Xa umntu efunyaniswa ukuba unomhlaza webele, uziva ebuhlungu kakhulu kwaye esoyika. Yinto eqhelekileyo leyo. Kodwa ngesayensi yezonyango yanamhlanje ephucukileyo, uninzi lweentlobo zomhlaza webele zinokulawulwa kwaye zinyangeke. Nangona kunjalo, kukho ezinye iintlobo zomhlaza ekunzima ukuzinyanga kunezinye. Ezi zibizwa ngokuba "zii-breast cancer ezinzima ukuzinyanga." Abaphandi bezonyango banethemba elikhulu ngale nto, kuba unyango olutsha luphuhliswa yonke imihla. Makhe sithethe ngale nto namhlanje.
Kutheni kunzima ukunyanga ezinye iintlobo zomhlaza wamabele?
Ngamafutshane, unyango lomhlaza webele oluphumeleleyo lujolise ekulawuleni indlela iiseli zomhlaza ezikhula ngayo. Cinga ngale ndlela: ukuba iseli yomhlaza ifana nomnyango, iihomoni ezithile kunye neeproteni zifana nezitshixo ezivula loo mnyango. Unyango lusebenza ngokuvala iingcango (ii-receptors) ukuze ezi zitshixo zingasebenzi. Umhlaza webele wahlulwe waba ziintlobo ezintathu eziphambili ngokusekelwe kuhlobo 'lweengcango'.
Ngoku makhe sibone ukuba zeziphi ezi ntlobo zintathu.
| Uhlobo lomhlaza | Ingcaciso elula |
|---|---|
| Umhlaza we-hormone receptor positive (HR-positive) | Ezi seli zomhlaza zine-estrogen receptors (ER) kunye/okanye i-progesterone receptors (PR), nto leyo eyenza ukuba ziphendule ngakumbi kunyango lweehomoni. |
| Umhlaza one-HER2 (HER2-positive) | Ezi seli zineproteni ephezulu ebizwa ngokuba yiHER2. Ngoko ke, zinokulawulwa ngonyango olujolise kwi-HER2 receptor. |
| Umhlaza Webele Ongalunganga Kathathu (TNBC) | Olu lolona hlobo lunzima kakhulu. Ezi seli zomhlaza azina-estrogen receptor, azina-progesterone receptor, kwaye azina-HER2 receptor. Oko kuthetha ukuba ezi seli azinazo ezo 'ngcango' zintathu endizikhankanyileyo ngaphambili. |
Phakathi kwe-10% kunye ne-20% yazo zonke izigulana ezinomhlaza wamabele zinale mekoLuhlobo lomhlaza webele olubizwa ngokuba yi -triple-negative breast cancer (TNBC). Unyango lweehomoni olusetyenziswa ngempumelelo kwezinye iintlobo zomhlaza alusebenzi kolu hlobo lomhlaza, kuba alunazo ii-hormone receptors. Kwakhona, amayeza ajolise kwi-HER2 awancedi.
Ukongeza, umhlaza we-TNBC unamandla ngakumbi kunezinye iintlobo. Oku kuthetha ukuba umhlaza usenokuba sele usasazeke kwamanye amalungu omzimba ngexesha lokuxilongwa kwawo. Uziphatha ngendlela eyahlukileyo kumntu ngamnye, kwaye unokutshintsha ngokuhamba kwexesha ukuze ube nokumelana namayeza athile.
Utshintsho lwemfuza luyichaphazela njani le nto?
Enye yezona ndlela zibalaseleyo zokufumanisa umhlaza ofana ne-TNBC kwangethuba kukubona abo basengozini enkulu. Ukuze benze oku, abaphandi bafunda utshintsho lwezakhi zofuzo (iinguqu) ezidluliselwa kwizizukulwana ngezizukulwana kwaye zinxulunyaniswa nomhlaza webele.
- I-BRCA1 (i-gene yomhlaza webele 1)
- I-BRCA2 (iGene 2 yoMhlaza webele)
Ukuba uzuze utshintsho kwenye yezi jini zimbini, usengozini enkulu yokuba nomhlaza wamabele kunye nowesibeleko. Ukuba unalo olu tshintsho, usenokuba nomhlaza usemncinci.
Uninzi lomhlaza wamabele olune-BRCA1 gene mutation lune- triple-negative . Ke ngoko, ukuqonda le gene kunokunceda ekufumaneni iindlela ezingcono zokunyanga i-TNBC.
Abanye oogqirha bacebisa ukuba wonke umntu one-TNBC ahlolwe iijini ezinxulumene nomhlaza, kuquka i-BRCA1 kunye ne-BRCA2. Ukuba ufunyenwe une-TNBC ngaphambi kweminyaka engama-60, okanye ukuba umntu kusapho lwakho ukhe waba ne-TNBC, ugqirha wakho unokucebisa olu vavanyo lwe-genetic. Oku kunokukunceda wena nogqirha wakho nikhethe unyango olusebenzayo kuwe.
Yintoni ekufuneka uyazi malunga nomhlaza webele osasazekayo?
