Yini i-Panitumumab: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Panitumumab iyimithi yomdlavuza eqondiwe esiza ukulwa nomdlavuza we-colorectal ngokuvimba amaprotheni athile asiza amaseli omdlavuza ukuthi akhule. Inikezwa ngokufakwa kwe-IV esibhedlela noma esikhungweni sokwelashwa komdlavuza, lapho ithimba lakho lezokwelapha lingakuqapha eduze kuyo yonke inqubo.

Le mithi ingeyeqembu elibizwa ngokuthi ama-monoclonal antibodies, asebenza njengemishini eqondisiwe eqondise amaseli omdlavuza ngenkathi ishiya iningi lamaseli anempilo yedwa. Udokotela wakho ngokuvamile uzoncoma i-panitumumab lapho ezinye izindlela zokwelapha zingasebenzi kahle njengoba bekulindelekile, noma kanye neminye imithi yomdlavuza ukuze kwenze ukwelashwa kuphumelele.

Yini i-Panitumumab?

I-Panitumumab iyi-antibody eyenziwe e-laboratory elingisa amaprotheni emvelo omzimba wakho wokuzivikela. Iqondise futhi ivimbe ngokuqondile iprotheni ebizwa nge-EGFR (epidermal growth factor receptor) ehlala ebusweni bamaseli omdlavuza futhi iwasiza ukuthi aphindaphindeke futhi asakazeke.

Cabanga nge-EGFR njengokhiye kumaseli omdlavuza, futhi i-panitumumab njengokhiye ofanelana nalowo khiye futhi uyeke ukusebenza. Lapho leli protheni livinjelwa, amaseli omdlavuza awakwazi ukuthola izimpawu abazidingayo ukuze bakhule futhi bahlukaniswe ngokushesha.

Le mithi iyinto yokwenziwa ngokuphelele, okusho ukuthi idalwe e-laboratory kunokuthi itholakale emithonjeni yabantu noma yezilwane. Inqubo yokukhiqiza iqinisekisa ukuvumelana nokuphepha kuwo wonke umthamo owutholayo.

Yini i-Panitumumab Esizokwenzelwa Yona?

I-Panitumumab iphatha umdlavuza we-colorectal metastatic, okusho umdlavuza oqale emathunjini akho amakhulu noma emathunjini amancane futhi osakazekele kwezinye izingxenye zomzimba wakho. Udokotela wakho uzonquma le mithi kuphela uma amaseli akho omdlavuza enokwakheka okuthile kofuzo okwenza kube nokwenzeka ukuthi aphendule kahle.

Ngaphambi kokuqala ukwelashwa, uzodinga ukuhlolwa okukhethekile kwezakhi zofuzo okubizwa ngokuthi ukuhlolwa kwe-KRAS ukuze uhlole ukuthi amaseli akho omdlavuza anawo yini ukuguquka okuthile. Lolu vivinyo lubalulekile ngoba i-panitumumab isebenza ngempumelelo kuphela kubantu abamaseli omdlavuza wabo angenawo lawa ma-KRAS athile aguqukiwe.

Udokotela wakho wezifo zomdlavuza angase ancome i-panitumumab njengokwelashwa okukodwa noma ayihlanganise neminye imithi ye-chemotherapy efana ne-FOLFOX noma i-FOLFIRI. Indlela yokuhlanganisa ivame ukusiza ukuthuthukisa imiphumela yokwelashwa ngokuhlasela amaseli omdlavuza ngezindlela eziningi ngasikhathi sinye.

Ngezinye izikhathi odokotela banikeza i-panitumumab lapho okunye ukwelashwa kuyekile ukusebenza ngempumelelo, kukunikeza enye indlela yokulwa nomdlavuza. Iphinde isetshenziswe njengokwelashwa komugqa wokuqala ezimweni ezithile lapho ukuhlolwa kwezakhi zofuzo kubonisa ukuthi umdlavuza wakho cishe uzosabela kahle.

Isebenza Kanjani I-Panitumumab?

I-Panitumumab isebenza ngokuzinamathela kuma-EGFR amaprotheni ebusweni bamaseli omdlavuza, ngokuyisisekelo ivimba amasiginali atshela amaseli omdlavuza ukuthi akhule futhi azale. Le ndlela eqondiwe yenza kube ukwelashwa okunembile uma kuqhathaniswa ne-chemotherapy yendabuko ethinta kokubili amaseli anempilo nawomdlavuza.

