Ingabe udokotela wakho ukutshelile ngohlobo lomuthi obizwa ngokuthi ama-SERM noma ama-SERD okwelapha umdlavuza webele? Ungakhathazeki, la magama angase azwakale eyinkimbinkimbi kancane. Namuhla, sizokhuluma ngamagama alula ngokuthi ayini, ukuthi asebenza kanjani, nokuthi yini okudingeka uyazi ngawo. Lezi yizinhlobo ezimbili ezibaluleke kakhulu zemithi ezingasisiza ekulweni nomdlavuza webele .
Ayini ama-SERM? Asebenza kanjani?
Kalula nje, ama-SERM (Selective Estrogen Receptor Modulators) uhlobo lomuthi ovimba ukukhula kwamaseli omdlavuza webele. Kodwa-ke, asebenza kuphela ohlotsheni oluthile lomdlavuza. Lolo uhlobo lomdlavuza olwaziwa ngokuthi yi -Estrogen Receptor-Positive . Ama-75% kuphela omdlavuza webele obonwa ezweni lethu angowalolu hlobo.
Cabanga nje, la maseli omdlavuza ane-"antenna" encane ebusweni bawo. Kwezokwelapha, siwabiza lawa ma-receptor ngokuthi. Lapho i-hormone i-estrogen emzimbeni wethu inamathela kula ma-antenna, iseli lomdlavuza lithola isignali yokuthi "lihlukane futhi likhule kakhulu."
Yilokhu okwenziwa yi-SERM :
Bayahamba bavimbe lawo ma-antenna, okungukuthi, ama-receptor. Bese i-hormone ye-estrogen ayinandawo yokuzihlanganisa. Ngenxa yokuthi ayitholi isignali, ukukhula kwamangqamuzana omdlavuza kuyama noma kulawulwa kakhulu.
Into ebalulekile ukuthi, ibizwa ngokuthi 'ikhethayo' ngesizathu esithile. Nakuba le mithi ivimba ukusebenza kwe-estrogen emabeleni, ivumela i-hormone ukuthi isebenze kahle kwezinye izingxenye zomzimba, njengamathambo nesibeletho. Yilokho okuyenza ibe ekhethekile.
Izinhlobo zama-SERM kanye nokusetshenziswa kwawo
Kunezinhlobo eziningana eziyinhloko zama-SERM avunyelwe umdlavuza webele .
| Igama lomuthi | Amacala okusetshenziswa ayinhloko |
|---|---|
| I-Tamoxifen |
|
| I-Toremifene | |
| I-Raloxifene |
Ngakho-ke ayini ama-SERD?
Ama-SERD (Selective Estrogen Receptor Downregulators) uhlobo lomuthi osebenza ngamandla kakhulu kune-SERM. Njengama-SERM, nawo avimba ama-estrogen receptors. Kodwa ngaphezu kwalokho, ama-SERD anciphisa inani lama-receptor (anciphisa) futhi ashintsha nomsebenzi wama-receptor asele, okwenza angasebenzi kahle.
Okwamanje kunezinhlobo ezimbili zama-SERD avunyiwe:
- I-Fulvestrant
- I-Elastrant
Lokhu kunikezwa ikakhulukazi kumdlavuza webele othuthukile, one-hormone receptor kanye ne -HER2-negative . I-HER2-negative isho ukuthi amangqamuzana omdlavuza awanawo iphrotheni ebizwa ngokuthi i-HER2 ebusweni bawo ewasiza ukuba akhule.
Ungayisebenzisa kanjani le mithi?
- Ama-SERM: Iningi lalawa liza ngesimo samaphilisi . Udokotela wakho uzokutshela ukuthi uthathe ama-20mg kuya ku-40mg ngosuku. Uma uthatha le mithi ukuvimbela umdlavuza ukuthi ungabuyi, kuzodingeka uqhubeke uyithatha iminyaka emi-5 kuya kweyishumi.
- Ama-SERD: Isibonelo, i-Fulvestrant iza njengomjovo.Okwesibili. Le mijovo emibili ifakwa emsipheni osesinqeni. Inikezwa kathathu ngenyanga yokuqala yokwelashwa bese kuba kanye ngenyanga ngemva kwalokho.
Kukuziphi izimo lapho ama-SERM nama-SERD anikezwa khona?
