Kunzima ukuchaza ukwesaba nokushaqeka okuzwayo lapho uthola ukuthi unomdlavuza webele . Unemibuzo eminingi engqondweni yakho. Kuvamile ukuba nemibuzo efana nokuthi, "Kungani lokhu kwenzeke kimi?", "Ngenzenjani manje?", "Ingabe lokhu kungelapheka?". Kulolu hambo, ngizama ukuchaza izinto kalula nangolimi ongaluqonda. Ukwazi kahle ukuthi hlobo luni lomdlavuza onalo kufana nokuqonda isitha ngaphambi kokuqala impi. Leso isinyathelo sokuqala nesibaluleke kakhulu ekukhetheni ukwelashwa okufanele wena.
Umdlavuza Webele One-Hormone Receptor Positive
Lolu uhlobo lomdlavuza webele oluvame kakhulu. Uma sikhuluma nje, cishe umdlavuza webele ongu-80 kwangu-100 uwela kulesi sigaba.
Ngakho-ke kusho ukuthini lokhu "kuxhomeke kuma-hormone"?
Cabanga nje ngakho. Imizimba yethu, ikakhulukazi imizimba yabesifazane, inama-hormone amabili avela ngokwemvelo abizwa ngokuthi i-estrogen ne -progesterone . Lawa abalulekile ezinqubweni ezijwayelekile emizimbeni yethu. Kodwa-ke, amanye amangqamuzana omdlavuza "alutha" kakhulu la ma-hormone. Okusho ukuthi, ebusweni bala maseli omdlavuza, kukhona "ama-receptor" amancane noma iminyango la ma-hormone angafika futhi anamathele kuyo. Lapho i-hormone ye-estrogen ifika futhi ingqongqoza kulowo mnyango, iseli lomdlavuza lithola ukondliwa kuwo bese liqala ukukhula nokuhlukana. Njengalapho unisela isitshalo, sikhula sibe sikhulu.
Uma umbiko wakho wezokwelapha uthi `ER-positive` (Estrogen Receptor-Positive), kusho ukuthi amangqamuzana akho omdlavuza azwela kakhulu ku-hormone estrogen. Uma uthi `PR-positive` (Progesterone Receptor-Positive), kusho ukuthi azwela kakhulu ku-hormone progesterone. Uma uzwela kakhulu kunoma yikuphi kwalokhu, umdlavuza ubizwa ngokuthi umdlavuza one-hormone receptor-positive .
Empeleni lezi yizindaba ezinhle ngandlela thile. Ngoba uma sazi ukuthi umdlavuza usetshenziswa yini ukukhula, singawuvimba lowo mzila futhi silawule umdlavuza. Yilokho okusetshenziswa khona "ukwelashwa ngama-hormone" .
Ukwelashwa ngama-hormone kuvame ukunikezwa ngemva kokuhlinzwa, i-chemotherapy, noma imisebe ukuvimbela umdlavuza ukuthi ungabuyi. Le mithi isebenza ngokuvala "iminyango" yamaseli omdlavuza, noma ngokuvimba umzimba ukuthi ukhiqize i-estrogen.
| Isigaba sokwelashwa | Incazelo elula nezibonelo |
|---|---|
| Ama-SERM (Ama-Selective ER Modulators) | Lokhu kuvimbela i-hormone receptor eseli lomdlavuza, kuvimbele i-hormone ukuthi ingangeni. Izibonelo: Tamoxifen, Toremifene . |
| Ama-SERD (Ama-Selective Estrogen Receptor Degraders) | Lokhu akugcini nje ngokuvimba i-receptor, kodwa futhi kuyayibhubhisa. Izibonelo: I-Fulvestrant (Faslodex), i-Elacestrant (Orserdu) . |
| Ama-Inhibitors e-Aromatase | Lokhu kuvimbela umzimba ekukhiqizeni i-hormone i-estrogen (evame ukunikezwa abesifazane asebekhulile). Izibonelo: i-Anastrozole (Arimidex), i-Letrozole (Femara) . |
| Ama-LHRH Agonists | Lokhu kuvimbela okwesikhashana ama-ovari ekukhiqizeni i-estrogen. Izibonelo: I-Goserelin (Zoladex), i-Leuprolide (Lupron) . |
| Ezinye Izindlela Zokwelapha Eziqondiwe | Eminye imithi ekhulisa impumelelo yokwelashwa ngama-hormone. Izibonelo: I-Palbociclib (Ibrance), I-Ribociclib (Kisqali), I-Alpelisib (Piqray) . |
Umdlavuza Webele One-HER2-Positive
Manje ake sixoxe ngolunye uhlobo. Amanye amangqamuzana omdlavuza webele (cishe ama-20% azo zonke izinhlobo zomdlavuza) akhiqiza iphrotheni ekhethekile kakhulu ebusweni bawo ebizwa ngokuthi i-HER2 (Human Epidermal growth factor Receptor 2) .
Cabanga nge-HER2 njenge-antenna encane etshela iseli lomdlavuza ukuthi "likhule ngokushesha, lihlukane ngokushesha." Iseli elivamile linezimbalwa zalezi zi-antenna. Kodwa iseli lomdlavuza eline-HER2-positive linazo eziningi zalezi zi-antenna. Yingakho lezi zinhlobo zomdlavuza zingaba nolaka kakhulu .
