Kodi kusinthika kwa zaka zingati kumayambitsa matenda osokoneza bongo? Kuopsa kwa mafinya oopsa kumakula ndi msinkhu. Izi zikuwonetsedwa momveka bwino ndi chiwerengero: M'zaka 20 mwayi wotsutsa matendawo ndi wofanana ndi wa 25000, mpaka zaka 80 - chimodzi mpaka khumi. Choncho, mayi aliyense wazaka khumi ayenera kukhala osamala. Pali zinthu zambiri zomwe zimachititsa khansa ya m'mawere. Chakudya cholakwika, chakudya chochuluka kwambiri, kutenga mimba mochedwa ndi ena mwa iwo. Ali ndi zaka makumi anayi, zimakhala zovuta kwambiri. Aliyense ali ndi ntchito yake. Woyamba kuyambira pa nthawi ya kutha msinkhu ali mu chizoloŵezi chokonzekera kumenyana kwa mimba ndi lactation ndipo pambuyo pa kubala kumasanduka fakitale ya mkaka. Zomwe zimayanjanirana ndi "woyandikana naye" zimapanga magawo pakati pa ma lobes omwe amapezeka, ndi mazira omwe mkaka wa amayi uyenera kupita nawo ku ntchentche. Minofu yamafuta mu kapangidwe ka phokoso pa nthawi ino ndi yochepa.
Pamene kusamba kwafika , kuchuluka kwake kwa minofu kumakhala kochepa, septa yothandizira imachepetsedwa, mphukira imatha. Koma: malo osakhala posachedwa anadzazidwa ndi minofu ya mafuta. Ndipo ndi malo abwino kwambiri opangira zotupa. Mfundo yakuti panthawi yoyamba yazimayi, thupi limasiya kupanga estradiol, hormoni yabwino ya mtundu wa estrogens. Mmalo mwa estradiol, "abale" ake - estrone ndi estriol, komanso mahomoni a chiwerewere - alowe m'sitima. Komabe, akhoza kukulitsa kukula kwa maselo oopsa. Zoona, estradiol imakhalanso ndi luso limeneli, koma mochepa.
Nchifukwa chiyani iwo omwe amagwera mu "thola" la khansa ya bere yotentha, chaka ndi chaka mochuluka? Kodi zimayambitsa "mliri"?
Kuwonjezeka kwa pachaka kwa chiwerengerochi ndi pafupifupi 3%. Chiwerengerochi chikuyembekezeredwa kuwonjezeka. Chifukwa choyamba ndi kuwonjezeka kwa estrogen pa thupi la azimayi. Akazi amakono amakhala ndi 300-400 miyezi yosiyana kwambiri ndi agogo awo.
Msambo uliwonse - mtundu wa bombardment wa thupi ndi estrogens (onse estradiol, ndi abale ake awiri). Kuwonjezera pamenepo, pofika zaka za zana la khumi ndi zisanu ndi zinayi, chiwerengero cha moyo wa mkazi chinali zaka 30: matenda, matenda omwe sanachiritse panthawiyo, komanso kubadwa kwapadera kunachepetsedwa ndi chiwerengero cha kugonana kwabwino.
