Matenda asanu atsopano a moyo- Provenge , Zytiga , Xtandi, Xofigo, ndi Jevana- amatha kupezeka khansa ya prostate zaka zisanu zapitazo. Mwamwayi, mankhwala achilendo akale monga ma radiation, Lupron, ndi Taxotere amakhalabe ogwira ntchito. Kawirikawiri khansara ya prostate imapita patsogolo pang'onopang'ono, kutanthauza kuti imfa imatha kuchedwa kwa nthawi yaitali.
Ngakhale zili zonsezi, amuna 28,000 amagwidwa ndi khansa ya prostate chaka chilichonse. Nthawi zambiri, imfa imapezeka chifukwa khansayo imakhala yosagwirizana ndi mankhwala onse omwe ali pamwambapa. Ngati izi zikuchitika, ndondomeko yotsatirayi ndikuyenera kuganizira mankhwala omwe ali ndi mankhwala omwe ali a FDA omwe amavomerezedwa ndi mitundu ina ya khansa, kansalu ya impso kapena khansara yamapapo. Vuto ndi kusankha pakati pazinthu zambiri. Ngati mutenga mfuti mumdima, kodi mungasankhe mfuti yanji?
Zotsalira Zamatsenga: Nkhani Yodwala
Kufuna kwa wothandizila wogwira ntchito bwino kungakhale ndi malipiro aakulu ngati muli ndi mwayi. Kuchokera ku maonekedwe a FDA, mankhwala ovomerezeka angagwiritsidwe ntchito ngati sakuvomerezedwa ngati wothandizira zaumoyo akuwona kuti wodwalayo ali woyenera, kaya ndi chifukwa chakuti palibe mankhwala ovomerezeka kuti athetse vutoli kapena chifukwa wodwalayo ayesa zonse zomwe zimavomereza mankhwala popanda kuona zotsatira.
Ndiloleni ndifotokoze nkhani ya Bill. Anayamba kuwapeza kumapeto kwa 2010 ndi PSA ya 4.2 ndi Gleason mlingo wa 3 + 4 ndipo anachitidwa opaleshoni kuchotsa prostate. Chizindikiro choyamba cha vuto lina chinali chakuti lipoti lake la matenda linasonyeza khansa kunja kwa m'mphepete mwa prostate. Chiwerengero chake cha Gleason chinakonzedwanso ku 4 + 5 = 9, ndipo PSA yake siidagwa mpaka zero pambuyo pa kuchotsedwa kwa prostate.
Mu March 2011, adalandira ma radiation opita ku dera limene prostate ankakhala, koma PSA inangokhala yochepa kwa nthawi yochepa. Kenaka anayamba Lupron, koma chotupa chake chinakhala chosagonjetsedwa mkati mwa chaka. Kwa zaka zitatu zotsatira, adachizidwa ndi mankhwala omwe atchulidwa pamwambapa, Provenge, Zytiga, Xtandi, ndi Taxotere. M'chaka cha 2014, khansara yake inafalikira ponseponse m'mafupa ake. Chithandizo ndi Xofigo chinayambika mu February 2014. Mwatsoka, iye anayamba kupuma kwa fupa la mafupa, chitukuko chofala pakati pa amuna omwe ali ndi khansara yosalamulirika ya prostate. Kupanga kwake kwa maselo ofiira ofiira kunali kovuta kwambiri basi akanangokhala ndi moyo ndi kuikidwa magazi tsiku ndi tsiku. Pamene Xofigo inaimitsidwa mu August 2014, PSA idakwera kufika pa 120. Chitsimikizo cha Bill kuti akhale ndi miyezi isanu ndi umodzi chinali osachepera mmodzi pa khumi.
Mpaka pano, dokotala wina anali kuyang'anira mlandu wake. Atatsala pang'ono kuyang'anira ntchito yake yachipatala ku ofesi yanga, dokotala wake wakale adayamba Bill pa mankhwala omwe amawatcha kuti Mekinist. Mekinist ndi mapiritsi omwe ali a FDA-omwe amavomerezedwa ku melanoma ya metastatic. Popeza ntchito ya kansa ya prostate (yopanda kugwiritsa ntchito mankhwala) siyikuphimbidwa ndi inshuwalansi, Bill adagula mapiritsi ake pa mtengo wa $ 10,000 pamwezi.
Komabe, ndalama zake zinalipira. Pofika chaka cha December 2014 PSA inatsikira ku 18,96, fupa lake linayamba kugwira ntchito, ndipo sanafunike kuika magazi patsogolo.
