Yini iMitotane: Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

I-Mitotane iyimithi ekhethekile esetshenziselwa ukwelapha i-adrenocortical carcinoma, uhlobo olungavamile kodwa olubucayi lomdlavuza oluthinta amaglandla e-adrenal. Uma wena noma othile omkhathalelayo enikezwe lo muthi, cishe ubhekene nemizwa eyinkimbinkimbi kanye nemibuzo mayelana nokuthi yini ezayo.

Lo muthi onamandla wokulwa nomdlavuza usebenza ngokukhethekile ngokugxila kumaseli omdlavuza ku-adrenal cortex ngenkathi futhi usiza ukuphatha izimpawu lapho umdlavuza ungenakususwa ngokuphelele. Ngenkathi i-mitotane idinga ukuqashwa ngokucophelela futhi ingabangela imiphumela emibi, iyithuluzi elibalulekile elisize abantu abaningi ukuphatha lesi simo esiyinselele.

Yini iMitotane?

I-Mitotane iyimithi yomlomo ye-chemotherapy engaphansi kwezigaba zemithi ebizwa ngokuthi ama-adrenolytic agents. Ikhomba ngqo ungqimba olungaphandle lwamaglandla akho e-adrenal, olubizwa ngokuthi i-adrenal cortex, lapho izinhlobo ezithile zomdlavuza zingakhula khona.

Amaglandla akho e-adrenal ahlala phezulu ezinso zakho futhi akhiqiza amahomoni abalulekile afana ne-cortisol ne-aldosterone. Lapho umdlavuza uvela kula maglandla, i-mitotane ingasiza kokubili ngokulwa namaseli omdlavuza nokunciphisa ukukhiqizwa ngokweqile kwamahomoni okuvame ukwenzeka ngalolu hlobo lwesimila.

Lo muthi usetshenziswe amashumi eminyaka futhi usahlala ungomunye wemithi ephumelela kakhulu etholakalayo ye-adrenocortical carcinoma. Ngenkathi ithathwa njengomuthi onamandla odinga ukuqashwa ngokucophelela, iziguli eziningi zikutholile ukuthi kuyasiza ekuphatheni isimo sazo.

Yini iMitotane Esetshenziselwa Yona?

I-Mitotane ikakhulukazi inikezwa ukwelapha i-adrenocortical carcinoma, umdlavuza ongavamile othinta cishe abantu abangu-1-2 kwisigidi ngonyaka ngamunye. Udokotela wakho angase ancome lo muthi ezimweni ezimbili eziyinhloko.

Okokuqala, i-mitotane ingasetshenziswa ngemva kokuhlinzwa ukuze kususwe umdlavuza we-adrenal, ngisho nalapho ukuhlinzwa kubonakala kuyimpumelelo. Le ndlela, ebizwa ngokuthi i-adjuvant therapy, isiza ukunciphisa ingozi yokuthi umdlavuza ubuye ngokuhlasela noma yiziphi izimila ezingase zibe zincane kakhulu ukuthi zingatholakala.

Okwesibili, lo muthi ungasiza ekuphatheni i-adrenocortical carcinoma ethuthukile lapho umdlavuza usabalale kwezinye izingxenye zomzimba noma lapho ungenakususwa ngokuphelele ngokuhlinzwa. Kulezi zimo, i-mitotane ingasiza ukunciphisa ukukhula komdlavuza futhi inciphise izimpawu ezibangelwa ukukhiqizwa kwamahomoni amaningi.

Abanye odokotela baphinda babhale i-mitotane ye-Cushing's syndrome uma ibangelwa izimila ze-adrenal. Lesi simo senzeka lapho umzimba wakho ukhiqiza i-cortisol eningi kakhulu, okuholela ezimpawini ezinjengokukhuluphalisa, umfutho wegazi ophezulu, kanye nezinguquko zemizwa.

Isebenza Kanjani I-Mitotane?

I-Mitotane isebenza ngokuhlasela ngqo nokubhubhisa amaseli e-adrenal cortex, kokubili amaseli anomdlavuza kanye namaseli avamile kule ndawo. Cabanga ngayo njengomuthi onokukhanga okuthile ezicutshini ze-adrenal, okuvumela ukuthi igxilise imiphumela yawo lapho idingeka kakhulu.

Lo muthi uphazamisa ukukhiqizwa kwamahomoni e-steroid emaglands akho e-adrenal, okuhlanganisa i-cortisol ne-aldosterone. Lesi senzo esiphindwe kabili sisiza ukulwa namaseli omdlavuza ngenkathi futhi sinciphisa amazinga amahomoni amaningi avame ukubangela izimpawu ezinzima ezigulini ezinomdlavuza we-adrenal.

