Ndiyaqonda ukuba kunzima kwaye kuyoyikisa kangakanani xa ufunyaniswa ukuba unomhlaza webele. Kwelinye icala, kukho ixhala ngesi sifo, kwaye kwelinye icala, xa oogqirha bethetha amagama anje ``(iKhemotherapy)`` kunye nonyango lwehomoni , ingqondo yakho idideka ngakumbi, akunjalo? "Ngaba nam ndiza kufumana ikhemo? Ngaba iinwele zam ziya kuwa? Ngaba kuza kuba nzima emzimbeni wam?" Kufuneka ube nemibuzo emininzi engqondweni yakho. Kodwa ungakhathazeki. Namhlanje, siza kuthetha ngendlela ubudala bakho kunye nokuba udlule kwixesha lokuya exesheni okanye akunjalo eziya kuba zibaluleke ngayo ekumiseleni unyango olunikwayo.
Ngaphambili, phantse wonke umntu wayenikwa i-chemotherapy kwangoko nje emva kokuba efumanise ukuba umhlaza webele usasazeke kwiindawo ze-lymph nodes. Kwakufana nokubamba isando nokwenza yonke into ibonakale ngathi yi-nail. Kodwa ngoku amayeza aqhubele phambili kakhulu. Ngoku siyazi ukuba ayizizo zonke ii-cancer zebele ezifanayo, kwaye ayizizo zonke izigulana eziya kusabela kunyango olufanayo. Ngamanye amaxesha iziphumo ebezingalindelekanga ze-chemotherapy zinokudlula iingenelo. Ngoko ke ngoku oogqirha abakhathali kuphela ngobukhulu be-tumor kunye nenqanaba lomhlaza, kodwa nakwindalo yomhlaza .
Kutheni ukunqamka ukuya exesheni kubalulekile kweli bali?
Nokuba ukhe wafikelela kwixesha lokuya exesheni okanye akunjalo, ixesha apho ixesha lakho lokuya exesheni liphela ngokusisigxina, libaluleke kakhulu kunyango lomhlaza webele. Zininzi izizathu zoku.
Ngamafutshane, umhlaza webele kubasetyhini abancinci, abangaphambi kokuya exesheni, unokuba yingozi ngakumbi kunomhlaza kubasetyhini asele beye exesheni .
Ukongeza, ikwamisela uhlobo lonyango oza kulufumana. Umzekelo, ukuba unomhlaza oxhomekeke kwiihomoni, uhlobo lonyango lweehomoni onokulufumana luya kwahluka ngokuxhomekeke kwimeko yakho yokuya exesheni.
- Emva kokuya exesheni: Usenokunikwa iyeza elifana ne-Arimidex, elithintela umzimba ekuveliseni i-hormone ye-estrogen.
- Ukuba ungaphambi kokuya exesheni: Amaqanda akho asavelisa i-estrogen, ngoko ke amayeza afana ne-Arimidex awayi kusebenza kakuhle. Ngoko ke ugqirha wakho uhlala ekunika iyeza elibizwa ngokuba yi-Tamoxifen. Oku kusebenza ngokuthintela umyalezo othunyelwa yi-estrogen kwiiseli zomhlaza.
Uyaqonda? Ngokuxhomekeke kwindlela umsebenzi weehomoni zomzimba wakho otshintsha ngayo, amayeza alwa nomhlaza nawo kufuneka atshintshe.
Ibhayoloji yoMhlaza: IiHormone Receptors kunye neHER2
Kulungile, ngoku makhe sijonge nzulu kancinci. Singayibeki ecaleni into yokuba unyango lwe-hormone lukulungele na okanye alukufanelanga, umbuzo omkhulu olandelayo kukuba ingaba uyayidinga na i-chemotherapy okanye awuyidingi.
