Njengoko uhamba ngonyango lomhlaza wesifo se-breast, ugqirha wakho uya kulandisa iimvavanyo ezininzi ukuze abone ukuba umhlaza wakho uphumelele okanye ukuba uphendule unyango. Ziziphi iimvavanyo eziqhelekileyo zenziwa, kwaye unokuhlangabezana njani novavanyo lokuxhalabisa ?
Ezinye zezi zifundo zengcamango kunye neemvavanyo zelabhu zisetyenziswe zombini xa umntu efunyaniswa ukuba unomdla wesantya okanye isifo somhlaza wesifo semetastatic, kanti abanye bangabutsha kuwe njengokuba kusetyenziswa ngokutsha ukujonga unyango lomhlaza wesifo se-metastatic.
Indlela Iintsholongwane Ezingatshintsha ngayo
Sivame ukucinga ngamagciwane angaguqukiyo, njengeeseli eziqhelekileyo kwiibele zethu ezingatshintshi ngokukhawuleza ixesha. Nangona kunjalo iisomhlaza zihlala ziguquka. Le yinguqu kwiimvumi, enyanisweni, ebangela ukuchaswa esikubonayo kwizonyango ezinjengezonyango ze- hormonal, iipilisi ezijoliswe kuyo kunye ne-chemotherapy ngokuhamba kwesikhathi.
Iimpawu ze-molecular ze-tumor zingatshintsha, kunye nesimo se- receptor seeseli zesisu. Iintsholongwane zihlala zilungelelanisa kwiindawo ezizungezile, zidla ngokuvelisa iiprotheni ezintsha ukuze zikhusele iintsholongwane zethu zokuzivikela kunye nokutshintsha ukubonakala kwazo ukuze zize zenzeke.
I-tumor i-estrogen yayibuhlungu xa ufunyaniswe okokuqala, kodwa ingaba ummiselo we-estrogen xa ungena empomfini. I-tumor ingaba yi- 2 YAKHIWO xa ifunyanwe okokuqala, kodwa i-HER 2 imbi kamva. Ezi zinguqu ziqhelekileyo, kunye neepesenti ezintlanu ze-HER 2 ezi-tumors ezihle ziba yi-HER 2 negative kamuva.
Ukongeza kwenguqu kwiimvumi ingumxholo we-tumor heterogenicity. Esikhundleni sokuba buninzi beeseli ezifanayo, iindawo ezahlukileyo zesifo sinokuba neempawu ezahlukileyo kunabanye, kuxhomekeke kwezi nguqulelo. Ngamanye amaxesha esinye isahlulo se-tumor phezu-sibonisa i-HER 2, ngelixa elinye icandelo le-tumor, okanye i-metastasis kwindawo eyahlukileyo, ayikho.
Le ngcaciso elula yento eyenzekayo, kodwa inokunceda ukuba ichaze ukuba yonke imhlaza yomhlaza ihlukile njani.
Biopsies
Enye yezona zibalulekileyo zokuqala iimvavanyo yi-biopsy yomhlaza wakho. Esinye isizathu sakho ugqirha ufuna ukuyihlaziya isisu sakho ukuqinisekisa ukuba ngumhlaza wesibeletho se-metastatic kunokuba uhlamba olungathandekiyo. Nangona kunjalo isizathu esibaluleke kakhulu se-biopsy, okanye "i-biopsy", ukujonga indlela umhlaza wakho ungatshintshwa ngayo ukususela kwakuba usufumene uvavanyo lokuqala.
UkuCatshulwa
Ukucinga okucatshulwayo ugqirha ugunyazisa kuya kuxhomekeka kwizinto ezininzi ukusuka kwindawo yakho yezihlamba kwizonyango ezisetyenzisiweyo. Uvavanyo oluqhelekileyo (njengoko kuxoxwe ngaphambili) lubandakanya:
- Imibala ye -X yeendawo apho ukhankanywa khona ukuba unesitastas
- I-Bone scans: I-scan scan iquka ukujoba umtsalane we-radioactive, ovavanywa ngokucinga. Izicathulo ze-Bone ziyakunceda ekuhloliseni i-boneastases yeethambo.
- I-PET ihlola : Uvavanyo lwe-PET luvavanyo olubalulekileyo lokumisela ubungakanani kunye neendawo zeemastastases emzimbeni wakho. Ngokungafani neengcingo ze-CT kunye ne-MRI ebonakalayo ngokukodwa kwiinkalo zesakhiwo, i-PET scan ibheka umsebenzi weeseli emzimbeni wakho. Ishukela e-radioactive ijojowe kwigazi lakho kwaye ithathwa ngamathambo anomdla njengomdlavuza. Uphononongo lweengcamango lunokuvumela ukuba ii-radiologists zibonise kwaye zifumane ezi ndawo emzimbeni. Ukongezelela ekuncedeni ukulinganisa umlinganiselo womhlaza wakho, ukuhlolwa kwe-PET kunceda kwiindawo ezahlukileyo ezifana nezicubu ezinobumba kunye ne-fibrosis ezivela kwiimvumi ezimbi ezikhulayo.
