Ngiyaqonda ukuthi kunzima futhi kwesabeka kangakanani uma utholakala unomdlavuza webele. Ngakolunye uhlangothi, kukhona ukukhathazeka ngalesi sifo, kanti ngakolunye uhlangothi, lapho odokotela besho amagama anjengokuthi ``(Chemotherapy)`` kanye nokwelashwa ngama-hormone , ingqondo yakho idideka nakakhulu, akunjalo? "Ingabe nami ngizoyithola i-chemotherapy? Ingabe izinwele zami zizowa? Ingabe kuzoba nzima emzimbeni wami?" Kufanele ube nemibuzo eminingi engqondweni yakho. Kodwa ungakhathazeki. Namuhla, sizoxoxa ngokuthi iminyaka yakho nokuthi ngabe uke wadlula esikhathini sokuya esikhathini noma cha kuzobaluleka kanjani ekunqumeni ukwelashwa okunikezwayo.
Esikhathini esidlule, cishe wonke umuntu wayenikezwa i-chemotherapy ngokushesha nje lapho ethola ukuthi umdlavuza webele ususakazekele kuma-lymph node. Kwakunjengokubamba isando nokwenza konke kubukeke njengesipikili. Kodwa manje imithi isithuthuke kakhulu. Manje sesiyazi ukuthi akuwona wonke umdlavuza webele ofanayo, futhi akuzona zonke iziguli ezizosabela ekwelashweni okufanayo. Ngezinye izikhathi imiphumela emibi ye-chemotherapy ingadlula izinzuzo. Ngakho-ke manje odokotela abakhathazeki nje kuphela ngobukhulu besimila kanye nesigaba somdlavuza, kodwa futhi nangendlela yemvelo yomdlavuza.
Kungani ukunqamuka kokuya esikhathini kubalulekile kule ndaba?
Kungakhathaliseki ukuthi uke wadlula esikhathini sokunqamuka kokuya esikhathini, isikhathi lapho ukuya kwakho kwanyanga zonke kuphela unomphela, kubaluleke kakhulu ekwelapheni umdlavuza webele. Kunezizathu eziningana zalokhu.
Kalula nje, umdlavuza webele kwabesifazane abasebasha, abangakayi ukuya esikhathini, cishe ungaba nolaka kakhulu kunomdlavuza kwabesifazane asebedlulile esikhathini sokuya esikhathini .
Ngaphezu kwalokho, inquma nohlobo lokwelashwa ozoluthola. Isibonelo, uma unomdlavuza oncike kuma-hormone, uhlobo lokwelashwa kwama-hormone ongaluthola luzohluka kuye ngesimo sakho sokunqamuka kokuya esikhathini.
- Ngemva kokunqamuka kokuya esikhathini: Unganikwa umuthi ofana ne-Arimidex, ovimba umzimba ekukhiqizeni i-hormone i-estrogen.
- Uma ungakayi ukuya esikhathini: Ama-ovari akho asakhiqiza i-estrogen, ngakho-ke imithi efana ne-Arimidex ngeke isebenze kahle. Ngakho udokotela wakho uvame ukukunikeza umuthi obizwa ngokuthi i-Tamoxifen. Lokhu kusebenza ngokuvimbela umyalezo othunyelwa yi-estrogen kumaseli omdlavuza.
Uyaqonda? Kuye ngokuthi umsebenzi wamahomoni omzimba wakho ushintsha kanjani, imithi elwa nomdlavuza nayo kumele ishintshe.
Ibhayoloji Yomdlavuza: Ama-Hormone Receptors kanye ne-HER2
Kulungile, manje ake sibheke ngokujulile. Uma singayibeki eceleni ukuthi ukwelashwa ngama-hormone kulungile yini kuwe, umbuzo omkhulu olandelayo ukuthi uyayidinga yini i-chemotherapy noma cha.
