IHormone Therapies ezingezizo iHormone zoPhuculo lweProstate Cancer

Umxholo

• Unyango lwehomoni kunyango oluphezulu lweprotate
• Isebenza njani unyango lwehomoni?
• Ulwamkelo lonyango lwehomoni
• Iinjongo zonyango
• Zilawulwa njani unyango?
• Ngubani umgqatswa?
• Iziphumo eziqhelekileyo
• Unyango lwe-non-hormone kunyango lomhlaza webele
• Kuvunyiwe unyango olungelulo ihomoni
• Iinjongo zonyango
• Ngubani umgqatswa?
• Zilawulwa njani unyango?
• Iziphumo eziqhelekileyo
• Umgca wezantsi

Ukuba umhlaza wedlala lobudoda ufikelele kwinqanaba eliphezulu kwaye iiseli zomhlaza zisasazekile kwamanye amalungu omzimba, unyango luyimfuneko. Ukulinda ngokubukela akusekho khetho, ukuba leyo yayiyinkqubo enolwazi kunye nogqirha wakho.

Ngethamsanqa, amadoda anomhlaza wesifo se-Prostate ngoku sele ekhetha unyango ngakumbi kunangaphambili. Oku kubandakanya zombini iindlela zonyango zehomoni kunye nokhetho olungenahomoni. Unyango oluchanekileyo oya kulifumana luxhomekeke kwinqanaba lakho lomhlaza webele kunye naziphi na iimeko onazo. Khumbula ukuba amava akho onyango ahluke kakhulu kowomnye umntu.

Ukuthatha isigqibo ngonyango, kuyakufuneka uqwalasele eyona njongo iphambili yonyango, iziphumo zalo ebezingalindelekanga, nokuba ungangumgqatswa olungileyo okanye hayi. Ukwaziswa ngonyango olufumanekayo kunokukunceda wena nogqirha wakho uthathe isigqibo sokuba loluphi unyango, okanye indibaniselwano yonyango olulungele wena.

Unyango lwehomoni kunyango oluphezulu lweprotate

Unyango lweHormone lukwabizwa ngokuba lunyango lwe-androgen lokunyanga (ADT). Ihlala ichazwa njengeyona ndawo iphambili kunyango lwe-metastatic cancer.

Isebenza njani unyango lwehomoni?

Unyango lweHormone lusebenza ngokunciphisa amanqanaba ehomoni (androgens) emzimbeni. I-Androgens ibandakanya i-testosterone kunye ne-dihydrotestosterone (DHT). Ezi hormone zikhuthaza umdlavuza wesibeletho ukuba wande. Ngaphandle kwe-androgens, ukukhula kwethumba kuyacotha kwaye umhlaza usenokuya uxolelo.

Ulwamkelo lonyango lwehomoni

Kukho unyango lwehomoni oluvunyiweyo lomhlaza webele. Oku kubandakanya:

• I-GnRH agonists, ezinje ngeleuprolide (Eligard, Lupron) kunye negoserelin (Zoladex). Oku kusebenza ngokunciphisa isixa se testosterone esenziwe ngamatyhalarha.
• I-anti-androgens, enje nge-nilutamide (Nilandron) kunye ne-enzalutamide (Xtandi). Ezi zihlala zongezwa kwi-GnRH agonists ukunceda ukuthintela i-testosterone ekuncamathiseleni iiseli zethumba.
• Olunye uhlobo lwe-GnRH agonist ebizwa ngokuba yi-degarelix (Firmagon), ethintela imiqondiso esuka kwingqondo iye kwiimvavanyo ukuze kumiswe ukuveliswa kwe-androgens.
• Utyando lokususa amasende (orchiectomy). Ngokwenyani, oku kuyakuyekisa ukuveliswa kwehomoni zesilisa.
• Abiraterone (Zytiga), umchasi we-LHRH osebenza ngokuthintela i-enzyme ebizwa ngokuba yi-CYP17 ukumisa ukuveliswa kwe-androgens ziiseli emzimbeni.

Iinjongo zonyango

Injongo yonyango lwehomoni luxolelo. Ukuxolelwa kuthetha ukuba zonke iimpawu kunye neempawu zomhlaza wedlala lobudoda ziyahamba. Abantu abaphumeleleyo ukuxolelwa "abanyangeki," kodwa banokuhamba iminyaka emininzi ngaphandle kokubonisa iimpawu zomhlaza.

