Ukuba wena okanye umntu omaziyo ufunyaniswe enomhlaza webele, kuyinto eqhelekileyo ukuziva uloyiko olukhulu kunye nokothuka. Ngokufanayo, njengoko sikhula, amathambo aba buthathaka kwaye nokuba ukuwa okuncinci kunokuwaphula. Nangona kunjalo, ngenxa yokuqhubela phambili kwezonyango, kukho unyango olusebenzayo kwezi meko. Namhlanje, siza kuthetha ngolunye unyango olunjalo.
Kalula nje, zithini ezi SERM?
Ii-SERM zifutshane ngee -Selective Estrogen Receptor Modulators . Olu luhlobo lonyango lwee-hormone. Oku kubandakanya ukulawula indlela esebenza ngayo i-hormone estrogen emzimbeni wethu. Cinga ngayo njengomphathi okrelekrele. Ithintela iziphumo ze-estrogen kwezinye iindawo zomzimba, kwaye isebenza njenge-estrogen kwezinye ukunceda umzimba.
Amayeza amabini aphambili kolu didi yiTamoxifen kunye neRaloxifene . La mayeza asetyenziswa njengonyango olusebenzayo kakhulu kwiintlobo ezithile zomhlaza wamabele kunye ne-osteoporosis.
La mayeza e-SERM asebenza njani emzimbeni?
Oku kungabonakala kunzima ukukuqonda, kodwa eneneni kulula kakhulu. Masiqonde oku ngomzekelo.
Cinga nge-estrogen njengesitshixo. Iiseli zomzimba wethu zine-receptors ezihambelana nesi sitshixo. Xa ufaka esi sitshixo emnyango, ucango luyavuleka kwaye umyalezo uthunyelwa kwiseli.
- Kumhlaza webele: Ezinye iiseli zomhlaza webele (ezibizwa ngokuba yiHormone Receptor positive okanye i-ER-positive cancers) zifuna umyalezo ovela kwisitshixo esibizwa ngokuba yi-estrogen ukuze zikhule kwaye zahlule. Amayeza e-SERM asebenza ngokuvala ucango (i-receptor) kwezi seli zomhlaza. Kufana nokufaka enye into kwisitshixo socango. Emva koko i-estrogen yokwenyani ayinakufikelela kwisitshixo ize ivule ucango. Ngenxa yoko, iiseli zomhlaza zilahlekelwa ngumyalezo wokukhula, kwaye ukukhula kwazo kuyayeka okanye kuyeke.
- Emathanjeni: Kwangaxeshanye, xa eli yeza le-SERM lisiya emathanjeni ethu, lisebenza njenge-estrogen apho. Oko kukuthi, liya kwiingcango ezisemathanjeni lize livule ezo ngcango, linceda ukugcina amathambo omelele kwaye ligcine i-calcium. Oku kuthintela i-osteoporosis.
Ngaba ukhe wayibona indlela elisebenza ngayo eli yeza? Eli yeza linye lisebenza ngeendlela ezimbini ezahlukeneyo kwiindawo ezimbini. Yiyo loo nto libizwa ngokuba yi "Selective".
Ziziphi iindlela eziphambili zokusebenzisa ii-SERM?
Oogqirha bacebisa olu nyango ikakhulu kwiimeko ezimbini.
1. Ngomhlaza webele
Ii-SERM ziyindlela ebaluleke kakhulu yonyango, ingakumbi kumhlaza webele oshukumayo kwiihomoni (ER-positive).
- Kwabo basengozini enkulu yokuba nomhlaza: Ukuba kukho umntu kusapho lwakhe obenomhlaza webele, okanye ukuba uvavanyo lwemfuza luqinisekisile ukuba uneziguquguquko zemfuza ezandisa umngcipheko wokuba nomhlaza, unikwa eli yeza ukuthintela umhlaza ukuba ungakhuli.
- Emva kotyando lomhlaza: Emva kokuba umhlaza ususiwe ngotyando, ii-SERM zisetyenziselwa ukuthintela umhlaza ukuba ungabuyi (`ukuphinda ubuye`) kunye nokuthintela umhlaza ukuba ungaphumi kwelinye ibele.
