Estrogen ndi Progesterone Posachedwapa Khansa ya M'bwere
Ngati mwakhala ndi chifuwa cha m'mawere kapena opaleshoni ya khansa ya m'mawere (kaya mastectomy kapena lumpectomy), chimodzi mwa zinthu zoyamba zomwe zimachitika ndi kudziwa momwe mthupi lanu limakhudzidwira. Udindo wamtundu wa homoni, ndi wofunikira kwambiri posankha njira zabwino kwambiri zothandizira khansa yanu. Tiyeni tiyang'ane mayesero osiyanasiyana a ma hormone, momwe chikhalidwe choipa kapena choipa chimatanthawuzira, ndi momwe izi zimakhudzidwira masitepe otsatirawa pakupeza ndi kuchiza.
Mayendedwe a Estrogen ndi Progesterone Ovomerezeka
Mayendedwe a Estrogen ndi progesterone amapepala ndi "mayesero" omwe amapezeka pa khansa yonse ya m'mawere. Izi zidzawonekera pamakalata anu odwala matendawa pambuyo pa chiwopsezo ndi pambuyo pa opaleshoni. Ovomerezanso amabwezeretsanso ngati mutabwereranso, monga momwe angasinthire ngati chotupa chimayambira kapena kufalikira. Zovomerezeka za mahomoni zimatsimikiziridwa pogwiritsa ntchito microscope pa chitsanzo cha biopsy.
Kumvetsetsa ovomerezeka a Hormone
Mavitamini a Estrogen ndi progesterone ndi mapuloteni omwe amapezeka pamwamba pa maselo a m'mawere. Estrogen ndi progesterone imagwirizanitsa ndi mapulogalamu awa (monga chingwe ndi fungulo) kuti awonetse selo kukula ndikugawaniza. Maselo onse a m'mawere ali ndi mapepala awa, koma amapezeka mambirimbiri pa maselo a khansa ya m'mawere omwe amawoneka kuti ndi abwino.
Pofuna kutseka chizindikiro chomwe chinayambira pamene estrogen kapena progesterone imamangiriza ku mapepala awa, ndizofunikira kuchita chimodzi mwa zinthu ziwiri.
Mungathe kuchepetsa kuchuluka kwa estrogen mu thupi (kudzera mu mankhwala ochotsera ovari asanayambe kusamba kapena kugwiritsa ntchito aromatase inhibitor pambuyo pa kutha kwa thupi) kapena kulepheretsa kulandira kuti estrogen yomwe ilipo mu thupi sungakhoze kumanga ndi receptor.
Kufunika kwa Estrogen ndi Progesterone Mkhalidwe Wopanda Khansa ya M'bwere
Khansa ya m'mawere yomwe ndi estrogen (ndi / kapena progesterone) zabwino ndi "yothamangitsidwa" ndi estrogen.
Sikuti khansa yonse ya m'mawere imayendetsedwa ndi estrogen. Ma khansa ena a m'mawere amalowetsa HER2 zabwino. Ndi khansa izi, kukula kwa thupi kumamatira ku HER2 receptors pamwamba pa maselo a khansa kuti ayendetse kukula kwa chotupacho. Ma khansa ena a m'mawere samakhala ndi zina zoterezi ndipo amatchulidwa kuti "khansa itatu".
Ma khansa ena a m'mawere onse ndi othandizira mahomoni komanso HER2 abwino. Ndi khansa imeneyi, maselo angakonzedwe kuti akule ndi maselo a estrogen / progesterone kumalo otchedwa estrogen kapena progesterone, kapena ndi kukula komwe kumamatira ku receptor HER2. Mankhwalawa akhoza kutchedwa "katemera wabwino" katatu. (Phunzirani zambiri za udindo wa estrogen mu khansa ya m'mawere).