- I-CT : I-CT scan ingenziwa ukujonga isisu sakho, isikhumba sakho, isifuba sakho okanye intloko yakho
- I-MRIs: I- MRIs inokwenziwa ukufumana ukujonga okuchanekileyo nakweyiphi na i-metastases yakho kwingqondo okanye kwezinye iindawo zomzimba wakho.
Kunceda ukwabelana ngezinto ezimbalwa malunga nokuhlolwa kweengcamango kunye nemida yabo ekulandeleni umdlavuza odidekisile abanye ngesifo somhlaza wesibeletho se-metastatic:
- Utshintsho kwi-scan luyakulibaziseka - Ukuba usanda kugqiba unyango olunjenge- chemotherapy , unokuziva udimazekile xa ukukhangela komhlaza wakho kungatshintshi ngobukhulu. Kunceda ukuqonda ukuba utshintsho kwi-test imaging lingathatha ixesha lokubonisa. Ngokomzekelo, ukwehla kobukhulu besifo ngenxa yonyango akunakuboniswa kwi-scan kuze kube kwiiveki ezimbalwa okanye kwiinyanga emva kokuba unyango lwakho lugqityiwe.
- Iimpawu azigqibekanga - Kungakhathaliseki ukuba unjani uhlobo lokuskena, kukho ithuba "lokufumana" into engayi kuba yingxaki. Uninzi lweemvavanyo ozenzayo, mhlawumbi oku kuya kwenzeka. Umzekelo ubandakanya amanqindi amaninzi angama-bladder etholakalayo kwi-CT scans esiswini esinokuba nzima ukuhlukanisa nomhlaza.
- Imibuzo ngaphandle kwe-PET i-scans ayikwazi ukukuxelela ukuba "indawo" iyakhula " - inokuba nzima ukuba uvavanyo olunjenge-CT scan ukuqinisekisa ukuba" indawo "ibonisa umhlaza okhulayo, ushiywe emva kokuba ummandla wesifo somhlaza uphathwe. I-PET i-scans ingakunceda ukuhlukanisa i-cancer ekhulayo ephuma kwiinkqubo ezinobungozi, kodwa ingaba "neempembelelo ezingamanga" -iindawo ezinokukhathazeka ezingaba nto.
- Utshintsho oluthile ngobukhulu besisu lube nenjongo -Abanye abantu bayadangala xa i-tumor ibonakala iyinentimitha ephezulu kwi-scan kunokuba ifunyenwe ngaphambili. Ukuba ubhekene nento efana nale, cela i-radiologist yakho malunga nemingcele ye-scan ethile. Kwezinye iimeko, isisu esinokuthi "sibonakale" sibe sikhulu okanye sincinci, sinokuthi singatshintshi ngobukhulu ukuba unako ukulinganisa umhlaza ngokuthe ngqo.
Amakhwala ahlambayo (ii-Biomarkers)
Iimpawu zamathambo okanye i-biomarkers zii-proteins ezinokuthi zifihlwe ngumzimba okanye umzimba ngokuphendula kwisisu. Iimvavanyo zegazi ukujonga ukuba ezi proteins zenziwa ukuze zilandele inkqubela yakho kunye nomhlaza wesifo se-metastatic.
Njengoko kuhlolwa kweemifanekiso, le mvavanyo ayifezekanga. Akunabo bonke abancinci bebele abangela ukuphakama kwezi zixhobo, kwaye xa ziphakanyisiwe, zi nokuba ngenxa yemeko engekho komhlaza. Utshintsho kumanqanaba ala manqaku, njengokuba kukhishwe izicatshulwa, kunokulibaziseka emva kweeveki ezimbalwa emva kokuba isisu sanda okanye sinciphisa ngobukhulu.
Ezi zivivinyana azifaneki zisetyenziselwe yedwa ukujonga inkqubela yomhlaza wesifuba kwaye zinceda kakhulu xa amanqanaba alandelwa ngexesha. Ukuxhamla amanqaku akho ugqirha unokulinganisa:
- I-antigen ye-cancer 15-3 (CA 15-3) - CA 15-3 yiprotheyini eyenziwa ngamaseli omhlaza wesifuba. Inokufumaneka kwi-50 ukuya kwi-90 ekhulwini labantu abanomdlavuza webele, kodwa kuphela iipesenti ezingama-30 zabantu abanomdlavuza wesibele. Amanqanaba esi sihloko sithatha ukuphakama ngokukodwa kulabo abanamathambo okanye ama-metastases. I-CA 15-3 inokulinganiswa ukuvavanya impendulo yomhlaza wakho kunyango, kodwa utshintsho kwinqanaba lungaze lwenzeke kwiiveki ezimbalwa (ngokuphindaphindiweyo ezine ukuya kweyesithandathu) emva kokuba i-tumor iphendule unyango okanye iqhubela phambili.
