Mavuto a mahomoni, Amayi, ndi Khansa ya m'mimba

Kodi Mimba ndi Kuyamwitsa Zimakhudza Bwanji Vuto Lanu la Khansa?

Pamene amayi amakhala ovuta komanso osokonezeka, amayi ena amakumana ndi vuto la khansa ya m'mawere. Akazi a msinkhu uliwonse kapena msinkhu wa moyo angathe kupezeka ndi khansa-sizimangokhala pamutu wapakati pa mimba ndi kuyamwitsa.

Mahomoni, makamaka mahomoni aakazi estrogen ndi progesterone, komanso khansa ya m'mawere imakhala yovuta kwambiri.

Kusintha kwa mahomoni azimayi kumachitika mwezi uliwonse pazaka za kubadwa kwa amayi ndipo amachepetsa kutha kwa kusamba. Nthawi yomwe mayi amakhala ndi moyo kwa mahomoni, omwe amadziwika kuti amatha msambo, amakhala ndi chiopsezo chochepa cha khansa ya m'mawere.

Komabe, pali zifukwa zambiri zokhudzana ndi mimba ndi lactation zomwe zingachepetse chiopsezo cha khansa ya m'mawere. Koma kwa amayi amodzi mwa atatu, khansa ya m'mawere nthawi kapena mimba itangoyamba kukhala yeniyeni.

Pokambirana ndi Breast Cancer Research Foundation (BCRF), Elisa Port, MD, wolemba buku la "New Generation Breast Cancer Book" adagawana nzeru zowunikira pa zomwe zimapangitsa kuti matenda a kansa ya m'mawere akhudze kapena atatenga mimba. khalani ochenjera pa thanzi, ndi njira zatsopano zothandizira. Dr. Port ndi kafukufuku wa BCRF ndi Chief Breast Surgery ndi Mtsogoleri wa Chigawo cha Brein Breast ku Mount Sinai Hospital ku New York.

Kupititsa Mawere Pamimba Pakati pa Mimba ndi Kuyamwitsa

Kutenga mimba kumayamwitsa ndi potsiriza, kuthamanga, kapena pamene chifuwa chimabwerera kumbuyo kwake, nthawi zina zimayambitsa maselo a m'mawere ndikusintha mtundu wa mahomoni omwe akugwira ntchito pachifuwa.

Njirayi imachepetsa kuchepa kwa estrogen.

Amakhulupirira kuti kuchepa kwa maselo a estrogen ndi mawere okhwima ochepetsetsa amachepetsa mwayi umene khansa ikhoza kukhala nayo. Ichi ndichifukwa chake msinkhu wa kubadwa koyamba ndi chiwerengero cha ana obadwa (omwe amadziwika kuti ali pakati) amachepetsa pang'ono chiopsezo cha khansa ya m'mawere m'moyo pamene mayi ali ndi zaka za m'ma 50, 60 kapena 70.

Kuyamwitsa Kumachepetsa Kuopsa Kwambiri kwa Khansa ya M'thupi

Kuyamwitsa kumayambitsa kusintha kwa mahomoni komanso chifukwa kumachepetsa kubwerera kumapeto kwa mimba, kumachepetsa kuchepa kwa mkazi pa estrogen pa nthawi yake ya mwezi uliwonse, kuchepetsa chiopsezo cha khansa ya m'mawere, makamaka kwa amayi omwe ali ndi mimba.

Poyerekeza ndi mayiko ena, kuyamwitsa ku US kumakhalabe kochepa, makamaka kwa akazi akuda poyerekeza ndi azimayi oyera: 62 peresenti ya amayi akuda poyerekeza ndi 79 peresenti amai oyera anayamba kuyamwitsa posachedwa kubadwa mwadzidzidzi zopezeka kuyambira 2014. Komabe, pa 6 miyezi yakubadwa atangobereka, 36 peresenti yokha ya amayi akuda akuyerekeza ndi 52 peresenti ya amayi oyera akuyamwitsabe. Izi zikukhudza makamaka, monga lipoti la posachedwapa kuti amayi akuda amatha kufa chifukwa cha khansa ya m'mawere kusiyana ndi anthu awo oyera, kusiyana komwe kumawonjezeka m'dziko lonselo.

