I-Axumin yi-FDA evunyelwe, iskena esithwetshwe ngamagciwane esingafinyelela ekutholeni ngokushesha umdlavuza we-prostate ngemuva kokuhlinzwa noma imisebe. Sekuyiminyaka sikwazi ukuthola umdlavuza we-prostate recurrences ne- PSA , kodwa izilinganiso ezijwayelekile zomzimba nezethambo azikwazanga ukucacisa indawo yomdlavuza kuze kube yizinga le-PSA eliphakanyisiwe kakhulu (10 kuya ku-30 noma ngaphezulu).
I-Axumin ingakwazi ukubona izifo eziphindaphindiwe ngamazinga e-PSA ngaphansi kwezingu-10 futhi ngezinye izikhathi eziphansi kakhulu, yingakho lokhu ukuskena kubalulekile ukuthuthukiswa.
Kungani Axumin Kubaluleke Kangako?
Ukukwazi ukuthola izifo zakuqala zesimiso nge-scan inikeza izinzuzo ezimbili ezibalulekile zokwelapha. Okokuqala, ukwazi ukuthi umdlavuza ukhona kuphi kungasiza ukuhola ukwelashwa okuphumelelayo endaweni ethile yomzimba futhi ukhawule umonakalo kwezinye izindawo zomzimba. Ukuskena kuthatha lapho umdlavuza engekho futhi lapho ukwelashwa kungadingeki khona.
Umnikelo wesibili owusizo owenziwe ngokunembile kunikezwa ukuqonda okujulile ngenqubo yesifo ngokwayo-ukuveza ukuthi umdlavuza usuwenzile noma cha, noma ngabe ngabe uhlelwe kanjani.
Umdlavuza ovame ukuboniswa yi-PSA ekhulayo akusiyo njalo ngenxa ye-metastases. Ngezinye izikhathi umdlavuza uhlala eduze noma lapho i-prostate yayikhona khona, ngakho-ke i-PSA ivela emdlavuza ophindaphinda ku-prostate gland emva kokushiswa kwemisebe noma i-prostate fossa ngemva kokuhlinzwa (i-fossa yindawo yomzimba lapho i-prostate itholakale ngaphambi ukususwa okukhishwayo), okuyaziwa ngokuthi "ukuphindaphinda kwendawo."
I-PSA ingaphakanyiswa ngenxa yomdlavuza okhulayo oye waqhathaniswa nama-lymph nodes noma amathambo. Lokhu kubizwa ngokuthi "ukuphindaphindiwe kwesistimu." Ukuphindaphinda kwesistimu kuyingozi nakakhulu kunokuphindaphinda kwendawo. Kungani? I-metastases ibonisa ukuthi umdlavuza unamandla okuba isakaze emhlabeni wonke-inqubo ekugcineni eholela ekufeni ezingaphezu kwengxenye yeziguli zomdlavuza we-prostate.
Ngakho-ke, ukwazi indawo yokuphindaphinda kuyaphendula umbuzo obaluleke kakhulu: ngabe isifo esiphindayo sinomthelela okwanele wokunciphisa umzimba.
Njengoba sesishilo, amandla omdlavuza okusakazeka yilokho okwenza umdlavuza ube yingozi ngempela. Lolu lwazi lukhulula udokotela ukuba enze uhlelo oluningi olwedlulele lwezokwelapha ngaphandle kokubhuka oluhlobene nokumesaba ukwelapha ngokweqile. Uma lesi sifo esivamile sisendaweni ye-prostate noma i-prostate fossa, indlela enjalo yokuphatha ukwelashwa ngeke ibe yinto engadingekile futhi engadingekile.
Ukwelashwa okudabukisayo kungahambisana nemiphumela emibi kakhulu. Kodwa-ke, uhlobo lwezokwelapha ezinonya engikhuluma ngalo luyimithi ehamba egazini futhi ibe nomphumela wokulwa nomzimba emzimbeni wonke, lapho i-chemotherapy ne- Taxotere noma ukwelashwa kwama-hormonal ne- Lupron ne-Casodex yizibonelo ezinhle.
I-Axumin isebenza kanjani?
Ama-bone scans asejwayelekile asebenzisa izinto ezinomsakazo ezihlobene ne-calcium ezigxila ezindaweni zethambo ezicasuliwe ngumdlavuza. Iskena se-Axumin PET sisebenza ngokubona umsebenzi we-metabolic womdlavuza ngokwawo .
I-Axumin ixhaphaza ukuthi i-prostate khancer ingenisa ama-amino acids ngesivinini esisheshayo kunamaseli avamile.
