Yini Ukwelashwa Ngamahomoni Ngomdlavuza Wendlala Yesinye? Inhloso, Izinhlobo & Nemiphumela

Ukwelashwa ngamahomoni ngomdlavuza wendlala yesinye kuyindlela yokwelapha evimba noma yehlisa i-testosterone namanye amahomoni esilisa akhuthaza ukukhula komdlavuza wendlala yesinye. Cabanga ngakho njengokunqamula ukuhlinzekwa kukaphethiloli okusiza amaseli omdlavuza ukuthi aphindaphindeke futhi asakazeke emzimbeni wakho wonke.

Le ndlela iyasebenza ngoba amaseli omdlavuza wendlala yesinye ancike kakhulu ku-testosterone ukuze akhule futhi asinde. Uma wehlisa lawa mazinga e-hormone, ungalinciphisa noma ulinciphise ngisho nomdlavuza, okukunika isikhathi esithe xaxa futhi ngokuvamile kuthuthukisa izinga lempilo yakho.

Yini ukwelashwa ngamahomoni ngomdlavuza wendlala yesinye?

Ukwelashwa ngamahomoni kuyindlela yokwelapha umdlavuza eqondise amahomoni umdlavuza wakho wendlala yesinye owadingayo ukuze ukhule. Kubuye kubizwe ngokuthi ukwelashwa ngokuncishiswa kwe-androgen (ADT) ngoba kunciphisa ama-androgen, okungamahomoni esilisa afana ne-testosterone.

Amaqanda akho kanye nezindlala ze-adrenal ngokwemvelo zikhiqiza lawa mahomoni. Amaseli omdlavuza wendlala yesinye anezamukeli ezikhethekile ezibamba i-testosterone futhi ziyisebenzise njengophethiloli ukuze iphindaphindeke. Ngokuvimba le nqubo, ukwelashwa ngamahomoni kunganciphisa kakhulu ukuqhubeka komdlavuza.

Lokhu kwelashwa akukuphulukisi umdlavuza wendlala yesinye, kodwa kungawulawula izinyanga noma iminyaka. Amadoda amaningi aphila impilo egcwele, esebenzayo ngenkathi ethola ukwelashwa ngamahomoni, ikakhulukazi uma kuhlanganiswe nezinye izindlela zokwelapha.

Kungani kwenziwa ukwelashwa ngamahomoni ngomdlavuza wendlala yesinye?

Odokotela batusa ukwelashwa ngamahomoni uma umdlavuza wendlala yesinye usakazekele ngaphandle kwendlala yesinye noma uma ezinye izindlela zokwelapha zingafaneleki esimweni sakho. Kuyasiza ikakhulukazi kumdlavuza wendlala yesinye othuthukile noma ometastatic.

Ungase uthole lokhu kwelashwa ngaphambi kokwelashwa ngemisebe ukuze unciphise umdlavuza futhi wenze imisebe isebenze kahle. Le ndlela yokuhlanganisa, ebizwa ngokuthi i-neoadjuvant therapy, ingathuthukisa imiphumela yakho yokwelashwa iyonke.

Ngesinye isikhathi ukwelashwa ngamahomoni kusebenza njengokwelashwa kwebhuloho ngenkathi unquma ezinye izinketho, noma lapho ukuhlinzwa kunganconywa ngenxa yobudala bakho noma ezinye izimo zempilo. Udokotela wakho uzocabangela isigaba somdlavuza wakho, impilo yonke, nezintandokazi zakho siqu lapho encoma le ndlela.

Ziyini izinhlobo zokwelashwa ngamahomoni ngomdlavuza wendlala yesinye?

Izindlela eziningana ezihlukene zingavimba noma zinciphise amahomoni adla umdlavuza wakho wendlala yesinye. Uhlobo ngalunye lusebenza ngendlela eyingqayizivele ukuze kuzuzwe umgomo ofanayo wokubulala amaseli omdlavuza.