Unyango lweHormone lunokusetyenziselwa ukunciphisa umngcipheko wokuphindaphinda emva konyango lokuqala kumadoda asemngciphekweni omkhulu wokuphindeka.

Zilawulwa njani unyango?

I-GnRH agonists inokuthi itofwe okanye ibekwe njengezinto ezincinci zokufaka phantsi kolusu. I-anti-androgens ithathwa njengepilisi kanye ngemini. UDegarelix unikezwe ngenaliti. Iyeza le-chemotherapy elibizwa ngokuba yi-docetaxel (Taxotere) ngamanye amaxesha lisetyenziswa ngokudibeneyo nonyango lwehomoni.

I-Zytiga ithathwa ngomlomo kanye ngemini ngokudibanisa ne-steroid ebizwa ngokuba yi-prednisone.

Utyando lokususa amasende lunokwenziwa njengenkqubo yokugula. Kuya kufuneka uye ekhaya kwiiyure ezimbalwa emva kwe-orchiectomy.

Ngubani umgqatswa?

Uninzi lwamadoda anomhlaza womhlaza wedlala lobudoda ngabagqatswa kunyango lwehomoni. Ihlala iqwalaselwa xa umhlaza wedlala lobudoda usasazeke ngaphaya kweprotrate, kwaye utyando lokususa ithumba alusenakwenzeka.

Ngaphambi kokuqala unyango, kuya kufuneka ukuba ube novavanyo lomsebenzi wesibindi kunye novavanyo lwegazi ukuze uqiniseke ukuba isibindi sakho singawaphula ngokufanelekileyo amayeza.

Okwangoku, i-enzalutamide (Xtandi) yamkelwe kuphela ukuba isetyenziswe kumadoda anomhlaza wesibeletho osele usasazekile kwamanye amalungu omzimba, kwaye ongasaphenduliyo kunyango okanye kunyango olwenziwayo ukuthoba amanqanaba e testosterone.

Ngamanye amaxesha, iiseli zomhlaza wedlala lobudoda zinokuxhathisa unyango lwehomoni kwaye ziphindaphindeke nokuba kungabikho iihomoni zesilisa. Oku kubizwa ngokuba ngumhlaza onganyangekiyo ngokwencindi yedlala. Amadoda anomhlaza wedlala lobundlobongela onganyangekiyo ayilonyulo kunyango lwehomoni.

Iziphumo eziqhelekileyo

Iziphumo eziqhelekileyo ezichaphazelekayo zonyango lwe-hormone ziquka:

• kushushu
• ukuncipha, amathambo aqhekezayo (i-osteoporosis) kuba amanqanaba asezantsi e-testosterone abangela ilahleko ye-calcium
• ukutyeba kwakho
• ukulahleka kobunzima bemisipha
• Ukungasebenzi kakuhle kwe-erectile
• ukulahleka kwesondo

Unyango lwe-non-hormone kunyango lomhlaza webele

Ukuba unyango lwehomoni alusebenzi okanye umhlaza wakho uyakhula kwaye usasazeka ngokukhawuleza, unyango kunye nezinye iindlela ezingezizo iihomoni kunokucetyiswa.

Kuvunyiwe unyango olungelulo ihomoni

Unyango olungenayo i-hormone yomhlaza wesifo esibuhlungu lubandakanya:

• I-Chemotherapy, efana ne-docetaxel (i-Taxotere), i-cabazitaxel (i-Jevtana), kunye ne-mitoxantrone (i-Novantrone). I-Chemotherapy ngamanye amaxesha inikwa ngokudibanisa ne-steroid eyaziwa ngokuba yi-prednisone.
• Unyango lwe-radiation, olusebenzisa imitha ye-eneji ephezulu okanye imbewu ye-radioactive ukutshabalalisa amathumba. Imitha isetyenziswa ngokudibeneyo ne-chemotherapy.
• I-Immunotherapy, kubandakanya i-sipuleucel-T (Ukuziphindezela). I-Immunotherapy isebenza ngokusebenzisa amajoni omzimba omzimba wakho ukubulala iiseli zomhlaza.
• I-Radium Ra 223 (Xofigo), equlathe inani elincinci lemitha kwaye isetyenziselwa ukutshabalalisa iiseli zomhlaza wedlala lobuchwephesha ethe yanwenwela kwithambo.

