Kwa amayi omwe ali ndi khansa ya m'mawere yotchedwa estrogen, mankhwala opangidwa ndi mahomoni amathandizidwa kawirikawiri pambuyo pa mankhwala oyamba ndi opaleshoni komanso mwinamwake mankhwala othandizira ndi mankhwala kapena mankhwala . Zosankha zikuphatikizapo tamoxifen kapena aromatase inhibitors monga Arimidex, Femora, kapena Aromasin. Kodi mtengo ndi mphamvu za mankhwalawa zimagwirizanitsa bwanji, ndipo muyenera kudziwa chiyani?
Kodi chimachitika ndi chiyani ngati mukuvutika kulipira mankhwalawa?
Mankhwala a Hormone ndi Kuopsa kwa Khansa ya M'thupi Yowonongeka
Tikudziwa kuti ngakhale pambuyo pa chithandizo chapadera cha khansa ya m'mawere pali ngozi yobwereza . Ndipo mochedwa recurrences zaka zingapo kapena makumi mutatha chithandizo ndizofala kwambiri ndi zotupa zotenga maselo a estrogen. Mankhwala opanga mahomoni awonetsedwa kuti achepetse chiopsezo cha kubwereza ndikupangitsanso kuti mitengo ikhale yopulumuka.
Mankhwala Omwe Amachititsa Kuti Kutentha Kwambiri Kukulepheretseni Kuopsa Kwambiri
Tikudziwa kuti estrogen imagwira ntchito ngati "kukula" pofuna kukula kwa zotupa zotchedwa estrogen-receptor zabwino mwakumangiriza ku maselo otchedwa estrogen pamwamba pa maselo a khansa. Choncho, kuchepetsa kuchuluka kwa estrogen m'magazi ndi kuletsa ma recerose a estrogen kungachepetse chiopsezo maselowa amakula ndikukhala akubwereranso.
Tamoxifen ndi aromatase inhibitors amagwiritsa ntchito njira zosiyanasiyana. Musanapite kumapeto, mazira ambiri ndiwo omwe amachokera ku estrogen.
Tamoxifen imagwira ntchito kwa amayi omwe amachititsa kuti thupi lawo lisamakhale ndi matenda a khansa ya m'mawere kuti isrogen isamangidwe ndi kuyambitsa maselo kukula. Tamoxifen ingathandizenso pambuyo pa kutha kwa thupi, koma aromatase inhibitors apezeka kuti akuthandiza kuchepetsa kubwereza.
Pambuyo pa kusamba, chitsimikizo chachikulu cha estrogen ndiko kutembenuka kwa androgens (komwe kuli m'ma maselo ambiri) kwa estrogen.
Enzyme yomwe imachita izi imatchedwa aromatase. Aromatase inhibitors amachititsa kuti aromatase ayambe kutero kotero kuti isrogen siingapangidwe.
Kusankha Mankhwala a Hormone ndi Matenda a Amuna
Amayi am'mbuyo asanamwalire, tamoxifen amafunika ngati chitsime chachikulu cha estrogen m'thupi chimachokera ku mazira. Pachifukwa ichi, aromatase inhibitors amangoletsa kokha kachilombo koyambako ka estrogen.
Amayi a Premenopausal amachizidwa ndi tamoxifen. Aromatase inhibitors angagwiritsidwe ntchito m'mapangidwe angapo. Ngati mkazi amatha kupuma kwa thupi (monga momwe adayesedwera ndi kuyezetsa magazi chifukwa chosadziwika pambuyo chemotherapy) akhoza kusinthidwa ku aromatase inhibitors. Amatha kulandira mankhwalawa ngati atatha kusamba thupi (kuchotsedwa kwa mazira ake) kapena kulandira chithandizo cha ovarian.
Aromatase inhibitors panopa ndi awa:
- Arimidex (anastrozole)
- Femara (letrozole)
- Aromasin (chiwombankhanga)
Nthawi Yambiri ya Hormonal Therapy ikugwiritsidwa ntchito
M'mbuyomu, tamoxifen kapena aromatase inhibitor amagwiritsidwa ntchito kwa zaka zisanu. Kafukufuku waposachedwapa akusonyeza kuti kupitiriza kwa zaka zina zisanu (nthawi zina kusintha kuchokera ku tamoxifen kupita ku aromatase inhibitor) kungachepetse ngozi yobwereza.
