Sauran maganin jinya guda biyar - Shari'ar , Zytiga , Xtandi, Xofigo, da kuma Jevtana -have sun sami damar maganin ciwon daji a cikin shekaru biyar da suka gabata. Abin farin, tsohuwar jiyya kamar maganin radiation, Lupron, da Taxotre sun kasance masu tasiri. Kullum, ciwon ciwon ciwon ciwon ciwon ci gaba yana cigaba da hankali, ma'ana cewa za a iya jinkirta mutuwa ga dan lokaci mai tsawo.
Duk da wadannan al'amurran da suka dace, kimanin mutane 28,000 sun shiga cikin cutar ta prostate a kowace shekara. A mafi yawancin lokuta, mace-mace tana faruwa ne saboda ciwon daji ya zama maƙarƙashiya ga dukan magungunan da aka tsara a sama. Idan wannan ya faru, mataki na gaba mai zuwa shi ne la'akari da jiyya-lakabi-lakabi irin su magunguna waɗanda ke FDA-sun yarda da sauran ciwon daji, sun ce ciwon daji ko ciwon huhu, misali. Matsalar ita ce zaɓi tsakanin zaɓuɓɓuka da dama. Idan za ku dauki harbi a cikin duhu, wane gun ya kamata ku karba?
Magoya bayanan Label: Labarin Mai haƙuri
Binciko na mai yin amfani da lakabi mai kyau zai iya samun babban biya idan ka samu sa'a. Daga bayanin FDA, ana iya amfani da miyagun ƙwayoyi da aka yi amfani dashi don amfani da marasa amfani idan wani mai kula da kiwon lafiya ya ji cewa yana da kyau ga masu haƙuri, ko saboda babu wani magani da aka yarda da shi don magance yanayin da aka ba shi ko kuma saboda mai haƙuri ya gwada duk wanda aka amince jiyya ba tare da ganin sakamakon ba.
Bari in karanta labarin Bill. An fara bincikarsa a karshen shekara ta 2010 tare da PSA na 4.2 da Gleason jigon 3 + 4 kuma aka bi da shi tare da tiyata don cire prostate. Alamar farko ta kara matsala ita ce rahotonsa na ilimin cututtuka ya nuna ciwon daji a gefen gefen prostate. Har ila yau, Gleason ya ci gaba da inganta shi zuwa 4 + 5 = 9, kuma PSA bai taba barin shi ba bayan da aka cire prostate.
A watan Maris na 2011, ya sami radiation da aka kai ga yankin jiki inda prostate yake kasancewa, amma PSA ya zauna kadan saboda dan kankanin lokaci. Daga nan sai ya fara Lupron, amma ciwonsa ya kasance mai sanyi a cikin shekara guda. A cikin shekaru uku masu zuwa, an magance shi da magungunan da aka ambata a sama, Provenge, Zytiga, Xtandi, da Taxotere. A lokacin rani na shekara ta 2014, ciwon daji ya yadu a cikin kofin kasusuwansa. An fara shan magani tare da Xofigo a watan Fabrairun 2014. A cikin baƙin ciki, ya ci gaba da ciwo mai raunin kashi kashi, ci gaba na yau da kullum a cikin maza da ciwon ciwon gurguwar karuwanci. Ya samar da kwayar jinin jini yana da matukar damuwa kuma zai iya kasancewa da rai tare da fassarar jini a kowane wata. Lokacin da aka dakatar da Xofigo a watan Agustan 2014, PSA ya kai sama da 120. Lissafin Bill na rayuwa har wata shida ya kasance ƙasa da ɗaya a cikin 10.
Har wa yau, wani likita yana kula da shari'arsa. Dama kafin ya sauke duba aikin likita a ofishina, likita na gaba ya fara Bill a kan wani nau'i mai suna Mekinist. Mekinist wani kwaya ne wanda ke FDA-an yarda da melanoma. Tun da amfani da ciwon gurguwar ƙwayar prostate (amfani da lakabin) ba a rufe shi da inshora, Bill ya sayi kwaya kanta a kan dolar Amirka dubu 10,000 a wata.
Duk da haka, ya zuba jari ya kashe. A watan Disamba na shekarar 2014 PSA ya ragu har zuwa 18.96, yunkirinsa ya fara aiki, kuma bai sake buƙatar ƙarin karfin jini ba.
