Yini i-Hormone Therapy yomdlavuza webele? Inhloso, Izinhlobo & Nemiphumela

I-Hormone therapy yomdlavuza webele yindlela yokwelapha evimbela noma yehlise ama-hormone e-estrogen ne-progesterone aqhuba izinhlobo ezithile zomdlavuza webele. Cabanga ngayo njengokusika ukuhlinzekwa kukaphethiloli okusiza le midlavuza ukuthi ikhule. Le ndlela eqondiwe inganciphisa kakhulu ingozi yokuthi umdlavuza ubuye futhi isize ukunciphisa izimila ezikhona ezigulini eziningi.

Yini i-hormone therapy yomdlavuza webele?

I-Hormone therapy isebenza ngokuvimba ama-hormone receptors kumaseli omdlavuza noma ukunciphisa inani lama-hormone umzimba wakho owenzayo. Cishe ama-70% emidlavuza yomdlavuza webele i-hormone receptor-positive, okusho ukuthi asebenzisa i-estrogen noma i-progesterone ukuze akhule futhi ande.

Lokhu kwelashwa kwehluke ngokuphelele ku-hormone replacement therapy abanye besifazane abayisebenzisela izimpawu zokuya esikhathini. Esikhundleni sokwengeza ama-hormone, i-hormone therapy yomdlavuza isusa noma iwavimbe ukuze ilambise amaseli omdlavuza ngalokho okudingayo ukuze asinde.

Ukwelashwa kuza ngesimo samaphilisi owathatha nsuku zonke noma ngemijovo yanyanga zonke, kuye ngohlobo udokotela wakho aluphakamisa. Abantu abaningi baqhubeka nalolu hlobo lokwelashwa iminyaka engu-5 kuya kwengu-10 ukuze bathole ukuvikelwa okungcono kakhulu ekuphindweni komdlavuza.

Kungani kwenziwa i-hormone therapy yomdlavuza webele?

Udokotela wakho uncoma i-hormone therapy ukuvimbela amaseli omdlavuza ukuthi angatholi ama-hormone abawadingayo ukuze akhule. Kufana nokususa ukhiye ovumela umdlavuza ukuthi uvule futhi uphindaphindeke emzimbeni wakho.

Izinhloso eziyinhloko zihlanganisa ukunciphisa ingozi yakho yokuthi umdlavuza ubuye ngemva kokuhlinzwa, ukunciphisa izimila ngaphambi kokuhlinzwa ukuze kwenziwe ukususwa kube lula, nokunciphisa ukukhula komdlavuza uma ususabalale kwezinye izingxenye zomzimba wakho.

Lokhu kwelashwa kusebenza kuphela emidlavuzeni yomdlavuza webele ye-hormone receptor-positive. Umbiko wakho we-pathology ngemva kwe-biopsy noma ukuhlinzwa uzokhombisa ukuthi umdlavuza wakho une-estrogen receptors (ER-positive) noma i-progesterone receptors (PR-positive).

Yini inqubo ye-hormone therapy?

Iningi le-therapy ye-hormone lihilela ukuthatha iphilisi lansuku zonke ekhaya, okwenza kube lula kakhulu kunama-chemotherapy adinga ukuvakashelwa esibhedlela. Udokotela wakho uzonquma ukuthi yimuphi umuthi othile osebenza kangcono esimweni sakho.

Kwabesifazane abangakayi esikhathini sokuya esikhathini, ukwelashwa kuvame ukuqala ngemijovo yanyanga zonke ukuvimbela ama-ovari akho ukuthi enze i-estrogen, ihlanganiswe namaphilisi ansuku zonke. Abesifazane abasele esikhathini sokuya esikhathini ngokuvamile bathatha amaphilisi ansuku zonke avimba ukukhiqizwa kwe-estrogen kwezinye izicubu zomzimba.

