Chidziwitso ndi mphamvu koma kusankha sikophweka
Jennifer Davis anali ndi zaka 19 pamene amayi ake, omwe ali ndi zaka 49, anapezeka ndi khansa ya m'mawere. Mwa njira, sizinadabwitsa. Khansara ya pachifuwa inanena kuti agogo ake aakazi ali ndi zaka 28. Ndipo agogo ake aamuna anamwalira ndi khansa ya ovari pa 69.
Ndiye, pamene amayi ake anachitidwa opaleshoni ndipo anayamba chemotherapy, Davis anapeza mtanda m'mimba mwake . Ngakhale zinali zoipa, anachita mantha.
Davis, wa ku Washington, DC, ananena kuti: "Ndinaona amayi anga akudutsa chemo ndipo ndinkadzifunsa kuti ndidzakhala ndani.
Kuyeza kwa majeremusi kunatsimikizira kuti Davis adalenga gene gene mutation yomwe imayambitsa chiopsezo cha khansa ya m'mawere kapena mazira. Ali ndi zaka 23, amayesetsa kufufuza komanso kukhala ndi moyo wathanzi, ndipo akuganiza mozama kuti amachotsa mawere ndi mazira ake ngati njira yodalirika, koma yoteteza.
Chifukwa kuyesa kwa majini sikudali kwatsopano, ofufuza sakudziwa kuti ndi angati omwe ali ndi mayina omwe ali ndi khansa ya m'mawere. Koma, iwo amayerekezera kuti mpaka 30 peresenti ya amayi a ku America ali ndi mamembala amodzi omwe amachizidwa khansa ya m'mawere.
Izi zikutanthauza kuti ngakhale atsikana omwe ali ndi mbiri ya banja lodziwika bwino ya matendawa amayamba kutenga njira zotetezera thanzi lawo. Komabe, izi zimaperekanso chisankho chovuta, kuphatikizapo opaleshoni yachipatala kapena kumwa mankhwala omwe amachepetsa chiopsezo cha khansa ya m'mawere koma nthawi zambiri amakhala ndi zotsatirapo.
1 Degree, 2 Degree & 3 Degree Achibale
Amayi ambiri a ku America ali ndi mwayi wokwana 12 peresenti yokhala ndi khansa ya m'mawere m'moyo wake. Chiwerengerochi chikhoza kupitirira kawiri kwa mkazi yemwe ali ndi mbiri ya banja la khansa ya m'mawere.
Malinga ndi US Centers for Disease Control and Prevention, amayi omwe ali ndi "chiwerengero choyamba" monga mayi kapena mlongo-amene anali ndi khansara ya m'mawere ali ndi mwayi woposa 30 peresenti ya matendawa.
Ngati wachibale woyambayo atapezeka kuti ali ndi kansa ya m'mawere (khansa ya m'mawere m'mawere onse), chiwopsezo chimafika pa 36 peresenti.
Mwa iwo omwe ali ndi "wachiwiri-digiri" achibale-agogo aakazi, azakhali, kapena apongozi-chiopsezo cha moyo chiri pafupi 22 peresenti. Kwa iwo omwe ali ndi wachibale wachitatu-a-cousin, agogo-agogo, kapena azakhali-omwe anali ndi khansa ya m'mawere, chiopsezo ndi 16 peresenti.
Komabe, mbiri ya banja sizitanthauza kuti matenda a khansa ya m'mawere. Akatswiri amati pafupifupi 5 peresenti pa 10 peresenti ya khansa ya m'mawere ndilo choloŵa chawo. Kuwonjezera apo, kusintha kwa majini omwe amachititsa kuti chiopsezo chachikulu cha khansa ya m'mawere ndi oyamwa chiwoneke ngati chikuwoneka kuti si chachilendo kwa anthu ambiri.
Izi ndizo zamoyo zomwe zimatchedwa BRCA1 ndi BRCA2 ndi ofufuza. BRCA imaimira khansa ya m'mawere ndipo manambala amasonyeza kuti ochita kafukufuku anapeza kuti kusintha kwa jini.
