Ka Hortagga Kansarka Naasaha

Macluumaad Guud Oo Ku Saabsan Kansarka Naasaha

Kansarka naasuhu waa cudur ay unugyo xunxun (kansar) ka samaysmaan unugyada naaska.

Naasku wuxuu ka kooban yahay lobes iyo tubbada.Naas kastaa wuxuu leeyahay 15 ilaa 20 qaybood oo loo yaqaan lobes, kuwaas oo leh qaybo yaryar oo badan oo loo yaqaan lobules.Lobules waxay ku dhamaanayaan daraasiin nalalka yaryar oo caano samayn kara.Lobes, lobules, iyo nalalka waxaa isku xira tuubooyinka dhuuban ee loo yaqaan tubbada.

Naas kastaa wuxuu leeyahay xididdada dhiigga iyo xididdada lymph.Xididdada limfigu waxay wataan dareere aan midab lahayn, oo biyo leh oo la yiraahdo lymph.Xididdada Lymph waxay qaadaan qanjidhada inta u dhaxaysa qanjidhada qanjidhada.Lymph nodes waa qaab-dhismeedyo yaryar, qaab-dhismeed digir ah oo miiraya lymfa oo kaydiya unugyada dhiigga cad ee ka caawiya la dagaalanka caabuqa iyo cudurrada.Kooxo ka mid ah qanjidhada qanjidhada ayaa laga helaa naaska agtiisa axilla (cududda hoosteeda), korka laf dhabarta, iyo laabta.

Kansarka naasuhu waa nooca labaad ee ugu badan ee kansarka dumarka Maraykanka.

Dumarka Maraykanka waxa ku dhaca kansarka naasaha in ka badan noocyada kale ee kansarka marka laga reebo kansarka maqaarka.Kansarka naasuhu waa kan labaad ee kansarka sambabada sababta oo ah dhimashada kansarka ee haweenka Maraykanka.Si kastaba ha ahaatee, dhimashada kansarka naasaha ayaa wax yar hoos u dhacday sannad kasta inta u dhaxaysa 2007 iyo 2016. Kansarka naasuhu wuxuu kaloo ku dhacaa ragga, laakiin tirada kiisaska cusub waa yar tahay.

Ka Hortagga Kansarka Naasaha

Ka fogaanshaha arrimaha khatarta ah iyo kordhinta arrimaha ilaalinta waxay kaa caawin karaan ka hortagga kansarka.

Ka fogaanshaha arrimaha halista kansarka ayaa laga yaabaa inay ka hortagto kansarrada qaarkood.Waxyaalaha khatarta ah waxaa ka mid ah sigaar cabista, miisaankaaga xad dhaafka ah, iyo inaadan helin jimicsi ku filan.Kordhinta arrimaha ilaalinta sida joojinta sigaarka iyo jimicsiga ayaa sidoo kale kaa caawin kara ka hortagga kansarka qaarkood.Kala hadal dhakhtarkaaga ama xirfadlaha kale ee daryeelka caafimaadka sida aad hoos ugu dhigi karto khatartaada kansarka.

Kuwa soo socdaa waa arrimo halis u ah kansarka naasaha:

1. Da' weyn

Da'da weyn ayaa ah khatarta ugu weyn ee kansarka badankood.Fursada aad ku qaadi karto kansarku way korodhaa marka aad sii weynaato.

2. Taariikhda shakhsi ahaaneed ee kansarka naasaha ama cudurka naaska (aan kansar lahayn).

Haweenka qaba mid ka mid ah kuwan soo socda ayaa halis dheeraad ah ugu jira kansarka naasaha:

• Taariikhda shakhsi ahaaneed ee kansarka naasaha ee faafa, kansarka ductal ee goobta (DCIS), ama kansarka lobular ee goobta (LCIS).
• Taariikhda shakhsi ahaaneed ee cudurka naasaha (aan kansar lahayn).

3. Khatarta la dhaxlo ee kansarka naasaha

Dumarka leh taariikhda qoyska ee kansarka naasaha ee qaraabada darajada koowaad (hooyada, walaasha, ama gabadheeda) waxay leeyihiin khatarta sii kordheysa ee kansarka naasaha.

