Uma sithola ukuthi sinomdlavuza, sonke sesaba kakhulu. Ngesikhathi esifanayo, sicabanga ngokwelashwa okufana ne-chemotherapy. I-Chemotherapy ibhubhisa amaseli ahlukana ngokushesha. Kodwa-ke, ingabhubhisa hhayi kuphela amaseli omdlavuza, kodwa namaseli anempilo emzimbeni wethu, isibonelo, amaseli ezinwele, amaseli abangela izilonda emlonyeni, namaseli emathunjini. Yingakho i-chemo ibangela ukulahleka kwezinwele, izilonda emlonyeni, kanye nokuphazamiseka kwesisu. Kodwa, cabanga... bekuyoba kuhle kangakanani ukube bekukhona uhlobo lomuthi olungahlasela amaseli omdlavuza kuphela, njengesibhamu se-sniper? Yilokho esizokhuluma ngakho namuhla. Lawa abizwa ngokuthi ama-Tyrosine Kinase Inhibitors , noma ama-TKI ngamafuphi.
Kalula nje, ziyini lezi TKI?
Ama-TKI awuhlobo lokwelashwa okuqondiwe olusetshenziswa ekwelapheni umdlavuza. Asebenza ngokuvimba izinto ezithile ngaphakathi kwamaseli omdlavuza eziwasiza ukuba akhule futhi ahlukane. Ngamanye amazwi, amaseli omdlavuza anesimiso sokuthumela izimpawu esiwatshela ukuthi "akhule futhi ahlukane." Ama-TKI asebenza ngokuphazamisa leso simiso sokuthumela izimpawu bese esimisa.
Le mithi ingase ingayelaphi ngokuphelele umdlavuza, kodwa ingasiza iziguli ukuthi zilondoloze ukulawula isikhathi eside (ukuxolelwa) komdlavuza, noma ziphile impilo enhle nomdlavuza.
Lomuthi usebenza kanjani ngempela? Ake sibheke kabanzi.
Ukuze siqonde lokhu, sidinga ukwazi okuncane ngenqubo evamile yokuhlukaniswa kwamaseli emzimbeni wethu. Ake sithi umzimba wethu uyifektri enkulu. Izisebenzi kule fektri zibizwa ngamaseli.
1. Izici zokukhula: Lezi yizithunywa ezivela ngaphandle kwefektri eziletha umyalezo othi "Qala ukukhiqiza manje."
2. Ama-Tyrosine kinase: Lawa ama-enzyme angaphakathi kwamaseli athatha umyalezo bese etshela abanye ukuthi "Kulungile, ake siqale ukusebenza."
Nakhu okwenzekayo kuseli eliphilile elijwayelekile. Isithunywa (isici sokukhula) siyafika bese sinikeza umlayezo kumphathi (i-tyrosine kinase). Umphathi uthatha lowo myalezo bese etshela iseli ukuthi lihlukane. Ngemva kokuba amaseli esehlukane ngangokunokwenzeka, umphathi uvala iswishi. Lena inqubo elawulwa kakhulu .
Kodwa kumaseli omdlavuza, lolu hlelo luyaphazamiseka. Kwezinye izinhlobo zomdlavuza, ikakhulukazi, laba baphathi (i-Tyrosine kinases) bayahlanya. Iswishi yabo ivuliwe unomphela. Abadingi umlayezo ovela ngaphandle, baqhubeka nje betshela amaseli ukuthi "ahlukanise, ahlukanise, ahlukanise." Lokhu kuhlukaniswa kwamaseli okungalawulwa yilokho esikubiza ngokuthi umdlavuza.
Lokho okwenziwa ama-TKI ukuya endaweni yokusebenza yomphathi ohlanyayo, ohlala njalo (i-Tyrosine kinase) bese emphazamisa ukuze angakwazi ukwenza umsebenzi wakhe. Bese leso signali "sokuhlukanisa" esiqhubekayo siyama. Amaseli omdlavuza ayayeka ukuhlukana, futhi isimila siqala ukuncipha.