Ngakhale kuti kufalikira kwakukulu kumeneku sikukudziwika, kafukufuku wina anapeza kuti pakati pa gulu la amayi pafupifupi 2,300, zaka 35 mpaka 64, pafupifupi azimayi awiri, azimayi okwana 1,4%, ndi 10.2 peresenti ya akazi achiyuda anali ndi kusintha kwa BRCA1. Phunzirolo linapezanso kuti 2,6 peresenti ya akazi akuda, 2.1 peresenti ya amayi oyera, ndi 1.1 peresenti ya akazi achiyuda anali ndi kusintha kwa BRCA2.
Mayeso a Zachibadwa
Madokotala ambiri tsopano amalangiza amayi omwe ali ndi mbiri ya banja la khansara ya m'mawere kapena ovari kuti ayambe kuyesedwa kwa majini. Chisankho chomwechi chingabweretse malingaliro ake komanso mfundo zothandiza.
Malingana ndi kafukufuku wina wa ku Canada wa anthu 39 omwe anayesera zabwino pa gene geneation, ambiri anawona zotsatirazo zikuthandizira. Ophunzira adanena kuti mayeserowa adawalola kutenga njira yowonjezereka ku chisamaliro chawo.
Koma, ochepa adanenanso kuti alibe chiyembekezo. Anthuwa anati adamva kuti "sadwala kapena ayi."
Kuonjezerapo, pamene inshuwalansi ya umoyo ndi chisankho zinali zoyipa, lamulo la Genetic Information Nondiscrimination Act la 2007-2008 tsopano limateteza chitetezo cha dziko lonse
Kujambula koyambirira
Kwa amayi ambiri osakwana zaka 35, kuyezetsa khansa ya m'mawere sikuli mbali ya chizoloŵezi chawo cha pachaka. Koma, kwa amayi omwe ali ndi mbiri ya banja la khansa ya m'mawere, akatswiri amati kuwonetsetsa kuyenera kuyambira ali ndi zaka 25.
Chigamulo cha khansa ya Memorial Sloan-Kettering imalimbikitsa kuti amayi omwe ali ndi chiwerengero cha digiri yoyamba omwe ali ndi khansa ya m'mawere ayambe kuyambira zaka khumi zapitazo kuposa pamene mwana wamwamuna wamng'ono kwambiri adapezeka.
Mwachitsanzo, ngati amayi atapezeka kuti ali ndi zaka 42, mwana wake ayenera kuyesedwa zaka makumi awiri ndi ziwiri (32). Azimayi omwe ali m'gulu loopsya limeneli, akatswiri amalimbikitsanso mayeso achiwerewere kawiri pachaka komanso mwezi uliwonse. ali ndi zaka 20.
Pali kutsutsana kwina zokhudza udindo wa MRIs womwe uyenera kuwonetsa mu kuyang'ana khansa ya m'mawere. Kafukufuku wina wasonyeza kuti kuyang'ana kwa MRI kuli kofunika kwambiri kuposa njira zina zowunikira. Madokotala ku Sloan Kettering amalangiza kuti amayi omwe ali ndi mbiri ya banja ali ndi MRI ndi mammogram pachaka. Komabe, palibe kafukufuku amene agwirizanitsa kuyang'ana kwa MRI ndi kuchepa kwa imfa ya khansa ya m'mawere.
Kupewa
Kafukufuku amasonyeza kuti kusuta ndi zakudya zamtundu wa mafuta zimapangitsa kuti pakhale ngozi ya khansa. Choncho, moyo wathanzi ndi wofunikira kwambiri kwa wina yemwe ali ndi mbiri ya banja lake.
Chemoprevention ndi njira ina yothandizira. Zina mwa mankhwala ofanana omwe amalembedwa kuti zisawonongeke zimaperekedwanso kwa amayi omwe akuyembekeza kupeŵa khansa ya m'mawere, koma kwa iwo omwe ali ndi zaka zoposa 35.
