Ngati muli ndi mbiri ya banja la khansara, mwinamwake mwamva za mawu akuti "zisanachitike." Ngati muli ndi chibadwa cha khansa ndipo simunamvepo mawuwa, mungapeze kuti kumathandiza kufotokozera zovuta kufotokozera, ndi kupeza chithandizo.
Tiyeni tiwone tsatanetsatane wa zowonongeka, njira zomwe angapeze zomwe zilipo, zapadera komanso mantha omwe angaperekane ndi zomwe apeza, ndi thandizo liti lomwe liripo.
Tanthauzo
Mawu akuti "zotsitsimutsa" amapangidwa ndi bungwe la CHIKHALIDWE ndipo limatanthawuzira kukhala ndi chiwerengero cha khansa. Ndi khansa zina, pali njira zothandizira zomwe zingatengedwe kuti zisawonongeke, koma mosiyana ndi omwe apezeka ndi khansa, mulibe zochepa za momwe mungayambire. Kodi mukuyenera kudziwa chiyani kuti mukhale ndi mphamvu zowonongeka kapena kuti mudziwe ngati ndinu wotsutsa?
Ndi khansa zina, pali mayeso oyeza omwe angathandize pakudziwa koyambirira. Kwa ena, pakhoza kukhala opaleshoni kapena mankhwala omwe angachepetse chiopsezo kuti mudzakhala ndi khansa poyamba.
Mwachitsanzo, ngati wina ali ndi kusintha kwa majeremusi a BRCA1 omwe ali ndi chiopsezo chachikulu chokhala ndi khansara ya m'mawere kapena ovari, mukhoza kuyamba kuyang'ana mofulumira ndi mafinya kapena mawere a MRIs . Anthu omwe ali pachiopsezo cha khansa ya coloni cholowa angayambe kuwonedwa poyang'anitsitsa ali wamng'ono. Njira zowonongeka zingakhaleponso, monga momwe Angelina Jolie anasankhira ndi zovuta zake .
Zifukwa Zina Zimakhala Zosasintha
Pali zifukwa zingapo zomwe munthu angaganizire kuti ndiwe woyenera. Zikuphatikizapo:
- Anthu omwe ali ndi chidziwitso cha kusintha kwa chibadwa chomwe chimayambitsa matenda a khansa, monga kusintha kwa BRCA1 ndi BRCA2.
- Amene ali ndi mbiri yolimba ya banja la khansara. Ambiri ammudzi ndi mtundu umodzi wa khansara kapena anthu omwe ali ndi khansa yowonjezera (monga khansa ya m'mawere m'magulu ena ndi pancreatic inanso) ndi ofunika kwambiri kuposa ena.
- Kukhala ndi chiopsezo cha khansa yomwe imabweretsa chiopsezo chanu, mwachitsanzo, kukhala ndi mbiri ya matenda opweteka a m'magazi omwe angabweretse vuto lanu la khansa.
Kupeza Ngati Ndiwe Mmodzi
Anthu ambiri omwe ali "opulumuka" mwina sakudziwa kuti mawuwo akugwirizana. Kuyesedwa kwa majeremusi kwa khansa ndizochitika posachedwa, ndipo kuzindikira kwathu za chiopsezo cha khansa kulikulirakulira tsiku ndi tsiku. Ndikofunika kuti aliyense adziwe mbiri ya banja lawo komanso dongosolo la chibadwa komanso kuti aphunzire za khansara yokhala ndi choloŵa chawo komanso kuyesedwa kwa majeremusi ngati kuli kotheka.
Popeza kumvetsa kwa khansa ya cholowa kumayambira, pali zambiri zambiri zolakwika kunja komweko. Palibe njira yosavuta ya magazi yomwe ingakuuzeni zomwe zingakulepheretseni kukhazikitsa, komanso kuti zikhale zovuta zowonjezera.
Kumvetsetsa kwakukulu kwa ziwerengero n'kofunikanso pamene mukuwerenga za kuopsa kwa majini kuti muteteze mantha osafunikira. Mwachitsanzo, mungamve kuti kukhala ndi jini wambiri kumapangitsa kuti mukhale ndi khansa. Ziwerengero ngati izi zikhoza kusocheretsa. Ngati akunena za khansa monga khansa ya m'mawere, khansara yomwe imapezeka mwa amayi asanu ndi atatu (8), izi ndizofunika kupeza. Kukhala ndi chiopsezo kawiri kukhoza kukupatsani vuto limodzi mwa magawo anai omwe angapangitse matendawa.
