Ni iki kivugwa na Hormone Therapy ku kanseri y'ibere? Intego, Ubwoko & Ibivamo

Hormone therapy ku kanseri y'ibere ni uburyo bwo kuvura buhagarika cyangwa bugabanya imisemburo ya estrogen na progesterone itera ubwoko bumwe bwa kanseri y'ibere. Bitekereze nk'uguca amavuta atuma izo kanseri zikura. Ubu buryo bwihariye bushobora kugabanya cyane ibyago byo gusubira kwa kanseri no gufasha kugabanya ibibyimba bisanzweho ku barwayi benshi.

Ni iki kivugwa na hormone therapy ku kanseri y'ibere?

Hormone therapy ikora mu guhagarika cyangwa kugabanya imisemburo ku turemangingo twa kanseri cyangwa kugabanya umubare w'imisemburo umubiri wawe ukora. Hafi 70% bya kanseri y'ibere ni hormone receptor-positive, bivuze ko bakoresha estrogen cyangwa progesterone kugirango bakure no kwiyongera.

Ubu buvuzi butandukanye rwose na hormone replacement therapy abagore bamwe bakoresha kubera ibimenyetso bya menopause. Aho kongera imisemburo, hormone therapy ya kanseri ikuraho cyangwa ikayihagarika kugirango izahaze uturemangingo twa kanseri ibyo dukeneye kugirango tubashe kubaho.

Ubu buvuzi buza mu buryo bw'ibinini ufata buri munsi cyangwa inshinge buri kwezi, bitewe n'ubwoko bw'umuganga wawe agushyiriraho. Abantu benshi bakomeza ubu buvuzi imyaka 5 kugeza kuri 10 kugirango babone uburinzi bwiza ku gusubira kwa kanseri.

Kuki hormone therapy ikorwa ku kanseri y'ibere?

Umuganga wawe agushyiriraho hormone therapy kugirango yirinde uturemangingo twa kanseri kubona imisemburo dukeneye kugirango dukure. Ni nko gukuraho urufunguzo rutuma kanseri ifungura no kwiyongera mu mubiri wawe.

Intego nyamukuru zirimo kugabanya ibyago bya kanseri isubira nyuma yo kubagwa, kugabanya ibibyimba mbere yo kubagwa kugirango bikurwe byoroshye, no gutinda gukura kwa kanseri niba yarakwiriye mu bindi bice by'umubiri wawe.

Ubu buvuzi bukora gusa kuri kanseri y'ibere ya hormone receptor-positive. Raporo yawe ya pathology nyuma ya biopsy cyangwa kubagwa izerekana niba kanseri yawe ifite estrogen receptors (ER-positive) cyangwa progesterone receptors (PR-positive).

Ni iki kivugwa na procedure ya hormone therapy?

Uburyo bwinshi bwo kuvura hakoreshejwe imisemburo busaba gufata ibinini buri munsi uri mu rugo, bigatuma biba byoroshye cyane kurusha imiti ivura kanseri isaba kujya kwa muganga. Muganga wawe azagena umuti wihariye ukora neza ku miterere yawe.

Ku bagore batarageza igihe cyo gucura, ubuvuzi akenshi butangirira ku nshinge ziterwa buri kwezi kugira ngo zibuze intanga z'abagore gukora imisemburo ya estrogen, byongeranywa n'ibinini bya buri munsi. Abagore bamaze gucura akenshi bafata ibinini bya buri munsi bibuza imisemburo ya estrogen gukorwa mu tundi duce tw'umubiri.

Itsinda ryawe ry'abaganga rizakugenzura buri gihe hakoreshejwe ibizamini by'amaraso n'ibizamini byo kwa muganga kugira ngo barebe niba ubuvuzi bukora neza kandi bagenzure ingaruka zose zishobora kubaho. Izo gahunda zikunda kuba buri mezi 3 kugeza kuri 6 mu gihe uvurwa.

Ni gute witegura ubuvuzi bwawe hakoreshejwe imisemburo?

Kwitegura ubuvuzi hakoreshejwe imisemburo bitangirira ku gusobanukirwa ibyo witeze no gushaka ubufasha mu itsinda ryawe ry'ubuvuzi. Muganga wawe azasuzuma amateka yawe y'ubuvuzi n'imiti ukoresha ubu kugira ngo birinde ubufatanye ubwo aribwo bwose buteye akaga.

Uzakeneye ibizamini by'ibanze birimo ibipimo by'ubucucye bw'amagufa, urugero rwa cholesterol, n'ibizamini by'imikorere y'umwijima mbere yo gutangira kuvurwa. Ibi bifasha muganga wawe kumenya uko ubuvuzi bugira ingaruka ku mubiri wawe uko igihe kigenda.