I-Axumin inomculi we-radioactive ohlobene ne-amino acid. Njengoba amangqamuzana omdlavuza athatha ama-amino acids ngaphezu kwamaseli avamile, imisebe igxila ngaphakathi kwamangqamuzana omzimba. Lapho isiguli sifakwe ngaphansi kwesithwebuli indawo yezindawo eziphakeme zemisakazo ye-radiation indawo yomdlavuza emzimbeni wesiguli.
Ukwaziswa Okusha Kanjani Kwenziwe I-Axumin?
Iskena se-Axumin sivunyiwe kumadoda asethuthukile i-PSA ekhulayo ngemuva kwemisebe noma ukuhlinzwa okudlule. Ngokomlando, ukuhlolwa kwethambo elilula kanye ne-CAT ukuhlola kudinga amazinga e-PSA ku-range 10 kuya ku-50 ngaphambi kokuba umdlavuza okwanele ube khona ukuze kutholakale ekuskeleni.
Ubuhle be-Axumin PET iskena ukuthi linikeza ithuba lokuthola izilonda ezincane zamathambo ezinkampeni zamakhansela namazinga e-PSA ebangeni eli-1 kuya ku-10.
Okunye okusemandleni okusebenza kwe-Axumin scan, ngaphandle kokubaluleka kwayo ekunqumeni indawo ye-PSA yokubuyela emuva, kungenxa yamadoda ayenziwe ukwelashwa kwe-chemo-hormonal yezifo ezihambile ze-metastatic. Ngemuva kokwelashwa, amadoda angaphumelela ekunciphiseni okukhulu kwe-PSA-mhlawumbe kusukela kuma-100 kuya kwezingu-10 noma ngaphansi. Iskena se-Axumin singase singabonakali indawo yomdlavuza emzimbeni obonisa umsebenzi oqhubekayo wokuxilonga umzimba, uphawu lokuthi amangqamuzana omdlavuza ahlala enamandla naphezu kokwelashwa kwamuva neLupron ne-Taxotere. Uma kunenani elilinganiselwe lezindawo zomsebenzi wokuphikisana okuqhubekayo, kutholakala ukuthi iziguli ezinjalo zingase zizuze emisebeni yendawo noma ezinye izinhlobo zokwelashwa ezibhekiswe ezifweni ezisele.
Ukusetshenziswa Kwesikhathi Esizayo
Ngisho noma ukuskena kuqale kuvunyelwe ukusetshenziswa ekusetshenzisweni kokuphindaphinda kwe- PSA , ezinye izinhlelo zokusebenza cishe zizosetshenziswa esikhathini esizayo. Owokuqala uzoba ngowokuthungatha abantu abasanda kutholakala ukuthi banezinhlamvu ze-Gleason ezingu-8 noma ngaphezulu noma emadodeni anamazinga e-PSA aphakeme ngaphezu kwe-20. Ukuthola izifo zakuqala zesimethrifu kuma-lymph nodes kumadoda asanda kutholakala kuyinto ebaluleke kakhulu. Iziguli ezinezifo zamathambo ezitholakalayo zitholakale zinezinga eliphezulu lokuphulukiswa kwamazinga uma bethola ukwelashwa okunamandla nge-Taxotere ne-Lupron. Iziguli ezingenayo i-metastasis ezinjalo zingelashwa ngokufutheka futhi zinciphise imiphumela yabo emibi ngaphandle kokunciphisa izinga labo lokuphulukisa.
Ukuhumusha ama-Scans
Ukuchazwa kwalezi zindlela ezintsha kuzobandakanya ikhefu lokufunda odokotela abafunda izikrini. Yilokho kunoma yibuphi ubuchwepheshe obusha. Kubalulekile futhi ukuthi iziguli ziqaphele ukuthi uhlobo lobuchwepheshe lokwenza lezo zicansi-okungukuthi, isithwebuli ngokwabo-luzohluka kusukela ekusebenzeni ukwenza. Eminye imikhuba inebuchwepheshe obudala futhi amandla okuthola amasayithi amancane amancane azosebenza kahle.
Ukuqaphela lezi zici ezinciphisa, kuzobaluleka ukuthi iziguli zikwazi ukukhomba izikhungo ezisetshenziswa yimishini yobuchwepheshe futhi zithole odokotela abenza inamba enkulu yokuskena. Lezi zikhungo zobuhle cishe zikwazi ukwazi kabanzi lezi zihloko kahle.