Lapho amaseli omdlavuza engakwazi ukuthola amasiginali okukhula nge-EGFR, aba nolaka oluncane futhi angase aqale nokufa ngokwemvelo. Le nqubo ayenzeki ngobusuku obubodwa, yingakho uzodinga ukwelashwa okuningi ezinyangeni eziningana ukuze ubone izinzuzo eziphelele.

Umuthi uthathwa njengokwelashwa komdlavuza okuphakathi nendawo, okuhloswe ngaso ngaphezu kwe-chemotherapy yendabuko kodwa kusanamandla ngokwanele ukubangela imiphumela emibi ebalulekile. Isistimu yakho yokuzivikela emzimbeni ingase iqale nokubona nokuhlasela amaseli omdlavuza ngempumelelo uma i-panitumumab iphazamisa amaphethini awo okukhula.

Ngokungafani nemithi ye-chemotherapy esebenza emzimbeni wakho wonke, i-panitumumab ithinta ikakhulukazi amaseli anamazinga aphezulu amaprotheni e-EGFR. Lokhu kuqondiswa okukhethekile kusiza ukuchaza ukuthi kungani kungasebenza kahle ekulweni iminyango ethile yomdlavuza ngenkathi kubangela imiphumela emibi embalwa ebanzi.

Kufanele Ngiyithathe Kanjani I-Panitumumab?

I-Panitumumab ihlala inikezwa njenge-IV infusion esibhedlela, esikhungweni somdlavuza, noma emtholampilo okhethekile lapho abasebenzi bezokwelapha abaqeqeshiwe bengakuqapha ngokusondela. Awukwazi ukuthatha lo muthi ekhaya noma njengepilisi, njengoba kudingeka ulethwe ngqo emjondolo wakho wegazi.

Ithimba lakho lezempilo lizofaka inaliti encane emthanjeni engalweni yakho, noma ungase ube nomugqa ophakathi nendawo noma imbobo uma wamukela ukwelashwa komdlavuza okuningi. Ukufakwa kwegazi kuvame ukuthatha imizuzu engaba ngu-60 kuya ku-90, lapho uzohlala ngokunethezeka esihlalweni esincike emuva.

Ngaphambi kokufakwa kwegazi ngakunye, ngokuvamile uzothola ukwelashwa ngaphambi kokwelashwa ukusiza ukuvimbela ukusabela komzimba. Lokhu kungabandakanya ama-antihistamine, ama-steroid, noma eminye imithi esiza umzimba wakho ukuba ubekezelele ukwelashwa kangcono.

Akudingeki ukuthi ugweme ukudla ngaphambi kokwelashwa, kodwa ukudla ukudla okulula ngaphambi kwesikhathi kungasiza ukuvimbela isicanucanu. Ukuhlala unamanzi kahle ngokuphuza amanzi amaningi ezinsukwini eziholela ekufakweni kwegazi nakho kusiza umzimba wakho ukuba usebenze umuthi ngempumelelo.

Hlela ukuchitha amahora angaba ngu-3 kuya kwangu-4 esikhungweni sokwelashwa ngokuqokwa ngakunye, okuhlanganisa isikhathi sokulungiselela, ukufakwa kwegazi kwangempela, nesikhathi esifushane sokubheka ngemva kwalokho. Ukuletha incwadi, ithebhulethi, noma ukuba nelungu lomndeni elihambisana nawe kungasiza ukwenza isikhathi sidlule ngokunethezeka.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Panitumumab?

Ubude bokwelashwa kwe-panitumumab buhlukahluka kakhulu kuye ngokuthi umdlavuza wakho usabela kahle kangakanani nokuthi umzimba wakho uyawubekezelela kanjani umuthi. Abantu abaningi bathola ukufakwa kwegazi njalo emavikini amabili, kodwa isimiso sakho esithile sizoxhomeka ohlelweni lwakho lokwelashwa.

Udokotela wakho we-oncologist uzoqhubeka nokwelapha uma nje umdlavuza wakho usabela kahle futhi ungaqali ukuzwa imiphumela emibi engaphezu kwezinzuzo. Abanye abantu bathola i-panitumumab izinyanga eziningana, kanti abanye bangase bayidinge unyaka noma ngaphezulu.

