Mankhwala a mahomoni a khansa ya prostate

Mankhwala a mahomoni a khansa ya prostate amagwiritsa ntchito maopareshoni kapena mankhwala kuti achepetse kuchuluka kwa mahomoni ogonana amuna m'thupi la munthu. Izi zimathandiza kuchepetsa kukula kwa khansa ya prostate.

Androgens ndi mahomoni ogonana amuna. Testosterone ndi mtundu umodzi waukulu wa androgen. Testosterone yambiri imapangidwa ndi machende. Zilonda za adrenal zimatulutsanso zochepa.

Androgens amachititsa kuti maselo a kansa ya prostate akule. Thandizo la mahormone la khansa ya prostate limachepetsa mphamvu ya ma androgens m'thupi. Itha kuchita izi ndi:

• Kuletsa machende kuti asapangitse androgens pogwiritsa ntchito opaleshoni kapena mankhwala
• Kuletsa zochita za androgens m'thupi
• Kuletsa thupi kupanga ma androgens

Mankhwala a Hormone sagwiritsidwa ntchito konse kwa anthu omwe ali ndi khansa ya prostate ya Stage I kapena Stage II.

Amagwiritsidwa ntchito makamaka pa:

• Khansara yayikulu yomwe yafalikira kupitirira prostate gland
• Khansa yomwe yalephera kuyankha kuchitidwa opaleshoni kapena radiation
• Khansa yomwe yabwerezedwanso

Itha kugwiritsidwanso ntchito:

• Pamaso pa radiation kapena opaleshoni yothandiza kuchepetsa zotupa
• Pamodzi ndi mankhwala a radiation a khansa omwe amatha kubwereza

Chithandizo chofala kwambiri ndikumwa mankhwala omwe amachepetsa kuchuluka kwa ma androgens opangidwa ndi machende. Amatchedwa ma luteinizing mahomoni otulutsa mahomoni (LH-RH) (majakisoni) ndi anti-androgens (mapiritsi amlomo). Mankhwalawa amachepetsa mayendedwe a androgen monganso opaleshoni. Chithandizo chamtunduwu nthawi zina chimatchedwa "castration ya mankhwala."

Amuna omwe amalandila chithandizo chakusowa kwa androgen ayenera kukhala ndi mayeso otsatira ndi dokotala wopereka mankhwalawa:

• Pakadutsa miyezi 3 kapena 6 mutayamba mankhwalawa
• Kamodzi pachaka, kuwunika kuthamanga kwa magazi ndikuchita shuga m'magazi (glucose) ndi kuyesa kwa cholesterol
• Kuti mupeze mayeso a magazi a PSA kuti muwone momwe mankhwalawa akugwirira ntchito

Mafananidwe a LH-RH amaperekedwa ngati kuwombera kapena ngati chomera chaching'ono choyikidwa pansi pa khungu. Amapatsidwa kulikonse kuyambira kamodzi pamwezi mpaka kamodzi pachaka. Mankhwalawa ndi awa:

• Leuprolide (Lupron, Eligard)
• Goserelin (Zoladex)
• Nthambeleni Nwananga
• Mbiri (Vantas)

Mankhwala ena, degarelix (Firmagon), ndi wotsutsana ndi LH-RH. Amachepetsa mayendedwe a androgen mwachangu ndipo amakhala ndi zovuta zochepa. Amagwiritsidwa ntchito mwa amuna omwe ali ndi khansa yayikulu.

Madokotala ena amalimbikitsa kuyimitsa ndikuyambiranso chithandizo (mankhwala apakatikati). Njirayi ikuwoneka kuti ikuthandizira kuchepetsa zoyipa zamankhwala othandizira mahomoni. Komabe, sizikudziwika ngati mankhwala opatsiranawa amagwiranso ntchito ngati chithandizo chamankhwala mosalekeza. Kafukufuku wina akuwonetsa kuti mankhwala opitilira muyeso ndi othandiza kwambiri kapena kuti mankhwala apakatikati ayenera kugwiritsidwa ntchito posankha mitundu ina ya khansa ya Prostate.

Opaleshoni yochotsa machende (castration) imayimitsa kupanga ma androgen ambiri mthupi. Izi zimachepetsanso kapena kuyimitsa khansa ya prostate kuti isakule. Ngakhale zili zothandiza, amuna ambiri samasankha njirayi.

