Ngaba unokhetho lonyango olukhoyo olunomdlavuza webele?

Umxholo

• Unyango lweHormone
• Iziyobisi ekujoliswe kuzo
• Unyango ngamayeza
• Imitha
• Ugqirha
• Amayeza entlungu
• Unyango olongezelelekileyo
• Umgca wezantsi

Ukuba nefom ephambili yomhlaza unokuziva ngathi unokhetho oluncinci okanye awunalo kwaphela. Kodwa akunjalo. Fumanisa ukuba zeziphi iindlela onokukhetha kuzo, kwaye uqalise ukufumana uhlobo olululo lonyango.

Unyango lweHormone

Kukho iindlela ezininzi zonyango lwehomoni ukunyanga i-hormone receptor-positive (i-estrogen receptor-positive okanye i-progesterone receptor-positive) yomhlaza webele:

I-Tamoxifen yonyango lonyango lwemihla ngemihla kubafazi be-premenopausal.

I-Aromatase inhibitors yimithi yomlomo yabasetyhini be-postmenopausal. Ezi zinokudityaniswa neziyobisi ekujoliswe kuzo ezinje nge palbociclib (Ibrance) okanye i-everolimus (Afinitor). I-aromatase inhibitors ibandakanya:

• anastrozole (Arimidex)
• exemestane (Aromasin)
• ilerozole (Femara)

Iziphumo ebezingalindelekanga zonyango lwehomoni zinokubandakanya:

• kushushu kwaye kubila ebusuku
• ukoma kwilungu lobufazi
• ukwehlisa ukuqhuba ngesondo
• ukuhamba kweemvakalelo
• ukuphazamiseka kumjikelo wokuya esikhathini kwabasetyhini abangaphambi kwexesha
• ngamehlo
• umngcipheko okhulayo wamahlwili egazi, ukubetha kwentliziyo, kunye nokuhlaselwa sisifo sentliziyo
• ukonakala kwamathambo

Unyango lwehormonal alusebenzi kunyango lwehomoni yokwamkela umhlaza webele.

Iziyobisi ekujoliswe kuzo

Amachiza aliqela ajolise kumhlaza webele we-HER2-positive. Qaphela ukuba olu nyango alunyango olusebenzayo lomhlaza webele we-HER2-negative.

I-Trastuzumab (i-Herceptin) ilawulwa nge-intravenous kwaye ihlala imiselwe ngokudibeneyo ne-chemotherapy. Idosi yokuqala ihlala ithatha malunga nemizuzu engama-90. Emva koko, iidosi zincinci kwaye zithatha malunga nesiqingatha seyure. Phakathi kweziphumo ebezingalindelekanga ezinokubakho zezi:

• ukumnika ukumnika
• ifiva
• isicaphucaphu nokugabha
• urhudo
• usulelo
• intloko ebuhlungu
• ukudinwa
• irhashalala

IPertuzumab (iPerjeta) ikwalawulwa ngaphakathi. Idosi yokuqala ithatha malunga neyure. Inokuphindwa qho kwiiveki ezintathu kwiidosi ezincinci. Ihlala isetyenziswa ngokudibana ne-chemotherapy. Iziphumo ezivela kwi-pertuzumab kunye ne-chemotherapy inokubandakanya:

• isicaphucaphu
• urhudo
• ukulahleka kweenwele
• ukudinwa
• irhashalala
• ukuphazamiseka kunye nokubetha (i-peripheral neuropathy)

Elinye iyeza elithatyathwe ngaphakathi, ado-trastuzumab emtansine (Kadcyla) ilawulwa rhoqo emva kweentsuku ezingama-21. Phakathi kweziphumo ebezingalindelekanga ezinokubakho zezi:

• ukumnika ukumnika
• ukudinwa
• isicaphucaphu
• intloko ebuhlungu kunye neentlungu musculoskeletal
• ukuqhina
• ukuphuma kwempumlo nokopha