Ithimba lakho lezokwelapha lizokuqapha njalo ngokuhlolwa kwegazi nokuhlolwa ukuqinisekisa ukuthi ukwelashwa kusebenza ngempumelelo futhi liphathe noma yimaphi imiphumela emibi. Lokhu kuqokwa kuvame ukwenzeka njalo ezinyangeni ezi-3 kuya kwezi-6 ngesikhathi sokwelashwa kwakho.

Ungalungiselela kanjani i-therapy yakho ye-hormone?

Ukulungiselela i-therapy ye-hormone kuqala ngokuqonda okufanele ukulindele nokubutha ukwesekwa eqenjini lakho lezempilo. Udokotela wakho uzobuyekeza umlando wakho wezokwelapha nemithi yamanje ukuvimbela noma yikuphi ukuxhumana okuyingozi.

Uzodinga ukuhlolwa okuyisisekelo okuhlanganisa ukuskena kwamathambo, amazinga e-cholesterol, nokuhlolwa komsebenzi wesibindi ngaphambi kokuqala ukwelashwa. Lokhu kusiza udokotela wakho ukuthi aqaphe ukuthi i-therapy iyithinta kanjani umzimba wakho ngokuhamba kwesikhathi.

Cabangela ukuxoxa ngamasu okuphatha imiphumela emibi neqembu lakho lezempilo ngaphambi kokuthi uqale. Ukuba nohlelo lwezinkinga ezivamile njengama-hot flashes, ubuhlungu bamalunga, noma izinguquko zemizwa kungakusiza ukuthi uzizwe ulungiseleleke futhi uqiniseke ngohambo lwakho lokwelashwa.

Ungawafunda kanjani imiphumela yakho ye-therapy ye-hormone?

Udokotela wakho ulandelela impumelelo ye-therapy ye-hormone ngokusebenzisa ukuskena okujwayelekile kwezithombe, ukuhlolwa kwegazi, nokuhlolwa komzimba kunokuba umphumela owodwa wokuhlolwa. Umgomo ukubona amathumba azinzile noma anciphayo uma unomdlavuza osebenzayo, noma ukuhlala nje ungenayo umdlavuza uma usemodini wokuvimbela.

Uhlolo lwegazi luqapha amazinga akho e-hormone ukuqinisekisa ukuthi imithi ivimba i-estrogen ne-progesterone ngempumelelo. Udokotela wakho uzobheka nomsebenzi wesibindi njengoba le mithi icutshungulwa esibindini sakho.

Ukuhlolwa kwamathambo kuba kubalulekile ngoba ukwelashwa ngama-hormone kunganciphisa amathambo ngokuhamba kwesikhathi. Udokotela wakho angase ancome izithasiselo ze-calcium ne-vitamin D noma imithi eqinisa amathambo uma kudingeka.

Ungazisingatha kanjani izinkinga ezibangelwa ukwelashwa ngama-hormone?

Ukuphatha imiphumela emibi kuhilela ukusebenza eduze nethimba lakho lezempilo ukuze uthole izixazululo ezikugcina ukhululekile ngenkathi uqhubeka nokwelashwa kwakho okubalulekile komdlavuza. Imiphumela eminingi emibi ingalawulwa ngendlela efanele.

Imiphumela emibi ejwayelekile namasu okuphatha afaka:

• Ukushisa okukhulu: Gqoka izingqimba, sebenzisa amafeni okupholisa, zama izindlela zokuphumula, noma buza ngemithi engasiza
• Ubuhlungu emalungeni nokuqina: Ukuzivocavoca okuvamile okulula, ukwelashwa ngokomzimba, ukugeza ngamanzi afudumele, noma imithi eqeda ukuvuvukala
• Ushintsho lwemizwa: Ukwelulekwa, amaqembu okusekela, izindlela zokuphatha ingcindezi, noma ama-antidepressants uma kudingeka
• Ukukhathala: Ukuhlela imisebenzi, isimiso sokulala esivamile, ukuzivocavoca okulula, nezindlela zokonga amandla
• Ukomiswa kwesitho sangasese sowesifazane: Izinto ezithambisa isikhumba, ama-lubricants, noma ukwelashwa okuyalelwe ngudokotela wakho

