Akwai hanyoyi masu mahimmanci da aka yi niyya don samuwa
A cikin 'yan shekarun da suka wuce, mun koyi cewa ba dukan nono ba daidai ne. Bugu da ƙari da bambancin da za a iya gani a ƙarƙashin microscope, akwai bambanci tsakanin waɗannan cututtuka akan matakin kwayoyin. Bayan ka sami biopsy ko tiyata za ka koyi ko ko ciwon nono ne mai karɓar mai jijiyoyin isrogen ko kuma mai karɓar mai karɓar kwayar cutar mai kyau, kazalika da yanayin HER2.
Idan an gaya maka cewa ciwon nono shine HER2 tabbatacce, menene hakan yake nufi? Waɗanne jiyya ne ke aiki musamman ga irin wannan ciwon nono da kuma wace irin magani ne za'a iya amfani dashi?
Bayani na Zabin Zama
Mutanen da ke da ciwon daji na HER2 masu kyau za a iya bi da su a hanyar da ta dace da mutanen da ke dauke da ciwon huhu na HER2 a wasu hanyoyi. Alal misali, tiyata (ko dai wata lumpectomy ko mastectomy,) adjuvant chemotherapy, da / ko maganin hormonal (idan ana iya amfani da ciwon isrogen receptor tabbatacce).
Anyi amfani da hanyoyin kwantar da hankula don ƙwayoyin cutar HER2 masu kyau kuma sun inganta yawan rayuwar rayuwa don ciwon sukari na HER2-tabbatacce. Za'a tattauna maganganun zafin jiki na farko da matakan metastatic a kasa.
Ta yaya Gidajen Harkokin Cutar Gida
Kusan daya daga cikin biyar ko shida mutane da ciwon daji za su sami ciwace-ciwacen da suke HER2 / neu tabbatacce. Wannan yana nufin cewa ciwon daji na ciwon ƙirjin nono yana da ƙarin aiki a cikin kwayoyin HER2, wanda zai haifar da ingancin sunadaran HER2.
Wadannan sunadaran sunyi aiki don fitar da ci gaban kwayar cutar cancer.
HER2 masu ciwon ƙirjin ƙirjinka na gaske sun kasance mafi muni, kuma a cikin shekarun da suka wuce sunyi rashin ganewa. A shekarar 1998 an riga an yarda da maganin farko don magance HER2. Wannan magani ne Herceptin (trastuzumab).
Tun daga wancan lokacin an gano wasu hanyoyin maganin HER2.
An yarda da Perjeta (pertuzumab) da T-DM1 (trastuzumab emtansine).
A shekara ta 2017, an yi amfani da magani na Nerlynx (neratinib) don mutanen da suka kamu da cutar kanjamau HER2-mai kyau bayan maganin Herceptin. Lokacin da aka ba da neratinib (mai maganin tyrosine kinase) a tsarin likita na ciwon nono a binciken binciken shekara ta 2016, cikakkun sakon amsawa ya fi girma ga mutanen da suka bi da Herceptin tare da daidaitattun ka'ida.
Tykerb (lapatinib) wani mai hana magunguna tyrosine kinase wanda za'a iya amfani dashi bayan magani tare da Herceptin ko wasu hanyoyin HER2.
Jiyya ga Matakan Farko
Yin jiyya na farko-farkon ciwon daji na HER2-tabbatacce na kama da na ciwon nono na HER2-korau, amma yawanci ya hada da yin amfani da miyagun ƙwayoyi na HER2 irin su Herceptin.
Zabuka sun haɗa da:
- Tiyata: Ko dai an yi amfani da lumpectomy ko mastectomy don cire tumɓin. Idan kututture shine DCIS (mataki 0) ko kuma idan yana da wata sanarwa ta kwayoyin halitta (gwajin gwajin jiki don gano haɗarin sake dawowa), za'a iya samun ƙarin jiyya. Ga ciwace-ciwacen da ya fi girma, kuma musamman ma wadanda ke da ƙwayoyin lymph namu , yawancin adjuvant yana da shawarar.
