Ingabe umdlavuza wakho webele une-HER2-Positive? Ake sixoxe ngalokhu ngokuningiliziwe!

Wake wezwa ngomdlavuza webele? Mhlawumbe umngane noma isihlobo sakho sike saba nawo. Empeleni kunezinhlobo ezahlukene zomdlavuza webele. Namuhla sizokhuluma ngomunye wawo, okhethekile futhi ongasakazeka ngokushesha. Lowo umdlavuza webele one-HER2-Positive (HER2-positive) . Uma uzwa leli gama, ungase ucabange ukuthi liyinkimbinkimbi kancane, kodwa ungakhathazeki. Sizokhuluma ngawo kalula, ngendlela ongayiqonda.

Uyini umdlavuza webele we-HER2-Positive (HER2+)?

Kalula nje, umdlavuza webele one-HER2 (HER2+) uhlobo lomdlavuza olukhula ngokushesha futhi olungasakazeka kalula ngaphandle kwebele (`invasive`) . Uma odokotela bethi unalolu hlobo lomdlavuza, kusho ukuthi amangqamuzana akho omdlavuza anamazinga aphezulu eprotheyini ekhethekile elawula ukukhula nokuhlukana kwamangqamuzana emzimbeni wakho - ebizwa ngokuthi ``Human Epidermal Growth Factor Receptor 2`` , noma i-HER2 ngamafuphi. Le phrotheyini ye-HER2 ifana ``nesignali'' etshela amangqamuzana ukuthi akhule. Uma kuningi kakhulu, amangqamuzana ahlukana ngokushesha nangokungalawuleki, okuholela kumdlavuza.

Lolu hlobo lomdlavuza webele luvame ukusabalala (ukusabalala kwe-metastasize) lusuka ebeleni luye kwezinye izingxenye zomzimba wakho, njenge-lymph nodes, isibindi, amaphaphu, noma ngisho nobuchopho bakho. Kodwa into ebalulekile ukuthi uma lo mdlavuza utholakala kusenesikhathi, ngaphambi kokuba usabalale kwezinye izingxenye zomzimba, odokotela bangawelapha ngempumelelo ngemithi yokwelapha ethuthukisiwe etholakalayo namuhla. Yingakho ukutholakala kusenesikhathi kubaluleke kangaka.

Uvame kangakanani umdlavuza webele one-HER2 positive?

Ngokusho kwe-American Cancer Society, abesifazane abangaphezu kuka-290,000 bazotholakala benomdlavuza webele ohlaselayo (invasive ductal carcinoma kanye nomdlavuza webele we-lobular) ngo-2023 kuphela. Kulaba , u-15% kuya ku-20% une-HER2-positive. Amadoda nawo angathola umdlavuza webele, kodwa umdlavuza webele one-HER2-positive awuvamile kakhulu kwabesilisa.

Ziyini izimpawu zomdlavuza webele one-HER2-positive?

Njengezinhlobo eziningi zomdlavuza webele, lolu hlobo lwe-HER2-positive ngezinye izikhathi alubonisi izimpawu ezisobala ekuqaleni. Kodwa uma izimpawu zivela, zifana nalezo ezibonakala kumdlavuza webele ojwayelekile. Ake sibheke ukuthi ziyini:

• Ushintsho ngobukhulu, ukuma, noma ukuma kwebele . Elinye ibele lingase lizwakale likhulu kunelinye, noma ukuma kwalo kungashintsha.
• Isigaxa noma iqhubu elisesifubeni noma ekhwapheni. Lokhu kungaba kuncane njenge-pea. Uma isigaxa siqhubeka ngemva kokuphela komjikelezo wakho wokuya esikhathini, kufanele ukhathazeke.
• Ushintsho ekubukekeni noma ekuzweni kwesikhumba sebele noma ingono. Isikhumba singaba mahhadlahhadla, sibe namaqhubu noma sibe namaqhubu, noma singase sizizwe sinamaqhubu noma sivuvukele. Ngezinye izikhathi isikhumba singase sibe bomvu noma sibe mnyama kunokujwayelekile.
• Ukuzwa indawo eqinile ngaphansi kwesikhumba, njengemabula .
• Uketshezi olunegazi noma olucacile oluphuma engonweni.