Zotsatira za Tamoxifen vs Aromatase Inhibitors (Arimidex, Femara, ndi Aromasin)
Zomwe ma tamoxifen ndi aromatase inhibitors zimayambitsa minofu, koma izi zimakhala zoyipa kwambiri pa aromatase inhibitor.
Tamoxifen ikhoza kuchepetsa kuperewera kwa mafupa pamene aromatase inhibitors angayambitse mafupa ndi kutupa mafupa.
Malinga ndi zotsatira zowopsa, tamoxifen nthawi zina imakhala ndi zotsatira zoyipa monga mwazi wa magazi ndi pulmonary. Aromatase inhibitors akugwirizana ndi chiopsezo chowonjezeka cha matenda a mtima mwa amayi omwe ali ndi mbiri ya mabotolo obisala.
Ngati zotsatira zake zimakhala zovuta, uzani dokotala wanu ndikufunseni njira zolimbana nazo; Pali njira zambiri zochepetsera zotsatirazi ndikupangitsa mankhwala kukhala osavuta. Ngakhale kuti izi zingakhale zovuta, kumbukirani kuti mwatsiriza mbali yambiri ya chithandizo ndipo mukupita ku moyo mutatha khansa ya m'mawere.
Mtengo wa Tamoxifen vs Aromatase Inhibitors
Tamoxifen ndi aromatase inhibitors monga Arimidex zingachepetse chiopsezo cha kubwereka kwa khansa ya m'mawere (ndi mwayi wina wogwirizana ndi aromatase inhibitors) koma ndalama zingakhale zosiyana kwambiri. Popeza tamoxifen ndi mankhwala akale kwambiri komanso ovomerezeka kwambiri, imakhala imodzi mwa zosakwera mtengo. Aromatase inhibitors kawirikawiri ndi ofunika kwambiri kuposa tamoxifen.
Mitundu yonse ya mankhwala a mahomoni imathandiza kuchepetsa kubwereka kwa khansa ya m'mawere, koma mitundu yonse ya mankhwala imabwera ndi mavuto ena komanso zotsatira zake.
Kusamalira Mtengo wa mankhwala a Hormonal
Mankhwala opanga mahomoni angakhale okwera mtengo, koma zingakuthandizeni kuganizira kuti ndi inshuwalansi yotsutsana ndi kubwereza.
Zomwe mumamwa mankhwalawa zimasiyana kwambiri ndi inshuwalansi yanu. Kuphatikizanso, makampani ena a inshuwaransi adzagwira mtundu umodzi wa aromatase inhibitor osati wina.
Ngati muli ndi vuto ndi mtengo, pali zambiri zomwe mungachite:
- Gwiritsani ntchito ndi dokotala wanu
- Lankhulani ndi kampani yanu ya inshuwalansi
- Mapulogalamu othandizira ma ARV.
Tiyeni tiyang'ane pa izi zilizonse.
Gwirani ndi Dokotala Wanu ndi Company Inshuwalansi
Gawo loyamba ngati mtengo wa mankhwala anu ndi wapamwamba kwambiri ndikulankhulana ndi dokotala wanu. Ngati akuganiza kuti pali chifukwa chomwe mankhwala ena angapangidwire wina (monga kuchepetsa chiopsezo chachikulu kapena zotsatira zochepa) ganizirani masitepe otsatirawa.
Chachiwiri, lankhulani ndi kampani yanu ya inshuwalansi. Zingakhale zosavuta kulankhula momasuka pafoni. Ngati mankhwala omwe dokotala akuganiza kuti ndi abwino sikuli pa formulary, adokotala akhoza kukwaniritsa chilolezo chisanafike kuti chiphimbidwe. Kaya muli ndi inshuwalansi yathanzi, Medicare Part D, kapena Medicaid, kuyenerera kwanu kumasiyana.
