Ko kenza yako yemazamu ine HER2-Positive here? Ngatikurukurei izvi zvakadzama!

Wakambonzwa nezvekenza yemazamu here? Pamwe shamwari yako kana hama yako yakambova nayo. Kune mhando dzakasiyana dzekenza yemazamu. Nhasi tichataura nezveimwe yadzo, iyo yakakosha uye inogona kupararira nekukurumidza. Ndiyo kenza yemazamu ine HER2-Positive (HER2-positive) . Paunonzwa zita iri, ungafunga kuti rakaoma zvishoma, asi usazvidya mwoyo. Tichataura nezvazvo zviri nyore, nenzira yaunogona kunzwisisa.

Chii chinonzi HER2-Positive (HER2+) Breast Cancer?

Zvichitaurwa zviri nyore, HER2-positive (HER2+) kenza yemazamu imhando yekenza inokura nekukurumidza uye inogona kupararira zviri nyore kunze kwezamu ('invasive') . Kana vanachiremba vachiti une rudzi urwu rwekenza, zvinoreva kuti masero ako ekenza ane huwandu hwakakura hweprotein yakakosha inodzora kukura nekupatsanurwa kwemasero mumuviri wako - inonzi ``Human Epidermal Growth Factor Receptor 2`` , kana kuti HER2 muchidimbu. Iyi HER2 protein yakaita se "signal" inoudza masero kuti akure. Kana yakawandisa, masero anopatsanuka nekukurumidza uye zvisingadzoreki, zvichikonzera kenza.

Rudzi urwu rwegomarara rezamu rune mukana wekupararira (metastasize) kubva pazamu kuenda kune dzimwe nhengo dzemuviri wako, dzakadai sema lymph nodes, chiropa, mapapu, kana kunyange uropi hwako. Asi chinhu chakakosha ndechekuti kana gomarara iri rikaonekwa nekukurumidza, risati rapararira kune dzimwe nhengo dzemuviri, vanachiremba vanogona kurirapa zvinobudirira nekurapa kwepamusoro kuripo nhasi. Ndosaka kuongororwa nekukurumidza kuchikosha.

Kenza yemazamu yeHER2-positive yakajairika zvakadii?

Sekureva kweAmerican Cancer Society, vakadzi vanopfuura 290,000 vachaonekwa vaine kenza yemazamu inopararira (invasive ductal carcinoma uye lobular breast cancer) mugore ra2023 chete. Pavanhu ava , 15% kusvika 20% vane HER2-positive. Varume vanogonawo kuwana kenza yemazamu, asi kenza yemazamu ine HER2-positive haina kuwanda muvarume.

Ndezvipi zviratidzo zvekenza yemazamu ine HER2-positive?

Kufanana nemhando dzakawanda dzekenza yemazamu, iyi mhando yeHER2-positive dzimwe nguva hairatidzi zviratidzo zviri pachena pakutanga. Asi kana zviratidzo zvikaonekwa, zvakafanana nezvinoonekwa mukenza yemazamu yenguva dzose. Ngationei kuti chii:

• Kuchinja kwehukuru, chimiro, kana chimiro chezamu . Zamu rimwe rinogona kunzwa serakakura kupfuura rimwe, kana chimiro charo chinogona kuchinja.
• Chibundu kana kuti bundu riri muzamhu kana muhapwa. Izvi zvinogona kuva zvidiki sepizi. Kana bundu rikaramba riripo mushure mekunge mwedzi wako wapera, unofanira kunetseka.
• Kuchinja kwechitarisiko kana kutaridzika kweganda rezamu kana zamu. Ganda rinogona kukwesha, kuita mavanga kana kuputsika, kana kunzwa kunge rine mavanga kana kuzvimba. Dzimwe nguva ganda rinogona kunge rakatsvuka kana kuti rakasviba kupfuura zvakajairika.
• Kunzwa nzvimbo yakaoma pasi peganda, sedombo remarble .
• Mvura ine ropa kana kuti yakajeka inobuda muzamu.

Fungidzira shamwari yako, ngatimuti "Sunita". Rimwe zuva, achigeza, Sunita akaona shanduko diki pazamu rake. Rakaita sebundu diki. Pakutanga, haana kuriteerera zvakanyanya, achifunga kuti, "Richangopera." Asi mushure memavhiki mashoma, rakanga richiripo. Gare gare, paakariratidza kuna chiremba, akaona kuti chiratidzo chekenza yemazamu. Saka, kana ukaona chero shanduko dzisingawanzoitika pamazamu ako, zvakakosha kutsvaga mazano echiremba usingaregeredze.

