Kunzima ukusho ngamazwi ukwesaba nokukhathazeka esikuzwayo lapho sithola ukuthi sinomdlavuza. Kodwa ngenxa yesayensi yezokwelapha ethuthukisiwe esifikile kithi namuhla, kunezindlela zokwelapha eziphumelela kakhulu zomdlavuza. Ubuwazi, kunezinhlobo ezithile zomdlavuza ezikhula "ngokondla" amakhemikhali emizimba yethu abizwa ngokuthi ama-hormone? Lapho selashwa umdlavuza onjalo, ukulawula ukukhiqizwa kwalawo ma-hormone kubaluleke kakhulu. Namuhla sizokhuluma ngokwelashwa okukhethekile okunjalo. Igama elithi 'Chemical Castration'. Nakuba igama lingase lizwakale lithusa kancane, empeleni lokhu kuyindlela yokwelapha eletha impumuzo ezigulini eziningi zomdlavuza.
Kalula nje, kuyini i-Chemical Castration?
Kulungile, ake sichaze lokhu kalula. 'I-Chemical Castration' ukusetshenziswa kwezidakamizwa noma amakhemikhali ukuvimba ukukhiqizwa kwama-hormone ocansi emizimbeni yethu. Lawa ma-hormone akhishwa egazini yizindlala ezahlukahlukene emizimbeni yethu. Lawa ma-hormone alawula izinto eziningi emizimbeni yethu; izinto ezifana namandla, ukukhula, kanye nemizwa. Ama-hormone ocansi abaluleke kakhulu ezintweni ezifana nokuthomba kanye nempilo yokuzala.
Kodwa-ke, ezinye izinhlobo zomdlavuza, njengomdlavuza wendlala yesinye kanye nezinye izinhlobo zomdlavuza webele, zincike kula ma-hormone ocansi ukuze akhule. Njengoba nje isitshalo sidinga amanzi ukuze sikhule, lawa maseli omdlavuza adinga ama-hormone ukuze akhule. Ngakho-ke, ukwelashwa nge-Chemical Castration kunciphisa inani lala ma-hormone ocansi emzimbeni. Ngemuva kwalokho amangqamuzana omdlavuza alahlekelwa "ukudla" akudingayo, futhi ukukhula kwawo kuyama noma kuyeke.
Kunezinye amagama amaningana asetshenziswa kulokhu kwelashwa. Uma uzwa wona, lokhu kuzocaca kuwe:
- Ukuthenwa Kwezokwelapha
- Ukwelashwa ngama-hormone
- Ukwelashwa Kokucindezeleka/Ukuswela/Ukucindezelwa kwe-Androgen
Wonke la magama asho into efanayo: anciphisa izinga lama-hormone ocansi emzimbeni.
Yiziphi izimo ezisetshenziswayo lokhu kwelashwa?
Odokotela basebenzisa kakhulu lokhu kwelashwa kwezimila ezincike kuma-hormone ocansi, ikakhulukazi:
- Umdlavuza Wendlala Yesitho Sabesilisa: Lo mdlavuza kwabesilisa uvame ukubangelwa yi-testosterone ye-hormone yabesilisa.
- Umdlavuza Webele: Amahomoni abesifazane i-estrogen ne-progesterone anethonya ekukhuleni kwezinye izinhlobo zomdlavuza webele kwabesifazane.
- Umdlavuza Webele Wabesilisa: Nakuba lokhu kungavamile, ukwelashwa ngama-hormone nakho kuyasetshenziswa kulokhu.
Elinye igama elivamile lama-hormone ocansi yi -androgens.Wonke umuntu ukhiqiza ama-androgen, kodwa amadoda akhiqiza amaningi awo. I-Testosterone iyi-androgen enkulu. Le hormone ibalulekile ekukhuleni nasekusebenzeni kwe-prostate gland. Uma kwenzeka umdlavuza, le hormone yiyo eqhuba umdlavuza ukuthi ukhule.
Kwenzekani ngaphambi kokuba ukwelashwa kuqale?
Ngaphambi kokuba udokotela wakho akuncomele ukwelashwa ngama-hormone, kudingeka azi kahle ukuthi uhlobo lwakho lomdlavuza luzosabela kahle yini kulo. Lokhu kuzohilela ukuhlolwa okuningana. Lokhu kuhlolwa kunganquma uhlobo lomdlavuza kanye nesigaba osusakazeke kuso.
Ezinye zezivivinyo ezenziwe ngale njongo yilezi:
- Ukuskena kwe-CT
- Ukuskena kwe-PET
- I-Endoscopy
- I-Biopsy - Ukuthatha isampula encane yamangqamuzana omdlavuza ukuze ihlolwe.