Mosiyana ndi zimenezi, ngati khansara yosawerengeka imapezeka m'modzi mwa anthu 100,000, kumva kuti muli ndi chiopsezo kawiri. Komabe, izi zikanangotanthauza kuti chiopsezo chanu tsopano ndi 1 mwa 50,000.
Ngati mwakhala mukukayikira kufunsa achibale anu zomwe zikuchitika m'banja lanu, simuli nokha. Zingakhale zokhumudwitsa kukambirana kuyambitsa. Mutha kuwona malingaliro a momwe mungakhalire ndi chibwenzi cha mbiri ya banja la khansa.
Mavuto
Tidzatha kuchita zina mwazochita zothandizira ngati mukuchita zinthu zowonongeka, kulingalira za njira za kulera, komanso momwe mungagonjetsere malingaliro, koma ndi kofunika kuti muyambe kuyankhula za chifukwa chake kusungulumwa kungakhale kovuta.
Ndipotu, anthu ena angapange ndemanga zabwino koma zovulaza, monga "mwina mulibe khansa!"
Amene ali ndi odwala matenda a khansa sangathe kuzindikira mavuto omwe angakhalepo chifukwa chotsutsa, monga momwe tawonera mu ndemanga yotsirizayi. Mungaganize kuti opulumuka ayenera kupeza chithandizo chothandiza kuchokera kwa omwe adapezeka kale, koma izi sizili choncho nthawi zonse. N'zomvetsa chisoni kuti, popeza pali ochepa chithandizo kwa opulumuka kusiyana ndi opulumuka. Monga chokonzekera, mukhoza kumva kuti muli nokha komanso muli nokha.
Kukhala wokonzeka nthawi zonse ndikumangokhalira kudandaula, ndipo mwa njira zina, nkhawa imeneyi ingakhale yoipitsitsa kuposa ya opulumuka. Chifukwa chiyani? Ngati mwapezeka ndi khansa mungathe kupanga dongosolo la mankhwala. Inu mukhoza kuchita chinachake. M'malo mwake, ngati zowonongeka, anthu amakumana ndi mantha a zosadziwika komanso osadziwika za tsogolo.
Kusiyananso kwina ndiko kukonza mankhwala. Malangizo alipo kwa ambiri khansa, ndipo ambiri oncologists amadziwika ndi izi. Kodi muyenera kuchita chiyani kuti muthe kuchepetsa chiopsezo chanu kapena kuthandizira kuti muwone khansa? Sizimveka nthawi zonse. Njira yamakono yogwiritsira ntchito chilengedwe (makamaka kuyesedwa kwa majeremusi) imakhala kutali kwambiri ndi kuzindikira kuti pangakhale cholengedwa. Chimodzimodzinso ndi chithandizo koma chimakhudzidwa kwambiri. Ganizilani za vutoli lachiwiri mwachinyamata , mkazi wopanda khansa.
Mu kafukufuku wina akuyang'ana uphungu wokhuza kubereka kwa opulumuka, anapeza kuti osachepera theka la akatswiri azaumoyo omwe anafunsidwa anali odziwika ndi otsogolera. Ndipo, mwa iwo omwe anali ozoloŵera, ambiri amanena kuti chidziwitso chawo chinali chochepa kapena chokhazikika.
Khansa Yopanda Ukhondo Pamodzi ndi Kusinthika Kwambiri kwa Gene
Kuti tifotokoze zina mwazovuta pakuzindikira khansa ya m'mawere, ndizothandiza kulankhula za tanthauzo la khansa ya m'mawere. Mwinamwake mwamva za kusintha kwa BRCA zamoyo, koma nkhaniyi ndi 20 mpaka 25 peresenti ya khansa ya m'mawere. Zosintha za BRCA zimaganiziridwa kuti ndizochitika pa 5 mpaka 10 peresenti ya khansa ya m'mawere.