Chii chinokonzera kenza yemazamu yeHER2-positive?

Kenza yemazamu ine HER2-positive inokonzerwa nekuchinja kwejini rinonzi HER2. Iri jini reHER2 rinogadzira puroteni yeHER2 yatakambotaura nezvayo. Mapuroteni aya eHER2 (anonziwo `receptors`) anowanzo kuwanikwa pamusoro pemasero ese emazamu.

Mumamiriro ezvinhu akajairwa, mapuroteni aya eHER2 anodzora kukura nekugadzirisa masero ezamu, zvichiita kuti masero matsva apatsanurwe muhuwandu hwakakwana kuti atsive masero akakuvara kana kufa.

Zvisinei, kana jini reHER2 rikachinja, rinoita makopi akawanda kwazvo. Kana jini reHER2 rikashandiswa zvakanyanya, rinoitawo puroteni yeHER2 yakawandisa. Kana puroteni yeHER2 yakawandisa, masero emazamu anokamuka nekukurumidza uye anokura zvisingadzoreki, zvichiita kuti pave nemabundu ekenza.

Ndezvipi zvinhu zvinokonzera njodzi iyi?

Kufanana nekenza yemazamu, njodzi dzekenza yemazamu yeHER2-positive dzakafanana nedzekenza yemazamu yenguva dzose. Unogona kuwana kenza yemazamu kunyangwe uine njodzi idzi kana kuti kwete. Zvisinei, zvinhu izvi zvinogona kuwedzera njodzi yako:

• Kuva nekuchinja kwemajini kwakagarwa nhaka . Semuenzaniso, kuchinja kwemajini eBRCA1 kana BRCA2.
• Ndakambova nekenza yemazamu kare.
• Kuva nezvimwe zvirwere zvine chekuita nemazamu zvakaita se `atypical ductal hyperplasia`.
• Kuenda kumwedzi kunotanga nguva isati yakwana.
• Kuenda kumwedzi kunoitika mushure menguva yakatarwa.
• Kutora mushonga wekutsiva mahormone.
• Kunwa doro rinopfuura rimwe chete pazuva.
• Ndakamborapwa nemwaranzi yezvirwere zvakaita se lymphoma (kenza ye lymphatic system).

Ndezvipi zvinetso zvinokonzerwa nekenza yemazamu yeHER2-positive?

Kenza yemazamu ine HER2-Positive inogona kupararira kune dzimwe nhengo dzemuviri, kana kuti 'metastasize'. Muvanhu vanenge hafu vane rudzi urwu rwekenza yemazamu, kenza yacho inenge yatopararira kune dzimwe nhengo dzemuviri, kunyanya uropi, panguva yavanoonekwa kuti vane chirwere ichi. Kenza yemazamu inenge yapararira kuuropi ('metastatic breast cancer to your brain') inogona kuisa upenyu panjodzi. Ndosaka kuonekwa nekukurumidza uye kurapwa nekukurumidza kwakakosha.

Ko HER2-positive cancer yemazamu inoonekwa sei?

Vanachiremba vanoshandisa biopsy yemazamu kuti vaongorore kenza dzese dzemazamu. Izvi zvinosanganisira kutora chidimbu chidiki chenyama kubva panzvimbo yezamu inofungirwa kuti yakasviba uye kuchiongorora pasi pemaikorosikopu.

Kana kuongororwa kwezamu kuchiratidza kuti pane kenza, chiremba wezvirwere (chiremba ane hunyanzvi mukuongorora zvirwere) achaita bvunzo dzakakosha kuti aone kana masero enyama yezamu aine HER2 protein. Kune mhando mbiri huru dzekuyedza izvi:

1. Immunohistochemistry (IHC): Bvunzo iyi inobvumira vanachiremba vezvirwere kutsvaga puroteni yeHER2 mumasero ekenza yemazamu. Bvunzo iyi inoshandisa dhayi yakakosha (immunostaining) kutarisa huwandu hwepuroteni yeHER2 mumasero ekenza.

2. Kusanganiswa kweFluorescence in situ (FISH): Iyi bvunzo yeFISH dzimwe nguva inoshandiswa kusimbisa mhedzisiro yebvunzo yeIHC. Iyi bvunzo inogona kuona kana paine mamwe makopi eHER2 gene.

