Arimidex, Femara, da kwatankwacin Aromasin da Hanyoyi
Idan ka gama yin maganin farko don farawa, kwantar da hankalin mai ciwon isrogen-tabbatacciyar ƙwayar nono , likitanku zai iya bayar da shawarar maganin hormonal na tsawon shekaru 5 zuwa 10. Zaɓin magungunan za su dogara ne a kan matsayin ku na mazaopausal, tare da masu hana masu amfani da aromatase yawanci na farko da za a zabi ga mata na post-menopausal da kuma wasu mata masu auren mata tare da maganin kutsawa na ovarian.
Mene ne bambanci tsakanin Femara, Arimidex, da kuma Aromasin, menene sakamako masu illa da za ku iya tsammanin, kuma ta yaya wadannan magunguna suka bambanta daga tamoxifen? Yaya suke da tasiri wajen hana yaduwar ciwon nono?
Masu haɗin Aromatase: Definition
Masu hana maganin rashin lafiya su ne magungunan da ke kange samar da isrogen cikin jiki. A yin haka, sun rage hadarin ciwon daji na haihuwa (da kuma ƙara yawan rayuka) ga matan da ke da ciwo mai ciwon isrogen-receptor na farko da kuma su ne masu matsakaici. Hakanan kuma suna iya rage hadarin komawa ga wasu matan da ke fama da ciwon nono fiye da tamoxifen. Akwai magunguna daban daban uku a cikin wannan nau'i na kwayoyi.
An fara maganin maganin mai kwantar da hanzari bayan magani na farko na ciwon nono. Wannan ya hada da aikin tiyata da kuma yiwuwar chemotherapy da / ko radiation far . An cigaba da jiyya don shekaru 5 zuwa 10 dangane da hadarin mutum na sake dawowa da kuma haɗakar da sakamakon illa.
Hormone Far for Breast Ciwon daji
Magunan nono wanda ke da karfin mai jijiyocin isrogen suna cike da estrogen. Kwayoyin ciwon daji na nono, kamar sauran ƙwayar nono, suna da masu karɓar isrogen a kan farfajiya. Ciwon daji da ake zaton "tabbatacce" ga masu karɓar estrogen ko progesterone su ne wadanda abin da waɗannan masu karɓar isrogen suke da shi ke da alhakin ci gaban ciwon daji.
Rawar da estrogen cikin wadannan ciwon sukari shine a ɗaure ga masu karɓar isrogene don ƙarfafa girma da rabuwa daga cikin sel.
Don ragewa ko dakatar da ci gaban kwayar cutar Kanjamau, haka muna bukatar hanyar da za mu rage estrogen a cikin jiki ko toshe masu karɓar isrogene saboda isrogirin da ke nan ba zai iya ɗaure ba.
Hanyar Harkokin Hormonal: Masu Tamoxifen da Masu Rushe Aromatase
Kafin menopause, ovaries shine babban hanyar samar da estrogen cikin jiki. Magungunan ƙwayoyi tamoxifen na aiki ne ta hanyar hana masu karɓar estrogen a kan ciwon daji na nono (da wasu kwayoyin halitta) don haka isrogen ba zai iya ɗaure ba. Tamoxifen yana da ciwon haɓo mai ciwon isrogen a wasu sassa na jiki kamar nono, amma hawan ciwon haɗin gwiwar ciwon estrogen a kan wasu, irin su kasusuwa (zai iya rage asarar kasusuwa). Da farko an yarda da shi a shekarar 1998, tamoxifen ya kasance babban magungunan maganin hormonal ga ciwon nono ga fiye da shekaru biyu.
Bayan mazaunewa, ainihin tushen isrogen ne daga karɓar gwanin androgens (halayyar namiji da aka samu a cikin kitsoyin mai) a cikin isrogen. Wannan maganin yana taimakawa ta hanyar enzyme da aka sani da aromatase. Masu hana masu kwantar da hanzari suna aiki ta hanyar hana aromatase don kada inrogens su canza zuwa isrogen cikin jiki.
Tun da mahimmancin isrogen din kafin mazaopause shi ne ovaries, ba gyare-gyare na haɗin gwiwar androgens ba, masu haɓaka na aromatase kawai zasu zama masu tasiri ga matan da suka ci gaba da kasancewa na farko (kuma wata mace na iya zama namiji na mace ko da kuwa lokacinta ya fita daga chemotherapy).