Nazi izinhlobo eziyinhloko udokotela wakho angazicabangela esimweni sakho esithile:

• Ama-LHRH agonists: Imithombo yegazi yanyanga zonke noma ngekota eyitshela ubuchopho bakho ukuthi buyeke ukuthumela amasignali ematesticles akho ukuthi enze i-testosterone
• Ama-LHRH antagonists: Imithombo yegazi evimba ngokushesha ukukhiqizwa kwamahomoni ngaphandle kokwanda kokuqala kwe-testosterone
• Ama-Anti-androgens: Amaphilisi avimbela i-testosterone ukuthi inganamatheli kumaseli omdlavuza
• Ukukhishwa kwamatesticles ngokuhlinzwa (orchiectomy): Inqubo ehlala njalo esusa amatesticles
• Imithi yamahomoni emisha: Imithi ethuthukisiwe efana ne-abiraterone ne-enzalutamide evimba izindlela eziningi zamahomoni

Udokotela wakho we-oncologist uzokhetha inketho engcono kakhulu ngokusekelwe ezicini zomdlavuza wakho, impilo yakho yonke, nokuthi usabela kanjani ekwelashweni. Amadoda amaningi aqala ngemithombo yegazi ngoba iyaguquleka futhi iyasebenza.

Ama-LHRH agonists kanye nama-antagonists

Imithi ye-LHRH (i-luteinizing hormone-releasing hormone) iyona yokwelapha amahomoni okuqala avamile. Zisebenza ngokugxambukela ekuthumeleni amasignali phakathi kobuchopho bakho namatesticles.

Ama-Agonists afana ne-leuprolide ne-goserelin ekuqaleni abangela ukwanda okwesikhashana kwe-testosterone ngaphambi kokuyeka ukukhiqizwa ngokuphelele. Lo mphumela wokukhanya uvame ukuhlala cishe amasonto amabili futhi ungase uqhubeke kabi izimpawu zakho okwesikhashana.

Ama-antagonist afana ne-degarelix aqhuma isigaba sokukhukhumala futhi anciphise ngokushesha amazinga e-testosterone. Lokhu kubenza babe wusizo ikakhulukazi uma unobuhlungu emathanjeni noma ukuvaleka komchamo okungase kube kubi ngokwanda kwe-testosterone.

Imithi elwa ne-androgen

Ama-anti-androgens amaphilisi avimbela i-testosterone ekubopheni kumaseli omdlavuza wendlala yesinye. Izinketho ezivamile zihlanganisa i-bicalutamide, i-flutamide, ne-nilutamide.

Le mithi ivame ukusetshenziswa kanye nemithi ye-LHRH ukuhlinzeka ngokuvaleka okuphelele kwe-androgen. Le nhlanganisela ingasebenza kangcono kunanoma iyiphi enye indlela yokwelapha yodwa, nakuba ingase yandise imiphumela emibi.

Ngezinye izikhathi odokotela banikeza ama-anti-androgens wodwa, ikakhulukazi emadodeni amadala noma labo abafuna ukugcina umsebenzi othile wezocansi. Kodwa-ke, le ndlela ngokuvamile ayisebenzi kangako kunokwelashwa okuhlanganisiwe.

Ungalungela kanjani ukwelashwa kwakho ngamahomoni?

Ukulungiselela ukwelashwa ngamahomoni kuhilela ukulungela ngokomzimba nangokomzwelo. Ithimba lakho lokunakekelwa kwezempilo lizokuqondisa kuzo zonke izinyathelo ukuze uqiniseke ukuthi uzizwa uqinisekile futhi unolwazi.

Qala ngokuxoxa ngomlando wakho wezokwelapha ophelele nodokotela wakho we-oncologist, okuhlanganisa noma yiziphi izinkinga zenhliziyo, isifo sikashukela, noma izinkinga zamathambo. Lezi zimo zingathinteka ekwelashweni ngamahomoni, ngakho udokotela wakho udinga isithombe esiphelele sempilo yakho.

Cabangela ukuba nezivivinyo zokuqala ngaphambi kokuqala ukwelashwa. Lokhu kungase kuhlanganise ukuskena ukuminyana kwamathambo, izivivinyo zomsebenzi wenhliziyo, nomsebenzi wegazi ukukala amazinga akho wamanje e-hormone kanye nezimpawu zempilo yonke.

Xoxa ngokukhululekile nomlingani wakho noma umndeni wakho mayelana nezinguquko ongase uzithole. Ukwelashwa ngamahomoni kungathinta imizwa yakho, amazinga amandla, nomsebenzi wezocansi, ngakho ukuba nokusekelwa nokuqonda ekhaya kwenza umehluko omkhulu.