Lesi sinqumo sivame ukusekelwe ezinhlotsheni zama-receptor ebusweni bamaseli akho omdlavuza . Cabanga ngala ma-receptor 'njengezi-antenna' kumaseli omdlavuza. La ma-antenna athatha 'izibonakaliso' ezidinga umdlavuza ukuze ukhule. Kunezinhlobo ezimbili eziyinhloko zama-receptor esizibhekayo.
1. Ama-Hormone Receptors (HR): Ama-Receptors azwela ama-hormone i-estrogen ne-progesterone.
2. I-HER2 receptor: Lena enye iphrotheni esiza amangqamuzana omdlavuza ukukhula.
Bheka ithebula elingezansi ukuze uthole ukuthi umdlavuza uhlukaniswa kanjani futhi ukwelashwa kunqunywa ngokusekelwe ekuhlanganisweni kwalokhu.
| Uhlobo lomdlavuza (kuye ngokuthi impendulo ithini) | Incazelo kanye nohlelo lokwelashwa olujwayelekile |
|---|---|
| I-HR-positive, i-HER2-negative | Kuzwela kuma-hormone, kodwa akuzweli ku-HER2. Ukwelashwa ngama-hormone kusebenza kahle. Ukunquma ukuthi i-chemotherapy iyadingeka noma cha kuyinkimbinkimbi. Isimo sokunqamuka kokuya esikhathini sibaluleke kakhulu lapha. |
| I-HR-positive, i-HER2-positive | Izwela kokubili kuma-hormone kanye ne-HER2. Inhlanganisela yokwelashwa ngama-hormone kanye nokwelashwa okuqondiswe ku-HER2 ingaletha imiphumela emihle. Ukwelashwa ngamakhemikhali okunamandla ngokuvamile kungagwenywa. |
| I-HR-negative, i-HER2-positive | Akuzweli kuma-hormone, kodwa kuzwela ku-HER2. Ukwelashwa ngamakhemikhali kuyadingeka kanye nokwelashwa okuqondiswe ku-HER2. |
| Okubi Kathathu | Zombili ama-hormone receptors kanye ne-HER2 receptor azikho, zontathu. Ngakho-ke, ukwelashwa ngama-hormone noma ukwelashwa okuqondiswe ku-HER2 akusebenzanga. Ukwelashwa ngamakhemikhali ngokuvamile kuyadingeka kakhulu. |
Iyini i-Oncotype Dx test?
Uma umdlavuza wakho une-HR-positive, i-HER2-negative, okungukuthi, uhlobo lokuqala kuthebula elingenhla, umbuzo othi "Ingabe ngidinga i-chemo?" unzima ukuwuphendula. Kusezimweni ezinjengalezi lapho odokotela basebenzisa khona ukuhlolwa kwe-genomic njenge -`Oncotype Dx` .
Lokhu kuhlolwa kuhlaziya izakhi zofuzo ezingu-21 kusampula encane yomdlavuza wakho. Ngokusekelwe kulokhu, kukunikeza amaphuzu abonisa ukuthi umdlavuza wakho usengozini ephansi, ephakathi, noma ephezulu yokuphinda ubuye esikhathini esizayo.
- Amaphuzu aphansi: Ngokuvamile ungalulama ngaphandle kwe-chemotherapy .
- Uma amaphuzu ephezulu: Ukwelashwa ngamakhemikhali (Chemotherapy) kufaneleka kakhulu.
Kodwa abantu abaningi bathola amaphuzu aphakathi nendawo . Yilapho inkinga iphinda ivele khona.
Izimpendulo ezivela ocwaningweni olusha
Ngenhlanhla, izifundo ezimbili ezinkulu zakamuva, i-TAILORx kanye ne-RxPONDER, zinikeze izimpendulo ezinhle kakhulu embuzweni wokuthi benzeni ngalaba besifazane abanamaphuzu aphakathi. Lezi zifundo ziqinisekisile ukubaluleka kokunqamuka kokuya esikhathini.