Lokhu kuthathwa njengomuthi onamandla ngoba kungathinta kakhulu ukusebenza kwakho kwe-adrenal. Ngenkathi le ndlela eqondiwe yenza i-mitotane isebenze ngokumelene nomdlavuza we-adrenal, futhi kusho ukuthi uzodinga i-hormone replacement therapy ukuze ugcine imisebenzi ejwayelekile yomzimba.

Umuthi wakha ezicutshini zakho ezinamafutha ngokuhamba kwesikhathi, okusho ukuthi uyaqhubeka nokusebenza ngisho nangemva kokuyeka ukuwuthatha. Lesi sici sisiza ukugcina imiphumela yawo yokulwa nomdlavuza kodwa futhi kusho ukuthi imiphumela emibi ingaqhubeka amasonto noma izinyanga ngemva kokuphela kokwelashwa.

Kufanele Ngiyithathe Kanjani I-Mitotane?

I-Mitotane kufanele ithathwe ngendlela eqondile njengoba kunqunywe udokotela wakho we-oncologist, ngokuvamile iqala ngomthamo ophansi okhuphuka kancane kancane ngokuhamba kwesikhathi. Udokotela wakho uzoqapha ngokucophelela amazinga egazi lakho futhi alungise umthamo ukuze athole ukulinganisela okulungile phakathi kokusebenza kahle nemiphumela engemihle elawulekayo.

Thatha i-mitotane nokudla, okungcono nakho ukudla okuqukethe amafutha athile, ngoba lokhu kusiza umzimba wakho ukuba umunce imithi ngempumelelo enkulu. Iziguli eziningi zikuthola kuwusizo ukuthatha imithi ngezikhathi ezifanayo nsuku zonke ukuze kugcinwe amazinga aqhubekayo ohlelweni lwazo.

Abantu abaningi baqala ngamagremu angu-2-6 ngosuku, ahlukaniswe abe izilinganiso ezingu-3-4 usuku lonke. Udokotela wakho angase akhuphule lokhu kancane kancane, ngezinye izikhathi kufika kumagremu angu-8-10 nsuku zonke, kuye ngokuthi uyayibekezelela kahle kangakanani imithi namazinga egazi lakho.

Kubalulekile ukuhlala unamanzi kahle ngenkathi uthatha i-mitotane futhi ukugweme utshwala, ngoba kokubili kungathinta indlela umzimba wakho oyiqeda ngayo imithi. Ithimba lakho lezempilo lizohlinzeka ngesiqondiso esiqondile mayelana nanoma yikuphi ukudla noma eminye imithi okufanele ukugweme.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Mitotane?

Ubude bokwelashwa nge-mitotane buhlukahluka kakhulu kuye ngesimo sakho esithile nokuthi usabela kahle kangakanani emithini. Ezinye iziguli ziyithatha izinyanga eziningana, kanti ezinye zingayidinga iminyaka.

Uma uthatha i-mitotane ngemva kokuhlinzwa ukuvimbela ukuphindeka komdlavuza, ukwelashwa ngokuvamile kuqhubeka iminyaka engu-2-5, uma nje uyibekezelela kahle futhi amazinga egazi lakho ahlala efanele. Udokotela wakho uzohlola njalo ukuthi ngabe ukuqhubeka nokwelashwa kuyazuzisa yini esimweni sakho esithile.

Nge-adrenocortical carcinoma ethuthukisiwe, ukwelashwa kuvame ukuqhubeka uma nje imithi isiza ukulawula umdlavuza futhi ulawula imiphumela engemihle kahle. Ithimba lakho lezempilo lizoqapha inqubekela phambili yakho ngokuskena njalo nokuhlolwa kwegazi.

Ungayeki ukuthatha i-mitotane ngokuzumayo ngaphandle kokuxoxa ngayo nodokotela wakho kuqala. Ngenxa yokuthi umuthi uhlala emzimbeni wakho amasonto noma izinyanga, ukwelashwa kwakho kokufaka amahomoni kanye nohlelo lokuqapha kungase kudingeke ukuthi kulungiswe ngisho nangemva kokuyeka ukuwuthatha.

Yiziphi Izimo Ezingezinhle ze-Mitotane?

