Ukwelashwa kwe-hormone kunqunywe i- oncologist yezokwelapha kwabesifazane namadoda athola umdlavuza webele we-hormone receptor-positive. Kunqunyelwe ukunciphisa noma ukuyeka ukukhula kwezicubu ezithinta i-hormone ngokuvimbela ikhono lomzimba lokukhiqiza ama-hormone noma ngokuphazamisa isenzo se-hormone. Uma kuthathwa abesifazane nabesilisa abanezifo zomdlavuza webele esifushane, kusiza ukunciphisa ingozi yokuphindaphinda umdlavuza webele wesifuba noma ukuthola umdlavuza omusha webele.
Njengoba kunikezwe ukubaluleka kokwelashwa kwe-hormone, ukusiza abesifazane nabesilisa ukuba baphathe imiphumela emibi ye-hormone yabo yokwelapha kubalulekile ukuhlala kuwo iminyaka emihlanu noma ngaphezulu.
Izidakamizwa zokwelapha amahomoni
I-Tamoxifen iyisidakamizwa esetshenziselwa ukuphatha i-ER-positive isifo se-cancer esesiswini sokuqala esesimweni se-premenopausal ne-postmenopausal abesifazane kanye namadoda. I-Tamoxifen ivunywe yi-FDA futhi isetshenziswe kabanzi iminyaka engaphezu kwengu-30.
I-Aromatase Inhibitors (AI) yilasilasi lezidakamizwa ezisetshenziselwa ukwelashwa komdlavuza wesifuba kubesifazane be-postmenopausal kanye ne-gynecomastia emadodeni. Zihlanganisa i-Anastrozole (Arimidex), i-Letrozole (i-Femara), isi-Exemestane (i-Aromasin), i-Goserelin (i-Zoladex).
I-Tamoxifen ne-Arimidex yizidakamizwa ze-hormone zokwelapha ngokuvamile ezibekiwe ezigulini ezinekhanda le-hormone le-receptor-positive ngemva kokuphelelwa ukwelashwa kwazo.
Okuqhamuka uma udla imishanguzo
Ezinye izidakamizwa zokwelapha i-hormone zinezimo ezimbi ezilinganayo, kanti ezinye zinemiphumela emibi echaphazela izinga lokuphila lomuntu osinda.
Ubuhlungu be-Bone and joint, okuyinto isikhalazo esikhulu sabaningi ukuthatha ukwelashwa kwe-hormone, umphumela ohlangothini owenza ngempela izinkinga ekuphileni kwansuku zonke.
Njengoba kunikezwa ukuthi ukwelashwa kwe-hormone ngokuvamile kunqunywe iminyaka emihlanu futhi mhlawumbe isikhathi eside, ukuthola izindlela zokunciphisa umthelela wezinthambo kanye nobuhlungu obuhlangene ekuhambeni, imisebenzi ehlobene nomsebenzi, kanye nemisebenzi evamile yokuphila kwansuku zonke kuyinkinga enkulu.
Lapho abesifazane nabesilisa ekwelapheni kwe-hormone bengenakukwazi ukuthola ukuphumula emathunjini abo kanye nobuhlungu obuhlangene, abaningi banquma ukuyeka ukukwelashwa, futhi abanye benza. I-Tamoxifen ne-Arimidex, i-aromatase inhibitor yokuzikhethela ekuqaleni kwesigaba, umdlavuza webele we-hormone-receptor-positive, bobabili bayaziwa ukwabelana ngemiphumela emibi efana nalokhu:
Ukushisa okushisayo nokukhukhumeza ebusuku
Ukulahlekelwa kobulili drive
Ukukhishwa kwamagciwane
Ukomiswa kwamagagasi noma ukushaya
Inzuzo yesisindo
Ukulala ubunzima
Imodi iyashintsha
Ezimweni ezingavamile, i-Tamoxifen ibike ukuthi ibangelwa ama-blood clots, ukulahlekelwa ngamathambo kwabesifazane be-premenopausal, umdlavuza we-endometrial, i-cataracts, nesifo sohlangothi.