Mankhwalawa amaletsa ntchito ya hormone ya female estrogen, yomwe imakhulupirira kuti imayambitsa mitundu ina ya khansa. Koma izi zikutanthauza kuti akhoza kuthandizanso kubereka , kotero sizivomerezedwa kuti zigwiritsidwe ntchito ndi amayi aang'ono pa msinkhu wobereka.
Kwa amayi oposa 35, kafukufuku wasonyeza mankhwalawa- Tamoxifen (Nolvadex) ndi Evista (Raloxifene) -ngachepetse chiopsezo cha khansa ya m'mawere yosautsa ndi pafupifupi 50 peresenti. Ndipo, amatha kuchepetsa chiopsezo cha khansa yosatetezeka ya m'mawere ndi 30 peresenti. Komabe, iwo alibe zotsatirapo zina-zina zomwe zimafanana ndi zizindikiro za kusamba kwa thupi, kuphatikizapo kulemera, kutentha kwambiri, ndi kuyanika kwa amayi.
Njira yodalirika, koma yothandiza kupewa ndi kuchotsedwa kwa mfuti imodzi kapena zonse ziwiri musanafike khansa. Ochita kafukufuku amayerekezera kuti opaleshoni imachepetsa chiopsezo cha khansa ya m'mawere ndi 90 peresenti. Kuchotsa mazira ambiri ndi opaleshoni yowonjezereka, koma yodzala ndi kukhudzidwa, makamaka kwa atsikana omwe tsiku lina akuyembekeza kukhala ndi ana.
Mawu Ochokera
Davis, amene anayesa kusintha kwa kusintha kwa BRCA1, adalangizidwa ndi mthandizi wake wa chibadwa kuti abwerere ana ake, kenaka mawere ake, mazira ake, ndi chiberekero achotsedwe-asanakhale ndi zaka 35. Ngakhale ali ndi zaka 23, amadandaula za kuthekera kukwaniritsa cholinga chimenecho. Koma amakhulupirirabe kuti opaleshoniyo idzam'patsa mpumulo. Choncho, khalani ndi nthawi yopenda mosamala njira iliyonse ndikupempha uphungu kwa dokotala wodalirika kapena uphungu wa ma geneso pakupanga chisankho.
Zotsatira:
"ACS Advises MRIs kwa Ena pa Kuopsa kwa Khansa ya M'bwere." ACS News Center . 28 Mar. 2007. American Cancer Society. 17 Apr. 2008.
"Malangizo Achidule Okhudza Kuyeza Kachiwerewere." Nkhani Za Khansa . 21 Apr. 2006. Chigawo cha khansa ya Memorial Sloan-Kettering.
de Agincourt-Canning, L. "Mphatso Kapena Yoke? Mayankho a Akazi ndi Amuna ku Mauthenga Oopsa a Genetic kuchokera ku BRCA1 ndi kuyeza kwa BRCA2." Clinical Genetics 70, 6 Dec. 2006. 462-472. 17 Apr. 2008.
Kachilombo ka Khansa ya Breast ndi BRCA Genesesi, April 6, 2015. Malo Othandizira Kudwala Matenda.
Malone, KE, JR Daling, DR Doody, L. Hsu, L. Bernstein, RJ Coates, PA Marchbanks, MS Simon, JA McDonald, SA Norman, BL Strom, RT Burkman, G. Ursin, D. Deapen, LK Weiss, S. Folger, JJ Madeoy, DM Friedrichsen, NM Suter, MC Humphrey, R. Spirtas ndi EA Ostrander EA. "Kukula ndi Kukonzekera kwa BRCA1 ndi kusintha kwa BRCA2 mu Phunziro Loyambira Kuchuluka kwa Khansa ya M'mimba mu White ndi Black American Akazi Azaka Zaka 35 mpaka 64." Kafukufuku wa khansa 66, 1615. Aug. 2006. 8297-82308. 17 Apr. 2008.
"Matenda Odziletsa: Mafunso ndi Mayankho." Magazini a National Cancer Institute Factory . 26 July 2006. National Cancer Institute. 17 Apr. 2008.