Dumarka dhaxlay isbeddellada hiddo-wadaha iyo hiddo-wadaha qaarkood waxay leeyihiin halis sare oo kansarka naasaha ah.Halista kansarka naasaha ee uu keeno isbeddellada hidde-sidaha la dhaxlo waxay ku xiran tahay nooca isbeddelka hidda-wadaha, taariikhda qoyska ee kansarka, iyo arrimo kale.

4. Naasaha cufan

Haysashada nudaha naaska ee cufan ee raajada naasaha waa arrin khatar ku ah kansarka naasaha.Heerka khatarta waxay ku xiran tahay sida ay u cufan yihiin unugyada naaska.Dumarka naasuhu aadka u cufan waxay leeyihiin halis sare oo ah kansarka naasaha marka loo eego dumarka cufnaanta naasaha yar.

Cufnaanta naasaha oo korodhay inta badan waa sifo la iska dhaxlo, laakiin waxa kale oo laga yaabaa inay ku dhacdo dumarka aan carruur dhalin, uurka ugu horreeya noloshooda daahay, qaata hormoonnada caadada ka dib, ama cabba khamriga.

5. U soo bandhigida unugyada naaska ee estrogen ee lagu sameeyo jirka

Estrogen waa hormoon uu jidhku sameeyo.Waxay ka caawisaa jirku inuu horumariyo oo ilaaliyo sifooyinka jinsiga ee dumarka.La kulanka estrogen muddo dheer waxay kordhin kartaa halista kansarka naasaha.Heerarka Estrogen-ka ayaa aad ugu sarreeya sanadaha ay haweeneydu caadadu qabto.

Soo-gaadhista haweeneyda ee estrogen-ka ayaa u kordhisa siyaabaha soo socda:

• Caadada hore: Bilowga caadada 11 jir ama ka yar waxay kordhisaa tirada sanadaha nudaha naaska ay la kulmaan estrogen.
• Laga bilaabo da'da dambe: Sannadaha badan ee haweeneydu caadadu, waa sii dheeraanayaa nudaha naaska ee u soo baxa estrogen.
• Da'da weyn ee dhalashada koowaad ama waligeed ma dhalin: Sababtoo ah heerarka estrogen waa hooseeyaa xilliga uurka, nudaha naasku waxay la kulmaan estrogen dheeraad ah haweenka uurka leh markii ugu horeysay da'da 35 ama aan waligood uur yeelan.

6. Qaadashada daaweynta hoormoonka ee calaamadaha menopause

Hormoonnada, sida estrogen iyo progesterone, ayaa laga samayn karaa qaabka kaniiniga shaybaarka.Estrogen, progestin, ama labadaba waa la siin karaa si ay u beddelaan estrogen-ka oo aysan samayn ugxan-yari ee dumarka ka dambeeya caadada ama haweenka laga soo saaray ugxantooda.Tan waxa loo yaqaan daawaynta hormoonka beddelka (HRT) ama daawaynta hoormoonka (HT).Isku darka HRT/HT waa estrogen oo lagu daray progestin.Noocan HRT/HT wuxuu kordhiyaa halista kansarka naasaha.Daraasaduhu waxay muujinayaan in marka haweenku joojiyaan qaadashada estrogen oo ay weheliso progestin, khatarta kansarka naasaha ayaa yaraada.

7. Dawaynta shucaaca ee naaska ama laabta

Daaweynta shucaaca ee laabta ee daaweynta kansarka waxay kordhisaa halista kansarka naasaha, laga bilaabo 10 sano ka dib daaweynta.Khatarta kansarka naasuhu waxay ku xidhan tahay qiyaasta shucaaca iyo da'da la siiyay.Khatarta ayaa ah mid ugu sareysa haddii daaweynta shucaaca la isticmaalo xilliga qaan-gaarnimada, marka naasuhu ay sameysmaan.

Daaweynta shucaaca ee lagu daweynayo kansarka hal naas uma muuqato inay kordhinayso halista kansarka naaska kale.

Dumarka dhaxlay isbeddellada hiddo-wadaha BRCA1 iyo BRCA2, soo-gaadhista shucaaca, sida kan raajada xabadka, waxay sii kordhin kartaa halista kansarka naasaha, gaar ahaan dumarka la raray ka hor 20 sano jir.

8. Cayilka

Cayilku wuxuu kordhiyaa halista kansarka naasaha, gaar ahaan dumarka ka dambeeya menopause ee aan isticmaalin daaweynta beddelka hoormoonka.

