Kwabesetyhini abanesifo somdlavuza se-estrogen, i-hormonal therapy ngokuvamile ixhaswa emva kokunyanga okuphambili kunye nokuhlinzwa kwaye mhlawumbi i- chemotherapy kunye / okanye unyango lwe-radiation . Iinqununu ziquka i-tamoxifen okanye i-aromatase inhibitors njenge-Arimidex, Femora, okanye i-Aromasin. Iindleko kunye neempembelelo zala mayeza zifanisa njani, kwaye yintoni oyifunayo ukuba wazi?
Kwenzeka ntoni ukuba unzima ukuhlawula le mithi?
IHormone Therapy kunye neNngcipheko yeCataltic Brever Recurrence
Siyazi ukuba nangona emva kokuba unyango oluphambili lomhlaza wesifuba unobungozi bokuphindaphinda . Kwaye emva kwexesha elidlulileyo kwiminyaka emininzi okanye kwiminyaka emininzi emva kokuba unyango luqheleke kakhulu kwiimvumi ezifumana i-estrogen. Iirmone zokwelapha ziye zaboniswa ukunciphisa umngcipheko wokuphindaphinda nokuphucula izinga lokusinda.
Ulwaphulo lweHormone lusebenza njani ukunciphisa ingozi yokuphinda ibuye
Siyazi ukuba i-estrogen isebenza njengento "yokukhula" ukunyusa ukukhula kwesisu se-estrogen-receptor ngokuzibophelela kwi-estrogen receptors kummandla wamaseli omhlaza. Ngako oko, kokubili ukunciphisa inani le-estrogen kwigazi kunye nokukhusela i-estrogen receptors kunokunciphisa ingozi ezi setyuli ziya kukhula kwaye zibuye zibuye ziphinde ziphinde zibuye.
I-Tamoxifen kunye ne-aromatase inhibitors isebenza ngeendlela ezahlukeneyo. Ngaphambi kokumiswa kwexesha, ii-ovari ziyimvelaphi ephezulu ye-estrogen.
I-Tamoxifen isebenza kubasetyhini be-premenopausal ngokuthintela i-estrogen receptors kwiiseli zomhlaza zesisu ukwenzela ukuba i-estrogen ayikwazi ukubopha nokuvuselela iiseli ukuba zikhule. I-Tamoxifen ingasebenza kwakhona emva kokumisa umva, kodwa i-aromatase inhibitors ifumaneke ukuba isebenze ngakumbi ekunciphiseni ukuphindaphinda.
Emva kokumiswa kwexesha, umthombo oyintloko we-estrogen kukuguqulwa kwe-androgens (ekhoyo kwiiseli ezinamafutha) kwi-estrogen.
I-enzyme eyenza oku kuthiwa yi-aromatase. I-Aromatase inhibitors ivimba isenzo se-aromatase ukuze i-estrogen ingenakwenziwa.
Ukhetho lweHormone Therapy kunye neMeko yeMenopausal
Ngabesifazana abasengaphambili bamadoda, i-tamoxifen iyadingeka njengoko umthombo oyintloko we-estrogen emzimbeni uvela kuma-ovari. Kule ndlela, i-aromatase inhibitors izakuvimba kuphela umthombo wesibini we-estrogen.
Abafazi be-Premenopausal ke baphathwa nge-tamoxifen. I-Aromatase inhibitors ingasetyenziswa kwizicwangciso ezimbalwa. Ukuba ibhinqa lihamba ngokumelana nokunyuka komzimba (njengoko kunqunywe ukuhlolwa kwegazi kuba kungenakuqinisekiswa emva kwekhemotherapy) unokutshintshwa kwi-aromatase inhibitors. Unako ukufumana ezi zi yobisi ukuba unesiphelo sokumisa umyeni (ukususwa kwee-ovaries) okanye ukufumana unyango lwe-ovarian.
I-Aromatase inhibitors njengamanje ifumaneka ziquka:
- Arimidex (anastrozole)
- Femara (letrozole)
- Aromasin (exemestane)
Ubude bexesha I-Hormonal Therapy isetyenziswe
Kwixesha elidlulileyo, i-tamoxifen okanye i-aromatase inhibitor yasetyenziswa iminyaka emi-5. Uphononongo olutshanje lubonisa ukuba ukuqhubeka kweminye iminyaka emihlanu (ngamanye amaxesha ukutshintsha ukusuka kwi-tamoxifen ukuya kwi-inhibitor ye-aromatase) kunokunciphisa umngcipheko wokuphindaphinda.