- Magungunan ciwon daji : Idan ciwon sukari ne kuma mai karɓar mai karfin ciwon isrogen ne, ana ba da shawara ga magungunan hormonal (bin chemotherapy a cikin waɗanda zasu sami chemotherapy adjuvant). Don matan mata na farko, zabin farko shine sau da yawa tamoxifen, tare da masu kwantar da kayan aikin aromatase da aka ba da shawarar ga mata wadanda ke da matsayi na maza. A madadin haka, maganin yarinyar jima'i, yarinyar mata, ko kuma mai wuya, anyi amfani da kwayar cutar ga matan mata kafin su rage yawan isrogen kuma su ba da izini don yin amfani da masu kwantar da aromatase.
- Chemotherapy: Dangane da mataki na ciwon nono, girman, ko aikin kumburi na lymph yana samuwa, kuma gwaje-gwajen gwaji, za'a iya ba da shawara ga admarin chemotherapy . Hakan yana farawa ne kusan wata guda bayan ɗaukar lumana ko mastectomy kuma an yi a tsawon kimanin hudu zuwa shida.
- HER2 Tarurrukan maganin HER2: Kamar yadda aka gani a sama, yanzu akwai zaɓuɓɓuka don magance ciwon ƙirjin nono na HER2-mai kyau, ciki har da Herceptin (trastuzumab), Perjeta (pertuzumab), da T-DM1 (trastuzumab emtansine), tare da sauran kwayoyi suna kimantawa a asibiti gwaji. Yawanci, ana amfani da Herceptin na farko. Tykerb (lapatinib) mai maganin tyrosine kinase tasiri ne don HER2 tabbatacciyar ƙwayoyin cuta. Nelynx (neratinib), wani maƙalli na kin kin, an kuma yarda da shi kwanan nan don maganin cutar kanjamau HER2-tabbatacciyar ciwon daji bayan maganin Herceptin.
- Magungunan radiation: Ga mutanen da suka zaɓa a cikin lumendomy, ana amfani da su a mafi yawan gyare- gyaren radiation bayan yin aikin tiyata. Ga ciwace-ciwacen da ke da hudu ko fiye da ƙwayoyin lymph namu, ana yin la'akari da yanayin radiation bayan mastectomy. Tumors da kashi daya zuwa uku na halayen lymph masu kyau sun kasance a cikin wani yanki mai launin fata, kuma yana da mahimmanci muyi magana da masu likitan lafiyar ku da likitan ilimin likita game da yiwuwar amfanin wannan magani.
- Gwajin gwaji: Akwai gwaje-gwajen gwaje-gwaje masu yawa da ke ci gaba da kallo daban-daban, samfurin shan magani, da kuma hanyoyin maganin radiation, da kuma gwada hanyoyi daban-daban na HER2 da kuma HER2. Akwai labarai masu yawa game da gwajin gwaji , duk da haka wani lokaci gwajin gwaji ya ba da mafi kyawun magani. Yana da muhimmanci a yi magana da masu ilimin likitancinka game da duk wani gwaji na gwaji wanda zai dace maka.
- Magunguna masu gyare-gyare: Kwanan nan, an duba kwakwalwar bisphosphonate a farkon lokacin ciwon ƙirjin nono kamar yadda zai iya rage haɗari ga matakan kasusuwan nan a nan gaba. Yi magana da likitanku akan wannan yiwuwar.
Jiyya ga Advanced Stages
Tare da matakan ƙaddara (mataki na 4) ciwon nono, hanyoyin maganin cutar ya zama maƙasudin magani. Yin aikin tiyata da radiation suna dauke da hanyoyin kwantar da hankulan gida kuma ba a amfani dashi akai-akai sai dai don dalilai masu banƙyama (don rage ciwo da / ko hana fractures).
