Kana munhu akaonekwa aine kenza yemazamu, anonzwa kusuruvara uye kutya. Izvozvo zvakajairika. Asi nesainzi yekurapa yemazuva ano, mhando zhinji dzekenza yemazamu dzinogona kudzorwa uye kurapwa. Zvisinei, kune dzimwe mhando dzekenza dzakaoma kurapa kupfuura dzimwe. Idzi dzinonzi "kenza yemazamu dzakaoma kurapa." Vaongorori vezvekurapa vane tariro huru yeizvi, nekuti mishonga mitsva iri kugadzirwa zuva nezuva. Ngatitaurei nezvazvo nhasi.
Sei mamwe magomarara emazamu achinetsa kurapa?
Zvichitaurwa zviri nyore, kurapa kenza yemazamu kunobudirira zvikuru kunovavarira kudzora kukura kwemasero ekenza. Funga nezvazvo nenzira iyi: kana sero rekenza rakaita semusuwo, mamwe mahormone nemapuroteni akafanana nemakiyi anovhura musuwo iwoyo. Kurapa kunoshanda nekuvhara magonhi (receptors) kuitira kuti makiyi aya asashande. Kenza yemazamu yakakamurwa kuita mhando nhatu huru zvichienderana nerudzi rwe'magonhi'.
Zvino ngationei kuti marudzi matatu aya ndeapi.
| Rudzi rwegomarara | Tsananguro iri nyore |
|---|---|
| Kenza ine hormone receptor positive (HR-positive) | Masero egomarara aya ane ma estrogen receptors (ER) uye/kana ma progesterone receptors (PR), izvo zvinoita kuti anzwe zviri nani kurapwa nemahormone. |
| Kenza ine HER2 (HER2-positive) | Masero aya ane puroteni yakawanda inonzi HER2. Saka, anogona kudzorwa nekurapwa kwakanangana neHER2 receptor. |
| Kenza yeZamu Isingakanganise Katatu (TNBC) | Iyi ndiyo mhando yakaoma zvikuru. Masero egomarara aya haana estrogen receptor, progesterone receptor, uye HER2 receptor. Izvi zvinoreva kuti masero aya haana 'masuo' matatu andambotaura. |
Pakati pe10% ne20% yevarwere vese vane kenza yemazamu vane izviImhando yekenza yemazamu inonzi triple-negative breast cancer (TNBC). Kurapwa kwemahormone kunoshandiswa zvinobudirira kune mamwe marudzi ekenza hakushandi kune rudzi urwu rwekenza, nekuti haina mahormone receptors. Zvakare, mishonga inotarisa HER2 haibatsiri.
Pamusoro pezvo, kenza yeTNBC ine simba kupfuura dzimwe mhando. Izvi zvinoreva kuti kenza iyi inogona kunge yapararira kune dzimwe nhengo dzemuviri panguva yainoonekwa kuti ine chirwere ichi. Inoitawo zvakasiyana mumunhu wega wega, uye inogona kuchinja nekufamba kwenguva kuti isarambe kunwa mimwe mishonga.
Kuchinja kwemajini kunokanganisa sei izvi?
Imwe yenzira dzakanakisisa dzekuona kenza yakaita seTNBC nekukurumidza ndeyekuona avo vari panjodzi huru. Kuti vaite izvi, vaongorori vari kudzidza shanduko dzemajini (kuchinja kwemajini) dzinopfuudzwa nezvizvarwa uye dzine chekuita nekenza yemazamu.
- BRCA1 (gene 1 rekenza yemazamu )
- BRCA2 (Gene 2 reKenza yeZamu)
Kana ukagara nhaka shanduko mune rimwe remajini maviri aya, une mukana wakakura wekuva nekenza yemazamu neyemaovari. Kana uine shanduko iyi, une mukana wakakura wekuva nekenza uri mudiki.
Mazhinji egomarara remazamu ane BRCA1 gene mutation haana triple-negative . Saka, kunzwisisa gene iri kunogona kubatsira kuwana nzira dziri nani dzekurapa TNBC.
Vamwe vanachiremba vanokurudzira kuti munhu wese ane TNBC aongororwe majini ane chekuita negomarara, kusanganisira BRCA1 neBRCA2. Kana wakamboonekwa uine TNBC usati wasvitsa makore makumi matanhatu, kana kuti mumwe munhu mumhuri mako akambova neTNBC, chiremba wako anogona kukurudzira kuongororwa kwemajini uku. Izvi zvinogona kukubatsira iwe nachiremba wako kusarudza mushonga unoshanda zvikuru kwauri.
Chii chaunofanira kuziva nezvekenza yemazamu yakapararira?
