Uma wena noma othile omaziyo etholakala enomdlavuza webele, kuvamile ukuzwa ukwesaba okukhulu nokushaqeka. Ngokufanayo, njengoba sikhula, amathambo aba buthakathaka futhi ngisho nokuwa okuncane kungawaphula. Kodwa-ke, ngenxa yentuthuko yezokwelapha, kunezindlela zokwelapha ezisebenzayo zalezi zimo. Namuhla, sizokhuluma ngenye yezindlela zokwelapha ezinjalo.
Kalula nje, ziyini lezi SERM?
Ama-SERM afinyeziwe ngokuthi ama-Selective Estrogen Receptor Modulators . Lolu uhlobo lokwelashwa kwama-hormone. Lokhu kuhilela ukuphatha indlela i-hormone estrogen esebenza ngayo emzimbeni wethu. Cabanga ngakho njengomphathi ohlakaniphile. Kuvimba imiphumela ye-estrogen kwezinye izingxenye zomzimba, futhi kusebenza njenge-estrogen kwezinye ukusiza umzimba.
Imithi emibili eyinhloko kuleli klasi yiTamoxifen neRaloxifene . Le mithi okwamanje isetshenziswa njengemithi yokwelapha ephumelela kakhulu kwezinye izinhlobo zomdlavuza webele kanye ne-osteoporosis.
Le mithi ye-SERM isebenza kanjani emzimbeni?
Lokhu kungase kubonakale kuyinkimbinkimbi ukukuqonda, kodwa empeleni kulula kakhulu. Ake sikuqonde lokhu ngesibonelo.
Cabanga nge-estrogen njengesihluthulelo. Amaseli omzimba wethu anezitho zokwamukela ezihambisana nalesi sihluthulelo. Uma ufaka lesi sihluthulelo emnyango, umnyango uyavuleka bese kuthunyelwa umlayezo esitokisini.
- Kumdlavuza webele: Amanye amangqamuzana omdlavuza webele (abizwa ngokuthi ama-Hormone Receptor positive noma ama-ER-positive cancer) adinga umyalezo ovela kukhiye obizwa ngokuthi i-estrogen ukuze akhule futhi ahlukane. Imithi ye-SERM isebenza ngokuvimba umnyango (i-receptor) kulawa maseli omdlavuza. Kufana nokufaka okunye embobeni yokhiye womnyango. Khona-ke i-estrogen yangempela ayikwazi ukufika kukhiye ivule umnyango. Ngenxa yalokho, amangqamuzana omdlavuza alahlekelwa umyalezo wokukhula, futhi ukukhula kwawo kuyama noma kuyeke.
- Emathanjeni: Ngesikhathi esifanayo, uma lo muthi we-SERM uya emathanjeni ethu, usebenza njenge-estrogen lapho. Okusho ukuthi, uya eminyango emathanjeni bese uvula leyo minyango, usize ekugcineni amathambo eqinile futhi agcine i-calcium. Lokhu kuvimbela i-osteoporosis.
Uke wayibona ikhono elimangalisayo lalo muthi? Umuthi ofanayo usebenza ngezindlela ezimbili ezihlukene ngokuphelele ezindaweni ezimbili. Yingakho ubizwa ngokuthi "Okukhethayo".
Yiziphi izindlela eziyinhloko zokusebenzisa ama-SERM?
Odokotela batusa lokhu kwelashwa ikakhulukazi ezimweni ezimbili.
1. Ngomdlavuza webele
Ama-SERM ayindlela yokwelapha ebaluleke kakhulu, ikakhulukazi kumdlavuza webele ozwela ama-hormone (ER-positive).
- Kulabo abasengozini enkulu yokuba nomdlavuza: Uma othile emndenini eke waba nomdlavuza webele, noma uma ukuhlolwa kofuzo kuqinisekisile ukuthi banezinguquko zofuzo ezandisa ingozi yokuba nomdlavuza, banikezwa lo muthi ukuvimbela umdlavuza ukuthi ungakhuli.
- Ngemva kokuhlinzwa komdlavuza: Ngemva kokususwa komdlavuza ngokuhlinzwa, ama-SERM asetshenziselwa ukuvimbela umdlavuza ukuthi ungabuyi (`ukuphindeka`) nokuvimbela umdlavuza ukuthi ungakhuli kwelinye ibele.