Umoyo wa Bill unasintha kwambiri kotero kuti anabwerera kuntchito yake nthawi zonse ndipo nthawi zambiri ankayenda ndi banja lake ku Ulaya ndi malo osiyanasiyana ku US zaka ziwiri zotsatira. The Mekinist inavomerezedwa bwino popanda zotsatira zoyipa. Mwatsoka, khansara yake ya prostate kenaka inagonjetsedwa ndi Mekinist ndipo khansa inayamba kukula. Ntchito yathu yowonjezereka yopezera mafilimu ena osagwira ntchito sizinapambane ndipo adagonjetsa matendawa kumayambiriro kwa chaka cha 2016.
Mekinist wa Bill anali kusankha mwayi wodabwitsa. Atatha kuonetsa kansa yaikulu ya khansa, adatha ngakhale kutsimikizira kampani yake ya inshuwaransi kuti aphimbe mtengo wake. Kupindula kwa chikhululukiro cha khansara pamapeto otere a matendawa ndizodabwitsa kwambiri, ndizogwirizana ndi zokolola zomwe zimapangidwira patsogolo pa makampani opanga mankhwala. Popeza kuti opangidwa atsopano ambiri akukambidwa, zovuta kuti phindu labwino, monga momwe Bill alili, kuti libwerezedwe likukula.
Mayeso a Zachibadwa: Njira Yopangira Chisankho
Vutoli ndilokuti pali oposa atsopano omwe akuvomerezedwa mu mitundu yonse ya khansa. Kodi mumadziwa bwanji kuti wothandizira ndani? Tayesera kupereka Mekinist kwa odwala ena owerengeka, koma popanda chithandizo chowoneka chotsutsana ndi kansa. Izi sizosadabwitsa chifukwa khansara ya prostate si matenda amodzi. Kwa nthawi yaitali takhala tikusiyana kwambiri ndi momwe odwala amachitira ndi othandizira osiyanasiyana. Komabe, palinso gawo lina lakupita patsogolo kwazamakono komwe kungatithandize kuthandizira odwala pazochiritso. Kufika kwa kuyesa kwa majini kwa maselo otupa kumapeto kumatha kuthetsa nthawi yopezera chithandizo mwachisawawa.
Lingaliro ndi kusankha chisamaliro pozindikira kuti maonekedwe a maselo a khansa ndi kusinthana kwa jini. Kukula kwa maselo osayendetsedwa, "khansa," kumachokera ku majeremusi olakwika. Majini osinthika omwe ali okhudzana ndi kukula kwa maselo akhoza kutsekedwa mu malo "pa". Kusintha kumeneku kumatha kudziwika ndi kuyendetsa majini. Mankhwala opitirira 50 akhala akudziwika kuti kuchepa kwa khansa ya prostate. Genetic kusanthula mitsempha yamatumbo imasonyeza kuti pafupifupi khansa yambiri ya majini anayi imasinthidwa. Komabe, chiwerengero cha majeremusi oipa omwe amapezeka angachoke pa ochepa kuposa mmodzi mpaka 10.
Zosangalatsa monga lonjezo la kusankha "mwanzeru" kumveka, pakadalibe mavuto angapo omwe angagonjetse. Gene kusinthanitsa kumatha kudziwa nthawi zonse majini osagwira ntchito, koma osati nthawi zonse geni ntchito yake. Tikamadziwa ntchitoyi, nthawi zambiri sitimakhala ndi mankhwala enieni kuti tipewe vuto lomwe jini limapanga. Ngakhalenso kumwa mankhwala okhwima kuti athetse mtundu wina wa khansa, palibe chitsimikizo chakuti kayendedwe ka kansalu kameneka kadzakhalanso kathanzi ya kansa ya prostate. Mwachitsanzo, Mekinist amaganiza kuti ndi yothandiza polimbana ndi khalidwe loipa la GNAS yomwe imakhala ndi odwala matenda a melanoma. Komabe, komabe, tilibe deta yosonyeza kuti Mekinist idzagwira ntchito kwa odwala khansa ya prostate ndi GNAS .