Cabanga nje, mngani wakho, ake simbize ngokuthi “uSunita”. Ngolunye usuku, ngesikhathi egeza, uSunita wabona ushintsho oluncane ebeleni lakhe. Kwaba sengathi yiqhubu elincane. Ekuqaleni, akazange alinake kakhulu, ecabanga ukuthi, “Lizophela nje.” Kodwa ngemva kwamasonto ambalwa, lalisekhona. Kamuva, lapho elibonisa udokotela, waqaphela ukuthi kwakuyisibonakaliso somdlavuza webele. Ngakho-ke, uma ubona noma yiziphi izinguquko ezingavamile emabeleni akho, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngaphandle kokusishaya indiva.

Yini ebangela umdlavuza webele we-HER2-positive?

Umdlavuza webele one-HER2 ubangelwa ukuguquka kwezakhi zofuzo ezibizwa ngokuthi i-HER2. Le zakhi zofuzo ze-HER2 zikhiqiza iphrotheni ye-HER2 esikhulume ngayo ngaphambilini. Lawa maprotheni e-HER2 (abizwa nangokuthi 'ama-receptor') avame ukutholakala ebusweni bawo wonke amaseli ebele.

Ngaphansi kwezimo ezijwayelekile, lawa maprotheni e-HER2 alawula ukukhula nokulungiswa kwamaseli esifuba, aqinisekisa ukuthi amaseli amasha ahlukana ngenani elanele ukuze athathe indawo yamaseli alimele noma afayo.

Kodwa-ke, uma i-HER2 gene iguquguquka, yenza amakhophi amaningi kakhulu ayo. Uma i-HER2 gene ikhiqizwa ngokweqile, nayo yenza i-HER2 protein eningi kakhulu. Uma i-HER2 protein iba yiningi kakhulu, amaseli ebele ahlukana ngokushesha futhi akhule ngendlela engalawuleki, abe yizimila ezinomdlavuza.

Yiziphi izinto ezibangela lokhu?

Njengomdlavuza webele, izici eziyingozi zomdlavuza webele one-HER2 ziyafana nezomdlavuza webele ojwayelekile. Ungathola umdlavuza webele kungakhathaliseki ukuthi unalezi zici eziyingozi noma cha. Kodwa-ke, lezi zinto zingandisa ingozi yakho:

• Ukuba noguquko lwezakhi zofuzo oluzuzwe njengefa . Isibonelo, uguquko lwezakhi zofuzo i-BRCA1 noma i-BRCA2.
• Njengoba nganginomdlavuza webele ngaphambili.
• Ukuba nezinye izimo ezihlobene namabele njenge-'atypical ductal hyperplasia'.
• Umjikelezo wokuya esikhathini uqala ngaphambi kwesikhathi esijwayelekile.
• Ukunqamuka kokuya esikhathini kwenzeka ngemva kweminyaka evamile.
• Ukuthatha ukwelashwa kokufaka esikhundleni sama-hormone.
• Ukuphuza utshwala obungaphezu kobunye ngosuku.
• Njengoba ngithole ukwelashwa ngemisebe yezimo ezithile ezifana ne-lymphoma (umdlavuza wesistimu ye-lymphatic).

Yiziphi izinkinga zomdlavuza webele one-HER2-positive?

Umdlavuza webele one-HER2-Positive ungasakazeka kwezinye izingxenye zomzimba, noma 'usakazeke'. Cishe ingxenye yabantu abanalolu hlobo lomdlavuza webele, umdlavuza usuvele usakazeke kwezinye izingxenye zomzimba, ikakhulukazi ubuchopho, ngesikhathi bexilongwa. Umdlavuza webele osusakazeke ebuchosheni ('umdlavuza webele osakazeke ebuchosheni bakho') ungaba yingozi empilweni. Yingakho ukutholakala kusenesikhathi kanye nokwelashwa okusheshayo kubalulekile.

