Ingaba umhlaza wakho webele une-HER2-Positive? Makhe sithethe ngale nto ngokweenkcukacha!

Ngaba wakha weva ngomhlaza webele? Mhlawumbi umhlobo okanye isihlobo sakho sikhe saba nawo. Kukho iintlobo ezahlukeneyo zomhlaza webele. Namhlanje siza kuthetha ngomnye wazo, okhethekileyo kwaye onokusasazeka ngokukhawuleza. Lowo ngumhlaza webele one-HER2-Positive (HER2-positive) . Xa usiva eli gama, unokucinga ukuba liyinkimbinkimbi kancinci, kodwa ungakhathazeki. Siza kuthetha ngalo ngokulula, ngendlela onokuyiqonda.

Yintoni i-HER2-Positive (HER2+) Breast Cancer?

Ngamafutshane, umhlaza webele one-HER2 (HER2+) luhlobo lomhlaza olukhula ngokukhawuleza kwaye lunokusasazeka ngokulula ngaphandle kwebele ('invasive') . Xa oogqirha besithi unolu hlobo lomhlaza, oko kuthetha ukuba iiseli zakho zomhlaza zinamanqanaba aphezulu eprotheyini ekhethekileyo elawula ukukhula kunye nokwahlukana kweeseli emzimbeni wakho - ebizwa ngokuba yi-'Human Epidermal Growth Factor Receptor 2'` , okanye i-HER2 ngamafutshane. Le protein ye-HER2 ifana 'nomqondiso'' oxelela iiseli ukuba zikhule. Xa zininzi kakhulu, iiseli ziyahlukana ngokukhawuleza nangokungalawulekiyo, nto leyo ekhokelela kumhlaza.

Olu hlobo lomhlaza webele lunokwanda kakhulu (ukusasazeka kwe-metastasize) ukusuka esifubeni ukuya kwezinye iindawo zomzimba wakho, ezifana nee-lymph nodes, isibindi, imiphunga, okanye kwanobuchopho bakho. Kodwa into ebalulekileyo kukuba ukuba lo mhlaza ufunyenwe kwangethuba, ngaphambi kokuba usasazeke kwezinye iindawo zomzimba, oogqirha banokuwunyanga ngempumelelo ngonyango oluphambili olufumanekayo namhlanje. Yiyo loo nto ukufunyanwa kwangethuba kubaluleke kangaka.

Uxhaphake kangakanani umhlaza webele we-HER2-positive?

Ngokutsho kwe-American Cancer Society, abafazi abangaphezu kwama-290,000 baza kufunyaniswa benomhlaza webele ohlaselayo (invasive ductal carcinoma kunye nomhlaza webele we-lobular) ngo-2023 kuphela. Kula mabhinqa , i-15% ukuya kwi-20% ine-HER2-positive. Amadoda anokufumana umhlaza webele, kodwa umhlaza webele we-HER2-positive awuxhaphakanga kakhulu kumadoda.

Zithini iimpawu zomhlaza webele one-HER2-positive?

Njengeentlobo ezininzi zomhlaza webele, olu hlobo lwe-HER2-positive ngamanye amaxesha alubonisi zimpawu zicacileyo ekuqaleni. Kodwa xa kuvela iimpawu, ziyafana nezo zibonwa kumhlaza webele oqhelekileyo. Makhe sijonge ukuba ziyintoni na:

• Utshintsho kubungakanani, imo, okanye ukwakheka kwebele . Elinye ibele lisenokuvakala likhulu kunelinye, okanye imo yalo ingatshintsha.
• Iqhuma okanye iqhuma elisesifubeni okanye ekhwapheni. Eli qhuma linokuba lincinci njenge-pea. Ukuba iqhuma liyaqhubeka emva kokuba umjikelo wakho wokuya exesheni uphelile, kufuneka uxhalabe.
• Utshintsho kwinkangeleko okanye ukuvakala kolusu lwebele okanye ingono. Ulusu lunokuba rhabaxa, lube namabala okanye luqhekeke, okanye lunokuvakala lunamaxolo okanye luvuvukele. Ngamanye amaxesha ulusu lunokuba bomvu okanye lube mnyama kunesiqhelo.
• Ukuziva indawo eqinileyo phantsi kolusu, njengemabula .
• Ulwelo olunegazi okanye olucacileyo oluphuma kwingono.

