Kudzivirira kenza yezamu

Ruzivo Rwose Pamusoro Pegomarara Rezamu

Chirwere chegomarara rezamu chirwere chinoumba masero akaipa (cancer) mumatishu ezamu.

Zamu rakagadzirwa nelobes uye ducts.Zamu rimwe nerimwe rine zvikamu 15 kusvika ku20 zvinonzi lobes, zvine zvikamu zviduku zvakawanda zvinonzi lobules.Lobules inopera mumakumi ediki magirobhu anogona kugadzira mukaka.Lobes, lobules, uye bulbs zvakabatanidzwa nemachubhu matete anonzi maducts.

Zamu rimwe nerimwe rinewo tsinga dzeropa uye lymph midziyo.Mitsipa ye lymph inotakura inenge isina ruvara, mvura ine mvura inonzi lymph.Midziyo yeLymph inotakura lymph pakati pe lymph nodes.Lymph nodes zvidiki, zvakaita sebhinzi zvimiro zvinosefa lymph uye kuchengeta masero machena eropa anobatsira kurwisa hutachiona nezvirwere.Mapoka emalymph nodes anowanikwa pedyo nezamu muaxilla (pasi peruoko), pamusoro pecollarbone, uye muchipfuva.

Gomarara repazamu ndiro rechipiri rinonyanya kuwanda rudzi rwegomarara muvakadzi vekuAmerica.

Vakadzi muUnited States vanobatwa negomarara rezamu kupfuura rumwe rudzi rwupi norwupi rwegomarara kunze kwegomarara reganda.Chirwere chegomarara chezamu chechipiri kune kenza yemapapu sechikonzero chekufa kwegomarara muvakadzi vekuAmerica.Zvakadaro, ndufu dzinokonzerwa negomarara rezamu dzakadzikira zvishoma gore rega rega kubva muna 2007 kusvika 2016. Gomarara rezamu rinowanikwawo muvarume, asi huwandu hwevatsva hushoma.

Kudzivirira kenza yezamu

Kudzivisa zvinhu zvine njodzi uye kuwedzera zvinhu zvinodzivirira zvinogona kubatsira kudzivirira cancer.

Kudzivirira kenza zvinogona kubatsira kudzivirira mamwe magomarara.Zvinokonzera njodzi zvinosanganisira kusvuta, kuwandisa, uye kusaita maekisesaizi akakwana.Kuwedzera zvinhu zvinodzivirira zvakaita sekusiya kuputa uye kurovedza muviri zvinogona kubatsira kudzivirira mamwe magomarara.Taura nachiremba wako kana imwe nyanzvi yezvehutano nezvekuti ungadzikisa sei njodzi yako yegomarara.

Izvi zvinotevera zvinogona kukonzera gomarara rezamu:

1. Zera

Kuchembera ndiko kukonzeresa njodzi yegomarara zhinji.Mukana wekubatwa negomarara unowedzera paunokura.

2. Nhoroondo yega yega yekenza yemazamu kana bhenign (noncancer) chirwere chezamu

Vakadzi vane chero chezvinotevera vane njodzi yakawedzera yegomarara rezamu:

• Nhoroondo yemunhu yekenza yemazamu inoparadza, ductal carcinoma in situ (DCIS), kana lobular carcinoma in situ (LCIS).
• Nhoroondo yemunhu ane benign (noncancer) chirwere chezamu.

3. Ngozi inogarwa nhaka yegomarara rezamu

Vakadzi vane nhoroondo yemhuri yekenza yemazamu mune yekutanga-degree hama (amai, hanzvadzi, kana mwanasikana) vane njodzi yakawedzera yegomarara rezamu.

Vakadzi vakagara nhaka shanduko mumagene kana mune mamwe majini vane njodzi huru yegomarara rezamu.Ngozi yegomarara rezamu inokonzerwa nekuchinja kwemajini anogarwa nhaka kunoenderana nerudzi rwekuchinja kwemajini, nhoroondo yemhuri yegomarara, uye zvimwe zvinhu.