Mushure mekuongororwa uku, vanachiremba vanoisa kenza muzvikamu zvakasiyana. Vanoshandisa 'system yekuongorora'. Izvi zvinotarisa kuti puroteni yeHER2 yakakura sei musampuli yematishu ezamu, pamwe nekuti masero mangani ekenza aripo. Funga nezvazvo nenzira iyi:

• Kana bvunzo ikaratidza kuti huwandu hweproteni yeHER2 hwakaderera, ichaonekwa se0 kana 1+ . Nyanzvi yezvirwere ichabva yati haina HER2 .
• Kana paine masero ekenza uye huwandu hweprotein huri pakati nepakati, unogona kuwana mamakisi e2+ . Ipapo chiremba wezvirwere achasimbisawo bvunzo ye 'FISH' yambotaurwa.
• Kana paine masero ekenza akawanda uye huwandu hweprotein hwakakwira zvakanyanya, unowana mamaki e3+ . Ndipo apo chiremba wezvirwere anotaura kuti ane HER2 positive .

Sisitimu iyi yekuongorora mapoinzi ndiyo inonyatsoona kana uri HER2-positive kana HER2-negative.

Ndeipi mishonga yekurapa kenza yemazamu ine HER2-positive?

Nekuti iyi imhando yegomarara rezamu rinopararira, nzira dzekurapa dzinosarudzwa nezvinhu zvakawanda, zvakaita sedanho regomarara uye mamiriro eHER2. Mishonga inotevera inogona kushandiswa:

• Kurapa kwakanangana:Uku ndiko kurapwa kwakanyanya kune kenza ine HER2. Kunosanganisira kupa mishonga inorwisa puroteni yeHER2 uye inouraya masero ekenza. Kune mhando dzakasiyana dzekurapa pasi peizvi:
• Kurapa kweMonoclonal antibody: Izvi zvinosunga kuHER2 protein uye zvinomisa kukura kwemasero ekenza.
• Kurapa kweTyrosine kinase inhibitor: Mishonga iyi inopinda mumasero ekenza uye inovhara nzira dzekutumira mashoko dzinobatsira masero kukura.
• Mishonga inorwisa kenza (ADCs): Iyi inzira yepamusoro-soro. Mukuita izvi, mushonga unorwisa kenza unosungirirwa kune antibody inotsvaga masero ekenza. Mushonga uyu unobva waenda zvakananga kumasero ekenza woburitsa mushonga, zvichiita kuti masero ane hutano asakuvare zvakanyanya.
• Kurapa nemakemikari: Kurapa nemakemikari kunoitwa vasati vavhiyiwa kuti bundu riderere (neoadjuvant therapy) kana kuti kuuraya chero masero ekenza asara mushure mekuvhiyiwa (adjuvant therapy). Dzimwe nguva chemotherapy inopiwa pamwe chete nekurapa kwakanangana.

Kunze kweizvi, zvichienderana nedanho regomarara, zvinhu zvakaita se 'kuvhiyiwa', 'radiation therapy', kana 'hormone therapy' zvinogonawo kuitwa.

Ndezvipi migumisiro yekurapa?

Migumisiro inogona kusiyana zvichienderana nekurapwa. Kana uri kurapwa, taura nachiremba wako nezvekuti kurapwa kwacho kuchakukanganisa sei uye kuti kuchakanganisa sei hupenyu hwako hwezuva nezuva. Zvakare, bvunza chiremba wako nezvekurapwa kwevarwere . Kurapwa kwevarwere ibasa rinokubatsira kudzora zviratidzo zvegomarara uye migumisiro yekurapwa uye rinokuita kuti unzwe wakasununguka sezvinobvira panguva yekurapwa. Hazvisi zvevanhu vasingagoni kurapa gomarara chete, asi zvinogona kubatsira chero munhu ari kurapwa.

Mishonga iyi inogona kurapa kenza yemazamu yeHER2-positive zvizere here?

Vanachiremba pavanoti "vakarapa" kenza, vangangoreva kuti kenza yakadzorerwa kwemakore nekurapwa. Kuregererwa kunoreva kuti hauna zviratidzo zvekenza uye hapana kenza inowanikwa pakuongororwa. Munhu akaonekwa aine kenza yemazamu yeHER2-positive, akarapwa, uye orarama kwemakore mashanu anoonekwa se "akarapwa."

Sekureva kweUS National Cancer Institute (NCI), vanhu vanopfuura 90% vakaonekwa vaine kenza yemazamu yeHER2 vachiri vapenyu mushure memakore mashanu. Vanogona kunzi varapwa kenza yavo. Zvisinei, kenza yeHER2-positive inogona kudzoka uye kupararira kune dzimwe nhengo dzemuviri. Saka, zvakakosha kuramba uchienda kunoongororwa nachiremba.

