Uma uhlala ngokushisa okushisayo , uyazi ukuthi ukuzwa akuyona into emnandi njengoba kungenzeka wake wakufanekisela. Omunye wesifazane ochaze ukushisa okushisayo ngokuthi "abe nehlobo lakhe langasese" kufanele ukuba ukhohliwe ngezinqwaba zokuhlanza ezihamba nalezi zinkinga. Noma kunjalo sifunda ukuthi ukushisa okushisayo akuwona kubi njalo. Eqinisweni, bangase babe i-silver lining, bebikezela ukuthi ukwelashwa kwakho komdlavuza webele kuyasebenza noma ukuthi usengozini encane kunokuba ungenalo ukushisa okushisayo nale mithi.
Izifundo zisitshela ukuthi "isenzakalo esibi" sokushisa okushisayo-ikakhulukazi uma sikhulu futhi senzeke njalo-sibikezela ukusinda okukhulu kubantu abaphathwa ngemithi yokwelashwa ye-hormone yomdlavuza wesifuba njenge-tamoxifen noma i-aromatase inhibitor exemestane. Futhi kulabo abangakaze babhekwe umdlavuza webele kodwa bebhekene nokushisa okushisayo, lezi zikhathi zokuhlwitha (noma ukugcoba) zingase zibe uphawu oluhle.
Ake sibheke lokho esikufundayo mayelana nokukhanya okushisayo nezinye izenzakalo ezimbi ezihlobene nokwelapha umdlavuza webele, nokuthi ungayisebenzisa kanjani lolu lwazi ngendlela engakusiza njengoba ubhekana nalezi zimo ezicasulayo.
I-Estrogen, i-Hot Flashes, ne-Cancer Breast
Ngendlela ethile, kunengqondo ukuthi ukukhanya okushisayo kungaxhunyaniswa nengozi ephansi yomdlavuza webele noma ukuphindaphinda umdlavuza webele. Siyazi ngokucacile ukuthi i- estrogen idlala indima emdlalweni webele webele kanye nokukhanya okushisayo kuvame ukuvela lapho ama-ovari eshiya ukukhiqiza i-estrogen ngesikhathi sokuya esikhathini.
Ngomdlavuza wesifuba, i-estrogen yenza izinto ezincane ezifana ne-jet fuel, okuphuthumayo ukukhula kwe- canrogen ye-receptor-positive cancer cancers . Uma i-estrogen ivaliwe (noma uma i-androgens ngemuva kokuya esikhathini sokuvunguza ingavunyelwe ukuba iguqulwe ku-estrogen), amangqamuzana omdlavuza wesifuba ayaphumelela gesi.
Imithi yama-hormone esetshenziselwa umdlavuza webele idala ukushisa okushisayo, kodwa lezi zibani ezishisayo azifani nomuntu ngamunye.
Abanye abantu bakhathazekile kakhulu ngokushisa okuvuthayo nokushisa ebusuku, kuyilapho abanye bezwa okuncane noma okungabikho kwalokhu "ukusabela okubi." Ukwazi lokhu, kunengqondo ukuthi abacwaningi bangaba nesithakazelo ekutholeni ukuthi abesifazane abashisa kakhulu yini (okukhulunywe ngodokotela ngokuthi " izimpawu ze-vasomotor ") baphendule kangcono kulezi zindlela zokwelashwa.
Ukushisa Okushisayo, Ukwelashwa Kwebele Ngesifo Sebele, Nokusinda
Ucwaningo oluthile phakathi kuka-2012 no-2016 lubheke ukuthi ukushisa okushisayo kungaba yini isibonakaliso sokuthi umuntu uzophendula kangcono kwezinye izindlela zokwelashwa kwe-hormonal, nokuthi, noma ngabe abesifazane abanezibani ezivuthayo kakhulu bangakwazi ukuthuthukisa umdlavuza webele kuqala.
Yize siyazi ukuthi ukukhanya okushisayo kuhlotshaniswa nokwehla kwe-estrogen emzimbeni, asazi kahle nokuthi kungani kwenzeka. Ngamanye amazwi, asiqiniseki ukuthi amazinga e-estrogen aphansi ashisa kokubili ukushisa okushisayo nokukhula komdlavuza wesifuba, noma uma kunezinye izindlela ezihambisana nezinqubo zombili.