I-Mitotane ingabangela imiphumela eminingi engemihle ngoba ithinta ukusebenza okujwayelekile kwamadlala akho e-adrenal, kodwa ukuqonda okungase kwenzeke kungakusiza ukuthi uzilungiselele futhi uzilawule ngempumelelo. Imiphumela eminingi engemihle ihlobene nomthelela womuthi ekukhiqizweni kwama-hormone kanye nesimiso sakho sezinzwa.

Nawa amanye amaphutha avamile ongase uwahlangabezane nawo:

• Izinkinga zokugaya ukudla: Ukucasuka, ukuhlanza, isifo sohudo, nokulahlekelwa isifiso sokudla kuvamile kakhulu, ikakhulukazi uma uqala ukwelashwa noma ukwandisa imithamo
• Izimpawu ze-Neurological: Isiyezi, ukudideka, ukukhathala, nezinkinga zokuxhumana zingenzeka njengoba umuthi uthinta isimiso sakho sezinzwa
• Ukungasebenzi kahle kwe-Adrenal: Uzodinga ukwelashwa kokufaka amahomoni ngoba i-mitotane inciphisa ukukhiqizwa kwakho kwama-hormone emvelo
• Ushintsho lwesikhumba: Ukuqubuka kwesikhumba, ukubomvu, noma ukwanda kokuzwela elangeni kungase kuvele
• Ukukhathala okujwayelekile: Iziguli eziningi ziba nokukhathala nobuthakathaka, ikakhulukazi emasontweni ambalwa okuqala okwelashwa

Le miphumela emibi ejwayelekile ivame ukuthuthuka njengoba umzimba wakho uzivumela emuthini futhi ukwelashwa kwakho kokufaka amahomoni kulungiselelwe. Ithimba lakho lezempilo lizosebenza eduze nawe ukuze lilawule le miphumela.

Ezinye izimo ezingavamile kodwa ezingathi sína zidinga ukunakekelwa kwezempilo ngokushesha. Ngenkathi lokhu kwenzeka ngesilinganiso esincane seziguli, kubalulekile ukuzazi:

• Izimpawu ezinzima zemizwa: Ukudideka okukhulu, izinkinga zenkumbulo, noma ubunzima bokuhlela obuphazamisa imisebenzi yansuku zonke
• Inkinga yama-adrenal: Ubuthakathaka obukhulu, isicanucanu, ukuhlanza, kanye nomfutho wegazi ophansi okungaba yingozi ekuphileni ngaphandle kokwelashwa ngokushesha
• Izinkinga zesibindi: Ama-enzyme esibindi aphakeme, ukuphuzi kwesikhumba noma amehlo, noma ubuhlungu obukhulu besisu
• Ukuphendula okukhulu komzimba: Ukuphefumula kanzima, ukuqubuka okukhulu, noma ukuvuvukala kobuso nomphimbo

Udokotela wakho uzokuhlola ngokucophelela ngezivivinyo zegazi ezivamile nokuhlolwa ukuze abambe noma yiziphi izinguquko ezikhathazayo ekuqaleni. Imiphumela eminingi emibi iyalawuleka ngosekelo olufanele nokulungiswa kohlelo lwakho lokwelashwa.

Ubani Ongafanele Athathe i-Mitotane?

I-Mitotane ayifanele wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi ingabe iyona ndlela efanele esimweni sakho esithile. Ezinye izimo zezempilo nezimo zenza lo muthi ungaphephile noma ungasebenzi kahle.

Akufanele uthathe i-mitotane uma wazi ukuthi unokungezwani komzimba nomuthi noma yiziphi izithako zawo. Abantu abanezifo zesibindi ezinzima kungenzeka bangakwazi ukucubungula umuthi ngokuphepha, njengoba i-mitotane ingase iqhubeke nokucindezela ukusebenza kwesibindi.

Ukukhulelwa kunikeza izinto ezikhethekile okufanele zicatshangelwe ngoba i-mitotane ingalimaza ingane esakhula. Abesifazane abakhulelwe noma abahlela ukukhulelwa kufanele baxoxe ngezindlela zokwelapha ezingezinye neqembu labo lezempilo. Bobabili abesilisa nabesifazane kufanele basebenzise izindlela zokuvimbela inzalo ezisebenzayo ngenkathi bethatha lo muthi.

Uma uncelisa, i-mitotane ingadlulela obisini lwebele futhi ilimaze ingane yakho. Udokotela wakho uzoxoxa ngezingozi nezinzuzo futhi akusize unqume ngendlela ephephe kakhulu kuwe nakumntwana wakho.

