Cishe uke wezwa ngomdlavuza webele, noma i-osteoporosis. Namuhla sizokhuluma ngeklasi ekhethekile yemithi esetshenziswa ukwelapha zombili lezi zimo. Zibizwa ngokuthi ama-Selective Estrogen Receptor Modulators, noma ama-SERM ngamafuphi. Nakuba igama lingase lizwakale liyisayensi kancane, indlela asebenza ngayo ilula kakhulu. Ake sibheke ukuthi ayini ama-SERM nokuthi athinta kanjani imizimba yethu.
Kalula nje, ziyini lezi SERM?
Ama-SERM awuhlobo lomuthi olawula noma oshintsha indlela i-hormone i-estrogen esebenza ngayo emzimbeni wethu. Cabanga nge-estrogen njengesihluthulelo. Amaseli omzimba wethu anezitho zokwamukela ezifanelana nalesi sihluthulelo. Uma i-estrogen ibopha kula ma-receptor, lawo maseli athola imiyalezo ethile. Isibonelo, umlayezo otshela ukuthi "akhule."
Ama-SERM enza umsebenzi omuhle kakhulu. Avimba i-estrogen ukuthi ingangeni emgodini okhiye kwezinye izingxenye zomzimba. Futhi, kwezinye izingxenye zomzimba, le mithi isebenza njenge-estrogen . Lokho kusho ukuthi umuthi ofanayo wenza izinto ezimbili, kuye ngendawo okuyo. Kufana nomuntu ofanayo osebenza njengomvikeli ngesikhathi esisodwa kanye nomsizi kwesinye.
Imithi emibili esetshenziswa kakhulu kuleli qembu yi -tamoxifen kanye ne-raloxifene .
Lawa ma-SERM asebenza kanjani?
Njengoba sishilo ngaphambili, lokhu kusebenza ngendlela ehlukile ezindaweni ezahlukene. Ake sichaze lokho kakhudlwana.
1. Ngokuphathelene nomdlavuza webele: Kunezinhlobo ezithile zomdlavuza webele ezisizwa ukukhula yi-hormone estrogen. Sibiza lezi ngokuthi i-hormone receptor (HR) positive noma i-estrogen receptor (ER) positive umdlavuza webele. Lezi zinhlobo zamaseli omdlavuza zinezindawo ebusweni bazo lapho i-estrogen ibopha khona. Uma i-estrogen ibopha kulezi zindawo, amaseli omdlavuza athola umlayezo othi "ahlukane futhi akhule kakhulu." Ama-SERM asebenza ngokuvimba lezi zindawo ngaphambi kokuba i-estrogen yenze kanjalo. Kufana nokufaka ukhiye ongafanele emgodini wesihluthulelo. Khona-ke i-estrogen efanele ayikwazi ukufika kukhiye bese ibopha. Lokhu kuvimbela amaseli omdlavuza ekukhuliseni umlayezo.
2. Impilo yamathambo: Ngakolunye uhlangothi, i-estrogen iyi-hormone ebaluleke kakhulu ekugcineni amathambo ethu eqinile. Ikakhulukazi ngemva kokunqamuka kokuya esikhathini, amazinga e-estrogen kwabesifazane ayancipha, okwandisa ingozi yokulahlekelwa amathambo, noma i-osteoporosis . Kuleli qophelo, ama-SERM asebenza emaseli ethambo ngendlela efanayo ne-estrogen . Okusho ukuthi, aya emathanjeni futhi awanike umyalezo othi, "Hlala uqinile, ungalahlekelwa yi-calcium."
Uyaqonda? Umuthi ofanayo uvimba ukusebenza kwe-estrogen emabeleni, kuyilapho usebenza njenge-estrogen emathanjeni futhi uvikela amathambo. Lona uhlobo olukhethekile lwale mithi.
Kuziphi izimo lapho kusetshenziswa khona ama-SERM?
Odokotela batusa kakhulu lo muthi ezimweni eziningana.
Ngomdlavuza webele
- Kwabesifazane abasengozini enkulu yomdlavuza webele one-ER: Uma othile emndenini eke waba nalo mdlavuza, noma uma ukuhlolwa kofuzo kuqinisekisile ukuthi banezinguquko zofuzo ezandisa ingozi yomdlavuza, banikezwa lo muthi wokuvimbela umdlavuza ngaphambi kokuba ukhule.
- Kulabo abake bahlinzwa umdlavuza webele: Ngemva kokuhlinzwa, le mithi inikezwa ukuvimbela umdlavuza ukuthi ungabuyi (ukuphinda ubuye). Futhi iyasiza ekuvimbeleni umdlavuza ukuthi ungakhuli kwebele eliphilile.
- Ku-DCIS (Ductal Carcinoma in Situ): Lesi yisigaba sokuqala somdlavuza webele. Ama-SERM asetshenziselwa ukuvimbela lesi simo ukuthi singasabalali.
- Ngomdlavuza webele osusakazekele kwezinye izingxenye zomzimba (i-Metastatic Breast Cancer): Lo muthi unikezwa ukulawula umdlavuza.
- Kumdlavuza webele wabesilisa: Yebo, amadoda nawo angathola umdlavuza webele. I-Tamoxifen isetshenziselwa nomdlavuza one-ER-positive.
Nge-osteoporosis
Umuthi obizwa ngokuthi i-raloxifene usetshenziselwa ukulawula ukulahleka kwamathambo ngemva kokunqamuka kokuya esikhathini nokunciphisa ingozi yokuqhekeka kwamathambo.
Kuphumelela kangakanani lokhu kwelashwa?