Pali mitundu yoposa 72 yosinthika kwa majini yomwe imayanjanitsidwa ndi khansara ya m'mawere , ena mwa iwo ali ndi chiopsezo chachikulu ndipo ena mwa iwo ali pangozi yaikulu. Pamwamba pa izi, mwinamwake pali angapo omwe sitinapezepo. Kuyesera kulipo kwa kusintha kwa BRCA, komanso ena ena, koma nthawi zambiri amai omwe ali ndi khansa ya m'mawere sakudziwa kuti ali ndi chiopsezo. Ichi ndi chifukwa chake n'kofunika kulingalira mbiri ya banja komanso osayang'ana kuyesa kwa majini okha. Ndipotu, madokotala ena amakhulupilira kuti aliyense yemwe ali ndi mayeso oyezetsa magazi ayenera kuyembekezera kuti azisintha. Wothandizira zamoyo angaone kuti pangakhale chiopsezo poyang'ana mbiri yakale ya banja lanu ngakhale mayesero anu ali oyenera.
Kusamalira Zowopsa Zanu
Kusamalira chiwerengero chanu cha khansa kumadalira pazifukwa zingapo, kuphatikizapo mtundu wa khansa, chiopsezo chachikulu kuti mutha kukhala ndi khansa, zaka zanu, ndi zina zambiri. Munthu aliyense ndi wosiyana, ndipo njirayo imatha kusiyana kwa anthu omwe adziwonekera malinga ndi kumene ali. Ngati mukufuna kukhala ndi banja, kukhala ndi mazira ochotsamo sikungakhale njira yabwino, koma ngati mwathetsa banja lanu ndikukhala ndi kusintha kwa BRCA.
Tiyeni tiwone zitsanzo za kufufuza (kuthandiza pakudziwika koyambirira) ndi mankhwala (kuchepetsa chiopsezo) zomwe zingaganizidwe.
Zitsanzo za njira zamankhwala ndizo:
- Zovuta zokhudzana ndi kusintha kwa majini ndi chikhalidwe chachikulu cha khansa ya m'mawere (BRCA1 kapena BRCA2).
- Kuchotsa mazira ndi mazira omwe amapezeka ndi amayi omwe ali ndi kusintha kwa BRCA.
Zosankha zojambula ndizo zokhazo zowonjezera khansa. Mwachitsanzo, ngati wina ali ndi chibadwa cha khansa yamapapu, sangathe kupempha kuchotsa mapapu awiri. Pachifukwa ichi, oyambirira, kapena kuyang'ana mobwerezabwereza angaganizidwe. Zitsanzo zikuphatikizapo:
- Kuwonetsa koyambirira ndi / kapena MRIs pa khansa ya m'mawere.
- Mayeso a GYN ndi ovarian ultrasounds kuti azindikire khansa ya ovari.
- Colonoscopy kuwonetsa kansalu yamtundu wa khansa (ndi matenda ena obadwa nawo monga Lynch syndrome izi zikhoza kuyambika kumapeto kwa ubwana).
- PSA ndi mayeso ena kwa amuna omwe ali ndi kusintha kwa BRCA. (Pokhala ndi BRCA kusintha kwa amuna sikutheka kukhala ndi kansa ya prostate koma ikhoza kukhala ndi khansa ya prostate yowopsya. Kusunga kwa zaka zisanu kwa amuna omwe ali ndi khansara ya prostate tsopano ndi 99 peresenti, pamene zaka zisanu zapakati pa moyo wa amuna omwe ali ndi khansa kusintha kwa BRCA ndi 50 peresenti).
- Kuyezetsa magazi nthawi zonse ndi mbiri ya banja la khansa ya khansa.
Kulimbana ndi Maganizo
Ngati mwaphunzira kuti ndinu wotsutsa, mwinamwake mukukumana ndi nkhawa komanso kukhumudwa. Kudera nkhaŵa chifukwa cha kusatsimikizika ndi kukhumudwitsidwa chifukwa malangizo, ngati alipo, sakudziwika.
Panthawi imodzimodziyo, mukhoza kapena samva chifundo chomwe mukuyenera. Ndemanga yomwe yatchulidwa pamwambayi, "osakhala ndi khansa," imayankhulidwa nthawi zambiri. Zomwe taphunzira ndi opulumutsidwa ndi khansa ndikuti kuya kwakukulu kwakumverera kumakhala kofanana ngati munthu atapezeka kuti ali ndi khansa yowonongeka kwambiri, kapena atapezeka kuti ali ndi kansa yapamwamba kapena yotsiriza.
Ngati mwauzidwa kuti muli ndi vuto linalake, ndizoopsa, ndipo mukusowa thandizo limene mungalandire ngati muli ndi khansa, ndipo mwinamwake. Kukhala ndi matenda otsimikizirika, ngakhale oipa, nthawi zina kumakhala kosavuta kusiyana ndi kukumana ndi zosadziwika.
