Ukwelashwa kweHormone komdlavuza wendlala yabesilisa

Ukwelashwa kwehormone komdlavuza wendlala yesinye kusebenzisa ukuhlinza noma izidakamizwa ukwehlisa amazinga ama-hormone abesilisa besilisa emzimbeni womuntu. Lokhu kusiza ukunciphisa ukukhula komdlavuza wendlala yabesilisa.

I-Androgens ngama-hormone ocansi abesilisa. I-testosterone uhlobo olulodwa oluyinhloko lwe-androgen. Iningi le-testosterone lenziwa amasende. Izindlala ze-adrenal nazo zikhiqiza inani elincane.

Ama-Androgens enza ukuthi amangqamuzana omdlavuza wendlala yesinye akhule. Ukwelashwa kweHormone komdlavuza wendlala yesinye kunciphisa izinga lomphumela wama-androgens emzimbeni. Ingakwenza lokhu ngo:

• Ukuvimba amasende ekwenzeni i-androgens kusetshenziswa ukuhlinza noma imithi
• Ukuvimba isenzo se-androgens emzimbeni
• Ukuvimba umzimba ekwenzeni ama-androgens

Ukwelashwa kweHormone cishe akukaze kusetshenziselwe abantu abanesifo somdlavuza wendlala yesigaba I noma iSigaba II.

Isetshenziselwa ikakhulukazi:

• Umdlavuza othuthukile osabalale wadlula indlala yesinye
• Umdlavuza ohlulekile ukuphendula ekuhlinzweni noma emisebeni
• Umdlavuza obuye wabuya

Ingasetshenziswa futhi:

• Ngaphambi kwemisebe noma ukuhlinzwa ukusiza ukunciphisa izicubu
• Kanye nokwelashwa ngemisebe komdlavuza okungenzeka kuphindeke

Ukwelashwa okuvame kakhulu ukuthatha imishanguzo eyehlisa inani lama-androgens enziwa amasende. Babizwa ngama-luteinizing hormone-releasing hormone (LH-RH) ama-analogs (imijovo) nama-anti-androgens (amaphilisi omlomo). Le mithi yehlisa amazinga e-androgen kanye nokuhlinzwa. Lolu hlobo lokwelashwa kwesinye isikhathi lubizwa nge- "castration chemical."

Amadoda athola ukwelashwa kokuncishwa kwe-androgen kufanele abe nezivivinyo zokulandelela nodokotela onquma izidakamizwa:

• Kungakapheli izinyanga ezintathu kuya kwezingu-6 ngemuva kokuqala ukwelashwa
• Okungenani kanye ngonyaka, ukuqapha umfutho wegazi nokwenza ushukela wegazi (i-glucose) nokuhlolwa kwe-cholesterol
• Ukuthola ukuhlolwa kwegazi kwe-PSA ukuqapha ukuthi umuthi usebenza kahle kangakanani

Ama-analogs e-LH-RH anikezwa njengesiqhumane noma njengokufakwa okuncane ngaphansi kwesikhumba. Banikezwa noma yikuphi kusuka kanye ngenyanga kuya kanye ngonyaka. Le mithi ihlanganisa:

• I-Leuprolide (Lupron, Eligard)
• I-Goserelin (Zoladex)
• I-Triptorelin (Trelstar)
• I-Histrelin (Vantas)

Omunye umuthi, i-degarelix (Firmagon), umphikisi we-LH-RH. Iyanciphisa amazinga e-androgen ngokushesha okukhulu futhi inemiphumela engemihle embalwa. Isetshenziswa emadodeni anomdlavuza osezingeni eliphezulu.

Abanye odokotela batusa ukumisa nokuqala kabusha ukwelashwa (ukwelashwa okufika ngezikhathi ezithile). Le ndlela ibonakala isiza ukunciphisa imiphumela emibi yokwelashwa kwe-hormone. Kodwa-ke, akucaci ukuthi ukwelashwa okwenzeka ngezikhathi ezithile kuyasebenza yini kanye nokwelashwa okuqhubekayo. Olunye ucwaningo lukhombisa ukuthi ukwelashwa okuqhubekayo kuyasebenza kakhulu noma ukuthi ukwelashwa okufika ngezikhathi ezithile kufanele kusetshenziselwe kuphela izinhlobo ezikhethiwe zomdlavuza wesinye.

Ukuhlinzwa ukususa amasende (ukuthena) kumisa ukukhiqizwa kwama-androgens amaningi emzimbeni. Lokhu kubuye kunciphise noma kumise umdlavuza wendlala yabesilisa ongakhuli. Ngenkathi isebenza ngempumelelo, iningi lamadoda alikhethi le nketho.

Eminye imishanguzo esebenza ngokuvimba umphumela we-androgen kumaseli womdlavuza wesinye. Babizwa ngama-anti-androgens. Le mithi ithathwa njengamaphilisi. Zivame ukusetshenziswa lapho imithi yokwehlisa amazinga e-androgen ingasasebenzi futhi.

