Xa sisiva ngomhlaza webele, sothuka kakhulu. Kwaye xa sisiva ukuba sikwinqanaba lesine, oko kukuthi, umhlaza usasazeke kwamanye amalungu omzimba, kuyoyikisa nangakumbi kwaye kunzima. Le yimeko enzima kakhulu. Kodwa ngale sayensi yezonyango iphucukileyo, kukho unyango oluninzi olunokwenziwa kweli nqanaba, olunokunceda ukulawula isifo kwaye lwandise ubomi. Ngoko masithethe ngale nto namhlanje, ukuze sifumane iimpendulo ezilula kwimibuzo onayo engqondweni.
Yintoni kanye kanye iSigaba IV?
Ngamafutshane, inqanaba lesi-4 lithetha ukuba iiseli zomhlaza eziqale emabeleni zisasazeke ngegazi okanye kwimithambo ye-lymph ukuya kwezinye iindawo zomzimba. Oku kusasazeka kubizwa ngokuba yi-'Metastasis'. Iindawo eziqhelekileyo apho umhlaza unokusasazeka ngale ndlela ngamathambo, ingqondo, imiphunga, okanye isibindi .
Into ebalulekileyo ekufuneka uyiqonde apha kukuba injongo ephambili yonyango kweli nqanaba ayikokunyanga isifo ngokupheleleyo, kodwa kukulawula ukukhula komhlaza, ukunciphisa iimpawu, kunye nokukunika umgangatho wobomi olungileyo kangangoko kunokwenzeka. Ezinye izigulana ziphila iminyaka emininzi ngolu nyango. Ke ngoko, kubalulekile ukuba ungoyiki xa usiva ngale nto inokwenzeka, kodwa uthethe ngononophelo nogqirha wakho malunga neendlela zonyango ezikhoyo.
Zeziphi iindlela zonyango eziphambili ezikhoyo?
Kwinqanaba lesi-4, kuba umhlaza usasazeke kwiindawo ezininzi, kunzima ukufumana iziphumo eziphumelelayo ngonyango olujolise kwindawo enye kuphela, njengotyando okanye unyango lwemitha. Ke ngoko, unyango olusebenzisa inkqubo yomzimba oluchaphazela umzimba wonke lusetyenziswa kakhulu.
Unyango ngamakhemikhali
I-Chemotherapy idla ngokuba lolona nyango luphambili kweli nqanaba. Isebenza ngokubulala iiseli zomhlaza ezahlulahlula ngokukhawuleza. Oku kunokucothisa ukukhula komhlaza. I-Chemotherapy inikwa ngeendlela ezahlukeneyo. Ngamanye amaxesha inikwa njengeepilisi, kodwa uninzi lwayo inikwa ngemithambo yegazi (ngomthambo) .
Olu nyango alunikwa rhoqo. Luhlala lunikwa ngemijikelo eliqela. Emva kokuba umjikelo omnye ugqityiwe, umzimba unikwa ixesha elifutshane lokuphumla ukuze ululame. Kuphela emva koko umjikelo olandelayo uqala.
Unyango lweHormone
Olu nyango alufanelekanga kuwo wonke umntu. Lusebenza kakhulu kubasetyhini abanohlobo lomhlaza olubizwa ngokuba yi-hormone receptor-positive . Oku kuthetha ukuba ii-hormone ezifana ne-estrogen emizimbeni yabo zikhuthaza ukukhula kweeseli zomhlaza. Cinga ngale ndlela: ii-hormone zifana nesitshixo, kwaye i-receptor kwiseli yomhlaza ifana nesitshixo. Xa ufaka isitshixo, isitshixo siyavuleka kwaye umhlaza uyakhula.
Ngoko ke into eyenziwa lolu nyango lweehomoni kukuyekisa ukuveliswa kweso sihluzo (ihomoni), okanye ukusithintela ukuba singangeni kwisitshixo. Iindidi eziphambili zamayeza anikezelwayo zezi:
- "Tamoxifen"
- Izithinteli zeAromatase (kubasetyhini abasele beyekile ukuya exesheni) - Imizekelo: I-Anastrozole (Arimidex), i-Exemestane (Aromasin)
- Amayeza afana ne-``Fulvestrant (Faslodex)`` athintela ii-hormone receptors.
Ngamanye amaxesha, ukususwa kwamaqanda ngotyando kuyacetyiswa kubafazi abangekafiki kwixesha lokuphela kokuya exesheni, kuba yindlela elungileyo yokuthintela ukuveliswa kweehomoni ezinceda ukukhula komhlaza.
Unyango olujoliswe kulo
Olu lunyango olutsha nolusebenzayo kakhulu. Endaweni yokonakalisa iiseli ezisempilweni ezifana ne-chemotherapy, luhlasela kwaye luhlasele iiproteni ezithile okanye iijini ezifumaneka kwiiseli zomhlaza kuphela . Oku kubangela iziphumo ebezingalindelekanga ezimbalwa.
Malunga nama-20% abasetyhini abanomhlaza webele baneproteni eninzi ebizwa ngokuba yi-'HER2'. Oku kubangela ukuba umhlaza usasazeke ngokukhawuleza. Kwabo banesifo somhlaza 'se-HER2', kunikwa amayeza afana ne-'Trastuzumab (Herceptin)'. Iyayimisa iproteni ye-'HER2' ekusebenzeni kwaye ilawula ukukhula kweeseli zomhlaza.