Umdlavuza webele one-HER2-positive utholakala kanjani?

Odokotela basebenzisa kakhulu i-biopsy yebele ukuxilonga zonke izinhlobo zomdlavuza webele. Lokhu kuhilela ukuthatha ingxenye encane yezicubu endaweni esolisayo yebele bese uyihlola ngaphansi kwe-microscope.

Uma ukuhlolwa kwebele kuqinisekisa ukuthi kukhona umdlavuza, udokotela wezifo zezokwelapha (udokotela ochwepheshe ekuxilongeni izifo) uzokwenza izivivinyo ezikhethekile ukuze abone ukuthi amaseli ezicubu zebele aqukethe iphrotheni ye-HER2. Kunezinhlobo ezimbili eziyinhloko zokuhlolwa kwalokhu:

1. I-Immunohistochemistry (IHC): Lokhu kuhlolwa kuvumela odokotela bezifo ukuthi babheke iphrotheni ye-HER2 emaselini omdlavuza webele. Lokhu kuhlolwa kusebenzisa idayi ekhethekile (i-immunostaining) ukuhlola izinga lephrotheni ye-HER2 emaselini omdlavuza.

2. Ukuhlanganiswa kwe-Fluorescence in situ (FISH): Lokhu kuhlolwa kwe-FISH ngezinye izikhathi kusetshenziselwa ukuqinisekisa imiphumela yokuhlolwa kwe-IHC. Lokhu kuhlolwa kungabona ukuthi kukhona yini amakhophi engeziwe e-HER2 gene.

Ngemva kwalezi zivivinyo, odokotela bahlukanisa umdlavuza ngokwezigaba. Basebenzisa 'uhlelo lokuhlola'. Lokhu kubheka ukuthi izinga leprotheni ye-HER2 liphakeme kangakanani kusampula yezicubu zebele, kanye nokuthi mangaki amangqamuzana omdlavuza akhona. Cabanga ngakho ngale ndlela:

• Uma ukuhlolwa kukhombisa ukuthi izinga le-HER2 protein liphansi, lizobekwa njengo- 0 noma u-1+ . Udokotela wezifo uzothi li- HER2 negative .
• Uma kukhona amangqamuzana omdlavuza futhi izinga leprotheni liphakathi nendawo, ungathola amaphuzu angu- 2+ . Khona-ke udokotela wezifo uzoqinisekisa nokuhlolwa kwe-'FISH' okukhulunywe ngakho ekuqaleni.
• Uma kunamangqamuzana amaningi omdlavuza futhi izinga leprotheni liphezulu kakhulu, uthola amaphuzu angu- 3+ . Yilapho-ke udokotela wezifo ethi une -HER2 positive .

Lolu hlelo lokuthola amaphuzu lunquma ngqo ukuthi u-HER2-positive noma u-HER2-negative.

Yiziphi izindlela zokwelapha umdlavuza webele one-HER2-positive?

Ngenxa yokuthi lolu uhlobo lomdlavuza webele 'oluhlaselayo', izinketho zokwelapha zinqunywa yizici eziningi, njengesigaba somdlavuza kanye nesimo se-HER2. Izindlela zokwelapha ezilandelayo zingasetshenziswa:

• Ukwelashwa okuqondiwe:Lokhu kuyindlela yokwelapha eqondile kakhulu yomdlavuza one-HER2. Kuhilela ukunikeza imithi ehlose iphrotheni ye-HER2 futhi ibulale amaseli omdlavuza. Kunezinhlobo eziningana eziyinhloko zokwelapha ngaphansi kwalokhu:
• Ukwelashwa ngama-antibody e-monoclonal: Lokhu kubopha iphrotheni ye-HER2 futhi kuvimbele amangqamuzana omdlavuza ekukhuleni.
• Ukwelashwa kwe-Tyrosine kinase inhibitor: Le mithi ingena emaseli omdlavuza futhi ivimbe izindlela zokubonisa izimpawu ezisiza amaseli ukuba akhule.
• Ama-Antibody-drug conjugates (ama-ADC): Lena indlela ethuthuke kakhulu. Kulokhu, umuthi wokulwa nomdlavuza unamathiselwa ku-antibody efuna amangqamuzana omdlavuza. Le nhlanganisela ibe isiya ngqo kumaseli omdlavuza bese ikhipha umuthi, okubangela umonakalo omncane kumaseli anempilo.
• Ukwelashwa ngamakhemikhali: Ukwelashwa ngamakhemikhali kunikezwa ngaphambi kokuhlinzwa ukuze kuncishiswe isimila (ukwelashwa nge-neoadjuvant) noma ukubulala noma yimaphi amangqamuzana omdlavuza asele ngemva kokuhlinzwa (ukwelashwa okusizayo). Ngezinye izikhathi ukwelashwa ngamakhemikhali kunikezwa kanye nokwelashwa okuqondiwe.

Ngaphandle kwalokhu, kuye ngesigaba somdlavuza, izinto ezifana 'nokuhlinzwa', 'ukwelashwa ngemisebe', noma 'ukwelashwa ngama-hormone' nazo zingenziwa.

Iyini imiphumela emibi yokwelashwa?

Imiphumela emibi ingahluka kuye ngokwelashwa. Uma uthola ukwelashwa, khuluma nodokotela wakho ngokuthi ukwelashwa kuzokuthinta kanjani nokuthi kuzokuthinta kanjani impilo yakho yansuku zonke. Futhi, buza udokotela wakho ngokunakekelwa kokwelapha ubuhlungu obungapheli . Ukunakekelwa kokwelapha ubuhlungu obungapheli kuyisevisi ekusiza ukuphatha izimpawu zomdlavuza kanye nemiphumela emibi yokwelashwa futhi ikwenze ukhululeke ngangokunokwenzeka ngesikhathi sokwelashwa. Akuyona nje eyabantu abangakwazi ukwelapha umdlavuza, kodwa kungasiza noma ubani othola ukwelashwa.

Ingabe lezi zindlela zokwelapha zingayelapha ngokuphelele umdlavuza webele one-HER2?

Uma odokotela bethi “baphulukise” umdlavuza, cishe basho ukuthi umdlavuza wafakwa ekuphumuleni iminyaka eminingi ngokwelashwa. Ukuphulukiswa kusho ukuthi awunazo izimpawu zomdlavuza futhi awukho umdlavuza ongatholakala ezivivinyweni. Umuntu otholakale enomdlavuza webele one-HER2, welashwe, futhi ophila iminyaka emihlanu ubhekwa “njengophulukisiwe.”

Ngokusho kwe-US National Cancer Institute (NCI), abantu abangaphezu kuka-90% abatholakale benomdlavuza webele one-HER2 basaphila ngemva kweminyaka emihlanu. Bangabhekwa njengabalaphekile emdlavuza wabo. Kodwa-ke, umdlavuza one-HER2 ungaphinde ubuye futhi usakazekele kwezinye izingxenye zomzimba. Ngakho-ke, kubalulekile ukuqhubeka nokuyohlolwa udokotela.

Lingakanani izinga lokusinda komdlavuza webele one-HER2-positive?

Amathuba okusinda kumdlavuza webele we-HER2-positive nawo ayahlukahluka kuye ngokuthi umdlavuza une-hormone receptor-positive (HR+) noma i-hormone receptor-negative (HR-) . (Lawa ma-hormone receptors angama-receptor ebusweni bamaseli angabopha ama-hormone. Cishe ingxenye yawo wonke ama-HER2-positive cancer anala ma-receptor. I-NCI ihlukanisa la mathuba ngesigaba somdlavuza: wendawo (ekhawulelwe ebeleni), yesifunda (esakazekela kuma-lymph node aseduze), kanye nekude (esakazekela ezingxenyeni ezikude zomzimba). Ungakhuluma nodokotela wakho ngalokhu ukuze ufunde kabanzi.

Ingabe umdlavuza webele one-HER2-positive ungavinjelwa?