Mkhalidwe wabwino ndi woipa wa Estrogen
Mapulogalamu a Estrogen Receptor abwino (ER +) amatanthauza kuti estrogen ikuchititsa kuti chifuwa chanu chikule, komanso kuti khansayo iyenera kuyankhidwa bwino ndi mankhwala opatsirana. Ngati mapepalawa ndi Estrogen Receptor negative (ER-), ndiye kuti chotupa chanu sichitengeredwa ndi estrogen, ndipo zotsatira zanu ziyenera kuyesedwa pamodzi ndi mayesero ena, monga HER2 yanu, kuti mudziwe njira yabwino kwambiri yothandizira.
Kodi Muyenera Kufunsa Nthawi Yanji pa Nambala Yambiri?
Ngati mayeso anu a ma hormone ndi olakwika, ndibwino kufunsa dokotala wanu chiwerengero chomwe chikuwonetsera mapepala enieni.
Ngakhale nambalayo ndi yochepa, khansayo imatha kuchiritsidwa ndi mankhwala a homoni.
Zambiri za Mkhalidwe Wokalandira Hormone
Pa lipoti lanu la matenda, mukhoza kuona zotsatira za maonekedwe a Hormone. Izi zikufotokozedwa ngati nambala pakati pa 0 ndi 3. Apa ndi momwe mungamvetsere nambala:
- 0 sizomwe zimapezeka,
- 1 + ndi nambala yaing'ono,
- 2+ ndi nambala yamkati, ndi
- 3+ ndi chiwerengero chachikulu cha zovomerezeka.
Mukhozanso kupeza chiwerengero cha maselo kuchokera ku maselo 100 omwe amayesa zowonongeka kwa ovomerezeka a mahomoni. Izi zalembedwa ngati chiwerengero pakati pa 0% (palibe zopatsa) ndi 100 peresenti (maselo onse ali ndi receptors).
Njira Zothandizira Opaleshoni ya Estrojeni Khansa Yabwino Yamatenda
Ngati chotupa chanu chiri ER + ndi / kapena PG +, mankhwala otchedwa hormonal mankhwala akulimbikitsidwa.
Koma kusankha kwa mankhwala, kumadalira momwe thupi lanu limayendera.
Musanayambe kusamba, mazira amatha kupanga kwambiri maantirogen. Pofuna kupewa tizilombo toyambitsa matenda kuti tizilombo toyambitsa khansa, tizilombo toyambitsa matenda timagwiritsa ntchito mankhwala otchedwa estrogen receptor modulator. Mankhwala awa, monga tamoxifen , amamanga kulandira estrogen kotero kuti estrogen sungamange.
Pambuyo pa kusamba, zochitikazo ndizosiyana. Pali ochepa kwambiri estrogen mu thupi. Mmalo mwa mazira ochuluka opanga estrogen, gwero lalikulu la estrogen mu thupi ndiko kutembenuka kwa androgens (mahomoni amtundu wa amuna) mu estrogen. Izi zimachititsanso kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda. Mankhwala otchedwa aromatase inhibitors amatha kuletsa ma enzyme kuti estrogen isapangidwe, ndipo sangathe kumanga maselo a khansa kuti akule.
Pali atatu aromatase inhibitors omwe alipo tsopano:
- Arimidex (anastrozole)
- Aromasin (chiwombankhanga)
- Femara (letrozole)
Aromatase inhibitors nthawi zina angagwiritsidwe ntchito kwa amayi omwe amatsogoleredwa ndi amuna apamtima atatha kuchira. Choyamba, mankhwala amagwiritsidwa ntchito omwe amachititsa kuti mazirawa asapangidwe ndi estrogen. (Njira ina, ngakhale kuti siyi yoyamba, ndiyo kuchotsa mazira ochuluka). Ndiye, mayi akhoza kusinthidwa kuchoka ku tamoxifen kupita ku imodzi ya aromatase inhibitors. Kuchita zimenezi kumawoneka kukhala ndi mwayi wopulumuka kwa amayi ena omwe ali ndi khansa ya m'mawere.
