Igama elithi "umdlavuza" lisesabisa kancane sonke, akunjalo? Kodwa ngokuthuthuka kwesayensi yezokwelapha, kuye kwavela izindlela eziningi ezintsha neziphumelelayo zokulwa nomdlavuza. Namuhla, sizokhuluma ngendlela yokwelapha ephumelelayo okukhulunywa ngayo kakhulu, ikakhulukazi yomdlavuza webele. Lokhu kubizwa ngokuthi i-Targeted Therapy . Ake sibheke ukuthi iyini, isebenza kanjani, nokuthi yini okudingeka uyazi ngayo.
Kalula nje, kuyini i-Targeted Therapy?
Cabanga ngakho, i-chemotherapy, njengoba sivame ukwazi, ibhubhisa amangqamuzana ahlukana ngokushesha. Lokhu kungalimaza hhayi kuphela amangqamuzana omdlavuza kodwa namaseli anempilo emzimbeni wethu. Yingakho i-chemotherapy ivame ukubangela imiphumela emibi njengokulahlekelwa izinwele kanye nesicanucanu.
Kodwa le ndlela yokwelapha ebizwa ngokuthi i-Targeted Therapy ihluke kakhulu kuleyo. Uma sikhuluma iqiniso, lokhu kuyindlela yokwelapha 'ehlakaniphile' kakhulu. Ihlasela futhi ihlasele amangqamuzana omdlavuza kuphela . Le ndlela yokwelapha isebenzisa amasosha omzimba wethu ukubhubhisa amangqamuzana omdlavuza, noma ukuvimba izimpawu zokuthi amangqamuzana omdlavuza adinga ukukhula. Lokhu kubangela umonakalo omncane kakhulu kumaseli anempilo. Inzuzo yalokhu ukuthi imiphumela emibi ivame ukuba mincane kuneye-chemotherapy.
Lokhu kwelashwa kusebenza ngezindlela ezimbili eziyinhloko:
1. Ukusetshenziswa Kwama-Antibody: Lawa ma-antibodies akhiqizwa ngamaseli akhethekile ohlelweni lokuzivikela lomzimba wethu. Lawa ma-antibodies enziwa ngokwenziwa elabhorethri futhi anikezwa umzimba njengomuthi. Lawa anamathela kumaseli omdlavuza futhi awavimbe ekukhuleni noma ekubhubhiseni.
2. Imithi yama-molecule amancane: Le yimithi engasetshenziswa njengamaphilisi. Isebenza ngokuvimba izindlela zokudlulisela izimpawu ngaphakathi kwamaseli omdlavuza ezisiza ukuthi ahlukane futhi akhule.
Udokotela wakho uzonquma ukuthi yiluphi uhlobo lokwelashwa oluqondiwe olufanele wena ngokusekelwe ohlotsheni oluqondile lomdlavuza webele onalo.
Umdlavuza Webele One-HER2-Positive kanye Nokwelashwa Kwawo
Cishe abantu abangu-20% abanomdlavuza webele, noma cishe oyedwa kwabahlanu, banesici ku-gene ebizwa ngokuthi i-'HER2'. Lesi sici sibangela ukuthi i-gene yenze amakhophi amaningi kakhulu. Uma kuneprotheni ye-'HER2' eningi kakhulu kumaseli omdlavuza, sibiza lowo mdlavuza ngokuthi "umdlavuza webele one-HER2."
Uma umdlavuza wakho 'une-HER2-positive', kunezindlela zokwelapha eziqondile nezisebenza kahle kakhulu eziqondiswe kuwo.
- I-Trastuzumab :Lona ukwelashwa okuyinhloko okuqondiswe kukho komdlavuza we-'HER2-positive'. Lo muthi utholakala ngaphansi kwamagama ahlukahlukene emikhiqizo njenge-'Herceptin', `Kanjinti', `Ogivri'. Ungumjovo ofakwa emthanjeni. Kukholakala ukuthi ulawula umdlavuza ngezindlela ezintathu eziyinhloko:
- Amaseli omdlavuza anamathela phezulu futhi awavimbeli ukukhula.
- Kusiza amasosha omzimba wethu ukuba abhubhise amangqamuzana omdlavuza ngokuwatshela ukuthi asebenze.
- Uma kunikezwa nge-chemotherapy, kwandisa impumelelo yalezo zindlela zokwelapha.
- I-Pertuzumab: Lo muthi, ongaphansi kwegama lomkhiqizo elithi `Perjeta`, ungomunye umuthi olwa namagciwane onikezwa umdlavuza we-`HER2-positive`. Uvame ukunikezwa kanye ne-`Trastuzumab` kanye nomuthi we-chemotherapy `docetaxel`. Kodwa-ke, awufanele abesifazane abakhulelwe, njengoba ungalimaza ingane engakazalwa.
- Eminye imithi: `I-Ado-trastuzumab emtansine (Kadcyla), `I-Margetuximab (Margenza), kanye ne-`I-Fam-trastuzumab deruxtecan-nxki (Enhertu)` iyimithi yesimanje enikezwa lolu hlobo lomdlavuza, ikakhulukazi ezimweni lapho umdlavuza ususakazeke khona (uthuthukile) noma lapho ezinye izindlela zokwelapha zehlulekile.
- Amaphilisi: I-Lapatinib (Tykerb) kanye ne-Neratinib (Nerlynx) yimithi eqondiswe kumdlavuza one-HER2 engathathwa njengamaphilisi. Lawa avame ukunikezwa ngemva kokunye ukwelashwa.
