Ukwelashwa kweHormone ngomdlavuza webele

Ukwelashwa kweHormone ukwelapha umdlavuza webele kusebenzisa izidakamizwa noma izindlela zokwelapha ukwehlisa amazinga noma ukuvimba isenzo samahomoni ocansi abesifazane (i-estrogen ne-progesterone) emzimbeni wowesifazane. Lokhu kusiza ukunciphisa ukukhula komdlavuza webele amaningi.

Ukwelashwa kweHormone kwenza umdlavuza ungabuyi emuva kokuhlinzwa komdlavuza webele. Kubambezela nokukhula komdlavuza webele osudlulele nakwezinye izingxenye zomzimba.

Ukwelashwa kweHormone kungasetshenziswa futhi ukusiza ukuvimbela umdlavuza kubantu besifazane abasengozini enkulu yomdlavuza webele.

Kuhlukile ekwelashweni ngehomoni ukwelapha izimpawu zokunqamuka kokuya esikhathini.

Ama-hormone estrogen ne-progesterone enza amanye umdlavuza webele ukhule. Babizwa ngokuthi umdlavuza webele ozwela i-hormone. Iningi lomdlavuza webele liyazwela kuma-hormone.

I-Estrogen ne-progesterone zikhiqizwa kuma-ovari nakwezinye izicubu ezinjengamafutha nesikhumba. Ngemuva kokunqamuka kokuya esikhathini, ama-ovari ayayeka ukukhiqiza la mahomoni. Kodwa umzimba uyaqhubeka nokwenza inani elincane.

Ukwelashwa kweHormone kusebenza kuphela kumdlavuza ozwela ama-hormone. Ukubona ukuthi ukwelashwa kwama-hormone kungasebenza yini, odokotela bahlola isampula lesimila esisusiwe ngesikhathi sokuhlinzwa ukuze babone ukuthi umdlavuza kungenzeka uzwele yini kuma-hormone.

Ukwelashwa kweHormone kungasebenza ngezindlela ezimbili:

• Ngokuvimbela i-estrogen ekusebenzeni kumaseli womdlavuza
• Ngokunciphisa amazinga e-estrogen emzimbeni wowesifazane

Ezinye izidakamizwa zisebenza ngokuvimba i-estrogen ekudaleni ukuthi amangqamuzana omdlavuza akhule.

I-Tamoxifen (i-Nolvadex) yisidakamizwa esivimbela i-estrogen ekutsheleni amangqamuzana omdlavuza ukuthi akhule. Inezinzuzo eziningi:

• Ukuthatha iTamoxifen iminyaka emihlanu ngemuva kokuhlinzwa komdlavuza webele kunciphisa ithuba lomdlavuza ukubuya ngesigamu. Olunye ucwaningo lukhombisa ukuthi ukuyithatha iminyaka eyishumi kungasebenza kangcono kakhulu.
• Kunciphisa ubungozi bokuthi umdlavuza uzokhula kwelinye ibele.
• Kubambezela ukukhula futhi kunciphisa umdlavuza osusakazekile.
• Kunciphisa ubungozi bokuthola umdlavuza kubantu besifazane abasengozini enkulu.

Eminye imishanguzo esebenza ngendlela efanayo isetshenziselwa ukwelapha umdlavuza osezingeni eliphezulu osakazekile:

• I-Toremifene (Fareston)
• I-Fulvestrant (Faslodex)

Eminye imithi, ebizwa nge-aromatase inhibitors (AI), imisa umzimba ekwenzeni i-estrogen ezicutshini ezinjengamafutha nesikhumba. Kepha, le mithi ayisebenzi ukwenza ama-ovari ayeke ukwenza i-estrogen. Ngalesi sizathu, zisetshenziswa ikakhulu ukwehlisa amazinga e-estrogen kwabesifazane abedlule esikhathini sokuya esikhathini (postmenopausal). Amaqanda abo awasenzi i-estrogen.

Abesifazane be-premenopausal bangathatha ama-AI uma futhi bedla imishanguzo evimba ama-ovari abo ekwenzeni i-estrogen.

Ama-aromatase inhibitors afaka:

• I-Anastrozole (Arimidex)
• I-Letrozole (Femara)
• I-Exemestane (Aromasin)

Lolu hlobo lwezokwelapha lusebenza kuphela kwabesifazane be-premenopausal abanama-ovari asebenzayo. Kungasiza ezinye izinhlobo zokwelashwa kwamahomoni ukuthi zisebenze kangcono. Iphinde isetshenziselwe ukwelapha umdlavuza osusabalele.