- Ku-DCIS: Ukuvimbela ukuphinda kuvele i-Ductal Carcinoma in Situ (DCIS), umdlavuza wesigaba sokuqala owenzeka emigudwini yebele.
- Ngomdlavuza osakazeke emzimbeni wonke: Ukulawula umdlavuza osakazeke kwezinye izitho zomzimba (i-Metastatic Breast Cancer).
- Kumdlavuza webele wabesilisa: Nakuba kungavamile ukuba amadoda abe nomdlavuza webele, lokhu kwelashwa kuyasetshenziswa futhi kuwo uma kwenzeka.
2. Nge-osteoporosis
I-SERM ebizwa ngokuthi i-Raloxifene isetshenziselwa ukulawula ukulahleka kwamathambo, ukuqinisa amathambo, nokunciphisa ingozi yokuqhekeka kwamathambo, ikakhulukazi kwabesifazane asebekhulile.
Kuphumelela kangakanani lokhu kwelashwa?
Yebo, lokhu kuyindlela yokwelapha ephumelela kakhulu. Izifundo zikhombisile ukuthi umuthi iTamoxifen ikakhulukazi unganciphisa ingozi yomdlavuza webele cishe ngo- 40% .
- Uma umuntu oke wahlinzwa umdlavuza kwelinye ibele ethatha i-Tamoxifen, ingozi yokuba nomdlavuza kwelinye ibele incishiswa ngo- 50% .
- Kumuntu oke waba nomdlavuza ngaphambi kokunqamuka kokuya esikhathini, ingozi yokuthi umdlavuza uphinde uvele ingancishiswa phakathi kuka -30% no-50% .
- I-Raloxifene nayo itholakale ukuthi inciphisa kakhulu ingozi yokuphuka komgogodla okubangelwa yi-osteoporosis ngemva kokunqamuka kokuya esikhathini.
Kwenzekani ngesikhathi sokwelashwa?
Lokhu kwelashwa kuvame ukunikezwa njengephilisi noma uketshezi oluthathwa nsuku zonke. Isikhathi sokwelashwa singahluka kuye ngesimo sakho kanye nezincomo zikadokotela wakho.
- I-Tamoxifen: Abantu abayithathayo ukuvimbela noma ukwelapha umdlavuza webele bavame ukuthatha lo muthi iminyaka emi-5 ilandelana. Udokotela wakho angandisa lesi sikhathi sibe yiminyaka eyi-10. Ungase futhi ushintshelwe komunye umuthi (njenge-aromatase inhibitor) ngemva kweminyaka embalwa.
- I-Raloxifene: Labo abayithathayo ukuze banciphise ingozi yomdlavuza webele noma ye-osteoporosis kufanele bayithathe njengephilisi nsuku zonke isikhathi eside njengoba udokotela wabo encoma.
Into ebaluleke kakhulu ukuthatha lo muthi isikhathi sonke njengoba udokotela emyalile. Ukuwuyeka phakathi kungase kungavezi imiphumela oyifunayo.
Yimiphi imiphumela emibi engaba khona yalokhu kwelashwa?
Njenganoma yikuphi ukwelashwa komdlavuza, ama-SERM angabangela imiphumela emibi ethile. Kodwa-ke, akuwona wonke umuntu ozobhekana nayo yonke. Iningi lalawa lingalawulwa.