Ungayeki ukwelashwa kwakho ngama-hormone ngaphandle kokukhuluma nodokotela wakho kuqala, ngisho noma imiphumela emibi izwakala iyinselele. Ithimba lakho lezokwelapha ngokuvamile lingashintsha ukwelashwa kwakho noma lengeze imithi esekelayo ukukusiza ukuthi uzizwe ungcono.

Yini indlela engcono yokwelashwa ngama-hormone?

Ukwelashwa okungcono ngama-hormone kuncike ekutheni ngabe udlule esikhathini sokuya esikhathini, izici ezithile zomdlavuza wakho, nempilo yakho yonke. Akukho ndlela eyodwa elingana wonke umuntu ngoba isimo somuntu ngamunye sihlukile.

Abesifazane abangakafiki esikhathini bavame ukuzuza ekucindezelweni kwama-ovari okuhlanganiswe nemithi efana ne-tamoxifen noma ama-aromatase inhibitors. Abesifazane asebekhulile ngokuvamile benza kahle ngama-aromatase inhibitors kuphela, nakuba abanye bengasebenzisa i-tamoxifen.

Udokotela wakho we-oncologist ucabangela izinto ezifana nesigaba somdlavuza wakho, ezinye izimo zempilo, umlando womndeni, nezintandokazi zomuntu siqu lapho edala uhlelo lwakho lokwelapha. Ukwelashwa okungcono kakhulu yilelo eliphatha ngempumelelo umdlavuza wakho ngenkathi ligcina izinga lempilo yakho.

Ziyini izici eziyingozi zokudinga ukwelashwa ngamahomoni?

Kungenzeka udinga ukwelashwa ngamahomoni uma umdlavuza wakho wamabele uhlolwa ukuthi unamahomoni receptors, kungakhathaliseki ezinye izici. Lokhu kuthatha cishe ama-70% wawo wonke amacala omdlavuza wamabele.

Izici eziningana zithonya uhlelo lwakho lokwelapha nobude baso:

• Isigaba somdlavuza nosayizi lapho kutholakala
• Noma umdlavuza usabalale kuma-lymph nodes
• Iminyaka yakho nesimo sokuyeka ukuya esikhathini
• Umlando womndeni womdlavuza wamabele noma wama-ovari
• Ukusetshenziswa kwangaphambilini kokwelashwa ngamahomoni
• Ezinye izimo zempilo ezifana ne-osteoporosis noma isifo senhliziyo

Abesifazane abanomdlavuza ongozi kakhulu bavame ukuqhubeka nokwelashwa ngamahomoni isikhathi eside, ngezinye izikhathi kufika eminyakeni eyi-10. Udokotela wakho uzohlola njalo ukuthi ngabe ukuqhubeka nokwelashwa kunikeza izinzuzo ezingaphezu kwezingozi.

Ingabe kungcono ukuba nomdlavuza wamabele onamahomoni-positive noma amahomoni-negative?

Umdlavuza wamabele onamahomoni-positive uvame ukuba nemiphumela engcono yesikhathi eside ngoba uphendula kahle ekwelashweni ngamahomoni. Ukuba nezinketho zokwelapha ezitholakalayo kukunika wena nodokotela wakho amathuluzi amaningi okulwa nomdlavuza ngempumelelo.

Imidlava yomdlavuza enama-hormone-positive ivame ukukhula kancane kunezinhlobo ezinama-hormone-negative, okungasho isikhathi esiningi sokuzithola nokuzelapha ngempumelelo. Amazinga okusinda eminyaka emi-5 ngokuvamile aphakeme kumdlavuza wamabele onamahomoni-positive.