Yini inqubo yokwelashwa ngamahomoni?

Inqubo iyahluka ngokuya ngohlobo lokwelashwa ngamahomoni olunconywa udokotela wakho. Ukwelashwa okuningi kulula futhi kungenziwa ehhovisi likadokotela wakho noma emtholampilo ongagcini esibhedlela.

Ngemijovo, uzovakashela umhlinzeki wakho wezempilo nyanga zonke, njalo emva kwezinyanga ezintathu, noma njalo emva kwezinyanga eziyisithupha kuye ngomuthi othile. Umjovo ngokuvamile unikezwa engalweni yakho, ethangeni, noma emsipheni wezinqe futhi kuthatha imizuzu embalwa nje.

Uma uthatha amaphilisi, uzolandela isimiso sansuku zonke ekhaya. Udokotela wakho uzohlinzeka ngemiyalelo ecacile mayelana nesikhathi, ukuthi uwathathe nokudla, nokuthi wenzeni uma weqa umthamo.

Ukuqokwa okuvamile kokuqapha kuzolandela ukuthi ukwelashwa kusebenza kahle kangakanani futhi kubheke imiphumela emibi. Lokhu kuvakasha ngokuvamile kufaka phakathi ukuhlolwa kwegazi ukuhlola amazinga akho e-testosterone kanye nezinombolo ze-PSA (i-prostate-specific antigen).

Ungawafunda kanjani imiphumela yakho yokwelashwa ngamahomoni?

Udokotela wakho uzoqapha izimpawu ezimbalwa ezibalulekile ukuze anqume ukuthi ukwelashwa kwakho ngamahomoni kusebenza kahle kangakanani. Izilinganiso ezibaluleke kakhulu izinga lakho le-testosterone kanye nezinga le-PSA.

Ukwelashwa ngamahomoni okuphumelelayo ngokuvamile kunciphisa i-testosterone yakho emazingeni aphansi kakhulu, ngokuvamile ngaphansi kuka-50 ng/dL (abanye odokotela bahlose ukuba ngaphansi kuka-20 ng/dL). Lokhu kubizwa ngezinga lokukhishwa, futhi ngokuvamile kwenzeka kungakapheli amasonto ambalwa uqale ukwelashwa.

Izinga lakho le-PSA kufanele futhi lehle kakhulu, ngokuvamile libe ngaphansi kuka-4 ng/mL noma ngisho naphansi. I-PSA ekhuphukayo ngenkathi usekwelashweni ngamahomoni ingase ikhombe ukuthi umdlavuza wakho uba ngumelana nokwelashwa, okuzodinga ukulungisa indlela yakho.

Udokotela wakho uzoqapha nempilo yakho yonke ngokuhlolwa kwegazi okuvamile okuhlola ukusebenza kwesibindi, amazinga kashukela egazini, ne-cholesterol. Lokhu kusiza ukubamba noma yiziphi izinguquko ezihlobene nokwelashwa ekuqaleni ukuze ziphathwe ngempumelelo.

Yini imiphumela emibi yokwelashwa ngamahomoni?

Ukwelashwa ngamahomoni kungabangela imiphumela emibi ehlukahlukene ngoba kunciphisa kakhulu amazinga akho e-testosterone. Ukuqonda okulindelekile kukusiza ukuthi ulungiselele futhi uphathe lezi zinguquko ngempumelelo.

Imiphumela eminingi emibi iqala kancane kancane emasontweni noma ezinyangeni, futhi eminingi ingalawulwa ngemithi noma ukulungiswa kwendlela yokuphila. Ithimba lakho lokunakekelwa kwezempilo lizosebenza nawe ukunciphisa noma yimiphi imiphumela engakhululeki.