Kusanthula kwapakati pa maphunziro 47, poyerekeza amayi omwe ali ndi amayi oyamwitsa ana omwe sanayambe kuyamwa, adapeza kuti:

• Amayi omwe amawayamwitsa nthawi zonse (nthawi yokwanira ya kuyamwa kwa ana onse) a chaka chimodzi anali ochepa kwambiri kuti apeze khansa ya m'mawere.
• Zaka zonse za moyo wa zaka 2 zakhala ndifupipafupi kawiri kuti kuchepetsa kupindula kapena kupweteketsa chiopsezo kusiyana ndi omwe akuyamwitsa kwa chaka chimodzi.

Kafukufuku amene anatulutsidwa mu Annals of Oncology anapeza kuti kuyamwitsa kungakhale koyenera makamaka kuchepetsa chiopsezo cha khansa ya Edzi / katatu yosamalitsa, makamaka mtundu wa nkhanza.

Sikuti kokha kuyamwa kumachepetsa chiopsezo cha khansara ya m'mawere m'moyo ndipo kumakhala ndi zakudya zabwino zambiri kwa mwana, kumathandizanso mayi kuchepetsa chiopsezo cha khansa ya ovari, matenda a postpartum, komanso mtundu wa shuga 2 .

Khansa ya m'mawere yokhudzana ndi mimba

Nthawi zambiri, kutenga mimba kungayambitse khansa ya m'mawere. Khansara ya m'mimba yomwe imachitika nthawi yayitali kapena atangoyamba kutenga mimba nthawi zambiri imapezeka pamalo ovuta kwambiri, chifukwa chakuti amayi ambiri sali kuyang'ana ndipo amapezeka mtsogolo, kapena amatha kudziwa zambiri zokhudza kuyamwitsa, monga mastitis.

Nazi njira zingapo zomwe mungayang'anire za umoyo wanu:

• Nthawi zonse dziwani kuti ndinu "wabwinobwino". Dziwani bwino thupi lanu ndi kusintha komwe kumachitika kale, panthaŵi yoyembekezera komanso mutatenga mimba (komanso nthawi zonse m'moyo wanu, kuyambira paunyamata).
• Ngati pali chinthu chilichonse chokayikira, onetsetsani kuti muwabweretsere kwa dokotalayo - kuphatikizapo zizindikiro zina osati zitsulo, monga kupotola kwa msana, kupweteka kwa khungu, kapena kutuluka kuchokera ku khungu kusiyana ndi mkaka wa m'mawere.
• Ngozi ya khansa ya m'mawere imakula zaka 4 mpaka 5 mutatha mimba. Chikhalidwe chachikulu chazing'ono ndi chakuti akazi ayenera kusamala kwambiri za kusintha kosasintha pamabere mpaka mwana wawo alowe m'zigawo zapamwamba.

Kuchiza kwa Khansa ya M'thupi Yogonana ndi Amayi

Pamene khansa ya m'mawere imapezeka pa nthawi ya mimba, chithandizo chimakhala chovuta. Kaya opaleshoni ndi / kapena chemotherapy zimadalira trimester.

Kachiwiri ndi katatu kafukufuku wamaphunziro ali ndi zotsatira zabwino zedi zokhala ndi mimba yabwino komanso yochizira khansa ya m'mawere. Chithandizo m'nthawi ya trimester yoyamba ndi nthawi yovuta kwambiri komanso yovuta kwambiri yosankha njira zothandizira chithandizo, kotero ndikofunikira kulinganitsa mankhwala ndi amayi omwe ali ndi zoopsa kwa mwanayo.

Kuchiza kwa khansa ya m'mawere yotchedwa Hormone

Chifukwa cha kafukufuku woperekedwa ndi BCRF ndi Dr. Charles Perou ndi asayansi ambiri padziko lonse, tsopano tikudziwa kuti khansa ya m'mawere si matenda amodzi, koma ambiri. Madokotala amatha kuzindikira mtundu wa khansa ya m'mawere yomwe mayi ali nayo pofufuza mapuloteni ndi DNA mu maselo otupa omwe amachotsedwa ndi mankhwala osokoneza bongo.

Chithandizochi chimatsatira kachitidwe ka opaleshoni, ma radiation ndi / kapena chemotherapy, koma kudziwa phokosoli kwawonjezera chitukuko cha mankhwala ochiritsidwa omwe angapangitse kuti munthu azisamalidwa bwino ndi matendawa.