Fahimtar Masu Gyara Aromatase: Arimidex, Femara, da Aromasin
A halin yanzu akwai masu hanawa uku na aromatase daban-daban waɗanda aka yarda don rage hadarin komawa ga mata da wuri-wuri, ciwon kwakwalwa na ciwon estrogen-tabbatacce. Wadannan sun haɗa da:
- Arimidex (anastrozole)
- Femara (letrozole)
- Abun (misali)
Wadannan magunguna sun bayyana kamar yadda suke da tasiri wajen hana dawowa amma suna da wasu bambance-bambance. Rikicin ne mai steroid, yayin da Arimidex da Femara ba. Maganin wadannan magunguna guda uku sunyi kama da irin wannan.
Tamoxifen da ciwon ƙwayar cutar ciwon ƙwayar cutar
Muna da labaran bayanai a wannan lokaci na kallo akan amfani da tamoxifen da kuma hadarin ciwon ciwon nono . Yawancin lokaci, idan aka yi amfani da shi a farkon lokaci, mai karfin maganin ciwon estrogen-tabbatacciya, ƙwayar miyagun ƙwayar yana rage hadarin komawa ta hanyar kashi 50 cikin 100. Tamoxifen yana rage rashin kuskuren cewa za ku ci gaba da ciwon ƙwayar cutar a cikin ƙirjin ku (idan kuna da wata alamar aiki) ko kuma za ku ci gaba da ciwon nono na biyu a cikin nono.
Masu maganin Aromatase da Ciwon Cutar Cancer
Masu kwantar da hanzari sun nuna cewa sun rage yawan hadarin dawowa har ma fiye da tamoxifen kuma yanzu ana daukar kwayoyi na zabi ga mata masu auren mata ko wadanda suka kasance masu tsauraran matakai kuma suna shan maganin farfadowa na ovarian.
Jagoran Jarrabawa don Farfesa Hormonal
Don mata masu auren mata da maza suna shan maganin aromatase, manufofin 2017 yanzu sun bada shawarar ta amfani da Zometa bisphosphonate (zoledronic acid) tare da mai hana injin aromatase. Haɗuwa da magungunan nan guda biyu yana bayyana don rage hadarin ciwon nono wanda ya yada kasusuwa fiye da na kwantar da aromatase kadai. Ƙara koyo game da amfani da bisphosphonates don ciwon nono na farko .
Masu haɗarin Aromatase a cikin Mata masu Tsarin Ma'aurata tare da Matsayin Mata na Ovarian
Tambayar ko ƙara magungunan ciwon daji (ta amfani da gonadotropins don yin motsa jiki) don tamoxifen ya kasance batun wasu muhawara. Wani binciken da aka wallafa a New England Journal of Medicine a shekara ta 2015, ya nuna cewa matan da suka kamu da su a lokacin da ake magance su da maganin kutsawa na ovarian domin suyi amfani da magungunan aromatase maimakon tamoxifen na iya samun yawan rayuwa.
Wani binciken da aka buga a wannan jarida a shekarar 2014 ya gano cewa Aromasin (exemestane) hade tare da maganin kutsawa na ovarian ya inganta inganta rayuwa idan aka kwatanta da maganin tamoxifen tare da magunguna.
Tun da masu cin zarafi na aromatase suna da ƙananan sakamako masu illa ga ƙwayoyin cuta kuma suna iya haifar da asarar kasusuwa, yawancin masu ilimin likita sun bada shawarar su dace da wannan hanyar don matan da suka fara auren mata wanda ke da Stage 2 da Stage 3 ciwon nono, wanda zai iya komawa.
Hanyoyin Gaba na Masu Cin Hanyar Aromatase
Kamar yadda yake tare da duk wani maganin magani, illa mai lalacewa da kuma halayen halayen iya faruwa ga wasu mata a kan masu hana masu aromatase.
