Mankhwala a Hormone vs. Osakhala a Hormone a Advanced Prostate Cancer

Zamkati

• Mankhwala a mahormone a khansa ya prostate yayikulu
• Kodi mankhwala othandizira mahomoni amagwira ntchito bwanji?
• Mankhwala ovomerezeka a mahomoni
• Zolinga zamankhwala
• Kodi mankhwala amaperekedwa motani?
• Wosankhidwa ndi ndani?
• Zotsatira zoyipa
• Mankhwala osagwiritsa ntchito mahomoni a khansa yapatsogolo ya prostate
• Ovomerezeka osakhala mahomoni
• Zolinga zamankhwala
• Wosankhidwa ndi ndani?
• Kodi chithandizo chimaperekedwa motani?
• Zotsatira zoyipa
• Mfundo yofunika

Khansa ya prostate ikafika pachimake ndipo maselo a khansa afalikira mbali zina za thupi, chithandizo ndikofunikira. Kuyembekezera mwachidwi sikulinso mwayi, ngati imeneyo ndi njira yodziwitsidwa ndi dokotala wanu.

Mwamwayi, amuna omwe ali ndi khansa ya prostate yapita tsopano ali ndi njira zambiri zothandizira kuchipatala kuposa kale. Izi zikuphatikiza zochiritsira za mahomoni komanso njira zomwe sizingachitike. Chithandizo chenicheni chomwe mungalandire chimadalira gawo lanu la khansa ya prostate ndi zovuta zilizonse zomwe muli nazo. Kumbukirani kuti chithandizo chanu chamankhwala chikhoza kukhala chosiyana kwambiri ndi cha wina.

Kuti musankhe chithandizo, muyenera kuganizira cholinga chonse cha mankhwalawo, zotsatira zake zoyipa, komanso ngati mungakhale woyenera kapena ayi. Kudziwitsidwa zamankhwala omwe alipo kungakuthandizeni inu ndi adokotala kusankha chithandizo, kapena kuphatikiza kwa mankhwala omwe angakuthandizeni.

Mankhwala a mahormone a khansa ya prostate yayikulu

Thandizo la mahormoni limadziwikanso kuti androgen androgensation therapy (ADT). Kawirikawiri amafotokozedwa kuti ndi njira yofunika kwambiri yothandizira khansa ya prostate.

Kodi mankhwala othandizira mahomoni amagwira ntchito bwanji?

Thandizo la mahomoni limagwira ntchito pochepetsa mahomoni (androgens) m'thupi. Androgens amaphatikizapo testosterone ndi dihydrotestosterone (DHT). Mahomoniwa amalimbikitsa khansa ya prostate kuti ichulukane. Popanda ma androgens, kukula kwa chotupa kumachedwetsedwa ndipo khansara imatha kukhululukidwa.

Mankhwala ovomerezeka a mahomoni

Pali mitundu ingapo yamankhwala yovomerezeka ya khansa ya prostate. Izi zikuphatikiza:

• Agnists a GnRH, monga leuprolide (Eligard, Lupron) ndi goserelin (Zoladex). Izi zimagwira ntchito pochepetsa kuchuluka kwa testosterone wopangidwa ndi machende.
• Anti-androgens, monga nilutamide (Nilandron) ndi enzalutamide (Xtandi). Izi nthawi zambiri zimawonjezeredwa kwa agonists a GnRH kuti ateteze testosterone kuti isaphatikize ku maselo otupa.
• Mtundu wina wa GnRH agonist wotchedwa degarelix (Firmagon), womwe umalepheretsa zikwangwani kuchokera muubongo kupita kuma testes kuti kupanga ma androgens kuyimitsidwe.
• Opaleshoni yochotsa machende (orchiectomy). Mwakutero, izi ziletsa kupanga mahomoni achimuna.
• Abiraterone (Zytiga), wotsutsana ndi LHRH yemwe amagwira ntchito poletsa enzyme yotchedwa CYP17 kuti aletse kupanga ma androgens ndi maselo mthupi.