Kunezindlela ezintathu zokwehlisa amazinga e-estrogen kuma-ovari:

• Ukuhlinzwa ukususa ama-ovari
• Imisebe yokulimaza ama-ovari ukuze ingasasebenzi, ehlala unomphela
• Izidakamizwa ezifana ne-goserelin (i-Zoladex) ne-leuprolide (i-Lupron) evimba okwesikhashana ama-ovari ekwenzeni i-estrogen

Noma iyiphi yalezi zindlela izofaka owesifazane esikhathini sokuya esikhathini. Lokhu kubangela izimpawu zokunqamuka kokuya esikhathini:

• Ukushisa okushisayo
• Ukujuluka ebusuku
• Ukoma kwesitho sangasese sowesifazane
• Ukushintsha kwemizwelo
• Ukucindezeleka
• Ukuphelelwa yintshisekelo kwezocansi

Imiphumela emibi yokwelashwa kwe-hormone incike kumuthi. Imiphumela emibi ejwayelekile ifaka phakathi ukukhanya okushisayo, ukujuluka ebusuku nokoma kwesitho sangasese sowesifazane.

Eminye imishanguzo ingadala imiphumela emibi ejwayelekile kepha emibi kakhulu, njenge:

• I-Tamoxifen. Amahlule egazi, ukushaywa unhlangothi, uketshezi lwamehlo, umdlavuza we-endometrial nowesibeletho, ukushintshashintsha kwemizwelo, ukudangala, nokuphelelwa wuthando kwezocansi.
• I-Aromatase inhibitors. I-cholesterol ephezulu, isifo senhliziyo, ukulahleka kwethambo, ubuhlungu bamalunga, ukushintsha kwemizwelo nokudangala.
• I-Fulvestrant. Ukuphelelwa isifiso sokudla, isicanucanu, ukuhlanza, ukuqunjelwa, isifo sohudo, ubuhlungu besisu, ukuba buthakathaka nobuhlungu.

Ukuthatha isinqumo ngokwelashwa kwamahomoni ngomdlavuza webele kungaba yisinqumo esiyinkimbinkimbi futhi esinzima. Uhlobo lokwelashwa olutholayo lungaxhomeka ekutheni usudlulile esikhathini sokuya esikhathini ngaphambi kokwelashwa komdlavuza webele. Futhi kungaxhomeka ekutheni uyafuna yini ukuba nezingane. Ukukhuluma nomhlinzeki wakho wezokunakekelwa kwempilo mayelana nezinketho zakho kanye nezinzuzo nezingozi zokwelashwa ngakunye kungakusiza wenze isinqumo esihle kakhulu kuwe.

Ukwelashwa kwamahomoni - umdlavuza webele; Ukwelashwa kweHormone - umdlavuza webele; Ukwelashwa kwe-endocrine; Umdlavuza ozwela i-hormone - ukwelashwa; Ukwelashwa okuhle kwe-ER; I-Aromatase inhibitors - umdlavuza webele

Iwebhusayithi yeAmerican Cancer Society. Ukwelashwa kweHormone ngomdlavuza webele. www.cancer.org/cancer/breast-cancer/treatment/hormone-therapy-for-breast-cancer.html. Kubuyekezwe ngo-Septhemba 18, 2019. Kufinyelelwe ngoNovemba 11, 2019.

UHenry NL, Shah PD, Haider I, Freer PE, Jagsi R, Sabel MS. Umdlavuza webele. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 88.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa kweHormone ngomdlavuza webele. www.cancer.gov/types/breast/breast-hormone-therapy-fact-sheet. Kubuyekezwe ngoFebhuwari 14, 2017. Kufinyelelwe ngoNovemba 11, 2019.

URugo HS, Rumble RB, Macrae E, et al. Ukwelashwa kwe-Endocrine yomdlavuza webele we-hormone receptor-positive metastatic breast: American Society of Clinical Oncology Guideline. J Clin Oncol. 2016; 34 (25): 3069-3103. I-PMID: 27217461 www.ncbi.nlm.nih.gov/pubmed/27217461.

• Umdlavuza Webele