Masiku ano, malinga ndi lipoti laposachedwapa la Mlembi Wamkulu wa UN, azimayi ambiri ali ndi zaka 68, motero, miyoyo ya amayi amatha mwezi wonse. Mahomoni amawonjezera mowa: Amayi ambiri amakonda kumwa zakumwa zoledzeretsa, ndipo ali ndi tizilombo toyambitsa matenda. Mahomoni a chomera amachokera m'thupi monga "mwini". Chifukwa chachiwiri ndi kusintha kwa njira ya moyo. Zimadziwika: pakati pa anthu okhala mumzinda wa anthu okhala m'midzi amadzimadzi amapezeka mobwerezabwereza kuposa omwe amakhala m'midzi. Anthu okhala mumzinda nthawi zambiri amagwira ntchito usiku, kukhala maso nthawi yaitali, zomwe zimachepetsanso kupanga melatonin. Imodzi mwa ntchito za hormone iyi ndiyo normalization ya biorhythms ndi kutetezedwa ku mawonekedwe a zotupa. Inde, ndi zachikazi "zathandiza": kugonana kokongola kunagonjetsa dzikoli, kumatsogolera makampani akuluakulu, kusuntha bar. Pakalipano, thupi lachikazi ndi mahomoni ake sangasinthidwe kuti akhale ndi moyo wathanzi. Awonetseni kugonana kwawo ndi mavuto a kugonana. Pambuyo pa chisudzulo, amayi ambiri, osakonzekera moyo wawo kachiwiri, akulowetsa kuntchito, kulenga, ndi kulera ana. Kugonjetsa (kugwiritsa ntchito mphamvu zogonana muzochita zina zosagonana) ndi khalidwe la nthawi yathu. Koma thupi limaganizira za kugonana monga chithandizo chofunikira pa zosowa zake zakuthupi kawiri kapena katatu pa sabata. Palibe nkhondo pa bedi - palibe ziphuphu, zopanda ziphuphu - machitidwe oyambirira a mitsempha ndi chithokomiro cha pituitary, chomwe chimapanganso mahomoni ofunikira kuti azikhala ndi thanzi labwino, sizikukhudzidwa. Kuwonjezeka kwa chiwerengero cha matenda opatsirana khansa ya m'mimba mwa amayi chifukwa cha zifukwa zambiri. Kuwonjezera pa zomwe tazitchula kale, ndikhoza kutchula dzina limodzi: chakudya cholakwika. Inde, ndiwotheka kuwonetsa zakudya zanu panopa, koma pakalipano akazi ambiri amagwiritsa ntchito zakudya zopanda mafuta ndi nyama, zomwe zimapangitsa kukhala ndi matenda.
Matenda ambiri tsopano ali aang'ono . Kodi tinganene chiyani pankhaniyi pa khansa ya m'mawere?
Zenera la m'badwo woyamba wa khansara ndi zaka 45-55 (chisanachitike, kusamuka kwa thupi ndi kusamuka kwa nthawi pambuyo pake). Chiopsezo chachiwiri kuti mudziwe za matendawa ndi omwe ali ndi zaka 65 mpaka 70. Ndipo pokhapokha-atsikana. Mwamwayi, pang'ono. Koma ndizodziwika bwino: achinyamata aunyamata, ndizoopsa kwambiri. Ndipotu, m'thupi laling'ono, njira zonse zimachitika mofulumira. Zoipa, mwatsoka, nayenso. Khansara ya m'mimba yakula pang'ono, koma ambiri - pa banja. Matenda ambiri omwe amapezeka kuti ali ndi matendawa ali ndi zaka 30 amadziwika bwino.
Kodi maudindo amathandiza bwanji kuti chitukukochi chikule bwino ndipo zingathetsedwe?
Genetics imayambitsa 5% ya matenda a "khansa ya m'mawere". Mungathe kutsutsana nazo. Ndikofunika kuti muphunzire mwana wanu wachinyamata ku fuko lachitatu, kokha - pa mzere wamayi, ndipo ngati wina m'banja ali ndi matenda, onani nthawi yomwe zinachitika, kuti adziwe matenda a jini. Pali majini awiri - BRCA-1 ndi BRCA-2, omwe ali ndi zambiri za "kansa". Mu zonyamulira za jini yoyamba, kuthekera kwa maonekedwe opweteka kwambiri ndi 8096. Amene ali ndi mitundu iwiri ya "cholowa" amakhala ndi chiopsezo chokumana ndi khansa ya ovari. Ngati mumadziwa za izi komanso chitani chithandizo chamankhwala, chitani nokha kuti muzitha kufufuza nthawi zonse, matendawa amatha kudziwika msanga ndikuonetsetsa kuti mukuchira. Koma, monga momwe ziwonetsedwere, anthu a kudziko kawirikawiri amakonda kusankha njira yachiwiri - musamachite chilichonse kapena musamadziwe za katundu wamba. Njira yachitatu, "yopambanitsa" ndiyo kuchotsa mfupa musanafike khansayo. Palibe khansa ya m'mawere - palibe matenda. Kupewa kotereku kumachitidwa ndi amayi a zaka 40, ndipo nthawi yomweyo amaika mipangidwe ya silicone. Ngati matendawa amapezeka ali aang'ono, ndiye kuti nthawi zambiri amayamba chifukwa cha majini. Majini awiri, BRCA-1 ndi BRCA-2, amathandizapo pano. Kumadzulo kwa Ulaya, pafupifupi 10 peresenti ya matenda onse a kansa ndi olowa. Pa theka la iwo, chifukwa chake ndi kusintha m'magulu awiriwa.
