– Amaphilisi esimanje e-anti-androgen asebenza kahle kakhulu - cishe kuzo zonke izigaba zokwelashwa anganciphisa isifo, andise impilo futhi abekezelelwe kahle kakhulu. Sikhuluma noDkt. Iwona Skoneczna, PhD, mayelana nemithi yokwelapha emisha yama-hormone namanje ayitholakali ngokugcwele kubantu basePoland.
Udokotela, umdlavuza wendlala yesinye ubulokhu uthatha igazi eliningi ngezinga lokufa kwabesilisa basePoland iminyaka. Esinye sezizathu "ukumelana kwabesilisa", okungukuthi ukwesaba udokotela ohlola umchamo, kanti esinye siwukufinyelela okulinganiselwe emithi yokwelapha yesimanje. Yini iziguli zasePoland eziphuthelwa kakhulu?
Amazinga okusinda kanye nokufa kuma-neoplasms ancike ezintweni eziningi, kodwa ngokuvamile kungashiwo ukuthi into ebaluleke kakhulu yisigaba sokuthuthuka kwesifo ngesikhathi sokuxilongwa kanye nekhono lokusebenzisa ngokuphumelelayo, ngokuvamile ukwelashwa okuhlukahlukene. Lo bhubhane wengeze izinkinga zokuxilonga esimweni lapho amadoda amaningi kudingeke ukuthi atholwe ukuthi ahlolwe umchamo.
Ngithanda ukuphinda futhi ukuthi umdlavuza wendlala yesinye isikhathi esifushane awubangeli zimpawu futhi uma singazami ukuhlola ukuthi asinawo yini ngokwethu, kungase kusimangaze futhi kukhiqize ama-metastases ngaphambi kokuba sazi. Esinye isici esibalulekile esiholela emiphumeleni emihle yokwelashwa, ikakhulukazi kumdlavuza wendlala yesinye osethuthukile, ukuthola izindlela zokwelapha zesimanje. Nalapha, naphezu kwentuthuko, kuningi okwakungenziwa.
Impumelelo ekwelapheni umdlavuza wendlala yesinye iwukuba ama-antiandrogens esimanje - asebenza kanjani?
Sekuyiminyaka engaphezu kwengu-50 sazi ukuthi ukukhula komdlavuza wendlala yesinye kuncike ekubeni khona kwamahomoni wesilisa, ikakhulukazi i-testosterone. Ama-Androgen receptors kumaseli omdlavuza athatha ama-androgens futhi umdlavuza ukhula ngokushesha. Ukwelashwa kokuqala kusewukwehlisa amazinga akho e-testosterone. Nokho, ngokuhamba kwesikhathi, lo mphumela uyaphela, futhi amangqamuzana omdlavuza akhiqiza ama-androgens awo noma aqale ukuziphindaphinda ngokuzimela.
Nokho, kuvela ukuthi lapho-ke i-androgen receptor ingavinjelwa unomphela futhi ukukhula kwesimila kwehla futhi. Amaphilisi esimanje e-anti-androgen anomphumela onjalo, asebenza kahle kakhulu, ngoba cishe kuzo zonke izigaba zokwelashwa anganciphisa lesi sifo, andise impilo futhi abekezelelwe kahle kakhulu.
Yiziphi iziguli ezizozuza kakhulu ekwelashweni okusha kwama-hormone?
Ku-oncology, sizama ukuhlonza izimpawu zokubuyela emuva kwangaphambi kwesikhathi ukuze sikwazi ukumelana ngokuphumelelayo nokuthuthukiswa kwama-clones amelana ngokushesha ngangokunokwenzeka. Kumdlavuza wendlala yesinye welashwa ngokuhlinzwa noma ngokwelashwa ngemisebe, ukukhuphuka kwe-PSA kuba uphawu lwakuqala lokuphindela emuva. Uma i-PSA iqhubeka nokukhula naphezu kokuncipha kwe-testosterone, ikakhulukazi uma iphindwe kabili ezinyangeni ezingaphansi kwe-10, futhi asikaziboni ama-metastase ekuhlolweni kwe-imaging yokulawula (i-tomography ne-bone scintigraphy), ngokolwazi lwezokwelapha, sekuyisikhathi sokusebenzisa okusha. izidakamizwa ze-hormonal (apalutamide, darolutamide noma enzalutamide). Uma zinikezwa iziguli kulesi sigaba, zibambezela ukuqala kwe-metastasis cishe iminyaka emi-2 futhi zengeze cishe unyaka ekusindeni sekukonke.
Iyini inzuzo yokwelashwa okusha kwehomoni yomlomo ngaphezu kwe-chemotherapy?
Kunzima ukuqhathanisa i-chemotherapy efakwa emthanjeni nokwelashwa kwe-hormone yomlomo yesizukulwane esilandelayo. Kokubili ukwelashwa kuyazuzisa futhi kungcono kakhulu ukusizakala kokubili. Kunconywa ukuxoxa ngohlelo lokwelapha ne-oncologist, kokubili okwamanje kanye nekusasa. Endabeni yesifo esinezimpawu ezinolaka, i-chemotherapy ivame ukunikezwa njengokwelashwa kokuqala, kuyilapho isifo esincane esingenazimpawu, singaqala ngokwelashwa kwe-hormone.
Yiziphi izindlela okufanele isiguli sihlangabezane nazo ukuze zifanelekele izindlela ezintsha zokwelapha umdlavuza wendlala yesinye ePoland?
Ukwelashwa kwamahomoni esimanje kumdlavuza wendlala yesinye esigabeni sokumelana nokwehliswa kwe-testosterone kutholakala kuphela ezigulini ezihlangabezana nemibandela yokufaneleka yalezo ezibizwa ngezinhlelo zezidakamizwa. Kuze kube namuhla, lezi yizinkomba ezihlanganisa kuphela abantu abane-metastase eqinisekisiwe, silinde isikhathi lapho sizokwazi ukubambezela ukubonakala kwama-metastase usebenzisa le mithi.
Ukutholakala kwezindlela zokwelapha zesimanje kubukeka kanjani kwamanye amazwe e-European Union?
Emazweni amaningi e-EU, imishanguzo emisha yamahomoni iyatholakala ekuqaleni kokwelashwa kunasePoland.
Kungani ngokubona kwakho izindlela zokwelapha ezintsha zomdlavuza wendlala yesinye zingabuyiselwa futhi ingabe likhona ithuba loshintsho esikhathini esizayo esiseduze?
Angikwazi ukuthola impendulo yombuzo wokuqala, kanti kowesibili: Ngithemba kanjalo.