Patinonzwa izwi rekuti kenza yemazamu, vazhinji vedu tinotya. Asi chinhu chakakosha chatinofanira kunzwisisa ndechekuti hadzisi dzese kenza dzemazamu dzakafanana. Kune mhando dzakasiyana dzadzo. Imwe yemhando dzakajairika i'estrogen receptor positive' kana sezvatinoidaidza nechiremba , ER+ (Estrogen-Receptor-Positive) kenza yemazamu . Kutaura zvazviri, 80% chete yekenza yemazamu yakaonekwa ndeyerudzi urwu. Saka nhasi tichataura nezvemhando itsva, inobudirira yemishonga yakawanikwa yekurapa idzi kenza dzemazamu dzeER+.
Kutanga, ngationei, chii chinonzi ER+ breast cancer?
Zvichitaurwa zviri nyore, hormone inonzi estrogen iri mumuviri wedu inobatsira masero ekenza aya kukura. Fungidzira kuti masero ekenza aya ane 'locks' dzakakosha (receptors) pamusoro pawo idzo hormone yeestrogen inogona kubatana nadzo. Kana 'kiyi' inonzi estrogen hormone yapinda mu 'lock' iyi, masero ekenza anogamuchira 'chiratidzo' chekuparadzanisa nekukura.
Ndosaka vanachiremba vachiwanzo rapa kenza yeER+ nekurapwa nemahormone . Kurapa uku kunoshanda nekudzivirira 'key' (estrogen) kuti isabatane ne'lock' (receptors). Asi dzimwe nguva, kunyanya kana kenza yapararira mumuviri wese (yakakura kana kuti yapararira), masero aya ekenza anova akangwara zvikuru. Anova asingade kurapwa nemahormone aya, zvichireva kuti haapindure zvakanaka pakurapwa. Apa ndipo patinoda kurapwa kutsva, kunoshanda zvakanyanya.
'Kuchinja kwekukura' kwemasero ekenza - majini ePI3K nePIK3CA
Vanachiremba nemasayendisiti pavaitsvaga zvikonzero zvegomarara iri risingagamuchirwi nemahormone, vakawana chimwe chinhu chakakosha: chikanganiso munzira yePI3K (Phosphatidylinositol-3-Kinase) , sisitimu huru yekuzivisa inodzora kukura, kupatsanurwa, uye kupona kwemasero mumuviri wedu.
Funga nezvenzira iyi yePI3K se'switchboard' huru musero. Inodzora sarudzo dzekuti sero rinofanira kukura here kana kupatsanurwa. Rimwe remajini makuru anodzora switchboard iyi ijini rePIK3CA .
Mune vamwe varwere vegomarara, jini iri rePIK3CA rine shanduko , zvichireva shanduko kana chikanganiso. Zvakaita sekuti switch ye'kukura' pa switchboard inonamira uye inogara 'yakabatidzwa'. Ipapo masero anotanga kupatsanurana nekukura zvisingadzoreki. Ichi ndicho chikonzero chikuru chegomarara. Tsvagiridzo yakawana kuti vanenge 40% yevarwere vane gomarara rezamu reER+ vane shanduko iyi yePIK3CA.
Saka chii chinonzi PI3K Inhibitors idzi?
Pano, semhinduro yedambudziko iri, boka remishonga inonzi PI3K inhibitors riri kuunzwa. Chinhu chiri nyore kuita mishonga iyi ndechekudzima 'kukura kwekuchinja' (PI3K pathway) yandambotaura kare iyo yakaramba 'iri'.
Zvichitaurwa zviri nyore, mishonga iyi yakafanana nenyanzvi yemagetsi. Anouya ogadzirisa switchboard iyoyo ine circuit pfupi, achimisa magetsi asingakoshi. Nenzira imwecheteyo, maPI3K Inhibitors anomisa chiratidzo chekukura chisingakoshi chichienda kumasero ekenza, zvichiita kuti masero ekenza afe uye zvichibatsira bundu kuderera.
Iyi inowanzouya iri muchimiro chemishonga inonwiwa. Kazhinji, mushonga uyu unopiwa varwere pamwe chete ne hormone therapy yambotaurwa (estrogen blocker).
Ndingaziva sei kana kurapwa uku kwakandinakira?
Uyu mubvunzo unokosha zvikuru. Mishonga inodzivirira PI3K haipiwi varwere vese vane kenza yemazamu . Yakagadzirirwa zvakananga kuti:
- Kune vakadzi vapedza kuenda kumwedzi nevarwere vechirume.
- Kenza inofanira kunge iri HR+ (Hormone-Receptor-Positive) uye HER2-Negative .
- Chinhu chinonyanya kukosha: Masero egomarara anofanira kunge aine PIK3CA gene mutation .