Nawa amanye amaphutha avamile ongase uwahlangabezane nawo:

• Ukushisa: Ukuzwa okungazelelwe kokushisa nokujuluka, okufana nokuya esikhathini
• Ukukhathala: Ukuzwa ukhathele noma ukuba namandla amancane kunokujwayelekile
• Ushintsho lwemizwa: Ukucindezeleka, ukukhathazeka, noma ukuzwela ngokomzwelo
• Ushintsho ngokocansi: Ukuncipha kwesifiso socansi nokungasebenzi kahle
• Ushintsho lomzimba: Ukuzuza isisindo, ukulahlekelwa kwemisipha, nokukhuliswa kwamabele
• Ukuncipha kwamathambo: Ukwanda kwengozi ye-osteoporosis kanye nokuqhekeka

Le miphumela ngokuvamile iyashintsheka uma uyeka ukwelashwa ngamahomoni, nakuba ezinye izinguquko zingase zithathe izinyanga ukuthuthuka. Udokotela wakho angakwazi ukukuyalela imithi futhi ancome izinguquko zendlela yokuphila ukusiza ukulawula iningi lalezi zinkinga.

Ukuphatha imiphumela emibi evamile

Ukushisa kuthinta kufika ku-80% yamadoda ekwelashweni ngamahomoni, kodwa amasu amaningana anganikeza impumuzo. Udokotela wakho angase akuyalele imithi efana ne-antidepressants noma imithi elwa nokuhlaselwa yisithuthwane enganciphisa imvamisa yabo kanye nobukhulu babo.

Ukuze uthole impilo yamathambo, udokotela wakho cishe uzoncoma izithasiselo ze-calcium ne-vitamin D, kanye nokuzivocavoca okuthwala isisindo. Amanye amadoda adinga imithi kadokotela ebizwa ngokuthi ama-bisphosphonates ukuvimbela ukulahlekelwa kwamathambo.

Ukugcina ubukhulu bemisipha nokuphatha ukuzuza isisindo kudinga ukuzivocavoca njalo nokunaka ukudla kwakho. Ukusebenza nochwepheshe wezokudla kanye nomqeqeshi womzimba kungakusiza ukuthi uthuthukise uhlelo oluzinzile oluhambisana namazinga akho wamandla namakhono akho.

Yini imiphumela yesikhathi eside yokwelashwa ngamahomoni?

Ukwelashwa ngamaphilisi amahomoni isikhathi eside kungaholela ezingxenyeni ezinkulu emzimbeni wakho, ikakhulukazi uma uqhubeka nokwelashwa iminyaka eminingana. Ukuqonda le miphumela engaba khona kukusiza ukuthi wenze izinqumo ezinolwazi mayelana nokunakekelwa kwakho.

Impilo yenhliziyo nemithambo yegazi iba yinto ekhathaza kakhulu ngemithi yamahomoni enwetshiwe. Ezinye izifundo zikhomba engozini eyengeziwe yesifo senhliziyo nesitroko, ikakhulukazi emadodeni anezimo zenhliziyo ezikhona.

Ukuqina kwamathambo kuvame ukwehla ngokuhamba kwesikhathi, okungaholela ku-osteoporosis kanye nengozi eyengeziwe yokuphuka. Udokotela wakho uzoqapha lokhu ngokucophelela futhi angase ancome ukwelashwa kokuvimbela uma ukuqina kwamathambo akho kwehle kakhulu.

Ushintsho lokuqonda, ngezinye izikhathi olubizwa ngokuthi

Ekugcineni, iminyango eminingi yomdlavuza wendlala yesinye iqala ukumelana nokwelashwa ngamahomoni, isimo esibizwa ngokuthi umdlavuza wendlala yesinye ongamelani nokukhishwa kwamahomoni (CRPC). Lokhu akusho ukuthi ukwelashwa kuhluleke ngokuphelele, kodwa kunalokho ukuthi umdlavuza uthole izindlela zokukhula naphezu kwamazinga aphansi e-testosterone.

Izimpawu zokuthi ukwelashwa ngamahomoni kungase kulahlekelwe ukusebenza kahle zihlanganisa amazinga e-PSA akhuphukayo, izimpawu ezintsha njengobuhlungu bamathambo, noma izivivinyo zokucabanga ezibonisa ukukhula komdlavuza. Lokhu kuvamile ukwenzeka kancane kancane ezinyangeni noma eminyakeni.

Lapho ukumelana kuvela, udokotela wakho unezinketho eziningi zokwelashwa ezintsha ezitholakalayo. Lokhu kufaka phakathi imithi yamahomoni ethuthukisiwe efana ne-abiraterone ne-enzalutamide, i-chemotherapy, i-immunotherapy, noma ukwelashwa okusha okuqondiwe.