Zolinga zamankhwala

Cholinga cha chithandizo cha mahomoni ndikhululukidwe. Kukhululukidwa kumatanthauza kuti zizindikilo zonse za khansa ya prostate zimatha. Anthu omwe apeza chikhululukiro "samachiritsidwa," koma amatha zaka zambiri osawonetsa khansa.

Mankhwala a mahomoni amathanso kugwiritsidwa ntchito pochepetsa chiopsezo chobwereranso pambuyo pa chithandizo choyambirira mwa amuna omwe ali pachiwopsezo chachikulu choti angabwererenso.

Kodi mankhwala amaperekedwa motani?

Agnist a GnRH amatha kubayidwa kapena kuyikidwa ngati tinthu tating'onoting'ono pakhungu. Anti-androgens amatengedwa ngati mapiritsi kamodzi patsiku. Degarelix amaperekedwa ngati jakisoni. Mankhwala a chemotherapy otchedwa docetaxel (Taxotere) nthawi zina amagwiritsidwa ntchito limodzi ndi mankhwalawa.

Zytiga amatengedwa pakamwa kamodzi patsiku kuphatikiza ndi steroid yotchedwa prednisone.

Kuchita opaleshoni kuchotsa machende kumatha kuchitidwa ngati kuchipatala. Muyenera kupita kunyumba patatha maola ochepa pambuyo pa orchiectomy.

Wosankhidwa ndi ndani?

Amuna ambiri omwe ali ndi khansa yayikulu ya prostate amafunafuna chithandizo chamankhwala. Kawirikawiri amaganiziridwa ngati khansara ya prostate yafalikira kupitirira prostate, ndipo opaleshoni yochotsa chotupacho sichitha.

Musanayambe kulandira chithandizo, muyenera kuyezetsa ntchito ya chiwindi pamodzi ndi kuyezetsa magazi kuti muwone kuti chiwindi chanu chitha kuwononga mankhwala moyenera.

Pakadali pano, enzalutamide (Xtandi) imangovomerezedwa kuti igwiritsidwe ntchito mwa amuna omwe ali ndi khansa ya prostate yomwe yafalikira kale mbali zina za thupi, komanso osayankhanso kuchipatala kapena kuchipatala kuti achepetse testosterone.

Nthawi zina, maselo a khansa ya prostate amatha kukana chithandizo cha mahomoni ndikuchulukirachulukira ngakhale kulibe mahomoni achimuna. Izi zimatchedwa khansa ya prostate yosagwira (kapena yotaya). Amuna omwe ali ndi khansa ya prostate yolimbana ndi mahomoni sali ofuna chithandizo chamankhwala ena.

Zotsatira zoyipa

Zotsatira zoyipa kwambiri zamankhwala othandizira mahomoni ndi monga:

• kutentha
• kupatulira, mafupa olimba (kufooka kwa mafupa) chifukwa kutsika kwa testosterone kumayambitsa kuchepa kwa calcium
• kunenepa
• kuchepa kwa minofu
• Kulephera kwa erectile
• kutaya kugonana

Mankhwala osagwiritsa ntchito mahomoni a khansa yapatsogolo ya prostate

Ngati chithandizo cha mahomoni sichikugwira ntchito kapena khansa yanu ikukula ndikufalikira mwachangu, chithandizo chamankhwala ena osagwiritsa ntchito ma hormone atha kulimbikitsidwa.

Ovomerezeka osakhala mahomoni

Mankhwala osagwiritsa ntchito mahomoni a khansa yapadera ya prostate ndi awa:

• Chemotherapy, monga docetaxel (Taxotere), cabazitaxel (Jevtana), ndi mitoxantrone (Novantrone). Chemotherapy nthawi zina amaperekedwa limodzi ndi steroid yotchedwa prednisone.
• Thandizo la radiation, lomwe limagwiritsa ntchito miyala yamphamvu kwambiri kapena mbewu za radioactive kuti ziwononge zotupa. Radiation imagwiritsidwa ntchito limodzi ndi chemotherapy.
• Immunotherapy, kuphatikiza sipuleucel-T (Kubwezera). Immunotherapy imagwira ntchito pogwiritsa ntchito chitetezo cha mthupi kupha ma cell a khansa.
• Radium Ra 223 (Xofigo), yomwe imakhala ndi radiation yochepa ndipo imagwiritsidwa ntchito kuwononga maselo a khansa ya prostate yomwe yafalikira mpaka fupa.