4. Mazamu akakora

Kuve nematishu emuzamu ane gobvu pa mammogram chinhu chinokonzera njodzi yegomarara rezamu.Chiyero chengozi chinoenderana nekuti dense yechipfuva tishu.Vakadzi vane mazamu akakora zvikuru vane njodzi huru yegomarara rezamu kupfuura vakadzi vane density yakaderera.

Kuwedzera kuwanda kwezamu kunowanzova hunhu hwekugara nhaka, asi hunogonawo kuitika kune vakadzi vasati vaita vana, vane nhumbu yekutanga pakupera kwehupenyu, kutora mahormone ekumashure, kana kunwa doro.

5. Kuratidzwa kwematishu ezamu kune estrogen yakagadzirwa mumuviri

Estrogen ihomoni inogadzirwa nemuviri.Inobatsira muviri kukura nekuchengetedza hunhu hwevakadzi.Kuve wakatarisana neestrogen kwenguva yakareba kunogona kuwedzera njodzi yegomarara rezamu.Estrogen mazinga akakwirira mukati memakore mukadzi ari kumwedzi.

Kuratidzwa kweestrogen kwemukadzi kunowedzera nenzira dzinotevera:

• Kukurumidza kuenda kumwedzi: Kutanga kuenda kumwedzi pazera ramakore gumi nerimwe kana kuti mudiki kunowedzera nhamba yemakore mazamu ari kuratidzirwa kuestrogen.
• Kutangira pazera repashure: Kana mukadzi achinge aenda kumwedzi kwakawanda, ndipo panobva patora nguva yakareba kuti mazamu ake ave neestrogen.
• Kuchembera pakuzvarwa kwekutanga kana kuti kusati kwambosununguka: Nemhaka yekuti mwero weestrogen wakadzikira panguva yekuzvitakura, matishu ezamu anoratidzirwa kune eestrogen yakawanda muvakadzi vanova nepamuviri kekutanga mushure memakore 35 kana kuti vasina kumbobvira vabata pamuviri.

6. Kutora hormone therapy zviratidzo zvekuenda kumwedzi

Mahomoni, akadai seestrogen neprogesterone, anogona kugadzirwa kuva piritsi murabhoritari.Estrogen, progestin, kana kuti zvose zviri zviviri zvingapiwa kuti zvitsive eestrogen isingachagadziriswi nemazai muvakadzi vanenge vaguma kumwedzi kana kuti vakadzi vakabviswa mazai avo.Izvi zvinodaidzwa kuti hormone replacement therapy (HRT) kana kuti hormone therapy (HT).Musanganiswa HRT/HT isrogen yakasanganiswa neprogestin.Mhando iyi yeHRT/HT inowedzera njodzi yegomarara rezamu.Ongororo dzinoratidza kuti vakadzi pavanorega kutora estrogen yakasanganiswa neprogestin, njodzi yegomarara rezamu inoderera.

7. Radiation therapy kuzamu kana chipfuva

Radiation therapy pachipfuva pakurapa gomarara inowedzera njodzi yegomarara rezamu, kutanga makore gumi mushure mekurapwa.Ngozi yegomarara rezamu inoenderana nehuwandu hwemwaranzi uye zera rainopihwa.Ngozi yacho yakanyanya kana kurapwa kwemwaranzi kwakashandiswa panguva yekuyaruka, mazamu paanenge achiumbwa.

Radiation therapy kurapa gomarara mune rimwe zamu hazviratidzike kuwedzera njodzi yegomarara mune rimwe zamu.

Kune vakadzi vane nhaka yekuchinja muBRCA1 uye BRCA2 majini, kuratidzwa kwemwaranzi, senge iyo kubva muchipfuva x-rays, inogona kuwedzera njodzi yekenza yemazamu, kunyanya muvakadzi vakaiswa x-ray vasati vasvika makore makumi maviri.