- Ukuhlolwa kwegazi komdlavuza
Kwezinye izimo, ikakhulukazi uma ufuna ukwehlisa amazinga akho e-testosterone unomphela, udokotela wakho angase axoxe ngenqubo yokuhlinzwa ebizwa ngokuthi i-orchiectomy . Lokhu kuhilela ukususa ngokuhlinzwa i-testicle eyodwa noma zombili. Lesi yisisombululo esihlala njalo. Enye indlela ukuhlinzwa ukususa kuphela izicubu ezenza i-testosterone. Kodwa-ke, esikhuluma ngakho lapha ukuthenwa ngamakhemikhali, hhayi ukuhlinzwa. Kuyindlela yokwelapha yesikhashana ngemithi.
Kwenzekani ngesikhathi sokwelashwa?
Lokhu akuyona ukwelashwa okwenziwa kanye kuphela. Lena inqubo eqhubekayo. Ngokuvamile, udokotela wakho uzokunika le mithi njengomjovo noma njengethuluzi elincane elifakwa ngaphansi kwesikhumba sakho (i-implant). Kodwa-ke, eminye imithi iyatholakala futhi njengamaphilisi.
Kuye ngohlobo kanye nomthamo wemithi onikwa yona, kungadingeka ukuthi uphinde lokhu kwelashwa kanye ngenyanga, kanye njalo ezinyangeni ezintathu, noma kanye ngonyaka.
Lapho welapha umdlavuza wendlala, kunezindlela eziningana lo muthi osebenza ngazo:
- Kunciphisa ukukhiqizwa kwama-androgens (ikakhulukazi i-testosterone) avela emasendeni.
- Kuvimba ikhono lama-androgen emzimbeni lokubopha nokusebenza namaseli omdlavuza.
- Kumisa ukukhiqizwa kwama-androgens kwezinye izingxenye zomzimba (hhayi amasende kuphela).
Yimiphi imithi esetshenziswa kulokhu?
Kunezinhlobo eziningana zemithi esetshenziswa umdlavuza wendlala. Ake sibheke kabanzi ngayo.
| Isigaba sezidakamizwa | Indlela esebenza ngayo kalula | Izibonelo (amagama emikhiqizo yemithi) |
|---|---|---|
| Ama-GnRH Agonists | Lokhu kuqala kubangela ukwanda okungazelelwe kwamazinga e-testosterone (ukushaqeka kwe-testosterone). Bese umzimba uqala ukungasinaki isignali yokukhiqiza i-hormone. Ngemva kwezinsuku ezimbalwa, ukukhiqizwa kwe-testosterone cishe kuyeka ngokuphelele. | I-Goserelin (Zoladex®), i-Leuprolide (Lupron®), i-Triptorelin (Trelstar®) |
| Abaphikisi be-GnRH | Lo muthi awukhuphuli amazinga ama-hormone ngokuzumayo njengohlobo lwangaphambilini. Umisa ngqo ukukhiqizwa kwe-testosterone. Ngakho-ke, 'i-Testosterone Flare' ayiveli. | I-Degarelix (i-Firmagon®), i-Relugolix (i-Orgovyx®) |
| Ukwelashwa Okulwa ne-androgen | Esikhundleni sokumisa ukukhiqizwa kwama-hormone, lokhu kuvimbela ama-hormone e-androgen emzimbeni ukuthi angabophani kumaseli omdlavuza. Ngamanye amazwi, kukhona ukhiye, kodwa ilokhi (i-receptor) ehambisana nayo ivinjiwe. | I-Bicalutamide (Casodex®), i-Enzalutamide (Xtandi®), i-Apalutamide (Erleada®) |
| Izithibi Zokwenziwa Kwe-Androgen | Lo muthi uvimba ukukhiqizwa kwama-androgens noma kuphi emzimbeni (amasende, izindlala ze-adrenal, ngisho namaseli omdlavuza). | I-Abiraterone (Zytiga®), i-Ketoconazole (Nizoral®) |
Ingabe le ndlela isetshenziswa nakwesifo somdlavuza webele?
Yebo. Odokotela batusa futhi lokhu kwelashwa ngama-hormone omdlavuza webele okuncike ku-estrogen kanye/noma ku-progesterone. Kusebenza ngokuvimbela ukukhiqizwa kwama-hormone abesifazane noma ukuwavimba ukuthi angasebenzi kumaseli omdlavuza. Kunezinhlobo ezahlukene zemithi yalokhu futhi:
- Imithi efana ne -Tamoxifen isebenza ngokuvimba i-hormone i-estrogen ukuthi inamathele kumaseli omdlavuza.
- Ama-Aromatase inhibitors (isib. i-Anastrozole, i-Letrozole) asebenza ngokuvimbela i-enzyme ekhiqiza i-estrogen emzimbeni.
- Imithi efana neGoserelin neLeuprolide (ephinde isetshenziswe ekwelapheni umdlavuza wendlala) imisa okwesikhashana ama-ovari ukuthi angasebenzi futhi inciphise ukukhiqizwa kwe-estrogen. Lokhu kufana nokunqamuka kokuya esikhathini okwesikhashana.
Yini ongayilindela ngemva kokwelashwa?
Le mithi iqala ukusebenza ngokushesha nje lapho uqala ukuyithatha. Iba nomthelela uma nje uyithatha.