Har ila yau, lafiyar Bill ya inganta, har ya koma aikinsa har tsawon lokaci, har ma ya yi tafiya tare da iyalansa zuwa Turai da wurare daban-daban a Amurka a cikin shekaru biyu masu zuwa. Mekinist ya yi haƙuri sosai ba tare da wani sakamako mai ban mamaki ba. Abin takaici, ciwon kansa na karuwanci ya zama mai tsayayya ga Mekinist kuma ciwon daji ya fara ci gaba. Mu kara kokarin da muke yi don gano wata takarda mai sihiri ba tare da nasara ba, kuma ya shiga cutar a farkon 2016.
Billkin Mekinist ya kasance mai ban mamaki. Bayan ya nuna irin wannan babban maganin cutar kanjamau, har ma ya iya shawo kan kamfanin inshora ya rufe kudin. Nasarar da ake samu na maganin ciwon daji a irin wannan mummunan mataki na cutar ya kasance mai ban mamaki sosai, wani samfuri ga samfurori da ke samo asali a cikin masana'antu. Bisa ga cewa an samar da sababbin sababbin jami'o'i, ƙwarewar gagarumin arziki, kamar cajin Bill, da za a maimaitawa yana inganta.
Nazarin Halittar Halitta: A Hanyar Yin Zaɓin Zaɓuɓɓuka
Matsalar yanzu shine cewa akwai irin wannan babban adadin sababbin wakilai da aka yarda da su a kowane irin ciwon daji. Yaya zaku san wane wakili ne zai karba? Mun yi ƙoƙarin bada Mekinist ga wasu marasa lafiya, amma ba tare da wani ciwon daji na ciwon ciwon daji ba. Wannan ba abin mamaki bane idan la'akari da cewa cutar ciwon gurguwar ƙwayar cutar ba wata cuta guda ce ba. Mun dade muna ganin bambancin bambanci game da yadda marasa lafiya ke amsawa daban-daban. Duk da haka, akwai wani bangare na ci gaban fasaha mai sauri wanda zai iya taimaka mana wajen fitar da marasa lafiya don maganin cutar. Zuwan gwajin kwayoyin kwayoyin tumatir zai iya kawo karshen ƙarshen lokacin shan magani bazuwar.
Manufar ita ce don zaɓar magani ta hanyar gane bayanan kwayoyin halittar kwayoyin cutar kanjamau ta hanyar samin kwayoyin halitta. Ci gaban salon salula wanda ba shi da wata ma'ana, "ciwon daji," yana haifar da mummunan kwayoyin halitta. Kwayoyin da aka kwatanta da ci gaban kwayar halitta zasu iya rufewa a matsayin "on". Wadannan canje-canje za a iya gano su ta hanyar samfurin kwayoyin halitta. Fiye da kwayoyin 50 an gano cewa rashin lafiya a ciwon daji na prostate. Tattaunawar kwayoyin cutar nama ya nuna cewa a cikin kwayar cutar ciwon daji game da kwayoyin halitta guda hudu ana samun su. Duk da haka, yawan mummunan kwayoyin halittar da aka gano zasu iya kasancewa daga masu yawa kamar ɗaya zuwa fiye da 10.
Kamar yadda farin ciki kamar alkawarinsa na wannan irin sauti na "mai kaifin baki", akwai sauran kalubale don cin nasara. Tsarin gwiwar Gene zai iya nuna jigilar kwayoyin cutar ta hanyar suna, amma ba kullum aikin ginin ba. Lokacin da muka san aikin, ba mu da wata magungunan musamman don magance matsalar da halittar ke haifarwa. Ko da lokacin da akwai maganin magani don magance wani nau'in cuta mara kyau a wani irin ciwon daji, babu tabbacin cewa gwamnatinsa za ta kasance mai tasiri a ciwon daji na prostate. Alal misali, Mekinist yana da tasirin yin tasiri ga mummunan halin da ake kira GNAS a cikin marasa lafiya da melanoma. Duk da haka, kamar yadda yake da haka, ba mu da bayanan da ke nuna cewa Mekinist zai zama tasiri ga marasa lafiya na prostate tare da GNAS .
