Ingabe Ukuhlolwa Kofuzo Kubamba Kanjani Indima Ekwelapheni Umdlavuza Webele We-Metastatic?

-Delile

• Kuyini ukuhlolwa kofuzo?
• Izinhlobo zokuhlolwa kofuzo komdlavuza webele we-metastatic
• Ukuhlolwa kofuzo lwe-BRCA
• Ukuhlolwa kofuzo kwe-HER2
• Ngabe ngidinga ukuhlolwa kofuzo uma nginomdlavuza webele we-metastatic?
• Kwenziwa kanjani lokhu kuhlolwa?
• Ingabe kufanele ngiye kumeluleki wezofuzo?
• Ukudla okudlela endlini

Umdlavuza webele we-Metastatic ngumdlavuza osabalale ngaphandle kwebele lakho kwezinye izitho ezifana nephaphu, ubuchopho noma isibindi. Udokotela wakho angabhekisa kulo mdlavuza njengesigaba 4, noma umdlavuza webele osezingeni eliphezulu.

Ithimba lakho lezokunakekelwa kwempilo lizokwenza izivivinyo eziningi ukuthola ukuthi unomdlavuza webele yini, ubone ukuthi selisabalale kangakanani, futhi lithole ukwelashwa okufanele. Ukuhlolwa kofuzo kuyingxenye eyodwa yenqubo yokuxilonga. Lezi zivivinyo zingatshela udokotela wakho ukuthi umdlavuza wakho uhlobene nokuguquka kwezakhi zofuzo nokuthi yiluphi ukwelashwa olungasebenza kahle kakhulu.

Akuwona wonke umuntu odinga ukuhlolwa kofuzo. Udokotela wakho kanye nomeluleki wezofuzo bazoncoma lezi zivivinyo ngokuya ngeminyaka yakho nobungozi bakho.

Kuyini ukuhlolwa kofuzo?

Izakhi zofuzo ziyizingxenye ze-DNA. Zihlala ngaphakathi kwe-nucleus yeseli ngalinye emzimbeni wakho. Izakhi zofuzo ziphethe imiyalo yokwenza amaprotheni alawula yonke imisebenzi yomzimba wakho.

Ukuba nezinguquko ezithile zofuzo, ezibizwa ngokuthi ukuguquka kwezakhi zofuzo, kungakhuphula amathuba okuthola umdlavuza webele. Ukuhlolwa kofuzo kubheka lezi zinguquko zofuzo ngazinye. Ukuhlolwa kweGene kubuye kuhlaziye ama-chromosomes - izingxenye ezinkulu ze-DNA - ukubheka ushintsho oluxhumene nomdlavuza webele.

Izinhlobo zokuhlolwa kofuzo komdlavuza webele we-metastatic

Udokotela wakho angalawula izivivinyo ukuthi azibheke I-BRCA1, I-BRCA2, futhi HER2 ukuguquka kwezakhi zofuzo. Okunye ukuhlolwa kofuzo kuyatholakala, kepha akusetshenziswa kaningi.

Ukuhlolwa kofuzo lwe-BRCA

I-BRCA1 futhi I-BRCA2 izakhi zofuzo zikhiqiza uhlobo lwamaprotheni aziwa ngokuthi ama-tumor suppressor protein. Lapho lezi zofuzo zivamile, zilungisa i-DNA eyonakele futhi zisiza ukuvimbela amangqamuzana omdlavuza ukuthi angakhuli.

Izinguquko ku I-BRCA1 futhi I-BRCA2 Izakhi zofuzo zibangela ukukhula kwamangqamuzana ngokweqile futhi zikhuphule ingozi yakho yomdlavuza webele nowama-ovari.

Ukuhlolwa kofuzo kwe-BRCA kungasiza udokotela wakho ukuthi afunde ingozi yakho yomdlavuza webele. Uma usuvele unomdlavuza webele, ukuhlolwa kwalokhu kuguqulwa kofuzo kungasiza udokotela wakho ukubikezela ukuthi izindlela ezithile zomdlavuza webele zizokusebenzela.

Ukuhlolwa kofuzo kwe-HER2

Amakhodi we-human epidermal factor factor receptor 2 (HER2) wokukhiqizwa kweprotheni yokwamukela i-HER2. Le protein iphansi kwamangqamuzana amabele. Lapho iphrotheni ye-HER2 ivuliwe, itshela amangqamuzana amabele ukuthi akhule futhi ahlukane.

Ukuguquka kwesimo ku- HER2 Ijini ibeka ama-HER2 receptors amaningi kumaseli webele. Lokhu kubangela ukuthi amangqamuzana amabele akhule ngokungalawuleki futhi akhe izicubu.

Umdlavuza webele ohlola ukuthi une-HER2 ubizwa ngokuthi yi-HER2-positive cancer cancer. Zikhula ngokushesha futhi maningi amathuba okusabalala komdlavuza webele we-HER2-negative.

Udokotela wakho uzosebenzisa olunye lwalezi zivivinyo ezimbili ukuhlola isimo sakho se-HER2:

• I-Immunohistochemistry (IHC) ihlola ukuthi unamaprotheni amaningi we-HER2 kumaseli akho omdlavuza. Ukuhlolwa kwe-IHC kunika umdlavuza amaphuzu angama-0 kuye kwangama-3 + kuye ngokuthi ungakanani u-HER2 onawo kumdlavuza wakho. Isikolo esingu-0 kuye ku-1 + siyi-HER2-negative. Amaphuzu angu-2 + angumngcele. Futhi amaphuzu we-3 + yi-HER2-positive.