Ama-anti-androgens afaka:

• I-Flutamide (Eulexin)
• I-Enzalutamide (Xtandi)
• I-Abiraterone (Zytiga)
• I-Bicalutamide (Casodex)
• I-Nilutamide (Nilandron)

Ama-Androgens angakhiqizwa kwezinye izindawo zomzimba, njengezindlala ze-adrenal. Amanye amangqamuzana omdlavuza wendlala yesinye nawo angenza i-androgens. Izidakamizwa ezintathu zisiza ukumisa umzimba ekwenzeni ama-androgens avela kwizicubu ngaphandle kwamasende.

Imithi emibili, i-ketoconazole (Nizoral) ne-aminoglutethimide (i-Cytradren), yelapha ezinye izifo kepha kwesinye isikhathi isetshenziselwa ukwelapha umdlavuza wendlala yabesilisa. Owesithathu, u-abiraterone (Zytiga) welapha umdlavuza wendlala yesibeletho osekusakazeke kwezinye izindawo emzimbeni.

Ngokuhamba kwesikhathi, umdlavuza wendlala yesinye usumelana nokwelashwa kwamahomoni. Lokhu kusho ukuthi umdlavuza udinga kuphela amazinga aphansi e-androgen ukuze akhule. Uma lokhu kwenzeka, kungezwa ezinye izidakamizwa noma ezinye izindlela zokwelapha.

I-Androgens inemiphumela kuwo wonke umzimba. Ngakho-ke, izindlela zokwelapha ezehlisa la mahomoni zingadala imiphumela emibi eminingi ehlukene. Uma uthatha isikhathi eside le mithi, maningi amathuba okuthi ube nemiphumela engemihle.

Kubandakanya:

• Unenkinga yokuthola ukwakhiwa futhi ungabi nentshisekelo kwezocansi
• Kushwabana amasende nomthondo
• Ukushisa okushisayo
• Amathambo abuthakathaka noma aphukile
• Imisipha emincane, ebuthakathaka
• Izinguquko emafutheni egazi, njenge-cholesterol
• Izinguquko kushukela wegazi
• Ukuzuza kwesisindo
• Ukushintsha kwemizwelo
• Ukukhathala
• Ukukhula kwezicubu zamabele, isisa sesifuba

Ukwelashwa kokuncishwa kwe-Androgen kungakhuphula ubungozi besifo sikashukela nesenhliziyo.

Ukuthatha isinqumo ngokwelashwa kwamahomoni komdlavuza wendlala kungaba yisinqumo esiyinkimbinkimbi futhi esinzima. Uhlobo lwezokwelapha lungancika ku:

• Ingozi yakho yokuba nomdlavuza ibuye
• Umdlavuza wakho usuthuthuke kangakanani
• Ukuthi ezinye izindlela zokwelapha ziyekile yini ukusebenza
• Ukuthi umdlavuza usakazekile yini

Ukukhuluma nomhlinzeki wakho ngezinketho zakho kanye nezinzuzo nezingozi zokwelashwa ngakunye kungakusiza wenze isinqumo esihle kakhulu kuwe.

Ukwelashwa kokuncishwa kwe-Androgen; ADT; Ukwelashwa kokucindezela i-Androgen; I-androgen blockade ehlanganisiwe; I-Orchiectomy - umdlavuza wendlala yesinye; Castration - umdlavuza wendlala yesinye

• I-anatomy yokuzala yowesilisa

Iwebhusayithi yeAmerican Cancer Society. Ukwelashwa kweHormone komdlavuza wendlala yabesilisa. www.cancer.org/cancer/prostate-cancer/treating/hormone-therapy.html. Kubuyekezwe uDisemba 18, 2019. Kufinyelelwe ngoMashi 24, 2020.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa kweHormone komdlavuza wendlala yabesilisa. www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet. Kubuyekezwe uFebhuwari 28, 2019. Kufinyelelwe kuDisemba 17, 2019.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa komdlavuza we-Prostate (PDQ) - inguqulo yezempilo. www.cancer.gov/types/prostate/hp/prostate-treatment-pdq. Kubuyekezwe ngoJanuwari 29, 2020. Kufinyelelwe ngoMashi 24, 2020.

Iwebhusayithi ye-National Comprehensive Cancer Network. Imikhombandlela ye-NCCN yokwenza imitholampilo ku-oncology (imihlahlandlela ye-NCCN): umdlavuza wendlala yabesilisa. Inguqulo 1.2020. www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Kubuyekezwe ngoMashi 16, 2020. Kufinyelelwe ngoMashi 24, 2020.

Ukwelashwa kwe-Eggener S. Hormonal yomdlavuza wendlala yesinye. Ku: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, ama-eds. ICampbell-Walsh Urology. Umhla ka-12. IPhiladelphia, PA: Elsevier; 2021: isahluko 161.

• Umdlavuza Wendlala Yesinye