Ndeipi chiyero chekupona kwekenza yemazamu yeHER2-positive?

Mikana yekupona kenza yemazamu yeHER2-positive inosiyanawo zvichienderana nekuti kenza iyi ine hormone receptor-positive (HR+) here kana kuti hormone receptor-negative (HR-) . (Aya mahormone receptors ndiwo mareceptor ari pamusoro pemasero anogona kubatana nemahormone. Inenge hafu yekenza dzese dzeHER2-positive dzine mareceptor aya. NCI inoronga mikana iyi nedanho rekenza: yemuno (yakaganhurirwa kumazamu), yemudunhu (yakapararira kumalymph nodes ari pedyo), uye iri kure (yakapararira kunzvimbo dziri kure dzemuviri). Unogona kutaura nachiremba wako nezveizvi kuti udzidze zvakawanda.

Ko kenza yemazamu ine HER2-positive inogona kudzivirirwa here?

Zvingangoita kuti kwete. Kunyangwe paine zvinhu zvaunogona kuita kuti uderedze njodzi yako yekubatwa nekenza yemazamu, kenza yemazamu yeHER2-positive inokonzerwa nekuchinja kwemajini eHER2 kunoita kuti masero ekenza aumbe. Vaongorori vachiri kudzidza kuti sei izvi zvichiitika, saka havasati vataura chaizvo zvingaitwa kudzivirira kenza yeHER2-positive.

Zvisinei, unogona kuita zvinhu izvi kuderedza njodzi yako yekenza yemazamu:

• Chengetedza hutano hwemazamu ako. Ita bvunzo dzemazamu nguva dzose, uye tora mammograms pazera uye nguva dzakakurudzirwa nachiremba wako. Ziva chero shanduko dziri kuitika mumazamu ako. Nenzira iyi, kenza inogona kuonekwa nekukurumidza uye kurapwa zviri nyore.
• Ramba uine huremu hwakanaka. Huremu uhwu hunofanira kunge huri nyore kwauri. Bvunza chiremba wako kuti akupe mazano ekuti ungachengetedza sei huremu hwakanaka.
• Idya chikafu chine hutano. Dzimwe ongororo dzakaratidza kuti kudya kwakapfuma mumiriwo, michero, zvigadzirwa zvemukaka zvakapfuma mucalcium, uye mapuroteni asina mafuta akawanda kunogona kuderedza njodzi yekenza yemazamu. Zvakanakawo kuderedza nyama tsvuku neyakagadziriswa.
• Iva nechido chekushanda nesimba. Ongororo dzakaratidza kuti kurovedza muviri nguva dzose kunoderedza njodzi yekubatwa nekenza yemazamu. Kunyangwe kungofamba kwemaminitsi makumi matatu pazuva kwakanaka.
• Dzivisa zvinwiwa zvinodhaka. Tsvagiridzo inoratidza hukama huripo pakati pegomarara remazamu nedoro. Sangano reAmerican Medical Association rinokurudzira vakadzi kuti vaderedze kunwa doro kusvika padoro rimwe chete pazuva.

Ndinozvitarisira sei?

Kurarama nekenza yemazamu zvinoreva kurarama nezviratidzo zvekenza, marapirwo, uye migumisiro yekurapwa. Uye, dzimwe nguva, ungafanira kurarama nepfungwa yekusava nechokwadi nezveramangwana. Unganzwa wakaremerwa uye wakaora mwoyo dzimwe nguva. Kana uchinzwa saizvozvo, funga nezvemazano aya ekuzvitarisira:

• Zorora zvakakwana.Gomarara repazamu nekurapwa zvinonetesa zvikuru. Yeuka kuzorora pese paunonzwa kuda, kwete chete kana uine nguva.
• Idya zvakanaka. Kurapwa kunogona kuderedza chishuwo chako chekudya, asi kudya chikafu chine michero yakawanda, miriwo, mapuroteni asina mafuta akawanda, uye zviyo zvine hutano kuchakubatsira kuti urambe wakasimba panguva yekurapwa.
• Dzora kushushikana kwako. Gomarara ndiro dambudziko guru. Kurovedza muviri kunogona kubatsira pane izvi. Kufamba-famba nguva dzose uye kutora chikamu muzvirongwa zvekurovedza muviri zvakaita seyoga zvakanaka.
• Wana rubatsiro. Uri munhu akapona kenza yemazamu, uye izvozvo zvinotanga zuva raunoonekwa kuti une chirwere. Bvunza chiremba wako nezvezvirongwa zvekuchengetedza kenza . Izvi zvinogona kukubatsira kukunda matambudziko ekurarama nekenza yemazamu. Kutaura nemhuri yako neshamwari inzira yakanaka yekuzviriritira.

