Sonke sesizwile ngomdlavuza webele. Kodwa bewazi ukuthi kunezinhlobo ezahlukene zomdlavuza webele? Ezinye izinhlobo kulula ukuzelapha, kodwa ezinye izinhlobo zimbi kakhulu futhi zimbi kakhulu. Namuhla sizokhuluma ngohlobo lomdlavuza webele olubi kakhulu, kodwa lungalawulwa uma luqondwa kahle futhi lwelashwa. Yilokhu odokotela abakubiza ngokuthi "umdlavuza webele ongemuhle kathathu" noma `(umdlavuza webele ongemuhle kathathu - TNBC)`.
Kuyini lokhu okune-Triple Negative?
Kalula nje, kunezinto ezintathu eziyinhloko ezisiza amangqamuzana omdlavuza webele ukuba akhule. Lawa ama-hormone i-estrogen ne-progesterone, kanye neprotheyini ebizwa ngokuthi i-HER2. Cabanga ngalawa "njengeminyango" emaseli omdlavuza. Odokotela banikeza "izihluthulelo" (okungukuthi, imithi efana nokwelashwa ngama-hormone) ezifanelana nalawa "minyango" futhi zivimbele umdlavuza ukuthi ukhule.
Kodwa-ke, kumdlavuza onezinhlayiya ezintathu, amangqamuzana omdlavuza awanazo zonke lezi zinhlayiya ezintathu (i-estrogen, i-progesterone, i-HER2). Lokhu kusho ukuthi 'azinazo'. Ngenxa yokuthi lezo zinhlayiya azikho, izinto ezifana nokwelashwa ngamahomoni okuvame ukunikezwa azisebenzi kulolu hlobo lomdlavuza. Ngenxa yalesi sizathu, lolu hlobo lomdlavuza lubhekwa njengolunamandla kakhulu, lusakazeka ngokushesha kunezinye izinhlobo.
Kodwa lokhu akusho ukuthi ayinakwelashwa. Lutho neze! Kunezinye izindlela zokwelapha ezinamandla ezingasiza. Udokotela wakho uzokhetha uhlelo lokwelapha olukufanele.
Ziyini izimpawu zalo mdlavuza?
Izimpawu zomdlavuza webele one-triple-negative zivame ukufana nezezinye izinhlobo zomdlavuza webele. Uma uhlangabezana nanoma yiziphi zalezi zimpawu, ungazinaki futhi ubone udokotela ngokushesha.
| Isibonakaliso | Incazelo elula |
|---|---|
| Isigaxa noma ukuqina kwebele | Iqhubu elisha elalingekho ngaphambili, ongalizwa esandleni sakho. |
| Ubuhlungu/ukubomvu kwebele noma ingono | Ubuhlungu obuqhubekayo noma ukubomvu okusobala. |
| Ukuguqulwa noma ukukhishwa kwengono | Ingono eyayivamile ngaphambili iyaphenduka noma kuphume uketshezi (olungelona ubisi). |
| Ukuvuvukala kwebele | Iqhubu lingase lingabonakali, kodwa ingxenye noma lonke ibele lingase livuvuke. |
| Isikhumba esifana nekhasi lewolintshi | Izimbobo esikhumbeni sesifuba ziyakhula, zibukeke njengobuso bekhasi eliphuzi. |
| Amaqhubu ekhwapheni noma eduze kwengalo | Ama-lymph node (ama-nodule) avuvukele endaweni engaphansi kwekhwapha noma eduze kwe-collarbone. |
| Ushintsho esimweni noma usayizi webele | Ibele elilodwa libukeka lihlukile kakhulu kwelinye. |
Ubani osengozini enkulu yokuthola lo mdlavuza?
Odokotela abakayazi imbangela eqondile yalolu hlobo lomdlavuza. Futhi akuvamile, kuthinta kuphela u-10%-20% wabesifazane abathola umdlavuza webele. Kodwa-ke, abanye abantu basengozini enkulu.
- Abesifazane abangaphansi kweminyaka engama-40 ubudala .
