Kunzima ukuchaza uloyiko kunye nokothuka okuzivayo xa ufumanisa ukuba unomhlaza webele . Unemibuzo emininzi engqondweni yakho. Kuqhelekile ukuba nemibuzo efana nale, "Kutheni oku kwenzeke kum?", "Ndenze ntoni ngoku?", "Ngaba oku kunokunyangeka?". Kolu hambo, ndizama ukuchaza izinto ngokulula nangolwimi onokuluqonda. Ukwazi kakuhle uhlobo lomhlaza onalo kufana nokuqonda utshaba ngaphambi kokuba uqale imfazwe. Elo linyathelo lokuqala nelibalulekileyo ekukhetheni unyango olulungele wena.
Umhlaza Webele OneHormone Receptor-Positive
Olu lolona hlobo luqhelekileyo lomhlaza wamabele. Xa sithetha nje, malunga nama-80 kwi-100 nganye yomhlaza wamabele awela kolu didi.
Ngoko ke kuthetha ukuthini oku "kuxhomekeka kwi-hormone"?
Khawucinge nje ngayo. Imizimba yethu, ingakumbi imizimba yabasetyhini, ineehomoni ezimbini ezenzeka ngokwendalo ezibizwa ngokuba yi-estrogen kunye ne -progesterone . Ezi zibalulekile kwiinkqubo eziqhelekileyo emizimbeni yethu. Nangona kunjalo, ezinye iiseli zomhlaza "zixhomekeke" kakhulu kwezi homoni. Oko kukuthi, phezu kwezi seli zomhlaza, kukho "ii-receptors" ezincinci okanye iingcango ezinokuthi zifike zinamathele kuzo ezi homoni. Xa ihomoni ye-estrogen ifika ize inkqonkqoze kuloo mnyango, iseli yomhlaza ifumana ukondliwa kuyo kwaye iqala ukukhula nokwahlukana. Njengaxa unkcenkceshela isityalo, sikhula sibe sikhulu.
Ukuba ingxelo yakho yezonyango ithi `ER-positive` (Estrogen Receptor-Positive), oko kuthetha ukuba iiseli zakho zomhlaza ziyasabela kwihomoni i-estrogen. Ukuba ithi `PR-positive` (Progesterone Receptor-Positive), oko kuthetha ukuba iyasabela kwihomoni i-progesterone. Ukuba iyasabela kwenye yezi, umhlaza ubizwa ngokuba ngumhlaza we-hormone receptor-positive .
Ezi ziindaba ezimnandi ngenene. Kuba ukuba siyazi ukuba umhlaza usebenzisa ntoni ukukhula, singayivala loo ndlela size silawule umhlaza. Yiloo nto "unyango lweehomoni" lusetyenziselwa yona.
Unyango lwehomoni ludla ngokunikezelwa emva kotyando, i-chemotherapy, okanye i-radiation ukuthintela umhlaza ukuba ungabuyi. La mayeza asebenza ngokuvala "iingcango" kwiiseli zomhlaza, okanye ngokuthintela umzimba ekwenzeni i-estrogen.
| Udidi lonyango | Ingcaciso elula kunye nemizekelo |
|---|---|
| Ii-SERM (ii-Selective ER Modulators) | Ezi zinto zithintela i-hormone receptor kwiseli yomhlaza, zithintela i-hormone ukuba ingangeni. Imizekelo: Tamoxifen, Toremifene . |
| Ii-SERD (Ii-Selective Estrogen Receptor Degraders) | Ezi azigcini nje ngokuthintela i-receptor, kodwa ziyayitshabalalisa. Imizekelo: I-Fulvestrant (Faslodex), I-Elacestrant (Orserdu) . |
| Izithinteli zeAromatase | Ezi zinto zithintela umzimba ekuveliseni i-hormone i-estrogen (edla ngokunikwa abafazi abasele beyekile ukuya exesheni). Imizekelo: i-Anastrozole (Arimidex), i-Letrozole (Femara) . |
| Abaxhasi be-LHRH | Ezi zinto zithintela okwethutyana ama-ovari ekuveliseni i-estrogen. Imizekelo: iGoserelin (Zoladex), iLeuprolide (Lupron) . |
| Ezinye iindlela zonyango ezijoliswe kuzo | Amanye amayeza aphucula impumelelo yonyango lweehomoni. Imizekelo: I-Palbociclib (Ibrance), I-Ribociclib (Kisqali), I-Alpelisib (Piqray) . |
Umhlaza webele one-HER2-Positive
Ngoku masithethe ngolunye uhlobo. Ezinye iiseli zomhlaza wamabele (malunga ne-20% yazo zonke iintlobo zomhlaza) zivelisa iproteni ekhethekileyo kakhulu kumphezulu wazo ebizwa ngokuba yi-HER2 (Human Epidermal growth factor Receptor 2) .