Mankhwala ena omwe amagwira ntchito poletsa zotsatira za androgen pama cell a khansa ya prostate. Amatchedwa anti-androgens. Mankhwalawa amatengedwa ngati mapiritsi. Amagwiritsidwa ntchito nthawi zambiri ngati mankhwala ochepetsa mayendedwe a androgen sagwiranso ntchito.

Anti-androgens ndi awa:

• Flutamide (Eulexin)
• Enzalutamide (Xtandi)
• Abiraterone (Zytiga)
• Bicalutamide (Casodex)
• Nilutamide (Nilandron)

Androgens amatha kupangidwa kumadera ena a thupi, monga adrenal glands. Maselo ena a khansa ya prostate amathanso kupanga androgens. Mankhwala atatu amathandizira kuletsa thupi kupanga ma androgens ochokera munyama kupatula machende.

Mankhwala awiri, ketoconazole (Nizoral) ndi aminoglutethimide (Cytradren), amachiza matenda ena koma nthawi zina amagwiritsidwa ntchito pochiza khansa ya prostate. Chachitatu, abiraterone (Zytiga) amachiza khansa ya prostate yomwe yafalikira m'malo ena m'thupi.

Popita nthawi, khansa ya prostate imayamba kugonjetsedwa ndi mankhwala a mahomoni. Izi zikutanthauza kuti khansa imangofunika ma androgen ochepa kuti akule. Izi zikachitika, mankhwala owonjezera kapena mankhwala ena amatha kuwonjezeredwa.

Androgens ali ndi zotsatira pathupi lonse. Chifukwa chake, mankhwala omwe amachepetsa mahomoniwa amatha kuyambitsa zovuta zosiyanasiyana. Mukamamwa mankhwalawa nthawi yayitali, mumakhala ndi zovuta zina.

Zikuphatikizapo:

• Vuto lokhala ndi erection komanso kusachita chidwi ndi kugonana
• Kutuluka machende ndi mbolo
• Kutentha kotentha
• Mafupa ofooka kapena osweka
• Minofu yaying'ono, yofooka
• Kusintha kwamafuta amwazi, monga cholesterol
• Kusintha kwa shuga m'magazi
• Kulemera
• Maganizo amasintha
• Kutopa
• Kukula kwa minofu ya m'mawere, kupweteka kwa m'mawere

Thandizo lothandizidwa ndi Androgen limatha kuwonjezera ngozi za matenda ashuga ndi matenda amtima.

Kusankha chithandizo chamankhwala cha khansa ya prostate kungakhale chisankho chovuta komanso chovuta. Mtundu wa chithandizo ungadalire:

• Chiwopsezo cha khansa kubwerera
• Khansa yanu yapita patsogolo bwanji
• Kaya mankhwala ena asiya kugwira ntchito
• Kaya khansa yafalikira

Kulankhula ndi omwe akukuthandizani pazomwe mungasankhe komanso maubwino ndi zoopsa za mankhwalawa zingakuthandizeni kupanga chisankho chabwino kwa inu.

Mankhwala a Androgen; ADT; Mankhwala a Androgen; Kuphatikizidwa ndi androgen blockade; Orchiectomy - khansa ya prostate; Castration - khansa ya prostate

• Kutengera kwamwamuna kubereka

Tsamba la American Cancer Society. Mankhwala a mahomoni a khansa ya prostate. www.cancer.org/cancer/prostate-cancer/treating/hormone-therapy.html. Idasinthidwa pa Disembala 18, 2019. Idapezeka pa Marichi 24, 2020.

Tsamba la National Cancer Institute. Mankhwala a mahomoni a khansa ya prostate. www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet. Idasinthidwa pa February 28, 2019. Idapezeka pa Disembala 17, 2019.

Tsamba la National Cancer Institute. Chithandizo cha khansa ya Prostate (PDQ) - mtundu wa akatswiri azaumoyo. www.cancer.gov/types/prostate/hp/prostate-kuchiza-pdq. Idasinthidwa pa Januware 29, 2020. Idapezeka pa Marichi 24, 2020.

Tsamba la National Comprehensive Cancer Network. Malangizo azachipatala a NCCN mu oncology (malangizo a NCCN): khansa ya prostate. Mtundu 1.2020. www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Idasinthidwa pa Marichi 16, 2020. Idapezeka pa Marichi 24, 2020.

Thandizo la Eggener S. Hormonal la khansa ya prostate. Mu: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, olemba. Urology wa Campbell-Walsh. Wolemba 12. Philadelphia, PA: Elsevier; 2021: chap 161.

• Khansa ya Prostate