Vuto vs Vuto Lophatikizapo Kusamalidwa Kwachipatala: Kanthawi Kanthawi Kapena Kosatha
Ngati mukukhala ndi khansara ya m'mawere, wanu wa oncologist ayenera kuti adayankhula ndi inu za mankhwala am'thupi. Kodi izi zikutanthauza chiyani? Kodi zimasiyanasiyana bwanji ndi kusamba kwa thupi komanso kusamba kwa thupi? Ndipo kodi zikhoza kukhala zosakhalitsa kapena zosatha?
Nchifukwa chiyani Kusamba Kwambiri N'kofunika Kwambiri ndi Khansa ya M'thupi?
Kwa amayi omwe ali ndi matenda a khansa pa nthawi ya matenda a khansa ya m'mawere ndipo ali ndi zotupa zabwino za estrogen , mankhwala (kapena opaleshoni) pofuna kuchepetsa kuchepa kwa thupi angaganizidwe.
Tikuphunzira kuti kugwiritsa ntchito aromatase inhibitors pambuyo pa tamoxifen mankhwala kungachepetse chiopsezo cha kubwereza, koma aromatase inhibitors sangagwiritsidwe ntchito ndi iwo omwe asanakwanitse kusamba.
Ngati mwakhala ndi chemotherapy mwinamwake munasiya kukhala ndi nthawi, makamaka ngati mutangoyamba kumene kusamba. Ngakhale ngati zili choncho, dokotala wanu angakulimbikitseni kuyesa kuti muwone ngati muli ndi vutoli. Kuti timvetsetse bwino izi, tiyeni tiyankhule za mitundu yosiyanasiyana ya kusintha kwa msinkhu, kusiyana pakati pa kuchepa kwa kanthaŵi kochepa komanso kosatha, ndi chifukwa chake izi ndi zofunika kwambiri.
Mitundu Yosiyanasiyana ya Kusamba kwa Mimba
Pali mitundu yambiri yosiyanasiyana ya kusamba kwa thupi. Malingana ndi mtunduwo, kusamba kwa nthawi kumakhala kosakhalitsa kapena kosatha, ndipo izi ndizofunika posankha njira zabwino zothandizira matenda a khansa ya m'mawere ngati chotupa chanu chiri cholowa cha estrogen.
Chibadwa cha Kusamba Kwambiri
Kusamba kwa thupi mwachibadwa ndi njira yazing'ono panthawi yomwe chiberekero cha mkazi chicheperachepera.
Pakati pa kusamba kwa thupi, mazira amayi amasiya kuyamwitsa mazira, ndipo thupi lake limapanga isrogen ndi progesterone yocheperako, kumapeto kwake kumatha ndipo pamapeto pake kumatha. Pamene kusamba kwa thupi kumatha, mkazi sangathe kutenga pakati. Kusamba kwa thupi mwachilengedwe nthawi zonse kumakhala kosatha.
Kupanga Manopause
Kupuma kwa mimba kumayambira pamene mazira a mkazi amachotsedwa opaleshoni, kapena ali ndi hysterectomy (kuchotsa chiberekero ndi mazira,) ndipo magulu ake a estrogen amasiya kwambiri. Popanda mazira kapena chiberekero, mkazi sali wobala. Kusamba kwa kusamba kwa thupi nthawi zambiri kumakhala chizindikiro choposa kusamba kwachibadwa chifukwa cha kusintha kwadzidzidzi. Kupuma kwa kusamba kwa thupi kumakhala kosatha.
Kusamalidwa kwa Mimba
Kusamuka kwa mimba ndizo zotsatira za mankhwala ochiritsira omwe angasokoneze mazira a mkazi kapena kupondereza ma esrogen ndi ma progesterone. Chemotherapy, mankhwala oletsa anti-estrogen, komanso mankhwala ochizira mazira angayambitse mwadzidzidzi ma hormone azimayi, omwe amachititsa kuti asakhalenso ndi nthawi yokha. Mtundu uwu wa kusamba kwa thupi ungatchulidwe monga:
- Kusamalidwa kwa mankhwala
- Kusamba kwa mimba
- Amamorrhea omwe amachititsa kuti mankhwalawa asokonezeke
- Kusamba kwa mankhwala
- Kupopera
Pambuyo pa chemotherapy, amayi ambiri amatha kusamba pang'ono, koma akhoza kusintha ngati nthawi yanu idzabwerera kapena ayi. Ngati mutayandikira kusamba kwachibadwa izi sizowonjezereka kusiyana ndi momwe munaliri wamng'ono ndipo simukutha msinkhu pa nthawi ya kugonana. Pamene kuchepetsa kusamba kwa mankhwala ndi kanthawi kochepa, ndi kovuta kudziwa (popanda labu kuphunzira) kaya kusamba kwa nthawi ndi kochepa kapena kosatha, ndipo nthawi yomwe musanadziwe ikhoza kusiyana.