Tekereza ku kuganira ku buryo bwo gukemura ibibazo biterwa n'imiti n'itsinda ryawe ry'ubuvuzi mbere yo gutangira. Kugira gahunda y'ibibazo bisanzwe nk'ubushyuhe bwinshi, kuribwa mu ngingo, cyangwa impinduka z'amarangamutima bishobora kugufasha kumva witeguye kandi ufite icyizere ku rugendo rwawe rw'ubuvuzi.

Ni gute usoma ibisubizo byawe by'ubuvuzi hakoreshejwe imisemburo?

Muganga wawe akurikirana intsinzi y'ubuvuzi hakoreshejwe imisemburo hakoreshejwe ibizamini by'amashusho buri gihe, ibizamini by'amaraso, n'ibizamini by'umubiri aho gukoresha igisubizo kimwe cy'ikizamini. Intego ni ukubona ibibyimba bihamye cyangwa bigabanuka niba ufite kanseri ikora, cyangwa gusa kuguma utarwaye kanseri niba uri mu buryo bwo kuyirinda.

Ibizamini by'amaraso bikurikirana urwego rw'imisemburo yawe kugira ngo barebe niba imiti ikora neza mu guhagarika estrogen na progesterone. Muganga wawe azareba kandi imikorere y'umwijima kuko iyi miti itunganyirizwa mu mwijima wawe.

Ibizamini by'ubucucike bw'amagufa birahinduka iby'ingenzi kuko imiti y'imisemburo ishobora guca intege amagufa uko igihe kigenda. Muganga wawe ashobora kugusaba ibiyobyabwenge bya kalisiyumu na vitamine D cyangwa imiti ikomeza amagufa niba bibaye ngombwa.

Ni gute wakwirinda ingaruka ziterwa n'imiti y'imisemburo?

Gukwirinda ingaruka zirimo gukorana bya hafi n'ikipe yawe y'ubuvuzi kugira ngo ubone ibisubizo bigufasha kumva umeze neza mu gihe ukomeza kuvurwa kanseri yawe y'ingenzi. Ingaruka nyinshi zishobora gucungwa neza hakoreshejwe uburyo bukwiye.

Ingaruka zisanzwe n'uburyo bwo kuzicunga zirimo:

• Gushyuha cyane: Kwambara imyenda myinshi, gukoresha abafana bakonjesha, kugerageza uburyo bwo kuruhuka, cyangwa kubaza ku miti ishobora gufasha
• Urubavu rw'amagufa n'ubugororokere: Imyitozo ngororamubiri ya buri gihe, kuvurwa mu buryo bw'umubiri, kwiyuhagira amazi ashyushye, cyangwa imiti irwanya umuvumo
• Impinduka z'amarangamutima: Inama, amatsinda ashyigikiye, uburyo bwo gucunga umunaniro, cyangwa imiti irwanya depression niba bibaye ngombwa
• Umunaniro: Gushyira ibikorwa ku murongo, gahunda yo gusinzira ya buri gihe, imyitozo ngororamubiri yoroheje, n'uburyo bwo kubungabunga imbaraga
• Ubwumvikane bw'igitsina gore: Ibintu bituma umubiri woroha, ibintu byisiga, cyangwa imiti muganga wawe ashobora kugusaba

Ntuzigere uhagarika imiti yawe y'imisemburo utabanje kuvugana na muganga wawe, kabone niyo ingaruka zigaragara nk'izigoye. Ikipe yawe y'ubuvuzi isanzwe ishobora guhindura imiti yawe cyangwa kongeraho imiti ishyigikira kugira ngo igufashe kumva umeze neza.

Ni ubuhe buryo bwiza bwo gukoresha imiti y'imisemburo?

Imiti y'imisemburo myiza iterwa niba waranyuze muri menopause, imiterere yihariye ya kanseri yawe, n'ubuzima bwawe muri rusange. Nta buryo bumwe bukoreshwa kuri bose kuko buri muntu afite uko ateye.

Abagore batarageza igihe cyo gucura akenshi bungukirwa no guhagarika imikorere y'intanga ngore hamwe n'imiti nka tamoxifen cyangwa aromatase inhibitors. Abagore bacuze akenshi babaho neza bakoresheje aromatase inhibitors gusa, nubwo bamwe bashobora gukoresha tamoxifen.