Idan ciwon daji na HER2 na ciwon daji shine ciwon daji na ciwon daji na farko na ciwon nono, yana da mahimmanci a lura cewa matsayi HER2 (da yanayin zabin karuwanci) zai iya canzawa. An bayar da shawarar shawarar biopsy na shafin yanar-gizon masarauta da kuma nazarin karatun mai karɓa. Wata ƙari wanda ya kasance HER2 mai kyau zai iya zama HER2 korau a kan komawa baya kuma a madadin.
Jigon farko na farfadowa na ciwon daji na HER2-tabbatacce zai dogara ne a kan waɗannan karatun masu karɓa. Ga wadanda suke da HER2 tabbatacce, daya daga cikin hanyoyin da aka kera na HER2 ana amfani dasu. Idan ciwon sukari ne kuma mai karɓa mai yadujin estrogen, ko dai maganin hormonal, HER2 farfado, ko duka biyu za'a iya la'akari. Har ila yau, ana iya amfani da kodimirai don wasu watanni.
Yana da mahimmanci a lura cewa makasudin maganin ciwon ƙwayar ciwon ƙwayar cutar ta jiki ne sau da yawa daban-daban fiye da yadda za a ci gaba da cutar ciwon nono, a cikin cewa idan an yi la'akari da sauki don magance cutar, ana bada shawara sosai.
Idan an riga an magance ƙwayar cutar tare da Herceptin (trastuzumab) a cikin adjuvant wuri, bayan bayanan marasa lafiya (wanda aka auna daga ƙarshen adjuvant trastuzumab) na kasa da watanni shida mafi yawan abin da aka fi dacewa shine magani T-DM1 (ado -trastuzumab emtansine). A madadin, idan an riga an riga an magance kututture tare da Herceptin a wuri mai adjuvant, bayan bayanan marasa lafiya na tsawon watanni shida Perjeta (pertuzumab) a hade tare da trastuzumab kuma ana iya amfani da haraji.
Ga marasa lafiya cewa ci gaba bayan trastuzumab da haraji a cikin tsarin matakan, T-DM1 shine zabi mafiya. Ga marasa lafiya wanda basu da maganin Herceptin a baya, haɗin Herceptin da Perjeta da haraji ya kamata a yi amfani dashi.
Idan ciwon daji ya ci gaba ba tare da waɗannan jiyya ba, za a iya gwada haɗin Tykerb (lapatinib) da Xeloda (capecitabine). Sauran ƙwayoyin cutar shan-jijiyo ko magungunan hormonal na iya gwadawa.
HER2 tabbataccen ciwon nono yana iya yadawa zuwa kwakwalwa da hanta fiye da ciwon daji na HER2. Abin farin, Herceptin, kuma mai yiwuwa Perjeta ya bayyana ta hanyar yaduwar cutar jini da kuma rage girman kwakwalwar ƙwayoyin cuta. Ga mutanen da suka hadu da kasusuwa na kasusuwa, ƙwayoyi masu gyaran ƙwayoyi irin su bisphosphonates na iya ba kawai rage hadarin fractures amma zai iya inganta rayuwar.
Hadin Gwiwar
Mutane da yawa sunyi tambaya game da yiwuwar hanyoyin magance cutar idan an gano su tare da ciwon nono. A halin yanzu, babu wata hanyar "madadin" maganin da aka samu a tasirin maganin nono. Maimakon haka, wasu mutanen da suka zaba wadannan hanyoyin shan magani ba tare da sababbin jiyya ba sun ɓace a kan hanyoyin kwantar da hankalin da aka nuna sun zama tasiri.
Amma yana da muhimmanci kada a fitar da jariri tare da wanka. Akwai hanyoyin magance ciwon daɗaɗɗa don ciwon daji wanda aka samo don taimakawa mutane su magance cututtukan cututtuka da maganin ciwon daji, wanda ya kasance daga gajiya da damuwa ga motsa jiki, rashin jin dadin jiki , da sauransu. Wasu daga cikin hanyoyin kwantar da hankali da aka yi nazarin musamman a cikin matan da ke fama da ciwon nono sun hada da yoga , tunani , gyare-gyare , da acupuncture .
