako ekutanga ekuma40, pane chimwe chinhu chekurangarira. Kurapa nemakemikari kunogona kukonzera kuti kuenda kumwedzi kumire zvachose uye kukonzera kuenda kumwedzi nekukurumidza. Kune avo vari vadiki, kuenda kumwedzi kunogona kumira kwechinguva uye kwozotangazve. Asi kana uchitarisira kuva nevana mune ramangwana, iva nechokwadi chekutaura nachiremba wako nezvekuchengetedza kubereka usati watanga kurapwa.
Pakupedzisira, iwe nachiremba wako muchasarudza kuti ndeipi mishonga yakakunakirai. Mukati mehurukuro iyoyo, mhando yekenza yenyu, danho renyu, Oncotype Dx score, uye kana mava nemakore ekuguma kuenda kumwedzi zvese zvinhu zvakakosha zvekukurukura.
Mharidzo Yekuenda Nayo Kumba
- Hadzisi dzese kenza dzemazamu dzakafanana, saka kurapwa kwakafanana hakuna kukodzera munhu wese.
- Kunyangwe wakambosvika panguva yekuenda kumwedzi kana kuti kwete zvichakanganisa zvikuru kurapwa kwaunowana, kunyanya chemotherapy ne hormone therapy.
- Kuongororwa kwemajini kwakaita seOncotype Dx kunogona kubatsira vakadzi vane gomarara reHR-positive, HER2-negative kuona kana chemotherapy ichikosha.
- Ongororo dzichangoburwa dzinoratidza kuti vakadzi vapedza kuenda kumwedzi havawanzowana rubatsiro rwakawedzerwa kubva kumishonga yekurapa kenza, asi inogona kubatsira zvikuru vakadzi vasati vasvika panguva yekuenda kumwedzi.
- Taura pachena uye wakatendeseka kuna chiremba wako nezvehurongwa hwako hwekurapa. Taura zvakajeka nezvezera rako, mamiriro ako ekusvika panguva yekuenda kumwedzi, uye zvirongwa zveramangwana (zvakaita sekuva nevana).
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