Axumin ndiyovomerezedwa ndi FDA, yotenga mankhwala omwe angapangidwe koyamba kwa kansa ya prostate kawirikawiri pambuyo pochita opaleshoni kapena mazira. Kwa zaka zambiri tatha kuzindikira kansa ya prostate yowonongeka ndi PSA , koma thupi lokhala ndi thupi ndi mafupa omwe sakhala akulephera kudziwa komwe kansara imafikira mpaka mlingo wa PSA ukukwera kwambiri (10 mpaka 30 kapena kuposa).
Axumin ikhoza kuzindikira matenda omwe ali nawo ndi ma PSA osachepera 10 ndipo nthawi zina mozama kwambiri, chifukwa chake kufufuza ndikofunika kwambiri.
Chifukwa chiyani Axumin Ndi Yofunikira Kwambiri?
Kuzindikira matenda oyambirira a metastatic pogwiritsa ntchito kanema kumapereka ubwino wochiritsira wofunika kwambiri. Choyamba, kudziwa kumene khansayo ilipo kungathandize kutsogolera chithandizo chabwino ku malo ena a thupi ndi kuchepetsa kuwonongeka kwa mbali zina za thupi. Kutsegulako kumayang'ana kumene khansayo siilipo komanso kumene mankhwala sakufunika.
Mphatso yachiwiri yamtengo wapatali yomwe ikuwunikiridwa molondola ndikumvetsetsa mwatcheru momwe matendawa akuyendera-kuwulula ngati khansa yatha, kapena ngati yayika, kapena ayi.
Khansara yomwe imatchulidwa ndi PSA yowonjezera si nthawi zonse chifukwa cha metastases. Nthawi zina khansayo imakhala pafupi kapena kumene prostate inkakhala, choncho PSA ikubwera kuchokera ku khansa yomwe ikubwereranso mu prostate gland pambuyo poizoni kapena mu prostate fossa pambuyo pa opaleshoni (fossa ndi malo a thupi limene prostate lidalipo kuchotsa opaleshoni), yomwe imadziwika kuti "kubwereza kwanuko."
PSA ingathenso kukwera chifukwa cha kukula kwa khansara yomwe yagonjetsedwa ndi maselo kapena mafupa. Izi zimatchedwa "systemic recurrence." Kubwezeretsa mwatsatanetsatane kumakhala koopsa kwambiri kuposa kubwereza kwanuko. Chifukwa chiyani? Matendawa amasonyeza kuti khansara ili ndi mphamvu yowonjezera kufalitsa thupi lonse-njira yomwe imayambitsa imfa mwa oposa theka la khansa ya prostate.
Motero, kudziŵa malo obwereza kumayankha funso lofunika kwambiri: kaya matendawa ndi owopsa kwambiri kuti awonongeke.
Monga tanena, mphamvu yothetsera khansara ndiyo yomwe imayambitsa khansa. Chidziwitso ichi chimamasula dokotala kuti agwiritse ntchito njira yowonjezereka yothandizira kuchipatala popanda kusungidwa komwe kumakhudzana ndi mantha ochiritsira kwambiri. Ngati matenda opatsiranawo amapezeka ku prostate kapena prostate fossa, njira yotereyi ingakhale yosayenera komanso yosafunika kwenikweni.
Mankhwala osokoneza bongo angagwirizane ndi zotsatira zoopsa. Komabe, mtundu wamankhwala oopsa omwe ndikuwukamba ndi mankhwala omwe amagawira magazi ndipo amakhala ndi thupi la thupi lonse, lomwe mankhwala a Taxotere kapena a hormonal treatments ndi Lupron ndi Casodex ndi zitsanzo zabwino.
Kodi Axinchito Amagwira Ntchito Bwanji?
Mafupa amtundu wambiri amagwiritsira ntchito zinthu zowonjezereka za calcium zomwe zimagwiritsidwa ntchito m'magawo omwe amakwiya ndi khansa. Pulojekiti ya Axumin PET imagwira ntchito pozindikira ntchito yamagetsi ya khansa yokha .
Axumin ikugwiritsira ntchito kuti khansa ya prostate imatengera amino acid pang'onopang'ono mofulumira kuposa maselo wamba.