Faɗakarwa
Kafin hanyoyin HER2 da aka yi niyya, babu wani magani na musamman da aka samu don ciwon sukari na HER2, kuma waɗannan an dauke su da cututtuka. Tare da zuwan ƙaddamar da shirin, duk da haka, wannan ya canza.
Wani bincike na shekara ta 2017 ya gano cewa mata masu fama da ciwon daji na HER2 na da ƙwayar rayuwa fiye da mata wadanda suka kasance HER2 korau lokacin da aka yi amfani da maganin Herceptin. Yawancin rayuwa mafi ƙasƙanci ya kasance ga mata masu fama da ciwon nono guda uku.
Gano Taimako
Abin farin ciki, ƙara yawan wayar da kan jama'a da kuma kudade don ciwon nono ya haifar da yawan albarkatu don taimakawa mutane su magance cutar. Kungiyoyin tallafi da kungiyoyin tallafi suna samuwa ga mata masu fama da ciwon nono a general, da kuma wadanda ke da mahimmanci magance ciwon daji. Ƙungiyoyin yau da kullum da har ma kungiyoyin Facebook na mutanen da ke dauke da ciwon daji na HER2-masu kyau sun taru yayin da suke fuskanci kalubale na musamman.
Kasancewa a cikin kafofin watsa labarun ya zama tushen tushen tallafi da ilimi ga mutane da yawa da cutar. Idan ka zaɓa don shiga cikin wannan hanyar, duk da haka, ɗauki ɗan lokaci don koyi yadda za a raba tafiya kan ciwon daji a cikin layi lafiya.
Intanit babban wuri ne kuma wasu lokuta yana iya fahimtar mutanen da suke fuskantar irin wannan tafiya zuwa naka. Domin haɗi tare da wasu waɗanda suke tare da, ko magancewa, ciwon nono, ta amfani da hashtag #BCSM yana da matukar taimako. BCSM yana tsaye ne ga kafofin watsa labarun nono.
Kalma Daga
A baya, cutar ciwon daji na HER2 na dauke da shi a matsayin mummunan ciwo ba tare da wani magani ba. Wannan ya canza a shekarar 1998 tare da amincewa da shirin HER2 na farko, Herceptin. Tun daga wancan lokaci, wasu magunguna sun samo samuwa ciki har da Perjeta, T-DM1, Lapatinib, kuma mafi kwanan nan neratinib, tare da sauran kwayoyi suna kimantawa a gwaji na asibiti. HER2 ƙayyadaddun maganin zai iya rage haɗarin dawowa a farkon mataki HER2-tabbatacciyar ƙwayar nono da inganta yawan rayuwa a cikin kwayar cutar HER2-tabbatacciyar ƙwayar nono.
Bugu da ƙari ga maganin cutar HER2 da aka yi niyya, maganin cututtuka na HER2-tabbatacciyar jariri ya haɗa da jiyya ga cututtukan HER2 ko cuta, irin su tiyata, maganin hormonal (idan ya dace), chemotherapy, radiation far, musamman jiyya ga metastases, da kuma yiwuwar gwaji gwaji .
> Sources:
> Chan, A., Delaloge, S., Holmes, F. et al. Neratinib Bayan Trastuzumab-Based Adjuvant Far a cikin marasa lafiya tare da HER2-Positive nono maganin (ExteNET): A Multicentre, Randomized, Double-Blind, Sanya-Sarrafa Phase 3 Trial. Lancet Oncology . 17 (3): 367-77.
> Kast, K., Schoffer, O., Link, T. et al. Trastuzumab da tsira daga marasa lafiya tare da ciwon ƙwayar cutar ciwon ƙwayar cuta. Cibiyar Gynecology da Obstetrics . 2017. 296 (2): 303-312.
> Park, J., Liu, M., Yee, D. et al. Amfani da Randomization na Neratinib a Cutar Cancer na farko. Jaridar New England Journal of Medicine . 2016. 375 (1): 11-22.