Khawucinge nje, mhlobo wakho, masimbize ngokuthi "Sunita". Ngenye imini, ngelixa ehlamba, uSunita wabona utshintsho oluncinci ebeleni lakhe. Lalivakala ngathi liqhuma elincinci. Ekuqaleni, akazange alinike ngqalelo ingako, ecinga, "Liza kuphela." Kodwa emva kweeveki ezimbalwa, lalisekhona. Kamva, xa walibonisa ugqirha, waqonda ukuba luphawu lomhlaza webele. Ke ngoko, ukuba ubona naluphi na utshintsho olungaqhelekanga emabeleni akho, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngaphandle kokuyityeshela.

Yintoni ebangela umhlaza webele we-HER2-positive?

Umhlaza webele one-HER2-positive ubangelwa kukuguquka kwejini ebizwa ngokuba yi-HER2. Le jini ye-HER2 ivelisa iproteni ye-HER2 ebesithethe ngayo ngaphambili. Ezi proteni ze-HER2 (ezikwabizwa ngokuba yi-'receptors') zihlala zifumaneka kumphezulu wazo zonke iiseli zebele.

Phantsi kweemeko eziqhelekileyo, ezi proteni ze-HER2 zilawula ukukhula nokulungiswa kweeseli zebele, ziqinisekisa ukuba iiseli ezintsha zahlukana ngamanani aneleyo ukuze zithathe indawo yeeseli ezonakeleyo okanye ezifayo.

Nangona kunjalo, xa i-HER2 gene iguquguquka, yenza iikopi ezininzi kakhulu. Xa i-HER2 gene ikhutshwa kakhulu, ikwavelisa i-HER2 protein eninzi kakhulu. Xa i-HER2 protein iba ninzi kakhulu, iiseli zamabele ziyahlukana ngokukhawuleza kwaye zikhule ngendlela engalawulekiyo, zibe ziithumba ezinomhlaza.

Zithini izinto ezibangela oku?

Njengomhlaza webele, izinto ezibangela umhlaza webele one-HER2 ziyafana nezo zibangela umhlaza webele oqhelekileyo. Ungafumana umhlaza webele nokuba unazo ezi zinto zibangela umngcipheko okanye awunazo. Nangona kunjalo, ezi zinto zinokunyusa umngcipheko wakho:

• Ukuba notshintsho lwemfuza oluzuzwe njengelifa . Umzekelo, utshintsho kwimfuza i-BRCA1 okanye i-BRCA2.
• Ndikhe ndanomhlaza webele ngaphambili.
• Ukuba nezinye iimeko ezinxulumene namabele ezifana ne-'atypical ductal hyperplasia'.
• Umjikelo wokuya exesheni uqala ngaphambi kwexesha eliqhelekileyo.
• Ukuya exesheni kwenzeka emva kwexesha eliqhelekileyo.
• Ukuthatha unyango lokutshintshwa kweehomoni.
• Ukusela iziselo ezinxilisayo ezingaphezu kwesinye ngosuku.
• Ukuba ukhe wafumana unyango lwemitha kwiimeko ezithile ezifana ne-lymphoma (umhlaza wenkqubo ye-lymphatic).

Ziziphi iingxaki zomhlaza webele one-HER2-positive?

Umhlaza webele one-HER2-Positive unokusasazeka uye kwezinye iindawo zomzimba, okanye 'uqhekeze'. Malunga nesiqingatha sabantu abanolu hlobo lomhlaza webele, umhlaza sele usasazeke uye kwezinye iindawo zomzimba, ingakumbi ingqondo, ngexesha lokufunyaniswa kwabo. Umhlaza webele osele usasazeke uye engqondweni ("umhlaza webele oqhekezeke engqondweni yakho") unokuba yingozi ebomini. Yiyo loo nto ukufunyaniswa kwangoko kunye nonyango olukhawulezileyo kubalulekile.