Isibonelo esihle kakhulu: I-Chronic Myeloid Leukemia (CML)
Lolu uhlobo lomdlavuza wegazi. Esikhathini esidlule, lapho i-CML iqala, kwakuyisifo esibulalayo. Kodwa ngemva kokutholakala kwama-TKI, i-CML manje isibe yisifo esingamahlalakhona esingalawulwa ngemithi efana nesifo sikashukela kanye nomfutho wegazi ophakeme.
Emaseli asemongweni wethambo weziguli ze-CML, i-enzyme ye-Tyrosine kinase esikhulume ngayo yakhiwe ngendlela engavamile, futhi ukushintsha kwayo 'kuvuliwe' unomphela. Ngakho-ke umongo wethambo ukhiqiza amaseli amhlophe egazi ngaphandle kokulawula. Lokhu kuvimbela ukukhiqizwa kwamaseli abomvu egazi anempilo, amaseli amhlophe egazi, nama-platelet. Ama-TKI, njenge- Imatinib (Gleevec®) , ahlose leyo enzyme engavamile futhi avale ukushintsha kwayo 'kokuvula'. Lokhu kuyinguquko enkulu emlandweni wokwelashwa komdlavuza.
Yiziphi izinhlobo zomdlavuza ezisetshenziswa ama-TKI?
Lokhu kwelashwa okuqondiwe manje sekusetshenziselwa izinhlobo eziningi zomdlavuza. Akusebenzi kuzo zonke izinhlobo zomdlavuza. Lokhu kungenxa yokuthi akuwona wonke umdlavuza one-Tyrosine kinase 'evuliwe'. Odokotela bathatha i-biopsy yamaseli omdlavuza bese bebona ukuthi banayo yini le molekyuli eqondiwe. Kuphela uma ikhona, lapho bezonikeza lo muthi.
Ngezansi kunezinhlobo eziyinhloko zomdlavuza olashwa ngama-TKI.
| Uhlobo lomdlavuza | Incazelo |
|---|---|
| Umdlavuza wegazi (i-Leukemia) | Izinhlobo ezifana ne-chronic myeloid leukemia (CML) kanye ne-chronic lymphocytic leukemia (CLL). |
| Umdlavuza Wamaphaphu | Ikakhulukazi ezigulini ezinomdlavuza wamaphaphu ongewona amaseli amancane (i-NSCLC) kanye nokuguqulwa kwezakhi zofuzo njenge-EGFR kanye ne-ALK. |
| Umdlavuza Webele | Ngezinhlobo ezithile ezifana nomdlavuza webele one-HER2-positive. |
| Umdlavuza Wesisu | Kumdlavuza ofana nezimila zesisu ezibangela ukusha kwesisu (i-GIST) ezenzeka esiswini nasemathunjini. |
| Umdlavuza Wezinso | Ikakhulukazi kumdlavuza wezinso osuthuthukile. |
| Umdlavuza Wesikhumba | Kumdlavuza wesikhumba ofana ne-melanoma ene-BRAF gene mutation. |
Njengamanje, i-US FDA ivumile ama-TKI angaphezu kwama-50 ukwelapha izinhlobo ezahlukene zomdlavuza. Umuthi wokuqala ovunyelwe, i-Imatinib (Gleevec®), usetshenziselwa ukwelapha izinhlobo ezi-7 zomdlavuza.
Ngingayithola kanjani le ndlela yokwelashwa? Kuthatha isikhathi esingakanani?
Lokhu kungenye indlela elula kakhulu yalolu hlobo lokwelashwa. Ama-TKI amaningi atholakala epheshaneni noma ngesimo soketshezi . Ngakho akudingeki uhlale esibhedlela bese ujova umuthi ngesisombululo sikasawoti. Kufanele nje uphuze iphilisi elilodwa noma amabili ngesikhathi esifanayo nsuku zonke ekhaya.