- Kwi-DCIS: Ukuthintela ukuphinda kwe-Ductal Carcinoma in Situ (DCIS), umhlaza wesigaba sokuqala owenzeka kwimibhobho yamabele.
- Ngomhlaza osasazeke emzimbeni wonke: Ukulawula umhlaza osasazeke kwamanye amalungu omzimba (iMetastatic Breast Cancer).
- Kumhlaza webele wamadoda: Nangona kunqabile ukuba amadoda abe nomhlaza webele, olu nyango lusetyenziswa nakubo ukuba uyenzeka.
2. Nge-osteoporosis
I-SERM ebizwa ngokuba yiRaloxifene isetyenziselwa ukulawula ukulahleka kwamathambo, ukuqinisa amathambo, kunye nokunciphisa umngcipheko wokuqhekeka kwamathambo, ingakumbi kubasetyhini abasele beyekile ukuya exesheni.
Luphumelele kangakanani olu nyango?
Ewe, olu lunyango olusebenzayo kakhulu. Izifundo zibonise ukuba iyeza iTamoxifen ngokukodwa linokunciphisa umngcipheko womhlaza webele malunga ne- 40% .
- Ukuba umntu oye watyandwa umhlaza kwelinye ibele uthatha iTamoxifen, umngcipheko wokuba nomhlaza kwelinye ibele uncitshiswa ngama- 50% .
- Kumntu okhe waba nomhlaza ngaphambi kokuba ayeke ukuya exesheni, umngcipheko wokuba umhlaza uphinde ubuye unokuncipha phakathi kwe -30% kunye ne-50% .
- I-Raloxifene ikwafunyenwe ukuba iyawunciphisa kakhulu umngcipheko wokuqhekeka komqolo okubangelwa yi-osteoporosis emva kokuya exesheni.
Kwenzeka ntoni ngexesha lonyango?
Olu nyango ludla ngokunikezelwa njengepilisi okanye ulwelo oluthathwa yonke imihla. Ubude bonyango bungahluka ngokuxhomekeke kwimeko yakho kunye neengcebiso zikagqirha wakho.
- I-Tamoxifen: Abantu abayisebenzisayo ukuthintela okanye ukunyanga umhlaza webele badla ngokuyisebenzisa le mithi iminyaka emi-5 ilandelelana. Ugqirha wakho angayolula le mithi ibe yiminyaka eli-10. Ungatshintshelwa kwenye iyeza (njenge-aromatase inhibitor) emva kweminyaka embalwa.
- I-Raloxifene: Abo bayithathayo ukunciphisa umngcipheko womhlaza webele okanye we-osteoporosis kufuneka bayithathe njengepilisi yemihla ngemihla kangangoko ugqirha wabo ecebisa.
Eyona nto ibalulekileyo kukuthatha eli yeza lonke ixesha njengoko ugqirha elichazile. Ukuliyeka phakathi kusenokungavelisi ziphumo zinqwenelekayo.
Zithini iziphumo ebezingalindelekanga ezinokubakho ngenxa yolu nyango?
Njengakweminye imithi yomhlaza, ii-SERM zinokubangela ezinye iziphumo ebezingalindelekanga. Nangona kunjalo, ayinguye wonke umntu oza kuzifumana zonke. Uninzi lwazo lunokulawulwa.