Zotsatira zochiritsira pa gawo lililonse ndizo:

• Khansara ya m'mawere itatu ( TNBC ), 10 mpaka 15 peresenti ya khansa ya m'mawere: Palibe mankhwala ochiritsira omwe amavomerezedwa ku TNBC. Komabe, chemotherapy cocktails ingakhale yothandiza kuthetsa TNBC ndipo nthawi zina imayankha mayankho amphamvu.
• Kansera ya khansa ya H22, 15 mpaka 20 peresenti ya khansa ya m'mawere : HER2 + inali mankhwala oopsa mpaka pamene mankhwala ochedwa Herceptin ^® anapangidwa.
  • Yavomerezedwa mu 1998. Khansa ya khansa ya khansa ya HER2 + inayamba kuchoka kuika moyo wake kuchipatala, mwina ngakhale kuchiritsidwa kwa odwala ena.
  • Khansa ya khansa ya khansa ya HER2 + imatha kubwerera m'thupi latsopano, ndipo imakhala yosagwirizana ndi Herceptin ^® . Mankhwala atsopano ochizira HER2 + ndi a Tykerb, Perjeta ^® ndi Kadcyla ^® (T-DM1) angathe kuthana ndi kuteteza Herceptin.
  • Mwachitsanzo, mu kafukufuku waposachedwa wa khansa ya m'mawere, anthu odwala kansa ya khansa ya HER2 + anali ndi moyo wabwino (miyezi 56 ndi miyezi 40) pamene Herceptin anali ndi Perjeta ^® , poyerekeza ndi odwala omwe amalandira Herceptin ^® okha.
• Kansera ya khansa ya ER +, 60 mpaka 70 peresenti ya khansa ya m'mawere: ER + ndiyo njira yofala kwambiri ya khansa ya m'mawere ndipo zotsatira zake ndi 60 mpaka 70 peresenti ya anthu 250,000 chaka chilichonse. Ikhoza kuchiritsidwa ndi opaleshoni, ma radiation, chemo Koposa mankhwala oletsa anti-estrogen. Tachita bwino kwambiri pochiza khansa ya m'mimba ya ER: Matenda atsopano otchedwa mTOR inhibitors komanso CDK4 / 6 inhibitors omwe amapanga mapuloteni enieni ndipo akuwonetsa malonjezowo m'mayesero a zachipatala, ndipo ambiri amavomereza m'zaka zaposachedwapa kuphatikizapo mTOR inhibitor [insert mTOR name] ndi CDK4 / 6 inhibitors Ibrance® ndi Kisaqli®.

Chiberekero Patatha Chithandizo

Ngakhale kuti kubala kwa khansa ya m'mawere kumakhala kovuta kwambiri, amayi ambiri amakhala ndi mimba yabwino pambuyo pa khansa ya m'mawere. Zolinga zamankhwala zambiri zimakhala ndi mankhwala ozunguza bongo monga tamoxifen kwa zaka 5-10 pambuyo pa opaleshoni ndi / kapena chemotherapy kuchepetsa chiopsezo cha kubwereranso ndipo popeza mankhwalawa angayambitse vuto la kubala mimba. Mankhwala ena odana ndi estrogen amaperekedwa ndi mankhwala omwe amalepheretsa ntchito ya ovarian kuti asungire chonde. Kusungunula mazira kapena mazira amakhalanso wamba ndipo zingakhale zotsogozedwa.

Zosankha ziyenera kukambidwa musanayambe kuchipatala kuti mkazi athe kupanga chisankho chabwino kwa iye ndi banja lake.

Zitengera Zapadera

• Mimba ndi kuyamwitsa kumachepetsa chiopsezo cha khansa ya m'mawere m'moyo.
• Ngozi ya khansa ya m'mawere imakula pang'ono kwa zaka zisanu mutatha mimba. Yang'anirani za ubereki wanu nthawi imeneyi.
• Ngati khansara ya m'mawere imachitika panthawi yomwe mayi ali ndi mimba, chithandizo ndi chovuta kwambiri kwa mayi ndi mwana.
• Njira zatsopano zothandizira khansa ya m'mawere yothandizira mahomoni zathandiza kuti chithandizo chamaphunziro chitheke.