Xa sisiva igama elithi umhlaza webele, uninzi lwethu luyoyika. Kodwa eyona nto ibalulekileyo ekufuneka siyiqonde kukuba ayizizo zonke iintlobo zomhlaza webele ezifanayo. Kukho iintlobo ezahlukeneyo zazo. Olunye uhlobo oluqhelekileyo yi-'estrogen receptor positive' okanye njengoko silubiza ngokwezonyango , yi-ER+ (Estrogen-Receptor-Positive) umhlaza webele . Enyanisweni, yi-80% kuphela yomhlaza webele ofunyenweyo ongowolu hlobo. Ngoko ke namhlanje siza kuthetha ngodidi olutsha, oluphumeleleyo lwamayeza olufunyenweyo ukunyanga ezi ntlobo zomhlaza webele ze-ER+.
Okokuqala, masibone, yintoni umhlaza webele we-ER+?
Ngamafutshane, i-hormone i-estrogen emizimbeni yethu inceda ezi seli zomhlaza zikhule. Khawuthelekelele ukuba ezi seli zomhlaza zine-'locks' ezikhethekileyo (ii-receptors) kumphezulu wazo ezinokunamathela kwi-hormone ye-estrogen. Xa 'isitshixo' esibizwa ngokuba yi-estrogen hormone singena kule 'lock', iiseli zomhlaza zifumana 'umqondiso' wokwahlukana nokukhula.
Yingakho oogqirha behlala benyanga umhlaza we-ER+ ngonyango lweehomoni . Olu nyango lusebenza ngokuthintela 'isitshixo' (i-estrogen) ekubopheleleni kwi-'lock' (ii-receptors). Kodwa ngamanye amaxesha, ingakumbi xa umhlaza usasazeke emzimbeni wonke (ophambili okanye osele usasazekile), ezi seli zomhlaza ziba ngamaqhinga kakhulu. Ziyachasana nolu nyango lweehomoni, oko kuthetha ukuba aziphenduli kakuhle kunyango. Kulapho ke sifuna khona unyango olutsha nolusebenzayo ngakumbi.
'Utshintsho lokukhula' lweeseli zomhlaza - iijini ze-PI3K kunye ne-PIK3CA
Njengoko oogqirha kunye noososayensi babekhangela izizathu zale mihlaza enganyangekiyo ngamahomoni, bafumene into ekhethekileyo: isiphene kwindlela ye-PI3K (Phosphatidylinositol-3-Kinase) , inkqubo ephambili yokubonisa elawula ukukhula, ukwahlukana, kunye nokusinda kweeseli emzimbeni wethu.
Cinga ngale ndlela ye-PI3K njenge-'switchboard' enkulu kwiseli. Ilawula izigqibo malunga nokuba iseli kufuneka ikhule okanye yahlulwe. Enye yezakhi zofuzo eziphambili ezilawula le switchboard yi -PIK3CA gene .
Kwabanye abaguli abanomhlaza, le jini ye-PIK3CA inenguquko , nto leyo ethetha utshintsho okanye isiphene. Kufana nokuba iswitshi 'yokukhula' kwi-switchboard inamathele kwaye isoloko 'ivuliwe'. Emva koko iiseli ziqala ukwahlukana nokukhula ngokungalawulekiyo. Le yeyona nto ibangela umhlaza. Uphando lufumanise ukuba malunga nama-40% ezigulane ezinomhlaza webele we-ER+ zinenguquko yejini ye-PIK3CA.
Ngoko ke zithini ezi PI3K Inhibitors?
Apha, njengesisombululo sale ngxaki, kuqaliswa udidi lwamayeza abizwa ngokuba yi-PI3K inhibitors . Eyona nto ilula la mayeza ayenzayo kukuvala ngokufanelekileyo 'i-growth switch' (indlela ye-PI3K) endikhankanyileyo ngaphambili enamathele 'kwi'.
Ngamafutshane, la mayeza afana nombane onobuchule. Ungena aze alungise loo switchboard imfutshane, emisa umbane ongafunekiyo. Ngendlela efanayo, ii-PI3K Inhibitors ziyayimisa imiqondiso yokukhula engeyomfuneko eya kwiiseli zomhlaza, nto leyo ebangela ukuba iiseli zomhlaza zife kwaye zincede iithumba zinciphe.
Ezi zihlala ziza ngohlobo lwamayeza aselwayo. Amaxesha amaninzi, eli yeza linikwa izigulana kunye nonyango lweehomoni olukhankanyiweyo ngaphambili (i-estrogen blocker).
Ndingazi njani ukuba olu nyango lufanelekile kum?
Lo ngumbuzo obaluleke kakhulu. I-PI3K Inhibitors ayinikwa bonke abaguli abanomhlaza webele . Yenzelwe ngokukodwa:
- Kwabasetyhini abasele begqithile exesheni kunye nabaguli abangamadoda.
- Umhlaza kufuneka ube yi-HR+ (i-Hormone-Receptor-Positive) kunye ne -HER2-Negative .
- Eyona nto ibalulekileyo: Iiseli zomhlaza kufuneka zibe notshintsho lwe-PIK3CA gene .