- Abantu abane -BRCA gene mutation , ikakhulukazi i-BRCA1 gene. Lolu ushintsho lwezakhi zofuzo oludluliselwa ezizukulwaneni ngezizukulwane.
- Abesifazane abakhuluphele ngokweqile futhi abangawuvivinyi umzimba ngemva kokunqamuka kokuya esikhathini (ukuphela kokuya esikhathini) .
Wazi kanjani ukuthi unomdlavuza?
Udokotela kuphela ongakutshela ngqo ukuthi uluhlobo luni lomdlavuza onalo. Lokhu kuhilela ukuhlolwa okuningana.
1. I-Mammogram kanye ne-ultrasound scan: Lokhu kungabona amaqhubu noma izinkinga ngaphakathi kwebele.
2. Ukuhlolwa kwe-Biopsy `(Biopsy)`: YilokhuUkuhlolwa okubaluleke kakhulu nokubaluleke kakhulu . Okwenziwa lapha ukuthatha ingxenye encane kakhulu yezicubu eqhubu elisolisayo ngaphansi kwe-anesthesia bese uyithumela kudokotela ochwepheshe ohlola izicubu.
3. Ukuhlolwa kwezicubu: Isampula yezicubu ihlolwa ngaphansi kwe-microscope ukuze kutholakale ukuthi inomdlavuza noma cha. Uma inomdlavuza, ihlolwa "iminyango" esikhulume ngayo ngaphambilini ebizwa ngokuthi i-estrogen, i-progesterone, kanye ne-`HER2`. Uma zonke ezintathu zingenayo i-HIV, itholakala njengomdlavuza one-triple-negative.
Ukunquma isigaba somdlavuza
Ngemva kokuba umdlavuza usutholakale, udokotela uzonquma "isigaba sawo." Lokhu kusho ukuthi umdlavuza mkhulu kangakanani nokuthi ususakazeke kangakanani. Lokhu kungafaka ukuhlolwa okufana ne-MRI, i-CT scan, kanye ne-PET scan.
Uhlelo lwe-`TNM` luyindlela eyamukelwa emhlabeni wonke.
- T (Isimila): Ingakanani isimila? (Amaphuzu asukela ku-0-4)
- N (Ama-Node): Ingabe umdlavuza usakazekele kuma-lymph node aseduze? (Isilinganiso esingu-0-3)
- M (Metastasis): Ingabe umdlavuza ususakazekele ezithweni ezikude njengamaphaphu, isibindi, noma amathambo? (0 noma 1)
Kusekelwe kulesi sigaba lapho udokotela ezonquma khona ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe.
Yiziphi izindlela zokwelapha?
Inhlanganisela yezindlela zokwelapha ivame ukusetshenziswa ekwelapheni umdlavuza onemiphumela emithathu.
1. Ukwelashwa ngamakhemikhali
Lokhu kuyindlela yokwelapha eyinhloko nebaluleke kakhulu yalolu hlobo lomdlavuza. Kuhilela ukunikeza umzimba imithi enamandla ebulala amangqamuzana omdlavuza. Uma itholakala kusenesikhathi, lo mdlavuza usabela kahle kakhulu ku-chemotherapy.
- I-Neoadjuvant Chemotherapy: I-Chemotherapy enikezwa ngaphambi kokuhlinzwa ukuze kuncishiswe isimila futhi kwenziwe ukuhlinzwa kube lula.
- I-Adjuvant Chemotherapy: I-Chemotherapy enikezwa ngemva kokuhlinzwa ukuze kubhujiswe noma yimaphi amangqamuzana omdlavuza asele.
2. Ukuhlinzwa
Kunezinhlobo ezimbili zokuhlinzwa.
- Ukususwa kweqhubu: Ukususwa kweqhubu elinomdlavuza kanye nenani elincane lezicubu ezizungezile.
- Ukususwa kwebele: Ukususwa kwebele lonke. Ngenxa yokuthi lo mdlavuza unamandla kakhulu, odokotela bavame ukuncoma ukuthi kususwe ibele lonke (i-mastectomy).