| Iziphumo ebezingalindelekanga eziqhelekileyo nezingaqhelekanga zeTamoxifen | |
|---|---|
| Imiphumela | Inkcazo |
| Iziphumo ebezingalindelekanga eziqhelekileyo (abafazi) | |
| Ubushushu obugqithisileyo | Ifana nophawu lokuya exesheni. |
| Ukubila ebusuku | Ubuthongo bunokuphazamiseka. |
| Ukuya exesheni okungaqhelekanga/ukopha kwegazi kwilungu lobufazi | Umjikelo wexesha lokuya exesheni kwabasetyhini abangekayi exesheni unokutshintsha. |
| Ukoma kwesisu, ukurhawuzelela, ukukhupha amanzi | Ubunzima besondo bunokubakho. |
| Iziphumo ebezingalindelekanga ezingaqhelekanga kodwa ezinzulu | |
| Amahlwili egazi | Inokwenzeka kwimithambo yemilenze (Deep Venous Thrombosis) okanye kwimiphunga (Pulmonary Embolism). |
| Umngcipheko womhlaza wesibeleko | Kukho umngcipheko omncinci kakhulu. Ukuba ufumana ukopha okungaqhelekanga, kufuneka wazise ugqirha wakho. |
| IiCataracts | Lumka xa kukho utshintsho embonweni. |
| Istroke | Yimeko engaqhelekanga kakhulu kodwa imbi kakhulu. |
I-Raloxifene inokuba nemiphumo emibi efanayo (umz. ubushushu, iintlungu zomlenze), kodwa umngcipheko womhlaza wesibeleko uphantsi kunakwi-Tamoxifen. Ugqirha wakho uza kukuchazela oku ngokweenkcukacha.
Ndingenza ntoni ukulawula iziphumo ebezingalindelekanga?
Kukho izinto ezimbalwa onokuzenza wena ukuze uphile nezi ziphumo ebezingalindelekanga kube lula.
- Kwizinto ezishushu: Nciphisa iziselo ezine-caffeine ezifana nekofu neti. Abanye abantu banokufumana isiqabu ngokutya ukutya okune-phytoestrogens ezifana neesoya, iitshizi kunye neelentile.
- Kwabo bangakwaziyo ukulala: Ukuzilolonga rhoqo kunokuphucula umgangatho wokulala.
- Ukoma kwelungu lobufazi: Kukho izinto zokuthambisa ilusu lobufazi ezikhethekileyo ezinokusetyenziselwa oku. Buza ugqirha wakho ngazo.
Ufanele ufune nini ingcebiso yezonyango ngokukhawuleza?
Ukuba iziphumo ebezingalindelekanga zixhaphakile, xelela ugqirha wakho. Nangona kunjalo, ukuba ufumana naziphi na kwezi mpawu zilandelayo, yiya kwicandelo lezonyango ezingxamisekileyo (ETU) ngokukhawuleza okanye utsalele umnxeba ku-1990. Ezi zinokuba ziimpawu zemeko enzima efana nestroke okanye ihlwili legazi emiphungeni (pulmonary embolism).
- Ukuba ndindisholo okanye ubuthathaka kwelinye icala lomzimba okanye lobuso.
- Ubunzima bokuthetha, ukungakwazi ukuthetha kakuhle.
- Intloko ebuhlungu kakhulu ngequbuliso.
- Ubunzima bokuphefumla ngequbuliso.
- Intlungu ebukhali esifubeni, engalweni, egxalabeni, okanye emhlathini ngaphandle kwesizathu esaziwayo.
Musa ukuzityeshela ezi mpawu. Ukuthatha amanyathelo ngoko nangoko kunokusindisa ubomi.
Umyalezo Wokuya Ekhaya
- Ii-SERM ziluhlobo olukhethekileyo lwamayeza alawula indlela esebenza ngayo i-hormone ye-estrogen. Ziyindlela yonyango esebenzayo kakhulu yomhlaza webele kunye ne-osteoporosis.
- La mayeza ayayimisa ukukhula kweeseli zomhlaza wamabele kwaye anceda nasekuqiniseni amathambo.
- I-Tamoxifen kunye neRaloxifene zezona SERM zisetyenziswa kakhulu.
- Njengakweminye imithi, kukho iziphumo ebezingalindelekanga, kodwa uninzi lwazo zinokulawulwa. Thetha ngokukhululekileyo nogqirha wakho ngazo.
- Lumka ngeziphumo ebezingalindelekanga ezinzulu kodwa ezingaqhelekanga ezifana nokuqhekeka kwegazi kunye nesifo sohlangothi. Ukuba kuvela iimpawu ezinjalo, funa ingcebiso kagqirha ngokukhawuleza.
- Ngugqirha wakho kuphela onokukunika icebiso elifanelekileyo malunga nokuba unyango lwe-SERM lukulungele na, kunye nezinto ezilungileyo nezingalunganga. Ngoko ke ungoyiki ukubuza nayiphi na imibuzo onayo.
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