Cinga nge-HER2 njenge-antenna encinci exelela iseli yomhlaza ukuba "ikhule ngokukhawuleza, yahlule ngokukhawuleza." Iseli eqhelekileyo inee-antenna ezimbalwa kuphela. Kodwa iseli yomhlaza ene-HER2-positive inee-antenna ezininzi. Yiyo loo nto ezi ntlobo zomhlaza zinokuba yingozi ngakumbi .
Kodwa kukho neendaba ezimnandi apha. Ngokuhambela phambili kwesayensi, ngoku kukho " iindlela zonyango ezijoliswe kuzo" ezijolise kwaye zitshabalalise ezi antennae ze-HER2. Ngenxa yokuba ezi zifumana kwaye zihlasela kuphela iiseli ezine-HER2 eninzi kakhulu, akukho monakalo mkhulu kwiiseli eziqhelekileyo.
Iyeza eliphambili nelisebenzayo kakhulu elinikezelwayo ngenxa yoku yiTrastuzumab (Herceptin) . Oku kunceda kakhulu ekuthinteleni umhlaza ukuba ungabuyi. Nangona kunjalo, kukho umngcipheko omncinci wemiphumo ethile entliziyweni okanye emiphungeni xa usebenzisa olu nyango. Ungakhathazeki ngaloo nto , ugqirha wakho uya kuhlala ejonga ukuba ikhona na.
| Ezinye iindlela zonyango ezijolise kuzo ezisetyenziselwa umhlaza we-HER2-positive | |
|---|---|
| IPertuzumab (iPerjeta) | I-Ado-trastuzumab emtansine (Kadcyla) |
| I-Lapatinib (Tykerb) | I-Neratinib (iNerlynx) |
| I-Tucatinib (iTukysa) | I-Enhertu (Fam-trastuzumab deruxtecan-nxki) |
Umhlaza Webele "Oneengxaki Ezintathu"
Olu lolona hlobo lwesithathu oluphambili. Malunga ne-10%-20% yomhlaza wamabele iwela kolu hlobo. Uyazi ukuba kutheni ibizwa ngokuba yi-"triple-negative" okanye "triple negative"?
Kuba kwezi seli zomhlaza ,
1. Akukho receptor ye-estrogen (ETU) .
2. Akukho receptor yeprogesterone (PR).
3. Akukho protein ingako ye-HER2 .
Ngenxa yokuba ezi seli zomhlaza azinazo iinjongo ezintathu eziphambili esizixubushile ngaphambili, akukho nyango lwehomoni okanye unyango olujoliswe kwi-HER2 olufana neHerceptin olusebenzayo kuzo. Ngoko ke ukunyanga kwazo kunokuba nzima kancinci.
Olu hlobo lomhlaza ludla ngokubangelwa yi-BRCA1.Inxulunyaniswa notshintsho kwi-gene ebizwa ngokuba yi-. Ngoko ke ukuba unomhlaza one-triple-negative, ugqirha wakho unokucebisa novavanyo lwe-genetic.
Olu hlobo lunyangwa kakhulu ngotyando, i-chemotherapy, kunye ne-radiation . Nangona kunjalo, ngoku kukho unyango olutsha oluhambelana nolu hlobo.
- Ii-PARP Inhibitors: Amayeza afana ne -Olaparib (Lynparza) kunye neTalazoparib (Talzenna) asetyenziswa kubantu abane-BRCA gene mutations. Ezi zithintela amandla eeseli zomhlaza okuzilungisa ngokwazo.
- Unyango lwe-Immunotherapy: Amayeza afana ne -Atezolizumab (Tecentriq) anceda ekulweni neeseli zomhlaza ngokusebenzisa iiseli zethu zomzimba.
Konke oku kusenokubonakala kuyinkimbinkimbi kancinci. Kuqhelekile oko. Into ebalulekileyo kukukhumbula ukuba nokuba loluphi uhlobo lomhlaza onalo, kukho unyango olufumanekayo namhlanje olufanelekileyo kulo. Ugqirha wakho kunye neqela lezonyango baya kusebenzisana nawe ukwenza isicwangciso sonyango esifanelekileyo kuwe.
Umyalezo Wokuya Ekhaya
- Umhlaza webele wahlulwe waba ziintlobo ezintathu eziphambili: iHormone Receptor-Positive, iHER2-Positive, kunye neTriple-Negative .
- Ukwazi uhlobo lomhlaza onalo kubalulekile ekucwangciseni unyango.
- Umhlaza one-hormone usabela kakuhle kunyango lwe-hormone.
- Nangona umhlaza we-HER2-positive ukhula ngokukhawuleza, kukho unyango olusebenzayo kakhulu olujoliswe kubo ngokukodwa.
- Nangona ukunyanga umhlaza one-triple-negative kunzima, kunokulwiwa nawo nge-chemotherapy kunye nonyango olutsha olujoliswe kulo.
- Ukuba unemibuzo malunga nantoni na ekwirekhodi yakho yezonyango, ungoyiki ukubuza . Cela ugqirha wakho ukuba akunike ingcaciso ecacileyo. Awuwedwa, kwaye baninzi abantu abanokukunceda.
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