Ukwelashwa Komdlavuza Webele Ongemuhle we-HER2
Uma amangqamuzana akho omdlavuza engenalo iphutha lezakhi zofuzo elithi 'HER2' elishiwo ngenhla, okusho ukuthi alikho iphrotheni eliningi kakhulu elithi 'HER2', khona-ke lowo mdlavuza ubizwa ngokuthi "umdlavuza webele ongemuhle we-HER2." Khona-ke uzonikezwa uhlobo oluhlukile lokwelashwa.
Kukhona nemithi ethile yokwelapha eqondiwe yalolu hlobo lomdlavuza.
- Imithi efana ne-'Everolimus (Afinitor), 'Palbociclib (Ibrance),' kanye ne-'Ribociclib (Kisqali)' inikezwa kanye nokwelashwa ngama-hormone. Lokhu ukwelashwa okunikezwa abesifazane, ikakhulukazi ngemva kokunqamuka kokuya esikhathini, abanomdlavuza osusakazeke kakhulu.
- Ama-PARP Inhibitors: Uma umdlavuza wakho ungenayo i-HER2 futhi une-BRCA gene mutation, unganikezwa uhlobo olukhethekile lwemithi ebizwa ngokuthi ama-PARP inhibitors, njenge-Olaparib (Lynparza) kanye ne-Talazoparib (Talzenna). Lezi futhi izindlela zokwelapha eziqondiwe eziqondiswe ngqo kumaseli omdlavuza.
Into ebalulekile ukuthi zonke lezi zindlela zokwelapha zinqunywa yizinga lofuzo kanye neleseli lomdlavuza wakho. Ngakho-ke kubalulekile ukuxoxa ngalokhu ngokucophelela nodokotela wakho bese ukhetha ukwelashwa okukulungele.
Yimiphi imiphumela emibi evamile?
Njengoba kushiwo ngaphambili, yize kunemiphumela emibi embalwa kune-chemotherapy, ukwelashwa okuqondisiwe kusengabangela eminye imiphumela emibi. Lokhu kuyahlukahluka kuye ngemithi. Uma uhlangabezana nanoma yimiphi imiphumela emibi , tshela udokotela wakho ngokushesha . Esikhathini esiningi, ingalawulwa.
| Imiphumela Emibi Evamile |
|---|
| Ukusabela kwe-allergic - ukuqubuka kwesikhumba, ukulunywa. |
| Isicanucanu kanye nesifo sohudo. |
| Umkhuhlane kanye nokubanda. |
| Ubuhlungu bomzimba, ukukhathala, kanye nobuthakathaka. |
| Ukuphefumula okungekuhle nokuvuvukala. |
| Isiyezi . |
Ungasibona kanjani isimo esiphuthumayo?
Uma uhlangabezana nesinye noma ngaphezulu kwalezi zimpawu ezilandelayo, kungaba yisimo esiphuthumayo. Ungalokothi uzishaye indiva. Shayela udokotela wakho ngokushesha. Uma ungakwazi ukumfinyelela, iya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
| Nakisisa lezi zimpawu! | |
|---|---|
| Umkhuhlane: Umkhuhlane ongaphezu kuka-100.4 Fahrenheit (38 Celsius). Uma uba nomkhuhlane ngemva kokubanda, tshela udokotela wakho ngokushesha. | Izinkinga zomlomo: Izilonda ezintsha emlonyeni, amabala amhlophe, ulimi oluvuvukile, noma izinsini eziphuma igazi. |
| Umphimbo obuhlungu: Umuzwa owomile, obuhlungu, oklwebhekayo, noma "ovuvukele" emphinjeni. | Ukukhwehlela: Ukukhwehlela okusha noma okuqhubekayo. |
| Izinkinga zomchamo: Ukuchama njalo, ukutheleleka komgudu womchamo, noma igazi emchameni. | Izinkinga zesisu: Isilungulela esibi kakhulu, isicanucanu, ukuhlanza, ukuqunjelwa, noma isifo sohudo esihlala izinsuku ezingaphezu kwezingu-2-3. |
| Ubunzima bokuphefumula: Ukuphefumula kanzima ngisho noma uzikhandla kancane. | Ukopha okungajwayelekile: Igazi esitulweni. |
| Ukuvuvukala: Ukuvuvukala emilenzeni noma endaweni yeqakala. | Ukukhathala okukhulu: Ukuzizwa ukhathele kangangokuthi awukwazi ukwenza lutho. |
Umlayezo Wokuya Nawe Ekhaya
- I-Targeted Therapy iyindlela yokwelapha yesimanje ehlasela ngqo amangqamuzana omdlavuza webele, ehlukile kumakhemikhali avamile.
- Uhlobo lokwelashwa olutholayo luzoncika ohlotsheni lomdlavuza onalo (isib., ukuthi `une-HER2` noma `une-HER2`). Ukuhlolwa okukhethekile kwenziwa ukuze kutholakale lokhu.
- Lokhu kwelashwa kungaba nemiphumela emibi, ngakho-ke vula umlomo nodokotela wakho nganoma yiziphi izinguquko noma ukungakhululeki okuzwayo.
- Hlala uqaphile izimpawu eziphuthumayo ezifana nomkhuhlane ophakeme, ubunzima bokuphefumula, kanye nokuvuvukala okungavamile. Uma ubona noma yikuphi kwalokhu, funa iseluleko sezokwelapha ngokushesha.
- Ukwelashwa komdlavuza kuwuhambo. Udokotela wakho kanye nethimba lezempilo bangabangane bakho abangcono kakhulu kulolu hambo. Ngakho-ke bathembe futhi usebenzisane nabo.
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