Ukuze afumanise ukuba umhlaza wakho unale nguqu yemfuza, ugqirha wakho uya kwenza uvavanyo olukhethekileyo. Oku kudla ngokubandakanya isampuli yegazi okanye iqhekeza elincinci lezicubu (i-biopsy) elithathwe kwithumba. Iziphumo zolo vavanyo ziya kuqinisekisa ukuba olu nyango lukulungele na.
| Ukufaneleka konyango | Inkcazo |
|---|---|
| Uhlobo lomhlaza | Kufuneka ukuba ngumhlaza webele ophucukileyo wohlobo lwe-HR+ (i-hormone receptor positive) kunye nohlobo lwe-HER2- (HER2 negative). |
| Utshintsho lwemfuza | Kufuneka kubekho utshintsho lwezakhi zofuzo lwe-PIK3CA. Oku kuqinisekiswa luvavanyo olukhethekileyo. |
| Isigulana | Ihlala icetyiswa kubafazi abasele beyekile ukuya exesheni kunye nabaguli abangamadoda. |
Zeziphi iziphumo ebezingalindelekanga ezinokubangela la mayeza?
Njengalo naluphi na unyango lomhlaza, izithinteli ze-PI3K zinokubangela ezinye iziphumo ebezingalindelekanga. Nangona kunjalo, ezi azenzeki kubo bonke abantu ngendlela efanayo. Kwakhona, ngoku kukho iindlela zokulawula ezi ziphumo ebezingalindelekanga.
Ezinye zezona ziphumo bezingalindelekanga zixhaphakileyo zezi:
- Isicaphucaphu nokuhlanza
- Ukulahlekelwa ngumdla wokutya kunye nokunciphisa umzimba
- Izilonda zomlomo
- Ukulahleka kweenwele
- Naziphi na iziphumo ekusebenzeni kwezintso, isibindi, okanye ipancreas
- Kunokubakho ukudumba kwesikhumba, ngamanye amaxesha okuqatha, okubangela ukuba ulusu luxobuke okanye lube namadyungudyungu.
- Iswekile Ephezulu Egazini: Esi sisiphumo esiqhelekileyo esichaphazela olu didi lwamayeza, njengoko indlela ye-PI3K ibandakanyeka kwimetabolism yeswekile emzimbeni wethu.
Musa ukothuka zezi ziphumo bezingalindelekanga. Ugqirha wakho uza kukujonga rhoqo ukuze ahlole ezi ziphumo bezingalindelekanga. Ukuba kuyimfuneko, uza kunciphisa umthamo wamayeza, ayeke ukuwasebenzisa okwethutyana (iholide yamayeza), okanye akunike elinye iyeza lokulawula iziphumo ebezingalindelekanga. Ungaze uyeke ukuthatha amayeza akho okanye utshintshe umthamo ngaphandle kokubuza ugqirha wakho.
Uphando lubonise ukuba ukuthatha amayeza eswekile ukulawula amanqanaba eswekile egazini okanye ukulandela ukutya okunamafutha amaninzi kunye ne-carbohydrate ephantsi ( i-ketogenic diet ) kunokunyusa ukusebenza kwale mayeza. Nangona kunjalo, kubalulekile ukuthetha nogqirha wakho ngaphambi kokuba wenze naluphi na utshintsho kwindlela yokutya.
Ingaba olu nyango lusebenza ngokwenene?
Ewe. Le yeyona nto ibalulekileyo. Uvavanyo oluninzi lwezonyango lubonise ukuba izigulane ezinomhlaza webele we-ER+ ezine-PIK3CA mutation zinokungenelwa yi-PI3K inhibitor kunye nonyango lweehomoni.
Olunye uphando olukhulu lufumanise ukuba izigulana ezifumene olu didi lwamayeza zazinokuphila ngaphandle kokuqhubekeka kwesifo kangangeenyanga ezili-11. Oku bekungaphantsi kweenyanga ezi-6 kwizigulane ezine-genetic mutation efanayo ezingazange zifumane i-PI3K inhibitors. Olu lutshintsho olukhulu kunye nethemba elikhulu. Ngenxa yale mpumelelo, amayeza amatsha kolu didi lwamayeza ngoku ayaphuhliswa.
Umyalezo Wokuya Ekhaya
- Ayizizo zonke iintlobo zomhlaza wamabele ezifanayo. Ukwazi uhlobo oluthile lomhlaza wakho (umz. i-ER+, i-HER2-, i-PIK3CA mutation) kubalulekile ukukhetha unyango olufanelekileyo nolusebenzayo.
- Ii-PI3K Inhibitors lunyango lwanamhlanje olujoliswe kumhlaza wamabele olune-ER+ kunye ne-PIK3CA gene mutations.
- Olu nyango alulungelanga wonke umntu. Ugqirha wakho uya kugqiba ukuba lukulungele na emva kovavanyo olukhethekileyo.
- La mayeza anokubangela iziphumo ebezingalindelekanga, ingakumbi amanqanaba aphezulu eswekile egazini, kodwa ugqirha wakho unokukunceda ukuba uwalawule kwaye uwalawule.
- Ukuba nolwazi olupheleleyo malunga nesicwangciso sakho sonyango kunye nokuthetha ngokukhululekileyo nogqirha wakho kuya kukunika amandla kunye nolawulo kolu hambo. Ungakhathazeki, amayeza anamhlanje aqhubela phambili imihla ngemihla.
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