Cishe akunjalo. Nakuba kunezinto ongazenza ukuze unciphise ingozi yakho yomdlavuza webele, umdlavuza webele one-HER2 ubangelwa ukuguqulwa kwezakhi zofuzo ze-HER2 okubangela ukwakheka kwamangqamuzana omdlavuza. Abacwaningi basacwaninga ukuthi kungani lokhu kwenzeka, ngakho abakwazi ukusho ngqo ukuthi yini engenziwa ukuvimbela umdlavuza one-HER2.

Kodwa-ke, ungenza lezi zinto ukunciphisa ingozi yakho yomdlavuza webele ngokujwayelekile:

• Nakekela impilo yebele lakho. Zihlole njalo amabele, futhi uthole ama-mammogram ngokweminyaka nangezikhathi ezinconywe udokotela wakho. Qaphela noma yiziphi izinguquko emabeleni akho. Ngale ndlela, umdlavuza ungatholakala kusenesikhathi futhi welashwe kalula.
• Gcina isisindo esinempilo. Lesi kufanele sibe isisindo esikujabulisayo. Cela udokotela wakho iseluleko sokuthi ungasilondoloza kanjani isisindo esinempilo.
• Yidla ukudla okunempilo. Ezinye izifundo zibonise ukuthi ukudla okucebile ngemifino, izithelo, imikhiqizo yobisi ecebile nge-calcium, kanye namaprotheni angenamafutha kunganciphisa ingozi yomdlavuza webele. Kungumqondo omuhle futhi ukunciphisa inyama ebomvu necutshungulwe.
• Yiba matasa. Izifundo zikhombisile ukuthi ukuvivinya umzimba njalo kunciphisa ingozi yomdlavuza webele. Ngisho nokuhamba imizuzu engama-30 ngosuku kuhle.
• Gwema iziphuzo ezidakayo. Ucwaningo lubonisa ukuxhumana phakathi komdlavuza webele notshwala. I-American Medical Association itusa ukuthi abesifazane banciphise ukuphuza utshwala kube yisiphuzo esisodwa ngosuku.

Ngizinakekela kanjani?

Ukuphila nomdlavuza webele kusho ukuphila nezimpawu zomdlavuza, ukwelashwa, kanye nemiphumela emibi yokwelashwa. Futhi, ngezinye izikhathi, kungase kudingeke uphile nomuzwa wokungaqiniseki ngekusasa. Ungase uzizwe ukhungathekile futhi ukhungathekile ngezinye izikhathi. Uma uzizwa ngaleyo ndlela, cabanga ngalezi ziphakamiso zokuzinakekela:

• Phumula ngokwanele.Umdlavuza webele kanye nokwelashwa kuyakhathaza kakhulu. Khumbula ukuphumula noma nini lapho uzizwa uthanda, hhayi nje uma unesikhathi.
• Yidla kahle. Ukwelashwa kunganciphisa isifiso sakho sokudla, kodwa ukudla ukudla okucebile ngezithelo, imifino, amaprotheni angenawo amafutha amaningi, kanye nokusanhlamvu okunempilo kuzokusiza uhlale unamandla ngesikhathi sokwelashwa.
• Lawula ukucindezeleka kwakho. Umdlavuza uyinkinga enkulu yokucindezeleka. Ukuzivocavoca umzimba kungasiza kulokhu. Ukuhamba njalo nokuhlanganyela ezinhlelweni zokuzivocavoca ezifana ne-yoga kuhle.
• Thola ukwesekwa. Ungumuntu osindile kumdlavuza webele, futhi lokho kuqala ngosuku otholakala ngalo ukuthi unesifo. Buza udokotela wakho ngezinhlelo zokusinda kumdlavuza . Lezi zingakusiza unqobe izinselele zokuphila nomdlavuza webele. Ukukhuluma nomndeni wakho nabangani nakho kuyindlela enhle yokuzisekela.

Kufanele ngimbone nini udokotela?

