Uma umuntu etholakala enomdlavuza webele, uzizwa edabukile kakhulu futhi esaba. Lokho kuyinto evamile. Kodwa ngesayensi yezokwelapha ethuthukisiwe yanamuhla, izinhlobo eziningi zomdlavuza webele zingalawulwa futhi zelapheke. Kodwa-ke, kunezinhlobo ezithile zomdlavuza okunzima kancane ukwelapha kunezinye. Lezi zibizwa ngokuthi "umdlavuza webele okunzima ukwelapha." Abacwaningi bezokwelapha banethemba elikhulu ngalokhu, ngoba ukwelashwa okusha kuthuthukiswa nsuku zonke. Ake sixoxe ngalokhu namuhla.
Kungani kunzima ukwelapha eminye imidlavuza yebele?
Kalula nje, ukwelashwa komdlavuza webele okuphumelele kakhulu kuhlose ukulawula indlela amangqamuzana omdlavuza akhula ngayo. Cabanga ngale ndlela: uma iseli lomdlavuza lifana nomnyango, amahomoni athile namaprotheni afana nezihluthulelo ezivula lowo mnyango. Ukwelashwa kusebenza ngokuvala iminyango (ama-receptor) ukuze la makhiye angasebenzi. Umdlavuza webele uhlukaniswe ngezinhlobo ezintathu eziyinhloko ngokusekelwe ohlotsheni 'lweminyango'.
Manje ake sibone ukuthi ziyini lezi zinhlobo ezintathu.
| Uhlobo lomdlavuza | Incazelo elula |
|---|---|
| Umdlavuza we-hormone receptor positive (HR-positive) | Lawa maseli omdlavuza ane-estrogen receptors (ER) kanye/noma i-progesterone receptors (PR), okwenza asabela kakhudlwana ekwelashweni kwama-hormone. |
| Umdlavuza one-HER2 (HER2-positive) | Lawa maseli anezinga eliphezulu leprotheyini ebizwa ngokuthi i-HER2. Ngakho-ke, angalawulwa ngokwelashwa okuqondiswe ku-HER2 receptor. |
| Umdlavuza Webele Ongemuhle Kathathu (TNBC) | Lolu uhlobo oluyinselele kakhulu. Lawa maseli omdlavuza awanayo i-estrogen receptor, awanayo i-progesterone receptor, futhi awanayo i-HER2 receptor. Lokho kusho ukuthi lawa maseli awanazo lezo 'zicabha' ezintathu engizikhulumile ekuqaleni. |
Phakathi kuka-10% no-20% wabo bonke abantu abanomdlavuza webele banalokhuLuhlobo lomdlavuza webele olubizwa ngokuthi umdlavuza webele one-triple-negative (TNBC). Ukwelashwa ngama-hormone okusetshenziswa ngempumelelo kwezinye izinhlobo zomdlavuza akusebenzi kulolu hlobo lomdlavuza, ngoba alunawo ama-hormone receptors. Futhi, imithi ehlasela i-HER2 ayisizi.
Ngaphezu kwalokho, umdlavuza we-TNBC unamandla kakhulu kunezinye izinhlobo. Lokhu kusho ukuthi umdlavuza cishe ususakazekele kwezinye izingxenye zomzimba ngesikhathi utholakala unawo. Uziphatha ngendlela ehlukile kumuntu ngamunye, futhi ungashintsha ngokuhamba kwesikhathi ukuze umelane nemithi ethile.
Ukuguquka kwezakhi zofuzo kukuthinta kanjani lokhu?
Enye yezindlela ezinhle kakhulu zokuthola umdlavuza njenge-TNBC kusenesikhathi ukuhlonza labo abasengozini enkulu. Ukuze benze lokhu, abacwaningi bafunda izinguquko zofuzo (ukuguqulwa kwezakhi zofuzo) ezidluliselwa ezizukulwaneni ngezizukulwane futhi ezihlotshaniswa nomdlavuza webele.
- I-BRCA1 (i-gene 1 yomdlavuza webele )
- I-BRCA2 (Ufuzo Lomdlavuza Webele 2)
Uma uzuze uguquko kwelinye lala ma-gene amabili, usengozini enkulu yokuba nomdlavuza webele kanye nowesibeletho. Uma unalolu guquko, unamathuba amaningi okuthola umdlavuza usemncane.
Iningi lomdlavuza webele one-BRCA1 gene mutation liyi -triple-negative . Ngakho-ke, ukuqonda leli gene kungasiza ekutholeni izindlela ezingcono zokwelapha i-TNBC.
Abanye odokotela batusa ukuthi wonke umuntu one-TNBC ahlolwe izakhi zofuzo ezihlobene nomdlavuza, okuhlanganisa i-BRCA1 ne-BRCA2. Uma utholakale une-TNBC ngaphambi kweminyaka engama-60, noma uma othile emndenini wakho eke waba ne-TNBC, udokotela wakho angase akuncome lokhu kuhlolwa kwezakhi zofuzo. Lokhu kungakusiza wena nodokotela wakho ukuthi nikhethe ukwelashwa okusebenzayo kakhulu kini.
Yini okudingeka uyazi ngomdlavuza webele osakazeke kakhulu?