Isikhathi osidingayo sokwelashwa sincike ohlotsheni lomdlavuza onawo, isigaba salesi sifo, kanye nendlela umzimba wakho osabela ngayo emuthini. Isibonelo, uma une-CML, kungadingeka ukuthi uthathe umuthi impilo yakho yonke. Kwezinye izinhlobo zomdlavuza, udokotela wakho anganquma ukuyeka umuthi uma umdlavuza usulawulekile.
Masiqaphele nemiphumela emibi.
Ngenxa yokuthi ama-TKI ayizindlela zokwelapha eziqondiwe, ngokuvamile anemiphumela emibi embalwa kune-chemotherapy. Lokhu kungenxa yokuthi adala umonakalo omncane kumaseli aphilile. Kodwa akunakwenzeka ukusho ukuthi "awanazo nhlobo imiphumela emibi." Lokhu kungenxa yokuthi i-molecule abayiqondisayo, ebizwa ngokuthi i-Tyrosine kinase, ayikho nje kuphela kumaseli omdlavuza, kodwa futhi itholakala ngamanani amancane kwamanye amaseli aphilile. Ngakho lawo maseli nawo angathinteka.
Imiphumela emibi iyahlukahluka kumuntu nomuntu futhi incike kumuthi we-TKI osetshenzisiwe.
Imiphumela emibi evamile:
- Ukukhathala: Lesi yisimo esivamile abantu abaningi ababhekana naso.
- Uhudo: Kungabangelwa ukulimala kwamaseli emathunjini.
- Isicanucanu Nokuhlanza: Abanye abantu bangase babe nalesi simo.
- Ukuqubuka Kwesikhumba: Ukuqubuka kwesikhumba, ukoma, kanye nokulunywa kuvamile.
- Ukushintsha kwesifiso sokudla kanye nesisindo: Abanye abantu bancipha isisindo, kanti abanye bangase bakhuluphale ngenxa yokuqunjelwa.
- Imfiva
Imiphumela emibi engaba khona:
Amanye ama-TKI angabangela imiphumela emibi enhliziyweni, esibindini, noma emaphashini. Angabangela nezimo zesikhumba ezingathi sína, ngisho nezisongela ukuphila, njenge -Stevens-Johnson syndrome , ethinta isikhumba. Kodwa lezi azivamile kakhulu. Umfutho wegazi ophakeme (umfutho wegazi ophakeme) ungenye inkinga.
Into ebaluleke kakhulu ukubuza udokotela wakho ngemiphumela emibi ethile yemithi oyiphuzayo ngaphambi kokuqala ukwelashwa. Uma uhlangabezana nanoma yiziphi izimpawu ezingavamile, ungazinaki futhi wazise udokotela wakho ngokushesha.
Yini engingayenza ukuze lokhu kwelashwa kube lula kimi?
Ukwelashwa komdlavuza kungaba isikhathi esinzima, ngokomzimba nangokwengqondo. Kunezinto ezimbalwa ongazenza ukuze wenze lesi sikhathi sibe lula kancane.
1. Ukuphumula: Ukukhathala kuyimbangela enkulu yokuphazamiseka kwengqondo. Ngakho-ke lala ngokwanele ngangokunokwenzeka, phumula emini, futhi ulalele umzimba wakho.
2. Ukudla Okunomsoco: Ukudla kungaba nzima ngenxa yezinto ezifana nokulahlekelwa yisifiso sokudla kanye nesicanucanu. Zama ukudla kancane izikhathi eziningana ngosuku. Phuza uketshezi oluningi njengamanzi, ujusi wezithelo, iphalishi, kanye nesobho. Uma wehlisa isisindo noma ukhuluphala ngokungadingekile, kubaluleke kakhulu ukufuna iseluleko kuchwepheshe wezokudla.