Ndinofanira kuona chiremba rini?

Uchafanira kuona chiremba wako nguva nenguva panguva yekurapwa. Zvisinei, kana ukaona shanduko itsva mumazamu ako kana mumuviri wako dzinogona kuva zviratidzo zvekuti kenza yako yeHER2-positive yapararira, taurira chiremba wako nekukasika. Semuenzaniso, kana kenza yemazamu yapararira kusvika kumapapu, unogona kuona zviratidzo zvakaita sekurwadziwa pachipfuva, hutachiona hwepachipfuva nguva nenguva, kuoma kufema, kana kukosora ropa.

Ndinofanira kuenda kuchipatara riini?

Kana maitiro emuviri wako pakurapwa kwegomarara akanyanya kuipa kupfuura zvawaitarisira, unofanira kuenda kuchipatara. Semuenzaniso, kana wapera mvura zvakanyanya nekuda kwekurutsa nguva dzose, enda kuchipatara nekukasika.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

Kana bvunzo dzako dzichiratidza kuti une HER2-positive kenza yemazamu, ungangoda kubvunza chiremba wako mibvunzo yakaita seiyi:

• Chii chaizvo chiri paHER2 yangu? (kureva kuti chibodzwa changu cheIHC/FISH chii?)
• Chii chiri kuitika pa hormone receptor yangu? (HR+ kana HR-?)
• Matambudziko aya eHER2 nehormone receptor anokanganisa sei fungidziro yangu (kureva, fungidziro uye mafambiro echirwere mune ramangwana)?
• Ndedzipi nzira dzekurapa dzamunokurudzira kuti ndirapwe nadzo? Sei?
• Ndinofanira kufunga nezvekupinda muchirongwa chekurapa kenza yemazamu ine HER2-positive here?

Kubudirira mukurapa kenza hakuwanzoitiki. Ndosaka vaongorori vekenza vakafara zvikuru apo zvidzidzo zvakaratidza kuti kuchinja kwemajini eHER2 kunoita kuti masero apatsanuke nekukurumidza kupfuura zvakajairwa. Vakakurumidza kuwana hukama pakati pekuchinja kwemajini eHER2 nemamwe marudzi ekenza yemazamu iri kukura nekukurumidza. Kubva ipapo, vakagadzira mishonga inogona kurapa kenza yemazamu yeHER2-positive pakutanga. Iye zvino vaongorori vari kutarisa pakutsvaga mishonga inoshanda inogona kunonoka kana kumisa kupararira kwekenza. Miedzo yekiriniki ndipo panowanikwa kuwanikwa uku kutsva. Kana uine kenza yemazamu yeHER2-positive ('metastatic'), taura nachiremba wako nezvekutora chikamu mukuyedzwa kwekiriniki. Vanogona kukubatsira.

Pakupedzisira, meseji yekudzokera nayo kumba

Kenza yemazamu ine HER2-positive imhando yekenza yakakomba uye inopararira nekukurumidza. Zvisinei, nekuona kwakarurama uye nekukurumidza uye nzira dzekurapa dzepamusoro, zvinokwanisika kudzora nekurapa chirwere ichi zvinobudirira.

• Gara uchitarisa muviri wako, kunyanya mazamu ako. Kana ukaona shanduko dzisingawanzoitiki, usadziregerere uye tsvaga rubatsiro rwechiremba nekukasika.
• Tevedzera bvunzo nekurapwa kwaunokurudzirwa nachiremba wako nemazvo. Usatya kutaura nachiremba wako nezvemibvunzo kana zvinokunetsa zvaungave nazvo.
• Zvakakosha kuti ugare uine tariro. Hausi wega. Kune mhuri, shamwari, vanachiremba, uye vapi vemazano ekukubatsira.

Tinovimba kuti ruzivo urwu ruchakubatsira. Ramba uine hutano hwakanaka!

` Kenza yemazamu, HER2-Yakanaka, zviratidzo zvekenza, kurapwa kwekenza, hutano hwevakadzi, majini ekuchinja, mammogram