I-hormone Treatments for Estrogen Receptor I-Cancer Breast Breast Positive
Ngaphambi kokuba sikhulume ngokubaluleka kokushisa okushisayo nemithi yomdlavuza wesifuba, kuyasiza ukukhuluma ngezikhathi ezimbalwa izidakamizwa esizikhulumayo, lezo ezibhekwa njenge-hormonal therapy (noma i-endocrine therapy) yomdlavuza webele.
Ngokulula, kunezinhlobo ezimbili eziyinhloko zokwelashwa kwe-hormonal ezisetshenziselwa ukwelapha umdlavuza webele we-estrogen we-receptor-positive.
- I-modulator ye-estrogen receptor (SERMs) ekhethiwe njenge- tamoxifen -Tamoxifen isebenza ngokuvimbela ikhono le-estrogen ukubopha amangqamuzana omdlavuza webele bese kubangela ukuba bakhule. Emadodeni ase-premenopausal, ama-ovari aqhubeka enza i-estrogen futhi kudingeka isidakamizwa esifana ne-tamoxifen.
- I-Aromatase inhibitors (AI) - I-AI yizidakamizwa ezisetshenziselwa abesifazane base-postmenopausal (noma abesifazane base-premenopausal abaye baphathwa nge-ovarian suppression therapy noma bachithe ama-ovaries) ukuze bavimbele ukuhlanganiswa kwe-estrogen emzimbeni. Benza lokhu ngokuvimbela ukuguqulwa kwe-androgens ku-estrogens, ukusabela okwenziwe yi-enzyme ebizwa ngokuthi ama-aromatase. Izidakamizwa ezibalwe njengezifo ezimbi ze- aromatase zihlanganisa i-Arimidex (i-anastrozole), i-Aromasin (i-exemestane) ne-Femara (i-letrozole).
Exemestane, Hot Flashes, kanye ne-Breast Cancer Response Response
Ucwaningo olwenziwe ngo-2012 olubheke abesifazane abathweswa i-exemestane lithole ukuthi labo abashisa kakhulu ngesikhathi sokwelashwa babenezinga elikhulu lokusinda-mahhala. Esinye isifundo ngo-2016 sibheke abesifazane base-postmenopausal bephathwa nge-exemestane benza imiphumela efanayo. Abesifazane ababenemiphumela ye-vasomotor (ukushisa okukhulu nokushisa ebusuku) kwakungcono kakhulu ukuphendula ukwelashwa kwe-exemestane kunelabo abangenazo lezi zimpawu (amaphesenti angama-70 namaphesenti angu-40.) Ngokuphambene, kwakungekho umehluko esilinganisweni sokuphendula isidakamizwa phakathi kwalabo abenza noma abangazange babe namahlumela emisipha noma izinhlungu ezihlangene. Kulolu cwaningo, impendulo ye-exemestane ichazwe njengamaphesenti angu-30 noma ngaphezulu okunciphisa ubukhulu be-tumor ekufundweni kwe-imaging.
I-Tamoxifen (noma i-Exemestane), i-Hot Flashes, ne-Breast Cancer Survival
Ucwaningo lwango-2013 lubheke abesifazane abangaphezu kuka-9 000 abaphathwa nge-tamoxifen noma i-exemestane. Labo abashisa ukushisa babenezinkinga ezingcono zokungenwa kwezifo (ngamaphesenti angu-27), ukusinda okuphelele (amaphesenti angu-45 ngaphezulu) kanye nezinsizakalo ezincane ezikude (amaphesenti angu-19 amathuba amancane ukuthi amathumba abo amabele azosakazeka ezithombeni ezikude ezifana nobuchopho, amaphaphu, isibindi , noma amathambo.)
Kulolu cwaningo (ngokungafani nesifundo esenhla), abesifazane abanobuhlungu be-muscle ne-joint, kanye nalabo ababenezibonakaliso ezinobungozi babengase basinde kunabesifazane abangenazo lezi zimpawu.