I-Lapatinib (iTykerb) lunyango lomlomo. Ingasetyenziselwa yedwa okanye idibaniswe ne-chemotherapy okanye ezinye iziyobisi ezijoliswe kuzo. Kuxhomekeke ekubeni ngawaphi amayeza adityaniswe nawo, i-lapatinib inokubangela:

• urhudo
• isicaphucaphu nokugabha
• irhashalala
• ukudinwa

Ezi zonyango zijolise kulandelayo zisetyenziselwa ukunyanga i-hormone receptor-positive / HER2-negative-cancer cancer:

I-Palbociclib (Ibrance) lunyango olusetyenziswa nge-aromatase inhibitor. Iziphumo ezinokubandakanya:

• isicaphucaphu
• izilonda zomlomo
• ukulahleka kweenwele
• ukudinwa
• urhudo
• ukwanda kwengozi yosulelo

Ichiza lomlomo i-everolimus (Afinitor) lithathwa ngomlomo kwaye lisetyenziswa ngokudibanisa ne-exemestane (Aromasin). Ngokuqhelekileyo ayisetyenziswanga de kube emva kokuba i-letrozole okanye i-anastrozole izame. Iziphumo ezinokubakho zibandakanya:

• ukuqhawukelwa ngumphefumlo
• ukukhohlela
• ubuthathaka
• ukwanda komngcipheko wosulelo, lipids ephezulu yegazi, kunye neswekile ephezulu yegazi

Unyango ngamayeza

I-Chemotherapy ingasetyenziselwa naluphi na uhlobo lomhlaza webele. Uninzi lwexesha, oku kuya kubandakanya indibaniselwano yamayeza e-chemotherapy aliqela.

Akukho lonyango lwe-hormonal okanye ekujoliswe kulo lomhlaza webele onazo zombini i-hormone receptor-negative kunye ne-HER2-negative (ekwabizwa ngokuba ngumhlaza webele ophindwe kathathu, okanye i-TNBC). I-Chemotherapy yonyango lodidi lokuqala kwezi meko.

I-Chemotherapy yinkqubo yonyango. Inokufikelela kwaye itshabalalise iiseli zomhlaza naphina emzimbeni wakho. Ngaphantsi kweemeko ezithile, amayeza e-chemotherapy anokuhanjiswa ngqo kwindawo ethile ye-metastasis, efana nesibindi sakho okanye ulwelo olujikeleze ingqondo yakho.

Amachiza afakwa ngaphakathi. Iseshoni nganye yonyango inokuhlala iiyure ezininzi. Inikwa rhoqo rhoqo ukuya kuthi ga kwiiveki ezininzi. Oku kukuvumela umzimba wakho ukuba uphinde kwakhona phakathi konyango.

Amachiza e-Chemotherapy ayasebenza kuba abulala iiseli zomhlaza ezikhula ngokukhawuleza. Ngelishwa, banokubulala ezinye iiseli ezinempilo ezikhula ngokukhawuleza. Oko kunokubangela uninzi lweziphumo ebezingalindelekanga, kubandakanya:

• isicaphucaphu nokugabha
• ukulahleka kweenwele
• Ukuphelelwa ngumdla wokutya
• ukuqhina okanye urhudo
• ukudinwa
• utshintsho kolusu nezikhonkwane
• izilonda zomlomo kunye neentsini ezophayo
• utshintsho lweemvakalelo
• ukwehla kobunzima
• ukulahleka kwesondo
• Iingxaki zokuchuma

Imitha

Kwezinye iimeko, unyango lwe-radiation lunokunceda kunyango lomhlaza webele ophambili. Eminye imizekelo yile:

• Ukujolisa kwimastastasis kwindawo ethile, enje ngengqondo yakho okanye umnqonqo
• ukunceda ukuthintela ukwaphuka kumathambo abuthathaka
• ekujoliseni ithumba elibangela inxeba elivulekileyo
• Ukunyanga ukuvaleka kwemithambo yegazi kwisibindi sakho
• ukubonelela ngeentlungu

Unyango ngemitha alunantlungu. Kodwa kunokubangela ukucaphuka kwesikhumba kunye nokudinwa kwexesha elide. Ihlala ilawulwa yonke imihla ukuya kuthi ga kwiiveki ezisixhenxe, ke ngoko kukho ukuzibophelela kwexesha lemihla ngemihla.