Ukuhlolwa njalo kanye nokuhlolwa kwegazi kuzosiza ithimba lakho lezokwelapha ukuthi linqume ukuthi ukwelashwa kusebenza ngempumelelo yini. Uma ukuhlolwa kubonisa ukuthi izinso ziyancipha noma zihlala zizinzile, cishe uzoqhubeka neshejuli yamanje.

Ukwelashwa kungase kumiswe noma kumiswe uma uqala ukuba nemiphumela emibi engathuthuki ngokunakekelwa okusekelayo, noma uma ukuhlolwa kubonisa ukuthi umdlavuza uyakhula naphezu kokwelashwa. Udokotela wakho uzochaza lezi zinto kuwe futhi akusize uqonde ukuthi yini ongayilindela.

Yini Imiphumela Eceleni ye-Panitumumab?

I-Panitumumab ingabangela imiphumela ehlukahlukene, ngezinkinga ezihlobene nesikhumba eziyinto ejwayelekile futhi ngokuvamile ebonakala kakhulu. Ukuqonda ukuthi yini ongayilindela kungakusiza ukuthi ulawule le miphumela futhi uxhumane ngempumelelo nethimba lakho lezempilo.

Imiphumela evame kakhulu ongase uyithole ihlanganisa ukusabela kwesikhumba okungaba ngaphandle kokunethezeka kodwa ngokuvamile kulawuleka ngokunakekelwa okufanele:

• Ukuqubuka okufana ne-acne ebusweni bakho, esifubeni, nasemhlane okungase kuvele emasontweni ambalwa okuqala kokwelashwa
• Isikhumba esomile, esiqhekekile esingase sibe buhlungu noma sinamathele uma singathuthukiswa kahle
• Ushintsho ekuthungeni kwakho kwezinwele, okuzenza zome, zibe buthaka, noma zigobe
• Ushintsho ezinzipho okuhlanganisa ubuhlungu, ukuvuvukala, noma ukutheleleka eduze kwezinzipho zakho zeminwe nezinzwane
• Ukuzwela okukhulu elangeni, okukwenza ushise kalula
• Ukukhathala okungase kwenze imisebenzi yansuku zonke ibe yinselele enkulu
• Ukuqunjelwa okungahluka kusuka kokuncane kuya kokukhulu
• Ukucasuka nokuhlanza ngezikhathi ezithile

Lezi zimo ezivamile ezithinta umzimba zivame ukuthuthuka njengoba umzimba wakho ujwayela ukwelashwa, futhi ithimba lakho labanakekeli bezempilo linganikeza imithi namasu okusiza ukuphatha ngempumelelo.

Abanye abantu bahlangabezana nemiphumela emibi kakhulu edinga ukunakekelwa kwezempilo ngokushesha, nakuba lokhu kungavamile:

• Ukuphendula okukhulu komzimba ngesikhathi noma ngemva nje kokufakwa, okuhlanganisa ubunzima bokuphefumula, ukuqina kwesifuba, noma ukuvuvukala
• Izifo ezinzima zesikhumba ezivela ekuzikweneni noma ukunakekelwa okunganele kwamabala
• Ukuphelelwa amanzi emzimbeni okukhulu okuvela kuhudo oluqhubekayo noma ukuhlanza
• Izinkinga zamehlo ezihlanganisa ukoma okukhulu, ubuhlungu, noma izinguquko embonweni
• Ukungalingani kwama-electrolyte okungabangela ubuthakathaka, ukudideka, noma izinkinga zesigqi senhliziyo
• Izinkinga zamaphaphu ezihlanganisa ukuphefumula kanzima noma ukukhwehlela okuqhubekayo

Ithimba lakho lezokwelapha lizokuqapha eduze ukuze libone le miphumela emibi futhi linikeze ukwelashwa ngokushesha uma kwenzeka. Imiphumela eminingi emibi iyalawuleka ngosizo olufanele lwezokwelapha futhi ayidingi ukumisa ukwelashwa unomphela.

Ubani Ongafanele Athole I-Panitumumab?

I-Panitumumab ayifanele wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi ingabe iyona ndlela efanele esimweni sakho esithile. Ezinye izimo nezimo zenza lokhu kwelashwa kungafaneleki noma kungaba yingozi.