Ukuvela kokumelana akusho ukuthi isimo sakho asithembi. Amadoda amaningi aqhubeka nokuphila kahle ngokwelashwa okuphumelelayo komdlavuza wendlala yesinye ongamelani nokukhishwa kwamahomoni, ngokuvamile iminyaka eminingi ngemva kokuthi ukwelashwa ngamahomoni kuyeka ukusebenza.

Ingabe ukwelashwa ngamahomoni kulungile kuwe?

Isinqumo sokuqala ukwelashwa ngamahomoni sincike ezintweni eziningi ezithile esimweni sakho. Udokotela wakho we-oncologist uzocabangela isigaba somdlavuza wakho, impilo yonke, ubudala, nezintandokazi zomuntu siqu lapho enza izincomo.

Ukwelashwa ngamahomoni kunenzuzo enkulu emadodeni anomdlavuza wendlala yesinye othuthukile noma ometastatic, noma labo abakuthola kanye nokwelashwa ngemisebe. Kungase kungabi yisinqumo sokuqala esingcono kakhulu somdlavuza wesigaba sokuqala ongaphulukiswa ngokuhlinzwa noma ngemisebe kuphela.

Izinhloso zakho zekhwalithi yempilo zibaluleke kakhulu kulesi sinqumo. Amanye amadoda abeka phambili ukulawula umdlavuza wawo kungakhathaliseki imiphumela emibi, kanti abanye bakhetha ukugcina izinga labo lamanje lempilo isikhathi eside ngangokunokwenzeka.

Thatha isikhathi sokuxoxa zonke izinketho zakho nethimba lakho lezempilo, okuhlanganisa izinzuzo ezingaba khona, izingozi, kanye nezinye izindlela. Ukuthola umbono wesibili kungakusiza futhi uzizwe uqiniseka kakhulu esinqumweni sakho.

Ukuphila kahle ngesikhathi sokwelashwa ngamahomoni

Amadoda amaningi aphila impilo enempilo futhi egcwele ngenkathi ethola ukwelashwa ngamahomoni. Okubalulekile ukuba uqaphele ukuphatha imiphumela emibi nokugcina impilo yakho yonke.

Ukuvivinya umzimba njalo kubaluleke kakhulu ngesikhathi sokwelashwa ngamahomoni. Ngisho nemisebenzi elula efana nokuhamba ingasiza ekugcineni imisipha, amandla amathambo, namazinga wamandla ngenkathi futhi ithuthukisa imizwa yakho.

Ukudla ukudla okunempilo okucebile nge-calcium, uvithamini D, kanye namaprotheni kusekela impilo yamathambo akho futhi kusiza ukuphatha izinguquko zesibalo somzimba. Cabangela ukusebenza nodokotela wezokudla obhalisiwe oqonda izidingo zokudla kwabantu abanesifo somdlavuza.

Hlala uxhumene nenethiwekhi yakho yokusekela, kungakhathaliseki ukuthi umndeni, abangane, noma amaqembu okusekela umdlavuza. Amadoda amaningi akuthola kuwusizo ukukhuluma nabanye abadlule ezintweni ezifanayo.

Kufanele ngibone nini udokotela ngesikhathi sokwelashwa ngamahomoni?

Ukuqokwa okulandelayo njalo kubalulekile ngesikhathi sokwelashwa ngamahomoni, kodwa kufanele futhi uthinte ithimba lakho lezempilo uma uhlangabezana nanoma yiziphi izimpawu ezikhathazayo phakathi kokuvakasha.

Shayela udokotela wakho ngokushesha uma uba nobuhlungu besifuba, ukuphefumula kanzima okukhulu, izimpawu zamaqhubu egazi, noma imicabango yokuzilimaza. Lokhu kungabonisa izinkinga ezingathi sína ezidinga ukunakwa ngokushesha.

Xhumana nethimba lakho lezempilo phakathi nezinsuku ezimbalwa uma uhlangabezana nokushisa okukhulu okungaphazamisi ukulala, ubuhlungu bamathambo obungachazeki, izinguquko ezinkulu zemizwa, noma yimiphi imiphumela emibi ekukhathazayo.