• I-Fluorescence in situ hybridization (FISH) ibheka amakhophi angeziwe we HER2 isakhi sofuzo. Imiphumela nayo ibikwa njenge-HER2-positive noma i-HER2-negative.

Ngabe ngidinga ukuhlolwa kofuzo uma nginomdlavuza webele we-metastatic?

Uma utholwe unomdlavuza webele we-metastatic, kungahle kusize ukufunda ukuthi ngabe ukuguquka kwezakhi zofuzo kubange umdlavuza wakho. Ukuhlolwa kofuzo kungasiza ekuqondiseni ukwelashwa kwakho. Imithi ethile yomdlavuza isebenza kuphela noma iphumelela kakhulu emdlavuzeni webele ngokushintshwa kwezakhi zofuzo ezithile.

Isibonelo, izidakamizwa ze-PARP inhibitor olaparib (Lynparza) ne-talazoparib (Talzenna) zivunyelwe kuphela yi-FDA ukwelapha umdlavuza webele we-metastatic obangelwa I-BRCA ukuguquka kwezakhi zofuzo. Abantu abanalezi zinguquko bangaphinde baphendule kangcono kwi-chemotherapy drug carboplatin kune-docetaxel.

Isimo sakho sezakhi zofuzo singasiza futhi ekunqumeni ukuthi hlobo luni lokuhlinzwa olutholayo nokuthi ufanelekile yini ukujoyina izivivinyo ezithile zomtholampilo. Kungasiza futhi izingane zakho noma ezinye izihlobo eziseduze ukuthi zifunde ukuthi zingaba sengozini enkulu yomdlavuza webele futhi zidinga ukuhlolwa okwengeziwe.

Imihlahlandlela evela kuNational Comprehensive Cancer Network incoma ukuhlolwa kofuzo kubantu abanomdlavuza webele:

• batholakala beneminyaka engama-50 noma ngaphambi kwalokho
• unomdlavuza webele ongahlosiwe kathathu otholakale ngaphambi noma ngaphambi kweminyaka engama-60
• ube nesihlobo esiseduze nesifo somdlavuza webele, i-ovari, i-prostate, noma i-pancreatic
• unomdlavuza emabeleni womabili
• bangabokuzalwa kwamaJuda aseMpumalanga Yurophu (e-Ashkenazi)

Kodwa-ke, umhlahlandlela wango-2019 ovela kwiAmerican Society of Breast Surgeons uncoma ukuthi bonke abantu abatholakala benomdlavuza webele banikezwe ukuhlolwa kofuzo. Khuluma nodokotela wakho mayelana nokuthi kufanele yini uhlolwe.

Kwenziwa kanjani lokhu kuhlolwa?

Okwe I-BRCA ukuhlolwa kwezakhi zofuzo, udokotela wakho noma umhlengikazi uzothatha isampula yegazi lakho noma i-swab yamathe ngaphakathi kwesihlathi sakho. Isampula legazi noma lamathe bese liya elabhoratri, lapho ochwepheshe bayihlolela khona I-BRCA ukuguquka kwezakhi zofuzo.

Udokotela wakho uyakwenza HER2 Ukuhlolwa kwezakhi zofuzo kumaseli webele kususwe ngesikhathi se-biopsy. Kunezindlela ezintathu zokwenza i-biopsy:

• I-biopsy aspiration biopsy enhle isusa amaseli noketshezi ngenaliti ezacile.
• I-Core needle biopsy isusa isampula elincane lezicubu zesifuba ngenaliti enkulu, engenalutho.
• I-biopsy yokuhlinza yenza ukusika okuncane ebeleni ngesikhathi senqubo yokuhlinzwa futhi kususe ucezu lwethishu.

Wena nodokotela wakho nizothola ikhophi yemiphumela, eza ngombiko wombiko wezifo. Lo mbiko ufaka imininingwane ngohlobo, usayizi, ukuma, nokubukeka kwamangqamuzana akho omdlavuza, nokuthi kungenzeka akhule masinyane kangakanani. Imiphumela ingasiza ekuqondiseni ukwelashwa kwakho.

Ingabe kufanele ngiye kumeluleki wezofuzo?

Umeluleki wezofuzo unguchwepheshe ekuhlolweni kwezofuzo. Bangakusiza uthathe isinqumo sokuthi ngabe udinga ukuhlolwa kofuzo kanye nezinzuzo nobungozi bokuhlolwa.

Lapho nje imiphumela yakho yokuhlolwa ingenile, umeluleki wezofuzo angakusiza uqonde ukuthi zisho ukuthini, nokuthi yiziphi izinyathelo okufanele uzithathe ngokulandelayo. Bangasiza futhi ukwazisa izihlobo zakho eziseduze ngezingozi zomdlavuza.

Ukudla okudlela endlini

Uma utholwe unomdlavuza webele we-metastatic, khuluma nodokotela wakho mayelana nokuhlolwa kofuzo. Kungasiza ukukhuluma nomeluleki wezofuzo ukuze uqonde ukuthi ukuhlolwa kwakho kusho ukuthini.

Imiphumela yokuhlolwa kwakho kwezakhi zofuzo ingasiza udokotela wakho ukuthi akutholele ukwelashwa okufanele. Imiphumela yakho ingazisa namanye amalungu omndeni wakho ngengozi yawo kanye nesidingo sokuhlolwa komdlavuza webele owengeziwe.