Umphumela oyinhloko ukwehla kwesifiso socansi/i-libido. Impendulo ekushukunyisweni kwengqondo noma ngokomzimba ingancipha. Isibonelo, ukuvama kwemicabango ngocansi kungancipha.
Kodwa into ebaluleke kakhulu lapha inzuzo enkulu yalokhu. Ukuthuthwa kwamakhemikhali akuhlali njalo. Kungaguqulwa.
Ngemva kokuyeka ukwelashwa, umzimba wakho uqala ukukhiqiza ama-hormone futhi. Kanye nalokhu, isifiso sakho socansi sibuyela ezingeni laso langaphambilini. Lena inzuzo enkulu yalokhu ngaphezu kokususwa kwamasende noma ama-ovari ngokuhlinzwa.
Ingabe zikhona izingozi nemiphumela emibi kulokhu kwelashwa?
Njenganoma yimuphi umuthi, ukwelashwa ngama-hormone kungaba nemiphumela emibi. Akuwona wonke umuntu oyithola yonke. Futhi ubukhali bale miphumela buyahlukahluka kuye ngomuntu. Udokotela wakho uzokhuluma nawe ngemiphumela emibi yemithi oyiphuzayo.
Ngokuvamile, nansi eminye imiphumela emibi evamile engenzeka uma uthatha lo muthi isikhathi eside:
- Isifiso esiphansi socansi
- Ukuzwa ukushisa okungazelelwe emzimbeni (Ukushisa okukhulu)
- I-Osteoporosis
- Ukunciphisa isisindo semisipha
- Ukwanda kokufakwa kwamafutha emzimbeni
- Ingozi eyengeziwe yesifo senhliziyo
- Ukucindezeleka noma ukushintshashintsha kwemizwelo
- I-anemia
- Ukuncipha kwezinwele zomzimba
- Izindlala zebele ezincane emadodeni
Ungakhathazeki ngale miphumela emibi. Eminingi yayo ingalawulwa. Isibonelo, udokotela wakho angancoma izithasiselo ze-calcium ne-vitamin D kanye nokuzivocavoca ukuze kusize ekubuthakathakeni kwamathambo. Ngakho-ke kubalulekile ukuvuleleka kudokotela wakho nganoma yikuphi ukungakhululeki okungenzeka ukuthi ubhekene nakho.
Eminye imibuzo evame ukubuzwa
Ingabe lokhu kuyindlela yokwelapha ebuhlungu?
Uma uthatha umuthi njengephilisi, abukho ubuhlungu. Uma uwuthatha njengomjovo, ungase uzizwe ubuhlungu noma ukushisa okuncane lapho unikezwa umjovo. Kodwa ngokuvamile awuhlali isikhathi eside.
Kungenzeka yini ukuba nokuqina ngemva kokwelashwa?
Yebo, ukuvuka kwenkanuko kungenzeka. Kodwa ngenxa yesifiso sobulili esiphansi, kungase kungenzeki kaningi njengakuqala. Futhi uhlobo lokuvuka kwenkanuko lungashintsha.
- Akunamandla njengakuqala
- Ukungakwazi ukunakekela isikhathi eside
- Ukwehla kwemvamisa yokwenzeka
Ingabe i-vasectomy nayo iwuhlobo lokuthenwa?
Cha. Lutho neze. I-vasectomy iwuhlobo lokuvimbela inzalo. Ivimbela kuphela isidoda ukuthi singaphumi endodeni kanye nesidoda. Ayinawo umthelela emazingeni akho ama-hormone, isifiso socansi, noma ukusebenza kocansi.
Into ebaluleke kakhulu ukuthi ukwelashwa komdlavuza kuwuhambo. Kuvamile ukuba nemibuzo, ukukhathazeka, kanye nokwesaba phakathi nalolu hambo. Khuluma ngakho konke lokhu nodokotela wakho. Uma kudingeka, ungafuna nezinsizakalo ezifana nokwelulekwa. Awuwedwa.
Umlayezo Wokuya Nawe Ekhaya
- Ukuthenwa ngamakhemikhali akuyona inqubo yokuhlinzwa. Kuyindlela yokwelapha umdlavuza esebenzisa imithi yokuvimba okwesikhashana ukukhiqizwa kwama-hormone ocansi emzimbeni.
- Lokhu kusetshenziselwa kakhulu umdlavuza we-prostate kanye nezinye izinhlobo zomdlavuza webele.
- Enye yezinzuzo ezinkulu zalokhu kwelashwa ukuthi kuyalungiseka . Uma umuthi usuyekiwe, amazinga ama-hormone abuyela esimweni sawo esijwayelekile.
- Imiphumela emibi efana nokuncipha kwesifiso socansi, ukushisa okukhulu, kanye nobuthakathaka bamathambo kungenzeka, kodwa udokotela wakho angakusiza ukuyilawula.
- Khuluma nodokotela wakho ngokukhululekile nganoma yimiphi imibuzo, ukukhathazeka, noma ukwesaba ongase ube nakho. Ulwazi olunembile kanye nokusekelwa kubaluleke kakhulu phakathi nalolu hambo.
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