Ngati chifuwa chimodzi chikukhudzidwa , kodi mankhwalawa amatha bwanji? Kodi zimadalira chiyani?
Kuopsa kwa chotupa mu Ichiwiri chachifuwa ndi pafupifupi 20%. Koma mwayi wa mawonekedwe awiri omwe amapezeka panthawi yomweyo ndi ochepa - ndi 4-5% okha.
Zomwe zilipo kuti chitukuko chikhale chonchi m'magulu awiri a mammary ndi chimodzimodzi, choncho chiopsezo cha "mnzako" ndi 15-20%. Zonse zimadalira pamene chotupacho chikadziwika (kenako, chowopsa kwambiri cha metastasis) komanso ngati chithandizocho chinayendetsedwa bwino.
Kodi njira zenizeni zotetezera khansa yapakhungu yotupa ndi iti?
Njira yabwino kwambiri yothetsera khansara ndi khansa ya m'mawere makamaka - ndi zakudya zabwino ndi masewera olimbitsa thupi, malinga ndi zomwe bungwe la WHO linanena, tsiku lodya zakudya zisanu ndi zisanu za zipatso ndi ndiwo zamasamba, kuchita masewera olimbitsa thupi nthawi zonse. DZIWANI ZOPHUNZITSIDWA ZA SANSI - Kutenga mavitamini D kumathandiza kupewa khansa ya m'mawere. Ngati pali kuthekera kowonetsetsa kuti chibadwa chosavomerezeka, chizoloŵezi chodziŵika bwino kapena njira yowonjezereka ikulimbikitsidwa - kuchotsedwa kwa mabere onse awiri.
1. Maganizo abwino ndi kudzikonda.
2. Ulamuliro woyenera wa tsikulo, kuphatikizapo ntchito ndi zosangalatsa.
3. Kugonana nthawi zonse, kupeŵa kuchotsa mimba (makamaka kubereka koyamba). Kuperekedwa mobwerezabwereza.
4. Kulemera kwa thupi, chifukwa kunenepa kwambiri ndi chinthu chofunika kwambiri.
5. Kuletsa shuga, makamaka ngati muli ndi shuga. Malingana ndi kafukufuku wosiyanasiyana, bere limakhudza mahomoni 30 mpaka 50, kuphatikizapo insulini. Zingathe kukulitsa kukula kwa maselo a khansa mmenemo.
6. Kugwiritsiridwa ntchito kwa mavitamini, makamaka - A, E ndi D. Za micronutrients zokhudzana ndi thanzi labwino, calcium ndi zothandiza.
7. Kuchokera pa zaka 28 kupita patsogolo, ultrasound ya mammary gland imachitidwa pachaka, ndipo kuchokera ku 40 - mammography.
Kodi khansara ya m'mawere ingayambitse zovala zamkati ndi zobvala zolimba?
Ine sindikuganiza. Koma zowopsya sizikufuna kukanika, zomwe zimalepheretsa kupeza magazi kwa thupi. Kuperewera kwa magazi kumakhala chimodzi mwa zinthu zomwe zimapangitsa kuti anthu azikhala osamala (dzina lachidziwitso la kusintha kosasinthasintha m'magazi a mammary). Ndine wotsimikiza kuti kusamala sikupita ku khansa. Pali matenda a khansa yolimbana ndi chiyambi cha chisamaliro, koma osati chifukwa cha izo. Funso limeneli ndimamva nthawi zambiri ku phwando. Yankho liri nthawizonse - ayi.
Kodi ndi zoona kuti amayi omwe alibe kubadwa amakhala ndi khansa ya m'mawere? Kodi udindo wa kuyamwitsa ndi wotani? Kuwongolera ndi chinthu chothandiza kwambiri, koma musamachite nawo mkaka. Nthawi yabwino ya kuyamwa kwa amayi ndi mwana ndi miyezi khumi ndi iwiri, mwinamwake mwayi wowonjezera kuchuluka kwa ma hormone prolactin kumawonjezeka. Zimalepheretsa kupanga progesterone, yomwe imateteza akazi kuti asatengeke kwambiri ndi estrogens. Kuyamwitsa ndi nthawi yabwino poletsa matenda. Tikudziwa kuti ngati mayi akudyetsa mwana nthawi yayitali, thupi lake limatetezedwa ku matendawa.