Wasu daga cikin cututtuka mafi rinjaye shine wadanda suke da alaka da rage yawan isrogen cikin jiki (cututtukan menopausal) kuma sun hada da hasken wuta, suturar dare, bushewa na farfajiyar, da kuma fitarwa ta jiki. Duk da yake waɗannan bayyanar cututtuka na iya zama mummunan, karatu ya nuna cewa walƙiya mai haske shine alamar kyau a cikin mata masu fama da ciwon nono, kuma wadanda ke fama da wadannan cututtuka suna da kyakkyawan sakamako.
Haɗin gwiwa da kuma tsoka tsohuwar maƙasudin magungunan aromatase ne. Wannan jiki ne wanda yake daya daga cikin manyan dalilan da mata ke daina amfani da wadannan kwayoyi.
Ɗaya daga cikin damuwa mafi tsanani a kan masu cin zarafin aromatase shine hasara na kasuwa, tare da yin amfani da waɗannan kwayoyi wanda zai iya haifar da osteoporosis da kuma fractures. Mutane da yawa masu ilimin likita suna bada shawarar maganin kashi kashi kafin su fara magungunan nan su zama tushen, da biyan baya dangane da sakamakon wannan gwajin farko.
Bugu da kari na bisphosphonates (Zometa) don farfadowa na aromatase na farfadowa zai iya rage wannan haɗari. An fara yarda da Bisphosphonates a matsayin jiyya na osteoporosis, kuma an gano Zometa don rage haɗari na layi da ɓarna na hanji (da kuma rashin lafiyar da ke faruwa tare da wadannan fractures). Zometa aka bada shawara ga mutanen da ke fama da ciwon daji, kamar yadda zai iya rage ciwon nama da kuma hadarin fractures da alaka da metastases. Karin bincike ya nuna cewa Zometa ta canza ƙananan kasusuwan kasusuwa don haka kwayoyin cututtukan nono ba zasu iya "tsaya" kamar yadda sauƙi ba. A cikin amfani da asibiti, yana bayyana ya rage damar da ciwon nono na mutum zai yada ga ƙasusuwansu.
Har ila yau, masu hana maganin rashin lafiya sun haɗa da haɗarin ƙwayar matsalar zuciya. Duk da yake wannan gaskiya ne, an gano cewa mummunar cututtuka na zuciya da cututtukan zuciya irin su ciwon zuciya da bugun jini ba su da yawa a cikin matan da suka yi amfani da maganin aromatase fiye da wadanda ba suyi amfani da kwayoyi ba. Yanayin zuciya wanda ke faruwa a kan waɗannan magunguna sun haɗa da cuta na zuciya, damusar zuciya , da kuma pericarditis (ƙonewar ƙwayoyin da ke kewaye da zuciya).
Idan Hanyoyin Hanya Kasa Kuna Dakatar da Magunguna
Hanyoyin da ke tattare da masu cin zarafin aromatase, musamman ma jiki, suna iya kalubale a wasu lokuta. Abin baƙin ciki shine, wadannan cututtukan da suka haifar sun haifar da mata da yawa da suka daina yin maganin su ba tare da daɗewa ba kuma sun rasa kan rigakafi (da inganta rayuwa) da suke bayar.
Idan kuna shan wahalar cutar, ku yi magana da likitanku. Kodayake lafiyar lafiya da mawuyacin kwayoyi uku a wannan aji sunyi kama da haka, kimanin kashi ɗaya cikin uku na mata zasu iya jure wa magani daban-daban a wannan aji.
Gyarawa daga Tamoxifen zuwa Mai Gudanar da Aromatase
Wasu mutanen da suka fara yin aiki na farko da kuma bi da su tare da tamoxifen na iya kasancewa a matsakaicin matsakaici a yayin jiyya. Wannan hakika gaskiya ne ga matan da suka ci gaba da ciwon nono a lokacin da suke yin hauka. Tun da yake cutar shan magani yana haifar da amenorrhea (babu lokaci), ana iya buƙatar gwaje-gwaje na jini don sanin ko kuna cikin menopause. Nazarin sun gano cewa sauyawa zuwa wani mai hana aromatase bayan shekaru 2 zuwa 3 na maganin tamoxifen zai haifar da rayuwa mafi kyau fiye da ci gaba a tamoxifen.