8. Kufutisa

Kufutisa kunowedzera njodzi yegomarara rezamu, kunyanya kuvakadzi vanenge vapedza kuenda kumwedzi vasina kushandisa hormone replacement therapy.

9. Kunwa doro

Kunwa doro kunowedzera njodzi yegomarara rezamu.Kuwanda kwenjodzi kunokwira sezvo huwandu hwedoro rinonwiwa hunowedzera.

Izvi zvinotevera zvinodzivirira kenza yemazamu:

1. Kusanyanya kuratidzwa kwematishu ezamu kuestrogen yakagadzirwa nemuviri

Kuderedza urefu hwenguva yezamu romukadzi rinoratidzirwa kuestrogen kungabetsera kudzivirira kenza yamazamu.Kuratidzwa kweestrogen kunoderedzwa nenzira dzinotevera:

• Kubata pamuviri kwepakutanga: Estrogen mazinga akaderera panguva yekuzvitakura.Vakadzi vane pamuviri pakazara vasati vasvika makore makumi maviri vane njodzi yakaderera yegomarara rezamu pane vakadzi vasina kuita vana kana kuti vanozvara mwana wavo wekutanga mushure memakore makumi matatu nemashanu.
• Kuyamwisa: Estrogen mwero inogona kuramba yakadzikira apo mukadzi anenge achiyamwisa.Vakadzi vanoyamwisa vane mikana yakaderera yegomarara rezamu pane vakadzi vakaita vana asi vasina kuyamwisa.

2. Kutora estrogen-chete hormone therapy mushure mekuita hysterectomy, selective estrogen receptor modulators, kana aromatase inhibitors uye inactivators.

Estrogen-chete hormone therapy mushure me hysterectomy

Hormone therapy ine estrogen chete inogona kupiwa kuvakadzi vane hysterectomy.Muvakadzi ava, estrogen-chete kurapwa mushure mekuenda kumwedzi kunogona kuderedza njodzi yegomarara rezamu.Pane njodzi yakawedzerwa yesitiroko uye chirwere chemwoyo nemidziyo yeropa muvakadzi vepamenopausal vanotora estrogen mushure mekuvhiyiwa.

Sarudza estrogen receptor modulators

Tamoxifen uye raloxifene ndezvemhuri yemishonga inonzi selective estrogen receptor modulators (SERMs).MaSERM anoita senge estrogen pane mamwe matishu ari mumuviri, asi anovharira maitiro eesrogen pane mamwe matishu.

Kurapa netamoxifen kunoderedza njodzi yeestrogen receptor-positive (ER-positive) kenza yemazamu uye ductal carcinoma in situ mu premenopausal uye postmenopausal vakadzi vari panjodzi huru.Kurapa neraloxifene kunoderedzawo njodzi yekenza yemazamu muvakadzi vepomenopausal.Nemushonga chero upi zvawo, njodzi yakaderedzwa inotora makore akati wandei kana kupfuura mushure mekumisa kurapwa.Mazinga akaderera emapfupa akatyoka akaonekwa kune varwere vanotora raloxifene.

Kutora tamoxifen kunowedzera njodzi yekupisa kupisa, kenza ye endometrial, sitiroko, cataract, uye magwamba eropa (kunyanya mumapapu nemakumbo).Ngozi yekuva nematambudziko aya inowedzera zvakanyanya muvakadzi vakura kupfuura makore makumi mashanu kana vachienzaniswa nevakadzi vadiki.Vakadzi vari pasi pemakore makumi mashanu vane njodzi yakakura yekenza yemazamu vanogona kubatsirwa zvakanyanya nekutora tamoxifen.Ngozi yekuva nematambudziko aya inoderera mushure mekunge tamoxifen yamiswa.Taura nachiremba wako nezve njodzi uye zvakanakira kutora mushonga uyu.