Ukusebenza Ngaphakathi Nezobuchwepheshe Banye
Esinye isizathu sokuthi i-Axumin iyimpumelelo ebalulekile ukuthi isiza odokotela ukuba basebenzise amandla okugcwele we-Intensity Modulated Radiation Therapy (IMRT). I-IMRT uhlobo oluthile olunembile lwama-radiation technology elingabhekisela ezindaweni eziningi zomzimba ezazingakafinyeleleki emisebeni. I-IMRT inembile kangangokuthi odokotela bangakwazi ukuhlosa ukugoba kwemisebe nge-precipitometer kanye nokugwema ngokuphelele umonakalo kwezakhi ezibucayi eziseduze ezifana namathumbu, isibonelo, ezigulini ezinezifo ze-lymph node esiswini. Esinye sezizathu zokuthi ukuskena kwe-Axumin PET kuyathandeka kakhulu ngoba empeleni kwenza ubuchwepheshe obukhona, i-IMRT, futhi busebenziseke nakakhulu.
Ithemba Elikhulile Ngekusasa
Ukufika kwesifo somdlavuza othuthukisiwe nge-Axumin kwandisa ithemba lokuthi ezinye izinhlobo ezintsha zokuphumelela ukuskena zizoza esikhathini esizayo esiseduze. Isibonelo, ezinye izinhlobo ze-PET zihlola, enye ebizwa ngokuthi i-PSMA, ihlose i-molecule ethile evame ukuvela phezu kwamangqamuzana omdlavuza wesibeletho. Inzuzo engaba khona ye-PSMA idlulisa ngaphezu kokusizakala kwayo nge-imaging; inesicelo esingahle sithetheke futhi. I-PSMA ligands ingaxhunyaniswa nemithi enamandla emisakazo enamandla okwanele ukubulala amaseli omdlavuza.
Umphakathi womdlavuza wesifo sofuba wulindele ngokulangazela ukuhlola ukukhomba indawo yomdlavuza wesifo sofuba emzimbeni ophethe ngokunemba ukuthi lezi zilinganiso ze-PET zingafinyelela. Lezi zibuko zimelela ukuphumelela okuphawulekayo. Manje ukuthi i-FDA ivumile lobu buchwepheshe, izinkampani zomshuwalense ziqala ukuhlola izindlela zokunikeza ukuhlinzeka. I-Medicare yinkampani yokuqala yomshuwalense ukuyimboza.
Yiziphi Izinkinga Zangaphambili?
I-Axumin mhlawumbe ingumdlavuza omkhulu we-prostate we-2017, kodwa ungase uzibuze futhi ngezinto ezibaluleke kakhulu eminyakeni emithathu edlule. Okokuqala, ukuhamba okusheshayo kokutholakala okusha kuyisimo esisha esisha, kepha ezinye izinto zihlanganisa:
Kungani Ukuphumelela Kuqhutshwa Ngokuphindaphindiwe?
Isizathu sokusheshisa emvuthweni wokuphumelela kuwukuphela kokucwaninga okuyisisekelo okuholela ekuqondeni okujulile kwe-biology yamangqamuzana yomdlavuza we-prostate. Ngokuqondile, ukuguqulwa okwenziwe ngokofuzo okubangela ukukhula kwamaselula okungalawulwanga kuye kwacaciswa.
Izakhi zofuzo ezithintekayo yilokho okwenza amaseli omdlavuza ahluke kumaseli avamile. Manje ukuthi lezi zinguquko zingabonakala, imithi emisha ingahle yenzelwe ukukhokhela izakhi zofuzo ezingavamile. Cabanga ukuthi i-patch yesofthiwe ingabhalwa kanjani nomhleli wekhompiyutha ukulungisa i-computer glitch.
Eminyakeni eyandulela, ngaphambi kokuba sifinyelele ekuqondeni kwethu kwamanje kwe-biology yeselula, imithi emisha yayiwumphumela wenqubo yokukhushulwa, yokuzama ukuhlola nokuphutha. Ikhemikhali elikhethwe ngokungahleliwe lizophathwa ngamangqamuzana omdlavuza okhula ePetri izitsha. Uma le makhemikhali yabangela ukuthi amangqamuzana omdlavuza afe, ayolungiselelwa izilwane ezine nomdlavuza. Uma umdlavuza uphezulu futhi isilwane siphila, sizohlolwa kubantu. Izivivinyo zomuntu eziphumelelayo zizoholela ekugunyazweni kwe-FDA nokutholakala kwezebhizinisi kokwelashwa okusha.
Ngokungafani nemithi eyenziwe ngokomthetho ngezikhathi zamuva, indlela le mithi etholakalayo ngayo umsebenzi wesilingo nesiphambeko yayivame ukungaziwa.