Ukushisa Okushisayo Nengozi Yokuthuthukisa Ingculaza Yesisu
Nakuba kunengqondo ngendlela abantu abashisayo abengeke bakwazi ukuthuthukisa umdlavuza webele; kwakungekho kuze kube maduzane ukuthi izifundo zithole lokhu kuyiqiniso.
Ucwaningo olwenziwe ngo-2011 lwathola ukuthi abesifazane abashisa ukushisa bekungaba yingxenye nje kuphela yokuthuthukisa umdlavuza webele kunabesifazane ababengakaze babone ukushisa okushisayo. Abesifazane abanokushisa okushisayo babengamaphesenti angama-50 amathuba okuthuthukisa i- ductal carcinoma yebele kanye namaphesenti angama-50 amathuba okuthuthukisa i- lobular carcinoma engavamile yebele . Ngaphezu kwalokho, kutholakala ukuthi ukushisa okuvame ukushisa okwenzeka kaningi, futhi ukuqina kakhudlwana, ukunciphisa okukhulu kwengozi yomdlavuza webele.
Kodwa esinye isifundo esisodwa ngo-2013 sathola ukuthi abesifazane abaye babhekana nokushisa okushisayo (kanye nezinye izimpawu zesifo sengculazi) babenengxenye eyodwa kuphela engozini yokuthuthukisa umdlavuza webele womntwana osemncane (ochazwe njengomdlavuza webele ngaphambi kokuba uneminyaka engama-50) kunabesifazane ababengakaze babone lezi izimpawu.
I-Link Between Hot Flashes ne-Cancer Breast
Yize zonke lezi zifundo zithole ukuxhumana phakathi kwezibani ezishisayo kanye nokuphendula kangcono kokwelashwa kwama-hormonal for umdlavuza webele (noma ingozi encane yokuthuthukisa umdlavuza webele) asisazi kahle ukuthi lezi zixhunyiwe kanjani nokuthi lokhu kwenzeka kanjani.
Usizo Lokukhanyisa Okushisayo
Ukukhanya okushisayo akumnandi futhi akwenzi okuningi ukuthuthukisa ikhwalithi yokuphila kwabesifazane abaningi abaphila nomdlavuza webele. Ngokujabulisayo, ucwaningo lubheka izindlela zokuthuthukisa lezi zimpawu (ngenkathi zigwema i-estrogen.)
Igama lokuqapha lenzelwe labo abacabangela izindlela zokwelashwa ezihlukile njengamalungiselelo e-herbal ukuze babhekane nokushisa okushisayo. Ezinye izithako ezifana ne-soy aqukethe "i- phytoestrogens ," i-estrogens esekelwe ezitshalweni ezinezakhiwo ezifana ne-estrogen. Njengoba i-estrogen isetshenziselwa njengamafutha ekhanda lomdlavuza wesifuba kubantu abane-tumoror positive receptor, ososayensi abaningi batusa ukuthi bahlale becacile okunye okusekelwe kwesoysi kuze kube yilapho sazi kabanzi.
I-Effexor i-antidepressant engasiza ngezitshalo ezishisayo kwabanye besifazane, futhi ngokungafani nezinye ze-anti-depressants, ayibonakali ukuthi inokuxhumana okufanayo ne-tamoxifen. I-Neurontin (gabapentin) imithi yokwelapha engasiza ekunciphiseni ukukhanya okushisayo. Kanti futhi kusetshenziselwa ukuphatha ubuhlungu be-neuropathy nobuhlungu be-neuropathic abantu abathile abakhulayo kwi-chemotherapy yomdlavuza webele.
Yize i-vitamin E isetshenziswe abanye, uhlobo lwe-vitamin E lubaluleke kakhulu, njengoba ezinye izinhlobo ze-vitamin E zingasusa izinzuzo ze-chemotherapy. Ngokuphambene nalokho, ifomu elilodwa elibhekwa ngokuthi i-tocotrienols empeleni lingabangela umphumela we-tamoxifen kumaseli omdlavuza webele we-estrogen we-receptor-positive.