Ingabe i-Tamoxifen noma i-Arimidex iyasebenza kakhulu?
I-Arimidex, iTamoxifen, i-Alone noma ye-Combination (ATAC) Trial iqhathanise izinzuzo nokuphepha kwe- Arimidex (1 mg) ne-Tamoxifen (20 mg) , eyanikezwa ngomlomo nsuku zonke iminyaka emihlanu, njengokwelashwa kwe-adjuvant kwabesifazane be-postmenopausal abanesifuba sokuqala umdlavuza.
I-Arimidex iphumelele kakhulu kuneTamoxifen. I-Arimidex iphumelela kakhulu ku:
- Ukwehlisa isikhathi phakathi kokuxilongwa kwangempela nokuphindaphindiwe kulabo abahlangabezana nokuphindaphindiwe
- Ukunciphisa ingozi yomdlavuza ekuqhakambiseni umzimba kwezinye izindawo zomzimba
- Ukunciphisa ingozi yokuthuthukisa umdlavuza omusha esibelethweni sesibambiso
Kodwa-ke, ubuhlungu be-bone kanye no-joint babikezwa njalo kwi-Arimidex kuneTamoxifen.
Ukulahlekelwa kwegazi kanye ne-arthritis nakho kwenzeka kaningi eminyakeni yokuqala 2 yokuthatha i-Arimidex.
Kwabaningi besifazane, ukuvela kwansuku zonke kanye nobuhlungu obuhlangene kuyinkinga yabo enkulu. Ubukhulu balobu buhlungu kanye nomthelela walo ekuphileni kwansuku zonke kubangela abanye besifazane ku-Arimidex ukuba bayeke ukuthatha.
Abaningi besifazane abazwa ubuhlungu besifuba kanye nohlangene babika ukuthi banesibindi nobuhlungu, lapho bevusa, ezandleni zabo, ezinqulwini, emuva, emadolweni, ezinyaweni nasemagxeni okwenza kube nzima ukwenza imisebenzi yansuku zonke nemisebenzi ephathelene nomsebenzi. Ubuhlungu obuhlangene buvame ukuvela emadolweni, emuva, ezinyaweni, nasezinyaweni njengoba, kanye nezinkalo. I-Carpal tunnel syndrome yayisikhalazo njalo.
Abesifazane abaningi babika ukuthi babe nomnene kuya emathunjini amathoyilethi kanye nobuhlungu obuhlangene; bakwazi ukuphumula ekutheni bangathathi izidakamizwa ezingezona ukuvuvukala.
Ucwaningo oluthile lubonise ukuthi abesifazane abathatha izithako zokudla ezifaka amavithamini, i-glucosamine kanye ne-chondroitin, i-vitamin D, namafutha we-omega fish, ngokuvamile babhekana nokukhululeka emathunjini amathanga nokuhlanganyela. Ukwakhiwa kwe-acupuncture uye kwabonisa ukuthi nakho kuyasiza ekunciphiseni ubuhlungu be-bone. Abesifazane abathatha i-Arimidex noma enye i-inhibitor ye-aromatase bayakhuthazwa ukuba bahlanganyele njalo ekuvivinya umzimba.
Njengoba kunikezwe ukuthi i-aromatase inhibitors yaziwa ngokubangela ubuhlungu bomzimba nobuhlungu, kubalulekile ukukhuluma neqembu lakho le-oncology uma uhlakulela umphumela ohlangothini. Ithimba lakho lizofuna ukuhlola amathambo akho kanye nobuhlungu obuhlangene, ukubhekisela ekuhlolweni kwethambo lokunciphisa umzimba futhi uncoma umzimba, imisebenzi, nokusetshenziswa kwemithi ukuze unciphise izinga lakho lobuhlungu.