Zolinga zamankhwala

Cholinga cha chemotherapy, radiation, ndi mankhwala ena osagwiritsa ntchito mahomoni ndikuchepetsa kukula kwa khansa ndikuwonjezera moyo wamunthu. Chemotherapy ndi othandizira ena omwe si a mahomoni mwina sangathe kuchiza khansa, koma atha kutalikitsa kwambiri miyoyo ya amuna omwe ali ndi khansa ya prostate.

Wosankhidwa ndi ndani?

Mutha kukhala woyenera kulandira mankhwala osapatsa mahomoni monga chemotherapy kapena radiation ngati:

• magulu anu a PSA akukwera mofulumira kwambiri kuti mankhwala a mahomoni aziwongolera
• khansa yanu ikufalikira mwachangu
• zizindikiro zanu zikuipiraipira
• mankhwala a mahomoni amalephera kugwira ntchito
• khansayo yafalikira m'mafupa anu

Kodi chithandizo chimaperekedwa motani?

Chemotherapy nthawi zambiri imaperekedwa mozungulira. Kuzungulira kulikonse kumatha milungu ingapo. Mungafunike mankhwala angapo, koma nthawi zambiri pamakhala nthawi yopuma pakati. Ngati mtundu umodzi wa chemotherapy usiya kugwira ntchito, adokotala angakupatseni njira zina zamankhwala zamankhwala.

Sipuleucel-T (Provenge) imaperekedwa ngati ma infusions atatu mumtsempha, pafupifupi milungu iwiri pakati pa kulowetsedwa kulikonse.

Radium Ra 223 imaperekedwanso ngati jakisoni.

Zotsatira zoyipa

Zotsatira zoyipa za chemotherapy ndi monga:

• kutayika tsitsi
• nseru ndi kusanza
• kutsegula m'mimba
• kutopa
• kusowa chilakolako
• maselo oyera oyera (neutropenia) komanso chiopsezo chachikulu chotenga matenda
• kusintha kwa kukumbukira
• dzanzi kapena kumva kulasalasa m'manja ndi m'mapazi
• kuvulaza kosavuta
• zilonda mkamwa

Mankhwala a radiation amatha kuchepetsa kuchuluka kwama cell of red magazi ndikupangitsa kuchepa kwa magazi. Kuchepa kwa magazi kumayambitsa kutopa, chizungulire, kupweteka mutu, komanso zizindikilo zina. Chithandizo cha radiation chingayambitsenso kutayika kwa chikhodzodzo (kusadziletsa) ndi kuwonongeka kwa erectile.

Mfundo yofunika

Chithandizo cha mahomoni ndi maopaleshoni nthawi zambiri amalimbikitsidwa koyamba kuchiza khansa ya prostate. Zitha kugwiritsidwa ntchito limodzi ndi chemotherapy. Koma pakapita nthawi, khansa yambiri ya prostate imayamba kugonjetsedwa ndi mankhwala a mahomoni. Zosankha zosagwiritsa ntchito mahomoni zimakhala zabwino kwambiri kwa amuna omwe ali ndi khansa ya prostate yomwe siyiyankhanso mankhwala a mahomoni kapena chemotherapy.

Ngakhale atalandira chithandizo, si matenda onse a khansa ya prostate omwe angachiritsidwe, koma mankhwala amatha kuchepetsa kukula kwa khansa, kuchepetsa zizindikilo, ndikupangitsa kuti munthu akhale ndi moyo. Amuna ambiri amakhala ndi khansa ya prostate zaka zambiri.

Kupanga zisankho pazithandizo zitha kukhala zosokoneza komanso zovuta chifukwa pali zambiri zofunika kuziganizira. Kumbukirani kuti simuyenera kupanga chisankho muli nokha. Ndi chitsogozo cha oncologist wanu ndi gulu la zamankhwala, mutha kupanga chisankho chanzeru pa njira yabwino kwambiri yothandizira inu.