Izimo ezithile zezokwelapha zidinga ukuqapha okwengeziwe lapho kucatshangelwa ukwelashwa nge-mitotane. Abantu abanezifo ezinzima zezinso, izifo eziqhubekayo, noma izimo eziphawulekayo zempilo yengqondo bangase badinge izindlela zokwelapha eziguquliwe noma ukuqapha okwengeziwe.

Amagama Omkhiqizo we-Mitotane

I-Mitotane itholakala ngaphansi kwegama lomkhiqizo elithi Lysodren emazweni amaningi, okuhlanganisa ne-United States. Lolu uhlobo oluvame kakhulu ukunqunywa lomuthi futhi lusetshenziswe ngokuphepha amashumi eminyaka.

Kwezinye izifunda, ungase uthole i-mitotane itholakala ngaphansi kwamanye amagama omkhiqizo noma njengezinhlobo ezivamile. Kodwa-ke, ngenxa yokuthi lo muthi udinga ukulinganiswa okunembile nokuqapha, kubalulekile ukuhlala ngomkhiqizo ofanayo noma ukwakheka ngaphandle uma udokotela wakho evuma ngokuqondile ushintsho.

I-pharmacy yakho kufanele ngaso sonke isikhathi ikhiphe umkhiqizo ofanayo noma inguqulo ejwayelekile ukuqinisekisa ukuqina ekwelashweni kwakho. Uma uqaphela noma yikuphi ukungafani ekubukekeni komuthi wakho, hlola nomphathi wakho we-pharmacy noma umhlinzeki wezempilo ngaphambi kokuwuthatha.

Ezinye Izindlela Zokwelapha Nge-Mitotane

Ngenkathi i-mitotane isahlala iyindlela yokwelapha eyinhloko ye-adrenocortical carcinoma, ezinye izinketho zingase zicatshangelwe kuye ngesimo sakho esithile nokuthi uyibekezelela kangakanani i-mitotane.

Kubantu abangakwazi ukubekezelela i-mitotane noma abangayiphenduli kahle, eminye imithi ye-chemotherapy efana ne-etoposide, doxorubicin, cisplatin, noma i-streptozocin ingase isetshenziswe yodwa noma ihlanganiswe. Lezi zindlela zokwelapha ezihlukile zisebenza ngendlela ehlukile kune-mitotane kodwa zingasiza ekulweni nomdlavuza we-adrenal.

Izindlela zokwelapha ezintsha eziqondiwe kanye nemithi ye-immunotherapy zifundwa nge-adrenocortical carcinoma, nakuba lezi zivame ukutholakala ngezivivinyo zemitholampilo noma ezimweni ezithile. Udokotela wakho we-oncologist angaxoxa ngokuthi ngabe ezinye zalezi zinketho ezintsha zingase zifanele yini icala lakho.

Ukuphatha izimpawu ezihlobene namahomoni, imithi efana ne-ketoconazole, metyrapone, noma i-etomidate ingasiza ekunciphiseni ukukhiqizwa kwamahomoni ngokweqile ngaphandle kokulwa ngqo namaseli omdlavuza. Lokhu kungase kusetshenziswe kanye noma esikhundleni se-mitotane ezimweni ezithile.

Ingabe i-Mitotane Ingcono Kunezinye Izindlela Zokwelapha Umdlavuza We-Adrenal?

I-Mitotane ithathwa njengendlela yokwelapha yegolide ye-adrenocortical carcinoma ngoba iyona muthi ocwaningwe kakhulu kulo mdlavuza ongavamile. Iminyaka eminingi yocwaningo ikhombisile ukuthi ingasiza ekunwebeni ukusinda futhi ithuthukise izinga lempilo labantu abaningi.

Ngokungafani neminye imithi ye-chemotherapy ethinta amaseli emzimbeni wakho wonke, i-mitotane iqondise ngqo izicubu ze-adrenal, okuyenza isebenze ngempumelelo emdlavuzeni we-adrenal. Le ndlela eqondiwe ivame ukuyenza isebenze ngempumelelo kunezidakamizwa ezijwayelekile ze-chemotherapy zalolu hlobo oluthile lomdlavuza.

Nokho,

Iziguli eziningi ezinomdlavuza zithatha ngempumelelo i-mitotane ngenkathi zigcina ukulawulwa kahle ushukela wegazi. Okubalulekile ukuxhumana okuvulekile nodokotela wakho we-oncologist kanye nethimba lakho lokunakekelwa sikashukela ukuqinisekisa ukunakekelwa okuhleliwe.

Kufanele ngenzeni uma ngiphuzile i-Mitotane eningi ngengozi?