Khumbula, inqanaba lesine alithethi ukuphela konyango. Eli lixesha lokugxila kunyango olunceda ukulawula isifo nokugcina umgangatho wobomi ulungile.
Makhe sijonge ezinye iintlobo zonyango olujoliswe kuzo kwitheyibhile engezantsi.
| Uhlobo lonyango olujoliswe kulo | Injongo kunye nomsebenzi | Iimeko zokusetyenziswa |
|---|---|---|
| Izithinteli zeCDK4/6 | Ithintela iiproteni ezibizwa ngokuba yi-CDK kwaye ilawula ukwahlukana kweeseli zomhlaza. Umzekelo: iPalbociclib (Ibrance), iRibociclib (Kisqali) | Kwimihlaza ene-hormone receptor-positive kunye ne-HER2-negative. |
| Izithinteli zePARP | Ijolise kwiproteni yePARP, enceda iiseli zomhlaza zikhule. Umzekelo: iOlaparib (Lynparza) | Kwimihlaza engenazo ii-HER2 kwaye ine-BRCA gene mutation. |
| Izithinteli ze-mTOR | Ithintela iproteni ye-mTOR kwaye iyeke ukukhula nokusasazeka kweeseli zomhlaza. Umzekelo: Everolimus (Afinitor) | Ngonyango lweehomoni kwiintlobo ezithile zomhlaza. |
| Ii-antibody-drug conjugates | Iyeza le-chemo lincamathiselwa kwi-antibody, ehambisa iyeza ngqo kwiseli yomhlaza ize iyitshabalalise. Umzekelo: Sacituzumab govitecan (Trodelvy) | Umhlaza webele ophucukileyo. |
Unyango lwe-immunotherapy
Olu lunyango oluphucukileyo kakhulu. Endaweni yokunika amayeza avela ngaphandle ukubulala umhlaza, luvuselela inkqubo yakho yomzimba yokuzikhusela ukuba ifumane kwaye itshabalalise iiseli zomhlaza. Ezinye iiseli zomhlaza ziyazi indlela yokuzimela kwinkqubo yomzimba yokuzikhusela. Ngoko ke la mayeza ayazithintela ezo ndlela zokufihla aze avumele iiseli zomzimba ukuba ziwubone umhlaza.
Utyando kunye neMisebe
Njengoko besitshilo ngaphambili, ezi azisetyenziswa njengonyango oluphambili kweli nqanaba. Nangona kunjalo, ukuba kukho iintlungu eziqatha kwindawo apho umhlaza usasazeke khona, umzekelo kwithambo, unyango lwemitha lunikezelwa ukulawula iintlungu kunye nezinye iimpawu . Kwakhona, utyando lunokwenziwa kuphela ukuba kuyimfuneko ukulawula naziphi na iingxaki.
Amanye amanqaku abalulekileyo
- Ulawulo lweziphumo ebezingalindelekanga: Zonke ezi ndlela zonyango zinokuba neziphumo ebezingalindelekanga, ezifana nokucaphuka, ukuhlanza, kunye nokudinwa. Kodwa kukho amayeza akhoyo okuzilawula. Ngoko ke xelela ugqirha wakho ngayo nayiphi na ingxaki ozivayo.
- Uvavanyo lweKliniki: Ngamanye amaxesha, unokukwazi ukuthatha inxaxheba 'kwiiMvavanyo zeKliniki', ezivavanya unyango olutsha olungasetyenziswa kakhulu. Ezi zinokukunika ithuba lokufumana unyango oluphambili. Buza ugqirha wakho ngale nto.
Olu hambo aluyiyo into odlula kuyo wedwa. Usapho lwakho, abahlobo, oogqirha, abahlengikazi, kunye neqela lonke lezonyango bakunye nawe. Fumana inkxaso yabo. Yabelana ngeemvakalelo zakho. Kuya kuba namandla amakhulu ukudlula kweli xesha linzima.
Umyalezo Wokuya Ekhaya
- Umhlaza webele weSigaba sesi-4 uthetha ukuba umhlaza usasazeke nakwamanye amalungu omzimba.
- Injongo ephambili yonyango kweli nqanaba ayikokunyanga ngokupheleleyo esi sifo, kodwa kukulawula umhlaza, ukunciphisa iimpawu, kunye nokwandisa ubomi ngomgangatho olungileyo wobomi.
- Unyango lwe-chemotherapy, unyango lwe-hormone, unyango olujoliswe kuyo, kunye nonyango lwe-immunotherapy zezona ndlela ziphambili zonyango.
- Ugqirha wakho uza kumisela unyango olufanelekileyo kuwe ngokusekelwe kuhlobo lomhlaza wakho (umz., i-HER2-positive okanye i-hormone receptor-positive).
- Kukwakho namayeza okulawula iziphumo ebezingalindelekanga ezivela kunyango, ngoko ke thetha nogqirha wakho ngayo nayiphi na ingxaki onokuba unayo.
- Kubaluleke kakhulu ukuhlala uqinile engqondweni kwaye ucele inkxaso kusapho nakwiqela lezonyango.
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