Kodwa-ke, iminyango yomdlavuza engahlobene nama-hormone ivame ukusabela kangcono ekhemotherapy futhi ingase iqedwe ngokuphelele ngemithi. Zombili izinhlobo zingelashwa ngempumelelo uma zitholwe kusenesikhathi, ngakho-ke gxila ekulandeleni uhlelo lokwelashwa olutuswe udokotela wakho kunokukhathazeka ngokuthi hlobo luni onalo.

Ziyini izinkinga ezingaba khona zokwelashwa ngama-hormone?

Abantu abaningi bayakwazi ukubekezelela ukwelashwa ngama-hormone kahle, kodwa njengayo yonke imithi, kungabangela imiphumela emibi esukela kokuncane kuya kokukhulu. Ukuqonda lokhu kukusiza ukuthi wazi ukuthi yini okufanele uyibheke nokuthi kufanele uxhumane nini nodokotela wakho.

Izinkinga ezivamile ezithinta iziguli eziningi zihlanganisa:

• Ukuqina kwamathambo (i-osteoporosis) okwandisa ingozi yokuphuka
• Ubuhlungu emalungeni nokuqina, ikakhulukazi ezandleni nasemadolweni
• Ukushisa okukhulu nokujuluka ebusuku
• Ushintsho lwemizwa oluhlanganisa ukucindezeleka noma ukukhathazeka
• Ukwanda kwesisindo noshintsho ekwakhekeni komzimba
• Ukuphazamiseka kokulala nokukhathala

Izinkinga ezingavamile kodwa ezingathi sína zihlanganisa:

• Amaqhubu egazi, ikakhulukazi nge-tamoxifen
• Ubungozi bomdlavuza we-Endometrial ngokusebenzisa i-tamoxifen isikhathi eside
• Ushintsho lomsebenzi wesibindi oludinga ukuqapha
• Ukulahleka kwamathambo okukhulu okuholela ekuphukeni
• Ushintsho lwesigqi senhliziyo ngemithi ethile

Udokotela wakho ukuqapha ngokucophelela ngesikhathi sokwelashwa ukuze abambe noma yiziphi izinkinga zisendaweni. Ukuhlolwa okuvamile kanye nokuhlolwa kwegazi kusiza ekuqinisekiseni ukuthi ukwelashwa kwakho kuhlala kuphephile futhi kusebenza kahle.

Kufanele ngibone nini udokotela ngesikhathi sokwelashwa ngama-hormone?

Kufanele uthinte udokotela wakho ngokushesha uma uba nobuhlungu esifubeni, ukuphefumula kanzima, ubuhlungu emlenzeni obukhulu, noma izimpawu zamaqhubu egazi. Lezi zimpawu zidinga ukunakekelwa kwezokwelapha okuphuthumayo futhi akufanele zilinde ukuqokwa kwakho okulandelayo.

Hlela ukuqokwa phakathi nezinsuku ezimbalwa uma unokushisa okukhulu okuqhubekayo, ubuhlungu emalungeni obuphazamisa imisebenzi yansuku zonke, izinguquko zemizwa ezikukhathazayo, noma ukuphuma kwegazi okungavamile ngasesithweni sangasese.

Ukuqokwa okuvamile kokulandela ngomkhondo kuvame ukwenzeka njalo ezinyangeni ezi-3 kuya kwezi-6 ngesikhathi sokwelashwa. Udokotela wakho uzofuna ukukubona futhi uma ucabangela ukuyeka imithi yakho noma uma imiphumela emibi ithinta kakhulu izinga lempilo yakho.

Imibuzo evame ukubuzwa mayelana nokwelashwa ngamahomoni ngomdlavuza wamabele

Umbuzo 1. Ingabe ukwelashwa ngamahomoni kuyasebenza kuyo yonke imidlava yomdlavuza wamabele?