Azimayi ena amatha kusamba kwa nthawi yayitali kwazaka 10 asanakhale a foremenopausal kachiwiri ndipo nthawi yawo ikuyambiranso.
Izi zimabweretsa mavuto ngati a oncologist akufuna kuika mankhwala omwe amagwiritsidwa ntchito kwa anthu omwe ali ndi postmenopausal. Aromatase inhibitors angakhale othandiza kwambiri kusiyana ndi tamoxifen poletsa kubwereza, koma ngati inu muli otsogolera iwo sali okwanira kuchepetsa mayendedwe anu a estrogen ndi tamoxifen akufunika kupatula mutalandira kachilombo koyambitsa ovarian
Kuchiritsa Kwachidakwa Kwambiri Kusamalidwa / Kupatsirana kwa Ovarian
Ngati mukuyandikira kusamba kwa thupi, wanu oncologist angayese kuyesa magazi kuti ayesetse kudziwa ngati mulidi kusamba kwa nthawi yosatha kapena ayi.
Ngati ndinu mzimayi wachinyamata, mutha kumwa mankhwala osakanizidwa panthawi yochepa. Pofuna kusunga estrogen ndi ma progesterone m'munsi, komabe musunge mazira anu, mutha kupatsidwa mankhwala kuti "muzimitsa" mazira anu.
(M'mbuyomu, opaleshoni yopanga mankhwala mwa kuchotsa mazira ochuluka nthawi zambiri ankalimbikitsidwa. Izi sizowonongeka chabe, koma zimachotsa mwayi woti amayi azitenga mimba m'tsogolomu atalandira chithandizo.)
Mankhwala osokoneza bongo amachititsa amayi kutenga nthenda yotchedwa aromatase inhibitor ndikupeza phindu la mankhwalawa. Mankhwalawa amaletsa mahomoni omwe amamasulidwa ku chifuwa cha pituitary ndikuuza mazira ochuluka kuti apange estrogen. Pamene mankhwalawa amaletsedwa, kusamba kwanu kumayambiranso.
Kusamalidwa Pakati pa Kugonana kwa Mimba
Ndikofunika kugwiritsa ntchito njira zakulera pamene mukudwala khansa ya m'mawere, ngakhale mutakhala ndi vuto la kusamba kwa mankhwala. Pali mwayi wapang'ono kuti mutenge pakati pa chithandizo, ndipo sitikumvetsa bwino zotsatira za mankhwalawa pa mimba yoyambirira. Musagwiritsire ntchito mapiritsi oletsa kubereka kapena mtundu uliwonse wa mankhwala opatsirana pogonana . Zosankha zingaphatikizepo zamkuwa , makondomu , spermicide , kapena njira zina zopewera kutenga mimba.
Kodi Mungatani Kuti Mukhale ndi Chizolowezi Chokha Posachedwapa?
Ngati mukudwala kusamba kwa thupi, kodi izi zikutanthauza kuti mwina mukuyenera kusintha msambo kawiri? Yankho likudalira pa msinkhu wanu komanso momwe muliri pafupi ndi kusamba. Ngati muli ndi zaka 40 zapitazo panthawi yomwe mumapezeka kuti mukudwala matenda a chemotherapy, kumwa mankhwala am'thupi kumakupangitsani kuti musakhalenso ndi vuto losiya kusamba popanda kubwerera kumwezi. Ngati muli ndi zaka makumi atatu ndi zitatu (30) panthawi yomwe mukudziwunikira, mungakhale ndi chizoloŵezi cha kusintha kwa thupi m'tsogolomu. Ngati muli ndi zaka zosachepera zisanu ndikusiya kusamba kwa thupi, nthawi yanu ingabwererenso mutatha kuchipatala ndipo mbeu yanu ingabwerere. (Phunzirani zambiri zokhudza momwe chithandizo cha khansa ya m'mawere chingakhudzire kubereka kwanu .) Ngati nthawi yachiwiri ikufika, mudzakonzeka kwambiri ndi njira zanu zothana ndi vutoli, mutapulumuka kale.
> Zotsatira:
> Jerzak, K., ndi K. Pritchard. Kudyetsedwa kwa mazira a Ovarian m'mayi a Premenopausal Omwe ali ndi Estrogen Receptor-Positive Cancer Breast Cancer: Zotsatira za 2016 Zotsatira za ASCO Guide ya Zomwe Amayi Akuchita. ASCO Post 06 / 1- / 16.
> Lambertini, M., Del Mastro, L., Viglietti, G. et al. Ntchito ya Ovariya Kudyetsa Akazi a Premenopausal omwe ali ndi khansa ya m'mawere oyambirira. Zochitika Zamakono Zamakono mu Oncology . 2017. 18 (1): 4.