Iinjongo zonyango

Injongo ye-chemotherapy, i-radiation, kunye nezinye iindlela zonyango ezingenayo i-hormone kukunciphisa ukukhula komhlaza kunye nokwandisa ubomi bomntu. I-Chemotherapy kunye nezinye ii-arhente ezingezizo iihomoni mhlawumbi ngekhe zikwazi ukuwunyanga umhlaza, kodwa zinokubunyusa ngokubonakalayo ubomi bamadoda anomhlaza wesifo seprostate.

Ngubani umgqatswa?

Unokuba ngumgqatswa kunyango olungelulo olwehomoni olunje ngekhemotherapy okanye ngemitha ukuba:

• amanqanaba akho e-PSA anyuka ngokukhawuleza kakhulu kunyango lwehomoni ukuyilawula
• umhlaza wakho usasazeka ngokukhawuleza
• iimpawu zakho ziya ziba mandundu
• Unyango lwehomoni alusebenzi
• umhlaza unwenwele emathanjeni akho

Zilawulwa njani unyango?

I-Chemotherapy ihlala inikwa kwimijikelo. Umjikelo ngamnye uhlala iiveki ezimbalwa. Unokufuna unyango oluninzi, kodwa kuhlala kukho ixesha lokuphumla phakathi. Ukuba olunye uhlobo lwe-chemotherapy luyeka ukusebenza, ugqirha wakho unokucebisa ezinye iindlela zekhemotherapy.

I-Sipuleucel-T (iProvenge) inikwa njenge-infusions ezintathu kwi-vein, malunga neeveki ezimbini phakathi kokufakwa ngaphakathi.

I-Radium Ra 223 nayo inikwe isitofu.

Iziphumo eziqhelekileyo

Iziphumo eziqhelekileyo zechemotherapy zibandakanya:

• ukulahleka kweenwele
• isicaphucaphu nokugabha
• urhudo
• ukudinwa
• Ukuphelelwa ngumdla wokutya
• iiseli zegazi ezimhlophe ezisezantsi (neutropenia) kunye nomngcipheko ophezulu wosulelo
• utshintsho kwimemori
• ukuba ndindisholo okanye ukubetha ezandleni nasezinyaweni
• ukutyunyuzwa ngokulula
• izilonda zomlomo

Unyango ngemitha lunokunciphisa inani elibomvu leeseli zegazi kwaye lubangele i-anemia. I-anemia ibangela ukudinwa, isiyezi, intloko ebuhlungu kunye nezinye iimpawu. Unyango ngemitha lunokukhokelela ekuphulukaneni nolawulo lwesinyi (ukungakwazi ukuzibamba) kunye nokungasebenzi kakuhle kwe-erectile.

Umgca wezantsi

Unyango lwehormone kunye notyando luyacetyiswa kuqala ukunyanga umhlaza wesibeletho. Zingasetyenziselwa ngokubambisana ne-chemotherapy. Kodwa emva kwexesha elithile, uninzi lwee-cancer zomhlaza zinganyangeki kunyango lwehomoni. Izinketho ezingezizo iihomoni ziba lolona khetho lufanelekileyo kumadoda anomhlaza wesifo seprostate ongasaphenduliyo kunyango lwehomoni okanye kwichemotherapy.

Nokuba kunyango, ayizokuphiliswa zonke iimeko zomhlaza wedlala lobudoda, kodwa unyango lunokunciphisa ukukhula komhlaza, linciphise iimpawu kunye nokuphucula ukusinda. Amadoda amaninzi aphila iminyaka enesifo somhlaza.

Ukwenza izigqibo malunga nonyango kunokudida kwaye kube ngumngeni kuba kuninzi ekufuneka kuthathelwe ingqalelo. Khumbula ukuba awudingi ukwenza isigqibo uwedwa. Ngesikhokelo esivela kwi-oncologist yakho kunye neqela lokhathalelo lwempilo, unokwenza isigqibo esifanelekileyo kwisicwangciso sonyango esifanelekileyo kuwe.