Uma ngengozi uphuza i-mitotane eningi kunaleyo ebekiwe, xhumana nomhlinzeki wakho wezempilo noma isikhungo sokulawula ubuthi ngokushesha. Ukuphuza i-mitotane eningi kungakhuphula ingozi yakho yemiphumela emibi engathi sína, ikakhulukazi izimpawu zemizwa nokucasuka okukhulu.

Ungazami ukulungisa umthamo owengeziwe ngokuqaqa umthamo wakho olandelayo ohleliwe. Kunalokho, landela isiqondiso somhlinzeki wakho wezempilo mayelana nendlela yokuqhubeka neshejuli yakho yokulinganisa ejwayelekile.

Izimpawu zokweqisa kwe-mitotane zingabandakanya ukucasuka okukhulu, ukuhlanza, ukudideka, izinkinga zokuxhumana, noma ukozela okungavamile. Uma uhlangabezana nanoma yiziphi zalezi zimpawu ngemva kokuthatha imithi eyengeziwe, funa ukunakekelwa kwezokwelapha ngokushesha.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Mitotane?

Uma uphuthelwa umthamo we-mitotane, yithathe ngokushesha lapho ukhumbula, ngaphandle uma sekuseduze isikhathi somthamo wakho olandelayo ohleliwe. Kulokho, weqa umthamo ophuthelwe futhi uqhubeke neshejuli yakho ejwayelekile.

Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo ophuthelwe, njengoba lokhu kungakhuphula ingozi yakho yemiphumela emibi. Ngenxa yokuthi i-mitotane ihlala ohlelweni lwakho isikhathi eside, ukuphuthelwa umthamo ngezikhathi ezithile akuyona inkinga kangako njengoba kunjalo ngeminye imithi.

Uma uvame ukukhohlwa imithamo, cabangela ukusetha izikhumbuzi zocingo noma usebenzise umhleli wamaphilisi ukukusiza ukuthi uhlale emgwaqeni. Ukulinganisa okuqhubekayo kusiza ukugcina amazinga egazi azinzile futhi kuthuthukise ukusebenza kahle komuthi.

Ngingayeka nini ukuthatha i-Mitotane?

Isinqumo sokuyeka i-mitotane kufanele senziwe ngaso sonke isikhathi ngokubonisana nodokotela wakho we-oncologist ngokusekelwe ekuphenduleni kwakho ukwelashwa, imiphumela emibi, nesimo sempilo esiphelele. Ungalokothi uyeke ukuthatha i-mitotane ngokwakho, ngisho noma uzizwa ungcono.

Udkt wakho uzohlola njalo ukuthi ukuqhubeka ne-mitotane kuyazuzisa yini ngokusebenzisa izifundo zokuthwebula izithombe, ukuhlolwa kwegazi, kanye nokuhlola izimpawu zakho. Uma umdlavuza ulawulwa kahle futhi uhlangabezana nemiphumela emibi ebalulekile, udkt wakho angase acabange ukuyeka noma ukunciphisa umthamo.

Ngenxa yokuthi i-mitotane ihlala ohlelweni lwakho amasonto noma izinyanga ngemva kokuyeka, uzodinga ukuqhubeka nokuqapha kanye nokwelashwa kokufaka amahomoni ngisho nangemva kokuyeka umuthi. Ithimba lakho lezempilo lizokwenza uhlelo lokushintsha umuthi ngokuphepha.

Ngingahamba Ngesikhathi Ngithatha I-Mitotane?

Ungahamba ngenkathi uthatha i-mitotane, kodwa kudinga ukuhlela okwengeziwe nezinyathelo zokuphepha. Hlala uphethe imithi yakho ezitsheni zayo zangempela futhi ulethe izinto ezengeziwe uma kwenzeka ukubambezeleka kohambo.

Ngenxa yokuthi uzobe uthatha ukwelashwa kokufaka amahomoni kanye ne-mitotane, qiniseka ukuthi unayo yonke imithi yakho eyanele yalo lonke uhambo kanye nezinsuku ezimbalwa ezengeziwe. Cabanga ngokuthwala incwadi evela kudkt wakho echaza isimo sakho sezempilo kanye nemithi.

Uma uhamba uye endaweni yesikhathi ehlukile, khuluma nomhlinzeki wakho wezempilo mayelana nendlela yokulungisa isimiso sakho sokulinganisa. Kubuye kuhlakaniphile ukucwaninga izikhungo zezokwelapha lapho uya khona uma udinga ukunakekelwa kwezempilo ngenkathi ungekho ekhaya.