Akufanele uthole i-panitumumab uma une-KRAS-mutated colorectal cancer, njengoba ukuhlolwa kwezakhi zofuzo kukhombisile ukuthi lo muthi awusebenzi ezimweni ezinjalo. Udokotela wakho uzohlala e-oda leli hlola lezakhi zofuzo ngaphambi kokuncoma ukwelashwa.

Abantu abanezinkinga ezinzima zenhliziyo, yamaphaphu, noma yesibindi kungenzeka bangabi ngabantu abafanelekayo be-panitumumab, njengoba lezi zimo zingenza kube nzima ngomzimba wakho ukucubungula umuthi ngokuphepha. Ithimba lakho lezokwelapha lizobuyekeza umlando wakho wezokwelapha ophelele ngaphambi kokwenza izinqumo zokwelashwa.

Uma uke waba nokusabela okukhulu komzimba kwezinye izidakamizwa ze-monoclonal noma imithi efanayo, i-panitumumab kungenzeka ingakulungele. Udokotela wakho uzoxoxa ngomlando wakho wokungezwani komzimba ngemininingwane ukuze ahlulele izingozi.

Abesifazane abakhulelwe akufanele bathole i-panitumumab, njengoba ingalimaza ingane esakhula. Uma unomnyaka wokuzala, uzodinga ukusebenzisa izindlela zokuvimbela inzalo ezisebenzayo ngesikhathi sokwelashwa kanye nezinyanga ezimbalwa ngemuva kwalokho.

Abantu abanezifo eziqhubekayo, ezinzima kungenzeka badinge ukulinda kuze kube yilapho lezi zithathwe ngokugcwele ngaphambi kokuqala i-panitumumab, njengoba umuthi ungathinta ikhono lomzimba wakho lokuzivikela ekulweni nezifo.

Amagama Omkhiqizo we-Panitumumab

I-Panitumumab ithengiswa ngaphansi kwegama lomkhiqizo elithi Vectibix e-United States nakwamanye amazwe amaningi. Lolu wukuphela kohlobo olutholakala ngokuthengisa lolu hlobo lomuthi, olukhiqizwa yi-Amgen.

Ngokungafani neminye imithi enamagama amaningi omkhiqizo noma izinguqulo ezivamile, i-panitumumab itholakala kuphela njenge-Vectibix. Lokhu kuqinisekisa ukuqina ekulinganiseni kanye nekhwalithi, njengoba bonke iziguli zithola ifomula efanayo kungakhathaliseki ukuthi zithola kuphi ukwelashwa.

Inkampani yakho yomshuwalense kanye nabanakekeli bezempilo bazobhekisela kulo muthi nganoma yiliphi igama - i-panitumumab noma i-Vectibix - futhi asho into efanayo. Abanye abasebenzi bezokwelapha bakhetha ukusebenzisa igama elivamile, kanti abanye basebenzisa igama lomkhiqizo kaningi.

Ezinye izindlela ze-Panitumumab

Eminye imithi eminingi isebenza ngendlela efanayo ne-panitumumab yokwelapha umdlavuza we-colorectal, nakuba ngamunye enezinto zawo ezisetshenziswa ngokuqondile kanye namaphrofayili emiphumela emibi. Udokotela wakho we-oncologist uzokhetha inketho engcono kakhulu ngokusekelwe ezintweni eziphawula umdlavuza wakho kanye nempilo yakho yonke.

I-Cetuximab (Erbitux) iyona efana kakhulu, njengoba nayo iqondisa amaprotheni e-EGFR kumaseli omdlavuza. Njenge-panitumumab, isebenza kuphela kubantu abamaseli omdlavuza wabo abangenayo i-KRAS mutations, kodwa inikezwa masonto onke esikhundleni samaviki amabili.

I-Bevacizumab (Avastin) isebenza ngendlela ehlukile ngokuvimba ukukhula kwemithambo yegazi enakekela imithombo yezimila. Lo muthi ungasetshenziswa kungakhathaliseki isimo sokuguquka kwe-KRAS, okwenza kube yindlela yokwelapha abantu abangakwazi ukuthola i-panitumumab.

Imithi emisha efana ne-regorafenib (Stivarga) kanye ne-TAS-102 (Lonsurf) iyizinketho zomlomo ezingase zicatshangelwe lapho ukwelashwa nge-IV njenge-panitumumab kungasasebenzi. Lezi zisebenza ngezindlela ezihlukene futhi zivame ukusetshenziswa kamuva ochungechungeni lokwelashwa.