Ukwelashwa ngamahomoni kusebenza kuphela emidlavuzeni yamabele enama-hormone receptor-positive, okumelela cishe ama-70% wawo wonke amacala omdlavuza wamabele. Umbiko wakho we-pathology uzokhombisa ukuthi umdlavuza wakho une-estrogen receptors (ER-positive) noma i-progesterone receptors (PR-positive).

Uma umdlavuza wakho une-hormone receptor-negative, lokhu kwelashwa ngeke kusebenze ngoba lawo maseli omdlavuza awancikile kumahomoni ukuze akhule. Udokotela wakho uzoncoma ezinye izindlela zokwelapha njenge-chemotherapy noma izindlela zokwelapha eziqondiwe esikhundleni salokho.

Umbuzo 2. Ingabe ukwelashwa ngamahomoni kubangela ukukhuluphala?

Abantu abaningi bathola ukukhuluphala okuthile ngesikhathi sokwelashwa ngamahomoni, ngokuvamile amakhilogremu angu-2 kuya kwangu-5 ngesikhathi sokwelashwa. Lokhu kwenzeka ngoba ukwelashwa kunganciphisa imetabolism yakho futhi kushintshe indlela umzimba wakho ogcina ngayo amafutha.

Ukukhuluphala kuvame ukuba kancane kancane futhi kulawuleka ngokudla okunempilo nokuzivocavoca njalo. Abanye abantu bathola ukuthi isisindo sizinzile ngemva konyaka wokuqala wokwelashwa njengoba umzimba wabo ujwayela imithi.

Umbuzo 3. Ngingakhulelwa yini ngenkathi ngithatha ukwelashwa ngamahomoni?

Ukwelashwa ngamahomoni kungathinta inzalo, kodwa akuyona indlela ethembekile yokulawula ukuzala. Uma usazoba sesikhathini futhi usebenza ngokocansi, kufanele usebenzise izindlela zokuvimbela ukukhulelwa ezingahlobene nama-hormone njengama-condom noma ama-copper IUDs.

Ukukhulelwa ngesikhathi sokwelashwa ngamahomoni akukhuthazwa ngoba kungaphazamisa ukwelashwa kwakho umdlavuza futhi kungase kuthinte ingane esakhula. Xoxa ngokuhlela umndeni ngokucophelela nodokotela wakho we-oncologist ngaphambi kokuqala ukwelashwa.

Umbuzo 4. Ngizodinga ukuthatha ukwelashwa ngamahomoni isikhathi esingakanani?

Abantu abaningi bathatha ukwelashwa ngamahomoni iminyaka engu-5 kuya ku-10, kuye ngokuthi izici zomdlavuza wabo kanye nezici eziyingozi. Udokotela wakho uzoncoma ubude obufanele ngokusekelwe esimweni sakho esithile kanye nocwaningo lwakamuva.

Abanye abantu abanomdlavuza oyingozi enkulu bangazuza ezikhathini zokwelashwa ezinde, kanti abanye bangase baqede ukwelashwa kwabo eminyakeni emi-5. Udokotela wakho uzohlola njalo ukuthi ngabe ukuqhubeka nokwelashwa kunikeza izinzuzo ezengeziwe kunezingozi.

Q.5 Ngingayeka yini ukwelashwa ngamahomoni uma imiphumela emibi iba nzima kakhulu?

Ungalokothi uyeke ukwelashwa ngamahomoni ngaphandle kokuxoxa ngakho nodokotela wakho we-oncologist kuqala, ngisho noma imiphumela emibi izizwa ikhulu. Udokotela wakho uvame ukulungisa imithi yakho, ashintshe umthamo, noma engeze ukwelashwa okusekelayo ukusiza ukuphatha imiphumela emibi.

Uma ngempela ungenakukwazi ukubekezelela imithi yakho yamanje, udokotela wakho angase akushintshele kwenye inketho yokwelashwa ngamahomoni. Okubalulekile ukusebenza ndawonye ukuthola isixazululo esikugcina ekwelashweni ngenkathi ugcina izinga lempilo yakho.