Tsarin Jiyya tare da Masu Rushewar Aromatase
Duk da yake an bada shawarar cewa mutane su ci gaba da tamoxifen ko mai cin hanci da aromatase shekaru 5 da suka wuce, sabon bayanai sun nuna cewa shan wadannan magunguna na tsawon shekaru 10 ya rage hadarin komawa. An sani da kyau cewa ciwon nono yana iya sake dawowa shekaru masu yawa ko ma shekarun da suka gabata bayan an fara maganin kututtuka, kuma wannan haɗari ya fi girma a cikin matan da suka sami ciwon sukari mai ciwon isrogen. Ba mu san dalilin da yasa cutar ciwon nono ta dawo bayan shekaru ko shekarun da suka gabata, amma mun san wannan yana faruwa sau da yawa.
Dukansu magungunan katako da aromatase sun kasance suna ci gaba da aiki bayan an dakatar da su, kodayake wasu masu bincike sunyi imanin cewa ci gaba da maganin hormone za'a iya karawa har tsawon shekaru 10 a nan gaba. Wannan ya ce, za a iya yin la'akari da halayen da ake bukata.
Kudin Masu Gudanar da Aromatase
Yayin da ba a yi kama da takaddama wanda ya kasance a cikin 'yan shekarun da suka gabata kuma yana da siffofin kwayar halitta, masu ƙetare aromatase na iya zama tsada. Shirye-shiryen asibiti suna ɗaukar wani ɓangare na kudin, ko da yake suna iya bayar da ɗaukar hoto don ɗaya daga cikin magunguna a cikin wannan aji. Idan kuna da wahalar yin amfani da AI, duba waɗannan matakai akan kula da farashin maganin hormonal .
Kalma Daga
Masu haɓaka na rashin lafiya sunyi aiki ta hanyar hana samar da estrogen a cikin kitsoyin mai, ainihin tushen isrogirin a cikin mata postmenopausal. Mun san wasu shekarun da suka gabata cewa tamoxifen zai iya rage haɗarin ciwon daji na ciwon nono kuma waɗannan lambobi sun kasance sun fi dacewa da masu haɓakar aromatase.
Abin takaici, kuma kamar yadda yake tare da kowace magani, illa na lalacewa na kowa, kuma jiki yana iya zama mafi muni. Idan kuna fuskantar wadannan, kuyi aiki da likitanku. Wasu lokuta yana da amfani don canzawa zuwa wani miyagun ƙwayoyi daban-daban a cikin wannan aji. Hanyoyi masu kyau daga jingine zuwa tunani zasu iya taimaka. Yana da mahimmanci don tunatar da kanka dalilin da yasa kake shan magani. Hanyoyi na iya zama m amma sun fi dacewa da samun komawa. Yanzu ana bada shawarar bisopsphonates tare da masu hanawa aromatase, damuwa akan raguwa da ƙananan kashi kuma osteoporosis na iya zama matsala ba a baya.
Ka tuna cewa kowace mace ta bambanta kuma babu wani "sihiri" tsawon lokaci wanda kowa ya dauki wannan kwayoyi. Ga kowane mutum, yana da muhimmanci a yi la'akari da amfanin da ya dace da abubuwan da ke faruwa da kuma hadarin gaske. Tabbatar tambaya da yawa tambayoyin kuma zama mai bada shawara a kulawa. Babu wanda ya fi ƙarfin cewa za ku rayu rayuwarku ba tare da ciwon daji ba.
> Sources:
> Francis, P., Regan, M., Fleming, G. et al. Adjuvant Ovarian Suppression a Premenopausal nono Ciwon daji. Jaridar New England Journal of Medicine . 2015. 372 (5): 436-446.
> Hague, R., Shi, J., Schottinger, J. et al. Kwayar cutar kwakwalwa Bayan Bayanin Aromatase Use. JAMA Oncology . 2016 2 (12): 1590.
> Pagani, O., Regan, M., Walley, B. et al. Adjuvant Exemestane tare da Ovarian Suppression a Premenopausal nono Ciwon daji. Jaridar New England Journal of Medicine . 2014. 371 (2): 107-118.
> Tjan- > Sauka >, V., Hellemond, I., Peer, P. et al. Ƙarar Aromatase Extended Adjuvant Bayan Bayanin Tsaro Endocrin (DATA): A Randomized, Phase 3 Trial. Lancet Oncology . 2017. 18 (11): 1502-1511.