9. Cabitaanka khamriga

Khamrigu wuxuu kordhiyaa halista kansarka naasaha.Heerka khatarta ayaa kor u kacda marka qadarka khamriga la isticmaalo uu kordho.

Kuwa soo socdaa waa arrimaha difaaca kansarka naasaha:

1. Soo-gaadhista unugyada naaska oo ku yar estrogen-ka uu jidhku sameeyo

Hoos u dhigida dhererka waqtiga nudaha naaska haweeneydu ay la kulmaan estrogen waxay kaa caawin kartaa ka hortagga kansarka naasaha.Soo-gaadhista estrogen-ka ayaa lagu yareeyaa siyaabaha soo socda:

• Uurka hore: Heerarka Estrogen-ku wuu hooseeyaa xilliga uurka.Haweenka uurka leh muddada-buuxa ka hor da'da 20 waxay leeyihiin khatarta kansarka naasaha ka hooseeya dumarka aan carruur dhalin ama kuwa dhalay ilmahooda ugu horreeya ka dib da'da 35.
• Naas-nuujinta: Heerarka Estrogen-ku waxa laga yaabaa inuu hoos u dhaco inta ay naagtu naaska nuujinayso.Haweenka naaska nuujiya waxay leeyihiin halis ka hoosaysa kansarka naasaha marka loo eego dumarka carruur lahaa laakiin aan naaska nuujin.

2. Qaadashada daawaynta hoormoonka Estrogen-keliya ka dib hysterectomy, beddelayaasha daaweeyayaasha estrogen-ka ee xulashada, ama inhibitors aromatase iyo kuwa firfircoon

Daawaynta hoormoonka-kaliya Estrogen-ka ka dib qalliinka

Daaweynta hoormoonka ee leh estrogen kaliya ayaa la siin karaa haweenka laga saaray ilmo-galeenka.Haweenkan, daawaynta estrogen-kaliya ka dib menopause waxay hoos u dhigi kartaa halista kansarka naasaha.Waxaa jira khatar sii kordheysa oo ah istaroogga iyo cudurrada wadnaha iyo xididdada dhiigga ee haweenka ka dambeeya menopause ee qaata estrogen ka dib qaliinka ilmo-galeenka.

Modulators receptor estrogen xulashada

Tamoxifen iyo raloxifene waxay ka tirsan yihiin qoyska dawooyinka loo yaqaan 'estrogen receptor modulators' (SERMs).SERM-yadu waxay u dhaqmaan sida estrogen oo kale unugyada jirka qaarkood, laakiin waxay xannibaan saameynta estrogen ee unugyada kale.

Daawaynta tamoxifen waxay hoos u dhigtaa halista kansarka naasaha ee receptor-positive (ER-positive) iyo kansarka naasaha ee kaadi-mareenka ee goobta ku yaal premenopausal iyo dumarka postmenopausal ee khatarta sare leh.Daaweynta raloxifene waxay sidoo kale hoos u dhigtaa halista kansarka naasaha ee haweenka postmenopausal.Labada daroogo, khatarta dhimista waxay socotaa dhowr sano ama ka badan ka dib marka daawaynta la joojiyo.Heerarka hoose ee lafaha jaban ayaa lagu xusay bukaanada qaadanaya raloxifene.

Qaadashada tamoxifen waxay kordhisaa halista soo ifbaxa kulul, kansarka endometrial, istaroog, cataract, iyo xinjiro dhiig (gaar ahaan sambabada iyo lugaha).Halista dhibaatooyinkan ayaa si aad ah ugu kordheysa haweenka da'doodu ka weyn tahay 50 sano marka la barbardhigo haweenka da'da yar.Haweenka da'doodu ka yar tahay 50 sano ee khatarta sare ugu jira kansarka naasaha ayaa laga yaabaa inay ka faa'iidaystaan ​​​​tamoxifen.Khatarta ah in dhibaatooyinkani ay hoos u dhacaan ka dib marka tamoxifen la joojiyo.Kala hadal dhakhtarkaaga khatarta iyo faa'iidooyinka qaadashada daawadan.