Ugqirha

Ugqirha lunokuba yinxalenye yonyango lomhlaza wamabele wakho ngezizathu ezimbalwa. Omnye umzekelo ngotyando lokususa ithumba elicinezela kwingqondo yakho okanye kwintambo yomqolo.

Utyando lunokusetyenziswa ngokudibeneyo nonyango lwemitha.

Amayeza entlungu

Zininzi iziyobisi ezinokusetyenziselwa ukunyanga iintlungu ezinxulunyaniswa nomhlaza webele oqhubele phambili.

Ungaqala ngokuphelisa iintlungu ekhawuntareni. Phakathi kwazo kukho:

• i-acetaminophen (iTylenol)
• ibuprofen (Advil, Motrin)
• I-naproxen (Aleve, uNaprosyn)

Thetha nogqirha wakho ngaphambi kokusebenzisa amayeza e-counter. Abanye banokuphazamisa ezinye iindlela zonyango.

Ngeentlungu ezibi kakhulu, ugqirha wakho unokumisela i-opioid yomlomo enje:

• I-morphine (i-MS iyaqhubeka)
• iioxycodone (Roxicodone)
• i-hydromorphone (iDilaudid)
• Iifentanyl (iDuragesic)
• imethadone (iDolophine)
• Ifowuni (iOpana)
• ibuprenorphine (iBuprenex)

Iziphumo ebezingalindelekanga zinokubandakanya ukozela, ukuqhina, kunye nesicanucanu. La mayeza anamandla kufuneka athathwe ngokuchanekileyo njengoko kuyalelwe.

Ezi zihlala zisetyenziselwa iintlungu ngenxa yeethambo le-metastasis:

• i-bisphosphonates: i-zoledronic acid (iZometa) okanye i-pamidronate (iAredia), inikezwe ngaphakathi
• RANK ligand inhibitor: denosumab (Xgeva okanye Prolia), enikezwe ngenaliti

La machiza anokunceda ukunciphisa umngcipheko wokuqhekeka kwethambo. Intlungu yemisipha kunye nethambo ziziphumo ebezingalindelekanga ezinokubakho.

Ezinye iintlobo zamayeza entlungu yomhlaza webele ophambili zezi:

• iziyobisi
• ii-anticonvulsants
• ii-steroids
• iintlungu zalapha ekhaya

Abanye abantu banengxaki yokuginya iipilisi. Kwimeko apho, amayeza athile entlungu ayafumaneka kulwelo okanye kwifom yokufaka isikhumba. Ezinye zinokulawulwa ngokufakwa ngaphakathi okanye ngezibuko lechemotherapy okanye i-catheter.

Unyango olongezelelekileyo

Olunye unyango olongezelelekileyo olunokukunceda ukulawula iintlungu zezi:

• ukutshiza
• ubushushu kunye nonyango olubandayo
• unyango lokuthambisa
• umthambo okanye unyango lomzimba
• iindlela zokuphumla ezinje ngokucamngca kunye nemifanekiso ekhokelwayo

Umgca wezantsi

Unyango lomhlaza webele osele uhambile luya kulungelelaniswa neemfuno zakho kunye nemeko yesifo sakho. Kuya kubandakanya unyango oluninzi ngaxeshanye. Kuya kufuneka iguquke, itshintshe njengoko iimfuno zakho zitshintsha.

Ugqirha wakho uya kujonga impilo kunye neempawu zakho. Akunyanzelekanga ukuba uqhubeke nonyango olungasebenziyo.

Unxibelelwano olulungileyo nogqirha wakho lubalulekile ekufezekiseni owona mgangatho wobomi.