Umuvuzi wawe w'indwara z'umwijima azirikana ibintu nk'icyiciro cy'indwara yawe y'umwijima, izindi ndwara ufite, amateka y'umuryango, n'ibyo wifuza ku giti cyawe mugihe akora gahunda yo kukuvura. Ubuvuzi "bwiza" ni bwo buvura neza indwara yawe y'umwijima mugihe bugumana ubuzima bwawe bwiza.

Ni ibihe bintu byongera ibyago byo gukenera imiti ya hormone?

Ushobora gukenera imiti ya hormone niba indwara yawe y'umwijima yerekana ko ifite hormone receptors, hatitawe ku bindi bintu. Ibi bigaragara mu byago bigera kuri 70% by'indwara zose z'umwijima.

Ibintu bitandukanye bigira uruhare muri gahunda yo kukuvura n'igihe izamara:

• Icyiciro cy'indwara y'umwijima n'ubunini bwayo igihe ivumbuwe
• Niba indwara y'umwijima yarageze mu nsinga z'amazi
• Imyaka yawe n'uko wamaze gucura
• Amateka y'umuryango y'indwara y'umwijima cyangwa y'intanga ngore
• Gukoresha imiti ya hormone mbere
• Izindi ndwara nka osteoporosis cyangwa indwara z'umutima

Abagore bafite indwara z'umwijima zifite ibyago byinshi akenshi bakomeza imiti ya hormone igihe kirekire, rimwe na rimwe imyaka 10. Muganga wawe azajya asuzuma buri gihe niba gukomeza ubuvuzi bitanga inyungu nyinshi kurusha ibyago.

Ese biruta kugira indwara y'umwijima ifite hormone cyangwa idafite hormone?

Indwara y'umwijima ifite hormone akenshi igira ibisubizo byiza by'igihe kirekire kuko yitabira neza ubuvuzi bwa hormone. Kugira uburyo bwo kuvura burahari bitanga wowe na muganga wawe uburyo bwinshi bwo kurwanya indwara y'umwijima neza.

Indwara zifite hormone zikunda gukura buhoro kurusha izitazifite, bishobora kuvuga igihe kinini cyo kuzivumbura no kuzivura neza. Imibare yo kubaho imyaka 5 akenshi iba hejuru ku ndwara z'umwijima zifite hormone.

Ariko, kanseri zitagaragaza imisemburo akenshi zivurwa neza na shimiotherapi kandi zishobora gukurwaho burundu n'ubuvuzi. Zombi zishobora kuvurwa neza iyo zamenyekanye hakiri kare, bityo wibande ku gukurikiza gahunda yo kuvurwa yategetswe na muganga wawe aho guhangayika ku bwoko ufite.

Ni izihe ngaruka zishobora guterwa n'imiti y'imisemburo?

Abantu benshi bakira neza imiti y'imisemburo, ariko nk'imiti yose, ishobora gutera ingaruka ziva ku zoroshye kugeza ku zikomeye. Kubisobanukirwa bifasha kumenya icyo ugomba kwitaho n'igihe ugomba kuvugana na muganga wawe.

Ingaruka zisanzwe zibaho zikagira ingaruka ku barwayi benshi zirimo:

• Kugabanuka kw'amagufa (osteoporose) byongera ibyago byo kuvunika
• Urubavu rw'ingingo n'ubugororokere, cyane cyane mu ntoki no mu mavi
• Gushyuha cyane no gucya mu ijoro
• Impinduka z'amarangamutima zirimo umubabaro cyangwa guhangayika
• Kongera ibiro no guhinduka kw'imiterere y'umubiri
• Ibibazo byo gusinzira no kunanirwa

Ingaruka zitabaho cyane ariko zikomeye zirimo:

• Amaraso avurirana, cyane cyane hamwe na tamoxifen
• Ibyago bya kanseri y'uruhu rw'inda hamwe no gukoresha tamoxifen igihe kirekire
• Impinduka z'imikorere y'umwijima zisaba gukurikiranwa
• Gutakaza amagufa cyane bitera kuvunika
• Impinduka z'umuvuduko w'umutima hamwe n'imiti imwe

Muganga wawe akurikirana neza mu gihe cyose uvurwa kugira ngo amenye ingaruka zose hakiri kare. Kugenzura buri gihe no gupima amaraso bifasha kumenya ko ubuvuzi bwawe bukomeza kuba bwiza kandi bugatanga umusaruro.

Ndagomba kubona muganga ryari mu gihe cyo kuvurwa n'imisemburo?

Ugomba guhita uvugana na muganga wawe niba wumva ububabare mu gituza, guhumeka bigoranye, ububabare bukomeye mu kuguru, cyangwa ibimenyetso by'amaraso avurirana. Ibi bimenyetso bisaba ubufasha bwihutirwa kandi ntibigomba gutegereza gahunda yawe itaha.