Olunye uhlobo lomdlavuza okunzima ukuwelapha umdlavuza webele osusabalele ezingxenyeni ezikude zomzimba. Lokhu kubizwa ngokuthi umdlavuza webele osabalele . Ungasabalala kwezinye izingxenye zomzimba, njengamathambo, ubuchopho, isibindi, noma amaphaphu. Ngezinye izikhathi umdlavuza utholakala uma ususabalele ngale ndlela. Kodwa kaningi, umdlavuza ubuya futhi usabalale ngemva kokwelashwa kokuqala, ngezinye izikhathi eminyakeni kamuva.
Umdlavuza wakho webeleUma umdlavuza ususakazekele ezindaweni ezikude, umgomo oyinhloko wokwelashwa ukulawula umdlavuza. Ukwelashwa okuhlelekile kuyindlela yokwelapha evame kakhulu kulokhu. Udokotela wakho uzonquma ukwelashwa kwakho ngokusekelwe ezimpawini zakho, ukwelashwa kwangaphambilini, lapho umdlavuza ususakazeke khona, kanye nohlobo lwamaseli omdlavuza.
Yiziphi izindlela zokwelapha zakamuva zalokhu?
Ukwelashwa kwe-TNBC, umdlavuza webele osabalele kanye nomdlavuza webele ophindaphindayo, kuye kwathuthuka kakhulu eminyakeni yamuva nje. Ukwelashwa ngamakhemikhali kuyindlela eyinhloko yokwelapha lokhu. Odokotela manje bakunikeza lokhu kuhlanganiswe neminye imithi.
Nazi ezinye izindlela ezintsha zokwelapha:
Izithibi ze-PARP
Lezi uhlobo lomuthi obhubhisa i-DNA yamaseli omdlavuza kubantu abane- BRCA gene mutations kanye ne-HER2-negative kanye ne-metastatic cancer. Izibonelo zifaka phakathi i-`olaparib (Lynparza)` kanye ne-`talazoparib (Talzenna).` Lezi zibonise nemiphumela emihle ye-TNBC yesigaba sokuqala.
Ukwelashwa nge-immunotherapy
Lezi zindlela zokwelapha zivuselela amasosha omzimba ukuze abhubhise amangqamuzana omdlavuza. I-Pembrolizumab (Keytruda) ingenye yemithi enjalo. Ngokuvamile inikezwa kanye ne-chemotherapy.
Ama-ADC ahlanganisa izidakamizwa ezilwa nomzimba (ama-ADC)
Lobu ubuchwepheshe obuthakazelisa kakhulu. Cabanga ngakho njengohlelo lwe-GPS oluqondisa umuthi esivivinyweni sawo. Ama-antibodies akule mithi athola amangqamuzana omdlavuza, anamathele kuwo, futhi abhubhise amangqamuzana omdlavuza ngomuthi onamathiselwe, ngaphandle kokulimaza amangqamuzana anempilo. I-`Sacituzumab govitecan (Trodelvy)` umuthi we-ADC ovunyelwe i-TNBC ethuthukisiwe.
Izindlela zokwelapha ezengeziwe
Kunemithi emisha eminingana enikezwa kanye nokwelashwa ngama-hormone omdlavuza wama-hormone receptor (HR-positive). I-Abemaciclib (Verzenio) ingenye yemithi enjalo.
Ayini amathemba esikhathi esizayo kulokhu?
Abacwaningi basebenza njalo ukwandisa izinketho zokwelapha lezi zomdlavuza, okuhlanganisa nokuthola amakhemikhali amasha e-immunotherapy kanye nokuhlonza izimpawu ezingabikezela imiphumela yokwelashwa.
Baphenya nokuthi imithi evunyelwe ezinye izifo izoba usizo yini ku-TNBC. Baphenya nezindlela zokusebenzisa imithi efana ne-PARP inhibitors kabanzi. Ezinye izifundo zizama nokusebenzisa ama-nanoparticles awusizo emzimbeni ukubulala amangqamuzana omdlavuza amelana nemithi.
Ngakho-ke, nakuba ukuphila nalolu hlobo lomdlavuza kungaba yinselele, kunethemba lokwelashwa okusha. Into ebaluleke kakhulu ukukhuluma nodokotela wakho njalo bese unquma uhlelo lokwelashwa olufanele wena.
Umlayezo Wokuya Nawe Ekhaya
- Eminye imidlavuza yebele, ikakhulukazi i-Triple-Negative Breast Cancer (TNBC) , kunzima ukuyiphatha ngoba ayinazo izitho zokwamukela ama-hormone noma iphrotheni ye-HER2.
- Ukuguqulwa kwezakhi zofuzo, njenge -BRCA1 kanye ne -BRCA2 , kubalulekile ekunqumeni ubungozi bakho be-TNBC kanye nokwelashwa kwakho. Uma une-TNBC, khuluma nodokotela wakho mayelana nokuhlolwa kwezakhi zofuzo.
- Umgomo wokwelapha umdlavuza osabalele ukulawula lesi sifo.
- Izindlela zokwelapha zesimanje ezifana ne-PARP inhibitors, i-immunotherapy, kanye ne-antibody-drug conjugates (ama-ADC) manje zinikeza ithemba elikhulu ngisho nangomdlavuza okunzima ukuwelapha.
- Kungakhathaliseki ukuthi isimo sakho sinjani, kubaluleke kakhulu ukusebenzisana eduze nodokotela wakho ukuze ukhethe inketho yokwelashwa engcono kakhulu.
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