Kuzodingeka ubone udokotela wakho njalo ngesikhathi sokwelashwa. Kodwa-ke, uma ubona noma yiziphi izinguquko ezintsha emabeleni akho noma emzimbeni wakho ezingaba yizimpawu zokuthi umdlavuza wakho one-HER2 ususakazekile, tshela udokotela wakho ngokushesha. Isibonelo, uma umdlavuza webele ususakazekele emaphashini, ungase ube nezimpawu ezifana nobuhlungu besifuba, ukutheleleka njalo esifubeni, ubunzima bokuphefumula, noma ukukhwehlela igazi.

Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Uma impendulo yomzimba wakho ekwelashweni komdlavuza imbi kakhulu kunalokho obekulindele, kufanele uye egumbini lezimo eziphuthumayo. Isibonelo, uma uphelelwe amanzi emzimbeni kakhulu ngenxa yokuhlanza okuqhubekayo, iya esibhedlela ngokushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma ukuhlolwa kwakho kubonisa ukuthi unomdlavuza webele we-HER2-positive, ungase ufune ukubuza udokotela wakho imibuzo efana nalokhu:

• Siyini ngempela isimo sami se-HER2 ? (okungukuthi, iyini isikolo sami se-IHC/FISH?)
• Sinjani isimo sami se-hormone receptor ? (HR+ noma HR-?)
• Lezi zimo ze-HER2 kanye ne-hormone receptor zithinta kanjani ukubikezela kwami ​​(okungukuthi, ukubikezela kanye nenkambo yesikhathi esizayo yesifo)?
• Yikuphi ukwelashwa ongincomayo? Kungani?
• Ingabe kufanele ngicabangele ukuhlanganyela esivivinyweni somtholampilo sokwelapha umdlavuza webele one-HER2?

Ukuphumelela ekwelashweni komdlavuza akuvamile. Yingakho abacwaningi bomdlavuza babejabule kakhulu lapho izifundo zibonisa ukuthi ukuguquka kwezakhi zofuzo ze-HER2 kubangela ukuthi amangqamuzana ahlukane ngokushesha kunokujwayelekile. Basheshe bathola ukuxhumana phakathi kokuguquka kwezakhi zofuzo ze-HER2 kanye nezinhlobo ezithile zomdlavuza webele okhula ngokushesha. Kusukela lapho, bathuthukise izindlela zokwelapha ezingalapha ngempumelelo umdlavuza webele wesigaba sokuqala we-HER2. Manje abacwaningi bagxile ekutholeni izindlela zokwelapha ezisebenzayo kakhulu ezinganciphisa noma zimise ukusabalala komdlavuza. Izivivinyo zemitholampilo yilapho lokhu kutholwa okusha kwenzeka khona. Uma unomdlavuza webele we-HER2 one-metastatic ('metastatic'), khuluma nodokotela wakho mayelana nokubamba iqhaza esivivinyweni semitholampilo. Bangakusiza.

Ekugcineni, umyalezo okufanele uwuthathe uye nawo ekhaya

Umdlavuza webele one-HER2-positive uhlobo lomdlavuza olubi kakhulu nolusakazeka ngokushesha. Kodwa-ke, ngokutholwa okunembile nokusenesikhathi kanye nezinketho zokwelapha ezithuthukisiwe, manje kungenzeka ukulawula nokwelapha lesi simo ngempumelelo.

• Hlala unake umzimba wakho, ikakhulukazi amabele akho. Uma ubona noma yiziphi izinguquko ezingavamile, ungazinaki futhi funa iseluleko sezokwelapha ngokushesha.
• Landela izivivinyo kanye nokwelashwa okunconywa udokotela wakho ngqo. Ungesabi ukukhuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho.
• Kubaluleke kakhulu ukuhlala unethemba. Awuwedwa. Kukhona umndeni, abangani, odokotela, kanye nezinsizakalo zokweluleka ezizokusiza.

Sithemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!

Umdlavuza webele , i-HER2-Positive, izimpawu zomdlavuza, ukwelashwa komdlavuza, impilo yabesifazane, ukuguquka kwezakhi zofuzo, i-mammogram