Teganya gahunda mu minsi mike niba ufite gushyuha cyane kudahagarara, urubavu rw'ingingo rubuza gukora imirimo ya buri munsi, impinduka z'amarangamutima zikubabaza, cyangwa kuva amaraso mu gitsina mu buryo budasanzwe.

Inama zo kugenzura zisanzwe ziba buri mezi 3 kugeza kuri 6 mugihe cyo kuvurwa. Muganga wawe azashaka no kukubona niba utekereza guhagarika imiti yawe cyangwa niba ingaruka zikomeye zigira ingaruka ku mibereho yawe.

Ibikunze kubazwa kubyerekeye imiti ya hormone ya kanseri y'ibere

Q.1 Ese imiti ya hormone ikora kuri kanseri zose z'ibere?

Imiti ya hormone ikora gusa kuri kanseri z'ibere zifite hormone receptor-positive, zihagarariye hafi 70% bya kanseri zose z'ibere. Raporo yawe ya patoloji izerekana niba kanseri yawe ifite estrogen receptors (ER-positive) cyangwa progesterone receptors (PR-positive).

Niba kanseri yawe ari hormone receptor-negative, iyi miti ntizakora kuko izo selile za kanseri ntizishingiye kuri hormone kugirango zikure. Muganga wawe azagusaba izindi miti nka chemotherapy cyangwa imiti yagenewe.

Q.2 Ese imiti ya hormone itera kongera ibiro?

Abantu benshi bagira kongera ibiro mugihe cyo gukoresha imiti ya hormone, mubisanzwe ibiro 5 kugeza kuri 10 mugihe cyo kuvurwa. Ibi bibaho kuko imiti ishobora gutuma metabolism yawe igenda gahoro kandi igahindura uburyo umubiri wawe ubika ibinure.

Kongera ibiro mubisanzwe bigenda buhoro kandi bigashoboka hamwe no kurya neza no gukora imyitozo ngororamubiri buri gihe. Abantu bamwe basanga ibiro bihamye nyuma y'umwaka wa mbere wo kuvurwa mugihe umubiri wabo uhinduka kubera imiti.

Q.3 Ese nshobora gutwita mugihe nkoresha imiti ya hormone?

Imiti ya hormone ishobora kugira ingaruka ku miterere, ariko ntabwo ari uburyo bwizewe bwo kuboneza urubyaro. Niba uri premenopausal kandi ukora imibonano mpuzabitsina, ugomba gukoresha uburyo butari bwa hormone bwo kuboneza urubyaro nka kondomu cyangwa copper IUDs.

Gusama mugihe cyo gukoresha imiti ya hormone ntibisabwa kuko bishobora kubangamira imiti ya kanseri yawe kandi bikaba byagira ingaruka ku mwana ukura. Ganira kubyerekeye imyiteguro y'umuryango neza na oncologue yawe mbere yo gutangira kuvurwa.

Q.4 Nzaba nkeneye gufata imiti ya hormone igihe kingana iki?

Abantu benshi bakoresha imiti ikora ku misemburo (hormone therapy) imyaka 5 kugeza kuri 10, bitewe n'imiterere ya kanseri yabo n'ibintu byongera ibyago. Muganga wawe azagusaba igihe cyiza cyo kuyikoresha bitewe n'uko ubuzima bwawe buhagaze n'ubushakashatsi buheruka.

Abantu bamwe bafite kanseri zifite ibyago byinshi bashobora kungukirwa no kuyivura igihe kirekire, naho abandi bashobora kurangiza imiti yabo mu myaka 5. Muganga wawe azajya asuzuma buri gihe niba gukomeza kuvurwa bitanga inyungu nyinshi kurusha ibyago.

Q.5 Mbese nshobora guhagarika imiti ikora ku misemburo niba ingaruka zibaye nyinshi cyane?

Ntuzigere uhagarika imiti ikora ku misemburo utabanje kubiganiraho na muganga wawe w'inzobere mu kuvura kanseri, kabone n'iyo ingaruka zikubangamiye cyane. Muganga wawe akenshi ashobora guhindura imiti yawe, guhindura urugero rwayo, cyangwa kongeraho imiti ifasha kugenzura ingaruka.

Niba udashobora na gato kwihanganira imiti yawe y'ubu, muganga wawe ashobora kuguha ubundi bwoko bw'imiti ikora ku misemburo. Ikintu cy'ingenzi ni ugukorana kugira ngo mubone igisubizo kigufasha gukomeza kuvurwa mu gihe urinda ubuzima bwawe.