Uma sizwa igama elithi umdlavuza webele, abaningi bethu bayesaba. Kodwa into ebaluleke kakhulu okudingeka siyiqonde ukuthi akuzona zonke izinhlobo zomdlavuza webele ezifanayo. Kunezinhlobo ezahlukene zazo. Olunye uhlobo oluvame kakhulu yi-'estrogen receptor positive' noma njengoba silubiza ngokwezokwelapha , i-ER+ (Estrogen-Receptor-Positive) umdlavuza webele . Eqinisweni, u-80% kuphela womdlavuza webele otholakale ungowalolu hlobo. Ngakho-ke namuhla sizokhuluma ngeklasi elisha, eliphumelelayo lemithi etholakale yokwelapha lezi zinhlobo zomdlavuza webele ze-ER+.
Okokuqala, ake sibone, uyini umdlavuza webele we-ER+?
Kalula nje, i-hormone i-estrogen emizimbeni yethu isiza lawa maseli omdlavuza ukuba akhule. Cabanga ukuthi lawa maseli omdlavuza ane-'locks' ekhethekile (ama-receptor) ebusweni bawo lapho i-hormone ye-estrogen inganamathela khona. Lapho 'ukhiye' obizwa ngokuthi i-hormone ye-estrogen ungena kulo 'lock', amangqamuzana omdlavuza athola 'isignali' yokwahlukana nokukhula.
Yingakho odokotela bevame ukunikeza ukwelashwa ngama-hormone ukwelapha umdlavuza we-ER+. Lokhu kwelashwa kuvimbela 'ukhiye' (i-estrogen) ekubophezeleni 'kukhiye' (ama-receptor). Kodwa ngezinye izikhathi, ikakhulukazi uma umdlavuza ususakazeke emzimbeni wonke (othuthukile noma osakazekile), lawa maseli omdlavuza aba nobuqili kakhulu. Aba ukumelana nalezi zindlela zokwelapha ngama-hormone, okusho ukuthi awasabeli kahle ekwelashweni. Yilapho sidinga khona ukwelashwa okusha, okusebenzayo kakhudlwana.
'Ushintsho lokukhula' kwamaseli omdlavuza - izakhi zofuzo ze-PI3K kanye ne-PIK3CA
Njengoba odokotela nososayensi babefuna izimbangela zale mithi yomdlavuza engamelani nama-hormone, bathole okuthile okukhethekile: isici endleleni ye-PI3K (Phosphatidylinositol-3-Kinase) , uhlelo oluyisihluthulelo lokubonisa olulawula ukukhula, ukuhlukana, kanye nokusinda kwamaseli emzimbeni wethu.
Cabanga ngale ndlela ye-PI3K njenge-'switchboard' enkulu esitokisini. Ilawula izinqumo mayelana nokuthi iseli kufanele likhule noma lihlukane. Elinye lamajini ayinhloko alawula le switchboard yi -PIK3CA gene .
Kwabanye abaguli abanomdlavuza, lesi sakhi sofuzo se-PIK3CA sinoguquko , okusho ushintsho noma iphutha. Kufana nokuthi iswishi 'yokukhula' ebhodini lokushintsha i-switchboard inamathele futhi ihlala 'ivuliwe'. Ngemuva kwalokho amaseli aqala ukuhlukana nokukhula ngokungalawuleki. Lesi yimbangela eyinhloko yomdlavuza. Ucwaningo luthole ukuthi cishe ama-40% eziguli ezinomdlavuza webele we-ER+ zinaloluguquko lwezakhi zofuzo lwe-PIK3CA.
Ngakho-ke ziyini lezi zithiyo ze-PI3K?
Lapha, njengesixazululo sale nkinga, kuqaliswa uhlobo lwemithi ebizwa ngokuthi ama-PI3K inhibitors . Into elula kakhulu eyenziwa yile mithi ukuvala kahle 'i-growth switch' (indlela ye-PI3K) engikhulume ngayo ekuqaleni enamathele 'kuyo'.
Kalula nje, le mithi ifana nochwepheshe kagesi. Uyangena alungise lelo bhodi lokushintsha elisebenza ngokujikeleza okufushane, amise ugesi ongadingekile. Ngendlela efanayo, ama-PI3K Inhibitors avimba isignali yokukhula engadingekile eya kumaseli omdlavuza, okubangela ukuba amaseli omdlavuza afe futhi kusize amathumba anciphe.
Lokhu kuvame ukuza ngesimo semithi yomlomo. Ngokuvamile, lo muthi unikezwa iziguli kanye nokwelashwa kwama-hormone okukhulunywe ngakho ngaphambilini (i-estrogen blocker).
Ngingazi kanjani ukuthi lokhu kwelashwa kulungile kimi?
Lona umbuzo obaluleke kakhulu. Ama-PI3K Inhibitors awanikezwa bonke abantu abanomdlavuza webele . Aklanyelwe ngqo ukuthi:
- Kwabesifazane asebekhulile kanye neziguli zesilisa.
- Umdlavuza kumele ube yi-HR+ (i-Hormone-Receptor-Positive) kanye ne -HER2-Negative .
- Into ebaluleke kakhulu: Amaseli omdlavuza kumele abe nokuguqulwa kwezakhi zofuzo ze -PIK3CA .