Kupeza Thandizo
Kupeza chithandizo n'kofunika ngati muli ndi zotsutsa. Timamva zambiri zokhudza thandizo lofunika kwambiri kwa omwe adapezeka kuti ali ndi khansa. Thandizo likugwirizananso ndi kupulumutsidwa mu maphunziro angapo! Omwe akugwiridwa ndi magulu othandizira khansa nthawi zambiri amasonyeza momwe kugwirizana kumeneku kulili kofunika ngakhale ngati ali ndi banja komanso abwenzi. Kumatsimikizira kulankhula ndi munthu yemwe "amapeza" komanso kumvetsa zomwe mukukumana nazo.
N'chimodzimodzinso ndi opulumuka, amene angadzimve kuti ndi osiyana ndi onse omwe alibe chikhalidwe ndi omwe ali ndi khansa. Mipingo monga FORCE (Kuyang'anizana ndi Nthenda Yathu ya Kansa Yopatsidwa Mphamvu) ili kunja uko. Magulu a Facebook akuwuluka, ndipo pali anthu ogwira ntchito pazinthu zina zamagulu. Ngati mukufuna kuyang'ana pa chithandizo cha chitukuko, ishtag ndi #previvor.
Malangizo
Malangizo ochepa owonetsera opulumuka ali, ngakhale aliyense ali wosiyana.
- Phunzirani za kuikidwa kwanu. Izi ndizochitika chimodzi chomwe chidziwitso chiri mphamvu.
- Landirani kuti si onse amene amamvetsa mantha ndi kusatsimikizika komwe kumapita ndi kukhala ndi chiwerengero cha khansa.
- Pezani dokotala yemwe amamvetsa ma genetic khansa ndipo ali ndi chidwi ndi chidziwitso chochepetsera chiopsezo ndi kuzindikira koyambirira.
- Khalani ndi woimira pakati pa abwenzi anu ndi abwenzi omwe angakuyimirereni ngati mukutsutsidwa chifukwa cha njira iliyonse yomwe mumatenga.
- Yesetsani njira zoyendetsera zokambirana zomwe anthu akukuuzani zomwe muyenera kuchita. Ngati mukulankhula poyera za kukhala choyambitsirana mungakhale ndi abwenzi abwino omwe amalimbikitsa chilichonse kuchokera ku chakudya cha karoti kokha mpaka kufupi ndi Amazon. Kumbukirani kuti kawirikawiri anthu amakhala ndi uphungu wambiri komanso malingaliro okhudza momwe angayendetsere khansa kapena kusinthidwa, koma kusintha maganizo awo ngati atapezeka.
- Pezani chithandizo.
Mawu Ochokera
Ngati mwaphunzira kuti muli ndi chiwerengero cha khansa, mukhoza kumangodandaula. Zangokhala zaka zaposachedwa kuti takhala ndi mayeso obadwa ndi mavitamini omwe alipo kapena omwe amadziwika ndi zina zomwe zakhala zikuchitika. Izi zingakulepheretseni.
Kuphunzira zambiri momwe mungathere ndi kuika zoopsa pazochitika ndizothandiza kwambiri. Kupeza akatswiri a zaumoyo omwe ali ndi chidwi ndi cholimbikitsidwa kukuthandizani ndizofunikira, koma kupeza thandizo la ena mofananamo ndikumana ndi zowonongeka ndi zopanda phindu.
> Zotsatira:
> Gietel-Habets, J., de Die-Smulders, C., Tjan-Heiginen, V. et al. Chidziwitso cha anthu ogwira ntchito, Mkhalidwe ndi Maulendo Omwe Amagwira Ntchito Poyambitsa Matenda a Kachilombo ka Pretlantation kwa Hereditary Cancer and Cancer Cancer. Bizinesi yowonjezera pa Intaneti . 2018. 36 (2): 137-144.
> Leonarczyk, T., ndi B. Mawn. Kusankha Kowopsa kwa Khansa Kupanga BRCA + Akazi. West Journal ya Research Nursing . 2015. 37 (1): 66-84.
> Robson, M., Bradbury, A., Arun, B. ndi al. American Society of Clinical Oncology Ndondomeko Yowonjezeretsa: Genetic ndi Genomic Kuyeza kwa Khansa Kulingalira. Journal of Clinical Oncology . 33 (31): 3660-3667.