Imiphumo emibi yeTamoxifen vs Aromatase Inhibitors (Arimidex, Femara, neAromasin)
Bobabini i-tamoxifen kunye ne-aromatase inhibitors zingabangela ama-acul aches, kodwa ezi zibi kakhulu kwi-inhibitor ye-aromatase.
I-Tamoxifen inganciphisa ukulahleka kwethambo kodwa i-aromatase inhibitors ingakhokelela ekulahlekeni kwethambo kunye ne-osteoporosis.
Ngokubhekiselele kwimiphumo emibi, i-tamoxifen ngezinye izihlandlo ingabangela imiphumo emibi efana ne-blood clots kunye ne-pulmary emboli. I-Aromatase inhibitors idibene nenengozi yokwandisa isifo senhliziyo kwabasetyhini abanembali ye-blockages yamatri.
Ukuba iziphumo zecala ziba nzima, xelela ugqirha uze ucele iindlela zokujamelana nayo; zikho iindlela zokunciphisa ezi ziphumo zecala kunye nokwenza unyango lula. Nangona le nto ingaba yinkqubo enzima, khumbula ukuba ugqibezele inxalenye enkulu yonyango kwaye uhamba ebomini emva komhlaza webele.
Iindleko zeTamoxifen vs Aromatase Inhibitors
Bobabini i-tamoxifen kunye ne-aromatase inhibitors ezifana ne-Arimidex inokunciphisa ingozi yakho yokuphindaphinda umdlavuza webele (kunye nenye inzuzo ehambelana ne-aromatase inhibitors) kodwa iindleko zingafani kakhulu. Ekubeni i-tamoxifen yonyango elidala kunye nelona lonyango elimiselweyo, lihlala linye yeendlela ezincinci. I-Aromatase inhibitors idla ngokubaluleke kakhulu kunexabiso le-tamoxifen.
Zombini iindidi ze-hormone therapies zinceda ukunqanda ukuphindaphinda komdlavuza webele, kodwa zombini iintlobo zamachiza ziza neengxaki ezithile kunye nemiphumo emibi.
Ukulawula iindleko zeThymnal Treatment
Ulwaphulo lwe-hormonal lungabiza, kodwa lunokunceda ukucinga ngalo njengenqubomgomo yomshuwalense ngokuphindaphinda.
Iindleko zala mayeza enokuthi zihluke ngokukodwa kwi-inshorensi yakho. Ukongezelela, ezinye iinkampani zomshuwalense ziza kugubungela uhlobo olulodwa lwe-aromatase inhibitor kwaye alukho enye.
Ukuba unobunzima ngeendleko, kukho ezininzi iinketho:
- Sebenza nogqirha wakho
- Thetha kwinkampani yakho yomshuwalense
- Iinkqubo zoncedo lweemviwo.
Makhe sijonge nganye kwezi zinto ngokwahlukileyo.
Sebenze kunye neNkampani yakho yoDokotela kunye neNkampani ye-Inthanethi
Isinyathelo sokuqala ukuba iindleko zamachiza akho ziphezulu kakhulu ukuthetha nodokotela wakho. Ukuba uvakalelwa ukuba kukho isizathu sokuba esinye isicatshulwa sinokuthandwa kwenye (njengokunciphisa umngcipheko omkhulu okanye imiphumo emibini) cinga ngamanyathelo alandelayo.
Okwesibini, khuluma nenkampani yakho yinshuwalense. Kungaba lula ukuthetha ngomntu phezu kwefowuni. Ukuba ugqirha ugqirha ugqirha akuyona into efanelekileyo kwi-formulary, ugqirha wakho unokukwazi ukugqiba ukugunyazwa kwangaphambili ukwenzela ukuba ihlanganiswe. Ingaba unempilo yomshuwalense wecala, i-Medicare Part D, okanye iMedicaid, ukufaneleka kwakho kuyahluka.
Unokufuna ukunxibelelana nekhemistiki yakho. Iinguqu zeGeneric zenye zala mayeza ziyafumaneka kwaye zinokubiza kakhulu.