Ufunyaniswa njani umhlaza webele one-HER2-positive?

Oogqirha basebenzisa ikakhulu i-biopsy yamabele ukuxilonga zonke iintlobo zomhlaza wamabele. Oku kuquka ukuthatha iqhekeza elincinci lesicwili kwindawo erhanelekayo yebele baze balihlole phantsi kwe-microscope.

Ukuba i-biopsy yebele iqinisekisa ukuba kukho umhlaza, ingcali yezonyango (ugqirha ochwephesha ekuxilongeni izifo) uya kwenza uvavanyo olukhethekileyo ukuze abone ukuba iiseli zezicubu zebele ziqulethe iproteni ye-HER2. Kukho iintlobo ezimbini eziphambili zovavanyo loku:

1. I-Immunohistochemistry (IHC): Olu vavanyo luvumela iingcali zezifo ukuba zikhangele iproteni ye-HER2 kwiiseli zomhlaza webele. Olu vavanyo lusebenzisa idayi ekhethekileyo (i-immunostaining) ukujonga inqanaba leproteni ye-HER2 kwiiseli zomhlaza.

2. I-Fluorescence in situ hybridization (I-FISH): Olu vavanyo lwe-FISH ngamanye amaxesha lusetyenziselwa ukuqinisekisa iziphumo zovavanyo lwe-IHC. Olu vavanyo lunokufumanisa ukuba kukho iikopi ezongezelelweyo ze-HER2 gene.

Emva kwezi mvavanyo, oogqirha bahlulahlula umhlaza ngakumbi. Basebenzisa 'inkqubo yokubeka amanqaku'. Oku kujonga ukuba inqanaba leproteni ye-HER2 liphezulu kangakanani kwisampuli yezicubu zebele, kunye nokuba zingaphi iiseli zomhlaza ezikhoyo. Cinga ngale ndlela:

• Ukuba uvavanyo lubonisa ukuba inqanaba leprotheyini ye-HER2 liphantsi, liya kunikwa amanqaku angama- 0 okanye 1+ . Ingcali yezifo iya kuthi emva koko i -HER2 negative .
• Ukuba kukho iiseli zomhlaza kwaye inqanaba leproteni liphakathi, ungafumana amanqaku angama -2+ . Emva koko ingcali yezifo iza kuqinisekisa uvavanyo lwe-'FISH' olukhankanyiweyo ngaphambili.
• Ukuba kukho iiseli ezininzi zomhlaza kwaye inqanaba leproteni liphezulu kakhulu, ufumana amanqaku angama- 3+ . Kulapho ingcali yezifo ithi ine -HER2 positive .

Le nkqubo yokufumana amanqaku imisela ngqo ukuba ngaba une-HER2-positive okanye i-HER2-negative.

Ziziphi iindlela zonyango zomhlaza webele one-HER2-positive?

Ngenxa yokuba olu luhlobo lomhlaza webele 'ongena emzimbeni', iindlela zonyango zimiselwa zizinto ezininzi, ezifana nenqanaba lomhlaza kunye nesimo se-HER2. Ezi ndlela zonyango zilandelayo zingasetyenziswa:

• Unyango olujoliswe kulo:Olu lolona nyango lukhethekileyo lomhlaza one-HER2. Lubandakanya ukunika amayeza ajolise kwiproteni ye-HER2 kwaye abulale iiseli zomhlaza. Kukho iintlobo ezininzi eziphambili zonyango phantsi koku:
• Unyango lwe-antibody ye-monoclonal: Ezi zibopha kwiproteni ye-HER2 kwaye zithintela ukukhula kweeseli zomhlaza.
• Unyango lwe-Tyrosine kinase inhibitor: La mayeza angena kwiiseli zomhlaza aze avale iindlela zokuhambisa imiyalezo ezinceda iiseli zikhule.
• Ii-Antibody-drug conjugates (ADCs): Le yindlela ephucukileyo kakhulu. Kule ndlela, iyeza lokulwa nomhlaza liqhotyoshelwa kwi-antibody ekhangela iiseli zomhlaza. Le khompawundi emva koko iya ngqo kwiiseli zomhlaza ize ikhuphe iyeza, nto leyo ebangela umonakalo omncinci kwiiseli eziphilileyo.
• Unyango lweKhemotherapy: Unyango lweKhemotherapy lunikwa ngaphambi kotyando ukuze kuncitshiswe ithumba (unyango lwe-neoadjuvant) okanye kubulawe naziphi na iiseli zomhlaza eziseleyo emva kotyando (unyango oluncedisayo). Ngamanye amaxesha ikhemotherapy inikwa kunye nonyango olujoliswe kulo.

Ngaphandle koku, kuxhomekeke kwinqanaba lomhlaza, izinto ezinje `ngotyando`, `unyango lwemitha`, okanye `unyango lweehomoni` nazo zinokwenziwa.

Zithini iziphumo ebezingalindelekanga zonyango?

Iziphumo ebezingalindelekanga zinokwahluka ngokuxhomekeke kunyango. Ukuba ufumana unyango, thetha nogqirha wakho malunga nendlela oluya kukuchaphazela ngayo kunye nendlela oluya kuyichaphazela ngayo ubomi bakho bemihla ngemihla. Kwakhona, buza ugqirha wakho malunga nonyango oluthuthuzelayo . Unyango oluthuthuzelayo yinkonzo ekuncedayo ukulawula iimpawu zomhlaza kunye neziphumo ebezingalindelekanga zonyango kwaye ikwenze uzive ukhululekile kangangoko ngexesha lonyango. Ayilolwabantu abangakwaziyo ukunyanga umhlaza kuphela, kodwa inokunceda nabani na ofumana unyango.

Ngaba olu nyango lungayinyanga ngokupheleleyo umhlaza webele one-HER2-positive?

Xa oogqirha besithi “baphilise” umhlaza, mhlawumbi bathetha ukuba umhlaza wapholiswa iminyaka emininzi ngonyango. Ukuxolelwa kuthetha ukuba awunazo iimpawu zomhlaza kwaye akukho mhlaza unokufumaneka kwiimvavanyo. Umntu ofunyaniswe enomhlaza webele one-HER2-positive, wanyangwa, waza waphila iminyaka emihlanu uthathwa “njengophilisiweyo.”

Ngokutsho kwe-US National Cancer Institute (NCI), abantu abangaphezu kwama-90% abafunyenwe benomhlaza webele one-HER2 basaphila emva kweminyaka emihlanu. Banokuthathwa njengabanyangiweyo kumhlaza wabo. Nangona kunjalo, umhlaza one-HER2 unokuphinda ubuye kwaye usasazeke kwezinye iindawo zomzimba. Ke ngoko, kubalulekile ukuqhubeka nokuya kuvavanyo lwezonyango.

Ingakanani izinga lokusinda kumhlaza webele one-HER2-positive?

Amathuba okusinda kumhlaza webele we-HER2-positive nawo ayahluka ngokuxhomekeke ekubeni umhlaza une-hormone receptor-positive (HR+) okanye i-hormone receptor-negative (HR-) . (Ezi hormone receptors zii-receptors ezikumphezulu weeseli ezinokubophelela kwii-hormone. Malunga nesiqingatha sazo zonke ii-HER2-positive cancers zinezi receptors. I-NCI ihlela la mathuba ngokwesigaba somhlaza: wengingqi (okhawulelwe kwibele), wengingqi (osasazeke kwii-lymph nodes ezikufutshane), kunye nowekude (osasazeke kwiindawo ezikude zomzimba). Ungathetha nogqirha wakho ngale nto ukuze ufunde okungakumbi.

Ngaba umhlaza webele one-HER2-positive ungathintelwa?