Unganqikazi ukufinyelela ngemibuzo mayelana nokwelashwa kwakho, ngisho noma kubonakala kuncane. Ithimba lakho lezempilo likhona ukukusekela ohambweni lwakho lokwelashwa.

Imibuzo evame ukubuzwa mayelana nokwelashwa ngamahomoni ngomdlavuza wendlala yesinye

Q1: Ingabe ukwelashwa ngamahomoni kuyi-chemotherapy?

Cha, ukwelashwa ngamahomoni akuyona i-chemotherapy. Nakuba kokubili kuyizindlela zokwelapha umdlavuza, zisebenza ngendlela ehlukile. Ukwelashwa ngamahomoni ngokukhethekile kuvimba noma kunciphisa amahomoni esilisa akhuthaza ukukhula komdlavuza wendlala yesinye, kuyilapho i-chemotherapy isebenzisa imithi ehlasela ngokuqondile amaseli ahlukanisa ngokushesha emzimbeni wakho wonke. Ukwelashwa ngamahomoni ngokuvamile kunemiphumela emincane eceleni futhi ehlukile uma kuqhathaniswa ne-chemotherapy.

Q2: Ngingakwazi yini ukuyeka ukwelashwa ngamahomoni uma imiphumela emibi iba nzima kakhulu?

Ungaxoxa ngokuyeka noma ukuthatha amakhefu ekwelashweni ngamahomoni nodokotela wakho we-oncologist uma imiphumela emibi ithinta kakhulu izinga lempilo yakho. Abanye odokotela batusa ukwelashwa ngamahomoni ngezikhathi ezithile, lapho uthatha amakhefu ahleliwe ukuze uvumele i-testosterone yakho ukuthi ilulame okwesikhashana. Nokho, ukuyeka ukwelashwa kungavumela umdlavuza wakho ukuthi ukhule, ngakho lesi sinqumo sidinga ukucatshangelwa ngokucophelela kwezinzuzo uma kuqhathaniswa nezingozi.

Q3: Ingabe ukwelashwa ngamahomoni kuzothinta ikhono lami lokuba nezingane?

Ukwelashwa ngamahomoni ngokuvamile kwenza amadoda angabi nenzalo ngenkathi ethola ukwelashwa ngoba kwehlisa kakhulu i-testosterone futhi kumisa ukukhiqizwa kwesidoda. Uma unentshisekelo yokuba nezingane esikhathini esizayo, khuluma nodokotela wakho mayelana nokugcinwa kwesidoda ngaphambi kokuqala ukwelashwa. Inzalo ingase ibuye ngemva kokuyeka ukwelashwa ngamahomoni, kodwa lokhu akuqinisekisiwe, ikakhulukazi ngemva kokwelashwa kwesikhathi eside.

Q4: Ngizodinga ukuhlala isikhathi esingakanani ekwelashweni ngamahomoni?

Ubude besikhathi buyahluka kakhulu kuye ngesimo sakho esithile. Amanye amadoda athola ukwelashwa ngamahomoni izinyanga ezimbalwa ngaphambi kwemisebe, kuyilapho amanye anomdlavuza othuthukile angaqhubeka iminyaka eminingi noma unomphela. Udokotela wakho we-oncologist uzohlola njalo ukuthi ngabe ukuqhubeka nokwelashwa kunikeza izinzuzo ezengeziwe kunezingozi. Umgomo uwukulawula umdlavuza wakho ngenkathi ugcina izinga elingcono kakhulu lempilo.

Q5: Ngingakwazi yini ukuzivocavoca ngokujwayelekile ngenkathi ngithola ukwelashwa ngamahomoni?

Yebo, ukuzivivinya kuyakhuthazwa ngempela ngesikhathi sokwelashwa ngamahomoni futhi kungasiza ekuphatheni imiphumela eminingi engemihle. Ungase udinge ukulungisa isimiso sakho ngenxa yokukhathala noma izinguquko zemisipha, kodwa ukuhlala usebenza kusiza ukugcina ukuminyana kwamathambo, ubukhulu bemisipha, nempilo yengqondo. Sebenzisana nethimba lakho lezempilo ukuze uthuthukise uhlelo lokuzivivinya oluphephile futhi olufanele izinga lakho lamanje lokufaneleka kanye nanoma yiziphi ezinye izimo zempilo ongase ube nazo.