Imithi yokwelapha ngomzimba njenge-pembrolizumab (Keytruda) ingase ibe yizinketho kubantu abanomdlavuza wamathumbu amakhulu onobunjwa obuthile be-genetic obizwa ngokuthi ukungazinzi kwe-microsatellite. Udokotela wakho uzohlola lezi zici ukuze anqume ukuthi ukwelashwa ngomzimba kufanelekile yini.

Ingabe i-Panitumumab Ingcono Kune-Cetuximab?

I-Panitumumab kanye ne-cetuximab yizona zombili izindlela zokwelapha ezisebenzayo zomdlavuza wamathumbu amakhulu, futhi ucwaningo lubonisa ukuthi zisebenza kahle ngendlela efanayo ezimweni eziningi. Ukukhetha phakathi kwazo kuvame ukuncika ezintweni ezingokoqobo njengeshejuli yokulinganisa kanye nokuhlukahluka kwemiphumela emibi kunokuthi enye ibe ngcono ngokuqinisekile.

I-Panitumumab inenzuzo encane yokuthi inikezwa njalo emavikini amabili esikhundleni samaviki onke, okusho ukuthi ukuhamba okuncane esikhungweni sokwelapha. Lokhu kungasiza ikakhulukazi uma uhlala kude nesikhungo sakho somdlavuza noma unezinselelo zokuthutha.

Ezinye izifundo zikhomba ukuthi i-panitumumab ingase ibangele ukusabela okuncane kakhulu okubi komzimba uma kuqhathaniswa ne-cetuximab, nakuba yomibili imithi ingabangela imiphumela emibi yesikhumba. Ukusebenza kahle okuphelele ekunciphiseni izimila nasekwenabiseni ukusinda kubonakala kufana kakhulu phakathi kwemithi emibili.

Udokotela wakho we-oncologist uzoqwalasela izinto ezifana neminye imithi yakho, izintandokazi zeshejuli yokwelapha, kanye nomshwalense lapho ekhetha phakathi kwalezi zinketho. Zombili zithathwa njengezindlela zokwelapha ezinhle kakhulu uma zisetshenziswa ezigulini ezifanele.

Imibuzo Evame Ukubuzwa Mayelana ne-Panitumumab

Ingabe iPanitumumab iphephile kubantu abanezifo zenhliziyo?

I-Panitumumab ingasetshenziswa kubantu abanezifo zenhliziyo, kodwa idinga ukuqashwa ngokucophelela futhi mhlawumbe ukulungiswa komthamo. Udokotela wakho wenhliziyo kanye nodokotela wakho we-oncologist bazosebenzisana ukuqinisekisa ukuthi isimo senhliziyo yakho sihlala sizinzile ngesikhathi sokwelashwa.

Umuthi ngezinye izikhathi ungabangela izinguquko emazingeni e-electrolyte, ikakhulukazi i-magnesium ne-potassium, okungathinta isigqi senhliziyo. Ithimba lakho lezokwelapha lizohlola lawa mazinga njalo futhi linikeze izithasiselo uma kudingeka ukuze inhliziyo yakho isebenze kahle.

Uma unenhliziyo ehluleka kakhulu noma ukuhlaselwa yinhliziyo kwakamuva, odokotela bakho bangase batusa ezinye izindlela zokwelapha noma balibazise i-panitumumab kuze kube yilapho isimo senhliziyo yakho sizinzile. Isimo ngasinye sihlolwa ngasinye ukuze kulinganiswe izinzuzo zokwelashwa komdlavuza nezingozi zempilo yenhliziyo.

Kufanele ngenzeni uma ngiphuthelwa ngengozi umthamo we-Panitumumab?

Uma uphuthelwa ukumnika i-panitumumab okuhleliwe, xhumana nethimba lakho le-oncology ngokushesha ukuze lihlehlise kabusha ngokushesha ngangokunokwenzeka. Ungalindi kuze kube yilapho uqokwe khona ngokujwayelekile, njengoba ukugcina isikhathi sokwelashwa okuqhubekayo kubalulekile ekusebenzeni.