Mwinanso mungakonde kulankhula ndi wamalonda wanu. Matembenuzidwe a generic ena mwa mankhwalawa alipo komanso akhoza kutsika kwambiri.
Mapulogalamu Othandizira Mankhwala
Ngati mulibe vuto lolemba mankhwala omwe dokotala wanu amamva kuti ndilobwino, palinso njira zambiri. Ena mwa awa ndi awa:
- Mapulogalamu Othandizira Olemba Odwala : Phunzirani zambiri za mapulogalamu osiyanasiyana othandizira odwala omwe akupezekapo ndipo fufuzani ndi opanga mankhwala kuti athandizidwe ndi mapulogalamu.
- Mapulogalamu othandizira mankhwala osokoneza bongo: Dziwani zambiri za omwe angapindule ndi khadi lochotsera mankhwala komanso pamene angathandize.
- Funsani zitsanzo: Ena oncologists amaperekedwa zitsanzo za aromatase inhibitors. Sungapweteke kufunsa.
- Onetsetsani kulemala: Ngati simunapite 65 koma mukhoza kukhala odwala, mukhoza kupeza mankhwala kudzera mwa Medicare.
- Makampani opanga pa Intaneti: Musanapite ku intaneti, phunzirani za momwe mungatetezere mankhwala osokoneza bongo pa intaneti .
- Mapulogalamu othandizira alimi a boma: Amitundu ambiri ku America ali ndi mapulogalamu othandizira kapena othandizira. Fufuzani kuti muwone ngati dziko lanu likupereka chithunzi.
- Thandizo lopanda phindu: Funsani dokotala wanu kapena chipatala za mabungwe am'deralo omwe amapereka thandizo ndi mtengo wa malamulo. Mukhozanso kufufuza ndi mabungwe omwe amapereka chithandizo cha khansa ya m'mawere. Kumbukirani kuti mabungwe osiyanasiyana ali ndi zolinga zosiyana. Ena amayesa kusintha kusintha pa National level. Ena amayesetsa kupeza kafukufuku. Ndipo ena ali ndi cholinga chothandiza anthu omwe ali ndi khansa lero; monga kupereka ndalama za mankhwala a mankhwala.
Sungani Zosamala
Ndi kusintha kwa inshuwalansi komwe kumafuna zopereka zazikulu kuchokera kwa anthu omwe ali inshuwalansi, kusunga zolemba mosamala n'kofunika kuposa kale lonse. Zambiri zimapangitsa kuti chithandizo cha khansa ndichoperekedwa pamsonkho, kuphatikizapo ndalama zowonongeka za mankhwala opatsirana.
Mawu Ochokera
Thandizo la mahomoni limalimbikitsidwa zaka zisanu ndi zisanu (10) kuchokera pakapita koyambirira ka khansa ya m'mawere, choncho ndikofunika kulingalira za phindu loletsa kubwereza, zotsatira za mbali ya mankhwala, komanso mtengo.
Ngati muli ndi zotsatira zoyipa ndizofunika kusankha ngati kusintha kungakhale kothandiza. Zikuoneka kuti anthu ambiri amasiya mankhwalawa ndipo amalephera kupeza phindu lomwe amapereka. Ndalama zingakhalenso zodzitetezera, koma zosankha zingapo zanenedwa pamwambapa.
Monga chitsimikiziro chomaliza, zina mwa zowawa kwambiri zotsatira za mankhwala a hormonal ndizo zizindikiro za menopausal. Komabe kutentha kwakukulu kumayenderana ndi kupulumutsidwa kwa khansa ya m'mawere . Chinthu chimodzi chokha cha siliva.
> Zosowa
> National Cancer Institute. Matenda a khansa ya m'mawere (PDQ) -Health Professional Version.
> Tjan-Hejinen, V., Hellemond, I., Peer, P. et al. Kuchulukitsidwa kwa Adjuvant Aromatase Kudzitsitsa Pambuyo Pogwiritsa Ntchito Matenda a Endocrine Opatsirana (DATA): Zomwe Zidzakhala Zosintha, Gawo 3. Lancet Oncology . 2017. 18 (11): 1502-1511.