- I-antigen ye-cancer 27.29 (i-CA 27.29 ) -I- CA 27.29 yiprotheni (i-antibody monoclonal) eyenziwa ngumzi obizwa ngokuba yi-MUC-1. Le protheni ifumaneka phezu kwamanqamu omhlaza wesifuba. Ngokwahlukileyo kwamanye amanqaku, i-CA 27.29 yiprotheyini yodwa ebonisa ngokuthe ngqo ukuba khona kweeseli zomhlaza zesisu. Nangona olu vavanyo lusetshenziselwa ukubeka esweni iindlobhinqa zamancinci zesantya zokuqala, zicinga ukuba ukuphakama kungenzeka malunga neenyanga ezintlanu ngaphambi kokuba umntu aqonde ukuba umhlaza wabo uphindele. Njengokuba kunjalo ne-CA 15-3, kukho iimeko ezingekho komhlaza wesifuba ongabangela ukuphakama kule protheni, kunye nokuphakama kunokuhlala ixesha elibalulekileyo (ezimbini ukuya kwiinyanga ezintathu) nangemva kokuba umhlaza uphathwe kakuhle. Ugqirha wakho unokuyalela ukuba yi-CA 15-3 okanye i-CA 27.29, kodwa kungekhona isibini.
- I-Carcinoembryonic antigen (CEA) - I- CEA yiprotheni engapheliyo enokuthi iphakanyiswe kubantu abanomdlavuza, kodwa inokuphakanyiswa ekuphenduleni kwezinye iimeko kunye nokuquka ukutshaya.
- Ukujikeleza iiseli zesisu - Ukujonga igazi ngokujikeleza iiseli zesisu (iiseli zesisu okanye iinxalenye zeeseli zesisu eziye zaphulwa kwisisu kwaye zangena egazini) yindlela entsha yokuvavanya nokulandela umdlavuza we-metastatic. Nangona kunjalo kakhulu uphando, uvavanyo olulodwa luye lwavunywa ngokusetyenziswa kwabesetyhini abanomdlavuza webele.
Ukujongana nobunzima
Uninzi lwabantu luya kuziva unqanaba lokuxhalabisa ngelixa ulinde iziphumo zeeskripthi okanye vavanyo lwebhubhoratri, kungakhathaliseki ukuba yeyiphi na inkalo ekwenzeni unyango. Ngomdlavuza webele we-metastatic, ngokukodwa, kukho iziphumo ezininzi zokuvavanya ukulinda.
Awuyedwa xa ingqondo yakho ikhula kwaye igxininise kwiimeko ezethusayo zeziphumo eziza kubakho-kwaye ngokubaluleke ngakumbi, zithetha ntoni.
Unokwenza izinto ezininzi ukujamelana ne "scanxiety".
- Buza malunga nexesha leziphumo zakho kunye nendlela oya kubafumana ngayo.
- Yiba ne-picky malunga nexesha lokuskena kwakho. Ukuba kusenokwenzeka ngosuku ekufundwa ngalo ekupheleni kosuku, ukugcina uxinzelelo kubusuku. Ngaphambili ekuqaleni kweveki kunokuthetha ukugcina uxinzelelo kwiveki.
- Cela umntu ukuba ajoyine nawe xa uya kwisivivinyo, njengokuphazamiseka.
- Lihle. Jonga umdlalo othakazelisayo oya kumdlalo, uye kumboniso womdlalo, okanye uzame nantoni na eya kukuncumoza.
Imithombo:
Graham, L., Shupe, M., Schneble, E. et al. Iindlela ezikhoyo kunye neengxaki ekujongeni unyango iimpendulo kwiCanscer Breast. Journal of Cancer . 2014. 5 (1): 58-68.
> DeVita, Vincent., Et al. I-Cancer: Imigaqo kunye nokuSebenza kwe-Oncology. Ngomhlaza we Breast. Wolters Kluwer, 2016.
> Liedtke, C., noH. Kolberg. Ulwaphulo lwe-Systemic lwe-Advanced / Metastatic Breast Cancer-Ubungqina Bokukhoyo kunye Neengcinga Zomso. Unakekelo lwebele . 2016. 11 (4): 275-281.