Kudzipenda ndi zabwino kapena maziko a psychosis?
Dothi la psychosis. Simukuyendera makina okha, koma kukhulupilira kwa akatswiri pa SRT. Ndibwino "kusonyeza" dokotala. Tinayesa kuyesera: 1, 2, 3 ndi 5 masentimita mipira anayikidwa mu chifuwa. Ophunzira a kuyesa, akumva "chifuwa" malingana ndi ndondomeko za timabuku todzifufuza, adapeza "zotupa" zomwe zili ndi masentimita atatu ndi masentimita asanu. Chotupa chokhala ndi masentimita 3-5 masentimita - ichi ndi gawo lachinayi la khansa, yosanyalanyazidwa kwambiri. Zotsatira zake ndizofotokozera.
Kuchita bwino kudzipenda sikungatsimikizidwe, koma, monga momwe kumasonyezera, nthawi zambiri zisindikizo mumtima zimapezeka ndi amayi okha. Kotero, ine ndikhoza kulangiza kuti akazi nthawizonse ayang'ane pa zovuta zawo. Ife, ku Germany, tili ndi maphunziro odzifufuza.
Kodi chasintha chithandizo cha matenda m'zaka 5-10?
Ukraine yakhala ikuyendera bwino: pali maphunziro a gene ndi a-oyendetsa makina, makina atsopano a ultrasound ndi mammographs. Ponena za otsogolera m'dziko lathu muli zolakwika zomwe zimagwiritsidwa ntchito kuti ayambe kupeza matenda. Kafufuzidwe kafukufuku ndi kuzindikira kwa ma antibodies kwa maselo a khansa. Ngati palibe khansa, antibodies, mofananamo, nayenso. Njirayi imathandiza kokha kuti munthu adziwe kuti akubwereranso. Komanso, nthawizina pali zotsatira zabwino zabodza za phunziro lino.
Mu chemotherapy ya zotupa zowononga, mankhwala osokoneza maselo okhawo a adani amapezeka. Chithandizo choterechi chimatchedwa kuti, "mfundo". Zomwe zakuthandizidwa posachedwapa za mankhwala ndi zamakono zamakono nthawi zambiri zimakhala muzipatala zapadera. Mfundo ya ntchito siinasinthe: ku Ukraine, kawirikawiri pamodzi ndi chotupacho, mawere amachotsedwa. Ndikufuna kuwona maganizo okhudza maganizo opitilira mudziko lathu - sayansi yomwe imaphunzitsa mphamvu ya maganizo a mkazi pa maonekedwe a matenda ndipo imathandiza kuthetsa nkhawa pambuyo pochoka kuchipatala.
Ndipotu, mayi nthawi zambiri amakhalabe ndi vuto lake, ndipo izi zimachepetsanso chiyembekezo cha moyo pambuyo pa ntchitoyo. Zaka zaposachedwapa, chithandizo chakhala chachikulu kwambiri, payekha. Madokotala a chipatala cha University of Freiburg amalingalira zochepa chabe za thupi la wodwala aliyense. Mwina posachedwapa tidzakhala ndi kafufuzidwe kafukufuku, ndipo tidzasankha ngati wodwala akufunikira mankhwala a chemotherapy kapena ayi. Masiku ano, mankhwala osokoneza bongo amagwiritsidwa ntchito pamene maselo a khansa amalowa m'mimba yamagulu kapena m'mimba mwa mtsikana.
Khansara ya m'mimba imatha kuchiritsidwa ndipo 80% amatha kuyankhula za machiritso (ngati matendawa amapezeka m'nthawi). Nthaŵi zambiri, timasunga mawere aakazi, kuchotsa kwake tsopano sikokwanira. Zosiyana ndi ziwalo zingapo panthawi imodzimodzi "m'makona" a chiwalo. Ngakhale chotupa chimodzi ndi cha kukula kwakukulu, mothandizidwa ndi mankhwala oyambirira a chemotherapy, tikhoza kuchepetsa kukula kwake ndiyeno ndikuchita opaleshoni, kusunga bere.