Olunye uhlobo lomhlaza olunzima ukunyanga ngumhlaza webele osasazeke kwiindawo ezikude zomzimba. Oku kubizwa ngokuba ngumhlaza webele osasazekayo . Ungasasazeka nakwezinye iindawo zomzimba, njengamathambo, ingqondo, isibindi, okanye imiphunga. Ngamanye amaxesha umhlaza ufunyaniswa xa usasazeke ngolu hlobo. Kodwa rhoqo, umhlaza ubuya kwaye usasazeke emva komjikelo wokuqala wonyango, ngamanye amaxesha emva kweminyaka.
Umhlaza wakho webeleUkuba umhlaza usasazeke kwiindawo ezikude, injongo ephambili yonyango kukulawula umhlaza. Unyango oluqhelekileyo lolona hlobo lonyango luqhelekileyo. Ugqirha wakho uya kugqiba ngonyango lwakho ngokusekelwe kwiimpawu zakho, unyango lwangaphambili, apho umhlaza usasazeke khona, kunye nohlobo lweeseli zomhlaza.
Ziziphi iindlela zonyango zamva nje zokunyanga oku?
Unyango lwe-TNBC, umhlaza webele ophindaphindayo kunye nomhlaza webele ophindaphindayo, luye lwaphucuka kakhulu kwiminyaka yakutshanje. I-chemotherapy lolona nyango luphambili loku. Oogqirha ngoku bayinika kunye namanye amayeza.
Nazi ezinye iindlela ezintsha zonyango:
Izithinteli zePARP
Ezi luhlobo lweyeza elitshabalalisa i-DNA yeeseli zomhlaza kubantu abane- BRCA gene mutations kunye ne-HER2-negative kunye ne-metastatic cancer. Imizekelo ibandakanya i-`olaparib (Lynparza)` kunye ne-`talazoparib (Talzenna).` Ezi zikwabonise iziphumo ezilungileyo kwi-TNBC yesigaba sokuqala.
Unyango lwe-immunotherapy
Olu nyango luvuselela amajoni omzimba ukuba atshabalalise iiseli zomhlaza. I-Pembrolizumab (Keytruda) yenye yeziyobisi ezinjalo. Zihlala zinikwa kunye ne-chemotherapy.
Ii-Antibody-drug conjugates (ii-ADC)
Le yiteknoloji enomdla kakhulu. Cinga ngayo njengenkqubo yeGPS ekhokela iyeza kwindawo elijolise kuyo. Ii-antibodies ezikula mayeza zifumana iiseli zomhlaza, zinamathele kuzo, kwaye zitshabalalise iiseli zomhlaza ngeyeza eliqhotyoshelweyo, ngaphandle kokulimaza iiseli ezisempilweni. `Sacituzumab govitecan (Trodelvy)` liyeza le-ADC elivunyiweyo kwi-TNBC ephucukileyo.
Unyango olongezelelweyo
Kukho amayeza amatsha amaninzi anikwa kunye nonyango lweehomoni zomhlaza one-hormone receptor (HR). I-Abemaciclib (Verzenio) yenye yezo ziyobisi.
Zithini izinto eziza kwenzeka kwixesha elizayo kule nkalo?
Abaphandi bahlala besebenza ukwandisa iindlela zonyango lwale mihlaza, kuquka ukufumana iikhompawundi ezintsha ze-immunotherapy kunye nokuchonga iimpawu ezinokuxela kwangaphambili iziphumo zonyango.
Bakwaphanda nokuba amayeza avunyiweyo kwezinye izifo aya kuba luncedo na kwi-TNBC. Bakwaphanda neendlela zokusebenzisa amayeza afana ne-PARP inhibitors ngokubanzi. Ezinye izifundo zikwazama ukusebenzisa ii-nanoparticles eziluncedo emzimbeni ukubulala iiseli zomhlaza ezinganyangekiyo ngamayeza.
Ngoko ke, nangona ukuphila nolu hlobo lomhlaza kunokuba nzima, kukho ithemba lonyango olutsha. Eyona nto ibalulekileyo kukuthetha nogqirha wakho rhoqo uze wenze isigqibo ngesicwangciso sonyango esifanelekileyo kuwe.
Umyalezo Wokuya Ekhaya
- Eminye imihlaza yamabele, ingakumbi iTriple-Negative Breast Cancer (TNBC) , kunzima ukuyinyanga kuba ayinazo ii-hormone receptors okanye iproteni ye-HER2.
- Utshintsho lwemfuza, olufana ne -BRCA1 kunye ne -BRCA2 , lubalulekile ekumiseleni umngcipheko wakho we-TNBC kunye nonyango lwakho. Ukuba une-TNBC, thetha nogqirha wakho malunga novavanyo lwemfuza.
- Injongo yonyango lomhlaza osasazekayo kukulawula esi sifo.
- Iindlela zonyango zanamhlanje ezifana ne-PARP inhibitors, i-immunotherapy, kunye ne-antibody-drug conjugates (ii-ADC) ngoku zinika ithemba elikhulu nakwimihlaza enzima ukunyanga.
- Kungakhathaliseki imeko yakho, kubaluleke kakhulu ukuba uhlale usebenzisana nogqirha wakho ukuze ukhethe olona khetho lufanelekileyo lonyango.
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