Qaadashada raloxifene waxay kordhisaa halista xinjirowga dhiigga ee sambabada iyo lugaha, laakiin uma muuqato inay kordhinayso halista kansarka endometrial.Dumarka postmenopausal ee qaba osteoporosis (cufnaanta lafaha oo yaraatay), raloxifene waxay hoos u dhigtaa khatarta kansarka naasaha ee haweenka leh khatarta sare ama hooseysa ee kansarka naasaha.Lama oga in raloxifene ay saameyn isku mid ah ku yeelan doonto haweenka aan qabin lafo-jileeca.Kala hadal dhakhtarkaaga khatarta iyo faa'iidooyinka qaadashada daawadan.

SERM-yo kale ayaa lagu bartaa tijaabooyin caafimaad.

Aromatase inhibitors iyo firfircooniyaal

Aromatase inhibitors (anastrozole, letrozole) iyo inactivators (exemestane) waxay yareeyaan halista soo noqoshada iyo kansarka naasaha cusub ee haweenka leh taariikhda kansarka naasaha.Aromatase inhibitors waxay sidoo kale hoos u dhigtaa halista kansarka naasaha ee haweenka leh xaaladaha soo socda:

• Dumarka ka dambeeya menopause oo leh taariikh shakhsiyeed ee kansarka naasaha.
• Haweenka aan lahayn taariikh shakhsiyeed oo kansarka naasaha ah kuwaas oo da'doodu tahay 60 sano iyo ka weyn, waxay leeyihiin taariikh kansarka ductal ee goobta leh mastektomi, ama waxay leeyihiin halis sare oo kansarka naasaha oo ku salaysan qalabka Gail model (qalab loo isticmaalo in lagu qiyaaso khatarta naaska kansarka).

Haweenka leh khatarta sii kordheysa ee kansarka naasaha, qaadashada aromatase inhibitors waxay hoos u dhigtaa qadarka estrogen ee uu sameeyo jirku.Menopause ka hor, estrogen waxaa sameeya ugxan-sidaha iyo unugyo kale oo ku jira jirka haweeneyda, oo ay ku jiraan maskaxda, unugyada baruurta, iyo maqaarka.Menopause ka dib, ugxan-yarigu waxay joojiyaan samaynta estrogen, laakiin unugyada kale ma joojiyaan.Aromatase inhibitors waxay xannibaan ficilka enzyme loo yaqaan aromatase, kaas oo loo isticmaalo in lagu sameeyo dhammaan estrogen-ka jirka.Aromatase inactivators waxay joojiyaan insaymka inuu shaqeeyo.

Dhibaatooyinka suurtagalka ah ee ka yimaada qaadashada aromatase-ka-horyaalka waxaa ka mid ah murqaha iyo xanuunka kala goysyada, lafo-jileeca, kululaynta, iyo dareenka daal badan.

3. Mastektomi-yaraynta khatarta ah

Dumarka qaarkood ee khatarta sare ugu jira kansarka naasaha ayaa laga yaabaa inay doortaan in la sameeyo mastektomi yareeya (labada naas oo laga saaro marka aysan jirin calaamado kansar ah).Khatarta kansarka naasaha ayaa aad uga yar haweenkan waxayna intooda badan dareemayaan welwel yar oo ku saabsan halista kansarka naasaha.Si kastaba ha ahaatee, aad bay muhiim u tahay in la sameeyo qiimaynta halista kansarka iyo la-talinta ku saabsan siyaabaha kala duwan ee looga hortago kansarka naasaha ka hor inta aan la gaadhin go'aankan.

4. Soo saarida ugxan-sidaha

Ugxantu waxay samaysaa inta badan estrogen-ka uu jidhku sameeyo.Daawaynta joojisa ama hoos u dhigta qiyaasta estrogen ee ay sameeyaan ugxan-yari waxa ka mid ah qalliinka lagaga saarayo ugxan-sidaha, daawaynta shucaaca, ama qaadashada daawooyinka qaarkood.Tan waxa loo yaqaan ablation-ka ugxan-sidaha.