Kutora raloxifene kunowedzera njodzi yekugwamba kweropa mumapapu nemakumbo, asi hazviratidzike kuwedzera njodzi yekenza ye endometrial.Mumadzimai ekupedzisira menopausal vane osteoporosis (yakaderera bone density), raloxifene inoderedza njodzi yekenza yemazamu kune vakadzi vane ngozi yakakura kana yakaderera yekenza yemazamu.Hazvizivikanwi kana raloxifene ichava nemigumisiro yakafanana kune vakadzi vasina osteoporosis.Taura nachiremba wako nezve njodzi uye zvakanakira kutora mushonga uyu.

Mamwe maSERM ari kudzidzwa mumakiriniki ekuedzwa.

Aromatase inhibitors uye inactivators

Aromatase inhibitors (anastrozole, letrozole) uye inactivators (exemestane) inoderedza njodzi yekudzokazve uye yekenza itsva yemazamu muvakadzi vane nhoroondo yegomarara rezamu.Aromatase inhibitors zvakare inoderedza njodzi yegomarara rezamu muvakadzi vane anotevera mamiriro:

• Vakadzi vePostmenopausal vane nhoroondo yavo yegomarara rezamu.
• Vakadzi vasina nhoroondo yavo yegomarara rezamu vane makore makumi matanhatu zvichikwira, vane nhoroondo yeductal carcinoma in situ ine mastectomy, kana kuti vane njodzi huru yegomarara rezamu zvichibva pachishandiswa cheGail model (chishandiso chinoshandiswa kufungidzira njodzi yezamu). cancer).

Muvakadzi vane njodzi yakawedzera yekenza yemazamu, kutora aromatase inhibitors kunoderedza huwandu hweesrogen inogadzirwa nemuviri.Kusati kwaenda kumwedzi, estrogen inogadzirwa nemazii uye mamwe matishu ari mumuviri wemukadzi, kusanganisira uropi, mafuta enyama, uye ganda.Mushure mekuenda kumwedzi, mazai anomira kugadzira estrogen, asi mamwe matishu haadaro.Aromatase inhibitors inovharira kuita kwe enzyme inonzi aromatase, iyo inoshandiswa kugadzira yeserogen yemuviri.Aromatase inactivators inomisa iyo enzyme kushanda.

Zvinogona kukuvadza kubva pakutora aromatase inhibitors zvinosanganisira kurwadziwa kwemhasuru uye majoini, osteoporosis, kupisa kupenya, uye kunzwa kuneta zvakanyanya.

3. Risk-kuderedza mastectomy

Vamwe vakadzi vane njodzi huru yegomarara rezamu vangasarudza kuita mastectomy inoderedza njodzi (kubviswa kwemazamu ese kana pasina zviratidzo zvegomarara).Ngozi yegomarara rezamu yakadzikira zvikuru mumadzimai aya uye vazhinji vanonzwa kusazvidya mwoyo pamusoro pengozi yavo yegomarara rezamu.Zvakadaro, zvakakosha kuve nekuongorora njodzi yegomarara uye kuraira nezve nzira dzakasiyana dzekudzivirira gomarara rezamu usati waita sarudzo iyi.

4. Ovarian ablation

Maovari ndiwo anogadzira yakawanda yeestrogen inogadzirwa nemuviri.Mishonga inomisa kana kuderedza huwandu hweesrogen inoitwa nemaovari inosanganisira kuvhiyiwa kubvisa mazai, kurapwa nemwaranzi, kana kutora mimwe mishonga.Izvi zvinodaidzwa kuti ovarian ablation.

