I-hormone yokwelapha inqunywe yi- oncologist yezokwelapha kwabesetyhini kunye namadoda afunyanwe nomhlaza webele we-hormone receptor-positive. Inqunyelwe ukunyusa okanye ukuyeka ukukhula kweemvumi ezithintekayo kwi-hormones ngokukhubaza amandla omzimba wokuvelisa ama-hormone okanye ukuphazamisa isenzo se-hormone. Xa kuthatyathwa ngabasetyhini kunye namadoda anomhlaza webele, sele kunceda ukunciphisa umngcipheko wokufumana ukuphindaphinda kwesifo somhlaza wesifuba sokuqala okanye ukufumana umdlavuza omtsha webele.
Ngenxa yokubaluleka kwonyango lwe-hormone, ukuncedisa abafazi kunye namadoda ukulawula imiphumo emibi yonyango lwabo lwe-hormone kubalulekile ukuhlala kuyo kwiminyaka emihlanu okanye ngaphezulu.
IHormone unyango lweziyobisi
I-Tamoxifen isilwanyana esisetyenziselwa ukuphatha i-ER-positive umdlalo wesifo somhlaza kwibele ye-premenopausal kunye ne-postmenopausalkazi kunye namadoda. I-Tamoxifen ivunyiwe yi-FDA kwaye isetyenziswa ngokubanzi iminyaka engaphezu kwe-30.
I-Aromatase Inhibitors (AI) yinkalo yeziyobisi ezisetyenziselwa unyango lomhlaza wesibeleko kubasetyhini abasemasopausus kunye ne-gynecomastia kumadoda. Ziquka u-Anastrozole (Arimidex), i-Letrozole (i-Femara), i-Exemestane (Aromasin), i-Goserelin (i-Zoladex).
I-Tamoxifen ne-Arimidex yi-hormone yeyeza unyango oluqhelekileyo elibhekiselwe kwizigulane ezineqanda le-hormone le-receptor-positive emva kokugqitywa kwonyango olusebenzayo.
Imiphumela
Ezinye izidakamizwa zonyango zine-hormone zineempembelelo ezincinci ukuya kuyingqinamba, ngelixa ezinye zineempembelelo ezichaphazela umgangatho wobomi.
Intlungu kunye neentlungu, esiyi-sikhalazo esikhulu sabaninzi ukuthatha unyango lwe-hormone, sisiphumo esisecaleni esenza ukuba kubekho iingxaki kwimpilo yemihla ngemihla.
Ngenxa yokuba unyango lwe-hormone luqhelekelelwe iminyaka emihlanu kwaye mhlawumbi lide, ukufumana iindlela zokunciphisa impembelelo yentlungu kunye nentsebenziswano yentlungu ekuhambeni, imisebenzi enxulumene nomsebenzi kunye nemisebenzi eqhelekileyo yokuphila kwimihla ngemiba enkulu.
Xa amabhinqa namadoda kwi-hormone therapy ayinakufumana ukuphulukana kwintlungu kunye nentlungu edibeneyo, abaninzi banokucinga ukuyeka unyango, kwaye abanye bayakwenza. I-Tamoxifen ne-Arimidex, i-aromatase inhibitor yokukhetha kwinqanaba lokuqala, umdlavuza webele we-hormone-receptor-positive, bobabili bayaziwa ngokubelana ngeziphumo ezifanayo ezibandakanya:
Ukutshisa okufudumayo kunye nokukhwaza ebusuku
Ukulahleka kwesondo
Ukukhutshwa kwamagciwane
Ukuma komzimba okanye ukutshiza
Ukutyeba kwakho
Ukulala ubunzima
Umoya utshintsha
Kwiimeko ezinqabileyo, i-Tamoxifen ibikelelwe ukuba ibangele ama-blood clots, ukulahleka kwethambo kubafazi be-premenopausal, umdlavuza we-endometrial, i-cataracts, kunye nesifo.
Ngaba i-Tamoxifen okanye i-Arimidex ngakumbi ngakumbi?