Imwe mhando yegomarara inonetsa kurapa igomarara remazamu rakapararira kunzvimbo dziri kure dzemuviri. Iyi inonzi gomarara remazamu rakapararira . Rinogona kupararira kune dzimwe nhengo dzemuviri, dzakadai semapfupa, uropi, chiropa, kana mapapu. Dzimwe nguva gomarara rinoonekwa kana rapararira nenzira iyi. Asi kazhinji, gomarara rinodzoka uye rinopararira mushure mekurapwa kwekutanga, dzimwe nguva makore gare gare.
Kenza yako yemazamuKana kenza yapararira kunzvimbo dziri kure, chinangwa chikuru chekurapa ndechekudzora kenza. Kurapa nehurongwa hwemuviri (systemic therapy) ndiko kunonyanya kushandiswa pakurapa izvi. Chiremba wako ndiye achasarudza marapirwo ako zvichienderana nezviratidzo zvako, marapirwo awakamboita, kwawakapararira kenza, uye rudzi rwemasero ekenza.
Ndeapi marapirwo azvino eizvi?
Kurapa kweTNBC, kenza yemazamu yakapararira uye kenza yemazamu inodzokororwa, kwakavandudzika zvakanyanya mumakore achangopfuura. Kurapa nemakemikari ndiyo nzira huru yekurapa izvi. Vanachiremba vava kupa mishonga iyi pamwe chete nemimwe mishonga.
Heano mamwe maitiro matsva ekurapa:
Zvinodzivisa PARP
Iyi imhando yemushonga unoparadza DNA yemasero ekenza muvanhu vane BRCA gene mutations uye HER2-negative uye metastatic cancer. Mienzaniso inosanganisira `olaparib (Lynparza)` uye `talazoparib (Talzenna).` Izvi zvakaratidzawo mhedzisiro yakanaka yeTNBC yekutanga.
Kurapa nekudzivirira muviri
Mishonga iyi inosimudzira masoja emuviri kuti aparadze masero egomarara. Pembrolizumab (Keytruda) ndeimwe yemishonga yakadaro. Inowanzopihwa pamwe chete nechemotherapy.
Mishonga inorwisa mabhakitiriya (ADCs)
Iyi tekinoroji inonakidza zvikuru. Funga nezvayo senzira yeGPS inotungamira mushonga kusvika paunoda. Ma antibodies ari mumishonga iyi anowana masero ekenza, onamatira paari, uye oparadza masero ekenza nemushonga wakabatanidzwa, pasina kukuvadza masero ane hutano. `Sacituzumab govitecan (Trodelvy)` mushonga weADC wakatenderwa kushandiswa paTNBC yepamusoro.
Mishonga yekuwedzera
Kune mishonga mitsva yakawanda inopiwa pamwe chete nekurapwa kwemahormone ekenza ine hormone receptor (HR). Abemaciclib (Verzenio) ndeimwe yemishonga yakadaro.
Ndezvipi zviri mberi mune izvi?
Vaongorori vari kushanda nguva dzose kuti vawedzere nzira dzekurapa gomarara iri, kusanganisira kutsvaga mishonga mitsva yekudzivirira muviri uye kuona zviratidzo zvinogona kufanotaura mhedzisiro yekurapa.
Vari kuferefetawo kana mishonga inotenderwa kune zvimwe zvirwere ichizobatsira TNBC. Vari kuferefetawo nzira dzekushandisa mishonga yakaita sePARP inhibitors zvakanyanya. Dzimwe ongororo dziri kuedzawo kushandisa nanoparticles dzinobatsira muviri kuuraya masero ekenza asingarapike.
Saka, kunyange hazvo kurarama nerudzi urwu rwegomarara kuchigona kuoma, pane tariro yekurapwa kutsva. Chinhu chakakosha kutaura nachiremba wako nguva nenguva uye kusarudza chirongwa chekurapa chakakunakira.
Mharidzo Yekuenda Nayo Kumba
- Dzimwe kenza dzemazamu, kunyanya Triple-Negative Breast Cancer (TNBC) , dzinonetsa kurapa nekuti hadzina mahormone receptors kana HER2 protein.
- Kuchinja kwemajini, kwakadai seBRCA1 neBRCA2 , kwakakosha pakuona njodzi yako yeTNBC uye kurapwa kwako. Kana uine TNBC, taura nachiremba wako nezvekuongororwa kwemajini.
- Chinangwa chekurapa kenza yakapararira mumuviri ndechekudzora chirwere ichi.
- Mishonga yemazuva ano yakadai sePARP inhibitors, immunotherapy, uye antibody-drug conjugates (ADCs) ikozvino inopa tariro huru kunyangwe kune kenza dzakaoma kurapa.
- Pasinei nemamiriro ako ezvinhu, zvakakosha kuti ugare uchishanda pamwe chete nachiremba wako kuti usarudze nzira yakanakisisa yekurapa.
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