| Imiphumela emibi evamile nengavamile ye-Tamoxifen | |
|---|---|
| Umphumela ongemuhle | Incazelo |
| Imiphumela emibi evamile (abesifazane) | |
| Ukushisa okukhulu | Kufana nophawu lokunqamuka kokuya esikhathini. |
| Ukujuluka ebusuku | Ubuthongo bungase buphazamiseke. |
| Ukuya esikhathini okungajwayelekile/ukopha kwesitho sangasese sowesifazane | Umjikelezo wokuya esikhathini kwabesifazane abangakayi esikhathini ungase ushintshe. |
| Ukoma kwesitho sangasese sowesifazane, ukulunywa, ukukhishwa kwamanzi | Kungase kube nezinkinga zocansi. |
| Imiphumela emibi engavamile kodwa emibi kakhulu | |
| Amahlule egazi | Kungavela emithanjeni yemilenze (Deep Venous Thrombosis) noma emaphashini (Pulmonary Embolism). |
| Ingozi yomdlavuza wesibeletho | Kukhona ingozi encane kakhulu. Uma uzwa ukopha okungajwayelekile, kufanele wazise udokotela wakho. |
| Ama-cataract | Qaphela uma kukhona ushintsho embonweni. |
| Isifo sohlangothi | Kuyisimo esingavamile kakhulu kodwa esibucayi. |
I-Raloxifene ingaba nemiphumela emibi efanayo (isib. ukushisa okukhulu, ubuhlungu emilenzeni), kodwa ingozi yomdlavuza wesibeletho iphansi kune-Tamoxifen. Udokotela wakho uzokuchazela lokhu ngokuningiliziwe.
Yini engingayenza ukuze ngiphathe imiphumela emibi?
Kunezinto ezimbalwa ongayenza wena ukuze wenze ukuphila nale miphumela emibi kube lula.
- Ukuze uthole ukushisa: Nciphisa iziphuzo ezine-caffeine njengekhofi netiye. Abanye abantu bangathola impumuzo ngokudla ukudla okuqukethe ama-phytoestrogens njengesoya, ubhontshisi, kanye ne-lentile.
- Ngokuqwasha: Ukuvivinya umzimba njalo kungathuthukisa ikhwalithi yokulala.
- Ukoma kwesitho sangasese sowesifazane: Kunezithambisi ezikhethekile zesitho sangasese sowesifazane ezingasetshenziswa kulokhu. Buza udokotela wakho ngalezi.
Kunini lapho kufanele ufune khona iseluleko sezokwelapha ngokushesha?
Uma imiphumela emibi evamile iba mibi kakhulu, tshela udokotela wakho. Kodwa-ke, uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, iya emnyangweni wezimo eziphuthumayo wesibhedlela (ETU) ngokushesha noma ushayele u-1990. Lokhu kungaba izimpawu zesimo esibucayi njengesifo sohlangothi noma ihlule legazi emaphashini (pulmonary embolism).
- Ukuba ndikindiki noma ubuthakathaka ohlangothini olulodwa lomzimba noma lobuso.
- Ubunzima bokukhuluma, ukungakwazi ukukhuluma kahle.
- Ikhanda elibuhlungu kakhulu ngokuzumayo.
- Ubunzima bokuphefumula ngokuzumayo.
- Ubuhlungu obukhulu esifubeni, engalweni, ehlombe, noma emhlathini ngaphandle kwesizathu esibonakalayo.
Ungazinaki lezi zimpawu. Ukuthatha isinyathelo ngokushesha kungasindisa ukuphila.
Umlayezo Wokuya Nawe Ekhaya
- Ama-SERM ayiklasi elikhethekile lemithi elawula indlela i-hormone i-estrogen esebenza ngayo. Ayindlela yokwelapha ephumelela kakhulu yomdlavuza webele kanye ne-osteoporosis.
- Le mithi iyamisa ukukhula kwamangqamuzana omdlavuza webele futhi iyasiza nasekuqiniseni amathambo.
- I-Tamoxifen ne-Raloxifene yizimbili ze-SERM ezisetshenziswa kakhulu.
- Njengayo yonke imithi, kunemiphumela emibi engaba khona, kodwa eminingi yayo ingalawulwa. Khuluma nodokotela wakho ngayo ngokukhululekile.
- Qaphela imiphumela emibi engathi sína kodwa engavamile njengokuqhekeka kwegazi kanye nesifo sohlangothi. Uma kuvela izimpawu ezinjalo, funa iseluleko sezokwelapha ngokushesha.
- Udokotela wakho kuphela ongakunikeza iseluleko esingcono kakhulu sokuthi ukwelashwa kwe-SERM kulungile yini kuwe, nokuthi yiziphi izinzuzo nezinkinga zako. Ngakho-ke ungesabi ukubuza noma yimiphi imibuzo onayo.
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