Palinso mankhwala ena omwe amatha kugwiritsidwa ntchito nthawi zina. Faslodex (fulvestrant) ndisankha mchere wotchedwa estrogen receptor-regulator (SERD). Zingagwiritsidwe ntchito kwa amayi omwe ali ndi matenda a khansa pomwe ali pa tamoxifen kapena aromatase inhibitor. Kuphatikizanso apo, palinso mankhwala ena opatsirana a khansa ya m'mawere yomwe ingaganizidwe kwa anthu ena.
Zovomerezeka za Hormone ndi Cancer ya Breast Recurrence kapena Metastases
Ndi khansa ya m'mawere oyambirira yomwe imalandira chithandizo chabwino cha maestrogen, mankhwala am'thupi amatha kuchepetsa kupitirira pafupifupi theka, kaya tamoxifen imagwiritsidwa ntchito kwa amayi omwe ali ndi mimba kapena aromatas inhibitors omwe amagwiritsidwa ntchito kwa iwo omwe ali amsinopaopausal.
Estrogen Receptor Matenda Osangalatsa ndi Bisphosphonates
Posachedwapa, bisphosphonates yakhala ikuwonjezeredwa pamodzi ndi aromatase inhibitors kwa khansa yoyambirira ya postmenopausal ya khansa yomwe ili ndi receptor yabwino. Akagwiritsidwa ntchito limodzi ndi aromatase inhibitors amawoneka kuti amachepetsa chiopsezo cha kubwereranso, makamaka kufalikira kwa khansa ya m'mawere ku mafupa.
Kutalika kwa Chithandizo
M'mbuyomu, mankhwala ndi tamoxifen kapena aromatase inhibitors nthawi zambiri ankapitirira zaka zisanu. Panopa amaganiza kuti kugwiritsa ntchito mankhwala a aromatase kwa zaka zoposa zisanu kumachepetsa chiopsezo cha kubwereza kwa amayi omwe ali ndi khansa ya m'mawere yomwe nthawi zambiri amatha kubwerera. Ndikofunika kuyankhula ndi dokotala wanu zazomwe mukupempha zokhudzana ndi chithandizo chamankhwala kupyolera mu maphunziro atsopanowa.
Pamunsi pa Zovomerezeka za Hormone Kuyesedwa ndi Khansa ya M'bwere
Udindo wamtundu wa homoni ndi mbali yofunikira kwambiri ya matenda a khansa ya m'mawere. Ngati chotupa ndi estrogen receptor positive (ER +) zimatanthauza kuti estrogen ndi "woyendetsa" mu kukula kwa khansa. Mofananamo, chotupa chomwe ndi progesterone receptor positive (PG +) chimayendetsedwa ndi kukhalapo kwa progesterone. Kawirikawiri, koma nthawi zonse, chotupa chidzakhala onse ER + ndi PG + kapena ER- ndi PG-.
Kwa amayi oyambirira, kuteteza isrogen pamatenda a khansa ya m'mawere ndi njira yachizolowezi. Kwa amayi omwe amatha kupha amayi awo, amaletsa mapangidwe a estrogen m'matenda am'thupi ndi aromatase inhibitors ndi njira yachizolowezi. Kugwiritsira ntchito mankhwala ochizira ammimba kwa anthu omwe ali ndi msinkhu woyambirira ndi receposor kapena progesterone zotengera zabwino zingachepetse kwambiri chiopsezo cha kubwereza. Kwa amayi omwe ali ndi khansara ya m'mawere, mankhwala am'thupi amatha kuwonjezera chiyembekezo cha moyo ndipo nthawi zambiri amachepetsa zizindikiro za matendawa.
> Chitsime:
> National Cancer Institute. Matenda a khansa ya m'mawere (PDQ) -Health Professional Version. Kusinthidwa 10/13/17. https://www.cancer.gov/types/breast/hp/mastast-treatment-pdq