Axumin imakhala ndi trace ya radioactive yomwe ili ndi amino acid. Popeza maselo a kansa amatenga mavitamini amino mosavuta kuposa maselo wamba, ma radiation amalowa mkati mwa maselo otupa. Pamene wodwalayo aikidwa pansi pa scanner malo ammwamba a ma radiation amasonyeza malo a khansara mu thupi la wodwalayo.
Kodi Zipangizo Zatsopano Zimaperekedwa Bwanji ndi Axumin?
Kujambula kwa Axumin kumavomerezedwa kwa amuna omwe apanga PSA yowonjezereka pambuyo pa mazira kapena ma opaleshoni oyambirira. Zakale, kuphweka kwa fupa la mfupa ndi zolemba za CAT zimafuna ma PSA m'masamba 10 mpaka 50 musanafike khansara yokwanira kuti ikawoneke pang'onopang'ono.
Kukongola kwa Axumin PET yowunikira ndiyikuti imapangitsa kuti tipeze zilonda zazing'ono m'matumbo ndi mapiritsi a PSA mu mndandanda wa 1 mpaka 10.
Njira ina yomwe ingagwiritsidwe ntchito pogwiritsa ntchito Axumin scan, pokhapokha ngati ikuthandizira kudziwa malo a PSA kubwereranso, ndi ya amuna omwe athandizidwa ndi matenda a mthupi. Pambuyo pa chithandizo, amuna akhoza kuchepetsa kwambiri PSA-mwinamwake kuyambira 100 mpaka 10 kapena pang'ono. Kujambula kwa Axumin kungathe kukhala ndi malo a khansa m'thupi lomwe likuwonetsa ntchito yotsitsimutsa yowonjezera, chizindikiro chakuti maselo a khansa amakhalabe othandizira ngakhale mankhwala atsopano ndi Lupron ndi Taxotere. Ngati chiwerengero chochepa cha zinthu zomwe zimakhalapo mosavuta, zimakhala zotheka kuti odwalawo apindule ndi ma radiation kapena mitundu ina yothandizira pa matenda otsalira.
Zotsatira Zamtsogolo
Ngakhale kuti seweroli lavomerezedwa kuti ligwiritsidwe ntchito panthawi yomwe PSA ikubwezeretsanso , ntchito zina zingagwiritsidwe ntchito m'tsogolomu. Chinthu chofunika kwambiri ndicho kukhala ndi amuna omwe amapezeka kumene ali ndi Gleason 8 kapena apamwamba kapena amuna omwe ali ndi mapangidwe apamwamba a PSA pamwambapa 20. Kuzindikira matenda oyambirira a mitsempha m'magulu am'mimba mwa amuna omwe angoyamba kumene kuwapeza ndi ofunika kwambiri. Odwala omwe ali ndi matenda a metastatic amapezeka kuti ali ndi mankhwala ochiritsika ngati atalandira mankhwala amphamvu ndi Taxotere ndi Lupron. Odwala omwe alibe mankhwala oterewa amatha kupweteka kwambiri komanso amachepetsa mavuto awo popanda kuchepetsa mankhwala awo.
Kutanthauzira Zithunzi
Kutanthauzira kwa zojambula zatsopanozi kudzaphatikizira kuphunzirira kwa madokotala omwe amawerenga zojambulazo. Izi ndizochitika ndi makina atsopano. N'kofunikanso kuti odwala azindikire kuti mtundu wa teknoloji yopanga zojambulazo, mwachitsanzo, zojambulazo-zidzasiyana ndizochita. Zikhalidwe zina zimakhala ndi teknoloji yakale komanso mphamvu yodziwira malo ochepa omwe angagwiritse ntchito masewerawa sangakhale ochepa.
Podziwa izi, zimakhala zofunikira kuti odwala azindikire malo omwe akugwiritsa ntchito zipangizo zamakono komanso adokotala omwe ali ndi chiwerengero chachikulu. Malo olemekezekawa akudziwika bwino kuti awerenge izi bwinobwino.