Esi sigqibo sidla ngokusekelwe kwiintlobo zee-receptors kumphezulu weeseli zakho zomhlaza . Cinga ngezi receptors njenge-'antennas' kwiiseli zomhlaza. Ezi antenna zithatha 'iimpawu' ekufuneka umhlaza ukhule ngazo. Kukho iintlobo ezimbini eziphambili zee-receptors esizijongayo.
1. IiHormone Receptors (HR): IiReceptors eziva iihomoni ze-estrogen kunye ne-progesterone.
2. I-HER2 receptor: Le yenye iproteni enceda iiseli zomhlaza zikhule.
Jonga itheyibhile engezantsi ukuze ubone indlela umhlaza ohlulwahlulwa ngayo kunye nonyango oluchongwa ngokusekwe kudibaniso lwazo.
| Uhlobo lomhlaza (kuxhomekeke kwimpendulo) | Intsingiselo kunye nesicwangciso sonyango ngokubanzi |
|---|---|
| I-HR-positive, i-HER2-negative | I-hormone iyachaphazeleka, kodwa ayichaphazeleki yi-HER2. Unyango lwe-hormone lusebenza kakuhle. Ukugqiba ukuba i-chemotherapy iyafuneka okanye ayifuneki kunzima. Imeko yokuya exesheni ibaluleke kakhulu apha. |
| I-HR-positive, i-HER2-positive | Ichaphazela zombini iihomoni kunye ne-HER2. Ukudibanisa unyango lweehomoni kunye nonyango olujoliswe kwi-HER2 kunokunika iziphumo ezilungileyo. I-chemotherapy enzima idla ngokuthintelwa. |
| I-HR-negative, i-HER2-positive | Ayinazo iihomoni, kodwa inovelwano kwi-HER2. I-chemotherapy iyadingeka kunye nonyango olujoliswe kwi-HER2. |
| I-Triple-Negative | Zombini ii-receptors zehomoni kunye ne-HER2 receptor azikho, zontathu. Ke ngoko, akukho nyango lwehomoni okanye unyango olujoliswe kwi-HER2 olusebenzayo. I-chemotherapy idla ngokuba yimfuneko ngokupheleleyo. |
Yintoni uvavanyo lwe-Oncotype Dx?
Ukuba umhlaza wakho une-HR-positive, i-HER2-negative, oko kukuthi, uhlobo lokuqala kwitheyibhile engentla, umbuzo othi "Ngaba ndiyayidinga i-chemo?" ngowona unzima ukuwuphendula. Kukwiimeko ezinje apho oogqirha basebenzisa uvavanyo lwe-genomic olufana ne -`Oncotype Dx` .
Olu vavanyo luhlalutya ii-genes ezingama-21 kwisampulu encinci yomhlaza wakho. Ngokusekelwe koku, ikunika amanqaku abonisa ukuba umhlaza wakho unobungozi obuphantsi, obuphakathi, okanye obuphezulu bokuphinda ubuye kwixesha elizayo.
- Amanqaku aphantsi: Unokuhlala ungcono ngaphandle kwe-chemotherapy .
- Ukuba amanqaku aphezulu: I-Chemotherapy yeyona ifanelekileyo.
Kodwa abantu abaninzi bafumana amanqaku aphakathi . Kulapho ke ingxaki iphinda ivele khona.
Iimpendulo ezivela kuphando olutsha
Ngethamsanqa, izifundo ezimbini ezinkulu zakutshanje, i-TAILORx kunye ne-RxPONDER, zinike iimpendulo ezilungileyo kakhulu kumbuzo wokuba mabenze ntoni ngaba bafazi banamabakala aphakathi. Ezi zifundo ziqinisekisile ngakumbi ukubaluleka kokuya exesheni.
- Uvavanyo lwe-TAILORx (kubantu abanomhlaza ongazange usasazeke kwii-lymph nodes):
- Olu phononongo lubonisa ngokucacileyo ukuba abafazi abasele beyekile ukuya exesheni abanamanqaku aphakathi e-Oncotype Dx abafumani nzuzo yongezelelweyo kwi-chemotherapy. Unyango lweehomoni lodwa lwanele kubo.