Imiphumela yocwaningo oluthile olwethulwa eSy Antonio Antonio Breast Cancer Symposium ngo-2013, lwabonisa ukuthi abasindile abasebenzisa i-aromatase inhibitor ababambe iqhaza njalo emisebenzini yokuzivocavoca unyaka banciphise amaphesenti angu-30 ebuhlungu babo obubi kakhulu futhi ukwehla kwamaphesenti angu-20 ngobukhulu bobuhlungu babo. Lokhu kunciphisa ubuhlungu kuholele ekwenzeni ukwandisa ukwenza imisebenzi yokuphila yansuku zonke. Abesifazane ocwaningweni abangazange balandele uhlelo lokuzivocavoca unyaka bathola ukwanda kwamaphesenti angu-5 ebuhlungu nasekubukeleni kobuhlungu babo.
Ukukhuluma ngokuhlangenwe nakho komuntu siqu, ubuhlungu bethambo kanye nohlangene no-Arimidex, i-aromatase inhibitor enqunyelwe kimi emva komdlavuza wami webele wesibili, kwakunzima ukuphatha ngaphezu kweTamoxifen, engangilandela umdlavuza wami webele wokuqala. Ubuhlungu obuvela ku-Arimidex buba cishe ezinyaweni zami kuphela, futhi ngokuvamile buhlala njalo, futhi bungivusela ekubuthweni. Iphazamise uhlobo lwami oluthandayo lokuzivocavoca, ukuhamba ngamamayela angu-2 ngosuku.
Ubuhlungu noTamoxifen buhlukana kakhulu emzimbeni wami futhi bufana nendlebe eyafika futhi yahamba. Inselelo enkulu kakhulu engokwenyama kaTamoxifen kwakuyizintambo zamasipha emanzini ami.
Ngiphatha ubuhlungu obuvela e-Arimidex nasezintanjeni zaseTamoxifen ngokuzivocavoca nsuku zonke, ukubhukuda 3x ngesonto, nokuzama ukuhamba amakhilomitha okungenani usuku ngalunye. Izicathulo eziqinile ngokusekelwa kwe-arch kanye nesithende esingu-1-1 / 2 intshi eyenza umehluko omkhulu ekukwazi kwami ukuhamba ngezinga elithile lokududuza. Ngokungafani nobuhlungu nokuqina kwesifo samathambo, ubuhlungu bonyawo buyogcina buyeke njengoba ngiqhubeka nokuhamba, futhi ngasekupheleni kokuhamba kwami, ngangingenabuhlungu. Ukugeza ngamanzi okufudumalayo kanye nokusikwa komlenze nomlenze ngezikhathi ezithile nakho kwasiza.
Izwi kusuka
Ukwelashwa kwe-hormone kusebenza futhi kunciphisa izigameko zokuphindaphindiwe. I-Arimidex imiswe kaningi kaningi kuneTamoxifen ngoba iboniswe ukuthi iphumelele kakhulu kuneTamoxifen ekuvimbeleni ukuphindaphindiwe. Uma uthatha i-inhibitor ye-aromatase futhi ubhekana nobuhlungu bezinthambo namajoyina, wabelane ngalokho okuhlangenwe nakho ngethimba lakho le-oncology. Ungase weluleke ukuba uhlanganyele ekilasini lokuzivocavoca elihleliwe emphakathini wakho noma ujoyine iqembu elihambayo. I-oncologist yakho yezokwelapha ingakutshela ukuthi yikuphi ukuphulukisa ubuhlungu ongayithatha ngokuphepha, njengoba ngisho nangaphezulu kwemithi ye-counter inemiphumela emibi.
> Imithombo:
> Cuzick J. Imiphumela ye-anastrozole kanye ne-tamoxifen njengokwelashwa kwe-adjuvant yesifo somdlavuza wesifuba sokuqala: ukuhlaziywa kweminyaka engu-10 kwecala le-ATAC. I-Lancet. I-oncology. 2010; 11 (12): 1135-41. http://www.ncbi.nlm.nih.gov/pubmed/21087898
> Gaillard S, Stearns V. Aromatase inhibitor-ezihlobene namathambo nemishuloskeletal: Ubufakazi obusha obuchaza i-etiology kanye namasu okuphatha. Ucwaningo lomdlavuza webele: BCR. 2011; 13 (2). http://www.ncbi.nlm.nih.gov/pubmed/21457526