Ithimba lakho lezempilo ngokuvamile lizozama ukukuhlehlisela ngaphakathi kwezinsuku ezimbalwa zokuqokwa kwakho okungaphuthelwanga. Bangase futhi balungise ukuhlela kwakho kwesikhathi esizayo kancane ukuze ubuyele emgqeni nohlelo lwakho lokwelashwa.

Ukuphuthelwa umthamo owodwa ngezikhathi ezithile ngeke kulimaze ukwelashwa kwakho, kodwa zama ukugcina ukuqokwa okungaphuthelwanga kuncane. Ithimba lakho lezokwelapha liyaqonda ukuthi izimo eziphuthumayo ziyenzeka futhi lizosebenza nawe ukuze ligcine uhlelo lokwelashwa olungcono kakhulu.

Kufanele ngenzeni uma ngiba nokusabela okukhulu ngesikhathi sokumnika?

Uma uhlangabezana nezimpawu ezinjengobunzima bokuphefumula, ubuhlungu besifuba, ukusabela okukhulu kwesikhumba, noma isiyezi ngesikhathi sokumnika kwakho i-panitumumab, yazisa umhlengikazi wakho ngokushesha. Izikhungo zokwelapha zihlome kahle ukubhekana nalezi zimo futhi zizoyeka ukumnika ngokushesha.

Iqembu lakho lezokwelapha cishe lizokunika imithi efana nama-antihistamine, ama-steroid, noma i-epinephrine ukuze kuqede ukusabela. Izinhlobo eziningi zokuphendula ukufakwa zingalawulwa ngempumelelo uma zitholwe ngokushesha futhi zaphathwa ngokushesha.

Ngemuva kokuphendula, udokotela wakho angase ancome imithi ngaphambi kokufakwa okuzayo noma anganciphisa izinga lokufakwa ukuze asize umzimba wakho ukuba ubekezelele ukwelashwa kangcono. Abanye abantu bangaqhubeka nokwelashwa ngempumelelo ngemuva kokulungisa indlela.

Ngingayeka nini ukuthatha i-Panitumumab?

Ungayeka ukuthatha i-panitumumab lapho udokotela wakho enquma ukuthi izinzuzo azisadluli izingozi, noma lapho izithombe zibonisa ukuthi umdlavuza wakho awusaphenduli ekwelashweni. Lesi sinqumo senziwa ngaso sonke isikhathi ngokubambisana phakathi kwakho nethimba lakho le-oncology.

Abanye abantu bakhetha ukuyeka ukwelashwa uma imiphumela emibi iba nzima kakhulu ukuyilawula, ngisho noma umdlavuza usaphendula. Ikhwalithi yakho yempilo iyinto ebalulekile okufanele icatshangelwe kulezi zinqumo, futhi ithimba lakho lezokwelapha lizosekela noma yisiphi isinqumo osenzayo.

Ungalokothi uyeke ukuthatha i-panitumumab wedwa ngaphandle kokuxoxa ngayo nodokotela wakho we-oncologist kuqala. Bangakusiza ukuthi uqonde imiphumela futhi baqinisekise ukuthi unezinketho zokwelashwa ezingezinye uma kudingeka.

Ngingathatha eminye imithi ngenkathi ngithatha i-Panitumumab?

Imithi eminingi engenye ingathathwa ngokuphepha nge-panitumumab, kodwa kufanele ngaso sonke isikhathi wazise udokotela wakho we-oncologist nganoma yimiphi imithi emisha, imithi engaphandle kwe-counter, noma izithasiselo ofuna ukuziqala. Eminye imithi ingase ihlangane noma idinge ukulungiswa komthamo.

Izinciphisi zegazi, imithi yenhliziyo, kanye nemithi ethinta amasosha akho omzimba kungase kudingeke ukuqapha okukhethekile uma kuhlanganiswe ne-panitumumab. Ithimba lakho lezokwelapha lizosebenzisana nodokotela bakho abanye ukuze kuqinisekiswe ukuthi yonke imithi yakho isebenza kahle ndawonye.

Njalo letha uhlu oluphelele lwazo zonke imithi kanye nezithasiselo kuwo wonke ama-aphoyintimenti, okuhlanganisa imithamo nesikhathi. Lokhu kusiza ithimba lakho lezempilo ukuthi linikeze ukwelashwa okuphephile nokusebenzayo ngangokunokwenzeka.