Kodwa kukhona nezindaba ezinhle lapha. Ngokuthuthuka kwesayensi, manje sekukhona " izindlela zokwelapha eziqondiwe" eziqondisa futhi zibhubhise la ma-antenna e-HER2. Ngenxa yokuthi lawa athola futhi ahlasele kuphela amangqamuzana ane-HER2 eningi kakhulu, kunomonakalo omncane kumaseli avamile.
Umuthi oyinhloko nosebenza kahle kakhulu onikezwayo ngalokhu yiTrastuzumab (Herceptin) . Lokhu kusiza kakhulu ekuvimbeleni umdlavuza ukuthi ungabuyi. Kodwa-ke, kunengozi encane yemiphumela ethile enhliziyweni noma emaphashini lapho uthatha lo muthi. Ungakhathazeki ngalokho , udokotela wakho uzohlala ekuhlola.
| Ezinye izindlela zokwelapha eziqondiwe ezisetshenziselwa umdlavuza we-HER2-positive | |
|---|---|
| I-Pertuzumab (i-Perjeta) | I-Ado-trastuzumab emtansine (Kadcyla) |
| I-Lapatinib (Tykerb) | I-Neratinib (i-Nerlynx) |
| I-Tucatinib (i-Tukysa) | I-Enhertu (Fam-trastuzumab deruxtecan-nxki) |
Umdlavuza Webele "Onemiphumela Emithathu Engalungile"
Lolu uhlobo lwesithathu oluyinhloko. Cishe u-10%-20% womdlavuza webele uwela kulolu hlobo. Uyazi ukuthi kungani ubizwa ngokuthi "unegative kathathu" noma "unegative kathathu"?
Ngoba kula maseli omdlavuza ,
1. Ayikho i-estrogen receptor (ETU) .
2. Akukho receptor ye-progesterone (PR).
3. Akukho protein eningi ye-HER2 .
Ngenxa yokuthi la maseli omdlavuza awanazo izinhloso ezintathu eziyinhloko esixoxe ngazo ngaphambili, ukwelashwa ngama-hormone noma izindlela zokwelapha eziqondiswe ku-HER2 njenge-Herceptin azisebenzi kuwo. Ngakho-ke ukuwelapha kungaba nzima kancane.
Lolu hlobo lomdlavuza luvame ukubangelwa yi-BRCA1.Kuhlotshaniswa nokuguquka kwezakhi zofuzo okubizwa ngokuthi i-. Ngakho-ke uma unomdlavuza one-triple-negative, udokotela wakho angase aphakamise nokuhlolwa kwezakhi zofuzo.
Lolu hlobo lwelashwa kakhulu ngokuhlinzwa, ngamakhemikhali nangemisebe . Kodwa-ke, manje sekukhona izindlela ezintsha zokwelapha eziqondene ngqo nalolu hlobo.
- Ama-PARP Inhibitors: Izidakamizwa ezifana ne -Olaparib (Lynparza) kanye ne-Talazoparib (Talzenna) zisetshenziselwa abantu abane-BRCA gene mutations. Lezi zivimba ikhono lamaseli omdlavuza lokuzilungisa.
- Ukwelashwa Ngezifo Ezingalawuleki: Imithi efana ne -Atezolizumab (Tecentriq) isiza ekulweni namaseli omdlavuza ngokusebenzisa amaseli ethu omzimba.
Konke lokhu kungase kubonakale kuyinkimbinkimbi kancane. Lokho kuvamile. Into ebalulekile ukukhumbula ukuthi kungakhathaliseki ukuthi unesifo somdlavuza esinjani, kunezindlela zokwelapha ezitholakalayo namuhla ezifanele sona. Udokotela wakho kanye nethimba lezokwelapha bazosebenzisana nawe ukuze bakhe uhlelo lokwelashwa olungcono kakhulu kuwe.
Umlayezo Wokuya Nawe Ekhaya
- Umdlavuza webele uhlukaniswe ngezinhlobo ezintathu eziyinhloko: i-Hormone Receptor-Positive, i-HER2-Positive, kanye ne-Triple-Negative .
- Ukwazi ukuthi hlobo luni lomdlavuza onalo kubalulekile ekuhleleni ukwelashwa.
- Umdlavuza one-hormone usabela kahle ekwelashweni ngama-hormone.
- Nakuba umdlavuza one-HER2 ukhula ngokushesha, kunezindlela zokwelapha ezihlosiwe ezisebenza kahle kakhulu ezenzelwe zona ngqo.
- Nakuba ukwelapha umdlavuza onemiphumela emithathu emibi kuyinselele, kungalwiwa nawo nge-chemotherapy kanye nezindlela ezintsha zokwelapha eziqondiwe.
- Uma unemibuzo nganoma yini erekhodini lakho lezokwelapha, ungesabi ukubuza . Cela udokotela wakho incazelo ecacile. Awuwedwa, futhi baningi abantu abangakusiza.
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