3. Ukwelashwa Ngemisebe
Ngemva kokuhlinzwa, lokhu kwelashwa kunikezwa ukuze kubhujiswe noma yimaphi amangqamuzana omdlavuza angase ahlale endaweni futhi kuvinjelwe umdlavuza ukuthi ungabuyi.
4. Ukwelashwa nge-immunotherapy
Lena indlela entsha yokwelapha. Esikwenzayo lapha ukuvuselela amasosha omzimba wethu , sisize ukuthi siqaphele futhi sihlasele amangqamuzana omdlavuza. Lena yindlela yokwelapha ephumelela kakhulu yomdlavuza onemiphumela emithathu emibi.
5. Ukwelashwa Okuqondiwe
Lena futhi indlela entsha yokwelapha. Kufana "nebhomu elihlakaniphile." Lokho okwenziwa yile mithi ukuthola ngqo amangqamuzana omdlavuza, ukuwanamathisela, bese eletha i-chemo ngqo kumangqamuzana omdlavuza. Lokhu kubizwa nangokuthi 'i-Antibody-drug conjugate (ADC).' Lokhu kubangela umonakalo omncane kakhulu kumangqamuzana anempilo.
Amathuba okululama nokubuyela emuva
Lo mbuzo ubaluleke kakhulu kubantu abaningi. Kunzima ukunikeza impendulo eyodwa ngoba iyahlukahluka kuye ngomuntu nomuntu. Amathuba okululama ancike ekutheni umdlavuza utholakala ngokushesha kangakanani nokuthi umzimba usabela kanjani ekwelashweni.
- Kumdlavuza webele wendawo, amathuba okusinda iminyaka emi-5 aphezulu afinyelela ku-91%.
- Uma isakazekela ezicutshini eziseduze (ezindaweni), leso sibalo singaba ngu-65%.
- Uma isakazekela ezithweni ezikude, leso sibalo sehla sibe yi-12%.
Ungakhathazeki ngalezi zibalo. Lezi ziyizilinganiso nje ezivela ezinkulungwaneni zabantu. Isimo sakho singaba ngcono kakhulu. Into ebaluleke kakhulu ukuqaphela izimpawu bese ubona udokotela ngokushesha okukhulu.
Umdlavuza one-triple-negative unengozi yokuphinda ubuye eminyakeni emithathu yokuqala ngemva kokwelashwa. Kodwa-ke, leyo ngozi iyancipha ngokushesha ngemva kweminyaka emihlanu. Ngakho-ke, kubalulekile ukuqhubeka nokuhlolwa okulandelayo njengoba kuqondiswe udokotela wakho ngemva kokwelashwa.
Umlayezo Wokuya Nawe Ekhaya
- Umdlavuza webele one-triple-negative (TNBC) uhlobo lomdlavuza olunamandla kakhulu futhi olusakazeka ngokushesha kunezinye izinhlobo.
- Lokhu kungenxa yokuthi la maseli omdlavuza awanazo i-hormone kanye nama-protein receptors asiza umdlavuza ukukhula.
- Nakuba ukwelashwa okuvamile kwama-hormone kungasebenzi kulokhu, kunezindlela zokwelapha eziphumelela kakhulu ezifana nokwelashwa ngamakhemikhali, ukuhlinzwa, ukwelashwa ngemisebe, kanye nokwelashwa nge-immunotherapy.
- Ukuqaphela izimpawu kusenesikhathi kubaluleke kakhulu ukuze kusindiswe izimpilo. Ungalokothi ungazinaki izinguquko emabeleni akho.
- Ungesabi ukubuza udokotela wakho imibuzo mayelana nokwelashwa kwakho kanye nesigaba somdlavuza wakho. Ukwazi konke ngokucacile kuzokunika amandla amakhulu engqondo.
- Awuwedwa kulolu hambo. Thola ukwesekwa ngumndeni wakho nabangani bakho. Kuzoba amandla amakhulu kuwe.
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