Vakadzi vepremenopausal vane njodzi huru yekenza yemazamu nekuda kwekumwe shanduko muBRCA1 uye BRCA2 majini vanogona kusarudza kuve neoophorectomy inoderedza njodzi (kubviswa kwemaovari ese kana pasina zviratidzo zvegomarara).Izvi zvinoderedza huwandu hweesrogen inogadzirwa nemuviri uye inodzikisa njodzi yegomarara rezamu.Oophorectomy inoderedza njodzi inoderedzawo njodzi yegomarara rezamu muvakadzi vakajairwa vasati vaenda kumwedzi uye muvakadzi vane njodzi yakawedzera yegomarara rezamu nekuda kwemwaranzi pachipfuva.Nekudaro, zvakakosha kuve nekuongorora njodzi yegomarara uye nekuraira usati waita sarudzo iyi.Kudonha kwakamwe kamwe kwemazinga eestrogen kunogona kuita kuti zviratidzo zvekuenda kumwedzi zvitange.Izvi zvinosanganisira kupisa, kutadza kurara, kufunganya, uye kuora mwoyo.Mhedzisiro yenguva refu inosanganisira kudzikira kwekuita zvepabonde, kuoma kwemukadzi, uye kuderera kwefupa.

5. Kuita maekisesaizi akakwana

Vakadzi vanosimbisa muviri maawa mana kana kupfuura pavhiki vane mikana yakaderera yegomarara rezamu.Mhedzisiro yekurovedza muviri panjodzi yegomarara rezamu inogona kuve yakakura muvakadzi vasati vasvika kumwedzi vane huremu hwakakwana kana hushoma.

Hazvina kujeka kana zvinotevera zvinokanganisa njodzi yegomarara rezamu:

1. Mishonga yeHormonal contraceptive

Hormonal contraceptives ine estrogen kana estrogen uye progestin.Dzimwe ongororo dzakaratidza kuti vakadzi varipo iyezvino kana vachangobva kushandisa nzira dzekudzivirira kubata pamuviri dzemahomoni vanogona kuve nekuwedzera kudiki kwengozi yegomarara rezamu.Zvimwe zvidzidzo hazvina kuratidza kuwedzera kwengozi yegomarara rezamu muvakadzi vanoshandisa hormonal contraceptives.

Mune imwe ongororo, njodzi yegomarara rezamu yakawedzera zvishoma kana mukadzi akashandisa nzira dzekudzivirira kubata pamuviri dzemahomoni.Imwe ongororo yakaratidza kuti kuwedzera kudiki kwengozi yegomarara rezamu kwakadzikira nekufamba kwenguva apo vakadzi vakamira kushandisa hormonal contraceptives.

Dzimwe ongororo dzinodiwa kuti uzive kuti nzira dzekudzivirira pamuviri dzemahomoni dzinokanganisa here njodzi yemukadzi yegomarara rezamu.

2. Zvakatipoteredza

Zvidzidzo hazvina kuratidza kuti kuratidzwa kune zvimwe zvinhu zviri munharaunda, senge makemikari, kunowedzera njodzi yegomarara rezamu.

Ongororo dzakaratidza kuti zvimwe zvinhu zvine zvishoma kana kuti hazvina zvazvinoita panjodzi yegomarara rezamu.

Zvinotevera zvine zvishoma kana kusakanganisa panjodzi yegomarara rezamu:

• Kubvisa pamuviri.
• Kuita shanduko yekudya sekudya mafuta mashoma kana mamwe michero nemiriwo.
• Kutora mavhitamini, kusanganisira fenretinide (rudzi rwevhitamini A).
• Kusvuta mudzanga, zvose zviri zviviri zvinoshanda uye zvisineyi (kukweva utsi hwefodya).
• Kushandisa underarm deodorant kana antiperspirant.
• Kutora statins (cholesterol-kuderedza zvinodhaka).
• Kutora bisphosphonates (zvinodhaka zvinoshandiswa kurapa osteoporosis uye hypercalcemia) nemuromo kana nekupinda mutsinga.
• Shanduko mune yako circadian rhythm (kuchinja kwemuviri, pfungwa, uye hunhu kunonyanya kukanganiswa nerima nechiedza mumaawa makumi maviri nemana), izvo zvinogona kukanganiswa nekushanda husiku mashifiti kana kuwanda kwechiedza muimba yako yekurara usiku.

Kwakabva:http://www.chinancpcn.org.cn/cancerMedicineClassic/guideDetail?sId=CDR257994&type=1