Kugwira Ntchito Muli ndi Zapulogalamu Zina
Chifukwa china chomwe Axumin ndizofunikira kwambiri ndikuti amathandiza madokotala kugwiritsa ntchito mphamvu zonse za Intensity Modulated Radiation Therapy (IMRT). IMRT ndi mtundu weniweni wa teknoloji ya radiation yomwe ingakhoze kulumikiza mbali zambiri za thupi zomwe poyamba zinali zosatheka kuzimitsa. IMRT ndi yolondola kwambiri moti madokotala akhoza kuyendetsa dothi la radiation ndi millimeter molondola ndipo amapewa kuwonongeka kwazomwe zimakhala ngati matumbo, mwachitsanzo, kwa odwala matenda a lymph node m'mimba. Chimodzi mwa zifukwa zomwe Axumin PET ikuyendera ndi zosangalatsa chifukwa zimapanga teknoloji ina, IMRT, yothandiza kwambiri.
Chiyembekezo Chowonjezeka cha M'tsogolo
Kufika kwa kansalu yowononga kansa ndi Axumin kumapangitsa chiyembekezo kuti mitundu yatsopano yowonongeka idzabwera posachedwa. Mwachitsanzo, mitundu ina ya PET imawoneka, imodzi mwa yotchedwa PSMA, imayimitsa kamolekyu yomwe imapezeka pamwamba pa maselo a kansa ya prostate. Phindu lopindulitsa la PSMA silingapindulitse zithunzithunzi; Zili ndi mphamvu zothandizira. PSMA ligands ikhoza kugwirizanitsidwa ndi zinthu zowonongeka kwambiri zomwe zili ndi mphamvu zokha kupha maselo a kansa.
Gulu la khansa ya prostate inkayembekezera mwachidule ma scans kuti azindikire malo a kansa ya prostate m'thupi ndi mtundu wolondola umene PET amawunika akhoza kuwathandiza. Zowonongekazi zikuimira kupambana kwakukulu. Tsopano kuti a FDA avomereza teknolojia iyi, makampani a inshuwalansi ayamba kufufuza njira zowunikira. Medicare anali kampani ya inshuwalansi yoyamba kuti igwirizane nayo.
Kodi Zotheka Zakale Zili Ziti?
Axumin ndiye mwansanga waukulu kwambiri wa khansa ya prostate ya 2017, komabe mungadabwe ndi zofunikira kwambiri zaka zitatu zapitazo. Choyamba, kuwonjezereka kofulumira kwa zatsopano zopezeka ndi chitukuko chatsopano, koma zina zowonjezera zikuphatikizapo:
N'chifukwa Chiyani Kupita Patsogolo kumachitika Nthawi Zambiri?
Chifukwa cha kufulumizitsa pafupipafupi zowonjezereka ndikumapeto kwa kufufuza kwakukulu kwakukulu komwe kumapangitsa kumvetsetsa kwakukulu kwa biology ya khansa ya prostate. Makamaka makamaka, kusintha kwasinthika komwe kumayambitsa kukula kwa ma selofoni sikulephereka.
Majini osinthika ndi omwe amachititsa maselo a khansa kusiyana ndi maselo obadwa. Tsopano kuti kusintha kumeneku kungawoneke, mankhwala atsopano angapangidwe kuti athetsere majini osagwira ntchito. Ganizirani momwe patch ya pulogalamuyi ingalembedwe ndi wolemba pulogalamu ya kompyuta kukonza makina a kompyuta.
Zaka zisanafike, tisanafike kumvetsetsa kwa masiku ano za biology yatsopano, mankhwala atsopano anali chifukwa cha ntchito yovuta, yoyesera ndi yolakwika. Mankhwala osankhidwa mosasamala angaperekedwe kwa maselo a khansa akukula mu Petri mbale. Ngati mankhwalawa amachititsa kuti maselo a khansa afe, angaperekedwe kwa nyama zodwala khansa. Ngati khansara inagwedezeka ndi nyamayo, idzayesedwa kwa anthu. Mayesero a anthu omwe angapambane adzalandire chipatso cha FDA komanso kugulitsa mankhwala atsopano.
Mosiyana ndi mankhwala omwe apangidwa mofulumira, njira yomwe mankhwalawa anapeza poyesedwa ndi zolakwika nthawi zambiri samadziwika.