Kunezimo eziningana lapho udokotela wakho angase akunike khona lezi zindlela zokwelapha.
| Ithuba | Incazelo |
|---|---|
| Ngaphambi kokuhlinzwa (Ukwelashwa Nge-Neoadjuvant) | Uma isimila sakho sikhulu, lo muthi unganikezwa ngaphambi kokuhlinzwa ukuze usinciphise futhi kube lula ukusisusa. |
| Ngemva kokuhlinzwa (Ukwelashwa Okungeziwe) | Lokhu kwelashwa kunikezwa ukubhubhisa noma yimaphi amangqamuzana amancane omdlavuza angase asale ngemva kokuhlinzwa nokuvimbela umdlavuza ukuthi ungabuyi. |
| Ngomdlavuza Wesigaba Sokugcina | Uma umdlavuza ususakazekele kwezinye izingxenye zomzimba ngaphandle kwebele, le mithi ingasiza ekulawuleni noma ekubambezeleni ukukhula kwawo. |
| Ukuvimbela | Ngisho noma ungakaze ube nomdlavuza webele, uma ingozi yakho yokuba nawo iphakeme kunesilinganiso ngenxa yezici ezifana nezakhi zofuzo, ama-SERM angase anikezwe ukunciphisa leyo ngozi. |
Yimiphi imiphumela emibi kanye nezingozi zalokhu kwelashwa?
Njenganoma yimuphi umuthi, lokhu kungaba nemiphumela emibi. Kodwa akuwona wonke umuntu oyitholayo. Kubalulekile ukuqaphela imiphumela emibi engaba khona.
Imiphumela emibi ye-SERMs
Imiphumela emibi evame ukubonwa ifana naleyo eyenzeka ngesikhathi sokunqamuka kokuya esikhathini.
- Ukushisa okukhulu
- Ukoma kwesitho sangasese sowesifazane, ukuphuma kwegazi, noma ukopha okuncane
- Ukujuluka ebusuku
- Isicanucanu
- Izinguquko zesimo sengqondo
Imiphumela emibi engavamile kodwa emibi kakhulu:
- Ukwanda okuncane kakhulu kwengozi yomdlavuza wesibeletho
- Amahlule egazi emilenzeni (i-Deep Vein Thrombosis, noma i-DVT) noma amahlule egazi emaphashini (i-Pulmonary Embolism)
- Ama-cataract
- Ukuncipha kwamathambo kwabesifazane ngaphambi kokunqamuka kokuya esikhathini
Imiphumela emibi ye-SERDs
- Ubuhlungu besikhashana endaweni yokujova
- Isicanucanu
- Ubuhlungu bamathambo, imisipha, noma amalunga
- Ikhanda elibuhlungu
- Ukusebenza kanzima
- Ukushisa okukhulu
Kubaluleke kakhulu: Ama-SERD anganciphisa inani lama-platelet, okusiza ukujiya kwegazi. Lokhu kungandisa kancane ingozi yokopha. Futhi, yomibili le mithi ayinconywa ngesikhathi sokukhulelwa noma uma uzama ukukhulelwa . Kubalulekile ukusebenzisa uhlobo lokuvimbela inzalo olungeyona i-hormone ngenkathi uthatha le mithi futhi okungenani unyaka ngemuva kokuyeka ukwelashwa.
Uma udokotela wakho ephakamisa lokhu kwelashwa, khuluma naye ngakho. Ungesabi ukubuza imibuzo efana nokuthi, "Yiziphi izinzuzo ezizonginika lo muthi?", "Yimiphi imiphumela emibi engingayilindela?", kanye nokuthi "Ngizodinga isikhathi esingakanani ngithathe lo muthi?"
Umlayezo Wokuya Nawe Ekhaya
- Ama-SERM nama-SERD ayindlela yokwelapha ephumelela kakhulu yomdlavuza webele one-estrogen receptor. Avimba ukusebenza kwe-hormone i-estrogen, ebalulekile ekukhuleni kwamaseli omdlavuza.
- Akuzona zonke lezi mithi ezifanele wonke umuntu. Udokotela wakho kuphela onganquma ukwelashwa okungcono kakhulu kuwe ngokusekelwe ohlotsheni lomdlavuza, iminyaka yakho kanye nempilo yakho.
- Imiphumela emibi ingase ivele, kodwa eminingi yayo iyalawuleka. Khuluma nodokotela wakho nganoma yikuphi ukungakhululeki okutholayo, kungakhathaliseki ukuthi kuncane kangakanani.
- Kubaluleke kakhulu ukugwema ukukhulelwa ngenkathi uthatha lo muthi. Qiniseka ukuthi uthintana nodokotela wakho mayelana nezindlela zokuvimbela inzalo ezifanele.
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