Uma ulwa nomdlavuza, noma uma unomuntu omthandayo onawo, cishe ujwayelene namagama anjengelithi “chemotherapy” kanye nelithi “radiation therapy.” Cishe uke wezwa ngemiphumela emibi ehambisana nalezi zindlela zokwelapha. Kodwa namuhla sizokhuluma ngeklasi elisha lemithi ehlose amangqamuzana omdlavuza kuphela futhi inciphise kakhulu umonakalo kumaseli anempilo. Lawa abizwa ngokuthi ama-PARP Inhibitors .
Kalula nje, iyini le PARP Inhibitor?
Ukuze siqonde lokhu, sidinga kuqala ukuqonda inqubo encane kodwa ebaluleke kakhulu eyenzeka ngaphakathi kwamaseli emizimba yethu. Ngaphakathi kweseli ngalinye emzimbeni wethu kukhona into ebizwa ngokuthi i-DNA. Cabanga ngayo njengohlelo olukhulu olubhale phansi ukuthi konke okusemzimbeni wethu kufanele kusebenze kanjani. Ngezinye izikhathi, amakhasi alolu hlelo lwe-DNA ayalimala kancane.
Yilapho iphrotheni ebizwa ngokuthi i-PARP iqala khona ukusebenza. Igama elithi "PARP" liyisifinyezo se- Poly (ADP-ribose) polymerase . I-PARP ifana "nomshini wokulungisa" ngaphakathi kwamaseli ethu. Lapho i-DNA yonakele, iphrotheni ye-PARP iyangena iyilungise. Lokhu kubalulekile ukuze amaseli aphilile asinde.
Kodwa inkinga iwukuthi, amangqamuzana omdlavuza nawo asebenzisa le ndlela ye-PARP ukuze azuze. Lapho i-DNA yamangqamuzana omdlavuza yonakele, asebenzisa le-PARP ukuyilungisa. Ngenxa yalokho, amangqamuzana omdlavuza awafi, kodwa ayaqhubeka nokukhula nokusabalala emzimbeni wonke.
Njengesixazululo salokhu, odokotela basebenzisa umuthi obizwa ngokuthi i-PARP Inhibitor. Igama elithi "Inhibitor" lisho "umvimbeli." Lokho okwenziwa yilo muthi "ukuvimba" indlela ye-PARP esiza amangqamuzana omdlavuza. Ngaphandle kosizo lwe-PARP, iseli lomdlavuza liyabuthaka kancane kancane, lingakwazi ukulungisa i-DNA eyonakele, futhi ekugcineni liyafa.
Lokhu kufana nokuvala "uhlelo lokusinda" lweseli lomdlavuza. Yingakho le ndlela yokwelapha ibizwa nangokuthi ukwelashwa okuqondiwe . Okusho ukuthi, le mithi ihlose ngqo ubuthakathaka emaseli omdlavuza.
Izinhlobo eziyinhloko zama-PARP inhibitors asetshenziswa emhlabeni
Kunezinhlobo eziningana zokuvimbela i-PARP ezivunyelwe ukwelashwa komdlavuza njengamanje. Uma udokotela wakho ekubhalela enye yalezi, ingase ibe kulolu hlu.
| Igama Elijwayelekile Lomuthi | I gama le-brand |
|---|---|
| I-Olaparib | I-Lynparza® |
| I-Niraparib | I-Zejula® |
| I-Rucaparib | I-Rubraca® |
| I-Talazoparib | I-Talzenna® |
Lo muthi usetshenziselwa ziphi izinhlobo zomdlavuza?
Ama-inhibitor e-PARP avame ukusetshenziswa emidlavuzeni esithuthuke kakhulu noma esisakazekele kwezinye izingxenye zomzimba (i-metastatic). Kunezinhlobo eziningana zomdlavuza ezisebenza kakhulu kuzo.