Njira Zoyesera Zachibadwa
Tinayesetsa kupeza maselo a khansa kuti tiyese ma genetic mu Bill kudzera pang'onopang'ono. Mwamwayi, chiwopsezocho sichinapambane chifukwa palibe maselo okhwimitsa omwe angathe kupezeka. Zomwe timakumana nazo ndi chiopsezo kuti tipeze maselo a mitsempha kuchokera ku fupa la kuyesa kwa majeremusi m'thupi la khansa ya prostate zakhala zikuwayendera bwino pafupifupi theka la odwala omwe tayeserapo kuchita zovuta. Mpaka posachedwa, fupa la mafupa ndilo njira yokhayo yopezeramo zamoyo m'ma maselo otupa. Matenda a mafupa, komabe, ndi ovuta komanso osasangalatsa omwe amafuna njala yaikulu. Mwamwayi, teknoloji ikupitirizabe kupita patsogolo mofulumira kwambiri. Zotsatira zatsopano ndi kupezeka kuti DNA yotuluka mu magazi kuchokera ku maselo a khansa yakufa ingadziwike ndikuyesedwa ndi kuyesedwa kwa magazi.
Kuyesera magazi a DNA n'kosavuta kusiyana ndi kupanga fupa. Kuphatikiza pa chinthu chophweka, DNA m'magazi ndi mbali ya DNA yomwe imatulutsidwa ku matumbo onse m'thupi. Zachibadwa zomwe zimachokera ku chiwopsezo cha chotupa chimodzi sichitha kunena nkhani yonse chifukwa khansara ndi yosasunthika kuti malo osiyana siyana a khansa ochokera kwa wodwala omwewo akhoza kukhala osiyana.
Kuyezetsa magazi kwa DNA yamagazi tsopano kulipo malonda. Kampani yomwe imayesa kuyesa imatchedwa Guardant Health. Amachitcha mayeso a magazi awo omwe amayesa matenda a khansa Guardant360. Kuyesera kwa mayeso kwa kusintha kwa makumi asanu ndi awiri (70) zomwe zimawoneka khansa. Kafukufuku wapangidwa pofuna kuyesa ngati majini osadziwika omwe amapezeka m'magazi amatsutsana ndi majini osazolowereka omwe amapezeka ndi chizolowezi cha chilakolako cha mimba m'thupi lomweli. Nthenda yamagazi ikuwoneka kuti ikuchita bwino kwambiri.
Pambuyo pa Gene Wosasamala Zimadziwika
Kotero tiyeni tibwerere ku mutu wathu waukulu wogwiritsa ntchito chidziwitso chochokera ku majini kuti tisankhe mankhwala ochotsera khansa kwa amuna omwe ali ndi khansara ya prostate omwe atopa njira zawo zovomerezedwa ndi FDA. Pamene jini losadziwika lapezeka pali zotsatira zinayi zomwe zingatheke:
- Palibe mankhwala omwe amadziwika omwe amagwirizanitsidwa ndi matenda oopsa a khansa.
- Pali mankhwala omwe amavomerezedwa ndi FDA a kansa ya prostate yomwe ilipo pamtundu umenewu
- Pali mankhwala omwe amavomerezedwa ndi FDA omwe amagwiritsidwa ntchito kwa mtundu wina wa khansara (mapapo, impso, khansa ya khansa, etc.) zomwe zingakhale ndi ntchito yachangu mu kansa ya prostate ndi jini yeniyeniyi.
- Pali zothandizira zatsopano kuti ziziyesedwa kuti zikhale zosawerengeka zenizeni mthupi mwa khansa ya prostate kapena mtundu wina wa khansara. Odwala omwe ali ndi mtundu uwu wamasinthidwe akhoza kukhala oyenera kuyankha kwa wothandizirayo poganizira momwe wothandizila amadziwira.
Kufotokozera zomwe tafotokozazi mwachidziwitso, zotsatira ziwiri zoyambirira sizithandiza kwambiri odwala. Mwachindunji, pokhudzana ndi zotsatira zachiwiri, odwala ambiri amene amawayezetsa kansa ya prostate atha kale kale mankhwala omwe amavomerezedwa ndi prostate-odwala khansa ya FDA . Zotsatira zachitatu ndi zachinayi ndizo zomwe zingagwiritse ntchito mtundu wa mankhwala omwe angatayikirepo pambuyo pa kuchuluka kwa zosankha zomwe sizingatheke kuganiziridwa.
N'zomvetsa chisoni kuti mbiri ya Bill siingatheke ngakhale titayesetsa kwambiri. Mphamvu ya Mekinist pa moyo wake wautali ndi umoyo wake unali wopambana kwambiri. Panthawiyi, sitikudziwa ngati yankho lake labwino lidachitika chifukwa chakuti ali ndi vuto la GNAS, jini kapena mtundu wina wa majini. Komabe, pokhala ndi zosavuta kupeza zokhudzana ndi majeremusi kudzera mu kuyezetsa magazi ndi Guardant360, tidzatha kuphunzira kuti ndi chithandizo chiti chomwe chingayambitse mayankho a khansa kuchokera kumbali yeniyeni ya wodwalayo.