Ngaphambi kokucabangela noma yikuphi okungeziwe, qiniseka ukuthi ukhuluma nodokotela wakho. Siyazi ukuthi kunamalungiselelo okuthiwa amavithamini namaminerali angaphazamisa ukwelashwa komdlavuza .
Abanye abantu bathole ukuthi ukukhishwa kwe- acupuncture kuyasiza ngezibani ezishisayo, kodwa futhi, khuluma nodokotela wakho. Ezinye zezindlela ezinhle zokuphatha ukukhanya okushisayo zilula kakhulu. Hlola lezi zindlela ezingu-10 zokubhekana nokushisa okushisayo nomdlavuza webele .
Izwi elivela
Umgogodla wezifundo ezibheke ukushisa okushisayo ngesikhathi ukwelashwa umdlavuza webele (okungenani ukwelashwa nemithi ye-hormone) ukuthi lezi zitshalo ezishisayo zingase zibe ne-silver lining. Ukukwazi lokhu ngeke kwenzeke ukukhanya kwakho okushisayo kukubekezeleleke, kepha lokhu kungaba yindlela yokusebenzisa ukuhlehlisa ukuze kukusize ukubhekana nalokhu.
Ukumisa kabusha kuyinkqubo lapho ubukeka khona ngokusuka esimweni esihlukile. Isibonelo, esikhundleni sokugxila ekulahlekelweni kwezinwele zakho ngesikhathi se-chemotherapy nokuthi lokho kukukwenza uzizwe kanjani, kungase kunalokho uthole isiliva lesiliva-akudingeki uhlambe imilenze yakho izinyanga ezimbalwa. Ngokuqinisekile, lokho kuyilula kancane, kodwa ngesikhathi esilandelayo uma ushisa kakhulu ungase uthande ukufanekisa isithombe esishisayo sokuxosha noma yiliphi amangqamuzana omdlavuza webele ongase ahlale emzimbeni wakho. Ngaleyo ndlela, okungenani "ihlobo lakho langasese" linomshini wesiliva.
> Imithombo:
> Desai, K., Mao, J., Su, I., Demichele, A., Li, Z, X, S., noP. Gehrman. Izifo Nezimo Zengozi Yokuntula Inhliziyo Phakathi Nezifo Zomdlavuza Webele Ngama-Aromatase Inhibitors. Ukondla Ukusekela Ekhanda . 2013. 21 (1): 43-51.
> Fei, C., DeRoo, L., Sandler, D., noC. Weinberg. Izimpawu zeMenopausal kanye Nengozi Ye-Young-Onset Breast Cancer. I-European Journal of Cancer . 2013. 49 (4): 798-804.
> Fontein, D., Charehbili, A., Nortier, J. et al. Imicimbi Ecacile Ebizayo ihlotshaniswa ne-Response to Exemastane Therapy emitholampilo ye-Postmenopausal Breast Cancer: Imiphumela evela ku-TEAMIA Study (BOOG2006-04). I-European Journal of Oncology Yokuhlinza . 2016 Dec 10.
> Fontein, D., Houtsma, D., Hille, E. et al. Ubudlelwano Phakathi Kwezehlakalo Ezimbi Nezimo Ezibucayi Ze-Exemastane Therapy Ekuguleni Kwama-Cancerusus Abesilisa Ababelethwe Ngama-Postmenopausal. Amanothi we-Oncology . 2012. 23 (12): 3091-7.
> Fontein, D., Seynaeve, C., Hadji, P. et al. Imicimbi Ecacile Embi Ukubikezela Inzuzo Yokusinda Ezigulini Ezibhekene Ne-Tamoxifen noma i-Aromatase Inhibitors: Ukuhlaziywa Kwecala Lokuzamazama Kwezwe Lonke LamaTamoxifen Exemestane. I-Journal ye-Clinical Oncology . 2013. 31 (18): 2257-64.
> Huang, Y., Malone, K., Cushing-Haugen, K., Ukuguqula, J., noC. Li. Ubudlelwane Phakathi Kwezibonakaliso Zezinkinga Zezinsizi Nengozini Ye-Postmenopausal Breast Cancer. I-Epidemiology ye-Cancer Epidemiology Biomarkers and Prevention . 2011. 20 (2): 379-88.