Ukuze athole ukuthi umdlavuza wakho unalolu shintsho lwezakhi zofuzo, udokotela wakho uzokwenza ukuhlolwa okukhethekile. Lokhu kuvame ukuhilela isampula yegazi noma ingxenye encane yezicubu (i-biopsy) ethathwe esigaxeni. Imiphumela yalolo vivinyo izonquma ukuthi lokhu kwelashwa kulungile yini kuwe.
| Ukufaneleka kokwelashwa | Incazelo |
|---|---|
| Uhlobo lomdlavuza | Kumelwe kube umdlavuza webele othuthukile wohlobo lwe-HR+ (i-hormone receptor positive) kanye nohlobo lwe-HER2- (HER2 negative). |
| Ukuguqulwa kwezakhi zofuzo | Ukuguqulwa kwezakhi zofuzo ze-PIK3CA kumele kube khona. Lokhu kuqinisekiswa ukuhlolwa okukhethekile. |
| Isiguli | Ngokuvamile kunconywa kwabesifazane asebekhulile kanye neziguli zesilisa. |
Yimiphi imiphumela emibi engabangwa yile mithi?
Njenganoma yikuphi ukwelashwa komdlavuza, ama-PI3K inhibitors angabangela imiphumela emibi ethile. Kodwa-ke, lokhu akwenzeki kuwo wonke umuntu ngendlela efanayo. Futhi, manje kunezindlela zokuphatha le miphumela emibi.
Eminye yemiphumela emibi evame kakhulu yile:
- Isicanucanu nokuhlanza
- Ukulahlekelwa yisifiso sokudla kanye nokwehla kwesisindo
- Izilonda zomlomo
- Ukulahlekelwa izinwele
- Noma yimiphi imiphumela ekusebenzeni kwezinso, isibindi, noma i-pancreas
- Ukuqubuka kwesikhumba, ngezinye izikhathi okukhulu, kungavela, okubangela ukuba isikhumba siqhekeke noma siqhume.
- Ushukela Ophezulu Egazini: Lona umphumela ovamile ophathelene nalolu hlobo lwemithi, njengoba indlela ye-PI3K ihilelekile ekugayweni koshukela emzimbeni wethu.
Ungakhathazeki ngale miphumela emibi. Udokotela wakho uzokuxilonga njalo ngale miphumela emibi. Uma kudingeka, uzonciphisa umthamo womuthi, ayeke ukuwuthatha isikhashana (iholide lemithi), noma akunike omunye umuthi wokulawula imiphumela emibi. Ungalokothi uyeke ukuthatha umuthi wakho noma ushintshe umthamo ngaphandle kokubuza udokotela wakho.
Ucwaningo lukhombisile ukuthi ukuthatha imithi yesifo sikashukela ukulawula amazinga kashukela egazini noma ukulandela ukudla okunama-carbohydrate aphansi, okunamafutha amaningi ( ukudla kwe-ketogenic ) kungandisa ukusebenza kahle kwalomuthi. Kodwa-ke, kubalulekile ukukhuluma nodokotela wakho ngaphambi kokwenza noma yiziphi izinguquko ekudleni.
Ingabe lokhu kwelashwa kuyasebenza ngempela?
Yebo. Lena yinto ebaluleke kakhulu. Izivivinyo eziningi zemitholampilo zikhombisile ukuthi iziguli ezinomdlavuza webele we-ER+ ezine-PIK3CA mutation zingazuza ku-PI3K inhibitor ngokuhlanganiswa nokwelashwa ngama-hormone.
Ucwaningo olukhulu olulodwa luthole ukuthi iziguli ezathola le nhlanganisela yemithi zazinokuphila okungenakho ukuqhubeka kwesifo cishe izinyanga eziyi-11. Lokhu kwakungaphansi kwezinyanga eziyi-6 ezigulini ezinezakhi zofuzo ezifanayo ezingazange zithole ama-PI3K inhibitors. Lolu ushintsho olukhulu kanye nethemba elikhulu. Ngenxa yale mpumelelo, imithi emisha kulesi sigaba semithi manje iyathuthukiswa.
Umlayezo Wokuya Nawe Ekhaya
- Akuwona wonke umdlavuza webele ofanayo. Ukwazi uhlobo oluthile lomdlavuza wakho (isib. i-ER+, i-HER2-, i-PIK3CA mutation) kubalulekile ukukhetha ukwelashwa okufanele kakhulu nokuphumelela kakhulu.
- Ama-PI3K Inhibitors ayindlela yokwelapha yesimanje, eqondiwe yomdlavuza webele enezinguquko zezakhi zofuzo ze-ER+ kanye ne-PIK3CA.
- Lokhu kwelashwa akulona okwawo wonke umuntu. Udokotela wakho uzonquma ukuthi kulungile yini kuwe ngemva kokuhlolwa okukhethekile.
- Le mithi ingabangela imiphumela emibi, ikakhulukazi amazinga aphezulu kashukela egazini, kodwa udokotela wakho angakusiza ukuyilawula nokuyilawula.
- Ukuba nolwazi oluphelele ngohlelo lwakho lokwelashwa nokukhuluma ngokukhululekile nodokotela wakho kuzokunika amandla nokulawula kulolu hambo. Ungakhathazeki, ezokwelapha zesimanje ziyathuthuka usuku nosuku.
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