- Umdlavuza webele
- Umdlavuza wesibeletho
- Umdlavuza we-Fallopian tube
- Umdlavuza we-prostate
- Umdlavuza oyinhloko we-peritoneal
- Umdlavuza we-pancreatic
Ubudlelwano obukhethekile nokuguqulwa kwezakhi zofuzo ze-BRCA
Nakhu okudingeka ukwazi ngempela nge -gene ye-BRCA . I-BRCA ingenye i-gene ebalulekile esiza ukulungisa i-DNA emaseli ethu futhi ivimbele umdlavuza. Kodwa abanye abantu bangase babe noguquko kule gene ye-BRCA. Lokhu kusho ukuthi enye yezinhlelo zabo eziyinhloko zokulungisa i-DNA ayisebenzi kahle. Ngenxa yalokhu, basengozini enkulu yokuba nomdlavuza.
Cabanga ngemoto njengenezinhlelo ezimbili zamabhuleki. I-BRCA ingenye, kanti i-PARP ingenye. Engqamuzaneni lomdlavuza eline-BRCA gene mutation, uhlelo olulodwa lwamabhuleki (i-BRCA) luvele luphukile. Ngakho-ke ingqamuzana lomdlavuza lithembele cishe ngokuphelele kolunye uhlelo lwamabhuleki (i-PARP) ukuze lisinde.
Manje uma sinikeza imithi ye-PARP Inhibitor, sicisha naleyo ndlela yesibili yokubopha amabhuleki. Khona-ke iseli lomdlavuza alinandlela yokulungisa i-DNA yalo, bese liyafa nje. Yingakho i-PARP Inhibitors isebenza kahle kakhulu kumdlavuza one-BRCA gene mutations.
Ngithola kanjani ukwelashwa futhi kuthatha isikhathi esingakanani?
Enye yezinto ezilula zalokhu kwelashwa ukuthi konke kuza ngesimo samaphilisi (ama-capsule noma amaphilisi). Ngakho-ke kufanele uthathe lo muthi kanye noma kabili ngosuku. Ngezinye izikhathi lo muthi wodwa unganele. Ngezinye izikhathi, kungadingeka ukuthi uwuthathe kanye neminye imithi yokwelapha umdlavuza.
Isibonelo, ngemva kokwelashwa okulimaza i-DNA yamaseli omdlavuza, njengokwelashwa ngamakhemikhali noma ngemisebe, unganikeza i-PARP inhibitor. Ngemuva kwalokho, njengoba i-PARP ingabasizi labo maseli omdlavuza abonakele ukuthi bazilungise, lawo maseli aqinisekisiwe ukuthi azofa.
Isikhathi sokwelashwa
Lokhu kuyahlukahluka kumuntu nomuntu.
- Abanye abantu banikezwa lo muthi isikhathi esithile, njengeminyaka emibili noma emithathu, ngemva kokuqeda ukwelashwa ngamakhemikhali.
- Abanye abantu bayaqhubeka nokuphuza lo muthi uma nje usebenza emizimbeni yabo.
- Ngezinye izikhathi, uma imiphumela emibi idlula izinzuzo zomuthi, ungakhuluma nodokotela wakho bese uyeka ukwelashwa.
Ngakho-ke, kubaluleke kakhulu ukuxoxa nodokotela wakho ukuthi kufanele uthathe isikhathi esingakanani bese uthatha isinqumo.
Yiziphi izinzuzo kanye nokungalungi kwalokhu kwelashwa?
Izithibi ze-PARP azikwazi ukwelapha umdlavuza ngokuphelele. Kodwa-ke, zingasiza iziguli ezinezinhlobo ezithile zomdlavuza ukuba ziphile isikhathi eside . Le mithi ilawula ukukhula komdlavuza. Odokotela bakubiza lokhu ngokuthi ukwandisa "izinga lokusinda elingenayo inqubekela phambili." Kalula nje, zandisa isikhathi umdlavuza ohlala ulawulwa kahle ngaphandle kokuba mubi kakhulu. Kwezinye izimo, zingasebenza kangcono kune-chemotherapy.
Kodwa-ke, ngokuhamba kwesikhathi, amanye amangqamuzana omdlavuza aqala ukuba "nokumelana" nale mithi. Lokhu kusho ukuthi imithi ayisasebenzi. Lokhu kungenzeka phakathi kuka-40% no-70% weziguli. Ososayensi bazama ukuqonda ukuthi kungani lokhu kwenzeka futhi bacwaninga ngezindlela ezintsha zokwenza le mithi isebenze kakhudlwana.
