I-Axumin iyagunyaziwe yi-FDA, i-scan ekhutshwe nge-Medicare ekwazi ukufikelela ekufumaneni kwangaphambili umdlavuza wesibeletho emva kokuhlinzwa okanye i-radiation. Sekuyiminyaka siye sakwazi ukubona umdlavuza we-prostate ukuphindaphinda kunye ne- PSA , kodwa i-standard standard kunye ne- scans scans ayikwazanga ukucacisa indawo yomhlaza kuze kube yinqanaba eliphezulu lePSA (10 ukuya ku-30 okanye ngaphezulu).
I-Axumin iyakwazi ukufumana izifo eziphindaphindiweyo ngamazinga e-PSA ngaphantsi kwe-10 kwaye ngamanye amaxesha amaninzi amaninzi, eso sizathu sokuba ukukhangela kubaluleke kangaka ukuphuhliswa.
Kutheni i-Axumin ibaluleke kangaka?
Ukukwazi ukufumana izifo zesifo se-earlyast ngokuskena kunika izibonelelo ezibalulekileyo ezibalulekileyo zokwelapha. Okokuqala, ulwazi malunga nokuba umhlaza unokuphi na unokukunceda ukukhokela unyango osebenzayo kuloo ndawo ethile yomzimba kwaye unciphise umonakalo kwezinye iindawo zomzimba. Ukutshekisha kuthatha apho umhlaza ungekho khona kwaye apho kungekho unyango olungadingeki khona.
Isibini sesigxina esibalulekileyo ekunikeni ukukhangela ngokuchanekileyo kukunika ingqiqo ejulile kwinkqubo yesifo ngokwawo-ukutyhila ukuba umhlaza awuzange uyeke, okanye ukuba uye waqhelaniswa kangakanani na.
Umdlavuza oqhelekileyo obonakaliswe yi-PSA ekhulayo ayikho ngaso sonke ixesha ngenxa yeemastastas. Ngamanye amaxesha umhlaza uhlala kufuphi okanye apho iprotrate yayisetyenziswa khona, ngoko iPSA ivela emdlavuza oqhubekayo kwi-prostate gland emva kwemisebe okanye kwi-prostate fossa emva kokuhlinzwa (i-fossa yindawo yomzimba apho iprotrate yayisisithuba ngaphambi kokuba ukususwa kokukhutshwa), eyaziwa ngokuba "ukuphindaphinda kwendawo."
I-PSA inokuphinda iphakanyiswe ngenxa yomhlaza okhulayo oye wahluthwa kwi-lymph nodes okanye amathambo. Oku kubizwa ngokuba yi-"systemic recurrence" Ngoba? I-metastases ibonisa ukuba umhlaza unamandla okusabalala emhlabeni wonke-inqubo ekugqibeleni iholele ekufeni kwisigqirha sesigulane somdlavuza wesibeletho.
Ngaloo ndlela, ukwazi indawo yokuphindaphinda kuyiphendula umbuzo obalulekileyo kakhulu: ingaba isifo esipheleleyo sisinamandla ngokwaneleyo ukuba ulungelelanise.
Njengoko sitshilo, amandla okusasazeka ngumhlaza yinto eyenza umdlavuza ube yingozi. Olu lwazi lukhulula ugqirha ukuphumeza inkqubo enonyango yokunyango lwezokwelapha ngaphandle kokungabikho kwiinkcukacha ezinxulumene noloyiko lokuphulukiswa ngokugqithiseleyo. Ukuba isifo esivamile sisendaweni yeprotrate okanye iprotate fossa, indlela enokunyango yokunyanga iya kuba yinto engavumelekanga kwaye ingekho ngokungadingekile.
Unyango olutshanje lunokudityaniswa nemiphumo emibi. Nangona kunjalo, uhlobo lwonyango olukhuselekileyo endithetha ngalo ngamachiza ajikeleza egazini kwaye anesiphumo somzimba kumzimba wonke, apho i-chemotherapy ne- Taxotere okanye unyango lwe-hormonal kunye ne- Lupron ne-Casodex yimizekelo emihle.
I-Axumin isebenza njani?
I-bone standard scans isebenzisa i-calcium ehlobene ne-radioactive substances ezigxininisa kwiindawo zethambo ezicasuliweyo ngumhlaza. Iskripthi se-Axumin PET sisebenza ngokubona umsebenzi weempawu zomhlaza ngokwawo .
I-Axumin ixhaphaza ukuba i-prostate cancers iyamkela ama-amino acids ngexesha elikhawulezayo ngakumbi kuneeseli eziqhelekileyo.