Kusenokwenzeka ukuba akunjalo. Nangona kukho izinto onokuzenza ukunciphisa umngcipheko wakho wokuba nomhlaza webele, umhlaza webele one-HER2-positive ubangelwa kukuguquka kwejini ye-HER2 okubangela ukuba iiseli zomhlaza zenzeke. Abaphandi basafunda ukuba kutheni oku kusenzeka, ngoko ke abanakutsho ukuba yintoni enokwenziwa ukuthintela umhlaza one-HER2-positive.

Nangona kunjalo, ungenza ezi zinto ukunciphisa umngcipheko wakho womhlaza webele ngokubanzi:

• Nyamekela impilo yebele lakho. Zihlole rhoqo iibele zakho, kwaye ufumane ii-mammograms ngokweminyaka nangexesha elicetyiswa ngugqirha wakho. Qaphela naluphi na utshintsho oluvela emabeleni akho. Ngale ndlela, umhlaza unokubonwa kwangethuba kwaye unyangwe lula.
• Gcina ubunzima obusempilweni. Oku kufanele kube bubunzima obukulungeleyo. Cela iingcebiso kugqirha wakho malunga nendlela yokugcina ubunzima obusempilweni.
• Yitya ukutya okunempilo. Ezinye izifundo zibonise ukuba ukutya okutyebileyo kwimifuno, iziqhamo, iimveliso zobisi ezityebileyo ngecalcium, kunye neeproteni ezingenamafutha kunokunciphisa umngcipheko womhlaza webele. Kukwangumbono olungileyo ukunciphisa inyama ebomvu neyosiweyo.
• Yiba nomdla. Izifundo zibonise ukuba ukwenza umthambo rhoqo kunciphisa umngcipheko womhlaza webele. Nokuba uhamba nje imizuzu engama-30 ngosuku kulungile.
• Ziphephe iziselo ezinxilisayo. Uphando lubonisa unxibelelwano phakathi komhlaza webele notywala. I-American Medical Association icebisa ukuba abafazi banciphise utywala babo kwisiselo esinye ngosuku.

Ndingazinyamekela njani?

Ukuphila nomhlaza webele kuthetha ukuphila neempawu zomhlaza, unyango, kunye nemiphumo emibi yonyango. Kwaye, ngamanye amaxesha, kunokufuneka uphile ungenalo ulwazi ngekamva. Ungaziva uxinezelekile kwaye udanile ngamanye amaxesha. Ukuba uvakalelwa ngaloo ndlela, cinga ngezi ngcebiso zokuzinyamekela:

• Phumla ngokwaneleyo.Umhlaza webele kunye nonyango kuyadinisa kakhulu. Khumbula ukuphumla nanini na xa uziva ufuna, kungekuphela nje xa unexesha.
• Yitya kakuhle. Unyango lunokunciphisa umnqweno wakho wokutya, kodwa ukutya ukutya okutyebileyo kwiziqhamo, imifuno, iiproteni ezingenamafutha, kunye neenkozo ezisempilweni kuya kukunceda uhlale unamandla ngexesha lonyango.
• Lawula uxinzelelo lwakho. Umhlaza ubangela uxinzelelo olukhulu. Ukuzilolonga kunokunceda kule nto. Ukuhamba rhoqo kunye nokuthatha inxaxheba kwiinkqubo zokuzilolonga ezifana neyoga kulungile.
• Fumana inkxaso. Ungumntu osindileyo kumhlaza webele, kwaye oko kuqala ngosuku ofunyaniswa ngalo isifo. Buza ugqirha wakho malunga neenkqubo zokusinda kumhlaza . Ezi zinokukunceda woyise imingeni yokuphila nomhlaza webele. Ukuthetha nosapho lwakho kunye nabahlobo bakho kukwayindlela entle yokuzixhasa.

Ndifanele ndimbone nini ugqirha?