I-Arimidex, iTamoxifen, Yodwa okanye kwi-Combination (ATAC) Uvavanyo lithelekisa iinzuzo kunye nokukhuselwa kwe- Arimidex (1 mg) kunye neTamoxifen (20 mg) , esinikwe ngomlomo imihla ngemihla iminyaka emihlanu, njengonyango oluxhasayo kumama-postmenopus nomhlaza.
I-Arimidex yabonakala iyasebenza ngakumbi kuneTamoxifen. I-Arimidex iphumelela ngakumbi:
- Ukukhawuleza ixesha phakathi kokuxilongwa kwangaphambili kunye nokuphindaphindiweyo kulabo bafumana ukuphindaphinda
- Ukunciphisa umngcipheko wesifo somhlaza kwisantya kwezinye iindawo zomzimba
- Ukunciphisa umngcipheko wokuvelisa umdlavuza omtsha kwisibele
Nangona kunjalo, intlungu kunye neentlungu ezidibeneyo zabikwa rhoqo kwi-Arimidex kuneTamoxifen.
Ukulahleka kwethambo kunye ne-arthritis kwenzeke ngokuphindaphindiweyo kwiminyaka emibili yokuqala yokuthatha i-Arimidex.
Kwabafazi abaninzi, ukuvela kwimihla ngemihla yesifo kunye nentlungu edibeneyo yinkxalabo yabo enkulu. Ubunzima beli ntlungu kunye nempembelelo yayo kwimihla ngemihla kubangela abanye abafazi kwi-Arimidex ukuba bayeke ukuyithatha.
Uninzi lwabasetyhini abafumana iintlungu zethambo kunye neentlungu ezixhamliweyo babika ukuba bunzima kunye nentlungu, ekuvukeni, ezandleni zabo, ezinqeni, emva, emadolweni, ezinyaweni, nasemagxeni okwenza kube nzima ukwenza imisebenzi yansuku zonke nemisebenzi ehlobene nomsebenzi. Intlungu edibeneyo idlalwa emadolweni, emva, ezinqeni, nasezinyaweni njengoko, kunye nezikhwebu. I-Carpal tunnel syndrome yayisikhalazo rhoqo.
Abaninzi abasetyhini babika ukuba babe nobumnene ukuya kwi-bone equate and pain joint; babenako ukufumana intlungu ekuthatheni izidakamizwa ezingenayo i-steroidal anti-inflammatory.
Izifundo ezincinci zibonise ukuba abafazi bathabatha izongezo zokutya ezibandakanya iivithamini, i-glucosamine kunye ne-chondroitin, i-vitamin D kunye neoli ye-omega yeentlanzi, ngokuqhelekileyo yafumana ukukhululeka kwintlungu kunye neentlungu. Ukukhishwa kwesikhumba kuye kwabonisa ukuba kuya kunceda ukukhulula intlungu. Abafazi bathatha iArimidex okanye enye i-inhibitor ye-aromatase bayakhuthazwa ukuba bathathe inxaxheba rhoqo kwisenzo sokuthwala ubunzima.
Ngenxa yokuba i-aromatase inhibitors yayaziwa ukuba ibangele ubuhlungu bomzimba kunye nokudibana, kubalulekile ukuthetha neqela lakho le-oncology xa uhlakulela le mpembelelo. Iqela lakho liza kuhlola i-bone yakho kunye nentlungu edibeneyo, ikubhekiselele ukuhlolwa koxinzelelo lwethambo kwaye uncoma ukusetyenziswa, imisebenzi kunye nokusetyenziswa kwamachiza okunciphisa intlungu yakho.