3. Ukulawulwa kwemiphumela emibi: Uma unesifo sohudo, yidla izinto ezifana namafutha, imifino ephekiwe kancane, ilayisi, nobhanana. Ukuphuza iziphuzo ezifana neJeevani kuhle kakhulu. Uma uthola ukuqubuka kwesikhumba, sebenzisa i-moisturizer engenaso insipho, engenaphunga. Khuluma nodokotela wakho ngalokhu bese uthola imithi efanele.
4. Hlela: Gcina idayari yezimpawu zakho nemiphumela emibi. Yibonise udokotela wakho uma ubona kuye. Khumbula ukuphuza imithi yakho ngesikhathi esifanele.
5. Impilo yengqondo: Kubaluleke kakhulu ukuhlala uqinile engqondweni phakathi nalesi sikhathi. Khuluma nomndeni nabangane. Yabelana ngezinkinga zakho. Uma kudingeka, funa iseluleko.
6. Ukunakekelwa Kokuphulukisa: Lokhu akusho ukuthi lesi sifo asilapheki. Leli yithimba lochwepheshe abakusiza ukuthi uphile ngokunethezeka ngokulawula izimpawu ezifana nobuhlungu, isicanucanu, nokukhathala okuhambisana nokwelashwa komdlavuza. Ungakhuluma nodokotela wakho ngale nsizakalo.
Ziyini izingozi zalokhu kwelashwa?
Nakuba ama-TKI esebenza kahle emidlavuzeni eminingi, ngezinye izikhathi izinkinga zingavela ngokuhamba kwesikhathi. Eyinhloko ukuthuthukiswa kokumelana .
Kalula nje, amangqamuzana omdlavuza angamaseli anobuqili kakhulu. Uma enikezwa umuthi ofanayo ngokuhamba kwesikhathi, angaguquka abe ukumelana nalowo muthi. Njengoba nje amagciwane eba ukumelana nama-antibiotic. Uma lokho kwenzeka, umuthi we-TKI owasebenza kahle ekuqaleni ungase ungasasebenzi.
Kodwa akusikho ukuphela komhlaba. Ngenxa yokuthi ososayensi bayazi lokhu, manje sekukhona ama-TKI "esizukulwane sesibili" kanye "nesizukulwane sesithathu" anganikezwa lapho kuvela ukumelana. Ngakho-ke uma umuthi owodwa ungasebenzi, udokotela wakho angakushintshela kwenye i-TKI.
Umlayezo Wokuya Nawe Ekhaya
- Ama-Tyrosine Kinase Inhibitors (TKIs) uhlobo oluthile lomuthi oluhlose futhi luvimbele uhlelo lokubonisa olulawula ukukhula nokuhlukana kwamaseli omdlavuza.
- Ngenxa yokuthi lezi zindlela zokwelapha eziqondiwe, azidali umonakalo omkhulu kumaseli anempilo futhi zinemiphumela emibi embalwa kune-chemotherapy yendabuko.
- Njengoba le mithi iza ngamaphilisi noma ngesimo soketshezi, kulula kakhulu ukukwazi ukuthola ukwelashwa ekhaya.
- Ngisho nomdlavuza obulalayo njenge-CML manje usuyizifo ezingamahlalakhona ezingalawulwa ngenxa yale mithi.
- Imiphumela emibi efana nokukhathala, isifo sohudo, kanye nokuqubuka kwesikhumba kungase kube khona. Bika noma yiziphi izimpawu ezingavamile kudokotela wakho ngokushesha.
- Ngokuhamba kwesikhathi, amangqamuzana omdlavuza angaba namandla okumelana nomuthi, kodwa kunezinhlobo ezintsha ze-TKI ezitholakalayo ezimweni ezinjalo.
- Nakuba le mithi ingawuqedi ngokuphelele umdlavuza, ingabasiza kakhulu abantu ukulawula lesi sifo futhi baphile isikhathi eside benempilo enhle.
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