I-Axumin ine-traceticactive tracer ehlanganiswe ne-amino acid. Ekubeni iintsholongwane zomhlaza zithatha ama-amino acids ngaphezu kweeseli eziqhelekileyo, i-radiation igxininisa ngaphakathi kweeseli zesisu. Xa isigulane sifakwe phantsi kwe-scanner indawo yeendawo eziphakamileyo zempawu zomsakazo indawo yomhlaza kwisitho somzi.
Ulwazi olutsha lubonelelwa njani ngeAxumin esebenzisiweyo?
Ukukhishwa kwe-Axumin kuvunyelwe ukuba amadoda aphuhlise i-PSA ekhulayo emva kwemisebe okanye ukuhlinzwa. Ngokomlando, i-bone elula kunye neenkcukacha ze-CAT zifuna i-PSA kumanqanaba angama-10 ukuya kuma-50 ngaphambi kokuba umhlaza okwaneleyo ube khona ukufunyanwa kwi-scan.
Ubuhle bovavanyo lwe-Axumin PET kukuba lunikeza ithuba lokufumana izilonda ezincinci zamathambo kwi-lymph nodes namazinga e-PSA kwi-1 ukuya kwe-10.
Esinye isisetyenziso sokusetyenziswa kwe-Axumin, ngaphandle kobuncedo bayo ekuqaliseni indawo ye-PSA kwakhona, yinto yamadoda ayenze unyango lwe-chemo-hormonal kwizifo eziphambili ze-metastatic. Emva kokonyango, amadoda angaphumelela ekunciphiseni okuthe ngqo kwi-PSA-mhlawumbi ukususela kuma-100 ukuya kwe-10 ukuya ngaphantsi. I-Axumin scan iyakwazi ukuqhawula ummandla womhlaza emzimbeni obonakalisa umsebenzi oqhubekayo wokuxilongwa, uphawu lokuba amangqamuzana omhlaza asebenzayo nangona unyango lwakutsha nje kunye neLupron ne-Taxotere. Ukuba inani elincinci lemimandla yomsebenzi oqhubekayo wokuxilongwa, iyakwazi ukuba izigulane zinokuzuza kwi-ray ray okanye ezinye iindlela zonyango ezibhekiselele kwizifo eziseleyo.
Ukusetyenziswa kwexesha elizayo
Nangona i-scan iqale yavunywa ukuba isebenziswe kwisimo sePSA kwakhona , ezinye izicelo ziyakuthi zisetyenziswe kwixesha elizayo. Eyona nto ibalulekileyo yayiza kuba ngabadlali abasanda kutshatyalaliswa abane-Gleason izikolo ezili-8 okanye ngaphezulu okanye kumadoda anamazinga aphakamileyo e-PSA angaphezulu kwama-20. Ukufumana izifo zesantya zangaphambili kwii-lymph nodes kumadoda asandul 'ufumanekile. Izigulane ezinesifo se-metastatic zifunyenwe ukuba zinezinga eliphezulu lokunyanga xa zifumana unyango olushushu kunye ne-Taxotere kunye ne-Lupron. Izigulane ezingenazo i-metastasis ezinjalo ziyakwenza unyango olunzima kwaye zinciphise iziphumo zazo ngaphandle kokunciphisa amazinga abo.
Ukutolika iiScans
Ukuchazwa kwezi zixhobo ezintsha kuza kuqukwa kwinqanaba lokufunda koogqirha abafunda izicatshulwa. Yiyo imeko nayiphi na iteknoloji entsha. Kwakhona kubalulekile ukuba izigulane ziqonde ukuba uhlobo lwethekhnoloji ekwenzeni ezo zicatshulwa-oko kukuthi, i-scanners ngokwabo-iya kuhluka ukusuka kwisenzo sokusebenza. Ezinye iindlela zinezobuchwepheshe obudala kunye namandla okufumanisa iindawo ezincinci zeemetastatic ziya kusebenza kakuhle.
Ukuqaphela le miba yokukhawulela, kuya kuba kubalulekile kwizigulane ukuchonga amaziko asetyenziswa izixhobo zobugcisa kunye neentlobo zamagqirha ayenamava aphezulu. Ezi ziko zokugqwesa ziyakwazi ukukwazi ukufunda ezi ziko ngokufanelekileyo.