- Isivivinyo se-TAILORx (kubantu abanomdlavuza ongakasabalali kuma-lymph node):
- Lolu cwaningo lubonisa ngokusobala ukuthi abesifazane asebedlulile esikhathini sokuya esikhathini abanamaphuzu aphakathi e-Oncotype Dx abatholi nzuzo eyengeziwe nge-chemotherapy. Ukwelashwa ngama-hormone kuphela kwanele kubo.
- Ucwaningo lwe-RxPONDER (lwabantu abanomdlavuza osusakazekele kuma-lymph node):
- Lokhu kubonisa into efanayo. Iningi labesifazane asebedlulile esikhathini sokuya esikhathini , noma ngabe umdlavuza wabo ususakazekele kuma-lymph node, abazuzi kangako nge-chemotherapy.
- Kodwa-ke, indaba ihluke ngokuphelele kwabesifazane abangakayi enkathini yokunqamuka kokuya esikhathini, ikakhulukazi labo abangaphansi kweminyaka engu-50. Uma i-chemotherapy ingezwa ekwelashweni ngama-hormone kubo, ikhono lokuvimbela umdlavuza ukuthi ungabuyi liyanda kakhulu .
Kalula nje, uma ungowesifazane osemusha ongaphambi kokuya esikhathini, i-chemotherapy ingaba yisikhali esinamandla esingasindisa impilo yakho. Kodwa uma usuya esikhathini, ungase ukwazi ukuthola imiphumela engcono ngokwelashwa ngama-hormone ngaphandle kokubhekana nemiphumela yako emibi.
Isinqumo sokugcina nezinto okufanele uzicabangele
Ngakho konke lokhu, cishe uyaqonda ukuthi kunzima kangakanani ukwenza lezi zinqumo wedwa. Yingakho kubaluleke kakhulu ukukhuluma ngokukhululekile ngakho konke lokhu nodokotela wakho.
Uma ungakafiki esikhathini sokuya esikhathini, ikakhulukazi eminyakeni yakho yokuqala engama-40, kukhona okunye okufanele ukukhumbule. Ukwelashwa ngamakhemikhali kungabangela ukuthi ukuya kwakho esikhathini kume unomphela futhi kubangele ukuya esikhathini kusenesikhathi. Kulabo abasebancane, ukuya kwakho esikhathini kungase kume okwesikhashana bese kuqala futhi. Kodwa uma unethemba lokuba nabantwana esikhathini esizayo, qiniseka ukuthi ukhuluma nodokotela wakho mayelana nokulondolozwa kokuzala ngaphambi kokuqala ukwelashwa.
Ekugcineni, wena nodokotela wakho nizonquma ukuthi yikuphi ukwelashwa okukulungele. Phakathi naleyo ngxoxo, uhlobo lomdlavuza wakho, isigaba, amaphuzu e-Oncotype Dx, nokuthi ngabe usuphelile yini ukuya esikhathini konke kuyizihloko ezibalulekile okufanele uxoxe ngazo.
Umlayezo Wokuya Nawe Ekhaya
- Akuwona wonke umdlavuza webele ofanayo, ngakho-ke ukwelashwa okufanayo akufanele wonke umuntu.
- Ukuthi uke wadlula esikhathini sokunqamuka kokuya esikhathini noma cha kuzothinta kakhulu ukwelashwa okutholayo, ikakhulukazi i-chemotherapy kanye nokwelashwa ngama-hormone.
- Ukuhlolwa kwezakhi zofuzo njenge- Oncotype Dx kungasiza abesifazane abanomdlavuza we-HR-positive, i-HER2-negative ukuthi banqume ukuthi i-chemotherapy iyadingeka yini.
- Ucwaningo lwamuva lubonisa ukuthi abesifazane asebekhulile abavame ukuthola izinzuzo ezengeziwe nge-chemotherapy, kodwa ingaba usizo kakhulu kwabesifazane abangakayiqedi ukuya esikhathini.
- Vula futhi uthembeke kudokotela wakho mayelana nohlelo lwakho lokwelashwa. Cacisa ngeminyaka yakho, isimo sakho sokunqamuka kokuya esikhathini, kanye nezinhlelo zakho zesikhathi esizayo (njengokuba nezingane).
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