Ulwazi lungamandla kepha ukukhetha akulula
UJennifer Davis uneminyaka engu-19 lapho unina, oneminyaka engu-49 ubudala, etholakala enesifo somdlavuza webele. Ngandlela-thile, kwakungeyona isimanga. Umdlavuza wesibindi wamtshela ugogo wakhe omama eneminyaka engu-28 ubudala. Ugogo wakhe wabulawa ngumdlavuza we-ovarian ngo-69.
Khona-ke, njengoba umama wakhe ehlinzwa futhi waqala ukwelashwa ngamakhemikhali, uDavis wathola isifuba esiswini sakhe . Nakuba kwakunobungozi, wesaba kakhulu.
U-Davis, waseWashington, DC, ukhumbula ukuthi: "Ngangisanda kubona umama edabula i-chemo futhi ngangizibuza ukuthi ngiyolandela yini."
Ukuhlolwa kofuzo kuqinisekisile uDavis ukuthi uzuze igugu lokuguqula izakhi ezandisa ingozi yakhe yokuthuthukisa umdlavuza webele noma ovari. Lapho eneminyaka engama-23, uzimisele ukuhlola nokuphila okunempilo, futhi ucabangisisa ekugcineni ekukhipheni amabele akhe nama-ovari njengendlela ephawulekayo, kodwa ephumelelayo yokuvimbela.
Ngenxa yokuthi ukuhlolwa kwezakhi zofuzo kusekusha, abacwaningi abaqiniseki ukuthi bangaki abantu abanezakhi zofuzo ezihambisana nomdlavuza webele. Kodwa-ke, balinganisela ukuthi amaphesenti angama-30 abesifazane baseMelika anelungu lomndeni eliseduzane elaphethwe umdlavuza webele.
Lokhu kusho ukuthi ngisho nabesifazane abasha abanomlando womndeni owaziwayo wesifo bangaqala ukuthatha izinyathelo zokuvikela impilo yabo. Noma kunjalo, lokhu kuveza nokukhetha okunzima, kufaka phakathi ukuthi kungenziwa yini ukuhlinzeka nge-prophylactic noma ukuthatha imithi eyancipha ingozi yomdlavuza webele kepha ngokuvamile inezimo ezimbi.
I-Degree engu-1, i-Degree yesibili ne-3rd Degree Relatives
Isilinganiso samantombazane aseMelika sinamathuba angu-12 okuthuthukisa umdlavuza webele ngesikhathi sakhe sokuphila. Lesi sibalo singaphezu kokuphindwe kabili kumfazi onomlando womndeni wesifo somdlavuza webele.
Ngokusho kwama-US Centers for Disease Control and Prevention, abesifazane abanobuhlobo bokuqala-njengomama noma udadewabo-abanomdlavuza wesifuba banamathuba angama-30 okuthuthukisa lesi sifo.
Uma lesi sihlobo esiphezulu se-degree sifinyelelwa ukuthi sinomdlavuza webele womzimba (isifo somdlavuza webele esifubeni samabili), ingozi iqhubekela kuma-36%.
Phakathi kwalabo abanesihlobo "sesibili-degree" -yinkhulukazi, ugogo, noma umshana-isikhathi sokuphila cishe cishe amaphesenti angu-22. Kulabo abanesihlobo "sesithathu-degree", umkhulu-omkhulu, noma omkhulu-obenomdlavuza webele, ingozi ingamaphesenti angu-16.
Noma kunjalo, umlando womndeni awuqinisekisi ukuhlolwa kwengculaza yesifuba. Ochwepheshe balinganisela ukuthi amaphesenti amahlanu kuphela kuya kwamaphesenti angu-10 omdlavuza webele webele anesifazana. Ngaphezu kwalokho, ukuguqulwa kwezakhi zofuzo ezihlobene nengozi eyengeziwe yokwelashwa kwebele ne-ovariya kubonakala ingavamile kubantu abaningi.
Lezi yizakhi zofuzo ezibizwa nge-BRCA1 ne- BRCA2 ngabacwaningi. I-BRCA imele umdlavuza webele kanti izinombolo zibonisa ukuthi abacwaningi bahlelwe ukuthi bazitholile ukuguqulwa kwezakhi.