Ukusebenza ngokusesikweni kunye namanye amaTeknoloji
Esinye isizathu sokuba i-Axumin ibaluleke kakhulu ekunceda ukuba oogqirha baxhaphaze ngokupheleleyo i-Intensity Modulated Radiation Treatment (IMRT). I-IMRT yindlela echanekileyo ye-teknoloji ye-radiation enokujolisa kwiindawo ezininzi zomzimba ezazingenakufikeleleka kumbane. I-IMRT ichanekile kangangokuthi oogqirha banokwenza iinjongo ze-radiation kunye ne-millimeter ukuchaneka kwaye bagweme ngokupheleleyo umonakalo kwizakhiwo ezibucayi ezinjengeemathumbu, ngokomzekelo, kwizigulane ezinezifo zesifo se-lymph node esiswini. Esinye sezizathu zokuthi u-Axumin PET ukukhangela kubangel 'umdla kuba yenze enye iteknoloji ekhoyo, i-IMRT, inokubaluleke ngakumbi.
Ithemba elongeziweyo ngekamva
Ukufika kokukhangela umdlavuza ophuculweyo kunye neAxumin kwandisa ithemba lokuba ezinye iintlobo zeendlela zokutshekisha ziya kuza kwixa elizayo. Ngokomzekelo, ezinye iintlobo ze-PET zikhangela, enye ebizwa ngokuba yi-PSMA, ijolise i-molecule ethile edla ngokubonakalayo phezu kweengqamuzana zomhlaza zesifo somhlaza. Inzuzo enokwenzeka ye-PSMA idlulisela ngaphaya kokunceda ukucinga; nesicelo esinokuthi sonyango. Ii-ligama ze-PSMA zinokudibaniswa nezinto ezinamandla ezinomsovutha ezinamandla okwanela ukubulala amaseli omhlaza.
Uluntu lomdlavuza wesifo seprotate ulindele ngokukhawuleza ukuba uhlalutye indawo yomhlaza womzimba wesifo somzimba ngesimo sokuchaneka ukuba ezi ziphumo zePET zingafikelela. Ezi ziko zimela ukuphumelela okuphawulekayo. Ngoku ukuba i-FDA ivume le teknoloji, iinkampani ze-inshorensi ziqala ukuhlola iindlela zokubonelela nge-coverage. I-Medicare yinkampani yokuqala yinshurensi yokuyikhusela.
Yiyiphi Impumelelo yangaphambili?
I-Axumin mhlawumbi yinkqubo enkulu yomdlavuza weprotate ukuqhubela u-2017, kodwa unokuzibuza kwakhona malunga nophuhliso olubalulekileyo kule minyaka emithathu edlulileyo. Okokuqala, ukuhamba ngokukhawuleza kweziphumo ezintsha kukuphuhliswa kwintsha, kodwa ezinye iintuthuko ziquka:
Kutheni ukuqhubela phambili kuqhubela phambili ngokuphindaphindiweyo?
Isizathu sokukhawuleza kwimiba yokuphumelela yinkqutyana yophando olusisiseko olukhokelela ekuqondeni okujonge ngakumbi kwe-biology yesifo somhlaza wesibeletho. Ngokukodwa, ukuguqulwa kwemizimba ethile eyenza ukukhula kwamaselula okungalawulwayo kuye kwacaciswa.
Izakhi zofuzo ezithintekayo yinto eyenza iiseli zomhlaza zihluke kwiiseli eziqhelekileyo. Kaloku ukuba ezi zinguqu zinokuthi zichongiwe, amayeza amasha angaklanywa ukuhlawulela izakhi zegesi ezingaqhelekanga. Cinga indlela i-software yepatch ingabhalwa ngayo ngumprogram wekhompyutheni ukulungisa i-computer glitch.
Kwiminyaka eyandulela, ngaphambi kokuba sifike ukuqonda kwethu kwintsuku ye-biology yeseli, amayeza amasha abe ngumphumo weenkqubo ezinzima, zolu vavanyo kunye nephutha. Ikhemikhali ekhethiweyo ekhethiweyo iya kuhanjiswa kumhlaza weseli okhulayo kwi-Petri izitya. Ukuba ikhemikhali yabangela ukuba iiseli zomhlaza zife, ziza kunikwa izilwanyana ezinomdlavuza. Ukuba umhlaza uphezulu kwaye isilwanyana siphila, siya kuvavanywa ngabantu. Uvavanyo oluphumelelayo lwabantu luya kubakhokelela ekuvunyelwene kwe-FDA kunye nokufumaneka kwezorhwebo kwonyango olutsha.
Ngokungafani nemichiza eyenziwe ngokwemiqathango yamaxesha amva nje, indlela abaye bayifumana ngayo imvavanyo yesilingo kunye nephutha ngokungaqhelekanga.