Kuya kufuneka ubone ugqirha wakho rhoqo ngexesha lonyango. Nangona kunjalo, ukuba ubona naluphi na utshintsho olutsha emabeleni okanye emzimbeni wakho olunokuba ziimpawu zokuba umhlaza wakho we-HER2-positive usasazekile, xelela ugqirha wakho ngoko nangoko. Umzekelo, ukuba umhlaza webele usasazeke waya emiphungeni, unokufumana iimpawu ezifana neentlungu zesifuba, usulelo lwesifuba oluqhelekileyo, ubunzima bokuphefumla, okanye ukukhohlela igazi.

Ndingaya nini kwigumbi likaxakeka?

Ukuba impendulo yomzimba wakho kunyango lomhlaza imbi kakhulu kunokuba ubulindele, kufuneka uye kwigumbi likaxakeka. Umzekelo, ukuba uphelelwe ngamanzi emzimbeni ngenxa yokuhlanza okungapheliyo, yiya esibhedlele ngoko nangoko.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ukuba uvavanyo lwakho lubonisa ukuba unomhlaza webele we-HER2-positive, ungabuza ugqirha wakho imibuzo efana nale:

• Ithini kanye kanye imeko yam ye-HER2 ? (oko kukuthi, amanqaku am e-IHC/FISH athini?)
• Injani imeko yam ye-hormone receptor ? (HR+ okanye HR-?)
• Ezi meko zeHER2 kunye ne-hormone receptor zichaphazela njani i-prognosis yam (oko kukuthi, i-prognosis kunye nenkqubo yexesha elizayo yesifo)?
• Loluphi unyango olundicebisayo? Ngoba?
• Ngaba kufuneka ndicinge ngokuthatha inxaxheba kuvavanyo lweklinikhi lokunyanga umhlaza webele one-HER2-positive?

Utshintsho kunyango lomhlaza aluqhelekanga. Yiyo loo nto abaphandi bomhlaza babevuya kakhulu xa izifundo zibonisa ukuba utshintsho kwi-HER2 gene lubangela ukuba iiseli zahlukane ngokukhawuleza kunesiqhelo. Bakhawuleza bafumanisa unxibelelwano phakathi kotshintsho kwi-HER2 gene kunye nezinye iintlobo zomhlaza webele okhula ngokukhawuleza. Ukusuka apho, baphuhlise unyango olunokunyanga ngempumelelo umhlaza webele we-HER2-positive kwinqanaba lokuqala. Ngoku abaphandi bagxile ekufumaneni unyango olusebenzayo olunokucothisa okanye lumise ukusasazeka komhlaza. Uvavanyo lweklinikhi kulapho ezi zinto zintsha zenzeka khona. Ukuba unomhlaza webele we-HER2-positive ('metastatic'), thetha nogqirha wakho malunga nokuthatha inxaxheba kuvavanyo lweklinikhi. Banokukunceda.

Okokugqibela, umyalezo oya ekhaya

Umhlaza webele one-HER2-positive luhlobo lomhlaza olubi nolusasazeka ngokukhawuleza. Nangona kunjalo, ngokufunyanwa ngokuchanekileyo nangokukhawuleza kunye neendlela zonyango eziphambili, ngoku kunokwenzeka ukulawula nokunyanga le meko ngempumelelo.

• Soloko unika ingqalelo emzimbeni wakho, ingakumbi amabele akho. Ukuba ubona naluphi na utshintsho olungaqhelekanga, musa ukulutyeshela kwaye funa ingcebiso kagqirha ngoko nangoko.
• Landela iimvavanyo kunye nonyango olucetyiswa ngugqirha wakho ngokuchanekileyo. Ungoyiki ukuthetha nogqirha wakho ngayo nayiphi na imibuzo okanye iinkxalabo onokuba nazo.
• Kubaluleke kakhulu ukuhlala unethemba. Awuwedwa. Kukho usapho, abahlobo, oogqirha, kunye neenkonzo zokunika iingcebiso zokukunceda.

Siyathemba ukuba olu lwazi luluncedo kuwe. Hlala usempilweni!

Umhlaza webele , i-HER2-Positive, iimpawu zomhlaza, unyango lomhlaza, impilo yabasetyhini, utshintsho lwemfuza, i-mammogram