Yebo, lezi izindlela zokwelapha eziphumelela kakhulu. Ake sibheke ezinye zezinto ezitholwe ocwaningweni:
- Ukunikeza i-tamoxifen kwabesifazane abasengozini enkulu abangakayi esikhathini sokuya esikhathini (abangakayi esikhathini sokuya esikhathini) kunganciphisa ingozi yomdlavuza webele cishe ngo-40% .
- Uma umuntu oke wahlinzwa umdlavuza kwelinye ibele ethatha i-tamoxifen, ingozi yokuba nomdlavuza kwelinye ibele incishiswa ngo-50% .
- I-Tamoxifen isiza ukunciphisa ingozi yokuphinda ivele ngo-30% kuya ku-50% kumuntu onomdlavuza webele osesigabeni sokuqala.
- Ucwaningo lubonise ukuthi umuthi i-raloxifene unciphisa ingozi yokuphuka komgogodla kwabesifazane asebekhulile abane-osteoporosis.
Yimiphi imiphumela emibi engaba khona yokuphuza lo muthi?
Njenganoma yimuphi umuthi, ama-SERM angabangela imiphumela emibi. Kodwa-ke, akuwona wonke umuntu othola yonke le miphumela emibi.Kubalulekile ukukhumbula lokho. Futhi, izinzuzo zale mithi zivame ukwedlula imiphumela emibi. Udokotela okwelaphayo uzochaza konke lokhu kuwe.
Ethebuleni elingezansi, sihlukanise imiphumela emibi evamile neyivelakancane yalo muthi.
| Uhlobo lomuthi | Okuqhamuka uma udla imishanguzo |
|---|---|
| I-Tamoxifen - yabesifazane | |
| Imiphumela emibi evamile |
|
| Imiphumela emibi engavamile kodwa engaba yingozi |
|
| I-Raloxifene - yabesifazane | |
| Imiphumela emibi evamile |
|
| I-Tamoxifen - yamadoda | |
| Okuqhamuka uma udla imishanguzo |
|
Into ebaluleke kakhulu ukukhuluma nodokotela wakho nganoma yikuphi ukungakhululeki okutholayo. Kunezindlela ezilula zokulawula eminye yemiphumela emibi.
Ingabe ukungakhululeki okubangelwa yimiphumela emibi kungancishiswa?
Yebo, ungakwenza nakanjani. Kunezinto ezimbalwa ongazenza ukusiza ekunciphiseni ukungakhululeki, ikakhulukazi izimpawu ezifana nokunqamuka kokuya esikhathini (ukushisa okukhulu, ukuqwasha, ukoma kwesitho sangasese sowesifazane).
- Nciphisa ukushisa: Nciphisa i-caffeine (ikhofi, itiye) nokudla okunongwe. Abanye abantu bathola impumuzo ngokudla ukudla okuqukethe ama-phytoestrogen, njenge-soya, ama-chickpeas, nama-lentile.
- Ngezinkinga zokulala: Ukuzivocavoca nsuku zonke kukusiza ukuthi ulale kangcono.
- Kokomisa isitho sangasese sowesifazane: Kunezithambisi ezikhethekile zesitho sangasese sowesifazane ezingasetshenziswa kulokhu. Ungabuza udokotela wakho ngalezi.
Kunini lapho kufanele ufune khona iseluleko sezokwelapha ngokushesha?
Uma unomuzwa wokuthi imiphumela emibi evamile iya iba mibi kakhulu, yazisa udokotela wakho. Kodwa-ke, kunezimo ezithile ezingathi sína ezingavamisile ukwenzeka nge-SERMs. Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, ungalibali. Yiya ekamelweni lezimo eziphuthumayo esibhedlela esiseduze (ETU) ngokushesha.
- Ukuba ndikindiki noma ubuthakathaka ohlangothini olulodwa lomzimba noma lobuso.
- Ubunzima bokukhuluma, ukungakwazi ukukhuluma kahle.
- Ikhanda elibuhlungu elibi kakhulu nelingalindelekile.
- Ubunzima bokuphefumula ngokuzumayo.
- Ubuhlungu obukhulu esifubeni, engalweni, ehlombe, noma emhlathini obuvela ngaphandle kwesizathu esibonakalayo.
Lokhu kungaba izimpawu zokuhlaselwa yisifo sohlangothi noma i-pulmonary embolism, ngakho-ke kufanele uqaphele kakhulu ngalokhu.
Umlayezo Wokuya Nawe Ekhaya
- Ama-SERM uhlobo olukhethekile lwemithi olushintsha indlela i-hormone i-estrogen esebenza ngayo emzimbeni.
- Lezi zisetshenziswa ngempumelelo enkulu ukuvimbela nokwelapha ezinye izinhlobo zomdlavuza webele nokulawula ukulahleka kwamathambo.
- Okukhethekile lapha ukuthi umuthi ofanayo uvimba isenzo se-estrogen engxenyeni ethile yomzimba, kuyilapho usebenza njenge-estrogen kwenye ingxenye.
- Njengayo yonke imithi, lokhu kungabangela imiphumela emibi, kodwa akuwona wonke umuntu oyitholayo. Khuluma nodokotela wakho nganoma yikuphi ukungakhululeki okutholayo.
- Qaphela izimpawu ezingathi sína ezifana nesifo sohlangothi noma amahlule egazi. Uma uhlangabezana nanoma yiziphi zalezi zimpawu, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela ngokushesha.
- Uma usengozini yokuba nomdlavuza webele noma une-osteoporosis, khuluma nodokotela wakho mayelana nokuthi lolu hlobo lokwelashwa lwe-SERM lukulungele yini futhi uqiniseke ukuthi uyaziqonda izinzuzo nezingozi.
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