Iziphumo zesifundo esincinci, esinikwe kwiSymposium ye-San Antonio ye-Breast Cancer Symposium ngo-2013, yabonisa ukuba abasindileyo abaphatha i-aromatase inhibitor abaye bathatha inxaxheba rhoqo kwixesha lokuzivocavoca unyaka babe ne-30 ekhulwini ekunciphiseni ubuhlungu babo bubi kunye nama-20 ekhulwini ngobunzima beentlungu. Oku kuncipha kwintlungu kubangele ukwandisa amandla okwenza imisebenzi eqhelekileyo yokuphila kwansuku zonke. Abafazi kwisifundo abangazange balandele inkqubo yesenzo somnyaka bafumana ukwanda kweepesenti ezi-5 kwiintlungu kunye nobukhulu beentlungu zabo.
Ukuthetha ngokuvela kumava akho, i-bone and joint joint of Arimidex, i-aromatase inhibitor endibekelwe yona emva kwesifo somhlaza wesibeleko sam 2, kwakunzima ukulawula ngaphezu kweTamoxifen, endiyilandelayo emva kwesifo somhlaza wesibeletho sam. Intlungu evela kwiArimidex yayikuphela nje kwiinyawo zam, kwaye ngokuqhelekileyo ihlala ihlala ihlala, ivuke nokuba ivuke ebuthongweni. Kwaphazamisa uhlobo oluthandayo lokuzivocavoca, ukuhamba ngeekhilomitha ezimbini ngosuku.
Intlungu kunye neTamoxifen yayisasazeka kakhulu emzimbeni wam kwaye yayifana nephunga elaza laza lahamba. Umngeni onzima kakhulu weTamoxifen wawuyimisipha yamathambo kumathole ami.
Ndayiphatha intlungu e-Arimidex kunye neenkampu zeTamoxifen ngokwenza imilenze yansuku zonke, ukubhukuda 3x ngeveki, nokuzama ukuhamba ubuncinane iimitha nganye ngosuku. Izicathulo eziqinileyo kunye nenkxaso yesigidi kunye nesithende se-intshi ye-1-1 / 2 yenza umda omkhulu ekukwazi kwam ukuhamba ngezinga elithile lokuthuthuzela. Ngokungafani nentlungu nokuqina kwesifo samathambo, intlungu yeenyawo ekugqibeleni iyancipha njengoko ndiqhubeka ndihamba, kwaye ekupheleni kokuhamba kwam, ndandingenabuhlungu. Ukuhlamba okuhamba ngamanyathelo okufudumala kunye kunye neenyawo kunye nomlenze wokunyusela umlenze wanceda.
ILizwi
I-hormone yokwelapha isebenza kwaye iyanciphisa iziganeko zokuphindaphinda. I-Arimidex isetyenziswe ngokuphindaphindiweyo ngaphezu kweTamoxifen ekubeni iboniswe ukuba iphumelele ngakumbi kuneTamoxifen ekuthintela ukuphindaphinda. Ukuba uthabatha i-aromatase inhibitor kwaye ufumana iintlungu zethambo kunye kunye kunye, wabelane ngezinto ojongene nazo neqela lakho le-oncology. Unokucetyiswa ukuba uthathe inxaxheba kwisigaba sokuqhuba umsebenzi ohleliweyo kwindawo yakho okanye ujoyine iqela elihambayo. I-oncologist yakho yezokwelapha inokukucebisa malunga neentlungu ezithintekayo ongazithatha ngokukhuselekileyo, njengoko nangaphezu kweyeza zamanqanaba ezineempembelelo.
> Imithombo:
> I-Cuzick J. Impembelelo ye-anastrozole kunye ne-tamoxifen njengonyango olusisigxina kumdlavuza wesifuba sokuqala: uhlalutyo lweminyaka eli-10 lwetyala le-ATAC. Lancet. Oncology. 2010; 11 (12): 1135-41. http://www.ncbi.nlm.nih.gov/pubmed/21087898
> Gaillard S, Stearns V. I-Aromatase inhibitor-ehambelanayo namathambo kunye nemishuloskeletal: Ubungqina obutsha obuchaza i-etiology kunye nezicwangciso zolawulo. Uphando lwebele lomhlaza: BCR. 2011; 13 (2). http://www.ncbi.nlm.nih.gov/pubmed/21457526