Masiqaphele nemiphumela emibi.
Njenganoma yikuphi ukwelashwa komdlavuza, izidakamizwa zokuvimbela i-PARP zingabangela imiphumela emibi ethile. Kodwa akuwona wonke umuntu oyitholayo. Futhi eminingi yale mithi ingalawulwa.
| Imiphumela emibi evamile | Isizathu salokho noma imininingwane eyengeziwe |
|---|---|
| Ukukhathala nokukhathala | Ngokuvamile kungabangelwa yi-anemia, okuwukwehla kwenani lamaseli abomvu egazini. |
| Ukopha (isb., imihuzuko, ukopha ekhaleni) | Kungase kube ngenxa yokwehla kwenani lama-platelet egazi. |
| Ukutheleleka okuvamile | Ukwehla kwenani lamaseli amhlophe egazi kungenza buthaka isimiso somzimba sokuzivikela. |
| Isicanucanu nokuhlanza | Eminye imithi ingathathwa ukulawula lokhu. |
| Ubuhlungu besisu, ukuqunjelwa, noma ukuqunjelwa | Kungalawulwa ngokushintsha ukudla kanye, uma kudingeka, ngemithi. |
| Ukushintsha kokunambitheka emlonyeni (i-dysgeusia) | Ukudla kungaba nokunambitheka okuhlukile. |
| Ukwehlisa isisindo, isiyezi, ikhanda elibuhlungu | Lezi futhi yizimo ezingase zenzeke kwabanye abantu. |
Akuvamile kakhulu, ezinye izithibi ze-PARP zingandisa ingozi yokuba nohlobo lomdlavuza wegazi olubizwa ngokuthi i-acute myeloid leukemia . Kodwa-ke, lesi yisimo esingavamile kakhulu.
Isikhathi sokwazisa udokotela wakho ngokushesha
Uma uthatha i-PARP inhibitor, kubalulekile ukutshela udokotela wakho uma uhlangabezana nanoma yimiphi imiphumela emibi emisha noma emibi kakhulu . Angase ashintshe umthamo noma akunikeze eminye imithi ukusiza ngezinto ezifana nesicanucanu.
Ikakhulukazi uma uhlangabezana nezimpawu ezilandelayo:Tshela udokotela wakho noma isibhedlela esikwelaphayo ngokushesha:
- Izimpawu zokutheleleka: umkhuhlane, ukubanda, kanye nokuthuthumela.
- Izimpawu ze-pneumonia: Ubunzima bokuphefumula, ukukhwehlela, ukuqina kwesifuba, njll. (Lesi yisimo sokuvuvukala kwamaphaphu).
- Izimpawu zokuqhekeka kwegazi: ukuvuvukala kwemilenze, ubuhlungu, ukubomvu noma ubuhlungu besifuba, ubunzima bokuphefumula.
Umlayezo Wokuya Nawe Ekhaya
- Ama-PARP Inhibitors awuhlobo "lokwelashwa okuqondiwe" oluqondisa uhlelo lokulungisa i-DNA yamaseli omdlavuza futhi luwabhubhise.
- Lokhu kusebenza kakhulu kumdlavuza ofana nomdlavuza webele, wesibeletho, kanye nomdlavuza wendlala onezinguquko zezakhi zofuzo ze-BRCA.
- Lokhu kwelashwa akukwenziwa ngomjovo, kodwa njengamaphilisi/ama-capsule athathwa nsuku zonke.
- Nakuba lokhu kungelaphi ngokuphelele umdlavuza, kusiza iziguli ukuba ziphile isikhathi eside ngokulawula ukukhula komdlavuza.
- Njengezinye izindlela zokwelapha umdlavuza, lokhu kunemiphumela emibi. Ukukhathala, isicanucanu, kanye nenani eliphansi lamaseli egazi kungenzeka.
- Kubaluleke kakhulu ukuhlala usondelene nodokotela wakho phakathi nokwelashwa kwakho futhi ubike noma yimiphi imiphumela emibi ngokushesha.
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