Hanyar hanyoyin gwaji
Mun zahiri ƙoƙarin samun ciwon daji don tantance gwajin kwayoyin a cikin Bill ta hanyar kwayar cutar kwayar halitta. Abin baƙin cikin shine, kwayar halitta ba ta samu nasara ba saboda ba'a samu kwayoyin tumo ba. Kwarewarmu da biopsy don samun kwayoyin tumo daga kashi don gwajin kwayoyin a marasa lafiya na prostate kawai sun ci nasara a cikin rabin rabin marasa lafiya wanda muka yi ƙoƙari muyi biopsy. Har sai kwanan nan, rassan kashi ne kawai hanyar samun dama ga kwayoyin halitta a cikin kwayoyin tumo. Kwayoyin cutar biopsy, duk da haka, yana da damuwa da rashin jin daɗi yana buƙatar buƙata mai girma. Abin farin ciki, fasahar ci gaba da cigaba a wani lokaci mai sauri. Nasarar ta ƙarshe ita ce gano cewa kwayar cutar ta DNA da aka saki cikin jini daga cututtukan kwayar cutar ciwon daji za a iya gano kuma an gwada shi tare da gwajin jini.
Samun DNA jini yana da sauki fiye da yin kasusuwan kwayar halitta. Baya ga yanayin haɓaka, DNA a cikin jini shi ne DNA mai yawa wanda aka fitar daga dukan ciwon sukari a ko'ina cikin jiki. Kwayoyin kwayoyin halitta da aka samo daga kwayar cutar kwayoyin halitta ba za su fada duk labarin ba saboda ciwon daji yana da mawuyacin yanayin cewa daban-daban shafukan yanar gizo na ciwon daji daga wannan haƙuri na iya zama daban-daban.
Samun jini na kwayar cutar DNA ta yanzu yana samuwa. Kamfanin da ke aiwatar da gwaji ana kiranta lafiyarsa. Suna kiran jinin su cewa jarrabawar kwayoyin cutar kanjamau Guardant360. Sakamakon gwaje-gwaje na 70 daga cikin maye gurbin da aka saba gani a cikin ciwon daji. An gudanar da bincike don jarraba idan kwayoyin da ke tattare da jini sunyi kama da kwayoyin cutar da kwayoyin halittu suka gano a cikin wannan haƙuri. Samun jini ya bayyana yana da kyau sosai.
Bayan an gano Dandalin Tsari
Saboda haka, bari mu koma mahimman batunmu na yin amfani da bayanan da aka samo asali don zaɓar cututtuka na ciwon ciwon daji a kan maza da ciwon ciwon karuwanci wanda suka ƙare hanyoyin da za a yarda da su na FDA. Lokacin da aka gano wani mahaukaci mahaukaci akwai sakamako mai yiwuwa hudu:
- Babu wani farfado da aka sani da wannan magungunan ciwon magungunan mahaifa.
- Akwai magani na FDA da aka yarda da shi don ciwon daji na prostate don wannan samfurin musamman
- Akwai magani da aka yarda da FDA wanda ke aiki don wani irin ciwon daji (ƙwayoyin cuta, koda, melanoma, da dai sauransu) wanda zai iya samun aikin maganin anticancer a ciwon daji na prostate tare da wannan mummunar mahaifa.
- Akwai sababbin wakilai da aka kimanta don wannan ƙananan kwayoyin halitta a gwaji na asibiti ko dai a cikin ciwon gurguwar jini ko wani irin ciwon daji. Marasa lafiya da ke da irin wannan maye gurbi zai iya zama mafi kusantar amsawa ga wannan wakili idan yayi la'akari da yanayin da aka sani na wakilin.
Idan aka kwatanta wannan a cikin maganganun da suka dace, sakamakon farko na biyu ba zai taimakawa marasa lafiya ba. Musamman, dangane da sakamakon na biyu, mafi yawan marasa lafiya waɗanda ke fuskantar gwajin kwayoyin cutar kanjamau sun riga sun ƙare da zafin hanyoyin likita na FDA da aka yarda da ciwon ciwon daji. Sakamakon na uku da na huɗu sune waɗanda zasu iya nuna wani nau'in farfadowa wanda zai rasa a baya a cikin ƙarshen yawan zaɓuka masu lakabi.
Abin takaici ne cewa ba za a iya samun bayanin martabar Bill ba duk da kokarinmu mafi kyau. Halin Mekinist a tsawon rayuwarsa da kuma rayuwar rayuwarsu ya kasance da gaske. A wannan batu, ba mu sani ba idan amsarsa mai kyau ta faru ne saboda rashin ciwo na GNAS, wani nau'i ko kuma wani nau'i na kwayoyin halitta. Duk da haka, yanzu tare da sauƙin samun damar bayani game da kwayoyin ta hanyar binciken jini tare da Guardant360, zamu iya koyi wane magani zai iya haifar da amsa ta hanyar cutar kanjamau bisa ga alamar ƙwararrun mahaifa.