Nakuba kutholakala ukuthi ukuguquguquka okuqondile kwezinguquko akukhona, ucwaningo olulodwa lwathola ukuthi ngaphakathi kweqembu labesifazane abangaba ngu-2 300, abaneminyaka engama-35 kuya ku-64, cishe amaphesenti angu-2.9 abesifazane abamhlophe, amaphesenti angu-1.4 wabesifazane abamnyama, kanye namaphesenti angu-10,2 abesifazane besifazane abane-BRCA1. Ucwaningo luphinde lwathola ukuthi amaphesenti angu-2.6 wabesifazane abamnyama, amaphesenti angu-2.1 wabesifazane abamhlophe, kanye namaphesenti angu-1.1 abesifazane besifazane abangamaJuda babenokuguqulwa kwe-BRCA2.
Ukuhlolwa kwe-Genetic
Odokotela abaningi manje banelulekisa abesifazane abanomlando womndeni wesifo somdlavuza webele noma ovariya ukuphishekela ukuhlolwa kofuzo. Lesi sinqumo somuntu siqu singabangela isabelo sayo semizwa kanye nokwaziswa okuwusizo.
Ngokwesifundo saseCanada sabantu abangu-39 abavivinyele ukuhleleka kwezakhi zofuzo, iningi labheka imiphumela njengoba ilungiselela. Ababambe iqhaza bathi ukuhlolwa kwabenza bavumela ukuthi bathathe indlela ehamba phambili ekunakekelweni kwabo kwezempilo.
Kodwa, abambalwa babonisa imizwa yokungathembeki nokungaqiniseki. Laba bantu bathi banomuzwa wokuthi "abagula noma baphelele kahle."
Ngaphezu kwalokho, ngenkathi umshuwalense wezempilo kanye nokucwaswa bekukhathazeka ngaphambili, uMthetho wezokuGcina ukuHlelwa koMphakathi we-Genetic Information 2007-2008 manje uqinisekisa ukuvikeleka komhlaba wonke
Ukuhlola ngaphambilini
Kulabo besifazane abangaphansi kweminyaka engama-35 ubudala, ukuhlolwa komdlavuza webele akuyona ingxenye yenkambiso yabo yonyaka yempilo. Kodwa, kubesifazane abanomlando womndeni wesifo somdlavuza webele, ochwepheshe bathi ukuhlolwa kufanele kuqale kuneminyaka engama-25.
I-Memorial Sloan-Kettering Center Cancer ikhuthaza ukuthi abesifazane abanesihlobo sokuqala esihlotshaniswa nesifo somdlavuza webele kufanele baqale izinyanga zaminyaka yonke kusukela ekuqaleni kweminyaka eyishumi ngaphambi kokuba ilungu lomndeni elisencane litholakale.
Isibonelo, uma umama ethola ukuthi uneminyaka engama-42 ubudala, indodakazi yakhe kufanele iqale ukuhlolwa kwe-mammography yaminyaka yonke eneminyaka engama-32. Kwabesifazane kuleli qembu lezinto eziyingozi, ochwepheshe nabo batusa ukuhlolwa kwebele emtholampilo okungenani kabili ngonyaka kanye nenyanga, ngokuzihlola kuqala eneminyaka engu-20.
Kukhona ingxabano mayelana nendima ye- MRIs okufanele idlale ekuhlolweni komdlavuza webele. Ezinye izifundo zibonise ukuthi ukuhlolwa kwe-MRI kuphumelela kakhulu kunezinye izindlela zokuxilonga. Odokotela eSloan Kettering batusa ukuthi abesifazane abanomlando womndeni bane-MRI kanye ne- mammogram ngonyaka. Kodwa-ke, akukho zifundo eziye zahlobanisa ukuhlolwa kwe-MRI ngokunciphisa ukubulawa komdlavuza webele.
Ukuvimbela
Ucwaningo lubonisa ukuthi ukubhema nokudla okunomsoco kunomthelela ekubambeni ingozi yomdlavuza. Ngakho, indlela yokuphila enempilo ibaluleke kakhulu kumuntu onomlando womndeni wesifo.
I-Chemoprevention enye enye inkambo yesenzo. Ezinye izidakamizwa ezifanayo ezinqunyelwe ukuvimbela ukuphindaphindiwe zinikezwa nabesifazane abanethemba lokugwema umdlavuza webele, kodwa kuphela kulabo abangaphezu kweminyaka engama-35.