IiNkqubo zoNcedo zoLwazi
Ukuba usenokuba nobunzima bokunika isigqirha sakho ugqirha ukuba uzive kakuhle, kukho ezinye iinketho. Ezinye zezi ziquka:
- IiNkqubo zoNcedo zoLondolozo lweMpilo : Funda ngakumbi malunga neenkqubo ezahlukeneyo zokuncedisa izigulane zonyango ezikhoyo kwaye ukhangele nabenzi beziyobisi ukwenzela uncedo kunye neenkqubo zokulondoloza.
- Iiprogram zokuphuhlisa izidakamizwa zesigqirha: Funda kabanzi malunga nabani abanokuzuza kwikhadi lokuphuhlisa iziyobisi kwaye xa banokunceda.
- Buza iisampula: Ezinye ze-oncologists zinikezwa iisampuli ze-aromatase inhibitors. Akunakulimaza ukubuza.
- Khangela ukukhubazeka: Ukuba awukho 65 kodwa unokufumana ukukhubazeka, unokukwazi ukufumana amayeza akho nge-Medicare.
- Iiprosemmesi ze-Intanethi: Ngaphambi kokuba uhambe kwi-intanethi, funda malunga nendlela yokukhusela ngokukhuselekileyo iziyobisi kwi-intanethi
- Iiprogram zenkxaso yoncedo lwezobisi: Amaninzi aseMerika athi aphuhliswe okanye ancedisa iinkqubo. Khangela ukujonga ukuba ngaba urhulumente wakho unikezela ngokukhawuleza.
- Uncedo olungenzi-nzuzo: Buza ugqirha okanye iklinikhi ngemibutho yendawo ekubonelela ngoncedo ngeendleko zemimiselo. Unokuphinda uhlolisise ngemibutho enika umdlavuza webele. Gcina ukhumbule ukuba imibutho eyahlukeneyo ineenjongo ezahlukeneyo. Abanye bazama ukwenza utshintsho kwizinga likazwelonke. Ezinye zijolise ekuxhaseni uphando. Kwaye abanye banenjongo yokunceda abantu ngabanye ukuba babhekane nomdlavuza namhlanje; ezifana nokufaka iindleko zemithi yonyango.
Gcina iiRekhodi eziKhathaleleyo
Xa utshintsho lwe-inshorensi ludinga ukufumana iminikelo emininzi kulabo baqinisekisiwe, ukugcina iirekodi ezicokisekileyo kubaluleke kunanini ngaphambili. Iindleko ezininzi zokufumana unyango lomhlaza zichithwa irhafu , kubandakanywa neendleko zokuphuma kwe-pocket ye-hormonal therapy.
ILizwi
I-hormone yokwelapha inconywa iminyaka emi-5 ukuya kwe-10 emva kokunyanga okuphambili komhlaza wesifuba, ngoko ke kubalulekile ukuqwalasela inzuzo malunga nokuthintela ukuphinda kwakhona, iphrofayili yempembelelo yecala ethile, kunye neendleko.
Ukuba unemiphumo emibi kubalulekile ukugqiba ukuba ngaba umbane ungasebenza. Kubonakala ukuba, abaninzi abantu bayeke la mayeza kwaye bahluleka ukufumana inzuzo epheleleyo abayinike yona. Iindleko zingaba ngumqobo, kodwa iinketho ezininzi zichazwe ngasentla.
Njengengxelo yokugqibela, ezinye zeempembelelo ezibi kakhulu zonyango lwe-hormonal ziyimpawu ze-menopausal. Sekunjalo ukutshisa okutshisayo kudibaniswa nokusinda komhlaza wesifuba . Enye yeesiliva zesiliva.
> Imithombo
> INational Cancer Institute. Ukwelashwa kweNtsholongwane kaBestile (PDQ) -Ingxelo yeNgcali yezobuNtu.
> Tjan-Hejinen, V., Hellemond, I., Oontanga, P. et al. I-adjuvant Aromatase Inhibition eyongezelelweyo Emva kokunyanga kwe-Endocrine (IiNTSHONO): I-Randomized, IsiGaba sesi-3. I-Lancet Oncology . 2017. 18 (11): 1502-1511.