Dumarka ka horreeya menopause ee leh khatarta sare ee kansarka naasaha sababtoo ah isbeddellada qaarkood ee hiddo-wadaha BRCA1 iyo BRCA2 ayaa laga yaabaa inay doortaan inay yeeshaan oophorectomy-yaraysa khatarta (saaritaanka labada ugxan-sidaha marka aysan jirin calaamado kansar ah).Tani waxay yaraynaysaa qiyaasta estrogen ee jidhku sameeyo waxayna hoos u dhigtaa khatarta kansarka naasaha.Oophorectomy-yaraynta khatarta waxay sidoo kale hoos u dhigtaa khatarta kansarka naasaha ee haweenka caadiga ah ee ka horreeya menopause iyo haweenka khatarta sii kordheysa ee kansarka naasaha sababtoo ah shucaaca xabadka.Si kastaba ha ahaatee, aad bay muhiim u tahay in la sameeyo qiimayn iyo la-talin khatarta kansarka ka hor inta aanad go'aankan gaarin.Hoos u dhaca degdega ah ee heerarka estrogen waxa laga yaabaa inay keento calaamadaha menopause inay bilaabaan.Kuwaas waxaa ka mid ah hurdo kulul, hurdo xumo, walaac, iyo niyad-jab.Saamaynta muddada-dheer waxaa ka mid ah hoos u dhaca waditaanka galmada, qallayl siilka, iyo cufnaanta lafaha oo yaraada.

5. Samaynta jimicsi ku filan

Haweenka jimicsada afar saacadood ama ka badan todobaadkii waxay leeyihiin khatar yar oo ah kansarka naasaha.Saamaynta jimicsiga ee khatarta kansarka naasaha ayaa laga yaabaa inay ugu weyn tahay haweenka ka horreeya menopause ee leh miisaan jidheed oo caadi ah ama hooseeya.

Ma cadda in kuwan soo socdaa ay saameeyaan halista kansarka naasaha:

1. Hormoonada ka hortagga uurka

Hormoonada ka hortagga uurka waxaa ku jira estrogen ama estrogen iyo progestin.Daraasadaha qaarkood ayaa muujiyay in haweenka hadda ama kuwa ugu dambeeyay ee isticmaala ka hortagga uur-qaadista hormoonnada laga yaabo inay yara korodho khatarta kansarka naasaha.Daraasado kale ma muujin khatarta sii kordheysa ee kansarka naasaha ee haweenka isticmaalaya ka hortagga uurka.

Mid ka mid ah daraasadda, khatarta kansarka naasaha ayaa yara korodhay muddada dheer ee haweeneydu isticmaashay ka hortagga uur-qaadista hormoonnada.Daraasad kale ayaa muujisay in korodhka yar ee khatarta kansarka naasaha ay hoos u dhacday wakhti ka dib markii haweenku joojiyeen isticmaalka ka hortagga uurka ee hormoonnada.

Daraasado dheeraad ah ayaa loo baahan yahay si loo ogaado in ka hortagga uur-qaadista hormoonnada ay saameyn ku yeelanayaan halista kansarka naasaha ee haweeneyda.

2. Deegaanka

Cilmi-baadhistu ma caddayn in la kulmida walxaha qaarkood ee deegaanka, sida kiimikooyinka, ay kordhiso khatarta kansarka naasaha.

Daraasaduhu waxay muujiyeen in arrimaha qaarkood ay wax yar ama aan wax saameyn ah ku yeelan khatarta kansarka naasaha.

Kuwa soo socdaa wax yar ama saamayn kuma laha halista kansarka naasaha:

• Ilmo iska soo xaaqid.
• Samaynta isbeddelada cuntada sida cunista dufanka yar ama khudradda iyo khudradda badan.
• Qaadashada fiitamiinnada, oo ay ku jiraan fenretinide (nooc ka mid ah fitamiin A).
• Sigaar cabista, labadaba firfircoon iyo kuwa aan fiicneyn (Neefsashada qiiqa gacanta labaad).
• Isticmaalka carafiyaha cududda ee gacanta hoostiisa ama dawooyinka lidka ku ah.
• Qaadashada statins (daawoyinka hoos u dhiga kolestaroolka).
• Qaadashada bifosphonates (daawooyinka loo isticmaalo daaweynta lafo-jileecu iyo hypercalcemia) afka ama faleebo xididka.
• Isbeddellada ku yimaadda laxanka wareeggaaga (isbeddelka jireed, maskaxeed, iyo dabeecadeed ee inta badan ay saameeyaan mugdiga iyo iftiinka wareegyada 24 saacadood), kuwaas oo laga yaabo inay saameeyaan saacadaha shaqada ee habeenkii ama qadarka iftiinka qolkaaga jiifka habeenkii.

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