Lezi zidakamizwa zivimbela umsebenzi we-hormone yesine estrogen, ekholelwa ukuthi ivuse izinhlobo ezithile zomdlavuza. Kodwa lokho kusho ukuthi kungathinta nokuzala , ngakho-ke akuvunyelwe ukusetshenziswa kwabesifazane abasebasha ekukhuleni.
Kwabesifazane abangaphezu kuka-35, izifundo zibonise lezi zidakamizwa- I- Tamoxifen (Nolvadex) no- Evista (Raloxifene) -nganciphisa ingozi yomdlavuza webele we-invasive ngamaphesenti angama-50. Futhi, zinganciphisa ingozi yomdlavuza webele ongapheli ngamaphesenti angu-30. Kodwa-ke, azikho imiphumela emibi-ezinye zazo zilinganisa izimpawu zokunqamuka kwesikhashana, kufaka phakathi ukuzuza kwesisindo, ukukhanya okushisayo, kanye nokomile kwesisu.
Indlela eyingozi, kodwa ephumelelayo yokuvimbela ukususwa kwesinye noma zombili amabele ngaphambi kokuba umdlavuza uqale. Abacwaningi bacabanga ukuthi ukuhlinzwa kunciphisa ingozi yomdlavuza webele ngamaphesenti angu-90. Ukukhipha ama-ovari kungenye ukuhlinzwa okuphumelelayo, kodwa okunye okuphethwe umzwelo, ikakhulukazi kwabesifazane abasebasha abesinye isikhathi abanethemba lokuba nezingane.
Izwi elivela
UDavis, oye wahlola okuhle nge-BRCA1, wayelulekwa ngumeluleki wakhe wezakhi zofuzo ukuba izingane zakhe zibe zincane, ngakho-ke amathumbu akhe, ama-ovarie, kanye nesisu sakhe asuswe-konke ngaphambi kokuba abe ngu-35. Ngisho naseneminyaka engu-23 ubudala, ukhathazekile ngokuthi uyakwazi ufeze lowo mgomo. Kodwa usakholelwa ukuthi ukuhlinzwa kuyokwenza umzwele. Ngakho-ke, thatha isikhathi sokucabangela ngokucophelela ukhetho ngalunye ngokucophelela futhi ufune iseluleko somdokotela othembekile noma umeluleki wezakhi zofuzo ekwenzeni izinqumo.
Imithombo:
"I-ACS Iziphakamiso Zomqondisi We-MIC for Some at Risk High of Cancer Breast." I-ACS News Centre . 28 Meyi 2007. I-American Cancer Society. 17 Apreli 2008.
"Izinkombandlela zokuhlola i-Cancer." Ulwazi lweCanscer . 21 Apreli 2006. Isikhungo soKhisimusi seS Memorial Sloan-Kettering.
d'Agincourt-Canning, L. "Isipho noma i-Yoke? Izimpendulo Zabafazi Nezimadoda Ekwazini I-Genetic Risk kusukela ku-BRCA1 no-BRCA2 Ukuhlolwa." I-Genetic Clinical 70, 6 Dec. 2006. 462-472. 17 Apreli 2008.
I-Hereditary Breast Cancer kanye ne-BRCA Gene, April 6, 2015. Amasevisi Okulawula Ukugula.
Malone, KE, JR Daling, DR Doody, L. Hsu, L. Bernstein, RJ Coates, PA Marchbanks, MS Simon, JA McDonald, SA Norman, BL Strom, RT Burkman, G. Ursin, D. Deapen, uLK Weiss, S. Folger, JJ Madeoy, uDM Friedrichsen, NM Suter, MC Humphrey, R. Spirtas no-EA Ostrander EA. "Ukuvama nokuqaphelisisa kwe-BRCA1 ne-BRCA2 Ukuguqulwa kwesimo se-Population Based Based Cancer Breast in White and Black American Women Ages 35 kuya ku-64." Ucwaningo lwe-Cancer 66, 1615. Aug. 2006. 8297-82308. 17 Apreli 2008.
"I-Mastectomy Yokuvimbela: Imibuzo Nezimpendulo." AmaSpredishithi e-National Cancer Institute Amashidi . 26 Julayi 2006. National Cancer Institute. 17 Apreli 2008.