Kuti aone kana kenza yako ine chirwere ichi, chiremba wako achaita bvunzo yakakosha. Izvi zvinowanzo sanganisira ropa kana chidimbu chidiki chenyama (biopsy) chinotorwa kubva mubundu. Mhedzisiro yebvunzo iyoyo ndiyo ichaona kana kurapwa uku kwakakunakira.
| Kukodzera kurapwa | Tsananguro |
|---|---|
| Rudzi rwegomarara | Inofanira kunge iri kenza yemazamu yemhando yeHR+ (hormone receptor positive) uye HER2- (HER2 negative). |
| Kuchinja kwemajini | Kuchinja kwemajini ePIK3CA kunofanira kunge kuripo. Izvi zvinosimbiswa nebvunzo yakakosha. |
| Murwere | Inowanzo kurudzirwa kuvakadzi vasvika panguva yekupedza kuenda kumwedzi nevarwere vechirume. |
Migumisiro ipi inogona kukonzera mishonga iyi?
Kufanana nechero nzira yekurapa kenza, mishonga inodzivirira PI3K inogona kukonzera mimwe migumisiro yakaipa. Zvisinei, izvi hazviitike kune wese munhu nenzira imwechete. Zvakare, ikozvino kune nzira dzekugadzirisa migumisiro yakaipa iyi.
Mimwe yemigumisiro yakajairika ndeiyi:
- Kusvotwa nekurutsa
- Kurasikirwa nechido chekudya uye kudzikira kwehuremu
- Maronda emuromo
- Kudonha kwebvudzi
- Chero mhedzisiro pakushanda kweitsvo, chiropa, kana pancreas
- Mapundu paganda, dzimwe nguva akanyanya, anogona kuitika, zvichiita kuti ganda ribviswe kana kuti riputike.
- Shuga Yakawanda Muropa: Uyu ndiwo mhedzisiro yakajairika kune iyi mhando yemishonga, sezvo nzira yePI3K ichibatanidzwa mukushandiswa kweshuga mumuviri wedu.
Usavhunduke nemhedzisiro iyi. Chiremba wako achakutarisa nguva nenguva kuti aone kana paine izvi. Kana zvichidikanwa, achaderedza mushonga, orega kuutora kwenguva yakati (zororo remishonga), kana kukupa mumwe mushonga wekudzivirira mhedzisiro yacho. Usamborega kutora mushonga wako kana kuchinja mushonga usina kubvunza chiremba wako.
Ongororo yakaratidza kuti kutora mushonga wechirwere cheshuga kudzora huwandu hweshuga muropa kana kutevedzera kudya kwemafuta akawanda ( ketogenic diet ) kunogona kuwedzera kushanda kwemushonga uyu. Zvisinei, zvakakosha kutaura nachiremba wako usati wachinja chero kudya.
Kurapa uku kunoshanda zvechokwadi here?
Ehe. Ichi ndicho chinhu chakakosha. Miedzo yakawanda yekiriniki yakaratidza kuti varwere vane kenza yemazamu yeER+ vane PIK3CA mutation vanogona kubatsirwa nePI3K inhibitor pamwe chete nekurapwa nemahormone.
Imwe ongororo huru yakawana kuti varwere vakagamuchira musanganiswa uyu wemishonga vaive nehupenyu husina kuenderera mberi kwemwedzi inosvika gumi nerimwe. Izvi zvaive zvisingasviki mwedzi mitanhatu kune varwere vane genetic mutation imwechete vasina kugamuchira PI3K inhibitors. Uku kuchinja kukuru uye tariro huru. Nekuda kwekubudirira uku, mishonga mitsva mukirasi iyi yemishonga iri kugadzirwa ikozvino.
Mharidzo Yekuenda Nayo Kumba
- Hadzisi dzese kenza dzemazamu dzakafanana. Kuziva rudzi chairwo rwekenza yako (semuenzaniso ER+, HER2-, PIK3CA mutation) kwakakosha kuti usarudze mushonga wakakodzera uye unoshanda.
- PI3K Inhibitors mushonga wemazuva ano, wakanangana nekenza yemazamu une ER+ uye PIK3CA gene mutations.
- Kurapa uku hakusi kwemunhu wese. Chiremba wako ndiye achasarudza kana kwakakunakira mushure mekuongororwa kwakakosha.
- Mishonga iyi inogona kukonzera migumisiro yakaipa, kunyanya huwandu hweshuga muropa, asi chiremba wako anogona kukubatsira kudzora nekudzivirira.
- Kuziva zvakawanda nezvehurongwa hwekurapa kwako uye kutaura pachena nachiremba wako zvichakupa simba uye kutonga rwendo urwu. Usazvidya mwoyo, mushonga wemazuva ano uri kufambira mberi zuva nezuva.
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