- Uphononongo lwe-RxPONDER (kubantu abanomhlaza osasazeke kwii-lymph nodes):
- Oku kubonisa into efanayo. Uninzi lwabasetyhini abasele beyekile ukuya exesheni , nokuba umhlaza wabo usasazeke waya kwiindawo ze-lymph nodes, abazuzi kangako kwi-chemotherapy.
- Nangona kunjalo, ibali lahlukile ngokupheleleyo kubafazi abangaphambi kokuya exesheni, ingakumbi abo bangaphantsi kweminyaka engama-50 ubudala. Xa i-chemotherapy yongezwa kunyango lweehomoni kubo, amandla okuthintela umhlaza ukuba ungabuyi ayanda kakhulu .
Ngamafutshane, ukuba ungumfazi oselula ongaphambi kokuba uyeke ukuya exesheni, i-chemotherapy inokuba sisixhobo esinamandla esinokusindisa ubomi bakho. Kodwa ukuba usele uyeke ukuya exesheni, unokukwazi ukufumana iziphumo ezingcono ngonyango lweehomoni ngaphandle kokufumana iziphumo ebezingalindelekanga.
Isigqibo sokugqibela kunye nezinto ekufuneka ziqwalaselwe
Ngenxa yako konke oku, mhlawumbi uyaqonda ukuba kunzima kangakanani ukwenza ezi zigqibo wedwa. Yiyo loo nto kubaluleke kangaka ukuthetha ngokukhululekileyo ngazo zonke ezi zinto nogqirha wakho.
Ukuba ungaphambi kokuya exesheni, ingakumbi xa uneminyaka engama-40 ubudala, kukho enye into ekufuneka uyikhumbule. I-chemotherapy inokubangela ukuba ukuya exesheni kwakho kuyeke ngokusisigxina kwaye ibangele ukuya exesheni kwangethuba. Kwabo baselula, ukuya exesheni kwakho kunokuyeka okwethutyana uze uqalise kwakhona. Kodwa ukuba unethemba lokuba nabantwana kwixesha elizayo, qiniseka ukuba uthetha nogqirha wakho malunga nokugcinwa kokuzala ngaphambi kokuba uqale unyango.
Ekugqibeleni, wena nogqirha wakho niza kugqiba ukuba loluphi unyango olukulungeleyo. Ngexesha lengxoxo, uhlobo lomhlaza wakho, inqanaba, amanqaku e-Oncotype Dx, kunye nokuba usele ugqithile ukuya exesheni zonke zizihloko ezibalulekileyo ekufuneka zixoxwe ngazo.
Umyalezo Wokuya Ekhaya
- Ayizizo zonke iintlobo zomhlaza wamabele ezifanayo, ngoko ke unyango olufanayo alufanelekanga kuye wonke umntu.
- Nokuba ukhe wafikelela kwixesha lokuya exesheni okanye akunjalo kuya kuba nefuthe elikhulu kunyango olufumanayo, ingakumbi i-chemotherapy kunye nonyango lwe-hormone.
- Uvavanyo lwe-genetic olufana ne -Oncotype Dx lunokunceda abafazi abanomhlaza we-HR-positive, i-HER2-negative ukuba bamisele ukuba i-chemotherapy iyimfuneko na.
- Uphando lwakutshanje lubonisa ukuba abafazi abasele beyekile ukuya exesheni abasoloko befumana luncedo olongezelelweyo kwi-chemotherapy, kodwa inokuba luncedo kakhulu kubafazi abasele beyekile ukuya exesheni.
- Thetha ngokukhululekileyo nogqirha wakho malunga nesicwangciso sakho sonyango. Cacisa ngeminyaka yakho, imeko yakho yokuya exesheni, kunye nezicwangciso zakho zexesha elizayo (ezifana nokuba nabantwana).
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